PMID- 3534189 TI - Intraoral reconstruction of mandibular defects after tumor resection. AB - The intraoral reconstruction of mandibular defects resulting from tumor resection with autogeneic iliac bone is described. Large pieces of pelvis can be harvested and split sagittally for lengthening or altering the direction and shape of the body or angle of the reconstructed mandible. A graft taken from the iliac tubercle region can be used for satisfactory reshaping of the chin area. Delays in reconstruction, if necessary, should be of short duration, and a fabricated Kirschner wire splint with fixation screws, or a Kirschner wire and acrylic condyle may serve to counteract scar retraction prior to grafting. Esthetic and functional results have been good, and postoperative complications have been minimal. PMID- 3534190 TI - Superselective angiography with digital subtraction and embolization of a maxillary hemangioma in a patient with Eisenmenger's syndrome. AB - Central maxillofacial hemangiomas can represent diagnostic and therapeutic problems. The concurrent existence of Eisenmenger's complex in the presented case added an anesthetic challenge. The development of superselective arterial catheterization and digital subtraction angiography has been instrumental in improving the ability of clinicians to diagnose and effectively manage vascular lesions, especially in the maxillofacial region. Embolization remains an excellent adjunctive therapy for vascular processes. PMID- 3534191 TI - A clinical evaluation of fixed bridges, 10 years following insertion. AB - In this long-term clinical study, the condition of extensive fixed bridges was investigated 10 years after cementation. From the records of the Swedish Insurance System (Gothenburg branch) the individuals were randomly selected. All restorative treatment had been performed by private general practitioners. The investigation comprised a total of 238 bridges making 1606 units, 944 abutment and 662 pontics. Seven bridges had been removed and in a further nine cases the bridge had been separated and units removed. Loose retainers were detected at thirty (3%) abutments. In 14.5% of the surfaces a deficiency in marginal adaptation was found. An open margin seemed to be the most serious defect and was often related to caries in contact with the margin of the crown. Caries and fillings in relation to the margin were detected in 8.1% of the surfaces. Porcelain bonded to gold restorations were significantly more often overcontoured in the interproximal space compared with acrylic resin veneer gold bridges. In the investigation the caries status has been also thoroughly reported. Abutment teeth, presumed to be vital, had a prevalence of 10% radiographically visible periapical lesions. Finally, 93.3% of the bridges cemented 10 years prior to the investigation were still in function without any parts being removed. PMID- 3534192 TI - Retentive and stress characteristics for a magnetically retained partial overdenture. AB - The retentive and stress characteristics of a magnetically retained partial overdenture were studied. The retentive properties were compared to those of an I bar and Zest Anchor retained overdenture. The magnetically retained partial denture uniformly distributed stress to the supporting structures and exhibited significantly greater retention than that of the I-bar, but less than that of the Zest Anchor. Based on these observations, the magnetically retained denture should be considered as an option to be used instead of or in conjunction with other types of partial overdentures. PMID- 3534193 TI - Physiology and pathophysiology of skeletal muscle contractions. Part I. Dynamic activity. AB - An overview is presented of the physiology and pathophysiology of dynamic skeletal muscle contractions in the intact living organism. Dynamic muscle activities are divided into concentric contractions with shortening of muscle fibres and the production of positive work, and eccentric contractions with lengthening of muscle fibres and the production of negative work. In positive work, muscle tension overcomes external forces. In negative work, external forces overcome muscle tension. The latter phenomenon, with relatively few active motor units, explains the injuries induced by eccentric contractions. Both the contractile and non-contractile elements are involved in the muscle injuries and, clinically, they are referred to as myofibrositis. PMID- 3534194 TI - Physiology and pathophysiology of skeletal muscle contractions. Part II. Static activity. AB - An overview is presented of the physiology and so-called pathophysiology of static muscle contractions in the intact living organism. Static muscle activity produces no external mechanophysical work, but is used for fixation. Contingent upon the levels of the generated forces, and the duration of the isometric contractions, static activities give rise to fatigue and pains. The discomforts are viewed as somatic responses that are normally within physiological limits. That is, upon cessation of isometric contractions there is usually rapid recovery from the discomforts, and they do not normally induce chronic lesions. PMID- 3534195 TI - Barbiturate therapy in acute brain injury. PMID- 3534196 TI - Viral and bacterial organisms associated with acute pharyngitis in a school-aged population. AB - To investigate the causes and clinical characteristics of acute pharyngitis among school-aged children (4 to 18 years), we obtained throat cultures for respiratory viruses, Mycoplasma pneumoniae, group A streptococcus, and Chlamydia trachomatis from 320 patients with sore throat and 308 controls without respiratory complaints. The study was conducted from January to April 1985 in a private pediatric practice in central New York State. Sixty percent of the patients and 26% of the control subjects had positive cultures for at least one organism. Forty percent of patients had positive cultures for group A streptococcus, compared with 11.9% of the controls. Fifty (16%) patients had positive viral cultures, compared with eight (2.6%) controls; the predominant viral isolate was influenza A Philippines. Patients infected with influenza A were significantly more likely to complain of cough and hoarseness, and were less likely to have pharyngeal exudate or tender cervical adenopathy, than were patients who had positive cultures for group A streptococcus. Although 49 (15.8%) patients with acute pharyngitis had cultures positive for M. pneumoniae, 53 (17.6%) asymptomatic controls were also had M. pneumoniae-positive cultures. Thus detection of M. pneumoniae in the throat of school-aged children with pharyngitis may not be sufficient to establish a diagnosis of disease caused by this organism. C. trachomatis was not isolated from any patient or control. PMID- 3534197 TI - Autoimmune neutropenia of infancy. AB - Neutrophil antibodies were demonstrated in 119 of 121 infants and young children with chronic neutropenia, establishing the diagnosis of autoimmune neutropenia of infancy. The median age at diagnosis was 8 months (range 3 to 30 months), and the female/male ratio was 6:4. Autoimmune neutropenia of infancy was manifested by recurrent fever and infection. All patients had selective neutropenia (absolute neutrophil count 0 to 500), and many had monocytosis. Fifteen of 16 patients tested failed to respond to epinephrine and hydrocortisone stimulation. Bone marrow had myeloid hyperplasia and reduced mature neutrophils. Recovery occurred in all 81 patients who passed the age of 5 years, except for one patient who is recovering at 6 1/2 years. The median age at recovery was 30 months; 95% recovered before 4 years. The estimated median duration of disease was 20 months. Neutrophil antibodies were detected early in the neutropenic phase by a combination of immunofluorescence and agglutination tests. Ten percent of these antibodies had specificity for NA1 or NA2. Ten of the 12 serum samples with a strong reaction in the flow cytometer reacted only with neutrophils. Two also reacted with an unidentified subpopulation (30%) of lymphocytes. Lymphocyte subsets were normal in 10 patients investigated, and abnormal levels of circulating immune complexes were detected in sera from 11 of 25 (44%) patients tested. Temporary remission was induced in all of eight patients who received intravenous IgG therapy. Autoimmune neutropenia of infancy is probably the most common cause of chronic neutropenia in infancy and early childhood, can be diagnosed by immunologic techniques, and requires only conservative management; spontaneous cure appears to be the rule. PMID- 3534199 TI - Interpreting results of a "negative" study. PMID- 3534198 TI - Glycine-based oral rehydration solution: reassessment of safety and efficacy. AB - We evaluated the safety and efficacy of a glycine-based orally administered rehydration solution by comparing it with a standard oral rehydration solution (ORS) without glycine in a randomized double-blind trial in United States infants (age less than 15 months) given treatment for acute gastroenteritis as inpatients or outpatients. The response to therapy (stool volume and duration of illness) was similar in the two groups, except that in four (13%) of 31 hospitalized infants receiving glycine-ORS hypernatremia developed, (one had symptoms) compared with none of 35 receiving ORS (P less than 0.04). Among the 77 outpatients there were no differences between the groups. This study demonstrates that glycine-ORS did not provide any therapeutic advantage over standard ORS, and hypernatremia developed in some patients receiving glycine-ORS. We suggest that caution be used with this type of solution until further safety studies have been done. PMID- 3534200 TI - Probing the mysteries of maleness. PMID- 3534201 TI - Use of barbiturate therapy in severe perinatal asphyxia: a randomized controlled trial. AB - The possible cerebral sparing effect of thiopental was evaluated in 32 severely asphyxiated neonates randomly assigned to either a thiopental treatment or control group. All infants had neurologic manifestations of asphyxia and required assisted ventilation. Thiopental was begun at a mean age of 2.3 hours and was given as a constant infusion that delivered 30 mg/kg over 2 hours. Treatment was continued at a lower dose for 24 hours. Seizure activity occurred in 76% of infants given thiopental and 73% of control infants at a mean age of 1.5 and 2.5 hours, respectively. Although initial arterial blood pressure was similar in both groups, hypotension occurred in 88% of treated and 60% of control infants. The amount of blood pressure support required was significantly greater (P less than 0.005) in the thiopental treatment group. Three infants died in the control group, and five in the treatment group. Developmental assessment was performed at a minimum of 12 months of age in 22 infants. There were no significant differences in neurologic, cognitive, or motor outcome between groups. Deteriorating performance over time was a consistent trend in both groups. These findings indicate that treatment of severe perinatal asphyxia with thiopental does not appear to have a cerebral sparing effect and may be associated with significant arterial hypotension. PMID- 3534202 TI - Randomized clinical trial of an oscillating air mattress in preterm infants: effect on apnea, growth, and development. AB - To investigate claims that oscillating mattresses reduce apnea of prematurity and improve growth and neurobehavioural development, we performed a randomized clinical trial using a predetermined sample size. Preterm infants weighing from 750 to 1750 gm at birth were randomly assigned, by 250 gm strata, to either a conventional mattress (n = 63) or to an air mattress (n = 59) oscillating at 14 to 16 regular pulses per minute. Infants remained on the oscillating air mattress for at least 7 days or until 34 weeks postmenstrual age. Apneic episodes occurred and required treatment equally in the two groups; this lack of an effect was seen for both sexes and all weight groups. Both weight and energy intake were similar. Neurobehavioral development as shown by sleep state, habituation testing, and behavioral assessment at term, 3, 6, and 12 months was similar in the two groups. There was no difference in the incidence of neurologic abnormalities. We conclude that an oscillating air mattress has no prophylactic value in reducing apnea and does not enhance growth and development. PMID- 3534203 TI - A randomized controlled trial of amoxicillin plus clavulanate compared with cefaclor for treatment of acute otitis media. AB - We performed a randomized controlled trial of amoxicillin plus clavulanate versus cefaclor for treatment of acute otitis media. Total daily doses given in three divided doses were 40 mg/kg amoxicillin plus 10 mg/kg clavulanate, and 40 mg/kg cefaclor. Pathogens were eradicated from the middle ear exudate after 3 to 6 days of therapy in 35 (97%) of 36 patients given amoxicillin-clavulanate compared with 24 (75%) of 32 given cefaclor (P = 0.028). When analysis was restricted to patients with positive urine or serum drug assays during therapy, pathogens were eliminated in 33 (97%) of 34 patients given amoxicillin-clavulanate compared with 21 (75%) of 28 given cefaclor (P = 0.026). Bacterial isolates associated with bacteriologic failure of cefaclor therapy were Streptococcus pneumoniae (two patients), beta-lactamase-negative Haemophilus influenzae (four), and beta lactamase-positive Branhamella catarrhalis (two). The single failure with amoxicillin-clavulanate therapy was associated with non-beta-lactamase-producing H. influenzae isolated from the middle ear exudate. We conclude that cefaclor is less efficacious than amoxicillin-clavulanate for the treatment of acute otitis media. PMID- 3534204 TI - Neonatal hyperglycemia. PMID- 3534205 TI - Chemical and physical bases determining the instability and incompatibility of formulated injectable drugs. PMID- 3534206 TI - A computerized marijuana decision maze: expert opinion regarding its use in health education. PMID- 3534207 TI - Spina bifida children and their parents: a population prone to family dysfunction? PMID- 3534208 TI - Treatment of tracheomalacia: eight years' experience. AB - Between 1978 and 1985, 21 patients were treated for tracheomalacia, (group I) and 4 for tracheobronchomalacia (group II). The median age at treatment was 7 months (range 1 to 96 months). Indications for surgery in group I were, "dying spells" (n = 12), recurrent pneumonia (n = 4), intermittent respiratory obstruction (n = 3) and inability to extubate airway (n = 2). 18 had esophageal atresia repair. Treatment in group I was aortopexy (n = 19), three of whom also required an external airway splint; two had an airway splint only. Airway obstruction was relieved in all. Group II patients required surgery because they could not be extubated; none had esophageal atresia. Aortopexy in all and splinting in one failed in 3 of 4 patients. Aortopexy is the primary treatment of tracheomalacia. External airway splinting may be used where aortopexy is inadequate. A satisfactory treatment for tracheobronchomalacia has not yet been devised. PMID- 3534209 TI - The effect of different treatment modalities on connective tissue attachment. AB - This study compared the effect of four treatment modalities on connective tissue attachment. Ligature-induced periodontitis was established around the mandibular premolars of five young beagle dogs over 8 weeks. Following a 2-week period without ligatures, a reference dog was sacrificed to estimate the extent and nature of the disease. Three dogs received flap procedures in one mandibular posterior segment, and the six experimental roots were treated with citric acid (pH 1) for 3 minutes; the contralateral mandibular segments received flap procedures and the roots were treated with 4% chlorhexidine gluconate in the Hibiclens preparation for 3 minutes. One segment of the control dog received flap procedures, and the roots were treated with sterile normal saline; the contralateral segment received closed root planning. The experimental dogs were sacrificed 1, 2 and 3 months after treatment. The control dog was sacrificed 3 months postoperatively. One week before sacrifice each dog received a Procion dye injection. At sacrifice the study segments of all four treated dogs were clinically healthy, with no observable differences between the different treatment modalities. Histologically, the 1, and 3-month chlorhexidine, the 3 month saline and 3-month root planed specimens had long junctional epithelial adhesions with little connective tissue attachment. The 2-month chlorhexidine and all citric acid-treated sections showed appreciable amounts of new connective tissue attachment. Some 2-month and 3-month citric acid and 2-month chlorhexidine sections showed cementum over the apical portion of the long junctional epithelium. The frequency of occurrence and the length of cementum overlapping epithelium increased appreciably over time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534210 TI - Smoking and periodontal disease. A review of the literature. AB - The literature related to smoking and periodontal disease is reviewed. The effects of smoking on oral hygiene, gingivitis, necrotizing gingivitis, periodontitis, bacteria and the host's response are presented. From this review it is apparent that while the relationship between smoking and periodontal disease needs further study, smoking is detrimental to periodontal health as it worsens the oral hygiene status and depresses the host's defense posture. PMID- 3534211 TI - An SEM study of overhang removal methods. AB - The sonic scaler, the curet, and the reciprocating motor-driven diamond tip were evaluated by comparing the number of rough root surfaces produced by each device in recontouring overhanging root-surface margins of amalgam and composite resin restorations. Ninety extracted human teeth were restored with amalgam or composite resin so that overhangs were created. Each instrument was used to remove 30 overhangs. The root surfaces apical to the overhangs were photographed under the scanning electron microscope at a magnification of x 140 and compared by five dentists, in a single-blind manner, with two control photomicrographs of surfaces classified as rough (treated with a coarse diamond bur) or not rough (treated with a greenstone). The number of rough responses for each instrument were compared statistically. For both restorative materials, the sonic scaler produced a significantly greater number of rough responses than did the other two instruments. Similar comparisons between the curets and the diamond-tip system showed no significant differences. No differences in the number of gaps produced between restoration and tooth were noted among the instruments. Clinical ease of overhang removal was greatest for the reciprocating motor-driven diamond tip and least for the curet. The approximate time to remove an overhang from a tooth was 3 minutes for the motor-driven diamond tip, 7 minutes for the sonic scaler and 15 minutes for the curet. PMID- 3534212 TI - A comparison of postoperative pain experience following periodontal surgery using two local anesthetic agents. AB - This controlled, double-blind, split-mouth study was designed to evaluate postoperative pain experience following periodontal surgery on 20 patients. Two commercially available local anesthetic agents, bupivacaine HCl and lidocaine HCl, were used. Periodontal surgeries were standardized to minimize differences in difficulty, extent and time. A patient questionnaire was used to collect data for the 24-hour observation period following periodontal surgery. During this period, pain perception was assessed by visual analogue scales. The results indicated that when bupivacaine was used, there was less postoperative pain, fewer postoperative analgesics taken and a longer period of "numbness" (anesthesia) as compared to lidocaine. The patients expressed a strong preference for bupivacaine over lidocaine. PMID- 3534214 TI - [Metabolic activation of marihuana constituents: relations to pharmacological and toxicological effects]. PMID- 3534213 TI - Identification of a Cl-/Ca2+-dependent glutamate (quisqualate) binding site in bovine pineal organ. AB - The presence of a high concentration of glutamic acid, a transmitter shown to have excitatory action in the pineal organ, prompted us to search for and to characterize glutamate receptor site in the bovine pineal organ. By using 10 nM- 100 microM of labeled and unlabeled L-glutamate and by employing the LIGAND computer program, we found a glutamate binding site with a dissociation equilibrium constant (KD) of 0.534 microM and a receptor density (Bmax) of 4.84 pmol/mg protein. This pH- and temperature-dependent binding site showed stereospecificity, was activated by Ca2+, and displayed affinity for both glutamate agonists and antagonists. The IC50 values for L-glutamate, L-aspartate, L-cysteate, L-cysteine sulfinate, quisqualate, and (+/-) ibotenate were 0.5, 2, 12, 16, 25, and 30 microM, respectively, whereas those for D-aspartate, L-alpha aminoadipate, L-homocysteate, and DL(+/-) 2-amino-4-phosphonobutyrate were greater than 100 microM. Kainate, N-methyl-D-aspartate, and L-glutamic acid diethyl ester were inactive. Based on these results, the presence of a quisqualate-type, Cl-/Ca2+-dependent glutamate binding site in the pineal organ is suggested, and a possible neuroexcitatory role for glutamic acid, aspartic acid, and certain sulfur-containing amino acids is also implied. The precise nature of this excitatory effect in modulating the function(s) of the pineal organ and the synthesis of its hormone(s) remains to be elucidated. PMID- 3534215 TI - The purification and activities of an alkaline protease of Aspergillus clavatus from Nigerian poultry feeds. AB - Optimal growth and extracellular protease production by Aspergillus clavatus Des. was recorded at 30 degrees C and between days 5 and 7 of the 8-day incubation period. Purification of this enzyme was achieved by a combination of ultrafiltration, alcoholic precipitation and fractionation on DEAE-cellulose and Sephadex-G.200. A single peak of an alkaline protease was subsequently obtained with a 9-fold increase in specific activity and a final recovery value of 26.2%. The enzyme had optimal activity at 37 degrees C and a pH of 7.8. The enzyme did not degrade leucine amide, hippurylphenylalanine and hippurylarginine indicating lack of exo-protease activity. However, endo-protease activity led to a rapid hydrolysis of gelatin with optimal activity at 40 degrees C and pH 7.8. The high incidence of A. clavatus on Nigerian poultry feeds vis-a-vis the potential health risks posed to farm animals is discussed. PMID- 3534216 TI - Epikeratophakia following previous refractive keratoplasty surgery: two case reports. AB - Epikeratophakia is becoming a significant and worthwhile surgical modality for selected cases of pediatric and adult aphakia, keratoconus, and myopia. Ultimately, it may also provide a safe and effective means of obtaining satisfactory surgical correction when the results from a previous refractive technique are insufficient. We present two successful cases of epikeratophakia following refractive keratoplasty: one following radial keratotomy for myopia and one following penetrating keratoplasty for keratoconus. PMID- 3534217 TI - A history of the Philadelphia County Dental Society. PMID- 3534218 TI - Role of the vascular endothelium in the contractile response to prostacyclin in the isolated rat aorta. AB - Prostacyclin (PGI2) relaxes vascular smooth muscle in several species but, in high doses, PGI2 has been reported to contract several isolated arteries. Vascular endothelium is known to be obligatory for the vasodilatory responses to acetylcholine and several other substances. We therefore investigated the contractile effect of various prostanoids on rat abdominal aorta in which the endothelium was left intact or was removed. PGI2 (4-2000 ng/ml), 6-keto prostaglandin (PG) E1, PGE1 and PGE2 (4-800 ng/ml) contracted both intact and de endothelialized aortic segments in a dose-dependent manner. PGI2 (8-2000 ng/ml) increased the force generated by aortic rings with intact endothelium from 77.3 +/- 24.6 to 685 +/- 99.2 mg. The response to similar doses of PGI2 in aortic rings with the endothelium removed was reduced significantly (22.7 +/- 14.1 to 260 +/- 116.4 mg). This contractile response to PGI2 in both intact and de endothelialized aortic rings was abolished by indomethacin pretreatment (20 micrograms/ml for 30 min) and was also blocked completely by the thromboxane receptor antagonist SQ 29548 (100 ng/ml). In contrast, the thromboxane synthase inhibitor OKY 1581 (2.5 micrograms/ml) did not significantly reduce the contractile response to PGI2. Unlike PGI2, the force generated by PGE2 (4-800 ng/ml) in aortic rings with intact endothelium (0-550.0 +/- 107.2 mg) was not significantly different from that generated by aortic rings without endothelium (35.0 +/- 23.6 to 650.0 +/- 193.2 mg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534219 TI - Effects of ethylketazocine and morphine on schedule-controlled behavior in pigeons and squirrel monkeys. AB - The behavioral effects of morphine and ethylketazocine were compared in squirrel monkeys and pigeons responding under fixed-interval schedules of food presentation, and in monkeys responding under fixed-interval schedules of electric-shock presentation. Both morphine and ethylketazocine produced dose related decreases in rates of responding maintained by food presentation in either species. However, intermediate doses of both drugs increased rates of responding maintained by shock presentation in monkeys; at higher doses both drugs decreased rates of shock-maintained responding. In monkeys and pigeons, the dose-effect curves for both ethylketazocine and morphine were shifted to a comparable degree of naloxone. Maximal effects of morphine were observed 16 to 24 min after injection and typically lasted the entire 40-min observation period. Effects of ethylketazocine had a faster onset (maximal effects were observed by 8 to 16 min after injection), and shorter duration (effects diminished by 24 to 40 min after injection). Ethylketazocine was 30 to 100 times more potent than morphine under either the schedule of food or shock presentation in squirrel monkeys, whereas the two drugs had similar potencies in pigeons. Thus, the effects of at least one of the drugs may be mediated differently in one of the two species. PMID- 3534220 TI - [Neural control of deglutition and esophageal motility in mammals]. AB - Swallowing is a complex motor sequence involving the coordinated contraction of many muscles of the buccopharyngeal cavity, the larynx and the oesophagus. Most of the muscles are striated except those of the distal oesophagus which, in human and some other species, are of the smooth type. During swallowing, usually divided into a buccopharyngeal and an oesophageal stage (peristalsis), the sequential activity of the muscles results from motor orders programmed by a rhombencephalic swallowing centre and conveyed to the periphery by efferent fibres belonging to various pairs of cranial nerves (Vth, VIIth, IXth, Xth). Apart from the motor nuclei of the cranial nerves, the swallowing centre contains an nuclei of the cranial nerves, the swallowing centre contains an interneurone network responsible for the programming of deglutition. During swallowing, these interneurones (INs) exhibit a sequential activity quite parallel to that of muscles, and persisting in the absence of sensory feedback. The "swallowing INs" are located in two medullary regions: a dorsal region including the nucleus of the solitary tract and the adjacent reticular formation, a ventral region corresponding to the reticular formation surrounding the nucleus ambigus. The dorsal INs are involved in the initiation and the programming of swallowing. The ventral INs receive their swallowing input from the dorsal neurones and are probably switching neurones that distribute the swallowing excitation to the various pools of motoneurones. The swallowing program can be triggered by inputs originating from either the peripheral reflexogenic areas or the supramedullary structures (cerebral cortex in particular). Under physiological circumstances, the swallowing program is continuously modified by peripheral afferents (especially muscular) that adjust the force and the timing of contractions to the size of the swallowed bolus. In addition, an important operating feature of the programming network consists of a functional polarization so that the activity of proximal portions of the swallowing tract inhibits that of distal portions. This polarization implies the existence of inhibitory connections between interneurones, that could constitute "time-lag lines" responsible for the series of delays typical of the swallowing contractile sequence. Lastly, although the smooth muscle oesophagus contains its own programming system (intramural nervous system), motility of this area during deglutition also depends on the medullary program that combines with the intramural program by ways not yet elucidated. PMID- 3534221 TI - Esthetic porcelain margins: a modified porcelain-wax technique. PMID- 3534222 TI - Natural teeth pontics for a cast metal resin-bonded prosthesis. AB - A technique using natural teeth as pontics for a cast metal resin-bonded prosthesis was described. The patient's periodontally condemned teeth were used for pontics after extraction, endodontic obturation, and preparation for resin bonding to a cast metal framework. The advantages are technique simplicity, esthetics, conservation of natural tooth structure, and reduced laboratory cost. PMID- 3534223 TI - Effect of four pretreatment techniques on porcelain-to-metal bond strength. AB - Porcelain bond strengths of three base metal alloys with different metal pretreatment techniques were studied. Statistically significant differences were found in bond strengths achieved between the different metals but not with the different pretreatments. Each metal displayed considerable variation in bond strength with each of the pretreatment techniques. Collectively, the base metal alloys evaluated displayed a disturbing tendency for adhesive failure through the porcelain-metal interface, although this was not universal. Manufacturers and ceramists should develop a specific regime for porcelain bonding for each alloy used. Standardized testing should demonstrate adequate bond strengths with cohesive failure through the body of the porcelains. PMID- 3534224 TI - Relationship of surface area and design to the bond strength of etched cast restorations: an in vitro study. PMID- 3534225 TI - Veterans Administration Cooperative Studies Project No. 147. Part II: A new assessment system for rating metal-ceramic crowns. AB - The rating system developed for this study combined ordinal and numerical scoring. The method involved the following: defining the critical criteria, defining the ordinal rating criteria for the assignment, assigning numerical scores for each individual criterion and totalling the scores for each restoration, adding an adjustment number, and scaling the results to the 0-to-10 range and rounding off to the nearest tenth. When tested on sample data gathered at the 12-month followup appointment, the new system elicited a finer discrimination of differences in the quality of the restorations. Although the system fully meets the needs of the specific project, it should not be considered an answer to the needs of all clinical investigations. It should be viewed as a different approach in the development of an acceptable clinical rating system. PMID- 3534226 TI - Dimensional stability of composite used as a core material. PMID- 3534227 TI - Direct retainers for distal-extension removable partial dentures. AB - Clinical observations at the University of Washington indicated that the wrought wire clasp assembly, the I-bar clasp assembly, and the L-bar clasp assembly yield similar results. A periodic recall system for patients with removable partial dentures has been in effect since 1976. Several thousand observations have been made by the faculty, and no special trend of problems has been noted that would cause one clasp assembly to be favored over another. These three types of clasp assemblies work satisfactorily when properly chosen and carefully applied. PMID- 3534228 TI - Magnetically retained implant denture. AB - This technique offers the following advantages: The disks allow the castings to be placed with a minimum amount of torque or tension. The casting can be removed from the frame for cleaning at scheduled appointments. Removal of the casting permits evaluation of the fixation of each implant. PMID- 3534229 TI - A prosthesis fabrication technique for the edentulous maxillary resection patient. AB - A technique for making final impressions, registration of jaw relations, and positioning of anterior teeth with the same record bases during the fabrication of an obturator prosthesis is described. By using this technique, a more predictable result may be attained with respect to jaw relations, obturator height, and lip position, all of which may be compromised in the edentulous patient with a postsurgical maxillary defect. PMID- 3534230 TI - Temporomandibular joint disorders: a diagnostic challenge. AB - During the past decade much interest has been focused on disorders of the TMJ. The etiology appears to be multifactorial, with signs and symptoms difficult to evaluate and radiologic investigations insufficient. This review attempted to analyze current diagnostic tools. The recent introduction of various techniques promises optimism for this diagnostic and therapeutic challenge. PMID- 3534231 TI - A simplified palatal expansion prosthesis. AB - A palatal expansion prosthesis made of cast silver can be easily fabricated at any facility that has the ability to cast type III gold. The ductility and malleability of pure silver allow for ease of adaptation or alteration as a chairside or operating room procedure. PMID- 3534232 TI - Spray-sprinkle-on technique for stabilized complete denture record base fabrication. PMID- 3534233 TI - Movement of artificial teeth in waxed trial dentures. AB - Movements of artificial teeth during the wax trial denture stage was investigated in three dimensions by means of a traveling microscope. Fixed points of reference were devised for accurate measurements of teeth movements. Porcelain and plastic anterior and posterior teeth set in five wax trial dentures were tested at 2, 4, 7, and 24 hours. Tooth movements in wax trial dentures invariably occurred and lacked correlation in direction and time. PMID- 3534234 TI - Evaluation of the 45-degree labial bevel with a shoulder preparation. AB - This study compared the margin opening of cemented porcelain-fused-to-metal crowns of three different casting designs: 80-degree bevels with metal collars, 80-degree bevels with porcelain applied to the labial collars, and 45-degree labial bevels with metal and porcelain to a common margin termination. There were no statistically significant differences between the margin opening of the three groups. Porcelain application and firing did not distort the facial margin. The 45-degree bevel with porcelain to the margin has greater esthetic potential and the same margin adaptation as the 80-degree bevel with an all-metal collar. PMID- 3534235 TI - A reinforced composite fixed partial denture. PMID- 3534236 TI - In vivo adaptation of restorative materials to dentin. PMID- 3534237 TI - Retention of prefabricated posts with dental adhesive and composite. AB - Sixty-three No. 4 Dentatus threaded posts were cemented in extracted teeth and tested for tensile strength. The cementing medium was Silar composite alone or in combination with a conventional bonding agent or Scotchbond dental adhesive, or both. Results indicate that: Retention was greater when the posts were cemented with the Silar composite preceded with the application of Scotchbond. Retention was less with Silar composite alone or combined with a conventional bonding agent. Scotchbond is suggested for use as a bonding agent when cementing Dentatus posts with composites. PMID- 3534238 TI - Retention of serrated endodontic posts with a composite luting agent: effect of cement thickness. AB - When Prosthodent composite was used as a cementation material for endodontic posts (ParaPost), adaptation of the post to the canal was not crucial. Changes of the composite layer thickness up to 500 microns did not decrease retention. Variation in the diameter of the posts did not effect the retention. The retention obtained for the combinations of posts and cements was high and suitable to resist dislodgment of the posts. Consequently, the thinnest post in the root canal, cemented with a composite is recommended. Thus the removal of tooth structure is unnecessary because the cylindrical preparation is formed in the composite. PMID- 3534239 TI - Veterans Administration Cooperative Studies Project No. 147. Part III: Assessment of blindness in a clinical evaluation of alternative alloys for metal-ceramic crowns. PMID- 3534240 TI - A photoelastic study of rests on solitary abutments for distal-extension removable partial dentures. AB - With a distal-extension removable partial denture, maximum use of existing oral structures can aid in the total support of the prosthesis and reduce the force on the solitary abutment. Four rests with relieved and unrelieved guide plates were evaluated for optimum stress distribution around the root of a solitary premolar abutment. These rests were the mesial, the distal, the mesial and distal, and the continuous rest. The findings demonstrated that The continuous rest had the most favorable stress concentration. All other rest designs demonstrated more lateral stress than the continuous rest. Relieved guide plates demonstrated 58% less maximum shear stress in the apical portion than unrelieved guide plates. PMID- 3534241 TI - Analysis of facial surface undercuts to determine use of RPI or RPA clasps. PMID- 3534242 TI - Quick boxing of impressions with irreversible hydrocolloid. PMID- 3534243 TI - Use of the periodontal probe to determine border extensions of impression trays. PMID- 3534244 TI - Record keeping for removable prostheses. PMID- 3534245 TI - American Board of Prosthodontics. PMID- 3534246 TI - Study duration in antidepressant research: advantages of a 12-week trial. AB - There has been an increasing interest in studying the effectiveness of antidepressants in non-melancholic depressives. For non-melancholic patients who are characterized by transient mood improvement, a single cross-sectional evaluation may reflect temporary change. Transient improvement, like any source of instability in an outcome measure, reduces validity and consequently power. To minimize the effects of transient mood change in non-melancholic depressives, we designed a two-phase drug trial. The first phase was a standard 6-week trial. Those judged responders at the end of the first phase entered the second 6-week phase. Between weeks 6 and 12 it was anticipated that a smaller proportion of six week responders would relapse on drug than placebo, thus sharpening the contrast between treatments. The purpose of this paper is to demonstrate the power advantages of the 12-week design. Data is presented which suggests that a 12-week design reduces transient improvement, increases treatment effect size, and requires a smaller number of patients for equivalent statistical power. It also offers a better estimate than a 6-week study of the proportion of patients who will have persistent clinical benefit. PMID- 3534247 TI - The relationship between physicians and the pharmaceutical industry. A report of the Royal College of Physicians. PMID- 3534248 TI - Graves of Graves' disease, 1796-1853. PMID- 3534249 TI - [Pulmonary digital subtraction angiography. A comparative study of 2 technics. Electrocardiographic servo-assistance versus 3 images per second]. AB - A prospective study in 60 consecutive patients evaluated gain in quality of image using ECG servo-assistance during pulmonary digital subtraction angiography (PDSA). Two groups of 30 comparable patients were randomly allocated to examination with ECG servo-assistance or three images per second technique. Criteria for assessment of quality of image were defined and used to compare results. No significant difference were noted and ECG servo-assistance failed to improve images during PDSA. PMID- 3534250 TI - [Echographic aspects of candidiasis of the urinary tract in infants. Apropos of 2 cases]. AB - Predisposing factors in two children with urinary tract candidiasis included: neonatal period, uropathy with malformation, massive antibiotic therapy. Ultrasound images showed dilated excretory cavities of variable echo intensities and without posterior shadow cone. Diagnosis was confirmed by urine culture and a satisfactory outcome obtained by specific therapy and surgery for malformations. PMID- 3534251 TI - [Aneurysm of the celiac trunk. A review of the literature. Apropos of a new case]. AB - Aneurysms of celiac trunk are rare (82 cases reported worldwide), and the clinical picture is usually little suggestive of the lesion, which may be totally asymptomatic. Positive diagnosis and determination of possible extension of the disease, as well as postoperative follow up is ensured by modern imaging techniques (ultrasound, CT scan, digital subtraction angiography). Etiology of the aneurysm varies but is generally atheromatous disease or intimal fibrodysplasia. PMID- 3534252 TI - [Detection of left intraventricular thromboses. Comparison of 2-dimensional ultrasonics with scanography and scintigraphy with indium 111-labeled platelets]. AB - Three methods of diagnostic imaging : bi-dimensional ultrasonography, scanography and 111Indium-labelled platelet scintigraphy were compared in 61 patients to detect left intraventricular thrombotic lesions, in order to determine their respective diagnostic values. PMID- 3534254 TI - [The French Society of Medical Radiology. 1986 directory]. PMID- 3534253 TI - [Osseous hydatidosis of the pelvic girdle. Contribution of computerized tomography and ultrasonics. Apropos of 3 cases]. AB - Three cases of bone hydatidosis of pelvis with invasion of soft tissues provided data on the effectiveness of CT scan and ultrasound imaging for diagnosis, evaluation of extension and follow up surveillance of this affection. Two of the three patients treated medically were followed up by review CT scan and ultrasound examinations. The two techniques were found to be effective for detecting recurrence and for surveillance of hydatid lesions of soft tissues during medical therapy. PMID- 3534255 TI - Premature ovarian failure. Current concepts. AB - Premature ovarian failure is not uncommon. It can occur at any age and has important implications for both patient and clinician. Various therapeutic options are available, including in vitro fertilization with donor oocytes. PMID- 3534256 TI - Neonatal myotonic dystrophy associated with prenatal ventriculomegaly. A case report. AB - Myotonic dystrophy is an autosomal dominant neuromuscular disease in which the maternal manifestations may be mild or subclinical. However, the congenital form, transmitted only from affected mothers, is reported to have a neonatal mortality rate as high as 50%. Ultrasonographic features of pregnancies with affected fetuses include hydramnios and decreased fetal movement, breathing motion and swallowing. Several reports have also noted an occasional infant with ventriculomegaly or hydrocephalus. It appears that prenatal ventriculomegaly may also be an occasional ultrasonographic finding heralding neonatal myotonic dystrophy. PMID- 3534257 TI - Current vulvar diagnostic methods, with special reference to vulvar cytology. AB - The established noninvasive procedures for early detection of vulvar cancer failed in the past, probably because they were based on indirect criteria for malignancy. Exfoliative cytology, however, is the only method that is able to identify specific morphologic features although completely different from the well-known features of cervical cytology. A smear should be taken, therefore, from every vulvar lesion. Using all the relevant diagnostic methods, including punch biopsy, should lead to an improvement in early vulvar cancer detection. PMID- 3534258 TI - Involucrin expression in vulvar lesions. AB - Involucrin, a precursor of the envelope protein present in human stratum corneum, may be used as a histologic marker. Involucrin expression was studied in biopsy specimens from different types of vulvar lesions. In general, the pattern of staining for involucrin has been the one described for similar pathologies of the integument in other bodily areas. However, an unexpected pattern was noted in lichen sclerosus of the vulva. PMID- 3534259 TI - Antibodies to peptidoglycan in juvenile onset ankylosing spondylitis and pauciarticular onset juvenile arthritis associated with chronic iridocyclitis. AB - Using an indirect enzyme linked immunosorbent assay, antibodies of the IgG class to Streptococcus pyogenes group A peptidoglycan-polysaccharide polymers (PG-GSP) were measured in the sera of 37 patients with juvenile onset ankylosing spondylitis (JAS), 22 with pauciarticular onset juvenile arthritis associated with chronic iridocyclitis and 20 healthy children. Mean antibody activity, measured in arbitrary units, was of 184 U in JAS and 250 U in chronic iridocyclitis (p = NS). The results in both groups differed significantly from those found in healthy children (p less than 0.001 and p less than 0.01, respectively). This suggests either a possible role of bacterial cell wall products in the pathogenesis of these disorders or a state of immune reactivity to PG-GSP in these children. PMID- 3534260 TI - Longterm auranofin therapy in patients with juvenile rheumatoid arthritis. AB - Auranofin (AF, Ridaura) was administered to 23 children with juvenile rheumatoid arthritis during a prospective, open labelled, noncontrolled trial designed to establish longterm safety and preliminary efficacy. Dosages of AF were up to 0.2 mg/kg/day, with either aspirin (60-80 mg/kg/day), naproxen (400-600 mg/m2/day), or tolmetin sodium (20-40 mg/kg/day) serving as the concurrent nonsteroidal antiinflammatory drug. Nearly all patients showed an initial favorable response, however tachyphylaxis occurred in one-third (mean duration of therapy prior to the development of inefficacy = 22.6 mo). Clinical remission was observed in 6 patients an average of 15 months after enrollment. The drug appears to be safe for extended periods; 7 children are continuing AF at the present time with a mean duration of therapy of 4.25 years (maximum followup = 4.6 years). PMID- 3534261 TI - A single blind randomized endoscopic study comparing the effects of diflunisal and naproxen in patients with osteoarthritis. AB - A single blind randomized endoscopic study comparing the effects of diflunisal and naproxen on the gastric and duodenal mucosa of 34 patients with osteoarthritis was performed over a 2-week period. At the dosages utilized in the study, diflunisal produced significantly less gastric injury than naproxen, as assessed by mean gastric injury scores (p = 0.0002). Sixty-five percent of the diflunisal treated group had no evidence of gastric mucosal injury compared with 13% in the naproxen group. Moreover, treatment with diflunisal resulted in a significantly lower incidence of severe gastric injury than naproxen (p less than 0.01). PMID- 3534262 TI - 19S IgM rheumatoid factor plaque forming cells in a five-year-old patient with juvenile rheumatoid arthritis. PMID- 3534263 TI - The radiologist as guinea pig: radiation hazards to man as demonstrated in early radiologists, and their patients. PMID- 3534264 TI - Fate of the testis following epididymitis: a clinical and ultrasound study. AB - The progress of 33 men suffering from acute epididymitis, the majority of whom were treated as hospital inpatients, was prospectively monitored in order to determine the incidence of complications, and to assess the prognostic implications of clinical and scrotal ultrasound features found at initial presentation. Serious testicular complications resulting in frank infarction, suppurative necrosis and late atrophy developed in 39%. Three factors were shown to have significant discriminant value in predicting an adverse outcome: severe degree of inflammation with induration of the spermatic cord; the presence of a coexistent bacterial urinary infection; and a uniformly reduced testicular echo pattern on the affected side as visualized on ultrasound. A more aggressive approach in addition to medical measures appears to be indicated in these patients. The rationale of early surgical decompression by epididymotomy and spermatic fasciotomy is discussed. Scrotal ultrasound should be considered as a routine investigation in the management of epididymitis. PMID- 3534265 TI - Emergency management of accidental hypothermia: a review. PMID- 3534266 TI - A history of Kaposi's sarcoma. PMID- 3534267 TI - Hyperbaric oxygen in multiple sclerosis: discussion paper. PMID- 3534268 TI - Joan of Arc, creative psychopath: is there another explanation? PMID- 3534269 TI - Teaching skills in medical information retrieval to medical students. AB - Most students are admitted to medical school with little or no prior training in medical information retrieval. Despite the increasing dependence of physicians on new information tools, such as computer data bases and on-line literature searching, few medical schools have included more than token emphasis on information retrieval skills in their curricula. Reports on information skills courses have revealed that the courses often encounter serious obstacles, including poor student acceptance. The authors here describe a project that attempts to overcome the principal obstacles and to provide an efficient and effective method of teaching information retrieval skills to second-year medical students. The method includes a pretest that contains case scenarios, a diagnosis of individual students' deficiencies in information skills, a self-paced individual learning module, and a posttest. Evaluation of the program showed that the students had deficiencies in information retrieval skills and that the students who used the self-instruction module had significantly higher scores on the posttest than the students who did not. PMID- 3534270 TI - A voice-activated, interactive videodisc case study for use in the medical school classroom. AB - The instructional technology of voice recognition, interactive videodisc, and microcomputer offers new opportunities in medical education. The TIME Project is using this technology to create engaging, believable clinical situations that promote experiential learning, discovery learning, and contextual instruction in the medical school classroom. The TIME Project will conduct a field test of three interactive case studies as part of the introduction to clinical medicine curriculum at five medical schools to determine the educational effectiveness of the prototype design and its acceptance by faculty members and students. PMID- 3534271 TI - Isotype responses of mice to tetanus-toxoid preparations. AB - The development of anti-tetanus antibodies in CBA/Ca and Balb/c mice immunised with two tetanus-toxoid preparations has been investigated by sensitive enzyme linked immunoassays. These studies revealed the presence in both strains of mice of naturally occurring antibodies to tetanus toxoid. These were of the IgM, IgA and, to a lesser extent, the IgG3 isotypes. Differences in the responses of mice to the two toxoid preparations were noted; the purer preparation elicited a more rapid and pronounced response. Both strains of mice exhibited similar isotype responses. PMID- 3534272 TI - Proliferation of human peripheral blood mononuclear cells induced by Candida albicans and its cell wall fractions. AB - Glutaraldehyde-inactivated cells and cell-wall fractions of Candida albicans were studied for their capacity to induce or inhibit the in-vitro proliferation of human peripheral blood mononuclear cells (PBMC), as measured by 3H-thymidine incorporation. Both the intact cells (CA) and a phosphorylated gluco-mannan protein complex of the cell wall (GMP), in microgram doses, were strong inducers of PBMC proliferation, with a peak of activity at 6-9 days of culture and varying with the PBMC donor. A significant but much lower proliferation was observed on exposure of PBMC to a low-protein (less than 3% by weight) mannan component (M) of the cell wall. Both a hot-alkali extracted mannan-protein complex (M-alk), comparable to GMP in crude chemical composition, and an alkali-insoluble cell wall glucan (GG) were inactive. None of the Candida fractions induced a lymphoproliferation of umbilical cord blood cells and all fractions, except GG, were equally effective in binding human anti-Candida antibodies as shown by a sensitive ELISA-inhibition assay. Moreover, a monoclonal antibody against the class II determinant of the HLA complex inhibited PBMC proliferation irrespective of the Candida antigen used. Taken together, the data shows that in inducing lymphoproliferation, Candida fractions act as specific antigens rather than as non-specific mitogens. Use of intact Candida cells and chemically-defined cell wall components appears preferable to use of undefined antigenic mixtures as stimulators of PBMC proliferation. PMID- 3534273 TI - Effects of Bacteroides asaccharolyticus cells and B. fragilis surface components on serum opsonisation and phagocytosis. AB - The effect of Bacteroides asaccharolyticus on the opsonisation and phagocytosis of gram-positive and gram-negative bacteria by human polymorphonuclear leukocytes (PMNL) was investigated. Uptake of most isolates of staphylococci, streptococci and clostridia by PMNL after opsonisation with serum treated with B. asaccharolyticus was largely unimpaired. The same treatment of serum before opsonisation of isolates of Pseudomonas, Enterobacter, Klebsiella and Gardnerella resulted in the uptake by PMNL varying with individual isolates; a large reduction occurred with some and none with others. Treatment of serum with B. fragilis lipopolysaccharide before opsonisation of Proteus mirabilis produced a marked reduction in uptake, whereas treatment with B. fragilis capsular polysaccharide had little effect. PMID- 3534274 TI - Virulence plasmid-associated sensitivity to acid in Escherichia coli and its possible significance in human infections. AB - Several strains of Escherichia coli were markedly sensitised to killing at pH 2.5 or 3.5 when the ColV,I-K94 virulence plasmid was introduced into them. For strain 1829, the effect on acid sensitivity was due to the presence of plasmid in the previously resistant strain rather than to its introduction into an acid sensitive variant already in the population. Acid sensitivity was also conferred by the ColV-K30 and ColB-K98 plasmids and the resistance plasmid R124-F2; other plasmids tested had no marked effect. Studies of ColV+ strains carrying mutant plasmids indicated that it was the presence of ColV-encoded transfer components that made ColV,I-K94+ strains acid-sensitive. Organisms in the exponential phase of growth were more sensitive to acid than were those from stationary phase cultures and this difference was more marked for ColV,I-K94+ strains than for Col ones. Moreover, ColV+ strains exposed to conditions of low pH for short periods subsequently grew less well than the Col- parent and appeared to be sensitised by the damage to the effects of H2O2. These results indicate that some ColV+ strains may be more sensitive to gastric acid and to phagocytic acidity than are Col- strains. ColV,I-K94+ strains grew as well as Col- ones in broth or urine at pH 4.5-6.0 which suggests that the presence of the plasmid would not be detrimental to bacterial growth in the urinary tract. The presence of transfer components in the outer membrane of ColV,I-K94+ bacteria may destabilize the lipopolysaccharide layer allowing increased penetration of hydrogen ions. PMID- 3534275 TI - Proteinase-related broad-spectrum inhibitory activity among group-A streptococci. AB - Some 10% of group-A streptococci have inhibitory activity against all nine strains (eight of them streptococci) in a set of indicators in an inhibitor production typing (P-typing) scheme. This activity was associated with the concurrent synthesis of cell-associated proteinase by the streptococcal strain. Inhibitor production was prevented either by incubation of the test strain in conditions inimical to proteinase production, e.g., at low temperature and alkaline pH, or by addition to the medium of substances, such as glucose, iodoacetic acid, lincomycin, Congo red or trypan blue, that had an anti proteinase effect. Inhibitory activity was not detectable in liquid cultures, but freeze-thaw extracts of cultures of group-A streptococcus strain A1013 on Gibco Columbia Agar Base (Gibco Diagnostics, Madison, WI, USA) had some inhibitory activity. The inhibitor was concentrated and partially purified, and the active agent was shown to be a high-mol.-wt cationic protein which was bactericidal for various bacteria in the logarithmic growth phase, including the homologous producer strain. PMID- 3534276 TI - Adherence of Mycobacterium leprae to Schwann cells in vitro. AB - Adherence of Mycobacterium leprae was studied in vitro in monolayer cultures of purified mouse Schwann cells. The optimum temperature and time for adherence were determined. Pretreatment of Schwann cells with lipase reduced adherence, but pretreatment with trypsin enhanced it and with four monosaccharides--L-arabinose, L-galactose, L-rhamnose and D-glucose--there was no significant effect, indicating that the receptors involved in adherence may be lipid. PMID- 3534277 TI - Immunocytochemical localization of nerve growth factor in mouse kidney. AB - The presence of NGF in mouse kidney was investigated using immunocytochemical methods. Female and male adult Swiss-Webster mouse kidneys were fixed by perfusion with 4% paraformaldehyde or Zamboni's fixative. The kidneys were frozen, and serial sections were prepared. Rabbit NGF antiserum was used for the primary incubation, and the avidin-biotin complex immunoperoxidase procedure was utilized for immunostaining. NGF immunoreactivity was localized in the apical and perinuclear cytoplasm of cells lining the late distal nephron, in a portion that corresponds to the connecting tubule. This portion of the nephron has been consistently observed in close anatomical relationship with arterioles, which are known to be richly innervated. Some cells of the connecting tubule, corresponding to intercalated cells, lacked NGF immunoreactivity. PMID- 3534278 TI - Segmental pancreas allograft: a report of one case surviving more than one year with functioning graft. PMID- 3534279 TI - Application of quantitative determination of urinary proteins in the diagnosis of acute rejection following renal transplantation. PMID- 3534280 TI - Vivax and falciparum malaria seen at an Indian service hospital. AB - The cases of 740 adult males with vivax and/or falciparum malaria managed in a military hospital in north-eastern India during the period from June 1978 to March 1981 were analysed. Four hundred and nine (55.3%) were infected with Plasmodium falciparum, 237 (32.0%) with P. vivax and the remaining 94 (12.7%) with both P. vivax and P. falciparum. The majority of cases were chloroquine sensitive and did not pose diagnostic or therapeutic problems. Of 381 patients subjected to an extended field test, 82 (21.5%) exhibited a variable degree of chloroquine resistance. Cerebral and haemopoietic involvement were the commonest of the pernicious syndromes observed in 92 (12.4%) patients. Atypical presentations, variable chloroquine resistance and presentation with complications call for timely recognition and institution of a specific supportive therapeutic regime. PMID- 3534281 TI - Quantitative assessment of malaria morbidity based on longitudinal data in 10 Indian villages. AB - House-to-house visits were made at weekly intervals to investigate malaria morbidity. The survey covered 7337 individuals in 10 villages in Jhansi District, Uttar Pradesh. Incidence rates of 252 spells of sickness from fever and six symptomatic cases of malaria per 1000 population were recorded. The incidence rates of unhealthy periods due to fever, of people sick and of spells of sickness per person were significantly higher in males. Morbidity from fever was highest in the 15-24 year age group in males and in the 10-14 year age group in females. The rates for malaria did not show any correlation with age. Morbidity rates were relatively higher from July to October, peaking in September. The annual slide positivity rate was 2.4%. Plasmodium vivax and P. falciparum were the only species observed in the area, with the former more prevalent. PMID- 3534282 TI - Adult cerebral malaria in Zambia: preliminary report of clinical findings and treatment response. AB - Fifty-six adult patients diagnosed as having 'cerebral malaria' were admitted and treated over a 4 month period. The presenting symptoms were similar to those of control patients with malaria without cerebral manifestations except that vomiting and convulsions were significantly more frequent and joint pains were less frequent in the cases than in the controls. Physical examination revealed significantly more frequent occurrence of nuchal rigidity, positive Kernig's sign, confusion, muteness, pallor and jaundice in the cases than controls, while splenomegaly was significantly more common in controls than cases. Laboratory data showed that cerebral malaria cases had significantly lower haemoglobin and significantly higher reticulocyte count and erythrocyte sedimentation rate than controls. There was no significant difference in the parasite density between the cases and controls. All patients were treated with 200 mg base of intravenous chloroquine in 250 ml of isotonic saline infused over 2 h and repeated 12 hourly till oral therapy was possible. This proved to be efficacious and the recovery rate was over 90%. Five patients died and the diagnosis was confirmed in three in whom autopsy was permitted. A simple staging system is proposed which retrospectively seems to have prognostic value. It is recommended that the validity of this system be tested prospectively. PMID- 3534283 TI - Human pulmonary infections with bovine and atypical mycobacteria in Lagos, Nigeria. AB - A total of 2784 cases with persistent symptoms of lower respiratory tract infections were seen in four of the chest clinics in Lagos between January and June of 1983. Of these, 668 were randomly selected and screened for pulmonary tuberculosis. Repeated sputum samples from the 668 patients were cultured on Lowenstein-Jenseen slopes and 102 pure mycobacterial isolates were obtained. The isolates were differentiated into tubercle bacilli, bovine or atypical mycobacteria on the basis of results obtained from nine identification tests. Of the 102 mycobacterial isolates obtained, 87 (85%) were identified as Mycobacterium tuberculosis, four (4%) as M. bovis and 11 (11%) as atypical mycobacteria. Among this atypical group, six were classified as M. avium, four as M. kansasii and one as M. fortuitum. The study showed the involvement of bovine and atypical mycobacteria in pulmonary infections in Lagos. Tuberculosis-like diseases produced by some of the atypical group are resistant to most of the conventionally used anti-tuberculosis drugs. The need for adequate bacteriological analysis in current-day diagnosis and treatment of pulmonary tuberculosis is therefore highlighted since the 11 atypical cases seen in this study would otherwise have been diagnosed and treated as cases of classical tuberculosis. PMID- 3534284 TI - Effect of deworming and vitamin A administration on serum vitamin A levels in preschool children. PMID- 3534285 TI - Monoclonal antibodies (Mabs) in head and neck cancer. AB - The development of monoclonal antibodies (Mabs) represents a major contribution of immunology to the study of head and neck cancer. The interest of the otolaryngologist in this new field is quite recent, but our knowledge of cancer and other immunoproliferative disorders will exponentially expand with the characterization of tumor-associated antigens of squamous cell carcinomas. The author reviews briefly the technique for producing monoclonal antibodies and presents an overview of the application of Mabs to clinical medicine, oncology and, more specifically, head and neck cancer. Very few contributions have been made in head and neck cancer, but the field of Mabs will significantly alter our diagnostic and therapeutic armamentarium. PMID- 3534286 TI - Placental changes in fetal triploidy syndrome. AB - The sonographic findings in fetal triploidy syndrome include intrauterine growth retardation, hydrocephalus, oligohydramnios, and hydropic changes of the placenta. Ultrasonography can establish the diagnosis only when placental findings coexist with a fetus. Although the majority of triploid conceptions abort spontaneously in the first trimester, occasionally they will progress further, but rarely to term. Six cases are presented in which the diagnosis was suspected by early ultrasound examinations, including one case in which there was an unusually large trophoblastic cyst. Determination of the karyotype is important for the management of a pregnancy with a live fetus, and has implications for genetic counseling of subsequent pregnancies. PMID- 3534287 TI - Percutaneous drainage of pelvic abscesses: management of the tubo-ovarian abscess. AB - Percutaneous drainage of 35 pelvic abscesses secondary to pelvic inflammatory salpingitis are reported. Two methods of drainage were used: simple aspiration and catheter drainage. The success rate of aspiration drainage was 94 per cent, while catheter drainage yielded a 77 per cent success rate. The differences between pelvic abscess drainage and other types of percutaneous drainage are presented. The role of percutaneous drainage in the treatment of pelvic inflammatory disease is also discussed. PMID- 3534288 TI - Ultrasonography of prostatic carcinoma employing amplitude-enveloped (AM) and frequency-demodulated (FM) imaging: in vivo, in vitro, and pathologic correlation. AB - Thirty patients with biopsy proven carcinoma of the prostate were examined with transrectal (TR) (5-MHz linear array transducer) and transabdominal (TA) (3-MHz sector scanner) ultrasonography prior to prostatectomy. All patients had clinical stage A (n = 5) or B (n = 25) disease. Following retropubic radical prostatectomy, in vitro waterbath studies of the resected specimens were performed obtaining both conventional amplitude-enveloped (AM) images and frequency-demodulated (FM) images. The ability of each imaging modality (TR, TA, AM, FM) to detect the cancerous lesion was determined, and in all cases correlation with pathology was obtained. Transabdominal suprapubic ultrasonography did not prove helpful in detecting early carcinoma. Longitudinally oriented linear array transrectal ultrasonography was positive in nearly two thirds of the patients. Insignificantly lower positive correlation with pathologic findings was obtained from in vitro AM images; the lesions were often better visualized on transverse than on longitudinal images. The highest correlation with pathology was obtained from the in vitro frequency-demodulated images. PMID- 3534289 TI - Sonographic evaluation of liver, spleen, and splanchnic vessels following partial liver resection. AB - The liver and spleen size and the splanchnic vessel caliber were evaluated by means of real-time ultrasonography in 12 consecutive patients who underwent a partial hepatic resection for benign or malignant lesions. All parameters were evaluated before surgery and 14 days, 28 days, two months, and six months after the partial hepatic resection. The liver size, which was halved after the resection, progressively increased during the follow-up. The splanchnic veins showed, at 14 and 28 days, a significant increase in caliber and a reduced compliance to breathing, which progressively returned to normal levels. The spleen size increased after partial hepatectomy and remained enlarged throughout the study. Ultrasonography was able to detect that partial hepatic resection is followed by a progressive regeneration of the residual parenchyma and by a transient increase in portal pressure, which returns to normal levels when the liver regenerates. PMID- 3534290 TI - Interlaboratory comparison of ultrasonic attenuation and speed measurements. AB - A set of test samples, all containing ultrasonically equivalent tissue-mimicking material, was produced and measurements of ultrasonic speed and ultrasonic attenuation coefficients were made at seven laboratories using various techniques. The ultrasonic speed values agree well with one another, having a spread of about 0.3 per cent; thus, speed values for tissue parenchyma appearing in the literature are likely to be accurate. Values of ultrasonic attenuation coefficients agree fairly well with one another, with differences between individual values and the group mean of generally less than 20 per cent of the group mean. PMID- 3534291 TI - Effect of ultrasound on development. Part 1: Introduction and studies in inframammalian species. Report of the bioeffects committee of the American Institute of Ultrasound in Medicine. AB - This report reviews and establishes patterns from the literature on experimental ultrasound exposures of inframammalian embryos and prenatal laboratory mammals. Exposure to ultrasound can produce adverse affects on development, and the sensitivity and responses of the test systems vary with the stage of development. Generally, however, deleterious effects are demonstrable only with exposure parameters that far exceed those used in clinical practice, and the few reports of mammalian embryotoxicity under clinically relevant exposure conditions have not been repeatable. Although it may be impossible to unequivocally establish absolute safety, there is a need for further studies to evaluate subtle and delayed indicators of developmental effects, potential mechanisms, and to attempt to estimate threshold exposure conditions. PMID- 3534292 TI - Massive congenital solitary nonparasitic cyst of the liver in infancy. PMID- 3534293 TI - Prenatal ultrasonic diagnosis of congenital duplication of the stomach. AB - A case of gastric duplication cyst first visualized sonographically in the prenatal period is described. The prenatal identification of abnormality allowed prompt postdelivery diagnosis and surgical treatment. The characteristic location of this cyst is in the right upper quadrant of the fetal abdomen. The presence of peristalitic activity within the cyst can point to a gastrointestinal origin. A hypoechoic outer rim and hyperechoic inner rim also suggests the stomach as the etiologic origin of the cyst. With this entity, the presence of associated congenital anomalies should be sought. No known associated genetic chromosomal anomalies are reported. PMID- 3534294 TI - Cholecystosonography in pregnancy. PMID- 3534295 TI - Cortical sulcal development. PMID- 3534296 TI - Sonographic findings in a case of Castleman disease of the neck. PMID- 3534297 TI - Large lumbar osteophyte: an unusual cause of false clinical impression of common iliac artery aneurysm. PMID- 3534299 TI - 31st annual convention of the American Institute of Ultrasound in Medicine. September 16-19, 1986, Las Vegas, Nevada. Abstracts. PMID- 3534298 TI - Gallstones simulating polyps sonographically: a report of two cases. PMID- 3534300 TI - Hydroxyurea-resistant vaccinia virus: overproduction of ribonucleotide reductase. AB - Repeated passages of vaccinia virus in increasing concentrations of hydroxyurea followed by plaque purification resulted in the isolation of variants capable of growth in 5 mM hydroxyurea, a drug concentration which inhibited the reproduction of wild-type vaccinia virus 1,000-fold. Analyses of viral protein synthesis by using [35S]methionine pulse-labeling at intervals throughout the infection cycle revealed that all isolates overproduced a 34,000-molecular-weight (MW) early polypeptide. Measurement of ribonucleoside-diphosphate reductase (EC 1.17.4.1) activity after infection indicated that 4- to 10-fold more activity was induced by hydroxyurea-resistant viruses than by the wild-type virus. A two-step partial purification which yielded greater than 90% of the induced ribonucleotide reductase activity in the fraction obtained by 35% saturation with ammonium sulfate resulted in a substantial enrichment for the 34,000-MW protein from extracts of wild-type and hydroxyurea-resistant-virus-infected, but not mock infected, cells. In the presence of the drug, the isolates incorporated [3H]thymidine into DNA earlier and at a rate substantially greater than that of the wild type, although the onset of DNA synthesis was delayed in both cases. In the absence of the drug, the attainment of a maximum viral DNA synthesis rate was accelerated after infection by drug-resistant isolates. The drug resistance trait was markedly unstable in all isolates. In the absence of selective pressure, plaque-purified isolates readily segregated progeny that displayed a wide range of resistance phenotypes. The results of this study indicate that vaccinia virus encodes a subunit of ribonucleotide reductase which is a 34,000-MW early protein whose overproduction confers hydroxyurea resistance on reproducing viruses. PMID- 3534301 TI - Management of cystine nephrolithiasis with alpha-mercaptopropionylglycine. AB - The effect of long-term treatment with alpha-mercaptopropionylglycine was examined in 66 patients with cystinuria. Of the patients 49 took D-penicillamine before therapy, whereas 17 did not. Over-all side effects to alpha mercaptopropionylglycine were common, and occurred in 75.5 per cent of the patients with and 64.7 per cent without a history of D-penicillamine treatment, compared to 83.7 per cent who suffered toxicity to D-penicillamine. Serious adverse reactions requiring cessation of therapy were less common with alpha mercaptopropionylglycine. Among the patients who took both drugs 30.6 per cent had to stop taking alpha-mercaptopropionylglycine, whereas 69.4 per cent could not tolerate D-penicillamine. Of the latter group with toxicity to D penicillamine before therapy, whereas 17 did therapy only 5.9 per cent had side effects to alpha-mercaptopropionylglycine of sufficient severity to require withdrawal. Alpha-mercaptopropionylglycine was equally as effective as D penicillamine in reducing cystine excretion. During long-term treatment with alpha-mercaptopropionylglycine (average dose 1,193 mg. per day) urinary cystine levels were maintained at 350 to 560 mg. per day and urinary cystine was kept at undersaturated levels. Commensurate with these changes, alpha mercaptopropionylglycine produced remission of stone formation in 63 to 71 per cent of the patients and reduced individual stone formation rate in 81 to 94 per cent. Thus, alpha-mercaptopropionylglycine has a definite therapeutic role in cystinuric patients with toxicity to D-penicillamine. PMID- 3534302 TI - Transplantation of the prepuce to facilitate hypospadias repair in monozygotic twins. AB - We report a case of free transplantation of the prepuce derived from a monozygotic twin to aid in the reconstruction of penoscrotal hypospadias in his brother. Although monozygotic twins discordant for hypospadias are seen rarely the possibility of preserving and transplanting the prepuce of the unaffected sibling should be considered to facilitate reconstruction of the phallus with hypospadias. PMID- 3534303 TI - Seminoma in an adult with acute lymphocytic leukemia. AB - We present a unique case of a seminoma in an adult with acute lymphocytic leukemia in clinical remission. As survival improves with modern multimodal chemotherapy testicular relapse of acute lymphocytic leukemia is becoming more common. A histopathological diagnosis is needed to initiate appropriate local and systemic therapy. In children a transscrotal approach for testis biopsy is used. However, the approach in adults with presumed testicular relapse has not been addressed. The risk factors of testicular relapse, the use of ultrasound in the diagnosis and the need to consider the classic differential diagnosis of a testicular mass are discussed. PMID- 3534304 TI - Metastatic seminoma with regression of testicular primary: ultrasonographic detection. AB - We report a case of seminoma of the testis metastatic to the retroperitoneum. Biopsy of the retroperitoneal mass revealed anaplastic seminoma. No testicular mass could be palpated. Testicular ultrasonography showed a hypoechoic 3 X 2 cm. area in the left testis suggestive of a primary testicular tumor, most likely a seminoma. Histological evaluation of the resected testis revealed fibrous tissue but no definable tumor. PMID- 3534305 TI - The communicating hematocele: an unusual presentation for blunt splenic trauma. AB - The communicating hematocele is an unusual scrotal disorder that is rarely anticipated. Surgical exploration for an enlarging hydrocele and an abnormal scrotal sonogram in a 19-month-old boy revealed a communicating hematocele. Further evaluation demonstrated a fractured spleen. The association between a patent processus vaginalis and blunt abdominal trauma in the pathogenesis of the communicating hematocele is discussed. PMID- 3534306 TI - The in vitro effects of Salmonella enteriditis on urinary stone formation. AB - Salmonella enteriditis has been previously found to have both unique inhibiting and augmenting properties on urinary stone formation. A series of in vitro experiments were performed in order to determine if the in vivo results could be explained in an in vitro model. Urinary phosphorus was measured before and after incubation with various bacteria, and was found to increase significantly when incubated with S. enteriditis (p less than 0.05). Urinary citrate was measured in a similar fashion following incubation with S. enteriditis and E. coli. A statistically significant decrease in urinary citrate was found in urine incubated with S. enteriditis (p less than 0.005). Based on the results of these experiments the increase in urinary phosphorus may have contributed to the inhibiting foreign body stone formation in a previous in vivo model. The decrease in urinary citrate could explain the augmentation of calcium phosphate stone formation previously reported. PMID- 3534307 TI - Immunology of pyelonephritis. VIII. E. coli causes granulocytic aggregation and renal ischemia. AB - We studied renal venous blood after renal infection for its concentrations of leukocytes, complement and renin. In addition, we evaluated this blood for granulocytic aggregation and chemiluminescence of granulocytes. We found that very rapid activation of serum complement occurred with associated granulocytic aggregation and evident vascular occlusion and ischemia since renin rose rapidly. It appears that this early sequence of events will cause renal damage by ischemic change, as well as that known to occur from the inflammatory reaction. PMID- 3534308 TI - Differential distribution of pepsinogen II between the zones of the human prostate and the seminal vesicle. AB - Pepsinogen II (PG II) is a gastric proenzyme which has previously been found in both human seminal fluid and the prostate gland. However, no regional distribution of PG II has been noted within the prostate nor has it been found in the seminal vesicle. Bouins-fixed sections of central zone, peripheral zone and seminal vesicle, taken from 10 prostates removed at radical prostatectomy or cystectomy, were exposed to antibody against PG II and stained using the A-B-C immunoperoxidase technique. Formalin-fixed tissue from autopsy prostates of four men in the third decade, and six cases with BPH nodules, were also examined for PG II activity. In nine of 10 seminal vesicles, and seven of 10 central zone samples, more than 50 per cent of the cells stained positive for PG II. By contrast, in nine of 10 peripheral zone samples staining was present in five per cent or less of the epithelial cells. Similarly, PG II activity in the four autopsy prostates occurred almost entirely within the central zone and ended abruptly at the boundary between the peripheral and central zones. BPH nodules contained no PG II activity. These findings provide the first evidence that the central and peripheral zones may serve different biological functions. Embryologically it is currently thought that the prostate is of endodermal origin and the seminal vesicle of mesodermal origin. The presence of large amounts of PG II in both the seminal vesicle and central zone lends support to the hypothesis of a common mesodermal origin for these two structures. PMID- 3534309 TI - Diuresis renography 8 years later: an update. PMID- 3534310 TI - Treatment for muscle invasive carcinoma of the bladder. PMID- 3534311 TI - Long-term results with renal autotransplantation for ureteral replacement. AB - From 1970 to 1984 renal autotransplantation was performed on 23 patients to replace all or a major portion of the ureter. The conditions necessitating ureteral replacement were postoperative ureteral injury in 16 cases, recurrent renal colic in 4, urinary undiversion in 2 and an atonic ureter in 1. Six patients presented with a solitary kidney and 1 underwent staged bilateral autotransplantation. After autotransplantation urinary continuity was restored by ureteroneocystostomy in 11 patients, pyelovesicostomy in 7, ureteroureterostomy in 2, pyeloureterostomy in 2 and ureterosigmoidostomy in 1. Postoperatively, there was no mortality and all but 1 of the autotransplanted kidneys functioned immediately. Two kidneys required removal postoperatively owing to bleeding. Currently, 20 patients are alive with functioning renal autotransplants at intervals of 1.5 to 14 years. The current serum creatinine level in these patients ranges from 1.1 to 2.2 mg. per dl., which in each case is improved or stable compared to the preoperative determination. Only 1 patient has experienced chronic bacteriuria. We conclude that renal autotransplantation provides excellent long-term treatment for patients who require ureteral replacement. PMID- 3534312 TI - Prognostic significance of ABH antigenicity of mucosal biopsies in superficial bladder cancer. AB - ABH antigenicity of mucosal biopsies was studied in 36 patients with superficial bladder cancer. Those with mucosal biopsies positive for antigen had a recurrence rate of 0.33 recurrences per year, compared to 1.97 in those negative for antigen. This difference was highly significant on statistical analysis. ABH antigenicity of mucosal biopsies proved to be a better predictor of recurrent disease than other prognostic indexes, such as number, size, histological grade and ABH antigenicity of primary tumors, as well as histological status of the mucosal biopsies. PMID- 3534313 TI - Beta-2-microglobulins as a differentiation marker in bladder cancer. AB - The transformation of a normal cell through dysplasia to the malignant state usually is associated with changes at the molecular level within the nucleus, cytoplasm and cell surface. These changes can be monitored by the loss of normal cell surface antigens, such as the blood group antigen ABO(H) and major histocompatibility complex antigens, which in the human correlate with the histocompatibility locus antigens. A group of patients with bladder biopsy and diagnosis ranging from normal through severe dysplasia to papillary transitional cell carcinoma, invasive transitional cell carcinoma and carcinoma in situ were evaluated for the presence or absence of beta-2-microglobulin. This 11,000 molecular weight protein was used as an indirect marker for the major histocompatibility complex antigens on the cell surface. With immunoperoxidase as a marker, the presence of beta-2-microglobulin was seen in all patients with normal epithelium as well as benign disease. However, with progression through dysplasia to carcinoma there was progressive deletion of the beta-2 microglobulin. Carcinoma in situ exhibited minimal expression of the beta-2 microglobulin. The use of beta-2-microglobulin as a marker for major histocompatibility complex antigens on the cell surface may prove to be useful for monitoring transitional cell carcinoma. PMID- 3534314 TI - Testicular abscess: diagnosis by ultrasonography. AB - We reviewed 8 cases of surgically proved testicular abscess with emphasis upon the ultrasonographic findings. The images were correlated with testicular anatomy and the pathological findings of abscess formation. In 3 of 8 patients undergoing serial high resolution ultrasound examinations a consistent pattern of testicular abscess was present 1 to 7 weeks preoperatively. In the remaining 5 patients preoperative ultrasound documented the presence of abscess. Recognition of the ultrasonographic appearance of testicular abscess should permit expedient surgical intervention. PMID- 3534315 TI - Androgen priming and response to chemotherapy in advanced prostatic cancer. AB - A total of 67 patients with progressive stage D2 prostatic cancer refractory to orchiectomy was entered in a controlled clinical trial to test whether androgen priming enhances the efficacy of cytotoxic drugs. All patients were treated continuously with aminoglutethimide and hydrocortisone to lower adrenal androgen secretion and were given cyclic intravenous chemotherapy. In addition, the 34 patients randomized to the stimulation arm received fluoxymesterone for 3 days before and on the day of chemotherapy. There was 33 controls. The median duration of followup was 24 months. A modestly higher response rate (objective remission plus disease stabilization) was observed in the stimulation arm (85 versus 72 per cent, p less than 0.05) when the analysis was restricted to the evaluable patients. However, a larger fraction of unevaluable patients was present in the stimulation group (41 versus 16 per cent), mostly as a result of toxicity from fluoxymesterone, which prompted early discontinuation of treatment. Thus, when data analysis included all patients the response rate actually was slightly higher in the control than in the stimulation arm (60 versus 50 per cent, p not significant). No difference was observed in median duration of response (9 months in both groups) or over-all survival. Our data suggest that at least in those patients with advanced disease androgen priming does not seem to enhance significantly the antitumor effect of the combination of amino-glutethimide and chemotherapy, and is associated with significant toxicity. These largely negative results may be explained by the large number of hormone-resistant cells present in tumors that have become refractory to orchiectomy. PMID- 3534316 TI - The use of the expanded polytetrafluoroethylene vascular graft as an adjunct to hypothermic pulsatile perfusion for renal preservation. AB - A technique using expanded polytetrafluoroethylene (Teflon) vascular graft material for separation of kidneys in preparation for organ sharing is presented. PMID- 3534317 TI - Prevention of prolonged voiding problems after unexpected postoperative urinary retention: comparison of phenoxybenzamine and carbachol. AB - The efficacy of phenoxybenzamine and carbachol for the prevention of prolonged micturition problems was investigated in 160 consecutive patients with postoperative urinary retention. The patients were randomized into 3 groups: group 1-52 patients given 10 mg. phenoxybenzamine, group 2-55 who received 2 mg. carbachol and group 3-53 given a placebo. The drug was given orally twice daily for 3 days beginning immediately after the first catheterization. Only 17 per cent of the patients in group 1 had recurrent retention after the first catheterization compared to 49 per cent in group 2 and 57 per cent in group 3. Phenoxybenzamine is significantly more effective than carbachol or a placebo for the prevention of prolonged micturition problems in patients with unexpected urinary retention postoperatively. PMID- 3534318 TI - Perirenal subcapsular fluid collection in a patient with membranous nephropathy and renal vein thrombosis. AB - We report a case of perirenal fluid collection associated with membranous nephropathy and right renal vein thrombosis. Surgical removal of the fluid and instillation of povidone iodine resolved the problem. PMID- 3534319 TI - Acute renal failure in a solitary kidney due to bacterial pyelonephritis. AB - Deterioration of renal function after acute bacterial pyelonephritis is rare. We report on 2 patients with a solitary functioning kidney in whom acute renal failure developed in the setting of acute bacterial pyelonephritis. Following antimicrobial treatment kidney function returned to baseline values. This finding suggests that patients with a solitary functioning kidney are more prone to have renal dysfunction after acute bacterial pyelonephritis. PMID- 3534320 TI - Transrectal longitudinal ultrasonography of prostatic abscess. AB - A definite diagnosis of prostatic abscess sometimes is difficult to make. We report 2 cases of prostatic abscess diagnosed with the aid of transrectal longitudinal ultrasonography by electronic linear scanning. Transperineal aspiration of the abscesses was performed easily and correctly with this echographic technique. PMID- 3534321 TI - Nuclear magnetic resonance assessment of renal perfusion and preservation for transplantation. AB - The feasibility of using proton nuclear magnetic resonance (NMR) relaxation measurement to monitor organ perfusion and preservation was studied using a rat model. Intact kidneys were assessed with NMR following various periods of cold storage. Bilateral en bloc donor nephrectomy was performed on Sprague-Dawley rats with prior in situ flushing with Euro-collins', dextrose and other test solutions via a plastic cannula in the aorta. A paramagnetic agent, gadolinium-DPTA, dissolved in perfusion fluid was then injected into the renal vasculature. NMR analysis was repeated and the kidneys were reflushed with perfusion fluid to remove the gadolinium, followed by another NMR analysis. By sequential flushing and NMR measurement after 24, 48 and 72 hours of cold storage, the thoroughness of flushing, the patency of intrarenal vasculature and capillary integrity could be assessed. With the D5W, the T1 relaxation of kidneys dropped 56% with prolonged cold storage, indicating gadolinium accumulation in the interstitium, in effect loss of capillary integrity. With the Euro-collins', the T1 showed a small drop (23%) and almost complete flush-out, indicating superior tissue preservation and patency of vasculature. The addition of trifluoperazine, (TFP, a calmodulin inhibitor) to the Euro-collins' resulted in only a 9% drop in T1 after 72 hours. This possibly indicates TFP has additional protective action on cold ischemic damage. Using the small animal model presented here, proton NMR spectroscopy appears to be a sensitive technique in assessing renal vascular patency after cold storage and provides a useful tool for the investigation of other agents for organ preservation for transplantation. PMID- 3534322 TI - Assessment of renal preservation by phosphorus-31 magnetic resonance spectroscopy: in vivo normothermic blood perfusion. AB - To evaluate the usefulness of the monophosphate/inorganic phosphate ratio (MP/Pi) in assessing renal viability in a renal transplantation setting, we monitored intracellular phosphorous metabolites of 33 canine kidneys by phosphorus-31 magnetic resonance spectroscopy (MRS) after various amounts of ischemia. Renal viability (adequate perfusion and function) was directly assessed by the presence of intraoperative urine production in each kidney. Twelve normal, well-perfused kidneys (Group 1) exhibited high control MP/Pi ratios, with a mean of 0.87 +/- 0.12. Six in situ kidneys (Group 2), subjected to 45 minutes' warm ischemia followed by reperfusion, had a mean MP/Pi ratio of 0.50 +/- 0.12 after warm ischemia, which increased by a mean of 0.50 +/- 0.11 (to 1.0 +/- 0.07) after two to four hours of reperfusion. Fifteen kidneys (Group 3) were removed, cold flushed and transplanted after 24 hours of hypothermic storage. In eight (Group 3A), reperfusion was excellent; in seven (Group 3B), reperfusion was inadequate secondary to hypotension in two, hemorrhage in two, and renal vein thrombosis in three. Group 3A kidneys had a mean MP/Pi ratio after cold-storage ischemia of 0.54 +/- 0.08. After successful transplantation and two to four hours of reperfusion, this increased by a mean of 0.23 +/- 0.12 to 0.77 +/- 0.15. Group 3B kidneys all showed a continuous decline of MP/Pi, with a mean loss of 0.26 +/- 0.09 from baseline values (mean 0.56 +/- 0.08) to nonviable levels of 0.28 +/- 0.12 within four hours of transplantation. We conclude that MP/Pi ratios enable assessment of renal viability and ischemic damage and can predict the efficacy of renal preservation maneuvers in the dog kidney. These preliminary data support the theory that MRS can be applied to the noninvasive assessment of viability in ex vivo, cold-stored cadaveric human kidneys awaiting renal transplantation. PMID- 3534323 TI - Long-term hemodynamic and clinical sequelae of lower extremity deep vein thrombosis. AB - Forty-seven patients with phlebographically confirmed lower extremity deep vein thrombosis (DVT) were reexamined 5 to 10 years (mean, 7 years) after the thrombotic event. Clinical symptoms were recorded and the following noninvasive venous vascular laboratory tests were performed: Doppler examination to determine venous valve competence and photoplethysmography to measure ambulatory venous pressure and venous recovery time. Twenty-eight control subjects underwent similar examination. Although only 10 of 47 patients (21%) were asymptomatic, venous ulceration had developed in only two patients. The symptomatic patients had varying degrees of edema, pigmentation, and varicosities. Eighty-three percent of DVT patients had abnormal vascular laboratory findings. Both the severity of clinical symptoms and the magnitude of the hemodynamic abnormalities generally correlated with the extent of the initial thrombus. However, only 47% of patients whose initial thrombus appeared limited to the calf were asymptomatic, and only 25% of this group had normal venous hemodynamic findings. This study indicates that 5 to 10 years after lower extremity DVT 80% of patients will have both symptoms and abnormal venous hemodynamics regardless of the initial site of the thrombosis. PMID- 3534324 TI - Noninvasive diagnosis of renal artery stenosis by ultrasonic duplex scanning. AB - We retrospectively studied the results of duplex scanning for evaluation of renal artery disease in 158 patients. Satisfactory examinations were achieved in 144 patients (90%). Arteriograms were available for 43 renal arteries. We used the ratio of the peak velocities in the renal artery and the aorta (RAR) to separate nonstenotic arteries (less than 60% diameter reduction) from stenotic arteries (greater than 60% diameter reduction). With an RAR of greater than 3.5 to indicate stenotic lesions, duplex scanning had a sensitivity of 91% (20 of 22 diseased arteries correctly identified) and specificity of 95% (20 of 21 normal or insignificantly diseased arteries correctly identified). One of four occluded arteries was incorrectly interpreted as patent because of misidentification of a collateral vessel. Prospective studies will be necessary to validate this test and establish other criteria for a more detailed classification of renal artery stenosis. The ratio of the end-diastolic to peak systolic velocities in the renal artery (EDR) tended to decrease with increasing serum creatinine levels, presumably because renal vascular resistance increases with end-stage parenchymal disease. EDR may prove useful in the detection of advanced parenchymal disease before renal artery revascularization is attempted. PMID- 3534325 TI - A comparison of B-mode real-time imaging and arteriography in the intraoperative assessment of carotid endarterectomy. AB - In this study we compare intraoperative B-mode imaging with arteriography in the same patient for intraoperative assessment after carotid endarterectomy. Since April 1983, 158 patients have been studied with both techniques. After a routine intraoperative arteriogram, the vessel was examined in multiple planes with a B mode imager, and the impression of the operating surgeon was recorded before review of the arteriogram. Thirteen studies were unsatisfactory because the design of the probe did not allow examination of the high carotid bifurcation. Twelve patients had significant abnormalities (8.3%) in the internal carotid artery. Results were false negative in three intraoperative arteriograms (2.1%) and five B-mode imaging studies (3.4%). In each of the 12 cases the vessel was reopened and the abnormality confirmed and corrected. Fifty-seven patients had abnormalities (37%) in the external carotid artery. Results were false negative in eight arteriograms (5.3%) and in 12 B-mode imaging studies (7.9%). Fourteen of the 57 patients with abnormalities of the external carotid artery underwent repeat operation to correct the technical problem. Although not conclusive, the incidence of postoperative neurologic deficit as well as that of recurrent carotid stenosis seems decreased since both modalities for intraoperative assessment were used. The data suggest that neither intraoperative angiography nor B-mode imaging, when used alone, accurately detects all postoperative abnormalities. The results also suggest that a heightened sensitivity to technical details may improve both early and late postoperative morbidity. PMID- 3534326 TI - Quantitative analysis of continuous-wave Doppler spectral broadening for the diagnosis of carotid disease: results of a multicenter study. AB - This article reports the results of a multicenter study that compares 333 frequency analysis studies with the continuous-wave Doppler method with angiography. With receiver operating characteristic curves, the study documents the accuracy of the Doppler technique for the diagnosis of extracranial carotid arterial stenosis greater than 45% diameter reduction. It confirms the accuracy of the measurement of the maximal peak Doppler frequency and, in addition, shows that quantitative analysis of the instantaneous Doppler spectrum at peak systole by the measurement of the spectral broadening index is of diagnostic value. Likelihood ratios have been calculated with the use of curve-fitting techniques and it has been demonstrated how both the peak frequency and the spectral broadening index can be used together to improve the certainty of diagnosis. It is concluded that the probability that an individual patient has significant carotid arterial disease can be determined with the measurements of peak frequency and spectral broadening index from the continuous-wave Doppler spectral waveform. PMID- 3534327 TI - Distribution of venous valvular incompetence in patients with the postphlebitic syndrome. PMID- 3534328 TI - Screening blood donors for HTLV-III antibody. PMID- 3534329 TI - Control, treatment of drug abuse have challenged nation and its physicians for much of history. PMID- 3534330 TI - Testing for streptococcal pharyngitis. PMID- 3534331 TI - The Agnew Clinic. PMID- 3534332 TI - Pulmonary vascular talc granulomatosis. PMID- 3534333 TI - Therapeutic response to lovastatin (mevinolin) in nonfamilial hypercholesterolemia. A multicenter study. The Lovastatin Study Group II. AB - Lovastatin (mevinolin), a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, was investigated in a double-blind, placebo-controlled multicenter study of 101 patients with nonfamilial primary hypercholesterolemia. Dosages varied from 10 to 80 mg/d in single or divided doses. Patients receiving 40 mg twice a day experienced mean total and low-density lipoprotein cholesterol reductions of 32% and 39%, respectively. High-density lipoprotein cholesterol levels tended to rise slightly and plasma triglyceride levels were moderately decreased. Adverse effects attributable to lovastatin were infrequent and no patient was withdrawn from therapy. In this study, lovastatin was a well tolerated and effective agent for the treatment of nonfamilial hypercholesterolemia. PMID- 3534335 TI - Cholesterol and coronary heart disease. A new era. PMID- 3534334 TI - Normal cholesterol levels with lovastatin (mevinolin) therapy in a child with homozygous familial hypercholesterolemia following liver transplantation. AB - Patients with homozygous familial hypercholesterolemia produce no normal low density lipoprotein (LDL) receptors, and as a result, LDL accumulates in plasma, causing severe premature atherosclerosis. Two years ago, liver transplantation was performed in a child with homozygous familial hypercholesterolemia, restoring LDL receptor activity to about 60% of normal and reducing the LDL cholesterol level by 81%. However, the patient's lipoprotein levels remained significantly elevated for her age and sex. Treatment with lovastatin (mevinolin) one year after transplantation produced a marked improvement in the patient's lipoprotein profile. The total and LDL cholesterol levels fell 40% and 49%, respectively, to values within the normal range. The level of very low-density lipoprotein cholesterol fell 41%, and the level of total triglycerides declined 28%. While lovastatin therapy decreased the production rate of LDL by 35%, it did not affect the LDL fractional clearance rate. Thus, the combination of liver transplantation and lovastatin restored total and LDL cholesterol levels to normal in this patient with homozygous familial hypercholesterolemia. PMID- 3534336 TI - Landmark article, July 18, 1953: Coronary disease among United States soldiers killed in action in Korea. Preliminary report. By William F. Enos, Robert H. Holmes and James Beyer. PMID- 3534337 TI - Landmark perspective: Coronary atherosclerosis in soldiers. A clue to the natural history of atherosclerosis in the young. PMID- 3534338 TI - Four years of replacing ailing hearts: surgeons assess data, questions remain. PMID- 3534339 TI - Influence of diabetes mellitus on the results of coronary bypass surgery. Follow up of 212 diabetic patients ten to 15 years after surgery. AB - To determine the long-term influence of the severity of preoperative diabetes mellitus on the results of coronary bypass, a review was made of 212 diabetics operated on between 1968 and 1973, of whom 87 patients (41%) were receiving no drugs, 108 patients (50.9%) were receiving oral hypoglycemic agents, and 17 patients (8%) were receiving insulin. They were compared with 1,222 nondiabetic patients operated on over the same period. Perioperative mortality was similar in the diabetics and nondiabetics: 7.1% vs 4.5%. Improvement in anginal symptoms was similar in all patient groups: 85.9% to 92.7%. Overall 15-year survival probability was .53 for the nondiabetic group, .43 for the diabetics not receiving drugs, .33 for those receiving oral agents, and .19 for the insulin treated patients. Late graft patency ranged from 78% to 90% and was comparable in all groups. The preoperative blood glucose level was an important predictor of late mortality in all diabetic patients. Thus, coronary bypass surgery was effective in all groups of diabetic patients in long-term relief of anginal symptoms. Intermediate-term survival rates were good in all groups, but the initial severity of the diabetes was an important determinant of long-term survival rates. PMID- 3534340 TI - The total artificial heart as a bridge to transplantation. A report of two cases. AB - In 1985, at the University of Arizona, Tucson, two attempts were made to "bridge" patients from impending death to heart transplantation, using orthotopically positioned total artificial hearts. The first attempt, using an unapproved device on an emergency basis, failed after transplantation because of severe pulmonary edema and Pseudomonas pneumonia and the apparent transmission of a Pseudomonas infection from donor to recipient. The second experience, using a Jarvik-7 device, led to stable support for nine days with one major complication, a reversible neurologic deficit with no associated computed tomographic scan abnormality. This patient survived cardiac transplantation and, after being successfully treated for complications, has made a full recovery and returned to full-time work. PMID- 3534341 TI - Disseminated Trichosporon beigelii (cutaneum) infection in an artificial heart recipient. AB - A 44-year-old man with end-stage ischemic cardiomyopathy was supported with an intra-aortic balloon and The Penn State Heart (artificial) prior to orthotopic cardiac transplantation on the 14th hospital day. At the time of transplantation, intraoperative cultures of pericardial and mediastinal fluid showed growth of Trichosporon beigelii (cutaneum). Shortly thereafter the patient developed visceral dissemination of T beigelii with no associated skin lesions. He was treated with amphotericin B and rifampin, but postmortem examination showed persistent, disseminated infection. PMID- 3534342 TI - [History of epidural anesthesia in Japan]. PMID- 3534343 TI - [Effects of PEEP on myocardial blood flow and cardiovascular hemodynamics]. PMID- 3534344 TI - [First intratracheal anesthesia in Japan--achievements of Drs. Hayashi and Watanuki]. PMID- 3534345 TI - [A clinical study on imipenem/cilastatin sodium in the field of pediatrics]. AB - A clinical study on imipenem/cilastatin sodium (MK-0787/MK-0791) was carried out and the following results were obtained. MK-0787/MK-0791 was used for treatment of a total of 33 patients and clinical effectiveness, bacteriological efficacy and adverse reactions were evaluated. The clinical effects were excellent in 1 case, good in 21 cases and fair in 2 cases in a total of 24 cases with respiratory tract infections, were excellent in 5 cases and good in 1 case in a total of 6 cases with urinary tract infections, and were good in 2 cases and fair in 1 case in a total of 3 cases with gastroenteritis. Causative organisms isolated from 11 patients were 1 strain of Gram-positive cocci and 10 strains of Gram-negative bacilli. Ten out of 11 strains were eradicated for an eradication rate of 91%. The clinical efficacy was confirmed in 11 cases for an efficacy rate of 100%. The bacteriological study has shown that MK-0787/MK-0791 has a strong antimicrobial activity. No side effects were observed. There was only one abnormal laboratory finding, i.e., a case of eosinophilia. PMID- 3534346 TI - [Basic and clinical studies on imipenem/cilastatin sodium in the pediatric field]. AB - Basic and clinical studies have been performed on imipenem/cilastatin sodium (MK 0787/MK-0791) in the pediatric field. Antibacterial activities of MK-0787 against 14 clinical isolates of S. aureus and 67 isolates of E. coli were determined. The MIC of MK-0787 was 0.10 microgram/ml or less against all 14 strains of S. aureus. The MIC of MK-0787 was 0.39 microgram/ml or less against all 67 strains of E. coli. The pharmacokinetics of MK-0787/MK-0791 was studied at dose levels of 10 mg/10 mg/kg and 20 mg/20 mg/kg. The peak serum levels of MK-0787 achieved approximately 1 hour after the administration of 10 mg/10 mg/kg and 20 mg/20 mg/kg doses were 38.6 micrograms/ml and 36.2 micrograms/ml, respectively. The serum half-lives were 0.8 hour and 0.9 hour, respectively. The total 6-hour urinary excretions were 82.1% and 66.7%, respectively. The MK-0787/MK-0791 was administered to 13 children with bacterial infections. The clinical results were excellent or good in all cases. The overall efficacy rate was 100%. As a side effect, diarrhea was observed in 1 patient. Abnormalities in laboratory findings observed were elevation of direct bilirubin in 1 patient, thrombocytosis in 2, and a prolonged prothrombin time in 1 patient. Based on the above results, it can be concluded that MK-0787/MK-0791 is a safe and effective drug to use for the treatment of pediatric infections. PMID- 3534347 TI - [Bestrabucil-induced complete remission in a case of follicular lymphoma, medium sized cell type, stage IV (leukemic)]. AB - Bestrabucil, a chlorambucil-estradiol conjugate known to accumulate in malignant cells irrespective of the presence or absence of estrogen receptor, was administered to a 41-year-old man with follicular lymphoma, medium-sized cell type (LSG classification) stage IV (leukemic). A daily dose of 100 mg was given for two weeks and then 200 mg for a week. The WBC dropped from 43,100/mm3 with 82% abnormal lymphocytes to 12,800/mm3, and the drug was discontinued. It was resumed two weeks later at a daily dose of 50 mg. Four weeks thereafter, complete remission was obtained with the disappearance of all peripheral adenopathies and abnormal cells from the bone marrow. The patient remains disease-free for more than eight months on a maintenance dose of 50 mg per day. Transient erythema and gynecomastia have been the only side effects so far observed. PMID- 3534348 TI - Antiemetic efficacy of high-dose intravenous metoclopramide and dexamethasone in patients receiving cisplatin-based chemotherapy: a randomized controlled trial. AB - High-dose intravenous (IV) metoclopramide has shown efficacy with few side effects for the treatment of nausea and vomiting on the day of cisplatin administration. From November 1984 to January 1986, two randomized trials in an antiemetic study were conducted. In trial I, the antiemetic effect of a short course of high-dose dexamethasone was compared with that of high-dose metoclopramide in 29 patients with lung cancer receiving chemotherapy containing cisplatin (80 mg/m2 IV) in a randomized controlled trial. Dexamethasone was given IV at a dose of 16 mg 1/2 hr before and 8 mg, 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Metoclopramide was given IV at a dose of 2 mg/kg, 1/2 hr before and 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Major emetic control (0-2 episodes of vomiting) during the 24 hr after cisplatin administration was achieved in 55% (6/11) and 67% (12/18) of the patients receiving dexamethasone and metoclopramide, respectively, without serious toxicity. The duration of nausea or anorexia was similar for the two treatment groups. In trial II, the combination of metoclopramide and dexamethasone was compared with metoclopramide alone to assess the additive antiemetic effect of the two drugs in 23 patients with lung cancer receiving cisplatin at a dose of 120 mg/m2 IV in a randomized cross-over study. A major antiemetic response was observed in 27% (3/11) and 92% (11/12) of the patients receiving metoclopramide alone and metoclopramide plus dexamethasone, respectively (p less than 0.005). The duration of nausea and anorexia was similar for the two treatment groups. Patients tended to prefer the combination of metoclopramide and dexamethasone; however, the difference was not statistically significant (p = 0.14) in the small number of patients entered in this study. Despite excellent control of acute chemotherapy-induced emesis, 45% of 52 patients experienced delayed nausea and vomiting more than 24 hr after cisplatin administration even among those who had had an excellent short-term response to the antiemetic agents. PMID- 3534349 TI - [Diagnostic methods in liver diseases]. PMID- 3534350 TI - [Liver function tests: analysis of HB antigens and antibodies--HBs, HBc, and HBe antigens and antibodies]. PMID- 3534351 TI - [Liver function tests: serologic diagnosis (non-specific reactions). B. Paul Bunnell and cold agglutinin reactions]. PMID- 3534352 TI - [Liver function tests: ICG plasma clearance test]. PMID- 3534353 TI - [Liver function tests: metabolic detoxication test]. PMID- 3534355 TI - [Diagnosis of liver diseases by ultrasonics and computer tomography]. PMID- 3534354 TI - [Hepatic angiography]. PMID- 3534356 TI - [Liver function tests: blood coagulation and fibrinolysis tests]. PMID- 3534357 TI - [Peripheral lymphocyte examination--evaluation and application of the tests in the diagnosis of liver disease]. PMID- 3534358 TI - [Liver diseases and computer diagnosis: computer-assisted diagnosis programs in liver diseases and their clinical application]. PMID- 3534359 TI - [Liver diseases and computer diagnosis: diagnosis of liver diseases by computers using information on various protein components]. PMID- 3534360 TI - [Analysis of bile components in the serum: bilirubin, urobilin and bile acids]. PMID- 3534361 TI - [Liver diseases and computer diagnosis: test items and prognosis]. PMID- 3534362 TI - [Liver function tests: analysis of serum transferases and oxidoreductases]. PMID- 3534363 TI - [Liver function tests: analysis of non-protein nitrogen, BUN, NH3 and amino acids]. PMID- 3534364 TI - [Liver function tests: analysis of serum lipids--lipid peroxides, total cholesterol, cholesterol esters, free fatty acids, triglycerides and apolipoproteins]. PMID- 3534365 TI - [Liver function tests: blood sugar examination--blood glucose analysis and glucose tolerance test]. PMID- 3534366 TI - [Ultrasonic diagnosis of metastatic liver neoplasms]. PMID- 3534367 TI - [Dose response: is it present in clinical radiotherapy?]. PMID- 3534368 TI - [Ultrasonographic evaluation of gastric anisakiasis]. PMID- 3534369 TI - [A case of focal fatty infiltration of the liver]. PMID- 3534370 TI - [A case report of retroperitoneal hemorrhage in a 2-year-old male with hemophilia A]. PMID- 3534371 TI - [Complication of IVDSA--a case of mediastinal extravasation with a closed end catheter]. PMID- 3534372 TI - [Intra-venous digital subtraction angiography of arterial occlusive disease of the lower limb]. PMID- 3534373 TI - [Clinical experience with the new external pressure dressing band]. PMID- 3534374 TI - Ultrastructural studies on the effect of Triton WR-1339 on macrophage mycobacteria interaction. AB - Mycobacterium bovis (BCG organisms) suspended in saline or a 5% solution of a non ionic detergent, Triton WR-1339, was injected intraperitoneally into mice. Electron-microscopic observation was carried out on peritoneal exudate cells harvested therefrom. Electron-lucent vacuoles limited by the membrane structure were found in macrophages of the mice injected with BCG suspended in the detergent, but not in polymorphonuclear leukocytes or lymphocytes. Mycobacterial cells were present within such vacuoles. Without the detergent, the ingested mycobacterial cells were in close contact with the phagosomal membrane. Within the electron-lucent vacuoles, however, such close contact was not present. These observations, together with other collateral findings, led us to a view that Triton WR-1339 may inhibit the interaction between mycobacteria and the phagosomal membrane by intervening between them thus making the progress of infection delayed. PMID- 3534375 TI - [On the localization of enzymes in human spermatozoa. III. Esterase and acrosomal proteinase]. PMID- 3534376 TI - [Medicolegal document materials chronologically arranged in the Meiji Era (4)]. PMID- 3534377 TI - [Morphological and functional evaluation of the fetus--with special reference to ultrasonic diagnosis]. PMID- 3534378 TI - [Changes in the midwifery practice. 18. Contribution of Dr. Seki of the Ministry of Health and Welfare who incorporated his observation on the maternal health care policy of Nazi Germany into Japanese legislation]. PMID- 3534379 TI - [Urinary protein analysis of various renal diseases in childhood--significance of urinary protein analysis]. PMID- 3534380 TI - [Study of IgA nephropathy in the transplanted kidney--sequential changes in mesangial IgA deposits found one hour post-transplantation kidney biopsies]. PMID- 3534381 TI - [Systemic hemodynamics and intrarenal blood flow distribution in glycerol-induced acute renal failure in the rats]. PMID- 3534382 TI - [Effect of Ca antagonist on prostaglandins and thromboxane B2 in blood and urine]. PMID- 3534384 TI - [A pioneer in the postwar nursing in Japan Ms. Tsuru Akai]. PMID- 3534383 TI - [Computerized tomographic and ultrasonographic demonstration of renal hematomas following percutaneous renal biopsy]. PMID- 3534385 TI - [Modern clinical diagnosis. 10. Ultrasonic diagnosis]. PMID- 3534386 TI - [Background of literature search. Various types of literature]. PMID- 3534387 TI - [Background of literature search. Commentary: information retrieval in nursing: resources and their use]. PMID- 3534389 TI - [Background of literature search. Search for theoretical framework--literature search and evaluation for my Master's degree]. PMID- 3534388 TI - [Background of literature search. Commentary: a study of "amae" and my encounter with literature on "amae" and its related concepts]. PMID- 3534390 TI - [Background of literature search. The use of literature in the process of my experimental study]. PMID- 3534391 TI - [Background of literature search. method of search and its use in research]. PMID- 3534392 TI - [The approach to English language monograph: on the description of hypothesis and method of experimental research]. PMID- 3534393 TI - Relationship between hyperinsulinemia and risk factors of atherosclerosis. AB - In order to study the relationship between hyperinsulinemia and atherosclerosis, an examination was made on the relationship of hyperinsulinemia to the risk factors of atherosclerosis, using as subjects a total of 2,927 composed of Japanese resident in Hawaii and Los Angeles and Japanese resident in Hiroshima whose age ranged from 40 to 79 and who underwent oral glucose tolerance test in our Hawaii-Los Angeles-Hiroshima medical study between 1978 and 1982. The subjects were classified into five groups of comparable size according to fasting insulin level, studied on the various risk factors of atherosclerosis in each group. The results of this study showed that the hyperinsulinemia group had in comparison with the four other groups a higher mean body mass index, mean serum total cholesterol value and mean serum triglyceride value, and further had a higher prevalence of hypertension, diabetes mellitus, ECG abnormalities, hypercholesterolemia and hypertriglyceridemia. Moreover, the mean serum HDL cholesterol value was lower in the hyperinsulinemia group than in the other four groups. A similar examination was made with subgroups with normal body weight, and almost the same results were obtained. The above results suggest that hyperinsulinemia is rather strongly implicated in the development of atherosclerosis via a number of relationships though not specifically indicating that hyperinsulinemia independently is a risk factor of atherosclerosis. PMID- 3534394 TI - A case of Behcet's syndrome with rupture of a pulmonary aneurysm: autopsy findings and a literature review. AB - A 34 year old man suffering from oral and genital ulceration with uveitis (the complete type of Behcet's syndrome) developed fluctuating radiological opacities in the right lung and showed recurrent hemoptysis. Pulmonary angiography showed multiple aneurysms and obstruction of the pulmonary arteries. After he was treated with prednisolone, the symptoms and pulmonary manifestation improved temporarily. However, he died suddenly from a massive hemoptysis. An autopsy revealed the aneurysmal rupture of right basilar branch of pulmonary artery into the right B6 bronchus. Histopathological findings in the lung showed multiple organized thrombi, inflammatory infiltration and vascular wall destruction of pulmonary arteries of various sizes. Only 47 previously reported cases of Behcet's syndrome which showed pulmonary involvements were revealed by a search of the published literature. PMID- 3534395 TI - A case of renovascular hypertension with the nephrotic syndrome. AB - Nephrotic range proteinuria occurred in a 42-year-old woman with renal arterial occlusion and hyperreninemia. The administration of captopril, an angiotensin converting enzyme inhibitor, led to an amelioration of the proteinuria and the decrease of blood pressure, without surgical treatment. From the present observation, it is highly probably that the increased activity of the renin angiotensin system plays an important role in massive proteinuria. Conservative treatment for renovascular hypertension with nephrotic syndrome was effective in this patient. PMID- 3534396 TI - [History of early nursing education in Japan. Operation of the School of Nursing attached to Sakurai School for Girls described in correspondence with the U.S. Presbyterian Mission. Management of the nursing school]. PMID- 3534397 TI - [Early nursing education in Japan. The history of the nursing school associated with Sakurai High School for Girls described in the correspondence with the U.S. Presbyterian Mission. 3. The establishment of the Eiseien and the process leading to its closure]. PMID- 3534398 TI - Rapid cooling contracture. AB - In this minireview, the author summarized the works on rapid cooling contracture (RCC), including recent reports. RCC will be employed for studying the Ca2+ release mechanism from SR and mechanical properties during contraction. PMID- 3534399 TI - Effects of peptidase inhibitors on the [Met5]-enkephalin hydrolysis in ileal and striatal preparations of guinea-pig: almost complete protection of degradation by the combination of amastatin, captopril and thiorphan. AB - The contents of [Met5]-enkephalin and its four hydrolysis products, Tyr, Tyr-Gly, Tyr-Gly-Gly, and Tyr-Gly-Gly-Phe, in the sample obtained after enkephalin was incubated with tissues in either the absence or the presence of the peptidase inhibitor were estimated by high performance liquid chromatography combined with electrochemical detection in order to elucidate the effect of the peptidase inhibitor on enkephalin hydrolysis. Free Tyr was the major degradative product in the absence of the peptidase inhibitor, while the major hydrolysis product was the Tyr-Gly-Gly fragment in the presence of amastatin in both total homogenates and membrane fractions prepared from either the myenteric plexus-longitudinal muscle strip of guinea-pig ileum or the striatum of guinea-pig brain. Additionally, captopril significantly decreased the generation of Tyr-Gly-Gly in the presence of amastatin in both ileal and striatal membrane fractions. Moreover, thiorphan significantly prevented the formation of Tyr-Gly in the presence of both amastatin and captopril in both membrane preparations. Finally, when [Met5]-enkephalin was incubated with either an ileal or a striatal membrane fraction for 60 min at 37 degrees C in the presence of three peptidase inhibitors, amastatin, captopril, and thiorphan, approximately 98 or 94%, respectively, of enkephalin remained intact. The results indicated that [Met5] enkephalin was almost exclusively hydrolyzed by three distinct enzymes, amastatin sensitive aminopeptidase, captopril-sensitive peptidyl dipeptidase A, and thiorphan-sensitive endopeptidase-24.11 in both ileal and striatal membrane fractions. PMID- 3534400 TI - Responsiveness to vasoconstrictor and dilator agents of senescent beagle cerebral arteries. AB - With advancing age from 2 to 12 years, contractions of isolated beagle cerebral arteries mediated by histamine H1 and serotonin receptors increased, whereas those induced by noradrenaline and angiotensin II did not differ. Relaxations by vasodilator substances, such as prostaglandin (PG) I2, isoproterenol, adenosine and K+ (5 mM), and by stimulation of vasodilator nerves in the adult and senescent beagle arteries did not significantly differ. PMID- 3534401 TI - Right hepatic lobectomy for primary lymphoma: a case report and literature review. AB - Primary lymphoma of the liver is an extremely rare entity; only eight cases have been reported in the literature. We treated a 34-year-old man with primary hepatic lymphoma by right hepatic lobectomy, including right hemicolectomy the nephrectomy. The histological diagnosis was a small cell diffuse histiocytic lymphoma. Details of this case plus that of others in the literature are described in this report. PMID- 3534402 TI - Torsion of the gallbladder. AB - A 77-year-old Japanese woman with torsion of the gallbladder was surgically treated. Perhaps because of its rarity, the diagnosis is seldom made clinically, the condition generally being recognized only at laparotomy. Discussed herein are the possibility of preoperative diagnosis of this condition and the usefulness of ultrasonotomography. PMID- 3534403 TI - [Immunohistochemical study of renal cell carcinoma. I. Immunohistochemical studies on the cell skeleton in human renal cell carcinoma with special emphasis on intermediate filaments]. PMID- 3534404 TI - [Immunohistochemical study of renal cell carcinoma. II. Studies on glycocompounds and renal tubular antigen of renal cell carcinoma]. PMID- 3534405 TI - [Isoantigens ABH in bladder tumors as an indicator of malignant potential. Criteria for the loss of BGA based on the staining pattern by the PAP method and its correlation with CEA and fibronectin]. PMID- 3534406 TI - Profiles in courage: humanitarian medical aid to victims and refugees of the Soviet-Afghan war. PMID- 3534407 TI - Emergency care "high tech": implications for emergency nurses. PMID- 3534408 TI - "Remember who you are". PMID- 3534409 TI - "Dumping": interhospital patient transfers. PMID- 3534410 TI - Near death from a Gila monster bite. PMID- 3534411 TI - Implementing a career ladder program in the emergency department: one hospital's experience. PMID- 3534412 TI - Career ladders in nursing: an overview. PMID- 3534413 TI - ED patient classification matrix: development and testing of one tool. PMID- 3534414 TI - Converting patient classification data into staffing requirements for the emergency department. PMID- 3534415 TI - Acquired immunodeficiency syndrome: an update. PMID- 3534416 TI - Acquired immunodeficiency syndrome: legal issues in the emergency department. PMID- 3534418 TI - Neuroleptic malignant syndrome. PMID- 3534417 TI - Current ethical issues in emergency care. PMID- 3534419 TI - Nursing diagnosis in the emergency department. PMID- 3534420 TI - Calcium supplements. PMID- 3534421 TI - New federal law governs patient transfers: "antidumping" legislation enacted. PMID- 3534422 TI - Chest pain (nontraumatic) and alcohol problems. PMID- 3534423 TI - One dose of sodium spirit diffuser. PMID- 3534424 TI - Differential assessment of a child in respiratory distress. PMID- 3534425 TI - Effects of marrow grafting on preleukemia cells and thymic nurse cells in C57BL/Ka mice after a leukemogenic split-dose irradiation. AB - A split-dose regimen of whole-body irradiation (4 X 175 rad at weekly intervals) induced thymic lymphomas in C57BL/Ka mice after a latent period of 3-9 months. Meanwhile, preleukemia cells arose in the thymus and bone marrow and persisted until the onset of lymphomas. Simultaneously, thymic lymphopoiesis was impaired; thymocyte numbers were subnormal and thymic nurse cells disappeared in a progressive but irreversible fashion. The depletion of these lymphoepithelial complexes, which are normally involved in the early steps of thymic lymphopoiesis, was related to altered prothymocyte activity in bone marrow and to damaged thymic microenvironment, perhaps as a consequence of the presence of preleukemia cells. The grafting of normal bone marrow cells after irradiation prevented the development of lymphomas. However, marrow reconstitution did not inhibit the induction of preleukemia cells. They disappeared from the thymus during the second part of the latent period. At the same time, thymic lymphopoiesis was restored; thymocytes and nurse cell numbers returned to normal as a consequence of the proliferation of grafted marrow-derived cells within the thymus. The results thus demonstrated an intimate relationship between preleukemia cells and an alteration of thymic lymphopoiesis, which particularly involved the nurse cell microenvironment. Some preleukemia cells in marrow reconstituted, irradiated mice derived from the unirradiated marrow inoculate. Thus these cells acquired neoplastic potential through a factor present in the irradiated tissues. The nature of this indirect mechanism was briefly discussed. PMID- 3534426 TI - Passive smoking and lung cancer. PMID- 3534427 TI - The Kansas Medical Society. Membership directory 1986. PMID- 3534428 TI - [Plasma renin activity during different periods of the natural genetic history in genetically hypertensive rats]. PMID- 3534429 TI - [Treatment of peripheral arterial disease with prostacyclin. I. Effect of prostacyclin on the healing of ischemic ulcers of the lower extremities]. PMID- 3534430 TI - [Possibilities and limitations of the clinical evaluation of hyperkinetic circulation]. PMID- 3534431 TI - [Value of bacteriologic pharyngeal swabs for monitoring the individual and collective risk of infection in neonatal intensive care units]. PMID- 3534432 TI - Typical and atypical aspects of renin secretion from juxtaglomerular epithelioid cells. AB - A survey is given about features of renin synthesis and secretion from juxtaglomerular epithelioid cells that are largely atypical as compared to those of other secretory systems. Renin-producing cells have the capability of reversible metaplastic transformation into vascular smooth muscle cells, their secretory granules are very closely related to lysosomes, and they react paradoxically, i.e. with an inhibition instead of a stimulation of renin secretion, to a rise in intracellular free Ca++. The modes of renin secretion and activation of the enzyme as well as possible mechanisms involved in adjusting the ratio of secreted active to inactive renin to the current needs of the renin angiotensin system are discussed. PMID- 3534434 TI - [The profession of pediatric nurse in changing times. From the predecessor to the pediatric nurse]. PMID- 3534433 TI - [Problems of biocompatibility in hemodialysis treatment]. AB - Although hemodialysis is one of the best examined, and clinically best established, methods of patient treatment with artificial organs, a number of biocompatibility problems remain. This review discusses the problem of water quality. Recently, much concern has been focused on potential longterm risks from patients exposure to subthreshold concentrations of endotoxin in dialysate. Further problems comprise inorganic and organic contaminants, some of which with potential carcinogenetic hazards. Complement activation by, and thrombogenicity of, dialysis membranes have not been eliminated. Presumably, the hazards of complement activation are less acute shortterm reactions (which according to more recent studies appear to be ETO-related anaphylactoid reactions) but rather potential longterm hazards, e.g. beta 2 m related amyloid. However, the issue is not settled since we have recently found cell activation by dialysis membranes even in the absence of complement. Apart from membranes, dialysis tubing presents hazards, e.g. leakage of plasticizers and release of oligomers or radicals. The recognition of ETO as a potent immunogen, inducing antibodies detectable in approximately 40% of the dialysis population, will require to replace ETO as a sterilisant for dialysis devices. This demand is even more urgent in view of the recognized carcinogenicity of this alkylating agent. PMID- 3534435 TI - Mouse strain difference in bile duct lesions induced by swine serum injections. AB - The mouse strain difference in bile duct lesions was studied on male A/J, BALB/c, C57BL/6, C3H/He, DBA/2 and DDY mice 4 weeks old given intraperitoneal injections of swine serum (0.05 or 0.2 ml per mouse) twice a week for 4 weeks. The hepatic lesions were restricted to the portal tract. Biliary epithelial cells showed hypertrophy and hyperplasia, and eosinophilic and homogeneous or needle-shaped material appeared in the cytoplasm of such hypertrophied epithelial cells and in the ductular lumen. Around these damaged biliary epithelia, eosinophil leukocyte and plasma cell infiltration with proliferation of collagen fibres was commonly detected. These changes became more apparent with increasing size of bile duct. Such histopathological characteristics of hepatic lesions were essentially the same in all strains, but the severity showed a clear strain difference: the lesion was marked in the DDY, A/J and BALB/c strains, moderate in C3H/He and slight in C57BL/6 and DBA/2. A high production of anti-swine-serum antibodies associated with a marked increase in the number of mouse IgG-producing lymphocytes in the spleen was detected in the strains showing the marked hepatic lesions. PMID- 3534436 TI - The Yucatan miniature pig: characterization and utilization in biomedical research. AB - Yucatan miniature swine have a variety of applications in biomedical research. Sublines developed from the primary population at Colorado State University have been characterized genetically with special attributes. This report describes this unique laboratory animal, genetic selection programs, and its utilization in biomedical research. PMID- 3534437 TI - Swine in cardiovascular research. AB - Swine are being chosen with increasing frequency as subjects for cardiovascular research. Similarities to humans in their cardiovascular physiology, size, anatomy, and the perfusion distribution of blood flows make them better subjects than most species. In addition, swine can be less expensive than dogs and primates and they generally are not associated with the same high concern as other species about humane issues. PMID- 3534438 TI - Anatomic and anesthetic considerations in experimental cardiopulmonary surgery in swine. AB - We have used immature commercial swine (13-25 kg) successfully in a variety of experimental cardiopulmonary surgical procedures in our laboratories since 1981. Multiple drug anesthetic protocols using barbiturates, narcotics, paralytic and antiarrhythmic agents have been employed in over 400 procedures per year. Complications, including fatal cardiac arrhythmias, have been greatly reduced by anesthetic protocols and surgical procedures developed through experience. PMID- 3534439 TI - The pig as a model for behavioral research. AB - Behavioral studies of pigs have been carried out mainly for applied purposes, ranging from improvement in animal production to animal welfare issues. Since this research generally has made use of easy to measure behavioral end points, there is a relative lack of quantitative descriptions of behavioral sequences and of studies of mechanisms. For behaviorists, pigs present many interesting characteristics in their sensory-perceptual world and in the expression of some of their activities. Therefore, there is potential for more detailed behavioral studies in this species and some possibilities are presented. PMID- 3534440 TI - The impact of handling and environmental factors on the stress response and its consequences in swine. AB - This review examines the effects of handling by humans and housing systems on physiological stress and some consequences in swine. Small amounts of threatening behavior by humans, imposed either regularly or irregularly, can produce a chronic stress response, as evidenced by increases in plasma free corticosteroid concentrations resulting in adverse effects on avoidance behavior, growth and reproductive performance. Housing systems involving a high level of confinement can result in a chronic stress response in swine with adverse effects on metabolism and the immune system. This stress response may be the result of unstable social relationships and can be ameliorated by the design of housing systems. PMID- 3534441 TI - Endotoxemia in Yucatan miniature pigs: metabolic derangements and experimental therapies. AB - Endotoxemia is a frequent complication of many health disorders. It is characterized by systemic release of a variety of endogenous inflammatory mediators which effect cardiovascular depression, reductions in organ blood flow, tissue ischemia and derangements in cellular metabolism leading to death. During a continuous intravenous infusion of Escherichia coli lipopolysaccharide, the chronology of alterations in hepatosplanchnic blood flow, hepatic carbohydrate metabolism and pancreatic insulin secretion has been studied in awake Yucatan miniature pigs (Sus scrofa). Endotoxic shock in this model is characterized by reductions in portal venous and hepatic arterial blood flow, early transient increases in pancreatic insulin secretion, increases in the 3H-glucose-derived rates of glucose appearance and disappearance, profound hypoglycemia, hyperlactatemia and metabolic acidosis. Reductions in hepatic oxygen delivery are compensated for by enhanced oxygen extraction efficiency, but hepatic gluconeogenesis continues at an inadequate rate to compensate for increased glucose utilization. Experimental therapies including lidocaine, naloxone, captopril, dichloroacetate and glucagon each effect specific improvements in cardiovascular or metabolic function, but none significantly alter the composite derangements responsible for lethality in this model. PMID- 3534442 TI - Anesthetic, preoperative and postoperative considerations for liver transplantation in swine. AB - Perioperative care and anesthetic management of donor and recipient animals are crucial factors in studies involving experimental liver transplantation in the pig. Prevention of unacceptably high morbidity and mortality in the transplant recipients requires meticulous attention to anesthesia, preoperative and postoperative care. Liver transplant surgeries were performed using 15 pairs of pigs. Six of the transplant recipients were anesthetized with halothane plus 50% nitrous oxide (N2O) and oxygen (O2), and nine with isoflurane plus 50% N2O in O2. Arterial blood pressure, total anesthetic time, time of interruption of vena cava blood flow, and fluids administered, as well as length of survival were among the parameters measured and compared for the two groups. No deaths were attributed to either anesthetic technique. However, the isoflurane group had slightly higher blood pressure intraoperatively, better long range survival, and relatively rapid recoveries when compared to the halothane group. Because of these findings and the reported low rate of isoflurane metabolism and low resultant potential for formation of toxic metabolites when compared to halothane metabolism, we have elected to use the isoflurane-50% N2O regimen for this procedure. PMID- 3534443 TI - The pig as an experimental animal in plastic surgery research for the study of skin flaps, myocutaneous flaps and fasciocutaneous flaps. AB - The pig serves as an excellent model of skin flap research. Many flap types are available and flap designs can be modified easily for specific experimental requirements. Swine are large enough to permit multiple flaps and the skin color allows subjective observations of tissue circulation. PMID- 3534444 TI - Laboratory animal models for human scrub typhus. AB - A wide variety of animals have been utilized in an attempt to provide the information necessary to bring scrub typhus to the point where it is no longer a threat to man. The laboratory mouse is usually the animal of choice for the study of this disease. The discovery that certain strains of inbred mice are genetically resistant to Rickettsia tsutsugamushi, the agent of scrub typhus, has opened new avenues in the study of the immune response to the disease. The cynomolgus monkey, Macaca fascicularis, appears to be the best animal model for the study of scrub typhus as it occurs in humans and should be useful in the development of an efficacious vaccine. PMID- 3534445 TI - Spontaneous diabetes mellitus in a baboon (Papio cynocephalus anubis). PMID- 3534446 TI - Demonstration of OKT6 antigen on human thymic dendritic cells in culture. AB - In situ, two types of dendritic cells (DCs) have been characterized in more detail: the interdigitating DCs of peripheral lymphoid tissues and the epidermal Langerhans cells. In order to characterize human thymic DCs, normal human thymus specimens were obtained from children undergoing cardiovascular surgery. In culture, DCs could be easily differentiated from macrophages and epithelial cells by their long fine processes, irregular nucleus, and dark, membrane-bound granules. By immunoelectron microscopy, using the protein A-gold and the avidin biotinperoxidase complex techniques, cultured DCs were strongly labeled with anti Ia and anti-OKT6 monoclonal antibodies. These results demonstrate that the phenotype of thymic DCs is similar to that of epidermal Langerhans cells and suggest that they may belong to the same cellular lineage. PMID- 3534447 TI - In vivo induction of Ia antigen in resident leukocytes in the normal rat renal glomerulus. AB - The normal rat glomerulus contains a mesangial population of mononuclear leukocytes, 35 to 70% of which express class II major histocompatibility complex antigen (equivalent to mouse Ia) Schreiner GF, Unanue ER: Lab Invest 51:515, 1984. Inducing factors for cellular expression of class II antigens in normal leukocytes are unknown. In this population, glomerular leukocyte origin and Ia expression have been studied in kidneys from bone marrow-irradiated Lewis rats transplanted into normal syngeneic recipients. Leukocytes (LC+) and Ia positive (Ia+) cells were enumerated in isolated glomeruli by immunofluorescence using monoclonal antibodies to rat common leukocyte antigen (MRC OX1) and rat Ia antigen (MRC OX3, and OX4). Irradiation to donors caused extreme depletion of glomerular LC+ cells. Twenty-four hours after renal transplantation into normal recipients the glomerular LC+ population was restored to 65% of normal, and by 3 days was complete. In contrast Ia+ cells which were also depleted by irradiation, remained low 24 hours post-transplantation and only reached normal levels after 4 days. Thus, Ia antigen expression is induced in a population of leukocytes derived from circulating mononuclear leukocytes after a residence time of 3 to 4 days in the glomerulus. While the glomerular factors responsible are unknown, these experiments provide the first evidence for in vivo basal Ia induction in a normal resident mononuclear leukocyte population. PMID- 3534448 TI - Nephronophthisis. A primary tubular basement membrane defect. AB - In order to characterize abnormalities in nephronophthisis, renal tissues from four patients were studied by light and electron microscopies and immunofluorescence using antibodies to laminin, type IV collagen, and tubular basement membranes (TBM). There were constant morphological alterations affecting TBM of all segments of the nephron, with or without cysts. These included extreme thinning and attenuation, layering, and thickening of these structures which ranged in size from 36 nm to 2000 nm. A combination of these features often affected the same TBM simultaneously, with abrupt transitions between different lesions. Although the ultrastructural TBM aberrations were observed in a wide variety of other chronic and acute renal disorders, they rarely occurred to the extent as in nephronophthisis or with abrupt transitions, both suggesting diagnostic significance. Laminin and type IV collagen were present in normal intensity and distribution, however, anti-TBM antibody staining was inconstantly reduced, perhaps signifying lack of a normal antigenic component in the TBM. These findings may well indicate the fundamental defect in nephronophthisis to be production of abnormal TBM, similar to the glomerular basement membrane lesions and consequences in Alport's syndrome. PMID- 3534449 TI - Relationship between increased vascular permeability and extravascular albumin clearance in rabbit inflammatory responses induced with Escherichia coli. AB - Intradermal injections of killed Escherichia coli are known to cause a variety of pathophysiological changes in the microcirculation that facilitate the extravasation of plasma constituents into the interstitium. In an attempt to learn more of the factors that regulate the magnitude and duration of inflammatory edema, we have focused on the relationship between the extravasation of protein into the interstitium and the removal of extravascular protein from the lesion sites. Vascular permeability changes have been assessed by the local accumulation of systemically administered [131I] or [125I]-albumin and extravascular protein clearance measured by monitoring the disappearance of [125I]-albumin from the same sites. Radioactivity was quantitated with an external gamma-scintillation probe or by punching out the lesion sites in sacrificed animals and counting in a gamma-spectrometer. Scintillation probe measurements of the net accumulation of intravenously administered [125I]-albumin in E. coli-induced skin lesions revealed that the extravasation of albumin was greater than the clearance of protein from the same sites. Comparisons of the removal rates of albumin injected directly into the E. coli sites revealed that, despite increases in vascular permeability amounting to 170 to 700% of control values, the mobilization of deposited albumin was no greater than that from control tissues that received saline; in fact with high concentrations of E. coli (10(8) injected/site) the mobilization of protein from the lesions was significantly reduced. The systemic administration of 055:B5 endotoxin (0.3, 1.6, or 3.3 micrograms/kg) also suppressed the clearance of albumin from skin. In contrast to these results, 300 to 1500% increases in vascular permeability induced with other inflammatory stimuli including thermal injury, high concentrations of bovine serum albumin, or bradykinin, resulted in enhanced clearance of extravascular protein from lesion or injection sites. These experiments suggest that an inability to effectively mobilize extravascular protein from the inflammatory focus could be a major contributing factor in regulating edema in inflammatory reactions induced with E. coli and may possibly contribute to the edema associated with septicemia. PMID- 3534450 TI - Immunohistochemical localization of the epidermal growth factor receptor in normal human tissues. AB - A monoclonal antibody recognizing an epitope of the external domain of the human epidermal growth factor (EGF) receptor was used to localize this protein in selected normal human tissues. Two patterns of reactivity were recognized: strong linear or granular cell surface staining, and granular cytoplasmic staining. In one tissue, the endometrium, a change in the reaction pattern associated with changes in hormonal stimulation was observed. In some tissues such as epididymis and skin, the antibody showed surface reactivity with cells considered to represent part of the proliferating cell compartment, whereas in liver, pancreas, and prostate, all cells were reactive with the antibody, though the predominant reactivity was localized in the cytoplasm. The differential distribution of the epidermal growth factor receptor to specific cell types and cellular compartments may signify adaptations that permit growth factor responsiveness in a milieu of available ligand. PMID- 3534451 TI - Heterogeneous effects of inhibitors of receptor processing on insulin binding and intracellular accumulation in various cell types. AB - This study utilized uniform incubation conditions and demonstrated heterogeneity in the effects of various agents on 125-insulin binding and intracellular accumulation in five cell types. The cells used in this study included rat adipocytes, H4IIEC3 cultured hepatoma cells, normal human fibroblasts, and 3T3-L1 preadipocytes and adipocytes. Bacitracin increased insulin binding to rat adipocytes but inhibited binding to all other cells. Chloroquine increased total cell-associated insulin in all cells except H4IIEC3 hepatoma cells. Methylamine and dansylcadaverine increased or decreased binding depending on cell type. Similar heterogeneity was found in the intracellular accumulation of insulin. Under control conditions, intracellular insulin at steady state varied from 16 to 52% of the total cell-associated insulin. Bacitracin decreased intracellular accumulation of insulin in 3T3-L1 adipocytes, preadipocytes, and human fibroblasts but increased accumulation in rat adipocytes. Chloroquine increased insulin accumulation in all cell types except H411EC3 hepatoma cells. Both methylamine and dansylcadaverine increased intracellular insulin in rat adipocytes and decreased accumulation in human fibroblasts. These results provide additional evidence of heterogeneity in insulin and/or insulin receptor processing among different cell types. PMID- 3534452 TI - Josiah Clark Nott, M.D., 1804-1873. PMID- 3534453 TI - John Lawrence Ancrum, M.D. 1839-1900. PMID- 3534454 TI - Waller Hunn Nardin, M.D. PMID- 3534455 TI - Elocutionary utterances, medical education and Samuel Henry Dickson, M.D. PMID- 3534456 TI - Daniel Flud, M.D. PMID- 3534457 TI - Eli Geddings, M.D. (1799-1878). PMID- 3534458 TI - A developmental approach to pregnancy prevention with early adolescent females. AB - Traditional pregnancy prevention strategies employed with adults and older teens do not recognize significant developmental differences between early adolescents and other age groups. Methods that compliment, reflect, and are consistent with developmental needs of the young teen provide cogent approaches to teen pregnancy prevention. Particular emphasis should be placed on interpersonal relationships and their importance in the young woman's life, especially the relationship between the young teen and her parents. Developing and improving all relationships instrumental in positively affecting teen decision-making represent potent approaches to pregnancy prevention. The axioms of Piaget, Erikson, and Mercer are examined in regard to cognitive, social, emotional, and psychosexual development in the 12-14 year old. Young teens' responses to sex education as well as their use of contraception are reviewed in relation to developmental theory. PMID- 3534459 TI - Self-efficacy and health education. AB - Bandura's theory of self-efficacy has been applied in many areas of health education including smoking cessation, pain control, eating problems, cardiac rehabilitation, and adherence to regimens. Consequently, self-efficacy has emerged as an important concept with which health educators should be familiar. Self-efficacy refers to one's belief in the ability to do a specific behavior. Self-efficacy is a principle connection between knowledge and action since the belief that one can do a behavior usually occurs before one actually attempts the behavior. Self-efficacy also affects the choice of behavior, settings in which behaviors are performed, and the amount of effort and persistence to be spent on performance of a specific task. This article will examine self-efficacy theory, describe sources of self-efficacy, and present applications of self-efficacy theory. PMID- 3534460 TI - Incidental language teaching: a critical review. AB - Incidental language teaching refers to interactions between an adult and a child that arise naturally in an unstructured situation and are used systematically by the adult to transmit new information or give the child practice in developing a communication skill. The purposes of this paper are to review and critique current research on incidental language teaching, briefly discuss the theoretical reasons why incidental teaching might be expected to be effective, and to discuss directions for future research on this teaching approach with children who are language impaired and mentally retarded. PMID- 3534461 TI - Therapy and research: response to Siegel and Spradlin (1985) PMID- 3534462 TI - Galactose clearance as an estimate of effective hepatic blood flow: validation and limitations. PMID- 3534463 TI - Estradiol inhibition of pituitary luteinizing hormone release is antagonized by serum proteins. AB - We tested the influence of protein binding upon the rapid 17 beta-estradiol (E2) inhibitory effect on luteinizing hormone (LH) responsiveness to LH releasing hormone (LHRH) in perifused rat anterior pituitaries. LHRH pulses were given before 1 h after changing the perifusion medium to contain various combinations of protein and E2. In the absence of albumin an E2 concentration of about 27 pg/ml inhibited LH secretion in response to LHRH by 50% (judged from the change in secretion ratio, i.e LH response to LHRH pulse no. 2 divided by that to pulse no. 1). Albumin (1 g/dl) and human plasma enhanced the self-priming effect of LHRH (P less than 0.1) and blunted the slope of the dose-response relationship between E2 and LH secretion. These effects suggest a stimulatory effect of proteins on LH secretion which is independent of E2. However, proteins appear to antagonize the E2 effect in part by binding E2. A total E2 dose of 270 pg/ml or more was required to achieve about 50% inhibition of the LH secretion ratio in the presence of albumin. Since 20% of E2 was unbound in the presence of albumin, the 50% effective dose of free E2 was about 54 pg/ml. This closely approximates the comparably effective dose of E2 in the absence of protein. Although a total E2 concentration of 216 pg/ml was required for a 50%-inhibitory E2 effect in the presence of heat-inactivated plasma, this was equivalent to between 28 and 37 pg/ml of free E2 in these experiments. The effect of E2 in a total dose of 216 pg/ml was attenuated more by the use of TEBG-positive plasma than of TEBG negative (heat-inactivated) plasma (P less than 0.01). Our data indicate that the E2 inhibitory effect upon LH responsiveness to LHRH is attenuated by albumin and TEBG to approximately the extent expected by binding of E2 to these proteins. Our data are certainly contrary to those expected if either albumin or TEBG augmented this E2 action. Our data support the concept that the bioavailable fraction of plasma sex steroids is that which is free from binding to plasma proteins. PMID- 3534464 TI - Specificity and partial purification of a factor in spent media from Sertoli cell enriched cultures that stimulates steroidogenesis in Leydig cells. AB - There is increasing evidence that factors derived from the seminiferous tubules influence Leydig cell function in a paracrine way. In previous experiments we demonstrated that conditioned media from Sertoli cell-enriched cultures contain a protein with stimulatory activity on prepubertal rat Leydig cells. In this paper we further studied the specificity of this factor. In addition we describe a simple but efficient partial purification procedure. It is demonstrated that Sertoli cell conditioned media contain a factor that stimulates the testosterone output from prepubertal and adult Leydig cells. The effects are evident within the first hour of incubation and can be observed in the presence as well as in the absence of LH. Peritubular cells do not produce a similar factor but enhance the production of the Leydig cell stimulating factor when cocultured with Sertoli cells. The Sertoli cell factor acts on rat as well as on mouse Leydig cells. It barely influences the adrenostenedione output of ovarian stromal cells or the corticosterone output of adrenal cells. The production of this factor is enhanced by dbcAMP, FSH, L-isoproterenol and glucagon but is not affected by androgens. The characteristics of the Sertoli cell factor have been compared with those of a Leydig cell stimulating factor in the medium from an established rabbit kidney cell line: RK13. It is shown that the active principle in RK13 conditioned medium is also a thermolabile trypsin-sensitive protein with a mol. wt of more than 10,000. Nonetheless, the RK13 and Sertoli cell derived factors act by different mechanisms since at maximally effective concentrations their effects are additive. Finally it is demonstrated that molecular weight fractionation of Sertoli cell conditioned medium using an Amicon ultrafiltration system results in a 50- to 130-fold increase in Sertoli cell factor activity in a fraction corresponding to a mol. wt of 10,000 up to 30,000. PMID- 3534465 TI - Further characterization of a steroid receptor-active protease from the mature rabbit epididymis. AB - The nucleomyofibrillar fraction of mature rabbit epididymides contains a salt extractable and leupeptin-sensitive protease that alters the sedimentation coefficient of cytosolic steroid receptors. We refer to this modification as receptor conversion. The substrate used in these studies was cytosolic estrogen receptor obtained from frozen rabbit uteri. The unactivated form of the receptor exists as an oligomer under hypotonic (0.01 M KCl) conditions (S20,w congruent to 9.6, Stokes radius (Rs) congruent to 7.4 nm, Mr congruent to 320,000) and dissociates under hypertonic (0.4 M KCl) conditions to yield the steroid-binding monomer (S20,w congruent to 4.7, Rs congruent to 5.1 nm, Mr congruent to 104,000). According to analysis under hypotonic conditions, the epididymal protease disrupts the oligomeric architecture of the receptor and reduces the size of the steroid-binding monomer (S20,w congruent to 3.2, Rs congruent to 3.0 nm, Mr congruent to 42,000). The epididymal protease had no detectable effect on the structure of the proteins used as standards for the ultracentrifugal or gel filtration analyses. Although inhibited by leupeptin, the epididymal enzyme is not a typical thiol protease since it was unaffected by thiol-blocking agents (iodoacetamide and N-ethylmaleimide), and was partially inhibited by thiol reducing agents (monothioglycerol and dithiothreitol). Calcium and magnesium ions alone, or in combination with ATP, had no effect on the activity of the protease. However, both cations selectively suppressed recovery of the oligomeric receptor form. These results, in conjunction with those from previous studies, serve to distinguish the epididymal protease from receptor-active proteases described in extracts of other animal tissues. Molybdate, at a concentration of 50 mM, blocked receptor conversion. The ability of the receptor to be stabilized by molybdate was lost following conversion. Finally, the epididymal protease appears to remove a portion of the estrogen receptor that is necessary for nucleotide-binding. PMID- 3534466 TI - Receptor structure: a personal assessment of the current status. PMID- 3534468 TI - The Eloesser flap: past and present. AB - Leo Eloesser designed a flap to drain acute tuberculous empyema in the 1930s. The original concept and design are no longer efficacious because of the introduction of antibiotics and antituberculous drugs. The flap has been modified in both concept and design over the years and is used today for drainage of chronic empyemas, with or without bronchopleural fistulas. The history of the flap will be discussed. PMID- 3534467 TI - A protease acting on the estrogen receptor may modify its action in the adult rabbit epididymis. AB - We have previously shown that the cytosolic estrogen receptor in adult rabbit epididymides sediments as an congruent to 3 S species on sucrose gradients containing 0.01 M KCl while that from immature rabbit epididymides sediments at congruent to 9 S. This age-dependent decrease in sedimentation coefficient is attributable to the appearance of a leupeptin-sensitive protease as the animals mature. We now show that if adult epididymides are homogenized in buffer containing leupeptin, the 9 S receptor can be demonstrated, indicating inhibition of receptor degradation. In vitro nuclear uptake studies conducted in the absence of leupeptin indicated that the proteolyzed receptor was not an efficient nuclear binder. When leupeptin was present, nuclear uptake increased 6-fold and it was accompanied by depletion of receptor from the cytosol. Binding of the receptor to nuclei was specific since it could be inhibited by unlabeled estrogens but not by unlabeled 5 alpha-dihydrotestosterone or progesterone. In vitro mixing experiments indicated that the proteolytic activity was associated with the crude nuclear fraction since, in the absence of leupeptin, they had reduced ability to bind estrogen receptor present in immature epididymal cytosol. Specific in vivo binding of [3H]estradiol by adult and immature rabbit epididymides could be demonstrated. The time course of in vivo binding of [3H]estradiol by adult rabbit epididymal nuclei indicated maximum binding (70 fmol/g tissue) at 30 min following injection. By 60 min, the amount of binding had decreased to about 25 fmol. The accessory sex organs, which do not contain the protease, also exhibited maximum binding (150 fmol/g tissue) at 30 min. However, at the 60 min period binding was still about 140 fmol. Processing the tissues in buffers containing leupeptin had no effect on the results obtained. These results are interpreted to indicate that the presence of the protease decreases nuclear binding of the estrogen receptor and shortens nuclear occupancy. This combination of factors may be responsible for the decrease in estrogen action in the adult rabbit epididymis. PMID- 3534469 TI - Advances in the treatment of cholelithiasis by expulsion of the gallstones. PMID- 3534470 TI - A synopsis of Chinese ancient therapeutic methods. PMID- 3534471 TI - Ge Hong, renowned alchemist and physician. PMID- 3534472 TI - A clinical and experimental study of acupuncture treatment of tertian malaria. PMID- 3534473 TI - Acupuncture treatment for disturbances in urination and defecation from sacral cryptorachischisis--a clinical observation of 254 cases. PMID- 3534474 TI - Prolymphocytoid transformation of CLL: a clinical and immunological study of 22 cases. AB - The clinical, morphological and immunological features of 22 cases of chronic lymphocytic leukaemia in 'prolymphocytoid' transformation (CLL-Pro) are reported. Immunophenotypic patterns in CLL-Pro differ from CLL by the appearance of significant (greater than 15%) FMC7-positive components and/or increased SIg densities in most cases. Membrane TU1 and MRBC receptor expression was similar to that found in typical CLL. Morphologically, all cases showed a mixture of small lymphocytes and larger nucleolated 'prolymphocytes' although the degree of prolymphocytoid change was unrelated to immunological patterns. Clinically, the cases behaved in a very heterogeneous fashion, with some patients dying rapidly following transformation despite treatment, while others even if untreated had a long, stable and relatively benign course. It was not possible to predict which patients would do badly from immunological or morphological features but the presence of more than one involved lymph node site and the occurrence of B symptoms appeared to identify a group that did badly. Immunological assessments were however important in therapeutic terms, drawing distinction between CLL-Pro variants and prolymphocytic leukaemia (PLL). PMID- 3534475 TI - Angiography for delineation of systemic-to-pulmonary shunts in congenital pulmonary atresia: evaluation with the dynamic spatial reconstructor. AB - In patients with pulmonary valve atresia, the arterial supply to the lungs is derived entirely from the aorta or its major branches. The anatomic detail of this arterial supply is usually identified by obtaining multiple selective arteriograms involving numerous injections of contrast material and x-ray exposures. In this study, we demonstrated that the information obtained from conventional diagnostic angiography in two patients with congenital pulmonary atresia was also clearly evident on scans from the dynamic spatial reconstructor (DSR), a high-speed three-dimensional computed tomographic system. Thus, numerous shunts, stenoses, and systemic collateral arteries were demonstrated by DSR scanning, which involved only one or two nonselective injections of a contrast agent and less x-ray exposure than that normally necessitated by angiographic study. PMID- 3534476 TI - Dorothea Lynde Dix: ardent reformer. PMID- 3534477 TI - Untreated rupture of the tunica albuginea. AB - A patient with untreated rupture of the tunica albuginea underwent surgical exploration 6 weeks after acute scrotal trauma. A layer of epithelium had grown across the bulging seminiferous tubules, and no further surgical repair was necessary. This spontaneous repair phenomenon has not previously been reported pictorially in the human testis. The recommended treatment of testicular rupture is surgical exploration and repair. PMID- 3534478 TI - Castable ceramic: a 'megatrend'. PMID- 3534479 TI - [New perspectives on the origin of obesity. II. Factors and theories implicated in its etiology]. PMID- 3534480 TI - [Colonic diverticulosis]. PMID- 3534481 TI - [Disappearance of mesangial IgA deposits in the kidneys from 2 donors after transplantation]. PMID- 3534482 TI - Approach to a hospital-based application of a medical expert system. AB - CADIAG-2 is a data-driven fuzzy medical expert system built for computer-based consultation in internal medicine. It has been integrated into the medical information system WAMIS of the Vienna General Hospital. Through the integration, CADIAG-2 is able to access patient data and laboratory test results already collected in the central patient database of WAMIS. CADIAG-2 operates in two subsequent phases: (1) as an automatic screening procedure for detecting pathological states in the patient, for generating diagnostic hypotheses, and for proposing further useful examinations; and (2) as an on-line consultation system for the clinician to assist him in clarifying patients' disorders completely and in great detail. At present, CADIAG-2 is subject to extended clinical trials. There are four application areas: rheumatic diseases, pancreatic diseases, gall bladder and bile duct diseases and colon diseases. First results on the performance of CADIAG-2 based on the evaluation of about 500 cases were obtained. In this paper, the principal goals, main components and concepts of CADIAG-2, and the experience gained until now are discussed. PMID- 3534483 TI - Mexico's national biomedical bibliography: a proposal for the setting-up of a computer-based indexing system. AB - The planning, design and implementation stages of a computer-based approach to the indexing of the biomedical bibliography in Mexico are described; a proposal for an index to be set up at Mexico's National Health Information and Documentation Centre (CENIDS). Factors such as Mexico's biomedical information production; local information needs; and establishment of objectives/goals of the indexing system are described as relevant indicators to be considered at the planning stage. General computer and non-computer functions, as well as two possible alternatives to the design stage are proposed. A 'phase approach' implementation is also advised. Finally, several information management and organization factors are described as the benefits derived from this proposal; transference of national knowledge; current awareness services and international collaboration, among others. PMID- 3534484 TI - The pharmacology of the parkinsonian syndrome producing neurotoxin MPTP (1-methyl 4-phenyl-1,2,3,6-tetrahydropyridine) and structurally related compounds. PMID- 3534485 TI - Stereochemistry: a source of problems in medicinal chemistry. PMID- 3534486 TI - A possible role of epinephrine in the development of hypertension. PMID- 3534487 TI - Carrier erythrocytes. PMID- 3534488 TI - Thoughts on the Wellcome Trust 1963-82. PMID- 3534489 TI - Sir Henry Wellcome's museum for the science of history. PMID- 3534490 TI - Constructing the medical elite in France: the creation of the Royal Academy of Medicine 1814-20. PMID- 3534491 TI - The manuscript lecture-notes of Alexander Monro primus (1697-1767). PMID- 3534492 TI - "Physic and philanthropy. A history of the Wellcome Trust 1936-1986." By A. R. Hall and B. A. Bembridge. Essay review. PMID- 3534493 TI - [The man behind the syndrome: Sven Lofgren. His observations resulted in increased knowledge of acute sarcoidotic arthritis]. PMID- 3534494 TI - [Is digital subtraction angiography superior to conventional vascular radiography?]. PMID- 3534495 TI - [Paternity determination and the analysis of twins--genetic technics give new possibilities]. PMID- 3534496 TI - [Acute sinusitis--when, how and by whom should it be treated?]. PMID- 3534497 TI - [Dialysis treatment in diabetic nephropathy--a review]. PMID- 3534498 TI - The vascular endothelium as a target tissue in acute cadmium toxicity. AB - Sensitivity of tissues to the acute toxicity of cadmium is reviewed. It is concluded that the initial effect of acute cadmium administration is on the integrity and permeability of the vascular endothelium; other necrotic changes occur secondarily to this effect. In a sensitive tissue, not all of the endothelial cells are susceptible to cadmium. Furthermore, after necrosis of the sensitive cells, the resistant cells proliferate and result in regeneration of the vasculature and subsequent acquired resistance to the metal. It is found that sex hormones are probably important in determining susceptibility and response of tissues to cadmium. The role of metallothionein in these phenomena remains to be elucidated. PMID- 3534499 TI - Protein turnover in adipose tissue from fasted or diabetic rats. AB - Protein synthesis and degradation in vitro were compared in epididymal fat pads from animals deprived of food for 48 h or treated 6 or 12 days prior with streptozotocin to induce diabetes. Although both fasting and diabetes led to depressed (-24% to -57%) protein synthesis, the diminution in protein degradation (-63% to -72%) was even greater, so that net in vitro protein balance improved dramatically. Insulin failed to inhibit protein degradation in fat pads of these rats as it does for fed animals. Although insulin stimulated protein synthesis in fat pads of fasted and 12 day diabetic rats, the absolute change was much smaller than that seen in the fed state. The inhibition of protein degradation by leucine also seems to be less in fasted animals, probably because leucine catabolism is slower in fasting. These results show that fasting and diabetes may improve protein balance in adipose tissue but diminish the regulatory effects of insulin. PMID- 3534500 TI - Catecholaminergic regulation of ovarian function in mammals: current concepts. AB - A review of the rapidly accumulating data in the literature continues to support the notion that catecholamines regulate ovarian function, and extends the complexity of catecholaminergic effects on the ovary via interactions with pituitary and adrenal hormones. It is clear that catecholamines affect growth and differentiation of ovarian follicles, but their role in follicular rupture during ovulation and in corpus luteum function remains unclear. The effects of catecholamines (mediated by membrane receptors) on ovarian function probably should be considered paracrine but classic endocrine regulation of ovarian function cannot be ruled out. Myogenic tonus of ovarian vasculature appears to be regulated by catecholamines, and estrogens may enhance adrenergic receptors in ovarian smooth muscle cells. PMID- 3534501 TI - Acetylcholine stimulates glucose metabolism by pancreatic islets. AB - Acetylcholine stimulates insulin secretion in the presence of physiological concentrations of glucose. Stimulation of insulin secretion by acetylcholine is accompanied by an increase in glucose usage by isolated rat islets. Acetylcholine increased glucose usage by 38%, 28%, and 12% at 3.5 mM, 5.5 mM, and 10 mM glucose, respectively, compared to glucose usage by isolated islets incubated with glucose alone. Data showing increased glucose usage in islets treated with acetylcholine converge with data from an earlier report (J. Biol. Chem. 254 3921 3929 [1979]) showing a crossover point for glycolytic metabolites at phosphofructokinase to indicate that activation of glycolysis by acetylcholine results from increased phosphofructokinase activity and coordinate activation of hexokinase in intact islets. PMID- 3534502 TI - Biochemical evidence for existence of immunoreactive renin in human prolactinoma tissue. AB - High activity of renin was demonstrated in human prolactinoma tissue. This activity was almost completely inhibited by specific antibody raised against human renal renin, indicating that it was not due to the nonspecific action of proteases. The specific activity of renin was 5.04 ng of angiotensin I generated/mg of protein per h, comparable to that of the pituitary tissue prepared from postmortem human subjects. The biochemical properties of the prolactinoma renin were generally similar to those of well-known kidney enzyme, such as molecular mass (Mr = 46,000), optimum pH (6.0), and glycoprotein nature. However, the isoelectric points (pI) of the prolactinoma renin (pI = 4.90, 5.04, 5.24 and 5.41) differed somewhat from those of plasma and kidney renins reported hitherto. These results indicate that true renin can be produced in human prolactinoma tissue. PMID- 3534503 TI - Upper gastrointestinal tract bleeding: assessing the diagnostic contributions of the history and clinical findings. AB - Various strategies can be used in the diagnosis of upper gastrointestinal tract bleeding. This study investigates the relevance of anamnestic and clinical findings for the diagnosis of the bleeding source. The authors introduced a computer-aided diagnostic system using Bayes' theorem and compared it with clinicians' predictions using anamnestic and clinical findings only. There was no difference in the overall accuracy rates, but a difference was observed in the diagnostic behaviors of the two "systems." In addition, the discriminatory ability of the computer-aided system, the sharpness of the predictions obtained, and the reliability of the posterior probabilities were analyzed. It is concluded that the clinician and the computer-aided system are not able to discriminate well between the disease categories. Derived classification matrices and probability-based measures show the reasons for the inadequacy of diagnostic information obtainable from the clinical history and physical findings. PMID- 3534504 TI - The determinants of treatment choice in end-stage renal disease: can we generalize about decision making from specific studies? AB - Practitioner judgments about treatments for hypothetical end-stage renal disease patients were examined by two mailed surveys. It was hypothesized that treatment choice was a function of four hierarchically arranged sets of factors: disease- and treatment-specific, patient-specific, environment- and institution-specific, and practitioner-specific. The first survey identified six vignettes for which the case-specific factors alone did not yield a generally accepted treatment decision. These six cases were used in the second survey, whose results are reported here. Practitioner-specific characteristics were found to be only weakly related to treatment choice. Guttman scale analysis showed no significant practitioner propensity to use any given treatment. Instead, the number of colleagues in a respondent's renal unit picking a given therapy for a given patient was the strongest predictor of an individual's choice. Contextual factors -clinical details of the case and decision rules within the institution--appeared to overwhelm provider-specific tendencies; characteristics of the decision generally outweighed characteristics of the decision maker. This framework of factors may be useful for analyzing inter-provider variation. Consequences for certain approaches to the study of decision making (especially single-site studies and regression-based models) are noted. PMID- 3534505 TI - [Positron emission tomography (physico-technical aspects)]. PMID- 3534506 TI - Acute soft tissue injuries--a review of the literature. AB - The classification, pathology, and management of acute soft tissue injuries are reviewed. Classifications based on etiology and severity are outlined. The pathological processes at a cellular level are described in three phases: acute inflammatory, repair, and remodelling. the management of acute soft tissue trauma is embodied in the acronym RICE for rest, ice, compression, and elevation during the first 48 to 72 h. Additional benefit from anti-prostaglandin medications has not been clearly demonstrated in clinical trials, and if used, these medications should be restricted to the first 3 days. Cryotherapy (crushed ice) for 10 to 20 min, 2 to 4 times/day for the first 2 to 3 days is helpful in promoting early return to full activity. Early mobilization, guided by the pain response, promotes a more rapid return to full activity. Early mobilization, guided by the pain response, promotes a more rapid return to full functional recovery. Progressive resistance exercises (isotonic, isokinetic, and isometric) are essential to restore full muscle and joint function. Rehabilitation is complete when the injured and adjacent tissues are restored to full pain-free functional capacity under competitive conditions in association with the necessary level of cardiovascular respiratory fitness. PMID- 3534507 TI - Benefits of aerobic exercise for the paraplegic: a brief review. AB - The importance of exercise for the general population is emphasized widely; therefore, it must be even more important for paralegics who are already threatened with poor health due to the sedentary nature of their lifestyle. The effects of functional degeneration are vast and greatly reduce the overall health of paraplegics, particularly within the musculoskeletal and cardiovascular systems, thereby increasing their risk for cardiovascular disease. Recent investigations suggest that this process may be reversible through exercise training and that paraplegics respond to exercise training in essentially the same manner as the non-handicapped individual. In addition, exercise training has been reported to decrease the resorptive process of the skeleton by decreasing bone and collagen catabolism and possibly aiding in new bone formation. This review attempts to summarize the available literature on the effects of exercise on the paraplegic and will hopefully provide some direction not only for further research but also recommendations for practitioners working in the field. PMID- 3534508 TI - Activity in the spinal cord-injured patient: an epidemiologic analysis of metabolic parameters. AB - Individuals with traumatic spinal cord injury (SCI) represent a population with extreme inactivity. The purpose of the current research was to investigate the metabolic differences between extremely inactive disabled individuals (SCI sedentary group), active disabled individuals (SCI athletes), and able-bodied individuals. Fasting morning blood samples were obtained for the determination of high density lipoprotein cholesterol (HDLc) subfractions, glucose, and insulin. The sedentary SCI group was comprised of 77 consecutive male admissions to a rehabilitation center. The 17 SCI athletes were recruited prior to competition at the annual National Wheelchair Games. Total HDLc and both its subfractions were significantly lower (P less than 0.01) in the male SCI sedentary population than in the SCI athletes or able-bodied controls. HDL2 was significantly elevated (P less than 0.01) in the SCI athlete compared to the SCI sedentary group (42.7 vs 34.1 mg X dl-1) and was similar to the control population (46.1 mg X dl-1). Glucose levels were similar in the two SCI groups but were both significantly lower (P less than 0.05) than in the able-bodied controls. These data suggest that the extreme inactivity observed in disabled populations is associated with lower HDLc concentrations and presumably an increase in coronary heart disease risk if these values were to persist over time. Additionally, it appears that physical activity is associated with increases in total HDLc, primarily through the HDL2 subfraction. Glucose and insulin were similar for both SCI groups despite the marked difference in activity levels, suggesting that these parameters may not be associated with activity. PMID- 3534509 TI - A randomized exercise trial in older women: increased activity over two years and the factors associated with compliance. AB - The health effects of increased physical activity in the prevention or treatment of any disease can only be meaningfully assessed if compliance to the exercise regimen is maintained. The current research examined compliance in a clinical trial investigating the effect of walking on bone loss in 229 postmenopausal women, randomized into either a walking or a control group. Although at baseline there was no difference in physical activity between the two groups, after a period of 2 yr, the walking group reported significantly greater physical activity as measured by reported mean blocks walked daily and objective activity monitor day readings. Closer examination of the walking group revealed that compliers (average 7+ miles walked/wk over the 2 yr), when compared to non compliers, tended at baseline to be more active, lighter weight, and non-smokers. However, the variable that best differentiated between the two compliance groups was the frequency of reported illness over the 2-yr period, with compliers claiming significantly less illness. PMID- 3534510 TI - "The burden of disproof...". PMID- 3534511 TI - Reversibility of graft rejection following a short cyclosporin-A administration 5 days after grafting. AB - The aim of this research was to investigate whether cyclosporin-A (Cy-A) could exert its action on graft rejection in progress. For this purpose, heart-lung grafting was performed in a strong histoincompatible combination of rats (BN/LEW). In one group of animals, Cy-A was administered at the dose of 15 mg/kg daily for 10 days starting on the 5th day after grafting. In a control group only olive oil was administered. Five of six animals treated with Cy-A showed a graft survival over 4 weeks and in two cases it was over 2 months when they were killed. PMID- 3534512 TI - "New" microvascular clamps for thoracic surgery in the rat. AB - The development of "new" microvascular clamps for lung transplantation in the rat was necessary because the generally used microclamps were found to be not feasible in preliminary experiments. A mosquito clamp modified in a Satinsky-like manner made lung transplantation in the rat possible. However, most suitable was the smallest Blalock pulmonary clamp with some modifications. This clamp has been used in over 500 left lung transplantations in the rat now, and is no longer subject to further innovations. This report shows that relatively large instruments can be appropriate microvascular clamps. PMID- 3534513 TI - Sorting large numbers of clones expressing Plasmodium falciparum antigens in Escherichia coli by differential antibody screening. AB - We describe an approach to classifying a large number of clones expressing Plasmodium falciparum antigens in Escherichia coli by virtue of their differing reactivities with 100 human anti-malarial sera. Individual sera exhibited marked differences in the patterns of reactivity with these clones. These patterns led to the identification of sets of clones, here termed "serological families", which were shown to encode distinct P. falciparum antigens. A serological family was found to be composed of non-identical clones derived from portions of the same antigen. Using this approach six new P. falciparum antigens were identified. One of these is described in detail and is a 102 X 10(3) Mr antigen, predominantly of schizonts. Sequencing studies on four cDNA clones encoding parts of this antigen revealed blocks of hydrophilic dipeptide and tripeptide repeats and so the antigen has been termed the acidic basic repeat antigen (ABRA). PMID- 3534514 TI - Glucose intolerance in Friedreich's ataxia: association with insulin resistance and decreased insulin binding. AB - Friedreich's Ataxia (FA) is a neurologic disorder associated with a high prevalence of diabetes mellitus. To assess insulin secretion and insulin resistance, glucose and insulin responses to oral glucose and insulin binding to circulating monocytes and dextran gradient fractionated and unfractionated red blood cells (RBCs) were compared in 11 subjects with FA to 11 age-matched controls. Glucose and insulin responses were elevated from one to three hours after oral glucose in FA. The mean corrected insulin responses were not different while peripheral insulin activity (A) was significantly decreased (1.38 +/- 0.22 v 0.77 +/- 0.16, control v FA, P less than 0.025) indicating the presence of insulin resistance. A significant correlation between the degree of insulin resistance (A) and duration of neurologic symptoms was found (r = .65. P less than 0.025). Resistance to exogenous insulin was confirmed in ten subjects with FA by intravenous insulin tolerance tests (KITT, %/min, 6.25 +/- 0.90 v 3.93 +/- 0.61, P less than .05). Both FA and control groups showed highest insulin binding to fraction A (youngest) RBCs, but no difference was observed between the two groups. However, insulin binding to monocytes was significantly decreased in subjects with FA (% specific binding/10(7) cells/mL, 6.37 +/- 0.71 v 4.51 +/- 0.39, P less than 0.05, control v FA). This was associated with a decrease in apparent receptor affinity. We conclude that FA is associated with insulin resistance, which increases with the duration of neurologic impairment. The insulin binding to monocytes suggests that the insulin resistance may be partially explained by a receptor defect. PMID- 3534515 TI - Portal v peripheral hyperinsulinemia and very low density lipoprotein triglyceride kinetics. AB - The effect of subcutaneously delivered insulin on the kinetics of rat plasma triglycerides was compared to that of intraperitoneally delivered insulin. The former route delivered insulin primarily extrahepatically and the latter, intraportally. In comparison to the intraperitoneally delivered insulin, the subcutaneously delivered insulin was associated with a higher peripheral serum insulin, lower serum glucose, lower serum FFA, lower serum triglycerides, and similar rate of triglyceride secretion. The activity of adipose tissue lipoprotein lipase was directly related to the serum insulin concentration. The pattern of serum triglycerides and lipoprotein lipase in the rats receiving subcutaneous insulin suggested that their rate of triglyceride removal exceeded that seen in the rats receiving intraperitoneal insulin. These observations indicate that the route of insulin delivery can influence the balance between the hepatic and extrahepatic effects of insulin on triglyceride kinetics. PMID- 3534516 TI - One month's insulin treatment of type II diabetes: the early and medium-term effects following insulin withdrawal. AB - In order to see if subcutaneous insulin treatment of type II diabetes might produce lasting physiologic changes, ten patients received one month's insulin treatment under strict dietary supervision. When compared to the pretreatment period, 48 hours after discontinuing insulin treatment fasting plasma glucose had fallen (P = 0.005), fasting serum insulin had risen (P = 0.005), and fasting hepatic glucose production measured by 3H-3-glucose turnover had fallen (P = 0.008). The metabolic clearance rate of glucose measured with the glucose clamp rose significantly after treatment at insulin infusion rates of 40 mU m-2 min-1 (P = 0.015) and 400 mU m-2 min-1 (P = 0.012). The serum insulin and C-peptide responses to oral glucose improved after the treatment in association with the improvement in glucose tolerance, but the plasma glucose response was unchanged. Six other type II diabetic patients who received only dietary supervision did not show significant changes in these variables. Six weeks after discontinuing insulin, the patients' fasting hepatic glucose production was still reduced compared to pretreatment (P = 0.028) and insulin action was still improved at both the lower (P = 0.028) and the higher (P = 0.028) insulin infusion rates, but the fasting plasma glucose and insulin and C-peptide responses to oral glucose had returned to pretreatment values. The improvement in glucose tolerance and beta-cell function induced by insulin treatment seems to be of more limited duration than the improvements in basal hepatic glucose production and in insulin action. PMID- 3534517 TI - Prior exercise potentiates the thermic effect of a carbohydrate load. AB - It is unclear whether dietary-induced thermogenesis (DIT) is increased after exercise. To test this possibility, six healthy volunteers, male and female, exercised for 45 minutes at 70% of maximal aerobic capacity (VO2 max) in the morning after an overnight fast. Two hours after the end of the exercise, by which time VO2 had returned to near baseline levels, subjects ingested a 100-g glucose load. Blood samples and respiratory gas exchange data were collected over the next three hours. On a separate day on which the subjects did not exercise, the test procedure was repeated. Glucose tolerance and the insulin response to the glucose load were not significantly different between the two trials; however, VO2 increased by 15.5% over baseline on the exercise day, compared with only 8.9% when exercise was not performed. The net increase in energy expenditure for the three-hour period following glucose ingestion was 15 kcal/180 min greater on the exercise than on the control day, with increases upwards of 20 kcal/180 min in several individuals. No correlation was found between the magnitude of exercise-enhanced DIT and VO2 max, suggesting that this effect is independent of the state of training. The results indicate that the thermic effect of exogenous carbohydrate can be potentiated by prior exercise. PMID- 3534518 TI - Diminished A-cell secretion in the early phase of type I diabetes mellitus. AB - The A-cell function in "true pre-type I diabetes" or in early phase of type I diabetes has not been reported. We studied A-cell reserve in response to intravenous arginine infusion in six individuals characterized by type I diabetes associated immunologic defects and absent first-phase insulin secretory response to intravenous glucose prior to development of diabetes. The peak glucagon response in these patients was markedly impaired (153 +/- 39 pg/mL, mean +/- SEM) compared to a group of 23 normal, healthy controls (301 +/- 18; P less than 0.01) and a group of 11 healthy, discordant monozygotic twins of type I diabetic patients (250 +/- 25, P less than 0.05). The glucagon concentrations in response to oral glucose were completely suppressed to undetectable levels in three of the patients studied. In view of the well-known observations of insulitis in the prediabetic phase in man and in experimental models of type I diabetes and anti islet cytoplasmic antibodies directed against all islet cells, our observations suggest an impairment of A-cells during the evolution of type I diabetes. PMID- 3534519 TI - Glucose tolerance in chronic alcoholics after alcohol withdrawal: effect of accompanying diet. AB - The effect of alcoholism or acute alcohol ingestion on carbohydrate metabolism is not clear. The metabolic features of alcoholics cannot be easily achieved in normal men submitted to investigations concerning the effects of alcohol on glucose tolerance. Undernutrition and/or malnutrition characterize the eating behavior of alcoholics. It is also well-known that diet is an important determinant of carbohydrate tolerance. Thus, we studied the effects of a controlled diet on glucose tolerance and insulin release in a group of chronic alcoholics, with or without withdrawal from alcohol. Twenty-two subjects took part in the study; their mean caloric intake was 2,805 +/- 91 kcal/d, 58% of which was due to alcohol. In all subjects five days after an isocaloric diet and no alcohol, we performed an oral glucose tolerance test (OGTT). After that, the subjects were divided into three subgroups: group A, eight subjects with alcohol withdrawal and an 17.5 kcal/kg/d diet; group B, eight subjects with alcohol withdrawal and a 35 kcal/kg/d diet, and group C, six subjects with a 35 kcal/kg/d diet plus ethanol 200 g/d. After 3 weeks a second OGTT was performed. We found a significant improvement of the glucose tolerance and of the release of insulin in group B as well as group C; the alcohol withdrawal per se was irrelevant to the observed modifications of the glucose tolerance. Our data suggest that a poor diet would be a major cause of carbohydrate intolerance in alcoholics. PMID- 3534520 TI - Insulin resistance in uremia: in vitro model in the rat liver using human serum to study mechanisms. AB - We have previously demonstrated in a rat model of chronic uremia that the liver is resistant to insulin. To further investigate the mechanism(s) of insulin resistance in uremia, primary cultures of normal rat hepatocytes were incubated with varying dilutions (1/10 to 1/10,000) of sera from undialyzed end stage uremic and normal humans for 20 hours. We then studied insulin action, binding, and postbinding events. Dilutions of uremic sera as low as 1/1,000 rendered the hepatocytes resistant to maximal concentrations of insulin with regard to [14C]acetate incorporation into lipids. The dose response curve for insulin stimulated [14C]aminoisobutyric acid uptake demonstrated a shift to the right in hepatocytes incubated with uremic sera when compared with those incubated with normal sera. The 125I-insulin binding sites and affinity, 125I-insulin internalization and degradation, insulin receptor structure, autophosphorylation of the insulin receptor, and its tyrosine-specific kinase activity were normal in the hepatocytes rendered resistant to insulin by uremic sera. However, these cells failed to generate the chemical mediator or second messenger of insulin action, as assessed by its ability to stimulate pyruvate dehydrogenase (PDH) in liver mitochondria from normal rats. We concluded that uremic sera renders normal rat hepatocytes resistant to insulin. Insulin resistance is a postinsulin receptor kinase defect possibly due to lack of the generation of the chemical mediator of insulin action. This in vitro cell model may be useful to further define the mechanism(s) and the serum factor(s) responsible for insulin resistance in uremia in the absence of complicating hormonal and substrate changes that occur in vivo. PMID- 3534521 TI - Proline isomerization studied with proteolytic enzymes. PMID- 3534522 TI - Computer-aided diagnosis of acute abdominal pain when taking into account interactions. PMID- 3534523 TI - A user-oriented approach to decision making in differential diagnosis and therapeutic advice. PMID- 3534524 TI - Infant care in Tudor and Stuart England. PMID- 3534525 TI - Where have all the spina bifida gone? PMID- 3534526 TI - [Study of the effect of the fungicide zineb on microorganisms]. AB - Changes in yeast cells induced by the fungicide zineb were studied using biochemical, genetic techniques and electron microscopy. The primary changes involved anabolic processes since RNA and protein content increased in the cells. The data were consistent with a larger size of mitochondria. The oxidative reductive activity of cell extracts did not change under the action of the fungicide. Zineb at a concentration of 0.5 to 50 mg/litre exerted a genetic activity towards indicator microorganisms. The changes in the morphophysiological characteristics of yeast growth under the action of zineb are presumed to be of a protective nature. Zineb traces in soil must be controlled in terms of the microbiological index. PMID- 3534527 TI - [Sorption of microorganisms by fiber materials]. AB - Candida guilliermondii and Escherichia coli cells were adsorbed on glass and basalt fibres with a similar specific surface, but with a different charge. The quantity of adsorbed microorganisms did not depend on the type and charge of a fibre surface. However, cells were adsorbed faster and more firmly on positively charged and uncharged fibres than on negatively charged fibres. PMID- 3534528 TI - [5 cases of Plasmodium malariae infection following blood transfusion]. AB - Five Plasmodium malariae cases were diagnosed in our parasitology laboratory. All five were induced malariae cases and patients had been infected via transfusion of blood at different intervals. These cases were as follows: 1968 H.A (25) female, 1970 K.Y (45) male, 1971 I.H (38) female, 1972 A.B (18) male and 1976 K.A (4 months) infant. All the cases were notified to the Ankara Malaria Eradication Regional Centre and all were confirmed in their laboratory and after given radical treatment of three days chloroquine and two weeks primaquine. PMID- 3534529 TI - [Dental aspects of Bidloo's "Anatomy" (1685), illustrated by Lairesse and plagerized by Cowper (IV)]. PMID- 3534530 TI - Uncommon problems of the double uterus. AB - Although often asymptomatic, congenital anomalies of the uterus may be associated with many gynaecological and obstetrical problems. The double uterus should always be considered in cases of severe dysmenorrhoea and chronic pelvic pain; in cases of the failure of intrauterine contraceptive devices; in cases of a symptomatic or asymptomatic pelvic mass that is inseparable from the uterus; in cases where termination of pregnancy has been unsuccessful; and in cases of cervical incompetence. Where uterine malformations are overlooked patients may not be treated properly before excessive fetal wastage occurs and may undergo extensive surgical procedures that may terminate fertility. Clinical suspicion, accurate documentation of curettage findings and the increased use of hysterography and, especially, ultrasound enable earlier diagnoses and the application of the correct treatment. PMID- 3534531 TI - An unusual infection after renal transplantation. PMID- 3534533 TI - Australian doctors and the visual arts. Part 5. Doctor-artists in South Australia, Tasmania, Western Australia and Queensland. AB - The contributions of Australian doctors to the visual arts are being described in a series of six articles. Work from doctors in New South Wales and Victoria has been covered previously. Now activities in South Australia, Tasmania, Western Australia, Queensland and the Northern Territory are presented. PMID- 3534532 TI - Caffeine: a toxicological overview. AB - The health effects of caffeine have been examined in a review of its toxicological and pharmacological properties together with its effect on children. Caffeine commonly causes symptoms of an acute overdose and withdrawal symptoms. These may be identified as anxiety in moderate consumers and can lead to severe central nervous system effects in heavy consumers. Pharmacological effects occur even at low doses but their severity is influenced by wide individual variation and the development of tolerance. Nevertheless, chronic consumption of caffeine is implicated in various minor symptoms of ill health and is associated with elevated serum cholesterol levels. At the doses that are consumed by humans, there is little evidence at present to suggest effects on reproduction, teratogenesis, tumour formation or the incidence of myocardial infarction. A reduced consumption of caffeine is advocated for all age groups. PMID- 3534534 TI - Azidothymidine for AIDS. PMID- 3534535 TI - Wilfred Trotter and the biosociology of peace and war. PMID- 3534536 TI - Cytochromes P-450 of yeasts. PMID- 3534537 TI - Philosophy of new drug discovery. PMID- 3534539 TI - [Microbial agents of the oral cavity: what is the relationship to oral neoplastic lesions?]. PMID- 3534540 TI - [Scanning electron microscopy of the metal etching for the Maryland bridge. II]. PMID- 3534541 TI - [Child-physician psychological relationships with special reference to dentistry]. PMID- 3534542 TI - Nicotinic binding sites in rat and mouse brain: comparison of acetylcholine, nicotine, and alpha-bungarotoxin. AB - The properties of the binding sites for radiolabeled acetylcholine (measured in the presence of atropine), nicotine, and alpha-bungarotoxin were compared in brain tissue prepared from both rat and mouse. These three binding sites were tested for the following properties: affinity and density of ligand binding, effects of competitive inhibitors, regional distribution, effects of treatment with dithiothreitol and the reversal of these effects by treatment with 5,5' dithiobis(2-nitrobenzoic acid), thermal lability, effects of protease treatment, and response to chronic administration of nicotine in vivo. The binding sites for acetylcholine and nicotine were affected identically for all measurements, whereas the binding site for alpha-bungarotoxin was affected in a manner different from that for the other two ligands. Although the regional distribution of nicotine and acetylcholine binding differed between rat and mouse brain, other properties of this binding site were very similar between the two species. The results are consistent with the proposal that acetylcholine and nicotine bind to the same sites in both rat and mouse brain, whereas alpha-bungarotoxin binds to different sites. PMID- 3534538 TI - Biosynthesis and metabolism of arginine in bacteria. PMID- 3534544 TI - Arginyl residues and thermal stability in proteins. AB - Guanidination and amidination of bovine serum albumin, yeast enolase and yeast alcohol dehydrogenase were accompanied by increases in thermal stability at lower extents of modification. Decreases in thermal stability result from greater modification. These results support suggestions that surface guanidino groups (arginyl groups) are an important factor in thermal stability of proteins. PMID- 3534545 TI - The effect of insulinomimetic agents on protein degradation in H35 hepatoma cells. AB - A wide variety of agents are shown to mimic insulin action and inhibit rates of intracellular protein degradation in H35 hepatoma cells. For oxidizing agents such as NaNO2, H2O2 and oxidized glutathione, inhibition of protein breakdown is reversed by adding catalase. Phenylhydrazine behaves like an oxidant and mimics insulin action in a manner potentiated by superoxide dismutase and reversed by catalase. Similarly the effect of insulin itself is increased by superoxide dismutase and reduced by catalase. Sulfhydryl reagents also mimic insulin action: inhibition of protein breakdown is seen following addition of 2-mercaptoethanol or a brief pre-treatment with N-ethylmaleimide or iodoacetate. Mild pre-treatment with trypsin also inhibits subsequent rates of protein breakdown. A model is proposed suggesting that these insulinomimetic actions involve a common mechanism which links the generation of active oxygen species through the redox potential of the cell to the activation of a proteinase. PMID- 3534543 TI - Higher eukaryotic aminoacyl-tRNA synthetases in physiologic and pathologic states. AB - The aminoacyl-tRNA synthetases play a dual role in cell metabolism by synthesizing aminoacyl-tRNAs and an odd dinucleotide diadenosine-5', 5''-P1, P4 tetraphosphate which appears to be involved in DNA replication and the control of cell proliferation. This review is a synthesis of recent results on the structure, genetics, cell biology, physiology, role in neoplasia, and role in autoimmune myositis of the higher eukaryotic aminoacyl-tRNA synthetases. PMID- 3534546 TI - [Thiol peptide hydrolases from animal tissues, their structure and function]. AB - Data on properties, structure and biological functions of a variety of thiol (cysteine) peptide hydrolases from animal tissues have been summarized. This large group of diverse intracellular enzymes involves both endo- and exopeptidases. Best studied are lysosomal thiol peptide hydrolases: cathepsins B, H and L, the primary structure of which is deciphered. They present a family of homologous proteins, structurally similar to papain. Ca2+-dependent neutral proteinases is another family of related proteins. The biological functions of various thiol peptide hydrolases are considered: their participation in protein turnover, post-translational processing, regulation of unidirectional biological processes and metabolic refolding. Data on endogenous inhibitors of thiol peptide hydrolases and on regulation of enzymic activity are presented. PMID- 3534547 TI - [Effect of mutation in phoB and phoM genes for the positive control of alkaline phosphatase biosynthesis on Escherichia coli envelope proteins]. AB - The suppression of some envelope proteins, localized in both the periplasm and the outer and inner membranes was shown in phoB and phoM phoR mutants of E. coli. Among these proteins are the proteins of the phosphate regulon and also those not pertaining them. As a result of phoB and phoM phoR mutations, the cytoplasmic membrane was found to be lacking in minor protein of 28,000 Mr, which belongs to the phosphate regulon. Besides, the phoM phoR mutation leads to the loss of protein of 55,000 Mr of the outer membranes, whereas phoB mutation causes loss of protein 37 000 Mr, identified as outer membrane protein OmpT. A damage in the phoB mutant of the protein proteolytic modification, probably determining the suppression of the biosynthesis of E. coli envelope secreted proteins is suggested. PMID- 3534548 TI - [Sense codon in Escherichia coli are translated in context]. AB - The nucleotide frequencies 5' and 3' to the sense codons in highly and weakly expressed genes have been investigated by the chi-squares method. A comparison between the experimental and computer-generated random nucleotide sequences (in which each codon is substituted by a random synonymous one) was made. It was shown that the choice of a particular codon among the synonymous ones in a given position of the gene depends on the three nucleotides 3' and 5' adjacent to the codon in highly expressed genes (the triplet 3' and a single nucleotide 5' to the codons in weakly expressed genes). Concrete patterns for the preferable choice of synonymous codons depending on their contexts are presented. It is suggested that these constraints are related to the efficiency of messenger translation. The constraints on the amino acid sequences of encoded proteins also lead to statistically significant bases in nucleotide frequencies around the sense codons. The biological role of these constraints is discussed. PMID- 3534549 TI - [Statistical characteristics of primary structures of the functional regions of the Escherichia coli genome. III. Computer recognition of coding regions]. AB - We have presented the method for recognition of structural domains of DNA. This method uses statistical description of coding and non-coding regions in the form of stationary or nonstationary Marcov chain, which was introduced in our previous papers. Calculation of the probability that the given fragment of the DNA appears part of the coding region, is the main operation of this algorithm. The results, obtained for the number of E. coli DNA sequences showed the ability of the method to find the structural domains and correct reading frame, so as to give the estimation of the extent of protein expressivity. Provided necessary statistical data are available, the proposed method may be used for the analysis of DNA of other organisms. PMID- 3534550 TI - [Non-canonical nucleotide exchange catalyzed by Escherichia coli DNA-polymerase I and the two-center model of the mechanism of action of this enzyme]. AB - It is shown, that DNA hydrolysis catalyzed by E. coli DNA polymerase I is inhibited, when a reaction mixture contains one type of deoxynucleoside 5' triphosphate (dNTP). When the reaction mixture contains [32P]dNTP, then [32P] is incorporated into DNA and v. v. (32P) from DNA is transferred into dNTP. The nucleotide exchange between DNA and dNTP in the assay mixture is observed only in the case, when the chemical nature of nucleotide residue of dNTP and that of the 3'-terminus of DNA is the same. Analysis of products of DNA hydrolysis in the presence of one type of dNTP using electrophoresis in polyacrylamide gel shows that most of the DNA molecules are terminated at the 3'-termini by the dNMP residue of the same chemical nature as the dNTP in the assay mixture. However, in some cases DNA molecules contain one additional nucleotide residue. This phenomenon can be explained by incorporation of one additional dNMP residue originating from dNTP only in those cases, when a non-typical base pairing of this nucleotide residue with a template residue readily takes place. The above mentioned facts can be interpreted within the model for DNA hydrolysis with involvement of two intermediate covalent forms of dNMP residues with DNA polymerase I; one dNMP-intermediate should be placed at the elongation center and the other--at the hydrolysis center. The DNA hydrolysis by 3'----5' exonuclease activity of DNA polymerase I proceeds through these two covalent forms. DNA polymerases alpha from calf thymus and T4 phage do not catalyze the nucleotide exchange between DNA and dNTP from the reaction media. PMID- 3534551 TI - Multiple growth-associated nuclear proteins immunoprecipitated by antisera raised against human c-myc peptide antigens. AB - Different antisera raised against various regions of the human c-myc protein were used to identify four human c-myc proteins with apparent molecular masses in sodium dodecyl sulfate-polyacrylamide gels ranging from 64 to 68 kilodaltons (phosphoproteins pp64 and pp67 and nonphosphorylated proteins p65 and p68). pp64 and p65 were the major detectable c-myc proteins, and pp67 and p68 were minor but specific components of the immunoprecipitates. The c-myc proteins were all localized in the cell nucleus. Accumulation of [35S]methionine-labeled p65 was observed after pulse-labeling and chase, suggesting that the stable p65 c-myc protein is generated posttranslationally from short-lived precursors. pp64, pp67, and p68 possessed short half-lives and may therefore be precursors of the stable p65. Confirmation of the nuclear localization of the human c-myc proteins was obtained by immunofluorescent staining. The human c-myc proteins were revealed as a pattern of punctate nuclear staining with, particularly for p65, nucleolar enhancement that left an unstained annulus surrounding the nucleolus. PMID- 3534552 TI - Structural diversity of the major surface antigen of Plasmodium falciparum merozoites. AB - The structures of the major merozoite surface antigen of Plasmodium falciparum and the gene encoding it were indistinguishable for the Wellcome strain and the Thai clone T9/94 but different for clones T9/96, T9/98, and T9/101. The central portion of the gene is subject to the greatest variation in structure. The protein from all five lines was found to be posttranslationally modified by covalent addition of both carbohydrate and fatty acid. PMID- 3534553 TI - [Nocturnal hypoglycemias and cortisol excretion in overnight urine]. AB - In 20 juvenile diabetic inpatients the relationship between nocturnal hypoglycemia and overnight urinary cortisol excretion was studied. Cortisol was expressed as absolute quantity per kg body weight because the cortisol/creatinine ratio does not always yield reliable results in diabetic patients. Comparison between different patients yielded no significant difference between posthypoglycemic and non-posthypoglycemic cortisol values. Testing the difference between urinary cortisol excretion in posthypoglycemic and non-posthypoglycemic urine samples for every one of the patients intraindividually, however, a significant posthypoglycemic elevation was found. Posthypoglycemic cortisol response was irregular and variable not only in different patients, but also within the same patient. If a high excretion of cortisol is found in an overnight urine sample, it is very likely to be caused by nocturnal hypoglycemia. On the other hand it is impossible to exclude nocturnal hypoglycemia by normal urinary cortisol findings. Reactive hyperglycemia as described by Somogyi was seen only rarely in this study. It is concluded that even if a distortion by falsely high creatinine measurements in diabetics is ruled out, cortisol measurement in overnight urine samples cannot be used as easy routine method for the detection of nocturnal hypoglycemia. PMID- 3534554 TI - [Congenital intracranial teratoma. Sonographic prenatal diagnosis, clinical aspects and neuropathology]. AB - We report a case of a primary intracranial teratoma that was diagnosed by routine ultrasound already in the 31st gestational week. The ultrasonographic and computertomographic features are compared to the neuropathological findings. PMID- 3534555 TI - [Sonographic findings in infundibulopelvic stenosis]. AB - The sonographic findings in infundibulopelvic stenosis, which is a very rare malformation of the upper urinary tract, are presented in detail, and the differential diagnosis is discussed. PMID- 3534556 TI - Synthesis and mutagenicity of the two stereoisomers of an azide metabolite (azidoalanine). AB - The L- and D-isomers of azidoalanine (azide metabolite) have been chemically synthesized with 60% yield using corresponding N-(tert-butoxycarbonyl)-serine as starting materials. The mutagenic properties of synthesized L-azidoalanine are very similar to those of azide and in vivo synthesized azidoalanine. Synthetic D azidoalanine shows very low mutagenic activity on Salmonella typhimurium TA1530 strain compared to that of the L-isomer. Thus a stereoselective process is involved in azidoalanine mutagenicity. The data presented in this study suggest that further biochemical activation is required for L-azidoalanine to produce its mutagenic activity. PMID- 3534557 TI - Genotoxic activity of m-nitrobenzaldehyde. AB - m-Nitrobenzaldehyde (MNB) was evaluated for mutagenic activity using the Ames microbial mutagenicity test and for its ability to induce DNA single-strand breaks in rat hepatocytes as measured by alkaline elution. MNB was tested in S. typhimurium strains TA1535, TA1537, TA1538, TA98, and TA100, both with and without pretreatment with liver microsomes (S9) isolated from rats pretreated with Aroclor 1254. MNB produced 2-fold or greater increases in revertants in TA1538, both with and without S9, and in TA100 with S9 only. A 2-fold increase in revertants was seen in TA98, but only at the highest dose tested which did not produce inhibition of background growth. MNB caused a greater than 3-fold increase in elution slope, with DNA alkaline elution assay, but only at highly cytotoxic doses and, therefore, is not considered genotoxic in this system. It is concluded that MNB possesses weak genotoxic activity. PMID- 3534558 TI - Mutagen formation in fried meat emulsion containing various amounts of creatine. AB - The formation of mutagens in fried, minced meat emulsion was evaluated by the Ames Salmonella test system. Exogenous addition of creatine to the emulsion prior to frying greatly enhanced the mutagenicity of the emulsion. Addition of 5% creatine resulted in a 40-fold increase in the mutagenicity of the fried meat emulsion in the frameshift test strain, TA98, and in a 8-fold increase in the base substitution test strain, TA100. The present results suggest that creatine is an important factor in the mutagen formation in fried meat products. PMID- 3534559 TI - Nitrofuran mutagenicity: induction of frameshift mutations. PMID- 3534560 TI - The importance of 2-aminofluorene in the mutagenic activation of 2 acetylaminofluorene. AB - The mutagenic activation of 2-acetylaminofluorene (AAF) and its derivatives N hydroxy-AAF and 2-aminofluorene (AF) by pulmonary and hepatic microsomal fractions from untreated rabbits was investigated using Salmonella strain TA98. The mutagenicity of AAF in the presence of hepatic microsomes followed typical saturation kinetics. However, in the presence of pulmonary microsomes, the mutagenic activity increased linearly with increasing substrate concentration and approximated that obtained with low concentrations of AF. N-Hydroxy-AAF was 1/10th as mutagenic as AF in the presence of pulmonary microsomes, but 2-2.5 times more mutagenic than AF in the presence of hepatic microsomes. The activation of AAF by both fractions was completely inhibited by the deacetylase inhibitor paraoxon. Although AAF does not appear to be a substrate for cytochrome P450 form 5, antibodies to this form inhibited the activation of AAF by pulmonary and hepatic microsomes by 90% and 60%, respectively. These results indicate that the mutagenic activation of AAF by these fractions primarily involves deacetylation to AF, followed by cytochrome P450 form 5-mediated activation of AF. PMID- 3534561 TI - Mutagenicity and clastogenicity of the antineoplastic agents homo-azasteroidal ester of p-bis(2-chloroethyl)aminophenyl acetic acid and chlorambucil. AB - The mutagenic and clastogenic effects of the antineoplastic agents homo-aza steroidal ester (ASE) and chlorambucil (CBC) were tested for their ability to induce mutations in the Salmonella/microsome system and SCE in CHO cells in culture. ASE was found to be positive in strains TA1535 and TA100 and in the newer strain TA102 with and without metabolic activation, while CBC caused histidine reversion in strain TA102 after the addition of mammalian liver microsomal extract (S9). In addition, both agents were found to be strongly positive for SCE induction. The mutagenic and clastogenic actions of both agents were of a dose-response type. PMID- 3534562 TI - Mutagenicity testing of amniotic fluid from smokers and non-smokers at 16 weeks of pregnancy. PMID- 3534563 TI - Heterogeneous enzyme immunoassay: detection of anti-Candida albicans specific Ig isotypes and mannan antigen. PMID- 3534564 TI - Identification of the sporozoite antigens of Eimeria tenella. AB - The surface membranes of Eimeria tenella sporozoites were labelled with 125I and polypeptides resolved by polyacrylamide gel electrophoresis in sodium dodecyl sulphate (SDS-PAGE). The most heavily labelled polypeptides were 47, 26, 21 and less than or equal to 18 kDa but significant amounts of 125I were incorporated into a number of polypeptides with molecular weights ranging from greater than 200 000 to less than 18 000. Similar 125I-polypeptide profiles were observed after the surface labelling of sporozoites of E. acervulina, E. maxima and E. nieschulzi. Sporozoites of E. tenella were also radiolabelled by incubation in medium containing [35S]methionine and SDS-PAGE resolved more than 35 radiolabelled polypeptides with molecular weights from greater than 200 000 to less than 18 000. 125I and 35S-labelled sporozoites of E. tenella were solubilised in the detergents Triton X-100 or sodium deoxycholate and immunoprecipitated with serum from chickens immunized by infection with this species. Polypeptides of unlabelled E. tenella sporozoites, resolved by SDS-PAGE, were blotted onto nitrocellulose and the antigens, which reacted with the chicken serum, identified by immunoperoxidase staining. There was some variation between different sporozoite preparations in the number and molecular weights of antigens identified by these techniques but, consistently, the major surface polypeptides that were specifically immunoprecipitated were 104, 47 and 43 kDa. Specifically immunoprecipitated 35S-labelled antigens were of 123-94 kDa, 54-42 kDa and 32-25 kDa and antigens detected on Western blots were within the following ranges: 113 96 kDa, 73-67 kDa, 54-42 kDa, 37-32 kDa and 18-14 kDa. PMID- 3534565 TI - Partial inhibition of trypomastigote entry into cultured mammalian cells by monoclonal antibodies against a surface glycoprotein of Trypanosoma cruzi. AB - Monoclonal antibodies were raised against the surface of trypomastigote forms of Trypanosoma cruzi. Although some of these antibodies reacted against antigens shared by trypomastigote and epimastigote or amastigote forms, the majority were trypomastigote-specific. Trypomastigote-specific monoclonal antibodies recognized all infective stages, including trypomastigotes from the bloodstream of infected mice, insect feces, tissue culture and those resulting from differentiation of epimastigotes in axenic culture media. The monoclonal antibodies H1A10 and 6A2, as well as Fab fragments from H1A10, partially prevented T. cruzi invasion of LLC MK2 cell monolayers (inhibition of 50-70%) when present throughout the entire experiment. Both antibodies recognized an 85 kDa glycoprotein (Tc-85) of the trypomastigote surface which contains N-acetyl-D-glucosamine and/or sialic acid. PMID- 3534566 TI - Characterization of the mechanism of protein glycosylation and the structure of glycoconjugates in tissue culture trypomastigotes and intracellular amastigotes of Trypanosoma cruzi. AB - Trypomastigote cells of Trypanosoma cruzi incubated with [U-14C]glucose accumulated dolichol-P-P-linked Man7GlcNAc2 and Man9GlcNAc2. Evidence is presented indicating that both oligosaccharides were transferred to asparagine residues in proteins. On the other hand, intracellular amastigotes behaved as epimastigotes, i.e., only Man9GlcNAc2 accumulated and was transferred to proteins under similar incubation conditions. Intracellular amastigotes differed, therefore, from amastigotes obtained from an axenic culture, which behaved as trypomastigotes. A similar processing of protein-linked Man9GlcNAc2 and Man8GlcNAc2 occurred in epimastigotes and trypomastigotes but the structure of the main Man7GlcNAc2 isomer produced by demannosylation of the above mentioned oligosaccharides differed from that of the Man7GlcNAc2 transferred in trypomastigotes and amastigotes from axenic cultures. The infective trypomastigote stage of the parasite showed, therefore, an alteration in the mechanism of protein N-glycosylation when compared to the other stages, namely epimastigote (insect vector stage) and amastigote (mammalian intracellular stage). Complex-type, asparagine-bound oligosaccharides were found to be synthesized in both epimastigotes and trypomastigotes but the amounts of those compounds were extremely low when compared to those of high mannose-type oligosaccharides. PMID- 3534567 TI - Hypoglycemia in hospitalized patients. Causes and outcomes. AB - We analyzed 137 episodes of hypoglycemia (serum glucose less than or equal to 49 mg per deciliter) occurring in 94 adult patients hospitalized during a six-month period at a tertiary care hospital. Forty-five percent of the patients had diabetes mellitus, and administered insulin was implicated in 90 percent of episodes in diabetics. Hypoglycemia in diabetic patients occurred under a variety of circumstances, frequently because of decreased caloric intake related to illness or hospital routine. Insulin-induced hypoglycemia also occurred during treatment of hyperkalemia (eight patients) or during hyperglycemia related to total parenteral nutrition (six patients). Forty-six of the 94 patients had chronic renal insufficiency, and 20 of these 46 had underlying diabetes mellitus. Thus, renal insufficiency unrelated to diabetes mellitus was the second most frequent diagnosis associated with hypoglycemia. The majority of other cases of hypoglycemia were related to liver disease, infections, shock, pregnancy, neoplasia, or burns. Hypoglycemia was not the apparent cause of death in any patient, but the overall hospital mortality was 27 percent and was related to the degree of hypoglycemia and the number of risk factors for hypoglycemia. We conclude that hypoglycemia is a common problem in hospitalized patients, is common in renal insufficiency, is usually iatrogenic, and correlates with high mortality in severely ill patients. PMID- 3534568 TI - Efficacy of pneumococcal vaccine in high-risk patients. Results of a Veterans Administration Cooperative Study. AB - We conducted a randomized, double-blind, placebo-controlled trial to test the efficacy of the 14-valent pneumococcal capsular polysaccharide vaccine in 2295 high-risk patients (patients with one or more of the following: age above 55 years and the presence of chronic cardiac, pulmonary, renal, or hepatic disease, alcoholism, or diabetes mellitus). Seventy-one episodes of proved or probable pneumococcal pneumonia or bronchitis occurred among 63 of the patients (27 placebo recipients and 36 vaccine recipients). Vaccine-serotype Streptococcus pneumoniae strains were recovered in association with 11 infections in the placebo group and 14 infections in the vaccine group. Pneumococcal infections occurred most frequently among patients with chronic pulmonary, cardiac, or renal diseases. Among vaccine recipients who subsequently had vaccine-type pneumonia or bronchitis, the majority did not make or sustain serum antibodies against their infecting organism in concentrations that were twice as high as the base-line values, or more than 400 ng of antibody nitrogen per milliliter, although their base-line levels were higher than those in subjects in whom infection did not develop. We were unable to demonstrate any efficacy of the pneumococcal vaccine in preventing pneumonia or bronchitis in this population. Our data suggest that chronically ill patients, who are most susceptible to infection, may have an impaired immune response to the pneumococcal vaccine. PMID- 3534569 TI - Heart transplantation. Recent policy developments. PMID- 3534570 TI - Randomized trial of allopurinol in the prevention of calcium oxalate calculi. AB - In a double-blind study, we examined the efficacy of allopurinol in the prevention of recurrent calcium oxalate calculi of the kidney. Sixty patients with hyperuricosuria and normocalciuria who had a history of calculi were randomly assigned to receive either allopurinol (100 mg three times daily) or a placebo. After the study, the placebo group had 63.4 percent fewer calculi (P less than 0.001), whereas the allopurinol group had 81.2 percent fewer calculi (P less than 0.001). During the study period, the mean rate of calculous events was 0.26 per patient per year in the placebo group and 0.12 in the allopurinol group. When the treatment groups were compared by actuarial analysis, the allopurinol group was found to have a significantly longer time before recurrence of calculi (P less than 0.02). We conclude that allopurinol is effective in the prevention of calcium oxalate stones in patients with hyperuricosuria. The large reduction in the frequency of calculi in the placebo group underscores the positive treatment bias that regularly occurs in trials of prophylaxis against renal calculi when historical controls are used. PMID- 3534571 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 47-1986. A 64-year-old man with unsteady gait and unilateral exophthalmos. PMID- 3534572 TI - Natural-killer-cell function and bone marrow transplantation. PMID- 3534573 TI - The effect of proteolytic enzymes on the thermostability of egg-white. AB - The effect of proteolytic enzyme preparations such as Proteopol PB (bacterial origin), ficin, and pancreatin on the thermostability of egg-white proteins during pasteurization was investigated. Proteolytic activities of each enzyme were measured at three different doses which were calculated by the ANSON method. The degree of white protein degradation was evaluated by the determination of amino-nitrogen. Effectiveness in reducing the coagulation of egg-white proteins varied, depending on the type and dose of enzyme used. Proteopol PB showed only little effect, ficin demonstrated the best anticoagulation properties at the lowest dose, while for pancreatin the middle dose proved to be the most effective. It was concluded that moderate proteolysis is useful for improving the thermostability of egg-white proteins during pasteurization. Total bacterial counts increased considerably after incubation of egg-white with enzyme preparations, but after pasteurization the number of bacteria decreased to levels which were compatible with bacteriological standards for egg-white products. PMID- 3534574 TI - [Nursing research related to the clinical scene: study of the literature, its application to the practice, and development of new research]. PMID- 3534575 TI - [Nursing research by clinical nurses: recommendation of 6 reference books]. PMID- 3534576 TI - Nobel prizes. Growth factors bring rewards. PMID- 3534577 TI - Monoclonals and marrow transplants. PMID- 3534578 TI - Fritz Lipmann (1899-1986). PMID- 3534579 TI - An IgG autoantibody which inactivates C1-inhibitor. AB - Antibodies are considered to play a specific pathogenic role in certain disease states such as myasthenia gravis, Graves' disease and autoimmune haemolytic anaemia. Autoantibodies which interfere with the function of enzyme cascade systems have also been described in diseases such as acquired haemophilia (anti factor VIII antibodies) and glomerulonephritis (C3 nephritic factor). The identification of these autoantibodies is crucial to an understanding of the aetiology of such diseases and is also of importance in revealing the inter relationships of the immune system with other biological pathways. This is the first report of an immunoglobulin G (IgG) autoantibody reactive with C1-inhibitor (C1-Inh), a pivotal inhibitor of the inflammatory response which is known to inactivate proteins of the complement, kinin, fibrinolytic and 'contact phase' systems. This autoantibody was isolated from a patient with a novel variant of acquired angioedema and C1-Inh dysfunction. This finding highlights the involvement of the immune system in the pathogenesis of disorders characterized by the presence of dysfunctional inflammatory response proteins. PMID- 3534580 TI - Mapping human visual cortex with positron emission tomography. AB - Positron-emission tomography (PET) can localize functions of the human brain by imaging regional cerebral blood flow (CBF) during voluntary behaviour. Functional brain mapping with PET, however, has been hindered by PET's poor spatial resolution (typically greater than 1 cm). We have developed an image-analysis strategy that can map functional zones not resolved by conventional PET images. Brain areas selectively activated by a behavioural task can be isolated by subtracting a paired control-state image from the task-state image, thereby removing areas not recruited by the task. When imaged in isolation the centre of an activated area can be located very precisely. This allows subtle shifts in response locale due to changes in task to be detected readily despite poor spatial resolution. As an initial application of this strategy we mapped the retinal projection topography of human primary visual cortex. Functional zones separated by less than 3 mm (centre-to-centre) were differentiated using PET CBF images with a spatial resolution of 18 mm. This technique is not limited to a particular brain area or type of behaviour but does require that the increase in CBF produced by the task be both intense and focal. PMID- 3534581 TI - Immediate and long-term toxicity of adjuvant chemotherapy regimens containing doxorubicin in trials at M.D. Anderson Hospital and Tumor Institute. AB - Seven hundred and ninety-six consecutive patients with operable primary breast cancer treated with doxorubicin-containing postoperative adjuvant chemotherapy between 1974 and 1982 were evaluated for assessment of the acute and long-term toxicities of the program. Most patients experienced nausea, vomiting, and alopecia, side effects that were totally reversible. Doxorubicin skin infiltration was observed in 6% of the patients. Hematologic toxicity was moderate, and only 26% of the patients had a granulocyte nadir of less than 1000 cells/ml. Febrile or infectious complications occurred in 6% of patients, of which 3% required hospitalization for observation and antibiotic treatment. No long-term hematologic changes were observed. Amenorrhea was reported by 80% of premenopausal patients. However, none of the patients under 30 years of age had menstrual abnormalities, whereas 96% of those 40-49 years of age developed amenorrhea. Amenorrhea was permanent for most women over 40, but for 50% of patients under 40 years of age, it was reversible. Endocrinologic studies showed that amenorrhea was a result of primary ovarian failure. The incidence of second malignant neoplasms was lower (1.3%) in the group treated with 5-fluorouracil, doxorubicin, and cyclophosphamide than in the historical control group (4.8%). Cardiac toxicity data was evaluated in 460 patients. When up to a cumulative dose of 300 mg/m2 was given, 1% of the patients developed congestive heart failure. In 4 of these 5, adequate control was achieved with medical treatment; 1 patient died as a consequence of cardiac toxicity. PMID- 3534582 TI - Review of Canadian trials of adjuvant endocrine therapy for breast cancer. AB - Adjuvant ovarian ablation delays recurrence and prolongs survival in premenopausal patients with breast cancer, but the differences fall short of statistical significance; this effect is enhanced to statistically significant differences by low-dose prednisone. Adjuvant tamoxifen has delayed recurrence in post-menopausal patients with steroid receptor-positive tumors and positive axillary nodes, but, to date, has not affected survival. PMID- 3534583 TI - Adjuvant tamoxifen in postmenopausal high-risk breast cancer patients: present status of Danish Breast Cancer Cooperative Group trials. AB - The aim of the present study was to analyze the efficacy of adjuvant tamoxifen (TAM) in postmenopausal patients with high-risk breast cancer. The primary surgical treatment was total mastectomy with axillary sampling. There were 1,650 eligible patients; 829 were randomized to receive postoperative radiotherapy (RT) and 821, to receive RT + TAM (10 mg three times daily for 1 yr). The 2 groups were identical with respect to age, tumor size, number of positive lymph nodes, degree of anaplasia, and estrogen and progesterone receptor content. Overall recurrence-free survival at 6 years was 39% in the RT group, compared to 48% in the RT + TAM group (P = 0.0008), but there was no significant difference in survival (P = 0.14). From retrospective analyses of recurrence-free survival according to prognostic variables, it appears that 4 subgroups of patients benefited from adjuvant TAM: those less than 69 years of age, those with 4 or more positive nodes, those with grade I-II tumors, and those with high estrogen receptor values (greater than 100 fmol/mg cytosol protein). PMID- 3534584 TI - Tamoxifen versus placebo: double-blind adjuvant trial in elderly women with stage II breast cancer. AB - One hundred eighty-one elderly women with stage II breast cancer were prospectively randomized to receive tamoxifen or placebo for 24 months in a double-blind adjuvant trial conducted by the Eastern Cooperative Oncology Group. They were stratified prior to randomization on the basis of the number of positive axillary nodes and the estrogen receptor status of their primary tumor. One hundred seventy were considered eligible and analyzed in this trial. The median age was 71 years with a range from 65 to 84 years. Twenty-one percent of the patients were over the age of 75 and 33% were between 71 and 75 years. Estrogen receptor status was positive in 85% of the patients and unknown in another 12%. Progesterone receptor status was positive in 35%, negative in 16%, and unknown in 49%. With a median follow-up of 55 months, the overall percent disease free at 4 years is 73 for the tamoxifen arm and 52 for the placebo arm (P = .003). Significant benefit is seen following tamoxifen in the subsets with 4-10 positive axillary lymph nodes, those who were estrogen receptor positive, or progesterone receptor unknown, and those who had a tumor size less than 3 cm. Most other subsets benefited as well. There were more distant (29 vs. 13) and bone only (15 vs. 3) sites of first recurrence in the placebo arm, whereas locoregional recurrences were similar (8 each). The recorded toxicity was similar, except for more hot flashes observed among women in the tamoxifen arm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534585 TI - Swiss adjuvant trial (OSAKO 06/74) with chlorambucil, methotrexate, and 5 fluorouracil plus BCG in node-negative breast cancer patients: nine-year results. AB - Between 1974 and 1977, a total of 254 patients with stages T1-3a, N0-1, and M0 operable breast cancer (node negative and node positive, stratified) were randomized to either modified radical mastectomy alone or the same surgery and adjuvant chlorambucil, methotrexate, 5-fluorouracil (LMF) plus BCG. After a median follow-up of 9 years (January 1985), we concluded that LMF plus BCG significantly increased relapse-free survival (RFS) in 240 fully evaluated patients, especially postmenopausal women. This gain in RFS ceased to transform into a gain in overall survival (OAS) after 7 years of median follow-up for the whole patient group. In the 122 node-negative patients studied, LMF plus BCG produced a marked increase in RFS up to the fifth year and in OAS up to 8 years after initial surgery, thus prolonging significantly the median disease-free interval compared with surgical control patients. This trend favoring LMF plus BCG-treated patients continues. Although median time to first relapse and to generalized disease were increased in relapsing patients by LMF plus BCG, the subsequent intervals from local relapse to distant disease and from distant metastases to death were equal for both treatment regimens. Subjective and objective acute toxicity from LMF plus BCG was mild. At 9 years of median follow up, fewer second tumors were noted in the node-negative group receiving LMF plus BCG than in surgical controls. PMID- 3534586 TI - Adjuvant chemotherapy of axillary node-negative carcinoma of the breast using doxorubicin and cyclophosphamide. AB - One hundred fifty-six women with axillary node-negative breast cancer and primary tumors less than or equal to 5 cm in diameter (T1N0 or T2N0) were treated with a brief course of postoperative adjuvant chemotherapy consisting of doxorubicin and cyclophosphamide. Treatment was well tolerated and toxicity was minimal. With a median follow-up time of 58 months, there has been 1 relapse among 58 patients with T1 primary lesions and 15 relapses among 98 patients with T2 primary tumors. When compared with a matched historical control group receiving surgery alone, significant improvement was apparent in disease-free survival among the patients who received adjuvant chemotherapy. Prospective controlled trials are needed if we are to confirm this favorable experience with adjuvant chemotherapy in the treatment of women with node-negative breast cancer. PMID- 3534587 TI - Adjuvant therapy for breast cancer patients with negative lymph nodes. AB - Although approximately 50,000 cases of axillary node-negative breast cancer are diagnosed in the United States annually, the natural history of this heterogeneous disease is incompletely defined. Several series have reported 5 year relapse-free and overall survival ranging from 56% to 89% and 74% to 92%, respectively. Tumor necrosis and anaplastic morphology correlate with early treatment failure. The estrogen receptor and size of the primary tumor are probably also predictive of clinical course. Thus far, perioperative cyclophosphamide is the only systemic treatment demonstrated to prolong survival in a statistically significant fashion. Several ongoing studies are investigating the role of tamoxifen or cytotoxic chemotherapy, or both, in prospective randomized trials. However, too few patients with insufficient follow-up have been analyzed to permit definitive conclusions or recommendations. PMID- 3534588 TI - Emerging modalities for adjuvant therapy of breast cancer: neoadjuvant chemotherapy. AB - There is evidence from theoretical models and experimental studies that indicates that preoperative timing of chemotherapy (neoadjuvant treatment) may be a superior treatment strategy than its use postoperatively. We have shown in our pilot study of 43 premenopausal patients with newly diagnosed cancer of the breast that administration of one cycle of CMF chemotherapy preoperatively was safe. Subsequently, a randomized study of preoperative against postoperative adjuvant chemotherapy has been started and to the present time, 98 patients have been randomized. Preliminary assessment of the randomized study confirmed the safety of the adjuvant chemotherapy with one course of cyclophosphamide, methotrexate, and 5-fluorouracil given preoperatively and also showed that the interval between diagnosis and the first course of chemotherapy can be substantially reduced. In addition to the preoperative timing, other aspects of the neoadjuvant approach are discussed. They include a more frequent utilization of fine needle aspiration so that the tissue diagnosis of breast cancer can be obtained and also refinement of diagnostic techniques, used before the preoperative treatment for the selection of high-risk patients (the neoadjuvant staging). The purpose of our presentation is not to recommend presently preoperative chemotherapy routinely but rather to indicate a need for well controlled studies testing its appealing theoretical rationale. Its use in adjuvant therapy of breast cancer represents a major departure from the conventional management and, therefore, if the cooperation of practitioners and cooperative groups is to be secured, its rationale and safety must be well defined. PMID- 3534589 TI - Systemic adjuvant therapy in treatment of primary operable breast cancer: National Surgical Adjuvant Breast and Bowel Project experience. AB - This report provides an overview of information presented by us at a recent National Institutes of Health Consensus Development Conference on Adjuvant Chemotherapy. The data, derived from 7 randomized clinical trials conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP) since 1958, permit us to conclude that the use of systemic adjuvant therapy is of benefit in both premenopausal and postmenopausal patients with primary breast cancer. Data from the first NSABP trial begun in 1958 with short-course perioperative thiotepa demonstrated a long-term survival benefit in premenopausal but not postmenopausal patients. Ten-year findings from a second trial evaluating response to melphalan (P) implemented in 1972 indicated that, when related to age and nodes, there was a benefit from this drug in both the 1-3 and greater than or equal to 4 positive node premenopausal groups but those with fewer nodes were most improved. In this group characterized by premenopausal women with 1-3 positive nodes, mortality was reduced 64% with a cumulative odds ratio of 3.25 (P = .009) at 10 years after surgery. When related to nuclear grade, there was a striking benefit in survival from P in patients less than or equal to 49 and greater than or equal to 50 years with undifferentiated tumors. The addition of 5-fluorouracil (F) to melphalan (PF) resulted in an increase in disease-free survival and survival over that observed with P in patients less than or equal to 49 and greater than or equal to 50 years of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534591 TI - National Institutes of Health Consensus Development Conference on Adjuvant Chemotherapy and Endocrine Therapy for Breast Cancer. Editorial overview. PMID- 3534590 TI - Current status of Milan adjuvant chemotherapy trials for node-positive and node negative breast cancer. AB - This report summarizes the most important clinical results achieved at the Milan Cancer Institute through various randomized trials with systemic adjuvant chemotherapy. In the study testing surgery versus surgery plus 12 cycles of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) in node-positive patients, the reduction in failure rate (34%) significantly favored CMF-treated patients (P less than 0.001). Despite a reduction in the death rate of 23%, the overall survival showed only a trend for CMF compared to surgery alone (P = 0.10). In a second study, the 8-year results confirmed the lack of difference in relapse-free survival and total survival rates between patients who received 12 and 6 cycles of CMF. The third study indicated that at 6 years, postmenopausal women who had 1-3 positive lymph nodes and were treated with full-dose sequential non-cross-resistant combinations had rates of relapse-free survival and total survival that were superior to those previously achieved with CMF in the same menopausal subset. In a limited series of patients with negative axillary nodes as well as negative estrogen receptors, there was clear evidence of very poor prognosis in women given only local-regional therapy, compared to women treated with adjuvant CMF. Within the node-negative subset, the proliferative activity (labeling index) of the primary tumor appears to be a more effective prognostic discriminant than estrogen receptor status. The proportion of primary drug resistant tumor cells as well as the lack of relative dose intensity in the drug programs tested so far probably represent the two most important causes for the failure of adjuvant chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534592 TI - Adjuvant therapy of breast cancer: Southwest Oncology Group studies. AB - The Southwest Oncology Group has conducted a series of randomized studies of adjuvant therapy in patients with primary breast cancer and positive axillary nodes. The first study, during which combined chemotherapy with cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone (CMFVP) administered for 1 year was compared with single agent therapy with melphalan (L-PAM) for 2 years, was activated in 1975 and closed in 1978. Of the 366 patients who were eligible, 191 received L-PAM and 175 were given CMFVP. The 2 groups were comparable with regard to known prognostic factors. At a median follow-up of 8 years, CMFVP continues to be superior to L-PAM in disease-free (P = .005) and overall survival (P = .01). Thirty-five percent of patients on CMFVP have died compared with 46% on L-PAM. The greatest survival benefit is apparent in premenopausal women and women with 4 or more positive axillary nodes. Acute toxicity was more frequent with CMFVP than with L-PAM, but it was acceptable and reversible with both regimens. Long-term toxicity was limited to myeloproliferative disease in 2 patients on L-PAM and 1 on CMFVP. The second generation series of studies, activated in 1979, were designed according to nodal status, estrogen receptor (ER) status, and menopausal status. We randomized ER negative, node-negative patients to 6 months of combination chemotherapy or to no treatment. Because of slow accrual, the study was closed and patients are now being entered onto a similar intergroup study with the Eastern Cooperative Oncology Group. We randomized ER-negative, node-positive patients to either 1 or 2 years of CMFVP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534593 TI - Postoperative chemotherapy and chemohormonal therapy in women with node-positive breast cancer. AB - Separate trials for premenopausal and postmenopausal (less than or equal to 65 yr of age) patients with node-positive breast carcinoma were initiated by the Eastern Cooperative Oncology Group in 1978 to evaluate adjuvant chemotherapy and chemohormonal therapy approaches. Postoperative patients were stratified by degree of axillary nodal involvement and estrogen receptor (ER) status prior to randomization. Premenopausal patients received 12 monthly cycles of intermittent cyclophosphamide, methotrexate, and 5-fluorouracil (CMF), CMF plus prednisone (CMFP), or CMFP plus continuous tamoxifen (CMFPT). Postmenopausal patients received either observation or 12 monthly cycles of CMFPT or CMFP. The median follow-up for the analyzed patients is 54 months for the 553 premenopausal patients and 59 months for the 223 postmenopausal patients. The premenopausal trial has not demonstrated any significant differences between the regimens for either relapse-free or overall survival. The relapse-free survival in the postmenopausal trial has demonstrated a trend for CMFPT over observation (P = .07). Both CMFP and CMFPT are associated with an improved relapse-free survival over observation alone in ER-negative patients (P = .01) and in progesterone receptor-negative patients (P = .01). However, the relapse-free survival advantages have not translated to survival. Side effects were significantly increased with the addition of P to CMF in the premenopausal trial. The addition of T to CMFP was associated with an increased incidence of edema and hot flashes in premenopausal patients; however, the latter was decreased in postmenopausal patients relative to CMFP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534594 TI - Results of adjuvant chemotherapy trials in breast cancer at M. D. Anderson Hospital and Tumor Institute. AB - Between 1974 and 1982, 796 patients with operable breast cancer following local therapy were treated with 3 consecutive doxorubicin-containing adjuvant therapy trials. The median follow-up of patients entered on the first trial was 102 months; the second trial, 71 months; and for the third trial, 41 months. The treatment program consisted of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC). We altered the study designs to determine the role of nonspecific immunotherapy with BCG and postoperative irradiation in the second trial and the impact of additional chemotherapy with alternate drugs after completion of FAC in the third trial. In the first study, an overall 39% reduction in mortality was observed, and, in stage II disease, reductions of 54% and 37% in mortality were observed for patients less than 50 and greater than or equal to 50 years of age, respectively, in comparison to the historical control group. The data of the second trial illustrated that BCG and postoperative irradiation had no significant impact on the disease-free and overall survival. In the third trial, patients with estrogen receptor-positive tumor treated with additional chemotherapy with alternate drugs following completion of FAC had significantly superior disease-free survival compared with patients who did not receive additional chemotherapy. The results of 3 studies show that intensive combination chemotherapy significantly reduced the risk of recurrence and death in patients with breast cancer. PMID- 3534595 TI - Analysis of dose intensity for chemotherapy in early (stage II) and advanced breast cancer. AB - In chemotherapy of advanced breast cancer, the dose intensities of regimens containing cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) and cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) correlate with remission rate. The correlation is even better if dose intensity is calculated from doses actually given instead of from targeted doses. Also, in adjuvant chemotherapy of stage II breast cancer, the dose intensities of CMF-containing regimens correlate with relapse-free survival. The adjuvant trials analyzed included studies containing only 1 or 2 of C, M, or F or with L-phenylalanine mustard (melphalan) instead of C. Three-year relapse-free survival was clearly related to dose intensity whether the analysis was of trials containing all 4 prognostic groups [women less than 50 yr with 1-3 and greater than 3 positive nodes; and those greater than or equal to 50 yr with 1-3 and greater than 3 positive nodes (P less than .00001)] or of trials in which each of these 4 groups were analyzed separately (P less than .005). In multivariate analysis, dose intensity correlated with relapse-free survival (P less than .00001), independent of the number of positive nodes or menopausal status. Randomized trials will be required before we can determine if prospective increases of dose intensity will improve outcome of chemotherapy in breast cancer. PMID- 3534596 TI - Duration of therapy in adjuvant chemotherapy trials. AB - Almost all the adjuvant chemotherapy regimens that have been established as effective in prolonging the survival of patients with early breast cancer have been administered for 1 to 2 years. If equally effective, shorter courses of therapy would result in less overall toxicity and allow early introduction of non cross-resistant regimens. The efficacy of 2 regimens differing only in duration was compared in 5 randomized trials that have been conducted. None have shown an overall survival advantage for a longer course of therapy, and only 1 has shown an advantage in time to recurrence for a longer course. There has been a nonsignificant trend in some of the trials in favor of the shorter arms of therapy. It must be concluded at the present time that regimens that utilize 4 to 6 months of therapy are likely to be as effective and are probably preferable to 12 or more months of therapy. PMID- 3534598 TI - [Mammography, sometimes a fallible study]. PMID- 3534597 TI - Influence of definitive radiation therapy for primary breast cancer on ability to deliver adjuvant chemotherapy. AB - Primary radiotherapy as a means of managing stage I and II breast cancer is receiving increasing attention. In a prospectively randomized trial comparing modified radical mastectomy to lumpectomy followed by definitive radiotherapy, we evaluated whether radiotherapy has a deleterious effect on the ability to administer adjuvant doxorubicin and cyclophosphamide to patients with histologically positive axillary lymph nodes. All patients were treated with an identical regimen, and doses were escalated to the same degree until myelosuppression occurred. There were no significant differences in the amount of chemotherapy administered to either treatment group. Patients in both groups received approximately 100% of the predicted dose of doxorubicin and approximately 117% of the predicted dose of cyclophosphamide. At present, we have no evidence that there are differences in recurrence rates as a function of the quantity of drug received, although longer follow-up is required. PMID- 3534599 TI - [Echoscopy and fertility studies]. PMID- 3534600 TI - [Amputate or leave it to nature? A surgical case from the 18th century (Johan Hendrik Correvont, Abraham Muller)]. PMID- 3534601 TI - [Current picture of a classical disease]. PMID- 3534602 TI - [Immunofluorescence study of the skin in lupus erythematosus]. PMID- 3534603 TI - [Prenatal echoscopic diagnosis of congenital heart defects]. PMID- 3534604 TI - The career plan--a luxury item? PMID- 3534605 TI - Long-term results of dialysis and transplantation in patients with end-stage renal failure from hypernephroma. AB - We analyzed long-term, 2- to 9-year results and risk factors in 13 patients treated with dialysis and transplantation for hypernephroma. Eight were dialyzed only, 6 died, 4 of them from metastatic disease that occurred in less than 8 months in 3. Five patients were also transplanted. Three died, 1 of metastatic disease. Two are alive, 1 with metastatic disease, 6 years after transplant, 3 years after diagnosis of metastasis. There were no differences in age and sex in those with early metastatic disease when compared to those without, but stage III IV disease and time of less than 5 years between first and second nephrectomy were more common in those with early metastatic disease. These data indicate that a 7-month waiting time on dialysis is enough to avoid transplanting those with early recurrence, and that patients with stage III-IV and early reappearance of tumor in the second kidney are best treated with conservative management rather than a second total nephrectomy. PMID- 3534606 TI - Evaluation and correlation of clinical and histological features of focal segmental glomerulosclerosis. AB - Clinico-histological features in 32 patients with nephrotic syndrome (NS) due to focal segmental glomerulosclerosis (FSGS) were examined. Thirteen (group A1) were diagnosed as cases of FSGS within 2 years of the onset of NS, and 8 (61%) showed progressive renal dysfunction. Ten (group A2) developed FSGS more than 2 years after the onset of NS and had a favorable prognosis. Nine (group B) differed from groups A1 and A2 in that the remaining nonsclerosed glomeruli showed slight mesangial proliferation. All but 1 patient of group B developed FSGS within 2 years of the onset of NS, and the prognosis was poor. No patient studied showed a transition between groups A and B. In some patients, lipoid nephrosis preceded FSGS, in group A2. Thus, for an accurate prediction of the prognosis, FSGS should be divided into three subclasses, based on clinico-histological features. PMID- 3534608 TI - Lymph vessels of the transplanted kidney. AB - Lymph vessels were evaluated in 20 transplanted canine kidneys. Prior to the occurrence of morphological rejection changes, transplants with good blood flow rates show areas with dilated but, less frequently, also undilated lymph vessels. In transplants with the presence of a rejection infiltrate and a decrease of the blood flow rate of 21-50% the lymph vessels may be focally dilated or, in contrast, narrowed by the cells of the rejection infiltrate. Numerous vesicles and vacuoles can be seen within the cytoplasm of endothelial cells. Interendothelial junctions may be occasionally open, the walls of endothelial cells become attenuated, and disintegration of the cell membrane is followed by a focal destruction of the wall and the development of defects. Cells of the rejection infiltrate penetrate through the gaps in the wall of the lymph vessels. The possible mechanism of the disintegration is discussed in this paper. PMID- 3534607 TI - Asymptomatic bacteriuria in health and glomerulonephropathies. AB - In a comparative study of prevalence of asymptomatic bacteriuria in a Thai population, 1.4% of 955 apparently healthy adults (12 female and 1 male) were found to have positive urine culture. Of these, 6 individuals grew staphylococcal coagulase-negative, 3 grew E. coli, and the rest grew various other organisms. Among 176 patients with glomerulonephropathies (GNP), 20.5% (17 male and 16 female) yielded positive urine cultures. These included 18 positive for E. coli, 3 for staphylococcal coagulase-negative, 5 for Klebsiella and 3 for Enterobacter; the rest grew various other organisms. There was a higher overall prevalence of asymptomatic bacteriuria in GNP when compared to the controls. Heavy proteinuria is also a predisposing factor for an increase in the prevalence of asymptomatic bacteriuria in female GNP only. PMID- 3534609 TI - Role of renal prostaglandin E2 in two-kidney, one-clip renovascular hypertension in rabbits. AB - To investigate the role of renal prostaglandin E2 (PGE2) in renovascular hypertension, urinary PGE2 was measured in rabbits with hypertension produced by left renal artery constriction. In the acute phase of renovascular hypertension (1 week after the constriction), urinary excretions of PGE2 and sodium were significantly increased without correlations with changes in the systemic blood pressure (delta BP). In this phase, delta BP was directly proportional to plasma renin activity and plasma aldosterone concentration (p less than 0.001). In the intermediate phase (5 weeks), delta BP lost significant correlations with plasma renin activity and plasma aldosterone concentration and had a inverse correlation with urinary sodium excretion (p less than 0.01). In the maintenance phase (10 weeks), delta BP showed inverse correlations (p less than 0.01) with both PGE2 and sodium excretions, although their excretions decreased to normal levels. In the clipped kidney, only urinary PGE2 excretion in the acute phase was significantly elevated (p less than 0.02), and both sodium and PGE2 excretions were significantly decreased (p less than 0.01) in the maintenance phase. In the nonclipped kidney, urinary PGE2 and sodium excretions were elevated in the acute and intermediate phases, but decreased to the control levels in the maintenance phase. In this phase, delta BP showed inverse correlation (p less than 0.01) with both PGE2 and sodium excretions from the nonclipped kidney. The infusion of saralasin, an angiotensin II analogue, dose dependently reduced the blood pressure in the acute phase, but showed no effect in the intermediate and maintenance phases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534610 TI - Renal functional reserve of transplanted kidneys. PMID- 3534611 TI - Anticoagulation in renal diseases: 20 years on and what is the outcome? PMID- 3534612 TI - Digital intravenous angiography for the study of hemodialysis vascular access. AB - Digital intravenous angiography is a simple and safe procedure and can be performed on an outpatient basis. Poor function of a hemodialysis vascular access due to increased graft resistance, reduced arterial inflow or shunt steal can be evaluated by this technique. Complications of direct graft puncture or conventional arteriography can be avoided using digital angiography. PMID- 3534613 TI - [Adult nephronophthisis: a single disease or 2 diseases?]. AB - Six families including 27 patients with adult nephronophthisis were studied. The diagnosis was based on the evidence of heredofamilial chronic tubulointerstitial renal disease, not related to urologic abnormality, and progressing to renal failure in at least 2 members of each kindred. In two families, the mode of inheritance is compatible with recessive autosomal transmission; retinal heredodegeneration was found in both kindreds; mean age at end-stage renal failure (ESRF) was 22 years. In one additional case, kidney involvement is apparently sporadic, and associated with retinal changes and blindness. In one kindred, the mode of inheritance could not be determined. In the last 3 families, pedigrees are compatible with dominant autosomal transmission; retinal involvement was found in none; ESRF developed at a mean age of 47 years. Renal cysts were detected by ultrasonography in 9 of 12 patients; they were located at the cortico-medullary junction or in the medulla in 5 cases. Renal biopsy showed rather similar changes in the various kindreds. These results are compared with those already reported from 29 families with adult nephronophthisis. PMID- 3534614 TI - [Treatment of chronic renal failure in Tunisia]. AB - Treatment of end-stage renal disease started in Tunisia in 1968 and has been used for 543 patients; 364 of them are still living. There are now 10 centers, 4 in public hospitals and 6 in private centers. Transplantation is still performed abroad. Among living patients, 312 (86%) are on hemodialysis, 11 (3%) are on CAPD and 41 (11.2%) are living with a transplanted kidney. The mean survival rate of patients is similar to the European mean and professional rehabilitation is good in most cases. New dialysis centers are planned to open and renal transplantation with related living donors will probably be performed soon. PMID- 3534615 TI - [Pharmacokinetics of anti-hypertensive drugs in renal failure]. AB - Anti-hypertensive drugs which are mainly eliminated by the kidney can accumulate in renal failure. Posology of hydrosoluble beta-blockers, converting enzyme inhibitors and central anti-hypertensive drugs should therefore be reduced. Anti hypertensive drugs whose metabolism is predominantly or exclusively hepatic, such as liposoluble beta-blockers, calcium antagonists and prazosin, can be used at usual posologies. At end-stage renal failure posology of diuretics may have to be increased in order to attain a pharmacodynamic effect. PMID- 3534616 TI - [Bone marrow graft: graft versus host reaction and rejection]. AB - The graft versus host reaction (GVH) remains the major setback of allogeneic bone marrow transplantation. GVH is observed in more than 50% of HLA identical transplantations. GVH can occur as an acute or chronic syndrome. The severity is variable, the GVH being responsible for the death of 10 to 20% of transplanted patients. Cytotoxic T lymphocytes or helper T lymphocytes are able on their own to mediate the GVH reaction. These T lymphocytes are specific for minor histocompatibility antigens. Some of them are restricted to specific tissues such as the skin. The frequency of the GVH reactions is increasing with the age of the recipient, with the degree of HLA antigens incompatibility and with presence of viral infections in the host. Several ways of GVH reaction prevention have been used such as the use of Methotrexate or Cyclosporin A. T cell depletion of the bone marrow appears to be the most effective method, allowing the achievement of HLA mismatched bone marrow transplantation. However, bone marrow T cell depletion is associated in 10 to 20% of cases with graft failure. The rate of graft failure is extremely high for HLA incompatible bone marrow transplantations. This could be due to the lack of antirejection effect of donor T lymphocytes. Graft rejection is mediated by host residual immunity. Cytotoxic T lymphocytes and perhaps natural killer cells are the effector cells. Several procedures attempting at the prevention of graft failure are currently under investigation. They tend to block the host residual immunity either by increasing chemotherapy or total irradiation, by using lymphoid irradiation or by the in vivo infusion of monoclonal antibodies specific for lymphoid cells. PMID- 3534617 TI - [Organ transplantation in France in 1984 (activity report of France-Transplant)]. AB - Nine hundred and seventy four renal transplantations were performed in 1984, thus attaining a total 7927 grafts made in France at the end of 1984. The numbers of heart transplantations (77), to which 100 prospects in 1985 can be added, as well as liver grafts (13) plus 50 prospects in 1985, are showing a spectacular increase. Although the considerable improvement of heart graft and liver graft results can be attributed, essentially to the use of Cyclosporine, this trend can be dependent in the case of kidney transplantations also on transfusions before and on a better HLA-B DR compatibility which can in optimal situations represent a respective gain of 10% and 15% of graft survival. PMID- 3534618 TI - [Destruction of the allograft]. AB - Allograft rejection is an immunological process which appears as a two-step phenomenon: during the first step, alloantigens are recognized as foreign, or "non-self", and production of "killer agents" is initiated. During the second step, the target organ is invaded by these killer agents and destroyed. Recognition, attack and destruction of the target are the different phases of rejection step II, and its clinical and/or pathological expression is generally referred to as a rejection episode. There is only one mechanism leading to the destruction of the allograft. However, its clinical or pathological expression can vary according to its severity and to the predominance of one of the effector agents (antibody or cytotoxic cell). Although permanent, the rejection process usually progresses in a wave motion; first waves are sharp and severe, but with time they become smoother and less severe. Rejection episodes are, therefore, generally described as hyperacute, acute and chronic. Endothelial cells of the allograft arteries are the main target although all the various histological structures of the graft can be injured. Immuno-suppressive agents as well as good histocompatibility can drastically modify both the course of rejection and its expression. PMID- 3534619 TI - [Role of interleukin 2 in the pathogenesis and clinical course of multiple sclerosis]. PMID- 3534620 TI - [Development of the surgical methods of treating of cervical spondylosis]. PMID- 3534621 TI - [Surgical treatment of moyamoya disease]. PMID- 3534622 TI - The development of the human blood-brain and blood-CSF barriers. AB - The commonly held belief that the fetal blood-brain and blood-CSF barriers are immature is reviewed. Results obtained from carefully conducted experiments with horseradish peroxidase and optimal freeze-fracturing suggest that the chick, rat and monkey brain barrier systems to proteins are tight from the earliest stages of development. Previous studies are reviewed in the light of new information on retrograde axonal transport, circumventricular organs, the proper use of horseradish peroxidase, freeze-fracturing, immunocytochemistry and plasma protein gene expression in the developing human brain. Original data on the development of human brain barrier systems are included. Tight junctions between cerebral endothelial and choroid plexus epithelial cells form the morphological basis for these systems. CSF in the fetus contains a remarkably high concentration of protein in contrast to adult CSF which is characterized by a very low protein concentration. This has previously been interpreted as due to immaturity of barriers in the fetal brain. Tight junctions between cerebral endothelial cells and between choroid plexus epithelial cells have been investigated in human embryos and fetuses by freeze fracture and thin section electron microscopy. As soon as the choroid plexus and the brain capillaries differentiated they exhibited well formed tight junctions. These junctions were very complex at early stages of development. A new barrier consisting of 'strap junctions' was found in the developing germinal matrix. The very high concentration of protein in early human fetal CSF cannot be accounted for by a lack of tight junctions in the developing brain barrier systems. Some transfer of proteins from blood to CSF, possibly via an intracellular route, has been demonstrated in immature experimental animals, but it seems that an important contribution to CSF proteins in the fetus may be synthesis by the developing brain and choroid plexuses with subsequent release into the CSF. PMID- 3534623 TI - Pineal-retinal molecular relationships: distribution of "S-antigen" in the pineal complex. AB - The immunocytochemical localization of S-antigen, a specific protein first discovered in retinal photoreceptors, was studied in the pineal complex of vertebrates (eel, pike, frog, lizard, passerines, mouse, hamster) using monoclonal antibody immunofluorescence. S-antigen immunoreactivity was demonstrated concurrently in retinal photoreceptors and in most pineal phototransducers of all species, i.e. in pineal cells of the receptor series (cone-like, modified photoreceptor cells, pinealocytes) and in cone-like photoreceptors of the frog frontal organ and lizard parietal eye. The labelling was distributed either in all compartments of these cells, or restricted to outer segments. The functional significance of the S-antigen as well as some phylogenetic and ontogenic implication of this marker are discussed. PMID- 3534624 TI - [Heterotopic liver transplant for irreversible hepatic necrosis. An experimental study in the pig]. PMID- 3534625 TI - Langenbuch's cholecystectomy, once a remarkably controversial operation. AB - Carl Langenbuch (1846-1901) has been appropriately designated the 'creator' of surgery of the gallbladder. In the surgical treatment of gallstone disease, Langenbuch advocated cholecystectomy in favour of cholecystostomy since he realised that the gallbladder should be removed not because it contained stones but because it originated the stones. In 1882, he successfully performed the first cholecystectomy in a 43-year-old patient. The new operation gave rise to a vehement, international discussion questioning the dispensability of the gallbladder in view of its alleged role in bile physiology. The famous abdominal surgeon Lawson Tait appeared to be a strong opponent of cholecystectomy, maintaining cholecystostomy as the procedure of choice. In the medical journals, he rejected cholecystectomy in unequivocal terms. The controversy about cholecystectomy persisted for several decades, delaying its wide acceptance. PMID- 3534626 TI - Correlation between a positive gallbladder culture and subsequent wound infection after biliary surgery. PMID- 3534627 TI - Transgenerational influences on the development of early prodigious behavior: a case study approach. PMID- 3534628 TI - [Budd-Chiari syndrome. Description of 2 cases]. AB - The causes of Budd-Chiari syndrome are quickly reviewed with reference to the pathology described in series from various parts of the world. In the West the syndrome is caused by obstruction of the Inferior Vena Cava in its retrohepatic course with or without concomitant obstruction of the suprahepatic veins attributable to fibrous regression of the vessel wall and subsequent endoluminal thrombosis. In the Far East and South Africa the syndrome is caused by the presence of a thin fibrous septum obstructing the vein immediately upstream of the right atrium. Of the two cases of Budd-Chiari syndrome described, one presented high grade stenosis of the Vena Cava caused by fibrous regression of the vessel wall and the other a fibrous septum situated transversally to the lumen. The description of the first case is particularly interesting because before the clinical picture was correctly understood, a succession of major complications induced incorrect diagnosis and treatment. In contrast the second was a classic case of rapid diagnosis and successful treatment. The discussion of the two cases highlights the primary role currently played by abdominal echography with Doppler ultrasound, examination with lower cavography using a contrast medium in documenting a caval flow pathology of this kind. CAT scanning, arteriography of the Celiac tripod and closed hepatic needle biopsy appear to be much less decisive. PMID- 3534629 TI - [Alcoholic gastropathy. Notes on its epidemiology and the therapeutic experience using pirenzepine]. AB - Chronic alcoholic gastritis is a very important social problem in the Health District of Arezzo, which covers an area where wine is an integral part of the diet. The etiology of this disease is related to the alcohol induced rupture of the gastric mucosal barrier. For this reason we wanted to verify the therapeutic effect of a "barrier acting drug" such as pirenzepine. A selected group of 50 randomized patients (46 males and 4 females, mean age 52.6 years) received in a double blind fashion 50 mg b.i.d. of pirenzepine or placebo for consecutive 4 weeks. Endoscopy and histological examinations performed before and after treatment together with the clinical evaluation of the dyspeptic symptoms, showed that pirenzepine was more active than placebo. In addition our results suggest that pirenzepine stimulates defence mechanisms of the gastric mucosa. PMID- 3534630 TI - [Occupational asthma from the use of synthetic resins. Personal case histories and a review of the literature]. AB - 33 cases of occupational asthma in plastics workers encountered by Turin INAIL in 1971-85 are examined. Functional and immunological test data reveal the possibility of various asthmogenic mechanisms both immune and non-immune. PMID- 3534631 TI - [Potential use of indenolol in hypertensive patients with chronic bronchial asthma]. AB - The data are reported on a double blind clinical experiment using indenolol on a group of asthmatic hypertensives. The drug revealed a satisfactory anti hypertensive action in the absence of any significantly bronchoconstrictive effect. The orciprenaline test performed at the end of the experiment showed that the drug does not reduce the availability of beta 2 bronchial receptors vis-a-vis the beta 2 stimulants. PMID- 3534632 TI - [Efficacy of the simultaneous aerosol administration of fenoterol and 2(alpha thenoylthio)propionylglycine]. AB - The aim of the present study was to investigate the effect of a new mucolytic drug 2-alpha-tenoiltium-propionylglycine (2-alpha-TPG) administered in spray form together with a selective beta 2 stimulant, fenoterol. A double blind test was conducted on 26 patients to whom 2-alpha-TPG-fenoterol and placebo-fenoterol were given in spray form in two daily doses for 15 days at 10 day intervals. The data suggest the existence of an additive effect between the mucolytic drug (2-alpha TPG) and the beta 2 stimulant (fenoterol) that would justify the use of the combination in the treatment of such patients. PMID- 3534633 TI - [Heart transplants in Italy. Statement of the National Association of Hospital Cardiologists (April 1986)]. PMID- 3534634 TI - [Antibacterial and antifungal activity of isoflurane and common anesthetic gases]. AB - An in vitro analysis was conducted to investigate the hypothetical antibacterial and antimycotic activity of the common anesthetic gases (halothane, enflurane, isoflurane, methoxyflurane) in view of the clinical absence of bronchopulmonary pathology after inhalation narcosis despite the many risk factors involved. For this purpose scalar dilutions of the four gases were prepared on cultures of Klebsiella pneumoniae and Candida albicans and the antibacterial action of the gases was tested in vitro. Even with the weaker concentrations used, halothane and methoxyflurane totally inhibited both microorganisms. Enflurane had less effect on Klebsiella p. and almost none on Candida. Isoflurane, a new halogen ether anesthetic was found to have an excellent inhibitory effect. In conclusion it is hypothesised that the anesthetic gases considered might have an in vivo antibacterial activity considering the experimental results obtained in vitro. PMID- 3534635 TI - Adenosine deaminase-containing hypothalamic neurons accumulate 5 hydroxytryptophan: a dual-colour immunofluorescence procedure using a new fluorescence marker. AB - Neurons of the posterior hypothalamic magnocellular nucleus (PHMN) in the rat are immunoreactive for adenosine deaminase (ADA) and cells coextensive with this nucleus show immunoreactivity for serotonin after pretreatment with 5 hydroxytryptophan (5-HTP). The degree to which ADA coexists in cells having 5-HTP uptake capability was analyzed by a new double immunohistofluorescence procedure employing diethylaminocoumarin (DAMC). It was determined that 5-HTP accumulating cells of the PHMN represent a subpopulation of those immunoreactive for ADA. These results add further to the neurochemical characterization of this globally projecting hypothalamic cell group and point out the utility of DAMC as a new immunohistofluorescence marker. PMID- 3534636 TI - Localization of 125I-insulin binding sites in the rat hypothalamus by quantitative autoradiography. AB - In vitro autoradiography and computer video densitometry were used to localize and quantify binding of 125I-insulin in the hypothalamus of the rat brain. Highest specific binding was found in the arcuate, dorsomedial, suprachiasmatic, paraventricular and periventricular regions. Significantly lower binding was present in the ventromedial nucleus and median eminence. The results are consistent with the hypothesis that insulin modulates the neural regulation of feeding by acting at sites in the hypothalamus. PMID- 3534637 TI - Substance P-like immunoreactivity in the retina and optic lobe of the squid. AB - The distribution of substance P-like immunoreactivity within the squid retina and brain was studied by immunofluorescence. Positive immunoreactivity was observed as a single layer of fibres in the retina. The retina was devoid of tyrosine hydroxylase, serotonin, gamma-aminobutyric acid, cholecystokinin, neuropeptide Y, somatostatin, enkephalin and vasoactive intestinal peptide immunoreactivities. Substance P immunoreactivity was particularly abundant in the optic lobe. The optic lobe had a distinct layer of substance P fibres near the periphery. Immunoreactive cell bodies, fibres and varicosities were additionally present in various areas of the optic lobe. Substance P immunoreactivity in the other ganglia of the brain was restricted to a few scattered fibres. PMID- 3534638 TI - The distribution of 'extraurophyseal' urotensin I-immunoreactivity in the central nervous system of Catostomus commersoni after urophysectomy. AB - The occurrence and distribution of the fish neuropeptide urotensin I immunoreactive (IR-UI) perikarya and fibres was investigated by peroxidase-anti peroxidase immunohistochemistry in paraffin and vibratome sections of the central nervous system of urophysectomized and control fishes. IR-UI neurones not described previously were found in the area ventralis telencephali pars dorsalis, in the area pretectalis and in two unidentified brainstem nuclei of control and urophysectomized fishes. In urophysectomized fishes a 4-fold increase in the number of parvocellular IR-UI neurons was observed in the nucleus lateralis tuberis, whereas no significant differences were seen in other IR-UI neuronal groups. A functional relationship between IR-UI 'extraurophyseal' (i.e. brain) and caudal neurosecretory systems is suggested. PMID- 3534639 TI - Coexistence of immunoreactivity for melanin-concentrating hormone and alpha melanocyte-stimulating hormone in the hypothalamus of the rat. AB - Coexistence of immunoreactivity for melanin-concentrating hormone (MCH) and alpha melanocyte-stimulating hormone (alpha-MSH) within rat hypothalamic neurons has been examined by the unlabeled antibody enzyme method. Neurons exhibiting both MCH- and alpha-MSH-like immunoreactivities were found in the dorsolateral hypothalamus, whereas no MCH-like immunoreactive perikarya were seen in the arcuate nucleus, where some neurons were stained with alpha-MSH antiserum. There seem to be two distinct alpha-MSH-like immunoreactive neurons in the rat hypothalamus, one exhibiting coexistence with MCH-like immunoreactivity and the other not showing any cross-reaction with MCH antiserum. PMID- 3534640 TI - Changes in human diaphragmatic electromyogram with positive pressure breathing. AB - An increase in diaphragmatic electromyogram (EMG) recorded via oesophageal electrodes during positive pressure breathing has been reported to indicate an increase in the neural outflow to the muscle. However, using similar techniques, the size of compound muscle action potentials produced by supramaximal phrenic nerve stimulation also increased during positive pressure breathing. It is concluded that a change in EMG recording conditions rather than in central respiratory outflow may explain the increase in diaphragmatic EMG produced by positive airway pressure. PMID- 3534641 TI - Demonstration of a neuropeptide Y (NPY)-like immunoreactivity in the pigeon retina. AB - The distribution of neuropeptide Y (NPY)-like immunoreactivity in the pigeon retina was investigated by fluorescence immunohistochemistry. NPY-positive cells were found in central and peripheral retina. NPY somata were located in the proximal portion of the inner nuclear layer and their processes directed to the inner plexiform layer where they ramified in 3 immunoreactive bands. NPY might play a role as a neurotransmitter or neuromodulator in the pigeon retina. PMID- 3534642 TI - The biosynthesis of carotenoids. PMID- 3534643 TI - Calcium ions act as modulators of intracellular information flow in retinal rod phototransduction. PMID- 3534644 TI - Synaptic plasticity, memory, and learning. In memory of the late Dr. Nakaakira Tsukahara. PMID- 3534645 TI - The role of neurochemical modulation in learning. AB - Tsukahara creatively exploited the advantages of a "simple system" approach in a vertebrate context to gain cellular insights into the learning process. The molluscs Aplysia and Hermissenda have provided useful invertebrate examples of this approach. For classical conditioning of Hermissenda a temporal sequence of cellular transformations has been found to correspond to and to substantially account for a learning-specific behavioral transformation. For at least days after the conditioning a biophysical record persists: two voltage-dependent K+ currents, IA and ICa2+-K+, remain reduced in amplitude and at least IA shows an increased rate of inactivation. More recently, a similar biophysical record of associative memory has been identified in the mammalian brain (Disterhoft et al., 1986). Other experiments suggest that a synergistic interaction of C-kinase activation with Ca2+/CaM-kinase activation enhances and prolongs Ca2+-mediated K+ current reduction. The effects of alpha-receptor agonists to enhance depolarization of type B cells (a site of visual-vestibular convergence) and in turn acquisition of classical conditioning are in contrast to the effects of serotonin which can hyperpolarize and thereby reduce depolarization during the acquisition process. For both LTP and LTD, application of a neurotransmitter itself is not sufficient to produce long-lasting neural modification. In this respect, both the LTP and LTD models are more similar to the biochemical sequence implicated in Hermissenda conditioning than to the mechanism initiated by serotonin-like substances proposed for Aplysia sensitization. PMID- 3534646 TI - Some principles emerging from the study of short- and long-term memory. AB - Recent studies indicate that in invertebrates short-term memory for various forms of learning involves covalent modifications of pre-existing proteins. By contrast, long-term memory utilizes genes and proteins not required for short term memory. PMID- 3534647 TI - Long-term depression as a memory process in the cerebellum. AB - When details of neuronal network structures of the cerebellum were uncovered in the 1960's, a hope emerged that functions of the cerebellum would eventually be explained in terms of operation of the cerebellar neuronal network. While various network models were proposed, involvement of synaptic plasticity in the cerebellar neuronal network as a memory process became a focus of discussion. The characteristic dual inputs to Purkinje cells, one from parallel fibers (axons of granule cells) and the other from climbing fibers, were suggested to represent such synaptic plasticity, and under this assumption, the cerebellar cortex was envisaged as a learning machine for pattern recognition. Despite these theoretical suggestions, earlier efforts to reveal the postulated synaptic plasticity in the cerebellar cortex were unsuccessful. It had then to wait for a decade before long-term depression (LTD) was finally found as its possible substrate. LTD is a long-lasting depression of parallel fiber-to-Purkinje cell transmission that occurs following conjunctive activation of parallel fibers and a climbing fiber both converging onto one and the same Purkinje cell. LTD has now been established by means of various testing methods, and recent efforts have been directed toward its molecular mechanisms. Efforts have also been devoted to demonstrate roles of LTD in motor learning through studies of adaptation of the vestibulo-ocular reflex, adaptive adjustment of hand movement, and more recently eyelid blink conditioned reflex. This article reviews recent efforts to characterize the LTD as a memory process, presumably the major, in the cerebellum. PMID- 3534648 TI - Using learning theory to design and evaluate computer-assisted instruction software. PMID- 3534649 TI - A one and future nurse. PMID- 3534650 TI - Screening for H.I.V. antibodies. PMID- 3534651 TI - Anniversary special: 15 nurses of distinction. 15 years of working together. PMID- 3534652 TI - Prospective payment--a good idea gone awry? PMID- 3534653 TI - Endogenous anticonvulsant substances. AB - Epileptic seizures will normally arrest abruptly and spontaneously, and the brain will remain refractory to further seizures for some time thereafter. This paper reviews the possible mechanisms underlying this seizure arrest and refractoriness. The data suggests that neuronal fatigue is not involved in either of these processes, whereas the role of ions and excitatory systems are unclear. Rather, seizure arrest and refractoriness may come about by the seizure-induced release and/or activity of multiple endogenous anticonvulsant substances. The spontaneous arrest of the seizure may involve the purine adenosine, in addition to other unknown mechanisms. Seizure refractoriness involves multiple systems, the most important of which, on the available evidence, are prostaglandins and opioid peptides and possibly benzodiazepine systems, although other neuropeptides and the purines may also be involved. The implications of these conclusions to anti-epileptic drug development and status epilepticus are discussed. PMID- 3534654 TI - Pineal indoles: significance and measurement. AB - Despite intensive investigation, particularly over the past fifteen years, many aspects of pineal function with respect to mammalian physiology remain obscure. Much of this work is reviewed and particular attention focussed on indole metabolism within the pineal gland. Emphasis is placed on the development of new analytical techniques with special reference to high performance liquid chromatography coupled with electrochemical detection. The growth in knowledge regarding pineal indole synthesis which can be attributed to the use of this technique is discussed. The possibility that pineal indoles other than melatonin may function as hormones or neuromodulators is considered. A functional role for 5-hydroxytryptophol as a neuromodulator, possibly associated with diffuse neuroendocrine function (amine precursor, uptake and decarboxylation, APUD) is suggested. PMID- 3534655 TI - Feeding children: in the beginning--nutrition and pregnancy. AB - The health and well-being of every child is affected by both the quality and quantity of food, but when does nutrition first begin to be important? Is it after the birth or from the moment of conception, or perhaps even before this? This paper will focus on the nutritional status of the mother, before as well as during pregnancy, and its relationship to the birth weight and subsequent health of the child. Pre-pregnant weight is a major factor affecting birth weight; underweight women may be at increased risk of delivering a low birthweight infant and of complications of pregnancy, whilst those who are excessively obese are at greater risk of gestational diabetes and hypertension. Animal studies have demonstrated that severe vitamin and mineral deficiencies have dramatic effects on reproductive outcome, and there is now growing evidence that even marginal deficiencies in women may have deleterious effects on pregnancy outcome. Nutrition interventions which involve low-risk women appear to have little effect but beneficial effects have been demonstrated in interventions directed at high risk women. Information about nutrition should be the mainstay of any advice given to prospective parents. PMID- 3534656 TI - Overdentures in clinical practice: a review and three case reports. PMID- 3534657 TI - Multiple dose insulin regimen using the NovoPen. PMID- 3534658 TI - Out of Africa. PMID- 3534659 TI - Endosteal blade implants with tricalcium phosphate--a technique for a more predictable prognosis. PMID- 3534660 TI - The Manhattan bridge--a new silk-wrap technique. PMID- 3534661 TI - Functional images of lung 99Tcm-DTPA aerosol transfer in smokers and nonsmokers. AB - The large amount of information from dynamic 99Tcm-DTPA lung can be simplified and rendered easily interpretable by the use of functional images. Eight such images have been devised: a maximum count image, a minimum count image, a time of maximum count image, a time of minimum count image, percentage maximum change image, a T50 image, a standard error image and a correlation coefficient image. These images enable the distribution of aerosol after inhalation, the reliability of the calculated T50 value and movement artefacts to be easily identified. They also allow rapid assessment of the distribution of T50 values in the lungs which may be particularly useful in segmental lung disease. PMID- 3534663 TI - The stress of driving. PMID- 3534662 TI - Modern treatment of vaginal embryonal rhabdomyosarcoma. PMID- 3534664 TI - Coping with stress. PMID- 3534665 TI - The chronic mental health patient: lost in the bureaucratic shuffle. PMID- 3534666 TI - Selecting a nursing diagnosis resource. PMID- 3534667 TI - [10 years of the AIO. Working Group for Internal Oncology of the German Cancer Society]. PMID- 3534668 TI - [Organization of oncologic management facilities by the established medical community 1976-1986]. PMID- 3534669 TI - [Current emphasis in experimental cancer research and its relation to clinical oncology]. PMID- 3534670 TI - [The Farmitalia Carlo-Erba prize]. PMID- 3534671 TI - [Phase II study group of the Workshop for Internal Oncology of the German Cancer Society: conception, development and activities]. PMID- 3534672 TI - [10 years' therapy of acute leukemias]. PMID- 3534673 TI - [10 years' therapy of malignant lymphomas]. PMID- 3534674 TI - [10 years' therapy of breast cancer]. PMID- 3534675 TI - [The development of oncology in the last decade]. PMID- 3534676 TI - [The development of tumor centers in West Germany]. PMID- 3534677 TI - Hexamethyldisilazane in preparation of retinal tissue for scanning electron microscopy. AB - A new rapid procedure for desiccating frozen resin-cracked retinal tissue for scanning electron microscopy (SEM) which permits air-drying was found to compare favorably with tissues prepared by critical-point drying: Retinal tissue was fixed in 4% phosphate-buffered neutral formaldehyde, dehydrated by means of graded ethanol, embedded in Epon, cracked and washed in propylene oxide. For desiccation, the specimens were immersed in hexamethyldisilazane (HMDS), air dried and finally sputter-coated. The method is time-saving, gives extended information in SEM, and the number of good specimens is increased. PMID- 3534678 TI - Vitamin D-dependent calcium binding protein immunoreactivity in human retina. AB - Using immunohistochemistry, vitamin D-dependent calcium binding protein (D-CaBP) has been detected in human retina. In the photoreceptor layer the cones are positive but the rods are negative. In the inner nuclear layer, horizontal cells and some bipolar cells are D-CaBP. In the ganglion cell layer both small and large somata are immunoreactive for D-CaBP. Beaded fibres from the outer plexiform, inner plexiform and fibre layers are also positive. PMID- 3534679 TI - [Our experience in preparing demineralized bone transplants]. PMID- 3534680 TI - [X-ray characteristics of transplants in pelvic reconstructive operations on patients with congenital hip dislocation]. PMID- 3534681 TI - [Outcome prognosis in treating patients by transosseous osteosynthesis]. PMID- 3534682 TI - [Organic bone matrix: new biochemical data]. PMID- 3534683 TI - [Ultrasonic diagnosis of hypertrophic pyloric stenosis]. PMID- 3534684 TI - [Ultrasonic diagnosis of splenic complications of chronic pancreatitis]. PMID- 3534685 TI - [In memory of Janos Angyan]. PMID- 3534686 TI - [Corporate activities of Peter Rath, pharmacist]. PMID- 3534687 TI - [Jzsef Jakab was born 90 years ago]. PMID- 3534688 TI - Periodicity of urinary beta-2-microglobulin excretion. AB - Using the cosinor system we examined the chronobiology of urinary beta-2 microglobulin excretion. The following dimensions were studied: urinary volume, creatinine concentration, creatinine excretion, beta-2-microglobulin concentration, beta-2-microglobulin excretion and the beta-2 microglobulin/creatinine ratio. Urinary volume showed an acrophase at 1704 hours (p = less than 0.01), creatinine concentration showed an acrophase at 0512 hrs (p = less than 0.006) and the beta-2-microglobulin/creatinine ratio presented an acrophase at 1736 hrs (p = less than 0.03). Data were related to a tau = 24 hrs. The data clearly reveal that the beta-2-microglobulin/creatinine ratio shows a circadian rhythm in urinary excretion. PMID- 3534689 TI - [Treatment of stage IV neuroblastoma with high-dose melphalan and autologous bone marrow transplantation following in vitro preliminary treatment of the bone marrow with the active cyclophosphamide derivative Asta Z-7654]. AB - The case of a 4 year 8 months old boy with neuroblastoma of unknown primary, metastatic to the bone and to the bone marrow is presented. After achieving a partial remission with six cycles of conventional chemotherapy, the patient was given supraconventional chemotherapy (melphalan 220 mg/m2 bolus i.v.) in an effort to eliminate residual disease. Prior to the administration of the drug, 560 cc of autologous bone marrow, morphologically free of tumor was harvested (total 110 X 10(8) nucleated cells) and concentrated to a mononuclear cell fraction with a total of 10 X 10(8) cells. After in vitro purging with the stable metabolite of 4-hydroperoxycyclophosphamide ASTA Z 7654 (40 micrograms/2 X 10(7) mononuclear cells/ml), the mononuclear cell suspension was retransfused 10 hours following the application of high dose melphalan. Hemopoietic reconstitution was delayed with a platelet count reaching 70,000/microliter only after seven months. At the time of this writing (20 months after diagnosis and 16 months after autologous bone marrow transplantation) there is no evidence for active disease according to the bone scan and multiple bone marrow biopsies. In view of the dismal prognosis of patients with neuroblastoma, stage IV it is recommended that further patients should be treated with a slightly modified protocol of the cooperative austrian neuroblastoma study. PMID- 3534690 TI - Transcutaneous electrical nerve stimulation (TENS) in angina pectoris. AB - The aim of this study was to determine the efficacy of transcutaneous electrical nerve stimulation (TENS) in the treatment of chronic stable severe angina pectoris. In a short-term study the effect of TENS was studied in 10 male patients with angina pectoris (functional class III and IV). All patients had previously been stabilized on long-term maximal oral treatment. The effects of the treatment were measured by means of repeated bicycle ergometer tests. All patients had an increased working capacity (16-85%), decreased ST segment depression and reduced recovery time during TENS. No adverse effects were observed. A long-term study of TENS on similarly selected patients showed beneficial effects in terms of pain reduction, reduced frequency of anginal attacks, increased physical activity and increased working capacity during bicycle ergometer tests. An invasive study was carried out with respect to systemic and coronary hemodynamics and myocardial metabolism during pacing provoked myocardial ischemia in 13 patients. The results showed that TENS led to an increased tolerance to pacing, improved lactate metabolism, less pronounced ST segment depression. A drop in systolic blood pressure during TENS treatment at identical pacing rates indicated a decreased afterload. An increased coronary flow to ischemic areas in the myocardium was supported by the fact that the rate pressure product during anginal pain increased during TENS. PMID- 3534691 TI - Measurement of pain and morphine hypalgesia in monkeys. AB - In order to determine the relative sensitivities of different behaviors to systemic morphine, monkeys were trained: to escape electrical stimulation (ES) at intensities that defined escape thresholds and permitted quantification of reactions to sub- and suprathreshold stimuli, to perform the same operant response to auditory stimulation for food reinforcement, and to detect minimal intensities of light tactile stimulation, defining thresholds for touch. Thresholds for escape responses corresponded to pain thresholds of human subjects previously tested with identical stimulus parameters. The response measures that best differentiated suprathreshold levels of stimulation of the hind limbs were the force and the speed of escape responses by the forelimbs. Reflexive responses of the stimulated leg were related to ES intensity by a negatively accelerating function that was flat through much of the range of stimulus intensities that were escaped. Frequency histograms of adjunctive behaviors in the intertrial intervals revealed little, if any, relationship to the presence or the intensity of ES. The frequencies of intertrial vocalizations, spontaneous bar pulls and general bodily activity were similarly distributed following subthreshold vs. suprathreshold levels of ES and following ES vs. food reinforced trials. Dose response curves for the different behavioral measures revealed significant effects of systemic morphine at the following dosages: The adjunctive behaviors clearly were the most susceptible to depression. Intertrial vocalizations, bar pulls and activity were reduced significantly in frequency at 0.25 mg/kg and above. At doses of 1 mg/kg and above, the percentage, speed and force of escape responses were reduced. The effects on response tendency and latency cannot be ascribed with confidence to an inhibition of pain, since the percentage and speed of responses for food reinforcement also were reduced at these dosages; and thresholds for detection of light touch were significantly elevated. The force of appetitive responses was not significantly reduced by moderate doses of morphine, suggesting that reduction of escape force may represent an effect on pain sensitivity. The magnitudes of reflexive responses to ES were increased by doses below 3 mg/kg, and 3-5 mg/kg attenuated reflexive force.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3534692 TI - Percivall Pott 1714-1788. PMID- 3534693 TI - Perineal decubitus ulcer with urethro-cutaneous fistula without bilateral ischiectomy: case report. AB - Perineal decubitus ulcer with urethro-cutaneous fistula has previously been reported in paraplegics as a late complication following bilateral ischiectomy. This case report illustrates the occurrence of the problem in a male paraplegic without bilateral ischiectomy, and this has not been previously reported in the English literature. Successful reconstruction was accomplished with a full thickness skin graft tube and and gracilis muscle flap. PMID- 3534694 TI - Immunoglobulin class responses to Taenia taeniaeformis in susceptible and resistant mice. AB - The immunoglobulin class response of two inbred strains of mice, C57BL/6 and C3H/He, to infection and challenge with Taenia taeniaeformis larvae was compared using the enzyme-linked immunosorbent assay and gel electrophoresis followed by immunoelectrotransfer blot (Western blotting) techniques. The C57BL/6 mice, which are relatively resistant to infection, had a more restricted humoral response than the more susceptible, C3H/He mice. C3H/He mice produced a wider range of immunoglobulin classes, in particular IgA and IgG3, to those antigens recognized by both strains of mice. In addition they produced antibodies to a wider range of antigens. The production of these additional antibodies by the susceptible strain raises the possibility that some of the antibodies may have specificities which interfere, or block the action of potentially protective antibodies. Antibodies, mainly of the IgG1, IgG2a and IgG2b classes, to antigens of approximately less than 21,000, 21,000-23,000, 30,000 and 60,000 mol. wt, present both in the oncosphere and the metacestode extracts, were found in serum from previously infected and resistant mice of both strains. These antigens may be important in stimulating protective concomitant immunity. PMID- 3534696 TI - [Interdisciplinary meeting on anti-infection chemotherapy. 5 December 1985, Paris]. PMID- 3534695 TI - Post lung-stage schistosomula of Schistosoma mansoni exhibit transient susceptibility to macrophage-mediated cytotoxicity in vitro that may relate to late phase killing in vivo. AB - Studies of protective immunity against Schistosoma mansoni in immunized mice suggest that a proportion of challenge parasites may be eliminated after they have passed through the lungs of the host several days after infection; however, no potential immune effector mechanism of resistance against this stage of the parasite has yet been identified, since schistosomes have been shown to rapidly become resistant to antibody-dependent killing mechanisms. In this study, different development stages of S. mansoni were examined for their susceptibility to in vitro cytotoxicity by lymphokine-activated macrophages. As previously shown, newly transformed larvae were readily killed by lymphokine-treated peritoneal macrophages or the macrophage cell line IC-21 (80% mortality over 48 h in vitro), whereas 7 and 10 day old lung-stage parasites had become refractory to macrophage effects. However, after 2 to 2 1/2 weeks of development in vivo, juvenile parasites recovered from the liver were again susceptible to activated macrophage-mediated cytotoxicity (25-65% mortality). Ultrastructural studies of 2 1/2 week old parasites co-cultured with activated IC-21 cells revealed that damage was largely restricted to the areas beneath the parasite surface and gut syncitia; surface membrane disruption was not evident. This late stage of susceptibility was transient and by 4 to 6 weeks liver-stage worms had again become refractory to macrophage killing. The interaction of post lung-stage parasites with activated macrophages was antibody independent. Furthermore, schistosomes isolated from the portal circulation 2 1/2 weeks after infection showed no evidence of surface-bound immunoglobulin in a quantitative immunofluorescence assay, nor did antisera from chronically infected mice (CIS) or mice vaccinated with irradiated cercariae (VS) react with the surface of these parasites in vitro, making the possibility of direct antibody-dependent killing mechanisms unlikely. However, both CIS and VS did recognize excretory/secretory proteins synthesized by 2 1/2 week old liver-stage schistosomes, including a major antigen of approximate Mr (X 10(-3] 220 (220K). It is therefore possible that such antigens might participate in protective immunity, for example via immune complex formation or activation of sensitized T cells. These observations support the role of macrophages as immune effector cells in mice immunized against Schistosoma mansoni, and provide the first physiologically relevant mechanism whereby the immune system might recognize and kill post-lung stage schistosomes. PMID- 3534697 TI - [A study by the National Reference Center for Antibiotics on inocula for antibiotic sensitivity testing]. AB - We compared the diameters of inhibition zones obtained during antibiotic sensitivity testing using two different techniques for preparing and seeding the inoculum, i.e. photometric adjustment followed by flooding, and turbidity adjustment followed by swab streaking. There was no significant difference between the results recorded following photometry-flooding of a light inoculum (2 to 3 X 10(6) CFU/ml) and following swab seeding of a bacterial suspension with a turbidity equal to 0.5 Mac Farland unit. These results indicate that both methods tested answer the NCCLS performance standards for disc antibiotic sensitivity testing and the critical values of the S.F.M. Antibiotic Sensitivity Testing Committee. PMID- 3534698 TI - [In vitro study of ceftriaxone binding to blood]. AB - Binding of ceftriaxone, a new third generation cephalosporin, to blood was studied in vitro. Steady state dialysis with 14C-ceftriaxone was used. Percentages of ceftriaxone bound to plasma within the range of therapeutic concentrations (10 to 1,000 microM) varied widely (80 to 50%). Indicating that the binding process is saturable, investigations performed with various isolated plasma proteins in physiologic concentrations show that ceftriaxone binds mainly to albumin, and marginally or not at all to alpha-1-acid glycoprotein, gammaglobulins, transferrin, haptoglobin, and lipoproteins. Albumin has a single binding site (n = 0.7) with moderate affinity (Ka = 72,000 M-1) for ceftriaxone. The presence of this site explains why ceftriaxone binds to plasma according to a saturable process. Only a small proportion (5%) of ceftriaxone (75-450 microM) binds to red blood cells in whole blood with a 50% hematocrit. A strongly significant inhibition of ceftriaxone (520 microM) binding to plasma was found with high bilirubin levels (230 microM) (24% decrease; p less than 0.01). A small but significant decrease in ceftriaxone (380 microM) binding to plasma was found with high serum oleic acid (1014 microM) or uric acid (1,800 microM) concentrations (2% decrease; p less than 0.05). PMID- 3534699 TI - [Bronchial diffusion of ceftriaxone]. AB - The value of a single daily injection of 2 g ceftriaxone in lower respiratory tract superinfections was demonstrated in 22 patients in a neurosurgical intensive care unit. Catheter bronchial samples were submitted to bacteriological investigation and ceftriaxone concentrations were determined in serum and bronchial secretions. Results show that sustained efficient levels of ceftriaxone were achieved and enabled the successful treatment of lower respiratory tract infections due to susceptible pathogens. PMID- 3534700 TI - [Pharmacokinetics of ceftazidime injected peritoneally in continuous ambulatory peritoneal dialysis]. AB - Peritonitis is the most frequent complication in patients under continuous ambulatory peritoneal dialysis. Intraperitoneal administration of ceftazidime in a dose of 125 mg per liter dialysate achieved serum concentrations higher than the minimal inhibitory concentrations of most organisms in spite of low peritoneal clearance. Serum concentration was stable up to the 120th hour. Dialysate osmolarity had no influence on serum concentration, peritoneal absorption or clearance of ceftazidime. Peritoneal inflammation did not cause changes in ceftazidime pharmacokinetics. Ceftazidime used alone as the first choice treatment was successful in 85%, of cases. PMID- 3534701 TI - [Experimental and clinical evaluation of the biliary elimination of ceftazidime]. AB - After adding 10 mg of ceftazidime to the circulating blood of five isolated rabbit liver perfusions, total antibiotic excretion over a 3 hours period accounted for 1.4% of the administered dose; only 0.9% was found to be metabolized by the liver. In five healthy subjects given 2 g ceftazidime intravenously, 0.05% (102 +/- 576 micrograms) was recovered in the duodenal fluid over a four-hour period. In 10 patients with a T-tube inserted following cholecystectomy, 0.21% of a 2 g dose of ceftazidime injected intravenously was found in the bile collected over a 12-hour period (4 161 +/- 489 micrograms); a mean biliary peak of 36.3 +/- 4.0 micrograms/ml was recorded during the second hour. In 10 patients in whom serum, choledochal bile and gallbladder bile were sampled simultaneously during surgery 1 hour after IV administration of ceftazidime, the concentrations found were 40.6/e 2.1, 78.3 +/- 12.0 and 17.9 +/- 7.5 micrograms/ml respectively. Our results suggests that ceftazidime may be suitable in the treatment of biliary tract infections. PMID- 3534702 TI - [Diffusion of aztreonam in the tissues and biological fluids of the female genital tract]. AB - Diffusion of aztreonam into female genital tract tissues was investigated. After a single IV injection of 1 g, aztreonam was assayed in uterine tissue, uterine tube tissue and peritoneal fluid in 15 patients undergoing coelioscopy or hysterectomy. In addition, to evaluate placental transfer of aztreonam, maternal blood, amniotic fluid and cord blood samples were collected in five women undergoing cesarean section. Concentrations of aztreonam were determined using a microbiologic method. Mean concentrations 1 to 2 hours after administration of the drug were 11 to 25 micrograms/g in the endometrium and uterine tube tissue and 18 to 30 micrograms/g in the myometrium. Concentrations in peritoneal fluid samples were lower, ranging from 4.7 micrograms/ml (0.5 h) to 16 micrograms/ml (1 to 2 hours after the injection). The ratio of tissue concentrations to serum concentrations found at the same time, expressed as a percentage, ranged from 50 to greater than or equal 100%. Placental transfer of aztreonam proved comparable to that of other recently studied beta-lactams: the amniotic fluid/maternal blood and cord blood/maternal blood ratios ranged from 27 to 33% thirty minutes after administration of the antibiotic. No adverse effects were recorded in the offspring. These results indicate that diffusion of aztreonam into female genital tract tissues is good, producing concentrations capable of preventing or curing gynecologic and obstetrical infections caused by Gram negative bacilli. PMID- 3534703 TI - [An early and specific indicator of aminoglycoside nephrotoxicity: isoenzyme B of urinary N-acetyl-beta-D-glucosaminidase (NAG)]. AB - 88 patients (aged 55-96 years) with severe infections were treated during ten days with one of four different aminoglycosides: gentamicin, dibekacin, netilmicin (3 mg/kg/day) or amikacin (15 mg/kg/day). Creatinine clearance and urinary N-acetyl-glucosaminidase (NAG) activity were measured daily. In addition, NAG isoenzyme patterns were determined on the day of maximal urinary NAG excretion. Aminoglycoside-induced acute renal failure was more prevalent in the gentamicin group (42.8%) than in the dibekacin, netilmicin or amikacin groups (42.8%, 5.5% and 0% respectively). No relationship was found between total urinary NAG activity and nephrotoxic risk. Conversely, significantly elevated levels (p less than 0.001) of B isoenzyme were detected in the gentamicin group, whereas the highest A and I isoenzyme levels were found in the dibekacin and netilmicin groups. These results suggest that functional enzymuria with preferential urinary excretion of A and I isoenzymes should be distinguished from lesional enzymuria with preferential urinary excretion of the B isoenzyme. According to our data, the NAG-B isoenzyme may possibly be a specific marker of aminoglycoside nephrotoxicity. PMID- 3534704 TI - [Kinetics of tobramycin in newborn infants in intensive care]. AB - Maximal and minimal tobramycin concentrations were studied in 16 preterm and 4 fullterm neonates on the last day of a four-day course of tobramycin (infusion of 2 mg/kg twice a day). Maximal concentrations were under 6 mg/l in all patients and minimal concentrations were above 2 mg/l in one-third of the preterm babies. Next, tobramycin pharmacokinetic parameters were studied in 4 fullterm and 4 preterm neonates following a first infusion of 2 mg/kg. Half-life was 4 hours in term babies and 7.75 hours in preterm babies. Mean clearance was 0.118 l/h/kg and 0.06 l/h/kg in fullterm and preterm babies respectively (significant difference). Our results show that the 2 mg/kg dosage is too low and that, in preterm neonates, the 12-hour interval between infusions is too short. PMID- 3534705 TI - [Diffusion of an orally administered single dose of ofloxacin into human bronchial mucus]. AB - As part of a systematic investigation of the penetration of antibiotics into human bronchial mucus, we assayed ofloxacin concentrations following ingestion of a single dose. 25 patients with acute superinfection of a chronic lower respiratory tract disease were studied. Each patient had single drug therapy with ofloxacin in a daily dosage of 200 mg taken in the morning on an empty stomach. Patients were divided into five groups according to the time interval between ingestion of ofloxacin and collection of samples (bronchial mucus and serum): 1 hour, 3 hours, 6 hours, 12 hours or 24 hours. Duplicate determinations of ofloxacin on individual samples were done using a microbiologic method. Mean serum concentrations were 1.85, 1.64, 1.32, 0.75 and 0.20 mg/l respectively, with a half-life of 6.7 hours; the corresponding concentrations in mucus were 1.83, 1.51, 1.20, 0.66 and 0.19. These results demonstrate ofloxacin's outstanding penetration into bronchial mucus. PMID- 3534706 TI - [Diffusion of fosfomycin into the human and rabbit eye (aqueous humor and vitreous body)]. AB - The intraocular distribution of fosfomycin was studied in 32 patients undergoing cataract surgery and in 8 rabbits after experimental infection of one eye by Staphylococcus aureus. Concentrations found 1 to 6 hours after termination of a 4 g fosfomycin infusion ranged from 14 to 18.8 mg/l in the aqueous humor and 8 to 12.5 mg/l in the vitreous body. These levels are higher than the MICs for 80 to 90% of the bacteria responsible for endophthalmitis. In each rabbit, the fosfomycin concentration in the infected eye as compared to the healthy eye was increased 2.5 to 5--fold for the aqueous humor and 4.9 to 19.2--fold for the vitreous body. Fosfomycin, in association with a third generation cephalosporin (ceftriaxone) or one of the new quinolones (pefloxacin) can be recommended for the prevention or early treatment of endophthalmitis. PMID- 3534707 TI - [Rapid ATB staph: 4-hour antibiotic sensitivity test of staphylococci. Description and performance]. AB - Rapid ATB Staph is a method for four-hour antimicrobial susceptibility testing of staphylococci. The equipment and theoretical basis are identical to those already described for rapid testing of enterobacteriaceae. A standardized procedure is required to perform the test. The inoculum should be prepared from a culture no older than 24 hours and accurately standardized at 10(8). Temperature of incubation should be 35 degrees C to 37 degrees C; otherwise growth is delayed by approximately one hour. Time of incubation should not exceed 5 hours. Using these standardized conditions, rapid ATB Staph was compared with the reference agar dilution method for 22 antibiotics. Overall agreement was 96.3%. The rapid system is more sensitive than the reference method fort the detection of netilmicin and amikacin resistance; it is reliable for detecting penicillin resistance, oxacillin resistance and inducible resistance to erythromycin (agreement 96.7%, 94.8% and 98.4% respectively). A Rapid ATB Staph strip containing 15 antibiotics has been designed for routine susceptibility testing. PMID- 3534708 TI - [Sensitivity of 858 strains of staphylococci to 27 antibiotics]. AB - Susceptibility to 27 antimicrobial agents of 858 strains of staphylococci was determined. Tested strains belonged to the following species: S. epidermidis, S. saprophyticus, S. haemolyticus, S. hominis, S. simulans, S. warneri, S. cohnii, S. xylosus and S. intermedius. The antibiotics were: penicillin G, amoxycillin, augmentin, oxacillin, streptomycin, kanamycin, tobramycin, dibekacin, amikacin, gentamicin, sisomycin, netilmicin, doxycycline, minocycline, chloramphenicol, erythromycin, josamycin, clindamycin, pristinamycin, rifampin, fusidic acid, fosfomycin, trimethoprim, sulfamethoxazole, cotrimoxazole, and vancomycin. The ATB system was used, with the criteria for categorization recommended by the Antibiotic Sensitivity Testing Committee. Penicillin-resistance, that was found in all species, was high for hospital-acquired strains (67 to 75%) but also for some other strains (32% for S. simulans). Oxacillin-resistance varied across species (0% for the least prevalent hospital strains, 6% for S. epidermidis and 28% for S. haemolyticus). All strains were susceptible to vancomycin. For some drugs, resistance was a characteristic of the species: resistance to fosfomycin was often found for S. saprophyticus, S. haemolyticus, S. warneri, S. cohnii, and S. capitis; resistance to trimethoprim was common for S. simulans, and S. haemolyticus. S. haemolyticus was the most resistant species, a fact that justifies routine identification of this pathogen in clinical specimens. PMID- 3534709 TI - [Prevalence of antibiotic resistance of Haemophilus influenzae isolated in France: a year of activities of the network of surveillance for H. influenzae infections]. AB - The prevalence of antimicrobial resistance among clinical isolates of Haemophilus influenzae was assessed in France. A total of 705 isolates, obtained from CSF (98 strains), blood (76), ears (118), eyes (164), lower respiratory tract specimens (144), genital specimens (28), and various other specimens (71) were examined. These isolates were obtained from microbiological laboratories distributed throughout France and were sent to the Center for the study of H. influenzae during one year. Biotype of isolates was determined by use of API 10 E system and serotype was determined by slide agglutination procedure. All isolates were examined for beta-lactamase production with a chromogenic test. Susceptibility to ampicillin, cefotaxime, gentamicin, kanamycin, chloramphenicol, tetracycline, minocycline, erythromycin and rifampicin was determined by disk diffusion test and MIC determination by agar dilution procedure. Drug resistance was observed for 92 strains (13%). The overall resistance was 11.2% to ampicillin (all but one strain were beta-lactamase producers), 9% to tetracycline (Tc), 3.4 to chloramphenicol (Cm) and 6.8% to kanamycin (Km). Eleven phenotypes of resistance were observed: the most frequently observed were Ap-Km-Tc, Ap, Ap-Km-Cm-Tc, Ap Tc, Ap-Km, Tc. Antimicrobial resistance rates varied by specimens: resistance to ampicillin concerned 12.2% of the strains from CSF, 10.5% from blood, 12.5% from sputum, 16.1% from ears, 6.7% from eyes; tetracycline resistance concerned 14.2%, 10.5%, 10.4%, 7.6% and 4.8% of the same strains respectively; resistance to chloramphenicol concerned 4%, 5.2%, 1.3%, 3.3% and 2.4% of the strains respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534710 TI - [Growth curves and killing rate of Haemophilus influenzae exposed to amoxicillin, cefaclor and cefotaxime]. AB - The antibacterial activity of beta-lactams against H. influenzae is difficult to evaluate as a result of the osmotic-pressure-dependent formation of filaments and spheroplasts whose viability is still under debate. We compared growth curves obtained by optic density measurements and by UFC/ml counts for H. influenzae in the presence of amoxicillin, cefaclor and cefotaxime in various concentrations. Only the early response to antibiotics, observed during the first six hours of antibiotic-culture contact, was considered. Results showed, for each of the three antibiotics: an increase in optic density with formation of abnormal organisms that correlated poorly with antibiotic concentrations; a stable number of UFC/ml for more than 90 mn, followed by a slow fall reaching at the most 1.5 Log 10 UFC/ml at the sixth hour. We conclude that amoxicillin, cefaclor and cefotaxime in active concentrations rapidly produce the formation of abnormal organisms with an increase in biomass as a result. These abnormal organisms lose their viability slowly, even with concentrations greater than 50 time the MIC. Cefaclor's MIC and MBC are underestimated when results are read only after 24 hours. PMID- 3534712 TI - [Inhibition of cephalosporinase of enterobacteria by ceftriaxone]. AB - Resistance of ceftriaxone, cefotaxime and cefmenoxime to inactivation by the chromosomal constitutive cephalosporinases of Enterobacter cloacae P99, Morganella morganii GN 1510 and Serratia liquefaciens 132 was determined using high performance liquid chromatography. The inhibitory properties of ceftriaxone against the same cephalosporinases were studied by determining the residual amount of cephalothin used as the substrate. With a 1:50 cephalosporinase cephalosporin ratio, ceftriaxone was less resistant to hydrolysis than cefotaxime of cefmenoxime but showed stronger inhibitory properties. PMID- 3534711 TI - [Multicenter study of ofloxacin activity on bacteria isolated from a hospital environment]. AB - Minimal inhibitory concentrations (MICs) of ofloxacin were evaluated by agar dilution for 1508 bacterial strains isolated in five hospitals. For Enterobacteriaceae sensitive to nalidixic acid, MICs ranged from 0.008 to 1 microgram/ml (mode MIC: 0.12); the different species of Enterobacteriaceae exhibited similar mode MICs (0.12) with the exception of E. coli (0.06-0.12), P. mirabilis (0.5) and Providencia (0.25). Among strains intermediate and resistant to nalidixic acid, most of which were Serratia, Providencia and Citrobacter, 41% had a MIC within the susceptibility range, while the others had a MIC of 2 to 8 micrograms/ml, or even 64 micrograms/ml in a few instances. Ofloxacin also exhibited satisfactory activity against P. aeruginosa, with MICs ranging from 0.25 to 16 micrograms/ml (mode MIC: 2) for 87% of strains, and A. calcoaceticus, with MICs from 0.25 to 2 micrograms/ml (mode MIC: 1). Haemophilus sp. (MIC: 0.008 to 0.06 microgram/ml; mode MIC: 0.03), Gonococci (mode MIC: 0.008), and Meningococci (mode MIC: 0.016) were very sensitive to ofloxacin. The spectrum of ofloxacin included Gram positive cocci: MICs of Staphylococci were 0.06 to 2 micrograms/ml (mode MIC: 0.5); Enterococci, other Streptococci and Pneumococci were less sensitive, with MICs of 2 to 4 micrograms/ml for the majority of strains. As for anaerobic bacteria, ofloxacin proved more active against Clostridium (0.5 to 2 micrograms/ml) than Bacteroides (0.5 to 16 micrograms/ml). PMID- 3534713 TI - [In-vitro activity of ceftriaxone on Gram-negative bacilli with various resistance phenotypes to cephalosporins. Comparison with cefotaxime, cefmenoxime, moxalactam, ceftazidime]. AB - In vitro activity of ceftriaxone was studied on 245 cephalothin-resistant strains of enterobacteria representing 7 different phenotypes of resistance to cephalosporins and on 130 Gram negative oxidative bacilli. Ceftriaxone was compared to cefotaxime, cefmenoxime, moxalactam and ceftazidime. With modal MICs of 0.015 to 0.25 mg/l, ceftriaxone is active on all phenotypes of enterobacteria not simultaneously resistant to cefamandole and cefoxitin. Among the bacteria with this last phenotype, only K. pneumoniae, C. Freundii and E. cloacae are occasionally found to have intermediate susceptibility or even resistance; ceftriaxone is more active than cefotaxime, cefmenoxime and ceftazidime with inhibition of 95.1% of strains at 4 mg/l. Moxalactam is superior to ceftriaxone against enterobacteria that are intermediate or resistant to both cefamandole and cefoxitin. Activity of ceftazidime is strongest against oxidative bacilli and weakest against enterobacteria regardless of phenotype. PMID- 3534714 TI - [Effects of subinhibitory concentrations of pefloxacine on hemolysin production and adherence of urinary Escherichia coli]. AB - The in vitro effect of subinhibitory concentrations of pefloxacin on E. coli's production of hemolysin and adherence to eucaryotic cells was studied. Six uropathogenic E. coli strains, with mannose-resistant and/or mannose-sensitive adhesins were tested. All strains produced an alpha-hemolysin and were susceptible to pefloxacin (0.125 less than or equal to MIC less than or equal to 0.250 mg/l). The effect on hemolysin production was studied using microtitration plates to determine the concentration inhibiting 50% of E. coli's hemolytic activity. The inhibition of adhesion was tested following adhesion of E. coli to uroepithelial cells. Sub-MICs of pefloxacin strongly inhibited the production of alpha-hemolysin and adhesion of E. coli regardless of adhesin type. A correlation between the inhibition of hemolysin production and the inhibition of adhesion to uroepithelial cells was found for four E. coli strains. PMID- 3534715 TI - [Evaluation of the antibiotic sensitivity of Pseudomonas sp. using the API-ATB PSE system. Comparison with diffusion and the reference agar dilution method]. AB - In vitro activity of twelve antibiotics (ticarcillin, mezlocillin, azlocillin, piperacillin, cefoperazone, cefsulodin, ceftazidime, gentamicin, netilmicin, pefloxacin and ciprofloxacin) was determined by measuring minimum inhibitory concentrations (MICs) using agar dilution according to WHO recommendations, agar diffusion and the API-ATB-PSE system. One-hundred and forty-two Pseudomonas strains were studied. Five species of Pseudomonas were represented, i.e. aeruginosa, maltophilia, cepacia, stutzeri and paucimobilis. Isolates came from two Paris hospitals. Percentages of total agreement, minor discrepancies and major discrepancies between the results obtained with the API-ATB-PSE method and those recorded with the reference methods were determined. After checking the discordant strains, the results are discussed in order to evaluate the reliability of the ATB method for antibiotic susceptibility testing with Pseudomonas sp. PMID- 3534716 TI - [In vitro study of the pefloxacine-ceftriaxone combination against 18 strains of Acinetobacter]. AB - The bacteriostatic and bactericidal activity of the pefloxacin-ceftriaxone combination was studied in Mueller-Hinton broth against 18 clinical strains of acinetobacter calcoaceticus var. anitratum by the checkerboard technique. The bactericidal activity was tested after 2, 4, 6 and 24 hours contact. MICs were 0.12 to 4 mg/l for pefloxacin and 2 to 64 mg/l for ceftriaxone. The bacteriostatic interaction of the antibiotics was synergistic for 5 strains (FIC index = 0.375 to 0.5) and additive for 13 strains (FIC index = 0.51 to 1). The bactericidal interaction was synergistic for 1 strain after 2 hours, 3 strains after 4 hours, 6 strains after 6 hours, and 12 strains after 24 hours. By the FBC technique at 24 hours, the combination was synergistic for 5 strains (FBC index = 0.375 to 5) and additive for 13 strains (FBC index = 0.51 to 1). No antagonism was detected. The combination is mainly additive but synergism is observed for some strains of acinetobacter. Ceftriaxone prevented the late regrowth noted with pefloxacin. PMID- 3534717 TI - [In vitro activity of roxithromycin, new semisynthetic macrolide against obligate anaerobes]. AB - The "in vitro" susceptibility to roxithromycin and three other macrolides of 236 anaerobes isolated from clinical samples in 1984/1985 was determined by an agar dilution method on Wilkins Chalgren medium. 90% of Gram positive cocci were susceptible to both roxithromycin and josamycin (MIC less than 1 mg/l, whereas 1 mg/l erythromycin and 2 mg/l spiramycin were able to inhibit respectively 46 and 86% of the same tested strains. No resistance to the four macrolides was observed among Eubacterium, propionibacterium and Bifidobacterium. Two C. perfringens strains and one C. difficile strain were resistant to all four macrolides, while 97% of Clostridium sp. strains were inhibited by 4 mg/l erythromycin, josamycin or roxithromycin. Against Gram positive anaerobes, roxithromycin was equal or superior to erythromycin and spiramycin. At a concentration of 4 mg/l, roxithromycin inhibited 82% of B. fragilis strains. Roxithromycin and josamycin were more active against Gram negative bacilli that erythromycin and spiramycin. Macrolides had no effect on Fusobacterium strains. In this study, 4 mg/l roxithromycin inhibited 217 of the 236 anaerobic strains investigated (92%). PMID- 3534718 TI - [Comparative in vitro activity of a new macrolide RU 28965 and of erythromycin against Chlamydia trachomatis]. AB - Activity of a new macrolide, RU 28965, and erythromycin against 8 Chlamydia trachomatis strains isolated from the human genital tract was studied. Minimal inhibitory concentrations were determined using cycloheximide-treated McCoy cells. Giemsa and immunofluorescence staining with monoclonal antibodies were used to detect Chlamydial inclusions. Immunofluorescence proved more sensitive and easier to read. All the strains were highly susceptible to RU 28965 (MIC = 0.05 mg/l - 0.1 mg/l) and erythromycin (MIC = 0.02 mg/l - 0.2 mg/l). PMID- 3534720 TI - [Clinical evaluation of ceftriaxone in severe infections in adults]. AB - Thirty patients (17 male, 13 female; age 17 to 84 years; normal renal function in 23 cases) with severe bacterial infections were treated with ceftriaxone. The infections was septicemia in 20 cases, a septicemia-like condition in 2 and a focal infection in 8 (2 abscesses of the lung, 2 pyelonephritis, 1 abscess of the liver, 1 subphrenic abscess, 1 meningitis developed from an abscess of the brain and 1 acute intestinal infection). 25 infections were bacteriologically documented, with recovery of the following pathogens: 20 Gram negative rods (including 10 E. coli) that were all susceptible to ceftriaxone (MIC = 0.02 to 0.5 mg/l) except 2 (1 Pseudomonas and 1 E. cloacae), 5 susceptible Gram positive cocci (3 Pneumococcus, 1 Streptococcus and 1 Staphylococcus epidermidis) and 3 susceptible anaerobes (2 B. fragilis and 1 B. melaninogenicus). Ceftriaxone was given alone in 15 cases and in association with another antibiotic in 15 cases (aminoglycoside in 10 cases, nitroimidazole in 4 and fosfomycin in 1). The dose of ceftriaxone was 1 to 2 g per day in 28 cases, 3 g per day in 1 case (meningitis with abscess of the brain) and 1 g every other day in 1 case (chronic renal failure under hemodialysis). Duration of treatment ranged from 10 to 62 days (average 17 days). The usual routes of administration were IV and IM; the SC route was used on 4 occasions. Pharmacokinetic studies of serum levels were carried out in several patients including two who had ceftriaxone subcutaneously; results were consistent with those previously reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534719 TI - [Clinical evaluation of timentin in intensive care]. AB - 16 patients admitted to a MICU were treated with timentin (ticarcillin + clavulanic acid) for bacterial infections: 11 cases of pulmonary infection, 3 cases of urinary tract infection, 2 septic shocks, 3 septicemias and 1 case of multifocal infection. The pathogens considered as a firmly established cause of infection were: 5 Acinetobacter, 12 Pseudomonas, 3 Serratia, 4 Klebsiella, 1 E. coli, 2 Proteus, 1 Providencia, 1 Staphylococcus aureus, 1 Staphylococcus epidermidis, 1 Streptococcus D and 1 Flavobacterium meningosepticum. The susceptibility of these pathogens to ticarcillin and timentin is reported. Timentin was prescribed alone in 9 cases and associated (with an aminoglycoside) in 7, in a daily dose of 9 to 18 g, for 6 to 45 days. 3 patients died. The value of timentin in infections due to multiresistant MICU pathogens is stressed. PMID- 3534721 TI - [Clinical and pharmacokinetic study of ceftriaxone in severe infections in adults in intensive care]. AB - Twenty patients with severe nosocomial bacterial infections hospitalized in an intensive care unit were treated by ceftriaxone alone, in a single daily IV injection of 2 g. Clinical and bacteriological results show that ceftriaxone has good activity against enterobacteria. The four patients (20%) who failed to respond had superinfection by Pseudomonas aeruginosa, a finding that suggests that ceftriaxone should be used in combination with another antibiotic for the treatment of nosocomial infections. Pharmacokinetic results in our patients show that with the dosage used peak and trough serum levels are greater than the MICs of susceptible pathogens. PMID- 3534722 TI - [Cefotetan: clinical trial in elderly persons using a single daily dose of 2 grams as the sole therapy]. AB - Effectiveness of cefotetan, a new generation semisynthetic cephamycin, was studied in a clinical trial in elderly patients. Cefotetan was used as single drug therapy. A single daily injection of 2 g was given to each of 33 elderly subjects (mean age 70.2 years, range 69-92 years). The infections were severe: pneumonia in 13 cases, septicemia in 12, upper urinary tract infections in 3 and miscellaneous infections in the remaining cases. The regimen used proved clinically effective (93% successes) and achieved residual serum levels greater than the MICs of all the Gram negative bacteria and most of the Gram positive cocci isolated. In addition to being efficient, the single daily injection regimen causes minimal damage to peripheral veins, provides optimal comfort to the patient, and saves both material and time. PMID- 3534723 TI - [Treatment of moderate or severe infections using imipenem/cilastatin. 41 cases based on a multicenter protocol]. AB - Imipenem and cilastatin in combination have a broad spectrum in vitro with a strong killing activity on most bacteria. Using a multicenter study design, we investigated 41 patients with moderate or severe infections: septicemia in 18 cases (Gram negative rods in 10, Gram positive cocci in 7 and combination of both in 1), pneumonia in 7, osteitis in 4, soft tissue infection in 7, infection of the genitourinary tract in 6 and miscellaneous infections in the remaining cases (1 abscess of the pancreas, 1 typhoid fever, 1 presumptive endocarditis). All of the bacteria were susceptible to imipenem/cilastatin: MICs ranged from 0.02 to 0.8 mg/l and MBCs from 0.015 to more than 10 mg/l. All patients except one recovered or improved under imipenem/cilastatin. The patient who failed to respond had septicemia due to a methicillin-resistant Staphylococcus aureus with a MBC and MIC above 10 and 0.5 mg/l respectively. Tolerance was outstanding: only 4 patients had adverse effects requiring withdrawal of the drug. PMID- 3534724 TI - [Evaluation of the use of ofloxacin in the treatment of various infections]. AB - We investigated the clinical efficiency and safety of ofloxacin, a new fluoroquinolone, for the treatment of various documented bacterial infections in 26 patients (10 females, 16 males) aged 17 to 84 years. Ofloxacin monotherapy was given orally in a dose of 200 mg twice (25) or three times (1) a day. Antibiotic levels and serum bactericidal activity were measured using a microbiological method on the second and sixth days, before and 2 and 6 hours after a single dose. The infectious episode treated was enterocolitis in 7 cases (5 Shigella, 2 Salmonella), Salmonella septicemia in 9 (7 typhoid fevers and 2 Salmonella minor infections), chronic osteoarthritis in 3 (1 E. coli, 2 S. aureus + P. aeruginosa), a soft tissue infection in 3 (2 S. aureus, 1 E. coli), acute pleuropneumonia in 2 (2 Klebsiella pneumoniae), pyelonephritis with bacteremia in 1 (Klebsiella pneumoniae), and pneumococcal pneumonia with septicemia in 1. Mean duration of therapy was ten days for 23 patients (range 7 to 30 days). The three patients with osteoarthritis were treated for 35, 95 and 270 days respectively. 24 patients recovered free of sequelae or germ carriage. Treatment failed in 1 case of chronic osteitis (S. aureus + P. aeruginosa) and in 1 staphylococcal soft tissue infection. No adverse reactions were observed except a slight increase in transaminases in 3 patients. Peak and through serum ofloxacin levels were 3.70 micrograms/ml and 0.95 micrograms/ml respectively on the second day and 3.25 micrograms/ml and 0.80 microgram/ml respectively on the sixth day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534725 TI - [Curative activity of spiramycin adipate by parenteral route in experimental septicemia in mice. Comparison with orally administered basic spiramycin]. AB - Experimental septicemia was induced in mice by intraperitoneal injection of 10 to 100 lethal doses of Staphylococcus aureus and Streptococcus pneumoniae. Animals were treated by a mixture of adipic acid and spiramycin (subcutaneous route) or by spiramycin base (oral route), 1 and 6 hours after infection. To determine the effective dose 50% that achieves survival of half the mice after 7 days, each drug was used in 6 dosages (mg/kg) and each dosage was given to 12 mice. In 21 independent experiments, ED50S of spiramycin adipate by the subcutaneous route were found to be 5 to 50 times lower than those of spiramycin base per os. These results are consistent with the high serum peak concentrations of spiramycin adipate observed following subcutaneous administration. PMID- 3534726 TI - [Treatment of neurosurgical bacterial meningitis using the combination of ceftriaxone-fosfomycin]. AB - 16 patients with bacterial meningitis following a neurosurgical procedure were given a combination of ceftriaxone and fosfomycin. 8 microorganism were isolated: 2 Staphylococcus epidermidis, 1 Staphylococcus aureus, 1 Neisseria meningitidis, 1 Streptococcus pneumoniae, 1 Haemophilus influenzae, 1 Serratia marcescens and 1 Aeromonas hydrophila. No pathogen was identified in the remaining cases. All of the isolated strains were susceptible to both antibiotics. In vitro, neither synergy nor antagonism were observed between the two antimicrobial agents. The acute infectious episode resolved in all patients. One relapse only was observed, in a patient with meningitis related to a ventricular shunt, and successfully treated by the same therapeutic schedule associated with removal of the tubing. Lastly, CSF concentrations of both antibiotics were assayed and found to be comparable with those reported by most author. PMID- 3534727 TI - [Urinary tract infections in general medical practice. A study of clinical findings, of the distribution of causative microbial species and their sensitivity to 16 antibiotics]. AB - From April to July 1984, all of the strains recovered by 10 private laboratories in Upper-Normandy region (France) from urine samples from outpatients seen in office practices (public and private hospitals excluded) were preserved. A total of 829 strains were collected, identified and tested against antibiotics using disk diffusion techniques. These investigations, together with a synthesis of clinical findings, were carried out by the Laboratory of Bacteriology of the Rouen University Hospital. 78.1% of patients were females; all age groups were represented with a greater prevalence of subjects aged 26 to 35 and above 66. E. coli was the most prevalent pathogen (74.5% of all strains), followed by Proteus and Providencia (10%). E. coli was recovered in 78% of first infections against 67.7% of recurrent infections and 50% of prostatitis. More than 25% of strains were resistant to ampicillin; norfloxacin showed the best activity, with 96.5% of susceptible strains. PMID- 3534729 TI - [Ofloxacin (RU 43280): clinical evaluation in urinary and prostatic infections]. AB - Ofloxacin, a new fluoroquinolone, was given to fifty patients (29 females and 21 males) aged 25 to 86 years with urinary tract infection or prostatitis. Urinary tract infections usually chronic and associated with urologic anomalies, included 17 cases of cystitis and 19 cases of pyelonephritis. 14 patients had prostatitis. Pathogens recovered from the urine were 26 E. coli, 2 Citrobacter, 4 Proteus mirabilis, 2 Klebsiella, 2 Enterobacter, 3 Serratia, 3 Staphylococcus aureus and 11 Pseudomonas. Minimal inhibitory concentrations of ofloxacin ranged from 0.03 to 0.12 microgram/ml (mean MIC: 0.6 microgram/ml) for 27 nalidixic acid-sensitive strains, and from 0.25 to 4 micrograms/ml (mean MIC: 1 microgram/ml) for 26 nalidixic acid-resistant strains. Ofloxacin was given as single drug therapy in all patients, in a daily dosage of 200 mg b.i.d. in 46 patients and 400 mg b.i.d. in 4 patients, for 7 to 97 days (average 40 days). Follow-up after discontinuation of treatment was 3 to 12 months. Therapeutic results were as follows: 17 cures for the 17 cystitis patients, 17 cures and 2 failures by relapse for the 19 cases of pyelonephritis, and 11 cures, 1 failure by persistence of bacteriuria and failure by relapse for the 14 cases of prostatitis. Digestive disorders, i.e. nausea, abdominal pain, constipation, occurred in 6 patients and required withdrawal of the drug in 1; candidiasis of the tongue was recorded in one patient and digestive complaints with neuropsychic disorders in another. Two patients had short-lived, moderate leukopenia with granulopenia and one had transient worsening of preexisting renal failure. Hepatic tolerance was good. PMID- 3534728 TI - [Clinical and bacteriological study of O-demethylfortimicin A sulfate in urinary infection]. AB - O-demethyl-fortimicin-A-sulfate (ODMF) is a semisynthetic derivative of fortimicin-A with increased in vitro activity especially against Pseudomonas aeruginosa. This study was designed to determine the efficacy of ODMF in the treatment of UTI and to evaluate the in vitro susceptibility of bacteria isolated from the urine of patients to ODMF as compared to tobramycin (To), gentamicin (Ge) and amikacin (Ak). In 28 hospitalized patients with acute UTI, ODMF (free base) in a dose of 2 to 5 mg/kg was administered during 7 to 14 days. Every 2 days and at least 5 times during therapy, ODMF serum levels were determined (peak and trough levels) for dosage adjustment. Urine cultures were performed on day 0 and between days 2 and 4, and susceptibility of the organisms was determined. Patients were monitored for oto and nephrotoxicity. The treatment was successful in 53.5% of patients. 35.5% of patients relapsed due to severe underlying disease. ODMF was discontinued or given in reduced dosages in 10.7% of cases because of an increase in serum creatinine during therapy. Among the 37 significant strains recovered from urine, there were 54% E. coli, 10.8% Enterobacter sp., 10.8% Proteus sp., and 10.8% Pseudomonas sp. Resistance to ODMF was demonstrated in only 5.8% of strains, against 14.7% for Ge and 11.7% for To. Susceptibility of the strains was very similar for ODMF and Ak. On the whole, clinical and bacteriological results were satisfactory and did not differ from those usually obtained with aminoglycosides in the treatment of UTI due to Gram negative bacilli. PMID- 3534730 TI - [Comparative study of cefoperazone and cotrimoxazole in kidney stone surgery via percutaneous approach]. AB - The effectiveness and drawbacks of cefoperazone and cotrimoxazole in the prevention of postoperative infections following percutaneous removal of renal stones were studied comparatively. 60 patients were divided at random into two groups. 30 subjects were given 1 g cefoperazone IV every 8 hours for 5 consecutive days starting on the day before the procedure. The 30 other patients had an infusion of 800 mg sulfamethoxazole and 160 mg trimethoprim every 12 hours on the same 5 days. Age, sex and type of surgical procedure were comparable in both groups. Results were as follows: in the cefoperazone group, one patient had intraoperative septic shock due to a stone infected by a resistant Pseudomonas aeruginosa; in the cotrimoxazole group, 2 patients had postoperative fever due to stones infected by resistant Gram negative rods (Pseudomonas aeruginosa) and three patients had a urinary tract infection (Candida albicans in 1 case, Escherichia coli in 1 and Pseudomonas aeruginosa in 1). Tolerance was satisfactory for both regimens. The authors conclude that intravenous cefoperazone in the more effective drug and should be continued throughout the first three postoperative days. PMID- 3534731 TI - [Treatment with ofloxacin (RU 43280) of uncomplicated bacterial urethritis in males]. AB - Ofloxacin is a new fluoroquinolone with in vitro activity against the three main urethritis-causing pathogens: i.e. Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. 18 adult males with acute uncomplicated urethritis took 200 mg ofloxacin by mouth twice daily for 7 (non-chlamydial urethritis) or 14 (chlamydial urethritis) days. 12 patients had N. gonorrhoeae; 2 had H. parainfluenzae, 1 had E. coli and 5 had C. trachomatis. Urethral cultures were obtained before treatment and on day 7 (non-chlamydial urethritis) or 28 (chlamydial urethritis). Clinical and microbiological cure was achieved in 17 of the 18 patients. Clinical manifestations failed to resolve in one patient due to the presence of Trichomonas vaginalis recognized on day 7. No side effects were observed. According to these results, ofloxacin is effective and safe against gonococcal and chlamydial urethritis. PMID- 3534732 TI - [Treatment of typhoid fever using ofloxacin. Clinical experience and determination of antibiotic diffusion into the mesenteric lymph nodes]. AB - Nine patients with typhoid fever were given ofloxacin in a daily dosage of 400 mg for ten days. All patients recovered with no relapses. No case of Salmonella typhi carriage was recorded. Diffusion of ofloxacin into mesenteric lymph nodes was studied in four patients. Mean concentration was 1.46 micrograms/g after four 200 mg doses. According to our results, ofloxacin could be considered as one of the alternatives for treating typhoid fever. PMID- 3534733 TI - [Lymphatic and lymph node diffusion of ceftriaxone. Incidence in the treatment of typhoid fever]. AB - Following intravenous administration of 2 g ceftriaxone, concentrations of the drug were assayed in serum, in thoracic duct lymph from dogs, and in mesenteric lymph nodes in patients. Antibacterial activity of lymph against S. typhi was also studied. Results show that ceftriaxone concentrations in serum and lymph are comparable; with a satisfactory antibacterial activity of both fluids against S. typhi. In mesenteric lymph nodes, mean ceftriaxone concentration was approximately 1000 times the MIC for S. typhi. Our data contribute to explain the successful clinical results achieved with ceftriaxone in patients with typhoid fever. PMID- 3534734 TI - [Treatment of peritonitis due to continuous ambulatory peritoneal dialysis using a single daily intraperitoneal dose of 1g cefotiam]. AB - Peritonitis remains the main complication of CAPD. This study demonstrates that most cases can be successfully treated with cefotiam. In 17 patients under CAPD, 33 cases of bacterial peritonitis were observed, with clinical manifestations in 28. The mean cell count in peritoneal dialysis fluid was 2 820/mm3, with 2 200/mm3 polymorphonuclear leukocytes. Causative pathogens were Staphylococcus in 18 cases, Streptococcus in 4, Stomatococcus mucilaginous in 1, Corynebacterium J.K. in 1, Enterobacter in 3, Acinetobacter in 3 and Pseudomonas in 2. Two cultures were negative. First choice treatment was a daily intraperitoneal injection of 1 g cefotiam. 68.80% of patients recovered within 6 days. Failures were due to a methicillin-resistant Staphylococcus epidermidis in 3 cases, a relapsing Stomatococcus mucilaginous infection in 1, a Streptococcus faecalis in 1, an Acinetobacter in 3 and a Pseudomonas in 2. Mean cefotiam concentrations 24 hours after the intraperitoneal injection were 9.4 +/- 7.0 micrograms/ml (range 1.3-26.4 micrograms/ml) in serum and 3.4 +/- 3.3 micrograms/ml (range 0.4-12.2 micrograms/ml) in dialysate. These concentrations are greater than most of cefotiam's MICs for susceptible bacteria, a finding that confirms the value of treatment with a single daily intraperitoneal injection of cefotiam. PMID- 3534735 TI - [Antibiotic sensitivity of bacteria isolated from pathological specimens and utilization of beta-lactams in an orthopedic surgery service]. AB - From 1980 to 1984, computerized data on the sensitivity to the main antibiotics of 1991 strains isolated from clinical specimens were evaluated in relation to beta-lactam use and hospital activity in a unit of orthopedic surgery. No major variations were found in distribution of species throughout the study period, whereas sensitivity to antimicrobial agents changed. From 1980 to 1982, patients had postoperative prophylactic treatment with cephalosporin (cefazolin) for two days; during the same period, 59% of 557 Gram negative organisms were resistant to cefazolin and 31% of Staphylococci were resistant to methicillin (and to other antibiotics). In 1983 and 1984, cefazolin was replaced by intraoperative flash therapy with a penicillin-M (cloxacillin); concomitantly, sensitivity to cefazolin increased among Gram negative organisms (38% of 485 isolates were cefazolin-resistant; p less than 0.001) and Staphylococci (16% of 342 isolates were methicillin-resistant; p less than 0.001). Phage typing of S. aureus failed to disclose any epidemic outbreak. Since hospital activity remained the same throughout the period under study, it seems justified to correlate the increase in bacterial sensitivity observed to the decrease in use of cephalosporin, although other factors (microepidemic, isolation techniques) may be involved. PMID- 3534736 TI - [Cloxacillin concentration in suction fluid following flash antibiotic therapy during insertion of a hip prosthesis]. AB - Since 1982 we have administered cloxacillin intraoperatively during total hip replacement. 1 g cloxacillin is injected intravenously at induction of anesthesia, followed by 1g every hour until the end of the procedure or a total of 6 g. In our study, cloxacillin concentrations were determined in the fluid collected from the deep suction catheter inserted at the end of the surgical procedure. Fluid samples were collected 2 h, 4 h, 6 h, 8 h and 24 hours after the last injection of cloxacillin. Serum samples were taken 2 h, 6 h and 24 hours after the last injection. Cloxacillin was assayed using an agar-diffusion microbiologic method. 18 patients were studied. Each had received 3 to 5 g cloxacillin over 3 to 5 hours. Mean suction catheter fluid concentrations were to 69.7 micrograms/ml, 37.6 micrograms/ml, 24.2 micrograms/ml, 15.5 micrograms/ml, and 6.8 micrograms/ml respectively in the samples collected 2 h, 4 h, 6 h, 8 h and 24 hours after the last injection of cloxacillin. Mean serum concentrations were 34.1 micrograms/ml, 4.2 micrograms/ml, and 0 microgram/ml respectively 2 h, 6 h and 24 hours after the last injection. Our results indicate that cloxacillin concentrations within the hip joint are probably effective against staphylococci for 8 to 12 hours. PMID- 3534737 TI - [Multicenter clinical study and pharmacokinetics of ceftazidime in children and newborn infants]. AB - The pharmacokinetics and clinical efficacy of ceftazidime, a new cephalosporin with activity against Pseudomonas aeruginosa, were studied in children and neonates. Our studies suggest that ceftazidime should be considered for the treatment of sever infections in pediatric patients (neonatal septicemia and meningitis, urinary tract infections due to multiresistant bacteria) and for the empirical therapy of febrile episodes in immunocompromised children. Ceftazidime appears to be effective and safe, alone or associated with an aminoglycoside, in the treatment of acute exacerbation in cystic fibrosis. The dosage recommended on the basis of our pharmacokinetic studies is 30 to 50 mg/kg intravenously every eight hours for infants and children and 30 mg/kg every 12 hours for neonates. Larger doses should be used in cystic fibrosis patients, immunosuppressed children, meningitis, and bacterial infections due to organisms with high MICs. PMID- 3534738 TI - [Optimum choice of antibiotic treatment in neonatal infections due to group B streptococci]. AB - Morbidity and mortality among neonates with group B streptococcal infections remain high. As delays in bacterial killing may be responsible for these poor results, there is a need for studies into killing kinetics. We investigated antimicrobial sensitivity and killing effect time lags for penicillin, ampicillin and mezlocillin, alone and in combination with gentamicin or amikacin, against 20 strains of group B streptococci isolated in cultures of blood and cerebrospinal fluid from neonates. A culture of each strain (10(5) germs/ml) was exposed to the antibiotics individually or in combination. Antibiotics were used in the concentrations achieved clinically. Surviving bacteria were counted after 2 h 30, 4 h 30 and 24 h. incubation. Mean killing curves showed that the time interval until onset of a killing effect was 24 hours with either penicillin or ampicillin alone, against 4 h 30 with penicillin-amikacin or ampicillin-gentamicin. The most rapid killing effect (2 h 30) was observed with mezlocillin alone and ampicillin amikacin. No antagonism was found between mezlocillin and aminoglycosides. Choice of the best antibiotic treatment for group B streptococcal infections should be based on both the rapidity of the in vitro killing effect and the antibiotic's diffusion into the site of the infection. PMID- 3534739 TI - [Comparative sensitivity of yeasts to antifungal agents using a standardized micromethod]. AB - The comparative susceptibility of 1 850 yeast strains belonging to 8 species was determined. The standardized micromethods used allows determinations of minimal inhibitory concentrations (MICs) or categorized sensitivities for two different concentrations (AB). Overall results showed that amphotericin B (AMB) is the most active agent, followed by the various imidazoles. 5-fluorocytosine (5FC) was the least effective drug, with 68% susceptible strains. However, results varied widely across species and drugs. For instance, among Candida albicans and Torulopsis glabrata strains, none were resistant to AMB and only 6% were resistant to 5-FC; in contrast, Candida albicans was highly susceptible to imidazoles (0.8 to 2.5% resistant strains) whereas Torulopsis glabrata showed much higher resistance rates (18% of strains for tioconazole and 70% for ketoconazole). Variations in susceptibility were also recorded across imidazoles: clotrimazole, tioconazole and ketoconazole were much more effective against Candida tropicalis and Candida parapsilosis than miconazole and econazole, whereas almost no strains were resistant to AMB and more than 50% of strains were resistant to 5-FC. Results obtained by AB (967 strains) and MIC (455 strains) were consistent for the 1 422 Candida albicans strains. Our results show that standardized micromethods should be used to determine the susceptibility of yeasts to antifungal agents. PMID- 3534740 TI - [Interdisciplinary meeting on anti-infection chemotherapy. 5 December 1985, Paris]. PMID- 3534741 TI - [Bactericidal activity of ceftriaxone, amikacin and their combination]. AB - Third-generation cephalosporins such as ceftriaxone are often used alone; however, with Enterobacter (ENT), Citrobacter (CIT), Serratia (SER) and Morganella (MOR), a combination of two drugs is advisable. Aminoglycoside-beta lactam combinations are often synergistic. However, results are not consistent with the new cephalosporins. We determined the killing kinetics of ceftriaxone (C) alone, amikacin (A) alone and both drugs in combination (AC). The antibiotics were tested in the following concentrations: 0.25, 1, 4 and 16 X MIC for C, 0.5, 2 and 8 X MIC for A, and, for AC, 0.5-0.25 X MIC (1), 0.5-1 X MIC (2) and 2-0.25 X MIC (3). Surviving bacteria were enumerated at 0 h, 1 h, 3 h, 5 h and 24 hours. Amikacin showed a strong, dose-dependent bactericidal activity. Maximal activity of ceftriaxone was observed at 1 or 4 X MIC. Time of contact had a significant influence, indicating a time-dependent activity. In 5 hours, the killing effect of the AC combination rarely exceeded that of each antibiotic alone. Higher killing rates were observed with AC and; the killing effect of AC (3) was similar to amikacin's maximal killing effect. In 24 hours, the AC (3) combination was clearly synergistic with inhibition of late regrowths. PMID- 3534742 TI - [Hepatic diffusion of ceftriaxone]. AB - We studied the intrahepatic diffusion of ceftriaxone, a new third generation, very potent cephalosporin with a long serum half-life. Sixteen patients had percutaneous liver biopsy for suspected liver disease or protracted fever of unknown origin. Serum samples and liver biopsy specimens were taken simultaneously. Serial determinations of ceftriaxone concentrations showed that the hepatic half-life was significantly shorter than the serum half-life. We suggest that ceftriaxone be used in higher or more closely spaced doses for the treatment of liver infections. PMID- 3534743 TI - [In vitro activity of a new 3d-generation cephalosporin, cefodizime, on hospital bacteria]. AB - Minimal inhibitory concentrations (MICs) of cefodizime were evaluated by agar dilution for 746 bacterial strains isolated in two hospitals. For enterobacteriaceae MICs ranged from 0.008 micrograms/ml to more than 128 micrograms/ml (mode MIC: 0.25); mode MICs varied across species, ranging from 0.016 micrograms/ml for Proteus mirabilis to 1 microgram/ml for Citrobacter; MICs ranged from 0.12 to 8 for most Enterobacter and from 1 to 64 for Serratia. The rare cefotaxime-resistant strains, most of which were Citrobacter or Enterobacter, also showed resistance to cefodizime. Cefodizime was noticeably less active against Pseudomonas aeruginosa and Acinetobacter, with MICs ranging from 32 to more than 128. Haemophilus sp. and Gonococci, regardless of beta lactamase-production status, as well as Neisseria meningitidis, were highly susceptible (MIC less than or equal to 0.008-0.016). Cefodizime was moderately active against methicillin-susceptible Staphylococci (MIC: 2 to 16 micrograms/ml) and failed to inhibit methicillin-resistant strains. Enterococci were slightly susceptible or resistant. Whereas the other Streptococci and Pneumococci had low MICs (0.03-0.12). A fairly wide range of MICs was found for anaerobes, with lower values for Clostridium (0.008 to 1) than for Bacteroids (8 to 128 mu g/ml). Our results show that cefodizime has the same properties as other third-generation cephalosporins: cefotaxime-resistant Enterobacteriaceae strains also exhibit resistance to cefodizime. PMID- 3534744 TI - [In vitro antibacterial activity of a new cephalosporin: cefpirome (HR 810). Comparison with ceftriaxone, cefotaxime, latamoxef and ceftazidime]. AB - In vitro activity of a new cephalosporin, cefpirome (HR 810) was tested using an agar dilution procedure against 393 hospital bacterial isolates. Results were compared to those obtained with ceftriaxone, cefotaxime, latamoxef and ceftazidime. Cefpirome was the most active drug against oxacillin-susceptible staphylococci and the only drug with activity against streptococci D (MIC 90%: 7 mg/l). Against Enterobacteriaceae strains with varying degrees of resistance to cephalosporins, results varied across species: activity of cefpirome was greater than that of the four other drugs for E. cloacae and C. freundii, similar to that of ceftriaxone for E. coli, S. marcescens, P. morganii and Salmonella sp., inferior to that of latamoxef for P. stuartii. However, against all Enterobacteriaceae strains as a whole, cefpirome proved the most active of the five agents tested (99.1% of strains inhibited by 4 mg/l) as a result of its greater activity against strains with resistance to second generation cephalosporins or cefotaxime. Cefpirome in a concentration of 4 mg/l inhibited 50% of tested P. aeruginosa strains (MIC 90%; 13 mg/l) and was inferior only to ceftazidime (MIC 90%: 4 mg/l). However, cefpirome exhibited no activity against A. calcoaceticus and L. monocytogenes. PMID- 3534745 TI - [In vitro activity of carumonam (RO 17-2301) on hospital bacteria]. AB - Minimal inhibitory concentrations (MICs) of carumonam (RO 17-2301), a new synthetic antibacterial agent of the monobactam group, were evaluated by agar dilution for 399 hospital isolates. RO 17-2301 was inactive against Gram positive and anaerobic bacteria. Most Enterobacteriaceae were inhibited by concentrations less than 1 microgram/ml, with mode MICs approximating 0.03 micrograms/ml except for Providencia (0.016), Citrobacter (0.06), Serratia (0.06) and Enterobacter (0.12). A few strains, most of which were Enterobacter or Citrobacter, had high MICs (greater than 8 micrograms/ml). RO 17-2301 was less active against Pseudomonas aeruginosa (mode MIC 2 micrograms/ml) and Acinetobacter (mode MIC 8 16 micrograms/ml). Haemophilus influenzae sp. were sensitive to RO 17-2301 (mode MIC 0.12-0.25), regardless of beta-lactamase production status; MICs ranged from 0.06 to 0.25 micrograms/ml for Meningococci, and from 0.008 to 0.06 for Gonococci except for a few strains that had higher MICs (0.25 to 0.5 and even 4 micrograms/ml). In vitro activity of RO 17-2301 on Gram negative bacteria proved similar to that of third-generation cephalosporins; cefotaxime-resistant Enterobacteriaceae are resistant to RO 17-2301. PMID- 3534746 TI - [Urinary excretion of phospholipids: index of aminoglycoside nephrotoxicity]. AB - Aminoglycosides have a low molecular weight and bind weakly to proteins. They are easily filtered through the glomeruli, bind to phospholipid receptors located on the brush border of proximal tubule cells, and penetrate within the cells by endocytosis. Aminoglycosides decrease lysosomal A and C phospholipase and sphingomyelinase activities. This impairs the degradation of phospholipids, with formation of abnormal intralysosomal structures called myeloid bodies as a result. These myeloid bodies are gradually eliminated from the cells into the lumen of the tubule and excreted in the urine. We studied the urinary excretion of phospholipids following 1, 3, 5 and 10 days of treatment with gentamicin (3 mg/kg/day) or tobramycin (3 mg/kg/day) in patients with acute pyelonephritis. Infection-free, non-treated subjects were used as controls. Patients with a urinary tract infection treated by a quinolone made up a third group. Urinary N acetyl-beta-D-glucosaminidase (NAG), an indicator of epithelial necrosis, was also evaluated. Results were expressed per ml urine, per mg creatinine and per 24 hours. Only the results expressed per mg creatinine appeared valid. No significant increase in serum creatinine or urinary NAG was found in patients under gentamicin. In the patients with a urinary tract infection not treated with an aminoglycoside, urinary phospholipid excretion on D1 was decreased as compared to controls (p less than 0.01). Urinary phospholipid excretion was never found to be increased in patients under aminoglycosides. No significant difference was found between males and females. Mistaken interpretations occurred if urinary excretion of phospholipids or NAG was not expressed per mg creatinine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534747 TI - [Can gentamicin nephrotoxicity in rats be modified by chronic administration of muzolimine?]. AB - Some loop diuretics seem to increase gentamicin nephrotoxicity. We investigated this property for a new diuretic, muzolimine, in female Wistar rats. Each rat was given gentamicin intraperitoneally in a dosage that induces morphological and functional modifications in the kidneys (20 mg/kg/day for 7 days). Muzolimine was given in a daily dosage of 15 mg/kg starting 15 days before the first gentamicin injection and continuing throughout the seven-day gentamicin course. As compared to controls given gentamicin alone, modifications induced by the muzolimine gentamicin combination showed no significant differences for the following criteria: renal accumulation of gentamicin, membrane lysosomal latency, renal oxidative mitochondrial metabolism and cortical activity of renal cathepsin B, N acetyl-beta-D-glucosaminidase (NAG) and alanine aminopeptidase. However, slightly lower sphingomyelinase activities (p less than 0.05) were found for muzolimine + gentamicin as compared to gentamicin alone. Urinary NAG excretion increase more with muzolimine + gentamicin than with gentamicin alone, perhaps as a result of the very significant increase in urinary output observed with the diuretic. Our results show that, in contrast to findings with another loop diuretic, furosemide, the renal toxicity of gentamicin is not noticeably modified by concomitant administration of muzolimine. PMID- 3534748 TI - [Circadian variations of amikacin nephrotoxicity in rats]. AB - We have studied the circadian variations in the nephrotoxicity of a single dose of a recently developed aminoglycoside, amikacin, in rats. Male rats placed in cages providing constant thermal conditions and lighted from 08:00 to 20:00 h were given a single intraperitoneal injection of 1.2 g/kg amikacin at different times of the 24 hour cycle (08:00, 14:00, 20:00 or 02:00). The study was carried out in October/November. Several parameters were monitored, including urinary excretion of gamma-glutamyl transferase, an enzyme found in the brush border of proximal tubule cells. The increase in urinary excretion of gamma-glutamyl transferase (expressed as a percentage) was found to vary according to the time of administration of amikacin. The highest GGT excretion occurred following administration of amikacin at 20:00 (484% +/- 62.75) and the lowest excretion, similar to that observed in controls, was found following administration at 14:00 (127% +/- 16.85). Thus, it seems that circadian variations in amikacin nephrotoxicity exist in rats. In a previous study we had found circadian variations in acute amikacin nephrotoxicity in mice. A thorough knowledge of these phenomena would improve our use of antibiotics in human clinical practice. PMID- 3534749 TI - [Effect of erythromycin on the fecal flora of infants less than 1-year old]. AB - Erythromycin ethyl succinate is an antibiotic frequently administered in pediatrics. According to some authors, this drug sharply decreases the fecal count of enterobacteria. The fecal flora of 12 infants less than one year old, treated by erythromycin ethyl succinate for 7 to 10 days was studied by differential count. A variable effect was observed on enterobacteria: a 10(3) to 10(5) fold reduction in 9 cases with a final count superior or equal to 10(4) per gram of feces, with or without coming back to the initial count; in 3 cases no modification. MIC of enterobacteria and concentrations of erythromycin in feces were not predictives of flora variation. Anaerobic flora was weakly modified. No implantation of potentially-pathogenic bacteria or multi-resistant or highly erythromycin resistant enterobacteria occurred. Thus, erythromycin ethyl succinate is valuable in pediatrics as it does not disturb barrier effects. But its use for selective decontamination of gut must be discussed depending on pharmacologic form and posology administered. PMID- 3534750 TI - [Pharmacokinetics of ofloxacin in the elderly (65-85 years) with normal renal function after a single oral dose of 200 mg]. AB - Ofloxacin is a fluoroquinolone that is mainly eliminated through the kidneys. We studied ofloxacin pharmacokinetics following administration of a single oral 200 mg dose to each of 16 elderly patients (77 +/- 2.4 years). Serum and urine concentrations were assayed using high performance liquid chromatography. Peak serum ofloxacin concentrations were 3.60 (+/- 0.36) micrograms/ml; residual concentrations were 1.33 (+/- 0.15) and 0.62 (+/- 0.10) micrograms/ml at 12 and 24 hours respectively. Urine concentrations approximating 100 micrograms/ml were found up to the 12th hour. As compared to healthy adults, in elderly subjects ofloxacin distribution volume (85.3 +/- 6.3 l) was decreased by 34%, apparent clearance (4.97 +/- 0.53 l/h) was divided by 2.6 and elimination half life (13.3 +/- 1.2 h) was almost doubled. A linear correlation was found between individual apparent ofloxacin clearances and creatinine clearances. In view of these significant changes in ofloxacin pharmacokinetics found in elderly subjects, we advocate reducing the usual dosage by half. PMID- 3534751 TI - [Evaluation of the Rapid-ATB system for testing the sensitivity of staphylococci to antibiotics. Comparison with the agar dilution reference method]. AB - Rapid ATB Staph is a new, automated, four-hour procedure for testing the susceptibility to antibiotics of staphylococci. Results obtained with this method were compared to those recorded using agar dilution. For all tested antibiotics as a group (5 on 201 strains, 8 on 100 strains), overall agreement between the two sets of results was 96%. 1,809 susceptibility tests were performed, with only 24 minor discrepancies (1.3%) mainly involving cotrimoxazole, and 50 major discrepancies (2.7%) mainly involving doxycycline and chloramphenicol. Rapid ATB Staph clearly demonstrates the heterogeneous oxacillin-resistance of staphylococci as well as their inducible resistance to erythromycin. Our results show that this new system is a very accurate means for testing the susceptibility to antibiotics of staphylococci. PMID- 3534752 TI - [Sensitivity of Kingella kingae to antibiotics]. AB - Kingella kingae is a small Gram negative rod of the Neisseriaceae family, formerly called Moraxella kingae. This microorganism is found occasionally in the oral cavity and is capable of causing infections. We report three cases of septic arthritis in children due to K. kingae. In vitro susceptibility of the recovered strains was tested using determination of MICs in agar. The strains were susceptible to penicillin, ampicillin, ticarcillin, cephalothin, cefotaxime, gentamicin, chloramphenicol, tetracycline, trimethoprim-sulfamethoxazole, and pefloxacin, less susceptible to erythromycin and resistant to lincomycin (MIC 32 mg/l). PMID- 3534753 TI - [Sensitivity to antibiotics of Salmonella typhi and paratyphi strains isolated in Algeria 1979-1984]. AB - Outbreaks of typhoid fever due to multiresistant strains of S. typhi have occurred in some countries. Monitoring of the susceptibility of S. typhi and paratyphi strains to antibiotics, especially those used to treat Salmonella infections, is therefore essential. In this paper, we report the results of our study of strains isolated in Algeria from 1979 through 1984. Studied strains were isolated in our laboratory from stool or blood samples or sent to us for confirmation of the diagnosis. We used agar dilution with IPA 20 medium (Mueller Hinton medium enriched with tryptophan). 6,178 strains were tested, including 5,940 S. typhi strains (96.15%), 123 S. paratyphi A strains (1.99%) and 115 S. paratyphi B strains (1.86%). No resistance was found among the strains tested, whereas 7 resistant strains had been found between July 1973 and December 1978. These results indicate that resistant strains have not spread. However, as new resistant strains might emerge in the future, continued monitoring is needed. PMID- 3534754 TI - [Klebsiella oxytoca beta-lactamases: study of their action on 3d-generation cephalosporins]. AB - Indole-positive Klebsiella pneumoniae or K. oxytoca are usually resistant to penicillins as a result of the production of a chromosomally-mediated beta lactamase with a low level of synthesis (specific activity approximately 50 to 100 mU/mg). Although most strains are susceptible to the majority of cephalosporins, some strains exhibit resistance to cephalosporins including third generation drugs. These resistant strains produce a chromosomally-mediated beta lactamase with a high level of synthesis (specific activity approximately 5,000 mU/mg or higher). Four beta-lactamases have been identified on the basis of their isoelectric points: pI = 5.5, 5.7, 6.0 and 6.3; nevertheless they have similar kinetic constants, and are inhibited by clavulanic acid. These enzymes hydrolyze most third-generation cephalosporins, in the following order of decreasing velocities: cefoperazone, ceftriaxone, cefotaxime, cefodizime, cefpirome; ceftazidime, and cefoxitin, cefotetan, latamoxef, cephamycins which are totally resistant to these enzymes. PMID- 3534755 TI - [Evaluation of the API ATB-CMI system for testing the sensitivity of Haemophilus influenzae to antibiotics. Comparison with other technics and reflections on interpretation criteria]. AB - The API ATB-MIC system was used for antibiotic sensitivity testing of H. influenzae (following addition of NAD and hemin). Results were compared to those obtained with agar dilution and disc diffusion. Eighty-four strains with a variety of resistance phenotypes (including beta-lactamase-producing strains and strains resistant to chloramphenicol, tetracycline or kanamycin) were tested. The API ATB-MIC system studies the susceptibility of H. influenzae to antibiotics by determining minimal inhibitory concentrations. Agreement between the methods ranged from 83% to 98% according to the antibiotic. Discrepancies involved ampicillin, minocycline and, to a lesser extent, chloramphenicol. These discrepancies had no influence on the interpretation of results except in one instance involving chloramphenicol. Comparison of the results obtained with each of the three methods leads to a discussion of the criteria that indicate resistance of H. influenzae and of the cutoff concentrations and diameters used for other species. Criteria indicating resistance are production of beta lactamase for ampicillin, production of enzyme, a MIC above 2 mg/l or a diameter below 26 mm for chloramphenicol, and a diameter below 18 mm or a MIC above 4 mg/l for tetracycline and minocycline. PMID- 3534756 TI - [Comparative activity in vitro of ceftizoxime, ceftazidime and imipenem against Acinetobacter calcoaceticus]. AB - Acinetobacter calcoaceticus, a nosocomial pathogenic agent, is isolated with increasing frequency from hospitalized patients. Acinetobacter is one of the most resistant pathogens to currently available antibiotics, particularly beta-lactam antibiotics. Beta-lactamases (TEM penicillinase and cephalosporinase) and problems of permeability are the most frequent mechanisms of resistance. The authors compared the in vitro activity of ceftizoxim, ceftazidim and imipenem against 82 clinical isolates of Acinetobacter calcoaceticus. Ceftizoxim, structurally similar to cefotaxim, was highly active in vitro; MIC 50%, 90% and geometric mean were respectively 6.28, 15 and 6.9 micrograms/ml. A significant difference was observed between the anitratum and lwoffi varieties. The lwoffi variety was more susceptible to tested drugs than the anitratum variety. Ceftazidim activity was comparable with MIC 50 of 6.5 micrograms/ml and MIC 90 of 26.2 micrograms/ml. A good bactericidal activity was observed against susceptible strains (MIC less than or equal to 4 micrograms/ml). Imipenem showed the greatest activity since 0.47 microgram/ml of the drug inhibited 90% of Acinetobacter calcoaceticus. PMID- 3534757 TI - [Antibacterial activity in vitro of 10 quinolones against 20 strains of Legionella pneumophila]. AB - Minimal inhibitory concentrations (MICs) of 10 quinolones were determined by dilution method on BCYE, for 20 strains of Legionella pneumophila. Since the BCYE Agar medium reduces the antibacterial activity of some antimicrobials, a correction factor was calculated. It was found to be 1 to 16 according to the antibiotic tested. The following mode adjusted MIC show the good in vitro antibacterial activity of quinolones on L. pneumophila: ofloxacin, pefloxacin, ciprofloxacin, norfloxacin, A 56620 cMIC: 0.06 microgram/ml), A 56619, enoxacin (cMIC: 0.12 microgram/ml), rosoxacin (cMIC: 0.25 microgram/ml). Pipemidic acid (cMIC: 2 micrograms/ml) and nalidixic acid (cMIC: 1 microgram/ml) were the least active. PMID- 3534758 TI - [Treatment with erythromycin of experimental legionellosis in guinea pigs infected by aerosol]. AB - The infectious strain L. pneumophila serogroup 1 Philadelphia (ATCC 33152) was cultured on charcoal dialysed yeast extract agar medium (CDYE agar) which produces more virulent strains than those grown on classical agar media. The aerosol was dispersed in a depression chamber by means of a nebuliser and the density was controlled by a density probe. Male albinos Dunkin-Hartley guinea pigs weighing 250-300 g were exposed for 30 minutes to an aerosol dose of 1 LD50 (10(3) viable organisms) and 10 LD50 (10(4) viable organisms). Erythromycin lactobionate (Abbott) was administered subcutaneously 18 hours after the infection, at dosages of 270 mg/kg/day for 4 days in the animals treated with 1 LD50 and for 6 or 7 days in the animals treated with 10 LD50. The guinea pigs were observed for 9 days (weight, rectal temperature; serological and bacteriological tests (cardiac blood, lungs, spleen) and erythromycin assays (serum, lungs) were performed and compared in the treated animals, the non treated infected control animals and the control animals which only received erythromycin. The percentage survival in the treated guinea pigs after inhalation of 1 LD50 and 10 LD50 (2 tests) were 100%, 75% and 87.5% respectively. Three weeks after treatment, the survivors had antibody titres from 32 to 1,024; the bacteriological cultures and erythromycin assays were negative. In this study, an improvement in the treatment of experimental Legionnaires' disease was observed in comparison with previous experiments. The increased dosage and duration and the early initiation of treatment resulted in survival rates of 75%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534759 TI - [Activity of an antiseptic against mycobacteria]. AB - Since the publication of Afnor standards for the determination of bactericidal activity we have studied different antiseptics. Most were inactive on the test strains of Mycobacteria, M. smegmatis. We investigated one antiseptic that did exhibit bactericidal activity against M. smegmatis to find out whether this product's spectrum included other mycobacteria such as those responsible for skin diseases (M. marinum, M. ulcerans, M. chelonei and M. fortuitum). We used the dilution-neutralization method (NF T 72-150) according to all the Afnor requisites, changing only the strains (5 mycobacterial strains recently recovered from clinical specimens), culture conditions, and, for some studies, temperature (21 degrees C and 32 degrees C) and time of contact (5 and 30 minutes). Under Afnor standard conditions (5 mn at 21 degrees C), the tested antiseptic in a concentration of 90% was bactericidal only for M. smegmatis. For the other strains, inhibition was limited (M. fortuitum) or nearly non-existent (M. chelonei). Another series of tests at 32 degrees C showed bactericidal activity (5 log reduction) in 5 minutes for all strains including M. marinum. Despite the fact that these results are of limited practical usefulness, they show 1) that trials under strict conditions can be carried out with all Mycobacteria (including slow growing species), and 2) that broad spectrum bactericidal antiseptics are available. PMID- 3534760 TI - [Sensitivity of anaerobes to 8 antibiotics]. AB - We studied the susceptibility of 282 obligate anaerobes to 8 antibiotics. The strains were isolated from clinical specimens taken during 1983 and 1984. Minimal inhibitory concentrations (MICs) were determined using a microplate method for 245 strains and agar dilution for 33 Bacteroides asaccharolyticus strains. Tested strains were as follows: 85 Bacteroides fragilis, 71 Clostridium, 19 Fusobacterium nucleatum, 35 Peptostreptococcus, 39 Bacteroides oralis and Bacteroides bivius and 33 Bacteroides asaccharolyticus. Tested antibiotics were: metronidazole, clindamycin, minocycline, cefoxitin, cefotaxime, moxalactam, keflin and carbenicillin. For Bacteroides fragilis, the three most active antibiotics were metronidazole (inhibition of all strains with 8 micrograms/ml), minocycline and clindamycin (inhibition of 95% of strains by MICs less than or equal to 0.5 microgram/ml). However, four strains were resistant to clindamycin (MICs greater than 8 micrograms/ml). The other anaerobic strains tested were susceptible. However, a few Bacteroides bivius strains were resistant to keflin (MIC greater than or equal to 64 micrograms/ml for 5% of strains). PMID- 3534761 TI - [Evaluation of the sensitivity to antibiotics of Bacteroides and Fusobacterium using the ATB ANA system]. AB - The susceptibility to antibiotics of 100 Gram negative obligate anaerobes of the Bacteroides and Fusobacterium species was tested using the ATB ANA method. Results were compared to those obtained by addition of the tested antibiotics to Wilkins-Chalgren medium in the critical concentrations. Agreement between the two methods was satisfactory (80 to 100%) for the low cutoff concentrations, except for doxycycline. When the pathogens are divided into susceptible, intermediate and resistant strains, results are more difficult to interpret because of the existence of the intermediate category: however, major discrepancies (R/S) did not exceed 3.2% except for cefotaxime (15%). Our results show that use of ATB ANA microplates in an anaerobic enclosure is a valuable method in clinical practice. PMID- 3534762 TI - [Diffusion of piperacillin into bronchial secretions]. AB - Piperacillin is a ureido-penicillin characterized by the presence of a piperazine group at the position 6 of the beta-lactam ring. This group confers a broader spectrum that includes Pseudomonas. In vitro studies have shown that piperacillin is active against clinical strains recovered from intensive care unit patients with severe lower respiratory tract infections. The purpose of our study was to investigate the usefulness of piperacillin in such patients by evaluating the drug's diffusion into bronchial secretions. A single 4 g dose of piperacillin was given intravenously over three minutes to each of 6 intensive care unit patients. Serum and bronchial secretion samples (obtained through a tracheal intubation or tracheostomy tube) were taken 1/2 hour, 2 h, 4 h and 6 h after the injection to evaluate piperacillin kinetics. Serum piperacillin concentrations were maximal 30 mn after the IV (mean value: 90.6 +/- 23.8 micrograms/ml) and thereafter fell gradually (mean value after 4 hours: 40.4 +/- 27.5 micrograms/ml). Peak concentrations in bronchial secretions were recorded at 2 hours (12.2 +/- 8.5 micrograms/ml); the mean residual value at 6 hours was 4.9 +/- 8.7 micrograms/ml. The diffusion ratio (ratio of bronchial secretion concentration to simultaneous serum concentration) was 15.5% to 24.5%. Our results show that the diffusion of piperacillin into bronchial secretions is outstanding and support the use of this drug in severe respiratory tract infections. PMID- 3534763 TI - [Serum and bronchial concentrations of netilmicin during its continuous intratracheal administration]. AB - Respiratory tract infections in intensive care units have a high fatality rate, perhaps as a result of the poor diffusion into bronchial secretions of aminoglucosides given by a systemic route. Endotracheal administration of aminoglycosides has been advocated but the optimal dosage remains to be determined. To investigate this problem we studied 13 patients free of renal failure and 6 patients with renal failure. Netilmicin was given by continuous endotracheal infusion in a daily dosage of 3 to 30 mg/kg. A good correlation was found between infused doses and serum concentrations; very high bronchial secretion concentrations were consistently found. There is a significant risk of accumulation in patients with renal failure. The characteristics of the respiratory tract secretions had no influence on the passage of netilmicin into the bloodstream. The dosages we advocate on the basis of our results are 8 mg/kg/day in patients free of renal failure and 4 mg/kg/day in patients with renal failure; serum netilmicin concentrations should not exceed 1 microgram/ml. PMID- 3534765 TI - [Trial chemoprophylaxis of traveler's diarrhea using nifuroxazide]. AB - Traveler's diarrhea is a very common condition that affects approximately 12 million subjects each year. This disorder is benign but nevertheless interferes with the traveler's plans in 40% of cases. Several drugs have been used for prophylaxis, in association with appropriate precautions concerning food and drink. Trimethoprim-sulfamethoxazole and cyclines are effective but may induce adverse effects. Nifuroxazide in a dose of 400 mg each day throughout the trip has proved effective. Tolerance was outstanding with no adverse effects. PMID- 3534764 TI - [The drug combination amoxicillin-clavulanic acid compared to the triple combination ampicillin-gentamicin-metronidazole in the treatment of severe adnexal infections]. AB - Forty-four patients with severe pelvic inflammatory disease were randomly divided into two groups. Single drug therapy with the amoxicillin-clavulanic acid was used in 22 patients (group A). The other 22 patients (group B) were given a combination of ampicillin, gentamicin and metronidazole. Clinical results were comparable in both groups with 91% successes and 9% improvements in group A, against 86% successes, 9% failures, and 5% non-interpretable results in group B. The difference between the two groups was not statistically significant (p = 11.6%). 30% of patients in each group had positive serologic tests for Chlamydiae. This had no influence on therapeutic results but led to secondary prescription of a cycline. Because amoxicillin-clavulanic acid is active against aerobic and anaerobic pathogens, including beta-lactamase-producing microorganisms, it is a satisfactory alternative to the ampicillin-gentamicin metronidazole combination, especially as it is simpler to use, less toxic and less expensive. PMID- 3534766 TI - [Isolation of Clostridium difficile from the stools of hospitalized patients with diarrhea]. AB - 408 stool samples from 354 hospitalized patients with diarrhea were evaluated for the presence of Clostridium difficile. C. difficile was detected in stools of 42 patients (12%), 19 of them being hospitalized in neurosurgery units. The strains were cytotoxigenic in 31 cases and non cototoxigenic in 11 cases. The diagnosis of C. difficile induced diarrhea was based on the clinical setting [presence of diarrhea that could be attributed to antimicrobial therapy and endoscopy for detection of pseudomembranous colitis (PMC)], laboratory studies (cytotoxigenic strains of C. difficile) and therapeutic response (oral vancomycin or metronidazole). C. difficile was implicated as a cause of PMC (2 cases) and antimicrobial associated diarrhea (8 cases) (PMC not documented). The pathogenic role of C. difficile was questionable in 24 cases (no specific therapy) and unlikely in 8 cases. In fact C. difficile could be implicated as a cause of diarrhea in 24% of the cases. PMID- 3534767 TI - [In vitro spectrum of action of a new antifungal derivative of naftifin: terbinafin (SF 86-327)]. AB - Terbinafine (SF 86-327) is a new antifungal agent derived from naftifine and effective by the oral route. We studied the in vitro antifungal activity of terbinafine (SF 86-327) against several pathogenic fungi responsible for human disease. Tested pathogens included yeasts (Candida), dermatophytes (Microsporum, Trichophyton, Epidermophyton), molds (Aspergillus, Scopulariopsis) and dimorphic fungi (Sporothrix schenkii). Broth dilution (Sabouraud) or agar dilution (Sabouraud, Kimmig) were used. 322 strains of pathogenic fungi belonging to 23 different species were tested. The yeasts showed varying degrees of susceptibility (MICs ranging from 10 to 100 micrograms/ml) except for Candida parapsilosis (MICs 1 to 2 micrograms/ml). Strong susceptibility was found for molds (MICs 0.1 to 2 micrograms/ml), especially Scopulariopsis brevicaulis and Sporothrix schenkii (MICs 0.2 microgram/ml). Dermatophytes were also highly susceptible to terbinafine (MICs 0.001 to 0.02 microgram/ml). PMID- 3534768 TI - [Comparative study of the fungistatic activity in vitro of omoconazole and 6 other imidazoles against yeasts]. AB - Omoconazole (CM 8282) is a new synthetic antifungal agent with a spectrum of activity quite similar to that of the imidazole family. Fungistatic activity of this product was compared to that of the six following reference products: clotrimazole, econazole, isoconazole, ketoconazole, miconazole, and tioconazole. MICs against 55 recent clinical yeast isolates were determined by agar dilution on pH 5.5-adjusted Sabouraud and casitone media. MIC 90% values showed that tioconazole was the most active product, followed by omoconazole and econazole, whereas ketoconazole was the least active compound under our experimental conditions. PMID- 3534769 TI - [Application of a micromethod to the study of the bactericidal activity of 2 antiseptics based on chlorhexidine gluconate]. AB - Minimal bactericidal concentrations (MBCs) of two antiseptics containing chlorhexidine digluconate (5% for the A solution, 1.5% for the B solution) were determined using a microdilution method. This method is a miniaturization of the Afnor T 72150 standard for antiseptics and disinfectants. 133 hospital isolates were studied, including 68 Enterobacteriaceae, 11 Acinetobacter, 18 Pseudomonas, 1 Achromobacter, 23 Staphylococcus, and 12 S. faecalis. Each microplate was seeded with eleven of these strains and one reference strain (E. coli CIP 54127, P. aeruginosa CIP A22, S. aureus CIP 53154, and S. faecium CIP 5855). Ten microliter of a standardized inoculum (2 to 3 10(8) bacteria/ml) were added to 90 microliters of a solution containing the antiseptic. Each antiseptic was tested in various concentrations (1.95 to 125 mg/l for A and 1.17 to 75 mg/l for B). After five minutes contact at 21 degrees C, 1.5 microliter from each well was seeded on a neutralizing agar plate (letheen agar + 3% tween 80 + 0.3% lecithin + 3% saponin + 0.1% histidine). The neutralizing effectiveness of this plate on the antiseptics in the concentrations used had been ascertained previously. The Afnor T 72150 standard was established for each reference strain. MBCs 90 (in mg/l) found were as follows: 31.2 (A) and 18.8 (B) for Enterobacteriaceae, 15.6 (A) and 9.4 (B) for Acinetobacter, 31.2 (A) and 18.8 (B) for Pseudomonas, 62.5 (A) and 37.7 (B) for Staphylococcus and 125 (A) and 37.5 (B) for S. faecalis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534770 TI - [Proposal for a method of studying the activity of soap or antiseptic against the microbial flora of the hands after a single surgical scrub]. AB - The authors, all members of the Antiseptics group of the Societe Francaise de Microbiologie, propose a standardised method for the evaluation of the activity of antiseptics on the microbial flora of the hands in the context of surgical scrubbing. This paper defines the aims of the method, its field of application and describes the media and materials required. The various phases of the preliminary study and the definitive trial also described. PMID- 3534771 TI - Diagnosis and management of Lyme disease. PMID- 3534772 TI - Cardiopulmonary function of cats with respiratory distress induced by N-nitroso N methylurethane. AB - The purposes of this study were to determine the effects of positive end expiratory pressure (PEEP) and end-expiratory lung volume on systemic blood flow, whether PEEP levels yielding maximum systemic oxygen transport are associated with maximum lung compliance, and the effects of end-expiratory lung volume on pulmonary resistance to gas flow, in an animal model of respiratory distress. Twelve cats were inoculated with 12 mg/kg N-Nitroso N-Methylurethane (NNNMU) to induce respiratory distress. The NNNMU caused a 76% decrease in disaturated phosphatidyl-choline of lung lavage, a 34% decrease in functional residual capacity (FRC), an 80% decrease in lung compliance, an 88% increase in pulmonary resistance to gas flow, a 43% decrease in PaO2, and a 37% decrease in oxygen consumption. Systemic blood flow and systemic oxygen transport were not significantly altered by the chemically induced respiratory distress. PEEP levels of 5.1 +/- 0.8 cm H2O returned end-expiratory lung volume to normal FRC levels. Increases in PEEP caused systemic blood flow to decrease even when end-expiratory lung volume was below or equal to normal FRC levels but did not significantly affect systemic oxygen transport, lung compliance, or pulmonary resistance. We conclude that in cats with NNNMU-induced respiratory distress: PEEP causes decreases in systemic blood flow, lung compliance and systemic oxygen transport are not clear indicators of optimal PEEP level, and returning end-expiratory lung volume to normal FRC does not significantly reduce pulmonary resistance to gas flow. PMID- 3534773 TI - Pediatric hypertension: an approach to imaging. AB - Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound in identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension. PMID- 3534774 TI - Transient gallbladder distention in sick premature infants: the value of ultrasonography and radionuclide scintigraphy. AB - Transient gallbladder distention in sick premature infants has been reported with increasing frequency over the last few years. It is important to be aware of this entity of gallbladder disease which resolves spontaneously and to be able to differentiate it from other problems that require surgical correction. We believe that ultrasonography is most helpful in confirming the diagnosis, excluding stone formation, and documenting any changes in size or appearance. However, there are no reliable ultrasonic criteria for distinguishing inflamed or pathologically distended gallbladders from noninflamed or temporarily enlarged gallbladders. Radioisotope imaging, though useful in demonstrating malfunction of the hepatobiliary system, should be interpreted with caution. In the final analysis, the dilemma as to whether gallbladder distention is a transient or persistent malfunction can be settled best by thoughtful clinical judgement. PMID- 3534775 TI - Ultrasound of the infant hip. Part 1. Basic principles. AB - Method and the basic principle of infant hip studies by means of ultrasound are described. It is the purpose of this imaging modality to detect dislocations and dysplasia at an early stage. The visible structures of the hip-joint are shown in histologic-sonographic correlation. Based on the pathomechanics of hip-dysplasia diagnostic criteria for ultrasound studies are developed. Our classification system, in close similarity to Graf, is presented. PMID- 3534776 TI - Ultrasound of the infant hip. Part 2. Validity of the method. AB - The reproducibility of classifications and measurements used in ultrasound of the infant hip has been evaluated in a prospective, double-blind study. Normal values and range distribution are defined for the main types as well as the potential for discriminating these types by means of ROC-analysis. The clinical validity of the method in defining normal and pathologic findings is discussed in comparison with X-ray diagnosis and follow-up sonographic investigations. Visual analysis focussing on a few diagnostic criteria, mainly the inclination of the acetabular roof and the position of the femoral head, provides sufficiently high accuracy (94% agreement rate) and the best diagnostic results. A correct examination which includes tests of the mobility of the hip joint and limitation of the section level to the maximal depth of the acetabular fossa, allows nearly perfect diagnosing of dysplasia and dislocation. PMID- 3534777 TI - Ultrasound, computed tomography and magnetic resonance of a neonatal ganglioglioma of the brain. AB - Ganglioglioma is an uncommon nerves-cell tumour (0.4% of all brain tumours). In 800 brain tumours in children, Garrido et al. (Toronto) found 14 gangliogliomas (1.7%). To our knowledge, ganglioglioma has not been reported in children under 2 1/2 years of age. We have incidentally discovered a ganglioglioma in a 3-day-old girl. Appearance on US, CT and MR are described and discussed. PMID- 3534778 TI - Effects of a leukotriene antagonist on the early hemodynamic manifestations of group B streptococcal sepsis in piglets. AB - In order to evaluate the influence of leukotrienes on group B streptococcal (GBS) sepsis we studied the effect of a leukotriene antagonist, FPL 57231, on the early hemodynamic changes occurring secondary to an infusion of live GBS. Paralyzed, mechanically ventilated piglets received a continuous intravenous infusion of bacteria (5 X 10(8) org/kg/min) while systemic arterial pressure and pulmonary artery pressure were measured continuously. Cardiac output was measured by thermodilution; and plasma samples for determination of thromboxane B2 and 6-keto PGF1 alpha were taken at preset intervals. In addition to GBS, treatment animals received a continuous infusion of FPL 57231 starting 15 min after the bacterial infusion was begun. Study animals as a whole responded to bacteria within 15 min with a marked elevation in pulmonary artery pressure from 13.6 +/- 4 to 44.6 +/- 6 mm Hg (p less than 0.001), and a decline in PaO2 (79 +/- 9 to 44 +/- 5 mm Hg) (p less than 0.001) and a cardiac output (0.27 +/- 0.07 to 0.15 +/- 0.06 liter/min/kg) (p less than 0.0001). In animals treated with FPL 57231 these changes were reversed or significantly attenuated by 60 min. In the control group pH deteriorated significantly to 7.17 +/- 0.1 compared to baseline values (p less than 0.01) by 60 min, while treatment group animals maintained a pH of 7.3 +/- 0.23. Thromboxane B2 and 6-keto PGF1 alpha were similar in both groups and did not change during the study period. In addition, survival was significantly longer in treatment (191 +/- 44 min) compared to control animals (100 +/- 32 min) (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534779 TI - Richard L. Day--the quintessential skeptical inquirer. Presentation of the Howland award 1986. PMID- 3534780 TI - Development of autologous specific reactivity to human neuroblastoma. AB - Antigenic analysis of neuroblastoma cells was performed by autologous typing and indirect immunofluorescent test combined with absorption tests. Serum of a patient with neuroblastoma before treatment showed weak reactivity with cultured autologous neuroblastoma cells, while serum obtained from the same patient 3 months after chemotherapy exhibited strong reactivity with the same indicator cells. This reactivity was absorbed with neither cultured autologous fibroblasts nor allogeneic tumor cells from seven neuroblastoma and two melanoma patients. In addition, cultured hematopoietic cells from two subjects, normal fetal and adult tissues also failed to remove the reactivity. This reactivity, however, was completely removed by the absorption with the cultured autologous neuroblastoma cells and the homogenate, suggesting that these neuroblastoma cells may express tumor specific antigen(s), located on neither normal cells in any stage of the development nor other malignant cells, although the cells and tissues we tested may not be adequate to confirm this. PMID- 3534781 TI - IgG subclasses and antibodies to group B streptococci, pneumococci, and tetanus toxoid in preterm neonates after intravenous infusion of immunoglobulin to the mothers. AB - High doses of intravenous immunoglobulin were given to seven pregnant women between the 27th and 36th wk of gestation who were at risk for preterm delivery. Determinations of IgG subclasses and of antibodies against group B streptococcal serotypes, pneumococcal polysaccharides, and tetanus toxoid were done in maternal serum before and after intravenous IgG infusion and after delivery in cord serum. Substantial transplacental passage of the infused material could be observed in five cases where delivery occurred at the 34th wk or later. After the 36th wk of gestation, IgG subclass and antibody concentrations in cord serum were increased up to the levels in the maternal serum. PMID- 3534782 TI - Enhanced endothelial cell proliferation in acute Kawasaki disease (muco-cutaneous lymph node syndrome). AB - Paired sera from 30 patients with muco-cutaneous lymph node syndrome (Kawasaki disease) were studied for possible effects on human vascular endothelial cells growth in vitro. The majority of sera from acute phase muco-cutaneous lymph node syndrome patients significantly enhanced endothelial cell proliferation more than those from convalescent phase patients, infectious diseases patients, and age matched normal controls. This stimulation was considered to be specific for EC since muco-cutaneous lymph node syndrome sera did not enhance fibroblast growth more than normal sera. Fractionation of the serum with gel filtration failed to clearly detect the molecular properties of this effect, although both heavy and light material possessed this activity. Extensive search for circulating immune complex in muco-cutaneous lymph node syndrome sera were negative, suggesting that the enhanced endothelial cell proliferation was due to serum components other than immune complexes. PMID- 3534783 TI - [Assisted ventilation in infants with acute bronchiolitis]. AB - Our experience concerns 36 infants ventilated for bronchiolitis over the last five years. Among the infants admitted in the pediatric department during the same period 11% have been ventilated. Their age ranged between 1.5 and 49.5 weeks (mean 9.2 weeks) and their weight between 2,700 and 8,000 g (mean 3,841 g). Fourteen were premature born infants. 16 patients have been intubated for apneas, 13 for clinical deterioration and 10 for hypercarbia. The duration of ventilation ranged between 1 and 18 days (mean 6.5 days). No death occurred. Neither neurological nor respiratory sequelae could be related to ventilation. Mechanical ventilation is a safe method able to suppress mortality in infants bronchiolitis. PMID- 3534784 TI - [Stevens-Johnson syndrome associated with Mycoplasma pneumoniae infection. Apropos of a pediatric case]. AB - A 13 years old girl presented an acute episode of fever, productive cough, purulent rhinorrhea and bilateral pulmonary crepitant rales. 36 hours later a maculopapular eruption appeared on the face, extended to all body and became bullous. Pluriorificial mucous membranes lesions were associated (conjunctivae, buccal mucosa, lips, nasal mucosa, genitalia and the perirectal area). Parenteral prednisone was administered and the extension of the eruption was stopped in a few hours. Lesions healed in about 10 days. Association with mycoplasma pneumoniae was documented by serologic studies (high titers of complement fixing antibodies and presence of IgM antibodies in immunofluorescence). PMID- 3534786 TI - Stone-age art "Venuses" as heuristic clues for types of obesity: contribution to "iconodiagnosis". AB - Two types of obesity (gluteal and abdominal) depicted quite consistently in prehistoric art of different European locations suggests the potential cross fertilization for physiological inquiry by medical interpretation of prehistoric art, called iconodiagnosis. PMID- 3534787 TI - In respect of the RI. PMID- 3534785 TI - [Peritoneal metastasis of a pineoblastoma in a patient with a ventriculo peritoneal shunt]. AB - A 12 years old child had an increase of intra cranial pressure secondary to a large pinealoblastoma. A ventriculo peritoneal shunt procedure was performed followed several days later by a partial resection of the pinealoblastoma. One year later, ultrasound and computed tomography examinations discovered a solid mass in the pelvis. At surgery it appeared to be a metastasis of the pinealoblastoma. It is a very seldom complication of the shunt and various mechanisms are discussed. PMID- 3534788 TI - [Dental amalgam--a topic for discussion 55 years ago]. PMID- 3534789 TI - The proofreading of hydroxy analogues of leucine and isoleucine by leucyl-tRNA synthetases from E. coli and yeast. AB - Three analogues each of leucine and isoleucine carrying hydroxy groups in gamma- or delta- or gamma- and delta-position have been synthesized, and tested in the aminoacylation by leucyl-tRNA synthetases from E. coli and yeast. Hydrolytic proofreading, as proposed in the chemical proofreading model, of these analogues and of homocysteine should result in a lactonisation of these compounds and therefore provide information regarding the proofreading mechanism of the two leucyl-tRNA synthetases. Leucyl-tRNA synthetase from E. coli shows a high initial substrate discrimination. Only two analogues, gamma-hydroxyleucine and homocysteine are activated and transferred to tRNALeu where a post-transfer proofreading occurs. Lactonisation of gamma-hydroxyleucine and homocysteine could be detected. Leucyl-tRNA synthetase from yeast has a relatively poor initial discrimination of these substrates, which is compensated by a very effective pre transfer proofreading on the aminoacyl-adenylate level. No lactonisation nor mischarged tRNALeu is detectable. PMID- 3534790 TI - Cloning and sequencing of a gene for Mucor rennin, an aspartate protease from Mucor pusillus. AB - The aspartate protease of Mucor pusillus (Mucor pusillus rennin; MPR) is a milk clotting enzyme used in the cheese industry. The partial amino acid sequence of MPR was determined and oligonucleotide probes were synthesized for cloning of the MPR gene. A clone giving positive hybridization with the probes was selected from the cosmid library. Sequencing of the cloned DNA revealed an open reading frame of 1281 bp without introns which encodes 361 amino acids for the expected MPR with an NH2-terminal extension of 66 amino acids. MPR seems to be synthesized as a prepro enzyme. PMID- 3534791 TI - Complete nucleotide sequence of the Escherichia coli ptr gene encoding protease III. AB - The nucleotide sequence of a 3120 bp region of the E. coli chromosome that includes the entire ptr gene has been determined. The proposed coding region for Protease III is 2889 nucleotides long, which would encode a protein consisting of 962 amino acids with a calculated molecular mass of 107,719 daltons. The predicted primary structure of the protein includes a 23-residue signal sequence, cleavage of which would give rise to a mature protein of molecular mass 105,124 daltons. At its 3' end, the ptr gene overlaps the start of the recB coding sequence by 8 bases, suggesting that these genes may form part of an operon. PMID- 3534792 TI - Codon usage in regulatory genes in Escherichia coli does not reflect selection for 'rare' codons. AB - It has often been suggested that differential usage of codons recognized by rare tRNA species, i.e. "rare codons", represents an evolutionary strategy to modulate gene expression. In particular, regulatory genes are reported to have an extraordinarily high frequency of rare codons. From E. coli we have compiled codon usage data for highly expressed genes, moderately/lowly expressed genes, and regulatory genes. We have identified a clear and general trend in codon usage bias, from the very high bias seen in very highly expressed genes and attributed to selection, to a rather low bias in other genes which seems to be more influenced by mutation than by selection. There is no clear tendency for an increased frequency of rare codons in the regulatory genes, compared to a large group of other moderately/lowly expressed genes with low codon bias. From this, as well as a consideration of evolutionary rates of regulatory genes, and of experimental data on translation rates, we conclude that the pattern of synonymous codon usage in regulatory genes reflects primarily the relaxation of natural selection. PMID- 3534794 TI - A binary vector for transferring genomic libraries to plants. AB - The transformation of mutant plants with a complete recombinant library derived from wild-type DNA followed by assay of transformed plants for complementation of the mutant phenotype is a promising method for the isolation of plant genes. The small genome of Arabidopsis thaliana is a good candidate for attempting this so called shotgun transformation. We present the properties of an A. thaliana genomic library cloned in a binary vector, pC22. This vector, designed to introduce genomic libraries into plants, contains the oriV of the Ri plasmid pRiHR1 by which it replicates perfectly stably in Agrobacterium. Upon transfer of the library from E. coli to A. tumefaciens large differences in transfer efficiencies of individual recombinant clones were observed. There is a direct relation between transfer efficiency and stability of the recombinant clones both in E. coli and A. tumefaciens. The stability is independent of the insert size, but seems to be related to the nature of the insert DNA. The feasibility of shotgun transformation and problems of statistical sampling are discussed. PMID- 3534793 TI - High level production and rapid purification of the E. coli trp repressor. AB - Two small, multicopy, expression plasmids were constructed that permit convenient insertion of trpR, the structural gene for the trp repressor of Escherichia coli, with its natural ribosome binding site or adjacent to the ribosome binding site for the trp leader peptide. In these plasmids trpR is positioned between the strong regulated tac promoter and the rpoC transcription terminator. IPTG induction of lacIq strains bearing these plasmids results in the production of 25 50% of the soluble cell protein as trp repressor. Mutant and wild type repressors overproduced in this manner have been purified by simple procedures. PMID- 3534795 TI - The adjacent dnaZ and dnaX genes of Escherichia coli are contained within one continuous open reading frame. AB - The dnaZ and dnaX loci of Escherichia coli have been genetically defined as separate genes, both of which are essential for DNA replication (1). The 2.1 kb region of DNA that complements mutations in both genes has a maximum coding capacity of approximately 80,000 daltons. Two protein products are produced from this region with molecular weights of 77,000 and 52,000 (2,3). We have sequenced a 2.7 kb fragment containing the dnaZ and dnaX genes and determined that it contains only one open reading frame of sufficient length to encode either of these proteins. This open reading frame may encode a protein of 71,147 daltons or of 68,451 daltons depending on which potential translational initiation codon is utilized. There are two transcriptional promoters preceding the gene as well as a ribosome binding site preceding the two potential initiation codons. Both the promoters and ribosome binding sites are predicted to be weak, perhaps contributing to the low expression of these genes. PMID- 3534797 TI - Reference sources for nursing. By the Interagency Council on Library Resources for Nursing. PMID- 3534796 TI - The profession in a class by itself. PMID- 3534798 TI - Aztreonam. AB - Aztreonam is a new, totally synthetic beta-lactamase agent--the first monobactam. It is highly resistant to hydrolytic inactivation caused by plasmid-mediated (except PSE-2 enzyme found in some Pseudomonas species) or chromosomally mediated beta-lactamases (except for K1 produced by rare strains of Klebsiella oxytoca). Accordingly, aztreonam remains active against many pathogens that are resistant to other beta-lactam antibiotics. The drug exhibits directed antibacterial activity against gram-negative organisms and is effective as monotherapy against most Enterobacteriaceae and Hemophilus and Neisseria species, including beta lactamase-producing strains; it is not active against anaerobes or gram-positive organisms. Before culture results are known, it may be necessary to administer the agent empirically in combination with other antibiotics. Aztreonam is rapidly distributed to most body tissues and fluids when administered parenterally. Its serum half-life is 1.7 hours, suggesting a dosing interval of 6-8 hours for severe or life-threatening infections and 8-12 hours for moderately severe infections and urinary tract infections. It is primarily eliminated unchanged in the urine and in much lesser amounts as a microbiologically inactive metabolite; slight biliary excretion may occur. Aztreonam is well-tolerated, lacking any serious adverse hematologic, otic, or renal system effects. Its lack of effect on anaerobes helps to maintain resistance against colonization. Particularly in light of its safety and unique properties, aztreonam promises to be a useful alternative to aminoglycoside therapy. PMID- 3534799 TI - Vancomycin: an update. AB - Vancomycin is a narrow-spectrum glycopeptide antibiotic with potent antistaphylococcal activity. It is primarily active against gram-positive organisms. Bacterial resistance rarely develops due to its numerous modes of action. The toxic potential of vancomycin is less significant than previously thought. "Red neck syndrome" seems to be the most common side effect and appears to be caused by rapid intravenous infusion. It is characterized by erythema at the base of the neck and the upper back; hypotensive episodes may also occur. Nephrotoxicity and ototoxicity are rare. Relationships between toxicities and serum concentrations have not been established. The disposition of vancomycin after intravenous administration proceeds biphasically--rapid distribution followed by elimination. The drug is excreted primarily unchanged in the urine by glomerular filtration. Vancomycin clearance is reduced and elimination half-life is prolonged in patients with renal insufficiency. Various methods have been published to aid in dosing the drug in these patients. Vancomycin is the drug of choice in the treatment of methicillin-resistant staphylococcal infections. It is also useful in the treatment of gram-positive endocarditis and has been used as alternative therapy in the treatment of prophylaxis of gram-positive infections in penicillin-allergic patients. Oral vancomycin is the preferred therapy in antibiotic-associated colitis. PMID- 3534800 TI - Methotrexate in rheumatoid arthritis: an update. AB - Methotrexate, a folic acid antagonist, is being employed more frequently in an attempt to control rheumatoid arthritis that has not responded adequately to conventional therapies. Systemic administration of 7.5-15 mg weekly in a pulse fashion appears to be effective without precipitating serious adverse effects. Concern over potentially serious adverse effects and lack of well-controlled clinical trials have limited its use to severe, refractory disease. Its use in the future is likely to increase in these patients because of its ease of administration and the high response rate noted in clinical studies. PMID- 3534801 TI - The effect of low-dose hydrochlorothiazide on blood pressure, serum potassium, and lipoproteins. AB - Recent clinical trials in hypertension suggest that thiazide diuretics may increase coronary heart deaths in selected patients, possibly through adverse effects on serum potassium, lipids, lipoproteins, and/or apolipoproteins. Administration of smaller doses of diuretics has been recommended to decrease this risk. We evaluated 12.5-mg and 112.5-mg daily doses of hydrochlorothiazide (HCTZ) administered for 1 month to nine postmenopausal black female hypertensives using a double-blind, randomized, crossover design. Both regimens produced significant reductions in sitting diastolic blood pressure, a mean of 11 mm Hg with the high dose and 8 mm Hg with the low dose. The high dose produced a mean 0.7 mEq/L reduction in serum potassium while the low dose caused no change. Both doses produced similar changes in serum lipoproteins. Statistically significant elevations were seen in total cholesterol (approximately 12%), LDL cholesterol (approximately 20%), cholesterol: HDL ratio (approximately 15%), and apolipoprotein B (approximately 20%). Apolipoprotein A1 was significantly reduced (approximately 6%). These results support the use of low doses of HCTZ in mild hypertension to avoid hypokalemia, but suggest that adverse changes in serum lipids will occur. PMID- 3534802 TI - Venous thrombosis: an overview. AB - Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, 125I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. PMID- 3534803 TI - Review of the Multicenter Trial Committee report: a prospective, randomized study on the prophylaxis of postoperative deep venous thrombosis. AB - The etiology of postoperative deep venous thrombosis (DVT) is thought to be due to a combination of factors including stasis, a hypercoagulable state and venous endothelial damage. Methods of prophylaxis are directed toward correcting one or more of these pathologic events. Methods counteracting more than one of these factors can be expected to be even more effective. The combination of dihydroergotamine (DHE) and heparin was anticipated to minimize stasis and the hypercoagulable state respectively. Based upon current experimental evidence and current theory, an additional benefit might include minimizing venous endothelial injury by controlling venomotor tone. A prospective, randomized, double-blind, multicenter trial was designed and performed in the United States evaluating the prophylactic efficacy of DHE 0.5 mg plus heparin 5000 U, DHE 0.5 mg plus heparin 2500 U, heparin 5000 U, and DHE 0.5 mg versus placebo. General surgical patients including those undergoing noncardiac thoracic and pelvic operations who were identified at moderate to high risk for postop DVT were included. Study medications were injected subcutaneously two hours preoperatively and every 12 hours postoperatively for 5-7 days or until the 125I-fibrinogen-uptake test (RFUT) became positive. Eight hundred and eighty eight patients were entered into this trial and 744 (85%) completed the study. Results showed a statistically significant benefit from DHE/Hep 5000 compared to placebo (p less than 0.01) and compared to other active agents (p less than 0.05). None of the other active agents showed a statistically significant prophylactic benefit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534804 TI - Combination dihydroergotamine mesylate and heparin sodium with lidocaine HCl. Pharmacokinetics, mechanism of action, clinical efficacy, and adverse effects. AB - Dihydroergotamine(DHE)-heparin combination offers a unique treatment modality for the prevention of deep vein thrombosis. The combination appears to affect all 3 limbs of Virchow's triad: hypercoagulability, venous stasis, and endothelial damage. In most efficacy studies, data indicated that the combination of DHE 0.5 mg and heparin 5000 IU was superior to low-dose heparin alone. Even when the efficacy of DHE-heparin was the same as that of heparin alone, the use of the combination allowed for a decrease in the heparin dose required. PMID- 3534805 TI - Helen Brooke Taussig: 1898-1986. PMID- 3534806 TI - Systematic approach to diagnosis and coding of pediatric cardiac disease. AB - A new system for coding congenital heart defects and related problems was developed to facilitate the computerized storage and retrieval of detailed diagnostic information. The system is based on the segmental approach to diagnosis with comprehensive tables indicating all possible mutually exclusive intersegmental alignments and connections. Diagnostic entities rather than nomenclature are the subjects of the codes. This system represents the best effort to date to develop an all-inclusive, precise, and accurate code while insuring completeness and maximizing efficiency in data collection by the use of a highly structured code book. PMID- 3534807 TI - Fetal adrenal VIP: distribution and effect on medullary catecholamine secretion. AB - Vasoactive intestinal peptide (VIP) was found in the adrenal gland of ovine fetuses at 130-135 days gestation and was shown to stimulate catecholamine secretion. VIP was demonstrated by immunocytochemistry using the indirect antibody-enzyme method. VIP-immunoreactive nerve fibers were observed in the capsule, zona glomerulosa and inner layer of the cortex as well as in the medulla; furthermore small clusters of VIP-containing cell bodies were found at the corticomedullary border. To study the direct effect of VIP on catecholamine release, fetal adrenal medulla was dispersed into single cells and incubated in vitro with VIP for 6 hours. Catecholamine release into the medium was measured at 1, 3 and 6 hours. At 6 hours of incubation, VIP stimulated total catecholamine release from fetal adrenomedullary cells in a dose-dependent manner at concentrations ranging from 10(-8) to 10(-4) M. The release of norepinephrine and epinephrine, but not dopamine, was significantly enhanced. The presence of VIP in the fetal adrenal cortex and medulla, and the ability of VIP to stimulate catecholamine release from fetal adrenomedullary cells in vitro suggest that VIP may be an important modulator of medullary catecholamine secretion during fetal life. PMID- 3534808 TI - Central nervous system effects of peptides, 1980-1985: a cross-listing of peptides and their central actions from the first six years of the journal Peptides. AB - A tabular synopsis is presented for articles concerned with the effects of peptides on the central nervous system that appeared in the journal Peptides from 1980-1985. A table arranged alphabetically by peptide and one arranged by effects, both listing routes of injection, species, direction of change, and qualifying notes, provides easy cross-referencing of peptides and their effects. Over 80 peptides and over 135 effects are listed. The list of peptides includes, but is not limited to: ACTH, angiotensin, bombesin, bradykinin, calcitonin, casomorphin, CCK, ceruletide, CGRP, CRF, dermorphin, DSIP, dynorphin, endorphins, enkephalins, GRF, gastrin, LHRH, litorin, metkephamid, MIF-l, motilin, MSH, NPY, NT, oxytocin, ranatensin, sauvagine, substances P and K, somatostatin, TRH, VIP, vasopressin, and vasotocin. The list of effects includes, but is not limited to: aggression, alcohol, analgesia, attention, avoidance, behavior, cardiovascular regulation, catalepsy, conditioned behavior, convulsions, dopamine binding and metabolism, discrimination, drinking, EEG, exploration, feeding, fever, gastric secretion, GI motility, grooming, learning, locomotor behavior, mating, memory, neuronal activity, open field, operant behavior, rearing, respiration, satiety, scratching, seizure, sleep, stereotypy, temperature, thermoregulation and tolerance. PMID- 3534809 TI - The nature of photoaging: its prevention and repair. PMID- 3534811 TI - Assessment of addictive disorders. The use of clinical reflection and hypotheses testing. AB - This article examines how a multidimensional conceptual schema (biologic, sociologic, psychodynamic, and behavioral) can be applied directly to clinical practice methods during the assessment of addictive disorders. This practice is offered to minimize some of the conceptual problems often associated with the diagnostic process. Clinical reflection and hypotheses testing are considered as meta-models that can effectively guide the conduct of clinical assessment. The purpose of this approach is to provide a parsimonious means of organizing and verifying clinical information, thus making the assessment process both manageable and teachable. The ability to manage and teach clinical methods is considered as an essential step toward the development of a practice theory in the addictions. PMID- 3534810 TI - Phototoxicity testing of fenflumizole, a human model. PMID- 3534812 TI - Psychodynamic factors in the development of drug dependence. AB - In this article we have brought to bear on the complex problem of substance dependency the psychodynamic perspective: a model that views the problem from the inner experience and psychological structure of the individual drug user. Chronic drug dependence has been associated with a range of personality styles and psychopathologic conditions but most frequently with character disorder and vulnerability to depression. Regardless of specific symptoms or personality styles, certain characterologic features are repeatedly observed to characterize substance-dependent individuals. These include problems in affect management, narcissism, object relations, judgment, and self-care. These developmentally and structurally determined problems generally predispose individuals to drug dependence because they are the basis of the distresses that are relieved by drug taking; they specifically predispose to drug dependence because, in various ways, the taking of drugs and the experience of their effects are syntonic with existing modes of defense, adaptation, and self-concept. The actual vulnerability to substance dependency can vary considerably both between individuals and for the same individual at different times. For many, a necessary precipitating event involves a severe crisis in which usual adaptive capacities are diminished and narcissistic vulnerability is intense. Once drug taking is initiated in a susceptible state and the user has experienced adaptive benefit from the experience, a variety of other processes are set in motion that often lead to the state of dependency. These processes include both regressive effects that can exacerbate the original character problem and progressive effects that promote stable functioning. In both cases, however, this may interfere with further maturation of character, particularly when onset of use occurs in adolescence. Dependency involves the gradual incorporation of the drug effects and their experienced need into the defensive structure building activity of the ego itself. Undoing a dependency involves dealing with the unconscious and conscious components of this outcome. The user must be able to relinquish behaviors and drug effects that have come to be experienced as a valued (even if also hated) part of the self-capacity to function, cope, and be comforted in distress. PMID- 3534813 TI - Role of conditioning factors in the development of drug dependence. AB - Conditioned opioid phenomena have now been documented in both opiate-dependent and abstinent patients. Although the existence of these phenomena is generally accepted, their potential role in drug use and relapse is still under study. Our own research indicates that both physiologic and subjective responses may be conditioned, and that these responses are present in a significant proportion of patients who abuse opiates. Patients' responsivity (for example, craving or a reduction in skin temperature) may vary depending upon mood, cognitive set, and the individual relevance of the drug-related stimuli. Extinction procedures have been developed that are effective in reducing both subjective and physiologic conditioned responses. The clinical impact of these extinction procedures is now being assessed in a large-scale treatment-outcome study with abstinent patients. The results of this project will help determine the actual clinical significance of these complex but potentially important phenomena. PMID- 3534814 TI - Genetic factors in the development of alcoholism. AB - The main approaches to studying the genetics of alcoholism have been twin and adoption studies. Twin studies have demonstrated differences between monozygotic and dizygotic twin pairs in regard to alcohol use, but tend to be contradictory with regard to alcoholism. Most adoption studies suggest a genetic predisposition to alcoholism in some individuals. PMID- 3534815 TI - Old wine, new bottle. The alcohol dependence syndrome. AB - The alcohol dependence syndrome is at once a fresh approach and a restatement of established clinical lore. It is, perhaps, old wine in a new bottle. Nonetheless, behavioral researchers in this field have needed some clinically sound criteria to differentiate between subjects to account for the variability of behavioral and psychophysiologic responses to alcohol in the laboratory. Cross-cultural researchers, and those interested in the genetics of alcoholism, have needed culture-free criteria for the diagnosis of alcoholism that might help them to separate aspects of the disorder that are genetically determined from those that are influenced by culture, immediate environment, and psychopathology. The beauty of the alcohol-dependence syndrome construct is its apparent specificity and its potential clinical usefulness. The difficulty with the concept is that no questionnaire has proven entirely satisfactory in defining the severity of alcohol dependence nor have biologic variables been identified that can provide valid and reliable indicators of severity. Nonetheless, advances in biomedical research frequently await the development of a nomenclature that will permit replicable scientific investigation. The evolving definition of the alcohol dependence syndrome is consistent with this tradition. PMID- 3534816 TI - Adolescent drug abuse. Diagnosis, treatment, and prevention. AB - There are clear temporal developmental stages in drug use beginning with cigarettes and alcohol, then progressing to marijuana and finally cocaine, hallucinogens, and other drugs. Of considerable interest is the decline in prevalence of marijuana use and the stabilization of alcohol use in the face of a rise in the incidence of cocaine use. This decline occurs in the face of a decrease in the age of first initiation into drug use. Cocaine use is accompanied by serious medical, psychological, and social consequences including seizures, depression, paranoia, and suspension from school. These findings have definite implications for designing treatment and prevention programs. Inpatient and outpatient programs must require abstinence from drug use. Dysfunctional development, poor interpersonal skills, learning deficits, and concurrent psychiatric illness must be addressed. Family involvement in treatment is mandatory. Every chemically dependent person has a significant impact on the lives of several other people. The social pressures model is the most recent approach to drug prevention and the one most likely to succeed. Direct informational appeals to adolescents are unlikely in themselves to produce immediate changes in drug-related behavior but may assist in gradually changing community norms. School prevention programs need to be designed to target adolescents before the onset of drug use. The seventh grade or before is the correct point to begin. Finally, methods to assess the success of such pilot programs can greatly assist future development efforts. More research into the biologic and behavioral consequences of current drug use patterns including marijuana, cocaine, and hallucinogens is greatly needed. PMID- 3534817 TI - Prescription drug abuse. AB - Prescription drug abuse (PDA) accounts for much drug-related morbidity and mortality. The PDA issue contains several interrelated dimensions: regulatory, practical, and clinical. Historical and current governmental efforts to regulate prescribing practices are reviewed. The authors discuss the many ways that prescription drugs can be diverted for abuse purposes and how potential abuse situations can be identified in the clinical setting. Types of prescribers at risk for promoting PDA are discussed and remedies for PDA are offered in terms of physician and patient education. PMID- 3534818 TI - Psychotherapy for substance abuse. AB - Professional psychotherapy can provide benefits for substance abuse patients. It is probably most helpful for specific types of patients and only under certain conditions. Work that carefully defines these patient subtypes and conditions is only just beginning. PMID- 3534819 TI - Pharmacologic treatments of cocaine abuse. AB - Because current studies have small sample sizes and limited controls, firm conclusions or treatment recommendations cannot be made at present, but pharmacologic approaches probably have a place in the treatment of cocaine abuse. Pharmacologic treatments of cocaine abusers may relate to underlying psychiatric diagnoses. Cocaine abusers with adult attention deficit disorder appear to respond well to methylphenidate, but other cocaine abusers have increased cocaine craving when getting this medication. Cyclothymic cocaine abusers appear to respond to lithium with reduced cocaine use. Depressed cocaine abusers, who may constitute about 30 per cent of abusers, have decreased cocaine craving and increased abstinence when treated with desipramine. Other cocaine abusers without underlying psychiatric disorders may also respond well to desipramine if they fail to reduce their cocaine use during psychotherapy. PMID- 3534820 TI - [Nuclear magnetic resonance in multiple sclerosis]. PMID- 3534821 TI - [Evaluation of the clinical usefulness of molsidomine in ischemic heart disease]. PMID- 3534823 TI - [The significance of ribosome particle immunochemistry in current diagnostic and therapeutic methods]. PMID- 3534822 TI - [Congenital ventricular septal defects]. PMID- 3534825 TI - Role of adrenal androgens in prostate regression in rats treated with an antiandrogen and an LHRH agonist. AB - Histrelin, a potent luteinizing hormone releasing hormone (LHRH) agonist, and flutamide, an antiandrogen, were administered to intact and adrenalectomized rats to determine the role of adrenal androgens in the additive effects of the two drugs on prostate regression. Each compound, given separately, was effective in decreasing prostate weights in intact rats. When given together, additive effects were demonstrated by even greater atrophy of the prostates. It has previously been proposed that this additive effect may be primarily attributed to the ability of the antiandrogen to block the action of adrenal androgens. However, in adrenalectomized rats, the combination of histrelin and flutamide still produced a greater reduction in prostate weights than did either drug alone, indicating that the role of adrenal androgens in this effect is negligible. This experiment also was repeated with castrate, androgen-supplemented rats, and the additive effects previously described were not observed. In a final experiment, prostatic atrophy in castrate rats was not enhanced by either adrenalectomy or flutamide treatment. Thus, the additive effects of histrelin and flutamide appear to focus on testicular rather than adrenal androgens. PMID- 3534824 TI - Opiate-like peptides. Part VIII. Methylamides and dimethylamides of [D-Leu5] enkephalin and [D-Ala2, D-Leu5]-enkephalin. Synthesis and analgesic activity. AB - Syntheses of [D-Ala2, D-Leu5]-enkephalin, methyl ester of [D-Ala2, D-Leu3] enkephalin, methylamides and dimethylamides of [D-Leu5]-enkephalin and [D-Ala2, D Leu5]-enkephalin are described together with their analgesic activity determined on the basis of four analgesic tests: the hot-plate method, the reaction to electric stimulus, the tail immersion test and the frequency of writhing syndrome test. The neurotoxicity was estimated by the rota-rod test. The most pronounced analgesic effect was induced by compound: [D-Ala2, D-Leu5]-enkephalin, [D-Ala2, D Leu5-OMe]-enkephalin and [D-Ala2, D-Leu5-NMe2]-enkephalin. In the tail immersion test all analogs did not exhibit analgesic activity. PMID- 3534827 TI - Exercise testing in children with congenital heart disease. AB - In children with congenital heart disease, interest concerning cardiovascular performance capacity is directed mainly to the operated patient. Indirect and/or submaximal tests to assess cardiovascular ability are based on assumptions that are at least partially incorrect, so that test results may not be valid. Standardization of values should be performed according to body height, but should also account for age. There is a lack of information concerning the cardiovascular performance capacity of children following Senning or Mustard operations for transposition of the great arteries and following Fontan procedures for different malformations. In considering participation in sports, it should be realized that it is not the cardiovascular performance capacity that generally plays a dominant role. In technical disciplines and in short-term efforts, motor performance may be more important. Endurance training cannot be recommended in view of the anatomical disorders still present in many patients after cardiac surgery. Ergometry can add information on dysrhythmias, which may cause problems postoperatively, but may also be present without organic heart disease. PMID- 3534826 TI - AIDS--a public health crisis. PMID- 3534828 TI - Preparticipation sports examination of the child and adolescent athlete: changing views of an old ritual. AB - The role of the pediatrician in the management of the child athlete has expanded in accord with the burgeoning number of children involved in sports competition. Growing information regarding physiologic responses to exercise in the pediatric age group has added to the importance and utility of this involvement. The scope of the preparticipation evaluation has enlarged in response to these changes; newer issues such as injury prevention, body composition assessment, and athlete education become important in not only assuring safe participation but also optimizing athletic performance. At the same time, the low yield of important findings during these examinations has prompted a reassessment of when, where, and by whom they might be most efficiently conducted. PMID- 3534829 TI - Blood pressure response to dynamic exercise in healthy and hypertensive youths. AB - Recent evidence suggests that the blood pressure (BP) response to exercise may be useful in prediction of future hypertension. It has been shown that hypertensive youths have a higher systolic BP (SBP) response to exercise than their normotensive counterparts. Normotensive trained youths appear to have a higher BP response to exercise than untrained normotensive and in some instances hypertensive youths. While there is, at present, no clear explanation for this higher SBP response in trained youths, there is no evidence to suggest that these individuals are at increased risk of future health problems. Endurance-type conditioning is probably of benefit to hypertensive youths, and individuals with mild to moderate hypertension should not have restrictions of physical activity unless they show abnormalities during exercise testing. A lack of standardization in measuring and reporting SBP response to exercise exists. It is recommended that exercise BP measurement should be indirect, during upright exercise, recorded at more than one submaximal exercise level and at a steady state. The reference point for reporting BP should be the heart rate. PMID- 3534830 TI - Role of the physician and physical education teacher in the treatment of obesity at school. AB - Obesity ranks as a leading chronic pediatric disorder, with estimates ranging from 10 to 25% of the childhood and adolescent population. Physical hypoactivity is prevalent among obese youth and may be an etiological factor. Physical training, with or without nutritional intervention, has been found effective for weight and body fat control. The purpose of this paper is to examine the role that the physician and physical education teacher can play in the treatment of obesity at school. Studies of school-based intervention programs utilizing exercise, nutrition and behavior modification are reviewed. Suggestions are outlined for school-based obesity programs. PMID- 3534831 TI - Longitudinal studies on the development of health and fitness and the interaction with physical activity of teenagers. AB - Coronary heart disease is recognized as a serious public health problem in Western industrialized countries. Its origin is early in life, and thus preventive pediatric strategies should be developed. This paper reviews longitudinal studies of risk indicators for coronary heart disease during the adolescent period from 12 to 18 years of age. Developmental aspects of maximal aerobic power during the teenage period is reviewed, as well as the relationship of coronary heart disease and maximal aerobic power, to obesity, high blood pressure and hypercholesterolemia to habitual physical activity. PMID- 3534832 TI - Urinary tract infections in infants and children. Guidelines for averting permanent damage. AB - Urinary tract infection (UTI) is common in childhood and, early in life, is often associated with vesicoureteral reflux or other urinary tract anomalies. Since the combination of reflux and infection can cause renal scarring and impaired renal function, identification of children at risk and provision of close follow-up are important. Diagnosis in the first year of life relies on a high index of suspicion on the part of the clinician, as signs and symptoms are nonspecific. Reliable cultures are the cornerstone of accurate diagnosis and will be the basis for selection of acute and long-term management. Vigilant follow-up of all children with UTI can prevent ultimate morbidity. PMID- 3534833 TI - Clinical assessment of anemia. PMID- 3534834 TI - Hand infections--the academic surgeon's perspective. 1. A historical sketch and the status of surgical drainage. AB - The academic surgeon must teach by example and action the importance of aseptic technique and proper wound care, practices that were supremely important in the prevention and treatment of surgical infections before the introduction of antibiotics but that remain so even in the modern medical age. The advent of antibiotics has greatly lowered the incidence of hand and other infections, opened the way for prophylactic treatment, and reduced the need for surgical drainage. However, over the years one theme has recurred: Initial care is preeminent in the prevention and treatment of all surgical infections. PMID- 3534835 TI - Fibromyalgia. 1. Review of a common rheumatologic syndrome. AB - Fibromyalgia is a nonarticular rheumatic syndrome of unknown cause characterized by diffuse musculoskeletal aching, pain and stiffness, easy fatigability, multiple discreet tender points, emotional distress, and often, light and restless sleep with intensification of symptoms upon awakening. Symptoms are modulated by environmental, physiologic, and psychological factors. Generally, findings from laboratory tests and roentgenograms are normal. In primary fibromyalgia, no underlying rheumatic or other systemic organic disease is present. Secondary fibromyalgia is a manifestation of underlying disease. PMID- 3534836 TI - Surgical infections--the referral center's perspective. With special reference to difficult intraabdominal infections. PMID- 3534837 TI - Septum of the gallbladder, clinical implications and treatment. AB - We report four patients with a congenital gallbladder septum whose symptoms resembled those of cholelithiasis, in one case giving rise to acute cholecystitis. Cholecystectomy relieved symptoms in all cases and examination of the operative specimen confirmed the clinical diagnosis and X-ray findings. Ultrasonography made a positive diagnosis in the last two cases and no stones were found in any of the cases described. Cholecystectomy is advocated in symptomatic patients with this condition, even when gallstones are not present. PMID- 3534838 TI - Obstruction is unimportant in the pathophysiology of hypertrophic cardiomyopathy. AB - There has been a longstanding controversy about the significance of intracavitary pressure gradients in hypertrophic cardiomyopathy (HCM). It has been generally assumed that the gradient is the result of an 'obstruction' that impedes left ventricular outflow and which can be relieved by operative intervention. In the first decade after the discovery of HCM (1957-66), the site of 'obstruction' was thought to be a muscular sphincter or contraction ring in the submitral region of the left ventricle, and operations designed to emulate pyloromyectomy (for hypertrophic pyloric stenosis) were developed. Following a challenge to the existence of the 'contraction ring' and an alternative non-obstructive explanation of the pressure gradient, the site of 'obstruction' was translocated to a point of apposition between the anterior mitral leaflet and the interventricular septum, a result of systolic anterior motion (SAM) of the mitral valve. Despite the translocation of the site and mechanism of 'obstruction', the operation for 'relief of obstruction' has not changed significantly. The newer site of 'obstruction' has been challenged on the grounds that the ventricle is not demonstrably impeded in its emptying; when a gradient is provoked, the ventricle empties more rapidly and more completely than it does without a gradient. In addition to a non-obstructive explanation of the gradient, other phenomena thought to be indicative of 'obstruction' can be explained by rapid and complete emptying of the ventricle (cavitary obliteration). Since the morbidity and mortality of symptomatic HCM patients without pressure gradients may exceed that of patients with pressure gradients, it is suggested that 'obstruction' may be unimportant in the pathophysiology of HCM and attention should be focused on abnormal diastolic function and life threatening arrhythmias. PMID- 3534839 TI - Eosinophils in eosinophilic endomyocardial disease. PMID- 3534840 TI - Calcium antagonists and chronic cardiac failure. PMID- 3534842 TI - Glucose intolerance during diuretic therapy in elderly hypertensive patients. A second report from the European Working Party on high blood pressure in the elderly (EWPHE). AB - Five hundred and seven elderly hypertensive patients were followed for 1 year, 371 for 2 years and 270 for 3 years in a double-blind, randomized, controlled trial in which they received either placebo or 25-50 mg hydrochlorothiazide and 50-100 mg of triamterene daily. One third of the active treatment group also received 250 mg to 2 g methyldopa daily. After 1 year the active treatment group had an average increase in fasting blood sugar of 2.5 mg/dl compared with an average fall of 1.4 mg/dl in the placebo group (P = 0.01). The increase in blood sugar 1 hour and 2 hours after 50 g oral glucose tended to be greater in the actively treated group but these increases did not achieve statistical significance. The effects of diuretic treatment were established after one year and did not increase further over the next 2 years. Overall there was an increase in fasting blood sugar of 5 mg/dl in the active treatment group which occurred mainly in the first year. The hyperglycaemic effect of diuretics appeared to be partly or wholly related to potassium loss since, in both groups, impairment of glucose tolerance was most marked in those in whom serum potassium decreased. The measures of blood sugar were also positively related to systolic pressure before and after treatment. PMID- 3534841 TI - Campylobacter enterocolitis: general and surgical aspects. PMID- 3534844 TI - Captopril--a decade of discovery. Proceedings of a symposium. London, 24-25 October 1985. PMID- 3534843 TI - Group B streptococcal meningitis in a diabetic adult. AB - A rare case of adult group B streptococcal meningitis is presented. The association with diabetes mellitus is emphasized and attention is drawn to microscopic and serological confusion that may arise in differentiating it from pneumococcal meningitis. PMID- 3534845 TI - Low dose captopril twice daily lowers blood pressure without disturbance of the normal circadian rhythm. AB - The effect of captopril 25 to 50 mg twice daily on 24 h blood pressures was compared with placebo in 14 patients with essential hypertension. Captopril was started in a dose of 25 mg b.d. in all patients. This dose was increased to 50 mg b.d. in those patients whose blood pressure was not normalized after 4 weeks (group II, n = 5), while in the others the same dose was continued (group I, n = 9). Blood pressure was measured at the end of the placebo period and after 8 weeks captopril, both in the office with a random zero sphygmomanometer and ambulant at home with a portable automated non-invasive blood pressure measuring device (ICR). In comparing the ICR measurements with those made with a standard mercury sphygmomanometer good agreement between the two methods for both diastolic (r = 0.94, n = 110) and systolic (r = 0.96, n = 110) blood pressure was found. In group I office blood pressures (mean +/- s.e.m.) decreased from 166 +/- 7/100 +/- 3 mm Hg to 144 +/- 4/87 +/- 2 mm Hg (P less than 0.001). In group II these reductions were from 165 +/- 7/104 +/- 2 mm Hg to 152 +/- 5/90 +/- 4 mm Hg (P less than 0.05). During ambulatory monitoring, blood pressure was shown to have a circadian rhythm both on placebo and on captopril. Captopril 25 mg b.d. lowered blood pressure throughout the 24 h observation period, although these reductions were smaller at night than during the day. In group II comparable effects of captopril 50 mg b.d. were demonstrated. Captopril 25 to 50 mg twice daily adequately controls blood pressure in most patients with mild to moderate essential hypertension. PMID- 3534846 TI - Efficacy of low dose captopril once daily in diuretic resistant hypertension. AB - In 12 essential hypertensive patients insufficiently controlled by treatment with 50 mg hydrochlorothiazide, the blood pressure lowering effect of the addition of 25 mg captopril once daily was examined. Twenty four hour ambulatory blood pressure monitoring was performed using portable automatic recording devices before treatment, after 4 weeks of treatment with hydrochlorothiazide alone, and again after 4 weeks of combined treatment with captopril. The combined treatment yielded a marked additional blood pressure reduction in comparison with the previous medication of the diuretic alone. The additional antihypertensive effect of captopril lasted 24 hours. During the daytime between 08.00 h and 20.00 h the mean blood pressure was 158 +/- 13/100 +/- 8 mmHg before treatment. After treatment with hydrochlorothiazide alone it was 151 +/- 11/93 +/- 8 mmHg and after hydrochlorothiazide and captopril it was 140 +/- 13/88 +/- 9 mmHg. Our results indicate that the addition of only 25 mg captopril once a day to a diuretic may result in a marked additional blood pressure reduction or normalization in cases of insufficient control by the diuretic alone. PMID- 3534847 TI - Effects of captopril and of other antihypertensive drugs on cell membrane ion transport--a preliminary report. AB - We measured red blood cell Na+-K+ pump, Na+-Li+ countertransport and Na+-K+ cotransport activities, together with intraerythrocyte sodium content before and after 3 months therapy with captopril and two other antihypertensive drugs (atenolol and canrenoate potassium) in subjects suffering from essential hypertension. All patients discontinued any previous treatment at least 3 months before the basal evaluation of cell membrane activities. All three drugs significantly lowered blood pressure but only captopril and canrenoate potassium induced significant modifications in red blood cell parameters. After three months of captopril therapy intraerythrocyte Na+ content was significantly decreased (P less than 0.01) without any detectable change in cation transport system activity. After 3 months of canrenoate potassium therapy we also observed a significant decrease in internal Na content (P less than 0.01), together with a significant increase in Na+-K+ pump (P less than 0.02) and Na+-Li+ countertransport (P less than 0.05) activities. PMID- 3534848 TI - Comparative study of the efficacy and tolerance of capozide and moduretic administered in a single daily dose for the treatment of chronic moderate arterial hypertension. AB - A comparative study was made of the effects of a new therapeutic agent consisting of 50 mg captopril and 25 mg hydrochlorothiazide (Capozide) with an already existing agent Moduretic (50 mg hydrochlorothiazide and 5 mg amiloride). In the Capozide group (32 patients), 20 achieved normal blood pressure, 8 responded but were not brought under control, and 3 were non-responders. In the Moduretic group (31 patients), 17 achieved normal blood pressure, 10 were partially controlled and 4 were non-responders. Moduretic appeared to be most effective in patients previously untreated or who had been taking only one drug, while Capozide controlled patients who had been taking 1 or 2 antihypertensive drugs which had been either ineffective or poorly tolerated. The long-acting effect of a single dose of Capozide was demonstrated by blood pressure measurements taken at least 10 hours later. Both drugs were generally well tolerated and no significant changes were observed in the laboratory measurements. The combination of an angiotensin converting enzyme inhibitor with a diuretic proved more effective than single agents in lowering raised blood pressure. We therefore conclude that Capozide is an effective alternative to traditional medication in the treatment of moderate hypertension. PMID- 3534849 TI - Captopril/hydrochlorothiazide combination in elderly patients with mild-moderate hypertension. A double-blind, randomized, placebo-controlled study. AB - Fifty-six elderly patients (mean age 72.1 +/- 4.1 years; mean creatinine 111.0 +/ 9.8 mumol/l were randomly assigned to either captopril (C) hydrochlorothiazide (HCT) fixed combination once daily (o.d.) (n = 29) or placebo (n = 27). Previous medication was stopped and following a run-in period of 2 weeks on placebo, the initial dosage was C (25 mg)/HCT (12.5 mg) o.d.; after 6 weeks it was increased to C (50 mg)/HCT (25 mg) o.d. for all the treated subjects; these doses were maintained for an additional 6 weeks. Blood pressure, heart rate, body weight and side effects were assessed every 2 weeks. After the run-in period as well as after the two treatment periods, routine biochemical examinations were carried out on all patients. Twenty to 24 hours after the last intake both C 25/HCT 12.5 o.d. and C 50/HCT 25 o.d. had significantly lowered blood pressure compared with placebo (P less than 0.001). The percentages of normalized patients (supine diastolic less than or equal to 90 mm Hg) were 3.7% (placebo), 72.4% (C25/HCT 12.5) after 6 weeks and 7.7% (placebo) and 96.6% (C 50/HCT 25) after 12 weeks. No important side effect was reported on captopril/hydrochlorothiazide combination. Haematological and biochemical changes were within the normal range in both groups. We conclude that a once daily captopril/hydrochlorothiazide combination is effective and safe in elderly patients with mild to moderate hypertension. PMID- 3534850 TI - Neurohormonal responses to antihypertensive treatment with captopril or hydrochlorothiazide. AB - In order to assess the neurohormonal responses to oral administration of two drugs with different antihypertensive mechanisms, and their implications for long term efficacy, we studied the changes in plasma renin activity, aldosterone, catecholamines and blood pressure after two cross-over periods of treatment with captopril and hydrochlorothiazide for three months in 14 patients with moderate essential hypertension. Similar levels of plasma renin activity were achieved with both but plasma levels of noradrenaline and aldosterone rose with hydrochlorothiazide (P less than 0.005 and P less than 0.05). Dopamine levels decreased with captopril. Six patients on hydrochlorothiazide had potassium levels under 3.5 mmol/l. Captopril and hydrochlorothiazide were effective in controlling blood pressure in 78% and 50% of the patients respectively, but in cases where noradrenaline was significantly increased after treatment, the effect on diastolic blood pressure was less (P less than 0.05). These data suggest that captopril is highly effective for blood pressure control and that the neurohormonal responses to the drug probably provide additional benefits for long term therapy in hypertension. PMID- 3534851 TI - Efficacy of captopril and hydrochlorothiazide administered once a day. AB - One hundred and ten mild and moderately hypertensive patients were treated with a fixed combination of captopril 50 mg and hydrochlorothiazide 25 mg (Capozide 50) once daily for 12 months. Eighty four patients were treated initially with Capozide 50 12 hourly for 3 months before receiving Capozide 50 o.d.; the other 26 patients received Capozide 50 as initial treatment immediately after the placebo run-in period. Blood pressures were measured 24 hours after ingestion of the drug. Capozide 50 once daily induced statistically significant reductions in supine blood pressure and these beneficial effects were sustained throughout the duration of the trial. In patients receiving Capozide 50 as initial therapy, a gradual hypotensive effect was seen. No clinically significant changes in biochemical or haematological variables were recorded although a small but statistically significant rise in uric acid was noted. This latter effect was attributed to the thiazide component of the combination. The efficacy and safety profile of this once-a-day compound makes it an ideal therapeutic agent for the management of mild and moderate hypertension. PMID- 3534852 TI - Captopril in mild heart failure: preliminary observations of a long-term, double blind, placebo-controlled multicentre trial. AB - Ninety-four patients on digitalis treatment for chronic congestive heart failure (NYHA class II-III) were enrolled for a 12 month trial in a random, double-blind, placebo-controlled study. After a placebo run-in period, patients were assigned to placebo or captopril 25 mg t.i.d. Digitalis was continued while diuretics were withdrawn. Clinical status, exercise capacity, cardiac dimensions and performance were evaluated with a full physical examination, 12 lead ECG, chest X-ray, 24 hour Holter monitoring, bicycle effort capacity, M-mode echocardiography and radionuclide ventriculography at 1, 2 and 3 weeks and 1, 2, 3, 6 and 12 months. There were no significant differences in the trend of survival curves after six months follow-up between the captopril or placebo treatment groups. Patients treated with captopril, without the addition of diuretics, had an improvement in NYHA class (P less than 0.01), an increase in exercise capacity (P less than 0.025), a decrease in cardiothoracic ratio (P less than 0.025) and an increase of echocardiographic left ventricular contractility (P less than 0.005). Only four patients treated with captopril were withdrawn from the follow-up for allergic side effects. Preliminary results at 6 months prove that captopril, compared to placebo, is useful in mild to moderate heart failure. PMID- 3534853 TI - Effects of intravenous captopril on inducible sustained ventricular tachycardia one week after experimental infarction in the anaesthetized pig. AB - The effect of captopril on inducible sustained ventricular tachycardia (VT) one week after myocardial infarction was studied in 6 Yorkshire swine. In 24 pigs, controlled myocardial infarction (MI) was produced by reversible occlusion of the left anterior descending artery during 60 minutes using an inflatable balloon catheter. Four animals died during this procedure and another 4 during the first week. After 7 days, programmed electrical stimulation (PES) was performed in the surviving animals. Seven animals showed inducible VT, which could not be terminated in one. Subsequently, intravenous captopril (0.6-1.2 mg/kg) was administered as a rapid bolus injection. PES was repeated after 5 minutes and VT was no longer inducible in all 6 pigs (P less than 0.05). Right ventricular refractoriness decreased from 253 to 228 ms (n.s.). Blood pressure and heart rate were not significantly changed. We conclude that captopril can protect the heart against PES-induced VT late after MI. It is suggested that inhibition of angiotensin II and subsequent inhibition of noradrenaline may be responsible for this effect. PMID- 3534854 TI - Influence of captopril on intracellular ions--a possible mode of action. AB - The effects on intra- and extracellular Na+ and K+ (Nai, Ki; Nae, Ke) of 2 months treatment with captopril or hydrochlorothiazide given alone or in combination were assessed in 47 hypertensive patients. Before therapy, diastolic blood pressure was directly related to Nai and to Nai/Ki and inversely to Ki. The correlation coefficient was even higher when Ki/Ke was considered instead of Ki alone. Treatment with captopril induced a decrease in Nai, no change in Ke and an increase in Ki and Ki/Ke. Hydrochlorothiazide induced a decrease in Nai, in Ke and in Ki but an increase in Ki/Ke. The Nai decrease was maximal in patients receiving the combination of captopril and hydrochlorothiazide. In these subjects Ke was not reduced and Ki was still increased. The percent reduction in diastolic blood pressure induced by captopril was significantly related to the percent increase in Ki/Ke whereas the reduction induced by hydrochlorothiazide was best related to the decrease in Nai/Nae. These data suggest that blood pressure is related to the Ki/Ke ratio and that any increase in this ratio could produce a fall in blood pressure. This phenomenon can be explained by the Ki/Ke ratio being an important factor in determining membrane potential and thus arterial smooth muscle tone. PMID- 3534855 TI - Effects of captopril in heart failure complicating acute myocardial infarction and persistence of acute haemodynamic effects in chronic heart failure after 3 years of treatment. AB - A study was made of ten subjects with post myocardial left ventricular failure. All patients were treated with captopril with successive doses of 12.5 mg, 25 mg, 50 mg. Heart rate and mean blood pressure remained unchanged. Cardiac output increased from 4.30 +/- 0.56 to 4.6 +/- 0.57 litres/min in response to the 12.5 mg dose (P less than 0.05), from 4.30 +/- 0.56 to 4.77 +/- 0.59 litres/min on administration of the 25 mg dose (P less than 0.01) and from 4.34 +/- 0.56 to 4.86 +/- 0.66 litres/min after the 50 mg dose (P less than 0.01). Total systemic resistance fell from a baseline mean of 1847 +/- 338 to 1697 +/- 35 dyne/s/cm-5 with the 12.5 mg dose, to 1547 +/- 329 with the 25 mg dose and to 1489 +/- 308 with the 50 mg dose. All the reductions were statistically significant. Right atrial pressure, pulmonary blood pressure, wedge pressure, total pulmonary resistance and pre-capillary resistance decreased statistically significantly. In a separate study on the possibility that captopril long term therapy may induce tachyphylaxis we studied the acute haemodynamic effects of a dose of 25 mg of captopril after 17 to 36 months (mean 29.5 +/- 5.3) treatment with it for chronic congestive heart failure. Cardiac index increased from 2.02 +/- 0.25 to 2.59 +/- 0.62 (P less than 0.01) total systemic resistance, mean pulmonary pressure and wedge pressure decreased statistically significantly. PMID- 3534856 TI - Haemodynamic, radionuclide ventriculography and ergometric evaluation of captopril treatment in congestive heart failure. AB - Eight patients with NYHA Class II congestive heart failure were studied before and after captopril with right heart catheterization, cycloergometric stress tests and radionuclide 99Tc cineventriculography. Acute administration of captopril increased stroke volume and cardiac index and reduced left ventricular filling pressure. Similar changes though less marked were seen after 30 days of captopril therapy. Functional aerobic capacity and left ventricular performance improved over 15 and 30 days of captopril respectively. We therefore suggest that captopril can be effective also in patients with moderate congestive heart failure. PMID- 3534857 TI - Comparison of captopril and digoxin in mild to moderate heart failure. AB - Captopril 25 mg every 8 hours for 1 month appeared to improve dynamic effort tolerance and cardiac function under the stress of isometric exercise in patients with chronic heart failure, functional class II-III NYHA. The improvement was comparable to that obtained in the same subjects with digoxin 0.25 mg once a day given for a similar period of 1 month. Therefore, captopril with its lower toxicity and wider therapeutic range, might be considered as a valid alternative to digoxin for treatment of patients in sinus rhythm with mild to moderate heart failure. PMID- 3534858 TI - ACE inhibitors or inotropic drugs after diuretics in heart failure--a personal critique. PMID- 3534859 TI - Addition of captopril versus increasing diuretics in moderate but deteriorating heart failure: a double-blind comparative trial. AB - In 15 patients with moderate congestive heart failure not completely controlled on digoxin (0.25 mg o.d.) and frusemide (25 mg o.d.), we compared the addition of captopril (12.5 to 50 mg b.i.d.) with increasing doses of frusemide (25 to 100 mg o.d.), in a randomized double-blind, double-dummy, comparative trial. Thirteen patients completed the 3 months study: two dropped-out in the frusemide group. Statistically significant clinical improvement occurred in both treatment groups. Exercise tolerance also significantly improved in both groups in a parallel fashion. Echocardiographic cardiac function data showed a significantly better pattern of changes in the captopril group. The addition of low doses of captopril to basal therapy seems to be as effective as the addition of high doses of frusemide in uncontrolled moderate congestive heart failure. This approach with captopril also appears to be more physiological and safe. PMID- 3534860 TI - Interaction between the adrenergic and renin-angiotensin-aldosterone-systems. AB - In congestive heart failure (CHF) both the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone-system (RAAS) are activated. Both phenomena are only of short-term benefit and inevitably detrimental with prolonged activation. There are many possibilities for interaction between the systems, in particular when they are both in the activated state as in CHF. Renin release from the renal juxtaglomerular cells is stimulated by the SNS via beta 1-adrenoceptors. At a higher level of renal nerve stimulation there is recruitment of antinatriuretic and finally vasoconstrictor activity, mediated by alpha 1-adrenoceptors. The vasoconstrictor potency of angiotensin II (AII) involves both postsynaptic angiotensin II-receptors and also various processes stimulating sympathetic activity and its sequelae. The following sympathetic components may contribute to the effect of angiotensin II:ganglionic stimulation; enhanced release of noradrenaline (tyramine-like effect); inhibited noradrenaline re-uptake; facilitation of noradrenaline release via presynaptic AII-receptors; sensitization of postsynaptic alpha-adrenoceptors. The presynaptic AII-mechanism is probably the most sensitive and relevant process, which is also involved in the vasodilator activity of ACE-inhibitors. PMID- 3534862 TI - Captopril in the treatment of hypertension associated with claudication. AB - The effect of captopril was studied in 40 hypertensive patients (WHO stages I and II) with peripheral vascular disease of the lower limbs (Fontaine stages IIa and IIb). We assessed systolic and diastolic arterial pressure, heart rate in supine and upright position, relative and absolute pain free intervals, and ankle/arm pressure index at rest and after treadmill exercise test. In the first part of the study 20 patients were divided into two groups, one of which was treated with chlorthalidone (25 mg/day) and the other with captopril (50 mg two times a day) for 8 weeks. Statistically significant improvements were only obtained in the captopril-treated group. They concerned the ankle/arm pressure index at rest (P less than 0.05) and after exercise (P less than 0.05) and the absolute pain free interval (P less than 0.05) as well as systolic arterial pressure. Furthermore, 20 more patients were treated with captopril (50 mg two times a day) for 8 weeks, and improvements were found in ankle/arm pressure index at rest (P less than 0.01) and after exercise (P less than 0.001) and in relative and absolute pain free intervals (P less than 0.001) as well as in systolic and diastolic arterial pressure. These results indicate an increase in flow to the limbs of patients with vascular disease treated with captopril, and suggest that captopril is an effective drug without contraindications for the treatment of hypertension associated with claudication. PMID- 3534861 TI - Sodium and potassium fluxes and concentrations in erythrocytes of normal subjects during prolonged sodium depletion and repletion. AB - The erythrocyte concentration and fluxes of sodium and potassium were investigated in normal white male subjects during dietary sodium restriction and repletion, each period lasting for 16 weeks. During dietary sodium restriction the intra-erythrocyte sodium concentration decreased and the red cell ouabain sensitive 86Rb-uptake increased; no significant changes were observed in the ouabain-insensitive fluxes of sodium such as the total, frusemide-resistant and frusemide-sensitive Na+-efflux and the Na+, Li+-countertransport. The decrease in the intra-erythrocyte sodium concentration could result from an increased Na+,K+ ATPase pump activity. The latter increase could be secondary to the early decrease in a digitalis-like plasma inhibitor and the late increase could be facilitated by the late rise in the intracellular ATP concentration, which is the energy supplier for this pump. During the subsequent first month of sodium repletion the intra-erythrocyte sodium concentration remained low, the red cell ouabain-sensitive 86Rb-uptake and ATP concentration remained elevated and returned to baseline only after 16 weeks. This long-term effect suggests either the involvement of a mechanism which can only be slowly reversible or a mechanism which is irreversible so that normalization takes place only when new red cells are released into the circulation. PMID- 3534863 TI - Effects of captopril on myocardial perfusion in patients with coronary insufficiency: evaluation by the exercise test and quantitative myocardial tomoscintigraphy using thallium-201. AB - Nine patients with coronary insufficiency were investigated using an exercise test coupled with quantitative myocardial tomoscintigraphy with thallium-201 before and after 48 hours' treatment with captopril. After captopril treatment, an improvement in ST segment depression was noted during exercise. The quantitative tomoscintigraphy showed a reduction in the ischaemic zone with captopril during exercise. However, in three patients, although there was an overall improvement in myocardial perfusion during exercise, aggravation of wash out was observed in some regions, reminiscent of a coronary steal effect. PMID- 3534864 TI - The effect of captopril on the coronary circulation and myocardial metabolism of patients with coronary artery disease. AB - The acute effects of captopril in three groups of patients with coronary artery disease were studied: 25 patients with congestive heart failure; 8 patients with hypertension; and 14 normotensive patients with angina, and systolic arterial pressure greater than 120 mmHg, but no evidence of heart failure. Systemic haemodynamics were assessed by balloon-tipped thermodilution catheter and coronary haemodynamics were assessed by thermodilution catheter in the coronary sinus. Despite significantly different baseline haemodynamic values, captopril decrease systolic arterial pressure without increasing heart rate in all three groups, thereby decreasing double-product, a major determinant of myocardial work. Coronary blood flow and myocardial oxygen consumption decreased similarly in all groups and decreased in parallel to double-product, while coronary vascular resistance and transmyocardial oxygen difference did not change except for a slight decrease in transmyocardial oxygen difference in those patients with congestive heart failure. Transmyocardial lactate extraction increased insignificantly. These findings suggest that captopril may improve metabolic balance in various types of patients with coronary artery disease and that it does this by decreasing myocardial oxygen demand. PMID- 3534865 TI - Effect of converting enzyme inhibitors in hypertensive patients with non-insulin dependent diabetes mellitus. AB - The aim of this study was to evaluate the effect of captopril on carbohydrate metabolism in diabetic patients with essential arterial hypertension. Sixteen patients with non-insulin-dependent diabetes mellitus and hypertension were studied. Captopril was employed in different doses, and where patients receiving 100 mg/day remained hypertensive, hydrochlorothiazide 50 mg/day was added. Treatment was maintained for 90 days in 14 patients, 2 being excluded because of side effects. Basal blood pressure was normalized in 8 patients (57%) with captopril alone, and in 6 patients (43%) following the addition of hydrochlorothiazide. Basal glucose levels were not altered. Oral glucose tolerance tests performed during captopril treatment showed a lower glucose response, without changes in the insulin response. There was significant weight loss during the study. We conclude that captopril appears to be a safe treatment in essential hypertension associated with non-insulin-dependent diabetes mellitus, producing no deleterious effects on metabolic control. PMID- 3534866 TI - Captopril in the treatment of hypertension in type I and type II diabetic patients. AB - This investigation was performed in two groups of adult patients, 10 with type I and 10 with type II diabetes mellitus, all with arterial hypertension (160 to 200 mm Hg systolic and 95 to 120 mm Hg diastolic). Captopril, 50 mg twice a day, was administered for 12 weeks and was effective as monotherapy in 16 patients. Mean arterial pressure (+/- s.d.) in type I patients changed from 121.4 +/- 9.6 to 100.2 +/- 10.1 after 4 weeks and to 102.0 +/- 3.8 mm Hg after 12 weeks; in type II patients it changed from 132.8 +/- 5.7 to 123.9 +/- 13.5 after 4 weeks and to 109.1 +/- 11.1 mm Hg after 12 weeks. The differences were statistically significant. In only 4 patients was it necessary to add a thiazide after the first month of therapy. No significant change was induced by captopril in urine output, osmolar clearance, free water clearance inulin, and PAH clearances. No significant change was observed in serum and urine Na+, Cl-, Ca++ and Mg++, whereas a statistically significant reduction was found in the renal clearances of K+ and PO4-. No important change in serum aldosterone was found, while plasma renin activity was increased, as expected. No alterations in urine protein, glucosaminoglycans, gamma GT, and N-acetyl-beta-glucosaminidase were observed during follow-up. All patients maintained good metabolic control of their disease. No neutropenia and orthostatic hypotension were seen. Captopril appears to be an effective and safe drug for lowering blood pressure in diabetic patients, without affecting renal function, electrolyte balance and the metabolic control of diabetes. PMID- 3534867 TI - Effect of captopril on left ventricular mass and function in hypertensive patients and in the rat. AB - Twenty-seven mild to moderate essential hypertensive patients were treated with captopril alone or combined with hydrochlorothiazide and left ventricular echocardiographic changes were evaluated after 1, 3 and 6 months. The left ventricular mass decreased slightly after 3 months, together with mean wall stress and total peripheral resistance, while the cardiac performance, as measured by fractional shortening and cardiac output, was unaffected. A high degree of individual variability was observed, and only 9 out of 20 patients examined after 3 months had a consistent reduction in left ventricular mass. The effect of captopril on the isomyosin composition was also evaluated in 4 normotensive rats after 12 weeks of drug administration. No interference with the physiological pattern was observed and no modifications of the biochemical and structural properties of the myocardium were detected. PMID- 3534868 TI - Effect of exogenous angiotensin II infusion after one year of captopril therapy in essential hypertension. AB - The effect of exogenous angiotensin II on plasma renin activity (PRA), plasma renin concentration (PRC) and plasma aldosterone (PA) was investigated in a group of 8 patients with essential hypertension after one year of captopril therapy. The results were compared with those obtained in a group of 18 normotensive volunteers not on captopril. Angiotensin II was infused at increasing doses until a pressor response (increase of diastolic blood pressure by 20 mm Hg) was evoked. The normotensive volunteers exhibited the expected decline of PRA during angiotensin II infusion. However, no significant change was observed in PRA nor in PRC levels in the group of hypertensive patients. The PA values increased significantly both in volunteers and patients (P less than 0.02). The dose of angiotensin II necessary to evoke a pressor response was higher in the hypertensive patients than in the normotensive volunteers (6.0 +/- 2.6 s.d. ng/kg/min vs 2.5 +/- 0.9; P less than 0.01). We conclude that patients with essential hypertension, after chronic treatment with captopril, show no inhibition of renin secretion in contrast with the controls. They also require more angiotensin II to evoke a pressor response during infusion of this peptide. PMID- 3534869 TI - Comparative study of the efficacy of captopril at a single daily dose of 100 mg and at a twice daily dose of 50 mg by measuring ambulatory pressure over 24 hours. AB - Variations in blood pressure were investigated by an automatic, non-invasive ambulatory method in 9 subjects with essential hypertension. Recordings were made after 6 week periods during which captopril was taken either once or twice daily, in a double-blind cross-over study. Although the effects of captopril administration either once or twice daily were broadly similar, there was a significant decrease in diastolic blood pressure values on the once-daily regimen. These results suggests that treatment once a day can advantageously replace twice-daily treatment. PMID- 3534871 TI - Prune belly in trisomy 13. AB - Prune belly (urethral obstruction sequence) has previously been reported as an isolated malformation sequence, in association with trisomy 18 (Nevin et al., 1983) and more recently with trisomy 13 (Beckman et al., 1984). A further case associated with trisomy 13 in a fetus is reported. This emphasizes the importance of karyotyping fetuses with prune belly identified prenatally. PMID- 3534870 TI - [Immunohistochemical studies of open lung biopsies in exogenous allergic alveolitis]. PMID- 3534872 TI - [A new preparation procedure for preserving cement in the fine tissue study of cemented endoprostheses]. PMID- 3534873 TI - [Focal and diffuse nesidioblastosis and persistent neonatal hyperinsulinemic hypoglycemia. A morphologic analysis of 12 patients]. PMID- 3534874 TI - [Granular cell tumor of the breast]. PMID- 3534875 TI - Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs. AB - The concepts of efficacy and effectiveness are examined from the viewpoints of the traditions and philosophies of health-care research and social program evaluation. Consideration of the status of the program being assessed, its availability to, and its acceptance by the target audience leads to the derivation of four levels of health promotion program testing: efficacy trials, under optimum conditions of program implementation and recipient participation; treatment effectiveness trials, with expected variation in target audience acceptance; implementation effectiveness trials, under varying conditions of implementation; and program evaluation of previously untested programs. These four levels of testing, together with experience in one area of health promotion research (smoking prevention), suggest eight phases of research for the development of health promotion programs: basic research, hypothesis development, pilot applied research, prototype evaluation studies, efficacy trials, treatment effectiveness trials, implementation effectiveness trials, and demonstration evaluations. Issues of design, the use of random assignment, the use of blinding procedures, and of the role of process evaluation in these different research levels, particularly efficacy and effectiveness trials, are considered in light of the terminologies and methods of health-care and social program evaluation research. Suggestions are made for improved health promotion research. PMID- 3534876 TI - [Microbiological synthesis and transformation of prostaglandins]. AB - The review surveys current literature on microbiological synthesis and modification of prostaglandins. Three possible approaches to the use of microorganisms for prostaglandin production are considered including synthesis de novo, arachidonic acid transformation, and prostaglandin modifications. The most typical reactions of prostaglandin transformations by microorganisms are analysed: hydrolysis, hydroxylation, reduction and beta-oxidation. PMID- 3534877 TI - [An optimum regimen for the use of malate dehydrogenase and lactate dehydrogenase during chemical regeneration of the cofactor]. AB - The steady-state kinetics of malate oxidation by malate dehydrogenase was being studied without coupling reagents under the conditions of chemical regeneration of the cofactor by the following pairs: phenazine methosulphate (PMS)- dichlorphenolindophenol (DCPIP) and PMS--tetranitrotetrazolium blue (TNTB). The comparative kinetic study was carried out of the steady-state oxidation of lactate and the reduction of pyruvate by lactate rehydrogenase, as well as of the dehydrogenation of lactate, coupled with the cofactor regeneration by the pair PMS-DCPIP. Optimum reagent concentrations, optimum pH and activation energies were determined for six systems. Malate dehydrogenation coupled with regeneration of the cofactor by the pair PMS-TNTB is the most promising reaction for enzyme immunoassay. PMID- 3534878 TI - [Historical background of periodontology]. PMID- 3534879 TI - Metalloendoprotease inhibitors that block fusion also prevent biochemical differentiation in L6 myoblasts. AB - The effect of metalloendoprotease inhibitors on the biochemical differentiation of the rat skeletal muscle line, L6, was investigated. Confluent unfused L6 cells exposed briefly to 1,10-phenanthroline, a chelator of divalent metal cations, or continuously to dipeptide amide metalloendoprotease substrates that are blocked at the NH2-terminals, N-carbobenzyloxyserylleucyl amide and N carbobenzyloxyglycylleucyl amide, did not fuse or express creatine kinase, myosin heavy chain, or alpha-actin. These effects were reversible and dose-dependent. Exposure to N-carbobenzyloxylglycylglycyl amide, which is not a metalloendoprotease inhibitor, had no effect. As the differentiation in a culture progressed, 1,10-phenanthroline became less effective in blocking the accumulation of creatine kinase and myosin heavy chain. Exposure of partially fused cultures to N-carbobenzyloxyserylleucyl amide prevented any further accumulation of muscle-specific proteins. In confluent cultures where cell division was blocked before the onset of differentiation, N carbobenzyloxyserylleucyl amide still prevented fusion and the induction of creatine kinase. This indicates that these inhibitors do not act by interfering with the cell cycle. Experiments that measured DNA synthesis rates, plating efficiencies, and the effects of sequential dipeptide and dimethyl sulfoxide treatments indicate that L6 myoblasts do not irreversibly withdraw from the cell cycle when exposed to N-carbobenzyloxyserylleucyl amide. These results are consistent with the role of a metalloendoprotease in initiating the terminal differentiation of cultured muscle cells. PMID- 3534880 TI - Two mammalian heat shock proteins, HSP90 and HSP100, are actin-binding proteins. AB - Two high molecular weight heat shock proteins, HSP90 (Mr, 90,000) and HSP100 (Mr, 100,000), were separately purified from extracts of cultured cells of a mouse lymphoma cell line, L5178Y. Both of the HSPs exist in homodimeric form under physiological conditions. Their physicochemical properties are quite similar to each other. Each of the purified HSPs was shown to coprecipitate with rabbit skeletal muscle actin under actin-polymerizing conditions. Both HSP90 and HSP100 increased the low-shear viscosity of filamentous actin solutions in a dose dependent manner, which suggests that these HSPs cross-link actin filaments. Although some molecular properties and the effects described above on actin solution of HSP90 and HSP100 resemble those of alpha-actinin, the HSPs were distinguished from alpha-actinin by various means, including visualization of molecular shapes by electron microscopy with the aid of the low-angle rotary shadowing technique. Immunofluorescence staining by specific antisera against HSP90 revealed that HSP90 was localized in ruffling membranes in addition to the cytoplasmic space. PMID- 3534881 TI - Hydrogen peroxide-inducible proteins in Salmonella typhimurium overlap with heat shock and other stress proteins. AB - Hydrogen peroxide treatment induces the synthesis of 30 proteins in Salmonella typhimurium. Five of these proteins are also induced by heat shock, including the highly conserved DnaK protein. The induction of one of these five proteins by heat shock is dependent on oxyR, a positive regulator of hydrogen peroxide inducible genes, while the induction of the other four by heat shock is oxyR independent. Five of the 30 hydrogen peroxide-inducible proteins have been identified, and their structural genes have been mapped. Other stresses such as nalidixic acid, ethanol, or cumene hydroperoxide treatment also induce subsets of the 30 hydrogen peroxide-inducible proteins as well as additional proteins. Hydrogen peroxide-inducible proteins are shown to be largely different from those proteins induced by aerobiosis. In addition, the expression of the katG (catalase) gene is shown to be regulated by oxyR at the level of mRNA. PMID- 3534882 TI - Action mechanism of ABC excision nuclease on a DNA substrate containing a psoralen crosslink at a defined position. AB - Many carcinogenic as well as chemotherapeutic agents cause covalent linkages between complementary strands of DNA. If unrepaired, DNA crosslinks are blocks to DNA replication and transcription and therefore represent potentially lethal lesions to the cell. Genetic studies of Escherichia coli have demonstrated that the repair enzyme ABC excision nuclease, coded for by the three unlinked genes, uvrA, uvrB, and uvrC, plays a crucial role in DNA crosslink repair. To study the molecular events of ABC excision nuclease-mediated crosslink repair, we have engineered a DNA fragment with a psoralen-DNA interstrand crosslink at a defined position, digested this substrate with pure enzyme, and analyzed the reaction products on DNA sequencing gels. We find that the excision nuclease cuts only one of the two strands involved in the crosslink, incises the crosslink by hydrolyzing the ninth phosphodiester bond 5' and the third phosphodiester bond 3' to the furan-side thymine of the crosslink, and does not produce double-strand breaks at any significant level. Based on these data, we present a model by which ABC excision nuclease initiates crosslink repair in vivo. PMID- 3534883 TI - Small nuclear RNAs from Saccharomyces cerevisiae: unexpected diversity in abundance, size, and molecular complexity. AB - Previous work showed that the simple eukaryote Saccharomyces cerevisiae contains a group of RNAs with the general structural properties predicted for small nuclear RNAs (snRNAs), including possession of the characteristic trimethylguanosine 5'-terminal cap. It was also demonstrated that, unlike their metazoan counterparts, the yeast snRNAs are present in low abundance (200-500 molecules per haploid cell). We have now used antibody directed against the 5' cap to investigate the total set size of snRNAs in this organism. We present evidence that the number of distinct yeast snRNAs is on the order of several dozen, that the length of the capped RNAs can exceed 1000 nucleotides, and that the relative abundance of a subset of these RNAs is 1/5th to 1/20th that of the class of snRNAs described previously. These findings suggest that the six highly abundant species of snRNAs (U1-U6) typically reported in metazoans may represent a serious underestimation of the total diversity of snRNAs in eukaryotes. PMID- 3534884 TI - Transcription attenuation in Salmonella typhimurium: the significance of rare leucine codons in the leu leader. AB - The leucine operon of Salmonella typhimurium is controlled by a transcription attenuation mechanism. Four adjacent leucine codons within a 160-nucleotide leu leader RNA are thought to play a central role in this mechanism. Three of the four codons are CUA, a rarely used leucine codon within enteric bacteria. To determine whether the nature of the leucine codon affects the regulation of the leucine operon, we used oligonucleotide-directed mutagenesis to first convert one CUA of the leader to CUG and then convert all three CUA codons to CUG. CUG is the most frequently used leucine codon in enteric bacteria. A mutant having (CUA)2CUGCUC in place of (CUA)3CUC has an altered response to leucine limitation, requiring a slightly higher degree of limitation to effect derepression. Changing (CUA)3CUC to (CUG)3CUC has more dramatic effects upon operon expression. First, the basal level of expression is lowered to the point that the mutant grows more slowly than the parent in a minimal medium lacking leucine. Second, the response of the mutant to a leucine limitation is dramatically altered such that even a strong limitation elicits only a modest degree of derepression. If the mutant is grown under conditions of leucyl-tRNA limitation rather than leucine limitation, complete derepression can be achieved, but only at a much higher degree of limitation than for the wild-type operon. These results provide a clear-cut example of codon usage having a dramatic effect upon gene expression. PMID- 3534885 TI - Immunization with synthetic peptides of a Plasmodium falciparum surface antigen induces antimerozoite antibodies. AB - Polypeptides expressed on the surface of merozoites, the invasive stage of the asexual blood cycle, are good candidates for the development of malaria vaccines. Five synthetic peptides with predetermined specificity deduced from a genomic DNA clone coding for the NH2-terminal portion of the main merozoite surface polypeptide of Plasmodium falciparum were evaluated for their capability to raise antibodies that react with the P. falciparum merozoites. Antibodies induced by two of the peptides (3 and 5) reacted with the membrane surfaces of seven of seven isolates of P. falciparum from different geographic areas. Antibodies against peptide 4, which contains a repeated amino acid sequence (Gly-Gly-Ser and Val-Ala-Ser), reacted with six of seven isolates. Structural analysis of the deduced polypeptides suggests that peptide 3 is exposed at the surface of merozoites. When it was used to immunize monkeys, three of the four animals were partially protected from a challenge infection that induced a fulminant infection in control animals. PMID- 3534886 TI - Platelet glycoproteins IIb and IIIa: evidence for a family of immunologically and structurally related glycoproteins in mammalian cells. AB - Human and bovine cultured cell lines and circulating leukocytes were examined for the presence of surface proteins similar to platelet glycoproteins IIb (GPIIb) and IIIa (GPIIIa). Human endothelial cells, smooth muscle cells, and MG-63 fibroblast-like cells were found to have surface proteins that cross-reacted with platelet GPIIb and GPIIIa antibodies, existed as complexes, and had molecular weights similar to those of the corresponding platelet glycoproteins. Bovine endothelial cells and smooth muscle cells also expressed GPIIb- and GPIIIa-like surface proteins. Metabolic labeling studies with [35S]methionine demonstrated that the cultured cells synthesized these glycoproteins. The GPIIIa-like protein in human endothelial and smooth muscle cells had the same isoelectric point as platelet GPIIIa, whereas their GPIIb alpha-like protein was slightly more acidic than platelet GPIIb alpha (pI = 5.2-5.3 versus 5.5). Platelet and endothelial cell GPIIb alpha (but not GPIIIa) showed an increased electrophoretic mobility in Ca2+ -containing versus EDTA-containing gels, implying a Ca2+ -GPIIb alpha interaction. The amino acid sequence of the amino termini of platelet GPIIb alpha and GPIIb beta and of the alpha chains of the leukocyte LFA-1 and Mac-1 glycoprotein complexes had significant sequence homology. These data indicate that glycoproteins that have either immunological cross-reactivity or amino terminal sequence homology with the platelet GPIIb-IIIa complex are widely distributed in human and non-human adherent cells and circulating leukocytes and suggest that these proteins may be the products of a large gene family whose expression is cell specific. PMID- 3534887 TI - Improved flow cytometric analysis of leukocyte subsets: simultaneous identification of five cell subsets using two-color immunofluorescence. AB - Flow cytometric analysis of human peripheral blood leukocytes has typically been achieved by staining multiple aliquots of the same sample with fluorescent reagents specific for cell subsets of interest. Spectrally discrete fluorochrome tags have been developed for applications in which identification of multiple subsets (e.g., T and B cells) or of subsets not uniquely identified by a single reagent (e.g., activated T cells) requires use of multiple reagents per aliquot. Extension of this approach to more than two reagents per aliquot has led to multicolor methods requiring dual laser excitation and complex instrumentation. We describe an alternative two-color method using commercially available reagents that allows simultaneous identification of five discrete immune cell subsets using only a single excitation source. The technique uses dilution of commercial fluorochrome-labeled reagents with competing unlabeled reagents to selectively produce discrete fluorescence intensity profiles for cell subsets that would otherwise display overlapping or indistinguishable profiles when stained with reagents bearing the same fluorochrome. For example, the fluorescence intensity of phycoerythrin-labeled helper T (Th) cells can be adjusted to be distinct from that of phycoerythrin-labeled suppressor T (Ts) cells. Extending this technique to two colors, we have used a combination of seven different monoclonal antibodies to simultaneously quantify Th, Ts, B cells, natural killer cells, and monocytes in a single aliquot. An additional advantage of this approach is the ability to more accurately quantify "null" cells. Adjustment of fluorescence intensity profiles of different cell subsets by this method is applicable to flow cytometric analysis of a wide variety of cell types. The technique significantly extends the analytical capacity of flow cytometry without significantly increasing the complexity of the instrumentation required. PMID- 3534888 TI - Antibodies cytotoxic to bovine parathyroid cells in autoimmune hypoparathyroidism. AB - We utilized a recently developed long-term serum-free culture system for bovine parathyroid cells to detect antibodies in seven patients with autoimmune hypoparathyroidism (AHP). Antibodies were tested by indirect immunofluorescence methods and by cytotoxicity utilizing the chromium (51Cr) release technique. Seven AHP sera caused specific lysis [57 +/- 6% release of 51Cr vs. 5 +/- 1% for 56 controls (15 normal subjects and 41 patients with diverse other conditions associated with immune dysfunction)]. The least effect of any of the AHP sera on cell lysis exceeded the greatest effect of any of the control sera. Absorption of AHP sera (two cases) with bovine pituitary, thyroid, liver, or kidney cells did not affect lysis, but absorption with adrenal or parathyroid cells caused a marked decrease in specific lysis. Cytotoxicity determined by 51Cr release increased with antiserum concentration and time of incubation. Cytotoxicity was dependent on complement. Replicating parathyroid cells provide a uniform reproducible detection method for anti-parathyroid antibodies in AHP. The autoantibodies in AHP appear to be specific for tissue (parathyroid and adrenal cortex) but not for species. PMID- 3534889 TI - Micromethod for the determination of free and total prolactin receptors: measurement of receptor levels in normal and malignant mammary and prostate tissues. AB - A sensitive micromethod for the determination of free and total prolactin receptors in normal or malignant tissues has been developed. Positive and negative quality controls are incorporated in the procedure. Either whole tissue or the pellet fraction remaining from tissue that had undergone processing for estrogen receptors can be used. Crude microsomal and plasma membrane fractions obtained by homogenization and differential centrifugation are incubated with labeled prolactin in the presence or absence of increasing amounts of unlabeled hormone. The labeled ligand is prepared by a stoichiometric iodination procedure in which one atom of iodine-125 is incorporated into one molecule of the hormone, resulting in an intact labeled prolactin with a high specific activity of 170-186 muCi/micrograms (1 Ci = 37 GBq). Human prolactin labeled by this procedure has much greater specific binding capacity to various rat tissues than does iodinated rat prolactin. This technique permits an accurate measurement of prolactin receptors in as little as 50 micrograms of membrane protein. Highest levels of free and total prolactin receptors were found in the liver of 60-day-old female rats that served as a positive control. Liver of immature 21-day-old male rats, devoid of prolactin receptors, was used as a negative control. The amount of detectable free receptors was dependent on the level of circulating plasma prolactin. In 3-day postpartum lactating rats with high prolactin levels in plasma, all prolactin receptors in the mammary glands were found to be occupied, and no free receptors could be detected. When these receptors were desaturated from the endogenous prolactin by exposure to 3 M MgCl2, one class of receptors in a high quantity (1.75 nmol/mg of protein) and with a moderate affinity (Kd = 6.41 X 10(-9) M) was detected. A similar type of receptor was found in the mammary glands of rats at midpregnancy and of cycling adult female rats. In malignant rat mammary tissue, however, fewer receptors (27 pmol/mg of protein) but with a very high affinity (Kd = 6.8 X 10(-14) M) were detected. Normal ventral and dorsolateral rat prostate contained two classes of prolactin receptors (Kd = 3.46 X 10(-10) M and 1.93 X 10(-8) M). In the cancerous rat prostate, however, only one of these two classes of receptors was detected, and the number was smaller. PMID- 3534890 TI - beta-Glucuronidase from Escherichia coli as a gene-fusion marker. AB - We have developed a gene-fusion system based on the Escherichia coli beta glucuronidase gene (uidA). The uidA gene has been cloned from E. coli K-12 and its entire nucleotide sequence has been determined. beta-Glucuronidase has been purified to homogeneity and characterized. The enzyme has a subunit molecular weight of 68,200, is very stable, and is easily and sensitively assayed using commercially available substrates. We have constructed gene fusions of the E. coli lacZ promoter and coding region with the coding region of the uidA gene that show beta-glucuronidase activity under lac control. Plasmid vectors have been constructed to facilitate the transfer of the beta-glucuronidase coding region to heterologous control regions, using many different restriction endonuclease cleavage sites. There are several biological systems in which uidA-encoded beta glucuronidase may be an attractive alternative or complement to previously described gene-fusion markers such as beta-galactosidase or chloramphenicol acetyltransferase. PMID- 3534893 TI - [The herb garden. The origin, significance and functions of a cultural memorial]. PMID- 3534891 TI - Translation of a synthetic two-cistron mRNA in Escherichia coli. AB - A synthetic two-cistron expression system was constructed for the high-level expression of eukaryotic genes in Escherichia coli. This system was designed to overcome translational inhibition of mRNAs containing eukaryotic sequences. The first cistron in this system is a 31-base A + T-rich synthetic sequence that provides for efficient translation initiation. The second cistron contains the protein coding sequence for the eukaryotic gene. Insertion of the first cistron between the 5' untranslated region of the mRNA and the protein coding region separates the two and thereby potentially minimizes the formation of local secondary structures that might prevent ribosomes from binding and initiating translation. The 31-base cistron contains three nonsense codons (TAA), one in each of the three translational reading frames, and an 8-base Shine-Dalgarno sequence that is complementary to the 3' end of the 16S rRNA. The effects of translation of the first cistron in all three reading frames on the expression of the second cistron was examined. The most efficient expression of the second cistron seemed to occur when the stop codon that terminates translation of the first cistron is located 3' to the Shine-Dalgarno sequence and close to the AUG start codon for the second cistron. When the Shine-Dalgarno sequence was deleted from the first cistron, no detectable expression of the second cistron was observed. This two-cistron system has been used to express the gene encoding methionylalanyl bovine growth hormone with its native codons and the gene encoding methionyl human growth hormone at a level greater than 20% of total cell protein. In the case of human growth hormone, we show that the amount of gene product is not significantly diminished by placing a "functional" first cistron in front of a gene that can be expressed without a cistron. PMID- 3534892 TI - Identification of the parasite transferrin receptor of Plasmodium falciparum infected erythrocytes and its acylation via 1,2-diacyl-sn-glycerol. AB - The transferrin receptor of schizont-infected erythrocytes of Plasmodium falciparum (Gambian clone FCR-3/A2) is a parasite-encoded protein of Mr 102,000, which is present in purified erythrocyte membranes. Polyclonal antiserum to the purified Mr 102,000 protein was raised in rabbits. At physiological pH, immunoaffinity-purified protein bound human ferrotransferrin but not apotransferrin. Conversely, antibody to human transferrin was used to purify the ferrotransferrin-receptor complex from infected cells. The isolated receptor was specifically recognized by the polyclonal rabbit antiserum raised against the Mr 102,000 protein. Preliminary analysis indicated that, unlike the human receptor, the plasmodial transferrin receptor is not a disulfide linked dimer but a single polypeptide acylated via 1,2-diacyl-sn-glycerol. PMID- 3534894 TI - Comparative effects of several simple carbohydrates on erythrocyte insulin receptors in obese subjects. AB - The effects of simple carbohydrates on erythrocyte insulin receptors, plasma insulin and plasma glucose were studied during four hypocaloric, hyperproteic, diets. One diet contained no carbohydrate; the other three contained 36 g of either glucose, galactose or fructose. These diets were given for a 14-day period to groups of moderately obese subjects. The hypocaloric carbohydrate-free diet produced a decrease in plasma insulin and glucose concentrations concomitant with an increase in the number of insulin receptors. A similar increase in insulin receptor number was found when the diet was supplemented with glucose or galactose, but not with fructose. The presence of fructose in the diet prevented any increase in insulin receptor number. PMID- 3534896 TI - Methods for estimating drug bioavailability parameters. Part 3: Peculiarities of pharmacokinetic analysis in assessment of bioavailability. PMID- 3534895 TI - The causal role of PAF and leukotrienes in acute cardiac allograft rejection in rats. PMID- 3534897 TI - [Capillary isotachophoresis--a new method in drug analysis. 4. Analytic capillary tachophoresis of obidoxime and pyridine-4-aldoxime]. PMID- 3534898 TI - The neuropharmacology of capsaicin: review of some recent observations. PMID- 3534899 TI - Controlled trial on the possible advantages of a combined therapy with maprotiline and haloperidol in endogenous depression. AB - There is some clinical evidence that neuroleptics are able to increase the therapeutic effect of antidepressant drugs. From a theoretical viewpoint this could be due to influences on pharmacokinetics or receptor sensitivity. In a controlled three-week trial in 28 patients with endogenous depression the potential advantages of a combined medication of 150 mg maprotiline and 9 mg haloperidol per day (given for the first six days) in comparison with monotherapy with maprotiline were tested. Neither during the time of combined medication nor following withdrawal of haloperidol did this treatment regimen show better clinical results in comparison with controls. In keeping with results described elsewhere, the serum levels of the antidepressant, but not of its desmethyl metabolite, were higher in the experimental group. PMID- 3534900 TI - Clonidine trial in tardive dyskinesia. Therapeutic response, MHPG, and plasma DBH. AB - The a2-adrenergic receptor agonist clonidine has a beneficial effect on tardive dyskinetic symptomatology (TDS), in the pathophysiology of which the involvement of noradrenergic mechanisms, among others, has been proposed. The authors investigated possible relationships between the therapeutic efficacy of clonidine in patients with tardive dyskinesia (TD) and concentrations in urine and plasma of the main noradrenaline (NA) metabolite methoxyhydroxyphenylglycol (MHPG), and of the NA biosynthetic enzyme dopamine-b-hydroxylase (DBH) in plasma. Clonidine was administered to twelve chronic schizophrenic patients with TDS in a double blind, cross-over, single-dose trial. MHPG was measured in urine samples collected before and after administration. MHPG and DBH were also measured in plasma of blood samples taken three hours after administration. Ten patients then received clonidine in addition to neuroleptics for a period of two weeks. Clonidine caused significant amelioration in TDS both in the single-dose and the two-week trials. The degree of amelioration was, however, not correlated with the MHPG or DBH baseline values, or with the differences between placebo and drug in the single-dose trial. PMID- 3534902 TI - Experimental clinical studies on the effect of eburnamonine in cerebrovascular disorders. AB - Two double-blind, placebo-controlled studies were performed successively to demonstrate the efficacy of Eburnamonine. In the first study, the efficacy of 12 weeks of administration of 3 X 60 mg Eburnamonine per day (n = 25) was investigated in 49 inpatients with cerebrovascular disorders. In the second, the effect of 12 weeks of therapy with 1 X 60 mg Eburnamonine per day (n = 25) was investigated in 50 patients of the same diagnostic category. Results related to the efficacy were analyzed on the basis of the physician's global rating of therapeutic effect, and evaluated by the x2-test. Global therapeutic effect was confirmed and illustrated by effects on specific variables (List of Cerebral Symptoms, function test, NOSIE) evaluated by analysis of covariance. Under the influence of both dosages, therapeutic improvement was observed more frequently than under placebo. The incidence of gastrointestinal side effects was higher under the dose of 3 X 60 mg than under placebo. No effects were observed with respect to parameters of clinical chemistry. In the quasi-experimental comparison of 3 X 60 mg and 1 X 60 mg Eburnamonine, the higher dose was found to yield more therapeutic improvement, but also more frequent side effects than the lower dose, which, in this respect, did not differ from placebo. PMID- 3534901 TI - On the effects of pyritinol on functional deficits of patients with organic mental disorders. AB - In 120 geriatric patients suffering from cerebral functional disorders with a moderate to rather severe degree of chronic brain syndrome, the effects of pyritinol were investigated in a placebo-controlled, randomized double-blind study. Furthermore, we attempted to find some evidence for the validity of a neurophysiological vigilance model which had already been used earlier. In the previous study it had been possible to show a rise in the vigilance level in patients under pyritinol treatment. The investigation began with a two-week single-blind placebo wash-out phase and continued over a 12-week treatment period, with six weeks' treatment in a hospital ward and six weeks' outpatient treatment (or in a geriatric home within a hospital setting). Pyritinol was administered three times daily in coated tablets each containing 200 mg. The course of the trial was controlled using two rating scales (SCAG, BGP), a physician's Global Impression (GI) and two performance tests (SKT, ZVT-G). There were 13 drop-outs, four because of intercurrent diseases, nine because they did not fulfill the inclusion criteria. The data of 107 patients were included in the statistical analysis, 54 on pyritinol and 53 on placebo. No notable adverse drug reactions were observed that were not similarly reported in the placebo group (Table 1). Statistically significant results were found in favor of pyritinol compared with placebo in both the level of clinical symptomatology (Fig. 1) and the performance level (Fig. 4). Particularly impressive was the superiority of pyritinol in the factor "social behavior" of the SCAG. Considering the clinical relevance of the changes it can be concluded that in both groups improvements occurred.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3534903 TI - Twenty-first Mary McMillan lecture. PMID- 3534904 TI - Brief history of Department of Physiology at State University of New York at Buffalo 1846-1986. PMID- 3534905 TI - The tides of physiology: departmental histories. PMID- 3534906 TI - History of Physiology Department at University of British Columbia. PMID- 3534907 TI - History of Physiology Department at University of Florida: 1956-1981. PMID- 3534908 TI - History of Department of Physiology at University of South Florida. PMID- 3534909 TI - History of Physiology at Philadelphia College of Osteopathic Medicine. PMID- 3534910 TI - History of Physiology at University of California, Davis. PMID- 3534911 TI - United States Army Research Institute of Environmental Medicine: first quarter century. PMID- 3534912 TI - History of Physiology Department at Medical College of Wisconsin: 1921-1985. PMID- 3534913 TI - Tides of physiology at Berkeley. PMID- 3534914 TI - Dependence of food intake on acute and chronic ventricular administration of insulin. AB - Several lines of evidences indicate that insulin affords short- and long-term neuroendocrine signals to modulate ingestive behavior. To further study a possible role of insulin in the control of food intake, male Wistar rats were subjected to various intra-third cerebro-ventricular applications of saline and insulin. Infusion of 2.0 mIU/rat of insulin at 1100 and 1900 decreased food intake in a 23.5 hr test period. Infusion of 0.5 mIU/rat of insulin between 1100 and 1200 decreased nighttime food intake during the 1st and 2nd days. Infusion of 2.0 mIU/rat/24 hr of insulin from osmotic minipumps decreased nighttime food intake throughout the active pump period and the effect persisted into the post pump period. The results support the notion that insulin is involved in the regulation of food intake in the rat. PMID- 3534915 TI - Effect of intra-third ventricular administration of insulin on food intake after food deprivation. AB - It has been suggested that insulin may participate as a signal in the overall control of feeding. To further study this possible role of insulin, food-deprived male Wistar rats were subjected to intra-third cerebro-ventricular infusions of insulin. Infusion of 0.5 and 2.0 mIU/rat at 0745 hr, and 2.0 mIU/rat of insulin at 1900 hr in 24.5 hr food-deprived rats, and 2.0 mIU/rat of insulin at 2200 hr in 4 hr food-deprived rats did not significantly affect food intake. Infusion of the high dose of 8.0 mIU/rat of insulin at 2200 hr in 4 hr food-deprived rats significantly decreased food intake with a long-delayed and long-lasting effect. This and previous evidence suggest that intra-third ventricular administration of small amounts of insulin induce a decrease of food intake only in non-food deprived rats. PMID- 3534917 TI - [Living memory (Malgorzata Zmudzka)]. PMID- 3534916 TI - Seasonal variations in activity rhythms of male voles: mediation by gonadal hormones. AB - Adult male Microtus montanus were castrated or sham-castrated and housed under 16 hours of light (LD 16:8). Castrates showed increased preference for diurnal and decreased preference for nocturnal activity compared to shams. Castrates showed a trend toward increased crepuscular preference. Shams showed more total activity than castrates. Longterm castrates (under LD 8:16) displaying either predominantly diurnal or crepuscular activity were implanted with either empty Silastic capsules or capsules containing testosterone. Animals with testosterone implants displayed increased preference for nocturnal and decreased preference for crepuscular activity as compared to controls. No significant difference in preference for diurnal activity was found. Testosterone increased total activity. Testosterone appears to be an important, but not the only, cue in determining timing of running wheel use in male M. Montanus. Seasonal changes in reproductive function may be involved in the dramatic seasonal variations in activity timing observed in some field populations of microtine rodents. In all treatments, high interanimal variation occurred. This variation may be a function of the inherent flexibility of activity in microtine rodents. PMID- 3534918 TI - Learned food aversion: a component of anorexia syndromes. PMID- 3534919 TI - Eating disorders: a bibliography (major emphasis on psychopharmacology). PMID- 3534920 TI - Attention deficit disorders: a bibliography (contains references from 1/1/84 to 9/30/85). PMID- 3534921 TI - [Concentrated meditation and cognitive behavior therapy: possibilities for integration and differences]. PMID- 3534922 TI - Tobacco dependence: psychology, biology, and treatment strategies. PMID- 3534923 TI - Balancing science and history: a problem of scientific biography. "Black Apollo of science: the life of Ernest Everett Just." By Kenneth R. Manning. Essay review. PMID- 3534924 TI - The theory of evolution: the case for randomness in the evolution of DNA and proteins. "The neutral theory of molecular evolution." By Motoo Kimura. PMID- 3534926 TI - Claude Bernard, the milieu interieur, and regulatory physiology. PMID- 3534925 TI - [Vulpian's research on the properties of sensory and motor nerve fibers]. PMID- 3534927 TI - Defending Lavoisier: the French Academy's Prize Competition of 1821. PMID- 3534928 TI - [Physical chemistry and hemoglobin function, 1925-1951]. PMID- 3534929 TI - [Historical and present-day infant mortality: dialogues between the historian and the pediatrician, and between developed countries and the Third World]. PMID- 3534930 TI - Ideas about sexual reproduction. "Gametes and spores: ideas about sexual reproduction 1750-1914." By J. Farley. Essay review. PMID- 3534931 TI - Laboratory diagnosis and incidence of diphtheria in Mosul Province, Iraq. PMID- 3534932 TI - [Clinical longitudinal study of composite restorations]. PMID- 3534933 TI - [In memoriam: Charlie Przetak. 24 April 1928-16 May 1986]. PMID- 3534934 TI - [Profilometric and photomacroscopic studies of the surfaces of dental enamel, dentin, and root cementum after treatment with a powder-abrasion device]. PMID- 3534935 TI - [Prostaglandins and interphase death of irradiated cells]. AB - The contribution of the post-irradiation changes in prostaglandin transformation to the biochemical mechanism of interphase death of irradiated cells is estimated. It is supposed that prostaglandins are secondary trigger-effectors which initiate the development of primary biochemical reactions giving rise to radiation sickness. It is suggested that the biochemical mechanism of interphase death is complex and involves several concurrent trigger mechanisms including prostaglandin regulation system. PMID- 3534936 TI - [The problem of peroxidation in radiobiology]. AB - A hypothesis is validated concerning the products of free radical oxidation of lipids and the phenol compounds as a mediator unit of the stress-syndrome. The data are reviewed on activation of peroxidation under the effect of radiation, cytochemical agents, etc., secondarily stimulating the neurohumoral system function of homeostasis regulation. With the emotional-algesic and cold-stresses, the regulatory system stimulation is of primary, reflex, nature, but it secondarily promotes the peroxidation activation. The radiotoxins (of the quinoid and lipid nature) appearing in tissues under the effect of ionizing radiation, are similar in structure and mechanism of action to peroxidation activation products formed under the effect of other stress-agents. PMID- 3534937 TI - [Spectrum of formation of photo- and non-photoreactivated damage in E. coli cells irradiated with UV light (250-334 nm)]. AB - A relative contribution of photoreactivated (modified by visible light) and non photoreactivated (modified by temperature) damages to UV-irradiated (250-334 nm) E. coli B cells was estimated. The contribution of damages modified by temperature to a lethal effect of UV-radiation was invariable within the range from 250 to 334 nm. The photoreactivation of E. coli B cells was also independent of lambda-inactivating UV-light within 250-313 nm, and its value exceeded that of the wild-type E. coli WP2 which did not vary by the mode of UV-damages repair. Moreover, in contrast to E. coli B. cells, the value of the photoreactivation of E. coli WP2 decreased, as lambda-inactivating UV-light increased from 250 to 313 nm. PMID- 3534938 TI - [Role of DNA damage in the formation of radiation damage to chromosomes]. AB - The data are reviewed on the role of various DNA lesions in the formation of structural damages to chromosomes. The concepts are developed that the molecular damages to nuclear DNA induce chromosome mutagenesis. PMID- 3534939 TI - [Functional status of the rat insular apparatus and adrenal cortex at early periods after irradiation]. AB - As early as 0.5-3 h after X-irradiation of rats with a lethal dose of 12 Gy glucocorticoid activity of adrenal cortex was enhanced and 11-oxycorticosteroid level in blood was increased. The increasing of the immunoreactive insulin content of blood was registered at the background of hypercorticoidism and normal function of insular apparatus during the first hours following irradiation. At later times (24-72 h), a stable hypercorticoidism developed, the ability of beta cells to react adequately to glucose was impaired, and IRI content of blood decreased. PMID- 3534940 TI - [Practical experiences with radioiodine labeling of antibodies--a review]. PMID- 3534941 TI - [Ultrasound tomography of the breast in problematic mammographic findings]. PMID- 3534942 TI - [Diagnosis and therapy of an intrapericardial teratoma in an infant]. PMID- 3534943 TI - [A- and B-mode ultrasound diagnosis in diseases of the paranasal sinuses and soft tissues of the face]. AB - A-mode ultrasonography in paranasal sinus disease for 13 years and of B-mode ultrasonography for 10 years provide the experience to define the role of both diagnostic imaging procedures in various processes of the paranasal sinuses and the overlaying soft tissues. While A-mode ultrasonography of the maxillary and frontal sinus remains an excellent screening method for initial examinations and follow up controls, the improved imaging quality of B-mode ultrasonography facilitates diagnosis in case of ethmoid sinus involvement and in lesions of the facial soft tissues. In infantile sinusitis, ultrasonography is far more reliable than conventional x-ray projections. The global conformity for this method depends on the localization of the affected sinus and on the nature of the disease process. PMID- 3534944 TI - Studies on the olfactory nervous system of the Old World monkey. AB - From the results of our electrophysiological and HRP studies in the old world monkey, multiple olfactory pathways have been clarified. The old world monkey has two neocortical olfactory areas, but no functional vomeronasal system. The response patterns to odors in various olfactory areas have also been studied. On the other hand, in the rabbit (Onoda and Iino, 1980) and dog (Onoda et al., 1981, 1982), which do have active vomeronasal systems, only one neocortical olfactory area was found. This important difference had already been indicated in three previous papers in which Takagi (1979, 1980, 1981) theorized that mammals can be divided into two groups according to their olfactory nervous mechanisms. One group includes old world monkeys, higher primates and man, and the other new world monkeys and lower mammals. PMID- 3534945 TI - Sprouting and remodelling at the nerve-muscle junction. PMID- 3534946 TI - [Three-dimensional structures of proteins: archives, research and applications]. PMID- 3534947 TI - [Can a protein data bank help to define the binding site of proteolytic enzyme?]. PMID- 3534948 TI - [Neg-entropy and local information content: a new approach to the analysis of nucleotide and amino-acid sequences]. PMID- 3534949 TI - [Protein structure, evolution, and conformational change]. PMID- 3534950 TI - [Computer graphics representations of protein structures]. PMID- 3534951 TI - [Tertiary structure and molecular evolution of protein]. PMID- 3534952 TI - [Research uses of protein sequence databases]. PMID- 3534953 TI - [Biosequence analysis system on a VAX computer]. PMID- 3534954 TI - [Data base for information of peptide (DBIP): efficient production of protein sequence data base and its problem]. PMID- 3534955 TI - [Amino acid sequence analysis by a microcomputer]. PMID- 3534956 TI - [An evaluation of the information contained in the amino acid sequences of fibrinogen]. PMID- 3534957 TI - [The primary structure and molecular evolution of proteins closely associated with hemolymph coagulation of invertebrate animals]. PMID- 3534959 TI - [Correlation between the primary structure and tertiary structure of protein]. PMID- 3534958 TI - [Similar domains in different proteins: detection and significance]. PMID- 3534960 TI - [Prediction of the secondary structure of proteins: a method using homology to proteins of known structures]. PMID- 3534961 TI - [Protein conformation and gene evolution]. PMID- 3534963 TI - Salt and hypertension. PMID- 3534962 TI - [Progressive addition technics in ceramics for occlusal reconstructions]. PMID- 3534964 TI - [Experimental and clinical studies on the treatment of acute pancreatitis]. PMID- 3534965 TI - [Electrical stimulation for inducing osteogenesis in the treatment of nonunions]. PMID- 3534966 TI - Postoperative radiotherapy of carcinoma in bilharzial bladder using a three fractions per day regimen. AB - Patients with T3 bladder cancer who survived surgery and proved to have P3a, P3b or P4a tumors were randomized to either no further treatment (61 patients) or postoperative total pelvic irradiation (55 patients). A three-fraction per day regime was adopted with a dose per fraction of 125 cGy and an interval of 3 h between fractions. The total dose amounted to 3750 cGy divided into 30 fractions over 12 days. Patients of the postoperative radiotherapy group were re-randomized to radiotherapy alone or radiotherapy plus misonidazole (MISO) in a daily dose of 1 g/m2 given orally 2 h before the first daily fraction. The 2-year disease-free survival rate in the cystectomy alone group was 33 +/- 6% compared to 65 +/- 6% in the postoperative radiotherapy group. The therapeutic benefit applied to the two cell types, all histological grades and stages and to patients with or without nodal metastases. The benefit of postoperative irradiation was also verified by the Cox's multivariant analysis which adjusts for the relative representation of the important prognostic factors particularly pathological stage and nodal involvement. MISO did not seem to add to the therapeutic gain. No late complications were encountered in the wall of the rectum, small bowel or uretero-intestinal anastomotic sites. This is suggested to be due to the small dose per fraction used. However, early small bowel reactions were dose-limiting. PMID- 3534967 TI - Radiobiological considerations in the treatment of neuroblastoma by total body irradiation. AB - Neuroblastoma is a radiosensitive neoplasm for which total body irradiation (TBI) is presently under clinical consideration. Collated data on the radiobiology of human neuroblastoma cells in vitro (11 cell lines derived from seven patients) indicates moderate cellular radiosensitivity and low capacity for accumulation of sublethal damage (median survival curve parameters: Do = 104 cGy, Dq = 32 cGy, n = 1.36). Mathematical studies incorporating these parameters suggest that low dose fractionated TBI is unlikely to achieve significant levels of tumour cell kill. When high dose TBI is used in conjunction with bone marrow rescue a tumour "log cell kill" of 4-5 should be achievable. This effect would be additional to that achieved by chemotherapy. The optimum schedule for exploitation of radiobiological differences between neuroblastoma cells and the dose-limiting normal tissues has a hyperfractionated structure. Twice-daily treatments with fraction sizes in the region 120-150 cGy seems appropriate. Single dose treatments at high dose rate are contraindicated. Fractionated TBI with bone marrow rescue may be curative for some patients in clinical remission who are presently destined to relapse. PMID- 3534968 TI - Oesophageal carcinoma: the problems of historical controls. PMID- 3534969 TI - [Total body irradiation and bone marrow transplant]. AB - Any malignancy, mainly hematological, may be sensitive (with complete remission) to high-dose chemo and/or radiotherapy. The dose of most antineoplastic agents is limited by the toxicity to the normal marrow. The availability of marrow for transplantation (allogenic, syngenic or autologous), and the capability of reconstituting hematopoietic function, makes it possible to administer chemoradiotherapy in supralethal doses in an effort to kill a greater fraction of the malignant cells. Total Body Irradiation is used both to eradicate the malignant cells and to suppress host immune reactivity enough to prevent rejection of allogenic marrow. The transplanted allogenic marrow can also exert an antitumor effect. A survey of radiobiological studies undertaken is presented and preliminary results of a series of patients treated with TBI at ISSR are discussed. PMID- 3534970 TI - [Diagnostic images of renal angiomyolipoma]. AB - The authors report 26 cases of renal angiomyolipomas (AML) detected in a three years period (1983-85). In all cases echography, in 6 renal arteriography and in 13 CT were performed. The review of the pathway and of literature stress some new aspects in diagnostic problems of AML. The extensive use of diagnostic ultrasound shows an higher rate of tumors than in the pre-echographic period. Most of these lesions are asymptomatic and incidentally detected as small nodules. Ultrasound, combined with CT, can resolve the diagnostic dilemma of benign lesion. An echographic follow-up is sufficient to confirm this evaluation in typical cases. In large or bleeding tumors and when there is a prevalence of connective and/or muscular tissue, a diagnostic and ablative surgery is mandatory. PMID- 3534971 TI - [Ultrasonics in the diagnosis of deep hematomas in hemophilia]. AB - The authors emphasize the clinical importance of US in evaluating the extent and the topographic relationships of haematomas. Seven haemorrhagic episodes occurred in this group of patients have been studied using US. For retrobulbar haematomas we have utilized a single water bath transducer operating at 5 and 7.5 MHz, while for soft tissue (muscle) we have utilized linear array transducer operating at 3.5 MHz. The haemorrhagic complications consisted of two deep haematomas involving the ileo-psoas muscle, with different evolution; two relapsing haematomas of the soleus muscle followed by different clinical course; two post traumatic relapsing retrobulbar haematomas which gave rise to severe complications; two haematomas which occurred simultaneously in the right iliac fossa. Our experience suggests that US can give both accurate diagnostic information and useful clues concerning the solution and therapeutic management of haematomas. This leads to a better prognosis, mostly when the instrumental investigation is carried out early. PMID- 3534972 TI - [Radiological aspect of the irradiated lung]. PMID- 3534974 TI - Alternative major connectors for mandibular partial dentures. PMID- 3534973 TI - [Capillary cavernous hemangioma. Possibilities of instrumental diagnosis]. PMID- 3534975 TI - The influence of chemically active composite resins upon the tensile retentive impact strength of resin bonded bridges. PMID- 3534976 TI - The conversion crown revisited. PMID- 3534977 TI - [A Class II cavity with adhesive materials which preserves points of contact]. PMID- 3534978 TI - Steroid secretion by foetal mammal gonads and its regulation by gonadotrophins. PMID- 3534980 TI - The intravenous insulin tolerance test in type I diabetes. AB - The intravenous insulin tolerance test (ITT) allows general assessment of insulin sensitivity by determining the fall in plasma glucose after injection of 0.1 unit/kg regular insulin. To evaluate the usefulness of this test diagnostically in distinguishing Type I from Type II diabetes, 24 patients with Type I diabetes (defined as early age of onset, ideal body weight or less at onset, and insulin dependence) underwent ITTs. Seven patients had normal glucose disposal rates (Ki greater than or equal to 2.5. Nine patients had Ki less than 2.5 but greater than 1.0. Eight patients had Ki less than 1.0. The slopes did not correlate with the control of the diabetes (as assessed by measurement of glycosylated hemoglobin), the presence or titer of anti-insulin antibodies, the duration of the diabetes, the age of onset, the presence of complications, or the current insulin dose. These results indicate that varying amounts of insulin resistance may be present in Type I diabetes and cannot necessarily be explained by poor control or the presence of insulin antibodies. PMID- 3534982 TI - Role of pH in the lethal direct cell damaging action of miconazole. AB - Experiments with Candida albicans showed that the direct cell-damaging lethal action of miconazole is operative against log-phase cells at pH 7.0 but not at pH 5.5. Cultivation at pH 5.5 without miconazole did not inhibit development of susceptibility to miconazole kill, but killing itself was prevented at pH 5.5. It is suggested that non-protonated neutral drug molecules are required for direct lethal miconazole action. PMID- 3534979 TI - [Effects of PGF2 alpha prostaglandins on milk ejection in the ewe. Consequences of ovariectomy with or without estroprogestative complementation]. AB - The intrajugular administration of 200 micrograms of Dinolytic (tromethamine salt of PGF2 alpha) to lactating ewes caused an intramammary pressure (IMP) increase only during the luteal phase of the sexual cycle (group A). The increase in progesteronemia, induced by three daily injections of 2.5 micrograms of LH-RH, did not modify response amplitude (group B). On the other hand, bilateral ovariectomy (groupe C) led to the suppression of those responses, but supplementary oestroprogestative (table 1) did not re-establish them. It is probable that the milk ejection caused by PGF2 alpha resulted from a release of oxytocin by the corpus luteum. The ineffectiveness of the exogenous and endogenous reinforcement of progesterone therefore suggests that this hormone plays no part in the putative control of hypothalamic receptivity to prostaglandins. PMID- 3534981 TI - Endotoxin-induced changes in nitrogen metabolism. AB - Intraperitoneal administration of a sublethal dose of E. coli endotoxin to fasted rats produced within 12 hrs a rise in plasma ammonia, urea, glutamine, glutamate and aspartate as compared to controls. At this time, hepatic ureagenesis also increased as did the levels of glutamate, glutamine, aspartate, alanine and asparagine. However, liver glucose and ketone levels were unchanged. Hepatic [ATP]/[ADP] ratios declined in endotoxin-treated animals and there was an oxidation of mitochondrial pyridine nucleotides and a reduction of cytosolic pyridine nucleotides. The results suggest that impairment of nitrogen metabolism is an early effect of endotoxemia. PMID- 3534983 TI - Use of an enzyme indirect antiglobulin test for the diagnosis of autoimmune haemolytic anaemia in the dog. AB - Blood samples from 34 dogs with autoimmune haemolytic anaemia (AIHA) were studied using a variety of serodiagnostic tests. Enzyme enhancement of red cells was found to be necessary for an unequivocal laboratory diagnosis of AIHA because other techniques, the direct and the indirect Coombs' tests, often gave negative results. The most frequently encountered auto-antibody was an IgG, with a titre of 1024 or more. PMID- 3534984 TI - Immunoglobulin containing cells in the tracheobronchial tree of cattle: relationship to age. AB - The cells of the pulmonary immune system of cattle were examined using an immunoperoxidase technique to identify cytoplasmic immunoglobulins. Cells reacting immunohistochemically with bovine IgG1, IgG2, IgA and IgM antisera were quantified in formalin-fixed paraffin embedded tissues from systematically selected sites within the tracheobronchial tree. Non-pneumonic lungs were selected for study from five groups of cattle which ranged in age from neonatal calves to aged adult cattle. Age associated differences were found. Neonatal calves lacked immunoglobulin containing cells (ICC). The numbers of ICC in 18 month-old cattle were significantly greater than in other age groups. The relative frequency of each immunoglobulin class among the cells of the airway mucosa was IgA greater than IgG1 greater than IgG2 greater than IgM for all cattle four months and older (n = 20) with an IgA to IgG1 ratio of 3.46. All airway categories from trachea to bronchiole had similar proportions of cells in each immunoglobulin class although the cell density declined in the distal airways. PMID- 3534986 TI - [Use of carbon-carbon as an ossicle implant. An experimental and clinical study]. PMID- 3534985 TI - Proteinuria in the dog: a clinicopathological study in 51 proteinuric dogs. AB - In 51 dogs with predominantly massive urinary protein loss, the daily loss was quantified and glomerular and tubulointerstitial lesions from renal biopsies were characterised and graded using histology, immune fluorescence and electron microscopy. The highest median daily urinary protein loss occurred in dogs with membranous glomerulonephritis (median 380 mg kg-1 d-1) and renal amyloidosis (median 257 mg kg-1 d-1). Although in nine febrile dogs the urinary protein loss was transient, both glomerular and tubular lesions were diagnosed in five and seven of these dogs, respectively. The pattern of urinary proteins was determined using sodium dodecyl-sulphate polyacrylamide gel electrophoresis. The albumin fractional clearance (FC) was raised in 46 dogs, whereas the FCS of the low molecular weight (MW) protein fraction (MW less than 66,000) and high molecular weight protein fraction (MW more than 66,000) were raised in 42 and 28 dogs, respectively. Both the high molecular weight protein FC and albumin FC significantly correlated to the grade of glomerular lesions, whereas the low molecular weight protein FC only moderately significantly correlated to the grade of tubular lesions. The selectivity index, calculated as (formula; see text) did not differentiate between the various forms of glomerulopathies. The urinary lysozyme concentration was significantly correlated to the grade of tubular lesions. It is concluded that although quantitative and qualitative measurements of urinary proteins can provide additional clinical information, they do not have a reliable predictive value and histopathological examination of renal tissue is still necessary for the final diagnosis. PMID- 3534987 TI - [Bullous skin diseases]. PMID- 3534988 TI - [Echographic examination of the scrotal contents. Apropos of 200 case reports]. PMID- 3534989 TI - [Lexicon]. PMID- 3534990 TI - [Customized etching splints]. PMID- 3534991 TI - [Respiratory complications of anticancer chemotherapy]. AB - Pulmonary toxicity associated with chemotherapy is still rare, but its incidence may increase with intensive and iterative regimens. Following a review of the four main drugs responsible for lung toxicity (bleomycin, methotrexate, busulfan and BCNU), the authors underline the risk of combined chemotherapy and radiotherapy. To recognize, at an early stage, the signs suggesting lung toxicity is essential to reduce its extent and, above all, to exclude other pathologies which often have the same clinical and radiological features. Only histological studies provide evidence of toxicity. Treatment is frequently disappointing; the only hope of regression lies in withdrawal of the responsible drug and corticosteroid therapy. PMID- 3534992 TI - Perennial rhinitis treated with a new steroid: fluocortin butylester (FCB). AB - The effect of fluocortin butylester (FCB) in the topical treatment of perennial rhinitis was investigated in a double-blind study using a cross-over technique. The daily dose was 4 mg. Of the 30 patients who completed the trial, 26 had either allergy or nasal eosinophilia. 20 of the 30 patients preferred FCB to placebo. Moreover, there was a positive, but not statistically significant, therapeutic effect according to the patient score cards (0.1 less than p less than 0.2). In other words, the results are positive, but not definite. It is concluded that possibly the dose ought to be increased to obtain a more reliable effect. PMID- 3534993 TI - [Asymptomatic subcapsular splenic hematoma in infectious mononucleosis (Pfeiffer disease)]. AB - Splenic rupture in infectious mononucleosis (Pfeiffer disease, or glandular fever) is a rare but life-threatening complication. The exact mechanism of rupture of the spleen is unknown to date. A case of a spontaneous, asymptomatic, subcapsular haematoma of the spleen of an eighteen-year old female with infectious mononucleosis is presented with special reference to the echographic findings. A complete remission without any complication was obtained. The contribution of the sonographic examination and follow-up in the diagnosis of infectious mononucleosis is emphasised. PMID- 3534994 TI - [Rotator cuff ruptures of the shoulder joint. Sonography--arthrography]. AB - 47 patients suspected of rupture of the rotator cuff were sonographed and arthrographed. Rupture of the rotator cuff was diagnosed in 12 cases, both diagnostic methods yielding the same result. In 29 patients sonography and arthrography did not reveal any abnormal findings. Six ruptures evident in sonography were not confirmed by arthrography and were considered false positive. Direct pointers towards rupture of the cuff would be: echoless defects, cuff cannot be visualised fully or in part, irregularities of movement during dynamic examination. Echoless "cystic" areas in the periarticular soft parts must be considered an indirect pointer. Echorich focal findings in the echopoor cuff represent a differential diagnostic problem and we cannot give a final assessment as yet. Shoulder sonography is justified as a screening method in suspicion of rotator cuff rupture before initiating arthrography. If sonography reveals no abnormal findings, shoulder arthrography need not be performed. PMID- 3534995 TI - The role of infections with Yersinia pseudotuberculosis and Yersinia enterocolitica in the pathogenesis of chronic inflammatory, rheumatic and collagen diseases. AB - From 50 cases of polyarthritis with febrile onset, 3 were found with serum positive Yersinia pseudotuberculosis (YPT) at a titer higher than 1/100. Reactive polyarthritis with gram-negative germs (YPT) serologic type I, involved in their etiology have been rarely encountered especially in North Europe and in the Far East. Though the 3YPT positive cases mentioned above, presented on admission particularly severe forms of joint inflammation, under therapy with Tetracycline and Phenylbutazone derivatives the articular inflammations were cured without relapses in the 6 months of investigations. PMID- 3534996 TI - [Determining factors of ecologic fallacy and procedures for its control]. PMID- 3534997 TI - [Review of the recent literature apropos of a case of Burkitt's lymphoma in the maxillofacial area]. AB - A case is reported of a child of white race with a maxillofacial localization of Burkitt's lymphoma (BL), and recent published data on epidemiology, clinical and therapeutic aspects, histologic criteria and immunologic properties of this lymphoma reviewed. The association in Africa of BL with the Epstein-Barr virus, and with remarkably constant cytogenetic anomalies suggests the need to recall the oncogenetic hypotheses for this affection. PMID- 3534998 TI - [A review on facial fractures]. AB - It is For Teaching that the authors have done this review of the French and strange Literature about the Facial Fractures. This Study permits to join an important number of cases giving so some weight at this evaluation. However, in reason of the heterogeneity of the origins it has done seem advisable to limit this subject at the basic data. PMID- 3534999 TI - Immunological comparison of renin substrate with erythropoietin. AB - Immunological similarities between human renin substrate and erythropoietin were studied. Purified renin substrate was coupled to erythrocytes, and haemagglutination was demonstrated both with antisera against renin substrate and erythropoietin. Extensive purification of renin substrate was performed on fast protein liquid chromatography (FPLC), and fractions were collected and assayed for renin substrate and erythropoietin. Following FPLC, the major protein peak corresponded to renin substrate, whereas erythropoietin immunoactivity dissociated from this peak. Iodinated renin substrate and erythropoietin containing fractions showed specific binding to both renin substrate and erythropoietin antisera. The results suggest that human erythropoietin or erythropoietin-like material may co-purify with renin substrate, and that preparative procedures like FPLC should be included to obtain pure angiotensinogen preparations. While renin substrate and erythropoietin, judging from the present results and cloned DNA sequences, appear completely unrelated, the possible relationship between renin substrate and other erythropoietic factors remains unsettled. PMID- 3535000 TI - Relationship between changes in GIP concentrations and changes in insulin and C peptide concentrations after guar gum therapy. AB - In order to elucidate the mechanisms of the action of gel-forming fibre in diabetes, we measured insulin, C-peptide and GIP responses to meals during treatment with guar gum and placebo in normal and non-insulin-dependent diabetic (NIDD) subjects. Dietary supplementation with guar gum caused a sustained reduction of the GIP response in normal and diabetic subjects (p less than 0.05), but did not influence insulin responses. On the other hand, guar gum increased the C-peptide response to meals in normal subjects (p less than 0.05) resulting in a 40% decrease of the insulin/C-peptide ratio (p less than 0.01). Assuming that the insulin/C-peptide ratio reflects the hepatic extraction of insulin, this would be compatible with increased hepatic removal of insulin. The change in insulin/C-peptide ratio was positively correlated with the change in GIP response after guar gum (r = 0.75; p less than 0.001) and this correlation was strengthened in normal subjects (r = 0.91; p less than 0.001). Our data thus suggest that guar gum stimulates rather than suppresses insulin secretion. The apparent insulinotropic action of GIP may partly be explained by a reduced hepatic extraction of insulin. PMID- 3535001 TI - The value of serum CK-MB and myoglobin measurements for assessing perioperative myocardial infarction after cardiac surgery. AB - In 41 patients who underwent coronary bypass surgery, creatine kinase (CK)-MB mass concentration was repeatedly measured in serum during and after the intervention using a new two-site immunoenzymetric assay (IEMA). Serum CK-MB activity was determined with the use of four different techniques: immunoinhibition, immunoinhibition-immunoprecipitation, column chromatography and electrophoresis. Myoglobin (Mb) was also measured in each specimen by radioimmunoassay. In the 33 patients who followed a completely uneventful postoperative course, the cumulated CK-MB release was, on the average, 12.2-fold less than after acute myocardial infarction. The CK-MB peak concentrations using the IEMA were 33 +/- 3 micrograms/l (X +/- SEM) and occurred 6.4 +/- 0.5 h after the intervention was started; CK-MB levels had decreased to 2.9 +/- 0.4 micrograms/l at the end of the first postoperative day. The evolution of the CK MB concentration was parallel to that of the enzyme activity. The serum Mb maximum concentrations (518 +/- 39 micrograms/l) were reached after 3.3 +/- 0.1 h. The other eight patients developed perioperative myocardial infarction (PMI); in this group, the cumulated CK-MB release was higher, and the serum CK-MB postoperative curves were of three different types. The patients with delayed CK MB peaks (type I pattern) or sustained elevations (type III) of this isoenzyme also showed increased serum Mb levels at the end of the first postoperative day. The PMI patients with early (10 h) CK-MB elevations (type II) did not demonstrate abnormal serum Mb levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535002 TI - Acute and long-term effect of antihypertensive treatment on exercise-induced albuminuria in incipient diabetic nephropathy. AB - The aim of the study was to clarify whether antihypertensive treatment could affect the systolic blood pressure (SBP) and urinary albumin excretion (UAE) in diabetics during exercise (450 kpm/min, followed by 600 kpm/min, 20 min each). Young male insulin-dependent diabetics with normal UAE (n = 9) and diabetics with incipient nephropathy (n = 7) were examined in an acute study. Five patients with incipient diabetic nephropathy participated in a long-term study. Incipient diabetic nephropathy is defined as persistently elevated UAE (greater than 15 micrograms/min), but no clinical proteinuria. In the acute study, using placebo/metoprolol 10 mg i.v. in patients with normal UAE, the maximal SBP at 600 kpm/min was reduced by 17 mmHg +/- 10 (SD) (2p less than 1.0%) and the maximal SBP at 600 kpm/min in the patients with incipient nephropathy was reduced by 15 mmHg +/- 11 (SD) (2p less than 1.0%). However, no difference was observed in UAE, in patients with normal UAE or those with incipient nephropathy. Five of the patients with incipient nephropathy were followed with repeated exercise tests before and during 2.6 years of antihypertensive treatment, using metoprolol 200 mg/24 h and subsequently also hydroflumethiazid 25 mg/24 h. The maximal SBP at 600 kpm/min at the end of the study compared to the pretreatment level was reduced by 38 mmHg +/- 12 (SD) (2p less than 1.0%), and furthermore the exercise induced elevated UAE was reduced by 61% +/- 29 (SD) (2p = 2.0%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535003 TI - Effects of insulin on the total number of [3H]ouabain binding sites in normal human lymphocytes and after stimulation in vitro with concanavalin A. AB - The effects of insulin in vitro on the total number of [3H]ouabain binding sites were studied in normal and concanavalin A-stimulated human T-lymphocytes after incubation for 18 and 42 h with 0, 10(2) and 10(5) mIU/l of insulin. While no effect on [3H]ouabain binding could be demonstrated in non-stimulated cells, a significant decrease could be produced in concanavalin A-stimulated cells. Mean +/- SD for the total number of [3H]ouabain binding sites per cell after 18 h incubation time with concanavalin A in the absence of insulin was 46,099 +/- 6,620 as compared with 44,783 +/- 8,347 in the presence of 10(2) mIU/l of insulin (non-significant) and 42,406 +/- 7,066 in the presence of 10(5) mIU/l (p = 0.031). The corresponding 42-h values were 47,075 +/- 9,412, 43,761 +/- 9,273 (p = 0.033) and 43,824 +/- 9,312 (p = 0.005). PMID- 3535004 TI - Double-blind crossover study of ranitidine and placebo in gastro-oesophageal reflux disease. AB - The effect of 150 mg ranitidine twice daily was compared with placebo by the double-blind crossover technique (8 weeks twice) in patients with gastro oesophageal reflux (paired comparison in 38 patients). Ranitidine was superior to placebo with regard to effect on symptoms, improvement of oesophagitis as assessed by endoscopy and biopsy, and decrease of oesophageal acid hypersensitivity. The symptomatic response to ranitidine was, however, unsatisfactory in more than half of the cases. When symptomatic responders taking ranitidine (R) were compared with non-responders (NR), there was no difference with regard to the severity of oesophagitis or frequency of positive acid perfusion tests before or after the 8-week treatment. NR were younger and more often had endoscopic signs of incompetence of the cardia and gastric prolapse. Ranitidine is an efficient drug in patients with reflux disease. It cannot be expected that mechanical problems in the hiatal region will be influenced by ranitidine, which is probably why half the patients did not respond. PMID- 3535005 TI - Maintenance treatment with ranitidine compared with fundoplication in gastro oesophageal reflux disease. AB - The study comprises 31 patients with gastro-oesophageal reflux disease who received 8 weeks' treatment with ranitidine. Sixteen of the patients received in addition maintenance treatment with ranitidine (150 mg twice daily) for another 6 months, and fundoplication was performed on 15 patients. There was a significant improvement in endoscopic and histologic findings, a decrease in gastric acid secretion, and a reduction of symptoms during short-term treatment with ranitidine. No further improvement was seen in any of the factors after half a year of ranitidine. After surgery the total reflux time during 24 h decreased to practically zero, all patients had normal endoscopic findings and negative acid perfusion tests, and reflux symptoms had disappeared completely. Anti-reflux surgery was superior to treatment with ranitidine. Reflux oesophagitis is therefore not improved any further by a half year's treatment with ranitidine beyond what is achieved with short-term therapy. PMID- 3535006 TI - Long-term ranitidine in progressive systemic sclerosis (scleroderma) with gastroesophageal reflux. AB - Eighteen patients with progressive systemic sclerosis and symptomatic gastroesophageal reflux were studied for 20 weeks. All patients were initially treated with ranitidine for a 6-week period. From the 7th week the patients were randomized to further treatment with either ranitidine or placebo. Heartburn and dysphagia, the endoscopic appearance of the esophageal mucosa, the esophageal motility, and gastroesophageal reflux were assessed during the study. The efficacy of ranitidine was maintained during the 20-week period. A shift to placebo was recognized by the patients almost immediately and caused heartburn and esophageal mucosal inflammation to increase significantly. PMID- 3535007 TI - Gastric ulcer: a double-blind comparison of 100 mg pirenzepine plus antacid versus 800 mg cimetidine plus antacid. AB - Fifty-five patients with endoscopically confirmed gastric ulcers received either cimetidine (28 patients) or pirenzepine (27 patients) in a randomized double blind manner. Fifty-seven per cent of the patients treated with cimetidine and 48% of those treated with pirenzepine presented with endoscopically healed ulcers after 4 weeks of treatment. By 8 weeks complete healing had occurred in 83% of the patients taking cimetidine and 76% of those taking pirenzepine. These differences were not statistically significant. Severity of pain on entering the study was correlated with slower healing of the ulcer. Side effects occurred in 5 of 27 patients in the pirenzepine group and 3 of 28 in the cimetidine group. They were mostly mild and did not differ from side effects observed in other studies. PMID- 3535008 TI - Ketanserin versus placebo in carcinoid syndrome. A clinical controlled trial. AB - Seven patients, four women and three men, with a median age of 64 years (range, 53-74 years) were randomized to treatment with either ketanserin, 40-160 mg daily, or placebo. The study included 13 treatment periods with ketanserin and 13 with placebo. All patients had typical symptoms, with flushing as their main complaint. The diagnosis had been verified histologically. All had elevated excretion of 5-hydroxy-3-indoleacetic acid in urine. During the trial ketanserin reduced the number of flushing attacks in five patients (p less than 0.05). Diarrhoea was reduced in two patients. No side effects were observed. Ketanserin seems valuable for the symptomatic relief in the carcinoid syndrome. PMID- 3535009 TI - Colicinogeny in chronic inflammatory bowel disease. AB - There are several indirect arguments for a possible role of colicins in chronic inflammatory bowel disease (IBD). Colicinogeny was therefore investigated in 54 patients with ulcerative colitis, 39 patients with Crohn's disease, and 160 clinically healthy controls. No significant difference was found among the examined groups. The leukocyte migration inhibition test (with colicins as antigens) was performed to estimate cellular hypersensitivity to colicins. Migration indices not exceeding the normal range in controls contrasted with abnormal values found in 36% of ulcerative colitis and 80% of Crohn's disease patients. The results are believed to be proof of cellular hypersensitivity of IBD patients to colicins of their own Escherichia coli strains. The importance of this finding must be further clarified. PMID- 3535010 TI - A single-centre study of gastric ulcer healing with 300 mg ranitidine at night versus 150 mg ranitidine twice daily. AB - In a single-centre study 59 patients with gastric ulcer were treated either with 300 mg ranitidine at night or with 150 mg ranitidine twice daily. After 4 and 8 weeks 73% and 97%, respectively, of those treated with 300 mg at night and 59% and 86% of those treated with 150 mg twice daily had complete ulcer healing. These differences between the two groups were not statistically significant. No serious side effects were seen. Ranitidine, 300 mg at night, appears to be at least as effective as the standard 150 mg twice daily regimen in the treatment of gastric ulcer. PMID- 3535011 TI - Treatment of bleeding oesophageal varices. PMID- 3535012 TI - Effect of the prokinetic drug cisapride on gastrointestinal hormone release. AB - The influence of the prokinetic drug cisapride on the release of gastrointestinal hormones was studied in volunteers. First, acute effects of single doses of cisapride compared with saline were investigated. Cisapride at doses of 8 mg and 20 mg intravenously significantly increased plasma concentrations of pancreatic polypeptide (hPP) by 145% and 146%, respectively. Cholecystokinin (CCK) levels were increased by 176% at 8 mg cisapride, whereas gastrin and insulin levels remained unchanged. Enhancement of PP and CCK secretion was almost completely abolished by pretreatment with 1 mg atropine. Carbachol (250 micrograms subcutaneously) increased PP release by 62% but did not affect the other hormones. Second, the influence of a 1-week treatment (10 mg three times daily, given orally) on plasma hormone levels was studied. After 1 week the postprandial CCK release was diminished by 58%. Basal levels and postprandial responses of gastrin, PP, and insulin were not altered by prolonged cisapride administration. It is concluded that acute application of cisapride stimulates secretion of PP and CCK via atropine-sensitive mechanisms and that chronic treatment with cisapride diminishes CCK release by an unknown mechanism. PMID- 3535013 TI - Anti-reticulin antibodies: a diagnostic and monitoring test for childhood coeliac disease. AB - The importance of anti-reticulin antibodies (ARA)--R1 pattern--has been evaluated as a diagnostic and monitoring test for childhood coeliac disease. A prospective study was performed in 140 patients: 68 children with coeliac disease, 32 with miscellaneous diarrhoea, and 40 controls. An indirect immunofluorescent test was used for ARA screening. The indirect correlation found in our study between the presence of ARA and coeliac disease in children on a normal diet and after gluten challenge and between the absence of ARA and coeliac disease in children on a gluten-free diet seems to be of value in the diagnosis of coeliac disease and in monitoring the response to treatment in coeliac disease children. PMID- 3535014 TI - The value of dynamic ultrasound scanning in Crohn's disease. AB - In a prospective, blinded study we investigated 30 patients with Crohn's disease (CD) and 27 normal controls by means of dynamic grey-scale ultrasound scan. Within a few weeks the patients were also examined by radiography of the small bowel. Of the 30 patients, 21 had CD lesion of the small bowel as judged by radiography. A target lesion at the ultrasound scan indicating thickened bowel wall was seen in 15 CD patients, of which 14 showed radiographic signs of CD in the ileum and/or right side of the large bowel, whereas one had normal radiographic findings. Seven patients out of 15 without sonographic changes had radiographic signs of CD. The patients with discrepancy between the two examinations could not be clinically characterized as an entity. None of the 27 normal controls showed signs of intestinal disease at the ultrasound examination. We conclude that dynamic grey-scale ultrasound examination is a new tool in depicting the CD lesion, but it does not seem to be able to replace the radiographic examination. However, it may find a place in the follow-up study of patients with known CD, thereby avoiding repeated radiographic examinations. Furthermore, the possibility of diagnosing abscesses and fistulae by sonography is well known and has relevance in CD. PMID- 3535015 TI - Pathogenesis of peptic ulcer disease and gastritis: importance of aggressive and cytoprotective factors. AB - Acid production is a major gastric function. Second messengers (cyclic AMP and calcium) are released when parietal cell membrane receptors (H2, muscarinic and gastrin) are stimulated. The second messengers then stimulate the 'gastric proton pump' to produce hydrogen ions. New evidence suggests that there is a unidirectional flux of hydrogen ions into the lumen induced by unique physical properties of mucus and a sodium gradient from lumen to serosa. Luminal hydrogen ions, bile salts, ingested drugs, and ingested alcohol are potential gastric epithelial toxins. The stomach's protective mechanism includes a well-defined mucus layer, an epithelial bicarbonate secretion, a tight epithelium, and a good nutrient blood supply. Endogenous prostaglandins partly control these mechanisms. Modern therapeutics are increasingly directed towards improving gastric cytoprotection. PMID- 3535016 TI - Recent experimental and clinical studies on the pharmacology of colloidal bismuth subcitrate. AB - Recent experimental and clinical pharmacological studies on colloidal bismuth subcitrate (CBS) are reviewed. CBS combines with mucus to produce a marked retardation of the movement of hydrogen ions. CBS has potent anti-ulcer and anti erosive action in various experimental models in animals, and is able to stimulate the generation of gastric mucosal prostaglandins. CBS is thought to be a cytoprotective agent. The type of mucosal cell repair in the vicinity of the ulcer is favourably affected in man. CBS also exhibits anti-pepsin and bile acid binding properties. Pyloric campylobacter are inhibited in vitro and in vivo. The recent pharmacological findings are discussed in the light of the clinical efficacy of CBS and new indications. PMID- 3535017 TI - Potential hazards of hypochlorhydria in the treatment of peptic ulcer. AB - The introduction of ulcer-healing drugs that do not induce hypochlorhydria--the main aim of therapy thus far--has led to the consideration of the possible disadvantages of acid secretion inhibition. Potential dangers are that micro organisms destroyed by the normal stomach survive and proliferate in the stomach and small intestine. The incidence of gastric cancer is higher in pernicious anemia and after partial gastrectomy. It has been suggested that the intragastric bacteria may convert dietary nitrate into nitrite that may then be nitrosated to carcinogenic N-nitroso compounds. The third potential hazard is the development of stagnant loop syndrome in patients treated with H2 antagonists. In a double blind randomised trial of colloidal bismuth subcitrate (CBS) versus cimetidine in duodenal ulcer, gastric juice was aspirated for pH measurement. There was a significant increase in the total number of bacteria isolated during cimetidine treatment (P less than 0.01) and an increase in nitrate-reducing organisms (P less than 0.05), but no change in the CBS group. It is concluded that there may be advantages in using ulcer-healing drugs that do not reduce H+ concentration. PMID- 3535018 TI - The role of colloidal bismuth subcitrate in gastric ulcer and gastritis. AB - The pathophysiology of gastric ulcer and gastritis has been related to an increase in damaging factors such as duodeno-gastric reflux and anti-inflammatory drugs. A decreased capacity for mucosal prostaglandin generation is highly likely. Acid secretion is usually normal or even reduced. Colloidal bismuth subcitrate (CBS) has been shown to increase gastric mucosal defence. In controlled trials a clear superiority over placebo has been demonstrated. Amalgamation of the data shows an average healing rate of about 70% in gastric ulcer, which is statistically significantly higher than that for cimetidine in comparative trials. The therapeutic gain (the difference between the healing rate of drug and placebo in a direct comparison) of CBS is high compared with other anti-ulcer agents. In campylobacter gastritis we have shown that the microorganism is very sensitive to CBS, and its eradication results in histological improvement. PMID- 3535019 TI - The role of colloidal bismuth subcitrate in the short-term treatment of duodenal ulcer. AB - Colloidal bismuth subcitrate (CBS) is a drug used in the treatment of duodenal ulcer; it acts mainly by increasing mucosal resistance against endoluminal aggressive agents, without inhibiting gastric secretion. In previous clinical trials, CBS solution induced healing rates significantly higher than placebo and similar to those observed with cimetidine. In spite of these promising results, the drug has never been widely employed, mainly because of its unpleasant taste, which greatly reduced patient compliance. For this reason, chewing tablets have been introduced. CBS tablets have been reported to induce healing rates significantly higher than placebo and similar to those obtained with CBS solution, cimetidine, and ranitidine. CBS may therefore represent an important alternative to antisecretory drugs in the therapy of duodenal ulcer patients. PMID- 3535020 TI - The influence of colloidal bismuth subcitrate on duodenal ulcer relapse. AB - Antisecretory drugs, although able to promote ulcer healing, have been shown to be unable to modify the course of ulcer disease. Relapse rates after short-term cures and after prophylactic long-term therapy are equivalent to those observed during placebo treatment. Conversely, evidence shows that colloidal bismuth subcitrate (CBS)--by means of a mechanism as yet unclear--reduces the risk of ulcer relapse after a short cure for acute disease. This has been shown in several controlled trials and in two studies on duodenal ulcer patients undertaken by our group. Our experience has shown that 12 months after treatment the relapse rate in patients treated with CBS only during the acute phase was: a) equivalent to that observed in patients whose acute ulcers had healed with cimetidine and had thereafter been treated prophylactically with cimetidine 400 mg at night (69% versus 68%), and b) significantly lower than that of patients whose ulcers had healed with ranitidine and who were subsequently placed under medical observation (67% versus 84%; P less than 0.05). It is concluded that CBS is a valid alternative in the prophylactic treatment of duodenal ulcer. PMID- 3535022 TI - Colloidal bismuth subcitrate as coated tablets: four times versus twice daily dosage in duodenal ulcer. AB - Forty patients with endoscopically proven duodenal ulceration have cooperated in a clinical trial to compare the ulcer healing effect of colloidal bismuth subcitrate (CBS) at standard dosage administered either twice or four times a day. No statistically significant difference was found to exist between ulcer healing in the two groups after 4 weeks (70% and 95%, respectively), and it is concluded that twice daily CBS is an effective treatment for duodenal ulcer with clear advantages as regards patient cooperation. PMID- 3535021 TI - An international multi-clinic study comparing the therapeutic efficacy of colloidal bismuth subcitrate coated tablets with chewing tablets in the treatment of duodenal ulceration. AB - The results of a randomized, single-blind, multi-clinic study comparing the therapeutic efficacy and degree of oral staining of new colloidal bismuth subcitrate (CBS) coated tablets over 4 weeks of treatment in patients suffering from duodenal ulceration are reported. The data were collected from 9 clinics in the Netherlands, Belgium, Ireland, the United Kingdom, and Italy. The results from 94 patients treated with CBS coated tablets and 95 patients treated with CBS chewing tablets were statistically evaluated. Healing rates after 4 weeks of therapy appeared to be 76% for CBS coated tablets and 72% for CBS chewing tablets, so no statistically significant difference in therapeutic efficacy was seen. A highly significant degree of discolouration of all parts of the oral cavity was observed in patients treated with CBS chewing tablets, whereas only a few patients treated with CBS coated tablets experienced a slight staining of the tongue. Blood bismuth concentrations during the study had a range of less than or equal to 3 to 33 micrograms/l. The new CBS coated tablet form has an excellent patient compliance as compared to the chewing tablets. PMID- 3535023 TI - Endoscopic ultrasonography. Proceedings of the 4th International Symposium on Endoscopic Ultrasonography. Amsterdam, The Netherlands, 31 October and 1 November 1985. PMID- 3535024 TI - Technique of endoscopic ultrasonography investigation: esophagus, stomach and duodenum. AB - Endoscopic ultrasonography (EUT) allows a better sonographic image of the internal organs. Moreover, it is possible for the first time to explore the upper GI tract wall. To achieve this, three methods are available: 1) direct apposition of the transducer on the mucosa; 2) contact of a small balloon filled with water over the tip of the ultrasonic probe; 3) direct instillation of water. The esophageal wall is explored with the first and second method; the gastric wall is best explored with the third method; the duodenal wall is explored with the second or the third method. Exploration of esophagus and stomach has been achieved in 100% of cases, duodenal exploration in 72% of cases. No complications occurred in this study. PMID- 3535025 TI - Comparison of blind transrectal ultrasonography with endoscopic transrectal ultrasonography in assessing rectal and perirectal diseases. AB - Blind transrectal ultrasonography (BUS) and endoscopic transrectal ultrasonography (EUS) were performed in 10 patients with rectal cancer, in 5 with rectal adenomas, and in 5 with benign perirectal disease. BUS and EUS were equally accurate in staging advanced rectal cancer. EUS was more accurate than BUS in assessing small tumors localized in the mucosa and/or submucosa. Adjacent lymph node abnormality was more clearly visualized with EUS because of the high resolution of this instrument, using a 7.5-MHz ultrasonic beam. In contrast, distant lymph node involvement was more readily seen with BUS because of the penetration depth of this 5-MHz beam. Differentiating rectal adenoma from rectal adenoma with malignancy was easier with EUS than with BUS. Perirectal disease was more accurately visualized with BUS than with EUS. Further studies in a larger number of patients are necessary to document fully the accuracy and limitations of both new diagnostic modalities. PMID- 3535026 TI - Endoscopic ultrasonography of the pancreas. Technical aspects. AB - Endoscopic ultrasonography was mainly developed to improve the diagnostic possibilities in pancreatic diseases. To standardize the technique and to evaluate the diagnostic possibilities of endoscopic ultrasonography, 76 examinations were performed in patients with suspected pancreatic disorders, using two types of ultrasonic device, a sector scanner and a linear array. The pancreatic region was visualized with good resolution, and a definite diagnosis was possible in most patients. Up to now endoscopic sonography has been used specially to supplement upper gastrointestinal tract endoscopy and external ultrasonography. PMID- 3535027 TI - Endosonographic diagnosis of benign pancreatic and biliary lesions. AB - The transduodenal and transgastric route provides good access to the pancreas and to large parts of the biliary tract, and endosonography (ES) creates images of high-detail resolution. Of 87 patients examined, 33 had benign lesions of the pancreas and biliary tract. All of 12 patients with chronic calcifying pancreatitis were correctly diagnosed, and ES in addition displayed minute cysts that were missed with conventional imaging modalities. Two of three apudomas were seen with ES, and seven of eight common bile duct (CBD) stones could be identified. Adenomyosis of the papilla of Vater was missed in all of three cases. Although minor alterations of the gallbladder can be displayed by ES, benign lesions of this organ are at present not indications for ES, whereas changes in the terminal portion of the CBD are rewarding for ES examination. ES proved to be a useful morphological technique in the diagnosis of minor benign alterations of the pancreas and prepapillary stones. PMID- 3535028 TI - Endoscopic ultrasonography of chronic pancreatitis and pancreatic pseudocysts. AB - Endoscopic ultrasonography has been applied to 30 patients with suspected pancreatitis. All were difficult clinical problems which had not been resolved by conventional ultrasonography. CT scanning, and pancreatography. There were 7 technical failures where the instrument could not be advanced through the pylorus. A definite result was produced in 23 patients. In 7 the EUS findings were confirmed by histology obtained at surgery. In 6 a definite diagnosis of mild chronic pancreatitis was made. Previously undescribed morphological features such as peri-ductal fibrosis, branch duct ectasia and lobular inflammation were shown and correlated with the histological appearance. In 10 patients an EUS diagnosis of a normal pancreas has not been challenged after clinical follow up of six months to two years. The high resolution of EUS is capable of showing unique morphological detail in pancreatitis. PMID- 3535029 TI - Endoscopic ultrasonography in the differential diagnosis of pancreatic disease. A preliminary report. AB - Endoscopic ultrasonography was performed in 14 patients with suspected pancreatic disease. Cancer of the pancreas was recognized in 60% of the cases, while chronic pancreatitis was recognized 100% of the time. Technical difficulties limited the success of the examination in 28.5% of cases. The presence or absence of pancreatic disease can be determined in most cases by endoscopic ultrasonography, although we have not as yet discovered any specific finding(s) that reliably differentiate pancreatic cancer from chronic pancreatis. PMID- 3535031 TI - Technical aspects of endoscopic ultrasonography of the biliary system. AB - The technical aspects of endoscopic ultrasonography (EUS) of the biliary tract are described. EUS was performed in 55 patients with biliary tract diseases (20 cases in the gallbladder, 23 in the choledochus, and 12 in the papilla of Vater). For ultrasonographic visualization of the whole biliary tract including the papilla of Vater, entry into the second portion of the duodenum was necessary. At the papilla of Vater, ultrasonographic scanning was started, to obtain images of the papilla of Vater and the intrapancreatic common bile duct. Then we began to withdraw the instrument slowly to the post-bulbar or bulbar region of the duodenum, obtaining ultrasonographic images of the common bile duct and gallbladder. With this scanning, ultrasonograms of the whole biliary tract could be obtained. Detection by EUS in all 11 cases of a small tumor of less than 30 mm in the biliary tract provided valuable information for the precise diagnosis. Thus, EUS has important indications in the detection of small lesions in the papilla of Vater, common bile duct, and gallbladder. PMID- 3535030 TI - Endoscopic ultrasonography in staging local resectability of pancreatic and periampullary malignancy. AB - Endoscopic ultrasonography (EUS) was performed before surgery in 14 patients with pancreatic cancer and in 9 patients with periampullary carcinoma. EUS enabled accurate determination of the extent of the lesions and the presence of suspicious lymph node enlargements. Carcinoma deeply infiltrating into the surrounding structures and major blood vessels was strongly indicative of local non-resectability. In contrast, clearly defined well-circumscribed hypoechoic tumours with no evidence of distant lymph node involvement were compatible with local resectability. The presence of multiple enlarged lymph nodes with irregular echo pattern adjacent to the major blood vessels (hepatic artery, coeliac trunk, aorta) surrounding locally resectable tumours was indicative of the palliative nature of the resection. Technical improvement, in particular the possibility of guided cytological aspiration, may further enhance the diagnostic value of this new imaging technique. PMID- 3535032 TI - Endoscopic ultrasonography in analysing peri-intestinal lymph node abnormality. Preliminary results of studies in vitro and in vivo. AB - Endoscopic ultrasonography (EUS) was performed on fresh postmortem material, intraoperatively in patients with lymph node abnormality, preoperatively (in vivo), and on corresponding resection specimens (in vitro). Well-defined round or ellipsoid structures adjacent to the intestinal wall, manifesting a more hypoechoic pattern than the surrounding tissues, were interpreted as lymph nodes, which was confirmed by histology. Lymph nodes with an inhomogeneous echo pattern, either similar or more hypoechoic than the pattern of the primary lesions and revealing sharply demarcated borders, were interpreted as highly suggestive of malignancy. In contrast, lymph nodes with a homogeneous but more hyperechoic pattern than that of primary lesions with non-sharply delineated (pseudopoid) boundaries were indicative of inflammatory changes. Small micrometastatic lymph nodes were difficult to detect and often missed. Moreover, lymph nodes that could not be brought adequately into the focus of the ultrasonic beam were not clearly identified. Further studies both in vivo and in vitro, particularly preoperatively and intraoperatively, should be performed to enhance our knowledge and accuracy in interpreting lymph node abnormalities. PMID- 3535033 TI - Problems and variations in the interpretation of the ultrasound feature of the normal upper and lower GI tract wall. AB - The aim of this study was to define the various ultrasound appearances of the normal upper and lower GI tract wall and to discuss current interpretations of the relationship between each echographic layer with the real anatomical structures. We studied a total of 70 patients by means of endoscopic ultrasonography and examined in vitro some surgical specimens of the normal stomach, colon and rectum. We found a 'five layer' structure at the level of the esophageal and gastric wall. This pattern was not recognized in the duodenum during the in vivo study. Our experimental results support the hypothesis that the first and fifth hyperechoic layers of the gastric wall are partially generated by ultrasound reflection at the interface liquid/wall and that the second hypoechoic layer corresponds to the deepest part of the mucosa. Important variations in the thickness of each layer were found in different conditions during in vivo studies. The fourth hypoechoic layer becomes very thin after water distension of the stomach. The in vitro investigation of the specimen of normal colon and rectum showed some different features. At this level it is sometimes possible to distinguish a separate very thin hypoechoic layer in the deepest part of the second layer, probably corresponding to the muscularis mucosae. The muscular layer is sharply divided into two distinct layers related to the circular and longitudinal muscular coats. PMID- 3535034 TI - Endoscopic ultrasonography of lymph nodes surrounding the upper GI tract. AB - We investigated the usefulness of endoscopic ultrasonography (EUS) of lymph nodes surrounding the upper GI tract and tried the enhanced EUS by the method of the oral administration of '10% oil-in-water-type emulsion.' The results were as follows: The ultrasonographic visualization rate of lymph nodes surrounding the esophagus was 33.7% in total; however, it was 43.4% for those greater than 5 mm and 58.7% for those greater than 10 mm. The frequency of lymph node metastasis of esophageal cancer was 48.1% for those larger than 10mm with a round shape and 14.3% for the same size with an ellipsoid shape; for those less than 10mm, it was also low. Lymph nodes surrounding the esophagus and the stomach were enhanced by administration of 10% oil-in-water-type emulsion. The visualization rate of lymph nodes can be increased by using this new method. Endoscopic ultrasonography is very useful for the detection of swelling lymph nodes surrounding the upper GI tract before the operation. PMID- 3535035 TI - Endoscopic ultrasonography of normal and pathologic upper gastrointestinal wall structure. Comparison of studies in vivo and in vitro with histology. AB - Endoscopic ultrasonographic analysis of the upper gastrointestinal wall was performed in vivo (preoperatively) and in vitro (resection specimen or postmortem material). The images obtained were correlated with histology. The normal intestinal wall was visualized as a five layer structure. The wall structure was interpreted as abnormal when partial or total destruction of the wall architecture was visualized. A diffuse submucosal hypoechoic structure without penetration into the muscularis propria was indicative of a benign lesion. Diffuse irregular hypoechoic echo pattern penetrating into the muscularis propria, with or without alteration of the mucosal layer, was usually found in linitis plastica. As a rule, early gastric cancer could readily be differentiated from advanced gastric cancer when penetration of the lesion into the muscularis propria appeared to be absent. Follow-up EUS was helpful in the differentiation between a benign and malignant ulcer. Remaining sonographic abnormalities after successful treatment of an ulcer was compatible with malignancy. Further in vivo and vitro studies must be performed to determine the accuracy and limitations with which the ultrasonographic findings are interpreted. PMID- 3535036 TI - Ultrasound and the intestinal wall: experimental methods. AB - High-frequency, high-resolution ultrasound provides a new approach to imaging structures in the wall of the gastrointestinal tract. Questions about internal ultrasound include: is the ultrasound image specific for disease states, in which diseases will this technology add new and useful information not available from existing diagnostic studies, and what are the necessary characteristics for a system to accomplish these diagnoses? Answering these questions requires that precise correlations be made between the ultrasound image and pathology. We have developed a method to image a resected gastrointestinal tissue with ultrasound and to remove and examine the corresponding piece of tissue histologically. Changes in wall thickness, obliteration of layers, and changes in the characteristics of the tissue can be studied. We have shown that ultrasound can resolve the layers of the gut wall. This system should enable us to answer questions about which intestinal wall diseases are suitable for internal ultrasound imaging and characterize the engineering features of an optimal ultrasound system for clinical application. PMID- 3535037 TI - Benign lesions of the upper GI tract by means of endoscopic ultrasonography. AB - In contrast to conventional ultrasound tomography endoscopic ultrasonography (EUS) allows an exact evaluation of the wall of the upper GI tract. The gastric and esophageal walls give a typical five-layer image presumably corresponding to the mucosa (two inner layers), submucosa (middle echogenic layer), muscularis propria (outer echo-poor layer), and serosa (outer echogenic layer). A thickening of the mucosa may be demonstrated in Menetrier's disease. In patients with gastric antrum ulcers there is considerable thickening of the gastric wall, especially of the submucosa and muscularis. Benign gastric and esophageal submucosal tumors are easily localized between the different layers. They are easily distinguished from malignant processes by means of EUS. In patients with polypoid endoscopic aspect due to an impression from outside, a tumor can be easily excluded. PMID- 3535038 TI - Malignant lesions of the upper gastrointestinal tract. AB - For malignant tumours of the upper gastrointestinal tract, endoscopic ultrasonography is used to assess their depth of penetration, infiltration of neighbouring organs, and metastatic spread to regional lymph nodes. Our experience so far in 124 echo-endoscopic examinations shows that the superior resolution of endoscopic ultrasonography makes possible a very accurate assessment of the depth of penetration of the tumour, and of lymphatic spread to the regional lymph nodes in oesophageal carcinoma. An assessment of infiltrative growth and differentiation from early carcinoma remains problematic. PMID- 3535039 TI - Endoscopic ultrasonography in detection and staging of gastric non-Hodgkin lymphoma. Comparison with gastroscopy, barium meal, and computerized tomography scan. AB - Endoscopic ultrasonography (EUS) was performed in 10 patients with gastric non Hodgkin lymphoma (NHL). EUS visualized hypoechoic intramural lesions with destruction of normal gastric wall architecture together with perigastric lymph node involvement. EUS was more accurate than endoscopy, barium meal, and computerized tomography scan in detecting and staging gastric NHL because of the high resolution. The non-resectability could reliably be diagnosed before surgery based on the detection of deep infiltration of the lesion into the surrounding tissues and/or organs EUS appears to be a sensitive diagnostic modality for detecting, staging, and following up after chemotherapy of gastric NHL. Technical improvements allowing ultrasonically guided biopsy or cytological puncture may further enhance its diagnostic usefulness. PMID- 3535040 TI - Endoscopic ultrasonography in the diagnosis of submucosal tumor of the upper digestive tract. AB - The clinical value of endoscopic ultrasonography (EUS) in the diagnosis of submucosal tumors (SMT) in the upper digestive tract was examined. EUS was performed in 83 patients with SMT or submucosal compressions by extracanal organs or lesions. The 50 cases of SMT and 33 cases of extracanal compression could be diagnosed accurately. All SMT were easily detected, even if they were smaller than 5 mm in diameter. EUS visualized in which of the five layers of the digestive tract wall the submucosal tumor was located and depicted the size of the tumor accurately as confirmed by examination of the resected material. Leiomyoma and leiomyosarcoma originating in the mucosal muscle layer and the proper muscle layer were difficult to distinguish by EUS. The submucosal tumors in the submucosal layer, such as cysts, an aberrant pancreas, fibromas, and lipomas could be diagnosed by the analysis of echogenicity and echo-pattern of the tumor ultrasonograms. EUS was considered to be the most useful method among the conventional body imaging techniques to visualize submucosal tumors. PMID- 3535041 TI - A fundamental study of normal layer structure of the gastrointestinal wall visualized by endoscopic ultrasonography. AB - The gastrointestinal wall could be separated into five layers or nine layers by means of the ultrasonic endoscope, and the histological structure of these layers was ascertained by comparing endoscopic ultrasonograms of resected specimens of the gastrointestinal tract with their corresponding histology. The results were as follows: With five layers of the gastrointestinal wall, the first and the second layer corresponded to the mucosa, the third layer was the submucosa, and the fourth layer corresponded to the muscularis propria. The first layer was a border echo demonstrated inside the mucosa. The fifth layer consisted of the serosa and a border echo visualized outside the serosa. When a thin layer was visualized at the same time in both the second and the fourth layers, the gastrointestinal wall was separated into nine layers in total. With nine layers of the gastrointestinal wall, the muscularis mucosae was composed of a thin layer in the second layer and a narrow layer between a thin layer in the second layer and the third layer. A thin layer in the second layer was a border echo visualized inside the muscularis mucosae. A thin layer in the fourth layer of the gastrointestinal wall consisted of a border echo and a connective tissue between the inner circular muscle and the outer longitudinal muscle. PMID- 3535042 TI - Sonoendoscopic evaluation of extraesophageal and extragastric abnormalities: a review. AB - A conventional fiberoptic gastroscope was modified to incorporate a 9-MHz transducer 7 cm from the tip. Conventional fiberoptic gastroscopy could be performed simultaneously with sonoendoscopic evaluation of the esophagus and gastric, extraesophageal, and extragastric areas. The instrument was utilized to evaluate intra- and extra-luminal abnormalities of the mediastinum and upper abdomen. This paper presents our data on extraluminal disease. Small hepatic and pancreatic tumors were identified, occasionally with more accuracy than conventional imaging studies. Additionally, mediastinal tumors, gastrointestinal tumors, and cardiac abnormalities were also clearly demonstrated. PMID- 3535043 TI - Detection of portal hypertension and esophageal varices by means of endoscopic ultrasonography. AB - Endoscopic ultrasonography (EUT) enables not only the visualization of the portal system and of the esophageal varices, as obtained by transabdominal ultrasonography and fiberoptic endoscopy, but also the visualization of intramural and periesophageal collateral veins. Fifteen cirrhotic patients were examined by EUT without complications. When present, esophageal or gastric varices were always detected. In all cases enlarged extrinsic periesophageal veins were visualized, and in 14 of 15 their caliber was correlated with the size of esophageal varices. In three patients examined after sclerotherapy the submucosal veins had disappeared, but extrinsic collateral vessels were patent. EUT will probably become a fundamental technique in the study of portal hypertension and esophageal varices, before and after therapy. PMID- 3535044 TI - The role of endoscopic ultrasonography in assessing local resectability of oesophagogastric malignancies. Accuracy, pitfalls, and predictability. AB - Preoperative EUS was performed in 62 patients with oesophagogastric malignancy. The results were prospectively correlated with surgery and the histology of the resected specimens. Overall, a high degree of accuracy was obtained in EUS staging of the lesion and metastatic lymph node involvement. Clearly demarcated intramural hypoechoic structures with or without regional lymph node involvement indicated local resectability. Involvement of multiple distant lymph nodes predicted the palliative nature of the procedure. Deep infiltration of the tumour into the surrounding tissues and/or organs strongly suggested non-resectability. Differentiation between reactive and metastatic lymph node enlargement was occasionally difficult. Technical improvements enabling guided cytologic puncture may further enhance the diagnostic value of EUS. PMID- 3535045 TI - Transrectal ultrasonography: interpretation of normal intestinal wall structure for the preoperative staging of rectal cancer. AB - An in vitro ultrasonographic study was carried out to four polyethylene membranes of different thicknesses and on four normal surgical specimens from the rectal wall, to assess its various layers and their anatomical structure. Three different techniques were used, and an electronic equipment measured the thickness of the membranes and of the surgical specimens. Polyethylene membranes less than 1000 microns thick gave linear echoes; the 1000-microns-thick membrane gave a three-layer image--two hyperechogenic layers separated by a hypoechogenic one. The rectal wall was separated into the mucosa-submucosa and the muscularis propria-serosa or muscularis propria (in the extraperitoneal rectum); their thickness ranged from 900 to 1000 microns and from 1500 to 8000 microns, respectively. Even though the mucosa-submucosa, the muscularis propria-serosa, and the muscularis propria each gave a three-layer ultrasonographic image (hyper hypo-hyper), the resulting image of the entire rectal wall was of five layers (hyper-hypo-hyper-hypo-hyper). Transrectal scan carried out on 20 control patients confirmed the results obtained in vitro, even though at times it was difficult to detect clearly the fifth layer. Interpretation of the five layers was as follows: the second and fourth corresponded to the mucosa-submucosa and muscularis propria, respectively; the first, third, and fifth were considered to reflect interfaces originating from different acoustic impedance structures. The fourth layer was always thicker than the second one. There was no difference between intra- and extra-peritoneal images. A further study carried out on nine patients with rectal cancer by transrectal ultrasonography proved the reliability of this method in assessing the cancer infiltration of the wall and its importance in the preoperative staging of rectal cancer. PMID- 3535046 TI - Endorectal sonographic prospective staging of rectal cancer. AB - Endorectal sonography was used to evaluate and prospectively stage rectal cancers in 59 patients. All patients were studied without knowledge of findings of other diagnostic studies, including sigmoidoscopic, computed tomographic (CT), and digital rectal examinations. Sonographic interpretation was established blindly and compared with CT and with pathological staging after surgery for the rectal cancer. Results demonstrate that endorectal sonography is more accurate in detecting the site of rectal cancer and in defining perirectal fat infiltration and perirectal lymph node involvement as compared with CT. The experience suggests endorectal sonography is a useful adjunct in the diagnosis and prospective staging of rectal cancer. PMID- 3535047 TI - The use of antibiotic serum levels to predict concentrations in tissues. AB - A review of the literature shows that antibiotic concentrations in tissues and tissue fluids are often quoted as being different in profile to concurrent serum levels. To study the relationship between serum and tissue concentrations we analysed published studies where different experimental models were tested simultaneously. In some models serum levels predicted tissue levels while in others they did not. The factors likely to be responsible for the differences were examined. The most important of these factors was tissue geometry (surface area to volume ratio; SA/V). Serum levels predicted tissue levels in models where the SA/V was high (greater than 60) but not where the SA/V's were low (less than 10); here the antibiotic concentrations were lower and more prolonged than serum levels. These observations can be extrapolated to the clinical situation. In most situations involving prophylaxis or treatment of infections in non-specialised tissues (naturally high SA/V), serum levels will closely reflect levels in extracellular tissue fluid where most bacterial infections are located. PMID- 3535048 TI - Ceftazidime in the treatment of serious Pseudomonas aeruginosa sepsis. AB - 28 patients with serious Pseudomonas aeruginosa sepsis were enrolled into a prospective open study using ceftazidime (CAZ). 10 patients had rapidly fatal underlying pathology, including 5 neutropenic (neutrophils less than 1.0 X 10(9)/l) patients with malignancy. 9 patients including all those with neutropenia also received concomitant therapy with other active antipseudomonal antibiotics (mainly aminoglycosides). All isolates were initially sensitive to CAZ. A favourable response was seen in 18/27 (67%) evaluable cases. Genitourinary infection and osteomyelitis responded well with 100% and 83% favourable responses respectively. Soft tissue and respiratory tract infection responded less well. Results with biliary sepsis were disappointing (all 3 failed therapy). Of the 9 patients failing treatment 5 responded to alternative antibiotics (usually combination therapy of ureidopenicillin plus aminoglycoside). 2 died primarily from underlying pathology and 2 as a direct result of Ps. aeruginosa sepsis. Toxicity was minimal. In the few cases observed other agents and underlying pathology possibly contributed. The most disturbing feature of the study was the emergence of multiple beta-lactam resistance in organisms whilst treated with CAZ. 5 cases occurred, 4 in the infected strain and 1 in a superinfecting strain, occurring in 4 patients within 10 days of starting therapy. 2 cases occurred in patients receiving concomitant aminoglycosides. PMID- 3535049 TI - The combination of pivampicillin and pivmecillinam versus pivampicillin alone in the treatment of acute pyelonephritis. AB - 96 patients with clinical symptoms of acute pyelonephritis were randomized to 2 weeks treatment with either a fixed combination of pivampicillin and pivmecillinam or to pivampicillin alone. If needed, treatment was first started with the respective parenteral equivalents of the drugs. Acute pyelonephritis was bacteriologically verified in 57 patients, in whom Escherichia coli was isolated in 80% of the cases, Klebsiella in 7% and Proteus mirabilis in 5%. 22 of the 39 patients excluded did not have significant bacteriuria (less than 10(8) c.f.u./l). Combination treatment was superior to pivampicillin/ampicillin alone, in terms of clinical effect, with successful treatment being noted in 93% in the combination group and in 53% in the ampicillin group (p = 0.002). The combination was also more effective bacteriologically and it did not select resistant strains in the urinary tract. Ampicillin treatment alone, was, however, associated with a significant increase in urinary strains resistant to ampicillin and to mecillinam. Unsuccessful responders had a significantly higher mean age (p less than 0.01) than successful responders. No serious side-effects were noted. PMID- 3535050 TI - Effect of mecillinam on Escherichia coli growth curves when given alone and associated with ampicillin. AB - The effects on growth curves of strains of Escherichia coli by mecillinam, ampicillin, and combinations of the two antibiotics were investigated using the Abbott-MS-2 system. Maximal increase in optical density in the residual growth phase was found to be concentration dependent for ampicillin and nearly concentration independent for mecillinam. The addition of ampicillin potentiated the effect on mecillinam. However, when mecillinam concentrations were more than 100 times the MIC or when ampicillin was added with a lag time, the growth curves for combinations of mecillinam plus ampicillin showed a mecillinam profile. Killing curves confirmed that the combination of ampicillin and mecillinam acts strongly synergistic and exerts a much faster bactericidal effect. PMID- 3535051 TI - Intrafamilial spreading of Escherichia coli resistant to trimethoprim. AB - Bacterial resistance to trimethoprim has mainly been considered a problem confined to hospitals. The present investigation was undertaken to check for any possible spread of trimethoprim resistance borne by uropathogenic Escherichia coli among families of outpatients. Family members, living in the same household as outpatients with urinary tract infections caused by a trimethoprim-resistant E. coli strain, were asked to deliver faecal specimens. Of a total number of 51 family members 16 were found to be carrying trimethoprim-resistant E. coli in their faecal flora. A comparison of serotypes showed 8 of the 16 family members to have the same E. coli strain in their faeces as originally isolated in the urine of the index patient from the same family. The results indicate that resistance to trimethoprim not only spreads in hospitals with intensive use of antibiotics, but also among the families of trimethoprim-treated outpatients. PMID- 3535052 TI - Evaluation of an Antimicrobial Removal Device (ARD) for detection of septicemia. AB - An Antimicrobial Removal Device (ARD) shown to inactivate 13 commonly used antimicrobial agents was used for processing blood samples before culture and compared with a conventional biphasic blood culture medium. 448 blood samples were processed using the ARD bottle with 472 parallel conventional cultures. The rates of clinically significant positive blood cultures were 6.9% and 8.9% respectively (not statistically significant). This study does not show any increased detection rate in ARD-processed cultures compared with conventional cultures in patients receiving antimicrobial agents. PMID- 3535053 TI - Norfloxacin versus parenteral therapy in the treatment of complicated urinary tract infections and resistant organisms. AB - As part of a multicenter randomized trial of the treatment of complicated urinary infections in hospitalized patients, we treated 35 patients of whom 28 were evaluable (16 patients given parenteral therapy and 12 norfloxacin). The distribution of pathogens was similar in both groups as was the elimination of the organisms (12/12 norfloxacin and 14/16 parenteral therapy). The only complication of norfloxacin therapy was an episode of anxiety in a patient with obstructive lung disease who had experienced anxiety and difficulty with a variety of other medications. The largest difference between the parenteral and norfloxacin treated groups was in the ease of therapy and in cost, which for the former was a total of $5 091, i.e. $318 per patient and $30.1/day, exclusive of administration costs. The parenteral administration costs averaged $45/day. Analogous costs for norfloxacin were estimated at $3.00/day per patient and administration costs for 2 tablets norfloxacin/day were calculated at $7.5. The variety of drugs used in the parenteral arm included a nephrotoxic aminoglycosides in half the cases and a wide variety of beta-lactams as well as vancomycin. Thus, for simplicity of therapy as well as cost norfloxacin was judged superior to parenteral therapy of hospitalized patients with mild or moderately severe urinary tract infections including patients with underlying urinary tract abnormalities and prior to long term foley catheter use. An additional 15 cases were treated in an open trial or on a compassionate use basis. All but one patient, who was noncompliant, responded, including, several with chronic relapsing infections with antibody coated bacteria in the urine. Three such patients who were followed for 3-6 months maintained urine free of bacteria. PMID- 3535054 TI - Norfloxacin in the treatment of bacterial enteric infections. AB - Diarrhoeal diseases are a major cause of illness and death among infants and young children, especially in developing countries. They are also the principal cause of illness in tourists who travel to these countries. Overall, the main causes of diarrhoea are bacterial. Campylobacter, enteropathogenic E. coli, shigella and enterotoxigenic E. coli are, in this order, the most common bacterial enteropathogens isolated in developing countries, and campylobacter and shigella in developed countries. Even though the cornerstone of the treatment of diarrhoea is oral rehydration, especially in children, the better knowledge of the pathogens involved and the mechanisms by which these organisms produce diarrhoea has brought the reconsideration of antibiotic use, which just a few years ago was considered unnecessary except for shigella. The increasing number of shigella and Salmonella typhi resistant to ampicillin and co-trimoxazole and the recognition of campylobacter, an enteropathogen normally resistant to these drugs as a major cause of diarrhoea, makes it necessary to investigate new agents against these three enteropathogens. Antimicrobial susceptibility studies done in Mexico and other parts of the world have shown that norfloxacin, a new quinolone, is very active against multi-resistant S. typhi and shigella and against campylobacter, with MIC values of approximately 0.8 mg/l. Furthermore, it achieves high concentrations in faeces after oral administration. Clinical studies of norfloxacin used in inflammatory diarrhoea and in prophylaxis of traveller's diarrhoea have demonstrated it to be an effective and well-tolerated drug. Norfloxacin has great potential for the treatment of bacterial enteric infections reflected by its broad in vitro activity as well as its effectiveness in initial clinical trials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535055 TI - Infection management during antileukemia treatment-induced granulocytopenia: the role for oral norfloxacin prophylaxis against infections arising from the gastrointestinal tract. AB - Aerobic gram negative bacterial infections occur commonly in patients with acute leukemia undergoing intensive chemotherapy-induced bone marrow aplasia, and often arise from the gastrointestinal (GI) tract. The value of oral prophylactic norfloxacin (400 mg every 12 hours) in preventing bacterial infections was determined for 68 adults with acute leukemia by a prospective, randomized, double blind, placebo-controlled trial. The efficacy of norfloxacin administered prophylactically throughout the course of intensive therapy and deep (less than 100 mm/3), prolonged (median 32 day) granulocytopenia against infections arising from the GI tract was demonstrated by its impact on the clinical manifestations of infection, microbiologically documented gram negative bacterial infections, overall antibiotic management, and GI colonization. Although there was no difference with respect to survival, norfloxacin decreased overall morbidity associated with gram-negative infections, was well tolerated, did not impinge on systemic antibacterial or antitumor therapy, and did not predispose to the development of bacteria resistant either to itself or to multiple other antibiotics. The advantages of norfloxacin relative to other oral agents used for GI prophylaxis and the potential beneficial effects of norfloxacin or overall medical cost are discussed. Oral norfloxacin achieves the goals of GI prophylaxis by effectively suppressing early infection arising from the GI tract and inhibiting GI colonization by multiply resistant pathogens that could give rise to late-onset infections during profound chemotherapy-induced bone marrow aplasia. PMID- 3535056 TI - Principles for targeted antibiotic use in urinary tract and enteric infections: a review with special emphasis on norfloxacin. AB - Urinary tract infections (UTI) and bacterial enteric infections are caused by the aerobic faecal flora. In UTI that flora is spread via the urethra to the urine and in some cases also to the renal parenchyma. Dissemination from urine to blood resulting in septicaemia may occur. Treatment of UTI should be given with antibiotics that cause minimal ecological disturbances in the faecal flora, i.e. emergence of resistance and selection of resistant species which may cause reinfections, should be avoided. If an antibiotic does not cause diarrhoea, poor absorption from the gastrointestinal tract is to be preferred when UTI is treated since it will result in a reduction of the reservoir of bacteria capable of reinfecting the patient post-treatment. In enteric infections, the aetiology is bacterial in about 60% of the cases. Such infections is by far more common in the third world where it is a problem mainly in neonates, infants and children but also for travellers. Antibiotic treatment of diarrhoea with antibiotics like doxycycline, ampicillin or co-trimoxazole may cause rapid selection of resistant faecal Enterobacteriaceae, which in many cases are multiple resistant. This is also the case if antibiotics are used to prevent travellers' diarrhoea. The 4 quinolones offer a new approach to treatment of both UTI and enteric infections. Their wide antibacterial spectrum against aerobes and lack of activity against anaerobes is in this respect optimal. Moreover, some of them, e.g. norfloxacin and ciprofloxacin, are poorly absorbed and will markedly reduce the faecal aerobes without selecting other bacterial species. Norfloxacin has a well proven efficacy in UTI but remains to be proven in enteric infections. PMID- 3535057 TI - World-wide clinical experience with norfloxacin: efficacy and safety. AB - This review covers 2346 norfloxacin treated patients in clinical trials world wide. These studies show that 400 mg of norfloxacin b.i.d. was effective and compared favorably with other standard oral agents in the treatment of urinary tract infections, including complicated and recurrent infections in men. This regimen given b.i.d. or t.i.d. was also effective in the treatment of acute gastroenteritis due to common gastrointestinal pathogens such as enterotoxigenic Escherichia coli, Salmonella spp., Shigella spp., Campylobacter spp. as well as less common organisms. A single 800 mg dose was effective in the treatment of gonorrhoea including patients with extra genito-urinary involvement and penicillinase producing strains of Neisseria gonorrhoeae. Preliminary data from ongoing trials have also shown that norfloxacin is effective in the prophylaxis of traveller's diarrhoea and infections in the granulocytopenic patient. These various regimens of norfloxacin were well tolerated with a low incidence (less than 3%) of drug related adverse experiences. The most common adverse experiences were nausea, headache, dizziness, rash, elevation of liver enzymes and eosinophilia. PMID- 3535058 TI - Quantification of texture match of the skin graft: function and morphology of the stratum corneum. AB - In an attempt to analyze the "texture match" of grafted skin, functional and morphological aspects of the stratum corneum were studied using the Skin Surface Hydrometer (IBS Inc.) and the scanning electron microscope. The results showed that hygroscopicity and water holding capacity of the stratum corneum played a crucial role in making the skin surface soft and smooth. Morphologically there were regional differences in the surface pattern and the mean area of corneocytes, suggesting that these differences affect skin texture. It is suggested that the present functional and morphological studies of the stratum corneum can provide a quantitative measure of the "texture match". PMID- 3535059 TI - The subcutaneous tissue flap and the misconception of fasciocutaneous flaps. AB - The authors report an anatomical study on the vascularisation of the subcutaneous tissue, which is an anatomical entity with a very rich vascular network. This leads to the concept of an original flap and suggests a modification of the concept of the fasciocutaneous flap. PMID- 3535060 TI - Clinical experience and complications with fasciocutaneous flaps. AB - Our experience over the last 5 years with fasciocutaneous flaps in various areas of the body is described. Flap complications and special variations of the fasciocutaneous principle are discussed. Observations on our imperfect knowledge of the blood supply of the skin and deep fascia have been made and relevant experimental work briefly outlined. PMID- 3535061 TI - Defibrinogating therapy for peripheral circulatory disturbance in patients with vibration syndrome. AB - This study examines the effects of batroxobin (a defibrinogating drug) on the peripheral circulatory disturbance of 118 patients with vibration syndrome. In 53 cases, batroxobin was intravenously administered once a day for three successive days in the order of 20, 10, and 5 batroxobin units (BU), and 5 or 10 BU were supplemented every day or every second day, respectively, for four weeks. In these cases, the blood fibrinogen and viscosity decreased. A significant decrement in the vascular resistance of the fingers also occurred after each administration. The other 65 cases were subjected to an intravenous administration of 20 BU initially and an additional 10 BU every 2 d for four weeks. For all of the 118 cases the results of skin temperature measurement, finger plethysmography, and nail compression in conjunction with cold provocation showed statistically significant improvement after the therapy. The transcutaneous partial pressure of oxygen and finger blood flow measured in 22 and 27 cases, respectively, were also significantly improved. A sensation of warmth in the whole body appeared in 70.3% of the 118 cases after the therapy. The results suggest that defibrinogation by batroxobin is useful for improving the peripheral circulatory disturbance of the vibration syndrome. PMID- 3535062 TI - Transmission of hand-arm vibration to the head. AB - A "tooth impression" was devised to measure head vibration. The vertical head vibration of four subjects was measured with the tooth impression during exposure of the hand to vertical sinusoidal vibration at acceleration levels of 3.15, 10.0, and 31.5 m/s2 root mean square in the range of 8-200 Hz. While in a standing position, the subjects pulled the vibrating handle upward at a force of 5 kg with the elbow joint stretched during the tests. The measurement was repeated twice. The difference between the two measurements was within 3 dB, a level which suggests that this method has good reproducibility. The vibration transmitted to the head was the greatest in the range of 12.5-16 Hz, and the attenuation was about 20 dB. Head vibration decreased by approximately 15 dB per octave at frequencies above 20 Hz as the frequency increased. When the excitation level was increased by 10 dB, the head vibration increased by about 8 dB. PMID- 3535063 TI - [Gastroesophageal reflux and asthma]. AB - Gastro-oesophageal reflux (GOR) occurs with increased frequency in asthmatics. GOR may cause pulmonary symptoms either by reflux of gastric contents into the trachea or by a reflex mechanism. Several studies have shown that the presence of acid in the oesophagus may induce slight bronchospasm. However, more recent studies have clearly demonstrated that acidification of the oesophagus may exacerbate the bronchial hyperreactivity characteristic of the asthmatic patient, thus rendering the patient more susceptible to bronchoconstriction by other stimuli. As some drugs used in the treatment of asthma decrease lower oesophageal sphincter pressure and thereby enhance GOR, a vicious circle may arise. As surgical and medical anti-reflux therapy has been shown to be effective in diminishing asthmatic symptoms in the asthmatic patient with proven GOR, 24-hour ambulatory oesophageal pH monitoring is recommended in order to detect such patients and give them a trial with an H2 receptor antagonist. PMID- 3535064 TI - [Initial experiences with bonded bridges and splints--a retrospective cross sectional study. 2. The risk factors and therapeutic concept]. PMID- 3535065 TI - [Reconstruction of large oral cavity defects using a microvascular anastomosed forearm flap]. PMID- 3535066 TI - NIH begins year-long 100th birthday party. PMID- 3535067 TI - Differentiation-linked leukemogenesis in lymphocytes. AB - Most human lymphoid malignancies preserve a pattern of gene expression reflecting their proliferative activity and the development level of clonal expansion and maturation arrest. Characteristics of leukemia and other cancer cells frequently considered to reflect aberrant differentiation may more often reflect clonal selection of cell types that are normally infrequent and transitory. The differentiation status of progenitor or mature lymphoid cells influences which genetic elements are at risk of being exploited, via mutation, recombination, or deletion, for clonal advantage. These alterations may frequently arise spontaneously as a consequence of the unique developmental and functional programs of lymphoid cells and have as a major phenotypic consequence the stabilization of transitory cellular phenotypes. PMID- 3535068 TI - An alternative pathway for meiotic chromosome segregation in yeast. AB - In meiosis I of most organisms, homologous chromosomes pair, recombine, and then segregate to opposite poles of the cell. Crossing-over is normally necessary to ensure the proper segregation of the homologs. Recently developed techniques have made it possible to study meiosis with highly defined artificial chromosomes. These techniques were used to demonstrate the existence of a system capable of segregating pairs of nonrecombined artificial chromosomes, regardless of the extent of their sequence homology. This system may contribute to the high fidelity of meiosis by mediating the segregation of pairs of natural chromosomes that have failed to recombine. PMID- 3535069 TI - Drug-resistant Salmonella in the United States: an epidemiologic perspective. AB - Salmonellosis poses a health problem of large proportions in the United States. Annually, it accounts for more than 40,000 reported cases, 500 deaths, and financial costs well in excess of $50 million. Antimicrobial resistance is increasing in Salmonella strains, a finding that has important public health implications. Although the chain of transmission of the bacteria is often complex, combined epidemiologic and laboratory studies with the use of new methods in molecular biology make it possible to trace antimicrobial-resistant salmonellae to their primary source--foods of animal origin. These studies suggest that the antimicrobial drugs to which food animals are exposed provide selective pressure that leads to the appearance and persistence of resistant strains. PMID- 3535070 TI - Leishmaniasis and malaria: new tools for epidemiologic analysis. AB - Parasitic diseases are still prevalent in many parts of the world, causing both human suffering and economic loss. Recent developments in biotechnology, such as the use of monoclonal antibodies and recombinant DNA, have the potential for providing both more extensive and detailed information on the parasite in the infected human and in insect vectors. New methods of detection, both in man and insect vectors, have been developed for two parasitic diseases, leishmaniasis and malaria. These new methodologies will be important in epidemiologic studies on the prevalence and transmission of these parasitic diseases. PMID- 3535071 TI - Retraction of data. PMID- 3535072 TI - Harvard researchers retract data in immunology paper. PMID- 3535073 TI - Reversible interconversion of two forms of a valyl-tRNA synthetase-containing protein complex. AB - When an enzyme-containing complex from yeast was incubated in a buffered solution at room temperature, the valyl-transfer RNA synthetase activity and total protein oscillated synchronously between two physical states. This observation suggests a regulatory process that controls a number of enzymes as a group, an integrated function of a kind not heretofore recognized. The two forms of the complex were separated by ammonium sulfate precipitation of one of them in samples withdrawn from the incubated solution every 30 seconds. Glutathione and dithiothreitol in high concentrations (50 mM) enhance formation of the 50% saturated ammonium sulfate-soluble form. Oxidized glutathione, diphosphopyridine nucleotide, triphosphopyridine nucleotide, and a mercurial thiol binding agent in moderate concentrations (0.1 to 1.0 mM) shift the distribution toward the precipitable form. It is suggested that the two forms represent functional and nonfunctional complex-bound enzymes which are interconverted in response to oxidoreductive signals. PMID- 3535075 TI - Cellular events mediated by thrombin and related proteinases: Part One. PMID- 3535076 TI - Thrombin-induced endothelial injury. PMID- 3535074 TI - Expression of bovine 17 alpha-hydroxylase cytochrome P-450 cDNA in nonsteroidogenic (COS 1) cells. AB - Cortisol production requires the activity of only 17 alpha-hydroxylase, whereas the formation of sex steroids requires both 17 alpha-hydroxylase and 17,20-lyase activities. Studies in reconstituted enzyme systems have suggested that a single steroid hydroxylase, 17 alpha-hydroxylase cytochrome P-450 (P-450(17) alpha), catalyzes both activities. By expression of bovine adrenocortical P-450(17 alpha) in COS 1 (transformed monkey kidney) cells, which normally contain no detectable P-450(17) alpha, it has now been established in situ that a single polypeptide chain does catalyze both the 17 alpha-hydroxylase and the 17,20-lyase reactions. This heterologous system supports 17 alpha-hydroxylation of pregnenolone and progesterone with equal efficiency, but catalyzes about five times as much 17,20 lyase activity when 17 alpha-hydroxypregnenolone is the substrate than when 17 alpha-hydroxyprogesterone is the substrate. For these activities to be observed in COS 1 cells, newly synthesized apocytochrome P-450(17) alpha must bind heme and insert into the endoplasmic reticulum such that endogenous cytochrome P-450 reductase can support hydroxylation. Thus, COS 1 cells are a useful system for expression and study of various forms of cytochrome P-450. PMID- 3535077 TI - Thrombin active-site regions. AB - Knowledge is being gained about topographic features of alpha-thrombin and how they may define thrombin specificity and biologic functions. Thrombin is not just an enzyme with moderately restricted proteolytic capabilities, yet with extraordinarily high specificities for certain bonds (such as the A alpha cleavage site in fibrinogen), but also is a protein with hormonelike activities involving cell receptor interactions. Such activities do not require the catalytically active enzyme, but are blocked by hirudin (also antithrombin III). These appear to involve an unique insertion and subsequent peptide segment at an exon junction. On the other hand, the enzymic functions of thrombin depend on the catalytic site, per se, and derive specificity from the adjacent apolar-binding site within the fibrinopeptide side and the independent anionic-binding site within the fibrin side of the active groove. PMID- 3535078 TI - Metabolism of antithrombin III-protease complexes by various cells in culture. PMID- 3535079 TI - Thrombin and trypsin activate phospholipase C in human platelets via a proteolytic-mediated pathway. PMID- 3535080 TI - [Sonography of the shoulder in rotator cuff defects. Technic and clinical value]. PMID- 3535081 TI - [Modified capsule-graft-plasty in the therapy of habitual shoulder dislocation]. PMID- 3535082 TI - Chromosome translocations in B and T cell neoplasias. PMID- 3535083 TI - Myelodysplastic syndromes (preleukemia). PMID- 3535084 TI - Cell kinetics of leukemia. PMID- 3535085 TI - Necroinflammatory liver diseases. PMID- 3535086 TI - Cytoskeleton in liver diseases. PMID- 3535087 TI - Collagen formation and cirrhosis. PMID- 3535088 TI - Current problems in diagnosis of biliary disease and cholestasis. PMID- 3535089 TI - Hepatic morphology in the inherited metabolic diseases. PMID- 3535090 TI - Shwartzman reaction as a pathogenetic mechanism in fulminant hepatitis. PMID- 3535091 TI - [Cytoprotective effect of prostaglandin E2 on pancreatic islet beta-cells of alloxan-induced diabetic rats]. PMID- 3535092 TI - Reproductive success and occupational class in eighteenth-century Lancashire, England. PMID- 3535093 TI - [Preventive study of acyclovir in herpes infections in bone marrow grafts]. PMID- 3535094 TI - [Bone marrow transplantation]. PMID- 3535095 TI - [Reflections on therapeutic studies in hemato-cancerology]. PMID- 3535096 TI - [Allogeneic bone marrow transplantations. Prevention of infectious complications]. PMID- 3535097 TI - [Psychological problems in the period after bone marrow transplantation]. PMID- 3535098 TI - [Bone marrow autograft. 2 cases]. PMID- 3535099 TI - Pocket computer for real-time ultrasound. AB - Real-time ultrasound has proved to be of value in fetal age determination, but calculation and interpretation of multiple parameters is time consuming and tedious. We present a program for use with the TRS 80 PC-2 or Sharp 1500 pocket computer and printer to provide rapid results of obstetric ultrasound studies. We also present a sample report. Using the pocket computer, we can have a complete, printed report before the patient leaves the testing area. The program has served us well, though it could be shortened, updated, and improved. The total cost of the computer, an additional 8K random access memory, and the printer is approximately $300. The cost of printer paper and pens is nominal. We believe the system has paid for itself many times over in time saved. PMID- 3535100 TI - Pharmacologic reduction of the risk of aspiration. AB - Parameters for significant risk of aspiration have been defined as a gastric pH less than 2.5 and/or a volume greater than 25 ml. We investigated the effects of metoclopramide and cimetidine, alone and in combination, on the pH and volume of gastric contents of patients taking nothing by mouth before general anesthesia. We divided 40 young women having gynecologic surgery into four groups: control subjects (group 1), those given metoclopramide (group 2), those given cimetidine (group 3), and those given both drugs (group 4). Injections were given 45 to 90 minutes before induction of general anesthesia, and no other premedicant was allowed. When the mean pH and volume of gastric contents were measured, the patients given both drugs had a mean pH of 6.9 and a mean volume of 2.0 ml. The control group showed significant risk for aspiration in terms of both volume and pH. Use of metoclopramide alone reduced the risk related to volume, and cimetidine alone reduced the risk related to pH. The most striking effects were achieved by the combination of the two agents, which produced a relatively narrow range of "safe" pH and volume. PMID- 3535101 TI - Pulmonary tuberculosis: contributions of radiology in diagnosis and treatment. AB - This review records the important place that radiologic examinations have had in the diagnosis and treatment of pulmonary tuberculosis in the past nine decades. Very soon after the discovery of x-rays it became apparent that chest roentgenograms would be a help in identifying pulmonary lesions. As the quality of the examinations improved, the benefits became significantly better. Earlier lesions were diagnosed. Follow-up studies after medical or surgical treatment were increasingly helpful. Newly developed techniques allowed demonstration of extrapulmonary complications. Radiologic monitoring of collapse therapy played a critical role in the successes achieved. Even after the medical conquest of active tuberculous lesions by drug therapy, identification of new lesions and follow-up of treated patients remains a significant role for radiology. Control of this once fatal and widely feared disease depends on continued early recognition and appropriate treatment. PMID- 3535103 TI - [Lenin's ideas on the social insurance of workers]. PMID- 3535104 TI - [International health exhibition of 1911 in Dresden and its role in the development of medical museum-exhibition matters]. PMID- 3535102 TI - Gastric epithelioid leiomyoma causing intraperitoneal hemorrhage. AB - We have presented a rare and interesting case of intraperitoneal hemorrhage due to an epithelioid leiomyoma, the second such case in the literature. Epithelioid leiomyomas are usually clinically insignificant. When hemorrhage occurs, it is usually intraluminal and rarely intraperitoneal. Ultrasonography, upper gastrointestinal series, and computerized tomography are important tools in the diagnosis of complicated gastric tumors. Wedge resection is generally recommended, but subtotal gastrectomy should be considered if malignancy is suspected. PMID- 3535105 TI - [Tasks of the history of medicine]. PMID- 3535106 TI - [Treatment of combined injuries to the flexor tendons and nerves in the distal portion of the fingers]. PMID- 3535107 TI - [Relaparotomy in diabetics]. PMID- 3535108 TI - [Automated diagnostic systems in medicine]. PMID- 3535110 TI - [Hydramnios]. PMID- 3535109 TI - [Diagnosis of acute destructive pancreatitis]. PMID- 3535111 TI - [The proteolytic activity of gastric juices in rats in induced hypergastrinemia and truncal vagotomy]. PMID- 3535112 TI - [Determination of the functional maturity of the fetal lung on the basis of its echogenicity]. PMID- 3535114 TI - Festschrift. Professor James Gear. PMID- 3535113 TI - [Historical development of exodontia (2)]. PMID- 3535115 TI - HTLV-III infection in the RSA. PMID- 3535116 TI - Recent ideas on the causation of auto-immune disease. PMID- 3535117 TI - Haemorrhagic phenomena in tropical diseases. PMID- 3535118 TI - The eradication of infectious diseases. PMID- 3535119 TI - Plague and cholera surveillance in southern Africa. PMID- 3535120 TI - Untreated pneumococcal bacteraemia of cryptic origin in the human adult with spontaneous recovery. PMID- 3535121 TI - Bacterial enteritis of infancy and childhood in Soweto. PMID- 3535122 TI - The rubella story, 1881-1985. PMID- 3535123 TI - The control of malaria with special reference to the contributions made by the staff of the South African Institute for Medical Research. PMID- 3535124 TI - The history of virology in South Africa. PMID- 3535125 TI - The Institute for Biomedical Communication of the South African Medical Research Council. AB - The need exists in the biomedical community for comprehensive, timely and easily obtainable information. The Institute for Biomedical Communication of the South African Medical Research Council meets this need. An overview of the activities of the institute is presented. Other services, such as the provision of documents, editing of manuscripts, and the evaluation of new information technologies, are also described. PMID- 3535126 TI - Grey Hospital, King William's Town. Its formative years. AB - Sir George Grey, Cape Governor and High Commissioner of British Kaffraria from 1854 to 1861, was the moving force behind the creation of proper hospital facilities in King William's Town for the Xhosa population of Ciskei and further afield. Grey's first step was to appoint Dr J. P. FitzGerald as Superintendent of Native Hospitals. FitzGerald opened the forerunner of Grey Hospital on 28 April 1956 in 18 cottages in the Pensioners' Village in King William's Town. During this phase the Superintendent played a major role in relieving the suffering during the cattle-killing mania in which an estimated 50,000 Xhosa eventually perished. He and Grey were also largely responsible for the erection of the Native Hospital which was designed by Woodford Pilkington. This imposing building cost over 16,000 pounds and was opened on 14 June 1859. As a fitting tribute to Sir George Grey the building was officially named Grey Hospital in 1887. This declared monument is today the oldest and best known institution in King William's Town and is still in use as a hospital. PMID- 3535127 TI - Comparison of cefixime and co-trimoxazole in acute uncomplicated urinary tract infection. A double-blind general practice study. AB - Five hundred and twenty-eight patients with presumptive acute uncomplicated urinary tract infection (UTI) were randomly assigned to receive cefixime 400 mg once daily, cefixime 200 mg twice daily or co-trimoxazole 2 tablets twice a day for 10 days; 477 completed at least 5 days of therapy. Of the patients 342 (65%) had positive baseline urine cultures, yielding 353 pathogens. A microbiological response was determined for 280 pathogens (79%), eradication being observed in over 94% of isolates; 153 pathogens (43%) were sensitive to both cefixime and co trimoxazole and eradication was observed in over 96% of cases. Clinical response correlated well with microbiological response. The incidence of diarrhoea and stool changes was higher (P less than 0.005) in the patients who received cefixime once daily than in the other groups. There was a significantly higher incidence of stool changes with cefixime twice daily than with co-trimoxazole (P less than 0.05), but these did not necessitate discontinuation of therapy. Nausea was commoner with co-trimoxazole (P less than 0.05). The majority of pathogens isolated were Escherichia coli, Proteus mirabilis and staphylococci. Approximately 24% of E. coli were resistant in vitro to co-trimoxazole (P less than 0.005). Cefixime 200 mg twice daily is an effective and safe alternative to co-trimoxazole in the management of acute uncomplicated UTI. PMID- 3535128 TI - Relationship between coronary-prone (type A) behaviour and other coronary risk factors in the coloured population of the Cape Peninsula. AB - In this investigation, conducted among 976 adult coloureds living in the Cape Peninsula, emphasis was placed on the relationship between type A (coronary prone) behaviour and a number of other coronary risk factors (hypertension, hypercholesterolaemia, overweight and cigarette smoking), as well as certain demographic variables (age, occupational group and level of education). There was a fairly even distribution between high and low type A behaviour scores for both sexes in the groups aged 15 - 54 years, whereas there were proportionally fewer high than low scores in people between 55 and 64 years old. Housewives generally had lower scores than working women and other women who were not economically active. Both male and female respondents with high type A scores recorded on average higher systolic blood pressure readings. Type A men also smoked more than others. It appears that type A behaviour is mainly independent of other coronary risk factors. PMID- 3535129 TI - President Kruger's eye disorder. PMID- 3535130 TI - Placental grading by ultrasonography as an index of fetal maturity. Its application to the problem of elective caesarean section. AB - Ultrasonographic placental grading for estimation of fetal maturity before elective caesarean section was assessed at 38 weeks' gestation in 100 patients. It was impossible to grade the placenta in 5 cases, but in 95 it could be graded with confidence. In 90 cases the placenta was graded as II or III, and all the infants in these two groups had achieved lung maturity. Five patients had grade I placentas, and one of these patients had an immature baby. Amniocentesis for determination of the lecithin/sphingomyelin ratio and the presence of phosphatidyl glycerol was attempted in all cases. We failed to obtain liquor amnii from 6 of the 100 patients. PMID- 3535131 TI - Epithelial ovarian tumours of low malignant potential. AB - The available literature and the management of epithelial tumours of low malignant potential (LMP) is reviewed. The criteria for a diagnosis of LMP at the University of the Witwatersrand are delineated in detail. Based on the records in the Ovarian Tumour Registry of this University, experience with 29 such tumours over 4 years is presented. Of these, 14 (48.3%) were of the serous variety, 12 were mucinous (41.4%), and 2 (6.9%) were mucinous-serous, the remaining 1 (3.4%) being endometrioid. LMP tumours accounted for 12.9% of proliferating epithelial ovarian tumours in black patients compared with 16.9% in white patients. Pelviperitoneal cytological washings for detection of malignant cells in patients with LMP tumours is mandatory. PMID- 3535132 TI - Vitamin D and mineral metabolism in normal pregnancy and in the normal fetus. AB - Metabolic bone diseases in neonates are being recognized with increasing frequency but, despite extensive research, the pathophysiology of neonatal osteopenia remains unclear. This review briefly summarizes vitamin D and mineral metabolism in the normal non-pregnant human adult, and then addresses the adaptations that occur during pregnancy and fetal life. PMID- 3535133 TI - New criteria for placement of a prophylactic vena cava filter. AB - In order to identify patients who, having had an initial pulmonary embolism, are likely to develop recurrent emboli despite adequate anticoagulation therapy, ten patients (group 1) with documented recurrent pulmonary embolism during anticoagulation therapy were compared with 31 patients (group 2) who showed no evidence of recurrent emboli during the treatment period. Risk factors for thromboembolic disease were similar between the two groups. Noninvasive venous studies of the lower extremities, including Doppler venous ultrasound and phleborheography (PRG), were performed upon all patients after the initial embolic event. Of the ten patients in group 1, seven (70 per cent) had clinical signs of deep vein thrombosis (DVT). Doppler studies were positive for eight of the nine patients studied, and PRG studies were positive for eight of eight patients tested. In contrast, of the 31 patients who responded well to medical therapy, one patient (3 per cent) had clinical signs of DVT, three patients (10 per cent) had positive Doppler studies and one patient (3 per cent) had a positive PRG. Combined Doppler and PRG studies were positive in 100 per cent of the patients in group 1 but in only 6 per cent of the patients in group 2 (p less than 0.001). The results of this study suggest that patients having an initial pulmonary embolism and DVT of sufficient extent detected by noninvasive studies may be at an increased risk for recurrent PE despite anticoagulation therapy. Insertion of a vena cava filter should be considered in these patients prior to the second embolic event. PMID- 3535134 TI - A comparison of piperacillin, cephalothin and cefoxitin in the prevention of postoperative infections in patients undergoing vaginal hysterectomy. AB - A randomized, double-blind, multicenter trial was initiated to compare the safety and efficacy of piperacillin, cephalothin and cefoxitin in the prophylactic treatment of patients undergoing vaginal hysterectomy. The total dose of each antibiotic was 6 grams given in three equally divided doses. A satisfactory prophylactic response was obtained in 143 of 151 (95 per cent) patients treated with piperacillin, in 82 of 87 (94 per cent) patients treated with cephalothin and in 57 of 60 (95 per cent) patients treated with cefoxitin. The pooled data indicated that the piperacillin treatment group did not differ from the combined cephalosporin treatment groups with respect to prophylactic response, presence of febrile morbidity, fever index, duration of postoperative hospitalization and incidence of reported adverse experiences. PMID- 3535135 TI - A prospective randomized study of continuous peritoneal lavage postoperatively in the treatment of purulent peritonitis. AB - Peritoneal lavage performed postoperatively in the treatment of purulent peritonitis was evaluated in a prospective randomized study. Patients with free purulent peritonitis due to perforated appendicitis or colonic perforation were treated with intravenous infusion of cefuroxime and metronidazole. The patients were randomly allocated to treatment with or without continuous postoperative peritoneal lavage. The patients were kept under observation for postoperative septic intra-abdominal complications. Of the 79 patients, 41 were treated with lavage postoperatively and 38 were not. No postoperative abscess or other septic intra-abdominal complication was found in any patient. In ten, the postoperative lavage was interrupted because of technical complications or complaints of discomfort by the patient. In this study, no clinical benefit of continuous peritoneal lavage postoperatively in the treatment of purulent peritonitis was noted. Lavage done postoperatively is expensive and seems to carry a risk of complications. Thorough rinsing of the infected abdominal cavity perioperatively and adequate antibiotic treatment, including an antianaerobic agent, seem to be effective in preventing intra-abdominal septic complications. PMID- 3535136 TI - Influence of the conjoint administration of insulin and glucagon upon hepatic regeneration. AB - In noneviscerated rats, the influence of the conjoint administration of insulin and glucagon in the regenerative response triggered by 70 per cent hepatectomy using the incorporation of tritiated thymidine by nuclear deoxyribonucleic acid as a parameter has been demonstrated. The response was earlier and more intense in relation to animals not hormonally stimulated and stimulated only with glucagon (previously reported by us). Such a response has been comparatively greater both in the nonparenchymal cells and in the hepatocytes, especially in the latter, which are the main cause of the early peak of thymidine incorporation in the periportal zones indicating a greater regenerative activity than in the intermediate and centrolobular zones. In our opinion, this indicates the importance of certain extrahepatic humoral agents in the manifestation of the regenerative process. Therefore, the results of our study ascertain the determining role and synergistic action of the pancreatic hormones--insulin and glucagon--in hepatic regeneration. PMID- 3535137 TI - The biomechanical effects of tight suture closure upon fascia. AB - The biomechanical effect of tight suture closure of fascial incisions in male rats was evaluated. The incision of rats in group 1 was closed with maximum tension on the first throw of the approximating knot. The incision of rats in group 2 was closed in a similar manner, however a 3.14 squared millimeter rod was placed in the suture loop before securing the first throw. The rod was removed after the knot was formed and fascial edges were observed to be loosely approximated. All rats were sacrificed after seven days. The abdominal fascial and muscle unit was dissected and a 1 by 6 centimeter strip containing two suture loops was excised. Scanning electron microscopic examination of tissue specimens, tensile strength measurements and energy-to-failure under tensile loading studies were performed. Specimens for hydroxyproline assay were obtained from the tissue immediately surrounding the incision and between two suture loops. The scanning electron microphotographs of group 1 showed tissue overlap from the excessive force on the initial knot throws. Wounds loosely approximated had proper alignment of the wound edges and had greater proliferative activity in the clefts of the wounds. The tensile strength and energy-to-failure studies showed loosely approximated wounds to be far stronger (p less than 0.001). No statistically significant difference (p greater than 0.05) was found between hydroxyproline assays of the two groups. PMID- 3535138 TI - A new technique to assist in the closure of the abdominal wound--the weave. PMID- 3535139 TI - A simple technique for improving the cosmesis of excision of a melanoma and skin grafting. AB - A simple technique is described to reduce the size of the skin defect resulting from excision of a malignant melanoma. An added advantage of this technique is the smoother contour at the native skin to skin graft junction. These effects are achieved by apposing the skin edge to the muscle using a simple pursestring suture technique which simultaneously draws the wound edges centrally. The resultant smaller area to be grafted, smaller donor site, better graft survival and superior cosmesis represent an improvement over conventional skin grafting techniques. PMID- 3535140 TI - H.J.M. Barnett. PMID- 3535141 TI - [Individuality of malignant neoplasms]. AB - The article concerns the implication of the tumor cell heterogeneity, which is caused by the genetic instability of tumor cells. Thereby, within a given tumor, subpopulations with differing marker profiles may appear in a very irregular fashion. For instance, some populations may show criteria which under normal circumstances are mutually exclusive. In so far, the tumor cell heterogeneity can be viewed as responsible for the fact that tumor classifications are never scientific classifications which are defined by reliable and stable criteria. Furthermore, the tumor cell heterogeneity must be born in mind when malignant tumors are graded. Grading provides usually only statistical results which must not necessarily be valid for the individual case. It is concluded that malignant neoplasias should be considered much more individually if we were to take their biologic behaviour properly into account. This, however, bears considerable difficulties, especially with respect to diagnostic and therapeutic conclusions. PMID- 3535142 TI - Evidence for and against a tumor type-specific vascularity. AB - Although there are some implications from experimental rodent tumors that the vascular morphology may be characteristic, but not unique for a special tumor, there is clear evidence that in general the histological type of a tumor and the degree of differentiation can only modulate, but not dictate the vascular pattern. Problems arising when trying to identify a certain tumor on the basis of its vascularity or vice versa are aggravated by considerable intra-tumor inhomogeneities of both vascular structure and function of the vascular bed. The same holds true for an individual tumor at different sizes. As a consequence, it is impossible to draw conclusions concerning the tumor vascularity from a known tumor histology. PMID- 3535143 TI - [Tumor vascularity: its possible prognostic and therapeutic value]. AB - Three studies have been conducted in order to find out a correlation between the degree of tumor vascularization and local recurrences or the survival of patients after radiotherapy. The results have been reviewed. They show a better effect of radiotherapy in tumors with dense capillary vascularization than in tumors with poor vascularization. The prognostic value of tumor vascularization is discussed with regard to the individualization of radiotherapy, considering especially the clinical application of sensitizing substances for hypoxic cells. The conclusion is drawn that, in order to obtain another valuable diagnostic parameter, an index of vascularization should be routinely defined when establishing the histopathologic features. PMID- 3535144 TI - [Trial of systemic postoperative irradiation of breast cancer]. AB - Most of all women submitted to radical operation for a loco-regionally advanced mammary carcinoma show a fateful latent formation of remote metastases necessitating a total body treatment. In a pilot study twenty patients underwent instead of adjuvant chemotherapy an irradiation of both the upper and lower body part administered in two sessions with a dose of 8 Gy to the lung and the median body line, respectively, in order to reduce or to destroy micrometastases. The irradiations were given in one day at intervals of three to four weeks. They were well tolerated. A negative influence on the disease has not yet been observed, however, the manifestation of metastases seems to be delayed. The method is not expensive and involves little inconvenience for the patient, on the other hand it still seems to be capable of improvement. PMID- 3535145 TI - Comparison of the postburn hyperdynamic state and changes in lung function (effect of wound bacterial content). AB - The pulmonary and systemic response to a full-thickness burn (15% of total body surface area) was determined in 15 adult sheep. Also compared was the effect of wound bacterial content and prostanoid release on this response. Burn wound thromboxane A2, measured as TxB2, and prostacyclin, measured as 6-keto-PGF1 alpha, were measured in burn wound lymph. Animals were monitored for 7 days. On the final day, a full-thickness biopsy specimen of burn tissue was obtained for quantitative bacteriology. Wounds with 10(4) or less organisms per gram of burn tissue were considered colonized, whereas those with 10(5) or more organisms per gram of burn tissue indicated wound infection. Seven sheep had 10(4) or less bacteria and the remaining eight sheep had 10(6) or greater bacteria. We noted a significant mean increase in cardiac index from a baseline of 5 to 6.2 L/min/m2, a decrease in systemic vascular resistance from 16 to 12 mm Hg/L/min, and a mean increase in oxygen consumption from a baseline of 135 to 165 ml/min/m2 during the 7-day study period. There were no differences in these responses between the colonized and the infected wounds. Pulmonary artery pressure increased from a mean baseline of 19 to 24 mm Hg and arterial oxygen tension (PaO2) decreased from a baseline of 90 to 80 mm Hg in the infected wound group, with values remaining at baseline in the colonized wound group. These changes corresponded with an increase in lymph and plasma TxB2 from a baseline of 200 to 210 pg/ml to 1000 +/- 250 and 600 +/- 190 pg/ml, respectively. Values in the animals with colonized wounds were not significantly increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535146 TI - Immunoreactive anionic and cationic trypsins in serum after experimental porcine pancreatic transplantation. AB - Immunoreactive anionic and cationic trypsins (irAT and irCT) were measured in blood samples taken daily from 20 pigs during 60 days after whole organ pancreatic transplantation. Immunosuppression was discontinued on the twenty eighth day after transplantation. IrAT concentrations showed three distinct peaks, the first immediately after operation, the second around the seventh day after operation, and the third irAT peak was seen 2 to 9 days after discontinuation of immunosuppression therapy. IrCT levels paralleled the irAT levels only in the first peak immediately after transplantation. After this there was a dissociation between the concentrations of the two immunoreactive trypsins, with low irCT levels and high irAT levels. Increased irAT levels heralded rejection of the pancreatic allograft by 4 to 30 days (median 20 days) in 13 of the 16 rejecting animals (80%). In addition, low irCT levels preceded hyperglycemia in 13 of the 16 rejecting pigs by 2 to 47 days (median 21 days). The first postoperative peak of immunoreactive trypsins is thought to be related to the operative and storage trauma, whereas the second and third peaks are thought to reflect a rejection process. The results suggest that immunoreactive trypsins can be used as markers for pancreatic allograft rejection. PMID- 3535147 TI - The pulmonary and systemic response to recurrent endotoxemia in the adult sheep. AB - The pulmonary and systemic hemodynamic effects of recurrent endotoxemia were studied in the adult sheep with lung lymph fistulas. Six sheep were given 1 mu/kg Escherichia coli endotoxin every 12 hours for 5 days, after which animals were monitored for another 3 days. The pulmonary response to the first three injections was characterized by an initial severe pulmonary hypertension, hypoxia, and a two- to threefold increase in lymph flow, QL. Lymph and plasma thromboxane A2 (TxB2) and prostacyclin (6-keto-PGF1 alpha) levels increased from baseline values of nearly 200 pg/ml to values exceeding 2000 pg/ml. The systemic response to initial doses was characterized by an increase in systemic vascular resistance, a decrease in cardiac index, and a transient 20% increase in oxygen consumption. With later endotoxin doses, the pulmonary response was markedly attenuated, with only modest changes in pulmonary artery pressure, lymph flow, and arterial oxygen tension noted. TxB2 increases were less than 800 pg/ml, and 6 keto-PGF1 alpha levels remained unchanged. However, we noted the progressive onset of a hyperdynamic state characterized by a sustained increase in cardiac index and body temperature, and a 50% increase in oxygen consumption, whereas systemic vascular resistance decreased by 45%. Three days after endotoxin injections were discontinued, the hyperdynamic state (including leukocytosis) was still present, whereas pulmonary variables returned to baseline levels. We conclude that a hyperdynamic state can be produced by repeated doses of endotoxin that will present even after the endotoxin insult is discontinued, which is a characteristic of the multisystem organ failure syndrome. PMID- 3535149 TI - Neural tube defects: a review of human and animal studies on the etiology of neural tube defects. AB - Although neural tube defects are a common congenital anomaly, their etiology is not known. Human studies have emphasized the pathology and epidemiology of the defects and suggest that in the majority of cases the etiology is multifactorial. Factors which appear possibly to be important are genetic predisposition, maternal illness, and fetal drug exposure. Animal studies have utilized naturally occurring neural tube defects and teratologically induced lesions. No animal model has been convincingly established as the equivalent of human neural tube defects. However, animal models have allowed investigation of the mechanisms of suggested human teratogens and determination of the pathogenesis of naturally occurring animal defects. Their most important contribution has been in furthering the understanding of the normal mechanisms of neural tube closure. It may be through this understanding that the etiology of human neural tube defects will be determined. PMID- 3535148 TI - Intraoperative ultrasonic imaging of the carotid artery during carotid endarterectomy. AB - Intraoperative real-time B-mode ultrasonography was used to evaluate the technical results of 155 carotid endarterectomies in 143 patients. Technical defects created as a result of the endarterectomy were detected in 43 of the 155 endarterectomies (27.7%) and included intimal flaps (73% of defects); strictures (18%); and arterial kinks, residual plaque, and intraluminal thrombi (9% collectively). Eleven of the 43 endarterectomy sites (7% of all endarterectomies) were reentered to correct a defect; none of these patients had neurologic deficits, which suggests that reentering an endarterectomy and correcting a defect does not, in and of itself, lead to a higher incidence of stroke. The incidence of stroke in patients with normal results of intraoperative ultrasonography was 3.8%, whereas the incidence of perioperative stroke in those patients with insignificant and thus uncorrected defects was 3.3%; this suggests that intraoperative ultrasonography is sufficiently sensitive to detect defects that, when left uncorrected, do not lead to a higher than usual incidence of stroke. Because intraoperative ultrasonography is safe and highly sensitive, we believe it is the method of choice for assessing the technical results of carotid endarterectomy. PMID- 3535150 TI - Septic pylephlebitis following shigella bacteremia: case report. PMID- 3535151 TI - [Pharmacologic aspects of the retinoids]. PMID- 3535152 TI - [Treatment of psoriasis with etretinate (Tigason)]. PMID- 3535153 TI - [Retinoids in the treatment of ichthyosis]. PMID- 3535154 TI - [Etretinate and the prevention of skin cancers]. PMID- 3535155 TI - [Retinoids in the treatment of epithelial skin tumors]. PMID- 3535156 TI - [Adverse effects of oral retinoids]. PMID- 3535157 TI - Differential effects of oral low-dose aspirin on prostacyclin synthesis by saphenous or mesenteric venous tissues. PMID- 3535158 TI - Prophylaxis of thromboembolic disease and platelet-related changes following total hip replacement: a comparative study of aspirin and heparin dihydroergotamine. AB - A prospective study involving 120 consecutive patients undergoing total hip replacement was performed to compare the effectiveness of aspirin (high and low dose) or a combination of heparin plus dihydroergotamine (heparin-DHE) in preventing isotopic and phlebographic deep vein thrombosis (DVT), and to evaluate their effect on postoperative platelet changes. Phlebographic DVT was demonstrated in 9 cases (30%) in control group, in 1 (3.3%) in aspirin (high dose) group (p less than 0.01), in 1 (3.3%) in aspirin (low-dose) group (p less than 0.01) and in 5 (16.6%) in heparin-DHE group (p = NS). Aspirin was able to reduce the postoperative increase in circulating platelet aggregates, platelet factor 4 and beta-thromboglobulin observed in control group. This study shows that aspirin is effective in the prevention of DVT for patients undergoing total hip replacement. Small aspirin dose (250 mg/day) represents an effective form of prophylaxis in these patients. PMID- 3535159 TI - Cellular localisation in placenta of placental type plasminogen activator inhibitor. AB - A specific plasminogen activator inhibitor is known to occur in placenta and in pregnancy plasma. Immunohistochemical methods with polyclonal and monoclonal antibodies against the inhibitor were used for its localisation in term placentas. Immunoreactive material was found in the trophoblastic epithelium. It was absent in the stroma of the chorion villi. PMID- 3535161 TI - [Chlamydia trachomatis. Direct detection with an immunofluorescence test]. PMID- 3535160 TI - Megakaryocytes from the marrow of a patient with Glanzmann's thrombasthenia lacked GP IIb-IIIa complexes. AB - Although it is recognized that glycoprotein (GP) IIb-IIIa complexes are deficient in platelets in Glanzmann's thrombasthenia, little is known of the origin of the defect. We have examined the megakaryocytes in a bone marrow aspirate obtained from a thrombasthenia patient during surgery. Analysis of platelet proteins by SDS-polyacrylamide gel electrophoresis confirmed the patient to be of the type I subgroup. The megakaryocytes were examined by immunofluorescence or by immunocytochemical procedures combined with electron microscopy. Antibodies used included the murine monoclonal antibody, AP-2 and the human allo-antibody, IgG L, both of which recognize determinants on GP IIb-IIIa complexes. Bound antibody was detected by anti-IgG antibodies coupled to fluorescein isothiocyanate or absorbed on gold particles. In the immunofluorescence studies, permeabilized megakaryocytes were identified by double staining using an antibody to von Willebrand factor (vWF). Whereas mature megakaryocytes and their small precursor cells from normal individuals were strongly fluorescent with AP-2 and IgG L, most vWF positive cells from the Glanzmann's thrombasthenia patient were negative and the remainder gave but a weak background fluorescence. Immunogold staining on the surface of marrow cells was severely reduced. Our results confirm a deficiency of GP IIb-IIIa complexes in megakaryocytes in thrombasthenia. PMID- 3535162 TI - [Insulin dependent diabetes. Control in general practice]. PMID- 3535163 TI - [NovoPen. An aid in multi-injection insulin therapy]. PMID- 3535164 TI - [Ultrasound and orthopedics. Diagnostic aid]. PMID- 3535165 TI - [Frequent cystitis in elderly women. A double-blind comparison of Hiprex and placebo in general practice]. PMID- 3535166 TI - [Renal oncocytoma]. PMID- 3535167 TI - [Integrated treatment of pain in cancer patients. Psychomotor therapy in the hospital]. PMID- 3535168 TI - An investigation of venom secretion by the venom gland cells of the carpet viper (Echis carinatus). AB - The indirect immunofluorescent antibody technique was applied to the study of Echis carinatus pyramidum venom antigens in venom gland tissue using semi-thin frozen sections. A total of four rabbit antisera, two monoclonal antibodies active against E. carinatus venom, two monoclonal antibodies active against the rodent malaria parasite, Plasmodium chabaudi, and two monoclonal antibodies active against the human malaria parasite, Plasmodium falciparum, were investigated. The results of this study suggest that each secretory cell within the main part of the gland produces all the venom constituents. The resultant venom is therefore considered to be produced as a single package by each individual secretory cell. The different constituents of the venom studied are not produced at the same time or at the same rate throughout the secretory cycle, some being produced at the beginning and others at a later stage. PMID- 3535169 TI - Monoclonal antibodies to Mojave toxin and use for isolation of cross-reacting proteins in Crotalus venoms. AB - Hybridomas secreting monoclonal antibodies against Mojave toxin were established. The antibodies were used for identifying cross-reacting proteins in individual C. s. scutulatus and other Crotalus venoms and to isolate Mojave toxin. The antibodies recognized five bands with a pI range from 5.1 to 6.1 in immunoblots of electrofocused crude venom and Mojave toxin purified by immunoaffinity chromatography. The specificity of the antibodies was for the basic subunit of the toxin, which resolved into four bands of pI between 9.3 and 9.6. Individual C. s. scutulatus venoms of snakes from Texas and southern Arizona had multiple bands with pI's ranging from 4.9 to 6.3. Cross-reacting proteins were also recognized by the antibodies in the electrophoresed venoms of C. basiliscus, C. d. durissus, C. d. terrificus, C. h. horridus and C. v. concolor, and may be isolated by immunoaffinity chromatography with the monoclonal antibodies. PMID- 3535170 TI - L-asparaginase effects on inhibition of protein synthesis and lowering of the glutamine content in cultured rat hepatocytes. AB - Primary cultures of rat hepatocytes were exposed to various concentrations of L asparaginase derived from Escherichia Coli. Protein synthesis was inhibited by about 33% and cellular glutamine was reduced proportionally to the enzyme concentration. However, protein synthesis was inhibited only by amounts of enzyme able to reduce glutamine to critical levels below 10 nmol/mg cell protein. These data suggest that the glutaminase activity which probably contaminates E. coli asparaginase may be responsible for reduced liver protein synthesis. PMID- 3535171 TI - Biological monitoring for organophosphate-induced delayed polyneuropathy. AB - Certain organophosphate (OP) pesticides cause a delayed polyneuropathy. The two step initiation mechanism for this toxicity involves the phosphorylation and subsequent 'aging' of a protein in the nervous system called Neuropathy Target Esterase (NTE). The observation of this enzyme activity in peripheral blood lymphocytes led to several studies to verify whether its measurement after OP exposures might be used as a biological monitoring test for the OP-induced delayed polyneuropathy (OPIDP). The evidence, so far, on the use of this biochemical test in man is discussed together with the need for further research. PMID- 3535172 TI - [Gold-colored metal surface film in prosthetic treatment--preclinical studies]. PMID- 3535173 TI - [Metal-ceramics for the improvement of the prosthetic treatment in the population of the GDR. 10: Clinical evaluation of fixed metal-ceramic dentures made from Gisadent NCA]. PMID- 3535174 TI - [Epidemiology of gingivitis and periodontitis and the need for clinically controlled studies]. PMID- 3535176 TI - [Bridge abutment after hemisection. Case report]. PMID- 3535175 TI - [Clinical-radiographic study of resorption of free bone grafts]. PMID- 3535177 TI - [Effects of the fascist dictatorship in Germany on the development of dentistry]. PMID- 3535178 TI - [Infantile cortical hyperostosis (Caffey-Silvermann Syndrome)]. PMID- 3535179 TI - Use of an enzyme immunoassay for detection of antibody to human immunodeficiency virus in low risk populations. AB - Antibody to Human Immunodeficiency Virus (HIV) was detected by an enzyme immunoassay (Genetic Systems LAV EIA) in low risk populations from five geographically distinct sites. The assay used virus (LAV) grown in the T-cell line CEM. In blood and plasma donor populations, 0.4 percent of the samples were initially reactive and 0.2 percent were repeatably reactive. Fourteen of the twenty-one (67 percent) repeatably reactive specimens were confirmed by immuneprecipitation (RIP). The assay demonstrated 99.9 percent specificity compared to RIP and had a positive predictive value of 67 percent. The data suggest that this test generates a low proportion of false positive EIA results and is highly suitable to screen blood donors. PMID- 3535181 TI - [The origin of the eukaryotic cell. III. Principles of the morphofunctional organization of the eukaryotic cell]. AB - The eukaryotic plasmalemma, eukaryotic cytoplasm with its usual cytomembranes, and eukaryotic nucleus are obligatory components of the eukaryotic cell. All other structural elements (organelles) are only derivates of the aforesaid cell components and they may be absent sometimes. There are protozoans having simultaneously no flagelles, mitochondria and chloroplasts (all the representatives of phylum Microspora, amoeba Pelomyxa palustris, and others). The following five general principles play the main role in the morphofunctional organization of the cell. The principle of hierarchy of block organization of living systems. Complex morphofunctional blocks (organelles) specific for the eukaryotic cell are formed. The compartmentalization principle. The main cell organelles (nuclei, flagellae, mitochondria, chloroplasts, etc.) undergo a relative morphological isolation from each other and other cell organelles by means of the total or partial surrounding by membranes; this may ensure the originality of their evolution and function. The principle of poly- and oligomerization of morphofunctional blocks. It permits the cell to enlarge its sizes and to raise the level of integration. The principle of heterochrony, including three subprinciples: conservatism of useful signs; a strong acceleration of evolutionary development of the separate blocks; simplification of the structure, reduction or total disappearance of some blocks. It explains a preservation of prokaryotic signs in the eukaryotic cell or in its organelles. The principle of independent origin of similar morphofunctional blocks in the process of evolution of living systems. The parallelism of the signs in unrelated groups of cells (or protists) arises due to this principle. PMID- 3535180 TI - Evaluation of a confidential method of excluding blood donors exposed to human immunodeficiency virus. AB - A confidential self-administered questionnaire was given to all donors prior to blood donation (n = 95,917). The questionnaire describes acquired immunodeficiency syndrome (AIDS) high-risk groups and requires the donor to designate his blood for either laboratory purposes or for transfusion. Six hundred and twenty-seven people (0.65%; 78% men) designated their blood for laboratory purposes. In addition to routine enzyme-linked immunoassay (EIA) screening for human immunodeficiency virus (HIV) antibody, all units from the latter group of donors were tested by Western blot (WB) irrespective of the EIA result. An equal number of donor units was selected from those designating their blood for transfusion (age, sex and clinic matched) and these too were tested by WB irrespective of the EIA result. We found that donors designating their blood for laboratory purposes had a 10 times (vs transfusion-designated controls) to 100 times (vs general donor population) greater exposure to HIV. In the laboratory-designated group, an EIA negative donor was WB positive, yielding an estimated EIA false-negative rate of 16 per million. A confidential questionnaire, as described, is a valuable adjunct in ascertaining high-risk blood donors. PMID- 3535182 TI - [Stabilizing action of heavy water (D20) on the cell]. AB - Literature data and our own findings show convincingly that heavy water (D2O) stabilizing proteins against denaturants and proteinases increases cell thermostability in plants and animals and that of microorganisms. In Drosophila, along with cell and organism thermostabilities, it enhances thermophilia. Evidence is given in favour of the suggestion that the protein stabilization is responsible for the above biological effects of D2O, although heavy water may increase the melting temperature of nucleic acids and, but slightly, of lipids. PMID- 3535183 TI - [Electron microscopic research on the extrachromosomal genetic elements of Escherichia coli]. AB - The structural organization of extrachromosomal genetic elements were studied in a subfraction obtained after centrifugation of the lysate of E. coli spheroplasts. With this method of isolation, the tertiary structure of the extrachromosomal genetic elements was preserved. The majority of DNA macromolecules were released in the form of single and connected rosettes. Typical rosettes composed of radial loops of DNA clustered around the central dense core (the diameter is about 60 nm). The mean length of the rosette loops was 1.06 +/- 0.4 micron. Both relaxed folded and supercoiled folded forms of DNA were observed on the preparation. Sometimes the rosettes were connected with large aggregates of DNA (possibly the material of bacterial chromosomes) and had the appearance of thick fibers with numerous lateral loops. Linear, cyclic and various replicative forms of DNA have also been observed. It is assumed that rosettes of the extrachromosomal elements of E. coli reflect one of the levels of organization of prokaryotic genetic material. PMID- 3535184 TI - [Analysis of the polyploidization kinetics of the parenchymal cells in the rat liver]. AB - Methodological approaches to kinetics of cell polyploidization in the rat liver parenchyma are discussed. Different ways of hepatocyte polyploidization in the course of postnatal liver growth have been assessed. The intensities of hepatocyte transitions from one ploidy class to another were determined. On the basis of literary experimental data the following is summarized: With the increase in the animal age, there is a decrease in hepatocyte transition from one ploidy class to and ther; in young animals the intensity of formation of tetraploid hepatocytes through the stage of binuclear cells (2c----2c X 2----4c) is 0.39-0.55 within two weeks, the intensity of direct transitions (2c----4c) being 0.00-0.19 within the same time. The intensity of entering to DNA synthesis is reduced with the increase in hepatocyte ploidy levels; in this case the coefficient of the reducing of mitotic activity is calculated as 0.10-0.22, and 0.01-0.05 for 4c- and 8c-hepatocytes, resp. The factors stimulating proliferation in the liver increase the intensity of the direct cell transition (2c----4c) by several times which can exceed the intensity of transition through the binuclear cell stage. PMID- 3535186 TI - [Adaptive properties of the cultured cells from a pig embryo kidney exposed to hypotonic media]. AB - A high tolerance of the cultured SPEV-cells was found under vital examination of their behaviour in hypotonic conditions. The dilution of cultured medium 1:1 hardly affects the cell morphology. With a 1:3 dilution, some minute alterations in the cells were noticed associated with the cell shape and the structure of the nucleus and of the cytoplasm, which later gradually disappear. A marked tendency of morphological alterations in the cells increases with increasing the medium dilution (1:7 and 1:15), however no cell destruction was observed. The complete lysis of the cells occurs only in the medium diluted by 32 times (1:31). PMID- 3535185 TI - [Isolation and fractionation of the nuclear matrix from cultured cells]. AB - A new method for the isolation of tissue culture cell nuclei is presented which involves incubation of the nuclei in the presence of Cu2+- or Zn2+-ions. This method eliminates the danger of nuclear aggregation and permits nuclear matrix isolation and subsequent fractionation. Stabilization of the inner matrix by Cu2 ions permits analysis of the role of nucleic acids in the maintenance of the matrix structure. It is shown that solubilization of more than 95% of matrix bound DNA and more than 90% of matrix-bound RNA did not cause any significant changes in the nuclear matrix structure. PMID- 3535187 TI - Controlled clinical trial of three short-course regimens of chemotherapy for pulmonary tuberculosis in Nigeria--a preliminary report. AB - A controlled clinical trial of daily short course (6-month) chemotherapy in newly diagnosed cases of pulmonary tuberculosis in Nigerians was carried out. The three regimens used contained streptomycin, isoniazid, rifampicin and pyrazinamide in the initial phase; and isoniazid plus rifampicin or isoniazid plus rifampicin and/or pyrazinamide in the continuation phase. Sputum culture conversion was satisfactory after 2 and 6 months of treatment and no positive cultures were found one year after treatment had been completed. Side effects were few and consisted mainly of arthralgia, possibly associated with pyrazinamide. PMID- 3535188 TI - Two potential improvements to BCG and their effect on skin test reactivity in the Lebanon. AB - An account of an ongoing project to assess the possible benefits of two additives to BCG vaccine is presented. These additives are suspensions of irradiation killed Mycobacterium vaccae in one case, and M. leprae in the other. Groups of children aged 7-17 living in Zgharta and Akkar districts of North Lebanon have received vaccination with BCG alone or with either of the two additives since 1980. This region was chosen since contact with environmental mycobacteria is small, but both leprosy and tuberculosis occur there. So far the effects of the additives have been assessed by annual skin testing of volunteers with Tuberculin, Leprosin A, Vaccin and Scrofulin, and by measuring the size of the vaccine scars. Some children have now been followed up on four occasions, and special attention is paid to them. No complications have been encountered in the 1740 children who have entered the study (by our observation, or by local report on those who have not attended for follow-up) and the mean scar sizes after vaccines with the additives are no larger than those after BCG alone. There is no evidence that the additives have prevented development of Tuberculin positivity after vaccination, or have changed the nature of reaction to it. Incorporation of M. leprae significantly increased Leprosin A positivity and both additives increased Vaccin positivity in comparison with the effects of BCG alone. The results are fitted to a model of the theoretical expectations of the study and may be beginning to show the advantages expected of the additives. The only unexpected finding was a reduction in Scrofulin positivity especially associated with the additives. The very low contact with environmental mycobacteria experienced in the study area has allowed the pattern of post-vaccination decay of skin test positivity to be studied with greater precision than has been reported before, and differences have been detected between the two districts where the study was conducted. Confirmation of the possible advantage of the additives will rest with data to be obtained in longer term follow-ups and in studies being carried out in other countries. PMID- 3535189 TI - [The role of vitamin A in the formation of extracellular structures of the chicken glandular stomach]. AB - Main notions on the vitamin A function in the organism are considered. A new concept is formulated postulating the vitamin A role in the support of the structure and function of the Golgi complex of epithelial cells of glandular stomach mucosa of chickens. PMID- 3535190 TI - [A method of quantitative determination of alcohol oxidase and catalase in yeast colonies]. AB - A rapid, simple and highly reproducible method is developed for qualitative determination of alcohol oxidase and catalase in yeast colonies using digitonin as a permeabilizing agent. The method permits finding differences in regulation of catalase by ethanol in methylotrophic and nonmethylotrophic yeasts. PMID- 3535191 TI - [Melittin: structure, properties, interaction with a membrane]. AB - The paper is concerned with the analysis of the present data as to the structure and properties of melittin, a biologically active peptide of bee venom, able to be inserted spontaneously into the natural and synthetic membranes and to destruct cells in micromolar concentrations. This property is a result of the peptide structure peculiarities. Attention is focused on the mechanism of melittin insertion into the phospholipid bilayer as well as on the possibility of its use to study the nature of protein-lipid interactions and formation of ionic channels. PMID- 3535192 TI - [Abruptio placentae. Etiology]. PMID- 3535193 TI - [Beta-blockers or thiazides for middle-aged and elderly patients with hypertension? A multicenter study in general practice]. PMID- 3535194 TI - [Treatment of postoperative pain with epidural morphine. 1 year's review from a regional hospital]. PMID- 3535195 TI - [Spinal analgesia with bupivacaine in various dosages]. PMID- 3535196 TI - [Suprarenal cysts]. PMID- 3535197 TI - [A comparative study of Unixan administered once daily and Theo-Dur administered twice daily]. PMID- 3535199 TI - Estimation of acoustic attenuation in liver using one megabyte of data and the zero-crossings technique. AB - Statistical fluctuations due to scatter-induced frequency variations in reflected acoustic pulses are a major problem when estimating acoustic attenuation. Disagreement exists in the ultrasound community as to how much data is sufficient to overcome these statistical fluctuations. The range of attenuation values for normal livers and a tissue equivalent phantom, using 1 megabyte of data per liver and the zero-crossings technique, was investigated. The significance of statistical fluctuations and their effects on attenuation are discussed. PMID- 3535198 TI - [The effect of doxapram after thoracotomy]. PMID- 3535200 TI - Direct ascent from shallow air saturation exposures. AB - Thirty-four healthy human subjects were exposed to shallow air saturation for 48 h [1.77 ATA (25.5 fsw) n = 19, 1.89 ATA (29.5 fsw) n = 15] and then decompressed to 1 ATA (0 fsw) in about 2 min. Symptoms included fatigue, limb and joint pain, headache, myalgias, and pruritus. No subject of 19 was diagnosed as having decompression sickness (DCS) after the shallower exposure, but 4 of 15 were diagnosed and treated for DCS subsequent to the deeper exposure. Almost all subjects in both groups had Doppler-detectable venous gas emboli (VGE) lasting up to 12 h postdecompression. Treated subjects had a recurrence of VGE several hours after the hyperbaric oxygen treatment. Only the duration of VGE, and not the VGE score, correlated with symptoms; and only the subjects body weight and age correlated with the VGE variables. This study indicates that hyperbaric air exposures of this magnitude are not as benign as previously thought. PMID- 3535201 TI - [Osteodensitometry: a promising method for evaluating bone density in humans]. PMID- 3535202 TI - Therapeutic principles of antimicrobial therapy and new antimicrobial agents. AB - It is important that newly developed antibiotics be used so as to increase our ability to eradicate infection, rather than to complicate the treatment of infection by spawning the creation of organisms resistant to multiple antibiotics. One must peruse the literature with a very critical eye, as most new agents are touted as tremendous advances on past antibiotics. With rising medical costs becoming of ever-greater significance, proper choice of antimicrobial agent assumes more importance as well. The proper bacterial coverage in a given clinical setting, duration of treatment, and drug pharmacokinetics and the concept of the "total cost" of administering an antibiotic (taking into account fixed and variable hospital costs) all must be considered. Although it is virtually impossible to become experienced in using all of the currently available antibiotics, it is not necessary, either. Based on the literature and discussion with infectious disease colleagues, one can choose to use one or two antimicrobials in each broad class and gain the benefits of that class for his or her patients. PMID- 3535203 TI - Antimicrobial prophylaxis in urologic surgery. AB - Nosocomial urinary tract infections represent approximately 40 per cent of all nosocomial infections, thereby contributing considerably to secondary bacteremia and sepsis and possibly increased mortality. Urethral catheterization is the single most important predisposing factor in the development of urinary tract infection. Patients at increased risk of nosocomial infectious complications are the elderly, malnourished and debilitated, those with diabetes or prosthetic devices, and those on immunosuppressive therapy. About 75 per cent of nosocomial urinary tract infections are attributable to gram-negative bacteria, a disproportionate number of which when compared with community-acquired infections are caused by Proteus, Klebsiella, and Pseudomonas. There is enough evidence in the literature to support the use of prophylaxis in urologic surgery. Antimicrobial prophylaxis reduces the incidence of postoperative urinary tract infection. It does not seem to reduce the incidence of transient perioperative bacteremia but probably prevents the development of sepsis, thereby reducing the number of serious infective complications, the average hospital stay, and the associated total cost of treatment. To achieve adequate urine, blood, and tissue levels of the antimicrobial agent at the time of surgery, the drug should be given preoperatively. A short perioperative course represents sufficient prophylaxis. Regimens with combinations of beta-lactam and aminoglycoside antibiotics or single use of an extended spectrum beta-lactam antibiotic are acceptable for this purpose. PMID- 3535204 TI - The role of imaging studies in urinary tract infection. AB - Technology has permitted significant advances in the imaging and early diagnosis and treatment of many serious urinary tract infections. The armamentarium is vast, with CT scan, ultrasound, nuclear scan, and magnetic resonance imaging on the horizon, with more studies certainly to follow. Nothing, however, can replace the value of proper assessment of clinical signs and symptoms and the logical pursuit of a diagnosis with knowledge of the capabilities and deficiencies of each study. PMID- 3535205 TI - Urosepsis. AB - Many years ago Osler suggested that "it is of use from time to time to take stock, so to speak, of our knowledge of a particular disease to see where we stand in regard to it, to inquire to what conclusions these accumulated facts seem to point, and to ascertain in what direction we may look for fruitful investigations in the future." With regard to gram-negative bacteremia, there is extant a notable and striking increase in both the incidence of these infections and the involvement of organisms that previously caused disease only uncommonly. Factors related to this escalation include an increase in the number of elderly and debilitated hospitalized patients, the large number of individuals with malignant disease who are immunosuppressed by their disease and the drugs used to treat them, the ubiquity of various types of respirators, drainage tubes, and catheters that may be colonized by gram-negative bacteria, and the progressively increasing resistance of these organisms to a growing number of antimicrobial agents. The emergence of resistance is at least partly due to the inappropriate use of antibiotics, often in combination, for prophylaxis or empiric therapy. It is unfortunate that even the necessary use of antibiotics will increase the frequency of disease caused by these gram-negative organisms. The inescapable conclusion is that gram-negative infections and bacteremia will only increase in prevalence in the future. Investigation of the pathophysiology of shock due to gram-negative sepsis has revealed that most of the physiologic alterations are mediated by products of the host's own immune system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535207 TI - Granulomatous nephritis. AB - Granulomatous nephritis (renal tuberculosis, malacoplakia, xanthogranulomatous pyelonephritis, and echinococcus disease) represents an infectious process that is characterized by (renal) parenchymal destruction and consists of a chronic cellular reaction and mature, mononuclear infiltrate. These infections may mimic one another as well as other renal infections and cystic and neoplastic disorders. This article addresses some of the unique aspects and similarities of these varied disease entities and their management. PMID- 3535206 TI - Pyelonephritis, cortical abscess, and perinephric abscess. AB - The causative agent in nonobstructive pyelonephritis has been shown most often to be P-fimbriated Escherichia coli, mainly because receptors for these fimbriae are found in the bladder, ureter, and the kidney tubules. Age and sex are factors leading to differences in the presentation of the disease, and early diagnosis followed by intensive therapy lessens the chance of renal damage. Renal abscess, perinephric abscess, and pyonephrosis all follow pyelonephritis in the host who is compromised by the presence of stone, obstruction, diabetes, or immunosuppression. PMID- 3535208 TI - Pediatric urinary tract infections. AB - Urinary tract infection is a frequent diagnosis in infants and children who are referred to a urologist. Infections in children are often benign, yet the potential for significant renal damage in this age group makes adequate urinary tract evaluation mandatory. Urinary obstruction, vesicoureteral reflux, periurethral bacterial colonization, and voiding dysfunction are important in the pathogenesis of pediatric infections. Adequate therapy requires detection and control of these conditions in order to prevent pyelonephritic renal scarring and its sequelae. PMID- 3535209 TI - Urinary tract infections in women. AB - Bacteriuria in the adult female is properly classified according to the pathogenesis and frequency of the infectious process. The vast majority of infections are reinfections that are characterized by sequential infections caused by different organisms. Reinfections result from inoculation of bladder urine in the sterile urinary system by enterobacteria from the vaginal flora and may be occasional or frequent. Susceptibility to frequent reinfections is due to enhanced colonization of the vaginal mucosa by enterobacteria. Persistent infections are characterized by sequential infections caused by the same organism. These infections, which are always frequent, usually result from the continued inoculation of urine by an infected focus within the urinary system. Because of the expense of health care, the efficacy of antimicrobial therapy for reinfections, and the infrequency of serious morbidity associated with reinfections, the rationale for traditional components of patient management has been questioned. An analysis of diagnostic and treatment options and recommendations for the management of bacteriuric women seen by the urologist has been presented. PMID- 3535210 TI - Complications and treatment of urinary tract infections during pregnancy. AB - Bacteriuria during pregnancy may result in serious complications, including development of acute pyelonephritis in the third trimester and premature labor. Because uninfected women commonly experience symptoms associated with urinary tract infections and many bacteriuric women are asymptomatic, all pregnant women should be screened by quantitative urine cultures. The goal of antimicrobial therapy is complete elimination of bacteria from the urinary tract. Major indications for complete urologic evaluation are failure of a patient with signs of acute upper-tract infection to improve on appropriate treatment and bacterial persistence after initial sterilization of the urine. Either problem may require surgical intervention. PMID- 3535211 TI - Prostatitis. A continuing enigma. AB - After all is said and done, prostatitis is still a syndrome often difficult to interpret and with an unclear etiology and pathogenesis in many patients. However, if approached intelligently by an interested, knowledgeable, and honest physician, prostatitis in its different variations can be diagnosed correctly and the adequate treatment adjusted accordingly wherever possible. When no specific treatment is available, reassurance and general supportive measures will often alleviate the condition remarkably. PMID- 3535212 TI - Infection stones. Evaluation and management. AB - Infection stones may be the cause of persistent or recurrent bacterial urinary infection. Evaluation of the infection and the character of the stones often aids in the selection of management and treatment options. The ultimate success of the treatment of infection stones should be measured, however, by control or removal of both the stone and the urinary infection. PMID- 3535213 TI - Urinary tract infections in compromised hosts. AB - Prevention of urinary tract infection in the compromised host represents the most efficacious management when significant bacterial colonization is likely. Assessing the degree of inflammatory response helps to tailor the antimicrobial therapy in both acute and chronic bacterial infestation. Therefore, frequent urine cultures and urinalysis in high-risk patients should assist the attending physician to avoid the high cost of morbidity and mortality. PMID- 3535214 TI - Catheter-associated bacteriuria. AB - Catheter-associated urinary tract infections are the most common nosocomial infection and a frequent cause of significant morbidity, sepsis, and death. The pathogenesis is multifaceted. Most frequently, bacteria from the urethral meatus ascend to the bladder between the mucosal and catheter surfaces. Alternatively, bacteria may ascend within the drainage system following contamination of the drainage bag or disruption of the catheter tubing junction. The incidence of infection is approximately 5 to 7 per cent for each day of catheterization and closely linked to unalterable host factors such as age, female sex, and debilitating disease. Efforts to reduce the incidence of infection must begin with reduction of the frequency and duration of catheterization. Aseptic insertion of the catheter and careful maintenance of the drainage system are mandatory to prevent incidental bacterial contamination. Prophylactic, systemic, or topical antimicrobial agents and modifications of the catheter drainage system that are designed to reduce contamination are expensive and have not been shown to be efficacious for the majority of patients. Furthermore, antimicrobial prophylaxis frequently leads to outgrowth of resistant bacterial strains that are difficult to eradicate. However, antimicrobial prophylaxis warrants consideration for high-risk patients who are catheterized for a short time. If bacteriuria occurs prior to removal of the catheter, the patient should be treated with appropriate antimicrobial therapy. Urinalysis or urine cultures should be obtained following removal of the catheter to assure sterility of the urinary tract. If these guidelines are followed, the incidence and sequelae of catheter associated urinary tract infections can be reduced. PMID- 3535215 TI - Future approaches to the management of urinary tract infections. AB - A basic hypothesis running through all of these possible future approaches to the treatment of urinary tract infections is the concept that these infections are first initiated by bacterial adherence to mucosal surfaces in the lower urinary tract and that therapy might be devised to lessen this adherence. This hypothesis represents a basic change from the concept that bacteria enigmatically appear in the bladder and kidneys (possibly as a consequence of obstruction) and that antibiotics must inevitably then be given in ever-increasing dosages and types. The concept of bacterial adherence as the initiating event for most ascending urinary tract infections has allowed a new era of excitement in urologic research and, at the same time, expanded the need for broad collaboration of many other disciplines because of the complexities in the immunology and biochemistry of the adherence process. Although many of these research areas will remain experimental, it is to be hoped that some can be brought into clinical application to help the many patients suffering from these infections. PMID- 3535216 TI - The myocardial signature: absolute backscatter, cyclical variation, frequency variation, and statistics. AB - This paper studies the absolute myocardial backscatter as a function of the frequency and phase of the cardiac cycle. This was achieved by calibration of the ultrasonic instrumentation and the random diffraction process. We have discovered a first-order model in which the scattering from the myocardium is Rayleigh scattering with a cardiac cycle variation in the scattering cross section. Furthermore, the statistics are approximately those of a radio frequency waveform with two independent Gaussian components (Rayleigh envelope). Deviations from the first-order model suggest measurable fine structure related to myocardial ultrastructure. This model has profound effects on the choice of optimal radiation patterns and signal processing schemes for preparing diagnostic parameters (e.g., integrated backscatter). PMID- 3535217 TI - The effect of focusing on ultrasonic backscatter measurements. AB - In this paper, the effect of transducer focusing on the integrity of ultrasonic backscattering measurements is examined. The rationale for this study stems from our observation that the calculated values of backscattering coefficients from data obtained with nonfocused transducers are always substantially lower than those obtained with focused transducers when the standard substitution method is used for backscattering measurements. It is postulated that this discrepancy is caused by the extremely complicated beam behavior of a focused transducer. This hypothesis is verified experimentally. It is therefore concluded that focused transducer could yield misleading results when a standard substitution method is used for absolute backscattering measurements. PMID- 3535218 TI - An interactive processing system for ultrasonic compound imaging, real-time image processing and texture analysis. AB - An interactive processing system for ultrasonic imaging, real-time image processing and texture analysis was developed and has been used under real clinical conditions at the 2nd Department of Gastroenterology and Hepatology, Vienna, since 1983. The major goal of this system is to determine what digital approaches to ultrasonic imaging, aided by computer processing, can contribute to ultrasonic diagnosis and whether clinically-relevant information can be extracted which is not obtained by conventional approaches. PMID- 3535219 TI - [Roentgenologic diagnosis of rhinocerebral mucormycosis]. PMID- 3535220 TI - Mycoplasma bovis infection in gnotobiotic calves and combined infection with respiratory syncytial virus. AB - Mycoplasma bovis was inoculated alone or in combination with respiratory syncytial virus into the respiratory tracts of 12 gnotobiotic calves. Clinical signs ranged from transient pyrexia to protracted fever accompanied by severe lower respiratory signs and in one case, arthritis. Pulmonary lesions included foci of coagulative necrosis surrounded by mononuclear cells and suppurative bronchiolitis with varying degrees of lympho-reticular hyperplasia. No enhancement of lesions occurred in the combined infections of M. bovis and respiratory syncytial virus. M. bovis was identified by immunoperoxidase labelling in lesions of necrosis, especially at interfaces between the lesion and mononuclear cells and in bronchiolar exudates. Organisms were also located in necrotic lesions of joint capsules, in tonsillar crypts, and in liver. PMID- 3535221 TI - Effect of diet or reproductive status on the histology of spontaneous pituitary tumors in female Wistar rats. AB - Hypophyses of four groups of 50 female rats (F0--nulliparous, F0--multiparous, F1 -standard diet, and F1--low protein) were examined by light microscopy and immunocytochemistry by the avidin-biotin complex method. In pituitary glands of rats fed a low protein diet, the incidence of neoplasms of the pars distalis, the number of multifocal tumors, and the degree of neoplastic cellular atypia were significantly reduced. Pituitary adenomata in rats fed a low protein diet also caused significantly less brain compression at the time of necropsy than in rats fed a standard diet. All but two neoplastic foci from the 83 tumors stained for prolactin, and 14 of these also stained for growth hormone. No differences were found in the frequency of hemorrhagic or solid patterns of tumor. These findings may reflect a reduction in pituitary tumor initiation, promotion, and/or progression in rats fed a low protein diet. PMID- 3535222 TI - Medullary thyroid carcinoma in a horse. PMID- 3535224 TI - Oral extramedullary plasmacytomas in two dogs. PMID- 3535223 TI - Schwannoma in the testis of a dog. PMID- 3535225 TI - An outbreak of toxoplasmosis in zoo birds. PMID- 3535226 TI - Ultrastructure of canine hemangiopericytoma. PMID- 3535227 TI - Review of Corynebacterium (Rhodococcus) equi lung abscesses in foals: pathogenesis, diagnosis and treatment. AB - Corynebacterium (Rhodococcus) equi is becoming increasingly significant as a cause of bronchopneumonia and lung abscessation in foals. The organism can survive within macrophages and may thus escape normal pulmonary defence mechanisms, particularly in immunocompromised animals. The disease has hitherto been associated with mortality rates as high as 80 per cent, partly as a result of inappropriate therapy. The selection of lipid-soluble antibiotics capable of intracellular penetration is critical for the successful treatment of C equi lung abscesses. A combination of two such antibiotics, erythromycin (25 mg/kg three times daily) and rifampicin (5 mg/kg twice daily) has been used on foals since 1981. Most of these animals had radiographic evidence of extensive lung abscessation, and in all cases the presence of C equi was confirmed on culture of tracheal aspirates. The duration of therapy ranged from four to nine weeks. Mild gastritis and diarrhoea were occasionally noted, but never such as to require termination of the therapy. No other adverse side effects were encountered. The success rate, as judged by a return to normal of chest radiographs and plasma fibrinogen concentrations, has exceeded 80 per cent. PMID- 3535228 TI - Screening for carriers of genetic diseases by biochemical means. AB - For some genetic diseases the underlying biochemical anomaly is known. Through the gene dosage phenomenon it may therefore be possible to detect the more numerous clinically normal heterozygotes and so initiate a control programme. Such programmes need to be carefully and individually planned according to certain general principles derived in part from experience with prototype programmes. Laboratory data may be interpreted in relation to the prior probability of an individual being heterozygous or normal which may be known from the status of parents or other close relatives. Instigation of a control programme based on heterozygote testing is best achieved by working through a breed society (or its equivalent) which can control pedigree breeding through the control of registrations. PMID- 3535229 TI - Efficacy of an oxibendazole-trichlorfon paste formulation against third stage larvae of Gasterophilus intestinalis and its safety in horses. AB - A paste formulation containing 14.3 per cent of oxibendazole and 44 per cent of trichlorfon was administered to 33 ponies and horses. The dose rate used was equivalent to 10 mg and 30 mg/kg bodyweight, of oxibendazole and trichlorfon respectively. After treatment 25 animals passed between one and 82 third stage larvae of Gasterophilus intestinalis in their faeces. Dosing with 0.2 mg ivermectin/kg bodyweight three weeks later resulted in six animals expelling between one and four bots. The efficacy of the oxibendazole-trichlorfon paste was on average 96.2 per cent. This drug combination given to 52 ponies and horses at the indicated dose rate and to six ponies at twice that dose was tolerated without side effects except transient softening of the faeces in several animals and mild symptoms of colic in two horses. PMID- 3535230 TI - Cow milk yield and composition before development of Escherichia coli mastitis. AB - High milk yield, low milk fat and low milk protein were considered as possible predisposing factors to bovine Escherichia coli mastitis. Morning and afternoon milk yields were recorded in 46 Friesian cows later developing E coli mastitis and compared with 92 uninfected controls. Animals developing E coli mastitis gave a significantly higher milk yield than controls. The overall morning: afternoon ratio was (mean +/- se) 1.66 +/- 0.41, with no difference in ratio for the two groups. Further studies on 85 animals later developing E coli mastitis, and 192 controls, in four Friesian herds did not reveal differences in milk fat content (except as related to yield), milk protein or in the interrelationship of days of lactation, milk protein or in the interrelationship of days of lactation, milk fat and milk protein in the two groups. Again there was a correlation between high milk yield and a tendency to develop E coli mastitis but this may have been an age effect in both investigations. No correlation between milk yield and mastitis severity was detected. High yielders which succumbed to E coli mastitis in three herds were producing less milk than mastitis-free controls in the fourth herd which suggests that the correlation is not with yield per se. PMID- 3535231 TI - Wooldridge memorial lecture. New horizons for veterinary medicine: can the educators respond? PMID- 3535232 TI - Treatment of pseudopregnancy with bromocriptin, an ergot alkaloid. AB - One hundred and forty-two dogs with single or multiple pseudopregnancies were treated with bromocriptin at three different dose rates and once in combination with mobilerone. The treatments that scored best were 30 micrograms/kg bromocriptin for 16 days and 10 micrograms/kg bromocriptin for 10 days. Vomiting was a frequent side effect (about 20 per cent of cases) and was treated successfully with metoclopramide at a dosage of 0.5 mg/kg. Metoclopramide had no effect on the effectiveness of the bromocriptin. PMID- 3535234 TI - Evaluation of a rapid inoculum standardization system for antimicrobial susceptibility testing of bacterial isolates from the bovine mammary gland. AB - A commercially available rapid inoculum standardization system (RISS) was compared to the broth inoculum standardization method (BIS) for antimicrobial susceptibility testing of bacterial isolates from the bovine mammary gland. Overall agreement between RISS and the BIS method was 95.9%. RISS bypasses the 2 8 h incubation period required by BIS, thus providing antimicrobial susceptibility test data in a more timely manner. RISS was determined to be an acceptable alternative method to the BIS method for preparation of standardized inoculum for antimicrobial susceptibility testing of bovine mammary gland isolates. PMID- 3535233 TI - Dysentery in calves caused by an atypical strain of Escherichia coli (S102-9). AB - Dysentery lasting 4-8 days was produced in five 4-day-old colostrum-fed calves, after inoculation with an atypical strain of Escherichia coli S102-9; peak excretion of S102-9 occurred during the period of dysentery. Two calves were killed when clinical signs were most severe and bacteria were seen attached to the surfaces of enterocytes in the large intestine; microscopic lesions were seen in these areas. The lesions were identical to those previously reported in a natural outbreak of dysentery in calves, from which E. coli S102-9 was isolated, and to those seen in gnotobiotic calves experimentally infected with S102-9. Reinfection of the three surviving calves 16-20 days later with S102-9 and primary infection of two calves aged 24 and 51 days did not cause dysentery. Four of 659 coliforms isolated from field outbreaks of calf diarrhoea resembled the atypical strain S102-9. These four isolates and S102-9 did not produce heat stable enterotoxin, but all produced a toxin cytopathic for Vero and HeLa cells. Two of the four isolates were inoculated alone into 4-day-old gnotobiotic calves deprived of colostrum; neither calf developed dysentery but microscopic lesions identical to those produced by S102-9 were detected in the large intestines of both animals. PMID- 3535235 TI - Magnesium-dependent plaque formation by bacteriophage P1cinC(-) on Escherichia coli C and Shigella sonnei. AB - Phage P1C(-), in a state of the phage not infective to Escherichia coli K12, was able to form plaques on a wild-type strain of E. coli C and on Shigella sonnei in the presence of Mg2+. Citrobacter freundii, Enterobacter aerogenes, and a Salmonella typhimurium galE mutant were not lysed by, but were lysogenized with P1cinC(-), whereas Klebsiella pneumoniae, Proteus rettgeri, and S. typhimurium LT2 were not susceptible to either P1cinC(-) or P1cinC(+). The lipopolysaccharide structure of E. coli C and Sh. sonnei is discussed with reference to receptors for P1cinC(-) and P1cinC(+). PMID- 3535236 TI - Precore sequence of hepatitis B virus inducing e antigen and membrane association of the viral core protein. AB - Hepatitis B virus (HBV) DNA contains a precore (pre-c) sequence of 29 codons with unknown function upstream of its gene for the major core protein. Its significance was studied by expression of core proteins with and without pre-c in Escherichia coli. Core protein without pre-c, P22c, assembled spontaneously to core particles and formed core antigen. It had the same size and antigenicity as core particles from infected liver. Core protein with pre-c, P25e, instead formed membrane-associated e antigen (HBeAg). The data suggest that pre-c functions as a signal peptide for the attachment of core protein P25e to cellular membranes. This hypothesis can explain the not yet understood relation between viremia and HbeAg and the protective role of anti-HBe antibody. PMID- 3535237 TI - [Papovavirus vectors]. PMID- 3535238 TI - [Adenovirus vectors]. PMID- 3535239 TI - [Persistent infection with rabies virus]. PMID- 3535240 TI - [Molecular biology of vaccinia virus and development of a new type of vaccine]. PMID- 3535241 TI - [Retrovirus vectors]. PMID- 3535242 TI - [Some epidemiological and clinical aspects of Chlamydia trachomatis infections]. PMID- 3535243 TI - [Transforming genes of human adenoviruses]. PMID- 3535244 TI - [Biological role of monooxygenases and control of their activity]. PMID- 3535245 TI - [Chemical basis of singlet oxygen behavior in humans (review)]. PMID- 3535246 TI - [Functional changes in the state of the insular system of animals after intravenous administration of diabetogenic factor]. AB - Natural diabetogenic factor, which is albumin with molecular mass 60,000 Da, occurring in blood plasma of rats impaired with alloxan diabetes, caused a stable hyperglycemia, distinct decrease of insulin in blood and increased the body resistance to insulin in healthy animals. Activity of the diabetogenic factor was neutralized by heparin. PMID- 3535247 TI - [Biological role of ceruloplasmin and its possible therapeutic use (review of the literature)]. PMID- 3535248 TI - [Comparative characteristics of lymphocyte proteolytic enzymes in normal conditions and in chronic lymphoid leukemia]. AB - Proteolytic activity was estimated in lymphocyte lysates of cattle in normal state and in chronic lympholeukosis using 3H-acetylated casein (pH 7.4) and 3H acetylated hemoglobin (pH 4.0) as substrates. Distinct individual variations in the enzymatic activity were observed either in neutral or slightly-acid media in the animal groups studied. In chronic lympholeukosis specific proteolytic activity, calculated per a cell, was decreased, while it was increased in calculation per a mg of protein. The lower content of protein (about 2.4-fold) was found in lysates of lymphocytes in chronic lympholeukosis as compared with normal state. An increase in proteolytic activity in lymphocyte lysates correlated with elevation of blood leukocytosis if chronic lympholeukosis developed in individual animals. Effects of a number of proteinase inhibitors and activators were studied in the cell lysates; the spectrum of proteinases in chronic lympholeukosis was dissimilar to that of normal state. Pepstatin inhibited quite completely the proteolytic activity at pH 4.0 in lymphocytes of healthy animals and hence cathepsin D was responsible for the activity; in chronic lympholeukosis, except of cathepsin D, thiol-dependent proteinase was also detected. Activity of proteinases at neutral pH value in lymphocytes of healthy and impaired animals was inhibited by phenylmethionine fluorosulfate and p-chloromercuribenzoate, thus suggesting that serine and thiol-dependent proteinases were present; the level of these enzymes was distinctly higher in chronic lympholeukosis as compared with normal state. PMID- 3535249 TI - [Comparative characteristics of the activity of proteolytic enzymes and their inhibitors in the lung tissue of guinea pigs during development of generalized and destructive tuberculosis]. AB - Two series of experiments were carried out using 66 guinea pigs infected with tuberculosis. In the first experiment generalized tuberculosis was stimulated by means of subcutaneous administration of Mycobacterium tuberculosis H37RV strain at a dose of 0.0001 mg. In the second experiment destructive form of tuberculosis was developed after intrapulmonary administration of the bacteria (1 mg) followed by VCG vaccination. In both experiments the animals were divided into groups with spontaneous form of the infection and the group of animals treated with rifamycin and isoniazid. Total protein, elastolytic activity, cathepsins B and D, free antitryptic activity were estimated in lung homogenates. Generalized and destructive forms of tuberculosis were shown to induce an increase in content of soluble protein as well as in cathepsin D, elastolytic and antitryptic activities in tissues. Destructive form of tuberculosis was characterized by more than 4 fold increase in elastolytic activity and by a distinct activation of cathepsin B. The antibacterial drugs used affected only slightly the biochemical patterns studied in lung tissue. PMID- 3535250 TI - [Sorption methods of detoxication in oncology]. PMID- 3535251 TI - Anti-HTLV III ELISA and Western blot testing in a blood donor population: implications for donor notification. AB - We have evaluated the western blot (WB) test for distinguishing anti-HTLV III ELISA-positive donors who have likely been exposed to HTLV III from those that are false positives. Of 1,955 donors, 26 were positive for anti-HTLV III by ELISA testing. Only 6 (23%) were positive by WB: 5 of these 6 were male homosexuals with multiple partners and 5 of 6 had low Th/Ts ratios. The WB-positive donors gave the highest absorbance values in the anti-HTLV III ELISA assay. The immunologic abnormalities in the WB-positive donors suggest that they should be notified of their test results. We conclude that basing a donor notification policy on WB results is the optimum public health strategy for blood banks at the present time. PMID- 3535252 TI - Development of immunoglobulin preparations for intravenous use. PMID- 3535253 TI - [Methods of determining blast cell sensitivity to chemical preparations in treating leukemias (a review of the literature)]. PMID- 3535254 TI - [Artificial saccharose substitutes in diseases with disordered carbohydrate and lipid metabolism]. PMID- 3535255 TI - [Perivascular lymphoid follicles as new organs of the immune system]. PMID- 3535256 TI - [Enzymotherapy in urology and nephrology (a review of the literature)]. PMID- 3535257 TI - Serogroup frequency and drug sensitivity of Shigella strains encountered at the University Hospital of the West Indies. PMID- 3535258 TI - [Usefulness of ultrasonographic examination in the diagnosis of ectopic pregnancy]. PMID- 3535259 TI - [Omeprazole in peptic ulcer--pros and cons]. PMID- 3535260 TI - [Amiodarone (Cordaron) in the long-term treatment of recurrent supraventricular tachycardia]. PMID- 3535261 TI - [Evaluation of the effectiveness of dihydroergotoxine (DHET) in the treatment of chronic cerebral ischemia syndromes in elderly patients]. PMID- 3535262 TI - [Initial manifestation of a non-Hodgkin lymphoma on the external ear--a case report on the differential diagnosis of pseudolymphoma of the skin]. PMID- 3535263 TI - [Ludwig Traube's contribution to pulmology]. PMID- 3535264 TI - [Detection of Clostridium perfringens enterotoxin in the feces of patients--a method for improving detection of food poisoning]. PMID- 3535265 TI - [The history of physiologic chemistry in the first years of its existence at the Berlin University. Contributions of the chemist M. H. Klaproth and others]. PMID- 3535266 TI - [The cooperation of antifascists and the Soviet military administration in Germany in the health care of resettlers in the province of Saxony in 1945]. PMID- 3535267 TI - [From the beginnings of radon therapy]. AB - The renaissance of the radon therapy in several countries since the end of the Second World War is made the occasion for a review to the beginnings of this special form of radiotherapy. Initially the early history of radioactivity research is described which among others led to the detection of the emanation as daughter product of radium. After this followed the evidence of the emanation as constituent of the natural atmosphere. The establishment of its presence in spring-waters led to the knowledge that there are more than average concentrations of emanation in several mineral springs. In the second part of the article the therapeutic use of the natural radion springs initiated by this is described in its development and importance for Austria (Badgastein, St. Joachimsthal) and Germany (Bad Brambach) up to the beginning of the First World War. PMID- 3535268 TI - [A new concept for immunosuppression after heart transplantation--avoidance of cyclosporin-conditioned organ toxicity]. PMID- 3535270 TI - [Problems in liver transplantation]. PMID- 3535269 TI - [The intramyocardial electrogram in the diagnosis of rejection after heart transplantation]. PMID- 3535271 TI - [Ia expression on Kupffer cells after orthoptic rat liver transplantation and cyclosporin A application: an additional help for the diagnosis of rejection reactions?]. PMID- 3535272 TI - Segmental pancreatic transplantation in diabetes mellitus. PMID- 3535273 TI - [Presence and manipulation of MHC class II antigens on isolated island of Langerhans cells]. PMID- 3535274 TI - [Specific lectin binding on pancreatic tissue and its applicability in the isolation of islet cells]. PMID- 3535275 TI - [Cardiac imaging by nuclear magnetic resonance. II. Spectroscopy]. AB - Nuclear magnetic resonance (NMR) spectroscopy is a new technique to study myocardial metabolism in living tissues by noninvasive means. The biochemical studies on intact hearts are performed in multinuclear NMR spectrometers using Fourier transform techniques for data acquisition. The biological NMR experiments preserve the tissues and can be repeated with a temporal resolution of seconds to several minutes in a reproducible fashion. As a marker of the intermediary metabolism P-31, C-13, H-1, F-19, N-14, Na-23, and K-39 isotopes are commonly used. NMR spectrum analysis permits the identification of several important substrates of the myocardial metabolism and their concentrational changes. In addition, the biophysical parameters of magnetic relaxation properties are measured. In some instances enzyme kinetics can be assessed. The disadvantage of NMR spectroscopy is the low sensitivity: only substrates with a intracellular concentration of greater than or equal to 0.5 mM can be detected. Improvements in sensitivity can be achieved, if the number of scans per spectrum and magnetic field strength are increased. The application of NMR spectroscopy in cardiovascular medicine is new and systematic studies on myocardial metabolism in vivo are not yet available. However, using P-31 MR spectroscopy several important results concerning the changes of the high energy phosphates and the intracellular pH changes during myocardial ischemia, as well as interesting insights into the regulatory principles of the cellular respiration were obtained. Similarly, C-13 NMR spectroscopy successfully described some aspects of glycogen metabolism and the kinetics of citric acid cycle in the myocardium. The clinical application of NMR spectroscopy appears feasible in a near future. The practical importance of this promising technique in clinical cardiology will depend on availability of the whole-body MR spectrometers, on the development of pertinent techniques for spatial MR signal resolution, and on our ability to uncover and to understand the biochemical principles of cardiac diseases. However, it is already today evident that MR spectroscopy successfully shifted the research interests towards biochemical processes at the cellular level as important causes and markers of cardiac diseases and extended our knowledge of the pathophysiology of the myocardium. PMID- 3535276 TI - [Infectious endocarditis in hypertrophic obstructive cardiomyopathy]. AB - Clinical and pathological findings in a 37-year-old female patient with HOCM and infective endocarditis of the aortal and mitral valves were reported. The patient died of septic shock. Infective endocarditis with acute insufficiency of the aortal and/or mitral valves is a severe complication in patients with HOCM, because the left ventricle with a disturbed compliance is unable to compensate the acute volume overload. The standard use of nitrates for congestive lung failure and catecholamines for septic shock is problematic. As with other valvular heart diseases, preventive treatment for infective endocarditis is also recommended for patients with HOCM. In the case of acute endocarditis combined with HOCM early surgical intervention must be discussed. PMID- 3535277 TI - [The elderly man--historical aspects. Several sketches from Bible and church history]. AB - Using biblical and biblical-apocryphal sources, the characteristics of Jewish Christian patriarchism are shown which as a system, especially embodied by elderly men, was very efficient up to the beginning of the 19th century. Following industrialization a decline set in which still continues, and by far exceeds the mere loss of masculine predominance. Particularly elderly men are affected by this. It is remarkable that the general decline of the Protestant Church (in Germany) is connected with the dwindling of responsible paternity. It is presumed that female emancipation and the recovery of masculine responsibility are not contrary but complementary qualities. PMID- 3535278 TI - [Industrial work and old age in Wilhelmian Germany]. AB - Starting with Alfred Weber's research, one has considered the age of forty as the decisive turning-point in the careers of nineteenth century industrial workers. Contrary to previous investigations which deduced an impoverishment of these workers in old age from the reduction of the average wages, the present study shows by means of income figures that the financial situation of workers generally did not deteriorate at all after reaching the age of forty. Estimates of the amount of possessions held at different stages of life, which also include workers who left industry early, prove furthermore that even older workers profited more and more from the increase of wages and the extension of places of work. The impoverishment which in early industrial times started at the age of thirty-five did not set in before the age of sixty-five in high industrialization. PMID- 3535279 TI - [Maud Leonora Menten, co-founder of the Michaelis-Menten equation and pioneer of pathological and clinical biochemistry]. PMID- 3535280 TI - To Karl Enigk on the occasion of his 80th birthday. PMID- 3535281 TI - The interaction of myotropic and macrophagotropic strains of Trypanosoma cruzi with myoblasts and fibers of skeletal muscle. AB - The process of interaction of bloodstream trypomastigotes from the myotropic CL and Colombiana strains and the macrophagotropic Y strain of Trypanosoma cruzi with mouse myoblasts and myotubes was analysed. After 24 h of parasite-host cell interaction, parasites from the CL and Colombiana strains appeared to be more infective to myoblasts than those from the Y strain. Parasites from the Colombiana strain were more infective for myotubes than those from the Y strain, while those from the CL strain showed very a low ability to infect the cells. For all strains the infectivity was low for short periods of interaction, increasing with time. Myoblasts infected with parasites from the Y strain fused with other infected and uninfected cells to form myotubes. However, the process of fusion was blocked when the myoblasts were infected with parasites from the CL and Colombiana strains. These data indicate a different behavior of muscle cells when in contact with myotropic or non-myotropic strains of T. cruzi. PMID- 3535282 TI - Stage-specific sensitivity of Plasmodium falciparum to antifolates. AB - Highly synchronous cultures of Plasmodium falciparum were exposed to therapeutic concentrations of sulfadoxine or pyrimethamine at different developmental stages to investigate the effect on subsequent growth. Morphological observations showed that schizont formation from uninuclear trophozoites was the only process inhibited by the drugs. Segmentation of mature schizonts, merozoite invasion and development of the ring stage remained unaffected. These results support earlier reports suggesting that DNA synthesis is most pronounced in 32-42 h old trophozoites. The possible relevance of our results to the metabolism of P. falciparum is discussed. PMID- 3535283 TI - Assessment of the in vitro growth of Plasmodium falciparum using fluorometry. AB - The growth of Plasmodium falciparum in vitro was quantitatively assessed by applying fluorometry using ethidium bromide. The fluorescence intensity of parasites stained with this dye was found to parallel the uptake of 3H hypoxanthine into nucleic acids during one growth cycle of development. The assay system can be used as a substitute of morphological and radiometric methods in drug-sensitivity tests and for the screening of antimalarials. PMID- 3535285 TI - The immunocytochemical demonstration of Toxoplasma antigen in the brains of congenitally infected mice. AB - The peroxidase anti-peroxidase immunocytochemical staining method was used to identify Toxoplasma antigen in paraffin embedded sections of the brains of 22 mice congenitally infected with the parasite. Intact Toxoplasma tissue cysts were readily demonstrated in the brain in all cases. In 4 of the 22 infected mice there was evidence of rupture of the cyst wall and/or presence of extra-cystic Toxoplasma antigen. Further support for the extra-cystic location of Toxoplasma antigen was obtained by electron microscopy of reprocessed tissue which revealed endozoites in the area immediately surrounding a ruptured cyst. The possible implications of these findings in relation to the pathogenesis of congenital toxoplasmic meningo-encephalitis are discussed. PMID- 3535284 TI - Studies of murine malaria antigens using monoclonal antibodies. Production, selection, and characterization of antibodies. AB - A panel of ten monoclonal antibodies made against Plasmodium chabaudi and Plasmodium yoelii infected mouse erythrocytes were used for characterization of antigens present in murine malaria. Screening of the antibodies in ELISA with different fractions of infected erythrocytes revealed both species-specific and fraction-specific monoclonal antibodies (MAbs), but also MAbs cross-reacting between the species. Two MAbs bound normal erythrocyte components. Subcellular localization of the target antigens was studied by immunofluorescence and their molecular identity by immunoblotting after SDS-PAGE. Of the MAbs to P. yoelii, one reacted with a cytoplasmic granule component of 137 k and two others reacted with vacuole-associated antigens of 26 k and 25/70/73 k, respectively. The latter antibodies cross-reacted with P. chabaudi antigens. Of the MAbs to P. chabaudi, all were species specific, one reacting with parasite surface antigens of 79 and 250 k and two with a vacuole-associated antigen of 70 k. PMID- 3535286 TI - Isolation and immunoelectromicroscopical characterization of Theileria annulata macroschizonts. AB - Theileria annulata macroschizonts were isolated from bovine lymphoblastoid cells grown in cell culture. To release the parasites, the cells were homogenized under hypotonic conditions. Intact host lymphocyte nuclei were lysed and the resulting chromatin precipitate was degraded by DNase. Host cell fragments were removed by ion-exchange chromatography. As revealed by electron microscopy, the preparations were free of intact host lymphocytes, lymphocyte nuclei and organelles. Antisera raised in rabbits against purified macroschizonts showed a specific reaction with the intracellular parasite in the indirect immunofluorescence test and in immuno electron microscopy. PMID- 3535288 TI - Immunoelectron microscopy shows that the 80,000-dalton antigen of Plasmodium falciparum merozoites is localized in the surface coat. PMID- 3535287 TI - Ultrastructural localization of the circulating cathodic antigen in the digestive tract of various life-cycle stages of Schistosoma mansoni. AB - In the present study the ultrastructural localization of the schistosome-derived circulating cathodic antigen (CCA) within the digestive tract of various life cycle stages of the blood fluke Schistosoma mansoni has been determined. Use was made of CCA-specific monoclonal antibodies in a two-step gold-labeling procedure. The following results were obtained: In cercariae gold label was found in the cytoplasm and in the luminal surface coat of the gut epithelium. The oesophagus of this life-cycle stage of the parasite showed minimal CCA reactivity, as gold label was limited to the luminal surface coat, locating proximally to the gut. In 3 1/2-week-old worms and in adult male and female worms CCA was demonstrable in the Golgi apparatus, in cytoplasmic vesicles and in the luminal surface coat; in the caudal quarter of the gut of adult worms CCA was also present in lysosome like bodies. The oesophagus of these worm preparations did not show any CCA reactivity. In miracidia CCA was not present. PMID- 3535290 TI - Pesticide poisoning in Papua New Guinea and the South Pacific. PMID- 3535289 TI - In memoriam Ernest Bueding (1910-1986). PMID- 3535291 TI - Medical tultuls and aid post orderlies. Some historical notes on the use of village health workers in Papua New Guinea up to Independence. PMID- 3535292 TI - [Sex determination of cadaver material by the detection of specific nucleotide sequences of the Y chromosome following DNA cleavage]. AB - A gene technological method of sex determination in cadaverous material is reported. The samples were taken from a child's corpse, which was nearly completely skeletonized after 1 year in water. From cells of the bone marrow the DNA was isolated and digested by restriction enzymes. A defined fragment of 2.12kb length was cleaved off by the endonuclease HaeIII in the presence of Y chromosomes. After agarose-gel electrophoresis of the DNA fragments, the specific sequence was detected by hybridization with the cloned, radioactively labelled complementary plasmide pHY2.1. PMID- 3535293 TI - [New results concerning the effectiveness of therapy of chronic glomerulonephritis. Results of cytostatics-anticoagulants-aggregation inhibitors, cystostatics-anticoagulants-aggregation inhibitors-prednisone and cystostatics prednisone therapy, derived from a retrospective study]. AB - The indication and effectiveness of the immunosuppressive therapy of chronic glomerulonephritis is now as ever controversial. As a result of a retrospective therapy study in an at least one-year therapy with cytostatics, thrombocyte aggregation inhibitors and anticoagulants (CAA-therapy, n = 27), additional prednisone therapy (CAAP-therapy, n = 95) and cytostatic-prednisone therapy (CP therapy, n = 33) we find favourable results for the CAA/CAAP-therapy in the nephrotic syndrome and glomerulonephritides with distinct clinical exacerbation also in sclerosations in histology. Clinically inactive nephritides with exclusive urinary findings and sclerosations cannot be influenced therapeutically. PMID- 3535294 TI - [Kidney sonography in glomerulopathies in childhood]. AB - The rapid progressive course of the glomerulonephritis shows an independent sonographic picture. Apart from the massive enlargement of the organ and the increase of the parenchyma-pyelo-index the kidneys show a high echogenicity, wavy marginal contours and unclear inner structures. In chronic glomerulonephritis both enlarged and diminished kidneys are to be found. A differentiation to the nephrotic syndrome is possible only with the help of the partly increased echogenicity. The elimination of the chronic glomerulopathies from the chronic pyelonephritis by means of sonography does not render any difficulties. In the Alport-syndrome the ultrasound diagnostic gives references to the activity or furidity of the disease. With the increase of the renal symptoms the sonographic picture of the kidneys also changes. In the sonogram no peculiarities for the Schonlein-Henoch nephritis and proteinuria are to be expected. For the acute and chronic glomerulonephritis as well as the Alport-syndrome the use of the sonography for the long-term control of the course is recommended. PMID- 3535295 TI - [A retrospective cross-sectional study: initial experiences with bonded bridges and bonded splints]. PMID- 3535296 TI - [Saint Apollonia and her servants]. PMID- 3535297 TI - [Portrait of a pioneer of prosthetics--Rainer Strack]. PMID- 3535298 TI - [The circular bridge--treatment of a severely reduced edentulous arch]. PMID- 3535299 TI - [Contents, management and planning of practical lectures in the professional continuing education of dental technicians on model casting]. PMID- 3535300 TI - [Casting mold form with fixed sleeves]. PMID- 3535301 TI - [Clinical and technical methods for complete denture treatment]. PMID- 3535302 TI - [Use of a pin attachment between the anchor elements and the framework base]. PMID- 3535303 TI - [Atraumatic-hygienic preparation of the cast framework of partial dentures]. PMID- 3535304 TI - [The accuracy of transfer copings]. PMID- 3535306 TI - [Procedure standards for "General and special working principles" and "Repairs"]. PMID- 3535305 TI - [From inlay castings to model cast dentures--historical view of dental casting technics]. PMID- 3535307 TI - [Use and evaluation of the "Guidelines for premium wages of dental technicians, 15 November 1983" in laboratories for general and specialized prosthetics]. PMID- 3535308 TI - [Inoperative ultrasound tomography in surgery of the bile ducts]. AB - Intra-operative ultrasonic tomography has proved to be superior to cholangiography for a number of aspects, including avoidance of both contrast media and radiation exposure as well as increase in potential information due to possible checkup of surrounding regions (gall bladder, liver, pancreas). Accurate coverage of prepapillary area and the papilla proper is somewhat difficult with this method. Bile duct stones were recorded from nine of 52 patients examined by both methods. Concrement stayed undetected by ultrasound in one case and sludge in another. Nevertheless, the assumption is made that under certain conditions intra-operative cholangiography can be substituted with good success by intra operative ultrasonic tomography. PMID- 3535309 TI - [Percutaneous catheter drainage of pyogenic liver abscess]. PMID- 3535310 TI - [Retroperitoneal ganglioneuroma as a cause of obstructed labor]. AB - The case of a primigravida is reported who was operated on for a retroperitoneal ganglioneuroma at the age of 12. At that time the tumor surgically could not be completely removed because of its size and anatomical location in relation to the backbone and the large blood vessels. A renewed tumour growth was observed in the course of the years. At the end of pregnancy the tumour proved to be an obstruction to the labour process. PMID- 3535311 TI - [Immunoreactive diseases in pregnancy]. AB - Immunoreactive diseases in pregnancy are not frequent and it is important to guarantee an optimal and interdisciplinary treatment. The herpes gestationis is a pregnancy-specific disease of the skin with unknown origin and a good prognosis for mother and child. The progressional lupus erythematodes visceralis has a high risk for mother and child, but the rheumatoid arthritis shows remissions during pregnancy. The Basedow's disease and the autoimmune thyroiditis are needed a pregnancy-associated therapy to prevent a hyperthyreotic syndrome of newborns. The autoimmune haemolytic anemia and the thrombocytopenia have a high fetal risk although by intensive management. Myasthenia gravis may cause a transient neonatal syndrome. PMID- 3535312 TI - [Ivemark syndrome]. AB - The Ivemark-Syndrome (Alienie Syndrome) is defined by the characteristic association of splenic aplasia, organsymmetry and other malformations especially of the cardiovascular system. More than 200 cases are reported. The incidence of Ivemark-Syndrome is very low. The aetiology is not yet clearly defined. As a main cause exogen factors between the 31st and 38th day of gestation are discussed, but a genetic cause has not been detected yet. Due to the unfavourable prognosis an intensive ultrasonographic screening is to be asked for. PMID- 3535313 TI - Propagation of ovine and bovine abortion strains of Chlamydia psittaci in suspension cultures of L-cells. PMID- 3535314 TI - [Organization of mass preventive examination of workers and dispensarization of neurology patients at the automated medical diagnostic center of the "Kommunar" automotive plant at Zaporozh'e]. AB - To ensure a wide-scale prophylactic examination of the population in Zaparozhie, an automated centre of medical diagnosis was set up on the basis of the medical centre at an automobile plant. Using computers working in the real time mode, wide-scale prophylactic screening of clinically healthy people is carried out at the Centre. This makes it possible to elicit patients with neurological abnormalities and to provide prophylactic and rehabilitative services for them. PMID- 3535315 TI - [Extraction of an informative cluster of factors for identification of patients with neuropsychiatric diseases]. AB - On the basis of a blanket examination of employees at a large industrial enterprise which revealed 743 patients with neuropsychic diseases, predominantly of a borderline nature, and of 273 mentally normal subjects the authors, using the algorithm of image recognition identified an informative aggregation of factors determining the status of mental health. In the total sample the authors received 85.5% of correct, 13.8% of erroneous, and 0.7% of unrecognized solutions. The authors also discuss signs considered as risk factors and as factors of resistance in relation to the development of neuropsychic abnormalities. The utilization of the results obtained may be promising in conducting the preliminary automatic screening of the population with the purpose of identifying groups at a risk of developing neuropsychic disturbances. PMID- 3535316 TI - [Psychiatric aspects of the activity of physicians in medical societies of the non-zemstvo districts of Russia]. PMID- 3535317 TI - [Deinstitutionalization and its consequences (review)]. PMID- 3535318 TI - [Tuberous sclerosis (review)]. PMID- 3535319 TI - [Effect of erythrocytes on the stability of prostacyclin in healthy subjects and patients with cerebral dyshemias]. AB - The authors studied the interaction between red blood cells (RBCs) and prostacycline (P) in normal subjects and patients with transient disorders of the cerebral circulation and cerebral stroke. RBCs accelerated P disintegration with the formation of inactive products, with the process being most accelerated in RBC aggregation. It has been found that hyperosmolarity of the medium and disoxygenation of RBCs increase their ability to break down P while lactacydosis decreases this ability. It has been also established that there is a greater proportion of people with a marked ability of RBCs to break down P among patients with cerebral dyshemias, particularly with cerebral stroke. This might be due to alterations in the conformation of the surface layers of RBCs in abnormal conditions. PMID- 3535320 TI - [Dexamethasone test and the clinical picture of depressive states (review)]. PMID- 3535321 TI - [Real-time sonography in pathological changes of the mouth floor and tongue]. PMID- 3535322 TI - [Complete denture remounting tests--a comparison of 2 processing technics]. PMID- 3535323 TI - Castleman's disease, plasma-cell type. Diagnosis of central nervous system involvement by cerebrospinal fluid cytology. AB - A case of Castleman's disease of the plasma-cell type is reported in which central nervous system (CNS) involvement was diagnosed by cerebrospinal fluid (CSF) cytology. The patient had multicentric disease with constitutional symptoms, immunologic abnormalities and peripheral blood cytopenias requiring cytotoxic agents and steroids for treatment. CNS symptoms and diagnostic cytologic findings in CSF occurred in the absence of morphologic lesions demonstrable by computed tomography or magnetic resonance imaging of the brain. PMID- 3535324 TI - Sellar lesions associated with isolated hyperprolactinaemia. Morphological, immunocytochemical, hormonal and clinical results. AB - In 204 patients with sellar lesions and isolated hyperprolactinaemia we analysed and compared many different morphological, immunocytochemical, hormonal, and clinical data for a differentiation of primary (Prl produced by a tumour) and secondary (Prl elevation by PIF inhibition) hyperprolactinaemia. We found Prl positive pituitary adenomas with primary hyperprolactinaemia in 62.7% and a secondary Prl elevation with different alterations in 37.3% (Prl-negative adenomas 28.9%, craniopharyngeomas 5%, and non-tumourous conditions 3.4%). In secondary hyperprolactinaemia the Prl values did not exceed 130 micrograms/l, higher levels indicated Prl-producing adenomas with a high probability. In patients with Prl elevation below 130 micrograms/l the clinical and sometimes the morphological analysis were not sufficient for a differentiation. Here immunocytochemical studies are necessary for a clear classification of hyperprolactinaemia. PMID- 3535326 TI - Autoimmune-resistance in Graves' disease tissues indication of a structural and functional heterogenicity. AB - Out of 256 patients with Graves' disease and a characteristically low echogenic ultrasound appearance of the thyroid gland, 12 patients (4.7%) showed additionally one single or several intrathyroidal focal alterations with high echogenicity. Their volume was 0.2 to 7.0 cm (X +/- SD: 1.75 +/- 2.24 cm). A common characteristic of the 12 patients was a longstanding history of Graves' disease and antithyroid treatment with thiamazol or carbimazol and a mean age of 55 +/- 9 (SD) years (range 42-75 years). The foci with high echogenicity had a normal or macrofollicular histological structure (mean follicle lumen diameter 119.7 micron, as proven by histology in 4 cases) which was significantly higher than follicle lumina of the surrounding Graves' disease tissue (mean follicular lumen diameter 38.3 micron; P greater than 0.001). The height of follicle epithelium and the nuclei cross-section area of such foci was similar to corresponding normal tissue parameter in 5 out of 7 foci. The 99mTc-uptake of the foci amounted to 40 to 80% in comparison with Graves' disease tissue. 131-iodine autoradiography, thyroglobulin immunochemistry and 125-iodine-TSH binding analysis performed in selected cases confirmed the heterogenicity of these foci. The data provided evidence that the foci were unresponsive to TSH-receptor mediated stimulation through Graves' immunoglobulins. It is concluded that longstanding Graves' disease can be associated with tissue foci which are in a functional sense resistant to immunogenic stimulation by TSH-receptor autoantibodies. PMID- 3535325 TI - Improved enrichment of functionally intact anterior pituitary cells by sequential centrifugal elutriation and density gradient sedimentation. AB - By centrifugal elutriation and subsequent Percoll density gradient centrifugation, we obtained highly enriched cell populations of the anterior pituitary of ovariectomized adult rats. Enrichment of somatotrophs, gonadotrophs and mammotrophs was 90%, 80% and 77%, respectively (determined by immunocytochemistry). 41% of the GH-cells showed a medium cell size and the highest density. 52% of the LH-cells and 44% of the FSH-cells were found within the population of the large and medium-dense cells. 69% of the prolactin-cells belonged to the small-sized cells with low density. Thyrotrophs were found within all of the size ranges. The majority of the corticotrophs (82%) showed a small cell size. The enriched somatotrophs, LH-gonadotrophs, and mammotrophs responded to GRF, LRH and TRH. Before and after enrichment, somatotrophs and mammotrophs showed the same responsiveness to releasing hormones. In contrast, enriched LH gonadotrophs exhibited a higher responsiveness to LRH than unfractionated LH gonadotrophs. PMID- 3535327 TI - LT4-monopreparation versus LT4-LT3-compound preparation in the treatment of diffuse endemic goitre. AB - Fifty-four patients with diffuse non-toxic goitre were observed before and under therapy either with 125 micrograms LT4 (group A) or 75 micrograms LT4 + 15 micrograms LT3 (group B) in a prospective double blind study, using 1-, 3- and 6 months controls. Changes in goitre size have been estimated by ultrasonic scanning. Both treatment forms provided a significant reduction of goitre size, even after 1 month of therapy: a 20%-decrease in group A and 16% in group B. The 6-month reduction was about 30% in group A and 27% in group B. Between the 2 groups there were no differences in the reduction of volume. The suppression of the TSH-response to TRH was identical in both groups, too. In group A there was a predominant increase of the TT4- and FT4-serum levels, both reaching the hyperthyroid range. In group B there was a predominant increase of the TT3- and FT3-serum levels and a slight increase of the FT4-levels. The TT3- and FT3-serum levels also exceeded the upper normal range. As the blood samples were drawn about 2 h after medication, acute hormone resorption influenced these data. In the 3-month controls only there was a significant correlation between the reduction of the thyroid volume and the suppression of TSH-release. In the 6 month controls we found a weak correlation of the reduction of volume and the decrease of the pertechnetate uptake value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535328 TI - Physiological role of thiol proteases in thyroid hormone secretion. AB - To determine the physiological role of the thiol proteases in T4 and T3 release from thyroglobulin, experiments were performed with 131I-prelabelled rat thyroid lobes incubated in vitro in the presence and absence of leupeptin, an inhibitor of thiol proteases. Basal secretion of [131I]T4 and [131I]T3 from rat thyroid lobes prelabelled in vivo was quite low, but in the presence of 10 mU/ml bovine TSH a marked stimulatory effect was observed. The stimulatory effect of TSH was completely abolished by leupeptin. This was associated with marked inhibition of lysosomal proteolytic activity, suggesting that the inhibitory effect of leupeptin on T4 and T3 secretion could be attributed to its inhibitory action on proteolysis of thyroglobulin. Further evidence for an inhibitory effect of leupeptin on intralysosomal hydrolysis of thyroglobulin was obtained when thyroid lobes were incubated with 131I- in the presence and absence of leupeptin and TSH. The crude lysosomal preparation was fractionated on a Percoll density gradient, which separates 131I-containing particles into a dense peak containing purified lysosomes and a buoyant peak containing pinocytotic vesicles. A marked increase in the 131I-content of the dense peak was observed in the presence of TSH + leupeptin. Analysis of the 131I in the dense fraction by sucrose density gradient centrifugation and by SDS-polyacrylamide gel electrophoresis demonstrated that leupeptin inhibited degradation of 19S thyroglobulin, especially the formation of [131I]peptides of MW less than 14K. PMID- 3535329 TI - The polymorphism linked to the human insulin gene: its lack of association with either IDDM or NIDDM in Japanese. AB - Polymorphism of 5' portion of the human insulin gene was examined in 188 unrelated Japanese subjects (49 normal, 71 with IDDM, and 68 with NIDDM) using restriction endonuclease analysis. Restriction fragments were classified according to the insertion size: Class 1 (600 base pairs), Class 2 (1300 base pairs), and Class 3 (2000 base pairs). We found a very high frequency of Class 1 alleles (96.8%) and a low frequency of both Class 2 (0.8%) and Class 3 alleles (2.4%) and that approximately 94% of the genotypes were Class 1/Class 1 homozygote. In addition, there was no correlation of allelic or genotypic frequency with NIDDM or IDDM. We conclude that length polymorphism of the human insulin gene cannot be a useful marker for diabetes in Japanese. PMID- 3535330 TI - Paediatric endocrinology 1986. Liber amicorum dedicated to Professor Andrea Prader. PMID- 3535331 TI - Growth hormone deficiency due to GH-N gene deletion in an Austrian family. AB - An 11 year old Austrian boy with isolated growth hormone deficiency type I A is described. On institution of GH therapy at the age of 2 2/12 years there was only a short growth response and anti-GH-antibodies with high binding capacity were detected, and growth was inhibited. Examination of the nuclear DNA by restriction endonuclease analysis demonstrated a defect of the GH-N gene in the patient. The results suggest the deletion in this Austrian family is different from that seen in other patients. The parents were heterozygous for the deletion and had a subnormal GH response to stimulation with arginine, but their somatomedin-C concentrations and their heights were normal. The patients' sister was of normal height, hormone analyses were normal, and the GH-N gene was not affected. PMID- 3535332 TI - Variants of sexual differentiation in relation to sex chromosomal aberrations. PMID- 3535333 TI - The control of the onset of puberty. PMID- 3535334 TI - Treatment of pubertal gynaecomastia with testolactone. AB - 22 Boys with pubertal gynaecomastia (age 15.9 +/- 1.9 years) were treated with testolactone (450 mg daily by mouth) for 2 to 6 months without side-effects. The mean breast gland diameter regressed from 4.4 to 3.3, 3.2 cm, and 1.7 cm at 2, 4, and 6 months, while pubic hair and testicular volume progressed normally. Plasma androstenedione increased from 5.4 to 73.1 nmol/l. Testosterone, DHEA, and oestrone increased less, and oestradiol remained unchanged. Androgen/oestrogen ratios increased (most marked change: androstenedione/oestrone from 15 to 140). LH (basal and maximum after LHRH) did not change, but FSH increased somewhat (basal 133 to 173, maximum 225 to 269 micrograms/l). Prolactin remained unchanged. It is concluded that testolactone, an inhibitor of steroid aromatization, is an effective and safe medical treatment for pubertal gynaecomastia. PMID- 3535336 TI - Annual progression of retinopathy in conventionally treated children and adolescents with type I diabetes mellitus. AB - In a cohort of 268 type I diabetic patients, aged 19.6 +/- 4.1 years (Mean +/- 1 SD), with a diabetes duration of 10.4 +/- 4.9 years, treated by the same team, using the same conventional treatment regime during the total observation period, the progression rate of early retinopathy within the first two decades of diabetes was deduced from observed transitions of the retinal status from one stage of retinopathy (as defined by fluorescein angiography) to a higher one (Malone et al., 1977) within one year. A total number of 83 such events were evaluated. After a gradual development of earliest changes within the fifth year of diabetes, the median annual rate of progression was found to be 12-13%, independent of the previous duration of diabetes and the actual retinal state. PMID- 3535335 TI - Adolescent sexology and ephebiatric sexual medicine. AB - Ephebiatric sexual medicine is a specialty that still awaits its Vesalius. The age of onset of puberty has decreased by four years in the past two centuries, without a concordant change in social and legal institutions governing sexual and economic autonomy. Concomitant with the reintroduction of the ancient European betrothal system, the adolescent age of first coitus has lowered and averages two years earlier than first contraception. The hiatus is attributed to the moral sanctions against open access to contraception in adolescence. The neglect of sexual learning in teenage allows cases of suicidal and homicidal lovesickness to be undetected and likewise the mental template or "lovemap" of paraphilic pathology in adolescence lacks both preventive measures and treatment. The newest treatment of the paraphilias is with antiandrogen combined with counseling. Positive or negative preparedness for first orgasm or first coitus correlate with positive or negative outcome in subsequent sexuoerotic health. Knowing the sexology of syndromes, for example genetic and endocrine syndromes of childhood, expedites the delivery of sexological health care service in adolescence. PMID- 3535337 TI - Prostaglandin excretion in pseudohypoaldosteronism type I. AB - In an infant with pseudohypoaldosteronism type I increased urinary excretion of PGE2 (1.32 ng/mg creatinine; normal mean +/- SE: 0.50 +/- 0.10) and PGF2 alpha (6.15 ng/mg creatinine; normal mean +/- SE: 2.93 +/- 0.91) was found. Prostaglandin excretion as well as the typical hyperkalemia, hyperreninemia and hyperaldosteronism normalized with adequate dietary salt supplementation. An abnormally high excretion of the renal prostaglandins was again present at age 4.4 years when the child was thriving although additional salt was withheld. These abnormalities are considered to be secondary to this condition's basic defect which remains to be elucidated. PMID- 3535338 TI - Some aspects of androgen insensitivity. AB - The clinical and endocrine features of the syndromes of androgen insensitivity which display a wide phenotypic spectrum are reviewed. A simple, dispersed whole cell assay to study androgen receptor binding in genital skin fibroblasts has been used to determine the pathogenesis of androgen insensitivity. Classification of the disorders based on in vitro studies does not show absolute concordance with the clinical sub-groups. Androgen-induced augmentation of basal specific binding is proposed as a possible functional test of androgen responsiveness in disorders such as partial androgen insensitivity, isolated hypospadias and micropenis. Understanding the cause of androgen insensitivity in many receptor positive patients awaits identification and isolation of DNA probes for the X linked gene locus for the androgen receptor. PMID- 3535339 TI - Serum insulin-releasing activity and the Prader-Willi syndrome. AB - Pathogenesis and etiology of the various clinical features of the Prader-Willi syndrome (PWS) are not completely understood. There is evidence suggesting a hypothalamic abnormality leading to hypogonadism in this syndrome. To test the possible hypothalamic involvement in the pathogenesis of obesity in these patients we studied the sera of 5 patients with PWS for insulin-releasing activity of possible hypothalamic origin. In addition 4 patients with a PWS-like syndrome and 6 obese patients with signs of central nervous system damage were studied. All five patients with PWS showed significant insulin-releasing activity in their sera. Of the four patients with PWS-like symptoms three showed similar activity while three of the obese patients with central nervous system damage had this activity in their sera. Serum insulin-releasing activity has been shown earlier to be associated with childhood obesity and it could play a role in the pathogenesis of obesity in PWS. PMID- 3535340 TI - Pituitary adenomas in childhood. PMID- 3535341 TI - The national hormone and pituitary program (NHPP) historical perspective. PMID- 3535342 TI - Peptide growth factors: a new frontier for pediatric endocrinology. PMID- 3535343 TI - The biosynthesis of somatomedins and their role in the fetus. AB - The somatomedins are a family of hormones consisting of insulin-like growth factors 1 and 2 as well as their variant forms. These peptides have a direct growth-promoting action on fetal cells mediated through their interaction with Type I and II receptors distributed throughout the fetus. The genes for both IGF 1 and IGF-2 are expressed in the fetus. In man, the predominant forms are the truncated IGF-1 variant and IGF-2. Unlike production at maturity, fetal biosynthesis appears independent of growth hormone and may instead be primarily regulated by nutrition. Other hormones such as placental lactogen are also involved in the regulation of fetal biosynthesis of somatomedins. PMID- 3535344 TI - [Properties and clinical use of perfluorocarbons]. PMID- 3535345 TI - [Use of small, moderate and large doses of cytarabine (ARA-C) in the treatment of leukemia and other diseases of the hematopoietic system]. PMID- 3535346 TI - [Ferritin--molecular structure, properties and function]. PMID- 3535347 TI - Studies of vasopressin in the human cerebrospinal fluid. AB - The development of sensitive radioimmunoassays has permitted measurement of the low concentration of vasopressin in the human cerebrospinal fluid. There is accumulating evidence to suggest that vasopressin is involved in a variety of brain functions. As an effective blood-cerebrospinal fluid barrier to vasopressin has been demonstrated, the concentration of vasopressin in the cerebrospinal fluid probably reflects the release of vasopressin within the brain. In human subjects without intracranial disease, the concentration of vasopressin in the cerebrospinal fluid is in the range 0.5-2.0 pg/ml with only little diurnal variation. Intracranial disorders associated with increased intracranial pressure may cause increased cerebrospinal fluid vasopressin concentrations, whereas degenerative brain diseases are associated with low concentrations. Only little is known about the physiologic stimuli which alter the concentration of vasopressin in cerebrospinal fluid. The concentration in cerebrospinal fluid is not influenced by a number of stimuli that cause release of vasopressin into the blood, i.e. changes in plasma osmolality, postural changes, and nausea. Elevation of the intracranial pressure, changes in the composition of the cerebrospinal fluid, electrical stimulation of the hypothalamus, and severe hemorrhage provoke an increase in cerebrospinal fluid vasopressin level. PMID- 3535348 TI - Epilepsy and state specific memory. PMID- 3535349 TI - A neuroanatomic perspective on state-dependent learning: the role of the striatum. PMID- 3535351 TI - Modes of action of posttrial manipulation of learning: memories lost and memories regained. PMID- 3535350 TI - State-dependent learning and drug discriminative control of behaviour: an overview. PMID- 3535352 TI - Some aspects of memory functions and the temporal lobes. PMID- 3535353 TI - Kindling: a model for epilepsy and memory. PMID- 3535355 TI - Development of stroma in malignant lymphomas of the brain compared with epidural lymphomas. An immunohistochemical study. AB - The relation of lymphoma cells to gliomesenchymal stroma within nervous tissue was studied by peroxidase-antiperoxidase immunostaining of formalin-fixed and paraffin-embedded surgical specimens for fibronectin (FN), factor VIII-related antigen and glial fibrillary acidic protein in 17 malignant non-Hodgkin lymphomas of the brain. For comparison, 9 non-Hodgkin lymphomas, 6 Hodgkin lymphomas, and 19 plasmacytomas of the spinal or cranial epidural spaces were studied with the same methods. Lymphoma cells were consistently negative for all markers. All lymphomas of the brain showed conspicuous concentric perivascular circles of immunoreactivity for FN in parts infiltrating brain tissue. Such structures are considered to derive from splitting of basal laminae of preexisting brain vessels; they were not seen in tumors of the epidural space. Cells with conspicuous FN content were found in brain as well as in epidural lymphomas. A monohistiocytic origin of those cells was confirmed by presence of monohistiocytic markers lysozyme and alpha-1-anti-chymotrypsin. Thus, additional immunostaining for FN seems to be useful for detecting monohistiocytes/macrophages in brain tumors. PMID- 3535356 TI - Technical failures and some related clinical complications in extensive fixed prosthodontics. An epidemiological study of long-term clinical quality. AB - Three hundred and sixteen fixed partial dentures made in 1975-1976 by 112 general practitioners in Malmo, Sweden, were selected for a questionnaire study of the technical failure rates after 6-7 years. Cariologic, periodontal, endodontic, and esthetic complications were also identified, as were those appearing in the stomatognathic system. The total material consisted of three groups with an approximately equal number of reconstructions. One group consisted of fixed partial dentures with distal abutment teeth, another was formed of fixed prostheses with single cantilever pontic/pontics, and a third consisted of double cantilever pontics. Excluding the 26 reconstructions, which had been made for patients who died (24) or emigrated (2) during the observation period, data was obtained for 97% of the selected restorations. The results showed high rates of cariologic (18-31%), endodontic (5-23%), periodontal (7-12%), esthetic (10-16%), and technical (8-34%) complications. Differences were noted between the groups. For all types of technical failures (fractures and loss of retention) higher frequencies were related to the extent of cantilevering. Direct relationships were found between the technical failure rate and the time in service, the sum of all cantilever extension pontics in the reconstructions, and the state of the pulps of the distal abutments. No relationship was found between the technical failure rate and the status of the dentition in the opposing jaw. The clinical significance of the results obtained is discussed. PMID- 3535354 TI - Pathogenesis of multiple sclerosis. A critical reappraisal. AB - The pathogenesis of multiple sclerosis remains a dilemma despite many years of study. Evidence for an infective agent is lacking: much doubt remains regarding the pathogenetic significance, if any, of the many reported alterations of the immune system. On the other hand, the well-documented facts that multiple sclerosis plaques are invariably located around blood vessels and that alterations of the blood-brain barrier permeability are always present in the plaque suggest that these old observations should be reconsidered. There is strong evidence to support the idea that the alteration of the blood-brain barrier is an obligatory step in the development of the plaque. It may result from a variety of environmental factors among which must be mentioned trauma to the nervous system, as well as the immunological changes resulting from viral infections and vaccinations. The available data lead to the following hypothesis: multiple sclerosis is a disease which requires the following factors for the production of demyelinating lesions of the central nervous system: a genetically determined susceptibility, an environmental, probably viral, probably immune mediated initiatory event producing a symptomless systemic illness, a subsequent alteration of the blood-brain barrier resulting from diverse mechanisms including trauma or a second, immune-mediated event, a myelinoclastic plaque-forming mechanism which is operative only in the central nervous system. PMID- 3535357 TI - Serum lipoprotein changes in climacteric women induced by sequential therapy with natural estrogens and medroxy-progesterone acetate or norgestrel. AB - Thirty perimenopausal women were randomized to sequential therapy with either estradiol-valerate and norgestrel (Cyclo-Progynon), or estradiol and medroxy progesterone acetate (EM 627). Blood samples were drawn before treatment and in the third treatment cycle during estrogen and progestogen phases respectively. The clinical effects of the two treatments were without significant difference. Ovulation was not suppressed by the treatments, which induced similar increases in serum estradiol and estrone concentrations. The medium serum high density lipoprotein-(HDL)-cholesterol concentration expressed as a percentage of the pretreatment level decreased in the postmenopausal women treated with Cyclo Progynon to 90% compared with 104% (p less than 0.01) in the EM 627 group. However, the concentrations expressed in mmol/l did not differ significantly, probably owing to non-significant differences in the pretreatment levels. Low density lipoprotein-(LDL)-cholesterol concentrations decreased by approximately 10% in the postmenopausal women during both treatments. Cyclic addition of medroxy-progesterone acetate to estrogen replacement therapy does not adversely affect the serum lipoprotein pattern, and may be preferable to norgestrel. PMID- 3535358 TI - alpha-Methyldopa for climacteric hot flushes. A double-blind, randomized, cross over study. AB - The effects of single evening doses of alpha-methyldopa and placebo have been compared in 40 women with climacteric hot flushes. The study was designed as a double-blind, randomized and cross-over investigation. Of the 24 patients who completed the study, 15 reported that they preferred the alpha-methyldopa treatment (p greater than 0.05). alpha-methyldopa seemed to affect both the severity (p less than 0.05) and the frequency of climacteric hot flushes (p greater than 0.05). It is concluded that alpha-methyldopa is efficacious against climacteric hot flushes when given as single evening doses, but further study is required to answer whether this dosage is as effective as a twice daily regimen. PMID- 3535359 TI - Does position and size of corpus luteum have any effect on nausea of pregnancy? AB - It is a puzzling fact that emesis might occur in one pregnancy, whereas other pregnancies in the same woman could be either free or again associated with nausea. Pregnancy-associated hormones are believed to cause nausea, possibly through effects mediated via the liver. In 43 women who applied for a legal abortion in early pregnancy the occurrence of nausea was recorded and the position and size of the corpus luteums were measured by means of ultrasound. It was found that emesis was associated with corpus luteum located predominantly on the right side, while the non-emetic pregnancy often had a left-sided corpus luteum. It is suggested that the venous drainage, which differs between the right and the left side, may be responsible for the fact that the same woman can either suffer from or be free from nausea during pregnancy. Ovarian vein insufficiency, being more common in multigravidity, may also explain why nausea is more common in multigravidae. PMID- 3535360 TI - Treatment of abscesses in the vulva. Conventional open treatment versus primary suture under antibiotic cover. AB - Seventy patients were treated for a subcutaneous abscess in the vulva. In 35 consecutive patients the abscess was treated conventionally with deroofing of the abscess and wet dressings. In the other 35 consecutive patients the abscess was treated by incision, curettage and primary suture under antibiotic cover with a single dose of clindamycin. In the conventionally treated group the median stay in hospital was 7 days and the median healing time 18 days. In the group treated by primary suture the median stay in hospital was 2 days and the median healing time 7 days (P less than 0.0001). Recurrence of abscess was observed in one patient in each group. No other complications were observed in either group. It is concluded that vulvar abscesses may be treated safely and advantageously by primary suture under antibiotic cover. PMID- 3535361 TI - In vitro perfusion studies on human umbilical arteries. II. Effects of prostacyclin and a thromboxane A2 mimetic. AB - Vascular effects of a thromboxane A2 mimetic, U46619, and prostacyclin on human umbilical arteries have been investigated by in vitro perfusions. Administration of U46619 invariably induced vasoconstrictory responses which were found to be dose-dependent and consistently stronger than those observed with other prostaglandins (e.g. PGF2 alpha and PGE2). Infusion of prostacyclin alone did not lead to significant alterations in the arterial perfusion pressure. However, when prostacyclin was introduced after a constriction with U46619 had been established, a transient pressure decrease was observed. When both drugs were introduced simultaneously, the U46619 response was suppressed. This suppression was partial and dependent on the PGI2 concentration. PMID- 3535362 TI - Placental grading with ultrasound in hypertensive and normotensive pregnancies. A prospective, consecutive study. AB - Placental grading was studied prospectively with real-time ultrasound in 654 consecutive pregnancies. The placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. The value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated. PMID- 3535363 TI - Reliability of ultrasound fetometry in estimating gestational age in the second trimester. AB - The reliability of ultrasound fetometry for estimating gestational age (GA) in the second trimester was evaluated, using the fetal variables: biparietal diameter (BPD), occipitofrontal diameter (OFD), mean abdominal diameter (AD), and femur length (FL), each value being taken as the mean of five measurements. Of the individual variables, BPD gave the best precision, with a standard deviation (SD) from true GA of 3.2 days. Using a combination of all four variables, GA could be estimated with a SD of 2.2 days, which was not significantly better than the formula, GA = BPD X 1.2 + FL X 1.0 + 49, which gave results with a SD of 2.4 days. Equations obtained from regression analysis of the variables against true GA were tested in 44 cases where the precise date of conception was known, GA being estimated by BPD with a SD of 3.2 days, and by the combination of BPD and FL with a SD of 2.7 days; the maximum difference between GA estimated by BPD and by FL was 7 days. Using a combination of BPD and FL to estimate GA in the total population, the number of post-term deliveries was only marginally less than when using BPD alone. PMID- 3535365 TI - Prenatal sonographic appearance of persistent cloaca. AB - A case of fetal persistent cloaca is presented. The intra-uterine sonographic appearance at 30 weeks' gestation is described. The clinical and ultrasonic differential diagnosis is discussed. PMID- 3535364 TI - Induction of labor by intra-cervical PGE2 in viscous gel. Mechanism of action and clinical treatment routines. AB - Induction of labor in women with immature cervix was accomplished by four different treatment schedules. The case material included a total of 100 subjects, each treatment group having 25 cases: Group A: Intravenous oxytocin; Group B: Intracervical PGE2-gel followed by intravenous oxytocin; Group C: Intracervical PGE2-gel twice with a 12-hour interval; Group D: Intracervical placebo gel twice with 12-hour interval. Oxytocin did not influence the Bishop score (B.S.) unless in the presence of active labor contractions. In contrast, there was an increment in B.S. by 3.6 points on average within 12 hours following PGE2-gel as calculated from data of subjects without signs of contractions. These results support the concept of a local action of PGE2-gel. The increment in B.S. was larger in subjects with very immature cervices (B.S. less than or equal to 2) than in those with moderately immature scores (B.S. 4). A second PGE2-gel instillation did not increase the B.S. above the level achieved by the first application, indicating that pharmacological ripening of the cervix by a single dose of PGE2 results in an effect approaching maximum. The success rate was the same for oxytocin and PGE2-gel treated women during the first 24 hours, when approximately 40% of the women had given birth. The oxytocin group remained at that level of success rate, whereas the PGE2-gel-oxytocin and PGE2-gel X 2 series continued to improve their success rate up to 75%. An interesting finding in the study was that women given PGE2-gel twice did not need intravenous oxytocin stimulation except in a few cases. PMID- 3535366 TI - Hydatidiform mole in a triplet pregnancy following gonadotropin therapy. AB - A first case is reported of complete hydatidiform mole with two coexistent fetuses in a triple pregnancy following human menopausal gonadotropin human chorionic gonadotropin (hMG-hCG) therapy. The molar mass and two fetuses were delivered separately at 17 weeks of gestation. The fetuses were female (155 g) and male (160 g) with individual placentae (85 g, 90 g). The hydatidiform mole (650 g) had a normal 46,XX karyotype. The sexes of the two fetuses and the karyotype of the mole are consistent with previous reports that the chromosomes of fetuses and moles are derived from both parents and the father, respectively. PMID- 3535367 TI - Sealing of retinal breaks with metal tacks. Evaluation of a new procedure in retinal re-attachment surgery. AB - Metal retinal tacks were used in 18 patients with complicated retinal detachments, such as giant tears (3 cases), severe proliferative vitreoretinopathy (PVR) (7 eyes) and diabetic traction and rhegmatogenous detachment (8 cases). All eyes had undergone vitreous microsurgery, including excision or segmentation of epiretinal membranes, fluid-air (SF6) or silicone oil exchange. Retinal breaks and the cut edges of retinotomies and retinectomies were successfully sealed by metal tacks. Retinal re-attachment was achieved in 9 cases and partial re-attachment in another 5 eyes (follow-up 3-6 months). Retinal tears in diabetic macular detachment associated with extensive epiretinal fibrovascular membranes were also successfully sealed despite persisting traction. Our first experience indicates that the closing of retinal breaks with metal tacks is a major step forward in retinal re-attachment surgery. PMID- 3535368 TI - Persistence of Serratia marcescens, Serratia liquefaciens and E. coli in solutions for contact lenses. AB - Twenty-four different brands of contact lens solutions were experimentally inoculated with strains of S. marcescens, S. liquefaciens and E. coli. Only flexol and hexidin could sufficiently suppress the growth of Serratia strains. If a soaking agent is to be effective in suppressing S. marcescens it must have a chlorhexidine concentration of at least 50 micrograms/ml and a thiomersal concentration of 10 micrograms/ml. PMID- 3535369 TI - A microbiological study of conjunctivitis with emphasis on Chlamydia trachomatis, in northern Norway. AB - To determine the microbiological agents in conjunctivitis in children and young adults, physicians outside hospitals were asked to obtain samples from the conjunctiva in patients presenting with conjunctivitis. Specimens from 194 patients and 177 healthy controls were cultivated for Chlamydia trachomatis. In 12 cases Chlamydia trachomatis was isolated (i.e. 4 neonates, 1 three-year-old child and 7 adults, aged 17 to 39 years), but in none of the controls. Of the specimens from patients 168 and all of the healthy controls were cultivated for both bacteria (including Chlamydia trachomatis) and viruses. The main micro organisms, regarded as infectious, were Haemophilus influenzae (20), Streptococcus pneumoniae (18), Staphylococcus aureus (14) and Chlamydia trachomatis (9). Haemophilus influenzae (non-typable strains) were isolated more frequently in the age group below 5 years of age than in the age group 5-50 years. Herpes simplex virus (type II) was isolated in one neonate. Chlamydia trachomatis is among the most important infectious agents in conjunctivitis treated outside hospitals. As chlamydial infections need special attention regarding treatment and follow-up, physicians should be encouraged to obtain specimens for microbiological examination, including chlamydia, from the population at risk. PMID- 3535370 TI - Immunohistochemical identification of squamous carcinoma of the head and neck with monoclonal antibody SQM1. AB - Frozen tissue sections of biopsies from head and neck squamous cancer lesions were examined for immunohistochemical staining with a recently developed monoclonal antibody, designated as SQM1 antibody and directed against the surface membrane of squamous carcinoma cells. SQM1 antibody stained selectively squamous carcinoma, while normal mucosa and cells of the stroma were non-reactive. Positive staining of tumor was found in 33/35 specimens obtained from several major sites of the head and neck area and was observed in primary manifestations and lymph node metastases as well as in recurrences. The most consistent reactivity was seen with carcinomas of the tongue. Well differentiated squamous carcinomas contained a higher proportion of SQM1 positive tumor cells than poorly differentiated carcinomas. We suggest that the SQM1 antibody may aid in the immunohistochemical identification of squamous carcinoma of the head and neck area. PMID- 3535371 TI - Experimental mesangioproliferative glomerulonephritis in rats induced by intravenous administration of anti-thymocyte serum. AB - Focal glomerulonephritis was induced in rats, by a single intravenous injection of anti-Thy-1.1 antibody (ATS). One hour after the administration, the glomeruli of affected rats developed necrotic changes of the mesangial cells while after two hours, mesangiolytic changes appeared. From six days onwards, focal segmental mesangial proliferation which persisted until 30 days, occurred. This is thought to be the first report of experimental nephritis induced by pure anti-mesangial antibody. PMID- 3535373 TI - Yeast preparations enriched with trace elements. PMID- 3535372 TI - [Alkaloids of Lycopodia from Lyycopodiaceae (continued)]. PMID- 3535374 TI - The effect of food composition on serum zinc. PMID- 3535375 TI - Kidney transplantation may cure aluminium osteodystrophy. PMID- 3535376 TI - Trace elements and cardiovascular diseases. AB - Evidence linking marginal intakes of the trace elements, chromium, copper, zinc and selenium, with abnormal lipid metabolism and ultimately cardiovascular diseases is accumulating from both animal and human studies. Chromium supplementation of normal adult men, as well as diabetics, has been reported to increase high density lipoprotein cholesterol and decrease triglycerides and total cholesterol. Subjects with the highest total cholesterol and triglycerides usually respond the most to supplemental chromium. Improvements in lipid metabolism, as well as those in glucose metabolism, appear to be related to improvements in insulin efficiency due likely to increased receptor number. Animal studies also indicate that improvements in serum cholesterol, aortic lipids and plaque formations due to supplemental chromium are associated with decreased circulating insulin. Insufficient dietary copper also leads to elevated lipid levels and impaired heart function. Animal studies indicate an obvious degradation of the heart muscles. Zinc appears to function in cardiovascular diseases primarily via its antagonism with copper. Selenium may also affect cardiovascular diseases since selenium is postulated to be involved in platelet aggregation. These data demonstrate that the trace elements, chromium, copper, and selenium, have beneficial effects on risk factors associated with cardiovascular diseases suggesting that a decreased risk of cardiovascular disease may be achieved by adequate intake of trace elements. PMID- 3535377 TI - Trace element levels in patients with renal failure and after transplantation. PMID- 3535378 TI - The immunocytochemical demonstration of metallothionein in human liver and small intestine. PMID- 3535379 TI - Synergistic neurotoxicity of carbon tetrachloride/carbon disulfide (80/20 fumigants) and other pesticides in grain storage workers. AB - Neurophysiologic, neurobehavioral, and neuropsychologic profiles in 17 grain storage workers, 1 grain inspector, and 4 malting laboratory workers are described. The effects of CS2 toxicity as seen in viscose rayon workers as well as in experimental animals is remarkably similar to the clinical profile of our grain storage workers. CS2 use explains the dysfunction of peripheral axons, auditory nerve, the optic nerve, and the extrapyramidal system, as well as altered behavior and cognition changes. The signs and symptoms in these workers seem to be dose-related and we note that workers separated out from the areas where fumigation took place reported improvement not seen by fellow workers who continued the fumigant treatment routine. Likewise, malting laboratory workers exposed only to the grain dust from 3 to 7 years showed only minimal symptoms. Though a number of mechanism have been suggested for the alteration of neuropsychological function, the chelating ability of DDC derived from CS2 and its ability to markedly increase copper and zinc within the central nervous system suggests a mechanism of toxicity analogous to copper intoxication as in Wilson's Disease and may explain the production of extrapyramidal symptoms in these patients. Chelation of copper might prove therapeutic in CS2 poisoning. It is obvious that both basic and clinical research will be necessary to sort out the questions raised. We applaud the EPA's decision to ban the use of 80/20 fumigants and also methyl bromide, and trust that similar toxic substances be carefully studied before their selection for replacing these previous toxic agents. We further decry the technique of re-introducing grain dust into the food chain rather than destroying it, since the dust contains very high residues of fumigant material. We speculate on the possible role of CS2 and other pesticides in the food chain and the incidence of Parkinsonian symptoms in these patients and the general public. PMID- 3535381 TI - Effect of fasting and refeeding on glucose metabolism in rat aorta. AB - The effect of refeeding on accumulation of [14C]glucose carbon, oxidation of [14C]glucose and glycogen concentration in rat aortic intima-media was studied in rats fasted for 3 days. Accumulation of glucose carbon and glucose oxidation were determined by incubating rat aorta in vitro for 2 h with 5.6 mM 14C-labelled glucose in the medium. Refeeding with standard pellets for 2-4 h augmented [14C]glucose accumulation in rat aorta but had no significant effect on glucose oxidation. The glycogen concentration in rat aorta tended to increase. After refeeding for 16 h both [14C]glucose incorporation and [14C]glucose oxidation were increased in rat aorta. Refeeding with carbohydrate-rich pellets (92% carbohydrate) for 3 h increased blood glucose more than did protein-rich (92% protein) pellets, whereas the rise in plasma insulin was about the same. The accumulation of [14C]glucose carbon measured during the subsequent in vitro incubation for 2 h was augmented after refeeding with protein-rich pellets and slightly reduced after carbohydrate-rich pellets. Refeeding of diabetic rats for 2 h with standard pellets increased plasma insulin and markedly increased blood glucose but had no effect on aortic [14C]glucose incorporation. Intravenous infusion of glucose in normal rats for 2 h markedly raised blood glucose but did not increase the aortic glucose incorporation. Raising the ambient glucose concentration from 5 to 10 mM during incubation of normal rat aorta in vitro for 2 h slightly decreased the [14C]glucose incorporation determined during a subsequent incubation for 2 h. These results suggest that refeeding with standard pellets augments glucose incorporation and glucose oxidation in rat aorta.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535380 TI - Effect of MPTP and its pyridinium metabolites on monoamine uptake and on central catecholamine neurons in mice. AB - The effect of MPTP and its pyridinium metabolites MPDP+ and MPP+ on the in vitro [3H]monoamine uptake in synaptosomal preparations from mouse striatum and cerebral cortex was investigated. All compounds inhibited [3H]monoamine uptake in a dose-dependent manner in both regions analysed. MPP+ had the highest affinity to dopamine and noradrenaline uptake sites, while MPTP had the highest affinity to serotonin uptake sites. The results indicate that the affinity of MPP+ to different monoamine uptake sites appears to be better correlated to MPTP neurotoxicity as expressed in vivo than MPTP and MPDP+. Intracerebral injection of MPP+ into substantia nigra produced an almost complete disappearance of dopamine in striatum and noradrenaline in cerebral cortex, while injection of MPTP or MPDP+ had no or only moderate catecholamine-depleting effects. The MPP+ induced catecholamine depletion could be partially reversed by pretreatment with the catecholamine uptake blocker nomifensine. Histological analysis disclosed that MPP+ was a potent generally cytotoxic agent, while MPDP+ less and MPTP least so. The present results are compatible with the view that an interaction with the catecholamine uptake mechanism, probably through an uptake and accumulation of extraneuronally formed MPP+, is most likely the explanation for neuron-specific neurotoxic action on catecholamine neurons following MPTP administration. PMID- 3535382 TI - Dissociation of phosphatidylinositol hydrolysis and insulin secretion of cultured mouse pancreatic islets. AB - The correlation between hydrolysis of phosphatidylinositol (PI) and insulin secretion was investigated in cultured mouse pancreatic islets. After prelabeling with [3H] glycerol or [3H] inositol, islets were incubated in the presence of different insulin secretagogues. Carbamylcholine induced a rapid decrease of PI bound radioactivity concurrent with stimulation of insulin secretion, and both these responses were blocked by atropine. After culture at a low (3.3 mM), glucose concentration, carbamylcholine evoked PI hydrolysis, but no insulin secretory response was observed. Carbamylcholine induced PI hydrolysis also under Ca2+-free conditions, which blocked insulin secretion. Stimulation of insulin secretion with high glucose (16.7 mM), K+(25 mM), or arginine (10 mM), or addition of theophylline (5 mM) to high (16.7 mM) glucose, were associated with unchanged rates of PI hydrolysis. In labelling experiments, both carbamylcholine and glucose (16.7 mM) were found to stimulate the incorporation of [3H] inositol into islet PI. These results demonstrate that stimulation of muscarinic cholinergic receptors increases islet PI turnover. There was, however, no general correlation between islet PI turnover and insulin secretion. PMID- 3535383 TI - Serotonin facilitates NMDA responses of cat neocortical neurones. PMID- 3535384 TI - Significant rise in plasma insulin after electroconvulsive therapy. AB - The effect of ECT on insulin plasma levels was studied in 10 single treatments in five patients suffering from DSM III-diagnosed schizophrenia. The treatments were chosen from early, middle and late ordinal positions. A significant rise was found 10, 20 and 30 min after an effective electrical stimulus. Values returned to normal in all cases at 60 min. The rise at 10 min occurred in all treatments, irrespective of ordinal position, but an incidental finding was that the higher the ordinal position of a given treatment, the higher the peak of insulin. PMID- 3535385 TI - Real-time ultrasonography of thyroid nodules. AB - Sonographic characteristics were analyzed in 141 histologically confirmed thyroid nodules including 84 benign and 57 malignant tumors. Seven items were examined: Presence of a 'halo'; presence of cystic components; presence of calcification; hypoechogenicity; heterogeneity of the internal echo pattern: irregular or obscured margin; and massive extrathyroidal extension. Only the last-mentioned item appeared exclusively, but not very often, in malignant lesions, and the other characteristics were encountered in both benign and malignant lesions. Although ultrasonography is a method of choice for the evaluation of thyroid nodules, its ability to distinguish benign from malignant lesions is limited. PMID- 3535386 TI - Perirenal lymphoma. Report of a case. AB - A patient with fever and abdominal pain was examined with ultrasonography and CT. The two methods demonstrated an isolated perirenal mass but the exact nature of it could not be established. Ultrasonographically guided coarse needle biopsy and the following histopathologic examination of the biopsy core demonstrated a malignant lymphoma. PMID- 3535387 TI - Quantitative metacarpal bone measurements before and after renal transplantation. AB - The outer (D) and inner diameter (d) of the second metacarpal bone, the combined cortical thickness (D-d), cortical area (D2-d2) and bone mass [D2d2)/D2) were measured in 74 renal transplant (RT) recipients at the time of renal transplantation and in a prospective analysis of 60 recipients after transplantation. The RT patient group was made up of recipients who after renal transplantation developed osteonecrosis or spontaneous fractures (RT-ON/SF) and an age- and sex-matched renal control group of subjects who did not develop these complications (RT-C). At the time of renal transplantation, in renal transplant recipient men and women, significantly reduced values in D, D-d and D2-d2 was noticed. These findings could be explained by a higher ratio of bone resorption than formation at the periosteal surface. Following renal transplantation, significant increases in d were seen with significant decreases in D-d, D2-d2 and (D2-d2)/D2, probably due to endosteal bone resorption, whereas D was unchanged compared with normal control persons. In the total group and in RT-ON/SF women, D decreased significantly and in ON/SF, increased significantly with significant decrease in bone mass compared with normal women whereas no significant changes in the parameters were seen in RT-C women. These findings indicate that bone loss after transplantation continues at the periosteal surface in women. The bone loss was most markedly demonstrated in women, who subsequently develop osteonecrosis or spontaneous fractures, probably due to a combined periosteal and endosteal resorption of calcified bony tissue. PMID- 3535389 TI - Ultrasound examination of foreign bodies. An in vitro investigation. AB - Ultrasound examination of foreign bodies most frequently encountered in the human body was performed when they were contained within a transmission medium acoustically resembling human soft tissues. All the foreign bodies evaluated (lead and plastic pellets, pieces of wire, nails, needles, small fragments of rock and glass, wooden slivers, surgical sponges and surgical threads) were detectable with ultrasound. Strong echoes were reflected from their surface when they were positioned favourably, although in some positions the echoes from a needle, fragment of glass, wooden silver, or surgical thread could not be distinguished from those of the surroundings. Acoustic shadows were also seen behind the foreign bodies. A striking column of reverberation echoes was demonstrated behind lead pellets and nails while behind a glass plate there was an acoustic shadow that was often difficult to detect because it was concealed by a mirror image. With modern grey-scale real-time equipment it is possible to demonstrate objects from various angles, a fact which should facilitate the detection of foreign bodies in vivo circumstances. PMID- 3535388 TI - Effect of motion on the sonographic and magnetic resonance patterns of ageing blood. AB - The sonographic appearance of a hematoma may be affected by various factors, including the age of the hematoma. The effect of mechanical motion on the echogenicity and histologic appearance, and on the proton relaxation times T1 and T2 of blood clots, was studied in vitro for up to 21 days. All clots were of similar echogenicity and microscopic appearance during the first 2 days. The minimally disturbed clots were sonolucent from day 4 onwards, whereas moderate mechanical disturbance changed the microscopic structure of the blood clots and caused them to retain their echogenicity. Proton relaxation times T1 and T2 of both minimally disturbed and vigorously manipulated blood samples showed a rapid shortening of T1 and a less marked decrease of T2 between days 1 and 4, which was independent of mechanical motion. The ultrasonic appearance reflected the histologic appearance but not necessarily the age of the clot. The magnetic resonance (MR) parameters T1 and to a lesser extent T2 accurately reflected the age of the clot during the first 6 days. Although relatively gentle motion caused a large change in the ultrasonic appearance of the clots, vigorous shaking did not affect the magnetic resonance appearance of human blood clots. PMID- 3535390 TI - [Hemolytic plaque cells (plaque forming cells) in patients with type I and type II diabetes mellitus]. PMID- 3535391 TI - Free insulin profiles in insulin-dependent diabetics treated with one or two insulin injections per day. AB - Twenty-four hour profiles of free insulin and blood glucose were determined in 12 healthy controls and 10 insulin-dependent diabetics treated with insulin regimens based on intermediate-acting insulin injected subcutaneously once or twice a day. The diabetics were ambulatory and in a good glycemic control, i.e. without hyperglycemic symptoms or frequent hypoglycemias and with HbA1 less than 9% (reference value 5.9-7.8%). Body weight was normal and median age (32 years) was the same in both groups. Free insulin was determined after polyethylene glycol precipitation of antibody-bound insulin. The controls had a low basal insulin level (median fasting value 3.9 mU/l) and postprandial peaks with a maximum within 30-60 min. There was no rise in plasma free insulin or blood glucose in the early morning hours. The free insulin profiles in the diabetics were highly unphysiological with hyperinsulinemia between the meals and during the night. The highest plasma free insulin value during the 24 hours was reached before lunch (approximately 5-fold compared to normals, p less than 0.01). Postprandially the free insulin concentrations did not reach the peak levels of the normals. After breakfast, blood glucose rose considerably in the diabetics (p less than 0.02 compared to normals) while the rise after lunch and dinner was not higher than in the healthy controls. The difficulties in glycemic control in the diabetic group, i.e. a blood glucose rise after breakfast and hypoglycemias in some patients, could largely be explained by the unphysiological insulin profiles. PMID- 3535392 TI - Effects of dietary supplementation with n-6 and n-3 long-chain polyunsaturated fatty acids on serum lipoproteins and platelet function in hypertriglyceridaemic patients. AB - Twenty-seven patients with hypertriglyceridaemia were given dietary supplementation either with evening primrose oil rich in gammalinolenic acid (GLA, 18:3 n-6) (n = 13) or a marine oil concentrate containing n-3 fatty acids (n = 14) in a double-blind cross-over design during 8 + 8 weeks with olive oil as placebo. During GLA supplementation, increases in GLA and dihomogammalinolenic acid (20:3 n-6) were found in plasma lipid esters and platelet phospholipids, whereas platelet function and serum lipoproteins were unaffected. During supplementation with n-3 fatty acids there was a significant decrease in triglycerides in all lipoprotein fractions with a slight increase in high density lipoprotein and low density lipoprotein cholesterol. A marked increase in the long-chain n-3 fatty acids was found both in plasma and platelets, mainly at the expense of the n-6 fatty acids. No pronounced effects on platelet reactivity could be demonstrated. Our results confirm a triglyceride-lowering effect of n-3 fatty acids, whereas no such effect of GLA could be demonstrated. PMID- 3535393 TI - Treatment of Graves' ophthalmopathy with cyclosporin A. AB - Six patients with Graves' ophthalmopathy (2 with acute and 4 with chronic alterations) were treated with cyclosporin A (10 mg/kg/day) for 5 weeks. This treatment had no effect on either the ocular manifestations (protrusion, eye muscle function) or subjective well-being of the patients. In contrast, creatinine clearance decreased from 83.5 to 55.5 ml/min during treatment, but normalized (94.9 ml/min) after cessation of the drug. A transient increase in serum 4-androstenedione was observed in 3 patients. We conclude that cyclosporin A has no convincing effect in the treatment of Graves' ophthalmopathy, but rather exerts serious renal effects. PMID- 3535394 TI - Digitalis--two hundred years. PMID- 3535396 TI - Detection of nocturnal hypoglycemia in insulin-treated diabetics by a skin temperature--skin conductance meter. AB - The efficacy and credibility of a skin temperature--skin conductance meter (Teledyne Sleep Sentry) for detecting hypoglycemia was studied during night-time in 22 adult insulin-treated diabetics. Capillary blood glucose concentration was measured 99 times (when the alarm sounded, in case of hypoglycemic symptoms, and at 3 a.m.). Hypoglycemia was defined as a capillary blood glucose concentration of less than or equal to 3 mmol/l. Blood glucose was measured 61 times in connection with sounding of the alarm and 38 times without the alarm sounding. At 3 a.m. the Sleep Sentry sounded the alarm 22 times, of which hypoglycemia was present 6 times giving a diagnostical specificity or diagnostical true positive rate of 0.27 (95% confidence limits 0.11-0.50). In 35 of 38 cases of no alarm the blood glucose was greater than 3 mmol/l, giving a diagnostical sensitivity of 0.92 (95% confidence limits 0.79-0.98). The Sleep Sentry sounded the alarm in 6 of 9 cases of hypoglycemia, giving a nosological sensitivity of 0.67 (95% confidence limits 0.30-0.93). The Sleep Sentry did not sound the alarm in 35 of 51 cases of non-hypoglycemia, giving a nosological specificity of 0.69 (95% confidence limits 0.54-0.81). In other words, the Sleep Sentry detects about 2/3 of blood glucose values less than or equal to 3 mmol/l, but in addition it sounds a false alarm in 2/3 of the cases. PMID- 3535395 TI - The effect of sodium depletion and potassium supplementation on vasopressin, renin and catecholamines in hypertensive men. AB - Seventeen 50-year-old hypertensive men (157 +/- 4/110 +/- 2 mmHg, mean +/- SE) were given low sodium diet for one week, which was supplemented with potassium the following week. The urinary Na+/K+ excretion ratio changed from 2:1 to 1:5 and 1:12, respectively, during dietary intervention. Arterial plasma vasopressin decreased by 3.4 +/- 1.7 ng/l (0.05 less than p less than 0.10) and urinary excretion of vasopressin was reduced by nearly 50% (p less than 0.001) during sodium depletion, while plasma noradrenaline increased by 38% (p less than 0.001) and plasma dopamine showed an increase by 58% (p less than 0.001). Plasma renin concentration increased four-fold during sodium depletion (p less than 0.001). With combined salt depletion and potassium supplementation, arterial plasma vasopressin decreased by 9.5 +/- 4.0 ng/l (p less than 0.05) compared to control. Urinary excretion of vasopressin together with plasma noradrenaline and dopamine were unchanged during the second week. The reduction of blood pressure was most marked during the first week (143 +/- 3/103 +/- 2 mmHg, p less than 0.05), but continued to fall also during the second week. Thus, during sodium restriction in middle-aged hypertensive men, blood pressure reduction occurs concomitantly with inhibited vasopressin release, despite enhanced renin and catecholamine release. Potassium supplementation during sodium restriction induces only minor changes in these variables. PMID- 3535397 TI - A controlled randomized study on the effect of long-term physical exercise on the metabolic control in type 2 diabetic patients. AB - The effects of 4 months' physical exercise on the metabolic control in non insulin-dependent diabetes were studied in 25 patients divided randomly into exercise (n = 13) and control (n = 12) groups. In the exercise group glycosylated hemoglobin A1 fell from 9.6-8.6% (p less than 0.01) and the 2 hour plasma glucose in oral glucose tolerance test decreased from 19.7-16.5 mmol/l (p less than 0.01). The mean fall in fasting plasma glucose from 11.8-10.5 mmol/l was not statistically significant. The responses of plasma insulin and C-peptide to oral glucose increased significantly during the exercise period. However, patients with initially poorest metabolic control were not able to improve their physical fitness and did not show significant improvement in metabolic control. In the control group no changes occurred in any parameter of glucose metabolism. The results suggest that physical exercise is beneficial for the glycemic control in patients with mild and moderate non-insulin-dependent diabetes. Increased insulin response is at least one main mechanism of the action of exercise. PMID- 3535398 TI - A follow-up study of 68 patients with anti-mitochondrial antibodies (AMA). AB - During the period 1976-83, anti-mitochondrial antibodies (AMA) were detected in 68 patients out of about 48 000 sera (0.14%) analyzed for a repertoire of autoantibodies at the Department of Immunology, University Hospital of Tromso. Fifty-five of these patients were women, and only 10 had unequivocal primary biliary cirrhosis (PBC). At follow-up in 1984, 48 out of these 68 patients were accessible for complementary testing. The AMA test became negative in 17 of these 48 patients during the observation period. Eleven of these 17 had originally a titer of 50. Seven of the 31 patients with persistent AMA were without detectable liver pathology. One patient had antibodies against smooth muscle, one against cell nucleus, whereas 35 had an increased serum IgM level. In conclusion, most patients with AMA do not have obvious PBC, a low AMA titer is likely to be transient, and there is a strong association between AMA and an increased serum IgM level. PMID- 3535399 TI - Latamoxef versus carbenicillin plus gentamicin or carbenicillin plus mecillinam in leukopenic, febrile patients with solid tumors. AB - Sixty-six febrile episodes associated with leukopenia were observed in 56 patients with solid tumors, WBC less than 1.5 X 10(9)/l and temperature greater than or equal to 38.5 degrees C. Stratification to antibiotic treatment regimen was made with regard to prior cis-dichlorodiamineplatinum (cis-platinum) treatment or not. Patients who had received no cis-platinum were randomized between carbenicillin 10 g every 8 h plus gentamicin 80 mg every 8 h or latamoxef 2 g every 8 h (group I). Patients having received cis-platinum were treated with carbenicillin 10 g every 8 h plus mecillinam 800 mg every 8 h or latamoxef 2 g every 8 h (group II). The first dose of latamoxef was preceded by 10 mg of vitamin K i.v. In group I, clinical response was observed in 10 of 19 febrile episodes (52.6%) treated with carbenicillin plus gentamicin and in 10 of 14 (71.4%) treated with latamoxef (p greater than 0.05). In group II, 6 of 14 febrile episodes treated with carbenicillin plus mecillinam responded (42.9%) while 11 of 19 (57.9%) responded to latamoxef (p greater than 0.05). No bleeding due to antibiotic treatment was observed. No statistical difference between standard antibiotic therapy and latamoxef was seen in this subset of patients. PMID- 3535400 TI - The influence of insulin on the raised plasma fibronectin concentration in human obesity. AB - Plasma concentrations of fibronectin, free insulin, C-peptide and plasma glucose were determined in 40 morbidly obese subjects and in 51 normal weight controls, matched for sex and age. All plasma concentrations were significantly elevated (p less than 0.01) among the obese subjects. A significant correlation (r = 0.34, p less than 0.05) between plasma fibronectin and plasma free insulin was found among the obese patients, but not among the controls (r = -0.02, p greater than 0.05). No significant correlation was found between plasma fibronectin and plasma C-peptide, neither in the obese patients nor in the controls (obese r = 0.06, controls r = 0.02; p greater than 0.05). Plasma fibronectin was insignificantly correlated with body weight (obese r = 0.21, controls r = 0.15; p greater than 0.05) and percentage overweight (obese r = 0.27, controls r = 0.04; p greater than 0.05). The raised level of circulating insulin may in part explain the excess of plasma fibronectin obese subjects. PMID- 3535402 TI - Physiological adaptation to physical conditioning. Old problems revisited. AB - Three classical problems in the field of man's adaptive response to exercise are reviewed. A case is made for the pump capacity of the heart limiting maximal oxygen uptake in man. This conclusion is based on findings that the capacity of skeletal muscle of man markedly surpasses that of the heart supplying it with a flow and thereby oxygen. It is suggested that only one third of the muscle mass of man can fully tax the capacity of the heart and consume the oxygen delivered by the heart. If a larger muscle mass is intensely engaged in the exercise, vasoconstriction must occur in the arterioles of the exercising limbs to avoid a reduction in blood pressure. Evidence is presented that a decrease in heart rate at submaximal exercise-observed after a period of physical conditioning, is caused by an altered autonomic chronotropic activity to heart, which most likely is due to a less potent feed back reflex from exercising muscles. The enlarged stroke volume is secondary to a larger diastolic filling, which via a Frank Starling mechanism results in an elevation in the stroke volume. Last, it is argued that the altered metabolic response to exercise after physical conditioning, i.e. the larger lipid oxidation and reduced lactate production, results from local regulatory mechanisms rather than from changes in supply of oxygen, substrates, or hormones. Further, the muscle metabolic response to exercise is thought to play a major role in modulating systemic cardiovascular regulation in exercise. PMID- 3535401 TI - Heat stroke in endurance exercise. AB - Six athletes were examined immediately after collapsing from heat stroke during exercise, and then followed for several weeks. At the time of collapse most of the patients were sweating profusely, their rectal temperatures being more than 42 degrees C. All recovered within a few hours. The renal function was not disturbed more than expected during heavy exercise, serum levels of liver enzymes were, however, increased for several weeks. Electrolyte homeostasis was undisturbed but for a transient hypercalcemia that can not be fully explained. The marked increments in plasma levels of catecholamines, vasopressin and renin were as expected after heavy exercise. We conclude that as heat stroke presents as a continuum of clinical pictures, biochemical evidence of liver cell injury is a sensitive and important parameter for the diagnosis. PMID- 3535403 TI - Preventive use of exercise rehabilitation after myocardial infarction. AB - Randomized controlled clinical trials of exercise after myocardial infarction, although difficult to compare, have not shown a reduction in mortality or morbidity. However, physiological and psychological improvements occur that enable patients to improve their quality of life. The effectiveness of exercise programmes is impaired by poor patient compliance. Some characteristics of poor compliers may be identified, but it is safer to assume all participants are potential non-compliers, and to apply compliance-improving strategies within exercise programmes. The authors' experience has indicated that a number of strategies may be followed at little cost. These include a spouse support programme, a written agreement to participate, self-control techniques including self-monitored exercise testing, and group discussion periods. PMID- 3535404 TI - Exercise training and hypertension. AB - Hypertension is a major health dilemma in the world today because of its high rate of incidence. Exercise training is usually mentioned as a useful nonpharmacological therapy for essential hypertension. Seventeen studies have assessed the effect of exercise training in individuals with essential hypertension. The majority of the results indicate that both systolic and diastolic blood pressure may be lowered by approximately 10 mmHg with training, however, this conclusion must be interpreted in light of numerous design deficiencies, methodological shortcomings, and the limited populations studied in these investigations. Some studies appear to indicate that mild to moderate intensity training may be as useful in lowering blood pressure as higher intensity training. Very little data is available to indicate if cardiac output and/or total peripheral resistance are reduced to bring about the reduction in blood pressure. Clearly more studies are required to evaluate the belief that exercise training is beneficial in essential hypertension and to determine the responsible mechanisms. PMID- 3535405 TI - Physical activity and prostanoids. AB - Physical activity plays an important role in the prevention of ischaemic heart disease. However, data on the mediating mechanisms are only partly established, and concentrated mainly on plasma lipoproteins. Prostanoids, especially prostacyclin and thromboxane, through their effects on vascular endothelium, platelet function, and interaction with lipoproteins, are postulated to be centrally involved in the pathogenesis of atherosclerosis. The reported acute effects of physical activity on prostanoids and platelet function are contradictory and may be considered both beneficial and unfavourable. On the other hand, although even less is reported on the response to regular exercise, data appear more favourable in relation to atherosclerosis. Currently, data on physical activity and prostanoids, including both acute and chronic effects, are limited and necessitate additional, systematic studies on dose-response relationships. PMID- 3535406 TI - Osteoporosis and physical activity. AB - Bone involution poses serious health risks for aging women. Bone mass is subject to both local (mechanical) and systemic (hormonal) homeostatic control mechanisms. The local forces acting on bone are due to gravity and muscular contraction. There are several theories concerning the mechanisms of local control. When bent, bone functions as a piezoelectric crystal with calcium accumulation on the negatively charged concave surface. Microfractures that occur in response to stress greater than normal levels stimulate osteoclastic activity to remove the damaged structure. Studies of astronauts and immobilized subjects have consistently found bone atrophy. The degree of bone loss is related to the difference in levels of stress normally applied and those at bedrest in the site studied. Correspondingly, athletes have greater bone mass than the sedentary population, with the greatest hypertrophy found in the areas most stressed. Exercise intervention also promotes bone hypertrophy. Both middle-aged and elderly women increase bone mass or reduce the rate of loss in response to physical activity intervention programs. PMID- 3535407 TI - Experimental studies on the influences of physical activity on ligaments, tendons and joints: a brief review. AB - The clinical practices of the future depend upon the experimental findings of today. Because of the uniqueness of connective tissue, animal experimentation will be essential for advances in this field. During the last decade, the improvements in technology and the increased interest of basic scientists and research clinicians on the effects of physical activity has markedly enhanced the amount of information available to practicing physicians. Studies spanning the appearances of structure to the changes in the crosslinks of collagen, clearly demonstrate that limb immobilization (inactivity) is deleterious to all structures involved whether evaluated anatomically, physiologically, or biomechanically. Furthermore, when surgical repair is included, there are stages when the deleterious processes become accelerated with or without immobilization. Hence, clinical immobilization must be utilized in a prudent and careful manner. There is sufficient experimental evidence for clinicians to utilize motion and mechanical stimuli as a means to improve the structure and function of tendons, ligaments, and joints. However, the unresolved issues are the mode, time of initiation, or the intensity of application. Even when used with repair, recovery of normal structures and function is protracted. The primary or secondary mechanisms associated with these effects of physical activity are unknown and virtually uninvestigated at the present time. PMID- 3535408 TI - Lower extremity overuse injuries. AB - Increased number of overuse injuries, particularly of the lower extremity, occurs in exercise. It is important for the physician who prescribes exercise to understand the mechanism of injury-repetitive microtrauma-and the risk factors for occurrence of these injuries. In the lower extremity, risk factors include inappropriate progression of the rate, intensity and duration of training; anatomic malalignment; muscle-tendon imbalances of strength, endurance, or flexibility; shoewear; surface; and pre-existent disease states. Specific recommendations for training progression, technique, and sports equipment may have to come from the physician, since the recreational athlete often does not have access to coach or athletic trainer. These are described. PMID- 3535409 TI - Muscle fatigue and pain. AB - Muscle fatigue and pain are together common symptoms which can be analysed physiologically. For many patients attending a medical clinic the problem for the doctor is to decide whether the problem is "in the mind" or "in the muscle". A history of the symptoms occurring at rest without any exercise is a hint of psychological origin. Exercise fatigue or pain should ideally be reproduced by an appropriate provoking exercise test. Needle biopsy with histochemistry is cost effective as a means of reaching a diagnosis while blood determinations of erythrocyte sedimentation rate and plasma creatine kinase and lactate are more specific but less sensitive indicators of a muscle cause. Fatigue is analysed by force and action potential measurements with electrically stimulated contractions. Pain worse after exercise can be related to muscle damage. A programme of therapeutic exercise may be tried as a further means of assessment of these symptoms. PMID- 3535410 TI - The cardiovascular risks of physical activity. AB - The incidence of sudden death, serious arrhythmias, and myocardial infarction in connection with both recreational and rehabilitative physical activity is small. However, the incidence of e.g. sudden death is several times higher in exercise than at other times. This relative risk is highest in middle-aged men, and higher in strenuous than in nonstrenuous exercise. In the vast majority of the cases the underlying cause is advanced coronary heart disease, which in large proportion of the cases has been asymptomatic and has allowed regular strenuous training. Attempts to prevent the complications by special large scale screening programs would be ineffective and individual counselling limited by lack of resources. These measures should, however, be used in selected groups and individuals. Another approach is to inform the exercisers and their families at large by systematic, well-planned and repeated messages of the risks of physical activity, of the symptoms and findings indicating this risk, of the individual and environmental factors increasing the risk, and of the necessary measures to be taken to minimize the risk. Even if all available measures at present were used, the cardiovascular complications of physical activity could not be totally prevented. Fortunately, preliminary evidence suggests that at population level the cardiovascular hazards of physical activity are outweighed by its cardiovascular benefits. PMID- 3535411 TI - Physical activity and muscle training in the elderly. AB - Most elderly people have some kind of regular daily activity, usually closely connected to their daily habits. A six-graded scale for classification of physical activity is presented. Persons with a low physical activity also usually perceive their physical strain as rather light or moderate. There is a reduction with age in muscle volume, muscle strength, and aerobic capacity which are rather parallel. From a muscular point of view there are only moderate qualitative changes up to the ages around 70; at higher ages there will be a tendency to more marked changes in muscle structure. The maximal aerobic power as well as muscle strength can be increased by physical training also in the elderly. At least up to the ages around 70 there will be an adaptation in muscle structure and enzymatic capacity. In very well-trained 70-year-old men high levels of oxidative enzymes are found together with high maximal aerobic power capacity. A positive attitude should be taken towards physical exercise for prevention and rehabilitation also in the elderly. PMID- 3535412 TI - The influence of exercise training on plasma lipids and lipoproteins in health and disease. AB - There is a very high probability that lipoprotein metabolism plays a central role in the etiology of coronary heart disease. In sedentary persons one way to favorably alter lipoprotein metabolism and possibly delay the progression of coronary atherosclerosis is by an increase in their habitual physical activity. More physically active persons tend to have lower plasma triglycerides and very low density lipoprotein concentrations, and a greater high-density lipoprotein mass due to higher concentrations of the subfraction HDL2 and apoprotein A-I. Plasma low-density lipoprotein concentrations usually are not significantly reduced by exercise unless accompanied by weight loss, but there may be important changes in the distribution among the low-density subfractions. These exercise effects are most likely mediated by alterations in the activity of enzymes involved in the synthesis, transport and catabolism of the various lipoproteins including lipoprotein lipase, hepatic lipase and lecithin: cholesterol acyltransferase. In healthy persons as well as in patients with ischemic heart disease, diabetes and renal failure, an increase in moderate-intensity, endurance type activity requiring an expenditure of approximately 4 MJ (1,000 kcal) per week usually produce favorable lipoprotein changes. Above this level a dose response relationship exists, with greater changes occurring up to energy expenditures of 19 MJ (4,500 kcal) per week. PMID- 3535413 TI - Hemodynamic adaptations to stress with advancing age. AB - With advancing adult aging an increase in vascular stiffness, an increase in systolic, pulse and mean arterial pressure, modest left ventricular hypertrophy, and a moderate decline in early diastolic filling rate have uniformly been observed. In some individuals these changes are not associated with enhanced systemic resistance if arterial pressure remains within the normotensive range. End-systolic volume, stroke volume, ejection fraction, velocity of ejection, and cardiac output are preserved in these elderly subjects. In other individuals both aortic impedance and peripheral vascular resistance are increased with age and modest declines in resting stroke volume and cardiac output have been observed. During maximal exercise a diminished heart rate and a diminished reduction of end systolic volume occur in elderly subjects. In some, an enhanced end-diastolic volume prevents a reduction in or enhances stroke volume (Starling mechanism); this adaptation bears a striking resemblance to that observed during exercise when the beta-adrenergic system is pharmacologically inhibited. In other elderly subjects, stroke volume during exercise does not increase to the extent that it does in younger subjects. Even in these subjects in whom peak cardiac output during exercise declines, however, it is not entirely clear that the central circulation limits peak oxygen consumption (VO2). The nonuniformity of results of studies that have investigated the effect of aging on cardiac function and vascular resistance suggests that variables that impact on cardiovascular function other than aging per se, i.e. life style variables, e.g. nutrition, smoking, physical conditioning status, or the prevalence of occult coronary disease, differed among the various subjects studied. PMID- 3535415 TI - Effect of exercise on obesity. AB - The changes in fitness and body composition which accompany physical training in people of normal weight would be very valuable in the treatment of obesity. However, one of the most marked disabilities arising from obesity is a reduced exercise tolerance, so severely obese patients are unable to perform the exercise which would bring these benefits. It has been suggested that exercise may confer benefits on the obese person by reducing voluntary food intake, or by causing a prolonged elevation of metabolic rate. There is no good evidence for these claims. Obesity is best treated by a combination of dietary restriction and exercise: the more severe the obesity the more important the diet component of treatment, but exercise becomes more important with the management of mild obesity or the prevention of obesity. PMID- 3535414 TI - Effects of exercise on glucose tolerance and insulin resistance. Brief review and some preliminary results. AB - With aging, glucose tolerance (GT) declines, plasma insulin concentration increases, and sensitivity to the action of insulin declines. Evidence is accumulating that this decline in glucose tolerance and insulin sensitivity can be prevented by regularly performed vigorous exercise. Preliminary results are presented in this paper showing that prolonged, strenuous and frequent exercise can also completely normalize GT by decreasing resistance to insulin in some patients with mild non insulin dependent diabetes mellitus (NIDDM) and in some individuals with impaired glucose tolerance (IGT). Exercise appears to be effective in normalizing GT only in patients who still have an adequate capacity to secrete insulin, and in whom insulin resistance is the major cause for abnormal GT. The amount of exercise required to normalize GT in such patients appears to be in the range of 25 to 35 km per week of running, or a comparable amount of another form of exercise, performed on a regular basis. PMID- 3535416 TI - Thermogenesis with relation to exercise and exercise-training. AB - Exercise-training at environmental temperatures outside the thermal neutral zone, causes thermoregulatory adaptive reactions. In the heat, sweat efficiency is enhanced thus reducing the incidence of hyperthermia while in the cold discomfort and danger of frostbite are minimized by an improved cutaneous circulation specially in the extremities. Over long periods of time exercise does not affect thermogenesis except when refeeding. It is suggested that the reduced postprandial heat production reported in exercise-trained subjects is related to changes in nutrient metabolism which in turn could be related to insulin and norepinephrine modified actions. PMID- 3535418 TI - [Variability and specificity of EEG reports in Creutzfeldt-Jakob disease]. PMID- 3535417 TI - Physical activity, other life-style patterns, cardiovascular disease and longevity. AB - Longitudinal study of 16,936 Harvard alumni, followed for life-style experiences as related to cardiovascular disease (CVD) and longevity, identified 572 first coronary heart disease (CHD) attacks, 1962-1972, and 1,413 all-cause deaths, 1962 1978. Men expending 8.4+ MJ (2,000+ kcal) per week in walking, stair-climbing, and sports play were at 39% lower risk of developing CHD than less active classmates. Attributable risk estimates suggested: there might have been 16% fewer CVD deaths in the alumni population if every man had exercised 8.4+ MJ per week; 25% fewer from total cigarette abstinence; 9% fewer from abolition of hypertension; 6% fewer with less obesity; and 11% fewer CVD deaths in the absence of parental CHD. Discounting the influence of blood pressure status, cigarette habit, net weight gain since college, and parental history of early death, the more active alumni (39% of the population) are estimated to have lived on average one and one-quarter years longer than less active men. PMID- 3535419 TI - [Electroencephalographic research in schizophrenia. Review of the literature on research during wakefulness]. PMID- 3535420 TI - [Role of membrane phospholipids in the process of cerebral aging]. PMID- 3535421 TI - Andre Barbeau. 1931-1986. PMID- 3535422 TI - [Anguish in clinical practice and its treatment]. PMID- 3535423 TI - [The 3/5 crown as an anchorage method for devitalized molars and premolars]. PMID- 3535424 TI - Ultracytochemistry of intracellular membrane glycoconjugates. PMID- 3535425 TI - Genetic epidemiology of familial aggregation of cancer. AB - Literature pertaining to genetic epidemiological studies of familial cancer has been reviewed from a historical perspective. Although interest in the question of heritability of cancer was extant at least as early as the beginning of the nineteenth century, early investigators were unable to produce consistent and meaningful evidence pertaining to the issue because of unsystematic methods of data collection and inadequate methods of data analysis. During the early twentieth century, developments in the fields of genetics, statistics, and epidemiology provided concepts and methods that permitted investigators to recognize important deficiencies in past studies, and to design others in which the critical comparisons could be made between patient groups and control groups. Registries of cancer incidence in large populations became available in several countries in the middle twentieth century, providing a standard "control group" for comparison. Large surveys of site-specific cancer experience in families, rigorously designed and analyzed, found for most kinds of cancers a two- to threefold increased risk for close relatives of propositi. These studies also reemphasized the great difficulty in obtaining even minimally complete family health history information, and the importance of verifying all reported cases with medical or vital records. Although clinical and laboratory investigation will be necessary to understand the mechanisms by which human genes may predispose to cancer, epidemiological approaches can estimate the extent to which genetic etiological factors may be present in a population, whether a general population or one defined by other factors under investigation. Population-based studies are already of practical significance to the clinical geneticist in the estimation of risk of eventual cancer development in unaffected family members, and can be expected to continue to identify specific groups and characteristics associated with genetic cancer predisposition. Finally, segregation and linkage analysis and their present applications to family studies of cancer were reviewed. As a result of the increasing number of DNA polymorphisms that are becoming available due to developments in molecular biology, the human gene map can be expected to be well defined in the near future, and investigation of families using segregation and linkage analysis will then be instrumental in defining the role of heredity in the development of cancer in human populations. PMID- 3535426 TI - Terminal transferase in normal and leukemic cells. PMID- 3535427 TI - Malignant metamorphosis: developmental genes as culprits for oncogenesis in Xiphophorus. AB - Neoplastic growth is a widespread developmental aberration among multicellular organisms ranging from primitive avertebrates such as coelenterates (Brien, 1961) and annelids (Cooper, 1969) to man. A major goal of the studies concerning neoplasia has been to obtain insight into its cellular and molecular basis, and it has been suggested as early as the beginning of this century that cellular genes are paramount in the etiology of neoplasis. Early support for this idea has been gained by Mendelian strategies applied to a number of experimental systems, such as Xiphophorus. During the last years molecular biology has provided some insight into the genetic mechanisms that might be involved in neoplasia in higher vertebrates, and it has been possible to identify proto-oncogenes as candidates for the agents directing cellular transformation and/or maintainance of the neoplastic state of the cell. The high degree of evolutionary conservation of the proto-oncogenes points to basic functions that these genes normally might have for the cell and at the same time indicates that crucial steps associated with tumorigenesis might take similar pathways in different classes of vertebrates. There are now four main lines of molecular evidence that relate cellular genes to neoplasia: insertional mutagenesis or chromosomal rearrangement that juxtaposes an exogenous or endogenous genetic element which augments gene expression next to a cellular gene, resulting in elevated expression (for review, see Varmus, 1982; Klein, 1983); gene amplification that results in an increase of the copy number and an elevated expression of a particular gene and, to date, has been found in tumors of humans and mice (for overviews, see Schwab et al., 1984; Schwab, 1985; Alitalo and Schwab, 1986); structural alteration of a cellular gene itself which results in the synthesis of an altered protein (Weinberg, 1982; Cooper, 1982); and generation of fusion genes as a result of gene translocation with possibly altered biological activities (for review, see Adams, 1985). It remains to be addressed in future experiments which genetic mechanisms are operative in development of tumors of genetic origin in Xiphophorus. PMID- 3535428 TI - Non-steroidal interference with male fertility. PMID- 3535429 TI - A randomized comparative trial of Nova-T and TCu200Ag in Yugoslavia. AB - The contraceptive efficacy and clinical performance of Nova-T and TCu200Ag were studied in a randomized comparative study with 819 interval acceptors. The 1- and 2-year gross termination rates were evaluated by means of the life-table method. The 12-month pregnancy rates were 1.0 per 100 women with Nova-T and 3.0 per 100 women with TCu200Ag. The preliminary 2-year rates were 1.7 and 5.5 per 100 respectively (p = 0.037). Rates of expulsion, medical and personal removals were not significantly different for the two devices. Continuation rates for the first year were 89.4 and 90.5 per 100 respectively. PMID- 3535430 TI - Contraception and the cervix. AB - In the human and subhuman primates the uterine cervix plays an important role in the reproductive process by its permissive and inhibitory action on sperm migration from the vaginal pool into the cervical canal, the uterine cavity and the fallopian tube, the site of gamete unification and fertilization. This is accomplished through physico-chemical (amount, clarity, viscosity, pH, electrolyte composition, etc.) alteration of the cervical mucus in response to the circulating sex steroids. In an ovulatory cycle, shortly prior to and at the time of ovulation the cervical mucus becomes most receptive to the spermatozoa whereas at other times, specifically following ovulation, it becomes hostile to the spermatozoa and virtually impenetrable. This unique property of the cervical mucus may, in addition to the presently available techniques (diaphragm, cervical cap and intracervical devices), allow identification of such potential contraceptive modalities as: pH modifier - changing the pH of the cervical mucus from alkaline to acid around the time of ovulation; Electrolyte modifier - changing electrolyte composition of the cervical mucus to produce a mesh impenetrable to spermatozoa. Finally, development of a temporary localized tissue fixed immune antibody to spermatozoa in the cervical mucus is within the realm of reality and deserves the necessary attention. PMID- 3535431 TI - Potential application of inhibin in male and female contraception. AB - After a review of investigations into the possible use of inhibin in the regulation of male and female fertility, briefly described and summarized in this article, the authors conclude that, at least in experimental animals, inhibin causes a significant reduction in testicular and epididymal spermatozoa in the male and luteal phase defect in the female. The precise mechanism by which inhibin brings about these effects is not known at present, and its elucidation will greatly help in the more effective use of inhibin. PMID- 3535432 TI - IUD insertion at cesarean section--the Chinese experience. AB - This review reports the experience of nine studies in Chinese maternity hospitals with insertions of an intrauterine device (IUD) at the time of cesarean section. In contrast to the usually high expulsion rates associated with immediate postpartum vaginal insertions, all nine studies reported low expulsion rates, thus resulting in high continuation rates with this procedure, comparable to those with interval insertions. This immediate post-cesarean section insertion procedure was also found to be safe. These findings are of programmatic importance for postpartum family planning delivery services and may eventually lead to an understanding of the expulsion mechanism in postpartum IUD contraception. Results of these reports have been synthesized in this review. Seven of these nine reports were originally in Chinese and were translated into English for the benefit of a broad international audience. Future research directions on this insertion procedure are also discussed. PMID- 3535435 TI - The eggs of monogeneans. PMID- 3535433 TI - Comparative performance of two copper IUDs: Nova-T and MLCu375. AB - A comparative randomized trial was made of two intrauterine contraceptive devices: Nova-T and MLCu375. The IUDs were used by 637 and 606 women, respectively, for one year, unless the device was removed earlier. The reasons for IUD removal were analyzed after one year using the life-table method. Statistically significant differences were found in expulsion and removal for bleeding and/or pain rates. PMID- 3535434 TI - Hypobiosis in parasitic nematodes--an update. PMID- 3535436 TI - Biochemical strain variation in parasitic helminths. PMID- 3535437 TI - The biology of pentastomids. PMID- 3535438 TI - Penetrating abdominal trauma: resuscitation, diagnostic evaluation, and definitive management. PMID- 3535439 TI - Lasers in general surgery. PMID- 3535440 TI - Valid alternatives in the management of early breast cancer. PMID- 3535442 TI - Up-to-date management of small-bowel Crohn's disease. PMID- 3535441 TI - Ambulatory procedures in anorectal surgery. AB - In view of the broad spectrum of conventional and unconventional STDs in the homosexual man, the following diagnostic workup is recommended: History. Physical examination, including proctosigmoidoscopy with biopsy. Urethral, pharyngeal, and rectal cultures. Darkfield examination of any genital ulceration. Stool cultures for bacteria and parasites. Serologic analysis, including VDRL and, where indicated, for Chlamydia trachomatis and amebiasis. It is an essential part of proctologic practice for the surgeon to be able to recognize, diagnose, and treat sexually transmitted diseases. PMID- 3535443 TI - Modern management of biliary tract stone disease. AB - A number of new techniques and approaches to the management of biliary tract stone disease have been developed in the past decade. The modern biliary surgeon must be aware of these and of their logical and proper place in the management of patients with biliary stone disease. However, the wise surgeon will continue to hone his surgical skills because the results of definitive, sure, and deliberate operative treatment of biliary tract stone disease remains the standard by which newer methods must be gauged. PMID- 3535444 TI - Current status of transplantation of the pancreas. PMID- 3535445 TI - The current management of acute pancreatitis. PMID- 3535446 TI - Double-blind study of imipramine and placebo for incontinence due to bladder instability. AB - We compared imipramine with placebo in a double-blind study in Leicester, in elderly incontinent patients. The results revealed that 14 out of 19 patients became dry after imipramine and six out of 14 after placebo treatment. Patients on imipramine also tended to become drier sooner. However, these results must only be taken as preliminary evidence of drug effect since statistical analysis between drug and placebo did not reach significance. The results do, however, confirm the great benefit of habit-retraining which all patients received. It is now our practice to try this alone first, and to reserve drugs for slow or nonresponders, because of their possible adverse effects. PMID- 3535447 TI - [Oral health status and the prosthetic therapy required in postpubertal subjects]. PMID- 3535448 TI - Renal cell carcinoma. An immunohistochemical study. Preliminary report on 20 cases. PMID- 3535449 TI - [Echography and stress incontinence in women]. PMID- 3535450 TI - Cannon lecture. The impact of radiology on hepatology. AB - Because of remarkable advances in diagnostic imaging and the development of a variety of useful interventional techniques, radiology now plays a central role in the diagnosis and treatment of patients with hepatic disease. These include focal, vascular, and metabolic liver diseases, abnormalities of the biliary tract, and conditions associated with hepatic transplantation. Thus, optimal care of patients with liver disease now requires that there be close cooperation between the two specialties. PMID- 3535451 TI - The diagnosis of acute acalculous cholecystitis: a comparison of sonography, scintigraphy, and CT. AB - The clinical and laboratory diagnosis of acute acalculous cholecystitis is difficult, and the reliability of various diagnostic imaging techniques has not been established. The results of several imaging procedures performed over a 6 year period on 56 patients with clinically suspected acute acalculous cholecystitis were evaluated retrospectively. Sonography and CT were both highly sensitive (92% and 100%, respectively) and specific (96% and 100%, respectively). Hepatobiliary scintigraphy was compromised by frequent false-positives; the result was a specificity of only 38%. Percutaneous bile aspiration was insufficiently sensitive (33%) for diagnosis. Sonography was as sensitive as hepatobiliary scintigraphy and was more specific in establishing the diagnosis. Because sonography is relatively inexpensive and can be performed at the bedside, it should be regarded as a satisfactory screening procedure. However, CT is a good alternative in an easily transported patient when other intraabdominal disease is suspected. PMID- 3535452 TI - Morphine-augmented cholescintigraphy in the diagnosis of acute cholecystitis. AB - Cholescintigraphy is a sensitive procedure for diagnosing or excluding acute cholecystitis. However, when rapid diagnosis is critical, the requirement for delayed images (4 hr or more after injection) to minimize the false-positive rate diminishes its utility. We prospectively evaluated 40 cholescintigraphic examinations that did not visualize the gallbladder 1 hr after injection of 99mTc diisopropyliminodiacetic acid. These examinations were then augmented by administration of IV morphine, followed by an additional 30 min of imaging. After the morphine, 18 of these examinations demonstrated visualization of the gallbladder; none subsequently required surgical exploration. Of the remaining 22, who demonstrated persistent nonvisualization of the gallbladder post morphine, 11 were explored surgically and found to be abnormal. The 11 others were treated medically. Low-dose morphine administered when the gallbladder fails to visualize after 1 hr is a useful adjunct to conventional cholescintigraphy because it reduces the time required to obtain a diagnostic result and decreases the number of false-positive results. PMID- 3535453 TI - Distal ureteral calculi: diagnosis by transrectal sonography. AB - Eight patients were studied by both transrectal sonography and excretory urography for the presence of distal ureteral calculi. The sonographic diagnosis was correct in 5 of 5 true positives and 3 of 3 true negatives. Urography was correct in 4 of 5 true positives and 2 of 3 true negatives. None of the sonograms and two of the urograms were considered equivocal. Transrectal sonography appears to be a useful adjunct for the diagnosis of distal ureteral calculi when excretory urography is equivocal or contraindicated. PMID- 3535454 TI - Simultaneous pancreatic-renal transplant scintigraphy. AB - 99mTc-DTPA scintigraphy was evaluated in seven patients as a technique to assess perfusion of the transplanted pancreas and kidney. Such scans provide high quality images of both organs in both the flow phase and later phases. The radionuclide is readily available and its brief effective half-life allows repeated evaluations at short intervals. 131I-hippuran, the major radiopharmaceutical for renal transplant scintigraphy, does not allow visualization of the transplanted pancreas or evaluation of its blood supply. Although the blood glucose is a gross indicator of the function of the pancreatic allograft, pancreatic scintigraphy with 99mTc-DTPA in one case was capable of detecting graft dysfunction before elevation of the blood glucose occurred. While additional studies will be necessary to determine the predictive value of this test, 99mTc-DTPA is valuable for pancreatic-renal transplant evaluation. PMID- 3535455 TI - Uterine duplication, unilateral imperforate vagina, and normal kidneys. PMID- 3535456 TI - Prenatal sonographic diagnosis of atrial hemangioma. PMID- 3535457 TI - Percutaneous drainage of subphrenic abscess: a review of 62 patients. AB - Sixty-two patients who presented with subphrenic abscesses had the abscesses drained percutaneously. Diagnosis of a subphrenic collection was usually made with sonography. Initial percutaneous drainage was accomplished with a combination of sonography and fluoroscopic guidance. More recently (in the last 31 cases) most drainages were done with sonographic guidance alone. Successful catheter drainage was achieved in 85% with a complication rate of 4.8%. Failure of catheter drainage (defined as any patient who was not cured by percutaneous drainage alone) occurred in patients with multiple collections or in whom the primary cause of the abscess necessitated surgery, for example, perforated ulcer, acute cholecystitis. Considerations for successful drainage include understanding the anatomy of the subphrenic space, recognizing the importance of a correct access route (avoidance of the pleura and lung), and the long time necessary for adequate drainage (longer than 10 days in 60%). An angled subcostal approach to the subphrenic space was used in 56 (90%) of 62 cases. No complications occurred in this group. The one pneumothorax that occurred in the remaining six cases was a direct result of using an intercostal approach through the parietal pleura into a subphrenic collection. We conclude that percutaneous drainage is a safe and effective method of treatment of subphrenic abscesses. PMID- 3535458 TI - Portable real-time sonographic and needle guidance systems for aspiration and drainage. AB - One hundred and two aspiration or drainage procedures were reviewed to determine the value of portable sonographic and real-time needle guidance systems. While the majority of thoracenteses or abdominal paracenteses were performed without the aid of real-time guidance, these systems were instrumental in the development of new procedures such as percutaneous cholecystostomy and in the drainage of small fluid collections in critical areas. Portable sonographic guidance was used in 32 cases, mostly for thoracentesis or abdominal paracentesis, but it had its greatest value in guiding drainage procedures at the bedside in critically ill patients. These portable drainage procedures included four cholecystostomies, one nephrostomy, drainage of two abdominal abscesses, and two empyema drainages. Complications included one case of an enterocutaneous fistula and one case of hemoptysis after thoracentesis. The failure rate was less than 7%. The use of portable real-time sonographic and needle-guidance systems has a direct impact on improving patient care. PMID- 3535459 TI - Comparison of the contrast-enhancing properties of albumin-(Gd-DTPA) and Gd-DTPA at 2.0 T: and experimental study in rats. AB - Albumin-(gadolinium-diethylenetriaminepentaacetic acid), albumin-(Gd-DTPA), a macromolecular MR contrast agent designed for intravascular distribution, was compared with gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA), an extracellular fluid agent, for imaging characteristics in normal rats at 2.0 T. Albumin-(Gd-DTPA) produced larger-intensity increases in myocardium (125%), liver (114%), and brain (21%), at a dose of 0.062 mmol Gd/kg than did Gd-DTPA at a dose of 0.2 mmol/kg. The duration and pattern of enhancement differed between the two compounds; the enhancement with albumin-(Gd-DTPA) persisted at relatively constant levels from 2 min to 1 hr. The Gd-DTPA tissue enhancement peaked at 2 min and had virtually disappeared at 60 min. Gd-DTPA better enhanced subcutaneous tissues, presumably because of capillary permeability and enhancement of the abundant extracellular fluid space. When albumin-(Gd-DTPA) is used, the strong persistent enhancement of the microvascular compartment is well demonstrated on subtracted images and supports potential application of albumin-(Gd-DTPA) for blood-volume and perfusion-dependent contrast enhancement of myocardium, liver, and brain. PMID- 3535460 TI - Tailgut cyst: diagnosis with CT and sonography. AB - Tailgut cyst is a rare congenital lesion that presents as a presacral mass, found in infancy or persisting undetected into adulthood, and characterized by multiple cysts lined with a gastrointestinal type of epithelium. In a retrospective review of five patients whose ages ranged from 1 month to 42 years--three cases with CT and two with sonograms--tailgut cyst appeared as a complex mass on both procedures, representing its composition of multiple small cysts filled with keratinous material and other debris. Other CT and sonographic features include well-defined borders, and, in one case, presentation as a mass lateral to the midline. CT also shows preservation of adjacent fat planes. Tailgut cyst should be included in the differential diagnosis of a retrorectal mass at any age. PMID- 3535461 TI - Communicating the significance of radiologic test results: the likelihood ratio. AB - The likelihood ratio is a useful but simple concept that helps the radiologist communicate to the clinician the significance of radiologic findings. It is defined as the ratio of the probabilities of a particular test result among patients with and without disease. Readily derivable from sensitivity and specificity, the likelihood ratio represents the degree to which a test result is positive or negative and serves as a proportionality constant that relates the pre- and posttest odds of disease in a linear manner. The linearity of the relationship permits the impact of a test result to be easily understood and allows for the integration of additional test results. The concept of likelihood ratio is explained in straightforward algebraic terms, and its practical application to clinical radiology is demonstrated by using several specific medical examples. PMID- 3535462 TI - Dynamic upper airway narrowing in patients with obstructive sleep apnea. PMID- 3535464 TI - Cognitive stress and cardiovascular reactivity. I. Relationship to hypertension. AB - This report reviews the current literature relating cognitive stress and cardiovascular reactivity to the development of hypertension. Cardiovascular reactivity may refer to a change in one or several cardiovascular parameters as a function of exposure to a cognitive stressor, e.g., systolic BP, HR, etc. The cognitive stressors involve laboratory-based mental tasks such as mental mathematics, choice reaction time, and stressful interviews. The current findings suggest that the reactivity literature may have something unique to contribute to the study of hypertension. Prospective studies linking clinical hypertension to early reactivity are few in number. However, reactivity appears to be reliable within individuals over short periods of time (3 months), and individuals at the upper end of the reactivity distribution may have a higher incidence of future hypertension than those at the lower end. Reactivity may also contribute to two other dimensions of hypertension. Subjects with positive family histories of hypertension may be expected to be among the most reactive to cognitive stress, and among established hypertensive individuals, the reactivity to stress may be correlated with casual BP lability. Several avenues have been suggested through which a hyperresponsiveness to mental stress may be implicated in the development of hypertension. Repeated stressor episodes might influence vascular rigidity, through direct alteration of smooth muscle morphology and downregulation of the alpha receptor or through a process of autoregulation of CO, blood volume, and changes in renal regulation of water and sodium balance. PMID- 3535463 TI - [Polyclonal stimulation activates the basal level of IgM and IgG plaque-forming cells against sheep erythrocytes without inducing a change from IgM to IgG]. AB - In previous works, we have postulated the existence of an immunological equilibrium between persistence of the antigen presence and the B-cell maturation differentiation; from this hypothesis, it follows that the antigen presence induces the IgM to IgG switch and the final exhaustion of the response which persists if the antigen stimulation persists. On the basis of those results, we have considered of interest to study the direct and indirect polyclonal activation of the background of murine plaque-forming cells (PFC), against sheep erythrocytes. We have investigated this activation by different doses of mitogens, which activate B cells, thus producing various cellular proliferations. The goal was to find out whether polyclonal activation increased the background (as expected) but did not change the IgM/IgG PFC ratio, probably because of a lack of antigenic stimulation. As mitogens, we have used: E. coli lipopolysaccharide (LPS), a known polyclonal activator of B cells which causes a proportional increase in the number of background plaque-forming cells to a given antigen, and pokeweed mitogen (PWM) which, although less frequently used, has been shown to stimulate both T and B lymphocytes. Female Swiss albino mice have been used; 10 mice per group for both control and test groups. The mitogens were administered according to the following doses and protocol: LPS-1 dose of 10, 50 or 100 micrograms; 3 doses of 10, 50, or 100 micrograms (1 dose per week). PWM-1 dose of 50, 100 or 200 micrograms; 3 doses of 50 or 100 micrograms (1 dose per week).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535465 TI - Cognitive stress and cardiovascular reactivity. II. Relationship to atherosclerosis, arrhythmias, and cognitive control. AB - This is the second of a two-part series on the effects of cognitive stress on cardiovascular disease. This paper reviews the relationship between cognitive stress and cardiovascular reactivity as it relates to the development of atherosclerosis and arrhythmias. In addition, the moderation of cardiovascular reactivity by the opportunity to exercise control over the stressor is discussed. The findings may be summarized as follows. First, recent animal work has suggested that the magnitude of heart rate change in the presence of a conditioned aversive stimulus is positively correlated with the extent of coronary atherosclerosis under diets high and low in atherogenic potential. Second, cardiovascular reactivity in humans may be related to several factors that could have an influence on the pathogenesis of atherosclerosis. These factors include: increased beta-adrenergic driving, increased shearing force on the intimal lining of the vessels, changes in pulsatile flow and the subsequent smooth muscle reparatory process. Cognitive (psychological) stress has also been related to ST segment depression, rate-pressure product changes, and changes in cardiac contractility. Animal studies have shown that the susceptibility to ventricular fibrillation may be enhanced by the presence of a conditioned aversive stimulus and may be reduced through adaptation to the aversive environment. The balance between sympathetic and parasympathetic influences on the myocardium may also play a critical role in the susceptibility of an already diseased heart to succumb to fatal arrhythmias during a behavioral stressor. Finally, studies in which subjects may exercise some control over an aversive stimulus suggest that cardiovascular reactivity may be pronounced and sustained in situations requiring frequent adjustment to changes in the criteria for successful performance, and/or the presence of positive incentives. PMID- 3535466 TI - Ethacizin: a new efficacious Soviet antiarrhythmic drug of the phenothiazine group. AB - Ethacizin, a new Soviet antiarrhythmic agent of the phenothiazine group, was tested on 82 patients with ventricular rhythm disturbances. Antiarrhythmic effects of the drug were assessed by means of ambulatory ECG monitoring. The investigation protocol included acute drug testing with 50 mg, 100 mg, and 150 mg, and short-term maintenance therapy with 150 to 300 mg/24 hours of ethacizin (mean 183 +/- 46 mg/24 hours) for 3 to 14 days (mean 7 +/- 3 days). Ethacizin reduced the total number of ventricular premature beats (VPBs) from 17,263/24 hours (on placebo) to 3458/24 hours (p less than 0.001) and suppressed couplets and ventricular tachycardia (VT) runs by 90% in 94% and 96% of patients, respectively. Maximum blood plasma concentration of ethacizin was observed in 110 to 120 minutes and accounted for 300 to 447 ng/ml (mean 354 +/- 77 ng/ml), with a minimum therapeutic drug plasma concentration ranging from 29 to 101 ng/ml (mean 73 +/- 27 ng/ml). There was a significant increase in PQ and QRS intervals with ethacizin. Ethacizin was well tolerated. Thus ethacizin had high antiarrhythmic efficacy in patients with VPBs and no significant side effects. PMID- 3535467 TI - Yant memorial lecture. Nickel. PMID- 3535468 TI - Self-contained respirators: effects of negative and positive pressure-demand types on physical exercise. AB - Ten volunteer subjects performed maximal exercise tests on a bicycle ergometer and a treadmill while under three breathing conditions: negative pressure-demand (NPD), positive pressure-demand (PPD) and normal breathing (N). No differences between breathing conditions were found in maximal work level, maximal heart rate or maximal blood lactate concentration. The experienced firemen among the subjects did show a lower respiration rate in NPD compared to PPD and N during submaximal exercise, but this was compensated for by an increased tidal volume. A remarkable finding concerned carbon dioxide pressure in arterialized blood, which was lower (0.5 to 0.8 kPa) during PPD compared to NPD or N, indicating an improvement in pulmonary gas exchange. In summary, it can be concluded that neither negative pressure-demand nor positive pressure-demand breathing affects maximal physical working capacity; therefore, their influence on the function of various organ systems during exercise apparently falls within normal physiological range. PMID- 3535469 TI - A computer-aided system to evaluate postural stress in the workplace. AB - Stress caused by awkward working posture of the trunk and shoulders can result in fatigue, musculoskeletal disorders and nerve entrapment syndromes. To aid in evaluating the relationship between work activities and postural stress, a computer-aided system was developed. This system produces a detailed description of work tasks and a continuous record of trunk and shoulder activity on the same time scale. The system was used to evaluate postural stresses on a case study job in an automobile assembly plant. The results of the postural analysis were used to identify specific causes of postural stress and to develop recommendations for changes in work station equipment and methods to reduce stress. PMID- 3535470 TI - Systemic systolic hypertension in the elderly: correlation of hemodynamics, plasma volume, renin, aldosterone, urinary metanephrines and response to thiazide therapy. AB - Twenty-four men, mean age 63 +/- 1.7 years, with systemic systolic hypertension were studied before and after 1 month of therapy with oral hydrochlorothiazide, 50 mg/day. The control mean plasma volume was 2,664 +/- 96 ml, cardiac index 3.9 +/- 0.2 liters/min/m2, stroke volume index 52 +/- 2 ml/beat/m2, systemic vascular resistance 1,351 +/- 80 dynes s cm-5, plasma aldosterone 8.6 +/- 1.0 ng/dl and 24 hour urinary excretion of metanephrines 0.371 +/- 0.044 mg. On renin-sodium profiling in 23 patients, 12 were classified into a normal group and 11 into a low-renin group; none had high renin values. Based on multiple regression analysis, the 24-hour urinary excretion of total metanephrines appeared to be the single most important factor explaining 28% of the variability in systolic blood pressure (BP). After therapy with oral hydrochlorothiazide, the elevated systolic BP decreased (p less than 0.0001) and diastolic BP decreased (p less than 0.005), with concomitant reduction in systemic vascular resistance (p less than 0.03). Patients in both the normal- and low-renin groups had normal plasma volume and responded similarly to thiazide diuretic therapy, without symptomatic side effects. PMID- 3535472 TI - Vasodilator therapy with a new stable prostacyclin analog, OP-41483, for congestive heart failure due to coronary artery disease and comparison of hemodynamic effects and platelet aggregation with nitroprusside. AB - A new stable prostacyclin analog, OP-41483, was used in patients with severe congestive heart failure (CHF) due to coronary artery disease and compared with nitroprusside. During infusion of both drugs, mean brachial arterial pressure, total pulmonary resistance, pulmonary artery wedge pressure and systemic vascular resistance decreased significantly. Cardiac index and stroke index also increased significantly. Platelet aggregation did not change significantly during nitroprusside but decreased significantly with OP-41483 infusion. Thus, this analog may be useful for treatment of patients with CHF due to coronary artery disease. PMID- 3535471 TI - Effects of orthotopic heart transplantation on sympathetic control mechanisms in congestive heart failure. AB - Abnormal sympathetic nervous system activity in severe congestive heart failure (CHF) was studied in 14 patients before and 3 to 6 months after orthotopic heart transplantation. Before transplantation plasma norepinephrine (NE) levels at rest were elevated (909 +/- 429 pg/ml, p less than 0.01 compared with normal, 185 +/- 60 pg/ml). No reflex activation of the sympathetic nervous system was seen with infusion of sodium nitroprusside despite a significant decrease in arterial pressure. The response to orthostatic tilt also was blunted in the patients before transplantation. Exercise capacity was reduced in these patients and plasma NE increased promptly at low exercise loads. After cardiac transplantation plasma NE levels returned to normal (319 +/- 188 pg/ml) and the sympathetic response to the stresses of orthostatic tilt (320 +/- 196 to 419 +/- 197, p less than 0.002) and nitroprusside infusion (255 +/- 94 to 555 +/- 130, p less than 0.001) normalized within 6 months after transplantation. Exercise capacity increased and the increase in plasma NE levels at various exercise loads was reduced for any given workload. Therefore, abnormal adrenergic activity in patients with severe CHF results mostly from the reduction in left ventricular pump function and is reversible if adequate pump function is restored. PMID- 3535473 TI - Design of a multicenter, double-blind study to assess the effects of prophylactic diltiazem on early reinfarction after non-Q-wave acute myocardial infarction: diltiazem reinfarction study. AB - This protocol describes the design of an international study to examine the potential prophylactic effect of 14 days of diltiazem therapy to prevent early reinfarction in patients initially presenting with non-Q-wave acute myocardial infarction. Reinfarction was defined by the detection of a secondary elevation of plasma MB-creatine kinase. The results of clinical trials, instrumental in this protocol design, that established the increased propensity for early reinfarction after initial non-Q-wave infarction are described and the implications of the present study are discussed. PMID- 3535474 TI - Prevention of atrial fibrillation or flutter by acebutolol after coronary bypass grafting. AB - Supraventricular tachyarrhythmias are common after coronary artery bypass graft surgery (CABG) and may have deleterious hemodynamic consequences. To determine if acebutolol, a cardioselective beta-blocking drug, prevents such tachyarrhythmias after CABG, 100 consecutive patients, aged 30 to 77 years (mean +/- standard deviation 53 +/- 9), were entered into a randomized, controlled study. Exclusion criteria were: contraindications to beta-blocking drugs, left ventricular aneurysm, major renal failure, history of cardiac arrhythmia and cardiac arrhythmia during the immediate postoperative period. From 36 hours after surgery until discharge (usually on the seventh day), 50 patients were given 200 mg of acebutolol (or 400 mg if weight was more than 80 kg) orally twice a day (dosage than modified to maintain a heart rate at rest between 60 and 90 beats/min). The 50 patients in the control group did not receive beta-blocking drugs after CABG. The 2 groups were comparable in angina functional class, ejection fraction, number of diseased vessels, antianginal therapy before CABG, number of bypassed vessels and duration of cardiopulmonary bypass All patients were clinically evaluated twice daily and had continuous electrocardiographic monitoring and daily electrocardiograms. A 24-hour continuous electrocardiogram was recorded in the last 20 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535476 TI - Survival after complete dislocation of a Bjork-Shiley prosthesis from the aortic valve position. PMID- 3535475 TI - Computer-assisted intraoperative mapping of the entire ventricular epicardium in the Wolff-Parkinson-White syndrome. AB - Intraoperative mapping with a hand-held, roving electrode requires a sustained rhythm lasting 5 to 10 minutes. To overcome this limitation, a computerized mapping system that records from 60 epicardial electrodes simultaneously was used to study 16 patients with Wolff-Parkinson-White syndrome. A sock containing 6 rows of electrodes arranged concentrically from base to apex was place over the ventricles. The total time from placing the sock to analyzing the most basal row of electrode recordings was 5 minutes. A 39 X 44-mm plaque containing 56 electrodes was than placed across the atrioventricular (AV) groove for detailed simultaneous mapping of the ventricle and atrium in the preexcited region identified from the most basal row of sock electrodes. During plaque placement and recording, the remaining sock recordings were analyzed and a complete isochronal epicardial map was drawn. The plaque recordings were then analyzed. This technique rapidly detects early activation at the AV groove as do other computer systems using only a band of electrodes around the AV groove. Also, complete epicardial mapping supplied important additional information. One patient with a posterior paraseptal accessory pathway had ventricular epicardial breakthrough below the strip recorded by the AV band. When more than 1 early activation site was present along the AV groove, complete maps allowed multiple pathways to be differentiated from normal activation fronts ascending from the bundle branches. Complete epicardial maps allowed the study of rapidly changing or short-lived electrical events including isolated premature impulses, initiation and termination of reciprocating tachycardia by pacing, entrainment and changing degrees of fusion created by pacing during reciprocating tachycardia, and ventricular responses during atrial fibrillation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535478 TI - Potential for reversibility of pulmonary vascular obstructive disease in children after cardiac transplantation. PMID- 3535477 TI - Early transient multivalvular regurgitation detected by pulsed Doppler in cardiac transplantation. PMID- 3535479 TI - Aortic false aneurysm: recognition by noninvasive techniques four years after mitral valve replacement. PMID- 3535480 TI - Intrapericardial spontaneous contrast echoes in pneumopyopericardium due to a gas forming organism. PMID- 3535481 TI - Somitic-vertebral correlation and vertebral levels in the human embryo. AB - Somitic and vertebral interrelationships and levels were studied in 84 human embryos of stages 9-23 (3-8 postovulatory weeks). The first four somites are occipital, the occipitocervical junction is at somites 4/5, and eight somites are involved in the cervical region: X, Y, Z, and C. 3-7. By stage 17 the total number of occipitovertebral "units," namely 38 or 39, is attained. Resegmentation (Neugliederung) of sclerotomes is not supported. A new scheme of somitic/vertebral correlation is proposed in which somites and centra are in register. Differential growth of the regions of the vertebral column was calculated, and it was found that the percentages of the total column occupied by the various regions vary from one stage to another. The cervical and coccygeal regions decrease, the thoracic and lumbar regions increase, and the sacral region remains more or less constant during embryonic development. The following structures descend with reference to the vertebral column during the embryonic period proper: roots of lower limbs, thyroid gland and thymus, tracheal bifurcation, lungs, heart, diaphragm, abdominal arteries, mesonephroi, and suprarenal glands. The gonads may descend slightly. The scapulae and the separation point between the trachea and the esophagus remain at a fairly constant level. The metanephroi ascend. The migration of many of these structures (e.g., the heart, diaphragm, and metanephroi) is much more marked in the embryonic period than later although it continues during the fetal and postnatal periods. The conus medullaris ascends during the fetal period. Anomalies of migration that affect such organs as the thyroid gland, gonads, and metanephroi are discussed. PMID- 3535482 TI - Dissociating damage. PMID- 3535483 TI - A brief history of dissociation. PMID- 3535484 TI - Pierre Janet and dissociation: the first transference theory and its origins in hypnosis. PMID- 3535485 TI - Suitability of a throat culture method for evaluation of group A streptococcal antigen detection kits. AB - Previous reports have indicated a wide variation in observed sensitivity of antigen-detection kits for group A streptococci. Before undertaking an evaluation of these new kits, the sensitivity of the throat culture technic routinely used by this laboratory was reexamined. Each throat swab was directly inoculated to sheep blood agar containing trimethoprim-sulfamethoxazole (SXT X BA) and drug free sheep blood agar (SBA) plates. Swabs were then washed in saline and the saline used to inoculate one more of each type of medium. SXT X BA cultures were incubated aerobically (5 to 10% CO2), and SBA cultures were incubated anaerobically, both for two days at 35 degrees C. From 726 patients, 164 (22.6%) of the specimens contained group A streptococci, 99% detected on directly inoculated cultures and 100% on cultures inoculated with the saline wash. Either an aerobically (CO2) incubated SXT X BA or an anaerobically incubated SBA, directly inoculated and held for two days, appears to offer a satisfactory reference culture method for the recovery of group A streptococci. PMID- 3535486 TI - Propionibacterium acnes cerebral botryomycosis. The role of plastic embedding in the diagnosis of grain-producing infections. AB - Botryomycosis is a chronic infection in which bacterial colonies, or "grains," occur in purulent exudate associated with draining sinus tracts or abscess formation. This condition usually is caused by Staphylococcus and Streptococcus, but other organisms occasionally have been implicated. This report describes the first case of botryomycosis caused by Propionibacterium acnes, a diphtheroid that has been rarely associated with opportunistic disease. In this case, plastic embedding allowed the observation of the structural details of the organisms composing the grains and permitted their presumptive identification as diphtheroids. The differential diagnosis of infectious agents that produce grains in tissue sections also will be discussed. PMID- 3535487 TI - Prostaglandins and acid peptic disease. AB - Naturally occurring PGs are considered important in maintaining the integrity of the gastrointestinal mucosa. Evidence indicates that synthetic analogs of PGs heal gastroduodenal ulcers in doses that suppress gastric acid. No consistent benefit of this class of drugs compared with already available conventional agents has been demonstrated in the treatment of duodenal or gastric ulcer disease. Nonantisecretory doses of PGs, by maintaining mucosal integrity and preventing ulcer recurrence, may eventually have a role in the treatment of ulcer disease. The potential of PGs to prevent gastroduodenal mucosal injury caused by nonsteroidal antiinflammatory drugs, alcohol, aspirin, and stress, if supported by the results of ongoing clinical trials, may be a major therapeutic advance for the treatment of peptic ulcer and related acid peptic diseases. PMID- 3535488 TI - Computed tomography and sonography in small bowel intussusception: a case report. AB - A 23-yr-old patient with a small bowel intussusception as diagnosed by CT and sonography is presented herein. Sonographic features include a soft tissue mass of bowel origin composed of alternating echodense and echolucent rings. Intussusception by CT has a characteristic appearance created by the individual layers of bowel wall, mesenteric fat located on one margin of the bowel wall, and intraluminal contrast. Awareness of these findings are important as both CT and sonography have become a primary imaging modalities. PMID- 3535489 TI - Therapeutic aspiration of pseudocysts: a cautionary tale of the pancreas. PMID- 3535490 TI - Exercise responses before and after long-term treatment with oral milrinone in patients with severe heart failure. AB - Administration of the positive inotropic vasodilator milrinone results in immediate improvement in the maximal and submaximal metabolic responses to exercise. To determine whether these effects persist during long-term therapy, nine patients with severe congestive heart failure were evaluated by upright maximal exercise testing before therapy (baseline), after 10 +/- 1 weeks of oral therapy, and during double-blind, placebo-controlled readministration of intravenous milrinone after withdrawal of oral drug for 24 hours. During long term oral therapy, maximal oxygen uptake was unchanged (baseline 792 +/- 72 ml per minute, oral therapy 820 +/- 83 ml per minute), whereas the anaerobic threshold was increased significantly from 570 +/- 53 ml per minute to 681 +/- 61 ml per minute. After withdrawal of milrinone, maximal oxygen uptake and anaerobic threshold decreased significantly; subsequent intravenous administration caused significant increases in maximal oxygen uptake and anaerobic threshold, back to the values measured during oral therapy. After oral milrinone withdrawal, maximal oxygen uptake decreased below baseline values, suggesting progression of the underlying disease. The anaerobic threshold expressed as a percent of maximal oxygen uptake was significantly increased during oral therapy (baseline 73 +/- 2 percent, oral therapy 84 +/- 2 percent) and remained significantly increased after drug withdrawal, suggesting a peripheral circulatory effect. These results indicate that in selected patients with severe congestive heart failure, milrinone exerts persistent effects on the metabolic responses to both maximal and submaximal exercise. Because of progressive deterioration in exercise capacity during long-term oral therapy, the effects of milrinone may not be apparent unless it is withdrawn. The relation of milrinone therapy to disease progression is not known. PMID- 3535491 TI - Clotrimazole treatment for prevention of oral candidiasis in patients with acute leukemia undergoing chemotherapy. Results of a double-blind study. AB - Fungal infections have become an increasing cause of morbidity in patients with acute leukemia undergoing chemotherapy. Oral candidiasis is prone to develop in these patients, and there is also a risk of the development of esophageal Candida infection. Clotrimazole troches have been previously reported to be effective in the treatment of documented oral Candida infection. This report documents a double-blind controlled study in 30 patients with acute leukemia in which the effectiveness of clotrimazole troches in preventing oropharyngeal candidiasis was assessed. Patients were randomly assigned to receive 10 mg troches of clotrimazole or a placebo three times per day. Mucosal scrapings were obtained weekly and examined directly by smear and culture. There were 28 evaluable patients. Of 12 patients with oral Candida infection, 11 were taking placebo and one received clotrimazole (p = 0.0002). Clotrimazole is effective in preventing oropharyngeal candidiasis. PMID- 3535492 TI - Prevalence of sensitivity to sulfiting agents in asthmatic patients. AB - Ingestion of sulfiting agents can induce wheezing in some asthmatic patients. However, neither the prevalence of sulfite sensitivity nor the clinical characteristics of the affected asthmatic population are known. In a prospective single-blind screening study, 120 non-steroid-dependent and 83 steroid-dependent asthmatic patients underwent challenge with oral capsules of potassium metabisulfite. Five non-steroid-dependent and 16 steroid-dependent asthmatic patients experienced a greater than 20 percent reduction in their one-second forced expiratory volume within 30 minutes following the oral challenge. Twelve of these sulfite reactors were rechallenged with metabisulfite capsules in a double-blind protocol. Under these conditions, only three of seven steroid dependent patients had a positive response. Moreover, only one of five non steroid-dependent patients had a response to double-blind challenge. On the basis of this challenge study, the best estimate of the prevalence of sulfite sensitivity in the asthmatic patients studied is 3.9 percent. This population, however, contained a larger number of steroid-dependent asthmatic patients than would be found in the general asthmatic population. It is concluded, therefore, that the prevalence of sulfite sensitivity in the asthmatic population as a whole would be less than 3.9 percent and that steroid-dependent asthmatic patients are most at risk. PMID- 3535493 TI - Does self-monitoring of blood glucose levels improve dietary compliance for obese patients with type II diabetes? AB - Self-monitoring of blood glucose levels is currently being recommended for obese patients with type II diabetes to improve weight loss and glycemic control. To determine whether self-monitoring of blood glucose levels improves dietary compliance in these patients, 50 obese patients with type II diabetes were randomly assigned either to a standard behavioral weight control program or to a weight control program that included self-monitoring of blood glucose levels and focused on the weight-blood glucose relationship. Both groups lost significant amounts of weight and maintained their losses for at least one year; reductions in medication could be made for 70 percent of patients. These data suggest that the behavioral weight control used in this study may be of benefit to patients with type II diabetes. However, there was no evidence that the addition of self monitoring of blood glucose levels to the treatment program improved the outcome in terms of weight loss, reduction in medication, dietary compliance, or mood state. PMID- 3535494 TI - Non-insulin-dependent diabetes in older patients. Complications and risk factors. AB - Non-insulin-dependent diabetes mellitus is predominantly a disease of aging, with more than 70 percent of non-insulin-dependent (type II) diabetic patients older than 55 years of age. The prevalence of macrovascular, microvascular, and neurologic complications in outpatients with type II diabetes between the ages of 55 and 74 was compared with that in a similarly aged nondiabetic group of patients. The association between duration of diabetes, hypertension, age, and other putative risk factors that are prevalent in this elderly diabetic population and the occurrence of complications was explored. This cross-sectional survey confirmed a significant increase in retinopathy, neuropathy, impotence, and macrovascular complications in patients with type II diabetes. Within the diabetic population, duration of disease was associated with the occurrence of retinopathy and neuropathy, but not associated with such macrovascular complications as coronary artery disease. Gender, type of therapy, and previously identified risk factors for vascular disease such as hypertension had little impact on the prevalence of complications in this population. The notion that type II diabetes in the elderly represents "mild" diabetes with regard to complications must be discarded. Further identification of risk factors within this diabetic population may suggest therapeutic approaches that will prevent or ameliorate the development of complications. PMID- 3535495 TI - Unusual manifestations of monoclonal gammopathies. Autoimmune and idiopathic syndromes. AB - Manifestations of monoclonal gammopathies are due to four broad mechanisms: destruction of bones, bone marrow, and normal tissues by an expanding tumor; nonspecific effects of large amounts of circulating paraproteins leading to hyperviscosity; autoantibody specificity of paraproteins that give rise to cryoglobulinemia, cold agglutinin disease, and other autoimmune phenomena, as well as incidental binding to bacterial antigens and haptens; and idiopathic syndromes due to as yet unidentified tumor products or other mechanisms. A review with an emphasis on the autoimmune and idiopathic manifestations of monoclonal gammopathies is presented. PMID- 3535496 TI - Alpha interferon in the treatment of hematologic malignancies. AB - The interferons are 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. Alpha interferon is the most extensively studied interferon species. Although antitumor activity has been seen both in vitro and in vivo in some solid malignancies, the most impressive responses have occurred in the hematologic malignancies. More than 90 percent of patients with hairy cell leukemia have a sustained recovery of their peripheral blood cell counts with alpha interferon therapy. Approximately 50 percent of patients with low-grade non-Hodgkin's lymphoma and cutaneous T cell lymphoma demonstrate a response to alpha interferon. More than 80 percent of patients with chronic myelogenous leukemia have a response to alpha interferon, and in one study, nearly half of the patients with response had complete suppression of the Philadelphia chromosome clone on at least one examination. Ongoing clinical trials are addressing such issues as optimal dosage, duration of alpha interferon therapy, and combinations of alpha interferon with other biologic agents, chemotherapy drugs, and radiation. PMID- 3535497 TI - Acute hypercalcemia and cardiac autotransplantation in dogs: long-term hemodynamic adaptability. AB - Cardiac autotransplantation (excision and reimplantation) is a unique model that isolates totally the cardiac afferent and efferent neural pathways and results in hemodynamic misadaptability to many provocative tests. Since the cardiovascular response to acute hypercalcemia is modulated by numerous factors among which the autonomic innervation plays a major role, the hemodynamic response to bolus administration of calcium gluconate was compared in normal and cardiac autotransplanted dogs. Twenty-two animals underwent an autotransplantation while a sham procedure was performed in 18 animals. Each dog was equipped with an electromagnetic flow probe positioned around the ascending aorta and with central venous and aortic catheters. Hemodynamic data were collected daily during 1 month, before and during rapid intravenous administration of calcium gluconate (0.90 mEq). Baseline hemodynamic studies indicate that for both groups myocardial failure is evident in the immediate postoperative period; despite progressive recovery, the autotransplants always show lower cardiovascular performance. Calcium administration elicits transient positive inotropism, which is more important in presence of myocardial failure; this is true for both control and autotransplanted dogs. In the early postoperative period, hemodynamic adaptability to this stress is impaired in the autotransplants. However, long term results indicate that minimal differences subsist over time in response to calcium administration, and when they are observed, they result from interferences in baroreceptor regulation and reflexes. PMID- 3535498 TI - Recent advances in the pathogenesis and pathophysiology of bacterial meningitis. AB - Bacterial meningitis continues to account for worldwide morbidity and mortality despite the advent of effective bactericidal antibiotic therapy. Recent advances over the past 10 years in the development of experimental animal models as well as basic investigation into critical bacterial surface virulence factors have begun to clarify a conceptual framework for understanding the mechanism of meningitis development in humans. Basic observations regarding competing host defenses and bacterial virulence factors have supported a pathogenetic sequence of mucosal colonization with a meningeal pathogen; systemic host invasion with intravascular replication; blood brain barrier penetration and unimpeded CSF proliferation amid the impaired host defenses in the CSF milieu; and pathophysiologic sequelae including vasogenic, cytotoxic, and interstitial brain edema (and other processes) accounting for irreversible neuronal injury and death. Only through continued basic investigation into each of these pathogenetic steps will significant reductions in morbidity and mortality ensue. PMID- 3535499 TI - Gastrointestinal manifestations of the acquired immunodeficiency syndrome. AB - The increasing frequency of acquired immunodeficiency syndrome (AIDS) mandates that all physicians be aware of the diverse nature of problems that affect this group of patients. The gastrointestinal tract is involved in approximately 50% of patients with AIDS, although not all are symptomatic. Common problems include diarrhea, malabsorption, and weight loss. These can be due to enteric infection, neoplasia, or an ill-defined enteropathy. Gastrointestinal bleeding can also become problematic either as a presenting manifestation of the illness or during the prolonged periods of debilitation that many of these individuals experience. An aggressive diagnostic approach is necessary to recognize treatable abnormalities in the digestive tract of AIDS patients. PMID- 3535500 TI - Abdominal distension in Kaufman-McKusick syndrome. AB - A female infant with Kaufman-McKusick syndrome redeveloped respiratory distress and abdominal distention at 5 weeks of age. Ultrasonography demonstrated recurrence of peritoneal cysts and hydrometrocolpos. It is postulated that refluxing vaginal secretions may contribute to the abdominal distention seen in many infants with Kaufman-McKusick syndrome. PMID- 3535501 TI - Midtrimester sonographic diagnosis of mandibulofacial dysostosis. AB - Two fetuses at risk for mandibulofacial dysostosis (MFD) were monitored sonographically during the midtrimester of pregnancy. Normal facial and auricular structure were identified in one fetus, and a healthy infant was subsequently delivered. Severe microtia and micrognathia were apparent in the second fetus and a diagnosis of MFD was made and confirmed at delivery. These observations indicate that midtrimester sonographic diagnosis of severe MFD is possible. PMID- 3535502 TI - Clinical anthropometry and medical genetics: a compilation of body measurements in genetic and congenital disorders. AB - Anthropometry has become an important tool in the study of genetic conditions, particularly as a diagnostic aid for the clinical geneticist. However, many practicing physicians do not do anthropometry of patients for several reasons, such as: appropriate measurements in a given situation are unknown; normative reference data are unavailable; or analysis and interpretation of the data are confusing. In this review we present an annotated compilation of informative measurements for hereditary and congenital disorders and a guide to normative anthropometric data of use in evaluation and diagnosis of such disorders. Further development of multivariate approaches will enhance the application of anthropometry as a means of identifying and classifying a syndrome and documenting the natural history of many disorders. Continued cooperation among physicians, geneticists, and anthropologists for the collection and assessment of patient and normative data is essential if these goals are to be realized. PMID- 3535503 TI - Recurrent focal segmental glomerulosclerosis. A pathological study of the early lesion. AB - We describe the early lesion of focal segmental glomerulosclerosis (FSGS) as it appeared in 2 cases of recurrent FSGS with early transplant nephrectomies (approximately 2 months) due to uncontrollable nephrotic syndrome. A quantitative evaluation showed that these lesions were present more often in the glomeruli of the juxtamedullary cortex. Epithelial cell proliferation and detachment and foam cells were seen frequently and were considered the hallmarks of the early lesion of FSGS. Hyaline deposits are secondary late phenomena. We suggest that the glomerular foam cells in FSGS are mesangial in origin. PMID- 3535504 TI - Circle of urine glasses: art of uroscopy. PMID- 3535505 TI - Idiopathic acute interstitial nephritis and uveitis in the adult. Report of 1 case and review of the literature. AB - In a 59-year-old female, concurrence of acute interstitial nephritis and uveitis was observed. While the clinical signs resolved after a few weeks, signs of renal tubular dysfunction persisted for 9 months, and creatinine clearance was still impaired (22 ml/min) more than 2 years after beginning of the symptoms. This is the 5th case of idiopathic interstitial nephritis with concomitant uveitis reported in adult patients. In contrast to the benign evolution observed in children, the renal function may remain impaired in adults. PMID- 3535506 TI - Successful treatment with streptokinase of renal vein thrombosis associated with oral contraceptive use. AB - The case of a 25-year-old diabetic female presenting with acute right main renal vein thrombosis associated with oral contraceptive usage is described. Rapid diagnosis with ultrasound and resolution of the thrombosis was accomplished with streptokinase. Ultrasound may be the diagnostic test of choice in selected patients with renal vein thrombosis. Streptokinase was an effective therapy in this case of acute renal vein thrombosis. PMID- 3535508 TI - Severe condylomata acuminata in a renal transplant recipient. PMID- 3535507 TI - Systemic lupus erythematosus presenting with hyporeninemic hypoaldosteronism in a 10-year-old girl. AB - Hyperkalemia has been noted to occur spontaneously in patients with long-standing systemic lupus erythematosus who did not have advanced renal insufficiency. The patients previously described all had relatively normal renin-aldosterone systems, and the hyperkalemia was thus presumed to be secondary to a primary defect in renal tubular potassium secretion. We describe at 10-year-old girl with lupus nephritis, without significant renal insufficiency, who had hyperkalemia from hyporeninemic hypoaldosteronism postulated to be due to vasculitis involving the afferent/efferent arterioles and juxtaglomerular apparatus. PMID- 3535509 TI - How do you use a closed suction adapter? PMID- 3535510 TI - Diabetes: controlling the insulin balance. The pharmacologic repertoire. PMID- 3535511 TI - Diabetes: controlling the insulin balance. Intensive conventional insulin therapy. PMID- 3535512 TI - Diabetes: controlling the insulin balance. Tight control: what does it mean. PMID- 3535513 TI - Helping children cope with painful procedures. PMID- 3535514 TI - The role of feticide in the management of severe twin transfusion syndrome. AB - Twin transfusion syndrome is a serious complication of monozygotic twin pregnancy. Diagnostic ultrasound now allows early diagnosis of this condition, but therapy has remained more elusive. In this article we present a case of severe twin transfusion syndrome diagnosed early in the second trimester. At 25 weeks' gestation, severe hydramnios, premature labor, and growth retardation of the donor twin suggested that selective feticide be contemplated to allow continuation of the pregnancy for the remaining twin. This was accomplished successfully by an in utero approach with subsequent follow-up and delivery of a healthy female infant at 37 weeks' gestation. Discussion of diagnosis, management, follow-up, and pathologic features is provided. PMID- 3535515 TI - Clinical application of the perineal scan: prepartum screening for cord presentation. AB - Real-time linear-array ultrasonographic scanning was performed from the perineum on 12 primiparous term women with the fetus in breech or foot presentation. Scanning was done with the patient initially in lithotomy position and then in semi-Trendelenburg position if a better view was required. The technique appears to be excellent for visualization of the forelaying umbilical cord even when the cervix is closed and is not affected by the acoustic shadow of the public arch. The information obtained by the scanning may be of value in avoiding or improving perinatal mobility of breech/footling fetuses and in providing better perinatal management. PMID- 3535516 TI - A cross-sectional study of in utero growth of the above average sized fetus. AB - In a cross-sectional study of 210 pregnancies resulting in above-average-sized term infants, biparietal diameter, femur length, and abdominal circumference were found to differ among three birth weight percentile groups (greater than 90, 76 to 90, and 51 to 75). Growth rates, however, were similar. Estimated fetal weights, derived from four formulas, showed the same pattern. Differences between large for gestational age infants and other above average sized infants exist; changes in growth are likely to have occurred before the thirty-third week of gestation. PMID- 3535517 TI - Use of a small-gauge needle for intrauterine fetal transfusions. AB - Intraperitoneal intrauterine fetal transfusions have generally been performed with large-gauge Tuohy needles, which increase the risk of traumatic fetal complications. We feel that this technique can be improved by use of a small gauge needle and continuous ultrasound visualization. A series of 20 transfusions is presented. PMID- 3535518 TI - Localization of an estrogen-responsive protein in the human cervix during menstrual cycle, pregnancy, and menopause and in abnormal cervical epithelia without atypia. AB - The presence and distribution of an estrogen-responsive protein with a molecular weight of 28,000 were investigated in the human cervix with use of a monoclonal antibody. This biochemical marker protein was localized with a light microscope and by immunocytochemical studies of the different cell types and cell layers of the cervix. The study involved 60 patients, 48 of whom were sexually active, eight pregnant, and four in menopause; strips of endometrial tissue were analyzed in 22 patients. In cycling women the estrogen-responsive protein was identified in the subcolumnar cells of the endocervix, whereas in the ectocervix the protein was detected mainly in the parabasal and intermediate cell layers but alternating with unstained areas. There were no significant variations in the presence of the protein in the ectocervical and endocervical epithelium during the different phases of the menstrual cycle. During pregnancy a more intense and homogeneous immunostaining of the protein was seen in the ectocervix, endocervical areas with squamous metaplasia showed strong estrogen-responsive immunostaining, and predecidual and decidual cells were positive for the protein. There were no prominent changes in the presence and distribution of the protein in the abnormal ectocervical samples without atypia. However, in the endocervix the protein detection was useful to follow the evolution of the subcolumnar cells to simple squamous metaplasia. These samples displayed intense estrogen-responsive immunostaining. No immunoreaction was observed in the cervix of menopausal women. The results of the present study have shown that the response of the normal uterine cervix to estrogenic influence is heterogeneous in different cervical cell types and in different sites within the same cell layer; during the normal menstrual cycle the capability of response of the cervical cells to variations of estrogen levels is limited when compared with the endometrium; and during pregnancy and in the process of indirect squamous metaplasia some of the cervical cells seem to be very reactive to estrogenic stimulation. This study defines the normal baseline for further analysis of the estrogen-regulated protein in the uterine cervix during abnormal growth. PMID- 3535519 TI - Predicting acute pelvic inflammatory disease: a multivariate analysis. AB - A multivariate logistic regression analysis of patient symptoms and signs and laboratory findings associated with the diagnosis of acute pelvic inflammatory disease was performed with use of data from 628 women who were clinically diagnosed as having the disease for the first time at the University of Lund, Sweden. In 414 women (65.9%) acute pelvic inflammatory disease was laparoscopically confirmed. We developed a mathematical model that correctly predicted 87.0% of the cases of acute pelvic inflammatory disease and had an overall correct classification rate of 75.6%. Variables that were good predictors of acute pelvic inflammatory disease were purulent vaginal discharge, erythrocyte sedimentation rate greater than or equal to 15 mm/hr, positive gonorrhea result, adnexal swelling on bimanual examination, and rectal temperature greater than or equal to 38 degrees C. Furthermore, we developed "mixed model I" and "mixed model II," which combine simple clinical parameters and laparoscopy in varying degrees. In mixed model I the sensitivity, specificity, and overall classification values were 93%, 67.2%, and 84.5%; in mixed model II these values were 100%, 67.2%, and 89.2%. Use of relatively simple and reproducible clinical parameters can identify those women who would most benefit from laparoscopy to diagnose acute pelvic inflammatory disease. PMID- 3535520 TI - Computed tomography in evaluation of gynecologic malignancies: a retrospective analysis. AB - The results of preoperative computed tomography and operative findings were assessed retrospectively in 52 patients with cervical, uterine, and ovarian neoplasms. Overall sensitivity and specificity for all disease states was 57% and 79%, respectively. Overall diagnostic accuracy was 69%. The use of computed tomography was felt to be helpful in evaluation of lymphadenopathy due to cervical cancer and in patients with suspected ovarian neoplasms. In uterine neoplasms, however, computed tomography did not add useful information. PMID- 3535521 TI - Prevention of neonatal group B streptococcal sepsis by the use of a rapid screening test and selective intrapartum chemoprophylaxis. AB - A randomized 18-month study was conducted to determine the effect of intrapartum chemotherapy in the prevention of neonatal group B streptococcal disease. Twelve hundred seven indigent patients at term were screened weekly for group B streptococci antenatally with a rapid test based on coagglutination methods and at the time of admission in labor, 263 (22%) were confirmed to have colonization, 67 of which had heavy colonization. One hundred thirty-five of these mothers were randomized to a group treated with 1 gm of ampicillin intravenously every 6 hours until delivery. The remaining 128 mothers were not treated. None of the infants born to the treated mothers had colonization with group B streptococci at surface culture sites. Fifty-nine (46%) of the infants born to untreated mothers, including 24 of 30 (80%) from mothers with heavy colonization, had colonization. Ampicillin treatment administered during labor to pregnant patients with heavy colonization significantly reduced vertical transmission of group B streptococci. PMID- 3535523 TI - Occupational therapists' use of media. AB - The purpose of this study was to examine current trends in the use of activities by occupational therapists, to identify factors influencing their selection of activities, and to examine relationships between activities used and therapeutic goals. A questionnaire sent to 500 members of the American Occupational Therapy Association elicited a low response rate; thus, the results are descriptive of only 22% of the original population. The therapists who responded were primarily using activities of daily living and physical or exercise-related modalities although there were some differences according to area of practice and according to the time period in which the therapist received professional training. Clinical education and classroom education were the most frequently cited influences on activity selection, and remediation of musculoskeletal deficits was the most frequently mentioned therapeutic goal. PMID- 3535522 TI - Scanning electron microscopy of conjunctival surfaces in patients with ocular cicatricial pemphigoid. AB - The conjunctival surfaces of ten patients with active, ocular cicatricial pemphigoid, three patients with drug-controlled ocular cicatricial pemphigoid, and six patients with normal conjunctivas were studied using scanning electron microscopy. A homogeneous granular sheet of amorphous mucin-like material was observed covering extensive areas of the conjunctiva in eight of ten patients with active ocular cicatricial pemphigoid. This sheet of amorphous material was absent on drug-controlled ocular cicatricial pemphigoid and normal conjunctival specimens. Our study demonstrates that patients with active ocular cicatricial pemphigoid possess ocular surface mucus that appears thicker and more continuous than normal ocular mucus when observed with scanning electron microscopy. This observation is in agreement with clinical observations of thick mucus strands in the inferior fornix of patients with active ocular cicatricial pemphigoid. PMID- 3535524 TI - Historical perspective on entry level discussion. PMID- 3535525 TI - Determinants of the initial comfort of hydrogel contact lenses. AB - A double-masked, randomized study was conducted to determine the effects of power and water content on the initial comfort of hydrogel contact lenses in 10 unadapted subjects. Three lens powers (-0.50, -5.00, and -10.00 D) were used in each of three water contents (38, 55, and 70%). A significant negative correlation (p less than 0.05) was found between lens comfort and lens water content; that is, lower water content lenses of lesser bulk were more comfortable than higher water content lenses. These data will allow practitioners to predict patient awareness to various lens types. When fitting hydrogel lenses to an apprehensive patient who has not worn contact lenses previously, it may be advisable to insert a thin, low water content lens initially, thereby maximizing lens comfort. PMID- 3535526 TI - Polyvalent antigen-antibody interactions are required for the formation of electron-dense immune deposits in passive Heymann's nephritis. AB - In order to analyze the initial steps involved in the formation of subepithelial electron-dense immune deposits, the authors induced passive Heymann's nephritis in rats by intravenous injection of monoclonal or polyclonal antibodies to the relevant antigen, a 330,000-dalton brush border protein also expressed within coated pits of glomerular epithelial cells. Whereas both mono- and polyclonal antibodies induced deposits detectable by indirect immunofluorescence, electron dense deposits were only found in glomerular capillary walls of rats injected with polyclonal antibodies. Immunoultrastructural analysis confirmed the subepithelial location of heterologous IgG: monoclonal antibodies were essentially confined to the coated pits of glomerular epithelial cells, whereas polyclonal antibodies were detected in coated pits and in the subepithelial electron-dense deposits. In the face of an excess of circulating antibody, gp 330 was not detectable in the deposits, but a striking increase in the number of endoplasmic reticula positive for gp 330 was found. The results indicate that highly cross-linked immune complexes formed by polyvalent antibodies on the epithelial cell surface are necessary for the induction of subepithelial electron dense deposits. PMID- 3535527 TI - Mesangial cell hillocks. Nodular foci of exaggerated growth of cells and matrix in prolonged culture. AB - To examine the capability of glomerular mesangial cells (MCs) to produce extracellular matrix, the authors studied MCs in culture by light and electron microscopy as well as immunocytochemistry. MCs were obtained from isolated rat glomeruli and maintained up to 12 weeks in medium containing 20% fetal calf serum. MC outgrowth of primary culture and of up to three subcultures showed characteristic organization consisting of bands of elongated or stellate intertwined cells. After confluency at 10-16 days, MCs continued to grow in irregular multilayers. MCs produced extracellular matrix material within 2-4 days after plating, and large amounts of matrix accumulated with time. By 2-3 weeks, foci of exaggerated MC proliferation, matrix secretion, and necrotic cell debris formed nodular protrusions, which gradually produced large hillocks. Immunocytochemical studies of MC outgrowths were performed on culture plates or on sectioned material with the use of specific rabbit polyclonal antibodies to isolated matrix proteins and FITC-conjugated, affinity-purified second antibodies. Within 3 days of culture, MCs elaborated fibronectin and collagen Types I, III, IV, and V. With time, strands of matrix, notably in the central mass of hillocks, stained extensively for these constituents. Staining for laminin was less pronounced. Smooth muscle cell myosin was regularly found on distinct intracellular fibrils and in the extracellular material of hillocks. Electron microscopy revealed the hillocks to be composed of elongated cells on the surface and stellate cells intermingled with matrix and necrotic cell debris in the core. The results show that proliferating MCs can be maintained in homogeneous culture for a prolonged time period. MCs produce large amounts of the extracellular matrix proteins (Type IV and V collagen, fibronectin, laminin), which are found in normal glomeruli. Cultured MCs also produce interstitial collagen Types I and III. MC hillocks show the nodular accumulation of matrix similar to that seen in the mesangium of diseased glomeruli. It is concluded that the in vitro model of prolonged MC outgrowth may facilitate the investigation of factors that govern mesangial matrix production. Such a model could be used in examining the response of the mesangium to defined inflammatory or metabolic stimuli. PMID- 3535528 TI - Recurrent hepatitis B in liver allograft recipients. Differentiation between viral hepatitis B and rejection. AB - The histologic findings in the original liver obtained from 9 liver allograft patients with active B virus hepatitis were compared with 28 posttransplant pathology specimens. All specimens were studied with the use of light and immunohistochemical microscopy in conjunction with pertinent clinical data. Eight of the 9 patients had chronic active hepatitis B (HB) with cirrhosis, prior to transplant, one of which had coexistent hepatocellular carcinoma. The ninth patient had fulminant hepatic necrosis secondary to acute HB prior to transplantation. In all of the patients with chronic HB prior to transplantation who survived more than 2 months after transplantation recurrent infection of the graft developed despite perioperative HB immunoglobulin therapy. The patient with acute fulminant hepatitis B pretransplant has done well postoperatively and has evidence of HB virus immunity (positive anti-HBs) 15 months after transplantation. Examination of tissue specimens obtained during episodes of allograft dysfunction in these 9 patients indicate that pathologic alterations of active HB infection of the allograft are associated with a preferential lobular insult, whereas those occurring in rejection preferentially involve portal tract structures. Serologic data combined with biopsy histopathologic data are essential in distinguishing between the two quite different events. PMID- 3535530 TI - Proteolysis in cultured cells during prolonged serum deprivation and replacement. AB - Cells in culture show a series of changes in intracellular protein degradation in response to serum deprivation and replacement that are similar to alterations in degradation in tissues of starved and refed animals. Rates of intracellular protein degradation are increased in confluent cultures of IMR-90 human diploid fibroblasts when deprived of serum, but this enhanced proteolysis is transient. By 24-48 h, rates of protein degradation decline to values comparable to or below those for cells incubated in the presence of serum. Longer serum deprivation leads to further reductions in proteolysis. The reduced proteolysis after long term deprivation cannot be explained by experimental artifacts or by gradual depletion of glucocorticoids or thyroid hormones from cells. Readdition of serum to deprived cells that are still in the enhanced phase of proteolysis restores degradation rates to values comparable to those in nondeprived cells. However, in cells deprived of serum for 24-48 h or longer, readdition of serum to the medium results in a marked reduction in proteolysis to rates below those observed in nondeprived cells. These responses of cultured cells to long-term serum deprivation and readdition may be of considerable physiological importance in that the proteolytic responses of tissues in starved and refed animals may be at least partially due to mechanisms operating at the cellular level. PMID- 3535529 TI - Morphologic evaluation of the effects of Shiga toxin and E coli Shiga-like toxin on the rabbit intestine. AB - The effects of a Shiga toxin derived from Shigella dysenteriae Type 1, Strain 60R, and a Shiga-like toxin from the enterohemorrhagic Escherichia coli O157:H7, Strain 933, were studied in the in vivo rabbit ileal loop model. The effects of both toxins were similar and resulted in severe villus blunting by 18-24 hours after exposure. With both toxins, a dose effect was noted; and the lesions, first detected at 2 hours after inoculation, became more severe over time. Both toxins appeared to act directly and selectively on the mature columnar absorptive epithelium of the intestinal villus, which resulted in the premature expulsion of these cells from the lateral villus wall, with a decrease in the villus/crypt ratio. The goblet mucous cells remained attached and frequently formed clusters on the blunt villus apices. The crypt epithelium underwent a rapid proliferation and maintained the epithelial integrity. The ultrastructural changes observed in the toxin-injured villus absorptive cells suggested that these cells underwent a process of apoptosis, rather than necrosis. These findings suggest that both toxins act in vivo in the small intestine on a specific cell population, the mature, differentiated absorptive villus epithelium. PMID- 3535531 TI - Increased insulin sensitivity and responsiveness during lactation in rats. AB - In 12-day lactating rats blood glucose and plasma insulin were decreased by, respectively, 20 and 35% when compared with nonlactating rats, despite a 25% increase of their glucose turnover rate. Then, by using the euglycemic hyperinsulinemic clamp technique, dose-response curves for the effects of insulin on glucose production and utilization in lactating and nonlactating rats were performed. Glucose production rate was totally suppressed at 250 microU/ml of insulin in lactating rats and for plasma insulin concentrations higher than 500 microU/ml in nonlactating rats. Plasma insulin level inducing half-maximal inhibition of glucose production was decreased by 60% during lactation. The maximal effect of insulin on glucose utilization rate and glucose metabolic clearance rate was, respectively, increased 1.5- and 2.4-fold during lactation and was obtained for plasma insulin concentrations lower in lactating than in nonlactating rats (250 vs. 500 microU/ml). Insulin concentrations inducing half maximal stimulation of glucose utilization and glucose metabolic clearance were decreased by 50% during lactation. In conclusion, this study has shown that insulin sensitivity and responsiveness of liver and peripheral tissues are improved at peak lactation in the rat. PMID- 3535532 TI - Fat feeding causes widespread in vivo insulin resistance, decreased energy expenditure, and obesity in rats. AB - High levels of dietary fat may contribute to both insulin resistance and obesity in humans but evidence is limited. The euglycemic clamp technique combined with tracer administration was used to study insulin action in vivo in liver and individual peripheral tissues after fat feeding. Basal and nutrient-stimulated metabolic rate was assessed by open-circuit respirometry. Adult male rats were pair-fed isocaloric diets high in either carbohydrate (69% of calories; HiCHO) or fat (59% of calories; HiFAT) for 24 +/- 1 days. Feeding of the HiFAT diet resulted in a greater than 50% reduction in net whole-body glucose utilization at midphysiological insulin levels (90-100 mU/l) due to both reduced glucose disposal and, to a lesser extent, failure to suppress liver glucose output. Major suppressive effects of the HiFAT diet on glucose uptake were found in oxidative skeletal muscles (29-61%) and in brown adipose tissue (BAT; 78-90%), the latter accounting for over 20% of the whole-body effect. There was no difference in basal metabolic rate but thermogenesis in response to glucose ingestion was higher in the HiCHO group. In contrast to their reduced BAT weight, the HiFAT group accumulated more white adipose tissue, consistent with reduced energy expenditure. HiFAT feeding also resulted in major decreases in basal and insulin stimulated conversion of glucose to lipid in liver (26-60%) and brown adipose tissue (88-90%) with relatively less effect in white adipose (0-43%). We conclude that high-fat feeding results in insulin resistance due mainly to effects in oxidative skeletal muscle and BAT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535534 TI - Effect of charge on hepatic specific nature of vesicle encapsulated insulin in conscious dogs. AB - Positively [(+)-VEI] and negatively [(-)-VEI] charged formulations of vesicle encapsulated insulin (VEI) were compared with insulin on the basis of their ability to suppress hepatic glucose production (hepatic Ra) and stimulate glucose utilization (Rd) in conscious dogs. Our results indicate that (-)-VEI and insulin have an equivalent capacity to suppress hepatic glucose production at dose levels of 0.2, 1.2, and 2.4 mU X kg-1 X min-1. (+)-VEI is less effective at suppressing hepatic Ra than both insulin and (-)-VEI at dose levels of 1.2 and 2.4 mU X kg-1 X min-1. Both (+)-VEI and (-)-VEI induced significantly less glucose utilization than a comparable amount of insulin at dose levels of 1.2 and 2.4 mU X kg-1 X min 1. The amount of glucose utilization stimulated by (+)-VEI was significantly less than that induced by insulin at 0.6 mU X kg-1 X min-1. This difference was not evident with (-)-VEI. These results suggest that the insulin contained in (+)-VEI is less bioavailable than that contained in (-)-VEI. This difference in bioavailability is believed to be the result of greater serum stability of (+) VEI vesicles when compared with that of (-)-VEI. In conclusion, both (+)-VEI and (-)-VEI have the capacity to shield encapsulated insulin from interacting with peripheral tissues and deliver insulin selectively to the liver. Both formulations afford one an opportunity to expand the therapeutic window for hepatically active compounds where their utility is limited by systemic toxicity. PMID- 3535533 TI - Plasma glucose concentration determines direct versus indirect liver glycogen synthesis. AB - In the present study hepatic glycogenesis by the direct versus indirect pathway was determined as a function of the glucose infusion rate. Glycogen synthesis was examined in catheterized conscious rats that had been fasted 48 h before receiving a 3-h infusion (iv) of glucose. Glucose, containing tracer quantities of [U-14C]- and [6-3H]glucose, was infused at rates ranging from 0 to 230 mumol X min-1 X kg-1. Plasma concentrations of glucose, lactate, and insulin were positively correlated with the glucose infusion rate. Despite large changes in plasma glucose, lactate, and insulin concentrations, the rate of hepatic glycogen deposition (0.46 +/- 0.03 mumol X min-1 X g-1) did not vary significantly between glucose infusion rates of 20 and 230 mumol X min-1 X kg-1. However, the percent contribution of the direct pathway to glycogen repletion gradually increased from 13 +/- 2 to 74 +/- 4% in the lowest to the highest glucose infusion rates, with prevailing plasma glucose concentrations from 9.4 +/- 0.5 to 21.5 +/- 2.1 mM. Endogenous glucose production was depressed (by up to 40%), but not abolished by the glucose infusions. Only a small fraction (7-14%) of the infused glucose load was incorporated into liver glycogen via the direct pathway irrespective of the glucose infusion rate. Our data indicate that the relative contribution of the direct and indirect pathways of hepatic glycogen synthesis are dependent on the glucose load or plasma glucose concentration and emphasize the predominance of the indirect pathway of glycogenesis at plasma glucose concentrations normally observed after feeding. PMID- 3535535 TI - Hormonal responses associated with early hyperglycemia after graded hemorrhage in dogs. AB - Trained, awake, splenectomized dogs (n = 17) were studied to examine potential mechanisms for early hyperglycemia after hemorrhage (H). Animals were surgically prepared under halothane-nitrous oxide 3 days before the experiment. Chronic catheters were placed aseptically in the portal vein (PV), femoral vein, and femoral artery. Electromagnetic flow probes were placed around the PV and hepatic artery. After an overnight fast, dogs were hemorrhaged 10, 20, or 30% of their estimated blood volume in 3 min. Flow measurements and blood samples for glucose (G), immunoreactive insulin (IRI), immunoreactive glucagon (IRG), catecholamines (C), and cortisol (F) were taken prior to H and from 5 min to 8 h post-H. Plasma IRI, IRG, and F were measured by radioimmunoassay, plasma C by high-pressure liquid chromatography, and G by a glucose oxidase method. Peripheral G did not change after 10% H but increased significantly after 20 and 30% H from 10 min to 2 h. Similarly, peripheral C did not change after 10% H but increased significantly from 10 min to 2 h after 20 and 30% H. In contrast, the portal venous delivery of IRG did not increase significantly until at least 1 h after any magnitude of H. Peripheral IRI did not change after any magnitude of H. However, portal venous delivery of IRI decreased significantly from 20 min to 6 h after 10% H. Plasma F increased significantly in peripheral blood after all magnitudes of H. These results indicate that an increase in the release of IRG occurs too late to account for the early hyperglycemia that occurs during the 1st h following H.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535536 TI - Effect of diet change on insulin action: difference between muscles and adipocytes. AB - To investigate the difference of insulin action between skeletal muscle and adipose tissue in response to dietary manipulation, we studied the effect of high sucrose (HS) and high-fat (HF) diet on insulin action by measuring insulin binding and insulin action both in soleus muscles and adipocytes. HS feeding led to a 14 and 28% decrease, and HF feeding led to a 25 and 36% decrease in insulin binding both to soleus muscles and adipocytes, respectively (P less than 0.01). In HF-fed rats, both rates of glucose uptake and intracellular glucose metabolism were impaired by 30-40% in soleus muscles (P less than 0.01), and adipocyte glucose uptake was also decreased by 30% in the submaximally insulin-stimulated state (P less than 0.05). On the other hand, in HS-fed rats with prominent hyperinsulinemia, glucose uptake was 2.3- to 2.7-fold increased in adipocytes (P less than 0.01). However, both rates of glucose uptake and intracellular glucose metabolism were not increased in soleus muscles from HS-fed rats. Steady-state plasma glucose (SSPG) level was unchanged in HS-fed rats during somatostatin, glucose, and insulin infusion, whereas the SSPG level of HF-fed rats was twice as much as that in controls (P less than 0.01). These results indicate that long term regulation of glucose metabolism by ambient insulin in skeletal muscle may be different from that in adipocytes and that insulin action in muscle, rather than in adipocyte, may reflect insulin action of whole body. PMID- 3535537 TI - Insulin but not GH directly stimulates growth of transplanted fetal rat paws. AB - We have investigated whether insulin or growth hormone (GH) can affect growth of transplanted fetal rat paws by direct and/or indirect actions. Paws from 15-day rat fetuses were transplanted under the kidney capsule of adult female hosts, and grown for 7 days. In hypophysectomized (HX) or diabetic hosts their growth was reduced by 65% and 35%, respectively. The direct effects of insulin and GH were studied by inserting a catheter connected to an osmotic minipump into the left renal artery. Thus transplants on the left (infused) kidney were exposed directly to much higher concentrations of hormone than were those on the right (uninfused) side. In HX hosts, infusion of GH (0.1 microgram X g body wt-1 X day-1) had no effect on growth of paws on either kidney. At 0.3 or 1.0 microgram X g body wt-1 X day-1 GH caused a dose-related restoration of transplant growth that was equivalent on both sides. In diabetic hosts infusion of insulin (2 U X kg body wt 1 X day-1) partially restored growth of paws on the infused kidney without affecting those on the right. Insulin at 6 U X kg body wt-1 X day-1 caused full restoration of growth of the paws on the left and a partial increase in those on the right. At 9 U X kg body wt-1 X day-1 insulin caused full restoration of transplant growth on both kidneys. These results indicate that insulin promotes normal growth of transplanted fetal paws by direct and possibly indirect mechanisms, but the effects of GH are apparently only indirect. PMID- 3535538 TI - Associations between transports of alanine and cations across cell membrane in rat hepatocytes. AB - Alanine transport across the liver cell membrane is a regulated key process in the amino acid metabolism of the body. The majority of alanine influx in hepatocytes is Na+ dependent and is stimulated by intracellular negativity. The molar ratio between cotransported Na+ and alanine is 1:1. Alanine efflux is stimulated by intracellular Na+, whereas the role of the membrane potential is unclear. The transmembrane Na+ electrochemical gradient seems to be the exclusive driving force for cellular alanine accumulation. At a physiological Na+ gradient, intracellular alanine can exceed the extracellular concentration about 20-fold, but metabolism will exert a conspicuous sink effect. Na+-coupled uptake of alanine appears to be a challenge that triggers a sequence of regulatory events: increased cellular Na+ leads to an increase in active Na+-K+-pumping and thus in K+ influx; influx of alanine and cations tends to increase the cellular content of osmotically active substances implying a tendency to water uptake; cell swelling, even when modest, induces an increase in the permeability of a conductive pathway for K+ leading to net efflux of K+ (with accompanying anions) and cellular hyperpolarization. Net efflux of K+ prevents excessive cell volume increase during amino acid accumulation, whereas hyperpolarization tends to support the driving force for alanine influx (and anion efflux). The pathway for K+ efflux needs further characterization, but it may involve single-file diffusion with Ca2+ as an activator. This model suggests that cell volume regulatory processes mainly serve to compensate for changes in intracellular content of ions and metabolites during activation of specialized cellular processes. PMID- 3535539 TI - Validation of a single crystal for measurement of transmural and epicardial thickening. AB - Conventional measurement of wall thickening with two transit-time crystals requires considerable skill, is associated with myocardial trauma, and does not discern the function of different layers of the left ventricular (LV) wall. To overcome these limitations, we have developed a 10 MHz pulsed Doppler technique that measures thickening at any depth of the LV wall from a single crystal sutured to the epicardium. To verify its accuracy, we compared measurements of thickening fraction (TF) by pulsed Doppler and transit-time methods in 25 open chest dogs. The epicardial Doppler crystal was placed over an intramyocardial crystal positioned either in the subendocardium or midwall. The epicardial crystal acted as both the Doppler transducer and the transit-time transmitter, so that TF was measured by each technique at the same site. A wide range of regional function (transmural TF:-28-42%, epicardial TF:-20-28%) was produced by coronary occlusion followed by reperfusion, and by isoproterenol and phenylephrine infusions. There was a good correlation between the two methods, both for transmural TF (r = 0.98, 107 paired measurements) and epicardial TF (r = 0.99, 70 paired measurements). Despite marked changes in function, the two techniques yielded similar measurements under all of the conditions tested (base line, ischemia, 5, 15, 30, 60, 120, and 180 min of reperfusion, isoproterenol and phenylephrine). One-millimeter errors in selecting the depth of the Doppler sample volume did not significantly affect the accuracy of TF measurements. Thus the single pulsed Doppler crystal provides a simple, atraumatic, and accurate means for measuring myocardial function, both transmurally and in selected layers of the LV wall. PMID- 3535540 TI - Muscle mechanics and Ca2+ transport in atrophic heart transplants in rat. AB - Isometric contractile activity and force-frequency relationship were investigated in heterotopically isotransplanted rat hearts that performed minimal external work for 8 wk and underwent atrophy. No changes were found in the isometric contraction phase of the papillary muscles from the transplants when compared with the hearts of recipient animals that carry full hemodynamic load. However, the relaxation phase of the transplants was impaired at higher frequencies (greater than 24 stimuli/min) of stimulation and at higher levels of calcium (greater than 2.0 mM Ca2+) in the medium. When Ca2+-accumulating activities of cardiac microsomes containing fragments of the sarcoplasmic reticulum (SR) were studied, a significant decrease was seen in the transplanted hearts in comparison with the host hearts. This decrease in Ca2+-uptake activity was observed at different times of incubation as well as different concentrations of free Ca2+ (10(-7) to 10(-5) M Ca2+). Although Ca2+-stimulated ATPase activity did not change, alterations in the phospholipid contents of the SR vesicles from the transplanted hearts were observed. These results provide some evidence for a depression in the SR Ca2+ uptake in transplanted hearts undergoing atrophy and may explain the underlying alteration in the relaxation phase of these hearts. PMID- 3535541 TI - Rat liver free cytosolic Ca2+ and glycogen phosphorylase in endotoxicosis and sepsis. AB - Rats were treated with Escherichia coli endotoxin (ET) either acutely or chronically or rendered septic by cecal ligation and puncture. At 6 h after ET injection, at various intervals of continuous ET infusion, and at 17-18 h after the onset of peritonitis, animals were killed and hepatocytes were isolated. Cytosolic [Ca2+] ([Ca2+]c) was measured by quin 2 during the resting state and after stimulation with epinephrine and vasopressin. Basal and epinephrine-, vasopressin- and glucagon-stimulated glycogen phosphorylase activity were also determined. In hepatocytes from acutely ET-treated rats, resting levels of [Ca2+]c were decreased 46% from 245.8 +/- 11.0 to 131.0 +/- 8.5 nM (n = 4-6, P less than 0.05). In septic rats a 39.5% decrease was noted [i.e., from 154.0 +/- 17.7 (n = 4, sham) to 93.3 +/- 91 nM (n = 5, septic, P less than 0.05)]. These decreased [Ca2+]c levels were associated with changes of glycogen phosphorylase activity in a manner suggesting a cause and effect relationship; e.g., acute ET treatment resulted in greater than 80% depression of phosphorylase a activity, whereas sepsis induced a 58% decrease in the activity of this enzyme. In ET infused rats the resting level of [Ca2+]c and its response to hormonal stimulation were not different from hepatocytes of saline-infused rats, although glycogen phosphorylase activity was less responsive to these hormones. The effect on the enzyme's response to Ca2+-mobilizing hormones was more marked than to glucagon. This is consistent with the concept that information flow in the Ca2+ messenger system is a site of metabolic lesions produced by endotoxicosis and sepsis. PMID- 3535542 TI - Expressed emotion: from predictive index to clinical construct. AB - Expressed emotion, a measure of family attitudes toward psychiatric patients that is predictive of relapse, has attracted renewed attention recently as interest in the chronic psychiatric patient has widened. The authors review the development of the concept and the limits of its meaning. In seeking the core clinical construct underlying the expressed emotion variable, the authors also review recent studies of the relationship of expressed emotion to family interaction patterns, physiological arousal states, precipitants of relapse, and parental personality style. While family intervention studies are necessary to demonstrate that expressed emotion influences outcome in psychiatric patients, methodological limitations in currently available studies leave this issue unresolved. PMID- 3535543 TI - Efficacy of clonidine in 24 patients with acute mania. AB - The authors treated 24 newly hospitalized patients suffering from acute mania with 450-900 micrograms/day of clonidine, an alpha 2-adrenergic agonist, for 2 weeks. A marked decrease in manic symptoms was observed after 5 and 13 days of treatment in about half of the patients. Early response seemed to predict the final result. Patients with a family history of affective disorder and patients who had had a good response to neuroleptics during a previous manic episode tended not to respond to clonidine. At the doses given, the patients' tolerance to clonidine was excellent: sedation was markedly lower than it is with neuroleptic treatment. PMID- 3535544 TI - Withdrawal syndrome with gradual tapering of alprazolam. AB - The clinical and biological correlates of gradual alprazolam withdrawal were investigated in 10 patients in a double-blind, placebo-controlled trial. During gradual alprazolam withdrawal, anxiety and plasma cortisol levels were higher than during a postwithdrawal medication-free period. PMID- 3535545 TI - Sedative or antimanic effects of carbamazepine and treatment of behavioral dyscontrol. PMID- 3535546 TI - Isocarboxazid in the treatment of bulimia. PMID- 3535547 TI - Fluoxetine-induced weight loss in overweight, nondepressed subjects. PMID- 3535548 TI - The case of Elise Gomperz. AB - In the late 1880s to mid-1890s Freud was involved in the treatment of Elise Gomperz. Theodor Gomperz's published letters provide us with details concerning the treatment as well as her husband's reactions to the treatment. These details enable us to explore the social factors that were involved in Freud's early clinical work. PMID- 3535549 TI - Magnetic resonance imaging as a tool for evaluation of traumatic knee injuries. Anatomical and pathoanatomical correlations. AB - Traumatic injury to the knee remains a diagnostic and therapeutic challenge. Magnetic resonance imaging (MRI) has been applied to musculoskeletal pathoanatomy and has been shown to be an effective tool for definition and characterization of knee pathology. A systematic approach is taken to establish anatomical and pathoanatomical correlations, as well as the role of MRI in the management of knee injuries. Imaging was performed at the UCLA Medical Center using a permanent magnet system and a combination of solenoidal surface coils and thin-section, high-resolution scanning techniques. Images depict structural anatomical and spatial details of the knee that correlate well with corresponding cadaveric cryosections. To determine pathoanatomical correlations and the efficacy of MRI, 105 patients with preoperative diagnoses of meniscal tears, anterior and posterior cruciate ligament tears, tibial plateau fracture, and patella and quadriceps injuries were imaged. Results indicated that for the medial meniscus MRI demonstrated a 95.7% sensitivity, 81.8% specificity, 90% accuracy, 88.2% positive predictive value (PPV), and 93.1% negative predictive value (NPV). Imaging of the lateral meniscus demonstrated a 75% sensitivity, 95% specificity, 91% accuracy, 80% PPV, and 94% NPV. MRI of the ACL revealed 100% sensitivity, specificity, accuracy, positive and negative predictive values. MRI is a noninvasive tool which uses no ionizing radiation and can accurately define and characterize anatomy and pathoanatomy. This study indicates that MRI in conjunction with clinical evaluation can contribute to treatment decision-making processes and assist in preoperative planning. An algorithm demonstrating the potential clinical use of MRI is presented. PMID- 3535550 TI - Soft tissue fixation to bone. AB - This experiment was designed to compare the immediate fixation strengths of various methods of soft tissue fixation techniques. The fixation techniques tested were the barbed staple, stone staple, suture techniques, screw with spiked plastic washer, and the screw with spiked soft tissue plate. Cadaveric soft tissue specimens were classified into three distinct morphologic types: capsular, tendinous, and extensor mechanism tissue. Each specimen was fixed to bone by one of the fixation techniques. The specimens were loaded in a cyclical fashion until fixation failure occurred. One hundred thirty-seven trials were performed. The screws with the spiked plastic washer and soft tissue plate proved superior overall for all three tissue types. The stone staple was the poorest technique tested. Therefore, if cyclic loading or tension is anticipated at the fixation site, the fixation technique of choice would be the screw with spiked plastic washer or soft tissue fixation plate. PMID- 3535551 TI - Comparison of nonwoven and woven gown and drape fabric to prevent intraoperative wound contamination and postoperative infection. AB - In a prospective, controlled clinical trial, nonwoven, disposable gown and drape fabrics were no better barriers to intraoperative wound contamination or postoperative wound infection than reusable cotton poplin. We observed no difference between the two study groups in either the frequency or level of intraoperative wound contamination as judged by cultures of specimens collected at the time of wound closure. Of procedures in which reusable fabrics were used, 13.1 percent had positive cultures compared with 15.5 percent of those in which disposable fabrics were used (difference not statistically significant). We recovered coagulase-negative Staphylococci from more than 95 percent of contaminated wounds. Rates of postoperative wound infection were virtually identical in the two groups. Our data suggest that either both fabrics were similar in their ability to block bacteria that were shed from skin surfaces from entering the wound, or that bacteria which contaminate the wound in clean surgical procedures are derived from sources other than skin. PMID- 3535552 TI - A randomized, double-blind trial of single dose piperacillin versus multidose cefoxitin in alimentary tract operations. AB - For elective alimentary tract operations in which contamination is moderate, single dose prophylaxis with piperacillin is equivalent to triple dose cefoxitin, a well established and effective regimen. Both methods failed to control infection arising in the perineal wound after abdominoperineal resection. Just as is the case with drain site infection, such infection often evolves from postoperative contamination and, indeed, is in theory and in fact unlikely to be controlled by perioperative prophylaxis. This study is among the first of several examining the issue of single dose prophylaxis and will be the harbinger of other studies from other groups examining whether or not the course of therapeutic antibiotics can be safely shortened in patients with peritoneal contamination. PMID- 3535553 TI - Single dose systemic antibiotic prophylaxis of surgical wound infections. AB - The proper duration of antimicrobial use for the prevention of postoperative surgical infection has been a subject of controversy. Currently, more than 40 published clinical trials are available in which the efficacy of single dose surgical prophylaxis with parenteral antimicrobials has been studied. These studies have compared single doses versus multiple doses of the same agent, single doses of antimicrobial versus placebo, single doses of various antimicrobials, and a single dose of one agent versus multiple doses of another agent. In all trials in which single dose regimens were compared with multidose regimens, the single dose regimens resulted in a similar frequency of postoperative wound infections. Single antimicrobial doses, usually cephalosporins given immediately before operation, are effective in preventing wound infections in gastric, biliary, and transurethral operations, hysterectomies and cesarean sections. For colorectal operations, the value of single parenteral doses of various agents has been established; however, it is not clear if there is an added benefit when oral antimicrobials are also used. For open heart operations or those in which prosthetic materials are implanted, the value of single dose regimens has not been established. PMID- 3535554 TI - Relationship between lipofuscin-like pigments formation and lipolysis in gamma irradiated rats. PMID- 3535555 TI - [Variation in the functional circulatory value measured by ultrasonic cerebral tomosphygmography during the administration of general intravenous anesthesia]. PMID- 3535556 TI - [Cerebral ischemic pathology of the carotid origin. Preoperative evaluation of the ischemic risk: digital subtraction angiography (diagnostic value, limits of interpretation and use)]. PMID- 3535557 TI - [Simultaneous use of ultrasonics and pulsed Doppler method with spectral analysis of frequency in pathology of cervical and cerebral vessels]. PMID- 3535558 TI - [Cerebral ischemia of the carotid origin: diagnostic strategy]. PMID- 3535559 TI - [Use of uterine sensitization before labor induction]. PMID- 3535560 TI - [Fetal syndrome of Bonnevie-Ullrich-Turner, diagnosed prenatally by echography]. PMID- 3535561 TI - Andrew Rose Robinson. Pioneer North American Dermatopathologist. PMID- 3535562 TI - Feijoo on the limitations of medical science. PMID- 3535563 TI - The man behind the eponym. Giulio Bizzozero and his son Enzo. PMID- 3535564 TI - [The history of tracheotomy. III]. PMID- 3535565 TI - [Reduction of circulatory reactions to intratracheal intubation--the effect of meptazinol]. AB - A controlled, randomized, double blind assessment of the efficacy of meptazinol 3 mg kg-1 in reducing the circulatory responses to tracheal intubation was carried out in 20 ASA class I patients. After thiopentone 4 mg kg-1, meptazinol 3 mg kg-1 (ten patients) or saline (ten patients), and suxamethonium 1.5 mg kg-1 tracheal intubation was carried out, and the changes in pulse rate and arterial blood pressure compared between the groups and with control values. Significance was assessed at the 5% level (Student's t-test and paired t-test). Patients who received saline exhibited a rise in pulse rate, significant 1 and 2 min after intubation, and a significant rise in mean arterial pressure for 5 min after intubation. Patients who received meptazinol exhibited no significant rise in pulse rate, but a significant fall in pulse rate occurred from 5 min onwards. Mean arterial pressure rose significantly for 4 min after intubation but the rise was significantly less than that seen in the saline group. Suppression of spontaneous ventilation or movement in 50% of the group lasted for 7 min and 9 min after induction of anaesthesia in the control group and meptazinol treated group respectively. Meptazinol 3 mg kg-1 modifies the circulatory responses to tracheal intubation, preventing the tachycardia and reducing the hypertension, and causes a short delay in the onset of spontaneous respiration or movement. PMID- 3535566 TI - [The history of endotracheal anesthesia, with special regard to the development of the endotracheal tube]. AB - Endotracheal anaesthesia is today the form of general anaesthesia most often applied. It represents more than 80% of the total in hospitals with different surgical specialties. The technique of endotracheal anaesthesia is already more than 1,000 years old. At the beginning of our century all preconditions had been given for a widespread and safe performance of endotracheal anaesthesia. The most important stages in the development of this form of anaesthesia are as follows: 1869: First endotracheal anaesthesia in human by use of a tracheotomy cannula by Friedrich Trendelenburg. 1880: First orotracheal intubation anaesthesia by William Macewen. 1894: Positive pressure ventilation following morphine intoxication by George Fell and Joseph O'Dwyer. 1895: Description of direct laryngoscopy by Alfred Kirstein. 1901: Franz Kuhn "Die perorale Intubation". PMID- 3535567 TI - [Puncture of the brachiocephalic vein]. AB - A specific central vein catheter for puncture of the brachiocephalic vein has been developed which is provided with a valve by which air-embolism and unwanted bleeding from the catheter are eliminated. Typical and often serious complications, which can develop on insertion of central vein catheter, can nearly be totally avoided by the puncture technique described. PMID- 3535568 TI - [Volkmar Feurstein--age 65]. PMID- 3535569 TI - Electroconvulsive therapy and anesthetic considerations. PMID- 3535570 TI - A foam cuff endotracheal tube T-piece system for use with nitrous oxide anesthesia. PMID- 3535571 TI - Cardiovascular depression secondary to ionic hypocalcemia during hepatic transplantation in humans. AB - Cardiovascular function, serum ionized calcium (Ca+2), and serum citrate were measured intraoperatively in patients (n = 9) undergoing orthotopic hepatic homotransplantation. Serum citrate increased 20-fold (P less than 0.0006) following transfusion of citrated blood products in the absence of a functional liver. Serum ionized calcium decreased (P less than 0.003) with concomitant decreases in cardiac index (P less than 0.005), stroke index (P less than 0.004), and left ventricular stroke work index (P less than 0.001). Hemodynamic depression and ionic hypocalcemia were reversed following the administration of CaCl2. In contrast to patients with normal hepatic function, who may tolerate large amounts of citrated blood, patients with end-stage liver disease demonstrate acute ionic hypocalcemia with concomitant hemodynamic depression when receiving citrated blood products during the course of hepatic transplantation. PMID- 3535572 TI - Hemodynamic effects of high-frequency jet ventilation in patients with and without circulatory shock. AB - Nineteen critically ill patients with acute respiratory failure were studied to compare the hemodynamic effects of continuous positive-pressure ventilation (CPPV) and high-frequency jet ventilation (HFJV) at comparable levels of alveolar ventilation. Patients were divided into three groups: Group 1 included seven patients without circulatory shock in whom mean airway pressure (Paw) was slightly higher during CPPV than during HFJV (17.3 +/- 3.0 vs. 13.0 +/- 2.9 mmHg); Group 2 included six patients without circulatory shock in whom HFJV and CPPV were compared at the same level of Paw (19.2 +/- 5.0 mmHg); Group 3 included seven patients with circulatory shock in whom HFJV and CPPV were compared at the same level of Paw (16.0 +/- 3.9 mmHg). The following respiratory frequencies were used in HFJV: Group 1, 200 +/- 76 beats/min; Group 2, 238 +/- 103 beats/min; Group 3, 286 +/- 149 beats/min. In all patients comparable levels of PaCO2 were obtained with CPPV and HFJV. In Group 1 patients, mean arterial pressure, cardiac index, and stroke index were significantly higher during HFJV. In Group 2 patients, no significant difference was found between HFJV and CPPV. In Group 3 patients, the following hemodynamic variables were significantly higher during HFJV: mean arterial pressure (71 +/- 24 vs. 84 +/- 23 mmHg), cardiac index (3.6 +/- 1 vs. 4.1 +/- 1.41 X min-1 X m-2), and oxygen delivery (403 +/- 93 vs. 471 +/ 124 ml X min-1 X m-2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535574 TI - Complex control of schistosomiasis. AB - The main problems of complete Schistosomiasis control in endemic areas are eradication of intermediate host snails, large-scale treatment and health education of the population. Health education seems to be the most important factor in maintaining the standard of control. The introduction of very cheap, effective and fast screening methods and the development of very efficacious and easily applicable drugs have made large-scale treatment one of the most important methods of epidemiological combat. The eradication of snails has lost importance, with chemical and, to a growing extent, biological means of snail control becoming the focus of interest. In view of recent success in combating Schistosomiasis, it can be assumed that this disease will cease to be a major threat to public health in endemic areas. PMID- 3535575 TI - Drug reactions: allergy and near-allergy. AB - In this review, allergic drug reactions are discussed in terms of their immunologic mechanisms, with an emphasis given to new information that has appeared recently in the medical literature. Because of their recent emergence as important categories to recognize and manage appropriately, the pseudoallergic reactions next receive special attention. The last section on management covers diagnostic and preventive strategies, and concludes with a discussion of desensitization. PMID- 3535576 TI - Recurrent infections following nephrectomy and renal transplantation for Goodpasture's syndrome. PMID- 3535577 TI - Clinical evaluation of the human basophil degranulation test in grass pollen allergic patients. AB - The reliability of the human basophil degranulation test (HBDT) is still in doubt. We took 20 orchard grass-sensitive patients and 20 non-sensitive subjects and compared the sensitivity of HBDT with skin test and RAST. Eighteen HBDTs were positive in skin test-positive patients. There was also a good correlation with the results of RAST. PMID- 3535578 TI - [Hemorheology and hemodilution]. PMID- 3535579 TI - [The place for using erythrocyte substitutes in hemodilution: fluosol-DA and polymerized pyridoxylated hemoglobin]. AB - In conditions of limited haemodilution (haematocrit 0.25), an improvement in the rheological properties of blood and an increase in cardiac output allow increased perfusion of capillaries and maintenance of tissue oxygenation so long as normal circulating volume is maintained. However, some authors have suggested that blood substitutes enabling oxygen transport are necessary. The suitability of such substitutes depends on their physicochemical properties and, until now, only the use of haemoglobin solutions and fluorocarbon emulsions has been. The use of fluorocarbons requires respiration under hyperoxia or pure oxygen, which is a major limitation. Haemoglobin solutions suffer from inadequate concentration, short vascular persistence and too high an affinity for oxygen, but these deficiencies disappear with polymerized pyridoxylated haemoglobin. Though both types of preparation can keep animals alive with zero haematocrit for some time, their contribution to oxygenation goes down as the haematocrit goes up. According to Zander and Makowski [40]. the minimum acceptable amount of oxygen in the blood is reached with a haemoglobin concentration of 4.4 g X 100 ml-1 with a Po2 of 90 mmHg (12 kPa), and of 3.3 g X 100 ml-1 with a Po2 of 550 mmHg (73 kPa); these values correspond to a haematocrit close to 0.10. At this haematocrit and with a Po2 of 90 mmHg, a 70 g X l-1 haemoglobin solution contributes for 28% to the consumption of oxygen in baboons, while Fluosol DA 20, used at Po2 550 mmHg, takes care of 55% of this consumption. At higher haematocrits, it is not certain that these substitutions have a real advantage over the usual plasma expanders at normovolaemic haemodilution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535580 TI - [Choice of a sympathomimetic amine for treating acute circulatory failure of peripheral origin]. PMID- 3535581 TI - [Pharmacokinetic changes induced by extracorporeal circulation]. PMID- 3535582 TI - [Preoperative assessment of respiratory risk]. PMID- 3535583 TI - [Use of barbiturates in preventing and treating the sequelae of cerebral ischemia]. PMID- 3535584 TI - [Effects of peridural obstetrical anesthesia on the fetus and the newborn infant]. PMID- 3535585 TI - [Plasma fluorine during anesthesia with enflurane or isoflurane for kidney transplantation]. PMID- 3535573 TI - Summary of the scientific literature for pain and anxiety control in dentistry. Journal literature, January-December, 1985. PMID- 3535587 TI - Emergency department management of ventriculoperitoneal cerebrospinal fluid shunts. AB - Emergency physicians must be familiar with VP shunts in order to recognize critical complications associated with these devices. Knowledge of the major types of shunt devices commonly used and the mechanics of those devices allows emergency physicians to evaluate patients with shunts in an orderly manner. PMID- 3535586 TI - Bacterial contamination of ambulance oxygen humidifier water reservoirs: a potential source of pulmonary infection. AB - The risk and benefit of oxygen humidification during ambulance transport is unknown. We cultured the water in plastic multiple-use bottles of humidifiers on 30 randomly selected area ambulances during November 1985. There were 22 positive cultures. Potentially pathogenic bacteria (four Pseudomonas maltophilia, three Pseudomonas aeruginosa, one Klebsiella pneumoniae, and one Staphylococcus epidermidis) were found in nine samples. Assuming that the water in ambulance humidifiers should have been sterile, the findings are statistically significant (P less than .01). Because there is no evidence that humidification is of benefit for nonintubated patients receiving oxygen at flow rates of 4 L/min or less when environmental humidity is adequate, we suggest that such patients should receive oxygen without humidification during ambulance transport. All other patients requiring oxygen during ambulance transport should continue to receive humidified oxygen. If a multiple-use humidifier reservoir is to be used, a written policy for its use must be developed and there must be appropriate documentation of compliance with the policy. An alternative is to replace the multiple-use humidifier reservoir with single-use sterile disposable devices, which cost approximately $2.00 per unit. PMID- 3535588 TI - Endocrinology of shock. AB - The development of shock initiates a cascade of responses in an effort to reestablish homeostasis. Three of the most important hormonal and neurohumoral changes are the secretion of glucocorticoids, catecholamines, and vasopressin. Regulation of adrenal function is much more complex than originally thought. Hemorrhage is a potent stimulus for cortisol release, and both ACTH and ACTH independent mechanisms have been described. The ACTH response to its releasing hormone, corticotropin releasing hormone (CRF), is itself amplified by vasopressin, which appears to have intrinsic CRF properties. Because ACTH is synthesized as part of a large precursor molecule (pro-opiomelanocortin) containing the amino acid sequences for several important proteins, stimulation of ACTH release has far-ranging effects, the specifics of which are just being clarified. Norepinephrine and epinephrine levels increase manyfold above baseline within minutes of the onset of hemorrhagic shock. Only patients experiencing cardiac arrest or the rare patient with a very active pheochromocytoma have higher concentrations. The levels reached are far in excess of those required to cause both cardiovascular and metabolic alterations. Because of the presence of the endogenous opiates leucine and methionine enkephalin in the neurosecretory granule, it is very likely that the enkephalins are coreleased with the catecholamines, modifying their cardiovascular effects and producing analgesia. Hypovolemia is also a potent stimulus for vasopressin secretion, which overrides hypotonicity, presenting a clinical picture quite compatible with the syndrome of inappropriate antidiuretic hormone secretion, from which it must be differentiated. Vasopressin also is released by pain, nausea, and hypoxia, all of which are likely to be present in the patient with shock.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535589 TI - Clinical trials of the pneumatic antishock garment in the urban prehospital setting. AB - As a result of experimental data and favorable clinical impressions, the pneumatic antishock garment (PASG) has gained widespread acceptance as a reasonable standard of care in emergency medical services (EMS) systems. It is currently legislated as required equipment for medical rescue vehicles in two thirds of the United States. But despite a decade of widespread use, prospective, randomized, controlled trials that demonstrate the efficacy of the PASG have not been published. Furthermore, certain complications have been reported and concerns have been raised about the use of the PASG under certain circumstances, such as penetrating thoracic injury. In the fall of 1983, the City of Houston EMS system embarked on a long-term prospective evaluation of PASG use in hypotensive victims of injury in the urban prehospital setting. All victims of injury whose systolic blood pressure was 90 mm Hg or less when they initially presented to paramedics in the field were entered into the study. All patients received the identical treatment protocol, with the sole exception of PASG application and inflation to full pressure prior to intravenous catheterization on an alternate day basis. Prospectively collected demographic data have demonstrated that the two resulting groups of PASG and no-PASG patients are well matched in terms of age, sex, injury type, anatomic location of the injury, initial field trauma score, injury severity score and probabilities of survival, as well as the amounts of IV fluids infused in the prehospital setting and the response, scene, and transport times.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535590 TI - Injury severity determination: requirements, approaches, and applications. AB - Injury severity determination serves multiple purposes in trauma care systems by aiding prehospital triage, assisting clinical management, and facilitating outcome evaluation. Numerous authors have described methods for quantifying injury severity, most of which use physiologic status or anatomic injury. For prehospital triage, such determination assists decisions regarding patient priority, disposition, and destination. For clinical management, it provides essential information on initial condition and eventual course, including response to therapy. Finally, for outcome evaluation, it enables objective assessment of care quality, using techniques that determine appropriateness of disability, morbidity, mortality, and reimbursement, based on case mix. PMID- 3535591 TI - Primary blast injuries. AB - Injury from explosion may be due to the direct cussive effect of the blast wave (primary), being struck by material propelled by the blast (secondary), to whole body displacement and impact (tertiary), or to miscellaneous effects from burns, toxic acids, and so on. Severe primary blast injury is most likely to be seen in military operations but can occur in civilian industrial accidents or terrorist actions. Damage is seen almost exclusively in air-containing organs--the lungs, the gastrointestinal tract, and the auditory system. Pulmonary injury is characterized by pneumothorax, parenchymal hemorrhage, and alveolar rupture. The last is responsible for the arterial air embolism that is the principle cause of early mortality. Treatment for blast injury is similar to that for blunt trauma. The sequalae of air embolization to the cerebral or coronary circulation may be altered by immediate hyperbaric therapy. Use of positive pressure ventilatory systems should be closely monitored as they may increase the risk of air embolism in pneumothorax. Morbidity and mortality may be increased by strenuous exertion after injury and by the wearing of a cloth ballistic vest at the time of the blast. PMID- 3535592 TI - Ca++ channel-blocking drugs in shock and trauma: new approaches to old problems? AB - The development of drugs that inhibit Ca++ influx through voltage-regulated cell membrane channels of excitable cells represents a new pharmacodynamic addition to the therapy of cardiovascular disorders. These drugs, the Ca++ channel-blocking agents, have important therapeutic roles in the management of exertional and variant angina and also in the treatment of certain types of supraventricular tachyarrhythmias. In addition, a rapidly expanding body of evidence indicates that these compounds also may exert beneficial actions in various other cardiovascular-related disorders, including different forms of shock and trauma. Theoretically, beneficial effects of Ca++ channel blockade may be explained by either a direct reduction of pathologic Ca++ overload in injured cells or, indirectly, by vasodilation and hemodynamic improvement in tissue perfusion oxygen demand relationships. Many questions remain unanswered, however, and recent experimental studies have questioned the routine use of these drugs in shock or trauma. Furthermore, the propensity for hypotensive and cardiodepressant actions of Ca++ channel blockade may well be enhanced in patients with preexisting or occult loss of myocardial contractile reserves. These complexities should be assessed carefully before Ca++ channel-blocking drugs are used in the treatment of shock states. PMID- 3535593 TI - Inhibition by pyrazinamide of tubercle bacilli within cultured human macrophages. AB - Pyrazinamide (PZA) is a unique antituberculosis drug because it is effective in vivo but not in mediums commonly used to culture tubercle bacilli. Consequently, it was employed to test the validity of an in vitro macrophage model of human tuberculosis for value as a correlate of clinical events. The drug was as active in the macrophage model as it was clinically, inhibiting virulent tubercle bacilli at concentrations at 20 micrograms/ml or higher. By contrast, it was ineffective in 7H9 bacteriologic culture medium, even at concentrations as high as 2,560 micrograms/ml. It could be either bacteriostatic or bactericidal against intramacrophage tubercle bacilli, depending on its concentration, the donor of the macrophages, and the length of exposure of the infected macrophages to the drug. The data presented suggest that the clinical effectiveness of PZA is determined by a complicated self-modulating sequence of interactions between it, tubercle bacilli, and host macrophages. Specific evidence was found that tubercle bacilli may replicate within human macrophages in non-acid-fast form, thus indicating that colony-forming unit counts are inherently more accurate than acid fast bacilli counts in these experiments, and also suggesting that important changes in bacillary cell wall composition may occur among tubercle bacilli within infected human macrophages. PMID- 3535594 TI - Clinical trial of two short-course (6-month) regimens and a standard regimen (12 month) chemotherapy in retreatment of pulmonary tuberculosis in Pakistan. Results 18 months after completion of treatment (Lahore Tuberculosis Study). AB - This study compared the efficacy and tolerability of two 6-month daily regimens of isoniazid and rifampin in combination with either pyrazinamide or ethambutol (RHZ and RHE regimens) against a standard daily regimen of streptomycin, isoniazid, and ethambutol (SHE regimen) given for 6 months followed by isoniazid and ethambutol for an additional 6 months. Only previously treated sputum positive patients suffering from active pulmonary tuberculosis were entered into the study. Three hundred and fifty-eight patients were admitted to the study and 267 (75%) completed chemotherapy. Eighty-five percent of RHZ-regimen and 82% of RHE-regimen patients achieved sputum culture negativity compared to 55% of patients in SHE regimen. Successfully treated patients were followed up for 18 months, and among these, all 3 treatment regimens showed broadly similar levels of culture negativity at the end of the follow-up period. Final therapeutic outcome was based on sputum culture results obtained throughout the follow-up period, and no statistically significant difference in relapse rate was noticed in the 3 regimens. Severe drug intolerance necessitated discontinuation of therapy in only 2 patients. PMID- 3535595 TI - The immunology of mycobacterial diseases. PMID- 3535597 TI - Jet ventilation at 100 breaths per minute in adult respiratory failure. AB - To compare the ventilation and oxygenation capabilities of jet ventilation at 100 breaths per minute with those of conventional mechanical ventilation (CMV) in adults with respiratory failure, we performed a 2- to 3-h cross-over trial of jet ventilation in 65 stable patients requiring mechanical ventilation. Jet ventilation was delivered with an inspiratory time of 0.2 s through a 1.62-mm injector cannula attached to the proximal endotracheal tube. Drive pressure was adjusted to approximate the arterial PaCO2 on CMV. Measurements of arterial blood gases, peak and mean airway pressures (Paw), blood pressure (BP), and heart rate (HR) were recorded during baseline CMV, after every 30-min period during jet ventilation, and again 30 min after returning the patient to CMV. For analysis, patients were divided into 4 clinical and radiographic patterns: diffuse parenchymal disease (n = 22), focal parenchymal disease (n = 18), obstructive airway disease (n = 6), and nonpulmonary disease (n = 19). Jet ventilation "failures" were characterized by significantly higher minute ventilation requirements, higher levels of PaCO2, higher airway pressures, and smaller PaO2/FIO2 ratios on CMV as compared to the 58 ventilatory "successes." In the ventilatory "successes," peak Paw was significantly lower, but mean Paw, PaCO2, PaO2, FIO2, BP, and HR were not significantly different with jet ventilation as compared to CMV. Moreover, in this ventilatory success group, patients with an increase in the PaO2/FIO2 during jet ventilation were not significantly different from patients with a decrease in PO2/FIO2 in terms of clinical characteristics, ventilation requirements, or gas exchange capabilities on CMV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535596 TI - The effects of prostaglandin E1 on the adult respiratory distress syndrome in septic primates. AB - The effects of prostaglandin E1 (PGE1) on the adult respiratory distress syndrome were studied in the septic primate (Macaca fascicularis). A 30-min infusion of Escherichia coli (1 X 10(10)/kg) resulted in severe septic shock and adult respiratory distress syndrome. Primates, if living, were killed 4 h after completion of the E. coli infusion. Three groups of primates were studied (n = 4 in each group). The control group (Group 1) received PGE1 at 100 ng/kg/min throughout the experiment. The septic group (Group 2) received a 30-min infusion of E. coli. The treatment group (Group 3) received a continuous PGE1 infusion (100 ng/kg/min) along with the E. coli infusion which was begun 30 min after the PGE1 infusion was started. Control primates had hemodynamic changes consistent with the vasodilatory effect of PGE1 (heart rate and cardiac output increased; blood pressure and systemic vascular resistance (SVR) decreased). All control animals survived the experiment and had no evidence of pulmonary damage. Primates given E. coli developed severe hypotension, decreased SVR, and lung injury evidenced by pulmonary edema, decreased oxygenation, and increased extravascular lung water. Primates treated with both PGE1 and E. coli developed similar cardiovascular and pulmonary changes as the septic group. There was no statistically significant difference between Group 2 and Group 3 animals with regard to mean arterial blood pressure, SVR, extravascular lung water, alveolar arterial oxygen difference, or survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535598 TI - Bronchial and alveolar absorption of inhaled 99mTc-DTPA. AB - The clearance rate of 99mTc-DTPA deposited in the lung by inhalation has been used as an index to measure lung epithelial permeability. To determine if differences exist between alveolar and bronchial absorption of 99mTc-DTPA we measured regional clearance rates in 4 beagle dogs for 30 min after preferential bronchial and alveolar deposition. Alveolar deposition was maximized by inhalation for 2 min of small 99mTc-DTPA particles (activity median aerodynamic diameter, AMAD = 0.5 micron; geometric standard deviation, GSD = 1.6) with deep slow ventilation (VT = 350 ml; f = 9 min-1), and bronchial deposition was increased by inhalation of large particles (AMAD = 4.1 microns, GSD = 2.3) with rapid shallow ventilation (VT = 50 ml; f = 65 min-1). Respective clearance rates from basal regions, which represent mainly alveolar absorption, were: for small particles, 2.29% min-1; for large particles, 1.57% min-1 (p = 0.10). Apical regions, which contain relatively more bronchial surface than do the basal regions, showed the following clearance rates: for small particles, 1.76% min-1; for large particles, 1.31% min-1 (p less than 0.05). These results indicate that in vivo alveolar absorption of 99mTc-DTPA is more rapid than bronchial absorption. Control or verification of the site of deposition of the tracer in the lung is of importance for the interpretation of the results of the 99mTc-DTPA lung permeability assay. PMID- 3535599 TI - Methacholine inhalation challenge studies in a selected pediatric population. AB - To determine bronchial reactivity patterns, 400 subjects, 5 to 21 yr of age, underwent a methacholine challenge in a Natural History of Asthma study. The diagnosis of asthma or allergy was based on a respiratory questionnaire. Subjects were nonsmokers and had had no respiratory infections for 1 month. Intradermal skin tests were done. The methacholine challenge response was expressed as the area beneath the dose-response curve (Area 35). Fifty-five asthmatics, 113 normal subjects from normal families, 103 normal subjects from asthma families, 60 normal twins, and 69 allergic subjects without asthma were studied. Overall, 52% of nonasthmatics and 47% of nonallergic subjects had an Area 35 less than 4,000 (800 breath units). There was a difference (p less than 0.05) in the distribution of methacholine Area 35 responses in normal subjects from that in normal families compared with normal subjects from asthma families. The age of the nonasthmatic subjects had an influence on the degree of bronchial reactivity. Methacholine challenge studies in pediatric patients must be interpreted with age, personal atopic status, and family asthma history in mind. PMID- 3535600 TI - Effects of muramyl dipeptide and lead acetate on carbon clearance and endotoxin induced mortality in mice. AB - Muramyl dipeptide (MDP) is a nonspecific immune adjuvant thought to affect the macrophage. MDP had been used safely without immunosuppressive or toxic side effects in our laboratory and others. Endotoxin, or lipopolysaccharide (LPS), is thought to be responsible for many of the systemic toxic effects of gram-negative infection. Lead acetate potentiates the lethal effects of endotoxin, an effect attributed to increased hepatotoxicity involving both hepatocytes and Kupffer macrophages. This study was undertaken to examine putative mechanism of action of MDP relating to the reticuloendothelial system. Endotoxin was given intraperitoneally to susceptible mice that were pretreated with MDP, lead acetate, or both, and to unmodified controls. Lead acetate significantly enhanced lethality due to LPS, but pretreatment with MDP did not alter mortality. Carbon clearance was measured in mice treated with MDP, lead, or both. There was no difference in the phagocytic index of control mice and those mice treated with lead acetate at various times prior to the injection. Carbon clearance increased significantly in mice pretreated with MDP but was unaltered by the addition of lead acetate. We conclude that if hyperphagocytosis of endotoxin occurs in MDP pretreated mice, it does not cause additional mortality. Muramyl dipeptide appeared to be a safe reticuloendothelial stimulant that did not enhance the toxicity of lead or LPS in this experimental model. PMID- 3535601 TI - Intravenous heparin for the prevention of stroke progression in acute partial stable stroke. AB - In a double-blind, placebo-controlled trial, 225 patients with acute partial stable thrombotic stroke were randomly assigned to receive continuous intravenous heparin therapy or placebo for 7 days for the prevention of stroke progression or death. No statistically significant difference between the two groups was found in degree of neurologic change; incidence of stroke progression after 7 days; or functional activity level of survivors at 7 days, 3 months and at 1 year after treatment. Compared with controls, a statistically significant greater number of patients in the group receiving heparin died in the year after the stroke. These deaths occurred 3 to 12 months after the initial stroke and probably were not related to treatment. Results of this study do not support the use of intravenous heparin to treat patients who have had acute partial stroke. PMID- 3535602 TI - Selective venous sampling for gastrin to localize gastrinomas. A prospective assessment. AB - In 27 consecutive patients with Zollinger-Ellison syndrome, we prospectively evaluated the ability of selective venous sampling for gastrin to localize gastrinomas, then compared the results with those from imaging studies and with findings at surgery. All patients had a gastrin gradient, but in only 20 patients was it significant. Neither the magnitude of the gastrin gradient nor its presence or absence correlated with the frequency with which gastrinoma was found at surgery. A gastrinoma was found at surgery in 15 patients, of whom 12 had positive imaging studies, 11 had a significant gastrin gradient, 14 had both tests positive, and 1 had both tests negative. A gastrinoma was not found at surgery in 12 patients, of whom 8 had a significant gradient and none had a positive imaging study. Gastrin sampling has equal sensitivity with imaging studies in localizing gastrinoma, but imaging studies have higher positive and negative predictive values and higher specificity. Thus, selective venous sampling for gastrin is much less useful in localizing gastrinoma than has been suggested and should not be routinely done preoperatively in patients with Zollinger-Ellison syndrome. PMID- 3535603 TI - Corynebacterium hemolyticum as a cause of pharyngitis and scarlatiniform rash in young adults. AB - Over an 8-year period from 1973 through 1980, Corynebacterium hemolyticum was isolated from 103 of 24,695 throat cultures done at our hospital. Medical records were available for review from 33 of the 80 patients with a positive culture. Pharyngitis was present in all but 1, and 20 of the 32 symptomatic patients had a diffuse, erythematous, macular skin rash, often with a fine papular component, on the extremities and trunk. Screening of household contacts of 9 patients showed the presence of C. hemolyticum in the pharynges of 6 of 17 siblings but in 0 of 10 parents. Therapy with benzathine penicillin G or erythromycin resulted in rapid clinical improvement in most patients. In contrast to streptococcal pharyngitis, which is predominantly a disease of childhood, C. hemolyticum infection affects mostly teenagers and young adults: 30 of the 33 patients in this study were between the ages of 11 and 22. Within this age group, infection with C. hemolyticum is an important cause of pharyngitis associated with a scarlatiniform skin rash. PMID- 3535604 TI - Throat cultures and rapid tests for diagnosis of group A streptococcal pharyngitis. AB - This article reviews the use of diagnostic tests to guide management of adults with sore throats. Pharyngitis due to group A beta-hemolytic streptococci represents the major diagnostic concern in these patients. Organisms other than group A streptococci can cause pharyngitis, but their clinical importance and their diagnostic tests have not yet been established. For many years, physicians have used routine throat cultures to diagnose group A streptococcal pharyngitis. Rapid tests have recently been introduced that detect the group A streptococcal antigen on throat swab specimens. Because both tests have high sensitivity and specificity, the choice of tests may depend on test turnaround time. Rapid tests should improve management by decreasing both short-term morbidity and inappropriate use of antibiotics. PMID- 3535605 TI - Standard and computed tomography in the evaluation of neoplasms of the chest. A comparative efficacy assessment. AB - Although in practice computed tomography (CT) has nearly replaced standard tomography in the evaluation of chest diseases, an analysis of the literature shows that standard tomography may be preferred in some settings. After a detailed review of studies on test performance, we calculated overall sensitivity and specificity values. Using Bayesian analysis, we then developed guidelines for choosing between computed and standard tomography. A test is recommended if its results might obviate the need for an invasive procedure. Standard tomography is recommended in the detection of mediastinal metastases from lung cancer. In the detection of hilar metastases, standard tomography is recommended for patients who have low pretest probabilities of metastases to this site, and computed tomography is recommended for patients who have high pretest probabilities. Computed tomography is recommended for the detection of calcification in solitary pulmonary nodules. Tomographic procedures are not recommended when the pretest probability is intermediate. The discrepancy between current practice and these guidelines highlights the need for carefully designed, multi-institutional comparative studies of radiographic procedures. PMID- 3535606 TI - Potential for bleeding with the new beta-lactam antibiotics. AB - Several new beta-lactam antibiotics impair normal hemostasis. Hypoprothrombinemia has occurred frequently with cephalosporins that possess a methylthiotetrazole substitution (cefamandole, moxalactam, and cefoperazone). The incidence ranges from 4% to 68%, and the risk is greatest in debilitated patients with cancer, intra-abdominal infection, or renal failure. Impaired platelet function caused by perturbation of agonist receptors on the platelet surface has occurred primarily with beta-lactam antibiotics having an alpha-carboxyl substitution (moxalactam, carbenicillin, and ticarcillin). These antibiotics often cause the template bleeding time to be markedly prolonged (greater than 20 minutes). Acylureidopenicillins, which lack the alpha-carboxyl marker, impair platelet function less frequently and only modestly prolong the bleeding time. If serious hemorrhage occurs, hypoprothrombinemia associated with methylthiotetrazole substituted cephalosporins should be treated with fresh frozen plasma. Likewise, dangerous bleeding due to impaired platelet aggregation requires treatment with platelet concentrates. PMID- 3535607 TI - Canadian cancer care: organizational models. AB - Canadian cancer care has evolved under systems of provincial and federal fiscal control and aims to optimize the management of patients within each province. In Manitoba, patients are initially assessed at one centre but can subsequently receive chemotherapy at an outreach centre closer to home. In British Columbia, two outreach mechanisms exist: consultative clinics provide consultative and follow-up care by radiotherapists and medical oncologists who travel to outreach centres, and community-based regional oncologists provide diagnostic and treatment services in small communities. In Ontario, peripheral clinics are staffed by oncologists from the two provincial cancer institutions, but efforts have been made to find newer outreach models that will better serve certain communities in that province. Two basic models of cancer care organization in the community presently exist in Canada: one stresses the extension of resources outward to the community from major cancer centres, and the other stresses the support of already established resources in the community. Efforts to coordinate these activities are being initiated. PMID- 3535608 TI - Nephrology in the United States from Osler to the artificial kidney. AB - Modern knowledge of renal physiology, kidney disease, and the body fluids in American medicine was established largely by Donald D. Van Slyke, Thomas Addis, John P. Peters, Homer W. Smith, and Alfred Newton Richards. Only two of these men were physicians, and through this group future nephrology was shaped by a dominant interest in metabolic problems and pathophysiology. Acute renal failure emerged as a new syndrome during World War II and fostered interest in hemodialysis and renal biopsy. Dialysis, when applied to chronic renal failure, eventually spawned an army of renal clinicians; and biopsy provided a specialist's nosology of what had once enjoyed the unity of "Bright's disease." A society and subspecialty board came late to nephrology and have been directed largely by renal academicians of the metabolic tradition. Nephrology is in the 1980s a bipartite subspecialty, its senior leaders still cherishing the metabolic physiologic tradition, and a growing army of dialysis practitioners mostly looking after patients with chronic and acute renal failure. PMID- 3535609 TI - The calcium deficiency hypothesis of hypertension: a critique. AB - Primary (essential) hypertension has recently been related to calcium deficiency, rather than excess. The evidence used to support this hypothesis includes surveys showing lesser dietary intake of calcium, lower levels of ionized calcium in the blood, and reduction of blood pressure with calcium supplements. This critique examines each of these points and the theoretical construct used to explain the hypothesis. We conclude that the theoretical construct is based on the use of only a portion of available experimental data and the clinical evidence remains inconclusive. Until the hypothesis is supported further, calcium deficiency should not be accepted as a mechanism responsible for hypertension and calcium supplements should be used with caution. PMID- 3535610 TI - [Tuberculosis in the immunodepressed patient]. AB - Tuberculosis is one of the opportunist infections which may complicate the course of many immunodepressive conditions generally those affecting cell-mediated immunity as the Koch bacillus is an organism which develops intracellularly provoking the activation of the cellular type of defence reaction. Recently, patients with malignant disease and immunosuppressive therapy have been joined by those with the acquired immunodepressive syndrome. It is important to understand that the frequency of tuberculosis in immunodepression is a reflection of the frequency of the disease in the general population. In addition, the diagnosis of atypical forms of tuberculosis can be difficult: the presenting signs are not specific and extrapulmonary forms are common. Therefore, tuberculosis should be suspected whenever immunodepressed patients develop unexplained symptoms. All practical means of confirming the diagnosis should be employed and the patient given a course of antituberculous drugs if there is any doubt as early treatment is an important prognostic factor. PMID- 3535611 TI - Levobunolol compared with timolol for the control of elevated intraocular pressure. AB - Two concentrations of levobunolol (0.5% and 1%) and one concentration of timolol (0.5%) were evaluated for the control of elevated intraocular pressure (IOP) in a double-masked, randomized study. Fifty-one patients received one of the three study treatments in both eyes bid for one year. Both drugs were equally effective in reducing IOP: The overall reduction in mean IOP was slightly more than 9 mm Hg in all three treatment groups. Levobunolol was as safe and effective as timolol for the long-term control of elevated IOP. PMID- 3535612 TI - [In vitro action on Plasmodium falciparum of the serum of subjects having received 3 injectable forms of quinine by the intramuscular route]. PMID- 3535613 TI - [Unusual localization of pheochromocytoma of the prostate: value of echography]. PMID- 3535614 TI - Plasma amino acid indices and urinary 3-methyl histidine excretion in dairy cows in early lactation. AB - The experiment was performed on six cows from parturition to the 70th day of lactation. The highest milk yield, from 23 to 36 kg FCM daily, was reached between the 25th and the 50th day of lactation. The onset of lactation was accompanied with the intensification of muscle protein catabolism expressed by the highest urinary 3-methyl histidine excretion and body mass loss. In the same time the lowest plasma level of insulin, glucose, alanine, threonine, serine, proline, citrulline, ornithine, arginine, and urea was stated. The PDI intake covered PDI requirement at the beginning of lactation, 5th-10th day, but exceeded it in the period between 25th and 70th day of lactation. It caused the decrease of urinary 3-methyl histidine excretion and the increase of plasma urea cycle metabolites (ornithine, citrulline, arginine, urea) level. PMID- 3535615 TI - [Infection of a non-traumatic, anticoagulant-induced retroperitoneal hematoma caused by contiguity with a pyonephrosis. Cure by nephrectomy]. PMID- 3535616 TI - [Current concepts on dilated cardiomyopathies]. PMID- 3535617 TI - [The surgical alternative in the treatment of terminal cardiomyopathies: cardiac transplantation]. AB - Between April 1983 and November 1985, 14 patients have undergone a heart transplant, or 10 men and 4 women, aged from 17 to 55 years. The surgical indication was a cardiomyopathy in terminal evolutive phase, of which the etiology was ischemia in 8 cases, congestion in 5 cases and rheumatism in one case. There was one operative death (7.1%) from acute rejection and a late death secondary to chronic rejection. The actuarial rate of survival at one and 2 years was 81.9%. Post-operative complications, most frequent at an early stage, were arterial hypertension (9 cases), rejection (8 cases) and renal insufficiency (6 cases). During an average post-operative evolution of 13 months, 17 rejection episodes occurred in 10 patients (71.4%) and 5 patients (35.7%) presented with 7 infectious episodes, one of them severe. Cyclosporin's toxicity appeared in the immediate post-operative period by an always reversible increase of the bilirubin and creatinin levels. On a long term, all patients present with arterial hypertension, accompanied by a moderate renal insufficiency (creatinin between 2.2 and 2.4 mg%). Among the survivors, 9 patients (75%) remain completely asymptomatic and have resumed normal physical activities. Cardiac transplantation has therefore become a valid therapeutic alternative, able to greatly improve survival and the functional condition of patients with terminal cardiomyopathy. PMID- 3535618 TI - Tissue adhesives and intestinal anastomosis. AB - This article presents a review of the literature concerning the employment of tissue adhesives in the production of intestinal anastomoses. The fibrin adhesive is the tissue adhesive of choice in as much as it is physiological does not possess histotoxicity or cause allergic reactions. Fibrin adhesive sealing of a conventional sutured anastomosis might improve this anastomosis as it reduced the postoperative mortality-rate significantly in a prospective study with a retrospectively matched control group comparing sealing and no sealing, but prospective, randomized trials are lacking. Finally a cyanoacrylate intestinal anastomosis has proved obsolete as in experimental trials it has proved inferior to the conventional anastomosis. PMID- 3535619 TI - Results of 32 major hepatic resections for primary and secondary malignancies of the liver. AB - Thirty-two consecutive liver resections performed during the years 1972-1984 for liver malignancies have been analysed. Among indications for resection were primary liver malignancy and liver secondaries equally often in 16 patients, mostly originating from colorectal cancer (12 patients). Ultrasound (US) was the most reliable diagnostic method being fully confident in 11 patients studied. Computed tomography (CT) missed one lesion out of 13 (confidence rate 92%), whereas angiography and liver scintiscan missed two and three lesions respectively with a confidence rate of 84 and 79. Most of the patients (94%) experienced an anatomical liver resection including 12 extended right lobectomies (ERL), eight right lobectomies (RL), five left lobectomies (LL), and five left lateral segmentectomies (LLS). The hospital mortality (16%) was almost exclusively connected to the ERL procedure with a 33% mortality rate. The crude 3 year survival rate of the series was 28%. Among the patients undergoing liver resection for colorectal cancer secondaries the corresponding figure was 41%. More than half of the patients surviving surgery have died of the same malignancy mostly developing in the remaining liver. PMID- 3535620 TI - Use of the renal pelvis as exocrine drainage in segmental pancreatic transplantation. A preliminary report. AB - A new technique for exocrine drainage in segmental pancreatic transplantation has been developed in which the renal pelvis is anastomosed to the pancreatic capsule in an end-to-end fashion, after nephrectomy. This technique can be used only in uraemic patients without renal function. The procedure was performed on a uraemic patient who was free of major problems until his death due to an intracranial haemorrhage, 41 days after transplantation. The procedure described here would appear as a new form of drainage of the pancreatic secretions in segmental grafting, with advantages over techniques previously described. PMID- 3535621 TI - The effect of phenylpropanolamine on female stress urinary incontinence. AB - In a randomized double-blind manner, 43 women with grade I and II stress urinary incontinence were treated with either phenylpropanolamine p.o. 50 mg twice daily (Rinexin, 1 tablet b.i.d.) or placebo during two weeks. Urethral CO2 profilometry, with recording of maximum urethral closure pressure (MUCP) and functional urethral length (FUL), and subjective response were considered for effect evaluation. The subjective response of Rinexin was highly significant (p = 0.01) above that of placebo. Clinical improvement was reported by 15 of 21 women on Rinexin and by 8 of 22 women on placebo. A significant increase in MUCP, 14%, was registered in women on Rinexin treatment. This increase was more pronounced in the grade I than in the grade II incontinent women. No statistically significant correlations were obtained between subjective response and increase in MUCP. An increase in FUL was recorded in both two treatment groups, but no statistically significant difference between them was obtained. Adverse drug reactions were rare. No changes in blood pressure occurred. Based on the present study, Rinexin (1 tablet b.i.d.) is an effective and safe medication for female grade I and II stress incontinence and is also recommended as adjunctive therapy to physiotherapy before Teflon injection or operation. PMID- 3535622 TI - Foreign body perforation of the gastrointestinal tract with formation of liver abscess. AB - A unique case of foreign body perforation of the stomach directly into the liver with formation of a liver abscess is presented. The literature concerning foreign body perforation of the gastrointestinal tract complicated by liver abscess is reviewed. PMID- 3535623 TI - Nasal width dimensions and anterior teeth in prosthodontics. AB - The arrangement of artificial anterior teeth in complete dentures has always relied on certain biometric guides. A study was conducted on 118 Chinese subjects to determine if there was any relationship between the interalar nose width and intercanine distance. The results show that men have wider noses and slightly greater intercanine distance compared to women. These dimensions have been shown to be generally greater than similar studies conducted on Caucasian subjects. However there was no demonstrable correlation between interalar width of nose and intercanine distance. PMID- 3535624 TI - Wound infection after mandibular reconstruction with autogenous graft. AB - An investigation on the fate of bone grafts in 38 patients, who had been subjected to a partial resection of the mandible for benign and malignant tumours, is presented. Apart from thorough drainage, meticulous suturing and gastric tube feeding, high and prolonged administration of antibiotics was practised to prevent infection. The basic antibiotic coverage in most patients consisted of 4 X 3 grams of flucloxacilline intravenously during ten days. After this period revascularization of a bone graft may be assumed to have progressed to such a degree, that thereafter the graft can "defend itself" against invading micro-organisms, if necessary supported by further lower dosage antibiotic treatment. In 28 patients no complications were encountered. Ten patients showed signs of infection, leading to complete loss of the graft in 3 patients. Incision, drainage, removal of sequestra and further antibiotic treatment resulted in preservation of the major part of the grafts in the other 7 patients. No correlation of infection with type of fixation, extent of soft tissue resection or time at which the reconstruction was done (primary or secondary) was found. The basic difference of maxillo-facial bone grafting as compared to bone grafting in other areas of the body is stressed, massive primary contamination combined with dead space and maybe dehiscence of the oral wound margins being mainly responsible for the relatively unfavourable conditions for grafting in this region. PMID- 3535625 TI - The use of collagen in oral surgery. AB - The suitability of collagen as a biomaterial for soft tissue temporary cover or implantation is discussed. Current methods used to cover areas denuded of mucosa in the mouth using split skin, mucosa and dermal autografts are examined. The properties of an ideal mucosal graft are stated and the suitability of a collagen heterograft in the form of freeze dried, chemically treated pigskin is questioned. A collagen xenograft has been used as a biological cover for areas of the mouth where soft tissue has been excised, for example, a denture irritation hyperplasia or leukaplakia and when increased wound strength or support is required to enable a wound to heal satisfactorily for example an oroantral communication. The results of the work are encouraging, demonstrating in most instances, satisfactory healing with no excess of granulation tissue, satisfactory mechanical properties in the early stages to resist the forces of mastication; a low rate of infection and no evidence of a hypersensitivity reaction to the modified foreign protein being evident clinically. Current adverse reactions seen after an injectable form of collagen is used are mentioned. A collagen xenograft would thus appear to satisfy many of the criteria of an 'ideal' biological cover and merits further critical examination. PMID- 3535626 TI - Introduction of the glabella composite graft for reconstruction of nasal tip defects and review of other methods. PMID- 3535627 TI - Orofacial granulomatosis--a 10 year review. AB - The granulomatous disorder, termed oro-facial granulomatosis, includes a localised condition affecting the mouth and face as well as the oral manifestations of Crohn's disease and sarcoidosis. The clinical presentation is variable and the apparent increase in the number of patients presenting in recent years probably reflects a greater diagnostic awareness. The aetiology remains to be established but some patients have been found to be intolerent of certain foods, the elimination of which from their diet leads to a resolution of the facial swelling. PMID- 3535628 TI - Orthodontic/orthopaedic adjunct of fixed orthodontic appliances. AB - In the treatment of malocclusion more emphasis is now placed on obtaining an excellent facial result as well as a set of teeth which is well aligned and in good function. The use of dento facial orthopaedic appliances have made these objectives possible. Not only can cases be finished better, they can also be completed in a shorter period of time. This paper reviews some of such appliances and case reports will also be presented. PMID- 3535629 TI - Endosseous implants: the host-implant surface. AB - The long term success of dental implants depends on the formation and retention of a stable host-implant interface: in the case of endosseous dental implants probably by ankylosis. This situation is influenced by: site preparation, implant material, epithelial behaviour, stress distribution, and oral hygiene. Thermal trauma and wound contamination are important in site preparation, if unfavourable and irreversible changes in the bone are to be avoided. Metals, plastics, and ceramics have all been used for making implants. Of the metals titanium and some titanium alloys have proved particularly suitable. The plastics and ceramics have poor physical properties for dental implant construction on their own, although composites, many of which are biocompatible, such as hydroxyapatite reinforced polyethylene and carbon fibre reinforced carbon may overcome these problems. Epithelium tends to migrate from the oral cavity around an implant and whilst there is some evidence for an epithelial attachment this is little understood. Loads on bone can modify its behaviour leading to an increase or decrease in its rate of formation or resorption, and whilst this has never been quantified it is known that excessively rigid implants can lead to high stress gradients in the surrounding bone. Poor attention to oral hygiene may lead to inflammation in the tissues around an implant and hasten its loss. PMID- 3535630 TI - The role of closed-packed positions in the pathogenesis of temporomandibular joint internal derangements. AB - A hypothesis is presented as to how certain occlusal relationships and habitual patterns of jaw use may predispose an individual to TMJ internal derangements. Knowledge of diarthrodial joint biomechanics, in general, and the appreciation of close-packed positions of the TMJ, in particular, would not only provide the clinician with a greater discriminatory sense when diagnosing intracapsular problems but also help him to make better decisions and judgement about therapy. Popular treatment regimens, in particular those based upon the age-old Centric Relation concept, will be re-appraised. PMID- 3535631 TI - Composite resin systems. PMID- 3535632 TI - Viruses and heart disease: a problem in pathogenesis. AB - Identification of viral myocarditis offers problems; pathologists fail to agree on the definition of the disease and biopsy-proven cases documented in the English literature are still few in number. Though endomyocardial biopsy is becoming a standard procedure at many medical centers, tissue sampling, especially in cases of patchy myocarditis, can result in further diagnostic difficulties. While conventional wisdom holds dilated cardiomyopathy the end stage of chronic viral myocarditis, a history of preceding viral infection is usually unobtainable. Some research suggests that myocardial necrosis is a cell mediated immune process and chronic myocarditis an autoimmune disease. Understanding the true relationship between viruses and heart disease will require further research. PMID- 3535634 TI - [The human renin-secreting cell. A morphological study]. AB - The availability of specific antisera to renin and the techniques of immunocytochemistry have facilitated the microscope study of renin-secreting cells. These techniques have been used in recent studies in the developing kidney as well as in both normal and pathological adult kidney. This work has clarified the close relationship between myoepithelioid cell and the blood vessel. The use of ultrastructural immunocytochemistry has led to new insights into the intracellular processing, storage and secretion of renin. These recent morphological studies are reviewed with the emphasis on the human renin-secreting cell within the kidney. PMID- 3535633 TI - Evaluation of the platelet surface by fluorescence flow cytometry. AB - Flow cytometry has significantly contributed to cell biology, especially with use of tagged monoclonal antibodies. Discovery of specific platelet surface membrane receptors has helped to elucidate the pathogenesis of several platelet related disorders. Concomitantly, monoclonal antibodies to specific receptors have also been developed. Using fluorescent antibody techniques, small populations of platelets with distinct characteristics can be analyzed efficiently. Monoclonal antibodies, e.g., (AP-3), specific for glycoprotein, IIIa and (6DI), directed against an epitope close to the VWF binding site, have already been employed,- the latter by fluorescence flow cytometry. In addition to studies of primary surface membrane disorders, flow cytometry has been applied to measurements of surface immunoglobulin and C3 on individual platelets in autoimmune and alloimmune thrombocytopenia. Flow cytometry may also be utilized for platelet crossmatching. This simple, specific and non-radioactive technique can effectively provide accurate platelet surface data in a small clinical laboratory. PMID- 3535635 TI - [From the renin gene to renin inhibitors]. AB - The only known action of renin is the hydrolysis of angiotensinogen into angiotensin I. Renin is synthesized as an inactive precursor, preprorenin. The processing of prorenin into active renin occurs after the clivage of a profragment, just after a dibasic pair of amino-acids. The renin profragment hinders the active site by its binding to the rest of the molecule. Circulating inactive renin is prorenin because it is recognized by antibodies produced against various parts of the renin profragment. Renin, like other aspartyl proteases, hydrolyses its substrate in its active center where two aspartyl residues are involved in the catalytic mechanism. The strong species specificity of renin lies in its interaction with its substrate through subsites which can be modelized by computer graphics. There is much promise in the inhibition of the renin angiotensin system at the level of the renin-angiotensinogen reaction. The i.v. infusions of human renin antibodies in primates produces a decrease in blood pressure which is parallel to that observed during inhibition of the angiotensin I converting enzyme. The magnitude of the blood pressure decrease depends on the intensity of the sodium depletion. Potent and specific pepstatin derived inhibitors have been synthesized which are able to inhibit primate renin in vitro and in vivo with a long duration of action. Other transition state analogs inhibitors have been administered parenterally in humans and similar results have been obtained. The concept of the treatment of hypertension by an anti-renin drug is becoming more and more a reality. However, it remains to find an orally active and a non-toxic compound which will compare well with the present converting enzyme inhibitors. PMID- 3535636 TI - [Estradiol-progesterone interaction in normal and pathological human breast cells]. AB - In most target tissues of the female genital tract, an adequate cell differentiation can be obtained with the successive and synergistic action of estradiol (E2) and progesterone (P), essentially because the progesterone receptor (PR) synthesis implicates the previous action of E2 via its E2 receptor (ER). In normal breast, E2 stimulates the growth of the ductal system whereas the development of acini depends on P secretion. In other words, when E2 plus P are secreted by the ovaries in balanced proportions, the two hormones permit a complete and harmonious development of the mammary gland. The antiestrogenic activity of P is carried out through the decrease of ER resynthesis and stimulation of 17 beta-hydroxysteroid dehydrogenase enzyme activity, which transforms E2 into its less active metabolite estrone (E1) in the target cells. These biochemical events are well documented concerning the endometrium. They have also been observed in normal mammary cells in primary cultures as well as in breast fibroadenomas with high epithelial cellularity. Moreover, data from literature indicate that E2 could be both a direct and indirect factor of cell multiplication in cancerous cell lines. P as well as progestins have the opposite effect. Recent results from this laboratory indicate that E2 and P also have antagonistic effects on the cell multiplication of normal human mammary cells in primary culture. Therefore, the hypothesis that a lack of P during a long period of the female genital like could be a factor in the promotion of breast cancer must be considered. PMID- 3535637 TI - [Catecholamines in the cardiovascular expression of pheochromocytomas. I. Physiological role of noradrenaline, adrenaline and dopamine]. AB - The very diverse clinical expressions of pheochromocytoma are dependent upon type of catecholamine secreted and excreted by the tumor. The role of each of the three amines (adrenaline, noradrenaline, dopamine) is reviewed in relation to physiologic regulation of blood pressure: adrenaline and noradrenaline are pressor hormones and act on almost all blood pressure factors. They possess chronotropic and positive inotropic effects by their action on cardiac beta 1 adrenoceptors, a peripheral vasoconstricting action by interaction with vascular alpha 1 receptors and a direct effect on renin production and tubular resorption of sodium. Inversely, dopamine presents as a hypotensive agent, opposing effects of adrenaline and noradrenaline and possessing numerous sites of action: central hypotensive action on cardiovascular integration structures, inhibitory effect on sympathetic ganglionic neurotransmission, action on specific presynaptic receptors at nerve endings, reducing sympathetic vasoconstrictor tone and finally a direct vasodilator effect. Based on these recent physiologic data the role is discussed of hypersecretion of each amine in the cardiovascular expression of pheochromocytoma. Attention should be concentrated on the nature of hormonal hypersecretion of pheochromocytoma, and a determining role given to the type of catecholamine secreted by the tumor and to the relation between the different amines with respect to the blood pressure symptomatology of pheochromocytoma. PMID- 3535638 TI - [The place of ultrasonics in the diagnosis of traumatic hemoperitoneum]. AB - Classically, the diagnosis of hemoperitoneum is based on clinical symptoms, which are not always relevant. Several complementary procedures can be considered when dealing with polytraumatic patients who may be comatose: scintigraphy, arteriography, CT, sonography and peritoneal lavage. The authors have finally selected sonography and lavage. Since ultrasound is reliable, reproductable and non aggressive, it is being more and more utilized. It readily shows solid-liquid contrast, and is particularly sensitive in displaying fluid in peritoneal recesses; parenchymal lesions are also evaluated. II enables one to explore the abdominal cavity with precision. Lavage is reserved for acute lesion with severe, evolutive hemoperitoneum, requiring immediate surgery. The indications for other imaging modalities are also discussed. PMID- 3535639 TI - [Cancer of the prostate. The practical problems posed by hormonal escape]. AB - Hormonal escape is defined as the continuation or progression of the course of prostatic cancer despite suppression of testicular androgens. Although 80% of patients are initially sensitive to the suppression of testicular androgens, 10% of patients die within six months, 50% die within three years and only 10% survive ten years. This phenomenon of hormonal escape reflects the selection of hormone-resistant clones rather than an adaptation of the whole population of tumour cells to the new conditions of androgen deprivation. Although various histological and biochemical elements and even a complex prognostic index can predict the duration of sensitivity to hormone treatment, it is virtually impossible to predict the duration of response of a given patient. The duration of response to hormonal treatment is identical, regardless of the modalities of suppression of testicular androgens. It is not significantly affected by either total androgenic deprivation (suppression of adrenal androgens) nor by the combination of cytotoxic drugs with androgenic treatment. When hormonal escape occurs, changing the modalities of androgenic suppression or escalation of the hormone therapy (increased doses of oestrogens, suppression of adrenal androgens, hypophysectomy) are generally of extremely limited value. The use of cytotoxic chemotherapy, with or without androgenic triggering, has not been shown to be significantly more effective than symptomatic treatment. In the current state of knowledge, cytotoxic chemotherapy should be reserved for patients included in rigorous clinical investigation protocols. PMID- 3535640 TI - [Malacoplakia and renal transplantation. Report of a case of testicular malacoplakia]. AB - The authors report a case of testicular malakoplakia in a renal transplant patient. They emphasise the predisposing role of immunosuppression which was particularly intense in this patient and they stress the risk of dissemination of the disease to the graft. PMID- 3535641 TI - My life with yeasts. PMID- 3535642 TI - Microaerophily and oxygen toxicity. PMID- 3535643 TI - Competition for nodulation of legumes. PMID- 3535644 TI - Persistence of RNA viruses in the central nervous system. PMID- 3535645 TI - Clonal analysis of descent and virulence among selected Escherichia coli. PMID- 3535646 TI - The biology of natural transformation. AB - Natural transformation is widely distributed among bacteria. Its variations, in terms of specific mechanisms, may in part reflect responses to different selective pressures in different bacteria. We have suggested that both gene transfer and acquisition of carbon, nitrogen, and energy represent physiological needs that may have contributed to the evolution of natural transformation. While natural transformation was the first mechanism of genetic exchange to be detected, it is perhaps the least understood. Our understanding of the mechanism for uptake and incorporation of soluble DNA has increased significantly in the last two decades, but the overall picture of transformation as a biologically significant function is still unfolding. The mechanism by which DNA is released for transformation, the control of genes involved in DNA release and uptake, the potential for transformation in the natural environment, and the potential of natural transformation as a tool for other microbiological studies are but a few of the important issues that remain. PMID- 3535647 TI - Microorganisms in reclamation of metals. PMID- 3535648 TI - In situ bacterial metabolism and colon mutagens. PMID- 3535649 TI - Invasion of erythrocytes by malaria parasites: a cellular and molecular overview. AB - Studies on the morphology, cell biology, and immunology of invasion have characterized events that are now being studied at the molecular level. The initial events of invasion are receptor-specific. A determinant associated with Duffy blood group antigens is involved in the invasion of human erythrocytes by P. knowlesi and P. vivax. The Duffy Fya antigen has recently been identified and further characterization of its role in reception and invasion should now be possible. P. falciparum utilizes erythrocyte ligands that differ from those of P. knowlesi and P. vivax. Sialic acid and a trypsin-sensitive erythrocyte membrane component are important for invasion by P. falciparum parasites. There is evidence that at least two ligands are involved in invasion. For P. knowlesi there is a ligand for attachment, common to both Duffy-negative and Duffy positive human erythrocytes, and a second ligand for invasion, which is found only on Duffy-positive human erythrocytes. P. vivax also appears to utilize two ligands, a Duffy-associated ligand and a ligand specific for reticulocytes. P. falciparum binds to sialic acid-dependent and sialic acid-independent trypsin sensitive ligands. P. falciparum merozoites require erythrocyte sialic acid to varying degrees in order to invade; this indicates heterogeneity of the receptor mechanism. Monoclonal antibodies and recombinant DNA technology have greatly facilitated the identification, isolation, and characterization of proteins that may be involved in invasion. Molecules that may have invasion-related functions include those whose antibodies block invasion, those that bind to erythrocyte ligands important for invasion, those that appear on the merozoite surface, and those that appear to be inserted into the erythrocyte membrane at the time of invasion. It has not been possible to identify a definite function for any of the molecules identified thus far. No monoclonal or polyclonal monospecific antibody has been identified that reacts specifically over the surface of the apical region of the merozoite where junction formation occurs. Identification of molecules responsible for apical attachment and junction formation will be important for our understanding of invasion. In terms of vaccine development, it is not yet known whether any of the molecules discussed here will prove to be effective immunogens. It is clear from the data obtained with the 140-kd protein of P. knowlesi that antigenic variation poses a potential problem for vaccine development. As the molecular events responsible for invasion become better understood, novel ways may be devised to interfere with the process and prevent the disease. PMID- 3535650 TI - Pathogenesis of infectious diseases of fish. PMID- 3535651 TI - Regulation of IgA expression by isotype-specific T cells and soluble binding factors. AB - The data presented here suggest a model for isotype-specific regulation of IgA synthesis by Fc alpha R+ T cells (Figure 1). Immature mIgM+ +/- mIgD+ B cells are induced by T switch cells to express cell surface IgA (a phenotypic switch). If the T switch cell induces mIgA expression via a long primary RNA transcript from an unrearranged C alpha allele, the hypothetical intermediate switch B cell results (step 1); this may be the mechanism of heavy chain expression in memory B cells that express low levels of Ig. Alternatively, T switch cells may induce a DNA rearrangement in the CH locus of the B cell (a genotypic switch), which results in a deletion of all CH loci except C alpha (step 2). TH inducer cells promote maturation of mIgA+ B cells to IgA-secreting plasma cells. This may involve a DNA switch rearrangement (step 3) or the maturation of previously switched cells (step 4), and appears to be mediated via an IgABF with enhancing activity. Not shown in this figure, but inherent in this model, is a suppressive regulatory arm that may be mediated via IgABF with suppressive activity released from Fc alpha R+ suppressor T cells. Due to the presence of Fc alpha R on a variety of cell types, IgABF may suppress synthesis of IgA by acting not only on mIgA+ B cells but also on regulatory cells (T cells, B cells, and macrophages) bearing IgA bound to Fc alpha R. If the IgA system is analogous with the IgE system, mIgA-bearing B cells may be the direct target of IgABF. Binding of Ig to FcR has been shown to (a) increase the number of Fc receptors per cell, (b) enhance the number of cells expressing Fc receptors, (c) induce the release of IgBF that either suppress or enhance Ig secretion, and (d) effectively convert surface Ig- cells into surface Ig+ cells that are therefore receptive to IgBF. Thus, FcR+ cells may interact with IgBF and Ig via a regulatory network to stimulate or inhibit the immune response in an isotype-specific manner. Cell surface molecules (mIg, FcR) may serve as sensors that allow the cell to detect and respond to fluctuations in the levels of immune mediators that serve to modulate Ig synthesis and secretion. The relationship between IgBF and FcR is not known, nor is it known whether Fc receptors expressed by different cell types are encoded by the same gene and are controlled similarly.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3535652 TI - The molecular biology of parasporal crystal body formation in Bacillus thuringiensis. AB - Data obtained using several experimental methods (curing, transconjugation, cloning, and hybridization) indicate that crystal protein genes in many subspecies of BT that are toxic to lepidopterans are located on one or more large plasmids; in some subspecies, the gene may be located on the chromosome. Detailed mapping has shown that in three plasmids (each from a different strain) the genes are surrounded by multiple copies of two repeated DNA elements; the arrangement of these elements is the same in the three plasmids. An analysis of the sequence of one of these repeated DNAs strongly suggests that it contains a transposase. Thus, transfer of crystal protein genes between plasmids and/or between plasmids and the chromosome would be possible either by transposition or by recombinational events mediated by the repeated DNAs. Crystal protein genes have been cloned from several plasmids and were expressed in E. coli and B. subtilis, whereas two genes cloned from chromosomal preparations were not expressed. Some of the factors that regulate expression of a plasmid-borne gene in E. coli and B. subtilis have been identified. Very little is known about the role of sporulation genes in regulating expression of the crystal protein gene in B. subtilis or BT. In BT, expression may also be affected by genes on other plasmids. Three homologous crystal protein genes have been identified and cloned from subsp. kurstaki and thuringiensis; different strains of these subspecies may contain one, two, or three of these genes. It seems probable that additional gene families will be found, since the crystals of different subspecies contain immunologically distinguishable proteins. The DNA sequences of the three homologous genes have been published as has the sequence of the crystal protein gene from subsp. sotto. These four genes have regions of identity (the promoter region) and similarity (the N-terminal approximately 280 amino acids, the C terminal half of the protein, and the terminator). It is interesting that the divergent portions of the molecules are not in precisely the same positions and that all overlap the toxin-encoding portion of the gene. It would be worthwhile to determine if the differences in the amino acid sequence are related to differences in the toxicity and/or the host range of the cloned genes, and to establish how the complement of genes in a given strain contributes to the overall toxicity of that strain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3535653 TI - Tryptophan biosynthetic genes in eukaryotic microorganisms. AB - In recent years more information about tryptophan biosynthesis in eukaryotic microorganisms has become available. The emphasis has been on genetics and biochemistry of the pathway. Eukaryotes manifest a trend toward fewer genes and toward multifunctional proteins, while prokaryotes have a greater tendency toward separate activity domains but the genes tend to be clustered genetically. Cloning of various structural tryptophan biosynthetic genes and studies on their expression in homologous and heterologous hosts have made it possible to analyze promoter structures in detail and to define structural elements involved in regulated gene expression. Comparisons of homologous genes from different organisms have highlighted the conservation of the activity domains or parts therefrom involved in the catalysis of single steps. These studies also point to a stringent maintenance of domains responsible for protein-protein aggregation. Physiological studies will be facilitated by the availability of single cloned genes and especially the artificial gene cluster containing all five TRP genes from yeast. The range of physiological manipulation has thus been enormously broadened. With chromosomal mutations it has been possible to study primarily downward modulation of a pathway. We can now initiate studies on upward modulation, since enzyme levels appear to increase in proportion to gene dose. The new range of downward and upward modulation in the levels of single enzymes and combinations of enzymes may contribute to a better understanding of flux regulation and its influence on the overall physiology of an organism. PMID- 3535654 TI - Genetics of bacterial enterotoxins. PMID- 3535656 TI - Genome organization in Pseudomonas. PMID- 3535655 TI - Organization, expression, and evolution of genes for mercury resistance. PMID- 3535657 TI - [Induced mutagenesis in Escherichia coli--a producer of penicillin acylase]. AB - The action of certain chemical mutagens such as N-nitroso methyl urea, N-nitroso ethyl urea, N-nitroso dimethyl urea and N-nitroso methyl biuret, as well as physical ones such as UV light on Escherichia coli producing penicillin acylase was studied. High mutagenic activity of N-nitroso methyl biuret with respect to this culture was shown. PMID- 3535658 TI - [The genus Micromonospora: its taxonomic position, antibiotic formation and methods for the targeted search for antibiotics]. PMID- 3535659 TI - In vitro and pharmacokinetic properties of the carbapenems. PMID- 3535660 TI - Comparison of cyclacillin and amoxicillin for therapy for acute maxillary sinusitis. AB - Cyclacillin, a new aminosalicylic semisynthetic penicillin, was compared with amoxicillin for the therapy of acute bacterial maxillary sinusitis in 80 patients (ages, 12 to 70 years) in a prospective, double-blind, randomized clinical trial. Direct sinus aspirations for quantitative culture were done for all patients before and after 10 days of therapy. Both drugs were administered at a dosage of 500 mg orally three times daily. Among culture-positive patients, clinical cure was achieved in 23 of 26 patients and 25 of 27 patients treated with cyclacillin and amoxicillin, respectively, for an overall cure rate of 91%. Bacteriologic failure occurred in 9% (4 of 44 patients); 3 of the 4 failures were in the cyclacillin group. There was no correlation between clinical or bacteriologic cure and the results of sinus transillumination (clear, dark) at follow-up. Initial direct sinus aspirates were positive in 57 of 80 cases (70%): 25 (44%) of these were the result of Streptococcus pneumoniae and 23 (40%) were the result of Haemophilus influenzae. All of these isolates were susceptible (MIC, less than or equal to 0.5 microgram/ml) to both study drugs; no ampicillin-resistant H. influenzae was recovered. On day 10 of therapy, mean concentrations of both drugs in serum were 2.5 to 2.7 micrograms/ml, but no antibiotic was detectable in 20 of 21 simultaneous sinus aspirates. Adverse effects (rash, diarrhea) were infrequent and similar in both groups. Cyclacillin appears equivalent to amoxicillin in the therapy of acute maxillary sinusitis. PMID- 3535661 TI - Clinical comparison of piperacillin and cefoxitin in patients with bacteriologically confirmed infections. AB - The objective of this double-blind study was to compare the efficacy and safety of piperacillin with that of cefoxitin in patients with bacterial infections. Seventy hospitalized patients were treated with intravenous piperacillin (18 g/day) or cefoxitin (12 g/day) for a mean period of 11.5 days. Multiple serious underlying conditions were present in 91% of the patients in both treatment groups. The infection sites were the respiratory, urinary, and gastrointestinal tracts, the skin and skin structures, and the bones. Among the patients with evaluated courses of therapy, 87% (20 of 23) of the patients in the piperacillin treated group and 90% (19 of 21) of the cefoxitin-treated patients were cured or improved. Multiple sites of infection were present in 6 patients given piperacillin and in 11 patients given cefoxitin. Gram-negative aerobic bacteria were the most frequently isolated organisms (56% of isolates). In each treatment group, 91% of the pathogens were eradicated. Three piperacillin-treated patients (9%) and four cefoxitin-treated patients (11%) had adverse clinical effects related to therapy; most of the effects were moderate in intensity. In conclusion, both piperacillin and cefoxitin were clinically safe and effective antibiotics for the treatment of these patients, most of whom had severe underlying conditions. PMID- 3535662 TI - Synthesis and antimicrobial activity of a series of caespitin derivatives. AB - Chemical modification of the naturally occurring phlorophenone antimicrobial agent caespitin is described. These modifications include variations in the phenone side chain, substitution with prenyl, allyl, and benzyl in the 4-position of the phlorophenone nucleus, and ring cyclizations via etherification to give furan and chroman compounds. Several of these derivatives show enhanced in vitro potency over caespitin. Studies on the development of microbial resistance against these compounds show that no or very little resistance developed after several passes of these compounds in representative microbial strains. PMID- 3535663 TI - Astromicin-induced membrane damage in Serratia marcescens. AB - The morphological changes in Serratia marcescens induced by astromicin were determined by a new technique of electron microscopy, a rapid freezing and substitution fixation technique, and a freeze-fracturing technique. Two structural changes were observed. One was damage to the cytoplasmic membrane, and the other was the accumulation of a large electron-dense mass in the cytoplasm. The damage observed in the cytoplasmic membrane was the disappearance of the unit membrane structure from the thin-sectioned profile of the drug-treated bacteria and the loss of the membrane particles from the fractured surface of the membrane. Damage to the membrane was also suggested by the results of examination of the spheroplasts for stability. The spheroplasts prepared from the drug treated bacteria were unstable in an osmotically controlled buffer. Most of the spheroplasts were lysed within 3 h, whereas those prepared from control cells were stable for more than 15 h. The electron-dense mass in the cytoplasm was usually seen in the polar region of the cell in close contact with the cell membrane. These structural changes were not specific for astromicin but were also found in gentamicin-treated cells. PMID- 3535664 TI - Continuous versus intermittent administration of ceftazidime in experimental Klebsiella pneumoniae pneumonia in normal and leukopenic rats. AB - Experimental Klebsiella pneumoniae pneumonia was used to study the influence of cyclophosphamide-induced leukopenia on the relative therapeutic efficacy of continuous and intermittent (6-h intervals) administration of ceftazidime. The antimicrobial response was evaluated with respect to the calculated daily dose that protected 50% of the animals from death (PD50) until 16 days after the termination of a 4-day treatment. When ceftazidime was administered intermittently to leukopenic rats, the PD50 was 24.37 mg/kg per day, 70 times (P less than 0.001) the PD50 of 0.35 mg/kg per day for normal rats. Continuous administration of ceftazidime to leukopenic rats resulted in a PD50 of 1.52 mg/kg per day, four times (P less than 0.001) the PD50 of 0.36 mg/kg per day for normal rats. Continuous administration of ceftazidime in daily doses that protected 100% of normal and leukopenic rats from death resulted in serum levels of 0.06 and 0.38 micrograms/ml, respectively, whereas the MIC for the infecting K. pneumoniae strain was 0.2 micrograms of ceftazidime per ml. The effect of the duration of ceftazidime treatment by continuous infusion on the therapeutic efficacy in relation to the persistence of leukopenia was then investigated in leukopenic rats. The administration of 3.75 mg of ceftazidime/kg per day for 4 days protected all leukopenic rats from death, provided the circulating leukocytes returned at the end of antibiotic treatment. When leukopenia persisted for 8 days this ceftazidime treatment schedule resulted in the mortality of rats (P less than 0.05). However, when ceftazidime treatment was continued for 8 days, until the return of the leukocytes, there was no significant mortality (P greater than 0.05). PMID- 3535665 TI - Novel morphological changes in gram-negative bacteria caused by combination of bulgecin and cefmenoxime. AB - The mode of action of bulgecin was investigated by examining its bactericidal and bacteriolytic activities, its effect on bacterial morphology, and its interaction with penicillin-binding proteins (PBPs). Bulgecin alone did not show any antibacterial activity against Escherichia coli and Serratia marcescens, but in concert with cefmenoxime, it induced potent growth-inhibitory and bactericidal activities. Electron microscopic examination of E. coli cells exposed to bulgecin combined with cefmenoxime revealed that a bulge developed in the middle of the cell, and additional smaller bulges were formed halfway between the central bulge and the polar ends. At the site of bulge development, vesicular mesosomelike structures appeared in the cytoplasm, the peptidoglycan layer facing them became faint, and the outer membrane protruded to form blebs. These morphological changes were quite different from those caused by the mecillinam-cefmenoxime combination that produces big bulges in E. coli. When S. marcescens was exposed to the combination of bulgecin and cefmenoxime, not only bulge formation, but also branching of the cells was observed. Bulgecin neither showed affinity for any PBPs of E. coli nor affected the binding of cefmenoxime or mecillinam to the PBPs. PMID- 3535666 TI - Influence of beta-lactam antibiotics and ciprofloxacin on composition and immunogenicity of Escherichia coli outer membrane. AB - The effects of subinhibitory concentrations of different beta-lactam antibiotics and one quinolone on the sedimentation of outer membranes (OMs) of Escherichia coli and on the qualitative properties and immunogenicity of OM components were studied. Membranes were prepared by osmotic lysis of plasmolyzed bacteria. OM and cytoplasmic membrane vesicles were separated by sucrose density ultracentrifugation. Two peaks of OM vesicles with different buoyant densities could be isolated; the quantitative contribution of these to the total OM varied, depending upon the growth phase. In early log phase, the OM consisted mainly of lighter material; in late log and stationary phases, the OM consisted mainly of heavier material. Moxalactam, imipenem, and ciprofloxacin inhibited the formation of heavier material in all growth phases. The immunogenicity of OM vesicles was tested in mice by the hemolytic plaque test. The lighter OM material was markedly less immunogenic than the heavier OM material. The vesicles from antibiotic treated bacteria and those from early-log-phase cells were less immunogenic than vesicles from untreated late-log-phase and stationary-phase bacteria. These changes were found for the immune response against lipopolysaccharides, as well as against OM proteins. Thus, the immunogenicity of OM components seems to be dependent upon the quantitative composition of lighter and heavier compounds, which is strongly influenced by growth phase and treatment with certain antibiotics. PMID- 3535668 TI - Characterization of a beta-lactamase-specifying plasmid isolated from Eikenella corrodens and its relationship to a commensal Neisseria plasmid. AB - A 9.4-kilobase plasmid encoding penicillin, streptomycin, and sulfonamide resistance was isolated from a beta-lactamase-producing Eikenella corrodens strain. This plasmid appears to be identical to a resistance plasmid common to saprophytic Neisseria strains. PMID- 3535667 TI - Allium sativum (garlic) inhibits lipid synthesis by Candida albicans. AB - The effect of aqueous garlic extract on the macromolecular synthesis of Candida albicans was studied. Protein and nucleic acid syntheses were inhibited to the same extent as growth, but lipid synthesis was completely arrested. Blockage of lipid synthesis is likely an important component of the anticandidal activity of garlic. PMID- 3535669 TI - Potential targets for antiviral chemotherapy. AB - Serendipity and random screening have been successful in producing effective antiviral agents. The increase in our knowledge of the basic biochemistry of viral replication and of virus-host interrelationships has revealed not only an understanding of the targets upon which existing antiviral agents exert their inhibitory effect, but also has uncovered new potential targets. The hope is that such molecular understanding will afford the synthesis of compounds with selective antiviral activity. A review of various viral targets which are potentially susceptible to attack, and a few approaches for development of antiviral agents are presented. PMID- 3535670 TI - One man's death should not signal the death of an era. PMID- 3535671 TI - Applications of polysaccharides. Patents and literature. PMID- 3535672 TI - Protein engineering and site-directed mutagenesis. Patents and literature. PMID- 3535673 TI - Immunological relationships among proteins making up the Bacillus thuringiensis subsp. israelensis crystalline toxin. AB - The immunological relationships among the proteins of the mosquito larvicidal toxin produced by Bacillus thuringiensis subsp. israelensis have been investigated by using polyclonal antisera specific for the 28-, 70-, and 135 kilodalton proteins. Each of these proteins was immunologically distinct. There was no cross-reaction among the three proteins and the two non-homologous antisera. Treatment of toxin proteins with larval gut enzymes for 20 h identified protease-resistant domains at approximately 65, 38, and 22 kilodaltons. Similar domains were generated by treatment with trypsin and chymotrypsin. Our immunological and kinetic data indicate that the 28-kilodalton protein is degraded successively to protein bands at 26, 25, 23, and 22 kilodaltons, the 70 kilodalton protein is degraded to a protein at 38 kilodaltons, and the 135 kilodalton protein is degraded successively to protein bands at 94, 72, and, probably, 65 kilodaltons. Solubilized toxin possesses two biological activities, larvicidal and general cytolytic (hemolytic). We used nondenaturing gel electrophoresis to show that the hemolytic activity resides in the 28-kilodalton protein. However, higher-molecular-weight proteins are required to achieve the level of toxicity observed in intact toxin. PMID- 3535674 TI - Mutagenicity of the Alternaria metabolites altertoxins I, II, and III. AB - The Ames Salmonella typhimurium assay was used to demonstrate that an extract of the mold Alternaria alternata was mutagenic. The mutagenic extract was fractionated, and the Ames test was used to determine which fractions were mutagenic. Subsequently, altertoxins I and II and a new compound referred to as altertoxin III were isolated by liquid chromatography and shown to be hydroxyperylenequinone compounds by mass spectrometry and infrared, ultraviolet, and proton magnetic resonance spectroscopy. Altertoxins I, II, and III were mutagenic to S. typhimurium TA98, TA100, and TA1537 with and without metabolic activation. PMID- 3535675 TI - Assessment of in vivo revival, growth, and pathogenicity of Escherichia coli strains after copper- and chlorine-induced injury. AB - Cells of one enteroinvasive and three enterotoxigenic strains of Escherichia coli were exposed to sublethal concentrations of copper and chlorine to produce 85 to 94% injury. Injured cells were intraluminally inoculated into ligated ileal loops of anesthetized mice, and injury was assessed at timed intervals. Substantial recovery (72-84%) of copper- and chlorine-injured cells was observed in the inoculated loops at 4 and 3 h, respectively. No appreciable increase in total numbers was observed during these time intervals. In vitro revival of copper injured cells in phosphate-buffered saline alone after incubation at 35 degrees C for 4 h was not observed. However, a 60 to 70% revival occurred when 200 micrograms of protein per ml of mouse intestinal mucosal homogenate was incorporated into saline cell suspensions. The enterotoxigenic activity of copper injured cells in rabbit ileal loops was somewhat reduced compared with that of chlorine-injured or uninjured cells. These results show that injured pathogenic E. coli cells can revive in the small intestine and appear to retain their enterotoxigenic activity. PMID- 3535676 TI - Enrichment of a 50-kilodalton polypeptide in a photosystem II-phycobilisome particle from Porphyridium cruentum. AB - A 50-kDa polypeptide was obtained from photosynthetically active phycobilisome photosystem II preparations from the red alga Porphyridium cruentum after removal of phycobiliproteins. Removal of phycobiliproteins caused destabilization of the structure of the phycobilisome-photosystem II preparations and was accompanied by a decline in photosystem II activity (oxygen-evolution and dichlorophenol indophenol (DPIP) reduction). The treatments in increasing relative effectiveness were: addition of EDTA (10 mM), lowering the pH (6.8----4.4), and lowering the ionic strength (to ca. 1 mM phosphate). The lowering of the ionic strength by dialysis resulted in a preparation highly enriched in a 50-kDa polypeptide (apparent molecular mass on SDS-PAGE). This preparation retained photosystem II activity as evidenced by the photoreduction of DPIP in the presence of diphenylcarbazide (222 mumol DPIP/mg chlorophyll/h). Also it had a 698-nm (77K) fluorescence emission maximum, as compared to a 668-nm emission in the unfractionated preparation, which indicates enrichment of the photosystem II reaction center. Comparing our results with those obtained from green plants and a cyanobacterium leads us to suggest that the reaction center II polypeptides are highly similar in all chlorophyll alpha-containing plants. PMID- 3535677 TI - Purification and characterization of benzoyl-L-arginine p-nitroanilide hydrolase from etiolated leaves of Zea mays. AB - Benzoyl-L-arginine p-nitroanilide hydrolase in the etiolated leaves of Zea mays L. has been purified 1,266-fold by a combination of gel filtration, ion exchange, and hydrophobic chromatography with a recovery of 13%. The specific activity of the purified enzyme is 5.7 units/mg protein. The enzyme is an acidic protein with a pI value of 4.6 and optimum pH of 8.2. The molecular weight of the enzyme was estimated to be 59,000. Substrate inhibition was observed at a concentration higher than 30 microM BAPA and the apparent Km for BAPA was 29 microM at pH 8.0. The enzyme activity was inhibited by sulfhydryl reagents, leupeptin, antipain, and N-tosyl-L-lysine chloromethyl ketone. The inhibitor study suggests that the enzyme belongs to the class of the sulfhydryl proteases. PMID- 3535678 TI - Electron transfer between reduced methyl viologen and oxidized glutathione: a new assay of Saccharomyces cerevisiae glutathione reductase. AB - Pure glutathione reductase from Saccharomyces cerevisiae catalyzed under anaerobic conditions the enzymatic reduction of GSSG using electrochemically reduced methyl viologen as electron donor. The new assay was completely dependent on the amount of active enzyme present, and involved the formation of 1 mol GSH per mole of reduced methyl viologen consumed. The enzyme followed a standard Michaelis-Menten kinetics; a Km = 230 microM for reduced methyl viologen and a turnover number of 969 mumol GSSG reduced per minute per micromole enzyme were determined. The enzymatic activity seemed to depend on the redox potential, showing half-maximal activity at -0.407 V. The enzyme was quite specific: the activity using reduced benzyl viologen as electron donor was just 1.5% of that obtained with reduced methyl viologen at the same concentration and potential. Glutathione reductase was totally inactivated after a brief anaerobic exposure with reduced methyl viologen in the absence of GSSG; a partial reactivation was observed following addition of glutathione disulfide. No inhibition of the methyl viologen-dependent activity was observed in the presence of 2',5'-ADP or 2'-P-5' ADP-ribose, two NADP(H) analogs, at concentrations which drastically inhibited the NADPH-dependent activity, thus suggesting that the reduced viologen does not interact with the pyridine nucleotide-binding site. PMID- 3535679 TI - Effect of fatty acid supplementation on thermotropic behavior of membrane lipids and leucine transport in Saccharomyces cerevisiae. AB - An unsaturated fatty acid-requiring mutant (KD 115) of Saccharomyces cerevisiae shows altered phospholipid composition, transport behavior, and physical properties of membrane lipids when grown in the presence of different cis- and trans-unsaturated fatty acids. There is an increase in phosphatidyl ethanolamine content and a concomitant decrease in phosphatidyl choline content in the cells supplemented with trans-unsaturated fatty acids. The affinity for uptake of L leucine is higher in the cis-unsaturated fatty acid-supplemented cells compared with the trans-unsaturated fatty acid-supplemented cells. The temperature dependence of L-leucine uptake bears a reasonably good correlation with the thermotropic behavior of the membrane lipids as studied by the steady-state fluorescence polarization technique. The present findings are discussed in light of the importance of the lipid environment in modulating membrane-associated functions. PMID- 3535680 TI - Lipovitellin inhibition of Artemia trypsin-like proteinase: a role for a storage protein in regulating proteinase activity during development. AB - Artemia trypsin-like proteinase has been reported previously to be highly inhibited in the embryo (B. Ezquieta and C.G. Vallejo (1985) Comp. Biochem. Physiol. 82B, 731-736). We report now that Artemia lipovitellin, the major storage protein complex, inhibits the proteinase. We have carried out an in vitro study of the characteristics of the inhibition. Lipovitellin, a glycolipoprotein of high molecular mass (650 kDa), behaves initially as a substrate but after a limited proteolysis becomes an inhibitor of the proteinase. The enzyme although inhibited in the hydrolysis of the protein substrate retains activity toward low molecular weight substrates. The residual activity on the protein substrate is inhibited by small inhibitors of the proteinase. These features of lipovitellin inhibition are reminiscent of the trap mechanism of alpha 2-macroglobulin inhibition, previously proposed as suitable for regulating proteolytic processes involved in development. Inhibition by lipovitellin is greater at low temperatures and has been determined at 17 and 37 degrees C, in the lower and higher part of the viable temperature range of Artemia development. At high temperature the proteinase hydrolyzes the inhibitor quite efficiently and the inhibition is lower. The inhibition by lipovitellin appears specific for Artemia trypsin-like proteinase when compared with other control pairs protein/proteinase. The results may provide support for an additional role of storage proteins as developmental inhibitors of proteinases. PMID- 3535681 TI - Superoxide dismutase and catalase in the murine malaria, Plasmodium berghei: content and subcellular distribution. AB - Plasmodium berghei, a murine malaria, lacks endogenous superoxide dismutase (SOD). Instead it appears to take up and concentrate SOD from its host cell, the erythrocyte. We now demonstrate that the adopted host enzyme is localized in granules which are probably lysosomes. In addition, isolated P. berghei parasites contain only low levels of catalase, probably as a result of contamination of the preparation with host cell material. Thus, the cytosol of this organism appears to be deficient in enzymes which protect against damage by activated oxygen. PMID- 3535682 TI - Immunohistologic patterns of congenital nevocellular nevi. AB - To establish sensitive histologic criteria for small congenital nevi (SCN), we examined 29 biopsy specimens of SCN from patients younger than age 1 year by serial sectioning and S100 immunoperoxidase staining. The depth of papillary and reticular dermal infiltration was variable; only the results of six biopsy specimens contained nevomelanocytes in the lower third of reticular dermis. However, all cases had focal nevomelanocytic involvement of adnexa at the midreticular dermis or below (26 of 29 cases in eccrine and 15 of 29 in pilosebaceous structures). Follow-up specimens in ten patients were obtained (mean interval, 10.25 years), and no difference in histologic pattern or cytology was observed. There were variable size increases in the surface area of SCN, ranging from no increase to a maximal ninefold increase. PMID- 3535683 TI - Cutaneous malignant neoplasms in patients with renal transplants. AB - There is an increased risk of developing cutaneous neoplasms in patients with renal transplants who are receiving immunosuppressive therapy. We studied 523 consecutive white patients who had received renal transplants at a Canadian medical center. Malignant neoplasms developed in 7.5% of these patients, and 72% of these neoplasms were cutaneous in origin. Compared with the general population, the rate of development of all skin cancers, squamous cell carcinoma, and basal cell carcinoma was 3.2, 18.4, and 1.4 times, respectively. In our study the squamous cell carcinoma to basal cell carcinoma ratio was 2.3:1, compared with 0.2:1 in the general population. There was no significant difference in the site of development of skin cancer in patients with renal transplants compared with the general population. There was, however, a propensity for the development of multiple skin cancers at an earlier age, especially on sun-exposed areas. The results of this study have been compared with those of other world medical centers. PMID- 3535684 TI - Hemorrhagic bullae in an anemic women. Paroxysmal nocturnal hemoglobinuria (PNH). PMID- 3535685 TI - Response to bronchodilators assessed by lung mechanics. AB - Abnormalities of compliance and functional residual capacity were shown in eight young children aged 2-8 years with asthma during an acute attack. In a randomised, placebo controlled study treatment with bronchodilator (salbutamol) was associated with a significant improvement in compliance and lessening of hyperinflation as shown by a reduction in functional residual capacity. PMID- 3535686 TI - Slow release theophylline in preschool asthmatics. AB - A double blind crossover trial with active or placebo slow release theophylline (Slo-phyllin) in children with asthma aged up to 4 years is described. Although no difference in symptom scores was shown, other differences in favour of active treatment were noted. We conclude that this preparation is of benefit in the management of the wheezing preschool child. The value of symptom scores as an index of clinical improvement is discussed. PMID- 3535688 TI - Sixty years young--a Diamond Jubilee. PMID- 3535689 TI - Archives of Disease in Childhood. Diamond Jubilee 1926-1986. PMID- 3535687 TI - Erythromycin versus tetracycline for treatment of Mediterranean spotted fever. AB - Eighty one children aged between 1 and 13 years participated in a randomised comparative trial of tetracycline hydrochloride and erythromycin stearate for treatment of Mediterranean spotted fever. Both therapeutic regimens proved effective, but in patients treated with tetracycline both clinical symptoms and fever disappeared significantly more quickly. Likewise, when those patients who began treatment within the first 72 hours of illness are considered the febrile period had a significantly shorter duration in the group treated with tetracycline. One patient was switched to tetracycline because there was no improvement of clinical manifestations, with persistence of fever, myalgias, and prostration, after receiving eight days of treatment with erythromycin. These results suggest that tetracyclines are superior to erythromycin in the treatment of Mediterranean spotted fever. PMID- 3535690 TI - Ancestors of the "Archives". PMID- 3535691 TI - "Archives" 1926-86. PMID- 3535692 TI - Editors of the "Archives". PMID- 3535693 TI - Fetal lymphangiectasia--another cause for a positive amniotic fluid acetylcholinesterase test. AB - A case of a fetal lymphangiectasia on the ventral aspect of the neck was detected prenatally by ultrasound examination. Polyhydramnios was present. AFP values in amniotic fluid and maternal serum were in the upper normal range. An acetylcholinesterase band was found on gel electrophoresis. After delivery the prenatal diagnosis of congenital isolated lymphangiectasia was confirmed. The case illustrates a further example of a positive acetylcholinesterase test not associated with a neural tube defect. PMID- 3535694 TI - Diagnosis and treatment of gestational diabetes according to amniotic fluid insulin levels. AB - In spite of dietary treatment, the infants of pregnant patients with abnormal glucose tolerance have hyperinsulinism and diabetogenic fetopathy in 10 to 36% of cases. Those patients, who require insulin to prevent from fetopathy cannot be reliably selected by maternal parameters such as blood glucose and glycosylated hemoglobin values. We recommend the measurement of amniotic fluid insulin between the 28 and 32 weeks of pregnancy to differentiate whether the fetus is compromised or not. Subjects with values above the 97th centile require insulin therapy. Inadequate insulin dosage or delayed fetal hyperinsulinism can be discovered by checking the amniotic fluid insulin level at 33 to 36 weeks. In a total of 88 gestational diabetic patients 19 had raised amniotic fluid insulin levels indicating the onset of diabetic fetopathy at an early stage. Diabetic patients with raised amniotic fluid insulin levels needed large doses of insulin, namely 64.6 +/- 29.5 (Mean +/- SD) U/24 h. This treatment reduced mean blood glucose levels from 98 +/- 9 (Mean +/- SD) mg/dl to 82 +/- 10 mg/dl and was sufficient to prevent from diabetic fetopathy. PMID- 3535695 TI - The effect of pericervical PGE2 instillation on levels of maternal serum 13,14 dihydro-15-keto-PGF2 alpha and progesterone. AB - In a prospective, randomized study 30 post-term pregnant women with low cervical scores were treated by a pericervical application of either 3 ml of 0.9% saline or 3 ml of 0.9% saline containing 1.5 mg PGE2. Twelve patients in the PGE2 group and two in the placebo group were delivered within 24 h (P less than 0.001). Eight blood samples were taken from each patient and serum PGFM and progesterone levels were measured by radioimmunoassay. In the women in whom labor started, PGFM serum levels rose progressively and progesterone levels fell consistently as the cervix dilated. After successful induction with PGE2 the variations were more marked than with labor of spontaneous onset. The PGFM-rise after PGE2 treatment must be due to stimulation of endogenous PGF2 alpha production by local therapy. PMID- 3535696 TI - [Caffey's disease or infantile cortical hyperostosis. A case of bilateral scapular localization]. PMID- 3535697 TI - [Histogenesis of tumors of the salivary glands]. PMID- 3535698 TI - [Value of immunocytochemical technics applied to products of cytopuncture in the cytodiagnosis of tumors and metastases]. PMID- 3535699 TI - Hemodialysis nursing care for postoperative heart transplant patients. PMID- 3535700 TI - Coping with pediatric renal transplant rejection. PMID- 3535701 TI - Vascular anastomosis with Mobin-Uddin vein/graft holder. AB - A vein/graft holder, designed for use during aortocoronary and peripheral vascular bypass surgery, is described. It holds the opening in a vein or synthetic graft securely during end-to-side and side-to-side anastomosis. The vein/graft holder is atraumatic, simplifies the suturing technique, and facilitates precise anastomosis. PMID- 3535702 TI - Clinical manifestations, diagnosis, and treatment of hiatal hernia. PMID- 3535703 TI - Sperm cervical mucus contact test and immunobead test for sperm antibodies. AB - Twenty-five patients were studied for the presence of sperm antibodies in their cervical mucus and seminal plasma. The sperm cervical mucus contact test (SCMC) and the immunobead test (IBT) were used to evaluate sperm antibody activity. A close correlation was found between the results of the SCMC and IBT tests, and it was concluded that both techniques can be regarded as good indicators of sperm antibodies. PMID- 3535704 TI - [Rickettsiosis 50 years after the death of Charles Nicolle]. PMID- 3535705 TI - [Toxoplasma gondii (Nicolle and Manceaux, 1909)]. PMID- 3535706 TI - [Present status of toxoplasmosis]. PMID- 3535707 TI - [Rapid technics for the laboratory diagnosis of rabies]. PMID- 3535708 TI - [Charles Nicolle and the accomplishments of his scientific thought]. AB - The author presents in this study the achievements of the scientific thought of Charles Nicolle, chiefly on the basis of two notions: the asymptomatic diseases and the destiny of infectious diseases. Recalling the factors which prevailing about the career of Charles Nicolle, he shows that the asymptomatic diseases became a fundamental notion in infectious pathology as human, animal, viral, bacterial and parasitic diseases. The notion allowed him to open the study of pathogen agents on the fields of the environment, so enriching the epidemiology, the prophylaxis and the medical ecology. After the notion of specificity of microbes pointed out by Pasteur, Charles Nicolle enlarged their implications and conceived the infinite complexity of microbes. The first he introduced in microbiology the notion of mutation and foresaw the birth, the evolution and the death of the infectious diseases. Not so long time after and now these anticipations has been proved. PMID- 3535710 TI - [Development of the drug resistance of Plasmodium falciparum in Africa]. PMID- 3535709 TI - [Campaigns for the eradication of malaria in Tunisia: history and current situation]. AB - The authors recall the historic of the different campaigns conducted against the malaria in Tunisia. Started since 1903 under the direction of Charles Nicolle, these campaigns were taken over after the end of each world war. However it must be necessary to wait the last campaign from 1966 to 1972, to conclude at the eradication of the disease, in 1977, into the country. Since this date, the systematic control of malaria is always conducted in the country. This end control is objected to avoid the resurgence of this parasitic disease in Tunisia, for the number of imported cases is increasing and the country presents ecological conditions propitious to Anopheles. PMID- 3535711 TI - [Origin, course and recession of an infectious disease, melioidosis, in temperate countries]. PMID- 3535712 TI - [Present status of rickettsiosis]. AB - Actual knowledges of the biology of rickettsia, their pathogenicity and the diagnostic are briefly exposed. The description of sero-epidemic surveys in Bolivia, Botswana, Ethiopia, Greece and France shows that fifty years after the death of Charles Nicolle, rickettsial diseases are still a major health problem in numerous countries. PMID- 3535713 TI - [Technical note on the demonstration of rheumatoid factor by immunofluorescence]. AB - The authors present a new technic to point out the rheumatoid factor by immunofluorescence and compare this technic and the others to classical technics of agglutination. This technic allows to avoid the absorption of rheumatoid factor in the serological reactions using the immunofluorescence. PMID- 3535714 TI - Transdermal clonidine in mild hypertension. A randomized, double-blind, placebo controlled trial. AB - In 30 patients with mild essential hypertension, clonidine hydrochloride was delivered from a skin patch reservoir designed to release medication at a constant rate for seven days. After a four-week washout period, patients were randomized (double-blind) into a clonidine- or a placebo-treated group. Clonidine or placebo was then given for five weeks, followed by a two-week washout period to assess withdrawal from treatment. Blood pressure was controlled in 11 of 15 clonidine-treated patients but in only four of 15 placebo-treated patients. The clonidine-treated group evidenced larger decreases in both systolic and diastolic blood pressures. In the clonidine-treated group, blood pressures and plasma clonidine levels were stable throughout a representative seven-day period. Besides mild skin irritation with both clonidine and placebo patches, few side effects were observed. After discontinuation of clonidine administration, plasma levels declined in a non-log linear manner. There was no rebound hypertension. The results suggest that clonidine delivered transdermally is safe and effective for control of mild essential hypertension. PMID- 3535715 TI - Thrombosis, recurrent fetal loss, and thrombocytopenia. Predictive value of the anticardiolipin antibody test. AB - To determine the predictive value of the IgG anticardiolipin antibody (ACA) test for thrombosis, recurrent fetal loss, and thrombocytopenia, the clinical features of 121 patients with varying antibody levels were studied. When patients were grouped into high-positive, low-positive, and normal groups according to their ACA levels, there were strong statistical correlations with arterial thrombosis, venous thrombosis, fetal loss, thrombocytopenia, and a positive Coombs' test. At levels of 7 SD and above, the test was highly specific (greater than 80%) and predictive (greater than 70%) for thrombosis, thrombocytopenia, and recurrent fetal loss. This study suggests that the IgG ACA test may be a useful predictor for thrombosis, recurrent fetal loss, and thrombocytopenia in patients with autoimmune disorders. PMID- 3535716 TI - Urinary eosinophils. AB - The sensitivity of the presence of urinary eosinophils for the diagnosis of acute interstitial nephritis is 60%. Of those with interstitial nephritis without urinary eosinophils, in most cases, few eosinophils are present in the renal interstitial inflammatory infiltrate. The specificity of urinary eosinophils for acute interstitial nephritis has not been determined but urinary eosinophils have been reported with eosinophilic cystitis, urinary tract infections, and various renal diseases. However, the incidence of eosinophiluria in any of these conditions has not been investigated. PMID- 3535718 TI - Staphylococcus aureus bacteremia. Potential impact of a new blood culture technique. PMID- 3535717 TI - Percival's Medical Ethics. The moral philosophy of an 18th-century English gentleman. PMID- 3535720 TI - Lysis-centrifugation blood culture technique. Clinical impact in Staphylococcus aureus bacteremia. AB - To determine the clinical impact of enhanced detection of Staphylococcus aureus by a lysis-centrifugation (LC) blood culture system, consecutive cases of S aureus bacteremia during a seven-month period were reviewed. Of 77 clinically significant cases, the LC system detected 70 cases (91%) while a conventional broth system detected 67 cases (87%). Of 60 cases detected by both systems, the LC system was positive earlier than the broth system by one or more days in 34 cases (57%) and later in none. It also detected more (12 vs four of 13) patients with persistent bacteremia who were receiving antimicrobial treatment. Forty three patients (56%) did not receive appropriate antimicrobial therapy until cultures were reported positive. Enhanced detection of S aureus bacteremia is a clinically important advantage of the LC blood culture technique. PMID- 3535719 TI - Relative efficacy and toxicity of netilmicin and tobramycin in oncology patients. AB - We prospectively compared the efficacy and safety of netilmicin sulfate or tobramycin sulfate in conjunction with piperacillin sodium in 118 immunocompromised patients with presumed severe infections. The two treatment regimens were equally efficacious. Nephrotoxicity occurred in a similar proportion in patients treated with netilmicin and tobramycin (17% vs 11%). Ototoxicity occurred in four (9.5%) of 42 netilmicin and piperacillin and in 12 (22%) of 54 tobramycin and piperacillin-treated patients. Of those evaluated with posttherapy audiograms, three of four netilmicin and piperacillin-treated patients had auditory thresholds return to baseline compared with one of nine tobramycin and piperacillin-treated patients. The number of greater than or equal to 15-dB increases in auditory threshold as a proportion of total greater than or equal to 15-dB changes (increases and decreases) was significantly lower in netilmicin and piperacillin- vs tobramycin and piperacillin-treated patients (18 of 78 vs 67 of 115). We conclude that aminoglycoside-associated ototoxicity was less severe and more often reversible with netilmicin than with tobramycin. PMID- 3535721 TI - Hyporeninemic hypoaldosteronism in a patient with cirrhosis and ascites. AB - A patient with cirrhosis and coexistent hyporeninemic hypoaldosteronism secondary to diabetic nephropathy rapidly formed ascites despite marked reductions in plasma aldosterone concentration and urinary aldosterone excretion. To my knowledge, this association has not been previously reported. This case supports the concept that hyperaldosteronism is not a necessary component of the salt retention of advanced liver disease. Furthermore, it suggests that certain renal disorders should be considered in cases of cirrhosis and ascites with decreased plasma renin activity. PMID- 3535722 TI - Further evidence for the presence of intermediate and mixed endocrine cells in the human pancreas undergoing nesidioblastosis. PMID- 3535723 TI - [Stool electrolyte concentration in acute infantile diarrhea in France]. AB - Sodium, potassium and chloride stool content was studied in 107 children aged 1 to 32 months (11 +/- 8 months) presenting with acute diarrhea related to a rotavirus infection (34 cases), to an invasive pathogen (Salmonella or Shigella 14 cases, E. coli 4 cases), or of non-identified etiology (65 cases). The therapeutic protocol was the same in all cases: rehydration for the first 24 hours, progressive realimentation from the second or third day, no drugs being given. An average of 4 stools were analysed for each child (range 2-14), the fecal samples being collected over 2 to 4 consecutive days. Na+ and K+ (n = 366) were assayed by flame photometry and chloride (n = 88) by continuous colorimetry. In the stool samples taken as a whole, without taking into account etiology or day of sampling, the electrolyte concentration (mean +/- SD) was 42 +/- 20 mmol/l for Na+ (range 4-166), 51 +/- 24 mmol/l for K+ (range 5-195), and 24 +/- 11 mmol/l for Cl- (range 4-93). No significant variation of these values was observed according to etiology, duration, severity of the diarrheal syndrome, oral rehydration or nutrition. PMID- 3535724 TI - [Physiopathology of cerebral hypoxia in the newborn infant]. PMID- 3535725 TI - [Infectious mononucleosis in children. Current aspects]. PMID- 3535727 TI - The use of normal filter paper for "dot-immunobinding assay" of some antibodies. AB - Normal filter papers were used for specific detection of tiny amounts of antibodies against two penicillin amidase molecular forms from Escherichia coli, monoclonal antibodies of IgG and IgM class against lipopolysaccharide from Citrobacter O36 and IgM antibody against glycoprotein N from human red blood cells. For colour detection of antibodies bound to proper antigens adsorbed on the paper, second antibody-horse radish peroxidase conjugates and hydrogen peroxide with 4-chloronaphthol were applied. The use of filter paper for dot immunobinding assay of antibodies gave similar results to those obtained with expensive nitrocellulose sheets used by other authors. PMID- 3535726 TI - [Value of ultrasonics in the diagnosis of acute intestinal invagination in infants and children. Apropos of a series of 60 cases]. AB - Sixty cases hospitalized between May and October 1985 for suspicion of acute intestinal intussusception in whom emergency ultrasonography was performed are reported. The diagnostic reliability of this non-invasive technique reduces the indication for performing barium enemas to treatment only. PMID- 3535728 TI - Effect of serum lymphocytotoxic activity on T and B cells in rabbits infected with Treponema pallidum. AB - The correlation between the level of cold autolymphocytotoxic activity in the sera of rabbits infected with T. pallidum, and the percentage of B and T cells in the peripheral blood of the same animals was determined. The percentage of cells was estimated by the E and EAC rosette techniques and by the immunofluorescence test on immunoglobulin-bearing (B) cells. It was found that the increase of the autolymphocytotoxic activity was connected with the proportional decrease of B lymphocytes and increase of T lymphocytes. Since the decrease of B cells was significant (p less than 0.05) it is suggested that the autolymphocytotoxic activity may be involved in killing of B lymphocytes also in vivo. The possible role of the complement-dependent autolymphocytotoxic serum activity in regulation of humoral response in syphilis is discussed. PMID- 3535730 TI - The American Board of Pathology. 50 years of service. PMID- 3535729 TI - Thorns in armadillo ears and noses and their role in the transmission of leprosy. AB - Both ears from 494 wild nine-banded armadillos (Dasypus novemcinctus) and nose specimens from 224 animals were collected and histopathologically studied. Lepromatous granulomas were present in the ear specimens of ten of 494 animals. There were thorns in the ears of 22.5% of animals, and in 36.6% of the nose specimens. In one armadillo, there was evidence to suggest that Mycobacterium leprae entered the tissue through the thorn pricks. In the normal habitat of the armadillo in Louisiana there are thorny bushes consisting mostly of the green briar and the southern dewberry. Thorn pricks as a means of transmission of leprosy in the wild armadillos is suggested. PMID- 3535731 TI - Immunologic detection of markers of keratinocyte differentiation. PMID- 3535732 TI - Peripheral and central primitive neuroectodermal tumors. A nosologic concept seeking a consensus. AB - The term primitive neuroectodermal tumor is widely used in the literature for a group of small, round-cell tumors in the central and sympathetic nervous systems and soft tissues as well as a specific diagnostic term for individual neoplasms; however, the contention that these various clinicopathologic entities (neuroblastoma, medulloblastoma, and peripheral neuroepithelioma) are histogenetically related is an unproved hypothesis. Morphologic, cytogenetic, immunohistochemical, biochemical, and in vitro studies have established phenotypic similarities among these putatively related neoplasms whether they originate in the brain, adrenal gland, or soft tissues. Because one tumor resembles another in terms of its phenotypic expression, that does not necessarily imply a common histogenesis. This point has been made by previous investigators. The purpose of this review is to evaluate and discuss the present status of our understanding and some of the controversial aspects of this enigmatic category of neoplasms, mainly occurring in children, known as the primitive neuroectodermal tumors. PMID- 3535733 TI - What is the role of extrarenal renin? PMID- 3535734 TI - Rapid diagnosis of disseminated histoplasmosis in tissues. AB - Disseminated histoplasmosis may resemble other disseminated infections, including mycobacterial, fungal, and parasitic diseases, and may be difficult to diagnose and treat in a timely fashion. Diagnosis may depend on microbiologic cultures that may take several weeks for definitive identification, with consequent prolonged hospitalization of the patient. An immunoperoxidase method is described for rapid diagnosis in tissues of Histoplasma capsulatum that can be applied to cytologic smears, frozen sections, and paraffin-embedded tissues processed by routine procedures. The stain can accurately distinguish histoplasma organisms from several other morphologically similar fungi or parasites, and can yield a definitive diagnosis in much less time than microbiologic culture. PMID- 3535735 TI - Aneurysmal bone cysts of the pelvis. AB - Twenty-three cases of pelvic aneurysmal bone cysts treated at the Istituto Ortopedico Rizzoli were reviewed after a mean follow-up of 7 years. Eighteen cysts involved the anterior arch, four extended into the iliac wing and the anterior arch, and one invaded the entire hemipelvis. The acetabulum was involved in 56.5% of the cases. Fourteen patients were treated with surgery (curettage 11; resection 3), and five with radiation therapy; two patients had both modalities; two additional patients refused any treatment after biopsy. The overall recurrence rate was 13% (one case after curettage, one after radiation therapy, and one after combined treatment). Significant complications affected the final functional result in four of seven patients who received radiation therapy, while only one minor complication was seen in the surgical group. PMID- 3535736 TI - A Delphi survey of traits of effective physiatric leaders. AB - A Delphi study of 14 physiatric leaders, 10 men and 4 women, ages 30 to 65, to determine their most important leadership characteristics, asked them to list the characteristics they considered most important for effective leadership. Responses were collated and any trait mentioned by at least three was put into a second survey, in which they were asked to rank the traits. A third survey gave them the results of the second, and asked for a final ranking. Fourteen traits made the final survey, in which the ten most important (in descending order of importance) were Organizational Skill, Commitment, Vision/Purpose, Communication Ability, Ability to Delegate, Sense of Ethics, Decisiveness, Knowledgeable, Flexibility/Adaptability and Analytical/Problem Solving Skill. PMID- 3535737 TI - [Oral carcinoma: immune dysfunction and risk factors]. PMID- 3535738 TI - [Chemico-physical properties of intracanal cements (critical review of the literature)]. PMID- 3535740 TI - Tumoricidal effects and patient survival after hyperthermic liver perfusion. AB - Hyperthermic liver perfusion for four hours at 42.0 degrees C to 42.5 degrees C was used as the sole modality of therapy for cancer confined to the liver in eight patients. Two patients had melanoma, one had cholangiolar carcinoma of the liver, and five had liver metastases from colorectal carcinoma. Two postoperative deaths occurred, both in patients with colorectal carcinoma metastases. Response was indicated by computed tomographic and/or liver biopsy or autopsy findings of tumor necrosis. There were five responders to hyperthermic liver perfusion among the six survivors. Hyperthermic liver perfusion was an effective tumoricidal agent for hepatic metastases from colorectal cancer; ie, tumor necrosis occurred in all five patients, as well as in the two who died, as shown by autopsy findings. Conversion to a disease-free state with hyperthermic perfusion may be possible with other treatment modalities used in combination or sequence. PMID- 3535739 TI - Increased expression of the epidermal growth factor receptor on human colon carcinoma cells. AB - Epidermal growth factor (EGF) is a small polypeptide hormone that promotes the growth of cells in culture and elicits the differentiation of epithelial tissues in vivo. The effect of EGF is mediated by a transmembrane receptor that is expressed in increased amounts on some tumor cells. We have used a monoclonal antibody to the EGF receptor to detect increased expression of the receptor on human colon carcinoma cells. All eight of the moderately well-differentiated colon carcinoma cell lines tested and several frozen colon carcinoma tissue sections showed increased expression of the EGF receptor, while five poorly differentiated colon carcinoma cell lines and normal colon tissue sections did not. Increased expression of the EGF receptor on moderately well-differentiated colon carcinoma cells but not on poorly differentiated colon carcinoma cells was also demonstrated by western transfer and iodine 125-labeled EGF binding assays. Increased expression of the EGF receptor on moderately well-differentiated colon carcinoma cells seems to be a useful marker for the differentiation of human colon carcinoma cells. In addition, it might provide a site for adjuvant hormonal therapy or immunotherapy. PMID- 3535741 TI - Doxorubicin chemotherapy in the treatment of soft-tissue sarcoma. Combined results of two randomized trials. AB - In 1978, there were initiated two independent randomized, prospective trials of adjuvant doxorubicin hydrochloride (Adriamycin) following primary therapy for soft-tissue sarcoma. The virtual identity of these two protocols permits their combination for analysis. A total of 75 patients (42 men, 33 women) with soft tissue sarcoma (stages IIB to IVA) were randomized, after receiving optimal regional therapy, to receive either doxorubicin hydrochloride (450 mg/m2) (37 patients) or observation (38 patients). Follow-up has ranged from 16 to 80 months (median, 49 months). Twenty-five patients (33%) died, and two patients receiving doxorubicin developed cardiotoxicity. No significant differences in local control, metastasis-free survival, disease-free survival, and overall survival were observed for the two treatment arms. Despite temporary prolongation of disease-free survival with doxorubicin in some subgroups, we conclude that there is no advantage to the use of adjuvant doxorubicin in the treatment of soft tissue sarcoma. PMID- 3535742 TI - [Bronchial hypersensitivity in infants with bronchial asthma]. PMID- 3535743 TI - [Immuno-peroxidase study of Langerhans' cells in the normal and fibrotic respiratory system]. PMID- 3535744 TI - [Lectin receptors in the salivary glands of the rat during postnatal ontogenesis]. AB - Distribution of lectin-binding sites in rat submandibular and sublingual salivary glands during postnatal development has been investigated. Lectin preparations include con A, lentin lectin, castor beans agglutinin, peanut, soybean and Sophora japonica agglutinins, wheat germ agglutinin and lectin from the bark of Laburnum anagyroides. The direct and indirect peroxidase techniques are used. According to the similarities of histochemical patterns, all lectins are divided into four groups. Besides the general patterns of lectin binding sites, some details are noted. Lectins of peanut and Sophora japonica possess an extremely high affinity to mast cells, con A, lens lectin, castor beans and wheat germ agglutinins--to serous demilunes cells. Laburnum lectin--to salivary ducts epithelia in adult rat salivary glands. Lentin lectin, con A and Laburnum lectin preferentially stain cells with specific granularity in granular ducts at early stages of postnatal development. Considering the character of staining, we propose for further histochemical investigations of the salivary glands lentin lectin, peanut agglutinin, wheat germ agglutinin and Laburum anagyroides lectin. PMID- 3535745 TI - [Regeneration of the epithelium of the pancreas during organ culture]. AB - By means of electron microscopy method, regeneration of the pancreas has been studied after its longitudinal resection in 3-day-old rats under conditions of organ cultivation, when antihypoxant is administered into the nutritive medium. It affects bioenergy of the cell, decreases hypoxia phenomena, that are observed at cultivation, and thus contributes to a prolonged preservation of vitality of the explants. PMID- 3535746 TI - [Standardization of methods of human placental morphometry]. PMID- 3535747 TI - [Increase in measurement accuracy and automation of the analysis of results obtained using the dual-frequency methodology on microspectrocytophotometer MTsFV 1 (LOMO)]. PMID- 3535748 TI - [Immunohistochemical research on human breast tumors using monoclonal antibodies to intermediate filament proteins. Cancer of the breast]. AB - Immunomorphologic study of 29 breast cancer cases using monoclonal antibodies to proteins of intermediate filaments shown to differentiate the lining epithelium from myoepithelium in the non-proliferating epithelial structures of the mamma, has shown the cells in the majority of tumours (according to the International WHO Classification defined as infiltrating ductal, lobular, and tubular cancer forms) to contain prekeratin (PK) C12, specific for normal lining epithelium, but not for the myoepithelium. In cases of cancer with chondroid metaplasia (a malignant variant of the so-called "mixed tumour") the cells contained PK E3, vimentin and structural myosin, normally specific for myoepithelium. The cell heterogenicity in PK C12 content or its absence noted in the infiltrating cancers with predominance of a solid component can indicate a high degree of tumour anaplasia. It is concluded that usage of monoclonal antibodies to PK C12, invariably found in the cells of fibrotic invasion foci, can be a useful indicator for early diagnosis of infiltrative tumour growth. PMID- 3535749 TI - [Use of glass knives for preparing histological sections from wax-embedded blocks]. AB - A technique using glass knives for making histological sections without application of epoxy resin is suggested. The method of embedding of the material fixed in formalin is described, according to which instead of paraffin dental wax is used. Sections were made on a rotation microtome "Leitz" modified for the fixation of a glass knife. PMID- 3535750 TI - Opsoclonus in adults. Report of three cases and review of the literature. AB - Opsoclonus is a rare but distinctive disorder of ocular motility. Although there are many reported cases of opsoclonus in children, there is no large series of cases in adults. In recent years, three cases of opsoclonus in adults have been identified at the University of Iowa, Iowa City. Review of 55 other cases of opsoclonus in adults reported in the literature showed that adults over 40 years of age with onset of opsoclonus should be investigated fully for underlying malignancy. In younger adults with a history of a preceding influenzalike illness, viral titers (acute and convalescent) should be obtained. Also, younger adults should be investigated for other causes of opsoclonus, such as drug or toxin exposure. Treatment is directed toward correcting the underlying process. PMID- 3535751 TI - Kisaku Yoshimura and the Chaddock reflex. AB - Kisaku Yoshimura, a Japanese internist, introduced the so-called Chaddock reflex in 1906, five years earlier than Chaddock's original report. Yoshimura should also be remembered in the history of clinical neurology as the person who first proposed the use of electrical stimulation to elicit the toe phenomenon. PMID- 3535753 TI - Balzac's 'Pierette'. An early description of chronic subdural hematoma. AB - In his novel Pierrette, written in 1840, Balzac describes a case of chronic subdural hematoma, including its traumatic origin and surgical treatment. The description was written at a time when subdural hematoma was not seen as a separate clinical entity, and was generally thought to be the result of inflammation. PMID- 3535752 TI - Systemic recombinant alpha-2 interferon therapy in relapsing multiple sclerosis. AB - This report describes the first use of recombinant-DNA-produced human interferon in patients with multiple sclerosis (MS). Ninety-eight patients who were clinically definite for MS with two or more documented exacerbations during the preceding two years were admitted to this placebo-controlled double-blind randomized trial. Although both groups were similar, placebo patients had later MS onset. Patients injected themselves with 2 X 10(6) IU of alpha-2 interferon or placebo three times each week for up to 52 weeks. This dose of interferon was well tolerated in that side effects were minimal. During the trial, the exacerbation rate was sharply reduced in both groups. In the three-month follow up period after stopping treatment, more patients who were receiving interferon than placebo became worse neurologically. More patients who were receiving interferon than placebo changed from exacerbating MS to progressive MS during the trial. Thus, no clear therapeutic benefit of alpha-2 interferon for MS was detected. PMID- 3535754 TI - Ophthalmologic services as a component of Medicare spending. PMID- 3535755 TI - Retinal detachment following penetrating keratoplasty. AB - The time-related risk of retinal detachment during the follow-up of 1146 penetrating keratoplasty procedures was evaluated, using survival analysis techniques. Twenty-eight retinal detachments were observed during follow-up. The Kaplan-Meier estimate of the risk of developing retinal detachment increased from 1.5% at three months to 2.1% at one year after surgery. Further follow-up showed a gradual increase in the cumulative proportion developing retinal detachment to 4.7% at 3.5 years after surgery. Of the preoperative and intraoperative factors available for study, performing an anterior vitrectomy during penetrating keratoplasty was associated with a greater risk of postoperative retinal detachment. The outcome of visual acuity following retinal detachment in these patients' eyes was poor; five patients could not perceive light with the affected eye, and 82% (23/28) had visual acuity of 20/200 or less. PMID- 3535756 TI - Collagenous proteins of blood vessels. PMID- 3535757 TI - Effects of fenofibrate on plasma lipids. Double-blind, multicenter study in patients with type IIA or IIB hyperlipidemia. AB - Of 240 patients with Type IIa and IIb hypercholesterolemia recruited in 11 centers, 227 were randomized to double-blind treatment with either fenofibrate (100 mg three times daily) or matching placebo for 24 weeks. A group of 192 of these patients were studied for a further 24 weeks during which all received fenofibrate in open label fashion. For the 92 Type IIa patients receiving fenofibrate in the double-blind phase, there were significant reductions (p less than 0.01 compared to baseline) in total plasma cholesterol (-18%), LDL cholesterol (-20%), VLDL-cholesterol (-38%) and total triglycerides (-38%). Mean plasma HDL-cholesterol in these patients increased by 11% (p less than 0.01). With the exception of LDL, which was not high before treatment, similar changes were seen in the 24 fenofibrate-treated Type IIb subjects. Lipid parameters of placebo-treated patients did not change significantly. This pattern of change was repeated in the open period for the 94 patients previously on placebo, while the 98 who had been on fenofibrate remained stable with small further reductions in total and LDL cholesterol (-38% and -5.5% respectively). Adverse effects were some allergic-type skin reactions early in treatment and an occasional increase in transaminases, BUN, or creatinine. The results were similar to those obtained in European open trials of fenofibrate and were better than the lipid changes seen at comparable times in the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT) cholestyramine study. PMID- 3535758 TI - Early onset neonatal group B streptococcal infection in Hong Kong. PMID- 3535760 TI - The dental handpiece--a history of its development. PMID- 3535759 TI - Antenatal diagnosis of fetus in fetu. PMID- 3535761 TI - The immediate maxillary full denture. III. The role of the immediate denture. PMID- 3535763 TI - A survey of dental health and attitudes of adults in Queensland with respect to denture wearing. PMID- 3535762 TI - Osseointegrated dental implants: 2 year follow-up replication study. PMID- 3535764 TI - Life before birth. PMID- 3535765 TI - Techniques in automated cell classification. PMID- 3535766 TI - Characterisation of the host response to Plasmodium falciparum infection. I. Cerebral malaria. AB - Cerebral malaria is a major form of complicated malaria consequent upon cerebral damage associated with endothelial cell necrosis. We have used assays of Plasmodium falciparum growth inhibition in vitro to study serum inhibitory factors in patients with cerebral malaria. Serum from children with cerebral malaria inhibited parasite growth in a non-synchronised 72-hour assay to a greater extent than did sera from immune adults or asymptomatic children (p less than 0.001). The high level of non-specific inhibition of parasite growth was particularly evident when sera were tested against three P. falciparum isolates, and contrasted with the inhibitory effect of sera from non-malaria febrile controls. In this study, serum from patients with cerebral malaria was more inhibitory than serum from the other groups (p less than 0.001) and its between isolate variation, when tested against a panel of P. falciparum isolates in growth assays, was significantly less than that of the other groups tested (p less than 0.005). These results are consistent with the hypothesis of toxin induced endothelial cell damage, with the sequence of pathogenic events involving host-derived serum factors capable of damaging P. falciparum. PMID- 3535767 TI - Immunological reconstitution in a patient with severe combined immune deficiency using non-sibling bone marrow depleted of T cells with HuLy-m1. AB - An infant with severe immune deficiency received bone marrow from an HLA-A, -B, DR matched, mixed leucocyte reaction non-reactive first cousin. The donor marrow was fractionated on a discontinuous Percoll gradient and before infusion was treated with the anti-human T lymphocyte antibody, HuLy-m1, and rabbit serum as a source of complement. Methotrexate was given during the following two weeks. A rise in the peripheral blood lymphocyte count, indicating engraftment, occurred six weeks after transplantation. There was no clinical evidence of graft versus host disease (GVHD). Engraftment has been sustained for one year and the patient is in normal health and has normal in vitro immunological function. In vitro treatment of human marrow with HuLy-m1 allows stable engraftment and may be useful in attempting to diminish or prevent GVHD. PMID- 3535768 TI - Shigella dysenteriae type 1 enterocolitis. AB - Shigella dysenteriae type 1 is much more virulent than Shigella flexneri and sonnei which are endemic in Australia. This report describes a 22 year old woman who acquired Shigella dysenteriae type 1 whilst travelling in India. During the course of her illness, she developed severe enterocolitis for which a subtotal colectomy was performed. The illness resembled fulminant ulcerative colitis and its infectious nature was difficult to establish because several fecal cultures failed to grow the pathogen. Her infection was complicated by shigella bacteremia, disseminated intravascular coagulation, and renal cortical necrosis which requires continued hemodialysis. PMID- 3535769 TI - Sudden cardiac death, ventricular arrhythmias, and antiarrhythmic therapy: current trials and tribulations. PMID- 3535770 TI - The genetics of diabetes mellitus. PMID- 3535772 TI - Fifty years of veterinary education in Queensland. PMID- 3535773 TI - Clinical trials in high risk endometrial carcinoma and carcinoma of cervix uteri. PMID- 3535771 TI - The evolving role of alpha interferon in the treatment of malignancies. PMID- 3535775 TI - Primary sclerosing cholangitis: sonographic findings. PMID- 3535774 TI - Ectopia vesicae in utero. PMID- 3535776 TI - Renin, aldosterone, and vasopressin responses to hypoxia during 6 hours of mild exercise. AB - The effect of hypoxia (H) on plasma renin (PRA), aldosterone (PA), and arginine vasopressin levels (AVP) was evaluated during 6 h of mild exercise (treadmill: 0 grade, 1 mph). A crossover study was performed on seven male volunteers during steady state conditions of H2O, Na+ and K+ balance while breathing 12.5% O2 (PaO2 42 +/- 3 mm Hg) and room air (N, 21% O2). After exercise there were no significant differences in body weight, hematocrit, calculated plasma volumes, serum or urine osmolality, urine Na+ or K+ excretion or AVP. Mean arterial pressure (MAP) while exercising was reduced during hypoxia (86 +/- 2 vs. 92 +/- 4 mm Hg), p less than 0.05. Normal diurnal variation in serum cortisol was lost during exercise (N and H). Plasma renin and aldosterone levels fell with exercise in both groups: PRA N 3.3 to 2.4 vs. H 4.9 to 2.3 ng X ml-1 X h-1; PA N 6.5 to 2.8 vs. H 9.3 to 2.3 ng X dl-1 (p less than 0.05). Hypoxia per se did not exert influence beyond mild exercise regarding serum osmolality, urine osmolality or Na+ or K+ excretion. Sustained hypoxia during 6 h of mild exercise despite a lower MAP failed to elevate PRA, aldosterone, or AVP levels when normal hydration is maintained. PMID- 3535777 TI - 50th anniversary of the Aerospace Medical Research Laboratory, Wright-Patterson Air Force Base, Ohio, and its rededication in honor of its founder as the Harry G. Armstrong Aerospace Medical Research Laboratory. June 5-6, 1985. PMID- 3535778 TI - Harry G. Armstrong dedicatory address. PMID- 3535779 TI - Biodynamics--the key to flight. AB - Biodynamics measures the effects of mechanical force on living tissues. The quantitative relations of mechanical stress factors and biological strain responses of the living body provide criteria for limits of injury threshold, reversible injury, permanently disabling injury, and fatal injury. These criteria are guidelines for aerospace design and performance standards involving human survival in the environment of flight. Below these limits, the effects of mechanical force factors on human performance while acutely or chronically exposed to them in aerial or space flight are crucial. Some can be accumulatively disabling; others can be adapted to over a period of time. Extremes of low frequency vibration cannot be long endured, while sustained zero gravity in space flight produces mild, transient malaise followed by adaptation in several hours. Aerospace flight biodynamics deals with human reactions to absence of gravity; sustained curvilinear acceleration; sustained acceleration and deceleration (launch and reentry in space flight); single impact force (collisions); low frequency vibration in the whole human body resonance response range; whole-body tumbling and spinning, as in high-altitude free-fall; acoustical range vibrations; explosive blast in air or water; abrupt decompression, as in cabin pressure failure; static forces in tension, compression, torsion and shear. Biodynamic stress analysis takes into account whole-body responses, particular responses of rigid bone, viscous elastic soft tissues, pneumatic and hydraulic effects of gas and fluids in hollow organs, and displacements of solid organs suspended in body cavities. Accurate and comprehensive results require physical measurements, clinical and laboratory studies before and after exposure, subjective reports of trained volunteer subjects, and objective medical and bioengineering evaluation of results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535780 TI - The genesis of human engineering. AB - In August 1945, almost 40 years ago, Lt. Col. Paul M. Fitts, Ph.D., arrived at AMRL to head the new Psychology Branch. The need for such an organization, directed at equipment design solutions to human operator problems, was recognized during WW II. Many aircraft had been lost through pilot error. Gunnery, radar, navigation, and other systems had suffered degraded performance because of operator errors. Similar problems were also recognized in the U.S. Navy and in Great Britain, where new organizations with similar goals were set up as the war was ending. The initial staff for the new Psychology Branch came mostly from the wartime selection and classification program in the Training Command. The psychologists attacked their new mission with vigor and rapidly switched their research efforts to the design of cockpits, instruments, radar scopes, gun sights, and navigation systems. They also interacted eagerly with biomedical personnel in AMRL, and with engineers and aircrew personnel in other Wright Patterson organizations. This paper reviews some scientific approaches of this pioneering effort. After 40 years, the Human Engineering Division is still active and well. This is testimony not only to its past history of accomplishments, but also to the organizational support and scientific environment provided by AMRL. PMID- 3535782 TI - The beginnings of space medicine. AB - The beginnings of space medicine are those of aviation medicine and involved, among many pioneers, Dr. Harry G. Armstrong and the Aeromedical Laboratory. Space Medicine has advanced in a short 23 years from arguments about man being capable of survival in space through animal and manned flights to flight durations of 6 months. The public and private arguments about man's capability to survive and work in space and the early decisions about flight duration and safety are chronicled from a personal point of view. PMID- 3535781 TI - The chemical frontier. AB - The evolution of toxicology research in the Air Force is reviewed and highlighted by a chronological account of major milestones. The need for realistic evaluation of toxic hazards in the aerospace environment and the interdisciplinary approach taken to accomplish this multifaceted program is discussed, together with the specific driving requirements. Because of the large number of chemicals studied in the past 30 years, only illustrative examples of specific studies are given to develop a representative cross-section of research activities. A brief overview of the development and special characteristics of the facilities and instrumentation is also presented. Because of the unique capabilities for inhalation exposure experiments which represent a national asset, cooperative research program accomplishments with participating sister services, other government agencies, and academic institutions are also described. PMID- 3535783 TI - The war years at the Aeromedical Lab: Wright Field (1941-46). AB - The author narrates his experiences at the Aeromedical Laboratory (AML) from his first visit in Spring 1941, when Maj. Otis O. Benson was its Chief, to the end of 1945, when its wartime Chief, Col. William Randolph Lovelace, returned to the Mayo Foundation and when Col. Lloyd E. Griffis arrived as the interim Chief. The rapid growth of the Laboratory is described--from a small unit in Bldg. 16 in 1941 to its new Bldg. 29 in Spring 1942--to its emergence as a fully active, working laboratory. The highlights of AML major wartime projects are presented: development and production of breathing oxygen equipment, including pressure breathing for use above 50,000 ft; evaluation of insulative and electrically heated flying clothing, useful for confined cockpit space and for use at first in B-17 gun turrets; development and evaluation of anti-G suits for the new, high performance, fighter aircraft; the role of anthropometry in design of aircraft cockpits and personal flying equipment; Laboratory tests of human tolerance to explosive decompression in new Air Force pressurized bombers (B-29) and future fighters (P-80 series), and actual flight tests in the Lockheed Constellation and Boeing C-97. Individual contributions of many distinguished physiologists, physicians, biophysicists, and engineers then on duty at Wright Field are mentioned whenever possible. PMID- 3535784 TI - The sky and tomorrow. AB - As a member of the "fifty-year" Air Force research and development club himself, the author first takes a "snap-shot" look at the environment surrounding this activity for each 5-year interval--from 1936 to the present, and into the future- and discusses the impact of the changes. Then, seven principal areas--technology, materials, vehicles and control, propulsion, electronics, weapons environment, and man--are discussed with respect to the timing and extent of their impact upon the Air Force, leading up to the opinion of the author that from now on into the foreseeable future, "man-related" R&D is expected to become a "dominant" force. Examples of R&D highlighting the importance of this area are given. PMID- 3535785 TI - Linkage of Pep-2 and Apk on mouse chromosome 10. AB - An ethylnitrosourea (ENU)-induced electrophoretic variant of mouse PEP-2, a tripeptidase, has been used to determine the location of the structural gene on chromosome 10. Gene order and recombination frequencies were estimated as Apk 21.8 +/- 3.9%-Pep-2-3.7 +/- 2.1%-Sl. Methods for rapid determination of Apk and Pep-2 alleles by cellulose acetate electrophoresis and a valuable linkage testing stock carrying the unique Apkm and Pep-2b alleles are described. PMID- 3535787 TI - Kinetic properties of monoclonal insulin antibodies. AB - We investigated four insulin-specific hybridoma antibodies with respect to their kinetic properties as well as the binding behaviour of some combinations of them. From equilibrium binding data all but one antibodies were shown to bear homogeneous binding sites. They revealed homogeneity of binding sites also by kinetic experiments, thus with high probability being monoclonal. At 0 degree C, two of them showed discrepancies between kinetic and steady state binding data in as much as, at steady state, the measured bound-to-free ratio of tracer insulin was 3-4 times lower than calculated from kinetic data. Thus a simple bimolecular reaction mechanism could possibly not be applicable. Mixing two monoclonal insulin antibodies, neither cooperative nor additive binding to the insulin molecule could be observed but only competitive effects. Especially, no positive cooperativity between two or more antibodies could be detected, which would be able to account for the higher affinity usually observed for polyclonal vs. monoclonal antibodies. PMID- 3535786 TI - Cardiovascular actions of dihydralazine as modified by dietary linoleic acid. AB - The experiments were carried out in order to examine whether the hypotensive effect of dihydralazine can be augmented by concomitant ingestion of a diet enriched with linoleic acid. After prefeeding with a linoleic acid rich diet (13.3 J%) an augmented hypotensive dihydralazine effect (11-24 mm Hg) could be observed in acute experiments in conscious (1 mg/kg i.v.) and pentobarbital anaesthetised (4 mg/kg i.v.) normotensive rats with different duration of the feeding period as well as in conscious (1 mg/kg i.v.) spontaneously hypertensive rats relative to linoleic acid poor (0.5 J%) fed animals. This effect was abolished by pretreatment with the cyclooxygenase inhibitors indomethacin (10 mg/kg i.v.) or acetylsalicylic acid (100 mg/kg i.v.). The chronotropic dihydralazine response was with one exception not different between the two dietary groups. In chronic experiments with spontaneously hypertensive rats the augmentation of the hypotensive dihydralazine effect (1 mg/kg X d, s.c.) after linoleic acid rich diet did not attain statistical significance after a 6-weak prefeeding period. The renovasodilatory action of dihydralazine (3 mg) was increased in isolated kidney preparations of linoleic acid rich fed rats. This effect was accompanied by a shift of the prostaglandin formation toward vasodepressive PGE. We conclude that the altered cardiovascular effects of dihydralazine after linoleic acid rich diet are primarily caused by changes in the formation of prostaglandins and the activity of the sympathetic nervous system. PMID- 3535788 TI - Purification of a hemolytic factor from ras oncogene transformed fibroblasts. AB - Transformation of NIH-3T3 fibroblasts by the Harvey murine sarcoma viral oncogene or by cultivation of fibroblasts under low serum conditions (spontaneous) resulted in the acquisition of hemolytic activity, as demonstrated by coincubation of the transformed fibroblasts with 59Fe-labeled red blood cells. The tumor Hemolytic Factor was partially purified from conditioned media produced by T-24 human bladder transformed fibroblasts by ammonium sulfate precipitation, followed by anion and gel filtration chromatography. The hemolytic factor has a molecular weight of 66,000 as documented by SDS-PAGE and is destroyed by heating to 60 degrees C. PMID- 3535789 TI - Structural stability of heterologous genes cloned in Streptomyces plasmid pIJ702. AB - A recombinant plasmid pWCL1 containing Streptomyces plasmid pIJ702, E. coli plasmid pUC12, and hepatitis B viral surface antigen (HBsAg) gene was stably maintained in E. coli, but exhibited structural instability in S. lividans 1326. The deletions were found ranging from 2.75 to 5.65 kilobases (kb) and most of them occurred within the melanin (mel) gene of pIJ702, resulting in the loss of part of the mel gene sequence plus the insert. The removal of the pUC12 sequence from pWCL1 eliminated the instability. However, pUC12 alone inserted in either orientation on pIJ702 also caused the deletion in S. lividans 1326. The results indicated that the structural instability of hybrid plasmid of pIJ702 depended on the interaction between the mel sequence and the inserted sequence. PMID- 3535790 TI - Glycolysis and lipid synthesis in brown adipose tissue during ageing in the rat. AB - The maximal activity of the enzymes hexokinase and 6-phosphofructokinase were measured in interscapular brown adipose tissue during ageing in the rat. The activity of these glycolytic enzymes increased markedly during the suckling weaning transition (20-22 days of age), but from 30 to 100 days of age the activities per gram wet weight and per mg protein decreased. The rate of lipogenesis in brown adipose tissue was also increased over the suckling-weaning transition and the contribution of glucose to this fatty acid synthesis was greater in weaned animals especially under the influence of insulin. PMID- 3535791 TI - A lectin-binding immunoassay indicates a possible glycosylated growth hormone in the human pituitary gland. AB - By means of a lectin binding immunoassay we detected a glycosylated human growth hormone-immunoreactive substance in the human pituitary gland. The assay involves reacting the test substance with concanavalin A immobilized on a solid support followed by treatment with human growth hormone antibodies. Quantitation is achieved by reaction of the concanavalin A-glycoprotein-antibody complex with an 125I-labeled second antibody. Specificity of the assay for a glycosylated human growth hormone was indicated by inhibition of binding by N-acetyl-D-glucosamine. Furthermore, use of antiserum that had been absorbed with human growth hormone reduced the amount of radioactivity bound to the tubes. Western blotting of pituitary immunoprecipitates after gel electrophoresis in sodium dodecyl sulfate revealed human growth hormone-immunoreactive components that also reacted with concanavalin A. PMID- 3535792 TI - Effect of vector type, host strains and transcription terminator on heterologous gene expression in yeast. AB - Using the surface antigen gene of the hepatitis B virus, and the promoter and terminator sequences of the yeast pho5 gene as a model system, a series of closely related expression plasmids were constructed to investigate the effect of vector type, genetic background of host strains and the presence of transcription terminator on the expression of heterologous gene in yeast. Plasmids carrying the replication origin of the 2 mu plasmids were found to be much more stable than those either independently or simultaneously carrying ars1 sequences. Gene expression was also higher with 2 micron-based plasmids. Yeast selection marker (trp1 or leu2) and therefore the host strains used did not have significant effects on gene expression. Addition of transcription terminator sequences downstream to the HBsAg gene also contributed only limited increases in gene expression levels. PMID- 3535793 TI - Insulin release from a cloned hamster B-cell line (HIT-T15). The effects of glucose, amino acids, sulphonylureas and colchicine. AB - Insulin release from statically incubated HIT-T15 cells was maximally stimulated by glucose, L-arginine and L-leucine. L-arginine stimulated insulin release in the absence of glucose. Glucose induced insulin release was potentiated by the addition of L-leucine, L-arginine and the two in combination. Both glibenclamide and chlorpropamide stimulated insulin release from HIT-T15 cells. Glibenclamide was the more potent and equivalent in insulinotrophic action to 7.5 mmol/l glucose. Only chlorpropamide significantly potentiated glucose induced insulin release. Perifused HIT-T15 cells produced a reproducible biphasic insulin response to glucose challenge which was characterised by a pronounced and sustained first phase and a reduced second phase. The stimulation of phase I by glibenclamide alone and the inhibition of phase II of glucose induced insulin release by colchicine suggested the presence of a readily available pool of insulin granules which was not rapidly restored by insulin biosynthesis and granule margination. PMID- 3535794 TI - Sequence homology of group A streptococcal Pep M5 protein with other coiled-coil proteins. AB - Group A streptococcal Pep M5 protein, an antiphagocytic determinant of the bacteria, is an alpha-helical coiled-coil molecule, and exhibits significant sequence homology with tropomyosin and myosin, but to a lesser degree with other coiled-coil proteins. Moreover, Pep M5 is more homologous to myosin than to tropomyosin, and the homologies are more numerous between the C-terminal domain of the Pep M5 protein and the S2 fragment of myosin. The C-terminal domain of the Pep M5 protein exhibits extensive sequence identity with the C-terminal region of Pep M6 molecule, another M protein serotype. Thus, regions within two M protein serotypes are homologous to the S2 region of the myosin molecule. These observations are consistent with the immunological findings of other investigators and thus may explain some of the previously reported immunological cross-reactions between antigens of the group A streptococcus and mammalian heart tissue. PMID- 3535795 TI - An altered adenylate cyclase in cdc35-1 cell division cycle mutant of yeast. AB - Adenylate cyclase activity was studied in Saccharomyces cerevisiae's cell division cycle (cdc) mutant 35-1. The temperature sensitive mutant cdc35-1 was previously mapped as an allele of cyr, the adenylate cyclase gene. However, the adenylate cyclase activities of membranes prepared from cdc35-1 were not thermosensitive. The adenylate cyclase activity of cdc35-1 was found to have an altered Mn2+ dependency and did not respond to Gpp(NH)p stimulation. These results suggest that cdc35-1 mutation may not be at the catalytic site but at a site where adenylate cyclase interacts with regulatory proteins. PMID- 3535796 TI - Identification of P-57, a serine proteinase, from human erythrocyte membranes, which cleaves both chains of human third component (C3) of complement. AB - A proteinase, which cleaves human third component of complement, was solubilized from erythrocyte membranes then purified by gel filtration chromatography, fluid phase electrophoresis, and hydroxylapatite chromatography. Labeling of the purified material by 125I or 3H-DFP and measurement of proteolytic activity subsequently isolated by SDS-polyacrylamide gel electrophoresis allowed to identify a 57 kDa single band, in non reducing conditions. Inhibition of this activity by PMSF supports covalent modification of an active serine residue. This membrane serine proteinase cleaved alpha and beta chains of human third component of complement, suggesting that p-57 is distinct from plasma serine proteinases. PMID- 3535797 TI - Glucose starvation alters insulin but not IGF-I binding to Chinese hamster ovary (CHO) cells. AB - The pattern of cellular protein glycosylation can be altered in CHO cells by glucose starvation. When wild type CHO cells are deprived of glucose, 125I insulin binding increases from a B/F of 0.033 +/- 0.004 to 0.063 +/- 0.011, due to an increase in receptor affinity. The already elevated insulin binding to mutant B4-2-1 CHO cells, whose genetic defect causes abnormal glycosylation mimicking the pattern seen in the glucose starved normal cells, is not affected by glucose starvation. In neither cell line is 125I-IGF-I binding affected by glucose starvation. These data support the hypothesis that abnormal glycosylation can alter insulin binding to its receptor. Furthermore, there is a striking difference in the susceptibility of IGF-I and insulin receptors to alterations in glycosylation. PMID- 3535798 TI - A novel peptide in the calcitonin gene related peptide family as an amyloid fibril protein in the endocrine pancreas. AB - Deposition of amyloid is the most constantly present alteration in the islets of Langerhans in type 2 diabetes mellitus and is also quite common in insulin producing tumors of the pancreas and it is very likely that these two amyloids are identical. We have isolated amyloid fibrils from an insulin-secreting human tumour and purified the fibrillar protein. N-terminal amino acid sequence of the protein is unique and does not resemble insulin or its precursors. Instead it has about 50% homology with the neuropeptide CGRP (calcitonin gene related peptide). PMID- 3535799 TI - Hexose transport after glucose refeeding of glucose-starved human fibroblasts: 1. The effects of tunicamycin and cycloheximide. 2. Insulin binding and action. AB - Hexose transport in glucose-starved human fibroblasts was readily reversed by glucose refeeding. This hexose transport reversal was not inhibited by tunicamycin (1.5 microgram/ml) but was blocked by cycloheximide (20 micrograms/ml). The ability of insulin (100 mU/ml) to stimulate hexose transport was returned by glucose refeeding and this was not affected by tunicamycin. Cycloheximide which blocked the glucose refeeding effect on hexose transport, decreased the ability of insulin to stimulate hexose transport. Specific 125I insulin binding was increased by glucose refeeding of glucose-starved cells and this change in binding was inhibited by tunicamycin and cycloheximide. Thus, it appears that under the conditions employed in human fibroblasts, the ability of insulin to stimulate hexose transport is differentially regulated more by factors affecting basal hexose transport than by those affecting changes in insulin binding. PMID- 3535800 TI - Inhibition of serine proteases by benzoxazinones: effects of electron withdrawal and 5-substitution. AB - A series of substituted 4H-3,1-benzoxazin-4-ones have been made and assayed as inhibitors of human leukocyte elastase (HLE) and other serine proteases. The benzoxazinones are kinetically competitive, alternate substrate inhibitors that inhibit by acylation and slow deacylation. Two structure-activity relationships have been found which are consistent with this mechanism. First, electron withdrawal at position 2 gives better inhibition (lower Ki values) because acylation rates are increased while deacylation is relatively unaffected. Second, benzoxazinones with methyl or ethyl substitution at position 5 are better inhibitors of HLE because the acyl enzymes formed from these compounds are 2,6 disubstituted benzoic acid esters and their deacylation is sterically hindered. PMID- 3535801 TI - Behavioural correlates of the action of selective D-1 dopamine receptor antagonists. Impact of SCH 23390 and SKF 83566, and functionally interactive D 1:D-2 receptor systems. PMID- 3535802 TI - The coupling of metabolic to secretory events in pancreatic islets: effects of 2 cyclohexene-1-one upon GSH content and secretory behaviour. AB - The GSH content and GSH/GSSG ratio were decreased in rat pancreatic islets exposed to 2-cyclohexene-1-one (CHX; 1.0 mM), but the drug failed to affect the cytosolic NADH/NAD+ and NADPH/NADP+ ratios. This coincided with inhibition of D glucose oxidation, whilst the oxidation of L-leucine and L-glutamine was little affected by CHX (1.0 mM). The release of insulin evoked by either D-glucose or 2 ketoisocaproate was inhibited by CHX (1.0 mM), whereas such was not the case for insulin secretion induced by L-leucine, alone or in combination with L-glutamine. The latter amino acid protected the B-cell against the inhibitory action of CHX upon glucose-stimulated insulin release. CHX severely altered the normal relationship between nutrient oxidation, [45Ca] net uptake and insulin release. Since CHX also inhibited insulin release evoked by non-nutrient secretagogues, it is speculated that GSH may be involved in several cytophysiological processes including the control of glycolysis, intracellular calcium distribution, and responsiveness to this cation of Ca2+-sensitive targets. PMID- 3535803 TI - Uptake of [3H]chloroquine by drug-sensitive and -resistant strains of the human malaria parasite Plasmodium falciparum. AB - Chloroquine accumulation by human erythrocytes infected with nine different strains of the malarial parasite Plasmodium falciparum, which varied by greater than or equal to 20-fold sensitivity to the drug, was measured as a function of time and drug concentration. Although the kinetics of uptake were clearly quite complex in this system, at least two general phases were observed, an extremely rapid short phase (less than 30 sec), followed by a slower phase leading to steady state within 60 min. The concentration of chloroquine in the parasite food vacuole quickly exceeded 1 mM at 10(-6) M external drug concentration. Minor alkalinization of this organelle was observed during the first 30 sec; this pH was reduced progressively over time in a concentration-dependent manner. The rate of pH reduction was highest in the drug-sensitive strains. Neither the rate of chloroquine accumulation nor intracellular chloroquine concentrations at steady state could adequately differentiate sensitive from resistant strains. Higher intracellular drug concentrations were required to kill resistant versus sensitive strains, suggesting that a change in sensitivity to chloroquine of an intracellular effector is the mechanism of resistance. The rapid rate and extensive accumulation of chloroquine, and the lack of significant alkalinization, indicate that a new theory of the mechanism of antimalarial action of the drug is required. PMID- 3535804 TI - Mutagenicity of thionitrites in the Ames test. The biological activity of thiyl free radicals. AB - Thiols, such as glutathione and cysteine, are mutagenic in the Ames test, using Salmonella typhimurium strain TA 100 and rat kidney S-9 preparation [Glatt et al. Science 220, (1983)]. Formation of thiyl free radicals, RS., has been implicated in this effect. We have prepared thionitrite (nitrosylmercaptan) derivatives of glutathione and other thiols. These unstable derivatives decompose by homolysis, yielding RS. radicals. Glutathione thionitrite is mutagenic to strains TA 100 and TA 102, in the absence of activation by mammalian S-9 preparations. We suggest that this mutagenicity is evidence for the role of thiyl free radicals as biological reactive intermediates. Since alkyl nitrites readily convert thiols to thionitrites, our findings have implications for the toxicology of nitrosating drugs, such as amyl nitrite. PMID- 3535805 TI - Inhibition of uridine phosphorylase from Escherichia coli by benzylacyclouridines. AB - The benzylacyclouridines, potent and specific inhibitors of mammalian uridine phosphorylase, were also found to be inhibitors of uridine phosphorylase but not thymidine phosphorylase from Escherichia coli. Competitive inhibition was observed in all cases and the most potent of these compounds was HM-BBAU (5-(3 benzyloxybenzyl)-1-[(2'-hydroxy-1'-hydroxymethyl)methyl]urac il) with a Ki value of 0.15 microM. The inhibitory potencies of these compounds parallel those obtained with enzymes from mammalian sources [Niedzwicki et al., Biochem. Pharmac. 31, 1857 (1982) and Naguib et al., manuscript in preparation] indicating that the structure of the active site of uridine phosphorylase from E. coli may resemble that of the mammalian enzyme. PMID- 3535806 TI - Dihydrodiol dehydrogenases in guinea pig liver. AB - Four major and four minor dihydrodiol dehydrogenases, with similar apparent molecular weights of 28,000 to 34,000 but with different charges, were purified from male guinea pig liver cytosol. One of the minor enzymes catalyzed only the oxidation of benzene dihydrodiol with a high Km value of 5.0 mM and was identified immunologically with aldehyde reductase. The other enzymes oxidized xenobiotic alicyclic alcohols and 17 beta-hydroxysteroids as well as benzene dihydrodiol. These enzymes exhibited higher affinity for 17 beta-hydroxysteroids than for alicyclic alcohols and benzene dihydrodiol, and immunologically cross reacted with testosterone 17 beta-dehydrogenase purified from the same source. Four major enzymes and one minor with Km values for benzene dihydrodiol of about 0.2 mM, possessed specificity for 5 beta-androstane--17 beta-hydroxysteroids and dual cofactor requirement, whereas the other two minor enzymes with high Km values of over 5 mM showed apparent NADP and 5 alpha-androstane specificity. The dihydrodiol dehydrogenase activity was localized in the cytosol of liver. The results indicate that the hepatic oxidation of dihydrodiols in the guinea pig is mediated by cytosolic testosterone 17 beta-dehydrogenase isozymes and aldehyde reductase. Testosterone 17 beta-dehydrogenase immunologically identical to the liver enzymes was detected only in kidney, whereas aldehyde reductase was detected in all tissues of the guinea pig. PMID- 3535807 TI - The roles of glucagon, insulin and glucocorticoid hormones in the effects of sublethal doses of endotoxin on glucose homeostasis in rats. AB - The effects of sub-lethal doses of endotoxin on plasma glucose, glucagon, insulin, glucocorticoids and non-esterified fatty acids (NEFA) were determined in rats. Endotoxin did not change the plasma concentration of glucocorticoids, but blocked the effects of elevated glucocorticoid hormone concentrations on both plasma glucose and hepatic tryptophan dioxygenase activity. Endotoxin increased the plasma concentrations of glucose, glucagon and insulin in rats with basal glucocorticoid concentrations, and changed the observed relationships between glucose, glucagon and insulin in a manner consistent with an increased sensitivity of glucagon secretion to lowered glucose concentrations. At the highest dose of endotoxin used, 20 mg/kg over 6 hr, a substantial decrease (greater than 7-fold) in the insulin/glucagon ratio provides evidence for changes in basal (as opposed to hormone-stimulated) glucose production and/or utilisation in vivo. PMID- 3535808 TI - [Localization of binding sites of E. coli DNA-dependent RNA-polymerase with photosensitive template analogs]. AB - The photoinduced covalent binding of E. coli RNA polymerase with decathymidylic templates containing 5-bromouracil residue has been carried out. Peptides from beta and beta' subunits of the core-enzyme, situated in the DNA-template binding site of the RNA polymerase active center have been localized. PMID- 3535809 TI - [Sensitivity of mannosyl transferases from Salmonella serotype E1 and B to modification of the donor heterocyclic base]. AB - A series of synthetic nucleoside diphosphate mannoses with different heterocyclic bases were tested as GDP-Man analogues in enzymatic mannosylation during assembly of O-antigen repeating units of Salmonella anatum and Salmonella typhimurium. The substrate efficiency was found to depend strongly on oxygen atom presence at C6 of the purine residue, the H2N-C2-N1-H grouping of the heterocyclic nucleus being less important. UDP-Man proved to be an efficient substrate for the mannosylation reactions. PMID- 3535810 TI - Cytoskeletal binding of monoclonal anti-DNA antibodies derived from tonsillar lymphoid cells of a normal subject. AB - The ability of monoclonal IgM anti-DNA autoantibodies derived from normal human lymphoid cells to bind to cellular constituents of human epithelial cells (HEp-2) was examined by immunofluorescence. Hybridoma supernatants from 10 different clones were studied. Four of them gave a strong fibrillar cytoplasmic staining that resembled cytoskeletal staining, 1 showed strong nuclear staining only, 3 showed weak nucleolar staining only, and 2 showed no staining. The hybridoma supernatants that reacted with HEp-2 cytoskeleton were either polyspecific for various nucleic acid antigens, such as single-stranded DNA, DNA, poly(dA:dT), poly(dG).poly(dC), RNA, and cardiolipin, or were restricted to cardiolipin. Cytoskeletal staining identical to the hybridoma supernatant staining was also seen with mouse monoclonal anti-vimentin antibody B11.5.1. Inhibition of the cytoskeletal staining was accomplished in 3 of the 4 hybridoma supernatants by preabsorption of these hybridoma supernatants with cardiolipin and/or single stranded DNA, or by preincubation of the HEp-2 cells with the mouse monoclonal anti-vimentin antibody. PMID- 3535811 TI - A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. AB - Sixty-two patients with fibromyalgia were randomly assigned to receive 25 mg of amitriptyline at night, 500 mg of naproxen twice daily, both amitriptyline and naproxen, or placebo in a 6-week, double-blind trial. Amitriptyline was associated with significant improvement in all outcome parameters, including patient and physician global assessments, patient pain, sleep difficulties, fatigue on awakening, and tender point score. Patients taking the combined naproxen-amitriptyline regimen experienced minor, but not significant, improvement in pain when compared with patients who took amitriptyline alone. Amitriptyline, or amitriptyline and naproxen, is an effective therapeutic regimen for patients with fibromyalgia. PMID- 3535812 TI - [Existence of an anabolically acting principle in an extract of E. coli]. AB - Colibiogen, extracted from E. coli (in the following called coli extract) was examined for factors with anabolic efficiency, especially for anabolically efficient bases of nucleic acids and for peptides. The results obtained are the following: Tests for nucleotides, nucleosides and bases of nucleic acids by thin layer chromatography technique turned out negative. To test anabolically efficient substances the so-called glutathione state test in the rat liver was used. In this test intraportal dosages of 200 micrograms coli extract and also 200 micrograms of the enzymatically decomposed muscle proteins (Pepton resp. Lab Lemco) gave rise to positive effects within 2 min. Contrary to peptides from the culture medium the efficiency of coli extract was considerably increased by previous tryptic fission (efficient concentration 6 micrograms). The quantities applied were related on microgram peptide. A coli extract preparation the phase of growth of which had been shortened to 12 h was separated into 4 fractions. The fourth fraction (lowest molecular weight) showed anabolic efficiency with 6 micrograms peptide in the state test. Before the denaturative extraction took place, the coli extract was separated by centrifugation in a third test series into coli extract bacteria mass and coli extract supernatant. Nothing but the supernatant showed anabolic properties. Two fractions, obtained by the separation of the bacteria mass, did not show any activity in the glutathione state test. It is discussed that E. coli-specific peptides with anabolic efficiency are candidates for the coli extract effects. PMID- 3535813 TI - Toxic and mutagenic effects of a low molecular weight heparin in rats. AB - Acute, subacute, chronic toxicity and mutagenicity studies of a new low molecular weight heparin (OP/LMWH) were carried out in rats. The LD50 values resulted lower by i.m. and s.c. route than after i.p. and i.v. administration. OP/LMWH given by subcutaneous route in subacute and in chronic toxicity produced no significant adverse effects at 5 mg/kg, only marginal effects at 10 mg/kg and moderate effects at the dose of 20 mg/kg. In these studies, unfractionated heparin at 10 mg/kg by s.c. route was used for comparison. At 10 mg/kg, heparin presented effects similar to those shown by OP/LMWH at 20 mg/kg. OP/LMWH did not show any mutagenic activity when compared with mutagenic standards. PMID- 3535814 TI - Effect of deoxycholic acid on lipoprotein and apolipoprotein levels in patients with familial hypercholesterolemia. AB - Seventeen patients with familial hypercholesterolemia (9 males and 8 females) were treated with 1000 mg deoxycholic acid or placebo daily during 2 weeks in a double-blind, randomised cross-over fashion. A wash-out period was held between the two periods of therapy. Clinical chemical parameters, lipoprotein cholesterol and apolipoproteins were measured before and after each period. Low density lipoprotein cholesterol was reduced by 7.5% and LDL-apo B by 5.6%. Only the latter change was significantly different from the corresponding changes in the placebo period (P less than 0.05). High density lipoprotein cholesterol did not change. Apolipoprotein A-I decreased by 4% (P less than 0.05). Apolipoprotein A II did not change. While taking deoxycholic acid, most patients had abdominal discomfort and/or diarrhoea. The serum transaminases increased in 7 patients taking this drug and in none while taking a placebo. We conclude that this therapy is of little value in hypercholesterolemic patients. PMID- 3535815 TI - Role of dietary and environmental factors in drug abuse. AB - A review of the literature indicates that a number of food constituents, e.g., dietary sugar, neurotransmitter amino acid precursors and food deprivation, may modulate the development of tolerance and physical dependence as well as influence the self-administration of several drugs of abuse in animals. In particular, the role of palatability of food, involvement of the autonomic nervous system, exposure to cold and nutritional status as well as seasonal cyclical changes is discussed. The effect of the above factors may in part be mediated by precursor modulation of monoaminergic neurotransmitters, modulation of endogenous opioid neurotransmitters in the neuronal terminals of the brain or modulation of endogenous peptides. This paper points to the need of conducting additional research to address this complex and potentially important area of research. PMID- 3535816 TI - [Contribution of immunohistochemical methods to the study of central nervous system tumors]. AB - The contributions of the immunoperoxidase technique for the demonstration of glial fibrillary acidic (GFA) protein, neuron specific enolase (NSE) and the Leu 7 (HNK-1) monoclonal antibody in central nervous system (CNS) tumors are reviewed. GFA protein is expressed in normal, reactive and neoplastic cells of astrocytic lineage. Its presence in nonastrocytic CNS tumors is related either to the development of gliofibrillogenesis (ependymomas), to ontogenetic factors (oligodendrogliomas; choroid plexus papillomas), or to uptake of the protein from adjacent reactive astrocytes (capillary hemangioblastomas). It has permitted the recognition of new entities such as the pleomorphic xanthoastrocytoma, and of little known variants such as lipidized glioblastomas. NSE is of diagnostic importance in peripheral neuronal, endocrine and neuroendocrine tumors, but of considerably less value in CNS tumors, since it may be found in the cells of a variety of glial and other cerebral neoplasma as well as in reactive astrocytes. It has also been found to be present in a number of unrelated tumors outside the nervous system. The Leu-7 (HNK-1) monoclonal antibody, a hematological marker, has been found to cross-react with a number of cells of schwannian origin and may be helpful in the differential diagnosis of schwannomas and neurofibromas from other soft tissue neoplasms. Its recognition of oligodendroglial tumor cells has been confirmed, but it is also frequently recognized by both reactive and neoplastic astrocytes. In addition to its reactivity with cells of the immune system, a number of epithelial tumors, in particular adenocarcinomas of the prostate, will also be recognized by the antibody.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535817 TI - [Immunohistochemistry of thyroglobulin in the diagnosis of clear cell carcinomas of the cervical region]. AB - 6 thyroid gland and 3 cervical lymph node clear-cells carcinomas are investigated by means of indirect immunofluorescence detection of thyroglobulin. Immunofluorescence was positive only in 1 case, which was a primitive thyroid carcinoma. In 7 other cases, its negativity pointed at the metastatic nature of the lesion, from a clear cell carcinoma of kidney (in 4 cases, nephrectomy was very remote, and in 3 cases, the renal lesion was discovered after our examination of the thyroid tumour). One observation showed negative staining reaction, and was a propagation of a parathyroid carcinoma to the thyroid gland. It is concluded that thyroglobulin can be used as an immunohistochemical marker to establish whether a clear cell cervical tumour originates from thyroid gland, or is a metastatic neoplasm. PMID- 3535818 TI - [Immunoperoxidase study of 18 malignant lymphoblastic lymphomas (LMLbl) in children]. AB - Eighteen cases of malignant lymphoblastic lymphomas in children were studied by immunoperoxidase technique on frozen tissue sections and/or cytological samples. Different monoclonal or polyclonal antibodies were used: OKT8, OKT11, OKB2, OKIal, anti immunoglobulins (mu, kappa, lambda chains). The results were compared with those of classical histology: three histologically unclassified malignant lymphoblastic lymphomas were linked to a Bor T line (one pre-B lymphoma and two T lymphomas). One diagnosis of T lymphoma could not be confirmed by immunoperoxidase technique. The technique did not reveal any surface immunoglobulins in two cases of malignant lymphomas of Burkitt type. Every one of the remaining 12 cases gave concordant results between morphological and immunological studies. In 12 cases it was possible to compare the results of immunological typing on tissue sections and cell suspension. The results were concordant in 11/12 cases. An advantage of this immunochemical technique on frozen sections and/or cytological samples is that it gives good visualisation of the cells and their reactivity with the antibodies. PMID- 3535819 TI - [Vesical amyloidosis. Apropos of a case and a review of the literature]. AB - A case of primary localized amyloidosis of the bladder in a 60 years old male is described. The initial symptom was hematuria. Cystoscopy revealed a redish angioma-like lesion on the trigone, and the diagnosis was pointed out with biopsy, complementary data, and a close follow-up during two years. In the literature we found 47 cases of primary localized amyloidosis of the bladder and 10 others cases of amyloidosis of the bladder which were part of generalized amyloid disease. The interest of the Wright's special staining method is underlined specifying, on light microscopic study, the AA or AL type of the amyloid disease. PMID- 3535820 TI - [Adenocarcinoid of the stomach. Histochemical and immunohistochemical study using optical and electron microscopy]. AB - A case of gastric adenocarcinoid was described by light and electron microscopy and immunohistochemistry. The tumor contained exocrine, endocrine and amphicrine cells. In endocrine cells, serotonin and pancreatic polypeptide were demonstrated. It was suggested that these gastric adenocarcinoid cells originate from totipotent immature cells of endodermal origin. PMID- 3535821 TI - Exposure to waste anesthetic gases--a review of toxic effects. PMID- 3535823 TI - Does routine newborn bathing reduce Staphylococcus aureus colonization rates? A randomized controlled trial. PMID- 3535822 TI - Rabies. AB - Medical science has evolved tremendously from the days when local cauterization was used to treat victims of rabies exposure. Indeed, with appropriate wound care and vaccination procedures, human rabies is a preventable disease. Despite these advances, physicians treating the uncommon but very dramatic cases of human rabies have not been so successful. As research in this field continues, our hope must be that not only will rabies be preventable and curable but that other mystifying central nervous system disorders will become better understood as well. PMID- 3535824 TI - What the Dublin trial suggests about benefits: what comments suggest about who should interpret the tracings; oxytocin, neonatal seizures and other insights derived from the Dublin trial. Roundtable. Part II. PMID- 3535825 TI - Morphometric requirements for image analysis and the IBAS interactive automatic image analysis system. AB - The morphometric demands made on an image analysis system are discussed, as is the IBAS interactive automatic system, which meets those requirements. The modular design of the IBAS image analysis system, with its tailor-made processors for image processing, system control and pattern recognition, gives speed and flexibility. The IMAGE image analysis language guarantees user friendliness, and, last but not least, the enormous amount of software offers accurate, reproducible measurements and dedicated evaluation programs. PMID- 3535826 TI - [Intracranial hemorrhage in the newborn infant: current concepts]. PMID- 3535827 TI - [Immune response to toxoplasmosis]. PMID- 3535829 TI - Biosafety in biotechnological processes. PMID- 3535828 TI - Effects of morphine, ethylketocyclazocine, and N-allylnormetazocine on classical conditioning of the rabbit nictitating membrane response. AB - The rabbit's nictitating membrane response was classically conditioned to tone and light conditioned stimuli presented for 800 ms before delivery of a 100-ms unconditioned shock stimulus. Both the mu receptor agonist morphine (5 mg/kg) and the kappa receptor agonist ethylketocyclazocine (1 mg/kg) significantly retarded the acquisition of conditioned responses (CRs). The retardant effects of both morphine and ethylketocyclazocine on CR acquisition could still be detected when the rabbits were tested 5 days after cessation of drug injections. At the dose employed in this study (5 mg/kg), the sigma receptor agonist N-allylnormetazocine had no effect on acquisition. The retardant effects of morphine and ethylketocyclazocine on acquisition were significantly antagonized by both naloxone (1 mg/kg) and N-allylnormetazocine (5 mg/kg). It was suggested that mu and possibly kappa receptors are involved in the retardant effects of opiates on the acquisition of classically conditioned responses. PMID- 3535831 TI - The hybridoma technology: I. Production of monoclonal antibodies. PMID- 3535830 TI - On-line determination of biochemical/physiological parameters in the fermentation of animal cells in a continuous or discontinuous mode. PMID- 3535832 TI - The hybridoma technology: II. Applications of hybrid cell products: monoclonal antibodies and lymphokines. PMID- 3535833 TI - New advances in animal and human virus vaccines. PMID- 3535835 TI - [Eulogy on the 65th birthday of Dr. Gerchow]. PMID- 3535834 TI - [In memoriam Herbert Elbel]. PMID- 3535836 TI - Dynamic and ultrastructural studies of in vitro interaction between Toxoplasma gondii and cultured cell lines. II. Intracellular replication. AB - This study deals with Toxoplasma gondii internal budding in continuous cellular lines. The stages of this process are described with phase contrast microscopy. Results are assessed in the light of ultrastructural considerations and events are studied with quantitative statistical analysis to define new parameters of cellular growth. PMID- 3535837 TI - Severe hypertension in a ten-year-old boy secondary to an aldosterone-producing tumour identified by adrenal sonography. AB - Severe hypertension discovered incidentally in a 10 year-old boy was associated with persistent hypokalaemia and metabolic alkalosis. Primary hyperaldosteronism was diagnosed by demonstrating elevated plasma aldosterone levels and increased urinary aldosterone excretion with concomitant depressed plasma renin activity. Adrenal sonography identified a left adrenal adenoma which was removed surgically; normotension and normalization of plasma renin and aldosterone values ensued. This appeared to be the first use in children of sonography to identify adrenal adenoma and it is suggested to be the first step in the differential diagnosis of primary hyperaldosteronism. PMID- 3535838 TI - Dynamic aspects of amino acid metabolism in alloxan-induced diabetes and insulin treated rabbits: in vivo studies with 15N and gas chromatography-mass spectrometry. AB - The present study was designed to determine the effect of alloxan-induced diabetes in rabbits on L-[15N]alanine and [15N]glycine kinetic parameters. This process was measured by single-dose administration of 15N-labeled amino acids to postabsorptive control rabbits and alloxan-induced diabetics and insulin-treated diabetic rabbits. Gas chromatography-mass spectrometry was used to determine the 15N enrichment of plasma glycine and alanine. Glycine and alanine pools and turnover rate constants were estimated from isotope enrichment time decay curves. The data from the present study indicate that plasma glycine and alanine turnover rate constants increased by 25-50% after alloxan administration but pool sizes showed only little changes, resulting in highly significant increases in fluxes and metabolic clearance rates of both alanine and glycine following alloxan administration; single-dose crystalline insulin or protamine zinc insulin treatment failed to restore the turnover rate constants of glycine or alanine toward control values and caused a depletion of 50% in glycine pool size; 7 days prolonged treatment with protamine zinc insulin restored alanine and glycine fluxes and metabolic clearance rates towards control postabsorptive values; and the reduction in flux values following insulin treatment is consistent with the reduction in the plasma glucose levels in rabbits. The data suggest that the regulatory mechanisms for uptake and metabolism of circulating glycogenic amino acids no longer are operative as a consequence of insulin deficiency following alloxan administration. Exogenous insulin restored the activity of the regulatory mechanism toward the postabsorptive control state. PMID- 3535839 TI - Removal of antibodies with immunoadsorption from an ABO incompatible recipient prior to renal transplant. PMID- 3535840 TI - Should vitamin C supplementation be restricted in regular hemodialysis patients? PMID- 3535843 TI - Electrophysiologic identification of the viability of a preserved heart in a hyperbaric chamber. PMID- 3535841 TI - Bridge to cardiac transplantation: successful use of prosthetic biventricular support in a patient awaiting a donor heart. AB - A 33-year-old man with dilated cardiomyopathy was successfully "bridged" to cardiac transplantation, with the use of left and right prosthetic ventricles. The prostheses supported the pulmonary and systemic circulations for 87 h, at which time they were removed and orthotopic transplantation was performed. Heart transplantation is the only viable long-term therapy for end-stage dilated cardiomyopathy. In the case of sudden decompensation in a patient who requires cardiac transplantation, if a suitable allograft is not immediately available, a system of prosthetic ventricles can be used to provide hemodynamic support until a donor organ is located. In addition, the use of a prosthetic ventricle or ventricles does not preclude the possibility of recovery of ventricular function, an option that is removed if a total artificial heart is used. PMID- 3535842 TI - Application of a prostacyclin analogue (PG) and protease inhibitor (FUT) as anticoagulants with an LVAD system. PMID- 3535844 TI - Carbacyclin derivative (CS-570). A new anticoagulant for hemodialysis. PMID- 3535845 TI - Calcium carbonate. A better phosphate binder than aluminum hydroxide. PMID- 3535846 TI - Endothelial cell growth factor attachment to biomaterials. PMID- 3535847 TI - Intra-arterial carbacyclin infusion inhibits canine platelet deposition on PTFE grafts. PMID- 3535848 TI - Renin-aldosterone response and systemic blood pressure in long-term anephric patients on hemodialysis. PMID- 3535849 TI - Microencapsulated hepatocytes as a bioartificial liver. PMID- 3535850 TI - Comparison of continuous arteriovenous hemofiltration and continuous arteriovenous dialysis in critically ill patients. PMID- 3535852 TI - Application of an antithrombogenic Anthron bypass tube to experimental orthotopic liver transplantation. Studies on blood coagulation and fibrinolysis. PMID- 3535851 TI - The artificial heart--1986: partial fulfillment of a promise. AB - While certain critically ill patients who are awaiting cardiac transplantation can be stabilized with either drugs, the intraaortic balloon pump, or a left ventricular assist device, other patients do not respond to these therapies and the use of a safe and effective artificial heart can be lifesaving. For this latter group, the pneumatic heart appears to be suitable, although minor improvements will be welcomed. The percutaneous tubes and bulky drive unit are not great disadvantages to the patient who uses an interim heart and remains in a constant care area. The patient with end-stage heart disease who cannot have a heart transplant has little hope at present. Interestingly, the pneumatic heart that is available now might be an acceptable alternative to death if the incidence of stroke could be overcome. In the future, these patients will be better served by either an electrically powered left ventricular assist pump or a totally artificial heart. PMID- 3535854 TI - Gagging: a chairside approach to control. PMID- 3535853 TI - Disseminated intravascular coagulation (DIC) during long-term bypass: incidence and clinical relevance. PMID- 3535855 TI - An evaluation of the bonding of glass-ionomer restoratives to dentine and enamel. PMID- 3535856 TI - Edward Samson: a Wessex branch tribute. PMID- 3535857 TI - Short-course high-dosage amoxycillin in the treatment of acute dento-alveolar abscess. PMID- 3535858 TI - Badges of the dental profession. Liverpool University Dental Alumni Association. PMID- 3535859 TI - Pharmacokinetics of morphine in two children before and after liver transplantation. AB - Plasma morphine, morphine-3-glucuronide and morphine-6-glucuronide concentrations were measured (HPLC) in two children immediately before orthotopic liver transplantation and in the postoperative period. Both of the patients had end stage hepatic failure, but one also had impaired renal function before operation and was oliguric during and after surgery. Both patients metabolized morphine rapidly, but in the patient with renal failure, the metabolites appeared to accumulate. Morphine has active metabolic products and the accumulation of these in patients with impaired renal function may lead to a clinically observable prolongation of its effect. PMID- 3535860 TI - Double-blind evaluation of a lignocaine-prilocaine cream (EMLA) in children. Effect on the pain associated with venous cannulation. AB - The effect of the topical application of a lignocaine-prilocaine cream (EMLA) on the pain of venous cannulation was tested in a double-blind manner. Sixty boys and girls between the ages of 4 and 10 yr who were to undergo surgery participated in the study. No analgesic premedication was given and the venous cannulation was performed during the preparation for general anaesthesia. Pain was assessed by the anaesthetist and the patient using a verbal rating scale and two different pictorial scales. The effect of EMLA in the alleviation of the pain of venous cannulation was considered significantly better than placebo by both anaesthetist (P less than 0.001) and patient (P less than 0.05) (verbal scales). One conventional pictorial scale showed a statistically significant difference (P less than 0.05), but the other, based on facial expressions, did not. Local reactions to the cream were minor and transient in both groups. PMID- 3535861 TI - Changes in diaphragmatic position in association with the induction of anaesthesia. AB - Images of a saggital section of the right hemidiaphragm were obtained using an ultrasound sector scanner in 20 patients in the supine position immediately before, and after, the induction of anaesthesia (with thiopentone). In the awake patient, the mean excursion of the part of the diaphragm that showed the greatest tidal movement was 1.56 +/- 0.52 (SD) cm. The end-expiratory position of this part of the diaphragm was noted before and after induction. Craniad movement of this position was seen in 10 patients. In a further eight, the end-expiratory position did not change, and in two patients it moved caudally. The mean movement was 0.36 +/- 0.52 cm in a cranial direction, which was statistically significant (P less than 0.01) but was only 23% of the movement associated with quiet breathing. The extent or direction of movement was not related to the weight of the patient (expressed as a proportion of the expected weight). The findings do not support the hypothesis that the reduction of lung volume on induction of anaesthesia is caused solely by movement of the diaphragm. PMID- 3535862 TI - Changes in pressor hormone concentrations in association with coronary artery surgery. Renin and vasopressin responses. AB - In 10 patients undergoing routine coronary artery surgery, plasma renin activity and vasopressin concentration were measured at intervals before the induction of anaesthesia, and for 6 h after bypass. In three patients plasma renin activity was increased, but the increases followed no particular pattern. Vasopressin concentrations increased in all 10 patients, but the changes were not significantly correlated with the postoperative arterial hypertension that was seen in seven of the patients. PMID- 3535863 TI - Recovery of cell subpopulations from human tumour xenografts following dissociation with different enzymes. AB - Human epidermoid tumours (Co112, HEp3, A431, ME180) grown in nude mice were dissociated using four different enzyme cocktails: 0.025% collagenase, 0.05% pronase, 0.04% DNase; 0.1% protease IX; 0.14% trypsin, 0.04% DNase; 0.025% collagenase, 0.02% DNase. Using these different enzymatic procedures, the total cell yields, host to tumour cell ratios, plating efficiencies and cell cycle distribution profiles obtained from each tumour model were compared. For all tumours tested, enzyme cocktail 1 was the most effective in releasing the greatest total number of cells g-1 tumour. However, for each tumour the percentage of neoplastic cells recovered, the plating efficiency and the cell cycle distributions varied according to the enzyme cocktail used to dissociate the tumour. For example, for HEp3 tumours, the highest plating efficiency was achieved using enzyme cocktail 4, whereas for ME180 tumours, this enzyme cocktail produced the lowest plating efficiency. Further, the effect of lethally irradiated (HR) feeder cells on the plating efficiency of the various tumours was found to be influenced by the enzymes chosen to dissociate the tumours. These studies indicate that the choice of an enzyme dissociation technique may profoundly influence the results obtained using human tumour xenografts. PMID- 3535864 TI - The immunohistochemical detection of lymph node metastases from infiltrating lobular carcinoma of the breast. AB - Immunological markers improve specificity and accuracy of cell detection, therefore it is important to evaluate their usefulness in improving standard histological procedures. This study investigates whether immunocytochemical techniques increase the accuracy of detection, in axillary lymph nodes, of metastatic cells from infiltrating breast lobular carcinoma (ILC). Fifty cases of ILC reported to be node-negative were selected. New serial sections were cut from a total of 767 lymph nodes, stained with H&E and tested in immunoperoxidase (ABC procedure) with a conventional anti-Epithelial Membrane Antigen (EMA) serum, with a monoclonal raised against human milk fat globule membranes (HMFG-2) and with a monoclonal against 54 kd keratin. Metastases were detected immunocytochemically in 12 cases (24%); in five of these cases metastatic cells were also visible in serial H&E sections. Monoclonals offered no evident advantage over anti-EMA conventional antiserum. Immunocytochemical positivity alone is not sufficient evidence for metastatic invasion since macrophages occasionally appear EMA- and HMFG-2-positive (probably because of secondary incorporation of the antigen), and so an improvement in the accuracy of breast cancer metastatic cell detection in axillary lymph nodes requires a combined histo-immunological approach. PMID- 3535865 TI - Histological, cytological and immunological analyses are complementary for the detection of neuroblastoma cells in bone marrow. AB - On 80 occasions 4 iliac biopsy trephines and 4 iliac aspirations were performed in 37 children with neuroblastoma at various stages of the disease. In 38 of these procedures, tumour cells were detected. In 24% of cases, both trephines and aspirates were positive, whereas in 63% neuroblastoma cells were detected only on the trephines and in 13% only on the aspirates. In addition, in 37% of the stagings, only one out of the 8 investigations was abnormal. Only in one of 33 pathological cases, was BM involvement diagnosed on trephine imprint. No involvement was ever observed on tibial and sternal aspirates without iliac involvement. Immunological studies with two monoclonal antibodies HSAN 1-2 and UJ13A were performed on 56 occasions. Cytohistological and immunological studies were concordant in 39. In 3 studies, the antigens recognized by the two monoclonal antibodies were not expressed by the initial tumour and in 3 additional studies immunological results were falsely negative; but in 11 cases monoclonal antibodies identified residual malignancy despite normal cytohistology. From this study, biopsies appear more helpful to detect malignant cells than aspirates. Immunological staining clearly leads to a better definition of tumour cells in aspirates. PMID- 3535866 TI - Scl 70 antibody--a specific marker of systemic sclerosis. AB - Scl 70 antibodies were tested for in 107 patients with systemic sclerosis: 68 with acrosclerosis and 39 with diffuse scleroderma. Anticentromere antibodies (ACA) and other antinuclear antibodies (ANA) were tested for by indirect immunofluorescence on HEp-2 cells. Positive results for Scl 70 antibodies were obtained in 77% of cases of diffuse scleroderma and 44% of acrosclerosis. ACA and Scl 70 antibodies were found to be mutually exclusive. If acrosclerosis cases positive for anticentromere antibodies are excluded, the percentage of acrosclerosis cases positive for Scl 70 was 63%. ACA were found to be a marker of a benign, abortive subset of acrosclerosis with almost no cutaneous involvement (CREST), whereas Scl 70 did not discriminate between acrosclerosis and diffuse scleroderma. On HEp-2 cells Scl 70 positive sera gave a characteristic, fine speckled, almost homogeneous nuclear staining pattern. PMID- 3535867 TI - Structure and function of the red cell membrane sialoglycoproteins. PMID- 3535868 TI - Determination of the plasma cell labelling index with bromodeoxyuridine in a double fluorescence technique. AB - A new technique is described in which plasma cells actively synthesizing DNA can be identified in a heterogeneous cell population such as bone marrow. This method uses bromodeoxyuridine (BrdU) and a fluorescent monoclonal antibody against BrdU in combination with cytoplasmic staining for immunoglobulin (Ig). In 26 patients with monoclonal gammopathy (MG) the plasma cell labelling index (LI) as determined by this immunofluorescent method was compared with the tritiated thymidine (3H-TdR) LI. No difference in sensitivity was found between the two methods. As the determination of the plasma cell LI with the BrdU/anti BrdU method is easy to perform and results can be obtained within 4 h, this immunofluorescent method seems to be an attractive alternative to the laborious time-consuming classic 3H-TdR LI. PMID- 3535869 TI - Autologous bone marrow transplantation for acute leukaemia in remission. AB - Between 1980 and 1985, 175 patients with acute leukaemia in first or subsequent complete remission (CR) were treated by chemotherapy or chemoradiotherapy followed by transfusion of autologous bone marrow cells that had been collected days or months previously. In 85 cases, autologous marrow cells were treated ex vivo with cytotoxic drugs or monoclonal antibodies with the intention of removing residual leukaemic cells. The actuarial relapse-free rate was 52% at 2 years. Of 89 patients autografted for acute non-lymphocytic (myeloid) leukaemia (ANLL), 60 were treated in first remission and 18 in second CR; their relapse-free rates at 2 years were 67% and 41% respectively (P less than 0.001). In contrast, of 77 patients autografted for acute lymphoblastic leukaemia (ALL), 32 were treated in first CR and 28 in second CR and their actuarial relapse free rates at 2 years were 56% and 55% respectively (P = NS). There was no significant difference in leukaemia relapse rates between patients autografted with purged and those autografted with non-purged marrow cells. These preliminary results suggest that autologous bone marrow transplantation may be valuable if offered to patients with ANLL in first CR or to patients with ALL in first or second CR but the need for marrow purging remains uncertain. PMID- 3535870 TI - Fetal and maternal uteroplacental leucocytes in aplastic anaemia. Case report. PMID- 3535872 TI - Double-blind controlled trial to compare anti-inflammatory effects of tolmetin 2%, prednisolone 0.5%, and placebo in post-cataract extraction eyes. AB - This paper compares the efficacy of tolmetin, prednisolone, and placebo (vehicle only) in controlling post-cataract extraction inflammation in a double-blind trial involving 120 patients. Seventeen patients were excluded from analysis. The results of the 103 patients analysed showed that 94% of the prednisolone treated group was judged to have been successfully treated as compared with 53% of the tolmetin treated group and 46% of the vehicle treated group. The differences between the prednisolone treated group and the other two groups were statistically significant (p less than 0.001). No statistical significance was found between the tolmetin and vehicle groups. PMID- 3535871 TI - Cryopreservation of rabbit corneas: assessment by microscopy and transplantation. AB - Rabbit corneas were frozen and thawed by three methods and compared by full thickness transplantation as well as specular microscopy, histology, and transmission electron microscopy. Two of the methods used a recently described technique, in which the excised cornea was immersed in a potassium-rich buffered solution containing the cryoprotectant dimethyl sulphoxide (Me2SO, 2 mol/l). This solution was designed to restrict the loss of intracellular potassium and to prevent cell swelling at low temperatures. In one group the corneas were frozen and thawed surrounded by 5 ml of medium, while in the second group corneas were drained of excess fluid and frozen in air. The third group consisted of corneas cryopreserved by Capella and colleagues' method. All the cryopreserved corneas were damaged, but those that had been frozen in air after exposure to the new medium showed better structure and function than corneas frozen by either of the other two techniques. PMID- 3535873 TI - The effect of rapid maxillary expansion on nasal airway resistance. AB - There has been a long-standing controversy over the efficacy of rapid maxillary expansion to relieve nasal obstruction and improve respiration. Recently rhinomanometry has provided a discipline for the investigation into nasal airway physiology with quantifiable parameters for evaluation and comparable studies. In this trial, a sample of 26 patients (13 male and 13 female, age range 10.10 to 19.6 years), receiving rapid maxillary expansion as part of their orthodontic mechano-therapy, were appraised for nasal airway resistance before and after expansion. The posterior rhinomanometric technique was used, measuring the respiratory flow between pharynx and the nostrils at a preset pressure difference between these two points. The formula for calculating the resistance is derived from the electrical Ohm's Law and requires that the pressure difference be divided by the flow. Reductions were recorded in all cases with an average of 36.2 per cent (range 11.6-58.6). The correlation between the resistance reductions and the delivered expansions (increases in trans-palatal widths) was weak (r = 0.32). In view of the probable significance of the liminal valve in nasal resistance, expansions in this area were assessed by changes in the trans alar widths. The correlation between trans-alar increases and the trans-palatal expansions was weak (r = 0.115), as it was between the trans-alar increases and the reductions in nasal airway resistance (r = 0.30). PMID- 3535874 TI - Practical and theoretical aspects of a method of orthodontic traction to unerupted teeth illustrated by three cases. AB - The methods of orthodontic management of unerupted teeth are critically discussed. The indications and contra-indications of the relatively new technique of gold chain traction via a directly bonded attachment are given. Three case reports illustrate different aspects of the technique. PMID- 3535875 TI - An Escherichia coli RNA polymerase tight-binding site on T7 DNA is a weak promoter subject to substrate inhibition. AB - A specific Escherichia coli RNA polymerase tight-binding (TB) site on bacteriophage T7 has been located at 32,988 base pairs from the left end of T7. This site is referred to as the T7 F promoter since it is fully active in vitro. Kinetics of association and dissociation have been measured by use of the abortive initiation assay and runoff transcription. The association constant, ka approximately 9 X 10(5) M-1 s-1, is of the same magnitude as ka for the T7 minor promoters. In competitive titration assays, the F promoter was found to be slightly weaker than the minor T7 E promoter at low RNA polymerase concentrations and, as expected, much weaker than the major T7 A3 promoter. An unusual RNA polymerase mediated inhibition of both the association rate and the transcriptional activity was observed at moderately high concentrations of polymerase. A mechanistic model analogous to enzyme substrate inhibition is presented. PMID- 3535876 TI - Active enzyme sedimentation, sedimentation velocity, and sedimentation equilibrium studies of succinyl-CoA synthetases of porcine heart and Escherichia coli. AB - Succinyl-CoA synthetases from Escherichia coli and porcine heart muscle have been viewed as prototypes of two classes of the enzyme. The bacterial enzyme has been reported to be an alpha 2 beta 2 tetramer, with many suggestions in the literature for cooperative interactions between active sites that may contribute to its catalytic efficacy. In contrast, gel filtration experiments of others have indicated that the heart enzyme is a simple alpha beta dimer, with no evidence of dimerization or interaction between like sites. All previous estimates of molecular size of these enzymes have been carried out at concentrations that are much higher than those that are used during activity measurements. The present study was carried out to confirm the differences in the quaternary structures of these two species of succinyl-CoA synthetase and to extend our knowledge of these structures to very low concentrations to enable correlation of their subunit structures with their catalytic properties. Conventional sedimentation velocity centrifugation with both enzymes indicates behavior typical of noninteracting globular proteins with no evidence of size heterogeneity. The sedimentation coefficients at infinite dilution (s20,w) have been determined to be 7.04 S and 4.55 S for the E. coli and porcine heart enzymes, respectively. Sedimentation velocity measurements have been extended to very low enzyme concentrations (typical of those used in activity measurements) by active enzyme centrifugation experiments, in which we have determined the rate of sedimentation of a zone of active enzyme through a chromogenic substrate solution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535877 TI - Folding of dihydrofolate reductase from Escherichia coli. AB - The urea-induced equilibrium unfolding transition of dihydrofolate reductase from Escherichia coli was monitored by UV difference, circular dichroism (CD), and fluorescence spectroscopy. Each of these data sets were well described by a two state unfolding model involving only native and unfolded forms. The free energy of folding in the absence of urea at pH 7.8, 15 degrees C is 6.13 +/- 0.36 kcal mol-1 by difference UV, 5.32 +/- 0.67 kcal mol-1 by CD, and 5.42 +/- 1.04 kcal mol-1 by fluorescence spectroscopy. The midpoints for the difference UV, CD, and fluorescence transitions are 3.12, 3.08, and 3.18 M urea, respectively. The near coincidence of the unfolding transitions monitored by these three techniques also supports the assignment of a two-state model for the equilibrium results. Kinetic studies of the unfolding and refolding reactions show that the process is complex and therefore that additional species must be present. Unfolding jumps in the absence of potassium chloride revealed two slow phases which account for all of the amplitude predicted by equilibrium experiments. Unfolding in the presence of 400 mM KCl results in the selective loss of the slower phase, implying that there are two native forms present in equilibrium prior to unfolding. Five reactions were observed in refolding: two slow phases designated tau 1 and tau 2 that correspond to the slow phases in unfolding and three faster reactions designated tau 3, tau 4, and tau 5 that were followed by stopped-flow techniques. The kinetics of the recovery of the native form was monitored by following the binding of methotrexate, a tight-binding inhibitor of dihydrofolate reductase, at 380 nm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535878 TI - Formation of mixed disulfide adducts at cysteine-281 of the lactose repressor protein affects operator and inducer binding parameters. AB - The lactose repressor protein has been modified with three sulfhydryl-specific reagents which form mixed disulfide adducts. Methyl methanethiosulfonate (MMTS) and 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB) completely reacted with all three cysteine residues, whereas only partial reaction was observed with didansylcystine. Cysteines-107 and -140 reacted stoichiometrically with MMTS and DTNB, while Cys-281 was modified only at higher molar ratios. Didansylcystine reacted primarily with cysteines-107 and -140. Affinity of MMTS-modified repressor for 40 base pair operator DNA was decreased 30-fold compared to unmodified repressor, and this decrease correlated with modification of cysteine 281. DTNB-modified repressor bound operator DNA with a 50-fold weaker affinity than unmodified repressor. Modification of the lac repressor with didanylcystine decreased operator binding only 4-fold, and nonspecific DNA binding increased 3 fold compared to unmodified repressor. No change in the inducer equilibrium binding constant was observed following modification with any of these reagents. In contrast, inducer association and dissociation rate constants were decreased approximately 50-fold for repressor completely modified with MMTS or DTNB, while didansylcystine had minimal effect on inducer binding kinetics. Correlation between modification of Cys-281 and the observed decrease in rate constants indicates that this region of the protein regulates the accessibility of the sugar binding site. The parallel between the increase in the Kd for repressor binding to operator, the altered rate constant for inducer binding, and modification of cysteine-281 suggests that this region of the protein is crucially involved in the function of the repressor protein. PMID- 3535879 TI - Characterization and modification of a monomeric mutant of the lactose repressor protein. AB - A monomeric mutant lactose repressor protein (T-41), containing serine at position 282 in place of tyrosine [Schmitz, A., Schmeissner, U., Miller, J. H., & Lu, P. (1976) J. Biol. Chem. 251, 3359-3366], has been purified by a series of chromatographic and precipitation methods. The molecular weight of the mutant as determined by gel filtration was approximately 40,000. The inducer equilibrium binding constant for the mutant was comparable to that of the tetrameric wild type repressor at pH 7.5, whereas operator DNA binding was not detectable. In contrast to wild-type repressor, equilibrium and kinetic rate constants for inducer binding to the monomer were largely independent of pH; thus, the quaternary structure of the wild-type repressor is required for the pH-associated effects on inducer binding. Although ultraviolet absorbance difference spectra indicated that inducer binding to T-41 protein elicited different changes in the environment of aromatic residues from those generated in wild-type repressor, the shift in the fluorescence emission maximum in response to inducer binding was similar for T-41 and wild-type repressors. Similarity in 1-anilinonaphthalene-8 sulfonic acid binding to monomer and tetramer suggests that this fluorophore does not bind at subunit interfaces. Modification of Cys-281 with methyl methanethiosulfonate was observed at low molar ratios of reagent per T-41 monomer (4-fold). This result is in contrast to data observed for tetrameric wild-type repressor which requires high molar ratios for this cysteine to react. We conclude that Cys-281, adjacent to the site of the T-41 mutation, is located on the surface of the monomer in this region crucial for subunit interaction. PMID- 3535880 TI - Allosteric regulation of inducer and operator binding to the lactose repressor. AB - The effects of cysteine modification and variations in pH on the equilibrium parameters for inducer and operator binding to the lactose repressor protein were examined. Operator binding affinity was minimally affected by increasing the pH from 7.5 to 9.2, whereas inducer binding was decreased for both the unliganded protein and the repressor-operator complex over the same range. Inducer binding to the repressor became more cooperative at high pH. The midpoint for the change in inducer affinity and cooperativity was pH 8.3; this value correlates well with cysteine ionization. The differential between repressor-operator affinity in the presence and absence of inducer was significantly decreased by modification of the protein with methyl methanethiosulfonate (MMTS). In contrast to unreacted protein, the inducer binding parameters for MMTS-modified repressor were largely unaffected by pH variation. The free energy for formation of the completely liganded protein was calculated for two pathways; the delta G values for these two independent routes were equivalent only for stoichiometries of four inducers and two operators per repressor molecule. All of the binding data were analyzed quantitatively by using a Monod-Wyman-Changeux two-state model for allosteric regulation. The observed dependences of the isopropyl beta-D-thiogalactoside binding curves on pH, DNA concentration, and MMTS modification were fitted by varying only the equilibrium constant between the two conformational states of the protein. With this analysis, high pH favors the T (high operator/low inducer affinity) state, while modification of cysteine-281 with MMTS elicits a shift into the R (high inducer/low operator affinity) state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535881 TI - Carbamoyl-phosphate synthetase: an example of effects on enzyme properties of shifting an equilibrium between active monomer and active oligomer. AB - Carbamoyl-phosphate synthetase from Escherichia coli is subject to allosteric activation by ornithine, allosteric inhibition by uridine 5'-phosphate (UMP), and reversible concentration-dependent self-association. Positive allosteric effectors, magnesium adenosine 5'-triphosphate (MgATP), K+, and inorganic phosphate facilitate association. The purpose of this study was to determine the state of association of carbamoyl-phosphate synthetase in the presence and absence of different substrates and effectors and to consider the basis for the observed effects of enzyme concentration on specific activity. Studies employing gel filtration chromatography have shown that when the concentration of carbamoyl phosphate synthetase is low (less than 0.01 mg/mL), the enzyme exists as monomer under all conditions, including the presence of UMP in phosphate buffer and the presence of all substrates plus ornithine (conditions that support maximal catalytic activity). At higher enzyme concentrations (e.g., greater than 0.01 mg/mL) the specific activity increases with increasing enzyme concentration when MgATP is nonsaturating but is independent of enzyme concentration when MgATP is saturating or when ornithine is present with MgATP being either saturating or nonsaturating. These results indicate that the catalytic activity of this enzyme is not directly linked to oligomer formation. The theoretical properties and possible significance of a generalized model of enzyme association-dissociation in which the active monomeric form, in equilibrium with another monomeric form, is specifically subject to self-association but the different states of association have the same specific activity, are discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3535882 TI - Kinetic and nuclear magnetic resonance study of the interaction of NADP+ and NADPH with chicken liver fatty acid synthase. AB - The ionic strength dependence of the second-order rate constant for the association of reduced nicotinamide adenine dinucleotide phosphate (NADPH) and chicken liver fatty acid synthase was determined. This rate constant is 7.2 X 10(7) M-1 s-1 at zero ionic strength and 25 degrees C; the effective charge at the cofactor binding sites is +0.8. The conformations of nicotinamide adenine dinucleotide phosphate (NADP+) and NADPH bound to the beta-ketoacyl and enoyl reductase sites were determined from transferred nuclear Overhauser effect measurements. Covalent modification of the enzyme with pyridoxal 5'-phosphate abolished cofactor binding at the enoyl reductase site; this permitted the cofactor conformations at the beta-ketoacyl and enoyl reductase sites to be distinguished. For NADP+ bound to the enzyme, the conformation of the nicotinamide-ribose bond is anti at the enoyl reductase site and syn at the beta ketoacyl reductase site; the adenine-ribose bond is anti, and the sugar puckers are C3'-endo. Nicotinamide-adenine base stacking was not detected. Structural models of NADP+ at the beta-ketoacyl and enoyl reductase sites were constructed by using the distances calculated from the observed nuclear Overhauser effects. Because of the overlap of the resonances of several nonaromatic NADPH protons with the resonances of HDO and ribose protons, less extensive structural information was obtained for NADPH bound to the enzyme. However, the conformations of NADPH bound to the two reductases are qualitatively the same as those of NADP+, except that the nicotinamide moiety of NADPH is closer to being fully anti at the enoyl reductase site. PMID- 3535883 TI - Phosphorylation-dephosphorylation of pyruvate dehydrogenase from bakers' yeast. AB - The pyruvate dehydrogenase complex was purified to homogeneity from bakers' yeast (Saccharomyces cerevisiae). No pyruvate dehydrogenase kinase activity was detected at any stage of the purification. However, the purified pyruvate dehydrogenase complex was phosphorylated and inactivated with purified pyruvate dehydrogenase kinase from bovine kidney. The protein-bound radioactivity was localized in the pyruvate dehydrogenase alpha subunit. The phosphorylated, inactive pyruvate dehydrogenase complex was dephosphorylated and reactivated with purified pyruvate dehydrogenase phosphatase from bovine heart. Tryptic digestion of the 32P-labeled complex yielded a single phosphopeptide, which was purified to homogeneity. The sequence of the phosphopeptide was established to be Tyr-Gly-Gly His-Ser(P)-Met-Ser-Asp-Pro-Gly-Thr-Thr-Tyr-Arg. This sequence is very similar to the sequence of a tryptic phosphotetradecapeptide derived from the alpha subunit of bovine kidney and heart pyruvate dehydrogenase: Tyr-His-Gly-His-Ser(P)-Met-Ser Asp-Pro-Gly-Val-Ser-Tyr-Arg. PMID- 3535884 TI - Fluorine-19 nuclear magnetic resonance studies of the structure of 5-fluorouracil substituted Escherichia coli transfer RNA. AB - 19F nuclear magnetic resonance has been used to study fully active Escherichia coli tRNA1Val in which 5-fluorouracil has replaced more than 90% of all uracil and uracil-derived modified bases. The 19F spectrum of the native tRNA contains resolved resonances for all 14 incorporated 5-fluorouracils. These are spread over a 6 ppm range, from 1.8 to 7.7 ppm downfield of the standard free 5 fluorouracil. The 19F resonances serve as sensitive monitors of tRNA conformation. Removal of magnesium or addition of NaCl produces major, reversible changes in the 19F spectrum. Most affected is the lowest field resonance (peak A) in the spectrum of the native tRNA. This shifts 2-3 ppm upfield as the Mg2+ concentration is lowered or the NaCl concentration is raised. Thermal denaturation of the tRNA results in a collapse of the spectrum to a single broad peak centered at 4.7 ppm. Study of the pH dependence of the 19F spectrum shows that five incorporated fluorouracils with 19F signals in the central, 4-5.5 ppm, region of the spectrum, peaks C, D, E, F, and H, are accessible to titration in the pH 4.5-9 range. All have pKa's close to that of free 5-fluorouridine (ca. 7.5). Evidence for a conformation change in the tRNA at mildly acidic pHs, ca. 5.5, is also presented. Four of the titratable 5-fluorouracil residues, those corresponding to peaks D, E/F, and H in the 19F spectrum of fluorine-labeled tRNAVal1, are essentially completely exposed to solvent as determined by the solvent isotope shift (SIS) on transfer of the tRNA from H2O to 2H2O. These are also the 5-fluorouracils that readily form adducts with bisulfite, a reagent that reacts preferentially with pyrimidines in single-stranded regions. On the basis of these results, resonances D, E, F, and H in the middle of the 19F spectrum are attributed to 5-fluorouracils in non-base-paired (loop) regions of the tRNA. Evidence from the ionic strength dependence of the 19F spectrum and arguments based on other recent studies with fluorinated tRNAs support earlier suggestions [Horowitz, J., Ofengand, J., Daniel, W. E., & Cohn, M. (1977) J. Biol. Chem. 252, 4418-4420] that the resonances at lowest field correspond to tertiary hydrogen bonded 5-fluorouracils. Consideration of ring-current effects and the preferential perturbation of upfield 19F resonances by the cyclophotoaddition of 4'-(hydroxymethyl)-4,5',8-trimethylpsoralen, which is known to react most readily with pyrimidines in double-stranded regions, permits initial assignment of upfield resonances to 5-fluorouracils in helical stems.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3535885 TI - Identification of form III conformers in tRNAPhe from Escherichia coli by intramolecular photo-cross-linking. AB - In the absence of divalent cations, at neutral pH, low ionic strength, and low to moderate temperature, tRNAs are known to be in a denatured form, designated form III in the tRNA phase diagram by Cole et al. [Cole, P. E., Yang, S. R., & Crothers, D. M. (1972) Biochemistry 11, 4358-4368]. Form III tRNAPhe from Escherichia coli has been studied at pH 7, 5 mM Na+, and 10 degrees C. As judged from ethidium bromide intercalation, it exhibits extensive secondary structure. 4 Thiouridine in position 8 of the tRNAPhe sequence was used as a built-in photoaffinity probe. Spectroscopic and spectrofluorometric analysis in the near UV range of form III tRNAPhe irradiated with broad-band near-UV light to completion of the reaction before or after reduction with NaBH4 revealed that the Pdo(4-5)Cyt (8-C) and Pdo(4-5)Urd (8-U) adducts form in equimolar yield. In different experiments, the overall yield of s4U conversion to these adducts varies between 20 and 40%. The remaining s4U is photolyzed to weakly absorbing product(s) in the near-UV range. The disappearance of s4U follows biexponential kinetics while the 8-C adduct formation follows monoexponential kinetics, indicating the presence of at least two tRNA classes of conformers, not in equilibrium on the time scale of the reaction. Migration on a denaturing polyacrylamide gel of irradiated form III tRNAPhe revealed three main bands, D1, D2, and D3, and no slowly migrating tRNA dimers. D1 migrates at the control position and presumably contains the photolysis product(s) P. The fast-migrating D2 and D3 bands contain 8-Pyr cross-links which were identified by sequence analysis as 8-(66-68) in D2 and 8-(40-43) and 8-(59-62) in D3. On the basis of these data, it is proposed that the minor poorly photoreactive class II conformers are the cloverleaf and close variants, whereas the major class I cross linkable conformers are essentially long-extended secondary structures. Clearly, our data demonstrate the polymorphism of form III tRNAPhe. PMID- 3535886 TI - Imino proton exchange in the 5S RNA of Escherichia coli and its complex with protein L25 at 490 MHz. AB - Imino proton exchange has been examined by NMR in the 5S RNA of Escherichia coli, its principal RNase A resistant fragment, fragment 1 (bases 1-11, 69-120), and complexes between that fragment and ribosomal protein L25 by using both real-time and relaxation techniques. Fragment 1 RNA imino protons exchange at rates between 0.5 and 15 s-1 at 303 K in 5 mM cacodylate buffer, pH 7.4. In contrast with many tRNAs, intact 5S RNA contains no imino protons with exchange lifetimes as great as 1 min. Consistent with the results of Gueron and his colleagues [Leroy, J. L., Bolo, N., Figueroa, N., Plateau, P., & Gueron, M. (1985) J. Biomol. Struct. Dyn. 2,915-939; Leroy, J. L., Broseta, D., & Gueron, M. (1985) J. Mol. Biol. 184, 165 178] with tRNA, exchange in 5S RNA is catalyst-limited under conditions generally used for imino proton spectroscopy, such as those given above. Using Gueron's catalyst saturation technique, base pair opening rates have been measured for several AU and GU base pairs in fragment 1. They range from 50 to 300 s-1 at 303 K and depend on base pair type and also to some degree on context. Similar studies have been done on complexes of L25 and fragment 1. The binding of L25 to fragment 1 reduces the exchange rate of many imino protons within the region to which it binds, consistent with the hypothesis that its binding stabilizes the secondary structure of 5S RNA. PMID- 3535888 TI - Secondary structure of acyl carrier protein as derived from two-dimensional 1H NMR spectroscopy. AB - Sequence-specific assignments of 1H NMR resonances were obtained for the backbone protons in acyl carrier protein (ACP) from Escherichia coli, a protein of 77 residues. The observations, in the NOESY spectra, of 1H-1H sequential and medium range connectivities indicate the presence of three or four alpha-helical segments joined by short sequences of mixed conformations. The observations are used to refine a secondary structure model previously proposed on the basis of a Chou-Fasman algorithm [Rock, C. O., & Cronan, J. E., Jr. (1979) J. Biol. Chem. 254, 9778-9785]. PMID- 3535887 TI - Processivity of T4 endonuclease V is sensitive to NaCl concentration. AB - We previously reported that endonuclease V of bacteriophage T4 reacts processively with pyrimidine dimers in UV-irradiated DNA, tending to react with all of the dimers on one DNA molecule before reacting with any dimers on another DNA molecule [Lloyd, R. S., Hanawalt, P. C., & Dodson, M. L. (1980) Nucleic Acids Res. 8, 5113-5127]. In this paper we show that this processivity depends upon salt concentration: it can be detected in 10 mM NaCl but not, by our methods, in 100 mM NaCl. In addition, we show that endonuclease V binds to unirradiated DNA in 10 mM NaCl but not in 100 mM NaCl. We conclude that T4 endonuclease V binds to pyrimidine dimers in a two-step process in 10 mM NaCl. It first binds electrostatically to undamaged sections of DNA, and it remains bound during the second step in which it "searches" for pyrimidine dimers. Our conclusion is analogous to the expanded target theory developed for Lac repressor [Berg, O. G., Winter, R. B., & von Hippel, P. H. (1981) Biochemistry 20, 6929-6948]. PMID- 3535889 TI - Pressure dissociation and conformational drift of the beta dimer of tryptophan synthase. AB - Micromolar solutions of tryptophan synthase beta 2 dimer dissociate into monomers in the pressure range of 800-1600 bars as shown by studies of the spectral shift of the intrinsic fluorescence and of the fluorescence polarization of dansyl conjugates. At 25 degrees C the standard change in volume on dissociation (dV0) of the holoprotein was -162 mL mol-1, and the dissociation constant at 1 bar was K0 = 3.7 10(-10) M. Pyridoxal-reduced holoprotein and apoprotein had, within 10%, the same dV0, but K0 was decreased in the reduced protein (6 X 10(-11) M) and increased in the apoprotein (3.6 X 10(-9) M). At 4 degrees C the free energy of association of the holoprotein was reduced by 1.4 kcal mol-1, but dV0 was unchanged. In all the protein forms the decompression curves differed from the respective compression curves, indicating the loss of some free energy of association following separation of the monomers. This hysteretic behavior was largest in the apoprotein and amounted to a loss of 2.6 kcal mol-1 in the free energy of association. When the pressure was rapidly raised to 2.2 kbars, half dissociation of the reduced pyridoxal beta 2 dimer took approximately 12 min. Upon return to atmospheric pressure reassociation was complete in 2-3 min and half of the enzyme activity was regained in 10 min; pyridoxal fluorescence recovered more slowly with a biphasic course. The independent return of these properties and the hysteretic behavior indicate that subunit separation is followed by a conformational drift like that observed in lactate dehydrogenase dissociated by either pressure or temperature or in enolase dissociated by dilution. PMID- 3535890 TI - Specific substitution into the anticodon loop of yeast tyrosine transfer RNA. AB - The aminoacylation kinetics of 19 different variants of yeast tRNATyr with nucleotide substitutions in positions 33-35 were determined. Substitution of the conserved uridine-33 does not alter the rate of aminoacylation. However, substitution of the anticodon position 34 or position 35 reduces Km from 2- to 10 fold and Vmax as much as 2-fold, depending on the nucleotide inserted. The ochre and amber suppressor tRNAsTyr both showed about a 7-fold reduction in Vmax/Km. Data from tRNATyr with different modified nucleotides at position 35 suggest that specific hydrogen bonds form between the synthetase and both the N1 and N3 hydrogens of psi-35. The effect of simultaneous substitutions at positions 34 and 35 can be predicted reasonably well by combining the effects of single substitutions. These data suggest that yeast tyrosyl-tRNA synthetase interacts with positions 34 and 35 of the anticodon of tRNATyr and opens the possibility that nonsense suppressor efficiency may be mediated by the level of aminoacylation. PMID- 3535892 TI - Possible role of histidine in the L-proline transport system of Saccharomyces cerevisiae. AB - The L-proline transport system of Saccharomyces cerevisiae is shown to be specifically inactivated upon incubation of intact yeast cells with the histidine modifier diethylpyrocarbonate. The extent of inactivation is half-maximum at 0.5 mM diethylpyrocarbonate for an incubation of 2 min at 30 degrees C and pH 6.0. Under the same conditions, the time dependence of inactivation is monophasic with the second-order rate constant of 5.5 M-1 X s-1 and the maximum rate Jmax of L proline transport is lowered by about 50%, while the KT value remains unchanged. Moreover, L-proline afforded significant protection against diethylpyrocarbonate inactivation. The complete reactivation of a partially inactivated L-proline transport system by neutral hydroxylamine and the elimination of the possibility that the modification of other amino acid residues are responsible for the inactivation, suggested that the transport protein inactivation occurs solely by a modification of histidine residues. PMID- 3535891 TI - Phosphatidylserine decarboxylase: generation of asymmetric vesicles and determination of the transbilayer distribution of fluorescent phosphatidylserine in model membrane systems. AB - Large unilamellar vesicles (LUV) that contained a fluorescent analog of phosphatidylserine (NBD-PS) were used in model systems to determine the feasibility of employing phosphatidylserine decarboxylase (PS-decarboxylase) to generate asymmetric vesicles and to determine the transbilayer distribution of PS. PS-decarboxylase prepared by sonication of Escherichia coli JA 200 pLC 8-47 was found to be stable in detergent-free buffers and catalyzed the conversion of NBD-PS to NBD-phosphatidylethanolamine (NBD-PE). PS-decarboxylase was capable of decarboxylating virtually all of the NBD-PS present in the outer leaflet of LUV containing a symmetric or asymmetric (outside only) distribution of NBD-PS, but not NBD-PS present in the inner leaflet of the vesicles. The ability of PS decarboxylase to decarboxylate only NBD-PS located in the outer leaflet of the vesicles was independently verified by resonance energy transfer (between NBD-PS and (lissamine) rhodamine B-labeled phosphatidylethanolamine) and by derivatization with trinitrobenzenesulfonic acid (TNBS). These techniques revealed that the exchangeable pool (the fraction of NBD-PS on the outer leaflet) and the respective fraction of Tnp-(NBD-PS) formed were equivalent to the extent of PS-decarboxylase-mediated decarboxylation of NBD-PS to NBD-PE. These results show that PS-decarboxylase can be used to generate asymmetric vesicles (i.e., PS inside, PE outside) and determine the intrabilayer distribution of PS in model membranes. PMID- 3535893 TI - Biochemical and morphological properties of membranes of unsaturated fatty acid auxotrophs of Salmonella typhimurium: effects of fluorinated myristic acids. AB - In order to investigate the utility of the fluorine-19 nucleus as a spectroscopic probe, a fluorinated analog of myristic acid has been incorporated into the membrane lipids of an unsaturated fatty acid auxotroph of Salmonella typhimurium. It is capable of supporting limited growth at temperatures above 37 degrees C. Freeze-fracture electron microscopic examinations of the membrane ultrastructure show a temperature and fatty acid supplement-dependent segregation of intramembranous protein particles into distinct patches in the auxotrophic membrane leaving intramembranous protein-denuded areas. The occurrence of these patches seems to be related to the phase separation of membrane lipids. Corresponding changes in the transport and accumulation of methyl thio-beta-D galactopyranoside and tetracycline are observed. However, transport of histidine does not appear to be dependent on the physical state of the membrane lipids. The auxotroph shows differences in growth and morphological characteristics from those of the wild type. Functions of both inner and outer membranes are shown to be affected as a response to the fatty acid chain composition of the lipids. PMID- 3535894 TI - An assessment of the ability of yeast cells to incorporate photolabile fatty acids into their membrane phospholipids in vivo. AB - The photolabile fatty acids 12-azidooleic, 12-(4-azido-2-nitrophenoxy)oleic, 12 azidolauric and 12-(4-azido-2-nitrophenoxy)lauric are readily taken up in vivo by an unsaturated fatty acid auxotroph of Saccharomyces cerevisiae. A low level of the two lauric acid derivatives and none of the two oleic acid derivatives are incorporated into membrane phospholipids. Under certain conditions of growth in the presence of 12-(4-azido-2-nitrophenoxy)oleic acid, the nitrophenylazide group is metabolized to a product that lacks the photolabile azido group. PMID- 3535895 TI - Vanadyl ions increase the order parameter of plasma membranes without changing the rotational relaxation time. AB - Differential polarized phase fluorometry of 1,6-diphenyl-1,3,5-hexatriene showed that vanadyl ions (VO2+) increased its limiting anisotropy (order parameter) in crude plasma membranes from brown adipose tissue of the golden hamster (Mesocricetus auratus). This was about 10(3) times larger than the effect of Ca2+ and was several times greater than the action of Co2+. Vanadate anions were without any effect. During the membrane treatment with VO2+, the rotational relaxational time of diphenylhexatriene did not change. This results suggest a possible positive influence of tetravalent vanadium on the stability of cell membranes. PMID- 3535896 TI - The secondary structure of salt-extracted ribosomal proteins from Escherichia coli as studied by circular dichroic spectroscopy. AB - Ribosomal proteins from Escherichia coli MRE600 have been obtained by a new, mild purification procedure. This involves extraction of the subunits with salt followed by chromatographic fractionation in the presence of salt. The use of urea or other denaturing agents and conditions is avoided. A survey of the secondary structure of the 30 S and 50 S proteins, as observed by circular dichroic spectroscopy, is presented. The spectra have been analysed by a new procedure which uses a library of 16 circular dichroic spectra of proteins with a known three-dimensional structure. This method provides a more reliable analysis, especially of the contribution from beta-sheet. The results show that most of the 30 S proteins have a high alpha-helix content, whereas the 50 S proteins are more diverse. The latter group shows a larger contribution from beta-sheet. The data presented here are compared with those already published for a number of proteins which were, with one exception, prepared in the presence of urea. In most cases we find higher alpha-helix and beta-sheet values for the salt-extracted proteins than for the corresponding urea-treated proteins. In those cases, however, where special care was taken to renature the urea-treated proteins agreement is found to within the expected experimental error. The results show that salt-extracted ribosomal proteins have a well-defined secondary structure with a relatively small contribution from unordered structure. PMID- 3535897 TI - Acyl-CoA:dihydroxyacetone phosphate acyltransferase in human skin fibroblasts: study of its properties using a new assay method. AB - In relation to the finding that human skin fibroblasts are capable of de novo either phospholipid biosynthesis, we have studied the properties of acyl CoA:dihydroxyacetone phosphate acyltransferase in fibroblast homogenates using a new assay method. The results indicate that the acylation of dihydroxyacetone phosphate shows an optimum at pH 5.5 with a broad shoulder of activity up to pH 6.4 and a decline in activity up to pH 8.2. At pH 5.5 the acyltransferase accepts dihydroxyacetone phosphate, but not glycerol 3-phosphate as a substrate. Furthermore, the transferase activity was found to be membrane-bound and inactivated by Triton X-100 at concentrations above 0.025% (w/v). Similar properties have been described for the enzyme as present in rat-liver and guinea pig liver peroxisomes. These data, together with the finding that acyl CoA:dihydroxyacetone phosphate acyltransferase is deficient in cultured skin fibroblasts from patients without peroxisomes (Zellweger syndrome), suggest that in cultured skin fibroblasts the enzyme is primarily located in peroxisomes. PMID- 3535898 TI - Development of enzyme immunoassay for serum 13,14-dihydro-15-ketoprostaglandin F2 alpha. AB - An enzyme immunoassay was developed for a convenient and sensitive assay of 13,14 dihydro-15-ketoprostaglandin F2 alpha, a metabolite of prostaglandin F2 alpha appearing in human blood. The compound was chemically conjugated to beta galactosidase from Escherichia coli. The enzyme-labeled antigen was mixed with a sample containing 13,14-dihydro-15-ketoprostaglandin F2 alpha, and the mixture was allowed to react competitively with the antibody immobilized in a polystyrene tube. The activity of beta-galactosidase bound to the antibody was assayed by fluorometry. The enzyme activity was plotted against the amount of authentic 13,14-dihydro-15-ketoprostaglandin F2 alpha to obtain a calibration curve, and the compound was detectable over a range of 10 fmol to 10 pmol. Prostaglandins were extracted from human serum by the use of an octadecylsilyl silica column, and the extract gave an abnormally high level of 13,14-dihydro-15 ketoprostaglandin F2 alpha by enzyme immunoassay due to the presence of unidentified interfering substance(s), which was removed by high-performance liquid chromatography (HPLC). The purified material gave a value in the order of 0.1 pmol per ml of human serum. Validity of the enzyme immunoassay was confirmed by radioimmunoassay and gas chromatography/mass spectrometry (GC-MS) of a methyl ester n-butoximedimethylisopropylsilyl ether derivative. PMID- 3535899 TI - Glucose-induced phospholipid hydrolysis in isolated pancreatic islets: quantitative effects on the phospholipid content of arachidonate and other fatty acids. AB - Our recent findings indicate that glucose-induced insulin secretion from isolated pancreatic islets is temporally associated with accumulation of substantial amounts of free arachidonic acid and that arachidonate may serve as a second messenger for intracellular calcium mobilization in islets. In an effort to determine the source of this released arachidonate, the endogenous fatty acid composition of phospholipids from islets has been determined by thin-layer chromatographic separation of the phospholipids, methanolysis to the fatty acid methyl esters, and quantitative gas chromatographic analyses. The relative abundance of phospholipids in islets as judged by their fatty acid content was phosphatidylcholine (PC), 0.63; phosphatidylethanolamine (PE), 0.23; phosphatidylinositol (PI), 0.067; phosphatidylserine (PS), 0.049. Arachidonate constituted 17% of the total islet fatty acid content, and PC contained 43% of total islet arachidonate. Islets incubated with [3H]arachidonate in the presence of 28 mM D-glucose incorporated radiolabel into PC with a considerably higher specific activity than that of PE, PS or PI. The total fatty acid content of PC from islets incubated with 28 mM glucose for 30 min was significantly lower than that of islets incubated with 3 mM glucose, and smaller effects were observed with PE, PS and PI. The molar decrement in PC arachidonate was 3.2 pmol/islet under these conditions, which is sufficient to account for the previously observed accumulation of free arachidonate (2 pmol/islet). A sensitive method involving negative ion-chemical ionization-mass spectrometric analyses of the pentafluorobenzyl esters of fatty acids derived from trace amounts of lysophosphatidylcholine (lyso-PC) was developed, and glucose-stimulation was found to reduce islet lyso-PC content by about 10-fold. These findings indicate that the insulin secretagogue D-glucose induces phospholipid hydrolysis in islets and suggest that PC may be the major source of free arachidonate which accumulates in glucose-stimulated islets. PMID- 3535900 TI - Kinin-releasing enzyme from the venom of Bitis arietans (puff adder). AB - A kinin-releasing enzyme was isolated from Bitis arietans (puff adder) venom by Sephadex G-100 and DEAE-cellulose column chromatographies. The kinin-releasing enzyme was shown to be homogeneous as demonstrated by a single band on acrylamide gel electrophoresis, isoelectric focusing, sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunodiffusion. Its molecular mass is approximately 45 kDa with an isoelectric point of 6.5. Kinin-releasing enzyme possesses proteolytic activity which hydrolyzes the Leu6-Cys7, His10-Leu11 and Ala14-Leu15 bonds of the B chain of oxidized insulin and the A alpha and B beta chain of fibrinogen. Kinin-releasing and benzoyl-L-arginine ethyl ester hydrolytic activities of this enzyme were inhibited by diisopropyl fluorophosphate, suggesting that the serine hydroxyl group is involved in enzymatic activities. PMID- 3535901 TI - Tunicamycin and papulacandin B inhibit incorporation of specific mannoproteins into the wall of Candida albicans regenerating protoplasts. AB - Regeneration of Candida albicans protoplasts began with the formation of a chitin network which was complemented after a lag of about 60 min by the deposition of beta-glucan. Proteins were incorporated early to the growing structure, beginning with the mannoproteins which are kept in place by non-covalent bonds. Incorporation of covalently linked mannoproteins took place only after deposition of glucan. The incorporation of these mannoproteins did not occur when protoplasts were incubated with papulacandin B which inhibited glucan formation, or with tunicamycin which blocked N-glycosylation of mannoproteins. In the presence of papulacandin B, large amounts of native mannoproteins accumulated in the medium. However, in the presence of tunicamycin, the large mannoprotein material found was of smaller apparent molecular weight, suggesting that it was deficient in glycosylation. Partially regenerated walls were able to incorporate 'in vitro' non-covalently bound mannoproteins, indicating that some components of very large cellular structures such as walls are capable of being articulated by a self-assembly process. PMID- 3535902 TI - T-kinin is released from T-kininogen by consecutive cleavage by cathepsin E-like proteinase and 72 kDa proteinase. AB - Using highly purified T-kininogen and cathepsin E-like proteinase and 72 kDa proteinase in rat spleen, the release of T-kinin from T-kininogen was found to occur by consecutive cleavage by cathepsin E-like proteinase and 72 kDa proteinase. 72 kDa proteinase seems to be serine proteinase, because it was completely inhibited by diisopropyl fluorophosphate but not by pepstatin, leupeptin and bestatin. PMID- 3535903 TI - Guanine nucleotides reduce the free calcium requirement for secretion of granule constituents from permeabilized human neutrophils. AB - Human neutrophils can be permeabilized with the cholesterol complexing agent digitonin and then induced to secrete lysosomal constituents by increases in free Ca2+ alone. In order of increasing requirements for Ca2+, vitamin B-12 binding protein, lysozyme and beta-glucuronidase were released. A variety of guanine nucleotides were examined with respect to their abilities to modulate this response. GTP, along with its analogues 5'-guanylylimidodiphosphate (Gpp[NH]p) and guanosine-5'-O-[3-thio]-triphosphate (GTP[gamma S]) decreased the Ca2+ requirements for secretion of all three granule constituents by one third to one order of magnitude. This synergy was dependent upon the concentration of guanine nucleotides employed. The effects of Gpp[NH]p could be blocked with the inactive derivative GDP[beta-S]. The active guanine nucleotides, particularly GTP, served as stimuli in their own right. At high concentrations of Ca2+ and GTP, degranulation was strikingly inhibited; inhibition was also achieved with high concentrations of guanylyl[beta, gamma-methylene]diphosphate (Gpp[CH2]p). Both GDP and GMP were without any effect. When neutrophils were pretreated with pertussis toxin, granule discharge induced by fMet-Leu-Phe was almost completely blocked, as reported by others. If the neutrophils pretreated with pertussis toxin were then permeabilized with digitonin, the synergy between Ca2+ and the stimulatory guanine nucleotides was maintained. These data suggest the involvement of G-proteins in secretion induced by Ca2+; however, this response either uses a different G-protein or a different pool of G-proteins from those responses triggered by fMet-Leu-Phe. PMID- 3535904 TI - The effects of alpha- and beta-adrenergic agents, Ca2+ and insulin on 2 deoxyglucose uptake and phosphorylation in perfused rat heart. AB - Insulin (0.1 microM) and 1 microM epinephrine each increased the uptake and phosphorylation of 2-deoxyglucose by the perfused rat heart by increasing the apparent Vmax without altering the Km. Isoproterenol (10 microM), 50 microM methoxamine and 10 mM CaCl2 also increased uptake. Lowering of the perfusate Ca2+ concentration from 1.27 to 0.1 mM Ca2+, addition of the Ca2+ channel blocker nifedipine (1 microM) or addition of 1.7 mM EGTA decreased the basal rate of uptake of 2-deoxyglucose and prevented the stimulation due to 1 microM epinephrine. Stimulation of 2-deoxyglucose uptake by 0.1 microM insulin was only partly inhibited by Ca2+ omission, nifedipine or 1 mM EGTA. Half-maximal stimulation of 2-deoxyglucose uptake by insulin occurred at 2 nM and 0.4 nM for medium containing 1.27 and 0.1 mM Ca2+, respectively. Maximal concentrations of insulin (0.1 microM) and epinephrine (1 microM) were additive for glucose uptake and lactate output but were not additive for uptake of 2-deoxyglucose. Half maximal stimulation of 2-deoxyglucose uptake by epinephrine occurred at 0.2 microM but maximal concentrations of epinephrine (e.g., 1 microM) gave lower rates of 2-deoxyglucose uptake than that attained by maximal concentrations of insulin. The addition of insulin increased uptake of 2-deoxyglucose at all concentrations of epinephrine but epinephrine only increased uptake at sub maximal concentrations of insulin. The role of Ca2+ in signal reversal was also studied. Removal of 1 microM epinephrine after a 10 min exposure period resulted in a rapid return of contractility to basal values but the rate of 2-deoxyglucose uptake increased further and remained elevated at 20 min unless the Ca2+ concentration was lowered to 0.1 mM or nifedipine (1 microM) was added. Similarly, removal of 0.1 microM insulin after a 10 min exposure period did not affect the rate of 2-deoxyglucose uptake, which did not return to basal values within 20 min unless the concentration of Ca2+ was decreased to 0.1 mM. Insulin mediated increase in 2-deoxyglucose uptake at 0.1 mM Ca2+ reversed upon hormone removal. It is concluded that catecholamines mediate a Ca2+-dependent increase in 2-deoxyglucose transport from either alpha or beta receptors. Insulin has both a Ca2+-dependent and a Ca2+-independent component. Reversal studies suggest an additional role for Ca2+ in maintaining the activated transport state when activated by either epinephrine or insulin. PMID- 3535905 TI - Role of the decrease in ionized calcium in the inhibition of insulin release by chloride-free solutions. AB - Replacement of extracellular Cl- by isethionate or sulfate during stimulation with glucose or tolbutamide reversibly inhibited insulin release by perifused mouse islets. The concentration of ionized Ca2+ was decreased by 30 and 55% in isethionate and sulfate solutions, respectively. If this fall was prevented, the inhibition of release was only slightly affected (isethionate) or substantially attenuated (sulfate). In conclusion, the inhibition of insulin release occurring in Cl(-)-free solutions cannot be completely ascribed to a decrease in ionized Ca2+ in the medium. The contribution of this latter depends on the Cl- substitute. PMID- 3535906 TI - [31P NMR study of changes in the intracellular pH of Escherichia coli after freezing-thawing]. AB - Influence of two types of freezing, at -196 and -50 degrees C with following thawing of Escherichia coli cells at 37 degrees C on the value of intracellular pH has been studied by means of 31P NMR spectroscopy. All the cycles of freeze thawing have been shown to result in acidification of intracellular medium on 1.0 unit pH apart from the freezing type. The extracellular medium (pHex) was acidified too, but the degree of pHex changes after freeze-thawing depended on the freezing depth. PMID- 3535907 TI - [The character of K+ uptake in anaerobically grown S. typhimurium]. AB - Tre character of K+ uptake in anaerobically grown S. typhimurium LT-2 is studied. In the alkaline media with glucose and moderate K+ activity these bacteria uptake K+ in two steps, the first of which has a high rate of K+ uptake, Km 2.1 mM and Vmax 0.44 mM/g. min and is sensitive to the medium osmolarity. Bacteria transfer from the media with high osmolarity to that with low one leads to a decrease of K+ uptake at the first step. The second increase of the medium osmolarity turns on the rapid K+ uptake only at alkaline pH. K+ uptake at the first step is inhibited by DCC and protonophores. In the absence of phosphate in the medium arsenate blocks K+ uptake at the first step, and when phosphate is available arsenate decreases K+ uptake. Valinomycin decreases the rate of K+ uptake. K+ uptake at the first step in S. typhimurium proceeds via Trk-like system which requires for K+ uptake both ATP and delta mu H+. PMID- 3535908 TI - [Physiological role of the creatine kinase system and the problem of regulating the activity of mitochondrial creatine kinase]. AB - The review contains the analysis of present-day concepts on the physiological role of the creatine kinase system. A hypothesis on the buffering functions of the creatine kinase system which ensures a constant ATP level in cells and a hypothesis according to which phosphocreatine is a macroergic phosphate carrier from mitochondria to the sites of their utilization are considered. In connection with the creatine phosphate carrier hypothesis according to which the transport function of the creatine kinase system is provided for by an effective function of mitochondrial creatine kinase, feasible mechanisms of mitochondrial creatine kinase activity regulation are considered: as a result of creation of local concentration of nucleotide substrates as well as changes in the properties of creatine kinase itself which may result from the enzyme conversion from the membrane-bound to the free form or from the interconversion of oligomeric forms of the enzyme. PMID- 3535909 TI - Serum and human milk IgA and zinc concentration after successful renal transplantation. AB - Although breast-feeding in renal transplant patients has been discouraged because of the potential risk to the infant from the immunosuppressive drugs, two of our patients chose to breast-feed their infants for 3-4 months period. Serum and human milk IgA and zinc concentration were measured by the immunodiffusion and atomic absorption spectrophotometry method, respectively. Human milk IgA and zinc levels were at the lower normal limits one week posttransplant and were found to be slightly decreased after three months of lactation. Although serum IgA and zinc levels were not measured to breast-feed infants they were both found to have normal blood counts, no increase in infections and above average growth rate. PMID- 3535910 TI - The significance of ponderal index as a prognostic factor in a low-birth-weight population. AB - Neonatal prognostic significance of some biometric parameters in a population study of 331 low-birth-weight newborns was investigated. Multiple logistic regression analysis demonstrates that length, head size and weight are the best predictors of neonatal outcome in small for gestational age (SGA) newborns. In the population of SGA newborns biometric parameters more affected by growth failure were thoracic circumference, weight, head circumference and length, in that order. It seems that the best parameters for the sonographic diagnosis of growth failure are the poorest predictors of neonatal outcome. The possible role of ponderal index as an expression of fetal and neonatal well-being is discussed. PMID- 3535911 TI - Failure of placenta to produce hPL in an otherwise uneventful pregnancy: a case report. AB - We report a further case of human placental lactogen (hPL) deficiency associated with a normal pregnancy. To our knowledge this is the first report in which the examination of placenta by means of the immunoperoxidase technique confirmed that hPL was absent from the trophoblast. PMID- 3535912 TI - Forty years of peptide chemistry. PMID- 3535913 TI - Application of an immobilized penicillin acylase to the deprotection of N phenylacetyl insulin. PMID- 3535914 TI - NMR analysis of the conformations of membrane-bound peptides. PMID- 3535915 TI - Further aspects of gonadotropin-releasing hormone research. PMID- 3535916 TI - Chemical synthesis of India cobra cytotoxin II by solid-phase condensation of fragments. PMID- 3535918 TI - Yeasts in molecular biology. Spheroplast preparation with Candida utilis, Schizosaccharomyces pombe and Saccharomyces cerevisiae. PMID- 3535917 TI - Pharmacokinetics of insulin following intravenous and subcutaneous administration in canines. AB - Studies were conducted to examine the absorption and disposition kinetics of insulin in dogs following intravenous (IV) and subcutaneous (SC) administration of commercial preparations. After IV and SC dosing, the plasma levels were described by models which considered basal insulin level contributions. Intersubject variation in the disposition kinetics was small with half-lives of 0.52 +/- 0.05 h and total body clearances of 16.21 +/- 2.08 ml min-1 kg-1. Calculated insulin plasma secretion rates in the canines were 14.4 +/- 3.3 mUh-1 kg-1. Following SC injection of regular insulin, the rate and extent of absorption were noted to be quite variable. The absorption process appeared first order with half-life values of 2.3 +/- 1.3 h and extents of absorption of 78 +/- 15 per cent with a range of 55-101 per cent. Insulin absorption from SC NPH preparations was evaluated as being composed of two zero-order release phases, a rapid and a slow release phase. With a dose of 1.65 U kg-1, the rapid release phase had an average duration of 1.5 h and a rate of 580 +/- 269 mUh-1 (4.2 per cent of dose) while the slow phase had a zero-order rate of 237 +/- 92 mU h-1 which continued beyond 12 h. The extent of absorption from the NPH preparation was 23.6 +/- 5.1 per cent and was significantly lower than that for the regular injection. PMID- 3535920 TI - International nomenclature of constitutional diseases of bones with bibliography. PMID- 3535919 TI - Monoclonal antibodies to rabbit liver cathepsin B. AB - Three stable hybridoma cell lines (AF8, BC11, CE2) have been produced that secrete antibodies specific for cathepsin B. These have been characterized by ELISA, SDS-PAGE immunostaining, immunoprecipitation and immunofluorescent staining. CE2 immunoprecipitated native cathepsin B with retention of enzymic activity, but failed to cross-react with the alkali-denatured enzyme. BC11 bound only to the denatured form of cathepsin B and AF8 cross-reacted with both native and denatured cathepsin B. However, unlike CE2-immunoprecipitated enzyme, activity could be detected only after dissociation of the antigen-AF8 antibody complex. No cross reaction was found with any lysosomal protein including the cysteine proteinases, cathepsins H and L. PMID- 3535921 TI - [Experimental study of the effect of captopril on pain reactions]. AB - The experiments on the electrical stimulation of the isolated guinea-pig ileum have shown that captopril (10(-6)-10(-4) g/ml) caused dose-dependent inhibition of the organ contractions, abrogated by naloxone. In mice, the drug in the doses of 0.1 to 0.5 mg/kg administered subcutaneously had hyperalgesic effect and, with the dose increase (1-25 mg/kg), progressively attenuated the degree of nociceptive reactions caused by thermal and chemical stimulation. When kininogen accumulations were depleted due to the injection of kininogenase activator cellulose sulfate, captopril in all the doses studied had an analgetic effect, with it reduced by naloxone. The data obtained show that dipeptidyl carboxypeptidase inhibition by captopril can affect the degree of nociceptive reactions caused by various nociceptive stimuli. PMID- 3535922 TI - [Use of germ-free mice in experimental transplantation]. AB - A comparative study of skin allografts was performed in germ-free A/Ola mice kept in boxes and in A/Ola and BALB mice raised in ordinary conditions. Skin graft (of C57B1/6 mice) in A/Ola and BALB mice raised in ordinary conditions was shown to reject 16-21 and 12-18 days after the transplantation, respectively without cyclophosphamide (CP) use. CP application in BALB mice, grown in ordinary conditions, prolonged the lifespan of grafts to 12-29 days. The use of CP in germ free A/Ola mice prolonged the lifespan of grafts to 19-39 days. In germ-free mice kept in boxes the use of an immunodepressant was not accompanied by infectious complications, while the animals kept in the vivarium often died of infectious diseases. PMID- 3535923 TI - Clonogenic cells in acute myeloblastic leukemia. PMID- 3535924 TI - Subunit composition of plasma von Willebrand factor in patients with the myeloproliferative syndrome. AB - In order to evaluate the role of proteolysis in acquired von Willebrand's disease (vWD) associated with the myeloproliferative syndrome, we have determined the relative quantity of von Willebrand factor (vWF) fragments as compared with the intact 225 kDa subunit in four patients. The plasma vWF of each individual lacked large multimers; each had a prolonged bleeding time; and both platelet and leukocyte counts were elevated. Plasma was obtained from blood drawn into 1 mmol/L leupeptin, 6 mmol/L N-ethylmaleimide, and 5 mmol/L EDTA to prevent in vitro proteolysis. vWF was isolated from plasma by immunoadsorbent chromatography, reduced, subjected to SDS-5% polyacrylamide gel electrophoresis, and immunoblotted with a mixture of 55 anti-vWF monoclonal antibodies. In three patients with essential thrombocytosis (ET) the 176 and 140 kDa fragments were increased in proportion to the intact 225 kDa subunit indicating increased proteolysis. Treatment of one ET patient with CCNU (Lomustine) decreased the platelet count and, to a lesser extent, the white blood cell count. This was associated with a correction of the bleeding time, a partial correction of the multimeric abnormality, and a lessening of vWF cleavage. In a patient with polycythemia rubra vera (PRV) the proportion of the 176 kDa fragment was increased to the upper limit of normal but there was no definite evidence of increased proteolysis. These studies provide evidence that proteolysis plays a role in the acquired von Willebrand's disease associated with the myeloproliferative syndrome. However, other mechanisms must also be considered. PMID- 3535925 TI - Extracellular deposition of eosinophil granule major basic protein in lymph nodes of patients with Hodgkin's disease. AB - Lymph nodes from each of the four histologic types of Hodgkin's disease were examined for the presence of eosinophils and for eosinophil degranulation by immunofluorescent localization of eosinophil granule major basic protein (MBP). Eosinophil degranulation shown by MBP deposition outside of eosinophils was found in six of eight nodes from patients with nodular sclerosing disease and in two of eight nodes from patients with lymphocyte depletion-type disease. Three nodes of the mixed cellularity type, one node of the lymphocyte predominance type, and one lymph node of the lymphocyte depletion type showed one or two small foci of extracellular MBP deposition. Lymph nodes from patients without Hodgkin's disease showed no extracellular deposition of MBP. Large numbers of eosinophils were found in seven of eight nodes of the nodular sclerosing variant, but were less frequently seen among the other types of Hodgkin's disease. The presence of extracellular MBP in lymph nodes of patients with Hodgkin's disease indicates that eosinophil degranulation commonly occurs and suggests that the released eosinophil granule proteins may participate in the inflammatory reaction in this disorder more extensively than is presently appreciated. PMID- 3535926 TI - Leukemia diagnosis and testing of complement-fixing antibodies for bone marrow purging in acute lymphoid leukemia. AB - In this paper a microplate method is described for diagnosing acute leukemia and for investigating the reactivity of monoclonal antibodies (MoAbs) against membrane antigens in combination with rabbit or murine antibodies to nuclear terminal transferase (TdT). The speed of this method facilitates the investigation of fresh leukemic cells from individual patients and assesses the cytolytic efficacy of the relevant MoAbs in the presence of complement (C'). Lymphoblasts (TdT+) are mixed in equal proportions with known numbers of "inert" cells, eg, RBC or nonleukemic bone marrow (BM). Following incubation with MoAbs and C' the ratio of residual TdT+ cells and inert cells is determined on cytospin preparations. Initially, percentages of TdT+ cells are counted in a unit volume of 5,000 inert cells, followed by the scanning of greater than 2 X 10(4) inert cells on entire slides. With this method more than 4 log cytoreduction of TdT + cells is detected. The method is also applicable for studying the cytolysis of malignant B cells by using mostly monoclonal lg expression rather than TdT for the identification of residual B cells. Ten representative patients selected from a group of greater than 100 are reported. In some cases cytoreduction of greater than 4 log with no identifiable residual TdT + cells is achieved by a single C' fixing MoAb: anti-CD10 (RFAL3) in common acute lymphoid leukemia (ALL) and anti CD7 (RFT2) in T cell ALL (T-ALL). Other cases require cocktails of anti-CD10, anti-CD19, and anti-CD24 in common ALL or anti-CD7 and anti-CD8 in T-ALL. In T ALL a few TdT + cells remain that exhibit the features of normal TdT + BM cells (CD7-, HLA-DR+). This is particularly noticeable when patients are studied in partial remission or if nonleukemic BM is used as a source of inert cells. The methods described here contribute to establishing a range of MoAbs (ie, of IgM class) and techniques for efficient purging and to comparing the efficacy of "clean-up," in remission, of common ALL, T-ALL, and B cell malignancies. PMID- 3535927 TI - Autologous bone marrow transplantation in acute myelogenous leukemia: in vitro treatment with myeloid cell-specific monoclonal antibodies. AB - Second or third chemotherapy-induced remissions in acute myelogenous leukemia (AML) are limited by early relapse of the leukemia. We developed monoclonal antibodies (MoAbs) that are cytotoxic to myeloid leukemia cells to treat bone marrow from these patients ex vivo for autologous transplantation. In this pilot study, bone marrow was harvested from ten patients with AML in remission, treated with one or two complement-fixing MoAbs, PM-81 and AML-2-23, which react with myeloid differentiation antigens, incubated with rabbit complement, and cryopreserved. These MoAbs were chosen because they have broad reactivity with AML cells but not with pluripotent progenitor cells. At the time of transplant, 6 patients were in second complete remission, 1 each was in third complete or partial remission, and 2 were in early first relapse. The patients were treated with cyclophosphamide (60 mg/kg a day for 2 days) and total body irradiation (200 cGy twice a day for 3 days) and given infusions of MoAb-treated bone marrow. Full bone marrow reconstitution was observed in eight patients; two patients did not recover platelets. Seven of the ten patients are surviving and disease-free at 21.0, 15.0, 13.0, 10.0, 6.0, 3.0, and 2.0 months posttransplant. Treating bone marrow with MoAbs to myeloid differentiation antigens does not interfere with pluripotential stem cell engraftment. Longer follow-up and a controlled study are necessary to prove that the apparent efficacy of this therapeutic approach in some patients is attributable to MoAb-mediated killing of leukemia cells. PMID- 3535928 TI - Interleukin-1 (22-K factor) induces release of granulocyte-macrophage colony stimulating activity from human mononuclear phagocytes. AB - An electrophoretically pure preparation of natural human interleukin-1 (IL-1) was shown to stimulate in vitro colony formation in human bone marrow cultures. Day 4 myeloid cluster-forming cells (CFC), as well as early (day 7) and late (day 10) granulocyte-macrophage colony-forming units (CFU-GM) were stimulated in a dose dependent fashion. At optimal concentrations of IL-1, the number of day 4 CFC reached 72%, the number of day 7 CFU-GM reached 32%, and the number of day 10 CFU GM reached 80% of the respective numbers of colonies obtained by addition of crude leukocyte-conditioned medium (LCM). The IL-1-induced stimulatory effect on CFU-GM growth could be completely neutralized by a rabbit anti-IL-1 antiserum. Colony growth was abrogated by depleting the marrow cell suspensions of phagocytic cells prior to IL-1 addition. Conversely, the effect could be reintroduced by addition of marrow-derived adherent cells to bone marrow cell suspensions that had been depleted of both phagocytic and E rosetting T cells. Furthermore, media conditioned by bone marrow-derived adherent cells or by peripheral blood mononuclear phagocytes in the presence but not in the absence of IL-1, stimulated in vitro colony growth of phagocyte-depleted bone marrow cell suspensions. These results indicate that IL-1 induces release of granulocyte macrophage colony-stimulating activity (GM-CSA) from human mononuclear phagocytes. PMID- 3535929 TI - Histocompatible unrelated volunteer donors compared with HLA nonidentical family donors in marrow transplantation for aplastic anemia and leukemia. AB - We treated 14 patients by transplantation of marrow from unrelated volunteer donors. Eight patients had severe aplastic anemia, 3 had chronic granulocytic leukemia, and 3 had Fanconi's anemia. The results are compared with those of a group of 14 similar patients transplanted concurrently from human leukocyte antigen (HLA)-mismatched family members: Sustained engraftment was achieved in 8 of 14 patients in both groups; one additional patient survived with autologous marrow reconstitution following an unrelated donor transplant. In the unrelated donor group, 6 of 9 evaluable patients developed grade III through IV acute graft v-host disease, as compared with 4 of 9 patients after family-mismatched transplants. Overall survival was similar in the two groups. In the unrelated donor group 4 of 14 (29%) patients survived (median survival 1,299 days) as compared with 5 of 14 (36%) in the mismatched-family donor group (median survival 808 days). In both groups, patients with HLA phenotypically matched donors fared better than those with donors who were mismatched for one or more HLA antigen. Of the patients transplanted from HLA phenotypically matched donors 6 of 12 patients (50%) survived, as compared with 3 of 16 patients (19%) transplanted from HLA mismatched donors. We conclude that unrelated donor bone marrow transplantation (BMT) should be considered in those cases of leukemia or bone marrow failure in which the chance of cure using conventional therapy is remote and a HLA genotypically or phenotypically matched family donor is not available. PMID- 3535930 TI - Decreased incidence of marrow graft rejection in patients with severe aplastic anemia: changing impact of risk factors. AB - Patients with severe aplastic anemia were conditioned with cyclophosphamide (200 mg/kg) and given marrow grafts from HLA-identical family members. Among 233 patients transplanted, 225 survived greater than or equal to 14 days and could be evaluated for engraftment. Forty-four of the 225 rejected their graft; 33 of these died and 11 survive. One hundred eighty-one patients had sustained engraftment; of these, 46 died and 135 survived. Binary logistic regression analyses revealed five risk factors for graft rejection: year of transplant, a large number of platelet transfusions, a positive relative response in mixed leukocyte culture, a low marrow cell dose, and omission of donor buffy coat cell infusion for transfused patients. These data show that patients transplanted recently had a lower likelihood of graft rejection than did patients transplanted in earlier years. Conceivably, this was related to changes in transfusion practices, but other factors as yet unidentified are likely to be involved. The data confirm that the largest possible number of marrow cells should be transplanted. Although the difference in the incidence of graft rejection between untransfused and transfused patients was not significant, it should be noted that transfused patients were given buffy coat cells. Because the addition of buffy coat cells results in a higher incidence of chronic graft-v-host disease (GVHD), it is still desirable to transplant patients with marrow alone early in their course before they have been transfused. PMID- 3535931 TI - Immunoadsorption for removal of anti-A and anti-B blood group antibodies in ABO incompatible bone marrow transplantation. AB - About 10-15 percent of all patients undergoing allogeneic bone marrow transplantation have a major ABO-incompatibility with their donors. The risk of acute hemolytic reactions due to the infusion of an incompatible donor marrow into the recipient can basically be prevented by recipient antibody depletion or by donor marrow red cell depletion. Nine patients were treated by immunoadsorption using a cartridge with chemically synthesized human blood group A and B antigen as immunoadsorbent for antibody depletion. Within a four-hour procedure about 2-4 times the patient plasma volume could be processed, thus lowering the anti-A and -B hemagglutinins by 2 to 3 tubes. There was a tendency of better IgG removal when titers initially were high, showing a high antibody clearing capacity. There was no significant correlation between starting titer or amount of plasma volume processed and titer reduction. No decrease in titers were observed in one case. We propose repeated immunoadsorption procedures over 2-3 consecutive days before BMT. The procedure is largely safe and without serious side effects. A major advantage is the avoidance of nonautologous human blood products compared to the conventional plasma exchange. All 8 patients surviving long enough had prompt and stable engraftment of all three cell lines post BMT. No late serological complications occurred when patients were regularly monitored and in vivo adsorption was used when titers increased. PMID- 3535932 TI - Acquired immune haemolysis by anti A 1 antibody following bone marrow transplantation. AB - In ABO mismatched organ or bone marrow transplants recently some cases of acquired immune hemolysis have been reported. It was felt that these life threatening complications were due to immunosuppressive treatment with cyclosporin-A. A case of severe hemolysis following mismatched BMT is reported. Here no cyclosporin-A treatment was given since the bone marrow was T-cell deprived by an E-rosetting technique. Apparently T-cell purging can under these conditions become dangerous. PMID- 3535933 TI - Tumor nuclear grade, estrogen receptor, and progesterone receptor: their value alone or in combination as indicators of outcome following adjuvant therapy for breast cancer. AB - Previous reports by us have shown that the outcome of breast cancer patients who have received systemic adjuvant therapy is influenced by tumor estrogen or progesterone receptor (ER or PR) content or by nuclear grade. This publication provides information regarding the relative merit of those three markers. Findings from patients receiving L-PAM plus 5-FU (PF) or PF plus tamoxifen (PFT) indicate that the disease-free survival and survival within each regimen was almost identical when related to either ER, PR, or nuclear grade. Those having tumors with either of the receptors greater than or equal to 10 fmol or a good nuclear grade had a better outcome through five postoperative years than did those with ER or PR 0-9 fmol or poor nuclear grade. The magnitude of the difference was similar for each of the three discriminants. Since they were found to be of equal predictive value, one marker might well serve as a substitute for another. Cox regression analyses, however, clearly indicate that ER, PR, and nuclear grade have an independent influence on outcome and that a more accurate assessment of outcome is obtained when more than one marker is employed. Thus, information should be obtained on as many markers as possible. This conclusion is supported by observations presented which indicate that nuclear grade in combination with either or both of the receptors is a better predictor than either marker alone and that, as indicated by life table probability values and relative odds ratios, an increasing number of favorable tumor prognostic indicators results in a better patient outcome particularly in PFT-treated patients. A possible explanation is considered for why the separation of receptor/nuclear grade categories is more orderly and pronounced in PF-treated patients receiving tamoxifen than in those given PF alone. PMID- 3535934 TI - [Cancer of the prostate: current status of chemotherapy]. AB - Life expectancy of patients with prostatic cancer is varying from one case to another and, sometimes, these patients have a very long life expectancy. Less than a third of this patients are dying from their cancer. This notion implies to be very careful in the choice of aggressive treatments. Isolated or combined chemotherapy assays permitted to select cyclophosphamide, methotrexate, cis platinum or estramustine phosphate as active drugs in the treatment of prostatic cancer. But the randomized studies, in Europe or in U.S.A., are not demonstrative enough to propose these drugs for a routine treatment. Cancer of the prostate is usually represented by cellular groups that are more or less sensitive to the different kind of available treatments. Perhaps in the future the best results of treatment will be the association of chemotherapy-radiotherapy and hormonotherapy. PMID- 3535935 TI - [Cancer of the prostate: therapeutic trials in 1985]. AB - Phase III trials began since 1960 with the VACURG's studies and their results are sometimes difficult to interpret because of the variability of staging, classification, criteria of response, preliminary nature of some of them. Twenty three trials published between 1973 and 1984 are analyzed: 14 concerning advanced disease. 9 concerning loco-regional disease. For advanced disease, cyproterone acetate is not better than DES (3 mg), but a sufficient dose of Estracyt (10 mg/kg) seems to work better with less toxicity (Wisconsin trial). Among traditional hormonal manipulations, sub-capsular orchidectomy appeared to be better. The absence of results of ongoing trials with LHRH analogues, castration and anti-androgen combination do not allow an approach of their respective role. Chemotherapy has several efficacious compounds, CTM, 5FU, MTX, CDDP, ADM, which may be required after failure of hormonotherapy. Their association may take into account age and bone marrow reserves. For loco-regional disease NPCP protocols 900 and 1000 will focus indications of prostatectomy, cryosurgery, radiotherapy for stages B2, C, D1, as well as those of adjuvant treatment which will be probably modulated by prognostic factors such as stage, differentiation, lymph node status. For pelvic irradiation, the Standford trial make it easier to determine the target volume in correlation with lymph node status. PMID- 3535936 TI - Uptake of platinum compounds in human tumors. In vitro study. AB - The kinetics of intratumoral uptake of cisplatin, carboplatin (CBDCA) and TNO-6 were studied in vitro in fragments of tumors of the head and neck maintained in culture medium under conditions simulating therapeutic conditions of chemo embolization. Cisplatin and TNO-6 are more rapidly taken up than CBDCA (carboplatin). With each of these compounds, after 24 hours a fraction of the platinum taken up is not irreversibly bound to the tissue. The rate of uptake and the proportion of platinum irreversibly bound depends a great deal on the tumor under study. The characteristics of the diffusion indicate that TNO-6 is better used with chemo-embolization than with systemic injection. The opposite finding is seen with carboplatin. Cisplatin appears to to be about equally well-suited for either method of injection. PMID- 3535937 TI - Prospects for the application of fast neutrons in cancer therapy. Radiobiological bases and survey of the clinical data. AB - The rationale for introducing fast neutrons in therapy initially was a reduction in the Oxygen Enhancement Ratio (OER). The recent radiobiological developments indicate that, more generally, fast neutrons tend to reduce the difference in radiosensitivity between cell lines, or related to the degree of oxygenation (Oxygen Gain Factor), the position of the cells in the mitotic cycle (Kinetics Gain Factor), etc. The reduction of the differences in radiosensitivity brings a benefit for certain types of tumours (normally resistant to photons), but a disadvantage for other types of tumours (those which can currently be controlled by photon treatment). A review of the available clinical data is presented. The tumour types or sites for which a benefit has been observed are discussed: locally advanced tumours of the salivary glands, paranasal sinuses, some tumours of the head and neck area with metastatic lymph nodes, slowly growing, well differentiated soft tissue sarcomas, inoperable/recurrent melanomas, locally extended (C, D1) prostatic adenocarcinomas. Selection of the patients suitable for neutron therapy remains the main problem. Collaboration between neutron therapy centres is essential to accelerate the acquisition of sufficient clinical data needed in order to improve patient selection, as well as the optimum modality of application of fast neutrons. PMID- 3535938 TI - 4-Chloro-3-methylphenol: Salmonella/mammalian-microsome mutagenicity test and subacute toxicity test in rats. PMID- 3535939 TI - [Monitoring of the ambient and biological environment in occupational exposure to precious metals in a dental technology laboratory]. PMID- 3535940 TI - Oddments in dental history: an unusual case of macroglossia a century and a half ago. PMID- 3535941 TI - One hundred years of the Odontographic Society of Chicago. PMID- 3535942 TI - Otto Walkhoff--renaissance man of dentistry. PMID- 3535943 TI - Carl Koller and the discovery of local anesthesia. PMID- 3535944 TI - The contributions of John Ross Callahan. PMID- 3535945 TI - Tufted toothpicks and teeth blackening customs in Ukiyoe. PMID- 3535946 TI - Enigma of tic douloureux before 1900. PMID- 3535947 TI - Strain distribution in the maxillary partial denture of a patient with only one remaining tooth. PMID- 3535949 TI - Sesquicentennial of the National Library of Medicine. Still counting. PMID- 3535948 TI - End-user searching in medicine. AB - Investigation of end-user searching at the New York Hospital-Cornell University Medical Center (NYH-CUMC) revealed that 8% of the physicians surveyed were end users, 63% were interested in learning to search, and 29% were not interested. When training sessions were offered at the Burke Rehabilitation Center, an affiliated institution, 50% of the medical staff attended at least one class, but only 7% of the total staff became frequent searchers. Analysis of the precision and recall ratios of searches conducted by five end users at HYH-CUMC indicated that the best results were obtained by end users who had been taught to search by experienced librarian-searchers. The quality of end user searches did not appear to be affected by the "friendliness" of the systems used, the frequency of searching habits, or the length of time that an end user had been searching. PMID- 3535950 TI - From Surgeon General's bookshelf to National Library of Medicine: a brief history. AB - The National Library of Medicine originated as a few books in the office of the army's surgeon general, Joseph Lovell, between 1818 and 1836. It became the nation's largest medical library after the Civil War under the direction of John Shaw Billings and began publishing the Index-Catalogue of the Library of the Surgeon General's Office and preparing the Index Medicus. After Billings retired in 1895, the library marked time as army medical officers were rotated through as directors until modernization began under Harold Wellington Jones during World War II. during the directorship of Frank B. Rogers (1949-1963), who introduced MEDLARS, guided the move to a new building in Bethesda, and revitalized other operations, the institution received statutory authority as the National Library of Medicine within the Public Health Service (1956). By 1965, which was marked by the passage of the Medical Library Assistance Act, the library had again regained a position of world leadership. PMID- 3535951 TI - The National Library of Medicine: from MEDLARS to the sesquicentennial and beyond. AB - The two decades since the introduction of MEDLARS and the passage of the Medical Library Assistance Act have been especially eventful in the history of the National Library of Medicine. The library's collections and services have grown to keep pace with the expanding health sciences literature and the needs of health professionals. Networking has emerged as an invaluable method for disseminating biomedical information. NLM has assumed new responsibilities for information services in toxicology, pharmacology, and environmental health, and for research and development in biomedical communications. Research now being carried out by NLM has the potential for enhancing the library's archival programs and for improving information dissemination in support of health sciences research, education, and practice. PMID- 3535952 TI - Exporting the American (information) revolution: the international impact of the National Library of Medicine. AB - The National Library of Medicine has had an enormous impact on health information services all over the world. Although NLM is primarily a national institution, it has become an important international resource by responding to requests from the international community. NLM has been influential in three major ways. First, NLM has provided a model for other national and regional health information services. Second, it has been a catalyst, in that MEDLARS and other services it provides formed the nucleus of many regional networks. NLM helped such networks get started by giving advice on how to set up services and build collections and by "training the trainers" on the MEDLARS system. Third, NLM has supported national and regional operations by providing the additional training and materials needed for day-to-day service. PMID- 3535953 TI - Selected list of books and journals in the allied health sciences. AB - This list of 450 books and 69 journals is intended as a selection guide to be used in a library supporting allied health educational programs and/or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused mainly on the twenty-three educational programs accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association, plus physical therapy, dental allied health, and medical secretarial programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (157 books and 27 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1986 subscriptions) would require an expenditure of about $16,700. The cost of only the asterisked items totals $6,700. PMID- 3535954 TI - Recognition for Billings. PMID- 3535955 TI - [In memoriam Maurice Derot, honorary foreign member]. PMID- 3535956 TI - [Academic eulogy of Prof. Guy Bruynoghe, titular member and former President]. PMID- 3535957 TI - The role of Dr. Max Som in conservation surgery of the head and neck. PMID- 3535958 TI - A historical and histological view of partial laryngectomy. PMID- 3535959 TI - Drug abuse in Asia. AB - The article focuses on countries and areas of South-East Asia, which are seriously affected by drug abuse and the problems associated with it. Opium has traditionally been used for treating illnesses and alleviating physical and mental stress, as well as for recreational and social purposes. The prohibition of the sale and use of opium in Burma, Hong Kong, Malaysia, Singapore and Thailand forced many habitual opium users to switch to heroin. Over the past two decades there has been an increasing trend towards drug use, often involving experimentation with more than one substance, among youth in and out of school. For example, a survey of students at teachers' colleges in northern Thailand showed that at some time in their lives 30-40 per cent of the male respondents and 3-6 per cent of the female respondents had used cannabis, and that 18-20 per cent of the males and 12-27 per cent of the females had sniffed volatile solvents. The same survey showed that 5-10 per cent of both the males and females had used stimulants and nearly 2 per cent had used heroin. During the 1970s the abuse of heroin and other opiates emerged as a serious problem of epidemic nature, predominantly affecting young people in many countries of South-East Asia. While opiates, including heroin, have been abused by inhaling and by smoking, there has recently been an increasing trend towards injecting heroin of high purity (80-90 per cent pure heroin). Heroin addiction spread first to the populations of capital cities and then to other cities and towns and even to the hill tribes, as studies in Thailand have revealed. Most recent studies have shown that heroin abuse has spread further in Asia, both socially and geographically, involving such countries as India and Sri Lanka, which had no previous experience with the problem. Studies have also shown that the abuse of manufactured psychotropic substances has been increasing and that heroin addicts resort to these substances when heroin is difficult to find. The article also briefly reviews the history of opium use in China and the history of drug abuse in Japan, particularly with regard to the problem of methamphetamine abuse, which has appeared in two epidemic-like waves. The first followed the end of the Second World War and disappeared at the end of the 1950s; the second reappeared in 1975 and since then has gradually been increasing in size. PMID- 3535960 TI - Gross self-neglect in old age. AB - Most elderly, including those with physical or mental disability manage to maintain their standard of life, often owing to the support of their relatives and neighbours. Only a few let their self-care drop to alarmingly low level, thus causing public concern. Health workers, when asked to help, face medico-legal and moral dilemmas, some of which are explored. PMID- 3535961 TI - Anaesthesia and liver disease. AB - Severe liver disease is not a common problem in patients presenting for anaesthesia and surgery. However, because many vital functions are performed by the liver, impairment of these has important implications for the anaesthetist. In addition, since the metabolism and elimination of drugs may be altered, the response of the patient to anaesthetic agents may be unpredictable. PMID- 3535962 TI - Thrombolysis for myocardial infarction. AB - Treating myocardial infarction by dissolving occlusive thrombi in coronary arteries is an attractive idea. Although some thrombolytic agents have been available for many years their use in this role has only recently been critically examined. The place of thrombolysis in the management of myocardial infarction has yet to be determined. PMID- 3535963 TI - The ethics of cardiac transplantation. PMID- 3535965 TI - Contraction and growth of wounds covered by meshed and non-meshed split thickness skin grafts. AB - Full thickness wounds, one on either side of the backs of rabbits, were covered with meshed or non-meshed split thickness skin grafts. The wounds were measured over a 3 month period and the minimum and maximum sizes of the wounds determined as well as the rate of growth. Wounds covered with meshed grafts contracted to 55% of the original size while those covered with non-meshed grafts contracted to 81.5% (p = less than 0.0001). The meshed wounds grew to 114.6% of original area and non-meshed grew to 153.3% (p = 0.035) after 13 weeks. PMID- 3535964 TI - The properties and uses of non-expanded machine-meshed skin grafts. AB - Machine-meshing a split skin graft gives it a three-dimensional flexibility that enables it to conform to irregular and concave surfaces without fixation. The drainage of fluid through the slit-like perforations prevents haematoma formation and permits the graft to be applied to an actively bleeding wound. Rapid firm adhesion occurs, allowing early mobilisation. By ensuring that the skin is applied without expansion, excellent cosmetic results can be achieved. This technique has become the method of choice in our unit when grafting awkward sites and for the cover of tangentially-excised burn wounds and we report on 111 consecutive cases. PMID- 3535966 TI - A new approach to the problems encountered with Opsite as a donor site dressing: systemic ethamsylate. AB - A prospective clinical trial has shown that systemic ethamsylate reduces the problems with exudation sometimes seen when Opsite is used as a dressing for split skin graft donor sites. PMID- 3535967 TI - Prophylaxis with tinidazole of infection in major head and neck surgery for malignant disease. AB - In a double-blind study, 20 patients undergoing surgery for the removal of an oropharyngeal squamous carcinoma received tinidazole either as a single perioperative prophylactic dose of 2 g or as a treatment course of 8 g given over a 7 day period. The wounds were assessed daily and specimens of fluid from the upper neck drain were submitted for culture. Four patients, two in each group, developed complications that might have been associated with infection (flap necrosis, fistula formation or both). There was no significant difference in the efficacy of these two regimens and single dose prophylaxis with tinidazole is advocated. PMID- 3535968 TI - History of the Sheffield Plastic Surgery Unit. PMID- 3535970 TI - A new pressure device for securing skin grafts. AB - A method is described in which the traditional tie-over dressing is replaced by a pressure device, resulting in substantial savings in both time and material costs. The device will allow graft inspection with restoration of the pressure dressing. PMID- 3535969 TI - "Tie-over sutures" fixed by staples. PMID- 3535971 TI - Mindlessness and brainlessness in psychiatry. PMID- 3535973 TI - Treatment of mania with the cholinomimetic agent RS 86. PMID- 3535972 TI - Does viloxazine really improve sex drive? A double-blind controlled study. AB - The action of viloxazine on libido and sex drive was evaluated with a randomised controlled double-blind trial against placebo on a population of 26 male out patients affected by primary depression (DSM III). Modifications in the sexual sphere were assessed by the ad hoc inclusion of a series of items in the Zung Self-Rating Depression Scale. Thus modified, the scale was administered at the beginning and the end of a four-week trial period. Viloxazine proved to have a considerable disinhibiting effect, whose principal expression level was a return to pre-depression levels of frequency in sexual relations. PMID- 3535974 TI - Causal models in psychiatric research. PMID- 3535975 TI - Clovoxamine and doxepin in major depressive disorder: a double-blind controlled trial. AB - Clovoxamine, an inhibitor of neuronal uptake of both serotin and noradrenaline, was compared with doxepin in depressed patients over four weeks. Antidepressant efficacy was comparable for both drugs, but clovoxamine might have a special degree of efficacy for patients with more severe depressive illnesses. PMID- 3535976 TI - Comparison of the prophylactic action of flupenthixol with placebo in lithium treated manic-depressive patients. AB - A double-blind cross-over trial of depot flupenthixol in recurrent manic depressive psychosis was carried out. All patients continued on lithium. Eleven patients completed the two-year trial. Flupenthixol appeared to have no prophylactic effect. PMID- 3535977 TI - Witchcraft and psychotherapy. AB - Belief in witchcraft, which serves a variety of social functions and personal defences, is bound to emerge in psychotherapy with individuals from a culture that holds such beliefs; endeavouring to understand it can open up new therapeutic possibilities. The nature of witchcraft, the profiles with which it intrudes into therapy, and the socio-psychological functions it fulfills are considered. Referring such patients to witchdoctors is morally unjustifiable, but the witch-doctor's folk-image provides a floating transference, around which the therapeutic relationship can be built. In dealing with witchcraft-ideation, understanding is based as much on cultural as on personal empathy, and to enhance its relevance, therapy may appropriate some of the functional dynamics of the witchcraft system into its own therapeutic manoeuvres. PMID- 3535978 TI - Psychiatric disorder in the general hospital. AB - There have been many reports of psychiatric disorder in medical populations, but few have used standard methods on representative patient groups. Even so, there is consistent evidence for considerable psychiatric morbidity in in-patient, out patient and casualty department populations, much of which is unrecognised by hospital doctors. We require a better classification of psychiatric disorder in the general hospital, improved research measures, and more evidence about the nature and course of the many different types of problem so that we can provide precise advice for their management of routine clinical practice. PMID- 3535979 TI - Conditioning and sensitisation in the longitudinal course of affective illness. AB - Few biological theories of manic-depressive illness have focused on the longitudinal course of affective dysfunction and the mechanisms underlying its often recurrent and progressive course. The authors discuss two models for the development of progressive behavioural dysfunction--behavioural sensitisation and electrophysiological kindling--as they provide clues to important clinical and biological variables relevant to sensitisation in affective illness. The role of environmental context and conditioning in mediating behavioural and biochemical aspects of this sensitisation is emphasised. The sensitisation models provide a conceptual approach to previously inexplicable clinical phenomena in the longitudinal course of affective illness and may provide a bridge between psychoanalytic/psychosocial and neurobiological formulations of manic-depressive illness. PMID- 3535980 TI - Applied relaxation training for generalised anxiety and panic attacks: the efficacy of a learnt coping strategy on subjective reports. AB - The results of applied relaxation training in patients with generalised anxiety and panic attacks are reported. ART was taught during one session, by means of participant demonstration, written instructions, taped instructions, or a combination of all three, with instructions to practice at home. All four methods proved superior to a waiting list control, but there were no differences between the treatment groups. There was some evidence for the non-specific effect of expectancy, but this did not completely explain the treatment effect. PMID- 3535981 TI - The relationship of anxiety and depression: a review of the literature. PMID- 3535982 TI - Peptic ulcer, nonsteroid anti-inflammatory drugs and the rheumatic diseases. PMID- 3535983 TI - Lack of effect of total body irradiation in rheumatoid arthritis. AB - We are reporting a pilot study of total body irradiation in six patients with progressive rheumatoid arthritis, who had previously received gold and penicillamine. Radiation (150 cGy) was administered in ten fractions over 5 weeks. There was a transient pancytopenia following radiotherapy and the total peripheral lymphocyte count remained below pre-treatment levels after 6 months. There were no serious short-term adverse effects. By 6 months, there was no evidence of any change in clinical and laboratory estimates of disease activity. We feel that further studies of this regimen in intractable rheumatoid arthritis are not justified. PMID- 3535984 TI - Diagnosis of rheumatic disease: a plea for contemplation of the future. AB - In clinical practice the definition of diagnosis is far from clear, since different levels of diagnosis are employed from the symptomatic to the pathological and aetiological. The recent development of computer data bases has important implications for the future, but will require a great deal of thought regarding the nature and quality of the data to be used. Evolution of diagnosis has occurred gradually during the history of medicine. As we see it, computer assisted data handling will have a profound effect on diagnosis and classification of disease. To meet this challenge we require to define our terms regarding diagnosis of rheumatic disorders. In this paper we comment on the state of the art of diagnosis and classification of rheumatic diseases, and then propose changes to meet the needs of future developments. PMID- 3535985 TI - Paracetamol and diclofenac in the painful shoulder syndrome. PMID- 3535987 TI - Catheters and urethral strictures. PMID- 3535986 TI - The influence of caffeine ingestion on incremental treadmill running. AB - The aim of this study was to determine the effects of caffeine ingestion on estimated substrate utilisation during treadmill running at an initial level of 70%-75% of maximal oxygen consumption after which subjects ran to exhaustion. Twelve subjects undertook either a control, placebo, a small (10 mg X kg-1) or a large (15 mg X kg-1) dose of caffeine in a double-blind design to determine whether caffeine affected the substrate usage during running. Venous blood was collected prior to and during the experimental runs and was later analysed for free fatty acids (FFA), glycerol, triglycerides, lactate and glucose concentrations. The results of this experiment suggest that maximal running performance can be increased by large doses of caffeine. Furthermore, the subjects' respiratory exchange ratios were lower and FFA concentrations were higher following the ingestion of large amounts of caffeine than during other trials, suggesting that a larger proportion of energy was derived from fat being used preferentially during the trial following ingestion of this large dose of caffeine. The subjects rating of perceived exertion (RPE) were lower following the ingestion of a large dose of caffeine than it was in any of the other trials. This study differs from others in this area in so much that caffeine has been found to have positive effects during maximal running when used in large doses. PMID- 3535988 TI - The sapphire crystal infrared photocoagulator and polyglactin (Vicryl) mesh: two new alternatives to the suturing of radial nephrotomies. AB - The sapphire crystal infrared photocoagulator and polyglactin (Vicryl) mesh, two new methods for closure of radial nephrotomies, were assessed in 16 dogs. Six radial nephrotomies were carried out in each dog; in 10 the nephrotomies were sealed by the infrared photocoagulator and in six they were left open, but the kidney was covered with a polyglactin mesh. Functional and morphological studies were performed using creatinine clearance, microfil casting, corrosion cast angiography and histology. There was no significant loss of function or loss of renal tissue. Both methods were shown to be safe and effective in the closure of radial nephrotomies. PMID- 3535989 TI - The use of transabdominal ultrasound in the detection of early bladder tumours. AB - We have studied the accuracy of transabdominal ultrasound (TAUS) in the diagnosis of early superficial bladder carcinoma. One hundred and twenty-six patients returning for check cystoscopy were scanned pre-operatively with the Technicare Autosector Scanner and the results compared with the endoscopic findings. Forty four patients (37%) had a tumour recurrence. TAUS demonstrated a lesion in 50% of these with a false positive rate of 11%. The diagnostic accuracy was proportional to the tumour size (82% of patients with tumours above 5 mm were detected compared with 38% below 5 mm), but was not affected by grade, stage or position in the bladder. TAUS may prove a useful adjunct to cytology as a screening test for bladder cancer. PMID- 3535992 TI - Focal circumvention of blood-brain barrier with grafts of muscle, skin and autonomic ganglia. AB - The efficacy with which circulating horseradish peroxidase (HRP) spreads from transplants into the brain's interstitial spaces (IS), was assessed by 3 factors: graft type, site and age. Pieces of skeletal muscle, skin or entire superior cervical ganglion (SCG) were inserted into the IV ventricle (ventricular) or substance of the brain (parenchymal). The age of the grafts, i.e. the intervals after transplantation, were 1, 3, 6 and 12 months. Generally, HRP spread into the IS to about the same extent from ventricular muscle and skin autografts--1 mm, but less from parenchymal SCG allografts--0.5 mm. The spread from all grafts- ventricular and parenchymal--diminished with time. Exudation distance from muscle was the same as that from skin grafts for the first 6 months, but by 1 year, the penetration was significantly greater from muscle than from skin transplants. The flow of HRP was more extensive from parenchymal SCG grafts than from parenchymal muscle and skin grafts at 6 and 12 months. In some of the 6 and 12 month old parenchymal grafts of muscle and skin, no detectable HRP was extravasated. HRP consistently penetrated the brain more deeply from ventricular skin and muscle grafts than from parenchymal ones because more tissue mass survived in ventricular than in parenchymal autografts. Though care was taken not to damage the brain surface during ventricular insertion, there was a consistent, vigorous, collateral sprouting of, as yet unidentified, cranial nerves. These sprouts innervated muscle and skin autografts which, consequently, were able to survive for at least 1 year and contained vessels permeable to HRP. Allografts of muscle between inbred strains did not become innervated, survived for only 2 months and contained the central, barrier type of vessels, but not their intrinsic, permeable type. Thus, it is the muscle cell or its basal lamina within muscle grafts that determines the type of surviving vessel. In SCG allografts, even when all their ganglion cells had disappeared, leaving only connective tissue, Schwann cells and their basal lamina, the ganglion's capillaries survived and remained permeable to HRP. Therefore, the characteristics of the SCG vessels are determined by the Schwann cell-fibroblast milieu rather than the neuronal one. PMID- 3535990 TI - Psychological impact of adjuvant chemotherapy in the first two years after mastectomy. AB - Psychological symptoms were assessed over two years in a randomised trial of three forms of treatment given to women after mastectomy for stage II breast cancer. The treatments were: three weeks' radiotherapy; one year's adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil; and radiotherapy followed by chemotherapy. Analysis of the results on an intention to treat basis showed no substantial differences in depression or anxiety among groups at one, three, or six months after the operation. At 13 months, however, patients who had been allocated chemotherapy had significantly more symptoms, especially depression, than control patients treated with radiotherapy alone. Conditioned reflex nausea and vomiting increased considerably during the second six months of chemotherapy and persisted for up to a year afterwards. The psychological morbidity of adjuvant chemotherapy could be substantially reduced if courses of treatment were restricted to about six months. PMID- 3535993 TI - Immunological cross-reactivity of cultured rat hippocampal neurons with goldfish brain proteins synthesized during memory consolidation. AB - Ependymins are goldfish brain glycoproteins exhibiting a specifically enhanced rate of synthesis when the animals adopt a new pattern of swimming behavior. With specific antisera against ependymins it has become possible to look for ependymin like immunoreactivity in other animal species, both qualitatively by immunofluorescence staining and quantitatively by radioimmunoassay. Ependymin like immunoreactivity was detected not only in other fish but also in rat brain. In the rat radioimmunoassay measurements were highest for the hippocampal formation and for cultured neurons derived from the embryonic hippocampus. Immunofluorescence staining was performed on various cell culture systems derived from rat brain, in order to establish which cell type contains the antigen. Only neuronal cell populations reacted with the anti-ependymin antisera. Cells derived from embryonic rat brain hippocampus which resembled pyramidal neurons stained particularly bright for ependymin-like immunoreactivity. The antigenic material was distributed throughout the cytoplasm including the neuronal extensions. Various neuron-specific antisera have been used to counterstain the cells containing ependymin-like immunoreactivity. PMID- 3535994 TI - The olfactory gonadotropin-releasing hormone immunoreactive system in mouse. AB - The olfactory gonadotropin-releasing hormone (GnRH) system in mice was studied with immunofluorescence in combination with lesions of the olfactory bulb and retrograde transport of horseradish peroxidase (HRP) which was administered intravascularly, intranasally or into the subarachnoid space. GnRH-positive neurons were located in the two major branches forming the septal roots of the nervus terminalis, in the ganglion terminale, within the fascicles of the nervus terminalis throughout its extent, in a conspicuous band which connects the ventral neck of the caudal olfactory bulb with the accessory olfactory bulb and in the nasal mucosa. GnRH-positive fibers were seen in all areas in which neurons were found, i.e. in the rostral septum, the ganglion and nervus terminalis and in the nasal subepithelium. In addition, a broad bundle of fibers was observed to surround the entire caudal olfactory bulb, connecting the rostral sulcus rhinalis with the ventrocaudal olfactory bulb. Fibers were seen in close association with the main and accessory olfactory bulb, with the fila olfactoria and with the nasal mucosa. Throughout the olfactory bulb and the nasal epithelium, an association of GnRH fibers with blood vessels was apparent. Intravascular and intranasal injection of HRP resulted in labeling of certain GnRH neurons in the septal roots of the nervus terminalis, the ganglion terminale, the nervus terminalis, the caudal ventrodorsal connection and in the accessory olfactory bulb. After placement of HRP into the subarachnoid space dorsal to the accessory olfactory bulb, about 50% of the GnRH neurons in the accessory olfactory bulb and in the ventrodorsal connection were labeled with HRP. Also, a few GnRH neurons in the rostral septum, the ganglion terminale and in the fascicles of the nervus terminalis had taken up the enzyme. Lesions of the nervus terminalis caudal to the ganglion terminale resulted in sprouting of GnRH fibers at both sites of the knife cut. Lesions rostral to the ganglion terminale induced sprouting mostly at the distal site of the knife cut while most but not all GnRH fibers proximal to the lesion had disappeared. The results of the present study indicate that the olfactory GnRH system is mostly associated with the nervus terminalis. This cranial nerve apparently projects to the central nervous system as well as the periphery. The results of the HRP uptake studies suggest that the GnRH neurons in the nervus terminalis have access to fenestrated capillaries in the subepithelial connective tissue of the nasal mucosa, to the nasal epithelium proper, and to the subarachnoid space.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3535991 TI - Gonadotropin-releasing hormone (GnRF), molluscan cardioexcitatory peptide (FMRFamide), enkephalin and related neuropeptides affect goldfish retinal ganglion cell activity. AB - Recently gonadotropin-releasing hormone (GnRF)-like and molluscan cardioexcitatory peptide (FMRFamide)-like compounds have been colocalized immunocytochemically to the terminal nerve, a presumed olfactoretinal efferent system in goldfish. In the present study these and related neuropeptides were shown to affect ganglion cell activity, recorded extracellularly, when applied to the isolated superfused goldfish retina. GnRF was usually excitatory. Salmon GnRF (sGnRF) was 10-30x more potent than chicken or mammalian GnRF. FMRFamide and enkephalin also were often excitatory but caused more varied responses than sGnRF. Met5-enkephalin-Arg6-Phe7-NH2 (YGGFMRFamide), which contains both enkephalin and FMRFamide sequences, tended to act like both of these peptides but with mainly enkephalin-like properties. Neuropeptide Y and the C-terminal hexapeptide of pancreatic polypeptides, whose C-terminus (-Arg-Tyr-NH2) is closely related to that of FMRFamide (-Arg-Phe-NH2), gave no consistent responses. Threshold doses were equivalent to: 0.1 microM for sGnRF; 0.5 microM for YGGFMRFamide; 1.5 microM for FMRFamide and enkephalin. Rapid, complete and irreversible desensitization was induced by single, 10-20x threshold doses of sGnRF; but desensitization was infrequent and limited with the other peptides. In general, all peptides tested affected the spatially and chromatically antagonistic receptive field components similarly, but selective actions were seen in a few cases with FMRFamide and with the opioid antagonist, naloxone. Responses, especially to sGnRF and FMRFamide, tended to be most frequently obtained and pronounced in winter and spring, suggesting a correlation with seasonally regulated sexual and reproductive activity. Our observations provide further evidence for transmitter-like roles of neuropeptides related to sGnRF and FMRFamide in the teleostean terminal nerve. The actions of agonists and antagonists, singly and in combination, imply strongly that there are distinctive postsynaptic receptors and/or neural pathways for GnRF-, FMRFamide- and enkephalin-like peptides in the goldfish retina. PMID- 3535995 TI - Development of the hypothalamic serotoninergic system during ontogenesis in rats. Immunocytochemical and radioautographic study. AB - The development of the hypothalamic serotoninergic system has been studied in rats from the 14th fetal till the 9th postnatal day. Serotoninergic elements were detected with immunocytochemistry using antiserum to serotonin (5-HT) and radioautography following the injections of [3H]5-HT into the cerebral ventricles. Immunocytochemistry failed to recognize hypothalamic 5-HT neurons either in fetuses or in neonatal rats. Conversely, radioautography demonstrated sparse radioactively labeled cells, undifferentiated in appearance, at the 16th and 18th fetal days. Moreover, at the 18th fetal day an accumulation of radioactively labeled typical neurons appeared in the suprachiasmatic region. By the 9th postnatal day, practically all radioactively labeled cells looking like highly differentiated neurons were concentrated in the dorsomedial nucleus. As to nerve fibers, a small number of 5-HT-immunoreactive axons arising from the raphe nucleus were first detected in the hypothalamus at the 16th fetal day. Two days later, both 5-HT-immunoreactive and radioactively labeled fibers became widely distributed through the hypothalamus with especially high concentrations in and around the optic chiasma. By the 9th postnatal day, the frequency of 5-HT fibers increased considerably both in the anterior and middle hypothalamus. Some 5-HT fibers were apposed to unlabeled neurons and others abutted on the capillaries either in the organum vasculosum of the lamina terminalis or in the median eminence. The present morphologic study suggests that during the perinatal period the hypothalamic 5-HT system becomes developed enough to be involved in the regulation of some neuroendocrine functions. PMID- 3535996 TI - Development of gamma-aminobutyric acid immunoreactivity in chick hyperstriatum ventrale and cerebellum: light and electron microscopical observations. AB - The presence of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the avian hyperstriatum ventrale and dorsal cerebeller vermis was investigated immunocytochemically using a recently characterized antiserum raised against GABA. Tissue from domestic chicks aged from 19 days in ovo to 28 days posthatch was studied with both light and electron microscopy using pre-embedding immunocytochemistry. Basket, stellate and Golgi cells in the cerebellum, considered to be GABA-ergic, exhibited specific GABA-like immunolabelling in perikarya and in axonal and dendritic processes throughout the developmental period investigated. Purkinje cells also exhibited specific GABA-like immunoreactivity in both pre- and posthatch birds but the distribution and intensity of the immunolabelling varied with age and also in its location within the Purkinje neuron. In prehatch birds Purkinje perikarya exhibited heavy immunostaining which was substantially reduced posthatch, whereas the Purkinje primary dendrites remained immunopositive throughout the developmental period. A small population of cells in the medial hyperstriatum ventrale (mHV) were GABA positive prehatch, but no immunopositive perikarya were evident in any posthatch samples. Small GABA-positive punctate profiles, representing boutons and transversely sectioned axons or dendrites, were present in the neuropil of all age groups studied. Possible reasons for these findings are discussed and it is suggested that the loss of perikaryal immunostaining, both in the cerebellar Purkinje cells and in those of the mHV, may be governed by maturational processes. PMID- 3535997 TI - Immunocytochemical distribution of transferrin and its receptor in the developing chicken nervous system. AB - Transferrin is the plasma protein responsible for iron transport in all vertebrates. While transferrin is known to have growth-promoting activity on a variety of cells in culture, the role of transferrin and its membrane receptor in neuronal development is unknown. Using antibodies to transferrin and transferrin receptors, we studied the immunocytochemical localization of transferrin and its receptor in developing chicken neural tissues by the peroxidase-antiperoxidase method. In 5-day-old embryonic brain, germinal cells of the ventricular zone showed a positive reaction for transferrin receptors but were negative for transferrin. By 6-7 days, transferrin-positive cells were seen in the inner layer of the ventricular zone and a few 'patches' of transferrin-positive cells were also seen in the adjacent area. By 10 days, large neurons throughout the brain were strongly positive for transferrin. By 11-16 days, all neurons in the brain showed a strong positive reaction for the protein. Thereafter, the transferrin positive reaction became gradually weaker in neurons whereas the walls of blood capillaries showed a positive reaction for transferrin. In the adult brain, neurons showed very weak or negative staining. A similar staining pattern for transferrin was observed in the developing spinal cord and dorsal root ganglia (DRG). By 10-12 days, both spinal cord neurons and DRG neurons showed strong reactions for transferrin. Thereafter, the transferrin-positive reaction gradually diminished in older spinal cord neurons and completely disappeared from DRG neurons. Cultured cerebral hemisphere, spinal cord, and DRG neurons showed positive staining reactions for both transferrin and its receptor. Our results suggest that: transferrin is initially taken up by developing neurons from cerebrospinal fluid via receptor-mediated endocytosis; the accumulation of transferrin ultimately reaches a maximum level within immunoreactive neurons and then declines just prior to hatching; in contrast to other CNS neurons, DRG neurons accumulate transferrin only briefly and then become negative for transferrin by immunocytochemistry; and after closure of the blood-brain barrier, transferrin may reach neurons by transport across capillaries into the 'paravascular' spaces. In view of these results, transferrin may play some important but unrecognized role in early neuronal development in vivo as well as in vitro. PMID- 3535999 TI - Cholinergic mechanisms in depression. AB - Evidence supporting a cholinergic hypothesis of depression is presented. First, cholinergic overdrive produces behavioral, neuroendocrine, and polysomnographic features of melancholia, and melancholics exhibit state-independent supersensitivity to cholinergic overdrive. Drugs inducing up-regulation and supersensitivity of cholinergic systems produce behavioral, polysomnographic, and neuroendocrine effects of melancholia when withdrawn. These observations also implicate cholinergic system supersensitivity as a factor in the pathophysiology of certain affective disorders. Cholinergic and monoaminergic mechanisms reciprocally regulate drive-reduction, and substances of abuse either activate monoaminergic networks or antagonize cholinergic systems. These points are consistent with the hypothesis that dynamic interaction between cholinergic and monoaminergic systems is involved in the regulation of mood and affect. Finally, antimuscarinic agents have antidepressant effects. Thus, the hypothesis that supersensitivity of cholinergic systems is involved in the pathophysiology of affective disorders is supported by several lines of evidence. This evidence is reviewed; directions for future research and promising methods of investigation are discussed. PMID- 3535998 TI - Output systems of the dorsal column nuclei in the cat. AB - Numerous authors have demonstrated that the dorsal column nuclear complex (DCN) is functionally heterogeneous and has multiple terminal targets throughout the neuroaxis. In order to increase understanding of the functional significance of DCN's divergent connections, the present study used single and double light microscopic retrograde tracing strategies in the cat to characterize the location and morphology of DCN neurons that project to different portions of the diencephalon, rostral mesencephalon and spinal cord. These neuronal populations were then compared with those (previously reported from this and other laboratories) that project to the caudal mesencephalon, pons, inferior olive and cerebellum. When the results are considered together, a tentative picture of DCN emerges in which a population of clustered neurons that project exclusively to VPL form a core that is surrounded by and infiltrated with neurons projecting to other parts of the nervous system. Although the neuronal populations projecting to each of the different targets were individually separable anatomically by their location and/or morphological characteristics, previously reported physiological and other anatomical evidence permitted a preliminary grouping of these populations into 3 main systems. The first, a sensory tactile and kinesthetic 'cortical' system, consisted of 3 components: a double core of round, clustered medium-sized neurons (one each in the gracile and cuneate nuclei) and a variform rostral group projecting to the ventroposterolateral nucleus (VPL), a ventral group of unclustered large round neurons in the middle cuneate nucleus and a dense group of neurons in nucleus Z projecting to VPL's border with the ventrolateral nucleus (VPL/VL), and a group of mainly small-sized neurons located between the clusters of neurons or in the thin dorsal rim around the caudal and middle portions of the double cores and a populous, variform rostral group projecting indirectly (and possibly directly) to the posterior group through the intercollicular region of the tectum. The second, a sensorimotor 'cerebellar' system, consisted of multiple, subtly separable populations of neurons with different morphological characteristics all of which were located in different parts of the complex region that surrounds the cores on all sides. These neurons projected to restricted portions of interconnected targets within the zona incerta, tectum, pretectum, red nucleus, pontine grey, pontine raphe, inferior olive, and cerebellum.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536000 TI - Bovine pineal antireproductive tripeptide binds to luteinizing hormone-releasing hormone: a model for peptide modulation by sequence specific peptide interactions? AB - We report results of chromatographic, pH titration and nuclear magnetic resonance (NMR) spectroscopy studies demonstrating that the bovine pineal antireproductive tripeptide, Thr-Ser-Lys (BPART), binds to luteinizing hormone-releasing hormone (LHRH) at a site comprised of LHRH 2-5 (His-Trp-Ser-Tyr). BPART and LHRH have been shown to be antagonists in vitro. The binding constant is ca. 2 X 10(3)/mole. An NMR study of fifty other peptide pairs demonstrates that the binding is sequence and residue specific. The binding provides evidence of the amino acid pairing hypothesis, and suggests the possibility of modulation of one peptide by directly binding with another peptide. PMID- 3536001 TI - Feeding regulation by endogenous sugar acids through hypothalamic chemosensitive neurons. AB - Analysis of blood of fasted rats revealed two endogenous sugar acids, 3,4 dihydroxybutanoic acid (2-deoxytetronic acid; 2-DTA) and 2,4,5 trihydroxypentanoic acid (3-deoxypentonic acid; 3-DPA), that might be related to food intake control. Injection of 2-DTA into the third cerebral ventricle reduced food intake for 24 hr in 72 hr deprived rats and depressed single neurons activity in the lateral hypothalamus (LHA). The same amounts of 3-DPA elicited feeding in a dose-related fashion, and increased LHA single neuron activity with 6 to 8 min latency. Intravenous injection of 3-DPA, but not 2-DTA, was effective. Liposome encapsulation of 2-DTA enhanced its potency after intraperitoneal injection, probably by allowing passage across the blood-brain barrier. Electrophoretic application of 2-DTA significantly and specifically suppressed, and 3-DPA facilitated activity of glucose-sensitive (GS) neurons in the LHA. Neither affected glucose insensitive LHA neurons. Both sugar acids affected glucoreceptor (GR) neuron activity oppositely in the ventromedial hypothalamic nucleus (VMH). Intracellular recordings verified that the effect of 2-DTA on the GS and GR neurons was the same as glucose. Hyperpolarization of GR neurons with a membrane conductance increase was brought about by 3-DPA. The levels of plasma glucose and insulin changed oppositely by 2-DTA and 3-DPA, respectively when these were applied into the third cerebral ventricle. Feeding behavior and LHA and VMH neuron activity changes after injection suggest 2-DTA may be an endogenous satiety substance and 3-DPA a hunger substance, with effects mediated by GS neurons in LHA and GR neurons in VMH. Effects of 3-hydroxybutyric acid were also verified and discussed. PMID- 3536002 TI - CCK and other peptides modulate hypothalamic norepinephrine release in the rat: dependence on hunger or satiety. AB - The purpose of this investigation was to determine the functional relationship between putative satiety peptides and endogenous norepinephrine (NE) activity in the hypothalamus. Permanent guide cannulae for push-pull perfusion were implanted stereotaxically in Sprague-Dawley rats so as to rest above the medial or lateral hypothalamus (LH). Post-operatively, the animals were either satiated with food and water, both available ad lib, or fasted for 18-22 hr prior to an experiment. To perfuse a site in the LH, paraventricular (PVN) or ventromedial nucleus (VMN), a concentric 29-23 ga push-pull cannula system was lowered to a pre-determined site, in most cases after catecholamine stores had been pre-labeled with [3H]-NE. During control tests, an artificial CSF was perfused at a rate of 20-25 microliter/min for 5-8 min with a 5 min interval between each sample. The addition of cholecystokinin (CCK) in a concentration of 2.0-6.0 ng/microliter to the CSF perfused in PVN or VMN of the satiated rat enhanced the efflux of NE; however, in the fasted animal CCK often suppressed the catecholamine's release. Perfused in the LH, CCK exerted opposite effects, typically augmenting NE output when the rat was fasted but not affecting the amine's activity during the sated condition. Proglumide (1.2 micrograms/microliter) attenuated CCK's effect in releasing NE when the antagonist was perfused in the PVN of the satiated rat. Similar experiments in which neurotensin (NT) was perfused in the LH, PVN and VMN revealed virtually the same inverse effects on NE release in the fasted and satiated rat, which again were anatomically specific. Finally, insulin and 2 deoxy-D-glucose (2-DG) exerted similar state-dependent effects on the release of NE within LH and PVN. Overall, the results suggest that CCK or other neuroactive peptide could serve as a "neuromodulator" of the pre-synaptic release of NE within classical hypothalamic structures which are thought to underlie both hunger and satiety. The state-dependent nature of the peptides' activity on the noradrenergic feeding mechanism implies that these substances constitute a pivotal portion of the profile of factors which impinge functionally upon the hypothalamic neurons responsible for the feeding response and its cessation. PMID- 3536003 TI - [Dimensions of the biliary tract in ultrasonography]. PMID- 3536004 TI - [Serologic diagnosis of human chlamydial infections]. PMID- 3536005 TI - [New diagnostic procedures in hyperthyroidism: clinical evaluation]. PMID- 3536006 TI - [Electroencephalographic study of 40 patients with subacute sclerosing panencephalitis]. PMID- 3536007 TI - [Place and principles of surgery in the treatment of gastroesophageal reflux]. PMID- 3536008 TI - [Antioxidants likely to be introduced into chewing gums]. PMID- 3536009 TI - [Red blood cells and alcohol: the blood rheological manifestations of alcoholism]. PMID- 3536010 TI - [Demonstration in mice, of the radiosensitizing effect of the inhalation of a nitrous oxide/oxygen mixture]. PMID- 3536011 TI - [Cardiac biopsy in cardiovascular pathology]. PMID- 3536012 TI - [Broncho-alveolar lavage, a spearhead in pneumological research]. PMID- 3536013 TI - [Use of the broncho-alveolar lavage technic in the clinical study of sarcoidosis patients]. PMID- 3536014 TI - [Importance of cellular data from broncho-alveolar lavage in interstitial pulmonary pathology]. PMID- 3536015 TI - [Acute respiratory insufficiency following illicit silicone injections: the value of broncho-alveolar lavage]. PMID- 3536016 TI - [Revival and adverse effects of heparin therapy: low molecular weight heparins; thrombogenic thrombopenias]. PMID- 3536017 TI - [A peculiar cause of cardiac insufficiency in the aged subject: acute mitral insufficiency due to chord rupture]. PMID- 3536018 TI - [Human epidermis grown in in vitro culture is not rejected and may be used as a skin allograft]. PMID- 3536019 TI - [In defense of the title of general physician against so-called alternative medicine]. PMID- 3536020 TI - [A new technic of prenatal diagnosis: trophoblast biopsy]. PMID- 3536021 TI - [The 1st reproducible remissions in the evolution of Duchenne's muscular dystrophy]. PMID- 3536023 TI - [Louis Pasteur Vallery-Radot or the genius of friendship]. PMID- 3536022 TI - [The physician and the man (Louis Pasteur Vallery-Radot)]. PMID- 3536024 TI - [The grandson of Pasteur (Louis Pasteur Vallery-Radot)]. PMID- 3536026 TI - [Eulogy for Pierre Grabar (1898-1986)]. PMID- 3536027 TI - [A plea for allergology]. PMID- 3536028 TI - [Value of the new hearing aids]. PMID- 3536025 TI - [Pasteur Vallery-Radot and the radiance of France]. PMID- 3536029 TI - [Evolution of the medical and social concept of occupational diseases in France]. PMID- 3536030 TI - History of burn care. A survey of important changes in the topical treatment of thermal injuries. PMID- 3536031 TI - Evaluation of a new antiseptic dressing in minor burns. AB - A prospective trial was conducted to compare a new povidone iodine impregnated dressing (Inadine) with a standard petroleum jelly gauze dressing for small superficial burns treated on an outpatient basis. The results show no difference between comfort and ease of removal of dressings, in the number of positive bacteriological cultures or the number of days to healing. Inadine is more than twice as expensive as petroleum jelly gauze. PMID- 3536032 TI - [Ernst von der Porten]. PMID- 3536034 TI - Napoleon's legacy: "Waterloo teeth". PMID- 3536033 TI - [Fatal neoplastic embolism during liver transplantation]. PMID- 3536035 TI - Limitations of cardiac output measurements by thermodilution. PMID- 3536037 TI - Targeting preventive services in the Saskatchewan Dental Plan. PMID- 3536038 TI - Paleodontopathology and paleodontotherapy. PMID- 3536039 TI - Vancouver Dental Society surveys dental habits. PMID- 3536040 TI - Dental surveillance produces earlier diagnosis of oral cavity cancers. PMID- 3536036 TI - Anesthesia and myocardial infarction. PMID- 3536041 TI - Traumatic granulomas resulting from a jet injection device. Two case reports. PMID- 3536042 TI - Correction of mandibular prognathism in osteogenesis imperfecta tarda. A case report. PMID- 3536043 TI - [Secondary effects of radiotherapy on the oral tissue of children]. PMID- 3536045 TI - Aerobic degradation of choline by Proteus mirabilis: enzymatic requirements and pathway. AB - Cleavage of choline to trimethylamine and acetaldehyde by extracts of Proteus mirabilis requires both particulate and soluble protein fractions, K+, and a bound divalent metal cation. The reaction shows a long lag period, abolished only by preincubation of the particulate fraction in the complete reaction system. The two-carbon fragment produced is acetaldehyde; choline cleavage appears to be tightly coupled to dismutation of the acetaldehyde to ethanol and acetate, as indicated by stimulation by NAD+, ADP, and Fe2+ and inhibition by reagents reacting with acetaldehyde. The system is thus similar to that previously described in anaerobes (Desulfovibrio, Clostridium). Attempts to demonstrate a cobamide coenzyme requirement (as in the similar ethanolamine ammonia-lyase reaction) were unsuccessful; the reaction was carried out by fractions devoid of vitamin B12 activity (not supporting growth of Lactobacillus leichmannii) and insensitive to light. PMID- 3536044 TI - On the role of luteinizing hormone-releasing hormone in the in vitro synthesis of bioactive human chorionic gonadotropin in human pregnancies. AB - The dynamics of luteinizing hormone-releasing hormone (LHRH) induced human chorionic gonadotropin (hCG) production were studied in isolated placental cells from normal and anencephalic midterm and term gestations. A spontaneous release of immunoreactive hCG was first detected after 24-36 h of preparation in term control cells. The addition of LHRH at a concentration ranging from 10(-9) to 10( 6) M induced a threefold increase in this output of hCG. Placental cell responsiveness to LHRH varied according to the number of days of cell cultures, with maximal response on days 1 and 6. Placental cells from normal pregnancies incubated with 1 X 10(-6) M LHRH showed a release of both immuno- and bio assayable hCG, which was four- to six-fold higher at midgestation than at term (p less than 0.001). In contrast, placental cells from pregnancies with anencephalic fetuses showed, at both stages of gestation, an hCG production that was comparable to that observed with normal term placental cells. We conclude that LHRH at a concentration appropriate for its placental receptor binding affinity induces a production of bioactive hCG in humans. Furthermore, our data suggest that anencephaly changes the placental response of hCG to LHRH stimulation. PMID- 3536046 TI - 1985 Herbert Jasper lecture. Pioneers in neurosciences: the Sherrington era. PMID- 3536047 TI - Glial fibrillary acidic protein (GFAP) in oligodendrogliomas: a reflection of transient GFAP expression by immature oligodendroglia. AB - Fourteen pure oligodendrogliomas were studied by light- and electronmicroscopy and immunohistochemistry to examine glial fibrillary acidic protein (GFAP) positivity in the tumors. To compare the immunohistochemical staining patterns of neoplastic oligodendroglia and immature oligodendroglia, myelination glia in the white matter of eight normal brains from children under 6 months of age were studied. The tumors possessed light microscopic and ultrastructural features characteristic of oligodendrogliomas. Microtubules were found in the cytoplasm of nine tumors on electronmicroscopy. In one, intermediate filaments and microtubules were observed in occasional tumor cells with polygonal crystalline structures in the cytoplasm. Using the peroxidase-antiperoxidase technique, all specimens were stained for GFAP, vimentin, S-100 and neuron-specific enolase (NSE). In nine tumors, variable numbers of cells with an oligodendroglial morphology reacted positively for GFAP. All tumors were positive for S-100 and negative for vimentin and NSE. The myelination glia in the eight normal brains stained positively for GFAP but not for vimentin. Vimentin is expressed by developing, reactive and neoplastic astrocytes. Thus, GFAP positivity combined with vimentin negativity in both neoplastic and immature oligodendroglia suggests that GFAP positivity in oligodendrogliomas may reflect the transient expression of this intermediate filament by immature oligodendroglia. PMID- 3536048 TI - Oral acetylsalicylic acid improves patency rates in small-vessel anastomoses. AB - Because platelet aggregation is the critical step in vascular thrombosis, this study investigated the possibility that acetylsalicylic acid given orally would improve patency of anastomoses in small arteries. Under clean conditions, in male Sprague-Dawley rats, the superficial femoral arteries were divided and reanastomosed using the sleeve technique with 10-0 nylon suture. Fifty-one rats received a full laboratory diet and acetylsalicylic acid in their drinking water (1.08 mg/ml), before and after operation. A control group of 54 rats was matched for weight, water intake and duration of vessel occlusion. Vessel patency was assessed on postoperative day 7, at sacrifice, by dye angiography. In the experimental group 7 (13.7%) anastomoses became occluded, compared with 20 (37.0%) in the control group (chi 2 = 5.99, df = 1, p less than 0.025). Serum thromboxane B2 levels in five rats given acetylsalicylic acid orally (33.1 +/- 6.1 ng/ml) were significantly (p less than 0.001) lower than in five control rats (86.6 +/- 49.1 ng/ml). The authors concluded that acetylsalicylic acid administered in the drinking water to Sprague-Dawley rats improved the patency rate of femoral artery anastomoses probably because of a reduction in platelet aggregation. Orally administered acetylsalicylic acid may be of clinical benefit to patients who undergo small-vessel anastomoses. PMID- 3536049 TI - Controversies in biliary tract surgery. AB - There are many controversies regarding the surgical management of calculous gallbladder disease. Newer data in the surgical literature and competing medical treatments compound this confusion. In this guest lecture the author reviews current data and provides an update in seven controversial areas: the timing of operation in acute cholecystitis, the management of the diabetic patient with gallstones, the treatment of the patient with asymptomatic gallstones, the medical treatment of gallstones, the use and abuse of operative cholangiography, the management of the patient with gallstone pancreatitis and management of the patient with acalculous cholecystopathy. PMID- 3536050 TI - Thymostimulin prophylaxis of postoperative infections in anergic patients. AB - The rate of postoperative infections is significantly increased in anergic patients. The authors evaluated prospectively, in a controlled, randomized and stratified study, the efficiency of thymostimulin in reducing postoperative infections in 42 such patients. Excluded were those who were malnourished in whom preoperative alimentation corrected the anergy. The incidence of infections was significantly (p less than 0.05) reduced in thymostimulin-treated patients (4.8% versus 28.6%). PMID- 3536051 TI - Prevalence and prenatal diagnosis of neural tube defects in Nova Scotia in 1980 84. AB - A survey of the records of all hospitals with obstetric services in Nova Scotia revealed that during 1980-84 there were 122 pregnancies involving a neural tube defect. The mean rate was 2/1000 births. Of the affected fetuses or infants 54% had spina bifida, 35% had anencephaly and 11% had encephalocele. The records showed that in the early part of the period studied at least one prenatal ultrasonographic examination had been performed in 60% of the pregnancies; in 1984 the rate was 74%. When examinations done before 16 weeks' gestation were excluded, the overall detection rates at the first ultrasonographic examination were 100% for anencephaly and 73% for spina bifida and encephalocele; the rates improved toward the end of the study period. PMID- 3536052 TI - Legionnaires' disease caused by Legionella dumoffii in distilled water. AB - Five cases of Legionnaires' disease caused by Legionella dumoffii were identified within an 11-month period in a hospital in the Quebec City area. In four cases bacterial isolates were obtained from clinical specimens, and in one case seroconversion was demonstrated. All the patients had been admitted to hospital within 10 days before diagnosis. Two of the patients were immunosuppressed children. Only 1 of the 40 hot water samples from the hospital yielded L. dumoffii; however, 6 of 11 distilled water samples contained the bacterium. All the patients had been exposed to distilled water, four through respiratory therapy equipment and one through a room humidifier. Following the use of sterile distilled water in the apparatus, no further cases were identified. This is the first reported outbreak of Legionnaires' disease caused by L. dumoffii, and it is the first time that nosocomial legionellosis has been linked to contaminated distilled water in Canada. PMID- 3536054 TI - CMAJ: 75 years as the voice of the profession. PMID- 3536053 TI - Clinicopathological study of fulminant hepatitis: coinfection with hepatitis B virus and delta agent. PMID- 3536055 TI - The prevalence and scope of urinary incontinence. AB - The prevalence of urinary incontinence in different types of settings is reviewed. Some of the influences on the prevalence estimates are examined. Finally, methodologic issues that should be considered by clinicians reviewing the literature and by researchers are discussed. PMID- 3536056 TI - Psychosocial factors in urinary incontinence. AB - This article reviews psychosocial factors involved in the development and maintenance of urinary incontinence. Four aspects of this relationship are examined: the perception of and response to urinary incontinence; the development and/or exacerbation of incontinence symptoms; the psychosocial consequences for individuals, families, and caregivers; and the role of psychosocial factors in treatment. Areas for future research are identified and clinical implications of existing findings are presented. PMID- 3536057 TI - The economic impact of urinary incontinence. AB - This article provides a conceptual framework for estimating the economic impact of urinary incontinence on the society. Using this framework, the cost of urinary incontinence is estimated to be about $8 billion annually: $2 billion for nursing homes and $6 billion for the community setting. Because of a lack of reliable epidemiologic and health care utilization data, these estimates should be considered primarily illustrative. They do, however, underline the potential economic benefits to the society of reducing the incidence of urinary incontinence among the elderly. PMID- 3536058 TI - Age-related physiologic and pathologic changes affecting lower urinary tract function. AB - The physiologic changes and pathologic conditions that are frequently seen in the elderly population create a clinical challenge requiring knowledge of the "normal" voiding function, as well as commonly observed alterations. This article reviews the more common physiologic changes, disease states, and iatrogenic causes associated with aging that affect urinary tract function. PMID- 3536059 TI - Diagnostic evaluation of geriatric urinary incontinence. AB - Most continent geriatric patients can be managed appropriately after a clinical assessment including a history, physical examination, urinalysis and culture, and simple tests of bladder function. A subgroup will benefit from urologic, gynecologic, and formal urodynamic evaluation. Algorithms described in this chapter are being developed and tested; these algorithms will make clinical assessment more practical and cost effective. PMID- 3536060 TI - Urologic and urodynamic evaluation of the elderly population. AB - The importance of a thorough history and physical examination in conjunction with appropriate laboratory, radiographic, endoscopic, and urodynamic studies is emphasized, with the goal of defining the cause of incontinence in the elderly. Once the pathologic process that is causing the symptom of incontinence is objectively identified, appropriate treatment can proceed logically. PMID- 3536061 TI - Surgical treatment for female geriatric incontinence. AB - Surgery may be the most effective treatment for incontinence in the elderly female patient. Today, most of these incontinent patients are cured with surgery using the transvaginal approach, an access at low risk (especially for the geriatric female population). Surgery for stress urinary incontinence of all grades is established; however, surgical treatment for urge incontinence due to bladder instability is still controversial. PMID- 3536062 TI - Surgical treatment for male geriatric incontinence. AB - Surgical treatment of urinary incontinence in elderly men is usually reserved for those patients for whom medical therapy has failed. In properly selected patients, however, an operative approach may offer the best chance for cure. PMID- 3536063 TI - Drug therapy for geriatric urinary incontinence. AB - This article summarizes drugs currently available to treat the different types of geriatric urinary incontinence. Practical aspects of using these drugs and evidence in the literature for their efficacy are reviewed. Directions for further research on drug treatment of this condition are also discussed. PMID- 3536064 TI - Behavior therapies for urinary incontinence in the elderly. AB - Behavior therapies improve continence through systematic changes in environmental conditions. A range of procedures from self-management techniques for cooperative, independent patients to external management by caregivers for patients with significant functional impairment are described. Carefully planned and implemented behavioral interventions have been shown to reduce incontinence in several patient populations. PMID- 3536065 TI - Environmental support for geriatric incontinence. Toilets, toilet supplements, and external equipment. AB - Environmental barriers to urine control can be anticipated and eliminated through proper assessment and intervention. Various types of external equipment and products for wetting management are useful adjuncts to diagnostic and treatment plans for those with urinary incontinence. PMID- 3536066 TI - Catheters and catheter care. AB - For patients with incontinence who cannot be managed by other means, external or internal urine collecting devices may be useful. Condom catheters have been used for men, but analogous external collection devices for women are not widely available. Long-term urethral catheterization causes a dynamic polymicrobial bacteriuria that may be complicated by fever, catheter obstruction, bacteremia, acute pyelonephritis, urinary stones, chronic tubulointerstitial nephritis, renal failure, or death. Understanding these complications may lead to better decisions for patients and perhaps to new management options for incontinence. PMID- 3536067 TI - Incontinence in nursing homes. Research and treatment issues from the nursing perspective. AB - While bladder training appears to be a feasible modality for treating urinary incontinence in long-term care patients, many issues exist that prevent effective use of such a program. Multiple factors, including staff, patient, and environmental variables influence the outcome of treatment and research protocols and therefore must be addressed before any protocol can be effectively implemented. This article addresses and examines such issues in long-term care settings. PMID- 3536068 TI - Children who lie: a review of the literature. AB - In this paper we review 18 years of literature on the causes and management of lying in children. Developmental, psychoanalytic, interactional and sociological frames of reference have been applied in different papers to understand this phenomenon of childhood and adolescence. In recent years, some experimental studies confirm developmental concepts, yet others suggest that children of the eighties are changing in their moral development. The scarcity of references on the management of lying as a symptom is noted. PMID- 3536069 TI - The neuroleptic malignant syndrome: a review. AB - An overview of the neuroleptic malignant syndrome (NMS) is presented. Its clinical manifestations, pathogenesis, and current treatment are discussed. An increased appreciation of the syndrome may result in more timely interventions and reduce morbidity and mortality in this disorder. PMID- 3536071 TI - Plasmacytoma of the lung. A case report describing two tumors of different immunologic type in a single patient. AB - Two pulmonary plasmacytomas of different immunologic type, occurring with an interval of 5 years in the same 65-year-old woman are reported. Both displayed identical light chain types, but different heavy chains. The immunoperoxidase staining technique was used. The patient underwent segmental resection, and no evidence of recurrence or multiple myeloma was found 4 years later. Differential diagnoses are discussed, and the importance of immunologic staining is stressed. PMID- 3536070 TI - Prognostic significance of tumor grade in clinical trials of adjuvant therapy for breast cancer with axillary lymph node metastasis. AB - The prognostic significance of histologic tumor grade has been evaluated in 1537 women entered into the Ludwig Trials I-IV of adjuvant therapy for node-positive breast cancer. Tumor grade was determined on histologic review of primary tumor sections by two central review pathologists using a modification of the Bloom and Richardson grading system. The 5-year overall survival rates (+/- SE) were: Grade 1, 86% +/- 2; Grade 2, 70% +/- 2; and Grade 3, 57% +/- 2 (P less than 0.0001). This survival difference was seen in both premenopausal (P less than 0.0001) and postmenopausal (P less than 0.0001) women. Significant differences in disease free survival (DFS) by tumor grade were also observed (P less than 0.0001). The tumor grade determined by the 75 contributing local clinic pathologists was also highly significant for predicting DFS and overall survival. Tumor grade remained a statistically significant prognostic factor for DFS (P less than 0.0001) and overall survival (P less than 0.0001) in multivariate analyses controlling for nodal status, tumor size, estrogen receptor status, menopausal status, age, peritumoral vessel invasion, and treatment assigned. In postmenopausal patients for whom adjuvant treatment was compared with no adjuvant therapy, the prognostic significance of tumor grade was modified by the effect of treatment. The presence of vessel invasion by primary tumor cells was a stronger predictor of early recurrence than was increasing tumor grade in postmenopausal patients who received no adjuvant therapy. The higher failure rates for patients with high grade tumors was due to a larger number of failures in regional and visceral sites. Tumor grade can be determined by any pathologist and allows for selection of a subpopulation of breast cancer patients at high risk for early mortality. PMID- 3536072 TI - Fatty replacement of lymph nodes mimicking lymphoma relapse. AB - A 70-year-old man was treated successfully for diffuse histiocytic lymphoma involving the left ilium and bone marrow. He received radiation therapy to the left hip for stabilization, then eight cycles of intense (COP-BLAM) chemotherapy. Restaging at the completion of therapy demonstrated a normal physical examination, laboratory values, bone scan, bone survey, and abdominal computerized tomographic scan. One month after restaging he developed rapidly enlarging lymphadenopathy. Biopsy of an axillary node showed complete fatty replacement without lymphoma, and the patient remains in remission 16 months later. Recent reports of residual masses after lymphoma therapy have demonstrated fibrous replacement, necrotic tissue, thymic hyperplasia, and vascular anomalies mimicking lymphadenopathy. Lymph node enlargement may be due to nonmalignant causes, including fatty replacement, and not due to recurrent lymphoma. PMID- 3536073 TI - TAH: a bridge to transplant. PMID- 3536074 TI - Chromosome breakage in Fanconi's anemia and normal cells following in vitro and in vivo cocultivation. AB - Studies of Fanconi's anemia (FA) have been in conflict as to the existence of a clastogenic factor. Two male FA patients who received bone marrow transplants were studied. One FA patient received a transplant from his normal sister whose engrafted lymphocytes showed spontaneous, as well as diepoxybutane (DEB)-induced chromosome breakage in the normal range. The second FA patient received a transplant from his obligate heterozygous mother whose engrafted lymphocytes exhibited increased spontaneous chromosome breakage but not in response to DEB treatment. In vitro cocultivation of FA and FA heterozygous lymphocytes and of FA and normal lymphocytes showed chromosome breakage levels consistent with their genotypes. These results suggest that no detectable clastogenic factor is produced by FA cells. PMID- 3536075 TI - Chromosome translocations and human cancer. PMID- 3536076 TI - Differential turnover of the subunits of ribonucleotide reductase in synchronized leukemia L1210 cells. AB - Ribonucleotide reductase catalyzes the rate-limiting step in the de novo synthesis of 2'-deoxyribonucleoside 5'-triphosphates that is required for DNA replication. The mammalian enzyme consists of two nonidentical protein subunits that are both required for enzyme activity. In leukemia L1210 cells, enriched in G1-phase cells by centrifugal elutriation, it was found that ribonucleotide reductase activity increased as the cells progressed to S-phase. The two subunits making up the holoenzyme did not increase coordinately. The nonheme iron subunit increased much more rapidly than the effector-binding (EB) subunit. The activity of the holoenzyme paralleled the level of the EB subunit, which was limiting. The half-lives of the holoenzyme and its subunits were determined in S-phase cells by treatment with cycloheximide. The half-lives of the holoenzyme and the nonheme iron and EB subunits, as determined by enzyme activity, were 3.5, 7.6, and 4 h, respectively. These half-lives are consistent with the data that indicate that the EB subunit is the limiting component in L1210 cells. PMID- 3536077 TI - Metabolism of nitromiphene (CI 628) in the immature female rat: role of gastrointestinal microflora in the biotransformation of a triarylethylene antiestrogen. AB - Nitromiphene (NIT; CI 628) is a triarylethylene antiestrogen shown to be effective in treatment of experimental breast cancer. We have studied the fate of NIT in the immature female rat, the animal model in which most of the biochemical studies of NIT have been carried out. NIT was eliminated mainly via the feces after i.p. administration, primarily as metabolites. One of these, a diphenylmethane derivative, p-[2-(N-pyrrolidinyl)ethoxy]-p'-methoxybenzophenone (PMB), was also eliminated in urine as such and as its O-demethyl and keto reduced metabolites. In uterine and liver tissue, unchanged NIT was accompanied by demethyl NIT (CI 628M), PMB, and a diarylacetophenone derivative, p-[2-(N pyrrolidinyl)ethoxy-p'-hydroxybenzhydryl phenyl ketone (demethyl KET). In vitro studies showed that O-demethyl NIT was produced in the presence of liver enzymes and that PMB and demethyl KET were produced in the presence of intestinal bacteria. These results suggested that PMB and demethyl KET accumulate in uterine and liver tissue due to reabsorption from the intestine after having been produced there from NIT and demethyl NIT, respectively. The effects of antiestrogens and their metabolites may be due in part to interaction with antiestrogen binding sites. Both demethyl KET and PMB had good affinity for such sites. Thus, these enteric bacterial metabolites not only have the ability to accumulate in vivo, but could, together with demethyl NIT, contribute to the antiestrogenic effects observed with NIT. PMID- 3536078 TI - Terminal erythroid differentiation in the K-562 cell line by 1-beta-D arabinofuranosylcytosine: accompaniment by c-myc messenger RNA decrease. AB - Two erythroid markers, acetylcholinesterase and hemoglobin, can be reversibly induced in the K-562 cell line after sodium butyrate treatment. In the present paper we show that 1-beta-D-arabinofuranosylcytosine (ara-C), induces the coordinate, irreversible expression of these two erythroid markers. This induction occurs at an ara-C concentration (0.05 mM) that results in K-562 cytostasis and is accompanied by deep morphological changes of cells. The differentiated phenotype is independent of the K-562 cell clone used [K-562, K 562 (S), K-562 (S)P] and is associated with the loss of cell renewal capacity. Continuous presence of the inducer is not necessary to achieve terminal differentiation. In contrast to what is seen for other inducers (sodium butyrate and hemin), one of the early effects of ara-C treatment is the marked decrease of c-myc mRNA expression after the first 4 hours of induction, whereas N-ras and histone 4 expression remain constant during the first 48 h. Our results suggest that ara-C treatment can irreversibly activate the erythroid differentiative program of K-562 cells. PMID- 3536079 TI - Microinjection of the ras oncogene protein into nonestablished rat embryo fibroblasts. AB - Early (twice) and late (eighth) passage nonestablished rat embryo fibroblasts exhibit dramatically different responses to microinjection of the oncogenic form (T24) of the ras protein. Late passage cells respond like established cultures in that they both synthesize DNA and divide in response to the oncogenic protein. However, early passage cells are shown to be much less responsive to the introduction of this protein in terms of the threshold concentration required to elicit a mitogenic response. Furthermore, conditioned medium from late passage cells can both potentiate the effect of ras in early passage cells and stimulate colony formation in soft agar. In addition, we show that human cells can respond to microinjection of the ras oncogene protein by synthesizing DNA. PMID- 3536080 TI - Membrane-associated glycoprotein (gp 160) identified on human lung tumors by a monoclonal antibody. AB - A monoclonal antibody (5E8) has been used to identify and structurally characterize a previously unreported macromolecule present on the surface of human lung tumors. This antibody was derived from a hybrid clone that was produced using spleen cells of mice immunized with a surgically excised squamous cell carcinoma. Using immunofluorescence, the 5E8 antibody was observed to stain many different human lung tumor cell lines and surgically excised human lung tumors including squamous cell carcinomas, adenocarcinomas, alveolar carcinomas, and a portion of the large cell tumors tested. With few exceptions, notably the basal layer of the skin, little or no detectable staining of 5E8 to normal human tissues (lung, brain, kidney, heart, stomach, breast, erythrocytes, or lymphocytes) was observed. The 5E8 antibody was used to immunoprecipitate detergent lysates of biosynthetically labeled or surface radioiodinated lung tumors. Analysis of the immunoprecipitates by sodium dodecyl sulfate gel electrophoresis revealed a major band and a faster migrating second minor band. The molecular weights of these two proteins were estimated to be 160,000 and 120,000, respectively. The addition of a reducing agent to the gels did not alter the migration pattern of the immunoprecipitated macromolecules. The removal of a terminal carbohydrate, sialic acid, did not restrict the binding of 5E8 to the tumor-associated antigen. However, labeling studies using galactose oxidase and tritiated borohydride revealed the presence of galactose on the immunoprecipitated protein. This major Mr 160,000 glycoprotein that was identified on two different human lung tumor cell lines was also found on a human large cell tumor tissue obtained by surgical biopsy. The 5E8 antibody and the Mr 160,000 glycoprotein that it recognizes represent two very useful components with which to test several new antibody-mediated drug delivery systems in the treatment of human lung tumors. The tumor-associated glycoprotein also represents a potential analyte for a diagnostic or prognostic immunoassay for lung cancer. PMID- 3536081 TI - Cancer procoagulant in human tumor cells: evidence from melanoma patients. AB - It has repeatedly been proposed that fibrin plays a role in tumor growth and metastasis. Among tumor cell products or activities which may promote clot formation, cancer procoagulant (CP), a direct activator of coagulation factor X, has been suggested to be selectively associated with the malignant phenotype. We report here the enzymatic and immunological identification of this cysteine proteinase procoagulant in extracts and cells from human melanoma. CP activity was independent of both the intrinsic and extrinsic pathways of blood coagulation, using factor IX and factor VII deficient plasmas, and was inhibited by the cysteine proteinase inhibitors iodoacetamide and HgCl2. CP activity was detectable in extracts and cell suspensions from all 32 patients studied and was higher in extracts from metastases (14.8 +/- 3.9 units/mg protein) than from the primary tumors (3.7 +/- 1.0 units/mg protein). CP activity was not affected by an anti-apoprotein III antibody or by concanavalin A, a known inhibitor of thromboplastin. In contrast, no CP activity or antigen was detected in extracts from six benign melanocytic lesions. The procoagulant activity was dependent on factor VII and was inhibited by anti-apoprotein III antibody and by concanavalin A, properties that suggest that the procoagulant was tissue thromboplastin. These data indicate that CP can be expressed by human tumor cells and that, among melanotic lesions, its presence is associated with the malignant phenotype and its activity is particularly high in metastatic cells. PMID- 3536082 TI - Histochemical studies with an estrogen receptor-related protein in human breast tumors. AB - The histochemical characteristics of a Mr 29,000 phosphoprotein related to estradiol receptor are described in a large series of human breast tumors. The antigen was detected with a monoclonal antibody (D5) raised against partially purified human myometrial estradiol receptor. An indirect immunoperoxidase method was used with methacarn-fixed, wax-embedded sections. Quantitation of staining and its reproducibility are described. Results with trucut biopsies agree with those obtained with larger tumor sections. Normal breast is infrequently positive. Histochemical staining is higher in invasive carcinoma than in normal breast with ductal carcinoma in situ adjacent to infiltrating tumors exhibiting intermediate values. Furthermore, most in situ carcinomas have a heterogeneous staining pattern. About 20% of invasive tumors also exhibit heterogeneity. No simple correlation is seen between staining and histological grade. There are more low-staining tumors in young (less than 50 yr old) patients than in older women. Staining correlates with levels of cytosol estradiol receptor but not cytosol progesterone receptor. However, cytosol estradiol receptor-negative, cytosol progesterone receptor-positive tumors tend to have positive Mr 29,000 phosphoprotein levels. Positive staining is associated with a higher response rate to hormone therapy (50%). None of the negative tumors responded to hormone treatment. With these patients, comparison of histochemical assay for Mr 29,000 phosphoprotein and [3H]estradiol binding assays indicated that the former was at least as good as the latter assay in predicting hormone response. About 20% of cytosol estradiol receptor-positive tumors have low Mr 29,000 phosphoprotein, and such tumors have poor response to hormone treatment. PMID- 3536084 TI - Biochemical mechanisms of oncogene activity: proteins encoded by oncogenes. PMID- 3536083 TI - Purification, partial characterization, and clinical evaluation of an adenocarcinoma-associated antigen. AB - The current investigation describes the purification and partial characterization of a new adenocarcinoma-associated antigen (ACAA). ACAA is a large molecular weight glycoprotein (Mr 790,000 by size chromatography on Sepharose CL-6B) that migrates in the alpha 1 region upon electrophoresis and is eluted from a DEAE cellulose column at a 0.1 M NaCl concentration. ACAA is immunochemically and biochemically different from carcinoembryonic antigen, alpha-fetoprotein, pancreatic oncofetal antigen, human pancreatic tissue antigen, CA 19-9, ferritin, and acute-phase proteins. Assays for ACAA were carried out using a solid-phase sandwich enzyme immunoassay. The results indicate that ACAA is present in sera of all individuals. Patients with cancer have higher serum levels of ACAA than normal individuals. The greatest frequency of elevated serum values of ACAA was seen in patients with lung and pancreatic cancers followed by colorectal, breast, and prostate cancer. The measurement of ACAA levels may be valuable in the diagnosis and clinical management of patients with certain cancers. PMID- 3536085 TI - Biochemical mechanisms of oncogene activity: proteins encoded by oncogenes. Introduction. PMID- 3536086 TI - The sis gene and PDGF. AB - The aberrant expression of a protein that is involved in normal growth regulatory pathways can cause cell transformation. One of the best examples of this phenomenon is the transformation of fibroblasts by the simian sarcoma virus (SSV). An oncogene (v-sis) of this virus encodes a protein whose amino acid sequence is highly homologous to one of the subunits of a mesenchymal cell mitogen, platelet-derived growth factor (PDGF). How does expression of the v-sis or related genes transform cells? Clearly, this process uses biochemical pathways involved in the normal actions of growth factors. For example, the v-sis-encoded protein appears to act through cellular PDGF receptors. The biochemical consequences of PDGF receptor activation include increased tyrosine kinase activity, enhanced expression of a set of genes associated with cell proliferation, the dramatic alteration in cellular cytoskeleton, a rapid turnover of membrane phospholipids and the commitment of the cell to proceed through a series of responses culminating in the replication of DNA. An important issue is whether, in SSV transformed cells, these biochemical pathways are simply overstimulated by an abundance of self-made growth factor, or are there qualitative alterations in the pathways that are unique to these cells. Several specific related questions are addressed in this discussion: Is the protein encoded by the v-sis gene functionally identical to PDGF? Does the v-sis-encoded protein act at the cell surface or at intracellular sites? In the action of PDGF like compounds, what are the biochemical steps distal to receptor stimulation?(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536087 TI - Differentiating agents in the treatment of human malignancies. PMID- 3536088 TI - Sarcoid reactions in malignant tumours. AB - Tumour-related tissue reactions resulting in the formation of epithelioid-cell granulomas have been known for almost 70 years. Such sarcoid reactions may occur in lymph-nodes draining an area housing a malignant tumour, in the tumour itself, and even in non-regional tissues. Overall, sarcoid reactions occur in 4.4% of carcinomas, in 13.8% of patients with Hodgkin's disease, and in 7.3% of cases of non-Hodgkin lymphomas. Similar histologic changes in sarcoma appear to be extremely rare. Most probably, sarcoid reactions are caused by antigenic factors derived from the tumour cells, eliciting an immunological hypersensitivity reaction leading to the formation of epithelioid-cell granulomas. Sarcoid reactions may be a marker of an immunologically mediated antitumour response of macrophages activated by T-lymphocytes, and in Hodgkin's disease there is evidence that patients with sarcoid reactions have a better prognosis. On occasion sarcoid reactions may be so extensive that they complicate the diagnosis of an underlying malignant disease. Problems may also arise of distinguishing between tumour-related sarcoid reactions and true systemic sarcoidosis. PMID- 3536089 TI - Minimal residual neoplastic disease--concept, pathogenesis, and supplementary therapeutic possibilities. PMID- 3536090 TI - Cerebral infarction in term neonates: diagnosis by cerebral ultrasound. AB - Cranial ultrasound (US) through the newborn's open fontanelle can diagnose not only intracerebral hemorrhages but also diffuse and localized hypoxic-ischemic encephalopathies. Sonographically, it was possible to distinguish between different courses of cerebral ischemia in seven neonates: ischemic infarction, usually in the area of the middle cerebral artery: borderline infarction; transient ischemia. The patients showed lateralized seizures during the first days of life with a corresponding focus in the electroencephalogram (EEG). Computed tomography showed areas of partially reduced density corresponding to the regions of increased echogenicity in ultrasound. The course was various; prognosis was good except in one patient. Etiologically, embolism, thromboses or hypoxemia were responsible for cerebral infarction. In some cases secondary bleeding ensued. The prognostic value of cerebral lesions was dependent on the involved area, gestational age, and any concurrent hypoxic cerebral damage. PMID- 3536092 TI - Immunohistochemical study of carcinoembryonic antigen, epithelial membrane antigen, and secretory immunoglobulin system in the large bowel adenoma-carcinoma sequence. AB - To identify parameters for the malignant potential of large bowel adenomas, we used the avidin-biotin-peroxidase complex (ABC) technique. Patterns of carcinoembryonic antigen, epithelial membrane antigen, IgAs, and secretory component in 31 tubular, tubulovillous, and villous adenomas with different grading of dysplasia (mild, moderate, severe) and with early cancer were studied. All markers showed different degrees of staining intensity and various cellular localizations. We found that these variations might be related to dysplasia grading. Adenoma size did not influence the marker patterns. IgAs seemed to be the more selective among the markers studied. Our results suggested a dysplasia carcinoma sequence instead of an adenoma-carcinoma sequence concept. PMID- 3536091 TI - Cerebral aspergillosis and encephalomeningocele. AB - A case of massive cerebral aspergillosis complicating a frontal encephalomeningocele is reported. The etiology and pathogenesis are discussed and the diagnosis, symptoms, and treatment possibilities reviewed. PMID- 3536094 TI - Silent myocardial ischemia and its relationship to acute myocardial infarction. AB - The preceding review indicates that silent myocardial ischemia has definite prognostic implications in both symptomatic and asymptomatic patients with coronary artery disease. Patients surviving an acute myocardial infarction are at a particularly high risk if they show evidence of myocardial ischemia. At present, many noninvasive diagnostic modalities are available to the physician for the evaluation of symptomatic and silent myocardial ischemia in such patients. Because as many as 30 per cent of patients may become asymptomatic after myocardial infarction, physicians must be aggressive in evaluating their patients for the presence of silent myocardial ischemia. The presence of silent ischemia would help identify those patients at high risk of postinfarction complications. Future use of currently available therapeutic modalities directed toward treatment of total ischemic burden on the myocardium may help lower morbidity and mortality in these patients by reducing the risk of subsequent cardiac events. PMID- 3536093 TI - The role of host lymphocytes and host macrophages in antitumor reactions after injection of sensitized lymphocytes and tumor target cells into naive mice. AB - DBA/2 mice were immunized i.p. against syngeneic SL2 lymphosarcoma cells. At various days after the last immunization peritoneal and spleen lymphocytes were collected. The lymphocyte suspensions were enriched for T-cells by nylon wool filtration. The peritoneal T-cells from immunized mice (a) expressed direct specific antitumor cytotoxicity in vitro, (b) induced macrophage cytotoxicity in vitro, and (c) exerted tumor neutralization measured in a Winn-type assay. Spleen T-cells from these immunized mice (a) expressed no direct specific antitumor cytotoxicity in vitro, (b) only induced moderate macrophage cytotoxicity in vitro, but (c) exerted tumor neutralization in a Winn assay. For effective tumor neutralization in vivo effector target cell ratios of 1000:1 were required. When the effector/target ratio of 1000:1 was maintained but the absolute numbers of effector and target cells were lowered from 10(6) to 10(5) lymphocytes and 10(3) to 10(2) target cells respectively, no tumor neutralization was obtained. The major effect of the sensitized-transferred T-lymphocytes seemed to be the induction of cytotoxic macrophages in the (naive) recipient mice, as the peritoneal macrophages collected from the recipient mice 7 days after i.p. injection of a mixture of sensitized T-cells and tumor cells were cytotoxic. Purified peritoneal T-lymphocytes collected from these recipient mice were able to induce macrophage cytotoxicity in vitro but expressed no cytotoxic T-cell activity. In conclusion, our results show that in the tumor system used, tumor neutralization after transfer of sensitized lymphocytes is not dependent on the presence of cytotoxic T-lymphocytes. Lymphocytes with the strongest potency to render macrophages cytotoxic (in vitro and in vivo) also induce the best tumor neutralization in vivo, suggesting an important role for host macrophages as antitumor effector cells. PMID- 3536095 TI - Left ventricular function abnormalities as a manifestation of silent myocardial ischemia. AB - A large body of evidence exists indicating that left ventricular dysfunction is a common occurrence in patients with severe coronary artery disease and represents silent or asymptomatic myocardial ischemia. Such dysfunction probably occurs early in the time course of every ischemic episode in patients with coronary artery disease whether symptoms are eventually manifested or not. The pathophysiology of silent versus symptomatic left ventricular dysfunction due to ischemia appears to be identical. Silent ischemia-related left ventricular dysfunction can be documented during spontaneous or stress-induced perturbations in the myocardial oxygen supply/demand ratio. It also may be detected by nitroglycerin-induced improvement in ventricular function or by salutary changes in wall motion following revascularization. Silent left ventricular dysfunction is a very early occurrence during ischemia and precedes electrocardiographic abnormalities. In this light, its existence should always be kept in mind when dealing with patients with ischemic heart disease. It can be hypothesized that because silent ischemia appears to be identical to ischemia with symptoms in a pathophysiologic sense, prognosis and treatment in both cases should be the same. PMID- 3536096 TI - Treatment of silent myocardial ischemia. AB - Long-term studies regarding the effect of treatment on prognosis are lacking, but the adverse implications suggested for silent ischemia support aggressive management. Treatment of silent ischemic episodes is possible utilizing a large variety of agents. Optimal detection and quantitation methods are still being developed, but guidelines for treatment should be similar to those for treatment of symptomatic ischemia. PMID- 3536098 TI - Tricuspid valve replacement. PMID- 3536097 TI - Possible mechanisms responsible for silent myocardial ischemia: do patients with silent myocardial ischemia have altered pain thresholds? AB - There is some evidence that alterations in pain perception are present in patients with coronary artery disease and painless myocardial ischemia, but whether endorphins are implicated is still unclear. Further studies are also needed to document the validity of various theories of the cardiac pain mechanism itself, especially the existence of specific nociceptive sympathetic fibers. PMID- 3536099 TI - Pulmonic valve. PMID- 3536100 TI - Pharmacologic therapy of cor pulmonale. AB - Oxygen remains the mainstay for the therapy of pulmonary hypertension and right ventricular failure in patients with COPD. Oxygen selectively vasodilates the pulmonary vascular bed, increases oxygen delivery and mixed venous oxygen tension, and reduces the elevated pulmonary vascular resistance and right ventricular work. Clinically, oxygen therapy improves neurologic function, exercise performance, and survival. Digitalis therapy is indicated only in patients with biventricular failure or supraventricular tachycardia. Diuretics should be used carefully. Two investigational therapies offer promise, but are unproven. Almitrine increases arterial PO2, and vasodilators lower pulmonary vascular resistance. Despite the proper use of the drugs reviewed in this chapter, the current therapy for the treatment of right ventricular hypertrophy and failure is limited. Improved therapy will require a better understanding of the pathophysiology that causes a hypertrophied ventricle to fail. PMID- 3536101 TI - Chronic right heart failure: pulmonary considerations. AB - Right ventricular failure is a frequent companion of chronic pulmonary disease, particularly that associated with chronic desaturation. Increases in right ventricular after-load will occur as the result of a number of mechanisms, many of which are present in the face of altered pulmonary physiology. To assess the role of pulmonary disease in the development of chronic right failure, one needs a knowledge of the physiologic effects of the respiratory process in each individual. Is the physiologic profile appropriate to be associated with cor pulmonale? Advances in understanding control of breathing, sleep-disordered breathing, and exercise contribute to clarifying the clinical picture of many patients with chronic right heart failure. In these patients, changes in afterload continue to be the central predominant problem. PMID- 3536102 TI - Radionuclide and angiographic assessment of the right heart. AB - Although the pleomorphic nature of the human right ventricle makes wall motion assessment a challenge, it is a worthy challenge in terms of recognizing clinical infarction, ischemia, and primary contractile abnormalities of the right heart. As for the left ventricle, contrast angiography provides the best frame of reference, but will hopefully make way for noninvasive radionuclide ventriculographic methods after systemic evaluation has been carried out. PMID- 3536103 TI - Pathophysiology and therapy of right ventricular dysfunction due to pulmonary embolism. AB - When shock complicates an acute increase in RV afterload, initial therapy should be directed toward restoration of an adequate BP (RV coronary perfusion pressure) and CO. Current results indicate that norepinephrine, a drug with direct inotropic and pressor effects, may be an excellent agent for acute resuscitation and short-term maintenance of hemodynamic stability when frank circulatory instability complicates pulmonary embolism. Following hemodynamic stabilization, thrombolytic therapy should be initiated. Recent evidence suggests that the lytic agent can be given by bolus technique, but more work is required to determine the optimum dosing regimen. In the absence of shock, when a moderate decrease in CO complicates pulmonary embolism, isoproterenol or hydralazine may be used to improve flow. However, both of these agents may decrease systemic vascular resistance and BP. Accordingly, the latter parameter should be carefully monitored to ensure that excessive falls in BP and RV coronary perfusion pressure do not occur. Whereas in certain conditions volume expansion is appropriate therapy to increase CO, in acute pulmonary hypertension with excessive RV afterload, volume expansion may worsen RV function. Recent canine studies indicate that an increase in vascular closing pressure is the predominant mechanism explaining the increase in PAP and apparent increase in PVR complicating pulmonary embolism. Accordingly, in addition to decreasing vascular resistance, therapy to decrease RV afterload could be directed toward decreasing the vascular response producing excessive closing pressures. PMID- 3536104 TI - Right ventricular infarction. PMID- 3536105 TI - Right ventricular function: the assessment of contractile performance. PMID- 3536106 TI - Etiology of pure tricuspid regurgitation. AB - Of multiple etiologies for pure tricuspid regurgitation, the causes may be divided into those associated with anatomically abnormal and anatomically normal tricuspid valves. Conditions associated with anatomically abnormal valves include rheumatic, floppy, Ebstein's anomaly, carcinoid, infective endocarditis, papillary muscle dysfunction, and other rarer causes such as radiation, hypereosinophilic syndrome, and endomyocardial fibrosis. Conditions associated with anatomically normal tricuspid valves include multiple causes of cor pulmonale (chronic obstructive pulmonary disease, primary pulmonary hypertension, and pulmonary hypertension due to mitral stenosis). Of 45 necropsy patients with clinically documented pure tricuspid regurgitation, conditions producing pulmonary hypertension (cor pulmonale, mitral stenosis) were the most frequent etiology (47 percent), followed by floppy (16 percent), rheumatic (11 percent), idiopathic dilated cardiomyopathy (9 percent), Ebstein's anomaly (7 percent), and miscellaneous conditions (10 percent). Of multiple causes of pure mitral regurgitation, tricuspid valve anular circumference and leaflet area are useful measurements in establishing etiology: dilated anuli (greater than 12 cm) are associated with Ebstein's anomaly, floppy valves, and multiple causes of pulmonary hypertension. Increased leaflet areas are associated with floppy valves and Ebstein's anomaly. Anular insertion site separates floppy tricuspid valves from Ebstein's anomaly. Of 21 purely regurgitant operatively-excised tricuspid valves, the etiologies were: rheumatic (43 percent), "functional" due to pulmonary hypertension from mitral stenosis (38 percent), Ebstein's anomaly (9 percent), infective endocarditis (5 percent), and floppy (5 percent). In contrast to etiology of pure mitral regurgitation, rheumatic disease is the leading cause for operative excision of purely regurgitant tricuspid valves. Comparison of systolic pulmonary arterial pressures and tricuspid valve morphology disclosed that pulmonary arterial pressures greater than or equal to 55 mm Hg and tricuspid valve anuli greater than 12 cm were associated with anatomically normal tricuspid valves and that pulmonary arterial pressures less than or equal to 40 mm Hg and tricuspid anuli less than 12 cm were associated with anatomically abnormal tricuspid valves. PMID- 3536107 TI - Tricuspid valve prolapse. AB - Tricuspid valve prolapse is an infrequent echocardiographic finding that is most commonly associated with mitral valve prolapse. When compared with patients exhibiting isolated prolapse of the mitral valve, patients with tricuspid valve prolapse are somewhat older individuals with a slightly higher frequency of neurologic symptoms, fatigue, weakness, supraventricular arrhythmias (especially atrial fibrillation) and skeletal deformities. Tricuspid valve prolapse may serve as a marker of more-diffuse connective tissue abnormalities, and its identification also should prompt an echocardiographic search for evidence of prolapse and regurgitation of the other heart valves. PMID- 3536108 TI - Nifedipine in the treatment of Raynaud's syndrome. AB - Thirteen patients with Raynaud's syndrome (10 idiopathic and three with scleroderma) were treated with nifedipine or placebo in a double blind crossover study. The immediate response to 20 mg nifedipine or placebo and the response to a three week course of treatment (10 mg nifedipine eight hourly) were assessed by Doppler mapping of digital arteries, finger pulse volume recordings, skin temperature measurements, and arterial Doppler waveform analysis. In addition, the number, duration, and severity of vasospastic attacks were noted, together with patient and observer opinion of each treatment, an overall pain score, and patient preference. There was a significant reduction in the number of attacks and in linear analogue score for pain after three weeks of nifedipine. Patient and observer opinion showed a significant preference for nifedipine. The objective tests, however, failed to detect any significant change in either the short or long term. This study supports the use of nifedipine for the relief of symptoms in selected patients with Raynaud's syndrome and implies that it may have a unique mode of action. PMID- 3536109 TI - Use of the single-section technique in caries research. PMID- 3536110 TI - Histochemical studies on the effects of lethal total body X-irradiation on the pancreas of dogs rescued by autologous bone marrow transplantation. PMID- 3536111 TI - [The oral glucose tolerance test combined with the determination of insulin, cortisol, growth hormone, thyroxine and triiodothyronine in obese women. I. Results from the entire group]. PMID- 3536112 TI - [The significance of histocompatibility and certain other factors in kidney transplantation]. PMID- 3536113 TI - [Decreased activity of the renal vasodilation and natriuretic system in normotensive men with a familial history of essential hypertension and decreased Na+, K+-cotransport in erythrocytes]. PMID- 3536114 TI - [The 100th anniversary of the birth of Prof. Jiri Divis]. PMID- 3536115 TI - [Phoniatrics in Czechoslovakia]. PMID- 3536116 TI - Synthesis and distribution of laminin-related polypeptides in early amphibian embryos. AB - Western blotting experiments carried out with several heterospecific antibodies against mouse-derived laminin allowed the identification of four laminin-related polypeptides in early Pleurodeles waltlii embryos. Synthesis of all four polypeptides was detected from the early blastula stage to late gastrula stage. Immunofluorescent staining with anti-laminin and anti-fibronectin antibodies provided evidence for a close association of these laminin-related polypeptides with the fibronectin fibrillar network. PMID- 3536117 TI - Effects of degranulation of mast cells on proliferation of mesenchymal cells in the mesentery of mice. AB - A mast-cell activator, compound 48/80, causes proliferation of mesenchymal cells in the mesentery of rats. Its effect on W/Wv mice deficient in mast cells was tested to determine whether the proliferation is mediated in the degranulation of mast cells. Incorporation of [3H]thymidine into mesenchymal cells in the mesentery of these mice with or without compound 48/80 was very small compared to their normal litter mates. However, bone marrow transplantation markedly enhanced the effect of compound 48/80, and resulted in an incorporation of [3H]thymidine almost comparable to that observed in normal mice. Our results provide evidence that mesenchymal cell proliferation is caused by a product secreted by mast cells when stimulated by compound 48/80. PMID- 3536119 TI - Embryo implantation and proteinase activities in a marsupial (Macropus eugenii). Histochemical patterns of proteinases in various gestational stages. AB - Embryo implantation remains superficial (epithelio-chorial type) in most marsupials including the Macropodidae, but does involve formation of specialized contact zones of the trophoblast with the uterine epithelium. Since in eutherian mammals proteinases appear to play a central role in implantation-initiation mechanisms, a systematic histochemical investigation of proteinase patterns as related to implantation was performed in the tammar wallaby, Macropus eugenii (Macropodidae). Tammar uteri with embryos were collected at diapause and at days 7, 17, 18, 19, 20, 21 and 26 of the 27-day gestational period. Proteinase patterns were studied using a sensitive histochemical gelatin-substrate-film test previously optimized for the detection of trophoblast-dependent proteinase (blastolemmase) in the rabbit. Proteinase patterns were correlated with light microscopical morphology of the processes of shedding of the extracellular embryo coverings (shell membrane) and attachment of the trophoblast to the uterine epithelium. At acid pH values an intracellular proteinase is detected in yolk sac endoderm and trophoblast as well as in endometrial glands and certain stromal cells. This enzyme is proposed to be a cathepsin indicating high catabolic activity connected particularly with protein transport from the endometrium into the yolk sac. Peak activity is found in the avascular (bilaminar) yolk sac at the phase when contact with the endometrium is being established. A particularly interesting proteinase active at alkaline pH values is detected in the trophoblast-endoderm complex. This enzyme appears to be extruded into the interface between trophoblast and uterine epithelium where it shows maximal activity for only approximately one day, around day (18-)19, exclusively in the bilaminar (avascular) yolk sac. The activity is correlated with the process of shedding of the extracellular embryo coverings (shell membrane) and of subsequent attachment of the trophoblast to the uterine epithelium, in the bilaminar but not the trilaminar (vascular) yolk-sac region. This is the first report on an extracellular (alkaline) proteinase activity possibly serving a specific function in embryo implantation in a marsupial. PMID- 3536118 TI - The shape and distribution of astrocytes in the retina of the adult rabbit. AB - Astrocytes stained by antibodies to glial fibrillary acidic protein (GFAP) were examined in whole-mount preparations of retinae from adult rabbits and found to be restricted to the medullary rays. Astroglial cells exhibited a variety of shapes that varied between two extreme morphologies. One extreme was an astrocyte that possessed a few sturdy primary processes as well as finer processes and was strongly GFAP positive. The other extreme was an astroglial cell that displayed a star-shaped appearance; its perikarya gave rise to a few thin, radially oriented processes, which were rather weakly GFAP positive. The majority of astroglial processes were aligned with the ganglion-cell axons, but some of their processes were in contact with capillaries. It has been proposed that astrocytes are specifically associated with ganglion-cell axons. Their restriction to the medullary rays in the retina of the rabbit suggests, however, that their physiological role is also concerned with the vascular system. PMID- 3536123 TI - [E type botulism in China]. PMID- 3536121 TI - Effects of estradiol and mammalian LHRH on the ultrastructure of the pars distalis of the eel. AB - Male silver eels were injected with estradiol-17 beta (E2) to induce the development of gonadotropic (GTH) cells. They were subsequently injected with luteinizing hormone-releasing hormone (LHRH). Exocytotic figures and the lysis of some large globules and granules were observed. Morphometric studies showed a significant increase in the percentage of vacuoles after 4 and 6 injections of LHRH and a slight but significant decrease of granules. This response did not, however, occur in all GTH cells which never appeared completely degranulated and did not reach a vesicular stage. Hemi-pituitaries of E2-pretreated eels were incubated with or without LHRH (20 min to 2 h). Although typical exocytoses were not detected, an increased number of small granules near the basal lamina and lytic processes (globules with a raspberry-shaped structure, granules with variable electron density) were observed in the LHRH-incubated hemi-pituitaries compared with those kept in a control medium. The structure of GTH cells and their response to LHRH has been studied only under conditions of artificial stimulation, and their functional similarity to GTH cells of spontaneously maturing eels is discussed. Large female eels had unstimulated GTH cells. Growth hormone (STH), thyrotropic (TSH) and prolactin (PRL) cells were stimulated after E2 and LHRH. As with GTH cells, they regressed slowly after treatment was discontinued. PMID- 3536122 TI - [Use of monoclonal antibodies in epidemiology]. PMID- 3536120 TI - Effect of salt loading and salt deprivation on the vasopressin and oxytocin content of the median eminence and the neural lobe in adrenalectomized rats. AB - In adrenalectomized rats the influence of salt loading or salt deprivation on the vasopressin and oxytocin content of the median eminence (ME) and the neural lobe (NL) was studied by means of various methods: morphometric and microphotometric analysis of aldehyde fuchsin-stained sections of ME and NL; immunohistochemical demonstration of neurophysin, oxytocin, and vasopressin in the ME and in the NL; radioimmunological measurement of oxytocin and vasopressin in the ME and in the NL. Adrenalectomy in salt-substituted rats raised the vasopressin content of the outer layer of the ME (OLME) but had no influence on the amount of vasopressin in the inner layer of the ME and in the NL. Osmotic stimulation of adrenalectomized rats by hypertonic saline markedly diminished vasopressin and oxytocin in the inner layer of the ME and in the NL but did not, or only slightly reduced vasopressin in the OLME. Withdrawal of salt supplementation in adrenalectomized rats resulted in a decrease of plasma sodium and plasma volume. It did not change the vasopressin or oxytocin content of the inner layer of the ME and of the NL, but it was correlated with a decrease of vasopressin in the OLME. The present findings may suggest that vasopressin in the OLME is involved in salt and/or volume regulation by influencing the hypophysial-adrenal axis. PMID- 3536124 TI - Immunotoxins. PMID- 3536125 TI - Effects of bombesin and insulin on inositol (1,4,5)trisphosphate and inositol (1,3,4)trisphosphate formation in Swiss 3T3 cells. AB - The effects of bombesin and insulin, separately and in combination, have been studied in Swiss mouse 3T3 cells. Bombesin caused a rapid transfer of 3H from the lipid inositol pool of prelabeled cells into inositol phosphates. Label in inositol tetrakisphosphate (InsP4) and in Ins1,4,5P3 and Ins1,3,4P3 rose within 10 sec of stimulation and that in Ins1,4P2, another InsP2 and InsP1, more slowly. Insulin, which had little effect on its own, increased the turnover of inositol lipids due to acute bombesin stimulation and also enhanced the DNA synthesis evoked by prolonged bombesin treatment. The results suggest that bombesin acting as a growth factor, uses inositol lipids as part of its transduction mechanism and that insulin acts synergistically to enhance both inositol phosphate formation and DNA synthesis. PMID- 3536126 TI - Protein sorting in yeast: mutants defective in vacuole biogenesis mislocalize vacuolar proteins into the late secretory pathway. AB - We have devised a genetic selection for mutant yeast cells that fail to properly deliver the vacuolar glycoprotein CPY to the lysosome-like vacuole. This has allowed us to identify mutations in eight VPL complementation groups that result in aberrant secretion of up to approximately 90% of the immunoreactive CPY. Other soluble vacuolar proteins are also affected by each vpl mutation, demonstrating that a sorting system for multiple vacuolar proteins exists in yeast. Mislocalized CPY apparently traverses late stages of the secretory pathway, since a vesicle-accumulating sec1 mutation prevents secretion of this protein. Despite the presence of abnormal membrane-enclosed organelles in some of the vpl mutants, maturation and secretion of invertase are not substantially perturbed. Thus vpl mutations define a new class of genes that encode products required for sorting of newly synthesized vacuolar proteins from secretory proteins during their transit through the yeast secretory pathway. PMID- 3536127 TI - Pol I transcription: which comes first, the end or the beginning? PMID- 3536130 TI - A large calcium-binding protein associated with the larval spicules of the sea urchin embryo. AB - A tissue-specific, high molecular weight, calcium-binding protein from the sea urchin embryo is described. This protein, designated as CBP 180, has a molecular weight of 180,000 under reducing conditions, and is extractable with 1% Triton X 100. It accumulates rapidly during development, starting roughly at the onset of spiculogenesis. When embryos are cultured in the presence of inhibitors of spicule formation, such as tunicamycin and zinc ions, accumulation of CBP180 is depressed or stopped. By immunofluorescence technique and by using an antibody specifically generated against this protein, CBP180 is mainly localized in primary mesenchyme cells and spicular syncytium of the pluteus larva. Little or none is detectable in ectoderm, endoderm or blastocoelar extracellular matrix. These results suggest that the protein is involved in calcium sequestration in the differentiation of larval spicules. PMID- 3536129 TI - The DNA binding domain and bending angle of E. coli CAP protein. AB - We use a new gel electrophoretic analysis to map the thermodynamically defined DNA binding domain of Escherichia coli CAP protein in the lac promoter. Strong binding interactions span a 28-30 bp duplex DNA region, substantially larger than that found for typical repressors. Sequence changes outside the central 28 bp of the binding site are found to affect the electrophoretically observed extent of bending. We also report a study of the DNA bending induced at a symmetrized CAP binding site, compared with the wild-type site; binding and bending are stronger at the upstream than at the downstream half of the wild-type site. Bends of the estimated 90 degrees - 180 degrees magnitude could play a vital regulatory role by producing tertiary structure in a local DNA domain, and by storing elastic energy for subsequent use in transcription or replication. PMID- 3536128 TI - The yeast RNA gene products are essential for mRNA splicing in vitro. AB - The yeast rna mutations (rna2-rna11) are a set of temperature-sensitive mutations that result in the accumulation of intron-containing mRNA precursors at the restrictive temperature. We have used the yeast in vitro splicing system to investigate the role of products of the RNA genes in mRNA splicing. We have tested the heat lability of the in vitro mRNA splicing reaction in extracts isolated from mutant and wild-type cells. Extracts isolated from seven of the nine rna mutants demonstrated heat lability in this assay, while most wild-type extracts were stable under the conditions utilized. We have also demonstrated that heat inactivation usually results in the specific loss of an exchangeable component by showing that most combinations of heat-inactivated extracts from different mutants complement one another. In three cases (rna2, rna5, and rna11), the linkage of the in vitro defect to the rna mutations was ascertained by a combination of reversion, tetrad, and in vitro complementation analyses. Furthermore, each heat-inactivated extract was capable of complementation by at least one fraction of the wild-type splicing system. Thus many of the RNA genes are likely to code for products directly involved in and essential for mRNA splicing. PMID- 3536131 TI - Production of transgenic fish: introduction and expression of chicken delta crystallin gene in medaka embryos. AB - To produce a model of transgenic fish, recombinant plasmids containing chicken delta-crystallin gene were microinjected into the oocyte nucleus of a small teleost, medaka (Oryzias latipes). About 50% of the microinjected oocytes developed to 7-day-old embryos. By Southern blotting delta-crystallin gene was detected in 4 of 8 embryos, and, by Western blotting, delta-crystallin polypeptides in 5 of 16. In 1 of 6 examined histologically, delta-crystallin DNA was detected in all the tissues, and delta-crystallin polypeptides, in many of the tissues including the lens. Thus, the exogenous gene and/or its products were detected in 10 of 30 embryos examined. This is the first report of successful production of transgenic fish. PMID- 3536133 TI - Fixation of flexible implants in the temporomandibular joint. PMID- 3536132 TI - Immunohistochemical localization of S-100-containing cells in non-nervous structures of the human eye. AB - The present study reports on the immunohistochemical distribution of S-100 antigen in non-nervous cell types within the human eye at light microscopy. In the cornea the antigen was confined to endothelial cells covering its posterior surface; the lens exhibited immunoreactivity restricted to the epithelial cells located beneath the anterior capsule. In the iris and ciliary body, S-100 was detected in stromal cells and epithelial cells of the pigmented inner layer in the former and inner epithelial cells bounding the posterior chamber in the latter. PMID- 3536134 TI - Headaches: a differential diagnosis. PMID- 3536135 TI - Eagle's syndrome: review of the literature and implications in craniomandibular disorders. PMID- 3536136 TI - Double-blind clinical study of Piroxicam as adjuvant in the treatment of the pain and dysfunction of the temporomandibular joints. PMID- 3536137 TI - [The history of pharmacognosy]. PMID- 3536139 TI - Biosynthetic preparation of radioactively labelled ethanolamine plasmalogen (1-O [1'-14C]octadec-1'-enyl-2-acyl-sn-glycero-3-phosphoethanola mine) using a protozoan cell culture. AB - Ethanolamine plasmalogen radiolabelled mainly in the O-alkenyl moiety was prepared from cell suspension cultures of the flagellate Leishmania donovani previously incubated with [1-14C]octadecanol over one growth period. The optimal concentration of [1-14C]octadecanol for labelling was shown to be 1 microM, when 60% of total lipid radioactivity appeared in the 1,2-diradyl-sn-glycero-3 phosphoethanolamine fraction, with an overall yield of approx. 35%. Analysis of this fraction revealed that 93% of the label was present in O-octa-dec-1-enyl, 3% in O-alkyl and 4% in acyl moieties. A specific radioactivity of approx. 14 mCi/mmol was determined. Raising the culture medium concentration of [1 14C]octadecanol to 2 microM yielded a product with a specific radioactivity of 25 mCi/mmol. PMID- 3536138 TI - Bacterial beta-lyase mediated cleavage and mutagenicity of cysteine conjugates derived from the nephrocarcinogenic alkenes trichloroethylene, tetrachloroethylene and hexachlorobutadiene. AB - The metabolism of beta-lyase and the mutagenicity of the synthetic cysteine conjugates S-1,2-dichlorovinylcysteine (DCVC), S-1,2,2-trichlorovinylcysteine (TCVC), S-1,2,3,4,4-pentachlorobuta-1,3-dienylcysteine (PCBC) and S-3 chloropropenylcysteine (CPC) were investigated in Salmonella typhimurium strains TA100, TA2638 and TA98. The bacteria contained significantly higher concentrations of beta-lyase than mammalian subcellular fractions. Bacterial 100,000 X g supernatants cleaved benzthiazolylcysteine to equimolar amounts of mercaptobenzthiazole and pyruvate. DCVC, TCVC and PCBC produced a linear time dependent increase in pyruvate formation when incubated with bacterial 100,000 X g supernatants; pyruvate formation was inhibited by the beta-lyase inhibitor aminooxyacetic acid (AOAA). CPC was not cleaved by bacterial enzymes to pyruvate. DCVC, TCVC and PCBC were mutagenic in three strains of S. typhimurium (TA100, TA2638 and TA98) in the Ames-test without addition of mammalian subcellular fractions; their mutagenicity was decreased by the addition of AOAA to the preincubation mixture. CPC was not mutagenic in any of the strains of bacteria tested. These results indicate that beta-lyase plays a key role in the metabolism and mutagenicity of haloalkenylcysteines when tested in S. typhimurium systems. The demonstrated formation in mammals of the mutagens DCVC, TCVC and PCBC during biotransformation of trichloroethylene (Tri), tetrachloroethylene (Tetra) and hexachlorobutadiene (HCBD) may provide a molecular explanation for the nephrocarcinogenicity of these compounds. PMID- 3536140 TI - Diagnosis of Plasmodium falciparum infection by spot hybridization assay: specificity, sensitivity, and field applicability. AB - The spot hybridization assay for the detection of Plasmodium falciparum reported here uses as probe a repetitive DNA sequence from this species and exhibits a high degree of species specificity. Isolates from African, Asian, and South American patients were positive in the assay and gametocytes could be detected at the same level of parasitaemia as asexual parasites. An RNA probe containing the same repetitive sequence as the DNA probe has a detection limit of 1 parasite per 10(6) red blood cells. Comparison of the results of the assay with those obtained by microscopic examination of blood films indicated that the assay was more sensitive than microscopy if the blood films were examined for only 10 minutes; however, 40 minutes' examination by microscopy was slightly more sensitive than the assay. PMID- 3536141 TI - Induction of bacterial mutations by aminopyrazoles, compounds which cause mammary cancer in rats. AB - An aminopyrazole PD 71627 (5-amino-1,3-dimethyl-1H-pyrazol-4-yl) (2 fluorophenyl)methanone, and two amide derivatives, PD 108298, N-[4-(2 fluorobenzoyl)-1,3-dimethyl-1H-pyrazol-5-yl]-2- ([3-(2-methyl-1- piperidinyl) propyl]amino) acetamide-(Z)-2-butanedioate (1:2), and PD 109394, 2-(diethylamino) N-[4-(2- fluorobenzoyl)-1,3-dimethyl-1H-pyrazol-5-yl]acetamide hydrochloride, proposed neuroleptic drugs, were found to elicit mammary adenocarcinomas in male rats after 13 weeks of treatment. These compounds were assessed for their ability to induce His+ revertants (rev) in five strains of Salmonella typhimurium (TA98, TA100, TA1535, TA1537 and TA1538) in the presence and absence of S9 activation. All were found to be potent mutagens in TA98 and TA100 after a 20 min pre incubation with Aroclor 1254-induced rat liver S9. However, the activity of the amino-pyrazole PD 71627 was much greater than the amide derivatives, PD 108298 or PD 109394, with activity of 11,800 rev/mumol, 670 rev/mumol, and 230 rev/mumol respectively in TA100, the strain showing the greatest response. A comparison of liver S9 fractions from rats untreated or pretreated with phenobarbital (PB) or Aroclor 1254 showed that S9 from animals pretreated with PB provided the greatest activation capability for the aminopyrazole PD 71627 (59,300 rev/mumol in TA100). Three structural analogs of the aminopyrazole PD 71627, two without the amine and one with a methyl substituent on the amine, were compared with PD 71627 for induction of revertants in TA100 and TA98. The compounds without the amine had no mutagenic activity while the methyl derivative induced 3100 rev/mumol in TA100 after preincubation with Aroclor 1254-induced S9. This confirmed that the amine on the pyrazole ring was required for mutagenic activity. The results of these studies support the hypothesis that these compounds cause cancer in animals as a result of DNA damage. PMID- 3536142 TI - Chinese hamster cells harbouring the Escherichia coli O6-alkylguanine alkyltransferase gene are less susceptible to sister chromatid exchange induction and chromosome damage by methylating agents. AB - Clones of Chinese hamster V79 cells harbouring the Escherichia coli O6 alkylguanine (O6-AG) alkylphosphotriester (AP) alkyltransferase (ATase) gene (clone 8) or a subclone of it that codes only for O6-AG ATase activity (clone SB) have been exposed to increasing doses of N-methyl-N-nitrosourea (MNU) or methylmethanesulphonate (MMS) and the frequencies of induced sister chromatid exchanges (SCEs) measured. In control (clone 2) cells, SCE induction was almost linearly proportional to dose of MNU or MMS and at the highest doses used (15 or 80 micrograms/ml) SCE frequencies were 6 or 8 times background levels, respectively. Slightly lower levels of MMS-induced SCEs were seen in clone 8 and clone SB cells whilst, in contrast, MNU-induced SCE levels in these two clones were drastically reduced being less than twice background levels at 15 micrograms/ml. After treatment with N-butyl-N-nitrosourea, SCE frequency was similar in all three clones. At higher doses, MNU treatment produced less chromatid aberrations and micronuclei in clone SB than in clone 2 cells. These results suggest that ATase-repairable damage is involved in the induction of SCE, chromosome aberrations and micronuclei in V79 cells. PMID- 3536143 TI - Expression in mammalian cells of a truncated Escherichia coli gene coding for O6 alkylguanine alkyltransferase reduces the toxic effects of alkylating agents. AB - The lesion O6-alkylguanine (O6-AG) is produced in cellular DNA following exposure to monofunctional alkylating agents and its miscoding and mutagenic properties have been demonstrated in specific in vitro systems. In order to examine whether this lesion could be responsible for any of the biological effects of alkylating agents in mammalian cells, we have constructed a plasmid containing the O6-AG alkyltransferase (ATase) region of the gene from Escherichia coli, the product of which normally repairs both O6-AG and alkylphosphotriesters in DNA. We have transfected the construction into Chinese hamster fibroblasts which are deficient in endogenous ATase activity and selected a clone that expresses the truncated repair gene. We demonstrate that this protein is functional, acts on damage in host cell DNA and protects the cells from the toxic effects of those alkylating agents that react extensively at oxygen atom positions. PMID- 3536144 TI - Apurinic/apyrimidinic site induction in supercoiled DNA and mutagenesis in Salmonella typhimurium TA100 by 1'-acetoxysafrole and related electrophilic alkenylbenzene derivatives. AB - The abilities of seven electrophilic alkenylbenzene derivatives related to 1' acetoxysafrole to induce apurinic/apyrimidinic (AP) sites in supercoiled SV40 DNA were quantitated by gel electrophoresis after neutral thermal hydrolysis of DNA adducts with unstable N-glycosidic bonds and putrescine/Mg2+ ion-enhanced cleavage of the adjacent phosphodiester linkages. A 20-fold range in AP site production was observed for this series of closely related electrophiles. Analysis of SV40 DNA modified with [2',3'-3H]-1'-acetoxysafrole indicated that approximately 14% of the total safrole-DNA adducts generated AP sites under the conditions used. Neutral thermal hydrolysis of the modified DNA released a product with the same h.p.l.c. retention time as N7-(isosafrol-3'-yl)guanine. The mutagenic potencies in Salmonella typhimurium strain TA100 of these seven electrophilic alkenylbenzene derivatives covered a 75-fold range (from 0.1 to 7.7 revertants/nmol). Although the mutagenic activities of these electrophiles generally correlated well with the hepatocarcinogenic activities of the parent 1' or 3'-hydroxy derivatives on administration to preweanling male mice, the mutagenic and carcinogenic activities did not correlate with the abilities to induce AP sites. PMID- 3536146 TI - Cosmetic dentistry: is it in the cards for your patients? PMID- 3536145 TI - Endotoxin tolerance diminishes endotoxin-induced alterations in carbohydrate kinetics. AB - This study was designed to determine if attenuated mortality to a challenge dose of endotoxin was accompanied by or separated from alterations in glucose metabolism in endotoxin-tolerant rats. The in vivo effects of endotoxin were studied in catheterized endotoxin-tolerant rats and nontolerant control animals. Tolerance was induced by iv injections of 100 micrograms endotoxin/100 g BW (tolerance dose) for either 2 or 4 consecutive days; control rats received daily saline injections. On the day after the final tolerance dose, glucose kinetics were assessed by the constant infusion of [6-3H]-glucose prior to and after a challenge dose of endotoxin (1,000 micrograms/100 g) in tolerant and nontolerant rats. Following the challenge dose, 2-day tolerant animals exhibited an improved survival at 72 hr (LD 14 vs LD 92), a significantly smaller reduction in mean arterial blood pressure (20 vs 34%), and smaller increases in plasma glucose (9.4 +/- 0.6 vs 11.4 +/- 0.6 mM) and lactate (3.2 +/- 0.3 vs 8.5 +/- 1.4 mM) concentrations, compared to those in nontolerant control rats. However, increases in the rates of glucose appearance (Ra) and metabolic clearance (MCR) were not diminished. In 4-day tolerant rats, lethality to endotoxin was abolished, and no alterations in blood pressure or glucose kinetics were seen during the 4-hr period after endotoxin. However, the basal glucose Ra and MCR determined prior to endotoxin challenge were elevated in these rats compared to controls. Hyperglucagonemia was evident following the endotoxin challenge in control and 2 day tolerant rats, but not in 4-day tolerant animals. The hypothermia seen in nontolerant rats 4 hr after endotoxin was not present in either group of tolerant animals. The results show that after 2 days, tolerant animals have improved survival rates when challenged with endotoxin but still demonstrate acute changes in glucose kinetics. A complete protection against a normally lethal dose of endotoxin exists after 4 days. At this stage, rats showed no transient hemodynamic or metabolic alterations following endotoxin challenge. PMID- 3536147 TI - Orthodontics or bonding? PMID- 3536148 TI - Beyond randomized clinical trials: applying clinical experience in the treatment of patients with coronary artery disease. PMID- 3536149 TI - Arterial-venous relationships in the human left ventricular myocardium: anatomic basis for countercurrent regulation of blood flow. AB - The mechanism by which myocardial blood flow varies in response to metabolic demand is obscure. One hypothesis is a countercurrent regulation of arterial caliber by diffusible substances carried in venous blood. To study the anatomic basis for blood flow regulation, we performed combined arterial and venous injections in 20 human hearts and studied left ventricular intramyocardial vessels with radiography, 100 micron thick sections, and reconstructions of serial histologic sections. Penetrating arteries lie in interstitial spaces and are closely related to accompanying veins. These interstitial veins partially surround and are indented by branch arteries. A second system of veins lies within muscle fascicles between interstitial spaces and is not related to arteries. The isolated veins have collateral connections with interstitial veins and join them in the subepicardium. This vascular anatomy could allow arterial caliber to be regulated by diffusible substances carried in the interstitial veins. Arterial dilatation might prolong this effect by partial obstruction of interstitial veins, with the isolated venous system providing an alternative pathway for venous drainage and washout. The study shows that a vascular arrangement is present in human left ventricular myocardium that could provide a countercurrent regulation of blood flow with diffusible substances carried in venous blood. PMID- 3536150 TI - Evidence for a direct renal stimulating effect of prostaglandin E2 on renin release in patients with congestive heart failure. AB - The reduced responsiveness of the renin-angiotensin system to hemodynamic changes in patients with congestive heart failure (CHF) could be due to a defect of the juxtaglomerular apparatus. To test this hypothesis, the responses to viprostol, an analog of prostaglandin E2 (PGE2) that is known to stimulate both the macula densa and the juxtaglomerular cells, and to nitroprusside were compared in patients with CHF. An average fall in mean arterial pressure (MAP) of 6 mm Hg with viprostol was associated with a fivefold increase in plasma renin activity (PRA) from 11.4 +/- 6.4 to 47.9 +/- 31.0 ng/ml/hr; in contrast PRA did not change with nitroprusside, despite a significant decrease in preload and an average decrease in MAP of 16 mm Hg. These data demonstrate that the renin-angiotensin system could be activated by PGE2 in patients with CHF, this activation is not related to the global hemodynamic changes induced by PGE2, and the previously reported unresponsiveness of the renin-angiotensin system in patients with CHF cannot be attributed to a defective response of the juxtaglomerular apparatus. PMID- 3536151 TI - High-density lipoprotein cholesterol and coronary heart disease in hypercholesterolemic men: the Lipid Research Clinics Coronary Primary Prevention Trial. AB - Plasma levels of high-density lipoprotein cholesterol (HDL-C) at entry and subsequent changes from these baseline levels were inversely predictive of coronary heart disease (CHD) end points in hypercholesterolemic men followed for 7 to 10 years in the Lipid Research Clinics Coronary Primary Prevention Trial, especially in the 1907 participants receiving cholestyramine. When the men in this cohort were compared, each 1 mg/dl increment in baseline HDL-C (mean 44.3 mg/dl) was associated with a 5.5% decrement in risk of "definite" CHD death or myocardial infarction (Z = -5.4), and each 1 mg/dl increase from baseline HDL-C levels (mean increase = 1.6 mg/dl) during the trial was associated with a 4.4% risk reduction (Z = -2.2). In the 1899 participants receiving placebo, the corresponding risk decrements were 3.4% and 1.1%. Although baseline HDL-C level (mean = 44.4 mg/dl) remained a significant risk predictor (Z = -3.8) in the placebo cohort, increases in HDL-C (mean increase 0.5 mg/dl) were not significantly predictive of CHD (Z = -0.6) unless "suspect" as well as "definite" end points were analyzed (Z = -2.0). When the associations between HDL-C (baseline plus change) and incidence of definite CHD end points within each treatment cohort were compared, their difference approached nominal significance (Z = 1.9). The results suggest a synergistic interaction, in which cholestyramine treatment reduced CHD risk most substantially in men maintaining the highest HDL C levels. PMID- 3536152 TI - Quantitative analysis of myocardial infarct structure in patients with ventricular tachycardia. AB - To study whether myocardial infarction differs in patients with and without ventricular tachycardia, the hearts of 22 deceased patients with ventricular tachycardia and 21 deceased control patients were analyzed quantitatively. The hearts from the ventricular tachycardia group were heavier and more dilated than those from the control group. Histologic analysis of a representative cross section from each heart showed that the ventricular tachycardia group had larger, more solid infarcts than did the control group. The ventricular tachycardia group also had a greater area of spared subendocardium, more hydropic change of the spared subendocardium, and more "ribbon type" spared subendocardium, which was defined as spared subendocardium of uniform contour 1 mm thick or less. The ventricular tachycardia group was divided into a subacute subgroup (n = 14, dying less than or equal to 10 weeks after infarction) and a chronic subgroup (n = 8, dying greater than 10 weeks after infarction). The infarcts of the subacute ventricular tachycardia group were more solid and had a greater amount of ribbon type spared subendocardium than those of the chronic ventricular tachycardia group. This information can serve as a baseline for the evaluation of animal preparations of tachycardia and, when combined with knowledge of the location of the arrhythmogenic region furnished by intraoperative mapping, should lead to better understanding of the anatomic substrate for ventricular tachycardia. PMID- 3536154 TI - Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. AB - A study in vitro of specimens of human aortic and common carotid arteries was carried out to determine the feasibility of direct measurement (i.e., not from residual lumen) of arterial wall thickness with B mode real-time imaging. Measurements in vivo by the same technique were also obtained from common carotid arteries of 10 young normal male subjects. Aortic samples were classified as class A (relatively normal) or class B (with one or more atherosclerotic plaques). In all class A and 85% of class B arterial samples a characteristic B mode image composed of two parallel echogenic lines separated by a hypoechoic space was found. The distance between the two lines (B mode image of intimal + medial thickness) was measured and correlated with the thickness of different combinations of tunicae evaluated by gross and microscopic examination. On the basis of these findings and the results of dissection experiments on the intima and adventitia we concluded that results of B mode imaging of intimal + medial thickness did not differ significantly from the intimal + medial thickness measured on pathologic examination. With respect to the accuracy of measurements obtained by B mode imaging as compared with pathologic findings, we found an error of less than 20% for measurements in 77% of normal and pathologic aortic walls. In addition, no significant difference was found between B mode-determined intimal + medial thickness in the common carotid arteries evaluated in vitro and that determined by this method in vivo in young subjects, indicating that B mode imaging represents a useful approach for the measurement of intimal + medial thickness of human arteries in vivo. PMID- 3536153 TI - Hemodynamic-inotropic response to beta-blocker with intrinsic sympathomimetic activity in patients with congestive cardiomyopathy. AB - The rest and exercise hemodynamic-inotropic response to administration of the beta-blocker pindolol was evaluated in 10 patients with congestive cardiomyopathy to determine whether the intrinsic sympathomimetic activity (ISA) of this agent may preserve ventricular function in the setting of beta-blockade. A significant (p less than .05) rise in systemic and pulmonary vascular resistance and a decline in stroke volume and cardiac index was observed after a single 10 mg dose. The change in cardiac index was negatively correlated with free drug concentration (r = -.59, p less than .01); the change in pulmonary and systemic vascular resistance showed a positive correlation with plasma concentration (r = .67, r = .57, respectively; all p less than .05). The response to exercise reflected a predominant beta-blocking effect, with a significant decrease in peak heart rate and cardiac index and an increase in pulmonary vascular resistance. There were no significant changes in variables of right or left ventricular inotropy after administration of the drug. The mean baseline plasma norepinephrine concentration for the population was 609 +/- 172 pg/ml (normal = 196 +/- 7 pg/ml) and was markedly elevated in two patients (931 and 2053 pg/ml) who developed severe pindolol-induced hypotension. Renin increased markedly in these two patients, but decreased in each of the remaining eight patients. These data indicate that although inotropy is not adversely affected by pindolol, increased afterload, which appears to be mediated by peripheral beta-blockade, results in a reduction in ventricular performance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536155 TI - Continuous external counterpressure during closed-chest resuscitation: a critical appraisal of the military antishock trouser garment and abdominal binder. AB - Blood flow during closed-chest CPR may result from variations in intrathoracic pressure rather than selective compression of the cardiac ventricles. During chest compression, the thoracic and abdominal cavities are subjected to positive pressure fluctuations. It has been suggested that compression of the abdomen may improve left heart outflow during CPR by limiting diaphragmatic movement or improving venous return. Abdominal compression has been performed experimentally with pneumatic abdominal binders and with the abdominal compartment of the conventional military antishock trouser (MAST) garment. The MAST garment might also improve cardiac output with CPR through an "autotransfusion" effect. In animal studies, MAST-augmented CPR has improved systolic pressures; it has not been shown to improve vital organ perfusion. In the only available clinical study, CPR with the MAST did not improve survival from prehospital cardiac arrest when compared with conventional CPR alone. If inflation of the MAST does produce blood displacement from the peripheral to the central venous circulation, such an effect may be detrimental in that the arteriovenous pressure gradients necessary for vital organ flow may be adversely affected. Inflation of the MAST during CPR may also adversely effect artificial ventilation. Selective abdominal binding also increases systolic pressures during CPR but does not improve subdiaphragmatic venous return. Although abdominal binding may increase common carotid flow, it has not been shown to improve cerebral or myocardial perfusion when compared with conventional CPR alone. These CPR adjunct techniques have not been shown to improve outcome from cardiac arrest and should remain experimental until further well-designed studies addressing regional vital organ flow and outcome of resuscitation are performed. PMID- 3536156 TI - Management of paroxysmal supraventricular tachycardia. AB - Three forms of treatment are available for patients with paroxysmal supraventricular tachycardia (PSVT): nonpharmacologic, pharmacologic, and electrical. Nonpharmacologic treatments increase vagal tone and include the traditional carotid sinus massage and Valsalva maneuver as well as head-down tilt, activation of the diving reflex, and use of the pneumatic antishock garment. The most effective currently available pharmacologic agent is verapamil. Hemodynamically stable patients whose PSVTs are refractory to verapamil may be treated with digitalis. Patients with antegrade accessory pathway conduction (such as those with Wolff-Parkinson-White syndrome) and a history of atrial fibrillation should be treated with intravenous procainamide if they are hemodynamically stable and with synchronized electrical countershock if they are hemodynamically unstable. Synchronized electrical countershock is the treatment of choice for hemodynamically unstable patients. PMID- 3536157 TI - Electrical therapy for cardiovascular emergencies. AB - This presentation summarizes advances in electrical therapy of cardiovascular emergencies. The urgency of delivering definitive therapy is emphasized, and the roles of automatic internal and external defibrillators, practical external pacing, and mechanical techniques for cardioversion and defibrillation are evaluated. Standard position of the electroplates is recommended except in patients who have permanently implanted pacemakers. In these patients, the defibrillation electrodes should be at least 5 inches from the pacemaker generator. The energy requirement for defibrillation of ventricular fibrillation is reviewed, with the conclusion that the initial defibrillatory shock should be 200 J. The determinants of the transthoracic impedance are important, especially if low-energy shocks are to be used, since a high transthoracic impedance results in a poor success rate for defibrillation with low-energy shocks. When high energy (360 J) shocks are to be used, transthoracic impedance appears to be of less importance. PMID- 3536158 TI - Energy requirements for defibrillation. AB - Available clinical data indicate that an initial shock energy of 200 J will defibrillate the majority of patients. There is no advantage in starting at a higher energy, and lower energy shocks may be safer. Measurements of transthoracic impedance may permit the use of even lower energy levels for initial shocks. If the initial shock fails to defibrillate it should be repeated immediately, at the same energy level, and then increased if defibrillation is still not achieved. If the initial shock defibrillates but refibrillation occurs later there is no reason to increase the energy; it should be repeated at 200 J. We suggest the following energy selection algorithm for defibrillation (VF = ventricular fibrillation): (Formula: see text). PMID- 3536160 TI - Cerebral resuscitation after cardiac arrest: a review. AB - Cerebral neurons can tolerate at least 20 min of normothermic ischemic anoxia. Cerebral recovery from more than 5 min of cardiac arrest is hampered by complex secondary derangements of multiple organ systems after reperfusion. There is increasing support of our hypothesis that this "postresuscitation syndrome" includes the following: secondary cerebral perfusion failure, cerebral reoxygenation injury (cell-necrotizing cascades), and cerebral "intoxication" from derangements of extracerebral organs. To be optimal for the brain, CPR with optimal perfusion pressure must be started as promptly as possible. Significant though inconsistent mitigation of permanent brain damage after prolonged complete global brain ischemia has been achieved in animal outcome preparations with the use of the following treatments initiated at the start of reperfusion: brain oriented extracerebral life support by protocol, intra-arterial hemodilution, hypertension, and artificial circulation, barbiturates, calcium-entry blockers, free-radical scavengers, and multifaceted treatments. We currently recommend treatment 1 for patient care and treatment 2 for clinical feasibility trials. Treatment 3, thiopental loading (starting 10 to 50 min after restoration of spontaneous circulation), was tested in a randomized clinical trial and was not shown to confer a statistically significant benefit. A calcium-entry blocker is under clinical investigation. Many other novel treatments appear promising but further animal studies are required. The complex multifactorial pathogenesis of postcardiac arrest encephalopathy requires systematic multicenter development of etiology-specific combination therapies. PMID- 3536159 TI - The role of the esophageal obturator airway in cardiopulmonary resuscitation. AB - The esophageal obturator airway (EOA) has been in use for over a decade and has been inserted over 3 million times. It has given rise to a body of literature, some of it controversial, concerning the role of the device. Data concerning the ventilatory efficiency, safety, complications, limitations, indications, and contraindications as well as mortality and morbidity associated with its use are presented and its present role in CPR is described. In line with the recommendations of the 1985 Standards Committee, the EOA is regarded as a useful device in CPR, which complements the endotracheal tube in the training of paramedics. PMID- 3536161 TI - Special resuscitation situations: near drowning, traumatic injury, electric shock, and hypothermia. AB - Special resuscitation situations are cardiopulmonary arrests requiring modification or extension of conventional life support techniques. Significant controversy exists with regard to several aspects of special resuscitation, including whether or not there is a need to clear the airway of a near-drowning victim with the Heimlich maneuver and whether CPR should be initiated in an unmonitored hypothermic patient showing no signs of life. The previous standards and guidelines almost entirely neglected the management of cardiac arrest due to traumatic injury. The conference panel on Special Situations recommended that: the Heimlich maneuver should only be performed on near-drowning victims when the rescuer suspects that foreign matter is obstructing the airway or the victim fails to respond appropriately to mouth-to-mouth ventilation, further investigation is needed to better define the need for, the risks of, and the timing of the Heimlich in the near-drowning victim, there should be an expanded section in the standards and guidelines describing the differences in the management of a victim whose cardiac arrest is due to traumatic injury, CPR is indicated and should be done on a pulseless, unmonitored hypothermic patient in the field, but that a longer time to check for a pulse (up to one minute) may be required, and guidelines that the panel proposed be used for management of the underwater submersion victim in cardiac arrest. PMID- 3536162 TI - Cardiopulmonary resuscitation and hypothermia. AB - Current basic life support (BLS) protocols do not address the physiologic effects of accidental hypothermia in prehospital care. The extreme levels of bradycardia, bradypnea, and peripheral vasoconstriction that often accompany profound hypothermia may complicate the accurate diagnosis of cardiopulmonary arrest in the unmonitored patient. Although CPR is indicated in the truly pulseless, apneic victim of hypothermia, chest compressions may convert nonpalpable but adequately perfusing sinus bradycardia to ventricular fibrillation. This dilemma had led to disagreement among clinicians and researchers in hypothermia about prehospital care protocols for the severely hypothermic patient. This article reviews the controversy and recommends the application of a normal BLS protocol to hypothermic patients presenting in apparent cardiopulmonary arrest. PMID- 3536163 TI - External compression without adjuncts. AB - Over the past decade many exciting and promising new approaches of delivering CPR have been studied. Considerable data have accumulated suggesting that forward flow during CPR is generated, at least in part, by the development of elevated intrathoracic pressure with an extrathoracic arteriovenous pressure difference. This mechanism, known as the "thoracic pump," has been documented during "cough CPR" and has led to numerous attempts at optimizing the outcome by increasing intrathoracic pressure in CPR. Studies have demonstrated improved flows with simultaneous ventilation and sternal compression, with static or interposed abdominal compression, with longer duration compression, and with various combinations of these maneuvers. Other recent studies have suggested that the cardiac compression mechanism may indeed be operative, at least under certain circumstances, and that CPR may be optimized by increasing the force and rate of compression. Still others have advocated a simple change in the sequence of initiating ventilation and compression. Which, if any, of these newly advocated methods improve the outcome when applied to man remains to be established. If any of these techniques is shown to be more advantageous, its widespead use will depend on its applicability without adjuncts and its teachability to the lay public. PMID- 3536164 TI - Cardiopulmonary resuscitation with interposed abdominal compression. AB - The addition of interposed abdominal compressions (IACs) to otherwise standard CPR enhances artificial circulation both in anesthetized dogs with ventricular fibrillation and in electrical models of the circulation that demonstrate fundamental mechanisms generating flow. Manual abdominal compressions cause both central aortic and central venous pressure pulses but, because of differences in venous and arterial capacitance, the former are usually greater than the latter. Thus mean perfusion pressure is enhanced. Limited clinical studies confirm that IAC-CPR can improve perfusion pressures in humans, and reported complications of the technique are rare in animals and man. However, no study has demonstrated that IAC-CPR improves either short- or long-term survival after cardiac arrest in man. Accordingly, the method remains experimental and cannot be recommended for basic life support at the present time. PMID- 3536165 TI - Teaching and credentialing the physically challenged: state of the art. A review of change in the clinical and scientific data since 1980. AB - More than 30 million Americans are disabled. Wide experience has shown that these conditions do not prevent these individuals from becoming proficient in the knowledge and skills of CPR. Instructional materials and methods can be modified to help this special population learn CPR despite handicaps. The American Heart Association has supported these special efforts since 1978, but no comprehensive resource exists for CPR instructors interested in helping the "physically challenged" individual learn CPR. This article addresses general and specific suggestions for teaching selected handicapped populations. They are: hearing impaired, visually impaired, other physical impairment such as obesity, chronic obstructive pulmonary disease, arthritis, angina, and other medical conditions that may limit one's ability to learn the psychomotor skill of CPR. PMID- 3536166 TI - Calcium: limited indications, some danger. AB - Calcium chloride has been advocated since the 1920s for the resuscitation of asystole, electromechanical dissociation (EMD), and ventricular fibrillation. Reports of side effects and complications have been numerous. Studies of calcium assays following American Heart Association recommended dosages have shown dangerously elevated serum levels. Large retrospective clinical studies in Milwaukee and Tampa have found no evidence of improved survival with calcium chloride in asystole and EMD. A prospective randomized double-blind study comparing calcium chloride and saline controls in the Milwaukee Paramedic system for asystole and EMD using standard AHA protocols showed no statistically significant difference in resuscitation rates or long-term survival between the calcium and no-calcium groups for the rhythm of asystole. Although patients with EMD had statistically improved resuscitation rates when calcium chloride was given, only one of the patients survived to hospital discharge. Because of the low rates of resuscitation and long-term survival in patients presenting in asystole and EMD, proving that calcium chloride does not enhance survival would require large multicenter trials. However, since no controlled study has ever documented significant benefit, its routine use in asystole and EMD cannot be supported. Calcium has long been used in medical treatment of hypocalcemic and hyperkalemic states and should be administered in moribund patients who have the proper clinical history and clinical signs of hypocalcemia. PMID- 3536167 TI - Calcium-channel blockers and advanced cardiac life support. AB - Calcium channel-blocking drugs have potent antiarrhythmic and antianginal effects and in addition may reduce the extent of cellular injury after anoxia/ischemia. Verapamil is the treatment of choice (90% effective) for uncomplicated episodes of paroxysmal supraventricular tachycardia. All three calcium-channel blockers available, diltiazem, nifedipine, and verapamil, can reduce the frequency of angina occurring both at rest and with exertion. Calcium may mediate several cytotoxic events during the reperfusion period after prolonged ischemia that lead to irreversible cell injury. There is experimental evidence that calcium-channel blockers may reduce the cellular influx of calcium after ischemia and reperfusion, and thereby attenuate cerebral and myocardial injury, although most studies have failed to show benefit of treatment unless the drug is administered before the onset of ischemia. Most trials using calcium-channel blockers in the setting of acute myocardial infarction have failed to show a benefit of treatment. The safety and efficacy of calcium-channel blockers have yet to be shown in controlled studies of human resuscitation, although the potential for such treatment, if it is effective in attenuating myocardial cerebral cellular injury, could be enormous. PMID- 3536168 TI - Alternative approaches to external chest compression. AB - The finding that blood flow during external chest compression may be due to increased intrathoracic pressure, and the subsequent reporting of increased carotid blood flow with simultaneous ventilation and chest compression or with abdominal binding during CPR ignited a flurry of investigations into alternative approaches to CPR. A number of alterations of the conventional CPR technique were proposed, many resulting in improved hemodynamics when compared with standard CPR techniques in the same subject. However, some of the proposed methods increased cerebral blood flow but decreased myocardial perfusion. Others improved systolic pressures but decreased vital organ blood flow. More importantly, most studies with survival as an end point failed to show a benefit when alternative approaches to CPR were used. Therefore, it is unlikely that there will be significant changes in the recommendations for the use of adjuncts during CPR. Not all studies support the conclusion that blood flow during closed-chest compression is secondary to increased intrathoracic pressure. It is probable that in man there is a spectrum. In some individuals the predominant mechanism of blood flow during CPR may be cardiac and/or vascular compression, and in others flow may be secondary to an increased intrathoracic pressure. PMID- 3536169 TI - Building related illness. PMID- 3536170 TI - Associations between asthma history, atopy, and non-specific bronchial responsiveness in young adults. AB - In 105 subjects taken from a student population and aged between 15 and 30 there was a strong positive association between the presence of the atopic state, defined by skin tests, and a high level of non-specific bronchial responsiveness to methacholine (chi 2 = 10.5, d.f. = 2, P = 0.01). Regression analysis showed a history of asthma, and the symptom of wheeze, to be predominantly predicted by the degree of bronchial responsiveness (R2 = 31%), with only a minor independent contribution from the degree of atopy (R2 a further 5%). The genetic or other reasons for the association between bronchial responsiveness and atopy may have importance in understanding the aetiology of allergic asthma. PMID- 3536171 TI - Low dose sublingual therapy in patients with allergic rhinitis due to house dust mite. AB - In a double-blind placebo-controlled cross-over trial, low dose sublingual therapy with house dust mite was effective in relieving symptoms in 72% of the group of patients with perennial rhinitis due to house dust mite (P less than 0.03). Following active treatment, there was a significant increase in morning peak nasal inspiratory flow rate (P less than 0.01) in those who improved (thirteen out of eighteen) and resistance to nasal provocation with house dust mite also increased, in some cases up to 1000-fold (P less than 0.05). Oral therapy is safe and avoids the side effects of desensitizing injections which can be serious. The potential for oral desensitization is great and further studies on this form of treatment are needed. PMID- 3536172 TI - 6 beta-hydroxycortisol in serum and urine as determined by enzyme immunoassay on microtitre plates. AB - We modified our previous enzyme immunoassay (Clin Chim Acta 1986;157:267-76) for estimating 6 beta-hydroxycortisol (6 beta-OHF) to provide a more routine procedure for measuring it in urine and to increase sensitivity for its measurement in serum. Precision, analytical recovery, specificity, and detection limit are reported. 6 beta-OHF and 17-hydroxycorticosteroids in 24-h and 4-h (08:00-12:00 h) urine collections from healthy volunteers showed no significant day-to-day differences in excretion rate for either collection period. Mean values for 6 beta-OHF in serum of men, women, and women taking oral contraceptives showed no significant differences among these groups. PMID- 3536173 TI - Interferences in TDx digoxin assay in dialysis patients. PMID- 3536175 TI - Screening for cannabinoids in urine with the Technicon RA-1000 analyzer. PMID- 3536174 TI - Modified fluorescence polarization immunoassay compared with radial partition immunoassay and a radioimmunoassay for digoxin. PMID- 3536176 TI - SP1--really a tumor marker for lymphoid malignancy? PMID- 3536177 TI - Validation of a semi-automated technique for measuring lactate in whole blood. AB - An electrode-based lactate analyzer was recently developed to facilitate "stat" laboratory measurement of lactate in whole blood. The results obtained with this technique were compared with those of our continuous-flow enzymatic method for 172 analyses of samples from 25 pigs; 88 analyses of samples from 12 normal human volunteers before, during, and after exercise; and 91 analyses of samples from 80 critically ill patients. This comparison revealed strongly significant linear correlations: r = 0.992 for the porcine analyses and r = 0.994 for the combined human analyses. In analytical-recovery studies with pooled porcine plasma with an initial lactate concentration of 3.85 mmol/L, 94.3% of added lactate (1, 5, and 10 mmol/L) was accounted for in the electrode technique, 96% in the reference technique. We conclude that the electrode-based lactate analyzer is rapid, precise, and accurate for measurement of lactate in whole-blood samples. PMID- 3536179 TI - Placental transfer of drugs. PMID- 3536178 TI - Determination of rate of urinary excretion of aminoglycosides with a kit for plasma. PMID- 3536180 TI - Teratogenesis and other adverse effects on the fetus of antimicrobial drugs used in pregnancy. PMID- 3536181 TI - Antibiotics and breast feeding. PMID- 3536182 TI - The pharmacokinetics, pharmacology and activity of antibiotics in the newborn: the classical drugs. PMID- 3536183 TI - Antibiotic therapy in the newborn. PMID- 3536185 TI - Treatment of common infections in pregnancy and the puerperium. PMID- 3536184 TI - Antiviral therapy. PMID- 3536186 TI - Surgical prophylaxis. PMID- 3536187 TI - Treatment of parasitic infestations and exotic disease in pregnancy. PMID- 3536188 TI - Staphylococcal sepsis in the newborn. PMID- 3536189 TI - The pathogenesis and prevention of neonatal meningitis and septicaemia. PMID- 3536190 TI - Listeriosis: a cause of perinatal infection. PMID- 3536192 TI - Toxoplasmosis: with special reference to proposals for reducing congenital infection. PMID- 3536191 TI - Congenital malaria. PMID- 3536193 TI - Chlamydial infections. PMID- 3536194 TI - Studies on the mechanics of the normal human middle ear. AB - The middle ear was studied in temporal bone preparations using a laser-Doppler interferometer. For measurements at a sound level of 80 dB SPL this method proved to be very reliable, as was shown by good reproducibility of results in experiments over more than 6 hours. The vibrations of the tympanic membrane and stapes footplate were studied from 200 Hz to 10 KHz and the results demonstrate a piston-like movement of the stapes footplate up to 120 dB SPL. The damping effect of the normal ear is located mainly at the footplate/cochlea level and the middle ear cavity per se does not contribute significantly to the stiffness of the middle ear system. PMID- 3536195 TI - The aetiology and pathogenesis of trismus. AB - The word trismus, from the Greek 'trismos', is defined as a prolonged, tetanic spasm of the jaw muscles by which the normal opening of the mouth is restricted (locked jaw). The designation was originally used only in tetanus, but as inability to open the mouth may be seen in a variety of conditions, the term is currently used in restricted jaw movement regardless of aetiology. As the literature on the subject mainly consists of case reports, the authors have reviewed the pathogenesis, aetiology and management of trismus. PMID- 3536197 TI - Diabetic nephropathy: historical aspects. PMID- 3536196 TI - The genetics of diabetic complications. AB - Duration of disease is the major susceptibility factor for microangiopathy. Microangiopathy does not occur without the metabolic abnormality of diabetes and there is much circumstantial evidence to implicate poor diabetic control in its pathogenesis. The rate of development and severity of complications, however, are variable even in patients with apparently similar control and about 25% of diabetics will never develop clinical evidence of microangiopathy. Studies of identical twins suggest a genetic component in the pathogenesis of retinopathy in NIDDM, and less so in IDDM, but increased capillary basement membrane thickness does not occur in the non-diabetic identical co-twins of insulin dependent diabetics. There may also be genetic heterogeneity not only of diabetes, but also of its complications, although for a given type of diabetes the prevalence of microangiopathy is often very similar in different racial groups. Associations between several different HLA molecules (particularly DR4) and microangiopathy in IDDM have been reported but not consistently confirmed. Recently the finding of an increased frequency of the B3 allotype of the fourth component of complement C4B3 in subjects with retinopathy has suggested that there is an HLA linked association. Both complement and the immunoglobulins are concerned with humoral immunity and the report of an association between a phenotype of the IgG heavy chain markers on chromosome 14 and retinopathy is of particular interest. These associations appear to be additive but independent. These reports need confirmation but provide the best evidence we have for an immunogenetic component (HLA and non-HLA linked) of the aetiology of microangiopathy, at least in IDDM. The studies of identical twins, HLA and Gm associations provide good evidence that genetic factors are involved in susceptibility to microangiopathy, at least in some diabetics, although the most relevant genes may not have been identified. Searches for better genetic markers must continue in order to identify those patients at increased risk of developing microangiopathy. PMID- 3536198 TI - Structural changes in the diabetic kidney. AB - Diabetic glomerulopathy is characterized by a very slow development of basement membrane (BM) accumulation, manifested as thickening of the peripheral BM and increased volume of the mesangial BM-like material (BMLM) with mesangial expansion. The initiation of the process is probably at the onset of diabetes since the BM thickening is detectable after a few years. The BM accumulations at the two sites (PBM and BMLM) in the glomerular tuft are considered as two different expressions of a fundamental BM abnormality. The two locations present different conditions for quantitation, may have a different biochemical make-up, and immediate functional implications of the abnormalities may differ as well. In the long run, however, the two in concert lead to the ultimate solidification of the glomerular tuft with loss of capillary surface. The end-stage is glomerular closure, with elimination of glomerular function. A very close correlation has been found between the total remnant surface area of the glomerular capillaries and the level of GFR. Along with the classical changes of the diabetic glomerulopathy, changes in glomerular size are detectable. In early diabetes during the stages of glomerular hyperfunction, hypertrophy develops acutely at the onset of diabetes, leading to an increase in capillary surface corresponding to the increase in filtration rate. In the advanced stages when glomerular closure involves a proportion of the nephrons compensatory hypertrophy develops, thereby probably helping to preserve capillary surface for a period of time. The exact mechanisms that may influence these developments are not known, but underlying them all are the metabolic abnormalities of diabetes. PMID- 3536199 TI - The kidney in diabetes: significance of the early abnormalities. PMID- 3536200 TI - Clinical diabetic nephropathy: natural history and complications. AB - Diabetic nephropathy develops in about 45% of insulin dependent diabetics of whom two-thirds will develop renal failure, the rest dying from cardiovascular disease. Most of the excess mortality of insulin dependent diabetics occurs in those with proteinuria. Among non-insulin dependent diabetics nephropathy is also an important cause of increased mortality but this is mainly from cardiovascular disease. Once diabetic nephropathy is established it progresses relentlessly to end-stage renal failure over about seven years, but ranging from five to 20 years. The explanation for the different rates of progression in individual patients is not understood. Hypertension accompanies diabetic nephropathy and its treatment may retard the progression of renal failure. Other forms of intervention include glycaemic control which has not been shown to have any effect, and protein restriction for which no conclusions can be drawn at present. The diagnosis of diabetic nephropathy is straightforward in the presence of a typical history and clinical features. Non-diabetic renal disease is sometimes the cause of renal failure and may require specific treatment; prognosis for renal failure treatment may be better than for nephropathy patients with other diabetic complications. Other diabetic complications develop as diabetic nephropathy progresses, most notably cardiac and peripheral vascular disease. Proliferative retinopathy and neuropathy are considerable problems and their management needs attention both before and after renal failure treatment. PMID- 3536201 TI - Renal transplantation in diabetes. PMID- 3536202 TI - Dialysis: continuous ambulatory peritoneal dialysis and haemodialysis. PMID- 3536203 TI - Autonomic neuropathy: its diagnosis and prognosis. AB - Autonomic neuropathy is now well established as a relatively common and significant complication of diabetes mellitus. Its importance has been clarified in recent years during which the extent of autonomic control over all areas of body function has been defined. Using simple cardiovascular reflex tests, autonomic abnormalities can be demonstrated without any corresponding symptoms. The often stated concept of 'patchy' involvement in diabetic autonomic neuropathy should now be rejected as too should the view that autonomic neuropathy is either 'present' or 'absent' based on a single test result. When generalized and predominantly metabolic disturbances, as in diabetes, give rise to impaired nerve function, autonomic as well as somatic components of the nerve are affected. Where damage is severe this leads to the characteristic florid picture of symptomatic autonomic neuropathy with its particularly poor prognosis. For the physician in a busy clinic, much of the theoretical and experimental basis for autonomic neuropathy may not appear of direct relevance. However, he has now to be aware of the clinical implications of autonomic damage in the diabetic. This may have particular relevance in the care of the diabetic foot (see Chapter 10), the recognition of many of the vague symptoms associated with autonomic damage, the treatment of disabling features such as postural dizziness and nocturnal diarrhoea, and an awareness of the poor prognosis associated with symptomatic autonomic neuropathy. He will also need to be alert to the dangers of general anaesthesia in such patients, and the possibility of sudden unexpected deaths. Diabetic autonomic neuropathy causes widespread abnormalities, some of which are clinically apparent, some of which can be detected by sensitive tests, and others which have yet to be discovered. Inclusion of the neuropeptides and other hormones within the compass of autonomic control has opened up a whole new area of investigative interest, with many complex interrelationships which still need to be unravelled. This should lead to better understanding of the pathophysiological processes that cause damage to diabetic nerves. With so much research effort directed towards better glycaemic control and aldose reductase inhibitors (see Chapter 8), it may eventually be possible to reverse or prevent this potentially disabling and lethal complication of diabetes. PMID- 3536205 TI - Diabetic neuropathies and pain. AB - Many of the diabetic neuropathic syndromes are characterized by painful symptoms with a sensation of burning and associated with troublesome hyperaesthesia. It is important to distinguish between the acute and chronic forms of peripheral sensory neuropathy; while the former carries an excellent prognosis for symptomatic improvement within one year, the latter may cause persistent symptoms for many years. In contrast to the acute form, in which symptoms are particularly severe but abnormal neurological signs are minimal, patchy stocking and glove sensory loss together with peripheral small muscle wasting are often present in chronic sensorimotor neuropathy. Peripheral polyneuropathies are more common in patients with poor metabolic control, although recent evidence implicates blood glucose flux as a possible contributory factor to neuropathic pain. It is possible that blood glucose flux or altered peripheral blood flow leads to increased spontaneous activity in nociceptive afferent fibres which are present in the axonal sprouts that characterize small fibre neuropathy. In the diagnosis of the neuropathies, exclusion of other aetiological factors is of paramount importance as there is no specific diagnostic test for diabetic nerve damage. If there is no symptomatic improvement after a period of stable and optimal metabolic control together with simple analgesics, then the tricyclic drugs should be regarded as first line therapy. The rapid effect of these drugs suggests a peripheral rather than central mode of action. PMID- 3536204 TI - The diabetic foot: pathophysiology and treatment. AB - The diabetic foot can be classified into the neuropathic foot, characterized by the neuropathic ulcer, the Charcot joint and neuropathic oedema associated with a good circulation, in which neuropathy predominates, and the ischaemic foot in which atherosclerosis is the dominant factor leading to a reduction in blood flow with absent pulses. In the neuropathic foot, blood flow is increased, the vessels are still and dilated as a result of medial wall calcification and there is evidence for arteriovenous shunting. The neuropathic ulcer characteristically develops on the plantar surface following inflammatory autolysis and haematoma formation under neglected callosities. Chiropody is therefore the mainstay of treatment and recurrence is prevented by redistribution of weight bearing forces by moulded insoles in special footwear. Charcot osteoarthropathy is often preceded by fracture which is a further complication of diabetic neuropathy and which precipitates the rapid bone and joint destruction of the Charcot joint. Neuropathic oedema responds to ephedrine with a reduction in peripheral flow and an increase in urinary sodium excretion. The ischaemic foot is characterized by rest pain, ulceration and gangrene. Medical management can be successful in up to 72%, the remainder needing arteriography to assess suitability for arterial reconstruction or angioplasty. In the diabetic leg, atherosclerosis is predominant in the branches of the popliteal artery making arterial reconstruction difficult. Optimum care of the diabetic foot is provided in a diabetic foot clinic where the skills of chiropodist, shoe-fitter and nurse receive full support from physician and surgeon. Many lesions of the diabetic foot are avoidable and thus patient education is the cornerstone of prevention. PMID- 3536206 TI - Diabetic retinopathy: current concepts of evaluation and treatment. AB - Diabetic retinopathy is a common, and potentially blinding or visually disabling complication of diabetes. Nearly all diabetic subjects will have some degree of retinopathy after 20 years of diabetes, and 50% of those with insulin dependent diabetes will have proliferative retinopathy after 15 years. Macular oedema frequently produces central vision loss and legal blindness, most commonly in non insulin dependent diabetics. In recent years, several therapeutic modalities have been demonstrated to be effective on the basis of large-scale randomized, controlled clinical trials. These include panretinal photocoagulation (PRP), using the argon laser or xenon arc, for proliferative retinopathy, and focal photocoagulation for macular oedema. Vitrectomy surgery is effective for diabetic vitreous haemorrhage and traction retinal detachment, producing improved vision in most patients, but only a relatively small percentage of patients so treated recover good visual acuity (greater than or equal to 6/12). Other therapeutic modalities, such as hypophysectomy for severe retinopathy, remain controversial, while still others, such as rigorous blood glucose control and aldose reductase inhibitors, are currently under investigation. The primary care physician who deals with diabetic patients should be familiar with the lesions of diabetic retinopathy and with current therapeutic modalities. He should perform an examination of the posterior retina with the direct ophthalmoscope on each diabetic patient at each visit, and should institute prompt referral to an ophthalmologist at the first sign of change. Periodic examination of all diabetic patients by an ophthalmologist should be conducted at the intervals recommended in the previous section. Definitive evaluation and treatment of diabetic retinopathy should be carried out by the ophthalmologist. PMID- 3536207 TI - The colon in the pseudoobstructive syndrome. AB - Colonic pseudoobstruction can occur as part of a generalized chronic intestinal pseudoobstruction syndrome or as an isolated entity. Isolated colonic pseudoobstruction can occur in two unrelated forms: the acute and chronic forms. Acute colonic pseudoobstruction is frequently a hospital-acquired disease that arises as a complication of other illnesses. The syndrome must be recognized and treated with early colonoscopic decompression to prevent cecal or colonic perforation. Chronic colonic pseudoobstruction is a syndrome of many causes. The prognosis of patients with chronic colonic pseudoobstruction is much better than that of generalized chronic intestinal pseudoobstruction, because the patients become asymptomatic with appropriate operations. The pathogenesis of acute colonic pseudoobstruction and several types of chronic colonic pseudoobstruction is not known. Further investigations should include bacteriologic study, histopathologic studies (examinations of smooth muscle and myenteric plexus), and examination of extrinsic nerves of the colon. With these approaches, a better understanding of the pathogenesis of these syndromes will be achieved. PMID- 3536208 TI - Comparative physiology of the mammalian colon and suggestions for animal models of human disorders. AB - The large intestine is absent from the digestive tract of some mammals and shows a considerable degree of gross structural variation among the other species. The cecum serves as the major site for digesta retention and microbial fermentation in lagomorphs, most rodents, and many herbivorous marsupials, but the proximal colon appears to serve this purpose in most other mammals. The VFA end-products of microbial fermentation play an important role in the normal secretory and absorptive processes of the colon. Among those species that have received the most extensive study, the pig appears to have a colon most similar to that of humans in its gross structural and absorptive characteristics. PMID- 3536209 TI - Volatile fatty acids: their production, absorption, utilization, and roles in human health. AB - The evidence shows that microbial fermentation of carbohydrates and endogenous substrates occurs in the large intestine of humans and that VFA represent a major endproduct. The large number of bacterial species, the complex nature of their interactions, and the endproducts of their fermentation processes are all likely to have significance in human health. Fermentation in the human intestine resembles rumen fermentation with respect to the metabolic pathways involved in anaerobic degradation of organic matter and in the concentrations of VFA endproducts. Thus, rumen bacteria are useful for understanding the dynamics and potential interactions of human intestinal bacteria. Current research is directed towards examining fermentation processes in animals, such as the pig and some species of monkey, since these animals most closely resemble the human. From such animal studies the metabolic activities of VFA and the processes by which they are produced and absorbed can be more clearly investigated and understood. The effects of diet on the microflora and on the metabolic pathways leading to the generation of VFA are under investigation. Modification of diet seems the most likely way of modifying the extent to which VFA are produced and absorbed by the human. As methodologies and protocols for evaluating human intestinal fermentation in vivo are revised and made more sensitive, the significance of fermentation will become more clearly understood. However, it appears that VFA make a physiologically significant contribution to the health of the colonic mucosa, and to the energy supply of the host. The magnitude of these effects is probably influenced by diet. PMID- 3536211 TI - Physiologic insights into irritable bowel syndrome. PMID- 3536210 TI - Colonic mucin glycoproteins in health and disease. AB - Mucin glycoproteins form a viscoelastic gel which appears as a continuous protective barrier on the colonic mucosal surface. However, their structure and function in health and disease remain unclear. Further work is needed to define the structure of colonic mucin glycoproteins as well as the cellular basis for their heterogeneity. Further elucidation of the factors regulating their synthesis and secretion should provide insight into their function. A more detailed characterization of changes in mucin glycoproteins associated with specific disease processes may shed light on the role of these glycoproteins in the pathogenesis of a wide variety of colonic disorders. PMID- 3536213 TI - Clinical picture of diverticular disease of the colon. AB - Uncomplicated diverticular disease is usually asymptomatic. When abdominal pain or discomfort related to defecation, altered bowel habit, and flatulence occur, they are likely a result of a coexistent irritable bowel. Nonetheless, diverticula are subject to serious complications. Diverticular hemorrhage may be massive and require emergency angiography and segmental resection. Peridiverticulitis occurs when a diverticulum ruptures, perhaps because of inspissated fecal material. This occurs usually in the sigmoid, resulting in a peridiverticular abscess localized by the adjacent fat and mesentery. If the infection extends beyond this, abscess, fistula, or free perforation may occur. These complications require antibiotics, intravenous therapy, and, in the case of uncontrollable abscess or perforation, urgent surgery. Obstruction of the colon, sometimes associated with ileus, may occur and in this case one may find a carcinoma among extensive diverticular disease. Although there is insufficient evidence to justify a high-fiber diet for the general population, the notion of a low-residue diet in the management of uncomplicated diverticular disease should be laid to rest. PMID- 3536214 TI - Colonic muscle in diverticular disease. AB - The muscle abnormality in diverticular disease is seen most often in surgically excised specimens in the sigmoid colon, though a pancolonic form of the disease without muscle thickening also exists in the elderly. In terms of physiopathology, the condition has a raised intraluminal pressure operating on the wall locally, this being most readily demonstrated in symptomatic patients. In Western societies the colon loses its tensile properties throughout life. The anatomical and functional evidence is that the colon is outstandingly strong in infancy in both Africans and Europeans, but later the mechanical properties of the African colon become superior and they remain so throughout ensuing decades. The diminished tensile strength and elasticity of the wall is no different in the diverticular and non-diverticular subjects and this suggests that an additional factor, such as pressure, may be necessary in Europeans to cause the mucosal extrusion which constitutes each diverticulum. Fiber fills the colon with bulkier, moister feces, which necessitates less work, especially as it operates for most of the time as a low-pressure system, only occasionally evacuating by mass peristalsis into the rectum. Cereal fiber binds salt and water and there is evidence that this is mostly a physicochemical process, dependent on particle size. Certain types of fibers undergo chemical degradation in the cecum and increase the bacterial population of the stool. Population studies show that diverticular disease subjects consume less fiber and in countries where the fiber intake is reduced, fecal output is lessened, transit is slower, and intraluminal pressure may be rising. As a result of the adoption of high-fiber diets and the use of bulking agents elective operations for diverticular disease are less commonly performed. The number of operations in most Western countries may be increasing because of increasing longevity. Complications often arise after a relatively short history; most are explicable on the basis of sudden pressure increments. The recent important finding in this disease is the change in colonic wall compliance, which probably occurs because of a collagen failure. Contraction of the taeniae may follow elastosis, which may relate to under-filling; this produces the contracted structure seen in the excised colonic specimen. The strength of the colonic wall diminishes throughout life, due to changes in its composition; some of these changes are hastened by self-imposed stresses, which currently seem to be mainly of dietary origin. PMID- 3536212 TI - Electrophysiology of human colon motility in health and disease. AB - Recent years have seen a number of studies measuring electrical activities of the human colon muscle layers. In vitro studies have enhanced our understanding of myogenic control of colon motility. In vivo studies have suggested a relationship between patterns of electrical activities and the transport of colon contents. This chapter describes the patterns of electrical and motor activity that the human colon can perform depending on the nature and intensity of the stimulus, using recent in vitro and in vivo data. In vitro studies with human tissue have shown differences between the electrical activity of the longitudinal and circular muscles. They have also revealed the unique nature of the electrical control activity of the circular muscle of human colon. The electrical oscillatory activity of this layer is variable in frequency from 1 to 60 cpm, variable in amplitude, and not omnipresent. Furthermore, the activity is sensitive to stretch and markedly altered by excitatory and inhibitory substances. In vivo data, especially spike action potential recordings for 24 h, have revealed patterns of electrical activity related to intake of meals, sleep, and also constipation. The limitations of some intraluminal techniques to record electrical activity are discussed. Further studies are needed to accurately relate in vivo activities to cellular events recorded in vitro, and to relate these to altered patterns of activity in disease. The suggestion is made that a relevant in vivo assessment of the colonic motility of a patient can only be achieved by long-lasting (24-h) studies, because of the large variability in the hour-to-hour colonic activity. Timing of experimental drug intervention is important since colonic motility undergoes diurnal changes. Recent studies into profiles of electrical and motor activity in irritable bowel syndrome (IBS) suggest that there is not a typical IBS myogenic activity. Rather, patterns of electrical activity can be related to the symptoms of IBS: diarrhea and constipation. Recent electrophysiologic data on Hirschsprung's disease reveal absence of intrinsic inhibitory innervation in the aganglionic segment. In vitro studies on tissue from diverticular disease patients show abnormal myogenic activity. PMID- 3536215 TI - Defecation and the pathophysiology of constipation. PMID- 3536216 TI - Physiology and pathophysiology of the colonic circulation. AB - There is growing evidence that colonic blood flow is controlled by both intrinsic and extrinsic factors. The existence of intrinsic vascular control mechanisms is evidenced by pressure-flow (and oxygen uptake) autoregulation, reactive hyperemia, vascular responses to acute venous hypertension, and a functional hyperemia. Although myogenic factors have long been considered to be solely responsible for the intrinsic ability of the colon to regulate its blood flow, recent developments indicate that metabolic mechanisms may be of equal importance in this regard. Both parasympathetic and sympathetic nerves play an important role in regulating colonic blood flow. The influence of circulating vasoactive agents and ischemia on colonic oxygenation are largely explained in terms of the relationship between oxygen uptake and blood flow. Colonic vascular dysfunction appears to be a major factor in the pathogenesis of inflammatory bowel diseases, chronic portal hypertension, and neonatal necrotizing enterocolitis. Future progress in this area will require the development of techniques for the measurement of colonic blood flow in man. PMID- 3536217 TI - The pathogenesis and pathophysiology of rectal prolapse and solitary rectal ulcer syndrome. AB - Rectal prolapse and solitary rectal ulcer syndrome are both benign conditions affecting the rectum, mainly in women; prolapse tends to occur late in life, while solitary rectal ulcer syndrome has a predilection for the younger adult. Complete rectal prolapse probably starts as a mid-rectal intussusception, although a combination of this theory and the 'sliding hernia' theory has been proposed by Altemeier et al (1971). The pelvic floor weakness associated with prolapse, which gives rise to incontinence, is most likely due to a traction injury to the pudendal nerve. Anorectal manometry will indicate those incontinent patients likely to benefit from rectopexy. Abnormal descent of the perineum may be found in rectal prolapse and solitary rectal ulcer syndrome as well as descending perineum syndrome per se. The clinical features of these three conditions can overlap. Solitary rectal ulcer syndrome is essentially due to prolapse and traumatization of the rectal mucosa. Inappropriate puborectalis contraction, abnormal perineal descent, and overt rectal prolapse have all been cited as possible mechanisms of development of the condition. Defecography is the radiologic investigation of choice. Electromyography, as in rectal prolapse, may show evidence of pudendal nerve damage although incontinence is rare. PMID- 3536218 TI - The Johanson-Blizzard syndrome: report of a new case with special reference to the dentition and review of the literature. AB - We report a new case of Johanson-Blizzard syndrome. The clinical findings with special reference to the dentition are discussed, and the literature is reviewed. The reported case underlines the heterogeneity of ectodermal dysplasias mentioned by Freire-Maia (1971). PMID- 3536219 TI - Chromosomal mosaicism and maternal cell contamination in chorionic villi cultures. AB - In a series of 110 chromosome analyses, after chorionic villus sampling, mosaics were found in 3 out of 106 long term cultures. In all 3 cases, subsequent amniotic fluid cell cultures showed normal karyotypes. Maternal cell contamination was encountered in one long term culture derived from carefully dissected chorionic villi. PMID- 3536221 TI - T cell subclasses in fetal human ileum. AB - Lymphocytes within fetal human ileum were studied by immunocytochemistry to determine the appearance of T cells in human small intestine and the role of enteric antigen in the accumulation of cells of the suppressor/cytotoxic phenotype in the gut epithelium. In fetal human gut epithelium, cells bearing the pan T cell marker UCHT1 (CD3) were present in all of the specimens studied (11-19 weeks gestation). Of these, UCHT4+ (CD8, suppressor/cytotoxic phenotype) predominated over the leu3a+ (CD4, helper/inducer phenotype), although the differences were not as marked as in postnatal gut. UCHT1+ cells were also present in the lamina propria, frequently as small aggregates beneath the epithelium. PMID- 3536223 TI - Computer software. AB - Software is the component in a computer system that permits the hardware to perform the various functions that a computer system is capable of doing. The history of software and its development can be traced to the early nineteenth century. All computer systems are designed to utilize the "stored program concept" as first developed by Charles Babbage in the 1850s. The concept was lost until the mid-1940s, when modern computers made their appearance. Today, because of the complex and myriad tasks that a computer system can perform, there has been a differentiation of types of software. There is software designed to perform specific business applications. There is software that controls the overall operation of a computer system. And there is software that is designed to carry out specialized tasks. Regardless of types, software is the most critical component of any computer system. Without it, all one has is a collection of circuits, transistors, and silicone chips. PMID- 3536222 TI - Interleukin-1 stimulates the secretion of proteoglycan- and collagen-degrading proteases by rabbit articular chondrocytes. AB - Supernatants from the P388D1 murine macrophage cell line as well as commercially prepared human interleukin-1 (IL-1) stimulated primary rabbit articular chondrocytes to produce collagen- and proteoglycan-degrading proteases. The P388D1-derived factor had a molecular weight of 16,000-20,000 and a pI of 4.5 5.0, and was sensitive to phenylglyoxal treatment. Human IL-1 and the P388D1 supernatants enhanced glycosaminoglycan (GAG) release from bovine nasal cartilage explants. The proteoglycan- and collagen-degrading proteases required Ca2+ for activity. Latent proteoglycanase and collagenase had molecular weights of 44,000 56,500 and 34,000-44,000, respectively. The activated proteases had molecular weights of 30,000-40,000 and 22,000-36,000, respectively. Heparin-Sepharose affinity chromatography yielded two latent proteoglycanase-degrading protease activities and a collagen-degrading peak. The two proteoglycanase peaks also degraded fibronectin, laminin, gelatin, and azocoll but not type I collagen. The collagenase peak also degraded proteoglycan, gelatin, fibronectin, laminin, and azocoll. The activity of the proteoglycan- and collagen-degrading peaks was inhibited by phenanthroline and alpha 2-macroglobulin but not by phenylmethylsulfonylfluoride (PMSF), tosyllysylchloromethylketone (TLCK), pepstatin, or alpha 1-antitrypsin. The control of factors which augment protease production may offer a novel therapeutic approach to arthritis. PMID- 3536224 TI - A non-computer expert's experience with the computer. AB - In summary, I have tried to illustrate how the computer is rapidly becoming indispensable to the physician. This is true for both the physician in private practice as well as the physician involved in research. Computer technology has progressed to the point that a personal computer is readily affordable. Technologic advances and new software packages permit individuals who possess no computer skills to operate almost any system without limitations. There are no age limits to learn how to use the computer. I was introduced to the computer through my clinical research in malignant melanoma as a medical student. Its utility in research is undeniable. The uses of the computer have increased dramatically during the past few years. Today the computer aids not only in research but in the day-to-day care of patients and in medical education. Access to the information explosion is literally at the tips of the physician's fingers. PMID- 3536225 TI - DERM/INFONET achieves "very friendly" status. AB - DERM/INFONET, a group of dermatologic data bases, has been reorganized for easy log-ons and log-offs, plus fast, unambiguous selections from simplified menus. DERM/RX and DERM/PHARM data bases are dermatologic exclusives. The medical literature search will retrieve the most unencumbered dermatologic information for both the academician and clinician for getting the day's work done. PMID- 3536220 TI - Nutrition and autoimmunity: a review. PMID- 3536226 TI - Computer-assisted medical literature searching. AB - At present any physician with the interest and relatively inexpensive hardware can access large data bases of medical literature citations from home or office. This article describes some data bases of interest to dermatologists and gives examples of search strategies. Computer-assisted medical literature searching is of inestimable value for patient care, research, and teaching. PMID- 3536227 TI - Computer-aided diagnosis of dermatologic disorders. AB - In conclusion, several computer programs have been developed to aid diagnosis in dermatology. These have used various methods to reach a diagnosis, with some earlier programs using probabilistic techniques and later programs using cognitive models. Several current trends, if they continue, would indicate that computer-assisted diagnosis may play a greater role. The growing number of physicians who own the prerequisite computing resources will probably want diagnostic software to accompany their office management and data base software. The increasing ease of use of diagnostic software, with rapid access and ease of updating, should make these programs more attractive to physicians. Some of the newer peripheral devices such as optical disks and voice input will probably make the software more interesting. Perhaps the most important factor governing the acceptance of computer diagnostic adjuncts is whether the software will provide a useful service to physicians. If these programs can be demonstrated to improve patient care, they may become commonplace in physicians' offices. PMID- 3536228 TI - Computer-aided quantification of scalp hair. AB - In this article we present a statistical model that, when applied in conjunction with existing image analysis technology, allows for a precise quantification of two-component visual fields. Application of this methodology to the problem of quantification of hair density in patients with hair loss disorders yields excellent results. Under photographically controlled conditions this method should yield completely consistent and valid results. The complete absence of subjective bias in the application of this method makes it an extremely attractive alternative to existing procedures. Limitations to the use of this methodology are detailed, and an alternative approach is suggested. PMID- 3536229 TI - Computer models and images of the cutaneous surface. AB - This article describes how computer models of the skin can be used to obtain objective information about surface-altering events. Although alterations produced by various forms of therapy are being emphasized, more needs to be known about alterations produced by aging, environmental factors, and disease. The term "automated optical surfometry" has been applied to the method described in this chapter. (The term "optical profilometry" has also been used. Because this designation was applied at an earlier time to a method that is entirely different, the use of the word "optical surfometry" appears to be preferable as well as more accurate). Space limitations made it possible to allude only briefly to some of the other techniques that are being used to learn more about the configuration and dynamics of the surface of the skin. The development of imaging and modeling methods for topographic studies of the skin owe their origins in large measure to the advent of inexpensive computer technology. PMID- 3536230 TI - Increased immunoglobulin-secreting cells in the blood of patients with active idiopathic IgA nephropathy. AB - Peripheral blood lymphocytes from 33 patients with idiopathic IgA nephropathy (IgAN) and 15 healthy controls were stimulated in vitro by Protein A from Staphylococcus Cowan I; immunoglobulin (Ig) production was measured by a reverse hemolytic plaque assay to evaluate the quantity of cells secreting Ig. In addition, serum Ig levels, circulating IgG, IgA and IgM immune complexes (ICs) and the Fc and C3b receptor mediated phagocytosis of peripheral monocytes were measured. The laboratory findings in different phases of the disease were compared. The mean level of IgA-plaque forming cells (IgA PFC) in IgAN patients with normal renal function was significantly higher (p less than 0.001) than the mean control value. In contrast, they were reduced significantly in those patients who were subjected to periodic hemodialysis (p less than 0.001). Disease activity produced a significant increase in IgG PFC and IgA PFC, high IgG and IgM serum levels, high circulating IgG ICs, and low C3b-mediated phagocytic function of the peripheral macrophages. These findings demonstrate that IgAN is associated with an increased number of IgG and IgA-secreting cells in the peripheral blood of patients during the active phase of the disease and that the concurrent presence of high levels of circulating Ig ICs may be responsible for the gross hematuria, as their deposition in the glomeruli could activate the complement system. PMID- 3536233 TI - Evidence for acquired cystic disease during hemodialytic treatment. PMID- 3536231 TI - Corticosteroid therapy in IgA nephropathy with nephrotic syndrome: a long-term controlled trial. AB - A randomized prospective study of 34 patients with IgA nephropathy and nephrotic syndrome was conducted to determine the therapeutic value of corticosteroid therapy. The patients were divided into two groups: Group A, 17 patients receiving oral prednisolone/prednisone for four months; and Group B, 17 patients receiving no corticosteroid therapy and acting as controls. The groups are comparable in age of presentation, sex ratio, and duration of study. No difference in serum creatinine levels, creatinine clearance, serum IgA levels, severity of renal histopathological changes, incidence of hypertension or incidence of impaired renal function could be demonstrated but the Group A patients had significantly heavier proteinuria. During the mean study period of 38 months (range 12-106), no significant difference in serum creatinine levels and creatinine clearance was demonstrated between the two groups. Forty percent of the Group A patients developed complications related to steroid therapy. Despite the overall lack of therapeutic value in IgA nephropathy with nephrotic syndrome as reflected by change in renal function, corticosteroid treatment resulted in excellent remission of nephrotic syndrome in 80% of patients with mild glomerular histopathological changes. Our findings suggest that corticosteroid therapy is only beneficial to selected groups of patients with IgA nephropathy and nephrotic syndrome but its indiscriminate use should be discouraged. PMID- 3536232 TI - Controlled trial of calcitriol in hemodialysis patients. AB - We report on a 5-year, prospective, double-blind trial of 1,25 dihydroxycholecalciferol (calcitriol) versus placebo in 76 hemodialysis patients without biochemical or radiological evidence of bone disease. Calcitriol, 1 microgram daily, regularly induced hypercalcemia. Doses of 0.25 microgram daily or less proved satisfactory in most patients. During calcitriol treatment, plasma calcium concentration was significantly higher and serum parathyroid hormone concentration significantly lower than on placebo. There was no difference in the rates of development or of progression of vascular calcification in the two groups. Significantly more patients on placebo (17 vs. 6, p less than 0.05) developed a sustained elevation of plasma alkaline phosphatase concentration. Calcitriol appeared to protect against the development of histological evidence of osteitis fibrosa but not of osteomalacia, but accumulation of aluminum in bone occurred during the study. We conclude that calcitriol delays and may prevent the development of osteitis fibrosa in patients receiving regular hemodialysis and may reasonably be prescribed routinely in hemodialysis patients without biochemical or radiological abnormality, unless there is a substantial prospect of early renal transplantation. PMID- 3536234 TI - Acute leukaemias: biology and treatment. PMID- 3536235 TI - Interactions of oncogenes with haematopoietic cells. PMID- 3536236 TI - Prognostic significance of chromosomal abnormalities in acute leukaemias and myelodysplastic syndromes. AB - The main purpose of this review is to emphasize the critical role that chromosome analysis can play in the diagnosis, prognosis and management of blood malignancies. Table 3 shows that most patients with AML, MDS and ALL can be placed into one of three major prognostic categories. When chromosome analysis is combined with a cytological study in AML and MDS and with a cytological and immunophenotypic study in ALL, the clinical value of such analysis is further enhanced. Because of critical prognostic information that may be obtained primarily from refined chromosome analysis, we recommend that a major effort be undertaken to develop capability for such analysis in all large institutions so that the information derived can be used routinely in the assessment of haematological malignancies. In particular, it is now necessary to reassess the value of current treatments taking into consideration refined chromosome studies. We believe that patients within specific chromosomal categories should be treated with specific types of therapy in an attempt to improve overall survival. PMID- 3536237 TI - Differentiation-linked gene rearrangement and expression in acute lymphoblastic leukaemia. PMID- 3536239 TI - Acute leukaemia in children. PMID- 3536238 TI - Biology of acute myeloid leukaemia. AB - The assessment of clonogenic leukaemic precursors in cell culture has demonstrated considerable heterogeneity of patients with respect to their ability to give rise to leukaemic blast cell colonies. Specific growth patterns rather than the frequency of blast colonies, appear to be of prognostic value for the clinical outcome. In particular, blast cells with high self-renewal ability were associated with poor prognosis. A similar degree of heterogeneity among leukaemic blast cell populations can be identified by studies with monoclonal antibodies directed against various cell surface cytoplasmic determinants that are associated with haematopoietic precursors. Some of these reflect properties of pluripotent normal counterparts while others display patterns that are associated with precursors restricted to a single myeloid lineage. Blast cells examined after culture may differ in their marker expression from the original blast cell population. Usually, properties of more mature cells are acquired during the culture period. These changes reflect events of aberrant differentiation without leading to the full development of a morphologically normal phenotype and functional capability. The use of both technologies has provided considerable insight into the biology of leukaemic blast cell populations and it is anticipated that their future use will provide further information about the control mechanisms involved in their proliferation and their potential to differentiate normally. PMID- 3536240 TI - Acute lymphoblastic leukaemia in adults. PMID- 3536241 TI - Acute myeloid leukaemia: recent advances in therapy. AB - Over the past ten years, there have been substantial advances in the treatment of AML. Intensive induction chemotherapy using seven-day courses of cytarabine and daunorubicin or amsacrine produce remission in 60-85% of patients. Median remission duration is 9-16 months. In some series, 20-40% of patients are in continuous remission for two years or more; many of these patients remain in remission for five years or longer and some may be cured. Bone marrow transplantation has evolved as a useful therapeutic modality capable of achieving long-term survival in some circumstances in which chemotherapy is relatively ineffective. Its precise role in the initial therapy of AML remains to be defined but it is likely to be beneficial in selected patients. These data indicate substantial recent progress in the treatment of this disease which was almost uniformly fatal 30 years ago. The fact that most patients relapse within 1-2 years reflects a lack of progress in developing effective postremission therapy. Maintenance chemotherapy, immunotherapy and CNS prophylaxis have little role in AML. It is unclear whether consolidation or intensification extend remissions or increase the proportion of long-term survivors; controlled randomized trials should answer this question within the next few years. Future progress in the treatment of AML awaits the development of more sensitive methods for detecting residual leukaemia, more effective use of current therapeutic modalities and the introduction of new effective drugs. Most data suggest that early intensive treatment is of key importance for achieving cures. We cannot presently distinguish, however, between patients cured by initial treatment and those who require further chemotherapy. PMID- 3536242 TI - Lineage heterogeneity in acute leukaemia: acute mixed-lineage leukaemia and lineage switch. AB - Until recently, lineage fidelity was thought to be preserved in leukaemic cells, which by available tests showed surface markers and enzymatic patterns characteristic of an appropriate normal cell lineage and stage of differentiation. Our data indicate that this theory is too restrictive. If leukaemogenesis occurs in pluripotent progenitors in a relatively high percentage of cases, we would propose a model in which lymphoid and myeloid differentiation antigens are expressed simultaneously until the progenitor cell commits to a single lineage. Lineage commitment could involve external factors, e.g. growth factors (Sherr et al, 1985), that cause genes specific for the opposite lineage to be 'switched off'. The control of gene expression in mammalian cells and the specific chromosomal sites of genes coding for the various lineage-associated markers remain uncertain. However, recent studies indicate that most, if not all, leukaemic cells contain chromosomal abnormalities, many involving rearrangements of DNA (Williams et al, 1986). Since the control of eukaryotic gene expression is known to involve numerous sequence elements, some acting at a distance from the site of transcription (Dynan and Tjian, 1985), genetic perturbations within the cell (e.g. a reciprocal translocation) could be expected to deregulate certain genes, leading to their under- or overexpression analogous to activation of the c myc oncogene by the 8;14 translocation in Burkitt's lymphoma. Thus, an almost infinite variety of cell lineage-related phenotypes could be expected from this mechanism alone, even if the transforming event did not involve a pluripotent stem cell. Also, we have hypothesized that enzymes such as TdT, a DNA polymerase that catalyses polymerization of deoxyribonucleotides without a DNA template, could serve as a modifier of DNA sequences, permitting otherwise inactive genes to be expressed (Stass and Mirro, 1985). It is interesting that most cases of childhood acute mixed-lineage leukaemia are TdT positive, even though this is not true for the chronic leukaemias of adults. It is now clear that unusual combinations of myeloid and lymphoid cell lineages are much more common in acute leukaemia than have been generally recognized or suspected. The traditional division of the acute leukaemias into ALL and AML may not be the most accurate way to represent this class of haematological malignancies. That mixed-lineage leukaemia may require alternative therapy is a clinically important observation and underscores the need for comprehensive testing of blast cells at diagnosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536243 TI - Preleukaemia. PMID- 3536244 TI - Bone marrow transplantation in acute leukaemia. AB - Bone marrow transplantation is useful in AML. Results of chemotherapy and transplantation are compared in Table 4. Transplantation is the preferred treatment in individuals who fail chemotherapy. Transplantation is also likely to be superior or comparable to chemotherapy in individuals less than 30 years of age in first remission. Transplantation in older individuals in first remission is controversial, but it is unlikely that these results are inferior to results with chemotherapy. Transplants from donors other than HLA-identical siblings are less well investigated but may be a reasonable alternative in young individuals in first relapse or second remission, particularly if recipient and donor share most HLA antigens. Autotransplants are difficult to evaluate critically and should be considered investigational in individuals in second or later remission for whom a suitable donor is unavailable. Autotransplants in first remission should be restricted to controlled clinical trials, since their efficacy is otherwise inevaluable. It is uncertain whether in vitro treatment of the bone marrow is necessary in the context of autotransplantation; again, controlled trials are required. Bone marrow transplantation from an HLA-identical sibling is a useful therapy in individuals with ALL who relapse despite chemotherapy. Individuals undergoing transplantation in second or later remission or in relapse have a survival rate superior to those treated with chemotherapy; these data are summarized in Table 5. One important unresolved issue in ALL is whether children with high-risk ALL and adults should receive transplants in first remission. This answer will, to a considerable extent, depend on results achieved with chemotherapy alone. If intensive chemotherapy produces 50-70% disease-free survival in these individuals, it is unlikely that transplantation will be superior. If, however, alternative chemotherapy results are inferior, transplantation may be useful. Clearly, controlled clinical trials are needed. Results of transplants from donors other than HLA-identical siblings are less certain but this approach may be considered in selected young individuals who fail chemotherapy. Autotransplants should also be considered in this setting but not in individuals in first remission. It is likewise uncertain if in vitro treatment of the bone marrow is useful; this must be addressed in controlled trials. The data reviewed indicate an important role for bone marrow transplantation in the therapy of the acute leukaemias. We have attempted to precisely define its use in various disease states.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536245 TI - Reversed septal motion in right ventricular volume overload: false negative sign in the presence of increased septal thickness. AB - Paradoxical septal motion of the interventricular septum and right ventricular enlargement constitute diagnostic features of right ventricular volume overload. A diastolic septal displacement toward the left ventricle and its systolic normalization explain this phenomenon. A thick septum would, theoretically, impede such movement. One patient with a cardiac allograft and gross tricuspid regurgitation is described who, in the context of a rejection episode and in a very short interval, showed two septal motion patterns related to two different septal thicknesses. It is concluded that in a patient with large right ventricular dimension and increased septal thickness, lack of paradoxical septal motion does not rule out severe right ventricular volume overload. PMID- 3536246 TI - William Hamilton, 1893-1964. PMID- 3536247 TI - Osteoarthritis. The epidemiologic viewpoint. AB - Large epidemiologic studies of osteoarthritis (OA) performed over the past 30 years have confirmed that OA is a ubiquitous condition, that it is linked to age, that it is more frequent and more widespread in women older than 45 years of age, and that mechanical overuse of the joints is probably instrumental in the occurrence or the location of certain cases of OA. Epidemiologic evidence points to the existence of an entity of "generalized OA" composed of three or more locations with involvement of the interphalangeals. Heredity in cases associated with distal interphalangeal OA and inflammation in cases with proximal interphalangeal OA are the factors found to be most closely correlated to generalized OA. Surveys of several series of OA of the hip have pointed to the existence of several clinicoradiologic subsets that could have different clinical correlates and various pathophysiologic mechanisms. Because several conditions, such as crystal arthropathy, diffuse skeletal hyperostosis, and subsets of OA, have been described in recent years, a reappraisal of an epidemiologic approach of OA is advisable. PMID- 3536248 TI - Preoperative use of povidone-iodine. A prospective, randomized study. AB - One hundred one adult orthopedic surgical patients were studied in a randomized, prospective clinical trial to compare the effectiveness of the standard povidone iodine scrub and paint with povidone-iodine painting alone for presurgical skin preparation. No infections occurred in either group. The scrub-plus-paint group showed a 0.601 logarithmic reduction in bacteria counts, compared with 0.622 with painting alone. Further, 36.8% of the patients in the scrub-plus-paint group had skin counts that actually increased after preparation, compared with 13.8% of patients in the paint-only group. The preparation bacterial counts among inpatients, who received preoperative hexachlorophene showers, were significantly lower than that of outpatients, who did not receive preoperative showers. The data support the use of the preoperative hexachlorophene shower and the omission of scrubbing from the surgical skin preparation technique. PMID- 3536249 TI - The classic. Arthroplasty for ankylosed joints. By John B. Murphy. 1913. PMID- 3536250 TI - The synthetic processes of articular cartilage. AB - The cells of cartilage are constantly remodeling the matrix in which they are suspended. The stimulus to initiate remodeling is probably the chondrocyte's response to physical and or chemical changes in the environment. Heat, pressure, friction, load, pH, and growth are examples of such factors, which, if altered, would have a dramatic effect on the cell's state of health. The mode of response by the chondrocyte is specific for a given stimulus. Elevated temperature, for example, switches on a set of genes, the heat shock genes, in chondrocytes. This results in the synthesis of a series of cellular protein that presumably in turn protects the cell from the injurious effects of heat. Load and pressure affect both the synthetic rate of matrix protein and the degradation rates of preexisting matrix. A number of low-molecular-weight proteins appear to be involved in anabolic and catabolic processes of cartilage. A protein recently isolated from synovium stimulates the synthesis of degradative enzymes in cartilage. This factor is probably involved in the remodeling process under normal physiologic conditions. More recently, it has been found in elevated levels under pathologic conditions such as in the synovial fluid of patients with rheumatoid and osteoarthritis. The mechanism by which this factor turns on the degradative pathway appears complex and is under investigation. PMID- 3536251 TI - Articular cartilage breakdown in a lapine model of osteoarthritis. Action of glycosaminoglycan polysulfate ester (GAGPS) on proteoglycan degrading enzyme activity, hexuronate, and cell counts. AB - The action of glycosaminoglycan polysulfate (GAGPS) on the development of meniscectomy-induced "osteoarthritis" in rabbits was studied in respect to enzyme activities in articular cartilage. Rabbits were treated for 11 weeks beginning one week after meniscectomy and "therapeutic" treatment from the 12th to the 20th week after meniscectomy, following presumed development of lesions. The experimental design was identical to that of another study, in which prevention of cartilage erosions was indicated by gross morphologic and histologic parameters. In the present study, enzyme activities were measured for neutral metalloprotease(s), (NMPE), serine protease(s) and thiol protease(s) in extracts from cartilage obtained at sacrifice. Control cartilage enzyme activities consisted of intact normal and surgically altered rabbits treated with saline matched for each regimen. In the positive controls, there were highly significant elevations of NMPE active on proteoglycans and serine protease activity per milligram of wet cartilage at 20 weeks, as well a highly significant elevation of metalloprotease 12 weeks after operation. A significantly lower level of active NMPE was found in experimental groups compared with positive controls. Cell counts per unit volume were doubled in the treated versus untreated cartilages. Hexuronate as an index of proteoglycan content was reduced in positive controls and restored to normal levels or higher with the use of GAGPS in both prophylactic and therapeutic regimens. PMID- 3536252 TI - THARIES resurfacing arthroplasty. Evolution and long-term results. AB - The unsatisfactory results of total hip arthroplasty in the young patient led to the development of the concept of hip resurfacing. Total hip articular replacement by internal eccentric shells (THARIES) resurfacing was introduced in 1975, with the primary goal of bone stock preservation and the hope of increased durability in the young patient. Major changes in design and technique include thicker and more uniform acrylic layers, metal-backed flanged acetabular component, and reduction in femoral size for preservation of acetabular bone stock. Of the 584 hips (average patient age, 48 years) with one- to ten-year follow-up study, there have been 72 failures (revision rate, 12.3%) with 66 cases of loosening (nearly all beginning in or limited to the acetabular side), two neck fractures, and four sepses. Survivorship analysis revealed that the single most important factor related to prosthesis failure is age followed by diagnosis and experience of the surgeon. Osteoarthritis and rheumatoid arthritis were favorable categories with congenital dysplastic hip (CDH), osteonecrosis, and previous failed resurfacing being unfavorable categories. Experience has taught the importance in preserving acetabular bone stock, providing bone graft for socket coverage in severe dysplasia, and removing dead bone in osteonecrosis. While resurfacing did not solve the problems of the young patient, even those patients who failed often gained time for application of the newer techniques and materials. The femoral component infrequently failed. The head remained vascular. This leads the authors to conclude that the surface arthroplasty concept is a viable alternative to total hip arthroplasty and seems to be ideal for the application of porous technology. PMID- 3536253 TI - Estrogen- and progesterone-receptors in meningiomas. Review article. AB - Since 1979 much attention has been payed in the literature to the presence and importance of estrogen- and progesterone-receptors in meningiomas. The existence of these receptors seems to be proven, but the question about their biological activity is not solved conclusively. If the hypothesis of a biological activity of the estrogen- and progesterone-receptors in meningiomas is confirmed, some patients could benefit from a hormonal therapy. PMID- 3536254 TI - Clinical pharmacokinetics of allopurinol. AB - Allopurinol is a widely used drug in the management of hyperuricaemia. It is rapidly and extensively absorbed following oral administration. The major and active metabolite, oxypurinol, is detected in the circulation within 15 minutes of allopurinol administration. Oxypurinol concentrations are higher than those of the parent drug and accumulation occurs during long term administration. Up to 80% of allopurinol is recovered in the urine within 24 hours, mainly in the form of oxypurinol. Allopurinol is negligibly absorbed after rectal administration. In animals, allopurinol is found in highest concentrations in vascular tissue, blood, liver, intestine and heart. It is negligibly bound to plasma proteins. Oxypurinol is eliminated by the kidney and has a much longer elimination half life than allopurinol. Oxypurinol accumulates in patients with renal dysfunction; hence allopurinol dosages should be adjusted in such patients. Allopurinol inhibits the metabolism of 6-mercaptopurine and azathioprine, which require dosage modifications. The interaction of allopurinol with oral anticoagulants and phenytoin has not been clearly established in clinical practice. PMID- 3536255 TI - Myocardial uptake of drugs and clinical effects. AB - The process of uptake of cardioactive drugs into the myocardium is a major determinant of the efficacy and potential toxicity of such agents. Evaluation of responses to anti-arrhythmic and positive inotropic agents is best performed with reference to their concentration in the myocardium, and the potential toxicity of drugs such as tricyclic antidepressants and anthracycline antineoplastics is likely to be related to peak myocardial drug concentrations. Although it has been appreciated for many years that even during long term drug administration the myocardial drug content may not be readily predictable on the basis of estimation of plasma drug concentrations, methodology for direct assessment of myocardial drug content has remained limited. The results of in vitro experiments, utilising tissue culture preparations of myocardial cells or isolated atria, have shed some light on the role of local factors as determinants of myocardial drug uptake. For many agents, attainment of maximal cardiac drug content in vitro is a very slow process (taking up to 3 hours), although maximal inotropic and electrophysiological effects may occur more rapidly. The prolonged time course of drug washout from these preparations also reflects their extensive and slow intracellular accumulation. Mechanical activity of the myocardium appears to accelerate drug uptake, particularly for otherwise slowly equilibrating agents, but the major determinant of the extent of drug uptake into isolated myocardial preparations is lipophilicity, perhaps reflecting the passage of drugs through the sarcolemma. In intact animals, assessment of myocardial drug content after acute drug administration has been performed utilising serial myocardial biopsy or sacrifice of animals. Studies in open-chested dogs suggest that acute accumulation of agents may be most closely predicted from the second compartment of a 3-compartment pharmacokinetic model, and that there is a variable correlation between changes in plasma and myocardial drug concentrations. For example, bretylium concentrations within the myocardium continue to increase for up to 6 hours after drug administration. Factors which may influence drug uptake into the myocardium in intact animals include ischaemia, which usually results in a delay in both drug uptake and subsequent clearance. This change can also be inferred from the time course of onset of antiarrhythmic drug effects in some models of myocardial ischaemia. Anoxia may also inhibit myocardial drug uptake.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536257 TI - Population pharmacokinetics. Theory and clinical application. AB - Good therapeutic practice should always be based on an understanding of pharmacokinetic variability. This ensures that dosage adjustments can be made to accommodate differences in pharmacokinetics due to genetic, environmental, physiological or pathological factors. The identification of the circumstances in which these factors play a significant role depends on the conduct of pharmacokinetic studies throughout all stages of drug development. Advances in pharmacokinetic data analysis in the last 10 years have opened up a more comprehensive approach to this subject: early traditional small group studies may now be complemented by later population-based studies. This change in emphasis has been largely brought about by the development of appropriate computer software (NONMEM: Nonlinear Mixed Effects Model) and its successful application to the retrospective analysis of clinical data of a number of commonly used drugs, e.g. digoxin, phenytoin, gentamicin, procainamide, mexiletine and lignocaine (lidocaine). Success has been measured in terms of the provision of information which leads to increased efficiency in dosage adjustment, usually based on a subsequent Bayesian feedback procedure. The application of NONMEM to new drugs, however, raises a number of interesting questions, e.g. 'what experimental design strategies should be employed?' and 'can kinetic parameter distributions other than those which are unimodal and normal be identified?' An answer to the later question may be provided by an alternative non-parametric maximum likelihood (NPML) approach. Population kinetic studies generate a considerable amount of demographic and concentration-time data; the effort involved may be wasted unless sufficient attention is paid to the organisation and storage of such information. This is greatly facilitated by the creation of specially designed clinical pharmacokinetic data bases, conveniently stored on microcomputers. A move towards the adoption of population pharmacokinetics as a routine procedure during drug development should now be encouraged. A number of studies have shown that it is possible to organise existing, routine data in such a way that valuable information on pharmacokinetic variability can be obtained. It should be relatively easy to organise similar studies prospectively during drug development and, where appropriate, proceed to the establishment of control systems based on Bayesian feedback. PMID- 3536256 TI - Clinical pharmacokinetics of co-trimazine. AB - The clinical pharmacokinetics of co-trimazine (trimethoprim plus sulphadiazine) are reviewed and compared with those of co-trimoxazole (trimethoprim plus sulphamethoxazole). Both combination drugs have similar serum half-life values in persons with normal renal function (half-life of 8 to 12 hours), but the sulphamethoxazole metabolites are retained more than trimethoprim in reduced renal function. Sulphadiazine is less metabolised and the total sulphonamide load of therapeutic doses of co-trimazine is therefore less than for co-trimoxazole. Both co-trimazine and co-trimoxazole have high bioavailability. A suspension of co-trimazine gives serum concentrations comparable with those of tablets. The extravascular penetration of the co-trimazine components is reflected by the total area under the lymph concentration curve in comparison with serum. This measure shows a penetration into peripheral human lymph of 68% for sulphadiazine and 59% for trimethoprim. The proportions eliminated in urine are about 55% for sulphadiazine, 30% for its acetylated metabolite and 75% for trimethoprim. In comparison, for co-trimoxazole, the proportion of sulphamethoxazole eliminated in urine is 15%, that of the acetylated derivative 47%, and that of trimethoprim is also 75%. Urine concentrations of both combinations have similar bioactivity against urinary pathogens after 500 mg of co-trimazine and 960 mg of co trimoxazole. PMID- 3536259 TI - Acceptance of a connective tissue equivalent for grafting and capsuloligamentary reconstruction. AB - A strip of a connective tissue equivalent prepared by using the patient's fibroblasts cultivated in vitro and calf skin collagen, was used for capsuloligamentary reconstruction of the knee. The study of the humoral and cell mediated immune responses indicated that there was no cell-mediated immune reaction and only a transient humoral reaction 2 months after implantation. This first assay in human surgery gave a good functional result, and an immunological response was no longer observed 5 months after grafting. PMID- 3536258 TI - Responders, nonresponders, and placebo responders among children with attention deficit disorder. Importance of a blinded placebo evaluation. AB - The responses to methylphenidate of 118 children with attention deficit disorder (ADD) were studied under double-blind conditions. Three distinct types of response to medication and placebo were found, as determined by teacher ratings. One group, called "responders," improved dramatically in attention and hyperactivity ratings on active medication but showed essentially no change from baseline when on placebo. The group called "nonresponders" showed minimal change in ratings on either placebo or medication. The third group, "placebo responders," showed almost as much improvement as the responders on medication, but their ratings were not very different from medication ratings during the placebo trial. The placebo responders, 18 percent of the group, would have been considered responders in a nonplacebo-controlled study. Double-blind placebo evaluation of ADD children can and should be done by practitioners to avoid medicating children who are responding to nonspecific effects of drugs. PMID- 3536260 TI - The skeleton in diabetes mellitus: a review of the literature. PMID- 3536261 TI - A randomized, double-blind trial comparing a pulse of 1000 with 250 mg methylprednisolone in rheumatoid arthritis. AB - We compared, in a double blind, randomized, 3-center study, a pulse of 1000 mg methylprednisolone with a pulse of 250 mg methylprednisolone, in patients with active rheumatoid arthritis. Improvement of patients was similar in both groups and lasted up to 3 weeks. Side effects were minor. PMID- 3536262 TI - Calcitonin and reflex sympathetic dystrophy syndrome. AB - Reflex sympathetic dystrophy syndrome is a difficult condition to treat. Many modalities have been proposed, all of them being clinically effective but whose efficacy is often difficult to assess, and has not been properly compared. A regimen of physical therapy (pressure therapy, antalgic electrotherapy and exercise therapy) with or without calcitonin was investigated in 24 patients randomly assigned to 2 groups, one given physical therapy alone (Group I) and the other physical therapy plus salmon calcitonin 100 MRC units daily for 3 weeks (Group II). Efficacy assessment was based on clinical (pain, oedema and movement in the affected parts), biochemical (blood and urinary phosphorus and calcium levels, plasma 25-OH-D, plasma parathyroid hormone (PTH), creatinin, alkaline phosphatases and urinary hydroxyproline) and scintigraphic parameters, as well as on the patient's ability to resume working. There was significant improvement in pain in the Group II patients after one week of treatment. As a result the authors advocate the use of calcitonin in addition to physical therapy in reflex sympathetic dystrophy syndrome - and even of calcitonin alone where physical therapy is not possible. PMID- 3536263 TI - Piroxicam and naproxen plasma concentrations in patients with osteoarthritis: relation to age, sex, efficacy and adverse events. AB - Piroxicam and naproxen plasma concentrations were obtained after 4 weeks active therapy between 3 and 12 hours post-dose in 640 and 629 patients, respectively. These patients are a subset of 2,035 patients with osteoarthritis on whom we have reported previously (11) in a double-blind multicentre safety and efficacy trial comparing piroxicam 20 mg/day and naproxen 750 mg/day. The purpose of the present study was to look for an association of plasma drug concentration with the variables of: age, sex, adverse events and efficacy. There was a statistically significant increase in plasma concentrations of both drugs with increasing age and females had higher concentrations than males. The increase in plasma concentration seen with increasing age was of a magnitude of 25% for piroxicam and 20% for naproxen when comparing a 50 year old to an 80 year old. However, less than 15% of the variability in plasma concentrations seen between patients is accounted for by age and sex. Within the plasma concentrations achieved with these doses, no association with adverse events, non-serious or serious, and efficacy was noted. PMID- 3536264 TI - Simultaneous analysis of eighteen proteins in the sera and knee joint effusions of patients with rheumatoid arthritis and osteoarthritis. PMID- 3536266 TI - Managing the premenstrual syndrome. AB - The definition, classification, proposed etiologies, diagnosis, and treatment of the premenstrual syndrome (PMS) are discussed, and guidelines for the clinical management of PMS are presented. PMS encompasses a cluster of physical and psychosocial symptoms that recur during each menstrual cycle. Proposed etiologies for the syndrome include a hormonal imbalance between estrogen and progesterone, pyridoxine hydrochloride deficiency, hypoglycemia, excess prostaglandin production, and increased aldosterone concentrations in the luteal phase of the menstrual cycle. Diagnosis of PMS is usually based on a patient's history of recurrent symptoms accompanied by a seven-day, symptom-free period in the first half of the menstrual cycle. Management of PMS is complicated by the difficulty in diagnosing the syndrome and its unclear etiology. If possible, conservative nonpharmacologic treatment should be tried initially; suggested measures include modifications in diet, exercise, substance use, stress factors, rest patterns, and social support. Pharmacologic treatment should be considered when conservative therapies are ineffective or when PMS symptoms are more severe. Although most therapies are empirical, treatment with progesterone, pyridoxine, bromocriptine, or diuretics might prove beneficial. Once the decision is made to initiate drug therapy, the treatment regimen should be individualized and based on the patient's PMS symptom complex. The clinical management of PMS is complicated by the lack of well-designed clinical investigations of proposed treatments. Future research should be directed toward evaluating the efficacy of proposed therapeutic regimens. PMID- 3536265 TI - The arthritis of Mary Queen of Scots: due to Marfan's syndrome? PMID- 3536267 TI - Current concepts in clinical therapeutics: bacterial meningitis in infants and children. AB - The epidemiology and incidence, etiology, pathogenesis and pathophysiology, clinical presentation, diagnosis, principles of therapy, and treatment of bacterial meningitis in infants and children are reviewed. Bacterial meningitis is a major cause of morbidity and mortality, and most cases occur in children less than five years old. Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae are the major pathogens involved. Bacteremia or colonization of the upper-respiratory-tract epithelium often precedes meningitis. Defense mechanisms are poor in the cerebrospinal fluid; once an organism penetrates the blood-brain barrier, infection may follow quickly. Clinical signs and symptoms are somewhat nonspecific, with lethargy, restlessness, and poor feeding prominent; diagnosis often relies on the patient history along with preliminary results of lumbar punctures. Therapy is based on pharmacologic and pharmacodynamic principles concerning the available antimicrobial agents, the blood-brain barrier, and supportive therapy. Effective antimicrobial therapy requires attainment of adequate bactericidal activity in the cerebrospinal fluid; penetration of agents into the brain depends on their physico-chemical characteristics. Antibiotic therapy must generally be started before culture results are available, making empiric therapy based on the child's age, history, and underlying conditions important. Established therapeutic agents include penicillins, aminoglycosides, and chloramphenicol, though newer expanded-spectrum cephalosporins such as cefuroxime, ceftriaxone, and cefotaxime are being used with increasing frequency. However, the use of these newer, more potent antimicrobial agents have not appreciably altered associated morbidity and mortality. Aggressive supportive care and evaluation of newer nonantibiotic treatments should be addressed in future studies of bacterial meningitis in infants and children. PMID- 3536268 TI - Home blood pressure readings in clinical hypertension research. AB - The feasibility and reliability of home blood pressure measurement in clinical research were determined as part of a study to document the safety and efficacy of two captopril dosage regimens. Twenty patients were studied. Patients were instructed to record blood pressures twice daily (before morning and evening doses of captopril) for 24 weeks. All patients were instructed in blood pressure measurement and were required to demonstrate the accuracy of their techniques. Supine and standing blood pressures were measured every two weeks in the clinic. The mean of all home blood pressures recorded in the two-week period before each clinic visit was compared with the measurement obtained at that clinic visit for each patient. Blood pressure data could be evaluated for 17 patients. Each patient recorded 330-380 readings, and the mean home blood pressure measurement for each two-week period was calculated from 26-32 separate readings. Home blood pressures were consistently lower than clinic measurements but showed similar trends in response to treatment. There was good correlation between values obtained at home and in the clinic. Morning and evening blood pressures obtained by patients were not significantly different. Home blood pressure monitoring is a useful tool in hypertension research. PMID- 3536269 TI - Serum potassium concentrations after initiation of captopril therapy. PMID- 3536270 TI - Effects of a thromboxane antagonist (BM 13.177) during endotoxin-induced pulmonary vasoconstriction in sheep. AB - We investigated the effect of a thromboxane antagonist, BM 13.177, during endotoxin-induced pulmonary vasoconstriction in sheep. In control animals intravenous E-coli endotoxin (1 microgram/kg) caused a transient increase of pulmonary artery and airway pressure paralleled by large concentration increases of TXB2: in comparison peak plasma concentrations of 6-keto-PGF1 alpha (a prostacyclin metabolite) were small and delayed in time. Pre-treatment with BM 13.177 (bolus 5 mg/kg), followed by 0.75 mg/kg/min intravenously) abolished the rise of pulmonary artery and airway pressure. Plasma concentrations of TXB2 and 6 keto-PGF1 alpha were similar to controls. These and previous investigations imply that BM 13.177 specifically antagonizes TXA2 on the putative receptor in pulmonary vascular and airway smooth muscle. PMID- 3536271 TI - [Multicenter clinical experimentation with alprazolam]. PMID- 3536272 TI - [Stroke: from its etiology to its therapy]. PMID- 3536274 TI - Comparative evaluation of PathoDx Strep A test and culture for the detection of group A streptococci in pharyngeal specimens. AB - The PathoDx Strep A kit, a 10-min acid extraction and latex agglutination test, was compared with routine culture for the direct detection of group A beta hemolytic streptococci (BHS) in 414 pharyngeal specimens collected from children with pharyngitis. The results showed that the latex test compared favorably with culture for detecting group A BHS in pharyngeal specimens (sensitivity 96.7%, specificity 97.9%, and positive and negative predictive values of 97.2% and 97.4%, respectively). The comparable number of false-positive (five) and false negative (six) latex tests along with review of patient histories suggest that these discrepant results were attributable to sampling error during specimen procurement rather than deficiencies in the latex kit. In addition, clear-cut, agglutination reactions were obtained in over 96% of positive latex tests regardless of the amount of group A BHS that was recovered by culture. The PathoDx Strep A test is a rapid, reliable noncultural alternative for the detection of group A BHS in pharyngeal specimens. PMID- 3536273 TI - Bacterial adhesion in human upper gastrointestinal tract. AB - Small bowel biopsy specimens were taken from 21 patients undergoing gastrointestinal endoscopy to detect a possible adhesion of bacteria to the mucous layer of the upper gastrointestinal tract. In 30 control biopsy specimens taken from 10 patients free from gastrointestinal pathology, no associated bacteria were found, whereas in 23 biopsy specimens taken from eight gastrectomized patients an associated bacterial flora including E. coli or Pseudomonas was grown. Bacterial adhesion was confirmed by means of transmission electron microscopy of the eight patients yielding positive cultures. Bacterial adhesion induced local alterations of the brush border membrane. These results suggest that adherent bacteria may be present in hypochlorhydric patients. Pathophysiologic consequences require further studies. PMID- 3536275 TI - Strategy for efficient detection of respiratory viruses in pediatric clinical specimens. AB - Direct immunofluorescence (IF) with a polyclonal respiratory syncytial virus (RSV)-specific antibody preparation was used for antigen detection during the 1982-1983 RSV season (155 specimens) and gave an overall sensitivity of 94% with 87% specificity compared with viral culture. Indirect IF was used in the 1983 1984 season (265 specimens) and exhibited sensitivity of 96% with specificity of 79%. During these two seasons, 42 of 224 (18.8%) specimens that were IF-negative for RSV grew viruses other than RSV. In the winter of 1984-1985, we screened 297 specimens for RSV by IF and 80 (27%) were positive. Forty-four (20%) of the IF negative specimens were culture-positive for RSV(2) or other viruses(44). We conclude that, in the interest of cost reduction and expeditious detection of respiratory viruses, once a properly equipped laboratory has become thoroughly familiar with IF techniques, pediatric respiratory specimens can be screened for RSV by IF and only the IF-negative specimens need be inoculated into cell cultures for isolation of virus during the winter respiratory season. PMID- 3536276 TI - Performance of microtrak direct test for Chlamydia trachomatis in a prevalence study. AB - Three hundred thirty-two women, aged 18-30 yr. attending two clinics in Burlington Vermont were screened for infection with Chlamydia trachomatis by two methods. Microtrak Direct Test (SYVA) and cell culture. The overall sensitivity for Microtrak compared with culture was 75% (18 of 24), the specificity was 99.7% (307 of 308), the positive predictive value was 94.7% (18 of 19), and the negative predictive value was 98.1% (307 of 313). Prevalence of Chlamydia trachomatis in this population was estimated to be 7.2% (95% confidence intervals 4.4-10.0). The results from this study suggest that Microtrak is less sensitive when used in unselected patient groups from populations of lower prevalence, in contrast to higher sensitivities previously reported. PMID- 3536277 TI - Group A streptococcal pharyngitis and bacteremia associated with a Ludwig's angina-like syndrome. AB - Ludwig's Angina (LA) is an infection of the submandibular and sublingual spaces usually initiated by abscesses of the inferior molars due to mixed oral flora. Pharyngitis due to group A beta-hemolytic streptococci (GABHS) rarely results in bacteremia. A patient presented with the classical findings of LA, and had no odontogenic focus but had GABHS pharyngitis and bacteremia. Attempts to isolate other microbiological organisms from the submandibular and sublingual spaces were unsuccessful. The patient required emergent tracheostomy and was treated with penicillin G for 4 wk with complete resolution of his clinical illness. The case demonstrates a previously unreported association between GABHS pharyngitis and the development of LA. PMID- 3536278 TI - In vitro activity of carumonam (RO 17-2301), BMY-28142, aztreonam, and ceftazidime against 7,620 consecutive clinical bacterial isolates. AB - For 45-60 days four geographically separate clinical laboratories tested routine clinical bacterial isolates for susceptibility to carumonam, aztreonam, BMY 28142, and ceftazidime by the broth microdilution method. All four drugs were highly active against Enterobacteriaceae, inhibiting greater than 96% of the 4887 strains tested at less than or equal to 8.0 microgram/ml. The minimal inhibitory concentration at which 50% of the isolates were inhibited for each drug was less than or equal to 0.125 micrograms/ml. Ceftazidime was the most active against nonenteric gram-negative bacilli (86% inhibited at less than or equal to 8.0 micrograms/ml), followed by BMY 28142 (82%), carumonam (75%), and aztreonam (68%). The two monobactams exhibited no activity against gram-positive cocci at the concentrations tested, whereas BMY-28142 had excellent activity against nonenterococcal streptococci and good activity against staphylococci. PMID- 3536279 TI - Investigation of the heterogeneity of rhesus monkey alpha 1-antitrypsin. AB - Rhesus monkey alpha 1-antitrypsin (n = 144) was examined for heterogeneity by acid starch gel electrophoresis, isoelectric focusing in agarose and agarose gel electrophoresis. In contrast to other studies, no heterogeneity of Rhesus monkey alpha 1-antitrypsin could be documented using specific antisera. Rhesus monkey alpha 1-antitrypsin contained a reactive thiol. The pIs of the major isoforms of Rhesus monkey alpha 1-antitrypsin were 4.63, 4.69, 4.84 and 4.86 at 4 degrees C. No deficiency state of Rhesus monkey alpha 1-antitrypsin was detected. The six protease inhibitors in Rhesus monkey sera cross-reacted with antisera to the six human protease inhibitors. PMID- 3536280 TI - Phosphatase activity in Trypanosoma cruzi. Phosphate removal from ATP, phosphorylated proteins and other phosphate compounds. AB - T. cruzi epimastigotes have a lysosomal acid phosphatase (pH 4.0) and acid and alkaline phosphatases (pH 5.5 and 8.0) localized in the cytosolic fraction. The levels of the lysosomal acid phosphatase increase with the age of the cultures, but the cytosolic phosphatases decline after the logarithmic phase of growth. The lysosomal phosphatase preferentially hydrolyses low mol. wt phosphate esters; whereas, the cytosolic alkaline phosphatases primarily act on phosphorylated proteins, and both the cytosolic acid and alkaline phosphatases on uridine nucleotide derivatives. The parasite also contains a microsomal glucose 6 phosphatase, and ATPases (Mg2+ and Ca2+-activated) derived from plasma membranes and mitochondria. PMID- 3536283 TI - A computer program for the interpretation of exercise tolerance tests. AB - A software package has been developed to interpret exercise test data recorded by a metabolic measurement cart (MMC). This package reduces and interprets the exercise test data relative to population and patient specific criteria. The data flow for the data reduction and report printing is described. The data structures used in this processing are illustrated. The application of structured programming, a real-time executive and an easy-to-read language--such as Pascal- is illustrated for the implementation of a medical instrument. Issues of prediction and interpretation relative to exercise testing are discussed. PMID- 3536282 TI - Induction and inhibition of cathepsin B and hemoglobin-hydrolase activity in murine B16 melanoma by thiol protease inhibitors. AB - The effects of potent thiol protease inhibitors in vitro (leupeptin, antipain, chymostatin and E-64 (N-[N-(L-3-trans-carboxyoxirane-2-carbonyl)-L leucyl]agmatine) on intracellular cathepsin B and hemoglobin (Hb)-hydrolase from cultured B16 melanoma cells were studied. E-64 induced cultured B16 melanoma cells to decrease the activities of intracellular cathepsin B (EC 3.4.22.1.) but did not have this effect with Hb-hydrolase or acid phosphatase (EC 3.1.3.2). Leupeptin, antipain and chymostatin induced B16 melanoma cells to increase the activities of intracellular cathepsin B and Hb-hydrolase but not that of acid phosphatase. These results indicate that there are two kinds of thiol protease inhibitors, each with a varying reaction to cultured B16 melanoma--inhibition of intracellular cathepsin B, and conversely, inducement of both cathepsin B and Hb hydrolase. PMID- 3536284 TI - The multi-state Kalman Filter in medical monitoring. AB - In order to gain the best advantage from a computer database the way in which the information is displayed is vitally important. On-line statistical techniques could prove to be a great bonus to medical monitoring but have been limited by the methodology available. The Kalman Filter is one of the most powerful methods for time series analysis, and we have now shown it to be useful in a variety of settings, including the detection of kidney transplant rejection, where detection in some patients precedes that of experienced clinicians. PMID- 3536281 TI - Terminal oxidases in the trypanosomatid Trypanosoma cruzi. AB - Titration of Trypanosoma cruzi respiration with cyanide, with results treated as Dixon plots, indicated the presence of several terminal oxidases. The inhibitions obtained at low cyanide concentrations (0-300 microM), taken together with cyanide effects on cytochrome aa3-deficient, dyskinetoplastic epimastigotes, supported cytochrome aa3 as T. cruzi main terminal oxidase. By increasing cyanide concentration to 1.0 mM, two alternative terminal oxidases could be detected. One of these was active in both kinetoplastic and dyskinetoplastic (cytochrome aa3 deficient) epimastigotes, and azide- and antimycin-insensitive. Complementary cytochrome studies with intact epimastigotes and mitochondrial membranes revealed the presence of cytochromes aa3, b, c558, o and possibly d, as components of the parasite electron transport system. Fractionation studies demonstrated that both o and d were bound to the mitochondrial membrane. Reduction by endogenous substrates and complex formation with cyanide supported cytochrome o as alternative terminal oxidase. EB-cultured, dyskinetoplastic epimastigotes showed the same respiration rate as the kinetoplastic cells, despite the significant decrease of cytochrome aa3, thus indicating adaptive mechanisms that determine the expression of alternative oxidases, whenever the main terminal activity is depressed. PMID- 3536285 TI - The accuracy of a Bayesian computer program for diagnosis and teaching in acute abdominal pain of childhood. AB - The use of a computer program for diagnosing acute abdominal pain in children using Bayes' theorem is described and the results of a one-year trial are analysed in order to qualify and quantify the accuracy of the system and to suggest some of the educational benefits that might be obtained. A means of feedback to medical students is described which can localise their weaknesses based on their experiences of real patients and could be used by educators to measure the effectiveness of their courses and the major areas of difficulty being encountered by the students. The computer has in this instance achieved a remarkable degree of accuracy in view of several factors acting against it. Such experience is very encouraging for further endeavour in this area. PMID- 3536286 TI - Kraepelin and the differential diagnosis of dementia praecox and manic-depressive insanity. PMID- 3536287 TI - Localized juvenile periodontitis: historical background and therapy. PMID- 3536288 TI - Paul Revere and the beginnings of forensic dentistry. PMID- 3536289 TI - The relative efficacy of ibuprofen in dental pain. PMID- 3536290 TI - Preparation for anterior resin-bonded retainers. PMID- 3536291 TI - The world's first dental journal. PMID- 3536293 TI - Treatment of nickel dermatitis with Trientine. AB - 23 nickel-sensitive patients with hand eczema were treated with Trientine 300 mg daily and a placebo in a double-blind, crossover trial. No significant improvement occurred in the hand eczema. A surprising finding was that there was no detectable increase in urinary nickel excretion, in contrast to animal studies. PMID- 3536294 TI - Current status of liver transplantation. PMID- 3536295 TI - Noninvasive carotid artery evaluation by duplex Doppler. PMID- 3536296 TI - Preventing complications of vesicoureteral reflux. PMID- 3536292 TI - Handling previously treated silver point cases: removal, retreatment, and tooth retention. PMID- 3536297 TI - Fluid resuscitation: colloid versus crystalloid. PMID- 3536299 TI - Liver transplantation. PMID- 3536298 TI - Proposal for financing health care of the elderly. AMA Board of Trustees. American Medical Association. PMID- 3536300 TI - Use effectiveness of a spermicidal suppository containing benzalkonium chloride. AB - A multicentric trial in 9 Spanish Clinics of Family Planning was conducted to evaluate the effectiveness of a vaginal contraceptive Ovule (suppository), containing 18.9 mg of benzalkonium chloride. Gynaecological and cytobacteriological examinations were made to evaluate any possible side-effect. Six-hundred-fifty-three women at risk of unwanted pregnancy accepted the method as the only contraception during 9,517 months. The results are expressed in life tables (Tietze-Lewit). Net cumulative first segment rate at 12 months were: terminations 27.2; pregnancy 3.7; medical reason 2.3; planned pregnancy 2.8; other personal reasons 18.4. At 24 months the rates were: terminations 34.1; pregnancy 3.7; medical reason 2.6; planned pregnancy 6.5; personal reasons 21.3. Error or failure to use the spermicide resulted in 12 of 23 pregnancies (52%), while in another 4 pregnancies (17%) there were reasonable elements of doubt concerning its correct use. There were no gynaecological or cytological changes. We conclude that this product is a safe and very effective contraceptive if used according to the prescribed instructions and before any sexual encounter. PMID- 3536301 TI - Structure-activity relationships of the yeast alpha-factor. AB - The yeast Saccharomyces cerevisiae produces a peptide pheromone, termed the alpha factor, as a prelude to sexual conjugation. Haploid MAT alpha-cells, but not haploid MAT a-cells or MAT a/alpha-diploids, produce this tridecapeptide of the structure: Trp-His-Trp-Leu-Gln-Leu-Lys-Pro-Gly-Gln-Pro-Met-Tyr. Structural analogues of the alpha-factor have been prepared with alterations in many of the residues, derivatized peptides have been synthesized, and truncated and elongated peptides have been studied. These peptides have been analyzed for their biological activities by various assays. Mutants of S. cerevisiae have been isolated that do not respond to alpha-factor or are supersensitive to the pheromone and its analogues. The mating system of S. cerevisiae provides a powerful model in which genetics, biochemistry, and molecular biology can be used to unravel the mysteries of peptide hormone structure and function. PMID- 3536302 TI - The general control of amino acid biosynthetic genes in the yeast Saccharomyces cerevisiae. AB - Enzymes in diverse amino acid biosynthetic pathways in Saccharomyces cerevisiae are subject to a general amino acid control in which starvation for any amino acid leads to increased levels of the mRNAs encoding these enzymes. The short nucleotide sequence TGACTC, found nontandemly repeated upstream from the coregulated structural genes, serves as a cis-acting site for positive regulation of transcription. Multiple trans-acting repressors and activators have been identified. Most of these factors act indirectly by regulating the level of an activator encoded by the GCN4 gene. This regulation occurs at the level of GCN4 translation and is mediated by sequences in the long 5' leader of GCN4 mRNA. The GCN4 protein is the most likely candidate for the transcriptional activator that interacts with the TGACTC sequences at the structural genes. PMID- 3536303 TI - Evolution of the major histocompatibility complex. AB - The major histocompatibility complex is a group of closely linked loci that code for molecules used by T-lymphocytes as context for the recognition of antigens. The loci fall into two classes: I, coding for molecules used as context by cytotoxic T-lymphocytes and II, used as context by helper and other regulatory T cells. The Mhc is present in all mammals and perhaps all vertebrates. Some of the Mhc loci are highly polymorphic, while others are not. This article will summarize what is known about the genetic organization of the Mhc in different species and will discuss the selection pressures acting on the individual loci and the tempo and the mechanisms of their evolution. PMID- 3536304 TI - Cost-containment in critical care. PMID- 3536305 TI - Changing concepts of colonic polyps: clinical and radiographic implications. AB - The relationship of colonic polyps to carcinoma of the colon provides a basis for their importance. Recent advances in the detection of colonic polyps, including double contrast barium examination and colonoscopy, have provided a method for more extensive study of colonic polyps. Studies using these newer techniques indicate that many traditional concepts of colonic polyps were inaccurate. The relationships of polyp size to histology, polyp location to age, and the phenomenon of colon polyp clustering are important to both the immediate treatment of the polyp and to the long-term follow-up of the patient. The use of hemoccult stool screening as a technique for screening for colonic pathology is also of significance to the radiologist. The changing relationships of various parameters of colon polyps bring into question the utility of many of the currently recommended screening procedures for colon pathology. Undoubtedly, this will impact on the practice of radiology. PMID- 3536306 TI - Ascites or pleural effusion? CT and ultrasound differentiation. AB - The differentiation of fluid immediately above the diaphragm, i.e., pleural effusion, from subdiaphragmatic fluid, i.e., ascites, can be difficult. Freely mobile pleural effusions are easily proven with decubitus chest films, but loculated subpulmonic effusions can mimic intraabdominal fluid. The simultaneous presence of both ascites and pleural effusion is difficult to identify with plain radiographs. Both computed tomography (CT) and ultrasound (US) can be used to differentiate ascites from pleural effusion. Four criteria have been described to differentiate ascites from pleural effusion by CT. These four signs (the diaphragm sign, the displaced crus sign, the interface sign, and the bare area sign) are reliable when only one abnormal fluid collection is present. When both a pleural effusion and ascites are present, none of these criteria can reliably identify both fluid collections. The combined use of the four criteria, however, leads to a correct identification of abnormal fluid collections in the region of the diaphragm. US examination can differentiate ascites from pleural effusion using three of the above-mentioned signs (the diaphragm sign, the displaced crus sign, and the bare area sign). We will review the four signs and discuss the limitation of these signs in clinical practice. A thorough understanding of these CT and US criteria will allow for accurate identification of all juxtadiaphragmatic fluid collections. PMID- 3536307 TI - Magnetic resonance imaging of primary musculoskeletal tumors. AB - Magnetic resonance imaging (MRI) has a very high soft tissue contrast resolution and possibilities of tissue characterization unseen by any other imaging modality. Therefore, it has a great potential for evaluation of musculoskeletal tumors, and the experience in this field is steadily increasing. MRI has now proven to be superior for evaluation of the extent of intraosseous tumor growth, for evaluation of intraarticular involvement of tumor, and for delineation among tumor and muscle, fat, necrosis, and bleeding. The method reveals the neurovascular bundles in such detail that angiography in several cases is not longer necessary. However, for evaluation of calcification, periosteal and endosteal reaction, and new bone formation, the method is inferior to the traditional radiologic modalities, including computed tomography (CT). Concerning tissue characterization, it has been shown that different tumor groups differ in their T1 and T2 relaxation times, but much more research in this area is demanded. The combination of spectroscopy and imaging, still in its infancy, may prove important in this aspect. PMID- 3536308 TI - Neurological regulation of body weight. AB - We have now come full circle, from a consideration of the factors influencing the control of BW regulation to a review of the human disorders in which these control mechanisms no longer function appropriately. Experimental observation in both animals and man has led to the inescapable conclusion that FI, BW regulation, and thermogenesis are controlled in large part by the CNS. In man, the fairly stable regulation of BW within reasonably close bounds strongly suggests that BW is monitored in some way, and that FI and energy expenditure are regulated in response to this afferent set of signals. Certainly, the number of factors are legion which can influence the central integration and the effector mechanisms by which FI and energy expenditure are regulated by the CNS. The most striking observation is the relative precision with which the overall system works and how few are the number of pathological conditions which severely alter the regulation of BW. The most prominent challenges in this field are the identification of both the sensors of the nutritional status, composition and weight of the organism, and of the actual effectors of thermogenesis in mammals. A more complete understanding of these factors should enable us to better control perturbations of BW under pathological conditions. PMID- 3536309 TI - Single fiber EMG, macro EMG, and scanning EMG. New ways of looking at the motor unit. AB - This review of different EMG techniques has pointed to their value in studies of the normal and abnormal motor unit. It also shows that the combination of techniques gives more information than each of them alone. This approach makes possible a description of the microphysiology and anatomical arrangement of muscle fibers in a motor unit, as well as the motor unit size. Electrophysiological tests can also describe the physiological status of the motor unit in more detail than previously. It is hoped that these methods will help in the study of normal motor unit in man, will guide the physician to arrive at a diagnosis, and that they may further the understanding of pathophysiological processes in neuromuscular disorders. PMID- 3536310 TI - Spectroscopic methods in degenerative neurological diseases. AB - The molecular basis of many degenerative neurological diseases remains unknown. Biochemical, morphological, and genetic studies of several tissue types have provided some clues of the pathogenesis and etiology of such disorders; however, it has been spectroscopic investigations that have in several instances provided unifying bases for understanding the molecular defects involved. In particular, electron spin resonance, nuclear magnetic resonance, fluorescence, and Raman spectroscopic studies of cell membranes have provided needed insight into degenerative neurological disorders. This article will provide a brief background to each of the spectroscopic techniques listed above, will summarize our current understanding of cell membrane with special emphasis on the erythrocyte, and finally will give a critical evaluation of the literature of spectroscopic methods in degenerative neurological diseases. PMID- 3536311 TI - Ganglioside enhancement of neuronal differentiation, plasticity, and repair. AB - Gangliosides are carbohydrate-rich complex lipids of large size and great complexity which are found in cell membranes, especially neuronal cell membranes. They are present in the external leaflet of the membrane. The hydrophobic moiety, consisting of sphingosine and fatty acid (stearic acid, 95%), is inserted into the membrane, while the hydrophilic moiety, consisting of sialic acid (NANA) and other carbohydrates, protrudes towards the extracellular fluid. Although gangliosides were discovered some 50 years ago, their potential role in neuronal functions has been appreciated only recently. During development, their composition and concentration change in a variety of animal species. Their role is indicated from studies which have shown that abnormalities in ganglioside metabolism can have a severe impairing effect on normal development. The mouse mutant weaver is characterized by cerebellar granule cell death, which is correlated by the lack of GM1 expression on the neuronal surface. On the other hand, inborn metabolic errors causing ganglioside accumulation in neurons (GM1 gangliosides) are correlated to an aberrant neurite outgrowth. A further appreciation of ganglioside action has been obtained either by adding gangliosides to neurons in culture or by treating animals during neuronal regeneration. It was found that these agents increased the rate and extent of sprouting of regenerating axons and enhanced neuronal differentiation and sprouting in vitro. Such effects were dependent upon the presence of the growth factor in the bathing medium; ganglioside incorporation, however, did not alter nerve growth factor (NGF) binding and internalization, indicating that some membrane events triggered by ganglioside incorporation may be relevant in neuronal differentiation and sprouting. More recently, we have obtained evidence showing that neurons from animals treated with gangliosides are more resistant to anoxia and ionic unbalances. It seems that ganglioside treatment prevents the decay of some key enzyme activity, such as Na+-K+-ATPase occurring after trauma. Indeed, the recent literature suggests that gangliosides may play an important role during development and, when injected into animals, enhance reparatory events in the central and peripheral nervous system. PMID- 3536312 TI - The role of growth factors in neuronal development and plasticity. AB - The role of growth factors in the development of the nervous system, as well as in injury-induced plasticity, is of great interest. A neuronal growth factor is any substance that influences the growth of neurons, but two general classes of factors exist: diffusible substances and substrate-bound factors. Growth factors may affect neuronal survival as well as the extent and rate of neurite outgrowth in vitro. Although progress is slowly being made in the identification and characterization of putative growth factors, nerve growth factor (NGF) is the only identified molecule that clearly influences neuronal growth in vivo. Furthermore, although there are many examples of neuronal plasticity following injury, the role of growth factors in such rearrangements remains to be established. However, one model of collateral sprouting of axons from the peripheral nervous system (PNS) into the central nervous system (CNS) appears to involve the action of a growth factor with properties similar to NGF. The identification of specific molecules that affect neuronal growth should lead to an understanding of the etiology of degenerative neurological diseases such as Alzheimer's disease and, hopefully, to rational therapeutic approaches. PMID- 3536313 TI - Radiation preservation of foods of plant origin. Part V. Temperate fruits: pome fruits, stone fruits, and berries. AB - The current status of research on the application of ionizing radiation for improving the storage of temperate fruits, i.e., apple, pear, peach, nectarine, apricot, cherry, plum, strawberry, bilberry, cranberry, raspberry, and black currant, is reviewed. Changes in fruit metabolism, chemical composition, texture, and organoleptic quality attributes are discussed with reference to the irradiation dose. The feasibility of using radiation either alone or in conjunction with heat treatment, refrigeration, and controlled atmospheres (CA) for the control of storage decay caused by fungal pathogens is considered. Areas of further research are suggested before irradiation could be considered for practical application in some of these temperate fruits. The recent trends in the possible use of irradiation for disinfestation of certain pome and stone fruits and the prospects for the commercial utilization of irradiation for improving the market life of strawberries are discussed. PMID- 3536314 TI - Tannin analysis of food products. AB - Phenolic substances occur primarily in fruits and vegetables and in the seeds of certain pigmented cultivars of sorghum, millets, and legumes. One of the major difficulties encountered in polyphenol research is the lack of a standard quantitative method for the analysis of phenolics that would be suitable for a wide range of seeds, forage crops, and food products and under a variety of experimental conditions. Some methods measure "total phenol", which may not be a true index of the nutritional quality of foods and thus does not distinguish polyphenols of nutritional concern from other low-molecular-weight phenols that also occur naturally in these products. Tannic acid (a hydrolyzable gallotannin) is commonly used as a "reference standard", but this may be a questionable practice since its biological properties differ from those of tannins of flavonoid origin. Polyphenols of cereals and legumes are predominantly of the latter type. Also, commercially available tannic acid has been shown to be a mixture of four phenolic compounds, the relative proportions of which vary with the samples. Thus, the choice of a suitable standard for tannin analysis is also important. The quantitative extraction of the condensed tannins from plant tissue is always difficult, since it may be complexed to a carbohydrate or protein matrix which could be quite insoluble due to a high degree of polymerization. The literature on tannin methodology is diverse and at times conflicting. Currently available methods for tannin analysis range from simple colorimetric, UV spectrophotometric, chromatographic, and enzymic to more sophisticated and expensive nuclear magnetic resonance (NMR) techniques. None of these methods of analyses is completely satisfactory nor can it be applied to different food products with the same degree of success. This review covers physical and chemical methods for tannin analysis of different food products, the problems in analysis and interpretation of data, and future research needs in this area. PMID- 3536315 TI - Arthur Koestler: was his suicide rational? PMID- 3536316 TI - Corneal allograft rejection in rabbits. AB - We performed a phase I study to assess the therapeutic efficacy of an anti-T cell monoclonal antibody conjugated with ricin A-chain in a corneal graft rejection model. Corneal allografts were exchanged between Dutch and New Zealand rabbits. Rejections occurred within 16-22 days in untreated animals. Graft rejection was delayed by topical or retrobulbar cyclosporine, but not by subconjunctival injections of a murine anti-rabbit T cell monoclonal antibody, nor by either subconjunctival or intravenous F(ab')2-ricin conjugate. PMID- 3536317 TI - Immunofluorescent detection of Histoplasma capsulatum in primate experimental ocular histoplasmosis. AB - We have developed a polyclonal anti-Histoplasma capsulatum antibody to detect H. capsulatum antigens in ocular tissue. Antibodies were specific for H. capsulatum as determined by enzyme linked immunosorbent assay and immunoprecipitation. A total of 21 choroidal histoplasmic lesions in 4 primate eyes (Macaca speciosa and Macaca mulatta), taken at various times from 14 to 60 days after the internal carotid artery injection of yeast phase organisms, were evaluated. Using an indirect immunofluorescent technique, these antibodies stained yeast phase organisms within acute choroidal lesions at 14 days after infection. By 60 days intact organisms were no longer detected; occasional cells, however, contained intracellular inclusions that stained with these antibodies. Although yeast phase organisms are rapidly cleared from the primate choroid, these data indicate that residual H. capsulatum antigens may remain in choroidal lesions after the acute infectious stage. These findings are consistent with the hypothesis that H. capsulatum antigens play a role in the immunologic reactivation of atrophic choroidal scars in ocular histoplasmosis. PMID- 3536318 TI - Investigation of sloughed corneal epithelial cells collected by non-invasive irrigation of the corneal surface. AB - This paper reports the development of a non-contact corneal irrigation chamber (NC-CIC) which enables non-invasive collection of epithelial cells from the corneal surface of human subjects. Cells were viewed by fluorescence microscopy following vital staining with acridine orange (AO). Staining characteristics revealed two corneal epithelial cell types: cells with (i) green and (ii) orange red cytoplasmic staining. The green cytoplasmic stain appeared to indicate a more viable cell. Multi-cell aggregates were regularly collected from the corneal epithelial surface. Groups of up to seven epithelial cells were obtained. Quantitative studies of corneal epithelial cell sloughing, using isotonic NaCl (305 mOsm/kg) and isotonic "basic tear solution" (BTS, 305 mOsm/kg) as irrigating solutions, involving hourly irrigations between 8 a.m. and 4 p.m. were conducted. Consistently higher cell counts were obtained with NaCl. Using BTS, data scatter was reduced sufficiently to reveal significant differences in sloughing rate as a function of time of day. Instillation of one drop of 0.5% proparacaine caused a significant, but gradual, increase in epithelial cell sloughing rate over a period of hours, as indicated by subsequent BTS irrigations of the cornea. Since the NC-CIC technique is able to discriminate these effects, it may be an appropriate system for in vivo studies of the relationship between corneal epithelial cell mitosis and sloughing. PMID- 3536319 TI - The bovine lens neutral proteinase comprises a family of cysteine-dependent proteolytic activities. AB - Inhibitor studies with peptide substrates demonstrate that bovine lens neutral proteinase comprises three distinct activities. Diisopropylfluorophosphate distinguishes the activity hydrolyzing carbobenzoxy-Gly-Gly-Leu-p-nitroanilide (inhibited) from that hydrolyzing carbobenzoxy-Leu-Leu-Glu-2-naphthylamide (not inhibited). Leupeptin inhibits hydrolysis of the substrate carbobenzoxy-Leu-Leu Arg-2-naphthylamide, but not hydrolysis of carbobenzoxy-Gly-Gly-Leu-p nitroanilide or carbobenzoxy-Leu-Leu-Glu-2-naphthylamide, demonstrating the presence of the third activity. Inhibition of the three activities by thiol reagents suggests that each activity may be dependent on an active-site cysteine residue. PMID- 3536320 TI - Expression of class II antigen in endotoxin induced uveitis. AB - Uveitis can be induced by systemic or intravitreal administration of endotoxin (lipopolysaccharide, LPS). In this study we correlated the expression of class II antigens (la in rat) of the Major Histocompatibility Complex (MHC), with this experimental model of uveitis. Ia antigen was detected by immunohistochemistry using the Avidin-Biotin-Peroxidase Complex (ABC) method and the monoclonal antibody OX6. Ia antigen was not expressed in normal eyes. However, Ia was expressed in the anterior uvea epithelial cells in all eyes with LPS induced uveitis. This study demonstrates that the ocular Ia expression is a localized process in the anterior uvea in response to systemic or intravitreal LPS. This response appears to be distinct from the action of LPS on macrophage Ia expression, where LPS has been shown to inhibit the induction of Ia antigen in macrophages by gamma interferon. PMID- 3536322 TI - Controversies in hypertrophic cardiomyopathy. PMID- 3536321 TI - The current status of monoclonal antibodies in the diagnosis and therapy of cancer. PMID- 3536323 TI - The heart in neuromuscular disease. PMID- 3536324 TI - Diabetes mellitus in the child and adolescent: Part II. PMID- 3536325 TI - Spina bifida: the radiology of neural tube defects. PMID- 3536326 TI - Molecular features of class II MHC-restricted T-cell recognition of protein and peptide antigens: the importance of amphipathic structures. PMID- 3536328 TI - Indications and monitoring of use of fresh frozen plasma as a hemostatic agent. PMID- 3536327 TI - Peptides as probes to study molecular mimicry and virus-induced autoimmunity. PMID- 3536329 TI - Hemodynamic and oxygen transport effects of crystalloids and colloids in critically ill patients. PMID- 3536330 TI - Fluid resuscitation in circulatory shock. Colloids versus crystalloids. PMID- 3536331 TI - Effect of plasma and interstitial protein content on tissue edema formation. PMID- 3536332 TI - Colloidal and crystalloidal fluid resuscitation in shock associated with increased capillary permeability. PMID- 3536333 TI - Localized cicatricial pemphigoid (Brunsting-Perry syndrome). AB - A patient who presented with scarring alopecia from a vesicular disorder was diagnosed as having localized cicatricial pemphigoid. The diagnosis was confirmed by histopathology and immunofluorescent studies. The clinical, immunologic, and therapeutic features of this entity are reviewed. PMID- 3536335 TI - Fetal movements as an indicator of fetal well-being. PMID- 3536334 TI - Owl monkey gene mapping: the assignment of gene loci for catalase, beta-globin gene cluster, HRAS1, insulin, and parathyroid hormone. AB - Using somatic cell genetics and Southern blot hybridization, we have mapped five structural genes in the owl monkey, coding for catalase (CAT), the beta-globin gene cluster (HBBC), c-Ha-ras 1 (HRAS1), insulin (INS), and parathyroid hormone (PTH). All five loci are mapped to chromosome 19 of karyotype VI (2n = 49,50) of the owl monkey; CAT, HBBC, INS, and PTH can be assigned to chromosome 4 of karyotype V (2n = 46), while CAT and HBBC can be assigned to chromosome 2 of karyotype III (2n = 53). Using in situ hybridization, the CAT gene was precisely mapped on the mid-region and the beta-globin gene cluster on the telomeric end of chromosome 2q(K-III). Our results provide significant insight into the evolutionary history of these gene loci. While these loci are separated into at least two major segments in rodents such as the mouse, our results suggest conservation of a single chromosome arm among higher primates. PMID- 3536336 TI - Complement and function of neutrophils in chronic inflammatory bowel disease. PMID- 3536337 TI - Drug addiction and viral hepatitis in the dental patient. Studies on various aspects of providing dental care for drug addicts and their consequences for patients and dental personnel. PMID- 3536338 TI - Autoantibodies in juvenile connective tissue diseases. PMID- 3536339 TI - Isolation and characterization of antigens from Treponema phagedenis biotype Reiter cross-reacting with Treponema pallidum. AB - The specific aims of the studies reviewed here were to design a rational purification strategy for Reiter treponeme antigens using combinations of different chromatographic principles, to isolate and characterize the Reiter treponemal antigens, especially the antigens labelled TR-b, TR-c, TR-dl, TR-d2, and TR-e cross-reacting with antigens in Treponema pallidum, to develop and evaluate the use of these purified antigens in syphilis diagnostic enzyme-linked immunosorbent assays (ELISA), to investigate whether Reiter treponeme antigens can induce protective immunity against experimental syphilis in rabbits. By combining anion exchange chromatography, gel filtration, agarose gel electrophoresis, hydrophobic interaction chromatography, and affinity chromatography on Iminodiacetic acid-Sepharose CL 4B and Lysine Sepharose 4B we were able to isolate seven different water soluble Reiter antigens from one single Reiter sonicate supernatant (I, II, III, IV, V, VI). The applied chromatographic matrices were selected due to their efficiency for separation of the Reiter antigens in pilot experiments. In addition to the above mentioned Reiter antigens additional antigens labelled TR-o (V) and LPS (VI) were isolated. TR-b, TR-c, and TR-o were shown to be protein antigens (III, IV, V). The TR-c antigen of the Reiter treponeme cross-reacted not only with an antigen in T. pallidum but also with an antigen common to a wide range of bacteria (IX). The TR d antigen composed of a ribonucleic acid component (TR-dl) (II) and a protein component (TR-d2). The TR-e antigen represented the flagellum of the bacterium (I), and the LPS antigen was a pure lipopolysaccharide antigen (VI).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536340 TI - Diagnostic accuracy of coronary angiography utilizing computer-based digital subtraction methods. Comparison to conventional cineangiography. AB - To evaluate the efficacy of mask-mode digital subtraction angiography in selective coronary arteriography, we compared computer-based digital subtraction angiograms to standard film-based angiograms in 77 patients. Digital angiography was performed utilizing a 512(2) matrix and a framing rate of 30 frames/second. Radiation parameters were selected after a pilot dose-ranging trial, and were 70 120 KVP, 10-30mA and 0.8 to 5msec pulse width. Single view digital angiograms were compared to single view conventional angiograms in 27 patient; the two angiograms agreed within one grade of severity in 84 percent of the lesions or normal arteries seen. Multiple view digital angiograms were compared to multiple view conventional angiograms in 50 patients. Agreement within one grade of severity was found for 90 percent of lesions or normal arteries. Digital angiography detected 95 percent of collateral vessels seen on conventional angiography. We conclude that computer-based mask-mode digital subtraction angiography can be utilized in selective coronary angiography to obtain results comparable to those using conventional film-based cineangiography. PMID- 3536341 TI - Comparison of bronchial responses to ultrasonically nebulized distilled water, exercise, and methacholine in asthma. AB - We compared the responses to inhaled methacholine, ultrasonically nebulized distilled water, and exercise in 25 subjects with atopic asthma. The methacholine inhalation test and challenges with distilled water and exercise were performed on three separate days 48 hours apart. Bronchial responsiveness to methacholine and ultrasonically nebulized distilled water was measured as the concentration of methacholine (PC20M) and the volume output of the ultrasonic nebulizer (PO20 UNDW) producing a 20 percent fall in the forced expiratory volume in one second (FEV1). The response to exercise was expressed as the percentage of fall in FEV1 from the value before exercise. Seventeen subjects showed a fall in FEV1 of more than 20 percent after exercise. Eight subjects had a stimulus-response curve to distilled water that was flat up to the maximal volume output from the nebulizer, but only four of them also showed no significant response to exercise. The response to exercise correlated better with PO20 UNDW (r = -0.66; p less than 0.01) than with PC20M (r = -0.19; p greater than 0.5) in those responding to distilled water. In all of the tested subjects, exercise-induced bronchoconstriction correlated with PC20M (r = -0.61; p less than 0.01). The mean PC20M was significantly lower in the subjects with a significant response to distilled water and exercise (p less than 0.001 and p less than 0.0001, respectively). We concluded that ultrasonically nebulized distilled water and exercise provoke significant bronchoconstriction in the subjects with more severe nonspecific bronchial hyperresponsiveness. The correlation found between the two stimuli supports the hypothesis that they act by similar mechanisms. PMID- 3536342 TI - The prognostic value of loculations in parapneumonic pleural effusions. AB - Forty-eight patients with pleural effusions who had sonographically directed thoracocentesis were evaluated retrospectively for radiologic findings, pleural fluid chemistries, and outcome. Loculation was found to be a radiologic marker of diagnostic and prognostic significance. The presence of loculations correlated with exudative pleural fluid chemistries, but no radiologic finding was specific for empyema. "Extreme" pleural fluid chemistries were associated with loculation, but not with empyema. Patients with loculated effusions had larger effusions, longer hospitalizations, and more frequent tube thoracostomy procedures than patients with nonloculated effusions. Light's criteria for tube thoracostomy were found to be unreliable in patients with loculated parapneumonic effusions or in patients treated with prolonged antibiotic therapy prior to thoracocentesis. PMID- 3536343 TI - Clinical applications of body ventilators. AB - Interest has been increasing in providing ventilatory support in the home for patients with chronic respiratory failure, mainly with the use of positive pressure ventilation via a chronic tracheostomy. However, body ventilators that assist ventilation by applying intermittent negative or positive pressure to the thorax, abdomen, or airway without requiring an artificial airway, can offer distinct advantages for selected patients over systems requiring a permanent airway. These ventilators include the iron lung, portable lung (Portalung), pneumowrap, chest cuirass, pneumobelt, rocking bed, and positive pressure provided via a face or nose mask. They have successfully stabilized or reversed chronic hypercarbia when used intermittently in patients with slowly progressive chronic respiratory failure due to certain neuromuscular diseases and kyphoscoliosis. How they achieve this stabilization has not been clarified, but reversal of chronic respiratory muscle fatigue following periodic rest probably contributes. These ventilators are generally less effective than positive pressure ventilation through a tracheostomy and should be reserved for patients with relatively stable chronic respiratory failure and intact upper airways. However, they have the advantages of simpler operation and less expense, and they allow maintenance of a normal airway. PMID- 3536344 TI - Clinical aspects of silent myocardial ischemia. Effects of treatment. PMID- 3536345 TI - Pulmonary nocardiosis in the acquired immunodeficiency syndrome. Diagnosis with bronchoalveolar lavage and treatment with non-sulphur containing drugs. AB - A patient with the acquired immunodeficiency syndrome (AIDS) presented with Pneumocystis carinii pneumonia and pulmonary nocardiosis. The nocardial lesions appeared small and localized on chest radiograph. On two separate occasions, nocardial organisms were absent in transbronchial lung biopsy specimens, but were identified in bronchoalveolar lavage fluid probably because the latter specimen sampled a larger area of lung. The patient was initially treated with trimethoprim-sulfamethoxazole (TMP/SMX) for both infections. When TMP/SMX was discontinued because of an adverse reaction, the nocardiosis promptly exacerbated but was then easily controlled with minocycline and amikacin followed by minocycline and cycloserine. Among patients with AIDS who have sulfamethoxazole hypersensitivity during treatment for nocardiosis, alternative drugs may be efficacious and may be particularly important in this setting because they have a lower incidence of toxicity. PMID- 3536347 TI - [The "saga" of the dental office. Study of the conceptual development of dental operatory equipment]. PMID- 3536346 TI - Nonbacterial thrombotic endocarditis associated with bone marrow transplantation. AB - Two patients were treated with bone marrow transplantation and subsequently developed nonbacterial thrombotic endocarditis (NBTE). Both patients died of embolic sequellae and in neither was NBTE suspected antefinem. It is clear that NBTE occurs with increased frequency in bone marrow transplant (BMT) recipients and through arterial embolization contributes significantly to the morbidity and mortality of this procedure. In those at greatest risk, including BMT recipients, detection of disseminated intravascular coagulation; soft, changing systolic cardiac murmurs; hematuria; and signs of central embolic events suggest the diagnosis of NBTE. Awareness of the diagnosis of NBTE is essential for those who must interpret neurologic, myocardial and renal abnormalities in BMT recipients. PMID- 3536348 TI - [The "saga" of the dental office. Study of the conceptual development of dental operatory equipment]. PMID- 3536350 TI - [The "saga" of the dental office. Study of conceptual changes in dental operatory equipment]. PMID- 3536349 TI - [The "saga" of the dental office. Study of conceptual changes in dental operatory equipment]. PMID- 3536352 TI - [The "saga" of the dental office. Study of conceptual changes in dental operatory equipment]. PMID- 3536351 TI - [Polyvalent rotary instrumentation for clinical aspects of prosthetics]. PMID- 3536353 TI - [Pharmacologic prevention of cement-induced damage causing instability of joint endoprosthesis in experimental animals]. PMID- 3536354 TI - [Restoration of neural function after surgical treatment of inveterate injuries of the nerves of the upper extremity]. PMID- 3536355 TI - [Value of ultrasonography in the diagnosis and treatment of pre-dislocation conditions of the hip joint in infants]. PMID- 3536357 TI - [Urachus cord syndrome. A contribution to periumbilical abdominal discomfort]. PMID- 3536356 TI - [Comparison of the results of clinical studies and ultrasonographic examination of the hip joint in infants]. PMID- 3536358 TI - Spectral bandwidth in automated leukocyte classification. AB - Investigators have repeatedly pointed out the importance of spectral information in the automated classification of white blood cells. In general, monochromatic images recorded through two or three color filters are used to extract this information. Although it has generally been thought that the use of narrow band filters provides "cleaner" color information than is obtainable through wide band filters, the choice has not been fully investigated and the question is far from being settled. The use of wide band filters has the clear practical advantage of increased light levels at the detector, resulting in higher signal-to-noise ratio with less demand on light source design. In order to investigate this issue, a series of 681 leukocytes of the most frequently occurring types were digitized by the use of both narrow (10 nm) and wide (90 nm) band filters. Parameters were extracted independently from both sets of images. These parameters were then used to develop a classifier for each set of images. The choice of features and classifier results indicate that there are no major performance differences between the two types of filters. PMID- 3536359 TI - DNA microspectrophotometry of bone sarcomas in tissue sections as compared to imprint and flow DNA analysis. AB - The aim of the present study was to establish an upper limit of diploidy for microspectrophotometric (MSP) DNA measurements in sections of mesenchymal tissue analyzing DNA data of a large number of normal cell populations. The reliability of this upper limit of diploidy for discriminating between diploid and hyperploid bone sarcomas was tested by analyzing the same tumors by MSP in imprint preparations and flow cytometry (FCM). The median DNA value of control cells in tissue sections was given arbitrary value of DNA index (DI) 1.0, denoting the diploid DNA content. The proportion of cells with DNA values exceeding DI 1.25 (greater than DI 1.25) was determined for each normal cell population. The maximum percentage of cells with DNA values exceeding DI 1.25, encountered by analysis of 91 normal cell populations in tissue sections, was 31%. This percentage was set as an upper limit of diploidy. Hence, tumors with a higher percentage of cells greater than DI 1.25 were classified as hyperploid. When we applied this criterion, 31 of 36 sarcomas analyzed by MSP in tissue sections were hyperploid, which was in complete agreement with FCM and MSP in imprints of the same tumors. Apart from discriminating between diploid and hyperploid tumors, an attempt was made to determine peak DNA values of sarcomas analyzed in tissue sections. Peak DNA values, as defined by a minimum of 30% of the cells within a class width of DI 0.25, could be determined for 23 of 36 tumors. These peak DNA values correlated well with corresponding peaks obtained by FCM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536360 TI - The fate of the primary diploid population during spontaneous transformation of growth factor-supplemented murine cell cultures. AB - Primary cultures derived from lung and renal tissue of the newborn harvest mouse (Micromys minutus) were serially passaged in media supplemented with epidermal growth factor, hydrocortisone, transferrin, insulin, and triiodothyronine. Although these growth factor supplements eliminated the growth crisis commonly encountered during the initial stages of murine primary cultures, the original diploid cell fraction clearly underwent such a "crisis"; the truly diploid cells invariably disappeared as these cultures reached 20 to 40 population doublings. They were replaced, either gradually or precipitously, by various heteroploid cell fractions. In three of four independent cultures, these "established" cells were hypotetraploid and appeared to be derived from a small number of progenitors already present during the very early (precrisis) culture stages. In contrast to rather frequent DNA changes displayed by clones and subclones derived from the various heteroploid cell lineages, the predominant components of the established mass cultures displayed a highly constant DNA fluorescence pattern. Our results suggest that primary murine cell cultures develop heteroploid cell lineages even if the initial growth crisis is mitigated by growth factor supplements. These heteroploid cells appear to respond more efficiently to stimulation by various growth factors than the primary diploid cell population. PMID- 3536361 TI - Swine chromosomes: flow sorting and spot blot hybridization. AB - Flow cytometry analysis was applied to swine chromosomes prepared from phytohemagglutinin (PHA) stimulated peripheral blood lymphocytes. Flow karyotypes from both sexes and from t(3;7) translocation carrier females were obtained. A certain number of chromosome pairs could be assigned to various peaks. In fact, 13 peaks were observed for 18 autosomal pairs plus X and Y. Moreover, abnormalities owing to the t(3;7) translocation were readily observable. The number of base pairs for chromosomes associated with the various peaks was estimated by comparison with human flow karyotypes. The following four peaks were thus sorted: the peak assumed to represent the translocated chromosome 7 plus the normals associated with it; the corresponding peak from a normal swine; the peak assumed to contain among others the normal chromosome 7; and finally the peak corresponding to swine chromosome 1. Chromosomes of each peak were collected on Pall Biodyne membrane. Following appropriate denaturation and prehybridization, the four samples were hybridized with a human leucocyte antigen (HLA) class I 32P labelled cDNA probe, representing most of the coding sequence of the HLA B7 gene. The results confirmed previous data from other techniques that assigned the swine MHC(SLA) to chromosome 7. Subsequently, sorted samples were hybridized with a porcine genomic Interferon alpha probe in order to confirm the mapping of this gene family on porcine chromosome 1. PMID- 3536362 TI - Mapping by chromosome sorting of several gene probes, including c-myc, to the derivative chromosomes of a 3;8 translocation associated with familial renal cancer. AB - In eight members of a single family a constitutional translocation t(3;8) (p14.2;q24.1) is associated with the development of renal cancer. Chromosomes isolated from a cell line established from a subject with this translocation were analysed in flow with a fluorescence-activated cell sorter (FACS II). Nearly six million chromosomes from the flow karyotype region containing the der(8) and 5.5 million from the region containing the der(3) were sorted, the DNA extracted, digested with EcoRI, size fractionated by electrophoresis, and transferred to nitrocellulose. Hybridization with gene probes for c-mos, which has been localized to 8q11-q22 and somatostatin, which has been mapped to 3q28, confirmed that the sorted fractions contained, respectively, the der(8) and der(3) chromosomes. The cellular oncogenes c-raf-1 (3p25) and c-myc (8q24) were found to be translocated to the der(8) and der(3) chromosomes, respectively. The possible role that the relocation of c-myc might have on the development of renal carcinoma in carriers of this 3;8 translocation was further studied by analysis of the region surrounding the c-myc gene. By the use of cosmid cloning, no rearrangement 31 Kb 5'(or 19 Kb 3') of the translocated gene was found, indicating that the break-point is not immediately adjacent to c-myc. In an associated study, the DNA fragment D3S2 from chromosome 3 was found to map to 3p14.2-pter. This assignment in conjunction with published somatic cell hybrid data enabled D3S2 to be mapped more precisely to the interval 3p14.2-3p21. PMID- 3536363 TI - Extraction of nuclei from selected regions in paraffin-embedded tissue. AB - A method for the extraction of nuclei from selected regions in paraffin-embedded tissue is described. Fifty-micrometer sections are cut, dewaxed, and rehydrated. For the final handling, the sections are manually transferred from one tray to another. The sections are put on a slide under a dissection microscope and the region of interest is isolated by scraping off the irrelevant region with a scalpel. An optimal number of single nuclei is obtained by incubation in a protease solution with intermediate syringing. The nuclei are washed and can be used for flow cytometry. Resuspension of the nuclei in foetal calf serum and cytocentrifugation results in preparations suited for image analysis. DNA cytometric measurements of nuclei in a carcinoma in situ and an invasive carcinoma region in breast tissue present in the same tissue block and in a severe dysplasia/carcinoma in situ (CIN III) region of the cervix are presented. PMID- 3536364 TI - A simple method to select specific tumor areas in paraffin blocks for cytometry using incident fluorescence microscopy. AB - A simple method is described for the selection of tumor areas in paraffin blocks for cytometry. The surface of a paraffin block is stained with the fluorescent dye DAPI. By means of incident fluorescence microscopy on the cut surface of a total block, the tissue can be visualized. Location of the tumor area with the aid of conventional histopathological criteria is feasible using the adjacent section after hematoxylin-eosin staining as a diagnostic guideline. Once the position of the tumor area is determined, a small hollow bore, which is screwed in the objective holder, is pressed in the tissue. The depth is controlled by the microscrew of the microscope. After retraction of the bore, the block is removed, and a thick section is cut. The selected area can be processed for cytometry separately from the remaining tissue. The technique can be used either to enrich the sample to be analyzed with tumor cells or to analyze histopathologically different tumor compartments. Both flow and image cytometry can make use of this selection technique. PMID- 3536366 TI - Advantages and disadvantages of computer-assisted instruction. PMID- 3536365 TI - Altered thyroidal states modulate the insulin receptor characteristics of the developing rabbit brain. AB - We investigated the effect of propylthiouracil (PTU)-induced hypothyroidism and T4-induced hyperthyroidism on the fetal and neonatal rabbit brain insulin receptors (number and affinity) using plasma membranes. PTU administration to the pregnant mothers resulted in low serum-free T4 and normal total T3 concentrations, while T4 therapy to the mothers resulted in high serum-free T4 and high total T3 concentrations in the fetus and neonate. PTU-induced hypothyroidism did not affect the fetal brain insulin receptors, cholesterol content (brain homogenate) or protein content. On the other hand, brain insulin receptor number and total brain cholesterol content decreased in the neonate. T4 therapy at 100 micrograms/kg reversed the serum T4 to the control value and normalized the neonatal brain insulin receptor number and cholesterol content while a higher dose of T4 (200 micrograms/kg) increased the neonatal brain insulin receptor number, cholesterol and protein content. We conclude that altered thyroidal states modulate the brain insulin receptor (number and affinity) in neonatal, but not fetal brain plasma membranes. PMID- 3536367 TI - Vergence adaptation: a review. AB - The present review aims to discuss the current researches on the ability of the vergence system to adjust to new information. A concomitant or non-concomitant binocular retinal disparity caused by a prism or an anisometropic prescription can be adapted to such that the induced phoria of fixation disparity reduces back to the original value. The features and mechanisms of this normal adaptation and also the response in subjects with abnormal binocular vision are discussed. The less extensive work on the adaptive ability of the accommodative vergence system is also reviewed. PMID- 3536370 TI - [Interaction of tryptophanase with oxindolyl-L-alanine and L-alanine]. PMID- 3536369 TI - Insulin binding to differentiating muscle cell line L6. AB - We studied insulin binding to cultured differentiating muscle cell line L6. Insulin binding to the cells reached a plateau after incubation with 125I-insulin for 4 h at 22 degrees C, and was at an optimum at pH 7.8. Preincubation with 10 microM of hydrocortisone for 36 h at 37 degrees C resulted in significantly increased insulin binding (1.73 +/- 0.12 ng/mg protein for treated cells vs. 1.13 +/- 0.025 ng/mg protein for control cells, mean +/- SD, P less than 0.001). Preincubation with 1 microM of hydrocortisone or 1 microM of dexamethasone also led to increased binding. The number of insulin-binding sites per cell increased 2.5-fold in glucocorticoid-treated cells (9.7 X 10(3) sites/cell for treated vs. 3.8 X 10(3) sites/cell for control cells). Preincubation with trifluoperazine (5 microM), a calmodulin inhibitor, did not affect insulin binding to the cells. These results indicate that glucocorticoid might have some important role in regulating the number of insulin receptors in L6 muscle cells. PMID- 3536368 TI - Metabolism of a mutant insulin by a receptor-mediated process and an insulin degrading enzyme. AB - The metabolism of a mutant insulin, [LeuB25]-insulin, was studied in vitro and in vivo. Porcine or mutant insulin (4 micrograms/kg body weight) was injected i.v. into streptozotocin-induced diabetic rats and their plasma glucose and insulin levels were determined. The half-lives of porcine and mutant insulin were 3 min and 18 min, respectively. The ability of the mutant insulin to lower the blood glucose levels was 38% of that of normal when the glucose levels at the nadir were compared. Receptor-mediated degradation of the mutant insulin assessed by chromatography of the degraded materials in the media after incubation with cells was less compared with that of porcine insulin (4% vs. 24%). The media containing the insulin degrading enzyme (IDE) of IM-9 cells and rat livers degraded porcine and mutant insulin to the same extent. These results suggest that the decreased clearance of insulin is due to the decreased receptor binding and the decreased receptor-mediated degradation, but is not due to the decreased degradation by IDE. PMID- 3536372 TI - [Characteristics of transcripts of sup1 and sup2 genes in Saccharomyces yeasts]. PMID- 3536373 TI - [A preliminary study on the effect of oral amrinone in refractory congestive heart failure]. PMID- 3536371 TI - [High homology of nucleotide sequences of 26S rRNA cistron in Citrus limon and Saccharomyces cerevisiae]. PMID- 3536374 TI - [Ultrasonic examination of the inferior vena cava and hepatic vein and its clinical application]. PMID- 3536375 TI - Publication trends in fetal alcohol, tobacco and narcotic effects. AB - The rate of increase in publications dealing with pregnancy and three types of drugs--alcohol, tobacco and narcotics--was compared for the years 1973-1983 using Medline as literature source. The absolute number of publications for each of the three drug types per year was obtained and was used to calculate the percentage of articles for that type. The absolute number of articles on alcohol and on alcohol and pregnancy increased faster than the comparable absolute rates for the other two. The percentage of articles on pregnancy and alcohol, relative to all articles on alcohol, increased at a faster rate than that for narcotics, but not for tobacco articles. PMID- 3536376 TI - Premature mortality among prominent American authors noted for alcohol abuse. AB - An array of 27 American authors noted in the literature for their excessive drinking was compared for their longevity to a control group of 54 writers. The latter were selected for having similar sex distribution and distribution of dates of birth, as well as for their peer recognition among American writers. The median (and range) for the alcohol-abusing writers was 65 (33-77) years, whereas the control group survived to a median of 76 years (range 32-90). This difference was highly significant (p less than 0.001). Thus, data from American authors support those epidemiologic studies reporting alcohol abuse to be a cause of premature mortality, rather than others that have failed to demonstrate such a relationship. The social cost of an alcohol-related decrement in lifespan is emphasized by these data from a highly talented selection of American writers. PMID- 3536377 TI - Choice of blind methadone dose increases by methadone maintenance patients. AB - In the present study, a choice procedure was used in an outpatient methadone maintenance clinic to examine preferences for different double-blind methadone dose increases in 5 male patients. Subjects chose between 50 mg vs. 50 mg, 60 mg, 75 mg and 100 mg of methadone. In the 50 mg vs. 50 mg condition, each alternative was selected equally often. Percent selection of the higher doses (60, 75 and 100 mg) over the 50 mg dose of methadone increased in a dose-related fashion. Subject self-reports were consistent with methadone's opiate-like properties with dose related trends being noted in most scales (e.g. opiate effects, drug liking). Overall, the results show that a choice procedure can be used successfully to assess the reinforcing properties of drugs in methadone maintenance patients and that methadone dose increases can function as a reinforcer in this population even under blind dosing conditions. PMID- 3536378 TI - Physical methods in the study of the active site geometry of cytochromes P-450. PMID- 3536379 TI - The limitations of summary risk management data. PMID- 3536380 TI - Structure-metabolism relationships (SMR) for the prediction of health hazards by the Environmental Protection Agency. I. Background for the practice of predictive toxicology. PMID- 3536381 TI - Categorization of lipophilic xenobiotics by the enthalpic structure-function response of hepatic mixed-function oxidase. PMID- 3536382 TI - Hematological effects associated with beta-lactam use. AB - Beta-lactam antibiotics have continued to be the mainstay of antiinfective treatment. Newer agents, such as the third-generation cephalosporins or ureidopenicillins, have the advantage of a broader antimicrobial spectrum and improved pharmacokinetics. The beta-lactams are often promoted as alternatives to more toxic antibiotic regimens. However, several of the beta-lactams have been shown to produce hematological effects, some of which can be life threatening. The primary hematological effects appear to be inhibition of normal platelet function and the coagulation cascade, which is reflected by changes in bleeding times and increases in prothrombin time and activated partial thromboplastin time, respectively. Although not all patients will develop bleeding problems associated with these agents, close monitoring of patients with risk factors for bleeding and dosage adjustments may help to avert these drug-induced hematological problems. PMID- 3536383 TI - A review of alprazolam withdrawal. AB - A cumulative review of case reports in the literature describing withdrawal reactions secondary to alprazolam is presented. In four of eight reports, the primary withdrawal manifestations were grand mal seizures. One case was characterized by painful myoclonus. In the remaining three cases, the major complications consisted of rebound anxiety with psychotic features. Despite tapering of the daily dosage according to manufacturer guidelines, a withdrawal syndrome was precipitated in three of the cases. As a result of alprazolam's atypical pharmacodynamic profile, the issue is raised as to whether alprazolam is pharmacologically cross-tolerant with other benzodiazepines. PMID- 3536384 TI - Effect of protein on renal function and drug disposition. AB - Studies in animals have indicated that increasing dietary protein intake could increase renal blood flow, glomerular filtration rate, and kidney size and weight. More recent literature suggests that similar findings may be seen in humans with an oral protein load and continuous infusion of amino acids. This paper reviews this body of literature, and examines potential mechanisms involved in producing the observed changes in renal function seen with protein and amino acid administration and potential alterations in drug disposition. PMID- 3536385 TI - Cefsulodin. AB - The chemistry, microbiology, pharmacokinetics, adverse reactions, and clinical indications for cefsulodin are reviewed and compared to ceftazidime and cefoperazone. Cefsulodin is a narrow-spectrum, third-generation cephalosporin with activity virtually restricted to Pseudomonas aeruginosa. Cefsulodin is eliminated renally and has a serum half-life similar to ceftazidime and cefoperazone. Cefsulodin appears to be well tolerated and relatively free of any significant toxicity except for nausea and vomiting, which appear to be related to the infusion rate. Cefsulodin may be beneficial in those rare clinical situations where an infection is caused by a sensitive isolate of P. aeruginosa known to be resistant to the other antipseudomonal cephalosporins, and/or the avoidance of an aminoglycoside antibiotic is desired. However, its empiric use is to be discouraged. PMID- 3536388 TI - [The psyche, central nervous system and the gastrointestinal tract]. PMID- 3536386 TI - [Regression of coronary sclerosis in familial hypercholesterolemia IIa by specific LDL apheresis]. AB - The long-term effect of specific LDL plasma immunabsorption on the course of coronary arteriosclerosis was tested in ten patients with familial hypercholesteremia type IIa (seven females, three males; age range 15-57 years). Available were ECG, bicycle ergometry, hemodynamic and angiographic data. These tests were repeated seriatim in the course of the LDL immunabsorption. It was found that exercise tolerance markedly increased, ischemic ST-changes became less marked and the initial hemodynamic parameters remained unchanged. The morphology of the coronary arteries was influenced lastingly: among 22 stenoses only one progressed, there was no further progression in 11 stenoses and regression in ten. When there was generalized arteriosclerosis, progression occurred in two of 79 coronary artery segments, progression was arrested in 56 and regression was noted in 21 of 79 segments. These results demonstrate that specific LDL plasma immunabsorption for the elimination of LDL cholesterol favorably influences the course of coronary arteriosclerosis in patients with familial hypercholeremia type IIa. The findings support the lipid theory of atherosclerosis and coronary arteriosclerosis, at least in this special group of patients. PMID- 3536387 TI - [Follow-up care for differentiated thyroid cancer]. PMID- 3536389 TI - [Feasibility of methods of outpatient preparation for proctologic examination. Comparison of phosphate and sorbit enemas in a randomized double-blind study]. AB - Phosphate and sorbite enemas for preparing a patient for rectoscopy and flexible endoscopy were compared in a randomised double-blind study on 60 patients. Side effects were low and equally rare in both groups of patients. There was no statistically significant difference in the cleansing quality of both enemas. Phosphate enemas produced reliable onset of action in a significantly shorter time, and the cleansing depth was also significantly better. PMID- 3536390 TI - [Risk of infection during treatment with cyclosporin A]. PMID- 3536391 TI - [Sonographic examination of the colon]. PMID- 3536392 TI - [Diagnosis of deep venous thrombosis of the leg]. PMID- 3536393 TI - [Alcohol and arterial hypertension]. PMID- 3536394 TI - [Diagnosis of iodine-deficiency goiter]. PMID- 3536395 TI - [Therapy of iodine-deficiency goiter]. PMID- 3536396 TI - [Role of fibronectin in resistance to infection]. PMID- 3536397 TI - [Dose-dependent serum concentration of ISDN and its metabolites following administration of ISDN-retard. Studies under steady-state conditions]. AB - In a randomized cross-over trial of four groups of patients (total 49 patients) the serum concentrations of isosorbide dinitrate (ISDN), isosorbide-2-mononitrate (IS-2-MN) and isosorbide-5-mononitrate (IS-5-MN) were measured under steady-state conditions after administration of 20, 40, 60 and 80 mg, respectively, of two ISDN preparations, the two being bioequivalent. At the studied dosage there was a linear relationship between dose and serum concentration of ISDN and its two metabolites in the proportion of 1:6:70. Because the serum concentration of IS-5 MN is so high under steady-state conditions, there is the potential problem of tolerance developing. The drug should therefore be administered at a lower dose twice daily. PMID- 3536398 TI - [Atypical initial manifestation of abdominal aortic aneurysm. The causes of diagnostic and therapeutic errors]. AB - Initial manifestations of an abdominal aortic aneurysm may, depending on its site, morphology and direction of expansion, imitate numerous other intraabdominal diseases, but also lesions of peripheral vessels, vertebral column and spine. In this way they may give rise to errors of diagnosis and treatment. An abdominal aortic aneurysm should be considered especially in case of unclear gastrointestinal bleeding or abnormal intestinal passage (ischaemic colitis; mechanical displacement or compression of the duodenal-jejunal flexure and of the small-intestinal mesentery). In case of massive or recurrent gastrointestinal bleeding, especially in combination with a septicaemia, an aorto-intestinal fistula should be considered in the differential diagnosis. Radicular compression syndrome may be caused by an aortic aneurysm which is usually contained and predominantly suprarenal (to be considered especially once a herniated disk has been excluded by computed tomography). The same is true for unclear bone defects of the lumbar vertebrae (erosion by a penetrating aneurysm). Noninvasive methods, such as upper abdominal sonography, computed tomography and relatively minor invasive transvenous digital subtraction angiography now predominate in the definitive diagnosis of abdominal aortic aneurysm. PMID- 3536399 TI - [Aorto-enteric fistula. A rare but significant cause of gastrointestinal bleeding]. PMID- 3536402 TI - [Medullary thyroid cancer]. PMID- 3536401 TI - [The antinuclear antibody spectrum in circumscribed forms of scleroderma]. AB - Sera from 56 patients with circumscribed scleroderma (CS) were tested for the presence of antinuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells. 16 patients (28.6%) had ANA, mostly in low titers of 1: 40 and with uncharacteristic fluorescence patterns. Nucleolar antibodies as in progressive systemic sclerosis were seen in a few cases only. Two female patients demonstrated antibodies with a centromere-like pattern. ANA were most frequently found in patients with atrophodermia idiopathica progressiva (60%) and in linear CS (44%). Rheumatoid factor was present in 62% of patients with linear CS; it was less frequent in other forms of CS. Antibodies against double-stranded DNA were found only in one female patient, but three patients with systemic involvement had antibodies to single-stranded DNA. Antibodies to soluble nuclear Scl-70, Ul RNP and LA(SSB) antigens or to the cytoplasmatic Ro(SSA)-antigen, respectively, were not detected in the patients with CS. These results demonstrate that humoral autoimmune phenomena may occur in CS, mainly in patients with linear CS. These phenomena, however, are less frequent and specific than in progressive systemic sclerosis or in other collagen vascular diseases. PMID- 3536403 TI - [Alternatives to animal experiments in parasitology]. PMID- 3536400 TI - [Therapy of stomach ulcer with sucralfate and ranitidine. A multicenter double blind study]. AB - 134 outpatients with acute benign gastric ulcer confirmed by endoscopic biopsy received either 1 g sucralfate suspension four times daily or one 150 mg ranitidine tablet twice daily for six to 12 weeks in a multicentre therapy study (double-blind study according to the double-dummy technique). After six to 12 weeks, respectively, 56% and 82% of the ulcers had healed in the sucralfate group. The rates of healing in the ranitidine group were 72% and 88%, respectively. The differences in the rates of healing between sucralfate and ranitidine were not statistically significant. Ranitidine was superior to the sucralfate suspension in corpus ulcer. In the distally located ulcers, the two kinds of treatment were equivalent. There were no appreciable differences between the medications with regard to antacid consumption and compliance. Gastric pain was influenced better by ranitidine than by sucralfate. PMID- 3536404 TI - [Parasitic infestation of dogs and cats in Austria]. PMID- 3536405 TI - [Infestation with stomach parasites in horses in North Germany]. PMID- 3536406 TI - [Functional significance of the areae porosae of female Rhipicephalus evertsi evertsi, Neumann, 1897]. PMID- 3536407 TI - [Experimental Eimeria bovis infections in the calf: 1. Parasitologic and clinical findings]. PMID- 3536408 TI - [Gastrointestinal strongylid infestation of young cows and their effects on selected blood chemical parameters]. PMID- 3536409 TI - [Light and electron microscopy studies of the developmental cycle and effect of pentamidine on the morphology of intra-erythrocyte stages of Babesia microti]. PMID- 3536410 TI - [Distribution status and damage of black flies (Diptera: Simuliidae) in the Freising/Upper Bavaria area]. PMID- 3536411 TI - [Epizootiology of Moniezia benedeni (Moniez, 1879) in cattle in Allgau]. PMID- 3536412 TI - The function of non circulating microfilariae: Litomosoides carinii (Nematoda: Filarioidea). PMID- 3536413 TI - [New procedures for the elimination of the brown dog tick (Rhipicephalus sanguineus L.) without contaminating room air]. PMID- 3536414 TI - [Suitability of Echinococcus antigens of selected intermediate host-final host cycles for the detection of cystic echinococcosis in humans]. PMID- 3536416 TI - [Population dynamic studies of Diptera in horses in the Bavarian Lower Alps region]. PMID- 3536417 TI - [Interval treatment of cattle against gastrointestinal and lung worms]. PMID- 3536415 TI - [Treatment of sarcoptic mange in wild and domestic swine with ivermectin (Ivomec)]. PMID- 3536419 TI - [Transmission of cystic echinococcosis in cattle in Germany]. PMID- 3536418 TI - [Trials on the infectibility with Toxocara canis of puppies raised nematode free or with few nematodes]. PMID- 3536420 TI - [Ticks of domestic and wild animals in Germany: on the occurrence and biology of the hedgehog tick (Ixodes hexgonus) and the fox tick (Ixodes canisuga)]. PMID- 3536421 TI - [Control of mange mites and sucking and biting lice in cattle with pour-on Bayticol]. PMID- 3536422 TI - [Effect of a combination of fenbendazole and triclabendazole on naturally acquired helminth infections of sheep]. PMID- 3536423 TI - Oxaprozin. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. AB - Oxaprozin is a newer non-steroidal anti-inflammatory drug advocated for use in painful rheumatic and inflammatory conditions. As is the case with some other newer non-steroidal anti-inflammatory drugs, oxaprozin offers the convenience of once-daily administration. Published data suggest that oxaprozin 1200 mg once daily is comparable in effectiveness with usual dosages of aspirin, ibuprofen, indomethacin, naproxen, piroxicam and sulindac in the treatment of rheumatoid arthritis and osteoarthritis. More controlled clinical trials in adequate numbers of patients are necessary to evaluate its potential in other rheumatic and inflammatory conditions. Oxaprozin produced fewer gastrointestinal side effects than aspirin, and the short term tolerability of oxaprozin was similar to that of other non-steroidal anti-inflammatory drugs. If further definition of its efficacy and tolerability compared with other non-steroidal anti-inflammatory drugs during long term therapy confirms these initially favourable results, then oxaprozin would appear to offer a useful and convenient alternative in the treatment of painful rheumatic and inflammatory conditions. PMID- 3536425 TI - Antral packing in maxillary fractures. PMID- 3536424 TI - The diagnosis and treatment of macroglossia in children. PMID- 3536426 TI - Dermatophytoses in East Africa: a review. PMID- 3536427 TI - [Metal-ceramic bonding mechanisms in the Ceraplatin technic]. PMID- 3536428 TI - [Variations in model casting plans of several treatment providers for the same case]. PMID- 3536430 TI - [Determination of the height of the facial/oral alveolar bone margin using A-scan ultrasonography]. PMID- 3536429 TI - [Bonded bridge technics: electrolytic etching of NiCr alloy]. PMID- 3536432 TI - Assessing illness severity and outcome in critically ill patients. AB - Severity of illness scores have great potential to improve use of scarce resources and to help monitor quality of care. Injury severity scores can reliably separate trauma patients into high- and low-mortality groups, but have limitations when applied in triage decision making. Specific predictive models for chest pain patients have improved admitting practices in some emergency departments. Univariate predictors of survival include age, severity of illness, and presence of chronic illnesses, especially cancer. General multivariate models for intensive care patients have correctly categorized hospital outcome in approximately 85 per cent of cases when applied in a retrospective fashion. These models are insufficiently precise for application to individual patients; but they may be helpful in assessing quality of care in the intensive care unit, in assessing efficacy of new technologies, and in utilization review audits. PMID- 3536431 TI - [Influence of drugs on the effect of antitumor preparations in experiments and in clinic medicine]. AB - Experimental and clinical data concerning the interaction of cytostatics with diuretics, anticoagulants, neurotropic drugs, prostaglandin inhibitors, etc. are reviewed. It is considered necessary to take into account the possible clinical effect when applying different drugs for treatment of the tumour patients. Side by side with intensification of the antitumour activity of the cytostatic or with a decrease of its toxic effect on haemopoiesis and on the function of parenchymatous organs some undesirable effects such as an increase of the toxicity or a decrease of the antitumour effect are possible. Interaction of cytostatics with different groups of drugs demands further study taking into account the "medicinal background" of the modern population. PMID- 3536433 TI - Ventilatory management in the critically ill. AB - A basic understanding of respiratory physiology and ventilator-patient interaction is critical for the initiation of ventilatory support and management of the ventilated patient. A brief review of these subjects is incorporated in this outline of the approach to the patient requiring mechanical ventilation. PMID- 3536434 TI - Resuscitation of the critically ill patient. Use of branched-chain decision trees to improve outcome. AB - The algorithm approach provides criteria based on decision rules for expeditious monitoring, diagnostic and therapeutic decisions; algorithms are particularly useful in crisis situations, in which time is of great importance, for example, in the resuscitation of emergency patients. Because of its objectivity and usefulness as a teaching tool, this algorithmic approach is of practical benefit in the training of residents and students in teaching hospitals, as well as in the community hospital where less experienced physicians manage hypotensive emergency patients more infrequently. In a few instances there has been some reluctance to use the algorithm, but most often it was found to be useful in organizing the work-up and establishing therapeutic priorities. A second branched chain decision tree was designed for use after the initial resuscitation in hemodynamically unstable patients who only had CVP catheters but were suspected of having hypovolemia. In this algorithm, MAP, HR, urine output, Hct, and CVP are used as criteria. The underlying premise under these conditions was to evaluate increments of volume therapy without exceeding safe CVP pressures (less than 18 mm Hg) in order to obviate fluid overloading. A third algorithm for ICU patients with pulmonary artery catheters was developed from decision rules based on objective physiologic, heuristic, survival data as the criteria for post-trauma and postoperative patients who were critically ill despite apparent success with the initial resuscitation and CVP algorithms. The improved mortality in prospective studies supports the hypothesis that compensatory responses of the survivors are the major determinants of outcome. PMID- 3536435 TI - Surgical preparation of the trauma victim. AB - Successful management of the victim of multisystem trauma depends on an orderly scheme of resuscitation and diagnostic evaluation. This management is directed by the general surgeon heading the trauma service. Based on his or her knowledge of the mechanisms of injury and the initial physical examination, the surgeon establishes priorities of treatment for the most life-threatening injuries. He directs the preoperative preparation, including communication with the operating room and anesthesia staffs, assembly of a basic laboratory profile, and placement of lines and tubes. The trauma surgeon identifies need for consultation in the medical or surgical specialties and formulates a strategy for surgical management with the consultants. Finally, based on his or her impression of the injuries and their relative severity, the surgeon selects the diagnostic tests, particularly peritoneal lavage, CT scan of the head and body, and arteriography, all of which will be needed to complete the surgical preparation. PMID- 3536436 TI - Central venous access in critically ill patients in the emergency department. AB - Several techniques of percutaneous venipuncture and cut-downs for insertion of intravenous catheters and the respective clinical results are described. We believe that puncture of the subclavian vein from above the clavicle in the segment of the veins over the first rib is the safest anatomic approach to the vein. The first rib under the vein shields the pleural dome and the apex of the lung against the needle puncture, and the tip of the needle is directed away from the apex of the lung. Insertion of double and multiple IV catheters in one vein, adjacent veins, or even veins located away from each other is safe and much less costly than the double- and triple-lumen catheters. The special and unconventional venous cut-downs for providing IV access described here in patients with difficult access may be life saving. The experience with vascular access in our institution indicates that supervised training in vascular access and the personal experience of each physician with these techniques and teamwork help to reduce potential complications. PMID- 3536437 TI - Emergency cardiac pacing. AB - This discussion reviews and critiques the available emergency pacing methods for the control of symptomatic bradycardias and the management of tachyarrhythmias. In addition, attention is addressed to the emergency care of patients with permanent pacemakers. PMID- 3536438 TI - Emergency department management of life-threatening arrhythmias. AB - Emergency treatment of life-threatening arrhythmias is related to appreciation of their hemodynamic consequences. In all case, attention should be paid to treating the patient and not merely the electrical rhythm. Emergency cardioversion or defibrillation should be performed in tachyarrhythmias with associated significant end-organ hypoperfusion. Early drug therapy, stabilization, and referral for definitive therapy may be appropriate when tachyarrhythmias do not produce significant hemodynamic consequences. Asymptomatic bradycardia should not be treated emergently but referred for definitive care in those circumstances in which it is necessary. Bradycardia associated with end-organ hypoperfusion should be treated with trials of atropine, or isoproterenol, or emergency pacemaker insertion, and the stabilized patient referred to the cardiac procedure laboratory or cardiac care unit as appropriate. This same approach to bradyarrhythmias applies regardless of the anatomic and electrophysiologic etiology of the decreased heart rate. Attention to these few management principles clearly stresses the primary importance of the hemodynamic effects of any arrhythmia other than the arrhythmia itself. PMID- 3536439 TI - Invasive cardiorespiratory monitoring. AB - Several principles should be kept in mind when choosing appropriate monitoring. First, select monitoring devices that provide relevant information on which therapeutic decisions can be made. Second, when alternative, noninvasive monitoring devices are available, use these preferentially because the risk to the patient usually is decreased. Third, when invasive monitoring devices are used, sterile technique and catheter care become extremely important. Fourth, record information that is obtained from monitoring frequently, and titrate therapy continuously based on information generated. Fifth, remove invasive monitoring devices as soon as they are no longer necessary. Finally, when new monitoring approaches are presented, they should be evaluated not only on the basis of their sophistication and cost, but also on the basis of how important will be the new physiologic measurements they provide to improve patient outcome. PMID- 3536440 TI - Sepsis and septic shock. AB - Sepsis and septic shock remain all too frequent syndromes in modern medicine with unacceptably high mortality rates. Physicians must be aware of the many ways in which sepsis and septic shock may present and the multiple differential diagnoses. Early recognition and prompt institution of empiric therapy are of utmost importance. Our current limited understanding of the pathophysiology of sepsis and septic shock significantly limits our ability to treat this syndrome effectively and thus substantively alter mortality. New developments in immunology and metabolism seem promising in furthering our understanding and improving our therapy of this complex multisystem disorder. PMID- 3536441 TI - Shock in infants and children. AB - Physiologic data obtained from infants and children in shock indicate that there is a high frequency of abnormalities that can only be discovered with pulmonary artery catheters. Cardiogenic shock is a low-output, high-resistance condition, and septic shock is a relatively high-output, low-resistance condition. The use of pulmonary artery catheter data demonstrates that optimal therapeutic goals can be estimated and basic pathophysiologic abnormalities can be discovered. PMID- 3536442 TI - Head trauma. AB - Head injury is a common occurrence in the multiply injured patient. Because it is so common, physicians in busy emergency rooms should be well versed in its evaluation and treatment. A guide to appropriate evaluation and treatment has been established by Becker et al. Patients can be divided into four categories, depending on degree of neurologic injury. Group I patients suffer transient loss of consciousness only and then return to normal; they require observation only. Group II patients suffer loss of consciousness and continue to have impaired cognitive functions; they require observation and a CT scan. Group III patients suffer loss of consciousness, continue to have disordered cognitive functions, and have significant motor deficits. This group can be subdivided into patients with and without focal neurologic deficits. Both of these will require aggressive therapy to control intracranial hypertension, CT scanning, and possibly surgery. The last category, group IV, includes patients who meet the requirements of brain death. No further work-up or therapy is needed for this group. Patients who suffer head injury are at risk for many complications, but two that are emphasized are postconcussion seizures and the postconcussion syndrome. Identifying factors that predispose the patient to these complications can help to minimize their occurrence. PMID- 3536443 TI - Effect of substitution of a permeable weak acid for the permissive role of glucose in amino acid-induced electrical activity in B-cells. AB - The amino acids L-leucine, L-isoleucine, and L-arginine require a subthreshold concentration of glucose to elicit insulin release and electrical activity from B cells. There is evidence suggesting that protons couple the metabolism of glucose to the functional response of B-cells. In view of this, a permeable weak acid, sulfamerazine, was used to determine if the generation of intracellular protons could account for the permissive action of glucose. Addition of 10 mM sulfamerazine elicited constant spike activity only with 20 mM leucine. With 20 mM arginine or isoleucine, sulfamerazine induced silent depolarization no different from that caused by sulfamerazine alone. The pattern of the electrical activity of each amino acid plus 5.6 mM glucose or alpha-ketoisocaproic acid alone was qualitatively different; addition of sulfamerazine enhanced the electrical response. The permeable weak base NH4Cl at 20 mM immediately inhibited the electrical response to each amino acid plus glucose or alpha-ketoisocaproic acid alone. The effects of the permeable weak acid and base indicate that intracellular pH is important in maintaining amino acid-induced electrical activity. The permissive role of glucose may be due to provision of protons only with leucine. PMID- 3536444 TI - Further characterization of insulin secretion from the perfused duodenum-pancreas of chicken: a comparison of insulin release in chickens selected for high and low abdominal fat content. AB - Insulin release from the perfused pancreas was studied in genetically selected fat and lean chickens. The previously described glucose insensitivity of the chicken pancreas cannot be overcome by 5 or 10 mM D-glyceraldehyde, suggesting that the resistance is not related to glucose metabolism before the triose phosphate step. At 42 mM, glucose induced a biphasic insulin release which was specific, since 42 mM mannitol did not elicit insulin release. Arginine (10 mM) or acetylcholine (0.1-1 microM), which in themselves do not cause insulin release, generated a biphasic insulin release in the presence of a low nonstimulating glucose concentration (14 mM); the effect was synergistic. In contrast to the glucose tolerance test observed in vivo, the pancreas from the fat line chicken in response to glucose or glucose plus arginine released significantly less insulin during the first phase. The significance of this defect awaits further elucidation. On the other hand, acetylcholine, a more potent secretagogue, did not reveal any significant difference between fat and lean chickens. PMID- 3536445 TI - Flow cytometric analysis and sorting of live male rat anterior pituitary cell types by forward angle and perpendicular light scatter. AB - Light scatter patterns produced by living cells in the flow cytometer are known to provide useful information with regard to their size and internal structure. The purpose of this study was to determine if light scatter signals produced by live male rat anterior pituitary cells could be used as markers to aid in the identification and separation of different hormone-containing cell types. The typical light scatter pattern (4 X 10(5) cells/sample X 15 min) had three ridges in the forward angle light scatter (FALS) perpendicular light scatter (PLS) bivariate cell distribution. FALS signals could be correlated with the size of different cell types and PLS signals with their content of cytoplasmic secretory granules. Agranular cells dominated the low PLS ridge while moderately granulated PRL cells and heavily granulated GH cells dominated the medium and high PLS ridges, respectively. These light scatter patterns were reproducible both within and between different cell suspensions. Inclusion of dopamine in the pituitary gland dissociation medium, a treatment known to increase intracellular PRL contents of mammotrophs, increased the intensity of the PLS signals of a large population of cells, presumably PRL cells. Pituitary cells prepared from different aged male rats also showed changes in light scatter. Cell sorting on the basis of FALS-PLS signals established the relationship between cell type and light scatter pattern. PMID- 3536446 TI - Somatomedin-C substitutes for insulin for the growth of mammary epithelial cells from normal virgin mice in serum-free collagen gel cell culture. AB - We investigated the effect of somatomedin C (SM-C) on the growth of mouse mammary ductal epithelial cells in collagen gel culture. Epithelial cells, isolated by collagenase digestion of whole glands, were placed into primary serum-free collagen gel cell culture for 10-12 days, during which SM-C was added alone or in combination with other growth-promoting factors. Previous work has shown that these cells require a superphysiological concentration of insulin (10 micrograms/ml) for optimum growth in serum-free medium (a 1:1 mixture of Ham's F 12 and Dulbecco's Modified Eagle's medium) containing epidermal growth factor (EGF). When SM-C (1-250 ng/ml) alone was added to serum-free basal medium containing EGF, it stimulated growth (at concentrations greater than 25 ng/ml) to at least the same extent as insulin at 10 micrograms/ml. There was no additive stimulation of growth when optimal concentrations of insulin and SM-C were added together. The nonadditive stimulation at optimal concentrations of these hormones may indicate that the previous requirement for a superphysiological concentration of insulin for maximum growth was due to low affinity binding of insulin to the SM-C receptor. Rat insulin-like growth factor II (Collaborative Research) at 50 200 ng/ml did not stimulate growth in the presence or absence of insulin. SM-C could not stimulate growth alone. The presence of EGF or mammogenic hormones (progesterone and PRL) was required. PMID- 3536447 TI - Measurement of messenger ribonucleic acid for luteinizing hormone beta-subunit, alpha-subunit, growth hormone, and prolactin after hypothalamic pituitary disconnection in ovariectomized ewes. AB - A transnasal, transsphenoidal surgical approach was used to perform hypothalamic pituitary disconnections (HPD) in ovariectomized (OVX) ewes to examine the role of the hypothalamus in regulating the synthesis of anterior pituitary hormones. Ewes were killed at 1-3 days (n = 6), 1 week (n = 5), or 1 month (n = 5) after HPD. Pituitary glands were removed, and hemisected for analysis of hormone or messenger RNA (mRNA) content. Blot hybridization using specific complementary DNA probes was used to quantify the concentration of mRNA for LH beta-subunit, alpha subunit, GH, and PRL. Concentrations of mRNA for LH beta- and alpha-subunits were lower (P less than 0.01) at 1-3 days after HPD than in OVX ewes. At 1 week and 1 month after HPD, concentrations of mRNA for LH beta- and alpha-subunits were near the lower limit of detection of this assay system. In contrast, for 30 days after HPD, pituitary concentrations of mRNA for GH and PRL were not different (P greater than 0.05) from those in OVX ewes. At 1 week and 1 month after HPD, pituitary content of LH, FSH, and GH was lower (P less than 0.01) than in OXV ewes. Pituitary PRL content in all HPD ewes was lower (P less than 0.05) than in OVX ewes. In a separate group of five ewes that were bled daily for 30 days after HPD, serum concentrations of LH and FSH fell dramatically during the first 3 days after HPD. In contrast, serum concentrations of GH and PRL remained similar to pre-HPD concentrations for 30 days after HPD. Thus, hypothalamic stimulation is essential for maintaining the concentration of mRNA for LH beta- and alpha subunits within the anterior pituitary gland. Without continued hypothalamic support, pituitary and serum concentrations of LH and FSH rapidly decline. In contrast, concentrations of mRNA for GH and PRL are maintained in the absence of hypothalamic input. PMID- 3536448 TI - Anti-prolactin cell-surface immunoreactivity identifies a subpopulation of lactotrophs from the rat anterior pituitary. AB - Suspensions of cells dissociated from the anterior pituitary of the adult rat include many that contain intracellular PRL. After fixation, these cells can be identified and the distribution of their PRL determined by immunocytochemistry with anti-PRL antibodies. We have found that approximately 50% of the cells that contain intracellular PRL also have PRL or PRL-like immunoreactive material on the outer cell surface. Cell-surface PRL can be detected on unfixed anterior pituitary cells using anti-PRL antibodies and either fluorescence microscopy or fluorescence-activated cell sorting. Cell surface labeling by anti-PRL antibodies was restricted to PRL-containing cells; 85-97% of the labeled cells contained detectable intracellular PRL, while fewer than 2% contained detectable GH, ACTH, LH, or TSH. Subpopulations of live anterior pituitary cells could also be labeled on the cell surface by antibodies against GH, ACTH, LH, or TSH. This suggests that the presence of hormone at the cell surface may be a characteristic and identifying feature of different anterior pituitary cell types. PMID- 3536449 TI - Cell-specific expression of immunoreactive cholesterol side-chain cleavage cytochrome P-450 during follicular development in the rat ovary. AB - Using a specific antiserum against rat cholesterol side-chain cleavage cytochrome P-450 (P-450scc), we examined the expression of this key steroidogenic enzyme during follicular development in PMSG-treated immature rats. The accumulation of the enzyme was monitored in ovary homogenates by quantitative immunodot blot assay, while expression of P-450scc in various cell types was visualized concomitantly by immunofluorescent staining of ovarian cryosections. Before PMSG treatment, no labeling of P-450scc could be observed in follicular granulosa cells. In contrast, steroidogenic cytochrome was markedly expressed in interstitial cells, part of theca interna cells, and hypertrophied theca of atretic follicles. As a result of PMSG treatment, the interstitial thecal cells promptly enriched their P-450scc content within 24 h, whereas the granulosa cells acquired the enzyme at a later time, between 30 and 48 h after hormone administration. After ovulation, many corpora lutea filled most of the ovarian volume, and the ovarian content of P-450scc was 47 times higher than that in control ovaries of untreated rats. In granulosa cell population of a single preovulatory follicle, a downward gradient of P-450scc expression was observed, starting high in the cells abutting the basal lamina and decreasing toward the cells lining the antrum. Cumulus cells failed to express P-450scc. Referring to the basal lamina, theca interna cells exhibited a reverse gradient of P-450scc expression, starting high in peripheral cells close to the theca externa layer and decreasing in cells located near the follicular basement membrane. Immunofluorescent labeling revealed a major difference between P-450scc expression in thecal cells compared to that in granulosa cells. While expression of P-450scc in granulosa cells was restricted exclusively to cells within preovulatory follicles, P-450scc labeling was observed throughout the ovary in thecal and interstitial cells associated with follicles at any phase of follicular maturation. Therefore, it may be proposed that the thecal and interstitial cells represent an all ovarian network which expresses its steroidogenic capacity at early stages of follicular maturation and thereby is able to supply androgens necessary for the follicular development. PMID- 3536451 TI - Evidence for widespread atresia in the hypophysectomized estrogen-treated rat. AB - The question considered in this study concerns to what extent the ovaries of the immature hypophysectomized diethylestilbestrol-treated rat are populated by atretic follicles. Histological studies of ovaries on postoperative days 4-7 reveal the presence of numerous follicles showing signs of ill health. The granulosa cells constituting these follicles are heterogeneous and exist in three distinct zones. The cells in zone 1 are affixed to the basal lamina and form a tightly packed sheet of cuboidal epithelium one to two cells thick. The cells constituting zone 2 are located just medial to zone 1 and appear as a mass of loosely aggregated cells which show intense necrosis. Zone 3 is composed of the prospective cumulus-oocyte complex which appears completely normal. Results of histochemical studies show heterogeneity in the granulosa cells with respect to the presence and location of markers specific for atresia. In atretic follicles, the granulosa cells populating zones 1 and 2 contain lipid droplets and esterase activity, but are negative for the lysosomal enzyme acid phosphatase. The exact reverse is true for zone 3, where the cumulus express intense acid phosphatase activity but are negative for lipid and esterase activities. The granulosa cells in healthy follicles are totally negative for these histochemical markers. As a healthy preantral follicle grows, there is a dramatic increase in the mitotic index of the granulosa cells; however, in all atretic follicles, granulosa cell division is decreased by more than 90%. Further experiments using monoclonal antibodies as probes confirm the presence of atretic follicles and demonstrate that the structure-function changes in zones 1 and 2 are associated with striking changes in the antigenic properties of the granulosa cells. Morphometric studies indicate there are a total of 235 +/- 29 preantral follicles/ovary in the hypophysectomized diethylstilbestrol-treated rat. On postoperative day 4, 37 +/- 1.2% of the preantral follicles are atretic; this number increases linearly with time posthypophysectomy, reaching nearly 50% on postoperative day 7. Examination of follicles at different stages of development reveals that atresia is rare in the very early stages, e.g. follicles less than 200 microns in diameter; however, in the population of larger preantral follicles (those 200-400 microns in diameter), atresia is common, with nearly 80% being atretic on postoperative day 7. Collectively, these findings provide convincing evidence of widespread atresia in the ovaries of the hypophysectomized diethylstilbestrol-treated rat.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536450 TI - Proglucagon processing in a rat islet cell line resembles phenotype of intestine rather than pancreas. AB - Proglucagon, synthesized in the pancreatic islets and the intestinal L-cells, contains in its precursor structure glucagon, glicentin, and two glucagon-like peptides (GLP-I and GLP-II) separated by an intervening peptide (IP-II). We have cloned a stable rat islet cell line expressing the glucagon gene at high levels, thereby allowing us to study the posttranslational processing of proglucagon in this cell line. In contrast to the processing of proglucagon in the pancreas, in which glucagon is liberated, in the cell line we found the intestinal pattern of peptides consisting of glicentin, at least two forms of GLP-I [GLP-I-(1-37) and GLP-I-(7-37)], GLP-II, IP-II, and an amidated form of IP-II. No individually processed glucagon peptide was detected. GLP-I-(1-37), GLP-I-(7-37), GLP-II, IP II, and IP-II amide coeluted with their respective synthetic peptide standards on gel filtration and ion exchange chromatography. The existence of a single glucagon gene in the rat genome and indistinguishable glucagon mRNAs in pancreas and intestine indicates that the neoplastic transformation that occurred in these islet cells is associated with a phenotypic switch in the differential posttranslational processing of proglucagon to a pattern that mimics that found in the intestinal cells. These observations further support the hypothesis of a common progenitor for the intestinal (L) and islet (A) cells. PMID- 3536452 TI - Differential in vitro stimulation by naloxone and K+ of luteinizing hormone releasing hormone and catecholamine release from the hypothalami of intact and castrated rats. AB - We compared the effects of an opiate receptor antagonist, naloxone (NAL), on in vitro LHRH and catecholamine release from the medial basal hypothalamus-preoptic area (MBH-POA) of intact and castrated adult male rats. The MBH-POA (six per chamber) were perifused in vitro for 6 h. After 1 h of preincubation, basal LHRH, dopamine (DA), norepinephrine (NE), and epinephrine (E) release were estimated in perifusates collected during the second and third hours. During the fourth hour, chambers were perifused for 30 min with medium alone or medium containing NAL; tissue viability was confirmed during the sixth hour by adding 60 mM KCl to the medium. Tissue samples were weighed at the end of the perifusion and homogenized in 0.1 N HCl for subsequent analyses of LHRH contents. The basal release rate and cumulative hourly LHRH output from the MBH-POA of intact rats was about 3 times that from castrated rats (P less than 0.05). The NAL pulse stimulated LHRH release from the MBH-POA of intact and castrated rats (P less than 0.05); the amount released by the MBH-POA of intact rats was significantly higher than that from castrated rats (P less than 0.05). These differential LHRH release responses reflected the differences in the MBH-POA LHRH concentrations that normally occur between intact and castrated rats and also estimated at the end of the perifusion. In contrast to the LHRH response, the basal release rate and hourly output as well as NAL-induced DA release from the MBH-POA of intact and castrated rats were similar. On the other hand, as in the case of LHRH, basal NE release and hourly output from the MBH-POA of castrated rats were significantly reduced compared to those from the MBH-POA of intact rats (P less than 0.05). In addition, NAL promptly stimulated NE release, and the amount released was higher from the MBH-POA of intact rats (P less than 0.05). The basal amount of E released from the MBH-POA of intact and castrated rats was near or below the level of sensitivity of the assay. However, NAL increased E release from the MBH POA of both groups of rats, and E output was apparently 2-fold higher from the MBH-POA of intact than castrated rats. Prior perfusion with morphine failed to block NAL-evoked stimulation of LHRH release from the MBH-POA of intact rats.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536453 TI - Corticotropin-releasing factor in the dog adrenal medulla is secreted in response to hemorrhage. AB - To characterize the nature of CRF-like immunoreactivity (CRF-LI) in the dog adrenal, adrenal medullary, adrenal cortical, or hypothalamic tissue was extracted and subjected to RIA after partial purification on C-18 cartridges or Sephadex G-50. Using N- and C-terminal-directed antisera against rat/human (r/h) CRF, significant levels of CRF-LI were found in the adrenal medulla and hypothalamus, but not in the adrenal cortex. Immunocytochemical analysis revealed that CRF-immunoreactive cells were located in the adrenal medulla, many of them concentrated in the vicinity of blood vessels and at the border between adrenal medulla and cortex. However, the cortex was devoid of any CRF-positive cells. On reverse phase HPLC, CRF-LI in the adrenal medulla coeluted with synthetic r/hCRF. In a bioassay system, using dispersed rat anterior pituitary cells, purified adrenal CRF caused a dose-dependent increase in ACTH secretion parallel to the r/hCRF standard, indicating that dog adrenal medulla contains authentic r/hCRF. Evidence of CRF-LI secretion from the adrenal was supported by its presence in adrenal venous, but not in peripheral arterial, plasma. Adrenal venous plasma CRF LI coeluted with r/hCRF on reverse phase HPLC after affinity chromatographic purification. The CRF-LI secretory rate in conscious trained dogs was 68 +/- 19 pg/min (concentration, 27 +/- 5 pg/ml). In response to 20% hemorrhage, the CRF-LI secretion rate rose 3-fold within 15 min and was associated with increased catecholamine secretion. The existence of a biologically active CRF-like substance in the dog adrenal medulla and its secretion in conjunction with catecholamines after a hemorrhage suggest a physiological role for this peptide other than pituitary or central nervous system regulation. PMID- 3536455 TI - Characterization of purified rabbit uterine renin: influence of pregnancy on uterine inactive renin. AB - Using specific antibody raised against renal renin, we have documented that the majority of the uterine renin-like activity in gravid and nongravid uteri is immunoreactive renin. To characterize its physiochemical properties, we obtained highly purified uterine renin by two affinity chromatographic steps, pepstatin and antirenin. Uterine renin has a pH optimum of 6, an apparent mol wt of 38K, and a Km of 1.7 microM for homologous substrate. These properties are identical to those of renal renin and are not influenced by the pregnant state. In the basal state, an inactive form of the uterine enzyme constitute 55 +/- 10% of the total uterine renin. During pregnancy, active renin increased 40-fold as inactive renin fell to 4 +/- 3% of the total renin concentration. The renal renin concentration fell as plasma renin increased during pregnancy. These data suggest that the increased uterine renin concentrations during pregnancy are probably due to increased local production and conversion of renin precursor to the active enzyme. This stimulation of the uterine renin level appears to be independent of renal renin. PMID- 3536454 TI - Insulin-like growth factor I induces c-fos messenger ribonucleic acid in L6 rat skeletal muscle cells. AB - Insulin-like growth factor I (IGF-I) mediates growth promotion of GH on specific target cells. As other growth factor action has been associated with oncogene induction, we examined whether IGF-I activated cellular oncogenes in L6 rat muscle cells, known target cells of IGF-I stimulatory action. Quiescent cells were incubated in serum-free defined medium with IGF-I (Amgen recombinant analog, Thr59) from 5 min to 4 h. 32P-Labeled DNA was first prepared from IGF-I-treated cell poly(A) RNA using avian myeloblastosis virus reverse transcriptase. This labeled probe was hybridized against a blot containing 12 different immobilized oncogene DNAs. The v-fos DNA showed a positive hybridization signal, indicating the presence of c-fos mRNA sequences. Northern analysis with [32P]v-fos DNA revealed a major c-fos mRNA species (2.2 kilobases) induced by treatment of cells with IGF-I (100 ng/ml) or fetal calf serum (15%) for 45 min. We, therefore, measured c-fos induction by cytoplasmic RNA blot hybridization. IGF-I (6.25 ng/ml) stimulated c-fos mRNA 4-fold. Maximum stimulation (18-fold) was seen with 100 ng/ml IGF-I. Peak c-fos induction occurred after 30-min exposure to IGF-I and remained elevated for up to 2 h. Treatment of cells with a high dose of insulin (100 nM) also resulted in a modest (27%) increase in relative levels of c-fos mRNA. The results show that c-fos mRNA is induced by IGF-I in L6 cells. This novel observation suggests that IGF-I action at least in part may be mediated by c-fos, a cellular oncogene thought to play a critical role in cell differentiation and proliferation. PMID- 3536456 TI - Biphasic insulin response to high glucose and a role of protons and calcium. AB - In order to determine the role of protons and Ca++ in the biphasic insulin response to glucose, we studied the effect of monensin, a carboxylic ionophore, on the first phase and second phase of glucose-induced insulin release and Ca++ efflux from perifused rat pancreatic islets. The agent, 1-100 nM, dose dependently inhibited the insulin release from the islets incubated for 60 min in Krebs-Ringer bicarbonate buffer containing 16.7 mM glucose. Islet 14CO2 production rates from D-(U-14C)glucose were not affected by 10 or 100 nM monensin. Perifusion of the islets prelabeled with 45Ca++ demonstrated that 100 nM monensin had only a slight inhibitory effect on the first phase insulin response to 16.7 mM glucose and no effect on 45Ca++ efflux. This agent inhibited the second phase insulin release and depressed 45Ca++ efflux. When monensin was added at the start of the second phase release, the release was inhibited. When exposed to the agent before the stimulation by glucose, the first phase insulin release was observed, albeit significantly decreased, and the start of the insulin release and 45Ca++ efflux was delayed. The agent, added 30 min after the change to high glucose, immediately inhibited the insulin release. Thus, the first phase insulin release is mediated mainly through a mechanism which is not related to protons generated from glucose metabolism. Protons may be a crucial coupling factor in the second phase insulin release. PMID- 3536458 TI - [Prof. Roman Jozef Rembiesa (1927-1985)]. PMID- 3536457 TI - Regulation of androgen metabolism and luteinizing hormone-releasing hormone content in discrete hypothalamic and limbic areas of male rhesus macaques. AB - The conversion of androgens to active metabolites by neural tissue is believed to be an essential component in the cellular mechanism of androgen-induced neuroendocrine responses. In this study, we measured the in vitro aromatization and 5 alpha-reduction of androgens in incubations of microdissected brain regions from four intact and five castrated (6 weeks) adult male rhesus monkeys. Individual nuclei were microdissected from 600-microns frozen brain sections and homogenized in a potassium phosphate buffer. Aromatase activity was measured by a radiometric assay that uses the incorporation of tritium from [1 beta 3H]androstenedione into 3H2O as an index of estrogen formation. We estimated 5 alpha-reductase activity by isolating 5 alpha-dihydrotestosterone on two different chromatography systems and measuring the amount of this product formed from [1 alpha,2 alpha-3H]testosterone. We acidified a portion of each homogenate and determined LHRH content by RIA. Between brain nuclei, aromatase activity varied 1500-fold, whereas 5 alpha-reductase activity varied only 3-fold. Both enzyme activities were highest in amygdaloid, medial preoptic, and medial diencephalic nuclei and lowest in the caudate nucleus. Aromatase activities in the supraoptic nucleus, periventricular area, medial preoptic area-anterior hypothalamus, and lateral hypothalamus were significantly (P less than 0.05) lower in castrated males. Castration did not significantly affect 5 alpha reductase activity, except for an increase in the basolateral amygdala. The highest concentrations of LHRH were in the infundibular nucleus-median eminence and were 30 times greater than amounts measured in preoptic and medial hypothalamic nuclei. The LHRH contents of the infundibular nucleus-median eminence, ventral medial nucleus, and lateral hypothalamus were significantly lower in castrated males (P less than 0.05). In addition, we observed a significant correlation between aromatase activity and LHRH content in the basal hypothalamus of intact males (r = 0.947; P less than 0.05; n = 8), but not in the preoptic-anterior hypothalamus (r = 0.068; P greater than 0.05; n = 10). No correlation was observed between 5 alpha-reductase activity and LHRH content in either area. These data indicate that castration selectively affects androgen metabolism and LHRH content in discrete regions of the brain of male monkeys and suggest that aromatase and 5 alpha-reductase are regulated differentially in the primate brain. PMID- 3536459 TI - A simplified technique for rapid immunofluorescent assessment of cellular hormonal content. AB - Currently applied techniques for immunofluorescent staining of cultured cells are time consuming and not amenable to experimental design. Monolayers of rat anterior pituitary cells were stained in situ with rabbit follicle-stimulating hormone antiserum. Excision of the culture surfaces produced samples that were easy to handle and score for immunoreactivity without sacrificing resolution. The staining of in situ monolayers of cultured cells allows for assessment of both the secretory behavior and the hormonal content of the cells. PMID- 3536460 TI - Normal and pathological remodeling of human trabecular bone: three dimensional reconstruction of the remodeling sequence in normals and in metabolic bone disease. PMID- 3536461 TI - Ketoconazole and other imidazole derivatives as inhibitors of steroidogenesis. PMID- 3536462 TI - Antimullerian hormone: new perspectives for a sexist molecule. PMID- 3536463 TI - Role of vitamin D in skeletal muscle function. PMID- 3536465 TI - Fibrotic reactions in the lung: the activation of the lung fibroblast. PMID- 3536466 TI - Characterization of rat alveolar type II cells in vitro by immunological, biochemical, and morphological criteria. AB - Using an anti-rat surfactant apoprotein antiserum which specifically reacts with cytoplasmic structures in alveolar type II cells on histopathology sections of rat lung, we have examined the immunoreactivity of pulmonary type II cells in vitro. Single cell suspensions of lung tissue were prepared from male Fischer 344 rats by intratracheal elastase digestion according to standard published methods. Cytocentrifuged preparations of the resulting cell suspensions revealed that approximately 40% of the cells stained positive for surfactant apoprotein using an immunoperoxidase staining technique. Without further cell fractionation steps, the cell suspensions were plated at colonial densities in growth medium. The cells that attached after 24 hours of incubation and at daily intervals were analyzed for surfactant apoprotein immunoreactivity as well as for proliferation, morphology, and phospholipid biosynthesis. The percentage of immunopositive cells increased with time from 75% at day 1 to 94% at 4 days after plating. This increase was paralleled by a linear increase in the number of immunopositive cells, which expanded into cell colonies. During the initial 5 days in vitro, the immunopositive cells retained their epithelial morphology and contained cytoplasmic osmiophilic bodies. Phospholipid biosynthesis by the isolated lung cells was analyzed and the data revealed that the rate of incorporation of 14C choline into phosphatidylcholine increased with time in culture. These studies indicated that the anti-rat surfactant apoprotein antisera can be used to identify and quantitate functional alveolar type II cells in vitro. Thus the specific antisera may facilitate studies of type II cells undergoing various environmental alterations both in vivo and in vitro. PMID- 3536464 TI - Arginine vasopressin (AVP) and AVP-like immunoreactivity in peripheral tissues. PMID- 3536468 TI - Effect of long-term anticonvulsant therapy on glucose metabolism in humans. AB - This study was undertaken to evaluate the effect of anticonvulsants on glucose metabolism in humans. Tissue sensitivity to insulin (euglycemic clamp technique) and liver microsomal enzyme activity (oral antipyrine test) were measured in six subjects with epilepsy plus type 1 diabetes mellitus. They had received anticonvulsant drugs for greater than 8 years. Three groups--type 1 diabetics, persons with epilepsy, and healthy subjects--matched for sex, and weight, served as controls. Glucose disposal rate (M) was faster in subjects on anticonvulsant therapy as compared with the corresponding control group (p less than 0.01) and in nondiabetics as compared with diabetics (p less than 0.001). Antipyrine metabolism was rapid among patients on anticonvulsants and high normal in diabetics. Liver microsomal enzyme activity and glucose metabolism were related among diabetic (r = 0.593) and nondiabetic (r = 0.649) groups, respectively. Anticonvulsants with liver microsomal enzyme-inducing properties appear to enhance insulin sensitivity. These findings may serve to understand the long-term effect of anticonvulsants on glucose metabolism in humans. PMID- 3536469 TI - Vigabatrin in the treatment of epilepsy: a double-blind, placebo-controlled study. AB - The efficacy and tolerability of vigabatrin (gamma-vinyl GABA, GVG), given as add on therapy to 23 adult outpatients with severe drug-resistant epilepsy (17 with partial seizures), were studied using a double-blind, placebo-controlled, crossover design. The study consisted of two 7-week periods during which vigabatrin and placebo were administered in random sequence. Dosage was 1.0 g twice daily for patients weighing less than or equal to 65 kg and 1.5 g twice daily for patients weighing greater than 65 kg. Three patients were dropped from the study, two for reasons unrelated to treatment and one because of the appearance of vertigo, headache, dysarthria, and ataxia, which subsided rapidly when vigabatrin was stopped (3 g daily). Sixteen of the 20 patients available for analysis showed a decrease in the total number of seizures as compared with the placebo period. Of these, 12 showed a greater than 50% reduction in seizure frequency and 4 of the 12 showed a greater than 75% reduction. Both the total number of seizures and the number of partial seizures were significantly reduced by vigabatrin (p less than 0.01). Only in the patient who dropped out were severe adverse effects seen. The most frequently reported unwanted effect was mild drowsiness, which developed in seven patients on vigabatrin and in one on placebo. Positive effects, however, were also seen with six patients who reported an improved sense of well-being while receiving vigabatrin as compared with only 1 during the placebo period. No consistent changes in electrocardiogram (ECG), electroencephalogram (EEG), and visual-, auditory-, and somatosensory-evoked potentials were seen during the study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536467 TI - Identification of a teratogenic drug-protein complex in sera of phenytoin-treated monkeys. AB - Whole rat embryos were cultured for 48 h on sera drawn from monkeys before and 10 h after phenytoin gavage (275 mg/kg body weight). Sera from treated monkeys caused exencephaly, anophthalmia, microcephaly, and incomplete ventral curvature when used as culture media, whereas sera drawn from the same monkeys before treatment supported normal embryonic development. To identify the cause of serum teratogenicity, isolated constituents of teratogenic sera were added to nonteratogenic sera for testing by embryo culture. Serum extracts containing free phenytoin and its free metabolites were not teratogenic. Teratogenicity was found associated with serum proteins. Using polyacrylamide gel electrophoresis (PAGE) and an antibody that recognized phenytoin and its metabolites, we were able to demonstrate that phenytoin was bound to a protein of 80,000 daltons. Addition of this same antibody to teratogenic sera from dosed monkeys improved the development of cultured embryos and provided additional support for this complex as the proximal teratogen. Use of the antibody to follow the uptake and distribution of phenytoin in cultured embryos suggested that only the phenytoin protein complex (and not phenytoin itself) was able to pass through the yolk sac and reach the tissues of the embryo proper. These results suggested that a drug protein complex may serve to transport drugs from their site of activation in the maternal liver to the developing embryo. PMID- 3536470 TI - Effects of excision repair and plasmid pKM101 on mutagenic and cytotoxic potencies of anthracycline derivatives in test strains of Salmonella typhimurium. AB - The effects of excision repair and presence of plasmid pKM101 on the mutagenicities and cytotoxicities of the anthracycline derivatives Adriamycin, daunomycin, carminomycin, and 4-demethoxydoxorubicin were examined in strains of Salmonella typhimurium. Plasmid pKM101 has been shown to mediate inducible error prone repair in S. typhimurium. While the test compounds were shown to produce a range of mutational responses in excision repair defective (uvrB-), pKM101 bearing strains of different his- backgrounds, proficiency in excision repair generally resulted in the elimination of mutagenic responses in all such strains except those that contain the hisG428 site. In the absence of pKM101, only hisD3052 uvrB- strain TA1538 was shown to be sensitive to anthracycline mutagenicity. A suspension (preincubation) test as well as a direct plating test showed that while proficiency in either excision repair (uvr+) or plasmid pKM101 error-prone repair afforded cellular protection against anthracycline cytotoxicity, plasmid-free uvrB- strains were most sensitive to anthracycline cytotoxicity. PMID- 3536472 TI - Allogeneic transplantation of normal epidermal cells and squamous cell carcinomas in SENCAR mice. AB - A method used in our laboratory for the transplantation of single cell suspensions of epidermis and skin carcinomas is described. Silicone chambers were placed into a subcutaneous granulation tissue formed by the implantation of a glass disk. The skin was closed on top of the chamber by using Michael autoclips. Cells were injected 24 to 48 hr later through the skin using a syringe and needle. The neoformation of epithelia with adnexa was observed when newborn epidermal cells were injected. When a fresh cell suspension of squamous cell carcinoma was used, a typical differentiated carcinoma was formed within 2 to 4 weeks. However, after 4 weeks, some of the grafts showed mild signs of rejection. The technique described is a useful system to transplant squamous cell carcinomas and can also be used as a rapid assay for malignancy. PMID- 3536471 TI - Mutagenicity of N-substituted phenanthrene 9,10-imines in Salmonella typhimurium and Chinese hamster V79 cells. AB - We previously showed that some (nonsubstituted) aziridines derived from polycyclic aromatic hydrocarbons (arene imines) elicit various mutagenic and genotoxic effects in bacteria and mammalian cells and that these arene imines are active at much lower concentrations than the corresponding epoxide analogues. In the present study, N-substituted derivatives of phenanthrene 9,10-imine were investigated. All 10 derivatives studied showed direct mutagenicity in Salmonella typhimurium TA100. Some of the compounds additionally exhibited weak effects in the strains TA98 and TA1537. Most N-substituted derivatives were weaker mutagens than unsubstituted phenanthrene 9,10-imine but stronger mutagens than phenanthrene 9,10-oxide. Bulky substituents reduced the mutagenicity more than did small substituents. In addition, the derivatives with electron-withdrawing substituents (with the exception of N-chlorophenanthrene 9,10-imine) were weaker mutagens than those with electron-donating substituents. Phenanthrene 9,10-imine and five N-substituted derivatives were investigated to determine whether they induce gene mutations at the hgprt locus in V79 cells. Four compounds, including the parent aziridine, were positive in the V79 test. The other two compounds were negative. The mutagenic potencies in the V79 cell system did not correlate well with those obtained with the Salmonella system. Overall, the study shows that in addition to unsubstituted arene imines, N-substituted derivatives are mutagenic. This finding is of interest, as metabolic pathways leading from aromatic compounds to N-substituted arene imines are conceivable. PMID- 3536473 TI - Brain tumors in man and animals: report of a workshop. AB - This report summarizes the results of a workshop on brain tumors in man and animals. Animals, especially rodents are often used as surrogates for man to detect chemicals that have the potential to induce brain tumors in man. Therefore, the workshop was focused mainly on brain tumors in the F344 rat and B6C3F1 mouse because of the frequent use of these strains in long-term carcinogenesis studies. Over 100 brain tumors in F344 rats and more than 50 brain tumors in B6C3F1 mice were reviewed and compared to tumors found in man and domestic or companion animals. In the F344 rat, spontaneous brain tumors are uncommon, most are of glial origin, and the highly undifferentiated glioblastoma multiforme, a frequent tumor of man was not found. In the B6C3F1 mouse, brain tumors are exceedingly rare. Lipomas of the choroid plexus and meningiomas together account for more than 50% of the tumors found. Both rodent strains examined have low background rates and very little variability between control groups. PMID- 3536474 TI - Some aspects of the problem of individual predisposition to silicosis. AB - Based on experimental and epidemiological data findings presented here, as well as on data of other investigators, the authors conclude that a wide interindividual variability of susceptibility to silicosis is a real phenomenon. This susceptibility depends on both intrinsic features of the host and the influence of many environmental factors. The effect of any such factor is realized at different stages of silicosis pathogenesis and in close interrelation with the influence of other factors. The necessity of multifactorial analysis is stressed, and an example of such analysis is presented. PMID- 3536476 TI - Impaired acquired resistance of mice to Klebsiella pneumoniae infection induced by acute NO2 exposure. AB - The natural resistance of nonimmunized C57Bl/6 mice to an intraperitoneal Klebsiella pneumoniae challenge was not significantly affected by prior continuous exposure to 20 ppm NO2 for 4 days. In contrast, the acquired resistance of mice immunized just before and infected just after NO2 exposure was seriously impaired. This could not be explained by the loss of appetite (about 30%) observed in NO2 treated mice, for neither the natural nor acquired resistance of control air exposed mice given approximately 70% ad libitum food and water were significantly modified. PMID- 3536477 TI - Physiological effects of intermittently illuminated textual displays. PMID- 3536475 TI - Methylmercury in fish: a review of residue levels, fish consumption and regulatory action in the United States. AB - The dangers associated with the consumption of large amounts of methylmercury in fish are well recognized, and there is some evidence to suggest that methylmercury may be the cause of subtle neurological impairments when ingested at even low to moderate levels, particularly the prenatal and early childhood periods. This concern has prompted a continuing assessment of the risk of methylmercury toxicity among fish consumers in the United States as well as other countries. The toxicokinetics of methylmercury in humans are reviewed and used to estimate body burdens associated with toxic effects. To determine seafood consumption patterns among the continental U.S. population the Food and Drug Administration (FDA) has analyzed data from a diary study commissioned by the Tuna Research Foundation. Mercury residue levels in domestic fish sampled by the FDA were used to determine the level of exposure to methylmercury. Until evidence is presented that substantially lowers the known body burden of methylmercury which causes toxicity, calculations indicate that the current 1.0 ppm regulatory level provides adequate protection for the average fish consumer, for young children, and for a significant number of consumers exceeding the acceptable daily intake. However, additional studies are being carried out in a continuing process to ensure that safe levels of prenatal exposure to mercury residues in fish are maintained. PMID- 3536478 TI - Tetanus toxin: primary structure, expression in E. coli, and homology with botulinum toxins. AB - A pool of synthetic oligonucleotides was used to identify the gene encoding tetanus toxin on a 75-kbp plasmid from a toxigenic non-sporulating strain of Clostridium tetani. The nucleotide sequence contained a single open reading frame coding for 1315 amino acids corresponding to a polypeptide with a mol. wt of 150,700. In the mature toxin molecule, proline (2) and serine (458) formed the N termini of the 52,288 mol. wt light chain and the 98,300 mol. wt heavy chain, respectively. Cysteine (467) was involved in the disulfide linkage between the two subchains. The amino acid sequences of the tetanus toxin revealed striking homologies with the partial amino acid sequences of botulinum toxins A, B, and E, indicating that the neurotoxins from C. tetani and C. botulinum are derived from a common ancestral gene. Overlapping peptides together covering the entire tetanus toxin molecule were synthesized in Escherichia coli and identified by monoclonal antibodies. The promoter of the toxin gene was localized in a region extending 322 bp upstream from the ATG codon and was shown to be functional in E. coli. PMID- 3536479 TI - Identification of centrosomal proteins in a human lymphoblastic cell line. AB - Highly enriched preparations of centrosomes from human T-lymphoblasts KE 37 were analyzed for their protein content. The specific pattern of polypeptides was characterized by an abundant subset of high mol. wt proteins and a major group of proteins with mol. wt ranging from 50 to 65 kd. Several immunoreactive proteins were identified, using a rabbit serum spontaneously reacting with human centrosomes. They include a family of high mol. wt ranging from 180 to 250 kd, a 130-kd protein and a 60-65 kd doublet. These antigens have the following properties: they are localized within the pericentriolar material; their abundance, as judged by centrosome labelling, changes significantly during the cell cycle, the maximum being observed at the pole of the metaphasic spindle; in Taxol-treated cells where the centrosome is no longer acting as a nucleating center, they redistribute at one end of the microtubule arrays in both mitotic and interphasic cells, as expected for nucleating, or capping, proteins. All these properties are compatible with their involvement in microtubule nucleation. PMID- 3536480 TI - Engrailed gene expression in Drosophila imaginal discs. AB - Genetic and molecular analyses indicate that the Drosophila engrailed gene is required to distinguish posterior from anterior compartments in each segment of the developing animal. Here, the patterns of engrailed expression in the imaginal discs and ventral ganglion of Drosophila larvae are examined, using an antiserum against the engrailed protein and a novel image processing method to reduce non specific background. As expected, engrailed expression generally is restricted to cells in the posterior compartment of the discs, and the patterns of expression allow refinements in the fate maps of the discs to be made. More significant is the finding that expression of the gene is highly variable in different regions of posterior compartments, suggesting that engrailed may do more than simply specify 'posteriorness'. In the ventral ganglion engrailed appears to be expressed by a subset of cells, primarily in the posterior regions of each segment. In wing discs from animals that are homozygous for the en1 mutation, the pattern of expression of the gene is altered, as opposed to being simply reduced uniformly in the posterior cells. PMID- 3536481 TI - Removal of positioned nucleosomes from the yeast PHO5 promoter upon PHO5 induction releases additional upstream activating DNA elements. AB - The chromatin fine structure in the promoter region of PHO5, the structural gene for a strongly regulated acid phosphatase in yeast, was analyzed. An upstream activating sequence 367 bp away from the start of the coding sequence that is essential for gene induction was found to reside in the center of a hypersensitive region under conditions of PHO5 repression. Under these conditions three related elements at positions -469, -245 and -185 are contained within precisely positioned nucleosomes located on both sides of the hypersensitive region. Upon PHO5 induction the chromatin structure of the promoter undergoes a defined transition, in the course of which two nucleosomes upstream and two nucleosomes downstream of the hypersensitive site are selectively removed. In this way approximately 600 bp upstream of the PHO5 coding sequence become highly accessible and all four elements are free to interact with putative regulatory proteins. These findings suggest a mechanism by which the chromatin structure participates in the functioning of a regulated promoter. PMID- 3536482 TI - KIN28, a yeast split gene coding for a putative protein kinase homologous to CDC28. AB - We have isolated, in yeast, a nuclear gene named KIN28 which presents significant sequence homology with the cell-division-cycle CDC28 gene, with members of the protein-tyrosine kinase family (src, erb, abl, epidermal growth factor, etc.) and those of the family of protein kinases phosphorylating serine and threonine. This strongly suggests that KIN28 is endowed with a protein kinase activity. In contrast with CDC28, KIN28 is interrupted by an intervening sequence. The KIN28 gene failed to complement cdc28 mutations and was shown to be essential for cell proliferation. PMID- 3536484 TI - Transport of horseradish peroxidase from the cell surface to the Golgi in insulin secreting cells: preferential labelling of cisternae located in an intermediate position in the stack. AB - We have used serial sectioning to study the topology of Golgi cisternae in insulin-secreting cells during secretion-stimulated endocytotic uptake of exogenous horseradish peroxidase (HRP). HRP-labelled cisternae were followed on several series of consecutive sections. This revealed that labelled cisternae could always be traced to a position in the Golgi stack intermediate between the cis and the trans poles. This occurred in spite of the apparent cis or trans locations of HRP-containing cisternae on some sections. The latter images could be explained by the lack of the true cis or trans (clathrin-coated) cisternae at certain levels of the stack. PMID- 3536483 TI - The mom gene of bacteriophage Mu: the mechanism of methylation-dependent expression. AB - Transcription of the DNA modification gene (mom) of bacteriophage Mu requires methylation of three GATC sites upstream of the mom promoter by the Escherichia coli deoxyadenosine methylation function (Dam). The three sites map within a 40 bp segment termed region I. Small deletions, inversions, duplications and specific point mutations have been introduced in region I. Their effect on mom expression has been studied in dam+ and dam strains. Dam-dependent expression of the mom gene requires a specific arrangement of the three GATC sites and the presence of the methylated base in at least two of the three sites. We show that mom specific modification is regulated by a host protein. The Mom function is expressed in dam strains if they are defective in one component of the methylation-instructed mismatch correction system, mutH. We suggest that the product of mutH functions as a transcriptional repressor by binding to region I. PMID- 3536485 TI - Different oligosaccharide processing of the membrane-integrated and the secretory form of gp 80 in rat liver. AB - Rat liver synthesizes a glycoprotein with Mr of 80.000 (gp 80) which is partly inserted into the plasma membrane and partly secreted into the serum. The membrane-integrated and the secretory form of this glycoprotein have an identical peptide pattern, but different N-linked glycans. Whereas gp 80 from the serum is glycosylated with complex-type oligosaccharides, gp 80 from the plasma membrane has high mannose glycans. Phase separation with Triton X-114 showed that membrane integrated gp 80 contains hydrophobic portions, whereas secretory gp 80 has hydrophilic properties. Intracellular transport and oligosaccharide processing of gp 80 were studied in vivo in the endoplasmic reticulum, the Golgi apparatus and plasma membranes of rat liver and in serum using pulse-chase labeling with L [35S]methionine and immunoprecipitation. Peak labeling of gp 80 was reached in the endoplasmic reticulum 10 min after the pulse, in the Golgi apparatus 20 min later, and in the plasma membrane after 2 h; in the serum the specific radioactivity was steadily increasing during the experiment. Gp 80 of the endoplasmic reticulum was completely sensitive to endo-beta-N-glucosaminidase H (endo H), but simultaneously occurred in the Golgi apparatus in an endo H sensitive and endo H-resistant form. The endo H-sensitive form was transported to the plasma membrane, the endo H-resistant species secreted into the serum. Conversion from the endo H-sensitive to the endo H-resistant form was completed within 10 min after transfer of gp 80 to the Golgi apparatus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536488 TI - Cerebral malaria? Be on the look-out! PMID- 3536486 TI - Identification in chicken macrophages of a set of proteins related to, but distinct from, the chicken cellular c-ets-encoded protein p54c-ets. AB - Using an antiserum to a bacterially expressed polypeptide corresponding to 56 amino acids of v-ets, we previously identified in chicken tissues a protein of 54 kd (p54c-ets) which shares extensive sequence homology to the v-ets-encoded domain of the E26-transforming protein p135gag-myb-ets and is thus apparently encoded by the c-ets proto-oncogene. We report here that the anti-ets serum specifically identifies in chicken cells a second set of proteins of 60 kd (p60), 62 kd (p62) and 64 kd (p64) which appear to be highly related to each other but display only a limited domain of homology with p54c-ets and p135gag-myb-ets and are thus probably encoded by a gene(s) partially related to, but different from c ets. In contrast to p54c-ets which is expressed at high levels in chicken lymphoid tissues, prominent syntheses of p62 and p64 were found in both normal and transformed chicken macrophages but not in avian cells corresponding to immature stages of the myeloid differentiation pathway. These observations together with the fact that differentiation of avian myeloblastosis virus transformed myeloblasts into macrophage-like cells after treatment with 12-O tetradecanoylphorbol-13-acetate is accompanied by the synthesis of p62 and p64 suggest a role for these proteins in chicken macrophage differentiation or function. Induction of differentiation of human leukemia cell lines HL60 and U937 into macrophages is also accompanied by the increased synthesis of c-ets-encoded 68 kd, 62 kd and 58 kd proteins. PMID- 3536487 TI - The C terminus of penicillin-binding protein 5 is essential for localisation to the E. coli inner membrane. AB - Penicillin-binding protein 5 (PBP5) has been previously identified as a component of the inner membrane of Escherichia coli and we present here further evidence that PBP5 is tightly bound to the membrane. To investigate the regions of PBP5 involved in membrane binding we have constructed a series of C-terminal deletions and shown that the removal of as few as 10 amino acids results in the release of the truncated protein into the periplasm. The C terminus, therefore, appears to be important for interaction with the membrane; however, inspection of the amino acid sequence does not reveal extended runs of hydrophobicity typical of a membrane anchor. Thus we conclude that PBP5 is anchored to the inner membrane by a mechanism not previously described. PMID- 3536489 TI - The influence of cyclizine and perphenazine on the emetic effect of meptazinol. AB - The effectiveness of 50 mg cyclizine and 2.5 mg perphenazine against the emetic sequelae of 100 mg meptazinol were studied in a randomized double-blind placebo controlled trial. Three groups of 40 women received the opioid, together with an anti-emetic by i.m. injection, as premedication prior to minor gynaecological surgery. Beneficial or noxious effects were noted at standard time intervals and anaesthesia standardized as incremental methohexitone with nitrous oxide/oxygen. In the placebo group, 33 out of 40 subjects experienced either nausea or vomiting at some time after the opioid. Cyclizine, 50 mg, provided significant reduction of emetic tendency in both pre-operative and post-operative phases of the study with 22 out of 40 subjects experiencing nausea or vomiting overall. Perphenazine, 2.5 mg, showed no useful anti-emetic effect. Both anti-emetics increased the soporific effect of premedication at the 90-min interval. Subjects receiving perphenazine experienced significantly more dizziness than those of other groups. PMID- 3536491 TI - An attempt to develop a model to study the effects of intrathecal steroids. AB - An attempt has been made to develop a chronic inflammatory arachnoiditis model in the rat to study the influence of subarachnoid or epidural steroids. Through chronically implanted catheters in Wistar rats (250-350 g), either triamcinolone (3.5-350 micrograms) or methylprednisolone (3.5-350 micrograms) was injected intrathecally, daily for 7 days or weekly for 7 weeks. Some rats also received 100 mg kg-1 cefoxitin and 0.5 mg deoxycortone by intramuscular injection. Equivalent control groups were included. High doses of intrathecal steroids caused marked weight loss and infection and many rats died. These effects were mitigated at a lower dosage especially by the addition of cefoxitin and deoxycortone. The effects of triamcinolone were more marked than those of methylprednisolone. No systematic histological evidence of neurotoxicity was observed after either steroid. Injections of talc failed to cause arachnoiditis or meningitis probably because sufficient particulate talc could not be injected through the narrow catheter. PMID- 3536490 TI - The effect of labetalol on urinary prostacyclin secretion during surgery. AB - The effects of labetalol on the secretion of prostacyclin and plasma-renin activity (PRA) were evaluated, relative to a control group in 24 patients undergoing hip osteotomy. They were randomly assigned to two groups (G-I and G II) with 12 patients each. Patients allocated to both groups received standard anaesthesia (thiopentone, pancuronium, fentanyl and nitrous oxide). Patients belonging to Group II were given labetalol at a dose of 0.8 mg kg-1. The stable metabolite of PGI2, 6-keto-PGF1 alpha was quantified from urine samples by radioimmunoassay (RIA). Cortisol, PRA and aldosterone were determined from blood samples. A significant increase in 6-keto-PGF1 alpha elimination was observed in G-I. Labetalol administration partially but significantly inhibited this increase. We believe that prostacyclin is involved not through the beta 1 but through the alpha 1 receptors in the secretion of renin. PMID- 3536492 TI - Pharmacological models and their use in clinical anaesthesia. AB - Intravenous agents used in anaesthesia belong to a variety of chemical classes and cover a number of different pharmacodynamic responses. Compared to inhalational anaesthesia the combined administration of intravenous agents offers a greater degree of freedom because different pharmacodynamic effects can be controlled separately. This greater degree of freedom, however, requires a more detailed insight into the pharmacology of the drugs to allow control of drug administration and to meet the therapeutic optimum. This review considers the combination of pharmacokinetics and pharmacodynamics as a pharmacological model. The general principles of these two subunits relevant for dosing of intravenous agents are reviewed. In establishing a model of the non-linear system relating dosing to effect, pharmacokinetics introduces an intermediate step which describes the time course of drug concentrations as a function of dosing. It is thought that incorporating the entire dependence of the effect upon time is, in most cases, linear. Pharmacodynamics relate concentration to effect in a non linear but time-independent manner. It embodies the entire non-linearity of the system, but is assumed to be a static relation. Special attention is given to those principles which apply to any intravenous agent irrespective of its particularities. The impact of distribution and elimination, hysteresis, and ceiling on the induction, maintenance and recovery of anaesthesia, and on improving anaesthesia techniques and drug delivery are considered. PMID- 3536493 TI - Maintenance of unstable kidney donors. AB - Cerebral death is often associated with haemodynamic changes which include a decrease in cardiac output and peripheral resistance. Brain-death following head injury may also lead to acquired diabetes insipidus with secondary water and electrolyte derangement. It is therefore necessary to prevent and correct these alterations, particularly when long-term maintenance is required, in order to keep kidney function within the normal range. Computerized monitoring of renal function and electrolyte and water derangements has been adopted. In all cases where early data of renal failure or oliguria were present infusions of dopamine and fluids were started. When indicated, the optimal dose of dopamine was calculated using a computerized system to allow drug dosages and the time of haemodynamic derangement to be minimized. When acquired central diabetes insipidus was present and urine output greater than 4 ml kg-1 h-1 desamino-cis-D arginine vasopressin (DDAVP) was administered. PMID- 3536494 TI - The low pressure system: the integrated function of veins. PMID- 3536495 TI - Comparison of the effects of pre-exercise feeding of glucose, glycerol and placebo on endurance and fuel homeostasis in man. AB - Six men were studied during exercise to exhaustion on a cycle ergometer at 73% of VO2max following ingestion of glycerol, glucose or placebo. Five of the subjects exercised for longer on the glucose trial compared to the placebo trial (p less than 0.1; 108.8 vs 95.9 min). Exercise time to exhaustion on the glucose trial was longer (p less than 0.01) than on the glycerol trial (86.0 min). No difference in performance was found between the glycerol and placebo trials. The ingestion of glucose (lg X kg-1 body weight) 45 min before exercise produced a 50% rise in blood glucose and a 3-fold rise in plasma insulin at zero min of exercise. Total carbohydrate oxidation was increased by 26% compared to placebo and none of the subjects exhibited a fall in blood glucose below 4 mmol X 1-1 during the exercise. The ingestion of glycerol (lg X kg-1 body weight) 45 min before exercise produced a 340-fold increase in blood glycerol concentration at zero min of exercise, but did not affect resting blood glucose or plasma insulin levels; blood glucose levels were up to 14% higher (p less than 0.05) in the later stages of exercise and at exhaustion compared to the placebo or glucose trials. Both glycerol and glucose feedings lowered the magnitude of the rise in plasma FFA during exercise compared to placebo. Levels of blood lactate and alanine during exercise were not different on the 3 dietary treatments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536496 TI - Current controversies in the detection of septicemia. PMID- 3536497 TI - Treatment of bacterial meningitis. AB - Bacterial meningitis remains a life-threatening infection at any age, and prompt, adequate treatment is of great prognostic importance. Due to the special features of the meninges as a site of infection, many problems are associated with antimicrobial therapy. Approximately 80% of the patients with bacterial meningitis belong to the pediatric age group, and the three principal pathogens are Haemophilus influenzae type b, Neisseria meningitidis and Streptococcus pneumoniae. The diagnostic requirements essential for satisfactory management are defined and the antibiotic therapy of meningitis is discussed in detail. Data obtained from both experimental and clinical meningitis are indicative that a minimum bactericidal titre of 1:10 should be achieved in the cerebrospinal fluid for optimal therapeutic results. Recommendations are given for specific antimicrobial treatment according to patient's age and causative organism, as well as guidelines for further lumbar punctures, duration of therapy and prophylaxis, with emphasis on the important role of the newer cephalosporin compounds in treatment of meningitis. PMID- 3536498 TI - Susceptibility of group B and group G streptococci to newer antimicrobial agents. PMID- 3536499 TI - Widal-type serology using live antigen for diagnosis of Shigella flexneri dysentery. PMID- 3536500 TI - Antimicrobial chemotherapy of chlamydial infection: where next? PMID- 3536502 TI - Comparison of two enzyme immunoassays and an immunofluorescence test for detection of Chlamydia trachomatis. AB - Three rapid methods for the detection of Chlamydia trachomatis were compared: one immunofluorescence test and two enzyme immunoassays. Cervical and urethral specimens were obtained from 75 women in an outpatient clinic for therapeutic abortions and from 50 women in a sexually transmitted disease clinic. Urethral specimens were also obtained from 154 men in the same clinic. One hundred and nineteen cervical and 272 urethral specimens of a total 391 specimens were tested by the three methods. The direct immunofluorescence test detected Chlamydia trachomatis in 8% and the two enzyme immunoassays in 10% and 12% of the patients. The sensitivity of the immunofluorescence test was 76% compared to 91% and 80% for the two enzyme immunoassay tests. All three tests had a specificity of 99%. Dilution experiments confirmed that one immunoassay test, Chlamydiazyme, detected most of the positive specimens. The rapid and easily automated enzyme immunoassays are a valuable complement to the culture technique. PMID- 3536501 TI - Comparison of a fluorescent monoclonal antibody assay and a tissue culture assay for routine detection of infections caused by Chlamydia trachomatis. AB - The applicability of a commercial direct immunofluorescent monoclonal antibody assay for detection of Chlamydia trachomatis elementary bodies was studied on endocervical smears from 506 women attending a venereal disease clinic. The aim of this prospective examination was to simulate a daily routine. The results were compared to those of a well-functioning tissue culture assay. The overall positivity was 22.7%. Based on a positivity criterion of greater than or equal to 1 elementary body in the fluorescent antibody assay, the two assays agreed in 84.8% of the cases. In 50 specimens the antibody assay was positive and the culture assay negative, whereas in 23 the culture assay was positive and the antibody assay negative. The positive predictive value was 63.8%. Most of the discrepancies were found in specimens containing few elementary bodies or inclusions. Based on a criterion of greater than or equal to 10 elementary bodies, the positive predictive value was 70.9%, but the sensitivity fell to 67.5%. PMID- 3536503 TI - Diagnosis of genital Chlamydia trachomatis infection in males by cell culture and antigen detection test. AB - Urethral Chlamydia trachomatis infection was diagnosed in 204 of 1,011 (20.2%) male patients by cell culture, in 219 (21.7%) by an antigen detection test consisting of a solid phase immunoassay, and in 247 (24.4%) patients by both methods combined. The positive results of the two methods agreed for 176 patients, and both positive and negative results of the tests agreed for 940 patients (93%). With cell culture as the reference method, the antigen detection test had a sensitivity of 86.3%, a specificity of 94.7%, a positive predictive value of 80.4% and a negative predictive value of 96.5%. It gave false negative results in 28 patients. In 43 patients the antigen detection test gave a positive result, whereas culture was negative. Thirty-nine of these males were treated with antibiotics (tetracycline or erythromycin), 19 because their consorts had a proven Chlamydia trachomatis infection, and 20 for obvious clinical and/or microscopic findings of urethritis requiring treatment. According to this analysis there were 19 probable misses by cell culture test and four true false positives by the antigen detection test, i.e. less than 0.4% of all patients examined. Since one-third of males with a final diagnosis of Chlamydia trachomatis infection were clinically asymptomatic efforts to control genital chlamydial infections must identify this reservoir. The antigen detection test provides an alternative diagnostic method to the more laborious and time consuming cell culture procedure. PMID- 3536504 TI - Comparison of cell culture with two direct Chlamydia tests using immunofluorescence or enzyme-linked immunosorbent assay. AB - Two direct tests for diagnosis of infection due to Chlamydia trachomatis were evaluated on 417 specimens collected from a population with a low disease prevalence of 8.1%. The intensity of positive results was graded according to the number of inclusions or elementary bodies and the optical density of the reaction. Thirty-four specimens were positive in cell culture, 39 positive with MicroTrak and 43 positive with Chlamydiazyme assay. The sensitivity of the two direct tests was 91.2% (31 of 34); the specificity was 97.9% (381 of 389) for MicroTrak and 96.9% (377 of 389) for Chlamydiazyme assay. The positive predictive values were 79.5% (31 of 39) for MicroTrak and 72.1% (31 of 43) for Chlamydiazyme assay. None of the specimens negative by the culture method were positive by the two direct methods. Discrepancies were restricted to the slightly positive specimens. The direct tests seem to be an alternative for diagnosing Chlamydia trachomatis infections, but slightly positive results require cell culture confirmation. PMID- 3536505 TI - Chlamydial infections in children: a seroepidemiological study. AB - A seroepidemiological study was conducted in 329 Swedish children aged 3-12 years, some of whom had upper respiratory tract infections, in order to determine the prevalence of serum IgG and IgM antibodies to Chlamydia trachomatis in this age group. Serum antibodies were detected by microimmunofluorescence assay. IgG antibodies were found in 28 (8.5%) of the children; titers were greater than or equal to 1:16 in 15 children (4.6%). Their prevalence in boys (9.4%) and girls (7.6%) was not significantly different. IgM antibodies were found in only six children. Their peak prevalence occurred in boys at the age of 8, and in girls at the age of 12. The serological findings are discussed in the light of current knowledge about chlamydial infections in children and the specificity of chlamydial antibody tests. PMID- 3536506 TI - Comparative in vitro activity of RU 28965 against Chlamydia trachomatis. PMID- 3536507 TI - Lactate dehydrogenase and glyceraldehyde-phosphate dehydrogenase are single stranded DNA-binding proteins that affect the DNA-polymerase-alpha-primase complex. AB - Affinity chromatography on double-stranded (ds) and single-stranded (ss) DNA cellulose columns was employed to find analogs of the Escherichia coli and T4 single-stranded DNA binding proteins (SSB proteins) in calf thymus. The interaction of several purified SSB proteins with the pure DNA-polymerase-alpha- primase complex on DNA synthesis on activated DNA and on primase-initiated M13 DNA served as a criterion for a possible involvement of one of these proteins in the process of DNA replication. Two SSB proteins were purified to essential homogeneity. These most abundant proteins exhibited apparent relative molecular masses of 35,000 (SSB-35) and 37,000 (SSB-37) for the protomers and 140,000 and 80,000 for the native enzymes. Both proteins resisted elution with 0.5 mg/ml dextran sulfate and were eluted from the ssDNA-cellulose with 0.2 M and 1 M NaCl, respectively. SSB-35 stimulated the DNA-polymerase-alpha--primase complex from the same organism up to fivefold over a broad range of DNA covering. By contrast, SSB-37 inhibited the primase-initiated replication of M13 DNA. Like most eukaryotic SSB proteins, these proteins showed a 300-fold preference for binding to ssDNA over dsDNA in a nitrocellulose filter binding assay, as well as strong binding to several DNA and RNA homopolymers. Furthermore, we provide evidence for a cooperative mode of binding for SSB-37. Although SSB-35 and SSB-37 behave as typically eukaryotic SSB proteins in all assays employed, we tested these SSB proteins for dehydrogenase activities as well. SSB-35 was found to be identical with lactate dehydrogenase and SSB-37 was identical with a dimeric form of glyceraldehyde-3-phosphate dehydrogenase. These results imply that further studies are mandatory in order to prove the authenticity of eukaryotic SSB proteins. PMID- 3536508 TI - Nucleotide sequence of the Saccharomyces cerevisiae CTT1 gene and deduced amino acid sequence of yeast catalase T. AB - A 2642-base-pair DNA fragment containing the catalase T (CTT1) structural gene of the yeast Saccharomyces cerevisiae and its flanking regions has been sequenced. The gene codes for a protein of 562 amino acids (relative molecular mass 64,449) and appears to contain no intron. The amino acid sequence of catalase T derived from the DNA sequence shows 40.7% homology (52.2% including conservative replacements) to that of bovine liver catalase. All amino acids previously postulated to participate directly in catalysis by liver catalase and most of the amino acids of the immediate environment of hemin, the prosthetic group of catalase, are conserved in catalase T. The data obtained indicate that the folding of polypeptide chains of the two catalases compared has been conserved within a central region consisting mainly of the beta-barrel domain, which bears the prosthetic group, and a major part of the "wrapping domain". N- and C terminal regions involved in subunit interactions are less well conserved. It is suggested that their structure is more similar to that of the corresponding regions of Penicillium vitale catalase. However, catalase T lacks the C-terminal flavodoxin-like domain present in this protein. PMID- 3536509 TI - Glutamate decarboxylase side reactions catalyzed by the enzyme. AB - A homogeneous glutamate decarboxylase isolated from pig brain contains 0.8 mol of tightly bound pyridoxal 5-phosphate/enzyme dimer. Upon addition of exogenous pyridoxal 5-phosphate (pyridoxal-5-P), the enzyme acquires maximum catalytic activity. Preincubation of the enzyme with L-glutamate (10 mM) brings about changes in the absorption spectrum of bound pyridoxal-5-P with the concomitant formation of succinic semialdehyde. However, the rate of this slow secondary reaction, i.e. decarboxylative transamination, is 10(-4) times the rate of normal decarboxylation. It is postulated that under physiological conditions enzymatically inactive species of glutamate decarboxylase, generated by the process of decarboxylative transamination, are reconstituted by pyridoxal-5-P produced by the cytosolic enzymes pyridoxal kinase and pyridoxine-5-P oxidase. The catalytic activity of resolved glutamate decarboxylase is recovered by preincubation with phospho-pyridoxyl-ethanolamine phosphate. The experimental evidence is consistent with the interpretation that the resolved enzyme binds the P-pyridoxyl analog, reduces the stability of the covalent bond of the phospho pyridoxyl moiety, and catalyzes the formation of pyridoxal-5-P. PMID- 3536510 TI - Serine hydroxymethyltransferase. Effect of proteases on the activity and structure of the cytosolic enzyme. AB - Homogeneous preparations of cytosolic serine hydroxymethyltransferase from rabbit liver were incubated with several different proteases. Chymotrypsin rapidly cleaves a tetradecapeptide from the NH2-terminal end of the enzyme with the enzyme retaining full catalytic activity. Trypsin digestion results in the release of several small peptides from the NH2-terminal end of the enzyme. The remaining core protein is reduced in molecular mass by about 3500 Da. With L serine as substrate the core protein has 1.5 times the activity of the native enzyme. The difference in activity is due to a change in Vmax since the Km values for L-serine and tetrahydrofolate are unchanged. When allothreonine is used as the substrate the activity of the trypsin-treated enzyme is unchanged. Ks values for glycine and several folate compounds are also unchanged for the trypsin digested enzyme. The relative distribution of three glycine-enzyme complexes shows only small differences between the native and trypsin-digested enzyme. Thermal denaturation studies show that the trypsin-digested enzyme has a thermal transition three degrees lower than the native enzyme but the same enthalpy of denaturation. These results suggest that the 25-30 amino acid residues from the NH2-terminal end of the enzyme are not important in determining the catalytic activity and structural stability of the purified enzyme. Several other proteases had no observable effect on the activity and size of the enzyme. All of the proteases tested inactivated the apoenzyme and digested it into small fragments. The loss of enzyme activity in frozen liver is probably the result of the enzyme slowly being converted to the apoenzyme form, which is susceptible to protease degradation. PMID- 3536511 TI - Lipoprotein lipases from cow, guinea-pig and man. Structural characterization and identification of protease-sensitive internal regions. AB - Lipoprotein lipases from human, bovine or guinea-pig milk were purified, judged for domain relationships by characterization of sites sensitive to proteases, and structurally compared. The subunit of human lipoprotein lipase migrated slightly slower than those of bovine or guinea-pig lipoprotein lipases on sodium dodecyl sulfate/polyacrylamide gel electrophoresis. Bovine lipoprotein lipase is known to be a dimer of two non-covalently linked subunits of equal size, and the lipases from all three sources now yielded homogeneous N-terminal amino acid sequences (followed for 15-27 residues). The results indicate that the two subunits are identical. Bovine lipoprotein lipase had two additional N-terminal residues, Asp Arg, compared to the human and guinea-pig enzymes, and the next two positions revealed residue differences, but further on homologies were extensive between all three enzymes as far as presently traced. Exposure of bovine lipoprotein lipase to trypsin led to production of three fragments (T1, T2a, and T2b), suggesting cleavage at exposed segments delineating domain borders. Time studies gave no evidence for precursor-product relationships between the fragments, and prolonged digestion did not lead to further cleavage. Fragments T2a and T2b had the same N-terminal sequence as intact lipase. Fragment T1 revealed a new sequence, and represents the C-terminal half of the molecule. Plasmin caused a similar cleavage as trypsin, whereas thrombin, factor Xa, and tissue plasminogen activator did not cleave the enzyme. Chymotrypsin cleaved off a relatively small fragment from the C-terminal of the molecule, after which exposure to trypsin still resulted in cleavage at the same sites as in intact lipase. Tryptic cleavage of guinea-pig lipoprotein lipase yielded two fragments. One had a similar size as bovine fragment T2b; the other had a similar size as bovine fragment T1 and an N-terminal sequence homologous with that of T1. Thus, trypsin recognizes the same unique site in guinea-pig lipoprotein lipase as in the bovine enzyme. This confirms the conclusion that this segment is the border between two domains in the subunit. The binding site for heparin was retained after both tryptic and chymotryptic cleavages and was identified as localized in the C terminal part of the molecule. PMID- 3536512 TI - Biosynthesis of tetrahydrobiopterin. Purification and characterization of 6 pyruvoyl-tetrahydropterin synthase from human liver. AB - 6-Pyruvoyl-tetrahydropterin synthase, which catalyzes the first step in the conversion of 7,8-dihydroneopterin triphosphate to tetrahydrobiopterin, was purified approximately 140,000-fold to apparent homogeneity from human liver. The molecular mass of the enzyme is estimated to be 83 kDa. 7,8-Dihydroneopterin triphosphate was a substrate of the enzyme in the presence of Mg2+, and the pH optimum of the reaction was 7.5 in Tris HCl buffer. The Km value for 7,8 dihydroneopterin triphosphate was 10 microM. The product of this enzymatic reaction was the presumed intermediate 6-pyruvoyl-tetrahydropterin. This latter compound was converted to tetrahydrobiopterin in the presence of NADPH and partially purified sepiapterin reductase from human liver. The conditions and the effect of N-acetylserotonin on this reaction, and on the formation of the intermediates 6-(1'-hydroxy-2'-oxopropyl)-tetrahydropterin and 6-(1' oxo-2' hydroxypropyl)-tetrahydropterin have been studied. PMID- 3536513 TI - Mechanism of initiation of in vitro DNA synthesis by the immunopurified complex between yeast DNA polymerase I and DNA primase. AB - The immunopurified yeast DNA-polymerase-I--DNA-primase complex synthesizes oligo(rA) and oligo(rG) molecules that are used as primer for replication of poly(dT) and poly(dC). Neither initiation nor DNA synthesis is observed with poly(dA) and poly(dI). Nitrocellulose-filter binding shows that the enzyme complex binds to deoxypyrimidine polymers, but not to deoxypurine polymers. Although the yeast complex initiates DNA synthesis on deoxypyrimidine homopolymers, it prefers to elongate pre-existing primer molecules rather than to initiate de novo DNA replication. The size of the oligo(rA) and oligo(rG) primer molecules has been determined by urea/polyacrylamide gel electrophoresis: longer oligoribonucleotides are synthesized when their utilization is prevented by omitting dNTP. An oligodeoxythymidylate template with a chain length as short as five residues can support oligo(rA) synthesis catalyzed by the yeast DNA polymerase--DNA-primase complex and the size of the oligoribonucleotide products synthesized with oligodeoxythymidylate of differing chain length has also been determined. The mechanistic properties of the DNA-polymerase--DNA-primase complexes, purified from different eukaryotic organisms, appear to be very similar. The possible biological implication of the studies on the mechanism and specificity of initiation of DNA synthesis in a well-defined model template system has been discussed. PMID- 3536514 TI - Purification and tissue distribution of a small protein (BM-40) extracted from a basement membrane tumor. AB - A novel acidic glycoprotein, BM-40, with Mr = 40,000, was purified from the basement-membrane-producing mouse EHS tumor and characterized with regard to its unique chemical and antigenic properties. It was obtained from the tumor in a neutral salt-soluble form or as a component requiring extraction with 6M guanidine X HCl. This protein could also be identified in many other tissue extracts and cell and tissue cultures. The most intact form of BM-40 consists of a single polypeptide chain which undergoes limited proteolysis during extraction and purification. BM-40 exists in most tissues in stoichiometric amounts compared to other basement membrane proteins (laminin, nidogen) and is secreted by various teratocarcinoma and epithelial cells. It can be visualized by immunofluorescence in the extracellular matrix of the EHS tumor and Reichert's membrane. Other tissues which contain extractable BM-40 were negative in immunofluorescence. PMID- 3536515 TI - Regeneration of the GTP-bound from the GDP-bound form of human and yeast ras proteins by nucleotide exchange. Stimulatory effect of organic and inorganic polyphosphates. AB - The regeneration of the GTP-bound from the GDP-bound form of purified human and yeast ras proteins occurs in vitro by a nucleotide-exchange reaction. For both human and yeast ras proteins the dissociation of the protein-bound GDP is the rate-limiting step in the presence of Mg ions. The rate of formation of the ras X GTP complex is stimulated by weak Mg2+-chelating agents like ATP and inorganic polyphosphates and, to a lesser extent, by ADP. This suggests a possible mechanism of regulation of ras-dependent pathway(s) by intracellular metabolic products. PMID- 3536516 TI - Insulin-stimulating protein from human plasma. Chemical characteristics and biological activity. AB - A protein that potentiates the action of insulin in vitro was purified from human plasma. When reduced with 2-mercaptoethanol and then carboxymethylated, it yielded a single subunit, indicating that it was composed of two identical subunits connected by a single disulfide bond. This modified subunit tended to inhibit rather than stimulate insulin activity. A distinctive feature of the amino acid composition of this protein (H-ISP) was the absence of histidine, arginine, and tryptophan. The molecular mass, subunit composition, the characteristic amino acid composition and the N-terminal amino acid residue of H ISP are very similar to those of human plasma apolipoprotein A-II (apo A-II). The isoelectric point of H-ISP was estimated to be 4.91, which is identical with that of the major apo A-II isoform. H-ISP did not itself have insulin-like activity in increasing CO2 liberation from labeled glucose and 2-deoxyglucose uptake by isolated rat adipocytes, but it potentiated the action of insulin in these parameters. It had no appreciable affect on the binding or degradation of 125I labeled insulin by adipocytes. Like H-ISP, apo A-II isolated from human plasma also had no insulin-like activity by itself, but stimulated the effect of insulin on CO2 production from labeled glucose in isolated rat adipocytes. From these results, it is concluded that H-ISP is identical with the major apo A-II isoform. Incubation of isolated adipocytes with H-ISP resulted in marked increase in the activity of pyruvate dehydrogenase in a dose-dependent manner in the absence of added insulin. H-ISP also stimulated pyruvate dehydrogenase activity in a subcellular system consisting of plasma membranes and mitochondria from rat adipocytes. The effect of H-ISP on pyruvate dehydrogenase activity could be produced by treatment of the isolated mitochondrial fraction alone. PMID- 3536517 TI - Estrogen and progesterone receptors status in the prediction of response of breast cancer to endocrine therapy (preliminary report). AB - The authors selected 263 ER cases and 224 ER/PgR cases for receptor status analysis from 1548 breast cancer tissues assayed. 30 Operating-theatres address their breast frozen specimens at our laboratory and thanks to this wide cooperation, we can perform the statistical analysis and relationship with very good reliability. In our experience we observed that the response to hormonal therapy is present in 50% of the cases containing ER concentrations up to 100 fmol/mg of proteins, and in 74% of the cases with ER concentrations more of 100 fmol/mg of proteins. Considering the presence of both receptors (ER+/PgR+) we observed the response rate to hormonal treatment in 76% of the cases while in 9% of the cases the status is ER/PgR negative. The cases classified ER negative and PgR positive demonstrated a response rate of 28%, 7 out of 26 cases ER+/PgR- responded to hormonal therapy. In this last situation, in addition to experienced hypotheses, the authors believe it is important to examine sonographically the ovaries, because the presence of a functional ovarian cyst could influence the saturation of receptorial sites. PMID- 3536518 TI - 99mTc-DTPA and 99mTc-rhenium sulfur aerosol compared as adjuncts to perfusion scintigraphy in patients with suspected pulmonary embolism. AB - Two radiopharmaceuticals, 99mTc-DTPA (D) and 99mTc-rhenium sulfur (R), were evaluated with a nebulizer delivering submicronic particles. Seventy-seven patients were examined (42 D, 35 R). For all patients, the examination began with a ventilation study. Immediately after the last ventilation view, 99mTc MAA was injected. Aerosol performance was assessed in 37 D and 17 R. Nebulization yield was 8.98% for D and 9.31% for R. A lung clearance study was performed in 12 patients for D and in 12 different patients for R. The lung clearance was 0.22%/min for R and 2.35%/min for D. The quality of ventilation and the quantification of bronchial and gastric activity were evaluated; the difference between the two groups was not statistically significant. It may be concluded that radioaerosols allow good quality images to be obtained. The yield of the nebulizer is adequate, so that nebulization of 20 mCi delivers approximately 2 mCi of aerosol activity to the lung. When pulmonary embolism is being investigated, R, due to its slower lung clearance, would appear to be preferable to D for patients suspected of increased bronchoalveolar permeability, especially if the time between nebulization and recording is greater than 10 min. PMID- 3536520 TI - Association of parathyroid adenoma and autonomous nodule of the thyroid. Diagnostic efficacy of 201thallium-99mtechnetium scintigraphy. AB - The thallium-technetium subtraction technique, proposed originally by Ferlin and co-workers, is now widely used to localize parathyroid adenoma. We report here the case of a hypercalcemic woman, referred to our ward with the biologically assessed diagnosis of primary hyperparathyroidism. Thallium-technetium subtraction scintigraphy not only successfully localized the parathyroid adenoma but also revealed the existence of an autonomous nodule of the thyroid, which was not suspected. It has previously been shown that this method can localize parathyroid adenoma in cases of cold thyroid nodule. This report shows that this is also true in the case of hot thyroid nodule. No observations of concomitant parathyroid adenoma and autonomous nodule of the thyroid have been reported (at least during the two past decades). Is this association casual or has it never been noticed? Further examinations can be performed with thallium when a hot thyroid nodule is found in a hypercalcemic patient. PMID- 3536519 TI - Cholescintigraphy in the detection of cholelithiasis: a review of 23 cases and a case report demonstrating the sequential evolution of the appearance of the gallbladder defect. AB - Cholescintigraphy of cholelithiasis has been reported as a defect or photon deficient area in the gallbladder. We present the case of a patient with gallstones whose cholescintigraphic study showed a sequential evaluation of the scan appearance from a defect, to a septation, a hole, and finally a filled-in appearance. Cholescintigrams and histopathologic findings after cholecystectomy of another 22 patients with cholelithiasis were also retrospectively reviewed. The results of the study concluded that: cholelithiasis is rarely demonstrated by cholescintigraphy and nonvisualization of the gallbladder may be due to acute or chronic cholecystitis associated with cholelithiasis. PMID- 3536521 TI - 5-Hydroxytryptophan versus methysergide in the prophylaxis of migraine. Randomized clinical trial. AB - One hundred and twenty-four migraineurs were treated randomly with 5 hydroxytryptophan (5-HTP) or with methysergide (M). The two groups were homogeneous without significant statistical differences with respect to age, sex, pill use, type of migraine and frequency of attacks before entry. A significant improvement was observed in 75% of the patients treated with M and in 71% of the cases treated with 5-HTP. The most beneficial effect of 5-HTP appears to be felt with regard to the intensity and duration rather than the frequency of the attacks. Side effects were more frequent in the M group than in the 5-HTP group. These results suggest that 5-HTP could be a treatment of choice in the prophylaxis of migraine. PMID- 3536522 TI - Circadian stage-dependent prolongation by cyclosporine of segmental pancreatic allograft function in the rat. AB - While the toxicity of many drugs has been reduced by their administration at certain circadian rhythm stages (if not at certain times of day), as shown herein, direct therapeutic benefit from the improvement of the desired effect can be obtained by the circadian timing of intraperitoneal cyclosporine (Cs) for Lewis rats bearing an ACI segmental pancreas allograft. Under conditions of light (L) and darkness (D) alternating at 12-hour intervals, staggered by 8 h in 3 rooms kept at 24 degrees C, the effect of Cs in delaying graft rejection was improved by timing. When the mean time to rejection during the L span is equated to 100%, graft function is prolonged by 40% at the right time (injection daily during the D span) as compared to the wrong time (injection daily during the L span). PMID- 3536523 TI - Replacement of dog's aorta by autologous intestinal muscle in the infected retroperitoneum. AB - The free transplant of intestinal muscle lacking mucosa into an infected vascular bed has been shown to be a suitable replacement for the aorta in dogs. This type of transplant is incorporated into the infected area and shows a high tolerance against progressive infection. Therefore, an autologous transplant may be suitable to ensure continuous blood flow during the healing phase of a deep infection when a synthetic prosthesis is unsuccessful. PMID- 3536524 TI - Preoperative preparation of the bowel for urological surgery: a review. AB - The risk of postoperative complications following opening of the intestine can be reduced by lowering the intraluminal bacterial count. The latter is achieved principally by decreasing the mass of the gut content and by antibiotic prophylaxis. Macroscopically satisfactory decontamination of the gut can be attained with laxatives, enemas, elementary diet or orthograde lavage. We prefer oral lavage with Golytely solution since it allows rapid preparation of the gut and is well tolerated. The value of antibiotic prophylaxis in association with operations on the colon or rectum is undisputed and a number of regimes have been shown to be effective. In view of its effectiveness and lack of side effects. 24 hour perioperative parenteral prophylaxis with metronidazole can be recommended. PMID- 3536525 TI - A comparison of intracavitary talc and tetracycline for the control of pleural effusions secondary to breast cancer. AB - Forty-one patients with malignant pleural effusions secondary to breast cancer were randomly allocated to treatment with either intracavitary talc or intracavitary tetracycline. Of 33 evaluable patients, radiological control was achieved in 11/12 (92%) of the talc group compared with 10/21 (48%) of the tetracycline group (P = 0.022). Intracavitary talc provides effective palliation of metastatic pleural effusions secondary to breast cancer. PMID- 3536526 TI - Comparison of Halsted mastectomy with quadrantectomy, axillary dissection, and radiotherapy in early breast cancer: long-term results. AB - From 1973 to 1980 we randomly assigned 701 patients with breast cancer measuring less than 2 cm in diameter and with no palpable axillary lymph nodes to Halsted radical mastectomy (n 349) or to 'quadrantectomy' with axillary dissection and radiotherapy to the ipsilateral breast tissue (n 352). The two groups were comparable in age distribution, size and site of primary tumor, menopausal status, and frequency of axillary metastases. The average follow-up time was 103 months. Actuarial curves show no difference between the two groups in the disease free interval after surgery or in the overall survival rate. At 8 yr the disease free survival was 77% for the patients in the Halsted group and 80% for those in the 'quadrantectomy' group, and the overall survival was 83 and 85% respectively. We conclude that small breast cancers may be safely treated with the conservative treatment described. In our opinion total ablative operations are not justified. PMID- 3536527 TI - The growth and cellular kinetics of human cervical cancer spheroids in relation to drug response. AB - A methodology for culturing multicellular spheroids directly from tumour biopsy material has been established with a success rate of 82% for cervical carcinomas. Spheroids, selected for uniform size and shape, have been subjected to quantitative assay to determine their population dynamics using 3H-Tdr autoradiography and have also been treated with 13 commonly used anti-cancer drugs. Several characteristics of cervical spheroids, e.g. growth rate, labelling index, thickness of viable cell rim, were similar for drug responding and non responding spheroids but the faster growing spheroids responded to an increased number of types of drugs. Spheroids derived from poorly differentiated tumours also showed an increased response to drugs compared to those from moderate or well differentiated tumours. PMID- 3536528 TI - Recombinant interferon alfa-2C versus polychemotherapy (VMCP) for treatment of multiple myeloma: a prospective randomized trial. AB - Forty-two previously untreated patients with multiple myeloma were entered in a prospective, randomised trial comparing recombinant interferon alfa-2C monotherapy with VMCP (vincristin, melphalan, cyclophosphamide and prednisolone). Both treatment arms were comparable for the stratification variables such as paraprotein type, stage of disease, and renal function. Rec. interferon effected 14% responses and 29% minor responses, while 57 and 32% of VMCP-treated patients achieved a pathologically documented remission (P less than 0.001). The time on initial treatment was significantly shorter in the IFN group (3.2 months) than in the VMCP group (7.6 months). In four patients in the IFN arm, primary treatment had to be changed according to progressive or severe stationary disease. Since all four patients responded to second line therapy (VMCP) no significant difference has been observed between the two groups in survival (median follow-up greater than 12 months). Despite this clear superiority of the conventional four drug polychemotherapy, there was some suggestion that IFN might be particularly active in cases with low tumor-burden (stage I, II), and light-chain or IgA paraprotein type. PMID- 3536530 TI - Torasemide, a new potent diuretic. Double-blind comparison with furosemide. AB - The pharmacodynamic effects of torasemide, a new potent loop diuretic, were compared with those of furosemide in a double blind controlled study in 18 hypertensive patients with oedema of various origins. Given orally for 5 days, torasemide was clinically very effective and well tolerated. On a weight basis, the diuretic, natriuretic and chloruretic effects of torasemide were about 8 times greater than those of furosemide. However, the kaliuretic effect of torasemide was only 3-times greater than that of furosemide, suggesting that torasemide is more potassium sparing than furosemide. Torasemide displayed a rapid onset of action, similar to that of furosemide but had a longer diuretic effect without any rebound phenomenon. Torasemide and furosemide did not effect creatinine clearance or uric acid excretion. Both furosemide and torasemide lowered systolic blood pressure but the effect of torasemide was more marked than that of furosemide. In this group of aged and hypertensive patients with oedema, the pharmacokinetics of torasemide was comparable to that reported in young healthy volunteers, and were similar on the first and fifth days of treatment. The long duration of action and the potassium sparing effect of torasemide compared to furosemide are promising features of this new loop diuretic in the treatment of oedema and hypertension. PMID- 3536529 TI - Therapeutic equivalence of once- and thrice-daily glipizide. AB - Two cross-over studies were carried out in 23 patients with Type 2 diabetes, to examine whether glipizide, a potent sulphonylurea with fast and complete absorption and rapid elimination (t1/2 less than 5 h), can be given once-daily without loss of therapeutic effect. In both studies, patients were randomly assigned to an initial dose of 7.5 mg once daily or 2.5 mg three-times daily, which was increased to 15 mg o.d. or 5 mg t.i.d. if the fasting plasma glucose remained over 10 mmol/l on the lower dosage. In Study 1 (n = 11), administration once a day before breakfast was compared with intake before breakfast, lunch and early dinner (5 p.m.) and in Study 2 (n = 12) the comparison was between intake once-daily before breakfast and dosing before breakfast, lunch, and at bedtime (10 p.m.). Neither the 24-hour urinary glucose excretion nor HbA1, fasting plasma glucose, insulin or C-peptide levels differed between the once and three times daily administration with the third dose given before early dinner. The nadir plasma levels of glipizide were not significantly different and were often too low to be detected. Postponing the third dose until 10 p.m. did not produce any improvement in HbA1 or in fasting plasma glucose, insulin or C-peptide. The mean nadir glipizide levels following this schedule were twice as high as those after once-daily administration. As expected, the plasma glipizide after breakfast was higher when the whole dose was taken before breakfast than when it was divided. The corresponding plasma level of insulin was higher and that of plasma glucose was lower.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536532 TI - The D-1 dopamine receptor antagonist SCH 23390 also interacts potently with brain serotonin (5-HT2) receptors. AB - The interaction of SCH 23390 with central serotonin 5-HT2 receptors was studied in vivo on [3H]spiperone binding and in vitro on [3H]ketanserin binding. SCH 23390 inhibited [3H]spiperone binding in rat frontal cortex with an ID50 of 1.5 mg/kg i.p., thus being equipotent to the two 5-HT2 antagonists cinanserin and methysergide. In vitro, SCH 23390 competed with [3H]ketanserin with an IC50 of 30 nM. These data indicate that SCH 23390 also binds with high affinity to 5-HT2 receptors in rat brain. PMID- 3536531 TI - Failure of indomethacin to impair the diuretic and natriuretic effects of the loop diuretic torasemide in healthy volunteers. AB - The effects of torasemide, a new potent loop diuretic, on renin release, water and sodium excretion were investigated in young healthy volunteers before and after 3 days of treatment with indomethacin. Torasemide 20 mg i.v. induced a rapid and biphasic increase both in plasma renin activity and plasma angiotensin II levels, which was almost completely abolished by pretreatment with indomethacin. Torasemide also increased urine volume, sodium excretion and, during the first hour after dosing, the creatinine clearance. None of the latter effects was impaired by indomethacin pretreatment. It is concluded that, like other loop diuretics, torasemide stimulates renin release by increasing renal prostaglandin production. However, at variance with what is observed with other loop diuretics, the diuretic and natriuretic effects of torasemide as well as the change in creatinine clearance do not appear to be inhibited by indomethacin. PMID- 3536533 TI - Human renin inhibiting dipeptide. AB - KRI-1177, a dipeptide containing nor-statine inhibited renin activity in human and Japanese monkey plasma to a markedly greater extent than that in dog, rabbit and rat plasma. The systemic blood pressure of anesthetized monkeys was lowered by intravenous injections of this compound which also reduced plasma renin activity and concentration of angiotensins. KRI-1177 appears to selectively inhibit primate renin activity, thereby producing hypotension. PMID- 3536534 TI - 2-Deoxyglucose tissue levels and insulin levels following tolazamide dosing in normal and obese mice. AB - The effect of tolazamide (TZ), a sulfonylurea, on 14C-2-deoxyglucose (14C-2DG) tissue distribution and insulin levels of normal and obese mice was investigated using an in vivo physiological method. Acute doses of TZ (50 mg/kg ip) increased 14C-2DG levels in gastrocnemius muscle and retroperitoneal fat and produced a transient elevation of insulin which most likely accounts for the increased 14C 2DG levels in muscle and fat. The results demonstrate that the in vivo 14C-2DG method produced results consistent with known actions of sulfonylureas on in vitro hexose assimilation in muscle and fat. Subchronic treatment (7 days) with TZ 50 mg/kg ip twice daily did not result in increased insulin-stimulated 14C-2DG tissue levels in normal mice when compared to saline treated controls. However, insulin levels were lower in mice treated subchronically with TZ compared to saline controls suggesting an enhancement of insulin action. Viable yellow obese mice represent a model of maturity onset obesity presenting with insulin resistance. The insulin resistance of this obese strain appears to reside in the fat tissue as assessed by comparing 14C-2DG tissue levels of obese mice with lean littermate controls. Subchronic TZ treatment had no effect on 14C-2DG uptake in fat or muscle tissue of viable yellow obese mice and did not alter their plasma insulin levels. It appears that genetically obese viable yellow mice may be resistant to subchronic treatment with TZ. PMID- 3536535 TI - Measurement of insulin during isolation and purification from animal pancreas. A comparison of radioimmunoassay, radioreceptor assay and in-vivo bioassay. AB - For the purpose of monitoring the yield of the insulin extraction procedure from animal pancreas three methods of insulin determination were compared, i.e. the mouse convulsion test, a radioreceptor assay (RRA) on rat fat cells and a radioimmunoassay (RIA) which was especially laid out for high insulin concentrations. In samples containing actually insulin in general all three methods provided comparable results. Notable differences were only found in proinsulin-containing material. Because of its simplicity and high reproducibility as well as the good agreement of its results with those obtained with the other assays, the RIA turned out to be the most suitable assay. On the other hand, the RRA should be useful in detecting molecular differences between the investigated insulin-like preparations and standard insulin. PMID- 3536536 TI - The frequency of islet cell surface antibodies in newly diagnosed diabetics from Ethiopia. AB - Forty-three newly diagnosed diabetic patients from Ethiopia were studied for the frequency of islet cell surface antibodies and other clinical features which are relevant to the aetiopathogenesis and classification of diabetes mellitus. In preliminary investigations of a small number of controls and noninsulin-dependent diabetics we found, as expected, no circulating antibodies. Four first-degree relatives of ICSA-positive sibs were negative, too. However, 3 out of 7 known insulin-treated diabetics displayed ICSA in the blood serum. In our study of newly diagnosed diabetics we found ICSA in 39% (17/43). Five patients who were assigned to the NIDDM subclass had no antibodies. 37 diabetics required insulin treatment after clinical diagnosis and 16 (43%) of these were ICSA-positive. There were no differences in the assessed clinical parameters between ICSA positive and -negative patients. One ICSA-positive patient initially controlled with oral hypoglycaemic agents became insulin-dependent within our study period. Our observations in newly diagnosed diabetics from Ethiopia revealed a lower frequency of ICSA than in Caucasians, however, the results provide evidence for the occurrence of auto-immune phenomena in the aetiopathogenesis of diabetes mellitus in this ethnic group. PMID- 3536537 TI - Specific immunotherapy in insulin-dependent diabetes mellitus (preliminary report). AB - In 7 patients with newly diagnosed insulin-dependent diabetes mellitus a cytotoxic effect of blood lymphocytes against B-cells could be demonstrated by incubation of isolated rat islets with the lymphocytes. The addition of lymphocytes from healthy persons significantly reduced this effect in vitro. The transfusion of 1.9 X 10(9) - 1.5 X 10(10) lymphocytes from the parents to the patients produced a significant decrease of the cytotoxic effect of the lymphocytes from the patients. This effect could be demonstrated during the preliminary control period up to 12 weeks. PMID- 3536538 TI - Effects of metyrapone and a combined alpha- and beta-adrenergic blockade on plasma glucose recovery from insulin-induced hypoglycaemia in pigs. AB - The recovery of plasma glucose from insulin-induced hypoglycaemia was investigated in growing pigs during an inhibition of corticosteroid secretion (metyrapone infusion), an alpha- and beta-adrenergic blockade (phentolamine and propranolol infusion) or a combination of both treatments. In pigs which received an infusion of metyrapone for 4 h before and 3 h after a bolus injection of insulin (0.1 IU/kg body-weight), the plasma glucose response did not differ significantly from control animals. The infusion of phentolamine and propranolol (in each case 120 micrograms/kg/h for 3 h after a priming dose of 100 micrograms/kg) starting at the time of insulin injection significantly attenuated the restoration of normoglycaemia. An additional infusion of metyrapone increased this effect significantly only at the end of the experiment. The results indicate that adrenergic mechanisms are involved in the glucose counterregulation after an insulin-induced hypoglycaemia in pigs and the glucocorticoid secretion may become critical when the catecholamine response is impaired. PMID- 3536539 TI - Influence of microinjection of insulin into hippocampus on hepatic acetate metabolism in rabbits. AB - Insulin was injected directly into the dorsal hippocampus (DHPC) of rabbits, and changes in hepatic acetate metabolism were studied. The injection of 50 microU insulin into the DHPC decreased the rates of 14C transfer from 14C-1-acetate into glucose and ketone bodies, and increased 14C transfer into cholesterol ester, triglyceride, free cholesterol and free fatty acids. But after insulin injection into the DHPC of rabbits with lesions of dorsal fornix (DFX), hepatic acetate metabolism did not differ from that of control rabbits, which received saline injection into the same brain region. From these results it might be suggested that the DHPC are parts of insulin-sensitive brain regulator system in the hepatic acetate metabolism. PMID- 3536540 TI - Development of a chemically defined serum-free medium for differentiation of rat adipose precursor cells. AB - Stromal-vascular cells from the epididymal fat pad of 4-week-old rats, when cultured in a medium containing insulin or insulin-like growth factor, IGF-I, triiodothyronine and transferrin, were able to undergo adipose conversion. Over ninety percent of the cells accumulated lipid droplets and this proportion was reduced in serum-supplemented medium. The adipose conversion was assessed by the development of lipoprotein lipase (LPL) and glycerol-3-phosphate dehydrogenase (GPDH) activities, [14C]glucose incorporation into polar and neutral lipids, triacylglycerol accumulation and lipolysis in response to isoproterenol. Similar results were obtained with stromal-vascular cells from rat subcutaneous and retroperitoneal adipose tissues. Stromal-vascular cells required no adipogenic factors in addition to the components of the serum-free medium. Insulin was required within a physiological range of concentrations for the emergence of LPL and at higher concentrations for that of GPDH. When present at concentrations ranging from 2 to 50 nM, IGF-I was able to replace insulin for the expression of both LPL and GPDH. The development of a serum-free, chemically defined medium for the differentiation of diploid adipose precursor cells opens up the possibility of characterizing inhibitors or activators of the adipose conversion process. PMID- 3536541 TI - Mitogenic effect of a human placental factor on astrocytes and glial precursors. AB - We have characterized and partially purified a new 'factor' present in human placenta which strongly stimulates the in vitro proliferation of two immunocytochemically characterized subtypes of astrocytes and of bipotential precursors of putative fibrous astrocytes and oligodendrocytes. This 'factor' has an apparent Mr of 60-80 kD and exhibits physicochemical and chromatographic properties characteristic of polypeptides. Our observations suggest that placenta derived growth factors (PDMF) control the proliferation of glial cells and glial precursors during fetal development. PMID- 3536542 TI - Autocrine stimulation of WI38 cell proliferation in the presence of glucocorticoids. Characteristics of the stimulatory factor(s) involved in this response. AB - Chronic exposure to hydrocortisone (HC) or dexamethasone (DEX) results in a 20 40% extension in the proliferative lifespan of WI38 cells. Within a single growth cycle, the addition of HC or DEX at seeding results in saturation densities 20 40% higher than in control cultures. We have recently reported that, within a single growth cycle, the proliferative response of WI38 cells to glucocorticoids is mediated by a stimulatory factor(s) present in medium conditioned by cells in the presence of the hormone. We report here that chronic exposure to medium conditioned in the presence of HC for the first 24 h after seeding (24-h HC conditioned medium (24-h HC-CM)) results in a 25% extension in the proliferative lifespan of these cultures. The generation of the stimulatory factor(s) present in glucocorticoid-conditioned medium is apparently dependent upon undefined cellular alterations which result from the subcultivation-procedure; confluent or low-density quiescent cultures did not generate media stimulatory to cell growth in the presence of glucocorticoids. This response was not trypsin-dependent, since cultures subcultivated in the absence of proteolytic treatment generated media equally stimulatory to cell growth. A further characterization of this glucocorticoid-induced activity revealed the stimulatory factor(s) was of low MW (dialyzable and recoverable in the less than 10,000 MW fraction following ultrafiltration), heat-stable (95 degrees C), and resistant to treatment with trypsin, chymotrypsin, or protease (S. griseus). PMID- 3536543 TI - Clonal T-cell colony formation in agar culture: an attractive assay to test the T cell depletion from bone marrow. AB - Current studies suggest that the depletion of T-lymphocytes from donor marrow is an effective method for preventing acute graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation in man. To deplete the T-lymphocytes from bone marrow cells we use either monoclonal anti-T-cell antibodies and complement or T101 ricin A-chain immunotoxin. Residual T-lymphocytes are analyzed by their capacity to form clonal T-cell colonies in the presence of phytohemagglutinin (PHA), accessory cells, and recombinant interleukin 2. The method is compared to immediate indirect immunofluorescence (iF) and thymidine incorporation by marrow cells stimulated by PHA. IF is not suitable for evaluating the depletion by immunotoxin, and the interpretation of thymidine incorporation is generally questionable. The results of the colony formation show that the sensitivity of the colony assay is close to that of iF when T cells are depleted by complement lysis, and the sensitivity of the colony assay is not dependent upon the depletion procedure. Therefore, the T-cell colony assay is a simple functional control for the quality of bone marrow T-cell depletion, especially for T-cell depletion by immunotoxin. PMID- 3536544 TI - Proliferation of purified murine hemopoietic stem cells in serum-free cultures stimulated with purified stem-cell-activating factor. AB - Under conditions of steady-state hemopoiesis in normal mice, the majority of hemopoietic stem cells in the bone marrow are in the quiescent state of the cell cycle. These cells can be stimulated to proliferate in vitro by the addition of a factor termed the "stem-cell-activating factor" (SAF), which is present in medium conditioned by various cell types. This factor is indistinguishable in antigenic and molecular properties from the lymphokine interleukin 3 (IL-3). The action of SAF on the stem cell cycle was studied by examination of the survival of the spleen colony-forming unit(s) (CFU-S) after four days of serum-free culture in the presence of purified SAF. CFU-S subtypes were distinguished on the basis of the day of colony counting (i.e., days 7, 9, and 12 after transplantation). The results indicate that SAF selectively induces an increase of the day-7 CFU-S: the CFU-S number increased 2.7-fold on day 7 and 1.2-fold on day 9, and decreased fivefold for day-12 CFU-S. Similar results were obtained in SAF culture of partially and highly purified stem cells. The proliferation of day-9 CFU-S in cultures of low-density bone marrow cells was found to be similar to that of unfractionated bone marrow cells until day 4 of culture. However, in the culture of partially purified stem cells, this proliferation stopped between days 4 and 10, whereas it continued with unfractionated cells. This indicates that cocultured bone marrow cells affect the proliferation of stem cells upon induction by SAF; day-4 cultures of highly purified resting stem cells with purified SAF resulted in a similar decrease in day-12 CFU-S and an increase in day-7 CFU-S, as was observed with unfractionated bone marrow cells. The DNA histogram of the stimulated sorted cells clearly revealed an actively DNA synthesizing population. The results are in agreement with those of a selective induction of proliferation by SAF of resting pluripotent hemopoietic stem cells. PMID- 3536546 TI - Immunoreactive erythropoietin studies in hypoxic rats and the role of the salivary glands. AB - Rat erythropoietin (Ep) cross-reacts in the radioimmunoassay (RIA) for human Ep developed in this laboratory. Immunoreactive Ep was measured in serum and tissues of male rats in response to short-term hypoxia (0.43 atm for 24 h). In the unstimulated rat all tissues examined had low levels of Ep, with the exception of the submaxillary or salivary gland (SG). Exposure to hypoxia for 24 h resulted in significant increases in kidney and serum levels of Ep, with no apparent change in SG content. Sialectomy immediately prior to exposure reduced renal Ep production and serum levels significantly after 4 h of exposure. Nephrectomy (N) confirmed previous results by others: Ep production after exposure to hypoxia was reduced but not abolished. The effect of N plus sialectomy was identical to that of N alone, thus excluding the SG as a source of extrarenal Ep in nephrectomized rats. The long-term effect of SG ablation to the same constant stimulus was a steady decline of the Ep response during the first week after surgery, both in renal production and serum levels. Thereafter, from one to six weeks the serum levels remained constant, being higher than in the unstimulated rat but significantly lower than in intact hypoxic animals. No cross-reactivity in the RIA was found with renin, renin substrate, nerve and epidermal growth factor, or somatomedins. If this Ep-like substance in the SG were the source of extrarenal Ep, it should have been possible to document an increase in serum concentration before an increase could be measured in renal content. It appears, however, that the presence of the SG is necessary for renal tissue to be able to synthesize Ep during hypoxia. PMID- 3536545 TI - Abnormal T-lymphocyte colonies (CFU-TL) following bone marrow transplantation. AB - We studied the presence of peripheral-blood- and bone-marrow-derived T-lymphocyte colony formation (CFU-TL) in 28 bone marrow transplant recipients from 1 month to six years after transplantation. Peripheral blood leukocyte and lymphocyte counts were generally normal, and all had morphologic evidence of engraftment without leukemia at the time of study. Both peripheral-blood- and bone-marrow-derived CFU TL were markedly reduced after transplantation as compared to normal controls, which included bone marrow donors (14.2 +/- 5/4 X 10(4) vs 313 +/- 100/4 X 10(4) [p less than 0.001] and 26 +/- 4/2 X 10(5) vs 1004 +/- 60/2 X 10(5) [p less than 0.001]). Among the patients, four had no detectable bone-marrow-derived CFU-TL when tested less than six months after transplantation. Peripheral blood CFU-TL, while present in all patients, was markedly decreased for more than 12 months after transplantation. After two years, the number of CFU-TL returned to normal in several patients. The abnormalities in CFU-TL were unrelated to diagnosis, age, sex, graft-versus-host disease (GVHD), pretransplant conditioning, or posttransplant immunosuppressive treatment. Patients receiving autologous bone marrow transplants also had decreased CFU-TL. Cocultures of normal peripheral blood- or bone-marrow-derived mononuclear cells with recipients' mononuclear cells or sera did not inhibit normal CFU-TL growth. Furthermore, the addition of mononuclear cells or sera from normal individuals, or of exogenous interleukin 1 or interleukin 2, did not correct the deficiency of CFU-TL growth by recipient cells. Depletion of T-lymphocytes from bone marrow or peripheral blood in transplant recipients by physical techniques or with a monoclonal antibody (CT-2) and complement had no effect on CFU-TL recovery. Similarly, addition of recipients' T cells to normal peripheral blood or bone marrow mononuclear cells did not suppress CFU-TL. These data indicate that most transplant recipients have a marked reduction in CFU-TL which persists for up to two years after transplantation. This reduction in the growth of T-cell colonies appears to be due to deficient numbers of these cells or an intrinsic defect in their responsiveness to T-cell lymphokines, rather than a result of growth suppression by inhibitory cells or serum factors. This observed defect in CFU-TL may have implications for therapeutic attempts to facilitate immune reconstitution after bone marrow transplantation. PMID- 3536547 TI - Preparation of red-blood-cell-depleted marrow for ABO-incompatible marrow transplantation by density-gradient separation using the IBM 2991 blood cell processor. AB - Thirty patients who had major ABO blood group incompatibility with their HLA matched donors underwent allogeneic marrow transplantation after removal of red blood cells (RBC) from donor marrow by Ficoll-Diatrazoate (F-D) separation using the IBM 2991 blood cell processor. We selected the IBM 2991 because we were interested in obtaining information about RBC-depleted mononuclear cells for monoclonal antibody and complement incubation of marrow. The median residual marrow RBC volume was 2.6 ml (1.2% of the original volume) and marrow infusion was well tolerated in every instance. The median doses of nucleated and mononuclear cells were 8.7 X 10(7)/kg and 2.2 X 10(7)/kg recipient weight, respectively, representing median marrow total nucleated and mononuclear cell losses of 63.4% and 52.9%, respectively. The median CFU-GM loss was 52.4%. Four patients died 13-21 days after marrow infusion and were unevaluable for engraftment. One patient failed to achieve engraftment and received a second transplant on day 36 from a second donor. One patient with myelofibrosis had poor engraftment and died on day 177 with low peripheral blood counts. For evaluable patients, no significant differences were observed in the rate of recovery of peripheral blood granulocyte or platelet counts between those receiving RBC depleted marrow or ABO-matched unprocessed marrow. However, posttransplant red cell transfusion requirements were increased and transfusion independence delayed in patients receiving RBC-depleted marrow as compared to patients receiving unprocessed marrow. We concluded that red cell depletion using the IBM 2991 was effective in removing red cell, but resulted in significant and variable hematopoietic cell losses which may have contributed to graft failure in at least one patient. Such cell losses appear to be inherent in both manual and semiautomated methods for F-D cell separation. PMID- 3536548 TI - Separation and functional analysis of bone marrow cells separated by rhodamine 123 fluorescence. AB - Mouse bone marrow (BM) cells were separated on the basis of fluorescence intensity after labeling with the supravital, fluorescing dye rhodamine 123 (Rh 123). Rh 123 accumulates in the mitochondria. The BM fractions were tested for the presence of spleen colony-forming units (CFU-S) that produced colonies at day 8 and day 12 after bone marrow transplantation; for the ability to rescue lethally irradiated mice; and for thymus-repopulating ability. The results showed that all the day-8 CFU-S incorporated a relatively large amount of Rh 123, while the day-12 CFU-S were stained heterogeneously. Survival after lethal irradiation, as expressed in the numbers of day-12 CFU-S transplanted, was predominately mediated by the weakly fluorescing fraction. However, early thymus repopulation, which is caused by prothymocytes contained in the graft, was mediated by the brightly fluorescing fraction. Data in the literature indicate that a high uptake of RH123 is correlated with cellular proliferation. This suggests that all the day-8 CFU-S and about 60% of the day-12 CFU-S are cycling. In contrast, less than 10% of both day-8 and day-12 CFU-S are killed by S-phase-specific agents. From this we conclude that a high uptake of Rh 123 depends on other factors in addition to the cell cycle status. It is suggested that differentiation processes in which the day-8 CFU-S appears to be involved also cause the presence of many or very active mitochondria. The difference between the weakly and brightly fluorescing fractions in the number of day-12 CFU-S required for 30-day survival after lethal irradiation, suggests that there is heterogeneity among the day-12 CFU-S population or that the fraction weakly labeled with Rh123 contains other, less mature, cells that are responsible for survival after lethal irradiation. Finally, the presence of prothymocytes in the brightly labeled fraction shows that these cells are different from the stem cells that protect lethally irradiated mice. PMID- 3536549 TI - Effectiveness of micronic aerosol generators and their aerosol characteristics. AB - We assessed the effectiveness of various aerosol-generating systems. Taplin's settling method and Venticis generators had a lower efficiency (37.3 +/- 3.8% and 51.8 +/- 9.6%, respectively) than the Syntevent (88.8 +/- 6.9%, p less than 0.001), Cadema (89.8 +/- 9.9%, p less than 0.001) and Mefar (85.3 +/- 19.4%, p less than 0.001) generators. The Mass Median Aerodynamic Diameter of the particles produced by the Mefar nebulizer (2.05 +/- 0.27 micron) was larger than that of any other generators (p less than 0.001). The Syntevent (0.54 +/- 0.09 micron) generator produced smaller particles than the Mefar, Taplin (0.89 +/- 0.10 micron, p less than 0.01) and Venticis (0.79 +/- 0.06 micron, p less than 0.02) generators. Particles produced by the Cadema system (0.69 +/- 0.06 micron) were smaller than those generated by the Taplin system (p less than 0.05). We conclude: that the Syntevent, Mefar and Cadema aerosol generators are more efficient than the others, and that all the generators tested except the Mefar may be used for studies that depend on the peripheral deposition of small particles within the lungs. PMID- 3536550 TI - Experimental studies on emphysema and chronic bronchial injury. AB - The discovery of the association of emphysema and homozygous alpha-1-proteinase inhibitor deficiency gave rise to the hypothesis that emphysema was caused by an imbalance between endogenous proteases and antiproteases. Experimental studies with enzymes have confirmed that emphysema is induced only by enzymes with elastolytic properties. The lesion produced is similar anatomically and physiologically to human emphysema. Genetic and nutritional models of emphysema that appear to be caused by elastic fiber degradation are also known. Alpha-1 protease inhibitor is normally present in the lung; alpha-2-macroglobulin which can loosely complex with elastases, may enter the injured lung and participate in its defense. Alpha-1-protease inhibitor may be inactivated by oxidants derived from cigarette smoke or endogenous phagocytes. The elastase/antielastase hypothesis of emphysema is also believed to be relevant in emphysema caused by cigarette smoking because cigarette smoke gives rise to increased numbers of neutrophils and macrophages in the lung thus increasing the elastase burden of the lung. The precise role of oxidation of alpha-1-protease inhibitor in-vivo by cigarette smoke is not yet clear. In-vitro and experimental data suggest that oxidants can also interfere with repair of lung matrix. A variety of injuries, including proteases, can give rise to secretory cell metaplasia in the central airways. Peripheral airways injury is produced by gases with oxidant properties such as ozone and NO2. The presence of a low molecular weight protease inhibitor in airway epithelial secretory cells when considered with enzyme-induced secretory cell metaplasia raises the possibility of a protease/antiprotease hypothesis of chronic bronchial injury. Although information on the pathogenesis of emphysema is still incomplete, efforts are being made to develop antiproteases which might be used in the prevention of emphysema and chronic bronchial injury. PMID- 3536551 TI - Free proteolytic activities in bronchoalveolar lavage fluid. PMID- 3536552 TI - Anti-inflammatory drugs and experimental bronchitis. AB - Chronic bronchitis (chronic hypersecretion) and chronic bronchiolitis (small airways disease) are two conditions associated with cigarette smoking: both contribute to airflow obstruction in man, the latter associated with progressive deterioration in lung function. Mucous metaplasia and hyperplasia are characteristic histological changes. Experimentally, cigarette smoke given daily for two weeks, induces similar histological changes in the airways of specific pathogen-free rats, providing a suitable animal model for study: an early proliferation of basal cells, accompanied by mucous metaplasia of surface epithelial serous cells is followed by proliferation of newly formed mucous cells. There is also a significant increase in epithelial thickness due to cell hypertrophy without stratification or prior ulceration. Experimentally, secretory cell hyperplasia is inhibited completely or to varying degrees by prophylactic administration (intraperitoneal injection) of either indomethacin, flurbiprofen, dexamethasone, prednisolone, hydrocortisone (each at 2 or 4 mg/kg body weight) or a mucolytic drug, N-acetylcysteine(Nac), given orally as a 1% solution of the drinking water. Nac also inhibits the associated mucus-hypersecretion. It takes between 21 and 84 days, depending on airway level, for the increase in secretory cell number to return to control values (ie recover). Indomethacin and flurbiprofen (4 mg/kg, by ip injection) shorten recovery to between 4 and 9 days in intrapulmonary airways but have no effect on recovery time in the rat trachea. Nac is effective in 6 of 7 airway levels which showed cigarette smoke-induced mucous cell hyperplasia. In conclusion, in the rat, the response to cigarette smoke is one of mucous cell metaplasia and both basal and mucous cell proliferation. Cigarette smoke-induced mucous cell hyperplasia can be inhibited when selected drugs are given concurrently with the cigarette smoke: indomethacin, fluriprofen and Nac are also therapeutic. PMID- 3536553 TI - Effect of intermittent high-frequency intrapulmonary percussive breathing on mucus transport. PMID- 3536554 TI - Critical review on small airway dysfunction. PMID- 3536555 TI - Long-term oxygen therapy vs. IPPB therapy in patients with COLD and respiratory insufficiency: survival and pulmonary hemodynamics. PMID- 3536556 TI - Respiratory disorders during sleep. PMID- 3536557 TI - Aerosols as a way of treating patients. PMID- 3536558 TI - A brief review of the biochemistry and pharmacology of Eglin c, an elastase inhibitor. AB - Eglin c is a small protein inhibitor of human leucocyte elastase and cathepsin G which has potential as a therapeutic agent for the treatment of disease states associated with inflammation. In particular, Eglin c has been proven effective in experimental animal models of emphysema and shock. While initial studies indicate that Eglin c is virtually non-toxic and does not produce deleterious effects to the cardiovascular system, central nervous system or basic metabolism (unpublished results), an allergenic potential of the protein has not yet been ruled out. PMID- 3536559 TI - The pharmacological properties of almitrine bismesylate. PMID- 3536560 TI - A review of clinical studies carried out in Italy with almitrine bismesylate. AB - The authors refer to a double-blind versus placebo multicentric study, carried out in Italy on 128 hypoxaemic patients suffering from COLD, with Almitrine bismesylate, a new chemoreceptor stimulant drug, given by mouth for a period of two months. Almitrine induced significant changes (p less than 0.001) of PaO2, with a mean increase of 7.6 mmHg, and of PaCO2, with a mean decrease of 4.1 mmHg, without variations of lung volumes and caliber of large and/or small airways. Almitrine, well tolerated within the time limits of this trial, seems an effective oral respiratory drug, acting through a favourable effect on V/Q mismatching due mainly to a reduction of the shunt effect, but also to an improvement of the ventilatory pattern. PMID- 3536562 TI - Recent advances in chronic bronchitis and emphysema: a personal view. PMID- 3536561 TI - Almitrine bismesylate and hypoxemia in COPD patients (results of an Italian multicentric trial). PMID- 3536563 TI - A one-year double-blind placebo-controlled study of the efficacy and safety of almitrine bismesylate in hypoxic COLD patients. Monitoring progress status on 490 patients entered into the VIMS study before January 1st, 1984. AB - The aim of the VIMS group is to verify the efficacy and acceptability of almitrine bismesylate (ABM) taken orally in the treatment of chronic obstructive bronchitis, by an international long-term study, one year controlled against placebo. This study includes more than 800 out-patients in 70 centres in 12 countries. 490 patients entered the study before 1/1/84, after the first 9 months of the inclusion period. 60% of patients are treated in France, 20% in the U.K. and Ireland and 20% in Belgium, Denmark, Italy, Switzerland. Their mean FEV1 is 0.87 liters, their mean PaO2 is 57 mmHg. The study protocol foresees two control visits separated by a 3 week interval before entry into the study in order to verify the stability of the patients on the basis of clinical, spirometric and gazometric data; the variation in PaO2 is less than or equal to 6 mmHg in more than 90% of the patients. The severity of the disease is assessed by the existence of an hospitalisation during the year preceeding the study in 55% of the patients, the necessity of oxygenotherapy at home for at least 12hr/day in 1/3 of them. The treatment of the latter was attributed separately at random to seek in a prospective manner the interest of associating O2 and ABM. During the study, the mortality of the patients included is 6% and about 70% of the patients completed the study period. The survey of adverse reactions and reasons for treatment interruption is progressively established by close collaboration between the investigators and monitors, to comply with the directives of pharmacosurveillance for severe and polymedicated patients. The analysis of the results to be carried out at the end of the study after verification and correction by the investigators, should enable us to enhance our knowledge of the clinical and gazometric parameters in patients with chronic obstructive disease followed for one year and treated by conventional means (control group) and the activity of ABM in order to confirm its therapeutic value in the treatment of chronic obstructive bronchitis. PMID- 3536564 TI - Socio-economic causes and consequences of chronic bronchitis and emphysema: an overview. PMID- 3536565 TI - Is chronic bronchitis also an industrial disease? PMID- 3536566 TI - Bronchitis and emphysema: importance of environmental factors and prevention. AB - The importance of environmental factors in Bronchitis and Emphysema is analysed in general terms, namely in which concerns the atmospheric pollutants, the tobacco smoke and occupational, socioeconomical and infectious features. The environment is also pointed out according to its relationships with endogenous factors. Personal research in the concerned areas are presented namely in the smoking and occupational fields and in studies on the deep lung. Preventive measures of Bronchitis and Emphysema are presented and briefly analysed. PMID- 3536567 TI - Plasmodium berghei: relative immunogenicity of infected reticulocytes and infected oxyphilic red blood cells. AB - Hyperbleeding of mice 1 day before and 1 day after infection with Plasmodium berghei resulted in a more aggravated infection. Parasitemia rose significantly faster, but the mean survival time of these mice was not significantly different from control mice. At Day 5 of infection, parasites were almost exclusively in reticulocytes in contrast to control infections in which parasites were found in oxyphilic erythrocytes at Day 5 after infection. Purified parasitized reticulocytes taken from hyperbled mice at Day 5 after infection contained more young developmental parasite stages than purified parasitized oxyphilic erythrocytes taken from normal mice at Day 5 to 7 after infection. Parasitized reticulocytes were more readily opsonized by antibodies from immune serum when compared to parasitized oxyphilic red blood cells and when used to stimulate immune spleen cells the former were better stimulator cells than the latter. Results suggest either that parasitized reticulocytes are more immunogenic then parasitized oxyphilic red blood cells or that suspensions of parasitized reticulocytes contain more immunogenic parasite stages than suspensions of parasitized oxyphilic red blood cells. PMID- 3536568 TI - Plasmodium falciparum: protease inhibitors and inhibition of erythrocyte invasion. AB - Invasion of human red blood cells by Plasmodium falciparum is inhibited by the protease inhibitors, leupeptin and chymostatin. The efficacy of chymostatin was reduced if the cells were first treated with chymotrypsin. On the other hand, exposure of fresh cells to the supernatant from a synchronous culture at the reinvasion stage showed no such effect. This suggests that a proteolytic step occurs in the course of invasion and may be confined to the region of contact between the invading parasite and the erythrocyte. To test this, leupeptin or chymostatin was introduced into lysed cells, which were then resealed. The intracellular inhibitor strongly reduced invasion. Leupeptin also caused a striking effect on the development of the trophozoite stage of the parasites: a massive vacuole, apparently containing undigested haemoglobin, developed within the parasite. This did not totally stop development and the vacuolated parasites could be recovered in relatively pure form by lysis of the parasitised host cells with saponin. PMID- 3536569 TI - Trypanosoma cruzi: variable fusogenic ability by different growth phases of the epimastigote form. PMID- 3536570 TI - Psychrophilic and psychrotrophic microorganisms. AB - Psychrophilic and psychrotrophic microorganisms have the ability to grow at 0 degree C. Psychrotrophic microorganisms have a maximum temperature for growth above 20 degrees C and are widespread in natural environments and in foods. Psychrophilic microorganisms have a maximum temperature for growth at 20 degrees C or below and are restricted to permanently cold habitats. This ability to grow at low temperature may be correlated with a lower temperature characteristic than that of the mesophiles, an increasing proportion of unsaturated fatty acids in the lipid phase of the cell membrane, which makes it more fluid, and a protein conformation functional at low temperature. The relatively low maximum temperature of growth for these microorganisms is often considered to be due to the thermolability of one or more essential cellular components, particularly enzymes, while some degradative activities are enhanced, resulting in an exhaustion of cell energy, a leakage of intracellular substances or complete lysis. Psychrotrophic microorganisms are well-known for their degradative activities in foods. Some are pathogenic or toxinogenic for man, animals or plants. However in natural microbial ecosystems psychrotrophic and psychrophilic microorganisms can play a large role in the biodegradation of organic matter during cold seasons. PMID- 3536571 TI - Life without oxygen: what can and what cannot? AB - The basic principles involved in the biotransformation of organic carbon compounds in the absence of molecular oxygen (dioxygen) are presented in this paper. The role of various electron acceptors during the breakdown of organic compounds is discussed and the metabolic end-products expected are summarized. The different biochemical possibilities and strategies for the anaerobic degradation of organic matter and the metabolic response of some organisms to anaerobiosis are elucidated. Positive and negative effects of anaerobiosis on environmentally relevant processes and their influence on man and on animals are reviewed. Finally, some examples of the biotechnological application of anaerobic processes are presented. PMID- 3536572 TI - The rate of biliary cholesterol secretion in high- and low-responding rhesus monkeys. AB - The rates of secretion of cholesterol in bile measured by an isotope ratio method were found similar in cholesterol-fed high- and low-responding rhesus monkeys. The results indicate that the failure on the part of the high-responders to increase proportionately the fecal excretion of neutral steroids to compensate for the higher absorption of cholesterol than the low-responders, as suggested earlier, is not due to a difference in the rate of biliary cholesterol secretion but must lie in some other aspect of cholesterol metabolism. PMID- 3536573 TI - Lack of influence of vitamin D deficiency on insulin release from the isolated pancreatic islets of rats. AB - Pancreatic islets were isolated from young (100 g) and adult (390 g), normal and vitamin D deficient male Sprague-Dawley rats. The release of insulin from leucine stimulated or glucose-stimulated islet was not altered by vitamin D deficiency. The in vitro addition of either 25-hydroxy- or 1,25-dihydroxyvitamin-D had no effect on insulin release from either normal or vitamin D deficient islets. We conclude that the earlier report (Normal et al., Science 209 (1980) 823-825) on vitamin D deficiency depressing insulin secretion from the perfused pancreas must be related to the vitamin's effect on insulin synthesis and not the islet's release of insulin. PMID- 3536574 TI - Further chromosomal studies on Ellobius lutescens: heteromorphism of chromosome No. 1 is not associated with sex determination. AB - Twelve animals of the species Ellobius lutescens from two generations were studied with various chromosomal banding techniques. This species carries 17 chromosomes in both sexes. In preceding studies chromosomal sex determination was assigned to different structural variants of chromosome No. 1. In the present study, no definite chromosomal basis for sex determination was found. PMID- 3536575 TI - Fluorescence labeling of an aminoacyl-tRNA at the 3'-end and its interaction with elongation factor Tu.GTP. AB - A new approach for the fluorescence labeling of an aminoacyl-tRNA at the 3'-end is applied to study its interaction with bacterial elongation factor Tu (EF-Tu) and GTP at equilibrium. The penultimate cytidine residue in yeast tRNATyr-C-C-A was replaced by 2-thiocytidine (s2C). The resulting tRNATyr-C-s2C-A was aminoacylated and then alkylated at the s2C residue with N-(iodoacetylaminoethyl) 5-naphthylamine-1-sulfonic acid (1,5-I-AEDANS). A greater than 100% increase in the intensity of fluorescence emission of the modified Tyr-tRNATyr-C-s2C(AEDANS) A was observed upon interaction with EF-Tu.GTP. A ternary complex dissociation constant of 1.27 X 10(-8) M was calculated from this direct interaction. Using such fluorescent aminoacyl-tRNA, the affinity of any unmodified aminoacyl-tRNA can be determined by competition experiments. By this approach, we show here that the affinity of unmodified Tyr-tRNATyr-C-C-A is identical to that of the modified Tyr-tRNATyr. This indicates that the fluorescence labeling procedure applied does not alter the affinity of the aminoacyl-tRNA for EF-Tu.GTP. The introduction of 2 thiocytidine into nucleic acids and their labeling with spectroscopic reporter groups may provide a unique means of investigating various types of nucleic acid protein interactions. PMID- 3536576 TI - DNA sequence analysis of diuron-resistant mutations in the mitochondrial cytochrome b gene of Saccharomyces cerevisiae. AB - Diuron (3-[3,4-dichlorophenyl]-1,1-dimethylurea), an inhibitor of mitochondrial respiration, blocks the yeast respiratory chain between cytochrome b and c1. Diuron-resistant mutants of Saccharomyces cerevisiae have been selected and several mutations localized to the mitochondrial cytochrome b gene. The present paper identifies specific DNA base changes within the cytochrome b gene conferring diuron-resistance. DNA sequence analysis was done utilizing primer extension of crude mitochondrial RNA preparations in the presence of reverse transcriptase. Five independent diuron-resistant mutations have been sequenced. PMID- 3536577 TI - Destabilization of actin filaments as a requirement for the secretion of catecholamines from permeabilized chromaffin cells. AB - In the search for a functional role of cytoskeletal proteins in the mechanism(s) of stimulus-secretion coupling, we have previously demonstrated that the actomyosin system might be involved in the transport of cations across the plasma membrane of bovine adrenal chromaffin cells [(1986) J. Biol. Chem. 261, 5745 5750]. To establish whether actin and myosin might also be involved in later stages of the cellular response, we have examined the possible effects of various actin-specific reagents on the calcium-mediated secretion of catecholamines from digitonin-permeabilized cells. F-Actin-destabilizing agents, such as cytochalasin D or DNase 1, were found to promote Ca2+-stimulated (as well as basal) secretion. By contrast, stabilizers, like phalloidin, produced the opposite effect. It is concluded that stimulus-secretion coupling in chromaffin cells might require the reorganization of actin for modulating both ion transport across the plasma membrane and exocytotic secretion per se. PMID- 3536578 TI - Control of tubulin gene expression during metacyclogenesis of Trypanosoma cruzi. AB - During differentiation of the dividing epimastigote to the non-dividing metacyclic trypomastigote form of the parasitic protozoan Trypanosoma cruzi there is a marked reduction in the rate of synthesis of the major proteins alpha- and beta-tubulin. Our results indicate that the control of synthesis of these proteins during the differentiation event is exerted at the level of alpha- and beta-tubulin mRNA accumulation. PMID- 3536579 TI - Identification of an insulin-like growth factor-binding protein in human cerebrospinal fluid with a selective affinity for IGF-II. AB - Human cerebrospinal fluid (CSF) has been found to contain several different molecular forms of IGF-specific binding proteins (BPs). Qualitatively, they are similar to those present in serum, although their relative proportions are very different, as well as to those present in the culture media of brain tissue from which these BPs presumably arise. One particular form of BP is predominant in CSF. It has an Mr of 34,000, as estimated by SDS-polyacrylamide gel electrophoresis followed by transfer onto nitrocellulose, and an isoelectric point around 5.0 based on chromatofocusing. It has a selective affinity for IGF II (approximately 4 X 10(10) M-1) as shown by competitive binding experiments in which biosynthetic IGF-I was about 40-times less potent than native IGF-II in displacing 125I-labelled IGF-II. These findings are in agreement with the preponderance of IGF-II in nervous tissue and in CSF and suggest that this BP plays an important role in the interaction of IGF-II with its target cells. PMID- 3536580 TI - Progress in pancreatic oestrogen receptors. PMID- 3536581 TI - Correlation between estrogen receptor levels and clinical response to ovariectomy in premenopausal women with advanced breast cancer. AB - From 1974 to 1980, according to a controlled clinical trial, 66 premenopausal women with advanced breast cancer underwent bilateral ovariectomy (BO). Of the hormonal parameters evaluated, the present study deals with estrogen receptors (ER). The relation between the presence or the absence of ER and clinical response was evaluated, without considering their concentration in neoplastic tissue. The response was evaluated in relation to threshold values of 5 fmol/mg protein (considered at the time of the study the cut-off value of negativity and positivity) and 10 fmol/mg protein (recently found to be a more accurate cut-off value). The results of BO in relation to different receptor status showed an analogous response. Furthermore, the higher the receptor concentration, the better the response to BO, especially when the concentration was higher than 25 fmol/mg protein. PMID- 3536582 TI - Relationship between body fluid volumes and arterial pressure. AB - The mechanisms by which blood volume influences arterial pressure in situations of reduced excretory capacity are reviewed. The relationships between volume and arterial pressure are discussed as acute, transitional, and long-term phases, recognizing that they are part of a continuum of events leading to a steady state. The acute hydraulic effects, reflex and hormonal responses, and local autoregulatory responses and their interactions are reviewed. Important functional changes of the microcirculation that occur in the transitional phase (1-2 days) are presented. These include increased O2 sensitivity, elevated tone, increased vasomotion, and functional rarefaction, all of which appear to be mediated at the local tissue level. In situation of long-term chronic volume expansion, some of these functional changes evolve into permanent structural changes such as anatomical rarefaction. However, increased vascular sensitivity to oxygen remains. These changes appear to account for a maintained increase in total peripheral resistance with hypertension, which is sustained at relatively normal levels of blood volume and cardiac output. PMID- 3536583 TI - Neural mechanisms in body fluid homeostasis. AB - Under steady-state conditions, urinary sodium excretion matches dietary sodium intake. Because extracellular fluid osmolality is tightly regulated, the quantity of sodium in the extracellular fluid determines the volume of this compartment. The left atrial volume receptor mechanism is an example of a neural mechanism of volume regulation. The left atrial mechanoreceptor, which functions as a sensor in the low-pressure vascular system, is located in the left atrial wall, which has a well-defined compliance relating intravascular volume to filling pressure. The left atrial mechanoreceptor responds to changes in wall left atrial tension by discharging into afferent vagal fibers. These fibers have suitable central nervous system representation whose related efferent neurohumoral mechanisms regulate thirst, renal excretion of water and sodium, and redistribution of the extracellular fluid volume. Efferent renal sympathetic nerve activity undergoes appropriate changes to facilitate renal sodium excretion during sodium surfeit and to facilitate renal sodium conservation during sodium deficit. By interacting with other important determinants of renal sodium excretion (e.g., renal arterial pressure), changes in efferent renal sympathetic nerve activity can significantly modulate the final renal sodium excretion response with important consequences in pathophysiological states (e.g., hypertension, edema-forming states). PMID- 3536584 TI - Pressure diuresis mechanism in the control of renal function and arterial pressure. AB - Precise knowledge of the interrelationships between arterial pressure and urinary excretion of sodium and water is crucial to understanding the long-term control of arterial pressure. Although increases in renal perfusion pressure have been known for more than 35 years to inhibit tubular reabsorption, the mechanism of this pressure diuresis response, the humoral or physical factors involved, and even the nephron segments in which the changes in tubular function occur remain relatively unknown. This review focuses on the experimental evidence that supports current hypotheses concerning the mechanism of pressure diuresis. Specifically, it examines the possibility that pressure diuresis is caused by a small increase in glomerular filtration rate, alterations in the humoral or physical factors regulating proximal tubular reabsorption, and/or inhibition of tubular reabsorption in deep nephrons secondary to changes in hemodynamics in juxtamedullary nephrons. The concept originally proposed that the kidney serves as the dominant long-term controller of arterial pressure is largely based on the assumptions that the pressure diuresis phenomenon exists and that it occurs via a nonadaptive mechanism. It has been proposed that hypertension can develop only if the relationship between arterial pressure and sodium excretion is shifted toward higher pressures. The remainder of this review examines recent evidence indicating that an abnormality in the pressure natriuresis relationship may be associated with the development of hypertension in humans and in the genetic rat models of the disease. PMID- 3536585 TI - Intrarenal mechanisms mediating pressure natriuresis: role of angiotensin and prostaglandins. AB - The ability of the kidney to increase sodium and water excretion in response to increases in perfusion pressure has been recognized for more than 50 years. Because glomerular filtration rate is tightly autoregulated, pressure natriuresis occurs as the result of decreased tubular sodium reabsorption rather than increased filtered load. Micropuncture and microperfusion data support the contention that acute changes in arterial pressure can alter proximal tubule reabsorption; however, studies have failed to show a consistent association between changes in sodium excretion and peritubular, interstitial, or tubular pressures. Thus, the specific intrarenal mechanism for the change in tubular reabsorption in response to an acute change in arterial pressure does not appear to be related to the peritubular physical factors at the level of outer cortical nephrons. The possible roles of angiotensin and prostaglandins as humoral mediators of pressure natriuresis are considered in this report. Although angiotensin II is a powerful modulator of the slope of the pressure natriuresis relationship, the responsiveness of sodium excretion to arterial pressure is actually enhanced by angiotensin-converting enzyme inhibitors. These data suggest that angiotensin does not mediate the basic phenomenon. Recent experiments indicate that intrarenal prostaglandins also modulate the magnitude of the pressure natriuresis relationship, but these hormones do not appear to be essential for its basic manifestation. PMID- 3536586 TI - Regulation of sodium excretion by renal interstitial hydrostatic pressure. AB - Renal interstitial hydrostatic pressure (RIHP) appears to play a crucial role in linking the renal circulation to the rate of tubular reabsorption of sodium and water. Various physiological and pharmacological maneuvers that increase RIHP are associated with increases in sodium excretion. Renal vasodilators that increase RIHP also increase sodium excretion, whereas the vasodilators that do not alter RIHP do not affect sodium excretion. Preventing increases in RIHP during intrarenal infusion of vasodilators markedly attenuates the normal increase in sodium and water excretion. Techniques that directly increase RIHP by renal interstitial volume expansion increase urinary excretion of sodium and water. RIHP may be an important mediator of renal perfusion pressure (RPP) natriuresis. Experimental evidence suggests that the proximal tubule of deep nephrons may be an important nephron site that is sensitive to changes in RPP. PMID- 3536587 TI - Regulation of arterial pressure: role of pressure natriuresis and diuresis. AB - The importance of the renal pressure natriuresis and diuresis mechanisms in long term control of body fluid volumes and arterial pressure has been controversial and difficult to quantitate experimentally. Recent studies, however, have demonstrated that in several forms of chronic hypertension caused by aldosterone, angiotensin II (AngII), vasopressin, or norepinephrine and adrenocorticotropin, increased renal arterial pressure is essential for maintaining normal excretion of sodium and water in the face of reduced renal excretory capability. When renal arterial pressure was servo-controlled in these models of hypertension, sodium and water retention continued unabated, causing ascites, pulmonary edema, or even complete circulatory collapse within a few days. Apparently, other mechanisms for volume homeostasis, such as the various natriuretic and diuretic factors that have been postulated, are not sufficiently powerful to maintain fluid balance in the absence of increased renal arterial pressure when renal excretory function is reduced in these forms of hypertension. The intrarenal mechanisms responsible for pressure natriuresis and diuresis are not entirely clear, but they seem to involve small increases in glomerular filtration rate and filtered load as well as reductions in fractional reabsorption in proximal and distal tubules. During chronic disturbances of arterial pressure additional factors, especially changes in AngII and aldosterone formation, act to amplify the effectiveness of the basic renal pressure natriuresis and diuresis mechanisms in regulating arterial pressure and body fluid volumes. PMID- 3536588 TI - Anaerobiosis, lactate, and gas exchange during exercise: the issues. AB - The lactate increase during exercise is a critically important biochemical and physiological event that leads to decreasing cell pH, an accelerated rate of glycogen depletion in the muscle, and important changes in ventilatory and gas exchange dynamics. Lactate increases only slightly at low work rates, and this increase is proportional to pyruvate increase (i.e. compatible with accelerated glycolysis without a change in redox state). At high work rates lactate increases disproportionately to pyruvate, the increased rate of lactate accumulation and lactate/pyruvate ratio appearing to occur at a threshold O2 consumption for a given individual. This symposium addresses the biochemical origin and physiological consequences of the increased lactate production during exercise. PMID- 3536589 TI - Metabolic properties of muscle fibers. AB - Mammalian skeletal muscles are composed of slow (type I) and fast (type II) twitch fibers, which, as reflected by their enzyme activity patterns, are characterized by specific metabolic properties. Type I fibers are always "oxidative" but nevertheless form a spectrum. Type II fibers likewise form a spectrum but display a wider range with "oxidative" and "glycolytic" extremes. As a result, type I and type II fibers can be classified independently of myofibrillar ATPase histochemistry by their specific enzyme activity profiles. In this context, activity ratios between enzymes of anaerobic and aerobic pathways can be used as discriminative parameters. Similarly, specific ratios of enzymes catalyzing unidirectional reactions in hexose metabolism (hexokinase, phosphofructokinase, fructose-1,6-bisphosphatase) separate the two fiber populations. The histochemically defined IIA and IIB subtypes cannot be separated into distinct metabolic groups. In view of the continuum of metabolic properties, skeletal muscle is an extremely heterogeneous tissue in which each fiber represents a separate metabolic compartment. PMID- 3536590 TI - Muscular fatigue: effects of hydrogen ions and inorganic phosphate. AB - During muscular fatigue two metabolites, hydrogen ions (H+) and inorganic phosphate (Pi), increase in concentration. The effect of increase in [H+] has been modeled mathematically for a system containing creatine kinase (EC 2.7.3.2), adenylate kinase (EC 2.7.4.3), and the appropriate concentrations of their substrates. Assuming that no other equilibrium reactions are involved, the result of acidification should be a useful increase in the ratio [ATP]/[ADP]. It is also shown by a reanalysis of earlier 31P NMR studies that the observed combination of increased [H+] and increased [Pi] leads to an increase in the monobasic phosphate concentration [Pi-] that is inversely proportional to the force of contraction. This suggests that Pi- may be a direct inhibitor of the actomyosin ATPase system. PMID- 3536591 TI - Lactate production under fully aerobic conditions: the lactate shuttle during rest and exercise. AB - O2 insufficiency and other factors increase the rate of lactate production. Significant quantities of lactate are produced under postabsorptive as well as postprandial conditions in resting individuals. In humans during postabsorptive rest, 25-50% of the total carbohydrate combusted appears to pass through the lactate pool. During sustained submaximal (in terms of VO2max) exercise, the rates of lactate production (Ri) and oxidation (Rox) are greatly elevated as compared to rest. However, lactate production and oxidation increase relatively less than O2 consumption during moderate-intensity exercise. Because the lactate production index (RiI = Ri/VO2) decreases during submaximal, moderate-intensity exercise compared to rest, it is concluded that skeletal muscle and other sites of lactate production are effectively oxygenated. Alterations in the levels of circulating catecholamines can affect levels and turnover rates of glucose and lactate. In pure red dog gracilis muscle in situ and in the healthy and myocardium in vivo, contraction results in glycolysis and lactate production. This production of lactate occurs despite an apparent abundance of O2. Similarly, glucose catabolism in the human brain results in lactate production. The formation of lactate under fully aerobic conditions of rest and exercise represents an important mechanism by which different tissues share a carbon source (lactate) for oxidation and other processes such as gluconeogenesis. This mechanism has been termed the lactate shuttle. PMID- 3536592 TI - Exercise-induced injury to skeletal muscle. AB - Strenuous or unaccustomed exercise can cause injury to skeletal muscle. This paper reviews our understanding of the mechanisms of exercise-induced injury. Measurements of exercise-induced injury have included muscle soreness, increased serum levels of intracellular enzymes, increased lysosomal enzyme activities, structural changes in muscle fibers, and prolonged decreases in force development that cannot be attributed to fatigue. Injury can be induced by exercise of small muscle groups, which suggests that it involves processes localized in skeletal muscles. Exercise of relatively short duration can result in injury, which indicates that long durations of exercise and associated metabolic changes are not necessary for injury to occur. Exercise that involves lengthening contractions results in greater evidence of muscle injury than exercise involving isometric or shortening contractions. Lengthening contractions are associated with higher levels of force and lower metabolic costs per muscle fiber than isometric or shortening contractions. These results suggest that changes in muscle metabolism are not responsible for exercise-induced injury to skeletal muscle. Exercise-induced injury is more likely the result of mechanical disruption of muscle fibers. PMID- 3536593 TI - Effect of anaerobiosis on the kinetics of O2 uptake during exercise. AB - The anaerobic threshold is an O2-related threshold of metabolic acidemia of which the chief metabolic acid is lactic acid. As such, it is a crucial parameter of aerobic function. For power outputs that are below the anaerobic threshold, the dynamics of O2 uptake (VO2) is well characterized as a linear first-order exponential process. The system time constant for leg exercise in humans has been shown to be congruent to 25-35 s with a "delay" of 15-20 s. Steady states are therefore normally achieved within 3 min at this work intensity. Above the anaerobic threshold a second, slower component of VO2 becomes evident that delays the steady state (if attainable). Consequently, the difference in VO2 between the third and the sixth minute of exercise is zero if the work rate is subthreshold and becomes progressively greater, the higher the increment above this parameter; this also correlates highly with the increment of arterial blood lactate, [L-]. This slow phase of the VO2 kinetics results in "excess" VO2, in that the VO2 rises to values above those attained by fitter subjects. This excess VO2 correlates highly with the increased [L-] (and possibly other factors), although its magnitude increases even more rapidly at work rates for which the increase in [L-] exceeds 4-5 meq/liter. PMID- 3536594 TI - Balancing conflicting metabolic demands of exercise and diving. AB - During enforced diving, aquatic animals activate a set of physiological reflexes (apnea, bradycardia, peripheral vasoconstriction), which are termed the diving response and are in effect the first line of defense against hypoxia. At least in the Weddell seal, this strategy is now known also to be used in voluntary diving at sea, but the response is necessarily modified to accommodate potentially conflicting demands of diving and swimming exercise. The main modification appears to involve skeletal muscles used in swimming, which, because of their high energy requirements, must be powered by aerobic metabolism. Thus they must remain perfused at rates porportional to swimming velocity (which is why heart rates are adjusted to swimming velocity). The required regulation of O2 delivery is achieved at least in part by a well-paced release of oxygenated red blood cells, stored at the beginning of the dive apparently in the spleen. The main metabolic difference between laboratory and voluntary diving is that, in the latter, working muscles serve as a sink for lactate and thus the entry rates of lactate into the plasma can be balanced by exit rates from the plasma; the maintenance of this balance means that no excess lactate remains for a lactate washout in postdiving exercise except under long, exploratory diving. Even in the latter long dives, however, the amount of lactate formed is far less than would be expected if the energetic shortfall caused by hypoperfusion and O2 lack were made up by anaerobic glycolysis (Pasteur effect). Consequently, during diving, hypoperfused tissues necessarily sustain a metabolic arrest of variable degrees as a mechanism of defense against hypoxia. PMID- 3536595 TI - Lactate during exercise at extreme altitude. AB - Maximal exercise at extreme altitude results in profound arterial hypoxemia and, presumably, extreme tissue hypoxia. The best evidence available indicates that the resting arterial PO2 on the summit of Mount Everest is about 28 torr and that it falls even further during exercise. Nevertheless, some 10 climbers have now reached the summit without supplementary oxygen. Paradoxically, blood lactate for a given work rate at high altitude in acclimatized subjects is essentially the same as at sea level. Because work capacity decreases markedly with increasing altitude, maximal blood lactate also falls. Extrapolation of available data up to 6300 m indicates that a climber who reaches the Everest summit will have no increase in blood lactate. The cause of the low blood lactate during exercise at extreme altitude is not fully understood. One possibility is depletion of plasma bicarbonate in acclimatized subjects, which reduces buffering and results in large increases in H+ concentration for a given release of lactate. The consequent local fall in pH may inhibit enzymes, e.g., phosphofructokinase (EC 2.7.1.56), in the glycolytic pathway. PMID- 3536596 TI - Molecular biology of human serum cholinesterase. AB - More than 90% of the amino acid sequence of purified human serum cholinesterase has been determined in our laboratory. Purified enzyme was digested with several proteolytic enzymes; the resulting polypeptides were then separated, purified, and sequenced. Optimal sequence regions were identified and used as the basis for the synthesis of three 17-mer oligonucleotide probes. In addition, one long peptide of 58 amino acid residues was selected for construction of two unique sequence oligonucleotide probes of 39-mer and 53-mer; the peptide regions corresponding to the latter are six amino acids apart. The probes have been used to screen a human liver cDNA library and a human genomic library. Several positive clones to both types of probes have been identified. These are being characterized, and some of them have been or are now being sequenced. A high degree of homology in the amino acid sequence of the active center of human serum cholinesterase and that of acetylcholinesterase from the Torpedo fish has been noted. It appears that this region of cholinesterases has been conserved during evolution, and there may be an important, still unrecognized role for serum nonspecific cholinesterase in mammalian metabolism. PMID- 3536597 TI - Glycolipid membrane-binding domain of human erythrocyte acetylcholinesterase. AB - The membrane-binding domain of human erythrocyte acetylcholinesterase is a small hydrophobic structure at the COOH-terminus of the enzyme subunits. Papain digestion cleaves a COOH-terminal dipeptide linked to the hydrophobic structure with the sequence His-Gly-ethanolamine-Z, where the ethanolamine is in amide linkage to the glycine and Z is a partially characterized glycolipid. This glycolipid includes a second residue of ethanolamine and a residue of glucosamine, both of which have free primary amino groups accessible to radiomethylation. The glycolipid also contains a carbohydrate residue or residues that bind to concanavalin A and nearly stoichiometric amounts of both palmitate and C22 unsaturated fatty acids. Similarities in this membrane-binding structure to those reported for trypanosome variant surface glycoproteins and Thy-1 glycoprotein suggest an important new category of posttranslational modifications involving the attachment of COOH-terminal glycolipid. PMID- 3536598 TI - Primary structure of acetylcholinesterase: implications for regulation and function. AB - A cDNA encoding acetylcholinesterase (AChE) (EC 3.1.1.7) from Torpedo californica was isolated and from its nucleotide sequence the entire amino acid sequence of the processed protein and a portion of the leader peptide has been deduced. Approximately 70% of the tryptic peptides from the catalytic subunit of the 11 S form have been sequenced, and a comparison of the peptide sequences with the sequence inferred from the cDNA suggests that the cDNA sequence derives from mRNA for the 11 S form of the enzyme. The amino acid sequence is preceded by a hydrophobic leader peptide and contains an open reading frame encoding for 575 amino acids characteristic of a secreted globular protein. Eight cysteines, most of which are disulfide linked, are found along with four potential sites of N linked glycosylation. The active-site serine is located at residue 200. Local homology is found with other serine hydrolases in the vicinity of the active site, but the enzyme shows striking global homology with the COOH-terminal portion of thyroglobulin. Further comparison of the amino acid sequences of the individual enzyme forms with other cDNA clones that have been isolated should resolve the molecular basis for polymorphism of the AChE species. PMID- 3536599 TI - Regulation of class II gene expression in a murine pre-B cell line. AB - Class II major histocompatibility complex (MHC) gene expression has been studied in an Abelson virus-transformed pre-B cell line R8, and its Ia-negative variant R8205. These variant cells contained barely detectable levels of RNA specific for all class II genes, including the nonpolymorphic invariant chain gene (Ii), and did not express cell surface Ia. Fusion of this murine Ia-negative cell line to the human Ia-positive Raji cell produced an interspecies hybridoma that expressed the murine Ia. These data are further evidence for the existence of trans-acting factors that can regulate class II gene expression. Furthermore, the T cell derived lymphokine B cell stimulatory factor 1 (BSF-1) induced expression of class II genes in the R8205 cells. Exposure of R8205 cells to an antibody that has been shown to mimic BSF-1 activity on normal B cells also resulted in expression of class II genes. These data demonstrate that three distinct signals- a lymphokine, an alloantibody binding to membrane structures, and an interspecies trans-acting factor--can induce expression of class II genes. PMID- 3536600 TI - Immunologic influences on reproductive biology: sperm gametogenesis and maturation in the male and female genital tracts. PMID- 3536601 TI - The nature of inhibin and its use in the regulation of fertility and diagnosis of infertility. PMID- 3536602 TI - Ultrasound: a technique useful in determining the side of ovulation. AB - It is often assumed that ovulation commonly occurs from alternating sides each month, but it is unknown whether it can occur repeatedly from the same side. In an effort to answer this question, we selected 39 women from our infertility clinic who had six consecutive courses of ultrasound (US) to monitor ovulation and in whom the side of ovulation was recorded. Nine patients (23.1%) ovulated from the same side for six consecutive cycles, whereas no patient alternated side of ovulation in the same period of time. Stimulation with clomiphene citrate and/or human menopausal gonadotropin that results in single ovulation did not affect this pattern. The data were analyzed statistically with the use of a Markov Chain Model and the chi-square goodness-of-fit; the occurrence of persistent same-side ovulation was significant to P less than or equal to 0.001. PMID- 3536603 TI - Diagnosis of luteinized unruptured follicle by ultrasound and steroid hormone assays in peritoneal fluid: a comparative study. AB - Luteinized unruptured follicle detection was carried out in 27 women by means of ultrasound scans three times per day and estimation of 17 beta-estradiol and progesterone levels in peritoneal fluid. The incidence of luteinized unruptured follicle diagnosed by ultrasound was 2 of 27 and by estimation of steroid levels was 8 of 27. In three women, a follicle-like structure appeared within 24 hours after ovulation was established by ultrasound; this was accompanied by extremely low progesterone levels in the peritoneal fluid. The disparity between these methods requires further evaluation. PMID- 3536604 TI - The perimenopausal patient in in vitro fertilization: the use of gonadotropin releasing hormone. AB - The perimenopause, incipient ovarian failure, is a major problem in stimulation failures during an in vitro fertilization program. This must be recognized as not necessarily related to age but also associated with adnexal inflammatory and operative processes. Although ovulation occurs uninterruptedly, the follicle stimulating hormone in the early follicular phase is elevated and the luteinizing hormone is normal. Characteristically, there is no estradiol response to human menopausal gonadotropin therapy or a rapid response with a premature luteinizing hormone surge. These problems sometimes may be overcome with pulsatile intravenous gonadotropin-releasing hormone therapy, 5 or 10 micrograms/90 or 120 minutes. The major therapeutic problem is in the identification of a luteinizing hormone surge in these patients. Of eight women who were treated, two failed to respond with follicular maturation, three either had no oocytes aspirated from apparently postmature follicles or had postmature oocytes; and one had treatment cancelled due to ovulation. The four latter patients may have failed because of unrecognized ovulation. In the remaining two patients, one oocyte was fertilized and transferred, and one pregnancy occurred. PMID- 3536605 TI - Removal of bacterial contaminants from semen for in vitro fertilization or artificial insemination by the use of buoyant density centrifugation. AB - Buoyant density centrifugation of semen produces the accumulation of populations of highly motile, morphologically normal spermatozoa in the lowermost 1 ml of Percoll (Pharmacia Fine Chemicals AB, Uppsala, Sweden) density gradients. In addition, the majority of bacteria present in semen are retained in the seminal plasma at the top of the gradients. Of 40 semen samples examined, 37 contained detectable bacteria, but after buoyant density centrifugation, the spermatozoal populations collected from the lowermost 1 ml of the Percoll columns were found to contain few or no bacteria. When preparations were collected using sterile technique (by boring a hole through the bottom of the centrifuge tube), 14 of the 20 preparations were found to be bacteria-free. When preparations were collected by passing a spinal needle from the surface through the seminal plasma to the bottom of the centrifuge tube, the sterility of the final spermatozoa preparations was not maintained, with only 5 of the 20 samples completely free of bacteria. The residual bacterial contamination of the remaining 15 samples was, however, very low (less than 5 colonies after a 48-hour culture period). PMID- 3536606 TI - The effect of relaxin and prostaglandin E2 on the motility of human spermatozoa. AB - Relaxin and prostaglandin E2 (PGE2) are present in human semen and have been shown to affect sperm motility. The authors further examined the effects of porcine relaxin and PGE2 on the motility of human spermatozoa. A dose-response study revealed that PGE2 at a concentration of 25 micrograms/ml is most effective in improving the motility of washed human sperm. Relaxin (100 ng/ml), PGE2 (25 micrograms/ml), or the two combined have no effect on the motility of spermatozoa in fresh, normal semen, suggesting that the constituents of fresh semen are optimal for motility. Relaxin and PGE2 individually improve the motility of washed spermatozoa. However, relaxin, but not PGE2, improves the motility of sperm in semen incubated at 37 degrees C for 5 hours (aged). In contrast to the individual substances, a combination of relaxin + PGE2 has no effect on the motility of washed spermatozoa or aged spermatozoa, suggesting that these two substances antagonize each other's actions on sperm motility. The presence of both relaxin and PGE2 in seminal plasma with normal motility spermatozoa suggests that other factors in seminal plasma regulate the effects of these substances on sperm motility. PMID- 3536607 TI - Treatment of hyperprolactinemic amenorrhea with pulsatile gonadotropin-releasing hormone therapy. AB - Pulsatile GnRH therapy has been shown effective in the treatment of infertility associated with hyperprolactinemia by direct action on the pituitary. Gonadotropin secretion was restored in the setting of moderate hyperprolactinemia. GnRH should be considered as a potential alternative to BCPT therapy in this setting. PMID- 3536608 TI - Monitoring of follicular maturation. PMID- 3536610 TI - [The neostriatum and instrumental behavior]. PMID- 3536611 TI - [Circadian rhythmicity of the enzyme activity of different portions of the small intestine]. AB - The circadian rhythms of maltase, alkaline phosphatase and dipeptide hydrolase were assessed in duodenum, proximal, medial and distal parts of the rat small intestine. Functional activities were assessed every 4 hrs for 24 hrs. Patterns of all enzymatic activities were different in different parts. The mucosal protein content in each segment of intestine was constant throughout the 24-hour period. PMID- 3536609 TI - Reproductive potential in the older woman. AB - There is a definite increase in the number of women bearing children in the 30- and 40-year-old age groups. The total number of women who are 35 to 40 years of age in the United States is projected to increase 42% and the percent births to this age group is projected to increase 37%. This is apparently because of a trend to postpone childbearing and first birth due to women's career priorities, advanced education, control over fertility, financial concerns, late and second marriages, and infertility. Associated with this is an increase in visits to the infertility specialist for older women who have an intrinsic decrease in fecundity with advancing age. Although, on the average, a woman will not experience menopause until about 50 years of age, her effective childbearing period may stop almost a decade earlier. A woman in her late 30s and, especially, early 40s is at some disadvantage in terms of conception delay, ability to carry a chromosomally normal fetus until term, and risk of trisomic conception. Certain endocrinologic parameters have been identified for the woman entering the transition to menopause. Biologic aging of the hypothalamic-pituitary-ovarian axis is intertwined with changes in the endocrine milieu of the perimenopause and preperimenopause. Despite a clear association of decreased fecundity in older women due to multiple biologic and social influences, so long as the individual has regular cycles and essentially normal endocrine parameters, she should be a candidate for an expedited infertility workup and ovulation induction, if not more aggressive treatment. Her obstetric profile is much improved, except for an increase in congenital anomalies and chromosomal defects. Chorionic villus biopsy study or amniocentesis is advised in all cases, regardless of therapy. PMID- 3536612 TI - [The 1st Russian textbook of physiology (on the 150th anniversary of the publication of A. M. Filomafitskii's textbook "Physiology, published for the guidance of students")]. PMID- 3536613 TI - [ Structural characteristics of 2 different diamond burs]. PMID- 3536614 TI - [Kiel heterologous bone grafts for correction of periodontal defects]. PMID- 3536615 TI - [Maximum efficiency in point precision. Pin-ledge connector system]. PMID- 3536616 TI - [Periodontal-friendly dentures. Attachments and telescope with the Kamba-Bloc]. PMID- 3536617 TI - [Experimental studies of accuracy of cut models]. PMID- 3536618 TI - [Cunning idea with economical effect. The Oetken double cuvette]. PMID- 3536619 TI - [The Kuwata technic. I. Waxing with an occlusal plane analyzer]. PMID- 3536620 TI - Dental computing applications. AB - The inexpensive, modern day computer has many applications for the dental practice. Use of appropriate software and hardware for practice management, insurance, billing, marketing, financial, diagnostic, and educational applications can enhance the level of dental practice and fulfill the human needs for the patient, dentist, and office staff. PMID- 3536621 TI - Computer applications in dental hygiene. AB - Although the application of computers in dental hygiene has been minimal, the opportunities are limitless to enhance performance in all areas. This article includes a description of the roles of computers in clinical practice, practice management, dental hygiene education, and research. Even though several existing programs may be applicable for use in dental hygiene, there is a need for establishing programs unique to dental hygiene. PMID- 3536622 TI - Computers in dental education. Promise of the past versus reality of the present. AB - Computer usage in dental education has a history of about three decades. As envisioned during the infant years, this application has fallen considerably short of expectations, especially regarding instructional applications. The authors trace the early years through the present project a realistic view of computer-based usage in dental education in the coming years. PMID- 3536623 TI - Computer-assisted dental diagnosis. AB - Computer-assisted dental diagnosis has been discussed from the perspective of applications, decision-making processes, and a specific example of a diagnostic system. Rapid technologic advancement and anticipated developments in the field of artificial intelligence will undoubtedly change both our expectations of future evolutions and our capacity to transform these expectations into reality. The ability of computers to enhance the diagnostic capabilities of practitioners will make automation integral to future dental practice. PMID- 3536624 TI - Potential for computer and optical videodisk technology in dental education. AB - Dental education relies heavily on the use of color slides in the process of instruction. In fact, it is estimated that 300,000 slides are produced yearly for this purpose by all the dental schools in the country. This article describes how the wedding of computer and videodisk technology can create a powerful tool for managing a vast amount of visual information (54,000 slides) and an innovative means for providing instruction. PMID- 3536625 TI - The American Dental Network. Dentistry's information source. AB - A brief history of the development of telematics and electronic information retrieval was presented. Electronic information services of special interest to the dental professional were outlined. The American Dental Network, which provides the most comprehensive online services specifically for dentists, was described in detail. PMID- 3536626 TI - Computers in dentistry. AB - Traditionally, each professional school has developed its own course or department of health care informatics. We may find it more efficient and productive to establish a department of Medical Informatics to serve all health science colleges. Therefore the initial costs would be reduced and the common knowledge bank would be greatly increased. In a position paper written for the Association of Academic Health Centers lies the detailed plans for the establishment of an integrated health sciences center computer resource. The inclusion of computer courses in the curriculum can be summarized in the following action step. The chief administrative officer of the academic health center should facilitate the work of the deans of the schools of the health professions in convening faculty task forces that will address the introduction of computer literacy and computer applications in health care to the curricula. Although dental informatics is still in its infancy, we must lay a solid foundation for the controlled growth and development of this field of dental science. The problems encountered in developing a course in dental informatics are not unique to this one area. All specialties of health care are grappling with the questions posed by medical informaticians. Although each specialty has its own needs and requirements, the basic underlying principles of medical informatics remains the same. The knowledge we can gain by the exchange of experiences between all fields can greatly increase the speed and accuracy of development. The primary goal of computer literacy in dental education should be to prepare our students for the changing practice environment of the future. PMID- 3536627 TI - Human stress response and its possible relationship to disease. PMID- 3536628 TI - Relaxation skills for the patient, dentist, and auxiliaries. AB - The aforementioned stress reduction techniques can be useful for some people, but not all individuals will benefit to the same degree with a similar technique. Those who manifest severe stress symptoms, such as ulcers, hypertension, and migraine headaches, are advised to seek a medical evaluation before attempting relaxation or any other type of stress reduction method. The relaxation skill most beneficial for an individual's own needs might be best sought through a qualified therapist. Those who desire reduction in general tension, or who wish a rejuvenation during the workday, may well benefit from less controlled stress reduction techniques, such as taped instructions, breathing, and imagery methods. A trained therapist can provide the most appropriate relaxation method for an individual's needs. We, as health care providers, can enlighten our patients about methods which can aid them in dealing with anxiety and stress and thus gain better control over the pace of their lives and ours. PMID- 3536630 TI - Partial denture design: modern concepts. 3. Design: [ii] retention, safety and occlusal correction. PMID- 3536629 TI - Complete denture problems. PMID- 3536631 TI - Intrapartum fetal heart rate monitoring in a combined low- and high-risk population: a controlled clinical trial. AB - In a prospective clinical randomized investigation 487 women had the condition of the fetus during labour supervised by means of stethoscope (AUS), while 482 women went through labour under surveillance of electronic fetal monitoring, cardiotocography (EFM). 349 women refused to participate in the investigation (NAI) and had delivery conducted according to the normal procedures of the department (70% AUS, 30% EFM). Significantly more pathological fetal heart rate patterns (FHR) were found in the EFM group compared to the AUS group in both the first and the second stage of labour. As a result significantly more vacuum extractions were performed in the EFM group than in the AUS group, while no statistical difference was found between the groups in the incidence of acute cesarean sections carried out for asphyxia. One case of intrapartum death occurred in the AUS group. No differences were found in Apgar scores after 1 and 5 min or in neonatal morbidity at examination on the 2nd and 5th days after delivery. A tendency towards more biochemically compromised children was found in the AUS group. The specificity for both methods was found to be acceptably high (80%), while the predictive value for both methods was low (50%). More research is therefore urgently needed to evaluate supplementary investigations and parameters for the evaluation of the intrapartum fetal condition. PMID- 3536632 TI - Quadruplet pregnancy in IVF. AB - The frequency of multiple pregnancy following IVF with the presently accepted methods is ten times higher than in natural cycles, and is identical to that following induction of ovulation with HMG. In spite of the fact that multifetal pregnancy exposes both fetus and mother to certain dangers, most couples joining IVF programs expose themselves to, and generally accept the risk of, multiple pregnancy, since this is their last resort for having a baby of their own. We report such a case of quadruplet pregnancy after the IVF procedure and review the literature. PMID- 3536633 TI - Puncture of unilateral renal cyst in utero. AB - Although most authors do not recommend prenatal puncture of a unilateral single cystic renal mass, in case the contralateral kidney is normal and there is sufficient amniotic fluid, this case report shows that the procedure, which can be done very carefully under ultrasonic guidance, can be helpful in establishing the presumed diagnosis. PMID- 3536634 TI - Collagen production by rat liver fat-storing cells in primary culture. AB - Morphological changes, proliferation and collagen synthesis of fat-storing cells (FSC) in primary culture were examined. FSC, isolated from rats treated with vitamin A, showed numerous large lipid droplets in the cytoplasm and positive desmin staining. After 4-7 days culture, these cells were transformed into fibroblast-like cells with a gradual depletion of lipid droplets and with abundant well-developed rough endoplasmic reticulum. The proliferation analysis revealed that DNA synthesis preceded the increase of cell number. Enhancement of the collagen synthesis by FSC were associated with the morphological change of the cells. Quantitative analysis revealed that these cells produced mainly type I collagen (84%) and a small amount of type III collagen (16%). PMID- 3536635 TI - Fuel selection in animals. PMID- 3536636 TI - Ribosomal RNA processing in Escherichia coli and cultured mammalian cells. PMID- 3536637 TI - RNA processing in a structural gene from bacteriophage T4. PMID- 3536638 TI - Islet neoformation in tissue culture. AB - We have devised a tissue culture system that permits de novo formation of islets. Neonatal rat pancreata are enzymatically dissociated into single cells. The cell suspension is filtered through polyester cloth with 20 microns pores to exclude cell aggregates as well as preformed islets and a single cell suspension is then plated into tissue culture dishes at a density precluding reaggregation. Pancreatic cells proliferate forming numerous colonies of epithelioid cells. After a confluent monolayer, cells proliferate into a third dimension, the space occupied by the culture medium. Third dimensional proliferation occurs from basal monolayers of epithelioid colonies. At about 9 days in culture, numerous hillocks are visible that are spaced at about 1 mm from one another. Islets are observed to bud from the hillock surfaces. In 1 micron-thick sections, secretion granules are detected with the light microscope in some islet cells. With the electron microscope three basic cell types are seen. One peripherally located cell type is sparsely granulated and appears to be a precursor cell. The other peripherally located cell type shows a homogeneous population of secretion granules characteristic of A-cells. The third cell type is found in the interior of islets containing granules characteristic of B-cells. Islet cells, but not hillock cells, react immunocytochemically for insulin and glucagon. The cultures secrete 2 to 10-fold the amounts of glucagon present in fresh medium. It is concluded that differentiation of A- and B-cells occurs in neoformed islets. PMID- 3536639 TI - Tissue distribution, developmental profile and hormonal regulation of androgen responsive secretory proteins of rat seminal vesicles studied by immunocytochemistry. AB - The seminal vesicles of the rat synthesise large amounts of androgen-regulated secretory proteins. Indirect immunofluorescence cytochemistry and immunoblotting with monospecific polyclonal antibodies against three of the major secretory proteins (II, S and F) have been used to investigate the tissue distribution, subcellular localisation, androgen-regulation and developmental profile of secretory protein synthesis. There was no evidence for regional specialisation of the seminal vesicle epithelium; every epithelial cell synthesizes all three proteins via a classical secretory involving storage in secretory vesicles. Proteins S and II are contained within the same secretory vesicles. The time course of deinduction of proteins S and F after castration and their reinduction by testosterone closely followed that for their specific mRNAs described previously. During development, proteins S and F first appear between 10 and 15 days after birth. A protein immunologically related to seminal vesicle protein II is present in the lateral and dorsal lobes of the prostatic complex. PMID- 3536640 TI - Folic acid as an adjunct in the treatment of children with the autism fragile-X syndrome (AFRAX). AB - Four boys with the combination of infantile autism and the fragile-X syndrome were given oral folic acid and placebo, according to a double-blind crossover design. One boy's behaviour appeared to improve on folic acid, but another boy did not seem to be affected at all. For the remaining two boys the results were equivocal. Further study of folic acid in the treatment of autistic boys with the fragile-X syndrome is warranted. PMID- 3536641 TI - Alcohol consumption during pregnancy: a critical review. PMID- 3536643 TI - Birth asphyxia in the fullterm newborn: early assessment and outcome. PMID- 3536642 TI - Skeletal muscle adaptability. III: Muscle properties following chronic electrical stimulation. PMID- 3536644 TI - Effect of Ensure, a defined formula diet, in patients with Crohn's disease. AB - A prospective controlled 6-month study was undertaken to compare the effect of Ensure, a defined formula dietary supplement, and diet counselling in 122 outpatients with Crohn's disease. The compliance to Ensure was poor due to a high incidence of side effects. Taking any amount of Ensure reduced the need for surgery and the amount of hospitalization. There was a trend for patients receiving Ensure to experience a decline in the value of their Crohn's disease activity index (p less than 0.10). No consistent effects of Ensure were seen on the amount of work missed due to Crohn's disease, in laboratory measurements, in the need for prednisone or Salazopyrin. The vitamin B12 intake was improved, but otherwise nutrient intake declined due to a decreased food intake. Thus, certain beneficial clinical trends were associated with taking Ensure, but larger numbers of compliant patients will need to be studied to better assess the long-term role of defined formula diets in the management of outpatients with Crohn's disease. PMID- 3536645 TI - Immunological evidence for an H1(0) type of histone protein in chicken liver. AB - We prepared monoclonal antibodies against chicken histone H5. These antibodies could be divided into two classes, and we present the results obtained with one representative antibody of each class. One class reacted exclusively with chicken H5, whereas the other additionally cross-reacted with rat H1(0) and with material present in adult but not embryonic chicken liver. The cross-reacting material in adult liver was identified by Western blotting as representing a minor band in histone preparations. The protein was not present in histone extracts from chicken erythrocytes. It is likely that this newly identified protein is a chicken H1(0) histone. PMID- 3536646 TI - Mouse endometrial stromal cells produce basement-membrane components. AB - During mouse pregnancy, uterine stromal cells transform into morphologically distinct decidual cells under the influence of the implanting embryo and a proper hormonal environment. Mechanical stimulation of hormonally primed uterine stromal cells leads to the same morphologic alterations. The decidualization of stromal cells is characterized by the accumulation of pericellular basement-membrane material. Decidualized stromal cells of pregnancy differ in this respect from stromal cells obtained from nonpregnant uteri, which are not associated with any significant amounts of basement-membrane components. Mouse decidual cells isolated from 6- to 7-day pregnant uteri explanted in vitro continue to synthesize basement-membrane-like extracellular matrix. Using immunohistochemistry and metabolic labeling followed by immunoprecipitation, SDS PAGE, and fluorography, it was shown that the decidual cells synthesize laminin, entactin, fibronectin, type-IV collagen, and heparan sulfate proteoglycan. Stromal cells isolated from nonpregnant uteri and explanted in vitro produced the same basement-membrane components. Apparently, these cells were stimulated by the procedure used during isolation and explanation to undergo pseudodecidualization. We thus showed that stromal cells from pregnant and nonpregnant mouse uteri synthesize significant amounts of basement-membrane components in vitro, and hence could serve as a good model for the study of normal basement-membrane components. PMID- 3536647 TI - [Agustin Andrade (1836-1866)]. PMID- 3536648 TI - [2 medical bibliographic jewels from San Luis Potosi]. PMID- 3536649 TI - Fine-needle aspiration cytodiagnosis: a simple and safe procedure for cancer of the pancreas. AB - One hundred fine-needle aspirations (45 percutaneous ultrasonically-guided and 55 intraoperative) were performed in 82 patients suspected of having pancreatic cancer, in order to evaluate the contribution of cytologic data to definitive diagnosis of this tumor. The overall success rate of both cytologic methods was 90.6 p. 100 in our 64 patients who were histologically proved to have pancreatic cancer. Sensitivity was 77.4 p. 100 with percutaneous and 75.5 p. 100 with intraoperative aspirations. In all 18 cases with the final diagnosis of chronic pancreatitis results of both techniques were negative. Neither relevant morbidity nor mortality were recorded in any of the 82 patients. These cytologic studies are at present reliable, rapid, highly cost-effective (especially percutaneous aspiration) and most important, safer than histologic examinations. We believe that fine-needle aspiration cytology has gained a primary role in the diagnostic process of pancreatic carcinoma. Therefore the old view of considering examination of cytologic material only as a screening procedure should be abandoned. PMID- 3536650 TI - [Bismuth encephalopathy: a reappraisal of risk factors]. PMID- 3536651 TI - Intestinal uptake of IgG in suckling rats. Distinction between jejunal and ileal epithelial cells demonstrated by simultaneous ultrastructural localization of IgG and acid phosphatase. AB - During the suckling period, the proximal small intestine of neonatal rats absorbs maternal milk immunoglobulin G (IgG) into the circulation by a receptor-mediated mechanism. At the same time, milk IgG enters vacuoles in the distal small intestine unaided by a receptor and is degraded. To help define the distinction between the handling of IgG by the proximal and distal neonatal small intestine, we simultaneously localized IgG (by peroxidase-labeled antibodies) and acid phosphatase (by a lead phosphate technique) at the ultrastructural level. In the proximal small intestinal epithelial cells, IgG-containing vesicles were separate from acid phosphatase-containing structures, whereas in the distal intestinal epithelial cells, IgG was present together with acid phosphatase in large supranuclear vacuoles. These observations are consistent with the hypothesis that IgG avoids degradation in the proximal intestinal cells because vesicles in which it is transported do not fuse with lysosomes, whereas IgG in the distal small intestine is degraded in lysosomal enzyme-containing organelles. PMID- 3536652 TI - Intrahepatic distribution of hepatitis B surface and core antigens in chronic hepatitis B virus infection. Hepatocyte with cytoplasmic/membranous hepatitis B core antigen as a possible target for immune hepatocytolysis. AB - The intrahepatic distribution of hepatitis B core antigen (HBcAg) and surface antigen (HBsAg) was studied in 32 patients with chronic type B hepatitis, and the results were correlated with the status of hepatitis B e antigen/antibody (HBeAg/anti-HBe) and with the histologic activity of the patients. In HBeAg positive patients with minor hepatitis activity, HBcAg was distributed mainly in the nuclei, whereas HBsAg was diffusely located on the plasma membrane as well as focally in the cytoplasm. In HBeAg-positive patients with chronic active liver disease, although the distribution pattern of HBsAg in liver remained unchanged, the expression of nuclear HBcAg decreased significantly with concomitant increase in cytoplasmic/membranous HBcAg expression. In HBsAg carriers who were anti-HBe positive, HBcAg was undetectable anywhere, whereas HBsAg could be seen only in the cytoplasm. These results suggest that membranous expression of HBsAg relates closely to active viral replication but is probably not responsible for the observed histologic activities. In contrast, cytoplasmic/membranous expression of HBcAg correlates with high degree of liver inflammatory activity. It is therefore suggested that hepatocytes with cytoplasmic/membranous HBcAg expression might be the target cells for immune hepatocytolysis. PMID- 3536653 TI - "Solitary" rectal ulcer syndrome. Are "solitary" rectal ulcer syndrome and "localized" colitis cystica profunda analogous syndromes caused by rectal prolapse? AB - The hypothesis that SRUS and localized CCP are analogous syndromes is supported by the similarities in clinical presentation and biopsy pathology of patients with these conditions. The theory that rectal mucosal prolapse causes SRUS and localized CCP is strengthened by the observation of like pathology in other clinical situations and various animal models in which mucosal prolapse occurs. However, rectal prolapse is not clinically demonstrable in all patients. Therefore, the definitive diagnosis of SRUS and localized CCP must depend upon the recognition of specific histopathologic features in rectal biopsy specimens from ulcer margins or otherwise abnormal mucosa. Conservative medical management is satisfactory for most patients, and surgical intervention should be reserved for highly selected patients. PMID- 3536654 TI - Morphologic and biochemical evidence for a contractile cell network within the rat intestinal mucosa. AB - Subepithelial and pericryptal fibroblastlike cells form a two-dimensional network immediately subjacent to the epithelial basal lamina in the small intestine and colon in several mammalian species. Stellate-shaped cells with similar, but not identical characteristics, form a three-dimensional network deep within the villar lamina propria. Electron microscopic studies indicate that these cells contain a putative contractile apparatus, are attached to each other and to apparently organized elements of the extracellular matrix by typical adhesive devices, and form gap junctions with each other. Comparative in situ immunoperoxidase localization studies document the presence in these cells of four contraction-associated proteins (smooth muscle isotropomyosin, cyclic guanosine monophosphate-dependent protein kinase, both nonmuscle and smooth muscle isomyosin, and actin) in amounts generally greater than those found in connective tissue fibroblasts, but less than in smooth muscle cells. Taken together, these results strongly suggest a smooth muscle-like, contractile function for these cells and indicate that this cellular network may provide a supportive tonus for the epithelium, as well as provide the force needed for active movement of the villus, expulsion of crypt secretion products, and propulsion of absorption products in the lamina propria, the microvasculature, and lacteals of the intestinal villus. PMID- 3536655 TI - Localization of sucrase-isomaltase in the rat enterocyte. AB - We used immune electron microscopy to study the intracellular localization of sucrase-isomaltase, an intrinsic glycoprotein of the brush border membrane, to provide insight regarding the sites of its synthesis and intracellular processing and the mechanisms of its transfer to the brush border membrane. We identified the protein by postembedding staining with protein A-colloidal gold and by preembedding staining with peroxidase. The protein was found not only in the brush border membrane, but also in the endoplasmic reticulum including nuclear envelope, Golgi complex, smooth apical vesicles, and to a variable extent in the multivesicular bodies. Our findings are consistent with current concepts of biosynthesis of plasma membrane proteins, with synthesis, translocation, and initial glycosylation occurring at the membrane of endoplasmic reticulum and further processing occurring in the Golgi complex. The findings suggest the possibility that some intracellular degradation of sucrase-isomaltase occurs. Finally, our results appear to indicate that at least the final step of intracellular movement, transfer to the brush border membrane, is mediated by smooth apical membrane vesicles. PMID- 3536656 TI - Extrahypothalamic projection of luteinizing hormone-releasing hormone fibers in the brain of the toad, Bufo japonicus. AB - Extrahypothalamic projection of luteinizing hormone-releasing hormone (LHRH) fibers in the brain of the toad (Bufo japonicus) was examined immunohistochemically by the avidin-biotin-peroxidase complex (ABC) method. Immunoreactive LHRH perikarya are localized in the nuclei medialis septi and of the diagonal band of Broca. A part of the LHRH fibers are sent anteriad to the medial and dorsal pallia. Some fibers reach the olfactory bulb. Dorsocaudally, LHRH neurons in the medial septum project their fibers to the deep layers of the optic tectum and the posterior mesencephalon including the nucleus pretrigeminalis, which is considered to be a generator of mate calling behavior, via the habenular and posterior thalamic regions. In addition, LHRH fibers which run caudad through the dorsal infundibular region and then the mesencephalic reticular formation were widely distributed in both the gray and the white matter of the medulla oblongata. These findings suggest that LHRH acts as a neurotransmitter or a neuromodulator in the various neuronal circuitries for reproductive behavior in the central nervous system, because LHRH has been considered to be related to amphibian seasonal breeding, and many regions where the immunoreactive LHRH fibers were observed are the loci concerned with mating behavior. PMID- 3536657 TI - Use of pituitary cells in primary culture to study the regulation of gonadotropin hormone (GtH) secretion in rainbow trout: setting up and validating the system as assessed by its responsiveness to mammalian and salmon gonadotropin releasing hormone. AB - To study the regulation of gonadotropin secretion in rainbow trout in vitro, a method for preparing primary cultures of dispersed pituitary cells is described. Cells were dispersed by collagenase 0.1% in Hank's saline solution for 20 hr at 12 degrees and a high yield of viable cells was obtained. Attempts to improve cell functioning were made by varying culture conditions (density of cells initially plated, age of the culture). Cell functioning was assessed by their ability to respond to increasing doses of mammalian and salmon GnRH. Pituitaries were collected from spermiating males whose pituitaries are known to be sensitive to mammalian GnRH in vivo. Using 96-well plates, optimal conditions for good biological activity, are initial plating with 6.2 X 10(4) cells, incubation with GnRH for 24 hr on the third day after plating. In these conditions mammalian analog and salmon GnRH induced an increase in GtH release for doses ranging from 10(-9) to 10(-6) M. The GtH released during the GnRH incubation period does not decrease the sensitivity of the system since addition of 20 ng of GtH at the beginning of incubation does not modify the response profile. PMID- 3536658 TI - Purification of gonadotropic hormone from the pituitary of the African catfish, Clarias gariepinus (Burchell), and the development of a homologous radioimmunoassay. AB - Glycoprotein gonadotropic hormone (GTH) was purified from 2000 pituitaries of male and female African catfish, Clarias gariepinus. The first step was chromatography on concanavalin A-Sepharose followed by filtration on Ultrogel Aca 54, chromatography on DEAE-cellulose, and filtration on Ultrogel Aca 54, respectively. Finally, the purified fractions were analyzed by polyacrylamide gel electrophoresis. The gonadotropic activity in the different fractions was characterized using two tests: the radioimmunoassay for carp gonadotropin-beta subunit was used to quantify the immunoreactive GTH and a cAMP accumulation test was applied to measure the GTH biological activity. The purified glycoprotein GTH was used to raise antibodies and to develop a radioimmunoassay. This resulted in an assay with a variation between assays of approximately 4%, a precision of 4 8%, and an accuracy of 4-8%. GTH levels can be measured over a range of 0.8 to 12.5 ng/ml. PMID- 3536659 TI - The dopaminergic inhibition of the gonadotropin-releasing hormone-induced gonadotropin release: an in vitro study with fragments and cell suspensions from pituitaries of the African catfish, Clarias gariepinus (Burchell). AB - Pituitary fragments and pituitary cell suspensions of the African catfish in a perifusion system released gonadotropic hormone (GTH) spontaneously. After a few hours of perifusion a baseline of GTH release was established. The dopamine (DA) agonist apomorphine (APO) caused a decreased in the release from pituitary fragments but not from pituitary cell suspensions. APO abolished the luteinizing hormone-releasing hormone analog (LH-RHa)-induced GTH release from both pituitary fragments and cell suspensions. It was concluded that DA inhibits the GTH release induced by gonadotropin-releasing hormone. PMID- 3536661 TI - Properties of spontaneous mitotic recombination occurring in the presence of the rad52-1 mutation of Saccharomyces cerevisiae. PMID- 3536660 TI - Coexistence of urotensin I/corticotropin-releasing factor and urotensin II immunoreactivities in cells of the caudal neurosecretory system of a teleost and an elasmobranch fish. AB - By use of the indirect immunofluorescence method in conjunction with an elution restaining technique, cells in the caudal neurosecretory system of the big skate (Raja binoculata) and the plainfin midshipman (Porichthys notatus) were shown to contain both urotensin I (UI)/corticotropin-releasing factor (CRF) and urotensin II (UII) immunoreactivities. In the skate coexistence was complete, while in the midshipman some cells demonstrated immunoreactivity for only one or the other neuropeptide. The present results do not support previous suggestions that, like vasopressin and oxytocin in the hypothalamic magnocellular system, UI and UII exist in separate cellular populations in the caudal neurosecretory system. Results of these and other experiments indicate that there exists a wide range of species variation in the degree of coexistence of UI/CRF and UII immunoreactivities within caudal neurosecretory cells. PMID- 3536662 TI - DNA-binding and enzymatic domains of the bifunctional biotin operon repressor (BirA) of Escherichia coli. AB - The negative regulation of the biotin biosynthetic (bio) operon in Escherichia coli is mediated by the bifunctional birA gene product, which serves as the bio repressor and biotin-activating enzyme. Nucleotide sequence analysis of 18 mutations in the birA gene was employed to study the DNA-binding and enzymatic functions of the BirA protein. The results indicate that a predicted helix-turn helix structure, from amino acid (aa) positions 18 to 39 within the 321-aa BirA protein, may be responsible for sequence-specific DNA binding, whereas the temperature-sensitive mutations affecting biotin activation are found in two regions from aa positions 83-119 and 189-235. PMID- 3536663 TI - Expression of a wheat alpha-amylase gene in Escherichia coli: recognition of the translational initiation site and the signal peptide. AB - Transcription of a full-length cDNA clone of wheat alpha-amylase using a lac promoter in Escherichia coli results in synthesis of a precursor alpha-amylase polypeptide of the correct size, indicating that translation initiates correctly. Recognition of the plant translational initiation site by E. coli ribosomes is 15 20% as efficient as the ribosome-binding site of the beta-lactamase gene when it is fused to alpha-amylase. The alpha-amylase signal peptide is recognised in E. coli resulting in secretion of the enzyme into the periplasmic space; deletion of the signal peptide prevents secretion. Replacement of the alpha-amylase signal peptide with a beta-lactamase signal peptide also enables the bacterial cell to secrete the enzyme. The presence of the beta-lactamase and the alpha-amylase signal peptides in tandem results in secretion of the enzyme and removal of both signal peptides. PMID- 3536664 TI - Genetic characterization of the gene hupB encoding the HU-1 protein of Escherichia coli. AB - The gene hupB encoding the HU-1(HU beta) protein of Escherichia coli was mapped between proC at min 9 and minA at min 10 on the K-12 genome by plasmid integration and chromosome transfer studies. Genetic studies using plasmid rescue techniques demonstrated that the lon gene is located very close to the 5' end of hupB and that the two genes are both transcribed clockwise on the E. coli map [Bachmann, Microbiol. Rev. 47 (1983) 180-230]. PMID- 3536665 TI - Construction of plasmid vectors for the detection of streptococcal promoters. AB - Plasmid vectors have been constructed for detecting DNA fragments that exhibit promoter activity in Streptococcus sanguis. The plasmids are able to replicate in both S. sanguis and Escherichia coli, and contain an erythromycin resistance marker which is expressed in both hosts. Selection for promoter activity is dependent upon the insertion of appropriate DNA fragments upstream from a promoterless chloramphenicol acetyl transferase gene (cat) from Staphylococcus aureus. To facilitate this insertion, a pair of vectors, pMU1327 and pMU1328, were constructed with the polylinker from M13mp 18 in either orientation. The to transcriptional terminator of phage lambda is present downstream from cat. Translation stop codons in all reading frames are located between the polylinker and the initiation codon of cat. These plasmids have been used to isolate DNA fragments from S. sanguis, S. lactis and S. cremoris that exhibit promoter activity in S. sanguis. PMID- 3536666 TI - Identification and cloning of Thiobacillus ferrooxidans structural nif genes in Escherichia coli. AB - The presence of nucleotide sequences which are homologous to the nifHDK genes of Klebsiella pneumoniae was demonstrated in total DNA preparations from five different iron-oxidizing Thiobacillus ferrooxidans strains. A non-iron-oxidizing Thiobacillus novellus strain and a heterotrophic Acidiphilium strain, which occurs in close association with T. ferrooxidans, did not contain DNA homologous to the nifHDK genes. The T. ferrooxidans ATCC33020 nifHDK genes were cloned and their arrangement was characterized on a 6.7-kb insert in pIMP16. PMID- 3536667 TI - Identification of a sequence containing the positive regulatory region of Saccharomyces cerevisiae gene ENO1. AB - A DNA fragment which contains the 5'-flanking region of the Saccharomyces cerevisiae enolase 1 gene (ENO1) and a portion of the coding sequence was cloned in a plasmid pMC1587. This fragment was fused in frame to the lacZ gene of Escherichia coli. Many mutants which deleted a portion of the 5'-flanking region of ENO1 were isolated from this ENO1-lacZ fusion plasmid by in vitro recombination. Analysis of beta-galactosidase activity of these mutants indicated that the regulatory region responsible for an efficient expression of the ENO1 lacZ fused gene resides within an 86-bp sequence located at -487 to -402 upstream from the start codon of ENO1. We found that the segment encompassing the 86-bp region worked equally well in an inverted orientation, but the tandem duplication of the sequence did not enhance the expression of the fused gene. PMID- 3536668 TI - Conversation with ... Ralph DeFronzo, MD: dealing with the older diabetic. Interview by Richard L. Peck. PMID- 3536669 TI - [Protection of the health of children and adolescents in the 1st years of Soviet power]. PMID- 3536670 TI - [Evaluation of the mutagenic activity of tributyl phosphate on Salmonella typhimurium]. PMID- 3536672 TI - [Prolonged pregnancy. Diagnostic aspects]. PMID- 3536671 TI - [Description of fetal brain structure by ultrasound]. PMID- 3536673 TI - [Use of a calcium antagonist in the management of primary dysmenorrhea]. PMID- 3536674 TI - [Clinical course and diagnosis of chronic aspergillosis of the bronchi and lungs]. PMID- 3536675 TI - ["Conduit" in the surgical treatment of complex congenital heart defects]. PMID- 3536676 TI - [A compression method of forming an esophago-intestinal anastomosis]. PMID- 3536678 TI - Presidential address: Cervical cancer: a treatment evolves. PMID- 3536677 TI - Controlled trial of intravenous metronidazole as an adjunct to corticosteroids in severe ulcerative colitis. AB - A prospective double blind controlled trial was undertaken to examine the role of metronidazole as an adjunct to corticosteroids in the management of severe ulcerative colitis. Thirty nine patients with severe ulcerative colitis were randomised on admission to hospital to receive either intravenous metronidazole 500 mg eight hourly (19 patients) or an identical intravenous placebo (20 patients). The two groups were similar with respect to age, sex, and the extent of colitis. In addition all patients received a standard intravenous regimen consisting of methyl prednisolone 16 mg six hourly and parenteral nutrition together with a twice daily hydrocortisone 100 mg enema. Treatment was continued for five days when the patients were formally assessed. Fourteen of 19 patients (74%) receiving metronidazole and 14/20 (70%) receiving placebo were substantially improved, or in remission at the end of five days. Five patients treated with metronidazole and six with placebo had no improvement and all proceeded to urgent colectomy with no operative mortality. There were three late deaths, one in the metronidazole and two in the placebo group. These results do not support the routine use of intravenous metronidazole in the treatment of severe ulcerative colitis. PMID- 3536679 TI - Diagnostic capability of ultrasound versus CT for clinically suspected ovarian mass with emphasis on detection of adhesions. AB - Diagnostic capability was compared prospectively between ultrasound and CT using 25 consecutive cases of clinically suspected ovarian mass, which were found postoperatively to be comprised of 12 cases of ovarian neoplasm (of which 7 were malignant). 5 cases of endometriotic cyst, and 8 cases of nonovarian tumors including 4 cases of abscess. Accuracy for the histologic diagnosis with ultrasound and CT was 56 and 84%, respectively (P less than 0.05). With respect to discrimination of cystadenoma from cystadenocarcinoma, detection of intraperitoneal seedings, of paraaortic lymph node metastasis, and of ascites, either of the two imaging modalities was comparable to the other in their proficiency. In contrast to ultrasound, which permitted evaluation of adhesions to the uterus only in selected cases and hence was of limited use in this respect, CT was proficient in predicting the presence or absence of adhesions around the mass involving the uterus as well as other adjoining structures. The fact that CT is competent in detecting adhesions adds further value to CT as a powerful tool for the preoperative investigation of pelvic mass. PMID- 3536680 TI - Primary bronchial and ovarian carcinoid tumors in the same patient: a case report and histopathologic analysis. AB - The first case report of a 58-year-old woman with two different primary carcinoid tumors is presented. The bronchial carcinoid exhibited a mosaic pattern, whereas the ovarian tumor showed both insular and trabecular patterns. No teratomatous component was observed in the ovary. Both tumors presented an argyrophil reaction and neuron-specific enolase (NSE) immunoreactivity. The ovarian carcinoid contained a cell population of argentaffin and serotonin immunoreactive cells, while the bronchial carcinoid was unreactive. Peptide hormone immunostaining disclosed the presence of glucagon and pancreatic polypeptide (PP) in the bronchial carcinoid, whereas the ovarian carcinoid showed no immunoreactivity with the antisera used. The patient was treated surgically (bilobectomy of the right lung, 1978, and total abdominal hysterectomy and bilateral salpingo oophorectomy, 1984) and is now well with normal blood chemistry, normal urinary HIAA, and normal routine X rays of the lungs and the gastrointestinal tract, as well as normal ultrasonography of the abdomen and the liver. PMID- 3536681 TI - Infertility as caused by sperm antibodies. PMID- 3536682 TI - Ultrasound in the timing of artificial insemination with frozen donor semen. AB - Ultrasonography was performed to time ovulation in 30 patients participating in program for artificial insemination with donor semen (AID). During this study (10 months) 61 scans were carried out where one or more follicles were visible. The mean number of treatment cycles per patient was 2.8. Insemination with frozen donor semen was performed if a clear and mature follicle was detectable. The mean follicular diameter in successful inseminations was 20.1 +/- 0.8 mm, ranging from 16 to 23 mm. Twelve patients became pregnant, 9 (75%) of them after three treatment cycles. The mean time to conception was 2.75 cycles and the most successful day of the menstrual cycle was day 13. Ovulation was induced in 8 (56.7%) patients who conceived. Ultrasound is a noninvasive, quick and reliable method in the detection and timing of ovulation in most AID patients. PMID- 3536683 TI - Abnormally large placenta associated with Beckwith-Wiedemann syndrome. AB - A 37-year-old G1-P1 was diagnosed by ultrasonography at 26 weeks of gestation as having an abnormally large placenta with hemangiomas and a fetus associated with exomphalos. Placental protein 5 levels were relatively high in placental protein levels in maternal serum. The infant, delivered by cesarean section at 34 weeks, had the typical clinical features associated with Beckwith-Wiedemann syndrome. The abnormally large placenta weighed 1,492 g, measured 25 X 25 X 5.1 cm, and featured multiple hemangiomas. Microscopic placental features included edematous villi, increased fibrin deposition, intervillous thrombi, and multiple angiomatous and cellular chorangiomas. PMID- 3536684 TI - Prostacyclin is a more potent stimulator of thrombolysis than inhibitor of haemostasis. AB - The effects of prostacyclin (PGI2) on haemostasis and thrombolysis in human blood were investigated in vitro using the 'Haemostatometer'. In freshly drawn native blood samples, 5 ng/ml PGI2 greatly inhibited haemostasis but did not influence clotting time. The effect was potentiated in heparinised blood: 1 ng/ml PGI2 effect on haemostasis was still detectable, and the duration of the effect was prolonged. Thrombolytic activity was tested in heparinised blood by first allowing haemostasis and then measuring the time until rebleeding occurred through the consolidated haemostatic plugs. PGI2 at 0.5 ng/ml had no significant effect on haemostasis, but significantly decreased the time for spontaneous thrombolysis (p less than 0.001). Comparable effects were demonstrated in blood samples containing 50 U/ml streptokinase. Increased thrombolysis also occurred when haemostatic plugs formed from control blood were perfused with blood containing 5 ng/ml PGI2. The results suggest that PGI2 has a thrombolytic effect independent of any contribution from the vessel wall and that it is a more potent stimulator of thrombolysis than inhibitor of haemostasis. PMID- 3536685 TI - The use of monoclonal antibodies in graft versus host disease prevention. AB - One of the most important causes of procedure related death after bone marrow transplantation (BMT) is graft versus host disease (GvHD) in which donor T lymphocytes recognise alloantigens in the recipient and attack and damage the cells bearing them. Even when donor and recipient are matched at all loci of the major histocompatibility complex (MHC) 40%-70% of recipients develop severe graft versus host disease after conventional BMT: in a third of those affected the outcome is fatal. When donor and recipient are less than identical at the MHC the incidence and severity of acute graft versus host disease are correspondingly higher. The morbidity and mortality associated with acute GvHD has limited the application of bone marrow transplantation in two ways: first by restricting the procedure to patients with serious haematological disease and second by excluding individuals who might benefit from BMT but who lack an MHC identical sibling. In this review we discuss briefly the theoretical work that led us to our protocol for T-cell depletion for GvHD prevention and then describe the results of our own and other groups undertaking T-cell depleted bone marrow transplants. Finally, we discuss some of the new problems--and benefits--associated with T-cell depletion and outline the improvements in techniques now taking place. PMID- 3536686 TI - [Has trichloroethylene a future in anesthesia?]. PMID- 3536687 TI - [Congenital giant hairy nevi]. PMID- 3536688 TI - [The history of rheumatoid arthritis]. PMID- 3536689 TI - Using stress inoculation to prepare a patient for open-heart surgery. AB - Patients' emotional adjustment to illness may be a critical variable in their successful recovery. In a single-case study using stress inoculation to counter a patient's anxiety and depression before open-heart surgery, intervention was effective in reducing emotional distress. The value of applying stress inoculation in health care settings to combat stress related to illness is suggested. PMID- 3536690 TI - Evaluation of in vitro predictive tests for irritation and allergic sensitization. AB - Investigations of in vitro procedures to predict the potential of substances as skin irritants and as allergens inducing delayed hypersensitivity (contact dermatitis) are described, with indications of possible advances and known limitations. The examination of keratome slices of skin for release of enzymes, for changed histochemistry and for utilization of radioisotope-labelled amino acids will detect weak irritants but is of doubtful value for moderate irritants and will detect corrosive substances only through their inhibition of all cell activities. Fibroblast cultures, tested with Clostridium perfringens toxin and chemicals, show similar limitations in detecting moderate or severe irritants. Fibroblast cultures can be made more relevant to epidermal exposure by an overlying layer of agar containing keratin. In vitro tests to detect induction of sensitizing potential for delayed hypersensitivity have made little progress. The most promising approach is to treat antigen-presenting Langerhans cells with antigen and co-culture with lymphocytes. The lymphocytes may be examined for changes in receptor expression, for synthesis of interleukin 2, and possibly for responses to allergen if sufficient cells become specifically sensitized. There are several in vitro techniques to detect responses of in vivo- or in vitro sensitized lymphocytes treated with antigen. PMID- 3536691 TI - Chemical neurotoxicity: detection and analysis in organotypic cultures of sensory and motor systems. AB - Screening of chemical substances for human neurotoxic (and therapeutic) properties may be carried out with the aid of organotypic tissue cultures composed of foetal explants of mouse sensory and neuromuscular tissues that develop in vitro their characteristic cytoarchitectural and functional organization. Supporting this statement is a wealth of studies describing a range of specific, chemically-induced responses in organotypic neural cultures that parallel changes induced in the nervous system of humans and animals. PMID- 3536692 TI - Development of a primary culture system of rat kidney cortical cells to evaluate the nephrotoxicity of xenobiotics. AB - A method has been developed for preparing primary monolayer cultures of postnatal rat kidney cortical epithelial cells. These cultures maintained differentiated cell functions and epithelial-like morphology for several days in culture. The presence of alkaline phosphatase and maltase was used to confirm the presence of cells from the renal cortex. The concentrations of these enzymes were maintained in culture until day 3, but had declined significantly by day 5. Similar patterns were observed with cytochrome P-450 and glutathione content, although their concentrations remained stable from day 3 to day 5. Mercuric chloride, cadmium chloride and acetaminophen were evaluated for nephrotoxicity in this culture system. Treatment with these compounds resulted in dose-dependent changes in cell morphology and in biochemical parameters such as lactate dehydrogenase leakage, alkaline phosphatase activity and cellular glutathione content. With this culture system, it was possible to detect the acute toxicities of compounds that produce varying degrees of renal injury. Further development of this kidney culture system may have value in detecting potential nephrotoxins and in studying their mechanisms of toxicity. PMID- 3536693 TI - Detection of mutations in bacteria and of DNA damage and amplified DNA sequences in mammalian cells as a systematic test strategy for elucidating biological activities of chemical carcinogens. AB - The interdisciplinary evaluation of risks from carcinogens utilizes, inter alia, data on the activities of the compounds in short-term assays. A systematic approach is being used to determine mutagenesis in bacteria (the study of direct activities and specific modes of metabolic activation), DNA damage within primary mammalian cells (DNA single-strand breaks and persistence of damage, by a method extendable to the in vivo situation) and amplified DNA sequences in cultured cells (as an endpoint probably relevant to carcinogenesis). This test combination was expected to reduce some of the shortcomings of other batteries of tests, which suffer from a lack of appropriate metabolic conversion of compounds, irrelevancy of genetic endpoints and pharmacokinetic limitations. Furthermore, as each assay in the test strategy differs from the others only by one of the parameters described above, a reasonable understanding of divergent test results from assay to assay was anticipated. Several substances were investigated to elucidate why their activities in short-term assays and in carcinogenesis experiments do not correlate. The substances were N-nitrodimethylamine, for which formaldehyde is the reactive intermediate in bacterial mutagenesis but not in mammalian cells or in vivo, N-nitrosodiethanolamine, a carcinogen that must be activated by external alcohol dehydrogenase to be mutagenic in bacteria, N nitrosodialkylamines, with unique organotropism in vivo for which organ-specific activation was studied in vitro, N-nitroso compounds that are inactivated in vivo but not in vitro, and components of the aristolochic acid mixture which may be metabolized oxidatively or reductively, as well as numerous miscellaneous compounds that were expected to be genotoxins on account of their chemical structure. In addition to the assessment of genotoxicity, the results obtained in individual tests of this strategy yield important data on mechanisms of activity, such as organ-specific activation and deactivation, species variations, in vitro/in vivo correlation and persistence or repair of damage. PMID- 3536694 TI - Modifying action of vegetable juice on the mutagenicity of beef extract and nitrosated beef extract. AB - The effect of juices of different vegetables on the mutagenicity of beef extract (with S-9 mix) and nitrosated beef extract (with and without S-9 mix) was examined using the Ames test. All the juices affected the induced mutagenicity of beef extract and nitrosated beef extract in the presence of S-9 mix, but not the mutagenicity of nitrosated beef extract in the absence of S-9 mix. As the vegetable juices appear to affect mutagenicity only in the presence of S-9 mix, it is concluded that the constituents of vegetables do not act directly on the mutagens; the effects are apparently caused by an interaction with the metabolic activation system. PMID- 3536695 TI - Chlorinating poultry chiller water: the generation of mutagens and water re-use. AB - The purpose of this study was to assess the potential generation of mutagens by chlorination of water used to chill poultry carcasses. Unchlorinated chiller water from a nearby poultry processing plant was chlorinated to different levels in the laboratory. Residues of dichloromethane extracts of the treated water were tested for mutagenicity with the Ames Salmonella reverse mutation system. The rate of disappearance of added chlorine from the chiller water was also monitored using ferrous ammonium sulphate titration. The results showed a fast rate of disappearance of added free chlorine, only some of which reappeared as combined available chlorine. No mutagenic activity could be demonstrated at chlorination levels up to 100 ppm, but activity rose above 250 ppm, and a dose-response relationship was demonstrated. The significance of these findings for poultry processing is discussed. PMID- 3536696 TI - Salmonella/microsome mutagenicity tests of heat-processed milk samples. AB - Samples of whole milk were heat treated by commercial heat-sterilization, by commercial heat-pasteurization or by a laboratory heat-pasteurization (65 degrees C for 30 min). Each sample was tested for mutagenicity in Salmonella typhimurium strains TA98 and TA100 with and without S-9 mix. Dichloromethane extracts of milk heated at 100, 135 and 150 degrees C for 5 hr were also tested for mutagenicity using the same assay. None of these samples exhibited mutagenicity in the Ames assay used. PMID- 3536697 TI - [From the intestinal bacterium to the synthesis factory. 100 years of Escherichia coli]. PMID- 3536698 TI - [Experiences with human insulin. Results of a study in 1,267 diabetics previously treated with animal insulin]. PMID- 3536699 TI - [Carved nose and sponge gingiva. Noteworthy self-help management of gingival facial defect in the 18th century]. PMID- 3536701 TI - [An immunohistochemical study of myoglobin and S-100 protein in rhabdomyosarcoma]. AB - Twenty seven cases of rhabdomyosarcoma from pathologic files of the Hokkaido University Hospital from 1975 to 1985 were reviewed and the presence of myoglobin and S-100 protein was investigated immunohistochemically. Their average age at diagnosis was 30.7 years (ranging from two months to 77 years) and there was a predilection for males in a ratio of 1.7:1. The common locations were the head and neck. Nine cases were positively stained for myoglobin, mainly in the cytoplasm of rhabdomyoblasts and 19 cases were positive for S-100 protein and alpha-subunit of S-100 protein in the cytoplasm of immature tumor cells as well as of rhabdomyoblasts. In seven cases, both of myoglobin and S-100 protein were demonstrated. Although S-100 protein is not strictly specific, however, these results suggest that the immunohistochemical demonstration of S-100 protein can be a useful diagnostic tool of rhabdomyosarcoma. PMID- 3536700 TI - [Treatment of hypertension with alpha blockade or ACE inhibition. Multicenter double-blind study of urapidil versus captopril]. PMID- 3536702 TI - [Experimental orthotopic partial liver transplantation in rats]. AB - This report describes in detail a method and it's results for orthotopic partial liver transplantation in the rat. Cuff techniques were applied to two anastomoses at the infrahepatic inferior vena cava and the portal vein. Only 32% of the donor liver was used as a graft, which was provided with portal inflow only. Under these conditions the grafts hypertrophied, and about 65.9% of the last 47 grafts survived longer than one week. In conclusion, this study has proved that it is possible to obtain long term surviving orthotopic partial liver transplantation in the rat. PMID- 3536703 TI - Characterization of insulin receptors in liver membranes and isolated hepatocytes during rat ontogenic development. AB - The studies described in this paper were undertaken to characterize the hepatic insulin receptors in liver membranes and isolated hepatocytes, during rat ontogenic development. In liver membranes insulin binding was found to be the same in fetal and greater in suckling rats as compared with adult animals. Modifications of insulin binding reflect changes in the number of receptors, but not in the affinity constants. Time courses of insulin association and dissociation from liver membranes were unaffected by development. Degradation of insulin by liver membranes was significantly lower in fetal than in adult rats, but this does not seem to be responsible for the differences observed in binding. No significant differences in the degradation of insulin receptors between different groups of liver membranes were found. Similar results were obtained with isolated hepatocytes except for a reduced number of insulin receptors in fetal cells. This could be explained by the smaller cell surface of younger cells, since when the results were expressed by micron 2, insulin binding was almost the same in fetal and adult rats. These findings suggest that the early hepatic development of insulin receptors may play a significant role in the metabolic growth processes of the fetus and in the availability of nutrients after birth. PMID- 3536704 TI - Effect of sparteine sulfate on insulin secretion in normal men. AB - This study aimed at evaluating the influence of sparteine sulfate either upon basal plasma glucose and insulin or glucose-induced insulin secretion in normal man. Thirteen overnight fasted volunteers took part in this study; five of them were submitted to sparteine sulfate bolus (15 mg in 10 ml of saline solution) followed by a slow infusion (90 mg/100 ml X 60 min) and eight subjects underwent two different glucose pulses (20 gr. i.v.) in absence or in presence of sparteine, infused as described above. In basal conditions, along with sparteine infusion, plasma glucose showed a progressive and significant decrease (P less than 0.0001) and plasma insulin was significantly higher from min 10 to 120' (P less than 0.0005-0.001). Even during the glucose-induced insulin secretion, in the presence of sparteine infusion, plasma glucose levels were significantly lower while plasma insulin levels were significantly higher when compared to those observed after glucose alone. The acute insulin response (AIR) was 42 +/- 10 microU/ml after glucose alone vs 67 +/- 9 microU/ml after glucose plus sparteine (P less than 0.05). Total insulinemic areas were significantly different being 1410 +/- 190 vs 2250 +/- 310 microU/ml/min (P less than 0.001) during glucose and glucose plus sparteine infusion, respectively. This study thereby, demonstrates that in normal man sparteine sulfate, administrated by intravenous infusion, is able to increase either basal or glucose-induced insulin secretion. PMID- 3536705 TI - Plasma catecholamine levels during water immersion in man. AB - In ten normal subjects thermoneutral neck-out water immersion produced a highly significant natriuresis and diuresis mediated via an induced central hypervolaemia. During immersion suppression of plasma noradrenaline and adrenaline was observed but no change occurred in plasma dopamine levels. No correlation was found between the suppression of noradrenaline and the diuresis and natriuresis. The reduction in plasma noradrenaline observed may reflect a widespread diminution of sympatho-adrenal activity during water immersion. This reduction could be a consequence of the cardiovascular changes of immersion and may not be directly involved in the mechanism of the renal response. PMID- 3536706 TI - Protective effect of L-glutamine against the inhibitory action of 2-cyclohexene-1 one upon Ba2+-stimulated insulin secretion. PMID- 3536707 TI - Long term effect of noradrenaline on insulin binding to human adipose tissue "in vitro". PMID- 3536708 TI - Differential effect of insulin on the synthesis of lipoprotein lipase and glycerophosphate dehydrogenase activity in developing rat adipocyte precursor cells. PMID- 3536709 TI - Protein phosphorylation in a myogenic cell line: effects of insulin, epinephrine and glucose. AB - Protein phosphorylation was studied in L6 cultured muscle cells by incubating cells with Na 32Pi and subsequently exposing them to external agents. L6 cells readily incorporated 32Pi into a number of peptides approaching steady-state incorporation by 2 h. Insulin stimulated the phosphorylation of one peptide of molecular mass 29,000 daltons by 37% with an ED50 of 3 mU/ml. This peptide was located in the high-speed pellet (105,000 g 60 min) which is consistent with an S6 ribosomal protein. Epinephrine (10(-5) M) led to only a modestly stimulated (less than 14%) phosphorylation of three peptides of molecular masses 39,000, 29,000 and 21,000 daltons. Glucose (5-50 mM) stimulated the phosphorylation of one peptide of molecular mass 19,000 daltons by 24%. PMID- 3536710 TI - Ontogenesis of the insulin receptor in the rabbit brain. AB - We delineated the ontogeny of the brain insulin binding, insulin receptor number and affinity using plasma membranes isolated from the rabbit. Specific 125I insulin binding and receptor number expressed per milligram of protein increased from the 20 day gestation fetus to the 1-day-old newborn, declining thereafter to attain adult values by day 6 of postnatal life. Specific 125I-insulin binding and the receptor number in the adult brain was less than the fetal and neonatal (1 day) brain receptors. Although a similar trend was observed specifically during fetal development, the changes in receptor number expressed per microgram DNA were not significant in the neonatal period. The adult brain insulin receptor number was higher than the 20- to 27-day fetus and similar to that of the 30-day fetus and the 1- to 5-day newborns. The total receptor number correlated linearly with the brain plasma membrane protein increment velocity. The affinity of the receptors increased during early fetal development (20-27 days) and remained constant thereafter in the postnatal period. We conclude that the ontogenic changes of the brain insulin receptors are similar to the ontogenic changes of brain plasma membrane protein. The developmental changes are more pronounced when the receptor number is expressed per milligram protein versus microgram DNA. PMID- 3536711 TI - Demonstration of S-100 protein in sustentacular cells of phaeochromocytomas and paragangliomas. AB - Eighteen phaeochromocytomas, including both sporadic and familial cases, four cervical paragangliomas, two jugular paragangliomas, and one abdominal paraganglioma were examined immunohistochemically for the presence of S-100 protein. Positive staining in cells morphologically similar to the sustentacular cells of normal paraganglia and adrenal medulla were found in all paragangliomas and in the benign and aggressively growing phaeochromocytomas. In the two malignant tumours no positive reaction was demonstrated. In one tumour the sustentacular cells were shown to contain glial fibrillary acidic protein further supporting their Schwann cell relationship. The number of S-100 positive cells varied considerably. They demonstrated a spindle celled or elongated configuration with long slender processes. The nature of the sustentacular cell proliferation, neoplastic versus reactive, is discussed. PMID- 3536712 TI - Malignant hypertension due to a renin-secreting renal cell carcinoma--an ultrastructural and immunocytochemical study. AB - This is a case report of a 14-year-old girl who presented with malignant hypertension. She had high plasma levels of both active and inactive renin and investigation revealed a renal tumour. The tumour, a renal cell carcinoma, was removed by nephrectomy following which the blood pressure and the plasma renin levels fell to normal. An immunocytochemical study using an antibody to pure human renin showed no detectable renin in the kidney but the tumour contained a population of granular cells which showed strong positive staining for immunoreactive renin. We present the clinical, biochemical, histological, immunocytochemical and ultrastructural features of this case as evidence that this was a renin-secreting renal cell carcinoma. PMID- 3536713 TI - Decidual change in pelvic lymph nodes: a source of possible diagnostic error. AB - The presence of heterotopic decidual tissue in the sinuses of a pelvic lymph node from a pregnant patient with cervical carcinoma is described. The diagnostic implications are discussed. PMID- 3536714 TI - Electron-immunocytochemical localization of neuron-specific enolase in cytoplasm and on membranes of primary and metastatic cerebral tumours and on glial filaments of glioma cells. AB - A series of primary and metastatic human brain tumours was evaluated immunocytochemically for the electron microscopic localization of neuron-specific enolase (NSE). All contained cells which, regardless of the cell type, demonstrated an irregular distribution of NSE in their cytoplasm and on membranes. This was in contrast to the staining pattern in normal central nervous system (CNS) cells which, as previously reported (Vinores et al. 1984b), show only diffuse cytoplasmic staining usually not associated with membranes. In the tumours, the interior of nuclei and the cristae and matrices of mitochondria were consistently negative, as in normal CNS cells. Except in one low-grade fibrillary astrocytoma, the cytoplasmic filaments in neoplastic astrocytes were often, but not invariably, stained for NSE. The fine structural localization of NSE in neoplastic cells suggests that the conversion of 2-D-glycerophosphate to phosphoenolpyruvate by enolase may occur on the membrane and, in the case of astrocytic tumours, on the cytoplasmic filaments as well as in the cytoplasm. When cells which contain only the non-neuronal form of enolase (NNE) transform to neoplastic cells, they may acquire the ability to produce NSE. This presumably enables them to accommodate the increased metabolic demands of neoplasia by allowing them to elude the regulatory controls that are specific for NNE. PMID- 3536716 TI - Monotypic immunoglobulin E plasma cells in an allogeneic bone marrow transplant recipient. AB - A patient with acute lymphoblastic leukaemia in first remission received a bone marrow transplant from his HLA-identical brother. The patient had a remote history of asthma and the bone marrow donor had allergic asthma. The patient developed acute graft-versus-host disease and died 2 months after transplantation. At autopsy there were high numbers of plasma cells in lymphoid tissues. The majority of this cell population was of polytypic IgG, IgM or IgA origin, but there was a significant contribution by monotypic IgE-lambda containing cells, varying from 10% in the appendix to 35% in lymph node. The serum IgE level in the patient was less than 0.5 IU/ml before transplantation, and 8.5 IU/ml 1 month thereafter. In the donor the value was about 400 IU/ml. In the donor only, specific IgE antibodies to various allergens were detectable. The bone marrow of the donor contained 0.4% plasma cells, of which 36% were IgE positive (chi/lambda ratio 1/11). These findings are compatible with literature data on elevations in serum IgE level following bone marrow transplantation. We suggest that the IgE-lambda plasma cell population is of donor origin. PMID- 3536715 TI - Haemolytic-uraemic syndrome in recipients of bone marrow transplants not treated with cyclosporin A. AB - We report three cases of haemolytic-uraemic syndrome following bone marrow transplantation in young males. None of them was treated with cyclosporin A. All died in renal failure. Renal histology showed the typical appearances of haemolytic-uraemic syndrome. Immunoperoxidase examination of renal biopsies showed IgM and complement in blood vessels and glomeruli of all three cases. Cytomegalovirus infection was present in two cases and probable in the third. Two cases had been infected with herpes zoster. All had episodes of graft-versus-host disease. Possible pathogenetic mechanisms are discussed. PMID- 3536717 TI - Rural hospitals get relief, but battle's not over. PMID- 3536718 TI - Medicaid measure broadens care for women, children. PMID- 3536719 TI - Legal fog cleared from vendor fees. PMID- 3536720 TI - Public's concern about benefits for elderly rises. PMID- 3536721 TI - Medicare HMO/CMP review slated to begin Apr. 1. PMID- 3536722 TI - Joint ventures: why do 7 out of 10 fail? PMID- 3536723 TI - Federal involvement in HMOs, CMPs abounds. PMID- 3536724 TI - OMB's Steelman: DRG rate "adequate" through '88. Interview by Jeffrey Finn. PMID- 3536725 TI - Biotech, AIDS, tech reimbursement star in '86. PMID- 3536727 TI - Cumulative Index to IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans. PMID- 3536726 TI - Prenatal diagnosis in 200 pregnancies with a 1-in-4 risk of cystic fibrosis. AB - Prenatal diagnosis of cystic fibrosis was performed in 200 pregnancies with a 1 in-4 risk, and was based on significant modifications in amniotic fluid taken at 17, 18, 19 weeks of pregnancy, of six enzymatic assays: gamma-glutamyl transpeptidase, aminopeptidase M, and alkaline phosphatase (total and isoenzymes). On the basis of normal values, normal outcome was predicted in 135 pregnancies reaching term, all the babies were normal. On the basis of significantly abnormal enzymatic values, an affected fetus was predicted in 56 pregnancies, 53 were terminated, and 3 went to term; the infants were affected. There were discrepancies in enzymatic values in nine cases, in eight cases normal outcome was predicted, six babies were normal and two were affected; in one case an affected baby was predicted, the pregnancy went to term and the baby is normal. Criteria giving evidence for cystic fibrosis in fetuses have been described: macroscopic observation of a typical meconium ileus, significant increase of albumin content in the meconium, and PAS-positive mucus-like material in some pancreatic acini. Using these criteria, diagnosis of cystic fibrosis has been confirmed in all the examined fetuses. The recurrence rate of cystic fibrosis was 22.5% in 147 diagnoses in which the index case had cystic fibrosis without a history of meconium ileus at birth, but was 47.5% when the index case had meconium ileus. The results of the study suggest that prenatal diagnosis of cystic fibrosis can be performed with an accuracy of 98%. PMID- 3536729 TI - The immunochemistry of sandwich ELISAs. II. A novel system prevents the denaturation of capture antibodies. AB - The studies reported here describe a model system by which the effect of surface adsorption on the antigen capture capacity (AgCC) of monoclonal antibodies (MoAbs) can be quantitated. Three mouse anti-fluorescein (FLU) MoAbs were biotinylated and iodinated with [125I]Na. The AgCC/ng of these MoAbs was compared when they were adsorbed directly on plastic or immobilized via a Protein Avidin Biotin Capture (PABC) system. In this system, biotinylated MoAbs were allowed to adsorb on biotinylated carrier proteins through a "bridging" process using Streptavidin. This permits MoAbs to complex with antigen at some distance from the plastic surface. The AgCCs of the MoAbs immobilized using the PABC system were 5-400-fold higher than when they were directly adsorbed on plastic. PMID- 3536728 TI - Simultaneous immunofluorimetric quantitation of IgM and IgG in single splenic lymphoid cells after immunization. AB - The amount of IgM and IgG was determined in individual mouse spleen lymphocytes by double immunofluorimetry after "staining" with dimethylamino-naphthaline sulfonyl chloride-labeled anti-IgM and fluorescein isothiocyanate-labeled anti IgG. During a single immune response against sheep erythrocytes there was an inverse relationship between the amounts of these two immunoglobulins in individual cells. There was an early steep increase of the cellular amount of IgM during the first 3 days after immunization. Subsequently IgG increased exceeding the initial IgG levels while IgM decreased. Most cells containing high amounts of IgM had a low IgG content and vice versa. The present results directly demonstrate a quantitative switch from IgM to IgG in individual cells on the single cell level after an antigenic stimulus. This indicates simultaneous active production of both immunoglobulins in these cells. For an explanation of this phenomenon differential mRNA splicing rather than DNA rearrangement as an underlying process for immunoglobulin expression may be proposed in these early B cells. PMID- 3536730 TI - Effects of experimental non-closure of peritoneum on development of suture line adhesions and wound strength in dogs. PMID- 3536731 TI - An appraisal of insulin induced gastric acid secretion. PMID- 3536732 TI - Group B streptococci in IUCD users. PMID- 3536734 TI - Osseointegration: the efficacy of the transitional denture. PMID- 3536733 TI - Reconstruction of the severely resorbed mandibular ridge using the tissue integrated prosthesis. PMID- 3536735 TI - The application of rare earth magnetic retention to osseointegrated implants. PMID- 3536736 TI - Implants and overdentures: the osseointegrated approach with conventional and compromised applications. PMID- 3536737 TI - Tetrazolium reduction test in diagnosis of urinary tract infections. PMID- 3536738 TI - Carcinoma of the penis in the Indian context. PMID- 3536739 TI - Directory of on-going research in cancer epidemiology. 1986. PMID- 3536740 TI - [The bonded anterior "enamel" bridge]. PMID- 3536741 TI - [The Pierre Fauchard Museum in Paris]. PMID- 3536742 TI - [A new hemostatic technic in oral medicine]. PMID- 3536743 TI - Stage-specific and species-specific antigens of Plasmodium vivax and Plasmodium ovale defined by monoclonal antibodies. AB - Monoclonal antibodies (MAbs) were produced against the asexual blood stages of Plasmodium vivax and Plasmodium ovale and used to define antigens of plasmodial parasites in an indirect fluorescent antibody assay. The anti-P. vivax MAbs produced two distinct patterns in the indirect fluorescent antibody assay. Four patterns were found with the anti-P. ovale MAbs. Species-specific epitopes were defined for P. vivax and P. ovale; epitopes shared among all four species of human malaria parasites were also defined. Some of the anti-P. vivax MAbs reacted only with mature stages, and others reacted with all asexual stages. No asexual blood-stage specificity could be found with the anti-P. ovale antibodies. Five of the anti-P. vivax MAbs and three of the anti-P. ovale MAbs also reacted with sporozoites. PMID- 3536745 TI - Catalases, peroxidases, and superoxide dismutases in Mycobacterium leprae and other mycobacteria studied by crossed immunoelectrophoresis and polyacrylamide gel electrophoresis. AB - The five mycobacteria Mycobacterium lepraemurium, M. leprae, M. bovis BCG, M. smegmatis, and M. intracellulare were studied. Catalase and peroxidase activities were demonstrated in polyacrylamide and crossed immunoelectrophoresis gels for M. lepraemurium, M. intracellulare, and BCG, but not for M. leprae. Peroxidase and catalase activities were associated with the same precipitate line in crossed immunoelectrophoresis for M. lepraemurium, M. intracellulare, and BCG, showing that in these mycobacteria the two enzyme activities resided in the same molecule. M. smegmatis peroxidase and catalase activities were closely associated on polyacrylamide gel electrophoresis, but on the crossed immunoelectrophoresis catalase and peroxidase activities were associated with two different precipitate lines. Catalases without peroxidase activity were demonstrated in crossed immunoelectrophoresis and polyacrylamide gel electrophoresis in M. intracellulare and M. smegmatis. The catalase without peroxidase activity in M. intracellulare was heat resistant and therefore classified as an m-catalase. In M. smegmatis the catalase without peroxidase activity was only partially heat resistant. All of the catalases with peroxidase activity were heat-sensitive t-catalases. Superoxide dismutase activity in the crossed immunoelectrophoresis was associated with the M. leprae antigen no. 4 and with cross-reacting antigens in the other mycobacteria studied. Several superoxide dismutases were demonstrated in Mycobacterium duvalii. They were antigenically different from the other superoxide dismutases in this study, as shown by lack of reactivity with a monospecific antibody to M. lepraemurium superoxide dismutase. Molecular weights were estimated for all the enzymes in this study by sodium dodecyl sulfate polyacrylamide gels. PMID- 3536744 TI - An 88,000-Mr Giardia lamblia surface protein which is immunogenic in humans. AB - Human anti-Giardia lamblia sera specifically immunoprecipitated an 88,000-Mr surface protein from radioiodinated trophozoites, establishing this protein as a potentially important immunogen in humans. A mouse monoclonal antibody (GL-1) was isolated which immunoprecipitated the same 88,000-Mr surface protein recognized by the human sera. GL-1 gave uniform fluorescent staining of the cell surface and flagella of G. lamblia trophozoites from the Portland 1 and WB strains as well as fresh clinical isolates, but not of Giardia muris, suggesting that the surface antigen is specific to G. lamblia. Other human parasites, including Entamoeba histolytica, Trichomonas vaginalis, and Trichomonas hominis, were not stained. A second mouse monoclonal antibody (GL-2) gave weaker immunofluorescent staining of living G. lamblia trophozoites but intense staining of fixed cells. None of the other parasites tested were stained, with the exception of E. histolytica, which may contain a cross-reactive antigen. No proteins were recognized in immunoprecipitation studies with iodinated trophozoites. PMID- 3536747 TI - Binding of purified and radioiodinated capsular polysaccharides from Cryptococcus neoformans serotype A strains to capsule-free mutants. AB - Strains 6, 15, 98, 110, and 145 of Cryptococcus neoformans serotype A vary in capsule size, animal virulence, and susceptibility to in vitro phagocytosis. The isolated capsular polysaccharides (CPSs) differ in monosaccharide composition ratios and molecular size, as determined by gel filtration. The purpose of this investigation was to characterize the binding of CPSs to capsule-free mutants of C. neoformans and to examine CPSs from these strains for differences in their ability to bind, to determine whether such differences might explain the variation in the pathobiology of these strains. CPSs were partially periodate oxidized, tyraminated, iodinated with 125I, and used in binding studies with two capsule-free mutants of C. neoformans, strain 602 and Cap59. Binding was specific for yeast species and for polysaccharide and was saturable, which is consistent with a receptor-mediated mechanism of attachment. Binding occurred rapidly and was only slowly reversible. Binding was also independent of pH from pH 5.5 to 8, of cation concentrations, and of competition by sugars up to 1.0 M concentrations. Only a portion of CPS was capable of binding, and strains varied in the extent to which their CPS bound. CPS-15-IV (peak IV was the major polysaccharide peak on DEAE-cellulose chromatography of CPS from strain 15) had the highest proportion of binding (40%), followed by CPS from strains 98, 6, 145, 110, and 15-III (peak III was an earlier eluting fraction of CPS from strain 15). The CPSs differed similarly in their ability to competitively inhibit binding. Treatment of CPS, but not yeast cells, with proteinase XIV abolished binding without altering the CPS gross structure. Treatment of yeast cells with proteases, heat, or formaldehyde did not alter binding, and both strain 602 and Cap59 bound CPS similarly. Binding to encapsulated yeast cells was minimal. PMID- 3536746 TI - Strain variation in composition and molecular size of the capsular polysaccharide of Cryptococcus neoformans serotype A. AB - The capsule of Cryptococcus neoformans is an important virulence factor. In this investigation capsular polysaccharides (CPSs) were isolated by ethanol precipitation from culture filtrates of C. neoformans serotype A strains 6, 15, 98, 110, and 145. Capsule sizes on India ink examination ranged from barely perceptible (strain 15) to greater than the diameter of the yeast cell (strain 6); the others were intermediate in size. On ion-exchange chromatography on DEAE cellulose each CPS eluted at 0.2 M NaCl; CPS of strain 15 had two major peaks, designated III and IV. On gel-permeation chromatography CPSs of strains 6, 98, 110, and 145 eluted at the void volume of Sepharose CL-2B in the presence or 0.1 M EDTA, while the CPS of strain 15 eluted in two peaks. Sephacryl S-1000 resolved CPSs of all five strains in the following order, from largest to smallest molecular size: 145 greater than 110 greater than 98 greater than 6 much greater than 15. All five CPSs contained mannose, xylose, and glucuronic acid, while the carboxyl-reduced CPS of strain 110 also contained a large percentage of an inositol-like compound. The CPS of strain 110 contained approximately 30% uronic acid by weight, while the others had 15 to 20%. The composition of peak IV from the CPS of strain 15 resembled those of the other strains; peak III of strain 15 contained a substantial amount of galactose. Each CPS contained less than 0.2% protein by weight. The significant differences in molecular size and sugar composition among CPSs of these strains of C. neoformans serotype A may partially explain strain differences in virulence and biological properties of the organism. PMID- 3536749 TI - Molecular characterization of proteins from porcine spirochetes. AB - Sonicated preparations of Treponema hyodysenteriae and Treponema innocens were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis. Treponemal proteins were electrophoresed on a 10% polyacrylamide slab gel in a discontinuous Tris-glycine system and either stained with Coomassie blue dye or transferred electrophoretically at 20 mA for 16 h and 30 mA for 3 h to nitrocellulose paper. Staining of the gels revealed at least 42 distinct T. hyodysenteriae and T. innocens proteins, with molecular sizes ranging from greater than 100 to 14 kilodaltons (kDa). Each species contained 12 to 16 major protein bands; five of the proteins were common to both species. Fourteen major antigens were identified in T. hyodysenteriae isolate B204 by using serum specimens from pigs in the acute stage of swine dysentery. Twelve additional antigens were detected in isolate B204 when convalescent-phase serum specimens were reacted to the blot. A wide band at 16 kDa was identified with convalescent phase serum specimens in T. hyodysenteriae but not in T. innocens. This 16-kDa antigen was also identified in T. hyodysenteriae with colonic secretions from convalescent pigs. PMID- 3536750 TI - Antigenic variation among Borrelia spp. in relapsing fever. AB - Seven antigens of Borrelia hermsii, B. parkeri, and B. turicatae with isoelectric points in the range of 4.4 to 5.0 and molecular masses of 40 to 43 kilodaltons played a role in the relapse phenomenon of relapsing fever. Based upon location of the antigens in the outer envelope, the molecular weight, and Western blot analysis, the antigens from each phase of spirochetemia appeared to be a mixture of the serotype-specific antigens of cloned B. hermsii. PMID- 3536748 TI - Antibody response of swine to outer membrane components of Haemophilus pleuropneumoniae during infection. AB - Sera from pigs infected with Haemophilus (Actinobacillus) pleuropneumoniae were tested for antibodies to outer membrane proteins (OMPs) of the organism by immunoblotting. Convalescent sera were produced in naturally born, colostrum-fed pigs and in cesarean-derived, colostrum-deprived pigs given H. pleuropneumoniae serotype 5 intranasally twice at 5-week intervals. Sera, collected at weekly intervals, were reacted with Sarkosyl-insoluble, OMP-enriched preparations of H. pleuropneumoniae which had been separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and electrophoretically transferred to nitrocellulose. Antibodies were detected to OMPs with an apparent molecular weight of 16,500 (16.5K OMP); to 29K, 38.5K, 43.5K, 45K, 49.5K, and 66.5K OMPs; and to several high-molecular-weight (greater than or equal to 94,000) OMPs, but not to the major 42K OMP. Antibodies to the heat-modifiable OMP (29K/43.5K) and the 38.5K OMP were detected in sera from noninfected pigs. Antibodies were also detected to two broad 54,000- and 95,000-molecular-weight bands which did not stain with Coomassie blue, stained with silver nitrate, resisted proteinase K digestion, and were eliminated by oxidation with sodium metaperiodate. This indicates that the 54,000- and 95,000-molecular-weight bands represent polysaccharide, possibly capsular or lipopolysaccharide immunogens. Adsorption of sera with cells from the homologous serotype 5 strain removed antibodies to the 45K, 49.5K, 66.5K, and greater than or equal to 94K OMPs and to the two polysaccharide bands, indicating that these antibodies were directed primarily to surface-exposed epitopes. When tested with OMP preparations from other serotype 5 strains, heterogeneity was apparent, both in the reactions with OMPs and with the polysaccharide bands. Silver staining of proteinase K-treated, whole-cell lysates from serotype 5 strains also indicated variable expression of the polysaccharide bands. Sera also reacted with OMPs from H. pleuropneumoniae serotypes 1 and 7; however, several OMPs and the lipopolysaccharide or polysaccharide determinants of these serotypes appeared to be type specific. PMID- 3536751 TI - Selective infection of astrocytes by Chlamydia trachomatis in primary mixed neuron-glial cell cultures. AB - Both human biovars of Chlamydia trachomatis were able to productively infect primary cultures of fetal rat brain cells. Infected brain cells released bacteria that reinfected McCoy cells well as other cultured brain cells. The chlamydiae infected cultured astrocytes but were never observed to grow inside neurons, suggesting a selective susceptibility of specific brain cells to chlamydial infections. PMID- 3536753 TI - Secretory immunoglobulin A response following peroral priming and challenge with Shigella flexneri lacking the 140-megadalton virulence plasmid. AB - This study evaluates the ability of noninvasive Shigella spp., lacking the 140 megadalton virulence plasmid, to elicit a mucosal immunoglobulin A immune response in the intestine. For these studies, we used Shigella flexneri M4243A1 (which lacks the plasmid and is Sereny test negative) to prime and challenge three groups of rabbits perorally. Both primary and immunoglobulin A memory responses were detectable in these secretions. These findings indicate that a mucosal memory response can be primed by nonpathogenic strains of Shigella which lack the virulence plasmid. PMID- 3536752 TI - Modulation of lysosomal protease-esterase and lysozyme in Kupffer cells and peritoneal macrophages infected with Nocardia asteroides. AB - Virulent Nocardia asteroides reduces lysosomal acid phosphatase activity in murine macrophages. A computer-assisted imaging photometry system was used to quantitate lysozyme and nonspecific esterase-neutral protease levels within individual macrophages following ingestion of nocardiae. In contrast to acid phosphatase, lysozyme and esterase-neutral protease activity was either unchanged or increased following infection by increasing numbers of nocardial cells. PMID- 3536754 TI - Non-auditory effects of noise in industry. II. A review of the literature. AB - A review of the literature shows a growing interest in non-auditory effects of noise at work. Somatic, vestibular and psychological effects and different kinds of activity interferences are described. Suggestive evidence of an elevation of the blood pressure by noise exists, although the quality of the studies is limited. Many non-auditory effects can be described in a stress model. Annoyance and stress, however, were seldom the subject of field studies. PMID- 3536755 TI - Purification and characterization of two protein antigens from the heterogeneous BCG85 complex in Mycobacterium bovis BCG. AB - The heterogeneous BCG85 complex is a major component of BCG culture fluid. BCG85A and BCG85B were purified by combining ammonium sulphate precipitation with chromatography on hydroxyapatite, DEAE-Sephacel and phenyl-Sepharose columns. Twenty percent of BCG85B was recovered. The chromatographic separation procedures were monitored by fused rocket immunoelectrophoresis. The BCG85 complex was found to consist of three antigens, which were heterogenous with regard to electrophoretic mobility, molecular weight (MW), hydrophobic and immunological properties. They were designated A, B and C in increasing order, according to their electrophoretic mobilities. Thus BCG85A had the lowest electrophoretic mobility, BCG85C the highest. The MW of BCG85A was found to be 31,000, while BCG85B had a slightly lower MW, 29,000, as determined by SDS-PAGE. The antigenic relationship between the components was evaluated by crossed immunoelectrophoresis and double diffusion, and reactions of partial identity between the antigens were found. The BCG85 complex occurs in far lower concentration in sonicates of BCG than in culture fluid. PMID- 3536756 TI - MPB59, a widely cross-reacting protein of Mycobacterium bovis BCG. AB - The MPB59 protein of Mycobacterium bovis BCG was purified to homogeneity from culture fluid of BCG substrain Tokyo, and characterized by biochemical and immunological techniques. The molecular weight was 28,000, determined by SDS polyacrylamide gel electrophoresis, and the pI value was 5.3. The N-terminal amino acid sequence was determined for 32 steps and showed no significant homology with MPB64, MPB70 or MPB80. By crossed immunoelectrophoresis, MPB59 was found to belong to the BCG antigen 85 complex and identified as corresponding to the 85B component of this complex. The protein cross-reacted extensively with other species of mycobacteria, and induced a marked humoral immune response in armadillos and monkeys during development of systemic mycobacterial infection after inoculation with Mycobacterium leprae. PMID- 3536757 TI - Mucosal mast cells as a component of the inflammatory response to lower-urinary tract infection. AB - Globule cells have been observed in mucosae for many years. Recently, a subpopulation of these globule cells in the intestinal mucosa of man and rodents have been identified as unique mast cells. In this communication, intraepithelial globule cells and some lamina-propria mast cells found in the normal rat urinary bladder wall have been characterized as mucosal mast cells, similar to intestinal mast cells, and differentiated morphologically and histochemically from rat peritoneal mast cells. The number of mast cells in the bladder wall increased significantly during various bladder manipulations, including mechanical trauma, parasitic infestation and bacterial infection. The origin and function of the mucosal mast cells remains unknown. PMID- 3536758 TI - Analgesic nephropathy: an underestimated cause of end-stage renal disease. AB - Addiction and abuse of antipyretic analgesics has been recognized early after the turn of this century. The incidence markedly increased and the syndrome spread over many countries in the first half of the 20th century. The syndrome and its pathology, consisting of renal papillary necrosis and tubulo-interstitial nephritis, was first described in the medical literature in the early 1950's in Switzerland by Spuhler and Zollinger, who rightly suspected chronic analgesic (Saridon) intoxication as being the cause in their cases. Clinically the disease is characterized by slowly progressive renal failure with renal colics from passage of necrotic papillae. Death from uremia is common unless dialyzed. The disease has been particularly prevalent in certain areas of Australia, Belgium, Western Germany, in Switzerland and some other countries. The nephrotoxic agents are mixtures of salicylates (aspirin) with phenacetin or acetaminophen. The principal nephrotoxic compound is probably aspirin--the aminophenol derivatives increasing its nephrotoxicity. However, all these components alone may cause- exceptionally--the syndrome. Rarely some newer, nonsteroid analgesics (NSAID's) can also be nephrotoxic. Phenacetin has--in particular in compound mixtures--mood altering (euphoric) properties, giving rise to craving, addiction and chronic abuse. Addiction has been greatly facilitated by the over-the-counter availability of these cheap analgesic mixtures. Mass addiction--and abuse--may occur in all kinds of communities, in factories or families because of the euphoric effect, taking away fatigue and weariness and increasing productivity. There is a relation between the per capita consumption of antipyretic analgesics and analgesic nephropathy in several countries and in certain districts. The pattern of sales and mass consumption (and the incidence of nephropathy) is substantially promoted by the local presence of production facilities, usually accompanied by vigorous sales and advertising policies. Individual addiction usually occurs in psychoneurotic females often with social and marital problems and mental instability, often with long histories of headaches, backpains, and other, often psychogenic disorders. Analgesic nephropathy is often complicated by anemia, peptic ulcer, premature aging and atherosclerosis and in 8-10% by uro epithelial carcinoma (the so called analgesic syndrome). The diagnosis depends largely on the history of chronic abuse of analgesics, which is often doggedly denied, hampering the diagnosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536759 TI - Hepatorenal syndrome in a renal transplant patient. PMID- 3536760 TI - Acquired renal cystic disease and renal adenocarcinoma in a long term renal transplant patient. PMID- 3536761 TI - The influence of peritoneal dialysis on the outcome of transplantation. AB - The Authors' series of 44 patients transplanted after peritoneal dialysis suggests that the results of renal transplantation are comparable to those on hemodialysis. PMID- 3536762 TI - Measurements of serum gentamicin concentrations by a biological method, fluorescence polarization immunoassay and enzyme multiplied immunoassay. AB - Serum gentamicin levels were assayed in patients receiving the aminoglycoside to determine dosage adjustments. The accuracy and reproducibility of three methods were compared; bioassay, enzyme multiplied immunoassay (Syva EMIT) and fluorescence polarisation immunoassay (Abbott TDx). Each assay method offered acceptable precision. The bioassay method correlated well with both the enzyme multiplied immunoassay and the fluorescence polarisation immunoassay (correlation coefficients 0.854 and 0.937, respectively). The automated methods provide results within 15 min and are not influenced by combinations of antibiotics, hence they are the methods of choice for aminoglycoside determinations. PMID- 3536764 TI - An outline of hazardous side effects of Ritalin (methylphenidate). PMID- 3536763 TI - Ceftazidime in the treatment of Pseudomonas infections in intensive-care patients. AB - The present study was designed to define the clinical activity and pharmacokinetics of ceftazidime in Pseudomonas sp. infections. The intensive care patients included in this study were hospitalized for at least 2 weeks and have frequently received antibiotic treatment which contributed with poor host resistance to the infections with highly resistant Pseudomonas strains. Sixteen adult patients entered the study. Their age ranged from 18 to 70 years. Ceftazidime was administered in a dose of 2 g three times daily by a constant infusion over 20-30 min. Frequent clinical assessment multiple cultures and determination of renal, hepatic and bacteriological functions were performed. Bacterial cultures were obtained prior to the beginning of therapy and every 2-3 days thereafter with a follow-up period of about 1-2 weeks. Pharmacokinetics in the blood were performed. Measurements of ceftazidime were made by using HPLC. Mean peak serum concentration of ceftazidime was 58.5 micrograms/ml after administration of 2.0 g of ceftazidime and eight hours after dosing the mean plasma concentration was about 5 micrograms/ml. No accumulation of ceftazidime could be observed during the treatment period. Mean plasma half-life was 2.1 hours at the beginning and 2.2 hours at the end of therapy. The mean apparent volume distribution was 0.35 l/kg. No severe adverse effects were reported throughout the study. Ceftazidime may be effectively used as single antiinfective agent in various conditions and higher plasma concentrations are an important predictor of bacteriological and clinical response in pulmonary infections caused by Pseudomonas species. PMID- 3536765 TI - Enhancement of delayed cutaneous hypersensitivity by oral administration of RU 41740 (Biostim) in lymphoma patients--a randomized double blind multicentric trial. AB - RU 41740 (Biostim) is a glycoprotein extract from Klebsiella pneumoniae with immunostimulating properties in animal studies and in in vitro assays of human leukocyte functions. The present randomized double blind phase II trial showed that RU 41740 significantly (P less than 0.05, Mann & Whitney test) enhanced delayed cutaneous hypersensitivity to seven recall antigens (Multitest system) in lymphoma patients in unmaintained complete remission when given orally for 14 days at a daily dose of 8 mg, and compared to placebo. Daily doses of 2 and 32 mg were uneffective. PMID- 3536766 TI - Treatment of cancer ascites by intraperitoneal administration of a streptococcal preparation OK-432 with fresh human complement--role of complement-derived chemotactic factor to neutrophils. AB - The role of complement in the polymorphonuclear leukocyte (PMN)-mediated tumor cell destruction in cancer ascites was investigated in relation to a streptococcal preparation OK-432, a so-called biological response modifier. Incubation of OK-432 with fresh human serum at 37 degrees C for 60 min resulted in the generation of C3a and C5a chemotactic factors. Intraperitoneal (i.p.) injection of the mixture to a patient with cancer ascites revealed an accumulation of PMNs in the ascitic fluid for a longer period with a rapid reduction of the ascitic fluid, than an intraperitoneal injection of OK-432 alone examined in the same patient. PMNs were found to invade clusters of the tumor cells and then form rosettes followed by the destruction of tumor cells. These findings induced by OK-432 continued over 10 days in the presence of fresh serum, while diminished within 3-4 days when OK-432 alone was injected. When fresh human plasma or fresh frozen plasma was used instead of serum and i.p. injected with OK 432 avoiding preincubation, the same cytological and clinical changes were observed in other patients. These data strongly indicate that OK-432 activates human complement either in vitro or in the peritoneal cavity, and induces PMNs to accumulate in the ascitic fluid. Although the mechanism of killing of tumor cells by PMNs is obscure, addition of human serum or plasma to i.p. use of OK-432 seems to be valuable for the management of patients with malignant ascites. PMID- 3536767 TI - Suppressive effects of B-lactam-antibiotics on in vitro generation of cytotoxic T cells. AB - The in vitro effect of several compounds containing the B-lactam structure (including 6-aminopenicillanic acid, piperacillin, 7-aminocephalosporanic acid, ceftazidime and clavulanic acid) on the generation of cytotoxic lymphocytes was investigated in two different in vitro systems: (1) generation of virus specific cytotoxic T-cells and (2) proliferation of lymphocytes were assessed in secondary in vitro anti-viral immune responses. Both activities were suppressed by B lactams in a dose-dependent manner. In these experiments, as found previously with human in vitro granulopoesis and proliferation of the human erythroleukaemic cell line K-562, cephalosporins and clavulanic acid were five to twenty times more suppressive than penicillins. Since concentrations that were effective in vitro are being achieved, particularly with cephalosporins, in the serum of patients, the possible clinical consequences of our findings may have to be taken into consideration. PMID- 3536769 TI - "Generational equity" and the new victim blaming: an emerging public policy issue. AB - Recent attempts to frame complex policy issues in terms of "justice between generations" and "intergenerational equity" are based on a series of questionable assumptions and economic calculations concerning the relative financial well being of the elderly vis-a-vis other groups in U.S. society. On closer inspection, however, these assumptions--e.g., of a homogeneous and financially secure elderly population and of younger cohorts likely to become increasingly resentful of elderly entitlement programs--appear ill-founded. Census data revealing wide disparities in income among the elderly, and national opinion poll data suggestive of a large cross-generational and cross-ethnic group "stake" in Social Security and Medicare, are used to suggest that the intergenerational equity framework may well be an inappropriate one in the public policy arena. Such a framework, moreover, is seen as deflecting attention from more basic inequities in U.S. society and from the need for major policy shifts in response to these more fundamental problems. PMID- 3536768 TI - Immunopathology of chronic cadmium administration in mice. AB - Young male mice were given drinking water containing 50 ppm cadmium (Cd) for 3 weeks, and were killed 0, 3 and 6 weeks after the cessation of treatment. At 0 weeks, suppression in the number of splenic plaque-forming cells in response to sheep red blood cell immunization was noted 5 days after antigen injection, but not 7 days after injection. Plasma IgG concentration and thymic factor activity were unaffected at 0 weeks. The number of circulating lymphocytes tended to be less in the Cd-treated mice at all times. Cd treatment had no effect upon liver and kidney weights, and upon the weights and the lymphocyte contents of the thymus and spleen at any of the observation times. Employing immunofluorescence with anti-mouse IgG and C3, no evidence of an autoimmune response was found in the kidney of the treated mice at 0 and 3 weeks. Mitochondrial abnormalities in the renal proximal tubule cells were noted at 0 weeks in the Cd-treated mice. The Cd concentrations of the liver and kidneys remained high at all observation times. The results suggest that a modest dose of Cd produces some depression of the immune system, and the biological half-life of Cd is long. PMID- 3536771 TI - Ronald Harry Wharton 1923-1983. PMID- 3536770 TI - Rehabilitation after surgery for lumbar disc herniation: results of a randomized clinical trial. AB - The aim of this prospective study was to examine the one-year postoperative results in patients operated on for lumbar disc herniation randomized in two groups: one with comprehensive rehabilitation and the other taken care of by normal care facilities. A total of 212 patients without any previous spinal operations comprised the final study group. The physiatrist, the surgeon, the social worker, and the psychologist performed the handicap evaluation according to the occupation handicap scales of the WHO. The handicap was evaluated for two phases: before the onset of acute sciatica leading to operation and one year after operation. No significant differences in handicap distribution between the intervention and normal care groups were seen. The postoperative handicap correlated highly significantly with preoperative handicap for both groups. More than half (57%) of all the patients returned to work within two months of the operation. The amount of sick leaves did not differ significantly between the intervention and normal care groups. A total of 15 persons (7%) retired during the postoperative year. PMID- 3536772 TI - Effect of inhibitors on glucose transport in malaria (Plasmodium berghei) infected erythrocytes. PMID- 3536773 TI - Echinostoma revolutum in mice; dynamics of the antibody attack to the surface of an intestinal trematode. PMID- 3536774 TI - Reactions to music, touch and object presentation in the final stage of dementia. An exploratory study. AB - Two patients in the final stage of dementia of Alzheimer type were stimulated with music, touch and object presentation during 12 consecutive days (16 trials per patient). Evaluations were made by direct observations, analysis of video taped recordings and registrations of pulse and rate of respiration. Both patients reacted differently to music than to touch and object presentation. PMID- 3536775 TI - Root surface roughness after the use of different modes of instrumentation. PMID- 3536776 TI - Determinants for the selection of an anterior bonded prosthesis: case report. PMID- 3536777 TI - Comparison of pocket epithelium removal by sulcular and internally beveled incisions with and without prescaling. PMID- 3536778 TI - The induction of new bone and cementum formation. V. A comparison of graft and control in sites in deep intrabony periodontal lesions. PMID- 3536779 TI - Leukocyte activity during earthworm inflammatory reactions. AB - This inclusive review describes essentially the findings of the author and his colleagues on the responses of earthworm coelomocytes to wounding and parasite infection and the responses of the earthworms themselves to second-set tissue grafts. PMID- 3536780 TI - A miniaturized cell-mediated cytotoxicity assay with human effector mononuclear cells. AB - A miniaturized method (Microtest, MIT) for detecting natural killer (NK) and antigen-elicited cell-mediated cytotoxicity has been developed. It retains the sensitivity and the efficiency of conventional macroassay (Macrotest, MAT). In comparison with the standard MAT, MIT provides a 5-fold reduction in the number of effector and target cells without changing the final reaction volume. This avoids the excessive relative evaporation that could occur in microassays employing limited reaction volumes. Moreover the use of V-bottom microtiter plates allows the recovery of 0.15 ml of supernatant, thus increasing the efficiency of 51Cr recovery. MIT was adopted for the evaluation of the NK activity of untreated or interferon (IFN)-treated human mononuclear cells (MNC) and for cold-inhibition and cytotoxic T-lymphocyte (CTL) assays. In the experiments performed with both macro and micro assays, comparable values of the percentage of specific lysis and of the number of lytic units were found. The slopes of the curves obtained with MIT are generally slightly lower than those detectable with MAT. The Pearson coefficient r2 is generally better for the macroassay although it can be considered acceptable in the microassay. The MIT described here appears to be a useful method, especially for providing information on natural resistance and cytotoxic T-lymphocyte systems in a number of pathological conditions characterized by a small recovery of effector cells from standard blood collection for analytical purposes. PMID- 3536781 TI - Types of disposable medical devices reused in hospitals. AB - Rising health care costs have prompted hospitals to turn to reprocessing and reuse of disposable devices as a cost-saving measure. The safety, efficacy, and cost benefit of such a practice are largely unknown. Classification schemata are presented as a means of categorizing the reasons for reprocessing and the types of adverse effects that may result from reprocessing and reuse. The very limited literature on reuse of disposable devices is reviewed. Examples of the categories of reprocessing and adverse effects are provided from a review of the experience with reprocessing and reuse at a university medical center. With the rising pressure for containment of health care costs, it is likely that this practice will expand further. The practice of reprocessing and reuse should be subjected to scientific study. PMID- 3536782 TI - Metronidazole. PMID- 3536783 TI - Prevalence of colonization with antibiotic resistant gram-negative bacilli in a nursing home care unit: the importance of cross-colonization as documented by plasmid analysis. AB - A prevalence study was carried out on a 100-bed Veterans Administration nursing home care unit to determine the extent of colonization with gentamicin-resistant gram-negative bacilli (GRGNB). Hand cultures of 12 employees and 17 environmental cultures were negative. Twenty-six of 86 (30%) patients were colonized with 49 GRGNB. Sixteen patients (19%) had urinary colonization. Multivariate analysis revealed significant associations between rectal or perineal colonization (P less than 0.01), and the presence of a urinary device (82% condom catheters) (P less than 0.05), with urinary colonization. The most common isolates were Providencia stuartii (20), Escherichia coli (nine) and Klebsiella pneumoniae (nine). Twenty six of 49 isolates carried plasmids. Restriction endonuclease digestion of plasmid DNA was performed for 21. Cross-colonization, as defined by the presence of the identical species with the identical restriction endonuclease digestion profile of purified plasmid DNA found in different patients, was observed for eight of 21 (38%) strains. All were geographically clustered. No strains could transfer gentamicin-resistance by conjugation and only two plasmids could transform our E coli recipient to gentamicin resistance. One E coli plasmid was identical to two Citrobacter freundii plasmids and a P stuartii plasmid isolated from three different patients. This 105 kb plasmid is conjugative and encodes resistance to ampicillin, carbenicillin, tetracycline, and sulfonamides. Thus, 57% of strains were cross-colonizing or contained identical R-plasmids. Southern hybridization using a 1 kb TEM-1 gene probe demonstrated sequences homologous to this probe in five of five nursing home plasmids examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536785 TI - Advanced imaging techniques in ophthalmology. PMID- 3536784 TI - Nosocomial bloodstream infections: secular trends in a statewide surveillance program in Virginia. AB - Over a 7-year period (1978-1984) the authors studied the rates of nosocomial bloodstream infections in acute-care hospitals participating in a statewide surveillance network in Virginia. A total of 4,617 hospital-acquired bloodstream infections were documented among 1,807,989 patients at risk for an overall rate of 25.5 cases per 10,000 patient admissions/discharges (annual range = 22.1 to 30.7). Compliance of reporting for Virginia hospitals averaged 58% (1 to 5 monthly reports in a study year), and 39% (greater than or equal to 6 monthly reports annually). Significant changes in bloodstream infection rates (cases per 10,000 patient admissions/discharges) due to specific pathogens included the following: coagulase-negative staphylococci increased from a rate of 1.3 to 4.5 (P = .0003), and those due to all gram-positive cocci increased from a rate of 7.5 to 11.4 (P = .03). Candida species increased from a rate of 0.1 to 1.5 (P = .005). The data show a continuing rise of nosocomial Candida BSI and clearly document the re-emergence of gram-positive cocci as major nosocomial bloodstream pathogens. PMID- 3536786 TI - Introduction to diagnostic imaging techniques in ophthalmology. PMID- 3536787 TI - Ultrasonography of the eye. PMID- 3536788 TI - Ultrasonography of the orbit. PMID- 3536789 TI - Structure, development, and molecular pathology of basement membranes. PMID- 3536790 TI - Interaction of the hemostatic and immune systems in the metastatic spread of tumor cells. PMID- 3536791 TI - Mediation of cellular events by thrombin. PMID- 3536792 TI - Enhanced migration of tumor cells in response to collagen degradation products and tumor cell collagenolytic activity. AB - The migration of ascites and cultured hepatoma cells, AH109A of rat (Donryu) origin and MH134 of mouse (C3H), was enhanced by collagen degradation products (CDP) in vitro using the modified Boyden chamber, but not by collagen. Both tumor cells demonstrated somewhat increased motility in the presence of CDP regardless of whether or not there was a gradient present, but the maximum response was seen in the presence of a gradient. MH134 cells responded more effectively to CDP than AH109A cells and showed similar migratory responses to type I and IV collagen degradation products (CDP-I and -IV). Synthetic di- or tripeptides containing hydroxyproline were less chemotactic for MH134 cells than CDP-I and -IV. Both proteases (collagenase and trypsin) and MH134 cells could degrade a collagen substrate and generate CDP. These findings suggest that CDP released during the process of invasion may play a role in the migration of tumor cells and consequent formation of metastases. PMID- 3536793 TI - Role of tumor proteinases in tumor cell-induced platelet aggregation. AB - In a previous work we found a correlation between in vivo metastatic potential of cancer cells and their platelet aggregating activity in sublines of the mFS6 murine fibrosarcoma. In the present study the effects of different proteinase inhibitors on platelet aggregation induced by these cells were investigated. When the platelets were incubated with the inhibitors, only those effective against cysteine proteinases strongly reduced platelet aggregation by cancer cells; serine protease inhibitors, including hirudin, had no effect on platelet response. Incubation of neoplastic cells with the same inhibitors gave similar, though less evident results. Addition of neoplastic cells to platelet-rich plasma also caused significant production of fibrinopeptide A, more by the less malignant cells. Thus, in this experimental model a cysteine proteinase of the neoplastic cells appears to play an important role in the platelet aggregation induced by them, and this property was detected in the M4 cells with high metastatic in vivo activity. PMID- 3536794 TI - Pediatric radiology. Advances and current practices. PMID- 3536795 TI - Photoradiation diagnosis and therapy. Dermatologic and photobiologic aspects. AB - Photoradiation with photosensitizing porphyrins offers a potentially useful approach to the diagnosis and treatment of certain human cancers. The mechanism of porphyrin photosensitivity as studied in cultured cells or in the skin has been studied thoroughly. Possible targets that have been identified include membranous cellular organelles, DNA, and the plasma membrane. Mediators of the reaction include reactive oxygen species, particularly singlet oxygen, that may elicit lipid peroxidation and the activation of complement. Further research is needed to identify photosensitizers with greater selectivity for malignant cells and to develop even better sources of radiant energy. PMID- 3536797 TI - Assessment and approval of medical devices used in diagnostic imaging in the United States. AB - Development of new and improved medical imaging technology has been increasing rapidly over the past two decades. While media attention has focused on the revolutionary advances, such as computed tomography, magnetic resonance imaging and metabolic assessment by positron emission tomography, important progress has also been made in the more conventional modalities, including contrast radiography, ultrasound, scintigraphy and mammography. These evolutionary developments have produced fundamental changes in the character of imaging information and in the methods of its acquisition, storage, manipulation, analysis and display. The assessment process-vis-a-vis safety, effectiveness, efficacy or cost-has moved from a previously well-defined physical and engineering evaluation to one of assessing quality, relevance and appropriateness of the "information." A regulatory scheme has evolved in the U.S., whereby the Food and Drug Administration (FDA) is responsible for assuring that new medical devices be approved for commercial distribution only if their safety and effectiveness can be assured. Clear distinctions should be drawn between the FDA "approval" process, assessment of clinical efficacy, and planning for health care delivery. PMID- 3536796 TI - Characterization of a pyruvate dehydrogenase modulator purified from insulin treated rat brain plasma membranes. AB - A factor able to stimulate pyruvate dehydrogenase when added to purified mitochondria was prepared from the supernatant of brain plasma membranes incubated with physiological concentrations of insulin (25 microU/ml). The factor completely reactivated pyruvate dehydrogenase previously inhibited with ATP and was active on pyruvate dehydrogenase from brain and liver mitochondria and from peripheral lymphocytes. The insulin-dependent stimulator of pyruvate dehydrogenase was heat and acid stable, was not absorbed on charcoal and displayed an isoelectric point of 5.5. The insulin mediator was purified by gel filtration, DEAE-cellulose and sulfonated polystyrene chromatography and, after dansylation, by high performance liquid chromatography. The purified mediator displayed a molecular weight of about 2800 and appeared as a peptide rich in glycine and serine and void of proline and sulfur containing aminoacids. It retained its stimulatory action on pyruvate dehydrogenase after dansylation and was completely inactivated by trypsin and chymotrypsin. Full reactivation of ATP inhibited pyruvate dehydrogenase was attained when mitochondria were incubated with a mediator concentration of about 0.5 microM. PMID- 3536798 TI - Cerebral toxoplasmosis complicating bone marrow transplantation. AB - Cerebral toxoplasmosis occurred in a 34-year-old patient with chronic myelogenous leukemia following bone marrow transplantation. The clinical picture included headaches, nuchal rigidity, and right-sided hemiparesis during a course of disseminated cutaneous herpes zoster. The diagnosis of toxoplasmosis was based on serologic evidence and typical computed tomography scan of the brain as well as clinical improvement following specific anti-Toxoplasma treatment. To the best of our knowledge, this is the first report of cerebral toxoplasmosis in Israel. PMID- 3536799 TI - Laennec and the discovery of auscultation. AB - Rene Theophile Hyacinthe Lennec is famous chiefly for the invention of the stethoscope. In addition to this, he was also one of the pioneers of accurate clinical observation together with postmortem correlation of physical signs. One hundred and sixty years after his death, he is still considered to be one of the greatest clinicians of all time. PMID- 3536800 TI - A hidden dimension in headache work: applied history of medicine. PMID- 3536801 TI - Differential effects of training in relaxation and stress-coping in patients with migraine. PMID- 3536802 TI - Immunogold localization of ingested kidney bean (Phaseolus vulgaris) lectins in epithelial cells of the rat small intestine. AB - The interactions between dietary kidney bean (Phaseolus vulgaris) lectins and the epithelial cells of the rat small intestine were investigated by immunogold electron microscopy. The results demonstrated that the lectins bind to the glycocalyx of duodenal and jejunal microvilli and that some of these dietary constituents are endocytosed into lysosomal pathways within both absorptive and secretory gut cells. It is concluded that the lysosomal response serves to limit the absorption of nutritionally significant levels of these dietary toxins. PMID- 3536803 TI - The structure of the basement membrane of human lymph node high endothelial venules: an ultrastructural, histochemical and immunocytochemical study. AB - The structure of the basement membrane of the high endothelium of reactive human lymph nodes was investigated by techniques selective for carbohydrates (periodic acid-Schiff; critical electrolyte concentration staining with Alcian Blue; lectin histochemistry), specific proteins (immunohistochemistry for laminin and fibronectin) and by conventional techniques of light and transmission electron microscopy. Adjacent small lymphocytes were assigned to B and T cell subsets by use of monoclonal antibodies and they were analysed for non-specific esterase, beta-glucuronidase, beta-N-acetylglucaminidase and proteolytic activities. The basement membranes were shown to be distinctive and to contain three layers, of differing laminin, glycosaminoglycan and glycoprotein oligosaccharide content. Certain lymphocytes (probably T) contained enzymes potentially able to degrade some components of these basement membranes. PMID- 3536804 TI - Influence of embedding media in prolactin labelling with immunogold techniques. AB - Immunogold labelling of prolactin in three different embedding media was compared. The polymeric prolactin in secretory granules was labelled in the three media, however, acrylic monomers (Lowicryl K4M and LR White) provided a more intense labelling with higher dilutions of the primary antibody, compared to the labelling in the epoxy resin (araldite). An intense labelling of monomeric prolactin in Golgi complex was detected only in acrylic embedments, and the labelling on the rough endoplasmic reticulum was significant only in LR White embedded tissues. PMID- 3536805 TI - Glutathione localization by a novel o-phthalaldehyde histofluorescence method. AB - Glutathione in tissues forms an intense fluorophore with a solution of o phthalaldehyde at room temperature. We have studied the loss of glutathione from tissue sections and find that it is not measurable from thick sections. The fluorescence spectra of the induced fluorophore between glutathione and o phthalaldehyde are identical in model and tissue sections, while depletion of hepatic glutathione by diethyl maleate produces a comparable fall in fluorescence measured biochemically or histochemically. This simple method is specific as interfering substances, such as spermine and spermidine, produce very weak fluorescence under the conditions employed. PMID- 3536806 TI - Immunoelectron microscopical localization of ornithine transcarbamylase in hepatic parenchymal cells of the rat. AB - The electron microscopical localization of ornithine transcarbamylase in rat liver was investigated by a protein A-gold technique applied to thin sections of Lowicryl K4M- or LR gold-embedded materials and to ultracryosections. Gold particles were exclusively confined to mitochondria of the parenchymal cells but not of sinus-lining cells. In mitochondria, gold particles were present in the matrix and closely associated with the inner membrane. The most intensive labelling was obtained from ultracryosections, while weaker labelling was noted in sections of materials embedded in both Lowicryl K4M and LR gold. The association of the enzyme with the inner membrane was confirmed by quantitative analysis of distribution pattern. PMID- 3536807 TI - Immunohistochemical localization of epidermal growth factor in rat and man. AB - Epidermal growth factor (EGF) is a peptide which stimulates cell mitotic activity and differentiation, has a cytoprotective effect on the gastroduodenal mucosa, and inhibits gastric acid secretion. The immunohistochemical localization of EGF in the Brunner's glands and the submandibular glands is well documented. The localization of EGF in other tissues is still unclarified. In the present study, the immunohistochemical localization of EGF in tissues from rat, man and a 20 week human fetus were investigated. In man and rat, immunoreaction was found in the submandibular glands, the serous glands of the nasal cavity, Brunner's glands of the duodenum, the Paneth cells of the small intestine, and the tubular cells of the kidney. In the fetus EGF was found in the kidney and in the intestinal Paneth cells. Antisera raised against rat submandibular EGF did not recognize EGF in human tissues, whereas antisera against human urinary EGF worked in rat as well as man. EGF was found only in cells with an exocrine function. PMID- 3536808 TI - Localization of the neuronal cell adhesion molecule D2-protein in explant cultures of dorsal root ganglia by use of the colloidal-gold immunocytochemical technique. AB - The localization of the neuronal cell adhesion molecule (N-CAM), D2-protein, in explant cultures of rat dorsal root ganglia was investigated at the electron microscope level by the use of 17-nm-diameter colloidal gold particles coated with swine anti-rabbit immunoglobulin molecules. The minimum amount of IgG needed to coat the gold particles and the pH optimal for coating were both determined. Immunocytochemical studies of cultures revealed the binding of gold particles to the neuronal plasma membrane, especially on neuritic processes. Schwann cells were not labeled, and the level of unspecific background staining was very low. PMID- 3536809 TI - Electron microscopic cytochemical localization of alpha-hydroxyacid oxidase in rat liver. Association with the crystalline core and matrix of peroxisomes. AB - The substrate specificity and the intraperoxisomal localization of alpha hydroxyacid oxidase in rat liver has been investigated cytochemically by the cerium technique and biochemically with a luminometric assay. Rat liver is fixed by perfusion with a low concentration (0.25%) of glutaraldehyde and vibratome sections are incubated for 60 min at 37 degrees C in a medium containing 3 mM CeCl3, 100 mM NaN3 and 5 mM of an alpha-hydroxyacid in 0.1 M of one of the following buffers: Pipes, Mops, Na-cacodylate, Tris-maleate, all adjusted to pH 7.8. Ten different alpha-hydroxyacids with a chain length between 2 and 8 carbon atoms were tested. The best results were obtained with glycolic, argininic and L alpha-isocaproic acids. These cytochemical findings were confirmed also biochemically using purified peroxisomal fractions isolated by gradient centrifugation in metrizamide. The pattern of the intraperoxisomal localization of the enzyme was influenced markedly by the type of buffer used for the cytochemical incubation. Whereas in the Tris-maleate medium both the cores and the matrix stained with the same intensity, with all other buffers the reaction in cores was more prominent. The staining of cores was abolished by pretreating sections in Tris-maleate (pH 7.8) or alkaline pyrophosphate buffers. These observations establish the substrate specificity of alpha-hydroxyacid oxidase in rat liver and demonstrate the delicate association of this enzyme with the crystalline cores and the matrix of peroxisomes in rat liver. PMID- 3536810 TI - Electron microscopic cytochemical localization of alpha-hydroxyacid oxidase in rat kidney cortex. Heterogeneous staining of peroxisomes. AB - The substrate specificity of alpha-hydroxyacid oxidase in the rat kidney has been investigated cytochemically by the cerium technique and biochemically with a luminometric assay applied to isolated renal peroxisomes. Rat kidneys were fixed by perfusion via the abdominal aorta with a low concentration (0.25%) of glutaraldehyde. Vibratome sections were incubated for 60 min at 37 degrees C in a medium containing 3 mM CeCl3, 100 mM NaN3 and 5 mM of an alpha-hydroxyacid in 0.1 M Pipes or 0.1 M Tris-maleate buffer both adjusted to pH 7.8. Ten aliphatic alpha hydroxyacids with chain lengths between 2 and 8 carbon atoms and two aromatic substrates were tested. The alpha-hydroxyacid oxidase in the kidney exhibited a markedly different substrate specificity than the corresponding enzyme in the liver. Thus glycolate gave a negative reaction while two aromatic substrates, mandelic acid and phenyllactic acid, stained prominently. With aliphatic substrates a stronger reaction was obtained in Pipes than in the Tris-maleate buffered incubation media. The best reaction in the kidney was obtained with hydroxybutyric acid. These cytochemical findings were confirmed by the luminometric determination of the oxidase activity in isolated purified peroxisome fractions. By electron microscopy the electron dense reaction product of cerium perhydroxide was found in the matrix of peroxisomes in the proximal tubules. The intensity of reaction varied markedly in neighbouring epithelial cells but also in different peroxisomes within the same cell. Thus heavily stained particles were seen next to lightly reacted ones. These observations establish the substrate specificity of alpha-hydroxyacid oxidase in the rat kidney and demonstrate the marked heterogeneity in the staining of renal peroxisomes for this enzyme. PMID- 3536811 TI - Arginine-vasopressin immunoreactive material in the gastrointestinal tract. AB - Like many other neuropeptides, vasopressin is not confined to the hypothalamic neurohypophysial system. Furthermore, vasopressin was found to be a potent vasoconstrictor in the rat jejunum, reducing myenteric artery flow. These associations were the basis of this investigation on the presence of vasopressin in the gastrointestinal (GI) tract by both RIA and immunohistochemistry. Portions of the gastrointestinal tract and pancreatic islets of the rat were extracted with 0.1 N HCl for RIA measurements of AVP content. Similar portions from the male cat GI tract were used for immunohistochemistry studies. Acid extracts of the GI tract were found to contain immunoreactive AVP with the highest concentration (pg/mg protein) in the fundus portion of the stomach (15.0 +/- 1.6) and slightly lower values down along the antrum-pylorus portion (6.7 +/- 0.6), proximal jejunum (8.6 +/- 0.2), distal ileum (9.7 +/- 0.3) and colon (11.9 +/- 0.5). In the pancreatic islets the concentration was much higher (72.0 pg/mg protein). The extract inhibition curves showed parallelism with the appropriate standard preparation of AVP in the specific RIA. Immunohistochemical localization showed IR-AVP in the nerve fibers around the myenteric plexus of the second portion of the duodenum. It was also found in fibers starting from where the myenteric plexus goes through the layer of muscle fibers, penetrating the submucosa and duodenal mucosa, ending near the capillaries situated along the basal side of the villous epithelium cells. Similar IR-AVP activity was found in cells located in the mucosal epithelium of the duodenum, jejunum, ileum, colon and rectum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3536813 TI - Ultrasonographic evaluation of neonatal intracranial hemorrhage. PMID- 3536812 TI - Ultrastructural characterization of 6 immunoreactive enteroendocrine cells in Barbus conchonius (Teleostei, Cyprinidae). AB - Using the semi-thin/ultra-thin technique six different immunoreactive endocrine cell types are ultrastructurally identified in 0.5% glutaraldehyde fixed gut of B. conchonius. In addition two of them (gastrin- and PP-immunoreactive cells) are also characterized with the immunogold method, showing that the immunoreactivity is only restricted to the secretory granules. Size distribution histograms and the average diameters of 30% (d30) of the largest granules are given, showing a gradual increase in granule size from unspecific immunoreactive cells, (d30 = 110 nm) via gastrin- (119 nm), VIP-like- (127 nm), met-enkephalin- (143 nm) and PP- (174 nm) to glucagon-immunoreactive cells (178 nm). The presence of PP- and glucagon-immunoreactivity in the same cells and the consequence for their granule size is discussed. In the distal part of the gut endocrine cells are found showing no immunoreactivity with the antisera used; their granules (d30 = 144 nm) were, although not significantly, larger then those of VIP-like-immunoreactive cells, also found in that part of the gut. It is supposed that they represent substance P-immunoreactive cells. Unfortunately, secretory granules of several cell types showed about 20% more shrinkage in 0.5% glutaraldehyde fixed tissue, than in osmicated tissue. PMID- 3536814 TI - The 1984 Thomas L. Northup memorial address: Osteopathic manipulative care in preventive medicine. PMID- 3536815 TI - Andrew Taylor Still memorial lecture: Osteopathic medicine--is our future past? PMID- 3536816 TI - Depression in adolescence. A perspective. PMID- 3536818 TI - Normal physiological and psychosocial growth in the adolescent. PMID- 3536817 TI - Adolescents and exercise. AB - This paper has outlined the components of conditioning and has given detailed training guidelines. Training should be sports specific. Conversely, the sport used for a training program will specifically emphasize different energy systems to a certain degree. The effect of exercise on growth and development is also a necessary concern. Too much, as well as too little, exercise adversely affects development. Today good nutrition is very much correlated with exercise, having a strong beneficial effect on the performance of an adolescent athlete and the development of a healthy adult. Finally, the price that adolescents must pay to be involved in exercise should be considered. Becoming a well-rounded individual with many skills is a healthy approach to life. PMID- 3536819 TI - Why adolescent medicine? PMID- 3536820 TI - Normal reproductive development in the adolescent female. PMID- 3536821 TI - Infectious disease problems in adolescents. AB - Although adolescents are a generally healthy group, infection can create significant morbidity and occasional mortality. As in all patients, early diagnosis and treatment can shorten the duration of infection and limit complications. Physicians should provide teenage patients with guidance necessary to prevent transmission and recurrence. PMID- 3536822 TI - Biopsychosocial correlates of risk-taking behaviors during adolescence. Can the physician intervene? PMID- 3536824 TI - Financing reform and structural change in the health services industry. AB - This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms. PMID- 3536823 TI - Adolescence, stress, and psychosomatic issues. PMID- 3536825 TI - An analysis and comparison of the educational costs of clinical placements for occupational therapy, physical therapy, and speech pathology and audiology students. AB - The purpose of this paper is to describe the methodology and summarize the results of a study of the educational costs of clinical placement for students in occupational therapy, physical therapy, and speech pathology and audiology at The University of British Columbia. The sample represented 42.9% of the facilities offering occupational therapy placements, 41.4% of those offering physical therapy placements, and 52.4% of those offering speech pathology and audiology placements. During a 12-month period, these facilities provided 77.3% of the total clinical hours for the occupational therapy students, 65.1% for the physical therapy students, and 66.1% for the speech pathology and audiology students. Estimates of the number of hours of single-purpose and joint-purpose instructional activities and percentage estimates of direct-contact time were used as a basis for calculating the costs to facilities of accepting students for clinical placement. The methodology permitted comparisons of these costs across health disciplines. Both the methodology and the findings of this study can help government, educational institutions, and clinical facilities in defining policies and funding mechanisms for clinical training programs. PMID- 3536826 TI - Propioxatins A and B, new enkephalinase B inhibitors. I. Taxonomy, fermentation, isolation and biological properties. AB - A soil isolate of actinomycete, strain SANK 60684, was found to produce new enkephalinase B inhibitors, propioxatins A and B. The presence of both LL- and meso-2,6-diaminopimelic acid, glycine and galactose in the cell wall assigned this strain to genus Kitasatosporia. From the morphological, cultural and physiological characteristics, this strain was determined to be Kitasatosporia setae. The Ki values of propioxatins A and B were 1.3 X 10(-8)M and 1.1 X 10( 7)M, respectively, for enkephalinase B. All other proteases examined except aminopeptidases, which were slightly inhibited, were not inhibited by these two compounds. PMID- 3536827 TI - The antibacterial activity of ticarcillin/clavulanic acid (BRL28500) against ticarcillin-resistant bacteria. AB - The efficacy of BRL28500, a formulation of ticarcillin (TIPC, 15 parts) and clavulanic acid (CVA, 1 part), against TIPC-resistant strains of Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae was studied both in vitro and in vivo. The MICs of BRL28500 against these beta-lactamase producing strains were lower than those of TIPC or CVA alone against such strains. When BRL28500 was added during the logarithmic growth phase of bacteria at a concentration equivalent to the MIC, it demonstrated marked lytic activity. Cells treated with BRL28500 underwent morphological change, becoming filament-like, similar to those treated with TIPC alone. With CVA alone at concentrations above the MIC the cells assumed a stable round form. In bacterial cultures of the beta-lactamase producing strains, TIPC was protected from hydrolysis by the presence of CVA. The in vivo activity of BRL28500 against experimental infections in mice caused by beta-lactamase-producing strains of bacteria was superior to that of TIPC alone. TIPC and CVA were found to be well distributed in peritoneal fluid following subcutaneous administration of BRL28500 into mice with peritoneal infections. The residual TIPC concentrations achieved were higher than when TIPC alone was administered. These results suggest that BRL28500 will be effective in the treatment of human infections due to TIPC-resistant bacteria. PMID- 3536828 TI - A method for generating protoplasts from Clitopilus pinsitus. PMID- 3536829 TI - Validamycin G and validoxylamine G, new members of the validamycins. PMID- 3536830 TI - Virulence plasmid-associated adhesion of Escherichia coli and its significance for chlorine resistance. AB - Introduction of the ColV, I-K94 virulence plasmid into strains of Escherichia coli led (for four out of five strains tested) to a marked increase in the ability of organisms to adhere to glass beads. For strain 1829, the plasmid led to increased attachment to other materials including sand, agar, agarose, chitin and cellulose. The increased adhesion to glass beads was due to the presence of the plasmid and not to its introduction into a variant with altered adhesive properties. The plasmid-encoded VmpA protein did not appear to be necessary for the ColV, I-K94-promoted adhesion but adhesion was absolutely dependent on the presence of derepressed levels of transfer components in the ColV+ strains and partially dependent on the presence of colicin components. The extent of the plasmid-promoted adhesion was greatest for organisms grown at 30 degrees, 37 degrees or 42 decrees C and adhesion was almost abolished by growth at 21 degrees or 25 degrees C; this finding is in accord with transfer and colicin components being involved in adhesion. Of several other plasmids tested for their effects on adhesion, those with derepressed transfer properties showed a marked effect as did the RI resistance plasmid. Because of the ease of handling glass bead attached organisms, such preparations were used as a model for studying the relevance of attachment to the resistance of E. coli to chlorination in the water purification process. Organisms of 1829 ColV, I-K94, attached to glass beads, were more resistant to damage and killing by chlorine than were unattached organisms. Three findings suggest that such chlorine resistance may be significant for survival during water chlorination. Firstly, ColV, I-K94+ bacteria became attached if incubated in sewage effluent with glass beads at 20 degrees C. Secondly, ColV+ organisms already attached to glass beads maintained their attachment during 24 h incubation in effluent at 20 degrees C and thirdly such effluent incubated organisms remained chlorine resistant provided that they retained their attachment. PMID- 3536832 TI - Role of ventrolateral medulla in regulation of respiratory and cardiovascular systems. AB - It is now widely accepted that the ventrolateral aspect of the medulla oblongata (VLM) plays an important role in regulation of the respiratory and cardiovascular systems. The VLM has been implicated as being involved in a number of different physiological functions, including central chemoreception, integration of afferent inputs from certain sense organs to the respiratory and cardiovascular controllers, the source of excitatory input to preganglionic sympathetic neurons in the spinal cord, and location of synaptic relay between the higher brain defense areas and spinal cord sympathetic elements. In recent years there have been a number of important findings concerning both the anatomical substrate and neurophysiological characteristics of VLM neurons involved in regulation of the respiratory and cardiovascular systems. New anatomical findings show that neuronal networks located in the VLM send projections to and receive projections from brain stem nuclei that have traditionally been associated with respiratory and cardiovascular regulation. Nevertheless, there are still many important questions concerning the role of the VLM in control of these vital systems that have yet to be answered. For instance, are the same VLM neurons involved in control of both systems? Is the VLM the only site for central respiratory chemoreception? This review will endeavor to examine new findings and to reexamine some older findings concerning the VLM. PMID- 3536831 TI - Rapid method for the detection of group B streptococci from human sources. AB - A modification of the classical CAMP test has been devised for the rapid detection of streptococci of serological Group B from human sources. The method was compared with detection based on the development of orange pigmented colonies on a starch-based medium and with detection by conventional methods. In a survey of vaginal carriage of Group B streptococci in parturient women, the modified CAMP test detected a carriage rate of 13.09%, the starch-based, pigment enhancing medium, 5.76% and the conventional methods, 8.38%. It proved to be particularly useful for detecting the organisms in the presence of other bacteria. PMID- 3536833 TI - Carnitine metabolism during prolonged exercise and recovery in humans. AB - Lennon et al. (J. Appl. Physiol. 55: 489-495, 1983) have recently reported a large loss of muscle total carnitine (TC) after 40 min of moderate exercise. These authors have also suggested that elevations in plasma esterified carnitine (EC) were due to the release of these carnitine esters from muscle during exercise. After 10 male subjects underwent 90 min of cycle egometry we found no alteration in muscle TC from preexercise values. Plasma EC progressively increased above resting values during exercise and remained elevated above rest at 0.75 and 1.5 h into recovery. Elevations of plasma EC were largely due to a decrement in free carnitine (FC) in both conditions. Immediately postexercise the urinary fractional reabsorbsion of EC and FC were similar to that at rest. These results suggest that a net loss of TC from exercising muscle does not occur. As in other conditions marked by falling insulin concentrations, elevations in plasma EC could result from an exchange of carnitine with the hepatic carnitine pool. PMID- 3536834 TI - Metabolic responses to exercise after fasting. AB - Fasting before exercise increases fat utilization and lowers the rate of muscle glycogen depletion. Since a 24-h fast also depletes liver glycogen, we were interested in blood glucose homeostasis during exercise after fasting. An experiment was conducted with human subjects to determine the effect of fasting on blood metabolite concentrations during exercise. Nine male subjects ran (70% maximum O2 consumption) two counterbalanced trials, once fed and once after a 23 h fast. Plasma glucose was elevated by exercise in the fasted trial but there was no difference between fed and fasted during exercise. Lactate was significantly higher (P less than 0.05) in fasted than fed throughout the exercise bout. Fat mobilization and utilization appeared to be greater in the fasted trial as evidenced by higher plasma concentrations of free fatty acids, glycerol, and beta hydroxybutyrate as well as lower respiratory exchange ratio in the fasted trial during the first 30 min of exercise. These results demonstrate that in humans blood glucose concentration is maintained at normal levels during exercise after fasting despite the depletion of liver glycogen. Homeostasis is probably maintained as a result of increased gluconeogenesis and decreased utilization of glucose in the muscle as a result of lowered pyruvate dehydrogenase activity. PMID- 3536835 TI - Endotoxin increases pulmonary vascular protein permeability in the dog. AB - Endotoxin increases pulmonary vascular permeability consistently in some species but fails to reliably cause injury in the dog. We wondered whether this phenomenon depended on the method of injury assessment, as others have relied on edema measurement; we quantified injury by monitoring the rate of extravascular protein accumulation. 113mIn-labeled protein and 99mTc-labeled erythrocytes were injected into anesthetized dogs and monitored by an externally placed lung probe. A protein leak index, the rate of extravascular protein accumulation, was derived from the rate of increase in lung protein counts corrected for changes in intravascular protein activity. After administration of Salmonella enteriditis endotoxin (4 micrograms/kg), the protein leak index was elevated 2.5-fold (41.1 +/- 4.6 X 10(-4) min-1) compared with control (16.0 +/- 2.8 X 10(-4) min-1). In contrast, wet-to-dry weight ratios failed to increase after endotoxin (4.6 +/- 0.8 vs. control values of 4.2 +/- 0.5 g/g dry bloodless lung). However, we observed that endotoxin increased lung dry weight (per unit body weight), which may have attenuated the change in wet-to-dry weight ratios. To determine whether low microvascular pressures following endotoxin attenuated edema formation, we increased pulmonary arterial wedge pressures in five dogs by saline infusion, which caused an increase in wet-to-dry weight ratios following endotoxin but no change in the five controls. We conclude that low dose endotoxin causes pulmonary vascular protein leak in the dog while edema formation is minimal or absent. PMID- 3536836 TI - Nonthermoregulatory control of human skin blood flow. AB - Although it is well accepted that skin blood flow (SkBF) in humans is controlled by thermoregulatory reflexes, the conclusion that the cutaneous circulation is also controlled by reflexes of nonthermoregulatory origin is not universally held. This review considers the extent to which the cutaneous circulation participates in baroreceptor-mediated reflexes and in the reflexes associated with exercise. Exercise is explored in some detail, because it elicits both thermoregulatory and nonthermoregulatory reflexes. The overall conclusion reached is that thermoregulatory control of SkBF is subject to modification by or competition from several other sources. The fundamental pattern for control of SkBF is described by the threshold and slope of the SkBF-internal temperature relationship. Reflex effects of skin temperature act to shift the threshold of this relationship such that lower levels of skin temperature are associated with higher threshold internal temperatures at which cutaneous vasodilation begins. Similarly, baroreceptor reflexes, reflexes associated with exercise, and effects of some cardiovascular disease also operate against this background. Although modification of the SkBF-internal temperature slope is occasionally seen, the most consistent effect of these nonthermoregulatory factors is to elevate the threshold internal temperature for cutaneous vasodilation. The consequence of this modification of thermoregulatory control of SkBF is that temperature regulation will often suffer when increases in SkBF are delayed or limited. Blood flow to other regions, possibly including active skeletal muscle, may also be compromised when thermoregulatory demands for SkBF are high. PMID- 3536837 TI - Airway effects of purine nucleosides and nucleotides and release with bronchial provocation in asthma. AB - Adenosine, AMP, and ADP all caused similar concentration-related bronchoconstriction when inhaled by patients with asthma, whereas the adenosine hydrolysis product inosine had no effect. Geometric mean provocation concentrations of adenosine AMP and ADP causing a 20% fall in forced expiratory volume in 1 s (PCf20) were 2.34, 4.27, and 2.19 mumol/ml and 40% fall in specific airway conductance (PCs40) 3.16, 5.01, and 2.0 mumol/ml. Bronchoconstriction was rapid in onset, reaching a maximum 2-5 min after a single inhalation of AMP. In 31 asthmatic subjects a positive correlation was established between airway responsiveness to histamine, as an index of non-specific responsiveness, and airway reactivity to adenosine (PCf20, r = 0.60; PCs40, r = 0.64; P less than 0.01). Following bronchial provocation with allergen in nine subjects, plasma levels of adenosine increased from a mean base line of 5.4 +/- 0.9 to 9.6 +/- 2.0 ng/ml at 15 min (P less than 0.01) in parallel with a fall in forced expiratory volume in 1 s. With methacholine provocation bronchoconstriction reached maximum 2-5 min postchallenge being followed by, but not accompanied by, significant increases in plasma levels of adenosine. These data suggest that adenosine is a specific bronchoconstrictor that may contribute to airflow obstruction in asthma. PMID- 3536838 TI - Increased epinephrine response and inaccurate glucoregulation in exercising athletes. AB - Epinephrine responses to insulin-induced hypoglycemia have indicated that athletes have a higher adrenal medullary secretory capacity than untrained subjects. This view was tested by an exercise protocol aiming at identical stimulation of the adrenal medulla in the two groups. Eight athletes (T) and eight controls (C) ran 7 min at 60% maximal O2 consumption (VO2max), 3 min at 100% VO2max, and 2 min at 110% VO2max. Plasma epinephrine both at rest and at identical relative work loads [110% VO2max: 8.73 +/- 1.51 (T) vs. 3.60 +/- 1.09 mmol X l-1 (C)] was higher [P less than 0.05) in T than in C. Norepinephrine, as well as heart rate, increased identically in the two groups, indicating identical sympathetic nervous activity. Lactate and glycerol were higher in T than in C after running. Glucose production peaked immediately after exercise and was higher in T than in C. Glucose disappearance increased less than glucose production and was identical in T and C. Accordingly plasma glucose increased, more in T than in C (P less than 0.01). In T glucose levels approached the renal threshold greater than 20 min postexercise. Glucose clearance increased less in T than in C during exercise and decreased postexercise to or below (T, P less than 0.05) basal levels, despite increased insulin levels. Long-term endurance training increases responsiveness of the adrenal medulla to exercise, indicating increased secretory capacity. During maximal exercise this may contribute to higher glucose production, lower clearance, more inaccurate glucoregulation, and higher lypolysis in T compared with C. PMID- 3536840 TI - Rapidly adapting receptor activity in dogs is inversely related to lung compliance. AB - We examined the response of pulmonary rapidly adapting receptors (RAR's) to changes in dynamic lung compliance (Cdyn) in the physiological range. RAR impulse activity was recorded from the cervical vagus nerves in anesthetized open-chest dogs whose lungs were ventilated at constant rate and tidal volume (VT), with a positive end-expiratory pressure (PEEP) of 3-4 cmH2O. After hyperinflation to produce maximal Cdyn, RAR's were silent or fired sparsely and irregularly. Reducing Cdyn in steps by briefly removing PEEP increased firing proportionately, and RAR's began to discharge vigorously in inflation. Activity was restored to control by hyperinflating the lungs. Activity also increased when we increased inflation rate, and hence the rate of change of airway pressure (dP/dt), by reducing inflation time, keeping VT and cycle length constant. RAR's were stimulated more when dP/dt was increased by reducing compliance than when dP/dt was increased by increasing inflation rate. We conclude that RAR's are sensitive to changes in Cdyn and speculate that excitatory input from RAR's may help to maintain VT as the lungs become stiffer. PMID- 3536839 TI - Thromboxane A2 and prostacyclin do not modulate pulmonary hemodynamics during exercise in sheep. AB - The purpose of this study was to determine the role of thromboxane and prostacyclin in modulating pulmonary hemodynamics during maximal cardiopulmonary stress in the healthy lung. We studied 11 yearling sheep in paired studies during progressive maximal treadmill exercise with and without meclofenamate (n = 5), ibuprofen (n = 6), or UK38485 (n = 2). We also studied five sheep during hypoxia and hypoxic exercise, and six sheep during prolonged steady-state treadmill exercise for 45-60 min with and without drug treatment. We measured the metabolites of thromboxane A2 (thromboxane B2, TxB2) and prostacyclin (6 ketoprostaglandin F1 alpha, 6-keto-PGF1 alpha) in blood plasma and lung lymph in each protocol. We found that progressive exercise significantly reduced pulmonary vascular resistance but that cyclooxygenase or thromboxane synthesis blockade did not alter the change. Plasma TxB2 rose minimally but significantly during maximal exercise, but 6-keto-PGF1 alpha did not change. During continuous hypoxia, exercise reduced pulmonary vascular resistance nearly to base-line levels, but the degree of reduction was also unchanged by drug treatment. There were also no significant changes in lymph or plasma TxB2 or 6-keto-PGF1 alpha during 45-60 min of continuous moderate exercise. We conclude that neither TxB2 nor prostacyclin modulate pulmonary hemodynamics in the normal lung during maximal exercise, prolonged moderate exercise, or exercise-induced reductions in vascular resistance during hypoxia. PMID- 3536841 TI - Margaret Ransone Murray (1901-1986). PMID- 3536842 TI - Fine structure and immunofluorescent studies of the WISH cell line. AB - Morphological studies of the WISH cell line reveal an epithelioid cell type with some characteristics of both the original human amnion epithelium and a transformed state. WISH cells have a cytoplasm filled with microtubules; however, actin filament bundles are few, with actin localized at areas of cell contact and arranged diffusely through the cytoplasm, as viewed by indirect immunofluorescence. Fingerlike projections or short filopodia are observed connecting cells that grow in a closely apposed monolayer. Other surface features, as viewed by scanning electron microscopy, include microvilli and blebs. Transmission electron microscopy shows that WISH cultures consist of light or dark cells with organelles that include lipid droplets, abundant free ribosomes, tubular mitochondria, lysosomes, annulate lamellae, rough endoplasmic reticulum, 6-nm microfilaments, 10-nm intermediate filaments, and microtubules. Pleomorphic nuclei with multiple nucleoli and fibrillar nuclear bodies are common. Desmosomes and subsurface confronting cisternae connect cells. To our knowledge, these structural studies are the first to describe WISH and lead to subsequent investigation of the cell surface phenomenon of blebbing and surface charge in WISH and another human cell line. PMID- 3536843 TI - Purification of nitrogen regulator II, the product of the glnL (ntrB) gene of Escherichia coli. AB - We purified the product of glnL (ntrB), NRII, and the product of a mutant glnL allele, NRII2302. In vitro transcription of the nitrogen-regulated promoter glnAp2 by purified components of Escherichia coli required NRII or NRII2302 when the template DNA was linear. PMID- 3536844 TI - Partition functions of unit-copy plasmids can stabilize the maintenance of plasmid pBR322 at low copy number. AB - The maintenance of plasmid pBR322 is highly unstable in a polA12 strain of Escherichia coli at 29 degrees C due to severely reduced copy number. Under these conditions, introduction of the par (partition) locus of plasmid P1 or the par (sop) region of F into pBR322 stabilizes it. A region with similar activity was detected in the P7 plasmid. The activity of the P1 par locus was dependent on the P1 parA gene product and was sensitive to par-specified incompatibility. PMID- 3536845 TI - Expression of the bacteriophage T4 denV structural gene in Escherichia coli. AB - The expression of the T4 denV gene, which previously had been cloned in plasmid constructs downstream of the bacteriophage lambda hybrid promoter-operator oLpR, was analyzed under a variety of growth parameters. Expression of the denV gene product, endonuclease V, was confirmed in DNA repair-deficient Escherichia coli (uvrA recA) by Western blot analyses and by enhancements of resistance to UV irradiation. PMID- 3536846 TI - Glutathione in Escherichia coli is dispensable for resistance to H2O2 and gamma radiation. AB - Escherichia coli devoid of glutathione (because of transposon insertions in the gshA gene) has normal resistance to H2O2, cumene hydroperoxide, heat, or ionizing radiation. Intracellular glutathione thus does not protect E. coli from such lethal oxidative damage. The use of gshA::Tn10 mutants also revealed a glutathione-independent, H2O2-inducible resistance to N-ethylmaleimide. PMID- 3536847 TI - Starvation proteins in Escherichia coli: kinetics of synthesis and role in starvation survival. AB - Starvation proteins synthesized by Escherichia coli at the onset of carbon starvation (R. G. Groat and A. Matin, J. Indust. Microbiol. 1:69-73, 1986) exhibited four temporal classes of synthesis in response to glucose or succinate starvation, indicating sequential expression of carbon starvation response (cst) genes. A cst mutant of E. coli showed greatly impaired carbon starvation survival. Thus, it appears that E. coli undergoes a significant molecular realignment in response to starvation, which increases its resistance to this stress. New polypeptides were also synthesized by E. coli in response to phosphate or nitrogen starvation. Some of these polypeptides were unique to a given starvation regimen, but at least 13 appeared to be synthesized regardless of the nutrient deprivation causing the starvation. PMID- 3536848 TI - DNA replication termination in Escherichia coli parB (a dnaG allele), parA, and gyrB mutants affected in DNA distribution. AB - We investigated the Escherichia coli mutants carrying the parB, parA, and gyrB mutations, all of which display faulty chromosome partitioning at the nonpermissive temperature, to see whether their phenotype reflected a defect in the termination of DNA replication. In the parB strain DNA synthesis slowed down at 42 degrees C and the SOS response was induced, whereas in the parA strain DNA synthesis continued normally for 120 min and there was no SOS induction. To see whether replication forks accumulated in the vicinity of terC at the nonpermissive temperature, the mutants were incubated for 60 min at 42 degrees C and then returned to low temperature and pulse-labeled with [3H]thymidine. In all cases the restriction pattern of the labeled DNA was incompatible with that of the terC region, suggesting that replication termination was normal. In the parA mutant no DNA sequences were preferentially labeled, whereas in the parB and gyrB strains there was specific labeling of sequences whose restriction pattern resembled that of oriC. In the case of parB this was confirmed by DNA-DNA hybridization with appropriate probes. This test further revealed that the parB mutant over initiates at oriC after the return to the permissive temperature. Like dna(Ts) strains, the parB mutant formed filaments at 42 degrees C in the absence of SOS-associated division inhibition, accompanied by the appearance of anucleate cells of nearly normal size (28% of the population after 3 h), as revealed by autoradiography. The DNA in the filaments was either centrally located or distributed throughout. The parB mutation lies at 67 min, and the ParB phenotype is corrected by a cloned dnaG gene or by a plasmid primase, strongly suggesting that parB is an allele of dnaG, the structural gene of the E. coli primase. It is thus likely that the parB mutant possesses an altered primase which does not affect replication termination but causes a partial defect in replication initiation and elongation and in chromosome distribution. PMID- 3536849 TI - New locus (ttr) in Escherichia coli K-12 affecting sensitivity to bacteriophage T2 and growth on oleate as the sole carbon source. AB - The nature of resistance to phage T2 in Escherichia coli K-12 was investigated by analyzing a known phage T2-resistant mutant and by isolating new T2-resistant mutants. It was found that mutational alterations at two loci, ompF (encoding the outer membrane protein OmpF) and ttr (T-two resistance), are needed to give full resistance to phage T2. A ttr::Tn10 mutation was isolated and was mapped between aroC and dsdA, where the fadL gene (required for long-chain fatty acid transport) is located. The receptor affected by ttr was the major receptor used by phage T2 and was located in the outer membrane. Phage T2 was thus able to use two outer membrane proteins as receptors. All strains having a ttr::Tn10 allele and most of the independently isolated phage T2-resistant mutants were unable to grow on oleate as the sole carbon and energy source, i.e., they had the phenotype of fadL mutants. The gene fadL is known to encode an inner membrane protein. The most likely explanation is that fadL and ttr are in an operon and that ttr encodes an outer membrane protein which functions in translocating long-chain fatty acids across the outer membrane and also as a receptor for phage T2. PMID- 3536851 TI - Extracellular RNase produced by Yarrowia lipolytica. AB - Production of extracellular RNase(s) by Yarrowia lipolytica CX161-1B was examined in media between pHs 5 and 7. RNase production occurred during the exponential growth phase. High-molecular-weight nitrogen compounds supported the highest levels of RNase production. Several RNases were detected in the supernatant medium. Based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the RNases had estimated molecular weights of 45,000, 43,000, and 34,000. It was found that Y. lipolytica secretes only one RNase (the 45,000-molecular-weight RNase) and that the 43,000 and 34,000-molecular-weight RNases are degradation products of this RNase. The alkaline extracellular protease secreted by Y. lipolytica was shown to have a major role in the 45,000- to 43,000-molecular weight conversion, and it was demonstrated that the 45,000-molecular-weight RNase could be purified from a mutant which does not produce the alkaline extracellular protease. Purification of the RNase from a wild-type strain resulted in purification of the 43,000-molecular-weight RNase. This RNase was a glycoprotein with a molecular weight of 44,000 as estimated by gel filtration, an isoelectric point of pH 4.8, and a pH optimum between 6.5 and 7.0. PMID- 3536850 TI - Poly-beta-hydroxybutyrate membrane structure and its relationship to genetic transformability in Escherichia coli. AB - The effects of competence-inducing treatments on the composition and organization of membrane lipids in Escherichia coli K-12, DH1, DH5, HB101, and RR1 were investigated for two widely used protocols in which transformability is developed at low temperatures in Ca2+ buffers. At stages during each procedure, the lipid compositions of the cells were determined, and the thermotropic lipid phase transitions were observed in whole cell culture by fluorescence assay with the hydrophobic probe N-phenyl-1-naphthylamine. Competence was evaluated by determining transformation efficiencies with plasmid pBR322 DNA. The competence inducing procedures effected only slight changes in phospholipid compositions which did not correlate with transformability. However, the induction of competence was coincident with de novo synthesis and incorporation of poly-beta hydroxybutyrate into the cytoplasmic membranes and with the appearance of a sharp lipid phase transition above physiological temperatures. Transformation efficiencies correlated with poly-beta-hydroxybutyrate concentrations and with the intensity of the new phase transition. Transformability, poly-beta hydroxybutyrate synthesis and the new phase transition were not significantly affected by inhibition of protein synthesis with chloramphenicol or inhibition of respiration or ATP synthesis with azide, cyanide, arsenate, or 2,4-dinitrophenol; however, when poly-beta-hydroxybutyrate synthesis was inhibited with acetaldehyde, the new phase transition was not observed, and competence failed to develop. These studies suggest that genetic transformability in E. coli may be physiologically regulated. PMID- 3536852 TI - Proline transport in Salmonella typhimurium: putP permease mutants with altered substrate specificity. AB - The putP gene encodes a proline permease required for Salmonella typhimurium LT2 to grow on proline as the sole source of nitrogen. The wild-type strain is sensitive to two toxic proline analogs (azetidine-2-carboxylic acid and 3,4 dehydroproline) also transported by the putP permease. Most mutations in putP prevent transport of all three substrates. Such mutants are unable to grow on proline and are resistant to both of the analogs. To define domains of the putP gene that specify the substrate binding site, we used localized mutagenesis to isolate rare mutants with altered substrate specificity. The position of the mutations in the putP gene was determined by deletion mapping. Most of the mutations are located in three small (approximately 100-base-pair) deletion intervals of the putP gene. The sensitivity of the mutants to the proline analogs was quantitated by radial streaking to determine the affinity of the mutant permeases for the substrates. Some of the mutants showed apparent changes in the kinetics of the substrates transported. These results indicate that the substrate specificity mutations are probably due to amino acid substitutions at or near the active site of proline permease. PMID- 3536853 TI - Structure of two pectate lyase genes from Erwinia chrysanthemi EC16 and their high-level expression in Escherichia coli. AB - The pelB and pelE genes from Erwinia chrysanthemi EC16, which encode different pectate lyase enzymes, were sequenced and expressed at a high level in Escherichia coli. The genes possessed little similarity to each other in 5' signal regions, signal peptide sequences, coding sequences, or 3' noncoding regions. Both genes contained their own promoters as well as sequences 3' to the coding regions with considerable secondary structure which may function as rho independent transcriptional termination signals. High-level expression plasmids were constructed with both genes, which led to 20% or more of E. coli cellular protein. The pectate lyases were secreted efficiently to the periplasm and, to a lesser extent, the culture medium. The mature proteins in E. coli periplasmic fractions were obtained in milligram amounts and high purity with a single-column affinity purification method. E. coli cells which produced high amounts of the pelE protein macerated potato tuber tissue as efficiently as E. chrysanthemi EC16 cells but cells producing high amounts of the pelB protein were less effective. Thus, the pelE gene product is an important pathogenicity factor which solely enables E. coli to cause a soft-rot disease on potato tuber tissue under laboratory conditions. PMID- 3536854 TI - Increase in cell mass during the division cycle of Escherichia coli B/rA. AB - Increase in the mean cell mass of undivided cells was determined during the division cycle of Escherichia coli B/rA. Cell buoyant densities during the division cycle were determined after cells from an exponentially growing culture were separated by size. The buoyant densities of these cells were essentially independent of cell age, with a mean value of 1.094 g ml-1. Mean cell volume and buoyant density were also determined during synchronous growth in two different media, which provided doubling times of 40 and 25 min. Cell volume and mass increased linearly at both growth rates, as buoyant density did not vary significantly. The results are consistent with only one of the three major models of cell growth, linear growth, which specifies that the rate of increase in cell mass is constant throughout the division cycle. PMID- 3536855 TI - Purification of the phoU protein, a negative regulator of the pho regulon of Escherichia coli K-12. AB - Thermally induced transcription of the phoU gene under control of the major leftward promoter, pL, of phage lambda resulted in production of the PhoU protein to compose approximately 5% of the total cell protein. The PhoU protein was present in the cytoplasm in the form of an aggregate. The amino acid composition and N-terminal amino acid sequence of the purified protein confirmed the reading frame established earlier for the phoU gene. PMID- 3536856 TI - Molecular cloning of structural and regulatory hydrogenase (hox) genes of Alcaligenes eutrophus H16. AB - A gene bank of the 450-kilobase (kb) megaplasmid pHG1 from the hydrogen-oxidizing bacterium Alcaligenes eutrophus H16 was constructed in the broad-host-range mobilizable vector pSUP202 and maintained in Escherichia coli. hox DNA was identified by screening the E. coli gene bank for restoration of hydrogenase activity in A. eutrophus Hox mutants. Hybrid plasmids that contained an 11.6-kb EcoRI fragment restored soluble NAD-dependent hydrogenase activity when transferred by conjugation into one class of Hos- mutants. An insertion mutant impaired in particulate hydrogenase was partially restored in Hop activity by an 11-kb EcoRI fragment. A contiguous sequence of two EcoRI fragments of 8.6 and 2.0 kb generated Hox+ recombinants from mutants that were devoid of both hydrogenase proteins. hox DNA was subcloned into the vector pVK101. The resulting recombinant plasmids were used in complementation studies. The results indicate that we have cloned parts of the structural genes coding for Hos and Hop activity and a complete regulatory hox DNA sequence which encodes the thermosensitive, energy dependent derepression signal of hydrogenase synthesis in A. eutrophus H16. PMID- 3536858 TI - Expression of Escherichia coli infC: identification of a promoter in an upstream thrS coding sequence. AB - infC, the gene which codes for translation initiation factor 3, is situated in a cluster in the genome of Escherichia coli with genes for several other components of the translation apparatus. Only three nucleotides separate the termination codon of thrS from the initiation codon of infC. This implies that infC is either cotranscribed with thrS from a thrS promoter or that the transcriptional signals for infC are embedded within the upstream thrS coding region. In the present work, several plasmids have been constructed which encompass infC and various amounts of the upstream thrS sequence. The ability of the plasmid DNA, or derived restriction fragments, to direct the synthesis of initiation factor 3 was tested in an in vitro DNA-dependent coupled transcription-translation system and in plasmid-transformed maxicells. The results indicate that initiation factor 3 is synthesized in the absence of the thrS promoter. A promoter whose presence is sufficient for the expression of infC has been localized to an 89-base-pair region which lies 178 to 267 base pairs upstream of the infC initiation codon. S1 nuclease mapping of in vivo transcripts confirms that a transcription initiation site is located in this region. These studies demonstrate that infC can be transcribed from a promoter within the upstream thrS coding sequence. PMID- 3536857 TI - Amplified expression of the tag+ and alkA+ genes in Escherichia coli: identification of gene products and effects on alkylation resistance. AB - We have constructed plasmids which overproduce the tag and alkA gene products of Escherichia coli, i.e., 3-methyladenine DNA glycosylases I and II. The tag and alkA gene products were identified radiochemically in maxi- or minicells as polypeptides of 21 and 30 kilodaltons, respectively, which are consistent with the gel filtration molecular weights of the enzyme activities, thus confirming the identity of the cloned genes. High expression of the tag+-coded glycosylase almost completely suppressed the alkylation sensitivity of alkA mutants, indicating that high levels of 3-methyladenine DNA glycosylase I will eliminate the need for 3-methyladenine DNA glycosylase II in repair of alkylated DNA. Furthermore, overproduction of the alkA+-coded glycosylase greatly sensitizes wild-type cells to alkylation, suggesting that only a limited expression of this enzyme will allow efficient DNA repair. PMID- 3536859 TI - In vitro packaging of heteroduplex bacteriophage T7 DNA: evidence for repair of mismatched bases. AB - Heteroduplex DNA molecules that were wild type or contained combinations of amber, missense, and temperature-sensitive mutations were prepared from bacteriophage T7. These DNA molecules were then encapsulated in in vitro packaging reactions so as to produce infective T7 phage. The genotypes of the phage were examined to determine the degree to which mismatched base pairs in the heteroduplex had been corrected. The data show that conversion of the mismatches took place either during in vitro packaging or immediately after infection of either an Escherichia coli or Shigella sonnei host. The mode of mismatch conversion observed in these experiments was independent of the host mutH, mutL, mutS, and uvrD genes. There was no significant amount of discrimination between markers on either of the two complementary strands. The observed frequency of conversion of a mismatch depended on the genetic marker being monitored and on experimental conditions but was generally in the range between 5 and 30%. PMID- 3536860 TI - Binding specificity of the periplasmic oligopeptide-binding protein from Escherichia coli. AB - The structural properties required for the binding of peptide substrates to the Escherichia coli periplasmic protein involved in oligopeptide transport were surveyed by measuring the ability of different peptides to compete for binding in an equilibrium dialysis assay with the tripeptide Ala-Phe-[3H]Gly. The protein specifically bound oligopeptides and failed to bind amino acids or dipeptides. Acetylation of the peptide amino terminus of (Ala)3 severely impaired binding, whereas esterification of the carboxyl terminus significantly reduced but did not completely eliminate binding. Peptides composed of L-amino acids competed more effectively than did peptides containing D-residues or glycine. Experiments with a series of alanyl peptide homologs demonstrated a decrease in competitive ability with increasing chain length beyond tripeptide. Competition studies with tripeptide homologs indicated that a wide variety of amino acyl side chains were tolerated by the periplasmic protein, but side-chain composition did affect binding. Fluorescence emission data suggested that this periplasmic protein possesses more than one substrate-binding site capable of distinguishing peptides on the basis of amino acyl side chains. PMID- 3536861 TI - Osmotic regulation of transcription: induction of the proU betaine transport gene is dependent on accumulation of intracellular potassium. AB - The proU locus, which encodes a high-affinity betaine transport system, and the kdp operon, which encodes a potassium transport system, are the principal osmoresponsive genes in Escherichia coli and Salmonella typhimurium. The kdp operon is known to be induced in response to changes in cell turgor. We have investigated the control of proU expression and shown that it differs from that of kdp in a number of fundamental ways. Rather than responding to changes in turgor, proU expression is principally determined by the intracellular accumulation of potassium ions. Potassium and betaine were shown to play distinct osmoprotective roles. Potassium serves as the principal osmoprotectant and is accumulated in response to low-level osmotic stress to restore turgor. As external osmolarity is increased to a level at which the corresponding increase in internal potassium concentrations is potentially deleterious to enzyme function, betaine (when available) is accumulated in preference to potassium. The different mechanisms of proU and kdp regulation reflect the different physiological roles of these two osmoprotectants. PMID- 3536862 TI - Cloning and expression of Acinetobacter calcoaceticus catechol 1,2-dioxygenase structural gene catA in Escherichia coli. AB - Catechol 1,2-dioxygenase (EC 1.13.1.1), the product of the catA gene, catalyzes the first step in catechol utilization via the beta-ketoadipate pathway. Enzymes mediating subsequent steps in the pathway are encoded by the catBCDE genes which are carried on a 5-kilobase-pair (kbp) EcoRI restriction fragment isolated from Acinetobacter calcoaceticus. This DNA was used as a probe to identify Escherichia coli colonies carrying recombinant pUC19 plasmids with overlapping sequences. Repetition of the procedure yielded an A. calcoaceticus 6.7-kbp EcoRI restriction fragment which contained the catA gene and bordered the original 5-kbp EcoRI restriction fragment. When the catA-containing fragment was placed under the control of the lac promoter on pUC19 and induced with isopropylthiogalactopyranoside, catechol dioxygenase was formed in E. coli at twice the level found in fully induced cultures of A. calcoaceticus. A. calcoaceticus strains with mutations in the catA gene were transformed to wild type by DNA from lysates of E. coli strains carrying the catA gene on recombinant plasmids. Thus, A. calcoaceticus strains with a mutated gene can be used in a transformation assay to identify E. coli clones in which at least part of the wild-type gene is present but not necessarily expressed. PMID- 3536863 TI - Effects of nucleotides on ATP-dependent protein translocation into Escherichia coli membrane vesicles. AB - We have shown previously that Escherichia coli can translocate the same protein either co- or posttranslationally and that ATP hydrolysis is essential for the posttranslational translocation of the precursors of alkaline phosphatase and OmpA protein into inverted E. coli membrane vesicles. ATP-dependent protein translocation has now been further characterized. In the absence of exogenous Mg2+, dATP, formycin A-5'-triphosphate, ATP-alpha-S, and N1-oxide-ATP could replace ATP, but many other nucleotides were not only ineffective but inhibited ATP-dependent translocation. The inhibitors included nonhydrolyzable ATP analogs, ATP-gamma-S, 8-azido-ATP, AMP, ADP, cyclic AMP, PPi, and tripolyphosphate. On the other hand, adenosine, adenosine 5'-tetraphosphate, and N1,N6-etheno-ATP neither supported nor inhibited translocation. Moreover, photoaffinity labeling of azido adenine nucleotides rendered membranes inactive for subsequent ATP-dependent protein translocation. These results suggest that protein translocation involves at least an ATP-binding site in the membrane and hydrolysis of ATP and that both the adenosine and phosphate moieties of ATP play a role. PMID- 3536865 TI - Repair response of Escherichia coli to hydrogen peroxide DNA damage. AB - The repair response of Escherichia coli to hydrogen peroxide-induced DNA damage was investigated in intact and toluene-treated cells. Cellular DNA was cleaved after treatment by hydrogen peroxide as analyzed by alkaline sucrose sedimentation. The incision step did not require ATP or magnesium and was not inhibited by N-ethylmaleimide (NEM). An ATP-independent, magnesium-dependent incorporation of nucleotides was seen after the exposure of cells to hydrogen peroxide. This DNA repair synthesis was not inhibited by the addition of NEM or dithiothreitol. In dnaB(Ts) strain CRT266, which is thermolabile for DNA replication, normal levels of DNA synthesis were found at the restrictive temperature (43 degrees C), showing that DNA replication was not necessary for this DNA synthesis. Density gradient analysis also indicated that hydrogen peroxide inhibited DNA replication and stimulated repair synthesis. The subsequent reformation step required magnesium, did not require ATP, and was not inhibited by NEM, in agreement with the synthesis requirements. This suggests that DNA polymerase I was involved in the repair step. Furthermore, a strain defective in DNA polymerase I was unable to reform its DNA after peroxide treatment. Chemical cleavage of the DNA was shown by incision of supercoiled DNA with hydrogen peroxide in the presence of a low concentration of ferric chloride. These findings suggest that hydrogen peroxide directly incises DNA, causing damage which is repaired by an incision repair pathway that requires DNA polymerase I. PMID- 3536864 TI - Location of functional regions of the Escherichia coli RecA protein by DNA sequence analysis of RecA protease-constitutive mutants. AB - In previous work (E. S. Tessman and P. K. Peterson, J. Bacteriol. 163:677-687 and 688-695, 1985), we isolated many novel protease-constitutive (Prtc) recA mutants, i.e., mutants in which the RecA protein was always in the protease state without the usual need for DNA damage to activate it. Most Prtc mutants were recombinase positive and were designated Prtc Rec+; only a few Prtc mutants were recombinase negative, and those were designated Prtc Rec-. We report changes in DNA sequence of the recA gene for several of these mutants. The mutational changes clustered at three regions on the linear RecA polypeptide. Region 1 includes amino acid residues 25 through 39, region 2 includes amino acid residues 157 through 184, and region 3 includes amino acid residues 298 through 301. The in vivo response of these Prtc mutants to different effectors suggests that the RecA effector binding sites have been altered. In particular we propose that the mutations may define single-stranded DNA- and nucleoside triphosphate-binding domains of RecA, that polypeptide regions 1 and 3 comprise part of the single-stranded DNA-binding domain, and that polypeptide regions 2 and 3 comprise part of the nucleoside triphosphate-binding domain. The overlapping of single-stranded DNA- and nucleoside triphosphate-binding domains in region 3 can explain previously known complex allosteric effects. Each of four Prtc Rec- mutants sequenced was found to contain a single amino acid change, showing that the change of just one amino acid can affect both the protease and recombinase activities and indicating that the functional domains for these two activities of RecA overlap. A recA promoter down mutation was isolated by its ability to suppress the RecA protease activity of one of our strong Prtc mutants. PMID- 3536866 TI - cis-acting sites required for osmoregulation of ompF expression in Escherichia coli K-12. AB - OmpF and OmpC are major outer membrane proteins which form passive diffusion pores in Escherichia coli K-12. The expression of the structural genes for these proteins, ompF and ompC, is influenced by medium osmotic strength and requires the products of two regulatory genes, ompR and envZ. We have constructed a series of ompF-lacZ fusions containing different regions of ompF to determine sites involved with osmoregulation. These fusions were crossed onto a specialized transducing phage and integrated into the bacterial chromosome in unit copy. By measuring the fluctuations of beta-galactosidase activity in lysogens grown in high versus low osmolarity, we have identified three regions which are necessary. Furthermore, we have determined that, although the OmpR activation site is not sufficient, OmpR is probably essential for ompF osmoregulation. PMID- 3536867 TI - Genetic evidence for a switching and energy-transducing complex in the flagellar motor of Salmonella typhimurium. AB - The flaAII.2, flaQ, and flaN genes of Salmonella typhimurium are important for assembly, rotation, and counterclockwise-clockwise switching of the flagellar motor. Paralyzed and nonchemotactic mutants were subjected to selection pressure for partial acquisition of motility and chemotaxis, and the suppressor mutations of the resulting pseudorevertants were mapped and isolated. Many of the intergenic suppressor mutations were in one of the other two genes. Others were in genes for cytoplasmic components of the chemotaxis system, notably cheY and cheZ; one of the mutations was found in the cheA gene and one in a motility gene, motB. Suppression among the three fla genes was allele specific, and many of the pseudorevertants were either cold sensitive or heat sensitive. We conclude that the FlaAII.2, FlaQ, and FlaN proteins form a complex which determines the rotational sense, either counterclockwise or clockwise, of the motor and also participates in the conversion of proton energy into mechanical work of rotation. This switch complex is probably mounted to the base of the flagellar basal body and, via binding of the CheY and CheZ proteins, receives sensory information and uses it to control flagellar operation. PMID- 3536868 TI - Molecular cloning of an osmoregulatory locus in Escherichia coli: increased proU gene dosage results in enhanced osmotolerance. AB - The proU locus in Escherichia coli encodes an important osmoregulatory function which mediates the growth-promoting effect of L-proline and glycine betaine in high-osmolarity media. This locus was cloned, in contiguity with a closely linked Tn10 insertion, onto a multicopy plasmid directly from the E. coli chromosome. For a given level of osmotic stress, the magnitude of osmoresponsive induction of a single-copy proU::lac fusion was reduced in strains with multiple copies of the proU+ genes; in comparison with haploid proU+ strains, strains with the multicopy proU+ plasmids also exhibited enhanced osmotolerance in media supplemented with 1 mM L-proline or glycine betaine. Experiments involving subcloning, Tn1000 mutagenesis, and interplasmid complementation in a deletion mutant provided evidence for the presence at this locus of two cistrons, both of which are necessary for the expression of ProU function. We propose the designations proU for the gene originally identified by the proU224::Mu d1(lac Ap) insertion and proV for the gene upstream (that is, counterclockwise) of proU. PMID- 3536870 TI - Interaction between two regulatory proteins in osmoregulatory expression of ompF and ompC genes in Escherichia coli: a novel ompR mutation suppresses pleiotropic defects caused by an envZ mutation. AB - The ompR and envZ genes, which together constitute the ompB operon, are involved in osmoregulatory expression of the OmpF and OmpC proteins, major outer membrane proteins of Escherichia coli. The envZ11 mutation results in the OmpF- OmpC constitutive phenotype. A mutant which suppressed defects caused by the envZ11 mutation was isolated. The suppressor mutation also suppressed the LamB- PhoA- phenotype caused by the envZ11 mutation. The mutation occurred in the ompR gene and hence was termed ompR77. The ompR77 mutation alone produced no obvious phenotype. Functioning of the ompR77 allele remained envZ gene dependent. Although the ompR77 mutation suppressed the envZ11 mutation, it did not suppress a mutation that occurred in another position within the envZ gene (envZ160). These results indicate that OmpR and EnvZ, two regulatory proteins, functionally interact with each other. PMID- 3536869 TI - Germination conditions that require mitochondrial function in Saccharomyces cerevisiae: utilization of acetate and galactose. AB - Ascospores of Saccharomyces cerevisiae inherited at least one functioning mitochondrion as shown by their ability to germinate on nonfermentable carbon sources. After transfer to germination medium, the optical density of the culture at 600 nm decreased (phase-dark), reaching a minimum within 60 min in the presence of glucose and within 180 min after transfer to acetate medium; thereafter, the optical density increased. Budding cells first appeared 90 min after transfer to glucose and 150 min after transfer to acetate. Augmentation of respiratory components, respiratory activity, and macromolecular synthesis (except for DNA synthesis) started at about the same time on glucose and on acetate, although the highest values for all these processes were reached in the presence of glucose. Mitochondrial inhibitors which affected germination on acetate did not arrest germination on glucose. However, mitochondrial activity was required for germination on galactose in a strain carrying the mutated allele imp1 of the nucleomitochondrion-connecting gene IMP1. PMID- 3536871 TI - Transcriptional control of flagellar genes in Escherichia coli K-12. AB - Autoregulation of the expression of flagellar genes was investigated by the technique of operon fusion. The results suggested that the flaU gene is a repressor and the flaD gene is an activator of transcription of the hag, flaS, and Mocha operons. The action of the putative flaU repressor appears to be masked by its interaction with other flagellar proteins during assembly; thus, repression is apparent only when the interacting proteins are absent. This hypothesis is supported by the phenotype of an unusual flaU mutant, which represses even though it is unable to promote flagellar assembly. Presumably, the mutant synthesizes a repressor whose activity is no longer masked by interaction with other flagellar proteins. PMID- 3536872 TI - Growth-rate-dependent regulation of the expression and inactivation of thymidylate synthase in Saccharomyces cerevisiae. AB - Thymidylate synthase activity fluctuated dramatically as cultures of Saccharomyces cerevisiae progressed through the different stages of batch culture growth. During logarithmic growth these yeast cultures each contained about 40 microU (1 microU is 1 pmol of 3H released per min) of thymidylate synthase activity per 10(8) haploid cells, but as cultures entered the stationary phase and during the stationary phase, activity dropped dramatically, eventually reaching undetectable levels. Stimulation of stationary-phase cells with fresh medium resulted in rapid reestablishment of log phase levels. Two mechanisms, the regulation of thymidylate synthase-specific transcripts and the irreversible inactivation of thymidylate synthase activity, acted in concert to regulate activity levels. These results suggested that thymidylate synthase represents a special subset of yeast proteins whose levels per cell vary quickly and dramatically in response to changes in proliferation rates. PMID- 3536873 TI - Fluphenazine-resistant Saccharomyces cerevisiae mutants defective in the cell division cycle. AB - An fls1 mutant of Saccharomyces cerevisiae, which did not grow in the presence of 30 micrograms of fluphenazine per ml, was isolated. Mutants that were resistant to 90 micrograms of fluphenazine per ml and temperature sensitive for growth were obtained from the fls1 mutant. One fluphenazine-resistance mutation, fsr1, was located near the his7 locus on chromosome II. Growth of the fsr1 mutants at 35 degrees C was arrested after nuclear division. The other group of fluphenazine resistant mutants, carrying fsr2 mutations, showed Ca2+-dependent growth at 35 degrees C. Growth of the fsr2 mutants at 35 degrees C was arrested at the G2 stage of the cell cycle in Ca2+-poor medium. PMID- 3536874 TI - Osmotic adjustment in the filamentous fungus Aspergillus nidulans. AB - Aspergillus nidulans was shown to be xerotolerant, with optimal radial growth on basal medium amended with 0.5 M NaCl (osmotic potential [psi s] of medium, -3 MPa), 50% optimal growth on medium amended with 1.6 M NaCl (psi s of medium, -8.7 MPa), and little growth on medium amended with 3.4 M NaCl (psi s of medium, -21 MPa). The intracellular content of soluble carbohydrates and of selected cations was measured after growth on basal medium, on this medium osmotically amended with NaCl, KCl, glucose, or glycerol, and also after hyperosmotic and hypoosmotic transfer. The results implicate glycerol and erythritol as the major osmoregulatory solutes. They both accumulated during growth on osmotically amended media, as well as after hyperosmotic transfer, except on glycerol-amended media, in which erythritol did not accumulate. Furthermore, they both decreased in amount after hypoosmotic transfer. With the exception of glycerol, the extracellular osmotic solute did not accumulate intracellularly when mycelium was grown in osmotically amended media, but it accumulated after hyperosmotic transfer. It was concluded that the extracellular solute usually plays only a transient role in osmotic adaptation. The intracellular content of soluble carbohydrates and cations measured could reasonably account for the intracellular osmotic potential of mycelium growing on osmotically amended media. PMID- 3536875 TI - Bacterial alkaline phosphatase clonal variation in some Escherichia coli K-12 phoR mutant strains. AB - Several phoR alleles (phoR19, phoR20, phoR68, phoR69, phoR70, and phoR78) led to either a bacterial alkaline phosphatase (BAP)-constitutive phenotype or a variable behavior, depending upon the strain tested. Whereas Escherichia coli K10, MC1000, and XPh4 phoR mutants were constitutive, AB1157, BD792, MC4100, and W3110 phoR mutants displayed the metastable character. For the latter strains, constitutive mutants regularly segregated BAP-negative clones which yielded constitutive variants again at a high frequency. Indeed, the pattern of variation observed in BAP-variable phoR strains is phenotypically analogous to phase variation of the H1/H2 flagellum antigen type in Salmonella typhimurium and the molecular switch between the immune and sensitive states in bacteriophage lambda. The metastable behavior was not a general property of BAP-constitutive mutants, since several phosphate-specific transport-phoU mutations led to a constitutive (stable) phenotype regardless of the strain tested. But in phoR phosphate specific transport-phoU mutants, the metastable character was epistatic (dominant), and such double mutants showed clonal variation in BAP-variable strains. PMID- 3536876 TI - Cloning and mapping of the genetic determinants for microcin C7 production and immunity. AB - Microcin C7, a peptide antibiotic inhibitor of protein synthesis, is produced by Escherichia coli K-12 strains that carry the 43-kilobase low-copy-number plasmid pMccC7. Microcin C7 production and immunity determinants of this plasmid have been cloned into the vectors pBR322 and pACYC184. The resulting plasmids overproduce microcin C7 and express immunity against the microcin. Mcc- and Mcc- Imm- mutants have been isolated on recombinant plasmids by inserting transposable elements. Physical and phenotypic characterization of these mutants shows that a DNA region of 5 kilobases is required to produce microcin C7, and that two small regions located inside the producing region are also required to express immunity. Analysis of plasmids carrying mcc-lacZ gene fusions indicates that all microcin DNA is transcribed in the same direction. The results suggest that a structure like a polycistronic operon is responsible for microcin C7 production and immunity. PMID- 3536877 TI - Expression of the adenylate cyclase gene during cell elongation in Escherichia coli K-12. AB - Expression of the adenylate cyclase gene (cya) in synchronized Escherichia coli cells was investigated by using the cya-lacZ protein and operon fusion plasmids. The regulation of cya expression during the cell cycle is characterized as follows: cya is expressed during cell elongation; expression is repressed during cell division; regulation is exerted at the transcriptional level. To test cya expression during cell elongation, we constructed a plasmid (pLCR1) in which the lacUV5 promoter operator was fused to the structural gene of cya and investigated the effect of cya expression by isopropyl-beta-D-thiogalactopyranoside (IPTG) on the cell division of cells containing pLCR1. By the addition of IPTG, cell division was inhibited and filaments were formed. Such an inhibitory effect was antagonized by adding cyclic GMP to the culture medium and was not observed in the crp mutant. PMID- 3536878 TI - Three classes of Escherichia coli mutants selected for aerobic expression of fumarate reductase. AB - Fumarate reductase (encoded by frd) and succinate dehydrogenase (encoded by sdh) of Escherichia coli are both known to catalyze the interconversion of fumarate and succinate. Fumarate reductase, however, is not inducible aerobically and therefore cannot participate in the dehydrogenation of succinate. Three classes of suppressor mutants, classified as frd oxygen-resistant [frd(Oxr)], constitutive [frd(Con)], and gene amplification [frd(Amp)] mutants, were selected from an sdh strain as pseudorevertants that regained the partial ability to grow aerobically on succinate. All contained increased aerobic levels of fumarate reductase activity. In frd(Oxr) mutants expression of the operon showed increased resistance to aerobic repression. Under anaerobic conditions expression of the operon became less dependent on the fnr+ gene product, a pleiotropic activator protein for genes encoding anaerobic respiratory enzymes. Exogenous fumarate, however, was still required for full induction, and repression by nitrate was undiminished. Thus, aerobic repression and anaerobic nitrate repression appear to involve separate mechanisms. In frd(Con) mutants expression of the operon became highly resistant to aerobic repression. Under anaerobic conditions expression of the operon no longer required the fnr+ gene product or exogenous fumarate and became immune to nitrate repression. In partial diploids bearing an frd(Oxr) or an frd(Con) allele and phi(frd+-lac) there was no mutual regulatory influence between the two genetic loci. Thus, the frd mutations act in cis and hence are probably in the promoter region. In frd(Amp) mutants the frd locus was amplified without significant alteration in the pattern of regulation. PMID- 3536879 TI - Accumulation of a murein-membrane attachment site fraction when cell division is blocked in lkyD and cha mutants of Salmonella typhimurium and Escherichia coli. AB - Membrane fractionation studies were performed on Salmonella typhimurium lkyD(Ts) and E. coli cha(Ts) mutants that appeared to be blocked at a late stage of the cell division cycle. In both cases growth of the mutant strains at nonpermissive temperatures was associated with accumulation of a characteristic cell envelope fraction (fraction OML) that contained inner membrane, murein, and outer membrane components. The isolated fraction corresponded in composition and bouyant density to a fraction from wild-type strains that had previously been suggested (M. H. Bayer, G. P. Costello, and M. E. Bayer, J. Bacteriol. 149:758-767, 1982; K. Ishidate, E. S. Creeger, J. Zrike, S. Deb, B. Glauner, T. J. MacAlister, and L. I. Rothfield, J. Biol. Chem. 261:428-443, 1986) to contain adhesion sites between inner membrane, murein, and outer membrane. The accumulation of OML in LkyD- and Cha- cells was prevented by treatments that blocked DNA synthesis. The effects of interference with DNA synthesis did not appear to involve the SOS response. PMID- 3536880 TI - Compartmentalization of the periplasmic space at division sites in gram-negative bacteria. AB - Phase-contrast and serial-section electron microscopy were used to study the patterns of localized plasmolysis that occur when cells of Salmonella typhimurium and Escherichia coli are exposed to hypertonic solutions of sucrose. In dividing cells the nascent septum was flanked by localized regions of periseptal plasmolysis. In randomly growing populations, plasmolysis bays that were not associated with septal ingrowth were clustered at the midpoint of the cell and at 1/4 and 3/4 cell lengths. The localized regions of plasmolysis were limited by continuous zones of adhesion that resembled the periseptal annular adhesion zones described previously in lkyD mutants of S. typhimurium (T. J. MacAlister, B. MacDonald, and L. I. Rothfield, Proc. Natl. Acad. Sci. USA 80:1372-1376, 1983). When cell division was blocked by growing divC(Ts) cells at elevated temperatures, the localized regions of plasmolysis were clustered along the aseptate filaments at positions that corresponded to sites where septum formation occurred when cell division was permitted to resume by a shift back to the permissive temperature. Taken together the results are consistent with a model in which extended zones of adhesion define localized compartments within the periplasmic space, predominantly located at future sites of cell division. PMID- 3536881 TI - Magnesium transport in Salmonella typhimurium: characterization of magnesium influx and cloning of a transport gene. AB - The influx of Mg2+ in Salmonella typhimurium LT-2 was studied by both kinetic and genetic techniques. Wild-type cells grown in a high MgSO4 concentration (10 mM) exhibited a Km of 15 microM for Mg2+ influx, with a Vmax of 0.25 nmol of Mg2+ per min per 10(8) cells. The apparent Km decreased to 3 microM, and the Vmax increased 60% after growth in a low MgSO4 concentration (10 microM). Co2+ was a simple competitive inhibitor (Ki = 30 microM) of Mg2+ influx in cells grown in high Mg2+ concentrations but blocked only a portion of the Mg2+ influx in cells grown in low Mg2+ concentrations. Co2+ influx exhibited kinetics similar to those of Mg2+ influx (Km = 30 microM; Vmax = 0.5 nmol of Co2+ per min per 10(8) cells) but was not affected by growth conditions. Co2+ influx was competitively inhibited by both Mg2+ and Mn2+. Mutations affecting Mg2+ uptake were isolated by selection for spontaneous resistance to toxic levels of Co2+. One class of mutants designated corA mapped at 84 min near metE with the following gene order: corA, metE, zie-3161::Tn10, pepQ. A second class designated corB mapped at 98 min near pyrB. Mg2+ influx was decreased in a corA mutant strain (relative to that of the wild type) when grown in high Mg2+ concentrations but was restored when grown in low Mg2+ concentrations. Co2+ transport was completely abolished by the corA mutation under all growth conditions. Recombinant plasmids carrying the corA region from either Escherichia coli K-12 or S. typhimurium complemented the corA mutation in S. typhimurium, restoring uptake of both Co2+ and Mg2+ and conferring sensitivity to Co2+. The S. typhimurium corA gene was localized to a restriction fragment of approximately 1.5 kilobases. PMID- 3536882 TI - Determination of bacterial cell volume with the Coulter Counter. AB - Two methods were used to determine mean volumes of cells of Escherichia coli B/rA in both stationary- and exponential-phase cultures, i.e., electronic measurement with a Coulter Counter-Analyzer system and biophysical measurement of the total volume and number of cells in sedimented cell pellets. Within experimental errors, the methods gave the same mean cell volumes. PMID- 3536883 TI - Biological activity of the Asn-5,Arg-7 tridecapeptide encoded by MF alpha 2 of Saccharomyces cerevisiae. AB - The precursor predicted by the nucleotide sequence of the MF alpha 2 gene of Saccharomyces cerevisiae contains one copy of the tridecapeptide alpha-factor previously characterized (H2N-Trp-His-Trp-Leu-Gln-Leu-Lys-Pro-Gly-Gln-Pro-Met-Tyr COOH) and one copy of a peptide that contains two conservative amino acid substitutions (H2N-Trp-His-Trp-Leu-Asn-Leu-Arg-Pro-Gly-Gln-Pro-Met-Tyr-COOH). To determine whether the novel molecule possesses biological activity, the Asn-5,Arg 7 tridecapeptide was prepared chemically by solid-phase peptide synthesis. Growth arrest and morphogenesis assays gave identical activity profiles for the Asn 5,Arg-7 peptide and the other gene product, the Gln-5,Lys-7 peptide. The activities of the two peptides were additive and indistinguishable for S. cerevisiae X2180-1A. When present in fourfold molar excess, the biologically inactive desTrp-1,Ala-3 dodecapeptide reversed activity of the Asn-5,Arg-7 and Gln-5,Lys-7 tridecapeptides. Furthermore, neither peptide caused growth arrest of a MATa ste2(Ts) mutant when assayed at the restrictive temperature. These studies suggest that both pheromones interact with the alpha-factor receptor in a similar manner. PMID- 3536884 TI - Agglutination and mating activity of the MF alpha 2-encoded alpha-factor analog in Saccharomyces cerevisiae. AB - The MF alpha 2-encoded Asn-5,Arg-7 alpha-factor-like peptide has been shown shown to have similar activity to Gln-5,Lys-7 alpha-factor in morphogenesis and growth arrest studies (S. Raths, P. Shenbagamurthi, F. Naider, and J. M. Becker, J. Bacteriol. 168:1468-1471, 1986). We tested the Asn-5,Arg-7 peptide in agglutination and mating assays and found that its activity was similar to or slightly less than that of the Gln-5,Lys-7 alpha-factor. The Asn-5,Arg-7 alpha factor-like peptide is thus the most active analog of the Gln-5,Lys-7 alpha factor known. PMID- 3536885 TI - Nucleotide sequence of the hag gene encoding flagellin of Escherichia coli. AB - We determined the DNA sequence of the hag gene of Escherichia coli K-12 and deduced the primary structure of the flagellin consisting of 497 amino acid residues. Comparison of the amino acid sequence with those of other bacterial flagellins revealed a high homology in the NH2- and COOH-terminal regions. PMID- 3536886 TI - Inhibition of biosynthesis of Saccharomyces cerevisiae sugar transport system by tunicamycin. AB - Tunicamycin apparently inhibited the biosynthesis of glucose, galactose, and maltose transport systems in Saccharomyces cerevisiae. Under the conditions used, the antibiotic also blocked the biosynthesis of invertase, a well-known yeast glycoprotein, as well as the glycosylation of a marker mannoprotein of the yeast cell wall. However, the antibiotic did not affect certain proteins which did not contain carbohydrate. It seems, therefore, that these sugar carriers are glycoproteins. PMID- 3536887 TI - Biological role of DNA methylation: sequence-specific single-strand breaks associated with hypomethylation of GATC sites in Escherichia coli DNA. AB - The effect of methylation of GATC sites in Escherichia coli DNA on the formation of single-strand breaks was studied with dam+, dam mutant, and Dam-overproducer strains. Single-strand breaks have been observed in dam mutant cells predominantly at TpT and, to a lesser extent, at CpC. In dam mutant cells harboring pTP166 (a plasmid containing the dam gene), no such nicks were observed. PMID- 3536890 TI - Comparative effects of limbitrol and amitriptyline on sleep efficiency and architecture. AB - Chlordiazepoxide-amitriptyline (Limbitrol) has been shown to be more rapidly effective than amitriptyline alone for treating depression. A double-blind, randomized study was designed to compare the effects of Limbitrol and amitriptyline on insomnia, anxiety, and depression. The rate of improvement of symptoms was faster with Limbitrol. No differences were noted between groups in the degree or rate of improvement of the sleep laboratory parameters nor in sleep Stages 1 to 4. Percentages of rapid eye movement (REM) sleep and REM latency were similarly affected by the drugs, but REM density showed a significantly greater decrease with Limbitrol. Phasic REM factors may be crucial in the role of REM sleep and depression. PMID- 3536889 TI - Drug treatment of panic disorder: the comparative efficacy of imipramine, alprazolam, and trazodone. AB - Data from 74 patients with panic disorder were evaluated to determine the comparative efficacy of imipramine, alprazolam, and trazodone. All patients were treated with placebo for 3 weeks and were then blindly switched to active treatment for 8 weeks. Both imipramine and alprazolam were highly effective in reducing the symptoms of generalized anxiety, the frequency of panic attacks, and phobic avoidance. However, the time course of these effects differed; alprazolam demonstrated therapeutic properties during the first week, whereas the therapeutic efficacy of imipramine was not clearly apparent until the fourth week of treatment. Relative to imipramine and alprazolam, trazodone was not an effective treatment for panic disorder and was poorly tolerated; only 17 trazodone-treated patients completed at least 4 weeks of treatment, and only 2 patients were considered good or complete responders. These findings support the hypotheses that drugs that are efficacious in the treatment of panic disorders act by altering noradrenergic function and that drugs with primary actions on serotonin function are likely to be less effective treatments. The different time courses of therapeutic action of imipramine and alprazolam indicate that these drugs ameliorate panic anxiety via different mechanisms. The possible therapeutic applications of this observation are discussed. PMID- 3536888 TI - Control of metF gene expression in maxicell preparations of Escherichia coli K 12: reversible action of the metJ protein and effect of vitamin B12. AB - Expression of methionine regulon elements was controlled by the metJ protein gpMetJ. A maxicell system with cloned copies of the metF transcription unit allowed reversible action of gpMetJ. Expression of the metF transcription unit in maxicells was reduced by exogenous vitamin B12 at concentrations of 0.5 nM or greater. PMID- 3536892 TI - The mobility of gizzard myosin in pyrophosphate gel electrophoresis is increased by its light chain phosphorylation. AB - Phosphorylation of the 20,000 Mr light chain (L20) of gizzard myosin reversibly increased the mobility of myosin in pyrophosphate polyacrylamide gel electrophoresis (PP1 PAGE). Gizzard heavy meromyosin (HMM) with phosphorylated L20 also moved faster than that with unphosphorylated L20. This mobility increase of HMM is large enough to account for that of intact myosin. Scallop myosin, desensitized by removing its regulatory light chain, was combined with L20 and subjected to PPi PAGE. Hybrid myosin with the phosphorylated light chain moved faster than that with the unphosphorylated light chain. No such effect of light chain phosphorylation was observed with phosphorylatable light chain from breast or ventricular myosin. Thus, gizzard, but not breast or ventricular phosphorylatable light chain is furnished with the 'regulatory' property that is phosphorylation increases myosin mobility in PPi PAGE. PMID- 3536891 TI - Can blood immunocytes be used to study neuropsychiatric disorders? AB - The evidence that demonstrates a structural and functional interrelationship between the immune system and central nervous system is reviewed. Based on striking analogies between these two systems, the proposal was made that at least some neuropsychiatric diseases can be evaluated by functional studies of peripheral blood immunocytes. This hypothesis was supported by the results of immunologic function studies of various subpopulations of immunocytes obtained from patients with Alzheimer's disease and retinitis pigmentosa. PMID- 3536893 TI - Purification of membrane polypeptides of rat liver peroxisomes. AB - Peroxisomes were obtained by sucrose density gradient centrifugation from the livers of di(2-ethylhexyl)phthalate-fed rats, and the membranes were prepared by carbonate extraction (Fujiki, Y., Fowler, S., Shio, H., Hubbard, A.L., & Lazarow, P.B. (1982) J. Cell Biol. 93, 103-110). The integrated membrane polypeptides were solubilized with sodium dodecyl sulfate, and purified by repeated polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. Separation of 70 and 68 kDa polypeptides was not attempted in the present study because of their close migration in polyacrylamide gel electrophoresis. Other polypeptides with apparent molecular masses of 41, 27, 26, and 22 kDa were purified to near homogeneity. Antibodies were raised against these purified preparations. The 68 kDa polypeptide is suggested to be produced by the proteolytic modification of 70 kDa polypeptide, since the former increased concomitantly with decrease of the latter when the liver homogenate was incubated, and this change was prevented in the presence of leupeptin during the incubation. The 41 kDa polypeptide was a minor component. The 70 and 68 kDa polypeptides and 41 kDa polypeptide and their antibodies were cross-reactive, but the relation of these polypeptides was not clear. The 27 and 26 kDa polypeptides seemed to be another species of membrane polypeptides, although the relationship of these two polypeptides remains to be clarified. The 22 kDa polypeptide is not related to other membrane polypeptides. The results of immunoblot analysis of subcellular fractions of the liver and an electron microscopic immunocytochemical study to locate the antigenic sites with protein A-gold complex suggest that all of these polypeptides are localized on peroxisomal membranes. On proliferation of rat liver peroxisomes by administration of di(2-ethylhexyl)phthalate, a peroxisome proliferator, all of these polypeptides were markedly increased. PMID- 3536894 TI - Synthesis and characterization of human prorenin in Escherichia coli. AB - DNA sequences encoding Ile-Glu-Gly-Arg and human prorenin were joined and placed under the transcriptional control of the Escherichia coli trp promoter-operator in the expression vector pTR501. E. coli cells transformed with pTR501 expressed high levels (30% of total cell protein) of prorenin as part of a hybrid protein with the trp E gene product. The chimeric protein, accumulated in a sedimentable form, was dissolved in 6 M guanidine X HCl, purified to near homogeneity, and renatured by dialysis. The complete prorenin sequence was then excised from the renatured hybrid protein using blood coagulation factor Xa, a proteinase which is highly specific for the tetrapeptide insert Ile-Glu-Gly-Arg introduced between the 9 amino-terminal residues of the trp E gene product and the first amino acid (Thr 1) of prorenin. Human prorenin thus obtained was readily activatable with trypsin and showed close similarities to naturally occurring prorenin in its biochemical and immunochemical properties. PMID- 3536895 TI - Effects of temperature and monovalent cations on activity and quaternary structure of tryptophanase. AB - Effects of temperature and monovalent cations on the activity and the quaternary structure of tryptophanase of Escherichia coli were studied. The conversion of the apoenzyme into the active holoenzyme was attained at 30 degrees C in Tris-HCl buffer (pH 8.0) containing pyridoxal-P and K+, while no conversion occurred at 5 degrees C. The active holoenzyme thus formed was stable even at 5 degrees C, as long as the cation was present. When K+ was absent, however, the active enzyme gradually lost the activity upon chilling to 5 degrees C. The HPLC gel filtration analysis of the active holoenzyme and the low temperature-inactivated enzyme species revealed that the tetrameric holoenzyme dissociated into the dimeric apoenzyme concomitant with the low temperature-induced inactivation at 5 degrees C. The results of HPLC experiments together with other available evidence also suggest that the inactive tetrameric holoenzyme was first formed from the dimeric apoenzyme and pyridoxal-P prior to the formation of the active holoenzyme and that the cation promoted the conversion of the inactive holoenzyme into the active holoenzyme rather than being involved in the conversion of the apoenzyme and pyridoxal-P into the holoenzyme. Among various cations tested for the above effects, NH4+ exhibited the largest effect and K+ the second. PMID- 3536896 TI - Cloning and expression of human lymphotoxin mRNA derived from a human T cell hybridoma. AB - We cloned human lymphotoxin (LT) cDNA from a cDNA library prepared from phorbol myristate acetate (PMA) and Con A-stimulated human T cell hybridoma (AC5-8) cells, The nucleotide sequence of the cDNA insert in the plasmid, pLT13, was determined and compared with those of peripheral blood mononuclear cell derived LT cDNA and the LT gene. Four stretches, containing 14 nucleotides in total, were different among the three sequences. The differences included one base change from C to A in the coding region. Because this change was expected to result in a change in the amino acid at position 26 from Thr to Asn, we constructed an E. coli expression plasmid (pLT13tac6-8.2) and a mammalian cell expression plasmid (pSV2-LT) in order to confirm that pLT13 contains the coding sequence of human LT. Both plasmids were found to synthesize active LT molecules after transfection into JM105 and COS-1 cells, respectively, and their lytic activities were found to be completely neutralized by anti human LT serum. Using an insertion mutant and a deletion mutant, we examined the role of the C terminal domain in the LT activity. The results obtained strongly suggested that the intactness of the C terminal less than 10 residues is required for the LT activity. PMID- 3536897 TI - Ingensin, a high-molecular-mass alkaline protease from rabbit reticulocyte. AB - A high-molecular-mass protease, ingensin, was purified to homogeneity from rabbit reticulocytes by DEAE-cellulose, HPLC gel filtration, and hydroxyapatite chromatographies. By these procedures, ingensin activity was separated from the activities of two other unique aminopeptidases, one of which is activated by ATP. Ingensin had the following properties: the optimum activity was seen around pH 9.0 and at 50 degrees C; addition of 0.04% SDS and 1 mg/ml linoleic acid resulted in 8- and 4-fold increases in peptide-hydrolyzing activity, respectively. The molecular mass was found to be 700,000 +/- 100,000 daltons on gel filtration, but SDS electrophoresis revealed that the enzyme is composed of several subunits with molecular weights of less than 35,000. The N-terminal-blocked tyrosine- and arginine-MCA derivatives, but not Arg-MCA, were hydrolyzed rapidly by ingensin. The approximate Km values for the reaction of ingensin with Suc-Leu-Leu-Val-Tyr MCA and Z-Ala-Arg-Arg-MCA were 0.32 and 0.12 mM, respectively. The degradation of several proteins in the reticulocyte extract was stimulated by the addition of SDS and linoleic acid. The activator concentrations necessary for stimulation of the protein hydrolysis are similar to those of the purified reticulocyte ingensin for synthetic substrates. Ingensin did not associate with either right-side-out or inside-out red cell membranes. These results suggest that ingensin is a cytosolic fatty acid-stimulated protease, which is involved in the protein turnover in reticulocyte extracts. PMID- 3536898 TI - Identification of the tryptophan residue located at the low-affinity saccharide binding site of ricin D. AB - The saccharide binding ability of the low affinity (LA-) binding site of ricin D was abrogated by N-bromosuccinimide (NBS)-oxidation, while in the presence of lactose the number of tryptophan residues eventually oxidized decreased by 1 mol/mol and the saccharide binding ability was retained (Hatakeyama et al., (1986) J. Biochem. 99, 1049-1056). Based on these findings, the tryptophan residue located at the LA-binding site of ricin D was identified. Two derivatives of ricin D which were modified with NBS in the presence and absence of lactose were separated into their constituent polypeptide chains (A- and B-chains), respectively. The modified tryptophan residue or residues was/were found to be contained in the B-chain, but not in the A-chain. From lysylendopeptidase and chymotryptic digests, peptides containing oxidized tryptophan residues were isolated by gel filtration on Bio-Gel P-30 and HPLC. Analysis of the peptides containing oxidized tryptophan revealed that three tryptophan residues at positions 37, 93, and 160 on the B-chain were oxidized in the inactive derivative of ricin D, in which the saccharide binding ability of the LA-binding site was abrogated by NBS-oxidation. On the other hand, the modified residues were determined to be tryptophans at positions 93 and 160 in the active derivative of ricin D which was modified in the presence of lactose, indicating that upon binding with lactose, the tryptophan residue at position 37 of the B-chain was protected from NBS-oxidation. From these results, it is suggested that tryptophan at position 37 on the B-chain is the essential residue for saccharide binding at the LA-binding site of ricin D. PMID- 3536899 TI - Purification and immunofluorescence localization of the mutant gene product of a Tetrahymena cdaA1 mutant affecting cell division. AB - A division arrest mutant, cdaA, of Tetrahymena thermophila is known to have a ts defect in the formation of the fission zone which determines the position of the fission plane. A protein (Mr = 85,000; pI = 4.7, designated as p85) has recently been identified in our laboratory as a possible gene product of the cdaA locus by two-dimensional gel electrophoresis and genetic experiments (Ohba et al., submitted). In the present research, we have isolated p85, prepared its antibody, and demonstrated that in wild-type cells or in cdaA cells at permissive temperature, immunofluorescence for p85 appears on the equatorial basal bodies at the predicted fission zone just before formation of the zone. In such a case, the fission zone appears to be formed just anterior to the fluorescence-associated basal bodies, and then constriction of the division furrow occurs at the zone. However, in cdaA cells at the restrictive temperature, the equatorial p85 deposit and subsequent fission zone formation and furrowing do not occur at all. Thus, we conclude that p85 plays a key role in the formation of the fission zone and in the positioning of the equatorial fission line. PMID- 3536900 TI - Selective externalization of an ATP-binding protein structurally related to the clathrin-uncoating ATPase/heat shock protein in vesicles containing terminal transferrin receptors during reticulocyte maturation. AB - Transferrin receptors are lost from reticulocytes in vesicles that are released during the final stage of erythrocyte maturation (Pan, B. T., and Johnstone, R. M. (1983) Cell 33, 967-977). Transferrin receptor-containing vesicles have a major protein component present in a 1:1 ratio with the receptor that migrates on sodium dodecyl sulfate gels as two polypeptides of Mr = 71,000 and 72,000. The Mr = 71,000/72,000 doublet is indistinguishable from the clathrin-uncoating ATPase/heat shock protein based on cross-reaction with affinity-purified antibody against the uncoating protein, by comparison of peptide maps of the Mr = 72,000 and 71,000 polypeptides and the uncoating protein, and by selective binding of these polypeptides to ATP-agarose. This finding suggests a possible activity of proteins related to the uncoating/heat shock protein family in the disposal of aged membrane proteins by a pathway independent of lysosomes. PMID- 3536901 TI - Channeling of 3-hydroxy-4-trans-decenoyl coenzyme A on the bifunctional beta oxidation enzyme from rat liver peroxisomes and on the large subunit of the fatty acid oxidation complex from Escherichia coli. AB - Rates of the NAD+-dependent oxidation of 2-trans,4-trans-decadienoyl-CoA, a metabolite of trans-omega-6-unsaturated fatty acids, catalyzed by the mitochondrial enoyl-CoA hydratase plus 3-hydroxyacyl-CoA dehydrogenase and by the corresponding enzymes from peroxisomes, as well as Escherichia coli, were compared. The study of the mitochondrial system revealed that the conventional kinetic theory of coupled enzyme reactions cannot be applied to systems in which the primary reaction has a small equilibrium constant, and/or the concentration of coupling enzyme is higher than 0.01 Km for the intermediate and higher than the steady-state concentration of the intermediate. In contrast to the results obtained with the mitochondrial beta-oxidation system of unlinked enzymes, the steady-state velocities of 2-trans,4-trans-decadienoyl-CoA degradation catalyzed by either the peroxisomal bifunctional enzyme or by the E. coli fatty acid oxidation complex were found to be equal to the activities of enoyl-CoA hydratase even though the concentration of coupling enzyme was equal to that of the primary enzyme, and the quotient of Vmax/Km for the dehydration of 3-hydroxy-4-trans decenoyl-CoA is much larger than the Vmax/Km for its dehydrogenation. The extraordinarily high efficiencies of these two multifunctional proteins in catalyzing the degradation of 2-trans,4-trans-decadienoyl-CoA is best explained by the direct transfer of the 3-hydroxy-4-trans-decenoyl-CoA intermediate from the active site of enoyl-CoA hydratase to that of 3-hydroxyacyl-CoA dehydrogenase. The discovery of an intermediate channeling mechanism on the peroxisomal bifunctional enzyme explains on the molecular level why the peroxisomal beta-oxidation system is well suited for the degradation of trans fatty acids. PMID- 3536902 TI - Purification and identification of the functional sodium- and chloride-coupled gamma-aminobutyric acid transport glycoprotein from rat brain. AB - Using the reconstitution conditions developed recently (Radian, R., and Kanner, B. I. (1985) J. Biol. Chem. 260, 11859-11865) we have now purified the sodium- and chloride-coupled gamma-aminobutyric acid transporter from rat brain to apparent homogeneity. A partially purified transporter preparation was passed over wheat germ agglutinin-Sepharose 6MB and non-bound proteins were washed away. The transport activity, as expressed upon reconstitution of the protein into liposomes, was eluted by a solution containing Triton X-100 and N acetylglucosamine. The specific transport activity was increased almost 400-fold over that of the crude extract. Taking into account an approximately 2.5-fold inactivation during the lectin column chromatography, the actual purification is about 1000-fold. Sodium dodecyl sulfate-polyacrylamide electrophoresis of the active fractions revealed one band of 80 kDa and small amounts of a band which ran at an apparent molecular mass of 160 kDa. The ratio between the two could be experimentally changed such as, for instance, by lyophilization. Polyclonal antibodies were prepared against the 80-kDa band which also cross-reacted with the 160-kDa band, indicating that the latter apparently represents a dimer form of the first. Using Protein A-Sepharose Cl-4B and the antibody against the 80-kDa band, we were able to quantitatively immunoprecipitate the potential gamma aminobutyric acid transport activity from a crude transporter preparation. The pure transporter preparation exhibited the same features of the transporter in synaptic plasma membrane vesicles, namely dependence on sodium and chloride, electrogeneity, affinity, and efflux and exchange properties. We conclude that the 80-kDa band represents the gamma-aminobutyric acid transporter. PMID- 3536903 TI - N-terminal carbamylation of the hyaluronic acid-binding region and the link protein from the chondrosarcoma proteoglycan aggregate. AB - The ternary complex consisting of a 65-kDa peptide originating from the proteoglycan core protein and a 43-kDa link protein bound to hyaluronic acid was purified from a clostripain digest of the rat chondrosarcoma aggregating proteoglycan and 14C-carbamylated with potassium [14C]cyanate. At a pH of 8.0, 14C-carbamylation of the alpha-NH2 groups in the N-terminal amino acids was favored over carbamylation of epsilon-NH2 groups in the lysinyl residues for both the 65- and 43-kDa species. Two-dimensional tryptic peptide maps revealed a single major, distinctly different, fluorographic spot for each. These tryptic peptides had approximate masses of 4.5 kDa (from the 65-kDa species) and 3.0 kDa (from the 43-kDa species) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels and each contained greater than 60% of the total radioactivity associated with its original polypeptide. Primary amino acid sequencing of the 65-kDa species gave a defined sequence for the first 4 N terminal residues, whereas sequencing through the first 4 residues of a fully carbamylated species gave no dabsylated derivative for the first residue but identical residues in position 2-4 as for the noncarbamylated species and loss of radioactive derivative. Digests of 14C-carbamylated ternary complex with alpha chymotrypsin resulted in a limit 14C-carbamylated 55-kDa species which contained greater than 85% of the radiolabel originally in the 65-kDa peptide. Similarly, trypsin generated two radiolabeled species, 60 and 58 kDa. These limit digest peptides (55, 60, 58 kDa) all contained the 4.5-kDa N-terminal tryptic peptide. Thus peptides removed from the 65-kDa peptide digestion with either alpha chymotrypsin or trypsin were on the carboxyl end of the molecule. PMID- 3536904 TI - A sulfhydryl presumed essential is not required for catalysis by an aminoacyl tRNA synthetase. AB - Several aminoacyl-tRNA synthetases are sensitive to reagents that modify sulfhydryl groups. We report here the significance of N-ethylmaleimide (NEM) mediated inactivation of Escherichia coli glycyl-tRNA synthetase, and alpha 2 beta 2 enzyme. We confirmed earlier observations that NEM abolishes synthetase catalyzed aminoacylation with pseudo-first order kinetics and provided a second method of proof that the site of inactivation is located in the beta-subunit. Using oligonucleotide-directed mutagenesis of the glyS gene, each beta-subunit cysteine codon (positions 98, 395, and 450) was replaced, individually, by an alanine codon. The three resulting mutant proteins are each active in vivo, and their in vitro aminoacylation activities are comparable to that of the native enzyme. A mutant incorporating all three amino acid substitutions is also active in vivo and in vitro. These results establish conclusively that a beta-subunit cysteine thiol is not required for the catalysis of aminoacylation. The Cys98--- Ala and Cys450----Ala mutants are inactivated by NEM with the same kinetics as the wild-type protein. However, the Cys395----Ala mutant is refractory to NEM. This suggests that NEM inactivation of the native enzyme is due to alkylation of Cys395. Aware that inactivation may result from steric effects, we constructed a mutant with a bulkier amino acid residue at position 395 (Cys395----Gln). The aminoacylation activity of this protein is less than 10% of that of the wild-type enzyme. The glutamine substitution affects only the tRNA-dependent step of the reaction--the rate of glycyl adenylate synthesis is not lowered. In these features, the mutant resembles the NEM-inactivated protein. We propose that the NEM sensitivity of glycyl-tRNA synthetase, and possibly of other synthetases, arises from steric or conformational effects of the alkylated cysteine side chain. PMID- 3536905 TI - Fusion of negatively charged phospholipid vesicles by insulin. Relationship with lipid fluidity. AB - We have studied, by fluorescence methods, the association of insulin to liposomes, the modification of lipid fluidity, and the fusion of vesicles induced by insulin. All parameters showed a similar dependence on pH and ionic strength of the medium and on negative charges in liposomes. The influence of temperature indicated that the association of insulin to liposomes per se was not sufficient to produce a decrease in lipid fluidity and fusion of liposomes. The modification of lipid fluidity induced by insulin in biological membranes is discussed as a possible general event in the action of the hormone. PMID- 3536906 TI - The odorant-sensitive adenylate cyclase of olfactory receptor cells. Differential stimulation by distinct classes of odorants. AB - We have characterized odorant-stimulated adenylate cyclase activity in isolated chemosensory cilia prepared from frog and rat olfactory epithelium. Cilia from both species exhibit high levels of adenylate cyclase activity. Basal activity is stimulated approximately 2-fold by GTP and approximately 5-fold by guanosine 5' (3-O-thio)triphosphate and forskolin. Odorants augment enzyme activity 30-65% above the basal level in a tissue-specific and GTP-dependent manner. Calcium reduces GTP-stimulated activity with a 50% effective concentration at 10 microM. Odorants vary in their influence upon olfactory adenylate cyclase activity. Most fruity, floral, minty, and herbaceous odorants stimulate the enzyme. 3,7-Dimethyl 2,6-octadienenitrile (citralva), menthone, D-carvone, L-carvone, and 2-isobutyl-3 methoxypyrazine display similar potencies in activating the adenylate cyclase upto concentrations of 100 microM. Putrid odorants, such as isovaleric acid, triethylamine, pyridine, thiazole, and methoxypyrazine, and odorous chemical solvents, do not stimulate enzyme activity. In homologous series of pyrazine, thiazole, and pyridine odorants, compounds with the longest hydrocarbon side chains are best able to enhance enzyme activity. The failure of certain odorants to affect adenylate cyclase activity suggests that additional transduction mechanisms besides the formation of cAMP are involved in olfaction. PMID- 3536907 TI - A new yeast mutation in the glucosylation steps of the asparagine-linked glycosylation pathway. Formation of a novel asparagine-linked oligosaccharide containing two glucose residues. AB - We have isolated and characterized a new yeast mutation in the glucosylation steps of lipid-linked oligosaccharide biosynthesis, alg8-1. Cells carrying the alg8-1 mutation accumulate Glc1Man9GlcNAc2-lipid both in vivo and in vitro. We present evidence showing that the alg8-1 mutation blocks addition of the second alpha 1,3-linked glucose. alg8-1 cells transfer Glc1Man9GlcNAc2 to protein instead of the wild type oligosaccharide, Glc3Man9GlcNAc2. Pulse-chase studies indicate that the Glc1Man9GlcNAc2 transferred is processed more slowly than the wild type oligosaccharide. The yeast mutation gls1-1 lacks glucosidase I activity (Esmon, B., Esmon, P.C., and Schekman, R. (1984) J. Biol. Chem. 259, 10322 10327), the enzyme responsible for removing the alpha 1,2-linked glucose residues from protein-linked oligosaccharides. We demonstrate that gls1-1 cells contain glucosidase II activity (which removes alpha 1,3-linked glucose residues) and have constructed the alg8-1 gls1-1 haploid double mutant. The Glc1Man9GlcNAc2 oligosaccharide was trimmed normally in these cells, demonstrating that the alg8 1 oligosaccharide contained an alpha 1,3-linked glucose residue. A novel Glc2 compound was probably produced by the action of the biosynthetic enzyme that normally adds the alpha 1,2-linked glucose to lipid-linked Glc2Man9GlcNAc2. This enzyme may be able to slowly add alpha 1,2-linked glucose residue to protein bound Glc1Man9GlcNAc2. The relevance of these findings to similar observations in other systems where glucose residues are added to asparagine-linked oligosaccharides and the possible significance of the reduced rate of oligosaccharide trimming in the alg mutants are discussed. PMID- 3536908 TI - The interrelationship of the soluble and membrane-associated folate-binding proteins in human KB cells. AB - Human KB cells produce two immunologically cross-reactive folate-binding proteins: a particulate cell-associated protein which is solubilized by Triton X 100, and a soluble protein which is released into their growth medium. This compartmentation of these two folate-binding proteins provides a convenient system for studies of their biochemical relationship. The two folate-binding proteins behave similarly to the purified particulate and soluble folate-binding proteins of human milk in analysis by radioactive folate binding, Sephacryl S-200 gel filtration profiles, polyacrylamide gel electrophoresis in either Triton X 100 or sodium dodecyl sulfate, and in Triton X-100 binding based on sucrose density gradient ultracentrifugation in H2O and D2O. The two folate-binding proteins were endogenously labeled by pulsing methionine-starved KB cells with [35S]methionine, and each protein was purified to apparent homogeneity by affinity chromatography at different times during the chase with nonradioactive methionine. The time course of the changes in specific activity (moles of [35S]methionine per mole of folate-binding protein) revealed a more rapid initial rate of synthesis and an earlier maximum in specific activity for the cell associated folate-binding protein than for the soluble folate-binding protein released into the growth medium. Differences in the levels and specific activities of the two folate-binding proteins of cells exposed to cycloheximide compared with simultaneous controls after pulsing with [35S]methionine suggest that, whereas the cell-associated folate-binding protein is probably produced by de novo protein synthesis, the soluble folate-binding protein seems to be produced from a cellular pool of an already synthesized protein. These results combined with the immunologic cross-reactivity of the two folate-binding proteins strongly suggest a precursor-product relationship between them. PMID- 3536909 TI - Purification and properties of the Escherichia coli host factor required for inversion of the G segment in bacteriophage Mu. AB - G inversion in bacteriophage Mu requires the product of the DNA invertase gene gin and an Escherichia coli host factor termed FIS (factor for inversion stimulation). A recombination substrate must contain two recombination sites, arranged as inverted repeats, and a recombinational enhancer sequence termed sis. FIS has been purified to homogeneity. The purified protein has a relative molecular weight of 12,000 when analyzed under denaturing conditions. The intact protein behaves as a dimer of relative molecular weight 25,000 in gel filtration analysis. The purified protein does not possess any recombinogenic activity when assayed in the absence of the DNA-invertase Gin. In the presence of purified Gin FIS is the only additional protein required for efficient inversion. By performing gel retention assays, we show that FIS is a DNA-binding protein, which specifically binds to DNA fragments containing the recombinational enhancer sis. PMID- 3536910 TI - Substructure of human von Willebrand factor. Proteolysis by V8 and characterization of two functional domains. AB - The effects of Staphylococcus aureus V8 protease (V8) on the multimeric structure of human von Willebrand factor (vWF) were studied to test and expand our model for the substructure of vWF. Electron microscopy of V8 digests of vWF revealed that the multimers were cleaved where the flexible rod (R) domains join the large elongated globular (G) domains. The resulting two major fragments, which were purified by affinity and hydrophobic interaction chromatography and by glycerol gradient ultracentrifugation, are disulfide-linked homodimers of these domains (i.e. RR and GG) and are morphologically identical to the alternating RR and GG domains of intact vWF. The glycoprotein fragment GG (6.5 X 35 nm) has mass 343 kDa by sedimentation equilibrium and the amino-terminal sequence of intact plasma vWF. It contains the binding site for heparin within 300 residues of its amino terminus and a separate site for the platelet GPIb receptor responsible for platelet agglutination in the presence of ristocetin. With approximately 18% alpha-helix and approximately 15% beta-pleated sheet, fragment GG accounts for most of the ordered secondary structure present in whole vWF. The two thin flexible rod domains (1.8-2.0 X 30-34 nm) of fragment RR are joined at a small central nodule (approximately 5 nm diameter) and also have a small nodule at each free end. Fragment RR contains an extraordinarily high cystine content, lower than average amounts of other hydrophobic residues, and essentially no alpha helix, as judged by circular dichroism. The amino-terminal sequence and amino acid composition of fragment RR corresponded to that of the COOH-terminal 685 residues of the intact vWF subunit (Titani, K., Kumar, S., Takio, K., Ericsson, L. H., Wade, R. D., Ashida, K., Walsh, K. A., Chopek, M. W., Sadler, J. E., and Fujikawa, K. (1986) Biochemistry 25, 3171-3184). This sequence analysis gives a mass of 180 kDa for glycosylated fragment RR, somewhat higher than the 130 kDa we obtained by sedimentation equilibrium. Our sequence analysis of a 110-kDa plasmic vWF peptide also permitted identification of a major plasmin cleavage site 705 residues from the COOH terminus and a half-cystine residue (1360) involved in maintaining the multimeric structure of plasmin-degraded vWF.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3536911 TI - The ligand binding specificity and tissue localization of a rat alveolar macrophage lectin. AB - The parameters of the reaction between a rat alveolar macrophage lectin (Mr = 180,000) and its ligands have been examined. The reaction is dependent on Ca2+ over the optimal pH range for binding. The apparent dissociation constant for fucosyl bovine serum albumin, the standard ligand used in these studies, is 1.4 X 10(-10) M. The ligand binding specificity was determined by measurement of the inhibition of binding of fucosyl bovine serum albumin by various glycoproteins and saccharides. D-Mannose, L-fucose, and N-acetyl-D-glucosamine were the most effective inhibitors, and D-galactose was much poorer. The equatorial hydroxyl groups on the C-3 and C-4 of the mannose ring are important in the lectin-ligand interaction, and the axial hydroxyl group on the C-2 contributes to a lesser extent. Immunocytological studies revealed that the lectin isolated from alveolar macrophages is widely distributed in other rat tissues. Hepatocytes are devoid of the lectin, but hepatic Kupffer cells and endothelial cells contain significant amounts. This was confirmed by isolation of the lectin from liver. Spleen and skeletal muscle also contain lectin, but much smaller amounts were found in brain, kidney, and heart muscle. PMID- 3536912 TI - Purification and structure of 3-methyladenine-DNA glycosylase I of Escherichia coli. AB - We constructed a recombinant plasmid carrying a gene that suppresses tag mutation. To overproduce its gene product, a 0.8-kilobase DNA fragment which carries the gene was placed under the control of the lac promoter in pUC8. 3 Methyladenine-DNA glycosylase activity in cells carrying such plasmids (pCY5) was 450-fold higher than that of wild type strain, on exposure to isopropyl-beta-D thiogalactopyranoside. From an extract of such cells, the enzyme was purified to apparent physical homogeneity, and the amino acid composition and the amino terminal amino acid sequence of the enzyme were determined. The data were in accord with nucleotide sequence of the gene, determined by the dideoxy method. It was deduced that 3-methyladenine-DNA glycosylase I comprises 187 amino acids and its molecular weight is 21,100, consistent with the value estimated from the sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified protein. Only 3-methyladenine was excised from methylated DNA by the purified glycosylase. These results show that the tag is the structural gene for 3 methyladenine-DNA glycosylase I. PMID- 3536913 TI - Structure and expression of the alkB gene of Escherichia coli related to the repair of alkylated DNA. AB - When the alkB gene of Escherichia coli that controls sensitivity of bacteria to methyl methanesulfonate was placed under the control of the lac regulatory region on a multicopy plasmid, the gene product, AlkB protein, was overproduced. By monitoring the band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the protein was purified to near physical homogeneity. An amino-terminal sequence and total amino acid composition of the purified AlkB protein were in accord with the amino acid sequence deduced from the nucleotide sequence of the alkB gene, determined by the phage M13 dideoxy method. It was concluded that the AlkB protein is comprised of 216 amino acids and has a molecular weight of 23,900. The nucleotide sequence analysis also revealed that the ada and alkB genes are adjacent on the E. coli chromosome and that the first initiation codon for AlkB protein overlaps with the termination codon for Ada protein. We constructed hybrid plasmids carrying an alkB'-lacZ' fusion, with or without the ada control region, and investigated expression of the alkB gene in response to the alkylating agent. We obtained evidence that the ada and alkB genes constitute an operon. PMID- 3536915 TI - NAD(P)H:menadione oxidoreductase. Novel purification of enzyme cDNA and complete amino acid sequence, and gene regulation. AB - NAD(P)H:menadione oxidoreductase induction by polycyclic hydrocarbons is known to be governed by the aromatic hydrocarbon-responsive (Ah) locus. This cytosolic enzyme was isolated from 3-methylcholanthrene-treated rat liver by a rapid two step procedure with the use of affinity gel purification and fast-protein liquid chromatography. Polyclonal antiserum to menadione reductase was raised in rabbits. On Western (immuno) blot analysis, large increases in this hepatic menadione reductase protein (NMOR1) of 3-methylcholanthrene-treated C57BL/6N but not DBA/2N mice confirmed that induction of this enzyme by 3-methyl-cholanthrene is regulated by the Ah receptor. A cDNA expression library was constructed in lambda gt11 and screened with antiserum. Positive cDNA clones were plaque purified and further characterized by showing enhanced hybridization to 3 methylcholanthrene-induced poly(A+) RNA from rats; the longest cDNA clone (1,501 base pairs) has an open reading frame (bases 75-899) and a nucleotide sequence consistent with a new gene family. On Northern blot analysis, a single 3 methylcholanthrene-inducible rat liver mRNA (approximately 1.6 kilobases) hybridizes to the cDNA probe. On Southern blot analysis a total of 14-16 kilobases of rat genomic DNA fragments hybridize to the cDNA probe, indicating one or a small number of menadione reductase genes in this family. The amino acid sequence (274 residues) and Mr of 30,946 compare well with the size of the rat enzyme (32 kDa) estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The amino acid sequence of two internal fragments of the trypsin digested purified NMOR1 protein is in complete agreement with that deduced from the cDNA nucleotide sequence. This study represents the first cloning and sequencing of a cDNA encoding a Phase II drug-metabolizing enzyme under control of the Ah locus. PMID- 3536914 TI - Induction, identification, and cell-free translation of mRNAs coding for peroxisomal proteins in Candida tropicalis. AB - Peroxisomes have been purified from Candida tropicalis grown on oleic acid and shown to be nearly pure by marker enzyme analysis, electron microscopy, and comparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. They contain approximately 20 polypeptides, among which acyl-CoA oxidase, trifunctional hydratase-dehydrogenase-epimerase, and catalase have been identified. Rabbit antisera have been elicited that react with these three proteins. When C. tropicalis is grown on alkanes, a dozen mRNAs are strikingly induced. Nine of the 12 induced mRNAs code for polypeptides that comigrate in sodium dodecyl sulfate-polyacrylamide gel electrophoresis with peroxisomal proteins, among which three have been identified immunochemically as the acyl-CoA oxidase, the trifunctional protein, and catalase. These results indicate that some genes coding for peroxisomal proteins are strongly expressed during growth of C. tropicalis on alkanes. The data are consistent with evidence in other species that peroxisomes form by the post-translational incorporation of newly made proteins into pre-existing peroxisomes, generally without proteolytic processing, followed by peroxisome division. PMID- 3536916 TI - In vitro inactivation of methionine synthase by nitrous oxide. AB - Nitrous oxide (N2O) is commonly used as an anesthetic agent. Prolonged exposure to N2O leads to megaloblastic anemia in humans and to loss of methionine synthase activity in vertebrates. We now report that purified preparations of cobalamin dependent methionine synthase (5-methyltetrahydrofolate-homocysteine methyltransferase, EC 2.1.1.13) from both Escherichia coli and pig liver are irreversibly inactivated during turnover in buffers saturated with N2O. Inactivation by N2O occurs only in the presence of all components required for turnover: homocysteine, methyltetrahydrofolate, adenosylmethionine, and a reducing system. Reisolation of the inactivated E. coli enzyme after turnover in the presence of N2O resulted in significant losses of bound cobalamin and of protein as compared to controls where the enzyme was subjected to turnover in N2 equilibrated buffers before reisolation. However, N2O inactivation was not associated with major changes in the visible absorbance spectrum of the remaining enzyme-bound cobalamin. We postulate that N2O acts by one-electron oxidation of the cob(I)alamin form of the enzyme which is generated transiently during turnover with the formation of cob(II)alamin, N2, and hydroxyl radical. Generation of hydroxyl radical at the active site of the enzyme could explain the observed irreversible loss of enzyme activity. PMID- 3536917 TI - Identification and characterization of thiamin repressible acid phosphatase in yeast. AB - We have identified a genetic locus, pho4, in Schizosaccharomyces pombe which encodes a minor expressed cell surface acid phosphatase that is repressed by low concentrations (0.5 microM) of thiamin. The enzyme was purified from a strain that overproduces the enzyme. It is an Asn-linked glycoprotein. Removal of the carbohydrates by endoglycosidase H does not abolish enzymatic activity. The molecular mass of deglycosylated and unglycosylated enzyme that accumulates in membranes when cells are grown in the presence of tunicamycin is 56 kDa as determined by sodium dodecyl sulfate-gel electrophoresis. Thiamin regulation, at least in part, operates by reducing the level of pho4-mRNA. Pho4 is not genetically linked to the phosphate repressible acid phosphatase gene pho1. Phosphate and thiamin repressible acid phosphatase differ in their substrate specificity. Their protein moieties are immunologically related. Pho4 and pho1 are the only genes in S. pombe that express cell surface acid phosphatases being enzymatically active with nitrophenyl phosphate as substrate. S. pombe is not unique in having a thiamin repressible acid phosphatase. In Saccharomyces cerevisiae this enzyme is encoded by PHO3. PMID- 3536918 TI - Absence of a phosphorylated intermediate during ATP hydrolysis by Escherichia coli transcription termination protein rho. AB - We have established the suitability of adenosine 5'-O-(gamma thio)triphosphate(ATP gamma S) as an analog of ATP for the nucleoside triphosphatase activity of Escherichia coli transcription termination protein rho (EC 3.6.1.3). Steady-state analysis gives a Vmax of 1.5 mumol min-1 mg-1, 9% of the value with MgATP as substrate, and indicates that ATP gamma S binds as tightly (based on Km and Ki versus ATP) to rho as does ATP. (gamma-S)[beta gamma 17O,gamma-17O,gamma-18O]ATP gamma S was used as substrate to produce chiral product inorganic [17O,18O]thiophosphate and determine the stereochemical course of the hydrolysis. The results of this determination, inversion at the thiophosphoryl phosphorus, indicate that the enzymatic hydrolysis of ATP by rho consists of a direct transfer of the phospho group to water without the existence of a phosphoenzyme or phospho-RNA intermediate. PMID- 3536919 TI - Changes of deoxyribonucleoside triphosphate pools induced by hydroxyurea and their relation to DNA synthesis. AB - Hydroxyurea inactivates ribonucleotide reductase from mammalian cells and thereby depletes them of the deoxynucleoside triphosphates required for DNA replication. In cultures of exponentially growing 3T6 cells, with 60-70% of the cells in S phase, 3 mM hydroxyurea rapidly stopped ribonucleotide reduction and DNA synthesis (incorporation of labeled thymidine). The pool of deoxyadenosine triphosphate (dATP) decreased in size primarily, but also the pools of the triphosphates of deoxyguanosine and deoxycytidine (dCTP) were depleted. Paradoxically, the pool of thymidine triphosphate increased. After addition of hydroxyurea this pool was fed by a net influx and phosphorylation of deoxyuridine from the medium and by deamination of intracellular dCTP. An influx of deoxycytidine from the medium contributed to the maintenance of intracellular dCTP. 10 min after addition of hydroxyurea, DNA synthesis appeared to be completely blocked even though the dATP pool was only moderately decreased. As possible explanations for this discrepancy, we discuss compartmentation of pools and/or vulnerability of newly formed DNA strands to nuclease action and pyrophosphorolysis. PMID- 3536921 TI - Low density lipoprotein degradation by secretory granules of rat mast cells. Sequential degradation of apolipoprotein B by granule chymase and carboxypeptidase A. AB - The secretory granules of rat serosal mast cells are able efficiently to degrade the apolipoprotein B component of low density lipoproteins (LDL) Kokkonen, J. O., and Kovanen, P. T. (1985) J. Biol. Chem. 260, 14756-14763). The granules are known to contain two neutral proteases with complementary specificities: a chymotrypsin-like endopeptidase called chymase, and an exopeptidase, the granule carboxypeptidase A. The role of this enzyme pair in the proteolytic degradation of LDL was studied with the aid of specific enzyme inhibitors. Incubation of LDL with intact granules (both enzymes active) led to the formation of numerous low molecular weight peptides and the liberation of free amino acids, most of which (95%) were aromatic (Phe, Tyr, Trp) or branched-chain aliphatic (Leu, Ile, Val). Selective inhibition of granule carboxypeptidase A (leaving chymase active) blocked the liberation of free amino acids, but left the formation of peptides uninhibited. On the other hand, selective inhibition of granule chymase (leaving carboxypeptidase A active) totally abolished the proteolytic degradation of LDL. The results are consistent with a model according to which the proteolytic degradation of LDL by mast cell granules results from coordinated action of the two granule-bound enzymes, whereby the chymase first cleaves peptides from the apolipoprotein B of LDL, and thereafter the carboxypeptidase A cleaves amino acids from the peptides formed. PMID- 3536920 TI - Activation of glucose transport in muscle by prolonged exposure to insulin. Effects of glucose and insulin concentrations. AB - Glucose transport activity was found to increase over 5 h in rat epitrochlearis muscle in response to a moderate concentration (50-100 microunits/ml) of insulin. This process was examined using 3-methylglucose. The increase in permeability to 3-methylglucose was 2- to 4-fold greater after 5 h than after 1 h in muscles incubated with 50 microunits/ml of insulin and 1 or 8 mM glucose. The increase in permeability to 3-methylglucose during the period between 1 and 5 h of exposure to 50 microunits/ml of insulin and 1 mM glucose was due to an increase in the apparent Vmax of sugar transport. There were two components to this activation of glucose transport. One, which was not influenced by inhibition of protein synthesis, resulted in activation of sugar transport to the same extent by 50 microunits/ml as by 20,000 microunits/ml of insulin; however, this activation took approximately 20 times longer with 50 microunits/ml insulin. The other, which was blocked by cycloheximide, resulted in a further activation of sugar transport to a level higher than that attained in response to 20,000 microunits/ml of insulin. Glucose had no effect on activation of sugar transport during the first hour, but a high concentration (20-36 mM) of glucose prevented the further activation of glucose transport during prolonged treatment with 50 microunits/ml of insulin. It appears from these results that prolonged exposure to a moderate concentration of insulin has previously unrecognized effects that include: a progressive activation of glucose transport over a long time that eventually results in as great a response as a "supramaximal" insulin concentration, and in the presence of low glucose concentration, further activation of glucose transport by an additional, protein synthesis-dependent mechanism. The results also show that a high concentration of glucose can, under some conditions, inhibit stimulation of its own transport. PMID- 3536922 TI - Isolation of the structural gene encoding a mutant form of Escherichia coli phosphoenolpyruvate carboxylase deficient in regulation by fructose 1,6 bisphosphate. Identification of an amino acid substitution in the mutant. AB - The structural gene encoding a mutant Escherichia coli phosphoenolpyruvate carboxylase deficient in regulation by fructose 1,6-bisphosphate (Fru-P2) was isolated from total E. coli PpcI genomic DNA. This mutant gene is located on a 4.4-kilobase SalI DNA fragment which, when ligated to SalI-digested pBR322, resulted in the generation of the plasmid pFS16. Detailed restriction mapping of the wild-type and mutant genes for phosphoenolpyruvate carboxylase revealed the presence of a ClaI restriction site at position 563 of the mutant gene only. This ClaI site is located on a 289 PvuII/DdeI fragment which codes for amino acid residues 174-270 of the phosphoenolpyruvate carboxylase enzyme. When this portion of the mutant gene is present in chimeras of the wild-type and mutant genes, the phosphoenolpyruvate carboxylase produced cannot be activated by Fru-P2. The mutation resulting in the generation of the ClaI site in the mutant gene has also resulted in an amino acid substitution at residue 188; threonine in the wild-type enzyme has been replaced by isoleucine in the mutant enzyme. Comparison of the nucleotide sequence of this 289-base pair PvuII/DdeI region of the mutant gene with its homologous region in the wild-type gene verified that this mutation, which resulted in the generation of the ClaI site, is the only change that has occurred on this 289-base pair fragment of the mutant gene, and thus the amino acid replacement of threonine by isoleucine is the only change that could be linked to the inability of the mutant enzyme to be activated by Fru-P2. PMID- 3536923 TI - Novel expression of the angiotensinogen gene in a rat pancreatic islet cell line. Transcriptional regulation by glucocorticoids. AB - Angiotensinogen gene expression has a broad tissue specificity. Whereas angiotensinogen mRNA is undetectable in normal rat pancreas, we have identified angiotensinogen mRNA in all tumors and cell lines derived from a rat islet cell line, RIN-r. A subclone with the highest angiotensinogen mRNA levels, 1056A, secreted N-glycosylated angiotensinogen. Angiotensinogen mRNA of 1056A cells was approximately 200 nucleotides longer than that of liver, and this was shown to be due to an extension of the 3'-untranslated region. Dexamethasone increased angiotensinogen mRNA levels approximately 9-fold above control, and this increase was linear over 110 h, indicating a half-life of greater than 55 h for angiotensinogen mRNA during dexamethasone induction. This effect of dexamethasone was inhibited by the glucocorticoid antagonist RU 38486. Dexamethasone increased angiotensinogen gene transcription approximately 5-fold in a nuclear run-on assay. These results demonstrate that dexamethasone induction of angiotensinogen mRNA levels in 1056A cells is due, at least in part, to a transcriptional response and that 1056A cells will be useful for the study of angiotensinogen gene regulation and the identification of glucocorticoid regulatory sequences. PMID- 3536924 TI - Isolation of vesicles containing insulin-responsive, intracellular glucose transporters from 3T3-L1 adipocytes. AB - Insulin stimulation of glucose transport in fat and muscle cells occurs, at least in part, by the translocation of glucose transporters from intracellular membranes to the plasma membrane. In this report, we describe the isolation and partial characterization of vesicles containing translocatable intracellular transporters from 3T3-L1 adipocytes. The glucose transporter content of light microsomes in a 44,000 X g cell supernatant was found to decrease by 50% in response to insulin treatment of the adipocytes. A procedure was developed for the purification of transporter-containing vesicles from this supernatant by immunoadsorption onto Staphylococcus aureus cells coated with anti-transporter antibodies. The vesicles are about 50 nm in diameter and have a distinct polypeptide composition. After insulin treatment the number of transporter containing vesicles decreased by about 50%, as determined both by microscopic analysis of vesicle number and by the relative abundance of vesicle polypeptides. PMID- 3536925 TI - alpha-Carboxyl-linked glutamates in the folylpolyglutamates of Escherichia coli. AB - Folate cofactors in most cells contain polyglutamate side chains, which since the late 1940s have been assumed to be linked via their gamma-COOH groups. We report here an investigation of the structure of the polyglutamate chain attached to the folates of Escherichia coli. Folates were extracted from E. coli grown with [7 14C] p-aminobenzoate and cleaved to p-aminobenzoyl polyglutamates of varying chain lengths (pAB(Glu)n) by the method of Foo et al. (Foo, S. K., Cichowicz, D. J., and Shane, B. (1980) Anal. Biochem. 107, 109-115). The pAB(Glu)n derived from E. coli did not co-chromatograph with chemically synthesized pAB(gamma-Glu)n-Glu on several high performance liquid chromatography (HPLC) systems, except for the triglutamate which did elute with pAB(gamma-Glu)2-Glu. E. coli-derived pAB(Glu)3 8 were purified by HPLC on C18 columns eluted with acetonitrile/trifluoroacetic acid, and the structures were determined through mass spectrometry, chiral amino acid analysis, and peptidase digestion experiments. Molecular weight determinations on the methyl ester derivatives of E. coli-derived pAB(Glu)n by liquid secondary ion mass spectrometry and sequence analysis using collision activated dissociation on a tandem mass spectrometer confirmed the structures as pAB(Glu)3-8. Chiral HPLC of hydrolyzed and dansylated E. coli-derived materials, on a beta-cyclodextrin column, identified the glutamate as the L-enantiomer. pAB(Glu)n were digested with carboxypeptidase Y, which specifically cleaved glutamates linked at their alpha-carboxyls; E. coli-derived pAB(Glu)4-8 (but not synthetic pAB(gamma-Glu1-6-Glu) were sequentially digested to pAB(gamma-Glu)2 Glu. Thus, in E. coli folylpolyglutamates, glutamate residues 4-8 were each linked to the polyglutamate chain at the alpha-carboxyl of the preceding glutamate. PMID- 3536926 TI - In vitro synthesis of alpha-carboxyl-linked folylpolyglutamates by an enzyme preparation from Escherichia coli. AB - Extracts of Escherichia coli contained an enzymatic activity which catalyzed the addition of L-glutamate to the alpha-carboxyl of various polyglutamate substrates, including folylpolyglutamates. Much of the enzyme activity was separated by DE52 chromatography and gel filtration from the enzyme which adds the first three glutamates in the biosynthesis of folylpolyglutamates, dihydrofolate synthetase-folylpolyglutamate synthetase. The two enzyme activities differed in many properties. Whereas dihydrofolate synthetase-folylpolyglutamate synthetase preferred pteroate or pteroylmonoglutamate substrates, the folylpoly alpha-glutamate synthetase preparations effectively utilized tetrahydropteroylpolyglutamates, pteroylpolyglutamates, p aminobenzoylpolyglutamates (pAB(Glu)n), and even a polyglutamate tripeptide. Several di- and triglutamyl peptides were inhibitory to folylpoly-alpha-glutamate synthetase activity, but not to dihydrofolate synthetase-folylpolyglutamate synthetase. Conversely, dihydropteroate noncompetitively inhibits the folylpolyglutamate synthetase reaction of the dihydrofolate synthetase folylpolyglutamate synthetase protein, but did not inhibit the folylpoly-alpha glutamate synthetase reaction. Potassium chloride was inhibitory to folylpoly alpha-glutamate synthetase activity (as were other salts and several polyanions), in contrast to the absolute requirement of dihydrofolate synthetase folylpolyglutamate synthetase activity for a monovalent cation such as K+. Incubation of a folylpoly-alpha-glutamate synthetase preparation with (6S) tetrahydropteroyltri(gamma)glutamate generated products which after chemical cleavage to pAB(Glu)n were identical to those from growing E. coli, in high performance liquid chromatography retention times and in pattern of digestion by alpha-COOH bond-specific carboxypeptidase Y. High performance liquid chromatography and mass spectral analysis of the products of the in vitro reactions of folylpoly-alpha-glutamate synthetase with several substrates also demonstrated the addition of glutamate residues via alpha-COOH linkages. Thus, there appear to be two folylpolyglutamate synthetase activities in E. coli, dihydrofolate synthetase-folylpolyglutamate synthetase which adds the first three glutamate residues by gamma-COOH linkages and the folylpoly-alpha-glutamate synthetase activity which extends the folylpolyglutamate chain via gamma-COOH peptide bonds. PMID- 3536928 TI - A serine protease triggers the initial step of transmembrane signalling in cytotoxic T cells. AB - We report here by using stopped-flow fluorometry with three different fluorescent probes that a serine protease triggers the initial step of transmembrane signalling in cytotoxic T cells. When cytotoxic T cells (mouse LC7, H-2b anti H 2d) bound to the specific target cells (mouse mastocytoma P815, H-2d), cytotoxic T cells first increased their membrane fluidity, and calcium then was released from intracellular stores. After that, there was a calcium influx from the external medium into the T cells. All of these steps, however, were blocked by serine protease inhibitors (soybean trypsin inhibitor, N alpha-p-tosyl-L-lysine chloromethyl ketone and tosylphenylalanyl chloromethyl ketone). Bovine pancreatic trypsin and chymotrypsin in the external medium mimicked the signalling events which were triggered by the serine protease on the T cell surfaces. From the reaction time (within 1 s) and its specificity, this serine protease in cytotoxic T cells was considered to be different from a protease which works at the killing stage. PMID- 3536927 TI - Interaction between L-threonine dehydrogenase and aminoacetone synthetase and mechanism of aminoacetone production. AB - A mixture of threonine dehydrogenase and aminoacetone synthetase will catalyze the conversion of L-threonine to glycine. The overall reaction likely involves the conversion of L-threonine, NAD+, and CoA to glycine, NADH, and acetyl-CoA. Physical separation of L-threonine dehydrogenase from aminoacetone synthetase results in the formation of aminoacetone and CO2 from their substrates. A physical interaction between threonine dehydrogenase and aminoacetone synthetase has been demonstrated by gel permeation chromatography and fluorescence polarization. Polarization of fluorescence measurements of threonine dehydrogenase and aminoacetone synthetase labeled with fluorescein isothiocyanate indicated the formation of a soluble active complex, with an apparent dissociation constant (Kd) of 5-10 nM and an apparent stoichiometry of 2 aminoacetone synthetase dimers/1 threonine dehydrogenase tetramer. Chemical experiments have identified aminoacetone as the enzymatic product of L-threonine dehydrogenase acting on L-threonine. These experiments involved trapping pyrrole derivatives, [3H]NaBH4 reduction, and coupling with plasma amine oxidase. Kinetic experiments also showed NADH, CO2, and aminoacetone to inhibit threonine dehydrogenase in a manner consistent with an ordered Bi-Ter kinetic mechanism. NAD+ is the lead substrate followed by threonine, and the products are released in the order: CO2, aminoacetone, and NADH. PMID- 3536929 TI - The glucose transporter in 3T3-L1 adipocytes is phosphorylated in response to phorbol ester but not in response to insulin. AB - At maximally active concentrations with 20-min exposure, insulin and phorbol myristate acetate (PMA) stimulated hexose transport in 3T3-L1 adipocytes by 11- and 2-fold, respectively. The potential role of phosphorylation of the glucose transporter (GT) in these stimulations was investigated by the isolation of GT through immunoprecipitation from ortho[32P]phosphate-labeled 3T3-L1 adipocytes. It was found that there was no significant 32P incorporation into GT from basal adipocytes after 2- or 18 h-labeling in the presence of 0.5 mCi of 32Pi/ml. Furthermore, under these labeling conditions, insulin treatment for 1, 4, or 30 min failed to stimulate the phosphorylation of GT. Also, there was no detectable phosphate incorporation into GT upon reversal of insulin-stimulated hexose transport by the removal of insulin (half-time for reversal approximately 8 min). In contrast to these results, exposure of adipocytes to PMA (1 microM) for 20 min elicited a phosphorylation of GT to the extent of about 0.1 phosphate/GT molecule. Exposure of cells to both insulin and PMA resulted in a 3-fold increase in the level of phosphate in GT compared to that seen with PMA alone. Possibly this increase is due to the translocation of GT to the plasma membrane where it is a better substrate for activated protein kinase C. Stimulation of hexose transport was the same with the combined treatment of insulin and PMA compared to that seen with insulin alone. These results indicate that neither a change in the phosphorylation state of the GT nor activation of protein kinase C is involved in the mechanism by which the insulin receptor stimulates glucose transport. PMID- 3536930 TI - Yeast metallothionein function in metal ion detoxification. AB - A genetic approach was taken to test the function of yeast metallothionein in metal ion detoxification. A yeast strain was constructed in which the metallothionein locus was deleted (cup1 delta). The cup1 delta strain was complemented with normal or mutant metallothionein genes under normal or constitutive regulatory control on high copy episomal plasmids. Metal resistance of the cup1 delta strain with and without the metallothionein-expressing vectors was analyzed. The normally regulated metallothionein gene conferred resistance only to copper (1000-fold); constitutively expressed metallothionein conferred resistance to both copper (500-fold) and cadmium (1000-fold), but not to mercury, zinc, silver, cobalt, nickel, gold, platinum, lanthanum, uranium, or tin. Two mutant versions of the metallothionein gene were constructed and tested for their ability to confer metal resistance in the cup1 delta background. The first had a deletion of a highly conserved amino acid sequence (Lys-Lys-Ser-Cys-Cys-Ser). The second was a hybrid gene consisting of the sequences coding for the first 20 amino acids of the yeast protein fused to the monkey metallothionein gene. Expression of these genes under the CUP1 promoter provided significant protection from copper, but none of the other metals tested. These results demonstrate that there is significant flexibility in the structural requirements for metallothionein to function in copper detoxification and that yeast metallothionein is also capable of detoxifying cadmium under conditions of constitutive expression. PMID- 3536931 TI - The delineation of a decapeptide gonadotropin-releasing sequence in the carboxyl terminal extension of the human gonadotropin-releasing hormone precursor. AB - The human gonadotropin-releasing hormone (GnRH) precursor consists of the GnRH sequence followed by a 59-amino acid carboxyl-terminal extension. A 56-amino acid peptide within this extension has been shown to stimulate gonadotropin release, and this activity has been localized to its amino-terminal region. A series of seven overlapping peptide fragments corresponding to the first 24 amino acids of the carboxyl-extension of the GnRH precursor were synthesized and tested for their ability to stimulate luteinizing hormone and follicle-stimulating hormone release from cultured human anterior pituitary cells. All active peptide fragments were found to incorporate the decapeptide sequence Asn-Leu-Ile-Asp-Ser Phe-Gln-Glu-Ile-Val which is regarded as a minimal structural requirement delineated for gonadotropin-releasing activity. A further flanking sequence extending this active region from its carboxyl terminus was found to enhance gonadotropin-releasing activity although the flanking sequence itself was inactive. The gonadotropin release stimulated by the active peptides wa shown to be a dose- dependent, specific, and calcium-dependent phenomenon which occurred independently of the GnRH receptor on the pituitary gonadotrophs as a GnRH antagonist did not inhibit activity. PMID- 3536933 TI - [Spectrometric study of a clinical case of intra-oral corrosion]. PMID- 3536932 TI - Fasting and refeeding alter the insulin receptor tyrosine kinase in chicken liver but fail to affect brain insulin receptors. AB - Insulin receptors from chicken liver and brain were studied following alterations in the nutritional state. Chickens were either fasted for 48 h, fasted for 48 h and then refed for 24 h, or fed a regular diet ad libitum. 125I-Porcine insulin binding was significantly elevated in liver membranes from the fasted animals and lowered in refed chickens when compared to preparations from ad libitum fed chickens. These changes in 125I-insulin binding were inversely related to the levels of plasma insulin and since receptor affinities for insulin were similar in each group, they probably represent alterations in receptor number. Apparent Mr of alpha subunits of the insulin receptors was unaffected by alterations in the nutritional states. The presence of ATPase-like activities that co-eluted with liver insulin receptors from wheat germ agglutinin lectin columns but not from pea lectin columns necessitated the use of both pea and wheat germ agglutinin for liver insulin receptor purification. The insulin receptors purified from both lectin columns were recognized by anti-insulin receptor antiserum and had similar affinities for insulin which were unaltered by the nutritional state. Insulin-stimulatable autophosphorylation of the beta subunit of the insulin receptor was lower in livers from fasted chickens and intermediate in refed chickens. Furthermore, basal and insulin-induced phosphorylation of the artificial substrate poly(Glu,Tyr) 4:1 was significantly less in the fasting state and intermediate in the refed state compared to the ad libitum fed state. Insulin sensitivity (measured as the dose of insulin required for 50% maximal stimulation of kinase activity) was similar in all three states suggesting that the differences in insulin-induced phosphorylation are due to a change in maximal stimulation and not a change in insulin sensitivity. In contrast to the alterations seen with liver receptors, brain insulin receptors were unaffected by these alterations in nutritional state. These findings suggest that: liver insulin receptors are affected by altering the nutritional state; insulin binding to liver membranes is inversely related to plasma insulin levels; and tyrosine kinase is decreased both in fasted and refed animals suggesting an uncoupling of the normal interaction between alpha subunit and beta subunit in liver insulin receptors. PMID- 3536934 TI - Evaluation of the in vitro and ex vivo blood compatibility of primary reference materials. AB - The blood compatibility of the primary reference materials, low density polyethylene and polydimethylsiloxane, was evaluated using human in vitro and human ex vivo test devices, and was compared with that of polyetherurethane and polyvinylchloride. The effect of the materials on in vitro platelet activation was studied by measurement of platelet factor 4 release by enzyme immunoassay. The adsorption of fibrinogen and platelets from human native blood onto the surface of the material was measured using enzyme immunoassay technique. The four materials tested exhibited significantly different effects on in vitro platelet activation. In addition, the materials adsorbed fibrinogen and platelets to a different extent under ex vivo test conditions. Materials, which induced strong in vitro platelet activation, e.g. low density polyethylene and polyvinylchloride, demonstrated high concentrations of fibrinogen and platelets on the surface when tested under ex vivo conditions. Polydimethylsiloxane and polyetherurethane, which induced slight in vitro platelet factor 4 release, absorbed significantly lower concentrations of fibrinogen and platelets from human native blood. PMID- 3536936 TI - Sciatica from a sciatic neurilemoma. A case report and review of the literature. PMID- 3536935 TI - Fibrous dysplasia of the femoral neck. Treatment by cortical bone-grafting. AB - Fibrous dysplasia of the femoral neck is difficult to treat. In a series of fifteen young patients, ten had a monostotic lesion and five, the polyostotic form of the disease. Twelve patients were first seen with a fatigue fracture. Grafts of cortical bone were used. The objectives of relief of pain, union of the fracture, and prevention of deformity were achieved in all fifteen patients. Two patients required a repeat procedure. None of the patients had important deformity of the femoral neck, and none needed an osteotomy. PMID- 3536937 TI - The clinical utility of preoperative therapy for sarcomas. PMID- 3536938 TI - Sir Harry Platt's 100th birthday. PMID- 3536939 TI - Familial spondylolisthesis of the axis vertebra. AB - This report describes a nine-year-old girl with a spondylolisthesis of the C2 vertebra allowing 14 mm of slip. Her father had very similar vertebral anomalies. PMID- 3536940 TI - DNA adducts in experimental cancer research. AB - The role of DNA adducts in the initiation of cancer is scrutinized in this presentation. Work on the activation of oncogenes, particularly on ras, has provided new evidence to link DNA adducts and tumour formation. Polycyclic hydrocarbons and nitroso compounds can cause activation of ras oncogenes through a defined point mutation. The properties of two DNA binding agents, styrene oxide and cisplatin are discussed. Styrene oxide is a versatile electrophile causing numerous adducts; cisplatin has a high specificity towards guanine-N-7 and cross link formation. Finally, the relation of specific adducts to carcinogenic potency as defined by TD50 values is investigated. For small alkyl groups, O-alkylation of bases correlates with potency but among others, particularly the bulky carcinogens, 7-alkylguanines appear as correlates of potency. Most such potent agents forming 7-alkylguanines induce depurination and imidazole ring-opening. PMID- 3536941 TI - DNA adducts and cell cycle. AB - Cell cycle-dependent differences of transformation sensitivity may be due to alterations in the formation of ultimate electrophilic carcinogens during the cell cycle, preferential primary adduct formation during specific phases of the cell cycle, e.g. binding to single stranded DNA at the replication fork, base mispairing and mutation of transformation-related genes replicating at critical phases of DNA synthesis, or cell cycle-related differences in the repair of DNA adducts. Some recent data on these subjects are summarized, mainly in context of cell cycle-dependent transformation sensitivity of regenerating rat liver. PMID- 3536942 TI - DNA adducts and DNA damage by antineoplastic and carcinogenic N-nitrosocompounds. AB - Mechanisms of DNA adduct formation by antineoplastic 2-chloroethyl-N-nitrosoureas (CNUs) and of DNA damage induced by these compounds as well as by carcinogenic 2 hydroxyalkylnitrosamines are discussed. CNUs are monofunctional and bifunctional alkylating agents that form, in a quantitatively minor reaction, DNA-DNA crosslinks (XL). In vitro, by far the most abundant alkylation products of DNA are those resulting from 2-hydroxyethylation. The reaction sequence responsible for 2-hydroxyethylation comprises intermediate oxazolidine ring closure followed by generation of 2-hydroxyethylnitrosourea and ethylene oxide. Oxadiazolium intermediates have not been found to play a role. In contrast to the in vitro experiments, in vivo 2-hydroxyethyl adducts are formed to a much lesser extent und 2-chloroethyl adducts are predominant in rat kidney DNA. 2-Hydroxyethylation of phosphate groups introduces extreme instability into the sugar-phosphate backbone since the resulting phosphotriester rapidly breaks down through a dioxaphospholane ring intermediate. Measurements of DNA XL in target tumor tissue and in bone marrow provides a sensitive tool for evaluation in bone marrow provides a sensitive tool for evaluation of hormone-linked cytotoxic agents. The potent environmental carcinogen N-nitrosodiethanolamine (NDELA) has been found to be activated in the rat liver by a two-step metabolic transformation sequence involving alcohol dehydrogenase and, subsequently, sulfotransferase. Evidence for this mechanism is provided by measuring DNA single strand breaks in rat liver DNA and by studying the effect of various enzyme inhibitors on the extent of DNA damage induced in vivo by NDELA and its metabolites. PMID- 3536944 TI - Studies on the metabolic activation of diethanolnitrosamine in animal-mediated and in vitro assays using Escherichia coli K-12 343/113 as an indicator. AB - The mutagenic activity of diethanolnitrosamine (NDELA), a carcinogenic compound which leads to inconsistent results in standard in vitro procedures was tested in vitro and in animal-mediated assays with the indicator strain Escherichia coli (E. coli) K-12 343/113. This strain allows the simultaneous detection of forward and back mutations arising in several genes of the E. coli chromosome. In animal mediated assays in which mice were used as hosts for i.v. injected E. coli indicator cells, s.c. application of NDELA induced a dose dependent increase of galactose fermenting mutants in cells recovered from the livers of animals exposed for 3 h to the mutagen. Comparison with results obtained with diethylnitrosamine (DENA) in the same test system revealed that the two compounds apparently cause different types of mutagenic lesions. Induction of arg+ mutations by DENA and several other aliphatic nitrosamines is mainly due to base pair substitutions, whereas NDELA is rather mutagenic in the galRs system. This latter system is, in addition, sensitive to frameshifts and deletions. These differences in mutagenic specificity suggest that NDELA and DENA, although structurally closely related, are activated via different molecular mechanisms. In fact, evidence is accumulating that alcohol dehydrogenase (ADH) could be involved in the activation of NDELA. On the other hand, the effective mutagenesis of NDELA obtained in vitro with E. coli upon addition of rat liver microsomal fraction would not be expected if ADH is involved in the activation since the S-9 Mix used in the present experiments was devoid of cofactors (NAD, NADP), necessary to accomplish oxidation by ADH. Therefore, further in vivo studies were performed, in which pyrazole, a potent blocker of ADH, was administered prior (1 and 24 h) to the injection of the mutagen. The observation that a dose dependent increase of mutants in the liver (and to a lower extent in the spleens) of treated animals takes place under conditions in which ADH activity is blocked, whereas several microsomal enzymes are stimulated, indicated that besides oxidation of NDELA by ADH other metabolic activation pathways are involved. Apparently enzymes contained in the liver homogenate, possibly NADPH dependent enzymes of the microsomal ethanol oxidizing system, play an important role in the formation of mutagenic metabolites of NDELA. PMID- 3536946 TI - An editorial view on the reporting of results in heart valve bioprostheses. AB - Heart valve bioprostheses are most commonly analyzed as a group rather than individualized. Mechanical valves are usually referred to by specific name and manufacturer, while bioprostheses are pooled together as "tissue valves". Each specific bioprosthesis has its own structural characteristics and therefore a different level of performance and durability. Most large centers have an adequate number of these implants and a follow-up long enough to warrant separate analysis of each valve type. This review analyzes the differences among the most commonly used bioprostheses and reaffirms the reasons for their separate analysis. Authors, reviewers and editors must standardize their criteria to prevent this problem from recurring or escalating. New bioprostheses are now being released and unless we simplify their evaluation our questions will remain unanswered. PMID- 3536945 TI - Improved grading of bone tumors with the monoclonal antibody Ki-67. AB - A total of 60 bone tumors and tumor-like lesions presenting various grades of malignancy were investigated immunohistologically with the monoclonal antibody Ki 67 directed against a cell proliferation-associated nuclear antigen. The results obtained agree well with those of flow cytometric and autoradiographic studies on similar tumor entities. The monoclonal antibody Ki-67 was found to be a handy and reliable tool for improved grading of bone tumors. PMID- 3536943 TI - Deuterium isotope effects in carcinogenesis by N-nitroso compounds. AB - A number of N-nitroso compounds and an azoxyalkane have been labeled with deuterium in various positions and have been administered to rats, hamsters, or mice in parallel with the unlabeled compounds. The treatments with the labeled and analogous unlabeled compounds were equimolar and for the same time. Mortality rates from tumors and tumor incidences were compared between deuterium-labeled and the unlabeled analogs. In many cases more than one dose level was used for the comparisons. An increased rate of mortality from tumors or an increased incidence of induced tumors was considered an index of increased potency of one treatment compared with the other. Using these criteria deuterium in the alpha positions of nitrosodimethylamine, nitrosomorpholine, nitrosoheptamethyleneimine, and nitrosoazetidine reduced carcinogenic potency compared with the unlabeled compounds. This indicated that cleavage of a carbon-hydrogen bond in the alpha position was a rate-limiting step in carcinogenesis by these nitrosamines. In both nitrosomethylethylamine and nitroso-2,6-dimethylmorpholine, the presence of deuterium at different positions increased or decreased carcinogenic potency, suggesting that competition for oxidation between these sites might be the determining factor in activation of the molecule. This also applied to nitrosomethyl-n-butylamine and nitrosomethyl-phenylethylamine with deuterium at the methyl group or at the alpha carbon of the butyl or phenylethyl groups, and to azoxymethane with deuterium in the 1-methyl or 4-methyl group. In nitrosomethylcyclohexylamine, nitrosomethyl-n-dodecylamine, and dinitroso-2,6 dimethylpiperazine there was no detectable effect of deuterium on carcinogenic potency, suggesting that the conditions did not provide sufficient sensitivity for detection of an isotope effect, or that oxidation at the alpha carbon was not a rate-limiting step in carcinogenesis by these molecules. PMID- 3536947 TI - Wound colonisation following cardiac surgery. Reduction by adjuvant use of preincisional, presternal antibiotic infiltration: a double blind prospective randomised study. AB - In a double blind, prospective, randomised study of 100 patients undergoing elective cardiac surgery, a significant (p less than 0.01) reduction in wound colonisation, defined as positive culture of any wound discharge irrespective of wound appearance, occurred in those receiving preincisional presternal antibiotic infiltration (2%) as compared to a control group who received a similar volume of normal saline by the same route (24%). Both groups received, in addition, the same conventional intravenous regimen of broad spectrum antibiotic. A comparable concurrent group of patients, not entered into the study, demonstrated a wound colonisation rate similar to the trial control group (22%), thus excluding an adverse bias from the control saline infiltration. Analysis of control cases demonstrated a significant (p less than 0.001) discriminant effect in the degree of preoperative haemodilution with haematocrit falling on bypass by a mean of 25% in those who developed wound colonisation as compared to 13% in those who did not. PMID- 3536948 TI - Constrictive pericarditis following coronary bypass reoperation. Fibrotic pericardium and a foreign body reaction. AB - A 65-year-old male patient underwent two bypass operations because of coronary artery disease. After the second operation he developed congestive heart failure with breathlessness, ankle swelling, hepatomegaly and poor exercise tolerance. Echocardiographic and haemodynamic findings were characteristic of constrictive pericarditis. Pericardiectomy was performed three months after the second operation. The retrosternal space was replaced with fibrotic, patchy hyalinic tissue, and the pericardium was thick and rigid. Histologically, the thickened pericardium showed dense fibrosis and foreign-body granulomas with large multinuclear giant cells and irregular crystals. This report indicates that foreign body reaction following coronary artery bypass operation may result in constrictive pericarditis with severe heart failure. PMID- 3536949 TI - Surgical closure of persistent ductus arteriosus (PDA) in infants before 30 weeks gestation. AB - Between October 1981 and December 1983 21 premature infants of mean gestational age 27.5 weeks (range 26-29 weeks) underwent surgical closure of persistent ductus arteriosus. Mean birth weight was 1080 g. There was no operative mortality. One death in an infant with pseudomonas septicaemia occurred two days after surgery. Twenty infants had features of idiopathic respiratory distress syndrome (IRDS) and required assisted ventilation prior to operation. Six infants had associated bronchopulmonary dysplasia (BPD) and 11 had signs of congestive cardiac failure. All infants presented with clinical features suggesting the diagnosis of PDA and in 18 the left atrial/aortic ratio was increased (mean 1.9:1). In 18 infants a trial of Indomethacin therapy had failed. This experience supports the view that surgical closure of PDA in infants born before 30 weeks gestation can be accomplished safely. We believe that surgical treatment of PDA represents the optimal therapy in this high risk group of infants. PMID- 3536950 TI - Strut fracture of a Bjork-Shiley mitral valve prosthesis with successful reoperation. AB - Component failure of a mechanical valve is an extremely serious complication. We experienced strut fracture and disc embolization of a 27 mm Bjork-Shiley convexo concave mitral valve prosthesis implanted one year and 9 months previously. The emergency operation was successful. In the follow-up of patients with Bjork Shiley convexo-concave models manufactured before March 1982, the possibility of strut fracture should be kept in mind. PMID- 3536951 TI - Identification of a new protein localized at sites of cell-substrate adhesion. AB - A new protein found at sites of cell-substrate adhesion has been identified by analysis of a nonimmune rabbit serum. By indirect immunofluorescence this serum stains focal contacts (adhesion plaques) and the associated termini of actin filament bundles in cultured chicken cells. Western immunoblot analysis of total chick embryo fibroblast protein demonstrated an 82-kD polypeptide to be the major protein recognized by the unfractionated serum. This 82-kD protein is immunologically distinct from other known adhesion plaque proteins such as vinculin, talin, alpha-actinin, and fimbrin. Antibody affinity-purified against the electrophoretically isolated, nitrocellulose-bound 82-kD protein retained the ability to stain the area of the adhesion plaque, which confirms that the 82-kD protein is indeed a constituent of the focal contact. The 82-kD polypeptide has a basic isoelectric point relative to actin and fibronectin, and it appears to be very low in abundance. The 82-kD protein is ubiquitous in chicken embryo tissues. However, it appears to be more abundant in fibroblasts and smooth muscle than in brain or liver. Intermediate levels of the protein were detected in skeletal and cardiac muscle. The subcellular distribution of the 82-kD protein raises the possibility that this polypeptide is involved in linking actin filaments to the plasma membrane at sites of substrate attachment or regulating these dynamic interactions. PMID- 3536952 TI - Biosynthesis and supramolecular assembly of procollagen IV in neonatal lung. AB - The rate of biosynthesis of procollagen IV, the principal collagen of basement membranes, and the concentration of specific RNAs coding for procollagen IV were measured in neonatal rat lungs. Both decreased sharply at birth and then recovered again a few days later. The supramolecular assembly of procollagen IV was followed in neonatal rat, mouse, and chick lungs, which actively elaborate endothelial and alveolar basement membranes, and in chick embryo gizzard which is rich in smooth muscle. The tetramer of four procollagen IV molecules linked covalently through their amino ends was isolated as an assembly intermediate from all these tissues. While noncovalent association of the carboxyl ends of two procollagen IV molecules occurred readily, the subsequent establishment of covalent cross-links was substantially slower in the junctional complexes of the carboxyl ends than of the amino ends. Both disulfide bonds and other, unidentified covalent links formed. The six component carboxyl peptides of a junctional complex became progressively covalently linked into two kinds of carboxyl peptide pairs. We conclude that both amino-linked tetramers and carboxyl linked dimers of procollagen IV molecules are intermediates in the biological assembly of the collagen networks of these basement membranes. PMID- 3536953 TI - Regulation of genes encoding the large subunit of ribulose-1,5-bisphosphate carboxylase and the photosystem II polypeptides D-1 and D-2 during the cell cycle of Chlamydomonas reinhardtii. AB - Synthesis of the major chloroplast proteins is temporally regulated in light-dark synchronized Chlamydomonas cells. We have used cloned chloroplast DNA probes, and in vitro and in vivo protein synthesis to examine the cell cycle regulation of photosystem II polypeptides D-1 and D-2, and the large subunit of ribulose-1,5 bisphosphate carboxylase (RuBPCase LS). Synthesis and accumulation of D-1 and D-2 mRNAs occurs during the first half of the light period (G1), correlating with increasing synthesis of the polypeptides. Rifampicin, added immediately before the light period, inhibited the normal increase in D-1, D-2 polypeptide synthesis. During the dark period D-1, D-2 mRNAs persist at high levels despite reduced rates of mRNA synthesis and translation during this period. Cell-free translation analyses indicate that the D-1 mRNA present during the dark period is efficient at directing synthesis of the D-1 precursor in vitro. We conclude that expression of the psbA (D-1) and psbD (D-2) genes are regulated primarily at the transcriptional level during the light-induction period but at the translational level for the remainder of the cell cycle. Transcripts of the RuBPCase LS gene (rbcL) are also found at high levels during the light and dark periods but, unlike D-1 and D-2, LS mRNA levels do not increase until the last half of the light period and measurable synthesis and accumulation of this mRNA occurs during the dark. Furthermore, induction of LS polypeptide synthesis during the light period is insensitive to rifampicin. We conclude that LS production is regulated primarily at the translational level during the cell cycle. PMID- 3536954 TI - Involvement of nuclear lamins in postmitotic reorganization of chromatin as demonstrated by microinjection of lamin antibodies. AB - The nuclear lamins are major components of a proteinaceous polymer that is located at the interface of the nuclear membrane and chromatin; these lamins are solubilized and dispersed throughout the cytoplasm during mitosis. It has been postulated that these proteins, assembled into the lamina, provide an architectural framework for the organization of the cell nucleus. To test this hypothesis we microinjected lamin antibodies into cultured PtK2 cells during mitosis, thereby decreasing the soluble pool of lamins. The antibody injected was identified, together with the lamins, in cytoplasmic aggregates by immunoelectron microscopy. We show that microinjected cells are not able to form normal daughter nuclei, in contrast to cells injected with other immunoglobulins. Although cells injected with lamin antibodies are able to complete cytokinesis, the chromatin of their daughter nuclei remains arrested in a telophase-like configuration, and the telophase-like chromatin remains inactive as judged from its condensed state and by the absence of nucleoli. These results indicate that lamins and the nuclear lamina structure are involved in the functional organization of the interphase chromatin. PMID- 3536955 TI - Identification of a 52-kD calmodulin-binding protein associated with the mitotic spindle apparatus in mammalian cells. AB - A pool of 10 calmodulin-binding proteins (CBPs) was isolated from Chinese hamster ovary (CHO) cells via calmodulin (CaM)-Sepharose affinity chromatography. One of these ten isolated CBPs with a molecular mass of 52 kD was also found to be present in isolated CHO cell mitotic spindles. Affinity-purified antibodies generated against this pool of isolated CBPs recognize a single 52-kD protein in isolated CHO cell mitotic spindles by immunoblot analysis. Immunofluorescence examination of CHO, 3T3, NRK, PTK-2, and HeLa cells resulted in a distinct pattern of mitotic spindle fluorescence. The localization pattern of this 52-kD CBP directly parallels that of CaM in the spindle apparatus throughout the various stages of mitosis. Interestingly, there was no association of this 52-kD CBP with cytoplasmic microtubules. As is the case with CaM, the localization pattern of the 52-kD CBP in interphase cells is diffuse within the cytoplasm and is not associated with any discrete, cellular structures. This 52-kD CBP appears to represent the first mitotic spindle-specific calmodulin-binding protein identified and represents an initial step toward the ultimate determination of CaM function in the mitotic spindle apparatus. PMID- 3536956 TI - A novel mitotic spindle pole component that originates from the cytoplasm during prophase. AB - Several unique aspects of mitotic spindle formation have been revealed by investigation of an autoantibody present in the serum of a patient with the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, schlerodacytyly, and telangiectasias) syndrome. This antibody was previously shown to label at the spindle poles of metaphase and anaphase cells and to be absent from interphase cells. We show here that the serum stained discrete cytoplasmic foci in early prophase cells and only later localized to the spindle poles. The cytoplasmic distribution of the antigen was also seen in nocodazole-arrested cells and prophase cells in populations treated with taxol. In normal and taxol-treated cells, the microtubules appeared to emanate from the cytoplasmic foci and polar stain, and in cells released from nocodazole block, microtubules regrew from antigen-containing centers. This characteristic distribution suggests that the antigen is part of a microtubule organizing center. Thus, we propose that a prophase originating polar antigen functions in spindle pole organization as a coalescing microtubule organizing center that is present only during mitosis. Characterization of the serum showed reactions with multiple proteins at 115, 110, 50, 36, 30, and 28 kD. However, affinity-eluted antibody from the 115/110-kD bands was shown to specifically label the spindle pole and cytosolic foci in prophase cells. PMID- 3536957 TI - Cellular and biochemical events in mammalian cells during and after recovery from physiological stress. AB - We have examined and compared a number of cellular and biochemical events associated with the recovery process of rat fibroblasts placed under stress by different agents. Metabolic pulse-labeling studies of cells recovering from either heat-shock treatment, exposure to sodium arsenite, or exposure to an amino acid analogue of proline, L-azetidine 2-carboxylic acid, revealed interesting differences with respect to the individual stress proteins produced, their kinetics of induction, as well as the decay in their synthesis during the recovery period. In the initial periods of recovery, the major stress-induced 72 kD protein accumulates within the altered nucleoli in close association with the pre-ribosomal-containing granular region. During the later times of recovery from stress, the nucleoli begin to regain a normal morphology, show a corresponding loss of the 72-kD protein, and the majority of the protein now begins to accumulate within the cytoplasm in three distinct locales: the perinuclear region, along the perimeter of the cells, and finally in association with large phase-dense structures. These latter structures appear to consist of large aggregates of phase-dense material with no obvious encapsulating membrane. More interestingly we show, using double-label indirect immunofluorescence analysis, that much of the perinuclear and cell perimeter-distributed 72-kD protein coincides with the distribution of the cytoplasmic ribosomes. We discuss the possible implications of the presence of the 72-kD stress proteins within the pre ribosomal-containing granular region of the nucleolus as well as its subsequent colocalization with cytoplasmic ribosomes in terms of the translational changes which occur in cells both during and after recovery from physiological stress. PMID- 3536958 TI - Identification and nuclear localization of yeast pre-messenger RNA processing components: RNA2 and RNA3 proteins. AB - Temperature-sensitive mutations in the RNA2 through RNA11 genes of yeast prevent the processing of nuclear pre-mRNAs. We have raised antisera that detect the RNA2 and RNA3 proteins in immunoblots of extracts of yeast containing high copy number RNA2 and RNA3 plasmids. Subcellular fractionation of yeast cells that overproduce the RNA2 and RNA3 proteins has revealed that these proteins are enriched in nuclear fractions. Indirect immunofluorescence results have indicated that these proteins are localized in yeast nuclei. These localization results are consistent with the fact that these genes have a role in processing yeast pre-mRNA. PMID- 3536959 TI - Differential chromosomal distribution of ribonucleoprotein antigens in nuclei of Drosophila spermatocytes. AB - The ribonucleoprotein (RNP) composition of the active Y chromosomal structures in spermatocyte nuclei of Drosophila hydei has been investigated using the anti-RNP antibodies Dm 28K2 and pp60 as a probe. Antibody Dm 28K2 was raised against an RNP protein of cytoplasmic RNP particles in D. melanogaster cells, while antibody pp60 was raised against a pre-messenger RNP fraction from oocytes of Xenopus laevis. Both antibodies detect nuclear RNP (nRNP) antigens of D. hydei. This is shown by CsCl density centrifugation of nRNP from D. hydei cells and immunoblotting across the density gradient. Dm 28K2 and pp60 recognize antigens of nRNP complexes which band at a characteristic buoyant density of approximately 1.4 g/cm3 in CsCl. By indirect immunofluorescence we observe that the nRNP complexes identified by Dm 28K2 are localized at only two of the five Y chromosomal loop structures which are named according to their distinct morphology. Dm 28K2 decorates RNPs within the "clubs," within the cones, and within the matrix of the "pseudonucleolus." Ultrastructural bodies that are candidates for this immunoreaction are RNP granules that resemble the so-called perichromatin granules. Antibody pp60 recognizes RNP complexes close to the axes of the active Y chromatin. In the "pseudonucleolus" it can be shown that the structures recognized by pp60 are quite distinct from those detected by Dm 28K2. Thus, the "pseudonucleolus" is a striking example for the presence of different RNP populations within a same defined nuclear compartment. Together with previous results (Glatzer, K. H., 1984, Mol. Gen. Genet., 196:236-243), our data represent evidence that the morphological and apparently functional differences between the active Y chromosomal loops, which are involved in male fertility, are caused by the presence of qualitatively and possibly also functionally different RNP populations within these nuclear compartments. Because both RNP antigens are discussed in the literature in connection with repressed mRNP the observed cross reaction of the respective antibodies in D. hydei suggests a more general and important function of these proteins in the RNA metabolism of eukaryotic cells. PMID- 3536960 TI - Differential accumulation of ribonucleotide reductase subunits in clam oocytes: the large subunit is stored as a polypeptide, the small subunit as untranslated mRNA. AB - Within minutes of fertilization of clam oocytes, translation of a set of maternal mRNAs is activated. One of the most abundant of these stored mRNAs encodes the small subunit of ribonucleotide reductase (Standart, N. M., S. J. Bray, E. L. George, T. Hunt, and J. V. Ruderman, 1985, J. Cell Biol., 100:1968-1976). Unfertilized oocytes do not contain any ribonucleotide reductase activity; such activity begins to appear shortly after fertilization. In virtually all organisms, this enzyme is composed of two dissimilar subunits with molecular masses of approximately 44 and 88 kD, both of which are required for activity. This paper reports the identification of the large subunit of clam ribonucleotide reductase isolated by dATP-Sepharose chromatography as a relatively abundant 86 kD polypeptide which is already present in oocytes, and whose level remains constant during early development. The enzyme activity of this large subunit was established in reconstitution assays using the small subunit isolated from embryos by virtue of its binding to the anti-tubulin antibody YL 1/2. Thus the two components of clam ribonucleotide reductase are differentially stored in the oocyte: the small subunit in the form of untranslated mRNA and the large subunit as protein. When fertilization triggers the activation of translation of the maternal mRNA, the newly synthesized small subunit combines with the preformed large subunit to generate active ribonucleotide reductase. PMID- 3536961 TI - Assembly of different isoforms of actin and tropomyosin into the skeletal tropomyosin-enriched microfilaments during differentiation of muscle cells in vitro. AB - We have used a monoclonal antibody (CL2) directed against striated muscle isoforms of tropomyosin to selectively isolate a class of microfilaments (skeletal tropomyosin-enriched microfilaments) from differentiating muscle cells. This class of microfilaments differed from the one (tropomyosin-enriched microfilaments) isolated from the same cells by a monoclonal antibody (LCK16) recognizing all isoforms of muscle and nonmuscle tropomyosin. In myoblasts, the skeletal tropomyosin-enriched microfilaments had a higher content of alpha-actin and phosphorylated isoforms of tropomyosin as compared with the tropomyosin enriched microfilaments. Moreover, besides muscle isoforms of actin and tropomyosin, significant amounts of nonmuscle isoforms of actin and tropomyosin were found in the skeletal tropomyosin-enriched microfilaments of myoblasts and myotubes. These results suggest that different isoforms of actin and tropomyosin can assemble into the same set of microfilaments, presumably pre-existing microfilaments, to form the skeletal tropomyosin-enriched microfilaments, which will eventually become the thin filaments of myofibrils. Therefore, the skeletal tropomyosin-enriched microfilaments detected here may represent an intermediate class of microfilaments formed during thin filament maturation. Electron microscopic studies of the isolated microfilaments from myoblasts and myotubes showed periodic localization of tropomyosin molecules along the microfilaments. The tropomyosin periodicity in the microfilaments of myoblasts and myotubes was 35 and 37 nm, respectively, whereas the nonmuscle tropomyosin along chicken embryo fibroblast microfilaments had a 34-nm repeat. PMID- 3536962 TI - Titin and myosin, but not desmin, are linked during myofibrillogenesis in postmitotic mononucleated myoblasts. AB - Monoclonal antibodies specific for the muscle protein titin have been used in conjunction with muscle-specific antibodies against myofibrillar myosin heavy chains (MHCs) and desmin to study myogenesis in cultured cells. Desmin synthesis is initiated in replicating presumptive myoblasts, whereas the synthesis of titin and MHC is initiated simultaneously in their progeny, the postmitotic, mononucleated myoblasts. Both titin and MHC are briefly localized to nonstriated and thereafter to definitively striated myofibrils. At no stage during myofibrillogenesis is either protein observed as part of a sequence of mini sarcomeres. Titin antibodies bind to the A-I junction, MHC antibodies to the A bands in nascent, maturing, and mature myofibrils. In contrast, desmin remains distributed as longitudinal filaments until well after the definitive myofibrils have aligned laterally. This tight temporal and topographical linkage between titin and myosin is also observed in postmitotic, mononucleated myoblasts and multinucleated myotubes when myofibrillogenesis is perturbed with Colcemid or taxol. Colcemid induces elongating postmitotic mononucleated myoblasts and multinucleated myotubes to round up and form Colcemid myosacs. The myofibrils that emerge in these rounded cells are deployed in convoluted circles. The time required for their nonstriated myofibrils to transform into striated myofibrils is greatly protracted. Furthermore, as Colcemid induces immense desmin intermediate filament cables, the normal spatial relationships between emerging individual myofibrils is distorted. Despite these disturbances at all stages, the characteristic temporal and spatial relationship observed in normal myofibrils between titin and MHC is observed in myofibrils assembling in Colcemid-treated cells. Newly born postmitotic mononucleated myoblasts, or maturing myotubes, reared in taxol acquire a star-shaped configuration and are induced to assemble "pseudo-striated myofibrils." Pseudo-striated myofibrils consist of laterally aggregated 1.6-micron long, thick filaments that interdigitate, not with thin filaments, but with long microtubules. These atypical myofibrils lack Z bands. Despite the absence of thin filaments and Z bands, titin localizes with its characteristics sarcomeric periodicity in pseudo-striated myofibrils. We conclude that the initiation and subsequent regulation of titin and myosin synthesis, and their spatial deployment within developing sarcomeres are tightly coupled events. These findings are discussed in terms of a model that proposes interaction between two relatively autonomous "organizing centers" in the assembly of each sarcomere. PMID- 3536963 TI - A microtubule-binding protein associated with membranes of the Golgi apparatus. AB - A monoclonal antibody (M3A5), raised against microtubule-associated protein 2 (MAP-2), recognized an antigen associated with the Golgi complex in a variety of non-neuronal tissue culture cells. In double immunofluorescence studies M3A5 staining was very similar to that of specific Golgi markers, even after disruption of the Golgi apparatus organization with monensin or nocodazole. M3A5 recognized one band of Mr approximately 110,000 in immunoblots of culture cell extracts; this protein, designated 110K, was enriched in Golgi stack fractions prepared from rat liver. The 110K protein has been shown to partition into the aqueous phase by Triton X-114 extraction of a Golgi-enriched fraction and was eluted after pH 11.0 carbonate washing. It is therefore likely to be a peripheral membrane protein. Proteinase K treatment of an isolated Golgi stack fraction resulted in complete digestion of the 110K protein, both in the presence and absence of Triton X-100. A the 110K protein is accessible to protease in intact vesicles in vitro, it is presumably located on the cytoplasmic face of the Golgi membrane in vivo. The 110K protein was able to interact specifically with taxol polymerized microtubules in vitro. These results suggest that the 110K protein may serve to link the Golgi apparatus to the microtubule network and so may belong to a novel class of proteins: the microtubule-binding proteins. PMID- 3536964 TI - Conversion of proinsulin to insulin occurs coordinately with acidification of maturing secretory vesicles. AB - Proinsulin is a single polypeptide chain composed of the B and A subunits of insulin joined by the C-peptide region. Proinsulin is converted to insulin during the maturation of secretory vesicles by the action of two proteases and conversion is inhibited by ionophores that disrupted intracellular H+ gradients. To determine if conversion of prohormone to hormone actually occurs in an acidic secretory vesicle, cultured rat islet cells were incubated in the presence of 3 (2,4-dinitroanilino)-3' amino-N-methyldipropylamine (DAMP), a basic congener of dinitrophenol that concentrates in acidic compartments and is retained there after aldehyde fixation. The cells were processed for indirect protein A-gold colocalization of DAMP, using a monoclonal antibody to dinitrophenol, and proinsulin, using a monoclonal antibody that exclusively reacts with the prohormone. The average density of DAMP-specific gold particles in immature secretory vesicles that contained proinsulin was 71/micron 2 (18 times cytoplasmic background), which indicated that this compartment was acidic. However, the density of DAMP-specific gold particles in the insulin-rich mature secretory vesicle averaged 433/micron 2. This suggests that although proinsulin conversion occurs in an acidic compartment, the secretory vesicles become more acidic as they mature. Since the concentration of anti-proinsulin IgG binding in secretory vesicles is inversely proportional to the conversion of proinsulin to insulin, we were able to determine that maturing secretory vesicles had to reach a critical pH before proinsulin conversion occurred. PMID- 3536965 TI - Cell surface expression of membrane-anchored v-sis gene products: glycosylation is not required for cell surface transport. AB - The v-sis gene is able to transform cells by production of a growth factor that is structurally related to platelet-derived growth factor. This growth factor has been detected in the conditioned media of v-sis transformed cells, and is able to stimulate the autophosphorylation of the platelet-derived growth factor receptor. We have used the v-sis gene product to analyze the role of protein-encoded signals in cell surface transport. We constructed several gene fusions that encode transmembrane forms of the v-sis gene product. These membrane-anchored forms of the v-sis gene product are properly folded into a native structure, as indicated by their dimerization, glycosylation, and NH2-terminal proteolytic processing. Indirect immunofluorescence demonstrated that several of these membrane-anchored gene products are transported to the cell surface. Removal of the N-linked glycosylation site from the v-sis gene product did not prevent cell surface transport. Several of these mutant genes are able to induce focus formation in NIH3T3 cells, providing further evidence that the membrane-anchored proteins are properly folded. These results demonstrate that N-linked glycosylation is not required for the cell surface transport of a protein that is in a native, biologically active conformation. These results provide a correlation between cell surface expression of the membrane-anchored v-sis gene products and transformation. PMID- 3536966 TI - A monoclonal antibody against meningococcus group B polysaccharides distinguishes embryonic from adult N-CAM. AB - The neural cell adhesion molecules (N-CAM) occur chiefly in two molecular forms that are selectively expressed at various stages of development. Highly sialylated forms prevalent in embryonic and neonatal brain are gradually replaced by less sialylated forms as development proceeds. Here we describe a monoclonal antibody raised against the capsular polysaccharides of meningococcus group B (Men B) which specifically distinguishes embryonic N-CAM from adult N-CAM. This antibody recognizes alpha 2-8-linked N-acetylneuraminic acid units (NeuAc alpha 2 8). Immunoblot together with immunoprecipitation experiments with cell lines or tissue extracts showed that N-CAM are the major glycoproteins bearing such polysialosyl units. Moreover we could not detect any sialoglycolipid reactive with this antibody in mouse brain or in the neural cell lines examined. By indirect immunofluorescence staining this anti-Men B antibody decorated cells such as AtT20 (D16/16), which expressed the embryonic forms of N-CAM, but not cells that expressed the adult forms. In primary cultures this antibody allowed us to follow the embryonic-to-adult conversion in individual cells. In addition, the existence of cross-reactive polysialosyl structures on Men B and N-CAM in embryonic brain cells for caution in efforts to develop immunotherapy against neonatal meningitis. PMID- 3536968 TI - Immunogold electron microscopy of phytochrome in Avena: identification of intracellular sites responsible for phytochrome sequestering and enhanced pelletability. AB - Using monoclonal antibodies to the plant photoreceptor, phytochrome, we have investigated by immunogold electron microscopy the rapid, red light-induced, intracellular redistribution (termed "sequestering") of phytochrome in dark-grown Avena coleoptiles. Pre-embedding immunolabeling of 5-micron-thick cryosections reveals that sequestered phytochrome is associated with numerous, discrete structures of similar morphology. Specific labeling of these structures was also achieved by post-embedding ("on-grid") immunostaining of LR-White-embedded tissue, regardless of whether the tissue had been fixed chemically or by freeze substitution. The phytochrome-associated structures are globular to oval in shape, 200-400 nm in size, and are composed of amorphous, granular material. No morphologically identifiable membranes are present either surrounding or within these structures, which are often present as apparent aggregates that approach several micrometers in size. An immunogold labeling procedure has also been developed to identify the particulate, subcellular component with which phytochrome is associated in vitro as a consequence of irradiation of Avena coleoptiles before their homogenization. Structures with appearance similar to those identified in situ are the only components of the pelletable material that are specifically labeled with gold. We conclude that the association of phytochrome with these structures in Avena represents the underlying molecular event that ultimately is expressed both as red light-induced sequestering in vivo and enhanced pelletability of phytochrome detected in vitro. PMID- 3536967 TI - Fibrillin, a new 350-kD glycoprotein, is a component of extracellular microfibrils. AB - A new connective tissue protein, which we call fibrillin, has been isolated from the medium of human fibroblast cell cultures. Electrophoresis of the disulfide bond-reduced protein gave a single band with an estimated molecular mass of 350,000 D. This 350-kD protein appeared to possess intrachain disulfide bonds. It could be stained with periodic acid-Schiff reagent, and after metabolic labeling, it contained [3H]glucosamine. It could not be labeled with [35S]sulfate. It was resistant to digestion by bacterial collagenase. Using mAbs specific for fibrillin, we demonstrated its widespread distribution in the connective tissue matrices of skin, lung, kidney, vasculature, cartilage, tendon, muscle, cornea, and ciliary zonule. Electron microscopic immunolocalization with colloidal gold conjugates specified its location to a class of extracellular structural elements described as microfibrils. These microfibrils possessed a characteristic appearance and averaged 10 nm in diameter. Microfibrils around the amorphous cores of the elastic fiber system as well as bundles of microfibrils without elastin cores were labeled equally well with antibody. Immunolocalization suggested that fibrillin is arrayed periodically along the individual microfibril and that individual microfibrils may be aligned within bundles. The periodicity of the epitope appeared to match the interstitial collagen band periodicity. In contrast, type VI collagen, which has been proposed as a possible microfibrillar component, was immunolocalized with a specific mAb to small diameter microfilaments that interweave among the large, banded collagen fibers; it was not associated with the system of microfibrils identified by the presence of fibrillin. PMID- 3536969 TI - Correlation between plasma membrane surface area and transferrin secretion rate in isolated hepatocytes. AB - It is generally considered that in exocytosis the size of the secreting cells does not increase when the membranes of exocytosis vesicles fuse with the plasma membrane. As the factors involved in the regulation of this phenomenon are poorly understood, we thought it worthwhile to investigate the relationship between the plasma membrane surface area and secretory activity. Isolated rat hepatocytes were prepared by liver collagenase perfusion. Secretion of the plasma protein, transferrin (Tf) was detected at the single cell level with specific anti-rat transferrin antibodies using the reverse hemolytic plaque test. Hepatocyte surface and hemolytic ring surface areas were calculated from diameters of hepatocyte and hemolytic plaque measured after 5h of incubation. A highly significant correlation was established between the plaque-forming hepatocyte surface areas and the corresponding hemolytic surface areas. This result was confirmed using an automatic image analysis method. Two-month-old rats were compared to 4-month-old rats. We observed that the ratio of the quantity of transferrin secreted by hepatocytes to the hepatocyte surface area was constant for a given incubation time, whatever the size of the hepatocytes. These results suggest that the plasma membrane surface area of hepatocytes may constitute a limiting factor in Tf secretion. PMID- 3536970 TI - Contradistinctive growth responses of cultured rat intestinal epithelial cells to epidermal growth factor depending on cell population density. AB - The growth response of cultured rat intestinal epithelial (RIE-1) cells to epidermal growth factor (EGF) depends on the cell population density. EGF stimulated the proliferation of RIE-1 cells in dense cultures, but inhibited the proliferation of cells growing at low population densities. In contrast, insulin enhanced RIE-1 cell growth irrespective of the population density. The tumour promoter 12-0-tetradecanoylphorbol 13-acetate (TPA), like EGF, inhibited the proliferation of low-density RIE-1 cells, but differed from EGF in that it did not stimulate the growth of dense cultures. PMID- 3536971 TI - Studies on the mechanism by which glutamine and heat shock increase lactate synthesis by L929 cells in the presence of insulin. AB - Both glutamine and heat shock increase lactate production in the L929 cell system. Glutamine is now shown to increase hexose uptake in the presence of insulin, to inhibit pyruvate oxidation, and to provide reducing equivalents to the cytosolic compartment. The relative contribution of these processes to lactate production depends on the availability of pyruvate. When ample pyruvate is available from the culture medium, stimulation of lactate synthesis by glutamine and heat shock is transaminase dependent, suggesting that shuttling of reducing equivalents from mitochondria to cytoplasm is involved. In the absence of medium pyruvate, stimulation of glycolysis by both glutamine and heat shock is largely responsible for increased lactate synthesis. None of the observed effects of glutamine appears to be sufficient to explain the observed stimulation of glycolysis. PMID- 3536972 TI - Role of ATP hydrolysis in the degradation of proteins by protease La from Escherichia coli. PMID- 3536973 TI - Partial purification of microsomal signal peptidase from hen oviduct. AB - Signal peptidase has been purified approximately 600-fold from hen oviduct microsomes. Treatment of microsomes with ice-cold sodium carbonate at pH 11.5 removes soluble and extrinsic membrane proteins prior to solubilization of signal peptidase with Nonidet P-40. After dialysis to pH 8.2, the solubilized enzyme is chromatographed on diethylaminoethyl cellulose at pH 8.2. More than 90% of contaminating proteins bind to the column while signal peptidase and endogenous phospholipid are eluted in the column void volume. Enzyme activity subsequently binds to carboxymethyl cellulose at pH 5.8 and is eluted by approximately 100 to 200 mM NaCl during a NaCl gradient. Polypeptides present in partially purified hen oviduct signal peptidase have relative molecular masses ranging from 54 kD to less than 11 kD with major bands at 29, 23, 22, 19, 18 and 13 kD. The purified peptidase requires phospholipid for activity and is maximally active in the presence of 2 mg/ml phosphatidylcholine. PMID- 3536975 TI - Evaluation of immunosorbents for the analysis of small molecules. Isolation and purification of cytokinins. AB - This paper describes the preparation and evaluation of immunosorbents for the isolation of cytokinins. The nature of both the solid support and the linkage chemistry affected the non-specific adsorption of sample contaminants and the characteristics of the immobilized antibody. All the immunosorbents investigated provided sufficient purification of cytokinins for high-performance liquid chromatographic analysis with no further clean-up. This demonstrates a rapid and powerful purification method for small molecules for which antibodies can be generated. As a consequence, the procedures described for the immobilization of cytokinin antibodies are generally applicable to the preparation of immunosorbents. PMID- 3536974 TI - A monoclonal antibody reactive with an activated ras protein expressing valine at position 12. AB - Activated ras transforming genes have been described in a variety of neoplasms and encode 21,000-Dalton (p21) proteins with amino acid substitutions at positions 12, 13, and 61. In this report we describe a monoclonal antibody designated DWP that reacts specifically with synthetic dodecapeptides containing valine at position 12, to a lesser extent with peptides containing cysteine at position 12 and not with peptides containing glycine, arginine, serine, aspartic acid, glutamic acid or alanine at the same position. Western blot and immunoperoxidase studies showed that DWP specifically reacts with activated rasH or rasK proteins in NIH cells transformed by DNA from the human carcinoma cells that encode valine at position 12. DWP did not react with normal p21s encoding glycine at position 12, nor with activated p21s encoding aspartic acid, glutamic acid, arginine, serine, or cysteine at position 12. A survey of human tumor cell lines demonstrated that DWP reacted with the human bladder carcinoma cell line T24 but not with human tumor cell lines previously shown to contain other activating mutations at positions 12 or 61. DWP and perhaps additional antibodies that specifically react with alterations at positions 12 or 61 of the ras protein may be valuable in determining the presence and frequency of activated ras proteins in human malignancy. PMID- 3536976 TI - Removal of contaminating proteinases from crude preparations of microbial enzymes. PMID- 3536977 TI - Determination of thermodynamic parameters for the interaction of a lipid-binding peptide and insulin with a reversed-phase column. AB - The effect of temperature was investigated on the reversed-phase chromatography of a synthetic lipid associating peptide (LAP), with the following sequence (LESFLKSWLSALEQALKA) and on insulin. The LAP was chromatographed on a muBondapak alkylphenyl column with 1% aq. triethylammonium phosphate, pH 3.2-2-propanol (80:20) as the isocratic mobile phase. The insulin was separated on a Resolve-C18 column with a mobile phase that contained 0.1 M sodium phosphate, pH 2.0 acetonitrile (71.5:28.5). With the LAP the Van't Hoff plot (In k' vs. 1000/T) was linear and the value of enthalpy for association of the peptide with the reversed phase column was large and negative. The phase ratio was estimated for the column used in the separation and then derivation of the corresponding entropic term demonstrated that the association was enthalpy and not entropy drive. By contrast the corresponding Van't Hoff plot derived or the insulin study was non-linear and with a positive slope. Further study indicated that the formation of the insulin reversed phase complex could be attributed to a favorable entropy change. It is probable that the non-classical thermodynamics observed during the insulin chromatography could be related to conformational changes in the insulin structure during the chromatographic process. PMID- 3536978 TI - Stability studies on piriprost and piriprost potassium using high-performance liquid chromatography. PMID- 3536979 TI - Renal prostacyclin and thromboxane in normotensive and preeclamptic pregnant women and their infants. AB - Renal synthesis of the antiaggregatory and vasodilatory prostacyclin and its endogenous antagonist thromboxane A2 may be disturbed in patients with preeclampsia. We tested this hypothesis by measuring 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha; a hydration product of prostacyclin), 2,3-dinor-6-keto PGF1 alpha (generated from 6-keto-PGF1 alpha through beta-oxidation) and thromboxane B2 (a hydration product of thromboxane A2) in the urine of healthy pregnant and preeclamptic women. Urinary excretion of 6-keto-PGF1 alpha [19.8 +/- 10.5 pmol/mmol creatinine, (mean +/- SD)] and 2,3-dinor-6-keto-PGF1 alpha (19.2 +/- 7.5 pmol/mmol creatinine) increased during normal pregnancy, reaching a maximum (about 5-fold rise) during the last month of pregnancy. No significant changes occurred in the urinary excretion of thromboxane B2. In women with severe preeclampsia (n = 17), the excretion of both 6-keto-PGF1 alpha (37.7 +/- 29.5 pmol/mmol creatinine) and 2,3-dinor-6-keto-PGF1 alpha (54.5 +/- 56.2 pmol/mmol creatinine) was lower (P less than 0.001) than in the normotensive women during the last trimester of pregnancy (80.6 +/- 43.7 and 98.7 +/- 42.9 pmol/mmol creatinine, respectively). The neonates excreted 6-25 times more 6-keto-PGF1 alpha, 2,3-dinor-6-keto-PGF1 alpha and thromboxane B2 than did the nonpregnant women. In contrast to the adults, neonatal 6-keto-PGF1 alpha excretion was 2-3 times greater than that of 2,3-dinor-6-keto-PGF1 alpha suggesting reduced beta oxidation in the newborns. Infants born to preeclamptic women had reduced output of 6-keto-PGF1 alpha and 2,3-dinor-6-keto-PGF1 alpha on the first day of life. Thus, renal prostacyclin synthesis is diminished in women with severe preeclampsia and their infants. PMID- 3536980 TI - Documentation of hyperglucagonemia throughout the day in nonobese and obese patients with noninsulin-dependent diabetes mellitus. AB - Plasma glucose, insulin, FFA, glucagon, and GH concentrations were measured over an 8-h period in normal subjects and patients with noninsulin-dependent diabetes mellitus (NIDDM). Meals were consumed at 0800 h (20% of daily calories) and noon (40% of daily calories), and measurements were made hourly from 0800-1600 h. Day long plasma glucose, insulin, and FFA concentrations were higher than normal (by two-way analysis of variance) in patients with NIDDM, whether obese or nonobese. In addition, day-long plasma glucagon concentrations were also higher than normal (by two-way analysis of variance) in both nonobese and obese patients with NIDDM. Furthermore, direct relationships were found between the total plasma glucagon response from 0800-1600 h and total plasma glucose (r = 0.57; P less than 0.001) and FFA (r = 0.30; P less than 0.06) responses. In contrast, plasma GH levels were not increased in patients with NIDDM. These data demonstrate that ambient plasma concentrations of both glucose and FFA are higher in patients with NIDDM, despite the fact that coexisting plasma insulin levels are equal to or higher than normal. The higher day-long plasma glucagon levels in patients with NIDDM may contribute to their higher plasma glucose and FFA concentrations. PMID- 3536981 TI - Relationship of androgenic activity to splanchnic insulin metabolism and peripheral glucose utilization in premenopausal women. AB - The importance of androgenic activity in mediating the effects of obesity and body fat topography on splanchnic insulin metabolism and peripheral insulin sensitivity was studied in 19 nonhirsute premenopausal women with a wide range of ideal body weight [percent ideal body weight (% IBW), 78-202%] and body fat distribution pattern [waist to hip girth ratio (WHR), 0.67-0.91]. Turnover kinetics of peripheral plasma C-peptide and insulin were measured, and estimates of pancreatic insulin production (PIP) and the hepatic extraction fraction (HEF) were calculated. The peripheral insulin sensitivity index (M/I) was determined during an euglycemic insulin clamp study. Androgenic activity was assessed by estimating the plasma level of sex hormone-binding globulin (SHBG) and percentage of free testosterone (% FT). After iv glucose stimulation, PIP ranged from 40-254 mU/min X m2 and correlated highly with % IBW (r = 0.78; P less than 0.01). Insulin HEF ranged from 5-69% of the pancreatic production and was inversely proportional to WHR (r = -0.60; P less than 0.01). Increasing WHR also correlated with the diminution in M/I (r = -0.47; P less than 0.05), which, in turn, correlated with the decline in the HEF of insulin (r = 0.60; P less than 0.01). Since PIP, HEF, and M/I correlated with SHBG and % FT, and since the degree of androgenic activity correlated with % IBW and WHR, partial regression analysis was performed. After adjusting for the effects of SHBG and % FT, the relationship between % IBW and PIP remained unaltered, whereas the correlation between WHR and HEF or M/I and their relationship to each other were either markedly reduced or became insignificant. Thus, in premenopausal women, the increase in pancreatic insulin production with increasing weight is independent of the degree of androgenic activity. On the other hand, the decline in hepatic insulin extraction and diminution in peripheral insulin sensitivity with upper body fat localization are in part mediated by increased androgenic activity. This association may account for the pronounced hyperinsulinemia and insulin resistance characteristic of this form of obesity. PMID- 3536982 TI - Cerebrospinal fluid insulin levels increase during intravenous insulin infusions in man. AB - We hypothesized that plasma insulin crosses the blood-cerebrospinal fluid (CSF) barrier and, as people gain weight, provides a physiological feedback signal to the central nervous system to inhibit food intake and further weight gain. However, it has not been demonstrated in man that insulin can enter the CSF from peripheral blood. To test whether increases in plasma insulin result in elevated CSF immunoreactive insulin (IRI) levels, we infused insulin iv in varying amounts approximating postprandial levels in eight normal subjects for 4.5 h. Euglycemia was maintained [88 +/- 3 (+/- SEM) mg/dl] by means of a variable glucose infusion. Samples were obtained every 30 min for measurements of insulin in peripheral plasma and insulin in lumbar CSF. Plasma IRI increased from a mean basal level of 12 +/- 1.2 microU/ml to a mean (during the 180- to 270-minute period) of 268 +/- 35 microU/ml. CSF IRI increased in all subjects during the infusion from a mean basal level of 0.9 +/- 0.1 microU/ml to a mean (during the 180- to 270-min period) of 2.8 +/- 0.4 microU/ml (P less than 0.006). By contrast, CSF IRI in two subjects who received an infusion of 0.9% saline did not increase. In summary, CSF insulin concentrations increased during peripheral infusions of insulin. This is the first demonstration in man that plasma insulin gains access to CSF and indicates a mechanism whereby peripheral insulin could provide a feedback signal to the central nervous system. PMID- 3536983 TI - Long term evolution of glucocorticoid-suppressible hyperaldosteronism. AB - It is generally held that idiopathic hyperaldosteronism and glucocorticoid suppressible hyperaldosteronism (GSH) are distinct entities, distinguishable by thorough investigation. We report a patient who presented in 1974 at age 15 yr with blood pressure of 240/120 mm Hg, serum K of 3.1 mM, low renin, and high normal aldosterone excretion, with findings diagnostic of GSH. After dexamethasone treatment (2 mg/day for 4 weeks), urinary aldosterone was undetectable (less than 1 microgram/24 h), associated with correction of hypertension and hypokalaemia. While untreated, plasma aldosterone increased in response to ACTH infusion at a dose that did not influence plasma cortisol. Plasma aldosterone at 0800 h while recumbent was higher than in subsequent samples taken while ambulant, consistent with ACTH dependence of aldosterone secretion. Blood pressure, renin, and potassium remained normal for 4 yr during treatment with dexamethasone (0.5-0.75 mg/day), but hypertension then slowly returned. After 7 yr, the original studies were repeated. Urinary aldosterone excretion was again in the high normal range after 3 weeks of no treatment, but both plasma renin and aldosterone consistently increased in response to upright posture. After dexamethasone treatment (2 mg/day) for 4 weeks, urinary aldosterone was not suppressed (excretion rate, 10.8, 9.2, and 5.7 micrograms/day; urinary Na, greater than 100 mmol/day; urinary cortisol, less than 1 microgram/day). At this time, dexamethasone did not alleviate hypertension or increase renin. Control of blood pressure has been readily achieved, 8-12 yr after diagnosis, with a low dose of beta-adrenergic antagonist and amiloride. Aldosterone remains incompletely suppressible during sodium loading, so that the findings now resemble those of idiopathic hyperaldosteronism. This sequence indicates that glucocorticoids may not permanently control hypertension in GSH. The transient dominance of ACTH in control of aldosterone secretion indicates that the relationship between GSH and idiopathic hyperaldosteronism merits further evaluation in long term studies. PMID- 3536984 TI - Influence of age on pulsatile luteinizing hormone release and responsiveness of the gonadotrophs to sex hormone feedback in men. AB - The influence of aging on serum LH and testosterone (T) pulse frequency and gonadotroph sensitivity to androgen and estrogen feedback was studied in young (less than 55 yr old) and elderly (greater than 65 yr) Trappist monks. LH pulse frequency (sampling interval, 20 min) was significantly lower [0.25 +/- 0.03 (+/- SEM) vs. 0.38 +/- 0.02 pulses/h; P less than 0.01] in elderly (n = 21) than in young monks (n = 27); the pulse amplitudes were similar. Similarly, T pulse frequency was lower in the elderly than in the young monks (0.13 +/- 0.04 vs. 0.23 +/- 0.02 pulses/h; P less than 0.01). In elderly men, the hypothalamo pituitary complex was more sensitive to 5 alpha-androstan-17 beta-ol-3-one feedback, as determined by the decrease in serum LH and T levels. Moreover, during 5 alpha-androstan-17 beta-ol-3-one (125 mg/day, percutaneously, for 10 days) administration, the LH response to LHRH (100 micrograms, iv) was significantly higher in the elderly men compared to the pretreatment response. During estradiol (1.5 mg/day, percutaneously for 10 days) administration, the LH response to LHRH was decreased in the elderly men, but unchanged in the young men, suggesting greater responsiveness to estradiol in the elderly men. We conclude that in aged men, decreased testicular androgen secretion is not exclusively the consequence of a primary testicular alteration, but that important changes occur in hypothalamo-pituitary function, specifically decreased LH pulse frequency and increased LH responsiveness to sex hormone feedback. PMID- 3536985 TI - Insulin action does not change during the menstrual cycle in normal women. AB - Normal women have alterations in carbohydrate metabolism during pregnancy and when taking oral contraceptives, and clinical observations suggest that diabetic women need more insulin during menstruation. We, therefore, studied insulin action in normal women during the menstrual cycle in the follicular, luteal, and menstrual phases. Glucose tolerance was similar at all three times. Specific insulin receptor binding to monocytes did not change during the menstrual cycle. Euglycemic insulin clamp studies at four different insulin infusion rates (15, 40, 120, and 240 mU/M2 X min) showed no differences in insulin sensitivity or responsiveness throughout the menstrual cycle, and hepatic glucose output did not change. These studies suggest that if insulin action is impaired during menstruation in diabetic women it is because of factors that are not detected in normal women. PMID- 3536987 TI - [The purification, quantification, and physiological alterations of maltase and sucrase-isomaltase of rat intestinal brush border]. PMID- 3536986 TI - Serial studies on the cellular immune response to streptococcal antigens in acute and convalescent rheumatic fever patients in Trinidad. AB - Acute rheumatic fever (ARF) has the characteristics of an autoimmune disease, triggered by cross-reactive antigens shared by the group A streptococcus and a variety of tissues including the heart, endothelium, and basal ganglia. Using two parameters of cellular reactivity, migration inhibition and blastogenic transformation, ARF patients from Trinidad show significant lymphocyte reactivity to streptococcal antigens, particularly those from an ARF associated streptococcal strain. This reactivity, studied over a 2-year period, peaked at 1 to 6 months after the acute onset and remained significantly elevated for at least 2 years. The reactivity is directed mainly toward a nonionic detergent extractable material in the cell membrane. These studies suggest a possible streptococcal strain specificity in ARF and demonstrate persistent sensitization, which explains the increased susceptibility to recurrences in the 2 years following the acute episode. PMID- 3536988 TI - [A new purification method of the insulin secreting cells by applying affinity chromatography]. PMID- 3536989 TI - [A sonographic evaluation of upper urinary tract obstruction in children. Chronological changes in renal pelves induced by the water load stress test with diuretics administration, its assessment or evaluation and clinical significance]. PMID- 3536991 TI - [The use of intraoperative ultrasonography in brain tumors]. PMID- 3536990 TI - [Imaging of thyroid tumors]. PMID- 3536992 TI - Sialidase and protease activities of commercial (RDE) receptor destroying enzyme products used for the (HI) hemagglutination inhibition test of influenza viruses. PMID- 3536993 TI - Comparison of two new tests for rapid diagnosis of respiratory syncytial virus infections by enzyme-linked immunosorbent assay and immunofluorescence techniques. AB - The sensitivity and the specificity of two new commercial reagent tests, an indirect fluorescent antibody test (FAT) with a mouse monoclonal antibody (MAb) against respiratory syncytial virus (RSV) and an enzyme-linked immunosorbent assay (ELISA) RSV antigen detection kit, were determined by a comparison of results from these tests with those of tissue culture isolation and an indirect FAT with bovine polyclonal antibody (BPA). Of 251 nasal aspirates from infants with suspected RSV infection, positive results were found for 99 (39%) by the FAT MAb, 93 (37%) by the FAT-BPA, and 87 (35%) by the ELISA; 69 of 240 (29%) were positive by cultures. The FAT-MAb was a more sensitive technique than cultures, with 87% sensitivity for the FAT-MAb and 84% for the ELISA. It was also more sensitive than the FAT-BPA, with 97% sensitivity for the FAT-MAb and 85% for the ELISA. This could be caused only by the distinctive volume of suspended specimens used in these tests. Of 171 negative culture specimens, positive (but not false positive) results were found for 18% by the FAT-MAb and for 12% by the ELISA. Inversely, 13% of 69 culture positive specimens were FAT-MAb negative and 16% were ELISA negative, emphasizing the importance of tissue cultures for the maximum recovery of RSV, as well as for detection of other respiratory viruses. The FAT-MAb and ELISA were easy to perform and interpret, thus facilitating wider use. PMID- 3536995 TI - Rapid diagnosis of respiratory syncytial virus infection by antigen immunofluorescence detection with monoclonal antibodies and immunoglobulin M immunofluorescence test. AB - During a respiratory syncytial virus (RSV) infection outbreak in a pediatric hospital, diagnosis was made by immunofluorescence on smears by using an anti-RSV monoclonal antibody (IFm). Immunoglobulins M and G were titrated by indirect immunofluorescence on HEp-2 cells infected with an RSV strain. The IFm was sensitive (89%) and specific (75%) when compared with the cell culture method. We showed that the specimens which were found positive by IFm and negative by cell culture were truly positive. Under these conditions, the IFm test appears more sensitive and more specific than cell culture, particularly when no care is taken to maintain the specimens in the cold during transport. In this study the immunoglobulin M immunofluorescence test had a low sensitivity (34%), especially on serum samples taken on days 0 to 4 after the onset of illness. PMID- 3536994 TI - Effect of blind passage and multiple sampling on recovery of Chlamydia trachomatis from urogenital specimens. AB - Detection of chlamydial infections depends on the sensitivity of the techniques used. Variables include the number of body sites sampled, the number of samples obtained, and the number of passages in tissue culture. To assess these factors, microdilution plate cultures with a single blind passage were performed on specimens from 10,291 men and women attending a sexually transmitted disease clinic. Overall, 21% of the men and 30% of the women were culture positive. However, 18% of endocervical, 28% of female urethral, and 29% of male urethral cultures that were positive became so only after a single passage. Of culture positive women, 23% were positive at the urethra only. Pooled urethral and endocervical specimens were positive more often than an endocervical specimen alone but less often than separately cultured endocervical and urethral specimens. A total of 221 specimens from 92 men and 66 women were subjected to five serial blind passages. Of 83 positive specimens, 29 (35%) were positive only after two or more passages. A total of 37 (46%) women were culture-positive, but only 12 (33%) of those who were positive and had an endocervical culture would have been detected by a single endocervical culture that was not passaged. The sensitivity of chlamydial culture is substantially less than 100% but can be improved by culturing samples from both the urethra and endocervix in women and by serial passage in tissue culture. PMID- 3536996 TI - Demonstration of immunoglobulin M class antibodies to Toxoplasma gondii antigenic component p35000 by enzyme-linked antigen immunosorbent assay. AB - On the basis that 89% of 48 acute-phase toxoplasmosis patients showed immunoglobulin M (IgM) class antibodies to the 35,000-molecular-weight antigenic component (p35000) of Toxoplasma gondii, as demonstrated by IgM immunoblotting, the antigen was purified by sucrose gradient centrifugation and enzyme labeled for use in an enzyme-linked antigen immunosorbent assay (ELA) for the demonstration of IgM class antibodies to the p35000 component. The ELA showed a specificity of 96% with 139 serum specimens at a serum dilution of only 1:5. The test serologically detected 73 symptomatic acute-phase toxoplasmosis patients; 64 were positive in the 19S IgM indirect immunofluorescent-antibody test, and 9 were negative, although they showed IgM antibodies to p35000, as demonstrated by IgM immunoblotting. Also, the ELA turned out to be independent of IgM rheumatoid factors in six acute-phase toxoplasmosis serum specimens. PMID- 3536998 TI - Physical and chemical characterization of a Giardia lamblia-specific antigen useful in the coprodiagnosis of giardiasis. AB - We recently reported the isolation and identification of a Giardia lamblia specific antigen (GSA 65) that is shed in the stool of giardiasis patients. In the present study, this antigen was affinity purified from sonic extracts of axenically cultured G. lamblia trophozoites and characterized to better understand its biological function and its potential usefulness in the design of coprodiagnostic assays for giardiasis. GSA 65 was resistant to proteolytic digestion with trypsin, chymotrypsin, and protease but was sensitive to treatment with NaIO4 as assessed by Western blotting. This antigen was also stable during prolonged storage at 4 and -20 degrees C in 10% Formalin or distilled H2O as assessed by counterimmunoelectrophoresis. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and isoelectric focusing gel banding patterns, in conjunction with protein and carbohydrate assays and lectin binding studies, confirmed that this antigen is a highly glycosylated glycoprotein. The resistance of GSA 65 to proteolytic degradation, together with previous immunofluorescence data that indicate the antigen is an integral part of the G. lamblia cyst wall, suggests that this molecule may play a role in maintaining the integrity of the cyst in vivo. The ability of GSA 65 to maintain its antigenic structure under a wide variety of conditions makes it an ideal antigen around which to design sensitive immunodiagnostic assays for giardiasis. PMID- 3536999 TI - Comparison of Rapid NFT system and conventional methods for identification of nonsaccharolytic gram-negative bacteria. AB - This study examined the Rapid NFT system (Analytab Products, Plainview, N.Y.) to determine its ability to accurately identify 229 clinical isolates of mostly nonsaccharolytic gram-negative rods. Identifications were classified by the following scheme: correct (corresponding to excellent, very good, good, or acceptable identification as listed in the code book); low discrimination (correct identification among a range of listed possibilities, with additional tests necessary for accurate identification); incorrect. Correct identification was considered correct to species and subspecies for all organisms except Alcaligenes faecalis and "Alcaligenes odorans"; "A. faecalis/odorans" was considered a correct response. By using these criteria, 71.6% of the strains were correctly identified, 17.9% were identified with low discrimination, and 10.5% were incorrectly identified. When consideration was made for incorrect identification resulting from taxonomic problems (e.g., Alcaligenes and Moraxella spp.), incorrect identifications fell to 5.2%. The Rapid NFT system was truly rapid and was easy to use and interpret. Its use of carbon substrate assimilation enables it to provide more accurate identification of medically important nonsaccharolytic bacteria than do other commercially available systems. PMID- 3536997 TI - Toxoplasma antigens recognized by naturally occurring human antibodies. AB - Sera of most adults have high agglutination test titers to Toxoplasma gondii whether or not the adults have other serological evidence of the infection. This finding has been attributed to the presence of naturally occurring antibodies to T. gondii. Consistent with this observation, we have recently noted that protein blots (PB) of sera of individuals not previously infected with T. gondii had immunoglobulin G (IgG) and IgM antibodies to antigens of the parasite. To further define the antigens recognized by these naturally occurring antibodies, we studied PB of sera of 44 adults and 9 children who had no serological evidence of the infection. Multiple antigens of T. gondii with molecular weights of 15,000 to greater than 205,000 were recognized by IgG and IgM natural antibodies of each of the sera. Although a relatively consistent pattern was noted on the IgM PB of the sera of the adults in the molecular weight range of 48,000 to 85,000, greater heterogeneity was noted on the IgG PB. The most common bands noted on the latter were of approximately 30,000 and 92,000 molecular weight. All of the PB obtained with the serial sera collected at yearly intervals from the children revealed bands; in some cases, new bands had appeared with time, and in others the pattern was constant. In children older than 8 years, the patterns of the PB were similar to those noted in PB of sera of the adults. PMID- 3537000 TI - Detection of Trichomonas vaginalis in vaginal specimens by direct immunofluorescence assay. AB - Vaginal discharge specimens from 105 women were examined by wet mount, culture, and a new direct immunofluorescence assay to detect Trichomonas vaginalis. The organism was detected by culture in 31 patients, by direct immunofluorescence in 26 patients, and by wet mount in 21 patients. PMID- 3537001 TI - Time-resolved fluoroimmunoassay with monoclonal antibodies for rapid diagnosis of influenza infections. AB - Monoclonal antibodies that are broadly reactive with either influenza A or influenza B viruses were used to develop a 2- to 3-h antigen capture time resolved fluoroimmunoassay (TR FIA) for detecting influenza viral antigens in both original nasopharyngeal aspirate specimens and in tissue cultures inoculated with nose or throat swab specimens. The lower limit of sensitivity of the assay was about 10 pg of protein as determined with purified influenza A nucleoprotein expressed by recombinant DNA. When the TR FIA was performed with 96 nasopharyngeal aspirate specimens collected during outbreaks of influenza A (H3N2) virus and the results were compared with serodiagnosis results with paired sera, the specificity and sensitivity of TR FIA for the demonstration of influenza A infections were 95 and 85%, respectively. In culture confirmation assays, more than 80% of the swab specimens that grew influenza A or B virus within 7 days could be identified by the TR FIA within 48 h of the inoculation of cells. The results are consistent with those previously reported for respiratory syncytial virus and extend the applicability of monoclonal antibody-based TR FIA for the rapid diagnosis of acute respiratory viral infections. PMID- 3537002 TI - Isotype-specific enzyme immunoassay for influenza antibody with monoclonal antibodies to human immunoglobulins. AB - Mouse monoclonal antibodies specific for human immunoglobulin isotypes were investigated for use in an isotype-specific enzyme immunoassay for detection of antibody to influenza type A hemagglutinin (H1 and H3). The monoclonal antibody reagents were compared with isotype-specific, hyperimmune rabbit antisera from the National Institutes of Health. Endpoint titers for immunoglobulin G (IgG) obtained with the two reagents were within fourfold of each other 84% of the time (79 of 84) and within eightfold of each other 95% of the time (89 of 94). Regression analysis of the data gave a multiple correlation coefficient (r2) of 0.77 and a Spearman rank value of 0.83 (P less than 0.001). For IgA reagents, endpoint titers agreed within fourfold 77% of the time (88 of 114) and within eightfold 92% of the time (105 of 114). The r2 was 0.73, and Spearman rank was 0.83 (P less than 0.001). IgM antibody was detected in only 17 of 114 sera by either monoclonal or polyclonal reagents. Of these sera, 14 (82%) gave titers with the two reagents that were within fourfold of each other. A similar number of fourfold titer rises were detected with each reagent in paired sera showing hemagglutination inhibition titer rises. Monoclonal antibody reagents detected 27 IgA, 29 IgG, and 6 IgM rises, while polyclonal antisera detected 26 IgA, 31 IgG, and 7 IgM rises. These results show that monoclonal antibodies specific for human immunoglobulin isotypes are suitable as reagents for diagnostic assays. The advantages of monoclonal antibodies are their high degree of specificity and the ability to be standardized and produced in unlimited quantities. Moreover, the availability of immunoglobulin subclass- and allotype-specific monoclonal antibodies will enable a more detailed analysis of the antibody response to influenza as well as other infectious agents. PMID- 3537003 TI - Serodiagnosis of leprosy: relationships between antibodies to Mycobacterium leprae phenolic glycolipid I and protein antigens. AB - Sera from leprosy patients and controls were assayed for immunoglobulin M (IgM) and IgG antibodies to the Mycobacterium leprae-specific phenolic glycolipid I antigen (PG) by enzyme-linked immunosorbent assay, for IgG antibodies to M. leprae protein antigens by Western immunoblot, and for antibodies to a 65 kilodalton (kDa) protein antigen of M. leprae by a competition antibody binding assay. Elevated levels of anti-PG IgM were seen in lepromatous and borderline lepromatous patients, and elevated levels of anti-PG IgG were seen in borderline lepromatous patients. There was a significant correlation between the bacillary index (BI) and anti-PG IgM whether all leprosy patients or only multibacillary patients were analyzed. A significant correlation was seen between anti-PG IgG and BI when all leprosy patients were used for analysis, but not when only multibacillary patients were used. IgG antibodies to protein antigens of M. leprae, as detected by Western immunoblot, were more prevalent in lepromatous and borderline lepromatous patients than in borderline tuberculoid patients, while one of eight controls showed one weak band. There were significant correlations between the number of M. leprae protein antigens detected by the sera of patients and both BI and the level of anti-PG IgM. The 65-kDa competition antibody binding assay detected active multibacillary leprosy. Patients positive for antibody to the 65-kDa antigen had a significantly higher BI and levels of anti-PG IgM and anti-PG IgG than did patients that were negative. In addition, the level of antibody to the 65-kDa antigen correlated with both the BI and anti-PG IgM. We conclude that testing for antibodies to protein antigens of M. leprae may provide a useful adjunct to testing for antibodies to PG. PMID- 3537004 TI - Dip slide culture of intraoperative peritoneal irrigation fluid for prediction of septic complication in elective colorectal surgery. AB - A controlled prospective study of a simplified technique, the dip slide culture method, for assessment of bacterial concentration in peritoneal irrigation fluid at the end of an elective colorectal operation is presented. The prediction of postoperative surgical infection based on intraoperative culture was compared between this method and a standard streak-plate technique in 190 patients. One gram of metronidazole was given intravenously as prophylaxis on induction of anesthesia and 12 h postoperatively. Intraoperative growth of members of the family Enterobacteriaceae or Staphylococcus aureus was strongly correlated to infection (P less than 0.001). By using this finding as a single criterion for the prediction of sepsis, sensitivity and specificity for the dip slide method were 70.8 and 94.3%, respectively, compared with 79.2 and 94.6%, respectively, for the streak-plate method. Of the 24 infections, 20 (83.3%) were correctly predicted when a combination of the two methods was used. An increasing number of Enterobacteriaceae or S. aureus in the dip slide culture resulted in a steady rise in the rate of infections from 5.7% at 0 CFU to 57% at greater than or equal to 80 CFU compared with 4.1% at 0 CFU/ml and 45.4% at greater than or equal to 800 CFU/ml with the streak-plate method. The differences were statistically significant at the greater than or equal to 5 CFU level with regard to wound infection (P less than 0.001) and deep surgical infection (P less than 0.01). It is concluded that the dip slide is a simple, rapid, and reliable method for the routine assessment of bacterial contamination in colorectal operations. PMID- 3537006 TI - Pseudomonas maltophilia exoenzyme activity as correlate in pathogenesis of ecthyma gangrenosum. AB - Ecthyma gangrenosum has not been described during the course of blood stream invasion with Pseudomonas maltophilia, although it occurs with a 30% frequency in Pseudomonas aeruginosa septicemia. We isolated P. maltophilia from the blood and an ecthyma lesion in a leukemic patient. The organism was an avid protease and elastase producer and hence mimicked the exoenzyme profile of invasive P. aeruginosa. The patient responded to moxalactam to which the isolate was susceptible in vitro. On the basis of this report, P. maltophilia may be included among an emerging number of gram-negative bacillary species capable of producing severe cutaneous manifestations of bacteremia. PMID- 3537005 TI - Humoral immune response to Q fever: enzyme-linked immunosorbent assay antibody response to Coxiella burnetii in experimentally infected guinea pigs. AB - The response of guinea pigs experimentally infected with Coxiella burnetii organisms, the etiologic agents of Q fever, was obtained by the measurement of fever, circulating infectious C. burnetii cells, and anti-C. burnetii antibodies. The detection of antibodies by the enzyme-linked immunosorbent assay (ELISA) and traditional methods against phase I whole cells, phase II whole cells, and phase I lipopolysaccharide (LPS-I) (a virulence marker for phase I cells) antigens in the serum samples of infected animals revealed marked differences between intrastrain phase variants. Animals infected with the phase I Nine Mile strain produced a concomitant increase in temperature, circulating infectious C. burnetii cells, and antibodies against phase II cells, phase I cells, and LPS-I. At 15 weeks, a challenge of phase I-infected animals with viable phase I cells resulted in anamnestic antibody responses to phase I cells and LPS-I but not to phase II cells. Infection of animals with the phase II Nine Mile strain produced antibodies against only phase II cells. The challenge of phase II-infected animals at 15 weeks with viable phase II cells resulted in anamnestic antibody responses to phase I and phase II cells but not to LPS-I. Suppression of anti phase II responses by the phase I challenge was apparent with only the ELISA, because the immunofluorescence, microagglutination, and complement fixation assays were insensitive to these changes. The sensitivity and specificity of the ELISA with whole-cell and the LPS-I antigens in the detection of phase-specific antibody revealed that avirulent phase II cells induced an immune response to phase I antigenic epitopes. Although the avirulent phase II cells were rapidly cleared by the host immune responses, they were sufficiently infective to induce antibody responses to both phase variants. Thus, in the occurrence of Q fever, any conventional serological technique that uses only phase II antigens may not provide a true incidence of naturally acquired infection with both phase I and II C. burnetii organisms. PMID- 3537007 TI - Rapid determination of CSF lymphocyte subsets by labeled microspheres. AB - A new, easy and quick method for the quantification of CSF T lymphocyte subpopulations (T4, T8, Leu-7) is reported. The lymphocytes form visible rosettes with plastic spheres to which monoclonal antibodies to human T cell have been coupled. The rosettes can be enumerated by light microscopy. The method is similar to erythrocyte rosette (E-rosette) techniques. The Quantigen (BioRad) T4/T8 assay was used for control. However, the method can also be used for the demonstration and identification of CSF T cell subpopulations by transmission and scanning electron microscopy. PMID- 3537008 TI - alpha 1-Antitrypsin: molecular pathology, leukocytes, and tissue damage. PMID- 3537009 TI - Assessment of insulin action in insulin-dependent diabetes mellitus using [6(14)C]glucose, [3(3)H]glucose, and [2(3)H]glucose. Differences in the apparent pattern of insulin resistance depending on the isotope used. AB - To determine whether [2(3)H], [3(3)H], and [6(14)C]glucose provide an equivalent assessment of glucose turnover in insulin-dependent diabetes mellitus (IDDM) and nondiabetic man, glucose utilization rates were measured using a simultaneous infusion of these isotopes before and during hyperinsulinemic euglycemic clamps. In the nondiabetic subjects, glucose turnover rates determined with [6(14)C]glucose during insulin infusion were lower (P less than 0.02) than those determined with [2(3)H]glucose and higher (P less than 0.01) than those determined with [3(3)H]glucose. In IDDM, glucose turnover rates measured with [6(14)C]glucose during insulin infusion were lower (P less than 0.05) than those determined with [2(3)H]glucose, but were not different from those determined with [3(3)H]glucose. All three isotopes indicated the presence of insulin resistance. However, using [3(3)H]glucose led to the erroneous conclusion that glucose utilization was not significantly decreased at high insulin concentrations in the diabetic patients. [6(14)C] and [3(3)H]glucose but not [2(3)H]glucose indicated impairment in insulin-induced suppression of glucose production. These results indicate that tritiated isotopes do not necessarily equally reflect the pattern of glucose metabolism in diabetic and nondiabetic man. PMID- 3537011 TI - Structurally abnormal insulin in a diabetic patient. Characterization of the mutant insulin A3 (Val----Leu) isolated from the pancreas. AB - We have recently identified a diabetic patient with marked fasting hyperinsulinemia. Family study revealed that the abnormality was an autosomal dominant trait. High-performance liquid chromatography (HPLC) profile of the patient's serum insulin showed that she had an abnormal insulin in addition to a normal insulin. We have purified her insulin(s) from the specimen of her pancreas, which was biopsied during an operation of cholelithiasis. Insulin was also immunologically purified from the serum of her portal vein. The reverse phase HPLC analysis revealed that the ratios of normal to abnormal insulin in the pancreas, portal vein, and peripheral vein were 5:4, 4:5, and 1:7, respectively. Radioreceptor assay for insulin using guinea pig kidney membrane revealed that the binding activities of the normal component insulin, the abnormal component insulin and her pancreatic insulin containing both components were 100, 5, and 50% of standard human insulin, respectively. The biological activities of the normal component, the abnormal component and her pancreatic insulin to stimulate glucose oxidation in rat adipocytes were found to be 100, 8, and 60% of standard human insulin, respectively. Analysis of amino acid sequences of the abnormal insulin purified from her pancreas strongly suggested the substitution of leucine for valine at the third position of the A chain, A3 (Val----Leu). PMID- 3537012 TI - Therapeutic progress--review XXII. Are we making progress in the treatment of hypertension in the elderly? PMID- 3537010 TI - Splanchnic insulin metabolism in obesity. Influence of body fat distribution. AB - The effects of obesity and body fat distribution on splanchnic insulin metabolism and the relationship to peripheral insulin sensitivity were assessed in 6 nonobese and 16 obese premenopausal women. When compared with the nonobese women, obese women had significantly greater prehepatic production and portal vein levels of insulin both basally and following glucose stimulation. This increase correlated with the degree of adiposity but not with waist-to-hip girth ratio (WHR). WHR, however, correlated inversely with the hepatic extraction fraction and directly with the posthepatic delivery of insulin. The latter correlated with the degree of peripheral insulinemia. The decline in hepatic insulin extraction with increasing WHR also correlated with the accompanying diminution in peripheral insulin sensitivity. Increasing adiposity is thus associated with insulin hypersecretion. The pronounced hyperinsulinemia of upper body fat localization, however, is due to an additional defect in hepatic insulin extraction. This defect is closely allied with the decline in peripheral insulin sensitivity. PMID- 3537015 TI - Blastogenetic responsiveness of peripheral blood lymphocytes from patients with adult periodontitis, evaluated by a reverse hemolytic plaque assay. AB - Peripheral blood lymphocytes were obtained from 10 patients with advanced periodontitis and from 5 normal control subjects. The lymphocytes were cultured with dental plaque, supernatant of homologous fibroblast cytoplasm and Pokeweed mitogen (PWM). The number of immunoglobulin-secreting cells (ISC) was assessed after 7 days using a reverse hemolytic plaque assay (RHPA). The stimulation levels of lymphocytes from periodontitis patients and control subjects stimulated with dental plaque and PWM were not statistically different (p greater than 0.05). In contrast, the number of ISC produced after stimulation with fibroblast cytoplasm was increased significantly in the patients group (p less than 0.05). These data support the hypothesis that autologous substances play an important role in the cellular immune responses of patients with severe chronic inflammatory periodontal disease (CIPD). PMID- 3537014 TI - Histological pattern and changes in extracellular matrix in aortic dissections. AB - Samples from 34 patients were studied both histologically and immunocytochemically by the indirect biotin-avidin peroxidase technique to analyse the distribution of the extracellular matrix components (type IV collagen, fibronectin, types I and III collagens) in dissection of the aorta. Most showed defects in type IV collagen around medial smooth muscle cells. Defects in smooth muscle cell basement membrane were found throughout the media in cystic medial degeneration and in medionecrosis, whereas in atherosclerosis such unlabelled areas were found only above advanced atherosclerotic plaques. In aortitis other defects in the smooth muscle cell basement membrane were found in areas of inflammatory infiltrates. In all of these conditions similar defects in fibronectin expression were also found. No defects in the expression of interstitial collagens type I and III were seen in the dissecting aortas. Moreover, cystic medial degeneration, medionecrosis, and atherosclerosis were characterised by intense staining of these interstitial matrix components. In the pathogenesis of the aortic dissection local changes in the basement membranes of the medial layer may be important. PMID- 3537013 TI - Examination of products of conception terminated after prenatal investigation. AB - A large number of district general hospitals have access to diagnostic ultrasonography and other methods of prenatal diagnosis, resulting in an increased supply of freshly terminated malformed fetuses to general histopathology departments, and there is now more open discussion of malformation and greater concern over fetal wastage. General pathologists are therefore under greater pressure to produce complete and detailed descriptions of a wide range of often complex anomalies. The dismissal of specimens as "multiple congenital anomalies" is becoming increasingly unacceptable to couples who wish to embark on further pregnancies and to their medical attendants. As in other fields an understanding of the methods and terminology in clinical use and a consistent diagnostic approach should help pathologists to extract sufficient information for accurate counselling. PMID- 3537016 TI - False results associated with darkground microscopy of subgingival plaque. AB - This study considers false results which may arise due to problems in the preparation or examination of specimens for darkground microscopy of subgingival plaque. Subgingival plaque samples obtained with a sterile curette were placed in 0.1-0.3 ml sterile full or 1/4 strength Ringer's solution: 0.85% saline, 1% gelatin in 0.85% saline, formal saline or pyrogen-free water for injection. Test slides were prepared from the original dispersion, and control slides from the corresponding sterile solution. Optimal dispersion solution, syringe dispersion frequency and the effect on motility of delay in processing samples were tested. Slides were also prepared from dispersions of 11 representative subgingival "periodontopathic" organisms. Problems in sampling included variability in counts between sites with comparable pocket depths, contamination of the sample and reduction of the sample volume after scaling. Problems in dispersion included contamination, uneven distribution of the different morphotypes and destruction of delicate organisms. Problems in slide preparation included slide contamination, limitation in the number of samples that can be assessed by one examiner at a given time without loss of activity of motile cells, and preparation of a cell monolayer. Problems in identification and counting included confusion of Brownian movements with motility, coccoid particles with cocci, spirochetes with campylobacter, flagella with flagella-like structures, size of cocci, counting of fragmented spirochetes and non-motile flagellated organisms and motile cells, and also bias in counting. Problems in morphotype grouping included the observation that many (10 of the 11 representative) periodontitis related organisms were in the non-motile groups and not all cells of the motile species (Campylobacter, Capnocytophaga) showed motility. The results indicate that each stage of subgingival plaque darkground microscopy, sampling, dispersion, slide preparation, counting, morphotype grouping and interpretation may lead to false results if not representative or reproducible. Procedures are suggested for the minimisation of problems in the preparation and examination of subgingival plaque specimens for darkground microscopy. PMID- 3537017 TI - Clinical alterations in relation to the morphological composition of the subgingival microflora following scaling and root planing. AB - The aim of the present study was to relate shifts in the composition of subgingival plaque in periodontal pockets to alterations of the clinical periodontal conditions following a single course of subgingival scaling and root planing during a period of professional supragingival plaque control. For this purpose, 36 pairs of contralateral periodontal pockets in 10 subjects with moderately advanced periodontitis were assessed for the degree of gingival inflammation, probing pocket depths, bleeding on probing, attachment levels and the amount of supragingival plaque. In addition, samples of subgingival plaque were analyzed morphologically by dark-field microscopy. All patients received detailed information about proper oral hygiene and every 1-2 weeks, professional removal of supragingivally located deposits. When the oral hygiene standard had been sufficiently improved, 1 course of subgingival scaling on 1 side of each jaw only (test side) was carried out. Clinical and microbiological examinations were repeated after the scaling as well as after 2 and 6 months, while patients were recalled for supragingival prophylaxis every 2nd to 4th week. Our data showed that a single course of subgingival scaling and root planing resulted in reduced probing depths, a gain in clinical attachment and a shift in the composition of the subgingival microflora to a composition found in relatively healthy periodontal conditions. In relatively shallow pockets, however, a possible influence of repeated sampling on the subgingival microflora could not be ruled out. Bleeding on gentle probing was a reliable parameter for predicting a subgingival microflora where motile bacteria hold an increased portion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537019 TI - Healing following surgical and non-surgical treatment of juvenile periodontitis. A 5-year longitudinal study. AB - The patient sample used in the present study comprised 16 young individuals who were referred for treatment of advanced periodontal disease. Based upon the age of the patients and the location of the diseased sites, the patients were divided into 2 groups; a juvenile periodontitis group (JP) and a post-juvenile periodontitis group (post-JP). The patients in the JP group had periodontal lesions only at first molars and incisors. All 16 subjects were in excellent general health and none had been treated with antibiotics during a period of at least 12 months prior to the 1st examination. At a baseline examination and 6, 24 and 60 months after active therapy, the diseased sites were examined regarding plaque, gingivitis, probing pocket depths, probing attachment level, recession of the gingival margin and marginal alveolar bone level. Following a case presentation and instruction in proper oral hygiene measures, the 16 subjects were subjected to periodontal treatment, utilizing a split mouth design. By random selection, the diseased sites in one side of the jaws were treated by scaling and root planing in conjunction with a "modified Widman flap" procedure, while in the contralateral jaw quadrants treatment was restricted to scaling and root planing. During the 1st 6 months following active therapy, the patients were subjected to professional tooth cleaning once every 4 weeks. Subsequently, the interval between the recall appointment was 3 months. 2 years after treatment, this maintenance care program was terminated. A final examination was performed 5 years after therapy. None of the patients involved in the trial received antibiotic treatment during the 5 years of observation. The findings of the present study revealed that the response of the periodontal tissues to therapy, both in the JP and the post-JP group of patients, was almost identical to that found for similar types of treatment in patients with adult periodontitis. The re examinations performed after 6, 24 and 60 months following active therapy of JP and post-JP lesions revealed that excision of the granulation tissue in conjunction with flap elevation did not enhance the degree of probing pocket depth reduction, probing attachment gain and bone fill that occurred following meticulous root surface instrumentation. PMID- 3537018 TI - Concentration of doxycycline in human gingival fluid. AB - Doxycycline is a synthetic tetracycline compound whose main advantages over tetracycline hydrochloride are increased oral absorption, prolonged serum half life and decreased gastrointestinal side-effects. The purpose of this study was to measure the concentration of doxycycline in gingival fluid and blood after oral administration. 4 volunteers were given doses of 100 mg doxycycline every 12 h on the first day of antibiotic administration followed by a maintenance dose of 100 mg per day for an additional 4 days. 3 of these volunteers were also given tetracycline hydrochloride every 6 h for 5 days either 1 month before or after doxycycline administration to compare gingival fluid levels of these 2 tetracycline compounds. Gingival fluid was sampled from 4 gingival sites in each volunteer at hourly intervals from hours 0 to 6, 9, 24, 27, 48 to 54, 57, 72, 75, 96 to 102 and 105. Blood was sampled by finger puncture at hours 0, 3, 6, 24, 48, 54, 72, 96 and 102. Antibiotic levels in gingival fluid and blood were measured using an agar diffusion assay method. The results demonstrated that doxycycline achieved much higher levels in the gingival fluid than in blood and yielded comparable gingival fluid levels to those achieved by tetracycline hydrochloride. Doxycycline levels in gingival fluid ranged between 1.2 micrograms/ml and 8.1 micrograms/ml in the first 24 h and generally achieved 3-10 micrograms/ml after 48 h. Blood levels after 48 h ranged between 2.1 micrograms/ml and 2.9 micrograms/ml. Tetracycline hydrochloride in gingival fluid after 48 h was generally in the range of 4 micrograms/ml-10 micrograms/ml with blood levels between 2.2 micrograms/ml and 3.4 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537020 TI - GABA-immunoreactive neurons in the rat cerebellum: a light and electron microscope study. AB - An antibody raised against gamma - amino-butyric acid (GABA) coupled to bovine serum albumin with glutaraldehyde (Hodgson et al: J. Histochem. Cytochem. 33:229 239, '85) was used to localise immunocytochemically the presumptive GABAergic neuronal elements in the cerebellar cortex of the adult rat. employing the unlabelled antibody enzyme method with pre- and post-embedding immunocytochemical procedures, the following cellular structures were observed to be GABA immunopositive in both the light and electron microscopes: the somata, dendrites, and axonal processes (including axon terminals) of stellate, basket, and Golgi neurons. In immunopositive neuronal somata and dendrites, the reaction product was found to be associated with all intracellular organelles and with the postsynaptic densities of synaptic junctions. Specific GABA-like immunoreactivity was also seen around outer mitochondrial membranes, microtubules, and neurofilaments, and coating synaptic vesicles in presynaptic axon terminals. In the pre-embedding procedure with dilutions of the antiserum between 1:1,000 and 1:2,000, the perikarya and dendrites of Purkinje cells were GABA-immunonegative, whereas at an antiserum dilution of 1:500 the somata of Purkinje cells were mildly GABA-immunoreactive. Purkinje cell axon terminals in the infra- and supraganglionic plexuses and in the deep cerebellar nuclei were always strongly immunopositive. Neuroglia were invariably GABA-immunonegative, as were the dendrites, axons (parallel fibres), and somata of granule cells. Mossy fibre and climbing fibre afferents were also immunonegative. The pattern of immunoreactivity obtained with this antiserum directed against the inhibitory neurotransmitter GABA was found to resemble closely the immunocytochemical distribution of GABA and of the GABA-synthesizing enzyme glutamic acid decarboxylase (GAD) as reported previously in other immunocytochemical investigations (Oertel et al. and Wu et al: Cytochemical Methods in Neuroanatomy. New York: A. R. Liss, '82; Seguela et al: Neuroscience 16:865-874, '85; Mugnaini and Oertel: GABA and Neuropeptides in the CNS. Handbook of Chemical Neuroanatomy, Vol. 4, Part I. Amsterdam: Elsevier, '85. PMID- 3537021 TI - Colonization of the bowel by the precursors of enteric glia: studies of normal and congenitally aganglionic mutant mice. AB - The terminal portion of the ls/ls mouse is congenitally aganglionic because the precursors of enteric neurons fail to enter this region. This animal was studied in order to gain insight into the origin of enteric glia and into the process by which the precursors of these cells colonize the gut. In control (CD-1) mice, immunoreactivity of the glial marker, glial fibrillary acidic protein, appeared for the first time in the fetal bowel at day E16 and, in adults, was much more intense within intraenteric neural elements than in nerves outside the bowel. Glial fibrillary acidic protein developed in tissue cultures of fetal intestine explanted before the protein appeared in situ, and before the bowel became innervated by extrinsic nerves; thus, the precursors of cells able to elaborate glial fibrillary acidic protein must have been present, but unrecognizable, in the original explants. This explant assay demonstrated that these glial precursors were present in all regions of the bowel of control mice, but not in the presumptive aganglionic bowel of ls/ls mice. The nerves (of extrinsic origin) in the aganglionic tissue of ls/ls mice showed a high level of immunoreactive glial fibrillary acidic protein; nevertheless, their ultrastructure was typical of peripheral nerve, not enteric plexus, and they contained Schwann cells, not enteric glia. These observations support the view that enteric glia are derived from the single wave of neural crest colonists that populates the enteric nervous system before the gut receives its extrinsic innervation. These glial precursors, like neuronal precursors, tend to be excluded from the presumptive aganglionic ls/ls bowel. In contrast, Schwann cells grow into the abnormal ls/ls gut with the extrinsic innervation. The enteric microenvironment appears to promote the expression of glial fibrillary acidic protein in both enteric glia and Schwann cells; however, even within the bowel, Schwann cells retain their characteristic morphology. It is thus probable that the normal enteric nervous system contains supporting cells of separate lineages, enteric glia and Schwann cells. PMID- 3537022 TI - A developmental study of the quantitative distribution of LHRH neurons within the central nervous system of postnatal male and female rats. AB - The quantitative distribution of LHRH neurons within the central nervous system of male and female rats during postnatal development was investigated with light microscopic immunocytochemistry. Approximately 1,300 immunoreactive LHRH cells were found within the forebrain at all ages. The topographic distribution of LHRH neurons was adultlike in the earliest neonatal stage examined (2 days postnatal) and remained similar throughout development. Two LHRH cell subtypes, smooth LHRH cells and LHRH cells with spinelike processes (irregular LHRH cells), were found throughout the entire extent of the LHRH neuronal field in both sexes. A sex difference in the number of LHRH cells anterior to the organum vasculosum lamina terminalis/preoptic area (a 20% greater number in this region in females) was observed. This sex difference was present throughout development and was not limited to one specific LHRH cell subtype. These data are consistent with the hypothesis that the LHRH system is established early in postnatal development, and that the signal for reproductive maturation is related to the development of synaptic inputs to the LHRH cells. PMID- 3537024 TI - Nevoid basal cell carcinoma syndrome. A review and case report of a patient with unilateral basal cell nevus syndrome. AB - An exceptionally rare example of nevoid basal cell carcinoma syndrome occurring unilaterally is presented, along with a review of the syndrome. We ruled out the possible association of this case with the linear unilateral basal cell nevus with comedones because of several incongruities, including the absence of epidermal cysts and strialike atrophy and the presence of pigmented basal cell carcinomas. Linear unilateral basal cell nevus with comedones is not a variant of the nevoid basal cell carcinoma syndrome and the tumors follow a benign course. The aggressive, destructive behavior of numerous pigmented basal cell carcinomas that involve the eyelid and medial canthus of the eye and the head and neck area represents important evidence that our patient's condition was not an example of linear unilateral basal cell nevus with comedones. PMID- 3537023 TI - Adrenaline-synthesizing neurons in the medulla of the cat. AB - In this study, the distribution of neurons containing the adrenaline-synthesizing enzyme phenylethanolamine-N-methyltransferase (PNMT) was mapped in the medulla of the cat. Data from recent studies in the rat suggest that the anatomical structure responsible for cardiorespiratory changes that occur following application of neurotransmitters and drugs to Schlaefke's area on the ventral medullary surface is the nucleus reticularis rostroventrolateralis (RVL), which is distinguished from adjacent regions of the reticular formation, in part, by the presence of adrenaline-synthesizing neurons. To determine whether an equivalent adrenergic population is present in the RVL of the cat, we used antibodies raised against bovine adrenal PNMT to map the distribution of adrenaline-synthesizing neurons in the reticular formation. In the ventrolateral medulla, we found that labeled cells extended from the level of the retrofacial nucleus to the calamus scriptorius. The majority of labeled cells were seen in a nucleus designated RVL at the level of the rostral one-third of the inferior olive. In the dorsomedial medulla, cells were labeled in the caudal aspect of the nucleus tractus solitarii (NTS) and were especially dense in the subnucleus gelatinosus and commissural nucleus of the vagus. A few lightly labeled cells were also present in the rostral pole of the area postrema (AP). In contrast to the rat, few or no immunoreactive cells were found in the rostral NTS, medial longitudinal fasciculus, nucleus paragigantocellularis dorsalis, or periventricular gray. Our results are consistent with the notion that an area of the RVL containing adrenergic perikarya is the anatomical structure responsible for cardiovascular changes that occur when chemicals are applied to Schlaefke's area. PMID- 3537025 TI - Cutaneous chemical carcinogenesis. AB - This review is designed to inform the clinician of current concepts regarding the pathogenesis of chemically induced skin cancer. Chemicals induce cutaneous cancers in a wide variety of experimental animals and in humans. The most common benign experimental tumors are papillomas and keratoacanthomas, whereas common malignancies are squamous cell carcinomas and melanomas. Carcinoma development is a multistage process that involves at least three mechanistically distinct steps. Initiation is the earliest change in an epidermal cell exposed to carcinogens such as polycyclic aromatic hydrocarbons, alkylating agents, or nitrosamines. This stage appears to result from carcinogen-induced deoxyribonucleic acid damage leading to a mutation-like genetic change. Only a limited number of epidermal genes may be changed to yield the initiated cell, and one has been identified as the Harvey ras gene, a gene involved in epidermal proliferation. Initiated epidermal cells are not malignant but are insensitive to the normal signals for terminal differentiation in the epidermis. The second stage, tumor promotion, results from repeated exposure of initiated skin to one of a variety of noncarcinogenic promoting agents such as phorbol esters, benzoyl peroxide, anthralin, or certain halogenated aromatic hydrocarbons. Some promoters require specific cellular receptors and produce transient changes in the growth or differentiation of the epidermis. Collectively these agents produce a tissue environment that is conducive to the selective clonal outgrowth of the initiated cell population, resulting in a clinically apparent premalignant tumor. During the third stage of carcinogenesis, premalignant cells are converted to malignancy. This step may occur spontaneously, but the frequency is greatly enhanced by exposure to mutagens, including several initiating agents. Thus malignant conversion is likely due to additional mutations in a benign tumor cell. The Harvey ras gene may also be a potential target in the conversion step. Several agents, such as corticosteroids and retinoids, have been identified as anticarcinogens for skin. They appear to be primarily antipromoting agents and could important clinical applications. Melanomas can be induced in several species by repeated exposure to initiators or by exposure to an initiator and a tumor promoter. the experimental pathogenesis of this tumor is unclear. It is proposed that intermediates in the synthesis of melanin pigment could act as endogenous carcinogens or promoters in melanoma development. Increased awareness of the mechanisms of chemical carcinogenesis in skin will enhance cancer prevention in this tissue. Furthermore, astute PMID- 3537026 TI - A characteristic vesiculobullous eruption in patients with chronic lymphocytic leukemia. AB - We report ten cases of a characteristic vesiculobullous eruption in patients with chronic lymphocytic leukemia. Clinically, six lesions were thought to represent insect bites. All ten patients had bone marrow examinations that confirmed the diagnosis of chronic lymphocytic leukemia. In six of ten patients serum protein and immunoelectrophoresis were performed. Six patients had immunoglobulin disturbances: one polyclonal IgG and IgM gammopathy, two monoclonal IgM gammopathies, two decreased levels of IgA, and one hypogammaglobulinemia. Direct and indirect immunofluorescence procedures were performed on two patients and results were negative. Immunoperoxidase procedures for IgG stained nonspecifically along torn/separated areas of the basement membrane in five patients. No immunohistochemistry was performed on the remaining three patients. The etiology and pathogenesis of these lesions are unknown. We favor the concept that they represent an unusual reaction to an arthropod bite, secondary to the underlying lymphoproliferative disorder. A second, and less likely theory, is that these lesions represent an unusual clinical presentation of bullous pemphigoid in patients with chronic lymphocytic leukemia. PMID- 3537027 TI - Delayed healing in full-thickness wounds treated with aluminum chloride solution. A histologic study with evaporimetry correlation. AB - Optimizing wound healing parameters seems to be the utmost importance in the present age of sophisticated wound care and dressings. We studied the effect of two hemostatics: 30% aluminum chloride and ferric subsulfate (Monsel's solution) on the rate of wound healing in Yucatan miniature hairless pigs. Wound healing was examined in occluded and nonoccluded full-thickness 3-mm punch biopsy wounds. Wounds were treated either with 30% aluminum chloride solution or ferric subsulfate solution or were allowed to clot with minimal pressure from a gauze pad. The course of wound healing was followed utilizing evaporimetry readings from the wound sites in addition to periodic histologic examination in an attempt to correlate the evaporimetry readings with corresponding histology. Delay in reepithelialization was noted histologically both in wounds treated with aluminum chloride and in those treated with ferric subsulfate compared to controls. Presumably this delay was the result of tissue necrosis caused by these hemostatic agents, resulting in slightly larger and less cosmetically acceptable scars. Plots of evaporimetry data revealed a biphasic pattern of water loss during healing, with an initial rapid decline in water loss followed by a much slower decline. Histologic reepithelialization seemed to correlate best with the point on the evaporimery curve where the slope changed from the phase of rapid water loss to a slower rate. PMID- 3537028 TI - Epidural lipomatosis with lumbar radiculopathy: CT appearance. AB - Epidural lipomatosis is a relatively uncommon clinical entity in which large amounts of fat are deposited in the epidural space. In most of the previously reported cases of this entity an associated myelopathy has been reported. We describe a patient who presented with lumbar radiculopathy, which was probably caused by epidural lipomatosis. PMID- 3537029 TI - Computed tomography of renal angiomyolipoma presenting as right atrial mass. AB - Renal angiomyolipoma is a benign tumor with a propensity for extrarenal extension, although vascular invasion occurs only rarely. We present a case of an angiomyolipoma with extension via the left renal vein and inferior vena cava, into the right atrium. PMID- 3537030 TI - MR imaging of milk of calcium renal cyst. PMID- 3537032 TI - Histopathologic and immunopathologic study of pyoderma gangrenosum. AB - Sixty-three patients with pyoderma gangrenosum were seen and studied at the Mayo Clinic from 1971 to 1980. Biopsies from the erythematous border or necrotic edge of the pyoderma gangrenosum lesions usually demonstrated a characteristic pathogenic morphologic evolution. The early lesions revealed mild to moderate perivascular lymphocytic infiltrate associated with endothelial swelling. The fully developed lesions demonstrated necrosis in addition to a dense lymphocytic infiltration surrounding as well as involving the blood vessels. Extravasation of erythrocytes and thrombosis sometimes were seen. Ulceration, infarction, and abscess formation were found in the later stages of evolution. Direct immunofluorescence results were positive in the blood vessels of 36 of 65 (55%) specimens. IgM, C3, and fibrin were found in the papillary and reticular dermal vessels. IgG and IgA were only occasionally present. Pyoderma gangrenosum appears to be a reactive process that is manifested as a vasculitis. Biopsy material from the advancing active erythematous border has early characteristic dermatopathologic findings of lymphocytic vasculitis. Cutaneous vascular immune deposits suggest an immune pathogenesis of either an immune complex disease or lymphocytotoxic reaction. PMID- 3537033 TI - The significance of an IgM band at the dermo-epidermal junction. AB - We studied 190 patients with an IgM band at the dermo-epidermal junction demonstrated by direct immunofluorescence. In 55% of patients the final diagnosis was lupus erythematosus, 49% discoid lupus erythematosus, and 6% systemic lupus erythematosus. In 45% of patients the presence of an IgM band was associated with a number of other diagnoses. The finding of an IgM band at the dermo-epidermal junction in a cutaneous biopsy is not sufficient evidence to make a diagnosis of lupus erythematosus without supporting clinical, histological and serological evidence. PMID- 3537034 TI - Plasmid heterogeneity in Streptococcus cremoris M12R: effects on proteolytic activity and host-dependent phage replication. AB - Examination of single colony isolates from a culture of Streptococcus cremoris M12R revealed a high degree of variability in plasmid deoxyribonucleic acid composition. Fifty percent of the M12R population displayed proteolytic activity and harbored a 13-Mdalton plasmid (pLR2013). This plasmid was not present in proteinase-deficient variants isolated from the culture, which provided correlative evidence for linkage of proteinase activity to pLR2013. Four percent of the M12R population demonstrated resistance to phage m12r X M12. This resistance was identified by restriction and modification activities against m12r X M12 phage, which was dependent on the presence of a 20-Md plasmid, pLR1020. Loss of restriction and modification activities was observed upon curing of pLR1020. In conjugal mating studies with Streptococcus lactis ME2, transfer frequency of lactose-fermenting ability to a restriction and modification deficient variant of M12R was 10(2)-fold higher than to a variant exhibiting restriction and modification activities. The data provided evidence for restriction and modification activities in select S. cremoris M12R variants that are linked to pLR1020 and restrict both the plaquing ability of phage and efficiency of plasmid transfer by conjugation. PMID- 3537031 TI - MR imaging of osteoid osteoma. AB - An osteoid osteoma was detected in a young boy with a classic history for this lesion. Plain radiography was not helpful but ultrasound and magnetic resonance imaging demonstrated the tumor nidus. PMID- 3537036 TI - Implantable prostheses and reconstructive materials in oral and maxillofacial surgery. PMID- 3537035 TI - In vitro growth of mastitis pathogens in mammary secretions of the dry and peripartum periods. AB - In vitro growth of Escherichia coli, Streptococcus uberis, and Staphylococcus aureus was measured in skimmed, cell-free secretions of bovine mammary glands collected on d 0, 7, 14, and 28 of the dry period; 12, 8, and 4 d before expected calving; and on d 0 and 14 postpartum. There were marked and nearly inverse changes in growth of Escherichia coli and Streptococcus uberis over the experimental period. Escherichia coli grew well in secretions of d 0 of the dry period and d 0 and 14 postcalving but poorly or not at all in secretions of the mid-dry period. In contrast, Streptococcus uberis grew well in secretions of the involuted gland and poorly in samples from day of dry off and day of calving. Growth of Staphylococcus aureus changed relatively little over the dry period, but there was reduction in growth at d 7 of the dry period. Changing ability of the secretion to support bacterial growth may influence changing susceptibility to infection, but for Streptococcus uberis, poor correspondence between changes in growth supported by the secretion and changes in the incidence of naturally occurring infection over the dry period indicates that other factors may be more important. PMID- 3537038 TI - Weight loss of four calcium hydroxide-based materials following a phosphoric acid etching and washing cycle. PMID- 3537037 TI - Aspects of the metallography of some pre-formed root canal posts and dentine pins. PMID- 3537039 TI - Alveolitis sicca dolorosa (dry socket). PMID- 3537040 TI - Triazine monomers and their adhesion to dentin. AB - A series of 4,6-dichloro-1,3,5-triazines [e.g., 2-allylamino-(ADT), diallylamino (DADT), 2-N-p-allyloxyphenylamino-, 2-N-allyl-N-phenylamino-, and 2-N-allyl-N-p tolylamino-4,6-dichloro-1,3,5-triazine] was synthesized and characterized by IR, NMR, and mass spectrometry. These monomers have chlorine atoms that can react with NH2 or OH groups and double bonds capable of copolymerization. Aniline reacted readily with ADT and DADT, ethanol reacted with ADT, but acetone, H2O, and DMF did not react with either triazine. It appears that ADT or DADT will react with dentinal collagen through NH2 or OH groups in the peptide side-chains. An aprotic solvent should be used for ADT or DADT, but absolute dryness in clinical usage is not essential because of the slow hydrolysis of ADT and DADT. Stability of the N-di-substituted amino derivative (DADT) is greater than that of the mono-substituted compound (ADT), which may isomerize. ADT and methyl methacrylate were copolymerized at 37 degrees C with amine-peroxide. ADT solutions enhanced the adhesive strength of restorative resin to dentin. Thus, monomers such as ADT and DADT appear to be promising dentin-bonding agents. PMID- 3537041 TI - Cutaneous melanoma: "is it as black as it seems"? PMID- 3537042 TI - Circulating immune complexes in recurrent oral ulcers. PMID- 3537043 TI - Flow cytometric investigations of corneocytes from psoriatic scales and the effects of Ingram therapy. PMID- 3537044 TI - Immunohistochemical study of HLA antigens and lymphocyte infiltration in melanocytic tumors. PMID- 3537045 TI - Kimura's disease: immunohistochemistry of infiltrating cells using monoclonal and polyclonal antibodies. PMID- 3537046 TI - Five cases of porphyria cutanea tarda with mild cutaneous changes: evaluation of the efficacy of phlebotomy by the pattern analysis of urinary porphyrins. PMID- 3537047 TI - Bullous lichen planus developed on erythema ab igne. PMID- 3537048 TI - Satellite cell necrosis in two cases with dermatomyositis. PMID- 3537049 TI - Reticular erythematous mucinosis syndrome: a case report. PMID- 3537050 TI - A case of extensive subcutaneous sarcoidosis. PMID- 3537051 TI - Anaphylaxis due to cefaclor hypersensitivity. PMID- 3537052 TI - [Dark and light cells of the mammalian cutaneous tubular glands and the problems of classifying these glands]. PMID- 3537053 TI - [Quantitative patterns of erythropoiesis regulation]. PMID- 3537054 TI - Joseph Francis Volker. Alabama's most distinguished adopted son. Part II--The early years at Birmingham. PMID- 3537055 TI - The Presidents. William Robert Alstadt 1957-1958. PMID- 3537056 TI - Dentistry on stamps. PMID- 3537057 TI - The pharmacologic and toxicological properties of zinc oxide-eugenol. AB - An explanation of the therapeutic effects of zinc oxide-eugenol when placed in contact with intact or carious dentin, and the toxic effects of zinc oxide eugenol when placed in contact with soft tissue or tissue cultures is presented to allow for the rational, safe, and effective use of the material. PMID- 3537058 TI - Outcome of patients referred for cardiac transplantation. AB - The outcome of 1,102 patients referred for cardiac transplantation at five centers participating in the National Heart Transplantation Study was examined. Using medical and referral records, patients were tracked from date of referral until they were rejected as transplantation candidates or received a transplant. Overall, 34.6% of all patients referred were eventually accepted for transplantation but, of these, 71.9% underwent the procedure. Of those patients accepted but not undergoing the procedure, the vast majority (58.8%) died awaiting a donor heart; another 30.8% later refused the procedure. Very few patients (2.1%) who were accepted for transplantation were deselected as possible candidates because of improved health status. The number of patients awaiting transplantation at all centers was found to be small at the time of study. The results of the analyses revealed major differences among centers in evaluation procedures, proportion of patients accepted and number of patients receiving a transplant. For example, one center performed transplantation on only 50.0% of all patients it accepted, while another did so in more than 81.0% of such patients. It is concluded that both patient selection and donor supply will remain significant determinants of the outcome of patients referred for cardiac transplantation. PMID- 3537059 TI - Subselective measurement of coronary blood flow velocity using a steerable Doppler catheter. AB - The accuracy of coronary arteriography to predict obstruction to coronary blood flow has recently been questioned. Assessment of coronary hemodynamic variables and vasodilator reserve may provide more reliable information regarding the significance of coronary stenosis. To provide a clinically safe and reliable method of measuring coronary blood flow velocity and coronary flow reserve, a 3F steerable Doppler catheter capable of subselective placement in the coronary circulation was developed and validated in an animal model. Coronary blood flow velocity measured with the catheter correlated with simultaneous measurements by a previously validated external cuff type Doppler probe (r = 0.97), coronary sinus flow collections (r = 0.78) and femoral artery flow collections (r = 0.96). The extravascular Doppler cuff measurements of rest flow velocity and vasodilator reserve were not significantly different with or without the catheter in the artery, indicating that the Doppler catheter caused no obstruction to blood flow. The Doppler catheter has recorded stable and reproducible signals without complications in 28 patients, including 62 separate arterial cannulations. Thus: 1) the 3F Doppler coronary catheter is nonobstructing, steerable and safe; 2) there is an excellent correlation of blood flow velocity with volume collections; and 3) the catheter provides a reliable method of determining coronary blood flow velocity and coronary vasodilator reserve. PMID- 3537060 TI - Pulsed Doppler echocardiographic evaluation of valvular regurgitation in patients with mitral valve prolapse: comparison with normal subjects. AB - Pulsed Doppler echocardiography was used to determine prospectively the prevalence of mitral, aortic, tricuspid and pulmonary regurgitation in 80 consecutive patients with mitral valve prolapse and 85 normal subjects with similar age and sex distribution. Mitral valve prolapse was defined by posterior systolic displacement of the mitral valve on M-mode echocardiography of 3 mm or more (40 patients), the presence of one or more mid- or late systolic clicks (61 patients), or both. Mitral regurgitation, detected by pulsed Doppler techniques in 53 patients with prolapse, was holosystolic in 24, early to mid-systolic in 6, late systolic in 15 and both holosystolic and late systolic behind different portions of the valve in 8. Definitive M-mode findings were present in only 27 of the 53 patients, and only 21 had mitral regurgitation audible on physical examination. Tricuspid regurgitation was evident by pulsed Doppler echocardiography in 15 patients (holosystolic in 9, early to mid-systolic in 1, late systolic in 4 and both holosystolic and late systolic in 1); 12 of these 15 patients, including all with an isolated late systolic pattern, had an echocardiographic pattern of tricuspid prolapse, but none had audible tricuspid regurgitation. A Doppler pattern compatible with aortic regurgitation was recorded in seven patients, all without echocardiographic aortic valve prolapse and only two with audible aortic insufficiency. A Doppler shift in the right ventricular outflow tract in diastole, suggestive of pulmonary regurgitation, was recorded in 16 of the 78 patients with an adequate Doppler examination: only 1 of the 16 had audible pulmonary insufficiency. Of the 85 normal subjects without audible regurgitation, pulsed Doppler examination detected mitral regurgitation in 3 subjects (holosystolic in 1 and early to mid-systolic in 2), aortic regurgitation in none, tricuspid regurgitation in 9 (holosystolic alone in 8 and both holosystolic and late systolic in 1) and right ventricular outflow tract turbulence compatible with pulmonary insufficiency in 15. The prevalence of valvular regurgitation, detected by pulsed Doppler echocardiography, is high in patients with mitral valve prolapse. Regurgitation may involve any of the four cardiac valves and is clinically silent in the majority of patients. The prevalence rates of mitral and aortic regurgitation are significantly higher in patients with mitral prolapse than in normal subjects, suggesting that alterations in underlying valve structure in the prolapse syndrome may indeed be responsible for this regurgitation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537061 TI - Diagnosis of fetal arrhythmias using echocardiographic and Doppler techniques. AB - Fetal echocardiography is the most practical method for diagnosing prenatal arrhythmias. Because some prenatal tachyarrhythmias have been shown to respond to antiarrhythmic drugs, correctly diagnosing fetal arrhythmias has assumed new importance. With the aid of two-dimensional echocardiographic imaging, an M-mode cursor can be aligned to record atrial and ventricular wall motion--either independently or simultaneously. A consistent feature in the fetus is prominent atrial wall contractions that can be readily recorded on the M-mode tracing. By matching atrial and ventricular wall contractions with assumed P waves and QRS complexes, the fetal electrocardiogram can be reconstructed. In 57 fetuses studied, recurrent atrial and ventricular ectopic beats were the most common prenatal arrhythmias. However, atrial flutter, ventricular tachycardia, atrial and ventricular bigeminy and atrial and ventricular bradyarrhythmias have been correctly identified and in some instances appropriately treated. Marked fetal bradycardia in the midtrimester of pregnancy is shown for the first time to be caused by transducer pressure on the maternal abdominal wall. PMID- 3537062 TI - Pharmacology of heparin and warfarin. AB - Thromboembolic obstruction to three major components of the circulation- arterial, venous and intravascular foreign surfaces--contributes to premature death and disability in Western society. In many, but not all, of these conditions associated with thromboembolism, heparin and warfarin are the drugs of choice. It is the purpose of this presentation to provide some common ground in the area of anticoagulant prophylaxis that will be of intrinsic value for decision making in cardiac, cerebral and peripheral vascular disease. Only those aspects of the hemostatic mechanism most relevant to the antithrombotic action of heparin and warfarin are discussed. Assays for both drugs as well as some practical guidelines for their use in low, medium and high dose regimens are outlined. Techniques for improving the benefit/risk ratio for each drug are specifically detailed. PMID- 3537063 TI - Epidemiology and pathogenesis of venous thrombosis. AB - Venous thrombi are intravascular deposits composed predominantly of fibrin and red blood cells with a variable platelet and leukocyte component. They frequently arise in large venous sinuses in the calf, in valve cusp pockets either in the deep veins of the calf or thigh or in venous segments that have been exposed to direct trauma. Venous thrombosis can be produced experimentally by a combination of stasis and systemic hypercoagulability or by stasis and endothelial damage. Thrombosis is augmented if the fibrinolytic mechanism is inhibited or defective. A number of clinical conditions and laboratory abnormalities are associated with and predispose to venous thrombosis and, in many of these, it is possible to identify one or more of the thrombogenic factors discussed. Venous thromboembolism (venous thrombosis and pulmonary embolism) is a serious and potentially fatal disorder that usually complicates the course of sick hospitalized patients, but occasionally affects ambulant and otherwise healthy individuals. Screening studies with iodine-125 fibrinogen leg scanning, impedance plethysmography and perfusion lung scanning have shown that the majority of venous thrombi and pulmonary emboli that occur in hospitalized patients are small and asymptomatic, and it is likely that most are clinically insignificant. In bedridden patients, most thrombi commence in the calf and are asymptomatic. When a calf vein thrombus extends into the proximal venous segment, the risk of clinically significant pulmonary embolism increases. Less is known about the incidence and clinical significance in a nonhospital population; although asymptomatic disease occurs, its frequency is unknown. In contrast to the patients with asymptomatic venous thrombosis, symptomatic patients with venous thrombosis usually have large occulsive thrombi localized in their proximal veins. PMID- 3537064 TI - Clinical features and diagnosis of venous thrombosis. AB - The clinical diagnosis of venous thrombosis is inaccurate because the clinical findings are both insensitive and nonspecific. The sensitivity of clinical diagnosis is low because many potentially dangerous venous thrombi are clinically silent. The specificity of clinical diagnosis is low because the symptoms or signs of venous thrombosis all can be caused by nonthrombotic disorders. For these reasons, a practical approach for the diagnosis of venous thrombosis is important. A current approach to the diagnosis of clinically suspected venous thrombosis favors the use of impedance plethysmography over Doppler ultrasonography as the main test for this disorder. This is because impedance plethysmography is precise and objective, whereas the interpretation of Doppler ultrasonography is subjective and requires considerable skill and experience to form reliable diagnoses. The use of serial impedance plethysmography has been evaluated recently in a prospective study. The rationale of repeated impedance plethysmography evaluation is based on the premise that calf vein thrombi are only clinically important when they extend into the proximal veins, at which point detection with impedance plethysmography is possible. Therefore, by performing repeated examinations with impedance plethysmography in patients with clinically suspected venous thrombosis, it is possible to identify patients with extending calf vein thrombosis who can be treated appropriately. Impedance plethysmography is performed immediately on referral; if it is positive in the absence of clinical conditions that are known to produce falsely positive results, the diagnosis of venous thrombosis is established, and the patient is treated accordingly. If the result of the initial impedance plethysmography evaluation is negative, anticoagulant therapy is withheld, and impedance plethysmography is repeated the following day, again on day 5 to 7 and on day 10 to 14. If impedance plethysmography becomes positive during this time, a diagnosis of venous thrombosis is made and anticoagulant therapy is commenced. Positive impedance plethysmography in the presence of conditions known to produce a false positive result (for example, congestive cardiac failure) should be confirmed by venography. If noninvasive tests for the diagnosis of venous thrombosis are not available, a clinical suspicion of venous thrombosis should be objectively confirmed or excluded by performing ascending venography. PMID- 3537065 TI - Diagnosis of pulmonary embolism. AB - The clinical diagnosis of pulmonary embolism is highly nonspecific because none of the symptoms or signs of pulmonary embolism is unique and all may be caused by other cardiorespiratory disorders. Thus, objective testing is mandatory to either confirm or exclude a diagnosis of pulmonary embolism. Based on current available information, a diagnostic approach for the management of clinically suspected pulmonary embolism is proposed. After a history and physical examination, electrocardiogram and chest X-ray film, all patients should undergo perfusion lung scanning. The finding of a normal perfusion lung scan rules out clinically significant pulmonary embolism, and anticoagulant therapy is withheld. The management of patients with an abnormal perfusion lung scan is more complex. If this scan demonstrates one or more segmental (or greater) perfusion defects, ventilation lung scanning should be performed because the probability of pulmonary embolism is markedly increased if a mismatch is found, with a high probability scan (positive predictive value 86%) providing an end point for commencing anticoagulant therapy in the majority of patients. In an abnormal ventilation-perfusion study, the presence of a ventilation-perfusion match does not rule out the possibility of pulmonary embolism, and further objective testing is required in these patients with nonhigh probability scans. Similarly, in patients with small perfusion defects (one or more subsegmental defects) or indeterminate lung scan findings (in which the perfusion scan defects correspond to a defect on a chest X-ray film), the predictive values obtained from these ventilation-perfusion scan patterns are not sufficiently high or low to confirm or exclude the presence of pulmonary embolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537067 TI - Preventive and therapeutic approach to venous thromboembolic disease and pulmonary embolism--can death from pulmonary embolism be prevented? AB - Venous thromboembolism produces chronic sequelae in the legs and occasional immediate mortality due to pulmonary embolism. Because it occurs in certain high risk situations (for example, after surgery) its prevention is a practical proposition. This has been attempted using many different approaches. Administration of low dose heparin with or without dihydroergotamine to enhance venous return has been one of the most widely tested regimens. There is little doubt that this can prevent, in many patient groups, postoperative deep venous thrombosis and fatal pulmonary embolism, with a low incidence of adverse reactions. Some particularly high risk postoperative patient groups (for example, those undergoing hip surgery) warrant more aggressive measures to prevent thrombosis. Surveys have shown that increasing use is being made of this approach, and it is hoped that all surgeons will adopt a policy that will reduce postoperative venous thrombosis and pulmonary embolism. A reduction in the incidence of venous thromboembolism in large acute myocardial infarction is achieved by low dose heparin, although early mobilization is important. In addition, many of the patients at risk merit full dose anticoagulation to prevent intracardiac thromboembolism. Established venous thrombosis is treated effectively by intravenous heparin, followed by warfarin to keep the prothrombin time at 1.2 to 1.5 times control, as assessed using rabbit thromboplastin; most patients need three months of treatment. Anticoagulation is warranted for pulmonary embolism, with fibrinolytic therapy reserved for patients with massive embolism and hemodynamic compromise. Embolectomy is a heroic measure, which may occasionally be lifesaving. PMID- 3537066 TI - Venous thromboses in particular organs. AB - Although venous thrombosis most often occurs in the return circulation of the legs and pelvis, it may also occur in the veins of several organs and compromise venous return. Thus, the clinician, in any field will regularly be confronted with manifestations of venous thrombosis in particular organs. This review summarizes the pathogenesis and the main clinical features of venous thrombosis in the central retinal vein, the cerebral veins and sinuses of the skull, the renal and the portal veins and the hepatic and mesenteric veins as well as priapism. The principles of treatment are outlined. PMID- 3537068 TI - Disseminated intravascular coagulation. AB - Known variously as disseminated intravascular coagulation, defibrination consumption coagulopathy or, more simply, as defibrination, disseminated intravascular coagulation is a serious epiphenomenon that occurs most often as a complicating factor of an underlying disease process. Although frequently triggered by underlying disease such as infection or tumor, if not recognized and treated appropriately, disseminated intravascular coagulation alone may lead to the patient's death as a result of hemorrhage or thrombosis, or both, of vital organs. Frequently, it may only manifest itself as an abnormality of coagulation tests, causing no immediate problem for the patient, and potentially normalizing when the inciting cause is appropriately managed. The central process that marks disseminated intravascular coagulation is the generation of thrombin in the circulating blood by means of the activation of the coagulation mechanism, leading to the conversion of fibrinogen to fibrin, which, in turn, may lead to thrombosis mainly of the microcirculation. Because platelets and coagulation factors are consumed and fibrinolysis is enhanced during the coagulation process, hemorrhage may also ensue. Although disseminated intravascular coagulation is frequently encountered in medical and obstetric patients, the difficulty in diagnosis and controversy regarding optimal therapy are frustrating for both patient and physician. By understanding the pathophysiology of disseminated intravascular coagulation and combining clinical observation and laboratory data, one can arrive at the appropriate diagnosis. Therapy must be individualized, and assessment of the benefit versus risk ratio of intervention must be made. Early recognition of acute and life-threatening disseminated intravascular coagulation can be lifesaving with appropriate supportive measures. PMID- 3537069 TI - Role of platelet activation and fibrin formation in thrombogenesis. AB - Further progress in the search for more effective but safe antithrombotic agents is coupled to an improved understanding of the factors involved in arterial and venous thrombogenesis. Although arterial thrombosis is initiated by formation of a layer of platelets on modified endothelium or subendothelial constituents and subsequent recruitment of passing-by platelets, this phenomenon is not sufficient to lead to a full thrombus. Further growth of such a platelet mass depends, to a large extent, on the presence of free thrombin. Thrombin is mainly generated by activation of factor XI on the platelet contact with collagen. In addition, thrombin leads to formation of fibrin, which maintains the stability of the arterial platelet thrombus and is the main component of the venous thrombus. The search for agents that inhibit platelet activation and thrombin formation is, therefore, a logical endeavor. PMID- 3537071 TI - Role of antithrombotic therapy in unstable angina, myocardial infarction and sudden death. AB - The role of platelets and the clotting system in the initiation and progression of atherosclerosis has received significant attention. Most importantly, platelets and thrombosis play a pivotal role in the pathogenesis of the acute coronary syndromes of unstable angina, myocardial infarction and sudden death. In each stage of the development of coronary artery disease, from the early symptomatic stage through the growing lesion and finally to the complicated plaque that results in the precipitation of the acute coronary syndromes, platelets and the clotting system serve as a common link among them. Antithrombotic therapy aimed at halting the progression of these syndromes, preventing their occurrence or even reversing them (such as in the early stages of acute myocardial infarction), has provided exciting new modalities to treat these disorders. The use of aspirin in unstable angina in two well designed studies has clearly shown a reduction in fatal as well as nonfatal cardiac events compared with control groups not treated with aspirin. Although demonstration of a benefit of anticoagulant and antiplatelet therapy is difficult owing to a low event rate of thrombotic events (low sensitivity) and other nonthrombotic fatal events (low specificity) after myocardial infarction, pooled results have shown a favorable effect with their use. The usefulness of thrombolytic therapy in the early stages of acute myocardial infarction depends on the timing of initiation of therapy, the severity of the residual stenosis and possible use of agents that protect the ischemic myocardium. Other potential therapies for the acute coronary syndromes are also suggested. Further studies are in progress to establish the clinical benefits of antithrombotic agents in acute coronary syndromes. PMID- 3537070 TI - Antithrombotic therapy in patients with valvular heart disease and prosthetic heart valves. AB - Indications and the type of antithrombotic therapy for the prevention of thromboembolism in patients with valvular heart disease, mechanical prosthetic heart valves and bioprosthetic heart valves are discussed. The evidence for these clinical recommendations is described and graded into five levels. The indications for anticoagulation in patients with valvular heart disease are chronic or paroxysmal atrial fibrillation, sinus rhythm with a very large left atrium, severe left ventricular dysfunction or presence of heart failure or a history of previous thromboembolism. Anticoagulant therapy is administered to prolong the prothrombin time to 1.5 to 2.0 times control, using rabbit brain thromboplastin (standardized international normalized ratio = 3.0 to 4.5). Risk factors for thromboembolism in patients with prosthetic heart valves are discussed. Because intracardiac thrombus formation may start during and continues early after operation, restarting heparin therapy 6 hours after operation and continuing it for the duration of the hospitalization is advised. For mechanical prosthetic heart valves, oral anticoagulation as outlined plus dipyridamole is advised indefinitely. Platelet inhibitor therapy alone is insufficient. For bioprosthetic heart valves, heparin is followed by oral anticoagulation as outlined for 3 months after mitral or aortic valve replacement and indefinitely after mitral valve replacement if there is atrial fibrillation or a very large left atrium; aspirin may be recommended indefinitely after aortic valve replacement. Antithrombotic therapy is also considered for four special situations: noncardiac surgery, prosthetic valve endocarditis, anticoagulation after a thromboembolic event, and antithrombotic therapy during pregnancy. PMID- 3537072 TI - Thrombosis and embolism from cardiac chambers and infected valves. AB - In a number of cardiac conditions (acute myocardial infarction, chronic left ventricular aneurysm, dilated cardiomyopathy, infective endocarditis and atrial fibrillation in the absence of valvular disease), the risk of embolism gives cause for concern. Although anticoagulation with warfarin (Coumadin)-derivatives has been shown to be effective in some of these situations, there is no evidence regarding the role of antiplatelet agents. The common factor in the thromboembolic potential of acute myocardial infarction, chronic left ventricular aneurysm and dilated cardiomyopathy is mural thrombus. This can be detected by two-dimensional echocardiography and indium-111 platelet scintigraphy. Although of value in elucidating the natural history of mural thrombus, in most cases, management is not substantially aided by these investigations. In patients with extensive myocardial infarction, particularly anterior infarction, moderate intensity anticoagulation started soon after hospital admission reduces the rate of embolism. After 8 to 12 weeks, embolic risk is low so that anticoagulants can usually be discontinued. Patients with chronic left ventricular aneurysm have a low incidence of embolism; anticoagulation is, therefore, inappropriate. Dilated cardiomyopathy is associated with a high risk of embolism; moderate intensity anticoagulation may be advisable in many such cases. Little information is available regarding the incidence of thromboembolism or the role of antithrombotic therapy in the patient with a diffusely dilated left ventricle due to ischemic heart disease. In native valve infective endocarditis, the risk of hemorrhage is high, and the efficacy of conventional anticoagulants unclear; thus, anticoagulation should not be instituted for the cardiac condition as such. However, in prosthetic valve endocarditis, the risk of embolism seems to be very high, and anticoagulant therapy should be continued, but with great care because there is a substantial risk of cerebral hemorrhage. Atrial fibrillation in patients with valvular heart disease is dealt with in a previous review. Patients with nonvalvular atrial fibrillation are at varying risk of embolism, depending on the etiology of the arrhythmia; trials of antithrombotic therapy are needed for the various subsets of patients. In most elderly patients, the etiology is not known, and their stroke risk is high. The risk of embolism in younger patients with idiopathic atrial fibrillation is so low as to make any antithrombotic therapy unnecessary.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537074 TI - Atherosclerosis: an insulin-dependent disease? AB - Evidence is reviewed that dietary habits in industrially developed countries, especially an increased frequency of ingestion of foods of high energy density, may contribute to excessive hepatic cholesterol synthesis and to a preponderance of lipogenic versus lipolytic effects on the arterial intima, thereby favoring the formation and progression of atheroma. These effects are mediated by the rise and fall of circulating insulin levels. The evidence is suggestive of the possibility that frequent and prolonged exposure of the arterial wall to high circulating levels of insulin may favor the development of atherosclerotic lesions. Research on diet-atherosclerosis relationships should take into account not only overall diet composition but individual meal composition and size and their effects on serum insulin levels, as well as meal spacing and the relative durations of absorptive and postabsorptive periods during the 24-hour daily cycle. PMID- 3537073 TI - Thromboembolism and antithrombotic therapy in cerebrovascular disease. AB - The use of antithrombotic therapy of any type assumes a thrombotic mechanism for the patient's brain ischemia. Typical, but by no means specific, clinical and radiologic features of atherothrombotic, lacunar and embolic brain ischemia are outlined. The indications for anticoagulant therapy include progressing stroke and cardiogenic brain embolus. According to previous randomized trials, transient ischemic attacks should be managed with aspirin, 1.0 to 1.5 g daily, pending the results of studies of smaller aspirin doses and other platelet-active drugs. In patients with a suspected cardiogenic brain embolus, anticoagulation should be withheld pending the results of a computed tomographic scan done 24 to 48 hours from onset. If there is no evidence of hemorrhagic transformation or a large area of infarction and the patient does not have sustained hypertension, heparin therapy should be initiated in an effort to prevent a recurrent embolus. PMID- 3537075 TI - A crossover trial of high and low sucrose-carbohydrate diets in type II diabetics with hypertriglyceridemia. AB - Earlier work shows that hyperlipemic type II diabetics tolerate wide ranges of sucrose and carbohydrate intake without effects on glycemic control, but a rise of fasting serum triglycerides sometimes occurs. To address further the issue of individual susceptibility to carbohydrate, the current study was designed to use each patient as his own control when given diets widely varying in sucrose content. After a stabilization period in the hospital on a normal sucrose content diet, each subject was given either a very low sucrose (less than 3 gm/day)-low carbohydrate (38 +/- 2%) diet or a high sucrose (220 gm)-high carbohydrate (63 +/ 3%) diet for 4 weeks. On a separate admission the opposite diet was assessed, again after an initial normal sucrose content diet. No consistent differences occurred in serum glucose levels or in 24-hr urinary glycosuria. High sucrose carbohydrate intake raised fasting hypertriglyceridemia after 2 weeks but less thereafter. Severe sucrose-carbohydrate restriction did not significantly decrease fasting serum triglycerides; postprandial triglycerides changed in a trend opposite to fasting levels. No differences occurred in fasting serum insulin or serum cholesterol levels, but postprandial insulin levels were higher in high sucrose-carbohydrate diets. A diet with low sucrose and low total carbohydrate appears to offer no improvement in glycemic control over at least 70 fold higher dietary sucrose levels. However, high sucrose and carbohydrate diets increase fasting triglyceride levels in hypertriglyceridemic type II diabetics. PMID- 3537076 TI - Gastrointestinal infections--dietary interactions. AB - Considerable progress has been made in understanding the complexities involved in the production of bacterial diarrheal diseases. The general mechanisms of disease that have been recognized include enterotoxigenicity, enteroadherence, and invasiveness. The interplay of epithelial cell surface receptors with the surface components of the various bacterial pathogens or their toxins will be reviewed. Knowledge of the stereospecific interactions of bacterial ligands with the eukaryotic receptors has led to the development of new strategies for prevention and therapy. The presence of foodstuffs in the intestinal lumen can contribute by a number of mechanisms to interference with the invading organism's attack on the intestinal cell surfaces. The effects of milk fat and plant lectins on the colonization of the bowel by enteric organisms is discussed. PMID- 3537077 TI - Magnesium and lipids in cardiovascular disease. PMID- 3537078 TI - Magnesium and cardiac arrhythmias: nutrient or drug? AB - The antiarrhythmic potency of Mg has been described repeatedly since 1935, both as a factor in human disease and in animal experiments. Nevertheless, this therapeutic efficacy is rarely mentioned in textbooks. Both the pharmacological effect of Mg and the correction of Mg deficiency have been used in treatment of digitalis toxicity, variant angina, Torsades de Pointes, as well as in arrhythmia of unknown origin. Mg-deficiency can be caused by malabsorption or by excessive urinary loss. Both situations can occur on a congenital basis. The most frequent cause is probably alcoholism. Iatrogenic factors include digitalis, diuretics, gentamicin, as well as cisplatinum, which appreciably enhance urinary Mg loss. Correction of Mg-deficiency by parental and/or oral administration should lead to recovery. If the cause of the deficiency can be eliminated, once the deficit is repaired it may be acceptable to discontinue the supplement. However, the cause is often multifactorial, requiring further evaluation and treatment. PMID- 3537079 TI - The origin of airway hyperresponsiveness. AB - Consideration of the origin of airway hyperresponsiveness appears central to understanding the origin of asthma. Subjects with and without asthma differ both in the ease with which airway narrowing is produced by inhalation of histamine or methacholine and in the ability to demonstrate a maximal response to these agents. The latter appears, on present evidence, to be due to an added mechanism in asthma rather than the absence of a potent inhibitory process. Airway hyperresponsiveness is probably acquired during life as a result of airway reactions to various stimuli, although genetic factors such as atopy are likely to predispose the person to develop hyperresponsiveness. Environmental stimuli include inhaled allergens, chemical sensitizers, airway infections, immunization, and ozone. Allergen-induced airway hyperresponsiveness occurs in association with late-phase asthmatic responses. This and ozone-induced hyperresponsiveness have been demonstrated to be associated with release of chemical mediators and the cellular phase of inflammation. Their effect does not appear to be accounted for by increase in airway epithelial permeability, decrease in airway caliber, reflex bronchoconstriction, or beta-adrenoceptor blockade. The mechanism(s) responsible for the induced hyperresponsiveness are unknown but may involve airway epithelial damage, edema in and around the airway walls, stimulation of the noncholinergic excitatory or inhibition of the nonadrenergic inhibitory systems, or a change in function of airway smooth muscle. Airway hyperresponsiveness can be transient or persistent. Transient increases in responsiveness are almost certainly associated with mediator release and inflammation. It is not known whether persistent hyperresponsiveness is due to the same process, fired, for example, by leaky mediator-releasing cells and/or to some persisting change in neurogenic or smooth muscle function. PMID- 3537080 TI - Lung immunology and its contribution to the immunopathogenesis of certain respiratory diseases. PMID- 3537081 TI - Detection of antibodies to proteases used in laundry detergents by the radioallergosorbent test. AB - Two proteases, Esperase and Alcalase, derived from Bacillus licheniformis and B. subtilis, respectively, are used in laundry products. In testing for the prevalence of IgE antibodies to these enzymes in sera among 300 laundry product workers, we experienced two problems in the establishment of a reliable RAST for these antigens. The first problem was the propensity of the allergen, Esperase, to undergo autolysis, suggesting that solid-phase Esperase might also lose reactivity through degradation. Treatment of Esperase with phenylmethylsulfonyl fluoride stabilized the enzyme and permitted the synthesis of a stable solid phase antigen. The second problem was the finding that sera reactive with Esperase in the RAST were also reactive with Savinase, an enzyme from B. licheniformis to which the workers were not exposed. Immunochemical analyses of the three enzymes with specific rabbit antisera by gel diffusion and by two-site immunoradiometric assay demonstrated that they were not cross contaminated to any appreciable extent. RAST inhibition demonstrated that solid-phase Esperase possessed unique allergenic determinants in that the reactivity of IgE antibodies was inhibited by low concentrations of Esperase and only by very high concentrations of Alcalase and Savinase. In contrast, the reactivity of solid phase Alcalase was occasionally inhibited equally well by Esperase and Alcalase. Most strikingly, the reaction of IgE antibodies with solid-phase Savinase was always inhibited by comparable quantities of Esperase, Alcalase, and Savinase. Thus, the establishment of the RAST for these proteases appears to require the use of phenylmethylsulfonyl fluoride to retard autolysis, and the results must be interpreted with caution because IgE antibodies in certain sera demonstrate cross reactivity with Alcalase and Savinase. PMID- 3537082 TI - Predictive accuracy of late asthmatic reaction to Dermatophagoides pteronyssinus. AB - Sixteen patients with asthma were challenged with solutions of Dermatophagoides pteronyssinus extracts. Fifteen patients demonstrated an early asthmatic reaction, and 10 patients also demonstrated a late asthmatic reaction, as demonstrated by a 15% decrease of FEV1 within 1 hour or between 3 and 8 hours after challenge, respectively. Airway responsiveness to inhaled methacholine, expressed as the dose causing a fall of FEV1 of 15% (Pd15), and the serum IgE level (RAST), expressed as percent of the total radioactivity added, were also measured. Multiple regression analysis of data demonstrated that both early asthmatic reaction, expressed as the allergen Pd15, and late asthmatic reaction, expressed as the FEV1 maximum fall from control values, can be predicted with similar accuracy (explained variance of 63% and 68%, respectively) by a model that incorporates simultaneously methacholine Pd15, percent of total radioactivity added by RAST, and baseline values of FEV1. We conclude that the late asthmatic reaction is more likely to occur and is more severe in patients with more severe underlying disease. PMID- 3537083 TI - Allergen absorption in the intestine: implication for food allergy in infants. PMID- 3537085 TI - Predictive value of tests in childhood allergy. PMID- 3537084 TI - Effect of respiratory and other virus infections on IgE immunoregulation. PMID- 3537086 TI - Preventive measures in early childhood allergy. PMID- 3537087 TI - Smoking and atmospheric pollution. PMID- 3537088 TI - Food antigens and additives. PMID- 3537089 TI - Preventive allergy: genetics of IgE-mediated diseases. PMID- 3537090 TI - Cellular abnormalities in patients with elevated serum IgE levels. PMID- 3537091 TI - Late bronchial response and increase in methacholine hyperresponsiveness after exercise and distilled water challenge in atopic subjects with asthma with dual asthmatic response to allergen inhalation. AB - We investigated the occurrence of late asthmatic response and increased methacholine responsiveness after exercise and ultrasonically nebulized distilled water (UNDW) inhalation in 12 subjects with asthma with dual asthmatic response and increased responsiveness after allergen challenge. On 3 separate days, allergen, exercise, and UNDW challenges were performed 2 hours after methacholine. FEV1 was measured for 8 hours to detect any delayed change in airway caliber. If there were a further significant reduction in FEV1 after the recovery from the immediate bronchoconstriction, methacholine challenge was performed again when FEV1 had returned to baseline. Reproducibility of any observed late response to exercise and UNDW was also investigated by repeating these challenges on 2 subsequent days. After allergen inhalation only nine subjects had an early asthmatic response, whereas all the tested subjects demonstrated a late reaction and increased methacholine responsiveness. Ten subjects had an immediate response to exercise, and this was followed by a late response in only four patients. Nine subjects demonstrated early response to UNDW inhalation, and five subjects also had a late reaction. These late responses were associated with an increase in methacholine responsiveness in a subset of the tested subjects. Late-phase reactions to exercise and UNDW were not reproducible. PMID- 3537092 TI - Extrapulmonary effects of maintenance therapy with theophylline and inhaled albuterol in patients with chronic asthma. AB - The extrapulmonary effects of slow-release theophylline and an inhaled beta 2 agonist (albuterol) were examined separately and in combination among 18 adults and adolescents with asthma during a 3-month randomized, double-blind, crossover trial. Although neither global impressions nor daily diaries revealed differences in adverse effects, a structured questionnaire completed at the end of each regimen suggested a small but statistically significant increase in nausea and depressive and caffeine-like symptoms during the theophylline-containing regimens. Theophylline was also associated with improved verbal learning but decreased motor steadiness. Metabolic effects associated with theophylline included lower serum bicarbonate, greater urinary calcium excretion, and higher serum calcium, uric acid, and creatinine. Albuterol was associated with lower neutrophil counts and lower serum theophylline concentrations. There were no drug induced effects on cardiac rhythm. PMID- 3537093 TI - A double-blind placebo-controlled trial of polymerized whole grass administered in an accelerated dosage schedule for immunotherapy of grass pollinosis. AB - Forty-four patients were entered into a study of the efficacy and safety of individually polymerized grass (IPG) immunotherapy with an accelerated dosage schedule. Patients were paired on the basis of cutaneous end point titrations to timothy, orchard, and Bermuda grass-pollen extracts. In a double-blind manner, one patient in each pair was treated in nine weekly visits with 13 injections that totaled 24,000 PNU of each grass to which the patient had cutaneous reactivity. The other patient in each pair received caramelized glucose histamine placebo. Symptom and medication score sheets were completed by 33 patients each day of the grass season. Blocking antibody rose significantly in the IPG-treated group but was unchanged in the placebo-treated group. By Wilcoxon paired signed rank test, the symptom medication scores in the IPG-treated group were significantly lower than those in the placebo-treated group. There were no systemic reactions and no clinically significant changes in routine laboratory tests in either group. In summation, this study demonstrates the safety, immunogenicity, and efficacy of IPG therapy in an accelerated dosage schedule for treatment of grass pollinosis. PMID- 3537094 TI - Antidepressants and the elderly. AB - The pharmacologic treatment of depression in the elderly is often complicated by cardiovascular disease and other medical illnesses. Both the tricyclic antidepressants and the monoamine oxidase (MAO) inhibitors have adverse effects that are potentially dangerous in this age group. Second generation antidepressants may have fewer cardiovascular and anticholinergic side effects, but many do not offer any real advantage over the older drugs. In practical terms, the choice of antidepressants for use in elderly patients will be based largely on their degree of tolerance for unwanted effects. PMID- 3537095 TI - Skills training with supporters of the demented. AB - This study examined the effects of Supporter Endurance Training (SET) on family supporters of elderly demented patients. Single case methodology was used in evaluating the outcome of providing eight supporters with eight weekly training sessions in meditative relaxation and assertiveness. Four such supporters received no special training. A videotape dramatizing typical problem situations encountered with a demented family member was used to elicit information about supporters' coping styles. Post-training and six-month follow-up evaluation indicated improvements among trained individuals on measures related to assertiveness, problem solving, and stress reduction. Trained subjects' estimates of the length of time they would be able to cope with problems involved in caring for their relatives also increased. Few such improvements occurred among untrained subjects. These results suggest the usefulness of brief structured skills training programs in helping supporters to improve their coping abilities. PMID- 3537096 TI - Autopsy: seventy-five years after Cabot. PMID- 3537097 TI - Enzyme-linked immunolysis assay for tumour-specific surface antigens. AB - Expression of the activity of the cytosolic enzyme lactate dehydrogenase released on cell lysis by tumour specific antibodies in the presence of complement was investigated by direct assay of the expression of the occluded enzyme in tumour cell suspensions. This method, called Enzyme Linked Immunolysis Assay (ELILA) was shown to be more sensitive than conventional cytotoxic assays. The data fit well in the linear regression model, so that the technique can be used for quantitation of the antibody titres. PMID- 3537098 TI - Current concepts in craniofacial anomalies. A symposium in honor of Joseph J. Bonner. 1-2 August 1985. PMID- 3537099 TI - Computed tomography of podiatric disorders: a review. AB - Computed tomography has become invaluable in diagnosing various disorders of the foot and ankle. Because it provides a three-dimensional range of views of both soft tissue and osseous anatomy and depicts the spatial relationship between structures, it has many advantages over conventional methods. With the use of computed tomography, it is now possible to view the foot in a variety of planes by placing the patient in various positions. PMID- 3537100 TI - Bone grafts in the management of osteomyelitis. AB - Chronic osteomyelitis is a condition that requires aggressive surgical treatment in combination with adequate antibiotic therapy. The use of autogenous cancellous bone grafts to fill the defect created by radical sequestrectomy is an effective way of returning function and stability to the involved part and should, therefore, be considered a viable treatment modality by podiatric surgeons who deal with this type of problem. PMID- 3537101 TI - Effect of sodium ipodate and iodide on free T4 and free T3 concentrations in patients with Graves' disease. AB - Graves' hyperthyroid patients were treated daily for 10 days with 1 g sodium ipodate, a cholecystographic agent which exerts a blocking effect on the peripheral conversion of T4 to T3, or with 12 drops of saturated solution of potassium iodide (SSKI). Serum concentrations of free T4 (FT4) and free T3 (FT3) were measured before, during and 5 and 10 days after the administration of each drug. Sodium ipodate treatment induced a rapid decrement of serum FT4 concentrations which declined from 48.9 +/- 6.6 pg/ml to 26.0 +/- 2.7 pg/ml. In these patients serum FT3 concentrations declined from 12.4 +/- 2.0 pg/ml to 2.5 +/- 0.4 pg/ml. Ten days after sodium ipodate withdrawal, serum FT4 and FT3 concentrations returned to baseline values. In patients treated with SSKI serum FT4 concentrations declined from 51.1 +/- 8.8 pg/ml to 11.3 +/- 1.4 pg/ml and FT3 from 15.7 +/- 2 pg/ml to 2.6 +/- 0.3 pg/ml. Moreover, after therapy interruption serum free thyroid hormone concentrations returned to baseline values in these patients. Serum FT4 pattern during the study was not different between the two groups of subjects whereas serum FT3 concentrations were significantly lower in patients treated with sodium ipodate. These findings indicate that SSKI and sodium ipodate are effective in inducing a rapid decrement of serum free thyroid hormone concentrations. Therefore the employment of these drugs may be useful in the treatment of patients with thyroid storm and those undergoing thyroidectomy. PMID- 3537103 TI - [Removable partial denture cases: 2. The components of removable partial dentures]. PMID- 3537104 TI - "Opposed to pain": a history of the Antikamnia Chemical Company. PMID- 3537102 TI - The endocrine effects of ketoconazole. PMID- 3537105 TI - Medical museum notes (Dr. John Stough Bobbs). PMID- 3537106 TI - Meniere's disease. PMID- 3537107 TI - A comparison of peroxidase-antiperoxidase, avidin-biotin immunoperoxidase methods. PMID- 3537108 TI - [ Human enamel cracks and crazes caused by high speeds cutting technics ]. PMID- 3537109 TI - [Experimental studies on the retentive force of telescope crowns]. PMID- 3537110 TI - [Evaluation of denture adhesives]. PMID- 3537112 TI - [An experimental study on the mechanism of infection on the adherence of Escherichia coli to cultured oral epithelial cells]. PMID- 3537111 TI - [The effect of palatal plate thickness on masticatory function and phonetics]. PMID- 3537113 TI - Luminescent detection method for immunodot, Western, and Southern blots. AB - An anti-peroxidase-anti-biotin hybrid hybridoma rat cell line, capable of producing a bispecific monoclonal antibody, has been derived to explore its use in conjunction with a luminol immunodetection system. Luminescence was detected using x-ray film. The method was sufficiently sensitive and effective, but was less sensitive than autoradiographic methods using high-specific-activity 32P labeled probes. Exposure times, on the other hand, were of the order of seconds rather than days. The direct binding of both peroxidase and biotin by the bispecific monoclonal antibody is simpler but less sensitive than the more conventional indirect method using a commercial peroxidase coupled with anti-rat antibody as a developing antibody. PMID- 3537115 TI - An outbreak of gastroenteritis on a passenger cruise ship. AB - In an outbreak of gastroenteritis on board a cruise ship 251 passengers and 51 crew were affected and consulted the ship's surgeon during a 14-day period. There was a significant association between consumption of cabin tap water and reported illness in passengers. Enterotoxigenic Escherichia coli were isolated from passengers and crew and coliforms were found in the main water storage tank. Contamination of inadequately chlorinated water by sewage was the most likely source of infection. A low level of reported illness and late recognition of the outbreak delayed investigation of what was probably the latest in a series of outbreaks of gastrointestinal illness on board this ship. There is a need for a national surveillance programme which would monitor the extent of illness on board passenger cruise ships as well as a standard approach to the action taken when levels of reported illness rise above a defined level. PMID- 3537114 TI - Metal-catalyzed oxidation renders silver intensification selective. Applications for the histochemistry of diaminobenzidine and neurofibrillary changes. AB - Physical developers can increase the visibility of end products of certain histochemical reactions, such as oxidative polymerization of diaminobenzidine and selective binding of complex silver iodide ions to Alzheimer's neurofibrillary changes. Unfortunately, this intensification by silver coating is generally superimposed on a nonspecific staining originating from the argyrophil III reaction, which also takes place when tissue sections are treated with physical developers. The present study reveals that the argyrophil III reaction can be suppressed when tissue sections are treated with certain metal ions and hydrogen peroxide before they are transferred to the physical developer. The selective intensification of Alzheimer's neurofibrillary changes requires a pre-treatment with lanthanum nitrate (10 mM/liter) and 3% hydrogen peroxide for 1 hr. The diaminobenzidine reaction can be selectively intensified when physical development is preceded by consecutive treatments with copper sulfate (10 mM/liter, pH 5, 10 min) and hydrogen peroxide (3%, pH 7, 10 min). In peroxidase histochemistry, this high-grade intensification may help to increase specificity and reduce the threshold of detectability in tracing neurons with horseradish peroxidase or in immunohistochemistry when the peroxidase-antiperoxidase method is used. PMID- 3537116 TI - Salmonellosis in two dairy herds associated with a sewage farm and water reclamation plant. AB - Two dairy herds, situated on a sewage farm, were monitored for the presence of salmonellas following outbreaks of Salmonella dublin infection. In addition an S. dublin control scheme, which involved examination of adult animals and calf vaccination, was instigated. During the period 1975-84, 12 salmonella serotypes and 10 phage types of S. typhimurium were isolated from the cattle and their environment although their presence was seldom associated with disease. Two adult S. dublin excreters were detected but it was concluded that none of the tests employed to examine the adult animals was sensitive enough. The prevalence of disease in the calves was low and although vaccination may have been beneficial it did not eradicate S. dublin infection. Thus S. dublin persisted in adults and calves during the 8-year period but its presence was seldom associated with disease. The results are discussed with regards the disease risk to animals from the agricultural use of sewage sludge and the public health aspects. PMID- 3537117 TI - A rapid and simple method for the detection and enumeration of Escherichia coli in cleansed shellfish. AB - A multiple-tube technique based on peptone water incubated at 44 degrees C for 24 h followed by detection of indole was found to be sensitive and specific for the detection of Escherichia coli in oysters and mussels. The method has the advantage of providing rapid results and is both less expensive and less time consuming than other MPN techniques. PMID- 3537118 TI - Comparison of techniques for demonstrating antibodies to Rift Valley fever virus. AB - Nine serological techniques were compared by monitoring the response to infection with Rift Valley fever (RVF) virus in three sheep. Antibodies were monitored daily for the first 14 days after infection, then weekly and later fortnightly up to week 24. The earliest antibody response was detected in one sheep on day 3 by a plaque reduction neutralization test, and by day 6 antibodies were demonstrable in all three sheep by haemagglutination-inhibition, reversed passive haemagglutination-inhibition, immunodiffusion, indirect immunofluorescence (IF), enzyme-linked immunosorbent assay and neutralization of cytopathic effect in cell cultures. Antibodies were demonstrable by complement fixation on day 8 at the earliest. IF and the two neutralization techniques produced the highest titres, but all tests could be used satisfactorily for the serological diagnosis of RVF. Inactivated antigen could be used for all except the neutralization tests. A radioimmunoassay technique using 125I-labelled staphylococcal protein A detected antibodies on day 8 at the earliest and produced lower mean titres than some of the other techniques. This was probably because sheep immunoglobulins bind protein A poorly. PMID- 3537119 TI - Comparative pathogenicity and antigenic cross-reactivity of Rift Valley fever and other African phleboviruses in sheep. AB - Homologous and heterologous haemagglutination-inhibition (HAI), complement fixation (CF), immunodiffusion (ID) and mouse neutralization tests were performed with the Lunyo (LUN) and a Zimbabwean strain of Rift Valley fever (RVF) virus, the prototype and a South African strain of Arumowot (AMT) virus and prototype strains of Gordil (GOR), Saint-Floris (SAF) and Gabek Forest (GF) viruses, using immune mouse ascitic fluids prepared against these viruses. Reactions of identity occurred in all tests between LUN and the Zimbabwean strains of RVF and between the two strains of AMT virus. Otherwise, cross-reactions occurred between all the phleboviruses in HAI tests, while reactions in CF, ID and neutralization tests were monospecific for virus serotypes, except that weak cross-reaction occurred between GOR and SAF viruses in CF and ID tests. Four sheep infected subcutaneously with the Zimbabwean strain of RVF virus developed transient fever, viraemia, leucopaenia, relative thrombocytopaenia, haemoconcentration and raised serum enzyme levels, which indicated that the sheep had developed necrotic hepatitis. Disseminated focal necrotic hepatitis was confirmed in a sheep killed for examination on day 4 post-infection. The other three sheep recovered uneventfully after only mild depression and anorexia. Groups of three sheep infected with SAF, GOR, AMT and GF viruses had no demonstrable viraemia or other sign of infection or illness, except that the sheep infected with AMT developed mild fever lasting less than 24 h. Antibody responses were monitored at intervals over a period of 24 weeks in all sheep by homologous and heterologous HAI, CF and cell culture neutralization (CPENT) tests. Homologous antibody responses were marked in the RVF-infected sheep and their sera cross-reacted strongly in HAI tests with antigens of the other viruses. The sera of the RVF-infected sheep cross-reacted less markedly in CF and CPENT tests. Homologous antibody responses were poor in all the sheep infected with phleboviruses other than RVF, and the cross-reactivity of their sera for RVF antigen or virus was negligible. All sheep were challenged with RVF virus 48 weeks after their initial infection. The sheep which had originally been infected with RVF virus were immune and developed neither fever nor viraemia. All other sheep developed fever, viraemia and antibodies to RVF virus. It was concluded that the African phleboviruses, other than RVF, are unlikely to cause disease in livestock or to induce antibodies which could cause confusion in the diagnosis of RVF. PMID- 3537120 TI - The effects of polyinosinic:polycytidylic acid (pI:C) on the graft-vs-host (GVH) reaction. II. Increased NK-mediated rejection on C57BL/6 lymphocytes by (C57BL/6 X A)F1 mice. AB - We previously demonstrated that treatment of (C57BL/6 X A)F1 (F1) recipient mice with polyinosinic:polycytidylic acid (pI:C) before injection with 30 X 10(6) C57BL/6 (B6) lymphocytes prevents both the immunosuppression and pathologic lesions typical of graft-vs-host (GVH) reactions. We now report the further characterization of this phenomenon. Donor spleen and lymph node cells were labeled with fluorescein in vitro and injected into pI:C-treated or untreated mice. Two days later, recipient splenocytes were analyzed for the presence of fluorescein-labeled donor cells by flow microfluorometry. Treatment of F1 mice with pI:C resulted in a sharp reduction in the recovery of labeled B6 but not A strain parental cells. Treatment with pI:C had no effect when syngeneic recipients were used, or when F1 cells were injected into A, B6, or F1 recipients. These results suggest that pI:C treatment induces rejection of B6 but not A or F1 lymphocytes by F1 hybrid mice at least as early as 2 days after donor cell transfer. As F1 cells are not rejected by either parent, rejection does not seem to be directed against classical alloantigens. These observations are compatible with the previously described model of hybrid resistance (HR) against bone marrow grafts. The rapidity of rejection strongly suggested that natural cytotoxic mechanisms were involved, thus, natural killer (NK) cell and macrophage (M phi) cytotoxic activities were tested throughout the time when the parental cell graft was being rejected. Over this period, pI:C treatment increased cytotoxic activity against the NK-sensitive target cell line YAC-1 but had no effect on spontaneous M phi tumoricidal activity against the L5178Y and MDAY-D2 cell lines. The results suggest that NK cells, but not M phi, may be involved in the elimination of B6 parental cells by the pI:C-treated F1 mice. NK cells have been demonstrated to be radioresistant; thus, as a test of our hypothesis, we examined the effects of irradiation on the capacity of pI:C treated F1 mice to reject B6 lymphocytes. The results show that this capacity was not blocked by 750 cGy, a dose of radiation that abrogates most T and B cell functions. Furthermore, rejection of parental cells could be prevented by treatment of recipient F1 mice with antibodies to asialo GM1, a treatment that suppresses NK activity. These data demonstrate that pI:C-mediated protection from GVH-induced changes is due to increased rejection of grafted B6 parental cells by F1 NK cells, a phenomenon very similar, if not identical, to HR to bone marrow grafts. PMID- 3537121 TI - Natural cellular resistance of beige mice against Cryptococcus neoformans. AB - Previous reports have demonstrated that natural killer (NK) cells are capable of inhibiting the growth of Cryptococcus neoformans in vitro, and recent studies indicate that adoptively transferred NK cell-enriched spleen cell populations enhance clearance of cryptococci from the tissues of cyclophosphamide-pretreated recipients. The primary objective of these studies was to confirm that NK cells participate in early clearance of C. neoformans in vivo. Secondarily, the anti cryptococcal activities of polymorphonuclear leukocytes and macrophages were examined. Seven-week-old C57BL/6 bg/+ mice, which have normal levels of NK cell activity, were compared with their bg/bg littermates, which have impaired NK cell function. One and 3 days after injecting both groups of mice i.v. with 2 X 10(4) cryptococci, we assessed the NK cell activities in spleens, lungs, and livers and clearance of the organism from corresponding tissues as determined by the mean log10 numbers of cryptococcal colony-forming units (CFU) per organ. Three days postinfection, the mean numbers of cryptococcal CFU in lungs and spleens of bg/+ mice were significantly lower than in the corresponding organs of bg/bg mice. NK cell activities in spleens and lungs of bg/+ mice were significantly higher than were the NK cell activities in similar cell populations from bg/bg mice. In contrast, the mean numbers of cryptococcal CFU in livers of the two groups of animals were nearly equivalent, a situation not unexpected, since liver NK cell activities were extremely low and similar in both groups of animals. Although these data indicated a correlation between early clearance of cryptococci from tissues and levels of NK cell activities in the corresponding tissues, it was also possible that differences in phagocytic cell function between the bg/+ and bg/bg animals could account for the observed differences in clearance of cryptococci from the tissues. Therefore, phagocytic cells from the two groups of animals were compared with respect to their abilities to phagocytize and inhibit the growth of cryptococci and to their abilities to respond to chemotactic stimuli in vivo. Peritoneal PMNL from bg/+ and bg/bg mice were similar in their abilities to phagocytize and inhibit the growth of cryptococci, as well as in their chemotactic responses to viable cryptococci or sodium caseinate. In addition, there were no differences in splenic macrophage functions between the two groups of mice.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537122 TI - Induction of c-fos and c-myc expression in T lymphocytes after treatment with recombinant interleukin 1-alpha. AB - Our data demonstrate that an early-acting differentiation/growth factor, such as IL 1, can induce the sequential expression of c-fos and c-myc in lymphocytes. Because such a wide variety of agents induces c-onc expression in lymphocytes, we conclude that the expression of these cellular proto-oncogenes represents a common pathway of response of lymphocytes to an exogenous stimulatory signal regardless of the nature of the factor and its receptor. PMID- 3537123 TI - A human autoreactive T cell line specific for minor histocompatibility antigen(s) isolated from a bone marrow-grafted patient. AB - A human autoreactive T cell line named Bur-1 has been obtained from a woman 4 mo after an allogeneic bone marrow transplantation (BMT) from one of her HLA identical brothers. The phenotype of the cell line is 100% T11+ and over 90% T4+, and the karyotype confirms its donor (male) origin. These donor T cells proliferate specifically in the presence of donor's peripheral blood monocytes (PBM) but not recipient's cells, and they kill specifically donor's but not recipient's Epstein-Barr virus (EBV)-induced lymphoblastoid cell lines (LCL). PBM from another HLA-identical brother and from several unrelated donors also stimulate Bur-1 cells, and EBV-induced LCL from the same donors are killed in cytotoxicity assays. All of these donors share HLA-DR5 or HLA-DRw11 (the major split of HLA-DR5) with Bur-1 cells. However, some but not all of the PBM sharing HLA-DR5 with Bur-1 cells are recognized. Therefore, in contrast with the previously described autoreactive T cells, Bur-1 cells are not directed against self-MHC antigens but rather recognize autologous minor histocompatibility (mH) antigens in the context of autologous HLA class II molecules. Because both male and female cells can be recognized, the reacting minor antigen could not be the male-specific HY antigen. It is suggested that autoreactivity against mH antigens can be observed in bone marrow-grafted patients due to the education of bone marrow donor precursors in the recipient thymus not allowing tolerance to autologous (donor) mH antigens not shared by the recipient. PMID- 3537124 TI - Islet cell and 64K autoantibodies are associated with plasma IgG in newly diagnosed insulin-dependent diabetic children. AB - There is a high prevalence of islet cell antibodies (ICA) and autoantibodies detected against an islet cell protein of Mr 64,000 at the time of clinical diagnosis of insulin-dependent diabetes (IDDM). In view of the biphasic immune response after antigen presentation, the purpose of this study was to determine the presence of ICA and antibodies against the 64,000 islet antigen after separation of IgM from IgG to prevent interference between the two antibody classes. Plasma samples from 10 newly diagnosed IDDM children and 10 healthy controls were precipitated with polyethylene glycol (PEG), and the crude Ig was subjected to Sephacryl S-300 chromatography to separate IgM and IgG. ICA determined by indirect immunofluorescence on frozen sections of human pancreas showed reduced background immunofluorescence intensity in the purified fractions compared with crude plasma. The number of ICA-positive samples among the IDDM patients increased from 7/10 in plasma to 9/10 in the IgG fraction. There was an increase in the ICA titer in 6/9 of the positive samples. All purified IgM samples were ICA negative. Immunoprecipitation experiments by using Nonidet P-40 detergent lysates of [35S]methionine-labeled neonatal rat islets demonstrated that the 64,000 autoantibodies were in the IgG fraction. We found 7/10 IDDM samples to be positive, whereas all controls were negative. The background in the autoradiographic analysis was markedly reduced in the IgG fractions compared with immunoprecipitates with crude or PEG-purified plasma and the IgM fraction. ICA titers did not correlate to the ability of the IgG fraction to precipitate the 64,000 autoantigen. It is concluded that both the ICA and 64,000 autoantibodies are primarily of the IgG class at the time of clinical onset of IDDM, and that purification of IgG from human IDDM plasma facilitates the detection of the rat islet cell 64,000 antigen. PMID- 3537125 TI - Immunolocalization and partial characterization of a nucleolar autoantigen (PM Scl) associated with polymyositis/scleroderma overlap syndromes. AB - Precipitating anti-PM-Scl antibodies are present in sera from patients with polymyositis, scleroderma, and polymyositis/scleroderma overlap syndromes. By indirect immunofluorescence microscopy, anti-PM-Scl antibodies stained the nucleolus in cells of different tissues and species, suggesting that the antigen is highly conserved. By electron microscopy, anti-PM-Scl antibodies reacted primarily with the granular component of the nucleolus. Drugs that inhibit rRNA synthesis had a marked effect on the expression of PM-Scl antigen. In actinomycin D-treated cells, immunofluorescence staining by anti-PM-Scl was significantly reduced with residual staining restricted to the granular regions of nucleoli. Treatment with 5,6-dichloro-beta-D-ribofuranosylbenzimidazole (DRB) also selectively reduced nucleolar staining. On a molecular level, anti-PM-Scl antibodies precipitated 11 polypeptides with molecular weights (Mr) ranging from 110,000 to 20,000. The Mr 80,000 and 20,000 polypeptides were phosphorylated. Evidence suggests that the PM-Scl antigen complex may be related to a preribosomal particle. PMID- 3537126 TI - Major histocompatibility complex-encoded class I molecules are absent in immunologically competent Xenopus before metamorphosis. AB - The expression of class I and class II major histocompatibility complex (MHC) encoded antigens has been examined at various stages of the development of the clawed frog, Xenopus. By immunoprecipitation with alloantisera or xenoantisera from radio-labeled spleen and thymus lysates, and by mixed lymphocyte reaction analysis, it was determined that the same class II molecules are expressed throughout ontogeny. In contrast, by fluorescence on frozen sections of tadpoles and by immunoprecipitation, the class I molecule is not detected in tadpoles, but appears on all tissues at the climax of metamorphosis. Animals maintained as tadpoles for long periods of time by chemical treatment do express class I antigens; thus, their expression can be independent of other biochemical and morphological changes that occur at metamorphosis. Immunofluorescence detects an otherwise uncharacterized MHC-linked alloantigen on tadpole thymic epithelium from the earliest stages of thymus differentiation. PMID- 3537127 TI - Ganglioside expression in macrophages from endotoxin responder and nonresponder mice. AB - Peritoneal macrophage ganglioside patterns and ganglioside sialic acid content were compared for two congenic strains of mice having differing responses to bacterial lipopolysaccharide. Resident macrophage ganglioside patterns from C3H/HeJ mice (endotoxin hyporesponsive) and C3H/HeN mice (endotoxin responsive) were similar. Macrophages elicited with phenol-extracted or butanol-extracted endotoxin showed distinctly more complex ganglioside patterns in C3H/HeN mice. C3H/HeJ macrophages showed distinct, but less complex changes when elicited with butanol-extracted endotoxin. As expected, there were minimal alterations induced by phenol-extracted endotoxin in the C3H/HeJ patterns. When injected with whole killed E. coli, both strains of mice exhibited complex ganglioside patterns; however, there were relative differences in the quantities of multiple gangliosides. Differences in ganglioside patterns were mirrored in the relative ratios of N-acetyl- to N-glycolylneuraminic acid. When macrophages were activated by administration of either endotoxin preparation, macrophage gangliosides from C3H/HeN mice always contained a higher proportion of N-acetylneuraminic acid compared with C3H/HeJ macrophage gangliosides. Oxidative metabolism of the macrophage populations was assessed by PMA-induced H2O2 release. This indicated that endotoxin activation produced an increase in PMA-induced H2O2 release as well as a shift of sialic acid class from the N-glycolyl type to the N-acetyl type. However, no direct correlation could be made between ganglioside composition, sialic acid content, and macrophage function. These data indicate that both ganglioside composition and sialic acid composition of macrophages are profoundly altered with endotoxin activation. The data further indicate that under conditions which C3H/HeJ mice respond to Gram-negative bacteria, their macrophage ganglioside patterns still differ from normal mice. PMID- 3537128 TI - CS-A therapy in MRL-lpr/lpr mice: amelioration of immunopathology despite autoantibody production. AB - MRL-lpr/lpr mice spontaneously develop massive T cell lymphadenopathy, autoantibodies, and immune-mediated pathology. These mice are thought to be models of various human autoimmune diseases, including systemic lupus, Sjogren's syndrome, and rheumatoid arthritis. We have used cyclosporin A (CS-A) treatment as a tool by which the mechanisms of immune-mediated pathology might be dissected. CS-A was used because of its known preferential inhibition of T cell function and the marked expansion in MRL-lpr/lpr mice of an unusual L3T4-, Lyt-2 , 6B2+ T cell population. CS-A prevented lymphadenopathy and expansion of L3T4-, Lyt-2-, 6B2+ T cells in the peripheral lymph nodes, and also in the thymus. The increased expression of the c-myb and T cell receptor beta-chain genes associated with these unusual cells was also corrected. The finding of increased numbers of L3T4-, Lyt-2-, 6B2+ thymocytes in untreated mice suggests abnormal intrathymic differentiation in lpr/lpr mice, a defect that was corrected by CS-A. Treated mice had a marked decrease in arthritis and glomerulonephritis and significantly prolonged survival. These beneficial effects of CS-A occurred despite a lack of reduction in antibodies reactive with DNA, circulating immune complexes, rheumatoid factor titers, or immunoglobulin concentrations. These results demonstrate that the B cell hyperactivity of MRL-lpr/lpr mice can proceed without the T cell proliferative disease. PMID- 3537129 TI - Activity of recombinant tumor necrosis factor on Toxoplasma gondii and Trypanosoma cruzi. PMID- 3537130 TI - Recognition of the beta-2 microglobulin-B molecule by a CTL clone. AB - In this report we offer evidence that the beta-2 microglobulin-B (beta 2M-B) molecule is recognized by a cytotoxic T lymphocyte (CTL). Production of GA5, a CTL clone reactive against a membrane antigen with the same strain distribution pattern as beta 2M-B, is described. This clone lysed syngeneic target cells in which native beta 2M-A molecules had been exchanged with beta 2M-B molecules by incubating the cells in serum from beta 2M-B-positive mouse strains. Conversely, the CTL clone GA5 failed to lyse its specific target when beta 2M-B molecules had been exchanged with beta 2M-A molecules by incubating the cells in serum from beta 2M-A-positive, beta 2M-B-negative mouse strains. Strain combinations were chosen so as to limit reactivity to beta 2M and to preclude reactivity to H-3 antigens, thus indicating CTL clone GA5 to be reacting specifically with beta 2M B. PMID- 3537131 TI - Assessment by a fluorochrome microassay of phagocytic killing of group B streptococci adherent to glass. AB - An in vitro adherence assay was developed to study the interaction between bovine polymorphonuclear cells (PMN) and group B streptococci (GBS) on glass. The kinetics of uptake and killing of GBS in the presence and absence of opsonins were compared by staining bacteria with a fluorochrome (acridine orange). Opsonization was not required for the PMN to ingest and kill glass-adherent GBS. Nevertheless, the presence of serum during the phagocytosis incubation, or preopsonization of bacteria, both increased the rate of ingestion and the number of bacteria per PMN at the end of the reaction (90 min). Precolostral calf serum (PCS), almost devoid of antibodies, was as effective as normal bovine serum in this respect. By contrast, PCS was not an effective opsonin source when phagocytosis took place in suspension, demonstrating further that different underlying mechanisms operate depending on the physical presentation of bacteria to phagocytes. It was noted that PMN monolayers were able to ingest unopsonized bacteria that merely settled on the glass surface during phagocytosis incubation. The method should permit investigations on the mechanisms involved in surface phagocytosis, a defense mechanism of potential importance in local infections. PMID- 3537132 TI - Enzyme immunoassay for the measurement of histamine. AB - This paper reports a competitive solid-phase enzyme immunoassay for measuring histamine in various biological samples. In this assay, the histamine to be quantified is chemically modified by 1,4-benzoquinone treatment and allowed to compete with a histamine-peroxidase conjugate for binding to a limited amount of an anti-histamine monoclonal antibody which was used to coat the wells of a microtitration plate. After incubation and washing, peroxidase activity associated with the solid phase is measured. With this method the histamine concentration in blood or various tissues may be determined easily, safely and reproducibly. Histamine concentrations from 0.3 to 20 ng/ml may be measured with the procedure reported here. PMID- 3537133 TI - ELISA for detection of human antibodies to Chlamydiae. AB - An enzyme-linked immunosorbent assay for the detection of human antibodies to Chlamydiae is described which exploits the cross-react properties between the genus-specific antigen of Chlamydiae and the ReLPS constituent of the outer membrane of a Salmonella minnesota mutant. Of 100 random sera tested by ELISA ReLPS and immunofluorescence 78% showed an absolute correlation, 15% were positive in immunofluorescence and negative in ELISA and 7% were positive in ELISA and negative in immunofluorescence. Furthermore results obtained by the ELISA-ReLPS on 55 sera from patients with clinical evidence of Chlamydiae infection correlated well with the values obtained by an ELISA using Chlamydia coated microtitration plates and by two immunofluorescence tests using Chlamydia trachomatis and Chlamydia psittaci as antigens. The method described here is sensitive, simple, reproducible and may be employed for epidemiological and pathogenetic studies of chlamydial infections. PMID- 3537135 TI - Two-site column enzyme immunoassay for neuron-specific enolase (NSE) in human serum using monoclonal antibodies. AB - A new method for the rapid determination of neuron-specific gamma-enolase (NSE), gamma-subunit of alpha gamma- and gamma gamma-enolase in human serum was developed by employing monoclonal antibodies for the separation method. The assay system consists of 0.1 ml Sepharose 4B column with immobilized rabbit anti-mouse IgG antibodies for the separation of bound label, Fab' fragments of rabbit anti bovine gamma gamma-enolase IgG labeled with beta-D-galactosidase from Escherichia coli, and F(ab')2 fragments of two mouse monoclonal antibodies to gamma gamma enolase. Serum samples or standard NSE solutions were incubated at 30 degrees C with the monoclonal antibody fragments. 10 min later, the galactosidase-labeled antibody fragments were added to the mixture, and incubated at 30 degrees C for 30 min. Then the reaction mixture was applied to a micro-column of Sepharose 4B with immobilized anti-mouse IgG antibodies. From the galactosidase activity bound in the column, NSE concentration in the samples could be estimated within 2 h. The minimum detection limit of the assay system was 30 pg/tube, being sufficiently sensitive for the assay of serum NSE with a satisfactory precision. Serum concentrations of NSE determined by the present method correlated well with that by the colorimetric solid-phase immunoassay method. PMID- 3537134 TI - A colorimetric method for measuring the candidacidal activity of leucocytes. AB - The candidacidal activity of mouse neutrophils was determined by a colorimetric method, using a tetrazolium dye that detects living, but not dead, yeast cells. The assay is carried out in microtitre trays, read using a multiwell scanning spectrophotometer (ELISA reader), and can be analysed by computer. PMID- 3537136 TI - A simple assay for the detection of antibodies to endocrine islet cell surface antigens. AB - A simple and sensitive immunoradiometric assay for the detection of islet cell surface antibodies (CIRMA) has been developed. Live, transformed islet cells derived from a liver metastasis of a transplantable islet cell tumor were grown in removable microtiter wells and incubated with antibody. Cell-bound antibodies were quantitated using 125I-labelled second antibodies. The assay was used to detect islet cell antibodies present in sera from non-diabetic and diabetic BB rats and proved to be particularly effective for screening hybridoma supernatants in order to identify monoclonal antibodies recognizing islet cell surface antigens. PMID- 3537137 TI - Liposome immune lysis assay (LILA). Application of sandwich method to determine a serum protein component with antibody-bearing liposomes. AB - A complement-dependent liposome immune lysis assay (LILA) using carboxyfluorescein (CF)-entrapped liposomes bearing antibody was developed to measure C-reactive protein (CRP) antigen as a model of protein antigens in human sera. Goat anti-CRP antibody was covalently coupled to liposomes, and a specific lysis of the liposomes could be observed when the liposomes were incubated with both rabbit anti-CRP antibody (secondary antibody) and CRP antigen in sera in the presence of guinea pig complement. In this assay system, so-called sandwich assay, CRP (a multivalent antigen) bound to the liposomes bearing anti-CRP antibody and subsequently secondary antibody, which activated complement efficiently. The amount of CF released by a complement-dependent liposome immune lysis was proportional to CRP concentrations. This sandwich assay was simple, fast, highly sensitive, and covered the ranges 10-300 ng of CRP/ml in a homogeneous mode, that is, one where no separation step was employed. The results correlated well with those obtained by single radial immunodiffusion and enzyme immunoassay. This assay system would be applicable to the measurement of other protein antigens. PMID- 3537138 TI - A solid-phase enzyme immunoassay for the determination of IgM and IgG antibodies against translation products of pre-S1 and pre-S2 regions of hepatitis B virus. AB - The envelope of hepatitis B virus is coded for by pre-S1, pre-S2 regions and the S gene. A method was developed to determine antibody to the product of pre-S1 region (anti-pre-S1) and antibody to the product of pre-S2 region (anti-pre-S2), either of IgM or IgG class, by a solid-phase enzyme immunoassay. For the determination of anti-pre-S1, tubular particles containing translation products of pre-S1, pre-S2 regions and the S gene were broken into constituent envelope polypeptides and immobilized on a solid support. Serums were absorbed with spherical particles containing translation products of pre-S2 region and the S gene, obtained from plasma positive for hepatitis B e antigen (HBeAg) and deprived of particles carrying pre-S1 product by an affinity column. They were then tested for the binding with tubular polypeptides fixed on a solid support, and the bound antibody representing anti-pre-S1 was detected by monoclonal antibody to human IgM/mu or IgG/gamma labeled with horseradish peroxidase. For the determination of anti-pre-S2, test serums were absorbed with spherical particles containing the product of the S gene, obtained from plasma positive for antibody to HBeAg and deprived of particles bearing pre-S2 product by an affinity column. They were then tested for the binding with polypeptides, fixed on a solid support, composed of products of pre-S2 region and the S gene. The assay was applied to the determination of anti-pre-S1 and anti-pre-S2 of IgM or IgG class in asymptomatic carriers and in persons who had recovered from infection with hepatitis B virus. PMID- 3537139 TI - Affinity immunoblotting. High resolution isoelectric focusing analysis of antibody clonotype distribution. AB - A sensitive and specific method has been developed for analyzing specific antibody clonotype changes during an immune response or comparing multiple sera for antibody clonotype similarities. Polyclonal serum antibodies were separated by flatbed acrylamide isoelectric focusing (IEF) and analyzed by an affinity immunoblotting method using antigen-coated nitrocellulose membranes. Antibodies present on the surface of the acrylamide gels after IEF bound the antigen on the nitrocellulose when the coated nitrocellulose was laid over the gels. Non specific protein binding was inhibited with Tween 20. Bound IgG antibody clonotypes were detected using peroxidase-conjugated anti-IgG. This method has been used for the analysis of Ig clonotypes specific for five protein antigens and two carbohydrate antigens. Optimal antigen concentration for coating the nitrocellulose membranes ranged from 10 to 100 micrograms/ml. The reactions could be inhibited by saturating the nitrocellulose with soluble protein antigen or free hapten prior to immunoblotting. Antibodies of alternative allotypic forms were detected by probing the immunoblot with biotinylated anti-allotype antibodies instead of anti-IgG. The simultaneous analysis of alternative allelic forms of antibodies of defined specificity is not possible with methods which use labelled antigen for clonotype detection. PMID- 3537140 TI - [Percutaneous surgery of the kidney. Puncture and dilatation by the same operator]. AB - Based on results of more than 700 percutaneous renal operations, the performance of both puncture and dilatation by the same urologist is described in detail, as successive steps. Advantages of this method are outlined and two new instruments presented: a percutaneous working sheath and a lombotome guided by a guide-wire and possessing a double blade. PMID- 3537141 TI - [Comparative diagnostic value of ultrasonics and rectal examination in prostatic cancer in a series of 213 patients]. AB - The value of endorectal sonography for the diagnosis of prostatic cancer was established after retrospective interpretation of sonographic data issued from 213 patients without prior knowledge of either clinical or pathological data. Endorectal sonography was performed with a mechanical sectorial high frequency (7.5 MHz) probe realized by the authors. A pathology report (73 biopsies, 52 TUR, 7 suprapubic adenomectomy specimens) was available for 132 patients: 25 pathological examinations were interpreted as normal, 41 adenomas, 24 prostatitis or fibrosis and 42 cancers (5 clinical stage T0, 22 T1, 2 T2 and 13 T3). Specificity for the diagnosis of cancer was respectively 65% or 79% according to the normality reference considered, i.e. either the group of patients having a normal pathological control (90 patients) or the same group plus another group of patients with a normal rectal examination (171 patients). Sensitivity for the diagnosis of cancer was only 48%: 53% of cancers were falsely interpreted as prostatitis or adenomas and 9% as normal (2 T0 and 2 T1). The large proportion of local stages without capsular involvement (29/42) is partly responsible for this lack of sensitivity. Sonography can reveal the presence of abnormalities in the echostructure of the gland but does not allow tissue characterization. Rectal examination and sonography are complementary techniques. In the same study, rectal examination had a 48% specificity and a 92% sensitivity. PMID- 3537142 TI - [The seminal vesicle dynamic emptying test as an interventional echographic control of the spermogram in the examination of male sterility]. AB - Ultrasound imaging to verify effective emptying of seminal vesicles is proposed, during spermograms included in investigation of couple sterility. The aim is to detect distal obstructive seminopathies, often unilateral and inaccessible to enzymatic analysis of sperm. A review of recently drafted case reports of 41 sterile men showed that in half of them an insufficient ejaculate volume always corresponded to poor emptying of seminal vesicles as seen on ultrasound images. If an obstruction is present it is usually in the ejaculatory canal zones. Two patients with azoospermia were treated by endoscopic resection of terminal part of ejaculatory canals with only one good result in the spermogram. With respect to counting of spermatozoa, it is not possible in patients with decreased emptying of seminal vesicles, a part from those with azoospermia, to establish any correlation between type of obstructive seminopathy and its effect on the spermogram. Of the 41 men in this series, a half had problems with their partner and the other half another known sterility factor. PMID- 3537143 TI - [Degos disease: apropos of a case with a genital localization]. PMID- 3537144 TI - [Transvesical bypass]. PMID- 3537145 TI - IgA class antibody against human jejunum in sera of children with dermatitis herpetiformis. AB - Sera of 44 children with dermatitis herpetiformis with granular IgA deposits in the papillary dermis were investigated on cryostat sections of normal jejunum of three children aged 2 months, 1 year, and 10 years by indirect immunofluorescence. Eighteen of 25 patients on a normal diet had an IgA class antibody showing the following staining patterns on substrate jejunums: tubular positivity in the lamina propria--around the crypts, beneath the villous epithelial basement membrane, and in some instances in the middle of the villous also, following the capillary system of villi; coalescence of tubular positivity at the muscularis mucosae; and positive blood vessels and smooth muscle endomysium. Eleven of 18 children with positive sera were put on a gluten-free diet (GFD) and their sera became negative. One of these 11 patients was challenged with gluten and the antibody reappeared. Nineteen patients examined only on a GFD and 30 healthy blood donors did not have this antibody. There was no strict correlation between the titer of antibody and the severity of jejunal mucosal damage. PMID- 3537146 TI - HLA-D region antigen expression by human epidermal Langerhans cells. AB - We have systematically examined HLA-D region antigen expression by normal human epidermal Langerhans cells with an improved double label indirect immunofluorescence technique in order to better understand the immunologic potential of this human interstitial dendritic cell type. The results of this study which differ somewhat from earlier observations strongly suggest that 100% of OKT-6-positive epidermal Langerhans cells constitutively express HLA-DQ and HLA-DP as well as HLA-DR molecules. Since HLA-DQ expression has been positively correlated with the ability to present nominal antigen, our findings would suggest the possibility that epidermal Langerhans cells, like other members of the human dendritic cell series, might be more efficient than monocytes at nominal antigen presentation since only about 50% of peripheral blood monocytes express HLA-DQ molecules. PMID- 3537148 TI - Discrepancy between the localization of in vivo bound immunoglobulins in the skin and in vitro binding sites of circulating anti-BMZ antibodies in bullous pemphigoid: immunoelectron microscopic studies. AB - The immunoelectron microscopic reaction products showing in vivo bound immunoglobulins or complement in the basement membrane zone (BMZ) of the lesional skin of 12 patients with bullous pemphigoid (BP) were homogeneously distributed in the lamina lucida in 3 cases, just beneath the basilar surface of the basal cells in 5 cases, and were associated with the basal lamina in 4 cases. No reaction products could be found beneath the melanocytes in any of the first 2 groups; however, positive reaction products were found on the basal lamina beneath some melanocytes, and were associated with the detached basal lamina in the dermis in the latter 4 cases. In vitro binding sites of circulating anti-BMZ antibodies in the sera from 7 patients with BP indicated that the antibodies reacted with the basilar surface of the hemidesmosomes, with a weak reaction on the basal lamina in 5 cases and with no reaction in 2 cases. No positive findings were obtained beneath the melanocytes or on the basal lamina under the melanocytes. The discrepancy between the antigenic sites and the localization of immune deposits in BP is assumed to be due to the renewal of the hemidesmosomes and constant clearance of immune deposits in vivo. The in vivo bound immunoglobulins and complement seen in the BP skin are the result of their accumulation in the lamina lucida or in association with the basal lamina. PMID- 3537147 TI - Stimulation of muscle protein degradation by murine and human epidermal cytokines: relationship to thermal injury. AB - Accelerated muscle proteolysis is a characteristic of systemic reaction following trauma, sepsis, or extensive thermal injury. The factors involved in this accelerated muscle breakdown have not been fully described. However, recently leukocytic pyrogen or interleukin 1 (IL-1) have been implicated in the induction of muscle protein degradation in septicemia or trauma. The epidermal cytokine epidermal cell-derived thymocyte activating factor (ETAF) is biochemically and functionally similar to IL-1. Injury to skin can augment ETAF activity. Using a murine model, we found that thermal injury can significantly enhance ETAF/IL-1 activity in a dose-dependent fashion. In addition, ETAF can cause net muscle protein breakdown in vitro. Thus, increased amounts of ETAF produced by thermally injured skin may contribute to the accelerated muscle breakdown in extensive thermal injury. PMID- 3537149 TI - Patterns of junctional communication in skin. AB - The patterns of junctional communication in whole skin have been studied by iontophoretic injection of the fluorescent dye Lucifer Yellow CH into excised strips of tissue from newborn (less than 48-h) mice. Sections of injected specimens embedded in resin show that: coupling in the dermis is extensive, the injected dye spreads to more than 500 cells in 5 min; coupling in the epidermis is more restricted, dye spreads to less than 25 cells in 5 min; cells of the epidermis are not detectably dye-coupled to the cells of the dermis except at occasional restricted sites, probably related to hair follicle development; immature sebaceous gland cells are coupled but appear to be isolated from other cell types; and endothelial cells in the dermis are coupled to surrounding fibroblasts. PMID- 3537150 TI - Rat hair follicle dermal papillae have an extracellular matrix containing basement membrane components. AB - Dermal papillae are small mesenchymally derived zones at the bases of hair follicles which have an important role in hair morphogenesis in the embryo and control of the hair growth cycle in postnatal mammals. The cells of the papilla are enmeshed in a dense extracellular matrix which undergoes extensive changes in concert with the hair cycle. Here it is shown that this matrix in anagen pelage follicles of postnatal rats contains an abundance of basement membrane components rather than dermal components such as interstitial collagens. In particular, type IV collagen, laminin, and basement membrane types of chondroitin sulfate and heparan sulfate proteoglycans are present as matrix components. Dermal papilla cells, when initially isolated from adult rat vibrissae and cultured in vitro, retained the potential to synthesize this spectrum of matrix components, but this was gradually lost, to be replaced by synthesis of other components including type I and III collagens. It seems likely therefore that the dermal papilla cells in vivo synthesize a basement membrane type of extracellular matrix, although a contribution from epithelial, and in some cases capillary endothelial, cells cannot be ruled out. PMID- 3537151 TI - The variety of Cryptococcus neoformans in patients with AIDS. PMID- 3537152 TI - Inhibition of complement by culture supernatants of Aspergillus fumigatus. AB - Aspergillus fumigatus produced a water-soluble extracellular material that inhibited the opsonization of fungal cells by normal human serum. Blastospores of Cryptococcus neoformans and conidia from A. fumigatus or Aspergillus niger were used as fungal targets for ingestion by human monocytes. The opsonic inhibitor from A. fumigatus was found to decrease binding of complement component C3b to fungal surfaces by selectively interfering with activation of the alternative complement pathway. Inhibition of complement did not appear to result simply from proteolysis, as judged by the minimal degradation of casein and of purified C3 and C4. The complement-inhibiting activity was partially labile to heating at 100 C and could be concentrated by using dialysis tubing with a 10,000-dalton exclusion limit. Aspergillus flavus, which is also a pathogen for humans, also produced this activity; A. niger did not. We speculate that this material may represent a pathogenesis factor for Aspergillus species. PMID- 3537153 TI - Effect of aerosolized Escherichia coli and Staphylococcus aureus on iron and iron binding proteins in lung lavage fluid. AB - Iron-binding proteins have antibacterial activity; they have been identified in lung secretions, but their role in pulmonary antibacterial defenses is unclear. Murine lactoferrin and murine transferrin were used to generate polyclonal antiserum to lactoferrin and to transferrin, and the specificity of both antisera was shown by western blot. Mice were exposed to either aerosolized Escherichia coli or Staphylococcus aureus; they were killed 1, 4, 24, or 48 hr later; and their lungs were lavaged. We measured the levels of transferrin, lactoferrin, and albumin and did a cell count for the lavage fluid. The predominant iron-binding protein in resting animals was transferrin. Aerosolized E. coli caused a brisk PMNL response in the lungs that was associated with a major increase in the levels of lactoferrin. Challenge with S. aureus was associated with a moderate increase in the number of macrophages and a moderate decrease in the levels of transferrin and iron but no change in the levels of lactoferrin. The levels of iron-binding protein can vary according to the type of inflammatory response. PMID- 3537154 TI - Production of Shiga toxin and other cytotoxins by serogroups of Shigella. AB - We measured the cytotoxic activity of 119 strains of Shigella by using a quantitative [3H]thymidine-labeled HeLa cell assay. We assayed 13 strains of Shigella dysenteriae 1; 18 strains of S. dysenteriae types 2 and 3; and 88 strains of Shigella sonnei, Shigella flexneri, and Shigella boydii. Strains of S. dysenteriae 1 demonstrated high levels of cytotoxicity (geometric mean, 10(5.04) CD50/mg of protein; range, 10(3.95)-10(6.10). Cytotoxic activities of the non type 1 strains of S. dysenteriae and of the other Shigella serogroups were approximately 1/1,000 that of the S. dysenteriae 1 strains (range, 10(1.09) 10(3.11) CD50/mg of protein). Neutralization of cytotoxicity by using rabbit antiserum to purified Shiga toxin revealed that in all strains of S. dysenteriae 1, greater than or equal to 99.5% of cytotoxic activity was attributable to Shiga toxin. In contrast, 88 of the other Shigella strains produced only nonneutralizable cytotoxic activity. Six of 18 strains of non-type 1 S. dysenteriae and 12 of 88 strains from other Shigella serogroups produced both Shiga toxin and nonneutralizable toxin. PMID- 3537155 TI - Digital subtraction angiography: image-sequence analysis for regional myocardial perfusion dynamics. AB - Digital subtraction angiography with selective coronary injections of contrast media has enabled us to obtain clear images, not only of the artery, but of the capillary and venous phases of the myocardial perfusion. In the present study, densitometry was used to estimate regional myocardial perfusion dynamics in 10 control cases and 11 anterior myocardial infarction cases. The time density curve showed that contrast material increased rapidly in the arterial phase and appeared to be washed out monoexponentially in the venous phase. The time from the onset of contrast medium injection to the maximal density of the contrast medium (Tp), and the time constant obtained from the washout curve (Tc) were analyzed. In the control group, Tp in the apical region was slightly prolonged as compared with Tp in the anterobasal region, but the difference was not significant (5.2 +/- 0.5 vs 4.2 +/- 0.4 sec: mean +/- SEM). Tc did not definitely change in any portion of the myocardium (anterobasal 5.1 +/- 0.5, anterior 4.8 +/ 0.5, apex 4.6 +/- 0.5 sec, respectively). In anterior myocardial infarction, Tp in the marginal region was significantly prolonged compared to Tp in the control region (6.0 +/- 0.3 vs 4.7 +/- 0.3 sec, p less than 0.01). Tp was prolonged for more than 10 sec in the infarcted region. Tc in the marginal region was markedly prolonged compared to Tc in the control region (7.4 +/- 0.9 vs 4.4 +/- 0.5 sec, p less than 0.025). Tc could not be determined in the infarcted regions because data acquisition time of our apparatus was inadequate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537156 TI - [Myocardial perfusion imaging by digital subtraction angiography]. AB - Several methods of digital subtraction angiography (DSA) were compared to determine which could better visualize regional myocardial perfusion using coronary angiography in seven patients with myocardial infarction, two with angina pectoris and five with normal coronary arteries. Satisfactory DSA was judged to be achieved if the shape of the heart on the mask film was identical to that on the live film and if both films were exactly superimposed. To obtain an identical mask film in the shape of each live film, both films were selected from the following three phases of the cardiac cycle; at the R wave of the electrocardiogram, 100 msec before the R wave, and 200 msec before the R wave. The last two were superior for obtaining mask and live films which were similar in shape, because the cardiac motion in these phases was relatively small. Using these mask and live films, DSA was performed either with the continuous image mode (CI mode) or the time interval difference mode (TID mode). The overall perfusion of contrast medium through the artery to the vein was adequately visualized using the CI mode. Passage of contrast medium through the artery, capillary and vein was visualized at each phase using TID mode. Subtracted images were displayed and photographed, and the density of the contrast medium was adequate to display contour lines as in a relief map. Using this DSA, it was found that regional perfusion of the contrast medium was not always uniform in normal subjects, depending on the typography of the coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537158 TI - Some metabolic studies and its correlation with clinical condition in bilharzial hepatic fibrosis. PMID- 3537157 TI - The prevalence of Toxoplasma antibodies among students in faculty of girls, Al Azhar University. PMID- 3537159 TI - The course of Plasmodium berghei infection in mice subjected to variable dosages of the parasite and the peak parasitaemia obtained accordingly. PMID- 3537160 TI - A randomized study on oral administration of morphine and methadone in the treatment of cancer pain. PMID- 3537161 TI - [The relationship among hemodynamics, biochemical changes and the level of serum adrenaline during extracorporeal circulation]. PMID- 3537162 TI - [Two mechanisms of prostaglandin actions: prostaglandin receptor and transport]. PMID- 3537163 TI - [Advances in the study on endogenous cysteine proteinase inhibitor family]. PMID- 3537164 TI - [The insulin receptor and the gene]. PMID- 3537165 TI - [The influence of weight loss on the reproductive function of the female rat: changes in the estrous cycle and hypothalamo-pituitary-ovarian function during feed restriction and subsequent refeeding period]. AB - Twelve-week-old female SD rats were restricted to an 8 g/day feed intake for 2 months followed by feeding ad libitum for 3 weeks. Feed restriction resulted in weight loss and constant diestrous. A persistent increase in the hypothalamic GnRH content was observed during the underfed period. Serum LH and PRL levels dropped throughout the period but the initial reduction in the serum FSH level was observed on the 60th day. The reductions in the pituitary content of these hormones were observed on the 30th day. The decrease in the serum and ovarian E2 levels were detected on the 14th day. Anterior pituitary showed a significant response to GnRH + TRH during the course, and the relative increases in LH, FSH and PRL were greater than those in the pretreatment rats. In the course of refeeding, the body weight returned to the control level and regular estrous cycles were reestablished on the 15th and 21st day, respectively. Elevated hypothalamic GnRH content returned to the control level on the 16th day. The changes in the pituitary-ovarian axis were prompt rebound rises in serum FSH and PRL levels and pituitary FSH content, delayed restoration of serum and pituitary LH levels and serum and ovarian E2 levels, and a marked increase in the serum and ovarian progesterone levels on the 16th day. The relative increases in FSH and PRL after GnRH + TRH injection were smaller than those in the underfed period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537167 TI - [Treatment of decubitus ulcer]. PMID- 3537166 TI - [A basic study of the oxytocic effect of prostacyclin on the uterine muscle in pregnant rats]. AB - The effects of prostacyclin (PGI2) on the uterine muscle of pregnant rats were studied in terms of uterine contraction and the variation in cyclic nucleotides. The following results were obtained: The administration of PGI2 stimulated the pregnant uterine muscle (in vitro). The oxytocic potency of PGE1-analog (ONO-802) was greatest, followed in order by that of PGF2 alpha and PGI2. The effect of 5 lypoxygenase inhibitor (AA-861) on uterine contraction was greatest under the administration of LTC4, followed in order by PGI2, oxytocin, PGF2 alpha, LTD4 and ONO-802. The effect of AA-861 was greater under the simultaneous administration of LTD4/LTC4 and ONO-802 than under the simultaneous administration of oxytocin and ONO-802. Terbutaline exerted the inhibitory effect on each of the oxytocies within two minutes in all cases. Its inhibitory effect on the oxytocics was slight in the cases to which oxytocin or ONO-802 was administered. Changes in cyclic nucleotides in the bath medium were determined before and after the administration of each drug. When PGI2 was administered, both c-AMP and c-GMP increased and showed a pattern which was different from that for other oxytocics. This tendency was also observed when PGI2 and other drugs (terbutaline, ONO-802 and AA-861) were administered together. PMID- 3537168 TI - [Clinical significance of blood cell differentiation]. PMID- 3537169 TI - [Improvement of polycythemia and renin-dependent hypertension of a renal transplant patient after removal of bilateral native kidneys: a case report]. PMID- 3537171 TI - Transvaginal sonographically controlled ovarian puncture for oocyte retrieval for in vitro fertilization. AB - Two hundred twenty-two patients took part in a trial of follicle puncture via the transvaginal route under sonographic control for the purpose of in vitro fertilization (IVF). Induction protocols were mainly human menopausal gonadotropin (hMG) + human chorionic gonadotropin (hCG) and clomiphene + hMC + hCG. In 79.7% oocyte aspiration could be achieved without difficulty via the transvaginal route. An average number of 4.7 oocytes per attempt was obtained; 10.7% evolutive pregnancies were obtained. No major incident was noted. This technique offers several crucial advantages: it reduces surgical risk, reduces the length of the patient's stay in hospital as well as the overall cost of the procedure, and it also makes possible puncture in some cases hitherto regarded as excluded. PMID- 3537170 TI - Immunology of the sperm-egg interaction. AB - The study of immunologic factors in infertility is in its infancy, and many questions remain to be answered. Further studies using newer techniques are needed to elucidate the actual contributions of immune mechanisms to infertility. Understanding the role of immunologic factors should lead to more effective treatment of patients whose infertility is immunologic in etiology. PMID- 3537172 TI - Immunofluorescent localization of immunoglobulins on the cell surface of mouse oocytes and preimplantation embryos. AB - Living mouse oocytes and preimplantation embryos were assayed by indirect immunofluorescence for their ability to adsorb heterologous serum proteins from culture media to their cell surfaces. Bovine and human immunoglobulins of the IgG class were adsorbed by the oocytes and all stages of preimplantation embryos, while IgG of mouse or goat origin was not. In contrast, none of the serum albumins was adsorbed to the cell surfaces of mouse oocytes and preimplantation embryos. From the differential binding of IgG of some, but not all, of the species that were tested, we concluded that these cell surface IgG "receptors" on mouse oocytes and preimplantation embryos are likely to be heterophilic in nature. Similar observations were made irrespective of the strain of mice used to provide the oocytes and embryos. These observations raise the question of whether human oocytes and preimplantation embryos should also be assayed for their ability to adsorb animal serum proteins that are possible candidates as a substitute protein supplement for human serum in culture medium used in human in vitro fertilization/embryo transfer programs. PMID- 3537173 TI - Combined twin ectopic pregnancy and intrauterine gestation following in vitro fertilization and embryo transfer. PMID- 3537174 TI - The in vitro fertilization program in a developing country--Venezuela. PMID- 3537175 TI - Side effects of positive pressure ventilation on hepatic function and splanchnic circulation. AB - Positive pressure ventilation is associated with a reduction and redistribution of cardiac output. Splanchnic blood flow is decreased. Blood supply of the liver is reduced exceeding the fall in cardiac output. As a result oxygen transport to the mesenteric bed and liver is curtailed. There is a concomitant impairment of hepatic venous outflow. These hemodynamic changes may cause functional, structural and metabolic disturbances in organs whose blood supply arises from splanchnic circulation. PMID- 3537176 TI - Monitoring, past, present, future. A personal journey. AB - A little over 40 years ago, anesthesiology in the United States became recognized as a specialty. At that time, its practice was largely that of an art, the science of which was yet to come. A finger on the pulse, observation of color, skin turgor, perspiration, and perhaps a blood pressure cuff in adults, and an estimation of the reflex signs of anesthesia were the standards for the assessment of the patient status and 'the depth of anesthesia'. How far have we come in the intervening years? The journey, as reflected in the experience of one physician, will be held up to the looking-glass; easily as astounding as that through which Alice passed. Caught as we are in the socio-economic climate of the present, how shall we react? Has the gadgetry and electronics of this day given us a meaningful cost-effective handle on a decreased morbidity and mortality? What impact is there on decision-making and outcome? What indeed is the contribution of the machine versus the newer agents, techniques, and the advanced educational milieu. The first attempts at monitoring were clearly directed toward the cardiovascular system. The devices developed were simple and non-invasive. The Riva-rocci method of measuring blood pressure was first applied in anesthesia by Harvey Cushing at the turn of the century. But it was 40 years before the electrocardiogram was introduced as an instrument of potential importance. It took another 25 years for it to have general acceptance, and even later for the anesthesiologist to become comfortable with it as a diagnostic tool.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537177 TI - [Histopathologic changes of the pulp tissue after ultra-high speed tooth preparation]. PMID- 3537178 TI - [A finite element analysis of the mechanical behavior of the abutment teeth and the supporting tissues of anterior dowel crowns]. PMID- 3537179 TI - Fred M. Smith (1888-1946). PMID- 3537180 TI - The role of cognitive strategy training in improving the academic performance of learning disabled children. PMID- 3537181 TI - Two-dimensional and three-dimensional movement of human polymorphonuclear leukocytes: two fundamentally different mechanisms of locomotion [corrected]. AB - Patients with an inherited deficiency of the adherence glycoproteins LFA-1, Mac 1, and p150,95 are unable to mobilize polymorphonuclear leukocytes (PMNLs) to peripheral sites of inflammation. LFA-1/Mac-1/p150,95-deficient PMNL exhibited profoundly impaired movement stimulated by chemotactic factors when the cells were required to move over two-dimensional surfaces. Less impairment of movement was demonstrated in three-dimensional movement through cellulose filters. A possible explanation for this difference in cell translational mobility is that movement in cellulose filters is less adherence dependent than movement over a two-dimensional plastic surface. Movement of PMNL in collagen gels is known to be relatively independent of adherence. No deficiency of translational mobility of PMNL from LFA-1/Mac-1/p150,95-deficient patients was observed in collagen gels. Antibodies against the common beta subunit effectively blocked two-dimensional movement but had little effect on three-dimensional movement through cellulose filters or collagen gel matrices. HL-60 cells were employed as a model to investigate the effects of adherence on cell movement. Treatment of HL-60 cells with phorbol myristate acetate resulted in the appearance of Mac-1 and p150,95 on the cell surface. Concurrently, the cells exhibited increased adherence to glass and plastic. In spite of increased adherence, HL-60 cells showed no translational movement, indicating factors other than the ability to adhere were important in cell motility. These experiments implied that PMNLs undergo two fundamentally different kinds of motion, one adherence dependent (two-dimensional movement) and the other largely adherence independent (three-dimensional movement). These findings are consistent with the view that egress of PMNLs from the vascular space is adherence dependent. Movement through extravascular tissues may be adherence independent. PMID- 3537182 TI - Changes in splenic macrophage Mac antigen expression during tumor growth: a kinetic study of accessory cell function and antigen-defined phenotypes. AB - Three monoclonal antibodies, anti-Mac-1, -2, and -3, were used to modify accessory cell activity of whole spleen cell (WSC) or splenic adherent cell (SAC) preparations from normal or tumor-bearing hosts (TBH). Ligand activation by anti Mac-1, -2 and -3 modified normal and TBH WSC lectin responses differentially; the most pronounced effect was with anti-Mac 1, which augmented normal WSC responsiveness, whereas anti-Mac-2 and -3 augmented TBH WSC mitogenesis. Ligand interaction with Mac-2 epitopes resulted in significantly suppressed normal host WSC responsiveness. With complement, anti-Mac-1 and -3 each reduced normal and TBH WSC proliferation. Reconstitution of blastogenesis was obtained by combining Mac-2-depleted with Mac-3-depleted normal host WSC or by combining Mac-1-depleted with Mac-2-depleted TBH WSC. To evaluate the role of different types of splenic adherent cells in T cell lectin responsiveness, adherent cells were collected and depleted by antibody plus complement treatment and added back to normal T cells. Removal of TBH SAC indicated the number of Mac-1+ SAC susceptible to lysis increased during tumor growth, whereas those susceptible to anti-Mac-2 and -3 treatment decreased. Removal of Mac-1+ normal host SAC stimulated the supportive accessory function of the remaining SAC. Enhancing accessory cell function diminished after removal of Mac-2+ or Mac-1+ normal and TBH SAC, respectively. T cell responsiveness was increased by adding back combinations of normal host SAC, Mac-1-depleted with Mac-3-depleted SAC or Mac-1-depleted with Mac-2-depleted SAC but not by Mac-2-depleted with Mac-3-depleted SAC. In contrast, none of the TBH SAC combinations were completely restored in accessory activity. In summary, SAC from normal host demonstrated an accessory cell function corresponding to a Mac-1 phenotype, which was either replaced or obscured by the predominance of a Mac-1+ phenotype in TBH. PMID- 3537183 TI - Neutral glyceride synthesis from glucose in human adipose tissue: comparison between growing and mature subjects. AB - Basal and insulin-stimulated neutral glyceride syntheses from glucose were studied in fat cells of different size (fat cell volume, 0.07-0.20, 0.20-0.60, 0.60-1.00, 1.00-1.50 micron3 X 10(6)) obtained from subcutaneous adipose tissues in 20 subjects aged 3 months to 67 years. In 0.07-0.20 or 0.20-0.60 micron3 X 10(6) fat cells, the basal rate of glucose conversion to neutral glyceride was significantly lower in mature (36 to 67 years old) than in growing (0 to 12 years old) subjects. In 0.60-1.00 or 1.00-1.50 micron3 X 10(6) fat cells, however, basal rate was not significantly different between the two groups. The stimulating effect of insulin on conversion of glucose to neutral glyceride was not significantly different from the basal rate in fat cells of each size taken from the mature subjects, whereas in fat cells from growing subjects, it was significantly different from the basal rate in each fat cell size category. These results indicate that when fat cell size is taken into account, not only is the rate of basal glucose conversion to neutral glyceride higher in growing subjects but also its responsiveness to exogenous insulin, and that insulin insensitivity of large fat cells, reported previously, may be influenced by age. PMID- 3537184 TI - Design of an integral computer-based wheelchair controller/linear synchronous motor system. AB - The purpose of this paper is to illustrate the advantages of designing computer based motor controllers together with innovative motors, such that maximum controller/motor system benefits are obtained. Specifically, this paper describes how a computer-based controller/drive system for powered wheelchairs has been designed and is being built and tested. This type of integral controller/drive system has been possible to build into a wheelchair only with the advent of the microprocessor-based feedback motor controller. The type of motor chosen for this project was a linear synchronous motor (LSM), which is highly efficient (90%+) and could easily be made an integral part of a wheelchair wheel, providing a "no moving-parts" drive system. However, an LSM cannot be variable-speed-controlled without knowledge of, and controlled adjustment to, the absolute rotor versus stator position at each point in time. Microprocessor-based feedback motor controllers make precise, efficient control of LSMs possible at a reasonable cost. In addition, this combination of controller and motor provides a very flexible wheelchair control/drive system that may be easily programmed to suit the needs and necessities of the wide variety of over 200,000 persons now using powered wheelchairs. PMID- 3537185 TI - Interactive videodisc to teach combat trauma life support. AB - Training military physicians in trauma management is a dilemma in peacetime, since there are few opportunities to gain clinical experience within the military care system. This program provides experience in clinical decision making through case simulation. Five cases, of increasing difficulty, are presented in a single videodisc side. The program is implemented on a system based on the IBM PC, and is written in the C programming language. The program emphasizes clinical realism by providing many clinical options at each decision point, and by audiovisually depicting combat clinical care in very realistic ways. The user interface is flexible and, though complex, is easy to use; it is supported by a narrated, on line tutorial. PMID- 3537186 TI - A method linking statistics and knowledge engineering for making medical consulting systems. A medical consulting system for electric response audiometry through auditory slow vertex response. AB - There are two methods of making medical consulting systems: the statistical method and the knowledge engineering method. Since both of these methods seem to be very different from each other, they have been recognized and applied separately. We contend, however, that a combination of statistics and knowledge engineering is a more effective and suitable way to create a medical consulting system than is the use of either method alone. In order to justify this contention, we created a medical consulting system, AUTSVR-V1.1, which detects auditory slow vertex responses (SVR) through observing and identifying background activities of the electroencephalogram (EEG) automatically during measurement of SVRs for the purpose of objective electric response audiometry (ERA), and compared it with AUTSVR-V1.0, which depends on statistics only. PMID- 3537188 TI - A comparative study of 3-day and 6-day clotrimazole therapy in patients with vaginal candidosis. PMID- 3537187 TI - Problems in establishing the medical expert systems CADIAG-1 and CADIAG-2 in rheumatology. AB - CADIAG-1 and CADIAG-2 are medical expert systems with applications in rheumatology, gastroenterology, and hepatology. CADIAG-1 is based on a symbolic logic representation of medical relationships between symptoms, signs, or findings and diseases. Definite relationships (obligatory occurrence, confirming, and excluding) as well as uncertain relationships (facultative occurrence and not confirming) are applied to confirm or exclude diagnoses and to establish diagnostic hypotheses. CADIAG-2 employs fuzzy set theory and fuzzy logic to formalize medical entities and relationships. The medical concept of confirming or excluding diagnoses is identical to that of CADIAG-1, but diagnostic hypotheses are generated differently. Here, a documentation of medical relationships allowing gradual transitions from "always" to "never" for the frequencies of occurrence of symptoms with and from "strong" to "weak" for their strengths of confirmation for diseases leads to strongly or weakly supported diagnostic hypotheses in the actual case. Tests with 322 real patient cases from a rheumatological hospital, each including between 500 and 700 symptoms, signs, and findings, were carried out. The percentage of cases diagnosed correctly is about 80%. Problems and pitfalls that became apparent in the evaluation of the cases are shown and discussed. PMID- 3537189 TI - Effects of lithium and phorbol esters on the dynamics of LH release from dispersed sheep pituitary cells. AB - The possible involvement of polyphosphoinositides in the stimulation of LH release was investigated. Dispersed sheep pituitary cells were incubated in test tubes, or perifused in columns, with gonadotrophin-releasing hormone (GnRH) and Li+, or with a phorbol ester, and the amounts and patterns of LH release over time compared. Treatment with Li+ (10 mmol/l), which is known to increase levels of inositol phosphates in gonadotrophs, was shown to have effects only on the responses of desensitized cells, significantly decreasing the rate at which the cells desensitize (P less than 0.005) and decreasing the response to supramaximal levels of GnRH stimulus (P less than 0.01). It is suggested that these effects could be due to increased levels of inositol monophosphate, inositol bisphosphate or inositol 1,3,4-trisphosphate. Responses to single or repeated pulses of GnRH at 18-, 30- and 60-min intervals were not significantly altered. Phorbol 12 myristate 13-acetate (PMA), an activator of the calcium and phospholipid dependent protein kinase (protein kinase C), was specifically active in releasing LH with a half-maximal stimulating dose of approximately 3 nmol/l. Phorbol 12,13 diacetate, which is structurally similar to PMA but does not activate protein kinase C, did not release LH, except at high levels in freshly dispersed cells. The timing of PMA-stimulated LH release was similar to that for GnRH-stimulated release, and PMA was able to release greater amounts of LH than could GnRH. This suggests that activation of protein kinase C is likely to be important in the GnRH-stimulated release of LH from gonadotrophs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537190 TI - The cause of postrestorative sensitivity and its prevention. PMID- 3537191 TI - Helodermatine, a kallikrein-like, hypotensive enzyme from the venom of Heloderma horridum horridum (Mexican beaded lizard). AB - We have purified and characterized the major N-benzoyl-L-arginine ethyl ester hydrolase from the venom of Heloderma horridum horridum. The enzyme belongs to the serine proteinase family, and its activity vs. peptide amide substrates and human high-molecular-weight kininogen suggests a similarity to the family of kallikreins. This interpretation is corroborated by its reactivity with the natural inhibitors soybean trypsin inhibitor and Kunitz-type bovine pancreatic trypsin inhibitor (aprotinin). Injection of the enzyme (2-16 micrograms/kg) into anesthetized rabbits leads to a rapid dose-dependent transient decrease of the arterial blood pressure. Like glandular kallikrein it specifically converts single-chain tissue type plasminogen activator into its double chain form. In contrast to other kallikrein-like enzymes from snake venoms it shows no thrombin like or plasminogen activator activity. The enzyme is a single-chain glycoprotein (Mr 63,000). The N-terminal sequence revealed significant homology to pig pancreatic kallikrein and to kallikrein like enzymes from Crotalus atrox and Crotalus adamanteus venom. This enzyme, which we name Helodermatine, is the first purified from Sauria with kallikrein-like properties. PMID- 3537193 TI - Proteolytic enzyme treatment reduces glomerular immune deposits and proteinuria in passive Heymann nephritis. AB - We investigated the effect of proteolytic enzyme treatment on the course of passive Heymann nephritis (PHN). PHN was induced by intravenous injection of Heymann antibody into Sprague Dawley rats. Protease-treated rats received intraperitoneal chymopapain and subtilisin. In rats given subnephritogenic doses of Heymann antibody (5 or 10 mg, insufficient to cause proteinuria), glomerular immune deposits were assessed by immunofluorescence and electron microscopy. In rats given 5 mg Heymann antibody and treated with protease in the heterologous phase of the disease (days 1-7), fewer animals were positive for rabbit IgG and rat IgG, as determined by immunofluorescence on day 12, compared with controls (p less than 0.01). Rats given 10 mg Heymann antibody and treated on days 1-5 were less frequently positive for rabbit IgG on day 5 than controls (p less than 0.05). When treatment was given on days 6-12 (autologous phase), fewer rats had glomerular rabbit and rat IgG compared with controls (p less than 0.025). Protease treatment of rats given nephritogenic doses of Heymann antibody (greater than or equal to 40 mg, causing proteinuria) did not result in significant differences in immunofluorescence deposits. However, protease treatment significantly reduced the number of electron dense deposits at all doses of antibody (p less than 0.01). Furthermore, rats given 60 mg Heymann antibody followed by enzyme treatment in the heterologous phase (days 1-7) or throughout the autologous phase (days 6-18) had significantly reduced protein excretion during the autologous phase compared with control rats (p less than 0.05). After onset of significant proteinuria on day 15 in rats given 40 mg Heymann antibody and treated from day 15 until day 25, there was significantly less (p less than 0.05) proteinuria on days 21-22 and 24-25 than in control rats; thus, enzymes could reverse proteinuria. In normal rats, administration of proteases did not have significant effects on urinary protein excretion, serum creatinine, or renal morphology, nor did protease affect anti-rabbit IgG antibody production in rats injected with Heymann antibody. The overall results indicate that proteolytic enzyme treatment can prevent or remove glomerular immune deposits and can prevent or reverse proteinuria. PMID- 3537192 TI - Adhesion-promoting receptors on human macrophages recognize Escherichia coli by binding to lipopolysaccharide. AB - We report here that human macrophages bind Escherichia coli by recognizing bacterial lipopolysaccharide (LPS). Purified LPS was inserted into erythrocyte membranes, and the resulting LPS-coated red cells were bound by macrophages with the same temperature and cation dependence as observed for E. coli. When receptors for LPS were withdrawn from the plasma membrane by spreading the macrophages on LPS-coated surfaces, the binding of E. coli was blocked. We have also identified the receptors on macrophages that recognize LPS. Macrophages express three structurally homologous cell surface proteins, CR3, lymphocyte function-associated antigen (LFA-1), and p150,95. We used surface-bound monoclonal antireceptor antibodies to selectively remove these proteins from the apical surface of macrophages. We found that each of these proteins mediated the binding of E. coli to macrophages. PMID- 3537194 TI - Major histocompatibility complex (MHC) restriction of foreign transplantation antigens in rats rendered tolerant at birth. AB - Evidence is presented that MHC restriction of foreign transplantation antigens occurs when tolerance is induced. Whereas PVG and F344 rats rendered tolerant at birth with (DA X PVG)F1 and (DA X F344)F1 hybrid bone marrow cells (BMC), respectively, accept ACI skin grafts, presumably because the foreign transplantation antigens of these third party grafts, which are MHC-compatible with DA, are recognized only in association with the MHC of the hosts, DA rats rendered tolerant with (DA X PVG)F1 or (DA X F344)F1 hybrid BMC usually reject ACI skin. Further support that MHC restriction accompanies the induction of tolerance is provided by the observation that Lewis.1N rats rendered tolerant at birth with athymic (nude) Wag BMC are much more likely to accept BN.B2 (MHC compatible with Wag) skin grafts, than BN (MHC-compatible with Lewis.1N) grafts. PMID- 3537196 TI - Regional variations in antigenic properties of skin. A possible cause for disease specific distribution of skin lesions. AB - The possibility that the distribution of skin lesions in some cutaneous diseases is due to variations in the antigenic properties of skin was investigated by mapping the expression of the skin-specific pemphigus vulgaris and bullous pemphigoid antigens in different regions of the body. The expression of both antigens was relatively stable within the same region, but varied between regions in a pattern that was distinct for each antigen. For each antigen there was a correlation between regions of high expression and location of skin lesions in autoimmune diseases involving the antigen. The results indicate that there are marked regional differences in the antigenic properties of skin and suggest this may influence the distribution of cutaneous lesions in some skin diseases. PMID- 3537195 TI - The pore-forming protein (perforin) of cytolytic T lymphocytes is immunologically related to the components of membrane attack complex of complement through cysteine-rich domains. AB - Structural, functional and immunological similarities between the ninth component of complement (C9) and the lymphocyte pore-forming protein (PFP, perforin) have recently been described (8-10). PFP is shown here to be immunologically related to all other components of the membrane attack complex (MAC) of human complement, namely, C5b-6, C7, C8, and C9. Polyclonal antibodies raised against purified human C5b-6, C7, C8, or C9 react with other components of the MAC and with mouse lymphocyte PFP. The antigenic epitopes shared by human complement proteins and mouse lymphocyte PFP are limited to cysteine-rich domains. Only complement proteins that have been reduced and alkylated elicit the production of crossreactive antibodies when used as immunogens. The nonreduced forms of complement components or lymphocyte PFP neither react with these antibodies nor give rise to crossreactive antibodies. The homologous domains of complement proteins and lymphocyte PFP may play related functions in their attachment to lipid membranes and assembly of membrane lesions. PMID- 3537198 TI - Comparison of monoclonal and polyclonal enzyme immunoassays for carcinoembryonic antigen. AB - A new commercially available CEA immunoassay, using monoclonal antibody, was evaluated for the purpose of routine clinical use. The between-day coefficient of variation was 5.2% at the 6.6 micrograms/l level and 4.1% at the 14.2 micrograms/l level. The results of analysis of sera from 260 patients were compared with the data from an established method with polyclonal antiserum. A good correlation between the two methods was found. When the patients were classified according to groups with known types of carcinomas no systematic differences between the monoclonal and polyclonal modes of assay were apparent. Relatively large differences in serum CEA levels did occur in individual patients necessitating a transition period in changing from one method to the other. PMID- 3537197 TI - The assessment of foetal lung maturity by chemical analysis of amniotic fluid. AB - Advances in the understanding of the neonatal respiratory distress syndrome have led to a proliferation of amniotic fluid tests. Measurement of pulmonary surfactant production is the most direct means of assessing pulmonary maturity. Assays of surfactant are subjected to certain pre-analysis sources of variation, such as variability in amniotic fluid volume, sample collection site, centrifugation speed and time, and contamination with blood and/or meconium. Amniotic fluid surfactant assays can be divided into biochemical and functional tests. When properly performed, both approaches yield results that correlate well with clinical findings. However, no single method has achieved the distinction of total reliability and universal applicability. In most tests the value for mature lungs is almost 99% accurate. On the other hand, immature values have very low accuracy. Therefore, it is advisable to perform an additional test or to repeat the determination. The determination of the lecithin/sphingomyelin ratio is characterized by sufficient accuracy for routine analyses. For scientific studies we recommend the use of a capillary gas-chromatographic method allowing an accurate assessment of dipalmitoylphosphatidylcholine, the most important surfactant constituent. PMID- 3537199 TI - Likelihood ratio and the febrile child. PMID- 3537200 TI - Comprehensive care of travelers. AB - Travel, especially if it is international, often means major changes for the family. Family physicians should assess the epidemiologic risk and psychosocial significance of travel or relocation in light of the family's life-cycle stage and antecedent health. Using core references, which are kept current in partnership with public health agencies, family physicians are able to provide comprehensive immunization, medications, and patient education for all travel risks. Families are given medical record summaries and recommended sources of care at their destination. Eight weeks after their return patients are reassessed for newly acquired illness and helped to integrate the perspectives gained during the travel into the family's future dynamics. Taking advantage of growing travel medicine opportunities, family medicine educators should base the care of travelers and teaching of residents on defined competence priorities. Travelers' health provides a mutually rewarding model of shared care with public health consultants in the community medicine curriculum. PMID- 3537201 TI - Use of selective vs standard sheep blood agar for the diagnosis of hemolytic streptococcus group A pharyngitis. PMID- 3537203 TI - Computerized prescription inventory program for the education of residents (PIPER). PMID- 3537202 TI - Tetanus immune status of adult patients in an urban family practice. PMID- 3537204 TI - DNA cloning vectors utilizing replication functions of the filamentous phages of Escherichia coli. PMID- 3537205 TI - Restricted expression of measles virus proteins in brains from cases of subacute sclerosing panencephalitis. AB - The presence of five structural proteins of measles virus in brain material obtained at autopsy from four patients with subacute sclerosing panencephalitis (SSPE) was examined by immunofluorescence employing monoclonal antibodies. In addition, the humoral immune response against measles virus antigens in serum and cerebrospinal fluid was analysed by immunoprecipitation in combination with gel electrophoresis, revealing a reduced response mainly to the matrix (M) protein. In none of the brain material were all five structural proteins simultaneously detected. Nucleocapsid protein and phosphoprotein were found in every diseased brain area, whereas haemagglutinin (H) protein was detected in two, fusion (F) protein in three and M protein only in one SSPE case. In two cases, variations in the occurrence of H and F proteins could be observed between regions displaying different degrees of neuropathological changes. No correlation was observed between the humoral immune response and the immunohistological findings. These data support the hypothesis of a restricted synthesis of measles virus proteins, in particular the envelope and M proteins, in SSPE. PMID- 3537206 TI - Effect of P22-mediated receptor release and of phage DNA injection on cell viability of Salmonella typhimurium. AB - Infection with u.v.-inactivated P22 bacteriophage at multiplicities higher than 30 caused a decrease in Salmonella typhimurium viability without cell lysis. Neither the action of the endoglycosidase of the P22 virion on the lipopolysaccharide of S. typhimurium nor the concomitant release of cell wall components was responsible for m.o.i.-dependent cell death. Using both free P22 tails and u.v.-inactivated P22, we have shown that p9 tail protein activity has no effect either on the integrity of host cells or on cell viability. Our results show that cell death is due to the injection of the u.v.-inactivated P22 DNA. PMID- 3537207 TI - Diagnostic significance of anti-HBcIgM prevalence related to symptoms in Canadian patients acutely or chronically infected with hepatitis B virus. AB - A total of 362 sera from 295 Canadian patients were examined for HBsAg, anti-HBs, anti-HBc, anti-HBcIgM, HBeAg, and anti-HBe using commercial immunoassays. Serial samples from 70 acutely infected patients demonstrated that anti-HBcIgM may detect 10% more positives than HBsAg within 4 months after the onset of clinical symptoms, and all except two were negative for anti-HBcIgM after the fourth month. None of 66 asymptomatic (HBeAg rate 18.2%) and two of 14 (14.3%) symptomatic (HBeAg rate 64.3%) carriers of HBsAg were positive for anti-HBcIgM (P = 0.029). Elevated marker responses were measured in two symptomatic carriers for a 20-month period. Anti-HBcIgM was not detected in either 100 asymptomatic patients positive for total anti-HBc, negative for HBsAg and negative for or possessing low levels of anti-HBs, 25 patients with liver disorders not caused by HBV, or 20 healthy milk donors. In diagnostic laboratory practice this anti HBcIgM test may be useful in the following situations: to supplement HBsAg testing, providing a theoretical 10% increase in positives within 4 months following onset of acute viral hepatitis; to replace testing for anti-HBc and anti-HBs in symptomatic HBsAg-negative patients; to confirm whether a patient is experiencing acute or chronic HBV infection or symptoms superimposed upon asymptomatic HBsAg carriage by another cause, such as nonA-nonB viral hepatitis. PMID- 3537209 TI - Effect of glucose and fat feeding on norepinephrine turnover in rats. AB - The norepinephrine turnover in organs of glucose-fed and fat-fed rats were compared to those of starved rats. Rats fed only glucose had higher rates of norepinephrine turnover than starved rats in heart, pancreas, kidney, liver, and lung. The effect of glucose-feeding on norepinephrine turnover was most pronounced in heart (+197%) and pancreas (+120%), which were examined in the fat feeding study. Rats fed only fat showed the same suppression of insulin levels as fasting rats, and a greater reduction in plasma glucose levels. However, their norepinephrine turnover in heart (+182%) and pancreas (+173%) was similar to that of glucose-fed rats. Thus glucose and fat increase norepinephrine turnover in the absence of any other nutrients. If these nutrients increase norepinephrine turnover via the same intermediate signal, it cannot be insulin or increased glucose metabolism. PMID- 3537210 TI - Problems arising during chronic treatment with L-dopa for Parkinson's disease: changes in response to treatment. AB - Some aspects of the problems of long-term L-dopa treatment syndrome are reviewed, with special attention to the changes in response to treatment with dopaminergic agents, specifically end-of-dose deterioration, the on-off phenomenon and hyperkinesia. The various hypotheses for interpreting these are presented, with particular stress on changes in the function of DA-ergic receptors. It is concluded that the on-off phenomenon is probably related to changes in plasma L dopa levels and to decreased stores of intraneural dopamine. PMID- 3537208 TI - Inpatient diagnoses during Adolf Meyer's tenure as director of the Henry Phipps Psychiatric Clinic, 1913-1940. AB - Between 1936 and 1950, detailed abstracts were prepared on all patients admitted to The Phipps Psychiatric Clinic from its opening in 1913 through 1950. Of these abstracts, 74% contained follow-up reports. Except for four papers on schizophrenia and affective disorders published between 1939 and 1943, none of this material has ever been analyzed. The present paper, the first of a series, examines the 8172 first admissions from 1913 through 1940, the period of Adolf Meyer's tenure as Clinic Director. Based on discharge diagnoses, we have sorted the patients into eight diagnostic groups with the following frequencies; schizophrenia, 17%; paranoid state, 3%; manic-depressive, 7%; depression, 27%; organic, 20%; neuroses, 15%; substance abuse, 6%; psychopath, 5%. Our manic depressive group contains cases discharged primarily as hyperthymergasia, mania, or manic depressive insanity (MDI). Of the 349 cases diagnosed MDI at discharge, 10 had neither a history of nor present symptoms of mania, and these were put in the depression group. Frequencies for most of the diagnoses remained remarkably stable over the 28-year period. Only 9% were discharged recovered, whereas 43% were rated unimproved. Mean length of hospitalization was 76 days, with 10% of the patients readmitted. The mean length of follow-up was 9 years. Correlations of diagnoses, year of admission, length of stay, condition at discharge, age, sex, readmissions, change of diagnoses, somatic treatment, length of follow-up, and deaths in the clinic are presented. Meyer's influence on diagnostic practice is discussed. PMID- 3537211 TI - The anatomy of the spinal cord pain paths: a review. PMID- 3537212 TI - Historical aspects of migraine. PMID- 3537213 TI - Hepatic metastatic thymoma and myasthenia gravis twenty-two years after the apparent cure of an invasive thymoma. A case report and review of the literature. AB - We report the case of a 62-year-old woman who presented in myasthenic crisis 22 years after radiation- and chemotherapy of an invasive thymoma which occurred during pregnancy. There was no evidence of recurrence of the thymoma at its original site, but an isolated hepatic metastasis was discovered. Biopsy of the mass revealed a spindle cell thymoma, whereas the original histology was that of a mixed round and spindle cell thymoma with moderate lymphocytic infiltration. The patient expired in spite of treatment with steroids, pyridostigmine bromide and plasma exchange on the one hand and cyclophosphamide with adriamycin on the other. To our knowledge, 22 years is the longest reported interval for the appearance of metastatic thymoma and myasthenia gravis after the diagnosis and apparent cure of a primary thymoma. This is also the only reported case of thymoma occurring during pregnancy but not associated with a rapidly fatal outcome. PMID- 3537214 TI - Twice-daily nicardipine in the treatment of essential hypertension. AB - The antihypertensive effect of twice-daily nicardipine, an investigational calcium-channel blocker, was evaluated in a placebo-controlled, single-blind trial in 18 adult patients with essential hypertension (supine diastolic blood pressure [BP] of greater than or equal to 95 and less than or equal to 120 mmHg). Following a 4-week run-in period in which patients received placebo for the final 2 weeks, nicardipine was administered for 12 weeks with a treatment goal of a supine diastolic BP of less than 90 mmHg at 12 hours postdosing or to a maximum dose of 60 mg twice daily. Supine and standing BPs and heart rates were determined at 1 hour and 12 hours postdosing. At all dose levels, supine and standing BPs were reduced at 1 hour after dosing, with partial loss of efficacy seen at 12 hours. Increases in heart rate seen at 1 hour were not significant at 12 hours. Eight patients withdrew from the study for minor, although troublesome, side effects, such as palpitations and headaches. These data suggest that nicardipine monotherapy given in a twice-daily dosing regimen has only a limited role to play in the chronic treatment of patients with essential hypertension. PMID- 3537215 TI - History of blood gas analysis. VI. Oximetry. AB - Oximetry, the measurement of hemoglobin oxygen saturation in either blood or tissue, depends on the Lambert-Beer relationship between light transmission and optical density. Shortly after Bunsen and Kirchhoff invented the spectrometer in 1860, the oxygen transport function of hemoglobin was demonstrated by Stokes and Hoppe-Seyler, who showed color changes produced by aeration of hemoglobin solutions. In 1932 in Gottingen, Germany, Nicolai optically recorded the in vivo oxygen consumption of a hand after circulatory occlusion. Kramer showed that the Lambert-Beer law applied to hemoglobin solutions and approximately to whole blood, and measured saturation by the transmission of red light through unopened arteries. Matthes in Leipzig, Germany, built the first apparatus to measure ear oxygen saturation and introduced a second wavelength (green or infrared) insensitive to saturation to compensate for blood volume and tissue pigments. Millikan built a light-weight ear "oximeter" during World War II to train pilots for military aviation. Wood added a pneumatic cuff to obtain a bloodless zero. Brinkman and Zijlstra in Groningen, The Netherlands, showed that red light reflected from the forehead could be used to measure oxygen saturation. Zijlstra initiated cuvette and catheter reflection oximetry. Instrumentation Laboratory used multiple wavelengths to measure blood carboxyhemoglobin and methemoglobin is cuvette oximeters. Shaw devised an eight-wavelength ear oximeter. Nakajima and co workers invented the pulse oximeter, which avoids the need for calibration with only two wavelengths by responding only to the pulsatile changes in transmitted red and infrared light. Lubbers developed catheter tip and cuvette fiberoptic sensors for oxygen tension, carbon dioxide tension, and pH. PMID- 3537216 TI - Medical Research Council leukaemia trial--UKALL V: an attempt to reduce the immunosuppressive effects of therapy in childhood acute lymphoblastic leukemia. Report to the Council by the Working Party on Leukaemia in Childhood. AB - The Medical Research Council UKALL V trial for children with standard-risk acute lymphoblastic leukemia (ALL) (aged 1 to 14 years, leucocyte count less than 20 X 10(9)/L) was designed to determine whether the immunosuppressive effects of treatment could be reduced without sacrifice of antileukemic effect by alterations in the type of continuing therapy or in fractionation of cranial irradiation. Remission was achieved in 496 children on standard induction therapy, and 309 children received 24 Gy of cranial irradiation in ten to 16 fractions over 21 days, and 174 received 21 Gy in five to nine fractions over 21 days. The type of radiotherapy administered had no influence on relapse at any site or rate of death in remission. All 496 children were randomized to receive chemotherapy for 2 or 3 years with 6-mercaptopurine and methotrexate either as a continuous (group C) or a semicontinuous (group G) regimen or as a five-day pulse every 3 weeks (group I). All groups also received vincristine and prednisolone every 6 weeks. With a minimum follow-up of almost 7 years, patients in group I had significantly fewer remission deaths (P = .025) but a much higher rate of bone marrow relapse than those in group C or G (P = .002). There was an overall benefit for 3 years of chemotherapy compared with 2 years, which in contrast to previous studies, was more apparent in girls and in patients in groups C and G. Testicular relapse occurred in 37 boys, including 19 patients off therapy, with a previously negative biopsy. The overall results confirmed the prognostic significance of initial leucocyte count, even among these standard-risk patients, while girls had a superior rate of disease-free survival, but not of hematologic remission. It is concluded that, even among standard-risk patients, the prognosis is influenced by the height of the initial leukocyte count. While alterations in the fractionation of cranial irradiation do not appear to have influenced disease free survival, intermittent continuing chemotherapy, although less immunosuppressive, is less effective than conventional continuous therapy in the treatment of ALL. In this study, 3 years of chemotherapy appeared superior to 2 years. PMID- 3537218 TI - High-dose chemotherapy without autologous bone marrow transplantation in melanoma. AB - High-dose chemotherapy with BCNU, melphalan, or both, followed by autologous bone marrow transplantation (ABMT) has been reported to produce response rates in excess of 60% in patients with advanced melanoma. We tested doses of BCNU associated with reversible bone marrow toxicity and acceptable extramedullary toxicity without the use of ABMT in 19 patients with a diagnosis of advanced malignant melanoma. All patients were evaluable for toxicity and 18 were evaluable for response; one patient had a new primary tumor. The patient population had a median age of 44 years (range, 16 to 71) and a median Karnofsky performance status of 80 (range, 50 to 100). Ten were women and nine were men, all had visceral dominant disease, and none had received previous chemotherapy. Our purpose was to test the feasibility of treatment without ABMT, its toxicity and efficacy, and the possibility of administering sequential repeated courses of therapy. Vincristine was added to the regimen to potentially increase efficacy. Treatment consisted of BCNU (750 mg/m2) and vincristine (2 mg days 1 and 8). Six patients who recovered bone marrow function received melphalan (60 mg/m2) and vincristine (2 mg days 1 and 8). Twenty-two percent (95% confidence limits, 3% to 39%) of patients had remissions (all partial) and these were of short duration. Toxicity was substantial with 16% early lethality and 29% incidence of lethal drug-related complications. Two patients (11%) died toxic after a second course of BCNU. Our results suggest that there is no practical role for high-dose BCNU in the treatment of melanoma. PMID- 3537219 TI - A critical appraisal of low-dose cytosine arabinoside in patients with acute non lymphocytic leukemia and myelodysplastic syndromes. AB - We reviewed 53 publications reporting 751 patients with hematologic malignancies treated with low doses (5 to 20 mg/m2/d) of cytosine arabinoside (LoDAC). Of 507 patients evaluable for response, complete remission (CR) rates varied from 32% for patients with primary acute non-lymphoblastic leukemia (1 degree ANLL) to 16% for patients with hematologic malignancies secondary to previous chemotherapy or following a myelodysplastic syndrome (MDS) (2 degrees ANLL), and 16% for MDS. Median duration of CR was 9.5 months for 1 degree ANLL, and 10.5 months for both 2 degrees ANLL and MDS. Based on limited available survival data, overall median survival for these groups was 9 months, 3 months, and 15 months, respectively. Only three CRs were reported of 31 evaluable patients treated for a variety of other hematologic malignancies. CR rates for patients with 1 degree ANLL greater than or equal to 50 years old was 56%, compared with 29% less than 50 years old (P = .10). While prior chemotherapy was more common in 1 degree ANLL patients less than 50 years of age (86% v 21%; P less than .001), it did not influence response rates in those greater than 50 years of age, suggesting other biases. Hematologic toxicity was mentioned in only 33 of 53 publications, affecting 254 of 289 patients (88%), with at least 15% treatment-related deaths. LoDAC hypothetically acts as a differentiating agent; however, correlative laboratory studies were rarely performed. Cytogenetic data were available for only 15%, and in vitro studies for 10% of all patients with marked discrepancies in the interpretation of results. LoDAC is clearly cytotoxic for both malignant and normal hematopoietic cells. While large numbers of patients have been reported, the lack of well-designed clinical trials prohibits definitive conclusions as to its role as a differentiating agent. Future LoDAC studies should determine optimal dose and schedule, with clinical laboratory correlates to assess differentiation. Trials in ANLL comparing LoDAC with conventional chemotherapy, and in MDS with supportive care alone, may help identify the role of LoDAC. Until appropriate indications can be identified, LoDAC should not be routinely used in clinical practice. PMID- 3537220 TI - Treatment of non-Hodgkin's lymphoma in the elderly. PMID- 3537217 TI - High-dose busulfan and cyclophosphamide with autologous bone marrow transplantation support in advanced malignancies in children: a phase II study. AB - Twenty children with advanced, nonleukemic malignancies entered a phase II study of high-dose busulfan-cyclophosphamide followed by bone marrow transplantation (BMT). All had disease refractory to conventional and/or high-dose chemotherapy (HDC). There were ten neuroblastoma patients, six non-Hodgkin's lymphoma, three Ewing's sarcoma, and one rhabdomyosarcoma. Eight had primarily resistant disease, ten were in second progressive relapse, and two in third progressive relapse. One patient was not evaluable for response. Among the 19 evaluable patients the responses observed were complete response (CR), seven; partial response (PR), three; objective effect, five; and failure, four. However, survival was poor: 15 patients died, two are alive with disease, and three are alive with no evidence of disease (NED) at 8+, 11+, 14+ months post-BMT. Toxicity was high but considered as acceptable, taking into account the terminal state of these patients. Seven treatment-related deaths were observed. This combination therapy proved to be highly effective, with a response rate of 50%, and its value for eradication of residual disease in less advanced patients should be investigated. PMID- 3537221 TI - Fast neutron therapy for malignant astrocytomas. A review. AB - The treatment of supratentorial malignant gliomas has continued to be a major problem for neurosurgeons and oncologists. Post-operative conventional radiotherapy is known to prolong survival and to enhance the quality of life. Local persistence of tumor kills the majority of patients. Fast neutron irradiation is being utilized to treat malignant gliomas based on its reputed radiobiological advantages for treatment of large tumors and the encouraging preliminary reports showing tumor eradication in post-radiation biopsy and autopsy specimens. This paper reviews the results of fast neutron irradiation alone and in combination with photons and hypoxic cell sensitizers. Survival comparisons do not show any superiority for neutrons compared to conventional radiation. However, post-neutron radiation tissue samples have shown less aggressive and minimal residual tumor in many instances. At the same time radiation necrosis has emerged as a significant problem. In summary, even though neutron irradiation can eradicate malignant gliomas a therapeutic window has yet to be identified. PMID- 3537222 TI - Technique and preliminary results of interstitial irradiation for primary brain tumors. AB - We have conducted a phase-I clinical trial of CT-guided stereotactic implantation of Ir192 in the treatment of malignant astrocytomas. During the past year, 16 patients have been implanted with two to four catheters in the residual enhancing portion of their tumor. These patients represent 50% of our total experience with the CT compatible Leksell frame. Each catheter contains three to six high intensity (2.0 to 2.5 mg Ra equivalent) seeds with 0.5 cm separation between the sources. The total activity of Ir192 per implant has been 30-65 mg radium equivalent. In the 16 patients, 49 catheters have been placed, an average of three targets calculated per patient and no targets have been missed. The radiation exposure to personnel has been surveyed in detail and drops off to less than 2 mr/h six feet from the patient when our custom-built radiation shield is employed. We have reserved permanent implantation of I125 for patients with tumors in unusual locations (e.g. pineal) or for individuals with slowly growing non-gliomatous lesions (i.e. meningioma). The tumor volumes have ranged from 12 120 cm3. Unique aspects of our implant procedure include the use of a Leksell frame already adapted to the GE-8800 scanner, the use of pre- and post-implant computerized treatment planning programs to determine the dose distribution profiles and the use of adjustable metal collars crimped to the outer catheters to provide ease of insertion, uniform pre-implant catheter length, and protection against source migration. Two of our patients have suffered from subacute radiation reactions, primarily due to delayed cerebral edema and both of these cases have largely resolved.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537223 TI - Histologic conversion of an unfavorable primary brain lymphoma to a favorable type. AB - Histologic conversion of a less aggressive non-Hodgkin's lymphoma to a more aggressive type has been established in several studies. Neither this trend nor vice versa has been reported in primary brain lymphoma, because of the poor median survival in the clinical setting which precludes further invasive procedures. The authors report a case of transformation of a primary brain lymphoma, histiocytic type, to poorly differentiated lymphocytic lymphoma 2 1/2 years after treatment with radiation and intrathecal methotrexate. PMID- 3537224 TI - Patterned response to odor in mammalian olfactory bulb: the influence of intensity. AB - Responses of single neurons in the olfactory bulb of anesthetized hamsters were recorded extracellularly while odors of defined concentration and time course were delivered to the olfactory system at constant flow. Responses could be either excitatory or suppressive, as judged by the first distinguishable change in firing rate during odor delivery. However, when the time course of the response was examined in more detail, approximately one-third of all tests and one-half of the tests at high concentration resulted in complex temporal patterns of firing rate that involved both increases and decreases with respect to spontaneous activity. Approximately two-thirds of all tests produced responses where increased firing rate preceded any distinguishable suppression. Excitatory and suppressive responses were each classified into four groups according to their temporal patterns. Different patterns were not equally represented in the data and the proportions of patterns elicited by the same odor changed with stimulus intensity. Complex responses, where temporal patterns included periods of firing rate above and below spontaneous rate, were increasingly common and intensity was increased. Magnitude of response is difficult to define when a single response includes both increases and decreases of firing rate but more than half of the neurons that responded to more than one stimulus concentration clearly had nonmonotonic intensity-response functions. Forty-one out of 101 neurons were classified as output cells because they could be driven at short constant latency by lateral olfactory tract stimulation. Their responses were not clearly different from the remaining cells that could not be classified as output cells. The contribution of the inhibitory circuits of the olfactory bulb to the generation of patterned response and to changes in pattern with intensity are discussed. The lateral inhibitory circuits of the bulb appear to be sufficient to explain the data presented here. PMID- 3537226 TI - The pathway for the slow inhibitory postsynaptic potential in bullfrog sympathetic ganglia. AB - Intracellular and sucrose gap recording techniques were used to examine synaptically evoked potentials and the response of neurons in bullfrog paravertebral sympathetic ganglia to muscarinic agonists. These neurons were defined as either B or C cells on the basis of the conduction velocity of antidromically evoked action potentials. Following stimulation of preganglionic C fibers in the rostral portion of the VIIIth spinal nerve, a fast nicotinic excitatory postsynaptic potential (EPSP) and a slow atropine-sensitive inhibitory postsynaptic potential (IPSP) could be recorded intracellularly in C cells of the IXth and Xth paravertebral ganglia treated with 70 microM d-tubocurarine chloride (dTC). Under these conditions, local iontophoretic application of acetylcholine (ACh) could produce a slow hyperpolarization of C cell membrane potential. ACh hyperpolarizations or slow IPSPs were not detected in ganglionic B cells. Stimulation of the preganglionic B-fibers in the sympathetic chain produced a fast nicotinic EPSP and a slow muscarinic EPSP in ganglionic B cells. A small population of C cells also received cholinergic B-fiber innervation from the sympathetic chain and exhibited a slow IPSP upon tetanic stimulation of this pathway. When curarized ganglia were examined by means of sucrose gap recording, superfusion of the muscarinic agonist, methacholine (MCh), produced an initial hyperpolarization (MChH) followed by a depolarization (MChD). Both responses were blocked by atropine and therefore presumably reflect the activation of muscarinic receptors involved in the generation of the slow IPSP and the slow EPSP, respectively. Although synaptic transmission was blocked by Ringer solution containing 4 mM Co2+, neither this solution nor 10 microM tetrodotoxin reduced the amplitude of the MChH. The MChH was slightly reduced by Ringer solution containing 0.1 mM Ca2+, however, the response could be restored by the addition of 6 mM Mg2+. These results indicate that the MChH in curarized bullfrog sympathetic ganglia results from a direct muscarinic action on ganglionic cells. This suggests that the slow IPSP is mediated by ACh released from cholinergic preganglionic fibers that make synaptic contact with ganglionic C cells. PMID- 3537225 TI - Visual, auditory, and somatosensory convergence on cells in superior colliculus results in multisensory integration. AB - Convergence of inputs from different sensory modalities onto individual neurons is a phenomenon that occurs widely throughout the brain at many phyletic levels and appears to represent a basic neural mechanism by which an organism integrates complex environmental stimuli. In the present study, neurons in the superior colliculus (SC) were used as a model to examine how single neurons deal with simultaneous cues from different sensory modalities (e.g., visual, auditory, somatosensory). The functional result of multisensory convergence on an individual cell was determined by comparing the responses evoked from it by a combined-modality (multimodal) stimulus with those elicited by each (unimodal) component of that stimulus presented alone. Superior colliculus cells exhibited profound changes in their activity when individual sensory stimuli were combined. These "multisensory interactions" were found to be widespread among deep laminae cells and fell into one of two functional categories: response enhancement, characterized by a significant increase in the number of discharges evoked; and response depression, characterized by a significant decrease in the discharges elicited. Multisensory response interactions most often reflected a multiplicative, rather than summative, change in activity. Their absolute magnitude varied from cell to cell and, when stimulus conditions were altered, within the same cell. However, the percentage change of enhanced interactions was generally inversely related to the vigor of the responses that could be evoked by presenting each unimodal stimulus alone and suggest that the potential for response amplification was greatest when responses evoked by individual stimuli were weakest. The majority of cells exhibiting multi-sensory characteristics were demonstrated to have descending efferent projections and thus had access to premotor and motor areas of the brain stem and spinal cord involved in SC mediated attentive and orientation behaviors. These data show that multisensory convergence provides the descending efferent cells of the SC with a dynamic response character. The responses of these cells and the SC-mediated behaviors that they underlie need not be immutably tied to the presence of any single stimulus, but can vary in response to the particular complex of stimuli present in the environment at any given moment. PMID- 3537227 TI - Haskell Askin "wanted" by police in New Jersey and Pennsylvania for his expertise in forensic dentistry. PMID- 3537229 TI - Automated endodontics. PMID- 3537228 TI - Avoiding failures of porcelain laminate veneers. PMID- 3537230 TI - Intravenous digital subtraction angiography and duplex ultrasonography in postoperative assessment of carotid endarterectomy. AB - Seventy-four consecutive patients who had undergone carotid endarterectomy procedures were examined with intravenous digital subtraction angiography (IV DSA) and duplex ultrasonography (DUS) at intervals ranging from 1 to 14 months postoperatively. Ninety-one percent of the DUS and 74% of the DSA images were of diagnostic quality. The two modalities agreed in the assessment of the endarterectomy appearance in 84% of the arteries, with 85% showing no evidence of significant residual disease. There were no arteries with severe restenosis or complete occlusion. In the 10 vessels in which the two modalities disagreed in disease assessment, the IV-DSA images were often degraded by artifact or vessel overlap leading to underestimation of disease. The authors conclude that DUS is the examination of choice for routine follow-up studies of carotid endarterectomy. PMID- 3537231 TI - The surgical treatment of congenital hydrocephalus. AB - The Authors discuss the incidence, the etiology, the pathology and the pathophysiology of congenital hydrocephalus. Furthermore, the problems of intrauterine surgical procedures are in particular discussed. On the light of the experimental and clinical results the Authors believe that the shunting fetal procedures should be considered anything but experimental and, therefore, subject to rigorous limitations. The results of the postnatal surgical procedures in congenital hydrocephalus are also discussed. Owing to the fact that early treatment of hydrocephalus in newborns seems to obtain the most satisfactory results, particular regard is reserved to that diagnostic techniques which could allow to recognize the right and early moment for surgical intervention, such as transfontanelle Doppler ultrasound examination. PMID- 3537232 TI - Transcranial Doppler ultrasound. Examination technique and normal reference values. AB - A newly developed Transcranial Doppler system (TCD) has been used in a group of subjects without any cerebrovascular disease (CVD) in order to establish the standard criteria for transcranial basal cerebral arteries examination and settle normal velocimetric and hemodynamic parameters. TCD examination in patients suffering from CVD provides useful information for clinical management of such pathological conditions. PMID- 3537233 TI - Contribution of hypertensive rat models to medicine. Fifth International Symposium on Rats with Spontaneous Hypertension and Related Studies. 20-22 October 1985, Kyoto, Japan. Festschrift in honour of Dr. Kozo Okamoto. PMID- 3537234 TI - Electrolytes and spontaneous genetic hypertension in rats. AB - Electrolytes are involved to a greater or lesser extent in the hypertension of probably all the inbred strains but it is difficult to sort out whether the involvement is primary or secondary and the detected abnormalities differ in the various strains. The fundamental faults are still elusive, except perhaps in the Dahl salt-sensitive rats, which appear to have a form of mineralocorticoid hypertension. Sodium and calcium appear to be the electrolytes most closely implicated in the pathogenesis of hypertension but potassium, magnesium and chloride should not be neglected. More data are needed. Knowledge gained from rat studies is useful in the context of both basic physiology and human hypertension. PMID- 3537235 TI - A renal abnormality in the Milan hypertensive strain of rats and in humans predisposed to essential hypertension. AB - Many similarities in kidney-function abnormalities were found between hypertensive rats of the Milan strain (MHS) and young normotensive human subjects with hypertensive parents, compared with the appropriate controls. These similarities included an increased glomerular filtration rate, increased pressor effect of the kidney after transplantation, increased 24-h urinary output and lower plasma renin activity and urinary kallikrein. The isolated MHS kidney perfused in vitro with an artificial medium had a higher glomerular filtration rate, a higher urinary output, higher tubular sodium reabsorption and higher oxygen consumption than the kidney of control Milan normotensive rats (MNS). Further, reogenic sodium transport across brush border vesicles isolated from proximal tubular cells is faster in MHS than in MNS. Erythrocytes and proximal tubular cells of MHS have a lower volume and sodium content than those of MNS, while sodium transport is faster and the Ca2+-ATPase at Vmax is lower. This indicates that the 'genetic' cellular abnormality responsible for the renal function abnormality and the hypertension is also present in erythrocytes. Thus these cells may be used to study the genetic cellular mechanisms of hypertension. Experiments with bone marrow transplantation and with F2 hybrids obtained by crossing the F1 (MHS X MNS) hybrids showed that the MHS erythrocyte abnormalities are genetically determined within the stem cells and are genetically associated with the hypertension. Since, in human hypertensives, there was a correlation between abnormal erythrocyte sodium transport and renal function, it is proposed that erythrocytes may be used in studying the cellular molecular mechanisms of hypertension. PMID- 3537236 TI - Edgar Rudolph "Painless" Parker (1872-1952). The "P.T. Barnum" of dentistry. Part II: Parker and American dentistry. PMID- 3537237 TI - Fragile X syndrome: a review. PMID- 3537238 TI - Skull bone grafts in maxillofacial and craniofacial surgery. AB - The various techniques of harvesting skull bone grafts are presented, and the numerous advantages of this type of graft are illustrated and discussed. PMID- 3537239 TI - Acquired immune deficiency syndrome (AIDS) in the United States in 1986: etiology, epidemiology, clinical manifestations, and dental implications. AB - The acquired immune deficiency syndrome (AIDS) results from a lymphotropic retrovirus (HTLV-III) infection and is characterized by specific opportunistic infections and malignancies. The virus is transmitted primarily by semen and blood. Infection is limited principally to defined risk groups, i.e., homosexual men and intravenous drug users. Head and neck manifestations include cervical lymphadenopathy and Kaposi's sarcoma. Oral manifestations include Kaposi's sarcoma, candidiasis, hairy leukoplakia, precocious periodontal disease, xerostomia, herpes simplex, recurrent aphthae, erythema multiforme, and venereal warts. Although HTLV-III is present in saliva, there are no reported cases of transmission secondary to dental procedures. Appropriate precautions and techniques are recommended in treating patients at risk for AIDS. PMID- 3537240 TI - Secondary management of the premaxilla in bilateral cleft lip and palate patients. AB - Bilateral clefts of the palate pose difficult and unique problems in surgical rehabilitation. The premaxilla traditionally has been a controversial subject with a historic lack of uniformity in treatment protocol. Based on a review of facial growth and the evolution of premaxillary cleft surgery, principles of management and secondary reconstruction of the premaxilla are discussed. Timely surgical intervention combining osteotomies and bone grafting in conjunction with closure of soft tissue defects is shown to result in satisfactory functional and aesthetic results. PMID- 3537241 TI - Incorporation of purified plasma fibronectin into explants of articular cartilage from disease-free and osteoarthritic canine joints. AB - The purpose of this study was to determine if articular cartilage was able to accumulate fibronectin, a large molecule of 440,000 daltons, from the external medium, and if so, to compare the extent of accumulation by normal and osteoarthritic cartilage and to localize the sites of fibronectin accumulation within the articular cartilage. The uptake of canine serum albumin, another protein present in plasma and synovial fluid with a lower molecular weight (67,000 daltons) and a lower pI, was compared. Purified plasma fibronectin and canine albumin were labelled with 125I or N-hydroxysuccinimidobiotin by standard procedures and incubated with articular cartilage explants. The 125I-fibronectin that had bound to cartilage components was extracted with 4 M urea, and both extract and cartilage residues were counted. Cartilage accumulated fibronectin to a greater extent than albumin. For normal cartilage, a level of saturation appeared to be reached at an external concentration for fibronectin of about 150 micrograms/ml. Degenerated cartilage accumulated about 10-fold more fibronectin than normal cartilage. Biotinylated fibronectin was localized within frozen sections of articular cartilage by probing with peroxidase-linked avidin. Fibronectin accumulation in normal cartilage was restricted to the articular surface and the cut edge. In degenerated cartilage, penetration of fibronectin was more extensive but proceeded only from the articular surface. Staining of adjacent sections with peroxidase-linked antifibronectin antibody confirmed previous observations that endogenous fibronectin is present throughout the cartilage matrix. The possibility that synovial fluid fibronectin could be a source of cartilage fibronectin, especially in degenerated cartilage, was discussed. PMID- 3537242 TI - [Vertebral arterial hemodynamics in patients with vertigo]. PMID- 3537243 TI - Jubilee volume: Journal of Pathology (G. S. Woodhead). PMID- 3537244 TI - Distinctive gastrointestinal anomaly associated with Coffin-Siris syndrome. PMID- 3537246 TI - Fluorescent antibody vs culture for detecting Chlamydia. PMID- 3537245 TI - Short- and long-term effects of furosemide on lung function in infants with bronchopulmonary dysplasia. AB - Although furosemide improves lung mechanics in some infants with broncho pulmonary dysplasia (BPD), this may not be important unless gas exchange also improves. To determine the relationship between improvement in mechanics and improvement in gas exchange, the short- and long-term effects of furosemide therapy were studied in 16 spontaneously breathing infants with severe BPD who were both oxygen dependent and hypercarbic (mean PCO2 54 +/- 11 torr). Each infant was examined at least three times: before furosemide therapy, 1 hour after the first dose of furosemide, and after a 6- to 10-day course. Ten of the 16 infants were also examined three times during a 7-day control period. Transcutaneous PO2 and PCO2, esophageal pressure, air flow, and tidal volume were measured. Pulmonary resistance, lung compliance, and the alveolar to skin PO2 difference were calculated. After a single dose of furosemide, only compliance significantly improved. After prolonged therapy, compliance, resistance, and oxygenation significantly improved in the group as a whole, but better oxygenation was achieved in only six of 16 infants. tcPCO2 was unaffected by long term furosemide therapy, but in all infants with decreased tcPCO2 1 hour after a single dose, there was sustained decrease in PCO2 after prolonged therapy. Changes in gas exchange were not explained by changes in lung mechanics. These data indicate that long-term diuretic therapy can improve the mechanical properties of the lungs of spontaneously breathing infants with BPD, but that gas exchange is usually unaffected. PMID- 3537248 TI - Safety and immunogenicity of bovine rotavirus vaccine RIT 4237 in 3-month-old infants. AB - To assess the safety and immunogenicity of bovine rotavirus vaccine, we administered attenuated strain RIT 4237 to 54 inner-city infants randomized to one of three groups in a double-blind fashion to receive a dose at 3 and 5 months of age of either placebo, vaccine virus at 10(7) TCID50/ml, or vaccine virus at 10(8) TCID50/ml. Vaccination began in early fall 1984, and continued through spring 1985. Forty-nine infants received one dose of vaccine or placebo; 43 received both doses of vaccine or placebo. At 2 and 3 months after vaccination, homologous geometric mean neutralizing antibody titers were significantly higher in children who received either dose of vaccine compared with placebo recipients. Cumulative seroconversion to bovine rotavirus after either dose of vaccine virus was 87% at 6 months of age. Seroconversion was significantly higher (P less than 0.01) in both vaccine groups compared with the placebo group. No ill effects were associated with vaccine administration. RIT 4237 vaccine appears to be safe and immunogenic when administered to young infants living in the United States. PMID- 3537247 TI - Neurologic complications of immunizations. AB - Although there does appear to be at least a temporal relationship between pertussis immunization and serious acute neurologic illness, data to suggest that children with stable preexisting neurologic disease or positive family history of neurologic disease are at increased risk for complications of pertussis immunizations are inconclusive. Furthermore, there are no firm statistical data concerning the incidence of pertussis vaccine-related encephalopathy. Rather, the literature on pertussis vaccine complications is replete with anecdotal reports and retrospective studies with a number of questionable conclusions drawn from this inadequate data base. Unfortunately, these conclusions have been sensationalized and exploited with litigious fervor to the point that the practice of pertussis immunization is being questioned in the United States. A number of points should be reiterated: pertussis is a dangerous and deadly disease, as seen in the epidemic in Great Britain; pertussis immunization is effective in protecting against the disease; and there is no conclusive proof that the incidence of complications from pertussis vaccination of children with seizure disorders or other preexisting stable neurologic abnormalities is higher, because appropriate studies have not been done to define such a risk. We would do well to keep these facts in mind in order to avoid a disaster similar to the pertussis epidemic in Great Britain. Pertussis vaccination should be given to all children except those with allergic hypersensitivity, a progressive neurologic disorder, or an adverse reaction to a previous pertussis dose. PMID- 3537249 TI - Methionyl human growth hormone and oxandrolone in Turner syndrome: preliminary results of a prospective randomized trial. AB - Seventy girls with Turner syndrome, 4 to 12 years of age, were randomly assigned to receive either no treatment (control) or methionyl human growth hormone (0.125 mg/kg three times per week), oxandrolone (0.125 mg/kg/day), or combination hGH plus oxandrolone therapy. Baseline growth rates averaged 4.3 cm/yr, and all were within 2 SD of mean growth velocity for age in girls with Turner syndrome. Sixty seven girls remained in the study for a minimum of 1 year. Growth rates and growth velocity (in standard deviations for age in girls with Turner syndrome) were control 3.8 cm/yr (-0.1 SD), hGH 6.6 cm/yr (+2.3 SD), oxandrolone 7.9 cm/yr (+3.7 SD), and combination therapy 9.8 cm/yr (+5.4 SD). Mean bone ages advanced 1.0 years (hGH), 1.3 years (oxandrolone), and 1.6 years (combination). However, median increments in height age/bone age (delta HA/delta BA) ratios ranged from 1.0 to 1.1 for treatment groups, compared with 0.8 for the controls. Predicted adult height by the method of Bayley-Pinneau increased 2.5 cm for hGH or oxandrolone alone, and 3.2 cm for combination treatment. These data indicate that both hGH and oxandrolone can significantly stimulate short-term skeletal growth in patients with Turner syndrome, and potentially increase final adult height. PMID- 3537250 TI - Growth-stimulating effects of human growth hormone therapy in patients with Turner syndrome. AB - We determined the effect of pituitary human growth hormone treatment on the growth rate of 52 children with Turner syndrome. The pretreatment growth rate was 3.2 +/- 0.8 cm/yr. Growth hormone treatment (0.2 IU/kg three times per week) resulted in enhancement of the growth rate to 5.9 +/- 1.4 cm/yr for the first year of therapy. The bone age advanced approximately 1 year during the year of therapy. The growth hormone therapy was discontinued at 12 months, and the mean growth rate decreased to pretreatment levels, 3.1 +/- 1.9 cm/yr; 26 of 41 patients actually had post-treatment growth rates that were less than the pretreatment rate. Glucose tolerance tests at 6-month intervals did not indicate an effect of hGH treatment on glucose intolerance. Several patients had glucose intolerance that preceded hGH treatment, but this remained stable during treatment; glucose intolerance likely was related to obesity in this group of patients. Basal and hGH-stimulated somatomedin C levels (32 patients) correlated with age of the patient but not with growth rate during therapy. We conclude that hGH therapy can accelerate the growth rate of patients with Turner syndrome. The growth rate increased to "normal" levels and was dependent on continued treatment with hGH. If the response continues, long-term treatment of Turner syndrome may result in increased adult height. PMID- 3537252 TI - Ultrasound and the diagnosis of renal and ureteral calculi. AB - We retrospectively compared ultrasound examination with plain film radiography of the abdomen (KUB) in the diagnosis of renal and ureteral calculi in 13 patients. Overall, ultrasound was more sensitive than KUB (84% versus 54%) in detecting calculi. However, KUB was superior for the diagnosis of ureteral stones. No calculi were detected by intravenous urography that were not first seen on either ultrasound or KUB. Our experience suggests that the combination of ultrasound and KUB is less invasive and more sensitive than intravenous urography for the diagnosis of calculi in patients with symptoms and signs suggestive of stone disease or who are at high risk for stone formation. PMID- 3537251 TI - Effect of low doses of estradiol on 6-month growth rates and predicted height in patients with Turner syndrome. AB - We randomly assigned 16 girls with Turner syndrome, age 5 to 15 years, to receive treatment with 100 ng/kg/day ethinyl estradiol or placebo for 6 months, with crossover after a 2-month interim period. We assessed growth by measurement of the 4-week lower leg growth rate and by height velocity. Bone age was determined at the beginning and end of treatment. Growth rate during ethinyl estradiol treatment was approximately 70% greater than during placebo (P less than 0.001), without any bone age advancement relative to that with placebo. The change in predicted height was significantly greater after 6 months treatment with ethinyl estradiol than after treatment with placebo (mean +/- SEM, +0.35 +/- 0.38 cm vs. 0.85 +/- 0.32 cm, P less than 0.03). Breast budding occurred in six patients. We conclude that it may be feasible to begin low-dose estrogen therapy to promote growth at an earlier age than would be conventionally used to induce pubertal development. These data are still relatively short term, however; until long-term data are available, it would be premature to make definitive recommendations regarding the dose and timing of estrogen treatment in Turner syndrome. PMID- 3537254 TI - Some biochemical effects of the growth hormone analogue produced by plerocercoids of the tapeworm Spirometra mansonoides on carbohydrate metabolism of adipose tissue from normal, diabetic, and hypophysectomized rats. AB - Plerocercoids of Spirometra mansonoides produce a functional analogue of mammalian growth hormone (GH). Plerocercoid growth factor (PGF) mimics the growth promoting actions of GH, but has not been shown to duplicate all of the actions reported for GH. The purpose of this study was to determine the effects of plerocercoid infection (chronic PGF treatment) on glucose metabolism of adipose tissue and to compare the effects to those elicited by insulin and GH in intact, diabetic, and hypophysectomized male rats. Groups of rats were constantly exposed to PGF (via plerocercoid infection) or injected twice daily with bovine GH, insulin, or saline for 10 days. Basal oxidation rates of [U-14C]glucose to 14CO2 in adipose tissue segments were measured in vitro immediately after tissue removal. Other aliquots of adipose tissue were preincubated in hormone-free medium for 3 hr prior to testing the ability of the tissue to respond to insulin or human GH (hGH) added in vitro. Adipose tissue from PGF-treated intact and hypophysectomized rats had significantly elevated basal glucose oxidation rates, and the tissue was sensitive to further stimulation by insulin or hGH. The results obtained with intact and hypophysectomized rats were essentially the same, indicating that the effects of PGF were not due to suppression of endogenous GH. The basal glucose oxidation rate in adipose tissue from diabetic rats was stimulated (P less than 0.01) by PGF, but the tissue was not sensitive to insulin added in vitro. Furthermore, PGF had no effect on body growth or blood glucose concentrations of diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537253 TI - Highlights in recent research on tick-borne diseases of domestic animals. PMID- 3537255 TI - Studies of comparative infectivity of fifteen strains of Plasmodium vivax to laboratory-reared anopheline mosquitoes, with special reference to Anopheles culicifacies. AB - The Sattoki strain of species A of the taxon Anopheles culicifacies Giles was infected with 15 different strains of Plasmodium vivax from Asia, New Guinea, and Central and South America. A comparison of the relative infectivity indicated a marked variation for the different strains of P. vivax when compared to Anopheles freeborni mosquitoes. PMID- 3537256 TI - Infection of Aotus azarae boliviensis monkeys with different strains of Plasmodium falciparum. AB - Eleven strains of Plasmodium falciparum from Asia, Africa, and Central America were inoculated into a total of 58 splenectomized Aotus azarae boliviensis monkeys. Eight of the strains produced high-level parasitemias, whereas 3 (2 from Honduras and 1 from Zaire) produced only low-level parasitemias. Mosquito infections were only obtained during the first 2 linear passages of the Santa Lucia strain from El Salvador. The results indicate that this species of Aotus monkey is highly susceptible to infection with strains of P. falciparum from different geographic areas, and therefore may be useful for a number of chemotherapeutic or immunologic studies. Its usefulness for mosquito infection studies is very limited. PMID- 3537257 TI - Does concanavalin A treatment of host cells enhance or inhibit their association with Trypanosoma cruzi trypomastigotes? AB - Concanavalin A (Con A) has frequently been used as a probe of cell surface molecules that mediate cell-cell interactions. There have been conflicting reports that Con A treatment of vertebrate host cells can subsequently increase or reduce the level of association (surface attachment and penetration) of Trypanosoma cruzi trypomastigotes with these cells. In this work, we have established that the type of effect produced by treatment of host cells with Con A depended on whether or not fetal bovine serum was present during the interaction of trypomastigotes and host cells; Con A treatment reduced host cell association with T. cruzi in the presence of the serum, but increased it when the serum was absent. In addition, ovalbumin, a glycoprotein with a high mannose content and the ability to specifically bind to Con A, was found capable of altering the effect of Con A treatment of host cells on parasite association levels in a manner similar to fetal bovine serum. These results suggested that glycoproteins present in the serum can modulate the effect of Con A, possibly by blocking free sites remaining on the Con A molecules which had bound to the surface of host cells. If free binding sites on the Con A molecule remained unblocked, they could conceivably form bridges between host cells and parasites resulting in an artifactual enhancement of their level of association in serum free medium. PMID- 3537258 TI - Host specificity of Cryptosporidium sp. isolated from chickens. AB - The host specificity of Cryptosporidium sp. infecting chickens was evaluated by oral inoculation of oocysts into 6 different species of neonatal rodents, adult nude mice (athymic), neonatal conventional and gnotobiotic pigs, turkeys, muscovy ducks and bobwhite quail. Examinations of tissue sections, ileal mucosal smears, fecal flotations and stained feces failed to reveal any infections in the mammalian species examined. Oocysts were observed in the feces, and developmental stages were observed in tissue sections, of turkeys and muscovy ducks but not bobwhite quail. This study indicates that Cryptosporidium sp. infections in avian species are probably not a zoonotic threat to humans. PMID- 3537259 TI - Application of the serial sectioning and tridimensional reconstruction techniques to the morphological study of the Plasmodium falciparum mitochondrion. AB - The use of serial sectioning followed by tridimensional reconstruction is a convenient way to study the spatial morphology of any structure (cell or organelle). This method was applied to the study of organelles of Plasmodium falciparum (FCR3) and enabled clarification of morphological features of the mitochondrion. The mitochondrion is polymorphic; in single sections it may be rounded, elongated or branched in shape. Its matrix may be dense or transparent, and it may or may not possess cristae. The 3-D reconstruction indicated that the mitochondrion is single in P. falciparum. Its form varies according to the age of the trophozoite. It becomes branched, and each lobe of the mitochondrion follows a daughter nucleus during the formation of merozoites. PMID- 3537260 TI - Innate and acquired immune responses against Candida albicans in congenic B10.D2 mice with deficiency of the C5 complement component. AB - Congenic mice, sufficient or deficient with respect to the C5 component of complement, were evaluated for their innate and acquired immune responses to Candida albicans. When unimmunized mice were challenged intravenously and sacrificed at intervals for cultural analyses of kidneys, it was clear that C5 sufficient mice were able to deal more effectively with C. albicans during the first week after challenge than C5-deficient mice. When immunized mice were challenged intravenously to assess the development of protective responses, an intact complement cascade appeared to contribute to the more rapid clearance of fungi during the first few weeks following challenge, but by the fourth week after challenge, the numbers of fungi had decreased significantly in both types of mice and were at levels which were not significantly different. No significant differences were detected in the development of delayed hypersensitivity or Candida-specific antibody between C5-sufficient and C5-deficient mice either. C5 deficient mice did have slightly elevated levels over the C5+ mice, but this may simply reflect the prolonged antigenic load during the first 3 weeks following intravenous challenge in both immune and nonimmune animals. The later-acting complement components, while appearing to contribute to the early inhibition of the growth of C. albicans in the nonimmune animal, had no adverse effect on the development of specific immune responses, in that delayed hypersensitive responses were equivalent between the two groups, antibody response was not significantly altered and the ultimate outcome of challenge in immunized animals was not affected. PMID- 3537262 TI - Correlative relationship between proteinase production, adherence and pathogenicity of various strains of Candida albicans. AB - Fifty-three isolates of Candida albicans, representing seven strain types, were tested for their proteinase production and this parameter was correlated with adherence to buccal epithelial cells in 23 isolates and lethality to mice for 14 isolates. Variation in proteinase production and adherence existed both among isolates of the same strain type and different strain types. All isolates tested, irrespective of strain type or source, excreted an inducible proteinase and showed a tendency towards epithelial adherence. A correlation was found between adherence, proteinase production and pathogenicity. The C. albicans isolates which adhered most strongly to buccal epithelial cells had the highest relative proteinase activities and were most pathogenic. This was obvious with strain type -C--, which had a higher prevalence than other strain types in both patients and control groups. These results emphasize the role played by some specific properties of certain strains of C. albicans in the pathogenesis of candidosis. PMID- 3537261 TI - Comparison of the pathogenicities of Fusarium solani and Candida albicans in the rabbit cornea. AB - The pathogenicity of F. solani was compared with that of Candida albicans in experimental keratitis in rabbits. F. solani was inoculated into the right eye of each rabbit, and C. albicans into the left eye. The corneal lesions in both eyes were examined by slit lamp every day for 3 weeks and the severity of infections compared clinically and histopathologically. F. solani produced significantly more severe clinical infection in the cornea, compared to C. albicans. Histopathologically, F. solani appeared to spread more rapidly, enter the anterior chamber more easily, and produce a more severe inflammatory reaction in the cornea, compared to C. albicans. PMID- 3537263 TI - Phospholipase activity as a criterion for biotyping Candida albicans. AB - The phospholipase activity of 100 oral isolates of Candida albicans was determined by a plate assay. 94% of the C. albicans isolates were phospholipase producers with varying degrees of activity ranging from Pz values of 0.3 to 0.9. As variations in the degree of phospholipase activity on repeat testing of isolates was high it is concluded that the latter criterion cannot be usefully incorporated into a biotyping system of C. albicans. PMID- 3537264 TI - Consistency of protein patterns in Candida albicans during hyphal septum and branch formation. AB - Candida albicans was grown in its hyphal form in five different media and in the presence of two concentrations of ketoconazole, and in its yeast form in one medium. Polyacrylamide gel electrophoresis patterns of proteins obtained by disruption of the fungal cells at different times around the stages of septum formation and branch initiation revealed no differences in intracellular protein composition related to growth conditions or time. Autoradiography of proteins labelled with [35S1]-methionine similarly revealed no differences in protein composition related to growth conditions or time. These findings suggest either that septum formation and branch initiation proceed independently of synthesis of new proteins or that proteins related to these processes are synthesized too transiently or in amounts too small to be detected under the conditions of the experiments. PMID- 3537265 TI - Direct bonding of orthodontic brackets. PMID- 3537266 TI - Estimation of birth weight. PMID- 3537267 TI - Analysis of cerebroarterial Doppler flow velocity waveforms in newborn infants: towards an index of cerebrovascular resistance. AB - Doppler ultrasound has been used extensively to study cerebral hemodynamics in the human newborn. This report presents a continuous recording in an infant with epileptic seizures. Heart rate, mean aortic blood pressure and mean flow velocity, obtained from the anterior cerebral artery by Doppler ultrasound, all increased markedly during the seizures. The Poucelot index was calculated from the cerebral blood flow velocity waveform and is supposed to reflect cerebrovascular resistance. This index decreased. Three mutually contradictive interpretations were possible in terms of cerebral metabolic rate, cerebral blood flow, metabolism-flow coupling and pressure-flow autoregulation. Sympathetic activation and its effects on cerebral hemodynamics is discussed. It is pointed out that the competence of the pressure-flow autoregulation may not be studied reliably during changes in blood pressure associated with altered sympathetic activity. An electrical model of the systemic arterial system is presented and used to demonstrate that the resistance index is likely to be severely affected by changes in cerebroarterial compliance, peripheral resistance, duration of systole as a fraction of heart cycle and patency of the arterial ductus. A pulsatility index ratio, which is corrected for arterial pulse pressure, is suggested to avoid some of these errors. PMID- 3537268 TI - External cephalic version: a clinical experience. AB - Eighty-five normal women underwent external cephalic version (ECV) for breech presentation in the late 3rd trimester. The protocol included real time ultrasonic scanning and pre- and post-procedure electronic fetal monitoring. Subcutaneous terbutaline sulfate (0.25 mg.) was administered to (43/85 or 50.5%) of ECV candidates and rendered the procedure easier for patient and operator. A single operator, head-over-heels technique assisted by supine Trendelenberg's position was used. Rh negative women were routinely administered 300 mcg of immune globulin. Successful ECV (53/85, 62.5%) was related to maternal parity, but not to gestational age nor eventual delivery weight. In this series only engagement of the breech was reliable in predicting ECV failure. Fifty of 51 (98.1%) successfully verted women delivered a cephalic presentation infant at term. Cesarean section was performed in 5/51 of these patients (9.8%) for routine obstetrical indications. In one case, compound presentation at term resulting in dystocia and eventual cesarean section was believed related to prior successful version. In contrast, 15/30 (50%) of the ECV failure patients went on to operative delivery despite a liberal institutional policy toward term vaginal breech trials. In addition, the only serious fetal complication in this series, meconium aspiration, occurred in a vaginally delivered breech infant. It is unlikely that late 3rd trimester ECV will impact on out overall rate of cesarean delivery. In North America prematurity is the greatest risk factor in malpresentation and our policy increasingly is to permit attempts at term breech vaginal delivery. Nonetheless, ECV deserves serious consideration. When successful, ECV avoids the costs and/or risks of either cesarean section or vaginal trial of breech.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537269 TI - Antenatal assessment of fetal outcome in pregnant diabetics. AB - The predictive value of three parameters (amniotic fluid insulin and C-peptide, and HbA1) in prognosticating major neonatal symptomatology was investigated in 57 pregnancies of diabetic women. The prediction of a healthy neonate can be achieved with a 90% accuracy by measurement of the amniotic fluid insulin alone. The correct prognosis for a child with major neonatal problems due to maternal diabetes can be made with 70% certainty using the same method. All other parameters can be judged less valuable based on our results. By using more than one of those parameters mentioned, the prediction of a healthy child can be made more correctly with a certainty of almost 100%. The accuracy in predicting a child with major symptoms cannot be increased any further. PMID- 3537270 TI - Fetal growth and the accuracy of ultrasonic measurements. PMID- 3537271 TI - [Analgesia of opioid origin. A brief review of the question]. PMID- 3537272 TI - Effect of neurotropin (NSP) on the in vivo and in vitro antibody responses in mice. AB - Intraperitoneal administration of neurotropin (NSP) did not modify the antibody response to sheep red blood cells (SRBC) in normal BALB/c mice. However, the suppressed antibody responses to SRBC in restraint-stressed mice were favorably restored to normal level by NSP at a dose of 10 or 25 mg/kg either before or even after the stress loading. The suppressed antibody responses in hydrocortisone treated mice were restored by NSP when it was administered after cortisone. Moreover, NSP augmented the in vitro antibody response to a T cell-dependent antigen, SRBC, but not to T cell-independent antigens such as dinitrophenylated Ficoll and trinitrophenylated-lipopolysaccharide. PMID- 3537273 TI - Effects of long and short photoperiod on the ultrastructure of pinealocytes of the cotton rat (Sigmodon hispidus). AB - The ultrastructure of the pinealocytes of wild-captured cotton rats (Sigmodon hispidus) housed in either long or short photoperiod was examined. Quantitative comparison of selected pinealocyte organelles revealed larger relative volumes of mitochondria, granular endoplasmic reticulum and ribosomes, Golgi apparatus, and inclusion bodies, as well as a higher number of dense-core vesicles in the animals kept in short photoperiod (LD 8:16) as compared to those in animals kept in long photoperiod (LD 16:8). These observations suggest that restricting the amount of light to which animals are exposed activates pinealocytes of the cotton rat. PMID- 3537274 TI - Surface hydrophobicity of plasmid-carrying virulent Shigella flexneri and their avirulent variants. AB - Five pairs of strains of S. flexneri each differing in the colour of their colonies after growth on Congo red agar have been tested for their ability to cause keratoconjunctivitis in the guinea pig eye, for the presence of the 140 Md virulence plasmid, for the presence of the virulence marker antigen, and for their ability to adsorb to hydrophobic surfaces (cellulose nitrate filters and Phenyl Sepharose). The results suggest that the presence of the 140 Md virulence plasmid provides the bacterial surface with a rather high degree of hydrophobicity; exceptions have been found. PMID- 3537275 TI - Lead, cadmium, zinc and certain other metals in foods on the Swedish market. PMID- 3537276 TI - Determination of total and encapsulated insulin in a vesicle formulation. AB - A method for the determination of the amount of insulin in a vesicle formulation was developed. Samples were treated with anion exchange resin to quantitatively remove the insulin outside the vesicle walls. Encapsulated insulin was released from vesicles by disruption with a surfactant and the amount released was determined by reversed-phase HPLC. Recovery of insulin from the vesicle matrix was 99, 97, and 98% for vesicle solutions spiked with 1.0, 0.5, and 0.2 U/mL of insulin, respectively. The sample preparation steps resulted in removal of greater than 99.5% of the unencapsulated insulin; 98% recovery of the vesicles from the resin; 97% recovery of the encapsulated insulin from the resin; and greater than 99% disruption of the vesicles by the surfactant. Precision of the measurements for the amounts of total and encapsulated insulin was 2.7 and 3.3% relative standard deviations, respectively, for insulin levels of 0.7 U/mL. PMID- 3537277 TI - 2,3,5-Triphenyltetrazolium chloride as a novel tool in germicide dynamics. AB - A novel, colorimetric method using 2,3,5-triphenyltetrazolium chloride (TTC) in tandem with membrane filtration is described for the determination of death rates of Escherichia coli (E. coli) due to microbiocides. This method enables results to be obtained on the same day in contrast to the 18 h required by the accepted aerobic plate count method. The microbiocides investigated were the preservatives 2-bromo-2-nitro-1,3-propanediol (Bronopol), N-(hydroxymethyl)-N-(1,3 dihydroxymethyl-2,5- dioxo-4-imidazolidinyl)-N'-(hydroxymethyl)-urea (Germall II), phenethyl alcohol, and benzyl alcohol. D values (time required per log reduction of E coli) were determined by this method, and equations relating the D values to preservative concentrations were derived [i.e., eta values (the logarithmic values relating changes in rates of kill for specified changes in concentration) and A values (extrapolated D values at 1% concentration) were determined]. these equations are compared with those previously published using the accepted aerobic plate count method. The potential advantages of this method are that it has a broad range of application as TTC is reduced by a wide variety of microbes; the test is easily done; results can be achieved in one day; dead cells do not cause interference; test sensitivity can be increased by increasing the length of incubation time or by using membrane filtration in tandem with TTC reduction; and preservative inactivation may be achieved by filtration and flushing with an inactivator, or by adding neutralizers to the TTC broth. PMID- 3537279 TI - [The ascidian embryonic development as an original type of the vertebrate embryonic development]. PMID- 3537278 TI - [Neuronal organization of the elementary vestibulo-ocular reflex arc]. PMID- 3537280 TI - [Genotoxicity of pyrolysis products in food]. PMID- 3537281 TI - Comparison of Medicaid and non-Medicaid dental providers. AB - A statewide mail survey of a stratified sample of 640 Michigan general dentists was conducted in 1983, with a response rate of 41 percent, n = 261. An analysis was performed to compare Medicaid and non-Medicaid providers. About half of all respondents reported that they were not seeing any Medicaid patients (Group 1); 29 percent reported that less than 10 percent of their patients were Medicaid eligible (Group 2), and 22 percent reported that 10 percent or more of their patients were Medicaid-eligible (Group 3). Significant differences existed among the three groups for age of respondent, length of time in practice, and number of new patients seen each month. Respondents with greater percentages of Medicaid patients in their practices were more likely to be in group practice. Stratification of respondents by location suggested that rural providers were more likely than urban respondents to have some Medicaid patients in their practices. Over 40 percent of respondents from all groups reported themselves as being not busy enough. In 1984, more than one million persons in Michigan were eligible for Medicaid dental benefits, but only one-fourth of these individuals were recipients of dental care. Factors that may limit dentists' participation in the Medicaid program, despite the presence of a large eligible population and self-reported lack of business, are discussed. PMID- 3537282 TI - The scientific proceedings of "Leishmaniasis: The First Centenary 1885-1985". 9 November 1985. PMID- 3537283 TI - The malaria threat to the Army in Hong Kong. AB - Changes in mosquito ecology and active anti-vector measures abolished endemic malaria transmission in Hong Kong by 1969. Unfortunately, endemic transmission of P. vivax reappeared in 1977. The threat posed to the British Army in Hong Kong however, appears to be small (5 cases since 1983), and restricted to areas close to the border with the Peoples Republic of China. Malaria biology and protective measures are discussed. PMID- 3537284 TI - Author and subject indexes. Volumes 58-72. Supplements 28-32. 1980-1984. PMID- 3537285 TI - Ultrasound guidance for selected dilatation and evacuation procedures. AB - Intraoperative ultrasound was used as an adjunct in difficult dilatation and evacuation (D&E) procedures for first-trimester abortions. This technique was useful in eight technically difficult D&Es in the presence of acute retroflexion, acute anteflexion, cervical stenosis and lower uterine segment fibroids. PMID- 3537286 TI - Reliability of the frozen section in sharp knife cone biopsy of the cervix. AB - Eight patient records were reviewed following cold knife conization in which frozen section diagnosis was utilized to aid the surgeon in formulating appropriate therapy after conization. Two patients were diagnosed as having microinvasive squamous cell carcinoma on final pathology when frozen sections were read as showing no invasion. Furthermore, in the 51 instances in which a degree of cervical dysplasia was determined from frozen sections, 14 discrepancies were noted on final pathology (27%). Such discrepancies may lead to unnecessary hysterectomies performed for cervical dysplasia that is easily treated with outpatient office procedures, especially when cold knife conization and frozen section diagnosis are performed without prior colposcopy and biopsy. PMID- 3537287 TI - Leiomyomatosis peritonealis disseminata. A case report and literature review. AB - Leiomyomatosis peritonealis disseminata is a rare disorder characterized by the presence of multiple small nodules, consisting of benign smooth muscle, scattered over the abdominopelvic viscera and peritoneum. The case described below is the 21st reported in the medical literature to our knowledge. The condition generally occurs in menstruating, parous women in the third decade of life, and the symptoms are similar to those of uterine leiomyomata. There is a very high association with excess exogenous and endogenous female gonadal steroids, specifically estrogen and progesterone. Leiomyomatosis peritonealis disseminata is a benign condition for which conservative management is indicated, particularly if fertility is desired. PMID- 3537288 TI - Does dimethicone increase the efficacy of antacids in the treatment of reflux oesophagitis? AB - Dimethicone is a common additive to antacids, although its value in the treatment of reflux oesophagitis is unproven. Its efficacy was assessed by comparing the effect of a dimethicone-containing antacid gel (Asilone Gel) with a simple antacid gel in a double-blind trial in 45 patients with reflux oesophagitis. Thirty-eight patients completed the eight-week course of therapy. Antacid therapy alone resulted in a significant improvement of both symptoms and oesophagitis in gastro-oesophageal reflux. The inclusion of dimethicone in the antacid gel preparation did not confer any benefit in terms of symptomatic assessment but did confer a small advantage with regard to objective markers of oesophageal inflammation, suggesting that a dimethicone-containing antacid is of value in the treatment of symptomatic gastro-oesophageal reflux. PMID- 3537289 TI - Reye's syndrome and aspirin: a review. PMID- 3537291 TI - Orthopaedics: evolution of the specialty. PMID- 3537290 TI - Tropical sprue--its aetiology and pathogenesis. PMID- 3537292 TI - Flea control on pets in southern Africa. AB - Aspects of the biology and life-cycle of the flea which are important to the practising veterinarian are discussed. The "cat flea", Ctenocephalides files is the most prevalent species on dogs and cats in those parts of the world where it has been surveyed. Whether the flea is a temporary or permanent obligatory parasite is still a controversy. The insecticides and product formulations available for flea control in South Africa are reviewed with emphasis on the systematic agent, fenthion. Practical protocols for flea control on dogs and cats are proposed. PMID- 3537293 TI - Insulin deficiency and metabolic disorders in high-yielding dairy cows. PMID- 3537295 TI - The new role of genetics in medicine. Evolution, progress and prospects. PMID- 3537296 TI - Prenatal diagnosis. PMID- 3537297 TI - Review of the glycogen storage diseases. PMID- 3537298 TI - The kidney in genetic disease. An overview. PMID- 3537294 TI - Williams syndrome. PMID- 3537299 TI - Computer-assisted instruction in patient management for internal medicine residents. PMID- 3537301 TI - A rapid and simple technique for correlating light microscopy, transmission and scanning electron microscopy of fixed tissues in Epon blocks. AB - A simplified and standardized technique for close correlation between light microscopy (LM), transmission electron microscopy (TEM) and scanning electron microscopy (SEM) is described. Perfusion and immersion fixed tissue specimens were embedded in Epon 812 and cut for conventional LM and TEM. The Epon blocks with remaining tissue were thereafter treated with epoxy solvent (ethanol-NaOH solution) for partial epoxy resin removal only (dissolving rate approx 33 microns/h). The blocks with partially blotted tissue specimens were then critically point dried and gold coated for SEM. This method, in an easy way, allows repeated observations with LM, TEM and SEM with preserved fine structure and exact correlation. Since the technique is so simple and there is no need for special equipment the method can easily be adopted in all laboratories with basic SEM standards. PMID- 3537303 TI - Section thickness terminology: a source of confusion in microscopy. PMID- 3537302 TI - Study of the conditions necessary for propane-jet freezing of fresh biological tissues without detectable ice formation. AB - The performance of a commercial double-propane-jet freezer (Balzers QFD 101) has been assessed, for rapid freezing of fresh tissues in freeze-etch work. Samples of diaphragm muscle and intestinal villi were frozen between copper sheets, with a spacer to give 20-30 microns thickness of tissue. Fracture cuts were made with the Balzers BAF 400 freeze-etch microtome within 5-10 microns of a freezing face (i.e. a tissue face in contact with the copper sheets of the frozen sandwich). After some modifications to the QFD 101, replicas showing no evidence of ice were obtained of muscle cells, although for intestinal epithelial cells some evidence of ice formation was found. Infiltration with 5% glycerol or dimethylsulphoxide improves the depth of good freezing. Results and problems arising from such infiltration are briefly discussed. PMID- 3537300 TI - Recording of foetal movements: a comparison of three methods. AB - As decreased foetal movement (FM) may indicate impaired foetal health, FM recording has been suggested as a method of assessing foetal well-being. A non intrusive, automated method of recording FM (FM-detector), was compared with maternal and ultrasonographic assessment of FMs in 24 women in the third trimester of pregnancy. The FM-detector detected a greater proportion of ultrasonographically recorded FMs than the mothers did (median 70% and 38%, respectively; p less than 0.001). Parity, gestational age, placental site or thickness, maternal weight or the distance from the maternal abdominal surface to the amniotic cavity did not affect the ability of the FM-detector to detect ultrasonographically recorded FMs. The estimation of FM strength by the FM detector agreed fairly well with the assessment of FM strength by the ultrasound observer. The FM-detector would seem suitable for clinical use, as in the examination of pregnant women complaining of feeling 'less FM'. PMID- 3537304 TI - James Grant Thompson Memorial Lecture. Osteoporosis: benefits and risks of estrogen-progestogen replacement therapy. PMID- 3537305 TI - Use of bacteriophage T7 RNA polymerase to direct selective high-level expression of cloned genes. AB - A gene expression system based on bacteriophage T7 RNA polymerase has been developed. T7 RNA polymerase is highly selective for its own promoters, which do not occur naturally in Escherichia coli. A relatively small amount of T7 RNA polymerase provided from a cloned copy of T7 gene 1 is sufficient to direct high level transcription from a T7 promoter in a multicopy plasmid. Such transcription can proceed several times around the plasmid without terminating, and can be so active that transcription by E. coli RNA polymerase is greatly decreased. When a cleavage site for RNase III is introduced, discrete RNAs of plasmid length can accumulate. The natural transcription terminator from T7 DNA also works effectively in the plasmid. Both the rate of synthesis and the accumulation of RNA directed by T7 RNA polymerase can reach levels comparable with those for ribosomal RNAs in a normal cell. These high levels of accumulation suggest that the RNAs are relatively stable, perhaps in part because their great length and/or stem-and-loop structures at their 3' ends help to protect them against exonucleolytic degradation. It seems likely that a specific mRNA produced by T7 RNA polymerase can rapidly saturate the translational machinery of E. coli, so that the rate of protein synthesis from such an mRNA will depend primarily on the efficiency of its translation. When the mRNA is efficiently translated, a target protein can accumulate to greater than 50% of the total cell protein in three hours or less. We have used two ways to deliver active T7 RNA polymerase to the cell; infection by a lambda derivative that carries gene 1, or induction of a chromosomal copy of gene 1 under control of the lacUV5 promoter. When gene 1 is delivered by infection, very toxic target genes can be maintained silent in the cell until T7 RNA polymerase is introduced, when they rapidly become expressed at high levels. When gene 1 is resident in the chromosome, even the very low basal levels of T7 RNA polymerase present in the uninduced cell can prevent the establishment of plasmids carrying toxic target genes, or make the plasmid unstable.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537306 TI - Involvement of tryptophan 209 in the allosteric interactions of Escherichia coli aspartate transcarbamylase using single amino acid substitution mutants. AB - Five mutant versions of aspartate transcarbamylase have been isolated, all with single amino acid substitutions in the catalytic chain of the enzyme. A previously isolated pyrB nonsense mutant was suppressed with supB, supC, supD and supG to create enzymes with glutamine, tyrosine, serine or lysine, respectively, inserted at the position of the nonsense codon. Each of these enzymes was purified to homogeneity and kinetically characterized. The approximate location of the substitution was determined by using tryptic fingerprints of the wild-type enzyme and the enzyme obtained with a tyrosine residue inserted at the position of the nonsense codon. By first cloning the pyrBI operon, from the original pyrB nonsense strain, followed by sequencing of the appropriate portion of the gene, the exact location of the mutation was determined to be at position 209 of the catalytic chain. Site-directed mutagenesis was used to generate versions of aspartate transcarbamylase with tyrosine and glutamic acid at this position. The Tyr209 enzyme is identical with that obtained by suppression of the original nonsense mutation with supC. The two enzymes produced by site-directed mutagenesis were purified using a newly created overproducing strain. Kinetic analysis revealed that each mutant has an altered affinity for aspartate, as judged by variations in the substrate concentration at one-half maximal activity. In addition, the mutants exhibit altered Hill coefficients and maximal activities. In the wild-type enzyme, position 209 is a tryptophan residue that is involved in the stabilization of a bend in the molecule near the subunit interface region. The alteration in homotropic cooperativity seems to be due to changes induced in this bend in the molecule, which stabilizes alternate conformational states of the enzyme. PMID- 3537307 TI - Alteration of the growth-rate-dependent regulation of Escherichia coli tyrT expression by promoter mutations. AB - The growth-rate regulation of transcription of the Escherichia coli tyrT gene depends on sequences in at least two distinct regions of the promoter, the upstream element required for optimal activity and the discriminator adjacent to the transcription start-point. Since mutations in the discriminator also alter the response of the promoter to amino acid starvation, we conclude that growth rate and amino acid control mechanisms share a common target molecule, probably RNA polymerase. PMID- 3537308 TI - Mnemonic aspects of Escherichia coli DNA polymerase I. Interaction with one template influences the next interaction with another template. AB - When Escherichia coli DNA polymerase I (Pol I) replicates a homopolymer, the excision/polymerization (exo/pol) ratio varies with enzyme and initiator concentration. The study of this effect in the case of poly(dA).oligo(dT) replication led us to propose a mnemonic model for Pol I, in which the 3' to 5' excision activity warms up when the enzyme is actively polymerizing, and cools down when it dissociates from the template. The model predicts that the exo/pol ratio must increase with processivity length and initiator concentration and decrease with enzyme concentration. It predicts also that contact of the enzyme with one template alters its excision efficiency towards another template. The exo/pol ratio and processivities of Pol I and its Klenow fragment were studied on four templates: poly(dA).(dT)10, poly(dT).(dA)10, poly(dC).(dG)10 and poly(dI).(dC)10. We show that the Klenow fragment is usually much less processive than Pol I and when this is the case it has a much lower exo/pol ratio. At equal processivity, the exo/pol ratios are nearly equal. Furthermore, many factors that influence processivity length (e.g. manganese versus magnesium, inorganic pyrophosphate, ionic strength) influence the exo/pol ratio in the same direction. The study of deaminated poly(dC) replication, where we followed incorporation and excision of both G and A residues, allowed us to assign the origin of the dNMP variations to changes in the 3' to 5' proof-reading activity of Pol I. Similarly, the lower dNMP turnover of the Klenow fragment observed with deaminated poly(dC) was specifically assigned to a decreased 3' to 5' exonuclease activity. The exo/pol ratio generally increased with initiator and decreased with enzyme concentration, in agreement with the model, except for poly(dI).oligo(dC), where it decreased with initiator concentration. However, by terminating chain elongation with dideoxy CTP, we showed directly that, even in this system, excision is relatively inefficient at the beginning of synthesis. Interaction of Pol I with poly(dA).(dT) or with poly(dC).(dG) modifies its exo/pol characteristics in the replication of poly(dI).(dC) and poly(dA).(dT), respectively. The Klenow enzyme is not sensitive to such influences and this correlates with its reduced processivity on the influencing templates. Our results reveal the existence of differences between Pol I and its Klenow fragment that are more profound than has been thought previously.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537309 TI - Periplasmic accumulation of truncated forms of outer-membrane PhoE protein of Escherichia coli K-12. AB - In order to localize the information within PhoE protein of Escherichia coli K-12 required for export of the protein to the outer membrane, we have generated deletions throughout the phoE gene. Immunocytochemical labelling on ultrathin cryosections revealed that the polypeptides encoded by the mutant alleles are transported to, and accumulate in, the periplasm. These results show that, except for the signal sequence, there is no specific sequence within the PhoE protein that is essential for transport through the cytoplasmic membrane. The overall structure of the protein, rather than a particular sequence of amino acids, seems to be important for assembly into the outer membrane. PMID- 3537310 TI - Mechanism of ribosomal translocation. Translocation limits the rate of Escherichia coli elongation factor G-promoted GTP hydrolysis. AB - The pre-steady-state kinetics of GTP hydrolysis catalysed by elongation factor G and ribosomes from Escherichia coli has been investigated by the method of quenched-flow. The GTPase activities either uncoupled from or coupled to the ribosomal translocation process were characterized under various experimental conditions. A burst of GTP hydrolysis, with a kapp value greater than 30 s-1 (20 degrees C) was observed with poly(U)-programmed vacant ribosomes, either in the presence or absence of fusidic acid. The burst was followed by a slow GTP turnover reaction, which disappears in the presence of fusidic acid. E. coli tRNAPhe, but not N-acetylphenylalanyl-tRNAPhe (N-AcPhe-tRNAPhe), stimulates the GTPase when bound in the P site. If the A site of poly(U)-programmed ribosomes, carrying tRNAPhe in the P site, is occupied by N-AcPhe-tRNAPhe, the burst of Pi discharge is replaced by a slow GTP hydrolysis. Since, under these conditions, N AcPhe-tRNAPhe is translocated from the A to the P site, this GTP hydrolysis very probably represents a GTPase coupled to the translocation reaction. PMID- 3537311 TI - Ultrastructure of native lipoprotein from Escherichia coli envelopes. AB - The free form of the major lipoprotein from Escherichia coli cells envelopes has been purified to homogeneity by gentle extraction procedures and conventional chromatographic separations in a non-ionic detergent. The morphology of paracrystals obtained from homogeneous protein was investigated by low-dose electron microscopy. Electron diffraction of the paracrystals was consistent with alpha-helices arranged perpendicularly to the main cross-band with a periodicity of 20 nm. PMID- 3537312 TI - Co-operativity value of DNA RecA protein interaction. Influence of the protein quaternary structure on the binding analysis. AB - We show that an erroneous estimation of the quaternary structure of free protein distorts the quantitative analysis of its interaction with DNA, affecting especially the co-operativity value found. This could explain the discrepancy reported for the co-operativity value of the RecA-DNA interaction. The large cluster observed by electron microscopy indicates a very high co-operativity, whereas analysis of the binding isotherm indicates a moderate one, on the assumption of monomer. But if RecA is a large oligomer, the latter analysis would give a much higher co-operativity value and the former a smaller one, and they would be in accordance. Our sedimentation and light-scattering experiments suggest an oligomerization of about 30-mer or more, and support this explanation. PMID- 3537313 TI - Nucleotide sequence of the phoB gene, the positive regulatory gene for the phosphate regulon of Escherichia coli K-12. AB - phoB encodes a positive regulator for a number of the genes belonging to the phosphate regulon of Escherichia coli, including phoA, phoS, phoE and ugpAB. We have determined the nucleotide sequence of the chromosomal segment containing the promoter and the coding region of the phoB gene. The sequence data combined with the known amino-terminal amino acid sequence of a PhoB-LacZ hybrid protein suggest that the PhoB protein consists of 228 amino acid residues with a Mr of 26,302. In the regulatory region of the gene, a consensus nucleotide sequence shared by the regulatory regions of the phoA, phoS and phoE genes, which we name the "phosphate box", was found. Since these genes are positively regulated by the product of phoB, this suggests that transcription of the phoB gene is also regulated positively by its own product. Extensive homology was found in the amino acid sequences of the products of phoB, ompR and dye, all of which are positive regulatory genes for a number of genes coding for envelope proteins. This implies that these genes were originally duplications of a protogene that evolved to have divergent but related functions. PMID- 3537314 TI - Temperature-dependence of local melting in the myosin subfragment-2 region of the rigor cross-bridge. AB - We have used alpha-chymotrypsin as an enzyme-probe to detect local melting in the subfragment-2 region of the cross-bridges of rigor myofibrils and glycerinated psoas fibers. The kinetics of proteolysis and the sites of cleavage were determined at various temperatures over the range 5 to 40 degrees C by following the decay of the myosin heavy chain and the rates of appearance of light meromyosin fragments, using electrophoresis on sodium dodecyl sulfate-containing polyacrylamide gels. Cleavage occurs primarily at the 72,000 Mr and 64,000 Mr (per polypeptide chain from the C terminus of myosin) sites within the light meromyosin-heavy meromyosin hinge domain of the subfragment-2 region, under all experimental conditions. At pH 8.2 to 8.3 and at low divalent metal ion (0.1 mM), where the actin-bound cross-bridges are thought to be released from the thick filament surface, the intrinsic cleavage rate constant (k) increases markedly as the temperature is raised. This suggests substantial thermal destabilization of the released cross-bridge in the intact contractile apparatus. Addition of divalent metal ion (10 mM) lowers the cleavage rate and shifts the k versus temperature profile to higher temperatures. Normalized rate constants for chymotryptic cleavage within the subfragment-2 hinge region of released cross bridges (pH 8.2, low divalent metal) of rigor fibers were markedly lower than activated fibers at all temperatures investigated (5 to 40 degrees C). Results show that conformational melting within the subfragment-2 hinge region is amplified on activation and is well above that observed when the actin-attached rigor bridge is passively released from the thick filament surface. PMID- 3537315 TI - Specificity of N-acetoxy-N-2-acetylaminofluorene-induced frameshift mutation spectrum in mismatch repair deficient Escherichia coli strains mutH, L, S and U. AB - The mismatch repair system of Escherichia coli is known to contribute to the fidelity of the replicational process. This system involves the functions of mutH, mutL, mutS and mutU (uvrD) loci which recognize mispaired bases as a consequence of errors due to the polymerase itself. Chemical modifications of DNA have also been suspected to create mispaired bases which, if the mispaired bases are removed, will lead to mutations by frameshift. Using the pBR322 plasmid DNA modified by the ultimate carcinogen N-acetoxy-N-2-acetylaminofluorene (N-Aco-AAF) we have investigated this possibility in a forward mutational assay (tetracycline sensitivity). This fluorene derivative has been shown to induce predominantly frameshift mutations. Our results show that: The sensitivity of the deficient strains mutH, mutL and mutS to the AAF adducts is similar to that of the corresponding wild-type strain. However, the mutU strain appears much more sensitive to those adducts although less than a uvrA, B or C-deficient strain. This suggests that the mutU gene product is involved in the repair of AAF adducts. For the four mut deficient strains, and as it was shown with the wild type strain, AAF adducts induced mutations to tetracycline sensitivity are only observed when the SOS system of the host bacteria is induced by irradiation of the cells prior to transformation with the modified plasmid. The mutation frequencies depend upon the ultraviolet light doses and similar maxima were found for the four mut strains and the corresponding wild-type strain. In agreement with the results obtained with wild-type or uvrA strains we observe that AAF adducts induce mostly frameshift mutations in the mut strains. Two types of hot spots of mutagenesis were described in wild-type and uvrA strains occurring either at repetitive sequences or at sequences of the type 5' G-G-C-G-C-C 3' (NarI restriction enzyme recognition sequence). While the second type of mutational hot spot does exist in the mismatch repair-deficient strains, we observe that the repetitive sequences are no longer hot spots of mutations in these strains, suggesting that the mismatch repair protein complex is involved in the establishment of AAF-induced frameshift mutations at repetitive sequences. PMID- 3537316 TI - Pairwise perturbation of flagellin subunits. The structural basis for the differences between plain and complex bacterial flagellar filaments. AB - Although plain and complex bacterial flagellar filaments differ in their physical properties and helical symmetry, they both appear to derive from a common underlying structure. Analysis of electron micrographs of complex filaments of Rhizobium lupini revealed that the unit cell has twice the length of that of plain filaments, with a corresponding reduction in helical symmetry whereby the six-start helical family present in plain filaments collapses into a three-start family. Mass per unit length measurements were made by scanning transmission electron microscopy. These, together with the unit cell dimensions and the molecular weight of the flagellin monomer, enabled the number of monomers per unit cell to be estimated. Whereas plain filaments have a single monomer per unit cell, complex filaments have two. These results suggest that complex filament structure differs from plain filament structure by a pairwise perturbation, or interaction, of the flagellin monomers. The additional bonding interactions involved in the perturbation in the complex filament may make it more rigid than the plain filament, which has no such perturbation. PMID- 3537317 TI - Recognition of B and Z forms of DNA by Escherichia coli DNA polymerase I. AB - Since the substrate binding domain of the large proteolytic fragment of Escherichia coli DNA polymerase I has been shown to interact with the B forms of DNA, we have studied the ability of this enzyme to recognize structures other than the B form. The polymerase activity has been used to evaluate the degree of recognition of the B and Z forms of DNA. The Z form was found to promote less activity, indicating the probable inability of the polymerase to move along the conformationally rigid form of the template. The present study indicates that the Z-DNA found in vivo may have a role in the control of replication. PMID- 3537318 TI - Magnesium in cardiac energy metabolism. AB - Free intracellular magnesium ion, which influences many metabolic processes, is the subject of ongoing research. Its concentration has been difficult to measure because the available methods, including dye injection, microelectrodes, and nuclear magnetic resonance measurements, are invasive or indirect. Concentrations ranging from 0.1 mM in frog muscle to 6 mM in barnacle muscle have been reported. We describe recent experimental evidence regarding the concentration of free intracellular magnesium and consider the limitations of these methods. A substantial body of evidence, including our models of cardiac energy metabolism and its magnesium-related processes, indicates that intracellular concentrations of free magnesium are low (ca. 0.4 mM) and vary with time and conditions. PMID- 3537319 TI - Effect of prostacyclin on the severity of ischaemic injury in rabbit hearts subjected to coronary ligation. AB - The hypothesis that prostacyclin (PGI2) might have a direct cytoprotective action in ischaemic cardiac tissue was investigated. Myocardial ischaemia was induced in perfused rabbit hearts by ligating the left main coronary artery. Coronary flow, oxygen uptake, and turnover of lactate and purines were measured before and up to 120 min after coronary occlusion. After this, ischaemic tissue was separated from perfused myocardium, and levels of lactate, adenine nucleotides and creatine phosphate were determined in specimens from non ischaemic, ischaemic and border zones. PGI2 (final conc. 10(-7) M) was infused before or 30 min after ligation and the results were compared to those in control hearts. Coronary ligation reduced coronary flow and oxygen consumption by about 50%. The fractional extraction of lactate decreased from 20% to close to zero and purine release increased 5-fold. In the non-ischaemic area the tissue levels of ATP and creatine phosphate were high, with a low content of lactate, but in the ischaemic area the levels of ATP and creatine phosphate were considerably reduced and the content of lactate was high. Although coronary flow and oxygen uptake were elevated after treatment with PGI2, no change in lactate or purine turnover was observed. Neither the weight of the non-perfused myocardium nor the tissue levels of the adenine nucleotides, creatine phosphate and lactate were affected by PGI2 treatment. The data indicate that in this model, in which effects on cardiac work, collateral flow and platelets are eliminated, PGI2 does not limit ischaemic myocardial injury. Hence, the hypothesis of a direct cytoprotective action of PGI2 in ischaemic myocardial tissue was not supported. PMID- 3537320 TI - Mouse therapy and religion, magic, hygiene, geography. PMID- 3537322 TI - Intravenous digital subtraction angiography (DSA) of hemodialysis access fistulae. AB - Hemodialysis access fistulae or grafts are subject to a variety of complications, including thrombosis, stenoses, and aneurysm or pseudoaneurysm formation. The usual radiologic methods to evaluate these problems consist of retrograde venous angiography or standard femoral or brachial arteriography. Both are invasive, and may traumatize the artery or graft. Six patients with internal blood access were studied using digital subtraction angiography; five using a central venous injection and one with direct graft injection. Preliminary results indicate that intravenous digital subtraction angiography (IV-DSA) can depict the anatomy of access fistula with adequate spatial resolution. Pathologic entities (stenoses, aneurysms) can be demonstrated, as well as other findings of uncertain clinical significance (kinks and webs). In addition, hemodynamic data can be inferred from the near-physiologic sequence of vessel opacification. Methods are in development that will allow determination of absolute blood flow in pertinent vessels via IV DSA. There were no complications in this small series, and all examinations were performed on outpatients utilizing standard technique. PMID- 3537323 TI - Mutagen activation of 1,2-dibromo-3-chloropropane by cytosolic glutathione S transferases and microsomal enzymes. AB - It is not clear whether glutathione (GSH) conjugation to 1,2-dibromo-3 chloropropane (DBCP) results in genotoxic activation. Therefore S9, cytosolic, and microsomal fractions from uninduced rat liver were evaluated for their relative ability to activate DBCP in a modified Ames system. The S9 enzymes, either alone or in combination with exogenous GSH, did not enhance the mutagenicity of DBCP; identical results were obtained with cytosolic enzymes. Significant mutagenic activation of DBCP was produced by either S9 or microsomal fractions in the presence of NADPH. Activation was proportional to cytochrome P 450 concentrations, and was diminished by exogenous GSH. The protection against genotoxicity exerted by GSH did not require cytosolic glutathione S-transferases (GST). Thus, mutagenic activation of DBCP as obtained with S9 fractions is primarily due to biotransformation by microsomal rather than by cytosolic enzymes. Kinetic studies of cytosol-catalyzed conjugation of GSH to DBCP revealed tissue-specific differences in apparent Km and Vmax. Renal and testicular GSTs were associated with 28-46% smaller Vmax values when compared to hepatic GSTs (31.2 +/- 1.9 nmol/min X mg protein). However, renal and testicular GSTs had relatively higher affinities for DBCP. Thus, extrahepatic tissues possess significant capacity to conjugate GSH to DBCP. DBCP-GSH conjugates may undergo enzymatic modification by extrahepatic peptidase and beta-lyase to yield other sulfur-containing moieties that perhaps mediate DBCP's extrahepatic toxicity. PMID- 3537324 TI - Grafting of cultured allogeneic epidermis on second- and third-degree burn wounds on 26 patients. AB - Twenty-six individuals with second- and third-degree burn wounds have been grafted with cultured allogeneic epidermal cells. These epidermal cell grafts were grown in culture from cadaver skin according to a technique which we have developed. After being grafted with cultured allogeneic epidermal cells, superficial wounds, e.g., donor sites, healed within 7 days, compared to 14 days for mirror image control sites. Deep second-degree burn wounds which were excised before grafting with cultured cells healed in a mean time of 10 days. Deep second degree burn wounds which were not excised before grafting healed in a mean time of 14 days. The cultured cells produced rapid healing in 11 of the 12 patients with deep second-degree burn wounds. The deep second-degree wounds grafted with cultured allogeneic epidermal cells healed with results which were comparable to the deep second-degree wounds which were autografted. Grafts of cultured allogeneic epidermal cells placed on full-thickness, or third-degree burn, wounds did not grow well. PMID- 3537325 TI - Light and electron microscope immunocytochemical studies on the role of binucleate cells in villus growth in goat placentomes. AB - The monoclonal antibody SBU-3 exclusively labels granules and Golgi cisternae in fetal trophectodermal binucleate cells but only similar granules in the adjacent syncytium in goat placentomes. This localisation supports previous morphological evidence that binucleate cells migrate and form the syncytium by fusion. SBU-3 reactivity is not demonstrable in binucleate cells or syncytium before the start of placentomal fetal chorionic villus formation (30-34 days post coitum (d.p.c.)) but then rises rapidly to a peak during the period of maximal villus growth into the caruncle (36-95 d.p.c.). During this period the highest reactivity and numbers of granules are concentrated in the most extensive syncytium and largest binucleate cells at the advancing tips of the villi. After the villi have reached maximum length (90-100 d.p.c.) the SBU-3 reactivity decreases and the binucleate cell distribution becomes more diffuse, although even at term (145-150 d.p.c.) SBU-3 positive granules are present in binucleate cells and the syncytium. In the interplacentomal regions, where no chorionic villi form, no binucleate cells or syncytium show any SBU-3 activity at any stage of pregnancy despite having equivalent ultrastructure (including granules) to their placentomal neighbours. These results support the concept of two populations of binucleate cells of equivalent ultrastructure but different granule content and function in the goat placenta. The distribution of the SBU-3 positive population suggests a role in placentomal villus formation. PMID- 3537327 TI - Organization of the exoerythrocytic stage of the rodent malaria parasite Plasmodium berghei. A cytochemical study. AB - With the osmium tetroxide-zinc iodide impregnation technique the visualization of the internal organization of the exoerythrocytic form of the rodent malaria parasite Plasmodium berghei was improved. Osmium impregnation leached the ground matrix of the parasite thereby displaying a system of intermediate-sized filaments. Because microtubules are only present as part of the mitotic spindle and as remnants of the sporozoite cytoskeleton, the observed intermediate-sized filaments comprise most of the cytoskeletal organization of the liver stage malaria parasite. PMID- 3537326 TI - Peroxidases induced in rat uterus by estrogen administration. I. Synthesis, secretion and immunofluorescent demonstration of fluid enzymes. AB - Uterine secretions are of fundamental importance in reproductive processes. Uterine activity is related to the hormonal status of the animal, and peroxidase is a major estrogen-regulated glycoprotein in the uterine fluid. Estrogen-induced peroxidase (EIP) can be separated into several isoelectric variants. SDS-PAGE electrophoresis suggested that EIP has a molecular weight of approximately 70kd. The observed pattern of EIP isoforms appears to result from differential glycosylation of a single protein species because neuraminidase treatment resulted in a gradual shift of EIP to the more basic isoelectric variants prior to abolishing enzymatic activity. Antibody raised against one of the major isoelectric variants of EIP demonstrated uterine epithelial cells by immunofluorescence indicating an epithelial cell localization for the enzyme. Radioactive bands comigrating with major EIP isozymes were detected in uterine fluid by in vivo labeling after estrogen treatment. The results of these studies support the hypothesis that EIP is a major estrogen-regulated secretory protein of the uterine epithelium. PMID- 3537328 TI - Studies on the recasting characterization of a palladium-silver porcelain alloy: the effects of the oxidation layer. PMID- 3537321 TI - Tubo-ovarian abscess: pathogenesis and management. AB - That a female patient with abdominal pain is often considered to have pelvic inflammatory disease until proven otherwise is ubiquitous in the medical literature. This view is dangerous and should be challenged because it has resulted in episodes of ruptured appendix, death from ruptured ectopic pregnancies, and serious morbidity from delayed diagnoses of such entities as diverticulitis and endometriosis. Proper diagnostic steps should be taken for all patients with abdominal pain of unclear etiology.This article reviews the pathogenesis of tubo-ovarian abscesses so as to separate and clearly identify fact from fiction. Diagnostic steps and management guidelines are discussed. PMID- 3537329 TI - [The bonding mechanism of certain precious metals for porcelain-fused-to-metal crowns. II. A study of surface texture and trace elements of precious metals for metal-ceramics treated with hydrofluoric acid]. PMID- 3537330 TI - Facial anatomy of the fetus. AB - Real-time ultrasonography was used in this study to demonstrate details of the anatomy of the face and neck of the fetus. Details such as the ocular globe, vitreous body, lens, anterior chamber, rectus muscles, optic nerve and disc, and the ophthalmic artery are visible at the level of the eye. The helix, scaphoid fossa, triangular fossa, concha, antihelix, antitragus, intertragic incisure, and lobule can be seen at the level of the ear. The tip of the nose, the alae nasi, and the columna are also seen. The epiglottis is visible in the vestibulum of the larynx. The fetal face is an important structure that can provide invaluable information in the search for congenital malformations, and possibly also in fetal behavior. PMID- 3537331 TI - Evaluation of the prone view for cholecystosonography. AB - Routine sonographic examination of the gallbladder is performed in the supine, right anterior oblique, and erect positions. The purpose of this study was to evaluate the prone view for examination of the gallbladder. To obtain prone views, the gallbladder is scanned through the right lateral intercostal spaces in the mid-axillary line, with the patient in the prone position. Prone views can be helpful in the diagnosis of stones, sludge, or polyps in the gallbladder. Occasionally, stones or sludge in the gallbladder can be demonstrated best or exclusively on prone views. The mobility of the stones can be demonstrated best by turning the patient from prone to supine position. Prone views are frequently helpful to avoid reverberation artifacts from the abdominal wall or bowel residue. Therefore, addition of the prone view to the routine supine and erect views is suggested for sonographic examination of the gallbladder. PMID- 3537332 TI - Real-time B-mode ultrasonography for better specificity in the noninvasive diagnosis of deep venous thrombosis. AB - In order to evaluate the usefulness of B-mode ultrasonography in the diagnosis of deep vein thrombosis, a prospective study was performed on 145 patients. Each patient was examined with occlusive venous plethysmography, continuous wave Doppler, real-time B-mode ultrasonography, and radiographic contrast phlebography. The diagnostic sensitivity and specificity versus phlebography were 91 and 82.1 per cent, respectively, for plethysmography, 92 and 86.6 per cent for Doppler, and 94 and 100 per cent for B-mode sonographic scanning. The combined noninvasive approach reached a 96 per cent sensitivity. B-mode ultrasonography demonstrated a mass in eight cases, and showed a superficial venous thrombosis in four cases, among the 45 patients without deep vein thrombosis. B-mode ultrasonography, therefore, appears to be very useful in obtaining a better specificity and differential diagnosis. PMID- 3537333 TI - Factors associated with renal parenchymal echogenicity in the newborn. AB - A prospective renal ultrasound study of 134 newborns (49 prematures weighing less than 2500 g and 85 more mature babies) was undertaken to investigate factors associated with increased renal cortical echogenicity (RCE). Increased RCE was seen in 39 (29 per cent) babies. It was significantly related to body weight, age, medical status, blood urea nitrogen, and serum creatinine. In view of the interdependence of these factors, however, multivariate analysis was performed, which revealed that age was the most important factor associated with increased echogenicity (r = -0.46), and the other factors had only small independent effects, increasing the multiple r to 0.56. The authors conclude that an infant's immaturity is the most important determinant of increased RCE. PMID- 3537334 TI - Utility of a screening examination of the fetal extremities during obstetrical sonography. AB - The hands, feet, and long bones of the extremities were visualized and an image of the femur was obtained as part of a brief fetal anatomy survey during approximately 6,700 low-risk and high-risk obstetric sonograms. This examination identified four fetuses with five instances of isolated extremity abnormalities and nine fetuses with ten instances of generalized extremity abnormalities. Isolated abnormalities included malformation or complete or partial absence of an extremity. Generalized abnormalities included fused hands and feet, polydactyly, phocomelia, hyperechoic muscle with contractures, and several varieties of dwarfism. Most fetuses had other structural abnormalities as well and two had an abnormal family history. The sensitivity of the fetal anatomy survey for the detection of extremity malformations would not have been changed if the routine femur measurement had been retained but the systematic visualization of the fetal extremities had been done only in selected fetuses with a malformation of any kind or an abnormal family history. PMID- 3537335 TI - Postmenopausal endometrial fluid collections: always an indicator of malignancy? AB - An endometrial collection in a postmenopausal woman is abnormal. Its potential for heralding pelvic malignancy has been emphasized. Although malignancy must always be excluded, the authors' experience with a large outpatient population indicates that benign causes of uterine fluid collections may be more common than previously reported. During a 14-month period eight postmenopausal women with endometrial fluid collections were identified in the outpatient ultrasound department of the Massachusetts General Hospital. Seventy-five per cent of these were secondary to benign processes. PMID- 3537336 TI - Effect of ultrasound on development. Part 2: Studies in mammalian species and overview. AB - This report reviews and establishes patterns from the literature on experimental ultrasound exposures of inframammalian embryos and prenatal laboratory mammals. Exposure to ultrasound can produce adverse affects on development, and the sensitivity and responses of the test systems vary with the stage of development. Generally, however, deleterious effects are demonstrable only with exposure parameters that far exceed those used in clinical practice, and the few reports of mammalian embryotoxicity under clinically relevant exposure conditions have not been repeatable. Although it may be impossible to unequivocally establish absolute safety, there is a need for further studies to evaluate subtle and delayed indicators of developmental effects, potential mechanisms, and to attempt to estimate threshold exposure conditions. PMID- 3537337 TI - Sequential bilateral torsion of normal ovaries in a child. PMID- 3537338 TI - Antenatal sonographic detection of a fetal theca lutein cyst: a clue to maternal diabetes mellitus. PMID- 3537339 TI - Fetal hydrops associated with extralobar pulmonary sequestration. PMID- 3537340 TI - Sonographic diagnosis of the bilobate placenta. PMID- 3537341 TI - Prohead core of bacteriophage T4 can act as an intermediate in the T4 head assembly pathway. AB - Bacteriophage T4 assembly was impaired in Escherichia coli hdB3-1 at an incubation temperature below 30 degrees C. Naked prohead cores (head scaffold) bound to the inner surface of the plasma membrane accumulated, and the major shell protein (gp23) precipitated into visible intracellular aggregates in the cytoplasm. Shifting the temperature to 42 degrees C allowed newly synthesized gp23 to assemble around the accumulated cores. We conclude that synchronous assembly of the scaffold and shell is not obligatory and that naked cores can serve as intermediates in the T4 assembly pathway. PMID- 3537343 TI - Does the in situ technique improve flow characteristics in femoropopliteal bypass? AB - A postulated advantage of in situ over reversed vein bypass is improved flow characteristics. This study compares Doppler frequency analyses in 22 patients with reversed veins and in 21 patients with in situ femoropopliteal vein grafts. Signals from the common femoral artery, the femoral anastomosis, and the vein in the mid thigh were analyzed and the pulsatility index (PI) and flow disturbance index (FDI) calculated (FDI = maximum frequency divided by median frequency). The two groups were similar clinically and common femoral artery PI showed inflow to be similar and satisfactory. Marked turbulence occurred at the femoral anastomosis where peak FDI rose from 1.67 +/- 0.19 (mean +/- SD) to 2.96 +/- 0.69 in the in situ vein group and from 1.74 +/- 0.51 to 3.11 +/- 0.64 in the reversed vein group (p less than 0.001). This turbulence was much reduced at mid thigh level where peak FDI had fallen to 1.45 +/- 0.17 in the reversed vein group and 1.51 +/- 0.23 in the in situ vein group (p less than 0.001). Comparison of the signals from the femoral anastomosis and from the vein at mid thigh showed that the amount of flow disturbance was no different in the in situ vein group from that in the reversed vein group (unpaired t test). In this study flow patterns were not improved by use of the in situ bypass technique. PMID- 3537342 TI - Does the in situ technique for autologous vein femoropopliteal bypass offer any hemodynamic advantage? AB - The improved patency rates that have been claimed for in situ femoropopliteal vein bypass have been attributed to improved hemodynamics because of the natural taper of the vein and maintenance of wall compliance because of preservation of the nutrient vasa vasorum. Blood flow in 31 in situ and 21 reversed vein grafts was measured noninvasively with a duplex ultrasound scanner at a median of 6 months after operation. There was no significant difference in the resting or hyperemic flows between the two groups (p much greater than 0.1). The compliance of 15 undisturbed and 15 fully mobilized in situ vein grafts was measured noninvasively by Doppler ultrasonography immediately after operation and at 3 months. There was a significant fall in compliance in both groups (p less than 0.001) but no significant difference between them (p much greater than 0.1). We have been unable to demonstrate any significant hemodynamic advantage with the in situ technique but believe that its use is still justified because of technically easier anastomoses and an improved utilization rate. Preservation of the vasa vasorum does not maintain wall compliance and complete mobilization of the vein relieves any uneven tension and ensures that all venous tributaries are ligated, removing the risk of arteriovenous fistulas. PMID- 3537344 TI - Leads from the MMWR. Plasmodium vivax malaria--San Diego County, California, 1986. PMID- 3537345 TI - On lymphokines, cytokines, and breakthroughs. PMID- 3537347 TI - CD-ROM. A new advance in medical information retrieval. AB - The massive production of medical information is being met by new technologies for storing and retrieving knowledge. Recent years have witnessed the maturation of time-sharing information utilities into a full-blown industry. In medicine these services have provided bibliographic information but have recently expanded to full-text availability of journals and books. Now optical storage technology, most conspicuously the compact disk read only memory (CD-ROM), provides similar massive information storage and retrieval affordable to microcomputer users. Such devices might replace many of the functions of time-sharing. PMID- 3537346 TI - Another facet of brittle diabetes. PMID- 3537348 TI - A proposal for financing health care of the elderly. AB - The American Medical Association House of Delegates has adopted a proposal for financing health care of the elderly, developed by the Board of Trustees, the Council on Medical Service, and the Council on Legislation. The proposal would replace the present Medicare program with a system of vouchers to older persons to purchase private health insurance policies or plans providing specified adequate benefits including catastrophic coverage. Vouchers would be financed by a new tax on adjusted gross income during working years that would replace the present employee health insurance payroll tax, and by continuation of the employer health insurance payroll tax. Tax rates would be at a level sufficient both to meet obligations to current Medicare beneficiaries and, over a 30-year period, to achieve prefunding of benefits. All tax contributions after that date would be preserved for the future use of those taxed, and could be invested during earning years, rather than being paid out immediately for present beneficiaries. The proposal would place health care for the elderly on a fiscally sound basis, provide increased cost sharing for those who are financially well off, and provide the protection against catastrophic health care expense lacking under the current Medicare program. PMID- 3537349 TI - Clouds on the 'private Medicare' horizon. PMID- 3537350 TI - The management of sore throat: adjusting to success. PMID- 3537352 TI - 100 citation classics from the Journal of the American Medical Association. AB - The 100 most-cited JAMA articles were identified using the 1955 through 1983 Science Citation Index of the Institute for Scientific Information. The most cited article received 705 citations, while the least-cited article received 158. The oldest was published in 1910 and the most recent in 1976. These articles describe important medical advances in areas such as asbestos exposure, smoking, and oral contraceptives. Most of the 285 JAMA authors are Americans and include Baruch S. Blumberg and Edward A. Doisy, both Nobel laureates. Thirteen of the articles were included in JAMA's original landmark series; the editorial committee used a combination of peer review and citation frequency to select 51 articles. PMID- 3537353 TI - [Local anesthetics and the cell membrane]. PMID- 3537351 TI - Treatment of primary moderate hypercholesterolemia with lovastatin (mevinolin) and colestipol. AB - The introduction of inhibitors of cholesterol biosynthesis offers a new approach to treatment of hypercholesterolemia. One such agent, lovastatin (formerly, mevinolin), causes significant reductions in plasma cholesterol levels. This action can be enhanced by bile acid sequestrants. In this study, lovastatin and colestipol hydrochloride together were administered to ten patients with primary moderate hypercholesterolemia. Compared with a control period, the combined-drug therapy caused a 36% reduction in plasma total cholesterol level, a 48% decrease in low-density lipoprotein (LDL) cholesterol level, and a 17% increase in high density lipoprotein cholesterol level. The reduction in LDL cholesterol level was due to three factors: a 27% decrease in the production rate of LDL, a 20% increase in fractional catabolic rate of LDL, and a 15% depletion of cholesterol in LDL particles. This major reduction in LDL cholesterol level produced by combined-drug therapy may be valuable for prevention of coronary heart disease in high-risk patients with primary moderate hypercholesterolemia. PMID- 3537354 TI - Acute effects of captopril on the baroreflex of normotensive and spontaneously hypertensive rats. AB - When captopril was injected intravenously in urethane anesthetized rats, a hypotensive effect accompanied by bradycardia was obtained, while an intravenous (i.v.) injection of prostaglandin I2 (PGI2), which induced hypotension of the same magnitude as the hypotensive effect obtained with captopril, caused a marked tachycardia. Simultaneously, sympathetic nerve activity recorded from abdominal sympathetic nerves was unchanged following injection of captopril, while it was significantly increased during hypotension induced by PGI2. The bradycardia, but not the hypotensive effects induced by captopril was abolished by i.v. pretreatment with atropine. Intracisternal injection of a small dose of captopril inhibited reflex tachycardia during hypotension induced by PGI2 and prolonged the hypotensive effect, while intravenous administration of this dose did not inhibit the reflex tachycardia induced by PGI2. In spontaneously hypertensive rats (SHR), the hypotensive effect of captopril was increased partly, however, the accompanying bradycardia was significantly reduced. These findings suggest that captopril inhibits the baroreflex and centrally activates the cardiac vagal nerve. Moreover in SHR, the effect of captopril on cardiac vagal activity was disturbed. PMID- 3537355 TI - [Tumor markers]. AB - Recently discovered new tumor markers were introduced, clinical data of tumor markers were also summarized using figures and tables. Monoclonal antibody technique and establishment of human cancer cultured cell line were very useful for discovery of new tumor markers. PMID- 3537356 TI - [Imaging diagnosis of hepatobiliary system and pancreas--computed tomography, ultrasound and angiography]. AB - CT, US and angiography have become the most important examinations in the diagnosis of hepatobiliary and pancreatic diseases. Therefore updated and precise knowledge of these modalities are mandatory not only for the diagnosis but also for the interventional radiology in this field. General review on the advantages and limitations of these medical images are described. PMID- 3537357 TI - [Current status of chemotherapy of advanced gastrointestinal tumors]. AB - In general, progress of chemotherapy for advanced gastrointestinal tumors has been slow, however, introduction of cisplatin has improved the results of chemotherapy in esophageal cancer. Cisplatin has been also recognized to be active for gastric cancer and study of combinations containing it is underway. Adriamycin appears to be the most active for hepatoma and 5-fluorouracil for pancreatic and colorectal cancers. Thus, combinations containing these drugs have been extensively studied but none has shown a definitive superiority over single agent efficacy of both drugs. PMID- 3537358 TI - [Carcinoma of the oral cavity]. AB - The diagnosis and treatment of carcinoma of the oral cavity have improved with the recent progress of medical science, further enhancing the recovery of oral function and therapeutic results. These processes are described with special reference to primary cases of carcinoma of the oral cavity (squamous cell carcinoma) examined in our department during the past eight-year period. PMID- 3537359 TI - [Salivary gland tumors]. AB - A standard histopathological classification of salivary gland tumor is presented by the World Health Organization and is widely used. It, however, needs a minor modification from the clinical point of view. Histologically there are different character according to different kinds of tumor. For instance malignant change occurs occasionally from benign pleomorphic adenoma, and adenoid cystic carcinoma often causes distant metastasis. Therefore, treatment should be based on histological character of tumor. However, preoperative clinical examinations to differentiate high or moderate grade malignancies from benign tumors are not yet satisfactory. By these tests malignancies are sometimes taken for benign. Parotidectomy with preservation of the facial nerve is indicated not only benign tumors but also for malignancies of low grade extension and for moderate grade malignancies. Combined use of surgery with irradiation and anti-cancer drugs is presumed to be useful for prevention of recurrence and metastasis. PMID- 3537360 TI - [Endoscopic ultrasonic diagnosis of esophageal cancer]. AB - Endoscopic Ultrasonography (EUS) has been developed rapidly and is becoming a new routine examination of the digestive diseases. In this thesis, the usefulness of EUS with reference to the diagnosis of the depth and the margins of the cancer invasion and the metastatic lymph nodes is described. Furthermore, the judgment of the efficacy of the combined therapy including radiotherapy, chemotherapy and immunotherapy will be possible with EUS. The information from EUS is useful to determine the treatment plan of esophageal cancer. Therefore, EUS is expected to become a preoperative necessary examination of cases with esophageal cancer. PMID- 3537361 TI - [Diagnosis of the infiltrating depth of gastric cancer by endoscopic ultrasonography]. AB - In the diagnosis of the infiltrating depth of thirty four cases with gastric cancer, in which twenty two cases were early cancer and fourteen cases advanced cancer, the rate of the diagnostic accuracy by EUS was eighty eight % in the differentiation between early cancer and advanced cancer. While, in distinction of cancer spreading into the mucosa, the submucosa, the muscularis propria and over the subserosa, diagnostic accuracy was sixty four % in early cancer and seventy five % in advanced cancer. There were two reasons mainly in the wrong diagnosis of EUS. One was the existence of fibrosis in cases of the depressed type of early cancer and the other was the dissemination of the cancer cells extending into the deeper tissues, which could be detected only by histological examinations. PMID- 3537362 TI - [Current status of adjuvant chemotherapy of gastric cancer]. AB - Effect of adjuvant chemotherapy on the postoperative survival of gastric cancer patients has been suggested by various clinical trials with an aim of controlling minimum residual tumors after surgery. Incorporation of adjuvant chemotherapy with MMC, 5-FU, FT-207, or immunomodulators into the treatment modalities might be one of the basic treatment strategies for gastric cancer. Well designed, controlled trials in terms of selecting proper drugs and patients, and of statistical methodology, are essential for the proper evaluation of the adjuvant chemotherapy. PMID- 3537363 TI - [Diagnosis of pancreatic carcinoma]. AB - The diagnosis of small pancreatic carcinoma is difficult since specific tumor marker is not currently available. Diagnostic modalities are used to evaluate patients in whom pancreatic carcinoma is clinically suspected. US is frequently used as a screening procedure. Should this be abnormal, a lesion is confirmed by CT. If not ERCP is indicated. If ERCP reveals an abnormality, angiography is performed to determine whether the lesion is benign or malignant. Between 1972 and 1984, 150 pancreatic carcinomas have been diagnosed. Thirty-nine tumors were less than 3 cm, and the smallest lesion measured 9 mm. Four-year survival rate of small resectable tumors is 40%. PMID- 3537364 TI - [Ultrasonic diagnosis of early gallbladder cancer]. AB - In a series of 514 consecutive cholecystectomy specimens excised for biliary disease, 1.4% exhibited early carcinoma and 4.5% advanced. On the other hand benign tumors and pseudotumors were observed in 2.0% of cholesterol polyps, 0.8% adenomas, 1.0% inflammatory polyps and 10.8% adenomyomatosis. On the basis of these finding in this series, diagnostic usefulness and difficulties of ultrasound were discussed. Sonography can provide critical diagnostic information for preoperative identification of small polypoid lesion and irregular wall thickness. PMID- 3537365 TI - [Preoperative clinical evaluations of rectal cancer using rectal echo, X-ray CT and MR-CT]. AB - In order to evaluate the depth of invasion and to determine the stage of rectal cancer, we have recently performed intra-rectal echo, X-ray CT and MR-CT preoperatively. Conventional approaches such as barium enema X-ray and colonofiberscope are not satisfactory to determine the depth of invasion of tumor and to detect adjacent metastatic lymphnodes. Intra-rectal echo can reveal rectal wall layers fairly well, which can be divided into five layers. Using this technique, we are able to determine the depth of invasion of rectal cancer. X-ray CT can demonstrate all the intra-pelvic organs and metastatic lymphnodes surrounding rectal tumor. Invasion to the neighboring organs such as urinary bladder, prostate, seminal vesicle and uterus can also be evaluated preoperatively. MR-CT is also helpful to determine the stage of rectal cancer before operations. Though the images of MR-CT are not so sharp, multi-directional slices of X-ray photographs can be taken by MR-CT and so furthermore evaluations of rectal tumor invasion and adjacent metastatic lymphnodes are possible. In addition, IR-image of MR-CT demonstrates the tumor site dramatically. In conclusion, using these three techniques we can evaluate preoperative clinical stages of rectal cancer and the best operative method can be determined preoperatively. PMID- 3537366 TI - [Transrectal ultrasonography for the assessment of invasion in rectal carcinoma]. AB - Transrectal ultrasonography is an effective method in visualizing the tomographical view of rectal tumors. The advantage of this method over computed tomography is that with this method it is possible to visualize the layered structure of the bowel wall. The invasion was assessed as whether or not the tumor has penetrated the muscularis propria which was visualized in low echoic layer. With 5.0 MHz linear array scanner, it was possible to make relatively accurate diagnosis of depth of cancer invasion. The new 7.5 MHz linear probe visualized the rectal wall in five to seven layers, and the resolution with this probe was far better than that with the 5.0 MHz linear probe. PMID- 3537367 TI - [Erythroenzymopathies: present status and prospects]. PMID- 3537368 TI - [Bone marrow transplantation in aplastic anemia with refractory states in platelet transfusions]. PMID- 3537369 TI - [Screening of pancreatic neoplasms and the diagnostic rate of small pancreatic neoplasms]. PMID- 3537370 TI - [Etiology of jaundice associated with small pancreatic neoplasms]. PMID- 3537371 TI - [The current diagnostic system for pancreatic neoplasms and associated problems]. PMID- 3537372 TI - [Image diagnosis and the diagnostic rate of small pancreatic neoplasms--efficacy and limits. 2). Ultrasonic diagnosis]. PMID- 3537373 TI - [Occurrence of pancreatic tumor markers and diagnosis of small pancreatic tumors. 3). POA (pancreatic oncofetal antigen)]. PMID- 3537374 TI - [Occurrence of pancreatic tumor markers and diagnosis of small pancreatic tumors. 5). DU-PAN-2]. PMID- 3537375 TI - [Occurrence of pancreatic tumor markers and diagnosis of small pancreatic tumors. 6). Application of tumor marker KM 01 analysis in the diagnosis of pancreatic neoplasms]. PMID- 3537376 TI - [Occurrence of pancreatic tumor markers and diagnosis of small pancreatic tumors. 7). Usefulness of combination assay]. PMID- 3537377 TI - [Hemochromatosis]. PMID- 3537378 TI - [Interleukin 4--special reference to the cloning of genes]. PMID- 3537379 TI - [Development of an influenza vaccine using an artificial membrane]. PMID- 3537380 TI - [Campylobacter infections]. PMID- 3537382 TI - [Automated analysis of the electrocardiogram]. PMID- 3537381 TI - [Enzyme immunoassay]. PMID- 3537383 TI - [Computer diagnosis of electrocardiograms and vectorcardiograms]. PMID- 3537384 TI - [Pericholecystic fluid collection (PCFC) in acute cholecystitis]. PMID- 3537385 TI - [Ultrasonic visualization of the non-dilated extrahepatic bile duct]. PMID- 3537386 TI - [The ultrasonic manifestation of obstructive jaundice in infancy]. PMID- 3537387 TI - [Ultrasonography of superficial soft tissue masses]. PMID- 3537388 TI - [Liver cysts]. PMID- 3537389 TI - [Roentgenographic diagnosis of inflammatory diseases of the colon]. PMID- 3537390 TI - [Lectin-binding pattern of sweat gland tumors--histochemical investigation using avidin-biotin-peroxidase complex (ABC) method]. PMID- 3537391 TI - [Dermo-epidermal blister formation in normal human skin in organ culture by linear IgA dermatosis sera]. PMID- 3537392 TI - [Studies on a pathogenesis of SSSS]. PMID- 3537393 TI - [Splenic blood flow in liver disease--blood flow measurement in the splenic artery using an ultrasonic duplex system]. PMID- 3537394 TI - [A trial of the mass examination of pancreatic cancer using measurement of serum CA 19-9 and elastase-1 and ultrasonography]. PMID- 3537395 TI - [A case of gallstone ileus diagnosed by ultrasonography]. PMID- 3537397 TI - [Mechanical properties of living tissues]. PMID- 3537396 TI - ["Basal blood pressure" at rest in middle and old-aged patients with mild essential hypertension]. PMID- 3537398 TI - [Electrical properties of biological substances]. PMID- 3537399 TI - [Thermal characteristics of living substances]. PMID- 3537400 TI - [Optical properties of the human body]. PMID- 3537401 TI - [Ultrasonic properties of biological tissues]. PMID- 3537402 TI - [Interactions of ionizing radiation with biological matter]. PMID- 3537403 TI - [Mechanical properties of the cardiac muscle]. PMID- 3537404 TI - [Measurement of the mechanical properties and heat production of muscle]. PMID- 3537405 TI - [Mechanics and mechanical properties of the synovial joints]. PMID- 3537406 TI - [Measurement of body movement with special emphasis on locomotion]. PMID- 3537407 TI - [Respiratory mechanics and its measurements]. PMID- 3537408 TI - [Heat transfer in the living body--its mechanism and measurement]. PMID- 3537409 TI - [Medicolegal document material chronologically arranged in the Meiji Era (5)]. PMID- 3537410 TI - [Witnesses of postwar nursing history. Postwar nursing development and my personal maturation]. PMID- 3537411 TI - [Witness to the post-war nursing history in Japan: Ms. Ayako Nakao who practiced nursing based on the nursing ideal]. PMID- 3537412 TI - [History of Nursing School attached to Sakurai Girls' High School seen in correspondence with the U. S. Presbyterian Mission. 4. On Maria T. True and Kajiko Yajima--search of historical data]. PMID- 3537413 TI - In vitro system of corneal endothelium. AB - A method for preparation of highly ordered monolayer cultures of the corneal endothelium was described. The technique of agar and palladium double-coating of culture plates was utilized for demarcation of the haptotactic area. The culture plate was prepared by precoating with agar and subsequent coating with palladium to define areas where growth of corneal endothelial cells was allowed. A micro mass culture of corneal endothelial cells on the area defined by the palladium coating demonstrated their active growth and their reconstitution of the typical cellular pattern of the corneal endothelium. PMID- 3537414 TI - Mechanical, thermal, and optical changes of the nerve membrane associated with excitation. AB - Nerve fibers produce several non-electrical signals on excitation. Recent findings on such non-electrical signals are discussed, in the hope that some of them might give us clues to molecular events underlying the excitation process. At present this expectation is not fulfilled, but progress is being made which allows one to look optimistically at future developments. PMID- 3537415 TI - Effect of captopril on some ventricular contractility indices in spontaneously hypertensive rats (SHR). AB - Two groups of SHR were treated with captopril (Squibb): the first group (1 month old)--30 mg/kg i.p. twice daily for 77 days, and the second group (8 months old)- 20 mg/kg p.o. twice a day for 23 days. The recording of electrocardiogram (ECG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and some isometric indices of the left-ventricular contractility indicate that in all treated animals the values of most of the parameters are considerably lowered compared to the controls. The ratio between velocity of pressure increase and intraventricular pressure/equal to 50 mmHg--(dP/dt)/ICP50/does not change significantly. It can be concluded that in SHR, captopril practically does not influence the inotropic condition of the myocardium. PMID- 3537416 TI - Mood alterations and sleep. AB - We have reviewed literatures about neurobiological aspect of mood disorders in the light of abnormalities of REM sleep. A shortened REM latency is a consistent finding in depressed patients and may be considered a biological marker for depression. Most depressed patients with shortened REM latency also show non suppression on dexamethasone-suppression test (DST). The commonly used antidepressant drugs cause a significant reduction in REM sleep. Patients with abnormal DST show a better response to sleep deprivation than those with normal DST. Recent studies indicated that borderline patients, primary dysthymic patients and obsessive-compulsive patients (OCD) have shortened REM latency. Farthermore, patients with OCD have a fairly good response to antidepressant clomipramine. Diagnostic and therapeutic strategies can conceivably be related on the examination of sleep patterns of psychiatric patients. PMID- 3537417 TI - [Immunohistochemical studies on proliferative and metaplastic lesions in the bronchial epithelium]. PMID- 3537418 TI - [Gastrointestinal bleeding following renal transplantation]. PMID- 3537419 TI - [Studies on the non-motile Escherichia coli with mucoid-form colony isolated from urological infection]. PMID- 3537420 TI - [Detection of chlamydial antigen with an EIA in patients with sexually transmitted disease]. PMID- 3537421 TI - [Experience of kidney transplantation in 350 patients]. PMID- 3537422 TI - Use of echography in rabbits for pregnancy diagnosis. PMID- 3537423 TI - Luteal hypoplasia and induced ovulation in cows. PMID- 3537424 TI - Effects of glucose injection and cold exposure on secretory responses of insulin, glucagon and 11-hydroxycorticosteroids in piglets. PMID- 3537425 TI - Species specificity of Haemophilus pleuropneumoniae hemolysin demonstrated in the cytocidal and anti-phagocytic effects. PMID- 3537426 TI - [The first editorial]. PMID- 3537427 TI - [Mileposts on a 90-year journey]. PMID- 3537428 TI - [Greetings from the president of the National Board of Health to the 90th anniversary issue of the Finnish Midwives' journal]. PMID- 3537429 TI - [From cabin wench to expert]. PMID- 3537430 TI - [From the Arctic to the Equator (Lyyli Jouskari)]. PMID- 3537431 TI - [From my student days]. PMID- 3537432 TI - [Midsummer at Tolvajarvi in 1942]. PMID- 3537433 TI - [Comparison of various sutures and suture technics and their effects on episiotomy healing and results--research report]. PMID- 3537434 TI - Bullous pemphigoid antigens. PMID- 3537435 TI - Surgery for cardiac arrhythmias. When and how? PMID- 3537437 TI - [Indicators of the diastolic period of the left ventricle]. PMID- 3537436 TI - [Effect of treatment with pindolol (Visken) on hemodynamics in patients with primary hypertension]. PMID- 3537438 TI - [The kallikrein-kinin system and hemostasis in acute myocardial infarct]. PMID- 3537439 TI - [Clinical use of heparin and its low-molecular fractions]. PMID- 3537440 TI - [Prevention of recurrent myocardial infarcts by long-term aspirin therapy]. AB - Daily 500 mg doses of aspirin were shown to be sufficient to produce lasting (one year long) inhibition of platelet aggregation. Two matched samples of postmyocardial infarction patients were compared: 844 untreated controls and 570 patients treated with 500 mg aspirin daily for 1 year following myocardial infarction. In the treated sample, the incidence of recurrent myocardial infarction, including sudden death, dropped from 13.1 to 8.9%, coronary mortality, including sudden death, from 7.2 to 4.7%, sudden death rate, from 3.2 to 1.9%, and total mortality, from 9.3 to 6.6%, as compared to the untreated sample. PMID- 3537441 TI - [Effect of stepwise rehabilitation of patients with various types of myocardial infarct on their work capacity and disability and means of increasing the social efficacy of rehabilitation measures (cooperative study)]. AB - The results of stepwise rehabilitation as part of current state-wide rehabilitation system, on working capacity and invalidism of the survivors of transmural, large-focal and small-focal myocardial infarction and 2 years' follow up of 2193 patients of giving age are reported. Combined stepwise rehabilitation improves working capacity and invalidism rates both within the first and second year after myocardial infarction. Great potentials of improving social efficacy of stepwise rehabilitation involve better assessment of patients' condition, using specific criteria (clinical ones in particular) with due regard to acceptable and unacceptable occupations, careful choice of adequate jobs and correct estimation of the duration of temporary postinfarction disability. PMID- 3537442 TI - [Effect of a short course of physical training on the mental status of post myocardial infarct patients]. AB - The psychological effect of short exercise on a bicycle trainer (30 sessions over 10 weeks) was assessed in 20 postmyocardial infarction patients, while spontaneous mental changes were assessed in 21 untrained controls. Exercise was started 2 to 2.5 months after the attack. Mental states were assessed by the brief multifactorial personality assessment questionary (the BMPAQ test) and the neuroticism scale (NS). Physical exercise contributed to a more rapid psychological rehabilitation, as evidenced by the BMPAQ and NS testing. The mentality of the control patients improved less rapidly as shown by the BMPAQ test, while their NS parameters remained unchanged. Mental parameters of trained and untrained patients were basically similar within 12 months, after myocardial infarction as evidenced by the BMPAQ test. PMID- 3537443 TI - Recent advances in the biochemistry of glomerular basement membrane. PMID- 3537444 TI - Changes in single nephron renin release are mediated by tubular fluid flow rate. AB - In vivo renin release from single nephrons microperfused with artificial tubular fluid was studied in recollection experiments. Renin concentration was measured in systemic arterial plasma (A-PRC) and in either early proximal tubular fluid (TFR), or in plasma from the welling point of the efferent arteriole (SV-PRC) belonging to the microperfused nephron. Micropuncture collections were controlled to maintain the proximal intratubular pressure equal to the control free-flow pressure. Increasing the Henle loop flow rate from 12 to 18, or to 34 nl/min, was followed by a significant decrease in TFR, while reducing the flow rate from 12 to 6 nl/min caused a significant increase in TFR. Similarly, increasing the Henle loop free-flow rate by 6 to 8 nl/min depressed SV-PRC, while reducing the flow rate by fluid aspiration at 8 to 10 nl/min caused a significant increase in SV PRC. These data indicate: that renin release, to a significant part at least, occurs into the vascular lumen of the afferent arteriole: that modest changes in early distal flow rate may control renin release from the JG-cells; and that increasing the flow rate depresses renin release, and vice versa. It is suggested that the renin system is directly involved in an additional TGF mechanism controlling postglomerular vascular resistances. PMID- 3537445 TI - Effect of experimental diabetes on insulin binding by renal basolateral membranes. AB - Removal of insulin from the peritubular vessels involves binding of insulin to specific receptors in the basolateral membranes (BLM); this is followed by phosphorylation of the receptor which may mediate the actions of the hormone. In most tissues receptor number is regulated by plasma insulin levels and is increased in insulinopenic diabetics. To determine whether cortical BLM insulin receptors are similarly regulated, we studied insulin binding to receptors in BLM from normal control rats and rats with streptozotocin diabetes of varying severity. Specific binding of insulin did not differ between control and modestly insulinopenic diabetics but was increased significantly in the severely insulinopenic diabetics. Insulin treatment returned binding to normal. Scatchard analysis suggested an increase in the binding capacity of the severe diabetic BLM rather than an increase in affinity for insulin. This latter was confirmed by competitive experiments in which similar displacement curves were obtained with control and diabetic membranes. Insulin removed by glomerular filtration binds to specific receptors in the luminal membranes but unlike BLM receptors, phosphorylation of these luminal receptors has not been observed. To determine whether luminal and BLM receptors differ structurally, binding sites in both membranes were affinity labelled with 125I-insulin and the cross linking agent, disuccinimidyl suberate, and subjected to SDS-polyacrylamide gel electrophoresis in the presence of a reducing agent. Autoradiograms revealed that the major specifically labelled subunit in both membranes is a 135,000 Mr species which is more abundant in the BLM. We conclude that insulin receptors in cortical BLM respond to severe insulinopenic diabetes as do receptors in most other tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537446 TI - Beta 2-microglobulin: a new form of amyloid protein associated with chronic hemodialysis. AB - Carpal tunnel syndrome (CTS) has been associated with amyloid deposits and is now regarded as a major complication in chronic hemodialysis patients. While this new syndrome has been receiving increasing attention, its etiology has not been clarified. We have isolated amyloid fibrils from amyloid laden tissues inside the carpal tunnel in four different hemodialysis patients with CTS. After solubilization in guanidine HCl, a significant amount of the protein was located in a homogeneous, low molecular weight fraction. Each protein was found to be identical to beta 2-microglobulin with regard to its molecular weight of 11,000 on SDS-PAGE, amino acid composition and N-terminal amino acids: Ile-Gln-Arg-Thr Pro-Lys-Ile-Gln-Val-Tyr-Ser-Arg-His-Pro-Ala-Glu. In direct immunofluorescent study, anti-beta 2-microglobulin did react positively with amyloid deposits. These results demonstrate that the amyloid associated with chronic hemodialysis contains as major component a new form of amyloid fibril protein that is homologous to beta 2-microglobulin. It is postulated that beta 2-microglobulin cannot be removed from the blood by conventional hemodialysis, and accumulates in tissues causing the formation of amyloid fibrils, which, having a relatively high affinity to the carpal tunnel area, thus causes CTS. PMID- 3537447 TI - Immunohistochemical study of the C5b-9 complex of complement in human kidneys. AB - The presence and localization of the C5b-9 neoantigens of the terminal complement sequence, of antigens expressed by cleavage fragments of C3, and of Factor H antigens have been studied by immunohistochemical techniques in morphologically normal adult human kidneys and in biopsy specimens from patients with a wide range of renal diseases with and without immune deposits. In morphologically normal kidneys, C5b-9 neoantigens were observed within all connective matrices (arteriolar media, glomerular basement membrane (GBM), mesangial matrix and tubular basement membrane). The C3d and C3g antigens of the C3dg, and C3bi cleavage fragments of C3 and Factor H antigens were found in similar locations. None of the matrices stained for immunoglobulins. Immunoelectron microscopy demonstrated that C3d, C3g, H antigens and the C5b-9 neoantigens were localized on membranous and vesicular structures embedded in the connective matrices. These structures represent cell membranes shed from adjacent cells as evidenced by their ultrastructural appearance and by the fact that those which were in close vicinity to pedicles within the GBM expressed the C3b receptor antigen, a specific marker for podocyte membranes. Formation of C5b-9 complexes in the shielded environment of connective matrices may explain their persistence over long periods of time in the absence of apparent immunopathological consequences. Biopsies from pathological kidneys were classified into three groups based on the pattern of glomerular staining with anti-C5b-9 antibodies. In the first group, a sparse mesangial labeling was seen, similar to that observed in normal kidneys. In the second group, abundant clusters of C5b-9 were seen in the same location as immune deposits. Activation of the complement system to completion could be documented in the absence of detectable C3 (C3c) antigen in glomeruli. Immunoelectron microscopy demonstrated that C5b-9 neoantigens were present on cell remnants in connective matrices in all specimens that were studied. Labeled cell remnants were present in large amounts in sclerotic matrices. C5b-9 neoantigens were constantly found on old and large immune deposits, and absent or occasionally present on recent and small immune deposits. In membranous nephropathy stage I, proteinuria appeared to be independent of the presence or absence of detectable C5b-9 neoantigens on immune deposits. Thus, the presence of C5b-9 neoantigens in pathological renal tissue does not have an univocal significance, and requires analysis of the localization of the antigens and appropriate controls in order to assess the potential role of C5b-9 in tissue damage. PMID- 3537448 TI - Altered skeletal muscle ultrastructure in renal transplant patients on prednisone. AB - Treatment with glucocorticoids causes wasting of proximal skeletal muscles. The purpose of the present investigation was to quantify in the thigh muscle the areas of the different fiber types determined by histochemical methods, and the muscle ultrastructure by means of electron microscopy, in normal subjects (N = 41) and in renal transplant patients treated with prednisone (N = 12). The cross sectional area of all three fiber types was reduced in renal transplant patients treated with prednisone (10.6 +/- 4.3 mg/day), the fast glycolytic fibers being most affected (slow oxidative fibers: 2642 +/- 625 vs. 3677 +/- 970 micron2, P less than 0.001; fast oxidative fibers: 3275 +/- 735 vs. 4443 +/- 1343 micron2, P less than 0.01; fast glycolytic fibers: 2305 +/- 802 vs. 3920 +/- 1522 micron2, P less than 0.001). This was mostly due to a decrease in the volume of myofibrils per unit volume of muscle fiber (-30%). The intracellular lipid content and the volume density of subsarcolemmal mitochondria were increased by more than 70% in prednisone treated patients. In conclusion, the decreased myofibril areas might account for the muscle weakness in renal transplant patients treated with prednisone, and the decrease in myofibrils is in part functionally compensated by an increase in subsarcolemmal mitochondria and intracellular lipid content. PMID- 3537449 TI - The sympathetic nervous system in clinical and experimental hypertension. AB - In summary, many lines of evidence indicate that the sympathetic nervous system, via the renal nerves, plays an important role in the pathogenesis of renovascular hypertension in humans and laboratory animals. Patients with established renovascular hypertension have increased sympathetic nervous system activity, as evidenced by increased plasma and urinary norepinephrine levels, elevated excretion of catecholamine metabolites, and an exaggerated depressor response to centrally acting sympatholytic agents. The observation that converting enzyme inhibitors can cause both blood pressure and urinary norepinephrine excretion to return to normal in patients with renovascular hypertension is consistent with the interpretation that activation of the sympathetic nervous system in these subjects is, at least in part, angiotensin-induced. The sympathetic nervous system, via the efferent renal nerves, plays a role in the pathogenesis of hypertension in a number of experimental models. In the spontaneously hypertensive rat of the Okamoto strain (SHR) and in the DOCA/NaCl hypertensive model, increased renal efferent nerve activity contributes to the development of hypertension by causing increased renal sodium retention. In both of these experimental models, renal denervation delays the development and blunts the severity of hypertension. This delay is associated with increased urinary sodium excretion, suggesting a renal efferent mechanism. In contrast to the predominantly efferent renal nerve mechanisms observed in the DOCA-NaCl and SHR models, studies of the effects of renal denervation in one-kidney, one-clip and two-kidney, one-clip Goldblatt hypertensive rats suggest that renal afferent nerves are important in these models of hypertension. Total renal denervation in rats with established 1K, 1C and 2K, 1C hypertension attenuates the severity of the hypertension without altering sodium intake or excretion, renin activity, water intake, or renal function. Thus, efferent renal nerve activity does not appear to be involved in the development of maintenance of 1K, 1C or 2K, 1C hypertension. In contrast with the findings in SHR and DOCA-NaCl rats, these studies provide indirect evidence that the renal afferent nerves play a role in the pathogenesis of this form of experimental hypertension. The major effect of renal denervation in these models appears to be an interruption of renal afferent nerve activity, which by a direct feedback mechanism attenuates systemic sympathetic tone, thereby lowering blood pressure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537450 TI - Neoplasia and glomerular injury. PMID- 3537451 TI - Roles for thromboxane A2 and leukotrienes in endotoxin-induced acute renal failure. AB - Bolus i.v. administration of 100 micrograms/kg of E. Coli lipopolysaccharide endotoxin (LPS) to adult male Munich-Wistar rats (N = 18) resulted in a progressive fall in RBF and GFR from 6.9 +/- 0.2 SE and 1.1 +/- 0.05 ml/min to minimal values at 50 minutes of 3.8 +/- 0.4 and 0.32 +/- 0.08 (P less than 0.05), respectively, without a fall in mean arterial pressure. At 50 minutes, renal cortical generation rates of PGE2 (1075 +/- 108 pg/mg tissue), 6 keto PGF1 alpha (221 +/- 41 pg/mg), and TxB2 (106 +/- 12 pg/mg) were significantly higher than those of vehicle-treated control rats (N = 10, PGE2 = 466 +/- 107, 6 keto PGF1 alpha = 94 +/- 3, and TxB2 = 35 +/- 3 pg/mg), and morphologic examination revealed normal histology with notable absence of leukocytes and platelets. Pretreatment of a third group of nine rats with TxA2 synthetase inhibitor UK 37.248 (dazoxiben, 10 mg/kg) selectively abolished the LPS-induced rise in TxB2 (29 +/- 3 pg/mg), but not PGE2 (837 +/- 62 pg/mg) or 6 keto PGF1 alpha (179 +/- 5 pg/mg), prevented the fall in RBF at 50 minutes (6.3 +/- 0.4 ml/min), and allowed for significant preservation of GFR (0.67 +/- 0.08 ml/min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537452 TI - Benefit from high intrarenal levels of gentamicin in the treatment of E. coli pyelonephritis. AB - The importance of high intrarenal levels of gentamicin on the outcome of experimental pyelonephritis was studied in rats receiving either a short course (three days) of gentamicin (G) alone or combined with a longer course (14 days) of ampicillin (A), cephalothin (C), or trimethoprim (T), or two weeks of therapy with ampicillin, cephalothin, trimethoprim and gentamicin given alone. While ampicillin, cephalothin and trimethoprim were undetectable in the medulla within six hours of cessation of therapy, gentamicin was still detectable in levels six folds above the MIC up to six months after treatment had ceased. Six months after the end of treatment, the percentage of sterile left kidneys in animals treated with ampicillin (50%), cephalothin (15%), trimethoprim (20%) was lower than the percentage of animals receiving 14 days of gentamicin (100%), or the combinations AG:89%, CG:67% and TG:60%, P less than 0.01. Following three days of gentamicin, 50% of the left kidneys were sterilized. When compared to ampicillin, cephalothin or trimethoprim alone, combined therapies significantly reduced the number of CFU in the kidneys P less than 0.01. These combinations were almost as effective as two weeks of therapy with gentamicin. Short-term therapy (three days) with an aminoglycoside which concentrates in the renal parenchyma, combined with an antibiotic which will accumulate in other parts of the nephron, may result in "pharmacological synergy". This new approach to therapy of pyelonephritis may be promising. PMID- 3537453 TI - Monoclonal antibody identification of infiltrating mononuclear leukocytes in lupus nephritis. AB - Populations of mononuclear inflammatory cells infiltrating the renal interstitium in LN were studied by means of an avidin-biotin immunoperoxidase technique applied to cryostat sections of 26 renal biopsies (3 WHO class IIb; 4 class III; 8 class IV; 4 class V; 4 class III and V; and 3 class IV and V). The majority of interstitial leukocytes were T cells (mean 65.7 +/- 14.1). The number of cells reactive with OKT8 (47.3 +/- 11.0) exceeded the number of OKT4 positive cells (32.5 +/- 11.3) in 22 of 26 biopsies. Cells reactive with antimonocyte antibodies OKM1 and OKM5 (6.7 +/- 5.9 and 7.9 +/- 5.9, respectively) and B lymphocytes (OKB2 3.9 +/- 3.5) were a minor component of the interstitial infiltrates. Monocytes were the predominant cell type among stained cells in glomerular tufts and crescents. Tissue T4/T8 ratios varied widely (range 0.31 to 1.81), and were less than 1 in 22 of 26 patients. There was no correlation between tissue T4/T8 ratios and simultaneous peripheral blood T4/T8 ratios. Using stepwise multivariate linear regression, tissue T4/T8 ratio was found to correlate highly with renal histologic activity (P less than 0.001) but was not independently predictive of any other histopathologic or clinical variable studied. Mean tissue T4/T8 ratio in LN was significantly lower than that of other glomerular and interstitial diseases studied (P less than 0.001), a finding which may reflect differences in the pathogenesis of renal injury. These findings suggest that local cellular immune mechanisms may be important in the modulation of disease activity in LN. PMID- 3537454 TI - Hemodynamic instability during hemodialysis. PMID- 3537455 TI - Abstracts. The Australasian Society of Nephrology. 22nd annual scientific meeting. Perth, Australia, February 12-14, 1986. PMID- 3537456 TI - Monoclonal antibodies and identification of glomerular antigens. PMID- 3537458 TI - Direct antiGBM antibody induced alterations in glomerular permselectivity. AB - The glomerular fixation of anti-glomerular-basement-membrane (antiGBM) antibody is associated with complement activation, neutrophil accumulation, and renal injury. This injury manifests both as an increase in the rate of urinary protein excretion and altered renal hemodynamic characteristics. We have utilized an isolated perfused kidney system (IPK) to assess the capacity of antiGBM antibody to alter glomerular permselectivity in the absence of both glomerular complement activation and neutrophil infiltration. Control perfusions with Krebs-Henseleit buffered 5% albumin solutions containing normal sheep globulin had a protein excretion rate of 0.223 +/- 0.044 mg/min (mean +/- SEM). Assessment of glomerular permselectivity using fractional dextran clearances demonstrated an intact negative charge barrier in control preparations. AntiGBM antibody bound in a dose related fashion to the kidney and was localized to the glomerular basement membrane on immunofluorescence. Antibody induced a significant increase in mean protein excretion (2.009 +/- 0.681 mg/min, P less than 0.01) in association with a loss of the glomerular filter's negative charge barrier. These IPK studies demonstrate that antiGBM antibody can itself produce proteinuria, in association with loss of the glomerular capillary negative charge barrier, in the absence of all circulating humoral and cellular inflammatory mediator systems. PMID- 3537457 TI - Elevation of intrarenal adenosine by maleic acid decreases GFR and renin release. AB - Maleic acid administration produces a defect in tubular reabsorption resembling that seen in the Fanconi syndrome and also causes a decrease in glomerular filtration rate (GFR). The mechanism by which maleic acid alters renal function is uncertain, though the tubular defect is known to be associated with decreased ATP levels. Because of this alteration in nucleotide metabolism the present study was undertaken to determine the role of elevated endogenous adenosine in mediating the maleic acid-induced changes in renal function. Since the renal effects of exogenous adenosine are enhanced by sodium-depletion and attenuated by sodium-loading, the present study compared the time course of the effects of maleic acid on renal function in 10 dogs maintained on a low sodium diet, and 10 dogs maintained on a high sodium diet. In addition, we examined the effect of maleic acid on adenosine levels in renal venous plasma, on the urinary excretion of adenosine, and the effect of the adenosine antagonist, theophylline, on the maleic acid-induced changes in renal function. After 100 min of maleic acid, GFR was decreased significantly by 55 +/- 4% of control in the sodium-depleted dogs, and by 39 +/- 4% of control in the sodium-loaded dogs. In the sodium-depleted dogs, renin release was also significantly depressed (12 +/- 8% of control) during the infusion of maleic acid. The fractional excretion of sodium was significantly increased in both groups. The renal venous concentration of adenosine and the urinary excretion of adenosine were both significantly increased during maleic acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537459 TI - Lymphokine (MIF) production by glomerular T-lymphocytes in experimental glomerulonephritis. AB - Glomerular T-lymphocyte infiltration has recently been demonstrated to precede glomerular macrophage influx in a pre-immunized model of anti-glomerular basement membrane antibody-induced glomerulonephritis (antiGBM-GN). In the current study, the functional role of these glomerular T-lymphocytes in directing macrophage localization was sought by measuring their production of macrophage migration inhibition factor (MIF). MIF activity in supernatants from cultured isolated glomeruli was measured in a conventional capillary tube bioassay. Glomerular T lymphocytes (OX19 positive cells) were maximal (1.95 +/- 0.19 cells/glomerular cross section, c/gcs) 24 hours after injection of antiGBM antibody into sensitized animals. Seventy-two hours after antibody injection, T-lymphocyte numbers were reduced (1.02 +/- 0.14 c/gcs) while macrophage accumulation was maximal (at 24 hrs 4.2 +/- 1.3 macrophages/glomerulus (m/g), at 72 hrs 19.8 +/- 3.7 m/g). MIF activity was only detected in supernatants from T-lymphocyte infiltrated glomeruli (12 hrs 40.81 +/- 4.32% migration inhibition, 24 hrs 45.11 +/- 4.11% migration inhibition, 48 hrs 38.24 +/- 3.53% migration inhibition, 72 hrs 20.86 +/- 3.85% migration inhibition, all P less than 0.05). Control glomeruli from normal animals, pre-immunized animals given normal sheep globulin, pre-immunized animals given anti-GBM antibody and Cyclosporin A, and non-pre immunized animals given antiGBM antibody did not contain glomerular T lymphocytes, and their supernatants contained no MIF activity. This data indicates that the glomerular T-lymphocytes in pre-immunized antiGBM-GN are sensitized cells which release MIF and thus may direct glomerular macrophage localization in this model of antibody-induced glomerulonephritis. PMID- 3537460 TI - Direct antigen binding to glomerular immune complex deposits. AB - We evaluated the contribution of intrarenal factors in the increased renal accumulation of bovine serum albumin (BSA) in chronic serum sickness (CSS). Renal transplantation was used to study 125I BSA uptake (single and paired label techniques) in normal and CSS kidneys exposed to the same immunologic milieu. In CSS, the daily dose of BSA (dose 15 to 150 mg) was substituted with radiolabeled BSA. Uptake in washed kidney homogenates (24 hours) in the recipient's native CSS kidney varied from 0.29 to 38.40 micrograms/g of kidney (mean 11.70) compared to 0.09 to 2.19 micrograms/g (mean 1.01) in the transplanted normal kidney. The ratio of uptake in the CSS/normal kidney varied from 2.1 to 17.5. These findings indicated that intrarenal factors were important in renal uptake since both kidneys had been exposed to the same circulating immune complex load. Transplantation between "early" (nonproteinuric) and late (proteinuric) CSS rabbits again suggested intrarenal factors influence the uptake of 125I BSA immune complex components with late CSS kidney/early CSS kidney uptake ratios of 25 and 49 in the pairs examined. When CSS kidneys were transplanted into normal rabbits, the binding of 1 to 160 mg of radiolabeled BSA in the transplanted CSS kidney varied from 0.68 to 22.89 micrograms/g (mean 7.15) compared to 0.01 to 0.84 microgram/g (mean 0.18) in the normal rabbit's native kidney. The uptake in the CSS kidney always exceeded that in the recipient's normal kidney (ratio varied from 18 to 289). The binding of radiolabeled BSA in the CSS kidney was quantitatively similar to that found previously in the intact CSS rabbit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537461 TI - Effects of chlorpropamide on loop of Henle function and plasma renin. AB - We have suggested that inhibition of renin release by sodium chloride is related to increased absorptive solute transport in the loop of Henle. In the rat, we have shown that reduced chloride transport in the loop is associated with increased renin release. Based on indirect evidence, it has been suggested that chlorpropamide (CPMD) increases loop solute transport. This study directly evaluates the effect of CPMD on loop chloride transport and plasma renin activity (PRA) in the male Sprague-Dawley rat. Loop of Henle chloride reabsorption (measured by recollection micropuncture) and PRA were determined before and after acute infusion of CPMD (N = 8) or vehicle (N = 8). Although delivery to the loop was not significantly changed, CPMD increased (P less than 0.05) absolute loop chloride reabsorption from 1798 pEq/min +/- 200 SE to 2453 pEq/min +/- 206 SE. PRA was decreased (P less than 0.01) from 9.2 ng/ml/hr +/- 1.0 SE to 5.6 ng/ml/hr +/- 0.8 SE following CPMD infusion. Comparable vehicle infusion did not alter loop chloride reabsorption or PRA. Arterial pressure, and whole kidney and single nephron glomerular filtration rates were unchanged following infusion of CPMD or vehicle. These results demonstrate that an increase in loop chloride reabsorption is associated with a decrease in renin release. This observation is consistent with the hypothesis that renin release is inversely related to the magnitude of chloride transport in the thick ascending limb of the loop of Henle. PMID- 3537462 TI - Peritoneovenous shunt in the management of the hepatorenal syndrome. AB - The hepatorenal syndrome (HRS) is a terminal complication of severe liver disease associated with a mortality of 80 to 90%. Although the renal functional abnormalities in the HRS suggest prerenal azotemia, volume expansion with saline, albumin or ascitic fluid rarely results in reversal of the HRS because fluid redistributes from the vascular space. Since the peritoneovenous (PV) shunt causes sustained central volume expansion, it has been advocated for the treatment of the HRS. We prospectively compared the PV shunt (N = 10) to Medical Therapy (MED) (N = 10) on renal function and mortality in 20 patients with the HRS associated with alcoholic liver disease. The HRS was diagnosed on the basis of clinical, hemodynamic, and laboratory criteria. The insertion of a PV shunt resulted in an increase in pulmonary capillary wedge pressure (4.2 +/- 1.1 vs. 1.5 +/- 1.0 mm Hg, P less than 0.01) and in cardiac index (0.8 +/- 0.3 vs. -0.2 +/- 0.3 1/min/m2, P less than 0.05). After 48 to 72 hours, weight (+3.1 +/- 1.1 kg) and serum creatinine (3.9 +/- 0.5 to 5.5 +/- 0.7 mg/dl, P less than 0.001) were increased with MED therapy and decreased (weight: -3.7 +/- 0.7 kg; serum creatinine: 3.6 +/- 0.4 to 3.0 +/- 0.5, P less than 0.05) with the PV shunt. Despite improvement in renal function, only one patient with the PV shunt had prolonged survival (210 days). In the remainder, survival was 13.8 +/- 2.2 days compared to 4.1 +/- 0.6 days with MED therapy. We conclude that the PV shunt often stabilizes renal function, but does not prolong life in patients with the HRS. PMID- 3537463 TI - Clinical characteristics and diagnostic considerations in acquired renal cystic disease. AB - Acquired multiple bilateral cystic transformation of kidneys has been increasingly noted in patients with long-standing renal failure treated by chronic dialysis. To study the clinical characteristics of this newly described disease and assess the utility of available diagnostic methods, 130 patients with chronic renal failure (100 on dialysis, 30 nondialyzed) were studied with ultrasonography and/or computerized tomography (CT). Among patients on dialysis, 22% had acquired renal cystic disease (ARCD), an additional 30% had one to three solitary cysts, and 48% had no cysts. In nondialyzed patients, 7% had ARCD, 53% had one to three solitary cysts, and 40% had no cysts. Among these 130 chronic renal failure patients (nondialyzed and dialyzed), 21 of 86 males compared to 1 of 44 females had ARCD (P less than 0.001). Duration of dialysis therapy and age were greater in patients with ARCD (49.8 +/- 8 months, 55 +/- 4 years, respectively) compared to those with solitary cysts (28 +/- 6 months, 45 +/- 2 years) or no cysts (15 +/- 3 months, 42 +/- 2 years). The diagnostic accuracy of ultrasound (US) was compared to CT. CT is purportedly 100% accurate in the characterization of renal cysts. We are disappointed at the low level of diagnostic accuracy for both CT and US in the detection of renal cysts in chronic uremia. It appears both a negative CT and ultrasound are necessary to absolutely exclude either ARCD or solitary cyst. PMID- 3537464 TI - The treatment of lupus nephritis. PMID- 3537465 TI - [Microflora of the digestive tract in patients with stomach ulcer after surgical treatment]. PMID- 3537466 TI - [Regeneration in the area of an anastomosis of the stomach and small intestine]. PMID- 3537467 TI - [Possibilities of endoscopic hemostasis in patients with acute hemorrhages from gastroduodenal ulcers]. PMID- 3537468 TI - [Repeated operations in patients after suturing perforated pyloroduodenal ulcers]. PMID- 3537469 TI - [Pathophysiological mechanisms of vagotomy]. PMID- 3537471 TI - [Acute emphysematous gastritis]. PMID- 3537470 TI - [Surgical tactics in bleeding chronic duodenal ulcers]. PMID- 3537472 TI - [Anatomo-topographic features of liver transplantation in the dog]. PMID- 3537473 TI - [Ultrasonic diagnosis of surgical diseases of the organs of the abdominal cavity]. PMID- 3537475 TI - [Potential donor sites in the surgical treatment of burns]. PMID- 3537474 TI - [Current trends in the diagnosis and treatment of calculous cholecystitis complicated by jaundice (review of the foreign literature)]. PMID- 3537476 TI - [Treatment of deep and extensive burns of the lower extremities]. PMID- 3537477 TI - [New methods in the diagnosis of urogenital tuberculosis]. PMID- 3537478 TI - [Comparative study of the cosmetic effect of using a vertical pi-shaped skin suture with gauze rolls in abdominal operations]. PMID- 3537479 TI - [Kidney transplantation--23 years' clinical experience]. PMID- 3537480 TI - [In memoriam Zakhari Kharalambiev Donchev at 70]. PMID- 3537481 TI - [Dr. Janos Balassa and his monograph on plastic surgery]. PMID- 3537482 TI - [Selection of the dermatome in the free transplantation of skin]. PMID- 3537483 TI - [Percutaneous drainage of pancreatic pseudocysts under echographic control]. PMID- 3537484 TI - [The place of echographic diagnosis of splenic lesions]. PMID- 3537485 TI - [Ultrasonic follow-up of the transplanted kidney]. PMID- 3537486 TI - [The place and prospects for ultrasonic diagnosis in urologic practice]. PMID- 3537487 TI - [Ultrasonic diagnosis of diseases of the scrotum and its contents]. PMID- 3537488 TI - [Clinical interpretation of hemodynamic parameters obtained by the invasive study of patients in a critical state]. PMID- 3537489 TI - [Hepatic resection over the past 10 years]. PMID- 3537490 TI - [Duodenal stasis]. PMID- 3537491 TI - [Use of plastic surgery methods in treating skin tumors]. PMID- 3537492 TI - [Echographic differential diagnosis of post-traumatic motility disorders of the eye]. AB - Following an analysis of echographic findings in 94 patients with posttraumatic ocular motility disorders, a flow-chart for detecting the basic pathomechanism was worked out. Normal muscle diameter is observed in entrapment of the perimuscular tissues or in a recent palsy, whereas increased muscle thickness suggests hematoma or incarceration, and thinned muscles an atrophy. A lack of change in muscle diameter when the patient looks in the direction in which motility is restricted is characteristic of atrophy or palsy, whereas an increase in muscle diameter is a sign of incarceration if a fracture has also been detected by echography; if not, muscle hematoma can be diagnosed. PMID- 3537493 TI - [Group B streptococcal panophthalmia in neonatal infection]. AB - Hemolyzing streptococci of group B were isolated from an ulcerative keratitis in a 14-day-old girl (gestational age: 39 weeks, birth weight: 3230 g) suffering from septicemia. The differential diagnosis includes all bacteria and virus species able to penetrate the intact cornea, e.g. Pseudomonas sp., N. gonorrhoeae and Herpes simplex virus II. Perinatal infection may be via the birth canal. PMID- 3537494 TI - [From the bibliographer's files (XXVI). 125 and 100 years ago]. PMID- 3537496 TI - Clinical and biochemical aspects of the insulin autoimmune syndrome (IAIS). AB - A 44-year old patient presented with recurrent hypoglycemic attacks after ingestion of carbohydrates. High insulin levels in the range of 350 microU/ml (normal range less than 20 microU/ml) were detected which rose to peak levels of 2,460 microU/ml (normal range less than 300 microU/ml) after oral glucose. The apparently high insulin concentrations were caused by insulin autoantibodies interfering in the radioimmunoassay (RIA) system (and thus with correct insulin quantitation). 125I-insulin added to the patient's serum was not bound to dextran coated charcoal but was precipitated with antihuman IgG serum. The antibodies bound human, porcine, and bovine insulin with similar affinity. Following Sephadex G-50 gel filtration, the patient's insulin eluted after the void volume. Free insulin was extracted from serum using Sep-Pak C 18 cartridges and characterized by high pressure liquid chromatography (HPLC); it eluted similarly to synthetic human insulin. Quantitation of free insulin during a hypoglycemic attack (3.5 h after oral glucose, with a blood sugar of 20 mg/dl) showed an increased insulin level of 50 microU/ml. Insulin receptor concentration on erythrocytes was near the lower normal limit. We believe that the insulin antibodies present in this patient's serum (who supposedly never received insulin) led to the formation of a large circulating insulin pool, binding the insulin released after glucose stimulation, and causing hypoglycemias by delayed postprandial liberation of bound insulin. PMID- 3537495 TI - Mitochondrial antigens and autoantibodies: from anti-M1 to anti-M9. AB - The specificity and clinical relevance of nine antimitochondrial antibodies (AMA) - anti-M1 to anti-M9 - are described. All nine AMA types react with antigens which are associated either with inner (M1, M2, M7) our outer mitochondrial membranes (M3, M4, M5, M6, M8, M9) derived from rat liver or beef heart mitochondria. These antigens can be clearly distinguished by their different physical and chemical properties. Anti-M1 to anti-M9 can be related to distinct clinical entities: anti-M1, anti-M5, and anti-M7 are found in nonhepatic disorders, such as syphilis (anti-M1), undefined collagen diseases (anti-M5), and some forms of cardiac diseases (anti-M7). Anti-M3 and anti-M6 are detected in drug-induced disorders, such as phenopyrazon-induced pseudolupus syndrome (PLE; anti-M3) and iproniazid-induced hepatitis (anti-M6). Anti-M2, anti-M4, anti-M8, and anti-M9 are confined to primary biliary cirrhosis (PBC). Anti-M2 is a specific marker for the diagnosis of PBC; 96% of PBC patients (n = 752) were anti M2 positive. Anti-M4 and anti-M8 seem to reflect disease activity. Anti-M9 antibodies occur preferentially in early PBC. The clinical course of PBC was analyzed with respect to four different AMA profiles: profile A: only anti-M9 positive in the ELISA; profile B: anti-M9 and anti-M2 positive in the ELISA; profile C: anti-M2 positive in ELISA and complement fixation test (CFT), but anti M4 and anti-M8 positive only in the ELISA; and profile D: anti-M2, anti-M4, anti M8 positive in ELISA and CFT. Patients with profile A and B were found to have a rather benign course while those patients with profile C and D showed a rather progressive course when followed over a period of 6-15 years. Considering the similarities between bacterial and mitochondrial membranes, it is suggested that the formation of AMA of different specificities in PBC, especially of the anti-M2 type, may be induced by cross-reacting antigens. PMID- 3537497 TI - Lysostaphin-based assay of human granulocyte functions: a reevaluation. AB - Lysostaphin, a staphylococcus-derived staphylocidal substance, has widely been used in assays of granulocyte phagocytic and bactericidal capability. It rapidly kills extracellular bacteria. Thus, a separate determination of intracellular surviving bacteria can be performed. One prerequisite for this approach is the safe inactivation of lysostaphin (usually brought about by trypsin) before the intracellular bacteria are externalized for plating. This inactivation has been found by others to be incomplete. Data are presented demonstrating a safe inactivation of lysostaphin by trypsin, if the pH value is maintained within the alkaline range. A low variation of results is obtained by plotting the total number of bacteria killed per incubate vs the logarithm of initial bacterial inoculum or of the intracellular surviving bacteria, leading to linear regression lines. The variation of the results increases greatly for initial bacteria/granulocyte proportions of greater than 5/1. The results obtained for two different St. aureus strains are significantly different. Dexamethasone pretreatment (12 mg p.o. within 8 h) had no detectable influence, when fresh blood was assayed, while blood storage at room temperature for 12 h (without dexamethasone pretreatment) led to a significant functional impairment, mainly of bactericidal capability when analyzed in a pairwise fashion. A major limitation of this kind of assays is that killed bacteria cannot be determined directly. PMID- 3537498 TI - [Ultrasonic diagnosis of gallbladder cancer]. PMID- 3537499 TI - [Digestive system lesion in alcoholism]. PMID- 3537500 TI - [Diagnosis, therapy and prevention of pyoderma]. PMID- 3537501 TI - [Controversial problems in the surgical treatment of peptic ulcer]. PMID- 3537502 TI - [Lev Nikolaevich Tolstoi and the problems of medicine]. PMID- 3537503 TI - [Contribution of Academician N. D. Strazhesko to Soviet internal medicine (on the 110th anniversary of his birth)]. PMID- 3537504 TI - [Nikolai Nikolaevich Anichkov (on the centenary of his birth)]. PMID- 3537505 TI - [V. I. Dal']. PMID- 3537506 TI - [Endogenous intoxication syndrome in pancreonecrosis]. PMID- 3537508 TI - [Campylobacteriosis]. PMID- 3537507 TI - [The ideas of M. P. Konchalovskii in modern rheumatology]. PMID- 3537509 TI - [Echographic study of the pancreas]. PMID- 3537510 TI - [On the 100th anniversary of the separating out of Weil-Vasil'ev disease into an independent nosologic form]. PMID- 3537511 TI - [Immune-complex mechanisms of the pathogenesis of systemic lupus erythematosus]. PMID- 3537512 TI - [Carbohydrate metabolism of patients with polycythemia vera and symptomatic polycythemia]. PMID- 3537513 TI - [Structure and function of otoliths]. AB - Current data on the structure and function of the otoliths are reviewed. The function of the otolith organ in microgravity is discussed. Biophysical approaches to its study are presented. This paper may have theoretical and practical importance since it may help clarify certain aspects of space motion sickness. PMID- 3537515 TI - [Receptor epithelium of the vestibular apparatus and cochlea in exposure to acceleration and noise]. AB - The method for isolating and treating the vestibular and cochlear compartments of the inner ear was developed. Also, the procedure of histological treatment of temporal bones was modified. The pathogenesis of vestibulo-cochlear disorders due to acceleration and noise was investigated using histology, electron microscopy and histochemistry methods. It was found that exposure to acceleration of 10 Gx for 5 min and single and repeated (for 7 days) exposures to high-frequency noise of 100 dB produced histological changes and functional-morphological variations in all receptors located in the vestibular and cochlear compartments of the inner ear. PMID- 3537514 TI - [Problems and prospects for the drug correction of orthostatic tolerance in space medicine]. AB - This paper reviews published data concerning physiological mechanisms of man's orthostatic tolerance and its decline under the influence of space flight factors. The principles, goals and potentialities of drug correction of orthostatic intolerance are presented. The applicability of selected drugs used separately or in combination with traditional countermeasures is discussed. PMID- 3537516 TI - [Evaluation of the effect of excess intrapulmonary pressure on human respiratory function]. AB - The parameters characterizing lung ventilation and electrical activity of expiratory muscles were investigated in six healthy young men exposed to the positive intrapulmonary pressure 20, 30 or 40 mm Hg. Gas mixtures with a varying oxygen content were used. The effect of two compensatory devices that applied different counterpressures to the body surface was evaluated. It was found that the parameter that can best characterize the respiratory function in the case of a positive intrapulmonary pressure is electrical activity of expiratory muscles. The hypoxic effect makes no important contribution to the change of respiratory parameters during short-term exposures to the positive intrapulmonary pressure 20, 30 or 40 mm Hg. The different methods of applying compensation do not influence changes in the above respiratory parameters. PMID- 3537517 TI - [Proteolytic enzyme activity in the blood serum of human subjects following a stay in a hypoxic environment]. PMID- 3537518 TI - [ADP in the nursing school--how to go about it?]. PMID- 3537519 TI - [Nursing care and the computer: it is time to talk about it...]. PMID- 3537520 TI - Age dependency of the inflammatory response. PMID- 3537522 TI - The antigens and antibodies of hepatitis B: a review. PMID- 3537521 TI - Glomerulonephritis induced by monoclonal anti-Thy 1.1 antibodies. A sequential histological and ultrastructural study in the rat. AB - The present report describes the natural history of an experimental acute glomerulonephritis with massive proteinuria induced by a single intravenous injection of a (mouse) monoclonal anti-rat Thy 1.1 antibody into the rat. The disease is characterized by direct although transient binding of this monoclonal antibody to glomerular basement membrane and mesangium after injection as demonstrated by immunofluorescence microscopy. Immediate activation of complement occurs as shown by glomerular deposition of C3 and C9. Concomitant activation of the coagulation cascade is reflected by the presence of fibrinogen deposits in the affected glomeruli. One hour after injection mesangial alterations are prominent including condensation of mesangial cell chromatin, and lysis of mesangial cells as shown by light- and electron- microscopy, leading to the formation of aneurysms in the capillary tuft. Commencing on day 4 mesangial cell proliferation can be observed, accompanied by glomerular crescent formation at day 14, which decreases gradually 3 weeks after antibody administration, whereas mesangial hypercellularity can be observed up week 10 after intravenous injection of the antibody. The disease is clinically characterized by a massive transient proteinuria starting immediately after antibody injection, reaching mean values of 300 mg/24 hours at days 2 to 4, gradually decreasing to normal levels after 3 weeks. It is concluded that in this unique model of glomerulonephritis induced by a monoclonal antibody, recognition of Thy 1.1 epitopes as well as activation of complement including the C5-C9 membrane attack complex may play a major role in the pathogenesis of this experimental disease. PMID- 3537523 TI - Substance abuse prevention research: recent developments and future directions. AB - Substance abuse continues to be one of the most serious problems facing communities throughout the United States. Existing school-based prevention programs have produced disappointing results when carefully evaluated. However, promising research has been conducted during the past eight years with two new prevention models that focus on the psychosocial factors believed to promote substance abuse. One, the social influence model, is designed to increase adolescents' ability to resist social influences to smoke, drink, or use drugs. The other model, though also designed to increase adolescents' resistance to pro substance use social influences, focuses primary attention on the development of an array of cognitive-behavioral personal and social skills. More than 20 research studies testing programs based on these two prevention models have demonstrated significant reductions in substance use. Though future research is clearly needed, the results of these studies provide considerable cause for optimism. PMID- 3537524 TI - Community-based substance abuse prevention: a multicultural perspective. AB - Communities represent complex organizational entities which frequently are comprised of varying racial, ethnic, and sociocultural subgroups. This diversity, which is often underestimated and at times overlooked, presents a formidable challenge to substance abuse prevention efforts. The different lifestyles exhibited by various subgroups within a community represent a range of target behaviors that must be addressed if community health promotion initiatives are to be effective. This paper describes the barriers to achieving the goals of community-based substance abuse prevention that can arise from failing to recognize socioculturally-defined subgroups. An intervention planning model, which addresses the barriers from the perspective of a communication-behavior change (CBC) theoretical framework, is presented. PMID- 3537525 TI - Mass media linkages with school-based programs for drug abuse prevention. AB - The most appropriate role the media can play in preventing drug abuse is the dissemination of school-based approaches of proven efficacy. In this paper, that statement is justified from theoretical and empirical perspectives. Suggestions for putting it into practice are offered. Review of the theoretical perspectives of Cartwright, Lazarsfeld and Merton, and Katz suggests that effective uses of mass media for drug abuse prevention must ensure adequate dissemination, maximize positive attention by the target audience (selectivity), encourage positive interpersonal communication, and maximize the principles of monopolization, canalization, and supplementation. Several major ways in which mass media programming can be linked with school-based or community-based programming to achieve these objectives are suggested. Mass media programs are seen as means to improve acceptance of school-based prevention programs by parents. Conversely, schools are seen as playing a crucial role in increasing exposure to media prevention programming, especially if it is an inherent component of a classroom curriculum, and increasing and improving interpersonal discussion about the issues, between students, between students and teachers, and particularly between students and parents. PMID- 3537526 TI - The efficacy of peer leaders in drug abuse prevention. AB - The results from school-based, peer-led psychosocial smoking prevention programs suggest that this approach is effective in reducing smoking onset rates. This paper provides a theoretical rationale for using peer leaders as a major strategy in school-based drug abuse prevention programs and reviews the available literature assessing the impact of peer leadership in such programs. Furthermore, some of the practical issues involved in selecting and training peer leaders and teachers are discussed, and process evaluation data from studies conducted at the University of Minnesota are presented. The authors conclude that peer leadership can be an effective vehicle for drug abuse prevention among adolescents. However, increased research is necessary to clarify the conditions under which the impact of peer leaders is enhanced. PMID- 3537527 TI - Quantitative myoelectric determination of bowel viability. AB - A new device designed to quantitatively measure viability in ischemic bowel was studied in 20 dogs. This strain gauge device is clipped on the serosal surface and can rapidly deliver an electrical stimulus. The threshold stimulus level (TSL) was the stimulus necessary to produce a clearly defined smooth muscle contraction. TSL was compared with blood flow measured by Doppler ultrasound at 2 cm intervals in 30-cm ischemic segments as a determinant of bowel viability. Doppler readings were taken from the bowel wall (BW), peripheral arteriolar branches of the marginal artery (PA), and marginal artery (MA), itself, at each 2 cm interval. Bowel color and peristalsis were correlated with Doppler and TSL data. TSL scale ranged from 0 to 100 mA and varied from 21 +/- 2 mA in normal bowel to 98 +/- 2 mA in gangrenous bowel. At the locus of the last audible Doppler signal in the BW, PA, and MA, mean TSL readings were 27 +/- 5, 34 +/- 6, and 48 +/- 16 mA, respectively. These readings were each significantly greater than the TSL of normal bowel at P less than or equal to 0.0001 level. Portions of each ischemic segment were resected and reanastomosed. Absence of Doppler signals in the BW and PA did not preclude healing of ischemic bowel. These data suggest that TSL measurement is more sensitive than either Doppler ultrasound or gross visual evaluation in assessment of bowel viability. PMID- 3537528 TI - Cephalosporins and coagulopathy. PMID- 3537530 TI - External diffusion in solid-phase immunoassays. AB - Calculations are presented describing the influence of external diffusion in the kinetics of solid-phase immunoassays. The analysis is concerned with systems where one reactant is immobilized at the surface of a sphere of arbitrary radius. The solution for a plane surface is found as a limiting case. The factors determining whether the reaction is diffusion or reaction controlled are found to be sphere radius, surface concentration of binding sites, forward reaction rate and diffusion constant of reacting species. Means of determining whether the reaction is diffusion or reaction controlled from observable quantities are described. When applied to heterogeneous antibody-antigen binding it is found that normally the binding to cell-size spheres is not limited by external diffusion. However, when applied to solid-phase assays with high surface concentrations of binding sites immobilized at plane surfaces or macroscopic spheres the binding is found to be diffusion limited. The importance of a mass transfer analysis in this case is also discussed. PMID- 3537529 TI - Use of two-dimensional ultrasonic imaging to measure pharmacologically induced vasomotion in rabbit aorta. AB - We have developed a novel method combining two-dimensional ultrasonic imaging and computerized edge detection to study the vasomotor responses of isolated arterial vessels to various pharmacological agents. Using this in vitro system, we studied the contraction and relaxation of rabbit aorta, respectively, to phenylephrine and acetylcholine. Quantification of these drug-induced changes in vessel wall diameter was achieved by computerized edge detection processing of the two dimensional ultrasonic vessel wall images. Resolution of this imaging system was determined to be +/- 0.27 mm. Dose-response curves obtained via this new method showed a high degree of correlation with data obtained by classical tissue bath techniques using ring segments. Two-dimensional ultrasonic imaging combined with computerized edge detection is a new and sensitive method to study vasoreactivity of whole, isolated arterial vessels to pharmacological agents. PMID- 3537531 TI - Modelling of DNA sedimentation profiles from irradiated eukaryotic cells. AB - A simple mathematical model of DSB distributions in DNA from irradiated interphase eukaryotic cells is considered and an approximate description of resulting DNA sedimentation profiles is derived. The model takes into account the differences found between the radiosensitivities of heterochromatin and euchromatin and is based, contrary to the usual approach, on a non-homogeneous distribution of DSB in eukaryotic DNA. Comparison with some experimental DNA sedimentation profiles prefers the proposed model to the common one. At the same time a greater radiosensitivity difference (at least in yeast cells for the present) has been established in anoxic conditions compared to aerobic ones. PMID- 3537532 TI - Clinical temporary ventricular assist. Pathologic findings and their implications in a multi-institutional study of 41 patients. AB - Forty-one patients, distributed among four centers, had left (33 patients), right (five), or bilateral (three) temporary ventricular assistance with textured (24) or smooth (17) surfaced diaphragm pumps, during an evaluation supported by the National Institutes of Health. Cardiac failure had occurred in 39 postoperative patients (after aorta-coronary bypass [23], valve replacement [four], both [nine], or other [three]), with total cardiopulmonary bypass time mean 306 minutes (range 69 to 600). Two patients had cardiomyopathy. Death of 35 nonsurvivors was due to myocardial necrosis (14), hemorrhage (nine), cerebrovascular accidents (three), infection (three), and other (six). Mean duration of support in all patients was 62 hours. In 16 patients (40%) whose condition improved, cardiac assist duration was mean 127 hours (range 48 to 264), compared with mean 19 hours (range 1 to 120) in 25 who did not. Of 17 patients in whom duration of support exceeded 72 hours, 15 (88%) improved, 11 were weaned, and six survived long term. Tissue examination (in 33 patients) by biopsy at pump implantation or autopsy revealed coagulation or contraction band myocyte necrosis, with or without hemorrhage, in 26 patients; of these, 10 improved and six were long-term survivors. Pump-related complications (two) included pulmonary embolism, most likely related to a cannulation site thrombus, and an aortic cannulation site infection in one patient each. This study suggests that mechanical cardiac assist may be accomplished with a low complication rate; should not necessarily be denied to patients with existing necrosis, because myocardial necrosis does not preclude improvement or survival; and frequently leads to functional myocardial recovery if patients survive early noncardiac complications, often the result of long duration of cardiopulmonary bypass. PMID- 3537534 TI - Relief of membranous obstruction of the inferior vena cava in a 5-year-old child. AB - Membranous obstruction of the inferior vena cava is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of the hepatic drainage. We report membranous obstruction of the inferior vena cava in a 5-year-old boy. Surgical repair was prompted by signs and symptoms of hepatic venous obstruction. To our knowledge, this is the youngest patient successfully operated on for this anomaly. PMID- 3537533 TI - Baron Dominique Jean Larrey (1766-1842). Father of modern military surgery, innovater, humanist. AB - There is no question that Baron Larrey was the first modern military surgeon. The high morale of Napolean's troops, which contributed to the success of his armies, was in a major way dependent on Larrey's superb medical care of the wounded. It was Napoleon's brilliance to recognize this and to give Larrey free rein. Beginning in the Civil War, when ambulances first brought in the wounded to receive surgical care at the Battle of Antietam (1862), down to World War II and the Vietnam War, his principles were increasingly followed by the U.S. Army Medical Corps. In Vietnam a true "flying ambulance," the medical helicopter, was obviously the final perfection of Larrey's ambulance volante. Perhaps his dedicated humanism in the care of the wounded soldier was his best characteristic and the one that should be followed most carefully today. Even in this era of great ethical concerns for the sick and wounded, Larrey's principles set the highest of standards for all. PMID- 3537535 TI - Mechanical support of the circulation followed by cardiac transplantation. AB - Improvements in both mechanical circulatory support devices and immune therapy promise a wider use of sequential mechanical support as a bridge to orthotopic cardiac transplantation. The intra-aortic balloon pump, the left and right ventricular assist pumps, and the pneumatic artificial heart represent the range of devices capable of keeping a patient alive who is awaiting a donor organ. The major difficulty in using circulatory support devices is infection, which is caused by their required percutaneous tubes. We report here our experiences with mechanical circulatory support devices as a bridge to cardiac transplantation. In a series of 31 consecutive transplant procedures, six patients have required preoperative mechanical circulatory support. The intra-aortic balloon pump was used in two patients for 2 and 14 days, respectively, before transplantation. Both patients are well 10 and 11 months after the transplant procedure. Two patients required the left ventricular assist device for 11 and 21 days and are alive 3 weeks and 8 months, respectively, after transplantation. One patient was supported by the pneumatic artificial heart for 10 days before a donor heart became available but died of septic shock 17 days after transplantation. A second patient received a pneumatic artificial heart 7 days after transplantation when the heart transplant failed. He has been in stable condition for 45 days but is recovering from renal failure. Our early experiences indicate that either partial or total mechanical support as a bridge to transplantation is successful if overwhelming sepsis or renal failure can be avoided. PMID- 3537536 TI - A computer-assisted video technique for preparing high resolution pictures and stereograms from thick specimens. AB - A computer-assisted video technique is presented for rapidly and accurately gathering, storing and depicting three-dimensional anatomical structures in thick specimens. Several optical sections through the specimen are combined to produce high-resolution photographs with essentially infinite depth-of-field. Further, the depth information implicit in the series of optical sections makes the creation of stereoscopic pairs relatively simple. The technique employs a real time digitizing frame store and a computer. A video camera is attached to a microscope and successive optical sections are stored digitally as the plane of focus is systematically changed. After storage, the image of each optical section is enhanced to emphasize elements that are sharply focussed. The final two dimensional image is generated by selecting for each point in the final picture the darkest grey value occurring at the corresponding point in any of the pictures in the through-focus series. A picture with essentially infinite depth of-field is produced when points of correspondence in the series are determined by a ray passing normal to the plane of optical section. Right and left pictures for a stereoscopic pair are produced when points of correspondence are determined by a ray slanting either left or right of normal. This technique is illustrated with cobalt chloride-filled neurons from whole-mounted cricket ganglia, with HRP filled axons from whole-mounted goldfish tectum, with Golgi-Kopsch-impregnated neurons from cat visual cortex, and with sections of cobalt chloride-filled antennal afferents in cricket. PMID- 3537537 TI - A new Golgi method for adult human brains. AB - A new fast and reliable Golgi method to impregnate neurons in adult human brains which have been routinely fixed in neutral buffered formalin is described. In addition to potassium dichromate and sucrose, this technique uses microwave energy and hydrogen peroxide. Dendrites and perikarya of cortical pyramidal neurons and large subcortical multipolar neurons are the neuronal structures most commonly impregnated by this method. PMID- 3537538 TI - Chromation at low temperatures improves impregnation of neurons in Golgi-aldehyde methods. AB - A modification of the Golgi-aldehyde methods is proposed in which the tissue is maintained at 4 degrees C during chromation. This prevents precipitation of the solution, and significantly improves the quality of the Golgi stain, probably owing to better fixation of the tissue. PMID- 3537539 TI - PAP complex: a pitfall in immunocytochemistry of the pig hypothalamus. AB - Use of rabbit peroxidase-antiperoxidase (PAP) complex in immunostaining of the pig hypothalamus resulted in false positive staining of elements of the supraoptic and paraventricular nuclei due to binding of rabbit PAP complex and rabbit immunoglobulins to these structures. This phenomenon seriously hampers immunohistochemical investigation of the pig hypothalamus. Specific binding of swine immune serum against luteinizing hormone-releasing hormone has been detected with the protein A-biotin-streptavidin method employed on paraffin and vibratome sections of fetal and postnatal pig hypothalamus. PMID- 3537540 TI - Laminin immunohistochemistry: a simple method to visualize and quantitate vascular structures in the mammalian brain. AB - Immunohistochemistry using antiserum against the basement membrane glycoprotein laminin, was shown to be an excellent marker for brain blood vessels. Throughout the brain of mice, rats, guinea pigs, monkeys and humans, the basement membrane of the vascular structures were strongly laminin-positive. The neuropil itself was laminin-negative, whereas a positive reaction was observed in the meaninges. When the laminin antiserum was preabsorbed with its proper antigen, no specific fluorescence was observed. Using India ink perfusion as a comparative method, it was found that probably all vascular structures were also visualized with laminin immunohistochemistry. Laminin immunofluorescence was found well-suited for computer-assisted quantitative image analysis of brain vascularity. As expected in the periphery, the basement membrane of many other structures except blood vessels such as endoneurium, epithelium and smooth muscle cells were laminin positive. Although the vascular network was also strongly laminin-immunoreactive, it was difficult to differentiate between blood vessels and non-vascular structures in the periphery as compared to the central nervous system. In conclusion, laminin immunohistochemistry has proven to be a simple, useful and specific method to study vascular structures in the central nervous system and an excellent alternative to more conventional and laborious methods such as perfusion with India ink. PMID- 3537541 TI - Method of lesioning brainstem determines seizure probability. AB - We examined 3 different methods of brainstem lesioning to assess their propensities to evoke seizures in the early postoperative period. Lesioning by electrolysis or microinjection of the neurotoxin, N-methyl-D,L-aspartate, caused seizures, but lesioning by thermocoagulation (radiofrequency current) did not. In paradigms in which postoperative lesion-induced seizures could confound interpretation of experimental results, the thermocoagulative method offers an important advantage. PMID- 3537542 TI - A method for measuring regional cerebral blood flow in freely moving, unstressed rats. AB - Regional cerebral blood flow (rCBF) was measured in awake, freely moving, unstressed rats using the diffusible indicator, [14C]iodoantipyrine (IAP). Rats were prepared with catheters in the abdominal aorta and the right jugular vein and allowed to recover for 5-7 days in a special chamber. The catheters were accessible from the outside of the chamber and permitted cerebral blood flow to be measured without disturbing the rat. The length of the arterial catheter created a time delay and a dispersion of the tracer in blood as it was sampled over time. A correction was made for the catheter length using a numeric solution of the convolution integral. Blood flow in regions composed predominantly of grey matter ranged from 68 to 240 ml/100 g/min with the highest flow in the inferior colliculus. Flows in cortical regions ranged from 103 to 200 ml/100 g/min. Flow in the neural lobe of the pituitary was 454 ml/100 g/min. These studies demonstrate that the errors in measuring arterial tracer concentration when blood is sampled from a long catheter can be corrected. The correction permits rCBF to be measured in freely moving rats. PMID- 3537543 TI - [Threatened abortion]. PMID- 3537544 TI - Prostacyclin and heparin during haemodialysis: comparative effects. AB - Haemodialysis was performed using heparin (dialysis I: heparin regimen 1, 2000 U/h) in ten patients. These subjects were then given an infusion of prostacyclin, in the form of epoprostenol sodium salt (dialysis II: prostacyclin, 5 ng X kg-1 X min-1), followed by an infusion of prostacyclin and heparin (dialysis III: heparin regimen 2,500 U/h). Absolute platelet count, in vitro platelet aggregation and plasma beta-thromboglobulin decreased during prostacyclin infusion. Haemodialysis neutropenia was improved by prostacyclin. The membrane sieving coefficient factor and ultrafiltration volume were not improved by prostacyclin alone (dialysis II). Prostacyclin together with heparin (dialysis III) showed, 60 minutes after the start, an unchanged sieving coefficient factor compared with that of heparin alone, while the ultrafiltration volume significantly (P less than 0.001) improved. The results of this study confirm those of earlier studies and suggest that prostaglandin I2 together with low-dose heparin improve the biocompatibility and efficiency of dialysis treatment. PMID- 3537546 TI - Proceedings of the second meeting of the IUIS Lymphokine Standardization Subcommittee. March 5 and 8, 1986, Erlangen, West Germany. PMID- 3537547 TI - Phase I clinical trial of MAF containing preparation of RPMI-1788 B-cell human lymphoblastoid lymphokine in advanced cancer patients. AB - We report a summary of a Phase I clinical trial of the partially purified MAF containing supernatant of RPMI-1788 human B-cell lymphoblastoid lymphokine conducted in 39 patients with advanced cancer. The trial was conducted in four parts: two subcutaneous and two intravenous routes and schedules of administration. Dose limiting toxicity in the subcutaneous trials was volume dependent. The intravenous trial was remarkably well tolerated so that the maximum tolerable dose exceeded expectations. The study demonstrated modification of the immune system including an increase in skin test reactivity, an increase in absolute lymphocyte counts, alteration in the monoclonal lymphocyte antibody markers, and an increase in MAF activity. Toxicity in the intravenous trial was limited to transient febrile reactions that were ameliorated by increasing the infusion time. Three objective tumor responses were observed. PMID- 3537545 TI - Prevention of vascular graft lesions in renal transplant recipients with a new antithrombotic agent (defibrotide): a controlled study. AB - Eighty transplanted patients were randomized to receive either a new antithrombotic agent, defibrotide (group A), or dipyridamole (group B) in addition to immunosuppressive therapy, in order to evaluate the effectiveness of these drugs in preventing graft vascular damage. While the incidence of rejection and the occurrence of specific anti-HLA antibodies were similar in the two groups, the peak serum creatinine levels during rejection were significantly lower in patients treated with defibrotide (3.3 +/- 1.8 versus 5.6 +/- 2.4 mg/dl; P less than 0.01), 97.5 per cent of whom had a still-functioning graft after a mean follow-up period of 24 months, compared with 80.5 per cent of the patients treated with dipyridamole (P less than 0.05). Graft biopsy, carried out during rejection, showed less severe vascular lesions in patients from group A than in those from group B. Our results suggest that the prophylactic administration of defibrotide may play a role in improving the long-term results of renal transplantation. PMID- 3537548 TI - Consideration of the proteins and peptides produced by new technology for use as therapeutics. PMID- 3537549 TI - Analysis of IL-2 producing subsets of human lymphocytes. AB - A limiting dilution procedure using lymphocytes isolated by FACS is described to assess the role of individual T cell subsets for the production of IL-2 in the presence of purified B (Leu-12+) cells. Purified B cells were isolated by two color FACS using B (anti-Leu-12) and T (anti-Leu-4) cell specific fluorescent conjugated antibodies. The Leu-12+ cells were treated with anti-Leu-5b plus complement to remove contaminating sources of IL-2 producing cells and titrated with purified T cell subsets using a miniassay to determine IL-2 production. Results indicated that less than 1000 Leu-4+ T cells in the presence of 98% Leu 12+ B cells could produce an equivalent amount of IL-2 produced by the 40,000 T cells estimated in the unsorted population. A comparison of the Leu-2+ and Leu-3+ T cell subsets isolated by two-color cell sorting and activated with phytohemagglutinin (PHA) demonstrated that the Leu-3+ cell population produced significantly higher higher levels of IL-2 on a per cell basis than Leu-2+ cells. Furthermore while purified preparations of Leu-3+ cells were capable of secreting small amounts of IL-2 in the absence of accessory cells, the Leu-2+ population appeared to be completely dependent upon these cells for production of this lymphokine. PMID- 3537550 TI - Measurement of human IL-1 by LIF induction, pancreatic islet-cell cytotoxicity, and bone resorption. PMID- 3537551 TI - The phagocytosis of yeast cells by monocytes: effects of colchicine, beta lumicolchicine, and gamma-lumicolchicine. AB - The effect of microtubule antagonist (MA) colchicine and its two non-MA derivatives beta-lumicolchicine and gamma-lumicolchicine on the phagocytosis of yeast cells by glass-adherent monocytes were studied with a fluorescence quenching technique which allowed a distinction between the adherence and engulfment phases of phagocytosis. The engulfment of yeast cells was depressed by colchicine (p = 0.031) but not by the lumicolchicines. The adherence of yeast cells to the monocytes, on the other hand, was depressed by gamma-lumicolchicine (p = 0.028). The colchicine effect suggests that cytoplasmic microtubules play a role in the engulfment process whereas the lumicolchicine effect suggests a role of nucleoside transport over the cell membrane in the adherence process of phagocytosis. PMID- 3537552 TI - Peritoneal lymphoid cells. PMID- 3537553 TI - The Polish Hippocrates--Matthew of Miechow. PMID- 3537554 TI - The intellectual and social testament of Karol Marcinkowski. PMID- 3537555 TI - Professor Kazimierz Kostanecki (1863-1940), renowned Polish anatomist. PMID- 3537556 TI - Macrophage procoagulant factors--mediators of inflammatory and neoplastic tissue lesions. AB - Mononuclear phagocytes, a specialized cell lineage comprising bone-marrow precursors, blood monocytes and tissue macrophages, can interact with blood coagulation mechanisms with resulting thrombus formation or extravascular fibrin accumulation. Such procoagulant activity is usually activation dependent and requires interaction of the cells with immune or nonimmune stimuli. In the former case (e.g., alloantigens, soluble protein antigens) collaboration of mononuclear phagocytes with T lymphocytes is necessary and is mediated by cell-to-cell contact or lymphokines. Prototype of a direct acting stimulus is bacterial lipopolysaccharide. Mononuclear phagocyte procoagulant activity is expressed in the form of cell membrane-bound or released factors which display molecular heterogeneity. They include the initiator of the extrinsic clotting pathway, tissue factor, known clotting proteases such as factors V and VII, and novel proteolytic enzymes including prothrombinase and a factor X activator. Mononuclear phagocyte procoagulants are pathogenetically involved in generalized disorders with intravascular coagulation and thromboembolic phenomena. These disorders, exemplified by the Shwartzman reaction and possibly by paraneoplastic thromboembolism, are initiated by blood monocytes. Extravascular fibrin deposition can be initiated by tissue-infiltrating monocytes and macrophages in disease states such as acute renal allograft failure and solid tumours. PMID- 3537557 TI - The in vitro pharmacology of chloroquine and quinacrine. AB - The effects of guanethidine, chloroquine and quinacrine on noradrenergic nerves have been compared in vitro using the isolated expansor secundariorum muscle of chicks. The effect of chloroquine on alpha-methyl-noradrenaline uptake by noradrenergic nerve terminals in various tissues were studied. The inhibitory action of guanethidine and quinacrine on noradrenergic nerves appeared to be mediated intraneuronally. The inhibitory action of chloroquine was readily reversible and unaffected by dexamphetamine. Chloroquine caused supersensitivity of the expansor muscle to noradrenaline by blocking its neuronal reuptake since the supersensitivity caused by denervation was not further increased by chloroquine. This was confirmed by the finding that chloroquine inhibited alpha methylnoradrenaline uptake (Uptake1). Quinacrine did not cause supersensitivity to noradrenaline, possibly due to its direct depressant action on the expansor secundariorum muscle. PMID- 3537558 TI - [Orthotopic hepatic transplant: first year of experience]. PMID- 3537559 TI - [The function of macrophages]. PMID- 3537560 TI - [Clinical research in Spain: characteristics of authors]. PMID- 3537561 TI - [High-density lipoproteins and atherosclerosis]. PMID- 3537562 TI - [Current aspects of serum sickness]. PMID- 3537563 TI - [The bibliography of a research project]. PMID- 3537564 TI - [Cimetidine, single nocturnal doses in the treatment of duodenal ulcer]. PMID- 3537565 TI - [Bibliography and scientific communication]. PMID- 3537566 TI - [Reactive pericarditis associated with Salmonella gastroenteritis]. PMID- 3537567 TI - [Acute myocardial infarct of embolic origin in bacterial endocarditis]. PMID- 3537568 TI - [Ectopic pregnancy. A critical review]. PMID- 3537569 TI - [Radioimmunoassay in hormonal quantification. The end of an era?]. PMID- 3537570 TI - [Adrenal cysts: apropos of 3 cases]. PMID- 3537571 TI - [ Acute non-calculous Salmonella enteriditis cholecystitis, diagnosis by percutaneous puncture]. PMID- 3537572 TI - [Total prosthesis of the knee]. PMID- 3537573 TI - New diagnostic techniques in anatomic pathology. AB - A variety of methods involving better instrumentation and the use of immunologic techniques enables the anatomic pathologist to provide precise diagnoses on a timely basis. A shift in the emphasis toward endoscopic biopsy places the pathologist on the front line with the clinician. PMID- 3537574 TI - Recent advances in imaging and evaluation of blood flow using ultrasound. AB - Use of ultrasound for noninvasive evaluation of the vascular system is now commonplace. A new imager has been developed that depicts Doppler images (moving structures) and B-mode images (nonmoving structures) on the same image screen. The new instrument and its potential for clinical use are described. PMID- 3537575 TI - Ventricular arrhythmia: management strategy. AB - The management of ventricular arrhythmia continues to be one of the most difficult therapeutic problems in medicine today. Both invasive and noninvasive techniques have demonstrated success in management of patients at high risk for sudden cardiac death. High-risk subgroups include patients who have experienced sudden cardiac death and have been resuscitated successfully, patients with high grade ventricular ectopy associated with left ventricular dysfunction, and patients who have had recent myocardial infarction. Traditional and experimental antiarrhythmic agents are available to the clinician, and in some patients combination therapy may prove more useful than application of a single agent alone. In individuals in whom pharmacologic intervention fails, map-guided surgical excision may be beneficial. The application of the automatic implantable defibrillator appears to have promise in truly refractory situations. PMID- 3537576 TI - Use of fiberoptic endoscopy in diagnosis and therapy of upper gastrointestinal disorders. AB - The future role of therapeutic endoscopy appears bright and depends on the possibilities of technology and the ingenuity of those performing the procedures. New techniques are being devised, and the therapeutic applications are being evaluated continually. Such issues as appropriate indications, efficacy, and cost effectiveness remain important considerations for the practitioner dealing with gastrointestinal disorders. PMID- 3537577 TI - Evaluation of sleep disorders. AB - This review summarizes the current approach to the diagnosis and treatment of sleep disorders. Classification of sleep disorders, basic sleep physiology, use of the sleep laboratory, and management of patients are discussed. PMID- 3537578 TI - [Umbilical metastasis of carcinoma of the gallbladder]. AB - The case of a 60 year old woman with an umbilical nodule of sudden onset, followed one year later by cholestatic jaundice and weight loss, is reported. The histology of the nodule suggested a metastatic adenocarcinoma of undetermined origin. Laboratory and radiological investigations, abdominal echography and laparotomy disclosed carcinoma of the gallbladder with invasion of the main biliary duct and peritoneal dissemination. A biliodigestive derivation was found technically impossible at the surgical operation and the neoplastic disease far too advanced tu justify chemotherapy. Only eleven cases of biliary tract carcinoma with umbilical metastases could be found in the literature. The relative incidence of the primary tumors giving umbilical metastases, the different ways in which they can reach the umbilicus and the ominous meaning of these metastases are discussed and the relevant literature is reviewed. PMID- 3537579 TI - [De Sanctis-Cacchione syndrome. Apropos of 2 cases]. AB - We report two cases of xeroderma pigmentosum (XP), with neurologic alterations, representing a partial, although not complete form of the syndrome of De Sanctis Cacchione. The clinical and aetiological features of the condition are discussed. PMID- 3537580 TI - [Large cell acanthoma]. AB - The authors relate a clinical case of large cell acanthoma with multiple lesions that predominate on the inferior limbs. They comment the nosological position, the clinical aspects and, concerning the histopathology, emphasize the enlarged dimensions of the cellular nuclei in acanthoma and the differential diagnosis. Probably, the large cell acanthoma is a much more frequent entity that has not been diagnosed due to the little knowledge of this pathology. PMID- 3537581 TI - [Treatment of chromomycosis with liquid nitrogen]. AB - Five patients with chromomycosis have been treated by liquid nitrogen application. The evolution of disease has been of one to twenty five years, with 4 patients with verrucous patches and one patient with sarcoid-like lesion. In all cultures grows-up Fonseca pedrosi. The authors believe that this method of treatment has advantage to be more economic, to avoid hospitalization and surgical acts with anesthesia, and also could be realized at ambulatory level. The efficacy of this method has been proved by the follow-up the patients during a period between two to four years, without any recurrency. PMID- 3537582 TI - [Urticarial vasculitis: apropos of 12 cases]. AB - 12 cases of urticarial vasculitis in 6 males and 6 females of average age are studied. Cutaneous lesions are accompanied with fever (3 cases), arthralgias (5 cases), renal manifestations (2 cases) and gastrointestinal pain (2 cases). The majority presented elevated VSG and increment of the alpha-2-globulin. Histopathologically, we find two different patterns: leukocytic-classic vasculitis and lymphocytic vasculitis of small vessels. Clinical characteristics give up with dapsone better than with doses of corticoids. We consider the influence of climatological agents (fundamentally solar exposition) and we compare our cases with the literature. PMID- 3537583 TI - [Tobacco and dermatologic lesions]. AB - The authors consider the clinical pathologic aspects of the skin and mucosa in chronic smokers. This features are not exclusively found in these impatiens, but in spite of no specificity the authors mention the significance of this pathology with special reference to oral cancer. PMID- 3537584 TI - [Actinic granuloma]. AB - We report a case of starting actinic granuloma. A revision about the subject is realized emphasizing the importance of histopathologic findings in starting lesions. PMID- 3537585 TI - [Congenital lymphedema]. AB - We add to the dermatologic bibliography, a family with two exceptional cases of congenital lymphedema. We comment etiopathogenesis, clinical, associations and complications, and insisting on the necessity of forward diagnostic. PMID- 3537586 TI - [Peutz-Jeghers syndrome. 2 cases]. AB - We describe two cases of Peutz-Jeghers syndrome, a 13 years old female and a 8 years old male patients. In the first case the patient showed pigmented macules on lips, face and oral mucosa, as well as gastric and jejunal polyposis which caused total gastrectomy and segmental enterectomy. The second patient had melanosis on the lower lip, face, buccal mucosa, forearms and perianal area, and the gastric endoscopy revealed two small gastric polyps on the angular incisura. PMID- 3537587 TI - [Connective tissue nevi, associated variety]. AB - We made the subject's review of the connective naevus because a boy of thirteen years old has consulted us about it. He has it on the back, on the forearm and on the right, it is associated to a cavernous tubero angioma of the mouth, this eventuality was described and commented by McBurney and his coworkers (1979) in his article "Angiokeratomas, connective tissue nevus, hemangioma". We bring out its main characteristics based on publications and displays of national authors' cases and our experience achieved at the cathedra about this nevoid dysplasia, from universal rareness, motif that will help to increase the scarce statistics of associate connective tissue naevus. PMID- 3537588 TI - [Calcinosis of the scrotum]. AB - A critical review of the present classification of the calcinosis cutis is done and the difficulties to make it more precise are pointed out: it is hard to put together diseases totally different that have in common only calcium deposits in the skin; there is a lot of confusion in the current terminology; some authors don't recognize certain entities and; in a few times their own definitions are not respected. A cause of scrotal calcinosis (SC) secondary to epidermoid cysts calcification is presented. The authors believe that many cases classified as idiopathic calcinosis of the scrotum can be in reality late stages of a dystrophic calcification. They suggest that serial cuts in the histopathology examination of every lesion of SC should be performed in order to establish the existence or not of any epithelial remnant. Considering the fact that the treatment is surgical and mostly due to esthetic reasons, they also suggest to follow, if possible, a significant number of patients from an early to a late stage of the disease; only in this way it will be possible to know about the natural history of the scrotal calcinosis. PMID- 3537589 TI - Physiological pharmacokinetic models: principles, applications, limitations and outlook. PMID- 3537590 TI - [The man behind the syndrome: Prosper Meniere. He was the first one to consider that vertigo and hearing disorders can be an expression of swelling in the middle ear]. PMID- 3537591 TI - [Antidepressive agents in the treatment of agoraphobia and panic--an evaluative review]. PMID- 3537592 TI - [Surgical treatment of gastroesophageal reflux--a review]. PMID- 3537594 TI - [Ultrasound diagnosis of benign and malignant parotid tumors]. AB - The value of high resolution real time ultrasound imaging in the preoperative differential diagnosis of focal disease of the parotid gland was evaluated in 35 cases. After description of the ultrasound imaging of the normal gland, the majority of benign and malignant tumours are demonstrated. Ultrasound patterns allow a good differentiation of mixed tumours, warthin's tumours and carcinomas. Differential diagnosis between mixed tumours on the one hand, mucoepidermoid and serous cell adenomas on the other can be difficult or even impossible. This holds true for pathologic lymphomas, too, whereas cysts can be distinguished very well. On the whole, the differentiation between benign and malignant tumours was correct in 28 out of 35 cases. Furthermore, in 21 cases the ultrasound pattern was in accordance with the result of the histologic examination. Compared with sialography, needle biopsy and CT scanning, ultrasonography is a reliable, safe and noninvasive method of high value in preoperative examination of parotid tumours. PMID- 3537593 TI - [Effects and adverse effects of decongestants in otosalpingitis]. PMID- 3537595 TI - [History of intubation]. AB - The Arabian doctor Avicenna (980-1037) described the first orotracheal intubation in dyspnoea. The history of peroral endotracheal intubation actually begins in the 18th century. At that time obstetricians and lifesavers used breathing tubes. In 1880 Macewen preoperatively intubated a patient to prevent the aspiration of blood during extirpation of a tumour from the base of the tongue. Regular peroral intubation to keep the respiratory tract clear during narcosis was first applied by Franz Kuhn in 1900; unfortunately, the pioneer himself did not live to see his method become a routine procedure. It was only as late as 1945, that endotracheal intubation became part of hospital practice at our clinic. PMID- 3537596 TI - Prevention of recurrent acute otitis media: chemoprophylaxis versus tympanostomy tubes. AB - Otitis media has long been recognized as one of the most common diseases of childhood. Several therapeutic modalities have been advocated for the prevention of recurrent episodes of acute otitis media (AOM). A blinded, prospective, randomized study was designed to determine the efficacy of tympanostomy tubes, antibiotic prophylaxis, and placebo. Children with recurrent AOM were entered in the study and followed for at least 6 months. A total of 65 children completed the protocol. Sixty-three of those were under the age of 4 years. Treatment failure was defined as two or more episodes of AOM or otorrhea in less than 3 months. Five of 22 children in the tympanostomy tube group failed, compared to 12 of 20 in the placebo group (p = .02). There were 8 or 21 treatment failures in the sulfisoxazole group. Children with otitis media with effusion (OME) at the time of their initial visit had significantly less middle ear disease when treated with tympanostomy tubes. Tympanostomy tube insertion for prophylaxis of recurrent acute otitis is supported by these findings. Improvement of recurrent AOM was observed in the sulfisoxazole group, but was not statistically significant. PMID- 3537597 TI - [Campylobacter pyloridis--saprophyte or pathogen?]. PMID- 3537598 TI - [Sonographic demonstration of liver hemangiomas]. PMID- 3537599 TI - Historical background to the development of leprosy control in Malawi. PMID- 3537600 TI - Ten years' leprosy control work in Malawi (Central Africa)--II. Patterns of endemicity since 1973. PMID- 3537601 TI - Neuropeptide Y normalizes renin secretion in adrenalectomized rats without changing blood pressure. AB - In the periphery, neuropeptide Y is present in plasma, in the adrenal medulla as well as in sympathetic nerve endings and in the juxtaglomerular apparatus. The aim of the present study was to assess the effect of this peptide on renin secretion. Normotensive rats were adrenalectomized or sham-operated and made hypertensive with methylprednisolone acetate (20 mg/kg s.c. once weekly). Deoxycorticosterone pivalate (10 mg/kg s.c. once weekly) was also given to prevent mineralocorticoid deficiency. Two weeks after initial surgery, 12 adrenalectomized and 8 sham-operated conscious rats were infused for 30 min with neuropeptide Y (0.1 micrograms/min) whereas 8 other adrenalectomized and 9 sham operated conscious rats received under similar conditions the vehicle of neuropeptide Y (10 microliter/min). Neither before nor during the infusions was there a significant difference in blood pressure and heart rate between the 4 groups of animals. Plasma renin activity, measured at the end of the infusion, was 30.5 ng/ml/hr in the adrenalectomized group receiving vehicle and 6.3 ng/ml/hr in that infused with neuropeptide Y (p less than 0.001). This latter value did not differ from that found in sham-operated rats. These results suggest that neuropeptide Y may play an important role in regulating renin secretion. PMID- 3537602 TI - Induction of turning by direct intrastriatal injection of dopaminomimetic drugs in mice: pharmacological analysis of a simple screening model. AB - A new simple model designed for the screening of dopaminomimetic drugs in mice is presented. When injected directly into the right striatum of conscious mice, the dopamine (DA) receptor agonists apomorphine, SKF 38393 and bromocryptine, the indirect DAmimetic drugs (+)-amphetamine and nomifensine, the atypical DAergic antidepressant drug minaprine, induced contralateral rotations. Rotations induced by DA mimetics were antagonized by i.p. injected haloperidol. A pretreatment with the D1 antagonist SCH 23390 (s.c.) antagonized the turning induced by apomorphine or by the D1 agonist SKF 38393, and, to a lesser extent, that induced by the D2 agonist bromocryptine. In contrast, the D2 antagonist (-)-sulpiride (i.p.) blocked the effects of the 3 agonists to the same extent. A pretreatment with alpha-methylparatyrosine (i.p.) antagonized rotations induced by bromocryptine, (+)-amphetamine and minaprine, but not those induced by nomifensine or apomorphine. The results suggest that this model could represent a useful screening tool for the search of new DAmimetic drugs, and for the assessment of DA receptor blockade. PMID- 3537604 TI - Human extrahepatic biliary atresia: portal connective tissue activation related to ductular proliferation. AB - Surgical bile flow restoration in extrahepatic biliary atresia (EHBA) does not prevent the development of ongoing hepatic fibrosis and cirrhosis. Portal connective matrix was studied on liver biopsies obtained from seven children submitted to portoenterostomy. Electron microscopy and immunohistochemical techniques (using specific antibodies directed against collagen isotypes and associated glycoproteins) were performed. The study of extracellular and cellular components of connective matrix demonstrated the existence of two distinct areas according to their situation with regard to ductular proliferation: loose connective matrix--mainly composed of fibronectin, type III collagen, type IV collagen and laminin--associated with microvessels and myofibroblasts proliferation characterized periportal zones adjacent to bile ductules; in areas distant from ductular proliferation, connective matrix appeared dense, composed of type I and type III collagen associated with fibroblasts. The connective matrix pattern observed in periductular areas can be compared to that described in cicatricial and hypertrophic processes where the myofibroblastic cell population is known to play an important role in fibrosis development. Although the connective matrix activation process remains unclear in EHBA, it may be suggested that activation of a connective tissue cellular clone might be responsible for this portal fibromatosis. PMID- 3537603 TI - Cardiovascular effects of adenosine infusion in man and their modulation by dipyridamole. AB - In man, intravenous infusion of adenosine has been useful in inducing sustained hypotension during anesthesia. Bolus injections terminate supraventricular tachyarrhythmias by delaying AV node conduction. It has been proposed that some of its cardiovascular effects are related to inhibition of noradrenergic neurotransmission. We assessed the cardiovascular and sympathoadrenal effects of intravenous infusion of adenosine (10 to 140 micrograms/kg/min) in 7 conscious normal subjects. At the highest infusion rate achieved, adenosine increased heart rate by 33 bpm (p less than 0.005), increased systolic blood pressure by 13 mm Hg (p less than 0.02) and decreased diastolic blood pressure by 8 mm Hg (p less than 0.02). Plasma norepinephrine and epinephrine increased 44% and 213% respectively. Basal plasma renin activity was 0.7 +/- 0.09 ng AI/ml/hr and remained unchanged. Higher doses were not given due to the appearance of subjective side effects (headache, nervousness, flushing and an urge to breathe deeply). During dipyridamole administration, 4-fold lower doses were required to produce equivalent cardiovascular effects. We conclude that in conscious man, intravenous infusion of adenosine is associated with activation rather than inhibition of the sympathoadrenal system. The possible mechanisms of this sympathetic activation are discussed. PMID- 3537605 TI - Bacteremia in cirrhosis of the liver. AB - In a retrospective study the average yearly incidence of bacteremia in cirrhosis patients was found to be 4.5%. This is about 5-7 times higher than in two general materials of all bacteremic patients from the same hospital. There was no difference between the distribution of bacterial strains in the 43 bacteremic cirrhosis patients and the two general materials of all bacteremic patients. PMID- 3537606 TI - The psycho-social impact of a liver transplant programme. AB - Through in-depth interviews, an inventory has been made of the experiences of 18 liver patients who have been considered for or undergone a liver transplant. Interviews were also held with the patients' relatives. Chronic patients especially seem to regard a transplant as their last chance, and all their hopes become based on it. The strict selection procedure is distressing, and being turned down causes negative feelings. As far as the operation itself is concerned, patients are inclined to create high success rates for themselves in relation to their survival chances and the expectations of quality of life. For some patients a transplant means a marked improvement in the various aspects of their functioning. Others are not so fortunate, but do not give up hope of improvement. From the relatives of the patients who had died post-operatively, no negative feelings were encountered over the 'failure' of the technology'. PMID- 3537608 TI - [High-frequency spatial filtration of roentgenogram images]. PMID- 3537607 TI - [Intracavitary ultrasonic diagnosis of rectal cancer]. PMID- 3537609 TI - [Ionizing radiation and risk of breast cancer in women]. PMID- 3537610 TI - Anatomy of a knowledge-based consultant system: AI/RHEUM. PMID- 3537612 TI - Trauma and sudden death. PMID- 3537613 TI - Acute poisoning due to non-steroidal anti-inflammatory drugs. Clinical features and management. AB - Despite the widespread use of non-steroidal anti-inflammatory drugs (NSAIDs), the current number of reported cases of poisoning is small. However, with the introduction of 'over-the-counter' preparations of NSAIDs in some countries (e.g. ibuprofen in the UK and USA) an increased incidence of acute poisoning from this group of drugs can be expected. Conventionally, NSAIDs are divided into the following groups based on their chemical structure: arylpropionic acids, indole and indene acetic acids, heteroarylacetic acids, fenamates, phenylacetic acids, pyrazolones and oxicams. Unless NSAIDs are ingested in substantial overdose, acute poisoning with these agents does not usually result in significant morbidity or mortality. In most cases the clinical features are mild and confined to the gastrointestinal and central nervous systems, though acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse and cardiac arrest may complicate severe poisoning. Arylpropionic acid derivatives were thought initially to have a low order of toxicity in overdose but, in addition to anticipated gastrointestinal symptoms, headache, tinnitus, hyperventilation, sinus tachycardia, hypoprothrombinaemia, haematuria, proteinuria and acute renal failure have been described. In addition, drowsiness, coma, nystagmus, diplopia, hypothermia, hypotension, respiratory depression and cardiac arrest have been reported in severe cases of poisoning. Oxyphenbutazone and phenylbutazone are considerably more toxic in overdose. Complications of severe poisoning include coma, convulsions, hepatic dysfunction, acute renal failure, sodium and water retention, haematuria, cardiovascular collapse, respiratory alkalosis, metabolic acidosis, hypoprothrombinaemia and thrombocytopenia. In contrast, indomethacin appears to be much less toxic. In addition to gastrointestinal symptoms, indomethacin taken in overdose induces headache, tinnitus, dizziness, lethargy, drowsiness, confusion, disorientation and restlessness. Only 1 case of acute sulindac poisoning has been reported in the literature. A 16-year-old boy was admitted with hypokalaemia (2.2 mmol/L), transient granulocytosis and 'scanty' haematemesis after ingesting 12 g sulindac. No case of acute tolmetin poisoning have been reported. The fenamates (flufenamic acid, meclofenamic acid, mefenamic acid, tolfenamic acid) are, with the exception of mefenamic acid, not as widely prescribed as other groups of NSAIDs. In overdose, mefenamic acid may result in nausea, vomiting, diarrhoea, muscle twitching, convulsions and coma.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537611 TI - Quick medical reference (QMR) for diagnostic assistance. PMID- 3537614 TI - Adverse reactions and interactions with newer cephalosporin and cephamycin antibiotics. AB - In this review, adverse reactions and interactions associated with the use of the newer cephalosporins and cephamycins are surveyed; special emphasis is placed on those reactions specific for some of these newer agents, namely disulfiram-like reactions with alcohol, effects on prothrombin synthesis, and lower gastrointestinal tract reactions. It is apparent that cephalosporins with a 3 methylthiotetrazole side-chain in the cephem nucleus cause clinically significant side effects more frequently than those without such a moiety. While still having a high degree of safety, cephalosporins with this chemical structure clearly have a higher degree of toxicity than those without this side-chain. PMID- 3537615 TI - Immunotherapy in the poisoned patient. Overview of present applications and future trends. AB - Immunotherapy for reversal of toxicity due to poisons and drugs is not new. However, refinements in antibody isolation and purification as well as the advancement of hybridoma technology and recombinant DNA biotechnology has led to a new generation of immunotherapeutic and diagnostic agents. The advent of monoclonal antibody technology in 1975 heralded the new age of immunopharmacology and immunotoxicology. Monoclonal antibodies designed for a specific antigen resolved the problem of polyclonality and cross-reactivity of traditional antibodies. Along with the production and isolation of active antibody fragments from both polyclonal and human monoclonal sources, as well as the ability to tailor-make chimeric antibodies by recombinant biotechnology, the development of novel immunotherapeutic agents has taken place. Two immunotherapeutic modalities, digoxin-specific antibody fragments (Fab) and snake antivenin, have been available for the clinician's armamentarium for years. Along the same lines of anti-digoxin Fab development, application of newer antibody isolation technology has led to a purified IgG(T) antibody for snake venom poisoning which is still in the developmental stages. Potential future developments in immunotherapeutics must overcome the clinical problems of immunogenicity and adverse reactions to the antibodies. Human monoclonal sources, active antibody fragments, and chimeric antibodies from transfectomas are all potential resolutions to these problems. PMID- 3537616 TI - Role of the toxicology laboratory in the treatment of acute poisoning. AB - The modern toxicology laboratory can play an important role in the evaluation of poisoning. In order to appreciate the nature and extent of this role, several essential elements necessary to an acute care toxicology service should be considered. When an ongoing and effective dialogue between clinicians and the toxicology laboratory staff is established, and a broadly based analytical approach is applied to the analysis of the appropriate biological fluids, a dynamic and viable toxicology service will result. How these elements work together to facilitate this service will be discussed, based primarily on experience in a large teaching hospital. This experience indicates that if the elements necessary to provide laboratory support in the investigation of an alleged poisoning are in place, the toxicology laboratory plays an important role in ensuring optimum and effective patient care. PMID- 3537617 TI - Theophylline poisoning. Pharmacological considerations and clinical management. AB - The recent marketing of slow release preparations of theophylline and new indications for the use of the drug have resulted in a marked increase in the sale of theophylline products. This phenomenon combined with the drug's highly variable pharmacokinetics has led to an increase in the number of theophylline intoxications. The morbidity and mortality rates associated with theophylline intoxication are significant. Therefore it is essential that clinicians are aware of the pathophysiology, clinical presentation and treatment of this poisoning. Theophylline intoxication mainly affects the gastrointestinal, cardiovascular and central nervous systems. Signs and symptoms range from mild gastrointestinal upset to serious central nervous system manifestations such as seizures, a symptom often associated with a bad prognosis. Theophylline serum concentrations are very useful for making decisions regarding treatment. However, their interpretation should take into account several factors such as the age of the patient and the type of intoxication (acute versus chronic). Prevention of gastrointestinal absorption should be the principal objective of treatment of an oral theophylline poisoning. The repetitive administration of activated charcoal not only prevents theophylline absorption but also increases its rate of Once absorbed, external methods such as haemodialysis and haemoperfusion can significantly accelerate the elimination of the drug from the body. Finally, the rapid suppression of seizures and cardiac arrhythmias are essential to prevent severe neurological sequelae and death. Since theophylline intoxication can be potentially life-threatening, its administration should be monitored with regular measurements of the serum theophylline concentration, especially in the very young and the very old. PMID- 3537618 TI - Techniques of postmarketing surveillance. An overview. PMID- 3537619 TI - Cathartics and laxatives. Do they still have a place in management of the poisoned patient? PMID- 3537620 TI - Drug- and chemical-induced methaemoglobinaemia. Clinical features and management. AB - Methaemoglobin is haemoglobin with the iron oxidised to the ferric (Fe ) state from the normal (or reduced) ferrous (Fe++) state. Methaemoglobinaemia refers to the presence of greater than the normal physiological concentration of 1 to 2% methaemoglobin in erythrocytes. Methaemoglobin is incapable of transporting oxygen. It has an intense dark blue colour; thus, clinical cyanosis becomes apparent at a concentration of about 15%. The symptoms are manifestations of hypoxaemia with increasing concentrations of methaemoglobin. Concentrations in excess of 70% are rare, but are associated with a high incidence of mortality. Methaemoglobinaemia may be congenital but is most often acquired. Congenital methaemoglobinaemia is of two types. The first is haemoglobin M disease (several variants) which is due to the presence of amino acid substitutions in either the alpha or beta chains. The second type is due to a deficiency of the NADH dependent methaemoglobin reductase enzyme. This deficiency has an autosomal dominant transmission, and both homozygous and heterozygous forms have been reported. The heterozygous form is not normally associated with clinical cyanosis, but such individuals are more susceptible to form methaemoglobin when exposed to inducing agents. A wide variety of chemicals including several drugs, e.g. the antimalarials chloroquine and primaquine, local anaesthetics such as lignocaine, benzocaine and prilocaine, glyceryl trinitrate, sulphonamides and phenacetin, have been reported to induce methaemoglobinaemia. An intense 'chocolate brown' coloured blood and central cyanosis unresponsive to the administration of 100% oxygen suggests the diagnosis. A simple bedside test using a drop of the patient's blood on filter paper helps to confirm the clinical suspicion. Methaemoglobin can be quantitated rapidly by a spectrophotometric method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537621 TI - Poisoning due to tricyclic antidepressant overdosage. Clinical presentation and treatment. AB - Tricyclic antidepressants are among the commonest causes of both non-fatal and fatal drug poisoning in the world. Their toxicity is due to effects on the brain, the heart, the respiratory system and the parasympathetic nervous system. Symptoms usually appear within 4 hours of an overdose and all but the most seriously poisoned patients recover within 24 hours. The most common clinical features are dry mouth, blurred vision, dilated pupils, sinus tachycardia, pyramidal neurological signs, and drowsiness. In severe poisoning, there may be coma, convulsions, respiratory depression, hypotension and a wide range of electrocardiographic (ECG) abnormalities. The most frequent findings on the ECG are prolongation of the PR and QT intervals; the tracing may resemble bundle branch block or supraventricular or ventricular tachycardias. Treatment of poisoning due to the tricyclic antidepressants is essentially supportive, there being insufficient evidence at present to recommend the use of methods to increase elimination of the drug from the body. Gastric aspiration and lavage should be performed if more than 750 mg of drug have been taken. There must be regular monitoring for hypoxia, acidosis and hypokalaemia and these complications should be corrected enthusiastically. Convulsions should be treated with diazepam or chlormethiazole. Muscular paralysis and artificial ventilation should be employed if anticonvulsants are ineffective. Hypotension should be treated firstly by fluid replacement and then with sympathomimetic agents (dopamine or dobutamine). Antiarrhythmic drugs should only be employed if there is evidence of circulatory failure which fails to respond to correction of hypotension. Sodium bicarbonate infusions should be given to cardiotoxic patients who are acidotic and are worth trying even if the patient is not acidotic. Although physostigmine salicylate will reverse most of the features of tricyclic antidepressant poisoning, its effects are short-lived in serious toxicity and it can produce dangerous side effects; physostigmine should therefore be reserved for those patients who have complications of coma or who have resistant cardiotoxicity or convulsions. Drug screening and quantitative determination of tricyclic antidepressant serum concentrations are useful in a minority of patients who have severe, unusual or prolonged symptoms. PMID- 3537622 TI - Acute overdose with sustained release drug formulations. Perspectives in treatment. AB - Acute overdose with sustained release formulations presents special problems for the health care system. Proper management requires a basic understanding of the pharmacokinetic and pharmacodynamic characteristics of the drugs taken in overdose because different techniques employed by the manufacturers to produce sustained release formulations lead to differences in these characteristics in comparison with conventional formulations. In general, with sustained-release formulations, there is a prolongation of the time for the patient to manifest toxicity ('preclinical phase'), as well as the period of high drug concentrations and clinical toxicity ('toxic phase') and the resolution phase (clinical improvement with declining drug concentrations). Continued drug absorption over a prolonged period alters the normal drug concentration-time profile. The prolonged absorption half-life may appear as an increase in elimination half-life, even though the clearance of the drug stays the same. Gastrointestinal decontamination is extremely important in the management of overdose with sustained release formulations. We advocate an aggressive decontamination approach to management, especially in the preclinical phase. With a history of potentially toxic ingestion of an adsorbable drug, a charcoal stool following administration of oral activated charcoal should be a minimum requirement for discharge of the patient. Gastrointestinal decontamination is critical in the preclinical and the toxic phases and may be of value during the resolution phase until the drug concentrations decline to the therapeutic range. PMID- 3537623 TI - Methanol and ethylene glycol poisonings. Mechanism of toxicity, clinical course, diagnosis and treatment. AB - Methanol and ethylene glycol poisonings share many characteristics both clinically and biochemically. Both alcohols are metabolised via alcohol dehydrogenase to their toxic metabolites. Methanol is slowly metabolised to formaldehyde which is rapidly metabolised to formate, the metabolite mainly responsible for methanol toxicity. Formate metabolism depends upon the folate pool which is small in primates compared with other animals. Therefore, formate accumulates in primates during methanol intoxication and is mainly responsible for the metabolic acidosis in the early stage of intoxication. In late stages lactate may also accumulate, mainly due to formate inhibition of the respiratory chain. This tissue hypoxia caused by formate may explain the ocular as well as the general toxicity. Ethylene glycol is metabolised more rapidly than methanol, via alcohol dehydrogenase to glycolaldehyde which is rapidly metabolised to glycolate, the metabolite mainly responsible for the metabolic acidosis in ethylene glycol poisoning. Glycolate is metabolised by various pathways, including one to oxalate which rapidly precipitates with calcium in various tissues and in the urine. Ethylene glycol toxicity is complex and not fully understood, but is mainly due to the severe metabolic acidosis caused by glycolate and to the calcium oxalate precipitation. The clinical course in both poisonings is initially characterised by the development of metabolic acidosis following a latent period, which is more pronounced in methanol poisoning and is the time taken for both alcohols to be metabolised to their toxic metabolites. In methanol poisoning there are usually visual symptoms progressing to visual impairment, whereas ethylene glycol victims develop renal and cardiopulmonary failure. Prognosis is excellent in both poisonings provided that there is early treatment with alkali to combat acidosis, ethanol as an antimetabolite, and haemodialysis to remove the alcohols and their toxic metabolites. Ethanol is also metabolised by alcohol dehydrogenase, but has a much higher affinity for this enzyme than methanol and ethylene glycol. Presence of ethanol will therefore inhibit formation of toxic metabolites from methanol and ethylene glycol. Due to competition for the enzyme, the therapeutic ethanol concentration depends on the concentration of the other two alcohols, but a therapeutic ethanol concentration around 22 mmol/L (100 mg/dl) is generally recommended. Most patients are, however, admitted at a late stage to hospitals not capable of performing analyses of these alcohols or their specific metabolites on a 24-hour basis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537624 TI - Adverse effects of nitrous oxide. AB - Although once considered completely devoid of complications, it is now recognised that the misuse or inappropriate use of nitrous oxide (N2O) often results in adverse side effects. Hypoxia, particularly the entity 'diffusion hypoxia', can occur with the administration of inadequate amounts of oxygen during or immediately after a N2O anaesthetic. N2O will diffuse into air-containing cavities within the body faster than nitrogen diffuses out. This results in a temporary increase in either the pressure and/or volume of the cavity depending upon the distensibility of its walls. The magnitude of the effect is proportional to the blood supply of the cavity, the concentration of N2O inhaled and the length of time the patient is exposed to N2O. Significant morbidity or even death can result from this phenomenon. A property unique to N2O is its ability to oxidise and inactivate the vitamin B12 components of certain enzymes in both animals and man. One such enzyme, methionine synthetase is essential for normal DNA production. Animal and human studies have demonstrated that the haematological, immune, neurological and reproductive systems are each affected. These adverse effects of N2O can occur after both acute (surgical) or long term (occupational) exposure to the gas. Because of its effects on the pressure and volume characteristics of air-containing spaces, N2O should not be used for patients with bowel obstruction, pneumothorax, middle ear and sinus disease, and following cerebral air-contrast studies. Many anaesthesiologists feel that use of N2O should be restricted during the first two trimesters of pregnancy because of its effects on DNA production and the experimental and epidemiological evidence that N2O causes undesirable reproductive outcomes. Since N2O affects white blood cell production and function, it has been recommended that N2O not be administered to immunosuppressed patients or to patients requiring multiple general anaesthetics. Many anaesthesiologists believe that the potential dangers of N2O are so great that it should no longer be used at all for routine clinical anaesthesia. However, the continued use of N2O remains a controversial topic since, at present, a suitable substitute gas is not available. PMID- 3537625 TI - Role of the intensive care unit in the management of the poisoned patient. AB - By applying a sensible toxicological approach to the general principles of intensive care, an optimum setting for the treatment of poisoning is created. The intensive care unit (ICU) can perform the necessary close observation and monitoring, and thus facilitate rapid detection of symptoms, and the institution of early appropriate treatment. Diagnosis may be complex in poisoning and require continuous qualified interpretation of clinical and analytical data. Antidote therapy and treatment to enhance elimination of the poison must often be dealt with under careful supervision. The capacity of the ICU to counteract various toxic effects in a nonspecific way and to provide optimum symptomatic and supportive care is crucial. However, the ongoing toxic effects on the body must always be considered and allowed to guide symptomatic treatment. Thus, clinical toxicology appears to be a specialised branch of intensive care medicine. PMID- 3537626 TI - Effects of phosphate loading on leg power and high intensity treadmill exercise. AB - Stim-O-Stam is a commercial ergogenic aid purported to improve human performance by reducing recovery time and enhancing endurance. The tablets contain a mixture of sodium acid phosphate and potassium phosphate. In this study, under a double blind cross-over design, 11 male subjects underwent acute (1.24 g one hour before exercise) and chronic (3.73 g X d-1 for 6 d prior to exercise) consumption of Stim-O-Stam to determine the effects of phosphate loading on: treadmill endurance time; treadmill endurance time after 15 min of recovery from first treadmill run; leg power measured for 1 min on the Cybex device; leg power after 10 min recovery from first power test; and oxygen uptake during the treadmill run. Run times ranged from 172 to 183 s on run 1 and 145 to 152 s for run 2. Leg power averaged 62 W for both tests. Oxygen uptake averaged 52 ml X kg-1 X min-1 under all conditions. Analysis of variance showed that there was no significant effect of acute or chronic ingestion of phosphate tablets beyond that of the placebo treatment on any of the performance tests. These results argue against the claim of ergogenic benefits ascribed to this nutritional supplement. PMID- 3537628 TI - The characterization of bacterial and nonbacterial prostatitis by prostatic immunoglobulins. AB - Although inflammatory diseases of most human secretory surfaces are difficult to investigate clinically, the secretory immune system of the human prostate may be studied relatively easily because prostatic fluid may be obtained from the gland by digital massage. We studied inflammatory conditions of the prostate to establish whether we could use the humoral immune response to differentiate these conditions. Using a sensitive solid-phase radioimmunoassay, we measured total IgA and IgG, and IgA and IgG antibodies to Enterobacteriaceae in the serum and prostatic fluid of men with and without prostatic inflammation. These studies show that levels of IgA and IgG in the prostatic fluid of men with bacterial prostatitis are higher than those in men without histories of urinary or prostatic infections. In men with bacterial prostatitis, prostatic antibodies to Enterobacteriaceae were elevated 12 to 18 months after curative treatment and indefinitely after ineffective treatment; anti-Enterobacteriaceal IgG levels returned to normal after infection only with cure. Total IgA and IgG in the prostatic fluid of men with nonbacterial prostatitis--men who have signs of prostatic inflammation without evidence of old or ongoing bacterial infection- are also higher than levels found in uninfected individuals. Although this finding supports an inflammatory etiology for the symptoms seen in nonbacterial prostatitis, no significant IgA or IgG Enterobacteriaceal antibody titers were detected in these patients. This excludes a remote Enterobacteriaceal infection as a cause of nonbacterial prostatitis. These observations confirm that the prostate gland is a distinct part of the male secretory immune system. PMID- 3537627 TI - Renal prostaglandin E2 and F2 alpha synthesis during exercise: effects of indomethacin and sulindac. AB - To assess the effects of acute exercise on renal prostaglandins E2 (PGE2) and F2 alpha (PGF2 alpha) synthesis, urine collections were obtained from six women before and after 30 min of treadmill exercise at approximately 80% of their maximal oxygen consumption. After receiving a placebo for 3 days, with acute exercise, there was a significant increase only in recovery urine PGE2 concentration. Due to a decline in urine volume, PGF2 excretion was unchanged and PGF2 alpha excretion was significantly decreased by exercise. Subjects repeated the tests after 3 d of indomethacin treatment (150 mg X d-1), a known renal prostaglandin (PG) inhibitor, and 3 d of sulindac (300 mg X d-1), a non-steroidal anti-inflammatory drug which may not inhibit renal PG synthesis. Pre-exercise urine PGE2 concentrations were decreased by indomethacin but not by sulindac, whereas, PGF2 alpha concentrations were decreased by both drugs. When compared to the control test, indomethacin and sulindac had different effects on pre-exercise urine/plasma osmolality ratios and free water clearances. Neither indomethacin nor sulindac influenced the decreases in free water clearances, which were observed during the placebo tests. Exercise proteinuria was significantly increased by indomethacin but not by sulindac. In conclusion, these data demonstrate that acute exercise may stimulate renal PGE2 synthesis. During exercise, renal PG synthesis attenuates protein excretion. There also appear to be differences between indomethacin and sulindac with regard to the effects on renal PG synthesis and kidney function. PMID- 3537629 TI - Beware of Medicaid fraud. PMID- 3537630 TI - Changes in insulin sensitivity and clearance in anorexia nervosa. AB - Anorexia nervosa (AN) is a state of self-induced malnutrition characterized by a marked pursuit of thinness and the fear of obesity. Although low fasting blood glucose and insulin have been demonstrated, there is contradictory data on insulin sensitivity and a lack of information about insulin metabolism and its metabolic effects in AN. Insulin sensitivity, kinetics, and metabolic effects were measured using the euglycemic clamp in nine females with AN (age 25.2 +/- 1.9 years and 70.6 +/- 2.2% ideal body weight), and the results compared with seven female normal controls (NC) (age 23.6 +/- 1.0 years and 92.7 +/- 2.5% ideal body weight). Fasting plasma glucose (FPG), immunoreactive insulin (IRI), and C peptide were significantly lower in AN as compared to NC (84.3 +/- 1.5 v 91.5 +/- 1.7 mg dL-1, 9.3 +/- 1.0 v 13.5 +/- 1.4 microU mL-1, and 0.26 +/- 0.03 v 0.41 +/- 0.02 pmol mL-1) (P less than 0.05). During the glucose clamp, the glucose metabolized (M), the metabolic clearance rate of glucose (MCRg), and the glucose metabolized per unit of insulin (M/I ratio) were all higher in AN as compared to NC (M, 8.7 +/- 1.2 v 6.9 +/- 0.6 mg min-1 kg-1; MCRg, 9.9 +/- 1.5 v 7.4 +/- 0.6 mL min-1 kg-1; M/I ratio, 8.6 +/- 1.6 v 5.0 +/- 0.3 mg min-1 kg-1/microU mL-1 X 100), but only the M/I ratio attained statistical significance (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537632 TI - Insulin effects on apolipoprotein B lipoprotein synthesis and secretion by primary cultures of rat hepatocytes. AB - Lipoprotein synthesis and secretion were examined in primary cultures of rat hepatocytes cultured on collagen-coated plates and incubated with pharmacologic and physiologic concentrations of insulin. Media insulin concentration declined rapidly over the course of incubation indicating that hepatocytes rapidly degrade insulin. When insulin was present in the media, cellular triglyceride accumulated while lipid secretion declined. Insulin inhibited the incorporation of labeled amino acids into total secretory lipoprotein apoproteins and apolipoprotein B (apo B) as well as apo B mass as measured by monoclonal radioimmunoassay. The effect of insulin on apo B secretion occurred as early as three hours after the addition of insulin to the culture media and both apo B of higher molecular weight (apo BH) and apo B of lower molecular weight (apo BL) were affected. Cellular apo B did not accumulate within cells. The majority of secretory lipid radioactivity synthesized from acetate was in VLDL density lipoproteins. The composition of newly synthesized lipids as assessed by thin layer chromatography was not significantly altered with insulin. These studies support the finding that insulin inhibits VLDL secretion by hepatocytes while at the same time stimulating overall triglyceride synthesis. A suggested mechanism is that insulin uncouples triglyceride and apo B synthesis, which influences subsequent lipoprotein assembly and secretory pathways. These results are consistent with the concept that postprandial insulin release inhibits hepatic lipoprotein secretion while intestinal lipoprotein metabolic pathways are most active. PMID- 3537631 TI - Regulation of myofibrillar protein degradation in rat skeletal muscle during brief and prolonged starvation. AB - Myofibrillar protein breakdown during brief and prolonged starvation was assessed in perfused rat skeletal muscle from 8-week-old fat-fed rats that conserve skeletal muscle protein during starvation and survive for 12 to 15 days and age matched chow-fed rats that do not conserve protein and survive only five to six days. Following the inhibition of protein synthesis with cycloheximide, myofibrillar proteolysis was assessed by measuring the release of 3 methylhistidine from the perfused rat hindquarter while simultaneous measurement of total protein breakdown was assessed by measuring tyrosine release. Myofibrillar proteolysis progressed through three distinct phases during starvation: an early phase occurring within 24 hours in which proteolysis increased in all rats, a middle phase, which took three to five days to develop and during which proteolysis decreased and was present only in fat-fed rats, and a late phase in which proteolysis again increased. Total protein breakdown (ie, tyrosine release) changed little in phase I, decreased in phase II, and increased in phase III. The release of 3-methylhistidine from the perfused hindquarter reflected changes in muscle and urine of intact rats suggesting that data obtained with the perfused hindquarter reflected the in vivo situation. Insulin, amino acids, high concentrations of glucose, indomethacin, or epinephrine as well as adrenalectomy failed to attenuate the increase in 3-methylhistidine release from the perfused hindquarter during brief and late starvation. Free fatty acids and ketone bodies were also without effect in vitro. Refeeding fasting rats for four hours decreased myofibrillar proteolysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537633 TI - Maternal considerations in the use of pelvic examinations in labour. PMID- 3537634 TI - A review of study findings of the risks and benefits of oestrogen therapy in the female climacteric. AB - A literature review was conducted to assess the evidence regarding the risks and benefits of oestrogen therapy in climacteric women. Consideration was given to the route of administration, effects on lipid levels, the skin and urinary symptoms, endometrial cancer, mortality and replacement therapy. It was concluded from the data examined that properly administered oestrogen treatment does not increase the risk of endometrial cancer and that the relative risk of death in oestrogen users aged over 40 is markedly lower than than in non-users. PMID- 3537635 TI - Effect of guanfacine, an alpha-adrenergic agonist, on menopausal flushing. AB - The effect of guanfacine (0.5 mg/day), an alpha-adrenergic agonist, on menopausal flushing, was studied in a double-blind, placebo-controlled crossover study in 11 patients. Both guanfacine and placebo significantly decreased the total number of flushes from baseline values. There was, however, no significant difference between placebo and guanfacine. Larger doses of guanfacine may be required to exert a therapeutic effect similar to that reported in the literature with the alpha-adrenergic agents, clonidine and alpha-methyldopa. PMID- 3537636 TI - Effects of natural oestrogen/progestogen substitution therapy on carbohydrate and lipid metabolism in post-menopausal women. AB - Oral glucose tolerance tests were performed in 30 post-menopausal women before and after 1 mth and 6 mth of cyclic 17 beta-oestradiol/norethisterone acetate substitution therapy. Before undergoing treatment the patients were divided into three groups comprising subjects with normal glucose tolerance, subjects with impaired glucose tolerance and diabetic subjects receiving oral diabetic treatment respectively. Carbohydrate metabolism was evaluated during a 2-h oral glucose tolerance test following a 100 g glucose load. Both blood glucose and plasma insulin values were measured. The fasting serum cholesterol and triglyceride levels were also determined. Hormone substitution therapy had no effect on fasting blood glucose values in any of the three groups. At the end of the 6 mth substitution therapy, however, it was found that the blood glucose values in the subjects with impaired glucose tolerance were significantly lowered by the end of the 2-h test period. The glucose areas under the curve during oral glucose tolerance tests following the hormone treatment were also reduced in this same group. In the case of insulin, the areas under the curve remained unchanged in all three groups. Fasting serum cholesterol levels tended to fall, while the triglyceride levels remained unaltered, during the hormone treatment periods. However, a slight increase in triglyceride levels was observed in the subjects with impaired glucose tolerance. PMID- 3537637 TI - Enzymatic characterization of Staphylococcus aureus strains: a possible role of habitat and methicillin-resistance in the determination of the differences observed. AB - Twenty five strains of Staphylococcus aureus of human and environmental origin were tested for their enzymatic patterns. All human strains possessed acid phosphatase, while only 25% of the environmental staphylococci demonstrated acid phosphatase activity. In addition, the enzyme alpha-glucosidase was present only in the methicillin resistant-multiresistant strains, in spite of their origin. This work suggests a possible role of the enzyme on penicillin-binding protein mediated methicillin-resistance and stresses the importance of external habitat in the expression of enzymatic activity of bacteria. The enzymatic pattern may confirm or exclude cross-infection, when a single species, with uniformly antibiotic responses, is involved. PMID- 3537638 TI - A nystatin-resistant mutant of Saccharomyces cerevisiae: isolation and characterization by electron microscopy and chemical analysis of whole cells, cell-walls and protoplasts. AB - A mutant of Saccharomyces cerevisiae NCYC 239 with a high minimum inhibitory concentration (35 micrograms ml-1) for nystatin, compared to that of the parent strain (2 micrograms ml-1), was derived by a series of subcultures in media containing increasing antibiotic concentrations. In the absence of nystatin, the growth rate of the mutant was significantly lower than the parent strain, although mean cell-size and size-distribution were similar. No differences between strains were detectable by electron microscopy. Analysis of whole cells showed the total sterol present and the ratio of ergosterol:24(28)dehydroergosterol was similar. However, there were marked differences in amino acid content and chain-length of fatty acids in the cell wall, and protoplasts from resistant cells had decreased amounts of unsaturated fatty acids. It is suggested that alterations in cell wall components in the mutant may be directly linked to the mechanism of nystatin resistance. PMID- 3537639 TI - Cytological interrelationships between the cell cycle and duplication cycle of Candida albicans. AB - The cytology of nuclear division and septation in the yeast and hyphal phases of Candida albicans growing at 37 degrees C has been studied by fluorescence microscopy after staining of specimens with 4'6-diaminido-2-phenylindole (DAPI) and Calcofluor. Yeast and hyphal cells replicated their nuclei at about 18 min after the emergence of a bud or germ-tube. The site of nuclear division coincided with the future location of the septum in both forms. This occurred at the junction of the bud and parent yeast cell or 6.0 micron from the parent yeast in germ tubes which were formed in medium containing serum. The filamentous forms of a range of clinical and laboratory strains grown in a variety of germ tube inducing media were all extensively vacuolated. Germ tube extension in all of these media was linear. It is suggested that there is little biosynthesis of cytoplasm during the initial stages of germ tube growth in this organism and that this accounts for the development of the large vacuoles and the linear growth kinetics. PMID- 3537641 TI - Here are 20 years of medical society highlights. PMID- 3537640 TI - Uptake of nystatin by sensitive and resistant cells of Saccharomyces cerevisiae. AB - The uptake of nystatin by sensitive and by resistant cells of Saccharomyces cerevisiae was studied as a function of nystatin concentration, temperature and pH. The presence or absence of glucose in nystatin uptake experiments was also studied. The rate data, effects of glucose and the derived activation energies for nystatin uptake revealed significant differences in response between sensitive and resistant cells. The role of the cell wall in the uptake process is discussed. PMID- 3537642 TI - Ingestion of bacteria by antibody-coated Ehrlich ascites tumor cells mediated by protein A. PMID- 3537643 TI - Breastfeeding and wet nursing. PMID- 3537644 TI - Sudden vascular death: the roles of the liver and anaphylaxis in sudden cerebro or cardiovascular infarction. AB - Much has been written about how coronary and cerebrovascular atherosclerosis, and how it increases the risk of myocardial or cerebral infarction. The cardiologists and pathologists whose articles appear in scientific journals are dealing in detail with the progress of the arterial disease, but are still seeking the cause of the sudden event that leads to an acute myocardial or cerebral infarction. A new concept is herewith presented for consideration, regarding the cause of an acute myocardial infarction or cerebrovascular thrombosis. It is conceivable that these catastrophic events occur during the anaphylactic reaction of the liver. Experimental evidence and clinical observations are briefly presented. PMID- 3537645 TI - The neuropsychological implications of allergenic clinical titration in the treatment of allergic diseases. AB - The wheal is used for assessment of the Provocation-Neutralisation Response in Clinical Titration. It is the third, slowest, and most indirect measure of the Antigen-Antibody Reaction as demonstrated in the Triple Response. The flare is produced by an axone reflex. It appears rapidly as a direct neurological response to antigen challenge. It is associated with local changes in Direct Current Potential. These are transmitted distally through the d.c. Perineural Analogue System. Neutralisation values appear in a harmonic series with increasing dilutions of antigen. Passive Allergenic Neutralisation does not require active antigen administration into the patient's tissues. Passive Neutralisation can be performed in the absence of allergenic material. It is concluded that the wheal need not be associated with the Provocation-Neutralisation technique, and that a neuropsychological basis for the Provocation-Neutralisation response should be explored. PMID- 3537646 TI - Hypothesis: AIDS encephalopathy is due to primary and persistent infection of the brain with a human retrovirus of the lentivirus subfamily. AB - Recent evidence has demonstrated that human T-lymphotropic retroviruses are present in the brain of patients with acquired immunodeficiency syndrome (AIDS). Studies by neuropathological, ultrastructural and nucleic acid hybridization techniques indicate that these human retroviruses are neurotropic as well as lymphotropic. Striking similarities to the animal retroviruses of the lentivirus subfamily provide a rationale to implicate these human retroviruses (lentiviruses) in the pathogenesis of AIDS encephalopathy. PMID- 3537647 TI - Ecology and arteriosclerosis. AB - An ecological theory of arteriosclerosis invokes antirisk factors dependent on infections and parasitic infestations through the medium of immunoglobulins. Dysglobulinemia modifies blood cholesterol, platelet function, hemostasis, and biophysics of the blood in the vessels. This could explain the differences in epidemiology of arteriosclerosis between northern developed countries and tropical countries, and the present frequency of coronary heart disease in developed countries. Arteriosclerosis is conditioned by environmental factors other than diet. PMID- 3537648 TI - Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D. AB - A group of young patients having multiple sclerosis was treated with dietary supplements containing calcium, magnesium and vitamin D for a period of one to two years. The experimental design employed self-pairing: the response of each patient was compared with his/her own case history as control. The number of exacerbations observed during the program was less than one half the number expected from case histories. No side effects were apparent. The dietary regimen may offer a new means of controlling the exacerbation rate in MS, at least for younger patients. The results tend to support a theory of MS which states that calcium and magnesium are important in the development, structure and stability of myelin. PMID- 3537649 TI - Remote physiological sensing: historical perspective, theories and preliminary developments. AB - Many physiological processes are characterized by the generation and propagation of multiple, dynamic, infinitely variable, and often transient electrical phenomena in the respective tissues and organs where they originate. The purpose of physiological recording is to obtain a record that is an exact facsimile or analog of the events under investigation. However, since it is seldom feasible to attach pickup elements directly to the tissues or organs being investigated, some method of sensing the reflections and projections of the phenomena from the surface of the body must usually be employed. Such methods always introduce measurement errors that result in a distorted picture of the processes being recorded. In spite of this limitation, these techniques have proven highly useful for the medical and allied professions. As a result of the transition of medicine from a descriptive to an analytical science, a wide variety of pickup elements of various sophistication have been developed and are presently available for recording many important phenomena associated with various physiological functions from different anatomical sites. With the exception of the electrocardiogram (ECG), electroencephalogram (EEG), and electromyogram (EMG), other forms of biomonitoring have not yet achieved the acceptance necessary to allow their full development. It would seem that the development of the ECG, EEG, and EMG are reaching toward a plateau, and other forms of biomonitoring techniques are required to interpret physiological changes and parameters. PMID- 3537650 TI - Current status of circulatory support with an intra-aortic balloon pump. AB - Although the initial clinical application of IABP was for the purpose of support of circulation in cardiogenic shock, its indications have expanded and include prophylactic use, especially in patients with ischemic heart disease. Controversy exists regarding the efficacy of this device in these conditions. Prolonged balloon support for periods of more than 5 days is presently employed in patients with chronic heart failure undergoing cardiac surgery, without concern for so called "balloon dependence." In recent years, the incidence of use of IABP has declined markedly mainly because of comparable effects obtained by hemodynamic treatment with various drugs aimed at altering a specific parameter of cardiac function. Percutaneous application of an intra-aortic balloon catheter, although associated with a higher complication rate, has brought to clinical practice a rapid method for utilization of this device under fluoroscopic control. Because of an appreciable number of complications, however, balloon assist should be used for very specific clinical conditions. PMID- 3537653 TI - The enigma of testicular leukemia: a critical review. AB - Isolated testicular relapse (T.R.) in acute lymphoblastic leukemia (ALL) has an overall incidence of 10% and affects mainly patients off therapy. Multivariate analysis of pretreatment characteristics has shown that lymphadenopathy and splenomegaly are independently associated with increased risk of T.R. during maintenance and off therapy, respectively. Sequential biopsy studies have demonstrated that testicular biopsies are unable to detect scanty infiltrates and have no practical utility. Prophylactic gonadal irradiation produced equivocal results and should not be used because of its sterilizing effect. Intensive multi drug regimens or prolonged maintenance were unable to substantially reduce T.R. rate. On the contrary, intermediate-dose methotrexate (IDM) early in remission has almost abolished T.R. These findings strongly support the hypothesis that testicular interstitium is a very peculiar site where blasts are partially protected from the drug action; high drug concentrations are required for the optimal cytocidal effect. There are sufficient clues of a link between the excess of late marrow relapse in male sex and the capacity of testes of harboring blasts. Therefore IDM early in remission should be routinely adopted for prevention of testicular leukemia and its potential of late spread. PMID- 3537654 TI - Bone marrow transplantation for acute monocytic leukemia following the treatment of Hodgkin's disease. AB - A 32-year-old woman developed acute monocytic leukemia within a year of treatment for Hodgkin's disease with chemotherapy and radiation. Residual leukemia was present in the bone marrow after two induction courses of high-dose Ara-C. She received a bone marrow transplant from an HLA- and DR-identical sister and remains in complete remission more than 2 years after transplantation. Only one other instance of a remission greater than 2 years after transplantation for secondary acute leukemia could be found in the literature. Although bone marrow transplantation may be carried out successfully in these patients, it is possible that they may be more vulnerable to transplant-related complications because of their previous exposure to chemotherapy and radiation. Only further study can clarify this matter and determine the best time for the procedure and which regimen should be used. PMID- 3537652 TI - Passive protection by human sera in mice against challenge with strains of group B streptococci. AB - The passive protective activity of 100 human sera in mice challenged with strains of group B streptococci (GBS), types Ia, Ib, Ic, II and III, was investigated. The number of sera which offered protection against type strains III, II and Ib were 10, 6 and 1, respectively, while 5 sera gave protection against type strains Ia and Ic. The activity was 2-mercaptoethanol sensitive while anti-human IgG, IgA and IgM rabbit sera were capable of negating the protective activity. Furthermore, type antigens removed the protective activity, resulting in the reduction of the amounts of IgG, IgA and IgM in normal human serum. These findings suggest that the protective activity of human sera is related to specific immunoglobulins against type antigens of GBS. PMID- 3537651 TI - Interaction of beta-lactam antibiotics with the bactericidal activity of leukocytes against Escherichia coli. AB - The effect of beta-lactam antibiotics on phagocytosis and intracellular killing of four isogenic Escherichia coli strains differing in their 0- and K antigens was studied by adopting the rat polyvinyl-sponge model. The penicillins mezlocillin, ticarcillin and piperacillin rendered all four isogenic E. coli strains more susceptible to intraleukocyte killing; the cefalosporins tested exhibited inhomogenous effects; lamoxactam was marginally effective, whereas cefoxitin was completely ineffective; cefotaxime caused an increase in intracellular killing of the capsule-defective mutant only. The beta-lactam promoted increase in intracellular killing could be inhibited by alpha methylmannoside but not by alpha-methylglucoside. Free-flow electrophoretic separation of mezlocillin-treated bacteria and guinea pig erythrocytes revealed that co-migration of E. coli and erythrocytes respectively could be inhibited by alpha-methylmannoside but not by alpha-methylglucoside. These data indicate that mezlocillin interferes with the mannose sensitive adhesins of E. coli. PMID- 3537655 TI - A helium-ion beam for stereotactic radiosurgery of central nervous system disorders. AB - A new radiation beamline configuration for stereotactic heavy-ion Bragg peak radiosurgery of patients with intracranial deep arteriovenous malformations, including carotid-cavernous fistulas, has been developed using the 230 MeV/u helium ion beam at the 184-in. Synchrocyclotron at the University of California, Berkeley. The modified beam has five characteristics: uniform field between 10 and 40 mm in diameter; variable depth of penetration between 40 and 140 mm; stopping region for primary ions that can be broadened up to 40 mm; sharply defined lateral and distal borders; and dose rate greater than 2 Gy/min. It is adapted to the ISAH (irradiation stereotactic apparatus for humans) at the 184 in. Synchrocyclotron, with effective stereotactic localization of defined volumes within the brain, and is designed to reach all intracranial targets. It has proven suitable for all patients with intracranial vascular disorders treated with stereotactic radiosurgery at our laboratory. PMID- 3537656 TI - Subtraction of simultaneously acquired dual radionuclide images. AB - The physical aspects of a simultaneous dual radionuclide technique incorporating computer subtraction for the diagnosis of infection using 67Ga citrate and 99mTc methylene diphosphonate (MDP) or sulfur colloid are considered. The efficacy of the data acquisition protocol and the interpretation of the subtracted images are shown to depend significantly on fundamental imaging system parameters. Measurement of these parameters using simple phantoms and their role in elucidating the technique is detailed. Subtracted images produced by three variations of the basic method arising from different normalization algorithms in current usage are compared. Simple phantoms are again used in assessing the accuracy of each variation. Clinical results are reported elsewhere. PMID- 3537657 TI - Presentation of the 1986 Coolidge Award to Warren Keith Sinclair. PMID- 3537659 TI - [The basic bolus principle of insulin therapy. Renaissance of an old treatment concept]. PMID- 3537658 TI - [Intermediate results of therapy studies HD1, HD2 and HD3 of the German Hodgkin Study Group]. PMID- 3537660 TI - [Portohepatic angiography with intra-arterial digital subtraction technic]. PMID- 3537661 TI - [Treatment and management of patients with chronic kidney diseases]. PMID- 3537662 TI - [Sonographic diagnosis of pleuropulmonary diseases]. PMID- 3537663 TI - [Transesophageal echocardiography in the evaluation of hemodynamics in artificial respiration with positive end expiratory pressure]. PMID- 3537664 TI - [Treatment of stress-induced angina pectoris and chronic heart failure with molsidomine]. PMID- 3537666 TI - [Solitary kidney and pregnancy]. PMID- 3537665 TI - [Continuous glucogram, insulin and C-peptide in various minimal diets]. PMID- 3537668 TI - [Endoscopic sonography of the upper digestive tract]. PMID- 3537667 TI - [B streptococcal infection and right-sided diaphragmatic hernia--chance coincidence or causal relation?]. PMID- 3537669 TI - [Sonographic diagnosis in diseases of the scrotal contents]. PMID- 3537671 TI - The Department of Anesthesiology--history and present status. PMID- 3537670 TI - [Magaldrate (100 mmol/d) versus ranitidine (300 mg/d). Healing rates of stomach ulcer in a German double-blind study]. PMID- 3537673 TI - An introduction to HLA typing. PMID- 3537672 TI - Malignant hyperthermia--a clinical review. PMID- 3537674 TI - [Opioid peptides. Their role in the physiopathology of the endocrine pancreas function]. PMID- 3537675 TI - [Counter-regulatory mechanisms in insulin hypoglycemia. Physiological aspects and changes in insulin-dependent diabetes mellitus]. PMID- 3537676 TI - [Diagnosis of sialopathies. I. Echography]. PMID- 3537678 TI - [Gingival fluid. An early sign of tissue response to the accumulation of bacterial plaque]. PMID- 3537677 TI - [Chondroma of the tongue. A clinical case and review of the literature]. PMID- 3537679 TI - [Differentiated impression with the individual sectional impression tray]. PMID- 3537680 TI - [Present status and future view of cardiac surgery in Japan]. AB - Analysis of present status: The institutes for cardiac surgery, amounting to 300 are spread throughout Japan. Consequently, the number of operation for the acquired heart disease, congenital heart disease and thoracic aortic aneurysm, has been counted 8088, 7837, and 839 respectively and in total, 16774 cases were operated in 1984. The increase in number of surgery for new born baby and infant recently proves the remarkable advance of cardiac surgery in Japan. The gradual increase in number of surgery for the aged reflects the Japanese social conditions today. The increase in number of aorto coronary bypass surgery should be paid attention, from the view of the disease structure in Japan. The problems, existing under today's condition are as follows; the establishment of the other department concerned with that of cardiac surgery, training condition to become specialists, practical use of medical resources and economical efficacy of medical care. Future view: It should be noted that the severe patients exist in Japan as well as in other countries and their lives cannot be saved without the heart or the heart-lung transplantation. We should immediately consider the organ transplantation as one of the medical treatments for the above-mentioned patients out of love for mankind. Heart transplantation is very much different from the general cardiac surgery in technical, ethical aspects and so on. Therefore, as the procedure for the success to establish heart transplantation as one of the medical treatments, careful consideration is indispensable in the nationwide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537681 TI - [Renal tubular impairment in traumatized patients]. AB - Urinary beta 2-microglobulin (beta 2M) and N-acetyl-beta-D-glucosaminidase (NAG) in addition to conventional renal parameters such as creatinine clearance (Ccr), free water clearance (CH2O) and fractional excretion of sodium (FENa) were measured in 79 traumatized patients. These patients were separated into two groups, one with shock on admission (N = 43). In patients with shock, CH2O, FENa and urinary excretion of Beta 2M and NAG indicated abnormal levels correlating with impairment of Ccr, inspite of adequate urine output, on the day of trauma. Even in patients without shock, urinary Beta 2M and/or NAG increased without impairment of urine output, Ccr, CH2O and FENa, and did not return to normal level during the following 7 days. The results suggest a liability to damage and the delayed improvement of renal tubulus in traumatized patients. PMID- 3537682 TI - [Biliary carcinoembryonic antigen, non-specific cross-reacting antigen and biliary glycoprotein--their analysis and clinical aspects]. AB - Bile sample were collected in 17 cases of choledocholithiasis, 28 of malignant obstructive jaundice and 7 of hepatolithiasis and biliary CEA levels were measured by the EIA method. In the malignant obstructive jaundice group, the biliary CEA level was higher than that in the choledocholithiasis group and the bile gave a positive test for CEA more frequently than the serum. As for the hepatolithiasis group, the biliary CEA level was higher than that in the malignant obstructive jaundice group. The EIA method, however, had a possibility that not only CEA but also CEA-related antigens were measured. Therefore, antigen for CEA, NCA and BGP were prepared, and biliary CEA, NCA and BGP levels were measured by the ELISA method. The biliary CEA level (mean +/- S.D.) was 0.086 +/- 0.26 for 21 cases of cholelithiasis, 0.119 +/- 0.24 for 15 of pancreatic carcinoma, and 0.117 +/- 0.016 for 17 cholangiocarcinoma, cholecystic carcinoma, being thus significantly (p less than 0.05) higher in malignant disease. In malignant disease, both biliary NCA and biliary BGP increased, though not so remarkable compared with CEA. Even in controls, the biliary NCA and BGP levels were not negligible. PMID- 3537683 TI - Ability of guanine nucleotide derivatives to bind and activate bovine transducin. AB - Several guanine nucleotide analogs, in one series of which a hydrogen on the 2 amino group is replaced with the p-n-butylphenyl group (BuPGNP derivatives), were used to probe the GTP binding domain of bovine transducin. The order of apparent binding affinities in a series of nucleoside 5'-triphosphates was GTP gamma S greater than GTP approximately BuPGTP greater than dGTP approximately ITP much greater than ATP, values which were 30-100 times higher than affinities of the corresponding 5'-diphosphates. A derivative bearing a 6-aminohexylamino group on the gamma-phosphate, BuPGTP X C6, had a 60-fold lower affinity compared to BuPGTP. In contrast, the p-n-butylphenyl substituent on the 2-amino group had little effect on the binding affinity relative to GTP. Substitutions at the 2 amino group had little effect on either the hydrolysis of the derivatives by the GTPase activity associated with the alpha-subunit of transducin or the activation of cGMP phosphodesterase. The results indicate that the GTP binding domain of transducin is similar in tertiary structure to the corresponding domain of EF-Tu. The 5'-phosphates of GTP are oriented in the binding site of transducin so that the bulky C6 group of BuPGTP X C6 dramatically interferes with binding. The 2 amino group on the guanine ring is probably located at the periphery of the binding site, with the p-n-butylphenyl substituent of BuPGTP facing outward and only weakly interacting with the protein. BuPGTP should be an excellent parent compound for development of novel probes of G-protein interactions with other cellular proteins involved in receptor signal transduction. PMID- 3537684 TI - Tightly centromere-linked gene (SPO15) essential for meiosis in the yeast Saccharomyces cerevisiae. AB - We used DNA fragments from the centromere regions of yeast (Saccharomyces cerevisiae) chromosomes III and XI to examine the transcriptional activity within this chromosomal domain. DNA transcripts were found 200 to 300 base pairs from the 250-base-pair centromere core and lie within an ordered chromatin array. No transcripts were detected from the functional centromere region. We examined the cellular function of one of these tightly centromere-linked transcripts. (CEN11)L, by disrupting the coding sequences in vivo and analyzing the phenotype of the mutant yeast cell. Diploids heterozygous for the (CEN11)L disruption sporulated at wild-type levels, and the absence of the (CEN11)L gene product had no effect on the viability or mitotic growth of haploid cells. Diploids homozygous for the (CEN11)L disruption were unable to sporulate when induced by the appropriate nutritional cues. The mutant cells were competent for intragenic recombination and appeared to be blocked at the mononucleate stage. The temporal ordering of (CEN11)L function with respect to the sporulation mutant spo13 suggests that the (CEN11)L gene product may be required at both the first and second meiotic cell divisions. This new sporulation gene has been termed SPO15. PMID- 3537685 TI - Structure and sequence of the centromeric DNA of chromosome 4 in Saccharomyces cerevisiae. AB - The CEN4 sequences from chromosome 4 that impart mitotic stability to autonomously replicating (ARS) plasmids in yeast cells have been localized to a 1,755-base-pair (bp) fragment. This fragment could be cut in half to give two adjacent, nonoverlapping fragments, that each contained some mitotic stabilization sequences. One of the half-fragments worked as efficiently as the larger fragment from which it was derived, while the other half provided a much poorer degree of mitotic stabilization. Sequencing of 2,095 bp of DNA including this region revealed the presence of a centromere consensus sequence, elements I, II, and III (M. Fitzgerald-Hayes, L. Clarke, and J. Carbon, Cell 29:235-244, 1982), in the half-fragment providing high levels of mitotic stability. The poorly stabilizing half-fragment did not contain any obvious sequence homologies to other centromere sequences. Deletion analysis of the 1,755-bp fragment indicated that removal of the 14-bp element I plus 16 of the 82 bp of element II impaired mitotic stability. Removal of elements I and II eliminated the mitotic stability provided by the consensus sequence. PMID- 3537686 TI - Sequence specificity of point mutations induced during passage of a UV-irradiated shuttle vector plasmid in monkey cells. AB - A simian virus 40-based shuttle vector was used to characterize UV-induced mutations generated in mammalian cells. The small size and placement of the mutagenesis marker (the supF suppressor tRNA gene from Escherichia coli) within the vector substantially reduced the frequency of spontaneous mutations normally observed after transfection of mammalian cells with plasmid DNA; hence, UV induced mutations were easily identified above the spontaneous background. UV induced mutations characterized by DNA sequencing were found primarily to be base substitutions; about 56% of these were single-base changes, and 17% were tandem double-base changes. About 24% of the UV-induced mutants carried multiple mutations clustered within the 160-base-pair region sequenced. The majority (61%) of base changes were the G . C----A . T transitions; the other transition (A . T- --G . C) and all four transversions occurred at about equal frequencies. Hot spots for UV mutagenesis did not correspond to hot spots for UV-induced photoproduct formation (determined by a DNA synthesis arrest assay); in particular, sites of TT dimers were underrepresented among the UV-induced mutations. These observations suggest to us that the DNA polymerase(s) responsible for mutation induction exhibits a localized loss of fidelity in DNA synthesis on UV-damaged templates such that it synthesizes past UV photoproducts, preferentially inserting adenine, and sometimes misincorporates bases at undamaged sites nearby. PMID- 3537687 TI - Structure of the transcriptionally repressed phosphate-repressible acid phosphatase gene (PHO5) of Saccharomyces cerevisiae. AB - We developed a high-copy-number plasmid system containing the entire structural and regulatory sequences of the phosphate-repressible acid phosphatase (PHO5) gene and the TRP1/ARS1 replicator sequences of the yeast Saccharomyces cerevisiae to investigate the mechanism of repression-derepression of transcription. The resulting plasmid was used to transform either wild-type cells or a number of strains which contain mutations in various trans-acting regulatory loci for the production of acid phosphatase. Results of analysis of mRNA levels isolated from the transformed strains grown under repressed or derepressed conditions suggested that normal transcriptional regulation of the gene persisted, although gene copy number was significantly increased. Analysis of changes in linking number (i.e., the number of negative supercoils) of the plasmid isolated under repressed and derepressed growth conditions revealed that the transcriptionally inactive plasmid contained approximately three more negative supercoils than the transcriptionally active plasmid. This difference in topological state was similarly seen in a plasmid containing a sequence-related acid phosphatase gene (PHO11) under the same regulatory control system, but it was not seen in plasmids isolated from some strains containing mutations which caused either fully constitutive or nonderepressible production of acid phosphatase. Finally, analysis of the nucleosome positioning along the inactive gene sequence revealed that an abnormally broad internucleosomal spacer is present in a region presumed to function in the regulation of transcription by the level of Pi in the growth media. PMID- 3537688 TI - Thermolabile L-A virus-like particles from pet18 mutants of Saccharomyces cerevisiae. AB - pet18 mutations in Saccharomyces cerevisiae confer on the cell the inability to maintain either L-A or M double-stranded RNAs (dsRNAs) at the nonpermissive temperature. In in vitro experiments, we examined the effects of pet18 mutations on the RNA-dependent RNA polymerase activity associated with virus-like particles (VLPs). pet18 mutations caused thermolabile RNA polymerase activity of L-A VLPs, and this thermolability was found to be due to the instability of the L-A VLP structure. The pet18 mutations did not affect RNA polymerase activity of M VLPs. Furthermore, the temperature sensitivity of wild-type L-A RNA polymerase differed substantially from that of M RNA polymerase. From these results, and from other genetic and biochemical lines of evidence which suggest that replication of M dsRNA requires the presence of L-A dsRNA, we propose that the primary effect of the pet18 mutation is on the L-A VLP structure and that the inability of pet18 mutants to maintain M dsRNA comes from the loss of L-A dsRNA. PMID- 3537689 TI - Single base-pair mutations in centromere element III cause aberrant chromosome segregation in Saccharomyces cerevisiae. AB - In this paper we show that a 211-base pair segment of CEN3 DNA is sufficient to confer wild-type centromere function in the yeast Saccharomyces cerevisiae. We used site-directed mutagenesis of the 211-base pair fragment to examine the sequence-specific functional requirements of a conserved 11-base pair segment of centromere DNA, element III (5'-TGATTTATCCGAA-3'). Element III is the most highly conserved of the centromeric DNA sequences, differing by only a single adenine X thymine base pair among the four centromere DNAs sequenced thus far. All of the element III sequences contain specific cytosine X guanine base pairs, including a 5'-CCG-3' arrangement, which we targeted for single cytosine-to-thymine mutations by using sodium bisulfite. The effects of element III mutations on plasmid and chromosome segregation were determined by mitotic stability assays. Conversion of CCG to CTG completely abolished centromere function both in plasmids and in chromosome III, whereas conversion of CCG to TCG decreased plasmid and chromosome stability moderately. The other two guanine X cytosine base pairs in element III could be independently converted to adenine X thymine base pairs without affecting plasmid or chromosome stability. We concluded that while some specific nucleotides within the conserved element III sequence are essential for proper centromere function, other conserved nucleotides can be changed. PMID- 3537691 TI - New, small circular DNA in transfected mammalian cells. AB - Circular DNA isolated by the Hirt procedure from transfected mammalian cells was examined by electron microscopy. Typically, the number of small (1- to 5 kilobase) DNA circles increased about fivefold even though DNA of larger size classes (5 to 15 kilobases) has been transferred. In one case, where extensive rearrangement of the transferred DNA was observed, the rearrangement products were cloned and analyzed. In most cases, however, no rearrangement could be detected, but the amount of small circular DNA was still increased. This effect was seen with two transfection procedures (erythrocyte ghost fusion and calcium phosphate precipitation) and with various combinations of transfecting DNA and recipient cell type. The origin of the new small circular DNA is discussed. PMID- 3537690 TI - Assembly of a tRNA splicing complex: evidence for concerted excision and joining steps in splicing in vitro. AB - Splicing of tRNA precursors in Saccharomyces cerevisiae extracts proceeds in two steps; excision of the intervening sequence and ligation of the tRNA halves. The ability to resolve these two steps and the distinct physical properties of the endonuclease and ligase suggested that the splicing steps may not be concerted and that these two enzymes may act independently in vivo. A ligase competition assay was developed to examine whether the excision and ligation steps in tRNA splicing in vitro are concerted or independent. The ability of either yeast ligase or T4 ligase plus kinase to join the tRNA halves produced by endonuclease and the distinct structures of the reaction products provided the basis for the competition assay. In control reactions, joining of isolated tRNA halves formed by preincubation with endonuclease was measured. The ratio of yeast to T4 reaction products in these control assays reflected the ratio of the enzyme activities, as would be expected if each has equal access to the substrate. In splicing competition assays, endonuclease and pre-tRNA were added to ligase mixtures, and joining of the halves that were formed was measured. In these assays the products were predominantly those of the yeast ligase even when the T4 enzymes were present in excess. These results demonstrate preferential access of yeast ligase to the endonuclease products and provide evidence for the assembly of a functional tRNA splicing complex in vitro. This observation has important implications for the organization of the splicing components and of the gene expression pathway in vivo. PMID- 3537692 TI - Antibodies to the ras gene product inhibit adenylate cyclase and accelerate progesterone-induced cell division in Xenopus laevis oocytes. AB - Microinjection of monoclonal antibodies (lines 238, 172, and 259) directed against the ras gene product, p21, into Xenopus laevis oocytes accelerated progesterone-induced germinal vesicle breakdown. Antibody 238 had the greatest effect on the acceleration of progesterone-induced oocyte maturation, and this effect was correlated with in vitro inhibition of adenylate cyclase (EC 4.6.1.1) activity in a concentration-dependent manner. Inhibition of adenylate cyclase by antibody 238 was also measured in membranes prepared from oocytes pretreated with either cholera toxin or pertussis toxin. These results suggest a role for the ras gene product in the regulation of vertebrate cell adenylate cyclase activity. PMID- 3537693 TI - A deletion that includes the segment coding for the signal peptidase cleavage site delays release of Saccharomyces cerevisiae acid phosphatase from the endoplasmic reticulum. AB - We studied ultrastructural localization of acid phosphatase in derepressed Saccharomyces cerevisiae cells transformed with a multicopy plasmid carrying either the wild-type PHO5 gene or a PHO5 gene deleted in the region overlapping the signal peptidase cleavage site. Wild-type enzyme was located in the cell wall, as was 50% of the modified protein, which carried high-mannose-sugar chains. The remaining 50% of the protein was active and core glycosylated, and it accumulated in the endoplasmic reticulum cisternae. The signal peptide remained uncleaved in both forms. Cells expressing the modified protein exhibited an exaggerated endoplasmic reticulum with dilated lumen. PMID- 3537694 TI - Biochemical characterization of polypeptides encoded by mutated human Ha-ras1 genes. AB - We expressed six forms of p21-ras polypeptides in Escherichia coli with differing transformation potentials resulting from amino acid substitutions at position 12. The ability of the encoded p21's to autophosphorylate, bind guanine nucleotides, and hydrolyze GTP was assessed. All versions of p21 bound GTP equivalently; the kinase activity, while dependent upon residue 12, did not correlate with the transforming potential of the polypeptide. All transforming versions exhibited an impaired GTPase activity, while a novel nontransforming derivative [p21(pro-12)] possessed an enhanced GTPase activity. These results provide strong support for the proposal that an impairment of the cellular p21 GTPase activity can unmask its transforming potential. PMID- 3537695 TI - Protein product of proto-oncogene c-mil. AB - Using antipeptide antibodies with specificity for the carboxyl termini of v-raf and v-mil protein products, two proteins with apparent molecular weights of approximately 71,000/73,000 and 215,000 were detected in immunoprecipitates from normal uninfected chicken cells. The 71,000/73,000-molecular-weight protein was identified as the product of the c-mil proto-oncogene by the close structural relationship of its 42,000-molecular-weight carboxyl-terminal domain to the v-mil encoded domain of the hybrid protein p100gag-mil specified by the avian retrovirus MH2. The amino-terminal domain of the cellular protein is encoded by 5' c-mil sequences that have not been transduced into the genome of MH2. The c mil protein (p71/73c-mil) was found to be phosphorylated in vivo, and homologous proteins were detected at variable levels in a variety of vertebrate cells, including human cells. PMID- 3537696 TI - The alpha subunit of initiation factor 2 is phosphorylated in vivo in the yeast Saccharomyces cerevisiae. AB - The phosphorylation state of the alpha subunit of initiation factor 2 (eIF-2 alpha) in Saccharomyces cerevisiae has been determined by two-dimensional gel electrophoresis and autoradiography of lysates from cultures grown under a variety of conditions. The alpha subunit was maintained in a phosphorylated state during logarithmic growth on fermentable and nonfermentable carbon sources, during starvation for an essential amino acid, during heat shock, during stationary phase, and during sporulation. Only when cells were starved for a carbon source for 2 h in 1 M sorbitol was eIF-2 alpha isolated in the nonphosphorylated state. This is in contrast with the studies in rabbit reticulocyte lysates, in which arrested protein synthesis was correlated with a relative increase in the extent of phosphorylation of eIF-2 alpha. PMID- 3537697 TI - RNase P activity in the mitochondria of Saccharomyces cerevisiae depends on both mitochondrion and nucleus-encoded components. AB - A requisite step in the biosynthesis of tRNA is the removal of 5' leader sequences from tRNA precursors. We have detected an RNase P activity in yeast mitochondrial extracts that can carry out this reaction on a homologous precursor tRNA. This mitochondrial RNase P was sensitive to both micrococcal nuclease and protease, demonstrating that it requires both a nucleic acid and protein for activity. The presence of RNase P activity in vitro directly correlated with the presence of a locus on yeast mitochondrial DNA previously shown by genetic and biochemical studies to be required for tRNA maturation. The product of the locus, the 9S RNA, and this newly described mitochondrial RNase P activity cofractionated, providing further evidence that the 9S RNA is the RNA component of yeast mitochondrial RNase P. PMID- 3537698 TI - Electron microscopic study of Saccharomyces cerevisiae rDNA chromatin replication. AB - An electron microscopic study was made of the replication of rDNA chromatin of Saccharomyces cerevisiae. Two different methods were used to synchronize cells. cdc7-1 cells were raised to a restrictive temperature, whereas A364a cells were blocked with mating factor. Replication bubbles typically opened in the nontranscribed spacers of rDNA repeats in both cell types. The mean position of the center of these bubbles corresponds closely to a position where an autonomously replicating sequence previously has been mapped in an rDNA repeat. Clusters of replication bubbles containing up to four bubbles spaced one to three genes apart were seen opening in early S phase. PMID- 3537699 TI - Tandemly duplicated upstream control sequences mediate copper-induced transcription of the Saccharomyces cerevisiae copper-metallothionein gene. AB - Transcription of the Saccharomyces cerevisiae copper-metallothionein gene, CUP1, inducible by copper. By analyzing deletion and fusion mutants in the CUP1 5' flanking region, we identified two closely related, tandemly arranged copper regulatory elements. A synthetic version of one of these elements conferred efficient copper induction on a heterologous promoter when present in two tandem copies. PMID- 3537700 TI - A human Ki-ras oncogene encodes two transforming p21 proteins. AB - The human Ki-ras gene was previously reported to contain two alternative fourth exons which encode two distinct p21 proteins differing only at their carboxy termini. The present study shows that either p21 protein is able on its own to transform NIH 3T3 cells to a tumorigenic state. PMID- 3537702 TI - The Saccharomyces cerevisiae chromosome III left telomere has a type X, but not a type Y', ARS region. AB - A yeast Saccharomyces cerevisiae telomeric region was isolated by chromosome walking from HML alpha, the most distal known gene on the chromosome III left (IIIL) end. The terminal heterodisperse 3.3-kilobase (kb) SalI fragment on chromosome IIIL, 8.6 kb distal to HML alpha, was cloned in a circular vector to generate a telomeric probe. Southern hybridization and DNA sequencing analyses indicated that 0.6 kb (+/- 200 base pairs) of 5'-C1-3A-3' simple tandem repeat sequence, adjacent to a 1.2-kb type X ARS region, constitutes the telomere on the chromosome IIIL end, and no type Y' ARS region homologies exist between HML alpha and the IIIL terminus. PMID- 3537701 TI - Biosynthesis of the v-sis gene product: signal sequence cleavage, glycosylation, and proteolytic processing. AB - The v-sis oncogene and its cellular homolog c-sis encode chain B of platelet derived growth factor. Cells transformed by v-sis produce a platelet-derived growth factor-related molecule which is able to stimulate the platelet-derived growth factor receptor in an autocrine fashion. Site-directed mutagenesis was used to construct several mutations which substitute charged residues for hydrophobic residues in the proposed signal sequence of the v-sis gene product. Two of these mutations resulted in the synthesis of altered v-sis gene products with an unexpected nuclear location and a loss of biological activity. We also report here the intracellular localization of the v-sis gene product to the endoplasmic reticulum-Golgi compartment, where signal sequence cleavage and N linked glycosylation occur. The v-sis gene product contains no transmembrane regions, as it is completely protected within isolated microsomes from trypsin proteolysis. Site-directed mutagenesis was also used to alter a proposed proteolytic processing site in the v-sis gene product. This mutant v-sis gene, which encodes Asn-Ser in place of Lys-Arg at residues 110 to 111, was found to retain full biological activity. PMID- 3537703 TI - DNA methyltransferase induced by PBCV-1 virus infection of a Chlorella-like green alga. AB - A DNA methyltransferase was isolated from a eucaryotic, Chlorella-like green alga infected with the virus PBCV-1. The enzyme recognized the sequence GATC and methylated deoxyadenosine solely in GATC sequences. Host DNA, which contains GATC sequences, but not PBCV-1 DNA, which contains GmATC sequences, was a good substrate for the enzyme in vitro. The DNA methyltransferase activity was first detected about 1 h after viral infection; PBCV-1 DNA synthesis and host DNA degradation also began at about this time. The appearance of the DNA methyltransferase activity required de novo protein synthesis, and the enzyme was probably virus encoded. Methylation of DNAs with the PBCV-1-induced methyltransferase conferred resistance of the DNAs to a PBCV-1-induced restriction endonuclease enzyme described previously (Y. Xia, D. E. Burbank, L. Uher, D. Rabussay, and J. L. Van Etten, Mol. Cell. Biol. 6:1430-1439). We propose that the PBCV-1-induced methyltransferase protects viral DNA from the PBCV-1 induced restriction endonuclease and is part of a virus-induced restriction and modification system in PBCV-1-infected Chlorella cells. PMID- 3537704 TI - Effects of progressive depletion of TCM1 or CYH2 mRNA on Saccharomyces cerevisiae ribosomal protein accumulation. AB - When present in excess, the mRNAs for Saccharomyces cerevisiae ribosomal proteins L3 and L29 are translated less efficiently, so that synthesis of these proteins remains commensurate with that of other ribosomal proteins (N.J. Pearson, H.M. Fried, and J.R. Warner, Cell 29:347-355, 1982; J.R. Warner, G. Mitra, W.F. Schwindinger, M. Studeny, and H.M. Fried, Mol. Cell. Biol. 5:1512-1521, 1985). We used a yeast strain with a conditionally transcribed derivative of the L3 gene to deplete cells progressively of L3 mRNA. In this case translation of L3 mRNA did not become more efficient so that L3 was not maintained at a normal level. Even when there was an initial excess of L3 mRNA, interruption of its further transcription produced an immediate drop in L3 synthesis, suggesting that the translational efficiency of preexisting mRNA cannot be altered. Lack of L3 synthesis afforded an opportunity to examine coordinate accumulation of other ribosomal proteins. Without L3, apparent synthesis of several 60S subunit proteins diminished, and 60S subunits did not assemble. A similar phenomenon occurred when, in a second strain, synthesis of ribosomal protein L29 was prevented. Loss of 60S subunit assembly was accompanied by a destabilization of some 60S ribosomal protein mRNAs. These data suggest that synthesis of some S. cerevisiae ribosomal proteins may be regulated posttranscriptionally as a function of the extent to which they are assembled. PMID- 3537705 TI - Three different M1 RNA-containing viruslike particle types in Saccharomyces cerevisiae: in vitro M1 double-stranded RNA synthesis. AB - Killer strains of Saccharomyces cerevisiae bear at least two different double stranded RNAs (dsRNAs) encapsidated in 39-nm viruslike particles (VLPs) of which the major coat protein is coded by the larger RNA (L-A dsRNA). The smaller dsRNA (M1 or M2) encodes an extracellular protein toxin (K1 or K2 toxin). Based on their densities on CsCl gradients, L-A- and M1-containing particles can be separated. Using this method, we detected a new type of M1 dsRNA-containing VLP (M1-H VLP, for heavy) that has a higher density than those previously reported (M1-L VLP, for light). M1-H and M1-L VLPs are present together in the same strains and in all those we tested. M1-H, M1-L, and L-A VLPs all have the same types of proteins in the same approximate proportions, but whereas L-A VLPs and M1-L VLPs have one dsRNA molecule per particle, M1-H VLPs contain two M1 dsRNA molecules per particle. Their RNA polymerase produces mainly plus single strands that are all extruded in the case of M1-H particles but are partially retained inside the M1-L particles to be used later for dsRNA synthesis. We show that M1-H VLPs are formed in vitro from the M1-L VLPs. We also show that the peak of M1 dsRNA synthesis is in fractions lighter than M1-L VLPs, presumably those carrying only a single plus M1 strand. We suggest that VLPs carrying two M1 dsRNAs (each 1.8 kilobases) can exist because the particle is designed to carry one L-A dsRNA (4.5 kilobases). PMID- 3537707 TI - Extrachromosomal and chromosomal gene conversion in mammalian cells. AB - We constructed substrates to study gene conversion in mammalian cells specifically without the complication of reciprocal recombination events. These substrates contain both an insertion mutation of the neomycin resistance gene (neoX) and an internal, homologous fragment of the neo gene (neo-526), such that gene conversion from neo-526 to neoX restores a functional neo gene. Although two reciprocal recombination events can also produce an intact neo gene, these double recombination events occur much less frequently that gene conversion in mammalian cells, We used our substrates to characterize extrachromosomal gene conversion in recombination-deficient bacteria and in monkey COS cells. Chromosomal recombination was also studied after stable integration of these substrates into the genome of mouse 3T6 cells. All extrachromosomal and chromosomal recombination events analyzed in mammalian cells resulted from gene conversion. Chromosomal gene conversion events occurred at frequencies of about 10(-6) per cell generation and restored a functional neo gene without overall effects on sequence organization. PMID- 3537706 TI - Molecular characterization of cell cycle gene CDC7 from Saccharomyces cerevisiae. AB - The product of the CDC7 gene of Saccharomyces cerevisiae appears to have multiple roles in cellular physiology. It is required for the initiation of mitotic DNA synthesis. While it is not required for the initiation of meiotic DNA replication, it is necessary for genetic recombination during meiosis and for the formation of ascospores. It has also been implicated in an error-prone DNA repair pathway. Plasmids capable of complementing temperature-sensitive cdc7 mutations were isolated from libraries of yeast genomic DNA in the multicopy plasmid vectors YRp7 and YEp24. The complementing activity was localized within a 3.0 kilobase genomic DNA fragment. Genetic studies that included integration of the genomic insert at or near the CDC7 locus and marker rescue of four cdc7 alleles proved that the cloned fragment contains the yeast chromosomal CDC7 gene. The RNA transcript of CDC7 is about 1,700 nucleotides. Analysis of the nucleotide sequence of a 2.1-kilobase region of the cloned fragment revealed the presence of an open reading frame of 1,521 nucleotides that is presumed to encode the CDC7 protein. Depending on which of two possible ATG codons initiates translation, the calculated size of the CDC7 protein is 58.2 or 56 kilodaltons. Comparison of the predicted amino acid sequence of the CDC7 gene product with other known protein sequences suggests that CDC7 encodes a protein kinase. PMID- 3537708 TI - mRNA transcription in nuclei isolated from Saccharomyces cerevisiae. AB - We developed an improved method for the isolation of transcriptionally active nuclei from Saccharomyces cerevisiae, which allows analysis of specific transcripts. When incubated with alpha-32P-labeled ribonucleoside triphosphates in vitro, nuclei isolated from haploid or diploid cells transcribed rRNA, tRNA, and mRNAs in a strand-specific manner, as shown by slot blot hybridization of the in vitro synthesized RNA to cloned genes encoding 5.8S, 18S and 28S rRNAs, tRNATyr, and GAL7, URA3, TY1 and HIS3 mRNAs. A yeast strain containing a high copy-number plasmid which overproduced GAL7 mRNA was initially used to facilitate detection of a discrete message. We optimized conditions for the transcription of genes expressed by each of the three yeast nuclear RNA polymerases. Under optimal conditions, labeled transcripts could be detected from single-copy genes normally expressed at low levels in the cells (HIS3 and URA3). We determined that the alpha-amanitin sensitivity of transcript synthesis in the isolated nuclei paralleled the sensitivity of the corresponding purified RNA polymerases; in particular, mRNA synthesis was 50% sensitive to 1 microgram of alpha-amanitin per ml, establishing transcription of mRNA by RNA polymerase II. PMID- 3537709 TI - New positive and negative regulators for general control of amino acid biosynthesis in Saccharomyces cerevisiae. AB - The biosynthesis of most amino acids in Saccharomyces cerevisiae is coregulated. Starvation for a single amino acid results in the derepression of amino acid biosynthetic enzymes in many unrelated pathways. This phenomenon, known as general control, is mediated by both positive (GCN) and negative (GCD) regulatory genes. In this paper we describe the identification and characterization of several new regulatory genes for this system, GCN6, GCN7, GCN8, GCN9, and GCD5. A mutation in the negative regulator GCD5 was isolated on the basis of its suppression of a gcn2 mutation. The effect of gcd5 is a posttranscriptional increase in histidine biosynthetic enzyme activity. Suppressors of gcd5 which are deficient in derepression were in turn isolated. Eight such mutations, defining four new positive regulatory genes (GCN6 through GCN9), were obtained. These mutations are recessive, confer sensitivity to multiple amino acid analogs, and result in decreased mRNA levels for genes under general control. The GCN6 and GCN7 gene products were shown to be positive regulators for transcription of the GCN4 gene, the most direct-acting positive regulator thus far identified. The interaction of GCN6 and GCN7 with GCN4 is fundamentally different from that of previously isolated GCN genes. It should also be noted that these gcn selections gave a completely different nonoverlapping set of mutations from earlier selections which relied on analog sensitivity. Thus, we may have identified a new class of GCN genes which are functionally distinct from GCN1 through GCN5. PMID- 3537710 TI - Reciprocal regulation of the tandemly duplicated PHO5/PHO3 gene cluster within the acid phosphatase multigene family of Saccharomyces cerevisiae. AB - We characterized the organization and expression of PHO5 and PHO3, the tightly linked repressible and constitutive acid phosphatase genes of Saccharomyces cerevisiae. The "constitutive" gene, PHO3, is expressed only when PHO5 is not. Altering PHO5 expression, either through promoter deletions or through mutations in trans-acting regulatory genes, showed that PHO5 expression is sufficient to block transcription of PHO3. An active genomic copy of PHO5 was able to block expression of PHO3 from a high-copy-number plasmid, showing that some trans acting product of PHO5 is involved. This is probably a translation product, since the presence of a nontranslatable PHO5 RNA did not inhibit transcription of PHO3. PMID- 3537712 TI - Substrate specificity of a mammalian DNA repair endonuclease that recognizes oxidative base damage. AB - The substrate specificity of a calf thymus endonuclease on DNA damaged by UV ligh, ionizing radiation, and oxidizing agents was investigated. End-labeled DNA fragments of defined sequence were used as substrates, and the enzyme-generated scission products were analyzed by using DNA sequencing methodologies. The enzyme was shown to incise damaged DNA at pyrimidine sites. The enzyme incised DNA damaged with UV light, ionizing radiation, osmium tetroxide, potassium permanganate, and hydrogen peroxide at cytosine and thymine sites. The substrate specificity of the calf thymus endonuclease was compared to that of Escherichia coli endonuclease III. Similar pyrimidine base damage specificities were found for both enzymes. These results define a highly conserved class of enzymes present in both procaryotes and eucaryotes that may mediate an important role in the repair of oxidative DNA damage. PMID- 3537711 TI - ADR1-mediated regulation of ADH2 requires an inverted repeat sequence. AB - DNA sequence analysis of wild-type and mutant ADH2 loci suggested that two unusual features 5' of the promoter, a 22-base-pair perfect dyad sequence and a (dA)20 tract, were important for regulation of this gene (D. W. Russell, M. Smith, D. Cox, V. M. Williamson, and E. T. Young, Nature [London] 304:652-654, 1983). Oligonucleotide-directed mutagenesis was used to construct ADH2 genes lacking the 22-base-pair dyad or the (dA)20 tract (V.-L. Chan and M. Smith, Nucleic Acids Res. 12:2407-2419, 1984). These mutant genes and other ADH2 deletions constructed by BAL 31 endonuclease digestion were studied after replacing the wild-type chromosomal locus with the altered alleles by the technique of gene transplacement (T. L. Orr-Weaver, J. W. Szostak, and R. S. Rothstein, Proc. Natl. Acad. Sci. USA 78:6354-6358, 1981), using canavanine resistance as the selectable marker. Deletions lacking the dyad failed to derepress normally and did not respond to mutations at the ADR1 locus, which encodes a protein necessary to activate ADH2. Deletions of the (dA)20 tract did not have a detectable phenotype. A small deletion located just 3' to the (dA)20 tract (between positions -164 and -146) had a low amount of ADR1-dependent transcription during repressed growth conditions, indicating that the regulatory protein encoded by ADR1 is present in a potentially active form during repression and that alterations of a DNA sequence in the promoter region can unmask its latent activity. PMID- 3537713 TI - An RNA polymerase I enhancer in Saccharomyces cerevisiae. AB - By the use of an artificial gene coding for rRNA (rDNA gene), we found that transcription of the major precursor rRNA in Saccharomyces cerevisiae cells is stimulated 15-fold by a positive control element located 2 kilobases upstream of the transcription initiation site. Analysis of in vitro runon transcripts suggests that this promoter element increases the frequency of initiation by RNA polymerase I molecules. A 190-base-pair fragment encompassing the promoter element can stimulate transcription on a centromere plasmid in either orientation, upstream or downstream of the transcription initiation site, suggesting that it is an enhancer element. Integration of artificial rDNA genes into a nonribosomal locus in the genome demonstrates that the rDNA enhancer functions either 5' or 3' to an rRNA transcription unit, suggesting it may operate in both directions within the rDNA tandem array. This is the first observation in S. cerevisiae of the stimulation of transcription by an element placed downstream. Finally, enhancer activity is dependent upon sequences that lie at both boundaries of the 190-base-pair fragment. In particular, a 5-base pair deletion at the extreme 3' boundary of the 190-base-pair fragment greatly reduces the activation of transcription and implicates a set of inverted repeats. PMID- 3537715 TI - Toxic effects of excess cloned centromeres. AB - Plasmids carrying a Saccharomyces cerevisiae centromere have a copy number of one or two, whereas other yeast plasmids have high copy numbers. The number of CEN plasmids per yeast cell was made artificially high by transforming cells simultaneously with several different CEN plasmids carrying different, independently selectable markers. Some host cells carried five different CEN plasmids and an average total of 13 extra copies of CEN3. Several effects were noted. The copy number of each plasmid was unexpectedly high. The plasmids were mutually unstable. Cultures contained many dead cells. The viable host cells grew more slowly than control cells, even in nonselective medium. There was a pause in the cell cycle at or just before mitosis. We conclude that an excess of centromeres is toxic and that the copy number of centromere plasmids is low partly because of selection against cells carrying multiple centromere plasmids. The toxicity may be caused by competition between the centromeres for some factor present in limiting quantities, e.g., centromere-binding proteins, microtubules, or space on the spindle pole body. PMID- 3537714 TI - Isolation and functional analysis of sporulation-induced transcribed sequences from Saccharomyces cerevisiae. AB - Strains of the yeast Saccharomyces cerevisiae that are heterozygous for the mating-type locus (MATa/MAT alpha) undergo meiosis and spore formation when they are starved for nitrogen and are provided with a nonfermentable carbon source such as potassium acetate. Haploids and diploids homozygous for the mating-type locus (MAT alpha/MAT alpha or MATa/MATa) are asporogenous and undergo neither meiosis nor spore formation when incubated under the same conditions. A small number of genes produce transcripts that appear to be induced specifically in sporulating cells. These transcripts either are not found or are present at much lower levels both in vegetatively growing cells and in cells from asporogenous strains that have been incubated in sporulation medium. Several genes complementary to these MATa/MAT alpha-dependent sporulation-induced transcripts were isolated from a gene-size insert yeast-lambda recombinant DNA library, by differential-plaque filter hybridization. An attempt was made to determine the function of three of these genes by mutating them in the yeast genome with in vitro mutagenesis and one-step gene replacement techniques. One gene was extensively disrupted by both a 0.3-kilobase deletion and the insertion of two large DNA sequences at different sites within the gene. Surprisingly, this compound mutation did not appear to affect meiosis or the production of viable ascospores, indicating that this gene was dispensable for differentiation. The other two genes were disrupted by simple insertion mutations at a site where it was possible that they might still possess some gene activity. These mutations also did not appear to affect sporulation. These results suggest that not all sporulation-induced genes are essential for meiosis and the production of viable ascospores under the conditions examined. PMID- 3537716 TI - Proliferative response and oncogene expression induced by epidermal growth factor in EL2 rat fibroblasts. AB - Extensive evidence supports a two-step model for the control of fibroblast growth, which includes first the action of a competence factor (e.g., platelet derived growth factor) followed by the stimulus of a progression factor (e.g., epidermal growth factor [EGF]). We investigated whether this model may be applied to the euploid EL2 fibroblast line recently isolated from rat embryos (E. Liboi, M. Caruso, and C. Basilico, Mol. Cell. Biol. 4:2925-2928, 1984). Our results clearly show that EGF alone leads EL2 cells to proliferate in serum-free conditions at a rate corresponding to 50 to 60% of that observed in the presence of 10% calf serum. It is of interest that, when resting EL2 cells were exposed to EGF, transcription of both c-myc and c-fos was markedly induced. Altogether, these observations suggest that, in contrast with the model of fibroblast growth mentioned above, EL2 cells require the presence of a single growth factor (EGF) for induction of DNA synthesis, and the expression of myc and fos proto-oncogenes may represent an obligatory step in the pathway of commitment of EL2 cells to proliferation. In addition, we showed that EGF may induce EL2 cells to acquire some properties of transformed cells, such as growth in agar and loss of contact inhibition. This suggests that the particular response to EGF of the EL2 line may be strictly connected with the expression of a transformed phenotype. PMID- 3537717 TI - Identification of a regulatory region that mediates glucose-dependent induction of the Saccharomyces cerevisiae enolase gene ENO2. AB - There are two yeast enolase genes, designated ENO1 and ENO2, which are expressed differentially in vegetative cells grown on glucose and in cells grown on gluconeogenic carbon sources. ENO2 is induced more than 20-fold in cells grown on glucose, whereas ENO1 expression is similar in cells grown on glucose and in cells grown on gluconeogenic carbon sources. Sequences within the 5' flanking region of ENO2 which are required for glucose-dependent induction were identified by deletion mapping analysis. These studies were carried out by using a fused gene containing the ENO2 5' flanking sequences and the ENO1 coding sequences. This fused gene undergoes glucose-dependent induction and is expressed at the same level as the resident ENO2 gene in cells grown on glucose or gluconeogenic carbon sources. Expression of fused genes containing deletion mutations within the ENO2 5' flanking region was monitored after integration at the ENO1 locus of a strain carrying a deletion of the resident ENO1 coding sequences. This analysis showed that there are two upstream activation sites located immediately upstream and downstream from a position 461 base pairs upstream from the transcriptional initiation site. Either one of these upstream activation sites is sufficient for glucose-dependent induction and normal gene expression in the presence of gluconeogenic carbon sources. Deletion of both regulatory regions results in a complete loss of gene expression. The regulatory regions function normally in both orientations relative to the coding sequences. Mutant fused genes containing small deletions within the regulatory regions were constructed; these genes were expressed normally in gluconeogenic carbon sources but were not induced in the presence of glucose. Based on this analysis, ENO2 contains a cis-acting regulatory region which is required for gene expression and mediates glucose dependent induction of gene expression. PMID- 3537718 TI - Secretion-defective mutations in the signal sequence for Saccharomyces cerevisiae invertase. AB - Nine mutations in the signal sequence region of the gene specifying the secreted Saccharomyces cerevisiae enzyme invertase were constructed in vitro. The consequences of these mutations were studied after returning the mutated genes to yeast cells. Short deletions and two extensive substitution mutations allowed normal expression and secretion of invertase. Other substitution mutations and longer deletions blocked the formation of extracellular invertase. Yeast cells carrying this second class of mutant gene expressed novel active internal forms of invertase that exhibited the following properties. The new internal proteins had the mobilities in denaturing gels expected of invertase polypeptides that had retained a defective signal sequence and were otherwise unmodified. The large increase in molecular weight characteristic of glycosylation was not seen. On nondenaturing gels the mutant enzymes were found as heterodimers with a normal form of invertase that is known to be cytoplasmic, showing that the mutant forms of the enzyme are assembled in the same compartment as the cytoplasmic enzyme. All of the mutant enzymes were soluble and not associated with the membrane components after fractionation of crude cell extracts on sucrose gradients. Therefore, these signal sequence mutations result in the production of active internal invertase that has lost the ability to enter the secretory pathway. This demonstrates that the signal sequence is required for the earliest steps in membrane translocation. PMID- 3537719 TI - Mutational analysis of the coordinate expression of the yeast tRNAArg-tRNAAsp gene tandem. AB - tRNA genes occur in the yeast genome as highly dispersed and independent transcriptional units. The 5'-tRNAArg-tRNAAsp-3' gene tandem, separated by a 10 base-pair spacer sequence, thus represents a rare case of tight clustering. Previous in vitro studies did not reveal any primary transcript from the tRNAAsp gene, but rather a dimeric precursor containing both gene sequences plus spacer, which undergoes a series of maturation steps. This seems anomalous since the tRNAAsp gene contains the sequences necessary for its own transcription. We found that site-directed mutation of the highly conserved C at position 56 to a G in the tRNAArg gene suppresses all transcription and does not activate the tRNAAsp gene. Precise deletion of the entire tRNAArg gene gives a similar result. Rescue of tRNAAsp gene transcription is effected either by the precise deletion of both the tRNAArg gene and spacer or by the precise deletion of this gene with concomitant introduction of an artificial RNA polymerase III start site in the spacer. This artificial start site is ineffective if the tRNAArg gene is present upstream. PMID- 3537720 TI - Interaction of the FLP recombinase of the Saccharomyces cerevisiae 2 micron plasmid with mutated target sequences. AB - The 2 micron plasmid of Saccharomyces cerevisiae codes for a site-specific recombinase, the FLP protein, that catalyzes efficient recombination across two 599-base-pair (bp) inverted repeats of the plasmid DNA both in vivo and in vitro. We analyzed the interaction of the purified FLP protein with the target sequences of two point mutants that exhibit impaired FLP-mediated recombination in vivo. One mutation lies in one of the 13-bp repeat elements that had been previously shown to be protected from DNase digestion by the FLP protein. This mutation dramatically reduces FLP-mediated recombination in vitro and appears to act by reducing the binding of FLP protein to its target sequence. The second mutation lies within the 8-bp core region of the FLP target sequence. The FLP protein introduces staggered nicks surrounding this 8-bp region, and these nicks are thought to define the sites of strand exchange. The mutation in the core region abolishes recombination with a wild-type site. However, recombination between two mutated sites is very efficient. This result suggests that proper base pairing between the two recombining sites is an important feature of FLP-mediated recombination. PMID- 3537722 TI - Effect of heat shock on ribosome structure: appearance of a new ribosome associated protein. AB - After a nonlethal but heat shock protein-inducing hyperthermic treatment, ribosomes isolated from Tetrahymena thermophila contained an additional 22 kilodalton protein (p22). When maximally ribosome associated, this protein was found to be on the small subunit in a 1:1 stoichiometric ratio with other ribosomal proteins. Using an antiserum directed against the purified 22 kilodalton protein, we found that non-heat-shocked and heat-shocked cells contain identical amounts of this protein, the only difference being that in the stressed cells p22 is entirely ribosome bound, whereas in the unstressed cells p22 has little or no detectable ribosome association. Because the two-dimensional electrophoretic properties of p22 showed no alterations after heat shock, this change in state of ribosome-p22 interaction does not appear to be caused by a chemical modification of p22. When not strongly ribosome associated, p22 is not found free in the cytoplasm. During that time in heat shock when p22 is first becoming ribosome associated, it is found preferentially on polysomal ribosomes. Subsequently, all ribosomes, whether polysome bound or not, obtain a bound p22. The functional significance of this association is discussed. PMID- 3537721 TI - The PEP4 gene encodes an aspartyl protease implicated in the posttranslational regulation of Saccharomyces cerevisiae vacuolar hydrolases. AB - pep4 mutants of Saccharomyces cerevisiae accumulate inactive precursors of vacuolar hydrolases. The PEP4 gene was isolated from a genomic DNA library by complementation of the pep4-3 mutation. Deletion analysis localized the complementing activity to a 1.5-kilobase pair EcoRI-XhoI restriction enzyme fragment. This fragment was used to identify an 1,800-nucleotide mRNA capable of directing the synthesis of a 44,000-dalton polypeptide. Southern blot analysis of yeast genomic DNA showed that the PEP4 gene is unique; however, several related sequences exist in yeasts. Tetrad analysis and mitotic recombination experiments localized the PEP4 gene proximal to GAL4 on chromosome XVI. Analysis of the DNA sequence indicated that PEP4 encodes a polypeptide with extensive homology to the aspartyl protease family. A comparison of the PEP4 predicted amino acid sequence with the yeast protease A protein sequence revealed that the two genes are, in fact, identical (see also Ammerer et al., Mol. Cell. Biol. 6:2490-2499, 1986). Based on our observations, we propose a model whereby inactive precursor molecules produced from the PEP4 gene self-activate within the yeast vacuole and subsequently activate other vacuolar hydrolases. PMID- 3537723 TI - Proline utilization in Saccharomyces cerevisiae: analysis of the cloned PUT1 gene. AB - The PUT1 gene was isolated by functional complementation of a put1 (proline oxidase-deficient) mutation in Saccharomyces cerevisiae. Three independent clones with overlapping inserts of 6.8, 10.5, and 11 kilobases (kb) were isolated from S. cerevisiae genomic libraries in YEp24 (2 micron) and YCp50 (CEN) plasmids. The identity of the PUT1 gene was determined by a gene disruption technique, and Southern hybridization and genetic analyses confirmed that the bona fide gene had been cloned. Plasmids containing the PUT1 gene restored regulated levels of proline oxidase activity to put1 recipient strains. The PUT1 DNA was present in a single copy in the yeast genome and encoded a transcript of ca. 1.5 kb. S1 nuclease protection experiments were used to determine the direction of transcription of the PUT1 message and to localize its 5' and 3' termini within a subcloned 3-kb DNA fragment. Approximately 50-fold more PUT1-specific mRNA was detected in induced (proline-grown) cells than in uninduced (ammonia-grown) cells. A yeast strain carrying the previously identified put3 regulatory mutation that caused constitutive levels of proline oxidase activity was found to have sevenfold elevated PUT1 mRNA levels under noninducing conditions. The absence of a functional electron transport system in vegetative petite (rho-) strains interfered with their ability to use proline as a nitrogen source. Although these strains were Put- and made no detectable proline oxidase activity, PUT1 message was detected under inducing conditions. The PUT1 gene was mapped distal to the GAL2 gene on chromosome XII by tetrad analysis. PMID- 3537724 TI - Effect of intron mutations on processing and function of Saccharomyces cerevisiae SUP53 tRNA in vitro and in vivo. AB - The Saccharomyces cerevisiae leucine-inserting amber suppressor tRNA gene SUP53 (a tRNALeu3 allele) was used to investigate the relationship between precursor tRNA structure and mature tRNA function. This gene encodes a pre-tRNA which contains a 32-base intron. The mature tRNASUP53 contains a 5-methylcytosine modification of the anticodon wobble base. Mutations were made in the SUP53 intron. These mutant genes were transcribed in an S. cerevisiae nuclear extract preparation. In this extract, primary tRNA gene transcripts are end-processed and base modified after addition of cofactors. The base modifications made in vitro were examined, and the mutant pre-tRNAs were analyzed for their ability to serve as substrates for partially purified S. cerevisiae tRNA endonuclease and ligase. Finally, the suppressor function of these mutant tRNA genes was assayed after their integration into the S. cerevisiae genome. Mutant analysis showed that the totally intact precursor tRNA, rather than any specific sequence or structure of the intron, was necessary for efficient nonsense suppression by tRNASUP53. Less efficient suppressor activity correlated with the absence of the 5-methylcytosine modification. Most of the intron-altered precursor tRNAs were successfully spliced in vitro, indicating that modifications are not critical for recognition by the tRNA endonuclease and ligase. PMID- 3537725 TI - Intron mutations affect splicing of Saccharomyces cerevisiae SUP53 precursor tRNA. AB - The Saccharomyces cerevisiae amber suppressor tRNA gene SUP53 (a tRNALeu3 allele) was used to investigate the role of intron structure and sequence on precursor tRNA splicing in vivo and in vitro. This gene encodes a pre-tRNA which contains a 32-base intervening sequence. Two types of SUP53 intron mutants were constructed: ones with an internal deletion of the natural SUP53 intron and ones with a novel intron. These mutant genes were transcribed in vitro, and the end-processed transcripts were analyzed for their ability to serve as substrates for the partially purified S. cerevisiae tRNA endonuclease and ligase. The in vitro phenotype of these mutant RNAs was correlated with the in vivo suppressor tRNA function of these SUP53 alleles after integration of the genes into the yeast genome. Analysis of these mutant pre-tRNAs, which exhibited no perturbation of the mature domain, clearly showed that intron structure and sequence can have profound effects on pre-tRNA splicing. All of the mutant RNAs, which were inefficiently spliced or unspliced, evidenced cleavage only at the 5' splice junction. Base changes in the intron proximal to the 3' splice junction could partially rescue the splicing defect. The implications of these data for tRNA endonuclease-substrate interactions are discussed. PMID- 3537726 TI - Identification of a second trans-acting gene controlling maltose fermentation in Saccharomyces carlsbergensis. AB - Maltose fermentation in Saccharomyces spp. requires the presence of a dominant MAL locus. The MAL6 locus has been cloned and shown to encode the structural genes for maltose permease (MAL61), maltase (MAL62), and a positively acting regulatory gene (MAL63). Induction of the MAL61 and MAL62 gene products requires the presence of maltose and the MAL63 gene. Mutations within the MAL63 gene produce nonfermenting strains unable to induce the two structural gene products. Reversion of these mal63 nonfermenters to maltose fermenters nearly always leads to the constitutive expression of maltase and maltose permease, and constitutivity is always linked to MAL6. We demonstrated that for one such revertant, strain C2, constitutivity did not require the MAL63 gene, since deletion disruption of this gene did not affect the constitutive expression of the structural genes. In addition, constitutivity was trans acting. Deletion disruption of the MAL6-linked structural genes for maltase and maltose permease in this strain did not affect the constitutive expression of a second, unlinked maltase structural gene. We isolated new maltose-fermenting revertants of a nonfermenting strain which carried a deletion disruption of the MAL63 gene. All 16 revertants isolated expressed maltase constitutively. In one revertant studied in detail, strain R10, constitutive expression was demonstrated to be linked to MAL6, semidominant, trans acting, and residing outside the MAL63-MAL61-MAL62 genes. From these studies we propose the existence of a second trans-acting regulatory gene at the MAL6 locus. We call this new gene MAL64. We mapped the MAL64 gene 2.3 centimorgans to the left of MAL63. The role of the MAL64 gene product in maltose fermentation is discussed. PMID- 3537728 TI - Isolation of mip (microtubule-interacting protein) mutations of Aspergillus nidulans. AB - We identified four mutations in two previously undescribed loci involved in microtubule function in Aspergillus nidulans as extragenic suppressors of benA33, a heat-sensitive beta-tubulin mutation. Three of the four mutations map to a locus closely linked to riboB on linkage group VIII; we designated this locus mipA (for microtubule-interacting protein). We were not able to map the remaining suppressor because of chromosomal rearrangements. However, since it recombines with riboB at a significantly higher frequency than the mipA alleles, it is unlikely to be in mipA; thus, we designated it mipB1. The mip mutations are not allelic to the previously identified loci that encode alpha- and beta-tubulin, and it is likely that mipA and mipB encode previously unidentified nontubulin proteins involved in microtubule function. Each of the mip mutations suppresses the heat sensitivity conferred by benA33 and suppresses the blockage of nuclear division and movement conferred by this mutation at high temperatures. Interactions between mipA and benA are allele specific. All of the mipA mutations are cryptic in a wild-type benA background but cause cold sensitivity in combination with benA33. These mutations also confer cold sensitivity in combination with benA31 and benA32 and reduce the resistance conferred by these mutations to the antimicrotubule agent benomyl but do not suppress the heat sensitivity conferred by these alleles. Finally, the mipA alleles suppress the heat sensitivity conferred by benA11, benA17, and benA21 but do not confer cold sensitivity in combination with these alleles. PMID- 3537729 TI - Escherichia coli aspartate transcarbamylase: a novel marker for studies of gene amplification and expression in mammalian cells. AB - Eucaryotic expression vectors containing the Escherichia coli pyrB gene (pyrB encodes the catalytic subunit of aspartate transcarbamylase [ATCase]) and the Tn5 phosphotransferase gene (G418 resistance module) were transfected into a mutant Chinese hamster ovary cell line possessing a CAD multifunctional protein lacking ATCase activity. G418-resistant transformants were isolated and analyzed for ATCase activity, the ability to complement the CAD ATCase defect, and the ability to resist high concentrations of the ATCase inhibitor N-(phosphonacetyl)-L aspartate (PALA) by amplifying the donated pyrB gene sequences. We report that bacterial ATCase is expressed in these lines, that it complements the CAD ATCase defect in trans, and that its amplification engenders PALA resistance. In addition, we derived rapid and sensitive assay conditions which enable the determination of bacterial ATCase enzyme activity in the presence of mammalian ATCase. PMID- 3537727 TI - mRNA polyadenylate-binding protein: gene isolation and sequencing and identification of a ribonucleoprotein consensus sequence. AB - We identified and produced antibodies to the major proteins that interact with poly(A)+ RNAs in the yeast Saccharomyces cerevisiae. The major proteins which were cross-linked by UV light to poly(A)+ RNA in intact yeast cells had apparent molecular weights of 72,000, 60,000, and 50,000. The poly(A) segment of the RNA was selectively cross-linked to the 72,000-molecular-weight protein (72K protein). Mice immunized with purified UV-cross-linked RNA-protein (RNP) complexes produced antibodies to the three major RNP proteins. A yeast genomic DNA library constructed in the lambda gt11 expression vector was screened with the anti-RNP serum, and recombinant bacteriophage clones were isolated. One recombinant phage, lambda YPA72.1, bearing a 2.5-kilobase insert, produced a large beta-galactosidase-RNP fusion protein. Affinity-selected antibodies from the anti-RNP serum on this fusion protein recognized a single 72K protein which was cross-linked to the poly(A) segment of RNA in the intact cell. Furthermore, the fusion protein of lambda YPA72.1 had specific poly(A)-binding activity. Therefore, lambda YPA72.1 encodes the 72K poly(A)-binding protein. Immunofluorescence microscopy showed that this protein was localized in the cytoplasm. Hybrid-selected mRNA translated in vitro produced the 72K poly(A) binding protein, and mRNA blot analysis detected a single 2.1-kilobase mRNA. DNA blot analysis suggested a single gene for the poly(A)-binding protein. DNA sequence analysis of genomic clones spanning the entire gene revealed a long open reading frame encoding a 64,272-molecular-weight protein with several distinct domains and repeating structural elements. A sequence of 11 to 13 amino acids is repeated three times in this protein. Strikingly, this repeated sequence (RNP consensus sequence) is highly homologous to a sequence that is repeated twice in a major mammalian heterogeneous nuclear RNP protein, A1. The conservation of the repetitive RNP consensus sequence suggests an important function and a common evolutionary origin for messenger RNP and heterogeneous nuclear RNP proteins. PMID- 3537730 TI - Negative regulatory gene for general control of amino acid biosynthesis in Saccharomyces cerevisiae. AB - In Saccharomyces cerevisiae, many amino acid biosynthetic pathways are coregulated by a complex general control system: starvation for a single amino acid results in the derepression of amino acid biosynthetic genes in multiple pathways. Derepression of these genes is mediated by positive (GCN) and negative (GCD) regulatory genes. In this paper we describe the isolation and characterization of a previously unreported negative regulatory gene, GCD3. A gcd3 mutation is recessive to wild type, confers resistance to multiple amino acid analogs, and results in overproduction and partially constitutive elevation of mRNA levels for amino acid biosynthetic genes. Furthermore, a gcd3 mutation can overcome the derepression-deficient phenotype of mutations in the positive regulatory GCN1, GCN2, and GCN3 genes. However, the gcd3 mutation cannot overcome the derepression-deficient phenotype of a gcn4 mutation, suggesting that GCD3 acts as a negative regulator of the important GCN4 gene. Northern blot analysis confirmed this conclusion, in that the steady-state levels of GCN4 mRNA are greatly increased in a gcd3 mutant. Thus, the negative regulatory gene GCD3 plays a central role in derepression of amino acid biosynthetic genes. PMID- 3537731 TI - Construction and behavior of circularly permuted and telocentric chromosomes in Saccharomyces cerevisiae. AB - We developed techniques that allow us to construct novel variants of Saccharomyces cerevisiae chromosomes. These modified chromosomes have precisely determined structures. A metacentric derivative of chromosome III which lacks the telomere-associated X and Y' elements, which are found at the telomeres of most yeast chromosomes, behaves normally in both mitosis and meiosis. We made a circularly permuted telocentric version of yeast chromosome III whose closest telomere was 33 kilobases from the centromere. This telocentric chromosome was lost at a frequency of 1.6 X 10(-5) per cell compared with a frequency of 4.0 X 10(-6) for the natural metacentric version of chromosome III. An extremely telocentric chromosome whose closet telomere was only 3.5 kilobases from the centromere was lost at a frequency of 6.0 X 10(-5). The mitotic stability of telocentric chromosomes shows that the very high frequency of nondisjunction observed for short linear artificial chromosomes is not due to inadequate centromere-telomere separation. PMID- 3537732 TI - Anchoring a secreted plasmodium antigen on the surface of recombinant vaccinia virus-infected cells increases its immunogenicity. AB - We show that the subcellular location of foreign antigens expressed in recombinant vaccinia viruses influences their effectiveness as immunogens. Live recombinant viruses induced very poor antibody responses to a secreted repetitive plasmodial antigen (the S-antigen) in rabbits and mice. The poor response accords with epidemiological data suggesting that S-antigens are poorly immunogenic. Appending the transmembrane domain of a membrane immunoglobulin (immunoglobulin G1) to its carboxy terminus produced a hybrid S-antigen that was no longer secreted but was located on the surface of virus-infected cells. This recombinant virus elicited high antibody titers to the S-antigen. This approach will facilitate the use of live virus delivery systems to immunize against a wide range of foreign nonsurface antigens. PMID- 3537733 TI - Structure and expression of two temperature-specific surface proteins in the ciliated protozoan Tetrahymena thermophila. AB - The presence of specific proteins (known as immobilization antigens) on the surface of the ciliated protozoan Tetrahymena thermophila is under environmental regulation. There are five different classes (serotypes) of surface proteins which appear on the cell surface when T. thermophila is cultured under different conditions of temperature or incubation medium; three of these are temperature dependent. The appearance of these proteins on the cell surface is mutually exclusive. We used polyclonal antibodies raised against 30 degrees C (designated SerH3)- and 40 degrees C (designated SerT)-specific surface antigens to study their structure and expression. We showed that these surface proteins contain at least one disulfide bridge. On sodium dodecyl sulfate-denaturing polyacrylamide gels, the nonreduced 30 degrees C- and 40 degrees C-specific surface proteins migrated with molecular sizes of 69 and 36 kilodaltons, respectively. The reduced forms of the proteins migrated with molecular sizes of 58 and 30 kilodaltons, respectively. The synthesis of the surface proteins responded rapidly and with a time course similar to that of the incubation temperature. The synthesis of each surface protein was greatly reduced within 1 h and undetectable by 2 h after a shift to the temperature at which the protein is not expressed. Surface protein synthesis resumed by the end of 1 h after a shift to the temperature at which the protein is expressed. The temperature-dependent induction of these surface proteins appears to be dependent on the synthesis of new mRNA, as indicated by a sensitivity to actinomycin D. Surface protein syntheses were mutually exclusive except at a transition temperature. At 35 degrees C both surface proteins were synthesized by a cell population. These data support the potential of this system as a model for the study of the effects of environmental factors on the genetic regulation of cell surface proteins. PMID- 3537734 TI - MRC OX-45 antigen: a leucocyte/endothelium rat membrane glycoprotein of 45,000 molecular weight. AB - Monoclonal antibodies MRC OX-45 and OX-46 detect identical or juxtaposed antigenic determinants on a novel rat membrane molecule that plays a possible role in macrophage suppression of antigen-induced T-cell responses. These antibodies react with most mature hematopoietic cells and their bone-marrow precursors, vascular endothelium and some connective tissue. The OX-45 antigens were purified from brain (mainly endothelium) and spleen by immunoaffinity chromatography, and were found to be glycoproteins with apparent Mr 43,000 and 45,000, respectively, as determined by SDS-PAGE analysis. The amino acid compositions of the two preparations were very similar but with no distinguishing features. The broad pattern of distribution was not the result of fortuitous cross-reaction of the MAbs as a single N-terminal sequence was obtained from mixed spleen populations of cells. Carbohydrate compositions of the brain and spleen molecules differed both in absolute amount (22 and 41% by weight, respectively) and in the ratios of various saccharides reflecting overall differences in the patterns of glycosylation between the two tissues. MRC OX-45 IgG showed an heterogeneity in the Mr of its H chain due to the attachment, in some molecules, of carbohydrate structures to the Fd fragment. PMID- 3537737 TI - [Digital subtraction angiography in children and adolescents]. AB - We report the results and indications of 106 digital subtraction angiographies in 84 pediatric patients up to 16 years of age. 70 of the intravenous and all of the 21 intraarterial studies revealed diagnostic results and no further vascular study for the demonstration of the pathologic conditions was necessary. PMID- 3537736 TI - Experimental embryology of the mouse. PMID- 3537735 TI - [Preparation of root surfaces. Morphology and degree of residual roughness after instrumentation]. PMID- 3537738 TI - [Salmonella osteoarthritis in hemophilia A]. AB - The unexpected course of a hemarthrosis in a young man with severe hemophilia and septic osteoarthritis is described. The arthritis appeared first as a relapse of a series of hemarthroses . However, the further course of the disease led to the diagnosis of a salmonella osteoarthritis. PMID- 3537739 TI - Introduction and perspective exemplified by delta hepatitis and by disturbances of regulatory networks in hepatic diseases. PMID- 3537740 TI - Hepatic ultrastructure and adaptation. PMID- 3537742 TI - Pathology of viral hepatitis. PMID- 3537741 TI - The interaction of ethanol with biological membranes: an overview. PMID- 3537743 TI - New developments in diagnostic liver pathology. PMID- 3537745 TI - Immunopathology of chronic hepatitis. PMID- 3537746 TI - Cholestasis: surgical pathology, mechanisms, and new concepts. AB - This report has attempted to describe concisely the main diagnostic morphological features seen in cholestasis and to explain them mechanistically. The number of clinical conditions in which cholestasis can be found is extremely large and varied, so that no single mechanism explains all cases; in fact, multiple factors are operative in frequent instances. Currently used terminology and concepts are explained. The report is not intended to be comprehensive but is intended to deal with the most common types of cholestasis and with those in which recent advances in new knowledge have been made. The first step, in all cases, is to try to localize the site of obstruction, so an anatomic classification of cholestasis is offered as being most helpful, both in diagnostic work and in consideration of the mechanisms involved. In selecting the cases for special consideration, a personal bias is introduced but is unavoidable. The discussion of canalicular cholestasis is particularly abridged because many of the mechanisms proposed, including the two that are briefly discussed, are still the subject of ongoing investigation but are included because they are illustrative of current concepts in the field. PMID- 3537747 TI - The utility of therapeutic plasmapheresis for neurological disorders. PMID- 3537744 TI - Xenobiotics, drug metabolism, and liver injury. AB - The covalent binding hypothesis has been and remains a dominant organizing principle in biochemical pathology. Cellular injury mediated by the interaction of chemically reactive metabolites with macromolecules has been invoked to account for the liver cell death produced by a wide variety of xenobiotic chemicals and drugs. The evidence to support such a role for covalent binding is largely circumstantial and is based on the persistent correlation between the extent of binding and the severity of the accompanying liver necrosis. The more recent studies of the toxicity of haloalkanes (e.g., carbon tetrachloride), aryl halides (e.g., bromobenzene), and compounds capable of redox cycling with dioxygen (e.g., acetaminophen) have suggested alternative mechanisms for coupling mixed function oxidation to lethal cell injury. In this review, I have sketched the outlines of an emerging scheme that places emphasis on variations in the normal mixed function oxidation cycle that derive from the chemical properties of the hepatotoxin in question. I discussed three different causes--biochemical lesions, if you will--of variations with three classic hepatotoxins, carbon tetrachloride, acetaminophen, and bromobenzene. The nature of the variation and how it presumably leads to liver cell injury was reviewed. PMID- 3537748 TI - The impact of routine HTLV-III antibody testing on public health. PMID- 3537750 TI - [Morphological changes in islands of Langerhans following occlusion of the pancreatic duct in dogs]. PMID- 3537751 TI - [Lupus nephritis in autopsy material. Morphological studies]. PMID- 3537752 TI - [Postmortem immunofluorescence study of the kidney]. PMID- 3537749 TI - [Structural changes in the contractile elements of tenotomized muscles]. PMID- 3537753 TI - Rupture of allograft kidney: a salvageable condition. PMID- 3537754 TI - Plasma insulin response to oral glucose in alcoholics with and without exocrine pancreatic hypersecretion. PMID- 3537755 TI - Highly selective vagotomy: history, development, and current clinical results. PMID- 3537756 TI - [The role of recA and umuC, D genes in bacterial mutagenesis induced by ultraviolet rays]. PMID- 3537757 TI - [The use of monoclonal antibodies for the determination of diphtheria toxin and its components]. PMID- 3537758 TI - [Modifiers of chemical mutagenesis and carcinogenesis]. PMID- 3537759 TI - [Proteolytic cleavage of influenza virus A protein NP characteristic of the strains of human origin detected in various strains isolated from animals]. PMID- 3537760 TI - [Effect of various cellular processes on the mutagenic activity of ethylating agents in bacteria and mammalian cells]. PMID- 3537761 TI - [Molecular dosimetry: biochemical and immunochemical methods of detecting DNA damage in vitro and in vivo]. PMID- 3537762 TI - [Cation-dependent induction of bacterial competence: the study of cationic interaction with E. coli cells]. PMID- 3537763 TI - [Plasmids of the pathogenicity of Yersinia pestis]. PMID- 3537764 TI - [Characteristics of the damage to bacteria by formaldehyde]. PMID- 3537765 TI - [Selection of suppressor-free cells from Escherichia coli Su+ strains]. PMID- 3537766 TI - [Effect of the preradiation history of E. coli WP2 cells on the residual fixation of mutations at locus rpsL (strA)]. PMID- 3537768 TI - [Design and characteristics of a new Salmonella typhimurium indicator strain for screening mutagenic agents]. PMID- 3537769 TI - [Proteolytic processing of viral and bacterial proteins and its potentials in controlled modification for vaccine design]. PMID- 3537767 TI - [Gene expression of the surface antigen of the hepatitis B virus in yeast cells]. PMID- 3537770 TI - [Effect of deletions in the ori-Tc region of plasmid pBR322 on its compatibility with replicon pMB1]. PMID- 3537771 TI - [Ribosomal genes--the only homologous DNA segments in mycoplasmas]. PMID- 3537772 TI - [Cloning and gene expression of Corynebacterium flavum ATCC14067, complementing ArgA and ArgE mutations in Escherichia coli cells]. PMID- 3537773 TI - Mutagenesis by 8-methoxypsoralen plus near-UV treatment: analysis of specificity in the lacI gene of Escherichia coli. AB - We have studied the specificity of mutation induced by PUVA treatment in the lacI gene of E. coli. Cells were exposed to near UV (approximately 365 nm) in the presence of 8-methoxypsoralen under conditions yielding about 7% survival and a 10-fold increase in mutation frequency. The cloning and sequencing of 131 mutants recovered following PUVA treatment revealed that almost all classes of mutation including base substitutions, frameshifts and deletions were induced. The distribution of mutations was non-random and a region of the lacI gene was found to be virtually silent for all classes of mutation. Intriguingly, the broad spectrum of mutation is accompanied by the recovery of mutation at two spontaneous hotspots. We observed a 7-fold increase at a frameshift hotspot involving the gain or loss of a tetramer tandemly repeated 3 times at this site and a 23-fold increase at an A:T----G:C transition hotspot located at the +6 mutational spectrum recovered following PUVA treatment was unique and a detailed analysis of the different classes of mutations indicates a role for DNA repair of both monoadducts and cross-links in the production of mutation. PMID- 3537775 TI - Mutagenicities of indole and 30 derivatives after nitrite treatment. AB - Indole and 7-derivatives, L- and D-tryptophan and 9 derivatives, and beta carboline (norharman) and 11 derivatives were tested for mutagenicity to Salmonella typhimurium TA100 and TA98 after nitrite treatment. 1-Methylindole, which is present in cigarette smoke condensate (Grob and Voellmin, 1970; Hoffmann and Rathkamp, 1970), was the most mutagenic to TA100 without S9 mix after nitrite treatment, inducing 615,000 revertants/mg. 2-Methylindole, 1-methyl-DL tryptophan, harmaline and (-)-(1S,3S)-1,2-dimethyl-1,2,3,4-tetrahydro-beta carboline-3- carboxylic acid also showed strong mutagenicity after nitrite treatment, inducing 129,000, 184,000, 103,000 and 197,000 revertants/mg, respectively. These mutagenic potencies were comparable with those of benzo[alpha]pyrene, 3-methylcholanthrene and 2-amino-9H-pyrido[2,3-b]indole (A alpha C) (Sugimura, 1982). Of 31 compounds tested, 22 were mutagenic after nitrite treatment. Since various indole compounds are ubiquitous in our environment, especially in plants, the presence of their mutagenicities after nitrite treatment warrants further studies, including those on their in vivo carcinogenicities. PMID- 3537774 TI - Effects of plant-derived flavonoids and polyphenolic acids on the activity of mutagens from cooked food. AB - The ability of 3 plant flavonoids (morin, myricetin and quercetin) and 4 polyphenolic acids (caffeic acid, chlorogenic acid, ellagic acid and ferulic acid) to inhibit the genotoxic effects of a number of cooked-food mutagens (IQ, MeIQ, MeIQx, Trp-P-1 and Trp-P-2), was investigated in a bacterial mutation assay using Salmonella typhimurium TA98 as indicator and hepatic S9 mixes from either SWR mice or Syrian hamsters as metabolic activating systems. Although the polyphenolic acids failed to have an effect, the flavonoids generally inhibited IQ, MeIQ, MeIQx and Trp-P-1 induced mutagenesis in a dose-dependent manner, irrespective of the source of S9. This was not the case with Trp-P-2 where the flavonoids were only observed to inhibit when SWR mouse S9 but not Syrian hamster S9 was used. Of the 3 compounds, myricetin and quercetin were superior to morin in their inhibitory capacity. PMID- 3537777 TI - Rhodium(III) complexes as genotoxic agents: photochemical effects and their implications. AB - The genetic toxicology of coordination compounds of transition metals has been of considerable interest since the application of cis-platinum(II) to the therapy of solid tumors. The nature of reactions of such compounds with DNA is still unclear, despite intensive investigation. In this study, several coordination compounds of rhodium(III) were tested for DNA-damaging activity and mutagenicity in bacterial assays in an attempt to understand both the chemical species involved in interactions with DNA and any structural requirements for such interactions. For several complexes it appears that dissociation of a ligand from the complex precedes reactions with DNA. This conclusion stems from the finding that photosensitive complexes of rhodium(III) are often many times more toxic to repair-deficient bacterial stains of E. coli K12 when incubated in the light than when incubated in the dark. Similar responses were seen for mutagenicity in S. typhimurium strain TA100. However, reversion of strain TA102 was largely independent of light exposure. Comparisons between mutagenicity and DNA-damaging activity revealed that the 3 activities measured sorted with some independence among the different compounds tested. Thus, the profiles for crosslink formation and/or generation of oxidative mutagens (mutagenicity in S. typhimurium strain TA102), mutagenicity in TA100 and DNA-damaging activity for the various groups of complexes showed many of the theoretically possible combinations of response in the assays. It is possible, then, that there are different structural requirements for DNA-damaging activity and mutagenicity respectively. This may indicate that synthesis of coordination compounds with specific genotoxic properties is possible. Such syntheses may provide complexes for study of DNA metal interactions and could, later, direct an approach to the design of new antitumor agents. PMID- 3537776 TI - Mutagenicity of the anticancer drug, caracemide, and related compounds for salmonella. AB - Caracemide, MeCON(CONHMe)(OCONHMe) (I), is a novel anticancer drug. Since it was derived from acetohydroxamic acid (II), a known mutagen, its potential metabolites and related compounds were synthesized and tested for mutagenicities in S. typhimurium TA98 and TA100. These compounds were: MeNHCONH(OCONHMe) (III), MeCONH(OCONHMe) (IV), MeCONOH(CONHMe) (V), MeNHCOONH2 X HCl (VI), MeNHCONHOH (VII), MeNHCOON(CONHMe)2 (VIII), and NOH(CONHMe)2 (IX). The mutagenicities in the absence of rat liver homogenate were: (VI) much greater than (IV) greater than (II), (III), (V). The other compounds were not mutagenic. (I) was mutagenic only in the presence of rat liver homogenate. The doses required to demonstrate mutagenicities of these compounds were from 0.05 to 5 mumoles/plate. The major hydrolytic products at 25 degrees C, pH 7, were (III), (IV), and (V) from (I); (II) and (III) from (IV); and (II), (III), (VII) and MeNHCONH(OCOMe) (X) from (V). (III) was stable at pH 7. Treatment of (IV) with HCl yielded (VI). Hydrolysis of (III) or (V) with ammonia yielded (VII). These results suggest that caracemide may be activated enzymatically or nonenzymatically by deacetylation or decarbamoylation, and its anticancer activity may be related to the reactivity of its metabolites with DNA. The synthetic procedures and characterizations of new compounds (IV), (V) and (X) are described. PMID- 3537778 TI - Genotoxic activity of two furan analogues of benzo[a]pyrene and their 2-nitro derivatives. AB - We measured the genotoxic activities in two bacterial tests, the Salmonella/histidine assay (a reverse mutation assay) and the SOS Chromotest (an assay for SOS induction in E. coli), of two pairs of isomeric furan analogues of benzo[a]pyrene: pyreno[1,2-b]furan (R7490) and pyreno[2,1-b]furan (R7692) and their 2-nitro derivatives, 8-nitro-pyreno[1,2-b]furan (R7489) and 8-nitro pyreno[2,1-b]furan (R7691). We found that: For all 4 compounds, the responses were correlated in the two tests. For the 2-nitro derivatives, R7489 and R7691, the responses were extremely high, reaching SOS-inducing potencies of 5.2 X 10(3) and 10(5)/nmole in the SOS Chromotest and mutagenic potencies of 6.3 X 10(4) and 3.7 X 10(7) revertants/nmole in the Salmonella/histidine assay (strain TA98), respectively; the responses were only slightly decreased in nitroreductase deficient strains. The responses to the two pyrenofurans were increased in the presence of an "activating mixture" but were still lower than that to benzo[a]pyrene. In contrast to benzo[a]pyrene and pyreno[2,1-b]furan (R7692), pyreno[1,2-b]furan (R7490) also gave a response in the absence of an "activating mixture". (5) Compounds with the oxygen heteroatom within the "bay region" gave lower responses than their isomers with the oxygen heteroatom outside the "bay region". PMID- 3537779 TI - Suppressed mutagenicity of benzo[a]pyrene by the liver S9 fraction and microsomes from eugenol-treated rats. AB - The mutagenicity of benzo[a]pyrene (B[a]P) in the Ames test using liver S9 fraction prepared from rats pretreated with eugenol (4-allyl-2-methoxyphenol) was suppressed to a lower level than that obtained using liver S9 from untreated rats. There was a reverse correlation between the mutagenicity of B[a]P and the dose of eugenol administered to the animals. Similarly suppressed mutagenicity was observed when liver microsomes, instead of the S9 fraction, were used in the Ames test. The mutagenic activity of B[a]P and arylhydrocarbon hydroxylase (AHH) could not be inhibited by the direct addition of eugenol into the assay mixtures. In eugenol-treated microsomes, cytochrome P-450 content, AHH activity and total B[a]P hydroxylase activity were decreased to 81, 29 and 48% of the control values, respectively. The mutagenicity of B[a]P catalyzed by microsomes from rats fed ad libitum on a diet containing 5% eugenol in the Ames test was significantly decreased. AHH activity and total B[a]P hydroxylase activity were also decreased in these liver microsomes. These results indicate that the activation of B[a]P in rat liver by cytochrome P-450, which metabolizes B[a]P to ultimate mutagens or carcinogens, is reduced by the administration of eugenol. PMID- 3537780 TI - Study of MFD-type repair in locus determining resistance of Escherichia coli to streptomycin. AB - The yield of induced mutations to streptomycin resistance (Str) in E. coli, UV irradiated and temporarily incubated in liquid medium not permitting protein synthesis, depends upon the conditions of preirradiation growth and preirradiation treatment of the bacteria, i.e. on their physiological state at the moment of irradiation. This fact is not readily reconciled with a model postulating mutation production in the structural genes of E. coli during excision repair. A preferred explanation is offered, based on the assumption that the efficiency of mutagenesis at the rpsL (strA) locus is determined by interference of antimutagenic (generalized excision repair and MFD) and promutagenic (mutation fixation of excision repair) events. The participation of macromolecular syntheses in Str mutation fixation is suggested. PMID- 3537781 TI - Assessment of the uptake and mutagenicity of nickel chloride in salmonella tester strains. AB - NiCl2 was examined for mutagenic activity in a number of Salmonella tester strains. Conditions were established where there was substantial uptake of the metal into the bacterial cells. However, even when the metal ion was apparently taken up, as determined by metal association with cells, there was a lack of mutagenic activity. These results suggest that nickel is unable to induce basepair or frameshift mutations in Salmonella tester strains and are discussed in relationship to the low binding affinity of Ni(II) for DNA. PMID- 3537782 TI - Identification of proteins encoded by variant surface glycoprotein expression site-associated genes in Trypanosoma brucei. AB - The variant surface glycoprotein (VSG) genes of Trypanosoma brucei may be transcribed from several distinct telomeric expression sites (ESs). The mechanism responsible for regulating potential expression sites is unknown. Two members of a pleomorphic family of expression site associated genes (ESAGs) have been cloned and sequenced. By examination of the DNA sequences we inferred that ESAGs encode amphiphilic glycoproteins. Fragments of two ESAGs were inserted into the Escherichia coli expression vectors pATH and pEX. Antisera to the resulting anthranilate synthetase ESAG protein (ESAGP) fusion protein immune precipitated a 46 kDa glycoprotein from detergent extracts of T. brucei. In the presence of tunicamycin, the size of the immune-precipitated protein was reduced to 36 kDa, corresponding to the molecular weight predicted by the ESAG sequence. The 36 kDa and 46 kDa proteins were absent from procyclic culture forms of T. brucei. PMID- 3537783 TI - Positive response to edrophonium in patients with neurotoxic envenoming by cobras (Naja naja philippinensis). A placebo-controlled study. AB - To study the ability of anticholinesterase drugs to reverse the potentially fatal paralytic effects of cobra venom, we conducted a placebo-controlled, double-blind crossover trial of intravenous edrophonium (Tensilon) in 10 adults with neurotoxic envenoming caused by bites of the Philippine cobra (Naja naja philippinensis). There was significantly more improvement in ptosis and endurance of upward gaze after edrophonium than after placebo. Five minutes after injection, the mean difference (+/- SD) in the percentage of the iris that was uncovered was 39 +/- 5.47 (70 vs. 31 percent; P less than 0.01), and the mean difference in the number of seconds of upward gaze was 33.1 +/- 9.29 (39.7 vs. 6.6 seconds; P less than 0.01). The expiratory and inspiratory pressures, forced vital capacity, and ability to cough, speak, and swallow also improved after edrophonium. In both the patients who were studied electromyographically, pretreatment and postplacebo responses were typical of myasthenia gravis and became normal after edrophonium. We conclude that anticholinesterases are beneficial in the management of neurotoxic envenoming by Asian cobras (Naja naja), and we recommended a test of edrophonium in any patient with signs of neurotoxic envenoming after snakebite. PMID- 3537784 TI - A prospective trial of colchicine for primary biliary cirrhosis. AB - We entered 60 patients with primary biliary cirrhosis in a double-blind randomized controlled trial to determine whether colchicine is therapeutically effective. Thirty patients had early disease (Stages 1 and 2), and 30 had advanced disease (Stages 3 and 4). Fifteen patients with early disease and 15 with advanced disease received colchicine (0.6 mg twice daily), and the remainder received placebo. Patients were studied about every two months; those remaining in the blind phase at two years underwent repeat liver biopsy and were then placed on open-label colchicine (0.6 mg twice daily). With a few exceptions, the results in patients with early disease were similar to those in patients with advanced disease; hence, data on patients in all stages were combined in the main analysis. During the two-year study period the colchicine-treated patients, as compared with the placebo-treated patients, had improvement in levels of serum albumin, serum bilirubin, alkaline phosphatase, cholesterol, and aminotransferases. However, there was no such improvement in the severity of symptoms or physical findings; moreover, there was no significant difference in the histologic changes noted at liver biopsy in the two treatment groups. At four years after entry, the cumulative mortality from liver disease was 21 percent in patients given colchicine and 47 percent in those given placebo (P = 0.05). The only side effect of colchicine was diarrhea, noted in three patients. The consistent and significant improvement in a number of markers of liver disease and the apparent decreased mortality from liver disease suggest that colchicine may provide some long-term clinical benefit in patients with primary biliary cirrhosis. However, the failure of colchicine to reduce hepatic inflammation and fibrosis leaves uncertain the effect of the drug on the longterm outcome of this disease. PMID- 3537785 TI - Recurrent vulvovaginal candidiasis. A prospective study of the efficacy of maintenance ketoconazole therapy. AB - In a prospective, placebo-controlled study, 74 women with recurrent vulvovaginal candidiasis were treated with oral ketoconazole (400 mg daily for two weeks) and were then randomly assigned to receive placebo (Group A), prophylactic ketoconazole, 400 mg daily for five days beginning with the onset of menses for six menstrual cycles (Group B), or low-dose ketoconazole, 100 mg daily for six months (Group C). Within a six-month follow-up period, 15 of 21 women (71.4 percent) treated with placebo had symptomatic recurrence of candidal vaginitis. In contrast, candidal vaginitis recurred in 6 of 21 (28.6 percent) and in 1 of 21 (4.8 percent) women in Groups B and C (P less than 0.01; P less than 0.001). After the prophylaxis was discontinued, the recurrence rates of candidal vaginitis were high in women in Groups B and C. At the end of 12 months of follow up, 23.8 percent of the women in Group A remained asymptomatic and attack-free, in contrast to 42.9 percent of the women in Group B (P greater than 0.05) and 52.4 percent in Group C (P less than 0.05). It appears that maintenance prophylactic therapy with oral ketoconazole is effective in preventing recurrent episodes of vulvovaginal candidiasis, but that relapse is common after withdrawal of the drug. Because of the risk of hepatotoxicity, caution is essential in selecting patients for long-term ketoconazole therapy and in following patients undergoing such treatment. PMID- 3537786 TI - Medical complications of cocaine abuse. PMID- 3537787 TI - 13-cis-retinoic acid in the treatment of oral leukoplakia. AB - 13-cis-Retinoic acid has been reported to be effective in treating oral leukoplakia. We randomly assigned 44 patients with this disease to receive 13-cis retinoic acid (24 patients) or placebo (20), 1 to 2 mg per kilogram of body weight per day for three months, and followed them for six months. There were major decreases in the size of the lesions in 67 percent (16 patients) of those given the drug and in 10 percent (2 patients) of those given placebo (P = 0.0002); dysplasia was reversed in 54 percent (13 patients) of the drug group and in 10 percent (2 patients) of the placebo group (P = 0.01). The clinical response to the drug correlated with the histologic response in 56 percent (9 of 16) of the patients evaluated. Relapse occurred in 9 of 16 patients two to three months after treatment ended. The toxic effects of the drug were acceptable in all but two patients. Cheilitis, facial erythema, and dryness and peeling of the skin were common; conjunctivitis and hypertriglyceridemia also occurred. All adverse reactions could be reversed by reducing the dose or temporarily discontinuing the drug. We conclude that 13-cis-retinoic acid, even in short-term use, appears to be an effective treatment for oral leukoplakia and has an acceptable level of toxicity. PMID- 3537788 TI - Type I diabetes mellitus. PMID- 3537789 TI - Are humans a source of Escherichia coli O157:H7, the agent of hemorrhagic colitis? PMID- 3537790 TI - Transmission of Creutzfeldt-Jakob disease from formalin-fixed, paraffin-embedded human brain tissue. PMID- 3537791 TI - Tumors: wounds that do not heal. Similarities between tumor stroma generation and wound healing. PMID- 3537792 TI - An important medical use for the Baggie. PMID- 3537794 TI - 175 years old: some anniversary thoughts and a new look. PMID- 3537793 TI - Mexiletine. PMID- 3537795 TI - Subcutaneous-insulin-resistance syndrome. PMID- 3537796 TI - Do young children instinctively know what to eat? The studies of Clara Davis revisited. PMID- 3537797 TI - Hyperinsulinemia and non-insulin-dependent diabetes mellitus. PMID- 3537798 TI - Case 29-1986: DF-2 bacteremia. PMID- 3537799 TI - More on Hitler and Parkinson's disease. PMID- 3537800 TI - Edouard Seguin and the social power of thermometry. PMID- 3537802 TI - Multiple recurrent genomic defects in follicular lymphoma. A possible model for cancer. AB - Several steps in the clinical evolution of human neoplasia are associated with a variety of recurrent chromosomal defects that could prove essential to the understanding of cancer. We found 15 types of nonrandom chromosomal abnormalities in a study of 71 patients with follicular lymphoma; 10 of the types appeared to influence the histopathological findings, clinical course, or response to treatment. A translocation, t(14;18), observed in 85 percent of all patients appeared to be the main determinant of a follicular pattern. Ten patients with a t(14;18) as a single defect had the histologic features of follicular small cleaved-cell lymphoma. Most did not require treatment for one to four years, because their tumors had an initial indolent course. In contrast, patients with follicular small cleaved-cell lymphoma with t(14;18) and deletion 13q32 acquired the hematologic features of leukemia and had an acceleration of the disease. A deletion 6q together with a complete or partial trisomy 7 or trisomy 12 (or both) was associated with the clinically more aggressive follicular mixed small- and large-cell or large-cell histologic type, which often evolves from follicular small-cell lymphoma. A complete or partial trisomy 3, 18, or 21 correlated almost exclusively with follicular large-cell lymphoma. In all follicular stages, a trisomy 2 or duplication 2p often accompanied an accelerated clinical course and a poor response to treatment. This study suggests that several discrete genomic defects may govern the evolution of a patient's malignant disease. PMID- 3537801 TI - Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. Results of a combined phase I and II clinical trial. AB - We administered recombinant human erythropoietin to 25 anemic patients with end stage renal disease who were undergoing hemodialysis. The recombinant human erythropoietin was given intravenously three times weekly after dialysis, and transfusion requirements, hematocrit, ferrokinetics, and reticulocyte responses were monitored. Over a range of doses between 15 and 500 units per kilogram of body weight, dose-dependent increases in effective erythropoiesis were noted. At 500 units per kilogram, changes in the hematocrit of as much as 10 percentage points were seen within three weeks, and increases in ferrokinetics of three to four times basal values, as measured by erythron transferrin uptake, were observed. Of 18 patients receiving effective doses of recombinant human erythropoietin, 12 who had required transfusions no longer needed them, and in 11 the hematocrit increased to 35 percent or more. Along with the rise in hematocrit, four patients had an increase in blood pressure, and a majority had increases in serum creatinine and potassium levels. No organ dysfunction or other toxic effects were observed, and no antibodies to the recombinant hormone were formed. These results demonstrate that recombinant human erythropoietin is effective, can eliminate the need for transfusions with their risks of immunologic sensitization, infection, and iron overload, and can restore the hematocrit to normal in many patients with the anemia of end-stage renal disease. PMID- 3537803 TI - Convergent and divergent evolution of regulatory sites in eukaryotic phosphorylases. AB - The activity of many proteins in eukaryotic cells is regulated by reversible covalent phosphorylation. This regulatory modification is often linked to other allosteric controls within the same protein, and such overlapping regulatory mechanisms are best characterized for glycogen phosphorylase (EC 2.4.1.1). Phosphorylases from different organisms or cell types exhibit markedly contrasting regulatory features; this makes the enzyme attractive for studying the evolution of interacting molecular regulatory mechanisms. Extensive biochemical and crystallographic studies of rabbit muscle phosphorylase have led to a characterization of five regulatory regions (phosphorylation, glycogen storage, AMP, glucose and purine sites). Here we report the complete primary structure of the yeast Saccharomyces cerevisiae glycogen phosphorylase, deduced from the sequence of the cloned gene. Regions that are highly conserved between muscle and yeast enzymes include the active site, the glycogen storage site and possibly the glucose and purine inhibition sites. Partial conservation of the residues involved in AMP-binding suggests a binding site for the yeast enzyme inhibitor, glucose 6-phosphate. Other parts of the AMP site and the intersubunit contacts involved in AMP allostery are disrupted in the yeast enzyme by extreme sequence divergence. The poor alignment of amino termini and lack of homology at phosphorylation sites indicate that regulation by reversible phosphorylation evolved independently in yeast and vertebrate phosphorylases. PMID- 3537804 TI - Yeast genetics. Genetic control mechanisms: transcriptional twisting. PMID- 3537806 TI - Control of malarial invasion by phosphorylation of the host cell membrane cytoskeleton. AB - It has been shown that the entry of the malaria parasite into the red blood cell requires the presence of ATP in the host cell cytoplasm. In red blood cell ghosts that contain no ATP the receptor on the extracellular surface remains in place and parasites will bind to the membrane, but will not enter. ATP is thus necessary for one of the steps in the invasion sequence that follows recognition and attachment. The process of entry appears to involve the active participation of the host cell membrane cytoskeleton. We have suggested that the function of the intracellular ATP may be to regulate phosphorylation of the cytoskeleton. We now present evidence that the activity of the membrane-associated cyclic AMP independent kinase of the red blood cell is inseparable from invasion; the active substrate may be spectrin. PMID- 3537805 TI - Electrophoresis of ribonucleoproteins reveals an ordered assembly pathway of yeast splicing complexes. AB - Three splicing complexes formed with a yeast pre-messenger RNA during in vitro splicing can be resolved by non-denaturing gel electrophoresis after incubation in the presence of non-specific competitor RNA. The time course of the appearance of these complexes and their composition suggest that they represent an ordered pathway of splicing complex assembly. PMID- 3537807 TI - Albert Szent-Gyorgi (1893-1986). PMID- 3537808 TI - The Tetrahymena ribozyme acts like an RNA restriction endonuclease. AB - A shortened form of the Tetrahymena self-splicing ribosomal RNA intervening sequence acts as an endoribonuclease, catalysing the cleavage of large RNA molecules by a mechanism involving guanosine transfer. The sequence specificity approaches that of the DNA restriction endonucleases. Site-specific mutagenesis of the enzyme active site alters the substrate sequence specificity in a predictable manner, so that endoribonucleases can be synthesized to cut at a variety of tetranucleotide sequences. PMID- 3537809 TI - Differentiation state-dependent surface mobilities of two forms of the neural cell adhesion molecule. AB - The neural cell adhesion molecule (N-CAM) has been implicated in morphogenetic events during formation of the nervous system. Three forms of N-CAM exist, all glycoprotein chains, of relative molecular masses 180,000 (180K), 140K and 120K (N-CAM180, N-CAM140 and N-CAM120) which are differentially expressed on neural cell types and during development. The three chains are thought to carry similar if not identical amino-acid sequences on their extracellular amino-terminal domains, but differ in the length of their carboxy-terminal cytoplasmic region. They occur in highly sialylated embryonic and less sialylated adult forms. N CAM180 is selectively expressed in more differentiated neural cells and may play a role in the stabilization of cell contacts. To investigate this, we have studied in the surface membrane of a mouse neuroblastoma cell line N2A the lateral mobility of the two predominant forms of N-CAM, N-CAM180 and N-CAM140, as a function of differentiation. Here we report that as judged by fringe pattern photobleaching, the surface mobility of N-CAM140 is higher than that of N-CAM180, suggesting an association of N-CAM180 with the cytoskeleton or other stabilizing factors. We also show that brain spectrin, a membrane-cytoskeleton linker protein, binds only to N-CAM180. The immobilization of N-CAM in differentiated N2A cells is achieved by a shift in expression from N-CAM140 to N-CAM180. PMID- 3537811 TI - Medical indigency: annotated bibliography of recent research and policy documents. PMID- 3537813 TI - Unfair to diabetics. PMID- 3537812 TI - [Treatment of extensive avulsions of the skin and soft tissues of the extremities]. PMID- 3537814 TI - The effect of a normal tissue radioprotector Adeturone on the radiation sensitivity of Lewis lung carcinoma: an enhanced response. AB - The effect of the normal tissue radioprotector Adeturone (S-2 aminoethylisothiuronium adenosine-5'-triphosphate) on the response of primary and metastatic Lewis lung carcinoma to radiation was evaluated. It was found that this compound enhanced the antitumor effect of whole-body and local radiation. In experiments with whole-body radiation Adeturone eliminated the lethality due to radiation toxicity (for a daily treatment schedule--10 X 1 Gy/fraction) or reduced it from 50% to 25% (for an intermittent schedule--3 X 3.34 Gy/fraction). Following local radiation treatment combined with Adeturone, a higher TWI%, longer tumor doubling time and longer mean survival time were recorded than for either treatment alone. An enhanced activity against metastatic growth of Lewis lung carcinoma to the lungs was also found with combined therapy. PMID- 3537810 TI - Pancreastatin, a novel pancreatic peptide that inhibits insulin secretion. AB - In mammalian tissues the C-terminal amide structure has been found to occur only in neuroactive or hormonally-active peptides. About half known neuropeptide and peptide hormones have this unique chemical feature. Using a chemical detection method, a search for previously unknown peptides that possess the C-terminal amide structure in extracts of brain and intestine was carried out and a number of novel neuropeptides and hormonal peptides, designated neuropeptide Y, PHI, peptide YY, galanin and neuropeptide K were isolated. We recently performed a similar search in porcine pancreas and found a high concentration of a peptide having a glycine amide at its C-terminus. Here we report the isolation, primary structure and biological activity of this novel peptide. The 49-residue peptide strongly inhibits glucose-induced insulin release from the isolated perfused pancreas and was therefore named pancreastatin. It may be important in the regulation of insulin secretion and in the pathogenesis and treatment of diabetes mellitus. PMID- 3537815 TI - The results of clinical trial within the framework of CMEA on surgical methods of mammary gland carcinoma treatment. AB - The results of joint clinical investigation performed by 8 oncological centers within the framework of CMEA countries are reported. Out of 816 patients with mammary gland carcinoma (MGC) of lateral localization, stage T1-2N0-1aM0, classical radical mastectomy by Halsted was carried out in 230 patients, mastectomy by Patey in 318 patients and conservative operation of radical resection type--in 218 patients. Specific characteristics of the disease progression were studied considering the time of development and incidence rates of local relapse or distant metastases depending on the type of surgery and MGC stage. High rates of 5-year survival were found for all types of surgery, mastectomy by Patey proving somewhat superior. PMID- 3537816 TI - Carotid artery atherosclerotic disease assessed by flow velocity wave form analysis in hemodialyzed normotensive and hypertensive patients. AB - Cerebrovascular accidents, often secondary to severe atherosclerotic disease, are very common in uremic patients on long-term hemodialysis. The aim of the present study is to assess asymptomatic carotid artery atherosclerotic disease (CAAD) in hemodialyzed normotensive and hypertensive patients in comparison with age matched controls, by the use of Doppler ultrasound flow velocity wave form analysis (FVWFA), recorded from the common carotid artery. This study was performed on 47 subjects divided into four groups: 10 young and 10 middle-aged normals were considered in groups I and II, respectively, 5 young uremic normotensive, 6 young uremic hypertensive and 16 middle-aged uremic normotensive patients in groups III, IV and V, respectively. All the examined patients were nonsmokers, without diabetes or cardiopathy. The five wave form dimensions most capable of separating different degrees of atherosclerotic disease were determined on every common carotid tracing and used in a single best fit discriminant equation; the resultant discriminant score (DS) classified each carotid tracing and consequently every group's range. DS of groups I and III were not different, but significantly higher compared to the other three groups; besides DS was statistically not different in groups II, IV and V. In conclusion, FVWFA did not detect a different degree of CAAD between normotensive dialyzed patients and age-matched normals, whereas the blood pressure pharmacological control did not affect the velocity findings of advanced CAAD in young uremic hypertensive patients. PMID- 3537817 TI - Sexual acquisition of urinary tract infection in a man. AB - A man was admitted with acute pyelonephritis due to Escherichia coli. Three days prior to the onset of his symptoms his wife presented with a 7-day history of cystitis due to E. coli. Before the wife developed her symptoms the couple were having vaginal intercourse every night, and this continued for the first 3 days of her symptoms. The organisms isolated from the urine of both patients were found to have the same biotype, an identical antibiogram, and the same serotype. The temporal sequence of events and the bacteriological findings strongly suggest the sexual transmission of this organism from the wife to her husband. PMID- 3537819 TI - Treatment of hyponatraemia with captopril. PMID- 3537818 TI - Plasma and pituitary content of growth hormone luteinizing hormone, and prolactin in uremic rats. Effects of chronic infusion of insulin. AB - The influence of chronic renal failure on pituitary content and on serum concentrations of growth hormone (GH), prolactin (PRL), and luteinizing hormone (LH) was studied in chronically uremic rats by comparison with control rats fed ad libitum and diet-restricted rats pair-fed with uremic rats. A decrease of pituitary GH content was found in uremic and diet-restricted rats, in association with a normal circulating GH level. A decrease of pituitary PRL and LH content with respectively high and normal serum values was observed in uremic but not in diet-restricted rats. These data strongly suggest that GH disturbances are related to malnutrition, whereas PRL and LH abnormalities are related to the uremic state per se. As hypoinsulinemia was observed in uremic rats, and as insulin is largely implicated in growth, we have investigated the effects of chronic infusion of insulin, using miniosmotic pumps, on pituitary hormone content. In spite of normalization of circulating insulin levels in uremic rats treated with insulin, pituitary GH, LH, and PRL contents were unaffected. Thus, insulin deficiency did not appear to be responsible for the diminished pituitary reserve of these hormones. PMID- 3537820 TI - Beta 2-microglobulin in renal transplant recipients. PMID- 3537821 TI - Sensitivity testing with the Chymo-FAST test. PMID- 3537822 TI - [Clinical evaluation of Chymodiactin and post-marketing surveillance]. AB - After a short summary of the development of chemonucleolysis technique and of Chymodiactin, the result of a randomized double-blind placebo controlled trial, conducted in the USA with Chymodiactin in 108 patients with monosegmental lumbar disc hernia and an open multicentre-study in 1498 patients, are shown. Furthermore an interim evaluation is presented of an open controlled multicentre study with Chymodiactin, started in Germany in 1983. The results of these three clinical studies as well as the post-marketing surveillance pending in the USA demonstrate that chemonucleolysis with Chymodiactin is a secure technique with good results, representing a valuable enrichment in the treatment of lumbar herniated nucleus pulposus. PMID- 3537823 TI - Towards a model stroke trial. The single-centre naftidrofuryl study. AB - It has been questionable whether the lack of proven pharmacological treatments in acute cerebral infarction (ACI) reflects ineffective drugs or only inadequacies in their assessment. The difficulties in developing a rationale for drug therapy in this condition favoured the former, although the latter possibility was supported by re-evaluation of most published trials. In this paper, a plausible rationale, in terms of our current understanding of both the drug and the condition, is expounded for treatment of ACI with naftidrofuryl. Guidelines for the design and conduct of clinical trials in acute stroke are discussed in relation to the particular problems posed: need for early initiation of treatment; need for, and difficulties of, diagnostic confirmation; matching of treatment groups by prognostic indicators of uncertain significance, and requirements for large numbers of patients and long-term follow-up. The practical application of these guidelines is tested in a clinical trial of naftidrofuryl conducted in a single centre on 100 patients with proven diagnoses. Rigorous attention to all aspects of selection, treatment and follow-up, with an explanatory approach to the trial design, was predicted to produce a positive result if the drug was effective. The findings were that naftidrofuryl treatment was associated with no change in death rate but with clinically and statistically significant improvements in neurological recovery and bed-occupancy. Better functional recovery was also noted, so that the trial result was coherent. It was concluded that a beneficial effect had been recorded, and consistency of this outcome with those of previous studies is demonstrated. A case is made for further studies to define exactly the role of this drug in the management of ACI. PMID- 3537824 TI - Antemortem markers of Alzheimer's disease. AB - This review examines various approaches to the development of antemortem markers of Alzheimer's disease. Among the procedures discussed are: neurochemical and histopathologic studies of the cholinergic system, concentrating on CSF and blood plasma; genetic studies; imaging and electrophysiological studies; and neuroendocrine studies. PMID- 3537825 TI - Isolation of peripheral nerve collagen. AB - A new method for the isolation of high yields of collagen from human peripheral nerve is described. A major technique adopted in the present work is sedimentation of the tissue homogenates in a sucrose density gradient. The defatted fibrous material isolated after the removal of myelin was shown to be a relatively pure collagenous substance by amino acid analysis, indicating that the removal of noncollagenous proteins, especially glycoproteins, from collagen fibrils was effectively achieved by this method. The yield of collagen at this step was more than 90% of the total collagen in peripheral nerve. Subsequent extractions with solutions of neutral saline and sodium citrate were found to give further purification of the collagenous protein. The collagens from embryonic peripheral nerves were composed of Type I and III collagens, while Type III collagen was found to be less abundant in adult peripheral nerves. PMID- 3537826 TI - Purification and characterization of the D2 cell adhesion protein: analysis of the postnatally regulated polymorphic forms and their cellular distribution. AB - The developmentally regulated, D2 cell adhesion protein has been purified from 10 12 day old rat synaptosomes by sequential hydroxyapatite chromatography, wheat germ lectin affinity chromatography and gel filtration. The purified protein was found to be composed of two polypeptide components of 200 and 140 kd molecular weight which comprised 0.5-1.0% of total synaptosomal membrane protein. Lysine Sepharose affinity chromatography could further separate the purified protein into sialic acid-rich and sialic acid-poor forms. Immunoblot analysis of whole brain homogenates and synaptosomes with an antiserum raised against the purified protein (anti-D2) revealed the presence of three immunologically related polypeptides of 200, 140, and 115 kd molecular weight. These polypeptides, which appeared as a diffuse zone (greater than 200 kd) in fetal material, were found to developmentally regulate by altering their relative expression. This was particularly marked in the 200 kd component. Furthermore, the 200 kd polypeptide appeared to be neuron-specific as both the 140 and 115 kd components were common to synaptosomes and primary cultures of astrocytes. PMID- 3537827 TI - [Treatment of sciatica with injection of hydrocortisone into the sacral hiatus]. AB - A group of 305 patients was treated with injections of corticosteroids into the epidural space of the sacral canal through the sacral hiatus and recumbent position on hard surface. The injections were done every second day giving seven times hydrocortisone acetate 0.025 g and as the last injection Depo-Medrol 0.04 g (Upjohn) was administered. The control group comprised 324 cases treated by various other methods. The assessment of the results was based on two criteria: duration of hospital stay, and percent of patients referred for surgical treatment. In the control group the duration of hospital stay was 20 days, and 16.1% of patients were referred for surgical treatment. In the studied group these values were 17.5 days and 5.2%. Conclusion. In acute ischalgia administration of hydrocortisone and depo-medrol into the epidural space through the sacral hiatus and lying on hard surface shorten the duration of strong pain and reduce the indications to surgical intervention. PMID- 3537828 TI - [Cavinton in the treatment of ischemic cerebral stroke. Clinical and computerized tomographic evaluation]. AB - Intravenous Cavinton (ethyl ester of apovincaminic acid) was given to 27 patients with acute ischaemic stroke, while 30 patients were given aminophylline twice daily during 10 days. The results of this treatment was compared on the basis of clinical manifestations and changes in computerized tomograms (CT) before and after the treatment. It was found that Cavinton gave similar results as aminophylline and other vasoactive preparations studied by other authors. In the group of severe strokes better results were observed after Cavinton, --out of 14 patients 2 died and 12 improved. In the aminophylline group 5 out of 10 patients died, and in 2 no improvement was observed. Clinical improvement was not correlated with CT improvement, while a significant correlation was observed between the state of the patient during admission and the size of the focus in CT. Cavinton had a significantly greater effect on the regression of CT changes. PMID- 3537829 TI - [Multi-infarct dementia. I. Clinical picture and differential diagnosis]. PMID- 3537830 TI - [Empyema of cavum septi pellucidi and cavum vergae--case report]. AB - A case of an empyema of cavum septi pellucidi and cavum Vergae is reported. A 60 year-old male was admitted because of fever, chill shivering, and slight conscious disturbance four days after head trauma. CT scan on admission showed cavum septi pellucidi and cavum Vergae. Lumbar puncture revealed whitish cloudy CSF containing 12256/3 WBC. So he was treated with antibiotics under the diagnosis of suppurative meningitis. Five days after administration of antibiotics high fever went down and consciousness was cleared. But about 10 days later his conscious level was lowered again. The follow up CT demonstrated remarkable expansion of cavum septi pellucidi and cavum Vergae with enhanced cavity wall. Empyema of the cavums was suspected and stereotaxic operation was performed. 10 ml of yellowish pus was aspirated. Post operative course was uneventful. CT scan of 15 days after operation revealed a marked decrease in size of the cavums, which almost completely disappeared three months later. Case similar to this was not found to be reported. The mechanism of formation of empyema of cavum septi pellucidi and cavum Vergae after meningitis in this case is discussed. PMID- 3537831 TI - A monoclonal antibody to amyloid in the brains of patients with Alzheimer's disease. AB - A monoclonal antibody that reacts with the amyloid in senile plaques in the brains of patients with Alzheimer's disease, was produced. The antigen was the crude amyloid protein (DAM, Pras et al. 1968) from the spleen of a patient with primary amyloidosis. The antibody crossreacts with DAM, but does not stain the amyloid of primary amyloidosis in tissue sections. The presence of a common antigenic site or sites in both the amyloid of senile plaques and amyloid of primary amyloidosis which react with this antibody is postulated. PMID- 3537833 TI - Neurosurgery in Chile. PMID- 3537832 TI - Creutzfeldt-Jakob disease: implications for growth hormone deficient children. AB - For over 25 years children with short stature due to growth hormone deficiency have been able to achieve normal height with the aid of human growth hormone (hGH) injections. Following reports of four deaths due to Creutzfeldt-Jakob disease (CJD) in young adults previously treated with hGH this treatment has ceased. There are major implications due to the potential risks of further cases of CJD and to the lack of a previously well-tried therapeutic substitute. PMID- 3537834 TI - Neglect induced by thalamotomy in humans: a quantitative appraisal of the sensory and motor deficits. AB - Stereotactic lesions for the treatment of tremor and rigidity in patients with Parkinson's disease are occasionally followed by neglect of the use of contralateral extremities for spontaneous movement when there are no specific sensory or motor deficits. A group of patients with neglected extremities was compared with a group of patients in which thalamotomy did not produce neglect. Neglect was shown by changes in motor performance, somatosensory evoked potentials (SEP) and electroencephalographic frequency induced by the lesion, as well as radiological evidence of brain atrophy and place and extension of lesions. Reaction time to both auditory and somatosensory stimuli was significantly increased only in the extremities contralateral to the lesion of patients with neglect; tremor decreased equally in both groups, and other motor abilities remained unchanged. P-200 component of SEP decreased in amplitude and increased in latency only in cases with neglect, particularly ipsilateral to the lesion; early components and mean electroencephalographic frequency remained unchanged. Brain atrophy was significant in patients with neglect, particularly for the posterior portion of the 3rd ventricle. No differences in size and location of the lesions were found between the groups. Results indicate that this type of neglect is not secondary to lesions in specific sensory of motor pathways, but to lesions of structures coupling sensorimotor functions and the process of attention and that midline thalamic nuclei atrophy precipitates the neglect, perhaps by critically decreasing the amount of reticulothalamocortical projections engaged in selective attention. PMID- 3537835 TI - High altitude cerebral edema. AB - Acute mountain sickness (AMS) is usually a benign and self-limited illness that befalls previously healthy individuals who ascend rapidly to high altitude without sufficient acclimatization. In its more severe forms, AMS can progress to a life-threatening condition in which pulmonary or cerebral edema can occur singly or in concert. High altitude cerebral edema (HACE) is a little-known clinical entity that manifests itself by a perplexing array of both generalized and localized neurological symptoms and signs. Furthermore, the development of HACE in climbers offers a unique experimental situation in which to examine the effects of hypoxia on the central nervous system. The epidemiology and clinical picture of HACE are reviewed. In addition, the pathology and predominant pathophysiological mechanisms postulated to explain HACE are examined, and the present recommendations for the prevention and treatment of this dangerous and unusual form of brain swelling are discussed. PMID- 3537836 TI - The liability insurance crisis. PMID- 3537837 TI - Cholinergic function and intellectual decline in Alzheimer's disease. PMID- 3537838 TI - A quantitative investigation of the neuronal composition of the rat dorsal lateral geniculate nucleus using GABA-immunocytochemistry. AB - The proportion of neurons immunoreactive for gamma-aminobutyric acid (GABA), and their rostrocaudal distribution in the dorsal lateral geniculate nucleus of the rat, were determined quantitatively using post-embedding GABA-immunochemistry on semithin resin embedded coronal sections followed by stereological analysis. The mean total volume numerical density of neurons (total number of neurons per mm3) in the dLGN was 67,077 +/- 4412 mm-3 (mean +/- SEM; n = 5), comprising a mean volume numerical density for GABA-immunopositive neurons of 14,584 +/- 1324 mm-3, and a mean volume numerical density of GABA-immunonegative neurons of 52,493 +/- 3419 mm-3, GABA-immunopositive neurons constituted 21.7 +/- 0.5% of the total neuronal composition of the rat dorsal lateral geniculate nucleus. Although no rostrocaudal variation was detected in the total volume numerical density of neurons, the relative proportion of GABA-immunopositive neurons was significantly lower in the caudal segment (18.1 +/- 0.6%) compared with the middle (24.9 +/- 0.9%) and the rostral segments (22.1%). Furthermore, on the basis of somatic size distributions, GABA-immunonegative neurons were seen to be significantly smaller in the caudal segment than in the more anterior two segments. The somatic size of GABA-immunopositive neurons showed no rostrocaudal variation through the dorsal lateral geniculate nucleus. These data provide a morphological correlate for the structural and functional subdivision of the dorsal lateral geniculate nucleus described previously in electrophysiological and morphological studies. PMID- 3537840 TI - Postsynaptic-GABAergic inhibition of non-pyramidal neurons in the guinea-pig hippocampus. AB - Intracellular recording and staining was applied to study non-pyramidal neurons in the guinea-pig hippocampus. To avoid accidental impalement of pyramidal or granule cells, two hippocampal regions known to be devoid of pyramidal or granule cells were chosen. In transverse and longitudinal slices, neurons of the deep hilar region (zone 4 of Amaral3), and in transverse slices, neurons of the stratum lacunosum-moleculare (CA3) were impaled. The intracellular staining with Lucifer Yellow revealed that of 20 neurons stained in these zones all were non pyramidal neurons. Hilar neurons, situated just below the granular layer, differed from granule cells and CA3 neurons with respect to their action potential waveform and their current/voltage relationship. In contrast to granule cells, hilar neurons exhibited spontaneous bursts in the presence of bicuculline (25 microM). In all neurons impaled in the hilar region and the stratum lacunosum moleculare (n = 42), inhibitory postsynaptic potentials could be elicited. These inhibitory postsynaptic potentials were blocked by bicuculline. In transverse slices, perforant path stimulation elicited inhibition preceding excitation in hilar neurons and excitation preceding inhibition in granule cells. Since non pyramidal neurons are likely to be inhibitory neurons, our data suggest that GABAergic neurons in the hilus or in the stratum lacunosum-moleculare are controlled by inhibitory GABAergic synapses. This was verified by immunocytochemistry using antibodies against glutamate decarboxylase, the gamma aminobutyric acid synthetizing enzyme. In both hippocampal regions studied, glutamate decarboxylase-positive synaptic terminals on glutamate decarboxylase positive cells were observed. It is concluded that disinhibition is an important feature of information processing in the hippocampus, and that disinhibition is mediated by GABAergic synapses on GABAergic neurons. PMID- 3537839 TI - The sources of the nigrotectal pathway. AB - The nigrotectal pathway plays a role in the generation of saccade related responses by cells in the deep layers of the superior colliculus. By using a retrograde horseradish peroxidase technique that homogeneously fills neurons, the present experiments demonstrate that the source of the nigrotectal projection to the intermediate gray layer of the grey squirrel (Sciurus carolinensis) is a heterogeneous population of neurons whose somas and dendrites are concentrated in the rostral pole of pars reticulata. This region of pars reticulata receives projections from the posterior caudate, which in turn is a target of both the pulvinar and visual cortex. In addition, these experiments reveal the presence of a second, distinct set of neurons projecting to the midbrain tectum that are located in pars lateralis of the substantia nigra. These neurons can be distinguished from those in pars reticulata by their homogeneity and by their prominent basal dendrites. Furthermore, pars lateralis of the squirrel substantia nigra is, on cytoarchitectonic and immunocytochemical grounds, a distinct subdivision that does not receive projections from the posterior caudate. We conclude that both pars reticulata and lateralis are sources of the nigrotectal pathway. In addition, our results suggest, on connectional grounds, that the rostral pole of pars reticulata may be specialized to subserve the visual guidance of orienting movements. PMID- 3537841 TI - Immunocytochemical analysis of the GABAergic innervation of oxytocin- and vasopressin-secreting neurons in the rat supraoptic nucleus. AB - Antisera specific for gamma-aminobutyric acid (GABA) or its biosynthetic enzyme, glutamate decarboxylase, were used in pre- and postembedding immunocytochemical techniques at the light and electron microscopic levels, to visualize the GABAergic innervation of the hypothalamic supraoptic nucleus. Immunostaining for glutamate decarboxylase or gamma-aminobutyric acid were also combined with oxytocin and vasopressin immunolocalization, thereby permitting evaluation of the contribution of the innervation onto each type of neuron in this nucleus. Light microscopy of semithin plastic sections or vibratome slices stained for glutamate decarboxylase or gamma-aminobutyric acid, with peroxidase-antiperoxidase as immunolabel, revealed an extensive punctate labeling in the supraoptic nucleus and its immediate surroundings. Quantitative analysis of glutamate decarboxylase immunostaining in semithin sections indicated a comparable density of immunopositive punctae at the anterior and posterior levels of the nucleus (14-27 X 10(6) per mm3 tissue). Glutamate decarboxylase- or gamma-aminobutyric acid immunoreactive cell bodies were never observed within the nucleus although they were detected in the hypothalamus immediately dorsolateral to the nucleus. Electron microscopy of vibratome slices treated with antiglutamate decarboxylase or antigamma-aminobutyric acid and peroxidase-antiperoxidase, or of ultrathin sections stained directly with antigamma-aminobutyric acid and immunoglobulin coupled colloidal gold, showed that the immuno-reactive punctae represented, in the main, axonal terminals. They invariably contained small, rounded clear vesicles and, at times, one or two larger, dense cored vesicles; they all formed symmetrical synapses onto magnocellular cell bodies and dendrites. Oxytocin and vasopressin neurons were contacted in a similar fashion by glutamate decarboxylase- or gamma-aminobutyric acid-positive boutons in semithin sections of the nucleus stained simultaneously for glutamate decarboxylase and oxytocin and in ultrathin sections stained for glutamate decarboxylase or gamma aminobutyric acid and oxytocin or vasopressin. Glutamate decarboxylase- or gamma aminobutyric acid-positive terminals often formed synapses onto two postsynaptic elements in the same plane of section ("double" synapses), a synaptic configuration usually encountered in supraoptic nuclei of lactating animals. In such cases, the postsynaptic somata were oxytocinergic.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537843 TI - Envoi: an editor leaves. PMID- 3537842 TI - Acetylcholinesterase hydrolyses chromogranin A to yield low molecular weight peptides. AB - The major soluble protein of bovine chromaffin granules chromogranin A was purified by reverse-phase high performance liquid chromatography. Brief incubations with either acetylcholinesterase or trypsin cleaved chromogranin A to yield two chromogranin-immunoreactive polypeptides which were similar in molecular weight to two of the major endogenous chromogranin polypeptides. A number of peptidase inhibitors which strongly inhibited tryptic digestion of chromogranin A also inhibited the acetylcholinesterase digestion, although they were less potent. More prolonged digestion of chromogranin A with acetylcholinesterase produced a large number of peptides which were similar to some of the endogenous chromogranin peptides in their elution profile by high performance liquid chromatography. In contrast, complete tryptic digestion of chromogranin A yielded peptides with a totally different elution profile. The experiments indicate that acetylcholinesterase possesses a peptidase activity which is similar, but not identical to trypsin, and suggest that a second non tryptic activity is also present. They also suggest that acetylcholinesterase, an enzyme found in chromaffin cells, may process chromogranin A to yield lower molecular weight chromogranins in bovine chromaffin cells. PMID- 3537845 TI - [Preoperative echographic diagnosis of cancer of the gallbladder]. PMID- 3537846 TI - [Radiological study of thyroid tumors]. PMID- 3537847 TI - [Clinical classification and staging of thyroid tumors]. PMID- 3537844 TI - Trihexyphenidyl and torticollis. PMID- 3537848 TI - Amino acid neurotoxicity: intracellular sites of calcium accumulation associated with the onset of irreversible damage to rat cerebellar neurones in vitro. AB - Electron microscopy and the combined oxalate-pyroantimonate technique were used to locate calcium in intracerebellar nucleus neurones of rat cerebellar slices subjected to a neurotoxic concentration of N-methyl-D-aspartate. After a sub lethal exposure period (5 min) calcium pyroantimonate deposits were found in swollen cisterns of the Golgi apparatus and, in lesser amounts, in the nuclei. Deposits were more prominent in the nuclei after a just-lethal exposure (10 min) when they were additionally observed within a population of swollen mitochondria and also apparently free in the dendritic and somatic cytoplasm. The results support the proposal that amino acid neurotoxicity is a consequence of an intracellular Ca2+ overload brought about by excessive Ca2+ influx. PMID- 3537849 TI - Changes of vasoactive intestinal polypeptide-like immunoreactivity in cerebrovascular nerve fibers after subarachnoid hemorrhage: an experimental study in the dog. AB - A model of subarachnoid hemorrhage (SAH) was experimentally produced in the dog by a single injection of fresh autologous arterial blood into the cisterna magna, and then changes of vasoactive intestinal polypeptide-like immunoreactivity (VIP LI) in perivascular nerve fibers were examined immunohistochemically in the proximal portions of the middle cerebral artery. Perivascular nerve fibers with VIP-LI were markedly decreased in number during the 1st week after SAH. However, they were gradually reincreased during the 2nd to 9th week after SAH to be recovered to the normal level on the 63rd day after SAH. PMID- 3537850 TI - Myelination: a critical stage in development. PMID- 3537852 TI - Clinical relevance of experimental behavioral teratology. PMID- 3537851 TI - Neurotoxicology of food additives. PMID- 3537853 TI - Food additives as a source of behavioral disturbances in children. PMID- 3537855 TI - Collaborative studies on behavioral teratology in Japan. PMID- 3537854 TI - Developmental effects of narcotics. PMID- 3537856 TI - Developmental effects of cannabis. PMID- 3537857 TI - Maternal exposure to environmental chemicals. PMID- 3537858 TI - An evaluation of figure-eight maze activity and general behavioral development following prenatal exposure to forty chemicals: effects of cytosine arabinoside, dinocap, nitrofen, and vitamin A. PMID- 3537859 TI - Carbon monoxide and brain development. PMID- 3537860 TI - Developmental effects of lead: its mechanism in intellectual functioning and neural plasticity. PMID- 3537862 TI - Methylmercury poisoning of the developing nervous system: I. Pattern of neuronal migration in the cerebral cortex. PMID- 3537861 TI - Empirical and epistemic issues in the study of low dose lead effects. PMID- 3537863 TI - Time of exposure and time of testing in developmental neurotoxicology. PMID- 3537864 TI - n-3 fatty acids in the brain and retina: evidence for their essentiality. PMID- 3537865 TI - Isotretinoin and human teratogenicity. PMID- 3537866 TI - Production of 1,25-dihydroxyvitamin D3 in skin. PMID- 3537867 TI - Role of zinc in enzyme regulation and protection of essential thiol groups. PMID- 3537868 TI - The enzymes and kinetics of hepatic retinol metabolism. PMID- 3537869 TI - Current progress in endourology. PMID- 3537870 TI - Hemophilus influenzae and Streptococcus viridans endocarditis in an intravenous drug abuser. PMID- 3537871 TI - B cell lymphoma presenting as carcinoma of the lung. AB - A patient presented with superior vena caval obstruction caused by a tumour which resembled carcinoma of the lung both clinically and histologically. However, immunologic and cytogenetic analyses carried out on the mediastinal biopsy and on pleural fluid revealed that the tumour was of B cell origin, Burkitt-like in sub type, and had the t(8;14) translocation. The nature of many poorly differentiated tumours may be more clearly identified with the help of immunological and cytogenetic analyses. PMID- 3537874 TI - Stress: finding ways to cope. PMID- 3537873 TI - Pestilence from abroad? The 1918 influenza epidemic. PMID- 3537872 TI - A comparative trial of casein or whey-predominant formulae in healthy infants. AB - This study compared two infant formulae, one casein-predominant, Vitamilk and the other whey-predominant, Nurture. The nutritional components of Nurture were modified to be more similar to breast milk. This was a six week prospective double blind study of 100 healthy infants whose mothers had decided to bottle feed. The infants receiving Nurture showed significantly greater weight gain (p less than 0.005) and growth in head circumference (p less than 0.05) than those given Vitamilk. Analysis of the red cell membrane fatty acid profiles of the two groups showed significant differences which reflected the different fatty acids in the formulae. Nurture fed infants had significantly higher oleic and linoleic acid levels (p less than 0.001) and similar arachidonic acid levels to those fed Vitamilk. In both groups the concentrations of the essential fatty acids linoleic and linolenic were satisfactory. The blood urea concentrations were significantly lower (p less than 0.001) and the serum albumin concentrations significantly higher (p less than 0.01) in the infants fed Nurture. The formulae were well tolerated by all but seven infants. Four infants fed Vitamilk changed to a different formula because of constipation accompanied by sleeping problems, while three of those fed Nurture were changed, one for constipation and two with an atopic family history because of rashes and other symptoms. Constipation was significantly less frequent (p less than 0.01) in the infants receiving Nurture. While both formulae are satisfactory milk preparations for healthy infants, Nurture appeared to be superior. PMID- 3537875 TI - Final 1987 PPS regulations issued. Financial management. PMID- 3537876 TI - The vanishing twin: pathologic confirmation of an ultrasonographic phenomenon. AB - Although the phenomenon of the "vanished twin" has been noted repeatedly through the use of ultrasound, no confirmatory histologic evidence has been presented previously. This has raised questions concerning the validity of the vanishing twin syndrome. In the following case, a triplet intrauterine pregnancy was diagnosed ultrasonographically four weeks after in vitro fertilization, but only a single fetus and placenta were delivered at term. Careful examination of the placenta revealed histologic evidence of the vanished twin. This evidence consisted of a chorion-lined sac containing amorphous material, surrounded by degenerated chorionic villi juxtaposed against a normal amniochorionic membrane. PMID- 3537877 TI - Effect of cigarette smoking on plasmatic regulation of vascular prostacyclin in pregnancy and puerperium. AB - Prostaglandins, particularly prostacyclin, participate in the control of fetal and maternal circulations. In the present study the effect of cigarette smoking on plasma prostacyclin-stimulating activity during late pregnancy and the puerperium (four to six months) and in the newborns was assessed. Plasma samples from 22 apparently healthy nonsmokers and 17 smokers (more than 15 cigarettes per day) were obtained twice during pregnancy and once after delivery. Plasma samples from nine infants born to smokers and seven infants born to nonsmokers were obtained 72 to 96 hours after birth. Plasma activity was evaluated by incubating the plasma samples with cultured rat aortic smooth muscle cells and measuring the prostacyclin released in the culture medium by specific radioimmunoassay of its stable metabolite, 6-keto-prostaglandin F1 alpha. In all of the women, plasma activity did not change significantly during pregnancy or after delivery. In smokers, plasma activity was always lower than in nonsmokers, but not significantly so. The plasma activity of infants born to smokers was significantly lower than that of infants born to nonsmokers. PMID- 3537879 TI - Circulating antiovarian antibodies in premature ovarian failure. AB - The presence of antiovarian antibodies in sera of women with premature ovarian failure was determined by an indirect fluorescent antibody assay using human ovarian tissue. Of 27 patients, 14 had positive ovarian fluorescence, compared with zero of 24 normal cycling controls (P less than .001) and one of 22 postmenopausal controls (P less than .01). In patients with autoimmune diseases, five of 17 demonstrated positive fluorescence compared with zero of 24 premenopausal controls (P less than .01). Immunoperoxidase staining revealed antigen concentrated at the granulosa cells and oocyte in nine of the 14 ovarian failure cases. The finding that a significant proportion of patients with premature ovarian failure have circulating antiovarian antibodies confirms previous studies, but localization of peroxidase staining to granulosa cells and/or oocytes represents a new finding in this study. PMID- 3537878 TI - A new marker of maturation in the cervix: the estrogen-regulated 24K protein. AB - The presence of an estrogen-regulated protein (24K) in normal, dysplastic, metaplastic, and neoplastic cervical epithelium correlates with histologic criteria for squamous cell maturation. The 24K protein, originally discovered in the MCF-7 breast cancer cell line, was studied in 51 cases by the modified immunoperoxidase Avidin-Biotin Complex method, using an anti-24K mouse monoclonal antibody. Immunostained sections were compared to hematoxylin-and-eosin-stained sections cut from the same tissue block. The 24K protein was observed to be located primarily in the parabasal or "prickle cell layer" of normal cervical tissue (6 of 7 normal cervical tissue specimens tested were positive for 24K protein. Specimens were obtained from surgery for nonneoplastic causes) and in all cases (12 of 12) of dysplasia and carcinoma in situ. Intercellular bridges of these cells showed prominent immunostaining in normal cervix and dysplasia. 24K protein was observed as a granular cytoplasmic stain in all cases of squamous metaplasia (5 of 5) and keratinizing squamous cell carcinoma (9 of 9), and in 8 of 14 cases of nonkeratinizing squamous cell carcinoma. In this latter group, immunostaining was confined to only those cells showing cytoplasmic eosinophilia on H&E sections. In no case was the presence of the 24K protein associated with areas of mature keratin. 24K immunostaining was also observed in the reserve cells of morphologically normal endocervical glands adjacent to areas of dysplasia and carcinoma. We conclude that 24K protein is associated with squamous cell maturation and may be an important marker of reserve cell hyperplasia and squamous metaplasia. PMID- 3537881 TI - [50th anniversary of the V. P. Filatov Odessa Research Institute of Eye Diseases and Tissue therapy]. PMID- 3537880 TI - Size and weight determinations of nongravid enlarged uteri. AB - Uterine size was estimated in 66 women before hysterectomy by bimanual examination, uterine sounding, and pelvic ultrasound. The results were compared with weight and dimensions recorded after removal. There was greater error in estimation of uterine size using bimanual examination (standard error of the estimate [SEE] = 2.6 weeks) or uterine sounding (SEE = 2.2 weeks) than with ultrasound (SEE = 1.06 weeks). A close correlation existed between uterine size and weight (r = 0.95). PMID- 3537882 TI - [Etiological classification of retinal detachment]. PMID- 3537883 TI - [Apitherapy in ophthalmology]. PMID- 3537884 TI - [Sclera-enhancing surgical procedures in the treatment of rapidly progressive myopia]. PMID- 3537885 TI - [Role of the cell surface in the stimulation of cell multiplication]. AB - Fertilization of eggs and effects of many growth factors on the membrane receptors of the cultured somatic cells induce similar changes in the plasma membrane transport properties, which determine changes in Ca2+ and H+ concentrations in the cytoplasm. The data are discussed which favour the concept that Ca2+ and H+ are secondary messengers of growth-stimulating influences and control many intracellular processes related to cell multiplication. PMID- 3537886 TI - [A method of culturing preimplantation mouse embryos]. AB - A modification was proposed for the method of cultivation of preimplantation mouse embryos which does not require mineral oil and strict maintenance of CO2 content of gaseous phase. PMID- 3537887 TI - HLA-A,B and DR matching in corneal transplantation. AB - One hundred eighty-five consecutive corneal transplants were performed in recipients selected on the basis of the best available HLA-A,B and DR match. Endothelial rejection-free transplant survival in this group was compared to a retrospective historical control group of 199 consecutive transplants performed in recipients selected on the basis of age and longest wait criteria. The two groups were comparable with regards to primary diagnosis, preoperative corneal vascularization, donor and recipient age, and operative techniques. Thirty-eight transplants in the study group and 28 transplants in the control group were at high risk for endothelial transplant rejection. At 12 months, the estimated rejection-free survival (Kaplan-Meier method) of the high-risk study group transplants was 87% compared to 74% for the high-risk historical control group and transplants. This difference did not reach the significant level of 0.05 with the log-rank test. The 12-month estimated rejection-free survival of low-risk study group and historical control group transplants were similar. In the study group, the 12-month estimated rejection-free survival of well-matched transplants was 95% compared to 83% for poorly matched transplants (log rank, P less than 0.02). These findings suggest that a relationship exists between HLA-A,B and DR compatibility of donor and recipient and the corneal rejection-free transplant survival. PMID- 3537888 TI - The natural history and CT appearance of acquired hyperopia with choroidal folds. AB - Seven healthy adults with acquired hyperopic change in refractive error had choroidal folds in affected eyes. High resolution computerized tomographic scanning techniques used to obtain coronal, oblique coronal, and parasagittal reformations revealed flattening of the posterior globes and mild to moderate optic nerve enlargement. In 5 of 11 eyes, a space was noted between the optic nerve and its sheath, implying expansion of the sub-arachnoid perineural compartment. The clinical findings and natural history of this syndrome, based on an average follow-up of 4.5 years, are discussed. PMID- 3537890 TI - The half-fixed and half Maryland bridge. A solution to a difficult situation. PMID- 3537889 TI - Periodontal root amputations and hemisections. Indications, technique and restorative considerations. PMID- 3537891 TI - Histologic fate of dermal grafts following implantation for temporomandibular joint meniscal perforation: a preliminary study. AB - A study was carried out to evaluate the histologic changes of meniscus perforation repair associated with dermal grafts to the temporomandibular joint of cynomolgus monkeys (Macaca fascicularis) following surgical perforation of the meniscus. Dermal grafts were studied histologically at 3-week, 6-week, 3-month, and 6-month intervals. Results showed early attachment of the dermal graft to the meniscus, followed by gradual incorporation of the graft into the meniscus and subsequent return of the meniscal-graft complex to a normal meniscal architecture. PMID- 3537892 TI - Advances in sonography of the temporomandibular joint. AB - The term sonography is used to describe the technique for recording and interpreting sound. Several authors have used sonography to study the diverse sounds emitted from the temporomandibular joints of patients with facial pain and masticatory dysfunction. This article describes recent technologic advances in sonography that permit digital computerized recordings of joint sounds. In addition, a software package was developed to perform sound-power spectral analysis. Selected cases are described. The potential of this new technology is explored. PMID- 3537893 TI - Sjogren's syndrome: clinical and laboratory features, immunopathogenesis, and management. AB - Sjogren's syndrome may be accompanied by local oral problems such as dry mouth, rampant caries, candidosis, or sialadenitis, but it is a systemic autoimmune disorder with wide repercussions, including a small premalignant potential. This article reviews the clinical and immunopathogenic features, as well as the etiology, of Sjogren's syndrome and discusses the diagnosis and management of oral complications. PMID- 3537894 TI - Significance of the head and neck in late infection in renal transplant recipients. AB - The present study was undertaken to evaluate the overall significance of the mouth and contiguous structures as sites of late opportunistic infection in renal transplant recipients, to define the flora of such infections, and to determine factors that place patients at risk of infection. Of 323 patients who underwent renal transplants, 57% developed infection at least 1 month postoperatively. Sex, donor source, or age did not influence the risk of infection. Of the posttransplant infections, 30.6% occurred in the head and neck, 21.9% in the respiratory tract, 23.7% in the urinary tract, and 10% at sites of trauma. Of head and neck infections, 16.4% were bacterial, 20.5% were viral, and 21.9% were fungal. In the remainder a definitive causative organism could not be identified. These results emphasize that the head and neck area is a major site of late opportunistic infection in renal transplant recipients. PMID- 3537895 TI - Facts about gonorrhea and dentistry. AB - This article reviews gonorrhea and discusses various misconceptions that have appeared in the dental literature and in verbal presentations about gonorrhea and dentistry. Facts are presented and some conclusions are offered for the dental profession. PMID- 3537896 TI - Expression of blood group H antigen by normal, benign, and carcinoma cells of the oral epithelium: immunohistochemical study using monoclonal antibody RS13. AB - The H antigen was investigated by an indirect immunoperoxidase method in sections of 65 surgical specimens from the oral mucosa. These comprised 29 squamous cell carcinomas, 28 benign lesions, and 8 specimens of clinically healthy mucosa. A monoclonal antibody (RS13) was used to identify the H antigen. The peroxidase stain was positive at high dilutions of the antibody in the epithelium of normal mucosa, and the titers were significantly higher than those within benign lesions (p less than 0.001) and carcinomas (p less than 0.001). However, the titers in the benign lesions varied considerably, with two specimens recorded as negative. In contrast, the reaction for the H antigen was negative in 19 specimens (66%) of the malignant lesions and the endpoint titers of the H positive carcinomas indicated marked loss of the antigen. This loss was significant when compared to the benign lesions (p less than 0.001). The results show that the loss of the H antigen on malignant epithelial cells may be a valuable marker for primary squamous cell carcinoma. PMID- 3537897 TI - Estimation of alveolar crest height using routine periapical dental radiographs. AB - The reproducibility of estimations of the alveolar crest height based on their relationship to two other fixed points on the tooth has been analyzed in a study of 302 routine periapical radiographs of 96 endodontically treated teeth. The radiographs were made at normal recall appointments by use of the extension tube paralleling technique. The various distances between four fixed points on each tooth in any radiographic series were compared by means of a statistical model. The results indicate that, in periodontal follow-up studies, completely standardized projection of the structures onto the film is unnecessary since measurements of the crest height can be related to any suitable fixed measuring standard on the tooth. PMID- 3537898 TI - Vertigo-reducing effect of ginger root. A controlled clinical study. AB - The effect of powdered ginger root (Zingiber officinale) upon vertigo and nystagmus following caloric stimulation of the vestibular system was studied in 8 healthy volunteers in a double-blind crossover placebo trial. The results reported are based upon 48 vertigo scores and 48 electronystagmograms. Ginger root reduced the induced vertigo significantly better than did placebo. There was no statistically significant action upon the duration or the maximum slow phase velocity of nystagmus. PMID- 3537899 TI - Use of a diuretic (Dyazide) in the treatment of Meniere's disease. A double-blind cross-over placebo-controlled study. AB - In 33 Meniere patients (42 ears) the therapeutic effects of Dyazide (50 mg triamterene and 25 mg hydrochlorothiazide) were investigated in a cross-over placebo-controlled study. The hearing was measured by tone and speech audiometry whereas tinnitus and vertigo were recorded using fixed scales. In this study, Dyazide was found to have no significant effect on hearing or tinnitus. However, the vestibular complaints decreased significantly during the Dyazide treatment. Ears with a positive glycerol or furosemide test and ears with a fluctuating hearing loss did not show significant differences in hearing thresholds between the two periods in the trial. Of the 33 patients 17 had a distinct preference for Dyazide whereas 3 patients chose the placebo. The remaining 13 patients had no preference. PMID- 3537900 TI - [Use of chymotrypsin in the surgical treatment of benign tumors and tumor-like diseases of the bones in children]. PMID- 3537901 TI - [History of the creation of the 1st department and clinic of traumatology and orthopedics in Russia and the USSR]. PMID- 3537903 TI - [Plasma glucagon and insulin profile in obese non-diabetic and non-insulin dependent diabetic patients on a daily 800 calorie diet]. PMID- 3537902 TI - [The effect of the Ca2+ antagonist diltiazem on the respiratory function in chronic obstructive lung diseases]. PMID- 3537904 TI - [Transient neonatal hyperglycemia]. PMID- 3537906 TI - [Disulfiram (anticol) psychoses]. PMID- 3537905 TI - [Effect of bezafibrate therapy on serum and lipoprotein lipids]. PMID- 3537907 TI - [BCG immunotherapy in the treatment of superficial bladder tumors]. PMID- 3537908 TI - [The Lorand Jendrassik commemorative medal]. PMID- 3537909 TI - [Frigyes Verzar, medical historian]. PMID- 3537911 TI - [In memory of Hugo Preisz (1860-1949)]. PMID- 3537910 TI - [Remembering Pavlov on the 50th anniversary of his death]. PMID- 3537912 TI - [Incidence of suppurative lymphadenitis caused by BCG vaccination in Hungary]. PMID- 3537913 TI - [Nesidioblastosis in an adult]. PMID- 3537914 TI - [Experience with the determination of antibodies against islet cells]. PMID- 3537915 TI - [Significance of non-immune hydrops fetalis (based on 8 cases)]. PMID- 3537916 TI - [50th anniversary of the death of Ferenc Poor]. PMID- 3537917 TI - [Endre Hogyes, microbiologist. Centenary of the Hungarian "fix virus"]. PMID- 3537918 TI - [Otolaryngologic side effects of oral contraceptives]. PMID- 3537919 TI - A review and clinical perspective on the use of EMG and thermal biofeedback for chronic headaches. AB - A comprehensive survey of EMG and thermal biofeedback for chronic muscle contraction and migraine headaches is presented. The studies done to date suggest a high degree of short-term efficacy of biofeedback, which has been maintained on long-term follow-ups. While comparisons of biofeedback with relaxation generally have shown approximately equivalent effectiveness, the two forms of therapy may be differentially effective with different subjects. Attempts to correlate EMG and/or thermal parameters with headache parameters generally have failed to produce significant results, particularly in more recent and better-controlled studies; however, numerous technical and procedural difficulties have obscured meaningful interpretation of physiological data. Results with pseudofeedback do suggest a likely specific contribution of frontalis EMG to muscle contraction headaches, at least for some subjects. Comparable evidence for a specific contribution of thermal parameters to migraines is almost totally lacking. Clinical outcome research suggests that biofeedback in general may be more effective in younger anxious subjects who show no chronic habituation to drugs, and that there is little apparent benefit from repeating biofeedback for more than about 12 sessions maximum. Three broad areas for subsequent research are suggested: longitudinal study of EMG and thermal parameters in a naturalistic setting, specification of processes critically involved in biofeedback, and clinically relevant comparative outcome research with biofeedback and alternative therapies. PMID- 3537920 TI - James Daniel Hardy (1904-1985). Tribute to a pioneer in pain psychophysics. PMID- 3537921 TI - Synchronization of Plasmodium falciparum gametocytes using an automated suspension culture system. AB - An automated suspension culture system for the cultivation of Plasmodium falciparum is described which retains a degree of flexibility which is absent in other automated culture apparatuses. Not only does this system of cultivation promote rapid multiplication of asexual parasites but also permits the development and maturation of gametocytes. Using a combination of gelatin flotation and N-acetyl glucosamine treatment synchronous development of gametocytes was achieved. The total time for gametocyte maturation in vitro under the conditions provided was 7 days. Stages II and V required 48 h for development whilst I, III and IV needed 24 h each. Mature microgametocytes were relatively long lived in comparison with macrogametocytes. Electron microscopic study of the synchronized stages confirmed the observations of Sinden (1982) but, in addition, we noted the presence of Garnham bodies, a cytostome in all stages and dense spherules in stages I-III similar to the fenestrated buttons in sporozoites and exoerythrocytic forms. The relationship between the number of osmiophilic bodies in the mature gametocytes and their ability to escape from the red cell is reaffirmed. PMID- 3537922 TI - The mechanism of pyrimethamine resistance in Plasmodium falciparum. AB - The uptake of radioactive pyrimethamine by a sensitive and a resistant strain of Plasmodium falciparum, the metabolic fate of pyrimethamine inside these parasites and the kinetic properties of dihydrofolate reductase (DHFR) from both strains have been studied. Uptake of the drug was identical in both strains and no metabolite of pyrimethamine was found in either strain. DHFR from the resistant strain was 300 times less sensitive to inhibition by pyrimethamine than the enzyme from the sensitive strain, while the Michaelis constant for dihydrofolate remained unchanged and inhibition was competitive in both cases. Altered properties of plasmodial DHFR are apparently the only mechanism responsible for pyrimethamine resistance in the strain of Plasmodium falciparum studied. PMID- 3537923 TI - Seasonal and age distributions of Babesia, Hepatozoon, Trypanosoma and Grahamella species in Clethrionomys glareolus and Apodemus sylvaticus populations. AB - Four common blood parasites belonging to the genera Babesia, Hepatozoon, Trypanosoma and Grahamella were detected in sympatric populations of Clethrionomys glareolus and Apodemus sylvaticus. Seasonal changes in the abundance of hosts and parasites were monitored in a longitudinal field survey for 18 months. All parasites in both hosts showed similar seasonal patterns with most transmission occurring in summer and autumn and ceasing in winter. Amongst aged subsets of each host population, Hepatozoon and Grahamella spp. were primarily parasites of young animals whereas Babesia and Trypanosoma spp. generally infected older hosts. Data from the aged subsets were also used to estimate values for the basic reproductive rate, R0, for each parasite. In C. glareolus, R0 = 2.0 for B. microti, 2.6 for H. erhardovae, 1.7 for T. evotomys and 2.8 for Grahamella sp. In A. sylvaticus R0 = 2.2 for Grahamella sp. These estimates are probably representative only for summer and autumn of each year. PMID- 3537925 TI - [Cooperation between oncogenes: the function of immortalizing oncogenes]. PMID- 3537924 TI - Quantitative and qualitative changes in production of excretions/secretions by Litomosoides carinii during development in the jird (Meriones unguiculatus). AB - Excretions and secretions (E-S) were collected from a series of developmental stages of Litomosoides carinii maintained in vitro. Measurement of the protein content of E-S obtained from each stage indicates that the rate of production of E-S varies enormously during development of the worm. E-S was iodinated using both Iodogen and the Bolton and Hunter Reagent and was also biosynthetically labelled by incubating worms in the presence of [35S]methionine and [3H]leucine. Attempts to biosynthetically label E-S of mature worms and microfilariae with [3H]glucose were unsuccessful. Examination of radio-isotope labelled E-S by SDS PAGE revealed that some components were sex specific and that the differences in total E-S production during development were due to the existence of both stage specific components and components whose rate of release varied during parasite maturation. Antigenic characterization of E-S, carried out by immunoprecipitation in combination with SDS-PAGE, indicated that E-S consists of immunogenic components, a molecule which is probably a non-immunogenic parasite product, and host albumin. The implications of these findings for the construction of diagnostic tests to detect products of human filarial parasites are discussed. PMID- 3537926 TI - [Chromosome polymorphism in allogeneic bone marrow grafts. Methods and results]. AB - Cytogenetic studies using constitutive heterochromatin variations represent one of the best method in documentation of allogeneic bone marrow transplantation (BMT). Sex mismatched transplants are evaluated by gonosomal examination. In sex matched patients, several banding techniques are performed before BMT to detect autosomal polymorphism in donor and recipient. Can be informative: chromosomes 3 and 4 centromere, acrocentric centromere and satellites, chromosomes 1, 9 and 16 secondary heterochromatic constriction. Authors describe their methodology for these studies and results about 81 patients. PMID- 3537927 TI - [Giardia intestinalis: comparative study of lipid and nitrogen fecal excretions in adults and children with parasites]. AB - 10,000 faeces samples-from 9,120 adults and 880 children were examined to evaluate the faecal excretions. Giardia intestinalis was identified in 111 of those samples (84 adults and 27 children). A higher infection rate of G. Intestinalis was observed in child and male adult groups. Nitrogen excretion was evaluated and compared with fat excretion for the first time in the case of giardiasis. When malabsorption was obvious, both fat and nitrogen increased with generally moderate values. The malabsorption was much more frequent among children (88.9%) than among adults (26%) (p less than 0.001). These results could explain the fast settlement and the frequency of growth troubles in childhood. Giardiasis should be systematically and carefully investigated in a malabsorption in the person of a child. PMID- 3537928 TI - [Presence of immunoglobulins and complement in the walls of the coronary arteries in atherosclerosis]. AB - A histopathological and histoimmunological comparison was performed on 143 fragments on coronary arteries taken from 43 patients who died of ischemic heart disease and from 20 patients who died of other diseases. The immunological study research of Ig (A, G, M) and C3 fraction of complement in the 3 coronary layers was done by the immuno-peroxidase technique. The fixation was essentially observed in fibromyocytes. A good correlation existed between atherosclerosis lesions and fixation of Ig and C3 fraction of complement in both the media and the intima. On the other hand, this correlation was not observed in the adventitia. Accumulation of immunoglobulins and of the C3 fraction of complement in atherosclerosis seemed specific and proportional to the degree of arterial well lesion. The significance and the role of this accumulation remains to be studied. It may be hypothesized that Ig and complement fixation on fibromyocyte cell receptors or on the fibrous tissue fundamental substance is followed by the formation of antigen-antibody complexes, which act as foreign bodies which are either responsible for (or a reflection) of the onset of lesions or, at least, of their increasing severity or their persistence. PMID- 3537929 TI - [Prevalence of viral hepatitis B markers in a sample population seen at a center of preventive medicine]. AB - The frequency of hepatitis B markers was studied on 992 subjects attending health examinations in Preventive Medicine Center of Vandoeuvre-les-Nancy. The aim of this work was to precise some epidemiological factors in this population. Results of this study have specified that 9% of individuals have shown signs of past infection and 0.3% of subjects having at least one marker were positive for the HBs-antigen. Most results agree with the literature and markers prevalence was found associated with some parameters as age and ethnic origin. PMID- 3537931 TI - [Diffusion of ceftriaxone in human bone tissue]. AB - Ceftriaxone diffusion into spongious and cortical bone after single 2 g dose by intravenous injection was studied in 40 patients undergoing total hip replacement. Serum and tissue assays were performed by HPLC and microbiological method 2, 4, 12 and 24 hours after administration. Both methods produced similar results. Antibiotic levels (HPLC) were 19.3 +/- 7.3; 16.9 +/- 9.2; 11.2 +/- 4.7 and 5.6 +/- 2.7 micrograms/g in spongious bone at hours 2, 4, 12 and 24, and 6.5 +/- 1.6; 3.1 +/- 0.7; 3.3 +/- 1.1 and 2.2 +/- 0.4 micrograms/g in cortical bone at the same times. The tissue/serum ratios were 14% for spongious bone and 5% for cortical bone after 2 hours. At hour 24 these ratios were 21% and 8% in spongious and cortical bone respectively. These tissue levels remain higher than ceftriaxone MIC for most Enterobacteriaceae strains until hour 24. PMID- 3537930 TI - [Choice of a rapidly bactericidal beta-lactamin-aminoglycoside combination in the treatment of Pseudomonas aeruginosa infections at a child intensive care unit]. AB - Morbidity and mortality among children with Pseudomonas aeruginosa infection in Pediatric Intensive Care Unit remains high. Delays in bacterial killing may be responsible for the poor outcome. Antimicrobial sensitivity and timed-killing assays were determined for ticarcillin, azlocillin, piperacillin, cefsulodin, ceftazidime, gentamicin, tobramycin and amikacin alone and in combination against 40 strains of Pseudomonas aeruginosa isolated from blood cultures and tracheal aspirate. Antibiotic concentrations used were at clinically achievable level. None bactericidal effect was observed with each beta-lactamin alone. However with the combinations azlocillin or piperacillin or cefsulodin or ceftazidime plus amikacin a bactericidal effect was observed at 4.5 hours. PMID- 3537933 TI - [Malaria: the end of a multimillenia reign?]. AB - Malaria is one of the oldest and more pervasive diseases of mankind with half of the world's population still meeting with Plasmodium. The resistance of the parasite and its carrier, anopheles, at the current levels of antimalaria programs results in recurrence of this illness among the less developed tropical zones. The high risk groups for malaria are pregnant women and children, resulting in a delay of intra-uterine growth, neonatal/infantile morbidity and mortality. Recent progress in molecular biology provide new perspectives for preventive and curative solutions, more specifically in the relationship between host and parasite. PMID- 3537932 TI - [Diuretics]. AB - Microaspiration techniques and clearance studies have shown that reabsorption of filtered sodium approximates 65% in the proximal tubule, 25 to 30% in the ascending limb of the loop of Henle and 5 to 10% in the dilution segment. Reabsorption in the Henle loop is of special significance as it governs the process of dilution-concentration of urine. Moreover, inhibition of sodium reabsorption in the loop of Henle necessarily produces a substantial loss of sodium since only a fairly small fraction of urinary sodium is reabsorbed beyond the Henle loop (dilution segment, distal tubule). Excretion of water and electrolytes is regulated by humoral factors, such as the renin-angiotensin aldosterone system, some prostaglandins and certain kinins. Factors that promote excretion of sodium, produced in particular by the myocardium, have recently been demonstrated. The correlation between blood pressure and salt has been substantiated by many findings. Diuretics are commonly used to treat high blood pressure as well as edema. Recent evidence indicates that sodium transport is altered in idiopathic hypertension, at least in red blood cells. Clinical trials of diuretics are designed to localize the drug's action and quantify its saluretic activity (evaluation of potency and effectiveness--single doses, sustained treatment). Furthermore, the minimal efficient antihypertensive dosage should be determined. Diuretics can be divided into two groups according to whether they produce an increase or decrease in serum potassium. Diuretics that are capable of producing hypokalemia belong to two main families. One consists of the Henle loop diuretics that interfere with the mechanisms of dilution concentration of urine. Action of these drugs is potent and short-lived. For instance, following a single dose of furosemide, excretion of sodium can reach 25 30% of filtered sodium; renal blood flow increases; CH2O and TCH2O decrease. With furosemide, induction of diuresis is rapid (within a few minutes after IV injection and 20 mn after oral ingestion); elimination half-life is 50 mn; absolute bioavailability is 50-70%; 95% of the drug is bound to plasma proteins; elimination is mainly through the kidneys. Other Henle loop diuretics include ethacrynic acid, whose elimination half-life is less than one hour; bumetanide, which is 40 times more potent than furosemide; muzolimine, whose action is more lasting despite the fact that only 65% of the drug is bound to plasma proteins; and ozolinone, which has a saliuretic action comparable to that of furosemide and in addition exerts a direct vasodilating effect.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3537934 TI - [Action of isoconazole on Candida albicans. Study by scanning and transmission electron microscopy]. AB - Candida albicans yeast cells were treated prior to their growth phase with isoconazole at the following concentrations: 0.1 microgram/ml, 1 microgram/ml, 10 micrograms/ml), isoconazole induces a blockade of cell diprecipitates bearing witness to the presence of polysaccharides were noted in the cytoplasma and against the membrane wall, but cell division was apparently unaffected. At low concentrations (1 microgram/ml, 10 microgram/ml), isoconazole induced a blockade of cell division by its fungicidal action on synthesis and organisation of the membrane wall. At higher concentrations (50 microgram/ml; 100 micrograms/ml), isoconazole induces total necrosis and death. These findings confirm the analogy between the fungicidal actions of isoconazole and miconazole; however, the site of action of imidazole derivatives (wall or plasma membrane) is discussed. PMID- 3537935 TI - [Interactions of ceftriaxone with beta-lactamases including those which hydrolyze cefotaxime]. AB - As it occurs with most of 3rd generation cephalosporins, ceftriaxone has few, if any, interactions with penicillinase-type beta-lactamases, such as TEM-1, TEM-2 or PIT-2. These poor interactions are characterized by an extremely low hydrolysis, associated to a poor affinity of these compounds for the penicillinases. Conversely, ceftriaxone, as cefotaxime, shows a high affinity for chromosomally-mediated cephalosporinases (indole-positive Proteus, Enterobacter, Pseudomonas...), which is characterized by Ki values ranging from about 0.05 to 1 microM. Within these beta-lactamases, the hydrolysis of ceftriaxone, as that of cefotaxime, is always low, but significant. Then few beta-lactamases are able to hydrolyze more efficiently cefotaxime, as cefuroxime, such as those produced by P vulgaris and K oxytoca. Within these enzymes, ceftriaxone is also hydrolyzed, in a way quite similar to that of cefotaxime. PMID- 3537936 TI - [Radioimmunoassay of 5-androstene-3 beta, 17 beta-diol in plasma and breast cyst fluid]. AB - A simple and reliable radioimmunoassay for the determination of 5-androstene-3 beta,17 beta-diol (5-Adiol) in peripheral plasma and in breast cyst fluid, after chromatography on Celite microcolum has been described and evaluated. The antiserum used was raised in the rabbit injected with dehydroepiandrosterone-15 alpha-carboxymethyl-bovine serum albumin. In men below 40 years of age the levels ranged from 0.85 to 2.80 ng/ml (mean +/- SEM: 1.52 +/- 0.11; n = 24) and from 0.50 to 2.20 ng/ml (mean: 0.93 +/- 0.09; n = 20) in men aged between 41 and 62 years. The mean level was significantly different (p less than 0.001) between the two groups. A significant correlation (r = -0.56 p less than 0.01) was demonstrated between age and all male levels. In women the mean plasma level was in the follicular phase: 0.81 +/- 0.07 ng/ml (range: 0.40 - 1.50; n = 17; age: 19 41 years) and in the luteal phase: 0.83 +/- 0.05 ng/ml (range: 0.40 - 1.30; n = 29; age: 18-43 years). No cyclical change and no correlation with age could be evidenced. A significant difference (p less than 0.001) was shown between females and the young male group. In breast cyst fluid the levels of unconjugated 5-Adiol ranged from 0.05 to 13.70 ng/ml (mean: 2.21 +/- 0.73; n = 23) whereas the sulfate concentrations ranged from 75 to 7,500 ng/ml (mean: 1,973 +/- 543; n = 18), thus demonstrating very wide inter-individual variations. PMID- 3537937 TI - [Recognition of the activated form of estrogen receptor bound to estradiol and tamoxifen by a monoclonal antibody]. AB - Two forms (alpha and beta) of the estrogen receptor were differentiated in the cytosol fraction of fetal guinea pig uterus by using a monoclonal antibody (D 547). Only the alpha form is recognised by the monoclonal antibody, shifting its sedimentation coefficient in high salt sucrose gradients, from 4.5 S to 7.5 S. Dynamic studies of the translocation of the receptor to the nucleus show a correlation between the decrease of the alpha form in the cytosol and the increase of the nuclear receptor concentration, suggesting that the alpha form translocates to the nucleus. Several factors such as time, temperature and high salt concentrations provoke a transformation of the beta form initially found in the cytosol, to the alpha form and induce the activation of the receptor, determined by an increase in its binding to DNA-cellulose. Sodium molybdate inhibits the transformation to the alpha form and the receptor activation. These data suggest that the alpha form, which is recognised by the antibody, is the activated form of the receptor. On the other hand, the estrogen receptor bound to tamoxifen can be activated by time, temperature and high salt concentrations and the activated form of the tamoxifen-receptor complex is also recognised by the monoclonal antibody D 547. However, the interaction with the monoclonal antibody and the binding to DNA-cellulose are less than those of the estradiol-receptor complex. These data support the hypothesis that the action of tamoxifen is related to its interaction with the estrogen receptor. PMID- 3537938 TI - [Comparison of the secretion of growth hormone during sleep and after pharmacologic stimulation. Results of treatment with hGH in cases of dissociated secretions]. AB - Maximal response (peak) of growth hormone (GH) after conventional pharmacologic stimuli have been compared to maximal level reached during sleep in 215 children (123 prepubertal, 92 early pubertal) (group A). A weak correlation (r = 0.37, p less than 0.001) was observed. Five sub-groups of patients could be distinguished according to their GH pharmacologic or sleep peaks: 115 with normal secretion in both cases (I), 10 with complete deficiency (II), 27 with partial deficiency (III), 34 with normal GH sleep secretion and low responses to stimuli (IV) and 29 with the inverse situation (V). A second group (B) of 30 very short children (17 prepubertal and 13 early pubertal) had borderline or variable responses after several pharmacologic stimuli. hGH therapy was done to every patients of sub group A II, 12 of sub-group A III, 9 of subgroup A IV, 5 of sub-group A V and every one of group B. A sharp rise of growth rate has been obtained with hGH in every patients of sub-groups A II and A III, in 10 out of 14 patients of sub groups A IV and A V and in almost all patients of group B. A sharp rise of growth rate has been obtained with hGH in every patients of sub-groups A II and A III, in 10 out of 14 patients of sub-groups A IV and A V and in almost all patients of group B. hGH effect in the three last kinds of patients, with atypical GH secretion, was better in those who were in early puberty.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3537939 TI - [Use of hormonal parameters of phospho-calcium metabolism as a means of discriminating bone and joint disorders in patients with renal insufficiency]. AB - Serum carboxyterminal parathyroid hormone (PTH) concentration (homologous measurement of the 53-84 fragment and heterologous bovine measurement) has been measured and correlated with both clinical and radiological findings of secondary hyperparathyroidism (HPT), studied quantitatively according to a score published in literature, in 95 patients with chronic renal failure on maintenance hemodialysis. Mean serum PTH concentration (53.84) is statistically higher in patients with severe clinical and radiological evaluation of HPT than in patients with moderate or slight manifestations of HPT (M +/- DS: 515.8 +/- 243.7 pg/ml VS 271.3 +/- 166.1 pg/ml p less than 0.001). However, even with high serum concentration, serum PTH level does not allow to predict HPT severity, suggesting a retention of PTH fragments in serum without biologic activity probably. PMID- 3537940 TI - [Feedback of the magnesium ion on the parathyroid hormone: differences in the action of magnesium sulfate and pyrrolidone carboxylate]. AB - Fourty-five minutes after an intravenous injection of Mg SO4 (170 mg of element Mg), in 7 young and healthy men, a significant decrease in circulating 53-84 PTH has been observed. An injection of magnesium pyrrolidone carboxylate (170 mg of Mg) failed to induce changes in plasma levels of PTH. The urinary excretion of Mg was 2-fold higher after the injection of Mg SO4 than after the injection of magnesium pyrrolidone carboxylate. For both magnesium salts used, the time patterns of plasma magnesium concentrations were the same and red blood cells magnesium was not increased. These results suggest that, in our experimental conditions, the retention of magnesium was higher after magnesium pyrrolidone carboxylate than after Mg SO4 and that the drop in plasma PTH could partly explain the larger urinary excretion of magnesium after Mg SO4. PMID- 3537941 TI - [Laminin: biosynthesis, structure and functions]. AB - Biosynthesized by epithelial, endodermal and Swann type cells, laminin (Lam) is a cross shaped multifunctional glycoprotein formed by the multimeric assembly of subunits which result from the activation of several genes. In vivo, depending on its location, because of its adhesive properties and multivalent affinities, Lam is in association as a part of supramolecular complexes together with compounds of the plasma, the basement membrane and the cell coat. In the basement membrane (MB) Lam has structural and functional roles. It may also be adsorbed on the cell coat or secreted. It is interacting with epithelial cells by the way of a plasma membrane receptor and has a role to play in cellular differentiation and proliferation. Lam is a molecular link of epithelial cells to MB. These features implicate the molecule in organogenesis, embryogenesis and post-traumatic healing. As a structural component of MB and as an attachment factor, Lam is involved: 1 in tumoral invasion which allows metastatic spreading, 2 in homing because metastatic cell display an increased receptivity to the molecule. The study of Lam expression, Lam receptivity and their factors of control should lead to a better understanding of the biochemical and molecular basis of differentiation, embryogenesis, organogenesis and metastasis. PMID- 3537942 TI - Principles of interpretation and reporting in clinical microbiology. PMID- 3537944 TI - Clear cell carcinoma of the thyroid. PMID- 3537943 TI - Antibody probes in the diagnosis of anaplastic tumours. I. Malignant round cell tumours. AB - The introduction of hybridoma technology has rapidly expanded the scope of immunohistological analysis in the identification of anaplastic malignant tumours. High affinity antibodies now allow the detection of a wide range of tissue-specific antigens so that anaplastic tumours can be accurately classified without the need for costly and often unrewarding, time-consuming ancillary investigations such as electron microscopy, cell culture and chromosomal studies. This review examines the application of a panel of commercially available antibodies of proven specificity, chosen to allow separation of the various entities considered in the differential diagnosis of anaplastic round cell tumours. The specifications of the antibodies are discussed and details of selected cases are provided to illustrate the role of such tissue-specific antibodies as diagnostic probes. PMID- 3537946 TI - Radionuclide bone scintigraphy in pediatric orthopedics. AB - Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the "toddler's fracture," sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. PMID- 3537945 TI - A comparative analysis of the conditional reflex discoveries of Pavlov and Twitmyer, and the birth of a paradigm. AB - Research on conditional reflex (CR) in Pavlov's Physiological Laboratory has preceded Twitmyer's work on conditioning at the University of Pennsylvania by 3 or 4 years. The events in Pavlov's laboratory lead toward the postulation of a new paradigm that rejected the Cartesians conceptualization of the reflex as a mechanistic response to stimuli by replacing it with the Darwinian notion of the organism's adaptation to the environmental conditions. The Pavlovian paradigm rejected the Wundtian method in favor of the objective, conditional reflex method. PMID- 3537947 TI - [Clinical course and pathogenesis of Schonlein-Henoch nephropathy]. PMID- 3537948 TI - [Activities of the Wilno Pediatric Center]. PMID- 3537949 TI - Primary care pediatrics and child psychopathology: a review of diagnostic, treatment, and referral practices. PMID- 3537950 TI - Neonatal pemphigus vulgaris. AB - The case history of a baby with neonatal pemphigus vulgaris is presented. This is the 13th case of pemphigus vulgaris during pregnancy reported in the literature. The correlations between the clinical, histologic, and immunofluorescent findings are discussed and a review of all previously reported cases is presented. PMID- 3537951 TI - Periventricular intraparenchymal echodensities in the premature newborn: critical determinant of neurologic outcome. AB - Controversy exists concerning the degree of importance of periventricular intraparenchymal echodensities (IPE) observed on neonatal ultrasound scans in the determination of subsequent neurologic disability in premature infants. In this report, IPE was studied in 75 infants weighing less than 2,000 g at birth to determine the basic characteristics of the lesion, the likely pathogenesis, the outcome, and the aspects of the ultrasonographic appearance in the acute period of neonatal illness that are important for prediction of outcome. IPE was defined as any periventricular echodensity greater than 1 cm in at least one dimension. IPE was strikingly associated with large areas of intraventricular hemorrhage (IVH) (81% of cases). IPE was distinctly asymmetric. Thus, the lesion was either exclusively unilateral (67%) or bilateral with marked predominance on one side. The associated IVH was asymmetric in approximately 80% of cases, and in all 50 cases of large asymmetric IVH, IPE occurred on the same side as the larger amount of intraventricular blood. Moreover, more than 50% of such cases of IPE associated with large asymmetric IVH were progressive. Neuropathologic correlation showed that IPE represented hemorrhagic necrosis of periventricular tissue. Concerning pathogenesis, these data raise the possibility that large asymmetric IVH is related etiologically to IPE. Outcome varied with the severity of the IPE. Thus, the mortality rate among the 38 infants with extensive IPE was 79%. Of the survivors with extensive IPE, all had subsequent major motor deficits and all but one exhibited cognitive function less than 80% of normal. Among the 37 infants with localized IPE, the mortality rate was 38%. Of the survivors, although 79% had major motor deficits, 43% had cognitive function greater than 80% of normal. Thus, the findings demonstrate that with extensive IPE there is little or no chance for survival with normal neurologic and cognitive outcome, but with localized IPE, although major motor deficits are common, an appreciable proportion of infants have cognitive function in the normal range. Careful, quantitative assessment of the ultrasonographic features of IPE in the acute period of illness in the premature infant is of major value in estimating outcome. PMID- 3537952 TI - [Nephropathy in acute drug poisoning]. PMID- 3537954 TI - Diploma programs in nursing accredited by the NLN 1986-87. PMID- 3537953 TI - Eupatorium cannabinum L. A review emphasizing the sesquiterpene lactones and their biological activity. AB - A review on Eupatorium cannabinum L. is given, including botany, history and constituents. The sesquiterpene lactones are discussed in more detail, covering their biosynthesis, isolation, analysis and biological activity. Special attention is paid to the cytotoxic and antitumour activities of the sesquiterpene lactones. PMID- 3537955 TI - Structure of the RESA gene of Plasmodium falciparum. AB - We have determined the nucleotide sequence of the gene encoding the ring-infected erythrocyte surface antigen (RESA) of Plasmodium falciparum, an antigen that has been shown to confer protective immunity on monkeys. The sequence has enabled us to predict the structure of the RESA gene and the amino acid sequence of its protein product. The gene consists of two exons with a short intron located near the 5' end of the coding region. A hydrophobic amino acid segment predicted for the 3' end of exon 1 is consistent with the possibility that exon 1 encodes trafficking signal sequences. We show that restriction fragment length polymorphisms can be used to define two different alleles of RESA, represented by isolates FC27 and NF7, and compare the FC27 sequence with that of a long cDNA clone from NF7 described previously. PMID- 3537956 TI - Transcriptional arrest within the first exon is a fast control mechanism in c-myc gene expression. AB - DMSO (dimethylsulfoxide), a potent inducer of granulocytic differentiation in HL60 cells, causes a rapid decrease of cytoplasmic steady state c-myc RNA. This decrease is regulated mainly at the level of transcript elongation. Elongation is blocked within the untranslated c-myc leader. Twelve hours after transcriptional shut off of c-myc, DNAase I hypersensitive site II was still detectable, indicating that closing of this site upstream of the gene does not correlate with reduction in the steady state level of c-myc RNA. PMID- 3537957 TI - The relationship between mRNA stability and length in Saccharomyces cerevisiae. AB - A rapid and convenient procedure has been developed for the measurement of mRNA half-life in S.cerevisiae using the transcriptional inhibitor, 1,10 phenanthroline. A range of half-lives from 6.6 +/- 0.67 minutes to over 100 minutes, relative to the stability of the 18S rRNA control, has been obtained for fifteen mRNAs. They include the pyruvate kinase and actin mRNAs, as well as 13 randomly picked mRNAs of unknown function. The mRNAs clearly fall into two populations when their lengths and half-lives are analysed; one population is considerably more stable than the other when mRNAs of similar length are compared. Also, within each population, there is an inverse relationship between mRNA length and half-life. These results suggest that mRNA length and at least one additional factor strongly influence mRNA stability in yeast. PMID- 3537958 TI - Effect of site-specific DNA methylation and mutagenesis on recognition by methylated DNA-binding protein from human placenta. AB - Methylated DNA-binding protein (MDBP) from human placenta is the first protein shown to bind specifically to certain DNA sequences only when they are methylated at cytosine residues. Among the sites recognized by MDBP is pB site 1, a pBR322 derived sequence which has a high affinity for MDBP when methylated at all CpG positions. We have substituted pB site 1 with 5-methyl-cytosine (m5C) residues at one to three of its CpG dinucleotides on one strand by the use of m5C-containing oligonucleotides. MDBP binds best when all three CpG dinucleotides in the region 5'-ATCGTCACGGCGAT-3' are methylated. Even more binding is obtained when both strands are methylated. Alteration of various residues in this binding site by oligonucleotide-directed mutagenesis decreased the binding. However, two mutations which increased the dyad symmetry of part of the binding site yielded ligands with a higher affinity for MDBP. PMID- 3537959 TI - Chromogenic identification of oligonucleotide-directed mutants. AB - We describe a simple plaque color assay for identifying oligonucleotide-directed mutations in cloned DNA fragments. The basis of the method is to: fuse the sequence of interest in-frame to the E.coli lacZ gene to produce a blue plaque phage, mutate the site of interest to a stop codon to generate a white plaque phage, and revert the stop codon and surrounding nucleotides to give a blue plaque phage containing one or more desired amino acid changes. The advantages of this cyclic method are that it produces truncated as well as amino acid substituted protein molecules, it can be repeated to introduce additional mutations, and it eliminates the need for labor intensive screening. Essentially any piece of DNA can be mutated using this method if the fragment has one open reading frame. If there is an open reading frame between the site and the lacZ gene, ATG codons can be inserted at the target site. We have used this method to produce termination and amino acid substitution mutants in the yeast CUP1 gene. PMID- 3537960 TI - Complete nucleotide sequence of the Escherichia coli recB gene. AB - The complete nucleotide sequence of the Escherichia coli recB gene which encodes a subunit of the ATP-dependent DNase, Exonuclease V, has been determined. The proposed coding region for the RecB protein is 3543 nucleotides long and would encode a polypeptide of 1180 amino acids with a calculated molecular weight of 133,973. The start of the recB coding sequence overlaps the 3' end of the upstream ptr gene, and the recB termination codon overlaps the initiation codon of the downstream recD gene, suggesting that these genes may form an operon. No sequences which reasonably fit the consensus for an E. coli promoter could be identified upstream of the proposed recB translational start. The predicted RecB amino acid sequence contains regions of homology with ATPases, DNA binding proteins and DNA repair enzymes. PMID- 3537962 TI - Sequence of the gene for alkaline phosphatase from Escherichia coli JM83. PMID- 3537963 TI - Sequences closely related to an immunoglobulin gene promoter/enhancer element occur also upstream of other eukaryotic and of prokaryotic genes. AB - Decanucleotide sequences closely related to the TNATTTGCAT element which occurs upstream of the immunoglobulin genes and in the immunoglobulin gene enhancer were found also upstream of other eukaryotic and of prokaryotic genes. The possibility of evolutionary and functional relationships between the various transcriptional systems is discussed. PMID- 3537961 TI - Complete nucleotide sequence of recD, the structural gene for the alpha subunit of Exonuclease V of Escherichia coli. AB - Intracellular amplification of the Escherichia coli RecB and RecC proteins does not result in an increase in Exonuclease V activity unless the level of a third protein, encoded between the recB and argA genes, is also amplified. Nucleotide sequence analysis of this region reveals a 1,824 nucleotide open reading frame which would encode a protein of 608 amino acids with a calculated molecular weight of 66,973. This is assumed to be the structural gene for the alpha subunit of Exonuclease V, recently designated recD. The proposed initiation codon of the recD gene overlaps the termination codon of the upstream recB gene by one nucleotide, suggesting that these genes may form an operon. The deduced amino acid sequence of the RecD protein contains a region which is homologous to highly conserved sequences in adenine nucleotide binding proteins. PMID- 3537964 TI - Mechanism of intramolecular recyclization and deletion formation following transformation of Escherichia coli with linearized plasmid DNA. AB - The deletion end-points of a number of type I (less than monomeric) plasmid deletants obtained by transforming recA+ or recA- E. coli with linear pBR322 DNA were determined by DNA sequencing. In both monodirectional and bidirectional deletions the recyclization point was normally characterized by recombination between directly repeated sequences of between 4 and 10 bp present on each arm of the linearized pBR322 molecule. Frequently, short tracts of uninterrupted homology involved in recombinational recircularization were embedded in regions of relative non-homology. A model predicting the probability of matching sequences in either end of a linear plasmid molecule is presented. It is proposed that exonucleolytic processing of the exposed termini of linear plasmid molecules generates substrates for subsequent recombinational recyclization and deletion. The activity of host recombination and repair functions in recircularizing linear DNA molecules explains the generation of many of the aberrant recombinant DNA constructs obtained during gene cloning procedures. PMID- 3537965 TI - Analysis of the primary structure and promoter function of a pyruvate decarboxylase gene (PDC1) from Saccharomyces cerevisiae. AB - The PDC1 gene of Saccharomyces cerevisiae, encoding pyruvate decarboxylase was sequenced. The gene contains an open reading frame of 1647 base pairs. The codon usage shows the same strong bias as found for some other glycolytic enzymes. Transcription starts mainly at -30 and terminates 100 base pairs downstream of the termination codon. In some strains a second termination site, 46 base pairs upstream of the stop codon was observed. The function of the promoter region was analyzed by fusion to the bacterial structural gene encoding beta-lactamase (bla). On multicopy plasmid or integrated in the genome, the expression of the bla gene showed the regulation of the authentic PDC1 gene. PMID- 3537966 TI - A yeast protein HX has homologies with the histone H2AF expressed in chicken embryo. PMID- 3537968 TI - Dwellers of the hills. PMID- 3537969 TI - Spotlight on Children. An awkward age? PMID- 3537967 TI - Health visiting. Sharpening up their act. PMID- 3537971 TI - [Polish Phthisiopneumonological Society--its origin and development]. PMID- 3537970 TI - Intracranial hypertension: influence of nursing care activities. AB - Although there has been concern that a variety of nursing care procedures may serve as potent adaptive demands in patients with intracranial hypertension, research shows that activities such as bathing, oral hygiene, touching, and suctioning produce relatively small increases in ICP and are accompanied by adequate CPP. Head rotation and flexion are potent stimuli to increased ICP, although CPP has remained adequate in the small number of people in whom it has been measured. While considerable descriptive work has been done with respect to a variety of nursing care activities, much remains to be done. Little is known about the mechanisms by which activities (turning and suctioning) effect demands upon the craniospinal system, nor what the best predictors are of individuals who will respond adversely to such demands. The potential of affective touch and environmental sensory stimulation to reduce ICP and reduce the need for potent pharmacologic agents is intriguing but has not been adequately explored. Further investigators need to attend to reporting individual as well as group patterns to guide clinical application and describe predictors of individual response. In addition, the oscillatory nature of ICP and cardiovascular variables needs to be taken into account in interpreting whether or not "real" change has occurred in response to given activities. The full range of cerebrovascular variables needs to be measured to determine if changes in ICP pose a threat to cerebral perfusion. Finally, we need to examine nursing therapeutics with respect to ultimate outcomes (functional recovery) as well as to individual care activities. PMID- 3537972 TI - [History of Polish Phthisiology in the collections of the Museum of the History of Phthisiology]. PMID- 3537973 TI - [Clandestine medical education in the Wolski Hospital during the German occupation (1939-1944)]. PMID- 3537974 TI - [Dr. Maria Werkenthin]. PMID- 3537975 TI - [Underground activities in the Wolski Hospital]. PMID- 3537977 TI - [Selected aspects of the biomechanics of respiration]. PMID- 3537976 TI - [The Wolski Hospital during the Warsaw uprising]. PMID- 3537978 TI - Six-year clinical evaluation of fissure sealants placed after mechanical preparation: a matched pair study. PMID- 3537979 TI - [Infection and inflammation of the urinary tract: various cases of urinary tract infections investigated with the Thomas' test during forced water loading]. AB - We simultaneously employed the Water-Loading Test and the ABU Test in three patients suffering from UTI, when the commonly recommended diagnostic tests did not give explanatory results. Two different bacterial strains were discovered in two cases; in one case the strain responsible of the renal involvement was identified, in the other cases the results induced to perform further invasive procedures not recommended on the basis of the routine laboratory techniques. If the clinical interest of this approach is limited to selected cases, the results obtained induce to discuss about the various problems related to the host microbial interactions in the pathogenesis of UTI. PMID- 3537980 TI - [Economic and social aspects of pediatric dialysis in Italy]. AB - Rarely in italian medical journals have been discussed the social and economic problems related to dialysis much less the ones related pediatric dialysis. On the contrary, we believe that these problems hold a great importance due to their obvious consequences on the family structure, society and most of all on the psychophysical development of the affected child. Present structures of pediatric centers in Italy have been studied along with the available facilities, their spreading over the national territory and consequent transport problems. We also provided data regarding social and scholastic rehabilitation of the little patients as well as the effects of followed treatments on the family economy. Through these we can say that at the moment in Italy the 50% only of the children are treated in pediatric centers, which are still unequally distributed with a major concentration in the North, followed by the South and the Center Italy as last. However, it is important to notice that in every Center the child is seen as an individual and many efforts are done to reach his complete welfare. This purpose justify the presence, besides the specialized medical and nursing staff, of many dietitian, psychologist, teachers, play teachers, social workers. Results of a good recovery are evident in the sphere of the little patients, at school as at home, even if it is still difficult to evaluate a following complete integration in the work world. Still far away from solution is transplant problem in Italy: centers are insufficient and not perfectly working; patients suffer long waiting-lists; which causes to find the solution of their problem abroad. PMID- 3537981 TI - [Chromium and atherosclerosis]. AB - The authors report numerous experimental and clinical studies relating deficiency of chromium in the organism and atherosclerosis. They hope new researches to compute the pool of chromium in the organism and the validity and possibility to utilize this oligoelement in prevention of atherosclerosis. PMID- 3537982 TI - Management of dog bite avulsions of the lip vermilion. AB - A conservative approach allowing the wounds to heal by secondary intention has been used in 14 patients. The results have been very satisfactory, and only six of the 14 patients required minor scar revisions. PMID- 3537984 TI - Acute vomiting and abdominal pain in an infant. PMID- 3537983 TI - Risk of diagnostic lumbar puncture in acute bacterial meningitis. PMID- 3537985 TI - [Effect of naloxone on insulin and glucagon secretion in patients with chronic renal failure]. PMID- 3537987 TI - [Structure and role of the HLA major histocompatibility complex in the light of current theories]. PMID- 3537986 TI - [Use of yohimbine, an alpha-adrenolytic drug, in obesity]. PMID- 3537988 TI - [Effect of colloidal bismuth citrate on various components of gastric juice in patients with peptic ulcer]. PMID- 3537989 TI - [Principles of the pharmacologic treatment of decompression sickness in divers]. PMID- 3537990 TI - [Spontaneous pneumothorax in the light of current views]. PMID- 3537991 TI - Primary glomerular diseases (primary glomerulopathies). PMID- 3537992 TI - Localization of collagen types I, III, IV and V, fibronectin and laminin in human arteries by the indirect immunofluorescence method. AB - The distribution of types I, III, IV and V collagen and of the glycoproteins fibronectin and laminin in sections of human aortas, arteries and atherosclerotic plaques were studied using monospecific antibodies and indirect fluorescence microscopy. Types IV and V collagen and laminin were present in a narrow zone, representing the basement membrane, apposed to the endothelial layers of all these tissues. Types I and III collagen and fibronectin were located in the interstitial spaces of the intima and the media of blood vessels walls, whereas types IV and V collagen and laminin were found in the basement membranes underlying smooth muscle cells in these areas. Two types of atherosclerotic plaques were observed. Lipid-rich plaques contained less collagen and reduced amounts of the glycoproteins. Fibrous plaques consisted of regions deficient in types I and III collagen and collagen-rich regions with elevated levels of these two collagens as well as more fibronectin. The collagen-rich regions of fibrous plaques contained, however, little type IV and type V collagen and little of the glycoproteins laminin and fibronectin. This may be due to the reduced number of cells involved in the biosynthesis of these basement membrane proteins. PMID- 3537994 TI - Immunocytochemical localization of metallothionein in the rat prostate gland. AB - Metallothionein (MT), which binds zinc and other metals, was localized within the rat prostatic complex at light and electron microscopic levels utilizing immunocytochemistry. Two groups of mature, male Sprague-Dawley rats were injected with cadmium chloride subcutaneously (2 mg/kg body weight) to induce the synthesis of MT, and were sacrificed 48 h postinjection. From the first group, prostatic tissue from the three lobes was prepared for light microscopy. The indirect peroxidase antiperoxidase procedure was used for MT localization using rabbit anti-MT as the primary antibody. The three lobes of the rat prostate demonstrated a positive reaction for MT, but among the lobes variations in the intensity and localization of the reaction product occurred. Tissues from the second group of animals were prepared for electron microscopy. Using the indirect immunogold labeling technique with anti-MT, MT localization was confirmed in the rough endoplasmic reticulum, secretory vesicles, secretory products, and subepithelial connective tissue. These localizations suggest that MT binds zinc both intra- and extracellularly, where it may function in zinc storage and metabolism. PMID- 3537993 TI - The dihydrotestosterone (DHT) hypothesis of prostate cancer and its therapeutic implications. AB - Data are presented showing that human prostatic adenocarcinoma depends on dihydrotestosterone (DHT) and not testosterone (T) for growth. It follows that androgen ablative therapy should be directed toward elimination of DHT with retention of circulating T. This can be achieved by using a 5 alpha-reductase inhibitor such as 6-methyleneprogesterone (6-MP) (VII). Arguments are presented showing that 6-MP (VII) is expected 1) to function as a prophylactic agent against prostate cancer, 2) to represent an attractive therapeutic modality for palliative treatment of the hormone-responsive disease, and 3) to be compatible with other therapeutic modalities when very low prostatic levels of DHT should be within reach. PMID- 3537995 TI - Perinatal group B streptococcal infection in midgestation. AB - In a series of 32 fetuses and neonates studied at autopsy at Women and Infants Hospital, group B streptococcus (GBS) was isolated from the right atrial blood or from the lung. Eleven or 34% (5 stillborn fetuses and 6 liveborn infants) were delivered in midgestation, between 18 and 28 weeks, and all weighed less than 1000 g. Maternal clinical features in GBS infection during midgestation included vaginal hemorrhage in 4 and premature rupture of membranes in 8. The high rate of fetal death associated with this infection in midgestation (45%) bears emphasizing. Reproductive loss among mothers with previous pregnancies seems to be a risk factor for subsequent perinatal loss due to GBS. Of 17 pregnancies among these 11 mothers, only 3 resulted in living children. Colonized mothers with GBS are usually treated late in the third trimester, if at all. This study indicates that attention must be directed to midgestation, at least among the high-risk group. PMID- 3537996 TI - Rocky mountain spotted fever: hepatic lesions in childhood cases. AB - We studied 16 fatal childhood cases of Rocky Mountain spotted fever (RMSF). Hepatic histologic lesions with statistically significant differences from age- and sex-matched controls were portal triaditis consisting of polymorphonuclear leukocytes and large mononuclear cells, portal vasculitis, sinusoidal leukocytosis, erythrophagocytosis by Kupffer cells, and gross hepatic weight. Hepatocellular necrosis, cholestasis, and congestion were not more frequent in RMSF than in controls. Using immunofluorescence microscopy, we were able to demonstrate rickettsial organisms in portal blood vessels and sinusoidal lining cells of 7 cases. PMID- 3537997 TI - Gastrointestinal malformations associated with prune belly syndrome: three cases and a review of the literature. AB - Prune belly syndrome (PBS), a triad consisting of abdominal musculature hypoplasia, urinary tract malformations, and cryptorchidism, is frequently associated with other congenital malformations. Although it is acknowledged that gastrointestinal (GI) malrotation and mesenteric anomalies are frequent in PBS, other GI anomalies are generally considered to be exceedingly rare. Here we describe 3 autopsy cases with severe malformations of both midgut and hindgut derivatives and review the world literature to evaluate the spectrum of GI malformations associated with this syndrome. The relatively high frequency of distal stenoses and atresias suggests that the anomalous mesenteric attachments may predispose to prenatal volvulus and subsequent anatomic bowel obstruction. Postnatal volvulus is also occasionally observed. Infants with PBS also appear to be at a higher risk for persistence of the common fetal cloaca. PMID- 3537998 TI - Maternal phenylketonuria-chronology of the detrimental effects on embryogenesis and fetal development: pathological report, survey, clinical application. AB - Maternal phenylketonuria (PKU) is likely to have detrimental effects on embryogenesis and fetal development. Manifestations in the offspring include spontaneous abortion, various congenital malformations, intrauterine growth retardation, and microcephaly. The time at which the metabolic abnormalities induce pathologic embryogenesis can be documented by knowing the time of the development of specifically damaged organ systems. This review reveals that, while the most recognized congenital malformations occur in the heart, the most common abnormality is growth inhibition occurring throughout pregnancy. The organ system most commonly affected by this growth inhibition is the brain, resulting in a high incidence of micrencephaly. It appears that maternal phenylketonuria interferes with appropriate fetal growth and that this effect occurs during the entire course of pregnancy and has no tissue specificity. This information can be both informative to pathologists and useful to clinicians. PMID- 3537999 TI - Trisomy 18 with ectopia cordis, omphalocele, and ventricular septal defect: case report. AB - A case of thoracoabdominal ectopia cordis was diagnosed by ultrasonography at 21 weeks' gestation. Chromosomal analysis showed full trisomy 18. This case supports the associational of thoracoabdominal ectopia cordis (Cantrell's pentad) with chromosomal errors, specifically trisomy 18. PMID- 3538000 TI - Collagen and laminin immunoreactivity in Ewing's sarcoma: support for an uncommitted mesenchymal cell derivation. PMID- 3538001 TI - Postpartum mental and physical problems. How common are they? PMID- 3538002 TI - [Immunofluorescence in the diagnosis and treatment of pemphigus vulgaris]. PMID- 3538003 TI - [Transferring the path of insertion]. PMID- 3538004 TI - [Practica Odontologica, 1980-1986. 7 years of dental journalism]. PMID- 3538005 TI - [Artificial teeth]. PMID- 3538006 TI - [Sapphire dental implants]. PMID- 3538007 TI - [Relation between the incidence of denture stomatitis and the presence of Candida albicans in elderly people]. PMID- 3538008 TI - [Indices of the lipid spectrum of the blood serum and erythrocyte membranes in diabetes mellitus in children]. AB - The paper is concerned with the results of a comparative study of the blood serum lipid spectrum and erythrocytic membranes in 100 children with diabetes mellitus aged 7 to 15 and 20 healthy children of the same age. The ratio of lipid and lipoprotein fractions depending on a degree of compensation, duration of disease and the presence of complications was disturbed in the blood serum and erythrocytic membranes of the diabetic children. The recovery of lipid metabolism was delayed as compared to clinical convalescence of the patients, therefore appropriate correcting therapy was required. PMID- 3538009 TI - [Effect of atropine on the mechanisms of intestinoinsular interaction]. AB - The effect of atropine on insulin secretion stimulated by glucose administration in the duodenum was studied in chronic experiments on dogs prior to and following supradiaphragmatic vagotomy. The control experiments on 10 dogs have demonstrated that in the first 10 min. after glucose administration in the duodenum pancreatic islet B-cells show a raised sensitivity to glucose expressed in a higher value of the insulinogenic index at this time than in later periods. After vagotomy no significant differences in insulin secretion and glucose tolerance in animals were found as compared to preoperative values. However the experiments with atropine administration have shown that the blockade of M-choline receptors results in considerable weakening of insulin secretion and glucose tolerance in animals irrespective of the integrity of the nerves vagus. It has been assumed that an important role in the mechanisms of the intestinoinsular axis is played by the nervous connections of the duodenum with the pancreas through interaction of the intraorganic neurons of these organs. PMID- 3538011 TI - Designing a computer-assisted orientation program for the operating room. PMID- 3538010 TI - [Iodine metabolism and thyroid hormones in the normal state and in pathology]. PMID- 3538012 TI - [Alcoholism and tuberculosis]. PMID- 3538013 TI - Immunocytochemical diagnosis of cervicofacial actinomycosis with special emphasis on periapical inflammatory lesions. PMID- 3538014 TI - Oxidation of reduced menaquinone by the fumarate reductase complex in Escherichia coli requires the hydrophobic FrdD peptide. AB - Plasmids carrying cloned segments of the frd operon of Escherichia coli have been used in genetic complementation studies to identify two independent mutants defective in the frdD gene, which encodes the hydrophobic FrdD polypeptide of the fumarate reductase complex. Mutations in the frdA and frdB genes have also been mapped by this technique. One of the FrdD peptide mutants, DW109 (frdD-109), showed that fumarate reductase was not as tightly bound to the membrane in this mutant. In addition, the mutation in the FrdD peptide caused an almost total loss of the ability of the enzyme to oxidize either menaquinol-6, a physiological donor for fumarate reduction, or reduced benzyl viologen. However, the mutation did not impair the ability of the membrane-bound fumarate reductase complex to function with succinate as substrate, as evidenced by unchanged turnover numbers for phenazine methosulfate and 2,3-dimethoxy-5-methyl-6-pentyl-1,4-benzoquinone (a quinone analogue) reductase activities. These data establish the essential role of the FrdD polypeptide both in the interaction of the enzyme with reduced menaquinone and thus in anaerobic respiration with fumarate as electron acceptor, and in binding the enzyme to the membrane. PMID- 3538015 TI - Anti-beta-interferon antibodies inhibit the increased expression of HLA-B7 mRNA in tumor necrosis factor-treated human fibroblasts: structural studies of the beta 2 interferon involved. AB - Recombinant Escherichia coli-derived human tumor necrosis factor (TNF) induces the 1.3-kilobase beta 2 interferon (IFN-beta 2) mRNA in human diploid fibroblasts (FS-4 strain). IFN-beta 2 is serologically related to the well-characterized IFN beta 1 (respective antisera cross-neutralize the heterologous protein). Polyclonal and monoclonal anti-IFN-beta antibodies inhibit the increase in class I HLA gene expression (HLA-B7 mRNA) in TNF-treated FS-4 cells suggesting that TNF induced IFN-beta 2 mediates the enhancing effect of TNF on HLA gene expression in human fibroblasts. The structure of this autocrine human interferon has been determined. A cDNA library was prepared from polyadenylylated RNA extracted from TNF-induced FS-4 cells, and eight IFN-beta 2 cDNA clones were isolated using a 21 nucleotide synthetic oligonucleotide probe. The 1128-nucleotide sequence of IFN beta 2 mRNA and the 212-amino acid sequence of the IFN-beta 2 protein were deduced from these cDNA clones. The amino acid sequences of the serologically related human IFN-beta 1 and -beta 2 were compared using the Sellers TT metric algorithm for locating similarities and using the pattern scoring method for evaluating the observed similarities. IFN-beta 1 and -beta 2 each contain a segment that is approximately 100 amino acids including 39 amino acids that are aligned and identical in the two proteins. The hydropathic index plots across these segments in the two proteins are also strikingly similar. The region of similarity between IFN-beta 1 and -beta 2 includes a section that is also highly conserved in all IFN-alpha species sequenced. Thus IFN-beta 2 shares structural similarities with other human interferons that also preferentially increase class I HLA gene expression. PMID- 3538016 TI - Cloning and sequence analysis of rabbit progesterone-receptor complementary DNA. AB - Two lambda gt11 clones containing fragments of cDNA encoding the rabbit progesterone receptor were isolated with the aid of monoclonal and monospecific polyclonal antireceptor antibodies. RNA gel blot analysis showed that the corresponding mRNA was approximately equal to 5900 nucleotides in size and present in the uterus, where its concentration was increased by estrogen treatment, and in the vagina. This mRNA was not detected in liver, in spleen, in intestine, and in kidney where the receptor protein is known to be absent or present in very small concentration. Cross-hybridizing clones were isolated from a lambda 10 library. The DNA was sequenced, and the primary structure of the progesterone receptor was deduced. It consists of 930 amino acids and contains a basic, cysteine-rich region (residues 568-645) with extensive homology to the glucocorticoid and estrogen receptors and the v-erbA oncogene protein. This region is followed by a C-terminal domain that is similar in size to the corresponding domains of the other steroid receptors and v-erbA and shows striking amino acid homology with the glucocorticoid receptor and significant homology with the estrogen receptor. In contrast, the region extending from the cysteine-rich segment toward the N terminus differed in size and amino acid sequence from that of the other receptors and v-erbA. This region had a high proline content in the progesterone receptor. PMID- 3538017 TI - Isolation of yeast mutants defective in protein targeting to the vacuole. AB - We have constructed a PRC1-SUC2 gene fusion that directs the synthesis in Saccharomyces cerevisiae of a hybrid polypeptide consisting of a 433-residue amino-terminal domain derived from the yeast vacuolar protease carboxypeptidase Y (CPY; EC 3.4.16.1) and a 511-residue carboxyl-terminal domain derived from the secreted yeast enzyme invertase (EC 3.2.1.26). Fractionation data indicated that this amount of CPY primary sequence is sufficient to quantitatively divert invertase to the yeast vacuole. The phenotypic consequence of localizing active invertase to the vacuole has enabled us to select for mutants that "mislocalize" the hybrid protein to the cell surface. The corresponding mutations that lead to this effect are all trans-acting and recessive, and they define at least eight complementation groups. These vacuolar protein targeting (vpt) mutants also exhibit hybrid protein independent defects in wild-type CPY delivery to the yeast vacuole. Precursor forms of CPY accumulate in the mutants and are secreted into the yeast periplasm and extracellular medium. The vpt mutants should provide useful information pertaining to the mechanisms by which yeast cells regulate vacuolar protein traffic. PMID- 3538018 TI - Uromodulin, an immunosuppressive protein derived from pregnancy urine, is an inhibitor of interleukin 1. AB - Uromodulin, an 85-kDa glycoprotein isolated from pregnancy urine, has been shown to inhibit antigen-induced proliferation of human lymphocytes in vitro. The present investigation was undertaken to determine its mechanism of action. Uromodulin was found to be a potent inhibitor of interleukin 1 (IL-1)-induced thymocyte proliferation. Uromodulin was compared to a previously described 30- to 35-kDa IL-1 inhibitor isolated from urine of febrile patients (febrile inhibitor). Uromodulin and the febrile inhibitor blocked the effects of both human IL-1 and recombinant murine IL-1, but the activity of uromodulin was greater than that of the only partially purified febrile inhibitor preparation. However, in contrast to the febrile inhibitor, uromodulin markedly enhanced interleukin 2-induced thymocyte proliferation. Antigenic analysis of the two preparations by ELISA and immunoblot analysis demonstrated that the febrile inhibitor did not cross-react with uromodulin using monoclonal or polyclonal antisera. These findings indicate that uromodulin is a potent IL-1 inhibitor that is probably distinct from the IL-1 inhibitor derived from the urine of febrile individuals. Whether this IL-1 inhibitory activity underlies its immunosuppressive activity on human lymphocytes remains to be established. PMID- 3538021 TI - What is diabetes? PMID- 3538019 TI - Presence of the peroxisomal 22-kDa integral membrane protein in the liver of a person lacking recognizable peroxisomes (Zellweger syndrome). AB - Peroxisomes have not been detected in liver and kidney of patients with Zellweger syndrome. Some peroxisome proteins are missing; others are present in normal amounts but are located in the cytosol. We have prepared an antiserum against the 22-kDa integral membrane protein characteristic of rat liver peroxisomes. The antiserum crossreacts with the human liver counterpart, which likewise has a mass of 22 kDa. By immunoblot analysis, we demonstrate that the 22-kDa protein is present in normal amount in Zellweger liver and is integral to a membrane. The result suggests that peroxisome membranes are assembled in Zellweger syndrome but may be defective for the import of matrix proteins. As a result, newly synthesized proteins are left in the cytosol, where some persist and others are degraded. Lacking their usual content, such aberrant peroxisomal membranes would be unrecognizable morphologically. Immunoblot analyses also showed that the peroxisomal hydratase-dehydrogenase is deficient in Zellweger kidney as well as liver, but catalase is present in both organs. PMID- 3538020 TI - Reflex splanchnic nerve stimulation increases levels of proenkephalin A mRNA and proenkephalin A-related peptides in the rat adrenal medulla. AB - The effect of reflex splanchnic nerve stimulation on proenkephalin A biosynthesis was investigated in the rat adrenal medulla. Tissue levels of native [Met5]enkephalin-like immunoreactivity (IR) (measured by direct RIA of tissue extracts), cryptic [Met5]enkephalin-like IR (calculated as the increase in [Met5]enkephalin-like IR detected in tissue extracts after sequential digestion with trypsin and carboxypeptidase B), and proenkephalin A mRNA were determined in adrenal medulla from rats sacrificed at various times after a period of insulin induced hypoglycemia. Two hours of insulin hypoglycemia, which produced intense reflex stimulation of the splanchnic nerves as evidenced by a 55% decrease in the adrenal medulla catecholamine levels, resulted in a 3-fold increase in proenkephalin A mRNA levels in this tissue. The proenkephalin A mRNA levels reached a maximum 15-fold increase over control values 24 hr after this period of hypoglycemic stress and then gradually declined with an approximate half-life of 4 days. Native and cryptic [Met5]enkephalin-like IR had increased 9-fold and 12 fold, respectively, 24 hr after this period of hypoglycemia, and both demonstrated maximum increases of 130-fold and 50-fold, respectively, after 96 hr. Combined pretreatment (i.p. administration) with the ganglionic and muscarinic blocking agents chlorisondamine (5 mg/kg of body weight) and atropine (1 mg/kg) blocked the increase in levels of proenkephalin A mRNA seen in the rat adrenal medulla following insulin hypoglycemia. These data indicate that reflex splanchnic nerve discharge stimulates proenkephalin biosynthesis, probably at the level of gene expression. PMID- 3538022 TI - Pathogenesis of the atherosclerotic lesion: current concepts of cellular and biochemical events. PMID- 3538023 TI - Phospholipids, calcium binding and arterial smooth muscle membranes. AB - The effects of phosphatidylserine (PS), phosphatidylinositol (PI), and phosphatidylcholine (PC) on 45Ca uptake, binding and efflux in canine aortic microsomes and of PS on 45Ca distribution and tension in rabbit aortic smooth muscle are reviewed. PS potentiated contractile responses to histamine and norepinephrine, and these effects were correlated with PS-induced removal of superficial Ca++ and decreased exchangeability of membrane Ca++. In microsomal preparations, PS and PI (but not PC) increased high affinity 45Ca binding but not 45Ca uptake. Only PI increased low affinity 45Ca uptake, and both PS and PI decreased oxalate-potentiated 45Ca uptake. The Ca++ ionophore A23187 removed membrane Ca++ in contrast to PS and PI. Exogenous negatively-charged PS or PI may enter plasma membranes and increase Ca++ binding levels. The roles of endogenous phospholipids in altered vascular responsiveness and function in disease states may be of critical importance. PMID- 3538024 TI - AGEPC, a vasodilator phospholipid with profound circulatory actions. AB - Acetyl-glyceryl-ether-phosphoryl-choline (AGEPC) is a potent platelet activating factor which induces profound circulatory changes. AGEPC is synthesized in a variety of cell types including platelets, neutrophils, macrophages, basophils and endothelial cells. Biological responses include platelet activation, neutrophil activation, release of arachidonic acid metabolites and systemic anaphylaxis. Circulatory responses to AGEPC were evaluated in the present investigation. Intravenous administration of AGEPC (30 micrograms/kg/min) to anesthetized dogs reduced blood pressure, cardiac output, myocardial contractile force, renal blood flow and glomerular filtration. Intracoronary administration of AGEPC (0.3-3 micrograms) reduced blood pressure, coronary blood flow, and myocardial contractile force. Administration of AGEPC into the femoral vascular bed increased femoral artery blood flow. The data suggest that the circulatory response to AGEPC in the dog is complex and depends on the site of administration. The predominant response is hypotension mediated at least in part through myocardial depression. Intramuscular injection of AGEPC (10-30 micrograms/kg) to conscious spontaneously hypertensive rats (SHRs) reduced systemic blood pressure and increased heart rate. In pithed rats, AGEPC decreased pressor responses to sympathetic stimulation, angiotensin II and phenylephrine. Chronotropic responses were unchanged. Thus, antihypertensive doses of AGEPC reduced pressor responsiveness nonspecifically, but do not affect pre- or post junctional adrenergic mechanisms. High concentrations of AGEPC (100 microM) relaxed phenylephrine contracted rabbit aortic rings. Relaxation was dependent on an intact endothelium. Lyso-GEPC produced similar actions. In light of the low potency of AGEPC and the activity of lyso-GEPC, physiological significance to endothelium dependent relaxation by AGEPC in rabbit aortic rings is unlikely. The physiological role of AGEPC in circulatory homeostasis is unclear at present. AGEPC may play a hypotensive role in some forms of experimental hypertension. In addition, AGEPC may mediate part of the circulatory derangements associated with cardiac anaphylaxis. Lastly, AGEPC may be involved in circulatory control during states of platelet and/or neutrophil activation such as myocardial ischemia and shock. PMID- 3538025 TI - Regulation of contraction in smooth muscle: physiological studies. PMID- 3538026 TI - Resistance vessels in hypertension. AB - Hypertension differentially affects the functional behavior of the mesenteric resistance arteries compared with similar sized arteries from the cerebral vascular autoregulatory bed. Antihypertensive drug treatment may, or may not, reverse the vascular wall structural composition and smooth muscle cell receptor sensitivity and contractile properties. These effects depend on the agent used, the length of treatment, and the vascular bed. Rat brain resistance arteries are myogenic at transmural pressures that are similar to those measured in autoregulatory, in vivo flow studies, as is the elevation of this range as a consequence of hypertension. The methods we have developed afford the investigator quantitative control over the variables that might affect the function of resistance vessels when tested in vitro. These techniques maintain the vessel close to physiological, in vivo conditions, and are useful tools for unraveling the complex mechanisms that define both, the normal vessel properties, and those of the vessel which has undergone modifications as a result of hypertension. Whether the vascular changes that we find in the SHR rat model parallel those which occur in human essential hypertension must yet be ascertained. PMID- 3538027 TI - Electrophysiological mechanisms of arterial muscle activation: alterations associated with cerebral vasospasm and hypertension. AB - The active state of arterial muscle can be regulated by electrical events occurring at the plasma membrane. Factors which affect the level of the resting membrane potential can markedly alter resting tone, and sensitivity and contractility to agonists. The relative K+ conductance (gk) appears to be a principle factor in this regard. Reduction of gk induces generation of action potentials with concomitant mechanical activity. Cerebral arteries exposed to subarachnoid blood exhibit altered electrical and mechanical properties which predispose them to spasm; a phenomenon related to a reduced gk. Arterial muscle from hypertensive animals exhibit membrane electrical properties which may contribute to an elevated peripheral vascular resistance, namely, an elevated PNa/Pk ratio and altered electrogenic ion transport. Upon exposure to elevated transmural pressures, isolated cerebral arterial muscle cells depolarize and generate spontaneous "pacemaker-like" action potentials, processes which appear to be Ca2+ dependent. Cerebral arteries from spontaneously hypertensive rats depolarize more to elevated transmural pressures when compared to WKY. This increased membrane depolarization to pressure may be the result of an elevated Ca2+ permeability and/or an alteration in gk at the SHR arterial muscle cell membrane. Thus, abnormal activation of arterial muscle can be mediated by factors controlling transmembrane electrical gradients and ionic conductance systems. PMID- 3538028 TI - Regression and resolution in atherosclerosis. PMID- 3538029 TI - Role of autonomic nerves and endothelium in coronary vasospasm. AB - Coronary vasospasm may result from exaggerated contraction of the smooth muscle composing the arterial wall. An imbalance of the autonomic or humoral control of the smooth muscle might serve to initiate a pathological arterial contraction. Abnormal adrenergic or cholinergic nervous function might explain vasospasm of otherwise normal coronaries. Intimal damage due to disease leaves the smooth muscle deficient in the protective metabolic and vasodilator properties of the endothelium. The vasoactive substances released by the platelets aggregating at such a site could cause vasospasm by acting directly on the smooth muscle or by inhibiting the function of dilator nerves. PMID- 3538030 TI - Models of vasospasm: relationship of organic stenoses to sites of vasospasm. AB - This paper reviewed some possible mechanisms regarding coronary artery spasm. Since normal vasoconstriction cannot reduce luminal area sufficiently to decrease blood flow, amplification of the vasoconstriction response appears necessary. Hypercholesterol, platelets, and denudation probably hypersensitize the vessel, but may not cause hypershortening. Coronary atherosclerosis amplifies the effects of vasoconstriction and appears to be the primary factor in the pathogenesis of coronary artery spasm. Again, this paper has reviewed some potential mechanisms of coronary artery spasm. Additional studies are required to verify the exact cause of coronary artery spasm. For a more extensive review of coronary artery spasm, I recommend the articles by Maseri and Chierchia (1982), Freedman et al (1982), Yasue et al (1983), and Chierchia (1982). PMID- 3538031 TI - Hypocholesterolemic agents. PMID- 3538032 TI - The role of cholesterol in arterial wall function and its alteration in vascular disease. PMID- 3538033 TI - Methodological issues in clinical trials of dietary fat reduction in patients with breast dysplasia. PMID- 3538034 TI - Levels and sources of fat in the U.S. food supply. AB - The amount of fat in the U.S. food supply increased one-third between 1909-13 and 1984, from 124 grams to 166 grams per capita per day. Also, the proportion of food energy provided by fat increased from 32 to 43 percent. The gain in fat in the food supply was due to an increase in fat from vegetable sources. The share of fat from vegetable sources increased from 17 to 42 percent between 1909-13 and 1984. Although animal fats provided the largest share of fat, their proportionate contribution declined from 83 to 58 percent between 1909-13 and 1984. Three food groups--fats and oils; meat, poultry, and fish; and dairy products--provided about 90 percent of the fat in the food supply throughout the past 75 years. However, the shares of fat provided by these groups changed. The share from the fats and oils group increased from 37 to 44 percent between 1909-13 and 1984, while the share from the meat, poultry, and fish group declined from 37 to 34 percent, and the share from the dairy products group declined from 15 to 12 percent. Fat from the fats and oils group increased 59 percent between 1909-13 and 1984. Most of the gain in fat from this group was due to increased use of edible oils. Margarine replaced much of the butter and shortening replaced much of the lard as sources of fat. Fat from the meat, poultry, and fish group increased 24 percent between 1909-13 and 1984. Pork accounted for the largest proportion of fat from this group and beef ranked second. The share of fat from poultry, although much smaller than either pork or beef, almost tripled. Fat from dairy products was about the same in 1984 as in 1909-13. Cheese was the leading source of fat from dairy products by 1984. Until recent years, whole milk was the leading source, although its share declined substantially after the late 1950's. Despite their low fat content, the share of fat from skim and lowfat milks increased as use increased, particularly in the past 25 years. The proportion of fat provided by frozen desserts increased over the years, while that from creams decreased. Among the fatty acids in the food supply, the quantity of TSFA increased by 10 percent between 1909-13 and 1984. Quantities of oleic and linoleic acid increased by 39 and 189 percent, respectively, between 1909-13 and 1984.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3538035 TI - Food fats and oils. PMID- 3538036 TI - Dietary fat and the epidemiology of breast cancer. PMID- 3538038 TI - Experimental studies on dietary fat and cancer in relation to epidemiological data. PMID- 3538039 TI - Introduction to the effects of neutral fats and fatty acids on carcinogenesis in experimental animals. PMID- 3538037 TI - Heated and oxidized fats. PMID- 3538041 TI - Methodological issues in epidemiologic studies of dietary fat and cancer. AB - Every scientific discipline has unique methodological constraints. Each scientific discipline also has differing degrees of power to resolve different questions. The methods of epidemiology are not exempt from these generalizations. In this brief review, several categories of methodological problems in epidemiological studies of dietary fat and cancer have been cited. Other problems could have been discussed and, several more examples illustrating the occurrence of the problems in research could have been presented. These problems notwithstanding, epidemiologic study of the association of dietary fat to cancer is an essential investigative tool in moving toward a better understanding of the public health impact of dietary fat. There are no known biological universals, and, as persuasive as data from animal models may be, extrapolation from the laboratory environment to human experience always is tentative. Laboratory methods require human validation before application to populations at risk of disease. Given the mutual dependency of epidemiologic studies and laboratory approaches, it is useful that the evidence from both realms be integrated and evaluated together as they are in this volume. Finally, given the limitations of any single epidemiologic method applied to the topic, future progress in understanding the role of dietary fat in cancer cause and prevention must rely on the application of multiple methodologies. By this means, it may be possible to compare and contrast the findings from different approaches to yield insights which would not otherwise be achievable. PMID- 3538040 TI - Amount and type of dietary fat and colon cancer: animal model studies. PMID- 3538043 TI - Body size, body mass and cancer of the breast. PMID- 3538042 TI - Dietary fat and colon cancer: variable results in animal models. PMID- 3538044 TI - Enhancement of pancreatic carcinogenesis by dietary fat in the hamster and rat models. PMID- 3538045 TI - The macronutrients in experimental carcinogenesis of the breast, colon, and pancreas. PMID- 3538046 TI - Metabolic adaptations to dietary fats. PMID- 3538047 TI - Mechanisms of dietary fat modulation of tumorigenesis: changes in immune response. PMID- 3538048 TI - Effects of lipids on gap junctionally-mediated intercellular communication: possible role in the promotion of tumorigenesis by dietary fat. PMID- 3538049 TI - Interrelationship between dietary fat and endocrine processes in mammary gland tumorigenesis. PMID- 3538050 TI - The metabolism of the intestinal microflora and its relationship to dietary fat, colon and breast cancer. PMID- 3538051 TI - Fatty acid growth requirements of normal and neoplastic mammary epithelium. PMID- 3538052 TI - Potential responses to and impacts of epidemiological and experimental data on dietary fat and cancer. Dietary guidelines. AB - The majority of dietary guidelines discussed above suggest a reduction in the % of dietary calories derived from fat. Currently, approximately 40% of calories in Western countries come from fat. Some of the more recent guidelines call for a reduction in fat intake to 30% of calories. Indeed, the Committee on Diet, Nutrition and Cancer (National Academy of Sciences 1982) and the World Health Organization Report on Prevention of Coronary Heart Disease (WHO 1982) suggested that the evidence warranted an even lower fat intake, but 30% of calories is a moderate and practical target. Diets containing 30% of calories as fat are undoubtedly safe for the general population. During and immediately after the Second World War in Britain, dietary fat intake was at or about this level and no deleterious effects in the population were noted. (Greaves and Hollingsworth 1966). Indeed, the overall state of health of the population seemed improved. Furthermore, most of the world population exists and has existed on a primarily plant based diet, low in fat content, with no apparent ill effects and lower rates of chronic disease. (Mintz 1985). Most dietary guidelines recommend a reduction in saturated fat intake. The more recent guidelines suggest saturated fat should be restricted to less than 10% of total calories. While some of the earlier guidelines suggested an increase in polyunsaturated fat intake, more recent guidelines stress that polyunsaturated fat intake should not exceed 10% of calories. Thus, the focus of more recent guidelines appears to be to decrease total fat intake. Essentially all guidelines stress avoidance of obesity by avoiding excess caloric intake and increasing caloric expenditure. Diets low in total fat content are beneficial in this regard, a fact acknowledged in the Food and Nutrition Board's report "Towards Healthful Diets." (Food and Nutrition Board 1980 b) Most guidelines advise a decrease in calories derived from processed sugars and a concomitant increase in complex carbohydrate intake. This is best achieved by stressing whole grain cereals, fruits and vegetables in the diet. More recent recommendations advise moderation in the use of alcohol. Moderation in salt use is also a common theme. It is our belief that guidelines should be general in nature and not identify specific nutrients, e.g. vitamin A and C in foods, or specific foods themselves, e.g. cabbage, as conferring special benefits. The available data base does not support such specific claims.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3538053 TI - The Diet and Cancer Branch, NCI: current projects and future research directions. AB - Diet, perhaps more than any other environmental factor, has a significant potential for reducing the incidence of cancer. It has been projected that as much as 35 percent of all human cancer can be prevented through effective dietary modification strategies. The comprehensive research program of the DCB significantly directs diet and cancer research toward the ultimate cancer prevention goal of modifying dietary habits of the general population for optimal health. The DCB is currently supporting projects along the entire continuum from laboratory research to human intervention trials: basic research projects in food composition, encompassing dietary fiber, vitamin A and carotenoids and development of INFOODS; physiologic studies establishing safe and effective levels of dietary fiber and carotenoids; modification of eating behavior; human intervention trials of low fat diets in prevention of breast cancer; and clinical nutrition research units. PMID- 3538054 TI - Cancer and diet interactions. PMID- 3538055 TI - Dietary fat and cancer: a perspective from the livestock and meat industry. AB - It has been a popular belief that U.S. consumers ingest approximately 40% of their calories as fat and that a high percentage is from animal sources. In fact, animal fat consumption has declined 23% in the past 20 years and the increase in fat consumption has been solely due to vegetable (plant) sources. The decline in animal fat production probably explains why the estimates discussed in this presentation fall below earlier literature references. The validity of the estimates presented here will be determined as part of an in depth study undertaken by the National Academy of Sciences' Board of Agriculture. If this comprehensive study substantiates the values presented in this paper and other recent publications, a reconsideration of the impact of animal source fats on caloric intake and diet related diseases is indicated. The U.S. livestock and meat industry is extremely aware of and responsive to the role of meat and meat products in the nutrition, health and well-being of the nation. Research programs are designed with these factors as a guide and producers continue to adjust product characteristics to meet the changing needs. PMID- 3538056 TI - Gonadotropin down-regulation in gynecological practice. Proceedings of an international symposium. The Netherlands, April 25-26, 1986. PMID- 3538057 TI - Endometriosis: clinical symptoms and infertility. PMID- 3538058 TI - Management of endometriosis. PMID- 3538060 TI - Endocrinological aspects of the premenstrual syndrome. PMID- 3538059 TI - Uterine leiomyomata--aetiology, symptomatology and management. PMID- 3538063 TI - Opiate-induced turning in rats after injection into the ventral tegmental area. AB - Morphine and ethylketazocine caused ipsilateral circling when injected unilaterally into the ventral tegmental area (VTA) of rats. Systemic naloxone only slightly inhibited this effect while systemic diprenorphine completely prevented circling. Systemic haloperidol and alpha-methyl-p-tyrosine also blocked circling. Rats made tolerant to morphine still turned after morphine injection into the VTA. Levorphanol, dextrorphan, methadone, DADLE, dynorphin(1-13), SKF 10,047 and phencyclidine were inactive when injected unilaterally into the VTA of naive rats; naloxone and naltrexone alone also were inactive. The opiate-induced circling appears to involve a non-mu opiate receptor as well as a dopaminergic neuronal system. PMID- 3538062 TI - The effects of intracranial administration of hallucinogens on operant behavior in the rat. I. Lysergic acid diethylamide. AB - Lysergic acid diethylamide (LSD) was infused in one microliter volumes into discrete brain regions of rats trained to press a bar for food reinforcement. The sites were chosen as major areas of the brain 5-hydroxytryptamine (5HT) system: the dorsal and median raphe nuclei, dorsal hippocampus, lateral habenular nuclei, and the prefrontal cortex. Following training in a fixed ratio-40 (FR-40) operant behavior rats were implanted for the lateral habenular nuclei, dorsal hippocampus and the prefrontal cortex. Following recovery from surgery, LSD (8.6 to 86 micrograms) or vehicle was infused immediately before a daily operant session. Infusion of vehicle was inactive. LSD produced a dose-dependent decrease in reinforcements and an increase in 10-sec periods of non-responding (pause intervals). LSD was significantly more potent when infused into the dorsal raphe nucleus than following intracerebroventricular (ICV) administration, whereas LSD was less potent when infused into the median raphe, lateral habenula or dorsal hippocampus. ED50s for increases in pause intervals were 9, 13, 23, 25, and 54 micrograms for infusion into the dorsal raphe, prefrontal cortex, dorsal hippocampus, median raphe, and lateral habenular nuclei, respectively. The ED50 for ICV administration in a previous study was 15 micrograms. The ED50 of LSD placed into the prefrontal cortex did not differ significantly from that of the ICV infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538061 TI - Etiology and pathophysiology of endometriosis. PMID- 3538064 TI - [Bicyclo (2,2,2)octane compounds in pharmaceutical research]. PMID- 3538066 TI - Ethics of experimental surgery: the Baby Fae case--an interview and comment. Interview by Jack E. Bynum. PMID- 3538065 TI - Dr. and Mrs. Rinehart: a biographic and literary study. PMID- 3538067 TI - The Todd-Sanford "Clinical Diagnosis by Laboratory Methods": the story of a specialty. PMID- 3538068 TI - [Doppler and ultrasonic diagnosis in sclerosis of the saphenous veins]. AB - Basing his report on a series of several hundreds of examinations, the author presents his experience of Doppler and echotomography in the sclerosant treatment of varicose veins. The examination procedure comprised, during the initial examination, throughout the treatment and at the end of the treatment: a dynamic study using the Doppler examination, with search for reflux and measurement of its pressure; and a morphological study, using echotomography, of the saphenofemoral junction with the measurement of different gauges and compression techniques. The examination reveals the underlying haemodynamic and morphological elements. Subsequent surveillance enables the practitioner to objectivize the velocimetric and morphological modifications induced by sclerosis, the appreciation of which has up until now been purely clinical. The modifications consist of parietal thickening with reduced gauge and the frequent presence of a transitory thrombus. The transformation of a reflux into a flux of physiological type, and indeed, its disappearance, is the main consequence of these modifications. These techniques therefore appear to be of great interest in therapeutic orientation, given their successes, failures and their causes. However, the present work has only given fragmentary and qualitative results, which a future paper will give in more detail. PMID- 3538069 TI - Quantitation of DNA damage in non-radioactive DNA. PMID- 3538070 TI - Action spectra for inactivation and membrane damage of Saccharomyces cerevisiae cells irradiated in vacuum by monochromatic synchrotron UV radiation (155-250 nm). PMID- 3538071 TI - Somatic, metabolic and endocrine correlates of set point recovery in food restricted and ad lib-fed weanling rats with dorsomedial hypothalamic lesions. AB - Male Sprague-Dawley rats received either electrolytic lesions in the dorsomedial hypothalamic nuclei (DMNL rats) or sham-operations (CON), and were fed lab chow ad lib for 41 post-operative (POP) days. Subsequently one lesioned (DNML-AL) and one control group (CON-AL) continued to receive lab chow ad lib until the end of the experiment (POP day 78). A second lesioned (DMNL-RE) and control group (CON RE) were given 80% of the amount of food eaten by their ad lib-fed counterparts for 28 days. At this time several rats from each group were killed. The remaining animals were then given lab chow ad lib for nine days and then also killed. Both DMNL-RE and CON-RE recovered their lowered body weight, food intake and feeding efficiency and showed the same pattern and relative magnitude as their ad lib-fed counterparts. Similarly, carcass lipid, epididymal fat pad lipid, incorporation of glucose-U-C14 into fat pad saponifiable lipid, total lipid, total glycogen (DPM/protein), liver protein, incorporation of glucose into liver CO2 and concentrations of plasma glucose, glycerol, triglycerides and free fatty acids normalized on refeeding to the same extent and in the same pattern in DMNL-RE as in CON-RE. In contrast to previous studies, plasma insulin was lower in DMNL-AL than in CON-AL but DMNL-RE and CON-RE had similar levels on refeeding. Also on refeeding, both DMNL-RE and CON-RE showed the same enhanced glucose incorporation into liver total lipid. The data show that DMNL rats, although smaller in size and hypophagic in absolute terms, recovered lost body weight--at least under our relative mild reduction of 80% of their ad lib-fed controls--with the same competence and in the same time interval as sham-operated controls. It is quite possible that a more severe restriction of body weight would have uncovered some deficits in DMNL rats, however. Under the constraints of the present experimental arrangement, the data strengthen previous evidence for the existence in DMNL rats of an "organismic" set point that makes for a "scaled-down" but homeostatically normal animal. PMID- 3538072 TI - Sexual behavior in the female rat following removal of the vomeronasal organ. AB - We used female Wistar rats from which the vomeronasal organ (VNO) has been removed. The first question addressed was whether such females would show deficits in sexual behavior. The data left no doubt that removal of the VNO severely depressed lordosis as well as such proceptive behaviors as "darting" and "hopping." We then injected estrogen and progesterone and, in still another experiment, estrogen and luteinizing hormone-releasing hormone (LHRH). Estrogen and progesterone significantly enhanced lordosis, but only estrogen and LHRH raised the lordosis quotient of VNO-ablated females to that of the control females. We discuss the results in terms of a theoretical model involving the complementary action of estrogen and LHRH in inducing lordosis in the intact female. PMID- 3538074 TI - Body fat: what is regulated? AB - This paper assumes that body fat is regulated and then reviews our ignorance about how this is accomplished. It concentrates on the challenge posed by site differences between different depots, and discusses a variety of experimental approaches that may be helpful. PMID- 3538073 TI - Short day lengths decrease body mass of overweight female meadow voles. AB - Groups of adult ovariectomized (ovx) voles and sham-ovx controls were placed in a short photoperiod or left in the original long photoperiod (10 or 14 hr light/day). In the next 12 weeks long-day ovx voles increased their body mass by 11.3%, whereas animals transferred to the short-day photoperiod manifested an 11.9% decline in body mass. Short photoperiods not only reversed pre-existing weight gains attributable to ovariectomy, but also prevented further increases in body mass associated with the withdrawal of ovarian hormones. Fat-free dry carcass mass was increased by ovariectomy and decreased by short photoperiods; lipoprotein lipase activity of white adipose tissue was unaffected by ovariectomy or photoperiod. We suggest that reductions in body mass in voles transferred to the short photoperiod are mediated by changes in pineal melatonin secretion. PMID- 3538076 TI - [Silver anniversary (the Medyczne Studium Zawodowe in Wloclawek)]. PMID- 3538075 TI - [20th anniversary (The Lyceum of Nursing in Tomaszow Lubelski)]. PMID- 3538077 TI - Management and timing of cleft palate fistula repair. AB - This study reviewed 199 cleft palate repairs resulting in 22 percent fistula formation. Of these, 49 percent were judged to be symptomatic. Of 44 fistulas, 21 required treatment, of which 14 had conventional type surgical closure with an overall success rate of 35 percent. Good surgical technique and good surgical judgment were felt to be important factors both in preventing postoperative fistula and in the success of their repair. Conventional methods of surgical repair of hard palate fistulas were seen to result in a very poor success rate. Orthodontic movement of maxillary segments was seen to contribute to late postoperative fistula formation. Therefore, orthodontic movement should be completed before undertaking surgical repair of anterior palatal fistulas. Finally, the success rate of anterior fistula repair has been dramatically improved by the addition of free periosteal grafts and cancellous bone grafts. PMID- 3538078 TI - [Epidemiologic and clinical study of tuberculosis in Slovenia (part 1)]. PMID- 3538079 TI - [Pulmonary tuberculosis in humans due to M. bovis. 2 case reports of the disease and a review of bovine tuberculosis in Croatia]. PMID- 3538080 TI - [Epidemiologic and clinical study of tuberculosis in Slovenia (continuation and conclusion)]. PMID- 3538081 TI - Principles and techniques of primary wound closure. AB - Proper closure of most wounds will negate the need for later scar revision. The goals of wound closure in the primary care setting are to stop bleeding, prevent infection, speed healing, and preserve the appearance and function of the injured area. The physician must evaluate each wound separately and use those techniques of wound closure that will provide the best results. In this article, the goals, principles, and some of the techniques of wound closure, including types of debridement, undermining, and closure in layers, are discussed. Different types of stitches and closure of difficult lacerations are also discussed. PMID- 3538082 TI - Complex wound closure, excisional biopsy, and use of simple flaps. AB - The primary care physician can utilize the various techniques discussed in this article to close complex lacerations, modify scars, and perform excisional biopsies. Various methods for closure of square, triangular, semicircular, circular, and rectangular defects were described. The principle of flap advancement and Z-plasties was explained, and the method for performing excisional biopsies was detailed. These techniques can be mastered by the primary care practitioner and can lead to improved patient satisfaction. These techniques can be practiced using pig's feet. These minor plastic surgery techniques are an important component in a primary care practice. PMID- 3538083 TI - Surgical treatment of diseases of the nail. AB - Nail disorders and diseases are common enough that the primary care physician should be familiar with and capable of performing surgical procedures necessary to treat them. The anatomy of the nail should be well understood. The physician should have access to specialized instruments that are necessary for proper nail surgery and should be familiar with the various techniques of anesthesia and postoperative care that will lead to the best result. Finally, the physician needs to be aware of those instances when a nail disorder is best treated conservatively or when a better result can be obtained with the proper surgical procedure. PMID- 3538084 TI - The treatment of warts. AB - Warts are caused by the human papillomavirus and produce a variety of clinical manifestations, depending on the viral type and the site of the lesion. In this article, the pathophysiology of warts is reviewed briefly, and options for treatment, including liquid nitrogen, dinitrochlorobenzene, bleomycin, podophyllin, Duofilm, and surgical excision, are examined. Several case studies are also presented. PMID- 3538085 TI - Office management of epithelial cysts and cutaneous abscesses. AB - Epithelial cysts and cutaneous abscesses account for a significant percentage of visits to primary care physicians. The majority of these skin problems can be handled in the office setting. In this article, a variety of modes of treatment for these common lesions are outlined. PMID- 3538086 TI - Office gynecologic procedures. AB - The screening and detection of endometrial carcinoma can be done safely and effectively in the outpatient setting using recently developed endometrial biopsy devices. The indications and techniques of endometrial biopsy are described in this article. In addition, the use of cryosurgery of the uterine cervix for the treatment of benign cervical disease as well as cervical intraepithelial neoplasia is reviewed. PMID- 3538087 TI - Circumcision and meatotomy. AB - The indications for and complications of neonatal circumcision are presented in this article, along with a discussion of meatal stenosis. Suggested methods for performing office-based meatotomy and in-nursery circumcision are outlined. PMID- 3538088 TI - Outpatient management of hemorrhoids. AB - Hemorrhoids are a common medical problem that usually can be managed conservatively with dietary changes, stool softeners, and local hydrocortisone creams. Acutely thrombosed external hemorrhoids require excision of the entire hemorrhoidal mass and the overlying skin. Persistently bleeding or painful internal hemorrhoids are best managed by the technique of band ligation. PMID- 3538089 TI - Office diagnostic procedures. AB - Tympanocentesis, punch biopsy of the skin, bone marrow aspiration and biopsy, and temporal artery biopsy are procedures discussed in this article. They are principally diagnostic procedures used in the evaluation of skin and serious systemic disease. PMID- 3538090 TI - Aspiration of joints and soft tissue injections. AB - Musculoskeletal and connective tissue disorders are commonly encountered in primary care practice. These disorders include varieties of bursitis, tendinitis, myositis, arthritis, and related conditions. A certain group of these disorders lend themselves to diagnosis by needle aspiration or to treatment by injections. The conditions discussed in this article include subacromial bursitis, supraspinous and bicipital tendinitis, tennis elbow, de Quervain's syndrome, trigger finger, inflammation of the knee, ganglion, and muscle trigger points. PMID- 3538091 TI - [Study instrument for psychopathology in computer-assisted analysis of findings (Structured Psychopathologic Detection System)]. AB - With the Structured Psychopathological Evaluation-System (SPES) an instrument existed for employment of objective criteria. This study was designed to present an evaluation system based on new scientific results, that is applying on the strength of a reduced catalogue of symptoms (94 compared with 198 Items at SPES A) to clinical routine. Additional findings differentiated by this system be able to classify by the help of an operational decision system. PMID- 3538092 TI - [Possibilities of rapid diagnosis in meningitis]. AB - The paper reviews rapid diagnosis methods for meningitis, covering currently proved immunological and physiochemical procedures, supplemented by reference to clinical biochemical tests. PMID- 3538094 TI - [Polish psychiatric literature 1984]. PMID- 3538093 TI - [Expressed emotions (EE) as the basic prognostic indicator in schizophrenia. Review of studies]. PMID- 3538095 TI - Some research relating to the treatment of Bleuler's disease (schizophrenia). PMID- 3538096 TI - Systems theory and holism in social psychiatry, a philosophic-integrative commentary. PMID- 3538097 TI - Conversion disorders in children: a study of clinical outcome. PMID- 3538098 TI - A psychogeriatric outpatient service in a general hospital: is it medically worthwhile? PMID- 3538099 TI - [An outline of scientific psychosomatics]. PMID- 3538100 TI - Caution against 'the asylum'. PMID- 3538102 TI - Countertransference issues in inpatient psychiatry. PMID- 3538101 TI - Glycosylated hemoglobin (risk of diabetes mellitus) in lithium therapy. PMID- 3538103 TI - A survey of involuntary patients' attitudes towards their commitment. PMID- 3538104 TI - Plasma measurements of disulfiram and its metabolites in a case of severe disulfiram-ethanol reaction. PMID- 3538105 TI - Cog-wheel rigidity: a prodromal sign of lithium/haloperidol toxicity. PMID- 3538106 TI - A double-blind study with ceruletide in chronic schizophrenic patients: biochemical and clinical results. AB - We evaluated ceruletide, a cholecystokininlike peptide, in a double-blind, placebo-controlled study of 20 male chronic schizophrenic patients. After baseline investigations, 10 patients received 0.3 microgram/kg body weight ceruletide, and 10 patients received placebo (normal saline) intramuscularly once weekly for 3 consecutive weeks. Psychopathology was rated on the Brief Psychiatric Rating Scale and the Nurses' Observation Scale for Inpatient Evaluation. Blood was drawn on the same days for estimation of norepinephrine, epinephrine, beta-endorphin, cortisol, and prolactin. There were no significant changes in biochemical parameters. With regard to psychopathology, no significant differences in behavioral ratings were found between the ceruletide- and placebo treated groups. Furthermore, there was no changes in either positive or negative symptoms of schizophrenia secondary to ceruletide. Contrary to uncontrolled studies, we failed to show antipsychotic properties of ceruletide. PMID- 3538107 TI - How blind is blind? Assessment of patient and doctor medication guesses in a placebo-controlled trial of imipramine and phenelzine. AB - The purpose of the double blind is to protect the internal validity of a clinical trial by preventing knowledge of treatment conditions from influencing outcome or its assessment. We studied medication guesses of 137 depressed patients and/or their doctors at the end of a 6-week randomized trial of placebo, imipramine, and phenelzine. Overall, 78% of the patients and 87% of the doctors correctly distinguished between placebo and active medication. Clinical outcome, treatment condition, and their interaction each contributed to guessing accuracy, while medication experience and side effects assessed only in week 6 did not. Accuracy was high, however, even when cases were stratified for clinical outcome, indicating that other cues were available to the patients and doctors. These may include patterns and timing of side effects and clinical response not detectable in this end-point analysis. PMID- 3538108 TI - Effects of lithium administration on plasma catecholamines. AB - The mode of action of lithium in the treatment of bipolar affective disorder is unknown. Among its actions are effects on release and response to catecholamines in experimental animals. We have therefore examined its effect on peripheral catecholamines in man. After 3 weeks of administration of therapeutic doses of lithium carbonate, healthy volunteers showed a differential response of catecholamines to insulin stimulation. Although the response of plasma norepinephrine remained unchanged, epinephrine response was dramatically reduced. These findings provide additional evidence for the separate neural regulation of the adrenal medulla and sympathetic nerve endings. Further studies are necessary to determine whether these effects on peripheral epinephrine are paralleled by changes in central epinephrine. PMID- 3538110 TI - Corticotropin-releasing factor (CRF)--a review. AB - Corticotropin-releasing factor (CRF), a 41 amino acid polypeptide, has been isolated from ovine hypothalamic extracts, sequenced, and synthesized. It has a high potency for stimulating the secretion of corticotropin-like and beta endorphin-like immunoactive substances in vitro and in vivo in laboratory animals and humans. The high concentration of CRF-like immunoactivity in hypophyseal portal plasma supports the hypothesis that CRF is the physiological hypothalamic factor. Human and rat CRF (rCRF) also have been purified and synthesized. They have an 83% sequence homology with ovine CRF (oCRF). oCRF-like activity has been found in human hypothalamus, pituitary stalk, posterior pituitary, thalamus, cerebral cortex, cerebellum, pons, medulla oblongata, spinal cord and in the adrenal, lung, liver, stomach, duodenum and pancreas. oCRF-like activity also has been found in the human placenta and in tissues producing ectopic ACTH. The action of CRF can be potentiated by vasopressin, oxytocin, epinephrine, norepinephrine, VIP, and angiotensin II. Intracerebroventricular administration of CRF in the rat produces prolonged elevations of plasma epinephrine, norepinephrine, glucose and glucagon; elevates mean arterial pressure and heart rate; increases motor activity and exploration in familiar surroundings and oxygen consumption; and decreases feeding and sexual behavior. Testing with CRF has enabled the separation of patients with hypothalamic and pituitary adrenal insufficiency. The CRF stimulation test has been useful in distinguishing pituitary from ectopic causes of Cushing's disease. The distribution of CRF within and beyond the hypothalamus provides an anatomical context for the observation that CRF can simultaneously activate and coordinate metabolic, circulatory and behavioral responses that are adaptative in 'stressful' situations. CRF not only stimulates the pituitary-adrenal axis in man, but it also influences several aspects of CNS function which may be of relevance to psychiatric illnesses. PMID- 3538109 TI - Lithium and lecithin in tardive dyskinesia: an update. AB - Psychiatric inpatients with tardive dyskinesia (TD) were treated with either lithium alone (n = 9) or with a combination of lithium and lecithin (n = 9) for 5 weeks in a double-blind, placebo-controlled experiment. A statistically significant but clinically unimportant improvement of TD occurred during both treatments. The addition of lecithin to lithium had no effect. PMID- 3538111 TI - Integrated psychotherapeutic treatment of somatoform and other psychophysiological disorders. AB - In this article, we have described a subgroup of patients referred from a general medical setting and suffering from a cluster of similar physical and emotional symptoms, while presenting similar psychodynamics and personality traits. In contrast to a certain scepticism in the psychiatric community about the usefulness of psychotherapy with these people, our experience suggests that when a number of diverse psychotherapeutic techniques are drawn upon in an integrated fashion, psychotherapy can be an effective clinical tool. The coping-rest model, with its combination of physiological, behavioural and dynamic approaches, has been particularly helpful. We present 3 representative cases, which reflect the overall clinical and personality features of the subgroup and the integrated psychotherapeutic approach that was utilized. PMID- 3538112 TI - A randomised controlled trial of individual counselling of smokers in pregnancy. PMID- 3538113 TI - The effect of acid etching on two glass ionomer lining cements. PMID- 3538114 TI - Resin dentin bonding agents--rationale and results. PMID- 3538115 TI - The effect of restorative materials on the adaptation of two bases and a dentin bonding agent to internal cavity walls. PMID- 3538116 TI - Shade determination, communication, and realization: a novel approach. PMID- 3538117 TI - Bond strength of etched porcelain denture teeth of PMMA. PMID- 3538119 TI - [Bonded bridges in daily practice]. PMID- 3538118 TI - [Preparation and function of a combination acrylic resin-tin ring temporary prosthesis in the posterior region]. PMID- 3538120 TI - [Tuberculoid tissue reactions following implantation of a resorbable gelatin preparation]. PMID- 3538121 TI - [Basic prosthetic principles: complete denture (IX)]. PMID- 3538122 TI - [Diagnostic protocol of toxoplasmosis in materno-fetal infections (1981-1984 statistics)]. AB - The authors describe the most important methods in use for the laboratory diagnosis of toxoplasmosis, with special reference to the presence of IgM and to their significance in the diagnosis of acute infection. Statistics of tests carried out on pregnant women at the "Giovanni Lelli" Centre (Rome, Italy) during the years 1981-1984 are quoted. The recommended diagnostic protocol to be followed to prevent congenital infections is given. PMID- 3538123 TI - Avidin-biotin-peroxidase complex (ABC) method for immunohistochemical localization of carcinoembryonic antigen in large intestine. PMID- 3538124 TI - [Urine culture and analysis of data using a computer]. AB - A computerized investigation of microbiological data concerning 7042 culture exams of urines has been carried out. Interesting data from the epidemiological point of view came out: positivity percentages in relation to the different months of the year, strains frequency, incidence of the urinary pathology in relation to sexes. It is also interesting the analysis of positivity percentages in relation to the derivation of samples, since it is clear a significant negativity of non-hospital samples. The use of computerized analysis of data in the microbiological laboratory is discussed and is a well considered the need to use computer not only to identify microorganisms and to determine the sensibility of antibiotics, but also for data management especially from the epidemiological point of view. Therefore the use of computer as file is desired in order to obtain by the statistic analysis, evidence of epidemiological character, plannings, work plans finalized to a more efficient answer to the growing need of culture exams. PMID- 3538125 TI - [Preliminary considerations on blood lipid parameters and blood insulin after oral glucose tolerance test]. AB - The behaviour of total lipids, triglycerides and apolipoproteins A and B has been investigated in 41 subjects whose glucose and insulin levels have been evaluated after oral glucose tolerance test. Some of the patients showed a normal glycemic response, others a reduced glucose tolerance. Patients with a normal glycemic curve and a normal pattern of insulin values after loading had low mean total lipids and triglycerides and elevated Apolipo A values. Furthermore, subjects with altered glycemic curve and normal insulin levels presented high mean total lipids and triglycerides and low Apolipo A values. In conclusion we observed, in agreement with other authors, that a good blood insulin reaction is a favourable factor for the reduction of serum triglyceride levels, probably by activation of lipoproteinlipase, with a slight mean increase of apolipoproteins A. PMID- 3538126 TI - [Comparative evaluation of various direct and culture methods for the diagnosis of genital Chlamydia trachomatis infections]. AB - Commercially produced fluorescein labelled monoclonal antibodies for Chlamydia trachomatis detection have been recently become available. We have compared the data obtained using two monoclonal antibodies, one for detecting inclusion on cell cultures (culture confirmation) and the other for detecting C. trachomatis in smears from urethral and cervical swabs, with our routine isolation method which utilizes Giemsa staining of cycloheximide treated McCoy cell cultures. We also evaluated an enzyme immunoassay for detecting C. trachomatis antigens in urethral and cervical specimens. The culture confirmation system was slightly more sensitive and simpler than Giemsa staining. Between the results of immunofluorescence direct test and culture there was 96.3% agreement. Sensitivity, specificity and predictive positive and negative value were 72.2, 98.4, 80 and 97.6%. Between results of culture and enzyme immunoassay there was 97.2% agreement. The immunoassay sensitivity, specificity predictive positive and negative value were, in women, 100, 97.1, 63.6 and 100%; in men, 100, 95.7, 81.8, 100%. PMID- 3538127 TI - [Esthetics and function of complete dentures--realization of computer-assisted occlusal concept (I)]. PMID- 3538128 TI - [Painted and/or integrated use of the DTC-color system]. PMID- 3538129 TI - The concentration, physical state, and purity of bacterial endotoxin affect its detoxification by ionizing radiation. AB - Increasing concentrations of a highly purified bacterial lipopolysaccharide preparation, the U.S. Reference Standard Endotoxin, were exposed to increasing doses of ionizing radiation from a 60Co source. At identical radiation doses both the structural change and Limulus amebocyte lysate (LAL) reactivity were progressively smaller with increasing concentrations of the lipopolysaccharide in an aqueous medium. Under the experimental conditions used, there was a linear relationship between the endotoxin concentration and radiation dose for the structural changes. In contrast to endotoxin in aqueous medium, endotoxin irradiated in its dry state showed no decrease in LAL reactivity and rabbit pyrogenicity. Endotoxin exposed to radiation in water in the presence of albumin showed a much smaller decrease in LAL and pyrogenic activities than expected. The results show that the concentration, physical state, and purity of endotoxin influence its structural and functional alteration by ionizing radiation. PMID- 3538130 TI - Radiography in the United States Army during World War II: Part I. AB - This is the first of two articles highlighting Army radiography through World War II. Topics concentrate on a few important military and civilian events between wars (1918-1941), such as the Army's contributions in (classifying) radiographic knowledge and escalating x-ray commercialization. Peacetime objectives, the mobilization effort, personnel and training, and how WACs and civilians contributed are discussed also. PMID- 3538132 TI - RSNA (Radiological Society of North America) index to imaging literature. 1984 1986. PMID- 3538131 TI - [Pulsed duplex sonography in the detection of lower pole arteries in hydronephrosis]. AB - Pulsed duplex sonography was used for the diagnosis of lower pole arteries, which cross the uretero-pelvic junction and are possibly the reason of hydronephrosis. We could identify the crossing vessel in 8 patients by pulsed duplex sonography. The diagnosis is easy, though optimum patient preparation is required, and Duplexsonography may help to reduce the frequency of angiography in this special clinical situation. PMID- 3538133 TI - Lymphoceles: imaging characteristics and percutaneous management. AB - Twenty-five patients who had lymphoceles underwent sectional imaging and interventional radiologic procedures. Viewed using sonography, lymphoceles were hypoechoic to anechoic, occasionally with internal septa and debris. Low numbers (occasionally negative values) were observed using computed tomography (CT); these numbers strongly suggest the diagnosis of lymphocele. Calcification was observed on CT images of one patient. Diagnostic aspiration revealed tan to yellow fluid containing many lymphocytes; pathognomonic fat globules were observed in four cases. Malignant cells were found in two collections, an unusual occurrence. Therapeutic needle aspiration and short-term catheter drainage were usually unsuccessful (only one of five patients [20%] was cured). Long-term (1-5 week) catheter drainage cured 11 of 14 patients (78.6%). Sclerosing agents may have been beneficial for lymphocele obliteration in three of four patients. For most patients, lymphoceles may be diagnosed and treated successfully using radiologic means. PMID- 3538134 TI - Sonography of the internal capsule and basal ganglia in infants. Part II. Localization of pathologic processes in the sagittal section through the caudothalamic groove. AB - Sagittal sonograms through the caudothalamic groove routinely display a gangliothalamic ovoid delimited by the lateral ventricle, the perimesencephalic cistern, and the radiations of the corpus callosum. The caudothalamic groove divides the superior surface of the ovoid into an anterior caudate arc and a posterior thalamic arc. The cerebral peduncle divides the inferior surface of the ovoid into an anterior ganglial arc, a middle peduncular arc, and a posterior thalamic arc. The genu of internal capsule constantly courses from the anterior end of the caudothalamic groove down to the peduncular arc and is easily identified. The gangliothalamic ovoid exhibits four obliquely oriented bands of increased and decreased echogenicity. The anteriormost hyperechoic band 1 corresponds to the head of the caudate nucleus. Hypoechoic band 2 corresponds to the globus pallidus, genu of the internal capsule, and cerebral peduncle. Hyperechoic band 3 corresponds to the ventral and lateral thalamic nuclei (exclusive of the pulvinar). Hypoechoic band 4 corresponds to the pulvinar. Lesions of the medial nucleus of the globus pallidus appear as hyperechoic foci that abut on the anterior surface of genu just above the peduncle and that have a narrow convex caudal margin. Lesions of the lateral nucleus of globus pallidus abut on the genu distant from the peduncle, spare the medial nucleus adjacent to the peduncle, and have a broad caudal border. Lesions of the head of caudate nucleus affect the anterior pole of the ovoid; those of the body affect the caudate arc superior to the caudothalamic groove. Thalamic lesions increase the echogenicity of bands 3 and 4. PMID- 3538135 TI - Septal veins: a normal finding on neonatal cranial sonography. AB - The appearance of normal septal veins on cranial sonography is described. Septal veins are part of the deep cerebral (galenic) venous system. Improved technology allows these structures to be identified as they course in the walls of the cavity of the septum pellucidum (cavum septi pellucidi). These veins are normal structures that should not be misinterpreted as pathologic ventricular septations, calcifications, or evidence of prior intracranial hemorrhage. PMID- 3538136 TI - Focal adrenal hemorrhage: a new US appearance. AB - The ultrasonographic (US) appearance of neonatal adrenal hemorrhage has been described as a mass obliterating the normal contour of the entire gland. In the four cases described, different US appearances were found: In three, the hemorrhage was focal with the uninvolved portion of the gland visualized adjacent to the hemorrhage; in the fourth patient, hemorrhage involved primarily the medulla. Excellent computed tomographic or pathologic correlation with the US appearance was demonstrated. These findings suggest that adrenal hemorrhage should be considered in the differential diagnosis of focal adrenal masses in the neonate. PMID- 3538137 TI - Detection of multivessel disease after myocardial infarction using intravenous stress digital subtraction angiography. AB - Forty-six patients with prior myocardial infarction underwent stress intravenous digital subtraction angiography (DSA) and coronary angiography. The left ventricular ejection fraction (EF) and wall-motion responses to exercise were correlated with the coronary anatomy. Twenty-five patients with single vessel disease showed essentially no change in left ventricular EF with exercise (a decrease from 66% to 64%), but those with multivessel disease (21 patients) had a significant decrease in left ventricular EF (from 59% to 48%) (P = .0001). A decrease in left ventricular EF had a sensitivity of 95% and specificity of 60% for the detection of multivessel disease, whereas an increase in wall-motion abnormality had a sensitivity and specificity of 72% and 71%, respectively. After myocardial infarction, a fall in left ventricular EF with stress intravenous DSA is highly sensitive for the detection of multivessel disease, but there are a number of false-positive results, resulting in only moderate specificity. A new wall motion abnormality has only a moderate sensitivity and specificity. PMID- 3538138 TI - Mesenteric adenitis and acute terminal ileitis: US evaluation using graded compression. AB - One hundred seventy consecutive patients with clinical suggestion of acute appendicitis were studied by ultrasound (US) with the examiner using the graded compression technique. In 14 patients, the only US findings consisted of enlarged mesenteric lymph nodes in combination with mural thickening of the terminal ileum. This was consistent with the findings at surgery in four patients and with the results of barium studies in seven patients. In nine of 14 patients, stool cultures were performed, eight of which were positive for Yersinia enterocolitica. None of these 14 patients finally proved to have appendicitis. In a patient with acute pain in the right lower quadrant whose appendix cannot be visualized sonographically and whose US findings consist of enlarged mesenteric lymph nodes and mural thickening of the terminal ileum, the diagnosis is probably mesenteric adenitis and acute terminal ileitis. Appendectomy should be avoided in this condition. PMID- 3538139 TI - Mayer-Rokitansky-Kuster-Hauser syndrome: US aid to diagnosis. AB - The Mayer-Rokitansky-Kuster-Hauser syndrome is composed of vaginal atresia with other variable Mullerian duct abnormalities such as bicornuate or septated uterus. The fallopian tubes, ovaries, and broad and round ligaments are normal. Unilateral renal and skeletal anomalies are associated in 50% and 12% of cases, respectively. Patients have a normal female karyotype and normal secondary sexual development. Previously, one had to rely on radiographic contrast studies and surgical exploration for accurate definition of the reproductive tract anatomy. The authors performed ultrasound (US) examinations on 12 patients, aged 5 days to 18 years, with the Mayer-Rokitansky syndrome. US allowed correct identification of the genitourinary anomalies found in these girls, including eight cases of unilateral renal agenesis; one absent, one rudimentary, and ten duplicated or obstructed uteri; eight duplicated or obstructed vaginas; and associated complications such as endometriosis. Eight of the patients had lower abdominal pain, often cyclical in nature. The findings demonstrate that high-resolution, real-time US in conjunction with water vaginography permits the anatomy of these complex anomalies to be defined. PMID- 3538140 TI - Integrated stereotaxic imaging with CT, MR imaging, and digital subtraction angiography. AB - A stereotaxic frame, compatible with digital subtraction angiography, computed tomography, and magnetic resonance imaging, is described along with a set of software programs that run in an independent imaging computer system, as well as in the computers associated with each modality. Plexiglas plates fastened to the sides of the frame contain fiducial markers that can be recognized in the images and from which the section position and in-plane coordinates of any point in the image relative to the frame may be determined. Coordinate measurements of isolated point targets may be made to an accuracy of better than +/- 1 mm within a 15-cm field of view in the plane of the section or projection on all modalities. The stereotaxic system is of sufficiently high accuracy to be used on a routine clinical basis with one or more of the above modalities. PMID- 3538141 TI - Abnormal pregnancy: early diagnosis by US and serum chorionic gonadotropin levels. PMID- 3538142 TI - Arteriosclerotic ischemic cerebrovascular disease. PMID- 3538143 TI - Periventricular leukomalacia: radiologic diagnosis. AB - Fifteen infants and children with clinical evidence of periventricular leukomalacia (i.e., spastic diplegia or quadriplegia and premature birth) were studied. Computed tomography (CT) scans of the brain demonstrated the following characteristic abnormalities: reduction in quantity of periventricular white matter, particularly at the trigone, deep and prominent sulci that abutted the ventricles without interposed white matter, and ventriculomegaly with irregular outline of the lateral ventricles. The location and severity of abnormalities on CT scans correlated well with the neurologic abnormalities observed at follow-up and the known anatomic location of periventricular leukomalacia. These observations demonstrate the diagnostic value of CT scanning for periventricular leukomalacia during late infancy and childhood. Although serial ultrasonography during the first weeks of life may be diagnostic of periventricular leukomalacia, it is of less value later. In contrast, CT scans obtained beyond 6 months of age can demonstrate a characteristic pattern of abnormalities that may be considered diagnostic of periventricular leukomalacia. PMID- 3538144 TI - Complications of outpatient transbrachial intraarterial digital subtraction angiography. Work in progress. AB - To assess the safety of nonselective intraarterial digital subtraction angiography (DSA) performed from a brachial artery approach, the complications of 660 consecutive examinations, most of which (greater than 95%) were performed on outpatients, were studied. Contrast material injections into the aorta were made through a 4-F multiple side-hole pigtail catheter inserted percutaneously from the brachial artery. Two brachial artery complications severe enough to require surgery occurred (one hematoma and one arterial laceration/thrombosis), for a rate of 0.3%. No cerebrovascular complications were encountered. Delayed and minor complications were retrospectively studied in 137 patients; they included local arm pain in 24 patients (17.5%), transient paresthesia in ten (7.3%), ecchymosis in 69 (50.4%), and hematoma in 13 (9.5%). The transbrachial approach to nonselective intraarterial DSA is a safe alternative to the femoral artery approach. PMID- 3538145 TI - Localization of parathyroid adenomas in patients who have undergone surgery. Part I. Noninvasive imaging methods. AB - The authors evaluated computed tomography (CT), ultrasound (US), technetium/thallium scintigraphy, and magnetic resonance (MR) imaging as localization procedures in 53 patients with proved parathyroid adenomas and previous unsuccessful parathyroid surgery. CT had the highest overall sensitivity (47%), followed by US (36%) and scintigraphy (27%). There is still too little data to assess MR imaging. Adenoma size affected the sensitivity of CT, scintigraphy, and MR imaging but not US. When all three studies were used, at least one study depicted a lesion in 78% of patients, but definitive localization (two positive studies) was achieved in only 31%. PMID- 3538146 TI - Localization of parathyroid adenomas in patients who have undergone surgery. Part II. Invasive procedures. AB - The authors studied intraarterial digital subtraction angiography (DSA), conventional selective angiography, parathyroid venous sampling (PVS), and intraoperative ultrasound (US) as localization procedures for parathyroid adenomas in 53 patients with proved parathyroid adenomas and previous unsuccessful parathyroid surgery. PVS had the highest overall sensitivity as a single study (80%), followed by intraoperative US (78%), angiography (60%), and DSA (49%). Invasive procedures permitted successful localization of adenomas in 41 of 43 patients studied (95%). False-positive studies were uncommon. The optimum sequence of invasive localization procedures is determined by clinical factors and not by the sensitivity of individual tests. The authors recommend DSA be performed first, followed by angiography, PVS, and intraoperative US, in that order. PMID- 3538147 TI - Medullary thyroid carcinoma: role of high-resolution US. AB - Medullary thyroid carcinoma accounts for 10% of thyroid malignancies. Accurate determination of the extent of disease is important because surgery is required for initial treatment and recurrence. High-resolution (10-MHz) ultrasonography (US) of the neck was used to study 15 patients with medullary thyroid carcinoma; nine of the 15 had undergone thyroidectomy but had biochemical evidence of tumor recurrence. Metastatic cervical lymph nodes were detected with US in all 12 patients who had metastatic nodes at surgery, although these nodes were palpable in only four. Punctate bright echogenic foci were seen within some of the nodes in nine of the 12 patients (75%). Similar bright echogenic foci were seen within the primary intrathyroid tumor in five of the six patients who had not yet undergone thyroidectomy (83%). Pathologically, these foci correlated with deposits of calcium surrounded by amyloid, which is characteristic of medullary thyroid carcinoma. US is useful for the detection of nonpalpable recurrence of cervical metastatic lymph nodes, and because it is noninvasive and relatively inexpensive, it should be the first imaging investigation performed after thyroidectomy. PMID- 3538148 TI - Deep venous thrombosis: US assessment using vein compression. AB - To assess vein compressibility as a simple ultrasound (US) technique to determine the presence of venous thrombi, 51 patients undergoing contrast material venography of the lower extremity because of a clinical suspicion of deep venous thrombosis (DVT) also underwent high-resolution US evaluation of the veins. DVT was diagnosed on 28 venograms. In 25 patients US studies demonstrated non compressibility of the veins, indicating the presence of clot. In 23 patients with normal venograms, US examinations demonstrated total compressibility of the veins, indicating the absence of DVT. Clots below the knee were not depicted by US. In this study US had a sensitivity of 89% and a specificity of 100%. PMID- 3538149 TI - Recurrent female pelvic cancer: assessment with transrectal ultrasonography. AB - Fifty-two women with symptoms or signs suggesting pelvic recurrence of biopsy proved pelvic cancer were assessed in a prospective trial by clinical examination, transabdominal pelvic ultrasonography (TAU), computed tomography (CT), and transrectal pelvic ultrasonography (TRU). TRU significantly added to the information from TAU in the measurement of abnormalities on the pelvic sidewalls, and to TAU and CT in the measurement of abnormalities in the central and presacral regions of the pelvis. Results of this preliminary study suggest that TRU may provide information complementary to that from CT in women with suspected recurrence of gynecologic cancer. PMID- 3538150 TI - Vascular complications in renal allografts: detection with duplex Doppler US. AB - Renal allografts are subject to many vascular complications. Over a 2-year period, 334 duplex Doppler ultrasonographic (US) examinations were performed in 88 renal allograft recipients. Vascular occlusion on the basis of severe vascular rejection was documented in ten patients (11.4%) for a sensitivity and specificity of 100%. Seven patients, for whom there was clinical and Doppler US evidence for renal artery stenosis, underwent angiography. A significant stenosis was confirmed and treated by angioplasty in four patients; one had an insignificant stenosis in an accessory artery, one had kinking of the renal vessels, and another had normal findings. The most reliable criteria for stenosis were a high-velocity jet exceeding 7.5 kHz and distal turbulence. One arteriovenous fistula was diagnosed by the presence of an intrarenal high velocity jet. Duplex Doppler US is a useful, noninvasive, and portable initial procedure with which to screen patients for vascular complications of renal transplantation. PMID- 3538151 TI - Doppler signal quantitation in renal allografts: comparison in normal and rejecting transplants, with pathologic correlation. AB - Quantitative duplex Doppler sonography was performed in 55 renal transplant patients during 54 independent episodes of acute rejection, three episodes of chronic rejection, three episodes of acute tubular necrosis (ATN), and 23 occasions of normal graft function. Doppler signals were obtained from four arterial sites in each kidney. Nine patients, in whom signals were absent, were subsequently shown at nephrectomy to have absence of perfusion resulting from severe acute vascular rejection. In each patient with graft dysfunction, biopsy or nephrectomy was performed within 24 hours of the Doppler study. Arterial Doppler signals were quantified using a pulsatility index (PI). Acute rejection produced a significantly higher PI at each arterial site. Receiver-operator characteristics suggest that signals obtained from the segmental arteries are most sensitive to these changes. With a threshold PI of 1.5, the sensitivity of this technique for detection of acute renal allograft rejection is 75%; the specificity is 90%. In acute vascular rejection, the same PI yields a sensitivity of 79% and specificity of 90%. With a cutoff PI of 1.8, a specificity of 100% can be achieved. PMID- 3538152 TI - Porta hepatis: duplex Doppler US with angiographic correlation. AB - Duplex Doppler ultrasonography (US) and panhepatic angiography were performed and interpreted independently in 20 patients with suspected portal hypertension to assess the accuracy of duplex US in the porta hepatis. Hepatic arterial resistive indexes were correlated with corrected sinusoidal pressures. The results of duplex US agreed with those of angiography in 16 patients with a normal portal vein (including three with hepatofugal flow) and two with total thrombosis. One angiographically normal portal vein appeared thrombosed on an initial sonogram, but a second scan was normal. One case of partial thrombosis was not diagnosed with duplex US. Sensitivity and specificity for main portal vein disorders were 83% and 93%, respectively. Two patients had portal vein branch occlusions that were found by angiography but not by US. Portal vein echogenicity was neither sensitive nor specific for thrombosis. The resistive index of the hepatic artery was specific for portal hypertension when above .78, but it was not sensitive. Duplex US is accurate in prospectively assessing the direction of flow and the presence of total thrombosis in the portal vein, but partial thrombosis may not be detected on sonograms. PMID- 3538153 TI - Focal periportal sparing in hepatic fatty infiltration: a cause of hepatic pseudomass on US. AB - An unusual pattern of hepatic fatty infiltration was detected sonographically in 31 patients over a 1.5-year period. At appropriate gain settings and time gain compensation, the liver parenchyma demonstrated diffuse increased echogenicity except for a solitary hypoechoic area with relatively distinct margins, usually located in the medial segment of the left hepatic lobe. This hypoechoic periportal focus varied in size between 1.5 and 5 cm and was typically ovoid, but was occasionally spherical or irregular in shape. Eight patients with such foci underwent percutaneous needle biopsy because of concern that there was a space occupying mass. Microscopic examination of specimens from the hypoechoic periportal region revealed normal hepatic parenchymal cells, while tissue samples from the surrounding liver had high fat levels. In the remaining 23 patients, correlative radiologic studies supported the diagnosis of fatty liver and excluded a central-mass lesion. A localized area of normal hepatic tissue should be considered among the possible diagnoses when a circumscribed hypoechoic periportal area is demonstrated within a fatty liver. PMID- 3538154 TI - Quantitative estimation of liver attenuation and echogenicity: normal state versus diffuse liver disease. AB - A method based on broad-band amplitude for obtaining attenuation and echogenicity estimates from homogeneous phantoms and tissues is described. Although a number of assumptions about the beam and scattering properties must be made, the attenuation results are as accurate as those obtained by the spectral-difference method and show less variability. The method was applied to the livers of 18 healthy volunteers and 76 patients with liver disease, including 29 patients with chronic hepatitis and 30 patients with Gaucher disease. Patients with chronic hepatitis formed a bimodal distribution, with one group having lower than normal attenuation and echogenicity values and another having elevated values. Six patients with type I glycogen storage disease and fatty infiltration of the liver had highly attenuating, echogenic livers as did patients with fatty livers from other causes. This finding confirms the subjective impressions already reported in the literature. In contrast to previous literature reports, patients with cirrhosis had normal attenuation and echogenicity values. Reasons for this discrepancy are discussed. PMID- 3538155 TI - Hemangioma of the spleen: radiologic-pathologic correlation in ten cases. AB - Ten cases of hemangioma of the spleen were reviewed. Plain abdominal radiographs and scintigrams are helpful in specifying the splenic location. Calcification, either central punctate or peripheral curvilinear, can be detected on radiographs or computed tomographic (CT) scans. The spectrum form solid to cystic change observed in the pathologic specimens is reflected in analogous patterns on CT scans and sonograms: predominantly solid mass; mass with cystic spaces. The angiographic findings are nonspecific. It is possible to suggest the diagnosis of hemangioma of the spleen when an asymptomatic patient presents with a discrete splenic mass, particularly if there is evidence of calcification and cystic change within the lesion. PMID- 3538157 TI - Abdominal hydatid disease: US findings during medical treatment. AB - The sonographic appearance of 141 hepatic and abdominal hydatid cysts was studied in 63 patients undergoing therapy with benzoimidazolic compounds. The cysts were evaluated for size, margins of the cyst wall, and echo pattern of cyst contents to establish the response to the drugs. Changes seen on ultrasound (US) scans were classified as decrease in size, detachment of the cyst membrane, and appearance of echogenic material (matrix) in the cyst cavity. These findings, particularly the diffusely hyperechoic pattern, are explained on the basis of the action of the drugs. Twenty-one patients underwent surgery at the end of treatment. The US patterns of treated hydatid cysts are similar to those seen, though more rarely, in cases of spontaneous parasite involution in long-standing hydatidosis. PMID- 3538156 TI - High-dose clinical urography with the low-osmolality contrast agent Hexabrix: comparison with a conventional contrast agent. AB - A double-blind clinical trial was performed in 60 patients to compare Hexabrix (ioxaglate meglumine and ioxaglate sodium) and Renografin-60 (diatrizoate meglumine and diatrizoate sodium). Use of Hexabrix produced higher urinary iodine concentrations, lower urine volumes at 30 minutes, and excretory urograms significantly better in diagnostic quality, as rated by four independent observers. There was no difference in nephrogram quality between contrast agents. Patients receiving Hexabrix had less of an increase in heart rate and demonstrated a slight rise in mean arterial blood pressure, rather than the biphasic rise then fall seen with Renografin-60. There was no significant change for up to 96 hours after urography in results of hematology, clinical chemistry, or urinalysis, except for an increase of 0.005 in urine specific gravity with Renografin-60. Patients reported significantly less body heat, heat in the injection arm, and overall discomfort with Hexabrix. There was a similar amount of nausea and vomiting in the two groups. Hexabrix also caused histaminic-type reactions in three patients. PMID- 3538158 TI - Genetic and immunological factors in affective disorders and schizophrenia. PMID- 3538159 TI - Two syndromes in schizophrenia and the viral hypothesis. PMID- 3538161 TI - Brain noradrenaline and schizophrenia. PMID- 3538160 TI - Cholecystokinin and schizophrenia. PMID- 3538162 TI - Indoleamines in depression and suicide. PMID- 3538163 TI - Morphology and distribution of peptide-containing neurones in the cerebral cortex. PMID- 3538164 TI - Cerebral changes in Alzheimer's disease. PMID- 3538166 TI - Neuropeptides and schizophrenia. PMID- 3538165 TI - Neuropeptides and dementia. PMID- 3538167 TI - Neuropeptides in spinal cord. PMID- 3538168 TI - Neurochemistry and neural circuitry in the dorsal horn. PMID- 3538169 TI - Peptides in the peripheral nervous system. PMID- 3538170 TI - Immunohistochemical techniques. PMID- 3538171 TI - Peptides in body fluids in pain. PMID- 3538172 TI - Distribution of peptides in basal ganglia. PMID- 3538173 TI - Physiology of peptides in basal ganglia. PMID- 3538174 TI - Programmed electrical stimulation: its role in the management of ventricular arrhythmias in coronary heart disease. PMID- 3538175 TI - The Q-wave and non-Q wave myocardial infarction: differences and similarities. PMID- 3538176 TI - Vascular complications in experimental atherosclerosis. PMID- 3538177 TI - The Hypertension Detection and Follow-up Program design, methods, and baseline characteristics and blood pressure response of the study population. PMID- 3538178 TI - All-cause mortality in the Hypertension Detection and Follow-up Program: findings for the whole cohort and for persons with less severe hypertension, with and without other traits related to risk of mortality. PMID- 3538179 TI - Implications of the Hypertension Detection and Follow-up Program. The Hypertension Detection and Follow-up Program Cooperative Group. PMID- 3538180 TI - Cerebrovascular events in the Hypertension Detection and Follow-up Program. PMID- 3538181 TI - Adverse effects of antihypertensive medications in the Hypertension Detection and Follow-up Program. PMID- 3538182 TI - Clinicians' interpretation of the results and implications of the Hypertension Detection and Follow-up Program. PMID- 3538183 TI - The effects of drug treatment for hypertension on morbidity and mortality from cardiovascular disease: a review of randomized controlled trials. PMID- 3538184 TI - Utilization of isomers and analogs of amino acids and other sulfur-containing compounds. AB - Rats and chicks obtain little or no bioefficacy from the D-isomers of lysine, threonine, arginine, histidine and cystine. D-isomers of the branched-chain amino acids, i.e., leucine, isoleucine and valine (LEU, ILE, VAL) are utilized relatively well by chicks but poorly by rats. D-tryptophan is utilized efficiently by rats and pigs, but inefficiently by chicks, poults, mice and humans. The D-forms of phenylalanine (PHE), tyrosine and methionine (MET) are utilized well by both rats and chicks. Keto and hydroxy analogs of LEU, ILE, VAL, PHE and MET are utilized by both rats and chicks. The L-isomer of the alpha hydroxy analogs of ILE and PHE has bioactivity while the D-isomer has no bioactivity. D-OH-LEU and D-OH-VAL have bioactivity, but they are less efficacious than their corresponding L-OH analogs. D-OH-MET is a more efficient precursor of L-MET than is L-OH-MET. In general, alpha-keto analogs of LEU, ILE, VAL, PHE and MET are utilized no more efficiently than the active isomeric form of the alpha-OH analogs of these amino acids. The alpha-OH and alpha-keto analogs of ILE are utilized relatively efficiently when used to replace only a portion of L-ILE in a purified amino acid diet for either rats or chicks; utilization of L ILE analogs is poor, however, when all of the dietary L-ILE is replaced by analog material. In addition to MET and cyst(e)ine, many other dietary sulfur compounds must be considered when dealing with sulfur amino acid bioactivity. Glutathione, taurine, N-acetyl-MET, lanthionine and inorganic sulfate all have sulfur amino acid bioactivity under certain circumstances. Likewise, both oral and endogenous carnosine have histidine bioactivity, and purines, pyrimidines and urea have dispensable amino acid biosynthetic activity. PMID- 3538185 TI - Social and biocultural determinants of food selection. AB - Health professionals concerned with improving the nutritional status of populations are facing numerous problems ranging from emaciation to overnutrition. This review article addresses the complexity, the relative significance and the interaction of factors leading to the nutritional profile of specific groups and individuals. When availability of food is threatened, the programs designed to reduce the incidence of malnutrition must balance the food supply with energy resources and population needs as well as encourage economic improvement of food distribution systems. For those persons having access to an abundant food supply, social forces and technological factors may affect food patterns, resulting in unbalanced diets associated with chronic diseases. Misinterpretation of reliable scientific findings is a major cause of abnormal nutrition behaviour. Overreaction to health messages may precipitate such conditions as anorexia nervosa or nutrient toxicity. Adverse food reactions, real or imagined, lead to restrictions in food selection. Excessive austerity in food use negates the pleasure of eating, a useful mechanism in food choice ensuring food diversity. PMID- 3538186 TI - Nutritional aspects of preconceptional period as related to pregnancy and early infancy. AB - The maternal nutritional status is considered as one of the most important factors influencing the pregnancy and the state of the offspring. There are limited data available on inadequate intake, especially before conception. A variety of nutritional and non-nutritional factors can act during the preconceptional period. Prepregnancy body weight and gestational weight gain have an independent but cumulative influence on the birth weight. The vitamin deficiency in preconceptional period, especially of folates, seems to be associated with neural tube defects. The infants of women with total gestational weight gain below 9 kg have the mean birth weight always lower than those of women with weight gain more than 9 kg in all three categories of preconceptional relative weight (i.e. less than 95%, from 95% to 105% and greater than 105%). Also the proportion of infants with birth-weight greater than 2500 g is higher in average (6.2%) and under-weight (4.4%) groups than in those over-weight (1.8%). Several other maternal nutritional as well as non nutritional variables are related with the pregnancy outcome. Among those with harmful effect on pregnancy outcome since preconceptional period, are alcohol drinking and smoking. Work outside the home can be associated with preterm deliveries and low-birth-weight infants, but the results are not consistent. Nutritional intervention, energy and/or protein supplementation also contribute to an increase of the birth weight. As far as the antenatal care is concerned, only few studies investigated, with a scientific rigour the relation if any between prenatal care and pregnancy outcome. We concluded that the available evidence confirms a significant impact of preconceptional nutrition on pregnancy outcome. A sensitive evaluation of nutritional status in preconceptional period seems to be a positive strategy for prevention of at risk pregnancies. There is a clear need of prospective human studies with aim to relate the nutrient status of future mother to the evolution of her pregnancy. PMID- 3538187 TI - Cardiovascular effects of adenosine in man; possible clinical implications. AB - The results summarized above indicate that adenosine is a physiologically relevant modulator of the cardiovascular system in man. The levels of adenosine are low during resting conditions, but may increase during conditions of oxygen and/or substrate deficiency. Already the basal concentration seems to be sufficient to affect regional flow in vital organs such as the heart. Several drugs may act by increasing the levels of adenosine or by influencing its receptors. In addition, adenosine may be used in many clinical situations as a vasodilator, antiaggregatory compound as well as an antiarrythmic agent. Its effect is easy to control due to the extremely short plasma half-life. The dose range for the clinical effects are summarized in Table 6. Both the physiological and pharmacological aspect of adenosine are subject to intense study in several laboratories. PMID- 3538188 TI - [DNA polymerase alpha]. PMID- 3538190 TI - [Papers from seaweeds--manufacture and applications of alginate fiber papers]. PMID- 3538189 TI - [Cloning of metabolic regulators and regulation of cell proliferation]. PMID- 3538191 TI - [Anion transport system in human erythrocyte membrane: structure and function of band 3]. PMID- 3538192 TI - [Transcriptional control of the protooncogenes--human EGF receptor gene and c-Ha ras 1 gene]. PMID- 3538193 TI - [Molecular neurobiology of the enkephalins]. PMID- 3538194 TI - [High-performance affinity chromatography]. PMID- 3538195 TI - [The T cell receptor for antigen--a review]. PMID- 3538196 TI - [Activation and regulation of the proteinases in the complement system]. PMID- 3538197 TI - [Testing of occlusal rests for endurance]. PMID- 3538198 TI - [The relation between cross-section and length of a straight retention arm and the magnitude of acting forces and the depth of the undercut surface]. PMID- 3538199 TI - [Use of toluidine blue in dental prosthetics]. PMID- 3538200 TI - [Correction of complete denture occlusion with an occluder and using reocclusion]. PMID- 3538201 TI - [Materials for filling undercut surfaces in models for the preparation of acrylic plate removable partial dentures]. PMID- 3538202 TI - [Causes of the faulty connections of teeth to acrylic bases]. PMID- 3538203 TI - [A device for drying and heating models in polymerization boxes after melting away of the wax]. PMID- 3538205 TI - Studies on the pharmacokinetics of ZK 96 480, a novel PGI2-mimetic, in rat and cynomolgus monkey. AB - ZK 96 480 (5- [(E)-(1S,5S,6S,7R)-7-Hydroxy-6-[(3S,4S)-3-hydroxy-4- methylnona-1,6 diinyl]-bicyclo [3.3.0] octan-3-yliden]-3-oxapentanoic acid) is a novel PGI2 derivative. The pharmacokinetics and biodegradation of the new drug were studied in rat and cynomolgus monkey after i.v. and i.g. administration of 3H-labelled ZK 96 480. In a rat liver perfusion experiment ZK 96 480 remained unchanged over 90 min. Following i.v. and i.g. dosing, the metabolic pattern in the urine and the methanolic extracts of homogenized, freeze-dried feces samples revealed almost exclusively unchanged compound in both animal species. After i.v. treatment, drug disposition in the plasma exhibited half-lives of 0.14 h and 4.3 h in rat and 0.07 h, 0.4 h and 2.5 h in monkey. Total clearance was 14 ml/min/kg in the latter species. Excretion of 3H-label was mainly fecal in rat, but exhibited no preferred route in monkey. On the basis of the urinary excretion of 3H-label and unchanged drug both gastro-intestinal absorption and bioavailability were complete. Whole body autoradiographs in rat demonstrated that there was no specific enrichment of radiolabel in any tissue or organ. The present results demonstrate that ZK 96 480 is an orally available and metabolically stable carbacyclin derivative in female rats and monkeys. PMID- 3538204 TI - Vitamin C increases the prostacyclin production and decreases the vascular lesions in experimental atherosclerosis in rabbits. AB - Feeding a cholesterol-rich diet (0.3%) to rabbits resulted in an intimal thickening and lipid infiltration of the aorta. The prostacyclin production by the vascular endothelium was significantly decreased, after a transient increase after 2 weeks of diet. The arachidonic acid metabolism in platelets was hardly changed. Addition of a low dose vitamin C (150 mg/day) to the cholesterol rich diet resulted in decreased lipid infiltration and intimal thickening and the transient increase of the prostacyclin production was postponed to the 4th week. Although this dose of vitamin C could not restore the decreased prostacyclin production observed after 6 weeks diet, a higher dose of vitamin C (600 mg/day), besides its beneficial effect on the lipid infiltration and the intimal thickening in the thoracic aorta, kept the intimal prostacyclin production at normal levels for at least 8 weeks. PMID- 3538206 TI - [Prof. Kazimierz Lejman]. PMID- 3538207 TI - [Current theories on the etiopathogenesis of alopecia areata]. PMID- 3538208 TI - [Lyme disease]. PMID- 3538209 TI - [The heart in scleroderma]. PMID- 3538210 TI - [Prof. Kazimierz Lejman--dermatologist, scientist and the man]. PMID- 3538212 TI - Metal stops on all-porcelain occlusal surfaces. PMID- 3538211 TI - [Introductory speech of the 34th Congress of the International Psychoanalytic Society 28 July 1985]. PMID- 3538213 TI - Maxillary sectional impression tray technique for microstomic patients. PMID- 3538214 TI - An impression technique for bilateral mandibular distal extension partial dentures. PMID- 3538215 TI - Effect of etching technique on the clinical performance of porcelain veneers. PMID- 3538217 TI - A controllable impression tray for making complete denture impressions. PMID- 3538216 TI - Tensile bond strength variation with opaque powder/liquid ratio. PMID- 3538218 TI - Location and transfer of the vibrating line: clinical and laboratory techniques. PMID- 3538219 TI - The maxillary one-sided removable partial denture. PMID- 3538220 TI - Fabrication of a preformed shell for a provisional fixed partial denture. PMID- 3538221 TI - Fabrication of a strutted, resilient open obturator for maxillary defects. PMID- 3538222 TI - The radiation dose-response relationship for control of primary breast cancer. PMID- 3538223 TI - Secretin N-terminal hexapeptide potentiates insulin release in mouse islets. AB - Peptides representing the N-terminal part of secretin were synthesized and their effects tested on column-perifused isolated mouse pancreatic islets. Insulin release induced by D-glucose was potentiated by the two peptides His-Ser-Asp-Gly Thr-Phe-OMe (S1-6) and Ser-Asp-Gly-Thr-Phe-OMe (S2-6). The consecutive smaller N terminal peptides Asp-Gly-Thr-Phe-OMe (S3-6) and Gly-Thr-Phe-OMe (S4-6) had no effects while the dipeptide ester Thr-Phe-OMe (S5-6) also potentiated the release of insulin. The results suggest that the N-terminal part of secretin may be involved in the marked in vitro glucose-dependent insulin release induced by secretin. PMID- 3538224 TI - Pancreatic glucagon and bombesin inhibit meal size in ventromedial hypothalamus lesioned rats. AB - The effects of intraperitoneal injections of pancreatic glucagon and bombesin on meal size were tested in female rats in the dynamic phase of ventromedial hypothalamic (VMH) hyperphagia. Both pancreatic glucagon (100-2500 micrograms/kg) and bombesin (4-16 micrograms/kg) inhibited meal size in a dose-related manner. Percent inhibitions of meal size in VMH-lesioned and control rats did not differ significantly. These results suggest that the VMH is not necessary for peripheral administration of either pancreatic glucagon or bombesin to elicit postprandial satiety. PMID- 3538225 TI - Charting the trends in nuclear techniques for analysis of inorganic environmental pollutants. AB - Publications in analytical abstracts in the period 1975-1984 and papers presented at the Modern Trends in Activation Analysis international conferences series in the period 1961-1986 have been used as an empirical basis for assessing general trends in research and publication activity. Some ebbs and flows in the specialty of instrumental techniques for analysis of environmental trace pollutants are revealed by a statistical analysis of the publications. PMID- 3538226 TI - [Historical overview of Argentinian dental journals]. PMID- 3538227 TI - [An abscess in a Saint and Argentinian patriot]. PMID- 3538228 TI - [The Buenos Aires Dental School. Historical review]. PMID- 3538229 TI - [Echography and computerized tomography in abdominal diagnosis]. PMID- 3538230 TI - [Comparative study of hepatic metastasis with different modality ultrasound scanners]. AB - 57 patients affected by liver metastases were examined with different types of dynamic ultrasound scanners (linear-sector-convex) in order to assess the advantages and the limits of each scanner and to evaluate if a better diagnostic accuracy is possible by using 2 types of scanner in the same patient. The results were estimated at 3 different levels: quantitative analysis where we considered only the presence or not of liver metastases; complex quantitative analysis where we also evaluate number and site of the metastases; qualitative structural analysis where we compared the ultrasonographic appearance of the metastases. All the results were evaluated by a personal computer with a special program and a statistical analysis was elaborated. PMID- 3538231 TI - [First experiences with trans-rectal echotomography in perianal abscess pathology]. AB - Trans-rectal ultrasound with a 5 MHz probe was used to examine 16 patients who had perianal fistulas and 5 of them underwent one or more surgical explorations. In 11 cases, all surgically checked, sonography was able to demonstrate a pararectal abscess and accurately image the site, size, extension and--in some cases--the fistula itself. It can be advised that, using high frequency probes (7 or 10 MHz), transrectal ultrasound could provide even more exact diagnostic information in anorectal pathology. PMID- 3538232 TI - [Percutaneous drainage of abdominal abscesses]. AB - Percutaneous puncture with echographic guide was performed in 37 patients with suspected abdominal abscesses. The abscess has been confirmed in 31 cases and it has been related to previous surgery in 21. In 3 cases the 3 small cavities were evacuated by a single-stage aspiration; in the other cases different drainage catheters, in relation to the size and the content of the cavities have been employed. Benefits of proteolytic agents, irrigation with saline solution and permanent aspiration are stressed. Successful drainage avoiding surgery was achieved in 23/31 patients (74%), and positive results have been obtained in multiple abscesses, multilocular abscesses and infected haematomas as well. A partial success was achieved in 3 cases (10%): the patients were submitted to surgery after a clinical improvement. Two complications occurred (bowel perforation and small liver laceration). The percutaneous drainage turned out to be a technique of choice in the great majority of abdominal abscesses, and should be considered a good alternative to surgery, particularly in high risk patients. PMID- 3538233 TI - [Role of echography in the study of lymphangiomas. Presentation of 2 cases]. PMID- 3538234 TI - [Maryland bridge: evaluation of the metal etching technic]. PMID- 3538235 TI - [90 years of the Dental Association of Argentina]. PMID- 3538236 TI - [Bonded dentures. 100 cases]. PMID- 3538237 TI - [Ultrasound in Crohn disease]. PMID- 3538238 TI - [Immediate effect of the action of various rotary instruments and curets used in pulpotomy. Histological evaluation in dog teeth]. PMID- 3538239 TI - [A new look at Crede's method]. PMID- 3538240 TI - [The Edith de Magalhaes Fraenkel prize. Historical retrospective]. PMID- 3538242 TI - [Blade implants]. PMID- 3538241 TI - [Saint Apollonia and her ionography. The windows of Leon Cathedral]. PMID- 3538243 TI - [Homogenization and hardening of precious metals]. PMID- 3538244 TI - [Usefulness of hepatobiliary gammagraphy in the diagnosis of biliary obstruction]. PMID- 3538245 TI - [Public health impact of adsorption of enteroviruses on ocean and river sediments]. AB - Fixation of enteroviruses in sands, ocean sediments, and river mud constitutes a very real public health risk. The authors review the physicochemical and biological mechanisms of virus attachment to particles. Rates of adherence frequently reach 90 to 100%, especially in montmorillonites and sands. Studies devoted to microorganism adherence are mentioned. Attachment of enteroviruses to particles in suspension, to bacteria and other microorganisms--all becoming vectors--is described. Also reviewed is the manner in which these pathogenic substances are disseminated in the environment, especially at beaches, recreational areas and shellfish breeding areas. Greater vigilance to the dangers is advocated on the part of public health authorities, those responsible for environmental salubrity and for shellfish grounds. PMID- 3538246 TI - [Resuscitation in kidney donors]. PMID- 3538247 TI - [Methanol poisoning and renal transplant]. PMID- 3538248 TI - [Mechanical assistance for the heart]. PMID- 3538249 TI - [Indications for restoration with fixed dentures or tooth-supported removable partial dentures]. PMID- 3538250 TI - [The root anchor for coronal reconstruction of devitalized teeth]. PMID- 3538251 TI - [Technics for the functional evaluation of the thoracic cage]. AB - A study of lung volumes offers an overall index of thoracic mobility. The techniques of magnetometry and respiratory plethysmography by induction allow studies of thoracic wall movements to be separated into two compartments by measuring thoracic and abdominal movements. These techniques enable a quantitative evaluation of thoraco-abdominal incoordination seen notably in patients with chronic airflow obstruction and in cases of respiratory muscle fatigue. Similar information is obtained by measuring variations in inspiratory pleural and abdominal pressure, using oesophageal and gastric balloons. The maximal force of respiratory muscles is an important index of the functional reserve at a patient's disposal and may be assessed by measuring maximal inspiratory and expiratory pressures at the mouth against an occlusion. Diaphragmatic force is assessed by the maximal trans-diaphragmatic pressure. Respiratory muscle fatigue appears when their contraction is sustained above a certain threshold of tension and duration. This phenomenon may be detected by a diminution of maximal pressures. For example, the fatigue of inspiratory muscles is accompanied by a fall of maximal inspiratory and trans-diaphragmatic pressures. The fatigue process can also be detected early by changes in the pattern of the diaphragmatic electromyogram. The principles and limitations of different techniques of assessment of respiratory muscle fatigue are analysed. The use of one or several of these techniques accompanied by an awareness of the clinical signs of respiratory muscle fatigue ought to enable an early detection of this condition. PMID- 3538254 TI - [Oxygen transport to tumor tissues]. PMID- 3538252 TI - [Epidemiology and experimentation of anti-arrhythmia drugs]. PMID- 3538255 TI - [Functional significance of collateral circulation in coronary artery disease]. PMID- 3538256 TI - [Antiplatelet drugs]. PMID- 3538257 TI - [Alcohol and heart disease]. PMID- 3538253 TI - Effect of captopril on chronic puromycin aminonucleoside nephrosis in rats. AB - The effect of captopril, an angiotensin converting enzyme inhibitor, on the progression of chronic puromycin aminonucleoside (PAN) nephrosis was examined. Rats were injected with 15 mg/100 gm body weight PAN and 5 mg/100 gm body weight, on weeks - 1 and 5, respectively. A third group was injected with an equivalent volume of 0.9% saline, intraperitoneally (Group III) on week - 1 and 5. Beginning week 0, group I received 50 mg/kg captopril daily in the drinking water for 12 weeks. Group II received no treatment. Captopril failed to attenuate the peak level of proteinuria induced by the first injection of PAN or to alter the rate of decline of proteinuria when begun 1 week after the PAN injection. However, captopril did blunt the increase in urinary protein excretion following the second injection of PAN (p less than 0.05). Group II became hypertensive compared to Group I on week 8 and 12 and Group III on week 12 (p less than 0.05). Group I and II could not be distinguished on the basis of renal histologic rank (p = 0.80). We conclude that captopril affords some protection against the development of PAN-induced proteinuria, but it does not accelerate the recovery phase when glomerular permselectivity is being regained. PMID- 3538258 TI - [Prevention of postoperative pulmonary complications with an epidural block]. PMID- 3538259 TI - [Past, present and future of nephrology]. PMID- 3538260 TI - Papers from the International Society for Clinical Biostatistics. Sixth international meeting. September 1985. PMID- 3538261 TI - Assessing the performance and clinical impact of a computerized prognostic system in severe head injury. AB - The ability to predict outcome in the early stages of severe head injury would have several uses. A computerized system which has been developed in Glasgow to assist clinicians in this task, based on information from over 2500 severely head injured patients, is described, with particular attention to the testing of the statistical properties of the system, and, more importantly, the assessment of its clinical impact. PMID- 3538263 TI - Life-table methods for contraceptive research. AB - Life-table methods used for the analysis and interpretation of contraceptive follow-up studies differ from those used in other areas of medical research. The historical development of these methods in the contraceptive literature is outlined and the two main methods are discussed, compared and shown to differ mainly in their nomenclature; their results are very similar in practice. The daily life-table method is simpler to apply and interpret, and facilitates analysis using the logrank statistic as well as powerful regression modelling techniques for survival data. PMID- 3538262 TI - Patient accrual and interim statistical analysis in long-term randomized clinical trials: the French chronic lymphocytic leukemia CLL 80 protocol as a case study. AB - The CLL 80 clinical trial of treatment for chronic lymphocytic leukemia was designed using a three-stage prognostic classification. Within each stage patients received one of two treatments allocated by randomization, two adjacent stages having a common treatment. The fixed-sample design required 850 patients entered over a period of 8.5 years. Active patient recruitment led to 741 patients being randomized in four years. The first interim analysis, carried out at this point, showed a treatment difference in one stage which was statistically significant (p = 0.001) and justified an early termination of the protocol. This paper discusses practical aspects of patient accrual and interim analysis in this study. PMID- 3538264 TI - Selection of variables using 'independence Bayes' in computer-aided diagnosis of upper gastrointestinal bleeding. AB - In this paper two problems of computer-aided diagnosis with 'independence Bayes' were investigated: selection of variables and monotonicity in performance as the number of measurements is increased. Using prospective data from patients with upper gastrointestinal bleeding, the stepwise forward selection approach maximizing the apparent diagnostic accuracy was analysed with respect to different kinds of bias in estimation of the true diagnostic accuracy and to the stability of the number and type of variables selected. The results of this study suggest first that the selection of variables should be evaluated against the estimated true diagnostic accuracy obtained using all variables, and secondly that the results of a single selected sequence may be severely biased. PMID- 3538265 TI - Partitioning methods for classification and decision making in medicine. AB - The use of partitioning methods for classification is discussed. A brief outline of the method of recursive partitioning is given and a note is made of some of its potential drawbacks. An alternative approach is outlined in which a particular class of dichotomous partitions is considered. The class incorporates prior knowledge concerning the nature of an association. Strategies to choose a partition from this class are suggested. The method is illustrated by an analysis of data from patients with gastrointestinal cancer and benign disease. A partition to discriminate between cancer and benign disease is obtained using symptoms, age and tumour marker data. PMID- 3538267 TI - [Laboratory support for the diagnosis of asthma, allergic alveolitis and sarcoidosis]. PMID- 3538266 TI - [Bacterial meningitis in the child: diagnosis, treatment and prognosis]. PMID- 3538268 TI - [Biochemical, physical and physiological properties of tracheobronchial secretions]. PMID- 3538269 TI - Eccrine sweat glands. Adaptations to physical training and heat acclimation. AB - Heat dissipation, under conditions of thermal stress, is mediated primarily by evaporation of sweat. Physical training has been shown to enhance sweat production by eliciting changes in the sensitivity of eccrine glands, total sweat output and distribution of gland activity. These adaptations afford partial acclimation. Heat acclimation produces similar changes, and also results in reduced sweat thresholds. To account for these different responses it has been hypothesised that physical training induces peripheral adaptations, while acclimation produces both peripheral and central modifications. It is suggested that repeated cutaneous heat detection may be essential to the development of central sudomotor changes. PMID- 3538271 TI - Mouth guards for the prevention of injuries in contact sports. AB - There has been a significant increase in the number of individuals participating in contact sports. As a result, every effort must be made to provide the athletes with protection against mouth injuries. In this review the use, construction and benefits of mouthguards in all sports has been described. There is unanimous opinion attesting to the benefits of such protective devices and in those sports where the athlete is required to wear a mouth guard, a dramatic decrease in the number and severity of injuries has been reported. Custom-fitted mouth guards should be used in many sports that do not already have a compulsory rule requiring their use. Physicians, dentists, trainers and coaches need to be educated on the data supporting the benefits described. Studies on performance enhancement as a result of mandibular orthopaedic repositioning appliances have also been reviewed. Long term studies are required to assess the claims of ergogenic enhancement utilising proper study design. Current evidence exists relating to the effects of psychological phenomena on athletic performance, and it is believed the placebo effect contributes to the findings of performance improvement. PMID- 3538270 TI - The use of cryotherapy in sports injuries. AB - The use of cold therapy in acute sports injuries as well as in the rehabilitation of the injured athlete has become a generally accepted treatment method. Various cooling modalities are used to apply cold to the injured area, e.g. ice packs, ice towels, ice massage, frozen gel packs, ethyl chloride and other vapocoolants, chemical reaction devices and inflatable splints using refrigerant gas. Most clinical studies report that the use of cryotherapy has a positive effect on pain reduction and on the recovery of various injuries. When the physiological processes produced by cryotherapy are examined in experimental situations, some of these reactions differ from expectations. Skin, subcutaneous, intramuscular and joint temperature changes depend on application method, initial temperature and application time. Intramuscular temperature continues to drop after the cooling modality has been removed. Results of various studies are consistent on the effects on neuromuscular and pain processes. Results of studies on cold and blood flow vary considerably, however it appears that blood flow increases with superficial cold application and decreases when cold is applied to large skin surface areas. Motor performance is affected by temperature with a critical temperature being around 18 degrees C, above and beneath which muscle performance decreases. There is also a critical temperature for the application of cold with inflammation and oedema increasing at temperatures below 15 degrees C. Precautions should be taken because prolonged application at very low temperatures could have deleterious effects. PMID- 3538272 TI - Athletes, astronauts and orthostatic tolerance. AB - Specific alterations in autonomic functions induced by endurance training may lead to a reduced ability to withstand orthostatic stress. This possibility has caused some authorities to suggest that, because of potentially greater pooling of blood in the lower extremities during gravitational loading, endurance-trained athletes may make poor astronauts. Although results from spaceflight studies have provided little evidence to support this suggestion, data from water-immersion studies indicate that endurance-trained athletes do become more orthostatically intolerant following a few hours of simulated weightlessness. Unfortunately, other evidence supporting the hypothesis that endurance training reduces orthostatic tolerance has not received adequate publication in the open scientific literature. On the other hand, a number of studies which have been openly reported clearly refute this hypothesis. Nevertheless, the established physiological differences between endurance athletes and non-athletes are themselves sufficient to suggest that the hypothesis could be tenable. Consequently, it has to be concluded that the presently available information is both qualitatively and quantitatively inadequate to permit any definite statement regarding a possible relationship between aerobic power (VO2max) and orthostatic tolerance. PMID- 3538274 TI - [Shunt surgery yesterday and today]. PMID- 3538275 TI - [Present status of liver transplantation]. PMID- 3538273 TI - Knee injuries in athletes. Review of exertion injuries and retrospective study of outpatient sports clinic material. AB - About one third of all sports injuries admitted to outpatient sports clinics concern knees. The incidence of different knee disorders in an outpatient sports clinic material and a review of the literature concerning the wide and problematic area of knee exertion injuries in athletes is presented. Exertion injury is defined as non-traumatic pain syndrome in the musculoskeletal system, including typical stress injuries and pain syndromes associated with physical activity but also has other important aetiological factors. 2762 athletes were admitted to the Turku Sports Medical Research Unit's outpatient sports clinic from 1976 to 1983 and 886 (32%) of them, 697 male and 189 female athletes, had suffered knee disorders. Football (soccer) [20.8%], long-distance running (13.1%), volleyball (11.6%), orienteering (7.6%) and ice-hockey (7.2%) had the highest incidence and the most common knee disorders were patellar apicitis (20.4%), Osgood-Schlatter's disease (10.1%), patellar chondropathy (10.0%), ligamentous sprains (9.0%) and meniscus tears (6.9%). The mean age of all athletes with knee disorders was 20.8 years. On an average each complaint caused 2.16 appointments. Careful evaluation of malalignments predisposing the athlete to exertion injury is necessary in the treatment of knee disorders and to avoid the recurrence of the exertion injury due to some biomechanical reason. The authors emphasise the importance of careful clinical examination. Although our review does not include detailed information about injuries originating in a single trauma, it is important to pick up the cases of ligamentous tears early so they can be appropriately repaired. Diagnostic and operative arthroscopy adds a new method in avoiding diagnostic errors and in shortening the postoperative rehabilitation. PMID- 3538277 TI - [Surgery of stomach cancer]. PMID- 3538278 TI - [Kaposi's sarcoma in AIDS patients]. PMID- 3538276 TI - [Therapy of liver metastases of colorectal cancer. Review of the present status]. PMID- 3538279 TI - [The year 1910. Evocation of an era, that of the birth of "Praxis, Revue Suisse de Medecine"]. PMID- 3538280 TI - [Important milestones during 75 years of practical medicine]. PMID- 3538281 TI - [Sonography in gastroenterology practice: does it affect the cost of elucidation or the efficiency of the diagnosis? Does it create new problems?]. PMID- 3538282 TI - [Diagnostic significance of the sonographic cockade phenomenon in stomach and colon region]. PMID- 3538283 TI - [Ultrasound-guided thin-needle puncture from the cytologist's viewpoint]. PMID- 3538284 TI - [The thalamic syndrome of Dejerine-Roussy. Prolegomenon]. AB - Predicted by Dejerine and Long in 1898 and formally described by Dejerine and Roussy in 1906, the "thalamic syndrome" corrected the wrong hypothesis of a capsular "sensory cross roads" suggested by Charcot after 1873 and supported in France during 25 years. Both established the "persistent frank organic hemianesthesia" (sensory-sensitive for Charcot, pure sensitive for Dejerine), namely that a sensory deficit, still severe after regression of the early hemiplegia, could be due to focal brain damage. At that time such a clinical concept was hardly acceptable because it opposed the classic greek philosophical idea that sensation and movement should not be separated. Moreover, intelligence was at that time looked as a four-stage process including sensation, imagination, intellect and memory. The very first step began with the "sensus communis", an anteroom-like where all the sensations simultaneously perceived were coordinated to ensure mind unity. This "sensus communis" was given many subcortical seats during the following centuries, such as the trigone (Herophilus), the ventricles (Founders of the Church, Soemmering), the pineal body (Descartes), the striate bodies (Willis) and, finally, the thalamus (Todd and Carpenter's "English theory"). The description by Meynert in 1871 of a transcapsular direct "sensory bundle" and the cases reported by Turck in 1859 of a sensory-sensitive hemianesthesia after a posterior capsular lesion (in fact, thalamo capsulostriate) led Charcot to develop his theory after 1873. Owing to the new staining methods of Weigert and Marchi introduced around 1885, Dejerine showed in 1895 the route of the medial lemniscus and his arrival in the thalamus, which led him to postulate in 1898 a "thalamic syndrome" and later to demonstrate it. PMID- 3538286 TI - [Relations between the basal ganglia and the thalamus of the primate. New morphologic data. New physiopathologic interpretations]. AB - Considerable progress has been made over the last few years in our knowledge of the thalamus and basal ganglia and their relationships to the cerebral cortex. More detailed topographic studies in the macaque have demonstrated the separation, in the lateral region of the thalamus, between afferent cerebellar and basal ganglia territories. These territories fail to correlate with the subdivision between ventral and dorsal elements or the limits of a single cytoarchitectonic nucleus. The cerebellar territory corresponds to VIL (or VPLo) which projects towards the primary cortex, and to VIM (or area X) and DI (or VLc) which project towards premotor cortex. The nigral (and tectal) territory corresponds to VOM (or VAmc) and to some parts of the medial nucleus and projects mainly towards the oculomotor area, supplementary motor area and prefrontal cortex. In return, the oculomotor area and substantia nigra project towards the colliculus superior. Several thalamic nuclei constitute the pallidal territory: VOL (or VLo) projects mainly towards supplementary motor area, LPo (or VApc) and Do towards the prefrontal cortex. The median center, which receives afferents from pallidum and motor cortex, projects towards the striatum but also the motor cortex. The parafascicular nucleus projects towards the striatum and premotor cortex. It is still not possible to transpose data acquired in the macaque to man, but functional reinterpretations are possible. A system which involves the median pallidum, VOL and supplementary motor area could control motor initiative and flow of movement. A second system, involving the substantia nigra, colliculus superior, thalamic relay and oculomotor area could control posture. The pallidum and substantia nigra, anterior part of lateral mass, medial nucleus and prefrontal cortex could elaborate motor programmes. PMID- 3538285 TI - [Role of the ventrobasal complex of the thalamus in nociception and pain: data obtained in the normal rat and in a model of clinical pain]. AB - Recent anatomical, electrophysiological, neuropharmacological and behavioural studies have provided new elements for the understanding of the role of the thalamus in nociceptive and pain mechanism. Data presented here demonstrate that the thalamic ventrobasal complex (VB), which receives direct afferents from the spinothalamic tract in the rat and monkey, plays a role in the sensory discriminatory component of pain in these two species. Apart from the electrophysiological aspect, we discuss the effects of analgesic compounds on neuronal responses observed at this level and modifications in a nociceptive reaction threshold after lesions of this structure in the non-anesthetized freely moving animal. Data obtained in the normal rat are compared with those obtained under the same experimental conditions in a clinical pain model: the arthritic rat. In these animals the capacity of the VB neurons to respond to somatic stimuli is profoundly modified, many of them being activated by moderate stimuli from inflamed joints (lateral pressure, movements). Spinal tracts transmitting messages from these joints appear to differ (at least in part) from those transmitting nociceptive messages in the normal rat. Finally, at similar doses, morphine is much more effective in these animals than in the normal rat. Results of these studies show that nociception and clinical pain are not always exactly dependent on the same systems. PMID- 3538287 TI - [Role of thalamic nuclei in the hypertonia and tremor of Parkinson disease]. AB - Intraoperative recordings allowed the ventralis intermedius nucleus (Vim) to be distinguished from the ventrolateral nucleus (VL). Characteristics of the Vim include marked spontaneous activity, bursts synchronous with tremor, response of certain cells to contralateral kinesthetic and peripheral electric stimuli and paresthesia provoked by an intraoperative stimulus. Coagulation of Vim abolishes tremor while coagulation of VL abolishes hypertonus. PMID- 3538288 TI - [Role of the thalamus in the physiopathology of epilepsy]. AB - Early hypotheses on the origin of primary generalized epilepsy suggested a determinant role for the "centrencephalon" in the triggering of discharges of generalized spike-waves (GSW) and tonic-clonic crises (TCC). It was demonstrated in this respect that bilateral cortical spike-wave discharges at 3 c/sec were obtained by electrical stimulation of intralaminar nuclei in the rat. The role of the thalamus in the genesis of GSW and TCC was subsequently demonstrated in several experimental models. However, the thalamus is apparently not involved in the genesis of EEG manifestations of generalized epilepsy and most authors agree that the latter are of cortical origin since a) with or without cardiazol, generalized seizures may occur after ablation of cat thalamus; b) in the cat diffuse cortical application of dilute penicillin can reproduce signs of generalized epilepsy observed after systemic injection of penicillin to this animal; c) finally paroxysmal discharges which appear in subcortical structures in the photosensitive baboon are always preceded by frontal cortical spike-waves; similarly intermittent light stimulation-provoked TCC always arise from the frontal cortex and furthermore hemispheric synchronization of attacks disappears after callosotomy. These findings indicate that the origin of GSW and TCC, is not in the thalamus but that the latter nevertheless plays a role in their elaboration. PMID- 3538290 TI - [Tethered spinal cord and lipoma. Contribution of magnetic resonance imaging]. AB - A 12 year-old boy was investigated for progressive deformity of the left foot developing over 2 years. The foot was hollow with equinus varus and claw toes. Signs of a lesion of left L5 and S1 roots were present and spina bifida at L5 was noted on X-rays. Magnetic resonance imaging (MRI) showed a tethered spinal cord associated with a lipoma at the level of the S1 vertebra. Modes of presentation and physiopathology of disorders related to tethered cords are reviewed and the diagnostic value of MRI is emphasized. PMID- 3538289 TI - [Treatment of abnormal movements by thalamic lesions]. AB - Thalamic targets in the treatment of involuntary movements include the lateral and usually the intermediary ventral nuclei. Destruction of their afferents in Forel's fields provides the same therapeutic result but the size of the lesion must then be very small due to the proximity of essential structures, particularly corpus Luysi. Efficacy of treatment depends partly on the aetiology of the involuntary movement (and thus from the indication for surgery) and also on the technical possibilities of electrophysiologic mapping. The true dystonic element of the involuntary movement is usually little improved whereas tremors of all types are improved or suppressed. Essential tremor, familial or not, of large amplitude and very disabling, is an ideal indication for stereotaxic surgery when it presents as intention tremor. In Parkinson's disease, the treatment is effective against tremor and rigidity but akinesia is unaltered and the progressive course of the disease uninterrupted. Indications for surgery have become rare since the availability of L-dopa, perhaps too rare for the slowly progressive forms with predominant tremor poorly relieved by dopa-therapy, surgery has a curative and probably preventive effect on the involuntary movements of limbs induced by this treatment. Suppression of post-traumatic tremor and that due to multiple sclerosis is dependent on various factors: electrophysiologic precise mapping of the target since "electrical silences or holes" exist that disturb or prevent collection of evoked potentials or spike activity; multiple neurologic lesions that may be worsened by an additional thalamic lesion; finally residual cerebellar disturbance unmasked by the suppression of tremor, a poor "functional" result despite a good operative result.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538291 TI - [Myopathy in rheumatoid arthritis in children: interrelation of function, structure and metabolism]. PMID- 3538292 TI - [Quantitative evaluation of the degree of stenosis of the left atrioventricular ostium in patients with rheumatic mitral lesions according to the results of 2 dimensional Doppler echocardiography]. PMID- 3538293 TI - [Analysis of the longevity of dermatomyositis patients]. PMID- 3538294 TI - [Effect of alcohol on the course of gout and blood uric acid levels in healthy subjects]. PMID- 3538295 TI - [Prospective new approaches to the diagnosis of infection caused by group A streptococci and the control of rheumatic fever]. PMID- 3538296 TI - [Urogenic arthritis and alcoholism]. PMID- 3538297 TI - [Specific variant of the course of systemic lupus erythematosus]. PMID- 3538298 TI - [The thymus gland in systemic lupus erythematosus]. PMID- 3538299 TI - [Serum and urinary glycosaminoglycans in various forms of scleroderma]. PMID- 3538300 TI - [Status of purine metabolism in painters working in contact with lead-containing paints]. PMID- 3538301 TI - [Diffuse idiopathic skeletal hyperostosis]. PMID- 3538304 TI - [Difficulties and errors in the diagnosis of rheumatoid arthritis]. PMID- 3538302 TI - [Kidney lesions in hemorrhagic vasculitis]. PMID- 3538303 TI - [Muscular and ligamentous tunnel syndromes in various diseases of the musculoskeletal system]. PMID- 3538305 TI - [Diagnosis of Sjogren's syndrome]. PMID- 3538306 TI - [Radionuclide diagnosis and treatment of Baker's dissecting synovial cyst in a rheumatoid arthritis patient]. PMID- 3538308 TI - [Juvenile gout in a woman]. PMID- 3538307 TI - [Clinical review of the 34-year course of a discoid lupus patient with systemic manifestations]. PMID- 3538309 TI - [Diagnosis of the disseminated intravascular coagulation syndrome in rheumatoid arthritis patients]. PMID- 3538311 TI - [Removal of a fixed prosthesis or how to demystify taking down bridges]. PMID- 3538310 TI - [Experience using the Soviet thermoplastic material "Polivik" in rheumatologic practice]. PMID- 3538312 TI - [The compressive angular matrix (C.A.M.)]. PMID- 3538313 TI - Plasmids as epidemiologic markers in nosocomial gram-negative bacilli: experience at a university and review of the literature. AB - Bacterial plasmids have become valuable markers for the comparison of strains of nosocomial gram-negative bacilli. The importance of plasmids in nosocomial infections is primarily due to their transferable antibiotic resistance genes (R plasmids), but other plasmid-mediated traits may eventually serve as potential markers. Stable cryptic plasmids have also served to relate outbreak strains, particularly nonfermenting strains of gram-negative bacteria. Klebsiella pneumoniae and Serratia marcescens have been the major plasmid-containing species in outbreaks involving single or multiple species. Outbreaks of single species with common plasmid patterns have included the Enterobacteriaceae, Pseudomonas aeruginosa, Pseudomonas cepacia, Ewingella americana, and Legionella pneumophila. Intrageneric spread of the same or similar R plasmids has nearly always occurred within the Enterobacteriaceae in large medical centers or Veterans Administration hospitals. High-risk nurseries and burn units have been conspicuous foci for R plasmid evolution. Hospital epidemiologists and clinical microbiologists will likely have an ever-increasing need to determine the plasmid content of gram negative bacilli producing endemic and epidemic nosocomial infections. PMID- 3538315 TI - Antimicrobial agents and the medical journal: trends in publishing, 1936-1983. AB - Thirty-seven thousand one hundred twenty-six Index Medicus citations dealing with antimicrobial agents were selected for the period 1936 through 1983. Seventy-five percent of the citations have appeared since 1964, and the percentage of papers published in the English language has increased steadily since 1965. The mean number of relevant papers cited per page and unit weight of the bound Index has declined in recent years, suggesting that current publishing trends increasingly favor literature in other fields. PMID- 3538314 TI - Infectious disease in the sella turcica. AB - Intrasellar infection is characterized by pituitary dysfunction and damage to surrounding structures. In most cases patients have fever, headache, and visual disturbance and exhibit roentgenographic evidence of a mass. Suppurative infections may originate in the paranasal sinuses, meninges, or more distant foci and are commonest in the setting of preexisting pituitary adenomata. Pituitary tuberculosis may arise from hematogenous spread or extension of local lesions and may be confused with a variety of other granulomatous diseases. Congenital and acquired syphilis of the pituitary are more often diagnosed at autopsy or by the concurrence of pituitary dysfunction and serologic evidence of syphilis. Although viral infection may be associated with pituitary or hypothalamic dysfunction, overt hypophyseal infection is rarely documented. In contrast, a variety of parasites and fungi have been found in pituitary tissue. The diagnosis of pituitary infection should be considered when signs of intrasellar mass or pituitary dysfunction are accompanied by fever and other evidence of infection. PMID- 3538316 TI - Occurrence of congenital, cardiovascular, visceral, neurologic, and neuro ophthalmologic complications in late yaws: a theme for future research. AB - Late lesions of yaws are thought to be limited to skin, bones and joints, without congenital, visceral, or central nervous system (CNS) involvement. However, the treponemes isolated from patients with yaws, endemic syphilis, and venereal syphilis are genetically identical subspecies of Treponema pallidum. The controversy surrounding distinctions between syphilis and yaws is presented in its historical context, and reports of congenital, visceral, and CNS complications of yaws are reviewed. Isolation of treponemes from aqueous humor, as well as CSF abnormalities in 24.9% of 902 patients with yaws, indicate the existence of CNS involvement. The high prevalence of tropical myeloneuropathies of unknown origin discovered in areas of previous treponemal endemicity, particularly in Jamaica and Colombia, may represent late complications of yaws. Careful analysis of the collected evidence indicates that potential sequelae of yaws include congenital, visceral, and tertiary CNS lesions identical to those of venereal syphilis. The current worldwide resurgence of endemic treponematoses provides an unparalleled opportunity to settle conclusively questions still unanswered regarding the natural history of these infections. PMID- 3538317 TI - Characteristic features of neonatal sepsis due to Haemophilus influenzae. AB - The number of cases of neonatal Haemophilus influenzae sepsis reported in the literature has increased. The predominant serotypes (80%) involved in neonates appear to be non-type b whereas in older infants type b is responsible for the great majority of cases. It appears that most cases of neonatal H. influenzae sepsis begin before or at the time of delivery, as the disease is strongly associated with early postnatal onset (83%), prematurity (83%), and a variety of maternal complications (44%). The mortality rate is 55.5% overall but 90% among babies born at less than or equal to 30 weeks of gestation. PMID- 3538319 TI - Blood cultures: issues and controversies. AB - Blood-culture procedures must be designed to overcome the intermittency and low order of magnitude of most bacteremias and fungemias and to inhibit any antimicrobial properties or components of the blood. Among the several variables affecting yields, the volume of blood cultured appears to be most important. It is recommended that at least 10 ml, and preferably 20-30 ml, of blood be obtained for each of two to three separate cultures. More than three separate blood cultures per septic episode is rarely necessary. Other issues involve the systems used for blood culture and the procedures used for their examination. PMID- 3538318 TI - Pneumococcal endocarditis: report of a series and review of the literature. AB - Pneumococcal endocarditis has declined sharply in incidence since the advent of penicillin but remains a potentially lethal infection. From 1980 to 1984, pneumococcal endocarditis was diagnosed in seven patients--four adults and three infants. Apart from one patient who had had a splenectomy, there were no recognizable predisposing factors to infection due to Streptococcus pneumoniae, although all three children were younger than 15 months of age. Congenital heart disease was present in two patients, calcific aortic disease in one, and mitral valve prolapse in a fourth. The remaining three patients had previously normal hearts. Meningitis occurred in five (71%) of the seven patients. Five patients were cured of their infection: four by medical therapy alone (penicillin or vancomycin), and a fifth, by medical therapy plus valvular debridement. Two patients died: one with intractable heart failure, and the second, from the complications of cardiac surgery. Penicillin alone is effective therapy for pneumococcal endocarditis. Patients unable to tolerate penicillin may be treated with vancomycin. PMID- 3538320 TI - The serum bactericidal test. AB - The serum bactericidal test (SBT) has been used for almost 40 years to monitor therapy in patients with bacterial endocarditis, osteomyelitis, and other serious infections. The SBT is basically a variation of the broth dilution test adapted to assess the activity of a treated patient's own serum against the infecting microorganism. Only recently, however, have rigorous attempts been made to standardize all the relevant variables that affect results of the SBT. The widely recommended goal of a peak bactericidal titer of 1:8 in the therapy for infective endocarditis may be inadequate for the treatment of some patients. Peak titers of 1:64 or greater in the microdilution SBT should be sought if they can be achieved without toxicity. Titers of less than 1:8 may be acceptable, although they are less often successful, if serious toxicity would result from increased dosage. Peak SBT titers of 1:8 or greater yield high cure rates for acute osteomyelitis in children; data are limited in adults. A defined SBT method is necessary for additional multicenter clinical trials on which firmer recommendations for its future use can be made. PMID- 3538321 TI - Rationale for identification and susceptibility testing of anaerobic bacteria. AB - Anaerobic bacteria are involved in a wide variety of human infections. In recent years there have been major refinements in technical materials used for transporting specimens, growing and identifying anaerobic bacteria and performing antimicrobial susceptibility tests. Because of the major importance of anaerobic bacteria and their changing susceptibility patterns, it has become increasingly important to identify these organisms and, in certain situations, to determine susceptibilities. The commercial availability of prereduced, anaerobically sterilized systems for identification has been helpful. However, the recent development of rapid identification systems based on tests for preformed enzymes has been a major advance. Finally, the commercial availability of broth microdilution susceptibility systems makes routine testing feasible. Guidelines for using these procedures are presented. PMID- 3538322 TI - Classics in infections diseases. Significance of hemolytic streptococcic bacteremia: a study of two hundred and forty-six patients. By Chester S. Keefer, Franz J. Ingelfinger, and Wesley W. Spink, 1937. PMID- 3538323 TI - [Diagnosis of respiratory allergies to fungi and Candida albicans]. AB - Allergy to fungi and Candida albicans raises diagnostic and therapeutic problems that are common to pneumology and allergology. The results of this study seem to support the use of bronchial challenge tests for diagnosis and of specific desensitization for treatment. PMID- 3538324 TI - [Immunotherapy of recurrent respiratory infections. Double-blind study of a new immunomodulator in 60 patients]. AB - A new immunomodulator, SLO4 oral drops, was tested for treatment and prevention of recurrent respiratory infections in a double-blind, drug versus placebo trial conducted in 60 adults with chronic bronchitis or asthma. This agent brought about a highly significant reduction in the frequency and duration of infectious episodes, as well as a decrease in antibiotic consumption and lost work time. Well tolerated from the clinical and laboratory points of view, it proved remarkably effective. It has been hypothesized that induction of interferon may account for the excellent clinical results obtained with SLO4, and numerous authors regard this compound as one of the basic keys to regulation of immune reactivity. Pharmacological trials under way with SLO4 should help answer this question. PMID- 3538325 TI - [Induced labor: historical view]. AB - The authors recall the various techniques proposed from ancient times till to day and emphasize in this review, the privileged indications in the XIXth century in order to attempt by-passing pelvic atresiae. PMID- 3538326 TI - [Anatomical and physiological bases of labor onset]. AB - The induction of labor involves a series of complex mechanisms, the control of which is only partially explained in humans. It is accepted today that the maturing of the uterine cervix is independent of the onset of uterine contractions. These two phenomena are regulated by a complex system where prostaglandins play a key role. PMID- 3538327 TI - [The artificial induction of labor. Study of methods]. AB - Three methods deserve mentioning: on the one hand, administration of pitocin and prostaglandins, on the other hand, artificial rupture of the membranes. The authors are proposing a practical plan of these various indications. PMID- 3538328 TI - [Induced labor. Indications and contra-indications]. AB - The authors report all present and future indications of the induction of a term delivery, as well as their contra-indications. They present their experience in prophylactic delivery, and propose a comparative study of the incidence in the recent literature of the main indications of induction. PMID- 3538329 TI - [Malaria and pregnancy]. AB - A case of chronic falciparum malaria during pregnancy is reported. The only disturbance was an anaemia, without fever. With chloroquine, the patient was cured. About this case, the barreful results of malaria on pregnancy are discussed: abortion, premature birth, fetal death, low birth weight, congenital malaria, anaemia of mothers. Immune response of the pregnant living in tropical areas is discussed. So is emphasized the need for chemoprophylactic treatment of mothers without immune response, during pregnancy. PMID- 3538330 TI - [Prepubertal and pubertal development of the ovary]. PMID- 3538331 TI - [Cancer chemotherapy and fertility in women]. AB - Therapeutic advances for certain cancers raise now the problem of long-term toxicity of the chemotherapy, especially on the gonads. The risk of involvement of the gonadic function in women depends on the type of medication used, the dose and duration of the treatment and mostly the age of the patient. After the age of 35, amenorrhea is almost constant and often irreversible. The younger the woman, the better the prognosis. Finally, it seems that post-chemotherapy pregnancies are normal, and so are the children born. However, the carcinogenic risks of the descendants and the risks of mutation of other generations are not well known at the present time. PMID- 3538333 TI - [Clinical aspects of pregnancy in the sportswoman]. AB - The authors establish a bibliographical synthesis of the clinical aspects of pregnancy in the woman athlete. They study the clinical repercussions of sports on the pregnant woman and the fetus. They consider successively pregnancy, delivery and the post-partum period. PMID- 3538332 TI - [Antibiotic prophylaxis in surgery by vaginal route]. AB - The authors study 56 cases of vaginal hysterectomy divided in two groups of 28, one of which received antibiotics prophylaxis at the time of the procedure. The incidences on post-operative fever, infection of the vaginal section and the number of urinary infections are significantly much lower in the group treated. PMID- 3538334 TI - [Spread of human viruses in the soil]. PMID- 3538335 TI - [Use of the Biken test to demonstrate thermolabile enterotoxins in E. coli strains]. PMID- 3538337 TI - [Malaria]. PMID- 3538336 TI - [Campylobacter jejuni/coli--isolated by coprocultures from cases of acute diarrhea]. PMID- 3538338 TI - ["Top secret... or bum secret?"]. PMID- 3538339 TI - Flexobond: a direct adaptation technique for metal substructures. PMID- 3538340 TI - Mesh venting for better casting. PMID- 3538341 TI - The Renaissance crown: update on strength and versatility. PMID- 3538342 TI - New concept for an old problem: custom shade guide vs. conventional shade guides. PMID- 3538344 TI - Improving your business through the increased accuracy of your models and dies. PMID- 3538343 TI - A glossary of attachment terms. PMID- 3538345 TI - Enzyme immunoassay of complement-binding rheumatoid factors. AB - We describe an enzyme immunoassay for the determination of complement-binding rheumatoid factors. Polystyrene tubes are coated with heat aggregated human IgG. The rheumatoid factors (RFs) of patients heat inactivated sera are allowed to bind to aggregated IgG and thereafter saturated with fresh human complement. The amount of C3 complement bound is measured by indirect enzyme immunoassay. The levels of complement binding RFs were measured in 30 patients with seropositive rheumatoid arthritis (RA), in 19 patients with systemic lupus erythematosus (SLE), and in 30 healthy control subjects. Compared to the controls high levels of complement-binding RFs were found both in RA and in SLE (P less than 0.0005). The mean level of the complement binding RFs was higher (P less than 0.05) in active than in inactive SLE. Even though the 19 S IgM RF bound complement, in RA no correlation was found between the level of complement binding RFs and Waaler Rose titre, but the level of complement binding RF correlated with the levels of nonagglutinating IgM RF (r = 0.56, P less than 0.01) and IgG RF (r = 0.70, P less than 0.001) that were obtained by enzyme immunoassay. PMID- 3538346 TI - Cryodependent and cryoproducing involvement of organs in type II essential mixed cryoglobulinemia. AB - A review of the less frequent organ damage seen in the so-called essential mixed cryoglobulinemia, and distinguishing between cryodependent and cryofavouring organ involvement, is presented in this paper. In the first group, along with the well-known renal, cutaneous and articular lesions, the peripheral neuropathy and respiratory involvement, to date too little considered, are worthy of more accurate study. Gastroenteric and cardiac participations are rare. Among the cryofavouring manifestations of the disease, we have pointed out those affecting the liver. In our experience, however, as the immunohistochemical findings suggest, the histological patterns usually considered to be chronic persistent hepatitis are frequently an expression of a lymphoproliferative lymphoma-like process. A noteworthy percentage of lymphoid cells in the bone marrow has been found in 22 type II cryoglobulinemias after either needle puncture or osteomedullary biopsy. The histological pictures often resemble a lymphoproliferative disease. Clinical and laboratory (computerized tomographic scan) researches frequently show a moderate splenomegaly, but in none of the patients was superficial or deep lymph node enlargement found. The authors conclude by considering type II essential cryoimmunoglobulin to be a sign and a marker of a low-grade proliferative disease with rare evolution into overt lymphoma. At the same time, however, cryoimmunoglobulins themselves cause important injuries that affect the prognosis of the syndrome. PMID- 3538348 TI - Cell-cell interaction and carcinogenesis. AB - Before carcinogenic stimuli are introduced, a potentially cancerous cell functions normally; growth is controlled and the cell exists in complete harmony with that of surrounding cells in a given tissue. During the process of multi stage carcinogenesis, such harmony is destroyed and a presumptive initiated cell accomplishes a clonal expansion, neglecting the growth pattern of surrounding normal cells. Recent results from our own laboratory and others strongly suggest that blocked gap-junctional intercellular communication is an important determinant during the process of tumor promotion. PMID- 3538347 TI - [Relation between neurologic damage and collateral circulation detected by Doppler CW in occlusive pathology of the internal carotid]. AB - 76 patients affected by acute ischemic encephalopathy due to i.c.a. occlusion have been examined through a Doppler nosography, in order to evaluate the influence of the type of collateral circle on the neurologic damage. Collateral circles between the external and internal carotid arteries were established through the ophthalmic artery in 80% of cases (A) and through the Willis circle in 70% of cases (B). Those two types of compensation do not seem to have prognostic value with regard to disability; on the contrary a remarkable difference was observed in the type of pathology (A = Stroke 40%, RIA 60%; B = 77%, RIA 23%). PMID- 3538350 TI - In vitro effect of chloroquine, mefloquine and quinine on human lymphocyte proliferative responses to malaria antigens and other antigens/mitogens. AB - The effect of 3 antimalarial quinoline derivatives, chloroquine, mefloquine and quinine on human blood mononuclear cells in vitro was studied. High concentrations profoundly suppressed the proliferation of mitogen- and antigen stimulated lymphocytes, as indicated by decreased 14C-thymidine incorporation. On a weight base, the most potent drug was mefloquine. At clinically relevant doses, chloroquine and mefloquine did not affect the response to malaria antigens, but mefloquine decreased the response to phytohaemagglutinin; quinine suppressed the response to all mitogens (with the exception of pokeweed mitogen) and antigens studied, including P. falciparum merozoites. The drugs' potential adverse effect on the immune system is discussed. PMID- 3538351 TI - [Selected mechanisms of chemical carcinogenesis]. PMID- 3538349 TI - Concentrations of chloroquine and desethylchloroquine in capillary blood dried on filter paper during and after treatment of Tanzanian children infected with Plasmodium falciparum. AB - Chloroquine and desethylchloroquine concentrations were determined in capillary whole blood dried on filter paper. The samples were obtained from 20 Tanzanian children before, during and after standard treatment of Plasmodium falciparum malaria with a total dose of 25 mg chloroquine base/kg. Samples were obtained before each dose and then daily up to one week after initiation of treatment. Chloroquine concentrations were consistently above 1.0 micromol/L only on the day after termination of treatment. The inter-individual range of area under the curve (AUC) was 5.6 fold for chloroquine and 8.8 fold for desethylchloroquine. The AUC and elimination time of chloroquine and desethyl-chloroquine was less than the median in two children with persisting parasitemia despite treatment. Thus, pharmaco-kinetics of chloroquine in the individual might be important to consider when P. falciparum parasites are classified in different categories of resistance. PMID- 3538352 TI - The ultrasonic appearance of intussusception. PMID- 3538353 TI - [Spontaneous lysis of acute Leriche syndrome]. AB - Usually, obstructions of the terminal aorta require surgery involving an aortobifemoral bypass, especially if they occur with acute signs and symptoms, the clinical pattern of these signs being very marked. The authors report on a case where an extensive obstruction of the lumbar aorta and of the pelvic vessels finally dissolved without on-target therapeutic intervention via an obviously spontaneous lysis. PMID- 3538354 TI - [Sensible use and change in imaging procedures in diseases of the central nervous system]. PMID- 3538355 TI - [Evaluation of kidney function in daily practice]. PMID- 3538356 TI - [Replacement of the renal function. Therapeutic choices]. PMID- 3538357 TI - [History of the Fiessinger-Leroy-Reiter syndrome]. PMID- 3538358 TI - [75 years since the founding of the Biology Institute at the School of General Medicine at Charles University in Prague]. PMID- 3538359 TI - [The major immunogenetic (histocompatible) complex in organisms and its biomedical role. Review]. PMID- 3538360 TI - [Recombinant strains of the rat as an immunogenetic model. Review]. PMID- 3538361 TI - [The immunogenetic concept of insulin-dependent diabetes mellitus in the BB strain of rats. Review]. PMID- 3538362 TI - Urinary excretion of albumin and beta-2-microglobulin in hypertensive and normotensive renal transplant recipients during urinary diluting and concentrating tests. AB - Urinary excretion of albumin and beta-2-microglobulin was measured in nine hypertensive and nine normotensive renal transplant recipients and 10 healthy control subjects before and after an oral water load of 20 ml (kg body weight)-1 (study 1) and in eight hypertensive and 11 normotensive renal transplant recipients and 11 healthy control subjects during 24-h water deprivation (study 2). In both studies 1 and 2 urinary albumin excretion was significantly higher (p less than 0.01) in the hypertensive renal transplant recipients that in the normotensive patients and the control subjects (levels before loading; hypertensives: 23.9 micrograms/min (median), range 7.5-58.7; normotensives: 3.4 micrograms/min, range 1.0-49.3; controls: 2.9 micrograms/min, range 1.3-10.3). Urinary albumin excretion was significantly positive correlated to both systolic, diastolic and mean blood pressure (for mean blood pressure: rho = 0.625, n = 18, p less than 0.01) in transplanted patients. Albumin excretion tended to increase after water loading and to decrease during water deprivation in all groups. Beta 2-microglobulin excretion was approximately the same in all groups in both studies 1 and 2 and was not correlated to blood pressure. During a follow-up period of at least 18 months, none of the renal transplant recipients developed signs of chronic graft failure. Increased urinary albumin excretion in hypertensive renal transplant recipients thus appears to be caused by increased glomerular permeability that may be due to glomerular damage induced by arterial hypertension corresponding to the findings in essential hypertension. PMID- 3538363 TI - Changes in blood pressure, heart rate and thyroid hormones after sudden withdrawal of pindolol and atenolol in hypertensive patients. AB - In a double-blind study 19 patients with mild and uncomplicated arterial hypertension were randomized to treatment with either pindolol 10 mg or atenolol 100 mg once daily for 4 weeks. After abrupt withdrawal a minor overshoot of free T3 was seen in both groups. This was, however, statistically significant in the pindolol group only. The only overall haemodynamic changes which was observed after the withdrawal was an overshoot in heart rate in the standing position in the atenolol group. Great inter-individual differences in the haemodynamic parameters were found, however, and changes suggestive for withdrawal syndrome were found in 14 patients (pindolol = 7). The time for this overshoot varied considerably from 48-132 h post-drug in both groups. No correlation between the alterations in free-T3 and the cardiovascular parameters was found. PMID- 3538364 TI - Determination of eosinophil cationic protein in urine by an enzyme immunoassay. AB - An enzyme immunoassay has been developed which allows the determination in urine of eosinophil cationic protein (ECP). The antigen was prepared from urine from patients suffering from interstitial cystitis and found to be a 20,000 MW polypeptide. Eosinophil cationic protein has been determined in urine from normal people and in patients with interstitial cystitis and other bladder disorders. The results obtained using the enzyme immunoassay were compared with the results obtained with conventional radioimmunoassay. This new assay seems to be valuable in the diagnosis of interstitial cystitis. PMID- 3538365 TI - Plasma and urinary C-peptide in the classification of adult diabetics. AB - Plasma and urinary C-peptide determinations in the discrimination between insulin requiring and non-insulin-requiring diabetes were elevated in 61 adult diabetics. Specimens for C-peptide determinations were taken on two consecutive days: on the first day plasma C-peptide concentrations were determined before and 6 min after intravenous glucagon administration. On the second day 2- and 4-h urinary C peptide excretion was measured after an individual breakfast. Results of urinary C-peptide analyses were expressed as molar concentration and also as molar quantity excreted (without any corrections and related to creatinine excretion). Glucagon-stimulated plasma C-peptide turned out to be a reliable criterion for the detection of insulin requirement. Sixty-nine per cent of diabetics included in this study were classifiable by basal plasma C-peptide concentrations. Two hour postprandial urinary C-peptide/creatinine quotient turned out to be slightly less sensitive (89%) than the glucagon test (94%) and of equal specificity (96%). Glucagon-stimulated plasma C-peptide and postprandial urinary C-peptide excretion correlated significantly among insulin-requiring diabetics (r = 0.73), but not among non-insulin-requiring diabetics (r = 0.23). We regard determination of stimulated plasma C-peptide as a primary investigation for the direct assessment of endogenous insulin secretory reserves for clinical management decisions. Determination of postprandial urinary C-peptide is applicable in selected situations for non-invasive assessment of insulin secretion. PMID- 3538366 TI - Renal blood flow during acute ischaemic heart failure in dogs: effects of dopamine and high doses of insulin. AB - The effects of acute ischaemic heart failure on renal blood flow and the influence of dopamine at low dose range and high doses of insulin were examined. Acute left ventricular (LV) failure was induced in dogs by injection of 50-micron plastic microspheres into the left main coronary artery. The dogs showed signs of severely depressed LV function. Cardiac output was decreased to a significantly greater extent than renal blood flow, and while total peripheral resistance was significantly increased, there were no significant changes in renal vascular resistance. The results indicate different sympathetic discharge to the various vascular beds during acute ischaemic heart failure. Dopamine at low dose range and high doses of insulin were found to improve myocardial contractility and to reduce renal vascular resistance and increase renal blood flow. PMID- 3538367 TI - Multiple myeloma in central Norway 1981-1982: a randomized clinical trial of 5 drug combination therapy versus standard therapy. AB - 67 previously untreated patients with multiple myeloma were entered on a randomized clinical trial to determine whether the use of combination chemotherapy including vincristine, carmustine, alkylating agents, and prednisone was more effective than conventional therapy with melphalan and prednisone. The treatment groups did not show significant differences with respect to major prognostic factors. With the 2-drug combination therapy and 5-drug combination therapy, 67 and 74% of the patients achieved remission, respectively. Moreover, no significant difference was found between the two treatment schedules in terms of median survival (30+ months). The survival curves for stage III patients treated with the two regimens did not differ significantly. After 12 months, patients who had achieved remission were randomized to have treatment discontinued or to have maintenance treatment. 7 of 15 patients on maintenance therapy relapsed, whereas 9 of 14 patients who had their therapy discontinued relapsed, and the survival of the two groups was similar. PMID- 3538368 TI - Cerebrospinal fluid beta-2-microglobulin: a reliable index of leukaemic infiltration of central nervous system. AB - Cerebrospinal fluid (CSF) beta-2-microglobulin (B2m) has been proposed as a marker of central nervous system (CNS) involvement in myelo-lymphoproliferative diseases. Recently its reliability has been put in question because of false positive and false negative results. In our study, B2m was measured in 574 CSF samples collected from 74 patients affected by ALL, ANLL or lymphomas; 20 of these patients had CNS-involvement while they were under observation. There was a significant difference in CSF B2m between the patients with and without CNS involvement (p less than 0.001). No false positive or false negative results were obtained. In 4 cases the rising of CSF B2m was observed 8, 6, 4 and 4 wk before the clinical and laboratory diagnosis of CNS-involvement. In all patients the clinical and laboratory improvement of the neurological disease was associated with a progressive decrease of CSF B2m. Some hypotheses about the origin of CSF B2m are discussed. The authors conclude that CSF B2m is a useful and reliable marker of CNS-involvement in myelo-lymphoproliferative disease. PMID- 3538370 TI - Plasma lactoferrin content: differential effect of steroid administration and infective illnesses: lack of effect of ambient temperature at which specimens are collected. AB - The effect of parenteral hydrocortisone on plasma lactoferrin concentration, neutrophil count and lactoferrin:neutrophil ratio was assessed in 10 volunteer subjects. Administration of a single dose of corticosteroid was followed by a significant rise in the circulating neutrophil count, a significant but proportionately smaller rise in the plasma lactoferrin concentration and a significant fall in the lactoferrin:neutrophil ratio. Acute viral infections were found to be associated with a disproportionately low plasma lactoferrin concentration relative to the circulating neutrophil count. The relatively low lactoferrin concentrations in both these situations could be of significance in regard to the propensity to bacterial infection and superinfection which these 2 groups of subjects display. Compared to patients with viral infection, those suffering from Plasmodium falciparum malaria showed a significantly elevated lactoferrin:neutrophil ratio, although this ratio was not significantly different when malarial patients were compared to normal individuals. These findings suggest that the pathogenesis of relative neutropenia in viral and protozoal illnesses is fundamentally different. Finally, it was found that the temperature at which specimen collection takes place does not appear to be a significant variable determining the plasma lactoferrin concentration. PMID- 3538369 TI - High-dose therapy followed by autologous bone marrow transplantation (ABMT) in previously untreated non-Hodgkin's lymphoma. AB - 13 previously untreated patients with poor prognosis non-Hodgkin's lymphoma (NHL) underwent high-dose therapy followed by autologous bone marrow transplantation (ABMT). All patients experienced a great cytoreductive effect and 9 of them reached a complete remission (mean duration 32 months). The best results were observed in patients with more limited disease and in those without symptoms. 7 patients still remain in complete unmantained remission 15-46 months from the transplant. The probability of survival is 74% at 46 months. No therapy-related deaths were recorded. In differentiating our preliminary approach, we propose high dose therapy followed by ABMT as induction phase in patients with stage II and as consolidation after first line therapy in patients with stages III-IV. Further studies are warranted to determine which type of lymphoma may benefit more and which conditioning regimens may improve the remission rate. PMID- 3538371 TI - Role of serine proteases of Schistosoma mansoni in the regulation of IgE synthesis. AB - The regulation of the IgE response by schistosomula-released products (SRP) was studied either in vitro with rat and human cell cultures or in vivo by injection into rats of SRP with an unrelated allergen at primary or secondary immunization. The results obtained in vitro showed that non-dialysable factors present in SRP potentiate the IgE synthesis by rat and human cells. This enhancing effect was supported by molecules with serine protease activities. On the other hand, the inhibition or depletion of SRP in serine proteases induced a weak synthesis of IgM by rat cells in vitro. The injection of SRP into rats on day 0 with an unrelated allergen led to a potentiation of total IgE production, but an inhibition of specific IgE response. In contrast, a marked elevation of specific IgE response was obtained when SRP was injected upon secondary immunization. Serine proteases of SRP were partly responsible for this potentiative effect. PMID- 3538372 TI - Chemical composition of antigen 60 from Mycobacterium bovis BCG. AB - Antigen 60 (A60), the main thermostable immunogen of tuberculin and PPD, has been purified from Mycobacterium bovis BCG cytoplasm, and identified by crossed immunoelectrophoresis with anti-BCG polyclonal antiserum. Two A60 fractions, free lipids and lipid-conjugated compounds, have been recognized. The free lipids represented about 30% (dry weight), and consisted essentially of C16-C18 fatty acids, and of phosphatidyl-inositol-mannosides. Lipoconjugates, upon DEAE cellulose chromatography and gel filtration, yielded two main fractions of neutral and polar components. Chromatography of delipidated and deproteinized A60 on Sephadex G-100 yielded: a high molecular weight fraction (Al, 18%, a lipoglucan of congruent to 10(6)), and a low molecular weight fraction (B, 10%, a lipopeptidoglycan of congruent to 10(4)) containing mannose, glucose, and small amounts of arabinose. The polysaccharide moieties of fractions Al and B were submitted to acetylation, methylation, and acid hydrolysis, and the structure of the hydrolysed polymer was deduced by combined gas chromatography/mass spectrometry analysis. The results indicated a branched structure involving 1,4-, 1,6-, and 1,4,6-linked D-gluco- or D-manno-pyranosyl residues. Glucan- and peptidoglycan-bound fatty acids were identified as saturated (C16-C18) and monounsaturated linear acids (C12-C18). Immunodiffusion on agarose gel indicated that delipidation and proteolysis did not suppress the ability of A60 to yield immunoprecipitates with anti-A60 antiserum. The high polymer fractions obtained by chromatography on DEAE cellulose and Sephadex G-100 were also reactive. It is concluded that A60 is made of free lipids and of lipopeptidoglycans of high molecular weights (10(6)-10(7)) endowed with immunogenic properties. PMID- 3538373 TI - Dissociation of renin and noradrenaline release in the renal circulation. Studies on patients with renal hypertension. AB - Plasma renin activity (PRA) and noradrenaline concentration (NA) were measured in the renal veins (V) and arterial blood (A) in 30 patients investigated for renin mediated hypertension. Both PRA and NA concentrations in arterial blood were above our reference limits and they were positively correlated. In 18 of the patients renin secretion was unilateral from the diseased side. Their renal vein NA concentration was always higher on that side, compared to the contralateral one, but there were V-A gradients for NA on both sides in all but two cases. In 15 of the patients with such lateralisation of renin secretion the changes of PRA and NA V-A gradients were determined 30-60 min after an i.v. injection of dihydralazine. Both PRA and NA increased more markedly in the renal vein on the affected side where the estimated renal plasma flow was lower than on the contralateral side. The NA gradients increased less than the PRA gradients when changes on the renin secreting side were compared in patients with proven increase of renin secretion. We conclude that patients with renal hypertension have a high sympathetic nervous activity as evidenced by increased plasma NA concentrations and (V-A) gradients for NA on both sides. The release of NA into the renal circulation in renin mediated hypertension is thus not invariably accompanied by renin release. The higher renal vein NA concentration on the involved renin secreting side is explained by reduced RPF on this side. PMID- 3538374 TI - Indications for and timing of removal of non-functioning kidney transplant. AB - The clinical indications for and the timing of removal of non-functioning cadaver kidney transplants were studied in 49 of 58 kidneys which had never functioned or which ceased to function in the period 1979-1982. The reason for graftectomy was rejection in 32 cases, rejection and graft infection in eight, surgical complications in eight cases and infection in one case. Nine of the 58 failed kidney grafts were not removed. Graftectomy was performed within a week after diagnosis of graft failure in 24 of the 49 cases. The clinical indications for graftectomy were compared with the morphologic observations in the grafts. Discrepancy was greatest in regard to diagnosis of rejection and primary renal artery thrombosis. Severe complications related to graft failure aggravated the condition in 17 patients and resulted in eight deaths. Based on the findings, a management schedule is proposed. It facilitates postponement or avoidance of graftectomy and minimizes the risk of complications relating to failure of graft function. PMID- 3538375 TI - An epidemic of cirrhosis in Danish women revisited. AB - Between 1944 and 1947 the mortality statistics for the Danish population show an epidemic increase of liver diseases: subacute necrosis and cirrhosis. The epidemic only affected female mortality rates. Mortality due to cirrhosis remained at a higher rate for women than men until 1970 as a result of an excess mortality in the cohort of women who in 1945 were over the age of 45. Up to 1981 this group showed an excess of 4,000 fatalities. A reevaluation of medico statistical data shows that the disease cannot be explained by the epidemic hepatitis occurring in 1942-1944 or by increased consumption of alcohol. Possible causes could be pharmaceutical products or additives, perhaps hormone preparations. PMID- 3538376 TI - Clinical aspects of the hand-arm vibration syndrome. A review. AB - At present it seems likely that the different components of the hand-arm vibration syndrome, eg, vibration-induced white finger (VWF), numbing of the hands and arms, muscular fatigue, and occasionally prevalent bone degeneration, may arise independently, and therefore they should be evaluated separately. Evidence of changes caused in the autonomic nervous functions of the body by local vibration is not conclusive. The vascular history should be confirmed objectively with a cold provocation test under laboratory conditions. In individual diagnostics it is useful to record (with modern plethysmographic techniques) the recovery of digital temperature, digital blood pressure, and flow after local cooling. Vibrotactile perception measurement seems to be suitable for group diagnosis. Much of the diagnostic weight for VWF can be obtained from accurate case histories, although, for early changes, the history may be atypical. The lack of simple objective tests for evaluating the hand-arm vibration syndrome makes it difficult to, eg, confirm the history of its different components objectively and estimate the extent of the disability it causes. PMID- 3538377 TI - Gene therapy: current status and future directions. AB - Of the many techniques which have been used to introduce new genes into cells, four are of particular interest for gene therapy. Transfection has been most extensively studied and has been used to put new genes into mice and men. Homologous recombination offers the promise of curing certain mutations in situ, but is still largely unexplored. Injection of new genes into the nuclei of single cell embryos has had startling successes in animals, but there are many scientific and ethical issues to be resolved before such an approach can be considered for gene therapy. Retroviral vectors currently offer the most exciting prospect for introducing useful gene sequences into defective cells; however, safety issues and problems of low levels of gene expression are still to be resolved. It appears likely that the bone marrow will be the first target of gene therapy for genetic diseases. The marrow is accessible and contains proliferating stem cells which can transmit the new genes to progeny cells. The possibility of treating enzyme deficiency diseases and hemoglobinopathies by gene transfer is attractive. Experiments in two patients with thalassemia major indicate that it is feasible to introduce new genes into bone marrow cells of man and return the modified cells to hematopoietic sites. PMID- 3538378 TI - [Aplastic anemia]. AB - In vitro cultures of hemopoietic precursor cells and clinical studies have partly clarified the pathogenesis of aplastic anemia. The defect is located both in the hemopoietic precursor cells and in their microenvironment. The therapeutic possibilities have enormously improved. Allogeneic bone marrow transplantation remains largely limited to young patients with an HLA-identical sibling donor. In our experience successfully transplanted patients are completely cured. Mortality from rejection, graft-versus-host-disease and infection has been markedly reduced. Immune modulating therapy with ALG produces high remission rates but residual defects in hemopoietic precursor cells remain and clonal disorders such as paroxysmal nocturnal hemoglobinuria may ensue. Despite of this ALG is the treatment of choice for patients without an HLA identical sibling donor. PMID- 3538379 TI - [Transplantation of allogeneic bone marrow treated in vitro with Campath-1 monoclonal antibody]. AB - Out of 14 bone marrow transplants, 12 patients received transplantations with allogeneic bone marrow after in vitro T-cell depletion with monoclonal Campath 1. The patients also received short term cyclosporin. This small series is in agreement with the results of larger series using T-depleted marrow as far as the prevention of graft versus host disease is concerned, and with respect to mixed chimerism, slow take, late rejection and, possibly, increased risk of recurrence. PMID- 3538380 TI - [12 years' experience in bone marrow transplantation in leukemic patients in Switzerland]. AB - Between 1974 and December 1985 180 bone marrow transplants were performed in Switzerland for patients with leukemia. They were performed in 4 centers (Basle 133, Zurich 28, Geneva 17, Berne 2). The overall probability of survival at 10 years for all patients is 20%. Results are better for younger patients, for patients transplanted in recent years and for patients transplanted either in the first complete remission of acute leukemia or in the chronic phase of chronic myeloid leukemia. PMID- 3538381 TI - [Handicaps and needs of the elderly. A multifactor epidemiologic study under urban conditions]. AB - As the number of old people increases, the need for a reliable statistical basis for socio-medical planning becomes more and more evident. Results of a representative survey in two cities of German-speaking Switzerland are presented, including correlations between the extent of need for assistance and predisposing factors. About half of the elderly are not disabled in everyday life, but 9.3% of the 66- to 75-year-olds and 46.1% of the over 85-year-olds are in need of regular daily assistance. In addition to age, male sex and being unmarried turned out to be independent predisposing factors for an increased need for help. Women were in the majority in some particular disturbances, but as a whole their need for assistance was less than among men. Socio-economic status was the most important risk factor for need for assistance. In comparison to those from higher social classes, elderly from the lowest class are round five times as often in nursing homes and ten times as often in residential homes. Their need for all forms of assistance is increased, and, in particular, they need much more daily household help than those in higher socio-economic groups. The number of admissions to institutions could be considerably reduced if more of these elderly persons could be offered ambulatory household assistance services. Furthermore, elderly of low socio-economic status tend to live more in unsuitable dwellings, eat food of lower quality, get less physical exercise, are less often of normal body weight, and have functional disturbances more often. Among the predominant factors associated with the need for nursing care are disturbances of orientation, incontinence and visual disturbances, whereas cardiovascular diseases and malignant tumors are of little importance in this context. The situation is different with respect to the need for household help, which is particularly frequent among persons with disturbances of the extremities. These in turn are about twice as frequent among elderly of lower social class than among those who are better-off. In the population under study about 40% of the elderly requiring daily nursing assistance are cared for in their homes, with their own family members providing most of the assistance. This is less often the case in the lower socio-economic groups. Our analyses make it possible, for the first time in Switzerland at least, to demonstrate clearly the important role social status, family situation and gender play in determining the level of disability and need for assistance among the elderly.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3538382 TI - [Adverse effects of total body irradiation for bone marrow transplantation: prevention and therapy. Experience at Basel, July 1979-March 1986]. AB - Acute toxicity, delayed complications and the incidence of interstitial pneumonitis (IP) after total body irradiation (TBI) are reviewed. Between July 1979 and March 1986 118 patients with hematological malignancies underwent bone marrow transplantation (BMT): all were conditioned with cyclophosphamide and TBI. 106 patients received single dose irradiation (18 with lung-shielding) and 12 had fractionated TBI. Except for mucositis all other symptoms of acute toxicity such as fever, vomiting, parotitis, headache and abdominal pain were usually of short duration. Fractionated TBI did not produce less acute side effects than single dose irradiation. Irradiation, and particularly the maximum lung dose, plays an important role in the multifactorial pathogenesis of IP. Delayed complications may appear several months or years after TBI. The majority of men suffer definitive sterility caused by azoospermia. In women primary ovarian failure and permanent sterility is a common sequela of BMT with TBI. The risk of developing cataracts after single dose TBI is about 80%, and surgical repair was necessary in 43% of these cases. Secondary tumors after TBI have been reported. So far we have observed no secondary malignancies in our patients after BMT. Rampant dental decay can be avoided by careful dental prophylaxis. PMID- 3538383 TI - [Idiopathic hypercalciuria--recent pathogenetic and diagnostic aspects]. AB - The term "hypercalciuria" is not uniformly applied. Recent investigations show that the upper normal limits of 24-hour calciuria are above the originally defined 7.5 mmol in men in 6.25 mmol in women. There is no clear evidence that 24 hour calciuria is more often increased in idiopathic calcium stone formers than in healthy controls with normal calcium metabolism. Because of a disordered regulation of 1,25-dihydroxy-vitamin D3-production, the serum-1,25-dihydroxy vitamin D3 is increased in idiopathic calcium stone formers. A calcium loading test during undisturbed individual calcium homeostasis reveals increased intestinal calcium absorption in calcium stone formers. Metabolic evaluations are often not performed under the same conditions as those in which the stone formation occurred. As long as the primary metabolic defect has not been identified, classification into "absorptive" and "renal hypercalciuria" does not seem to be justified. PMID- 3538385 TI - [Clinical aspects of the adhesive bridge technic. I]. PMID- 3538384 TI - [Clinical study of the marginal adaptation of Cerestore crowns and of the behavior of the surrounding gingiva]. PMID- 3538386 TI - [Restoration instead of extraction]. PMID- 3538387 TI - [Effects of a quaternary ammonium compound on dental plaque: a clinical and bacteriologic study]. PMID- 3538388 TI - [Changes induced by heat treatment (porcelain firing simulation) in electrochemically etched adhesive bridge retainer elements made of a Ni-Cr-Be cast alloy (Rexillium III)]. PMID- 3538389 TI - [Surface structural findings in endosseous blade implants from the viewpoint of bone integration]. PMID- 3538390 TI - [Clinical aspects of adhesive bridge technics. II]. PMID- 3538391 TI - [Veterinary medicine dissertations in Bern. 1. Chronologic index of dissertation publications]. PMID- 3538392 TI - [Gene research and the antenatal diagnosis of alpha-thalassemia]. PMID- 3538393 TI - [Advances in research on arterial baroreceptor resetting]. PMID- 3538394 TI - [Fibronectins]. PMID- 3538395 TI - [Role of prostaglandins in the pathogenesis of cerebrovascular diseases]. PMID- 3538396 TI - [Effect of arachidonic acid metabolites on the lung]. PMID- 3538397 TI - [Functional segmentation of the kidney tubule]. PMID- 3538398 TI - [Deiodination of human iodothyronines and their derivatives]. PMID- 3538400 TI - [Bioavailability of dietary zinc]. PMID- 3538399 TI - [Progress in insulin receptor research]. PMID- 3538401 TI - [Membrane currents of the sinus nodal cells]. PMID- 3538402 TI - [Advances in the study of alternative electrical activity]. PMID- 3538403 TI - [Biological effect of fibrin/fibrinogen degradation products]. PMID- 3538404 TI - [Vagal inhibition of gastrin release]. PMID- 3538405 TI - [Prof. Lin Ke-sheng, forerunner of Chinese physiologists in China]. PMID- 3538406 TI - [A new study method: the perineal scan in obstetrics and gynecology]. AB - For gynecological/obstetrical ultrasound examination the abdominal wall constituted the first and for a long time the only acoustical window that could be used to visualize the female reproductive organs. Only recently transvaginal/transrectal endosonography has opened new approaches in this diagnostic field. Apart from the above-mentioned procedures, the female perineum can be regarded as a useful window to demonstrate the cervix uteri, the bladder and the urethra. At the Universitats-Frauenklinik Heidelberg this examination procedure was used since June, 1985, to evaluate its clinical reliability in obstetrics and gynecology. PMID- 3538407 TI - [Follow-up of the lateral ventricles and their development in congenital hydrocephalus using sonograms. II]. AB - Ultrasonographic observations of the development of the hydrocephalic lateral ventricles during the fetal period. Twenty-three pregnant women having a fetus with brain defects were followed up. Twenty had sonographically identified hydrocephalus and 3 others had a fetus with either porencephalia, cystencephalus or monstrous defect of the brain. The use of a ventricular model (see 1st communication) permitted an observation of the development of the volume of the lateral ventricles, the brain diameter and an estimation of the prognosis. Accompanying defects (e.g. spina bifida in 56% of cases) were noted. Detailed case studies, measurements, clinical observation of the course, combinations of defects, and special diagnostic measures were compared with postpartum conditions. PMID- 3538408 TI - [Ultrasound findings as a sign of fetal triploidy]. AB - A woman with severe pre-eclampsia refractory to treatment was examined in the 22nd week of pregnancy by ultrasound. This revealed a big renal cyst in the foetus and discrete signs of a partial hydatidiform mole. The pregnancy was terminated, chromosome analysis confirmed the presence of foetal triploidy, and the symptoms of severe pre-eclampsia disappeared immediately. This case illustrates that ultrasound can guide the obstetric management in the right direction, if the initial examination is performed early enough. PMID- 3538409 TI - [Prenatal ultrasound diagnosis of acardius]. AB - Ultrasonic criteria are formulated and discussed for the diagnosis of this twin malformation by an own case until the 37th week of pregnancy in connection with case history literature. The overall picture presents a cystic-solid tumorous formation with a complex interior structure that can be outlined from uterine wall and placenta owing to passive mobility. An precisely search for still existing fetus-specific structures (spinal column, diaphyses of the limbs) and the identification of vitality by the pulsatile cord in the region of insertion are the main aspects. The observation of the course comprises the growth of the acardiac monster as well as of the healthy twin, together with the search for ultrasonic symptoms of a beginning cardiac insufficiency. PMID- 3538410 TI - [Sonographic diagnosis of ectopic interstitial pregnancy. Case report]. AB - The authors present a case of an interstitial extrauterine pregnancy in the intramural portion of the left oviduct after preceding ipsilateral adnectomy. Sonographic diagnosis was confirmed by the site at operation. PMID- 3538411 TI - [Annular phased array--initial experiences with a new transducer technology]. AB - During a 3 month period 177 patients underwent sonographic examinations of the upper abdomen. Scanning was performed with a new annular phased array transducer and with a conventional rotating sector transducer. Our study indicates that the annular array is more effective for outlining boundaries of the liver, spleen and pancreas in the near and far zones. Due to the better lateral resolution the new technology permits sonographic imaging of parenchymal organs even in cases of severe obscuration by bowel gas. PMID- 3538412 TI - [Ultrasound-guided fine needle puncture of the abdominal organs: indications, results, risks]. AB - 2072 patients underwent ultrasonically guided fine-needle biopsy. 1384 patients could be assessed with regard to the final diagnosis. 854 patients underwent fine needle biopsy of the liver, 322 of the pancreas and 218 of retroperitoneal lesions. The effective sampling rate was 97% for liver biopsies, 86% for pancreas biopsies and 87% for the biopsy of the retroperitoneum. The sensitivity for the detection of malignancies was 90% in liver biopsies, 69% in pancreatic biopsies and 85% in biopsies of the retroperitoneum. The specificity of cytological findings was 100%. Complications occurred in 13 cases. There were two fatalities due to of bleeding, resulting in a complication rate of 0.6% and a lethality of 0.1% of all biopsied patients. The biopsy of the liver proved most dangerous with a complication rate of 1.4%. The bleeding risk of a haemangioma (2.5%) was nearly the same as the bleeding risk of a malignant liver tumour (1.5%). PMID- 3538413 TI - [Ultrasound-controlled percutaneous kidney biopsy]. AB - Nephrological diseases--in special cases also unsettled forms of microhematuria- require a biopsy of the kidney. To date this intervention has mostly been performed under x-ray control by means of the Menghini or the Trucut-needle. Ultrasound opened up new perspectives, particularly after the introduction of perforated ultrasound probes. These ensure complete control of the intervention provided that appropriate puncture systems are applied. The cut biopsy needle (Otto) offers great advantages because it is thinner than the puncture systems used so far. With identical quality of the cast compared to that obtained with conventional techniques, the needle recommended is less traumatic and hence both risk and patient discomfort are reduced. Report on 52 punctures. PMID- 3538414 TI - [Diagnostic and therapeutic puncture sonography of the prostate]. AB - Endosonography of the prostate in combination with ultrasonically guided biopsy is indicated to detect subclinical cancer and to determine local tumour extent. It is easy to puncture any area of interest in the prostate under accurate ultrasound guidance. The percutaneous, transperineal and ultrasonically guided 125iodine implantation enables, as an alternative procedure to radical surgery, good local tumour control in prostatic carcinoma. Ultrasonically guided puncture technique and implantation procedure are described and preliminary clinical results are presented. PMID- 3538415 TI - [Abscess therapy by ultrasound-guided fine needle puncture. 2]. AB - 29 intraabdominal abscesses were punctured with sonographic guidance. 26 cases were treated by an evacuating needle puncture which was curative in 23 cases (88%). The complications were temporary bacteraeminas in two cases, which were managed conservatively. Sonographically guided fine needle puncture is a simple and effective procedure for the treatment of abdominal abscesses and should be considered as an alternative to surgery and percutaneous drainage. PMID- 3538416 TI - [Intraoperative ultrasound study in surgery]. AB - Report on intraoperative sonography in 257 patients (89 with pancreatic and 67 with liver disease, 24 with vascular surgery and 24 with bile duct disease). Intraoperative sonography was helpful for the detection of tumors not evident by inspection and palpation. In vascular surgery it proved to be an excellent means for quality control. The main problems encountered concerned the evaluation of the bile ducts and of haemodynamically insignificant vessel wall lesions. PMID- 3538417 TI - [Sonographic vascular analysis in segmental aplasia-hypoplasia of the inferior vena cava]. AB - The absence or hypoplasia of the hepatic segment of the inferior vena cava with azygos continuation is a rare entity, sometimes associated with congenital heart disease, situs inversus or polysplenia syndrome. Ultrasonography as an easy, non invasive procedure enables reliable diagnosis of this anomaly replacing inferior cavography. Ultrasonic scans performed in various directions allow a more subtle analysis of vessels and location of azygos continuation. We present an analysis of the sonographic feature in this anomaly, as studied in 2 patients. The diagnosis of this usually incidental finding (chest X-ray) can be of major clinical importance e.g. if special surgical procedures such as ligature of the azygos vein are considered. PMID- 3538418 TI - [Ultrasound image and fetal complications in large chorioangioma of the placenta]. AB - In a case report the prenatal diagnosis by ultrasound and the outcome of the foetus in a pregnancy complicated by a giant chorioangioma of the placenta is presented. Prenatal diagnosis of chorioangioma is possible by ultrasound only. After the diagnosis hospitalisation of the patient and intensive control are mandatory. Perinatal mortality is reported to be as high as 39%. In our case foetal outcome was favorable. PMID- 3538419 TI - Social relationships and social cognition in nonhuman primates. AB - Complex social relationships among nonhuman primates appear to contribute to individual reproductive success. Experiments with and behavioral observations of natural populations suggest that sophisticated cognitive mechanisms may underlie primate social relationships. Similar capacities are usually less apparent in the nonsocial realm, supporting the view that at least some aspects of primate intelligence evolved to solve the challenges of interacting with conspecifics. PMID- 3538421 TI - Cellular events mediated by thrombin and related proteinases: Part Two. PMID- 3538420 TI - Separation of large DNA molecules by contour-clamped homogeneous electric fields. AB - Electric fields can be manipulated by a method in which multiple electrodes are arranged along a closed contour and clamped to predetermined electric potentials. This method may be applied to a broad range of problems in the separation of macromolecules by gel electrophoresis. DNA molecules as large as 2 megabases can be well separated with a contour-clamped homogeneous electric field alternating between two orientations 120 degrees apart. The pattern of separation is independent of position in the gel, which is an advantage over previous methods. DNA less than 50 kilobases can be separated without distortion even at high voltage with a nonalternating contour-clamped homogeneous field. Decreased band broadening in DNA less than 200 bases can be achieved with a contour-clamped inhomogeneous field. PMID- 3538422 TI - Antitumor action of crotalase, a defibrinogenating snake venom enzyme. AB - Recent reports have shown that malignant cells release a variety of factors that modulate the tumor microenvironment. These factors, after release or shedding, work in concert to produce extravasation of fibrinogen from surrounding blood vessels with subsequent fibrin deposition around the tumor cells. This fibrin deposit could act to mask the tumor from the host's immune surveillance system. Fibrin deposits have been observed by investigators in the vicinity of various malignant tumors of man and animals. Although these observations suggest a role for the blood coagulation mechanism in tumor biology, the pathogenesis and significance of fibrin deposits in tumors have not been thoroughly investigated. We have used crotalase, a highly purified defibrinogenating serine proteinase from eastern diamondback rattlesnake venom and a fibrinolytic enzyme from southern copperhead venom to modulate selectively the tumor microenvironment in order to evaluate the role of fibrin(ogen) in tumor growth and dissemination. B16 melanoma, carried in C57BL/6 mice, has been selected as the experimental model system to evaluate the effectiveness of treatment by the venom enzymes. For these studies, solid B16 melanoma was excised from mice and a cell suspension was prepared in serum-free RPMI 1640 medium. Treatment of the cells with crotalase (30 NIH clotting U/ml) produced a dramatic inhibition of growth after subcutaneous injection of cells into C57BL/6 mice. On day 17 after implantation of tumor cells alone, the average tumor weight was 70 mg/mouse. By contrast, mice that received the B16 melanoma cells pretreated with crotalase had an average tumor mass of only 2 mg/mouse.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538423 TI - Role of neutral serine proteases in tumor cell lysis by natural killer cells (large granular lymphocytes) and activated macrophages. PMID- 3538424 TI - Functional determination of antithrombin III in clinical samples and therapeutic concentrates. PMID- 3538426 TI - [The effect of the arranged position of lower anterior artificial teeth on pronunciation--[sa], [su], [se], [so], [shi], [chi] and [tsu]]. PMID- 3538425 TI - Hyperuricemia and gout. PMID- 3538427 TI - Diethylstilbestrol in pregnancy: an update. AB - Several decades ago, diethylstilbestrol (DES) was considered efficacious in improving pregnancy outcome. Later data did not support this, and the exposed mothers and offspring have suffered from a variety of problems attributed to the drug. Knowledge of these problems is essential in dealing with these patients. PMID- 3538428 TI - Neonatal poisoning: causes, manifestations, prevention, and management. AB - Neonates are exposed to a growing list of potentially toxic environmental and therapeutic agents. Such exposure may be through mishap, misjudgment in both drug dosage and route of administration, inadvertent misuse of medications, or improper baby care. In addition, the newborn infant may show signs of adverse reactions to a variety of drugs that are given to the mother and cross the placenta, thereby affecting the fetus before or during both labor and delivery. Because of the immaturity of the neonate's liver, lungs, kidneys, and central nervous system, the process of metabolizing and eliminating drugs and poisons is delayed. Moreover, the clinical signs and symptoms of poisoning are not always immediately recognized. Through reviewing various drugs and environmental pollutants, this article places emphasis on prevention rather than treatment. PMID- 3538429 TI - Corticosteroids in the treatment of asthma. AB - Corticosteroid medications have been regularly used in the management of asthma for more than 30 years. Review of the published literature suggests that steroids may enhance sensitivity to beta-adrenergic agonists and reduce local inflammation. These effects may not be clinically evident for six to 12 hours after steroid administration. Optimum dose, dose forms, and the role of plasma levels remain to be determined. Iatrogenic side effects, notably cushingoid features and hypothalamic-pituitary-related adrenal suppression, are dose-related and may be minimized with alternate-day regimens or the use of inhaled beclomethasone dipropionate. Beclomethasone may facilitate weaning from systemic corticosteroid therapy but usually cannot replace systemic therapy unless the daily dose is less than 20 mg of prednisone or its equivalent. Weaning should be undertaken cautiously, using objective measurements of pulmonary function, to reach a goal of the lowest daily dose consonant with control of symptoms, rather than complete withdrawal. PMID- 3538431 TI - Paracelsus: resolute Renaissance pioneer. PMID- 3538430 TI - Anesthetic management of chemonucleolysis with chymopapain. AB - Chemonucleolysis and lumbar laminectomy after unsuccessful chemonucleolysis are now common and accepted surgical procedures that require precise perioperative management based on a thorough understanding of the pathophysiology of chymopapain-induced anaphylaxis and the herniating nucleus pulposus syndrome. Preoperative management with appropriate screening tests, antihistamines, and steroids, combined with thoughtful premedication and vigilant monitoring during local or general anesthesia, can provide safe anesthetic management of patients having chemonucleolysis with chymopapain. PMID- 3538432 TI - Multiple pseudoaneurysms in a tuberculous patient. AB - I have presented the case of a 20-year-old woman with tuberculous pseudoaneurysm of the innominate artery associated with another pseudoaneurysm of the abdominal aorta. I believe this is the first report of such a case in the literature. PMID- 3538433 TI - Malignancy arising in the transplanted vagina. AB - With the increasing use of radical surgery for genital carcinoma in younger women, vaginal reconstruction is likely to be done more commonly. One of the complications to be considered is neoplasia arising in the vaginal graft. We have reported two cases of squamous cell carcinoma arising in a neovagina three years and four years after grafting, respectively. Both were detected by routine cytologic smears, emphasizing the importance of close follow-up after creating a neovagina. PMID- 3538434 TI - A seroepidemiologic study of hepatitis A in Malaysia. AB - Sera from 494 non-icteric patients admitted with illnesses other than overt hepatitis into the various hospitals in rural and urban Malaysia were tested for IgG antibody to hepatitis A virus. The overall antibody prevalence rate was 67.0% with rates increasing steadily from childhood 10 years old and under (39.4%) to middle-age and above (96.0%). No significant differences were noted between males (68.4%) and females (65.3%). The highest rate was in the Indians (80.6%), the lowest in the Chinese (55.9%) with Malays occupying intermediate position (70.3%). The rate in the rural patients (74.7%) was higher than that in the urban patients (65.5%) especially in the 21 to 40 year age-group where the rural patients had a rate of 96.7% compared with that in urban patients (61.1%). A comparison of antibody prevalence rates in different countries was made. PMID- 3538435 TI - Hepatitis B markers in non-icteric medical patients in Malaysia. AB - Sera were obtained from 494 non-icteric patients admitted with illnesses other than overt hepatitis into the medical wards of the rural and urban hospitals in Malaysia. They were tested for HBsAg, HBeAg, and anti-HBs by enzyme immunoassay. The overall HBsAg carrier rate was 18.0% ranging from 9.6% in children, (10 years and under), to a maximum of 23.5% in the adolescents (11 to 20 years), the rates decreasing subsequently to 16.5% and 20.8% in the adult and middle-age groups, respectively. The Chinese (18.6%) and Malays (19.9%) had similar HBsAg carrier rates but the rate in the Indians (9.0%) was distinctly lower. Similar rates were observed in the males (16.5%) and the females (19.8%). The carrier rate was 17.1% in rural patients compared with 21.4% in the urban ones. The 'e' antigen was found in 14 of the 89 HBsAg carriers (15.7%). The overall prevalence was 14/494 (2.8%) rising sharply from childhood (2.9%) to adolescence (5.3%), subsequently declining with advancing age. The Chinese had the highest rate (6.2%) followed by the Indians (1.5%) and the Malays (1.1%). Males had a rate of 3.3% compared to the females with 2.3%. Anti-HBs was found in 33.8% of the patients, increasing steadily from childhood (18.3%) to middle-age (46.4%). The Chinese had a higher prevalence rate (41.6%) than the Indians (32.8%) and the Malays (29.3%). The rates were similar for the males (35.6%) and the females (31.5%). Rural patients (46.1%) had a higher rate than urban patients (35.7%). Both areas showed rising prevalence with increasing age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538436 TI - The optimum spine. AB - System theory is used to describe the mechanism of the lumbar spine. The role of the spine in vertebrate evolution is presented. The importance of the intervertebral joint for the survival of the species is shown to be crucial. The mechanical behavior of the joint is derived, and from this the corresponding spinal motion and muscular responses is calculated. It is shown that physiologic behavior implies that the stress at the intervertebral joints is equalized and minimized. From this simple condition, the motion of the spine in the sagittal plane is calculated. From the analysis of sagittal plane motion together with a knowledge of the energy transfer through the intervertebral joint, a new theory of locomotion is derived. This theory of locomotion differs in important respects from current theories, but nevertheless explains available experimental data. This unified theory of the function of the human spine permits the determination of the level of safe loads that can be lifted and transported. It predicts the conditions of load transfer through a joint. It proposes a new approach to the mechanism of arthritis and to the repair of fractures. PMID- 3538437 TI - [Rheumatoid arthritis in medieval skeletal remains from old Serbia (Ras)]. PMID- 3538438 TI - [Stereotaxic biopsy in a patient with a complex course of a cerebral microglioma]. PMID- 3538439 TI - [Master Egidius, a Dubrovnik physician from the first half of the 14th century]. PMID- 3538440 TI - [Construction of a hollow abutment post]. PMID- 3538441 TI - [Review of the literature on the possibility of malignant transformation of oral leukoplakia]. PMID- 3538442 TI - [Tolerance of contrast media in double injections]. PMID- 3538443 TI - [Transvenous DSA: ECG-controlled cardiac effects and venous complications in pre trial injection of nonionic contrast media]. PMID- 3538444 TI - [T cell subset--recent progress and clinical implication]. PMID- 3538445 TI - [Result of a double-blind clinical study of EB-382 (Alminoprofen) in rheumatoid arthritis]. PMID- 3538448 TI - Fifty years at King Edward VIII Hospital, Durban. PMID- 3538447 TI - Insulin secretion in Indian patients with impaired glucose tolerance. AB - The insulin response to a 75 g oral glucose load was studied in 26 indian patients with impaired glucose tolerance (IGT) and 26 controls matched for age, sex and weight. There were no significant differences between the mean insulin responses and incremental insulin areas between the patients with IGT and controls. However, when the patients were divided into obese and non-obese subgroups and their mean insulin levels compared, the obese patients with IGT had significantly higher insulin levels at 120 minutes than the obese controls. PMID- 3538449 TI - The application, mechanism of action and side-effects of immunosuppressive agents in clinical transplantation. AB - The conventional agents (azathioprine and steroids) have been the mainstay or organ allograft immunosuppression for the past 20 years. The main drawback of the immunosuppressive agents at present in use is that they act nonspecifically with sequential general depression of the immune system. The introduction of cyclosporin, an undecapeptide of fungal origin, which selectively inhibits T-cell dependent immuno-reaction has made a significant impact on organ allograft survival rates. Clinical application has been complicated because of renal or hepatotoxicity. Thoracic duct drainage is of historical interest but the use of antilymphocyte serum, despite its chequered history, has recently been shown to be safe and effective in cadaver kidney transplant recipients. There has also been a resurgence of interest in the use of total lymphoid irradiation as an immunosuppressive agent. The introduction of xenogenic monoclonal antibodies with anti-T-cell specificity opened a new era in clinical immunology and OKT3-PAN has emerged as a powerful major immunosuppressive agent with low toxicity. PMID- 3538446 TI - Midazolam premedication in paediatric anaesthesia. AB - To investigate the efficacy of midazolam (Dormicum; Roche) as a paediatric premedication, 150 children, aged 6 months-5 years, were divided into three groups. All three groups spent time with the anaesthetist to allow rapport to be established. Group A received midazolam premedication, group B received oral trimeprazine, droperidol and methadone (TDM) and group C received no sedative medication. Midazolam gave the best behaviour patterns in the holding room. Behaviour at induction was the same in all three groups. The recovery times were similar in the midazolam and unsedated groups, but in the TDM group recovery was significantly delayed. Temperatures remained stable in the unsedated and midazolam groups, but decreased in the TDM group. It is concluded that midazolam is a satisfactory paediatric premedication agent. PMID- 3538451 TI - Impact of antitumor therapy on nutrition. AB - Surgery, radiation, and chemotherapy can result in further deterioration in nutritional status in patients who are frequently malnourished as a consequence of their underlying malignancy. Many of the effects are transient, and patients who have a good performance status may exhibit minimal alterations in nutritional parameters during the course of treatment. However, antitumor treatment may enhance morbidity, and in some, it leads to mortality if patients are in poor nutritional status ab initio. Such malnourished patients must be recognized prior to initiation of treatment, and steps must be taken to maintain adequate nutrition. The known toxic effects of many cancer therapeutic regimens must be weighed against their potential benefits. PMID- 3538450 TI - Double-blind study of sulindac and aspirin in juvenile chronic arthritis. AB - Sulindac (Clinoril; Frosst-MSD), a non-steroidal anti-inflammatory drug was compared with aspirin in a randomized double-blind cross-over controlled study in 30 patients with juvenile chronic arthritis. Sulindac was found to be safe and effective. Although it has the advantage of a twice-a-day dose regimen, both patient and doctor may prefer to be guided by pain relief and cost. PMID- 3538452 TI - [Childcare at the beginning of the 20th century in a rural Languedoc community]. PMID- 3538453 TI - The role of ultrasonography in the evaluation of primary hyperparathyroidism. AB - Ultrasonography was used preoperatively in 21 patients with primary hyperparathyroidism in an effort to locate enlarged parathyroid glands. It indicated the presence of a solitary mass compatible with a parathyroid adenoma in 14 patients. At operation, adenomas were found at the location indicated by ultrasonography in 13 of the 14 patients (93 per cent). In seven patients, ultrasonography failed to reveal evidence of a mass of the parathyroid gland. At operation, three had diffuse parathyroid hyperplasia and four had a solitary adenoma. Of the four patients with adenomas undetected by ultrasonography, one patient had an adenoma which had undergone infarction and three had coexisting nodular thyroid gland disease. We concluded that ultrasonography is valuable in the preoperative assessment of patients with primary hyperparathyroidism. This is especially so in the absence of coexisting nodular thyroid gland disease. When positive, ultrasonography accurately locates adenomas, and when negative, it strongly suggests the presence of hyperplasia. This may have clinical application in limiting the extent of dissection and, thereby, reducing the morbidity of parathyroid gland exploration. PMID- 3538455 TI - Antibiotic levels in the small intestine. AB - It is unknown if parenteral antibiotics commonly used for prophylaxis reach adequate therapeutic levels in the intestinal tissue to inhibit the growth of bacteria, such as Escherichia coli and Bacteroids fragilis, commonly associated with injury to the gastrointestinal tract. We have designed an experiment using dogs to study this problem. We considered an antibiotic to be effective if a single dose reached increased levels in the intestinal tissue to inhibit the growth of the majority of Escherichia coli and Bacteroides fragilis strains isolated from the gastrointestinal tract. Of 14 different antibiotics studied, we conclude that carbenicillin, mezlocillin, piperacillin, cefbuperazone and cefoxitin as single drugs and Timentin (ticarcillin with clavulanic acid) and clindamycin with gentamicin and co-trimoxazole (trimethoprium and sulfamethoxazole) achieved therapeutic levels. Azlocillin, cefoperazone, cefmenoxime and minocycline failed to achieve significant concentrations. This experiment using dogs was extremely useful to determine the pharmacokinetics of antibiotics in the small intestine and to predict the efficacy of antibiotics considered for prophylaxis. PMID- 3538454 TI - A new approach to the surgical management of paralysis of the laryngeal nerve after thyroidectomy. AB - Recurrent nerve palsy, immediate or delayed, or unilateral or bilateral, is a recognized complication of operations upon the thyroid gland and is not considered to be remediable as a presumed consequence of division of the nerve (or nerves). Removal of sutures and neurolysis of the nerve have met with variable success in restoration of function. In a prospective study over a period of 14 years, paralysis after thyroidectomy was assessed in 31 patients. Five had undergone previous operations upon the thyroid gland, four of these patients had known unilateral paralysis and 26 underwent operations which involved exploring the nerves. Immediate removal of the sutures was followed by complete recovery in four of the patients. Fifteen nerves of 13 patients with delayed paralysis were operated upon within six months of the original procedure; ligatures were removed in four patients, the nerve of one patient was sutured and the remaining underwent neurolysis. Some recovery of function within six months was seen in 13 nerves. Nine nerves were operated upon up to one year later, three divided nerves were sutured, one suture around a nerve was removed and five nerves were freed from fibrous tissue; recovery of function was seen in only two nerves. Of all the nerves which were sutured, slight mass movement of the corresponding vocal cord was seen in two. The results indicate that immediate paralysis after thyroidectomy should be investigated immediately, not only to excluded severance but also to relieve, if possible, physical involvement of the nerve by suture or ligature; the outcome of the operation is often beneficial. The benefits of neurolysis when the onset of paralysis is delayed due to fibrosis surrounding the nerve is also discussed; earlier intervention is associated with better results. Direct suture of the divided nerve is not recommended. PMID- 3538456 TI - The open management of the septic abdomen. AB - The mortality rate of severe intra-abdominal infections is still very high. The open management of the abdomen is a method of treatment which has gained popularity over the past few years. Its advantages include a better drainage of the peritoneal cavity, a greater protection of the parietes, an improved perfusion of the abdominal viscera and a decrease in postoperative pulmonary complications. It is indicated in patients with severe intra-abdominal sepsis, especially when multiple re-explorations of the abdomen are likely. A variety of techniques, including the use of Marlex mesh have been devised to contend with possible complications: spontaneous fistulas, exogenous bacterial contamination, evisceration and massive fluid losses. The open method of management has not made the treatment of septic abdomen much easier; it requires intensive care support and repeated assessment of the peritoneal cavity. The closure of the abdomen is a problem which must be addressed when the sepsis has subsided. The value of this technique is still difficult to assess in the absence of controlled randomized trials. PMID- 3538457 TI - Hydrocephalus--the remarkable case of James Cardinal. From Reports of Medical Cases, Volume II, 1831, by Richard Bright. PMID- 3538458 TI - Middle cerebral artery stenosis--a neglected problem? AB - Transcranial Doppler ultrasonography has great potential for clinical investigations that evaluate flow through the middle cerebral artery in health and disease. This technique will help to elucidate the syndromes of middle cerebral artery stenosis and occlusion, which have been overshadowed by the syndromes of internal carotid artery disease in the past. PMID- 3538459 TI - Stereotaxic biopsy and positron emission tomography correlation of cerebral gliomas. AB - Computer-directed stereotaxis was used to obtain tissue diagnosis in two cases of cerebral glioma, one low grade, and the other high grade. Both lesions had a similar computed tomographic appearance. Positron emission tomography was performed in each case using [18F]fluorodeoxyglucose. A correlation was made in each case between the metabolic activity of the tumor as measured by positron emission tomography, the radiographic appearance, and the tumor histology. PMID- 3538460 TI - [Esophageal carcinoma: the final results of a multicenter and controlled German study with misonidazole and radiation]. AB - A prospective, randomized clinical study on 91 patients with squamous cell carcinoma of the oesophagus was undertaken in order to investigate the radiosensitizing effect of misonidazole. After histologic verification and extensive diagnosis, the greater tumor region was at first irradiated during 2.5 weeks with ten fractions of 3 Gy each up to a target volume dose of 30 Gy. Prior to each fraction, patients received randomly misonidazole or a placebo in a dose of 1 g/m2 body surface. Then they were presented to the oncologic surgeon in order to decide whether a surgical resection should be performed or not. Following to this operation no further radiotherapy was performed. However, if a surgical intervention did not take place, radiotherapy was continued without administration of misonidazole or placebo up to a target volume dose of 60 to 70 Gy. There was no evidence of neurotoxic side effects or modifications of the blood count and some laboratory parameters caused by misonidazole. As to recurrence-free interval and survival time, no significant differences were found between the different therapy groups, so that a radiosensitizing effect of misonidazole was not demonstrated in this study. Regarding several positive phase II studies with misonidazole, some hopes had been placed in this study because at present the therapeutic situation in oesophagus carcinoma is extremely unsatisfactory. Even the combination of a most sophisticated operation technique prior or following to irradiation could not essentially improve the poor healing rates. PMID- 3538461 TI - [5-year cure results in the radiotherapy of cervix uteri cancers between 1928 and 1977. An historical survey of a half-century reporting period]. AB - The authors present the five-year healing results of 4347 uterine cervix cancers treated at our Radiotherapeutic Institute within the years of 1928 to 1977. The part of patients irradiated postoperatively increased by 30% during this period, and the average age of patients at the beginning of their disease increased by almost seven years. The overall five-year healing results increased from 47 to 60% during this half of a century, especially the prognosis of stage II and III was considerably improved. With almost the same rate of radiogenic side effects, the incidence of recurrences could be reduced by 50%. The healing results achieved by us in uterine cervix cancer during the last ten years under report correspond well with the healing results of other radiotherapeutic hospitals. Even when compared to the most recent reports on the success achieved by afterloading techniques, there is not much difference to our recent results obtained with radium brachytherapy. PMID- 3538462 TI - Effect of hyperparathyroidism on the control of diabetes mellitus. AB - Hyperparathyroidism is associated with abnormalities in glucose tolerance and insulin secretion. To assess the effects of hyperparathyroidism on the control of diabetes mellitus, 56 patients with concomitant hyperparathyroidism and diabetes mellitus were studied before and after parathyroidectomy. Fifty patients (89.3%) had hypercalcemia, and six patients (10.7%) had normocalcemia associated with inappropriately elevated parathyroid hormone. After surgery, three of five patients with insulin-dependent diabetes mellitus showed more than a 50% reduction in insulin requirement. Thirty-nine of 49 patients with noninsulin dependent diabetes mellitus were followed. Of these, three patients had restoration of normal blood glucose levels without any diabetic treatment including diet restriction. Diabetes control improved in eight parents, remained stable in 18, and deteriorated in 10 patients. In the remaining two patients, impaired glucose tolerance disappeared in one patient and progressed to frank diabetes in the other. Overall 60.7% of the patients improved or remained stable in their diabetes control after parathyroidectomy. We conclude that in patients with hyperparathyroidism, the coexistence of diabetes mellitus might be a further indication for parathyroidectomy. Physicians should be alerted to the possible change in diabetic regimen and the risk of hypoglycemia in patients with diabetes after parathyroidectomy. PMID- 3538464 TI - [Before the introduction of insulin 100]. PMID- 3538463 TI - The evolution of transsphenoidal pituitary microsurgery. AB - Serious interest in pituitary disease started 100 years ago when acromegaly was described (1886, Marie). Transcranial pituitary operations soon followed (1889, Horsley). Transnasal operations (1907, Schloffer) were complicated by cerebrospinal fluid leakage and meningitis. Improvements led to definitive transseptal (1910, Cushing and Hirsch) and transethmoidal (1911, Chiari) decompressing surgery for tumors. The mortality rate fell below 10%, and relief, mainly from local effects, often followed, sometimes for many years. By 1930 Cushing and most U.S. surgeons used a transcranial approach because suprasellar lesions were inaccessible from below, but several European surgeons continued to use transsphenoidal operations when appropriate (Hirsch, Dott, and Nager). By 1950 antibiotics had reduced infection, and cortisone soon rendered total hypophysectomy by all routes safe for tumorous and normal glands. Microsurgical transethmosphenoidal hypophysectomy was introduced by ear, nose, and throat surgeons (1957 or 1958, Gisselsson, Riskaer, Bateman, MacBeth, and James). Neurosurgeons introduced intraoperative radiofluoroscopy (1957, Guiot), air encephalography, televised fluoroscopy, microsurgical transseptal hypophysectomy, and selective anterior hypophysectomy (1965, Hardy). Microadenomectomy for lesions invisible radiologically was introduced in 1968 (Hardy). The operative death rate is now negligible. Computerized tomographic scanning helps locate tumors, but increasingly surgeons now regard endocrinologic diagnosis alone as justification for operation. Early outcome is excellent, especially in experienced hands, and particularly for noninvasive tumors, but later results are forthcoming. PMID- 3538465 TI - [A milestone in our nursing history: nurse Kari Martinsen--Doctor in Philosophy- with glory]. PMID- 3538466 TI - [Resin-retained bridges. 2. Preparations, construction design, choice of materials and dimension analysis]. PMID- 3538467 TI - [Pre-fabricated root canal posts]. PMID- 3538468 TI - [Healing following oral hygiene and scaling]. PMID- 3538469 TI - [Mononuclear phagocytes, the hemostasis system and the intravascular coagulation syndrome]. AB - The author analyses the reported data and his own findings concerned with the involvement of mononuclear phagocytes in the regulation of hemostasis and in the pathogenesis of a number of frequently occurring forms of the hemostatic system pathology. The content of monocytic thromboplastin was measured in 56 patients with the intravascular blood coagulation syndrome of varying etiology. Production of monocytic thromboplastin reached the highest degree in patients with purulent conditions whereas in patients presenting with the terminal stage of sepsis, it did not exceed normal or even dropped down, which may be connected with depletion of monocytes because of their preliminary hyperactivation. PMID- 3538470 TI - [Chromosomes and oncogenes in chronic myeloleukemia (on the 25th anniversary of the discovery of the Philadelphia chromosome)]. PMID- 3538471 TI - [Clinical aspects of bone marrow transplantation]. PMID- 3538472 TI - [Autologous bone marrow transplantation in malignant lymphohematopoietic diseases]. PMID- 3538473 TI - [Mature-cell lymphocytic tumors]. PMID- 3538474 TI - [Echotomographic picture of the lymph nodes of the abdominal cavity and retroperitoneal space in 2 histologic variants of lymphogranulomatosis]. PMID- 3538475 TI - [Experiences in transplanting bone marrow, leukocytes and human embryonic liver cells in hemoblastosis patients]. AB - The authors describe the experience gained with 19 allogenic and autologous transplantations of the bone marrow, peripheral blood leukocytes, embryonal liver cells of man and syngeneic transplantation of the bone marrow to 15 patients with hemoblastoses and aplastic anemia. Non-medullary toxicity of the pretransplantation conditioning of the patients was moderate and could be successfully corrected. The clinical analysis of the complications and causes of the patients' death demonstrated an evident reduction of organ lesions as a result of the use of the common methods of preventing exo- and endogenous infections and early treatment of the complications. The authors describe an acute secondary disease as the main reason for death during the latest allogenic transplantations of the bone marrow and support the conclusion about the necessity of transplantation only in the cases with a satisfactory prognosis. PMID- 3538477 TI - Intravenous aminophylline in patients already taking oral theophylline: effect on calculated dose of knowledge of serum theophylline concentration on admission. AB - Measurement of serum theophylline concentration is usually recommended before intravenous aminophylline is given to patients taking oral theophylline. Fifty patients with worsening airflow obstruction, all of whom were taking oral theophyllines and who had no contraindication to the use of parenteral aminophylline, were randomly allocated into two groups before treatment was given. The dose of aminophylline was calculated without (group A) and with (group B) knowledge of admission serum theophylline concentration. In group A a regimen incorporating corrections to account for factors affecting theophylline clearance was used in an attempt to represent a "knowledgeable" approach; in group B a formula incorporating the known serum theophylline concentration at the time of admission was used. All loading doses were given over 30 minutes as "mini infusions." The two groups were well matched for age, blood gas tensions, and severity of airflow obstruction. The results for four patients (one from group A and three from group B) were excluded from analysis after completion of the study. In each group the mean admission serum theophylline concentration measured (group A: 8.4 (SD 6.0)mg/l; group B: 7.2 (5.7)mg/l) and the aminophylline doses used (group A: loading bolus 172 (45.5)mg, infusion 815 (198)mg; group B: loading bolus 233(189)mg, infusion 788(214)mg) were similar. Mean serum theophylline concentrations during 24 hours' aminophylline treatment, number of patients with a serum theophylline concentration greater than 20 mg/l, symptoms of toxicity, and outcome were also similar in the two groups. Although satisfactory use of parenteral aminophylline was achieved for most patients without knowledge of serum theophylline concentration at the time of admission to hospital (with the aid of a "knowledgeable" clinical approach and constant infusion pumps), prompt measurement of serum theophylline concentration at the time of admission identified patients with either suboptimal or potentially hazardous theophylline concentrations. PMID- 3538476 TI - Effect of inhaled piriprost (U-60, 257) a novel leukotriene inhibitor, on allergen and exercise induced bronchoconstriction in asthma. AB - The leukotrienes, a group of oxidative metabolites of arachidonic acid, have potent pharmacological actions on human airways. We have investigated the effects of a leukotriene synthesis inhibitor, piriprost (U-60, 257) administered by inhalation on allergen and exercise induced bronchoconstriction in 12 subjects with allergic asthma. Subjects underwent diagnostic challenges with allergen and treadmill exercise to define the strengths of the stimuli required to reduce the FEV1 to about 25% of baseline (PS25). On separate study days subjects inhaled either piriprost 1 mg or vehicle placebo, followed 15 minutes later by the PS25 allergen or exercise. The FEV1 was measured at regular intervals before and after challenge up to 60 minutes. After allergen challenge in six subjects peak expiratory flow (PEF) was measured for the following 20 hours. When compared with placebo, inhalation of piriprost had no significant protective effect on the fall in FEV1 at any time point within 60 minutes of allergen or exercise challenge. In the four subjects with a documented late asthmatic reaction 2-12 hours after allergen challenge piriprost had no protective effect when compared with placebo. In the subjects who recorded PEF over 20 hours after allergen challenge there was no significant difference between piriprost and placebo. Piriprost was appreciably more irritant to the respiratory tract than was placebo. On the assumption that inhaled piriprost was bioavailable in the airways, this study casts doubt on any theory of a pivotal role for leukotrienes in the pathogenesis of acute exercise and allergen induced airway bronchoconstriction in asthma. PMID- 3538478 TI - Domiciliary comparison of terbutaline treatment by metered dose inhaler with and without conical spacer in severe and moderately severe chronic asthma. AB - The bronchodilator response to cumulative doses of terbutaline administered by metered dose inhaler with and without a conical spacer device and by Acorn nebuliser has been compared in groups of patients with chronic severe and moderately severe asthma. After laboratory studies the patients undertook a randomised domiciliary crossover comparison of bronchodilator response to terbutaline given by metered dose inhaler with and without a spacer device, during which the severity of asthma was assessed by thrice daily recordings of peak expiratory flow (PEF) and symptom score. Improvement in FEV1 produced in the laboratory by the metered dose inhaler with spacer device was significantly greater than by metered dose inhaler alone (p less than 0.001) and similar to that from the nebuliser in both asthmatic groups throughout a range of terbutaline doses. In the domiciliary comparison mean midday and evening PEF rates were significantly higher with the use of the spacer device both in those with severe (p less than 0.01) and in those with moderately severe (p less than 0.05) asthma, and mean morning PEF was significantly higher in the severe group (p less than 0.05). The spacer device also produced a significant improvement in symptom score in both the severe and the moderately severe groups (p less than 0.05). Regular domiciliary use of the spacer device with the metered dose inhaler improves bronchodilator response, particularly in patients with chronic severe asthma, and may be a useful alternative to nebuliser treatment. PMID- 3538479 TI - Interpretation of the variability of peak flow rates in chronic bronchitis. AB - Increased diurnal variation of expiratory flow rates has been documented in patients with chronic bronchitis, but this could be secondary to the disease process of bronchitis rather than an associated disease--namely, asthma. Peak expiratory flow was measured twice daily before and after inhalation of 200 micrograms salbutamol in 34 subjects with chronic bronchitis. The FEV1 ranged from 38% to 121% predicted. Diurnal variation (expressed as highest lowest/highest (%)) was increased in 18 subjects, all but three of whom had airflow obstruction and an increase in methacholine airway responsiveness. There was only a weak correlation between diurnal variation and airway responsiveness (r = -0.54) or the severity of the airflow obstruction. This finding, together with the occurrence of an increase in diurnal variation without an increase in methacholine airway responsiveness in three subjects, suggests that the increased diurnal variation in chronic bronchitis may have a different underlying mechanism from that in asthma. PMID- 3538480 TI - Acute severe asthma treated by mechanical ventilation: 10 years' experience from a district general hospital. AB - A retrospective study was made of patients requiring mechanical ventilation (intermittent positive pressure ventilation--IPPV) for acute severe asthma in a district general hospital during 1974-83. Thirty two patients required IPPV on 34 occasions. Complications included pneumothorax in six (18%) patients, chest infection in 12 (35%) patients, pulmonary collapse in three (9%) patients, hypotension at induction of IPPV in 12 (35%), and gastrointestinal bleeding in three (9%). Three (9%) patients died. Therapeutic bronchial lavage was performed in 19 patients. The procedure produced a rise in effective static compliance from a mean of 17 (SD 6) ml/cm H2O to 24 (9) ml/cm H2O at four hours. Bronchial lavage was associated with a significant excess of respiratory infections. A feature common to most patients was undertreatment before admission to hospital. PMID- 3538481 TI - Effect of nifedipine on arterial hypoxaemia occurring after methacholine challenge in asthma. AB - To investigate whether the effects of nifedipine on methacholine induced broncho constriction could impair pulmonary gas exchange in bronchial asthma a randomised, double blind, crossover study in 13 symptom free asthmatic subjects was designed. Each patient underwent a methacholine bronchial challenge test on two separate days one week apart, after having either oral nifedipine (20 mg thrice daily) or placebo for three days. Arterial blood gases were measured before and after methacholine challenge in nine subjects. Prechallenge values of forced expiratory volume in one second (FEV1) and arterial oxygen tension (Pao2) were similar after nifedipine and after placebo. After challenge, the cumulative doses of methacholine required to produce a 20% fall in FEV1 (PD20 FEV1) were significantly larger after nifedipine (280 (SD 347)) cumulative breath units (CBU) than after placebo (120 (183) CBU; p less than 0.01). After challenge the fall in Pao2 values (17.1 (1.6) mm Hg; (2.28 (0.21) kPa)) was significantly greater than after placebo (11.7 (2.4) mm Hg; (1.56 (0.32) kPa) p less than 0.03). Our data show that although oral nifedipine significantly reduces airway reactivity in patients with mild bronchial asthma, it also adversely affects pulmonary gas exchange, resulting in a lowered postchallenge Pao2, probably because of worsening ventilation-perfusion relationships. PMID- 3538483 TI - Charcot-Leyden crystals and Curschmann spirals in asthmatic sputum. PMID- 3538482 TI - Bone marrow transplantation and the lung. PMID- 3538484 TI - Lung function changes after allogenic bone marrow transplantation. AB - The lung function of 21 patients with leukaemia (11 with acute myeloid leukaemia, six with acute lymphatic leukaemia, four with chronic myeloid leukaemia) and of five with severe aplastic anaemia was tested before and after allogenic bone marrow transplantation. Vital capacity (VC) was lowered in patients with leukaemia before transplantation. VC and FEV1 fell significantly after transplantation. Residual volume (RV) and RV as a percentage of total lung capacity (RV % TLC) were already increased and rose significantly after transplantation. Patients with severe aplastic anaemia had noticeably increased RV and RV % TLC, values that did not change after transplantation. In contrast to the patients with aplastic anaemia, the patients with leukaemia had significantly reduced VC, RV, RV % TLC, and FEV1 before and after transplantation. The specific airway resistance (sRaw) was raised significantly before and after transplantation in the leukaemic patients. In addition, transfer coefficient (Kco) fell significantly more after transplantation in the patients with leukaemia than in those with severe aplastic anaemia. In three patients with histologically established obstructive bronchiolitis in conjunction with chronic graft versus host disease after transplantation, VC, FEV1 and FEV1 % VC fell, while RV, RV % TLC, and sRaw rose; Kco was far below normal. On the basis of these findings it is concluded that in patients with leukaemia obstructive disorders of ventilation develop or, if they are already present, worsen. In patients with severe aplastic anaemia lung function was not impaired in the early phase after transplantation. These differences are probably due to the more intensive immunosuppressive and cytotoxic preparatory regimen before transplantation in the leukaemic patients. Obstructive bronchiolitis, a complication of graft versus host disease, first manifests itself in a typical rise in specific airway resistance and must be treated early. PMID- 3538486 TI - Twice daily versus four times daily treatment with beclomethasone dipropionate in the control of mild childhood asthma. AB - The effects of controlling childhood asthma of the same daily dose (400 micrograms) of beclomethasone dipropionate, given in two or four equal divided doses from a metered aerosol, were compared in a double blind crossover study. Thirty one children aged 6-14 years completed the study. They had previously been shown to need beclomethasone by showing either symptoms or reduced peak flow when the treatment was withdrawn. They recorded their daytime and night time symptoms on a visual analogue scale and their morning and evening peak expiratory flow (PEF), and recorded their symptomatic use of bronchodilator aerosols. Spirometry was performed at the end of each treatment period. Control of asthma was good on both regimens. There were small differences in both objective and subjective measurements in favour of the four times daily regimen, but none reached statistical significance, apart from patients' assessment of daytime wheeze (p less than 0.05). In particular, the differences in the results of lung function tests were very small. Compliance was better for morning and evening doses. These results suggest that beclomethasone given as 200 micrograms twice daily is effective in controlling mild childhood asthma. It may be preferable to 100 micrograms four times daily because of better compliance and because it is unnecessary to take medication to school. PMID- 3538485 TI - Elastin and the lung. PMID- 3538487 TI - Value of serial peak expiratory flow measurements in assessing treatment response in chronic airflow limitation. AB - A double blind, randomised, placebo controlled, crossover trial of prednisolone (40 mg/day for 14 days) was carried out in 33 patients with chronic airflow limitation (mean age 62 years, mean FEV1 1.01 litres, mean FEV1/FVC ratio 44%), to assess the value of serial peak expiratory flow (PEF) measurements, taken five times daily in evaluating treatment response by comparison with other objective measurements and with measurements of symptoms. The mean serial PEF after a one week run in period was 189 1 min-1, during the second week of placebo 193 1 min 1, and during the second week on prednisolone 231 1 min-1. The difference in mean PEF values between placebo and prednisolone was significant (p less than 0.01). With regard to the response to steroids of the individual patients, 13 of the 33 had a detectable trend of improvement on visual inspection of serial PEF measurements during prednisolone treatment but only one during placebo administration. Of all the objective measurements made after the run in and after each treatment phase (12 minute walking distance, FEV1, forced vital capacity (FVC), serial PEF), the serial PEF chart provided the best discrimination between placebo and prednisolone treatment. There was no statistically significant association between steroid induced improvement in serial PEF measurements and in breathlessness, partly because of placebo improvements in symptoms in those who had no improvement in serial PEF values. This study indicates the importance of making objective measurements to identify a genuine steroid response rather than relying on symptomatic improvement alone. The best simple measurement to make is serial PEF during steroid trials. This is more sensitive in detecting a steroid response than are the 12 minute walking distance, FEV1, or FVC, and is also less likely than these measurements to show spurious placebo responses. PMID- 3538488 TI - Short burst oxygen treatment for breathlessness in chronic obstructive airways disease. AB - Most patients with chronic obstructive lung disease prescribed oxygen at home by their family doctor use it for short periods when they feel breathless. Many patients are normoxic. Nineteen patients with advanced disease and variable hypoxaemia undertook exercise until they indicated severe breathlessness on a 100 mm visual analogue scale. Air, 67% oxygen, and air delivered from a cylinder in an identical manner to the oxygen were randomly administered during the recovery periods. Respiratory rate, heart rate and oxygen and carbon dioxide tensions, estimated by transcutaneous electrodes (tcPo2, tcPco2), were measured throughout the exercise and recovery periods. The mean recovery time for breathlessness as judged by visual analogue score was significantly shorter when oxygen was used than during placebo or air recovery (p less than 0.05). The rates of return to baseline levels of respiratory and heart rates were not significantly affected by the gas inhaled. No placebo effect was detectable. It was not possible to select good responders from the results of prior physiological tests. In seven patients the study was repeated after an interval of between one week and a year. The consistency of observed response to oxygen was poor. Although recovery judged by visual analogue scores showed some consistency within individual patients and greater overall consistency than heart rate or respiratory rate, the direction of change in recovery judged by visual analogue score after the breathing of oxygen was variable. The change during the breathing of oxygen was towards improvement in both studies in three patients and towards deterioration in both studies in one patient, and it showed no consistent direction of change in the remaining three patients. It is difficult to determine which patients will derive substantial and reproducible benefit from short burst oxygen but their numbers are probably small. The results cast doubt on the justification for the current widespread prescription of oxygen cylinders for occasional use. PMID- 3538490 TI - Airway response to methacholine during exercise induced refractoriness in asthma. AB - To investigate the mechanisms contributing to refractoriness in exercise induced asthma a methacholine challenge test was performed 30 minutes before and 30 minutes after two exercise tests 45 minutes apart. Exercise was performed by 12 asthmatic patients while they were breathing cold air. There was a smaller airway response to the second exercise test than to the first, though there was wide variation between subjects. The response to the second methacholine challenge was reduced in some patients but showed no significant change overall. Refractoriness to exercise induced asthma positively correlated with a reduced response to methacholine. These data suggest that mediator depletion does not fully explain refractoriness. PMID- 3538492 TI - Prevalence of bronchial reactivity to inhaled methacholine in New Zealand children. PMID- 3538491 TI - Pulmonary tuberculosis due to Mycobacterium bovis. AB - During 1969-84 Mycobacterium bovis was isolated from 20 patients with pulmonary tuberculosis. This represented less than 1% of the total cases of respiratory tuberculosis confirmed bacteriologically at the Liverpool Public Health Laboratory during this period. All 20 patients were considered to have reactivated disease and all presented with the typical features of respiratory tuberculosis. During the same period four cases of pulmonary infection by Mycobacterium africanum were recognised. This organism is difficult to differentiate from M bovis and failure to distinguish the two mycobacteria could lead to a misleading epidemiological picture of bovine tuberculosis in man. PMID- 3538489 TI - Role of inflammation in the hyperreactivity of the airways in asthma. PMID- 3538493 TI - A fully automated immuno-turbidimetric determination of fibrin(ogen) degradation products. AB - A fully automated procedure for the determination of fibrin(ogen) degradation products was developed using the I. L. Multistat Centrifugal Analyzer (MCA). The assay is based on the turbidometric measurement of the interaction between antibodies to human fibrinogen and defibrinogenated specimens. The method allows, with high reproducibility, for the accurate quantitation of degradation products between 10 and 160 micrograms/ml. A comparative study of 100 normal and abnormal patient samples revealed an excellent correlation with the semi-quantitative manual procedure. The method can be adapted to existing automated coagulation procedures and can become part of coagulation panels. PMID- 3538494 TI - Relative insensitivity of epinephrine induced platelet aggregation to prostacyclin. PMID- 3538495 TI - Report of Workshop on expression of vitamin K-dependent proteins in bacterial and mammalian cells, Madison, Wisconsin, USA, April 1986. PMID- 3538496 TI - [Insulin 100 IE/ml--introduction in 1987]. PMID- 3538497 TI - Computerized information resources in toxicology and industrial health--a review. AB - The explosion in scientific information presents problems for toxicologists and industrial health specialists who need to respond rapidly and comprehensively to the information needs of the public, government and industry. The application of information technology enables large volumes of toxicology and industrial health information to be stored and retrieved through a variety of data-base resources. Three different categories of databases are described: dictionary, bibliographic and informational types. Examples of specific toxicology and industrial health databases within each category are given; their origin, style and content are reviewed. Specialists in the industrial health field are encouraged to improve their knowledge and literacy in the new disciplines of information technology and information science. PMID- 3538499 TI - Historical background of 6-mercaptopurine. PMID- 3538498 TI - Biological monitoring of nickel. AB - Measurements of nickel in body fluids, excreta, and tissues from humans with occupational, environmental, and iatrogenic exposures to nickel compounds are comprehensively reviewed. Correlations between levels of human exposures to various classes of nickel compounds via inhalation, oral, or parenteral routes and the corresponding concentrations of nickel in biological samples are critically evaluated. The major conclusions include the following points: Measurements of nickel concentrations in body fluids, especially urine and serum, provide meaningful insights into the extent of nickel exposures, provided these data are interpreted with knowledge of the exposure routes, sources, and durations, the chemical identities and physical-chemical properties of the nickel compounds, and relevant clinical and physiological information, such as renal function. Nickel concentrations in body fluids should not, at present, be viewed as indicators of specific health risks, except in persons exposed to nickel carbonyl, for whom urine nickel concentrations provide prognostic guidance on the severity of the poisoning. In persons exposed to soluble nickel compounds (e.g., NiCl2, NiSO4), nickel concentrations in body fluids are generally proportional to exposure levels; absence of increased values usually indicates non-significant exposure; presence of increased values should be a signal to reduce the exposure. In persons exposed to less soluble nickel compounds (e.g., Ni3S2,NiO), increased concentrations of nickel in body fluids are indicative of significant nickel absorption and should be a signal to reduce the exposures to the lowest levels attainable with available technology; absence of increased values does not necessarily indicate freedom from the health risks (e.g., cancers of lung and nasal cavities) associated with exposures to certain relatively insoluble nickel compounds. PMID- 3538500 TI - Chemical of current interest--propylene oxide: health and environmental effects profile. PMID- 3538501 TI - Mutagenicity of 4-nitrodiphenyl ether and its metabolites. AB - The mutagenic potential of 4-nitrodiphenyl ether (NDE) an intermediate of herbicides and an anthelmintic drug, and its reduced products (-NO, -NHOH) were investigated in the Ames test. All the three compounds were potent direct-acting base-pair and frameshift mutagens with activity order -NHOH greater than -NO greater than -NO2. The -NHOH compound has been considered to be the penultimate/ultimate mutagen. PMID- 3538503 TI - Light microscopic autoradiography followed by electron microscopy. PMID- 3538502 TI - [A comparative clinical study of an air polishing instrument]. PMID- 3538504 TI - [Quantitative characteristics of the gingival fluid in persons with an intact periodontium]. PMID- 3538505 TI - [Titanium nitride in orthodontics]. PMID- 3538506 TI - [Biological evaluation of titanium nitride used for coating dental prostheses]. PMID- 3538507 TI - [Multilayer protective nitride coatings on metal dentures]. PMID- 3538508 TI - [Clinical x-ray characteristics of graft survival in various receptive beds in an experiment]. PMID- 3538509 TI - [Specific features of carious dental lesions in the ancient population of Lithuania]. PMID- 3538510 TI - [Psychoemotional stress in the patient visiting the dentist]. PMID- 3538511 TI - [Alveoloplasty using brephograft material (an experimental study)]. PMID- 3538512 TI - [Diagnostic value of taste disorders]. PMID- 3538514 TI - Advances in surgery. PMID- 3538513 TI - [Recent developments in the design of the pontics of fixed bridges]. PMID- 3538516 TI - Vice-Admiral Lord Nelson's lost eye. PMID- 3538515 TI - Evoked responses and the eye. PMID- 3538517 TI - Corneal supply in the United Kingdom. PMID- 3538518 TI - The causes of tissue damage in toxoplasmic retinochoroiditis. AB - The pathogenetic mechanisms of tissue damage in toxoplasmic retinochoroiditis are complex and incompletely understood. They include invasion and parasitisation of retinal tissues by the Toxoplasma parasite and localised tissue damage by a complex associated immune response. Clinical and experimental studies which shed light upon our understanding of the disease process are reviewed and discussed with regard to current policies in treatment. PMID- 3538519 TI - Calculation of intraocular lens power--results in practice. AB - There have been many reports describing the use of formulas to derive lens implant power in cataract surgery. Typically over 80 per cent of patients are said to have a final refraction within one dioptre of the desired value. In our clinical practice results are worse. Modification of the formula to suit an individual surgeon and implant style would probably improve results. PMID- 3538520 TI - Longterm results of treatment of central serous retinopathy--a preliminary report. AB - The longterm follow-up of 38 patients with central serous retinopathy who were recruited into a prospective randomised trial of argon laser photocoagulation is reported. They were reviewed at a mean of 9.3 years after presentation. The results support the original findings that treatment shortens the disease, but does not benefit the final visual outcome. PMID- 3538521 TI - Computer automated visual acuity testing for visual screening. AB - A computer program was designed for automated visual acuity testing, the aim of which was to evaluate the effectiveness of such systems in a busy out-patient department. The time required for explanation and performing the automated test was compared with that taken by nurses measuring visual acuities in the conventional manner using a Snellen's chart. The correlation of the results of the computer system and the manual measurements was tested. PMID- 3538522 TI - Response of Plasmodium falciparum to dihydrofolate reductase inhibitors in Malindi, Kenya. AB - The response of Plasmodium falciparum isolates to dihydrofolate reductase inhibitors (DHFRI) was examined in Malindi, Kenya. All 20 infected children treated with pyrimethamine/sulphadoxine responded. In contrast, after treatment with pyrimethamine, parasitaemia in 9 of 14 infections failed to clear or recrudesced during the seven-day follow-up. In a 48-hour in vitro test, five of six isolates resistant to pyrimethamine in vivo had a minimal inhibitory concentration (MIC) to pyrimethamine greater than or equal to 300 nmoles/1 compared with less than or equal to 100 nmoles/1 for the four sensitive isolates; four isolates did not grow. MIC to M-B 35769, an experimental DHFRI structurally similar to pyrimethamine were the same (six isolates) or 10-fold lower (three isolates). In the laboratory four of five isolates adapted to in vitro culture had the same MICs as in the field while one isolate became less responsive to both drugs. Cycloguanil (the active metabolite of proguanil) was more active in vitro in the laboratory than pyrimethamine or M-B 35769. PMID- 3538523 TI - Serodiagnosis of Sudanese visceral and mucosal leishmaniasis: comparison of ELISA -immunofluorescence and indirect haemagglutination. AB - Two established immunodiagnostic techniques, immunofluorescence and indirect haemagglutination, were compared with ELISA (enzyme-linked immunosorbent assay) using intact promastigotes as antigen for the detection of specific antibodies against Leishmania in the serum of patients with visceral or mucosal leishmaniasis from the Sudan. The ELISA was found to be more sensitive and more specific than either of the other two tests. PMID- 3538524 TI - The serum bactericidal and opsonizing defect in sickle cell anaemia: restoration of activity by control serum. AB - Thirty-eight homozygous sickler sera were compared with a large pool of serum from healthy African non-sicklers with regard to bactericidal and phagocytic indices. One third of the sera showed reduced bactericidal activity against Salmonella enteritidis which was restored by the addition of 4% control serum; control serum provided both heat-labile (HL) and absorbable (ABS) serum factors. 76% of test sera showed greatly defective opsonization as indicated by ingestion by normal human neutrophils. Activity was not readily restored by the addition of control serum which provided only HL factors. Intracellular survival was increased when bacteria were ingested from sickler serum; activity was readily restored by control serum which provided both HL and ABS factors. In the presence of both serum and neutrophils 84% of test sera permitted increased bacterial survival; the defect was not readily reversed by the addition of control serum which provided both HL and ABS factors. PMID- 3538526 TI - Observations on the feeding habits of Triatoma rubrofasciata (Hemiptera: Reduviidae) PMID- 3538525 TI - Curative properties of muramyl dipeptide in experimental Naegleria meningoencephalitis. AB - Naegleria fowleri is a free-living amoeba which causes a fatal meningoencephalitis in man. Mice injected with the immunostimulant MDP or an attenuated 11RX strain of Salmonella enteritidis showed some resistance to an intranasal challenge with N. fowleri. In addition it was observed that some of the mice infected with N. fowleri and showing symptoms of naegleria meningoencephalitis, given a single injection of MDP were cured of this disease. Our findings suggest that the use of immunostimulants could be a new approach in the quest for therapeutic agents for this disease. PMID- 3538527 TI - Chloroquine-resistant falciparum malaria from Rwanda. PMID- 3538528 TI - Cyclosporine in allogeneic bone marrow transplantation. PMID- 3538529 TI - Recovery of glomerular and tubular function in autotransplanted dog kidneys preserved by hypothermic storage or machine perfusion. Relation of initial function to long-term function. AB - Sixteen male dogs had split renal function studies prior to unilateral nephrectomy and autotransplant. Kidneys were preserved for 24 hr by either simple hypothermic storage in Collins C2 solution (SHS) or machine-perfused (MP) on a Waters machine (MOX 100) with plasmanate perfusate. Renal function studies were repeated at 1 hr and at 7, 14, and 28 days, and the statistical relationship between initial and 1-month function was determined for a number of parameters. All MP kidneys functioned immediately, whereas 1/3 of SHS kidneys had delayed function. Recovery was more rapid in MP kidneys and was essentially complete by 14 days, at which time MP kidneys had higher rates of creatinine clearance and sodium reabsorption. However, by one month 3/7 MP kidneys (P = 0.15 compared with SHS) had lower creatinine clearance rates than at 2 weeks, and para aminohippurate (PAH) clearance and fractional sodium reabsorption were significantly decreased. During the same period SHS kidneys either showed continued improvement or maintained stable function. Thus, by one month there were no differences between the groups in clearances of creatinine and PAH, plasma creatinine and blood urea nitrogen concentrations, or fractional reabsorption of sodium, potassium, and water. For SHS kidneys, the 1-hr creatinine clearance and the absolute rate of sodium reabsorption were strong predictors of the eventual function of the kidneys at one month (r = 0.93 and r = .83, P less than 0.05, respectively). No such correlations were found in MP kidneys (r = less than .01, P greater than 0.9 for both variables). The data show that MP results in significantly better function early after transplant, but this advantage does not persist, and that SHS kidneys early function is a good predictor of long-term recovery, but this is not true for MP kidneys. PMID- 3538530 TI - Early indices of warm ischemic damage in autotransplanted canine kidneys preserved by simple hypothermic storage. AB - After measurement of normal renal function, dog kidneys (n = 52) were subjected to 3, 15, or 30 min of normothermic warm ischemia (WI). After 24 hr of preservation by simple hypothermic storage (SHS) in a modified Collins solution, autotransplant was done and renal function was again measured beginning at 1 hr. Compared with preharvest values, kidneys with minimal (3 min) WI had significantly decreased clearances of creatinine (Cr) and para-aminohippuric acid (PAH), PAH extraction, absolute and fractional Na reabsorption, Na excretion, and urinary Na concentration; no change in urine flow rate or K excretion; and significantly increased fractional excretion of Na, K, and H2O. Compared with minimal WI, 30-min WI produced further significant decreases in clearances of Cr, PAH, and PAH extraction; and further increases in fractional excretion of Na, K, and H2O. Urine flow was also decreased by about half and urine Na concentration rose significantly. Several parameters were very significantly correlated with the length of WI, but the most reliable index was the fractional reabsorption of Na. When several functional parameters were used together, kidneys with significant (30 min) WI prior to preservation could be identified with a high degree of statistical reliability. PMID- 3538533 TI - Multivariate prediction model of kidney transplant success rates. AB - An excellent correlation of predicted and observed cadaver kidney graft survival rates was obtained using a nine-factor computer model. A total of 924 recipients for whom a greater than 80% 1-year survival rate was predicted had an observed rate of 84.6%, whereas 179 recipients with a predicted 1-year success rate of less than 40% had an observed rate of 38.2%. Our model gives improved results as compared with previously published methods. We anticipate that the model's predictive power can be further refined, and that patient selection and organ sharing will benefit from the application of sophisticated computer models for the prediction of transplant success. PMID- 3538532 TI - Adverse effect of splenectomy on the survival of patients with more than one kidney transplant. AB - Risk factors associated with death were identified in a cohort of patients who received 2 or more kidney transplants. Data on 19 variables were collected by chart review on 774 patients who received allografts between 1973 and 1980 at any one of 3 hospitals in Philadelphia. 124 of the patients received two or more transplants and were followed for a minimum of 1.5 years. Modified life table analyses of single variables indicated that 7 factors--splenectomy, donor source, age, transplant hospital, number of HLA mismatches, donor sex, and survival time of the prior graft--were significantly related to patient survival. Using all 19 variables, the proportional hazards model was fit to the data. The characteristics most related to survival were splenectomy (P less than .001), donor source (P = .0022), and age (P = .0015). The other 4 factors that were significant on univariate analysis were not significant in this multivariate analysis. The relative risk of death was 5.5 for patients who had had a splenectomy compared with those who had not had a splenectomy. Patients who had received more than one transplant were compared with patients who had received only one transplant, and a subset of recipients of primary transplants who returned to dialysis after primary graft failure. Survival of patients who had received one transplant was approximately the same as that of the retransplanted population. When the proportional hazards model was fit to the populations that received one transplant and compared with the model for the retransplanted group, only age and donor source were common to all three models. The effect of splenectomy on survival was significant for the total population of primary transplant recipients but had no effect on the survival of the subset of recipients whose kidney grafts had failed and were returned to hemodialysis. Infection accounted for 45% of the deaths among splenectomized, retransplanted patients. A higher percentage of septic deaths occurred in patients whose grafts were functioning at the time of death when compared with patients who had returned to dialysis after secondary graft failure. Although retransplantation alone is not associated with an increased mortality, retransplantation in splenectomized patients carries a high risk of death. PMID- 3538534 TI - Tc-99m DTPA scans in renal allograft rejection and cyclosporine nephrotoxicity. AB - Renal allograft dysfunction arising from rejection or cyclosporine (CsA) nephrotoxicity can currently only be distinguished reliably by allograft biopsy. We have assessed Technetium (Tc)-99m diethylamine pentacetic acid (DTPA) scanning in 30 CsA-treated patients with allograft dysfunction. Scintigrams were performed during 20 biopsy-proved episodes of rejection and during 14 episodes of CsA nephrotoxicity. These results were compared with the scintigrams of 15 allografts showing stable function. Quantitative indices expressing allograft perfusion (flow index) and function (uptake index) derived from the DTPA scintigrams showed no significant differences between the groups of patients with rejection, CsA nephrotoxicity, or stable or improving function. Similarly, the flow and uptake indices of individual allografts obtained during periods of stable or improving function and then during episodes of dysfunction due to rejection or CsA nephrotoxicity did not significantly change. We conclude that Tc-99m DTPA scintigrams are of limited value in the management of allograft dysfunction in patients immunosuppressed with CsA. PMID- 3538531 TI - Concanavalin A-dependent cell-mediated cytotoxicity in bronchoalveolar lavage fluid. Correlation with lung allograft rejection in mongrel dogs during cyclosporine dose tapering. AB - Although cyclosporine (CsA) is widely used as the primary agent for inhibiting the rejection of organ allografts in man, the ideal immunosuppressive regimen for utilizing this drug is still uncertain. To investigate this question, a concanavalin A (con A)-dependent cell-mediated cytotoxicity (CDCMC) assay was used to examine the development of intragraft and peripheral blood cytolytic T lymphocyte activity during CsA dose tapering. These studies were conducted in a canine single-lung transplantation model that facilitates serial examination of intragraft effector cells by bronchoalveolar lavage (BAL). A remarkable correlation of increased intragraft CDCMC and clinical evidence of lung allograft rejection was observed during CsA dose tapering in some recipients. In other recipients CDCMC remained low and evidence of rejection was not observed during drug tapering. In contrast, peripheral blood CDCMC did not correlate well with evidence of rejection. Rejection phenomena observed after termination of CsA therapy were reversed by resumption of CsA treatment but were not reversed by administration of methylprednisolone. Furthermore, the increased level of CDCMC was diminished by reinstitution of CsA therapy at the initial dosage. Following termination of CsA therapy, a prolonged period of unresponsiveness was observed in nearly two-thirds of the recipients, and 60% of these latter dogs had unlimited survival of their lung allografts (median greater than 496 days). Intragraft CDCMC remained low during the periods of unresponsiveness and increased upon onset of rejection. We conclude that measurement of intragraft CDCMC is a useful in vitro method of monitoring lung allograft rejection, and therefore provides a technique for adjusting CsA dosage schedules to achieve maximally effective immunosuppression. The use of this assay for monitoring rejection of other organ grafts requires further investigation. PMID- 3538535 TI - Marrow graft rejection and veno-occlusive disease of the liver in patients with aplastic anemia conditioned with cyclophosphamide and cyclosporine. AB - Based on studies in multiply transfused dogs showing that cyclosporine (CsA) pregrafting reduced the incidence of rejection, we treated 11 multiply transfused patients with severe aplastic anemia with CsA, 12.5-20 mg/kg/day i.m. on days -6 to -1, and cyclophosphamide, 50 mg/kg/day i.v. on days -5 to -2, followed on day 0 by a marrow graft from an HLA-identical sibling donor. Patients were not given additional infusions of buffy coat cells from their marrow donors. As postgrafting prophylaxis for graft-versus-host disease 10 patients were given CsA, 12.5 mg/kg/day orally, and one patient was given a standard regimen of intermittent methotrexate. Among 10 evaluable patients, 2 rejected their marrow grafts. Eight patients had sustained engraftment. Two of these developed severe veno-occlusive disease of the liver, a complication previously observed only in patients conditioned with total-body irradiation but not in more than 200 patients with aplastic anemia conditioned with cyclophosphamide without the addition of CsA. These data indicate that conditioning of patients with cyclophosphamide and concurrent CsA does not uniformly prevent graft rejection and can result in severe hepatic toxicity. PMID- 3538536 TI - OKT3 monoclonal antibody plasma levels during therapy and the subsequent development of host antibodies to OKT3. AB - OKT3 levels and the presence of human antibodies to OKT3 were determined in the plasma of 66 patients receiving OKT3 monoclonal antibody (5 mg i.v. daily) for the treatment of acute renal allograft rejection. Plasma 24-hr trough levels of OKT3 rose over the first three days and then remained in a steady state over the remainder of the 14-day period of OKT3 therapy, with a mean level of 902 +/- 71 ng/ml (mean + SEM). On termination of OKT3 therapy plasma levels of OKT3 dropped to very low levels after 3 days. Host antibodies, usually of low titer, developed in a number of patients, usually 2-3 weeks after the start of OKT3 therapy. 37/43 patients (86%) who received OKT3 alone developed IgG anti-OKT3 antibodies; 9/23 patients (39%) who received Cytoxan in addition to OKT3 developed IgG anti-OKT3 antibodies, a significantly lower (P = 0.0002) incidence. The present regimens permitted maintenance of adequate levels of circulating OKT3 for 2 weeks, a sufficient time to reverse acute renal allograft rejection in most patients. PMID- 3538537 TI - The clinical course of IgA-nephropathy and Henoch-Schonlein purpura following renal transplantation. AB - Recurrence of IgA-nephropathy and Henoch-Schonlein purpura is a common finding after renal transplantation. From 1970 to 1984, 1788 transplants were performed at our center. 13 patients had IgA-nephropathy and 3 patients had Henoch Schonlein purpura. No patient with Henoch-Schonlein purpura had a proved recurrence. Six patients with IgA-nephropathy had a recurrence of IgA disease in the allograft within 3 to 8 months of transplantation. Three patients with a recurrence have retained their kidneys with stable renal function (follow-up of 1.7-2.7 years). Two of these patients lost their graft from severe rejection. One patient, who received an HLA-identical transplant, lost the graft from recurrent IgA disease associated with crescenteric glomerulonephritis. We found no difference in the prevalence of HLA-B 35 among the IgA patients compared with our total transplant population. IgA patients who received living related transplants had a higher recurrence rate of IgA in their allograft when compared with recipients of cadaveric kidneys (83% vs. 14%). Some caution is recommended in using related donors, especially HLA-identical siblings in patients with renal failure secondary to IgA-nephropathy. PMID- 3538538 TI - The splenic microenvironment and self recognition as factors in allograft rejection in rats. A study using indium-111-labeled cells. AB - Splenectomy facilitates organ allograft survival in some rat strains, and in weak donor-recipient histoincompatible pairs. We have found using a heart spleen "twin" graft model, using ACI rats as recipients and Lewis rats as donors, that the transplanted heart will survive in most recipients after delayed host splenectomy. The presence of a viable mass of splenic tissue will allow rejection to proceed only when the transplanted spleen is of host origin, and not when it comes from the donor (i.e., when it is allogeneic). The use of 111In-labeled cells has allowed us to show that lymphocyte traffic and trapping is markedly altered in the transplanted allogeneic spleens, when compared with control transplanted syngeneic spleens. Thus, despite the presence of the splenic "microenvironment," cardiac allograft rejection does not occur in the absence of syngeneic splenic tissue. We conclude that the role of the spleen in the immune response is to facilitate the recognition of self and the acquisition of alloreactivity in weak responder rat strains and donor-recipient pairs. PMID- 3538539 TI - Allogeneic hepatocyte transplantation in the rat spleen under cyclosporine immunosuppression. AB - An innovative approach for stimulating the rapid growth of allogeneic hepatocytes implanted into splenic tissue with maintenance of the structural integrity is described. Single cell suspensions of hepatocytes from normal male ACI-strain rats (RTIa) were injected (2 X 10(6) cells) into the spleen of allogeneic male Fischer (RTI1) recipient rats. A 70% partial hepatectomy (PH) was performed at the same time as hepatocyte transplantation. Animals were treated for 4 days prior to, and 1 day after, transplantation with a feeding regimen containing 0.05% 2-acetylaminofluorene (AAF) to inhibit regeneration of the residual host liver. Animals received cyclosporine (CsA) 3 mg/kg/day s.c. posttransplantation. Histological examination of a standard longitudinal section of the recipient spleen two days posttransplant revealed an approximately 0.54-mm2 area replaced by hepatocytes. By 7 days this had increased to 0.97 +/- .15 mm2. Without CsA administration, hepatocytes were undetected at 7 days. Both PH and AAF treatment were necessary for successful colonization and sustained proliferation. Withdrawal of CsA treatment at 10 days after transplantation resulted in rapid rejection of established hepatocytes. This study demonstrates that rapid colonization of the rat spleen with allogeneic hepatocytes can be achieved, and that the viability and structural integrity of these transplanted cells can be maintained for at least 14 days using cyclosporine immunosuppression. PMID- 3538540 TI - Renal transplantation in patients with a history of heroin abuse. PMID- 3538541 TI - HLA-DP matching and graft-versus-host disease in allogeneic bone marrow transplantation. PMID- 3538542 TI - Orthotopic liver transplantation for hepatobiliary malignancy. Report of three cases of special interest. PMID- 3538543 TI - Use of two donor-specific transfusions for living-related donor kidney transplantation. PMID- 3538544 TI - Microsurgically revascularized bone allografts with immunosuppression with cyclosporine. Preliminary report of the effect in an animal model CSC. PMID- 3538545 TI - Failure of allogeneic canine marrow grafts after total-body irradiation. Allogeneic "resistance" versus transfusion-induced sensitization. PMID- 3538546 TI - Immunosuppressive activity of serum from liver-grafted rats. Passive enhancement of fully allogeneic heart grafts and induction of systemic tolerance. AB - Immunological enhancement of allogeneic heart graft survival by serum from rats tolerized by liver grafting has been studied. Serum taken from long-term surviving PVG rats carrying orthotopic DA liver transplants (OLT serum) was able to increase the survival time of PVG.RT1a heterotopic heart grafts in PVG recipients. Administration of 1 ml of OLT serum at the time of heart grafting led to permanent survival of the grafts in all animals. The recipients became systemically tolerant of RT1a and several weeks later were able to accept permanently skin grafts from the same donor strain, while rejecting third-party grafts. Enhancement appeared to be mediated initially by IgG antibodies in the OLT serum against class II donor RT1a antigens; significant enhancement was produced by as little as 100 micrograms of antibody. Recipient alloantibody responses following enhancement were studied and showed selective suppression of the anti-class-I (RT1Aa) antibody levels, while the anti-class-II antibody response was apparently unaffected. The implications of these results for mechanisms of unresponsiveness following enhancement and liver transplantation are discussed. PMID- 3538547 TI - Renal transplantation in 45 patients with amyloidosis. AB - The results of renal transplantation in patients with amyloidosis were studied in 45 patients receiving primary cadaver grafts at a single center between March 1973 and October 1981. A control group of 45 patients with glomerulonephritis receiving primary cadaver grafts during the same period was also studied. These were matched according to the number of A and B locus incompatibilities and the date of transplantation. The 3-year survival of the patients with amyloidosis was statistically significantly inferior (51%) to that of the controls (79%). Age over 40 years was the major factor determining low survival in these patients. Mortality was concentrated in the early posttransplantation period. The 3-year graft survival rate was the same in amyloidotics (38%) and controls (45%); with death of patients not included in graft loss, the corresponding figures were 53% and 49%. Appearance of amyloid in the transplant was established by biopsy in four patients at 11-37 months of follow-up. Renal transplants functioning for more than one year were calculated to incur a minimum risk of 20% of acquiring amyloid. PMID- 3538549 TI - Evidence of a cyclosporine-binding protein in human erythrocytes. AB - To investigate the phenomenon of different erythrocyte saturation capacities for cyclosporine (CsA) in the blood of different individuals, hemolysates of washed red cells were examined for the presence of a CsA-binding protein. Using gel filtration column chromatography of hemolysates from patients receiving CsA orally, the majority of erythrocyte-associated CsA eluted as a single peak with Mr 15,000-17,000, distinct from hemoglobin and carbonic anhydrase. [3H]CsA added to a hemolysate in vitro eluted similarly. [125I]CsA added to a hemolysate eluted much later in the same position as [3H]CsA mixed with albumin and myoglobin (presumably as free unbound drug). These findings indicate that CsA normally binds to an intraerythrocytic protein similar in molecular size to calf thymus cyclophilin (Mr 15,000). By equilibrium dialysis, the purified erythrocyte proteins calmodulin (Mr 16,700) and cytochrome b5 (Mr 15,000) failed to bind CsA. By equilibrium dialysis, [3H] CsA did bind to column fractions containing the CsA binding protein, but [125I]CsA did not, suggesting that attachment to CsA occurs at or near a carbon-carbon double bond in an unusual nine-carbon amino acid of CsA. These results have important implications for CsA therapy with regard to distribution space, pharmacokinetics, and a possible protein-receptor mechanism of action. PMID- 3538548 TI - Immunoglobulin class and specificity of antibodies causing positive T cell crossmatches. Relationship to renal transplant outcome. AB - A group of 42 renal transplants performed in the presence of a T-cell-positive crossmatch were analyzed to determine the class and specificity of the donor reactive cytotoxic antibodies. Dithiothreitol (DTT) was used to reduce IgM antibodies and a monoclonal antibody directed at a monomorphic determinant present on all HLA class I antigens (PA2.6) was used to inhibit cytotoxicity of anti-HLA class I antibodies. Sera from 26 of the positive crossmatches were considered to be autoreactive, and the positive crossmatch proved to be due to IgM and not directed at HLA class I in each case. One year graft survival was 100% in the 5 living-related and 60% in the 21 cadaver donor transplants, of which 10 were regrafts. Of the 42 positive crossmatches, 16 were not due to autoantibody. One was positive in the current serum taken at the time of transplantation, and this graft was rejected hyperacutely, while 15 were positive with peak but not current serum samples. Of the positive crossmatches, 12 were inhibited by PA2.6 demonstrating that they were directed at HLA class I antigens. PA2.6 inhibition could not be shown in 3 and in 1 DTT reduction was technically unsatisfactory. While 4 of the 7 positive crossmatches due to IgM antibodies were successful, the 7 transplants performed with positive crossmatches due to IgG antibodies all failed. DTT reduction and inhibition of cytotoxicity by PA2.6 helps to define positive crossmatches with donor T cells that are not associated with graft failure. Transplantation in the presence of a peak positive T cell crossmatch due to an anti-HLA antibody might only be successful if the antibody in the peak serum is of the IgM class. PMID- 3538550 TI - The role of resident accessory cells in corneal allograft rejection in the rabbit. AB - Corneal grafts are more likely to be rejected when placed in a vascularized rather than in a normal host cornea. Using immunohistochemical techniques, normal rabbit cornea was found to contain measurable numbers of cells of hemopoietic origin, probably of either macrophage or dendritic lineage. After the deliberate induction of corneal inflammation and neovascularization, the number of these accessory cells was found to increase significantly. There was also a marked increase in the number of T cells present. Enzyme staining indicated a degree of heterogeneity in the infiltrate. The process of rejection of rabbit corneal grafts was found to occur earlier when additional infiltrating cells were present in either donor button or graft bed, and earlier still when the load of infiltrating cells was increased in both donor and recipient. We hypothesize that resident accessory cells of recipient origin may be implicated in graft rejection in vascularized, inflamed corneas. PMID- 3538551 TI - The effect of irradiation of the donor spleen on rejection of porcine pancreaticoduodenosplenic allografts. PMID- 3538552 TI - Enumeration of transferrin-receptor-expressing lymphocytes as a potential marker for rejection in human cardiac transplant recipients. PMID- 3538553 TI - The effect of repeated pregnancies on renal allograft function. PMID- 3538555 TI - Cell-mediated lympholysis in Kaposi's sarcoma after renal allograft. Report of two cases. PMID- 3538554 TI - Assessment of factors associated with donor-specific sensitization in patients given donor-specific blood transfusions. PMID- 3538557 TI - Stored-blood donor-specific transfusions with cyclosporine in distantly related and unrelated donor-recipient pairs. PMID- 3538556 TI - Immunofluorescence caused by cyclosporine in urinary exfoliative cytology in renal transplant recipients. PMID- 3538558 TI - Pneumatosis cystoides intestinalis with pneumoperitoneum in renal transplant patients on cyclosporine and prednisone. AB - Pneumatosis cystoides intestinalis has been detected in 3/103 kidney transplant patients (3%) treated with CsA and prednisone, in contrast to less than 1% of kidney transplant patients treated with Aza and prednisone. In these three patients, the diagnosis of PCI was made by plain x-rays, 10 to 25 days after transplantation. PCI may be more likely to occur in patients with CsA trough blood levels above the recommended therapeutic range. There was associated pneumoperitoneum in all three patients, but none were subjected to exploratory laparotomy. PCI and associated pneumoperitoneum were not associated with adverse effects in any of our three patients. Antibiotics and exploratory laparotomy appear to be unnecessary. PMID- 3538559 TI - Endomyocardial biopsy in the diagnosis of toxoplasmic myocarditis. PMID- 3538560 TI - Duodenocystostomy for exocrine drainage in total pancreatic transplantation: a preliminary report. PMID- 3538561 TI - Vascular supply of the pancreatic segment and its suitability for transplantation. PMID- 3538562 TI - Measurement of cyclosporine: methodological problems. PMID- 3538563 TI - Analysis of pharmacokinetic profiles in 232 renal and 87 cardiac allograft recipients treated with cyclosporine. AB - Analyses of cyclosporine (CsA)-related compounds (Cs) using the radioimmunoassay method were performed by 232 profiles in renal and 87 profiles in cardiac allograft recipients. Cardiac allograft recipients tended to have an increased, dose-corrected area under the concentration (AUC) v time curves after oral and, particularly, intravenous CsA administration, to display a slower drug clearance rate, and to have a slightly smaller volume of distribution. The impact of age, sex, hepatic impairment, nephrotoxicity, and concomitant corticosteroid dose could be discerned within the large number of studies in renal recipients. Only nephrotoxic cardiac transplant patients showed a significant alteration of increased AUC:dose and drug half-life compared with patients with normal renal function, a similar change to that observed in nephrotoxic renal transplant patients. Pediatric compared with adult renal recipients showed a threefold increased rate of mean drug clearance, namely 39.6 mL/min/kg in children v 12.3 mL/min/kg in adults, which may explain the almost 50% reduction in area under the plasma concentration curve v the time curve. There also appeared to be somewhat better oral absorption of CsA by children. Study of greater numbers of cardiac transplant recipients will be necessary to detect the subtle impact of demographic factors on pharmacokinetic parameters. PMID- 3538564 TI - Relationship of cyclosporine pharmacokinetic parameters to clinical events in human renal transplantation. AB - Serum trough levels in the early post-renal transplant course were set at 175 to 200 ng/mL in spite of a standard drug administration regimen by selecting once- v twice-daily dosing intervals, in order to attempt to compensate for differences in drug clearance rates, which might determine trough values. When pretransplant pharmacokinetic parameters were correlated with posttransplant events, patients dosed twice daily were at greater risk of rejection if they displayed a low AUC IV, a rapid CL, or a large Vd. On the other hand, once-daily-treated patients experienced infections if the AUC PO or Cmax was large or drug clearance was low. Patients treated twice daily displayed hepatotoxicity if their AUC IV was high and their Vd and CL low. Nephrotoxicity was seen in patients of both groups with high AUC IV and low CL. Comparison of pre- v posttransplant pharmacokinetic profiles correlated with rejection if the postoperative study showed a reduced Cmax and with hepatotoxicity if the AUC PO and F values were higher than preoperatively. The overall results suggested (although cadaver transplant outcome did not confirm) a lower incidence of rejection on the twice-daily compared with the once-daily regimen. There was no significant difference in the incidence of toxic complications between the groups. However, all of the patients who experienced nephrotoxicity during twice-daily therapy improved when converted to once-daily treatment. The present study suggests that specific values can be established for pharmacokinetic parameters, which would permit clinicians to individually tailor posttransplant immunosuppression to optimize the therapeutic effects of CsA. PMID- 3538566 TI - Clinical pharmacology of cyclosporine in patients undergoing bone marrow transplantation. PMID- 3538567 TI - Pharmacokinetics of cyclosporine in solid organ transplantation. PMID- 3538565 TI - Cyclosporine pharmacokinetic profiles in liver, heart, and kidney transplant patients as determined by high-performance liquid chromatography. AB - Cs pharmacokinetic profiles using HPLC have aided in predicting necessary dosage alterations for specific groups of transplant patients. Additional information has been gained by HPLC profiles in nontransplant subjects who are healthy or have a stable disease state. The clinician now knows that liver disease not only impairs Cs elimination but may also have a pronounced effect upon drug absorption. While the cardiac failure patient may have reversible inhibition of Cs clearance, other factors may affect the distribution of the drug to lower dosage requirements. Impaired renal function is not an impediment to Cs elimination, but malabsorption similar to that observed in liver and bone marrow transplant patients may still occasionally complicate therapy. Pharmacokinetic information on Cs must be integrated into the complex care plan of a transplant patient to optimally utilize and monitor this pharmacologic agent. PMID- 3538568 TI - Experiences with a blood level-adjusted cyclosporine regimen in kidney and liver allograft recipients. PMID- 3538570 TI - A safer approach to the clinical use of cyclosporine: the predose calculation. PMID- 3538569 TI - Cyclosporine trough concentration monitoring in liver transplant patients. AB - Trough blood or plasma concentration measurements of CsA must be carefully interpreted in OLT patients in relation to hepatic function, sample timing, assay specificity, and concurrent drug therapy. The RIA:HPLC ratio of blood or plasma measurements will vary with the patient's liver function, the time of blood sampling in reference to the time of drug administration, the absolute CsA concentration, and concurrent use of drugs that may alter the metabolism of CsA. The RIA assay should be used in conjunction with HPLC for trough blood or plasma measurement during the first postoperative weeks, during periods of changing hepatic function, and during changing drug regimens. In the future, the specific measurement of active or toxic metabolites of CsA should improve trough CsA concentration monitoring in OLT patients. PMID- 3538571 TI - Application of Bayesian forecasting to predict appropriate cyclosporine dosing regimens for renal allograft recipients. PMID- 3538572 TI - Cyclosporine metabolites in human blood and renal tissue. PMID- 3538574 TI - Absorption of cyclosporine A after oral dosing. AB - Variability in the absorption of CsA seems to contribute to the observed lack of correlation between the size of the oral dose and the trough concentration at steady state. Absorption is probably improved by thorough dispersion of the oral solution of CsA in the drink the patient prefers. Evidence for GI metabolism of CsA has only been gathered in animal experiments. The importance of bile for absorption of CsA into the portal blood is established. The bioavailability of CsA does not seem to be determined by the metabolism during the first passage through the liver. Enterohepatic recycling is likely for CsA metabolites and unlikely for unchanged CsA. A pharmacokinetic model that assumes zero-order absorption of CsA describes human data better than a model with first-order absorption. According to the zero-order model, CsA is absorbed only in the upper part of the small intestine by a mechanism that operates under saturation. Two independent findings in transplantation patients support this model. First, it was shown that small doses of CsA produce disproportionally high blood concentrations, probably due to a better bioavailability. Second, accelerated transit times in the intestine (diarrhea) lead to unexpectedly low blood concentrations, probably due to poor bioavailability. Further factors have been identified that cause low absorption of CsA: liver dysfunction and external bile drainage after liver transplantation. The influence of food on the absorption of CsA is still not determined conclusively, but it seems that giving CsA together with a standard breakfast results in higher blood concentrations. The observed increase in the bioavailability of CsA with time after transplantation could be caused by the attempt to steadily lower the dose. PMID- 3538573 TI - Excretion of cyclosporine and its metabolites in human bile. AB - Quantitative and qualitative studies of cyclosporine and its metabolites were performed on human bile from liver transplant and liver disease patients. The concentration of CsA in bile is higher in patients with normal liver function than in those with poor liver function but in neither case could account for more than 2% of an absorbed dose of CsA. Although concentrations of CsA plus metabolites in bile measured by RIA were 18 to 36 times higher than HPLC concentrations, they accounted for less than 50% of an absorbed CsA dose. By means of mass spectrometry and HPLC retention times of known metabolites, peaks equivalent to the previously isolated CsA M8, M13, M17, M1, M18, and M21 of Maurer et al were found in the ether extracts of bile. Future studies should not only concentrate on the pharmacologic and toxicologic effects of the metabolites but should also accurately quantitate these compounds in blood, plasma, urine, and bile. PMID- 3538575 TI - Regulation of gastrointestinal function by ileal nutrients in health and disease. PMID- 3538576 TI - Squamous cell carcinoma of the oesophagus--a current perspective. PMID- 3538578 TI - [Epidemiology of hydatid cyst in Tunisia: the contribution of systematic echography in 5 areas outside of the capital. Apropos of 9,122 subjects examined]. PMID- 3538577 TI - [Ultrastructural characteristics of the biological action of an endotoxin on sensorimotor cortical neurons]. AB - The work is devoted to the ultrastructural investigation of the state of the sensomotor cortex neurons after intravenous and intracisternal administration of endotoxin. The evidences are presented concerning ultrastructural alterations in mitochondria and the presence of compensatory reaction in them after intravenous injection of endotoxin. Besides, coated vesicles and subsurface cisternae whose formation is induced by the endotoxin action have been studied. PMID- 3538579 TI - [Treatment of hepatic hydatid cyst in sheep by echographic puncture]. PMID- 3538580 TI - [Fine-needle transhepatic cholangiography under echography: a new approach to bile duct opacification]. PMID- 3538581 TI - [Computed tomography. What further use in hydatid cyst?]. PMID- 3538582 TI - [Treatment of sciatica due to a herniated disk by chemonucleolysis]. PMID- 3538583 TI - [Sigmoid volvulus associated with volvulus of the small intestine. Apropos of 2 cases and a review of the literature]. PMID- 3538584 TI - [La Tunisie Medicale. 1re Annee--No. 6. 15 June 1911. Bilharziasis in Tunisia. By M. A. Conor]. PMID- 3538585 TI - [Reconstructive microsurgery]. PMID- 3538586 TI - [Hemostasis in traumatic splenic hemorrhage using collagen felt]. PMID- 3538587 TI - [Insulin allergy]. PMID- 3538588 TI - [Formula diet with a free additional food choice up to 1,000 kcal (4,2 MJ) compared with an isoenergetic conventional diet in the treatment of obesity. A randomized clinical trial]. PMID- 3538589 TI - [Iatrophobia and malaria]. PMID- 3538590 TI - [Bandaging of Colles' fracture with plaster of Paris. Low dorsal bracing versus high circular plaster of Paris]. PMID- 3538592 TI - [Symptomatic hydronephrosis in pregnancy. Occurrence, progress and prognosis]. PMID- 3538591 TI - [Treatment of pain after tonsillectomy. Comparison between naproxen (Naprosyn) and acetylsalicylic acid (Kalcatyl)]. PMID- 3538594 TI - Renal parenchymal disease: histopathologic-sonographic correlation. AB - Retrospective study of 60 patients with histologically confirmed renal parenchymal disease and ultrasound examination of kidneys was conducted at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. The various renal parenchymal abnormalities were: proliferative glomerulonephritis (26 cases), glomerulosclerosis and focal segmental glomerulonephritis (5 cases), membranous glomerulonephritis (7 cases), minimal changes (12 cases), sclerosing glomerulonephritis (3 cases), chronic interstitial nephritis (2 cases), mesangiocapillary glomerulonephritis (2 cases), amyloidosis (1 case), Wilson's disease (1 case), and medullary cystic disease (1 case). Ultrasound examination was normal in 31 cases (51% of 60 cases) and abnormal in the rest of the cases. Thus, there was no correlation among the specific type of renal disease, cortical echogenicity and corticomedullary definition. PMID- 3538593 TI - A trial of bacillus Calmette-Guerin versus adriamycin in superficial bladder cancer: a South-West Oncology Group Study. AB - One hundred and sixty-one evaluable patients with biopsy-confirmed transitional cell carcinoma of the bladder were studied in a cooperative protocol comparing intravesical BCG and adriamycin. Patients have been followed for 2-25 months (median 15.7 months) with cystoscopy at 3-month intervals, urinary cytology, and bladder biopsy. Sixteen of 88 patients (19%) who received BCG immunotherapy developed tumor recurrence compared with 45 recurrences (54%) in the 83 patients who received adriamycin chemotherapy (p less than 0.001, chi 2). Eighty-nine of the randomized patients had documented carcinoma in situ. The complete response rate in 41 patients with carcinoma in situ who received BCG was 85%, compared with a complete response rate of only 39% in 46 patients who received adriamycin (p less than 0.001, chi 2). These data suggest that BCG immunotherapy is superior to adriamycin chemotherapy in the prevention of recurrent superficial transitional cell carcinoma and the treatment of in situ carcinoma of the urinary bladder. PMID- 3538595 TI - Cavernous hemangioma of scrotum and penile shaft. AB - We report a 13-year-old boy with two independently detected cavernous hemangiomas of the scrotum and the penile shaft. A right scrotal cavernous hemangioma was incidentally found at the age of 6 years by a histological examination of a right scrotal hematoma attributed to contusion. The patient noticed a soft tumor of the penile shaft at the age of 10 and gradual enlargement of the tumor during the next 3 years. He consulted our department at the age of 13. An ultrasonic echogram revealed a heterogeneous tumor, a hemangioma, having dimensions of 3.5 X 2.5 X 1.5 cm and no connection of the corpus cavernosum penis. The tumor was completely removed surgically by means of circumcision on March 30, 1984, and histological examination demonstrated a cavernous hemangioma. PMID- 3538596 TI - [Clinical evaluation of beta 2 microglobulin in the blood and urine of children with vesico-ureteral reflux]. PMID- 3538597 TI - [Value of the antibody-coated bacteria test in the diagnosis of chronic pyelonephritis]. PMID- 3538598 TI - [Remote results of the treatment of lupus nephritis]. PMID- 3538599 TI - [Use of dibunol in the complex treatment of tuberculosis of the bladder]. PMID- 3538600 TI - [Treatment of urinary fistula after kidney transplantation]. PMID- 3538601 TI - [Disorders of urodynamics in intrarenal vascular abnormalities]. PMID- 3538602 TI - [Determining the degree of local spreading of cancer of the bladder]. PMID- 3538603 TI - [Diagnostic and prognostic value of determining beta 2 microglobulin in the blood and urine of patients with suppurative and inflammatory diseases of the kidneys during extracorporeal detoxication (plasmapheresis, hemosorption, hemodialysis)]. PMID- 3538604 TI - Ultrasonographic diagnosis of vesical leakage in a renal transplant recipient. AB - Technical complications following renal transplantation contribute significantly to graft loss, morbidity, and mortality. Since these patients are immunosuppressed such complications are life-threatening and require early diagnosis and management. Vesical extravasation is a major complication usually evident in the early posttransplant period and occurs more commonly in diabetic patients, and those with multiple prior bladder operations, persistent outflow obstruction, and urinary tract infection. The detection of vesical leakage by real-time ultrasound examination is described. PMID- 3538605 TI - Intraarterial digital subtraction angiography of renal transplants. AB - Nineteen renal allograft recipients with suspected vascular pathology of the graft were examined by digital subtraction angiography combined with intraarterial catheter technique. Image quality was excellent and diagnosis was definite in all cases. Dosages of contrast medium are reduced to a minimum (1.5 g iodine/patient) and the risk of nephrotoxic side effects is virtually negligible with this technique. PMID- 3538606 TI - Bladder mucosal tears during voiding cystourethrography in chronic renal failure. AB - We report 6 patients with chronic renal failure who developed contrast intravasation/extravasation during voiding cystourethrography. Two patients underwent cystoscopy and were noted to have diffuse mucosal tears, but had normal appearing bladder mucosa on follow-up inspection. None of the patients experienced symptoms or clinical sequelae. Pathophysiological changes in the chronically unused bladder which predispose it to mucosal injury are considered. PMID- 3538607 TI - Massive bilateral non-Hodgkin's lymphomas of the adrenals. AB - Two cases of diffuse histiocytic lymphoma limited to both adrenals are described. Familiarity with these rare lesions will lead to a proper diagnostic approach. PMID- 3538609 TI - Species differences in regenerative hyperplasia of bladder urothelium after transurethral cauterization. AB - The early histological changes in bladder urothelium following transurethral cauterization were sequentially studied in female rats, mice, hamsters and guinea pigs. The changes differed markedly between species: papillary hyperplasia or papilloma in the rats and simple hyperplasia in the mice, hamsters and guinea pigs. The regenerative response to the fulgurative ulcer within a given species was similar to the early response previously observed by others following administration of known bladder carcinogens. This suggests that there may be a regulatory mechanism in the urothelium which is common to urothelial proliferations induced by both carcinogenic and non-carcinogenic stimulations, though differing between animal species. PMID- 3538608 TI - Invasive bladder cancer--possible future treatment considerations. PMID- 3538610 TI - [Ileocystodynamics: urodynamic studies of the continent ileal bladder]. AB - The continent ileal bladder represents a combination of the Kock-Pouch and enterocystoplasty (Couvelaire-Camey): a continent intestinal urinary reservoir with antirefluxive nipple-ureteroileostomy and continence providing ileourethrostomy. Urodynamic investigations demonstrate the time dependent increase of maximal capacity and compliance reaching "normal"-bladder values in comparison to corresponding age groups within 4 months. The continent ileal bladder meets all requirements for bladder substitution including low-pressure reservoir function with reflux prevention, maintained continence and controlled voiding per viam naturalem. PMID- 3538611 TI - Value of cyclophosphamide or melphalan as combined chemotherapy in hormonally unresponsive prostatic carcinoma. AB - This prospective randomized study in nonhormonally responsive adenocarcinoma of the prostate shows that response rates to melphalan vs cyclophosphamide groups were virtually identical. PMID- 3538612 TI - Centrifugal cytology: a new technique for urine cytology. AB - A new technique, centrifugal cytology, appears to have a high recovery rate of malignant cells from voided urine specimens resulting in a high probability of early disease detection and should be considered a good supplement to cytoscopic evaluation of high-risk populations. PMID- 3538613 TI - Identifying leucocytes and leucocyte subpopulations in semen using monoclonal antibody probes. AB - An indirect immunoperoxidase technique employing specific monoclonal antibodies has been used to identify leucocyte subpopulations in cytocentrifuge smears of washed human ejaculate. Cells reacting with the pan antihuman leucocyte monoclonal antibody (HLe-1) were demonstrated in 63/67 specimens from subfertile patients with a mean count of 14.5 +/- 17.1 leucocytes per HPF (X 320). Cells with similar reactivity were observed in all specimens examined from 10 fertile men with a mean count of 41.6 +/- 26.3 leucocytes per HPF (X 320). Leu-T4+ cells (T-lymphocytes) were demonstrated in only 13/63 of the subfertile group with a mean count of 4.46 +/- 3.3 T-lymphocytes per HPF (X 320). Studies with the anti leu 2a antibody revealed that these leu-4+ cells were mainly of the suppressor/cytotoxic phenotype. In contrast, no leu-4+ cells were detected in the control group. No leu-12+ cells (B-lymphocytes) were detected in any of the 80 specimens examined. PMID- 3538614 TI - Endourologic approach to transplant kidney. AB - Two significant procedures, namely lithotripsy of staghorn calculus and dilatation of a stenotic calyceal infundibulum, were performed endourologically in a renal allograft drained by an ileal conduit. This is another example of the versatility of these minimally invasive urologic methods. PMID- 3538615 TI - Genital filariasis in Minnesota. AB - Genitourinary filariasis is a well-known entity in most tropical areas. However, filariasis cannot be eliminated from the differential diagnosis of testicular, epididymal, or spermatic cord masses in nontropical climes. We report a case of filariasis of the spermatic cord that manifested as an unexplained scrotal mass in a patient in Rochester, Minnesota. PMID- 3538616 TI - Ultrasound imaging in Peyronie disease. AB - Fifty-three patients with Peyronie disease were examined sonographically. The use of a water path facilitates good localization and measurement of the fibrotic plaques in the area of the tunica albuginea. Calcifications can be clearly detected. Penile sonography is painless, free of risk, and easy to perform and yields precise morphologic pictures. It is ideal for documentation and assessment of the anatomic alterations in Peyronie disease as well as for control of its course. PMID- 3538617 TI - [Immunologic diagnosis and prognosis in the survival of corneal transplants]. PMID- 3538618 TI - [Wedge resection of the cornea]. PMID- 3538619 TI - [Drainage of the anterior chamber of the eye using synthetic materials in glaucoma surgery]. PMID- 3538620 TI - [Ultrasonic diagnosis of limited forms of appendicular peritonitis in children]. AB - Results of an analysis of echographic diagnostics of appendicular peritonitis in 60 children have shown its high informative value. Under consideration are problems of the rational technique of investigation depending on localization of the pathological focus. Differential diagnostic criteria of various forms of limited peritonitis in children are presented. Possibilities of the method to establish the objective efficiency of the therapeutic treatment and substantiation of tactics of the treatment are shown. PMID- 3538621 TI - [Surgical treatment of congenital bilateral cleft lip]. AB - Operations were performed on 23 patients with bilateral cleft lips by the method of Mirault--Limberg--Kardozo. Five patients had bilateral symmetrical total cleft lips, eight patients had bilateral nonsymmetrical total cleft lips, ten patients had bilateral incomplete cleft lips. One-stage operations were used in 17 patients, two-stage operations--in six patients. The method consists in the angle shaped refreshing and uniting the margins of the cleft which provides the possibility to restore the correct form of the Cupid arch. The method is most expedient in children with bilateral non-symmetrical cleft lips with the well developed median portion. Long-term results were studied in 19 children. Good and excellent results were noted in 12 patients, satisfactory--in 7 patients. PMID- 3538622 TI - [Experience with reconstructive-plastic operations in bladder exstrophy in children]. AB - The author analyzes the experience with reconstructive-plastic operations in her modification mad in 22 children with exstrophy of the urinary bladder. Long-term results within 3-17 years were observed in 15 children. Good outcomes (complete retaining of urine, normal capacity of the bladder, good morphofunctional state of the kidneys) were noted in 8 children. Based on the results obtained the author recommends the surgical treatment of exstrophy of the urinary bladder to be started with reconstructive-plastic operations at the age of 1-3 years. PMID- 3538623 TI - [Ultrasonic diagnosis of closed kidney injuries in children]. PMID- 3538624 TI - [Surgical treatment of patients with arteriosclerotic disorders of cerebrovascular circulation]. AB - An analysis of the complex examination of 170 patients with ischemic diseases of the brain has been made. Seventy patients were operated upon. Operations either in brachiocephalic branches or extra-intracarotid shunts were performed corresponding to the three established levels of the injuries. The nearest and remote results were obtained in more than 80% of the patients. PMID- 3538626 TI - [Effect of a constant magnetic field on blood circulation after experimental operations on arteries of the extremities]. PMID- 3538625 TI - [Methods of ultrasonic angiography and spectrum analysis of the Doppler signal in the diagnosis of the degree of occlusive lesions of the brachiocephalic arteries]. AB - Results of an examination of 39 patients are described and critically assessed. An analysis of the resolving power of the method of ultrasonic angiography in pathological formations of major vessels of the neck is given. PMID- 3538627 TI - Viral diseases. PMID- 3538628 TI - The epidemiology of viral infections in dogs and cats. AB - Understanding the epidemiology of an infectious disease is a prerequisite to be being able to suggest the most appropriate methods for prevention and control of the disease. This article reviews some important epidemiologic concepts. PMID- 3538629 TI - The influence of host factors on the outcome of a viral infection. AB - The clinician confronted with a patient that has an infectious disease, particularly one caused by a virus, faces a series of difficult problems: diagnostic confirmation of the infection, instituting appropriate therapy, duration of treatment, preventing secondary complications, and preventing transmission of the virus to susceptible animals. Yet, it is the complex relationship between the patient, as host to a pathogenic virus, the virus, and the environment that ultimately influences the clinical course of an infection. The ability to accurately prognose the outcome of any infection is, therefore, predicated on the clinician's awareness of biological and environmental variables that apply to the individual patient. PMID- 3538630 TI - Diagnosis of canine viral infections. AB - The diagnosis of canine viral infections frequently requires the correlation of clinical, hematologic, pathologic, and laboratory findings. When laboratory diagnostics are utilized, appropriate specimens must be collected. In addition, correct timing of specimen collection and the proper handling and transport of these specimens are essential. Whenever possible, the practitioner should not rely on any one laboratory procedure for making a diagnosis; rather, a combination of techniques should be used. Submission of tissue for histopathology, virus isolation, and antigen detection techniques (FAT), serum for serologic analysis, and feces whenever enteric infections are investigated will maximize the chances of making a successful diagnosis. PMID- 3538631 TI - Diagnosis of feline viral infection. AB - A diagnosis of a specific viral disease in the cat involves a combination of an accurate history, careful observation of disease signs, demonstration of characteristic clinical pathologic changes, and isolation or identification of the virus. Isolation or identification of a virus from the patient does not establish that the disease observed was caused by the virus so isolated or identified; correlation and proper interpretation of all findings are necessary to establish a diagnosis. Virus identification may involve office laboratory tests, such as cytology or ELISA, or more specialized procedures. Whether specimens are to be sent out for specialized tests or office laboratory procedures are to be used, the veterinary practitioner must not only know what specimens are required but must also understand the test and be able to properly interpret the results in light of the patient's observed condition. PMID- 3538632 TI - Antiviral therapy. AB - Antiviral therapy is gradually coming of age. More agents including interferons as well as combinations of agents can be anticipated in the marketplace. Five antivirals are now approved for use, and there are at least seven that have a strong chance of becoming available. PMID- 3538633 TI - Biological response modifiers in the management of viral infection. AB - The rapid evolution of immunopharmacology as a recognized scientific discipline dedicated to unraveling complex interrelationships between immunologic responsiveness and disease states in general supports the importance of the potential role biological response modifiers have in clinical medicine. To administer a drug, or combination of drugs, that safely, effectively, and favorably alter the course of infection, cancer, autoimmune disease, and allergy is within grasp. Although the greatest emphasis on therapeutic application of BRMs is placed on cancer, many of these immunomodulating agents have well documented effects on the course of infectious disease. By either restoring immune responses or by enhancing the response of a normal immune system, it is conceivable that BRM therapy will someday be used routinely as adjunct therapy in the management of viral infections in companion animals. PMID- 3538634 TI - Vaccines and principles of immunization. AB - This article discusses the production of the various classes of vaccines and compares the advantages and disadvantages of each. Adjuvants, combination vaccines, heterologous viral vaccines, and vaccination failure are discussed briefly. Reported adverse reactions to vaccination are described at length. Essential vaccination for several exotic species is given. PMID- 3538635 TI - Host response to vaccination. AB - The desired response to vaccination is protection from clinical disease. This article presents several factors, related to both the host and the vaccine, which may result in inadequate protection from clinical disease following vaccination. Also presented is an overview of adverse reactions to vaccines and the response of young animals and pregnant animals to vaccination. PMID- 3538636 TI - A new generation of vaccines. AB - New technology in recombinant DNA, gene sequencing, and peptide synthesis will make possible a new generation of vaccines. These new vaccines will be safer, more stable, and can be produced in a more predictable manner than the present vaccines. This should lead to a wider use of vaccines and a greater control of infectious diseases. PMID- 3538637 TI - Bacteriology of summer mastitis secretions from cattle in Eire. PMID- 3538638 TI - Field trial of inactivated oil-adjuvant Gladysdale strain vaccine for contagious bovine pleuropneumonia. PMID- 3538640 TI - Prevalence of Anaplasma marginale, Babesia bigemina and B. bovis in Nigerian cattle using serological methods. AB - Serum samples collected randomly from 500 cattle from the 10 northern states of Nigeria were tested for antibodies against Anaplasma marginale by indirect fluorescent antibody (IFA), card agglutination (CT) and capillary tube agglutination (CA) tests. The serum samples were also examined for antibodies to Babesia bigemina and B. bovis by the IFA test only. Of the serum samples tested, 79.4% had antibodies against A. marginale by the IFA test, 40 and 25% in the CT and CA tests, respectively. The IFA test results for B. bigemina and B. bovis were 29.4 and 14.1%, respectively. PMID- 3538639 TI - The ecology of Escherichia coli in animals including man with particular reference to drug resistance. AB - The phenomenon of drug resistance among bacteria, particularly Escherichia coli, has been a major research interest of the University of Bristol's departments of microbiology and veterinary medicine during the past 15 years. Tens of thousands of E coli isolates from man and farm animals have been examined in studies of both the ecology of the species and the epidemiology of their resistance to therapeutic antibacterial agents. The principal findings obtained in these investigations are described. PMID- 3538641 TI - Cellular mechanisms of digoxin transport and toxic interactions in the kidney. AB - Renal tubular secretion of digoxin appears to be one of the main ports of elimination of the glycoside from the body. Because of its narrow therapeutic window and severe toxicity, the mechanisms of tubular handling of digoxin are important. Moreover, several drugs which are commonly administered with digoxin, including quinidine, spironolactone, verapamil and amiodarone have been shown to decrease renal clearance of digoxin without affecting GFR. We studied the handling of digoxin using in vitro and in vivo approaches. The handling of the glycoside by the brush border suggests passive reabsorption which is not enhanced by commonly coadministered drugs. Digoxin binding to the antiluminal (basal) membrane suggests that the secretion of the glycoside may not involve the pharmacologic receptor, the Na+, K+, ATPase. Using the multiple indicator dilution technique, we could directly show the two steps of secretion of digoxin: Its sequestration from the postglomerular circulation, and its appearance in the urine after transtubular transport. Digoxin transport is not inhibited by a cationic or anionic molecule (PAH and tolazoline). It is possible that digoxin is secreted by a yet unidentified transport mechanism. PMID- 3538642 TI - Biology of the group E streptococci: a review. AB - Group E streptococci are identified by a group antigen consisting of a cell wall rhamnose-glucose polymer. Other specific cell wall polysaccharides separate the group into at least six serotypes (II, IV, V, VI, VII and VIII). No species name has been accepted for the group E Streptococcus, although the organism is often designated as Streptococcus infrequens or S. lentus. Recently, the name S. porcinus has been proposed for a species that would include streptococci of groups E, P, U and V. Group E streptococci are fairly widely distributed in animals, especially swine, and are occasionally isolated from bovine milk. They cause streptococcal lymphadenitis of swine, an economically important disease, particularly in the United States. They do not appear to be the primary cause of any other disease or condition. The organisms enter the swine host through the mucosa of the pharyngeal or tonsillar surfaces, and are carried to the lymph nodes, primarily of the head and neck region, where abscesses are formed. Cell wall antigens induce the formation of serum agglutinins; a microtitration agglutination test, based upon reactions involving the type IV antigen, is considered a reliable test for detection of infection in animals. Antigenic components include group and type antigens, extra-cellular enzymes, and an antiphagocytic factor which may be associated with virulence of the organism and with protective immunity to streptococcal lymphadenitis of swine. This factor, a surface protein, develops on cells cultured in media fortified with serum, rendering the cells resistant to phagocytosis by porcine leukocytes. The classification, morphology, physiology, biochemistry and nutrition of the group E streptococci, and methods for their isolation, cultivation, and identification are reviewed. PMID- 3538643 TI - Pathology of acute Leptospira interrogans serotype icterohaemorrhagiae infection in the Syrian hamster. AB - The pathology of acute Leptospira interrogans serotype icterohaemorrhagiae infection in the Syrian hamster was investigated up to 7 days after infection using histology, electron microscopy and an indirect fluorescence test for leptospires. The disease was characterized by the presence of many leptospires in the tissues, jaundice, leukocytosis, haemorrhages, endothelial alteration and thrombotic glomerulopathy. The leptospires were present intravascularly, in the interstitium penetrating between liver cells and tubular epithelial cells and in the tubular lumina. The presence of leptospires was not necessarily associated with lesions. These findings support both pathogenetic mechanisms suggested in the literature, namely: the ability of leptospires to penetrate actively between cells with detachment of tight junctions, without obvious lesions to the cells, and an immune-mediated process with immune complex formation and binding and activation of complement resulting in leukocytosis, thrombotic glomerulopathy, endothelial alteration and haemorrhages. PMID- 3538644 TI - [Dr. Ivan Bogorov--activist, popularizer of veterinary medical science]. PMID- 3538645 TI - Cytoplasmic localization of the HTLV-III 3' orf protein in cultured T cells. AB - HTLV-III, the etiological agent of the acquired immunodeficiency syndrome, contains in its genome coding regions for several novel proteins. One of these, the 3' open reading frame (3'orf) encodes proteins of 26-27 kDa which are expressed in infected cells both in vivo and in vitro. A specific antiserum has been raised against the recombinant 3'orf protein synthesized in bacteria and used to localize the viral proteins by subcellular fractionation and immunofluorescence on HTLV-III infected cells. The antiserum specifically immunoprecipitated the 26- to 27-kDa proteins from both the cytoplasmic (S100) and the membrane fractions, with an enrichment in the latter. The proteins were not detected in the nucleus or organelle (S100 pellet) fractions. These proteins were also recognized in the same subcellular fractions by human sera from patients with AIDS. Indirect immunofluorescence on fixed infected cells confirmed the presence of the proteins in the cytoplasm. Immunoprecipitation and Western blot analysis of total proteins from disrupted HTLV-III virions with the specific antiserum failed to detect the 3'orf protein products, suggesting that they are not a major component of mature virions and may be involved in the intracellular regulation of viral replication. PMID- 3538646 TI - Energy balance in human beings: the problems of plenitude. PMID- 3538647 TI - Genetic defects in vitamin utilization. Part I: General aspects and fat-solumbe vitamins. PMID- 3538648 TI - Hormonal control of sexual development. PMID- 3538650 TI - [Ultrasonographic diagnosis of liver neoplasms]. PMID- 3538649 TI - Intracellular processing and secretion of parathyroid gland proteins. PMID- 3538651 TI - [Structure of an expert system for insulin therapy]. PMID- 3538652 TI - [Criteria and methods of assessing the risk of breast cancer]. PMID- 3538653 TI - [Mechanism of the leukemogenic action of ionizing radiation]. PMID- 3538654 TI - [Molecular-biological bases and outlook for vitamins in cancer prevention]. PMID- 3538655 TI - [History of the All-Union Congress of Oncologists]. PMID- 3538656 TI - [Use of the immunofluorescence method for determining hepatitis B antigens in liver tissue]. PMID- 3538657 TI - [Blood serum proteinases in the diagnosis of rheumatic diseases]. PMID- 3538658 TI - [Trypsin-type serine proteases in the blood serum and lymphocytes of patients with diabetic angiopathies]. PMID- 3538659 TI - [Local hemostatic therapy in the surgical treatment of dental patients with an increased risk of bleeding]. PMID- 3538660 TI - Sclerotherapy for bleeding esophageal varices after randomized trials. AB - Endoscopic sclerotherapy remains an uncertain therapy for bleeding esophageal varices. Several recently reported randomized trials address the efficacy of immediate, long-term and prophylactic sclerotherapy. Analysis of these studies suggests that sclerotherapy may stop acute bleeding but has little impact on survival of an acute bleeding episode. Ongoing sclerosis reduces the incidence of rebleeding episodes and improves survival for those patients fortunate enough to survive the acute bleeding episode. Prophylactic therapy is an exciting concept limited by difficulty in identifying "high-risk" patients and by the high rate of complications associated with sclerotherapy. PMID- 3538661 TI - Activated charcoal--past, present and future. AB - Poisoned patients were first treated with charcoal more than 150 years ago. Despite its almost universal acceptance today, activated charcoal's role has been overshadowed by the emphasis on treating poisoned patients first with gastric emptying. We review the current use of activated charcoal and recent studies that suggest that activated charcoal may be the single most effective treatment in many types of poisoning. New explanations for the mechanisms of action include "back diffusion" and disruption of enterohepatic loops. Clinical data endorse a new and aggressive role for activated charcoal in the management of poisoned and overdosed patients. PMID- 3538662 TI - Downwind update--a discourse on matters gaseous. PMID- 3538664 TI - Competition incentives--smaller carrot, bigger stick. PMID- 3538663 TI - Therapeutic drug monitoring. PMID- 3538665 TI - Pediatrician participation in Medicaid--findings of a five-year-follow-up study in California and elsewhere. AB - Medi-Cal-California's Medicaid program-underwent significant changes during the period 1978 through 1983. Most notable were the imposition of new copayments, reductions in physician reimbursement and selective contracting for hospital services. The state-funded medically indigent program was transferred to the counties and the state began to experiment with bulk purchasing of drugs and supplies, a lock-in for overutilizers and primary care case management. How have these changes affected primary care providers' participation in Medi-Cal? Surveys of California pediatricians in 1978 and 1983 suggest that while most continue to participate, the level of limited participation in Medi-Cal increased from 23% to 51%. Most pediatricians express discontent with the level of Medicaid payments and there is a growing sentiment that Medicaid regulations interfere with the provision of high quality medical care. Future Medi-Cal policy developments, such as contracting for physician services, should be structured in ways that maximize participation of primary care providers in the program. PMID- 3538666 TI - [Non-steroidal anti-inflammatory agents and the heart]. PMID- 3538667 TI - [Hiatal hernia]. PMID- 3538668 TI - [Socrates' concept of man]. PMID- 3538669 TI - Value of unspecific drugs in chemotherapy of trichinellosis. PMID- 3538670 TI - [Barany's discovery and its reception by his contemporaries]. AB - Barany's main achievement is that he unified known, but apparently contradictory facts into one perspective. The concept of a method for examining each ear individually by means of the caloric test fundamentally advanced diagnostics. In 1914 he was honoured with the Nobel Prize, but in his home town of Vienna he was denied the title of professor. Many debates took place about this. In 1917 he moved to Uppsala where he eventually became head of the laryngology department. Two reasons justify the fact that we may call Barany an Austrian Nobel Prize Winner, firstly that he kept his loyalty to Vienna, his birth place and, secondly, that all his work for which he was awarded the Nobel Prize was done in the Vienna General Hospital. PMID- 3538671 TI - [Multidimensional aspects in the therapy of anxiety]. AB - Anxiety seen as an unadaptive habit frequently results from lacking habituation. Anxiety-responses manifest themselves at three levels: in the cognitive, the motoric and the psychoautonomous. From this point of view it is understandable that the individual readiness to react may influence the various forms of neurotic or psychosomatic disorders. Furthermore, specific factors with respect to developmental or social conditions play some role in pathogenesis and in individual problem solving methods. Therapy, therefore, should include direct and indirect methods of overcoming anxiety: the direct methods include relaxation exercises and/or administration of psychopharmacological drugs such as tranquillizers, neuroleptics and antidepressants which influence the psychoautonomous system (sometimes also in combination); the indirect methods include techniques which aim at changes in cognition and coping-styles. PMID- 3538672 TI - [Chlamydia trachomatis in patients with genital contact infections in Austria- studies of 3,367 patients]. AB - In order to evaluate the epidemiological importance of Chlamydia trachomatis (C. trachomatis) as a genital microorganism, data were obtained from 3,367 patients with sexually transmitted diseases in Vienna and analyzed by computer-assisted methods. C. trachomatis was cultured in 26.1% of 2,594 patients investigated for the first time. The microorganism was found more often in male patients (31.3%) than in female patients (21%). 32.2% of positive Chlamydia cultures were obtained from patients with non-gonococcal urethritis (NGU) and 64% from postgonococcal urethritis (PGU) patients. A high coincidence with Neisseria gonorrhoeae (N. gonorrhoeae) was detected in males (31.2%) and females (43.5%). Data on Mycoplasma hominis (M. hominis), and Ureaplasma urealyticum (U. urealyticum) show that, in contrast to the low incidence of M. hominis and U. urealyticum in males, the organisms were found predominantly in females. PMID- 3538673 TI - [Transient biological false-positive specific syphilis serology in a blood donor]. AB - This paper reports the case of a 25 year-old blood donor with transient false positive specific syphilis serology and, furthermore, some transient immunological features similar to the findings in systemic lupus erythematosus. PMID- 3538674 TI - Sir Patrick Dun's: Dublin's refuge when epidemic raged. PMID- 3538675 TI - Stable mineral isotopes in nutritional and related research. PMID- 3538676 TI - Nutritional aspects on tooth formation. PMID- 3538677 TI - Sugar and health. PMID- 3538678 TI - Diet and cancer. PMID- 3538679 TI - Biotin. PMID- 3538680 TI - Nutritional assessment of the elderly. PMID- 3538682 TI - The Yale Plan of Medical Education: the early years. AB - This paper considers the early years of the Yale Plan of Medical Education, which has come to be called the Yale System. It chronicles and analyzes the incremental development of the System and considers evaluations of the plan and modifications introduced over time. Also considered are external factors which influenced design and implementation. The paper covers the period of medical education at Yale from the 1920s to the early 1950s. PMID- 3538683 TI - [Case finding and management strategy in the current status of tuberculosis]. PMID- 3538684 TI - [Problems in tuberculosis case finding--a retrospective analysis 1980 to 1983 in the Cottbus district]. PMID- 3538685 TI - [Clinical aspects and therapy of tuberculosis of the lung]. PMID- 3538681 TI - The adult respiratory distress syndrome. AB - The adult respiratory distress syndrome (ARDS) represents a common denominator of acute lung injury leading to alveolar flooding, decreased lung compliance, and altered gas transport. In the absence of specific etiology and therapy, the management of ARDS remains largely supportive. Ubiquitous use of intermittent positive-pressure ventilation with positive end-expiratory pressure (PEEP) improves arterial oxygenation but with some risk of pulmonary barotrauma and decreased cardiac output. The recent understanding of lung inflation as a modulator of right heart afterload and the effect of the right ventricle on global cardiac performance continues to redefine optimal patterns of ventilatory and hemodynamic intervention in ARDS. PMID- 3538686 TI - [Immunologic characterization of the rejection of the allogenic transplanted kidney in pigs with and without immunosuppression]. AB - After allogenic renal transplantation in pigs kinetics of the immunological reactivity have been investigated in order to diagnose rejection crisis. In a first series of 26 transplants without any immunosuppression we secured the diagnosis of rejection in 95% of cases of acute or chronic rejection by a combination of antigen-specific rosette test, inhibition of this parameter by autologous serum, complement dependent cytotoxicity and antibody dependent cell mediated cytotoxicity. The antigen-specific rosette test reacts very early, 2-3 days before a bad clinical feeling in the course of acute rejection or 5-14 days by chronic rejection. Under the therapy with prednisolone and azathioprine we could not reach any prolongation of survival by arbitrary donor-recipient selection. Under immunosuppression antibodies have never been observed by acute rejection in CDC and ADCC. In every case of acute rejection an increasing rosette formation of specific antigen binding cells appeared 2-3 days before an increasing of serum creatinine. In the case of other complications like infection or thrombosis this test is not reacting. However, by thrombosis of arteria or vena renalis there can be an increased specific rosette formation either independent of this process by beginning of immune reaction or by causal connection of both processes (necrotizing thrombotic rejection). So we have given the evidence, that the antigen-specific rosette test on a high level meets all requirements of a specific diagnosis of rejection under immunosuppression in pig. PMID- 3538688 TI - Virginia Medical's guide to HMOs in Virginia. PMID- 3538687 TI - [Clinical incidence of subclavian thromboses following pacemaker implantation]. AB - Although pacemaker (PM) implantation has developed into a standard therapy in appropriate rhythm disorders the procedure is not free of complications. One of the most common problems is thrombotic alteration in the region of the entry of the pacemaker electrode into the venous system. To obtain more details of the incidence and extent of these complications, we investigated a total of 97 patients in two groups, clinically, phlebographically and by Doppler-ultrasound technique. 56 (30 males, 26 females, mean age 73 years) were examined 1 week, and 41 (18 males, 23 females, mean age 72 years) 1 year after PM implantation. The thrombotic changes were quantified and correlated to various anamnestic and clinical parameters with the following results: 1 week after implantation 25% of patients show thrombi with collaterals, in 15% shorter than, and in 10% longer than 3 cm. One complete obturation of the implantation vessel was recognized. Thrombotic changes without collaterals were found in 36%, in 25% shorter than, and in 11% longer than 3 cm. One year after PM implantation there are organized thrombi in 71%, 41% of these patients show collaterals phlebographically. The others had no hemodynamic changes. Of all the anamnestic and clinical parameters, a significant correlation was found only between development of thrombi and material of electrodes. Polyurethane electrodes have a significantly higher rate of thrombosis than silicone electrodes (p less than or equal to 0.0066).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538689 TI - Chlorambucil induced pulmonary fibrosis: report of a case and review. PMID- 3538691 TI - [Antibiotic and enzyme therapy of gonorrhea]. PMID- 3538690 TI - [A case of Gottron reticulosarcomatosis of the skin]. PMID- 3538692 TI - Catecholaminergic differentiation associated with S100 protein-positive elements in human neuroblastoma. AB - The intratumorous distribution of catecholaminergic tumour cells and S100 protein positive elements of 8 neuroblastomas, 8 ganglioneuroblastomas and 2 ganglioneuromas were studied using catecholamine fluorescence and immunohistochemical staining, respectively. The elements of catecholamine fluorescence were observed in all tumour specimens, even in urinary VMA-negative cases, but the patterns of distribution were not uniform. Catecholamine fluorescence was observed in both tumour cell bodies and neurofibres, and the appearance of the latter but not that of the former correlated with the histological grade of differentiation, thereby suggesting the occurrence of catecholaminergic differentiation within the tumour. S100 protein-positive elements also correlated with the histological differentiation, and were distributed mostly in the area where the catecholamine-containing neurofibres were located. The possible correlation between catecholaminergic differentiation and the appearance of S100 protein-positive elements in neuroblastoma requires close attention. PMID- 3538693 TI - Zuelzer-Wilson's syndrome and absence of the enteric nervous system. Two rare forms of anomalies of the enteric nervous system with identical clinical symptoms. AB - 47 children have been treated in Basel for aganglionosis (Hirschsprung's disease) during the last 25 years. Six children presented severe vomiting and an ileus as leading symptoms instead of chronic constipation, the classical leading symptom of Hirschsprung's disease. Clinical, radiological and intraoperative findings were virtually identical in these 6 patients. However, enzyme histochemical and immunocytochemical investigations disclosed an aganglionosis of the entire colon (Zuelzer-Wilson's disease) in 3 patients, absence of the enteric nervous system in the small and large intestine in 2 patients, and a combination of both in 1 patient. In contrast to children suffering from aganglionosis of the entire colon, the chance of survival for patients with an absence of the enteric nervous system is extremely small. It is therefore necessary in presence of severe vomiting and an ileus to take intraoperative biopsies from the large and the small intestine. The precise diagnosis can be made only by using enzyme histochemical and immunocytochemical techniques. PMID- 3538694 TI - [Diagnosis and therapy of intraperitoneal cerebrospinal fluid pseudocyst in ventriculoperitoneal cerebrospinal fluid shunts in patients with hydrocephalus]. AB - Problems of an intraabdominal CSF cyst following ventriculoperitoneal shunt for hydrocephalus are demonstrated in an 8 1/2-month-old female infant. Whereas previously tentative diagnosis was made by plain abdominal x-ray and could be verified by laparotomy only, repeated ultrasound investigations now allow for early recognition of this complication. As it happened in this case, laparotomy was not necessary and mere aspiration of cyst contents via distal catheter followed by insertion of the distal catheter into the right atrium was sufficient. This method is an alternative to transabdominal cyst puncture and conventional surgical cyst resection. PMID- 3538695 TI - Cholelithiasis in children with congenital spherocytosis. AB - Cholelithiasis was diagnosed in two children with congenital spherocytosis of 7 and 9 years of age. Surgery was performed at age 10 and 14, respectively. The presence of gallstones should be considered in patients with congenital spherocytosis even under the age of 10. Various radiologic methods and ultrasonography are useful in the diagnosis of cholelithiasis in children as well as in adults. Once the diagnosis of cholelithiasis is established the treatment of choice is cholecystectomy and splenectomy at the same operation. To perform both procedures an upper midline incision proved to be satisfactory. PMID- 3538696 TI - Ultrasonographic diagnosis of intrahepatic rupture of hydatid cyst. PMID- 3538698 TI - [Basic principles of modern prosthetic therapy]. PMID- 3538697 TI - [Comparative study of the reproducibility of the measurements of the Periotron]. PMID- 3538699 TI - [Plastic penile induration. Selection criteria for surgical procedure and evaluation of surgical tactics]. AB - According to an elaborated algorithm 131 patients with i.p.p. were subdivided into groups. The 3 subjective criteria form the basis: wish for continuation of sexual intercourse, state of erection as well as the objective criterion, degree of symptomatology, the recognition of the pathomorphological state by the computed tomogram. On this basis the selection of patients for the operative correction of the penis deviation is possible. In 74 of 131 patients with i.p.p. an operative intervention was performed. In 15 cases we use the technique of the reconstruction of the tunica albuginea. Only in one quarter of the cases positive results were present. In 59 patients a duplicature of the tunica albuginea was performed. at the point of the maximum curvature of the penis with the aim of the erection of the penis. In 78% of the cases during the after-examination good functional results were present. The method is characterized by its universality, the avoiding of the opening of the corpus cavernosum, an intraoperatively possible after-correction and the non-existence of the pathological process. The selection of patients and the conservative aftercare reduce the possibility of a recidivation. The disadvantage of the method is in a moderate shortening of the penis. PMID- 3538700 TI - [Drug sclerosing of kidney cysts]. AB - A report is given on the medicinal sclerosing of renal cysts by percutaneous treatment of 15 patients of the age of about 50 to 70 years. By intracaval injection of Aethoxysklerol in a solution of 2% the vessels of the cysts wall are obliterated and the tissue is sclerosed. The described technique avoids incorrect application as well as complications and major strain for the patients. True recurrences are obviously seldom. The report indicates that any evidence of a tumour disease apart from the cysts must bei excluded. The successful treatment shows that the percutaneous sclerosing represents a recommendable alternative to surgical operations. The efficacy and compatibility of the sclerosing agent Aethoxysklerol are particularly mentioned. PMID- 3538701 TI - [St. Apollonia and her servants. II: 5 representations of dental care in Dutch paintings of the 17th century]. PMID- 3538702 TI - [St. Apollonia and her servants. III. Porcelain groups of Johann Joachim Kandler (1706-1775) from the earlier Meissen porcelain manufacture (2nd quarter of the 18th century)]. PMID- 3538703 TI - [Autopsy report of the corpse of the composer Robert Schumann-- publication and interpretation of a rediscovered document]. AB - The report, previously regarded as lost, of the post mortem examination performed on Robert Schumann was found in 1973 by G. Nauhaus in the Archive of the "Robert Schumann House" in Zwickau. The original version is published here for the first time. Dr. med. Richarz, director of the private psychiatric institution in which Schumann had been hospitalized, conducted the autopsy together with his assistant Dr. med. Peters. Fragments of the autopsy findings, published by Richarz are known through his letters, provided, until now, the only available facts. The prosector's diagnosis of brain atrophy is not supported by the brain weight of 1,336 g, which is near the average brain weight for men of the corresponding age, nor by the volume of the cranium. 1,510 cm3, as reported by Schaaffhausen. The indentations and protuberances of the cranial bones in the region of the middle cranial fossa were regarded as reflecting prominent indentations of the gyri and were attributed no pathological significance. A small osteophyte in the region was not regarded as clinically important. The thickenings and scattered adhesions of the arachnoid membrane described in the report, cannot be pathologically interpreted. Moreover such findings are so uncharacteristic as to provide no compelling evidence for a resolved or on-going chronic inflammatory process. The available information permits no further interpretation of a mass in the hypophyseal region, described as gelatinous and partly of cartilagenous consistency. The cardiac findings do not suggest hypertension. The condition of the kidneys is not mentioned. The rediscovered document contains no information which persuasively supports any of the hypotheses about Robert Schumann's underlying illness which have appeared in the literature. PMID- 3538704 TI - [The vascular pole of hepatocytes: structure, function and pathology]. AB - Structural and functional subdivision of the hepatocyte into a sinusoidal (vascular) zone, a lateral zone and a peri-canicular zone (adjacent to the bile canaliculi) highlights certain peculiarities of the vascular hepatocyte pole. In contrast to the total cytoplasm, this area is characterized by a high volume of mitochondria, altered peroxisome content, a high concentration of lipids and the absence of Golgi-apparatus. Of critical importance is the sinusoidal cell membrane: at birth, the hepatocyte of the rat bears some 1,000 microvilli, rising to 4,600 in the mature animal. The surface to volume ratio of this part of the cell is more than 250% of the overall cell ratio. The ectoplasmic area beneath it is of importance to the structural integrity and function of the cell membrane itself. Pathological changes such as formation of blebs, shedding of cytoplasm, detachment of portions of the vascular pole, emergence of phagocytic processes, production of atypical substances (i.e. amyloid precursors), are closely and interactively related to pathologic processes of other elements of this region (non-hepatocyte, space of Disse). The peri-sinusoidal functional complex, may have an importance for the pathology of the liver which has not been fully appreciated to date. PMID- 3538706 TI - [Importance of immunohistochemistry for neuro-oncology. III. Demonstration of glial fibrillary acidic proteins (GFAP) in anaplastic astrocytomas and glioblastomas]. AB - Expression of gliofibrillary acidic protein in 23 anaplastic astrocytomas and 33 glioblastomas has been investigated and correlated with tumor behavior as reflected in both the length of the preoperative history and in the post operative survival time. Three degrees of positive immunoreactivity to anti-GFAP can be distinguished: positive GFAP reaction in more than 2/3 of cells; in 1/3 to 2/3 of all cells; in less than 1/3 of all cells; negative reaction. All anaplastic astrocytomas and 27 of 33 glioblastomas showed GFAP positive reactions. The proportion of highly reactive tumors is higher by anaplastic astrocytomas than by glioblastomas (7 of 33). For both astrocytomas and glioblastomas there is a tendency for a decrease in the expression of GFAP to be associated with a shorter preoperative history and with a shorter survival time. This is more prominent for astrocytomas than for glioblastomas. This finding supports the opinion expressed in previous publications that the GFAP expression is reversely related to the level of tumor anaplasticity. PMID- 3538705 TI - [Immunohistochemical demonstration of tissue markers in histopathologic diagnosis]. AB - Our experience with the demonstration of tissue markers in histopathology supports their value in differential diagnosis of routine material. Microscopic diagnostic methods are genuinely enriched by the use of such monoclonal antibodies and conventional antisera whose specificity has been adequately demonstrated using indirect peroxidase techniques in cut sections and on cytologic preparations. On the basis of several epithelial markers (carcinoembryonic antigen, keratin, tissue polypeptide antigen, MAM-antigens) and other antigens (protein S-100, chromogranin) examples are given for their application to routine differential diagnosis problems. The detection of these markers has been adapted to standardized indirect immunoperoxidase techniques. More sensitive tissue markers (i.e. antigens which do not withstand formalin fixation and paraffin embedding) should best be dealt with by specialized working groups. PMID- 3538707 TI - [Pseudarthroses of the scaphoid and its surgical treatment]. AB - Sclerotic bone ends and failure of union have quite often resulted from scaphoid fractures due to relatively insufficient blood supply to the proximal fragment. Clearly manifest scaphoid pseudarthrosis can be repaired only by surgery. Transplantation of cancellous or corticocancellous bone in combination with freshening of the sclerotic bone ends are priorities on which emphasis is laid in such surgical intervention. 38 patients with scaphoid pseudoarthrosis received surgical treatment in the casualty ward of Linz, between 1976 and 1982. The shortest follow-up interval for 30 patients was twelve months. 4 surgical methods were used, the technique of Streli in 16 cases, that of Matti-Russe in 9 instances, the Matti technique in 3 cases, and the Russe-II approach in 2 cases. Bony union was achieved in 90 per cent of the above patients. The technique of Streli was used in most cases for postoperative immobilisation, that is forearm cast for six weeks, which differed from other methods in which axilla to palm cast is applied up to twelve weeks. This paper has been prepared, with the view to describing results obtainable from various surgical approaches to scaphoid pseudoarthrosis. PMID- 3538708 TI - [Indications and technic of arthroscopic meniscus refixation]. AB - Arthroscopy was applied in 792 instances to 47 knee joints, between 5 and 20 years after meniscectomy. High rates of cartilage damage, some of them accompanied by instability of the knee joint were among the most conspicuous findings. Total, subtotal, and partial meniscectomy and their effects upon the mechanism and functionality of the knee joint are discussed in some detail. An account is given of indication and arthroscopic technique for peripheral meniscus fixation. PMID- 3538710 TI - [Our surgical heritage. Carl Caspar von Siebold (1736-1807) on his 250th birthday]. PMID- 3538709 TI - [Ureteral injuries in rectal surgery]. AB - Injuries to the ureter were found to occur primarily in cases of left-side Dukes C tumour, along with dissection of regional lymph nodes to cope with peritumorous infiltration. The area of an injury must be very carefully dissected. A splint should be inserted, when the ureteral lumen has been opened. A few approximation sutures should be made and the retroperitoneum drained. Anti-refluxive re implantation and Psoas Hitch plasty are recommended to cope with situations in which distal parts of the ureter are missing (due to direct or indirect damage or late sequels). Percutaneous nephrostomy is considered to be the optional therapeutic approach to extravasation and engorgement of the kidney. PMID- 3538711 TI - [Clinical experiences with a single layer uterine suture in cesarean section]. AB - In this analysis 536 caesarean sections with a single layer uterine suture were compared to 256 sections with two layer closure. Their relations with regard to indications of operative delivery, complications during the puerperium and their courses in subsequent vaginal deliveries were taken into consideration. - The significant lower rate of pyrexia and shorter hospital stay of the patients may be a result of quicker and better healing of the single layer suture. The increased rate of complications in the puerperium is partially due to changes in the registry of dates. Absent disturbances during the placental period and the occurrence of only one uterine rupture, in the course of vaginal delivery in a patient with a previous single layer caesarean section suture, demonstrates the functional sufficiency of this technic. PMID- 3538712 TI - [Significance of surgical technics in the prevention of infectious complications following cesarean section]. AB - Serious infectious complications after caesarean sections may be avoided by a meticulous operative technique. The closure of the uterotomy with resorbable sutures placed at a distance of 15 to 20 mm to approximate the wound edges without tension creates an effective barrier of viable myometrium which prevents the progression of intracavitary inflammation. A prophylactic intra- or perioperative regimen seems to be of minor importance. PMID- 3538713 TI - [Submucous varicose veins of the lower uterine segment--a rare cause of pre- and postpartal hemorrhages]. AB - Report about one case of submucous varicosis of the lower uterine segment during pregnancy. Arrosion of these veins during labour was the reason of a severe postpartal bleeding. Recurrent haemorrhages ante partum presumably can be attributed to lesions of these veins, too. PMID- 3538714 TI - [Abdominal hysterectomy with fixation of the ligaments]. AB - Abdominal hysterectomy with fixation of ligaments has been performed by the authors for 15 years. An analysis of 382 operations of the years 1980-1984 resulted in a course without complications (no fever, no transfusion) in 70 per cent. No mortality and no severe complications have been observed. This method appears to be recommendable. PMID- 3538715 TI - [Reconstruction of the pubovesicocervical fascia following surgical failures of the anterior vaginal wall]. AB - Results of reconstruction of fascia pubo-vesico-cervicalis in 21 women are presented after operative failure on the anterior vaginal dropped wall. The former operation consisted of anterior incision, separation of the walls to the sides, vesical intussusception with purse-string suture or transverse suture and of application mattress sutures on paraurethral tissue. At present the reconstruction of selected fascia pubo-vesico-cervicalis based on the doubling like a waistcoat and suturing under the symphysis pubis. Such a management causes a correctly fibrous and connective tissue support for urinary bladder and elevates the cervix upwards. PMID- 3538716 TI - Molecular characterization of a protein, insoluble at low temperature, produced by Clostridium botulinum type G. AB - A preliminary study of a low-toxicity protein, called cryoprotein, produced by Clostridium botulinum type G, led to a better characterization of this substance and to discriminate its relationship with type G botulinum toxin. This sparingly soluble protein has been characterized as an aggregated form of a soluble precursor with an Mr of 170,000. This phenomenon is temperature-dependent. The monomeric protein is usually contaminated with a lower Mr form (150,000) quite probably originated by a limited proteolytic process. The amino acid composition of this protein is relatively analogous to that of the botulinum toxins A and B, the only notable exception being the absence of cysteine. The N-terminal amino acid is alanine and the C-terminal sequence is Val-Ala-Leu-OH. The low toxicity which is usually demonstrable in samples of this protein disappears after a reductive treatment, strongly suggesting that it is not an intrinsic property. Taking into account that some of its physiochemical properties are similar to those of the known botulinal toxins, it is quite probable that this substance accompanies G toxin preparations currently obtained by routine methods, increasing its non-toxic antigenic mass. This fact could be critical to the sensitivity and specificity of G toxin immunological detection methods. PMID- 3538717 TI - Properties of an inducible beta-lactamase from Proteus vulgaris. AB - The inducible beta-lactamase of the clinical Proteus vulgaris isolate 4917/81 was highly purified by column chromatography and by FPLC (cation ion exchange column). Molecular weight of the enzyme amounted 33,000 daltons, as revealed by SDS-electrophoresis. The enzyme was not inhibited by p-chloromercuribenzoate, but by low concentrations of oxacillin and clavulanic acid. The enzyme inactivated not only penicillin derivatives (including ureidopenicillins), but also first generation cephalosporins and above all oxime-cephalosporins such as cefuroxime, cefotaxime and related derivatives. Turnover rates of these agents were mainly influenced by the nature of substitution in 3' position of the cephalosporin nucleus. Breakdown was not detectable in compounds which were substituted in 6 alpha or 7 alpha position, respectively. The enzyme proved to be very sensitive to the nature of 6 alpha or 7 alpha substituent, as revealed by the study of enzyme kinetics; no turnover could be detected for the penem Sch29 482, imipenem, latamoxef, and aztreonam. PMID- 3538718 TI - [The tenacity of bacteria in the airborne state. IV: Experimental studies on the viability of airborne E. coli 0:78 under the influence of different temperature and humidity]. AB - In a static aerosol chamber the tenacity of airborne E. coli 0:78 was determined at a permanent temperature of 22 degrees C and different relative humidities (10, 15-20, 30, 75 and 85%) and also at a permanent humidity of 30-40% and different temperatures (22, 28, 30, 34 and 40 degrees C). The greatest viability of the bacteria with a half-life-time of 390 min was found at 22 degrees C and 85% humidity. At 10% humidity the half-life-time was only 55 min. At a humidity of 30 40% the tenacity decreased from 37 to 14 min half-life-time, when the temperature increased from 22 to 40 degrees C. In preliminary examinations it could be shown that the method of cultivation and age of the bacterial suspension had an influence on the tenacity in the airborne state. PMID- 3538719 TI - Comparative investigations of Klebsiella species of clinical origin: plasmid patterns, biochemical reactions, antibiotic resistances and serotypes. AB - A total of 124 K. pneumoniae and 52 K. oxytoca isolates obtained from clinical specimens was investigated for plasmid patterns, biochemical reactions, antibiotic resistances and serotypes regarding to the distribution and relationships of these characters. A great diversity of plasmid patterns, bio/serotypes and resistance patterns was revealed. About 90% of strains contained plasmid DNA and up to seven plasmid bands per isolate could be shown. For K. pneumoniae, serotype 7 and for K. oxytoca, type 55 were most common. In general, little difference between both species was found and characters were similarly distributed. With respect to the site of isolation, serotype 7 was predominating in K. pneumoniae strains from the respiratory tract. Highly multiple-resistant organism were found in the largest number in specimens from the urogenital tract, in the lowest in specimens from wounds. Extensive statistical analyses did not detect any relationship among the characters investigated. PMID- 3538720 TI - The concurrent associations of group A streptococcal serotypes in children with acute rheumatic fever or pharyngitis-associated glomerulonephritis and their families in Kuwait. AB - A group of 146 children with acute rheumatic fever and 256 members from their families, and a group of 125 children with post-streptococcal glomerulonephritis and 199 family members, together with a group of 145 children with non complicated group A streptococcal pharyngitis were examined over a period of three years. The purpose of the study was to explore the concurrent association and distribution of group A streptococcal serotypes among the three groups. Strains isolated from the children with non-complicated group A streptococcal pharyngitis represented the prevalent strains of group streptococci in the childhood community during the period of study. Rheumatic fever was encountered in a non epidemic situation. As expected, the recovery of group A streptococci was low. The strains however belonged mainly to two patterns, namely type M1 and M non-typable strains. Nephritis was pharyngitis-associated and occured also sporadically throughout the year. Types M12 and 49 accounted for the majority of the isolates. Type M12 accounted for 34.4% of the group A isolates from family members of children with nephritis and was totally absent in family members of children with rheumatic fever (p less than 0.001). The T pattern 8/25/Imp. 19 accounted for 40% of the group A isolates from family members of rheumatic patients compared to 3.3% from family members of nephritis patients (p less than 0.005). Data from this study show that the group A streptococcal serotypes, concurrently isolated from children with acute rheumatic fever and their families are disparately different from those of children with pharyngitis-associated glomerulonephritis and their families in the same population. These findings support the concept of "nephritogenicity" and "rheumatogenicity" and indicated the important role of the biological characteristics of the streptococcal serotypes in the aetiology of acute rheumatic fever and acute poststreptococcal glomerulonephritis. PMID- 3538721 TI - Streptococcal group A polysaccharide antibodies assayed by an ELISA determination of antibodies in rabbit hyperimmune sera; normal levels in man and comparison with levels in patients with rheumatic fever and with poststreptococcal glomerulonephritis. AB - An enzyme-linked immunosorbent assay (ELISA) was adapted to measure antibodies to streptococcal group A polysaccharide. The components of the reaction were studied, including the concentration of the polysaccharide antigen, the suppression of non-specific reactions, optimal conjugate binding conditions and the most suitable plates. The specificity of this test was documented by studies using immune sera and polysaccharide antigens of various groups of beta-hemolytic streptococci. In addition dynamics of the antibody response in animals as well as in man were investigated. The upper limit of normal level of this antibody in normal healthy persons was determined by this technique. We found that 80% of patients with rheumatic fever and acute glomerulonephritis showed an elevation of the group A polysaccharide antibody titer. Determination of this antibody response by the ELISA technique is clinically useful in evaluation patients with the nonsuppurative sequelae of group A streptococcal infections. PMID- 3538722 TI - [Clostridium difficile--one of the causes of enterocolitis in man]. PMID- 3538723 TI - [Role and significance of fever in the clinical course of the postvaccinal reaction]. PMID- 3538724 TI - [Potentials for the practical use of microorganism strains in medical and veterinary microbiology]. PMID- 3538725 TI - [The 80th anniversary of the Tomsk Research Institute of Vaccines and Sera]. PMID- 3538726 TI - [Use of a protective solution in the inoculation of bacterial cultures]. AB - The influence of the composition of solutions used for growing the bacterial cultures on the survival of microorganisms has been studied. The use of a protective solution, consisting of sodium chloride, orthophosphates, magnium sulfate, and gelatin, for suspensions of bacterial cultures has provided a higher isolation rate of enteric microorganisms, vs. cultivation with 0.9% sodium chloride solution. In evaluating the sensitivity of thioglycol medium test cultures are recommended to be inoculated with the above protective solution. PMID- 3538727 TI - [Antigenic similarity of microorganisms to human group-specific blood factors and the immune response of persons with various ABO classifications]. AB - The isohemagglutination test with the introduction of the heat-stable fraction of microbial broth culture into the reacting system was used as a model of the antigen-antibody interaction. In the "A-anti-A" system the inhibition of isohemagglutination in the presence of staphylococcal allergen was observed. This inhibition was caused by the binding of the allergen with anti-A-antibodies, which was indicative of the antigenic similarity between staphylococcus and group specific factor A. The influence of the similarity thus established on immune response was studied by the determination of antitoxic titers in 292 donors immunized with staphylococcal toxoid and in 86 patients with chronic hematogenic fistulous osteomyelitis with due regard of the ABO phenotype of the examinees. Subjects with group A(II) blood were found to have lesser antibody titers than those with blood of other groups and to be predisposed to the progressive course of staphylococcus-induced diseases. PMID- 3538728 TI - [Distribution of type-specific antibodies to streptococcal lipoproteinase based on population screening data]. AB - In the serum samples obtained from residents of the Todzhinsky district in the Tuva Autonomous Soviet Socialist Republic antibodies to 12 out of 15 studied types of group A streptococcal lipoproteinases (OF-factor) were detected, with the prevalence of types 2, 4, 22, 25, 48, and 60, their incidence in the population constituting 34%. Antibodies to OF-antigens 58, 62, and 63 were not detected. The distribution of OF-antibodies was found to vary with sex, occurring in females 1.5 times more frequently than in males, and with age, accumulating in subjects aged 21-30 and 31-40. The distribution of antibodies to different OF serotypes did not depend on the blood serum streptolysin O titers. PMID- 3538729 TI - [Comparative evaluation of the sensitivity of immunofluorescence methods, immunoenzyme analysis and the lectin test for the rapid diagnosis of influenza]. AB - Comparative study of the sensitivities of immunofluorescent microscopy (IFM), enzyme immunoassay, (EIA), and lectin test (LT) in the detection of influenza virus antigen in nasopharyngeal washings from patients with influenza, acute respiratory diseases, pneumonia, and laryngitis has been carried out. EIA modification (used in this study) based on the detection of a complex of viral core proteins (M + RNP) has been shown to be no less sensitive than IFM and suitable for use in the rapid diagnosis of influenza. It can be used in combination with other methods. The optimum time for collecting the washings off is day 2 from the disease onset for analysis by EIA technique and day 4 for LT. PMID- 3538730 TI - One hundred elective resections of the left colon and rectum with unprotected manual anastomosis. AB - One hundred consecutive elective resections with hand suture of the left colon and rectum without a protective colostomy are reported. The absence of clinical fistulas, wound infections and abcesses indicates the safety and the feasability of this approach. There was a two per cent mortality rate. The article stresses the importance of a good suturing technique, good preparation, the judicious use of anti-anaerobic drugs, the use of plastic ring drapes and the changing of gloves, drapes and instruments before wound closure. The absence of leakage and of septic complications lowers dramatically the overall complication rate. PMID- 3538731 TI - Clinical lung transplantation: state of the art after 23 years of rational progress. PMID- 3538732 TI - Arterial thromboembolectomy--should anticoagulants be administered? AB - Perioperative administration of heparin with subsequent coumarin therapy is often recommended in surgery for acute limb ischemia. This retrospective study compares the results of arterial thromboembolectomy with and without concomitant use of anticoagulants. Good results were more common in adequately anticoagulated patients, but the hospital death rate did not differ. Further analysis, however, showed that the better results in the anticoagulated patient group could have been influenced by selection factors. The cumulative recurrence rate of thromboembolism was not significantly reduced in patients on long-term anticoagulation treatment. A review of 15 recently published series of acute limb ischemia showed similar results from centers in which anticoagulants were administered after arterial thromboembolectomy and in centers where postoperative anticoagulant therapy was not used. Definite evidence of a beneficial effect of anticoagulants given before and after arterial thromboembolectomy thus is concluded to be lacking, and a prospective randomized trial is required. PMID- 3538733 TI - Ulceration of the carotid bifurcation. A preliminary report on a diagnostic problem. AB - The prevalence of ulceration in the carotid bifurcation, as judged from high resolution 2-D ultrasound scanning and angiography, was compared with the findings at carotid endarterectomy in patients with TIA or stroke. The surgeons registered ulceration in 26 of the 29 treated carotid arteries. Angiography and ultrasonography identified ulceration in 9 and 19, respectively, of the same arteries, indicating that high-resolution 2-D ultrasound scanning is superior to angiography in the diagnosis of carotid ulceration. All arteries with tight stenosis (diameter reduction greater than or equal to 75%), but only two of four with less than 30% stenosis were ulcerated. PMID- 3538734 TI - Coexistent metastatic malignant melanoma cells and Wuchereria bancrofti microfilariae in urinary sediment. PMID- 3538735 TI - Clinical and experimental aspects of long-wave ultraviolet (UVA) irradiation of human skin. PMID- 3538737 TI - Synthetic analogs of cholecystokinin terminal tetrapeptide that stimulate insulin but not glucagon release from pancreatic islets. AB - Two synthetic analogs of CCK-4, Glp-Met-Asp-Phe-NH2 (I) and Pro-Met-Asp-Phe-NH2 (II) reported earlier to stimulate insulin release from the isolated rat pancreatic islets in vitro at concentrations as low as 10(-10) M, have now been found to be totally ineffective as glucagon releasers at concentrations as high as 10(-6) M or higher. It is evident that the replacement of Trp in CCK-4 by Glp and Pro residues leads to peptides which exhibit insulin releasing activity without stimulating the release of glucagon. PMID- 3538736 TI - Insulin secretion and insulin sensitivity defects are a common feature of mild, clinically homogeneous, recently diagnosed type II (non-insulin-dependent) diabetics. AB - Alteration in insulin secretion and reduced peripheral sensitivity to the hormone have been reported in type II diabetes. In this paper, a comparison is made of basal glucose production (3H-6 glucose), insulin secretion and insulin sensitivity in vivo (hyperglycemic clamp) and in vitro (binding to circulating monocytes) in 24 patients with recently diagnosed type II diabetes, matched for age and fasting glycemia and divided into non-obese (14 subjects) and moderately obese (10 subjects), and in 9 non-obese controls. The non-obese diabetics were slightly hyperinsulinemic during fasting (10.8 +/- 1.0 vs 4.8 +/- 0.8 microU/ml in controls, p less than 0.0005), with a significant reduction in early and late insulin secretion (14.0 +/- 1.5 vs 20.8 +/- 2.0 microU/ml, p less than 0.01 and 24.8 +/- 3.3 vs 34.7 +/- 2.14 microU/ml, p less than 0.025). The insulin sensitivity index MCR/I was significantly reduced (2.30 +/- 0.32 vs 4.14 +/- 0.40, p less than 0.005). Endogenous glucose production was significantly increased (107 +/- 10.2 vs 84 +/- 3.7 mg/m2 per min, p less than 0.025) and displayed a positive correlation with fasting glycemia (r = 0.51, p less than 0.05). Insulin binding to monocytes was significantly lower than in controls (2.36 +/- 0.22% vs 4.06 +/- 0.32%, p less than 0.0005). Moderately obese diabetics also were significantly hyperinsulinemic in the fasting state (18.1 +/- 2.8 microU/ml, p less than 0.0005 vs controls) but, typically, lacked the early secretory phase (20.6 +/- 3.6 microU/ml vs baseline, n.s.). A similar increase of hepatic glucose production (107 +/- 11.2 mg/m2 per min, p less than 0.025 vs controls, n.s. vs non-obese diabetics) and decrease of peripheral sensitivity to insulin (MCR/I = 1.78 +/- 0.31, p less than 0.0005 vs controls, n.s. vs non-obese diabetics) was found in moderately obese diabetics, as well as a significant reduction of insulin binding to insulated monocytes (2.62 +/- 0.4% p less than 0.01 vs controls, n.s. vs non-obese diabetics). These results confirm that common defects of both non-obese and moderately obese type II diabetics are: lack of early phase of glucose induced insulin secretion, increase in hepatic glucose production and decrease of peripheral insulin sensitivity together with reduction of insulin binding to circulating monocytes. The hypothesis of a unique defect as a cause of hyperglycemia in type II diabetes in early clinical phase is not borne out by the results of this study. Moderate obesity, even if able to reduce insulin sensitivity, seems to be less important in determining hyperglycemia. PMID- 3538738 TI - C-peptide immunoreactivity and insulin content in the diabetic human pancreas and the relation to the stability of diabetic serum glucose level. AB - The content of insulin and C-peptide-like immunoreactivity (CPR) were determined in the tail of pancreas from 35 autopsied diabetic and 21 non-diabetic subjects. In the 28 diabetics who had been followed for more than 6 months, the relation between the amount of insulin or CPR in the pancreas and the stability of fasting serum glucose during diabetic life before death was analyzed together with the relation between the serum CPR response to the breakfast tolerance test before death and insulin content at autopsy. As an index of the instability of the blood sugar level, the standard deviation of the mean of 15 successive determinations of fasting serum glucose was used. Both insulin and CPR content in the pancreas were significantly decreased in diabetics as compared with non-diabetics. SD of the mean fasting serum glucose and insulin or CPR content in the tail of pancreas showed a significant inverse correlation on a logarithmic scale (P less than 0.01, r = -0.704 and P less than 0.01, gamma = -0.757, respectively). Serum CPR value during the breakfast tolerance test correlated significantly with the insulin content in the pancreas of diabetic subjects. These findings suggest that one of the causes of the instability of fasting serum glucose levels is the devastation of pancreatic beta-cells and that the pancreatic insulin content is logarithmically and inversely related to fluctuations in fasting serum glucose. PMID- 3538740 TI - Distribution of ornithine decarboxylase in ovaries of rat and hamster during pro oestrus. AB - The biosynthesis of polyamines is dramatically increased in the ovaries of rat and hamster during the evening of pro-oestrus. In an attempt to shed some light on the physiological function of this biosynthesis ornithine decarboxylase (ODC), which catalyzes the rate-limiting step in the biosynthesis of the polyamines, was immunohistochemically localized in the ovaries from rat and hamster during pro oestrus. At dioestrus, only a few immunoreactive cells were found in the ovaries. During the evening of pro-oestrus, on the other hand, numerous immunoreactive cells were observed in the ovaries. These cells were confined to the internal thecal layer of Graafian as well as smaller follicles and to the interstitial tissue of the ovary. The granulosa cells appeared to be devoid of immunoreactive ODC. The hamster ovary, which during this time exhibited considerably higher levels of ODC activity than the ovaries from the rat, did accordingly contain more immunoreactive cells than the rat ovary. PMID- 3538739 TI - Primary adrenocortical micronodular adenomatosis causing Cushing's syndrome. Effects of ketoconazole on steroid production and in vitro performance of adrenal cells. AB - Mild Cushing's syndrome was diagnosed in a 35 year old woman. Elevated plasma and urinary cortisol levels were unsuppressible with up to 32 mg dexamethasone per day. Aldosterone, 18-OH-corticosterone and testosterone in plasma were normal and dehydro-epiandrosterone-sulphate was low. No adrenal tumour was found by CT or adrenal venography, and bilateral cortisol secretion was demonstrated by steroid measurements in adrenal venous blood. A circadian rhythm of plasma cortisol was absent. Plasma ACTH was suppressed, even after injection of CRH, during insulin induced hypoglycaemia and after metyrapone administration, which led to a large fall in plasma cortisol but to a subnormal rise of plasma 11-deoxy-cortisol. The clinical diagnosis of primary micronodular adenomatosis of the adrenal gland was histologically confirmed, when the patient finally underwent bilateral adrenalectomy. In vitro, the adrenal cells did not produce more cortisol and aldosterone than adrenal cells from cadaver kidney donors. In vivo and in vitro, cortisol was slightly less than normally responsive to ACTH. Intermittent treatment of the patient with 800 mg/day of ketoconazole led to a rapid fall of cortisol secretion and clinical signs of adrenocortical insufficiency. Treatment for 7 weeks with 200-400 mg ketoconazole per day reduced plasma and urinary cortisol less dramatically into the normal range. This case unequivocally documents autonomous dysfunction of the adrenal cortex in this rare form of Cushing's syndrome and the efficacy of ketoconazole in the treatment of ACTH independent hypercortisolism. PMID- 3538742 TI - Glucose uptake and pulsatile insulin infusion: euglycaemic clamp and [3 3H]glucose studies in healthy subjects. AB - To test the hypothesis that insulin has a greater effect on glucose metabolism when given as pulsatile than as continuous infusion, a 354-min euglycaemic clamp study was carried out in 8 healthy subjects. At random order soluble insulin was given intravenously either at a constant rate of 0.45 mU/kg X min or in identical amounts in pulses of 1 1/2 to 2 1/4 min followed by intervals of 10 1/2 to 9 3/4 min. Average serum insulin levels were similar during the two infusion protocols, but pulsatile administration induced oscillations ranging between 15 and 62 microU/ml. Glucose uptake expressed as metabolic clearance rate (MCR) for glucose was significantly increased during pulsatile insulin delivery as compared with continuous administration (270-294 min: 8.7 +/- 0.7 vs 6.8 +/- 0.9 ml/kg X min, P less than 0.01, and 330-354 min: 8.9 +/- 0.5 vs 7.4 +/- 0.9 ml/kg X min, P less than 0.05). The superior efficacy of pulsatile insulin delivery on glucose uptake was not consistently found until after 210 min of insulin administration. In both infusion protocols, endogenous glucose production as estimated by the [3 3H]glucose infusion technique was suppressed to insignificant values. Finally, the effect of insulin on endogenous insulin secretion and lipolysis as assessed by changes in serum C-peptide and serum FFA was uninfluenced by the infusion mode. In conclusion, insulin infusion resulting in physiological serum insulin levels enhances glucose uptake in peripheral tissues in healthy subjects to a higher degree when given in a pulsed pattern mimicking that of the normal endocrine pancreas than when given as a continuous infusion. PMID- 3538741 TI - Low concentrations of interleukin-1 stimulate and high concentrations inhibit insulin release from isolated rat islets of Langerhans. AB - Isolated rat islets were incubated either with crude, affinity-purified or recombinant human interleukin-1 for 1 to 6 days. A significant (20-60%) increase of insulin release was observed at low concentrations of all three interleukin-1 containing preparations. In contrast, higher concentrations dose-dependently inhibited the insulin release. The increased insulin secretion occurred at concentrations below those necessary to augment the mitogen response to phytohaemagglutinin of murine thymocytes in vitro. These doses (0.05-0.5 U/ml) correspond to 0.2-2 ng of recombinant interleukin-1 per ml, equal to approximately 0.01-0.1 pmol/ml. In doses of 0.6-1.8 U/ml affinity-purified interleukin-1 significantly increased the islet insulin content per ng of DNA, indicating a stimulation of insulin-biosynthesis. The data support the concept that low concentrations of interleukin-1 may play a role in priming the physiological secretion of insulin. PMID- 3538743 TI - Plasma aldosterone-plasma renin activity ratio. A simple test to identify patients with primary aldosteronism. AB - Thirty-two patients with hypertension and recurrent hypokalaemia were investigated on the suspicion of primary aldosteronism. On the basis of unsuppressible aldosterone secretion upon oral mineralocorticoid administration in 16 patients, a surgical exploration was made revealing a typical aldosteronoma in 12 of them, macronodular hyperplasia in two, micronodular hyperplasia in one, and micronodular hyperplasia together with a phaeochromocytoma in one patient. The remaining 16 patients with normal aldosterone suppressibility were considered to have primary hypertension. The discriminatory power of various biochemical tests related to the renin-angiotensin-aldosterone axis was analyzed in retrospect. The only parameter allowing a separation of patients with biochemically and surgically confirmed primary aldosteronism from the other group was the plasma aldosterone-plasma renin activity ratio. The present study therefore confirms the diagnostic value of this ratio for identifying patients with primary aldosteronism. PMID- 3538744 TI - Localization of oxytocin and neurophysin in baboon (Papio anubis) corpus luteum by immunocytochemistry. AB - Immunoreactive oxytocin is detectable in the corpora lutea of women and cynomolgus monkeys by radioimmunoassay. To localize the presence of oxytocin and neurophysin I in ovarian tissues of subhuman primates, three corpora lutea and ovarian stromal tissues and two Fallopian tubes obtained during the menstrual cycle of the baboon and decidua from two pregnant baboons were examined using highly specific antisera against either oxytocin or neurophysin I and peroxidase antiperoxidase light microscopy immunohistochemistry. Oxytocin-like as well as neurophysin I-like immunoreactivities were found in some cells of all the corpora lutea only, but could not be demonstrated in ovarian stromal tissues, Fallopian tubes and decidua. Specificity of the immunocytochemical reaction was further confirmed by immunoabsorption of the antiserum with excess oxytocin or neurophysin, after which the immunoreactivities for both oxytocin and neurophysin in the luteal tissue were negative. Similar controls using normal rabbit serum gave no positive staining for either oxytocin or neurophysin. Counterstaining of the positive immunoreactivities for oxytocin and neurophysin I with Mayer's haematoxylin and eosin demonstrated clearly that the oxytocin and neurophysin I appeared as granular material mainly within the cytoplasm of the luteal cells. The localization of immunoreactive oxytocin and neurophysin I in the corpus luteum of the baboon demonstrates directly the presence of these two neurohypophysial peptides within primate luteal cells and suggests their local production. PMID- 3538746 TI - Intra erythrocytic differentiation of Plasmodium berghei. PMID- 3538745 TI - Initiation and control of ovulation in the mouse luteal phases. Effects of gonadotropins and gonadotropin releasing hormone. AB - The aim of the present study was to examine the induction of ovulation during pregnancy, pseudopregnancy, and suckling-delayed pregnancy in mice using exogenous gonadotropins. The present results demonstrate that there are mature follicles in the ovary which can be induced to ovulate with administration of either exogenous human chorionic gonadotropin (hCG) or luteinizing hormone (LH) during pregnancy (Days 1-12) and pseudopregnancy (Days 4-8) in the mouse. hCG was relatively ineffective in initiating ovulation during suckling-delayed pregnancy, and hCG could not induce ovulation on Days 3-6 in any animals, suggesting that follicular growth is not continuous during suckling-delayed pregnancy in the mouse. Ovulation occurred in pregnant and pseudopregnant mice following injection of gonadotropin releasing hormone (GnRH) in a gelatin delay vehicle. Injection of GnRH in saline did not initiate ovulation in pregnant or pseudopregnant mice. A large release of LH was shown to occur following injection of GnRH in gelatin, but no release occurred after the same dose of GnRH in saline. In conclusion, the experiments demonstrate the existence of mature follicles during murine pregnancy and pseudopregnancy, and the lack of inductable follicles during suckling-delayed pregnancy. PMID- 3538747 TI - The Medicare fast track. PMID- 3538748 TI - Spatio-temporal organization of bioelectrical processes in the nervous-system- its functional significance and complex quantitative estimation by means of spectral and coherent analyses. AB - The review of our research and the data in the literature shows that application of the systems approach and the complex quantitative analysis of local processes and spatio-temporal organization of bioelectrical activity in the nervous system provides better possibilities for the discovery and investigation of functionally significant changes, often discrete, appearing in the course of investigations performed under normal physiological conditions in man and in freely moving animals, as well as for the estimation of changes beyond the limits of homeostasis. PMID- 3538750 TI - Do B cells and peri-insular acinar cells of canine pancreas have nerves in common? AB - Synapses providing simultaneous contact with insulin-producing B cells and acinar cells have been found at the margins of islets of Langerhans in the dog. Blood vessels have also been observed in the vicinity of such synapses. The frequently described correlation between insulin and protein secretion might be a result of the simultaneous influence of these nerve endings on both enzyme- and hormone producing cells. PMID- 3538749 TI - Cell types of the pars distalis of the hedgehog (Erinaceus europaeus L.) adenohypophysis: cytological, immunocytochemical and ultrastructural studies. 4. Thyrotropic cells. AB - Staining and histochemical methods, immunofluorescence and electron microscopy were used to individualize the thyrotropic cells in the adenohypophysis of the non-hibernating hedgehog. One cell type was differentiated; its characteristics at the light and electron-microscopic levels were presented. Immunofluorescence has confirmed the functional significance of this cell type and the validity of the denomination of 'thyrotropic cells'. PMID- 3538751 TI - Choriocapillaris atrophy after experimental destruction of the retinal pigment epithelium in the rat. A study in thin sections and vascular casts. AB - Rats that receive intravenous injections of sodium iodate develop a retinopathy characterized by the partial loss of the retinal pigment epithelium (RPE). In thin sections examined by transmission electron microscopy the choriocapillaris atrophied adjacent to areas of RPE destruction. The endothelial cells thickened and lost their fenestrae and the lumen of the capillary was reduced. At sites where the RPE remained normal in appearance the choriocapillaris did not atrophy. Scanning electron microscopy of vascular casts of the choriocapillaris showed the coexistence of atrophic and normal choriocapillaris throughout the retina, presumably adjacent to sites where the RPE was destroyed or spared, respectively. Our observations support the concept that the RPE exerts some control over the structure and function of the choriocapillaris. PMID- 3538752 TI - Measurement of beta-2-microglobulin in human cerebrospinal fluid by ELISA technique. AB - This study introduces an enzyme-linked immunosorbent assay for measurement of beta-2-microglobulin in human cerebrospinal fluid. The concentration of beta-2 microglobulin in cerebrospinal fluid correlated with the age (p less than 0.001) of a control group of 40 subjects, probably reflecting age-related processes in the central nervous system. The reference interval of beta-2-microglobulin was considered to be 0.62-3.28 mg/1. Results obtained with various CNS disorders demonstrated that estimation of beta-2-microglobulin in cerebrospinal fluid add diagnostic information. The concentration of beta-2-microglobulin may increase without simultaneous aberrations in the content of protein, glucose and white blood cells. PMID- 3538753 TI - A randomized general practice group-comparative study of femoxetine and placebo in the prophylaxis of migraine. AB - In a randomized general practice study, the prophylactice effect of femoxetive (a 5HT uptake inhibitor) was compared with placebo in migraine patients. Treatment, with separate randomization schedules in each practice, was allocated to 65 patients. Each patient was treated for 16 weeks with 200 mg increasing during the first nine days to 600 mg daily. No effect of femoxetine could be demonstrated in attack frequency and headache index. Separate analysis of maximum reduction in serotonin concentration during treatment revealed no difference in efficacy when compared with placebo. This supports earlier studies that femoxetine generally exerts no prophylactic effect on migraine, and the hypothesis that platelet 5HT might be of major importance in the pathogenesis of migraine is not supported. PMID- 3538754 TI - Reconstruction after resection of the distal fibula for bone tumor. AB - We have reviewed 11 patients after distal fibular resection for benign or malignant tumors with different techniques of reconstruction. Seven patients had normal function and four had reduced mobility, one of whom had a lateral subluxation of the talus. All the patients were without pain. After resection of the lateral malleolus without replacement the soft tissues should be reinforced. PMID- 3538755 TI - Sonography, arthroscopy, and intracapsular pressure in juvenile chronic arthritis of the hip. AB - Sonography was used in the preoperative evaluation of the hip joint in 14 patients with juvenile chronic arthritis (JCA). The joint capsule distension found at sonography and the intracapsular pressure were increased in patients with severe synovitis revealed at arthroscopy. Sonography and intracapsular pressure-recording can be recommended for assessments of synovitis of the hip joint in JCA. PMID- 3538757 TI - Surgery for ununited clavicular fracture. AB - Twenty-four ununited, primarily conservatively treated clavicular fractures were treated operatively. The follow-up period averaged 3.5 years. In all cases, the primary displacement was at least equal to the clavicular thickness. The subjective outcome was good in 17 cases, satisfactory in six, and poor in one. In two cases, resection was performed. Our experience of rigid plate fixation and cancellous bone grafting was good with union in 20/22 cases. However, the operations are not uncomplicated and there is a risk of diminished muscle power and range of movement in the shoulder if the clavicle is shortened. PMID- 3538756 TI - Repair of the anterior cruciate ligament. Augmentation versus conventional suture of fresh rupture. AB - A prospective case control study was made by comparing the results of a modified combination parapatellar tendon transposition repair of a fresh anterior cruciate ligament rupture with those of the conventional Palmer technique. The mean follow up time was 4 (3-7) years. A tendency to better stability was shown by an objective clinical device. Subjective results concerning stability sensations of the knee were also better than those obtained by the conventional method. PMID- 3538758 TI - The use of subtraction arthrography in total hip prosthesis. PMID- 3538759 TI - [Revision of total hip prosthesis]. PMID- 3538760 TI - [Total prosthesis for acetabular protrusion. Reconstruction of the cup using an autograft of the femoral head perforated in situ]. PMID- 3538761 TI - Bone grafting in total hip replacement for acetabular protrusion. PMID- 3538762 TI - Reconstruction of acetabular bone stock. PMID- 3538763 TI - [Reconstruction of the cup using a bone graft and a cementless self-tapping CLW screw ring]. PMID- 3538764 TI - Long term results of primary suturing of the acutely torn anterior cruciate ligament. PMID- 3538765 TI - Sympathetic neurogenic control of blood flow in human nasal mucosa. AB - Nasal mucosal blood flow was investigated in patients undergoing a stellate ganglion blockade. Elimination of the sympathetic neurogenic control did not affect the resting blood flow in the mucosa, as registered with the 133Xe washout technique. This indicates that the basal sympathetic vasoconstrictor activity is low in the mucosal vessels that regulate blood flow. With laser doppler flowmetry, the normal pattern of spontaneous oscillations in blood flow was seen to be altered following stellate ganglion blockade. This suggests that vasomotion in the mucosa is partly dependent on sympathetic neurogenic activity. Furthermore, the decrease in blood flow normally induced by a peripheral cold provocation could not be elicited after the ganglion blockade, which means that the decrease is mediated by sympathetic vasoconstrictor fibres. PMID- 3538766 TI - [The development of tinnitus in the postoperative period of otospongiosis]. AB - Correlation between tinnitus and audiometric loss, modification of tinnitus by medical or surgical treatment, allow to suspect the origin of tinnitus due to otospongiosis and to give the patient a practically always confirmed prognosis. Audiometric localization of tinnitus is essential, as it is the best clue to etiology, treatment and prognosis of otospongiosis tinnitus. As far as irreducible tinnitus are concerned, as anxiety is the most pejorative parameter, not discouraging the patient is very important. PMID- 3538767 TI - Experimental study on secondary amyloidosis associated with chronic arthritis. AB - Various organs from rabbits immunized with heat-killed E. coli 0:14 to induce chronic polyarthritis resembling rheumatoid arthritis (RA) were examined for amyloid deposition since amyloidosis is a frequent feature of long-standing RA. Amyloids were confirmed mainly by polarizing as well as nonpolarizing light microscopy after Congo red staining and partly by electron microscopy and immunoperoxidase technique. Amyloid deposits after an additional 2 months from the first appearance of arthritis were most frequently found in the spleen and kidneys suggesting secondary amyloidosis. Amyloidosis was observed in 36% of 75 arthritic rabbits. The incidence of amyloidosis was significantly higher in the arthritic rabbits than in the non-arthritic rabbits (p less than 0.05). This suggests that prolonged sensitization with heat-killed E. coli 0:14 containing endotoxic substance participates in the formation of both arthritis and amyloidosis. PMID- 3538768 TI - Strumal carcinoid of the ovary. Ultrastructural and immunohistochemical study. AB - Strumal carcinoid of the ovary with mucinous cystadenoma of borderline malignancy is reported. A colloid-like material in the follicular structure contained thyroglobulin which was immunohistochemically demonstrated to confirm the thyroid element, whereas the carcinoid component, which showed argyrophilia and displayed neurosecretory granules, revealed an insular or trabecular structure. This confirmed the presence of colloid filled thyroid epithelium intimately admixed with the carcinoid. Electron microscopy revealed carcinoid cells expanding toward the inner layer of the follicles but thyroid epithelium almost always stretched its thin cytoplasmic processes to cover the colloidal lumen. No calcitonin was demonstrated but CEA was seen in some cells of the carcinoid. No amyloid was detected. PMID- 3538769 TI - Independent binding of native and aggregated IgG in group A streptococci. AB - Irrespective of IgG Fc-receptor activity, earlier characterized, many group A streptococci were recently found to bind aggregated IgG Fab and/or light chains. In the present study, binding of glutaraldehyde-aggregated, radiolabelled, intact human IgG (a*IgG) to group A streptococci was tested, and strains representing several M-types were found reactive. In particular, high binding was observed among type M12 strains, earlier found devoid of Fc-receptors for monomeric IgG; accordingly, unlabelled, native IgG had little influence on the binding. The sites binding a*IgG were highly sensitive to trypsin and relatively resistant to heat treatment. The binding to M12 was inhibited by human fibrinogen and, to a lesser extent, by heat-aggregated serum albumin. Rabbit antiserum to M12 was more inhibitory than antiserum to a heterologous type of group A streptococci or normal rabbit serum. Our results indicate that streptococcal M-protein binds a*IgG by a multipoint requiring interaction of low specificity and that previously described Fc-receptors binding native IgG are not involved. For comparison, in Cowan I staphylococci and one strain of group G streptococci tested, high binding of a*IgG was also observed; however, this binding was inhibited by native IgG, indicating that protein A and group G streptococcal Fc receptor, earlier known to bind untreated IgG, also bound a*IgG. PMID- 3538770 TI - Commercial kits are not equally sensitive in detecting the group antigen of group A streptococcus. AB - The relative sensitivities of four commercially available kits for the demonstration of the group antigen of group A streptococcus were estimated in laboratory experiments. Two kits gave positive reactions with swabs charged with approximately 10(5) colony-forming units of group A hemolytic streptococci of five common T-types. The two other kits required inocula ten times higher. Application of the antigen detection reagents from each kit to antigen extracts prepared by extraction reagents from the other kits revealed that the differences in sensitivity were largely attributable to differences in the extraction abilities. The four kits did not differ appreciably in their ability to demonstrate group A antigen in human pus mixed with group A streptococci; the minimum inoculum detectable was approximately 10(6) colony-forming units per 0.04 ml of pus. PMID- 3538772 TI - [A formula for estimating the half-life of a drug]. PMID- 3538771 TI - Continuous ambulatory peritoneal dialysis: microbiological diagnosis in peritonitis. AB - Dialysate samples from 29 Continuous Ambulatory Peritoneal Patients (CAPD) patients were taken in periods with and without peritonitis and cultured simultaneously in the Hemobact system and on conventional plate media, using a standard technique. Bacteria were demonstrated in 23 (92%) of 25 CAPD-patients with peritonitis by the Hemobact method and only in 6 (24%) by the standard technique. Sixty-four (100%) of the 64 samples taken during periods without peritonitis were negative by the standard technique. Sixty-two (97%) of the 64 samples were negative in the Hemobact system. In the remaining two samples coagulase negative staphylococci were demonstrated on the third day in only one of the bottles. In conclusion, blood cultivation systems should be preferred to conventional standard methods for adequate microbiological diagnosis in CAPD patients with peritonitis. PMID- 3538773 TI - [Chemical assay of anthraquinone derivatives in plant drugs]. PMID- 3538774 TI - [Studies on the alkaloids of lycopodia from Lycopodiaceae]. PMID- 3538775 TI - Effects and development of tolerance using transdermal nitrates in the treatment of congestive heart failure. AB - Vasodilator therapy is an accepted mode of treating patients with severe congestive heart failure (CHF). Nitrates have a predominantly beneficial effect on preload, but also afterload may be beneficially modulated with higher doses. There is some evidence that long-term treatment with isosorbide dinitrate is beneficial in patients with CHF. By contrast, recent reports of 24 hour hemodynamics following transdermal delivery seem disappointing and rapid development of tolerance has been observed. PMID- 3538776 TI - Biological effects of organic nitroesters and their mechanism of action. AB - Organic nitroesters e.g. glyceryltrinitrate (NTG) are of great clinical importance in the treatment of angina pectoris. The most important of their biological effects is vasodilation of peripheral arteries, peripheral veins and coronary arteries. Other biological effects, of unknown clinical relevance, are effects on myocardial metabolism and on platelet aggregation. In recent years evidences have accumulated that the vasodilating effects of organic nitroesters are mediated via the cGMP-system, although the exact mechanism of activation of the cGMP-producing enzyme guanylate cyclase is still obscure. Further research about this may elucidate the mechanism behind the development of tolerance. Another theory concerning the mechanism behind the vasodilating properties of NTG is that arachidonic acid metabolites are involved. However no clearcut evidences have been presented to support this theory. We show in this paper results indicating that arachidonic acid metabolites are of no importance for the vasodilating effects of NTG, at least not in vitro. NTG has also been shown to decrease the intracellular Ca2+ -concentration, an effect probably mediated via cGMP but the exact underlying mechanism is not yet fully understood. PMID- 3538777 TI - Tolerance development as a pharmacological and clinical problem. AB - Two main forms of acquired pharmacological tolerance may be distinguished, dispositional (pharmacokinetic) and pharmacodynamic. Pharmacodynamic tolerance is common, and can in many cases be attributed to adaptive receptor changes. Such changes of beta-adrenoceptors have been extensively studied and widely used as models for explaining the mechanisms of tolerance development. The mechanisms behind tolerance to adrenoceptor agonists are discussed, and also tolerance development to these and some other agents when used in the treatment of asthma, uterine hyperactivity and congestive heart failure. PMID- 3538778 TI - Clinical pharmacological aspects on nitrate tolerance. AB - There is strong evidence that nitrate tolerance develops rapidly during repeated administration in the systemic resistance vascular bed and that there exists cross tolerance between different nitrates. There are divergent opinions on how tolerance in the systemic capacitance and the pulmonary vascular bed develops. This may be explained by real differences in tolerance development in ischemic heart disease and congestive heart failure but also by the use of several different preparations of nitrates in the studies performed. Available data on the pharmacokinetics of nitrates present a complex picture with highly variable bioavailability, clearance and apparent volume of distribution both inter- and intraindividually. It is suggested that nitrate tolerance should be studied in very homogeneous groups of patients with well defined hemodynamics. The nitrate used should have a very short half-life allowing for simulation of various modes of administration by intravenous infusion. PMID- 3538779 TI - Nitrate tolerance in angina pectoris. AB - A review of the current literature concerning development of nitrate tolerance in the treatment of angina pectoris suggests that: development of nitrate tolerance is a clinical reality development of tolerance do not seem to differ for nitroglycerin, isosorbide-dinitrate or isosorbide-5-mononitrate a high nitrate dose seems to be more likely to induce tolerance a nitrate free interval during some part of the day or the night seems to restore vascular responsiveness by optimal use of different nitrate formulations the problem with development of tolerance may be reduced. PMID- 3538780 TI - Development of tolerance to nitrate therapy in chronic congestive heart failure. AB - In several studies the nitrate effects on central hemodynamics during less than 24 hours have been evaluated in heart failure. Higher doses than in angina have been used. A pronounced response is seen acutely. An attenuation has been reported after 12-24 hours. A relation to continuous (intravenous, transdermal) administration of nitroglycerin has been proposed, but it is not clear. During chronic treatment with ISDN a tolerance is not obvious within 12 weeks. The heart failure patient has a different neurohumoral situation compared to angina patients. This could be one reason for differences in tolerance development during nitrate therapy. PMID- 3538781 TI - Nitrate therapy today. AB - A review of nitrate therapy including a short summary of their physiological effects is presented. Both cardiac and non-cardiac indications are reviewed including esophageal spasm, spasm of bile ducts and urinary tract, Raynaud's disease, pulmonary hypertensive disorders, portal hypertension, bronchial asthma, and effect on arrhythmias. PMID- 3538782 TI - Digital pulse plethysmography (DPG) in studies of the hemodynamic response to nitrates--a survey of recording methods and principles of analysis. AB - Digital pulse plethysmography (DPG) has proved a technically simple, noninvasive, sensitive and informative technique for studying the effects of nitroglycerin and other nitrates on peripheral arteries. The importance of performing nitrate evaluation by DPG mainly in elderly subjects is emphasized. On the basis of observations with DPG some indirect conclusions on the effect of nitrates on the coronary arteries are justified. A review, with recommendations based on own experience, is given of various recording techniques and principles of evaluating quantitatively the digital volume pulse contour, with special reference to the influence of nitrates on the position and appearance of dicrotism. DPG seems to be a convenient, noninvasive and helpful procedure in studies on the development of nitrate tolerance. PMID- 3538784 TI - [Synthesis of 2,7-dimethyl(2,3f)benzofurane-3-carboxylic acid derivatives with potential pharmacologic activity. II]. PMID- 3538783 TI - Potentiation of insulin release in response to amino acid methyl esters correlates to activation of islet glutamate dehydrogenase activity. AB - Column perifusion of mouse pancreatic islets was used to study the ability of amino acids and their methyl esters to influence insulin release and activate islet glutamate dehydrogenase activity. In the absence of L-glutamine, L-serine and the methyl ester of L-phenylalanine, but neither L-phenylalanine nor L-serine methyl ester, stimulate insulin secretion. In the presence of L-glutamine, however, the effect of L-serine was additive, while the methyl esters of L-serine and L-phenylalanine as well as native L-phenylalanine, potentiated the glucose stimulated release of insulin. Measurements of islet glutamate dehydrogenase activity showed that only the two methyl esters of L-phenylalanine and L-serine activated the enzyme. It is concluded that the mechanism by which methyl esters of amino acids potentiate insulin release is most likely to be mediated by the activation of pancreatic beta-cell glutamate dehydrogenase activity. PMID- 3538785 TI - Psychosocial aspects of coronary heart disease. AB - Attention is drawn to studies which throw doubt upon the importance of nutrition and smoking in the etiology of coronary heart disease (CHD). The main part of the review deals with psychosocial research in the field of CHD. A number of studies show that there is a clearcut association between life style, life events, social class, economic cycles, culture and CHD. The modern coronary epidemic is related to the economic boom which the US experienced during the 1940-60s and which followed a decade later in Western Europe. The later decline of CHD is related to the economic stagnation that took place in the US at the end of the 1960s. Obviously, risk factors must be seen in a cultural perspective, and the moderating effects of social support should be taken into account. PMID- 3538786 TI - Double-blind efficacy and safety study comparing adinazolam mesylate and placebo in depressed inpatients. AB - In a 6-week, randomized, double-blind study, adinazolam mezylate (Deracyn Tablets, The Upjohn Company) was compared with placebo for the treatment of depression in 80 inpatients who met the criteria for single episode or recurrent DSM-III Major Depression. Subjects were admitted to the hospital 3 days before the start of the study and remained hospitalized for at least the first week of treatment. Efficacy was evaluated after 2, 4, 7, 14, 28, and 42 days of treatment. Adinazolam was significantly superior to placebo on all observer-rated and all global patient-rated measures of efficacy. Twenty-five subjects (63%) completed 6 weeks of adinazolam treatment and of these, 88% responded within 7 days. Only 15 placebo-treated subjects (38%) completed the study. Drowsiness and mild to moderate cognitive complaints were the only side effects observed more frequently with adinazolam, and both were transient. The results show that adinazolam is safe and more effective than placebo for the treatment of major depression. PMID- 3538787 TI - Immunoreactive parathyroid hormone and serum insulin levels in patients on maintenance hemodialysis. PMID- 3538788 TI - Anticancer drug sensitivity by human tumor clonogenic assay. AB - The anticancer drug sensitivity of human cancers was tested by the human tumor clonogenic assay (HTCA). Of 152 human cancer specimens tested, 63 (41%) formed more than 30 tumor cell colonies in control plates and could be used to evaluate the drug sensitivity of tumor cells. In 42 (93%) of 45 clinical trials in 24 patients, a parallel correlation was observed between the in vitro anticancer drug sensitivity measured by the HTCA and the clinical response of tumors to anticancer drugs. These results suggest that the HTCA is a good technique for the in vitro test of the anticancer drug sensitivity of human cancers. PMID- 3538790 TI - Magnetic Resonance Imaging (MRI) stereotaxis using the Patil System. A technical note. AB - Magnetic Resonance Imaging (MRI) scanning would prove useful for lesions that are not visualized on computed tomography (CT) scan or are better defined on MRI scan. The problem of reference marker visualization can be overcome by coating them with mineral oil or by placing paramagnetic fluid filled rods on them. The unique construction of the Patil System permits its use even in a strong magnetic field. The technique of MRI stereotaxis using this stereotaxic system without any modification is described. PMID- 3538789 TI - Prevention of vasospasm in subarachnoid haemorrhage. A controlled study with nimodipine. AB - A prospective randomized double blind study was conducted in 70 patients suffering from subarachnoid haemorrhage, due to aneurysm rupture, to determine if the use of nimodipine reduces the severity of ischaemic deficits secondary to vasospasm. At the end of the study, two patients had severe deficit or died in the treated group, while 10 had a bad outcome in the placebo group. Angiographic vasospasm was not significantly different in its frequency or its severity between the two groups. However, the association of extensive and diffuse vasospasm was less frequent in the nimodipine group. This study confirms the effectiveness of Nimodipine in reducing the occurrence of neurological deficit due to vasospasm, even if this action is not observed in all cases. PMID- 3538792 TI - [Adhesive restorative dentistry. Posterior composites]. PMID- 3538791 TI - [Anxiety in clinical practice and its treatment]. PMID- 3538793 TI - [Bonded veneer structures. Applied fundamental concepts. Protocol for standard mechanical trials]. PMID- 3538794 TI - [The compo-metal inlay-onlay: unit restoration and methods of anchoring bridges]. PMID- 3538795 TI - [Testing a photopolymerizable material for construction of complete denture bases]. PMID- 3538796 TI - [New materials for artificial teeth. Technical and clinical study]. PMID- 3538797 TI - [Use of screws in bonded esthetic dentistry]. PMID- 3538798 TI - [The horizontal insertion bonded bridge (HIBB). Clinical illustration]. PMID- 3538799 TI - Effect of drug therapy on survival in chronic heart failure. PMID- 3538800 TI - Physical training in patients with ventricular impairment. Benefits/limitations- open questions. PMID- 3538801 TI - Prognostic value of left ventricular dysfunction at rest and during exercise in patients with coronary artery disease. PMID- 3538802 TI - Assessment for prognosis during and after myocardial infarction. A plea for a stratified approach. AB - Right after the first signs and symptoms of acute myocardial infarctions the prognosis is determined by the interventions which are carried out at that time. Preservation of as much myocardial tissue is the key element. Early deobstruction and reperfusion of the myocardium at jeopardy can lead to limitation of the ultimate infarct size, improved ventricular function and a halving of the 1-year mortality. Early supportive therapy with beta-blockade and calcium antagonists may enhance this effect. Data in 533 patients randomized to either a reperfusion strategy or to conventional therapy, combined with those from the recent literature on thrombolysis and early beta-blockade, provide the basis for this point of view. Once infarction is unavoidable and in the process of completion, probably 3-4 h after onset of symptoms, only supportive therapy is recommended, which will hardly change the outcome except for interventions during clinical care such as defibrillation. In 351 other survivors of myocardial infarction the value of clinical variables, a symptom-limited bicycle stress test at discharge, radionuclide ventriculography and 24-hour ambulatory electrocardiogram was compared in predicting 1-year survival. A history of previous myocardial infarction and heart failure during the current episode proved to be the strongest clinical predictors of death. Similarly, a low ejection fraction (less than 40%) and an insufficient blood pressure rise during stress testing (less than 30 mm Hg) identified a high risk group. Stress-test-induced angina and ST depression as well as ventricular arrhythmias from 24-hour electrocardiography were less good as predictors. In these patients treatment should be individualized and may require arteriography. Patients eligible for and completing a normal bicycle stress test after myocardial infarction proved to be a low risk group, which may constitute 65% of the total, seen in tertiary referral centers and even more in community hospitals. They neither require therapy nor further investigation. A subgroup with an intermediate risk can be identified when clinical variables, stress testing and/or resting radionuclide ventriculography are abnormal. This group requires 'tailored' therapy. Therefore, after infarction recovery, we recommend a pre-discharge stress test routinely to complement the clinical evaluation, since it also provides information on physical capacity, the indication of arrhythmias and the presence of myocardial ischemia. Thus, optimal management of acute myocardial infarction requires a stratified approach, which does not require expensive testing procedures. PMID- 3538803 TI - Late effects of coronary reperfusion on regional left ventricular function. Can infarct size be estimated noninvasively? AB - The prognosis of patients with acute myocardial infarction is related to the infarction size. We evaluated the ability of a clinical technique, two dimensional echocardiography, to assess infarct size based on the extent of regional contraction abnormalities. Conscious closed-chest dogs with preplaced coronary snares underwent permanent coronary occlusion. The animals were studied by two-dimensional echo 20 min and 2 days after occlusion. The extent of myocardial contraction abnormalities (systolic wall thinning instead of normal systolic thickening) was correlated with the infarct size determined pathologically. Some dogs had pressure-induced left ventricular hypertrophy. Extent of regional contraction abnormalities demonstrated by two-dimensional echo correlated well with infarct size both early (20 min) (r = 0.92) and late (2 days) (r = 0.94) after permanent coronary occlusion. Dyskinesis extent modestly overestimated the infarct size. The relationship between dyskinesis and infarct size were similar in both normal and left ventricular hypertrophied hearts. We then undertook a study to assess the effects of coronary reperfusion on dyskinesis-infarct size relationships. Conscious, closed-chest dogs underwent 1-2 h of coronary occlusion followed by 2-10 days of coronary reperfusion. Significant regional dyskinesis was present after 1-2 h of occlusion and decreased by 50-60% of the occlusion value after 2 days of reperfusion without further change in extent of dyskinesis between 2 and 10 days of reperfusion. Of importance, however, was that there was no significant correlation between infarct size and extent of regional dyskinesis by two-dimensional echo after reperfusion, either after 2 days (r = 0.09) or 10 days (r = 0.29) of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538804 TI - Iterative cardiac catheterization: usefulness and limitations in follow-up studies. PMID- 3538805 TI - Pneumocystis carinii pneumonia. PMID- 3538807 TI - The diagnosis and definition of the acquired immunodeficiency syndrome. PMID- 3538806 TI - Liposome targeting to macrophages: opportunities for treatment of infectious diseases. PMID- 3538808 TI - Role of the substantia nigra in the kindling model of limbic epilepsy. PMID- 3538809 TI - Alterations in extracellular amino acids and Ca2+ following excitotoxin administration and during status epilepticus. PMID- 3538810 TI - Long-term alterations in amino acid-induced ionic conductances in chronic epilepsy. AB - Extracellular free sodium (Na+)o and calcium (Ca2+)o concentration changes were measured in the rat motor cortex, using ion-selective microelectrodes. During ionophoretic applications of excitatory amino acids, decreases in (Na2+)o and in (Ca2+)o were observed. Ca2+ signals were not or very little modified by applications of tetrodotoxin while Na+ signals were slightly depressed, up to 20%. Laminar profile analysis revealed that, while the magnitude of Na+ signals was rather constant throughout the cortex, Ca2+ signals were largest in upper cortical layers. Lesioning and pharmacological experiments indicated that the corresponding permeabilities were most probably located on apical dendrites of pyramidal tract neurons. The relative amplitude of Na+ and Ca2+ signals induced by the release of the glutamate agonists N-methyl-D-aspartate, quisqualate and kainate and the shape of the laminar profile of such responses indicated that different ionic permeabilities located on different neurons underlie such responses. Similar experiments performed on chronic epileptogenic motor foci in rats indicated that the amino acid-induced ionic responses were altered. The significance of such alterations for epileptogenesis is discussed. PMID- 3538811 TI - Excitatory amino acids and epilepsy-induced changes in extracellular space size. AB - Convulsant and stimulus induced seizures are associated with Ca, Na, K and Cl concentration changes in the extracellular space (ES), which are a resultant of transmembrane ionic fluxes and of changes in the ES size. The ES decreases on average by 30% during a single seizure. An analysis of the causes of ES size changes reveal a large contribution from the spatial glia K buffer mechanism which may account for up to 60% of the ES decreases. NaCl and KCl uptake into cells as well as increases in intracellular osmolarity due to anaerobic glycolysis contribute less to the local cytotoxic edema but account for a net gain of osmotic active particle at the site of the focus. Excitatory amino acids such as glutamate, aspartate, N-methyl-D-aspartate (NMDA), kainate and quisqualate also lead to Na, Cl and eventually Ca uptake into cells and to release of K with dose dependent decreases in [Na]o, [Ca]o and [Cl]o, increases in [K]o and transient decreases in ES size by up to 80% which are possibly associated with a net reduction of osmotically active particles. The predominant cause for this cytotoxic edema is NaCl uptake into cells but spatial K buffering through glial cells also contributes to this type of edema. The possible consequences of the various ion movements and the changes in osmolarity as well as ES size for tissue vulnerability are discussed. PMID- 3538812 TI - Effects of kainate on CA1 hippocampal neurons recorded in vitro. PMID- 3538813 TI - Characterization of glycoproteins: carbohydrate structures of glycoprotein hormones. PMID- 3538814 TI - Characterization of a sperm membrane glycoprotein. PMID- 3538815 TI - Chromatin structure and gene expression in germ line and somatic cells. PMID- 3538816 TI - Mammalian gene transfer and gene expression. PMID- 3538817 TI - Biosynthetic controls that determine the branching and microheterogeneity of protein-bound oligosaccharides. PMID- 3538818 TI - Immunological regulation of hematopoietic/lymphoid stem cell differentiation by interleukin 3. PMID- 3538819 TI - The eosinophilic leukocyte: structure and function. AB - The evidence reviewed here indicates that the eosinophil has the ability to kill many species of helminths and likely does so during worm infection. This toxic ability appears to be regulated by several other cells including mast cells, monocytes, and T lymphocytes. Eosinophils kill helminths through their ability to generate potent oxidants and through their content of cationic proteins, which likely achieve high concentrations at points of granule deposition. Eosinophils also participate in inflammation in human disease especially asthma, skin diseases, and heart disease. Though present concepts hold that the mast cell is the cornerstone of the allergic inflammatory response (450), the findings that eosinophils bind IgE and are activated by antigen-IgE complexes and that the eosinophil can elaborate many inflammatory mediators raise the possibility that the eosinophil might also be involved in the initiation of inflammatory responses. Finally, an eosinophil-related protein appears to play an undefined role in human reproduction. PMID- 3538820 TI - Idiotypic interactions in the treatment of human diseases. PMID- 3538821 TI - Neuroimmunology. PMID- 3538822 TI - Antigen presentation by B cells and its significance in T-B interactions. PMID- 3538823 TI - Organic mercury compounds and their toxicity. PMID- 3538825 TI - Pseudobursae: a useful finding in patients with painful hip arthroplasty. AB - A retrospective review of 178 consecutive subtraction hip arthrograms (175 patients) was performed to evaluate the significance of cavities or bursal communications (or both) with the pseudocapsule in patients with painful hip arthroplasty. Bursae and/or communicating cavities were shown in 75 (43%) of the 175 patients. Communicating irregular cavities were noted in 12 patients (nine infected), and smooth bursae or bursalike structures were noted in 63 patients. The most frequent bursal locations were the greater trochanteric region (32/63), supraacetabular region (18/63), and iliopsoas (12/63). Three patients had multiple bursae. Six of the 18 acetabular bursae were associated with previous dislocations. Twenty-seven patients with bursae had no radiographic findings of loosening or infection. Of these 27, 12 (44%) responded to local injection of anesthetic into the bursa and were judged clinically to have bursitis. Arthrography, with aspiration from the bursae or cavities and injection of anesthetic, provides additional information regarding painful hip arthroplasty and may prevent unnecessary surgery. PMID- 3538826 TI - Sonographic localization of hematomas in hemophilic patients with positive iliopsoas sign. AB - Sonography was performed on 23 hemophilic patients presenting with positive iliopsoas sign. In 21 of these patients sonography confirmed the presence of hematomas. Comparison of the presumed clinical location and the sonographic location, however, revealed a significant discrepancy. Only seven of 15 hematomas that were clinically suspected to be in the iliopsoas muscle were confirmed by sonography at that location. Of the remaining cases, three were localized in the hip joint, one in the proximal thigh, one in the abdominal wall, and one in the iliac fossa. Hemorrhage was not found in two cases. This study indicates that sonography provides valuable information about the site of hematoma in these patients. PMID- 3538824 TI - Bone marrow depression due to mianserin, phenylbutazone, oxyphenbutazone, and chloramphenicol--Part II. PMID- 3538827 TI - MR imaging of gallbladder carcinoma. PMID- 3538828 TI - Significance of membrane thickness in the sonographic evaluation of twin gestations. AB - A retrospective study of 55 twin pregnancies was performed to determine the role of sonography in distinguishing between dichorionic and monochorionic diamniotic gestations solely by evaluating the thickness of the membrane between the fetuses. The presence of a thick dividing membrane indicated a dichorionic diamniotic gestation in 38 (90%) of 42 cases in which it was identified. Inability to identify a membrane between dichorionic diamniotic twins occurred most commonly during the third trimester. A thin membrane indicated monochorionic diamniotic twinning and was seen in three (25%) of 12 cases. Membrane thickness was indeterminate in one case. Therefore, on the basis of the thickness of the dividing membrane imaged by sonography, dichorionic diamniotic gestations can be distinguished from monochorionic diamniotic gestations. Inability to show a separating membrane by sonography, however, can occur with any form of twin gestation, particularly in the third trimester. Membrane thickness should be used in conjunction with other sonographic criteria to predict the amnionicity and chorionicity of twin gestations. PMID- 3538829 TI - Severe polyhydramnios: incidence of anomalies. AB - The sonograms of 195 singleton pregnancies complicated by polyhydramnios were reviewed, and follow-up information was obtained on 191 patients. A grading system was developed that differentiated mild from severe polyhydramnios using real-time or static sonographic equipment. Mild polyhydramnios was present in 138 (71%), and severe polyhydramnios was present in 57 (29%). Previously it has been reported that 60% of cases of polyhydramnios are idiopathic and the pregnancies have a normal outcome. Twenty percent are associated with maternal abnormalities and 20% are associated with fetal anomalies. In this study, pregnancies with severe polyhydramnios had a much greater prevalence of fetal anomalies (75%) than pregnancies with mild polyhydramnios (29%). The 57 singleton pregnancies with severe polyhydramnios were analyzed in depth. Fourteen (25%) of the fetuses were normal; 43 (75%) had significant congenital abnormalities that predominantly involved the CNS, gastrointestinal tract, heart, and genitourinary tract. In all fetuses with primary CNS abnormalities, polyhydramnios was diagnosed at or before 30 weeks of gestation, while in most of the fetuses (83%) with gastrointestinal abnormalities it was diagnosed after 30 weeks. Sonographic findings correlated closely with the findings noted at birth or autopsy. In patients with severe polyhydramnios, normal sonograms were sensitive in excluding major congenital anomalies and, thus, were helpful in providing the parents with favorable prognoses. Sonograms should be performed in patients with polyhydramnios to identify congenital anomalies and to provide information regarding prognosis for fetal outcome. PMID- 3538830 TI - Memorial tribute to Russell H. Morgan, 1911-1986. PMID- 3538832 TI - Spontaneous resolution of neonatal ovarian cysts. PMID- 3538833 TI - An overview of informed consent for radiologists. AB - Because of the procedure-oriented nature of their specialty, radiologists obtain informed consent from patients daily. This paper attempts to help the radiologist obtain informed consent without incurring malpractice liability by discussing the important legal concept of simple consent as distinguished from informed consent, the elements a patient must prove to succeed in court with an allegation of lack of informed consent, the varying state requirements about the amount of information the patient must be given, the persons who must obtain consent from the patient, and the persons who can give consent for the patient. Consent for IV injections of contrast medium and consent forms are discussed because of the current controversy on these subjects. Courts and state legislatures have usually addressed only specific aspects of informed consent. However, except for the amount of information that must be given the patient, the courts have been relatively uniform in their requirements. Therefore, it is likely that a state court faced with issues of informed consent about which no law exists in their own state will use the existing law in other states as a precedent and adopt similar rules. However, each radiologist must be familiar with the specific rules for informed consent that have been developed by the courts and legislatures in the state in which he or she practices. PMID- 3538831 TI - Sonographic spectrum of placental abruption. AB - Fifty-seven cases of placental abruption detected by sonography were retrospectively reviewed. The location of hemorrhage was subchorionic in 46 cases (81%), retroplacental in nine cases (16%), and preplacental in two cases (4%). Subchorionic hematomas were more frequently shown in the 33 patients presenting before 20 menstrual weeks (91%) than in the 24 patients presenting after 20 weeks (67%). The echogenicity of hemorrhage depended on the time the sonogram was performed relative to the onset of symptoms: Acute hemorrhage was hyperechoic to isoechoic compared with the placenta, while resolving hematomas became hypoechoic within 1 week and sonolucent within 2 weeks. Acute hemorrhage was occasionally difficult to distinguish from the adjacent placenta. This occurred in five retroplacental hematomas that showed only an abnormally thick and heterogeneous placenta. Nine cases of placental abruption were initially confused with other mass lesions. Placental abruption causes a wide spectrum of sonographic findings that may be overlooked or misdiagnosed. PMID- 3538835 TI - CT and sonography of advanced urinary tract tuberculosis. AB - Sonographic and Ct examinations were performed prospectively on 14 patients with advanced urinary tract tuberculosis who had undergone serial urography. Sonography and CT showed abnormalities in the affected kidney in each patient. Detailed morphologic information (patterns of calcification and hydronephrosis) and functional status (nephrogram and urogram) were better shown by CT than by urography; sonography showed the fewest morphologic details. CT is probably at least as accurate as urography in detecting advanced urinary tuberculosis; sonography appears to be less accurate than either CT or urography. PMID- 3538834 TI - Sonography in the follow-up of 100 patients with thyroid carcinoma. AB - High-frequency, high-resolution sonography was used to detect recurrent thyroid carcinoma in 73 patients with papillary carcinoma, 16 with medullary carcinoma, 10 with follicular carcinoma, and one with small-cell carcinoma. Of the 36 patients with negative sonograms, 35 had no other evidence of recurrence, while one had surgical proof of recurrence. Of 25 patients with positive sonograms, confirmed with surgery or radioactive iodine (I131) scanning (sonographic sensitivity 96%, specificity 83%), palpation was negative in 17 (palpation sensitivity 32%, specificity 100%). Thirty-two patient with positive sonographic findings had no objective clinical proof of recurrence. There were seven false positive studies. This study suggests that sonography may be the method of choice for earliest detection and localization of recurrent carcinoma of the thyroid. PMID- 3538836 TI - Exercise in children before and after coarctectomy: hemodynamic, echocardiographic, and biochemical assessment. AB - After repair of coarctation of the aorta, some patients with normal blood pressure at rest have an exaggerated hypertensive response to activity. Blood pressure response to exercise was studied in 15 children, aged 5 to 15 years, prior to and at periods up to 6 months following coarctectomy. Preoperatively, 11 of 15 children had systolic hypertension at rest and 12 of 15 after exercise. After surgery, only one child had mild systolic hypertension at rest, whereas exercise-induced hypertension persisted in 33% of patients (all older than 10 years). Exercise plasma renin activity was elevated preoperatively but normalized following surgery. No significant difference was seen in resting and exercise plasma catecholamine levels measured before and after surgery. Over the follow-up period of 6 months, echocardiographic evidence of left ventricular hypertrophy regressed in the younger patients but not in the older patients with exercise induced hypertension. Exercise testing defines a subgroup of patients with exercise-induced hypertension evident soon after surgery. Structural upper segment arterial vessel wall changes in the older patient may explain these observations. PMID- 3538837 TI - Digital subtraction angiography in the diagnosis of vascular rings. AB - Digital subtraction angiography was performed in six patients suspected of having a vascular ring. There were four males and two females. Two patients were less than 6 months of age, two were between 14 and 20 months, and two were ages 4 and 53 years. Four of the six patients had abnormal esophagrams. Five patients underwent peripheral intravenous digital subtraction angiography and a sixth patient underwent digital subtraction angiography via arterial catheterization. In two patients (ages 20 months and 4 years), the presence of a vascular ring was excluded by demonstrating an anatomically normal arch with an anomalous right subclavian artery. In three patients, a right aortic arch was present. Two of these patients had mirror image branching and a left ligamentum arteriosum. The third patient had an aberrant left subclavian artery and a left ligamentum. One patient had an anomalous right subclavian artery and a systemic collateral vessel arising from the aorta, supplying a confluence of vessels in the right lung hilum. In all patients, anatomic definition was accurate with the intravenous injection and there were no complications. In the patient who underwent intra arterial injection, the dose of contrast was reduced 50% from the dose usually administered. Digital subtraction angiography appears to be a good adjunctive diagnostic method in patients in whom the presence of a vascular ring needs to be confirmed angiographically and obviates the need for arterial catheterization. PMID- 3538838 TI - Mitral valve prolapse: multifactorial etiologies and variable prognosis. PMID- 3538839 TI - Prevalence, incidence, and hazards of hypertension in the elderly. PMID- 3538840 TI - Some good cardiologic books published in 1986. PMID- 3538841 TI - Isomeric fatty acids in the US diet: levels and health perspectives. AB - Data on market size, market share, and compositional changes of various products made from partially hydrogenated fats and oils were used to estimate current, previous, and predicted levels of trans fatty acids in the US diet. Recent literature and various perceptions of the toxicological, physiological, and nutritional effects of trans fatty acids were reviewed. Trans acid availability has changed little during the last 15-20 yr and currently is estimated to be approximately 7.6 g X person-1 X day-1. Modest decreases in total fat intake, including trans fatty acid intake, may occur in the future if consumers adopt certain dietary recommendations. We believe that concerns about possible relationships of trans fatty acids to development of atherosclerotic disease or cancer are not supported by reliable data. Numerous literature accounts support the conclusion that trans fatty acids do not pose any harm to humans or animals consuming a balanced diet containing adequate linoleic acid. PMID- 3538842 TI - Some metabolic effects of overeating in man. AB - Metabolic responses to 20 days of overeating were examined in five healthy volunteers. Overfeeding caused a variable increase (1-18%) in basal metabolic rate but no change in metabolic rate during light exercise. Postprandial resting metabolic rate was 8-40% higher (mean 18%) during overeating. The increase in oxygen consumption during a norepinephrine infusion was the same before (20 +/- 2%) and after (17 +/- 3%) overfeeding. Overfeeding elevated basal insulin concentrations in all subjects and increased the insulin response to intravenous glucose in four of five subjects. Overfeeding did not significantly alter mean serum T3 concentrations or erythrocyte 86Rb uptake (an index of Na+,K+-ATPase activity). These data do not confirm reports that overfeeding increases metabolic rate more during exercise than during rest. They also suggest that the increase in resting metabolic rate during overfeeding is not caused by increased responsiveness to norepinephrine or increased serum T3 concentrations. PMID- 3538843 TI - The effect of protein ingestion on the metabolic response to oral glucose in normal individuals. AB - Eight normal subjects were given 50 g protein, 50 g glucose, or 50 g protein + 50 g glucose. Plasma glucose, insulin, C-peptide, glucagon, alpha-amino nitrogen (AAN), and nonesterified fatty acid (NEFA) responses were then determined over 4 h. Protein stimulated only a modest insulin rise and the area above fasting baseline was only 28% of that after glucose. The sum of the serum insulin area following protein ingestion and that following glucose ingestion was 100.4% of the combination meal. C-peptide changes confirmed the insulin response. The addition of glucose to the protein meal resulted in a 60 min delay in glucagon and AAN rise compared to the protein meal alone. Subsequently AAN and glucagon increased to levels greater than or equal to those observed after protein ingestion alone. In summary, protein is a much less potent secretagogue for insulin than is glucose in normal individuals, and the effect on insulin secretion is not synergistic. Addition of glucose to a protein meal results in a delayed rise in AAN and glucagon concentrations in normal subjects. PMID- 3538844 TI - Hyperglycemic complications associated with adjuvant chemotherapy of breast cancer. A cancer and leukemia group B (CALGB) study. AB - Many adjuvant chemotherapy regimens used for breast cancer include prednisone, which has the potential to cause hyperglycemia. We reviewed the results of three CALGB studies employing prednisone as part of adjuvant therapy to determine the incidence and severity of hyperglycemic complications. All treatment regimens included cyclophosphamide, methotrexate or doxorubicin, 5-fluorouracil, and vincristine in addition to prednisone. Among 1,237 evaluable patients receiving a five-drug regimen including prednisone, there were 98 patients (7.9%) who experienced any degree of hyperglycemia. Thirty patients (2.4% overall; 30.6% of those having any hyperglycemia) had severe or life-threatening degrees of hyperglycemia, including two patients whose hyperglycemia contributed directly to death. We conclude that prednisone administration as part of adjuvant chemotherapy regimens in breast cancer produces an appreciable incidence of hyperglycemia. Serum glucose levels should be monitored during therapy to help prevent the occasional severe or life-threatening episode of hyperglycemia in these patients. PMID- 3538845 TI - An overlapping syndrome of IgA nephropathy and lipoid nephrosis. AB - The authors studied eight cases of IgA nephropathy presenting with nephrotic syndrome. Renal biopsy revealed only mild mesangial proliferation or minor glomerular changes on light microscopic examination but typical features of IgA nephropathy on immunofluorescent and electron microscopic examination. A satisfactory response characterized by correction of hypoalbuminemia, clearance of proteinuria, and an increase of endogenous creatinine clearance occurred with corticosteroid therapy. These cases represent a variant of IgA nephropathy associated with a nephrotic syndrome that resembles lipoid nephrosis in its responsiveness to steroid. PMID- 3538846 TI - Enumerating T-cell subsets on blood smears. An evaluation of an indirect immunoalkaline phosphatase method. AB - Peripheral blood T-lymphocyte subsets in 179 Chinese subjects were enumerated by an indirect immunoalkaline staining method done on ordinary blood smears. Absolute counts (X 10(9)/L) were 1.32 +/- 0.53 (T11), 0.73 +/- 0.31 (T4), 0.45 +/ 0.22 (T8) for males (n = 135) and 1.22 +/- 0.39 (T11), 0.69 +/- 0.20 (T4), 0.44 +/- 0.19 (T8) for females (n = 44). T4:T8 ratio for males and females were 1.79 and 1.58, respectively (0.05 less than P less than 0.10). Within-film area-to area difference was 4.2 +/- 2.1% (n = 537 films). Interobserver discrepancy was 54 per 3,000 cells counted, or 1.8%. Film-to-film difference was 5.4 +/- 2.6% (30 pairs). T-lymphocyte subsets enumeration by immunostaining blood smears is a simple and reliable alternative to the immunofluorescence method. It avoids procedures that could artifactually affect lymphocyte subsets. The lower T4:T8 ratios revealed in this study could result because of technical reasons. PMID- 3538847 TI - Use of the RIM Escherichia coli Kit for rapid identification of Escherichia coli. AB - The Rapid Identification Method (RIM) Escherichia coli Kit (Austin Biologicals Laboratories Inc., Austin, TX) was evaluated as a means to rapidly differentiate at reduced cost clinical isolates of Escherichia coli from other members of the Enterobacteriaceae. A group of 408 gram-negative rods that were isolated on primary isolation plates were tested with the use of both the kit and complete bacterial identification. The RIM E. coli Kit identified 92.5% (272 of 294) of the E. coli isolates. Only 1 of 114 non-E. coli isolates was misidentified as E. coli (positive predictive value equal to 99.6). Although the RIM E. coli Kit was sufficiently rapid (less than one hour), any supply cost savings would depend upon the proportion of true E. coli in the group of organisms tested. Savings derived from the lower cost of using the RIM E. coli Kit would be reduced by the extra cost of screening non-E. coli isolates, which would then have to be completely identified. PMID- 3538848 TI - Can microscopic screening be used to determine the suitability of sputum for culture of Haemophilus species? AB - Sputum specimens with less than 25 squamous epithelial cells per low-power field were also examined microscopically for the presence of alveolar macrophages and Haemophilus-like organisms and cultured for Haemophilus species. The isolation of Haemophilus species was considered to be clinically significant in 11 of 13 (84.6%) specimens containing greater than or equal to 2+ alveolar macrophages (at least 1 alveolar macrophage/high-power field) and predominant Haemophilus-like organisms (greater than or equal to 12 Haemophilus-like organisms/oil immersion field); in 12 of 27 (44.4%) specimens with greater than 2+ alveolar macrophages and few, if any, Haemophilus-like organisms; and in only 1 of 20 (5%) specimens with few, if any, alveolar macrophages and Haemophilus-like organisms. It was concluded that only sputum specimens with either greater than or equal to 2+ alveolar macrophages or predominant Haemophilus-like organisms or both should be candidates for culture of Haemophilus species. PMID- 3538849 TI - Forensic medicine in Japan. PMID- 3538850 TI - "Scared to death". PMID- 3538851 TI - Gastrointestinal consequences of the eating disorders: anorexia nervosa and bulimia. PMID- 3538852 TI - Drug therapy of gastrointestinal parasitic infections. The ACG Committee of FDA related matters. PMID- 3538854 TI - Use of cancer controls in case-control cancer studies. PMID- 3538853 TI - High plasma cholecystokinin levels in patients with chronic pancreatitis having abdominal pain. AB - Plasma cholecystokinin (CCK) responses after ingestion of a test meal in patients with mild chronic pancreatitis having abdominal pain were studied with a radioimmunoassay using the CCK specific antiserum (OAL-656) produced by a novel immunization procedure. Mean concentration of the fasting plasma CCK determined using CCK-8 as a standard was 31.5 +/- 5.8 pg/ml in six patients who had mild impaired exocrine function with pain, and was significantly higher than 10 healthy subjects (9.8 +/- 1.8 pg/ml). In those patients, the ingestion of a liquid test meal led to a peak of 75.1 +/- 25.4 pg/ml at 30 min, and the 120-min integrated CCK response (5427 +/- 1217.3 pg X min/ml) was significantly higher than in healthy subjects (1538 +/- 110.1 pg X min/ml). PMID- 3538855 TI - Studies of risk factors for aminoglycoside nephrotoxicity. AB - The epidemiology of aminoglycoside-induced nephrotoxicity is not fully understood. Experimental studies in healthy human volunteers indicate aminoglycosides cause proximal tubular damage in most patients, but rarely, if ever, cause glomerular or tubular dysfunction. Clinical trials of aminoglycosides in seriously ill patients indicate that the relative risk for developing acute renal failure during therapy ranges from 8 to 10 and that the attributable risk is 70% to 80%. Further analysis of these data suggests that the duration of therapy, plasma aminoglycoside levels, liver disease, advanced age, high initial estimated creatinine clearance and, possibly, female gender all increase the risk for nephrotoxicity. Other causes of acute renal failure, such as shock, appear to have an additive effect. Predictive models have been developed from these analyses that should be useful for identifying patients at high risk. These models may also be useful in developing insights into the pathophysiology of aminoglycoside-induced nephrotoxicity. PMID- 3538856 TI - Cyclosporine nephrotoxicity: pathogenesis, prophylaxis, therapy, and prognosis. AB - Although cyclosporine (CsA) therapy has improved the outcome of allotransplantation, drug-induced nephrotoxicity presents a potentially serious complication in a significant proportion of patients. The nephrotoxic injury, which may present acutely in the peritransplant period, subacutely in the first few months, or chronically, may be caused by toxic effects at various levels of the nephron: arteriole, glomerulus, and/or proximal tubule. The nephrotoxic picture of decreased glomerular filtration rate, impaired urea secretion, hyperkalemia, hypertension, and tubular dysfunction with preserved sodium reabsorption occurs not only in the renal allotransplant setting, wherein it obscures the diagnosis of rejection, but also in recipients of other grafts and patients under treatment for autoimmune disease. Because conversion from CsA to other immunosuppressive agents carries a high risk of rejection and allograft loss (or recrudescence of autoimmune disease), the present management strategy uses cautious CsA does reduction with concomitant institution of full-dose azathioprine (Aza) therapy. Definition of pharmacokinetic and pharmacodynamic properties that predict patients at risk for nephrotoxic complications may lead to new CsA dosing regimens yielding an improved therapeutic index. PMID- 3538857 TI - Limitations of creatinine in quantifying the severity of cyclosporine-induced chronic nephropathy. AB - The glomerular filtration rate (GFR), as measured by the clearance of inulin, was depressed severely in 34 heart transplant recipients receiving cyclosporine (CsA) for 12 months or longer. The clearance of 99mTc-DTPA, a filtration marker similar in size to creatinine, was identical to that of the larger inulin molecule. In contrast, the clearance of creatinine was enhanced (P less than .01) such that its fractional clearance (relative to inulin) averaged 1.51 +/- 0.05. Moreover, there was an inverse relationship between fractional creatinine clearance (r = 0.36, P less than .01) and absolute inulin clearance. We conclude that in CsA induced chronic nephropathy 99mDTPA and inulin are unrestricted by the glomerular capillary wall and behave as true filtration markers, creatinine is progressively hypersecreted by renal tubules as the nephropathy worsens, and the ensuing enhancement of creatinine clearance over GFR blunts the expected rise in serum creatinine levels as GFR falls. As a result, serum creatinine in chronic CsA induced glomerulopathy exceeds 2 mg/dL consistently, only after true GFR has become depressed below normal values by two thirds or more. PMID- 3538858 TI - Renal side effects of nonsteroidal antiinflammatory drugs: clinical relevance. AB - Nonsteroidal antiinflammatory drugs (NSAIDs) induce a variety of renal side effects. We review their prevalence and clinical relevance, and identify the patients who are most at risk for these complications. NSAIDs induce hemodynamic renal failure in states of compromised renal perfusion and in the presence of a preexisting nephropathy. Association of triamterene and indomethacin is especially nephrotoxic and should be avoided. NSAIDs cause sodium retention and impair the natriuretic effect of diuretics: this side effect is clinically relevant in edema-forming states. Hyperkalemia induced by NSAIDs is harmful in case of renal failure and hypoaldosteronism. NSAIDs may induce an acute interstitial nephritis often associated with the nephrotic syndrome; the event is rare and unpredictable, and mainly propionic acid derivatives have been incriminated. NSAIDs are reported to attenuate the hypotensive effect of various drugs; further studies are warranted to better delineate the clinical relevance of this observation. PMID- 3538859 TI - Cisplatin nephrotoxicity. AB - Cis-dichlorodiammine platinum (II), or cisplatin, has emerged as a principal chemotherapeutic agent in the treatment of otherwise resistant solid tumors and is currently among the most widely used agents in the chemotherapy of cancer. The chief limit to its greater efficacy is its nephrotoxicity, which has made it necessary both to lower its dosage and actively hydrate patients to reduce it. The vulnerability of the kidney to cisplatin is almost certainly related to its primary role in the excretion of cisplatin. Cisplatin enters renal cells by a process that depends on normal oxygen utilization and is specifically inhibited by organic bases. Greater localization of platinum to the S3 segment of the proximal tubules suggests that the vulnerability of this segment may depend on its specific uptake of the drug. The majority of intracellular platinum is bound to macromolecules, including protein and DNA, yet a significant portion of cell platinum is biotransformed to a nonmutagenic and possibly nontoxic compound. Polyuria and hypomagnesemia, which are commonly associated with cisplatin nephrotoxicity, may be due to defects in deep nephron or collecting duct fluid and solute transport. Low single nephron glomerular filtration rates (SNGFR) during early cisplatinum-induced acute renal failure is accompanied by reduced renal blood flow and transglomerular hydrostatic pressure without elevated intratubular hydrostatic pressure, suggesting preglomerular vasoconstriction as an important determinant of renal failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538860 TI - Nephrotoxicity induced by cancer chemotherapy with special emphasis on cisplatin toxicity. AB - Renal failure in cancer patients is a common problem in oncology; this complication is frequently multifactorial in origin. Several antineoplastic agents are potentially nephrotoxic; previous renal impairment as well as combinations with other nephrotoxic drugs may increase the risk of nephrotoxicity during administration of chemotherapy. Methotrexate-related renal damage most frequently occurs with high-dose therapy and can be avoided by forced alkaline diuresis and administration of folinic acid. Renal dysfunction secondary to semustine (CH3-CCNU) is clearly related to cumulative doses in excess to 1,200 mg/m2; the onset may be delayed and renal failure progress despite drug discontinuation. Streptozotocin is also nephrotoxic and may cause proteinuria and renal tubular acidosis; progressive renal failure can be predicted by a close monitoring of proteinuria and prevented by drug discontinuance. Mitomycin associated renal failure frequently presents with signs of microangiopathic hemolytic anemia; renal failure is usually delayed but occasionally, it may be rapidly progressive despite drug discontinuance. Cisplatin nephrotoxicity is clearly dose-related and used to be considered dose limiting. Renal insufficiency can be prevented by hydration and forced diuresis; in addition, hyperhydration with mannitol-induced saline diuresis may allow administration of high doses and thus circumvent the dose-limiting effect of cisplatin-induced renal toxicity. Cisplatin-induced renal magnesium wasting occurs frequently and should be supplemented. Other approaches to reduce cisplatin nephrotoxicity are currently under investigation and are discussed. PMID- 3538861 TI - Recruitment and retention of Veterans Administration pharmacists. PMID- 3538862 TI - Work measurement in pharmacy research. AB - The applicability of various methods of work measurement to pharmacy research is discussed, and studies that have used these methods are reviewed. Methods of work measurement include subjective evaluation, direct time study, work sampling, statistical data, and pre-determined data. Subjective evaluation lacks precision in its estimates but may be useful in formulating hypotheses. Direct time study is most appropriate for readily observable, highly repetitive tasks that can be divided into short segments, although it has been used for longer and more variable activities. Work sampling is the most frequent method of work measurement used in pharmacy research, but few studies reported doing any check of measurement reliability or validity. Multidimensional work sampling and other forms of direct-entry, self-reporting work sampling may be useful in measuring the more complex and unobservable tasks of pharmacists such as clinical activities. By developing an understanding of the purposes and applications of measurement techniques, hospital pharmacists can choose the most appropriate method for their research setting and purpose. PMID- 3538863 TI - The immune system. AB - The components and functions of the immune system are described, and the clinical applications of agents that affect the immune system are discussed. Through both nonspecific and specific responses, the immune system recognizes and destroys or eliminates harmful foreign substances with which a host comes into contact. Nonspecific responses are usually associated with the first introduction of a foreign substance into the body and consist mainly of phagocytosis and inflammation. When the same substance, or antigen, is introduced into the body on subsequent occasions, antibodies specific for that antigen combine with the antigen and activate a complex network of specialized cells and soluble cellular secretions that eliminate the substance from the body. Certain antigens are inherited and are found on the cells and tissues of the body; these antigens play a major role in human allotransplantation, blood transfusions, and certain disease states. Recent advances in biotechnology have made it possible to alter an individual's immunologic response with such agents as azathioprine, cyclosporine, or monoclonal antibodies or to augment an individual's antitumor defenses with immunopotentiators. As the products of biotechnology are used more frequently in the hospital setting to treat or prevent disease, pharmacists will need to have a good understanding of the immune system to appreciate the functional capacity of and the problems that may exist with these agents. PMID- 3538864 TI - Role of inflammation and inflammatory mediators in airways disease. AB - Recent evidence suggests that airway inflammation is linked to hyper responsiveness of airway smooth muscle. Increases in airway responsiveness after many stimuli are accompanied by increases in inflammatory cells in bronchoalveolar lavage fluid and in the airway epithelium. Airway epithelial cells may themselves be an important source of inflammatory mediators, producing metabolites that can cause chemotaxis of neutrophils and that can selectively activate other cells in the lungs. Mast cells produce a variety of enzymes and vasoactive, chemotactic, and bronchoconstrictor substances in response to non immunologic as well as immunologic stimuli. The secretory profile of a mast cell may depend upon the specific stimulus applied. In addition, different populations of mast cells exist and distinct enzymatic pathways may predominate in different cell types. Mediators released by these cells may activate target cells by direct or indirect mechanisms. These inflammatory mediators, together with inflammatory cells, are important in the complex interactions involving airway epithelial cells, neutrophils, mast cells, smooth muscle, respiratory secretory cells, and nerves, which, in concert, are responsible for the pathophysiologic manifestations of obstructive lung disease. PMID- 3538865 TI - The Norway study: plasma concentrations, efficacy, and adverse events. AB - In the Norwegian comparative trials of piroxicam and naproxen in osteoarthritis, conducted by Husby and co-workers and Rugstad et al, relationships between plasma drug concentrations and the following were examined: efficacy in patients with osteoarthritis; all adverse reactions; and serious adverse events, which included gastrointestinal ulceration or bleeding and congestive heart failure. Increased plasma concentrations were correlated with age and female sex, but efficacy, overall side effects, and serious adverse events were not correlated with increasing plasma levels. PMID- 3538866 TI - Clinical benefits and comparative safety of piroxicam. Analysis of worldwide clinical trials data. AB - In response to concerns raised about the safety of piroxicam, Pfizer Inc. has reviewed three sets of data that constitute the largest body of current evidence regarding the efficacy and safety of piroxicam. First, data from all comparative clinical trials of piroxicam worldwide sponsored by Pfizer Inc. are reviewed with regard to safety issues, with particular attention to gastrointestinal side effects and safety among elderly patients. Second, the principal findings of a large Norwegian multicenter trial of piroxicam and naproxen, comprising 2,035 patients, are summarized. Finally, the worldwide database of more than 77,000 patients monitored in postmarketing surveillance studies is examined to assess gastrointestinal side effects and the relation of age and sex to these adverse events. There is no evidence in any of the comparative clinical data or postmarketing surveillance data to indicate that piroxicam has greater risks of gastrointestinal toxicity than do other nonsteroidal anti-inflammatory drugs, irrespective of patient age. PMID- 3538867 TI - Piroxicam pharmacokinetics: recent clinical results relating kinetics and plasma levels to age, sex, and adverse effects. AB - A large body of data is available regarding the relationship between demographic factors, particularly age, sex, and disease state, and the pharmacokinetics of piroxicam. Of additional interest is the relationship between piroxicam pharmacokinetics (particularly steady-state plasma levels) and adverse effects. Studies with piroxicam that are reviewed herein include studies on kinetics in renal impairment, single-dose studies, multiple-dose studies, and therapeutic drug monitoring studies. Although results were not always consistent, some studies suggested that plasma levels of piroxicam tend to be increased in elderly female patients. However, the increases were small and did not correlate with adverse events. These data suggest that there is no correlation between piroxicam plasma concentrations and adverse events. PMID- 3538869 TI - Cartilage metabolism and anti-inflammatory drugs in osteoarthritis. AB - The issue of selecting nonsteroidal anti-inflammatory drugs (NSAIDs) for the management of osteoarthritis based upon their direct effect on normal cartilage metabolism and their ability to modulate mechanisms that disturb such metabolism is addressed. This article provides an overview of the anatomic and biochemical changes that occur in diseased synovial tissue and cartilage, and the pathophysiologic mechanisms presumed to function in the induction and perpetuation of cartilage failure. Studies using experimental animal models of osteoarthritis are reviewed to evaluate the natural history of the disease, as well as the direct effect of NSAIDs on anabolic and catabolic cartilage function. Experimental evidence strongly indicates that NSAIDs of different classes, as well as members within a given class, function differently and manifest activity in addition to cyclo-oxygenase inhibition. PMID- 3538870 TI - The Norwegian multicenter study. AB - The largest multicenter, double-blind trial comparing piroxicam with naproxen in the treatment of osteoarthritis has recently been conducted in Norway. More than 2,000 patients were enrolled in the 12-week study. Both drugs showed similar efficacy, and serious gastrointestinal side effects occurred in less than 1 percent of the patients taking either agent. These findings are similar to results with other nonsteroidal anti-inflammatory drugs. This study indicates that in the treatment of osteoarthritis, piroxicam is as effective as naproxen and poses no greater risk of serious gastrointestinal side effects. PMID- 3538868 TI - A long-term evaluation of the treatment of osteoarthritis. AB - In a study of the long-term safety and efficacy of piroxicam (20 mg daily) in the treatment of osteoarthritis, 30 female patients with a mean duration of more than seven years of treatment were evaluated. Despite having had poor or no response with other drug therapies, in the majority of cases in which piroxicam was used half of the patients (15 of 30) reported feeling very good or good at their last visit, 13 said they felt fair, and only two reported feeling poor or very poor in terms of their sense of well-being. The incidence of adverse events was somewhat less than one event per patient year of exposure, and 94 percent of adverse events were mild or moderate. Laboratory measurements of drug safety did not reveal any evidence of renal, hepatic, or hematologic toxicity. It is significant that patients were willing to commit themselves to long-term piroxicam therapy for at least five years after an initial trial and that they preferred to continue taking the drug rather than switch to alternative forms of therapy. PMID- 3538871 TI - Risks to sibs of probands with neural tube defects: data for clinic populations in British Columbia. AB - The purpose of this study is to determine whether couples receiving genetic counselling because of a child with a neural tube defect (NTD) are a selected group and therefore not representative of the general population with respect to sib risks for NTDs. British Columbia (B.C.) provides an excellent opportunity to look at this for several reasons. Firstly, genetic counselling services are centralized. Secondly, there is virtually complete ascertainment of all infants with NTDs in the province. Thirdly, sib risks for NTDs in the general population have been derived previously [McBride, 1979] and, therefore, are available for comparison with the risks for sibships in the clinic populations. In the present study, data were available on 398 sibships in which the index case had anencephaly and/or spina bifida. In all instances, sib risks for the clinic populations did not differ significantly from those for the general population. In addition, congenital malformations other than NTDs did not occur among sibs of index cases more often than expected, based on provincial incidence data. PMID- 3538872 TI - The Samuel Pruzansky memorial lecture: introduction. PMID- 3538873 TI - March of Dimes award to Dr. Josef Warkany. PMID- 3538874 TI - Campomelia, cervical lymphocele, polycystic dysplasia, short gut, polysplenia. AB - An aborted fetus, the offspring of consanguineous parents, had the unusual combination of campomelia, cervical lymphocele, polycystic kidneys, pancreas, and liver, short gut, and polysplenia. Births of earlier similarly affected fetuses suggest an autosomal recessive inheritance. Skeletal, lymphatic, and renal lesions were seen at 26 weeks' gestation by ultrasonography, but not at 16 weeks. PMID- 3538875 TI - Identification of the small for gestational age fetus with the use of gestational age-independent indices of fetal growth. AB - This study reviews the roles of sonographic assessment of the rate of growth of the fetal abdominal circumference, the femur length/abdominal circumference ratio, and qualitative determination of amniotic fluid volume as gestational age independent indices for identification of the small for gestational age fetus. The sensitivity and specificity for single and combinations of test results were evaluated in 50 appropriate for gestational age and 40 small for gestational age fetuses. Positive and negative predictive values were derived for the general population. Our results indicate that either a rate of growth of the fetal abdominal circumference less than or equal to 10 mm/14 days or a femur length/abdominal circumference ratio greater than or equal to 23.5 correctly identifies most small for gestational age fetuses. When the general population is screened, only 15% of small for gestational age fetuses will be missed by this combination of criteria. The presence of a pocket of amniotic fluid less than or equal to 2.0 cm is highly suggestive of a small for gestational age fetus. However, the presence of a pocket of amniotic fluid greater than 2.0 cm does not guarantee an appropriate for gestational age fetus. We conclude that these gestational age-independent indices of fetal growth offer useful tools for differentiating between the small for gestational age and appropriate for gestational age fetus. PMID- 3538876 TI - Uteroplacental unit as a source of elevated circulating prorenin levels in normal pregnancy. AB - Circulating levels of inactive renin, that is, prorenin, are increased in normal pregnant women. To determine whether the uteroplacental unit secretes prorenin into the maternal circulation, we measured enzymatically active and inactive renin in plasma simultaneously obtained from the radial artery and uterine vein of 12 normotensive, nonlaboring patients undergoing elective cesarean section at term. We also measured these forms of renin in the umbilical arterial and venous blood of these patients. Our data reveal that the levels of inactive renin in both arterial and uterine venous blood of normal pregnant women are significantly higher than in peripheral venous blood of nonpregnant, normotensive control subjects; normotensive term patients have a ratio of plasma inactive to active renin of 9:1 in contrast to the 1:1 ratio in normotensive nonpregnant subjects; there is a significant uterine arteriovenous difference of prorenin (66.2 +/- 24.4 ng/ml/hr, p less than 0.05) but not of active renin (1.8 +/- 1.5 ng/ml/hr, not significant). These results suggest that the uteroplacental unit contributes to the elevated prorenin levels at term pregnancy. PMID- 3538878 TI - Management of diabetes mellitus. PMID- 3538877 TI - Subclinical abnormalities of glucose metabolism in subjects with previous gestational diabetes. AB - To investigate whether there are subclinical abnormalities of glucose metabolism in women with previous gestational diabetes that are consistent with a high incidence of diabetes mellitus in later life, eight patients with previous gestational diabetes and normal oral glucose tolerance were evaluated by means of body composition studies, intravenous glucose tolerance tests, and the hyperinsulinemic-euglycemic clamp coupled with 6-6 dideuterated glucose infusion, indirect calorimetry, and measurement of islet cell antibodies. Eight control subjects were matched for percent body fat and diet and studied in a similar fashion. Abnormalities of insulin response and insulin resistance were present in four (50%) of patients with previous gestational diabetes. Insulin resistance was significantly greater in the patients than in the control subjects. When compared with lean patients, obese patients with previous gestational diabetes had significantly greater insulin response to the intravenous glucose tolerance test and insulin resistance. These changes are consistent with reported findings of an early and progressive development of overt diabetes in patients who had gestational diabetes. PMID- 3538879 TI - Operative hysteroscopy under real-time ultrasonography. PMID- 3538881 TI - The proteinaceous coating and cytology of implant lenses in rabbits. AB - We performed extracapsular lens extraction with implantation of a J-loop posterior chamber lens in 14 rabbit eyes. Postoperatively, the animals were examined by slit lamp. They were killed after varying survival times of up to 12 weeks, and the implants were examined by scanning electron microscopy. Three days after the operation a thin amorphous coating that did not consist of collagen was found covering all implants. Three cell types were present on the coating: macrophages, leukocytes, and flattened giant cells. This coating resembled morphologically the fibronectin coating on intraocular lenses in vitro. PMID- 3538880 TI - The use of hydroxypropyl methylcellulose in extracapsular cataract extraction with intraocular lens implantation. AB - We conducted a prospective randomized clinical trial on the use of 2% hydroxypropyl methylcellulose and 1% sodium hyaluronate in the anterior chamber during anterior capsulotomy and nuclear expression in extracapsular cataract extraction with posterior chamber lens implantation in 70 patients. Both viscoelastic substances helped maintain the anterior chamber and facilitated the operation, although sodium hyaluronate was preferred. There was no excessive intraocular inflammation or toxicity noted with either agent. Patients given sodium hyaluronate had a larger increase in intraocular pressure during the early postoperative period (2.04 mm Hg) than did those given hydroxypropyl methylcellulose (1.1 mm Hg), but the difference was not significant. Nine weeks after surgery, the mean (+/- SD) central endothelial cell loss was 4.84% (+/- 7.26%) in the 17 eyes with sodium hyaluronate and 4.37% (+/- 9.84%) in the 53 eyes with hydroxypropyl methylcellulose. The intraocular pressure and corneal thickness were not significantly different before operation and nine weeks after it. PMID- 3538882 TI - Pigment dispersion syndrome in pseudophakic corneal transplants. AB - We observed the pigment dispersion syndrome in two patients after keratoplasty with posterior chamber intraocular lenses. In addition to a heavily pigmented trabecular mesh-work and iris transilluminating defects, an inferior linear pigmented endothelial line was seen in both patients. One patient developed glaucoma, which was well controlled with medication. Pigment dispersion syndrome in patients with penetrating keratoplasty should not be confused with an allograft reaction but should alert the transplant surgeon that a different process is occurring. PMID- 3538883 TI - Congenital generalized multicentric myofibromatosis with orbital involvement. AB - We studied a rare case of congenital myofibromatosis of the orbit as part of a generalized multicentric disease in a 5-month-old boy. The ultrasonographic and computed tomographic findings were those of a low-reflective, firm, vascularized, lesion with heterogeneous internal structure. The histopathologic findings showed vascular channels with large polygonal cells and transition toward myofibroblasts with interwoven collagen fiber bundles. PMID- 3538885 TI - The role of occupational therapy in disease prevention and health promotion. AB - There is considerable evidence that the goal of health care has moved beyond mere survival to positive health. The surgeon general's report emphasized the necessity to modify social environments by reducing risk-taking behaviors and life-styles. The increased attention the American people now pay to exercise, nutrition, environmental health, and occupational safety reveals the interest and concern with health promotion and disease prevention (Public Health Service, 1979). Naisbitt noted the increasing growth of wellness and fitness centers across our country and he projected that health care, nutrition, and fitness will be among the prime economic growth areas in the future (Naisbitt, 1982). Central to the concept of optimal functioning is the existence of a positive state of health in the whole person. This humanistic approach to health care in the United States, as called for in the surgeon general's report, is evidenced by a new self help paradigm and changes in personal habits to achieve this state of wellness. Gilfoyle spoke of creative partnerships in her inaugural address (1986). We can use this concept to encourage occupational therapists to become more involved in creative partnerships with other health professionals and the public to achieve the goal of a healthy society. There is now a unique opportunity for occupational therapists to be among those determining significant changes in the outlook on health care. Health, considered in terms of individual and societal fulfillment and accompanied by feelings of purpose and worth, has long been the goal of occupational therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538884 TI - Johann Friedrich Horner (1831-1886). PMID- 3538886 TI - Wellness and occupational therapy. AB - This article reviews terms associated with wellness, such as health promotion, illness, disease, and well-being, and describes the evolution of the concept of wellness. It also discusses the implications of concepts associated with wellness as they are relevant for occupational therapists who provide wellness or health promotion services or who employ wellness concepts in more traditional treatment or rehabilitation services. PMID- 3538887 TI - The case for health promotion programs containing health care costs: a review of the literature. AB - A review is conducted of major studies dealing with the impact of work site health promotion programs on health care costs. Inconsistent results were produced due to measurement, design, and sampling problems. A study of Blue Cross Blue Shield of Indiana employees provided the best evidence of program-related health care cost reductions. Suggestions are made which, if implemented, should enable researchers to more confidently attribute cost reductions to health promotion program activities. PMID- 3538888 TI - Expression of interleukin-1 in Reed-Sternberg cells and neoplastic cells from true histiocytic malignancies. AB - Interleukin-1, a peptide produced by monocytes, histiocytes, and interdigitating reticulum cells, plays an important role in the regulation of immune function. In this styde, we examined the production of interleukin-1 in 115 patients with a variety of human lymphomas by using a rabbit anti-interleukin-1 antibody and the immunoperoxidase technique. Interleukin-1 was detected in Reed-Sternberg cells from 20 patients with Hodgkin's disease as well as in neoplastic cells from 9 patients with true histiocytic lymphoma or malignant histiocytosis. In the other 86 cases, which included T- and B-cell lymphomas, no interleukin-1 could be detected. This result indicates a close relationship between Hodgkin's disease and true histiocytic malignancies and provides additional evidence to support our hypothesis that Reed-Sternberg cells are related to interdigitating reticulum cells. PMID- 3538889 TI - Expression of glial fibrillary acidic protein in the CNS and PNS of murine globoid cell leukodystrophy, the twitcher. AB - The expression of glial fibrillary acidic protein (GFAP) was found to be markedly enhanced immunohistochemically and biochemically both in the central (CNS) and peripheral (PNS) nervous systems of the twitcher mutant, an authentic murine model of human globoid cell leukodystrophy. The astrocytes in the CNS, the unmyelinated Schwann cells in the sciatic nerve, and the satellite cells in the trigeminal ganglion stained heavily with anti-GFAP antiserum. These changes in GFAP expression occurred shortly before the initiation of demyelination and coincided chronologically and topographically with infiltration of macrophages, suggesting that the same or closely related factors trigger the infiltration of macrophages and activate expression of GFAP. Cytoskeletal protein preparations showed increases in GFAP as well as in vimentin in the brainstem, spinal cord, and sciatic nerve. These results demonstrate that at least two types of peripheral glia (the unmyelinated Schwann cell and the satellite cell), in addition to the astrocyte, respond to some pathologic stimuli with an increased expression of GFAP. However, two other GFAP-positive structures, the Bergmann and radial glia, showed no significant changes in their immunostaining. PMID- 3538890 TI - Epithelial polyanion (podocalyxin) is found on the sides but not the soles of the foot processes of the glomerular epithelium. AB - The distribution of podocalyxin was determined by several different immunoelectron microscopic methods, which included so-called diffusion methods carried out on cryostat sections and surface methods done on ultrathin sections. When localization was carried out by three different indirect immunogold methods (using ultrathin frozen sections, ultrathin sections cut from tissues embedded in Lowicryl K4M or LR White, or 20- mu cryostat sections for incubations), gold particles were found exclusively on the urinary surfaces of glomerular epithelial cells and, at a lower concentration, on the luminal surface of glomerular endothelial cells. No gold was bound to the basal surfaces (soles) of the epithelial foot processes, the filtration slit diaphragms, the glomerular basement membrane (GBM), or those regions of the endothelial plasmalemma that face the GBM. When podocalyxin was localized by an indirect immunoperoxidase method on cryostat sections, heavy deposits of reaction product were seen on the same cell surfaces as with the immunogold methods. Each of the methods used had certain advantages as well as limitations, but the collective results obtained were convergent and complimentary. It is concluded that podocalyxin is restricted in its distribution to the urinary surfaces of epithelial cells and the luminal surface of endothelial cells; it is missing or present in very low concentrations on the soles (basal surface) of the epithelial foot processes, the slit diaphragms and the basement membrane surface of the endothelium; and the podocalyxin-containing regions of the epithelial and endothelial plasmalemmae constitute microdomains of distinctive membrane protein composition on the corresponding cell surfaces. PMID- 3538891 TI - Obliterative segmental sclerosis of pancreatic islets. A possible consequence of hypotensive shock in young BB rats. AB - During the conduct of a time-course study of peripheral blood T lymphocytes in BB rats, a hitherto unreported islet lesion was recognized in 8 of 17 glucose tolerant rats which had been subjected to repetitive cardiac puncture in early life and sacrificed at 186-190 days of age. Some of the large islets contiguous to fibrous septa demonstrated variable degrees of obliterative sclerosis and reduction of islet cell mass, associated with evidence of remote peri- and intrainsular hemorrhage. In 3 rats, additional features included an active, proliferative replacement of islet substance by fibroblasts and histiocytes. These islet alterations are not characteristic of BB rats, nor have identical lesions been described in studies of experimental or human diabetes mellitus. Affected rats had sustained repetitive episodes of blood loss (from 15% to 28% of total blood volume each time) during the early phase of the study. It is possible, but not proved, that hypovolemic shock was induced in some of these animals. Ischemic necrosis of islets has been reported in premature and young infants succumbing to shock. It is posited that hypovolemic shock in the young animal may, as in the infant, result in islet cell ischemic necrosis, sufficient to produce, with time, the described islet morphologic features. PMID- 3538892 TI - Spontaneous diabetes mellitus-islet amyloid complex in adult cats. PMID- 3538893 TI - Cholesteatoma of the external auditory canal and keratosis obturans. AB - Keratosis obturans and external auditory canal cholesteatoma have often been regarded as a single entity. However, these are two distinct disorders with their own clinical presentations, physical and pathologic findings, and treatment. Keratosis obturans is an accumulation of obstructive desquamated keratin in the external auditory meatus. External auditory canal cholesteatoma is an invasion and erosion of squamous epithelium into a localized area of the bony ear canal. The origin of both entities remains obscure. The clinical symptoms, pathologic processes, and treatment are outlined and compared. Case reports are presented to illustrate the features of these two diseases. PMID- 3538894 TI - Allergy and the immunologic aspects of otitis media with effusion. AB - We reviewed the literature since 1980, and discovered that there is a distinct small subset of patients with otitis media with effusion (OME) in whom the middle ear acts as a shock organ for an IgE-mediated, type I allergic reaction. In the majority of patients, however, no direct relationship between the type I reaction and OME can be drawn. Both the type III and type IV reactions are strongly incriminated in the pathogenesis of OME. Much work remains to be done to clarify the exact role of the immune system in OME. PMID- 3538895 TI - Postoperative deep venous thrombosis and pulmonary embolism: diagnosis, management, and prevention. AB - With the application of new surgical approaches and more extensive neurotologic procedures, the length of surgery may be prolonged and patients are often immobilized for extended periods. Statistics indicate that as many as 40% of patients over the age of 40 operated on for more than an hour will develop a deep venous thrombosis; the risk of fatal pulmonary embolus then becomes 37%. It becomes very clear that to assume proper care of their patients, surgeons must not only be cognizant of the diagnosis and management of these complications, but also be aware of those patients at risk, and the effective methods of prevention. The present article discusses the diagnosis and treatment of deep venous thrombosis and pulmonary embolism, and the steps that may be taken to prevent their occurrence postoperatively. PMID- 3538896 TI - Hormonal regulation of iodothyronine 5'-deiodinase in rat brown adipose tissue. AB - Norepinephrine, isoproterenol, insulin, and glucagon increase the type II (low Km) iodothyronine 5'-deiodinase (5'-D) in the brown adipose tissue (BAT) of intact rats. Cycloheximide or actinomycin D blocks the increase after norepinephrine, suggesting new mRNA synthesis is required for this effect. The 3- to 10-fold increase in BAT 5'-D after insulin administration was also blocked by cycloheximide. The effects of all stimulators are blunted by fasting or streptozotocin-induced diabetes. While all these hormones have the potential for stimulating BAT 5'-D, the dose-response relationships suggest that norepinephrine and insulin are the most potent. These and our earlier studies showing additional effects of thyroid and growth hormones on BAT 5'-D point to the complex regulation of this enzyme, suggesting that the triiodothyronine produced from its action has an important role in the thermogenic response of this tissue. PMID- 3538897 TI - Glucose-induced changes in pancreatic islet blood flow mediated by central nervous system. AB - Earlier experiments with the microsphere technique suggested that a heightened serum glucose concentration consistently leads to an increase in islet blood flow (IBF). Several lines of evidence suggest that this glucose-sensitive control mechanism is located at an extrapancreatic site. The purpose of this study was to define the possible role of the central nervous system in such a mechanism. D glucose, L-glucose, 3-O-methylglucose, or saline were therefore infused into the carotid artery, each at a dose of 1 mg X kg body wt-1 X min-1 for 3 min, and the pancreatic and islet blood flows were measured. None of these substances affected the systemic serum glucose level. The intracarotid infusion of D-glucose, however, caused a rapid increase in both the serum insulin concentration and IBF. The blood flow to the whole pancreas nevertheless remained unchanged, indicating a redistribution of flow within the gland. Carotid infusion of the other test substances or a similar amount of D-glucose given in a femoral vein did not affect these parameters. Both the increase in serum insulin concentration and the increase in IBF caused by D-glucose could be abolished by vagotomy or administration of atropine. When the systemic blood glucose concentration was increased by intraperitoneal glucose administration (2 g/kg body wt), vagotomy blocked the increase in islet blood flow but not the concomitant insulin release. These observations suggest that the glucose-induced increase in IBF is mediated by vagal cholinergic influences. PMID- 3538898 TI - alpha-Ketoisocaproate is superior to leucine in sparing glucose utilization in humans. AB - The present study was designed to examine the glucose-sparing effect of leucine and its keto acid alpha-ketoisocaproate (KIC) in vivo. Two groups of overnight fasted normal volunteers were studied. In the first group, eight subjects received an intravenous infusion of leucine and six subjects received KIC (2.3 mumol X kg-1 X min-1) for 3 h; on another occasion, all subjects received saline and acted as their own controls. In the second group, 11 subjects received an infusion of 1 mU X kg-1 X min-1 for 3 h with a variable glucose infusion to maintain euglycemia. On another occasion, five subjects received an additional infusion of leucine and six subjects received KIC each at 2.3 mumol X kg-1 X min 1 for 3 h. The amount of exogenous glucose required to maintain euglycemia (M, mg X kg-1 X min-1) was used as an index of total body glucose utilization. Forearm exchange of leucine, KIC, glucose, and lactate was determined in both groups. Both leucine and KIC infusions alone decreased glucose uptake (42 and 40%) and increased lactate release (37 and 116%, respectively). Hyperinsulinemia (6-fold basal) and euglycemia resulted in a fivefold increase in glucose uptake across the human forearm. The amount of exogenous glucose required to maintain euglycemia averaged 7.4 +/- 0.5 mg X kg-1 X min-1. The combination of leucine and insulin infusions did not alter the stimulated forearm glucose uptake nor did it change M (7.25 +/- 0.6 mg X kg-1 X min-1, P = NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538900 TI - Glycogen depletion and increased insulin sensitivity and responsiveness in muscle after exercise. AB - As judged by its ability to stimulate glucose uptake and alpha-aminoisobutyric acid (AIB) transport, the sensitivity and the responsiveness of perfused rat muscle to insulin are enhanced after moderately intense treadmill exercise. In fed rats, these enhanced effects of insulin are predominantly restricted to muscles that performed work as evidenced by glycogen depletion. The present study was designed to examine the relationship between glycogen depletion per se and the postexercise changes in insulin action. Toward this end, fed and 48-h starved rats were run on a treadmill for 45 min at moderate intensity, and glucose and AIB uptake were then assessed using the isolated perfused hindquarter preparation. Glycogen is depleted in red muscles such as the soleus and red fibers of the gastrocnemius in fed rats immediately after such exercise, whereas, in starved rats, muscle glycogen is unchanged. As previously shown, the stimulation by insulin of glucose utilization by the hindquarter and AIB transport into red muscles was substantially increased in fed rats after the treadmill run. This was due to increases in both insulin sensitivity and responsiveness. In starved rats, the treadmill run also enhanced the ability of insulin to stimulate these processes; however, this was solely due to an increase in insulin sensitivity. No change in insulin responsiveness was observed. The results indicate that the enhanced sensitivity of muscle to insulin after exercise is not dependent on glycogen depletion, whereas increased insulin responsiveness does not occur in its absence. They also suggest that the mechanisms by which prior exercise acts to increase insulin sensitivity and responsiveness are different. PMID- 3538899 TI - Secretion and degradation of insulin and glucagon in carbon tetrachloride-induced liver injury rats. AB - To elucidate the mechanism of hyperinsulinemia and hyperglucagonemia in liver diseases, secretion of insulin and glucagon from perfused pancreas and extraction of insulin and glucagon by perfused liver were investigated in carbon tetrachloride inhalated liver injury rats. Fasting plasma insulin and glucagon levels and insulin and glucagon levels after arginine injection (0.25 g/kg) in liver injury rats were significantly higher than those in control rats. Glucagon levels after glucose injection (0.5 g/kg) were slightly increased in the liver injury group. Insulin responses to 16.7 mM glucose and 10 mM arginine from perfused pancreas were similar in liver injury rats and control rats. Glucagon response to 10 mM arginine from perfused pancreas was also similar in liver injury rats and control rats. Insulin extraction by perfused liver in liver injury rats (45 +/- 9%) was significantly (P less than 0.05) lower than that (64 +/- 11%) in control rats, and glucagon extraction by perfused liver was also significantly (P less than 0.05) decreased in liver injury rats (57 +/- 8%) compared with controls (73 +/- 9%). It is concluded that in carbon tetrachloride induced liver injury rats, hyperinsulinemia and hyperglucagonemia may be dependent on decreased insulin and glucagon extraction by the liver. PMID- 3538901 TI - Elevation of plasma renin activity by alpha-adrenoceptor agonists in conscious dogs. AB - Experiments were performed in conscious trained dogs to determine whether renal alpha-adrenergic receptors mediate stimulation or inhibition of renin release. All dogs were uninephrectomized and surgically prepared with chronically indwelling catheters in the aorta, vena cava, and remaining renal artery at least 8 days before experiment. Direct renal artery (ia) infusion of the alpha adrenoceptor agonist phenylephrine, 0.25 or 0.50 microgram X kg-1 X min-1 for 30 min, increased plasma renin activity (PRA) to 145 +/- 13 and 212 +/- 28% of control, respectively, within 5 min of drug infusion (P less than 0.01) in conscious sodium-replete dogs. In contrast, intravenous phenylephrine infusion decreased PRA by 50% (P less than 0.001). The increase in PRA observed during ia phenylephrine infusion was prevented by renal alpha-adrenoceptor blockade with phenoxybenzamine but not by beta-adrenoceptor blockade with propranolol. Methoxamine, another alpha-adrenoceptor agonist, also increased PRA when infused ia in both sodium-replete dogs and in dogs maintained on a low-sodium diet. In dogs with renal arterial electromagnetic flowprobes, ia phenylephrine infusion increased PRA without decreasing total renal blood flow. In summary, stimulation of renal alpha-adrenoceptors increases PRA in conscious dogs. This stimulation can occur in the absence of significant changes in total renal blood flow. PMID- 3538902 TI - Calculation of metabolic fluxes with anatomically separated sources of tracer and tracee. AB - Traditional calculations of metabolic fluxes using isotope dilution are based on the assumption that tracer and tracee enter the distribution space through effectively identical ports. If the tracer infusion site is not identical with the site of endogenous release of the tracee, the traditional equations for calculating rate of appearance (Ra) of a metabolite may give rise to appreciable errors due to the presence of gradients in specific activity. When tracer and tracee enter by means of anatomically disparate sites, such as may be encountered in the study of metabolite (e.g., lactate, alanine, and glycerol) or free fatty acid turnover, one must employ a modification of the traditional specific activity. This modified specific activity is obtained as the ratio of tracer concentration "near" (in the same compartment as) the source of tracee to the concentration of tracee near the source of tracer infusion. This concept is employed to derive equations for calculating metabolic turnover in both steady- and non-steady-state conditions when entry sites of tracer and tracee are dissimilar. PMID- 3538903 TI - Contractile effects of TxA2 and endoperoxide analogues on cultured rat glomerular mesangial cells. AB - Vasoconstrictor metabolites of arachidonic acid (AA) affect renal hemodynamics in various disease models. Since mesangial contraction could be involved in the glomerular response to vasoconstrictors, we studied the effects of thromboxane A2 (TxA2), synthesized by sheep platelet microsomes, and of two stable prostaglandin (PG) endoperoxide analogues (END), U-44069 and U-46619, on the morphology of cultured rat mesangial cells. Computer-assisted image analysis microscopy was employed to measure cross-sectional area (CSA) of individual cells during 40-min incubations with the agonists. Both END induced a dose-dependent increase of contracting cells (U-44069, 1 pM, 14.2%; 1 nM, 25.0%; 1 microM, 34.4%; maximum CSA decrease, 16.6 +/- 2.9%; U-46619, 1 pM, 11.4%; 1 nM, 25.6%; 1 microM, 37.2%; maximum CSA decrease, 23.6 +/- 2.2%). TxA2 contracted 30.1% of the cells, with a maximum CSA decrease of 20.5 +/- 2.4%. The TxA2-receptor antagonists EP 092 (EP) and SQ 27,427 (SQ) significantly (P less than 0.05) reduced the number of cells contracting in response to U-44069 (+EP 7.3%, +SQ 10.8%) or U-46619 (+EP 14.2%, +SQ 11.1%), and eliminated TxA2-induced contraction. END also stimulated mesangial immunoreactive prostaglandin E2 (PGE2) synthesis (U-44069, 1 nM, from 2.17 +/- 0.62 to 4.36 +/- 1.0; U-46619, 1 nM, from 2.09 +/- 0.64 to 5.05 +/- 1.04, ng X mg protein-1 X 15 min-1 +/- SE). These results suggest that mesangial contraction, with resulting reduction of filtration surface area, may contribute to the effects of TxA2 and endoperoxides on glomerular hemodynamics. PMID- 3538904 TI - Involvement of calmodulin in mediating inhibitory action of intracellular Ca2+ on renin secretion. AB - This study sought to elucidate further the cellular mechanism(s) involved in the control of renin secretion by Ca2+. The rate of renin secretion in vitro by rabbit and dog renal cortical slices was inversely related to medium Ca2+ concentration. The inverse relationship was observed only when the cell membrane permeability to Ca2+ was increased by K+ depolarization, suggesting that the Ca2+ concentration in the juxtaglomerular cell modulates renin secretion. From this relationship, renin secretion appears to turn on at intracellular Ca2+ concentrations between 10(-8) and 10(-7) M. Calmidazolium, a potent calmodulin antagonist, markedly stimulated basal renin secretion in a concentration dependent manner. Pretreatment of slices with calmidazolium blocked the inhibition of renin secretion by high-K+ medium. Calmidazolium and several other calmodulin antagonists (W-7, W-13, and trifluoperazine) partly or fully reversed the inhibition of renin secretion previously inhibited by high-K+ medium in the order of their potencies as calmodulin antagonists. Indeed, W-5, a biologically inactive structural analogue of W-7, was without effect. These results support the hypothesis that renin secretion is inversely related to intracellular Ca2+ and that Ca2+ inhibits renin secretion by a calmodulin-dependent process. PMID- 3538905 TI - Carrier-mediated reabsorption of small peptides in renal proximal tubule. AB - Recent studies with a variety of tissue preparations in the kidney have demonstrated that proximal tubular cells possess specific transport systems for di- and tripeptides. In contrast to the well-known amino acid and glucose transport systems, active transport of peptides in these cells is energized by an H+ gradient rather than an Na+ gradient. Like amino acid-Na+ and glucose-Na+ cotransport systems, peptide-H+ cotransport is electrogenic and hence a membrane potential also contributes to the uphill transport of peptides in these cells. Di and tripeptides that are filtered at the glomerulus, as well as those that are produced in the tubular lumen from larger polypeptides by the action of brush border peptidases, serve as substrates for the renal peptide transport system under physiological conditions. The H+ gradient that is necessary to drive renal peptide transport is generated in vivo by concerted action of the basolateral Na+ K+-ATPase and the brush-border Na+-H+ exchanger. The peptidases and the peptide transport system in the renal brush-border membrane play a significant role in the reabsorption of peptide-bound amino acids as well as in the regulation of plasma levels of small peptides. PMID- 3538907 TI - Role of mineralocorticoids and glucocorticoids in blood pressure regulation in normotensive rats. AB - The separate role of mineralocorticoid and glucocorticoid hormone action in maintaining arterial pressure was studied in normotensive rats. Four groups were prepared: adrenalectomized (ADX) rats given 6 micrograms aldosterone/24 h (ALDO; n = 9) or 10 micrograms dexamethasone/24 h (DEX; n = 9) by intraperitoneal Alzet pumps, shamoperated controls (control; n = 10) and ADX rats with no hormone replacement (ADX; n = 9). All groups were given 1% NaCl + 2.5% glucose drinking solution. Measurements of plasma corticosterone and aldosterone and urinary aldosterone excretion confirmed the adequacy of the experimental groups. Forty eight hours after ADX or sham, base-line intra-arterial mean arterial pressure (MAP) in conscious undisturbed rats was similar in the four groups. Captopril (1 mg/kg iv) produced a similar reduction in MAP in ALDO (-11 +/- 2 mmHg) and DEX ( 12 +/- 1 mmHg) groups, despite a lower plasma renin activity (PRA) in ALDO (2.0 +/- 0.7 and 6.0 +/- 1.5 ng X ml-1 X h-1, respectively; P less than 0.05). dP (Me)TyrAVP (50 micrograms/kg iv) caused a greater decrease in MAP in ALDO (-15 +/ 3 mmHg) than in DEX (-8 +/- 1 mmHg; P less than 0.05). Combined blockade with both antagonists resulted in a greater MAP reduction in ALDO (-29 +/- 4 mmHg) than in DEX (-15 +/- 4 mmHg; P less than 0.05). These results indicate that glucocorticoid hormone action maintains arterial pressure in ADX rats by mechanisms similar to normal rats and largely independent of the renin angiotensin system and vasopressin. In contrast, mineralocorticoid replacement alone in ADX rats requires increased participation of both peptide systems for maintenance of arterial pressure. PMID- 3538906 TI - Escherichia coli endotoxin injections potentiate experimental ischemic renal injury. AB - The purpose of this study was to assess the influence of Escherichia coli endotoxin on the evolution of ischemic acute renal failure (ARF). Rats were subjected to 25 min of bilateral renal artery occlusion (RAO) plus subcutaneous/intraperitoneal injections of either boiled E. coli or purified E. coli endotoxin (1.5 mg). Boiling the E. coli renders them nonviable but leaves endotoxin intact. Ischemic controls were injected with saline. The E. coli injections exacerbated ischemic ARF, doubling the degree of azotemia and increasing the extent of tubular necrosis and cast formation. This occurred without an adverse effect on renal blood flow or blood pressure during the initiation phase or maintenance phase of the ARF. Endotoxin tolerant rats were totally protected against the E. coli-ARF potentiating effect. Neither Staphylococcus aureus nor E. coli with denatured endotoxin adversely affected ischemic injury. Purified E. coli endotoxin reproduced the E. coli-ARF potentiating action. Neither E. coli nor purified endotoxin induced azotemia in the absence of renal ischemia. CONCLUSION: E. coli endotoxin can exacerbate ischemic renal injury without compromising renal hemodynamics. This action appears to be mediated by an adverse effect of endotoxin on critical subcellular determinants of ischemic tissue injury. PMID- 3538908 TI - Increased aortic PGI2 and plasma lyso-PAF in the unclipped one-kidney hypertensive rat. AB - Previous studies have implicated vasodilatory prostaglandins (PGs) in the reversal of hypertension following unclipping in the one-kidney, one-clip (1K,1C) hypertensive rat. The capacity of the aorta to synthesize prostacyclin (PGI2) was compared in clipped (group A, n = 9), unclipped (group B, n = 8 and group D, n = 9), and sham-unclipped (group C, n = 9) 1K,1C hypertensive rats. The involvement of platelet-activating factor (PAF), a potent renal antihypertensive phospholipid, in the reversal of renal clip hypertension was also examined. Hypertensive rats [systolic blood pressure (BP) greater than 180 mmHg] were fed a synthetic diet for 4 wk, after which group A was killed immediately, group C was sham-unclipped, and groups B and D unclipped and killed 24 h later. Blood was drawn for the measurement of plasma lyso-PAF (the precursor of PAF) and the aorta removed for determination of 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha, the stable hydrolysis product of PGI2). BP fell substantially in the unclipped rats (groups B and D) but did not change in the sham-unclipped rats (group C). Mean aortic 6-keto-PGF1 alpha was increased in the unclipped groups [group B, 15.4 +/- 2.4 (SE) ng/mg; group D, 10.8 +/- 2 ng/mg] compared with group A (7.7 +/- 1 ng/mg) and group C (7.1 +/- 1 ng/mg) (H = 13.74, P less than 0.01). Plasma lyso PAF was also significantly increased in the unclipped (group D, 261 +/- 26 ng/ml) vs. the sham-unclipped group (group C, 211 +/- 23 ng/ml, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538910 TI - Doubly labeled water method: in vivo oxygen and hydrogen isotope fractionation. AB - The accuracy and precision of the doubly labeled water method for measuring energy expenditure are influenced by isotope fractionation during evaporative water loss and CO2 excretion. To characterize in vivo isotope fractionation, we collected and isotopically analyzed physiological fluids and gases. Breath and transcutaneous water vapor were isotopically fractionated. The degree of fractionation indicated that the former was fractionated under equilibrium control at 37 degrees C, and the latter was kinetically fractionated. Sweat and urine were unfractionated. By use of isotopic balance models, the fraction of water lost via fractionating routes was estimated from the isotopic abundances of body water, local drinking water, and dietary solids. Fractionated water loss averaged 23% (SD = 10%) of water turnover, which agreed with our previous estimates based on metabolic rate, but there was a systematic difference between the results based on O2 and hydrogen. Corrections for isotopic fractionation of water lost in breath and (nonsweat) transcutaneous loss should be made when using labeled water to measure water turnover or CO2 production. PMID- 3538911 TI - A review of brief individual psychotherapies. AB - The authors review and contrast four brief individual psychodynamic psychotherapies: focal, anxiety-provoking, time-limited, and broad-focus. They also summarize the techniques associated with two other brief individual psychotherapies that rely less on psychodynamic techniques: interpersonal psychotherapy and cognitive therapy. They find that differences among the therapies in the timing and type of interventions are at times more striking than the differences in their goals or identified problem areas. The authors also discuss educational and cost/benefit issues associated with the brief psychotherapies and recommend further empirical studies to determine the most effective brief therapy for selected psychiatric disorders. PMID- 3538912 TI - Psychiatric aspects of patients with malignant ventricular arrhythmias. AB - The major cause of cardiac mortality in the United States is sudden cardiac death, most often the result of ventricular tachycardia-ventricular fibrillation. Transient risk factors for sudden cardiac death include psychiatric conditions mediated through the CNS. Major advances in the evaluation and treatment of patients who have survived malignant ventricular arrhythmias have been accompanied by challenging management and therapy issues for the psychiatrist involved in the care of such patients. The authors suggest ways to meet these challenges, especially in the care of patients with concomitant anxiety, depression, delirium, or psychosis. PMID- 3538909 TI - Effect of autonomic agents on renin release in the turtle, Pseudemys scripta. AB - Experiments were conducted in the freshwater turtle, Pseudemys scripta, to study the effect of autonomic agents on the control of renin in this primitive species. The unique finding in these studies was that, unlike mammals, isoproterenol infusion fails to increase renin activity even though heart rate and arterial pressure patterns indicated that systemic responses were similar to that in mammals. On the other hand, acetylcholine (ACh) infusion resulted in a prompt threefold elevation (P less than 0.01) of renin activity. This response was blocked by propranolol but not atropine. Other experiments demonstrated that ACh elicited a prompt elevation of circulating norepinephrine and epinephrine in these turtles and led to the hypothesis that the renin response to ACh was secondary to the release of endogenous catecholamines. This hypothesis was supported by the fact that, in reserpinized turtles, ACh failed to elicit the usual renin response. Further evidence stemmed from the fact that epinephrine administration led to a prompt fourfold increase (P less than 0.01) in renin, which could be blocked by propranolol. On the other hand, phenoxybenzamine failed to block the response under identical conditions. Taken as a whole, these data suggest that in this primitive species renin activity is elevated by endogenous catecholamines even though isoproterenol, a classical beta-adrenergic agonist, is without effect. These data illustrate again the need for caution when assuming analogy when comparing responses in primitive species with that of mammals. PMID- 3538913 TI - Treatment of severe lithium-induced polyuria with amiloride. AB - One of the major side effects of lithium is nephrogenic diabetes insipidus. The established treatment for the disorder is thiazide diuretics, which are associated with hypokalemia and reduced lithium excretion, predisposing the patient to lithium toxicity. Amiloride is a new diuretic that reduces lithium induced polyuria in animals without affecting lithium or potassium levels. The authors found that 10-20 mg/day of amiloride given to eight patients who had become hypokalemic while being treated with hydrochlorothiazide for lithium induced nephrogenic diabetes insipidus increased renal concentrating ability and reduced polyuria. They conclude that amiloride can be useful in treating lithium induced nephrogenic diabetes insipidus and merits future randomized clinical trials. PMID- 3538915 TI - Virchow, the heroic model in medicine: health policy by accolade. PMID- 3538914 TI - Paradoxical effects of amitriptyline on borderline patients. AB - A paradoxical increase in suicide threats, paranoid ideation, and demanding and assaultive behavior occurred among 15 borderline inpatients receiving amitriptyline in a double-blind study. This pattern differed significantly from that of 14 nonresponding patients receiving placebo. PMID- 3538916 TI - Skin graft survival in the uterine lumen of ewes treated with progesterone. AB - An experiment was conducted to determine the effect of progesterone on survival of skin transplants placed in the uterine lumen of ovariectomized ewes. Animals were treated for 30 days with either a corn oil vehicle (n = 4) or progesterone at 50 (n = 3) or 200 mg/day (n = 3). An autograft and allograft were then placed in each uterus, and treatments were continued for an additional 30 days before grafts were examined for survival. All autografts were present 30 days after grafting and most appeared healthy upon histological examination. Allografts placed into the uterine lumen of progesterone-treated ewes were present 30 days after grafting but were necrotic in histological appearance. Allografts placed within the uterus of corn oil-treated ewes were completely resorbed. Uterine secretions that accumulated in the uterine lumen were examined for inhibitory effects on [3H-methyl]thymidine incorporation by lymphocytes stimulated with phytohemagglutinin (PHA). The total amount of immunosuppressive activity in the uterine lumen was greater (P less than 0.05) for progesterone-treated ewes than for corn oil-treated ewes. Concentrations of progesterone in uterine secretions of progesterone-treated ewes ranged from 0.3 to 3.4 ng/ml. Thymidine incorporation into PHA-stimulated lymphocytes was not affected by in vitro treatment with up to 500 ng/ml of progesterone. In conclusion, progesterone delayed resorption of skin allografts placed in the uterine lumen. Results are consistent with the hypothesis that progesterone mediated this effect by stimulating the secretion of immunosuppressive substances into the uterine lumen. PMID- 3538917 TI - Liver allograft rejection. An analysis of the use of biopsy in determining outcome of rejection. AB - Two-hundred-seventy biopsy specimens from 47 patients undergoing liver transplants at the University of Minnesota were analyzed to determine if histological features could predict the eventual outcome of rejection episodes. Thirty-six patients (76.6%) rejected the transplant. Of these, five either suffered acute liver failure due to rejection (two cases) or developed chronic rejection (three cases). Features of significance in predicting such a bad outcome were arteritis, bile duct paucity, or simultaneous hepatocellular ballooning and hepatocellular dropout and necrosis. Other features, such as type and intensity of infiltrate, degree of bile duct damage, or simple presence of hepatocellular necrosis, were not predictive of outcome. Our conclusion is that biopsy is useful in predicting outcome. Since many of the histologic findings of predictive value were not present in initial pretreatment biopsy specimens, follow-up biopsies of patients being treated for rejection are recommended to assess efficacy of therapy. PMID- 3538919 TI - Compatibility of relapse patterns of Plasmodium cynomolgi infections in rhesus monkeys with continuous cyclical development and hypnozoite concepts of relapse. AB - This report encompasses the results of two studies on the relapse patterns of infections with the B strain of Plasmodium cynomolgi treated repetitively with chloroquine. One study of sizeable dimensions dealt primarily with relapses that occurred within 120 days of onset of patency in infections induced with inocula of 10(5) to 7 X 10(6) sporozoites. The second study, of more limited dimensions, dealt with relapses that occurred over a 689-day period after inoculation with 5 X 10(0) to 5 X 10(6) sporozoites. Both studies showed that with few exceptions relapses occurred at relatively regularly spaced intervals. The second study showed that frequency of relapse was related directly to the size of the sporozoite inoculum and inversely to the age of the infection; also that an inoculum larger than the minimum infective dose was required for relapse. Attempted correlation of these observations with the new and generally accepted hypnozoite concept of relapse uncovered two areas of serious incompatibility and numerous defects in the experimental base of this conceptualization. With limited provisos, the relapse patterns of infections with P. cynomolgi are fully compatible with the older cyclical development concept. The results of this study argue for caution in discarding this concept and for continuation of efforts to determine the genesis of the extended post-primary attack latent period that characterizes infections with the majority of strains of P. vivax. PMID- 3538918 TI - Placental alkaline phosphatase immunoreactivity in testicular germ-cell neoplasms. AB - We analyzed the sensitivity of a polyclonal antibody to placental alkaline phosphatase (PLAP) in labelling testicular germ-cell neoplasms, by utilizing the peroxidase-antiperoxidase technique. The immunoreactivity of 89 germ-cell tumors for PLAP was as follows: 98% of cases with seminomatous elements were PLAP positive; 97% of embryonal carcinomas and 85% of endodermal sinus tumors also showed reactivity. Cytotrophoblastic cells were focally immunoreactive in one of two cases with choriocarcinomatous elements. Staining for PLAP was strongest and most diffuse in seminomas. Intratubular germ-cell neoplasia (ITGCN) or carcinoma in situ was present in 53 (84%) of 63 specimens that had adjacent seminiferous tubules available for evaluation; PLAP was demonstrated in 98% of these. In addition, the germ-cell elements in 11 gonadoblastomas were immunoreactive for PLAP. One of 17 cases of undescended testes had ITGCN that was also strongly immunoreactive, but the remaining 16 cases were negative. Five dysgenetic gonads without ITGCN were studied, and one was immunoreactive for PLAP. Three testicular biopsy specimens from infertile men without ITGCN were PLAP-negative. Our findings indicate that PLAP is a highly sensitive marker for seminomas, for the majority of embryonal carcinomas and endodermal sinus tumors of the testis, and for ITGCN. PMID- 3538920 TI - Giardia lamblia: a culture method for determining parasite viability. AB - A simple, quantitative method has been developed to assess the viability of Giardia lamblia trophozoites after exposure to a potentially lethal agent. This method utilizes the ability of trophozoites which remain viable to replicate and multiply. In this study, the percent dead trophozoites after incubation in 20% fresh human serum was determined first by morphologic criteria and then by the ability of parasites to multiply in fresh medium over 48 hr. Using the number of parasites after 48 hr of growth, the original number of dead trophozoites in the serum-exposed samples was determined by extrapolation from a standard growth curve. Ten sera which killed from 7% to 89% of trophozoites by morphologic criteria, killed 8% to 92% using the culture method; these two assays for viability correlated highly (r = 0.96). Use of the culture assay allows the assessment of the lethal effects of serum and can be applied both to the study of other host defense mechanisms on Giardia trophozoites and to antimicrobial susceptibility testing. PMID- 3538921 TI - Isolation of potential serodiagnostic Fasciola hepatica antigens by electroelution from polyacrylamide gels. AB - In the present study a partially purified antigen preparation enriched in Fasciola-specific antigens (designated p3 and 4) was used in the enzyme-linked immunoelectrotransfer blot (EITB) to identify polypeptides which induce antibody formation in acute fascioliasis. The pattern of antigens recognized by the sera of infected rabbits, humans, and cows was also compared. Similar but not identical patterns of recognition were obtained for the different models tested; the main antigenic polypeptides recognized were in clusters within 27-38, 18-23, and 11-14 Kd molecular weight (Mr) ranges. An antigen of 31-33 Kd was one of the most prominently recognized by all of the acute infection sera tested. This antigen, as well as those in the 18-23 Kd range, appear to have good specificity, as they are not recognized by antibodies to S. mansoni or P. westermani adult worm extracts. To further characterize and evaluate these low Mr antigens, we have isolated polypeptides by electrophoresing p3 and 4 F. hepatica antigens in 10%-15% gradient gels, identifying the desired Mr range with prestained markers, cutting individual gel strips, and then isolating them by electroelution. Antigen fractions of 19-23 and 31-33 Kd were isolated in this manner, re-electrophoresed, transferred to nitrocellulose and found to be reactive with the sera from a rabbit with acute fascioliasis. At least one of these antigens, of 20 Kd Mr, has been obtained by this means with a high degree of purity. This, as well as other antigen fractions isolated, showed high absorbance values in ELISA when reacted with the serum from a rabbit with an 8-week-old F. hepatica infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538922 TI - Randomized comparative trial of three monospecific antivenoms for bites by the Malayan pit viper (Calloselasma rhodostoma) in southern Thailand: clinical and laboratory correlations. AB - Three monospecific antivenoms for Malayan pit viper (MPV) (Calloselasma rhodostoma) were compared in Southern Thailand, where this species is the most common cause of snake bite morbidity. Forty-six patients with proved MPV bites and incoagulable blood, indicating systemic envenoming, were randomly allocated for treatment with Thai Red Cross (TRC), Thai Government Pharmaceutical Organization (GPO), or Twyford Pharmaceutical monospecific antivenoms. Both GPO and Twyford antivenoms produced rapid and permanent restoration of blood coagulability, but TRC antivenom failed in 2/15 cases. Patients in the GPO group showed the greatest increase in plasma fibrinogen concentration during the first 24 hr and had fewer early anaphylactic reactions (6/15) compared with Twyford 8/16 and with TRC 13/15. Pyrogenic reactions occurred more frequently after TRC antivenom (8/15) than GPO (1/15) or Twyford (0/16). Patients requiring more than one dose of antivenom were identifiably more severely envenomed on admission. In an accompanying laboratory study the antivenoms were assessed in rodents using five WHO standard tests of neutralizing activity. Compared with the other two antivenoms TRC was significantly inferior in anti-lethal potency, GPO was superior in anti-hemorrhagic and anti-necrotic potency and Twyford was superior in anti-procoagulant and anti-defibrinogenating potency. The clinical efficacy of these antivenoms against local necrosis remains equivocal. GPO and Twyford antivenoms are recommended for the treatment of systemic envenoming by MPV in an initial dose of 5 ampoules. PMID- 3538923 TI - Postsplenectomy infection in patients with chronic leukemia. AB - The added risk of infectious complications due to splenectomy in patients already immunocompromised because of chronic leukemia was studied over a 22 year period. When compared to patients with chronic leukemia who did not undergo splenectomy, survival was not influenced. Splenectomy did significantly increase the total number of serious infections (65 percent versus 35 percent, p less than 0.001), the number of infections per patient (p less than 0.05), and the interval between infections (p less than 0.01) in this patient population. Fatal septic episodes were not due to Streptococcus pneumoniae, but did occur significantly more often in the splenectomy group (22 percent versus 7 percent, p less than 0.05). Although the location of infection was similar, there was a significant difference in the number of Pseudomonas aeruginosa infections in the patients who had undergone splenectomy (p less than 0.05). Consideration must be given to the significantly increased risk of postoperative infectious morbidity in patients with chronic leukemia when evaluating the usefulness of splenectomy. PMID- 3538924 TI - Guidelines for weaning from positive end-expiratory pressure in ventilated patients. AB - Positive end-expiratory pressure is helpful in avoiding hypoxemia but can cause barotrauma to the lungs and heart. Reducing positive end-expiratory pressure as quickly as possible without sacrificing oxygenation is desirable. Weaning from positive end-expiratory pressure is an integral part of removing mechanical ventilation, but the selection of patients for positive end-expiratory pressure reduction and appropriate monitoring after this has not been established. We prospectively studied 29 positive end-expiratory pressure weaning trials to document oxygenation changes. Patients had stable vital signs and were not septic. All were receiving inspired oxygen concentrations of 50 percent or less and 5 to 12 cm H2O of positive end-expiratory pressure. Positive end-expiratory pressure was decreased by 2 cm H2O increments. Arterial blood gas levels were monitored at 1, 3, 5, and 30 minutes and at 1, 2, 4, and 6 hours after positive end-expiratory pressure reduction. Positive end-expiratory pressure reduction was successful if the partial pressure of oxygen value did not decrease below 65 mm Hg. Patients were successfully weaned from positive end-expiratory pressure in 27 of 29 trials (93 percent). The partial pressure of oxygen nadir occurred at 30 minutes. In successful trials, the partial pressure of oxygen value decreased an average of 12 mm Hg, an average change of -8 percent from the baseline partial pressure of oxygen value. This returned to baseline within 6 hours in only 13 patients (48 percent). The two patients in whom weaning failed had clinical signs of hypoxemia at 30 minutes. Their changes in partial pressure of oxygen at 30 minutes averaged -44 mm Hg (a 41 percent decrease). These data outline an approach to positive end-expiratory pressure weaning which is easy and practical. It supports oxygenation with the least physiologic embarrassment to the patient. In our patients it was 100 percent predictive of success. PMID- 3538925 TI - General surgical procedures in renal allograft recipients. AB - Since elective and emergent nontransplant-related surgical procedures are frequently necessary in renal allograft recipients, it becomes essential to determine the incidence and outcome of these operations in this population. For this reason, a retrospective analysis of 273 consecutive renal transplants performed in 254 patients between January 1978 and November 1985 was accomplished. During this interval, 139 patients underwent 162 nontransplant related surgical procedures. In the 44 patients who underwent 55 emergent or semiemergent procedures, 8 patients (18 percent) died in the postoperative period. All deaths occurred in patients who underwent major abdominal or thoracic procedures for perforated viscera, gastrointestinal bleeding, or empyema and lung abscess, and all deaths were secondary to sepsis and multiple organ failure. In the survivors of emergent procedures, the mean preoperative and discharge serum creatinine levels were 2.87 mg/dl and 2.82 mg/dl, respectively. In the 95 patients who underwent 107 elective procedures, most of which were performed under general anesthesia, the operative mortality was 4.2 percent. In patients with stable renal allograft function at the time of operation, mean serum creatinine levels preoperatively and at the time of discharge were not significantly different (1.74 mg/dl versus 1.64 mg/dl). In conclusion, emergent operative procedures for intraabdominal or thoracic catastrophes are associated with a high mortality rate in renal allograft recipients. On the other hand, elective surgical procedures can be undertaken with an acceptable mortality rate and no adverse affects on graft function. Of utmost importance in these patients is the close monitoring of the immunosuppressive regimen and the early detection and treatment of potential septic complications. PMID- 3538926 TI - [An experimental study of responses of denture supporting tissue. Light and electron microscopy study on human palatal mucosa stressed mechanically with dentures]. PMID- 3538927 TI - [Effects of removing methods on the deformation of impression--especially of vinyl silicone rubber impression materials immediately after removal]. PMID- 3538928 TI - The Health Care Financing Administration and Medicare. PMID- 3538929 TI - Radioactivity in the service of humanity. PMID- 3538930 TI - Epidermal Langerhans cells in patients with primary Sjogren's syndrome. AB - IgG-binding to the surface of Langerhans cells (LC) is a feature of primary Sjogren's syndrome and might be associated with qualitative and quantitative defects in LC. Fifteen patients with primary Sjogren's syndrome and 15 healthy controls had a punch biopsy performed from clinically unaffected skin. LC were enumerated in epidermal sheets by an immunoperoxidase technique, as well as demonstrated by immunofluorescence in vertical sections, which were furthermore examined for in vivo deposits of immunoglobulins, fibrinogen and C3. A significant (P less than 0.05) reduction in number of LC, measured on epidermal sheets, was found in patients as compared with controls. Examination of vertical sections did not reveal abnormalities in morphology or localisation of epidermal LC. Intraepidermal IgG deposits were demonstrated in 7/15 patients. In vivo deposits were not found in any of the controls. The density of epidermal LC was not correlated to the presence of intraepidermal IgG deposits. PMID- 3538931 TI - One-lung ventilation. The effect of positive end expiratory pressure to the nondependent and dependent lung. AB - We applied positive end expiratory pressure to the nondependent, nonventilated lung, or both nondependent and dependent, ventilated lung during one lung anaesthesia, and compared the results to those obtained by other techniques, such as increasing the inspired oxygen concentration in the dependent lung, or insufflating with oxygen using positive end expiratory pressure in the nondependent lung. Our study suggests that arterial oxygenation and intrapulmonary shunt can be lessened during one lung ventilation by continuous oxygen insufflation of the nondependent lung at 0.98 kPa positive end expiratory pressure while the dependent lung is ventilated with 0.49 kPa positive end expiratory pressure. PMID- 3538933 TI - Premedication for children. PMID- 3538932 TI - Severe upper airway obstruction and difficult intubation in cicatricial pemphigoid. AB - Upper airway obstruction in cicatricial pemphigoid is rarely seen by the anaesthetist. A case of severe dyspnoea due to progressive laryngeal obstruction is presented. Tracheal intubation during induction of general anaesthesia for permanent tracheostomy was extremely difficult and was successfully performed by introducing a size 12 French suction catheter through the stenotic laryngeal orifice. Adequate ventilation was achieved by using the oxygen flush valve to deliver oxygen intermittently through the catheter. PMID- 3538934 TI - Anaesthesia for extracorporeal shock wave lithotripsy. PMID- 3538935 TI - Safety of a new system for continuous positive airway pressure. PMID- 3538936 TI - [A controlled double-blind trial of the possibilities of using nalbuphine in anesthesia in major surgical interventions on the upper abdomen]. AB - A controlled, double-blind assessment of nalbuphine 0.3 mg kg-1 as an analgesic component of anaesthesia was made in 40 patients undergoing major upper abdominal surgery. The unpremedicated patients received thiopentone, alcuronium, nitrous oxide and oxygen, and either nalbuphine or saline. Enflurane was used to suppress autonomic nervous responses to surgery. Nalbuphine 0.3 mg kg-1 failed to influence the course of anaesthesia or the onset of post-operative pain, and produced no side-effects. PMID- 3538937 TI - [Ketamine/flunitrazepam--an alternative intravenous anesthesia]. AB - In a controlled randomized study, 21 patients who received a combination of ketamine and flunitrazepam with relaxation and N2O/O2-ventilation were compared with 20 patients who received neuroleptic analgesia (NLA) for intra-abdominal surgery. The two groups of patients were comparable with respect to age, sex, type of surgery, time of operation and coexistent diseases. The dosage of ketamine chosen was a total of 0.92 mg/kg per hour. For maintenance of anaesthesia, only 0.5 mg/kg per hour was used. In combination with 0.7-1.0 mg flunitrazepam and N2O/O2 ventilation, this low dose of ketamine was satisfactory. Electroencephalographic and electromyographic recordings demonstrated and adequate level of anaesthesia. The determination of serum free fatty acid levels showed a well-balanced in stress. Occasional elevations of blood pressure--which also were seen in the NLA-group--were not overcome by increasing the ketamine dosage. A brief addition of enflurane or isoflurane was more effective. The immediate postoperative onset of spontaneous respiration without complications and with normal CO2 levels was remarkable. The method was well accepted by the anaesthetist responsible and the nursing personnel. PMID- 3538938 TI - [Glucose-potassium-insulin in hypodynamic septic shock]. AB - Haemodynamic and metabolic effects of glucose-potassium-insulin (GKI) were studied in 14 patients with peritonitis. Study entry criteria were: hypodynamic septic shock (mean arterial pressure less than 50 mmHg and cardiac index less than 3.5 l/min) despite a highly positive fluid balance (greater than +2,000 ml during the last 12 h) and use of catecholamines (greater than 15 mcg/kg/min Dobutamine). GKI (glucose 70% 1 g/kg + potassium 10 mval + insulin 1.5 U/kg) was infused within 15 min via a central venous catheter. Before and 10 min after GKI haemodynamic and metabolic measurements were performed. GKI led to significant increases in systolic (+53%) and mean (+61%) arterial pressures, cardiac index (+50%), right (+60%) and left (+109%) ventricular stroke work indices, and oxygen consumption index (+18%). Heart rate remained unchanged, pulmonary shunt fraction increased slightly, systemic and pulmonary vascular resistances showed an insignificant decline. Serum glucose (p less than 0.01) and pCO2 (p less than 0.1) increased. The haemodynamic improvement lasted from 30 min or less (n = 3; 21%) to several hours. Nine patients (64%) survived more than 2 days, and two patients (14%) were eventually discharged from the hospital. We conclude, that in hypodynamic septic shock refractory to volume loading and catecholamine treatment GKI may be beneficial, although the mechanism of action remains unclear. PMID- 3538939 TI - Determination of ethylene dibromide in aquatic environments. PMID- 3538940 TI - [Efferent innervation of the larynx in domestic pigeons (Columba livia domestica L]. AB - The motoneurons innervating the larynx of the pigeon were localized with the horseradish peroxidase (HRP)-method (Mesulam 1978). After injection of HRP into the laryngeal muscles the exact position of the Nucleus ambiguous could be determined, which lays in the region of 600 micron rostral to 1,000 micron caudal of the obex. PMID- 3538941 TI - Anesthesia on the Western Front: the Anglo-American experience of World War I. PMID- 3538942 TI - [Anatomo-pathologic verification of non-invasive diagnosis: a duplex-scanner study of carotid atheroma]. PMID- 3538943 TI - Nocardiosis in recipients of renal transplants: evidence for nosocomial acquisition. PMID- 3538944 TI - Arteriosclerotic carotid lesions in hyperlipoproteinemia. AB - An ultrasonographic study was performed in 187 hyperlipoproteinemia patients to evaluate the incidence of atheromatous lesions in the extracranial carotid tract. A high-resolution, real-time, B-mode instrument with two probes (4- and 8-MHz) was used. Fifty-five subjects had high blood cholesterol levels, 70 high triglyceride values, and 62 both. Arteriosclerotic disease was present at other sites in 39% of the patients. Atheromatous carotid lesions were revealed in 37% of the patients, and there seemed to be no significant correlation with the type of hyperlipoproteinemia. There was also no correlation between blood cholesterol levels and the presence or absence of atheromatous lesions. Increasing age and arteriosclerotic disease at other sites were the factors most frequently associated with atheromatous lesions in the extracranial carotid tract. PMID- 3538945 TI - Double-blind comparison of ketanserin with placebo in patients with essential hypertension. AB - Two double-blind multicenter trials were performed to compare the antihypertensive action of ketanserin, at an oral dosage of 20 mg three times daily, with that of placebo over a period of four to six weeks. A subset of patients was treated in a crossover fashion for either four weeks (36 patients) or six weeks (24 patients). The patients had essential hypertension, with a diastolic blood pressure greater than or equal to 95 mmHg measured in sitting position at the end of a placebo run-in period of at least one week. In a first trial, 78 of 82 patients completed the four-week study period, where the mean drop of the systolic/diastolic blood pressure was -14/-12 mmHg in the ketanserin group (n = 32) versus -8/-5 mmHg in the placebo group (n = 46). This difference is statistically significant (p = 0.05/p less than 0.01). In 13 patients who after the initial ketanserin treatment were further treated with placebo in crossover for four weeks, the blood pressure rose slightly (+1/+3 mmHg). In the alternative group (n = 23), the blood pressure fell by -10/-7 mmHg after placebo and decreased further by -10/-8 mmHg after ketanserin. In a second trial, 24 patients completed a two by six week crossover treatment. In 12 patients assigned to the sequence placebo-ketanserin, there was a drop of the systolic/diastolic blood pressure by -7/-4 mmHg after placebo and an additional drop by -26/-10 mmHg after ketanserin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538946 TI - Flow velocity measurement using digital subtraction angiography for hemodynamic evaluation in arterial occlusive disease. AB - A method for mean flow velocity measurement using digital subtraction angiography (DSA) was evaluated, along with the results of phantom and animal experiments. The validity of its clinical use was studied by applying this technique in the arteries and bypass grafts in patients with arterial occlusive disease. Mean flow velocity was reliably determined by this method, but it could not be used as a determinant of arterial occlusive disease, because of a considerable overlapping between limbs with and without significant arterial lesions. A low value of mean flow velocity was not itself a reliable prognostic indicator of bypass failure. However, measurement of mean flow velocity was valuable in detecting functional abnormalities of the graft. PMID- 3538947 TI - [Effect of oxygen free radicals on collagen in inflammation]. AB - Oxygen derived free radicals are able to degrade collagen fibrils and to participate with the collagenases to collagen degradation in the inflammatory phenomena. This effect was experimentally demonstrated in vitro by the use of chemical or physical systems of oxygen free radicals production. In addition certain free radicals increase the cross-linking of collagen. The relationship between collagen degradation in inflamed areas and the subsequent fibrosis, despite its medical interest, is not yet explained. PMID- 3538949 TI - [Methods of studying platelet function. Biological markers of the activation of human platelets in vivo and in vitro]. AB - Platelets play a key role in hemostasis, thrombosis, atherosclerosis and their pathological consequences. It is possible to follow platelet activation in vivo by measuring bleeding time, platelet count, existence of circulating platelet aggregates or platelet survival and sequestration. In vitro tests include measurement of platelet adhesion, aggregation alpha, and dense granule secretion. It is also possible to follow biochemical events linked to platelet activation such as prostaglandin metabolism, Ca2+ levels or platelet membrane modifications (receptors, glycoproteins, coagulant activities, antigens). Some of these markers of platelet activation are modified in diseases (thrombotic events, hyperlipoproteinemia) and the use of artificial surfaces. It is not always possible to know if the modifications are the cause or the consequence of the pathological event. Unfortunately, some results are questionable because of methodological procedures. Some of these tests have been used to follow the involvement of platelets in a pathological event or to evaluate a prethrombotic state in a patient. It is not yet possible to identify directly, or by the mean of a marker of platelet activation, a patient who is likely to experience a thrombotic episode. PMID- 3538948 TI - [D-penicillamine and collagen]. AB - D-penicillamin is widely used for the treatment of various diseases, such as cystinuria. Wilson's disease or rheumatoid arthritis. It is an osteolathyrogenic agent. This effect may explain some side-effects such as fetal dysplasias, wound healing defects, skin lesions, obliterative bronchiolitis, auto-immune abnormalities. Conversely the collagen effects of D-Penicillamin explain its use in various fibrosis states such as progressive systemic sclerosis, liver or lung fibrosis. PMID- 3538950 TI - [Atheroma and heterogeneity of lipoproteins: the medical aspect]. PMID- 3538951 TI - [Stability and/or variability of the expression of genetic polymorphism of hydroxylation and acetylation in patients with various pathologies and under various treatments]. AB - During the last decade, the Drug Monitoring allowed the clinician to control the efficiency and/or the toxicity of the used drugs. This control is of a posteriori type. The discovery of the various genetic polymorphisms (acetylation, oxidation), the use of probe drugs (caffeine, sulfadimidine, dapsone, debrisoquine, sparteine) and the fact that other drugs exhibit the same polymorphisms as the probe drugs gave the opportunity to develop non invasive methods, to study in population the distribution of the various genetic tracts, to check the subjects who might be at risk toward a drug. Can, the obtained results in simple situation be extrapolated to complex pathological or therapeutic situations? Among patients with side and/or toxic effects of the drugs, there is a significant increase of the poor metaboliser (PM) status of debrisoquine. But it is necessary to carefully check the state of the patients before phenotyping them (drug, hepatic, metabolic, renal diseases). If the patients are taking drugs which share the same genetic polymorphism as debrisoquine during the time where the phenotype is established, some misfits can happen. The patients taking propafenone present a false PM status of debrisoquine. This is less obvious with mexiletine. In a population of 200 epileptics neither the disease nor the therapeutics seem to modify the distribution of the two phenotypes PM and EM. All things considered we do not know exactly the limits of use of these tests in the patients. We need more data to validate the advices dealing with the use of pharmacogenetic concepts as a provisional tool for patient cares? PMID- 3538952 TI - [Infectious viral diarrheas. Comparison of research methods for rotaviruses]. AB - Radioimmunoassay and enzyme immunoassay (EIA) are generally recommended for routine diagnosis of rotavirus infection in childhood gastroenteritis. Expensive and delicate, these techniques are ill-suited for processing a small number of samples. Recently, Latex agglutination tests have been introduced than can be performed by non specialized hospital laboratories. However, some questions have been raised as to the sensitivity and specificity of these tests. We have sought a direct appraisal of latex agglutination testing by comparing two enzyme immunoassays and two latex tests (Rotazyme, Enzygnost-Rotavirus, Rotalex, Slidex Rota-kit). Three comparative studies that involved 1217 stool samples from children with gastroenteritis were carried out. Specificity, sensitivity, of latex tests compared favorably with the more sophisticated EIA, they represent a very convenient alternative for routine laboratory use provided latex tests with low rate of non-specific agglutinations are chosen. PMID- 3538953 TI - Identification of Mycobacterium bovis, using miniaturized thin-layer chromatography and morphologic characteristics. AB - Lipid analysis was performed on 204 isolates of mycobacteria, using miniaturized thin-layer chromatography (MTLC). A previously described lipid component was found in 92 (96.8%) of 95 isolates of Mycobacterium bovis and in 2 (1.8%) of 109 isolates of other mycobacteria. Using MTLC, an isolate could be identified as M bovis 3 to 4 weeks earlier than by use of conventional biochemical techniques. Examination of isolates for colonial and cellular morphologic characteristics was a useful adjunct in the identification of M bovis by use of MTLC. PMID- 3538954 TI - Endotoxin-induced bovine mastitis: immunoglobulins, phagocytosis, and effect of flunixin meglumine. AB - Milk whey immunoglobulins (Ig) and phagocytosis of staphylococci by milk polymorphonuclear neutrophilic leukocytes (PMN) were measured in 12 cows (allotted to 6 pairs) during acute bovine mastitis induced by intramammary inoculation of endotoxin. Six of these cows (or 1 in each pair) were treated with flunixin meglumine and were compared with the others (given only saline solution). The endotoxin inoculation comprised 10 micrograms of Escherichia coli O26:B6 lipopolysaccharide injected into one of the rear quarters (mammae). Flunixin meglumine was administered parenterally at a dosage of 1.1 mg/kg every 8 hours (total of 7 doses) beginning at 2 hours after endotoxin was injected. Milk samples were obtained, and whey samples were prepared from each quarter of each cow 3 times before inoculation and at 2, 4, 8, 12, 24, 48, 72, 96, 120, 144, 168, and 336 hours after endotoxin was inoculated. Significant increases (P less than 0.05) in milk whey IgG1, IgG2, IgM, and IgA concentrations were observed in whey samples from endotoxin-inoculated quarters. Greatest relative increase was seen for IgG2. Increased whey Ig concentrations were not observed in quarters which were not inoculated with endotoxin. Concentrations of whey IgG1 and IgM in endotoxin-inoculated quarters were significantly (P less than 0.05) decreased in flunixin meglumine-treated cows, compared with those in saline solution-treated cows. Significant increases in phagocytosis of staphylococci by milk PMN were observed in whey samples from endotoxin-inoculated quarters. Significant differences in PMN phagocytosis were not found in whey samples from cows given flunixin meglumine when compared with whey samples from cows given saline solution. PMID- 3538955 TI - Methylprednisolone and gentamicin effects on hepatosplanchnic blood flow and carbohydrate metabolism in endotoxemic Yucatan miniature pigs. AB - Conjoint therapy of a glucocorticoid and aminoglycoside antibiotic have been recommended for septic shock. These studies examined the hemodynamic and metabolic effects of methylprednisolone sodium succinate (MPSS) with and without gentamicin sulfate in a nonanesthetized model of nonseptic endotoxemia in Yucatan miniature pigs. Methylprednisolone sodium succinate alone had no effect on endotoxin-induced systemic hypotension. Endotoxemic pigs treated with MPSS in combination with gentamicin sulfate had lower mean arterial pressures than did MPSS-treated and nontreated endotoxemic pigs. Methylprednisolone sodium succinate alone and with gentamicin sulfate improved portal and hepatic venous blood flows moderately. Net hepatic lactate extraction, glucose production, and whole body [6 3H]glucose-derived rates of glucose appearance were also improved, but [6 3H]glucose-derived rates of glucose disappearance and blood lactate concentrations were increased, leading to no improvement in plasma glucose concentration. Pancreatic insulin secretion was higher in treated groups, which may have contributed to greater glucose utilization rates. Hepatic oxygen extraction efficiency was not affected by treatment, but increased in all groups to maintain hepatic oxygenation at base-line values. Although a calcium antagonistic activity of gentamicin has been reported to synergize with endotoxin, thereby adversely affecting cardiovascular function, such effects did not complicate the metabolic response to steroid in the present studies. PMID- 3538956 TI - Ibuprofen prevents synthetic smoke-induced pulmonary edema. AB - Multiple potentially injurious agents are present in smoke but the importance of each of these agents in producing lung injury as well as the mechanisms by which the lung injury is produced are unknown. In order to study smoke inhalation injury, we developed a synthetic smoke composed of a carrier of hot carbon particles of known size to which a single known common toxic agent in smoke, in this case HCI, could be added. We then exposed rats to the smoke, assayed their blood for the metabolites of thromboxane and prostacyclin, and intervened shortly after smoke with the cyclooxygenase inhibitors indomethacin or ibuprofen to see if the resulting lung injury could be prevented. Smoke exposure produced mild pulmonary edema after 6 h with a wet-to-dry weight ratio of 5.6 +/- 0.2 SEM (n = 11) compared with the non-smoke-exposed control animals with a wet-to-dry weight ratio of 4.3 +/- 0.2 (n = 12), p less than 0.001. Thromboxane B, and 6-keto prostaglandin F1 alpha rose to 1,660 +/- 250 pg/ml (p less than 0.01) and to 600 +/- 100 pg/ml (p greater than 0.1), respectively, in the smoke-injured animals compared with 770 +/- 150 pg/ml and 400 +/- 100 pg/ml in the non-smoke-exposed control animals. Indomethacin (n = 11) blocked the increase in both thromboxane and prostacyclin metabolites but failed to prevent lung edema.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3538957 TI - A randomized controlled clinical trial of pharmacokinetic theophylline dosing. AB - Ninety-one patients admitted to hospital with acute air-flow obstruction and requiring theophylline therapy were randomly assigned to either a monitored or a control group. Intravenously administered and subsequent orally administered theophylline dosages for patients in the monitored group were adjusted daily on the basis of each patients's estimated theophylline clearance; dosages for control patients were determined by attending physicians, using knowledge of theophylline serum concentrations. During intravenous therapy, fewer monitored than control patients had serum theophylline concentrations in the toxic range (18.9 versus 37.8%, p = 0.04), and during subsequent oral therapy more monitored than control patients had serum theophylline concentrations in the therapeutic range (71.1 versus 44.4%, p = 0.018). There was a trend for peak expiratory flow rates to normalize more quickly in monitored patients, and their mean duration of hospital stay was shorter (6.3 versus 8.7 days, p = 0.029). Two patients in the control group died; both had theophylline concentrations above 25 micrograms/ml and clinical toxicity. No serious side effects were observed in the monitored group. With pharmacokinetic individualization of theophylline dosage, more patients achieved serum concentrations in the therapeutic range, and there was a tendency for more rapid clinical improvement. PMID- 3538959 TI - Diaphragm pacing and continuous positive airway pressure. AB - The effect of changes in continuous positive airway pressure (CPAP) on the tidal volume generation by the diaphragm during electrical stimulation of the phrenic nerves in a quadriplegic patient is presented. Measurements of tidal volume, end tidal PCO2, arterial PCO2, oxygen consumption, physiologic dead space to tidal volume ratio, diaphragm length, and thoracic and abdominal dimensions were made at values of CPAP from 0 to 20 cm H2O during periods of diaphragm pacing. Total respiratory compliance (TRC) was measured during controlled ventilation with incremental positive end-expiratory pressure (PEEP) from 0 to 20 cm H2O. A significant negative correlation was found between increasing CPAP and generated tidal volumes. This correlation was seen to occur even when TRC was constant at degrees of CPAP from 0 to 7.5 cm H2O. When phrenic nerve stimulation was commenced, oxygen consumption rose significantly from values obtained during controlled ventilation, but there was no significant correlation between changes in CPAP and the rise in oxygen consumption. Using inductance methods, thoracic and abdominal diameters were seen to rise as CPAP was increased. As suggested by the decrease in the length of the vertical and horizontal portions of the diaphragm in the chest roentgenogram, the conformation of the diaphragm also changed. It is suggested that the operating length and conformation of the diaphragm are principal factors affecting tidal volume generation during electrical stimulation of the phrenic nerves. PMID- 3538958 TI - Neural control of human airways in health and disease. AB - Several aspects of airway function are under autonomic control: airway smooth muscle tone, submucosal gland secretion, epithelial cell function, bronchial vascular tone and permeability, and probably secretion from mast cells and other inflammatory cells. Neural control of human airways is more complex than previously recognized. In addition to afferent nerves and cholinergic adrenergic mechanisms (including circulating catecholamines), there are nonadrenergic, noncholinergic nerves that may be both excitatory and inhibitory. The neurotransmitters of this third nervous system are uncertain, but there is some evidence that neuropeptides may be involved. Several neuropeptides have recently been identified in human airways and, although they have potent effects, their pathophysiologic role is uncertain. There is much evidence that autonomic control of the airways may be abnormal in airway disease, particularly in asthma, but the precise role of neural mechanisms in the pathogenesis of air-flow obstruction and bronchial hyperresponsiveness remains to be defined. PMID- 3538960 TI - Factors that contribute to inhibition of methacholine-induced bronchoconstriction. PMID- 3538961 TI - [Ovarian torsion in early childhood]. AB - Three cases of torsion of normal the uterine adnexa in premenarcheal girls are reported. The possible etiopathogenic mechanisms are commented, and the operative management is discussed. The value of ultrasonography in early diagnosis is pointed out. PMID- 3538962 TI - Oral norfloxacin for prevention of gram-negative bacterial infections in patients with acute leukemia and granulocytopenia. A randomized, double-blind, placebo controlled trial. AB - We evaluated the effect of norfloxacin, 400 mg given orally every 12 hours, on the prevention of bacterial infections in 68 adult patients who had acute leukemia throughout prolonged courses of granulocytopenia (median, 32 days). Gram negative infections were documented in 13 of the 33 patients receiving placebo, but only in 4 of the 35 patients receiving norfloxacin; no effect on the frequency of gram-positive or fungal infections was noted. Norfloxacin administration resulted in the suppression of gastrointestinal tract colonization by aerobic bacteria without the development of norfloxacin resistance. Patients receiving norfloxacin developed first infectious fevers later than did those receiving placebo, had more rapid resolution of that fever after systemic antibiotic treatment, and spent less time febrile. Therefore, although no difference was seen in survival duration, we found that the prophylactic administration of oral norfloxacin led to decreases in overall morbidity and gram negative infections, was well tolerated, and did not predispose to the development of multiply drug-resistant bacteria. PMID- 3538963 TI - Collagenous colitis. AB - Two hypotheses have been proposed to explain the pathogenesis and cause of the increased subepithelial collagen deposition that occurs in patients with collagenous colitis, a rare disease of unknown cause. One hypothesis considers an inflammatory origin, and the other, a local abnormality of collagen synthesis. An analysis of clinical, endoscopic, and histologic findings from one of our patients and from previously published cases suggests that collagenous colitis is a form of inflammatory bowel disease characterized by localization of the initial injury to the superficial subepithelial zone and with subsequent fibrosis in that area. The data show a spectrum of clinical and histologic changes that represent different stages in the evolution of the inflammatory process. PMID- 3538964 TI - Effect of a health maintenance organization on physiologic health. Results from a randomized trial. AB - In a previous comparison of persons between 14 and 62 years of age randomly assigned to receive care through a fee-for-service system (n = 784) or through a health maintenance organization (HMO) (n = 738) in Seattle, Washington, persons in the HMO had much lower hospital expenditures and admissions, more bed days, a higher prevalence of serious symptoms, and less satisfaction with care. We report an examination of 20 additional health status measures. Our results are consistent with a hypothesis of no differences in health status measures between the two systems. In addition, a comparison of nine health practices between the systems also indicated no overall differences. Most physiologic measures and health practices for a typical person were not affected by care received through the fee-for-service system or the HMO. However, we are less certain of this result in specific subgroups, such as persons of lower income initially at elevated risk, because confidence intervals are necessarily wider. We conclude that the cost savings achieved by this HMO through lower hospitalization rates were not reflected in lower levels of health status. PMID- 3538965 TI - The impact of health maintenance organizations on geriatric care. AB - Increasing numbers of health maintenance organizations (HMOs) are contracting with the federal government to permit enrollment of Medicare beneficiaries, and increasing numbers of the elderly are joining HMOs. A review of past HMO performance suggests that, although these organizations will try to effect a decrease in the rate and duration of hospitalization to control costs, a high rate of functional disability and acute illness in elderly patients will make it impossible to accomplish this significantly. Also, although HMOs will attempt to provide more comprehensive coverage, the demand for prescription drugs, eyeglasses, and medical devices will make such coverage very expensive. Attempts to ration the services of primary-care physicians will impede case management and continuity of care. If HMOs are to provide high-quality medical care at a reasonable cost, they will need to consider making use of geriatric assessment units, geriatric consultants, geriatric nurse practitioners, and special geriatric hospital wards. PMID- 3538966 TI - Medicare payment for physician services. Health and Public Policy Committee, American College of Physicians. PMID- 3538967 TI - Computer searching of the medical literature. PMID- 3538968 TI - The complete blood count and leukocyte differential count. An approach to their rational application. AB - The complete blood count and leukocyte differential count have no value in screening asymptomatic members of the general population. The complete blood count may be useful for screening infants in the first year of life, institutionalized elderly persons, pregnant women, and recent immigrants from Third World countries, if poor nutrition or inadequate iron intake is suspected. These tests are not useful for hospitalized patients, unless an abnormality is suspected or surgery with major blood loss is anticipated. It is appropriate to obtain the tests when a hematologic or infectious disorder is suspected, but they may not affect decision making if the diagnosis is clinically evident. The leukocyte differential count is unnecessary to confirm an infection in most cases in which leukocytosis is present. Repeat tests should be limited to situations where the clinical course is unclear, and at intervals long enough such that the results might affect clinical decision making. PMID- 3538969 TI - Hirsutism. AB - Excess body hair, or hirsutism, is usually only a problem in women and can cause considerable psychological distress. The disorder is usually androgen mediated. Because androgens come only from the adrenal glands or gonads or by conversion in peripheral tissues of precursor steroids from these organs, the causes of hirsutism are found in these two organs. Adrenal causes include Cushing's disease, adrenal tumors, and congenital adrenal hyperplasia. Ovarian causes include tumors, polycystic ovarian syndrome, and most cases of idiopathic hirsutism. The clinical evaluation is designed to differentiate between these diagnostic possibilities. When an underlying abnormality can be identified, such as an ovarian tumor, the treatment course is clear. When the diagnosis is idiopathic hirsutism, however, the best treatment is uncertain and several available regimens are possible. PMID- 3538970 TI - Monoclonal anti-DNA antibodies. The targets and origins of SLE autoantibodies. PMID- 3538971 TI - Studies of the effects of Y chromosome factors on the expression of autoimmune disease. PMID- 3538972 TI - Treatment of autoimmune disease with total lymphoid irradiation. Cellular and humoral mechanisms. PMID- 3538973 TI - Cyclosporine as a new approach to therapy of autoimmune diseases. PMID- 3538974 TI - Genetics of the complement system. PMID- 3538976 TI - [Laryngeal nerves. A histomorphometric and cartographic study]. AB - Major difficulties in laryngeal reconstruction are due to laryngeal nerves. A study was conducted of 100 larynges from fresh subjects after vascular injection. Vascularization of superior laryngeal nerves is derived essentially from superior laryngeal and ascending pharyngeal arteries. Inferior laryngeal nerves obtain their vascular supply from inferior thyroid and main carotid arteries. Histomorphometric study of laryngeal nerves used semi-automatic techniques: microscope, numerical table, computer, printer. The number of fibers per nerve varied between 511 and 2.244, the number of nerve fasculi between 3 and 14, and the diameter of myelinated fibers between 2 and 12 micron. Fibers of left inferior laryngeal nerve had a mean diameter (8.9 to 10.2) greater than those of right inferior laryngeal nerve (5.1 to 5.2 micron). Nerve tissue represented 60% to 66% of total. The left recurrent was longer than right nerve but had larger fibers providing more rapid conduction. Cartography of laryngeal nerves from 2 mm serial sections confirmed their plexis structure, this study providing new and objective precisions on laryngeal nerve structure. PMID- 3538975 TI - Anti-idiotypic immunity in autoimmunity. AB - It has been hypothesized that autoimmune disease may result from a derangement of the idiotype-anti-idiotype network. However, the evidence in favor of a role of anti-idiotypic immunity in autoimmunity is still scarce. For this reason, we have investigated animal models of autoimmune thyroiditis and glomerulonephritis, addressing the following questions: Are autoimmune responses idiotypically heterogeneous? Are auto-anti-idiotypic antibodies detectable in autoimmunity? Is it possible to demonstrate quantitative or qualitative changes in idiotypic and anti-idiotypic lymphocytes during the course of autoimmune disease? To date, results obtained in our laboratory may be summarized as follows: Cross-reacting idiotypes were present on human and animal autoantibodies; Circulating auto-anti idiotypic antibodies were not detected in any of the models studied; Changes in idiotypic and anti-idiotypic lymphocytes were observed in animals with autoimmune disease. PMID- 3538977 TI - [Functional subtotal laryngectomies with cricohyoidopexy. Technics, indications, results]. AB - Operative technique for functional subtotal laryngectomy with cricohyoidopexy is described and results analyzed in 120 patients after follow up for more than 5 years. Actuarial survival was 61% for the vestibules and 79% for the cords. Indications for Majer-Piquet, Labayle cricohyoidopexies and cricohyoido epiglottopexies are discussed. PMID- 3538978 TI - [Double Y pharyngocolostomy. An original procedure]. AB - An original procedure is presented which involves cervical anastomosis after colic esophagoplasty, allowing double drainage of pharynx. As a function of permeability of esophagus, two variants are described: "esophagopharyngocolostomy in Y" and "double pharyngocolostomy in Y". The operation is performed as either a one-stage (immediate) or, more frequently a two-stage procedure: to correct tracheal reflux after high pharyngocolic anastomosis (with oropharynx); in low end-to-side esophagocolic stenosis with colic tube in excess and in narrow caliber sclerous esophagus. This method was used in 6 cases of post-caustic esophageal stenosis with very good long-term results. The method is an anti reflux procedure which also ensures prophylaxis of recurrent stenosis of the cervical anastomis. PMID- 3538979 TI - Twelfth Daniel C. Baker Jr memorial lecture: Victor Negus: 57 years later. AB - The three-dimensional morphology of the mammalian larynx was studied for 15 years. Using specimens obtained from a wide variety of sources, efforts were made to correlate structure with function and thus explain the variations in size and morphology seen in over 150 families of mammals. PMID- 3538980 TI - Staged repair of extensive tracheal and laryngotracheal stenoses. AB - The usual operative procedures (primary tracheal anastomosis, cricotracheal anastomosis, skin grafting and stenting, pedicle cartilage grafts, or free rib grafts) used to correct stenoses of great length involving the trachea or laryngotrachea have a high incidence of failure. An alternative method of reconstruction is the open technique, which requires three stages. The initial stage creates a trough after resection of the stenotic area, followed by subcutaneous embedding of a rigid material adjacent to the trough, and finally closure of the trough by reformation of the anterior wall. This staged procedure has been used in adult patients with tracheal stenoses greater than 4 cm, in patients with tracheal stenoses involving the cricoid, and in patients whose primary corrective operative procedures have failed. This paper critically assesses 30 patients who have had a staged reconstruction with a minimum follow up of 12 months. The indications, number of procedures performed, time required for decannulation, complications, and analysis of failures are presented. The incidence of success in this series of patients is 76% (23/30). PMID- 3538981 TI - The quiet revolution. Techniques of cell biology applied to tissue diagnosis. AB - In the past decade many of the techniques of cell biology developed in the research laboratory have been applied to tissue diagnosis. Increasing use of electron microscopy has allowed ready differentiation of many neoplasms with an identical appearance under the light microscope. The identification of highly specific antigenic substances in individual cells using monoclonal antibodies in the immunoperoxidase technique has allowed a degree of diagnostic accuracy not previously available in tissue diagnosis. Recent efforts have been directed at more accurately predicting biological behavior on the basis of cellular characteristics. Techniques being introduced include morphometry (computer assisted image analysis), cytophotometry (measurement of cellular DNA content), flow cytometry (analysis of cells in suspension for DNA content and other physical and chemical properties), scanning electron microscopy, and cytogenetics (the study of cellular chromosomes). PMID- 3538982 TI - Osteoperiosteal flap in the treatment of ozena. New technique. AB - An osteoperiosteal flap taken from the anterior wall of the maxilla and pedicled on its periosteum was developed to narrow the nasal cavity of 15 patients with ozena. Good results were obtained in over 80% of cases. Crusting, fetor, and epistaxis disappeared. The nasal mucosa appeared healthy. The bulge in the lateral nasal wall persisted. The method is not liable to graft rejection or shrinkage. The advantages of this new technique are discussed. PMID- 3538983 TI - Computer aided diagnosis of acute abdominal pain at Middlesbrough General Hospital. AB - This presentation reports the experience of the surgical house staff and registrars at Middlesbrough General Hospital who used a desk-top computer system to support their clinical diagnosis of acute abdominal pain. The results cover a two year period and are compared with a baseline period of one year. Substantial benefits followed the introduction of the computer-aided diagnostic support system; increased diagnostic accuracy of the whole surgical team, reduction in negative laparotomy rates, earlier surgical intervention for acute appendicitis, reduction in the number of cases of perforated appendicitis and more efficient use of resources. The reasons for these improvements include more thorough collection of data, use of common terminology and an educational element provided by detailed feedback from the computer system. PMID- 3538984 TI - The acute abdomen: management with microcomputer aid. AB - This paper describes the management consequences of the use of a microcomputer as a special investigation in patients with an acute abdomen. Results in 812 patients seen by 42 junior doctors are compared six monthly and with baseline data from 295 cases from the preceding 2 years. Improvement in diagnostic ability from 48.5% to 71.8% (X2 = 25.8, P less than 0.001) resulted in a fall in negative appendicectomy from 37.5% to 9.71% (X2 = 16.2, P = less than 0.001). Bad management errors were also reduced from 22% to 10% (P = less than 0.01). The number of emergency investigation fell from 4 to 2 and inpatient stay of patients with non-surgical abdominal pain was reduced from 3 to 2 days. These results demonstrate that the use of microcomputers as investigative tools improves the surgical management of patients with acute abdominal pain. PMID- 3538985 TI - Transcutaneous electrical nerve stimulation following appendicectomy: the placebo effect. AB - A controlled trial was undertaken to compare the efficacy of transcutaneous electrical nerve stimulation (TENS) with standard intramuscular opiate analgesia in the management of postoperative pain following appendicectomy. Consecutive patients undergoing emergency appendicectomy were randomised into control, sham TENS and active TENS groups. There was a significant decrease in pain severity and analgesic intake in both active and sham TENS groups when compared with the control group (P less than 0.01). No difference was demonstrated in pain severity between active and sham TENS groups but the active TENS group required slightly less analgesia. These results suggest that the major benefit of TENS in the postappendicectomy patient is due to its 'placebo effect' and its use in this situation cannot be recommended. PMID- 3538986 TI - Primary suture or T-tube drainage after choledochotomy. AB - It has been suggested that decreased morbidity and mortality after choledochotomy is obtained by avoidance of T-tube drainage of the common bile duct. A prospective randomised trial involving 80 patients having either primary suture of the common bile duct or T-tube drainage has therefore been undertaken. The indications for exploring the duct together with the complications arising in the two groups are enumerated. There is a significant saving of hospital time after primary suture, P = 0.05 (Wilcoxon's test). PMID- 3538987 TI - Analgesia in the acute abdomen. AB - In a prospective sequential double blind trial 288 patients with acute abdominal pain were given sublingual buprenorphine 200 mcg, sublingual buprenorphine 400 mcg, or placebo. Pain relief was proportional to the number of tablets administered; buprenorphine had no difference in effect compared to placebo. Physical signs altered in proportion to dosage, but this had no effect on clinical diagnosis. We conclude that patients with acute abdominal pain may be given buprenorphine without fear of masking the diagnosis. PMID- 3538988 TI - The use of intravenous digital subtraction angiography in the evaluation of neck masses. AB - The advent of vascular imaging techniques utilising intravenous rather than intra arterial contrast delivery may render angiography safer and less expensive. Intravenous digital subtraction angiography is explained and its applications to the management of pulsatile neck masses illustrated. PMID- 3538989 TI - Index of European radiological journals 1982-1985. PMID- 3538990 TI - Teaching clinicians to search MEDLINE: description and evaluation of a short course. PMID- 3538991 TI - A prospective educational trial comparing efficacy of computer-assisted learning and weekly seminars in teaching EKG interpretation. PMID- 3538992 TI - Free thyroid hormone assays and thyroid function. PMID- 3538993 TI - Isotope dilution analysis using chromatographic separation of isotopic forms of the compound to be measured. AB - Using progesterone, testosterone, androstenedione, 11-oxoprogesterone and 11 beta hydroxyprogesterone as models, a new form of isotope dilution assay has been developed. A known mass of deuterium-labelled steroid is added to the serum sample. High-performance liquid chromatography is used to separate endogenous steroid from its deuterium-labelled form. After separation, the two forms of the analyte are quantitated using conventional methods: radioimmunoassay, enzyme linked immunoassay and, where the concentrations are high enough, ultraviolet light absorption. The ratio of the amounts of the two forms of the analyte is used to calculate the amount of unlabelled material in the original sample. The assay principle is quite general. A variety of high resolution methods are available to separate isotopic analogues of the same compound. A number of detection methods can be used to quantitate the separated isotopic forms. Extension of this principle to other fields of interest in bio-medicine is discussed briefly. PMID- 3538994 TI - Man in the sauna. PMID- 3538995 TI - Theophylline plus hydroxyzine versus theophylline monohydrate in the treatment of asthma. AB - The efficacy of 281.7 mg of theophylline monohydrate and a combination of theophylline (240 mg) + hydroxyzine (7.5 mg) were compared in a double-blind, crossover, placebo-controlled study in 15 patients with chronic reversible bronchial asthma. The patients took the drugs tested at 7.00 a.m., 3.00 p.m. and 10.00 p.m. During the 3-day trial period, the patients measured their peak expiratory flow (PEF) values every day at 7.00 a.m., 10.00 a.m. and 10.00 p.m., and during the last trial day, theophylline serum levels were also determined. Use of theophylline monohydrate resulted in slightly steadier serum theophylline levels than with theophylline + hydroxyzine and morning levels of theophylline were significantly higher (p less than 0.01) during the former treatment. Despite this, only the theophylline + hydroxyzine combination had a significant effect (p less than 0.05 at 7.00 a.m., p less than 0.01 at 10.00 a.m. and 10.00 p.m.) on PEF values at each time of measurement. There was a significant difference (p less than 0.05) in PEF values at 10.00 a.m. between the trial preparations in favour of the theophylline + hydroxyzine combination. Theophylline + hydroxyzine significantly decreased (p less than 0.05) nocturnal dyspnoea and most patients preferred this preparation. The differences in side effects were not statistically significant. The addition of hydroxyzine to theophylline increases the clinical efficacy of the latter. PMID- 3538996 TI - Pericentric inversions in man. A French collaborative study. Groupe de Cytogeneticiens Francais. AB - Pericentric inversions ascertained by the majority of French cytogenetics laboratories are collected and analysed. The whole sample is composed of 305 independent cases, most of which unpublished previously. inv(2)(p1200q14.100) = 87 probands, inv(5)(p1400q1400) = 22 probands, inv(10)(p11.22q21.109) = 17 probands, and inv(10)(p1209q11.109): 12 probands are the most recurrent. The risk of aneusomie de recombinaison varies from .00 to .10 in the progeny of inversion carriers, depending on the location of the breakpoints. The risk of other chromosome imbalances may be increased by a factor of 3, and that of abortions by a factor of 2. A reduction of fertility is likely to exist in male carriers, especially when large chromosomes are involved. In most instances, the apparent preferential segregation of the inverted chromosome may be due to ascertainment biases, but such segregations may exist for some recurrent inversions. Endogany may also explain recurrence, such as that of inv(2)(p12q14.100) which is observed mostly in the Jewish community originating from Spain before inquisition time and from North Africa. PMID- 3538997 TI - Inversions in evolution of man and closely related species. AB - By the comparative study of the karyotypes of many Primates, 35 inversions (25 peri- and 10 paracentric) having accumulated during evolution of species related to man were reconstructed. Some of them originated human chromosomes from more ancestral chromosomes still present in other primate species. Their detection in man would indicate the occurrence of reverse mutations. Other inversions occurred in ancestral chromosomes identical to those of man, and originated chromosomes of other Primates species. Their detection in man would indicate the occurrence of a convergent mutation. It is shown that such reverse and convergent mutations do occur. They are too frequently observed than by mere chance among patients ascertained in human cytogenetic laboratories. Their excess is still larger among radiation induced inversions in human cells. This demonstrates the nonrandom occurrence of inversions. In addition, it is concluded that inversions which have accumulated during evolution are more representative of mutagenesis than those detected in human cytogenetic laboratories. PMID- 3538998 TI - Effects of fish meal as source of protein on intestinal maltase activity and intestinal and renal leucine aminopeptidase activity of growing rats. AB - The effect of high-protein fish meal on maltase and leucine aminopeptidase (LAPase) activities of the intestinal mucosa as well as the renal LAPase activity was studied. Four groups of female Wistar rats, weighing between 40-60 g, were fed diets with a 4 or 12% protein content of dry matter for 25 days. The protein source was casein for the control groups and fish meal derived from Coryphaenoides rupestris for the test groups. The results show a decrease (p less than 0.005) in intestinal maltase and LAPase activities and renal LAPase activity in animals fed with 12% of fish meal protein compared to those fed with casein, while the rats fed 4% of fish meal protein showed a decrease in intestinal maltase activity and no significant difference in LAPase activity compared with the control group. These results seem to indicate that the intestinal maltase is influenced by the quality and quantity of dietary protein, while the intestinal and renal LAPase activity is only changed by the quality of protein. PMID- 3538999 TI - Influence of propranolol on the acute thermic effect of feeding in man. AB - The influence of a beta-adrenergic blocker on the thermic effect of feeding (TEF) a meal was investigated in 7 healthy male volunteers. Metabolic rate (MR) was measured before and for 180 min after the consumption of 2.0 MJ 'Ensure' (Abbott Laboratories, Queensborough, Kent, UK); there were 14, 33 and 53% of energy from protein, fat and carbohydrate, respectively. On one occasion propranolol (ICI plc, Macclesfield, Ches., UK) was administered intravenously at 0.1 mg/kg body weight at meal feeding. On the second occasion a similar volume of saline was infused. Serial blood samples (10 ml) were collected before and at 30-min intervals for 180 min after meal feeding. Mean (+/- SD) resting MR was 104 (13) and 116 (11) kJ/kg and MR increased by 12.8% and 10.8% after the test meal with and without propranolol, respectively. These differences were not significant. The postprandial changes in serum glucose and triiodothyronine were similar in the two trials. The magnitude of the rise of serum insulin was similar in the two trials, but the pattern was not. beta-Adrenergenic blockade resulted in an early peak in insulin output at 30 min compared with 60 min for the control trial. We conclude that propranolol had no influence on TEF in this study. PMID- 3539001 TI - Creutzfeldt-Jakob disease: clinical analysis of a consecutive series of 230 neuropathologically verified cases. AB - In this consecutive series of 230 patients with neuropathologically verified Creutzfeldt-Jakob disease (CJD), the disease was found to affect men and women with approximately equal frequency in a peak plateau between the ages of 55 and 75 years (mean, 61.5 years). Familial cases accounted for 4 to 8% of the total series. Nonspecific prodromal symptoms occurred in one third of the patients, and the neurological presentation, although usually a gradually evolving mental deterioration, was of rapid onset in 20% of patients and in 36% of patients consisted exclusively of neurological symptoms. The great majority of these symptoms were of cerebellar or visual origin. Extrapyramidal muscular rigidity, myoclonus, and characteristic periodic electroencephalographic (EEG) complexes were observed comparatively late in the illness, and some type of involuntary movement or periodic EEG activity was seen in over 95% of the patients. The median duration of illness was 4 months (mean, 7.6 months); 90% of patients died within a year of onset. PMID- 3539000 TI - Neurofibrillary degeneration of cholinergic and noncholinergic neurons of the basal forebrain in Alzheimer's disease. AB - Two principal features of Alzheimer's disease (AD) are (1) the occurrence of neurofibrillary tangles (NFTs) and senile plaques, and (2) the loss of cortical cholinergic activity because of dysfunction of neurons in the basal forebrain cholinergic system. The relationship of these two abnormalities is an unresolved issue in the pathology of AD. We used polyclonal antibodies specific for paired helical filaments (PHFs), combined with acetylcholinesterase (AChE) histochemistry, to assess the cytoskeletal changes of cholinergic and noncholinergic neurons in the basal forebrain in AD. In both sporadic and familial AD, the nucleus basalis of Meynert (nbM) showed a marked decrease in AChE-positive (AChE+) perikarya and abundant immunoreactive NFTs. In double labeling studies of the nbM, PHF reactivity was found both in surviving AChE+ neurons and in many AChE- NFTs that were not associated with microscopically recognizable cell structures. Some surviving AChE+ perikarya did not contain NFTs. Numerous NFTs and senile plaques were identified by PHF immunoreactivity in other basal forebrain areas, including subnuclei of the amygdala that showed low or absent AChE activity. We conclude that the dysfunction and death of cholinergic neurons in the nbM is associated with extensive NFT formation, including apparently residual NFTs in loci where nbM neurons once existed; and many noncholinergic neurons and neurites in the basal forebrain show NFT and senile plaque formation. The cytopathology of AD involves neurons of varying transmitter specificities, including cholinergic neurons in the basal forebrain. PMID- 3539002 TI - Cell surface markers for diagnosis of central nervous system involvement in lymphoproliferative diseases. AB - To diagnose lymphoproliferative central nervous system (CNS) involvement we have used monoclonal antibodies in an immunocytochemical method for differentiation of cells in cerebrospinal fluid (CSF) and peripheral blood. The cell distribution in 9 patients with B-cell lymphoma and 7 patients with chronic lymphatic leukemia was compared to that in a group of patients with aseptic meningitis. Most patients with neoplastic CNS involvement showed a high proportion of CSF B cells (OKB2+ and/or OKB7+) and a concurrently low proportion of CSF T cells (anti-Leu 1+). Proliferating cells expressing transferrin receptor (OKT9 labeled) were increased in the CSF of 2 patients with neoplastic CNS involvement. In 2 patients with infectious CNS complications, the cell distribution in CSF did not differ from that in patients with aseptic meningitis. Patients with leukemia who had no CNS symptoms, and also 1 patient with meningitis and blood-brain barrier damage, showed a normal cell distribution in CSF despite high B-cell numbers in the peripheral blood. This indicates a selective passage of leukocytes into the CNS and/or local proliferation. PMID- 3539003 TI - [Problems in the use of antibiotics in animal husbandry and veterinary medicine]. PMID- 3539004 TI - [Biosynthesis of penicillin acylases]. PMID- 3539005 TI - [Comparative analysis of 2 Bacillus polymyxa strains differing in the spectrum of exogenous polysaccharides produced]. AB - The characteristic features of the development of 2 Bacillus polymyxa strains differing in the spectrum of the produced extracellular heteropolysaccharides were compared. The strains were grown on solid media and under submerged conditions. Electron microscopy revealed marked differences in the ultrastructure of the developing cultures. It was noted that the mutant variant B formed a vigorous fibrillar and capsular layer of the polysaccharide nature strictly oriented in the space perpendicularly to the cell surface. Changes in the mutant growth processes were characterized by a lower growth rate of the cell population. In the process of growth the initial culture did not form structured capsules and was lysogenic. Pronounced differences in the proteolytic activity were indicative of a definite interrelation between sporulation of the strains and activity of their exoproteases. The regularities of the development of the mutant strain of B. polymyxa allowed one to define the fundamental approaches to development of optimal cultivation conditions for the organism producing extracellular polysaccharides. PMID- 3539006 TI - Antibiotic tolerance among clinical isolates of bacteria. PMID- 3539007 TI - Efficacy of ciprofloxacin in experimental aortic valve endocarditis caused by a multiply beta-lactam-resistant variant of Pseudomonas aeruginosa stably derepressed for beta-lactamase production. AB - The emergence of multi-beta-lactam resistance is a limiting factor in treating invasive Pseudomonas infections with newer cephalosporins. The in vivo efficacy of ciprofloxacin, a new carboxy-quinolone, was evaluated in experimental aortic valve endocarditis caused by a strain of Pseudomonas aeruginosa which is stably derepressed for beta-lactamase production and is resistant to ceftazidime and multiple other beta-lactam agents. A total of 51 catheterized rabbits with aortic catheters in place were infected with this strain and then received no therapy (controls), ceftazidime (75 mg/kg per day), or ciprofloxacin (80 mg/kg per day). Ciprofloxacin sterilized all blood cultures and significantly lowered vegetation densities of P. aeruginosa by day 2 of treatment versus controls (P less than 0.0005) and animals receiving ceftazidime (P less than 0.0005). This beneficial effect of ciprofloxacin was also noted on therapy days 6 and 11. Ciprofloxacin rendered most vegetations (85%) culture negative over the 11-day treatment period and achieved bacteriologic cure in 73% of animals (P less than 0.0005 versus other therapy groups). Ciprofloxacin prevented bacteriologic relapse at 6 days posttherapy. No ciprofloxacin resistance was detected among Pseudomonas isolates from cardiac vegetations. Ciprofloxacin warrants further evaluation in vivo versus multi-drug-resistant gram-negative bacillary infections. PMID- 3539008 TI - Two-dimensional thin-layer chromatography for simultaneous detection of bacterial beta-lactam acylases and beta-lactamases. AB - A rapid and specific procedure was developed for the simultaneous detection of bacterial acylases and beta-lactamases, using ampicillin and cephalexin as substrates. Bacterial suspensions from agar plates were incubated separately with each beta-lactam substrate for 1 h at 37 degrees C. The supernatant of the reaction mixture was dansylated, and the dansyl derivatives were separated by two dimensional thin-layer chromatography on polyamide sheets. The end products resulting from acylase hydrolysis, including the intact beta-lactam nucleus, 6 aminopenicillanic acid or 7-aminodeacetoxycephalosporanic acid, and the acyl side chain acid, D-(-)-alpha-aminophenylacetic acid, and the end product resulting from beta-lactamase hydrolysis (D-phenylglycylpenicilloic acid or D phenylglycyldeacetoxycephalosporoic acid) were separated from each unhydrolyzed substrate and amino acids by this procedure. The presence of the intact beta lactam nucleus in the reaction mixture is the indication of acylase activity. This method is sensitive and reproducible and has been successfully applied to screening for acylase activity in a variety of bacteria. It may be pharmaceutically useful for identifying organisms capable of removing the acyl side chain from naturally occurring beta-lactam antibiotics such as penicillin G, penicillin V, and cephalosporin C for production of the beta-lactam nuclei which serve as the starting materials for semisynthetic beta-lactam antibiotics. PMID- 3539009 TI - In vitro susceptibilities of four species of coagulase-negative staphylococci. AB - The in vitro susceptibilities of 260 strains of coagulase-negative staphylococci to penicillin G, oxacillin, nafcillin, methicillin, cephalothin, and seven non beta-lactam antimicrobial agents were determined and compared with the susceptibilities of 54 strains of Staphylococcus aureus with known patterns of susceptibility. Penicillin G susceptibility for S. aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus hominis was readily determined by using beta-lactamase tests with induced cells and with a standardized microdilution test. MIC criteria for susceptibility used for S. aureus were applicable to the coagulase-negative species. Percentages of organisms susceptible were as follows: S. epidermidis, 7%; S. haemolyticus, 5%; and S. hominis, 47%. Oxacillin susceptibility for these four species was readily determined by using a modification of the microdilution test. MIC criteria for susceptibility used for S. aureus were applicable to S. haemolyticus and S. hominis, but alternate criteria were necessary for S. epidermidis. Percentages of organisms susceptible were as follows: S. epidermidis, 29%; S. haemolyticus, 36%; and S. hominis, 97%. Staphylococcus saprophyticus differed from the other staphylococcal species; all strains were beta-lactamase negative and were penicillin susceptible but had higher penicillin G MICs than did susceptible strains of the other species. There was total cross resistance among the penicillinase-resistant penicillins and cephalothin for the coagulase-negative staphylococci as well as for S. aureus; oxacillin MICs were more reliable than MICs of the other drugs or a standardized disk diffusion test for distinguishing resistant from susceptible strains. Vancomycin, rifampin, and ciprofloxacin were consistently active against all staphylococci. Erythromycin, clindamycin, gentamicin, and trimethoprim-sulfamethoxazole were more active against oxacillin susceptible staphylococci than against oxacillin-resistant staphylococci. PMID- 3539010 TI - Penicillin-binding proteins of penicillin-susceptible and -resistant pneumococci: immunological relatedness of altered proteins and changes in peptides carrying the beta-lactam binding site. AB - There are several major differences between the penicillin-binding proteins (PBPs) of highly penicillin-resistant and -susceptible strains of pneumococci. The highest-molecular-size PBP 1a (98 kilodaltons [kDa]) of susceptible pneumococci is not detectable in resistant bacteria. Instead, resistant strains contain a PBP of smaller size: 92 and 94 kDa in South African strains 8249 and A95210, respectively, and 96 kDa in New Guinea strain 2955 (S. Zighelboim and A. Tomasz, Antimicrob. Agents Chemother. 17:434-442, 1980). Using antibodies prepared against PBP 1a of penicillin-susceptible pneumococci, we demonstrated that these anomalous-sized proteins in the resistant strains are immunologically related to PBP 1a of penicillin-susceptible bacteria. A second difference between the PBP patterns of strain 8249 and the susceptible pneumococci is that the 78 kDa PBP 2b is not detectable by the radioactive penicillin binding assay in the resistant strain. Using antibodies prepared against PBP 2b of susceptible cells, we demonstrated the presence of PBP 2b in membrane preparations from strain 8249 cells. Thus, the poor detection of this PBP appears to be related to its greatly decreased affinity for the antibiotic molecule. We also compared the patterns of penicillin-labeled peptides derived from PBPs of resistant and susceptible cells during partial proteolysis by V8 protease. Several changes were observable in small peptides carrying the beta-lactam binding site generated from the high Mr (PBP 1a-related) binding proteins. In contrast, no differences in the pattern of penicillin-labeled peptides were seen when the pattern of PBP 2a of susceptible pneumococci was compared with the peptide pattern of PBP 2a from resistant strains. One of the resistant isolates (strain 2955) also had a PBP 3 with a higher-than-normal molecular weight. This protein gave strong positive reaction with antibodies against PBP 3 of susceptible cells. Examination of the pattern of penicilloyl peptides generated from the susceptible and resistant PBP 3s during partial proteolysis revealed only differences which seem to reside distant from the beta-lactam binding site. PMID- 3539011 TI - Therapeutic evaluation of difloxacin (A-56619) and A-56620 for experimentally induced Bacteroides fragilis-associated intra-abdominal abscess. AB - Difloxacin (A-56619) and A-56620, two novel fluoroquinolones, were tested in comparison with ciprofloxacin, cefoxitin, and combined clindamycin and gentamicin in the treatment of experimentally induced intraabdominal abscess associated with Bacteroides fragilis. Difloxacin was found to be as effective as clindamycin gentamicin. A-56620, despite achieving subtherapeutic levels in serum, was found to be as effective as cefoxitin. Both difloxacin and A-56620 were effective in vivo against experimentally induced intra-abdominal abscess in rats. PMID- 3539012 TI - Beta-lactam-specific resistant mutants of Staphylococcus aureus. AB - In an approach to understanding the origin of methicillin resistance in clinical isolates of staphylococci, a series of Staphylococcus aureus mutants resistant to various beta-lactam antibiotics were isolated in the laboratory by antibiotic selection. Mutants with low- and intermediate-level resistance showed considerable specificity for the particular antibiotic used in the selection process (methicillin, cefotaxime, cephalexin, and amdinocillin), and resistance in such mutants also showed alterations in the antibiotic binding capacities of penicillin-binding proteins (PBPs). In each case the isolation of mutants resistant to high concentrations of antibiotics required sequential passage in gradually increasing concentrations of the drug. The acquisition of increasing levels of methicillin resistance was paralleled by a gradual decrease in the binding capacities of PBPs 2, 3, and, possibly, 1. In a highly methicillin resistant mutant (MIC, 150 micrograms/ml), PBPs 2 and 3 were no longer detectable by the penicillin binding assay. Instead, a new PBP of poor binding capacity and anomalous molecular size (about 78 kilodaltons [kDa]) appeared in these cells. This corresponds to the molecular size of PBP 2a, the unique PBP that appears to be the biochemical correlate of resistance in clinical isolates of methicillin resistant S. aureus. Also, similar to the case of resistant clinical isolates, high-level beta-lactam resistance was highly pH dependent in the laboratory mutants. We compared the patterns of radioactive peptides generated by partial proteolysis from the penicillin-labeled PBP 2 of antibiotic-susceptible staphylococci and from the 78-kDa PBP 2a of a resistant clinical strain. Although the patterns were clearly different, seven of the eight characteristic peptides generated from PBP 2 of the susceptible strain were also detectable among the peptides released from PBP 2a. The results suggest that the 78-kDa PBP 2a of the resistant clinical strain evolved from PBP 2 of antibiotic-susceptible staphylococci and that in PBP 2a of the clinical isolate mutational changes have resulted in extensive alterations near the beta-lactam binding site. PMID- 3539013 TI - In vitro activity of DQ-2556, a new cephalosporin. AB - The in vitro antibacterial activity of DQ-2556, a new semisynthetic cephalosporin, was compared with that of ceftazidime and cefotaxime. The activity of DQ-2556 against members of the family Enterobacteriaceae was roughly comparable to that of cefotaxime. Against Pseudomonas aeruginosa, DQ-2556 was slightly less active than ceftazidime. DQ-2556 was more active than the reference cephalosporins against staphylococci. Haemophilus influenzae and Neisseria gonorrhoeae were also highly susceptible to DQ-2556. PMID- 3539014 TI - Perioperative business manager. Advantages and disadvantages. PMID- 3539015 TI - Intraventricular insulin reduces food intake and body weight of lean but not obese Zucker rats. AB - Porcine insulin (2 mU/rat/day) and its saline vehicle were infused into the third cerebral ventricle of female lean or obese Zucker rats using 14-day osmotic minipumps. Lean rats receiving saline (N = 6) gained 14 +/- 3 g over the 14 days, whereas lean rats receiving insulin (N = 7) lost 12 +/- 4 g over the same interval (p less than 0.01). The average total food intake of the insulin-infused group was decreased by 14% (p less than 0.05) as compared with that of the saline infused group. The decreased caloric consumption was adequate to account for the body weight loss. Insulin infusion had no effect on food intake or body weight of the obese rats relative to their saline-infused controls (change in body weight: saline (N = 5), -14 +/- 23 g; insulin (N = 7), +3 +/- 14 g). These results suggest that genetically obese Zucker rats have reduced sensitivity to insulin in the central nervous system. We propose that this phenomenon may participate in the development and maintenance of hyperphagia and obesity in these animals. PMID- 3539016 TI - Direct fermentation of potato starch to ethanol by cocultures of Aspergillus niger and Saccharomyces cerevisiae. AB - Direct fermentation of unhydrolyzed potato starch to ethanol by monocultures of an amylolytic fungus, Aspergillus niger, and cocultures of A. niger and Saccharomyces cerevisiae was investigated. Amylolytic activity, rate and amount of starch utilization, and ethanol yields increased several-fold in coculture versus the monoculture due to the synergistic metabolic interactions between the species. Optimal ethanol yields were obtained in the pH range 5 to 6 and amylolytic activity was obtained in the pH range 5 to 8. Ethanol yields were maximal when fermentations were conducted anaerobically. Increasing S. cerevisiae inoculum in the coculture from 4 to 12% gave a dramatic increase in the rate of ethanol production, and ethanol yields of greater than 96% of the theoretical maximum were obtained within 2 days of fermentation. These results indicate that simultaneous fermentation of starch to ethanol can be conducted efficiently by using cocultures of the amylolytic fungus A. niger and a nonamylolytic sugar fermenter, S. cerevisiae. PMID- 3539017 TI - Localization of inclusion bodies in Escherichia coli overproducing beta-lactamase or alkaline phosphatase. AB - High-level synthesis of the periplasmic protein beta-lactamase in Escherichia coli caused the formation of insoluble protein precipitates called inclusion bodies. beta-Lactamase inclusion bodies differed from those reported previously in that they appeared to be localized in the periplasmic space, not in the cytoplasm. The inclusion bodies contained mature beta-lactamase and were solubilized more easily than has been reported for cytoplasmic inclusion bodies. In contrast, overproduction of the periplasmic protein alkaline phosphatase caused the formation of cytoplasmic inclusion bodies containing alkaline phosphatase precursor. PMID- 3539019 TI - Specificity and cross-reactivity of staphylococcal enterotoxin A monoclonal antibodies with enterotoxins B, C1, D, and E. AB - The cross-reactivity of monoclonal antibodies produced against staphylococcal enterotoxin A with purified and crude enterotoxins B, C1, D, and E and the specificity of such reactions were evaluated by the indirect enzyme-linked immunosorbent assay and immunoblotting of Western blots (from sodium dodecyl sulfate-polyacrylamide gel electrophoresis) followed by autoradiography. Purified and crude enterotoxins B were also tested with polyclonal antibodies. Specificity of reactivity was demonstrated by immunoblotting of crude enterotoxin A, crude enterotoxin A treated with trypsin, crude enterotoxin E, and also with crude A, B, C1, and D that were pretreated with Sepharose-4B-linked normal rabbit immunoglobulin G to remove protein A. A band corresponding to each staphylococcal enterotoxin was seen with monoclonal antibodies under all conditions tested and also with crude and purified enterotoxin B with two different (rabbit and goat) polyclonal antisera. PMID- 3539018 TI - Magnesium limitation and its role in apparent toxicity of ethanol during yeast fermentation. AB - The rate of ethanol production per milligram of cell protein begins to decline in the early stage of batch fermentation before high concentrations of ethanol have accumulated. In yeast extract-peptone medium (20% glucose), this initial decline appears to be related to growth and to result in part from a nutrient deficiency. The addition of yeast extract, peptone, and ashed preparations of these restored the ability of glucose-reconstituted medium (in which cells had been previously grown) to support vigorous growth. Magnesium was identified as the active component. Supplementing fermentations with 0.5 mM magnesium prolonged exponential growth, resulting in increased yeast cell mass. The addition of magnesium also reduced the decline in fermentative activity (micromoles of CO2 evolved per hour per milligram of protein) during the completion of batch fermentations. These two effects reduced the time required for the conversion of 20% glucose into ethanol by 1/3 with no measurable loss in ethanol yield (98% of theoretical maximum yield). It is possible that some of the reported beneficial effects of complex nutrients (soy flour and yeast extract) for ethanol production also result from the correction of a simple inorganic ion deficiency, such as magnesium. PMID- 3539020 TI - Chlorpromazine as permeabilizer and reagent for detection of microbial peroxidase and peroxidaselike activities. AB - Chlorpromazine was used to perform a test for the detection of microbial peroxidase activities. The compound acts as both a cell permeabilizer and a reagent in the procedure developed which allows the detection of peroxidase and peroxidase like reactions both semiquantitatively in whole cell determinations and quantitatively in cell-free supernatants. PMID- 3539021 TI - Mutagenicity of nitroxide-free radicals. AB - Stable nitroxides were found to be mutagenic using Salmonella typhimurium tester strain TA 104, a strain chosen on the basis of its high sensitivity to oxidative damage. Nitroxide mutagenicity was dramatically increased in the presence of the superoxide radical generating system, xanthine oxidase/hypoxanthine, and it was suppressed in cells carrying the oxyR1 mutation, which causes induction of enzymes protecting against oxidative stress. As nitroxide-free radicals occur biologically, e.g., in the metabolism of aromatic amines, these radical-induced mutations could be a model for the carcinogenicity observed with these compounds. PMID- 3539022 TI - Hexose metabolism in pancreatic islets: compartmentation of hexokinase in islet cells. AB - Hexokinase activity was found in both soluble (cytosolic) and particulate subcellular fractions prepared from rat pancreatic islet homogenates. The bound enzyme was associated with mitochondria rather than secretory granules. Relative to the total hexokinase activity, the amount of bound enzyme was higher in islet homogenates prepared at pH 6.0 (72 +/- 7%) than in islets homogenized at pH 7.4 (38 +/- 1%). The affinity of hexokinase for equilibrated D-glucose was not different in the cytosolic and mitochondrial fractions. In both fractions, hexokinase displayed a greater affinity for alpha- than beta-D-glucose, but a higher maximal velocity with the beta- than alpha-anomer. Glucose 6-phosphate inhibited to a greater extent cytosolic than mitochondrial hexokinase. A high Km glucokinase-like enzymic activity was also present in both subcellular fractions. It is proposed that the ambiguity of hexokinase plays a propitious role in the glucose-sensing function of pancreatic islet cells. PMID- 3539023 TI - Glycosylation characteristics of pigmentation-associated antigen (GP75): an intracellular glycoprotein of human melanocytes and malignant melanomas. AB - Pigmentation-associated antigen (PAA) or gp75 is a glycoprotein localized to the melanosomes of human melanomas and melanocytes to which a mouse monoclonal antibody (AbTA99) has been produced (T. M. Thomson et al. (1985) J. Invest. Dermatol. 85, 169). Treatment of 3H-labeled immunoprecipitated melanoma PAA with alkaline-borohydride, hydrazinolysis, or N-glycanase released three families of carbohydrate chains (I, II, and III). Peak I consists of a major component (Ia) of sialylated triantennary N-linked chains which are partially substituted with fucose on terminal positions as well as on the chitobiose core and a minor component (Ib) which is a sialylated biantennary N-linked species. Peak II was not well characterized but may be a monoantennary complex chain species. Peak III consists of typical N-linked high mannose units with six to seven mannose residues. Melanocyte PAA carbohydrate chains have the same general features as melanoma PAA except that the biantennary complex chain predominates; this difference resembles that observed between the cell surface glycopeptides of transformed animal cells and their nontransformed counterparts. The glycosylation characteristics of this melanosomal glycoprotein are compared with those of glycoproteins from endoplasmic reticulum, Golgi, and lysosomes, and with tyrosinase. It is suggested that the glycosylation pattern is a reflection of the biosynthetic origin and cellular destination of a particular organelle and its constituents. PMID- 3539024 TI - [LAK cells and cancer]. AB - The effectiveness of LAK cells (lymphokine-activated killer cells) on malignant tumors in vivo and in vitro was discussed. LAK cells induced from lymphocytes by interleukin-2 (IL-2) were able to kill target malignant cells in a nonspecific manner. Combination of IL-2 enhanced LAK activity. Adoptive immunotherapy with LAK cells and IL-2 carried out in the USA has produced effective results in several cases; complete regression of skin metastases of malignant melanoma and partial regression of other malignancies. However, high doses of IL-2 mediated a toxic side effect, capillary permeability leak syndrome. Our studies have revealed that LAK cells after one to two weeks incubation do not require such a high concentration of IL-2, and that adoptive immunotherapy using such, LAK cells and IL-2 can be carried out safely. PMID- 3539025 TI - [Enzyme immunoassay and radioimmunoassay using monoclonal antibody for the determination of estrogen receptors in human breast cancer]. AB - Enzymeimmunoassay (EIA) with monoclonal antibody against human estrogen receptor (ER) from MCF-7 breast cancer cells and radioimmunoassay (RIA) with monoclonal antibody against ER D-5 antigen from human myometrium were applied to human breast tumor, and the results were compared to those of steroid binding assay using the dextran coated charcoal (DCC) method. The rates of coincidence of positivity and negativity of ER between the DCC method and EIA or RIA in 30 human breast tumors were 96.7% (29/30) and 86.7% (26/30), respectively. A highly significant positive correlation was observed between ER values obtained by the DCC method and those by EIA (r = 0.87, P less than 0.001). On the other hand, the correlation between ER values obtained by the DCC method and those by RIA was less significant (r = 0.41, P less than 0.05). The discrepancy between these ER values may be due to the difference of the monoclonal antibody used in each new assay. The above results indicate that EIA and RIA with monoclonal antibody for human ER are useful for clinical use, although the reason for the partial discrepancy of the data between the DCC method and RIA remains to be elucidated. PMID- 3539026 TI - Kaposi's sarcoma and its management by radiotherapy. AB - Thirteen patients with Kaposi's sarcoma were treated by radiotherapy between 1975 and 1984. Five patients were kidney transplant recipients receiving immunosuppressive drugs, while eight patients had spontaneous Kaposi's sarcoma. Eleven patients were followed up for periods from two to 63 months (mean, 27 months). All patients had complete response throughout the period of follow-up except one patient who developed recurrence one year after completion of radiotherapy. There was no difference in the response between transplant recipients and patients with spontaneous disease. This response was also unrelated to the dose or type of radiation used. Radiotherapy has been found effective in the local control of Kaposi's sarcoma with complete relief of symptoms and minimal morbidity. PMID- 3539027 TI - Breast milk jaundice in premature infants. AB - In randomised study of 186 preterm infants those fed on maternal or banked breast milk had a significantly higher peak bilirubin concentration and a more prolonged jaundice than infants fed an artificial preterm formula and were over four times more likely to achieve plasma bilirubin values above 200 mumol/l (11.7 mg/100 ml). This dietary effect was seen even in a high risk subgroup of sick ventilated infants below 1500 g who were receiving restricted enteral intakes. We suggest that breast milk jaundice in preterm infants may increase clinical intervention. Our findings are discussed in the light of epidemiological data suggesting an association between moderate hyperbilirubinaemia (greater than 170 mumol/l) and neurodevelopmental outcome. PMID- 3539028 TI - Respiratory distress syndrome and inositol supplementation in preterm infants. AB - We report a randomised double blind trial of myo-inositol (inositol) supplementation for 10 days in 74 preterm infants with a birth weight less than 2000 g (mean gestational age 29.5 weeks and mean birth weight 1266 g). All infants required artificial ventilation for treatment of respiratory distress syndrome. Inositol (120-160 mg/kg/day) was administered by the ingastric or intravenous route. The 37 infants who received inositol supplementation required less mechanical ventilation during days 4-10, had less failures of indomethacin to close ductus arteriosus, and had less deaths or bronchopulmonary dysplasia, or both, than the infants treated with placebo. There were no detectable adverse effects. These preliminary results suggest that inositol is an important nutrient in immature preterm infants. PMID- 3539029 TI - Sonographic finding of the bright thalamus. AB - Six of 83 asphyxiated neonates showed a diffuse increase of echodensity in bilateral thalami with or without other lesions in the basal ganglia on sonographic examination. The thalamic image still had a fairly high echogenecity compared with the surrounding brain parenchyma on follow up examination and was hence termed the bright thalamus. These six patients had a poor neurological outcome, including psychomotor retardation, spastic diplegia or quadriplegia, microcephaly, failure to thrive, seizures, and one death. The bright thalamus is not an occasional or an isolated sonographic finding of hypoxic-ischaemic encephalopathy, but it may serve as a landmark of severe hypoxic brain damage with adverse outcome. PMID- 3539030 TI - DDAVP and urine osmolality in refractory enuresis. AB - A double blind crossover trial of 20 micrograms intranasal 1-deamino-8-d-arginine vasopressin (DDAVP) versus placebo was carried out in 17 children with intractable enuresis aged between 6 and 13 years who had failed to respond to drugs and an enuresis alarm. Fluid intake was not restricted. There was a significant reduction in the number of wet nights. Seven children (41%) were cured or showed considerable improvement, with strong evidence against any placebo effect. The best response was seen in children aged 10 years or over and if urine osmolality after DDAVP reached beyond 1000 mmol/kg or was already at this concentration. The degree of overnight rise in urine osmolality after treatment with DDAVP was not predictable but correlated well with the clinical improvement in nocturnal diuresis present in eight of the children. A further 12 children with equally refractory enuresis were given 20 micrograms of the active drug to take during their school journeys or holidays. Six of them had previously normal overnight urine osmolalities with only two successes, but of the six who had nocturnal diuresis before treatment, five became dry, suggesting that DDAVP acts largely by anti-diuresis and might be most useful in children with nocturnal polyuria. PMID- 3539032 TI - Inhalation powder and oral salbutamol combination. AB - Fifty six children with chronic asthma were treated with the inhaled dry powder of salbutamol or the combination of inhaled and oral salbutamol. Over three months the combination provided a significantly greater sustained symptomatic relief from asthma. Side effects were minimal and did not result in any withdrawals from the study. PMID- 3539031 TI - Nebulised beclomethasone dipropionate suspension. AB - We compared nebulised beclomethasone dipropionate suspension against placebo in 16 children with moderately severe asthma in double blind crossover fashion. Three children withdrew due to deterioration while on placebo. Of the remaining 13, eight were better on beclomethasone and five on placebo. These trends in favour of nebulised beclomethasone were not significant and do not suggest that the suspension is as effective as inhaled powder or aerosol topical steroid formulation. PMID- 3539033 TI - Topical anaesthesia for venepuncture. AB - A topical anaesthetic cream was tested in a randomised, double blind, placebo controlled trial of 15 children. The severity of pain experienced during venepuncture was assessed, using visual analogue and verbal rating scales. The topical anaesthetic cream was found to be significantly superior to placebo using each form of assessment. PMID- 3539034 TI - Ultrastructural lupus band test in the skin of MRL mice. AB - The ultrastructural localization of immunoglobulin deposits in the dermoepidermal junction of MRL/l mice was examined using immunoperoxidase staining. All specimens that showed positive findings at the basement membrane zone of the skin on light microscopy had reaction products at the sub-basal laminar area when observed by electron microscopy. In the skin that had no distinct eruptions or which was distant from the lesions, the reaction products were distributed mostly just beneath the basal lamina in fine to course granular deposits. In the lesional skin, they formed a rather uniformly granular pattern among the irregularly arranged collagen fibrils and increased fine fibrillar amorphous material under the highly infolded basal lamina. Some of the reaction products were located just on the collagen fibrils and some appeared to be related to the free basal lamina. From the perspective of immunoelectron microscopy, the skin eruptions of MRL/l mice may serve as a good dermatological model of human systemic lupus erythematosus. PMID- 3539035 TI - [Juvenile secretory carcinoma. 5 new cases in adult women]. PMID- 3539037 TI - Prediction of progressive joint damage in patients with rheumatoid arthritis receiving gold or D-penicillamine therapy. AB - Seventy two patients with classical or definite rheumatoid arthritis (RA) were randomly allocated to receive gold or D-penicillamine therapy (DPA) in a prospective study designed to evaluate whether it is possible to predict which patients will show radiological progression despite therapy. Forty five patients completed 12 months' treatment. There were no significant demographic or clinical differences between them and the 27 drop outs. Twenty of the 45 patients showed no radiological progression between six and 12 months. These patients had less severe initial radiological damage, lower levels of serum aspartate transaminase (serum AST) and lactic dehydrogenase (LDH), but higher levels of serum cholesterol. Twenty five patients did show progression during the six to 12 month period. This group included all the men with nodules. Of the 43 pretreatment clinical and laboratory variables examined, however, the majority failed to predict whether or not progression would subsequently occur. This included the acute phase response and seropositivity. PMID- 3539036 TI - Analysis of circulating immune complexes from patients with ankylosing spondylitis by gel electrophoresis and immunoblotting using antiserum against a psoriasis associated retrovirus-like particle. AB - Circulating immune complexes (CIC) were isolated from patients with ankylosing spondylitis (AS) and healthy blood donors by isopycnic ultracentrifugation in sucrose gradients. The CIC were analysed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. The major components of the CIC were identified as albumin, immunoglobulins, and complement factors. A 70 kD component and several low molecular weight components (Mr 19 kD and 14 kD (doublet] were detectable only in CIC from patients with AS. An antiserum raised against the envelope glycoprotein, gp70, of a psoriasis associated retrovirus-like particle was applied to check for cross reacting activity. This antiserum reacted with both a 70 kD and a 40-45 kD component in CIC from three out of six patients but not with CIC from any of the blood donors. PMID- 3539038 TI - Pilot study of phenytoin in rheumatoid arthritis. AB - The anticonvulsant drug phenytoin has several interesting immunological properties which could theoretically be of benefit in the treatment of rheumatoid arthritis. For this reason a pilot study has been carried out on 11 patients with active classical or definite disease. Seven patients completed a 20 week course of treatment and showed continuous improvement at 12 and 20 weeks and some deterioration eight weeks after the drug was stopped. Laboratory and clinical measurements of disease activity responded favourably during the treatment period, suggesting that phenytoin may have second line activity. PMID- 3539039 TI - Perforation of the colon in immunosuppressed patients. PMID- 3539040 TI - Cardiac biopsy interpretation. PMID- 3539041 TI - Incidence and management of intra-abdominal infections in pancreas transplant recipients. PMID- 3539042 TI - Granulocyte chemotaxis in acute human Plasmodium falciparum malaria. AB - The non-lymphoid elements of the peripheral leucocyte pool were examined in the present study to determine their response to chemotactic stimulation. Our results indicate that granulocytes are effectively mobilized during malaria infections and are not deactivated by complement-derived chemotactic factors. These findings provide further evidence for the restriction of immunosuppression to some specific T and B-cell related functions only. PMID- 3539043 TI - Consequences of continuous mebendazole therapy in alveolar hydatid disease--with a summary of a ten-year clinical trial. AB - The assessment of a ten-year clinical trial of continuous therapy in eight patients revealed further evidence of a significant therapeutic effect of mebendazole on alveolar hydatid disease. Life-expectancy was increased when compared to untreated historical controls, especially in the patients over 55 years of age. All symptomatic patients showed subjective improvement. In four patients, three had a 50% or greater reduction in the diameter of massive hepatic lesions, and in the fourth, progressively enlarging metastases were arrested. Fall in the IHA titre suggested that the causative organism had been destroyed in two additional patients. Of greater significance was the absence of progression of the disease process as measured by changes in the size of the hepatic lesion or lack of development of distant metastases in patients under therapy. In contrast, progressive enlargement of hepatic lesions or the appearance of distant metastases were cardinal features of untreated cases (15 of the 16 cases followed). In vivo determination of viability of tissues of the larval Echinococcus multilocularis from patients receiving long-term therapy was considered important in evaluating efficacy of the drug. Such tissues, obtained by autopsy from two patients under continuous therapy for four and ten years, failed to proliferate when inoculated into rodents (red-backed voles), whereas similar inoculations from untreated patients or those receiving 15 months' or less of therapy brought about production of vesicles in rodents in eight of 11 tests (73%). These two deaths, unrelated to therapy, resulted from late fibrotic constriction of end-stage parasitic lesions about the portal vein and major bile ducts. The clinical findings in combination with negative in vivo tests and other data indicate that the mebendazole therapy significantly alters the clinical course of alveolar hydatid disease. The evidence strongly indicates that long term therapy may eventually have a lethal effect on the larval cestode in advanced disease. PMID- 3539044 TI - Bacteria and helminth isolates from bile and faeces of zebu cattle slaughtered for human consumption in the Niger Delta areas of Nigeria. AB - Random bacteriological examination of 300 bile samples aseptically drawn from the gallbladders of adult cattle at slaughter revealed the presence of Escherichia coli in 30%, Enterobacter aerogenes in 14% and Klebsiella aerogenes in 56%. Bacteriological examination of another 116 faecal samples revealed Esch. coli in 60% and Ent. aerogenes in 40%, while parasitological examination revealed 50-100 strongyle ova per gram from pre-rain samples of faeces, 100-850 strongyle eggs per gram for faeces collected during the rains, and less than 50 strongyle eggs per gram for dry season faeces. No salmonellae were recovered from either the faeces or bile, and no Clostridium or any helminth of significant public health interest were recovered from faeces but it is still suggested that indirect consumption of bile and faeces from these animals may constitute a public health hazard. PMID- 3539045 TI - The status of human filariasis in relation to clinical signs in endemic areas of the Niger Delta. AB - A study was carried out in selected parts of the Niger Delta Basin on human filariasis and its relationship to clinical signs. One hundred and seventy-six (13.0%) of 1351 individuals examined were infected with microfilaria. Forty-six percent of microfilaria positive cases had M. perstans; 25.6% had W. bancrofti, 19.3% had L. loa, and 9.0% had O. volvulus. The prevalence of filariasis increased with age. Microfilarial density was generally low, 28.4% of infected individuals had counts of 50-100 microfilaria per 20 mm3 blood, 12.5% had counts less than five microfilaria per 20 mm3 blood. Onchocerca microfilariae did not exceed five microfilaria per snip. Microfilarial density was high among individuals aged between 20 and 49 years, but declined with increasing age above 50 years. Acute clinical signs of febrile attack, sink eruptions, and chronic clinical signs of chyluria, hydrocoele, elephantiasis and ocular lesions were observed in 61.9% of infected individuals, 73.4% of clinical cases were febrile attack and skin eruptions, 5.5% were chyluria, 12.8% were elephantiasis of the leg and scrotum, 7.3% were hydrocoele and 0.9% were ocular lesions. Chronic clinical signs were more prevalent in individuals over 40 years of age. PMID- 3539047 TI - Acute rejection after cardiac transplantation: detection by interstitial myocardial pH. AB - Intramyocardial pH was assessed as a potential marker for clinical evaluation and treatment of acute rejection following cardiac transplantation. Fifteen cats underwent forty operative procedures. Following intra-abdominal heterotopic heart transplantation, serial laparotomies were performed in the early (days 0 to 2), intermediate (days 5 to 7), and late (days 7 to 16) postoperative periods. Rejection was assessed by serial clinical examinations, ECG analyses, B-mode echocardiography, histological and ultrastructural analyses, and measurements of interstitial myocardial pH. Intramyocardial pH was measured by a new miniature (0.6 X 3.0 mm) fiberoptic pH transducer. At confirmed rejection, concomitant laparotomy and thoracotomy were performed and pH sensors were implanted in both native (anatomical) and graft hearts. Nine animals at rejection were given methylprednisolone and changes in graft and native heart pH were measured. The pH during absence of rejection, mild acute rejection, and severe acute rejection averaged 7.430 +/- 0.019, 7.233 +/- 0.040 (p less than .02), and 6.860 +/- 0.066 (p less than .02), respectively (mean +/- standard error of the mean). A progressive decline in pH was noted in each heart. In animals receiving steroids, graft heart pH increased over 90 minutes from 6.852 +/- 0.065 to 7.043 +/- 0.077 (p less than .05). Although pH decline may be secondary to either inflammatory or ischemic etiology, histological and ultrastructural analyses demonstrate a predominant inflammatory response with progressive mononuclear cell infiltration, interstitial edema, vascular wall edema, infiltration by polymorphonuclear neutrophil leukocytes, vacuolation of sarcoplasmic reticulum, and disarray of myocytes associated with falling pH. Degree of pH change correlated closely with degree of histological rejection, presence of ECG voltage decline, and change in wall thickness by ultrasound. PMID- 3539046 TI - The chemotherapy of onchocerciasis. XI. A double-blind comparative study of ivermectin, diethylcarbamazine and placebo in human onchocerciasis in northern Ghana. AB - Fifty-nine onchocerciasis patients with ocular involvement were randomly assigned to receive either 12 mg of ivermectin in a single dose or 1300 mg of diethylcarbamazine over eight days or matching placebo capsules. Detailed standardized follow-up examination was carried out for one year. Both ivermectin and diethylcarbamazine rapidly reduced skin microfilarial counts to a similar extent over six months, after which counts increased significantly more with diethylcarbamazine. Diethylcarbamazine rapidly eliminated microfilariae from the eye, while ivermectin did so over six months. Reactions to treatment were more severe with diethylcarbamazine, which also produced clinical ocular deficiency in two patients. Ivermectin produced intra-uterine sequestration and degeneration of microfilariae in adult worms, which may account for its ability to produce prolonged suppression of skin microfilariae. Ivermectin proved superior to diethylcarbamazine in safety, tolerance and efficacy, but further work is needed to assess fully its effects in patients with heavy intraocular microfilarial loads. PMID- 3539048 TI - Harvesting, routing, and anastomosing the left internal mammary artery graft. AB - A technique to harvest, intrapleurally route, and anastomose the left internal mammary artery is described. PMID- 3539049 TI - Surgical intervention in histoplasmosis. AB - Histoplasmosis is a ubiquitous disease in endemic areas that has a generally subclinical course. Excessive inflammatory response may bring some patients to the attention of a thoracic surgeon to exclude malignancy of a noncalcified pulmonary or mediastinal mass or to relieve compression of specific structures. Mediastinal granuloma or fibrosing mediastinitis may involve the superior vena cava, pulmonary vessels, heart and pericardium, tracheobronchial tree, or esophagus. The cases of 94 recently treated patients are presented as well as a review of the American surgical literature. The current use of computed tomography, the time and extent of operative intervention, and the role of antifungal therapy are important to an overall understanding of the surgical treatment of the manifestations of histoplasmosis. PMID- 3539050 TI - A symposium in honor of Johann L. Ehrenhaft. October 11-12, 1985. PMID- 3539051 TI - Asymptomatic carotid disease in patients undergoing major cardiovascular operations: can prophylactic endarterectomy be justified? AB - This article reviews the published experience supporting or refuting the value of prophylactic endarterectomy in patients with asymptomatic carotid disease who are candidates for major cardiovascular operations. Reports of 1,483 patients subjected to staged or concomitant carotid endarterectomy and coronary artery bypass grafting reveal a perioperative stroke rate of 2.9%. Timing of carotid endarterectomy did not influence stroke rate, but staged procedures were associated with a significantly greater incidence of perioperative myocardial infarction and death. Studies of patients undergoing major cardiovascular surgical operations without prophylactic carotid endarterectomy reported a perioperative stroke rate of 2.7%, which is not significantly different from that of patients undergoing prophylactic carotid endarterectomy. However, the author's prospective study of such patients showed a significant incidence of late postoperative neurologic deficits, which are usually transient ischemic attacks. There is no evidence to justify routine prophylactic carotid endarterectomy of asymptomatic carotid disease before major cardiovascular operations. Patients not undergoing endarterectomy, however, should be given careful postoperative follow up, because transient ischemic attacks may occur that require surgical intervention. PMID- 3539052 TI - Greenfield vena caval filter: rationale and current indications. AB - Prevention is the best therapy for deep venous thrombosis, but when this fails, prompt diagnosis and appropriate treatment can usually avoid lethal pulmonary embolism. Anticoagulation is the preferred treatment for thromboembolic disease because it prevents lethal pulmonary embolism and also arrests the underlying thrombotic process. However, in specific patients with documented pulmonary embolism or deep venous thrombosis, or who are at high risk that either of these will develop, anticoagulation therapy may be contraindicated, may fail to control the thrombotic process, or may offer inadequate protection from lethal pulmonary embolism. In these instances, or when a previous mechanical attempt has failed to prevent pulmonary embolism from a caval source, a Greenfield filter should be considered. The available information on the natural history of patients in these specific categories and subcategories is reviewed, and the indications for and timing of Greenfield filter placement are explained. PMID- 3539053 TI - Localization of met-enkephalin on human spermatozoa and evidence for its physiological role. AB - Pro-opio-melano-cortino-derived peptides have been identified in rat testicular extracts and in human seminal plasma, but their physiological role is still unknown. We report that met-enkephalin is localized on human spermatozoa, by means of an indirect immunofluorescent technique. Furthermore, we demonstrate that a met-enkephalin analog (D-Ala2-Mephe4-Met-(o)-ol-enkephalin, FK 33-824, Sandoz, Basel, Switzerland: DAMME) inhibits in a dose-dependent manner the acrosome reaction induction. The hypothesis of a physiological role of seminal met-enkephalin on human spermatozoa fertilizing ability is briefly discussed. PMID- 3539054 TI - Immunohistochemical localization of enkephalinlike peptides during testicular development in rats. AB - The distribution of opioid peptides is of interest in the rat testes, because the presence of opiate binding sites strongly supports the hypothesis of paracrine function for these peptidergic factors. Testes of Wistar albino rats between birth and adult stage were examined immunocytochemically for enkephalins, dynorphin, and alpha neoendorphin. The presence of immunoreactive enkephalinlike substances was visualized in both interstitial tissue and seminiferous tubules, but no staining was observed for dynorphin or neoendorphin. In interstitial tissue the material stained in Leydig cells raised after birth, declined at day 12, and increased again between day 22 and day 35 of life. From day 35 till adult stage we observed again a slight decrease of immunostaining. In seminiferous tubules, intense immunostaining was observed in stem spermatogonia until day 7 of life. After this period the presence of immunoreactive enkephalinlike material was detected, mainly in some spermatogonia and peritubular primary spermatocytes. These data suggest a possible implication of enkephalinlike peptides in spermatogonesis. PMID- 3539056 TI - Pretrigeminal preparation. AB - The pretrigeminal preparation (pretrigeminal animal) is obtained by transection the pons in front of roots of the trigeminal nerves. The rostral part of the preparation (isolated cerebrum) has olfactory, visual and humoral inputs and controls vertical position of eye and their pupillary diameter and accommodation. The pretrigeminal preparation was described in the cat and rat. During the acute stage the isolated cerebrum is continuously awake, alternatively alert and drowsy. In the chronic stage a sleep-waking cycle recovers, but paradoxical sleep remains absent and synchronized sleep is reduced. Thus the cerebrum can largely compensate for the withdrawal of influences from the deactivating structures of the lower brain stem. Olfactory and visual stimuli produce a virtually normal arousal response. Its major components are: dilatation of pupils, desynchronization of cortical EEG activity, appearance of theta activity in the hippocampal EEG, and an increase of the cerebral blood flow. If the stimulus is repeated, the arousal response habituates with a normal rate. In the pretrigeminal cat there are two ocular targeting reflexes: vertical fixation and accommodation. The fixation reflex has a normal general course and shows normal habituation, but it is less precise than in the intact cat. The accommodation reflex is normal. Classical and instrumental ocular conditioned reflexes can be elaborated in the pretrigeminal cat. The conditioned pupillary dilatation appears at a normal rate. On the other hand, the elaboration of the conditioned vertical eye movement is slower than in the intact cat, possibly as a result of the lack of the proprioceptive feedback from the extraocular muscles. In conclusion, excitability, integrity and plasticity of the isolated cerebrum of the pretrigeminal preparation seem to be virtually normal. In contrast to the pretrigeminal preparation, the "cerveau isole" is comatose during the acute stage. In the chronic stage, however, the sleep-waking cycle recovers and with time it becomes similar to that in the pretrigeminal preparation. However, the vertical fixation reflex remains impaired in the low "cerveau isole" and is obviously absent in the high "cerveau isole". The caudal part of the preparation has a normal contact with the outside world, but it cannot largely make use of it. However, it satisfactorily controls the circulation and respiration. Rats are superior than cats: pretrigeminal cat cannot turn over from one side to the other and is fed by stomach tube, whereas pretrigeminal rat can crawl and eat food introduced into the mouth.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539055 TI - Enkephalinase inhibition suppresses naloxone-induced jumping in morphine dependent mice. AB - The effect of the enkephalinase inhibitor phosphoramidon on the withdrawal syndrome following acute and chronic morphine-induced physical dependence in mice, was investigated. Phosphoramidon administered intracerebroventricularly (50 200 micrograms) suppressed significantly the naloxone-precipitated withdrawal jumping and wet dog shakes while forelimb shakes were potentiated in both acute and chronic morphine-dependent mice. It is suggested that increased saturation of the opioid receptors by endogenous opioid peptides following enkephalinase inhibition, might suppress the severity of the withdrawal syndrome. PMID- 3539057 TI - Giuseppe Moruzzi (1910-1986). PMID- 3539058 TI - Overproduction of the proFhuA outer membrane receptor protein of Escherichia coli K-12: isolation, properties, and immunocytochemical localization at the inner side of the cytoplasmic membrane. AB - The fhu operon of Escherichia coli K-12 comprises four genes, termed fhuA,C,D,B, which are involved in the uptake of iron-hydroxamate compounds. The fhuA gene encodes the outer membrane receptor protein. Cells that contained three copies of the fhuACD fragment on the thermoamplifiable plasmid pHK232 accumulated at 37 degrees C large amounts of the proFhuA protein. Most of the overproduced proFhuA protein was not translocated into the outer membrane but instead precipitated at the cytoplasmic side of the inner membrane, presumably at the sites of synthesis. Despite inhibition of export proFhuA synthesis continued. The precipitate formed was sedimented by centrifugation at 8,000 x g. The proFhuA protein could be solubilized in 1% sodium dodecyl sulfate. Replacement of sodium dodecyl sulfate by Triton X-100 resulted in a proFhuA protein which exhibited 10% of the phage T5 binding activity of renatured mature FhuA protein. Binding of the phage T5 was inhibited by the FhuA-specific ligands ferrichrome, albomycin and colicin M. Limited proteolysis of the isolated pro- and mature form of the FhuA protein with trypsin yielded similar oligopeptide patterns. Addition of ferrichrome affected trypsin cleavage of both proteins in the same way. The common proteolytic intermediates together with phage inactivation indicate a similar conformation of the pro- and mature form. PMID- 3539059 TI - [Various circumstances in the development of the medical and pharmaceutical departments of the Warsaw University]. PMID- 3539060 TI - [History of the development of academic pharmacy education in Warsaw 1809-1950]. PMID- 3539061 TI - [Reconstruction of 2 departments of Warsaw University: the medical and pharmaceutical departments and the Stomatological Academy after the liberation of Warsaw]. PMID- 3539062 TI - [Polish physicians--graduates of the University of Vienna. III. Letters K through M]. PMID- 3539063 TI - [Theoretical and practical contribution of Adam Wrzosek to the history and philosophy of medicine in Poland]. PMID- 3539064 TI - [Medical prescriptions advertised in a calendar for the year 1702]. PMID- 3539065 TI - [A History of the Polfa pharmaceutical plants in Pabianice. I. Chemical plants in Pabianice as a business concern 1889-1899]. PMID- 3539066 TI - Blocking of antibody passive hemagglutination reaction (Bl-AbHAp) as a test for in vitro recognition of type-specific soluble antigens of Clostridium botulinum. AB - The blocking of hemagglutination reaction (Bl-AbHAp) was used as a new indicating version of the HAp-test applied for rapid, type-specific in vitro identification of the Cl. botulinum A, B, E and F toxic culture supernatants. The laboratory diagnostic system based on the described method and a special computation table is proposed for simple indicating set with 30 minutes results reading of the test. PMID- 3539067 TI - [The nature of the major pathology in the perinatal period at the present time]. AB - The main pathology leading to mortinatality has been determined. It is shown that in 57.8% of cases mortinatality is associated with placental insufficiency, the reason for which can be found out by the pathoanatomical study of the afterbirth. It is proposed to differentiate afterbirth disorders of implantation, placentation, circulation and inflammatory changes. Fifty per cent of neonates are shown to die from the respiratory failure associated with the formation of atelectasis, hyaline membranes and edema with pulmonary hemorrhages. Next in frequency are cephalic ventricle extravasations. The main pathogenetic factor of both neonatal pathologies is prematurity with functional and morphological tissue immaturity. PMID- 3539068 TI - [Potentials and limits for the histologic diagnosis of apudomas]. AB - One should differentiate apudomas, two-component tumors (a combination of apudoma with a non-endocrine tumor), apudoma-like tumors and non-endocrine ones with admixture of APUD cells among the tumors with cells possessing the properties of APUD cells. Apudomas in their turn are represented by microapudomas and high- and low-differentiated macroapudomas. Routine light microscopy in most cases provides for apudoma verification, estimation of its differentiation and tissue origin, occasional identification of a secreted hormone. PMID- 3539069 TI - [Current aspects of infectious pathology in infants and fetuses]. AB - Analysis of biopsy specimen obtained at autopsies performed in hospitals for children from 1981 to 1984 are presented, as well as the results of goal-directed studies of some infectious diseases. It is noted that at adequate morphological and laboratory examinations the frequency of the diagnosed infectious diseases is rather high revealing mainly combined infections. The frequency of acute respiratory infections is especially high, as it is found in 3/4 of the nonsurvivors. There are viral, bacterial, Mycoplasma-induced and other diseases among them. The data on frequency and specific morphological features of different etiologic groups of infection, as well as separate diseases are given. Acute intestinal infections were less frequently diagnosed (in 9.8% of cases), coli-infection being predominant and appearing as a complication of different severe somatic diseases. Sepsis occurred rather frequently, though its rate was gradually decreasing (from 11.1% to 5.3%). Infections with predominant intracanal generalization were rare. Meningococcemia, developing, as a rule, in the presence of generalized viral infections, occurred in 2.2% of cases. Meningitis and meningoencephalitis, more often bacterial ones, complicating congenital malformations, were found in 4.5% of cases. Intrauterine infections, in particular caused by Mycoplasmas and viruses (cytomegalic, herpetic and respiratory ones) were very often diagnosed. They were associated with the same type of placental damage. Chlamydiosis, evidently frequent, was almost unidentified. Bacterial intrauterine infections including listeriosis were rare. PMID- 3539070 TI - [Viacheslav Vasil'evich Aliakritskii (on the centenary of his birth)]. PMID- 3539071 TI - [Pathomorphology of eclampsia]. AB - Pathomorphology of eclampsia is reviewed on the basis of literature data and it is noted that the problem has been studied insufficiently. Morphological features of eclampsia are subdivided into two groups; changes in the microcirculatory bed, that are generalized and undergo the following stages: spasm----wall swelling or necrosis----microthrombosis; and postischemic organ changes, such as dystrophy, necroses and hemorrhages. The role of disseminated intravascular coagulation syndrome is discussed in the development of some clinico-morphological features of eclampsia. PMID- 3539072 TI - [Anti-smooth muscle antibodies in a hospital population]. AB - A total of 139 sera being 60 patients with liver disease were tested for auto antibodies. Twenty six of the 60 patients had active chronic hepatitis, 19 acute hepatitis, 3 cirrhosis, 3 hepatosplenic schistosomiasis mansoni, and 9 miscelaneous liver pathology. We found positivity for smooth muscle antibody in 26 cases: smooth muscle antibody-V in 15 cases, for smooth muscle antibody-T in 9, and for smooth muscle antibody-G in 10 other patients. Nine out of 10 patients with positive smooth muscle antibody-G had chronic active hepatitis and the remaining had cirrhosis. The other kinds of smooth muscle antibodies were irregularly distributed among the different hepatic disease studied. The higher levels of auto-antibodies were found mostly in chronic hepatic disease. PMID- 3539073 TI - [Cystadenoma of the pancreas. Various aspects of the diagnosis and surgical management adopted in 3 cases]. AB - The authors report three cases of cystadenoma of the pancreas. Two cases were serouscystadenoma and one case was mucouscystadenoma. The best diagnostic procedures were computed axial tomography and ultrasonography. Decisions regarding operation depend on three factors: the patient's general conditions, site of the tumor and hystologic pattern. In the first case the elderly patient had the tumor in the head of the pancreas which had led to biliary obstruction. To establish satisfactory biliary drainage a biliodigestive anastomosis was used. The other two cases were younger patients with large protruding abdominal mass in the epigastrium and mesogastrium by a tumor of the body and tail of the pancreas. In these cases we opted for body pancreatectomy and splenectomy. Since the serouscystadenoma doesn't have the malignant potential that the mucouscystadenoma has, the surgical procedure can be different from the surgical resection used for the treatment of pancreatic cystadenoma. PMID- 3539074 TI - Development and current status of a total artificial heart. PMID- 3539075 TI - Artificial lung (oxygenators). PMID- 3539076 TI - Artificial liver. PMID- 3539077 TI - The movement of fluids and substances in the testis. AB - Three aspects of the control of movements of fluids and substances into, out of and inside the testis are discussed: the tubular barrier, the interstitial extracellular fluid and the testicular blood vessels. The functional basis for the tubular barrier is twofold; there are significant differences in the concentration of many substances inside and outside the tubules and marker substances enter or leave the tubular fluid at widely different rates, depending on lipid solubility and the presence of specific carrier systems. The anatomical basis for this barrier appears to be the specialized junctions between adjacent pairs of Sertoli cells. The barrier develops only at puberty, as the first cells undergo meiosis, but the development may not be as sudden as previously believed. The barrier breaks down after efferent duct ligation when spermatogenesis is disrupted. Techniques for measuring the volume, the turnover rate, the composition and fate of the interstitial extracellular fluid are described, and the unsatisfactory features of the presently available techniques for collecting this fluid for analysis are emphasized. There is a relationship between the fluid in the testis and lymph from vessels in the spermatic cord and lymph may be important for the transport of hormones to the general circulation in some circumstances and to other organs close to the testis. The testicular blood vessels display certain unusual features, a very high susceptibility to the toxic effects of cadmium salts, a high level of alkaline phosphatase activity in all endothelial cells but only after puberty and a high level of gamma-glutamyl transpeptidase in the endothelial cells of the arterioles and the testicular artery. These same cells are the site for a specific transport system for leucine and phenylalanine, with kinetic characteristics similar to the system in brain. Flow of blood may limit hormone secretion by the aspermatogenic testis, but diffusion limitation may also be important under some circumstances. A fuller understanding of the ways in which substances move around in the testis, particularly how they cross the endothelial cell layer or penetrate into the tubules, will be important for a better appreciation of testicular function. PMID- 3539078 TI - Liver transplantation in Australia: current status and future prospects. PMID- 3539079 TI - Popliteal entrapment: an epilogue. PMID- 3539080 TI - Nasal obstruction in infancy. AB - It is stated frequently that human infants during the first 6-12 postnatal months can breathe only through their noses, except when crying. It has been proposed that there are anatomical reasons for the apparent inability to switch to oral breathing when the nasal airway is occluded, namely the relatively high position of the larynx and base of the tongue and the presence of a velolingual sphincter. Others, however, consider that immaturity of the central nervous system may be responsible. Partial obstruction of the nasal airway triggers reflexes which increase both the strength of subsequent inspiratory efforts and the degree of inspiratory activity in muscles involved in maintaining the patency of the upper airway (e.g., genioglossus and laryngeal abductors). Receptors in the larynx and pharynx which sense pressure reductions have been shown recently to be involved in regulating the activities of these upper airway muscles. When the nasal airway is obstructed to the point where ventilation cannot be maintained (or when it is totally occluded) the appropriate response is to switch to oral breathing. This response to nasal occlusion, usually accompanied by arousal, has been reported recently in some sleeping human infants. Preliminary observations in awake lambs show that total occlusion of the nasal airway leads to a switch to oral breathing only after considerable hypoxaemia has developed. After a few breaths, which restore the blood gas status, the mouth closes until the animal becomes hypoxaemic again. The maturational time-course and mechanisms underlying the infantile response to prolonged nasal obstruction, including the influence of sleep-states, clearly require further investigation, through necessity, in experimental animals. PMID- 3539081 TI - Apnoea in the newborn infant. AB - Clinical apnoea in infants is defined as a pause in breathing of more than 20 s duration or a briefer pause associated with bradycardia. Such events are uncommon in term infants and usually are due to some precipitating factor. They occur more commonly in preterm infants and there is an exponential increase in incidence with decreasing gestational age at birth. Although insults such as infection or hypoxia can accentuate the problem, the major factor appears to be immaturity. Studies of brain-stem maturity using auditory evoked responses indicate that infants with immature responses have a higher incidence of apnoea. Brain-stem immaturity has also been implicated in histopathological studies of infants dying from Sudden Infant Death Syndrome (SIDS). In preterm infants, upper airway obstruction occurs commonly at the end of longer events and some infants have a predominantly obstructive pattern. These latter infants are often neurologically abnormal and have had prolonged endotracheal intubation. Both of there factors could be associated with disordered control of upper airway patency. This notion is supported by the finding of upper airway instability during nasal occlusion in these infants. A link with SIDS is uncertain, although preterm infants with chronic pulmonary insufficiency, usually following a prolonged intubation, are said to be at particularly high risk of dying suddenly and unexpectedly during infancy. PMID- 3539082 TI - The circulation in sleep in newborn lambs. AB - Interaction of the cardiovascular, homeothermic and behavioural systems has particular significance in early life as this period of development sees high cardiac output, limited circulatory reserves, a particular vulnerability to thermal stress, and long periods of rapid eye movement (REM) sleep during which thermal regulation may be suspended. In unstressed lambs, significant cardiovascular differences exist between behavioural states of sleep and wakefulness, with the REM sleep-state being outstanding. In REM sleep there is wide cardiac output variation, a low heart rate, and a high stroke volume. High levels of cardiac output occurring in combination with poorer oxygenation and respiration in REM may represent a risk to the newborn, as cardiac performance is already high and reserves are low in comparison with the adult. Lambs respond to cool stress with increases of cardiac output and oxygen consumption in wakefulness and quiet sleep, but not in REM sleep. Suspension of thermoregulatory processes in REM sleep also points to this as the more vulnerable state for the newborn. Arousal responses from quiet sleep or REM sleep to wakefulness occur if lambs are subjected to acute reductions of blood pressure. There is a delay before arousal which is longer in REM sleep than in quiet sleep. Animals fail to arouse in approximately 40% of hypotensive tests in both states. This shared feature of the sleep-states (failure to arouse) may be more important than the state-related difference (longer delay before arousal in REM) in understanding a cardiovascular mechanism of Sudden Infant Death Syndrome. PMID- 3539083 TI - Improvement of prolactin immunolabelling in osmium-fixed acrylic-embedded pituitary gland. AB - Immunolabelling of prolactin (PRL) with protein A-colloidal gold complex and tissue fine structure were enhanced after postfixation of pituitary gland with osmium tetroxide and embedment in acrylic momers (LR White). Thin sections were treated with sodium metaperiodate before immunocytochemistry. An intense PRL labelling was detected in secretory granules, Golgi complexes and extracellular accumulation of the hormone. The use of osmium greatly improved the fine structure of the tissue and its stability during acrylic embedment. PMID- 3539084 TI - Fibrinogen/fibrin deposits in mesenteric lymphadenitis due to Yersinia pseudotuberculosis type I: morphologic, immunohistochemical and electron microscopic studies of one case. AB - A case of mesenteric lymphadenitis due to Yersinia pseudotuberculosis type I is described in a young adult. The diagnosis is suggested by histological appearance and confirmed by serological tests. Histological and semithin sections reveal granulomas with central microabscesses and concentric coagulative necrosis. By histochemical and immunohistochemical techniques, fibrinogen/fibrin deposits are observed as a prominent intercellular meshwork around microabscesses or as loosely intertwining strands in small granulomas. Electron microscopy shows fibrinogen/fibrin deposits closely associated both fibrous long-spacing (FLS) fibers and thin collagen fibers. The pathogenesis and type of granuloma as well as the significance of fibrinogen/fibrin deposits are discussed with reference to current literature. PMID- 3539085 TI - Quantitative microphotometric studies of Feulgen-stained nuclei on sections of the human uterine cervix: optimization of preparation and measuring technique. AB - The total extinction of apparently normal intermediate cell nuclei was microphotometrically measured in formalin-fixed Feulgen-stained paraffin sections of the uterine cervix. We investigated whether reproducible microphotometric results can be obtained from a histologic section expected to contain a certain amount of sectioned nuclei and stained by a standard technique. The results have shown that exact reproduction of microphotometrically measured mean total extinction values of intermediate cell nuclei can be achieved with a threshold value of 90% transmission in 10 microns sections. PMID- 3539086 TI - [Modification of individual parameters of carbohydrate and lipid metabolism by medium and long-chain triglycerides]. PMID- 3539087 TI - [Fats in the parenteral nutrition of the child with special reference to the premature infant]. PMID- 3539088 TI - [Effect of insulin and glucagon on Intralipid-induced ketogenesis in the human]. PMID- 3539089 TI - [After-care and course of healing in an elephant cow following delivery with episiotomy]. PMID- 3539090 TI - [Significance of enterotoxic Escherichia coli strains as a cause of enteritis in the young dog]. PMID- 3539092 TI - Changing patterns in rehabilitative care. PMID- 3539091 TI - [Chronicle of the Freiburg Animal Health Institute in its most important phases from 1897 to the present]. PMID- 3539093 TI - Quality of life concerns in the rehabilitation of patients with cardiovascular disease. PMID- 3539094 TI - Immediate reperfusion in acute myocardial infarction. PMID- 3539095 TI - The role of psychosocial risk factors in coronary rehabilitation. PMID- 3539096 TI - The World Health Organization's contributions to the advancement of rehabilitation. PMID- 3539099 TI - The predicted secondary structure of enolase. AB - The results of several secondary-structure prediction programs were combined to produce an estimate of the regions of alpha-helix, beta-sheet and reverse turn for both chicken skeletal-muscle and yeast enolase sequences. The predicted secondary-structure content of the chicken enzyme is 27% alpha-helix and less than 10% beta-sheet, whereas in the yeast enolase a similar helix content but virtually no sheet are predicted. These results are in fair agreement with published experimental estimates of the amount of secondary structure in the yeast enzyme. The enzyme appears to be formed from three domains. PMID- 3539098 TI - The complete amino acid sequence of chicken skeletal-muscle enolase. AB - The complete amino acid sequence of chicken skeletal-muscle enolase, comprising 433 residues, was determined. The sequence was deduced by automated sequencing of hydroxylamine-cleavage, CNBr-cleavage, o-iodosobenzoic acid-cleavage, clostripain digest and staphylococcal-proteinase-digest fragments. The presence of several acid-labile peptide bonds and the tenacious aggregation of most CNBr-cleavage fragments meant that a commonly used sequencing strategy involving initial CNBr cleavage was unproductive. Cleavage at the single Asn-Gly peptide bond with hydroxylamine proved to be particularly useful. Comparison of the sequence of chicken enolase with the two yeast enolase isoenzyme sequences shows that the enzyme is strongly conserved, with 60% of the residues identical. The histidine and arginine residues implicated as being important for the activity of yeast enolase are conserved in the chicken enzyme. Secondary-structure predictions are analysed in an accompanying paper [Sawyer, Fothergill-Gilmore & Russell (1986) Biochem. J. 236, 127-130]. PMID- 3539100 TI - The purification and properties of yeast proteinase B from Candida albicans. AB - A serine proteinase (ycaB) from the yeast Candida albicans A.T.C.C. 10261 was purified to near homogeneity. The enzyme was almost indistinguishable from yeast proteinase B (EC 3.4.21.48), and an Mr of 30,000 for the proteinase was determined by SDS/polyacrylamide-gel electrophoresis. The initial site of hydrolysis of the oxidized B-chain of insulin, by the purified proteinase, was the Leu-Tyr peptide bond. The preferential degradation at this site, analysed further with N-blocked amino acid ester and amide substrates, demonstrated that the specificity of the proteinase is determined by an extended substrate-binding site, consisting of at least three subsites (S1, S2 and S'1). The best p nitrophenyl ester substrates were benzyloxycarbonyl-Tyr p-nitrophenyl ester (kcat./Km 3,536,000 M-1 X S-1), benzyloxycarbonyl-Leu p-nitrophenyl ester (kcat./Km 2,250,000 M-1 X S-1) and benzyloxycarbonyl-Phe p-nitrophenyl ester (kcat./Km 1,000,000 M-1 X S-1) consistent with a preference for aliphatic or aromatic amino acids at subsite S1. The specificity for benzyloxycarbonyl-Tyr p nitrophenyl ester probably reflects the binding of the p-nitrophenyl group in subsite S'1. The presence of S2 was demonstrated by comparison of the proteolytic coefficients (kcat./Km) for benzyloxycarbonyl-Ala p-nitrophenyl ester (825,000 M 1 X S-1) and t-butyloxycarbonyl-Ala p-nitrophenyl ester (333,000 M-1 X S-1). Cell free extracts contain a heat-stable inhibitor of the proteinase. PMID- 3539101 TI - Potentiation of specific association of insulin with HepG2 cells by phorbol esters. AB - The effects of tumour-promoting phorbol esters on the receptor-mediated endocytosis of insulin were investigated in the human hepatoma cell line HepG2. Treatment of these cells with the biologically active phorbol 12-O tetradecanoylphorbol 13-acetate (TPA), but not with the non-tumour-promoting analogue 4 alpha-phorbol 12,13-didecanoate, resulted in dramatic morphological changes, which were accompanied by a 1.5-2.5-fold increase in specific 125I insulin association with the cells at 37 degrees C. This increase in insulin binding was not observed when the binding reaction was performed at 4 degrees C. The potentiation of 125I-insulin association with TPA-treated cells at 37 degrees C could be completely accounted for by an increase in the intracellular pool of internalized insulin; there was no concomitant increase in cell-surface insulin binding. Dissociation studies showed that the enhanced internalization of insulin by cells after treatment with TPA resulted from a decrease in the rate of intracellular processing of the insulin after receptor-mediated endocytosis. The phorbol-ester-induced enhancement of internalized insulin in HepG2 cells was additive with the potentiation of endocytosed insulin induced by both the lysosomotropic reagent chloroquine and the ionophore monensin; this indicates that TPA affects the intracellular processing of the insulin receptor at a point other than those disrupted by either of these two reagents. The potentiation of insulin receptor internalization by tumour-promoting phorbol esters could be completely mimicked by treatment with phospholipase C, but not with phospholipase A, and partially mimicked by treatment with the synthetic diacylglycerol 1-oleoyl 2-acetylglycerol. By these criteria, the effects of phorbol esters on the insulin receptor in HepG2 cells appear to be mediated through protein kinase C. These results support the concept that the activation of protein kinase C by treatment with phorbol esters causes a perturbation of the insulin-receptor-mediated endocytotic pathway in HepG2 cells, reflected in a long-term decreased rate of dissociation of internalized insulin by the phorbol-ester-treated cells. PMID- 3539102 TI - The effect of purified aminoaldehydes produced by polyamine oxidation on the development in vitro of Plasmodium falciparum in normal and glucose-6-phosphate dehydrogenase-deficient erythrocytes. AB - Purified aminoaldehydes produced by polyamine oxidation were toxic to the malarial parasite, Plasmodium falciparum, cultured in human erythrocytes. There was a profound effect on young ring forms, and, during maturation, parasites became more sensitive to the aldehydes. Oxidation of the aldehydes abolished the lethal effect. The plasmodia within glucose-6-phosphate-dehydrogenase (G6PD) deficient erythrocytes were more sensitive to mono- and di-aldehydes than were parasites in normal erythrocytes. G6PD-deficient erythrocytes were also more sensitive to pretreatment with the dialdehyde produced by the oxidation of spermine. Pretreatment prevented further invasion by the parasites. PMID- 3539103 TI - Overproduction of the cyclic AMP receptor protein of Escherichia coli and expression of the engineered C-terminal DNA-binding domain. AB - Overproduction of the cyclic AMP receptor protein (CRP) from Escherichia coli, up to 25% of the soluble cell protein, has been achieved in an inducible host-vector system under transcriptional control of the lambda promoter PL. This system is ideally suited for large scale production and purification of CRP. In addition, a structural gene for the DNA-binding domain of CRP has been constructed. To this end the nucleotide sequence coding for the C-terminus was fused to the sequence coding for the first 10 N-terminal amino acids and cloned into suitable vectors. Good expression was achieved using the lambda PL promoter. The gene product, beta CRP, is recognized by anti-CRP antibodies. PMID- 3539104 TI - Hydrogenosomes in the rumen fungus Neocallimastix patriciarum. AB - Sedimentable hydrogenase activity was demonstrated in cell-free extracts from both zoospores and vegetative growth of the anaerobic rumen fungus Neocallimastix patriciarum. Electron micrographs of the fraction enriched in hydrogenase activity contained finely granular microbody-like organelles, about 0.5 micron in diameter and having an equilibrium density of about 1.2 g X ml-1 in sucrose, 1.12 g X ml-1 in Percoll and 1.27-1.28 g X ml-1 in Metrizamide. These organelles, which are sedimentable at 10(5) g-min, bear no similarity to mitochondria, but are morphologically similar to hydrogen-evolving organelles possessed by certain anaerobic protozoa and termed 'hydrogenosomes'. Other typical hydrogenosomal enzymes, namely 'malic' enzyme, pyruvate:ferredoxin oxidoreductase and NADPH:ferredoxin oxidoreductase, were enriched in the same particle fraction as hydrogenase. The synthesis of pyruvate:ferredoxin oxidoreductase was found to be suppressed when the organism was cultured under an atmosphere of CO2, and an alternative pathway is proposed for growth under these conditions. PMID- 3539097 TI - Proteoglycans in health and disease: structures and functions. PMID- 3539105 TI - Endopeptidase-24.11 in pig lymph nodes. Purification and immunocytochemical localization in reticular cells. AB - Endopeptidase-24.11 (EC 3.4.24.11), a widely distributed cell-surface endopeptidase in pig tissues, was purified by immunoaffinity chromatography from its second most abundant source, lymph nodes. The detergent-solubilized enzyme is a glycoprotein with an apparent subunit Mr of 91,000, by electrophoresis in the presence of SDS. This value is intermediate between those observed in preparations from kidney and intestine. The specific activity (125I-labelled insulin B-chain as substrate) was similar to that prepared from other sources. Immuno-peroxidase and immunofluorescent cytochemical methods with either a monoclonal antibody, GK7C2, or an affinity-purified polyclonal antiserum, RP109, were used to establish the distribution and localization of the antigen in lymph nodes. Examination of many nodes confirmed the variability of endopeptidase-24.11 content from node to node. Pig lymph nodes are composed of functionally discrete nodelets and are anatomically inverted, with medulla being located peripheral to the cortex. Endopeptidase-24.11 was present in medulla, paracortex and cortex. The medulla, containing relatively few lymphocytes, stained more intensely than other zones. Lymphocyte-rich areas stained only weakly, but antigen was detectable in the centres of follicles and more strongly in a band surrounding them. The pattern of staining was reticular in appearance in all zones. In primary cell cultures, set up after enzymic disruption of nodes, the immuno positive cells were found to be adherent to glass or plastic and to exhibit a fibroblastic morphology. Diffuse surface immunofluorescence and brighter intracellular immunofluorescence in granules were observed in these cells in the first few days of culture, but by the fourth day no immuno-positive cells remained and the fibroblasts that grew to confluence were somewhat different in morphology. The cells expressing the endopeptidase-24.11 antigen did not express Ia antigen and were clearly distinct from antigen-presenting dendritic cells. In appearance and properties they belong to the group described as reticular cells. PMID- 3539106 TI - Characterization of tetanus toxin binding to rat brain membranes. Evidence for a high-affinity proteinase-sensitive receptor. AB - Binding of 125I-labelled tetanus toxin to rat brain membranes in 25 mM Tris/acetate, pH 6.0, was saturable and there was a single class of high-affinity site (KD 0.26-1.14 nM) present in high abundance (Bmax. 0.9-1.89 nmol/mg). The sites were largely resistant to proteolysis and heating but were markedly sensitive to neuraminidase. Trisialogangliosides were effective inhibitors of toxin binding (IC50 10 nM) and trisialogangliosides inserted into membranes lacking a toxin receptor were able to bind toxin with high affinity (KD 2.6 nM). The results are consistent with previous studies and the hypothesis that di- and trisialogangliosides act as the primary receptor for tetanus toxin under these conditions. In contrast, when toxin binding was assayed in Krebs-Ringer buffer, pH 7.4, binding was greatly reduced, was non-saturable and competition binding studies showed evidence for a small number of high-affinity sites (KD 0.42 nM, Bmax. 0.90 pmol/mg) and a larger number of low-affinity sites (KD 146 nM, Bmax. 179 pmol/mg). Treatment of membranes with proteinases, heat, and neuraminidase markedly reduced binding. Trisialogangliosides were poor inhibitors of toxin binding (IC50 11.0 microM), and trisialogangliosides inserted into membranes bound toxin with low affinity. The results suggest that in physiological buffers tetanus toxin binds with high affinity to a protein receptor, and that gangliosides represent only a low-affinity site. PMID- 3539107 TI - Active transport of myo-inositol in rat pancreatic islets. AB - myo-Inositol transport by isolated pancreatic islets was measured with a dual isotope technique. Uptake was saturable with a half-maximal response at approx. 75 microM. With 50 microM-inositol, uptake was linear for at least 2 h during which time the free intracellular concentration rose to double that of the incubation medium. Inositol transport is therefore active and probably energized by electrogenic co-transport of Na+ down its concentration gradient as uptake was inhibited by ouabain, Na+ removal or depolarizing K+ concentrations. Inositol transport was abolished by cytochalasin B which binds to hexose carriers, but not by carbamoylcholine or Li+ which respectively stimulate or inhibit phosphoinositide turnover. Uptake of inositol was not affected by 3-O methylglucose or L-glucose (both 100 mM) nor by physiological concentrations of D glucose. The results suggest that most intracellular inositol in pancreatic islets would be derived from the extracellular medium. Since the transport mechanism is distinct from that of glucose, inositol uptake would not be inhibited during periods of hyperglycaemia. PMID- 3539108 TI - A sensitive and class specific solid phase enzyme immunoassay for anti-DNA autoantibodies in supernatants of lymphocyte cultures and human hybridomas. AB - A solid phase enzyme immunoassay using methylated bovine serum albumin (BSA) precoated and DNA-coated microtiter plates was developed for the detection of IgG and IgM anti-DNA autoantibodies in the supernatants of lymphocyte cultures and hybridomas. In patients with systemic lupus erythematosus (SLE) the significantly raised IgG anti-DNA antibody synthesis indicates that preactivated anti-DNA clones circulate in the peripheral blood. This was associated with the detection of anti-DNA antibodies in the sera. The screening of 53 supernatants from human x mouse hybridomas showed an antibody to denatured DNA in 16 supernatants. PMID- 3539109 TI - Investigations on the pyruvate decarboxylase catalysed oxidative decarboxylation of 2-oxoacids by 2.6-dichlorophenolindophenol. AB - Pyruvate decarboxylase, a thiamine pyrophosphate and Mg2+ dependent enzyme, catalyzes normally the simple decarboxylation of its substrate. However, in the presence of suitable hydrogen acceptors, such as dichlorophenolindophenol, it catalyzes an artificial reaction, the oxidative decarboxylation of 2-oxoacids to the corresponding carboxylic acids. As a result of kinetic studies a mechanism is presented in this paper, which describes the synchronous progress of both the oxidative ping-pong-type decarboxylation reaction and the physiological non oxidative decarboxylation reaction. Moreover, experiments using phenylglyoxylic acids that carry suitable substituents in the 4-position have shown that the electronic influence of the substituents (causing a decrease in the rate constants with increasing electron pressure) is in quantitative agreement for both types of reactions. A common rate limiting transition state preceding the alpha-carbanion intermediate of the enzymic reaction (2-(1-hydroxybenzyl) thiamine pyrophosphate carbanion) must therefore be assumed for both reactions. Acetaldehyde which acts as noncompetitive inhibitor in the normal enzyme mechanism does not influence the oxidative decarboxylation reaction. 4'-hydroxy 4'-deamino-thiamine pyrophosphate is inactive as coenzyme for both types of enzyme reactions. This confirms again the essential role of the 4'-amino group in the cofactor function. PMID- 3539110 TI - Transforming mutations in protein-tyrosine kinase genes. PMID- 3539111 TI - Nucleosome positioning in vivo and in vitro. PMID- 3539112 TI - Immunotoxins. PMID- 3539113 TI - The regulation of cellular differentiation in the dimorphic yeast Candida albicans. PMID- 3539114 TI - Multiple levels of gene regulation in the control of amino acid biosynthesis in Saccharomyces cerevisiae. PMID- 3539115 TI - Molecular cloning of cDNA for argininosuccinate lyase of rat liver. AB - A cDNA expression library constructed from poly(A)+ RNA of rat liver was screened immunologically using an antibody against argininosuccinate lyase (EC 4.3.2.1), a urea cycle enzyme, of rat liver. A cDNA clone was isolated and identified by hybrid-selected translation. The clone contained an insert approximately 1.5 kilobase pairs in length. In the bacterial clone, a specific protein of Mr = about 25,000 was expressed. The argininosuccinate lyase mRNA of about 2.1 kilobases long was detected in the liver and in a lesser amount in the kidney and spleen, but not in the small intestine and heart of the rats. PMID- 3539117 TI - The formation and metabolism of N-hydroxymethyl compounds--IX. N-(acetoxymethyl) 4-chlorobenzamide: an electrophile but not a mutagen in Salmonella typhimurium. AB - The electrophilic properties of 4-chloro-N-(hydroxymethyl)benzamide as a model compound of carbinolamides formed during the metabolic oxidation of N methylamides were investigated. 4-Chloro-N-(hydroxymethyl)benzamide did not react with nucleophiles such as cyanide or glutathione under physiological conditions. In contrast, N-(acetoxymethyl)-4-chlorobenzamide yielded the cyanomethylamide with KCN and S-(4-chlorobenzamidomethyl)glutathione with glutathione. Under nonaqueous conditions, N-(acetoxymethyl)-4-chlorobenzamide reacted avidly with ethanethiol, with methanol and with diethylamine in the presence of base, whereas 4-chloro-N-(hydroxymethyl)benzamide did not afford products under these conditions. These results show clearly that N-(acetoxymethyl)-4-chlorobenzamide is the precursor of reactive electrophilic methyleneimines. 4-Chloro-N (hydroxymethyl)benzamide was not biotransformed to such electrophilic species when incubated with mouse hepatic microsomes or a microsomal supernatant with acetyl-CoA or a PAPS generating system. Neither 4-chloro-N (hydroxymethyl)benzamide nor its acetate ester were mutagenic in the short term bacterial assay using Salmonella typhimurium. Nevertheless, esters of carbinolamides, such as N-(acetoxymethyl)-4-chlorobenzamide, might possess toxic or carcinogenic properties. PMID- 3539116 TI - Differences in glycerolipid synthesis and insulin regulation in rat hepatocytes and adipocytes. AB - Glycerolipid synthesis was studied by determining radioactive incorporation from either [1-14C] acetate or [U-14C] palmitate. Glycerolipid synthesis in adipocytes, mainly from exogenous palmitate, was preferentially directed to the formation of triacylglycerols, whereas in hepatocytes triacylglycerols and phospholipids were synthesized at similar rates. Insulin stimulated glycerolipid synthesis from acetate in both types of cells, being triacylglycerols more significantly increased than phospholipids. The most relevant difference was the finding that in adipocytes insulin strongly stimulated the formation of diglycerides, apparently from phosphatidate, whereas in hepatocytes insulin only slightly increased diglyceride levels. A possible role of diacylglycerol in insulin action in adipocytes, but not in hepatocytes, is also discussed. PMID- 3539118 TI - Guinea-pig liver morphine 6-dehydrogenase as a naloxone reductase. AB - Elution profiles of guinea-pig liver naloxone reductase and morphine 6 dehydrogenase on Matrex green A, Sephadex G-100 and DEAE-cellulose (DE32) column chromatography used sequentially in the purification procedure were identical. The ratios of the two enzyme activities were almost constant throughout all the purification steps. The two enzymes were similarly more stable at pH 6.0 than at pH 8.0 on storage at 4 degrees. The reversible inactivation of the two enzymes by the removal of 2-mercaptoethanol from the enzyme solution was the same. Inhibitory effects of lithocholic acid, CuSO4, quercitrin, phenylarsine oxide, and prostaglandin E1 on the two enzymes were almost the same. These results indicated that naloxone reductase is identical to morphine 6-dehydrogenase in the guinea-pig liver. For the reduction of naloxone, the enzyme utilized either NADPH or NADH as cofactor, and pH optima were 6.8 with NADPH and 6.2 with NADH. The Km values for NADPH and NADH were 6.5 and 2.2 microM respectively. The Vmax values for naloxone were 1.2 units/mg protein with NADPH and 0.5 unit/mg protein with NADH. The Km values for naloxone were 0.27 mM with NADPH and 0.44 mM with NADH. The reaction product formed by the enzyme was identified as 6 alpha-naloxol by thin-layer and gas-liquid chromatographic analyses. Accordingly, it is clear that the enzyme catalyzes the stereospecific reduction of naloxone to form the 6 alpha hydroxyl congener. PMID- 3539119 TI - Calcium antagonists stimulate prostaglandin synthesis by cultured rat cardiac myocytes and prevent the effects of hypoxia. AB - The effect of three calcium antagonists on the synthesis of prostacyclin (PGI2, assayed as 6-Keto-PGF1 alpha) and PGE2 by cultured rat cardiac myocytes and fibroblasts was investigated. In myocytes only, bepridil, diltiazem and verapamil (10(-9) to 10(-7) M) stimulated PGs synthesis by two- to three-fold, dose dependently. At a concentration of 10(-6) or 10(-5) M the intensity of the stimulation of PGI2 and PGE2 decreased. Cobalt chloride (2 X 10(-3) M) did not change PGs synthesis (pg/mg of protein/30 min; means +/- SE, N = 10; PGE2: 365 +/ 59 and 463 +/- 89 treated vs controls; PGI2: 824 +/- 214 and 799 +/- 143 treated vs controls). After 30 min exposure of myocytes to hypoxic conditions (glucose free medium and low PO2), the glycogen content was half that of the controls (P less than 0.001), ATP content did not change and PGI2 and PGE2 synthesis increased (X1.5, P less than 0.05). When applied to myocytes 30 min before inducing hypoxia, the three calcium antagonists stimulated PGs synthesis by three to seven-fold at maximal effect, and bepridil (10(-8) M) or diltiazem (10(-7) M) prevented the hypoxia-induced decrease in glycogen content. With 10(-5) M drug concentration, the effect on PGs was not significant, except for the effect of bepridil on PGI2 (P less than 0.05). It is concluded that therapeutic concentrations of calcium antagonists simultaneously prevent the decrease in myocyte glycogen induced by hypoxia and stimulate PGs synthesis by myocytes. PMID- 3539120 TI - Immunocytochemical localization of cytochrome P-450 in hepatic and extra-hepatic tissues of the rat with a monoclonal antibody against cytochrome P-450 c. AB - The cellular distribution of cytochrome P-450 has been studied in the liver and a number of extrahepatic tissues in the rat by immunocytochemistry, using an antibody raised against cytochrome P-450 form c. Immunoreactive cytochrome P-450, most probably form c, was found in the proximal tubules of the kidney, in the Clara cells of the lung, and in the olfactory epithelium and Bowman's glands of the olfactory tissue, in addition to its location in the liver. Immunoreactive cytochrome P-450 was not found in the small intestine, the testes or the adrenal gland, although these organs are known to contain isoenzymes of cytochrome P-450. The use of antibody titration enabled the effects of phenobarbitone, beta naphthoflavone and clofibrate on the content and distribution of immunoreactive cytochrome P-450 to be studied in both the liver and in the other organs discussed. Phenobarbitone induces epitope-specific cytochrome P-450 in the centrilobular cells of the liver but has no effect in any of the other tissues studied. Clofibrate is without effect on the levels of immunoreactive cytochrome P-450 in any of the tissues studied. In contrast, beta-naphthoflavone induces immunoreactive cytochrome P-450 in the periportal region of the liver, and also in the Clara cells of the lung, in the enterocytes of the small intestine and in the proximal tubules of the kidney. Of all of the tissues studied, in which immunoreactive cytochrome P-450 could be detected, only the olfactory epithelium failed to undergo enzyme induction following treatment with beta-naphthoflavone. PMID- 3539121 TI - Uptake of opioid drugs by rat cerebrocortical brain slices. PMID- 3539122 TI - Verapamil modulates mutagenicity of antitumour acridines in bacteria and yeast. PMID- 3539123 TI - Synthesis and antimicrobial activity of 7 alpha-methoxypyrimidinyl ureidocephalosporins. AB - The synthesis of a series of 7 alpha-methoxy-7-[(R)-2-[3-[5-pyrimidinyl]ureido]-2 (4-hydroxyphenyl) acetamido]-3-cephem-4-carboxylates 2 is described. 7-[(R)-2-[3 [2-(p-Aminosulfonyl)-anilino-4-hydroxy-5-pyrimidinyl]ureido- 2-(4 hydroxyphenyl)acetamido]-7 alpha-methoxy-3-[(1-methyl-1H-tetrazol-5 yl)thio]methyl-3-cephem-4-carboxylic acid, sodium salt (2k, UG-FA 132), has exhibited a broad range of antimicrobial activity. UG-FA 132 is highly active against Gram-positive and Gram-negative organisms, including Pseudomonas and lactamase producers, and shows potent activity against anaerobes. The high efficacy of UG-FA 132 was confirmed by in vivo experiments in mice. PMID- 3539124 TI - Bactericidal effect of combinations of cephalosporins with tobramycin on clinical isolates of Escherichia coli, Klebsiella and Staphylococcus aureus. AB - The antimicrobial activities of the cephalosporins cefazolin, cefotaxime, moxalactam or ceftazidime in combination with tobramycin against clinical isolates of E. coli, of Klebsiella, of beta-lactamase-negative and beta-lactamase producing S. aureus strains were compared in vitro by the checkerboard technique. Antibiotic dilutions differed by small arithmetic increments. Favourable interactions occurred with each bacterial species. This trend applied to third generation cephalosporins against E. coli and Klebsiella as well as to cefazolin against S. aureus. The antibiotics with already the highest intrinsic activity generally exhibited also the most favourable interaction. PMID- 3539125 TI - Effect of etofylline clofibrate on experimental thrombus formation and prostacyclin activation. AB - 1-(7-Theophyllinyl)-2-ethyl-[2-(p-chlorophenoxy)-isobutyrate] (etofylline clofibrate, theofibrate, Duolip) was shown to possess substantial thrombus disaggregating activity in the microcirculation of the hamster cheek pouch following minor vascular damage by electrical stimulation. At 12 mg/kg p.o. the moderate effect of a single dose (12% reduction in disaggregation time) increased to a maximum reduction of 31 and 43% following 5 and 7 consecutive daily applications, respectively. Etofylline clofibrate was more active than other drugs already tested in this test system, but less than the prostaglandins PGE1 and PGI2. The antithrombotic efficacy found in both in vivo tests, thrombus formation and disaggregation, suggests as mode of action of etofylline clofibrate an agonistic interaction with intimal PGI2. This could be by enhancement of its production or by a synergistic interaction with this prostanoid, rather than inhibition of thromboxane A2 synthetase. PMID- 3539126 TI - Genetic toxicology evaluation of the novel semi-synthetic antibiotic piperacillin. AB - Piperacillin (T-1220, Pipracil) a semi-synthetic antibiotic was evaluated in a battery of genetic toxicology assays. The assays employed were: the microbial assay, the host mediated assay, the microbial assay incorporating urine samples from mice dosed with piperacillin, the in vivo cytogenetic assay, and the dominant lethal assay. In all assays, piperacillin produced consistent negative results indicating that piperacillin does not have mutagenic potential. PMID- 3539127 TI - [A comparative gastroscopic study of lonazolac and indomethacin in healthy subjects]. AB - In 9 healthy volunteers the effects of a 14-day treatment with lonazolac 300 mg b.i.d. on gastric and duodenal mucosa have been endoscopically compared with those of indomethacin 75 mg b.i.d. in a double-blind placebo-controlled trial. Lonazolac and indomethacin induced significantly more gastric and duodenal mucosal injuries (1.9 +/- 0.4 and 1.7 +/- 0.3) compared to placebo (0.9 +/- 1.0) (p less than 0.05). The validity of different procedures in predicting the deleterious effects of nonsteroidal antiinflammatory drugs on the human upper gastrointestinal epithelium is discussed. PMID- 3539128 TI - [Comparative in-flight study of a scopolamine-containing membrane plaster versus dimenhydrinate under defined acceleration conditions]. AB - The efficacy and tolerability of Scopoderm TTS (SCOTTS), a transdermal system containing scopolamine, were compared with those of the oral antiemetic dimenhydrinate (double-dummy technique) in a controlled, double-blind, within patient study including 20 test persons with proven motion sickness. During a 1-h test flight, SCOTTS proved to be as effective as dimenhydrinate. The efficacy and tolerability of both SCOTTS and dimenhydrinate were assessed as to be equally good. Due to its galenic properties, SCOTTS is effective over a 72-h period and therefore is useful in the prevention of motion sickness during long-distance flights, where it is superior to dimenhydrinate. PMID- 3539129 TI - [Effect of homeopathic drugs on the phagocytic activity of human granulocytes. In vitro tests in a controlled single-blind study]. AB - Four homeopathic drug preparations with extract dilutions between D1 and D30 (expression for the homeopathic grade of potencies) and some additives (minerals and animal toxins) were investigated, using two in vitro and one in vivo phagocytosis models. All preparations enhanced significantly the activity of phagocytosis in all used systems. In controlled prospective single-blind studies with the preparations C and D performed on 12 and 14 verum and 13 male placebo volunteers respectively with i.v. injections within a 5-day treatment the phagocytosis indices were measured during 11 days using the microscopic smear method. In both investigations the maximum of phagocytosis activity was reached between the 4th and 5th day of injection. After the 4th or 5th (next to the last or last) injection, a rapid decrease of activity occurred which reached normal values on the 11th day. Other laboratory parameters investigated were not influenced. PMID- 3539130 TI - Third trimester ultrasonic presentation of infantile polycystic kidney disease. AB - Infantile polycystic kidney disease (Potter's Type 1) is an autosomal recessive disorder that affects the kidneys and liver. Use of ultrasound to make the diagnosis prenatally is well documented and, in fact, it is advocated as a screening device for second-trimester identification of potentially affected fetuses. The sonographic appearance is characterized by enlarged hyperechoic kidneys, enlarging fetal abdominal circumference, and oligohydramnios. It is suggested that a ratio of the kidney circumference to the abdominal circumference (KC/AC) be used as method of quantifying renal size and as a potential indicator of early kidney enlargement associated with infantile polycystic kidney disease (IPKD). We report a case of serial ultrasound examination of a pregnancy at risk for IPKD where the in utero diagnosis was not established until the third trimester. PMID- 3539131 TI - "Doctor, fix this building.". PMID- 3539132 TI - Intrapartum management of the fetus with idiopathic hydrocephalus. AB - Intrapartum management of fetal idiopathic hydrocephalus (IH) diagnosed late in pregnancy is controversial. Normal intellectual development is possible in many of these infants when neurosurgical intervention is undertaken in the neonatal period. Aggressive intrapartum management is indicated in most of these cases regardless of cortical mantle thickness. However, routine abdominal delivery is associated with increased maternal morbidity without proven fetal benefit. Transvaginal cephalocentesis for fetuses with IH in the cephalic presentation, followed by spontaneous vaginal delivery, lessens maternal morbidity and is compatible with good neonatal outcome. PMID- 3539133 TI - Cerebral palsy in very low birthweight infants surviving to 2 years with modern perinatal intensive care. AB - The rate of cerebral palsy and factors associated with its occurrence were determined in surviving 2-year-old very low birthweight (VLBW) infants born during an era of modern perinatal intensive care. Of the survivors, 12.5% (52/416) of those traced had spastic cerebral palsy. Motor handicaps were mild in 42%, moderate in 25%, and severe in 33% of children with cerebral palsy. The prevalence of cerebral palsy was similar in all birthweight groups up to the upper limit of 1500 gm, and was considerably higher than in survivors born in the same hospital a decade earlier. Although several perinatal variables were associated with the occurrence of cerebral palsy, either singly or in combination, little statistical or clinical confidence would be placed in these associations. Moreover, although 77% of children with cerebral palsy had one or more commonly recognized perinatal risk factors, almost identical rates of risk factors were present in normal children. The advent of cranial ultrasonography during the time of the study was associated with an increase in mortality but no effect on the prevalence of cerebral palsy. Cerebroventricular hemorrhage correlated poorly with the presence of cerebral palsy. The prevalence of cerebral palsy in surviving VLBW infants is unacceptably high; however, no obvious preventable factors in its etiology could be identified. PMID- 3539134 TI - Criteria for the prenatal diagnosis of holoprosencephaly. AB - Holoprosencephaly is a congenital anomaly of the central nervous system whose prenatal sonographic appearance may to similar to that of ventriculomegaly. A clear differential diagnosis is extremely important because the two conditions have different prognoses and therefore require different obstetric management. Eight cases of prenatally recognized holoprosencephaly are analyzed and criteria for a specific diagnosis proposed. The specificity and limitations of ultrasound findings, such as identification of a holoventricle, presence of a dorsal sac, and facial anomalies are discussed. PMID- 3539135 TI - Antibacterial activity of amniotic fluid in the early third trimester. Its association with preterm labor and delivery. AB - The purpose of this study was to determine the bacterial growth inhibitory property of amniotic fluid (AF) from patients in the early third trimester and to examine its relationship to preterm labor and delivery. A total of 38 AF samples from patients between 27 and 35 weeks gestation with intact membranes were studied. Antibacterial activity was tested against Escherichia coli, Staphylococcus aureus, and Bacteroides fragilis. Fifteen fluids were from patients in preterm labor who delivered near term after successful inhibition of labor. Five of these fluids (33%) were inhibitory to E. coli, five (33%) to S. aureus, and 11 (73%) to B. fragilis. Nine fluids were from patients who failed inhibition of labor and delivered preterm; none of these were inhibitory to E. coli, two (22%) to S. aureus, and only one (11%) to B. fragilis (P less than 0.005). Two of the nine fluids from patients who failed inhibition of labor also yielded fusobacteria. The remaining 14 fluids were obtained from patients without preterm labor and exhibited antibacterial activity similar to that from patients with successful labor inhibition. Results suggest a relationship between the absence of AF antibacterial activity against B. fragilis and preterm delivery in patients with preterm labor and intact membranes. PMID- 3539136 TI - Amniotic fluid protease activity, protease inhibitory activity, and fetal lung maturity. AB - Amniotic fluid acid protease and acid protease inhibitory activities were examined in normal pregnancies as a function of gestational age. The acid proteolytic activity of the amniotic fluid is almost constant during gestational weeks 16-29 (26 +/- 13 micrograms globin/ml/2 hrs, mean +/- SD, n = 64). The activity sharply increases after 29 weeks in a time-dependent fashion and reaches a value of 302 +/- 89 (mean +/- SD, n = 13) at 39-40 weeks gestation. Under standard conditions, the ability of amniotic fluid to inhibit bovine pepsin declined during gestation in a linear fashion from 44 +/- 13% (mean +/- SD, n = 36) at 16-18 weeks to 9 +/- 10% (mean +/- SD, n = 41) at 36-40 weeks. A correlation coefficient of r = 0.72 was found between pepsin inhibitory activity and gestational age. No consistent change was noted in the extent of inhibition of the endogenous acid protease throughout pregnancy. In 61 amniotic fluid samples, a correlation coefficient of r = 0.70 was found between acid protease activity and the lecithin/sphingomyelin (L/S) ratio. During the course of this study, five cases of respiratory distress syndrome (RDS) were diagnosed clinically. All five infants had a low protease activity (55 +/- 22 micrograms globin/ml/2 hr, mean +/- SD) as well as a low L/S ratio (0.68 +/- 0.20, mean +/- SD). In contrast, no case of RDS of the newborn was observed among 29 pregnancies with high protease activity and a high L/S ratio. The present observations may suggest a predictive value of amniotic fluid acid protease activity in assessment of fetal lung maturity. PMID- 3539137 TI - Preservation methods for liver transplantation. PMID- 3539138 TI - [Neonatal necrotizing enterocolitis: clinico-pathological correlation. 6 years' experience]. PMID- 3539139 TI - [True streptococcal infection or carrier state?]. PMID- 3539140 TI - High frequency antigens of human erythrocyte membrane sialoglycoproteins, III. Studies on the EnaFR, Wrb and Wra antigens. AB - The nature of the common erythrocyte antigens EnaFR and Wrb, that are both absent from En(a-) cells, and the rare Wra receptor, apparently encoded by an allele of Wrb, was investigated. Various modification, fractionation or cleavage products of erythrocyte membranes were used in hemagglutination inhibition assays. The EnaFR and Wrb antigens were shown to represent labile structures within the residues approx. 62-72 of the major (MN) sialoglycoprotein that require lipids, at least for complete expression of antigenic activity. During the course of these experiments, the arrangement of the MN glycoprotein's peptide chain with respect to the lipid bi-layer was also studied, using various proteinases. Furthermore, the MN glycoprotein was found to aggregate with the major membrane protein (band 3) in the presence of Triton X-100. The Wra antigen was shown to exhibit properties that differ considerably from those of the Wrb receptor. Analyses on the MN glycoprotein, isolated from the red cells of the only known Wra homozygote and two WraWrb individuals, did not reveal any amino-acid exchange within the residues 40-96 of the molecule. Therefore, the Wr locus that determines the presence or absence of the Wrb antigen on the MN glycoprotein might influence the post-translational modification of amino-acid residues, the structure of tightly bound lipids or the aggregation of the MN glycoprotein with a different protein such as band 3. PMID- 3539141 TI - Effect of diabetes and of 7 alpha-hydroxycholesterol infusion on the profile of bile acids secreted by the isolated rat livers. AB - The isolated livers from normal, streptozotocin-diabetic, and insulin-treated diabetic rats were perfused without and with infused 7 alpha-hydroxycholesterol. Biliary bile acids were extracted and analysed by gas chromatography. In each liver group, total bile acid concentration was more than four times greater with infused 7 alpha-hydroxycholesterol than without the sterol. Without infused 7 alpha-hydroxycholesterol, bile acids in the control group were composed mainly of beta-muricholic acid and to a lesser extent of cholic acid. In the diabetic group, the ratio between these two bile acids reversed. The ratio tended to be normalized by treatment with insulin. With infused 7 alpha-hydroxycholesterol, the control group secreted chenodeoxycholic acid at a considerable higher percentage besides major beta-muricholic acid and minor cholic acid. In the diabetic group, the ratio between the latter two bile acids reversed as was the case with the endogenous secretion, while the percentage of chenodeoxycholic acid remained then unchanged. The diminished percentage of beta-muricholic acid in the diabetic group was increased two times by treatment with insulin. PMID- 3539142 TI - Combinatorial diversity in the generation of antibody molecules. The complete amino-acid sequence of the variable domain of a monoclonal anti-streptococcal group A polysaccharide antibody. AB - The first complete amino-acid sequence of the variable region of the gamma 3 heavy chain from a murine anti-streptococcal group A polysaccharide (A-CHO) immunoglobulin (monoclonal antibody 2S1.3) is described. Therefore, in conjunction with the previously published 2S1.3 light chain sequence, a V kappa 25 structure, the entire variable domain of this antibody has been determined. In addition, four partial amino-terminal heavy chain sequences of other antibodies with the same specificity are reported. These heavy chains share a high degree of homology with heavy chains from fructosan-binding murine myeloma proteins with the exception of those positions known to be encoded by the D (diversity) segment in germ line DNA. The light chains associated with the heavy chains reported here are products of the V kappa 25, V kappa 27, and J kappa 5 genes. Up to date three VH and four V kappa subgroups have been shown to contribute genetic material to the assembly of antibodies specific for the A-CHO. Unlike other experimental systems employing structurally completely resolved full antigens the antistreptococcal immune response uses V genes previously shown to be involved in the formation of antibodies with different specificities. This provides further experimental evidence for the physiological relevance of heavy/light chain association as a posttranscriptional diversification mechanism in the generation of the antibody repertoire in addition to those somatic diversifiers acting directly upon the genes encoding the variable regions of individual chains. PMID- 3539143 TI - Kinetic studies on the interaction of alpha 1-proteinase inhibitor (Pittsburgh) with trypsin-like serine proteinases. AB - The rates of interaction of a number of serine proteinases with a mutant form of alpha 1-proteinase inhibitor (referred to as alpha 1-proteinase inhibitor (Pittsburgh)), in which a methionine-358 to arginine-358 mutation has occurred, have been determined. An approximately 6,000-fold increase in the second order association rate constant with human thrombin was observed (48 M-1 X s-1 for the normal protein to 3.1 X 10(5) M-1 X s-1 for the arginine mutant), confirming previously observed data using bovine thrombin (Owen, M.C., Brennan, S.O., Lewis, J.H. & Carrell, R.W. (1983) New England J. Med. 309, 694-698). However, substantial increases in the rates of association with other trypsin-like enzymes were also noted, indicating that the replacement of methionine by a basic residue affects all serine proteinases with this kind of specificity. There was a marked decrease in the rates of interaction of the Pittsburgh mutant with both human neutrophil elastase and porcine pancreatic elastase, the inhibitor being converted into lower molecular mass fragments after interaction with either enzyme. Butanedione caused a substantial loss in the inhibitory activity of the arginine mutant, while having no effect on the normal protein. These data, when compared to those previously reported for differences in reaction rates between normal and oxidized alpha 1-proteinase inhibitor (Beatty, K., Bieth, J. & Travis, J. (1980) J. Biol. Chem. 255, 3931-3934), are consistent with the interpretation that the amino acid in the P1-position at the reactive site of this protein has a marked effect on determining its primary specificity. PMID- 3539144 TI - Topography of all tyrosine residues in subtilisin DY. AB - The extracellular alkaline proteinase subtilisin DY was nitrated with increasing amounts of tetranitromethane. At 2-fold molar excess of the reagent with respect to the tyrosine residues in the enzyme, when 1.3 residues were modified, a peak of the caseinolytic activity (13% increase) was observed. Evidence is provided that the diminishing of the pK of the phenolic hydroxyl group in Tyr(3NO2)104 causes this phenomenon. The products obtained after nitration of the enzyme with 5-fold and 200-fold molar excess of tetranitromethane were cleaved by trypsin and cyanogen bromide and the peptides obtained were studied by analysis with respect to the tyrosine and 3-nitrotyrosine residues. Their degree of substitution was established. Tyrosine-104 was the first modified residue, then follow the residues with numbers 57, 143, 206, 262 and somewhat later 21, 209, 263, all fully modified by 200-fold molar excess of the reagent. Partial modification was observed at numbers 91, 167, 214, 238 and no modification at numbers 6 and 171. It has been established that the nonmodified residues are buried inside the molecule and the partially modified residues are screened by the side chains of lysine, valine, leucine, and tryptophan as seen on a working video three dimensional model of subtilisin Carlsberg. The approach for characterization of tyrosyl groups in proteins based on peptide sequencing and HPLC quantitation of the phenylthiohydantoin derivatives of tyrosine and 3-nitrotyrosine was further developed with respect to the quantitation of the HPLC-separated peptides using fragments of the protein studied. PMID- 3539145 TI - Covalent fixation of NAD+ to dehydrogenases and properties of the modified enzymes. AB - Starting from 6-chloropurine riboside and NAD+, different reactive analogues of NAD+ have been obtained by introducing diazoniumaryl or aromatic imidoester groups via flexible spacers into the nonfunctional adenine moiety of the coenzyme. The analogues react with different amino-acid residues of dehydrogenases and form stable amidine or azobridges, respectively. After the formation of a ternary complex by the coenzyme, the enzyme and a pseudosubstrate, the reactive spacer is anchored in the vicinity of the active site. Thus, the coenzyme remains covalently attached to the protein even after decomposition of the complex. On addition of substrates the covalently bound coenzyme is converted to the dihydro-form. In enzymatic tests the modified dehydrogenases show 80-90% of the specific activity of the native enzymes, but they need remarkably higher concentrations of free NAD+ to achieve these values. The dihydro-coenzymes can be reoxidized by oxidizing agents like phenazine methosulfate or by a second enzyme system. Various systems for coenzyme regeneration were investigated; the modified enzymes were lactate dehydrogenase from pig heart and alcohol dehydrogenase from horse liver; the auxiliary enzymes were alcohol dehydrogenase from yeast and liver, lactate dehydrogenase from pig heart, glutamate dehydrogenase and alanine dehydrogenase. Lactate dehydrogenase from heart muscle is inhibited by pyruvate. With alanine dehydrogenase as the auxiliary enzyme, the coenzyme is regenerated and the reaction product, pyruvate, is removed. This system succeeds to convert lactate quantitatively to L-alanine. The thermostability of the binary enzyme systems indicates an interaction of covalently bound coenzymes with both dehydrogenases; both binding sites seem to compete for the coenzyme. The comparison of dehydrogenases with different degrees of modifications shows that product formation mainly depends on the amount of incorporated coenzyme. PMID- 3539146 TI - A carrier-free 32P-labeled Edman reagent for the detection of proteins in the femtomole range. AB - A new route for synthesis of a 32P-labeled Edman reagent 2-(4 isothiocyanatophenoxy)-1,3,2-dioxaphosphinane 2-oxide (PEPITC) is reported. The carrier-free [32P]-PEPITC (specific radioactivity 3.3 X 10(17) Bq/mol) in theory allows the labeling and detection of a minimum amount of 0.1 femtomol of protein. The advantages of the new reagent, which has previously been used for protein sequencing, are demonstrated by gelelectrophoretical and immunological experiments. Its major role is seen in the quantitative monitoring of protein elution from preparative one- and two-dimensional gels. Proteins thus obtained are, after the usual desalting steps, ready for sequencing. PMID- 3539147 TI - Structure-function relationships of shortened [LeuB25]insulins, semisynthetic analogues of a mutant human insulin. AB - Replacement of B25-phenylalanine by leucine in the insulin sequence causes marked inactivation. The effect of this sequence variation was studied here in des-(B26 30)-insulin. [LeuB25]des-(B26-30)-insulin and its B25-amide were prepared by trypsin-mediated semisynthesis from N-terminally protected des-(B23-30)-insulin and synthetic tripeptides. The relative lipogenic potency in isolated rat adipocytes was 8.0% for the truncated analogue with a free B25-carboxyl function, and 18.1% for the amidated analogue. Binding to cultured human IM-9 lymphocytes was 4% and 9%, respectively. Thus, both shortened insulins are markedly more active than [LeuB25]insulin. The PheB25----LeuB25 substitution in both the shortened and the full sequence has a moderate effect on the CD spectrum, indicating that the gross main chain conformation is largely retained in both molecules. Independent of the substitution an absolute increase of the circular dichroism is observed upon amidation of the B25-carboxyl group. PMID- 3539148 TI - Blood culture and echocardiography in diagnosis of infective endocarditis: microbiological and clinical observations. AB - Short retrospective review of 77 cases of bacterial endocarditis, observed in the 1980-84 period, and diagnosed by means of echography and blood culture. Alfa haemolytic streptococcus strains were isolated (47.6% of 42 isolated strains) followed by Staphylococcus aureus (16.7%) and Staphylococcus epidermidis (11.9%). Positive bloodculture were more frequent in the patients with valvular prosthesis. The results are analysed and some comments are done. PMID- 3539149 TI - Persistent generalized lymphadenopathy in drug addicts: immunological studies. AB - The persistent generalized lymphadenopathy (PGL) in drug addicts displays the same immunological abnormalities previously found in homosexual and haemophiliac men with PGL: impaired in vivo and in vitro T cell functions, inverted T4/T8 ratio in blood and B cell abnormalities. The peripheral blood B-lymphocytes, in fact, show a reduced in vitro immunoglobulin synthesis after pokeweed mitogen and Staphylococcus aureus activation, with an increased spontaneous IgG secretion. In the lymph node biopsies, the immuno-histological studies reveal an infiltration of OKT8 positive cells in the germinal centers, a depletion of OKT4 positive lymphocytes slighter than in the blood and an explosive follicular hyperplasia with a striking destruction of the dendritic reticulum cell framework. This latter finding, together with the high levels of serum IgG and the presence of preactivated B cells in the blood, seems to be consistent with the presence of an in vivo polyclonal B cell activation. A high incidence of anti-HTLV III antibodies was also found in the PGL drug addicts. The significance of these findings is discussed in this report. PMID- 3539150 TI - Split calvarium cranioplasty. AB - Fronto-orbital deformities secondary to trauma, infection, or surgery create a difficult problem for the reconstructive surgeon. The location of the deformity is particularly critical because it involves the most visible part of the face. Since the skull is rarely able to produce bony regeneration over large areas, numerous alloplastic materials have been used to repair these defects. Complications with these materials are commonplace. Autogenous bone has been used with good results and avoids many of the problems inherent to the use of foreign materials. Rib, scapula, and iliac crest may be used, but they require a separate incision and often provide less than satisfactory cosmetic results. We describe a technique of cranioplasty utilizing split calvarium for repair of frontal bone defects. Cosmesis is excellent, morbidity is minimal, and only one incision is necessary. PMID- 3539151 TI - [Can the glucose load test predict insulin requirement in gestational diabetes with normal fasting blood glucose (Type B)?]. PMID- 3539152 TI - [Parallel pathways in the somatosensory system]. PMID- 3539154 TI - [Evolution of parallel sensory pathways, with special reference to the visual system]. PMID- 3539153 TI - [Multiplicity of the auditory pathways: organization of lateral lemniscal fibers converging onto the inferior colliculus]. PMID- 3539155 TI - Vitamin D metabolism during pregnancy. AB - Vitamin D metabolism is altered in the pregnant animal, presumably in response to fetal demands for calcium. Circulating levels of 1,25-dihydroxyvitamin D are elevated in the pregnant animal. The stimulus of this increase and the hydroxylase(s) (placental or renal) responsible are unknown. Maternal plasma 25 hydroxyvitamin D levels have been reported to be both unchanged and decreased during pregnancy but very much dependent upon exposure to ultraviolet light and vitamin D supplementation. The major vitamin D metabolites (25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D) circulate in fetal plasma but generally at lower concentrations than in the mother (exception is the sheep). All of these metabolites are able to cross the placenta. The fetal kidney and placenta both have 25-hydroxyvitamin D1 alpha- and 24-hydroxylase activity. However, the relative contribution of mother, fetus, and placenta to fetal vitamin D metabolism has yet to be fully determined. PMID- 3539156 TI - Development and cross-reactive properties of monoclonal antibodies to bovine matrix vesicle alkaline phosphatase. AB - Alkaline phosphatase (ALPase), concentrated in the membranes of matrix vesicles, is believed to play a role in initial calcification. To further purify, characterize, and identify this enzyme in tissue, a monoclonal antibody was developed against the ALPase of isolated fetal calf matrix vesicles. Splenic lymphocytes derived from mice immunized with Sepharose 6B-purified fetal calf matrix vesicle ALPase were fused with mouse plasmacytoma cells (line X63-Ag 8.653) using standard hybridoma technology. Hyperimmune sera and hybridoma culture supernatants were screened for the presence of specific antibody using a newly developed double-immunosorbent assay in which putative antibody is added to microtiter plate wells precoated with affinity-purified rabbit antimouse immunoglobulin. After incubation and washing, partially purified fetal calf matrix vesicle ALPase is added to each well. The enzyme adheres only to wells that contain specific anti-ALPase antibody. These wells are identified by adding the enzyme substrate p-nitrophenyl phosphate and reading the wells in a plate reading spectrophotometer at 405 nm. A hybridoma-producing specific antibody was subsequently cloned and grown as ascities-producing tumors in pristane-primed mice. Ouchterlony analysis indicated that the cell line secretes an immunoglobulin of IgG1 class. This antibody reacts specifically with ALPase derived from calf matrix vesicles and cross-reacts with ALPase of bovine kidney, liver, and placental origin and human bone but does not cross-react with bovine intestinal ALPase or ALPase derived from matrix vesicles isolated from rachitic rat growth plate cartilage. PMID- 3539157 TI - The uses of a new self-shearing cross-pin system. PMID- 3539159 TI - Badges of the dental profession. East Lancashire and East Cheshire branch. PMID- 3539158 TI - Sugar consumption in the United Kingdom. PMID- 3539161 TI - Badges of the dental profession. The British Society of Periodontology. PMID- 3539160 TI - Monoclonal antibodies in dentistry. PMID- 3539162 TI - Long term improvement in global left ventricular function after early thrombolytic treatment in acute myocardial infarction. Report of a randomised multicentre trial of intracoronary streptokinase in acute myocardial infarction. AB - The effect of reperfusion achieved by early intracoronary streptokinase in acute myocardial infarction on left ventricular function was studied in 533 patients enrolled in a prospective randomised multicentre study. Two hundred and sixty four patients were allocated to conventional treatment and 269 patients to thrombolysis. At the end of the procedure patency of the infarct related vessel was achieved in 198 (85%) of 234 patients in whom coronary angiography was performed. The median interval from onset of symptoms till the angiographic documentation of patency was 200 minutes. Data were analysed according to the original treatment allocation. Global left ventricular ejection fraction was determined by radionuclide angiography in 418 patients within two days of admission, in 361 patients after two weeks, and in 307 patients after three months. Global left ventricular function remained unchanged throughout the observation period in the control group, whereas it improved during the first two weeks in patients allocated to thrombolytic treatment. Improved function in these patients persisted up to three months after the infarction. Global left ventricular ejection fraction was significantly better in the thrombolysis group than in the control group at two days, two weeks, and at three months. In patients with anterior myocardial infarction the left ventricular ejection fraction was 9% better than in the control group at two weeks and at three months. In the patients with inferior myocardial infarction differences between the two treatment groups were smaller because of photon attenuation within the body. Angiographic evidence suggested that the improvement in function seen after thrombolysis is indeed associated with the patency of the infarct related artery. PMID- 3539163 TI - Epoprostenol sodium (prostacyclin) infusion in acute myocardial infarction. AB - Epoprostenol (prostacyclin) is a potent inhibitor of platelet aggregation and causes relaxation of vascular smooth muscle. These effects may be beneficial in patients with acute myocardial infarction. The effect of epoprostenol infusion in patients with acute myocardial infarction was evaluated in a randomised double blind study of 45 patients with evidence of myocardial infarction of less than 16 hours' duration. The patients were given a 72 hour infusion of epoprostenol (23) or placebo (22). The maximum dose was 5 ng/kg/min. The mean time to treatment was 8.3 hours (range 3.8-15.9 hours). The mean dose was 4.9 ng/kg/min. The patients were followed until day 30. No significant differences were found between the groups in mortality, development of congestive heart failure, cardiogenic shock, arrhythmias, recurrent chest pain, reinfarction, peak creatine kinase concentration, or the time taken to attain peak creatine kinase concentration. No significant difference in baseline ejection fraction was noted between groups, and no significant change in ejection fraction occurred within each group or between groups. The only significant side effect was the development of facial flushing in the epoprostenol group. In this pilot study epoprostenol was well tolerated by patients with acute myocardial infarction. No benefit from epoprostenol could be demonstrated at the dose range used when the drug was administered within 16 hours of the onset of symptoms. PMID- 3539164 TI - Non-invasive estimation of the mean pressure difference in aortic stenosis by Doppler ultrasound. AB - The mean pressure difference across the valve in aortic stenosis is an indicator of the severity of the obstruction to flow. Non-invasive determination of the mean pressure gradient by Doppler ultrasonography is, however, complicated by the squared relation between instantaneous velocities and pressure differences. The validity of a new simple formula for calculation of the mean pressure difference from the peak pressure difference was evaluated in 26 patients with aortic stenosis. The formula is: delta pmean = 0.64 delta ppeak, where delta pmean is the mean pressure gradient and delta ppeak the peak pressure gradient. There was a close correlation between the mean pressure differences determined by application of the formula to the peak pressure differences measured at catheterisation and the mean pressure differences obtained by planimetry (r = 0.97, SEE = 4.7 mm Hg). The correlation between mean pressure differences determined by continuous wave Doppler ultrasound and the formula and those measured by planimetry was also close (r = 0.91, SEE = 7.6 mm Hg) and only three patients showed a difference between the two methods of greater than 10 mm Hg. The new formula is a simple and reliable means of estimating the mean pressure difference from Doppler recordings and it facilitates the comparison of Doppler and catheterisation data. PMID- 3539165 TI - Ibuprofen in the management of postoperative pain. AB - The effect of the regular administration of ibuprofen on pain following abdominal surgery was investigated in a double-blind placebo-controlled study. The analgesic action of ibuprofen was measured by a reduction in the amount of morphine self-administered from an On-Demand Analgesic Computer. Pain scores, nausea scores and blood loss were similar in both groups, but patients receiving ibuprofen demanded significantly less morphine in the 24 h after surgery. PMID- 3539167 TI - The impulsivist: a multi-impulsive personality disorder. PMID- 3539166 TI - Phaeochromocytoma. Diagnosis, preoperative preparation and anaesthetic management. AB - Unless patients harbouring this uncommon tumour are correctly prepared and protected from the effects of excessive catecholamine release, they are greatly at risk when undergoing surgical procedures of any kind. This short review describes the clinical syndromes associated with phaeochromocytoma, the diagnostic procedures which may identify and localize the tumour(s), the principles and practical aspects of pharmacological control, and a method of anaesthetic management which has proved safe and effective in many patients. PMID- 3539168 TI - Respiratory disease and respiratory failure: implications for the young and the old. PMID- 3539169 TI - Successful management of primary invasive pulmonary aspergillosis. AB - We present the successful recovery of an immunocompetent patient with invasive pulmonary aspergillosis in the absence of any previous detectable lung damage or underlying systemic disease. PMID- 3539170 TI - Possible induction of disseminated intravascular coagulation in the mouse by group B streptococcal clumping factor. AB - A hydrochloric acid extract, the clumping factor fraction, obtained from a clumping factor-positive strain of group B streptococci, was capable of killing mice by administration after injection of heat-killed cells of group B streptococci or Escherichia coli intravenously. In mice killed between 24 and 48 h later, fibrin thrombi were observed in the renal glomeruli, as well as in the heart, lung, liver, and pancreas. These findings suggest the possible induction of disseminated intravascular coagulation by these organisms in the mouse. PMID- 3539171 TI - Low-dose etretinate in the maintenance of remission of palmoplantar pustular psoriasis. AB - Twenty patients with palmoplantar pustular psoriasis were treated initially for 4 weeks with 70 mg etretinate daily. This led to clinical improvement and a significant fall in pustule count. The patients were then allocated randomly to 30 mg etretinate daily or placebo for a further 12 weeks. There was a rapid deterioration in the clinical condition and a rise in pustule count in the placebo group. The etretinate-treated group still showed clinical improvement and a significantly lower pustule count after 12 weeks. Clinical side-effects were few and adverse effects on liver function and serum lipids were not found. PMID- 3539172 TI - Ex vivo T-cell depletion with the monoclonal antibody Campath-1 plus human complement effectively prevents acute graft-versus-host disease in allogeneic bone marrow transplantation. AB - We have developed a rapid and simple procedure for the elimination of mature T cells from the donor marrow using a single incubation with the monoclonal antibody Campath-1 and donor complement. This resulted in a reduction of T-cell contamination to a mean of 1%. This regimen reduced the incidence of acute graft versus-host disease significantly in 21 consecutive bone marrow grafts in 18 patients with leukaemia and non-Hodgkin's lymphoma. Purging was responsible for an increased incidence of graft rejection in HLA-identical transplants (13%). PMID- 3539173 TI - Progression of a myelodysplastic syndrome to pre-B acute lymphoblastic leukaemia with unusual phenotype. AB - This study shows the progression of a myelodysplastic syndrome (MDS) to pre-B acute lymphoblastic leukaemia (ALL) with an unusual phenotype. On diagnosis of leukaemia bone-marrow mononuclear cells were labelled with murine monoclonal antibodies HLA-DR, VIL-A1 (CALLA), 3813, VIM-D5 and with a rabbit antiserum to TdT using a double colour indirect immunofluorescence technique. In addition simultaneous detection of cytoplasmic mu chains (Cy mu) and of TdT was carried out and a direct immunofluorescence analysis for surface membrane immunoglobulins (SmIg) was performed. Two main populations were present: the major one being HLA DR+, Cy mu+, VIM-D5+, TdT-, CALLA-, SmIg-; the minor one HLA-DR+, Cy mu+, VIM-D5 , TdT+, CALLA-, SmIg-. The progression of our case to acute leukaemia with a population of leukaemic cells each of which demonstrated features of lymphoid and myeloid cells suggests that MDS would originate at the pluripotential stem cell level. PMID- 3539174 TI - Insulin stimulates cord blood erythroid progenitor growth: evidence for an aetiological role in neonatal polycythaemia. AB - Polycythaemia in the neonate is a serious pathologic entity which occurs particularly in infants of diabetic mothers (IDM) and small-for-gestational age (SGA) infants. Both of these conditions are associated with fetal hyperinsulinaemia. Cultures of cord blood mononuclear cells from polycythaemic IDM showed increased growth of late erythroid progenitor colonies, compared to cord blood mononuclear cells from non-polycythaemic infants, reflecting a possible expansion of this progenitor population in the polycythaemic fetus. No changes were observed in early erythroid progenitor populations. Biosynthetic human insulin at physiological levels characteristic of IDM stimulated growth in culture of late erythroid progenitors in cord blood from premature, term and IDM infants. Three out of five polycythaemic infants had elevated cord blood plasma levels of insulin C-peptide at birth, whereas no infant with a haematocrit of less than 65% had high insulin C-peptide measurements. These data suggest that the polycythaemia noted in infants of diabetic mothers may be secondary, in large part, to a stimulatory effect on erythroid progenitor growth by the hyperinsulinaemic environment in which they develop in utero. PMID- 3539175 TI - Autologous bone marrow transplantation following high dose chemotherapy for the treatment of adult patients with acute myeloid leukaemia. AB - 24 adult patients with acute myeloid leukaemia (AML) were treated with intensive chemotherapy followed by autologous marrow rescue. The procedure was repeated twice in eight patients. 11 of 16 patients treated in first remission continue in first unmaintained remission (9-54 months, median 17 months). Eight patients treated at relapse or second remission have relapsed again and died within 14 months of their first autologous bone marrow transplant (ABMT). This form of intensification therapy would appear valuable for adult AML patients in first remission. PMID- 3539176 TI - Relation between pathological grading and lung fibre concentration in a patient with asbestosis. AB - The fibre concentration and extent and severity of fibrosis have been analysed in 48 specimens from the left lung of a patient with asbestosis. Two different methods of fibre analysis were used. The results obtained by transmission electron microscopy were 2-2.5 times higher than those obtained by scanning electron microscopy. Low temperature ashed samples showed on average twice the number of fibres obtained after wet digestion of the samples. The transmission electron microscope detected considerably shorter fibres than the scanning electron microscope. Low temperature ashing produced also shorter fibres compared with the wet digestion procedure. A statistically significant correlation between fibre concentration and the grade of fibrosis was found only for low temperature ashed samples analysed in the transmission electron microscope. When dividing the lung into nine anatomical compartments and pooling the grade of fibrosis and the fibre concentration data within each compartment, an even better correlation was obtained. PMID- 3539177 TI - Corneal astigmatism following cataract extraction. AB - The changes in corneal curvature in the first six months after cataract extraction were studied by performing sequential keratometry on a group of 57 patients. 8/0 Virgin silk interrupted sutures were used for the closure of corneoscleral incisions, and 10/0 monofilament tied in double running (bootlace) or single running (continuous) fashion was used for corneal wound closure. A high degree of with-the-rule astigmatism was evident in all patients two weeks postoperatively, but thereafter the character of the astigmatism produced by 8/0 virgin silk and 10/0 monofilament closure was quite different: in the 8/0 virgin silk group there was an early and pronounced shift in the axis of astigmatism to against-the-rule, whereas in the 10/0 monofilament group there was little further change in the astigmatism unless the sutures were removed. Wound compression and wound gape as factors responsible for these changes are discussed. PMID- 3539178 TI - Cyclosporin A: tissue levels following topical and systemic administration to rabbits. AB - Plasma and aqueous levels of cyclosporin A (CsA) were determined following topical administration of CsA 1% to healthy rabbit eyes and compared with levels obtained when administered to rabbit eyes which had received corneal grafts 7-10 days previously. In addition plasma levels were determined following intramuscular administration of 50 mg CsA and the results compared with those obtained following topical administration. Topical administration to healthy rabbit eyes five times a day for three days resulted in plasma levels of CsA which were similar to those obtained over three days following an intramuscular administration of 50 mg CsA. The plasma levels in both were significantly higher than those obtained following topical administration to rabbit eyes which had received corneal grafts 7-10 days previously. Aqueous levels of CsA were lower than plasma levels, and there was no significant difference between levels obtained when CsA was administered topically to healthy eyes, to eyes which had received corneal grafts, or to the fellow eye. PMID- 3539179 TI - Identification of the 9-aminoacridine/DNA complex responsible for photodynamic inactivation of P22. AB - Acridine dyes bound to the condensed DNA within phage particles sensitize them to inactivation by visible light. The mechanism involves absorption of photons by an acridine/DNA complex, generating singlet oxygen, which covalently damages nearby proteins needed for DNA injection [Bryant, J., & King, J. (1985) J. Mol. Biol. 180, 837-863]. Acridines and related dyes interact with double-stranded DNA through a number of binding modes. To determine in condensed phage DNA the binding mode responsible for this inactivation, we have studied the formation of the DNA/acridine target complexes for photoinactivation. Analysis of the kinetics of 9-aminoacridine binding to Salmonella phage P22 particles revealed the formation of two binding species, one of which appeared more rapidly and was apparently an intermediate in the formation of the second. The rapidly forming species represented DNA sites with intercalated acridines, while the more slowly forming species represented the subsequent binding of additional acridine molecules to the DNA backbone of sites already containing intercalated dye. The rates of photoinactivation correlated with the rate of binding of 9-aminoacridine to the DNA backbone. This suggests that the most effective species for sensitizing phage to light-induced damage has acridine molecules stacked alongside the backbone of a region with intercalated molecules. PMID- 3539180 TI - Investigation of complexes formed between gene 32 protein from bacteriophage T4 and heavy-atom-modified single-stranded polynucleotides using optical detection of magnetic resonance. AB - Optical detection of triplet-state magnetic resonance (ODMR) is employed to study the complexes formed between gene 32 protein (GP32), a single-stranded DNA binding protein from bacteriophage T4, and the heavy-atom-derivatized polynucleotides poly(5-HgU) and poly(5-BrU). The triplet-state properties of some of the tryptophan (Trp) residues in the complexes are dramatically different from those in the free protein, in that they are subject to an external heavy-atom effect. Direct evidence for the presence of a heavy-atom effect, and hence a close-range interaction between mercurated or brominated nucleotide bases and Trp residues in the complex, is provided by the observation of the zero-field (D) + (E) ODMR transition of Trp, which is not normally observed in the absence of a heavy-atom perturbation. The amplitude-modulated phosphorescence-microwave double resonance (AM-PMDR) technique is employed to selectively capture the phosphorescence spectrum originating from the heavy-atom-perturbed Trp residue(s) in the GP32-poly(5-HgU) complex. Arguments based on our experimental results lead to the conclusion that the heavy-atom perturbation arises from aromatic stacking interactions between Trp and mercurated bases. Wavelength-selected ODMR measurements reveal the existence of two environmentally distinct and spectrally different types of Trp in GP32. One of these types is perturbed selectively by the heavy atom and hence undergoes stacking interactions with the heavy-atom derivatized bases of the polynucleotide while the second type of Trp residue is unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539182 TI - Direct ATP photolabeling of Escherichia coli recA proteins: identification of regions required for ATP binding. AB - When the Escherichia coli RecA protein is UV irradiated in the presence of [alpha 32P]ATP, a labeled protein--ATP adduct is formed. All the experimental evidence indicates that, in forming such an adduct, the ATP becomes specifically immobilized in the catalytically relevant ATP binding site. The adduct can also be identified after irradiation of E. coli cell lysates in a similar manner. This direct ATP photolabeling of RecA proteins has been used to identify regions of the polypeptide chain involved in the binding of ATP. The photolabeling of a RecA protein that lacks wild-type carboxy-terminal amino acids is not detectable. A RecA protein in which the amino-terminal sequence NH2-Ala-Ile-Asp-Glu-Asn- is replaced by NH2-Thr-Met-Ile-Thr-Asn-Ser-Ser-Ser- is only about 5% as efficiently photolabeled as the wild-type protein. Both of these RecA protein constructions, however, contain all the elements previously implicated, directly or indirectly, in the binding of ATP. ATP-photolabeled RecA protein has also been chemically cleaved at specific amino acids in order to identify regions of the polypeptide chain to which the nucleotide becomes covalently photolinked. The evidence is consistent with a region comprising amino acids 116-170. Thus, this work and that of others suggest that several disparate regions of the unfolded polypeptide chain may combine to form the ATP binding site upon protein folding or may influence binding through long-range effects. PMID- 3539181 TI - Interaction of recA protein with a photoaffinity analogue of ATP, 8-azido-ATP: determination of nucleotide cofactor binding parameters and of the relationship between ATP binding and ATP hydrolysis. AB - The binding and cross-linking of the ATP photoaffinity analogue 8-azidoadenosine 5'-triphosphate (azido-ATP) with recA protein have been investigated, and through cross-linking inhibition studies, the binding of other nucleotide cofactors to recA protein has also been studied. The azido-ATP molecule was shown to be a good ATP analogue with regard to recA protein binding and enzymatic function by three criteria: first, the cross-linking follows a simple hyperbolic binding curve with a Kd of 4 microM and a cross-linking efficiency ranging from 10% to 70% depending on conditions; second, ATP, dATP, and adenosine 5'-O-(3-thiotriphosphate) (ATP gamma-S) specifically inhibit the cross-linking of azido-ATP to recA protein; third, azido-ATP is a substrate for recA protein ATPase activity. Quantitative analysis of the cross-linking inhibition studies using a variety of nucleotide cofactors as competitors has shown that the binding affinity of adenine containing nucleotides for recA protein decreases in the following order: ATP gamma-S greater than dATP greater than ATP greater than adenylyl beta,gamma imidodiphosphate (AMP-PNP) much greater than adenylyl beta,gamma methylenediphosphate (AMP-PCP) approximately adenine. Similar competition studies also showed that nearly all of the other nucleotide triphosphates also bind to recA protein, with the affinity decreasing in the following order: UTP greater than GTP approximately equal to dCTP greater than dGTP greater than CTP. In addition, studies performed in the presence of single-stranded DNA demonstrated that the affinity of ATP, dATP, ATP-gamma-S, and AMP-PNP for recA protein is significantly increased. These results are discussed in terms of the reciprocal effects that nucleotide cofactors have on the modulation of recA protein--single stranded DNA binding affinity and vice versa. In addition, it is demonstrated that nucleotide and DNA binding are necessary though not sufficient conditions for ATPase activity. The significance of this result in terms of the possible requirement of critically sized clusters of 15 or more recA protein molecules contiguously bound to DNA for ATPase activity is discussed. PMID- 3539183 TI - Permissible discontinuity region of the alpha-chain of hemoglobin: noncovalent interaction of heme and the complementary fragments alpha 1-30 and alpha 31-141. AB - Generation of a fragment-complementing system of the alpha-chain on limited proteolysis with Staphylococcus aureus V8 protease has been investigated. Digestion of the alpha-chain (0.4 mM) of hemoglobin with V8 protease in phosphate buffer at pH 6.0 and 37 degrees C is limited to the peptide bonds of Glu-23, Glu 27, Glu-30, and Asp-47. Gel filtration of a V8 protease digest of the alpha-chain on a Sephadex G-50 column did not release any heme to the low molecular weight region, though some peptides were released from the protein. The filtration studies revealed the presence of two heme-containing components in the digest, the major one eluting at the alpha-chain position and the minor one eluting slightly ahead of the alpha-chain position. Reversed-phase high-performance liquid chromatography and amino-terminal sequence analysis demonstrated that the component eluting at the alpha-chain position contains species generated by the noncovalent interactions of heme and the complementary fragments alpha 1-30 and alpha 31-141. In dilute solutions (0.04 mM) the V8 protease digestion occurred exclusively on the carboxyl side of Glu-30(alpha). This high selectivity was also observed at pH 4.0 and pH 7.8. The visible spectra and the ultraviolet circular dichroic spectra of the digest reflect the native-like structure of the noncovalent fragment system. The dissociation constant of alpha 1-30 appears to be in the range of 10(-8) M. In tetrameric hemoglobin A the peptide bond of Glu 30-Arg-31 of the alpha-chain is not accessible to V8 protease digestion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539184 TI - An engineered intersubunit disulfide enhances the stability and DNA binding of the N-terminal domain of lambda repressor. AB - Site-directed mutagenesis has been used to replace Tyr-88 at the dimer interface of the N-terminal domain of lambda repressor with cysteine. Computer model building had suggested that this substitution would allow formation of an intersubunit disulfide without disruption of the dimer structure [Pabo, C. O., & Suchanek, E. G. (1986) Biochemistry (preceding paper in this issue)]. We find that the Cys-88 protein forms a disulfide-bonded dimer that is very stable to reduction by dithiothreitol and has increased operator DNA binding activity. The covalent Cys88-Cys88' dimer is also considerably more stable than the wild-type protein to thermal denaturation or urea denaturation. As a control, Tyr-85 was replaced with cysteine. A Cys85-Cys85' disulfide cannot form without disrupting the wild-type structure, and we find that this disulfide bond reduces the DNA binding activity and stability of the N-terminal domain. PMID- 3539185 TI - Evidence for a protonmotive force related regulatory system in Escherichia coli and its effects on lactose transport. AB - Strains of Escherichia coli with mutations in the eup (energy-uncoupled phenotype) locus do not grow on nonfermentable carbon sources, have reduced growth yields on limiting glucose, are insensitive to colicins A and K, exhibit resistance to aminoglycoside antibiotics, and are defective in protonmotive force coupled active transport. eup mutations do not result in lowered protonmotive force. Here we show that deenergization of a eup+ strain results in the appearance of a new low KT, low Vmax form of the lactose carrier; in a strain deleted of the eup locus, deenergization does not evoke the low KT, low Vmax form of the lactose carrier. Cells bearing a eup point mutation and exhibiting the Eup phenotype possess the low KT, low Vmax form of the lactose carrier even when energized. In addition to affecting the kinetic parameters of the lactose carrier, the eup point mutation also reduces the KT and Vmax of the proline carrier. On the basis of these findings, we suggest that the normal eup gene product mediates a novel regulation of lactose carrier function following deenergization. The defect in proline and lactose transport caused by eup point mutations may stem from an altered eup product aberrantly mediating the regulation under energized conditions. Finally, the pleiotropy associated with eup point mutations may be indicative of those protonmotive force driven functions that are subject to eup regulation. PMID- 3539186 TI - Evidence for a single steroid-binding protein in the rabbit progesterone receptor. AB - The rabbit uterine progesterone receptor copurifies as two molecular weight (Mr) forms of about 105,000 and 78,000. To investigate whether these are different proteins, we have used protease digestion, reversible denaturation, and photoaffinity labeling in studies on the steroid-binding domain of the receptor. Digestion of the Mr 105,000 and 78,000 forms, photoaffinity labeled with [3H]R5020, with Staphylococcus aureus V8 protease revealed identical peptide fragments of Mr 43,000, 39,000, and 27,000-30,000. When receptor in cytosol was denatured, separated by electrophoresis, and then reconstituted, [3H]progesterone bound specifically to a single form at about Mr 105,000. After partial purification, the reversible denaturation procedure revealed both the larger and the smaller progesterone-binding species similar to the photoaffinity-labeled species in this preparation. Receptor in uterine cytosol prepared under mild conditions appeared as a predominant large molecular weight form on photoaffinity labeling with [17 alpha-methyl-3H]R5020, [6,7-3H]R5020, or [3H]RU27987. Further purification of this cytosol showed the generation of a smaller labeled species. These results from three different approaches reinforce the view that the rabbit progesterone receptor contains a single steroid-binding protein. PMID- 3539187 TI - Synergism in folding of a double mutant of the alpha subunit of tryptophan synthase. AB - The urea-induced unfolding of the inactive single mutants Tyr-175----Cys and Gly 211----Glu and the active double mutant Cys-175/Glu-211 of the alpha subunit of tryptophan synthase from Escherichia coli was examined by using ultraviolet difference spectroscopy. Equilibrium techniques were used to determine the equilibrium free energies of unfolding for the mutant proteins to permit comparison with the wild-type protein. The sum of the changes in stability for the single mutants is not equal to the change seen in the double mutant. This inequality is evidence for a structural interaction between these two residues. Kinetic studies show that this synergism, which destabilizes the native form by 1.5-2.0 kcal/mol at pH 7.8, 25 degrees C, occurs only after the final rate limiting step of domain association. PMID- 3539188 TI - Ribosome-catalyzed formation of an abnormal peptide analogue. AB - The peptidyl-tRNA analogue N-(chloroacetyl)phenylalanyl-tRNAPhe was prepared by chemical aminoacylation and prebound to the P site of Escherichia coli ribosomes in response to poly(uridylic acid). Admixture of phenylalanyl-tRNAPhe to the A site resulted in the formation of two "dipeptides", one of which was formed by displacement of chloride ion from the peptidyl-tRNA. This constitutes the first example of ribosome-mediated formation of a peptide of altered connectivity and suggests a need for revision of the current model of peptide bond formation. Also suggested by the present finding is the feasibility of utilizing tRNAs to prepare polypeptides of altered connectivity in an in vitro protein biosynthesizing system. PMID- 3539189 TI - Anticodon loop of tRNAPhe: structure, dynamics, and Mg2+ binding. AB - The structure, dynamics, and Mg2+ binding reactions of the isolated anticodon hairpin loop from tRNAPhe (yeast) have been analyzed by fluorescence-detected temperature-jump relaxation, melting experiments, and equilibrium sedimentation. Most of the measurements were performed at an ionic strength of 0.15 M and at temperatures below 25 degrees C, where the hairpin loop proved to be stable. A relaxation effect with a time constant of approximately 100 microseconds, indicated by the Wye base fluorescence, is attributed to a conformational change of the anticodon loop and is very similar to a corresponding transition observed previously for the whole tRNAPhe molecule. A Mg2+ binding site reflected by an inner-sphere relaxation process and associated with a strong increase of the Wye base fluorescence closely resembles a corresponding site observed in the complete tRNAPhe and is attributed to a site in the anticodon loop identified by X-ray analysis. In addition to the Mg2+ site in the loop, which is associated with a binding constant of 2 X 10(3) M-1, the existence of sites with a higher affinity is demonstrated by an unusual relaxation effect, showing a minimum in the reciprocal time constant with increasing Mg2+ concentration. The experimental data can be described by a transition between two states and Mg2+ binding to both states resulting in a reaction cycle, which is extended by an additional Mg2+ binding reaction to one of the states. The unusual effect has not been observed for the complete tRNAPhe and is also not observed when Ca2+ is added instead of Mg2+. This result indicates the existence of a conformational change involving Mg2+ inner-sphere complexation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539190 TI - Codon-induced association of the isolated anticodon loop of tRNAPhe. AB - The binding of the codon UUC to the isolated anticodon loop of tRNAPhe (yeast) has been studied as a model of codon recognition by a simple adaptor. Fluorescence titrations demonstrate that UUC binds to the isolated anticodon loop with an equilibrium constant of 1.4 X 10(3) M-1 (at 7.2 degrees C). Equilibrium sedimentation curves reveal that UUC binding induces association of anticodon loops beyond the dimer stage. A set of complete sedimentation curves obtained for various reactant concentrations was analyzed according to a model with an infinite number of subsequent association steps for UUC-anticodon loop complexes and with equal affinity for each step. The coupling of association and sedimentation was considered quantitatively, and the information resulting from conservation of mass was used by integration. According to this procedure, the experimental data can be described by an isodesmic association constant of 8 X 10(3) M-1 with satisfactory accuracy. Temperature-jump relaxation detected by fluorescence measurements provides independent evidence for codon-induced association of the anticodon loop. The data are consistent with the following mechanism: UUC preferentially binds to one of two loop conformations with a rate constant of 4.5 X 10(6) M-1 s-1; the UUC-anticodon loop complex undergoes association with a rate constant of 6.5 X 10(6) M-1 s-1. The reactions observed for the isolated anticodon loop are surprisingly similar to those observed previously for the complete tRNA, suggesting that simple hairpin loops are appropriate adaptors for a translation process at an early stage of evolution; the codon-induced association of the hairpin loop should be very useful to facilitate the transfer of cognate amino acids during translation. PMID- 3539191 TI - Accuracy of natural messenger translation: analysis of codon-anticodon recognition in a simplified cell-free system. AB - A simplified plasmid-directed coupled system [Robakis, N., Cenatiempo, Y., Meza Basso, L., Brot, N., & Weissbach, H. (1983) Methods Enzymol. 101, 690-706] was used to study the accuracy of natural messenger translation in vitro. In this system, protein synthesis is limited to the formation of the N-terminal di- or tripeptide of the gene product. Such a control is obtained by restricting the supply of aminoacyl-tRNAs in the assay medium to those corresponding specifically to the first two or three triplets in the mRNA coding sequence. We analyzed comparatively the interaction of 6 different codons with their cognate tRNAs and 18 noncognate tRNAs able to recognize triplets differing from the legitimate sequences by one base only. Special attention was paid to the single base errors occurring at the first and second codon positions during ribosomal selection of aminoacyl-tRNA molecules. The noncognate tRNAs were assayed either in the absence of the legitimate tRNAs or under competition conditions. They were chosen so that all the possibilities for misreading any particular base as each of the other three bases could be studied. First, it was mainly observed that translation mistakes can be equally detected in the first and second codon positions; there is no compelling evidence for a most or least accurate site. Second, pyrimidines seem to be read more accurately than purines. In particular, U cannot be read as either C or G, and C can hardly be mistaken for any other base.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539192 TI - How do the polyene macrolide antibiotics affect the cellular membrane properties? AB - In the 1970's great strides were made in understanding the mechanism of action of amphotericin B and nystatin: the formation of transmembrane pores was clearly demonstrated in planar lipid monolayers, in multilamellar phospholipid vesicles and in Acholeplasma laidlawii cells and the importance of the presence and of the nature of the membrane sterol was analyzed. For polyene antibiotics with shorter chains, a mechanism of membrane disruption was proposed. However, recently obtained data on unilamellar vesicles have complicated the situation. It has been shown that: membranes in the gel state (which is not common in cells), even if they do not contain sterols may be made permeable by polyene antibiotics, several mechanisms may operate, simultaneously or sequentially, depending on the antibiotic/lipid ratio, the time elapsed after mixing and the mode of addition of the antibiotic, there is a rapid exchange of the antibiotic molecules between the vesicles. Although pore formation is apparently involved in the toxicity of amphotericin B and nystatin, it is not the sole factor which contributes to cell death, since K+ leakage induced by these antibiotics is separate from their lethal action. The peroxidation of membrane lipids, which has been demonstrated for erythrocytes and Candida albicans cells in the presence of amphotericin B, may play a determining role in toxicity concurrently with colloid osmotic effect. On the other hand, it has been shown that the action of polyene antibiotics on cells is not always detrimental: at sub-lethal concentrations these drugs stimulate either the activity of some membrane enzymes or cellular metabolism. In particular, some cells of the immune system are stimulated. Furthermore, polyene antibiotics may act synergistically with other drugs, such as antitumor or antifungal compounds. This may occur either by an increased incorporation of the drug, under the influence of a polyene antibiotic-induced change of membrane potential, for example, or by a direct interaction of both drugs. That fungal membranes contain ergosterol while mammalian cell membranes contain cholesterol, has generally been considered the basis for the selective toxicity of amphotericin B and nystatin for fungi. Actually, in vitro studies have not always borne out this assumption, thereby casting doubt on the use of polyene antibiotics as antifungal agents in mammalian cell culture media.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539193 TI - Fluorescence microphotolysis to measure nucleocytoplasmic transport and intracellular mobility. PMID- 3539194 TI - Differential scanning calorimetric studies of lipid-protein interactions in model membrane systems. PMID- 3539195 TI - Structure and properties of mixed-chain phospholipid assemblies. PMID- 3539196 TI - Immune response to autologous human melanoma: implication of class I and II MHC products. PMID- 3539197 TI - Membrane structures involved in auto-tumor recognition. AB - Tumor patients' blood lymphocytes have the capacity to recognize autologous tumor cells in vitro. A consequence of this recognition is the proliferation of small size, high-density, resting T cells. Both helper (CD4+) and cytotoxic/suppressor (CD8+) T lymphocytes proliferate in the mixed lymphocyte-tumor cell cultures. In contrast to the autologous mixed lymphocyte cultures, both the auto-erythrocyte rosetting and non-rosetting (AE+ and AE-) T cells participate in the auto-tumor response. In contrast to stimulation by virus-infected or hapten-modified cells, DR antigen expression is not essential for stimulation by autologous tumor cells. In a proportion of cancer patients, blood lymphocytes have the capacity to lyse the patients' own tumor cells in vitro. There are two populations of lymphocytes with auto-tumor cytotoxic function. The first is characterized by low buoyant density and by non-adaptive cytotoxicity. In contrast to the recognition of hapten-modified or virus-infected target cells by the CTL, recognition of autologous tumor cells by the cytotoxic LD cells occurs even when the MHC class I antigens are blocked by mAb. The CD3 complex is also not involved in LD-mediated lysis. The other population with auto-tumor cytotoxic function comprises high density, resting T cells. Recognition of autologous tumor cells by cytotoxic HD lymphocytes shares the characteristics of CTLs, i.e., their function is abrogated by pretreatment of the effectors with mAbs directed to the T3 receptor complex and by preincubation of the targets with mAb to the MHC class I antigens. Cytotoxicity of HD cells is restricted to the autologous tumor cells. This selectivity and the characteristics shared with CTL suggest that the auto-tumor reactivity of HD lymphocytes reflects an immune response against the autologous tumor. PMID- 3539198 TI - Human lymphokine-activated killer cells (LAK cells) as a potential immunotherapeutic modality. AB - Lymphokine-activated killer cells (LAK) are cytolytic lymphocytes with the unique capacity of killing NK-resistant fresh human tumor cells in short-term assays. LAK appear to kill autologous tumors as well as TNP-modified self and allogeneic tumors with complete crossreactivity, both at the population and clonal level. Initial studies on the classification of LAK conclude that LAK are distinct from the classical NK and T-lymphocyte systems based on a number of criteria including surface phenotype, activation conditions, and spectrum of susceptible target cells. LAK kill rasoncogene-transfected fibroblasts in a manner similar to fresh tumors. As yet, the target cell determinant responsible for susceptibility to LAK lysis is unknown, but cell-surface proteins are definitely involved. Activation of LAK requires only IL-2, and is most efficient using serum-free conditions. Because interleukin-2 alone is sufficient for LAK activation, we have tested in vitro whether fresh PBL could be activated in the presence of tumor, as might be desired in vivo. LAK activation was greatly suppressed by tumor presence. LAK activation is also suppressed by hydrocortisone, but not cyclosporine A. Because of the above and other findings, we have initiated a clinical protocol to test whether LAK made from brain-tumor patients' PBL could eliminate residual glioma tumor cells. Autochthonous LAK, plus rIL-2 to maintain lytic ability, are injected during surgery. Preclinical studies in a rat glioma model have shown this approach to be safe. Eleven glioma patients have been injected intracerebrally with IL-2 and/or LAK with no immediate or long-term (14 months follow-up) adverse effects. Much work is needed to understand the LAK phenomenon and to resolve its potential usefulness in cancer therapy as well as its inherent biologic role. PMID- 3539199 TI - T-cell responses at the host: tumour interface. AB - The evidence considered here reinforces the conclusion that T-cell responses to tumours involve complex cellular interactions. An attempt to summarize some of these interactions is shown. This emphasizes that not only are the interactions between the effector cell populations complicated, but that the target cell surface is also subject to variation and modification as a result of the immune response. A feature that also emerges from these studies is that most cells apparently responding to or infiltrating a tumour do not necessarily participate in its destruction, and it is in this area that experimental tumour systems have particular value. This also perhaps explains the preoccupation of experimentalists with the identification of 'the' effector cell crucial to tumour rejection. However, there is heterogeneity between systems in terms of the type of rejection response induced, but a logical basis for this heterogeneity is not established. If experimental studies could define the nature of the immune response generated by a tumour in the context of the biological features of the tumour itself, this could lead to the prediction of the immunogenicity and potential for induction of a rejection response for that tumor. Clearly, experimental tumour systems do not provide an exact reflection of the situation with human tumours. However, they may provide systems that illuminate particular aspects of the human response, and give precedents to guide the interpretation of data derived from human systems. This form of assessment is still at an early stage, but developments in the experimental field should provide a framework for the development and exploitation of T-cell responses to tumours. PMID- 3539200 TI - Tumour inhibition by interleukin-2 at the tumour/host interface. AB - Until recently, lymphokines were regarded suspiciously as 'ill-defined factors'. Today, however, some of them have been clearly defined in both structural and functional terms. The interleukin-2 (IL-2) molecule and its specific membrane receptors have been the subject of particular attention. Endogenous IL-2 has proved to be an important signal for the activation and expansion of various cell mediated immunity functions, while exogenous IL-2 has been used to activate numerous cell functions, both in vitro and in vivo, as well as in tumour immunotherapy, both alone or combined with lymphocytes previously activated in vitro (lymphokine-activated killer cells). Adoptive transfer of these cells together with high doses of IL-2 is particularly promising from the clinical standpoint, though by no means free from problems. IL-2 can also be employed in small doses locally in the presence of non-activated lymphocytes from tumour bearing mice to induce a local reaction that subsequently becomes systemic and can lead to the rejection of incipient tumours. Various host immune cells, primarily eosinophils and lymphocytes are involved in this reaction, which can also give rise to tumour-specific immune memory. In this way, the host immune system, despite its inevitable defeat in the first battle against a tumour, may acquire an important role in the long war that lies ahead. PMID- 3539201 TI - Human granulocyte-macrophage colony-stimulating factor purified from a Hodgkin's tumor cell line. AB - Human granulocyte-macrophage colony-stimulating factor (GM-CSF) was purified from 3 liters of serum-free conditioned medium of the Hodgkin's tumor cell line L428 KSA. The conditioned medium contained a high specific activity of 2.5 X 10(5) units of total colony-stimulating factor per mg protein. Colony-stimulating factor activity was determined by colony formation by human fetal liver cells or mouse bone marrow cells. The latter bioassay discriminated colony-stimulating factor 1, a subclass specific for monocyte/macrophage production, and G-CSF, specific for granulopoiesis, from GM-CSF. The starting material contained predominantly GM-CSF with CSF-1 and G-CSF constituting 10% and 12%, respectively, of the total activity. A seven-stage purification scheme was employed. The first stage involved concentration by batch chromatography on calcium phosphate gel. Subsequent stages involved gel filtration on Ultrogel AcA44, affinity chromatography on concanavalin A-Sepharose, batch chromatography on calcium phosphate gel and high-performance liquid chromatography on C1 reversed-phase (TSK TMS-250), gel permeation and C8 reversed-phase columns. The purified material showed a single disperse band, having an Mr of 30,000, by silver staining on sodium dodecyl sulfate polyacrylamide gel electrophoresis. An amino terminal sequence of 20 amino acids was determined in a gas-phase sequencer with 500 ng of purified material. The sequence was identical to that predicted from the cDNA sequence. It was active on human fetal liver cells with half-maximum colony formation at 1 X 10(-12) M, but was not active on mouse bone narrow cells. PMID- 3539202 TI - N-terminal sequence of human leukocyte glycoprotein Mo1: conservation across species and homology to platelet IIb/IIIa. AB - Mo1 and gp160-gp93 are two surface membrane glycoprotein heterodimers present on granulocytes and monocytes derived from humans and guinea pigs, respectively. We purified both antigens and found that their alpha subunits had identical N termini which were significantly homologous to the alpha subunit of the human adhesion platelet glycoprotein IIb/IIIa. PMID- 3539204 TI - The association reaction of yeast alcohol dehydrogenase with coenzyme is partly diffusion-controlled in solvents of increased viscosity. AB - The steady-state kinetics of the yeast and liver alcohol dehydrogenase catalyzed reduction of aldehydes were examined in solvent mixtures of increased viscosity. This was done to investigate the effects of diffusion control on the fast association of NADH with the enzymes. Both glycerol and sucrose were unsatisfactory as viscosogens, as they inhibited the enzyme, but poly(ethylene glycol)/water mixtures were satisfactory. The 5-fold faster reaction of yeast alcohol dehydrogenase with NADH is partly diffusion controlled, whereas the slower liver alcohol dehydrogenase reaction showed no diffusion effects. These results are consistent with a yeast alcohol dehydrogenase active site that has relatively little steric hindrance to NADH binding. It is estimated that contributions to this association reaction from diffusion control and chemical activation control are equal at a solvent viscosity of 10 cP. Thus, under physiological conditions of increased viscosity the NADH association may be significantly affected by diffusion effects. In order to estimate accurately the maximum diffusion-controlled rate constant from diffusion theory, the diffusion coefficients of NADH were measured in poly(ethylene glycol)/water mixtures and were found to vary inversely as the solvent viscosity raised to the power of 0.5. The non-Stokesian behaviour of molecules as large as NADH in polymer/water mixtures may be a serious limitation to the routine use of poly(ethylene glycol) as a viscosogen for diffusion studies. PMID- 3539203 TI - Effects of cholesterol and lipoproteins on endocytosis by a monocyte-like cell line. AB - The human monocyte/macrophage-like cell line U937 is a cholesterol auxotroph. Incubation of these cells in the growth medium in which delipidated fetal calf serum has been substituted for fetal calf serum depletes cellular cholesterol and inhibits growth. The cholesterol requirement of these cells for growth can be satisfied by human low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL), but not by high-density lipoprotein (HDL). U937 cells can bind and degrade LDL via a high-affinity site and this recognition is altered by acetylation of LDL. This indicates that these cells express relatively high LDL receptor activity and low levels of the acetyl-LDL receptor. The cells were used to study the role of cholesterol in lectin-mediated and fluid-phase endocytosis. Growth of the cells in the medium containing delipidated fetal calf serum results in impairment of both concanavalin A-mediated endocytosis of horseradish peroxidase and concanavalin A-independent endocytosis of Lucifer Yellow. Supplementation of the medium with cholesterol prevents cellular cholesterol depletion, supports growth and stimulates Lucifer Yellow endocytosis but fails to restore horseradish peroxidase endocytosis. However, if the cells are incubated in the presence of no less than 40 micrograms LDL protein/ml to maintain normal cell cholesterol levels, concanavalin A-mediated endocytosis of horseradish peroxidase is activated. The effect of LDL is specific since neither VLDL nor HDL3 at the same protein concentration activates horseradish peroxidase uptake by the cells. Furthermore, the activation of endocytosis by LDL is not inhibited by the inclusion of heparin or acetylation of the LDL indicating that binding of LDL to the LDL receptor is not required for these effects. The mediation of activation of horseradish peroxidase endocytosis by the lectin is presumed to involve binding of LDL to concanavalin A associated with the cell surface which in turn stimulates horseradish peroxidase binding and uptake by adsorptive endocytosis. The rate of fluid endocytosis and endosome formation seems to depend on cellular cholesterol content presumably because cholesterol is involved in maintaining the appropriate plasma membrane structure and fluidity. PMID- 3539205 TI - Effect of chloroquine on the activity of some lysosomal enzymes involved in ganglioside degradation. AB - Chronic chloroquine treatment of miniature pigs resulted in increased activity of several lysosomal enzymes of the liver and brain. The most affected enzyme was alpha-fucosidase which showed a 3-fold increase in liver (P less than 0.001) and a 2-fold increase in the brain (P less than 0.01). The increased activity of the other lysosomal enzymes was generally slightly more pronounced in the liver, in which beta-hexosaminidase, alpha-mannosidase and acid phosphatase were also significantly (P less than 0.01) increased. In contrast, chloroquine added in vitro reduced the activity of the lysosomal enzymes. Three of these, alpha fucosidase, beta-hexosaminidase and acid phosphatase, were further investigated, and at a drug concentration of 15 mM and optimum pH for each respective enzyme, the activity was reduced to 20-30% of the initial value. Kinetic analyses revealed that this inhibition was non-competitive with regard to beta hexosaminidase but competitive with regard to alpha-fucosidase. These results indicate that there is a multifactorial effect of chloroquine on the lysosomal enzymes, and that the inhibitory effect of alpha-fucosidase and beta hexosaminidase might well explain the ganglioside storage found in liver and brain. PMID- 3539206 TI - Astrocytes synthesize apolipoprotein E and metabolize apolipoprotein E-containing lipoproteins. AB - We have previously demonstrated that astrocytes synthesize and secrete apolipoprotein E in situ. In the present work, primary cultures of rat brain astrocytes were used to study apolipoprotein E synthesis, secretion, and metabolism in vitro. The astrocytes in culture contained immunoreactive apolipoprotein E in the area of the Golgi apparatus. Incubation of the astrocytes with [35S]methionine resulted in the secretion of labeled immunoprecipitable apolipoprotein E, which constituted 1-3% of the total secreted proteins. The apolipoprotein E secreted in culture and the apolipoprotein E in rat brain extracts differed from serum apolipoprotein E in two respects: both had a slightly higher apparent molecular weight (approx. 36,000) and more acidic isoforms than serum apolipoprotein E. Sialylation of the newly secreted apolipoprotein accounted for the difference in both the apparent molecular weight and isoelectric focusing pattern of newly secreted apolipoprotein E and plasma apolipoprotein E. The astrocytes possessed apolipoprotein B,E(LDL) receptors capable of binding and internalizing apolipoprotein E-containing lipoproteins. The uptake of lipoproteins by the cells led to a reduction in the number of cell surface receptors and to the intracellular accumulation of cholesteryl esters. Since apolipoprotein E is present within the brain, and since brain cells can express apolipoprotein B,E(LDL) receptors, apolipoprotein E-containing lipoproteins may function to redistribute lipid and regulate cholesterol homeostasis within the brain. PMID- 3539207 TI - Role of alpha-glucosidase in fetal lung maturation. AB - The role of lysosomal enzyme acid alpha-glucosidase in fetal lung development was investigated with the aid of a specific inhibitor, the pseudosaccharide acarbose. The drug was added to a Waymouth culture medium of fetal rat lung explants cultivated for 48 h from gestational stage 19.5 days, an in vitro system previously shown to allow morphological and biochemical maturation of alveolar epithelium. Glycogenolysis was reduced by 40% as compared with tissue cultivated on control medium, which means that alpha-glucosidase could account for as much as 40% of fetal lung glycogenolysis, the remaining 60% being presumably achieved by cytosolic phosphorylase and by a microsomal neutral alpha-glucosidase. By the same time, the increase of phospholipids of surfactant fraction extracted from cultivated explants was partially inhibited: total and saturated phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol and phosphatidylinositol were about 30-40% lower than in lungs cultivated on control medium. It should be emphasized that DNA concentration and increases in non surfactant phospholipids were unchanged by the drug. alpha-Glucosidase activity was evidenced in the lysosomal fraction, in the microsomal fraction and, although in lower amounts, in the surfactant fraction extracted from term fetal lung. The results suggest that lysosomal alpha-glucosidase plays a major role in lung maturation and could facilitate glycogenolysis for the specific use of glycogen stores in providing substrates for surfactant phospholipid biosynthesis. PMID- 3539208 TI - Receptor-mediated degradation of insulin in isolated rat adipocytes. Formation of a degradation product slightly smaller than insulin. AB - More than 90% of the radioactivity associated with isolated rat adipocytes incubated with [TyrA14-125I]monoiodoinsulin represented at steady state iodoinsulin possessing full binding affinity. In contrast, about half of the radioactivity dissociating from the cells was [125I]monoiodotyrosine. The other half was of a molecular size similar to that of iodoinsulin as judged from gel filtration chromatography. However, the descending limb of the 'insulin' peak (i.e., the smaller molecules) possessed a reduced binding activity compared with native iodoinsulin, material from the ascending limb, or a similar fraction isolated from dissociation medium from IM-9 lymphocytes, a cell type devoid of receptor-mediated insulin degradation. The cells, thus, release an intermediary degradation product. PMID- 3539209 TI - Naloxone but not CCK-8 may attenuate binge-eating behavior in patients with the bulimia syndrome. AB - We undertook a study to see if putative anorectic agents could attenuate binge eating episodes in bulimic patients. Bolus intravenous administration, followed by continuous intravenous infusion of naloxone, resulted in a significant decrease in the amount of food consumed during binge-eating episodes, whereas bolus followed by continuous intravenous infusion of CCK-8 failed to significantly suppress binge eating behavior. These results suggest that the endogenous opioid system is involved in the maintenance of binge eating behavior in patients with bulimia. PMID- 3539210 TI - Captopril treatment of depression. PMID- 3539211 TI - Hormonal probes of central serotonergic activity: do they really exist? AB - The response of a hormone allegedly under 5-hydroxytryptaminergic (5-HT-ergic) control to a compound stimulating or inhibiting serotonergic activity has been used as a measure of the functional state of central serotonergic systems. The relevant literature is reviewed, and based on that, it is concluded that, as yet, no reliable hormonal 5-HT probe exists. The main problems are nonselectivity of the challengers and noncomparability of individual studies because of variations in dose and route of administration. An acceptable hormonal 5-HT probe should at least have passed the following three tests. The influence of the challenger on catecholaminergic (CA) systems must be rendered unlikely in humans to avoid the pitfalls of, say, the 5-HT precursors whose CA-ergic influences have been overlooked. Dose-response relationships must be established to avoid the confusion caused by different investigators using the challenger in different doses. It must be demonstrated that the effect of the challenger is counteracted by its functional opponent. PMID- 3539212 TI - Evidence for dopaminergic regulation of prolactin and a luteotropic complex in the ferret. AB - The role of dopaminergic agents in prolactin (Prl) release and the luteotrophic role of Prl and luteinizing hormone (LH) were investigated in pseudopregnant female ferrets. A single injection of the dopamine antagonist pimozide (0.63 mg/kg) resulted in a tenfold elevation of plasma Prl in anestrous females. Subcutaneous injection of pimozide on alternate days from Day 2 through Day 16 of pseudopregnancy elevated both Prl and progesterone levels. Daily treatment with the dopamine agonist 2 alpha-bromoergocryptine (bromocriptine, 4 mg/kg), from Day 2 through Day 16 of pseudopregnancy lowered levels of both plasma Prl and progesterone. Neither pimozide nor bromocriptine had a direct effect on progesterone secretion by luteal cells in vitro. Daily intraperitoneal administration of a monoclonal antibody against gonadotropin-releasing hormone from Day 2 through Day 10 of pseudopregnancy lowered both plasma LH and progesterone, but had no effect on plasma Prl concentrations. Daily administration of equine antisera against bovine LH or 100 IU of human chorionic gonadotrophin to pseudopregnant ferrets lowered progesterone levels. It is concluded that Prl release is influenced by dopaminergic compounds, and both Prl and LH are required for luteal maintenance in the ferret. PMID- 3539213 TI - Puberty delay of bank vole females in a high-density population. AB - The onset of puberty in bank vole females was studied, with uterine weight, ovarian weight, and the number of large ovarian follicles used as indicators of gonadal activity. Maturation of females born at the beginning of the reproductive season was suppressed by the presence of other females. Puberty of animals born at the end of season was primarily influenced by climatic variation. PMID- 3539214 TI - Short photoperiod-induced gonadal regression: effects on the gonadotropin releasing hormone (GnRH) neuronal system of the white-footed mouse, Peromyscus leucopus. AB - The peroxidase-antiperoxidase method was used to determine quantitatively the effect of short photoperiod-induced gonadal regression on the immunoreactive gonadotropin-releasing hormone (GnRH) neuronal system of female Peromyscus leucopus. In mice exposed to either long (16L:8D) or short (8L:16D) photoperiod, immunoreactive cell bodies were loosely organized into six groups: olfactory peduncle, diagonal band of Broca, septum, preoptic area (POA), anterior hypothalamus (AH), and basal hypothalamus. The POA and AH contain the largest number of cell bodies, which supply the major GnRH innervation to the median eminence (ME) and several extrahypothalamic brain sites. Exposure to short photoperiod increased the number of immunoreactive cell bodies within the anterior hypothalamus and preoptic area (AHPOA) and also increased the optical density for staining of immunoreactive cell bodies in the AHPOA and olfactory peduncle. The ME of mice exposed to short photoperiod had a higher density of GnRH fibers relative to that of mice exposed to long photoperiod, and the content of GnRH fibers in the rostral ME was correlated with the optical content for immunostaining of cell bodies in the AHPOA. These results are evidence that gonadal regression induced by short photoperiod (mediated by the pineal gland) involves alterations of GnRH neuronal activity. Notably, data from this study are consistent with the hypothesis that suppressed release of GnRH from neurovascular terminals in the ME, rather than lack of availability of the decapeptide, promotes gonadal regression. PMID- 3539215 TI - Tissue reaction to polypropylene and polyester in obese patients. AB - Local tissue reaction was examined after subcutaneous implantation for 8 wk of small pieces of Marlex (polypropylene) and Dacron (polyester) in 11 extremely obese patients. Dacron gave a stronger chronic inflammatory reaction in 7 out of 11 patients, and a stronger foreign body giant cell reaction in all of them: Marlex is therefore perhaps more suitable than Dacron as a reinforcement band in gastric surgery for obesity. At reoperations due to complications after gastric banding the tissue reaction in the omentum which covered the band, was examined in 9 patients. No major difference in tissue reaction in the omentum compared to that in subcutaneous fat was found. None of the reoperations was caused by too strong a tissue reaction to the reinforcement band i.e. Marlex in 8 patients and Gore-tex (Teflon) in one patient. PMID- 3539216 TI - Nutrition and cancer. AB - Although no absolute certainty exists about the role of nutrition in the etiology of cancer, many facts in favor of the relationship became available during the last decades. Correlation studies, experimental work and to a lesser extent case control studies made it possible to clarify the role of certain nutrients and foods in carcinogenesis. The most important cancer sites where nutrition could play a role are esophagus, stomach, colon, rectum, prostate and breast. Esophageal cancer is of a very complex etiology, in which alcohol intake plays an important role, at least in western countries. The cancer-promoting properties of alcohol intake are enhanced by smoking. Three factors from nutrition are probably related to stomach cancer, namely salt, nitrate/nitrite and vitamin C. Salt is caustic to the stomach mucosa, resulting in atrophic gastritis. Salt is also co carcinogenic and stomach cancer-promoting in experimental animals. Nitrate is probably important at the stage of atrophic gastritis, where bacterial overgrowth, due to the high pH, converts nitrates in nitrites, making the loco synthesis possible of potent nitrosocarcinogens. Vitamin C inhibits the latter step. The epidemiological evidence for the role of those factors is provided. The most important among them is the strong and consistent association of stomach cancer mortality with stroke. Rectum, colon, prostate and breast cancer are related in some way to fat intake. They all seem positively related to saturated fat intake, whereas breast cancer is probably also promoted by polyunsaturated fat intake. However, polyunsaturated fat seems to be without effect on rectum cancer. Colon and prostate cancer are probably also influenced by polyunsaturated fat but to a lesser degree than breast cancer. An important argument for this are the positive ecological correlations between changes in rectum, colon and breast cancer mortality from 1968 on, and changes occurring in coronary heart diseases, stroke and diabetes mortality. Those six types of mortality are decreasing, or only slightly increasing in the USA, Belgium, France, the Netherlands, etc. They are strongly increasing in East European countries. The intake of saturated fat has generally decreased in the first group of countries, and has markedly increased in the second group.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539217 TI - Oncogenes. AB - Oncogenes or genes involved in malignant development are presented. Detection procedures, gene activation, action mechanisms, and problems involving gene molecular function as well as precise role of oncogenes are discussed. PMID- 3539218 TI - Cyclosporin neurotoxicity in patients treated with allogeneic bone marrow transplantation. AB - Toxicity to the central nervous system was observed in 3 out of 15 patients receiving cyclosporin prophylaxis for graft-versus-host-disease after allogeneic bone marrow transplantation. Neurological clinical features included grand mal seizures, dysarthria and vestibular and cochlear toxicity. In all three patients, cyclosporin plasma levels were increased at the time of overt clinical neurological signs. The symptoms resolved quickly with the reduction of the cyclosporin dose. PMID- 3539219 TI - [Argument for the multidisciplinary treatment of Ewing sarcoma with surgery]. AB - The authors summarize the literature on the local treatment of Ewing's sarcoma. They remind us that including surgery in local treatment increases disease free survival rate by 20-25% while it reduces functional sequelae and radioinduced sarcoma risk. They underline the major interest of histologic examination of in bloc resected tumor to guide postoperative chemotherapy. They advocate that local treatment of Ewing's sarcoma should always be surgical and conservative with the help when necessary of massive homograft and lengthening prosthesis. PMID- 3539220 TI - [Digital angiography of bone sarcoma in the child]. AB - The authors analyze the results of 50 computed angiographies made for osteosarcoma and Ewing's sarcoma. Better tolerated than conventional angiography computed angiography is also more sensitive in preoperative evaluation of effectiveness of neoadjuvant chemotherapy. Automatic subtraction, direct measuring of tumor size and vascularization density give to angiographic changes after chemotherapy the most predictive value. After conservative surgery or radiotherapy digital angiography provides most reliable local follow up. PMID- 3539221 TI - [Comparative study of the results of the detection of bacteriuria using the AUTOBAC apparatus and the classical method]. AB - The comparative study of the results of detection of bacteriuria in 214 samples did not show an evidence of major discrepancies between the classical reference technique on solid media and the AUTOBAC technique on liquid media. The AUTOBAC provides a reliable and rapid test for bacteriuria which saves time and material for the laboratory. Although it has raised considerable interest, it should be used with caution in aplasic or immunodeficient patients in whom the classical criteria of urinary infection cannot be rigourously applied. PMID- 3539222 TI - An analysis of haemopoietic and microenvironmental populations of mouse bone marrow after treatment with busulphan. AB - The effects of the cytotoxin busulphan (myleran) have been investigated in order to ascertain the unique nature of the lesion which it induces. It is one of only few compounds which can cause marked residual marrow dysfunction and the only drug reported to induce a marrow lesion of such magnitude that after a prolonged interval mice may die of the effects of pancytopaenia resulting from hypoplastic marrow failure. We have found that busulphan has a major microenvironmental effect as assessed by the ability of the marrow to form a complete organ in an ectopic site, which confirms existing evidence from a range of putative stromal assays. The effects upon CFU-S are known to include a selective action against certain subpopulations. Our investigation of the dose relationship of busulphan effects have shown that induction of the prolonged marrow lesion is not dependent on the dose of drug administered, or the fractionation regime employed, and is not dependent therefore on the number of CFU-S removed by the drug. The unique action of busulphan probably rests therefore in its ability to damage the microenvironment and the most primitive stem cells which are closely associated with it, if not entirely dependent on it, for their existence. PMID- 3539223 TI - Subunit assembly of hemoglobin: an important determinant of hematologic phenotype. AB - Hemoglobin's physiologic properties depend on the orderly assembly of its subunits in erythropoietic cells. The biosynthesis of alpha- and beta-globin polypeptide chains is normally balanced. Heme rapidly binds to the globin subunit, either during translation or shortly thereafter. The formation of the alpha beta-dimer is facilitated by electrostatic attraction of a positively charged alpha-subunit to a negatively charged beta-subunit. The alpha beta-dimer dissociates extremely slowly. The difference between the rate of dissociation of alpha beta- and alpha gamma-dimers with increasing pH explains the well-known alkaline resistance of Hb F. Two dimers combine to form the functioning alpha 2 beta 2-tetramer. This model of hemoglobin assembly explains the different levels of positively charged and negatively charged mutant hemoglobins that are encountered in heterozygotes and the effect of alpha-thalassemia and heme deficiency states in modifying the level of the variant hemoglobin as well as Hb A2. Electrostatic interactions also affect the binding of hemoglobin to the cytoplasmic surface of the red cell membrane and may underlie the formation of target cells. Enhanced binding of positively charged variants such as S and C trigger a normally dormant pathway for potassium and water loss. Thus, the positive charge on beta c is responsible for the two major contributors to the pathogenesis of Hb SC disease: increased proportion of Hb S and increased intracellular hemoglobin concentration. It is likely that electrostatic interactions play an important role in the assembly of a number of other multisubunit macromolecules, including membrane receptors, cytoskeletal proteins, and DNA binding proteins. PMID- 3539224 TI - Selective expression of fos proto-oncogene in human acute myelomonocytic and monocytic leukemias: a molecular marker of terminal differentiation. AB - Expression of human fos proto-oncogene (c-fos) was analyzed in primary cells from 50 untreated acute lymphocytic (ALL) and myeloblastic (AML) leukemias. c-fos RNA, analyzed by blot hybridization, was detected virtually only in myelomonocytic (M4) and monocytic (M5) AML. Both M4 and M5 samples show a strong positive correlation between the amount of c-fos transcripts and the percentage of leukemic cells expressing surface antigens specific for mature monocytes and macrophages. Normal mature monocytes exhibit a detectable level of c-fos RNA, which is virtually unaltered on activation to macrophage differentiation, but is always below that observed in M4 through M5 monocyticlike cells. These data provide evidence that c-fos expression is linked to terminal monocyte and macrophage differentiation in normal and leukemic hemopoiesis. PMID- 3539225 TI - Canine pluripotent hematopoietic stem cells and CFU-GM express Ia-like antigens as recognized by two different class II-specific monoclonal antibodies. AB - A previous study showed failure of autologous engraftment in lethally irradiated dogs when marrow was treated before infusion with anti-class II antibody 7.2 and complement. The current study extended this observation to a second monoclonal antibody (HB10a) that identifies a different determinant on Ia-like molecules. These results suggest the presence of Ia-like antigens on pluripotent hematopoietic stem cells or on "accessory cells" needed for sustained engraftment to occur. To distinguish between these two possibilities, stem cell-depleted Ia positive peripheral blood leukocytes obtained by discontinuous albumin density gradient were added as probable source of accessory cells to the marrow inoculum that was depleted of Ia-positive cells by treatment with antibody 7.2 and complement. Eight of ten dogs failed to show engraftment, providing further support for the hypothesis that pluripotent stem cells and not accessory cells were affected by cytolytic treatment. To provide direct evidence for the presence of Ia-like antigens on canine pluripotent hematopoietic stem cells, autologous transplants were performed using 0.7 to 13 X 10(6) Ia (7.2)-positive marrow cells per kg obtained with the help of fluorescence-activated cell sorter. Of three evaluable dogs, two showed sustained and complete engraftment, indicating that Ia like antigens, as recognized by anti-class II antibody 7.2, are expressed at least on part of canine pluripotent hematopoietic stem cells. Concurrent in vitro studies revealed that canine CFU-GM also expressed Ia-like antigens as recognized by the class II-specific monoclonal antibodies 7.2 and HB10a. PMID- 3539226 TI - Polymorphic glycoprotein-1 on mouse platelets: possible role of Pgp-1 and LFA-1 in antibody-dependent platelet cytotoxicity involving complement. AB - The presence of the Pgp-1 glycoprotein on mouse platelets is demonstrated by antibody-binding techniques, by immunoprecipitation, and by transblotting using the monoclonal antibody (MoAb) C71/26 against Pgp-1. C71/26 immunoprecipitates as a broad band of mol wt 87,000 to 100,000 as determined by radioiodination of the platelet cell surface and by the 3H-sodium borohydride labeling technique. Immunoblotting showed Pgp-1 expression on platelets to be quantitatively similar to its presence on macrophages and resolved platelet Pgp-1 into two bands of mol wt 87,000 and 97,000 whereas Pgp-1 on parasite-elicited peritoneal macrophages showed 82,000 and 87,000 mol wt species. Platelets and monocyte/macrophage cells from either peripheral blood or from the peritoneal cavity showed homogeneous binding of Pgp-1 antibody to greater than 97% of cells by flow cytometry. In contrast, lymphocytes from peripheral blood or from the spleen showed a heterogeneous binding pattern with 20% to 30% of cells being negative, and the majority weakly positive. In functional studies, MoAbs against CR1 and CR3 substantially inhibited platelet immune adherence, whereas C71/26 showed only marginal inhibitor. In contrast, C71/26 and other MoAbs against Pgp-1 inhibited platelet-dependent cytotoxicity of antibody-coated sheep erythrocytes in the presence of C5-deficient mouse plasma whereas M1/70 against CR3 showed no effect. In this assay, MoAbs against the alpha- and beta-subunits of leukocyte functional molecule LFA-1 also inhibited platelet cytotoxicity. These results show that the platelet cell surface moieties Pgp-1 and LFA-1 are involved in or closely associated with antibody-dependent cellular cytotoxicity by platelets. PMID- 3539227 TI - Heterogeneous distribution of transferrin receptors on parenchymal and nonparenchymal liver cells: biochemical and morphological evidence. AB - To investigate which cells of the liver express the receptor for transferrin, isolated rat liver cells produced by collagenase perfusion were fractionated by repeated differential centrifugation to produce hepatocytes (95% + 1%, mean +/- SD, n = 4) and nonparenchymal cells (97% + 1%, n = 3). Saturable, high-affinity binding of 125I-transferrin was demonstrated on intact cells at 4 degrees C, with average receptor numbers 20,900 +/- 3,160 (mean + SD, n = 4) for hepatocytes and 5,500 + 1,520 (n = 3) for nonparenchymal cells. Total cellular receptors measured in detergent permeabilized hepatocytes were 42,000 +/- 18,330 (mean +/- SD, n = 3) per cell and 14,760 +/- 7,120 (n = 3) per cell in the nonparenchymal fraction. Immunocytochemical demonstration of transferrin using antitransferrin, peroxidase antiperoxidase complex confirmed that both cell types bound transferrin. There was heterogeneity of the staining reaction since there was no detectable staining on 40% of hepatocytes and 60% of nonparenchymal cells. Microdensitometric analysis of the staining product corroborated the biochemical evidence that hepatocytes have, on average, more than three times more transferrin receptors than do nonparenchymal cells. These findings support the concept that the hepatocyte has a central role in the uptake and storage of transferrin iron. PMID- 3539228 TI - Topology and order of formation of interchain disulfide bonds in von Willebrand factor. AB - Interchain disulfide bonds between the subunits in von Willebrand factor (vWf) dimers and in vWf multimers have been studied using some unique features of the cultured human umbilical vein endothelial cell system. Ammonium chloride inhibition of multimerization of vWf allowed selective examination of vWf dimeric molecules, and monoclonal antibody against the vWf propolypeptide was used to separate pro-vWf dimers from mature dimers. After cleavage of dimers and multimers with Staphylococcus aureus V-8 protease, the location of interchain disulfide bonds in amino (N)-terminal or carboxyl (C)-terminal fragments was determined by gel electrophoresis under reduced and nonreduced conditions. The first interchain disulfide bonds formed during dimerization are in the C-terminal region of the subunits, whereas interdimer disulfide bonds are located in the N terminal portion. These data confirm recent electron microscopic projections of disulfide bond locations and provide support to the hypothetical role of the propolypeptide in the multimerization process. PMID- 3539229 TI - Proliferative and differentiative responses of B cells from human marrow graft recipients to T cell-derived factors. AB - Upon activation, B cells express growth and differentiation receptors that permit them to proliferate and differentiate. The aim of this study is to define the nature of the intrinsic B cell defects found in marrow recipients using assays for B cell activation, proliferation, and differentiation. B cells from five short-term (less than three months postgrafting) and 15 long-term (greater than one year postgrafting) marrow recipients (ten with and five without chronic graft v -host disease [GVHD]) were studied. T cell supernatants (T-sup) were prepared by stimulating normal T cells with 12-0-tetradecanoyl-phorbol-13-acetate (TPA) and phytohemagglutinin. Highly purified B cells were used to assess B cell proliferation responses to T-sup after Staphylococcus aureus Cowan I (SAC) activation and for B cell immunoglobulin production responses to T-sup stimulation after SAC activation. B cells from all five short-term patients and one long-term patient with chronic GVHD did not respond to any stimulation. B cells from two patients with chronic GVHD responded to SAC but had decreased proliferative and differentiative responses to T-sup. B cells from three of seven patients with chronic GVHD and two of five long-term healthy patients could proliferate but could not secrete immunoglobulin in response to SAC plus T-sup stimulation. Furthermore, there was a significant correlation between serum IgG and/or IgM in marrow recipients and the differentiative responses of their B cells to T-sup (P = 0.0075, Fisher's Exact). B cell defects occur at various stages of maturation postgrafting. These defects include the failure to respond to the SAC activation signal, the failure to proliferate in response to T-sup, and the failure to differentiate in response to T-sup. These findings are probably due to the inability of B cells from certain marrow recipients to undergo a second round of ontogeny. PMID- 3539230 TI - A monoclonal antibody to the membrane glycoprotein complex CD18 inhibits polymorphonuclear leukocyte accumulation and plasma leakage in vivo. AB - Previous in vitro findings suggest a critical role for the polymorphonuclear leukocyte (PMN) membrane glycoprotein complex CD18 in PMN adherence and chemotaxis. We examined the effect of the murine monoclonal antibody (MoAb) 60.3, recognizing CD18, on induced PMN accumulation in vivo. Rabbits were pretreated with MoAb 60.3, and the chemotactic factors fMLP, leukotriene (LT)B4, and C5a, as well as histamine, were injected intradermally; 4 hours later, plasma leakage (125I-albumin) and the PMN accumulation (myeloperoxidase) were determined. Both PMN accumulation and PMN-dependent plasma leakage were abolished in the inflammatory skin lesions of rabbits pretreated with MoAb 60.3 as compared with control animals, whereas histamine-induced PMN-independent plasma leakage was unaffected. Intravital microscopy of the rabbit tenuissimus muscle revealed that MoAb 60.3 inhibited both PMN adherence in the venules and migration into the tissue following application of LTB4 and zymosan-activated serum (ZAS). Rolling of PMNs along the venular endothelium was unaffected. Thus, these experiments confirm and extend earlier in vitro findings of the critical role of the membrane glycoprotein complex, CD18, in PMN adherence and chemotaxis. PMID- 3539232 TI - A symposium in honor of Marcel Bessis. PMID- 3539231 TI - Treatment of preleukemic syndromes with marrow transplantation. AB - Thirty patients with advanced preleukemic syndromes were treated with marrow transplantation. Most cases were diagnosed by the presence of peripheral pancytopenia and a diagnostic marrow examination but in 6 of the 30 patients pretransplant chromosome studies were instrumental in establishing the diagnosis. Three patients prepared for transplantation with cyclophosphamide alone recurred with their disease within 6 months of transplantation. The other 27 patients were treated with cyclophosphamide and total body irradiation. Twenty of these 27 patients had preleukemia not associated with prior therapy or severe marrow fibrosis. Thirteen of these 20 are alive and well 9 to 56 months from transplant and 7 died, 4 of interstitial pneumonia, 2 of candida septicemia, and 1 of disseminated zoster. There have been no disease recurrences in this group. The remaining preleukemic patients, which include 3 patients transplanted for preleukemia secondary to prior therapy and 4 patients transplanted for preleukemia associated with severe marrow fibrosis, have all died. Major problems in these patients included disease recurrence (2 cases) and, in those with severe marrow fibrosis, graft failure (2 cases). These results suggest that for patients with life-threatening pancytopenia due to spontaneous preleukemia without severe marrow fibrosis, marrow transplantation can prolong disease-free survival and may result in cure of the disease. PMID- 3539233 TI - Renewal and release of hemopoietic stem cells: does clonal succession exist? AB - The term "clonal succession" was proposed 20 years ago by Kay to characterize the release of stem cells from their primary pool, followed by the expansion of each cell to a clone and the succession of new clones as the mature cells of each clone are lost because of their finite life span. The authors point out that the events described by Kay as clonal succession are necessary features of hemopoietic proliferation. Clonal succession is equivalent to the universally recognized existence of a self-replicating primary stem cell pool that continuously supplies cells for amplification and maturation to subsequent compartments. The authors object to the term "clonal succession" because it has been used by a number of investigators to characterize specific schemes rather than the general aspects of hemopoietic proliferation, thus leading to confusion. They suggest that the descriptive term, "continuous release of stem cells for differentiation," would be preferable to the use or misuse of "clonal succession." PMID- 3539234 TI - Phagocytic capacity of cytokineplasts from human blood polymorphonuclear leukocytes. AB - Cytokineplasts (CKP) are membrane-bounded anucleate cytoplasmic fragments, induced from polymorphonuclear leukocytes (PMN) by the brief application of heat; derived from the cortical cytoplasm that gathers at the leading front of migrating PMN; and endowed with many of the motile properties of the parent cell. In this study we examine their phagocytic capacity by quantitative methods. CKP ingest Staphylococcus aureus and Serratia marcescens somewhat less avidly than do the corresponding intact PMN, yet rather impressively when one considers how restricted a portion of the parent cell they represent. Under the conditions employed, CKP killed about half as many of the bacteria presented to them as did their parent PMN. Thus, despite a heat-associated loss of demonstrable respiratory burst oxidase activity and a paucity of cytoplasmic granules, the organelle-depleted CKP deals with bacteria in a way that mimics its parent PMN. PMID- 3539235 TI - Developments in red cell rheology at the Institut de Pathologie Cellulaire. AB - The present day rheological approximation, which has been used successfully to quantitate the deformability properties of red cells, is based on the view that the cell has a liquid interior encapsulated by a viscoelastic solid membrane shell. A review of historical developments in this field shows that determination of intrinsic red cell membrane properties has not come from simple mathematical analysis of experiments. On the contrary, considerable insight has been required to bring together physical and biological methods to rationalize the unique deformability characteristics of the red blood cell. Key developments at the Institut de Pathologie Cellulaire (IPC) in the early 1970s played a role in our improved understanding of red cell rheology. In this article, we describe the material concepts of the red cell membrane held before 1970, discuss the seminal developments at Bicetre, and, finally, outline the contemporary view of red cell deformability. PMID- 3539236 TI - Reflections on science, technology, beauty, and human welfare: a tribute to Marcel Bessis. PMID- 3539237 TI - Enzymopenic hereditary methemoglobinemia: a clinical/biochemical classification. AB - Recessively inherited NADH-cytochrome B5 reductase deficiency, when present in the homozygous or doubly heterozygous form, is manifested by two different clinical presentations, depending on the nature and cellular distribution of the mutant enzyme. The observations supporting a clinical and biochemical classification of enzymopenic hereditary methemoglobinemia are summarized. Type I, with deficiency demonstrable only in the erythrocytes, presents as uncomplicated, benign methemoglobinemia. Type II, generalized cytochrome B5 deficiency demonstrable in all of the tissues that have been examined, is accompanied by severe, lethal, progressive neurological disability, in addition to methemoglobinemia. Type III deficiency is limited to hematopoietic cells and resembles Type I clinically. Type IV, also clinically like Type I, is associated with deficiency of the cofactor, cytochrome B5. Except for Type IV, the different types appear to be the result of mutations in paired alleles of a gene on chromosome 22 that affect the catalytic activity or stability of the cytochrome B5 reductase. PMID- 3539239 TI - Physiologic, biochemical, and cytologic aspects of nipple aspirate fluid. PMID- 3539240 TI - Chlorination of 4-hydroxycinnamic acid and its toxic risk as a natural occurring water contaminant. PMID- 3539238 TI - Relationship between ER-ICA and conventional steroid receptor assays in human breast cancer. AB - We applied a new immunocytochemical assay for estrogen receptors (ER-ICA) to 82 human breast tumors. Results were correlated with cytosolic estrogen receptors (ERc) and nuclear ER (ERn) determined on the same sample respectively by the radioligand binding assay and by an ER enzyme immunoassay (ER-EIA). All ER-ICA positive tumors contained more than 10 fmol/mg of protein of ERc and were therefore considered as ERc positive. In contrast, 15.4% of ERc-positive cases were ER-ICA negative. Comparison of ER-ICA results with ERn showed extensive agreement of negativity (92%), whereas 38% of ER-ICA-positive tumors were ER-EIA negative. However, the latter had ERc levels above the positivity threshold. Quantitative features of the immunocytochemical staining such as intensity and percentage of labelled cells, considered separately, did not reflect the amount of ERc or ERn. Cellularity was not significantly correlated with ER-ICA and biochemical results. PMID- 3539242 TI - [List of members of the French Ophthalmologic Society]. PMID- 3539241 TI - [Jules Francois (1907-1984)]. PMID- 3539243 TI - [Trophic ulcers after keratoplasty]. PMID- 3539244 TI - [Respective roles of the endothelium of donor and recipient in the long-term survival of corneal transplants]. PMID- 3539245 TI - [Immunologic reactions in perforating corneal transplants]. PMID- 3539246 TI - [Retrospective study of 242 keratoplasties. Analysis of the results and discussion of prognostic factors]. PMID- 3539247 TI - [Chorio-retinal involvement in a patient with lymphatic filariasis]. PMID- 3539248 TI - [Neuro-chorio-retinal manifestations in Onchocerca volvulus and Loa loa filariasis associated with malaria]. PMID- 3539249 TI - Adolph Meyer: some recollections and impressions. PMID- 3539251 TI - The sharing and computer exercising of human Know-How. PMID- 3539250 TI - Assessing and treating attention deficit disorder in adolescents. The clinical application of a single-case research design. AB - Psychiatric assessment strategies that integrate research findings with daily practice are necessary and clinically useful. This paper uses the example of an attention deficit disordered adolescent to illustrate how double-blind placebo controlled and multi-dose adjustment designs can be successfully implemented in routine clinical practice. These designs are especially valuable in evaluating the therapeutic effect of methylphenidate because of biases that may lead to clinical misuse of this stimulant medication. PMID- 3539252 TI - A note on Roentgen's X-ray absorption measurements in 1895. PMID- 3539253 TI - Liver lesions in histiocytosis X: findings on sonography and computed tomography. PMID- 3539254 TI - Objective measurement by ultrasound to distinguish cyclosporin A toxicity from rejection. AB - Measurement of the cross-sectional area of the transplanted kidney with ultrasound has been used to differentiate between cyclosporin A toxicity and rejection both in the immediate post-transplant period and at the time of conversion from cyclosporin A to azathioprine. Of 40 patients studied 21 have been converted from cyclosporin A to azathioprine. There were 12 rejection episodes in 9 patients in the early post-transplant period, and 7 rejection episodes in 7 patients at the time of conversion from cyclosporin A to azathioprine. All of these episodes were correctly diagnosed by ultrasound. Eight episodes of drug induced toxicity in seven patients were, in all but one case, diagnosed correctly. In only 8 of the 19 rejection episodes was the diagnosis suspected clinically at the time ultrasound detected an increase in cross sectional area. PMID- 3539255 TI - Pre-operative assessment of local invasion in rectal cancer: digital examination, endoluminal sonography or computed tomography? AB - Forty-four patients with primary rectal cancers and six patients with benign rectal lesions were examined pre-operatively digitally, with endorectal sonography (ELU) and also computed tomography (CT). Digital examination of the rectal cancers had an overall accuracy of 68 per cent and predicted invasion beyond the muscularis propria with a sensitivity of 68 per cent, specificity of 83 per cent, positive predictive value of 100 per cent and negative predictive value of 46 per cent. In comparison CT had an accuracy of 82 per cent, sensitivity of 86 per cent, specificity of 62 per cent, positive predictive value of 91 per cent and negative predictive value of 50 per cent. ELU was the most reliable indicator of local invasion in rectal cancer when compared with postoperative histopathology with an accuracy of 91 per cent, sensitivity of 94 per cent, specificity of 87 per cent, positive predictive value of 97 per cent and negative predictive value of 78 per cent. PMID- 3539256 TI - Influence of intraperitoneal drains on subhepatic collections following cholecystectomy: a prospective clinical trial. AB - In this prospective randomized study, the influence of an intraperitoneal drain on the incidence and clinical significance of subhepatic collections occurring in patients after acute or elective cholecystectomy was assessed by ultrasound examination. A total of 112 patients entered the study, of whom 54 received a drain. There was no significant difference between the drainage and the non drainage groups with respect to mean age or sex distribution, the number of patients in whom the gallbladder bed was formally closed (27 versus 21) nor in the number of acute cholecystectomies performed in either group (12 versus 13). Ultrasound detected 10 (18 per cent) collections in the drainage group and only one (1.8 per cent) in the non-drainage group (P less than 0.01, chi 2 test). None of the collections required any further treatment and no morbidity occurred that was directly attributable to the presence of the retained fluid. These results suggest that rather than preventing fluid collections, suction drains may predispose to the development of subhepatic collections after cholecystectomy. PMID- 3539257 TI - Studies on the development, antigenic phenotype and function of human glial cells in tissue culture. AB - Cell type-specific neural markers and indirect immunofluorescence were used to study the antigenic phenotype, development and function of astrocytes and oligodendrocytes in dissociated cell cultures of human fetal optic nerve and cerebral cortex. It was found that (1) two populations of GFAP+ astrocytes could be distinguished in optic nerve cultures using the A2B5 monoclonal antibody; (2) the proportion of A2B5+ astrocytes and of oligodendrocytes which developed in optic nerve cultures was dependent on the tissue culture medium; (3) A2B5+ cells were required for the development of galactocerebroside+ oligodendrocytes and at least some GFAP+A2B5+ astrocytes; (4) astrocytes purified from cerebral cortex were A2B5- and NCAM+; and (5) astrocytes supported the unfasciculated growth of rat CNS neurons. These results demonstrate close similarities between cultured rat and human neural cells. Such observations are likely to be of significance in future studies of the developing human nervous system and of a variety of neurological diseases. PMID- 3539259 TI - Immunocytochemical localization of progesterone receptor in the guinea pig central nervous system. AB - The distribution of neurons containing progesterone receptors in the brain of guinea pigs ovariectomized and primed by estradiol was investigated immunohistochemically using monoclonal antibodies to the progesterone receptor. We found that the picric acid paraformaldehyde perfusion provided satisfactory conditions of fixation for visualizing the progesterone receptor in sections of frozen tissue. Among the different techniques of immunocytochemical detection used, the indirect antibody peroxidase-antiperoxidase method gave the best results. The immunostained neurons were mainly located in two specific regions of the hypothalamus: the preoptic area and the mediobasal hypothalamus. Within the preoptic region, the majority of immunoreactive cells were present in the nucleus preopticus periventricularis particularly at the level of the pars suprachiasmatica. Within the mediobasal hypothalamus, immunostained neurons were found in the nucleus periventricularis, arcuatus, ventromedialis and premamillaris. Differences in the intensity of immunoreactivity appeared from one region to another. A marked cellular heterogeneity was observed: in each neuroanatomical structure, labeled cells alternated with non-labeled cells. The receptor, even in absence of progesterone, was localized in the nucleus. The nucleolus was not stained and only neurons were labeled. There was no progesterone receptor immunoreactivity in other regions of the brain, especially in the amygdala, hippocampus and cortex where biochemical studies have shown the presence of a non-estrogen regulated protein binding the progestin [3H]R 5020. Control experiments with antibody pretreated with purified progesterone receptor or with mouse receptor-unrelated monoclonal antibody did not show fluorescent or immunoreactive cells. PMID- 3539258 TI - Amplification of prostaglandin E2 stimulation of luteinizing hormone-releasing hormone release from median eminence explants: a metal(II)-specific effect of chelated copper. AB - We have previously demonstrated that extracellular copper amplifies prostaglandin (PG) E2 stimulation of the release of luteinizing hormone-releasing hormone (LH RH) from explants of the median eminence area (MEA). Two questions were addressed: what is the active form of copper and the metal(II) specificity for copper action? MEA explants were incubated for 5 min in the presence of CuCl2 (ionic) or copper complexed to histidine (CuHis) at a concentration of 200 microM each and then for 15 min in the presence of 10 microM PGE2. It was found that chelated copper but not ionic amplified PGE2 action, and that the magnitude of PGE2 stimulation of LH-RH release was 3-4-fold in copper-treated than untreated tissue. Moreover, PGE2-stimulated release was directly related to the dose of CuHis. To test the metal specificity, MEA explants were incubated for 5 min with one of the following metal(II) complexes: CuHis, NiHis, FeHis, ZnHis, CdHis, MnHis, or BaHis (200 microM each) and then for 15 min with 10 microM PGE2. Controls were incubated with metal(II) complex or PGE2. Of these complexes, only CuHis and to a lesser extent NiHis stimulated LH-RH release. However, CuHis was the only complex that amplified PGE2 stimulation of LH-RH release. Thus, amplification is specific for copper. The finding that chelated copper but not ionic copper amplifies PGE2 is suggestive that the copper-interactive sites on the LH-RH neurons are not exposed to the extracellular space but that they are either embedded in the plasma membrane, facing the intracellular space, or in the cytoplasm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539260 TI - Corticotropin-releasing factor mRNA is expressed in the inferior olives of rodents and primates. AB - Immunohistochemical studies have suggested that corticotropin-releasing factor (CRF) was a transmitter of the olivocerebellar projection. We used in situ hybridization histochemistry with a 35S-labeled oligodeoxyribonucleotide probe for CRF mRNA to show that inferior olivary neurons of rats, baboons, and humans synthesize CRF. PMID- 3539262 TI - [Computer-assisted topometry of the spinal cord]. PMID- 3539263 TI - [Mutagenicity tests of the local anesthetic, heptacaine, and its alkoxy analogs]. PMID- 3539261 TI - [Improved fixation of cilia of the respiratory epithelium for transmission electron microscopy]. PMID- 3539264 TI - Child abuse and multiple personality disorder: review of the literature and suggestions for treatment. AB - The syndrome of multiple personality is associated with a high incidence of physical and/or sexual abuse in childhood. Occasionally those with multiple personality abuse their own children. Multiple personality is difficult to diagnose both because of the nature of the syndrome and because of professional reluctance. Although multiple personality is most difficult to diagnose during childhood because of the subtlety of the syndrome, the much higher morbidity found in adult cases makes it imperative that it be diagnosed and treated early in order to avoid further abuse and greater morbidity and to shorten treatment time. This review describes the history, clinical features and treatment of multiple personality, particularly in children, in addition to exploring the professional reluctance to make the diagnosis. PMID- 3539266 TI - What the doctor says--T.B. isn't dead (Part 1). PMID- 3539265 TI - Childhood seduction and the spiritualization of psychology: the case of Jung and Rank. PMID- 3539267 TI - [The production of medical imaging examinations: evaluation of available findings]. PMID- 3539268 TI - Some characteristics of ruminants and swine that complicate management of general anesthesia. AB - Successful anesthetic management of food animals depends on knowledge of basic principles and techniques of anesthesia common to most species. When specifically considering food animals, additional emphasis is directed toward animal size, temperament, and anatomy. Respiratory failure induced by a variety of mechanisms is a major complication of special importance in ruminants. Problems relate especially to difficulty of endotracheal intubation, inhalation of saliva and rumen contents, and reduced lung gas volume caused by abdominal organ (especially rumen)-induced cranial diaphragmatic displacement. When evaluating swine for anesthesia, specific additional management considerations include accessibility of peripheral blood vessels, ease of endotracheal intubation, and porcine malignant hyperthermia. PMID- 3539269 TI - Disposition of anesthetic and anesthetic-related agents in ruminants. AB - Many factors may influence the actions and fates of anesthetic and anesthetic related agents in ruminant animals. These considerations need to be taken into account when these drugs are employed clinically. Some of the major principles governing the disposition of CNS-active drugs are reviewed, with special emphasis on the uniqueness of ruminant animals. General pharmacokinetic considerations are also covered as a preamble to a commentary on the kinetic characteristics of anesthetic and anesthetic-related agents that are commonly used in domesticated ruminants. PMID- 3539270 TI - Preanesthetic medications in ruminants and swine. AB - The use of preanesthetic agents alone or in various combinations in food animals is complex. In addition to considering the pharmacokinetics and dynamics of the medications, one must give additional consideration to the animals's temperament, its physical condition, and its environment. Also, the potential of residues from meat and milk products of animals treated with preanesthetic agents must be considered. PMID- 3539271 TI - Injectable anesthetic agents and techniques in ruminants and swine. AB - This article reviews the use of injectable anesthetic agents in cattle, sheep, goats, and swine. Emphasis is placed on short-term general anesthesia. Methods and drugs employed for continuous intravenous infusion are discussed. Capture drugs for fetal animals are briefly reviewed, as is electroimmobilization. PMID- 3539273 TI - Techniques of local analgesia in ruminants and swine. AB - This article explores the use of many popular and recently described techniques of local regional analgesia in ruminants and swine. The emphasis is on proper techniques and the national use of a 2 per cent lidocaine hydrochloride solution, providing excellent intraoperative conditions and a rapid recovery with minimal side effects. PMID- 3539272 TI - Techniques of inhalation anesthesia in ruminants and swine. AB - This article reviews the implementation of inhalation anesthesia in large and small ruminants and swine. A brief discussion of the general considerations for inhalation anesthesia of large animals is followed by a review of the pharmacology of inhalation agents, induction procedures commonly used when anesthetizing ruminants and swine, methods of assessing depth of anesthesia and maintenance of anesthesia, and anesthetic machines and delivery systems appropriate for use in large and small ruminants and swine. PMID- 3539274 TI - Management of intraoperative and postoperative anesthetic complications in ruminants and swine. AB - Complications that can occur during and following anesthesia in ruminants and swine are discussed. Because many of these complications can be life-threatening, they must be avoided to allow provision of safe general anesthesia. Emphasis is placed on prevention and recognition of these complications and the institution of therapy when they do occur. PMID- 3539275 TI - Anesthetic management of ruminants and swine with selected pathophysiologic alterations. AB - Surgical diseases induce pathophysiologic alterations in ruminants and swine that are often of critical importance in the perioperative period. Circulation and ventilation may be severely compromised. Alterations in acid-base balance, fluids, and electrolytes should be anticipated, identified, and corrected. Also discussed is the selection of appropriate anesthetic techniques and supportive therapy based upon the patient's physiologic status and surgical requirements. PMID- 3539276 TI - Capture techniques in feral ruminants. AB - This article deals with some of the methods that can be used to capture feral or escaped ruminants. Some of the more common types of live traps, such as snares, spotlighting, and drive nets, are discussed, as are methods of chemical immobilization. The article concludes with a discussion of the medical problems that can occur during capture. PMID- 3539277 TI - Anesthetic techniques in poultry. AB - Anesthesia may be required in various species of poultry to facilitate surgery, diagnostics, and research. Preanesthetic evaluation, careful anesthetic management, and proper supportive methods should be employed. Injectable regimens may be useful for some procedures, but inhalation methods are more appropriate for long periods of anesthesia. Intubation of the trachea and maintenance of ventilation are of particular importance in avian species. Monitoring and support should continue until recovery is complete. PMID- 3539278 TI - Euthanasia of food animals. AB - Humane euthanasia is considered to be the rapid and painless inducement of death. It is necessary for unconsciousness to occur quickly and be followed immediately by cardiac and/or respiratory arrest. Although many methods of euthanasia have been used, not all fulfill the criteria of humane euthanasia. Methods of euthanasia used in food animals are presented and evaluated as to their appropriateness. PMID- 3539279 TI - The epidemiology and control of swine parasites. Immunity and vaccines. AB - This article discusses the status of two experimental swine helminthic vaccines and how further knowledge of parasite biochemistry and swine immunology and the application of techniques of modern biotechnology may affect their future development. PMID- 3539280 TI - The mercury scare. If a dentist wants to remove your fillings because they contain mercury, watch your wallet. PMID- 3539282 TI - Tax considerations at the time of buying/selling a dental practice. PMID- 3539281 TI - An evaluation of a dental care program for Indian children in the community of Sandy Lake. Sioux Lookout Zone, 1973-1983. PMID- 3539283 TI - Rieger's syndrome. Severe dental anomalies with mild ophthalmic changes--a case report. PMID- 3539284 TI - Light-curing units and protective filters. PMID- 3539286 TI - The role of microcomputers in patient education. PMID- 3539285 TI - The learning characteristics of nursing students and computer assisted instruction. An exploratory study. PMID- 3539287 TI - The effect of insulin-induced hypoglycaemia on the secretion of glucagon and hepatic glucose production in pancreatectomized dogs. AB - The concentration of plasma glucose in insulin deprived pancreatectomized dogs was decreased from the basal 385 +/- 44 to 65 +/- 12 mg/dL by the infusion of 7 mU X kg-1 X min-1 insulin. During the infusion, the plasma concentration of immunoreactive glucagon (IRG) did not change and hepatic glucose production was decreased. This is in contrast to earlier findings in alloxan diabetic dogs in which plasma IRG decreased in hypoglycaemia. The hypothesis is put forward that, in contrast to pancreatic alpha cells in which the effect of insulin prevails, neither insulin nor a decrease in the ambient concentration of glucose exerts any effect on the secretion of glucagon from extrapancreatic alpha cells. PMID- 3539288 TI - Effect of insulin on gluconeogenesis and the metabolism of lactate in sheep. AB - Owing to the fermentative nature of their digestion, ruminant animals are highly dependent upon gluconeogenesis to meet their glucose needs. The role of hormones in regulating this process is not clear. The purpose of this study was to examine the effect of insulin on the utilization of lactate in glucose synthesis in sheep. The euglycemic model was used in sheep. [U-14C]Lactate and [6-3H]glucose were infused to monitor lactate and glucose fluxes. Hepatic metabolism was measured using radioisotopic and venoarterial concentration difference techniques. Insulin concentrations increased from basal concentrations of 16 +/- 2 to 95 +/- 9 microU/mL. Insulin reduced the net hepatic utilization of lactate (303 +/- 43 vs. 120 +/- 27 mumol/min), hepatic extraction efficiency of lactate (29 +/- 4 vs. 9 +/- 2%), hepatic output of glucose (338 +/- 33 vs. 103 +/- 21 mumol/min), and incorporation of lactate into glucose (90 +/- 5 vs. 46 +/- 8 mumol/min). Insulin at physiological levels can inhibit hepatic gluconeogenesis in ruminants. PMID- 3539289 TI - Role of thyroxine and insulin on the development of the fetal mouse duodenum in organ culture. AB - The role of thyroxine and insulin in the regulation of proliferation and differentiation of the immature duodenal epithelium of the fetal mouse was investigated using an organ culture method with a serum-free medium. Thyroxine (10 nM) stimulates specifically the activity of maltase. Insulin (125 mU/mL) remains without effect on the maturation of all hydrolytic functions studied. Each hormone significantly increases the percentages of brush border enzyme activities liberated in the medium and reduces the amount of glucose released in the medium. In the presence of dexamethasone (76 nM) the effect of thyroxine on maltase activity is still observed. Finally, thyroxine and insulin do not modify the labelling index in the duodenal crypts of the explants in the presence or absence of dexamethasone. These findings indicate that thyroxine and insulin can act directly on the development of the fetal mouse duodenum at the end of gestation. Nevertheless, their implication in prenatal development of the gut functions appears to be of minor importance. PMID- 3539290 TI - Effect of heat on endotoxin in plasma and in pyrogen-free water, as measured in the Limulus amoebocyte lysate assay. AB - Four modes of heating endotoxin in plasma and two different times of heating endotoxin in pyrogen-free water were compared. There were no significant differences in standard curves after heating endotoxin in plasma at 100 degrees C for 1 and for 10 min. However, the standard curve after heating for 10 min at 75 degrees C had a significantly less steep slope, and after heating for 10 min at 56 degrees C, it was completely flat. Heating of endotoxin in pyrogen-free water for 1 min also resulted in the flattening of the standard curve, which was even more pronounced after 10 min of heating. PMID- 3539291 TI - Histochemical and biochemical urease localization in the periplasm and outer membrane of two Proteus mirabilis strains. AB - Proteus mirabilis, a gram-negative bacillus, is often implicated in the formation of infectious kidney stones. As ureolytic activity of this organism is thought to play a major role in its pathogenesis, we adapted our recently described urease localization technique to visualize urease activity in vivo. Urease activity was ultrastructurally localized in two clinically isolated P. mirabilis strains by precipitating the enzymatic reaction product (ammonia) with sodium tetraphenylboron. Subsequent silver staining of the cells revealed urease activity to be predominantly associated with the periplasm and outer membranes of each strain. Biochemical measurements of urease activity in P. mirabilis cell fractions correlated well with histochemical observations in that the majority of urease activity was associated with the periplasm. Membrane-bound urease activity of these strains was associated mainly with the peptidoglycan in the detergent insoluble (outer membrane) fraction. PMID- 3539292 TI - Glutathione overproduction by selenite-resistant Escherichia coli. PMID- 3539293 TI - Investigation of the polymorphic region in the 5' flanking region of the insulin gene in patients with Alzheimer's disease. AB - A potential relationship between Alzheimer's Disease (AD) and insulin gene expression was suggested by the observation that patients with AD have altered levels of fasting blood sugar and insulin. Since polymorphisms in the region 5' to the insulin gene have been associated with blood glucose levels, we have studied this polymorphism in AD patients. Subjects were 19 nondiabetic AD patients with symptoms of aphasia and apraxia and a family history of AD; and 20 age and sex-matched nondiabetic controls without family history of AD. The 5' polymorphic region of the insulin gene was analyzed by restriction enzyme digestion of DNA extracted from whole venous blood. We did not observe a correlation between the size of the 5' polymorphic region and AD. PMID- 3539294 TI - Comparison of counts of neurons in the locus coeruleus made from serial sections and from a single section at the centre of the nucleus. AB - This paper describes the comparability of counts in the locus coeruleus made from serial sections and those made from a single section at the point of greatest density of neurons. Samples of the locus coeruleus neuronal population derived from single section counts though not exactly comparable, are of comparable utility to those obtained from more laborious total neuronal counts. The simpler method was used to examine the hypothesis that there are subtypes of senile dementia of the Alzheimer type. Separation into two groups was achieved when independent variables of cortical neuronal counts and tangle estimates were used. This finding adds to the growing evidence that Alzheimer's disease of the senile type is not a unitary disorder. PMID- 3539295 TI - A comparison of five serological tests for bovine brucellosis. AB - Five serological assays: the buffered plate antigen test, the standard tube agglutination test, the complement fixation test, the hemolysis-in-gel test and the indirect enzyme immunoassay were diagnostically evaluated. Test data consisted of results from 1208 cattle in brucellosis-free herds, 1578 cattle in reactor herds of unknown infection status and 174 cattle from which Brucella abortus had been cultured. The complement fixation test had the highest specificity in both nonvaccinated and vaccinated cattle. The indirect enzyme immunoassay, if interpreted at a high threshold, also exhibited a high specificity in both groups of cattle. The hemolysis-in-gel test had a very high specificity when used in nonvaccinated cattle but quite a low specificity among vaccinates. With the exception of the complement fixation test, all tests had high sensitivities if interpreted at the minimum threshold. However, the sensitivities of the standard tube agglutination test and indirect enzyme immunoassay, when interpreted at high thresholds were comparable to that of the complement fixation test. A kappa statistic was used to measure the agreement between the various tests. In general the kappa statistics were quite low, suggesting that the various tests may detect different antibody isotypes. There was however, good agreement between the buffered plate antigen test and standard tube agglutination test (the two agglutination tests evaluated) and between the complement fixation test and the indirect enzyme immunoassay when interpreted at a high threshold. With the exception of the buffered plate antigen test, all tests were evaluated as confirmatory tests by estimating their specificity and sensitivity on screening-test positive samples.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539297 TI - Susceptibility of Escherichia coli from bovine mastitis to new antimicrobial drugs. PMID- 3539296 TI - Acute inflammatory effects of intratracheally instilled Escherichia coli endotoxin and sonicated suspension of Haemophilus pleuropneumoniae in swine. AB - A single bolus of either Escherichia coli endotoxin, sonicated suspension of Haemophilus pleuropneumoniae, or pyrogen-free normal saline was intratracheally instilled in six week old specific-pathogen-free pigs. Pigs exposed to E. coli endotoxin developed fever, leukopenia followed by leukocytosis, and endotoxemia. Leukocytosis was the only clinical abnormality noted in pigs receiving the sonicated suspension of H. pleuropneumoniae. At one day postexposure, focal areas of atelectasis and consolidation were observed in the caudal lung lobes of animals receiving either E. coli endotoxin or the sonicated suspension of H. pleuropneumoniae. Lesions were characterized by a neutrophilic bronchitis and bronchiolitis with alveolitis in the surrounding tissue. Increased numbers of alveolar macrophages and evidence of phagocytosis were observed by light and electron microscopy. No clinical abnormalities or lesions were observed in animals receiving normal saline. Lesions typical of acute porcine Haemophilus pleuropneumonia were not produced by either E. coli endotoxin or sonicated suspension of H. pleuropneumoniae, indicating that multiple virulence factors are probably involved in lesion development. PMID- 3539300 TI - Adenocarcinoma of the pancreas associated with Clonorchis sinensis infection. PMID- 3539298 TI - Current approaches to the treatment of advanced-stage non-Hodgkin's lymphoma. AB - Non-Hodgkin's lymphomas (NHLs) are a diverse group of malignant diseases whose clinical behaviour and treatment are distinct from those of Hodgkin's disease. In advanced-stage NHL certain histologic subtypes grow relatively slowly, initially produce few symptoms and, even when untreated, are associated with survival that is usually measured in years. Other, less favourable subtypes grow more rapidly, produce symptoms earlier and result in rapid clinical deterioration and death if aggressive treatment is not begun at the time of diagnosis. Many patients with advanced-stage higher-grade NHL can now expect cure, whereas those with lower grade NHL cannot. Among the higher-grade lymphomas, factors associated with a poorer prognosis include B symptoms, age greater than 50 years, bulky disease (particularly in the abdomen) and extranodal disease with bone marrow or gastrointestinal involvement. These factors have less effect on prognosis in lower-grade lymphomas. Combination chemotherapy (CT) has been the mainstay of treatment for advanced-stage higher-grade NHL. Newer regimens contain more agents given earlier in the treatment plan. Radiotherapy is a useful supplement to CT in some patients with bulky disease. Most CT regimens have been developed through retrospective uncontrolled studies. Prospective randomized clinical trials must be designed to compare the efficacy of newer, more toxic but seemingly more effective regimens and earlier, less toxic regimens. Such trials should determine which patients may achieve optimal survival results with the least toxic therapy. PMID- 3539299 TI - Adverse immunologic effects of antithyroid drugs. AB - Propylthiouracil and methimazole are frequently used in the management of hyperthyroidism. Two patients in whom adverse immunologic effects other than isolated agranulocytosis developed during treatment with propylthiouracil are described. A review of the literature revealed 53 similar cases over a 35-year period. Rash, fever, arthralgias and granulocytopenia were the most common manifestations. Vasculitis, particularly with cutaneous manifestations, occurs and may be fatal. The clinical evidence suggests that an immunologic mechanism is involved. A number of different autoantibodies were reported, but antinuclear antibodies were infrequent, and none of the cases met the criteria for a diagnosis of systemic lupus erythematosus. Thus, the reactions do not represent a true drug-induced lupus syndrome. Current hypotheses and experimental data regarding the cause of the reactions are reviewed. No specific clinical subgroup at high risk can be identified, and manifestations may occur at any dosage and at any time during therapy. Cross-reactivity between the two antithyroid drugs can be expected. Except for minor symptoms (e.g., mild arthralgias or transient rash), such reactions are an indication for withdrawal of the drug and the use of alternative methods to control the hyperthyroidism. In rare cases of severe vasculitis a short course of high-dose glucocorticoid therapy may be helpful. PMID- 3539301 TI - Aspergillus-related aortic thrombosis. PMID- 3539302 TI - Dr. Charles Godfrey. PMID- 3539303 TI - The melancholy of Dr. Samuel Johnson. PMID- 3539304 TI - Hurthle cell thyroid tumors. An immunohistochemical study. AB - Twenty-three Hurthle cell neoplasms of the thyroid were analyzed immunohistochemically for thyroglobulin, carcinoembryonic antigen (CEA), and for immunoreactivity with a monoclonal antibody to p21 ras oncogene product. Both benign and malignant tumors defined by the presence or absence of invasion and metastasis stained positively for thyroglobulin. Most tumors expressed both CEA and p21 ras oncogene product. Clinicopathologic analysis showed that malignant tumors were larger, occurred in slightly older patients (mean age, 52.8 years), and had an almost equal sex distribution, whereas benign tumors were more common in women and occurred in younger patients (mean age, 44.7 years). These results indicate that both benign and malignant Hurthle cell thyroid tumors produce thyroglobulin and express both CEA and p21 ras oncogene product, whereas adjacent normal thyroid tissues showed weak to absent immunoreactivity for p21 ras oncogene product. Because there are no specific immunohistochemical markers to distinguish between benign and malignant Hurthle cell tumors, one needs to rely on traditional histologic features such as invasion and metastasis to distinguish between benign and malignant Hurthle cell neoplasms. PMID- 3539305 TI - Epithelial profile of epithelioid sarcoma. An immunohistochemical analysis of eight cases. AB - Eight cases of epithelioid sarcoma were examined immunohistochemically, in order to clarify the adjunct epithelial profile of the tumor and to ascertain the intermediate filaments contained in the tumor cells. All tissues showed a strongly positive immunoreactivity for epithelial membrane antigen (EMA) and tissue polypeptide antigen (TPA). In the case of carcinoembryonic antigen (CEA), one showed a strong reaction, whereas the others were variably less stained. Cytokeratins (45 kd and 54 kd) specific for simple epithelia, including coelomic epithelium, were regularly found in all cases; a small number of cells were positive for high molecular weight cytokeratin (57 kd) and none for 66 kd cytokeratin. Coexpression of both cytokeratin and vimentin was confirmed using fresh-frozen materials. Therefore, both microscopic and immunohistochemical evidence supports the hypothesis that epithelioid sarcoma masquerades as a carcinoma. PMID- 3539306 TI - Effect of trimethoprim/sulfamethoxazole prophylaxis on outcome of childhood lymphocytic leukemia. A Pediatric Oncology Group Study. AB - The Pediatric Oncology Group (POG) undertook a prospective randomized trial using a single chemotherapy regimen with or without trimethoprim/sulfamethoxazole (TS). In a previous acute lymphocytic leukemia (ALL) study of initial therapy, investigators were free to use TS prophylaxis or not. Analysis of those data seemed to favor TS for duration of continuous complete remission. In the study reported here, of 126 randomized patients with ALL, 63 received TS. There was no effect of TS on disease-free survival after 3 years follow-up. Overall severe toxicity did not differ. However, granulocytopenia was somewhat more severe in the TS group. Hepatic toxicity, measured by enzyme elevation approached significance in the TS group versus controls. Some institutions declined randomization and treated with or without TS as a routine. Outcome and toxicities did not differ from randomized patients. There was no statistically significant effect on severe, life-threatening or fatal infection between the randomized TS versus control groups. Children not receiving TS developed varicella more often, a disease for which one would not expect TS to show a preventative effect. Pneumocystis pneumonias were not reported. The authors conclude that TS prophylaxis did not increase the continuous complete remission rate in children with ALL or decrease the incidence of infection. Toxicity is somewhat higher on TS. PMID- 3539307 TI - Fatal cardiac toxicity in bone marrow transplant patients receiving cytosine arabinoside, cyclophosphamide, and total body irradiation. AB - Three patients developed fatal cardiac toxicity from the combination of cytosine arabinoside, cyclophosphamide, and total body irradiation while undergoing preparation for a bone marrow transplant. The pattern of the toxicity was unique for this combination of ablative chemotherapy. All three patients had autopsies demonstrating characteristic myocardial and pericardial toxicity. The cardiotoxic effects of this combination may be averted by lowering the dose of the cyclophosphamide. PMID- 3539308 TI - Immunohistochemical detection of antigen in human primary and metastatic melanomas by the monoclonal antibody 140.240 and its possible prognostic significance. AB - An indirect immunofluorescence technique was used to study the tissue distribution of the epitope recognized by the monoclonal antibody 140.240 which identifies a p97-like melanoma-associated oncofetal antigen. Cryostat sections of various normal and neoplastic human tissues were examined. The presence of antigenic activity was demonstrated in 20 of 39 (51%) primary skin melanomas, in 21 of 52 (40%) metastatic melanomas, and in 20 of 44 (45%) nevi. The reactive nevi were restricted to intradermal, junctional, compound and spindle cell types. Of the 110 samples of 12 major tumor types other than melanoma tested, only 1 of 6 epidermoid tumors, 1 of 4 benign breast tumors and 1 of 5 prostatic tumors gave weak staining. This antibody also reacted with sweat glands and fetal small intestine tissue, but not with other adult or fetal normal tissues. Intrapatient as well as interpatient heterogeneity in the epitope expression was present in primary as well as metastatic tumor lesions surgically removed from patients with melanoma. Evaluation of the immunohistologic data and the clinical outcome of patients with melanoma reveals that the expression of the epitope recognized by this antibody is associated with a more favorable prognosis. PMID- 3539309 TI - Muramidase, alpha-1 antitrypsin, alpha-1 antichymotrypsin, and S-100 protein immunoreactivity in giant cell lesions. AB - A spectrum of giant cell lesions was evaluated for muramidase, alpha-1 antitrypsin, alpha-1 antichymotrypsin, and S-100 protein immunoreactivity using an avidin-biotin-complex immunoperoxidase method. Peripheral giant cell granuloma, central giant cell granuloma, giant cell tumor, osteitis fibrosa cystica, cherubism, and giant cell tumor of tendon sheath showed similar patterns of reactivity. Granulomatous inflammatory lesions stained more intensely for muramidase than did noninflammatory lesions. Alpha-1-antichymotrypsin was a slightly better marker of giant cell lesions than was alpha-1-antitrypsin. Positive S-100 protein staining in half the lesions was thought to be due to the presence of Langerhans cells. The results supported the belief that giant cell lesions of bone and tendon sheath are differentiated toward cells of the mononuclear-phagocyte system and that multinucleated giant cells are derived from macrophages. PMID- 3539310 TI - Maturation of cerebellar neuroblastoma into ganglioneuroma with melanosis. A histologic, immunocytochemical, and ultrastructural study. AB - A ganglioneuroma with areas of melanosis was resected from the cerebellum of a 6.5-year-old girl. At 2.5 years of age, she was diagnosed to have cerebellar neuroblastoma, which was incompletely resected and then radiated. Histologic, ultrastructural, and immunocytochemical studies undertaken on tissue from both stages of the tumor demonstrated a neuroblastic origin and differentiation into a predominantly neuronal tumor with limited astroglial participation. In addition, widespread deposition of basal lamina material, perineuronal distribution of S 100 protein-bearing cells and melanosis were found. The various features and unusual biology of the tumor are discussed in the light of a review of the literature. PMID- 3539311 TI - Development of MoAb HMSA-2 for melanosomes of human melanoma and its application to immunohistopathologic diagnosis of neoplastic melanocytes. AB - To characterize the biologic and molecular nature of melanosomal proteins, we recently developed two mouse monoclonal antibodies (MoAbs), human melanosome associated antigen (HMSA)-1 and HMSA-2, for melanosomes isolated from human malignant melanoma. This study describes the methods of development for MoAb HMSA 2 and the specificity and distribution of antigen(s) reactive with it in normal and pathological tissues. Characteristically, MoAb HMSA-2 was found to detect neoplastic melanocytes on formalin-fixed and paraffin-processed specimens. The reaction patterns for benign and malignant melanocytic tumors were different, i.e., homogeneous reactivity in the dermal cells of common melanocytic nevi but heterogeneous reactivity in the same type of cells in malignant melanoma. MoAb HMSA-2 reacted positively with the epidermal melanocytes in the lesions of dysplastic melanocytic nevi, but not with those of common melanocytic nevi. Reaction products with MoAb HMSA-2 were localized in the cytoplasm. MoAb HMSA-2 did not react with normal melanocytes even on frozen sections. Benign and malignant epithelial and soft tissue tumors of the skin were usually negatively stained with MoAb HMSA-2. Findings indicate that MoAb HMSA-2 is a unique MoAb which identifies neoplastic melanocytes and which can be useful in differentiating each type of melanocytic tumor. PMID- 3539312 TI - Immunohistochemical study of thyroglobulin in thyroid carcinomas with monoclonal antibodies. AB - The effectiveness of an immunoperoxidase technique using four monoclonal antibodies (mAb) is compared to a technique using one polyclonal antibody (pAb) to detect human thyroglobulin (Tg) in paraffin sections of 55 thyroid carcinomas. With the pAb, a positive reaction was found in 82% of the cases. With the four mAb, the presence of Tg was demonstrated in 96.5% of the cases. The mAb gave better results than the pAb on poorly differentiated and anaplastic thyroid carcinomas. Many of the thyroid carcinomas in this study, especially the poorly differentiated and anaplastic type, failed to react with all four mAb to Tg. These results confirm the notion of the heterogeneity of Tg in thyroid carcinomas and indicate that a battery of carefully selected mAb can be successfully used for routine histopathologic detection of Tg in these tumors. PMID- 3539313 TI - Langerhans cells and prognosis in patients with gastric carcinoma. AB - Infiltration of Langerhans cells (LC) and macrophages into tumor tissues was investigated using immunohistochemical methods, anti-S-100 protein and anti lysozyme antibodies in 174 cases of gastric carcinoma. Varying population densities of S-100-positive LC were noted in tumor tissues; lysozyme-positive macrophages, however, were found in almost equal quantities. LC were mainly interspersed among the tumor cells, whereas macrophages were present in the stroma and around the necrotic foci. Although the survival time of patients with Stage I, II or IV gastric carcinoma did not relate to the density of LC, survival time in Stage III patients correlated well with the density of LC. In patients with a marked infiltration of LC, survival time was longer than in cases of only a slight infiltration (P less than 0.001). Therefore, LC in immunological defense mechanisms of the host against the tumor may be clinically effective in a certain phase of tumor development. PMID- 3539314 TI - Squamous cell carcinoma of head and neck in patients with well-differentiated lymphocytic lymphoma. AB - Seventy-six cases of well-differentiated lymphocytic lymphoma (WDLL) were reviewed for evidence of additional malignancies. Of these, 18 patients (24%) had one to three further tumors; one half (nine) had squamous cell carcinoma (SCC). The head and neck area was the primary site in all but one case of SCC. The carcinomas were frequently multiple, recurrent, and clinically aggressive. The tumors showed unusually poor differentiation histologically. Actinic keratosis and basal cell carcinomas were frequently associated with SCC. Fifty percent metastasized to cervical lymph nodes replaced by WDLL. Lymphadenopathy due to metastatic SCC may be mistaken for malignant lymphoma alone. In two of five patients (40%), death was directly attributable to SCC. As in renal transplant recipients, SCC of the head and neck in WDLL patients is a common cause of significant complications and mortality requiring aggressive management. Immunosuppression due to WDLL and/or to chemotherapy is likely an important predisposing factor in combination with sun exposure. PMID- 3539316 TI - [A look at beliefs that make sense out of life (Carl Gustav Jung). Interview by Gertrude Pelletier]. PMID- 3539315 TI - The relationship of lactoferrin to the anemia of renal cell carcinoma. AB - This study was designed to examine whether lactoferrin, a glycoprotein contained in neutrophils which binds free iron, mediates the anemia associated with renal cell carcinoma. Preoperative hematocrit, urinalysis, serum iron, total iron binding capacity, and ferritin levels were obtained in 24 patients with hypernephroma. At the time of radical nephrectomy, a tumor specimen was obtained from all 24 patients and corresponding normal renal tissue was obtained from eight patients. Fifteen patients had low serum iron, whereas nine patients had normal serum iron. All tissue samples were snap frozen at the time of surgery and were subsequently sectioned into 3-microns slices using the cryostat. Then all the sectioned specimens were stained with FITC (fluorescein isothiocyanate) and peroxidase conjugated rabbit derived anti-human lactoferrin. Ten of the 15 patients with low serum iron had positive anti-lactoferrin staining in both the FITC and peroxidase systems. None of the tumors from patients with normal serum iron and none of the normal renal parenchyma exhibited positive anti-lactoferrin uptake. Stains for iron in the bone marrow of two patients with low serum iron showed increased iron stores. These studies suggest that lactoferrin mediates the anemia often seen in association with renal cell carcinoma. PMID- 3539318 TI - Human tissues and cells in carcinogenesis research. PMID- 3539317 TI - Monosomy 21, partial duplication of chromosome 11, and structural abnormality of chromosome 1q21 in a case of lymphoma developing in a transplant recipient: characteristic abnormalities of secondary lymphoma? AB - Cytogenetic analysis by QFQ-banding of direct preparation of a testicular mass from a patient with secondary lymphoma revealed a modal chromosome number of 45,XY, including structural and numerical anomalies. The most consistent anomalies were the monosomy 21, duplication of the long arm of #11, and structural anomaly associated with chromosome #1 in band q21. PMID- 3539319 TI - Tissue distribution, immunochemical characterization, and biosynthesis of 47D10, a tumor-associated surface glycoprotein. AB - This report describes a new monoclonal antibody (MAb) designated 47D10 which was produced by immunizing mice against a human lung adenocarcinoma line, A549. The MAb 47D10 reacts with a surface antigen found in 95% of adenocarcinomas of the pancreas as well as on high percentages of adenocarcinomas from colon, breast, lung, and bile duct. The antigen was not detected in normal pancreas, in pancreatitis, or in a variety of normal tissues with the exception of colon and mature granulocytes. Lymphocytes and erythrocytes were also negative. The binding of 47D10 to tumor cells was unaffected by treatment of cells with neuraminidase. Immunoprecipitation followed by polyacrylamide gel electrophoresis showed that 47D10 MAb recognized a group of glycoproteins ranging in molecular weight from 67,000-98,000 on A549 lung carcinoma cells. Pulse-chase labeling showed two precursor proteins with molecular weights of 69,000 and 67,000 which were processed to the larger polypeptides in 1.5 h. At least part of the carbohydrates associated with the 47D10 antigen was asparagine linked because the antigen was sensitive to endoglycosidases, and tunicamycin inhibited the biosynthesis of 47D10 antigen. The 47D10 antigen was expressed on the cell surface because it could be detected on live A549 cells by enzyme-linked immunosorbant assays as well as by immunofluorescent staining. Furthermore, 47D10 antigens on tumor cell lines and granulocytes were vectorially labeled with 125I. The antigen found on granulocytes showed a higher molecular weight of 150,000-180,000, which was digested by endoglycosidase F to polypeptides with molecular weights ranging from 23,000-27,000. In contrast, the degradation product of the A549 antigen was a Mr 39,000 polypeptide after treatment with endoglycosidase F. The immunochemical characteristics of 47D10 antigen suggest that it is distinct from other antigens associated with pancreatic tumors, such as carcinoembryonic antigen, 19-9, and Du PAN-2. By virtue of its broad range of tumor cell reactivity and low activity on normal cells, the 47D10 MAb may represent an important immunological reagent for differential diagnosis, especially of pancreatic carcinoma. PMID- 3539320 TI - Repair of O6-alkylguanine during DNA synthesis in murine bone marrow hematopoietic precursors. AB - O6-Alkylguanine, a DNA adduct formed by nitrosoureas, becomes the site of a point mutation during DNA synthesis by preferentially base mispairing with thymine rather than correctly base pairing with cytosine. To repair this adduct, cells contain a limited amount of O6-alkylguanine-DNA alkyltransferase (alkyltransferase), a protein which removes the alkyl group in a stoichiometric reaction. To prevent mutations, repair must occur before DNA replication takes place. Consequently, formation of point mutations is related inversely to the number of alkyltransferase molecules and directly to the rate of DNA synthesis. Bone marrow hematopoietic precursors, the target for nitrosourea-induced leukemia, are deficient in alkyltransferase activity. We questioned whether regenerating bone marrow is more susceptible to nitrosoureas than other organs due to persistently low levels of alkyltransferase activity during periods of increased cell proliferation and DNA synthesis. Following syngeneic bone marrow transplantation, murine hematopoietic cells underwent rapid cell proliferation but alkyltransferase activity remained well below the activity in liver. After N nitrosomethylurea exposure, [3H]thymidine incorporation in rat bone marrow increased 3-fold and stem cell proliferation over 10-fold within 2 days of exposure, but alkyltransferase activity remained low. The relative susceptibility of bone marrow to mutagenic damage from O6-alkylguanine adducts was determined by comparing the ratio of alkyltransferase activity to [3H]thymidine incorporation in marrow, kidney, and liver. In untreated animals, the ratio was lowest in bone marrow and decreased further 48 h after N-nitrosomethylurea exposure to only 21% that of kidney and 1% that of liver. Thus, proliferating hematopoietic precursors appear more likely to form point mutations following nitrosourea exposure than other rodent tissues because they undergo rapid proliferation soon after DNA damage and before O6-alkylguanine adducts can be repaired. The combination of rapid cell proliferation and low DNA repair capacity may be the mechanism of nitrosourea induced leukemic transformation of the bone marrow. PMID- 3539321 TI - Characterization of a human squamous carcinoma cell line resistant to cis diamminedichloroplatinum(II). AB - We have developed a human head and neck squamous cell carcinoma cell line (SCC 25/CP) which is relatively stably resistant to cis-diamminedichloroplatinum(II) (CDDP) after repeated exposure to escalating doses of the drug. The studies reported elucidate the mechanism(s) by which the SCC-25/CP cell line is resistant to CDDP. The SCC-25/CP cell line is approximately 30-fold resistant to CDDP, approximately 10-fold resistant to carboplatin, and about 9-fold resistant to iproplatin. Using [195mPt]CDDP, we examined the levels of platinum in whole cells and cellular fractions of both the SCC-25 and SCC-25/CP cells after 1 h exposure to 100 microM drug. The SCC-25 cells took up 30 pmol of platinum/10(6) cells in 1 h; 64% of the drug was in the nucleus and 21% in the cytosol. The SCC-25/CP cells took up 7 pmol of platinum/10(6) cells; of this, 41% was in the nucleus and 33% in the cytosol. The SCC-25 cell nuclei contained 331 pmol of platinum/mg protein and the cytosol 21 pmol of platinum/mg protein, whereas the SCC-25/CP cell nuclei contained 47 pmol of platinum/mg protein and the cytosol 8.1 pmol/mg protein. The release of drug from both cell lines followed a very similar course and was most rapid over the first 6 h. There was no difference in the non-protein sulfhydryl content of the cell lines. The protein sulfhydryl content, as measured by Ellman's procedure, indicated that the SCC-25/CP cell line has approximately a 2 fold increase in protein sulfhydryl content compared to the SCC-25 cell line. The SCC-25/CP cell line is about 2-fold resistant to cadmium chloride at 50% cell kill and about 2.5-fold resistant at 1 log kill compared to the SCC-25 cell line. Glutathione transferase activity in crude cytoplasmic extracts was measured and found to be approximately 2- to 3-fold higher in the CDDP resistant cells. The isoelectric point of the glutathione transferase isozyme was 4.8 in both the sensitive and resistant cell lines, suggesting induction of the predominant isozyme present in the parent cell line. By alkaline elution there was greater cross-link formation by CDDP in the SCC-25 cell line than in the SCC-25/CP cell line at the same drug concentrations. In conclusion, the mechanism of resistance of the SCC-25/CP cell line to CDDP is multifactorial, involving plasma membrane changes, increased cytosolic binding, and decreased DNA cross-linking. PMID- 3539322 TI - Characterization of a cis-diamminedichloroplatinum(II)-resistant human ovarian cancer cell line and its use in evaluation of platinum analogues. AB - Human ovarian cancer cell lines with stable cisplatin resistance have been developed by chronic exposure of the parent cisplatin-sensitive A2780 line to increasing concentrations of cisplatin. 2780CP8 (CP8 refers to this cell line's growth in medium containing 8 microM cisplatin) has several clonal cytogenetic abnormalities but lacks homogeneously staining regions or double-minute chromosomes. It has a significantly greater monolayer growth rate, cloning efficiency in agarose, and total glutathione content compared to the A2780 line, but similar activities of several glutathione-dependent enzymes. The 2780CP8 subline is 7.3-fold resistant to cisplatin compared to the A2780 line, as well as cross-resistant to irradiation and melphalan. It is not cross-resistant to Adriamycin, but this develops with increased cisplatin resistance (14-fold) obtained by further cisplatin exposure of 2780CP8. Of the cisplatin analogues tested which are of current clinical interest, carboplatin, iproplatin, and tetraplatin, only the latter is more cytotoxic than cisplatin in the A2780 and 2780CP8 lines. The 2780CP8 subline is also cross-resistant to these analogues in the relative order carboplatin greater than iproplatin greater than tetraplatin (most to least cross-resistant). Treatment of a highly cisplatin resistant cell line (2780CP70) with either melphalan or cisplatin was associated with a significant increase in [3H]thymidine incorporation into DNA in the presence of 10 mM hydroxyurea compared with the parent sensitive cell line which showed essentially no capacity to repair DNA damage by these drugs. A2780 and its cisplatin-resistant cell lines may thus be useful in studying drug resistance mechanisms, in screening new drugs for activity (especially against drug resistant tumors), and in formulating induction and salvage therapies for ovarian cancer. PMID- 3539323 TI - Selective killing of human bladder cancer cells by combined treatment with A and B chain ricin antibody conjugates. AB - The monoclonal antibody 486P 3-12-1 raised against transitional bladder carcinoma cells was coupled to either the ricin A or B chain. The toxicity of A chain conjugates could be enhanced by addition of either free ricin B chain or by ricin B chain coupled to 486P 3-12-1 or to antibodies conjugated to ricin B and directed against the mouse monoclonal antibody. Using a two-step procedure where the A and B chains of ricin were delivered separately, the appropriate target cells 486P and 647V were killed, while the pancreatic cell line QGP-1 was not affected. The efficiency of killing by immunotoxin was independent whether free or coupled B chain was used, but B chain was essential for mediating the toxicity of the A chain. The two-step procedure enhances the selectivity of immunotoxin treatment by reducing nonspecific toxicity. Such a procedure could be applicable in vivo by direct administration to the bladder cavity. PMID- 3539324 TI - Detection of a transforming gene in spontaneous reticulum cell sarcoma of SJL/J mice: genetically linked and host-dependent neoplasia. AB - Spontaneous reticulum cell sarcoma (RCS) tumor induction occurs in 90% of SJL/J mice of 8-13 months of age. Tumor induction and growth has been shown to be under the influence of both H-2 and non-H-2 genes as well as the presence of an intact host T-cell system. We postulated that cellular oncogenes may play a role in the induction, growth, and characteristics of RCS. DNA-mediated gene transfer protocols were adopted to investigate the presence of transforming genes in DNA from RCS of SJL/J mice. High molecular weight DNA was isolated from these tumors as well as from brains and livers of control tumor-free SJL/J mice and transfected into NIH-3T3 mouse and F2408 rat fibroblast cell lines. Foci of transformed cells with a peculiar round morphology were scored in both rat and mouse cultures given tumor DNA, but not in those receiving DNA from normal tissues. DNA from first-cycle transformants was transfected in further cycles of transfection, giving rise to foci with similar morphological appearances and growth properties. These experiments suggest that a transforming gene, present in RCS spontaneous tumors, is involved in the malignant conversion of the transfected normal fibroblasts. The implication of these results with respect to the induction and growth properties of RCS is discussed. PMID- 3539325 TI - Enhancement of N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide-induced carcinogenesis by urinary tract infection in rats. AB - Epidemiological studies suggest that urinary tract infection is an important risk factor in the development of bladder cancer. Chronic urinary tract infection in rats is associated with urothelial hyperplasia and papillomatosis. In the Sprague Dawley strain, exposure to the 5-nitrofuran, N-[4-(5-nitro-2-furyl)-2 thiazolyl]formamide (FANFT), is associated in particular with the development of renal pelvic tumors. The present study was designed to evaluate whether chronic urinary tract infection could enhance tumor development in FANFT-induced urinary tract carcinogenesis. One hundred forty-four female Sprague-Dawley rats were divided into the following groups. Group 1 received 0.2% FANFT in the diet for 7 wk followed by control diet. Group 2 received 0.2% FANFT in the diet for 7 wk followed by control diet. One wk after completion of FANFT administration, the suspension of 0.5 ml of Escherichia coli (06K13H1) was injected into the bladder through the urethra. Group 3 received 0.2% FANFT in the diet for 7 wk followed by control diet. One wk after completion of FANFT administration, a suspension of heat-killed E. coli (06K13H1) was injected into the bladder through the urethra. Group 4 received a suspension of 0.5 ml of E. coli (06K13H1) through the urethra and received control diet throughout the experiment. Group 5 was fed control diet only. The experiment continued for 104 wk. A significantly higher number of urinary tract tumors, particularly of the renal pelvis, was recorded in Group 2 compared to Groups 1, 3, 4, and 5. The majority of the rats in Groups 2 and 4 had morphological signs of urinary tract infections, particularly pyelitis and/or pyelonephritis. Thus, a single injection of E. coli (06K13H1) into the bladder results in an enhancement of FANFT-induced urinary tract carcinogenesis in the Sprague-Dawley rat, especially for renal pelvic tumors. The formation of dimethylnitrosamine or other nitroso compounds from nitrates in the urine or increased cell proliferation due to chronic inflammation or both may be important pathogenetic factors in the tumor development. PMID- 3539326 TI - Effect of differentiation on the expression of a nucleolar antigen with a molecular weight of 145,000 in HL-60 cells. AB - Mr 145,000 nucleolar protein antigen (p145) is associated with growing cells (R. L. Ochs et al., J. Cell Biol., 101: 211a, 1985) and has been found in a broad range of human cancers (J. W. Freeman et al., Cancer Res., 46: 3593-3598, 1986). In this study the presence of nucleolar antigen p145 was examined in the human promyelocytic tumor cell line HL-60 which was induced to differentiate by retinoic acid. Differentiation was monitored by morphological changes, [3H]thymidine accumulation, the ability of cells to reduce nitroblue tetrazolium, and cell number. The monoclonal antibody to nucleolar antigen p145 produced bright immunofluorescence in all cycling interphase HL-60 cells; during mitosis only diffuse staining was detected. Nucleolar antigen p145 in HL-60 cells was undetectable after 132 h of treatment with retinoic acid. The absence of nucleolar antigen p145 was associated with an 81% decline in thymidine accumulation and apparent inactivation of ribosomal and nonribosomal DNA transcription as observed by electron microscopy. The loss in expression of the antigen also correlated with increased nitroblue tetrazolium-positive cells, appearance of morphologically distinct myeloid cells, and termination of cell proliferation. These data indicate that the expression of nucleolar antigen p145 occurred in cycling HL-60 cells but not in terminally differentiated noncycling HL-60 cells. PMID- 3539328 TI - Performance status assessment among oncology patients: a review. AB - Performance status is a global assessment of a patient's ability for self-care and ambulation. It is an important and widely used prognostic variable for patients with cancer. Several different scales to assess performance status are in use, and scale scores are used for a variety of purposes, including patient selection and stratification for cancer clinical trials. New uses for life quality evaluations have also been proposed. Despite the widespread use of the scales, little information is available about the reliability and validity of these measures. Improved and extended application of these scales requires that several types of data about measurement properties of the scales be collected and analyzed. Various issues related to the measurement properties of the scales and their implications for oncology need to be understood to best develop their use. PMID- 3539327 TI - Safe, rapid administration of cisplatin in the outpatient clinic. AB - The records of 147 cancer patients who received at least three courses of cisplatin-containing chemotherapy in the Arizona Cancer Center clinic between 1982 and 1985 were reviewed to determine the safety and tolerance of cisplatin administered in the outpatient setting. Cisplatin was administered at doses of 50 120 mg/m2 every 3-4 weeks. The drug was added to 400 ml of 10% mannitol, was brought up to 1-L volume with normal saline containing 3 g of magnesium sulfate, and was administered iv over 1 hour. An additional liter of normal saline was administered over approximately 1 hour in patients who received cisplatin doses of 70-120 mg/m2. Courses were interrupted if the serum creatinine was greater than 1.5 mg/dl just prior to the next scheduled dose. The median total doses of cisplatin per patient were 487, 595, and 683 mg/m2 and complete plus partial response rates were 64%, 71%, and 78% for those patients who received 50-60, 70 90, and 100-120 mg/m2/course, respectively. Cisplatin-containing therapy was tolerated without evidence of renal failure and with only moderate to severe emesis in 25% of the patients. Calculated creatinine clearances dropped only 4.9%, 13.9%, and 14.9% between Courses 1 and 6 in patients receiving cisplatin doses of 50-60, 70-90, and 100-120 mg/m2, respectively. We conclude that cisplatin doses of 50-120 mg/m2 can be administered safely and with acceptable tolerance in the outpatient setting. PMID- 3539329 TI - Phase I study of high-dose dimethylbusulfan followed by autologous bone marrow transplantation in patients with advanced malignancy. PMID- 3539330 TI - Overview of randomized trials comparing radical mastectomy without radiotherapy against simple mastectomy with radiotherapy in breast cancer. AB - An overview of mortality in the mature randomized trials comparing radical mastectomy without radiotherapy against simple mastectomy with radiotherapy has been conducted. These trials mark a transitional period between radical mastectomy and simple mastectomy as the generally preferred surgical treatment and as such are not strictly trials assessing the value of postoperative adjuvant radiotherapy. All known mature trials have been included and these four trials have entered a total of 3236 patients, in whom 1678 deaths have been recorded. Overall, no significant difference in survival was seen, but there was a nonsignificant trend for patients given radiotherapy to do worse after 15 years of follow-up. PMID- 3539331 TI - Diagnosis of diastematomyelia with high-resolution spinal ultrasound. AB - Two children with diastematomyelia were diagnosed before operation with high resolution spinal ultrasonography. Neonates with evident or suspected diastematomyelia can be effectively examined by high-resolution spinal ultrasonography and spinal radiography, reserving more invasive techniques for those for whom the method proves inadequate. PMID- 3539333 TI - An improved synthesis of 6-O-mycoloyl- and 6-O-corynomycoloyl-alpha,alpha trehalose with observations on the permethylation analysis of trehalose glycolipids. PMID- 3539332 TI - Characterization of the group A streptococcal polysaccharide by two-dimensional 1H-nuclear-magnetic-resonance spectroscopy. PMID- 3539334 TI - Structural studies of the O-antigen polysaccharide of Escherichia coli 09a. PMID- 3539335 TI - Use of radioactively labeled N-acetylmannosamine to monitor monooxygenase activity. PMID- 3539337 TI - Non invasive assessment of left ventricular function with first pass angiography in transplanted hearts. PMID- 3539338 TI - [Heart electrostimulation today: materials, stimulation technic, indications and complications]. PMID- 3539336 TI - A monoclonal antibody with binding and inhibiting activity towards human pancreatic carcinoma cells. I. Immunohistological and immunochemical characterization of a murine monoclonal antibody selecting for well differentiated adenocarcinomas of the pancreas. AB - The murine monoclonal antibody (MAb) BW 494 was characterized in relation to its tissue specificity, the epitope recognized, in vitro and in vivo radiolocalization and its potential to mediate antibody dependent cellular cytotoxicity (ADCC) and complement mediated cytolysis (CMC). The MAb defined carbohydrate epitope located on a greater than 200 k daltons glycoprotein was mainly expressed on the majority of well differentiated adenocarcinomas of the pancreas. Furthermore, the epitope is accessible to MAb BW 494 in vivo, allowing an enrichment of radioactive antibody at the tumor site in nude mice. Additionally, MAb BW 494 is able to use human peripheral blood lymphocytes as effector cells for ADCC reactions against appropriate tumor target cells in vitro. In contrast, the antibody does not mediate human or rabbit CMC. PMID- 3539339 TI - Thrombolytic therapy for acute coronary obstruction: status in 1986. PMID- 3539340 TI - [Arterial recanalization using lasers: present and future]. PMID- 3539341 TI - [Stress echocardiography]. PMID- 3539342 TI - Rationale for the treatment of ventricular arrhythmias following acute myocardial infarction: is there an answer? PMID- 3539343 TI - A bilateral distal-extension removable partial denture using a resin-bonded anterior bridge as an alternative to conventional full coverage. PMID- 3539344 TI - Dentistry in ancient Rome. PMID- 3539345 TI - An indirect approach for the study of the elastic modulus of the brachial artery in patients with essential hypertension. AB - An indirect approach for the study of the changes in the incremental circumferential modulus (E) of the brachial artery after arteriolar vasodilatation was undertaken in patients with sustained essential hypertension. The product of E and the thickness (h) of the arterial wall was evaluated by means of the Moens-Korteweg equation using determinations of brachioradial pulse wave velocity and brachial artery diameter with pulsed Doppler methods. In three homogeneous groups of patients with hypertension the Eh product was studied after vasodilatation caused either by nitrendipine, a calcium entry blocking agent, or by medroxalol, an alpha and beta blocking agent, or by isosorbid dinitrate. The three drugs caused similar reductions in blood pressure and increases in arterial diameter and hence decreases in wall thickness. Variance analysis for multigroups indicated that the decrease in Eh after vasodilatation was significant for nitrendipine but not for medroxalol and isosorbid dinitrate. Covariance analysis showed that for any level in Eh product the decrease in Eh was higher for nitrendipine than for isosorbid dinitrate and medroxalol. Since the three drugs had comparable mechanical and geometrical effects, the study provided evidence that, in men with essential hypertension, the smooth muscle tone of the brachial artery was significantly more sensitive to calcium inhibition than to autonomic blockade, causing a more important decrease in elastic modulus. PMID- 3539346 TI - Oral antiarrhythmic agents for ventricular arrhythmias. AB - Ventricular tachyarrhythmia is the most common terminal event causing sudden cardiac death. Risk stratification using 24-hour Holter monitoring to identify ventricular ectopy and noninvasive techniques to detect abnormal left ventricular function is becoming routine. Many cardiologists treat patients with potentially lethal ventricular arrhythmias even though it is unknown as yet whether sudden cardiac death can be prevented. Patients with lethal ventricular arrhythmias are always treated. A number of new oral antiarrhythmic agents have become available to the clinician. The modified Vaughan-Williams classification system categorizes the drugs according to their electrophysiologic and clinical characteristics. The class IC antiarrhythmic agents are emerging as the potential drugs of first choice for patients with benign or potentially lethal ventricular arrhythmias. The betablockers (class II) are used as antiarrhythmic agents, particularly in the presence of active myocardial ischemia or high catecholamine levels and in the postmyocardial infarction patient. Amiodarone (class III) may cause serious side effects and is reserved for patients with lethal ventricular arrhythmias when all other available agents have failed. PMID- 3539347 TI - Low-dose oral contraceptives: progestin potency, androgenicity, and atherogenic potential. PMID- 3539348 TI - Gastric acid secretion and mucosal defense mechanisms with special reference to the role of cimetidine in critically ill patients. AB - The gastromucosal barrier (GMB) can be disrupted by a number of aggressive factors or by a decrease in mucosal defense factors. If there is back diffusion of hydrogen ions into the mucosa, mucosal damage ranging from an erythematous gastro-duodenitis to erosive and ulcerative gastritis or life-threatening hemorrhage may ensue. The pathogenesis of stress-related mucosal damage seen in critically ill patients suffering from burns, sepsis, head trauma, respiratory insufficiency, or multisystem disease is also related to a decrease in mucosal resistance. Early studies of cimetidine in animals and in humans demonstrated its ability to increase gastric transmucosal potential difference, indicating an enhancement of the integrity of the GMB. Several studies show that cimetidine protects the stomach from aspirin-induced mucosal damage; increases gastric mucus production and mucus glycoprotein content, which contributes to the protective action of mucus; increases mucosal secretion of bicarbonate; increases gastric mucosal blood flow, which prevents mucosal hypoxia seen in patients in shock or otherwise critically ill patients; increases endogenous mucosal prostaglandin synthesis; and increases the rate of epithelial cell renewal, a factor important to mucosal healing. Since cimetidine suppresses acid secretion and enhances mucosal defense, it is an important therapeutic tool in the management of acid related disorders, particularly stress-related mucosal damage. PMID- 3539349 TI - Dose validation and study design criteria in current cimetidine studies. AB - A large dose validation study compared cimetidine 800 mg at bedtime, a dose known to provide maximum acid suppression through the night, with placebo, cimetidine 400 mg, and 1,600 mg in the treatment of acute duodenal ulcer. The study was also designed to assess the effects of smoking and ulcer size on duodenal ulcer healing. Results of the study indicated that both smoking and ulcer size negatively correlated with ulcer healing. Cimetidine 800 mg (75%) was superior to placebo (45%) and cimetidine 400 mg (60%) (P less than 0.05) in terms of ulcer healing. There was no statistically significant difference between cimetidine 800 mg and 1,600 mg (81%). Up to 80% of the patients treated with cimetidine 800 mg had some degree of pain relief after the first dose. Cimetidine 800 mg was superior to placebo with respect to both daytime and nighttime pain relief at all assessment points and was superior to 400 mg during the first week. There was no difference in pain relief between 800 mg and 1,600 mg at any assessment period. It was clear that cimetidine 800 mg is the most appropriate dosage in the acute therapy of duodenal ulcer, combining optimal healing with maximum pain relief. PMID- 3539350 TI - [Strategy and tactics of insulin therapy in diabetics]. PMID- 3539351 TI - [The development of diabetes morbidity and insulin use in Slovakia 1965-1990. Re evaluation after 10 years]. PMID- 3539352 TI - [Study of antibodies in diabetics. A comparison of methods]. PMID- 3539353 TI - Localization of enkephalin immunoreactivity in diverse tissues and cells of the developing and adult rat. AB - The distribution of enkephalin, an endogenous opioid, in tissues and cells of the developing and adult rat was determined by immunocytochemistry with antibodies to met- and leu-enkephalin. Met- and leu-enkephalin were found in all developing cells investigated, with staining generally located throughout the cytoplasm; cell nuclei were not immunoreactive. In comparison to developing cells, immunoreactive analogues to met-enkephalin were usually difficult to detect in the adult. Some notable exceptions were reaction products in leukocytes in blood, lung, and cortex of thymus, fibroblasts in the skin, and seminiferous tubules. These results, in concert with earlier reports that opioid receptors are found largely in developing, but not adult, tissues, indicate that endogenous opioids are specifically involved in biological development, particularly cell proliferation and differentiation. Immunoreactivity in adult non-neural cells may be related to their development in some cases, but also could indicate other functions. PMID- 3539356 TI - [A longitudinal survey of malaria by using the indirect fluorescent antibody test (IFAT)]. PMID- 3539355 TI - Synenkephalin in bovine and human spinal cord. AB - Synenkephalin, which comprises 70 residues at the aminoterminal of proenkephalin, was studied with immunocytochemical methods in the human and bovine spinal cord. Immunoreactive fibers had the same general distribution as methionine-enkephalin, but not as leucine-enkephalin fibers. They were found in all spinal layers and were most numerous in lamina II (outer zone) and V-VI (lateral portion). Synenkephalin immunoreactivity was overall less dense than that of the enkephalins. These results suggest that proenkephalin is the precursor protein also in enkephalinergic neurons of the human spinal cord. PMID- 3539354 TI - Development and fate of the secretory granules of juxtaglomerular epithelioid cells. AB - The development and fate of the secretory granules in murine, rat and human juxtaglomerular epithelioid cells were examined using ultrastructural and immunocytochemical methods. The formation of mature renin granules occurs by fusion of rhomboid protogranules followed by coalescence of their paracrystalline contents, and by the fusion of roundish juvenile granules having an amorphous internum. Protogranules with paracrystalline contents are prominent in animals with stimulated renin synthesis, indicating an overcharge in processing and/or packaging of the secretory product, renin, under these conditions. Various similarities between lysosomes/multivesicular bodies (MVBs) and juvenile renin granules have been observed. With the exception of small MVBs, no renin-negative organelles that could be regarded as lysosomes were found in epithelioid cells of mice and rats. Therefore, we suggest that renin granules are modified lysosomes. Immunocytochemical findings indicate that juvenile secretory granules of epithelioid cells represent the converting and activating compartment for prorenin. Endocytosed foreign tracers such as HRP or cationized ferritin are preferentially internalized by juvenile renin granules, which hence appear to be outstanding by their fusogeneity. Consequently, juvenile granules are probably responsible for the secretion of prorenin, and mature granules for that of active renin. PMID- 3539357 TI - [Advances in epidemiology]. PMID- 3539358 TI - [A study on the lysine decarboxylase test in screening for enteroinvasive]. PMID- 3539359 TI - [Epidemiology of diarrhea in tourists]. PMID- 3539360 TI - Prostaglandins: their release, biological effects and relationships to pain and inflammation. PMID- 3539361 TI - Naproxen and naproxen sodium in acute migraine attacks. PMID- 3539362 TI - Naproxen sodium in the treatment of migraine. PMID- 3539363 TI - Clinical evaluation of soft-tipped catheters for coronary angiography. AB - New soft-tipped Judkins catheters for coronary angiography were compared with conventional femoral catheters for coronary angiography in a randomized, controlled fashion with cross-over exchange of catheters when problems occurred. The problems encountered with a first generation of soft-tipped catheters (n = 113) versus conventional catheters (n = 103) were as follows: difficult introduction 27% versus 1% (p less than 0.01), difficult placement 13% versus 8% (not significant), difficult aspiration 4% versus 0% (p less than 0.05), wedging 5% versus 0% (p less than 0.05), spasm 3% versus 0% (not significant), overselectivity 7% versus 2% (not significant), cross-over necessary and successful 18% versus 1% (p less than 0.01). Problems with a second generation of soft-tipped catheters (n = 200), modified according to the experience gathered from the first generation, versus conventional catheters (n = 194) were as follows: difficult placement 10% versus 7%, difficult aspiration 2% versus 0.5%, wedging 2% versus 1%, spasm 1% versus 0%, overselectivity 3% versus 2%, ventricular fibrillation 1.5% versus 0%, cross-over necessary and successful 3% versus 2%. None of the differences attained statistical significance. The performance of soft-tipped catheters for coronary angiography was inferior for the first generation but comparable for the second generation to that of conventional catheters. In terms of safety, soft-tipped catheters were not superior on the basis of our criteria. PMID- 3539364 TI - Proton ionophores prevent assembly of a peroxisomal protein. AB - Peroxisomal matrix proteins are imported into the organelle posttranslationally. Here we report that proton ionophores disrupt the import and assembly of alcohol oxidase, a homo-octameric flavoprotein of the induced peroxisome from the methylotrophic yeast Candida boidinii. When drug is added to cells containing newly synthesized monomeric alcohol oxidase, octamerization fails to occur and a membrane-associated complex is formed instead. The formation of the complex, which appears to face the cytoplasmic side of the membrane, is reversed when drug is removed, leading to the generation of octamer. Surprisingly, when drug is added to cells containing newly assembled octamers, they dissociate into monomers. We suggest that both the complex and the labile octamer are intermediates in the normal assembly pathway of alcohol oxidase and that energy is required for import and maturation of this peroxisomal protein. PMID- 3539365 TI - Cast glass ceramic crowns: a one year clinical study. PMID- 3539366 TI - Immunological detection of an analogue of the erythroid protein 4.1 in endothelial cells. AB - Endothelial cells (EC) of arterial and venous origin were investigated by indirect immunofluorescence and immunoautoradiography for the presence of red cell membrane 4.1-like protein. By immunofluorescence, EC exhibited a relatively uniform fluorescent staining sometimes of a reticular pattern, distributed over the entire cell. All controls were negative. Immunoblot analysis of EC revealed a cross reactive band of a molecular weight comparable to that of the erythrocyte band 4.1. These findings indicate that endothelial cells of arterial and venous origin express a polypeptide immunologically related to the erythrocyte protein 4.1, which may play an important role in membrane-cytoskeleton interactions. PMID- 3539368 TI - Ultrastructural modifications of the cavities formed by folliculo-stellate cells in chicken adenohypophysis under septic shock conditions. AB - Effects of septic shock by repeated inoculations with Escherichia coli on the ultrastructure of the folliculo-stellate cells and cavities of the adenohypophysis of the chicken were investigated in order to determine the function of these cavities. The principal morphological modifications were dilation of the Golgi apparatus, endoplasmic reticulum and autophagic vacuoles, and necrosis phenomena in the stellate cells. The follicular cavities showed dilation, and there was heterogeneous dense material and granular elements in the follicular lumen. Based on results reported in the literature, the observations reported here are evidence of a "cleaning-role", for the removal of cell debris, when there is endocrine disfunction. PMID- 3539367 TI - Cellular distribution of a protein related to neuronal microtubule-associated protein MAP-2 in Leydig cells. AB - A monoclonal antibody to neuronal microtubule-associated protein MAP-2 was produced. Immunoblotting of lysates of cultured cells revealed that the antibody, called MA-01, bound to a protein of Mr 210 kDa. Double immunofluorescence microscopy showed that the antibody stained microtubules. No fibrillar structures were observed in cells treated with Colcemid, but the antibody stained vinblastine paracrystals. In cytochalasin B-treated Leydig cells, MA-01 antibody stained star-like structures that codistributed with actin patches and with a star-like arrangement of vimentin. These observations indicate that the protein immunologically related to MAP-2 in Leydig cells could be involved in the interaction of microtubules with intermediate filaments or microfilaments. PMID- 3539369 TI - [Biological testing of methenmadinone acetate (Superlutin Spofa) in clinical trials]. PMID- 3539370 TI - [Extraperitoneal cesarean section. I. History]. PMID- 3539371 TI - [30 years' of the Phoniatry Clinic at the Medical School of Charles University in Prague]. PMID- 3539372 TI - [A Czechoslovak psychiatrist who worked with Dr. Albert Schweitzer in Lambarene. II]. PMID- 3539373 TI - [40 years' of pediatric medicine in the North Moravia region]. PMID- 3539374 TI - Ligands of second generation platinum analogs decrease both platinum-induced DNA cross-linking and its ability to interact with 1-beta-D-arabinofuranosyl cytosine to potentiate cytotoxic efficacy. AB - We evaluated the cytotoxic and DNA cross-linking (CL) ability of four second generation platinum coordination complexes (TNO-6, JM-89, JM-8 and JM-9) delivered alone or in combination with 1-beta-D-arabinofuranosyl cytosine (ara-C) to human colon cancer cells (LoVo). Cell survival varied markedly as a function of the particular substitution moiety. JM-8 and JM-9 were virtually ineffective, even at concentrations as high as 50 micrograms/ml. At that concentration cis diamminedichloroplatinum(II) (cis-DDP) killed greater than 99.99% of the cells. JM-82 was slightly more active while TNO-6 was the only derivative with appreciably higher cytotoxic activity due to an abrogation of the shoulder region of the type C survival curve. The highest CL effect was observed for cis-DDP followed closely by TNO-6. Very little CL effects were demonstrated for the other three analogs JM-82, JM-8 and JM-9 when measured 6 h after treatment. The combination of cis-DDP and ara-C augmented 10-fold the cytotoxic activity of cis DDP alone, an effect accompanied by an almost 2-fold increase in CL; every other analog failed to interact in a potentiating manner (either cytotoxicity, or CL at 6 h) with the antimetabolite. Thus, it appears clear that the associated moieties of the Pt coordination complex play a fundamental role in reducing the interaction of the analogs with DNA (as reflected by the decreased CL and cytotoxic effects produced by each agent alone) and in totally preventing their interaction with ara-C to yield a potentiating lethal effect. PMID- 3539375 TI - Synthesis and enantioselective mutagenicity of azidoalanine in Salmonella typhimurium. AB - Azide mutagenicity involves the requisite formation of the putative novel aminoacid metabolite, beta-azidoalanine. The role of this metabolite, however, is unclear. In order to confirm the identity of this metabolite and provide additional information on possible stereochemical requirements for mutagenicity, authentic racemic and L-azidoalanine were synthesized by an unambiguous route and tested for mutagenicity in Salmonella typhimurium TA100, TA1535, hisG46 and Escherichia coli WP2-. A marked antipodal potency ratio was observed in strains TA100 and TA1535 when racemic and L-azidoalanine were compared. The mutagenic activity resided primarily in the L-isomer. The molar potency of L-azidoalanine in TA100 and TA1535 was nearly identical to that of azide. The lack of mutagenic response for racemic or L-azidoalanine in hisG46 and E. coli WP2- was like that reported for azide and is consistent with similar modes of action for these agents. PMID- 3539376 TI - Toxicity, mutagenicity and induction of recA protein in Escherichia coli treated with cis-diamminedichloroplatinum(II) and cis-diamminetetrachloroplatinum(IV). AB - After exposure of bacteria to equal concentrations of cis diamminedichloroplatinum(II) (DDP) and cis-diamminetetrachloroplatinum(IV) (DTP), the intracellular concentration of DTP was an order of magnitude greater than DDP. However, at identical intracellular drug concentrations, the Pt(IV) compound formed only half as many platinum-DNA lesions. For equal numbers of DNA lesions, the toxicity of both agents was identical whereas the mutagenicity of DTP was 7 times less than for DDP and its capacity to induce recA protein was less than DDP by a factor of 3.5. Bioreduction of Pt(IV) compounds to their corresponding Pt(II) analogues has been proposed as a mechanism for the reaction of Pt(IV) compounds with cellular DNA. According to this hypothesis, DTP would be reduced to DDP in the cell prior to its reaction with DNA and the platinum-DNA lesions of the two compounds should be identical. Our results suggest that reductive elimination can not entirely account for DNA damage caused by PT(IV) compounds in bacteria. PMID- 3539377 TI - Purification and characterization of a new peptide-mannan, SP-I, as a gastric secretion-inhibitory principle from autolysate of brewer's yeast. PMID- 3539378 TI - [Nursing care of patients with whole-piece and full-thickness facial skin grafts]. PMID- 3539379 TI - The technique of premature chromosome condensation to study the leukemic process: review and speculations. AB - The technique of premature chromosome condensation involves the fusion of mitotic cells with interphase cells resulting in the immediate condensation of the interphase chromatin into discrete chromosome units, the prematurely condensed chromosomes (PCC). The ability to visualize the interphase chromosomes of bone marrow and blood cells by this technique has proved useful in the study of human leukemia. This article describes how the PCC technique has been used to predict clinical outcome as well as gain insight into the biology of leukemia. PMID- 3539380 TI - The psychological effect of a sonar examination on parents-to-be. PMID- 3539381 TI - [Malignant tumors of the choroid. Clinical signs, clinical forms, differential diagnosis]. PMID- 3539382 TI - [Fluorescence angiography and malignant tumors of the choroid]. PMID- 3539383 TI - Contribution of drug transport and reductases to daunorubicin resistance in human myelocytic cells. AB - We developed three daunorubicin (D1)-resistant sublines (ML1/I, II, III) from the human myelocytic cell line (ML1). These sublines were 28-, 70- and 162-fold more resistant than sensitive (ML1/S) cells to the cytotoxicity of D1 and were cross resistant to adriamycin, epiadriamycin, actinomycin D, VP-16, VM26, and mitoxantrone. Steady-state levels of D1 in resistant sublines I and II, in the presence or absence of azide, were not significantly different from those of sensitive cells. However, the steady-state level of D1 in subline III was significantly increased in the presence of sodium azide. D1 efflux was minimal in ML1/S and resistant cells in the absenced of glucose. Addition of glucose enhanced D1 efflux only in subline III. Verapamil increased the cellular levels of D1 and inhibited its efflux from resistant III cells but not from ML1/S cells. Verapamil also greatly enhanced the cytotoxicity of D1 for sublines I, II, and III. The differences between sensitive and resistant cells in D1 uptake and retention seemed inadequate to cause 162-fold resistance and suggested other factors may be contributing to the development of resistance. In support of this hypothesis, daunorubicin reductase activity was significantly lower in resistant cells than in ML1/S cells. The greatest decrease in activity occurred at pH 8.5 which represents aldehyde reductases. Currently, we are investigating other possibilities for D1 metabolism, such as aglycone and free radical formation. PMID- 3539385 TI - Distribution of the pentose phosphate pathway in living organisms. PMID- 3539386 TI - Physiological functions of the pentose phosphate pathway. PMID- 3539384 TI - Comparative nephrotoxicity of carboplatin and cisplatin in combination with tobramycin. AB - The nephrotoxic potentials of cisplatin and carboplatin, alone and in combination with the aminoglycoside antibiotic tobramycin, were compared in male rats. Sixty (60) male Sprague-Dawley rats were divided into six groups of ten rats each and received the following treatments: Group I, saline; group II, cisplatin (5 mg/kg); group III, cisplatin (5 mg/kg) + tobramycin (50 mg/kg); group IV, carboplatin alone (50 mg/kg); group V, carboplatin (50 mg/kg) + tobramycin (50 mg/kg); and group VI, tobramycin alone (50 mg/kg). Carboplatin and cisplatin were each administered as a single i.v. injection on day 1. Tobramycin was administered i.-m. once daily on days 1-5. All rats were euthanatized on day 6. Smaller body weight gains occurred in groups II-V than in saline controls. Serum urea nitrogen (BUN) levels recorded on day 6 were elevated in group III. BUN values of all other groups were normal. Histopathologic examination of kidneys revealed acute tubular injury in rats treated with cisplatin, whether alone or in combination with tobramycin, and in carboplatin/tobramycin-treated rats. Carboplatin and tobramycin, when administered separately, were not nephrotoxic. The combination of cisplatin and tobramycin proved to be the most nephrotoxic treatment. PMID- 3539387 TI - Cellular biochemistry of glucose 6-phosphate and 6-phosphogluconate dehydrogenase activities. PMID- 3539388 TI - Prostacyclin and thromboxane A2 in septic shock: species differences. AB - Prostacyclin and thromboxane A2 have been implicated as mediators of septic shock. Correlations between the human prostanoid response to sepsis and experimental paradigms are poorly understood. The purpose of this study was to compare changes in plasma levels of prostaglandin 6-keto-F1 alpha (PGI) and thromboxane B2 (TxB) during septic shock in Sprague-Dawley rats, domestic pigs, mongrel dogs, and man. Severe sepsis followed by septic shock (systolic BP less than 90 mmHg) was induced in rats by inoculation of 1.0 X 10(9) Aeromonas hydrophila, in pigs by graded IV infusion of 1.0 X 10(9)/ml A. hydrophila; and in dogs by an IV bolus injection of 5.0 X 10(9)/ml Escherichia coli. Plasma PGI and TxB (pg/ml) were measured by radioimmunoassay in control, septic, and septic shock experimental blood samples, and in normal controls, severly septic, and septic shock (systolic BP less than 90 mmHg) S.I.C.U. patients. Control, septic, and septic shock TxB levels in the dog and the pig were significantly greater than in the rat and man. PGI levels in the dog were significantly greater than in other species. TxB increased significantly in murine sepsis and PGI increased significantly in sepsis and septic shock. TxB increased during porcine sepsis and septic shock. In man, both PGI and TxB were significantly increased in severe sepsis, compared to normal controls, but only PGI was significantly higher in septic shock versus normotensive sepsis. Patterns of change in TxB/PGI ratios were similar for all species studied. Changes in PGI in the porcine septic experiments most closely paralleled those observed clinically. PMID- 3539389 TI - Kupffer cell complement receptor clearance function and host defense. AB - Kupffer cells are well known to be important for normal host defense function. The development of methods to evaluate the in vivo function of specific receptors on Kupffer cells has made it possible to assess the role of these receptors in host defense. The rationale for studying complement receptors is based on the proposed important role of these receptors in host defense and on the observation that the hereditary deficiency of a complement receptor is associated with recurrent severe bacterial infections. The studies reviewed here demonstrate that forms of injury that are associated with depressed host defense including thermal injury, hemorrhagic shock, trauma, and surgery also cause a decrease in complement receptor clearance function. This decrease in Kupffer cell receptor clearance function was shown not to be the result of depressed hepatic blood flow or depletion of complement components. Complement receptor function was also depressed following the phagocytosis of particulates that are known to depress Kupffer cell host defense function. Endotoxemia and bacteremia also were associated with a depression of complement receptor function. Complement receptor function was experimentally depressed in uninjured animals by the phagocytosis of IgG-coated erythrocytes. There was a close association between the depression of complement receptor clearance function and increased susceptibility to the lethal effects of endotoxin and bacterial infection. These studies support the hypotheses that complement receptors on Kupffer cells are important for normal host defense and that depression of the function of these receptors impairs host defense. PMID- 3539390 TI - [Quantitative study on the role of Anopheles lesteri anthropophagus in malaria transmission]. PMID- 3539391 TI - [Analysis of target antigens of Plasmodium falciparum with human immune sera]. PMID- 3539392 TI - Equity in the selection of recipients for cardiac transplants. PMID- 3539393 TI - Selection of patients for cardiac transplantation. AB - Selection of potential cardiac recipients is not a simple process. Identification of patients who are declining from end-stage cardiac disease and may be expected to die within 12 months or less and deciding which of a number of cardiac invalids are reasonable candidates for cardiac transplantation involves prognostication as well as a working knowledge of the expected benefits and survival rates in cardiac transplantation. Screening by means of the currently accepted contraindications for cardiac transplantation is somewhat more difficult in 1986 than it was 10 years ago when these contraindications were changing less rapidly. However, for optimal use of the limited supply of donor organs and maintenance of reasonable survival rates such screening is absolutely necessary. A second area of restriction that is less approachable by the physician is that of financial limitations. It would appear that the working poor and lower middle class may be deprived of the opportunity for cardiac transplantation much as they are deprived of the opportunity for optimal medical care in our society today. PMID- 3539394 TI - A proposed solution to the present organ donation crisis based on a hard look at the past. PMID- 3539396 TI - Coordination of cardiac transplantation: patient processing and donor organ procurement. AB - As cardiac transplantation has evolved into a viable therapeutic option for some terminally ill patients with end-stage heart disease, the role of clinical transplant and donor organ procurement coordinators has evolved into a new health profession. These well-trained, highly skilled, and dedicated individual's permeate all levels of the organ transplantation process, providing continuity of care and smoothness to a complicated path of operation. PMID- 3539395 TI - Contrast ultrasonography of the kidney: a new method for evaluation of renal perfusion in vivo. AB - Assessment of the effects of pharmacologic agents on renal blood flow (RBF) is clinically important in many disease states, including hypertension and congestive heart failure. However, because of the complexities of RBF, quantitation in vivo has been technically difficult. This study demonstrates the utility of ultrasound imaging of the kidney combined with injection of a sonicated radiocontrast solution (Renografin-76) for the assessment of regional renal blood flow. The technique uses a suspension of uniform microbubbles (diameter 4.4 +/- 2.8 micron), which when injected directly into the descending aorta are distinctly visualized by renal ultrasound. Five dogs were studied. Catheters were placed in the descending aorta for injection of sonicated Renografin and in the renal artery for drug infusions. Data were collected before and during intrarenal artery infusions of bradykinin and norepinephrine. Total RBF was measured by electromagnetic flowmeter. Video density time curves were generated for comparable segments of the outer renal cortex and fit to a monoexponential decay curve. This allowed calculation of the mean exponential decay index (t1/2). An increase in t1/2 paralleled decreased renal perfusion (i.e., longer washout of contrast material). The opposite was true for a decrease in t1/2. Bradykinin increased RBF from 134 +/- 26 to 249 +/- 19 ml/min (p less than .01 vs control), and norepinephrine decreased RBF from 130 +/- 25 to 51 +/- 17 ml/min (p less than .01 vs control).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539397 TI - Immunosuppressive therapy with cyclosporine for cardiac transplantation. PMID- 3539398 TI - Cardiac transplantation: a psychological perspective. PMID- 3539399 TI - Supply and distribution of hearts for transplantation: legal, ethical, and policy issues. PMID- 3539400 TI - The opioid system in cardiac and vascular regulation of normal and hypertensive states. AB - The endogenous opioid system includes three major families of peptides: dynorphins (derived from pre-proenkephalin B), endorphins (derived from pre proopiomelanocortin), and enkephalins (derived from pre-proenkephalin A). Multiple species of opioid peptides are derived from these major precursors and many of them possess potent cardiovascular properties. Opioid peptides and opioid receptors, of which multiple forms have been defined, are present in the central nervous system and peripheral neural elements. In the central nervous system, opioid peptides and receptors are found in forebrain and hindbrain nuclei involved in baroregulation, sympathoadrenal activation, and several other vital autonomic functions. In the periphery, opioid peptides are found in autonomic ganglia, adrenal gland, heart, and other organs; multiple opioid receptors are also found in vascular tissue, heart, and kidneys. Although little is known to date on the regulatory mechanisms of the opioid system in normal cardiovascular states, it became clear that cardiovascular stress situations substantially modify the activity of the endogenous opioid system. The purpose of this review is to clarify the sites of interaction of the opioid system with all major components of the cardiovascular system and indicate the potential role of this system in the ontogenesis of cardiac malfunction, vascular diseases, and hypertension. PMID- 3539401 TI - The heart and the regulation of renin. AB - The cause of the low-renin state in hypertension is unknown. To consider our hypothesis that cardiopulmonary mechanoreceptors suppress renin release in these patients, it was necessary to prove that "low pressure" receptors affected renin levels in man. A series of experiments was performed to selectively alter the stretch (load) on carotid and cardiopulmonary baroreceptors in healthy human volunteers. These studies showed that selectively altering high-pressure baroreceptor load did not affect plasma renin activity. Selectively unloading the low-pressure receptors increased plasma renin activity. Simultaneous unloading of both baroreceptors caused the largest increases in renin activity. While the data indicated an interaction of high- and low-pressure receptors on the neural regulation of renin release, we interpreted these results as evidence for a predominant influence of cardiopulmonary mechanoreceptors on the neurogenic regulation of renin secretion in man. PMID- 3539402 TI - Evidence for the existence of renin in the heart. AB - Renin and other components of the renin-angiotensin system have been reported to be present in many extrarenal tissues. We have detected reninlike activities in mouse and rat hearts. Cardiac renin has a pH optimum similar to that of renal renin and its activity is inhibited by antirenin antibody. This enzyme is synthesized in the heart, based on the following evidence: renin messenger RNA was detected in mouse heart by Northern blot hybridization and renin activity was found in isolated cardiac myocytes. Nifedipine lowered the intracellular renin activity of isolated cardiac myocytes in vitro. These results demonstrate the existence of a cardiac renin system that may play a local regulatory role on cardiac function. PMID- 3539403 TI - Cardiac sensory receptors in Dahl salt-resistant and salt-sensitive rats. AB - The Dahl strain of genetically salt-resistant (DR) and salt-sensitive (DS) rats affords an opportunity to explore mechanisms responsible for salt resistance and sensitivity. Dahl sensitive rats exhibit abnormalities in sympathetic neural control of the circulation and in renal sodium handling. Since cardiac baroreflexes participate in regulation of sympathetic nerve activity and sodium excretion, we have evaluated cardiac baroreflex function in DR and DS rats. This article briefly reviews evidence that cardiac sensory endings with vagal afferents are reset to a higher threshold in DS rats before elevation of arterial or cardiac filling pressures, as a result of this resetting, cardiac baroreflex inhibition of sympathetic nerve activity during volume expansion is impaired in prehypertensive DS rats, a high-sodium diet enhances the gain of cardiac baroreflex inhibition of sympathetic nerve activity in DR but not DS rats, and atrial natriuretic factor stimulates cardiac sensory receptors with vagal afferents. Taken together, these studies prompt speculation that humoral factors released during intake of a high-sodium diet may sensitize cardiac baroreflexes and thereby protect against sodium retention and hypertension. An absence of this compensatory adjustment or plasticity in cardiac baroreflex function in DS rats may predispose to salt-induced hypertension. PMID- 3539404 TI - Hemodynamic benefits and prolonged survival with long-term captopril therapy in rats with myocardial infarction and heart failure. AB - To determine whether the hemodynamic profile of chronic heart failure secondary to myocardial infarction could be altered, captopril was administered to female Wistar rats 3 weeks after coronary artery ligation and continued for 3 months. Captopril reduced left ventricular mass, prevented the increase in right ventricular mass observed with increasing infarct size, lessened the increase in left ventricular end-diastolic pressure, and reduced mean arterial pressure and total peripheral resistance, whereas cardiac output and heart rate were maintained. The end-diastolic volume of treated rats with moderate infarcts was significantly less than that of untreated rats, and therefore the ejection fraction index was significantly increased. In rats given captopril until death or for a period of up to 1 year, survival was significantly prolonged, particularly in those rats with moderate-sized infarcts. PMID- 3539406 TI - Indications for contact lens fitting after keratoplasty. PMID- 3539405 TI - The presentation of a lost contact lens. PMID- 3539407 TI - The dry eye: its mechanisms and therapy, with evidence that contact lens is a cause. PMID- 3539408 TI - Cell-mediated immune responses to artificial food additives in chronic urticaria. AB - In some cases of chronic urticaria it is suspected that food additives such as tartrazine and sodium benzoate or salicylates may play a role in the pathogenesis of the condition. Since, at times, chronic urticaria may appear histologically similar to a mild cell-mediated immune response, the release of the T cell derived lymphokine leucocyte inhibitory factor (LIF), in response to incubation with these additives and with acetylsalicylic acid (ASA), was measured in vitro using cells from normal controls, from patients with chronic urticaria with or without clinically associated additive sensitivity and from patients with asthma with or without associated ASA sensitivity. It was found that significant production of LIF occurred in response to tartrazine and sodium benzoate in those individuals with chronic additive induced urticaria. In addition, tartrazine caused LIF release from mononuclear cells of ASA-sensitive asthmatics. These results may indicate a possible role for additive-induced cell-mediated immune responses in the pathogenesis of some cases of chronic urticaria and suggest a potential diagnostic test for this condition. PMID- 3539409 TI - Histamine and methacholine do not increase nasal reactivity. AB - Allergen provocation in the nose increases the non-specific nasal reactivity. The aim of this trial was to determine whether this 'priming effect' can be caused by histamine or methacholine, which is the most important biochemical mediator of allergic rhinitis, and an analogue to the important neurotransmittor, acetylcholine, respectively. Intranasal provocation tests with the two substances were carried out on thirteen normal subjects, and repeated 1 hr and 1 day later. The response, measured as the number of sneezes, the amount of blown secretion and the increase in nasal airway resistance, did not change with consecutive provocations. It was concluded that neither histamine nor methacholine were responsible for the allergen-induced 'priming' of the nasal mucous membrane. PMID- 3539410 TI - Plasma fibronectin in liver cirrhosis and its diagnostic value. AB - Plasma fibronectin (FN) has been measured by immunonephelometric method in 100 cirrhotic patients and compared with that of 77 normal subjects and with that of 57 patients suffering from liver disorders different from cirrhosis. Both, compensated and decompensated cirrhotics had lower plasma FN than controls (31.14 +/- 11.42 and 20.88 +/- 10.43 respectively vs 40.13 +/- 8.58 mg/dl; rho less than 0.02 and rho less than 0.001). FN in ascitic patients was lower than in non ascitic (rho less than 0.001). These differences were not due to different weight or age of patients. It appears, therefore, that FN parallels in cirrhosis the grade of liver function impairment. No significant difference has been noted between plasma FN of patients with liver diseases different from cirrhosis and control subjects. In cirrhosis, a positive relation has been observed among FN and other parameters of liver function such as serum albumin, cholinesterase activity, fibrinogen and prothrombin time. Plasma FN has a low sensitivity but a high specificity and a good positive predictive value in distinguishing normals and patients with liver disorders different from cirrhosis. This diagnostic value is similar to that of serum albumin. PMID- 3539411 TI - Diagnostic value of an immunoenzymetric assay compared with an enzymic immunoinhibition procedure for creatine kinase isoenzyme MB. PMID- 3539412 TI - Ovulation and normal luteal function during LHRH treatment of women with hyperprolactinaemic amenorrhoea. AB - Five patients with hyperprolactinaemic amenorrhoea who had been resistant to, or intolerant of bromocriptine were treated with pulsatile LHRH therapy. Ovulation was induced in 9 of 12 treatment cycles. In one patient hyperstimulation occurred in the first cycle of treatment but subsequently she ovulated normally on a reduced dose of LHRH. The gonadotrophin and ovarian responses to treatment in ovulatory cycles were normal despite prolactin concentrations that remained elevated throughout treatment and rose still further with resumption of ovarian activity. The length of the luteal phase and the mid-luteal serum progesterone concentrations were also normal. Pulsatile secretion of progesterone in response to LHRH pulses were observed. These data show that ovulation and normal luteal function can be induced by physiological LHRH replacement in women with persistent hyperprolactinaemia. This confirms that the mechanism of anovulation in hyperprolactinaemic amenorrhoea is disordered LHRH secretion. PMID- 3539413 TI - Effect of a calcium entry blocker on blood pressure, plasma renin activity, aldosterone and catecholamines in normotensive subjects. AB - The effects of the calcium entry blocker nifedipine on blood pressure, heart rate, plasma renin activity, aldosterone, noradrenaline and adrenaline were studied in 23 normotensive subjects in the supine and upright positions. Nifedipine, 10 mg administered sublingually, lowered mean blood pressure and increased heart rate, plasma noradrenaline and renin activity without increasing plasma aldosterone in the supine position. The increase in plasma aldosterone in response to upright posture was inhibited by nifedipine, whereas the rise in plasma noradrenaline was augmented. These results suggest that intracellular calcium is important as a regulator of aldosterone secretion as well as of vascular tone in normotensive subjects. PMID- 3539414 TI - Hormonal control of metabolism in trauma and sepsis. PMID- 3539415 TI - Immunological disturbances in patients with premature ovarian failure. AB - Eighteen patients with postmenopausal gonadotrophin levels and secondary amenorrhoea before the age of 35 years (premature ovarian failure, POF) were examined for the presence of cellular and humoral immune defects. Six patients had an abnormally low natural killer (NK) cell activity. The levels of circulating immune complexes were increased in six patients. Tissue antibodies were detected in six patients and two of these possessed ovarian antibodies. Leukocyte migration inhibition in the presence of ovarian antigen was slightly enhanced in three patients. Altogether 12 patients (66%) with POF had some immunological defect or defects suggesting that immune mechanisms are often involved in the aetiology of POF. PMID- 3539416 TI - Human fetal hypothalamic GnRH neurosecretion: dopaminergic regulation in vitro. AB - An in-vitro perifusion system was used to investigate GnRH release from fetal (21 23 weeks gestation) human hypothalami in response to dopamine (DA) and the DA receptor antagonist haloperidol. Administration of 1 mumol/l DA during five perifusions in which 1 mumol/l haloperidol was added to the medium failed to alter basal GnRH release. In contrast DA evoked a rapid and sustained 95.8 +/- 20.3% increase (P less than 0.01) in GnRH release during five matching perifusions with medium containing the alpha-adrenergic antagonist phentolamine. While exposure to 0.01 mumol/l DA failed to alter basal GnRH release during three perifusions, 0.1 mumol/l DA elicited a 145.7 +/- 65.2% increase (P less than 0.05) in GnRH release in three matching perifusions, indicating a dose-dependent effect. These studies demonstrate that DA can stimulate in-vitro release of GnRH from the mid-gestation fetal human hypothalamus by a DA receptor mediated mechanism. PMID- 3539417 TI - Anti-mullerian hormone. PMID- 3539418 TI - Fragile X; experience of a laboratory. PMID- 3539419 TI - The cellular responses of tuberculosis and leprosy patients and of healthy controls in skin tests to 'new tuberculin' and leprosin A. AB - The density and distribution of T4 and T8 lymphocytes and of monocyte/macrophages at the site of skin tests with mycobacterial antigens was studied in pulmonary tuberculosis and leprosy patients and in healthy controls. Most of the inflammatory cells were located in perivascular and periappendicular foci in the dermis: the percentage of the dermis occupied by focal infiltrate was unrelated to the clinical measurement of the area of induration. There was a less intense diffuse infiltrate in the dermis between the foci, most marked in the papillary dermis and lessening progressively in deeper layers. In patients, diffusely infiltrating lymphocytes were more numerous (mainly due to an excess of T8 cells) in relation to extracts of the pathogen causing their disease than to extracts of the other organism: T8 cells were particularly numerous in reactions to Leprosin A in three of four partly treated leprosy patients who had been classified as tuberculoid at the time of diagnosis. The density of diffusely infiltrating macrophages showed a similar density gradient and selective concentration in response to active disease pathogens. However these cells were less numerous in partly treated leprosy patients than in controls and most frequent in untreated pulmonary tuberculosis patients. Selective migration of monocyte/macrophages and, to a lesser extent T8 cells, appears to be a prominent feature in the reaction of patient with active mycobacterial disease to antigens derived from the causative organisms: this suggests that it might become possible to distinguish direct reactions from cross-reactions in human delayed hypersensitivity reactions by identification of these histological features. PMID- 3539420 TI - Long-term immunological reconstitution by peripheral blood leucocytes in severe combined immune deficiency disease: implications for the role of mature lymphocytes in histocompatible bone marrow transplantation. AB - A 7 month old girl with severe combined immunodeficiency disease (SCID) received a single transfusion of peripheral blood leucocytes from her histocompatible grandfather in an attempt to achieve immunological reconstitution. There was rapid restoration of humoral and cellular immunity which has persisted undiminished over a 54 month follow-up period and the patient has remained free of any significant infections. Lymphocytes of donor karyotype were repeatedly demonstrated in the patient's peripheral blood. In contrast, no evidence of donor cell engraftment in her bone marrow could be obtained by karyotypic, antigenic or enzyme phenotypic analyses. These observations suggest that long term immunological reconstitution may be achieved solely by peripheral engraftment of mature lymphocytes. A review of the literature reveals that this mechanism of immunological reconstitution may not be uncommon following histocompatible bone marrow transplantation for treatment of SCID. PMID- 3539421 TI - A simple technique for detecting the antigen of Heymann nephritis in glomeruli by immunofluorescence. AB - In the past, on routine 2-4 micron renal cortical frozen sections it has been difficult to demonstrate the putative glomerular antigen of Heymann nephritis (HN) by indirect immunofluorescence. We describe, herein, a technique which overcomes this difficulty and can be used to reliably detect glomerular antigen(s). The technique consists of first isolating individual glomeruli by sieving and then preparing a suitable frozen block that contains only glomeruli and no tubules to cut 2-4 micron frozen sections. Using this technique and the putative heterologous and autologous antibodies of HN we have succeeded in showing a clear and convincing reactivity of these antibodies with the glomerular antigen(s) by indirect immunofluorescence. In addition the results obtained provide at least a partial explanation for the puzzling discrepancy observed by many investigators of the findings of either no or poor reactivity of these antibodies to normal glomeruli on rat kidney sections in vitro and their readily demonstrable glomerular localization in vivo upon intravenous injection to normal rats. This technique may also prove useful in detecting reactivity of antibodies to other glomerular antigens that are difficult to demonstrate on routine frozen sections of kidney. PMID- 3539422 TI - B cells in patients with X-linked and 'common variable' hypogammaglobulinaemia. AB - E- cells from three patients with X-linked and three patients with non-familial 'common variable' hypogammaglobulinaemia were stained by indirect immunofluorescence with a panel of B cell specific monoclonal antibodies (anti Bp95, Bp35 and Bp135). The number of B cells detected with the pan-B cell antibodies was variable between patients. One patient in each group was found to have near normal numbers of circulating B cells although those of the X-linked patient were clearly immature. PMID- 3539424 TI - Characterization of a major antigenic component of Aspergillus fumigatus. AB - A component of Aspergillus fumigatus, Ag 7, previously identified as a major antigen for patients with allergic bronchopulmonary aspergillosis, has been isolated by gel filtration and further purified by affinity chromatography using monospecific antiserum. The antigen, which binds both specific IgG and IgE antibodies, was shown to be a high molecular weight, 150-200 kD, heat-stable glycoprotein, which binds to concanavalin A, suggesting the presence of alpha-D mannopyrannoside, or alpha-D glucopyrannoside end residues. On sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) it had a subunit of molecular weight 36 kD (with or without prior reduction), which retained antigenicity and allergenicity when tested with patients' sera. PMID- 3539423 TI - Clinical significance of a new autoantibody against a human eye muscle soluble antigen, detected by immunofluorescence. AB - The clinical significance of a circulating autoantibody against a recently identified soluble human eye muscle-derived antigen was studied in patients with Graves' ophthalmopathy and autoimmune thyroid disorders. Tests were positive in 73% of patients with Graves' ophthalmopathy, including six of seven with no associated thyroid disease (euthyroid Graves' disease). Tests were also positive in 27% of patients with hyperthyroidism but no clinically apparent eye disease, in 13% of patients with Hashimoto's thyroiditis without eye disease, in two of 12 patients with subacute thyroiditis, in one of 20 patients with nonimmunological thyroid disorders but in none of 39 normal subjects. There were significant positive correlations between serum levels of the antibody (expressed as a titre) and the severity of the eye muscle component quantified as an index as well as the duration of the eye disease. Antibodies were detected in three of five patients with only lid lag and state who subsequently developed active ophthalmopathy, in six of nine patients who developed eye disease after treatment of their hyperthyroidism and in one of eight first degree relatives of patients with Graves' ophthalmopathy. In addition three of the 12 patients with autoimmune thyroid disease without apparent eye involvement, but positive antibody tests, have developed ophthalmopathy since the time of testing. These findings suggest that tests for antibodies against a soluble human eye muscle antigen may be useful clinically as a diagnostic test and to predict the onset of eye disease in predisposed patients and subjects. PMID- 3539426 TI - Stimulation of circulating autoantibody levels in the rat with established progressive passive Heymann nephritis. AB - Rats with established progressive passive Heymann nephritis (PPHN) were stimulated with tubular nephritogenic antigen derived from rat kidney fraction 3 (rKF3) or heterologous antibody to the eKF3 antigen. Rats stimulated with antigen had elevated levels of circulating autoantibody and increased amounts of rat IgG in a beaded pattern around the glomerular capillaries. The brush border (BB) region of the proximal convoluted tubules also stained for rat IgG. Rats stimulated with antibody had similar changes, but in addition the injected antibody was demonstrated in the glomerular deposits and in the BB region of the proximal convoluted tubules. Proteinuria was markedly increased in the antibody injected rats. This study indicates that the cells of the 'primed' immune system of rats with PPHN can be stimulated by 'additional' rKF3 antigen or antibody to it, to produce increased levels of circulating autoantibody. It is suggested that the progression of PPHN is dependent on the availability and access of the nephritogenic autoantigen to the immune system and that autoantigen may be released by autoantibody. PMID- 3539425 TI - Monoclonal autoantibodies in Heymann nephritis. AB - We have developed hybridoma cell lines, each of which secretes a monoclonal antibody (MoAb) to rat renal and hepatic tissue antigens, from Lewis rat with Heymann's nephritis. Three antibodies bind to the brush border of proximal tubular epithelium (BB), one in a fine net-like pattern (no. 3-11), another one in a coarse granular pattern (no. 1-8) and the third one in a typical pattern (no. 3-9). Three antibodies bind to glomerulus in characteristic patterns but not to BB. After repeated intravenous injections of MoAb (no. 3-11), granular mesangial deposits of rat IgG were observed and of MoAb (no. 1-8), fine granular deposition along capillary walls. These monoclonal autoantibodies should be of value in research on the mechanism of autoimmune membranous nephropathy. PMID- 3539427 TI - Rat bovine serum albumin (BSA) nephritis. VI. The influence of chemically altered antigen. AB - Bovine serum albumin (BSA) used to incite chronic serum sickness glomerulonephritis in rats was chemically modified to study the effect of antigenic alteration. The BSA was used in its native form (n-BSA) as well as anionic (a-BSA), cationic (c-BSA) or glycosylated (g-BSA) forms. Spontaneously hypertensive rats (SHR) preimmunized 8 weeks earlier received daily intravenous injections of the respective BSA preparations for the ensuing 3 weeks. Histological examination of their kidneys revealed that c-BSA given for 2 weeks induced a severe diffuse proliferative glomerulonephritis and profound proteinuria. Electron-dense deposits localized preferentially in the subepithelial spaces of renal glomeruli from these rats, but a few in the mesangia. Quite differently, rats receiving n-BSA or g-BSA developed a less severe form of glomerulonephritis even after 3 weeks of injections. Besides the massive mesangial deposits, the subepithelial deposits were conspicuous in the glomeruli from rats given g-BSA for 2 weeks, but deposition in glomerular capillaries was rare in rats given n-BSA for the same duration. In contrast, the administration of a-BSA resulted in minimal abnormalities visible by light microscopy and a few immune deposits in the mesangia even at the third week. The antibody response in rats given c-BSA or a-BSA was apparently different from n BSA treated rats. The present study shows the important role of the antigen's electric charge in the pathogenesis of proliferative glomerulonephritis. The foregoing results also foster our proposal that the carbohydrate content of the antigen influences the development of this renal disease. PMID- 3539428 TI - Immunohistochemical detection of the terminal C5b-9 complement complex in children with glomerular diseases. AB - Kidney biopsies were obtained in 28 children with glomerular diseases and studied using indirect immunofluorescence and immunoperoxidase for IgG, IgA, IgM, C1q, C3c, C4, fibrinogen and the neoantigens of the terminal C5b-9 complement complex. C5b-9 deposits were detected in glomeruli of 14, in tubules of eight and in vessels of 12 cases. Patients with C5b-9 deposits fared worse than those without such deposits, even with the same histopathological type of glomerulonephritis. The C5b-9 complex suggests an in situ complement activation. PMID- 3539429 TI - Assay dependent specificities of monoclonal antibodies to bacterial antigens. AB - Six rat monoclonal antibodies, all of the IgG2b class, were generated from rats immunized with the 35A3 (Inaba) and NIH-41 (Ogawa) strain of Vibrio cholerae and selected by enzyme-linked immunosorbent assay (ELISA) on the whole organisms. When the fine specificity was dissected by several different immunological assays, the antibodies could be divided into three groups, each with a different specificity profile. Two antibodies were totally specific to the Ogawa serotype on all assays, three had a preference for Inaba but could be shown to display assay dependent cross reactions of variable intensity with Ogawa. The sixth showed total specificity for Ogawa on some assay systems, apparent total specificity for Inaba on others, and variable reaction with both serotypes on yet other assay systems. The data emphasize that it is possible to produce antibodies which do not conform to the conventional serological classification of antigens and that specificity is highly dependent on method of assessment. PMID- 3539430 TI - Effect of acute administration of prazosin on blood pressure, heart rate and plasma renin level in the conscious normotensive rat. AB - This study investigated whether the specific alpha-antagonist, prazosin, stimulated basal plasma renin levels and heart rate. Furthermore the beta adrenergic nervous system was also investigated to ascertain whether it was involved in this effect. Prazosin (0.1 or 1 mg/kg) was injected subcutaneously (s.c.) to conscious normotensive rats, either alone or in combination with the beta-adrenoceptor antagonist, DL-propranolol (1 or 3 mg/kg). Rats bore chronically implanted dorsal aorta cannula for measurement of blood pressure and heart rate and blood sampling for renin determinations. Acute administration of prazosin (1 mg/kg, s.c.) produced a fall in mean arterial pressure accompanied by renin release and tachycardia. A tenfold lower dose of prazosin did not alter blood pressure or heart rate but did stimulate renin release. Acute administration of DL-propranolol, (1 or 3 mg/kg, s.c.) produced falls in blood pressure and heart rate but did not affect plasma renin level. Combinations of prazosin with propranolol gave falls in blood pressure similar to those predicted on the basis of a simple addition of the effects of the two drugs given separately. Prazosin-induced tachycardia and renin release were attenuated by propranolol. It appears that prazosin produces renin release and tachycardia via stimulation of the beta-adrenergic adrenoceptor. PMID- 3539431 TI - The effects of immunosuppression and anticoagulation on fibrin deposition and swelling in rat cardiac allografts. AB - Rat cardiac allograft recipients were injected with radiolabeled human fibrinogen at intervals after transplantation. There was a progressive increase in tracer accumulation within graft ventricles, peaking at the time of rejection at about 30-fold that within syngeneic grafts. Protein extraction experiments indicated that ca. 90% of tracer was present as cross-linked fibrin at the time of rejection. Exudation within rejecting allografts was nearly threefold that in syngeneic grafts. The weight of allografts at different times after transplantation increased in close concordance with fibrin deposition. Pharmacologically immunosuppressed recipients showed negligible fibrin deposition and swelling whereas "B" rats and thoracic-duct-lymph-drained recipients showed moderate allograft swelling in the absence of significant fibrin deposition or rejection. The decreased fibrin deposition was not a result of depressed plasma clotting factor levels. B rats reconstituted with thoracic duct lymphocytes still had reduced allograft fibrin deposition in the presence of normal amounts of swelling and exudation. The anticoagulants warfarin and heparin greatly decreased allograft fibrin but were almost without effect on allograft swelling, exudation, and rejection. The possible participation of infiltrating macrophages in allograft fibrin deposition is discussed. Unlike cutaneous delayed hypersensitivity reactions, normal amounts of fibrin deposition appear not to be essential for full cardiac allograft rejection. PMID- 3539432 TI - Cellular immunity in patients with systemic juvenile rheumatoid arthritis. AB - We studied the cellular immune responses in 10 patients with systemic form of juvenile rheumatoid arthritis. The numbers of peripheral T lymphocytes and their helper/inducer and cytotoxic/suppressor subpopulation were within normal levels. Activated T lymphocytes (DR+) were slightly increased but not at statistically significant levels. In contrast to the T cells, B lymphocytes were increased; both the percentage of B cells (B1+) and the number of cells spontaneously secreting IgG, IgA, and IgM were increased. Stimulation of peripheral mononuclear cells in vitro with pokeweed mitogen induced poor plaque-forming cell responses, which were partially improved upon removal of monocytes. The presence of concanavalin A in the cultures led to complete suppression. We conclude that patients with systemic JRA are characterized primarily by B-cell rather than T cell abnormalities. PMID- 3539433 TI - Cytokines and fibrosis. AB - Inflammation is frequently associated with changes in the surrounding connective tissue. Inflammatory mononuclear cells (MNC) produce biologically active molecules, cytokines (CK), which may regulate the growth and function of connective tissue fibroblasts. In this article, we review the characteristics of lymphocyte and monocyte CK which appear to be involved in regulating fibroblast recruitment, proliferation, and matrix synthesis. Whereas these MNC products are important in normal physiologic wound healing, an imbalance of these CK may lead to pathophysiologic fibrosis and/or destruction of connective tissue components. Clinical states associated with MNC-mediated connective tissue pathology include scleroderma, rheumatoid arthritis, diffuse pulmonary idiopathic fibrosis, sarcoidosis and atherosclerosis. Characterization of the molecular pathways linking inflammatory mononuclear cells and fibrosis may provide avenues for therapeutic intervention. PMID- 3539434 TI - Laminin production by murine melanoma cells: possible involvement in cell motility. AB - Three lines of B16 melanoma cells (B16-F1, B16-F10 and B16-BL6) were examined for motility in the micropore filter assay and for synthesis in culture of the basal lamina glycoprotein laminin. All three lines synthesized laminin as judged by the incorporation of [35S]methionine into immunoreactive laminin and secreted (or shed) laminin into the culture medium as indicated by biosynthetic labeling studies and enzyme-linked immunosorbent assays. Immunoreactive laminin was also seen on the surface of the cells as indicated by immunofluorescence staining and by complement-mediated killing. Analysis of [35S]methionine-labeled laminin immunoprecipitates by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) both with and without reduction of intersubunit disulfide bonds revealed that all three cell lines produced a similar array of laminin forms, and that the Mr = 950 kD laminin molecule (but not the uncombined subunits) was secreted into the culture medium. Laminin biosynthesis appeared to be limited by the availability of the Mr = 400 kD A subunit as shown by the intracellular accumulation of excess B subunit in the form of uncombined B subunit (Mr = 200 kD) and as a disulfide-linked B dimer (Mr = 400 kD). The motility of all three cell lines was stimulated four- to five-fold by the addition of either exogenous laminin from the EHS sarcoma or culture medium from the B16 cells containing the secreted laminin. The stimulated motility was inhibited by antilaminin serum. These observations suggest that the laminin synthesized by the B16 melanoma cells themselves may facilitate their motility. PMID- 3539435 TI - Biomechanics of small bone fixation. AB - When the correct techniques are used, fixation with plates and screws is biomechanically the strongest fixation available for small bone (hand) fractures. With appropriate preoperative planning and surgical application, plate and screw fixation is rigid enough to withstand the stresses of early use. It is therefore a useful and reliable technique when early motion is desired after open reduction and internal fixation of small bone fractures. PMID- 3539436 TI - Scaphoid nonunion treated with the Matti-Russe technique. Long-term results. AB - Forty-three patients with scaphoid pseudarthrosis were surgically treated using the Matti-Russe technique. Twenty-seven patients were examined seven to 17 years after surgery (mean, 12 years). The interval between trauma and operation of the pseudarthrosis was 40 months. Before operation, all patients were unable to do any work because of pain. Fracture healing was observed in 22 cases (81%). Radiocarpal osteoarthrosis was present in 18 cases, compared with eight before operation. Radial deviation and extension was impaired, and pronation and supination was unaffected, compared with the healthy side. Twenty-four patients were satisfied with the operative result and none felt worse. All patients but one could return to work. The Matti-Russe method proved satisfactory in 24 of 43 patients available for long-term follow-up evaluation. PMID- 3539437 TI - The Classic. Contribution to conservative surgery of the injured hand. By Dr. A. Lambotte. 1928. PMID- 3539438 TI - Renal allograft rejection. Unusual scintigraphic findings. AB - During sequential renal imagining for evaluation of clinically suspected rejection, focal areas of functioning renal tissue were seen in two cases of renal transplant in the midst of severe and irreversible renal allograft rejection. A probable explanation for this histopathologically confirmed and previously unreported finding is discussed. PMID- 3539439 TI - Evaluation of technetium-99m DTPA for localization of site of acute upper gastrointestinal bleeding. AB - Intravenous Tc-99m DTPA was evaluated in 34 patients with active upper gastrointestinal bleeding. Active bleeding was detected in 25 patients: nine in the stomach, 12 in the duodenum, and four from esophageal varices. No active bleeding was seen in nine patients (two gastric ulcers and seven duodenal ulcers). Results were correlated with endoscopic and/or surgical findings. All completely correlated except: 1) one case of esophageal varices in which there was disagreement on the site, 2) three cases of duodenal ulcers that were not bleeding on endoscopy but showed mild oozing on delayed images and 3) one case of gastric ulcer, in which no bleeding was detected in the Tc-99m DTPA study, but was found to be bleeding at surgery 24 hours later. The Tc-99m DTPA study is a reliable method for localization of upper gastrointestinal bleeding with an agreement ratio of 85%. This method also can be used safely for follow-up of patients with intermittent bleeding. It is less invasive than endoscopy, is easily repeatable, and has the same accuracy. PMID- 3539440 TI - Biography of Sidney Goldring, M.D. PMID- 3539441 TI - Neurosurgery as a research discipline. PMID- 3539442 TI - Brain biopsy for encephalitis. AB - Brain biopsy is justified in patients suspected of having encephalitis or viral encephalopathy because those patients are most likely to be helped if a diagnosis is made rapidly and with the greatest certainty possible. Neurosurgeons are occasionally reluctant to undertake brain biopsy because the procedure is diagnostic rather than therapeutic in intent. However, using currently available techniques a 1 cm3 sample of brain tissue can be taken with very low risk of morbidity or mortality. We recommend that the sample be taken from the anterior portion of the inferior temporal gyrus on the more affected side in patients with herpes simplex encephalitis, and from an area of maximum demonstrated involvement in other situations, using stereotactic techniques and intraoperative ultrasound as necessary. The risk to the operating surgeon and to the other members of the operating team appears very low in all of the situations discussed in this chapter. However, the authors feel that every patient should be approached as if he carries the hepatitis B virus. As indicated, the incidence of contracting hepatitis B after sustaining needle stick exposure to blood from persons positive for hepatitis B surface antigen is 10-15%. Conjunctival contamination by splash from the wound is a known method of inoculation of surgeons with hepatitis B virus and is a possible means for transmission of other viral diseases. We recommend that every patient be approached as if he has hepatitis B, not because the agent diseases discussed are known to be as infectious as hepatitis B, but because constant vigilance and careful technique offer the best protection to the surgeon and the members of the operating team in most situations, and because one can never be certain what agent diseases a given patient may harbor. With the exception of the Creutzfeldt-Jakob virus, the agents responsible for all of the viral diseases discussed are inactivated by standard procedures for sterilization of operating room instruments. Procedures necessary to inactivate the Creutzfeldt Jakob disease virus have been presented. In the report documenting transmission of Creutzfeldt-Jakob disease through human growth hormone preparations the authors state, "We are once again dramatically reminded that human tissues are a source of infectious disease, and that any therapeutic transfer of tissue from one person to another carries an unavoidable risk of transferring the infection.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539443 TI - Antibiotic prophylaxis in neurosurgery. PMID- 3539444 TI - Steroid receptors and endometrial cancer. AB - Like breast carcinomas, endometrial carcinomas are derived from sex steroid target tissue. Progress and research directed into the clinicopathologic relationship of steroid receptors and endometrial carcinomas have been hampered by many factors, including: limited numbers of patients with advanced-stage disease compared to the number with breast carcinoma; contamination of specimens with surrounding benign endometrial components which may contribute to total steroid binding; and amount of tissue required for standard biochemical assays. Nevertheless, several clinicopathological associations have been made for steroid receptor content of endometrial carcinomas. Receptor content appears to correlate with histological differentiation in that well-differentiated lesions have higher mean levels of receptor and more receptor 'positive' lesions than do poorly differentiated lesions. Furthermore, receptor levels and status appear to correlate with prognosis of primary endometrial carcinomas and response to hormonal therapy of advanced endometrial carcinoma. Newer techniques utilizing monoclonal antibodies to directly localize receptor in tissue specimens may lead to a greater understanding of the dynamics of receptor physiology in endometrial carcinomas, and may make possible more accurate predictions of clinical behavior by allowing the direct analysis of the receptor content of the malignant component within a tissue specimen. PMID- 3539445 TI - Labor and delivery in the patient with structural cardiac disease. AB - The clinical management of labor and delivery in patients with serious structural cardiac defects is challenging. In this article, peripartum pathophysiology is discussed and management recommendations based on recent clinical data are presented. PMID- 3539446 TI - The obstetric patient and disseminated intravascular coagulation. AB - Disseminated intravascular coagulation remains a major problem for the practicing obstetrician. The various etiologies, the pathophysiology, and suggested therapeutic regimens are reviewed. PMID- 3539447 TI - Thromboembolic disease in pregnancy. AB - Suspicion of DVT or thromboembolism is critical to early diagnosis and treatment prior to development of severe or life-threatening pathology. Because the consequences of treatment are long-term inconvenience and risk of major complications, objective studies are necessary to confirm the diagnosis. Radiographic procedures such as angiography and lung scanning provide valuable information with low risk to mother and fetus. However, if the clinical situation is strongly suggestive, treatment with intravenous heparin can be immediately initiated followed by definitive diagnosis. When indicated, anticoagulation can be instituted with relative safety, providing there is careful monitoring. Heparin is unquestionably the drug of choice for treatment and prophylaxis during pregnancy. Because warfarin carries a significant risk to the fetus of anomalies and hemorrhage, its use during pregnancy should be reserved for those circumstances in which the benefits of such therapy outweigh the risks. Finally, awareness of the signs and symptoms of thromboembolism, as well as expeditious treatment, remain the mainstays for prevention of maternal and attendant fetal mortality. PMID- 3539448 TI - Septic shock in obstetrics. AB - Septic shock in the obstetric population remains an uncommon yet potentially lethal complication of infection. Effective therapy mandates early recognition and aggressive intervention. Although numerous similarities exist in comparison to the nonobstetric patient, differences in potential pathogens and alterations in physiologic parameters should be kept in mind. In addition, the antepartum subject carries with her another potentially viable human being who deserves consideration. Optimal therapy should be directed at reestablishing an effective intravascular volume, maintaining adequate oxygen delivery to peripheral and central tissues, and the initiation of appropriate broad-spectrum antimicrobial agents to eradicate the causative pathogens. PMID- 3539449 TI - Hemorrhagic shock in obstetrics. AB - Hemorrhage during pregnancy is life threatening to both the mother and her fetus. Physiologic preparation for blood loss at parturition does take place but the wise clinician also prepares for this eventuality. The usual causes of hemorrhage are discussed in this article, as well as a useful clinical approach to priorities in the management steps for obstetric hemorrhage shock are also presented. PMID- 3539450 TI - Principles of invasive hemodynamic monitoring. AB - The development of the flow-directed pulmonary artery catheter in the early 1970s moved invasive monitoring from the laboratory to the patient's bedside. Its current use in obstetrics is directed toward definition of certain pathophysiologic states unique to pregnancy and toward diagnosis and management of critically ill or potentially critically ill patients. PMID- 3539451 TI - Hemodynamic monitoring in severe pregnancy-induced hypertension. AB - This article considers the conceptual basis underlying acute hemodynamic management in severe preeclampsia, and the potential usefulness of pulmonary artery (Swan-Ganz) catheterization in this management. PMID- 3539452 TI - Amniotic fluid embolism. AB - A critical review of animal and human data leads to a reassessment of traditional concepts of amniotic fluid embolism. Left ventricular failure, rather than pulmonary hypertension, is the major hemodynamic derangement consistently seen in humans. The detection of squamous cells in the pulmonary artery blood of pregnant women is not pathognomonic for amniotic fluid embolism. PMID- 3539453 TI - Etiology and management of acute fatty liver of pregnancy. AB - Acute fatty liver of pregnancy (AFLP) remains a problem for which there is no discernible cause. Therefore, a precise definition awaits the discovery or elucidation of its exact etiology. AFLP is best described as acute hepatocellular dysfunction that occurs in pregnancy, generally during the third trimester or the early puerperium. It is characterized histopathologically by changes in the liver consistent with microvesicular fatty infiltration but occurring in a pregnant women with no clearly identifiable etiology. Management tenets include prompt delivery and supportive care of the mother. PMID- 3539454 TI - The use of colloid osmotic pressure in pregnancy. AB - The intravascular and interstitial colloid osmotic pressure represent two important Starling forces. Pregnancy, betamimetic therapy, preeclampsia, and a variety of other factors can affect these forces. Although controversial, the normalization of colloid osmotic pressure in various disease states may prove beneficial to the patient. PMID- 3539455 TI - Acute management of sickle cell crisis in pregnancy. AB - Vaso-occlusive sickle cell crisis (VSCC) is the most common maternal complication in pregnancies associated with sickle hemoglobinopathies. Maternal and fetal morbidity and mortality secondary to this serious obstetric problem can be reduced significantly with a well-devised therapeutic plan, expert perinatal teams, and careful attention to obstetric and medical detail in a setting of comprehensive tertiary health care. A variety of better medical, obstetric, and neonatal care practices have helped considerably to improve the combined life span for affected mothers and fetuses. In the absence of any effective and safe pharmacologic agent to prevent sickle crisis, our experience suggests that adherence to the described management principles offers the greatest hope to the sickling parturient that her vaso-occlusive crises can be effectively managed for a healthy outcome, both for herself and for her baby. PMID- 3539457 TI - False aneurysm of the femoral artery: computed tomographic and ultrasound appearances. AB - Twenty-five patients presenting with pulsating masses in the groin, 1-10 days after diagnostic arterial catheterisation, were investigated by computed tomography (CT), ultrasound (US) or both. False aneurysm was demonstrated in 10, four by CT alone, three by US alone and three by both CT and US. Both methods allowed rapid accurate and non-invasive diagnosis of this uncommon complication of arterial catheterisation. PMID- 3539456 TI - Evaluation of the indirect immunofluorescence assay as a confirmatory test for detecting antibodies to the human immunodeficiency virus. AB - One hundred and eighty-four serum specimens were assayed for antibodies to the human immunodeficiency virus. All specimens were screened with a commercial enzyme immunoassay and confirmed by two indirect immunofluorescence assays. Sera were also assayed by Western blot. Results from sera of 48 healthy heterosexual volunteers were all negative by EIA, IFA, and Western blot. Sera from 50 healthy homosexual men negative by EIA were also negative by IFA and Western blot. Sixty two patients with persistent generalized lymphadenopathy or newly diagnosed AIDS all were positive by EIA, IFA, and Western blot. Of 24 sera from patients with autoantibodies, with no evidence of AIDS-related diseases, five appeared to be false-positive by EIA, since they were nonreactive by IFA and Western blot. In addition, three other samples contained both autoantibodies and human immunodeficiency virus antibodies. False-positive results were observed in both the EIA and IFA with monoclonal antibodies directed toward the MHC class II antigens DQ and DR. The reactivity of these antibodies could not be distinguished from positive patients' sera, in either EIA or IFA. We conclude that in general indirect immunofluorescence performed well as a confirmatory test after screening by enzyme immunoassay for human immunodeficiency virus antibodies. PMID- 3539458 TI - Insulin action and dynamics modelled in patients taking the anabolic steroid methandienone (Dianabol). AB - Plasma glucose and insulin concentrations were measured during oral (OGTT) and intravenous (IVGTT) glucose tolerance tests in nine patients off- and on treatment with the anabolic steroid, methandienone (Dianabol). On-treatment, the tolerance tests showed a markedly increased insulin response accompanied by impairment of glucose tolerance, characteristics normally attributed to insulin resistance. However, fasting plasma glucose (FPG) and insulin (FPI) concentrations were significantly reduced, whereas the pattern normally associated with insulin resistance is for both to be raised. IVGTT glucose and insulin profiles were analysed using an algorithm derived from the minimal models of glucose and insulin dynamics originally proposed by R. Bergman and co-workers. Measures for the following parameters were thus obtained: Si, the sensitivity of glucose disposal to insulin; Sg, net insulin independent glucose disposal; phi 1, the integral concentration of insulin delivered during the first phase of insulin secretion relative to the initial increase in glucose concentration above a model derived threshold; phi 2, the sensitivity of the rate of rise of insulin concentration in the second phase of insulin secretion to the concentration of glucose above a model-derived threshold; kappa, the fractional clearance rate of insulin; and tau 1/2, the insulin half-life. S1 was significantly reduced on treatment by a factor of 4. Sg, phi 1, phi 2 and tau 1/2 were all significantly increased, and kappa was significantly reduced. The increases in Sg and phi 1 both showed significant correlations with the increase in weight on-treatment. The reduction in FPG and FPI can be explained by the combined effects of the increase in Sg and Dianabol-induced resistance to glucagon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539460 TI - Tumors of the brain. PMID- 3539459 TI - Prostacyclin in the circulation of patients with vascular disorders undergoing surgery. AB - The object of this study was to investigate clinical conditions in which increased production of prostacyclin (PGI2) has been reported. 6-Oxo prostaglandin F1 alpha (6-oxo-PGF1 alpha) is the stable hydrolysis product of PGI2 and was measured in plasma from patients undergoing hepatic or cardiac surgery and in unoperated patients with vascular and hepatic disease, using gas chromatography/mass spectrometry. Blood obtained simultaneously from portal and peripheral veins, during emergency surgery for bleeding oesophageal varices in six patients with cirrhosis of the liver, contained very high concentrations of 6 oxo-PGF1 alpha (range 99-11,485 pg/ml of plasma). 6-Oxo-PGF1 alpha was higher in portal than in peripheral blood in five out of six patients. Six unoperated patients with cirrhosis and oesophageal varices which were not bleeding all had normal peripheral plasma concentrations of 6-oxo-PGF1 alpha less than 2 pg/ml (normal up to 5 pg/ml). Seventeen patients with severe vascular disease had normal basal plasma 6-oxo-PGF1 alpha concentrations (less than 2 pg/ml). Eighteen subjects with atheromatous coronary artery disease underwent aorta-coronary artery grafting, and plasma concentrations of 6-oxo-PGF1 alpha were markedly elevated during surgery (range 55-1207 pg/ml). We conclude that surgery stimulates PGI2 production substantially, and argue that the function of PGI2 may be to limit intravascular extension of thrombus from sites of haemostasis. Inappropriate PGI2 synthesis may contribute to the massive haemorrhage characteristic of oesophageal variceal bleeding. PMID- 3539461 TI - Electromagnetic techniques in hyperthermia. PMID- 3539462 TI - Effects of physical exercise on insulin absorption in insulin-dependent diabetics. A comparison between human and porcine insulin. AB - Nine insulin-dependent diabetics with undetectable plasma C-peptide (less than 0.05 nmol l-1) and without insulin antibodies (insulin binding to IgG less than 0.05 Ul-1) received subcutaneous injections of 10 U 125I-labelled soluble human or porcine insulin in the thigh on 2 consecutive days. Disappearance rates of 125I were monitored continuously by external counting and plasma insulin levels were determined during rest for 30 min, bicycle exercise of moderate intensity for 40 min, and 60 min recovery. Subcutaneous blood flow was measured concomitantly in the contralateral thigh by the 133Xenon clearance technique. During the initial period of rest human insulin was absorbed approximately 40% faster than its porcine analogue (first order rate constants 0.37 +/- 0.06 vs 0.27 +/- 0.06% min-1, P less than 0.05) and the increment of the area under the plasma insulin curve was greater after human than after porcine insulin (184 +/- 46 vs 112 +/- 42 mUl-1 min, P less than 0.05). Exercise enhanced the absorption rates for both 125I-insulins to 0.50 +/- 0.06 and 0.48 +/- 0.10% min-1 for human and porcine insulin, respectively (P less than 0.05). This increase was less pronounced for human compared to porcine insulin (49 +/- 19 vs 105 +/- 40%, P = 0.06). During exercise plasma insulin rose to 37 +/- 5 mUl-1 after human and 30 +/- 5 mUl-1 after porcine insulin and the areas under the plasma insulin curves were similar. During the recovery phase the absorption rates decreased slightly compared to the exercise value for both insulins. The blood glucose lowering effect was similar for the two insulins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539464 TI - Mechanisms of insulin resistance in cancer associated malnutrition. AB - This study has evaluated insulin resistance under steady-state conditions using the glucose clamp technique. Euglycaemic clamp investigations were conducted at 4 5 different insulin levels (70-1600 mUl-1) in five malnourished cancer patients, four well-nourished Intensive Care Unit patients (ICU) and 11 well-nourished individuals. Whole body uptake of glucose was measured. In three cancer patients the flux of glucose across the leg was measured. Cancer patients had significantly reduced fasting insulin concentrations, while ICU patients had increased levels compared to controls. The fasting levels of glucose did not differ among the groups. Both insulin sensitivity and responsiveness were reduced by 50% in cancer and ICU patients. At insulin levels of 200-250 mUl-1, approximately 80% of the whole body glucose uptake could be accounted for by the peripheral tissues. This study confirms that insulin resistance is a significant metabolic alteration in cancer associated malnutrition. The results demonstrate both decreased insulin sensitivity and responsiveness. PMID- 3539465 TI - Determination of 99mTc-DTPA clearance by a single plasma sample method. AB - To derive a formula for determination of 99mTc-DTPA clearance (Cl) from the radioactivity in a single plasma sample, the relation Cl = ECV/t was used, where ECV is the extracellular volume and t is the mean transit time of the tracer in the organism. By studying 99mTc-DTPA time activity curves of 45 consecutive patients we found that ECV could be estimated from the body surface area, and that t could be calculated from the radioactivity in a single plasma sample. Cl calculated by the single sample method was almost identical to Cl calculated by a standard multiple sample method (r = 0.987). It is concluded that the single sample method is accurate and that it may prove useful as a routine method provided that the method is not used in patients with 99mTc-DTPA clearance less than 30 ml min-1, since this investigation includes only patients with Cl greater than 30 ml min-1; the method is not used for children, since the test material did not contain any children; the method is only used for plasma samples drawn at 180 less than or equal to t less than or equal to 300 min. PMID- 3539463 TI - Effect of muscular exercise on plasma C-peptide and insulin in obese non diabetics and diabetics, type II. AB - The levels of plasma insulin and C-peptide during exercise and subsequent recovery have been determined in obese non-diabetics, obese diabetics Type II and middle-aged female controls. It has been found that exercise reduces levels of peptides both in the control and in the obese non-diabetic group. This effect of acute exercise was found blunted in the obese diabetic group. Non-diabetic obese subjects pretreated with phentolamine showed no reduction either in plasma insulin or C-peptide levels during exercise. During the recovery, the level of plasma insulin returned promptly to the pre-exercise value in the control group but increased above the resting value in obese subjects, both non-diabetic and diabetic. In controls and non-diabetic obese the increment of C-peptide: insulin molar ratio occurred early after the onset of exercise and then returned to the resting value despite the exercise being continued. The plasma C-peptide:insulin molar ratios were reduced during the first 15 min of recovery period in obese non diabetic subjects and returned to normal in the next 15 min. The latter may suggest that reduced insulin removal could also contribute to the increase in plasma insulin values in the obese during recovery. PMID- 3539466 TI - [Multicenter study on the therapeutic activity of buflomedil chlorhydrate in obliterative arteriopathies of the legs]. PMID- 3539467 TI - [Validity and effectiveness of a pre-constituted captopril-hydrochlorothiazide combination in a single daily dose]. PMID- 3539468 TI - [Treatment of alcoholic hepatic steatosis with metadoxine. Preliminary results on the evaluation of the effects of the drug by an ultrasonographic study]. PMID- 3539469 TI - [Current concepts of insulin therapy]. PMID- 3539471 TI - Smoking cessation: a practical guide for the physician. AB - Physicians play critical roles in efforts to encourage nonsmoking, both in their individual interventions with smokers and in their contributions to broader political, educational, and public health efforts to encourage nonsmoking. These broader efforts, much aided by the authority and concern of individual physicians and organized medicine will continue, also, to provide a supportive background for individual clinical efforts. Together, the broad based and the clinical activity potentiate each other in decreasing the prevalence of smoking. The difficulties individuals experience in quitting smoking are best understood when placed within the context of the billion dollar marketing of an addictive product; the reality that quitting smoking occurs gradually over time, many smokers attempting to quit several times before succeeding; and the influence of physicians' continuing clinical and community activity in maintaining a culture actively cognizant of the risks of smoking. Through brief clinical counseling as outlined in this article, physicians can help almost all of their smoking patients move toward becoming a nonsmoker by trying to quit or, at least, giving greater thought to doing so. Additionally, the physician can help patients eager to quit by referral to well developed programs and materials such as have been described. In all, then, numerous effective resources are available for the clinician who wishes to deal responsibly with the most important preventable cause of morbidity and mortality in the approximately 30 per cent of patients who smoke. PMID- 3539472 TI - Respiratory muscle function. AB - The functional anatomy of the respiratory muscles has been reviewed. The diaphragm has been emphasized, since this is the most important inspiratory muscle, but the view has been presented that the intercostal, scaleni, and other accessory inspiratory muscles become increasingly important as airflow obstruction leads to hyperinflation. As work increases, the demand for energy and hence blood flow to those muscles has to increase. In spite of a large reserve there are situations in which demands may outstrip supply. This leads to local metabolic changes that result in muscle fatigue. We are now capable of detecting this change as alterations in EMG or in the ability to generate pressures. The latter leads to a decrease in the capacity of the respiratory pump to exchange gas, ultimately resulting in hypercapnia and hypoxemia. The true importance of respiratory muscle fatigue and its differentiation from weakness in patients with severe CAO requires more analysis. It is intuitively appropriate to address the overall decrement in the ability to maintain adequate ventilatory work at low energy cost with the different therapeutic modalities thought to be beneficial. A combination of a decrease in the load imposed on the respiratory muscles, an improvement in the contractility of those muscles, and, when there is absolute need, the resting of the fatigued muscles should result in a better chance to lead a meaningful life and perhaps to improve survival in these patients. PMID- 3539470 TI - Pulmonary rehabilitation: myth or reality? AB - Pulmonary rehabilitation is an art of medical practice incorporating many therapeutic modalities with the goal of improving the patient's functional ability. The gains to be realized and the basis for improvement following pulmonary rehabilitation are detailed in this article. PMID- 3539473 TI - Exercise in chronic obstructive pulmonary disease. AB - Several important differences exist between the training responses in normal patients and those in patients with chronic obstructive pulmonary disease (COPD). Chief among these is the lack of cardiovascular and metabolic changes in patients with COPD. Despite this, important and significant improvements do occur in exercise endurance after exercise training programs. Experience has shown that simple forms of exercise training and testing are effective and safe. PMID- 3539474 TI - Pulmonary rehabilitation--physical modalities. AB - This review assesses the role of controlled breathing techniques (breathing training) and chest physical therapy (PT) in the management and rehabilitation of patients with chronic obstructive pulmonary disease (COPD). The review focuses on pursed lip breathing, the head-down and bending forward postures, slow deep breathing, and diaphragmatic breathing exercises as methods of breathing training, and on postural drainage, chest percussion and vibration, and controlled cough as techniques of chest PT. These modalities may be beneficial in selected patients with COPD. PMID- 3539475 TI - Psychosocial issues in chronic obstructive pulmonary disease. AB - Chronic illnesses such as COPD require both comprehensive evaluations and multisystem treatment approaches with integration of biological, behavioral, psychological, and social systems. People function as biopsychosocial units, with complex interplay between themselves and their environments determining the degree of their illness. Illness, as distinct from disease, is a person's subjective response to the state of disease or organ pathology. Recognition and identification of the psychosocial components of a person's illness allows for far more effective therapeutic intervention. Treatment objectives include better acceptance of life changes and the development of new attitudes and goals through an increase in self-confidence and control over emotional, physical, and respiratory functioning. These rehabilitation goals can be fulfilled by the use of supportive therapies (individual, family, or marital and group) and educational behavioral techniques based upon a solid working alliance with the patient. PMID- 3539477 TI - Rehabilitation and home care for ventilator-assisted individuals. AB - An increasing number of patients with chronic irreversible respiratory disorders are receiving mechanical ventilation in the home. Rehabilitation prior to hospital discharge allows improved independence and mobility in the home for these individuals. PMID- 3539476 TI - Nutritional aspects of chronic obstructive pulmonary disease. AB - Nutritional status is an important factor in certain patients with chronic obstructive pulmonary disease (COPD). This article reviews the prevalence and effects of weight loss as well as potential strategies for nutritional repletion in COPD. PMID- 3539478 TI - Quality control in microbiology: a review and bibliography. AB - Quality control in microbiology, with the proliferation and widespread usage of commercial identification systems, has largely passed into the hands of the manufacturer. In this review the author attempts to provide a spectrum of information concerning the validity, precision, and specificity of commercially available systems and individual methods for the identification of bacteria, of various types of yeasts, and of bacterial antigens, as well as a review of blood culture systems. PMID- 3539479 TI - Quality control in hematology. AB - A quality control (QC) protocol for hematology, as for other sections of the laboratory, should encompass both internal and external QC programs. The extent to which a hematology laboratory should be involved depends upon various factors, including availability of facilities, financial resources, range of tests, workload, the number of staff and their levels of training, and the overall organization of the laboratory. To ensure quality patient care, the intralaboratory QC program must include at least the minimal measures of monitoring and control at each step from collection of blood specimens, through the actual processing and analysis, to reporting of the results. The protocol should be written concisely and in simple language; the procedure manual should offer all of the pertinent information along with references; all concerned personnel should be well trained and competent; and adequate facilities and time should be available for the purpose of QC. Continuing education is also an integral part of an effective QC program. Three very important aspects of QC in hematology are calibration of automated instruments, monitoring of accuracy and precision of instruments and procedures, and verifying the reliability of test results. In the absence of a true primary reference/standard for calibration of instruments for the CBC, the most commonly performed hematologic test, the use of commercial calibrators is acceptable. A combination of commercial controls (three levels) and retained or fresh patient blood specimens is recommended for monitoring of accuracy and precision on a long- and short-term basis. Patient red cell indices moving average data allow continuous monitoring of instrument performance and should be used as an adjunct to other QC approaches to detecting instrument calibration drift. Correlation of results of related parameters and careful review of blood films remain the two most important and widely used approaches to ensure reliability of results obtained from automated hematology instruments. Participation in an external QC program offers the most practical means of monitoring overall work performance in comparison with instrument, method, and/or reagent-based peer group data. A laboratory may choose to participate in one or more national and/or regional QC programs, depending upon the range of tests it performs and the requirements of accreditation and regulatory agencies. Most of the accreditation agencies require participation in programs covering at least all of the routinely or frequently performed tests and, if available, also in those for infrequently performed tests.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539480 TI - Quality control in the blood bank. AB - In discussing quality assurance in the blood bank, where many of the standard statistical techniques of measuring accuracy simply do not apply, three questions come to mind: How much? How often? Who says? Because of severe changes in the prospective payment plan and a new interest in cost effectiveness, many transfusion services are re-examining blood banking methodologies and their relative usefulness in promoting patient well-being. Many serologists are beginning to say that "less is better." This concern for simplification and reduction of workload is reflected in the quality control. PMID- 3539481 TI - Quality assurance in anatomic pathology. AB - Comprehensive quality assurance in anatomic pathology must address several levels of laboratory operation: procedural/technical issues, the quality of the diagnostic report, and the medical consultative role of the pathologist. Procedural/technical quality control in anatomic pathology differs very little from that practiced in the various sections of clinical pathology. Assessment of the quality of the final report is a major responsibility of the pathologist who renders the diagnosis. Guidelines that systematically address such issues as specimen handling and the content of the diagnostic report are effective in promoting consistency, completeness, and the clinical relevance of the information provided. Quality assessment of the pathologist's consultative role is more difficult to define and implement. However, systematic evaluation and correlative review of all available diagnostic information, appropriate use of consultation and case review, and participation in continuing education and self assessment activities all may contribute to and help document the quality of services provided. It is important to emphasize the value of flexibility in designing a comprehensive quality assurance program for anatomic pathology. Departments differ markedly in characteristics such as staff size, subspecialty interests, teaching commitments, and volume and type of case material. Nevertheless, the general principles of written organization, systematic monitoring, and documentation of adherence to the program should be followed. Just as the design of the program may benefit from flexibility, the laboratory should be prepared to modify its quality control and assurance techniques and implement corrective measures should surveillance identify problems such as frequent typographic errors, inadequate diagnostic information, or deterioration in correlation between frozen section and final diagnoses. The ultimate objective of all of these efforts is to provide the referring physician with an accurate, clinically relevant diagnostic report, thereby enhancing the pathologist's role as a valued medical consultant. PMID- 3539482 TI - Quality control in cytopathology. AB - Quality control in cytopathology involves specimen collection, preparation, screening, and final diagnosis. The measures to assure the optimal performance and to detect the malfunctions in these areas are discussed. Careful selection and application of proper procedures, proper training and continuing education of cytotechnologists and pathologists, and reasonable workload for screening cytotechnologists and important factors in quality assurance. PMID- 3539483 TI - Use of patient data for quality control. AB - This article discusses how specific patient data algorithms can be used and optimized for laboratory quality control. These algorithms include delta checks, patient averages, and multivariate checks. With the increasing emphasis on cost containment, the intelligent use of these algorithms should become widespread. PMID- 3539485 TI - Controlling the cost of quality control. AB - In the present era of expanding technology coexisting with economic constraint, appropriate quality control criteria to monitor laboratory performance must take into consideration not only analytic precision and medical utility, but also cost effectiveness. In this review, the effect of existing criteria on the clinical laboratory, the regulator, and the vendor is explored. Factors that contribute to excessive quality control cost are delineated. Strategies for developing a cost effective quality control program are proposed. PMID- 3539484 TI - Computer-assisted quality control: considerations for program design. AB - A well-designed laboratory computer system has the potential of enhancing all phases of quality control. Of most importance is the choice of an underlying approach that is statistically valid and robust. Specification of quality goals, participation in regional programs, and use of a flexible multi-rule approach are recommended. Careful attention to general and specific design is necessary to achieve full system potential. The design process must include detailed consideration of file and record structure, data integrity, flexibility of input and output, and display and report formats. For statistical run evaluation, theoretic validity, operational process, and ease of understanding by the user must be considered. PMID- 3539486 TI - Documentation of safe work practices in the clinical laboratory. AB - The safety manual supplemented by explicit safety statements in the laboratory procedure manual should specify the hazards and containment methods for personnel. Control of fire hazards, biohazards, and chemical hazards are specifically addressed along with waste management and radionuclide consideration. Suggestions for incorporation of safety training into the laboratory's continuing education program are provided. PMID- 3539487 TI - Quality control in the office laboratory. AB - Assuring quality of testing is as important in the doctor's office laboratory as it is in the hospital and independent laboratory. However, the office laboratory's problems and needs are different from those of the larger lab, and the professional laboratorian's solutions are not always appropriate for the office laboratory. It is necessary to recognize that the education and skill levels of the office laboratory staff preclude some of the quality control methods used in professionally staffed laboratories. For some test systems, new control methods will need to be developed. The professional laboratorian can provide valuable assistance to the doctor's office laboratory in assuring quality. PMID- 3539489 TI - Word recognition in early reading: a review of the direct and indirect access hypotheses. PMID- 3539488 TI - The onset of literacy: liminal remarks. PMID- 3539490 TI - Comparison of dental information obtained from self-examination and clinical examination. AB - The validity of self-examination information regarding the number and distribution of remaining teeth, the presence of dentures and the validity of molar support construed professionally from the self-examination data was assessed from 93 persons. This was done by comparing self-examination information with data from clinical and radiographical examinations. Agreement between self examination and clinical examination was found to be fairly good regarding the number of remaining teeth and the presence of removable dentures. Regarding the distribution of remaining teeth there was an average of 2.1 misdiagnosed teeth per person. In conclusion, self-examination method makes possible the collection of accurate data for screening and planning purposes in assessing oral health status regarding the number of remaining teeth and presence of removable dentures. PMID- 3539491 TI - [Action of immunostimulants on phagocytosis and derivative actions]. AB - One of the main objectives of immunopotentiators is their ability to enhance or to restore natural anti-infectious resistance of normal or immunocompromised hosts. Numerous experimental resistance models have been used in screening such potentiators. However, once such a substance has been selected, its potential and practical use will directly depend on the knowledge of the underlying resistance mechanisms induced, defining its cellular or molecular targets. Phagocytosis polymorphonuclear or monocyte-macrophage dependent--is the most frequently described variable which have been analysed among the various potentially active mechanisms of non-specific resistance. Various in vivo and in vitro tests might be used and the target of several immunostimulants among the different steps of phagocytosis are described. However, numerous intrinsic limitations are associated with such tests and news models or tests are presented and discussed in order to gain more insights into the evaluation of active substances. PMID- 3539492 TI - Effects of immunopotentiating agents on alveolar macrophage properties. AB - Infectious respiratory diseases in man and in domestic animals are characterized by the presence of a large number of different microorganisms: viruses, bacterias, mycoplasmas. It is therefore necessary to stimulate non-specific defense mechanisms in the lung and especially alveolar macrophages (AM). These cells, located in the alveolar air-spaces, play a major role in the lung clearance mechanisms and exert antibacterial, antiviral and antitumoral activities. Activation of alveolar macrophages was studied in vitro with lipopolysaccharide (LPS), lymphokines or mycobacterial derivatives (MDP). Rodent alveolar macrophages were rendered cytotoxic by in vitro exposure to LPS, free MDP or liposome-encapsulated MDP derivatives. In vivo, intravenously administered liposomes containing lipophilic MDP derivatives induced cytotoxic alveolar macrophages and protected mice against the development of pulmonary metastases. PMID- 3539493 TI - Blood transfusions as an immunomodulator--a review. AB - Blood transfusions have been shown for two decades to prolong allograft survival. The mechanism is complex, involving both T lymphocytes and macrophages. In the last five years, transfusion induced immunosuppression has been shown to increase the rate of tumor growth and to increase susceptibility to infectious complications. Prevention of this immunosuppression may be possible by the concomitant use of immunomodulators which inhibit suppressor T lymphocyte function or block prostaglandin E production. A second potential but as yet unproven method is by use of frozen washed red blood cells when transfusions are required. PMID- 3539494 TI - Immunomodulatory effect of serum on lymphocytes--consequences for the study of immunostimulants in vitro and in vivo. AB - The immunoregulatory effect of serum or plasma on the functions of body cells is often overlooked. Plasma is the natural environment for the cells of the immune system for at least a part of their life span and is the supplier of nutrients and regulatory molecules to the lymphoid tissues harboring immunocompetent cells. The plasma or serum immunoregulatory factors affect both in vivo and in vitro testing of immunostimulants. The serum immunoregulatory factors may be grouped into supporting factors, augmenting (co-mitogenic) factors, mitogenic factors, and suppressive factors. Some of them develop physiologically and appear or disappear during ontogeny, aging, pregnancy and other physiologic changes, others appear in connection with various diseases. The augmenting and mitogenic factors are mostly poorly defined. The natural and disease-induced immunosuppressive factors are a heterogeneous family of molecules ranging from immunoglobulins, through alphaglobulins and lipoproteins up to unidentified molecules of molecular weights from less than 6000 daltons to over 200,000 daltons. Proteins or polypeptides seem to play an important role in natural immunosuppressive factors, polysaccharides in disease-induced immunosuppressive factors. The presence of immunomodulatory plasma or serum factors affects the evaluation of immunostimulants in both in vivo and in vitro testing. All the cells, serum or plasma of experimental animals or donors should be pre-tested and carefully selected when immunostimulants are tested. PMID- 3539495 TI - Protection tests against parasitic diseases. AB - The development of parasite immunology during the last decade has been highly beneficial to our understanding of immune processes against parasites, and recent research has been devoted to the target antigens of effector mechanisms, especially those localized on the surfaces of the pathogens. In this context, define antigenic structures have been identified, which induced significant degree of protection. In malaria, circumsporozoite and merozoite proteins, with large repetitive sequences, have been isolated from various species of Plasmodium and cloned. Monoclonal antibodies produced against these antigens inhibited the invasion of host cells by living parasites. Some results have also been obtained in protective immunity against Leishmania and Toxoplasma. In schistosomiasis, the main characteristic of defence processes is the narrow association between cellular and humoral immunity in antibody-dependent cell-mediated cytotoxic mechanisms. Eosinophils, macrophages, and platelets efficiently killed schistosome larvae when activated by specific antibody of anaphylactic classes, especially IgE. Some of the target antigens have been characterized and cloned. The transfer to normal animals of monoclonal antibodies, and, in one case, of an anti-idiotype antibody, has induced a significant protection against challenge infestations. Optimistic perspectives can therefore be opened concerning an efficacious immunoprophylaxis of an increasing number of parasitic diseases. An adequate conjunction between potentially protective antigens and selective immunomodulators and adjuvants should lead to vaccination. Such an aim nowadays appears as more than a hope. PMID- 3539496 TI - Immunostimulation by TP-5 in immunocompromised patients and animals--current status of investigation. AB - TP-5 is a pentapeptide containing active site of the thymic hormone, thymopoietin. It has been shown to exert effects on multiple components of human and animal immune system both in vivo and in vitro. Initial studies demonstrated it to be necessary for T lymphocyte maturation. Its effects on other parts of the immune system are primarily immunostimulatory, and the drug can be used to correct immunodeficiencies resulting from several causes. TP-5 has been shown to improve survival rates in multiple animal studies where the animal has been rendered immunodeficient prior to septic challenge. It has also been successful in preventing and treating infections in a number of human studies. Evaluation of the exact mechanism by which the drug improves survival has demonstrated that it is of complex nature, involving interactions between various types of white blood cells. PMID- 3539497 TI - [What can one expect of immunostimulants in the clinical setting?]. AB - There exist many potential clinical indications of immunostimulants. Experimental models have elicited great hopes that have not always been confirmed by the preliminary clinical trials, too often performed with minor products. One may hope that new agents under study will allow to extend the use of immunostimulants in immunodeficiency diseases, infections, autoimmune diseases, atopy and cancers. PMID- 3539498 TI - Immunostimulants: clinical evaluation in non-cancer patients. AB - Immunostimulants have large potentialities but their clinical evaluation and development are still in infancy. The appropriate time to start clinical studies is not always easy to determine: when some knowledge is available on the targets of the molecule and on assays demonstrating some immunological effects, but before a full elucidation of the precise mechanism of action. The clinical fields in which an immunomodulator can be analyzed are very large: immunodeficiencies, infectious diseases, auto-immune conditions, allergic diseases etc., provided that there is a target cell able to respond to the compound. Well-controlled, double-blind investigations are necessary, using objective clinical criteria and precise laboratory tests. Adverse effects, including bone marrow lesions or auto immune manifestations, should be carefully looked for. The presently described strategy will probably be modified with progresses in this new discipline. A precise methodology for clinical evaluation will hopefully contribute to the development of more and more potent immunomodulators with a clearly defined activity in human diseases. PMID- 3539499 TI - From experimental to clinical attempts in immunorestoration with bestatin and zinc. AB - Severe impairment of the lymphopoietic cell renewal system is an important etiological factor of cancer development and it may be the consequence of massive radio and/or chemotherapeutic regimens. In a comparative study, we analysed the potential, systemic immunorestoratory capacity of bestatin, a microbial leucil aminopeptidase inhibitor and of the ubiquitous trace element zinc. In vivo administration of bestatin in mice stimulated both Interleukin 1 and Interleukin 2 production, and enhanced T cell, B cell as well as macrophage mediated immunoreactions. In a phase II clinical trial on 41 patients with non-Hodgkin lymphoma, Hodgkin disease and solid tumors, bestatin treatment corrected the pathological frequency of both OKT4 and OKT8 lymphocyte subpopulations. Zinc saturated transferrin had a significative stimulatory effect on the ongoing DNA synthesis of antigen activated human lymphocytes in culture. Oral administration of zinc-gluconate to patients who manifested a severe T cell subpopulation defect corrected preferentially the OKT8 suppressor/cytotoxic T cell unbalances. The clinical results obtained by both bestatin and zinc were observed only on a short term, so further studies are needed to elaborate long lasting regiments and to establish whether these treatments have determinant influence on the underlying disease. PMID- 3539500 TI - [Tumor stem cells and implications for the immunotherapy of cancer]. AB - Passive, active and adoptive immunotherapy of human cancers and leukemias raise a renewed interest strengthened by the availability of purified biological substances such as IL2, interferon, thymic hormones and by some recent favourable therapeutic results which have demonstrated the possibility of obtaining objective tumor regressions by immunotherapy. Analysis of results of chemotherapy shows that only 8 human cancers and malignant hemopathies are curable at an advanced diffuse stage of disease. These cancers are characterized by the rarity or absence of late metastases (more than 3-4 years after initial diagnosis). Cure may be considered as complete with a high probability if disease free status is maintained for 3 years. This finding suggests the absence of tumor stem cells capable to produce late metastases. Other cancers are not chemocurable at an advanced systemic stage. In most of them late metastases (greater than 4 years after diagnosis) are observed. A model of organization of malignant tumors based on the distinction between primitive tumor stem cells which are rarely or exceptionally in cycle and protected by a specific microenvironment and committed tumor stem cells is proposed. According to this model, only cancers and/or metastases and malignant hemopathies containing but committed tumor stem cells would be chemocurable. Analysis of a trial of adjuvant therapy of breast cancer with poly A: poly U shows the possibility of immunotherapy to prevent the development of late metastases, independently of hormonal status in contrast with standard adjuvant chemotherapy which is only active on early micrometastases in premenopausal women.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539501 TI - Hormonal effects on gluconeogenesis from (U-14C)glutamate in rainbow trout (Salmo gairdneri). AB - Blood glucose was significantly decreased by insulin (4 I.U./kg). Glucagon (1 mg/kg) and Cortisol (5 mg/kg) administration produced a significant hyperglycaemia. Insulin administration did not modify liver glycogen levels. Glucagon showed a marked liver glycogen mobilization. Cortisol stimulated liver glycogen deposition. Insulin and Glucagon showed a significant inverse effect on gluconeogenesis from (U-14C)glutamate, decreasing and increasing 14C-glucose formation respectively. Hormonal treatments did not influence the very low levels of incorporation of (U-14C)glutamate into liver and muscle glycogen. PMID- 3539502 TI - Heme synthetase in Trypanosoma cruzi. AB - Heme-synthetase (Heme-S) has been studied in the epimastigote form of T. cruzi (Tulahuen and Y strains). The enzyme is confined to the "mitochondrial" fraction (sedimented at 30,000 g). Activity was dependent on protein and time of cell storage. Enzymic proto- and meso-heme formation was inhibited up to 40 and 72% respectively by Triton X-100. The optimum pH was 7.2 for protoheme and 7.5 for mesoheme formation. Heme-S reached its maximum when the concentration values were 37; 35 and 32 microM for proto-, meso-, and deuteroporphyrin, respectively. The activity is several times higher when mesoporphyrin is used as substrate. At a final conc of 100 microM Fe2+ and Zn2+ ions enhanced activity 200-400%. Cu2+ and Co2+ had no effect, while Mn2+ and Mg2+ were highly inhibitory. A combination of Fe2+ and Zn2+ at varying concentrations still showed great activation. However, at a fixed level of Fe2+, Cu2+ was changed into a strong inhibitor. We propose that, if it can be demonstrated that T. cruzi cannot multiply when protoheme is replaced by mesoheme, administration of mesoporphyrin would then greatly affect replication of T. cruzi. Furthermore, the addition of certain metals, such as Cu2+ to T. cruzi cultures might specifically inhibit the parasite enzyme opening the possibility of selectively destroying the hemoflagellate without affecting the host. PMID- 3539503 TI - Appraisal of computerized medical histories: comparisons between computerized and conventional records. AB - Automated patient histories in internal medicine have been compared with written medical records by investigating the diagnostic statements that were generated for both types of records by three internists. Also the intra and interobserver variability was evaluated. In addition, the opinion of the internists about the usability of the different records was investigated. To have a fair comparison, the written record was transcribed to a computerized form and also offered to the internists. Each internist evaluated in total 72 records (from 18 patients) and altogether 529 diagnostic hypotheses were generated. The intraobserver agreement was for the written record 55%, for the automated history 46% and for the transcribed record 38%. Interobserver agreement was 23.5%, the agreement between the automated patient history and the written record was 24%, between the former and the transcribed record it was 36%. PMID- 3539504 TI - Computerized history taking for training medical students. AB - A lesson on computerized patient history-taking is described of a block-course in medical informatics, offered to medical students during their clinical training. The lesson stresses the importance of careful observation during the patient interview and the storage of original data without human interpretation. The lesson has been evaluated during 1 academic year and errors in different categories of medical data were determined: data exactly given by the patient, data hidden in the interview, and data not given by the patient. Mean errors in these types of data appeared to be 21, 47, and 58%, respectively. PMID- 3539505 TI - Hybrid digital subtraction angiography: initial clinical experience. AB - Hybrid digital subtraction angiography was performed after modification of a DSA system. Alternate high voltage (110-120 kV) and low voltage (65-70 kV) were obtained within short time intervals of 60-70 ms with a high voltage switching generator. Experimental phantom studies revealed the exposure dose per single image of hybrid subtraction was approximately 30% of that of conventional DSA. The SNR of hybrid subtraction was improved by increasing the exposure dose and application of postprocessing programs. Clinical application of intraarterial and intravenous DSA revealed that soft tissue artifacts were removed surprisingly well, but image quality decreased because of lowered SNR. Frame integration and matched filtering improved image quality of hybrid subtraction. PMID- 3539506 TI - Magnetic resonance imaging of an orbital varix with CT and ultrasound correlation. AB - A case of orbital varix demonstrated with computed tomography, ultrasound, and magnetic resonance imaging is reported. The clinical and radiographic findings are discussed. PMID- 3539507 TI - Obstructive jaundice secondary to multiple myeloma--a case report. AB - Reported is a patient who presented with clinical obstructive jaundice caused by multiple myeloma involving the pancreatic head. This is a rare complication and a review of the literature showed only three similar reported cases. PMID- 3539508 TI - Randomized comparison of different prostaglandin analogues and laminaria tent for preoperative cervical dilatation. World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction: Task Force on Prostaglandins for Fertility Regulation. AB - In an eleven-centre study, 627 nulliparous subjects in the 8th to 12th week of gestation admitted for termination of pregnancy were allocated to one of five treatments to induce pre-operative cervical dilatation. The treatments were: 0.5 mg PGE2 methyl sulphonylamide; 1.0 mg PGE1 methyl ester; 30 mg 9-methylene PGE2 free acid, 0.5 mg 15-methyl PGF2 alpha; a single medium-sized laminaria tent. The results indicate that the three PGE analogues are at least equally effective as one medium sized laminaria tent and more effective than 0.5 mg 15-methyl PGF2 alpha in producing adequate pre-operative cervical dilatation prior to vacuum aspiration. It is concluded that both pre-treatment with prostaglandin analogues and laminaria tent are effective methods for preoperative cervical dilatation and both types of treatment are associated with a low incidence of side effects. Prostaglandin analogue treatment can be administered by paramedical personnel but laminaria tent insertion has to be performed by medical staff. PMID- 3539509 TI - The analysis of vaginal bleeding patterns induced by fertility regulating methods. World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction. AB - Contraceptive methods often induce disturbances in vaginal bleeding patterns which are the main reason for women to discontinue method use. Knowledge of these changes is essential for effective counselling and product development and necessitates adequate methods of collection and analysis of vaginal bleeding data. These issues were reviewed by clinicians, medical statisticians and computer analysts during several consultations organized by the World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction and their discussions are summarized in this paper. Recommendations are made on the use of menstrual diary cards for data collection. It is suggested that the analysis of menstrual patterns be based on the reference period method developed by Rodriguez et al. in 1976 to which several modifications in terminology and choice of summary statistics are proposed. While these are presented as the minimum required for the comparability of studies, other points of analysis are identified which need further study, in an attempt to stimulate research in this field by other investigators. PMID- 3539510 TI - A pharmacokinetic and pharmacodynamic study of a 'visiting pill' containing norethisterone. AB - The pharmacokinetics and pharmacodynamic effects of two doses of norethisterone (5mg and 3mg) used as a 'visiting pill' were investigated. There were no significant differences in the pharmacokinetics of the two doses except for the peak concentration achieved and the bioavailability as assessed by the area under the serum norethisterone concentration - time curve. Both doses were rapidly absorbed. Pharmacodynamic effects were minor. No change occurred in serum concentrations of total cholesterol, total triglycerides or HDL-cholesterol. The area under the serum glucose concentration--time curve and particularly the area under the serum insulin concentration--time curve were significantly increased as a result of treatment but no change occurred in the serum levels of glycosylated haemoglobin. SHBG concentrations in serum decreased on treatment whereas those of ceruloplasmin increased. PMID- 3539511 TI - Effects of captopril and bradykinin on arterial pressure in rats with mestranol induced hypertension. AB - Hypertension was produced in 20 female rats by the oral administration of mestranol for 6 months; 20 control rats were not given mestranol during this time. The i.v. infusion of the angiotensin converting enzyme inhibitor, captopril, into 10 conscious mestranol-treated rats reduced mean arterial pressure from 139 +/- 2 (SEM) to 130 +/- 2 mm Hg (P less than 0.01); mean arterial pressure in 10 conscious control rats averaged 123 +/- 3 mm Hg, and was not significantly changed during captopril infusion. Injections of bradykinin at 0.1, 0.3, and 1.0 microgram/100 gm body weight decreased mean arterial pressure significantly more in 10 mestranol-treated rats than in 10 control rats. These results suggest that the ability of captopril to lower arterial pressure in rats with mestranol-induced hypertension may be due, at least in part, to the action of captopril to enhance bradykinin. PMID- 3539512 TI - Cocaine applications in otorhinolaryngologic anesthesia. AB - Cocaine applied by knowledgeable otolaryngologists is an excellent topical anesthetic agent. For procedures of the upper respiratory tract, it is unrivaled by the synthetic anesthetics. It possesses a short latency, an adequate duration of action, and a valuable inherent vasoconstrictive capability. To prevent accidental injection of cocaine solutions, we recommend that the solutions be colored by the pharmacy. Our recommended total dose for most adult procedures is 200 to 300 mg of cocaine. In the uncommon case in which this amount may be inadequate, injections of lidocaine with dilute epinephrine can be used to supplement the cocaine. To prevent overdosing, we recommend starting with a known amount, recording the amount given, and not exceeding this total dose. Familiarity with the pharmacology of cocaine is essential for its safe application in otolaryngology. PMID- 3539513 TI - Considerations for managing the airway in the ENT patient. AB - Anesthesiologists may encounter particularly challenging airway management problems and anesthetic requirements for any surgical procedure. However, this is frequently the case with ENT surgery and its patient population. Sharing the airway with the surgeon requires a special understanding of the procedure to be undertaken, clear communication, and cooperation. Basic knowledge concerning the airway anatomy and physiology is essential. Special ENT procedures require special skills. Anesthesiologists may be required to secure an airway in an unconventional manner in these patients, as well as use special ventilation methodology and challenging anesthesia techniques. PMID- 3539514 TI - Catecholamine anesthetic interaction in ENT surgery. AB - There are many crucial facets of catecholamine-volatile anesthetic interactions of which the anesthesiologist must be aware. Although still basically an excellent guideline, the recommendations originally forwarded by Katz and Katz cannot completely guide clinical actions. Many modifiers are now present, the knowledge of which will allow the anesthesiologist to provide optimum surgical conditions while still assuring maximum patient safety; the latter of which is our primary charge in the operating room. PMID- 3539515 TI - Upper airway obstruction: diagnosis and management options. PMID- 3539516 TI - Special pediatric airway problems. PMID- 3539517 TI - Some aspects of experimental heart transplantation. AB - In 144 experiments carried out on dogs, the possibility was proved to use for the recipient's protection during transplantation either deep immersion hypothermia or total artificial circulation without it being filled with the donor's blood. In order to maintain cardiac activity after clinical death of a non-heparinized organism for the purpose of later heart transplantation the authors propose to use the direct mechanical cardiac massage (DMCM) which makes possible not only to restore adequate pulsating blood flow in the dead body but also to assess after restoration of the heart's pump function the suitability of using it for transplantation. Functional adaptation of a transplanted heart proceeds in 3 stages: pronounced heart failure (5-15 min), functional heart failure (4-6 hours), stabilization of cardiac activity (2-3 days). Implantation of a second heart in experimental left ventricular failure of the recipient helped to achieve an effective and prolonged reduction of excessive functional overload of the affected heart. PMID- 3539518 TI - Leukocyte-poor blood. AB - The conventional techniques used to prepare leukocyte-poor red cell concentrates are described. These techniques conveniently group by their primary processing modalities which are centrifugation, freeze thawing, cell washing, and filtration. Each of these procedures has unique logistical requirements. The complexity, need of dedicated capital equipment, and stringent quality assurance requirements make the use of some of these techniques impractical for the hospital blood bank laboratory. The majority of patients benefit from the receipt of leukocyte-poor blood products prepared by an "in-line" microaggregate filtration technique. Those patients with symptoms which prove to be refractory to microaggregate-filtered blood products and those who require highly purified red cell concentrates to forestall sensitization to transplantation antigens should receive blood prepared either by the cryopreservation/deglycerolization technique or by cotton wool filtration. PMID- 3539519 TI - The computer in the blood bank. AB - This article will review the historical use of the computer in the blood bank and will show some examples of its current use today. A discussion will be included of the major areas in the blood bank where a computer would be particularly valuable and also of areas where it would be contraindicated. A few examples of the use in various institutions will be cited. Discussion of telecommunications as a possible method of inventory leveling and inventory control between blood banks will be included. PMID- 3539521 TI - Methods and application of bone densitometry in clinical diagnosis. AB - With the awareness of osteoporosis as a major health problem for an aging population, there is great interest in early recognition and treatment of abnormal bone loss. Effective prevention of bone loss has to occur prior to the occurrence of irreparable damage. Standard radiographic procedures are not sensitive enough for the task. Therefore, a number of alternative procedures to estimate bone loss have been developed over the years, ranging from efforts to quantitate information obtained from radiographic images to sophisticated procedures such as neutron activation analysis or procedures based on the Compton scatter phenomenon. Only two procedures, photon absorptiometry and computed tomography (CT), have emerged as applicable for routine clinical use. In photon absorptiometry the entire bone mineral (cortical and trabecular bone) of a specific skeletal site is measured. CT allows measuring of bone mineral of trabecular or cortical bone alone. Normally, bone mass reaches a maximum in the third decade and then continuously declines. This age-related bone loss is greater in women in whom an accelerated rate of loss occurs at the menopause. When bone density reaches a critical fracture threshold, skeletal fractures occur (spine, hip, and distal long bones). The age at which this critical fracture threshold is reached depends on the maximal bone mass achieved in early adulthood and the rate of loss with increasing age. With the exception of NaF, present-day therapeutic efforts only retard or prevent bone loss but do not significantly add bone mineral to the skeleton. Recognition of high-risk groups and early treatment are therefore required. Absorptiometry, and probably in the future CT, also permit the measuring of bone mineral at sites of fracture with sufficient accuracy and precision to allow an early detection of lower than normal (for age and sex) bone mass, estimating fracture risk, and monitoring of the rate of bone loss by repeated measurements. An operational diagnosis of osteoporosis based on fracture risk has also been attempted from bone mineral measurements. And last, the effect of a drug regimen used to prevent or decrease bone loss can be monitored with these procedures. PMID- 3539520 TI - Urinary nucleosides in leukemia: laboratory and clinical applications. AB - Urinary nucleosides offer a number of useful laboratory and clinical applications in the study and analysis of leukemia. There are significant differences in the excretion of modified nucleosides between normal individuals and individuals with various forms of leukemia, as well as between leukemia patients at opposite ends of the clinical spectrum, i.e., those with active disease and those in remission. The nucleoside excretion levels correlate to bone marrow tumor burden in certain forms of leukemia, and limited serial data indicate the potential value of the nucleosides for predicting relapse before the disease deterioration can be recognized clinically. In addition, it may be feasible to assess the effectiveness of chemotherapy used in the treatment of leukemia much more rapidly with the urinary nucleoside markers than with conventional invasive methods. PMID- 3539522 TI - Diagnosis of Clostridium difficile-associated intestinal disease. AB - Toxigenic Clostridium difficile is the major cause of antimicrobial agent associated pseudomembranous colitis and is the etiological agent of approximately 30% of cases of nonspecific colitis and diarrhea (without colitis) induced by antimicrobial agents. In addition, C. difficile has been implicated in certain intestinal diseases not related to prior antimicrobial administration. C. difficile has been reported to be one of the most common enteropathogens isolated from stool specimens submitted to hospital laboratories. Thus, diagnosis of C. difficile-associated intestinal disease should now be routinely performed in diagnostic clinical laboratories. The diagnosis of C. difficile-associated intestinal disease relies on the demonstration of either the organism or the toxin(s) in stool specimens or antibody response in serum to the toxin(s). Several selective medium are available for the recovery of C. difficile from stool specimens. The toxin(s) of C. difficile can be demonstrated using a variety of techniques, including biological assays as well as immunological assays. This article will review the techniques currently available to aid in the diagnosis of C. difficile-associated intestinal disease. PMID- 3539523 TI - Titrating positive end-expiratory pressure therapy in patients with early, moderate arterial hypoxemia. AB - A prospective randomized study to compare two physiologic end-points for titrating positive end-expiratory pressure (PEEP) was performed in patients with early, moderate arterial hypoxemia after surgery or trauma. All patients initially received 5 cm H2O of PEEP. In group 1 patients, PEEP was increased only if PaO2 decreased below 65 torr on an inspired oxygen fraction (FIO2) of 0.45. PEEP was then added in 2- to 3-cm H2O increments until PaO2 again was above 65 torr. Group 2 patients were treated with incremental PEEP until the PaO2/FIO2 ratio was greater than 300 or physiologic shunt (Qsp/Qt) was less than 0.20. All therapy other than PEEP was similar in the two groups. There were no statistically significant differences in entry PaO2 (mean 85 +/- 11 [SD] and 87 +/- 11 torr in groups 1 and 2, respectively), and Qsp/Qt was 0.22 in each group. Five (28%) of 18 patients in group 1 and 19 (95%) of 20 patients in group 2 received more than 5 cm H2O of PEEP. Between groups 1 and 2 there were no statistically significant differences in days intubated (3.4 +/- 3 vs. 5.3 +/- 5, respectively), ICU days (5.3 +/- 3 vs. 6.6 +/- 5), hospitalization days (26 +/- 24 vs. 28 +/- 24), incidence of pulmonary barotrauma (0/18 vs. 1/20), ICU mortality (22% vs. 20%), or overall mortality (33% vs. 25%). The number of blood gas analyses and cardiac output measurements, and the total hospital charges were also similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539524 TI - Pulmonary artery catheterization: a prospective study of internal jugular and subclavian approaches. AB - We compared complications of pulmonary artery catheter (PAC) insertion and maintenance at internal jugular (IJ) vs. subclavian (SC) sites. Patients were randomized into groups using an IJ or SC route, and insertions were timed. An air permeable dressing and anticontamination shield were used. Catheters were removed 72 h after insertion. If PAC monitoring was still needed, a new catheter was either inserted over a guidewire at the initial insertion site or inserted at a new site. On removal, the catheter tip, introducer-sheath tip, and catheter within the shield were submitted for semiquantitative culture. Sixty-six catheters were initially inserted, and 26 were changed. No determinative differences in the time for venous cannulation were found, but the IJ route was slightly faster. In 3% of the catheterizations, serious complications arose. The infection rate was 2% for initial catheters, 8% for second catheters placed over a guidewire, and 15% for second catheters placed at a new site. These differences were not consequential. No local infection or catheter-related sepsis occurred. Thus, using a standard, sterile-insertion technique and a catheter-maintenance protocol yielded a low risk of insertion and infectious complications at either the IJ or SC site. Our data indicated that PACs can be changed safely over a guidewire at 72 h, avoiding further insertion risks without increasing infectious complications. PMID- 3539525 TI - Does compliance reflect oxygen delivery in porcine septic respiratory failure treated with positive end-expiratory pressure? AB - Oxygen delivery (DO2) in patients with acute respiratory failure has been correlated with total lung and chest wall compliance (CT), the optimal positive end-expiratory pressure (PEEP) level reportedly corresponds to maximal DO2. To test the validity of the relationship, we studied the correlation between CT and DO2 in 12 septic pigs with acute respiratory failure induced by continuous infusion of live Pseudomonas aeruginosa bacteria. Cardiac output, pulmonary and systemic arterial BP, blood gases, extravascular lung water, tidal volume, and airway pressure were measured serially in six control animals and six animals receiving increasing amounts of PEEP. There was no significant correlation between DO2 and CT in either group; however, animals receiving PEEP had less extravascular lung water. PMID- 3539526 TI - Fellowship programs in critical care medicine: 1987-88. PMID- 3539527 TI - Confirming the null hypothesis. PMID- 3539529 TI - A review of basic concepts in rice-drying research. AB - Rice-drying research is international, diffuse, important, and deceptively difficult. This review presents current thinking, background, entrance citations to the literature, and critical analysis for each of the most significant problems in rice-drying research, as well as an overview summary and general recommendations. Discussion is limited to mechanical drying with hot air. The literature examples are divided into four groups by research approach: within kernel experimental, small-sample experimental, theoretical, and dryer design. While all areas have contributed and are expected to continue to do so, the small sample experimental approach is cited as appearing to have an untapped potential for bringing about a quantum advance. Problems discussed include: uniformity, fissuring sequence, stress and plastic flow, diffusion mechanisms, temperature and other environmental factors, kernel vs. husk, controlled drying rate, chemical changes, dryer design, timing of harvest, trade-offs, reliability of data, and experimental design or approach. PMID- 3539528 TI - Optimal energy management in grain drying. AB - Grain drying is very specific to the geographic location, kind of drying system, and the type of grain. Under a given set of conditions, the optimal system can be selected based on careful evaluation. However, a good choice of drying systems, procedures, and management practices can be made from the information already available. The review of several grain-drying procedures has provided some insight in making a quick evaluation of the process and arriving at the most suitable system for a particular application. Despite extensive research efforts, the present knowledge of grain drying is yet insufficient to optimally design each drying process with respect to capacity, quality, and energy requirement. There is a need for incorporating grain and air parameters more accurately. It is also important to develop comprehensive drying simulation models to encompass agronomic practices, such as planting and harvesting. Recent efforts indicate a strong influence of planting and harvesting strategies on optimal drying and storage system selection. Results of the varietal trials at Ohio State University indicate that it is now possible to select midseason varieties, which dry down rapidly, without sacrificing yield. Also, low moisture at harvest is important to the energy management process because it affects total drying time and energy required. It is also important from a quality standpoint because kernel damage increases rapidly at harvesting moisture levels above 25%. The trend in grain dryer design has shifted from focusing on drying capacity and operation reliability to energy consumption. The development in design of energy efficient continuous-flow dryers has been significant. Multistage concurrentflow dryers are excellent examples. Various aspects of dryer staging for efficient operation and control are yet to be determined. Recirculation of the exhaust air is a proven method of improving energy efficiency. Likewise, in batch-in-bin systems, stirring and intermittent drying are worth considering. Further research is required to formulate the best procedures for exhaust air recirculation and intermittent drying. Low temperature drying has a great potential in the U.S. corn belt. The suitability of low temperature drying at other places and for grains other than corn has not yet been well established. Energy savings resulting from low temperature drying entail careful planning and management on the part of the operator. Poor design and operation can result in a serious deterioration in grain quality.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539530 TI - Chemistry and technology of green gram (Vigna radiata [L.] Wilczek). AB - Green gram or mung bean (Vigna radiata [L.] Wilczek) is an important food legume grown under tropical and subtropical conditions. It is an excellent source of protein and is almost free from flatulence-causing factors. Because of this, green gram seeds are preferred for feeding babies and those convalescing. The seeds contain a higher proportion of lysine than any other legume seeds. The seeds are processed and consumed as cooked whole beans or splits (dhals), sprouts, immature seeds, and flour and are used in various recipes. The proposed work will incorporate available information on nutritional composition, processing, and utilization of green gram. The results reported in the literature on the above aspects of green gram will be analyzed critically, and future research needs will be defined to improve the utilization of green gram as human food. PMID- 3539531 TI - Prosthetic valve endocarditis. PMID- 3539532 TI - Enzyme-enzyme interactions and the regulation of metabolic reaction pathways. PMID- 3539533 TI - The concept of the intracellular amino acid pool and its relevance in the regulation of protein metabolism, with particular reference to mammalian cells. PMID- 3539534 TI - Control of 5-aminolevulinate synthase in animals. AB - The proposed mechanism by which hepatic ALV-synthase mitochondrial levels are regulated is outlined in Fig. 2. ALV-synthase catalyzes the first and rate limiting step in the heme pathway and is normally present in low amounts. A cytosolic, regulatory free heme pool tightly controls the amount of ALV-synthase in two ways. In the primary mechanism of regulation, heme is proposed to inhibit the synthesis of ALV-synthase mRNA. Most likely this would be mediated through the action of specific heme-binding protein(s) which recognize regulatory control regions of the ALV-synthase gene. Gene activity therefore is significantly repressed most of the time. When there is an increased demand for heme by newly synthesized cellular hemoproteins, the free heme pool is reduced, leading to a derepression of ALV-synthase mRNA synthesis. Once the need for increased heme synthesis is satisfied, inhibitory heme levels build up again. When drugs such as phenobarbital are administered to animals, there is a rapid induction in the liver of both cytochrome P-450 and ALV-synthase. It is proposed that the heme pool governing ALV-synthase levels is lowered by the increased heme demand due to cytochrome P-450 apoprotein formation. The primary event in the drug induction of ALV-synthase is therefore the increased synthesis of cytochrome P-450 apoprotein. However, the mechanism by which this occurs is unknown, although drugs do increase the synthesis of mRNA for cytochrome P-450 (Fig. 2). (There is evidence that for the aromatic hydrocarbons a specific cytosolic receptor exists.) In the acute hepatic porphyria diseases, uncontrolled synthesis of hepatic ALV-synthase occurs. The various forms are characterized by reduced levels of one of the heme pathway enzymes other than ALV-synthase. Attacks of the disease are commonly precipitated by drugs which induce cytochrome P-450, and the uncontrolled accumulation of ALV-synthase which accompanies these attacks results from the combined action of the block in the heme pathway and the increased cytochrome P 450 levels. A major challenge which now exists is to understand at the molecular level how the genes for ALV-synthase and cytochrome P-450 are regulated in the liver and other tissues.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539535 TI - Meprin: a membrane-bound metallo-endopeptidase. PMID- 3539536 TI - Role of the LFA-1 molecule in B cell differentiation. PMID- 3539537 TI - Regulation of c-myc mRNA and protein levels during activation of normal human B cells. PMID- 3539538 TI - Complex regulation of c-myc gene expression in a murine B cell lymphoma. PMID- 3539539 TI - Characterization and nuclear localization of the v- and c-myc proteins. PMID- 3539540 TI - Characterisation of human myc proteins. PMID- 3539541 TI - Plaque-forming cells in man. PMID- 3539542 TI - Ultrasound studies on fetal crown-rump length in early normal and diabetic pregnancy. PMID- 3539543 TI - The development and use of analytical methods for investigation of pathophysiological and immunopathological mechanisms in serum-sickness like reactions during penicillin treatment. PMID- 3539545 TI - Cardiopulmonary manifestations of systemic sclerosis. PMID- 3539544 TI - The long-term results following Billroth II resection for duodenal ulcer. PMID- 3539546 TI - Pulmonary fibrosis following pneumonia due to acute Legionnaires' disease. Clinical, ultrastructural, and immunofluorescent study. AB - During a recent nosocomial outbreak, 20 critically ill patients with acute Legionnaires' disease were admitted to the intensive care unit of Hopital Bichat, Paris. Pulmonary specimens were obtained at surgery or immediately after death in 12 patients and were examined by light, immunofluorescent, and electron microscopy. Five of these 12 patients showed evidence of pulmonary fibrosis. In all of these five patients, infection with Legionella pneumophila was evidenced by bacteriologic methods, and other diseases known to cause fibrosis were excluded. The condition of four patients deteriorated rapidly with respiratory failure, and they died with pulmonary fibrosis. Only one patient finally recovered but was left with pulmonary sequelae. Two distinctive morphologic patterns were observed, one in which interstitial fibrosis was predominant and one in which intra-alveolar organization and fibrosis were also present. The alveolar epithelial lining and the basement membranes were disrupted in all patients, as evidenced by ultrastructural observations and by immunofluorescent studies showing gaps in the distribution of type 4 collagen and laminin. Types 1 and 3 collagen accumulated in areas corresponding to thickened interstitium and intra-alveolar fibrosis. Thus, some patients who survive the acute pneumonia of Legionnaires' disease may develop pulmonary fibrosis, and this process may lead to functional impairment or death despite prompt and appropriate treatment. PMID- 3539547 TI - Leukocyte migration inhibition in methotrexate-induced pneumonitis. Evidence for an immunologic cell-mediated mechanism. AB - Methotrexate-induced pneumonitis is a well-known clinical entity, but the mechanism for the induction of the pulmonary disease is ill defined. In three patients with this disorder, evidence was obtained for elaboration of a lymphokine, leukocyte inhibitory factor (LIF), by peripheral blood lymphocytes after incubation with methotrexate (MTX) in the direct leukocyte migration inhibition test. Control lymphocytes from normal subjects, as well as from patients receiving methotrexate but without pneumonitis, failed to elaborate LIF in the presence of the drug in this test. Along with these results, we obtained bronchoalveolar lavage (BAL) cell data displaying high grade lymphocyte alveolitis with a lymphocyte subset inverted ratio. This production of LIF suggests that pneumonitis associated with methotrexate therapy is also associated with a specific cellular immune response to the drug. PMID- 3539548 TI - [Randomized melanoma study of perfusion of the extremities. Results of treatment 2 1/2 years after premature discontinuation]. AB - To evaluate the effectiveness of regional hyperthermic cytostatic perfusion in patients with malignant melanomas of the extremities 107 patients were included in a prospective randomized study. In a control group (A, n = 54) the tumors were excised widely and the regional lymph nodes were dissected. The patients in the perfusion group (B, n = 53) received additional hyperthermic (42 degrees C) perfusion with Melphalan. We chose the disease-free-survival time as the criterion for success. An intermediate evaluation (mean follow-up observation period of 550 days) revealed a highly significant difference between the groups (p = 0.0001) of 21 resp. 4 recurrences. A second evaluation, 2 1/2 years after prematurely discontinuation, also shows a highly significant difference in favour of perfusion (p = 0.0001). PMID- 3539549 TI - [Surgical therapy of malignant melanoma]. AB - 148 patients with malignant melanoma are presented. Localization, prognosis and clinical stadium are summarized. The surgical procedure is still three dimensional excision. The latitude of defects asks for a specialists surgeon. PMID- 3539550 TI - [Hematoma of the rectal sheath: clinical report of experiences with special reference to ultrasound diagnosis]. AB - Rectus sheath hematomas are rare sequelae of direct or indirect trauma to the abdominal wall, with or without muscle rupture or laceration of epigastric vessels. "Spontaneous" hemorrhage may occur in patients receiving anticoagulant therapy. The diagnosis remains frequently unrecognized prior to ill advised laparotomies performed for suspected abdominal emergencies. Nine patients suffering from rectus sheath hematoma are reported, typical etiological factors, clinical and radiological findings and diagnostic difficulties outlined. Ultrasonography has proven to be the procedure of choice, yielding immediate diagnosis and trend observation. PMID- 3539551 TI - [Value of primary closure of the choledochus]. PMID- 3539552 TI - [Gallbladder torsion]. PMID- 3539553 TI - Characterization of kinetochores in multicentric chromosomes. AB - Long-term cultures of certain rat and mouse cell lines carry several dicentric and some multicentric chromosomes. Using antikinetochore antibodies obtainable from serum of scleroderma (var. CREST) patients we studied the number of kinetochores formed along the length of these chromosomes. The rat cells displayed as many kinetochores as there were centromeres. However, mouse cells showed the synthesis of only one kinetochore in dicentric and multicentric chromosomes which had been in the culture for a period of 1 year or more. When translocations were induced by bleomycin in mouse L cells, the newly formed dicentric chromosomes showed the formation of two kinetochores. It is not known when the accessory centromeres lose their capacity to assemble kinetochore proteins. Possibly, in the rat the 'latent' kinetochore lack a specific component which renders them ineffective for microtubule binding. The reason for the formation of only one kinetochore in mouse multicentric chromosomes is not clear. It may be due to the accumulation of mutations, modification of the kinetochore protein so that it lacks the antibody binding component, or a more effective regulatory gene than in the rat. PMID- 3539555 TI - [Advances in thoracoscopy]. PMID- 3539554 TI - Arrangements of kinetochores in mouse cells during meiosis and spermiogenesis. AB - Antibodies from the serum of patients with the autoimmune disease scleroderma CREST were used to investigate the association and distribution of kinetochores in mouse cells during meiosis and spermiogenesis. The pattern of indirect immunofluorescent staining in pachytene nuclei indicated that each autosomal bivalent contains one fluorescent spot. Throughout pachytene, the kinetochores were arranged non-randomly into several clusters and distributed around the periphery of the nucleus. In subsequent stages of meiotic prophase I, distribution was random and the number of fluorescent spots increased from 21 to 40 corresponding to the diploid chromosome number and the number of halfbivalents oriented to the spindle poles at the metaphase I. Twenty pairs of kinetochores were observed at metaphase II. During spermiogenesis, the number of kinetochores correlated with the haploid chromosome number in early spermatids but tandem association of centromeres and clustering into a conspicuous chromocenter corresponded to a significant reduction in the number of fluorescent foci in mid spermatid nuclei. The number of stained sites per nucleus continued to decrease during sperm maturation and total absence of staining was apparent in mature spermatozoa. Immunoblotting of proteins extracted from mature sperm however, indicated that a kinetochore antigen of Mr 80,000 was still present. Therefore, the absence of kinetochore staining in mature spermatozoa is probably due to the blockage of epitopes during chromatin condensation. PMID- 3539556 TI - The endosonic appearances of normal colon and rectum. AB - With the increasing use of transrectal sonography, accurate preoperative staging of rectal cancer requires correct identification of the normal ultrasonographic appearances of the colon and rectum. Fifteen rectal and colonic specimens have been studied in vitro to define the normal anatomy. Five distinct ultrasonic layers have been identified; a first echogenic layer that corresponds to the mucosa, a second echopoor layer made up of mucosa and muscularis mucosae, a third echogenic layer that is submucosa, a fourth echopoor layer that is muscularis propria, and a fifth echogenic layer made up of serosa and perirectal fat. PMID- 3539557 TI - Conventional vs. triple rubber band ligation for hemorrhoids. A prospective, randomized trial. AB - Two hundred five patients with symptomatic first- and second-degree hemorrhoids were randomized to receive either conventional rubber band ligation or triple rubber band ligation. In conventional rubber band ligation, the hemorrhoids were ligated at one primary site per session at intervals of four weeks until symptoms were relieved or when all three hemorrhoids were ligated. In triple rubber band ligation, all three primary hemorrhoids were ligated in a single session. After completion of treatment, the patients were examined every three months, or earlier if symptoms recurred. Both methods were effective in the treatment of early hemorrhoids and the incidence of postligation pain and complications was similar. The advantages of having the treatment completed at the initial visit in triple rubber band ligation are obvious. Furthermore, less treatment sessions were required for triple rubber band ligation to control symptoms than for conventional rubber band ligation. Triple rubber band ligation is more cost effective and therefore is recommended. PMID- 3539558 TI - Carcinoma of the large intestine and nontraumatic, metastatic, clostridial myonecrosis. AB - Traumatic, clostridial myonecrosis is a rare and serious complication of wounds. Nontraumatic, metastatic, clostridial myonecrosis may be caused by carcinoma of the large intestine. Nontraumatic myonecrosis becomes evident with localized pain, generalized toxicity, local signs of inflammation, and crepitation. Serum creatine kinase determinations may be of help in diagnosing patients suspected of having acute myonecrosis. Immediate heroic surgical intervention, usually with demonstration of Clostridium septicum, is mandatory to control the myonecrosis. Appropriate antibiotic therapy is a valuable adjunct to surgical intervention, and penicillin in massive doses appears to be the agent of choice for the clostridia. Hyperbaric oxygen therapy may help in the optimal control. General supportive measures, including frequent blood transfusions, are most important. To save the life of the patient with nontraumatic, metastatic, clostridial myonecrosis, it is necessary, as soon as the patient's general condition permits, to diagnose and eliminate the cause of the myonecrosis. In addition to the case reported, 16 cases have been reported in the literature, making a total of 17. Five patients have survived (survival rate, 29 percent). PMID- 3539559 TI - Classic articles in colonic and rectal surgery. Arthur Dean Bevan, 1861-1943. Carcinoma of rectum--treatment by local excision. PMID- 3539560 TI - Elemental diet stimulates gallbladder contraction and secretion of cholecystokinin and pancreatic polypeptide in man. AB - This study was undertaken to investigate the effect of ingestion of 80 g Vivonex on gallbladder volume, plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) in eight healthy volunteers and to compare the results with those obtained after ingestion of 60 ml corn oil. Gallbladder volumes were measured by ultrasonography. Plasma CCK was determined by radioimmunoassay using region specific antibodies; antibody 1703 binds to COOH-terminal CCK-peptides containing at least 14 amino acid residues, while antibody T204 binds to COOH-terminal CCK peptides containing the sulfated tyrosine region. Plasma PP was also measured by radioimmunoassay. Ingestion of Vivonex induced significant increases in plasma CCK (0.6 +/- 0.1 to 4.6 +/- 0.6 pM, antibody 1703; 1.8 +/- 0.3 to 5.9 +/- 0.5 pM, antibody (T204; P less than or equal to 0.0005) and decreases in gallbladder volume (21.4 +/- 2.8 to 11.2 +/- 2.3 cm3; P = 0.0001). Integrated plasma CCK secretion and gallbladder contraction after Vivonex were not significantly different from the results found after corn oil. Both Vivonex and corn oil induced small increases in plasma PP. We conclude that Vivonex is a potent stimulus for the secretion of CCK and contraction of the gallbladder. PMID- 3539561 TI - Certain aspects of normal and abnormal motility of sphincter of Oddi. AB - Applications of electromyographic and endoscopic manometric techniques in experimental and clinical studies have enhanced our knowledge of the normal physiology and motility disturbances of the sphincter of Oddi. The sphincter of Oddi has an active role in coordinating the time and rate of secretion of biliopancreatic juice into the duodenum. In the opossum, the sphincter of Oddi exhibits spontaneous contractions that migrate distally along the sphincter and expels its contents into the duodenum. Although the motor activity of the sphincter of Oddi is independent from that of the duodenum, there is a correlation between the frequency of bursts of spike potentials in the sphincter of Oddi and the migrating motor complex phases in the duodenum. Abnormal motility of the sphincter of Oddi has been reported during endoscopic manometric evaluation of patients with choledocholithiasis and sphincter of Oddi dyskinesia. Patients with common bile duct stones have an increase in the frequency of retrograde propagation of phasic waves. Elevation of basal pressure as well as an increase in the frequency and amplitude of sphincter of Oddi phasic waves and the common bile duct-duodenum gradient pressure may occur in patients with sphincter of Oddi dyskinesia. Endoscopic manometric studies of the sphincter of Oddi may become an important method to diagnose sphincter of Oddi dyskinesia. PMID- 3539563 TI - Cytopathology of extramedullary hemopoiesis in effusions and peritoneal washings: a report of three cases with immunohistochemical study. AB - The clinical, cytopathologic, and immunohistochemical features of three cases of extramedullary hemopoiesis are presented. Differentiation of megakaryocytes from malignant cells can be difficult in cytologic material; we believe familiarity with cytologic features of megakaryocytes, along with factor VIII-related antigen immunoreactivity, is helpful in providing an accurate diagnosis. PMID- 3539562 TI - Phlegmonous gastritis and Hemophilus influenzae peritonitis in a patient with alcoholic liver disease. AB - A patient with alcoholic liver disease and ascites had Haemophilus influenzae peritonitis and died in spite of vigorous antibiotic therapy. At autopsy, a phlegmonous gastritis was found as a likely cause of the peritonitis. Phlegmonous gastritis is an uncommon cause of unexplained gastrointestinal symptoms in alcoholics and in the elderly, and it may be pathogenetic in rare patients with bacterial peritonitis of unclear source. PMID- 3539564 TI - [Glutamate decarboxylase from Escherichia coli: catalytic role of the histidine residue]. PMID- 3539565 TI - [The absence of excision repair of UV-induced DNA damage in Saccharomyces cerevisiae protoplasts]. PMID- 3539566 TI - Is drug-induced membrane stabilization a selective or a non-specific phenomenon? AB - In his review of 1958, Shanes described stabilizers as agents which decrease or reduce an increase in the ionic permeability of excitable membranes, thus preventing a change in membrane potential or excitability. A large variety of compounds, including anaesthetics, can produce this pharmacological activity. Lipid solubility of the active compounds appears to be the major requirement and since these compounds are structurally unrelated, earlier theories of mechanism emphasized a common physical (non-specific) mode of action. This implies that specific sites and/or receptors are not involved. The interaction with hydrophobic sites results in a perturbation measured as fluidization or expansion of membrane components such as lipids and/or proteins. The perturbation would induce, either directly or indirectly, conformation change of ionic channels producing a decrease of induced depolarization (stabilization). There is considerable evidence, however, which does not support a common, non-specific mechanism of action for all excitable membrane stabilizers. The hypothesis that drug-induced membrane stabilization is selective and dependent on molecular structure in addition to lipid solubility is evaluated. Studies using in vitro neuronal preparations will be discussed which clearly demonstrate that stabilizers can differentially alter properties and function of neuronal membranes. PMID- 3539567 TI - Structure-activity relationship in carbanilic acid derivatives. AB - The paper presents a survey of the relationship in carbanilic acid derivatives between structure and local anaesthetic activity. By modifying the three parts of a typical local anaesthetic, i.e., the aromatic (lipophilic) part, the intermediate chain and the basic (hydrophilic) part, substances with high local anaesthetic activity have been obtained. The derivatives with alkoxy substituents with 5-7 carbon atoms in the ortho and meta positions have proved advantageous. The local anaesthetic activity is significantly influenced by the basic part, usually formed by secondary or tertiary amines, and particularly by the structure of the intermediate chain. Significant differences have been found to exist between the activity of individual geometrically, optically and conformationally fixed isomers. The results indicate that in the carbanilic acid derivatives studied, local anaesthetic activity depends on their structural arrangement and physicochemical properties, which have been found to play an important role regarding the presumed non-specific effect of these substances. PMID- 3539568 TI - Myocardial cell membrane stabilization and antiarrhythmic action. AB - Shifts in the normal balance of neurovegetative and hormonal regulations, modifications in the ionic composition of the plasma and pathological changes such as ischaemia, hypoxia and hypercapnia may lead to changes in permeability of the cardiac cell membranes to different ions, resulting in electrophysiological changes. These are: depressed and non-homogeneous conduction of impulses, lack of homogeneity in excitability and recovery of excitability, increased ectopic automaticity, etc. Interaction of these changes may be responsible for the appearance of arrhythmias. Membrane stabilization in a broader sense means a tendency to restore pathologically altered membrane permeability, permitting normal ionic transport through membranes of the heart muscle cells and protecting the heart from arrhythmia. In this sense not only classical membrane stabilizing agents such as quinidine- or lidocaine-type drugs are antiarrhythmic; so are the very heterogeneous group of agents defined as calcium antagonists or the interventions changing the phospholipid composition of the cardiac cell membrane, such as a linoleic-acid rich diet or adjuvant arthritis. Examples of these actions are given in the heart in situ of the anaesthetized dog and in the conscious rat infarction model. PMID- 3539570 TI - Antibiotics in whooping cough. PMID- 3539569 TI - Mechanism of action of calcium antagonists on myocardial and smooth muscle membranes. AB - Although calcium channel blockers vary considerably in their chemical structure and pharmacologic profile, the widely accepted mechanism of their action is an inhibition of Ca2+ influx - via voltage-activated slow channels - into smooth and cardiac muscle. Other ways of Ca2+ entry, such as passive diffusion and Na+/Ca2+ and K+/Ca2+ exchange, are not affected by these compounds. However, various blockers exert a slightly different inhibitory action on the slow channels, which indicates that various binding sites in the cell membranes, or even in intracellular sites, may be involved. Potential sites of action of calcium channel blockers in the myocardium include: the slow calcium channels; Na+/Ca2+ channels; mitochondria; sarcoplasmic reticulum; myofilaments; and calcium efflux. However, experimental evidence has been given for only the first site, and the third and fourth sites are still controversial. In the vascular smooth muscles, calcium channel blockers could possibly block the potential-dependent or receptor operated channels, or bind to calmodulin. Again, only the first site of action has been experimentally proven. An important feature of calcium channel blockers is their different affinities for various tissues. For instance, cinnarizine and its difluorinated derivative flunarizine are 1000 times more effective in blocking slow channels in vascular smooth muscles than those in the myocardium. Even within the same system, such as the cardiovascular system, differences in tissue specificity are encountered. Thus, while nimodipine acts preferentially on cerebral vessels, diltiazem has more affinity for the coronary vasculature. Tissue specificity is exhibited even for different myocardial structures; thus, while verapamil affects the nodal and conductive tissues in the myocardium (hence its use as an antiarrhythmic agent), nifedipine is almost devoid of such activity. Organ selectivity of calcium channel blockers is one of the attractive features of this group of compounds; hence their use in a variety of cardiovascular conditions. PMID- 3539571 TI - [Phosphodiesterase inhibition as a new positive-inotropic principle]. PMID- 3539572 TI - Tamoxifen and mastalgia. An emerging indication. PMID- 3539574 TI - [Renal failure and pulmonary manifestations--a clinico-pathological conference]. PMID- 3539573 TI - Pirprofen. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. AB - Pirprofen is a non-steroidal anti-inflammatory drug, related structurally to drugs such as ibuprofen, ketoprofen and naproxen. Published clinical trials indicate that pirprofen 600 to 1200 mg/day as 2 or 3 divided doses is a suitable alternative to usual therapeutic dosages of aspirin, flurbiprofen, ibuprofen, indomethacin, ketoprofen, naproxen, piroxicam and sulindac in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, musculoskeletal disorders and non-articular rheumatism. More studies are required to evaluate its potential relative to other commonly used drugs in the treatment of gout, juvenile rheumatoid arthritis and dysmenorrhoea. In patients with acute postsurgical, trauma or cancer pain, single oral or intramuscular doses of pirprofen 200 to 400mg provide equivalent analgesic activity to usual therapeutic doses of aspirin, diflunisal, ketoprofen, noramidopyrine, paracetamol and pentazocine. As with other non-steroidal anti-inflammatory drugs, gastrointestinal complaints are the most frequently reported side effects. At equivalent analgesic or anti-inflammatory dosages, pirprofen probably causes fewer side effects than aspirin and appears to be as well tolerated as the other agents with which it has been compared. Long term tolerability, particularly compared with some of the newer, purportedly less gastrotoxic agents or formulations, needs to be investigated further. Pirprofen does not appear likely to offer any particular advantage with respect to efficacy and tolerability over other non-steroidal anti-inflammatory drugs, except aspirin. However, as no one agent is the most suitable drug for all patients requiring such therapy, pirprofen may be considered along with other drugs of this type in the therapy of arthritic conditions and acute pain states. PMID- 3539576 TI - ERPs associated with language and hemispheric specialization. A review. PMID- 3539575 TI - ERPs associated with preparatory and movement-related processes. A review. PMID- 3539577 TI - Current methodological issues in ERP research: some remarks and proposals. A review. PMID- 3539578 TI - Endogenous ERP components and cognitive constructs. A review. PMID- 3539579 TI - [The matter of computerized medical records in psychiatry]. AB - To determine the choice of an adequate automatic data processing system in psychiatry, as in medicine, requires a serious set of specifications: one must take into account the aims, and distinguish between everyday applications of file processing, and other ones, more demanding, of research and statistical applications, often little compatible with each other. The financial means have to be compared with the expected benefits (output): often in psychiatry, the patient turn-over is too low to justify the purchase of an expensive hardware. The objectives of filing and classification have to break out, in order to supply the best answer (soft ware). However a computer system alone will not be sufficient to settle, anyway, the question of diagnosis in psychiatry. PMID- 3539580 TI - [Immunohistochemical study of the basic lesions of Alzheimer's disease]. AB - Alzheimer's disease is characterized by the presence of two argentophilic histopathologic brain lesions: neurofibrillary tangles (NFT) and senile (neuritic) plaques (SP). NFT consist of large perikaryal masses of abnormal cytoplasmic fibers, most of which have the ultrastructural appearance of pairs of intermediate-sized (10 nm) filaments wound into a double helix and named Paired Helical Filaments (PHF). PHF also occur within the degenerating neurites of SP. The insolubility of PHF in strong detergents is turned to account for their isolation. We have isolated these structures from an Alzheimer brain and raised antibodies against PHF. The anti-PHF antibodies detected specifically NFT and SP on nervous tissue sections of Alzheimer brains, and also NFT in the hippocampus of normal aged brains. The stainings of NFT and SP by the anti-PHF or the classical Bodian silver staining technique were compared. The immunohistochemical method is more precise, more reproducible, more specific and will be of great interest for the quantification of these structures, specially when they are in minor quantities particularly in the atypical disease. Furthermore, the anti-PHF antibodies did not visualize neurofilament containing structures, and did not react with neurofilament protein subunits on immunoblots. These results are compared to those reported in the literature. PMID- 3539581 TI - Analysis of thyroglobulin antibody synthesis by cultured peripheral blood lymphocytes from patients with Hashimoto's thyroiditis using biotin-avidin solid phase enzyme immuno-assay. AB - The influence of bovine thyroglobulin (Tg) and/or staphylococcus aureus cowan I (SAC) on Tg antibody synthesis has been studied using cultures of 8 Hashimoto's and 5 normal peripheral blood lymphocytes (PBL). The detection of Tg antibody in the culture supernatants was performed by sensitive biotin-avidin solid phase enzyme immunoassay. By using this technique, we were able to detect small amounts of Tg antibody synthesized by cultured Hashimoto's PBL responsive to bovine Tg and/or SAC; PBL from three out of eight patients produced increased levels of Tg antibody in the presence of 0.02 microgram/ml bovine Tg. On the other hand, PBL from two other cases among them which were unresponsive to bovine Tg alone became responsive to bovine Tg following simultaneous stimulation with SAC. PBL from the other three cases failed to respond to bovine Tg or simultaneous stimulation with bovine Tg and SAC. The former five patients had serum Tg tanned red cell hemagglutination (TGHA) titers greater than 1:409,600 except in one case and the latter had serum TGHA titers less than 1:12,800. These results indicated the presence of the different functional stages of B cells to produce Tg antibody in the circulation of Hashimoto's patients and suggested that sufficient number of lymphocytes responsive to bovine Tg are present in the circulation of Hashimoto's patients with high titers of serum TGHA. PMID- 3539583 TI - Microbial microleakage and pulpal inflammation: a review. PMID- 3539582 TI - Changes in central and peripheral renin-angiotensin system after furosemide injection. AB - To examine the effects of acute stimulation on the peripheral and central renin angiotensin system, simultaneous sampling of blood and cerebrospinal fluid (CSF) for measurements of plasma renin activity (PRA), plasma angiotensin I immunoreactivity (PAng I-ir), plasma angiotensin II-immunoreactivity (PAng II ir), plasma angiotensinogen and cerebrospinal fluid angiotensin II-ir (CSF Ang II ir) and CSF angiotensinogen was carried out following intravenous injection of furosemide (5 mg/kg) in conscious dogs. Administration of furosemide induced marked increases in PRA, Ang I-ir, PAng II-ir and CSF Ang II-ir, however, neither plasma nor CSF angiotensinogen was changed. Furthermore, a relatively large dose (20 mg/kg/min) of intravenously infused synthetic Ang II for 20 min produced a five-fold increase in PAng II-ir compared with no significant increase in CSF Ang II-ir. In spite of significant suppression of PRA and PAng I-ir, there were no significant changes in either plasma or CSF angiotensinogen. These results primarily suggest that the peripheral and the brain renin-angiotensin systems may be linked and that acute changes in the peripheral renin-angiotensin system do not alter either plasma or CSF angiotensinogen. PMID- 3539585 TI - Tuberculosis of the esophagus and the importance of bacteriological tissue cultures. PMID- 3539584 TI - A randomized double-blind trial of cholecystokinin during ERCP. PMID- 3539586 TI - Addendum to "Putnam, Merritt, and the discovery of Dilantin". PMID- 3539587 TI - Structural organization in the serine proteases. I. Macromolecular specificity in limited proteolysis. AB - We have been developing computational approaches to increase our ability to analyze the growing body of three-dimensional structural data with applications centered about the serine proteases. The emphasis of these approaches is to compare and contrast macromolecules at the separate levels of secondary, tertiary, and quaternary structure. Our assumption is that in functionally related molecules, regions of structural and/or physicochemical similarity will exhibit functional similarity; regions that are different in structure and/or physicochemical properties will function differently and, therefore, be the source of specificity. Based on this assumption, the independent observations from studies of these enzymes in solution and in biological systems are combined with the structural observations from X-ray crystallographic analysis. A goal of the present research effort is to probe the biomolecular architecture of the serine proteases to evaluate the role of the three-dimensional structure beyond that of the active site in determining recognition and reactivity determinants for these enzymes, and to determine those principles that might be applied successfully to other enzyme systems as well. Of particular note has been our observation of a macromolecular recognition surface which occurs as a topographical feature outside of the active site and under evolutionary control to produce specificity towards macromolecular substrates and inhibitors. In addition we have established the important role of conformational changes that occur beyond the active site of an enzyme and differentiate between natural and synthetic inhibitor-enzyme interactions. This suggests that the specificity and reactivity determinants of a macromolecule are derived from its architecture and structural organization. PMID- 3539588 TI - Binding specificity of papain and cathepsin B. AB - In order to obtain useful information for the design of inhibitors of cathepsin B, an important enzyme in both physiological and pathological processes, the modes of interaction between ligands and thiol proteases (papain and cathepsin B) were analyzed. A new and powerful method was developed to quantitatively understand geometrical features of the interaction. Fairly good electrostatic complementarities were found for the oxygen atoms of P1 and P2 amide, and for the hydrogen atom of P2 amide. Electrostatic correlation potentials on the side chains of P1 and P2 were nearly neutral, so that interacting conformations in these regions are anticipated to be stabilized by hydrophobic forces rather than electrostatic ones. A three-dimensional structure of rat liver cathepsin B was deduced based on the assumption that the tertiary structure of cathepsin B is similar to that of actinidin. Furthermore, an inhibitor of the thiol proteases, benzyloxycarbonyl-L-phenylalanyl-L-alanine chloromethyl ketone was model fitted to cathepsin B, in order to investigate its mode of interaction with the enzyme. It was possible to account for some structure-activity relationships in the enzyme-ligand interactions. PMID- 3539589 TI - Promoters of Escherichia coli: a hierarchy of in vivo strength indicates alternate structures. AB - The strength in vivo of 14 promoters was determined in a system which permits the quantitation of RNA synthesis with high accuracy. Up to 75-fold differences in promoter strength were measured and the most efficient signals are promoters from coliphages T7 and T5. Their activity approaches the strength of fully induced promoters of the rRNA operons which may be close to the functional optimum of a single sequence. By contrast, a synthetic 'consensus promoter' belongs to the less efficient signals. Our data show that optimal promoter function can be achieved by alternate structures and strongly suggest that information outside of the 'classical' promoter region contributes to promoter activity. PMID- 3539590 TI - Functional dissection of Escherichia coli promoters: information in the transcribed region is involved in late steps of the overall process. AB - After binding to a promoter Escherichia coli RNA polymerase is in contact with a region of about 70 bp. Around 20 bp of this sequence are transcribed. Information encoded within this transcribed region is involved in late steps of the functional program of a promoter. By changing such 'down-stream' sequences promoter strength in vivo can be varied more than 10-fold. By contrast, information for early steps of the promoter program such as recognition by the enzyme and formation of a stable complex resides in a central core region of about 35 bp. Our data show that the strength of a promoter can be limited at different levels of the overall process. Consequently promoters of identical strength can exhibit different structures due to an alternate optimization of their program. PMID- 3539591 TI - Altered translation initiation factor 2 in the cold-sensitive ssyG mutant affects protein export in Escherichia coli. AB - The Escherichia coli gene secY (pr1A) codes for an integral membrane protein that plays an essential role in protein export. We previously isolated cold-sensitive mutations (ssy) as extragenic suppressors of temperature-sensitive secY24 mutation. Now we show that the ssyG class of mutations are within infB coding for the translation initiation factor IF2. The mutants produce altered forms of IF2 with a cold-sensitive in vitro activity to form a translation initiation complex. The mutation suppresses not only secY24 but also other secretion-defective mutations such as secA51 and rp10215. The beta-galactosidase enzyme activity of the MalE-LacZ 72-47 hybrid protein is strikingly reduced in the ssyG mutant at the permissive high temperature, while the hybrid protein itself is normally synthesized. This effect, which was observed only for the hybrid protein with a functional signal sequence, may result from some alteration in the cellular localization of the protein. These results suggest that IF2 or the translation initiation step can modulate protein export reactions. The isolation of cold sensitive ssyG mutations in infB provides genetic evidence that IF2 is indeed essential for normal growth of E. coli cells. PMID- 3539592 TI - Transcription of the phosphoglycerate kinase gene of Saccharomyces cerevisiae increases when fermentative cultures are stressed by heat-shock. AB - The single gene for phosphoglycerate kinase (PGK) in the haploid genome of Saccharomyces cerevisiae is expressed to a very high level in cultures fermenting glucose. Despite this it responds to heat-shock. When S. cerevisiae growing exponentially on glucose media was shifted from 25 degrees C to 38 degrees C transient increases of 6-7-fold in cellular PGK mRNA were observed. This elevation in PGK mRNA still occurred in the presence of the protein-synthesis inhibitor cycloheximide, but was not observed in cells bearing the rna1.1 mutation. From the kinetics of continuous labelling of PGK mRNA, relative to the labelling of other RNAs in the same cultures whose levels do not alter with heat shock, it was shown that the elevation in PGK mRNA in response to temperature upshift reflects primarily an increased synthesis of this mRNA and not an alteration of its half-life. PGK mRNA synthesis is therefore one target of a response mechanism to thermal stress. Synthesis of PGK enzyme in glucose-grown cultures is efficient after mild (25 degrees C to 38 degrees C) or severe (25 degrees C to 42 degrees C) heat-shocks. Following the severe shock, the synthesis of most proteins is abruptly terminated, but synthesis of PGK and a few other glycolytic enzymes continues at levels comparable to the levels of synthesis of most of those proteins dramatically induced by heat (heat-shock proteins). Cells that overproduce PGK due to the presence of multiple copies of the PGK gene on a high-copy-number plasmid continue their overproduction of this enzyme during severe thermal stress. Therefore PGK mRNA is both elevated in level in response to heat-shock and translated efficiently at supra-optimal temperatures. PMID- 3539593 TI - Hexokinase PII from Saccharomyces cerevisiae is regulated by changes in the cytosolic Mg2+-free ATP concentration. AB - Hexokinase PII is not inhibited by high Mg-ATP concentrations if the Mg2+-free ATP is kept at low levels (0.01 mM) in the assay mixture. Hexokinase PI activity is not affected either by Mg2+-free ATP nor by free Mg2+ in the assay mixture. Thus, hexokinase PI and PII activities appear not to be regulated by substrate inhibition as proposed previously [Kopetzki, E. & Entian, K. D. (1985) Eur. J. Biochem. 146, 657-662]. However, the level of Mg2+-free ATP in the hexokinase PII assay mixture strongly affects the enzyme activity by decreasing the Vmax and increasing the Km value for Mg-ATP from 0.15 mM to 5.0 mM. The physiological role of this inhibition, which has not been described previously, was investigated by determining the cytosolic ATP and Mg2+ concentrations in yeast cells grown under derepressing and repressing conditions. Derepression is accompanied by an important loss of Mg2+ from the cells, maintaining the ATP concentration constant. This produces an increase of Mg2+-free ATP in the cytosol from 0.01 mM to 0.1 mM. This free ATP concentration would lead to a maximal inhibition of hexokinase PII. PMID- 3539594 TI - Ferredoxin reductase levels in the ovaries of pigs and superovulated rats during follicular cell growth and luteinization. AB - The concentration of ferredoxin reductase, a component of the mitochondrial steroidogenic electron transport chain, was measured in the ovaries of pigs and superovulated rats by a protein blotting procedure using polyclonal antibodies to the purified protein. The concentration of ferredoxin reductase in porcine granulosa cells doubled during growth of follicles from small (1-2 mm diameter) to large (6-12 mm diameter). The concentration doubled again during the period of luteinization. This is in contrast to the rate of cholesterol side-chain cleavage, which showed little change during follicular growth but increased by more than tenfold during luteinization. A similar large increase in cholesterol side-chain cleavage occurs during the period of luteinization in the ovaries of superovulated rats, but as for the pig, only a small increase in ferredoxin reductase was observed. A threefold increase in the yield of mitochondrial protein from tissue homogenates was found between the granulosa cells of small medium follicles and the cells of the corpora luteum. The increase in ferredoxin reductase during follicular development and luteinization, therefore, correlates well with the increase in mitochondria in the cells, but does not correlate with the dramatic increase in cholesterol side-chain cleavage activity which occurs during luteinization. Based on these results, it is unlikely that the level of ferredoxin reductase limits the expression of the full steroidogenic activity of the granulosa cells of the ovary. PMID- 3539595 TI - Characterization of the elongation factors from calf brain. 1. Purification, molecular and immunological properties. AB - This work describes a method for the purification of the elongation factors (EF) from calf brain. The elongation factor responsible for the binding of aminoacyl tRNA to the ribosome is found in this organ as a light form (EF-1 alpha) and as a component of heavy, polydispersed aggregates (EF-1H). EF-1 beta, the factor enhancing the EF-1 alpha GDP/GTP exchange, is part of EF-1H and of smaller aggregates. The fraction of EF-1 alpha and EF-1 beta not associated with EF-1H, and EF-2 have been purified to homogeneity after several chromatographic steps. EF-1H consists of many proteins; among them, EF-1 alpha, EF-1 beta and an EF-1 gamma-like protein represent three of the major components. This conclusively shows that EF-1H from calf brain is not a polydispersed aggregate of only EF-1 alpha. EF-1 beta has also been purified to homogeneity from EF-1H. The property of EF-1 beta to aggregate with other proteins suggests that this factor plays an important role in the organization of EF-1H. The relative molecular mass of the purified factors have been determined as: EF-1 alpha, 50,000; EF-1 beta, 30,000; the EF-1 gamma-like component, 49,000; EF-2, 85,000. Some cross-reactivity with the antibodies against the prokaryotic counterparts has been shown for EF-1 alpha, EF-1 beta and EF-2 by functional and immuno-precipitation methods, suggesting the existence of structural homologies. PMID- 3539596 TI - Amino-acid sequence data of beta-tubulin from Physarum polycephalum myxamoebae. AB - Starting with 7.7 mg of a beta-tubulin isolated from myxamoebae of the slime mould Physarum polycephalum, 90% of the sequence has been determined by the Edman degradation of peptides generated by cyanogen bromide, trypsin and Staphylococcus aureus protease. Differences to other beta-tubulins are mainly conservative and spread evenly throughout the chain except for a high concentration at the C terminus. The Physarum beta-tubulin shows most homology to Chlamydomonas beta tubulin (90.5%) and least homology to yeast beta-tubulin (S. cerevisiae, 73.4%). Two tryptic peptides were isolated in approximately equal quantities which were identical except in one position (S/ALTVPELTQRMFDA) showing that at least two beta-tubulins are present in myxamoebae. However, since this was the only heterogeneity found, these beta-tubulins are probably very similar. PMID- 3539598 TI - Partial purification of the maturation-promoting factor MPF from unfertilized eggs of Xenopus laevis. AB - A 200-fold purification of the maturation-promoting factor or MPF from unfertilized eggs of Xenopus laevis is reported for the first time. Purification was achieved by three successive column chromatographies on hydroxyapatite, trisacryl blue and L-arginine-agarose. The presence of MPF was assessed by the usual maturation criteria after injections of test material into immature stage VI unstimulated X. laevis oocytes: the precocious appearance of the maturation spot (within 45-120 min), the germinal vesicle breakdown, the presence of the first polar body and the second metaphase spindle. Purification was monitored by the decrease of the minimal amount of protein injected in a constant volume (50 nl) required to induce 50% frequency of germinal vesicle breakdown. This amount decreased from 500 ng in the crude extract to 2.5 ng in the 200-fold purified material. Analysis by SDS-PAGE of the crude extract showed about 40 Coomassie blue-stained polypeptides with molecular masses ranging from 300 kDa to 20 kDa, whereas in the 200-fold purified MPF only 5 stained polypeptides were revealed, with molecular masses of 62, 53, 49, 39 and 37 kDa. In vitro phosphorylations for the detection of kinase activities for endogenous and exogenous substrates were monitored by analysis of autoradiograms of SDS-PAGE, after treatment of fractions with [gamma-32P]ATP. Only inactive fractions eluted from columns ahead of MPF, and fractions containing MPF activity were tested. Phosphorylation of numerous stained polypeptides was demonstrated in the crude MPF extract and exogenous substrates such as phosvitin, casein and histone type II-AS were also strongly phosphorylated. In the MPF fraction, purified on hydroxyapatite, a polypeptide of 53 kDa was more highly and specifically phosphorylated and the presence of kinase activities was observed for the above three exogenous substrates. In the 100-fold and 200-fold purified MPF, phosphorylation of endogenous substrates could not be shown and kinase activities for the above three substrates were drastically decreased as compared with the crude and purified MPF obtained after hydroxyapatite column chromatography. However, neither endogenous phosphorylations nor kinase activities with the above exogenous substrates could be shown in inactive fractions eluted ahead of MPF at the different purification steps. Some characteristics of the purified material are also described in this paper. PMID- 3539597 TI - Calmodulin-dependent multifunctional protein kinase. Evidence for isoenzyme forms in mammalian tissues. AB - Calcium/calmodulin-dependent multifunctional protein kinases, extensively purified from rat brain (with apparent molecular mass 640 kDa), rabbit liver (300 kDa) and rabbit skeletal muscle (700 kDa), were analysed for their structural, immunological, and enzymatic properties. The immunological cross-reactivity with affinity-purified polyclonal antibodies to the 50-kDa catalytic subunit of the brain calmodulin-dependent protein kinase confirmed the presence of common antigenic determinants in all subunits of the protein kinases. One-dimensional phosphopeptide patterns, obtained by digestion of the autophosphorylated protein kinases with S. aureus V8 protease, and two-dimensional fingerprints of the 125I labelled proteins digested with a combination of trypsin and chymotrypsin, revealed a close similarity between the two subunits (51 kDa and 53 kDa) of the liver enzyme. Similar identity was observed between the 56-kDa and/or 58-kDa polypeptides of the skeletal muscle calmodulin-dependent protein kinase. The data suggest that the subunits of the liver and muscle protein kinases may be derived by partial proteolysis or by autophosphorylation. The peptide patterns for the 50 kDa and 60-kDa subunits of the brain enzyme confirmed that the two catalytic subunits represented distinct protein products. The comparison of the phosphopeptide maps and the two-dimensional peptide fingerprints, indicated considerable structural homology among the 50-kDa and 60-kDa subunits of the brain calmodulin-dependent protein kinase and the liver and muscle polypeptides. However, a significant number of unique peptides in the liver 51-kDa subunit, skeletal muscle 56-kDa, and the brain 50-kDa and 60-kDa polypeptides were observed and suggest the existence of isoenzyme forms. All calmodulin-dependent protein kinases rapidly phosphorylated synapsin I with a stoichiometry of 3-5 mol phosphate/mol protein. The two-dimensional separation of phosphopeptides obtained by tryptic/chymotryptic digestion of 32P-labelled synapsin I indicated that the same peptides were phosphorylated by all the calmodulin-dependent protein kinases. Such data represent the first structural and immunological comparison of the liver calmodulin-dependent protein kinase with the enzymes isolated from brain and skeletal muscle. The findings indicate the presence of a family of highly conserved calmodulin-dependent multifunctional protein kinases, with similar structural, immunological and enzymatic properties. The individual catalytic subunits appear to represent the expression of distinct protein products or isoenzymes which are selectively expressed in mammalian tissues. PMID- 3539599 TI - Real time (US) scanning of palpable lesions in the soft tissues (muscles and tendons) of the extremities. AB - The results of real time ultrasound (US) examination of palpable lesions located in the muscle and tendon area of the extremities are reported in a series of 67 patients. The US appearance of various lesions is described. The contribution of real time US (B mode) during muscular contraction to the diagnosis and the results of diagnostic fine needle punctures (FNP) and their value are discussed. PMID- 3539600 TI - Image quality in intravenous renal DSA. A critical analysis of 300 examinations. AB - Renal venous DSA yields diagnostically adequate results in an unselected population in more than 85% of cases. Image quality is compromised predominantly by inadequate contrast enhancement, motion artifacts from the stomach and the bowel, and obesity. The effect of these factors increases with patient age. Selection of patients, careful bowel preparation, the use of a compression device and intravenous spasmolytics are recommended to improve image quality. The possible contributions of the injection technique, pulsed DSA and advanced post processing facilities are discussed. PMID- 3539601 TI - A comparative trial of the diagnostic quality of and tolerance for two low concentration low osmolality contrast media for phlebography. AB - We report a prospective randomised double blind study comparing the diagnostic quality of and tolerance for ascending phlebography in 100 patients using two different low osmolality contrast media, ioxaglate and iohexol, at a concentration of 200 mg I/ml. The immediate and delayed side effects were minimal in both groups and the difference between the two media was not statistically significant. All the phlebograms were of diagnostic quality. We conclude that both ioxaglate and iohexol are suitable agents for leg phlebography in low concentrations. PMID- 3539602 TI - Remarkable localization of ornithine decarboxylase in rat pancreas. PMID- 3539603 TI - Immunocytochemical localization of calmodulin in intact and acrosome-reacted boar sperm. AB - Localization of calmodulin on intact and acrosome-reacted ionophore A23187 induced boar sperm has been performed with indirect immunofluorescence and immunoelectron microscopy. The results obtained with immunofluorescence are in agreement with previous reports. Immunoelectron microscopy was performed with the methods of preembedding immunostaining and on-grid post-embedding immunostaining of Lowicryl K4M sections with the protein A-colloidal gold. The presence of calmodulin is demonstrated in the acrosomal content and in the equatorial and postacrosomal regions of intact sperm. Apparently, calmodulin is released in association with the plasma membrane and the outer acrosomal membrane in acrosome reacted sperm and it is maintained in the equatorial and postacrosomal regions. These results provide further evidence that also in mammalian sperm multiple classes of calmodulin-binding proteins may be present. PMID- 3539604 TI - Monoclonal antibody immunocytochemistry: novel method extending usefulness of monoclonal antibodies for antigen visualization. AB - We describe a novel procedure combining the multiple-site reactivity of polyclonal antibodies with the defined single epitope-specificity of monoclonal antibodies. The method is based on previous findings that IgG molecules often only react with tissue-bound antigens with one of their two antigen-combining sites; thus, the remaining site is free to bind subsequently added antigen. In the procedure devised, such (undenatured) antigen is subsequently detected by a specific monoclonal antibody and the reaction is finally revealed by immunogold silver staining. Antibody subpopulations to contaminating antigens may well be present in the polyclonal antiserum and may well bind first to tissue and then to the corresponding contaminants in the crude antigen preparation applied as second layer. Such contaminants will, however, not react with the monoclonal antibody and will therefore not be immunocytochemically detected. The method has been evaluated with one antigen which cannot be detected by monoclonal antibodies in paraffin sections (glial fibrillar acidic protein) and with another antigen (human chorionic gonadotropin) which can only be detected by the monoclonal antibody when occurring in high concentrations. In both cases the procedure resulted in strong specific staining of the antigens with no background. PMID- 3539605 TI - Reactivity of a panel of neurofilament antibodies on phosphorylated and dephosphorylated neurofilaments. AB - The work of the Sternbergers and their colleagues has shown that monoclonal antibodies reactive with neurofilament subunit proteins may be sensitive to the state of phosphorylation of these proteins. We therefore examined the ability of our previously described panel of monoclonal and polyclonal neurofilament antibodies to bind to normal and to enzymatically dephosphorylated neurofilament subunits. All the monospecific antibodies, both mono- and polyclonal, which we had previously documented as reactive with neurofilament H protein proved to bind only to the phosphorylated form of this protein, and H antibody staining of neurofilamentous profiles in frozen sections could be abolished by appropriate pretreatment of sections with alkaline phosphatase. In contrast, all monospecific antibodies, both mono- and polyclonal, reactive with native M and L proved to bind with apparently undiminished affinity following enzymatic dephosphorylation of the appropriate antigen, either in frozen sections or on Western blots. The class of monoclonal antibodies which react with both H and M were variable in their response to dephosphorylated neurofilaments; some completely lost their reactivity whilst others were partially or wholly unaffected. We stained frozen sections of nervous tissues from various mammalian species with the panel of antibodies, and observed filamentous staining of the perikarya and dendrites of a variety of different types of neuron with all antibodies, both mono- and polyclonal, directed against L and M. Antibodies with strong reactivity for phosphorylated H always failed to stain neurofilamentous dendritic and perikaryal profiles. We further describe the isolation and characterization of a new monoclonal antibody, which recognizes both phosphorylated and enzymatically dephosphorylated forms of H.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539606 TI - Propagation and morphologic phenotypes of human umbilical cord artery endothelial cells. AB - Human umbilical cord artery endothelial cells can be propagated on fibronectin coated dishes for approximately 50 cumulative population doublings in the presence of crude preparations of endothelial cell growth factor (ECGF) and serum. The cells were characterized by immunofluorescent staining and their ultrastructure. Different morphologic phenotypes could be demonstrated: closely attached cell monolayers, atypical cells, giant cells, tube-like structures. The formation of tube-like structures can be induced by proteolytic modification of fibronectin. Our data demonstrate that umbilical arteries may provide an excellent source for the routine serial cultivation of human arterial endothelial cells. PMID- 3539607 TI - The distribution of clathrin during amphibian oogenesis. AB - The distribution and content of clathrin during amphibian oogenesis was studied by indirect immunofluorescence and competitive ELISA assays. The antibody used for these studies was specific for the clathrin heavy chain and was capable of recognizing the antigen in a crude homogenate of amphibian oocytes. When this antibody was used to localize clathrin in fixed tissue slices of HCG-stimulated ovaries, differences were detected in the staining patterns of various sized oocytes. In cells less than 0.5 mm in diameter, the reaction appeared as a punctate pattern throughout the cytosol with a less intense reaction occurring in the region of the oolemma. As cell size increased, the intensity of the stain associated with the oolemma also increased, and the cytosolic reaction correspondingly decreased. To determine if this difference in intensity was due to an increase in clathrin concentration, competitive ELISA assays were carried out on extracts of variously sized oocytes. The results indicate that clathrin is preferentially synthesized in differently sized oocytes and that changes in the distribution and content of clathrin during oogenesis are related to developmental events occurring as the oocyte becomes progressively more specialized. PMID- 3539608 TI - A comparative analysis of collagen III, IV, laminin and fibronectin in Duchenne muscular dystrophy biopsies and cell cultures. AB - The role of collagen type III and IV (Coll III, IV) in Duchenne muscular dystrophy (DMD) was investigated by the indirect immunofluorescence technique (IIF) both in muscle biopsies and derived cell cultures. Ten dystrophic cases were studied and compared with twelve suitable control cases, extending the IIF analysis to two other representative non-collagenous proteins of the extracellular matrix (ECM), namely fibronectin (FN) and laminin (LM). DMD biopsies generally displayed a thickening of endomysial and/or perimysial connective, as compared to control specimens. All the markers analyzed were found to contribute to this connective proliferation, although from a quantitative point of view the relative involvement decreases progressively from FN through Coll III and IV to LM. However, due to Coll IV selective endomysial localization, Coll IV alteration can be considered a specific indicator of a muscle cell defect. Results from DMD muscle cultures revealed no significant changes in comparison to control cultures, except for Coll IV. A well-organized, Coll IV containing pericellular matrix was noted in a fraction of DMD cultures as a unique feature seen in no control culture. This alteration was again considered significant since Coll IV is the only marker clearly associated with the myotube component still expressed in vitro. The negative results obtained on the other marker proteins should not however be considered definitive, due to the lack in the simplified in vitro system used of humoral and/or neuronal factors which may be needed to express gene defect(s) in differentiated cells. PMID- 3539609 TI - Characterization of monoclonal antibodies directed against erythrocytic stage antigens of Plasmodium berghei. AB - Monoclonal antibodies recognizing various facets of the malaria parasite Plasmodium berghei and of the infected erythrocyte were obtained after generation of hybridomas between spleen cells from immunized mice and myeloma cells. The monoclonal antibodies were characterized by enzyme-linked immunosorbent assay, indirect immunofluorescence, immunoprecipitation of [35S]methionine-labeled proteins and immunoblotting. The most readily identified antigen was a parasite surface-associated protein of 230 kDa which is similar to the polymorphic schizont antigen described in a number of malarial species. In addition, three distinct antigens of 13, 31 and 120 kDa, which are external to the parasite, but within the infected erythrocyte were identified. PMID- 3539610 TI - The effect of dexamethasone on transferrin secretion by cultured fetal rat hepatocytes. AB - Cultured fetal rat hepatocytes derived from 12, 15 and 19-day gestation rats are capable of secreting transferrin. When dexamethasone is added to the medium an increased secretion rate is observed. The changes in secretion rates in control as well as dexamethasone-treated cells during culture have been shown to correlate with the level of mRNA coding for transferrin. Immunocytochemical experiments show that initially all hepatocytes contain transferrin which is localized in the lumina of the perinuclear space, rough endoplasmic reticulum and in the saccules and vesicles of the Golgi apparatus. During culture, particularly in control cells, the intensity of labelling varies from cell to cell. In addition, adjacent cells are observed to label more intensely in different intracellular organelles. PMID- 3539611 TI - The effect of monensin on chitin synthesis in Candida albicans blastospores. AB - Monensin, a monovalent cation ionophore, was used to investigate some steps of the wall synthesis and morphogenesis in Candida albicans blastospores. In the presence of the drug, the pathogenic yeast developed enormous wall and septum thickenings that reacted intensely and specifically with wheat germ agglutinin and chitinase coupled to colloidal gold and fluorescein isothiocyanate. Therefore, the aberrant zones are interpreted as sites of chitin accumulation. The increased production of this homopolymer, also demonstrated by the chemical analysis of cell wall preparations, implies that monensin interferes in some way with the regulatory factors that normally control, in space and time, chitin synthetase activity. PMID- 3539612 TI - Nuclear lamins during prophasing and telophasing in heterophasic HeLa and Chinese hamster homokaryons. AB - We have perturbed the dynamics of the nuclear lamins by means of cell fusion between mitotic and interphase cells and have studied redistribution of lamins in fused cells as a function of extracellular pH levels. We show here that in heterophasic M-1 HeLa homokaryons disassembly of interphase lamins predominates at low pH levels between 7.0 to 7.3, whereas deposition of cytoplasmic lamins around condensed metaphase chromosomes was observed at pH 8.0. In HeLa homokaryons lamina disassembly and lamina deposition around chromosomes are mutually exclusive. Using heterophasic M-1 homokaryons of the Chinese hamster cell line DON we observed that disassembly of interphase lamins and deposition of lamins around condensed chromosomes coexisted in the same homokaryon kept at pH 7.0. Disassembly of lamins developed synchronously with premature chromosome condensation (PCC) whereas lamina deposition around the condensed M-chromosomes was followed by telophasing. In fusions kept at pH 8.0 cytoplasmic lamins were exclusively deposited around mitotic chromosomes. The results are interpreted as showing that pH regulates the lamina dynamics in homokaryons of mitotic and interphase cells. PMID- 3539613 TI - The effect of isosorbide-5-mononitrate (5-ISMN) Durules on exercise tolerance in patients with exertional angina pectoris. A placebo controlled study. AB - Twenty-four patients with stable exercise-induced angina pectoris entered a double-blind cross-over study. Isosorbide-5-mononitrate (5-ISMN) 60 mg in a controlled release formulation (Durules) given once daily was compared with identical placebo. The exercise tolerance was determined by bicycle ergometry before and 3 h after a single dose of 5-ISMN and following one week's treatment with 5-ISMN and placebo. Nineteen patients completed the study. Exercise tolerance until the onset of chest pain and until 1 mm ST segment depression increased significantly 3 h after dose. The same increase was seen both after a single dose and the same dose under steady-state conditions. No increase was seen with placebo. The heart rate and systolic blood pressure reactions in the standing position were less pronounced 3 h after dose in steady-state than after a single dose of 5-ISMN. Headache was the only bothersome side-effect reported. The study demonstrates that 60 mg 5-ISMN in a Durules formulation given once daily has a significant anti-anginal effect and that tolerance does not develop. PMID- 3539615 TI - The renal response to neuroendocrine inhibition in chronic heart failure: double blind comparison of captopril and prazosin. AB - Activation of the renin-angiotensin and sympathetic systems in chronic heart failure causes important renal vasoconstriction. In a double-blind cross-over study, treatment with captopril for one month reduced systemic and renal vascular resistance by 14% and 25%, increased renal blood flow by 12%, and increased the percentage of the cardiac output perfusion to the kidney by 13%. Treatment with prazosin for one month also reduced systemic vascular resistance by 8%, renal vascular resistance increased by 20%, and renal blood flow and the percentage of the cardiac output going to the kidney fell by 14% and 26%. During captopril treatment, plasma aldosterone concentration was reduced to normal, but during prazosin treatment there was an initial increase in aldosterone of 45%, and a sustained increase in plasma noradrenaline concentration of 26%. Body weight decreased by 1.7 kg on captopril, but increased by 3.0 kg on prazosin, correlating inversely with the changes in renal blood flow. Sympathetic inhibition with prazosin causes systemic vasodilatation which diverts blood from the kidney and may result in fluid retention. Inhibition of the renin system with captopril causes preferential renal vasodilatation and can improve renal perfusion in chronic heart failure. PMID- 3539614 TI - Efficacy of incremental doses of tiapamil on exercise performance in patients with chronic stable angina pectoris. AB - Ten patients with chronic stable angina were treated with 4 incremental doses of tiapamil (200 mg, 400 mg, 600 mg and 800 mg) in a double-blind, placebo controlled study. Treadmill exercise electrocardiograms were performed before and after single oral doses of tiapamil. A dose-dependent increase in exercise duration occurred after tiapamil with significant improvement after tiapamil 600 mg and 800 mg. Mean exercise duration increased from 327 +/- 41 seconds (control) to 399 +/- 49 seconds (P less than 0.01) after tiapamil 600 mg and from 314 +/- 39 seconds (control) to 416 +/- 49 seconds after tiapamil 800 mg, P less than 0.001. There was an associated improvement in mean exercise time to onset of 1 mm ST-segment depression from 240 +/- 41 seconds (control) to 300 +/- 48 seconds in 10 patients after tiapamil 600 mg, (P less than 0.02) and from 206 +/- 35 seconds (control) to 272 +/- 51 seconds in 9 patients after tiapamil 800 mg, P less than 0.01. Two patients were free of angina and 1 patient normalized his ST-segments after tiapamil 800 mg. Dose-dependent side-effects were mild and tolerable. Tiapamil is safe and highly effective in improving exercise tolerance and relieving myocardial ischaemia in patients with chronic stable angina. PMID- 3539616 TI - Isosorbide dinitrate and pulsatile arterial haemodynamic variables in hypertension. AB - The effect of a sustained-release oral isosorbide dinitrate (ISDN) preparation on cerebral and forearm circulation was determined in 16 patients with mild to moderate essential hypertension. Measurements were made by pulsed Doppler velocimetry in the common carotid and the brachial arteries. Pulse wave velocity of the forearm was simultaneously recorded by means of strain gauge arterial mechanography allowing non-invasive evaluation of compliance and characteristic impedance of the brachial artery. Four hours after ISDN ingestion, the patients exhibited a significant decrease in blood pressure without a change in heart rate. An increase in carotid and brachial artery diameter was shown whereas blood flow increased only in the forearm. Resistance decreased significantly in both carotid and brachial vascular beds but only in the brachial vascular bed was the baseline resistance directly correlated with the change in brachial bed resistance. Concerning pulsatile large artery parameters, pulse wave velocity and characteristic impedance diminished, and brachial artery compliance increased significantly. The tangential tension of carotid and brachial arteries did not change. An increase in plasma renin activity was observed and related to the vasodilating effect on small arteries of the brachial vascular bed. This study showed that the antihypertensive effects of ISDN were accompanied by a strong vasodilatory action on small and large arteries and by an improvement in the pulsatile behaviour of large arteries. PMID- 3539617 TI - Haemodynamic effects of intravenous sotalol in acute myocardial infarction. AB - There are few placebo controlled studies in acute myocardial infarction concerning the haemodynamic effects of beta blockade. In a controlled, double blind randomized study, the haemodynamic effects of sotalol were evaluated in 20 patients with acute myocardial infarction within 24 hours of the onset. Sotalol was administered to 10 patients over 12 hours by a continuous infusion including three different infusion rates. A serum level around 1.4 microgram ml-1 was achieved after one hour of infusion. The placebo patients were given saline infusion. The patients were monitored invasively using a thermodilution catheter in the pulmonary artery. In the sotalol group, there was a significant reduction in heart rate, systolic blood pressure, cardiac output and stroke volume compared to placebo. A slight increase in the mean pressures of right atrium, pulmonary artery systolic and diastolic pressures was also seen. The infusion was well tolerated and no adverse reaction was seen. PMID- 3539619 TI - The pioneers of pediatric medicine: Evert Gorter(1881 -1954). PMID- 3539618 TI - Central haemodynamic effects of metoprolol early in acute myocardial infarction. A placebo controlled randomized study of patients with low heart rate. AB - The central haemodynamic effects of metoprolol in patients with acute myocardial infarction and with heart rate less than or equal to 65 beats min-1 have been investigated in a randomized double-blind trial. The aim was to study the tolerance in this selected patient group and to assess possible differences in haemodynamic response amongst patients with initially higher heart rates. Exclusion criteria were: treatment with beta blockers; heart rate greater than 65 beats min-1; systolic blood pressure less than 110 mmHg; and physical signs of serious heart failure. Following pulmonary artery catheterization, 22 patients were randomized to metoprolol 15 mg i.v. + 50 mg q.i.d. orally (N = 12) or placebo (N = 10). Central pressures and cardiac output were recorded before and during the 24 hours after drug administration. There was a significant fall in heart rate, cardiac index, rate pressure product and stroke work index of 10-20% in the metoprolol, compared with the placebo group. The differences were most pronounced immediately after the metoprolol injection. The pulmonary artery capillary wedge pressure was not significantly changed. The overall haemodynamic response to metoprolol was similar to that reported in patients with acute myocardial infarction and heart rate above 65 beats min-1. Tolerance was good. PMID- 3539620 TI - Pathogenic factors in recurrent urinary tract infections and renal scar formation in children. PMID- 3539621 TI - Influence of haemodialysis and renal transplantation on trace element concentrations in children with chronic renal failure. AB - Whole blood levels of Cd and Pb (microgram/g Hb), serum concentrations of Sr and Zn and their urinary excretion were measured in healthy, renal transplant and dialyzed children by atomic absorption spectroscopy. Furthermore, before and after dialysis the concentrations of these elements were determined in blood/serum as well as in the dialysis fluid. The predialytic concentrations of Cd, Pb and Sr in blood/serum were significantly increased compared to controls. Haemodialysis had only minor effects on whole blood Cd and Pb levels but serum Sr and Zn concentrations increased as a result of high metal levels in dialysis fluid. Children after renal transplantation showed no alterations in Pb, Sr and Zn concentrations compared to healthy children but whole blood Cd was increased. According to the renal function the Pb, Cd and Zn urinary excretion decreased in the following order: healthy, renal transplant and dialysis children. Sr urinary excretion was increased in haemodialysis and renal transplant patients. In conclusion, we found no Zn deficiency. Elevated blood levels of Cd and Pb and elevated Sr serum concentrations in paediatric patients undergoing dialysis and increased Cd whole blood levels in renal transplant children could be of clinical interest. PMID- 3539622 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 chronologic 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 administration, and a decreasing diastolic blood pressure were positively correlated with better growth rates after transplantation. The donor source and prior history of transplantation did not significantly influence growth rate. PMID- 3539623 TI - Sustained release verapamil in hypertension. Results from a noninvasive ambulatory blood pressure monitoring and a clinical study. AB - The antihypertensive effect of a new sustained-release matrix formulation of verapamil 200 mg was investigated in a dose-response study in patients with mild to moderate essential hypertension. Noninvasive ambulatory blood pressure measurements were recorded over 24 h in 6 patients with diastolic blood pressure greater than or equal to 100 mmHg. The patients received sustained-release verapamil 200 mg once daily and twice daily in a randomized order. Each medication period lasted 2 weeks. Verapamil 200 mg twice daily had a better antihypertensive effect than the same dose once daily. After a 6-week placebo period 27 patients with a diastolic blood pressure greater than or equal to 100 mmHg were included in a double-blind clinical trial. The patients received sustained release verapamil 200 mg once daily and twice daily in a randomized crossover manner. Each medication period lasted 6 weeks, with an intervening 6 week placebo period. A diastolic blood pressure of less than or equal to 95 mmHg was achieved in 6 patients with the once-daily regimen and in 14 with the twice daily regimen. The mean fall in diastolic blood pressure was 4 and 9 mmHg, respectively (p less than 0.05). We conclude that sustained-release verapamil 200 mg once daily gives a satisfactory blood pressure response only in a minority of patients, while 200 mg twice daily has a significantly better antihypertensive effect. Both doses were well tolerated. PMID- 3539624 TI - Pharmacokinetics of ceftazidime in patients with biliary tract disease. AB - After administration of ceftazidime as a 1 g i.v. bolus injection, its concentration was measured by HPLC at frequent intervals in serum, bile and tissue from different parts of the biliary tract in 32 patients undergoing operation for biliary tract disease. In bile from the functioning gallbladder and common bile duct, a high concentration of ceftazidime was found, mean 18.5 and 26.6 mg/l, respectively. In bile from the non-functioning gallbladder, a very low concentration was found (less than 1.5 mg/l). Ceftazidime in the gallbladder wall varied considerably with the type and degree of inflammation judged histologically; the mean level was 21.3 mg/kg. The elimination half-life of ceftazidime was 1.74 h, apparent volume of distribution 20.01 and total plasma clearance 133 ml/min. In bile from T-tube specimens a high concentration was found, the mean peak values being 27.2 mg/l. However, biliary excretion of the drug was low at less than 0.5% of the administered dose. These concentrations of ceftazidime were sufficient to inhibit the in-vitro growth of pathogens, namely the Enterobacteriaecae commonly responsible for biliary tract infection. PMID- 3539625 TI - The role of the renin-angiotensin system in compound 48/80-induced thirst in rats. AB - The role of the renin-angiotensin system in compound 48/80 (3 mg/kg s.c.)-induced thirst in rats was investigated. Bilateral nephrectomy attenuated drinking induced by compound 48/80 but not by polyethylene glycol (PEG) (30%, 5 ml s.c.). Pretreatment with tripelennamine (histamine H1-receptor antagonist, 40 mg/kg i.p.) prior to the administration of compound 48/80 reduced the effect of compound 48/80 on drinking, but pretreatment with cimetidine (histamine H2 receptor antagonist, 40 mg/kg i.p.) or propranolol (beta-adrenoceptor antagonist, 10 mg/kg i.p.) had no effect. The effect of SQ 14,225 (angiotensin converting enzyme inhibitor) in various concentrations (0.5-100 mg/kg s.c.) was investigated on the drinking response caused by compound 48/80 (3 mg/kg s.c.), PEG (30%, 5 ml s.c.), isoprenaline (0.5 mg/kg s.c.) and hypertonic saline (5.8%, 2 ml s.c.). SQ 14,225 at a dose of 50 mg/kg significantly attenuated the compound 48/80-induced water intake when administered within 30 min prior to the injection of compound 48/80. Pretreatment with a high dose of SQ 14,225 (50 or 100 mg/kg s.c.) 15 min prior to the injection of dipsogens caused inhibition of the drinking response to compound 48/80 or isoprenaline, but not to PEG or hypertonic saline. Pretreatment with lower doses of SQ 14,225 (0.5 or 5 mg/kg, s.c.) had no inhibitory effect on compound 48/80- or isoprenaline-induced water intake. The inhibition of water intake by SQ 14,225 seems to be dependent on the dose and time between administration of SQ 14,225 and compound 48/80 or isoprenaline. Compound 48/80 and hypertonic saline were additively effective in producing the drinking response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539626 TI - Quisqualate selectively inhibits a brain peptidase which cleaves N-acetyl-L aspartyl-L-glutamate in vitro. PMID- 3539627 TI - Establishment of calf trabecular meshwork cell cultures. AB - Trabecular meshwork cell cultures have been grown from excised calf aqueous outflow pathway tissue using two different methods. In one method, tissue explants were placed directly in culture dishes and primary cultures were established by those cells migrating from the tissue. In the second method, a cell suspension was generated by incubating trabecular tissue strips with 0.1% pronase, and the washed cells were used to seed primary cultures. The cell cultures generated by each method appeared to progress through morphological and biochemical changes characteristic of the cell type, although at different respective rates. Comparisons of the cell morphologies, biosynthetic activities, and growth characteristics of the respective subcultures suggested that similar cell populations were obtained by each method. These studies further suggested that sufficient quantities of calf trabecular cells could be grown in culture to permit biochemical and pharmacological studies of trabecular-cell metabolism. PMID- 3539628 TI - The membrane-associated cytoskeleton in cultured lens cells. Electron microscopical visualization in cleaved whole-mount preparations and platinum replicas. AB - The membrane-bound cytoskeleton of bovine lens cells was investigated using different electron-microscopic methods. Cells were grown on glass coverslips and fixed in 0.5% glutaraldehyde, post-fixed and prepared for critical-point drying following standardized methods. Cells were broken open before post-fixation or after critical-point drying in order to expose the cortical cytoplasm. Cleaved, critical-point-dried cells were subsequently rotary replicated. Cells were also cleaved on grids before post-fixation. These cells were examined directly in the microscope. All methods showed the presence of a cytoskeletal network. Bundles and starlike foci of microfilaments and microtubules were usually found in close association with the membrane. Occasionally also intermediate filaments were observed, in a few cases running close to the microtubules. The reliability of the methods to visualize the membrane-bound cytoskeleton of lens cells is discussed. PMID- 3539630 TI - Bronchoalveolar lavage in the investigation of disorders of the lower respiratory tract. PMID- 3539629 TI - Regulation of hexose transport in cultured bovine retinal microvessel endothelium by insulin. AB - In microvessel endothelium obtained from young calf retinas, insulin stimulated the uptake of 2-deoxy-D-glucose in a dose-dependent manner. The maximal level of glucose uptake (50-100% over basal values) was observed at 1 ng ml-1 insulin. The effects of insulin on glucose uptake were time-dependent, with optimum stimulation of glucose transport observed after 90 min of insulin treatment. The effects of insulin were prevented by 15 min pretreatment with 2 micrograms ml-1 cycloheximide or by 2 micrograms ml-1 actinomycin D, suggesting a role for new protein synthesis in the actions of insulin on glucose transport in this cell type. These results demonstrate that cultured retinal microvessel endothelial cells exhibit an insulin-sensitive glucose transport system. PMID- 3539631 TI - Ambroxol decreases bronchial hyperreactivity. AB - Ambroxol is a new compound which increases secretion of phosphatidylcholine by type II pneumocytes. The secretion of phosphatidylcholine could affect bronchial hyperreactivity in two ways: by increasing lysophosphatidylcholine turnover and/or by modifying the layer of bronchial secretion that covers airway receptors. To see whether ambroxol affects bronchial hyperreactivity, we carried out a double-blind cross-over study, evaluating the efficacy of this drug vs placebo in modifying methacholine PD20 in 11 asthmatic patients, 4 atopics and 7 non-atopics. 90 mg of ambroxol or placebo were randomly administered orally for one of two 14-day periods. Methacholine PD20 was evaluated before and after each treatment. A highly significant difference was demonstrated in the direct comparison between ambroxol and placebo as to their ability to modify mean metacholine PD20, which with ambroxol was more than double that with placebo. It was also seen that ambroxol induced a significant increase in baseline values of PD20, i.e. a significant decrease in bronchial hyperreactivity. Placebo did not do this. PMID- 3539632 TI - Lack of effect of i.v. prostacyclin on aspirin-induced asthma. AB - Inhibition of prostacyclin biosynthesis by aspirin might be expected to promote asthmatic attacks in aspirin-intolerant patients. In vitro, prostacyclin impedes generation of leukotrienes and opposes their bronchoconstrictive action. In a double-blind study we compared the effects of intravenous infusions of prostacyclin with those of its solvent on bronchoconstriction provoked by threshold doses of aspirin in nine known aspirin-sensitive asthmatics. The intensity of bronchial obstruction precipitated by aspirin was similar during prostacyclin and placebo infusions. There was no difference in other symptoms of intolerance, except for rhinorrhea which seemed accentuated by prostacyclin (possibly because of nasal vasodilatation). Our results suggest that either the inhibitory effects of prostacyclin on leukotrienes described in vitro do not apply in vivo, or the importance of leukotrienes has been overestimated in this type of asthma. PMID- 3539633 TI - Evaluation of the direct detection of group A beta-hemolytic streptococcal antigen in a pediatric population: comparison with the traditional culture technique. AB - An evaluation of the Directigen Group A Strep Test (DGAST) in comparison with the traditional culture technique, was carried out on 1907 throat specimens, obtained from pediatric patients suspected of having a group A beta-hemolytic streptococcal pharyngitis. Of the 344 specimens positive by culture, 277 were DGAST positive (sensitivity, 81%). Of the 1563 specimens negative by culture, 1511 were DGAST negative (specificity, 97%). Nineteen isolates of non-group A beta-hemolytic streptococci were recovered, primarily group C, B and G. The DGAST is easy to perform, rapid and very specific, but lower sensitivity indicates that a back up traditional culture is still necessary, especially in pediatric patients. PMID- 3539635 TI - Guanidinophenyl derivatives of pyrazole: synthesis and inhibitory effect on serine proteinases, blood coagulation and platelet aggregation. AB - Guanidinophenyl derivatives of pyrazole have been synthesized. Their inhibitory effects on (i) bovine trypsin, bovine thrombin, porcine pancreatic kallikrein catalyzed hydrolysis of p-nitro anilide of N alpha -benzoyl-arginine and (ii) blood coagulation and platelet aggregation, were investigated. The kinetic behaviour of all compounds conformed to that of a reversible competitive inhibition pattern, and they were also found to act in vitro as inhibitors of platelet aggregation induced by ADP. PMID- 3539634 TI - Smoking and reproduction. PMID- 3539636 TI - Specificity of prolyl endopeptidase. AB - A series of tetrapeptides, Cbz(Bz)-Gly-X-Leu-Gly, were synthesized and the kinetic parameters, kcat and kcat/Km, determined for their hydrolyses by prolyl endopeptidase from Flavobacterium. The peptides with X = N-Me-Ala, Sar and Ala as well as the standard substrate (X = Pro) were found to be good substrates, while those with X = alpha-aminobutyryl, Hyp, Ser and Gly were poor substrates, and those with X = pipecolyl, alpha-aminoisobutyryl, N-Me-Val, N-Me-Leu, Hyp(O-Bzl) and Ser(O-Bzl) were not cleaved at all. These results suggest that the specificity-determining site or S1 subsite of the enzyme is designed to fit exactly the proline residue of the substrate with allowance for the residues carrying substituents at the N and/or C alpha which must not exceed the size of the pyrrolidine ring of proline. PMID- 3539638 TI - Binding of phosphorylated and dephosphorylated heavy meromyosin to F-actin. AB - The effect of myosin light chain phosphorylation in skeletal muscle was investigated with respect to the binding affinity of phosphorylated and dephosphorylated heavy meromyosin (HMM) for F-actin in the absence of ATP. For phosphorylated HMM the affinity was 2.5-times weaker in the presence of Ca2+ as in its absence (HMM divalent binding sites saturated only with Mg). For dephosphorylated HMM the reverse was true, the binding being 2.4-times higher in the presence of Ca2+. PMID- 3539639 TI - [Profuse gastrointestinal hemorrhages of peptic etiology]. PMID- 3539637 TI - The polar head group of a novel insulin-sensitive glycophospholipid mimics insulin action on phospholipid methyltransferase. AB - A phospholipid has been purified from rat liver membranes which copurified with an insulin-sensitive glycophospholipid isolated from H35 hepatoma cells. The polar head group of this phospholipid was generated by treatment with a phosphatidylinositol-specific phospholipase C from Staphylococcus aureus and purified through a C18 extraction column. Like insulin, the addition of this polar head group to isolated rat adipocytes inhibited the stimulatory effect of isoproterenol on phospholipid methyltransferase. The polar head group was also active on a subcellular fraction. The addition of the polar head group to microsomes isolated from isoproterenol-treated adipocytes produced a time dependent inactivation of phospholipid methyltransferase, approaching basal activity. It is proposed that the effects of insulin on phospholipid methyltransferase may be mediated by this polar head group. PMID- 3539640 TI - [Rare and hazardous surgical operations to remove unexploded mines from the body of the wounded]. PMID- 3539641 TI - [The representation of medicinal plants on Soviet stamps and covers]. PMID- 3539642 TI - Pharmacokinetics of intravenous luteinizing hormone-releasing hormone administration in men: effects of various dosages. AB - Exogenous luteinizing hormone-releasing hormone (LH-RH) was intravenously administered as a single-bolus injection to 26 healthy normal men. LH-RH doses were selected at 1, 2.5, 5, and 20 micrograms for exploration of the optimum LH RH dose to obtain adequate pituitary stimulation. Blood samples (for LH-RH and LH determinations) were collected at frequent intervals from 10 minutes before to 60 or 90 minutes after injection. LH-RH peak levels varied, in a dose-dependent way, between 119 +/- 16 and 517 +/- 70 ng/l. Peak values were all reached between 1 and 3 minutes after injection, and elimination occurred rapidly, with half-lives between 2.6 +/- 0.4 and 5.2 +/- 1.0 minutes. The area under the curves increased significantly (P less than 0.01) if the doses of LH-RH had been augmented from 1 to 20 micrograms. Maximum LH values were reached more rapidly in the low-dose (1 and 2.5 micrograms) experiments (between 13.5 and 16.3 minutes), with an obvious decline afterwards. The area under the LH curves increased (P less than 0.01) if the doses of LH-RH had been elevated from 1 to 2.5 micrograms, but no further increase of LH release occurred (P greater than or equal to 0.21) if LH-RH doses were further elevated from 2.5 to 20 micrograms. The current study demonstrates that a 2.5-micrograms intravenous LH-RH dose is best suited for an adequate pituitary stimulation in normal men. PMID- 3539643 TI - Studies of the mechanism(s) of mammalian ovulation. PMID- 3539644 TI - The response of patients with organic hypothalamic-pituitary disease to pulsatile gonadotropin-releasing hormone therapy. AB - Treatment with pulsatile gonadotropin-releasing hormone (GnRH) therapy has been attempted in 13 women and 5 men with hypogonadotropic hypogonadism caused by structural lesions of the hypothalamic-pituitary axis. Ten patients responded to treatment with induction of ovulation or spermatogenesis. Of these subjects, seven had primary suprasellar lesions, and one had an apparently empty pituitary fossa on reconstructive computerized tomographic scanning. The eight patients who failed to respond to treatment all had extensive intrafossa damage, as a result of either surgery, irradiation, or infarction. Pulsatile GnRH therapy is not effective in patients with extensive intrafossa lesions. PMID- 3539645 TI - Can ultrasound be used to screen uterine malformations? AB - Eighty-nine patients were examined by ultrasound during the second phase of the menstrual cycle. The operators were not aware of the patients' history or results of previous ultrasonographic or radiologic investigations. The operators' aim was to diagnose uterine malformations graded as normal, suspected, or abnormal. Ultrasound identified 7 of 9 patients with a didelphic or complete septate uterus and 2 out of 3 with a bicornuate or partial septate uterus. Two other cases were suspected (one with a unicornuate, the other with a didelphic uterus). One false positive case occurred, and 10 patients were not identified as having a malformed uterus (sensitivity, 42.9%; specificity, 97.8%). False-negatives involved mainly minor malformations. PMID- 3539646 TI - The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. AB - The age at ovarian failure was determined in 90 women who had previously undergone abdominal hysterectomy with bilateral ovarian conservation and in 226 women who had undergone a spontaneous menopause. The mean age of ovarian failure in the hysterectomized group was 45.4 +/- 4.0 years (standard deviation), and this was significantly lower than the mean age of 49.5 +/- 4.04 years in the nonhysterectomized control group (P less than 0.001). There was a significant correlation between the age at hysterectomy and the age of ovarian failure in the women who were 44 years or less at the time of ovarian failure (r = 0.62, P less than 0.001), implying a causal relationship. The indication for hysterectomy did not influence the time of ovarian failure. Two explanations are proposed as to how conventional surgery for hysterectomy may adversely affect ovarian function. PMID- 3539647 TI - [The role of morphological properties of the dentition in the incidence of caries]. PMID- 3539648 TI - [Reconstructive head and neck surgery in Japan]. PMID- 3539649 TI - Electrocardiographic phenomena in the transplanted human heart. PMID- 3539650 TI - Delaware's first "doctor": Tyman Stidham, and the tools he used. PMID- 3539651 TI - [Impairment of sheep erythrocyte rosette formation by sera from patients with bullous pemphigoid]. PMID- 3539652 TI - [4th working seminar of the Dermatosurgical Section of the East Germany Dermatology Society. 29 November 1985, Berlin. Abstracts]. PMID- 3539653 TI - Ritodrine and pyridoxine in herpes gestationis. PMID- 3539654 TI - Expert systems in dermatology: the computer potential. The example of facial tumour diagnosis. AB - The expert system approach to computer diagnosis uses a non-algorithmic method to represent and manipulate an expert's knowledge and reasoning. This information, which may be provided by a dermatologist, is represented by rules in a logic based computer language in order to provide interactive and explanatory features. The major advantages of using expert system techniques for computer-aided diagnosis in dermatology are that knowledge is made explicit, the heuristic nature of an expert's knowledge can be more easily captured and the more easily readable programs make modification easier. In the example described, the differential diagnosis of nine facial skin tumours was considered. The program, using the language 'micro-PROLOG' in an expert system shell 'APES', consists of 'rules' and 'facts' which define a relationship between patient and symptom, symptom and disease or disease and therapy. The 'strength' of each relationship is defined and 'key symptoms' identified. The system finally offers a diagnosis, an estimate of certainty and simple management advice. PMID- 3539655 TI - An update on fissure sealants (1). PMID- 3539656 TI - Micrometering in medicine: an historical perspective. PMID- 3539657 TI - Characterization of Ac3-proteinase from the venom of Agkistrodon acutus (hundred pace snake). AB - Ac3-Proteinase from the venom of Agkistrodon acutus was isolated in a homogeneous form by a previously published method. Ac3-Proteinase possessed lethal, hemorrhagic, caseinolytic, azocaseinolytic, dimethylcaseinolytic and hide powder azure hydrolytic activities. These activities were inhibited when Ac3-Proteinase was incubated with the metal chelators ethylenediaminetetraacetic acid (EDTA), ethyleneglycol-bis-(beta-aminoethyl ether)-N,N'-tetraacetic acid (EGTA), tetraethylenepentamine (TEP), 1,10-phenanthroline, phosphoramidon or beta mercaptoethanol. The toxin also hydrolyzed the oxidized A and B chains of both insulin and fibrinogen. The cleavage sites in the oxidized B chain of insulin were identified as His(10)-Leu(11), Ala(14)-Leu(15), Tyr(16)-Leu(17) and Phe(24) Phe(25). The A alpha chain of fibrinogen was digested first followed by hydrolysis of the B beta chain. Toxicological and biochemical properties of Ac3 Proteinase were investigated further and are reported in this paper. PMID- 3539658 TI - The catalytic properties of a proteinase isolated from sheep abomasal mucosal mast cells. AB - The catalytic properties of a sheep mast cell proteinase (SMCP), isolated from abomasal mucosal mast cells, were investigated. The enzyme was shown to have chymotrypsin-like esterase activity, with no detectable amide activity, using a range of low molecular weight substrates. Maximal activity, against Benzyloxycarbonyl-L-tyrosine-4-nitrophenol ester, was determined to be in the range pH 7.6-8.0. Inhibitor studies showed that, unlike chymotrypsin, a serine proteinase, SMCP was found to be susceptible to the action of thiol blocking agents and chelating agents, but to be unaffected by diisopropylphosphofluoridate, a serine proteinase inhibitor. PMID- 3539659 TI - The developmental program of fast myosin heavy chain expression in avian skeletal muscles. AB - We have examined the types of fast myosin heavy chains (MHCs) expressed in a number of different developing chicken skeletal muscles by combining peptide mapping and immunoblotting to identify fast MHC-specific peptides among the total mixture of MHC digestion products. Using this technique, we have identified three different fast MHC patterns among the different fast and mixed (i.e., fast and slow) fiber type muscles of the adult. While the different muscles all underwent sequential changes in fast MHC isoform expression during their development, the exact sequence of these changes and the isoform patterns expressed varied from muscle to muscle. During late embryonic or fetal development, all muscles expressed a similar fast MHC pattern (designated here as the fetal pattern) which was replaced shortly after hatching with a different fast MHC pattern (the neonatal pattern). During the transition from the neonatal to the adult state that occurred sometime in the first year after hatching, many of the muscles underwent additional changes in fast MHC isoform expression. In muscles such as the pectoralis major and pectoralis minor, a new fast MHC isoform pattern was seen in the adult so that the developmental program of isoform switching in these muscles involved the sequential appearance of distinct fetal, neonatal, and adult fast MHCs. Other muscles, such as the sartorius and posterior latissimus dorsi, underwent a qualitatively different program of isoform switching and expressed as an adult a fast MHC pattern that was indistinguishable from that expressed during fetal development. Finally, in some muscles, such as the superficial biceps, no change in isoform pattern was detected during the neonatal to adult transition- in these muscles, expression of the neonatal MHC isoform pattern apparently persisted into the adult state. These data indicate that no single scheme or program of fast MHC isoform switching can describe all the developmental changes that occur in fast MHC isoform expression in the chicken and that at least three different programs of isoform switching and expression can be identified. PMID- 3539660 TI - Type VI collagen: immunohistochemical identification as a filamentous component of the extracellular matrix of the developing avian corneal stroma. AB - Selected stages of the developing chicken cornea have been examined for type VI collagen, employing monoclonal antibodies specific for this molecule. By immunofluorescence, the molecule is not detectable in 5 1/2 day corneas, a time at which the epithelial-derived, acellular primary stroma is the only corneal matrix present. One day later, the presumptive stromal fibroblasts have invaded this stroma and have initiated synthesis of the secondary (mature) stroma. By that time, a strong fluorescent signal for the type VI collagen molecule is detectable throughout the stroma. It is present in all subsequent ages examined. The molecule is not restricted to the cornea, and is present in most stromal matrices examined, including those of the sclera, eyelid, and nictitating membrane. Immunoelectron microscopy was also performed, utilizing a colloidal gold-labeled secondary antibody. These data show that the type VI collagen is not a component of the striated collagen fibrils, but instead is assembled in the form of thin filaments. The monoclonal antibody bound to the filaments at periodic intervals of about 100 nm. PMID- 3539661 TI - Localization of fodrin during fertilization and early development of sea urchins and mice. AB - Fodrin, a spectrin-like protein, is localized in gametes, zygotes, and embryos from sea urchins and mice. Mammalian fodrin comprises two polypeptides with molecular weights of approximately 240 kDa (alpha) and 235 kDa (beta). An antibody specific for mammalian alpha-fodrin cross-reacted with a 240-kDa polypeptide from sea urchin egg extracts. This indicates that sea urchins contain a protein of similar electrophoretic mobility and immunological properties to mammalian alpha-fodrin. When this antibody was used to stain the sea urchin gametes with indirect immunofluorescence, fodrin-specific fluorescence was localized to the acrosome of the sperm and was distributed over the entire egg near the surface in a punctate pattern similar to the distribution of polymeric actin. During sperm incorporation, the fodrin-specific fluorescence is found at the site of sperm incorporation, in the fertilization cone. After fertilization, the intensity of fodrin fluorescence increases. During mitosis and cytokinesis in sea urchins, the entire surface of the egg remains stained; the cleavage furrow also was stained but no more intensely than was the rest of the egg surface. Antibody labeling with colloidal gold followed by electron microscopy showed that fodrin was loated in the cytoplasm immediately beneath the plasma membrane. In unfertilized mouse oocytes, both actin and fodrin were stained most intensely beneath the membrane adjacent to the meiotic spindle. After insemination, the cell surfaces of the pronucleate egg and the second polar body were stained; however, the actin matrix surrounding the apposed pronuclei did not bind the fodrin antibody. During cytokinesis in the mouse, the cleavage furrow stained more intensely than did the rest of the egg cortex, and in embryos the cell borders were delineated. These results indicate that organisms as unrelated to mammals as sea urchins have fodrin-like proteins; the rearrangements of such proteins suggest that they participate in the actin-mediated events at the cell surface during fertilization and early development in both mice and sea urchins. PMID- 3539662 TI - A monoclonal antibody (SN1) identifies a subpopulation of avian sensory neurons whose distribution is correlated with axial level. AB - We have produced a monoclonal antibody, designated SN1, which binds to the surfaces of a subpopulation of avian sensory neurons, but not to other neurons of the peripheral or central nervous systems. The proportion of SN1(+) neurons in brachial and lumbosacral dorsal root ganglia (DRG), which innervate the wings and legs respectively, is low (30-40%), compared to the proportion (80-90%) in the lower thoracic DRG. SN1 immunoreactive fibers project to laminae I and II of the spinal cord dorsal horn, and are seen in the skin, but not the deeper tissues of older embryos. On the basis of the time of appearance, axial level-dependent distribution, and the central and peripheral projections of SN1(+) neurons, we suggest that they are cutaneous afferents that depend on interaction with peripheral targets to differentiate. PMID- 3539663 TI - An appreciation: Stephen P. Meier. PMID- 3539664 TI - The differentiation of normal and muscle-free distal chick limb bud mesenchyme in micromass culture. AB - Distal chick wing bud mesenchyme from stages 19 to 27 embryos has been grown in micromass culture. The behavior of cultures comprising mesenchyme located within 350 microns of the apical ectodermal ridge (distal zone mesenchyme) was compared to that of cultures of the immediately proximal mesenchyme (subdistal zone cultures). In cultures of the distal mesenchyme from stages 21-24 limbs, all of the cells stained immunocytochemically for type II collagen within 3 days, indicating ubiquitous chondrogenic differentiation. At stage 19 and 20, this behavior was only observed in cultures of the distal most 50-100 microns of the limb bud mesenchyme. Between stages 25 and 27, distal zone cultures failed to become entirely chondrogenic. At all stages, subdistal zone cultures always contained substantial areas of nonchondrogenic cells. The different behavior observed between distal zone and corresponding subdistal zone cultures appears to be a consequence of the presence of somite-derived presumptive muscle cells in the latter, since no such difference was observed in analagous cultures prepared from muscle-free wing buds. The high capacity of the distal zone for cartilage differentiation supports a view of pattern formation in which inhibition of cartilage is an important component. However, its consistent behavior in vitro indicates that micromass cultures do not reflect the in vivo differences between the distal zones at different stages. The subdistal region retains a high capacity of cartilage differentiation and the observed behavior in micromass reflects interactions with a different cell population. PMID- 3539665 TI - Monoclonal antibody identification of a type II alveolar epithelial cell antigen and expression of the antigen during lung development. AB - A monoclonal antibody identifying an antigen expressed by rat type II alveolar epithelial cells, but not by type I epithelial cells or other mature lung cells, was produced by immunization of mice with cells of the rat L2 cell line. The antigen recognized by the antibody was present on the microvillous luminal surface of type II epithelial cells. In adult rat lung, only type II epithelial cells bound the antibody. During fetal development the antigen was expressed by cuboidal epithelial cells lining the respiratory ducts of the first divisions of the tracheal bud, but not by epithelial cells lining the esophagus or trachea. The antigen continued to be expressed by cuboidal epithelial cells lining the larger respiratory ducts until approximately 19 days gestational age. Thereafter, expression was increasingly limited to selected single cells or clusters of two to four cuboidal cells in the smallest ducts. By the 21st postnatal day, the antigen was expressed only by type II alveolar epithelial cells. Type II alveolar epithelial cells isolated from adult lung and the L2 cell line in culture expressed the antigen on the cell surface. A protein of approximately 146,000 Mr was isolated by immunoadsorption of the antigen from non-ionic detergent extracts of type II cells and L2 cells. Preliminary studies of the binding of the antibody to other rat tissues indicate that the antibody binds to renal proximal tubular epithelial cells of the kidney and the luminal surface of the small bowel epithelial cells. PMID- 3539666 TI - Onset of endogenous synthesis of epidermal growth factor in neonatal mice. AB - We have analyzed mouse fetuses and neonates for the presence of epidermal growth factor (EGF)-specific mRNA. No detectable EGF-specific mRNA was found in fetuses, fetal membranes, or placentae from Day 9 of gestation through birth or in the early neonatal period. While the kidneys begin to produce EGF specific transcripts by two weeks postpartum, the salivary glands begin to produce detectable levels of EGF mRNA only after weaning and even then at levels far below the adult amount. Reports of EGF and EGF-related material in rodent fetuses failed to determine whether this material was of maternal or fetal origin. We now conclude that authentic EGF in these embryos is probably of maternal origin. We have performed experiments designed to determine whether EGF can be transported into the fetus. A small percentage of 125I-EGF administered to pregnant females either systemically or directly into the uterine arteries reached the fetus itself. The uterus and the placenta attained a high level of labeling, whereas the amniotic fluid and yolk sac were virtually devoid of the tracer. In the neonatal period, milk may be the physiologically relevant source of EGF. We have found that 125I-EGF ingested by neonates was absorbed into the circulation, reached many internal organs, and was eventually excreted in the urine. Previously demonstrated EGF receptors in mouse embryonic cell types may be activated by either alpha type transforming growth factor or maternal EGF transported via the placenta. PMID- 3539667 TI - Myocardial specificity for initiating endothelial-mesenchymal cell transition in embryonic chick heart correlates with a particulate distribution of fibronectin. AB - The early chick heart tube consists of myocardium and endothelium separated by a myocardially derived basement membrane (MBM). As development proceeds, the endothelium undergoes a transition into mesenchyme in a regionally specific manner; only the atrioventricular (AV) and outflow tract, but not the ventricular endothelium, is transformed into mesenchyme, the progenitor of heart septa and valves. Recent experiments have shown that an EDTA extract of MBM can initiate AV endothelium to form mesenchyme in an in vitro collagen gel culture system. Two dimensional gel electrophoresis of AV region EDTA extracts showed potentially three isoelectric forms of fibronectin (Fn), while extracts from ventricle contained only two forms. The purpose of the present study was to further investigate the significance of these regional differences by testing of specific myocardial regions (AV vs ventricle) for their ability to induce endothelium to form mesenchyme in vitro, and to immunohistochemically determine if a regionally specific distribution of Fn exists in the MBM that can be correlated with previous electrophoretic data. Embryonic heart regions cultured on three dimensional collagen gels showed that AV endothelium could only form mesenchyme if cocultured with AV myocardium. Coculture with ventricular myocardial explants did not initiate differentiation of AV endothelium. In contrast, ventricular endothelial cells did not form mesenchyme when cocultured with AV or ventricle myocardium. Immunohistochemical localization of Fn revealed three distinct morphological patterns of distribution in the AV-MBM, i.e., an intense lamina densa staining, diffuse staining in fibrils, and as particles. The Fn localized in particles (0.1 to 0.5 micron in diameter) appeared as a gradient of decreasing concentration extending from the myocardium toward the endothelium. In contrast, no particulate Fn staining was observed in the ventricular region. EDTA extraction selectively depleted the particulate form of Fn. Previous work has shown that this extract, which contains several lower Mr proteins in addition to Fn, is biologically active in initiating mesenchyme formation from AV endothelium in vitro. These results show that a regionally specific interaction of the myocardium with the endothelium is required to initiate the formation of prevalvular mesenchyme. This interaction may be mediated by a multicomponent complex involving Fn and other proteins which appear as a regionally distinct particulate only in areas of endothelial differentiation. PMID- 3539668 TI - The reduction of the number of animals used in the biological assay of insulin. AB - The biological control of insulin is vital as it is administered daily to a large proportion of the population during the major part of their lives. The development of the biological assay of insulin will be described with the progressive evolution of methods eventually to dispense with the need for animals. From the quantal Mouse Convulsion Method using around 600 mice per sample to the quantitative Mouse Blood Glucose method using an average of 120 mice per sample in which the fall in the blood glucose levels is used to estimate the potency of insulin by its hypoglycaemic effect. This was followed by the development of the in vitro Radioreceptor Method which is a procedure based on competition between the binding of insulin and [125I]-insulin to cells of the cultured human IM-9 cell line. The production of highly purified insulin by the Pharmaceutical Industry has made possible the recent introduction of new High Performance Liquid Chromatography technology. PMID- 3539669 TI - Studies on Escherichia coli vaccines: an in vitro approach to establishing safe limits of endotoxins in vaccines. AB - A total of fifty production batch samples from six different vaccines for pigs, sheep and cattle were monitored for their endotoxin content. All vaccines recommended for parenteral administration into pregnant animals were aqueous and cellular with the exception of one comprising enterotoxin only. The Limulus amoebocyte lysate test was used for endotoxin determination. Total endotoxin of the vaccine was estimated and a method has been devised to estimate the enterotoxin bound either to the cells or the adjuvant. The highest endotoxin levels obtained for pigs, sheep and cattle vaccines were 47.9 micrograms ml-1, 4.7 micrograms ml-1 and 2.4 micrograms ml-1 respectively. All these vaccines have been found to be safe in pregnant animals. The non-cellular vaccine containing enterotoxin only had an endotoxin level of 0.47 microgram ml-1. PMID- 3539670 TI - Assessment of immunity to Pasteurella haemolytica in sheep by in vitro methods. AB - The sera of conventionally-reared sheep which had been experimentally infected with Pasteurella haemolytica serotype A2 and Mycoplasma ovipneumoniae were compared with those of animals from the same source which had been vaccinated 3 times with an alhydrogel-adsorbed mixture of cell-wall extract and heat-killed cells of P. haemolytica A2 emulsified in Freund's incomplete adjuvant. Both groups of animals had high titres of anti-P. haemolytica A2 IgG by ELISA, high opsonic indices in a phagocytic assay involving ovine lung macrophages, and reacted with a large number of cell-wall antigens in an immunoblot test. Both types of sera also protected mice against challenge with P. haemolytica A2 in mucin. In contrast, sera from animals injected twice with a vaccine similar to the first but lacking oil adjuvant yielded much lower values in the ELISA, opsonic index and immunoblotting assays, and failed to protect mice against challenge. The correlations between the 3 in vitro tests and the passive protection test in mice suggest that evaluation of the efficacy of P. haemolytica vaccines may be possible by in vitro methods alone. PMID- 3539671 TI - Comparative studies of two potency tests for antirabies serum: neutralization test in mice (MNT) and rapid fluorescent focus inhibition test (RFFIT). AB - At our institute the mouse neutralization test (MNT) was replaced by the rapid fluorescent focus inhibition test (RFFIT). Therefore, RFFIT results were statistically analyzed for their percentage limits at the 95% confidence level and were compared with those of the MNT. An anti-rabies immunoglobulin of human origin and the WHO standard serum were assayed on 20 consecutive days to determine the reproducibility of the RFFIT. Sera of 60 vaccinees were assayed for rabies antibodies by the RFFIT and MNT. The titers as well as the international units per ml showed a correlation of 0.95 and 0.87 respectively. In accordance with previous publications by other authors it was found that the RFFIT is a significantly better reproducticible test system than the MNT and excellently correlates with the latter method. PMID- 3539672 TI - Increase in insulin antibodies during continuous subcutaneous insulin infusion and multiple-injection therapy in contrast to conventional treatment. AB - Forty-five insulin-dependent diabetics were randomized to 1 yr treatment with either continuous subcutaneous insulin infusion (CSII), multiple insulin injections (MI), or continued conventional treatment. The CSII group used regular insulin only, the MI group used 4-6 premeal injections of regular insulin and intermediate insulin at night, and the conventional group used two daily injections of combined regular and intermediate insulin. Only highly purified porcine insulin was used. Near normoglycemia was obtained during CSII and MI but not during conventional treatment. Antibodies against insulin were measured in serum samples by measuring the binding of iodinated porcine insulin to serum after removal of free and antibody-bound insulin from the samples by acid charcoal. The percent binding of 125I-labeled insulin increased significantly during MI and CSII, in contrast to conventional treatment. Nineteen patients had sufficient binding capacity for Scatchard analysis. In the CSII and MI groups, high- or low-affinity antibodies or both were induced. When insulin was administered subcutaneously during MI or CSII for 1 yr, the insulin antibody production increased, in contrast with conventional treatment. PMID- 3539673 TI - Prior cholecystokinin exposure sensitizes islets of Langerhans to glucose stimulation. AB - Prior, short-term exposure of isolated perifused islets to cholecystokinin (CCK8S) sensitizes them to subsequent glucose stimulation. This sensitization effect develops quickly and persists long after the removal of CCK8S from the perifusion medium. Continued binding of CCK8S to its receptor on the beta-cell and the increase in glucose metabolism noted with glucose stimulation are essential for the full expression of this response. This sensitization process may play an integral role in the postulated incretin effect of the peptide. PMID- 3539674 TI - Phosphorylation of purified insulin receptor by cAMP kinase. AB - Highly purified insulin receptor was shown to be a substrate for cAMP kinase. Approximately 1 phosphate was incorporated per molecule of receptor, and the cAMP kinase's affinity for the receptor was at least as high as its affinity for histone. The sites phosphorylated by cAMP kinase seemed distinct from those phosphorylated by the protein kinase C. Phosphorylation by cAMP kinase had no effect on the ability of several monoclonal antibodies to recognize the receptor or on the insulin-binding activity of the receptor. However, cAMP phosphorylation partially inhibited the tyrosine kinase activity of the receptor (approximately 25%). These results suggest that catecholamine-induced resistance to insulin may be partly due to a direct phosphorylation of the receptor by cAMP kinase and a subsequent inhibition of the ability of the receptor kinase to be activated by insulin. PMID- 3539675 TI - Modulation of insulin action on 2-deoxyglucose uptake by chloroquine in chick embryo fibroblasts. AB - Blazar et al. recently found that chloroquine therapy decreased intravenous insulin requirements in a case of extreme insulin resistance. However, no relationship has been shown to exist between insulin degradation and the stimulation of glucose uptake. In this study we investigate the action of insulin on glucose uptake by the ability of this hormone to stimulate 2-deoxyglucose. The effect on alpha-aminoisobutyrate uptake, which is known to be insulin sensitive, is also investigated. Cell-associated 125I-labeled insulin and trichloroacetic acid-soluble and -precipitable substances were measured in parallel. Chloroquine increased insulin-stimulated uptake of 2-deoxyglucose and alpha-aminoisobutyrate. Three hours were required for this effect to appear, and it did not depend on DNA synthesis. Chloroquine also increased cell-associated insulin and slightly decreased the percentage of trichloroacetic acid-soluble products. Methylamine affected neither nutrient uptake processes nor insulin binding and degradation; however, it did abolish the effect of chloroquine on these parameters. These data suggest that in chick embryo fibroblasts a relationship may exist between the increase in undegraded cell-associated insulin and the ability of the hormone to stimulate sugar and amino acid uptake. PMID- 3539677 TI - Endocrine cell proliferation and carcinoid development: a review of new aspects of hypergastrinaemic atrophic gastritis. AB - The accumulating evidence of an association between antrum-sparing hypergastrinaemic atrophic gastritis, frequently associated with pernicious anaemia, and the occurrence of gastric carcinoid tumours is briefly reviewed. The development of argyrophil cell carcinoid tumours in the atrophic fundic mucosa seems to be related to argyrophil cell hyperplasia caused by hypergastrinaemia. Epidemiologic considerations indicate that the gastric carcinoid generally is underdiagnosed and that the incidence of this tumour is higher than previously recognized. The clinical relevance of minute gastric carcinoids, or endocrine cell 'adenomas', is obscure. However, larger tumours should be regarded as potentially malignant. These findings are relevant to the aspect of long-term medically induced achlorhydria leading to hypergastrinaemia. PMID- 3539676 TI - Influence of age on responsiveness to diabetogenic action of growth hormone. AB - Responsiveness to the growth-promoting action of growth hormone (GH) develops gradually during post-natal life, and as the organism ages, sensitivity to the hormone declines. Our study was undertaken to determine whether there is a similar age-related pattern of sensitivity to the diabetogenic action of purified native human GH (hGH) in the obese (ob/ob) mouse. The ob/ob mouse was used because adults of this strain respond to chronic GH treatment with increases in fasting plasma insulin and blood glucose concentrations and with glucose intolerance. When hGH was given subcutaneously to adult (4-mo-old) female mice at doses of 5, 10, or 25 micrograms/day for 3 days, a significant increase in fasting blood glucose concentration and an impairment in glucose tolerance were produced by the 10-micrograms/day dose. Larger effects were obtained with the 25 micrograms/day dose. A threefold increase in fasting plasma insulin concentration was also produced with this dose of the hormone. By contrast, 25 micrograms/day of hGH had no effect on fasting plasma insulin, blood glucose, or glucose tolerance in 1-mo-old ob/ob mice. When a dose of 100 micrograms/day of hGH was given to 1-mo-old animals, a significant increase in fasting plasma insulin concentration occurred, but again there were no effects on fasting blood glucose or glucose tolerance. Mice 1.5 mo old showed marginal changes in fasting blood glucose and glucose tolerance when given hGH at doses of 25 or 100 micrograms/day. Mice 9 or 12 mo old exhibited responsiveness similar to that of 4 mo-old animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539678 TI - Activation and hyperplasia of gastrin and enterochromaffin-like cells in the stomach. AB - The stomach is rich in endocrine cells, most of which are still unidentified with respect to the peptide hormones they produce. The endocrine cell populations in the antrum usually differ from those in the oxyntic mucosa. Gastrin cells are found in the antrum and respond readily to stimuli from the gastric lumen, such as changes in the pH and the presence of food. In order to study the functional control of the antral gastrin cell, rats were subjected to different kinds of surgery. The serum gastrin concentrations in the various experimental groups were measured 8-10 weeks after the operations. Elevated antral pH raised the serum gastrin concentration. The combination of elevated antral pH and the passage of food over the pyloric glands produced gastrin cell hyperplasia. The operation that was most effective in inducing gastrin cell hyperplasia was removal of the acid-producing part of the stomach. Interestingly, gastrin cell hyperplasia was seen also after bilateral truncal vagotomy, indicating that an intact vagal innervation is not essential for the development of gastrin cell hyperplasia. Enterochromaffin-like (ECL) cells are endocrine/paracrine cells that are numerous in the acid-producing part of the stomach in many species. In the rat, they occur predominantly in the basal half of the oxyntic mucosa and produce and store histamine. The ECL cells have an unknown function and do not seem to respond to stimuli from the gastric lumen. They are activated by circulating gastrin and by vagal excitation. Gastrin mobilises histamine from these cells and activates the histamine-forming enzyme, histidine decarboxylase. Long-term hypergastrinaemia produces diffuse ECL cell hyperplasia, whereas hypogastrinaemia (following removal of the endogenous stores of gastrin by antrectomy) reduces the ECL cell number. Portacaval shunt brings about a marked increase in the number of ECL cells through an unknown mechanism. Also neuronal stimuli are important for the trophic control of the ECL cells. Studies of unilaterally vagotomised rats showed reduced weight and thickness of the oxyntic mucosa as well as a markedly reduced number of ECL cells on the denervated side. Gastric carcinoids in man are rare tumours predominantly made up of ECL cells. The incidence of such tumours is increased in patients with hypergastrinaemia (pernicious anaemia, Zollinger Ellison syndrome). A diffuse ECL cell hyperplasia is a common finding in such patients, which is in keeping with the known gastrin sensitivity of the normal ECL cell in the rat. PMID- 3539679 TI - Gastric carcinoids and related endocrine growths. AB - A series of 30 gastric endocrine tumours has been revised in the light of available available cytologic and clinicopathologic information. Among 24 well differentiated endocrine tumours-16 with and 8 without chronic atrophic gastritis (CAG)-3 gastrin cell tumours have been distinguished from 21 argyrophil carcinoids, 15 of which showed light- and/or electronmicroscopy patterns of enterochromaffin-like (ECL) cell tumours, 2 of EC cell tumours and 1 of D1/P cell tumour. One case of mixed carcinoid/adenocarcinoma and 5 cases of endocrine carcinomas, 4 poorly and 1 moderately differentiated, were also identified. Achlorhydria, due to type A CAG or HCl-suppressing drugs, and bombesin hyperstimulation are among possible factors inducing G cell hyperfunction and/or hyperplasia. Hypergastrinaemia is among causative agents of argyrophil ECL cell hyperplasias and, possibly, of tumours of the oxynticopeptic mucosa, while chronic inflammation and gland atrophy with or without concomitant hypergastrinaemia are important factors in inducing both hyperplastic and tumour argyrophil growths in CAG mucosa. PMID- 3539680 TI - Psychophysiological therapy for tinnitus. AB - Twenty-two patients with complaints of severe tinnitus received psychophysiological therapy. Biofeedback sessions were supplemented with body relaxation techniques through the use of audio cassette tapes. The experimental group was matched to a control group according to age and sex. The individuals' names in the control group were placed on a waiting list and received no therapy. Evaluation of the success of the experimental group was obtained at a time period of 6 to 9 months following the therapy sessions. The individuals on the waiting list were also contacted at the same time to assess the severity of their tinnitus symptoms. Results revealed that 60% of the treatment group showed improvement compared to 5% of the control group. The effectiveness of psychophysiological therapy in reducing tinnitus symptoms is supported. PMID- 3539681 TI - Insulin induces opposite changes in plasma and erythrocyte magnesium concentrations in normal man. AB - Plasma and erythrocyte magnesium levels were measured by atomic absorption spectrophotometry in 10 healthy volunteers during an oral glucose tolerance test and during an euglycaemic hyperinsulinaemic glucose clamp. At min 180 and 210 of the oral glucose tolerance test, a significant decline in plasma magnesium levels (p less than 0.01 and p less than 0.05 respectively) and a significant increase in erythrocyte magnesium levels (p less than 0.01 and p less than 0.05 respectively) were observed. Similar changes were seen during the second hour of the glucose clamp, during which euglycaemia (4.1 +/- 0.4 mmol/l) was maintained despite hyperinsulinaemia (110-130 mU/l). During in vitro incubations, glucose (5 mmol/l) did not modify erythrocyte magnesium levels. In contrast, erythrocyte magnesium levels were significantly increased (p less than 0.01) by insulin (100 mU/l), an effect entirely abolished by ouabain (5 X 10(-4) mol/l). These results suggest that insulin induces a shift of magnesium from the plasma to the erythrocytes both in vivo and in vitro. These data may help to interprete the abnormalities in magnesium circulating levels frequently reported in diabetic patients. PMID- 3539682 TI - Regulation of energy metabolism in pancreatic islets by glucose and tolbutamide. AB - The kinetics of insulin secretion and oxygen uptake in response to D-glucose and tolbutamide were compared in mouse pancreatic islets. In addition, the role of decreased ATP as a driving force for secretagogue-induced oxygen consumption was examined. D-glucose (10-30 mmol/l) triggered a biphasic insulin release which always coincided with a monophasic increase in islet oxygen uptake. In the presence of D-glucose (5-30 mmol/l), tolbutamide (3-500 mumol/l) consistently elicited an initial peak of insulin secretion which was followed by a continued decline. Tolbutamide-induced secretory profiles were accompanied by similar respiratory profiles. Oxygen consumption per ng of insulin released during the test phase was higher after elevation of the glucose concentration than after addition of tolbutamide. In conjunction with 5 or 10 mmol/l D-glucose, but not with 15 or 30 mmol/l D-glucose, tolbutamide (30-100 mumol/l) lowered islet ATP content significantly (p less than 0.02). Phosphocreatine was not found in isolated islets, although they contained substantial creatine kinase activity. It is concluded that the driving force for tolbutamide-induced oxygen uptake is a decrease in the phosphorylation potential caused by the work load imposed by stimulation of the secretion process. However, a major proportion of the respiratory response to glucose also results from enhancement of biosynthesis. PMID- 3539683 TI - Phenotype modulation in primary cultures of smooth-muscle cells from rat aorta. Synthesis of collagen and elastin. AB - Early in primary culture, arterial smooth-muscle cells undergo a transition from a contractile to a synthetic phenotype. This process includes the loss of myofilaments and of contractility. At the same time, an extensive rough endoplasmic reticulum and a large Golgi complex are formed, and active synthesis of DNA, RNA and proteins commences. In the present study, chemical and immunocytochemical methods were used to investigate the production of extracellular-matrix proteins in relation to this change in phenotypic properties. The results showed that the phase of rapid cellular proliferation that follows the structural modulation of smooth-muscle cells is associated with high rates of collagen and elastin synthesis, as measured by the incorporation of 3H-proline into 3H-hydroxyproline and 3H-valylproline, respectively. SDS polyacrylamide gel electrophoresis and fluorography indicated that type-I collagen is the main collagen species synthesized by these cells. Smaller amounts of type-V collagen and (although not definitively identified) type-III collagen were also detected. Indirect immunofluorescence and immunoelectron microscopy demonstrated that smooth-muscle cells surround themselves with an incomplete basement membrane, containing laminin and type-IV collagen, and thin fibrils of type-I collagen. Adjacent to these fibrils, aggregates of amorphous, elastin-like material were also found. Our observations confirm and extend earlier notions of a close similarity between the behaviour of arterial smooth-muscle cells during in vitro cultivation and during the early stages of the formation of atherosclerotic lesions. PMID- 3539684 TI - Endogenous lectin from terminally differentiated epidermal cells. AB - We isolated a concanavalin A (Con-A)-binding glycoprotein from human stratum corneum by nonionic detergent extraction, lectin affinity chromatography, and preparative gel electrophoresis. This glycoprotein migrates as a single band at 40 kilodaltons at sodium-dodecyl-sulfate gel electrophoresis with or without the presence of 2-mercaptoethanol. It was shown to have a heterogeneous distribution between pH 5.6 and 7.6 by isoelectric focusing. The glycoprotein is histidine rich (10.4%) but is distinct from other histidine-rich proteins (epidermal filaggrin and the histidine-rich glycoprotein from serum). It does not bind to lectins specific for L-fucose or alpha-D-galactose. We prepared a monospecific polyclonal antibody to the 40-kilodalton glycoprotein; at the ultrastructural level, it cytoimmunolocalizes exclusively to the membranes of the stratum corneum. A unique feature of the glycoprotein is that it is an endogenous lectin: it hemagglutinates trypsinized and gluteraldehyde-fixed rabbit erythrocytes. The inhibition of its hemagglutination was found to be greatest with amino sugars, down to a saccharide concentration of 10(-5) mM. Such a high affinity of binding at the cell surface suggests that this glycoprotein is a major carbohydrate binding, cross-linking molecule that holds adjacent corneocytes together in the stratum corneum. We hypothesize that this lectin plays a role in the adhesion and desquamation of the stratum corneum. PMID- 3539685 TI - Chondrogenic potential of mesenchymal cells elicited by bone matrix in vitro. AB - Demineralized bone matrix (DBM) induces development of bone in vivo via the endochondral mode of development. Early events in this inductive process involve the appearance of mesenchymal cells (day 3) followed by chondrogenic differentiation (day 7) after subcutaneous implantation of DBM. In this investigation the chondrogenic potential in vitro of day 3 and day 4 mesenchymal cells from a DBM-induced implant has been explored. Immunofluorescent examination of day 3 cell cultures maintained for 4 days revealed the presence of type II collagen and cartilage-specific proteoglycans only in spherical or polyhedral cells. Micromass cultures and agarose suspension cultures showed toluidine-blue metachromasia in only a small population of cells. Biochemical estimation of 35SO4-labeled proteoglycans from suspension cultures of day 3 and day 4 cells maintained for 3 days indicated the presence of 29% and 38% large cartilage specific proteoglycans, respectively. Addition of bone-inductive guanidine extract of DBM to the cultures did not significantly increase the percentage of large proteoglycans. These observations suggest that day 3 and day 4 cells can undergo chondrogenic differentiation in vitro without the continued presence of the bone-inductive guanidine extract. The presence of guanidine extract in cultures did not enhance chondrogenic expression or promote the recruitment of mesenchymal cells and their transformation to the chondrogenic phenotype. PMID- 3539686 TI - [Slow-virus encephalitis in subjects treated with growth hormone extract: unexpected risks of substitute therapy]. PMID- 3539687 TI - [Plasma levels of anti-arrhythmic drugs and clinical effectiveness in the treatment of ventricular arrhythmias]. AB - In spite of the ratio between plasmatic concentration and antiarrhythmic effects of a drug many factors can be influenced by many factors, the plasma level monitoring plays an important clinical role. The efficacy of the antiarrhythmic therapy should be evaluated not only by means of ECG-Holter monitoring and/or electrophysiological study but also by the means of determination of plasmatic and tissular concentration of a drug and metabolites. This latter is indispensable in the evaluation of new antiarrhythmic drugs and of a dose/effect relationship during acute and chronic therapy. PMID- 3539688 TI - [Cyclosporin: a selective immunosuppressor in hepatology]. PMID- 3539689 TI - [Abdominal lymph node tuberculosis: diagnostic value of echography and x-ray computed tomography]. AB - The aspects of abdominal ultrasonography and computed tomography (CT) were studied in 4 patients (3 African and 1 Haitian) with abdominal tuberculosis. All were markedly debilitated and three patients had protracted fever. Tuberculosis was documented in all cases by demonstrating Mycobacterium tuberculosis in cultures of lymph nodes taken during laparotomy and/or cultures of products of gastric aspiration. Ultrasonography showed enlarged lymph nodes in the pancreatic and peripancreatic areas and also in the mesenteric, perivascular and hepatic pedicle areas. CT showed hypertrophied lymph nodes with low tissue density ranging from 20 to 35 Hounsfield units. Although non pathognomonic, these aspects were suggestive of tuberculosis. Intravenous contrast medium administration failed to increase the density in the center of lymph nodes but disclosed the existence of a thick hyperdense rim surrounding the hypodense center of the caseous lymph nodes. Repeated ultrasound and CT examination allowed to control the efficacy of antituberculous chemotherapy. PMID- 3539690 TI - [Echographic diagnosis of intramural hematoma of the duodenum]. PMID- 3539692 TI - Effect of pectin on gastric emptying and gastroduodenal motility in normal subjects. AB - The effects of pectin ingestion on gastric emptying, gastroduodenal motility, and plasma levels of glucose, insulin, and glucagon were studied. Initial studies demonstrated that 15 g of pectin was the optimal dose. Subsequently 6 healthy male volunteers were studied on 4 separate days at random. On day 1, gastric emptying of a liquid and a solid meal was assessed by radioisotope technique using 99mTc-dithiopropylthiomine. On day 2, the gastric emptying study was repeated with the addition of pectin to each meal. Plasma levels of glucose, insulin, and glucagon also were determined during these 2 days. On day 3, the effects of liquid and solid meals on gastroduodenal motility were assessed by means of a perfused catheter system. On day 4, the motility study was repeated with the addition of pectin to each meal. Pectin supplementation caused a significant prolongation of gastric emptying half-time of both liquid and solid meals (p less than 0.05). The addition of pectin, however, did not have any significant effect on gastroduodenal motility other than increasing the duodenal motility index 10 min after the liquid meal. The addition of pectin to the liquid meal lowered plasma levels of insulin at 15, 30, and 45 min, and glucagon levels 15 min after the meal. No effect was noted on blood sugar levels. On the other hand, the addition of pectin to the solid meal had no effect on plasma levels of glucose, insulin, and glucagon. We conclude that pectin supplementation delays gastric emptying of both liquid and solid meals in normal human subjects without causing notable changes in gastroduodenal motility or significant variations in pancreatic hormone plasma levels. The pectin effect on gastric emptying may be caused solely by increasing the viscosity of the meals. PMID- 3539691 TI - Prospective study of the incidence of ultrasound-detected intrahepatic and subcapsular hematomas in patients randomized to 6 or 24 hours of bed rest after percutaneous liver biopsy. AB - Percutaneous liver biopsies were performed in 40 adult patients with acute or chronic liver disease. Real-time sector scan ultrasound of the right upper quadrant was obtained just before biopsy, 1 day after biopsy, and in 10 randomly selected cases 7 days after biopsy. Twenty patients were randomized, by sealed envelope, to 6-h and 20 patients to 24-h postbiopsy bed rest. Nine patients (23%) had ultrasound-detected hematomas 1 day after liver biopsy (7 intrahepatic, 2 subcapsular). Five of these patients had been randomized to 6-h and 4 to 24-h bed rest. Follow-up ultrasound at 7 days in the 10 randomly selected patients failed to reveal any hematomas not seen on day 1 (n = 6) and showed complete or partial resolution of those that had been detected previously (n = 4). Significant drops in systolic and diastolic blood pressure and increases in pulse rate were common postbiopsy findings, and were unrelated to hematoma formation. The results of this study indicate that intrahepatic and subcapsular hematomas are common after percutaneous liver biopsy. The length of postbiopsy bed rest (6 vs. 24 h) does not appear to influence the frequency of this complication. PMID- 3539693 TI - Cirrhosis as a consequence of graft-versus-host disease. AB - A 28-yr-old woman with severe idiopathic aplastic anemia received an HLA identical mixed lymphocyte culture nonreactive bone marrow transplant from her brother. In the months after successful engraftment, she developed cutaneous and hepatic graft-versus-host disease, associated with marked cholestatic jaundice. Despite a series of therapeutic maneuvers, cholestasis persisted but remained relatively stable over the ensuing 10 yr. However, serial liver biopsies revealed progressive biliary-type fibrosis culminating in cirrhosis. Subsequently, her clinical course deteriorated and she developed signs of hepatic failure, and ultimately died 10.5 yr after bone marrow transplantation. The evolution of chronic graft-versus-host disease to cirrhosis may be a limiting factor in the long-term survival of this group of bone marrow transplant recipients. The lack of correlation between the stable clinical or biochemical indices and the progressive hepatic disease underscores the need for sequential liver biopsies in patients with sustained liver function abnormalities after bone marrow transplantation. PMID- 3539694 TI - Regulation of the put operon in Salmonella typhimurium: characterization of promoter and operator mutations. AB - The two genes required for proline utilization by S. typhimurium form a divergent operon. Expression of the put operon is induced by proline and subject to catabolite repression. Genetic evidence suggests that putA protein autogenously represses transcription of the putA and putP genes. In order to establish the molecular mechanism of put operon regulation we isolated regulatory mutations in the put control region. These mutants were selected using two phenotypes: the ability to degrade a toxic proline analogue, dehydroproline, due to overexpression of putA enzyme activity, or overexpression of lacZ from put::Mud operon fusions. The effect of each mutation on transcription in both directions was determined by measuring lacZ expression from putA and putP operon fusions. These regulatory mutations were cis-dominant when the putA protein was provided in trans, and they map in a region between the two genes. The phenotypes of the mutants suggest that the put regulatory region has a single operator site where the putA protein binds to repress transcription in both directions, and the putA and putP promoters overlap. PMID- 3539695 TI - Frameshift suppression by thyA mutants of Escherichia coli K-12. AB - We have extended our previous study on the suppression of frameshift mutants by Escherichia coli thyA mutants by assaying suppression of 15 rIIB frameshift mutants of bacteriophage T4 on one of our suppressing thyA mutant strains. The majority of insertion mutants were suppressible, whereas none of the deletion mutants tested was suppressible. Frameshift suppression could be inhibited by adding thymidine to the assay medium, but was not affected by the presence of a restrictive rpsL mutation in the host strain. We suggest that the frameshift suppression event occurs at a nonsense codon generated by the frameshift mutation. PMID- 3539696 TI - Chromosomal translocations generated by high-frequency meiotic recombination between repeated yeast genes. AB - We have examined meiotic and mitotic recombination between repeated genes on nonhomologous chromosomes in the yeast Saccharomyces cerevisiae. The results of these experiments can be summarized in three statements. First, gene conversion events between repeats on nonhomologous chromosomes occur frequently in meiosis. The frequency of such conversion events is only 17-fold less than the analogous frequency of conversion between genes at allelic positions on homologous chromosomes. Second, meiotic and mitotic conversion events between repeated genes on nonhomologous chromosomes are associated with reciprocal recombination to the same extent as conversion between allelic sequences. The reciprocal exchanges between the repeated genes result in chromosomal translocations. Finally, recombination between repeated genes on nonhomologous chromosomes occurs much more frequently in meiosis than in mitosis. PMID- 3539697 TI - Repression of meiotic crossing over by a centromere (CEN3) in Saccharomyces cerevisiae. AB - The location of the centromere of chromosome III (CEN3) of Saccharomyces cerevisiae has been altered by means of transformation. The frequency of meiotic crossing over in the CEN3-PGK1 and LEU2-CEN3 intervals increases approximately 1.5- and fourfold, respectively, when CEN3 is repositioned at HIS4. The centromere-distal HIS4-LEU2 region experiences a three- to fivefold decrease in the frequency of meiotic exchange when CEN3 is repositioned at HIS4. The inhibition of meiotic crossing over is conferred by a 627-base-pair fragment of CEN3 DNA and is not dependent on the orientation of CEN3 relative to the rest of chromosome III. PMID- 3539699 TI - [Genetic activity of carbamate herbicides in Escherichia coli and Saccharomyces cerevisiae]. AB - DNA-damaging activity and herbicide-induction of gene point mutations, and intragenic mitotic recombination were studied in bacteria and the yeast tester strains. Herbicide (eptam, triallate, tillam, surpass) were not effective in DNA damaging and mitotic recombination tests. Of the 4 chemicals, only eptam was strongly mutagenic. Dose response curves for eptam differed in bacteria and yeast; maximum mutagenic activity was registered in bacteria at 5 mg/l. Maximum yield of prototrophs was observed after 2 h incubation time. Triallate was moderate, tillam and surpass being weak mutagens for the strains used. PMID- 3539698 TI - [Genetic analysis of the mitochondrial rho-mutability in Saccharomyces. II. Disomy for chromosome IV and spontaneous rho-mutability]. AB - The disomy for chromosome IV in the strains studied led to: reduction in the red pigmentation of ade1 mutant colonies; a decrease in spontaneous rho- mutant frequency, and impairment of sporulation in hybrids descended from disomic parents. The nuclear srm1 mutation decreasing the spontaneous rho- mutability promoted the spontaneous extra chromosome loss in the disomics for chromosome IV. This result suggests a close connection between the spontaneous rho- mutability and mitotic chromosome stability. PMID- 3539700 TI - [Variability of satellite DNA in 2 groups of field mice (Rodentia, Microtinae)]. AB - Nuclear DNAs of three forms of Microtus juldashi--M. carruthersi (group 1) and of three subspecies of polytypic species Alticola macrotis (group 2) were compared. Intensive interpopulational karyotype differentiation was observed in both groups, particularly, for centromeric heterochromatin quantity and localization. As satellite DNAs (satDNAs) were present in C-heterochromatin of the Rodents groups studied, the latter were used as a model for comparison of the satDNAs in the species in statu nascendi. With this view, the nuclear DNAs were studied by means of the neutral CsCl equilibrium centrifugation. In both groups examined, no correlation was found between the presence, the characteristics of the satDNAs and morphological as well as cytogenetic features of the animals. These results are an indirect confirmation of the idea, according to which satDNA does not possibly play significant role in the development of the reproductive isolation and species formation. PMID- 3539701 TI - [Effect of the chemical composition of natural waters on the adsorption of enterobacteria by water-saturated sand]. PMID- 3539702 TI - [Methods of predicting the toxicity of substances migrating from polymer materials used in the food-processing industry]. PMID- 3539703 TI - [Prenatal identification of large-for-gestational age neonates]. PMID- 3539704 TI - [Ultrasonographic images of fibrocystic mastopathy treated with bromocriptine]. PMID- 3539705 TI - [Results and prospects for the growth of occupational medicine in Eastern Siberia (on the 25th anniversary of the Angarsk Institute of Occupational Medicine and Occupational Diseases)]. PMID- 3539706 TI - [Possibility of using the structural disruption effect in leukocytes for biodosimetry purposes in the outpatient examination of persons working with ionizing radiation sources (review of the literature)]. PMID- 3539707 TI - Insulin responsiveness of diaphragm tissue and adipose cellularity in mice selected for rapid growth. AB - Four lines of mice, two lines selected for rapid growth (large body weights) (M16 and H6) and their unselected control lines (ICR and C2, respectively), were examined for traits related to obesity. The M16 line is obese while the other three lines are normal in body composition at 10 weeks of age when fed stock diet. In experiment I, mice were fed stock diet and examined at intervals from 4 to 22 weeks of age. Mice were fed either a high-carbohydrate or high-fat diet in experiment II and examined at 4, 6 and 10 weeks of age. The traits measured were serum glucose, serum insulin and in vitro insulin responsiveness of diaphragm muscle. Epididymal adipose cellularity was determined at 10 weeks of age. Insulin responsiveness was determined for the diaphragm muscle by 2-deoxyglucose uptake. Body weights differed significantly (M16 greater than H6 greater than ICR greater than C2, P less than 0.01). The M16 obese line was hyperglycemic and mildly hyperinsulinemic while the H6 line was hypoglycemic and normoinsulinemic. Basal 2 deoxyglucose uptakes by diaphragm muscle were similar among lines while the insulin-stimulated uptake by M16 and H6 lines was less (P less than 0.01) than the stimulated uptake by their control lines. Diet did not affect basal uptakes, but high-fat diets reduced (P less than 0.01) the insulin stimulated uptakes when compared to the high-carbohydrate diet. Selected lines had more and larger epididymal adipocytes than control lines when fed the stock diet (P less than 0.01). Decreased insulin responsiveness of muscle tissue among the lines occurred concomitantly with an increase in adipocyte size. PMID- 3539708 TI - Duodenal ulcer healing after presentation with haemorrhage. AB - Forty patients who were managed conservatively after haemorrhage from an endoscopically verified duodenal ulcer were randomised at discharge from hospital to enter a blind study of ranitidine therapy (150 mg bd) versus a placebo tablet. The patients were re-endoscoped after four weeks, ulcer status defined and the trial code broken revealing that five of 20 placebo patients had healed their duodenal ulcer compared with 16 of 20 ranitidine patients (p = 0.001). Lifestyle parameters of both groups improved during the study period but no directly related benefit in duodenal ulcer healing could be shown. We conclude that effective anti-ulcer therapy, such as ranitidine, is required to heal a duodenal ulcer which presents with haemorrhage. PMID- 3539709 TI - Use of branched chain amino acids for treating hepatic encephalopathy: clinical experiences. AB - The efficacy of branched chain amino acids in two consecutive clinical studies in patients with severe hepatic encephalopathy was tested. In the preliminary uncontrolled study 19 patients with grade 3-4 hepatic encephalopathy were given an intravenous solution containing leucine 11 g/l, isoleucine 9 g/l, and valine 8.4 g/l in 20% dextrose. A complete recovery of mental state was obtained in all patients in a mean time of 20.5 hours. In a subsequent controlled study 40 patients with grade 3-4 hepatic encephalopathy were randomly assigned to receive intravenous branched chain amino acid in 20% dextrose (group A) or oral lactulose (group B). Twelve patients (70.6%) in group A and eight (47%) in group B regained consciousness in a mean time of 27.6 and 31.5 hours, respectively. The difference in the recovery rate between the two groups, although evident, was not significant. Intravenous branched chain amino acids are thus at least as effective as lactulose in reversing hepatic coma. These data argue strongly in favour of a therapeutic effect of branched chain amino acids in the treatment of hepatic encephalopathy in patients with chronic liver failure. PMID- 3539711 TI - Diagnosing malnutrition. AB - The measurement of selected anthropometric, biochemical and immunological variables, and clinical judgment can be used to assess nutritional state. Nutritional assessment has three main aims: to define the type and severity of malnutrition; to identify high risk patients; to monitor the efficacy of nutritional support. The problems associated with the various methods to assess the nutritional state and the applications of nutritional assessment in clinical practice are presented and discussed. PMID- 3539710 TI - Muscle function and nutrition. PMID- 3539712 TI - Assessing nutritional state in inflammatory bowel disease. AB - Nutrient depletion is a common complication of inflammatory bowel disease, and some of the consequences can be severe. Although it is often easy to recognise the most severely undernourished subjects, those with lesser degrees of malnutrition may prove more difficult to detect. Measurements of many nutritional variables will be abnormal in patients with inflammatory bowel disease, especially in those with Crohn's disease, but are not always relevant to the clinical management of patients. Anthropometric means of assessment, in particular, measurement of mid arm circumference, can act as a simple, reproducible method of detecting those most at risk of appreciable undernutrition. PMID- 3539715 TI - Hildegard Peplau: grande dame of psychiatric nursing. PMID- 3539713 TI - Protein metabolism in inflammatory bowel disease. AB - Major loss of body protein mass in inflammatory bowel disease is much less common than weight loss, which is often attributable to losses of other body, particularly water and fat. It does occur, however, in a few patients, especially in those with compromised food intake. It is due principally to the combined effects of diminished intake and excessive intestinal losses of amino nitrogen. Nitrogen metabolism is influenced not only by protein nutritional state and net nitrogen intake but also by disease activity. There is some evidence for abnormally low secretion of growth hormone in adolescents with inflammatory bowel disease and growth failure. Low serum albumin concentrations are not necessarily related to protein undernutrition and are the combined result of relatively reduced albumin synthesis, increased intestinal losses, and maldistribution between intravascular and extravascular spaces. Concentrations in the plasma of IgG and acute phase reactants may be raised despite increased losses into the bowel lumen. The prevention of total body protein depletion is achieved principally by maintaining adequate and often not supranormal intakes of a balanced source of amino nitrogen in a balanced diet given orally, enterally, or parenterally, combined with a medical or surgical approach to reduce disease activity: supranormal energy intakes are not beneficial. PMID- 3539714 TI - Effect of branched chain amino acid infusions on body protein metabolism in cirrhosis of liver. AB - Thirty seven patients with established cirrhosis of the liver were subjected to measurement of body protein metabolism using L-(1-14C) labelled leucine as a tracer. The effects of disease severity and those of solutions containing 0%, 16%, 35%, 53%, and 100% branched chain amino acids were evaluated. Significant increases in protein synthesis were noted with solutions containing 35%, 53%, and 100% branched chain amino acids, but in patients receiving 100% branched chain amino acids without additional essential amino acid supplement the increase in synthesis was matched by a significant increase in protein breakdown. Protein balance was thus improved only in patients receiving 35% and 53% branched chain amino acids. It was concluded that the high increase in protein breakdown in patients receiving 100% branched chain amino acids was undesirable, and such a solution should not be recommended for clinical use. PMID- 3539716 TI - Recurrent carcinoma in situ of the vagina following split-thickness skin graft vaginoplasty. AB - A patient who developed squamous cell carcinoma in situ in a split-thickness skin graft neovagina is presented. This is the third reported case in the English literature of a patient previously treated for carcinoma in situ of the vagina who later developed an identical lesion in the graft. Management of this neoplasm is discussed, and follow-up for patients with neovaginas is emphasized. PMID- 3539717 TI - [Risk-benefit evaluation of the "micropill" is positive. Results of a multicenter study with Trinovum]. PMID- 3539718 TI - [Ambulatory ECG-monitoring in patients recovering from acute myocardial infarction]. PMID- 3539719 TI - [Neurological manifestations of acquired immunodeficiency syndrome]. PMID- 3539721 TI - [Immunological aspects of the hyper-IgE syndrome and recurrent staphylococcal abscesses]. PMID- 3539720 TI - [Autoimmune diseases in pregnancy]. PMID- 3539722 TI - Preparation of Clostridium septicum antigen for hyperimmunization of horses using a dialyzed culture. AB - The preparation of toxic cultures of Clostridium septicum is described, using an apparatus with a straight dialysis tubing, where the medium is filled both into the nutrition and cultivation space of the apparatus. Using the cultivation to nutrition volume rate 1:2, mean titre of lethal antigen in filtrates 3.86 limes mortis per mL and 300 dosis lethalis minima per Lm was obtained in comparison with the values of 2.22 and 150 respectively in flask filtrates. Native filtrates of dialyzed cultures were better antigens for hyperimmunization of horses than the culture filtrates from flasks. PMID- 3539723 TI - Enzymes of secondary metabolism and the biosynthesis of macrolide antibiotics. AB - Enzymes participating in the biosynthesis of macrolide antibiotics are reviewed. Enzyme activities are known to play a pivotal role in the formation of biologically active compounds. Hence it is essential to understand these enzymes, their properties and regulation. Macrolide antibiotics represent a relatively compact group of natural products and include several excellent model compounds suitable for enzyme studies that could be generalized to other oligoketide antibiotics. PMID- 3539725 TI - [Early treatment of children with cheilognathopalatoschisis. Technical modifications]. PMID- 3539724 TI - The killer phenomenon in yeasts. PMID- 3539726 TI - [Primary osteoplasty and a trial to determine its value from the orthodontic viewpoint]. PMID- 3539728 TI - [Orthodontic support for the developmental processes in the deciduous dentition in patients with cheilognathopalatoschisis]. PMID- 3539727 TI - [Orthodontic requirements for the closure of the cleft jaw]. PMID- 3539730 TI - [Uprighting and gap closure of the remaining cleft-adjacent teeth following autologous spongiosa transplantation in cheilognathopalatoschisis]. PMID- 3539731 TI - [Significance of HLA typing in corneal transplants with unfavorable prognosis in cyclosporin A therapy]. PMID- 3539729 TI - [Expansion of the upper dental arch of patients with cheilognathopalatoschisis]. PMID- 3539732 TI - [Qualitative and quantitative function study of the corneal endothelium following penetrating keratoplasty]. PMID- 3539733 TI - Characterization of insulin binding to slices of slow and fast twitch skeletal muscles in the rabbit. AB - Insulin binding was studied in rabbit semimembranosus proprius and psoas major muscles composed of slow-twitch oxidative (SO) and fast-twitch glycolytic (FG) fibers, respectively. For this purpose, we developed a technique using cryostat microtome muscle slices. Degradation of 125(I)-insulin during the incubation period was prevented by the addition of 1 mM bacitracin in the buffer. Specific binding to muscle slices plateaued by the 24 hrs. of incubation at 4 degrees C. It increased as a function of the amount of muscle, with a maximum binding occurring at about 5 mg of muscle slices. Triton X-100 has been shown to increase specific binding from a critical concentration of 10(-4) M with a maximum effect occurring at 3.3 10(-4) M. Under this condition, the binding was specific since displacement studies showed no inhibition of 125(I)-insulin binding by GH, HCG, ACTH and glucagon, whereas half maximal inhibition was achieved using 5 10(-10) M insulin, 3 10(-9) M IGF1 and 2 10(-8) M proinsulin. The analysis of the binding data yielded curvilinear Scatchard plots. The number of high affinity insulin receptors was higher in the SO muscle than in the FG muscle (4.3 +/- 0.7 vs 0.7 +/- 0.2 fmol/mg fresh muscle; P less than 0.001) with similar high affinity dissociation constants (Kd = 1.5 10(-10) M). Analogous results were obtained using muscle microsomal fractions. The differences in insulin binding might be related to the more intense metabolism of SO fibres which contract more often than FG fibres in vivo. PMID- 3539734 TI - Arginine, administrated in various ways, as a stimulator of insulin secretion in the rabbit. AB - The insulin-secretional effect of arginine administrated to rabbits either intravenously or via alimentary tract was measured. Arginine stimulatory effect on insulin secretion was found after both ways of amino acid introduction, however, the extent of the stimulation depended upon the route of administration, with intravenous route being four times more effective than the oral one. This difference may depend on the small susceptibility to food stimulators of the herbivorous animals. PMID- 3539735 TI - The status of magnesium in rabbits with experimentally-induced diabetes mellitus. AB - Epidemiological evidence suggests that magnesium deficiency may be a factor in the etiology of cardiovascular disease. In the present study, magnesium status was assessed in rabbits 10 weeks following the administration of a diabetogenic dose of alloxan which resulted in significant hyperglycemia and hypoinsulinemia. Decreased erythrocyte magnesium levels were apparent after 6-8 weeks, although no corresponding changes in the magnesium concentration of plasma were apparent. Depletion of magnesium was also observed in left ventricle, spleen, lung, pancreas and aorta. Insulin treatment (for 4 weeks) after 6 weeks of diabetes, prevented the magnesium depletion in both the tissues and red blood cells. Our results provide evidence for alterations in magnesium handling in an experimental model of chronic diabetes. PMID- 3539736 TI - Laboratory handling and its influence on hormonal and metabolic parameters during acute inflammation in rats. A critique of long-term treatment by repeated injections. AB - Twice a day, rats were exposed to handling stress by sham i.p. injections during a period of five days. This procedure progressively drove up the basic blood levels of free adrenaline, noradrenaline and dopamine, while insulin decreased to below normal. Blood glucose returned successively from hyperglycemia during the beginning of the experiment to normal later on. If rats subjected to acute inflammation were handled, the parameters blood catecholamines, glucose and the lymphocyte ingress into the site of inflammation all showed the same patterns of changes, suggesting a certain synchronization of the metabolic events. This synchronization failed to occur in animals with inflammation, but without handling. In any case, the disturbed metabolism of handled animals did not normalize during the test period of five days. Therefore, application of test substances by repeated injections is a useless method for the correct investigation of chronic exogenous influences. PMID- 3539737 TI - Smoothing effect of a new alpha-glucosidase inhibitor BAY m 1099 on blood glucose profiles of sulfonylurea-treated type II diabetic patients. AB - The alpha-glucosidase inhibitor BAY m 1099, a deoxynojirimycin derivative, was studied in sulfonylurea-treated type II diabetic patients using a placebo controlled double-blind cross-over design. Given in two daily doses the inhibitor smoothened the blood glucose profile by lowering significantly post-prandial blood glucose peaks. Fasting and daily mean blood glucose levels measured as the area under the blood glucose curves were however not influenced significantly. This might be due to the short duration of the treatment periods or the low dosage of the drug. Abdominal side effects were negligible. The alpha-glucosidase inhibitor BAY m 1099 might become a useful therapeutic tool in addition to sulfonylurea treatment in type II diabetes. PMID- 3539738 TI - Comparison of the absorption and biological activity of NPH human insulin (recombinant DNA) and NPH porcine insulin injected subcutaneously in type II diabetic patients. PMID- 3539739 TI - Influence of age on insulin requirement in insulin dependent diabetes mellitus patients treated with CSII. PMID- 3539740 TI - Bilateral lesions involving the suprachiasmatic nucleus suppress hyperglycemia due to peripheral administration of 2-deoxy-D-glucose. PMID- 3539741 TI - Propranolol for the prevention of recurrent variceal hemorrhage: a controlled trial. AB - We conducted a prospective, randomized single-blind trial of propranolol for the prevention of recurrent variceal bleeding. Seventy-nine patients shown to have variceal hemorrhage at endoscopy were included in the study within 72 hr following diagnosis. Fifty-seven patients had alcoholic cirrhosis, 10 cryptogenic cirrhosis, 6 posthepatitic cirrhosis, 4 biliary cirrhosis, 1 portal vein thrombosis without cirrhosis and 1 idiopathic portal hypertension. The severity of liver disease at inclusion was assessed according to the Pugh modification of the Child-Turcotte classification: 9 (11%) had Class A; 41 (52%) Class B, and 29 (37%) Class C disease. Patients were randomly assigned by sealed envelope to the propranolol group (42 patients) or the placebo group (37 patients). Propranolol dosage was titrated in order to produce plasma concentrations of propranolol of 50 to 150 ng per ml. beta-blockade was also confirmed by isoproterenol testing. The cumulative percentages of patients free of rebleeding 1 and 2 years after inclusion were 31 and 21% in the propranolol group, and 25 and 17% in the placebo group; both differences were not significant. Cumulative 1 and 2 years survival were also comparable: 64 and 54% in the propranolol group vs. 70 and 63% in the placebo group. There was no evidence for a therapeutic effect of propranolol after adjusting for potential confounding variables by multiple logistic regression. We conclude that propranolol is not effective for the prevention of variceal rebleeding, when administered early following the initial bleed, in cirrhotics unselected with respect to the severity of the liver disease. PMID- 3539742 TI - Demonstration of pre-S polypeptides of hepatitis B virus in infected livers. AB - The large (pre-S1), middle (pre-S2) and major (P24) polypeptides of HBsAg have been defined in detail, but their role in hepatitis B virus infection is not known. Therefore, we studied the expression of pre-S1, pre-S2 and P24 in the liver of 15 patients with acute or chronic hepatitis B virus infection using monoclonal and polyclonal antibodies in a double staining immunofluorescence method. The pre-S and major HBsAg polypeptides were co-expressed in the hepatocyte cytoplasm of all patients except for one case of chronic active hepatitis and cirrhosis. HBcAg was present in hepatocyte nuclei of nine patients suggestive of active hepatitis B virus replication. These studies support the hypothesis that the pre-S polypeptides represent essential components of the envelope of hepatitis B virus. PMID- 3539744 TI - The effects of ethanol and hyperosmotic perfusates on albumin synthesis and release. AB - Sucrose and ethanol inhibit albumin synthesis; sucrose via an osmotic mechanism and ethanol during its metabolism. The present study was undertaken to compare the effects of both of these agents on albumin synthesis and secretion, and to see if ethanol inhibition could be related to an osmotic effect. Male, fed rabbits served as liver donors in all studies. There were a total of 35 studies: 13 control; 10 ethanol (39 to 52 mM); 4 cycloheximide (0.5 mM), and 8 sucrose (1%). Plasma volume was measured with 125I-albumin (human) and extracellular volume measured with either 99mTc diethylenetriamine pentaacetic acid or [14C]sucrose. During perfusion, rabbit albumin content in the perfusate was measured immunologically every 15 to 30 min for 225 min. Interstitial albumin efflux was measured by the rate of appearance in the perfusate of 125I-albumin given to 10 other rabbits 3 days prior to hepatic removal and perfusion. During the initial 75 min of perfusion, 74% of the in vivo equilibrated exchangeable 125I-albumin appeared in the perfusate, and during this period the rabbit albumin that entered the perfusate was taken to represent efflux from the interstitial volume plus synthesis. Rabbit albumin appearing in the perfusate during the later period of 150 min was taken to represent mainly synthesis and was used to calculate the amount of albumin that would be synthesized in 75 min. The difference between these two values would be hepatic interstitial albumin appearing in the perfusate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539745 TI - Prompt payment policy rattles health industry. PMID- 3539743 TI - The effect of hepatic stimulatory substance, isolated from regenerating hepatic cytosol, and 50,000 and 300,000 subfractions in enhancing survival in experimental acute hepatic failure in rats treated with D-galactosamine. AB - Galactosamine induces a dose-dependent hepatic injury in rats and many other animals. The toxicity of D-galactosamine appears to be a consequence of the loss of hepatic UTP. It has previously been reported that regenerating liver cytosol is able to prevent, at least in part, the lethal effect of this substance by stimulating hepatic regeneration. Recently, we have separated a fraction using alcohol precipitation (80%) from regenerating liver cytosol and from weanling rat liver cytosol prepared in acetate buffer (100 mM, pH 6.5). We named this fraction hepatic stimulatory substance because of its ability to stimulate DNA synthesis in vivo when injected intraperitoneally in 40% hepatectomized rats and in vitro in the presence of hepatocytes isolated and maintained in monolayer cultures. The stimulatory activity of the hepatic stimulatory substance is fully evident in subfractions of molecular weight up to 300,000 and 50,000 daltons of the crude material obtained using Amicon Ultra membrane filters. The present report describes the ability of hepatic stimulatory substance and its subfractions to stimulate hepatocyte proliferation and the application of these hepatic extracts in successfully reversing the lethality of D-galactosamine-induced hepatic necrosis in rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539746 TI - Medicaid mandate tied to Cape Cod outpatient facility. PMID- 3539747 TI - Controversy brews over Alabama CMP. PMID- 3539748 TI - Geographic capitation revisited? PMID- 3539749 TI - Ganeles braces PRRB for change. PMID- 3539750 TI - Incentive plans: few "safe harbors" from abuse laws. PMID- 3539751 TI - Looking to acquire, merge? Do your homework. PMID- 3539752 TI - Medicare capital policy impacts debt market. PMID- 3539753 TI - OMB's capitation plans do not sit well with HCFA. PMID- 3539755 TI - Telecommunications. Proper planning is the crucial first step. PMID- 3539754 TI - Medicaid's overload sparks a crisis. PMID- 3539756 TI - Telemedicine picks up steam. PMID- 3539757 TI - Consultants meet telecom needs. PMID- 3539758 TI - Production of basement membrane laminin and type IV collagen by tumors of striated muscle: an immunohistochemical study of rhabdomyosarcomas of different histologic types and a benign vaginal rhabdomyoma. AB - Immunohistochemical methods were used to demonstrate the distribution of basement membrane laminin and type IV collagen in eight tumors derived from striated muscle (three botryoid, two alveolar, and two adult-type rhabdomyosarcomas; one benign vaginal rhabdomyoma). All of the tumors produced significant amounts of both basement membrane components. Stainings clearly revealed the alveolar nature of the rhabdomyosarcomas, with the alveolar spaces surrounded by distinct basement membranes. Different stages of cellular development were identified in the botryoid sarcomas, with the most immature cells of the cambium layer devoid of external basement membrane around the tumor cells, although the stroma contained finely dispersed basement membrane material and some cells contained intracytoplasmic laminin or type IV collagen, indicative of the synthesis of these proteins. The more mature cells, which had abundant granular cytoplasm, were enveloped by distinct basement membranes and seemed to have coalesced, forming structures resembling myotubes. The adult-type rhabdomyosarcomas were composed of large pleomorphic cells that were surrounded by basement membranes, either individually or in small groups. Some giant cells contained intracytoplasmic laminin. The vaginal rhabdomyoma was composed of round rhabdoblastic cells or elongated strap cells with cross-striations. Cells of both of these types were surrounded by thin but distinct basement membranes. The results suggest that demonstration of basement membranes would be helpful in the diagnosis of tumors derived from striated muscle. The findings concerning different stages of maturation of tumor cells are in accordance with previous in vitro observations of myoblastic cells. PMID- 3539759 TI - Endovascular papillary angioendothelioma of childhood: a vascular lesion possibly characterized by "high" endothelial cell differentiation. AB - Two cases of endovascular papillary angioendothelioma (EPA) of the skin were studied immunohistochemically to assess the expression of endothelial, leukocytic, and epithelial determinants by these lesions. The tumor cells in both cases were labeled by antibodies to Factor VIII-related antigen, vimentin, and blood group isoantigens; they also bound Ulex europaeus I agglutinin. On the other hand, immunoreactivity for epithelial membrane antigen, Leu-M1, HLA-DR (Ia like antigen), and leukocyte common antigen (LCA) was not observed. Stromal and intravascular lymphocytes were labeled intensely with antibodies to LCA and HLA DR and were intimately associated with papillary configurations of proliferating intravascular tumor cells. These results confirm the endothelial nature of EPA and suggest that the cells of this lesion may differentiate toward "high" endothelial cells, which have been shown to interact functionally with circulating lymphocytes. PMID- 3539760 TI - Amyloid deposits in lymph nodes: a morphologic and immunohistochemical study. AB - In a series of approximately 80,000 lymph nodes, amyloid deposition was found in 18; 12 of those nodes were selected, on the basis of availability of specimens, for investigation by immunohistochemical typing to identify the protein of origin and by correlation with morphologic criteria and clinical information. Four patterns of amyloid deposition were identified: lymph node vessel involvement, follicular deposition, diffuse deposition, and a combination of follicular and diffuse deposition. All cases were classified immunohistochemically with the amyloid type-specific antisera anti-AA, anti-A lambda, anti-A kappa, anti-ASc1, and anti-AF. Immunoglobulin-derived protein (AL) in lymph nodes was found in every case of isolated amyloidosis, lymphoplasmacytic/lymphoplasmacytoid immunocytoma, plasmacytoma, and idiopathic amyloidosis. Among the cases of AL amyloidosis were nine of A lambda and one of the A kappa type. AA protein was present in two cases of reactive systemic amyloidosis. There was no useful morphologic correlation with the immunohistochemically identified amyloid types. PMID- 3539761 TI - Isolated congenital renal tubular immaturity in siblings. AB - This paper describes two cases of an unusual renal abnormality discovered in anuric siblings (one male, one female) who were born at 36 and 34 weeks of gestation and died of systemic complications secondary to severe pulmonary hypoplasia shortly after birth. Both gestations were complicated by marked oligohydramnios. Antenatal ultrasound examinations showed slightly enlarged kidneys in the first case and normal kidneys in the second case, with no evidence of hydronephrosis or cystic disease in either. With the exception of enlargement of the first infant's kidneys, autopsies revealed grossly unremarkable kidneys and ureters. Microscopy, however, demonstrated increased glomerulogenesis with normal glomeruli and global immaturity of renal tubules and ducts without concomitant features of dysplasia. Immunoperoxidase staining for epithelial membrane antigen revealed the immaturity or complete absence of proximal convoluted tubules. This precise constellation of findings had not been described previously. One other similar family has been documented in a report implicating genetic factors. In the present cases, the possibility of a cocaine-associated etiology is also addressed. PMID- 3539762 TI - Mid-trimester ultrasonographic diagnosis of early manifesting "adult" form of polycystic kidney disease. PMID- 3539763 TI - The Webb (Wb) antigen in South Wales donors. AB - Eight Webb antigen Wb+ propositi, 2 in the same family, were found in testing 10,117 random blood donors in South Wales with anti-Wb serum. Family studies on the new propositi confirmed the Wb antigen to be inherited as an autosomal dominant character. Wb segregated independently from ABO, Rh, MNSs, K, Fy, Jk, and was not X- or Y-borne; for the first time Wb was shown to be independent of Lu. Wb antigen was destroyed by some proteolytic enzymes and by neuraminidase. Sera from 5,144 random donors were screened with Wb+ cells resulting in detection of 2 additional anti-Wb. PMID- 3539764 TI - Regulation of a physiological parameter or in vivo drug concentration by integral pulse frequency modulated bolus drug injections. PMID- 3539765 TI - Effect of millimeter-wave irradiation on growth of Saccharomyces cerevisiae. PMID- 3539767 TI - Computer competence for nurse educators. PMID- 3539768 TI - Imprint's directory of nursing clinical and occupational specialties. PMID- 3539766 TI - Dr. Gary Grau, 123rd ISDS President, "Members must become involved for the 'future of dentistry'". PMID- 3539769 TI - Career opportunity profiles. PMID- 3539770 TI - Maintenance of pancreatic endocrine cells of the neonatal rat: Part VIII--Effect of 2-deoxyglucose on insulin biosynthesis and proinsulin mRNA activity. PMID- 3539771 TI - Influence of the combination of intraperitoneal and footpad immunization on anti H-Y immunological reactivity. AB - In the following work the influence of the combination of intraperitoneal (i.p.) and footpad (f.p.) immunization on anti-H-Y immunological responsiveness in female CBA mice is described. Immunological responsiveness was determined on the basis of rejection or non-rejection of syngeneic male skin grafts from previously immunized CBA females. It was determined that the rejection of grafts is influenced by the nature of the first contact with the antigen. For instance, if the first immunization is by i.p. injection and the remainder by f.p. injections, then there is no rejection of grafts, and vice versa, rejection of grafts occurs if the first immunization is by f.p. injection regardless of whether the remainder are given i.p. The results are discussed in the context of existing theories in order to explain specific immunological (non-)responsiveness. PMID- 3539772 TI - Circulatory antigen of Heymann nephritis. II. Isolation of a 70,000 MW antigen from normal rat serum which cross-reacts with Heymann nephritis antigen. AB - Antigens cross-reactive with crude Heymann antigen, FXIA and purified antigen, gp600, were isolated from rat serum by immunoaffinity chromatography using polyclonal anti-gp600 antibodies. The eluted antigens predominantly contained a 70,000 molecular weight (MW) polypeptide. An antiserum was raised against this preparation which, when tested against rat serum by Protein A immunoblotting, showed that the antibodies were directed to 70,000 MW antigens. By immunodiffusion in gel, the antiserum produced three precipitin lines against the antigen preparation, three lines against FXIA and a single line against gp600. All three lines of the serum antigen were continuous with the three lines of FXIA showing complete identity of the isolated serum antigens with FXIA. One of the three common lines of the serum antigen and FXIA was in continuity with the line of gp600 showing cross-reaction of gp600 with the isolated 70,000 MW antigen. Testing of Western blots of gp600 and FXIA against this antiserum by protein A immunoblotting showed reaction with the 70,000 MW subunit of gp600 and FXIA indicating cross-reaction of the serum antigen with 70,000 MW antigen of FXIA and gp600. The antiserum reacted with structures in the glomerulus by indirect immunofluorescence. Patchy brush border staining was visible. When injected into an isolated perfused kidney, these antibodies localized in fine granular pattern along the glomerular capillary wall by direct immunofluorescence. Ultrastructural immunogold technique revealed that the 70,000 MW antigen was located in the brush border and in the GBM-endothelial interface. These results demonstrate that the 70,000 MW antigen present in rat serum is also present in the glomerular capillary wall. PMID- 3539773 TI - [Pemphigus-pemphigoid mixed bullous dermatosis in chronic lymphatic leukemia]. PMID- 3539774 TI - [Chronic pemphigus vulgaris associated with ulcerative rectocolitis. Apropos of a clinical case]. PMID- 3539775 TI - Seeds of time: fifty years ago Peter A. Gorer discovered the H-2 complex. PMID- 3539776 TI - Some recollections of Peter Gorer and his work on this fiftieth anniversary of his discovery of H-2. PMID- 3539778 TI - Recollections of a Chilean member of the very exclusive H-2 club. PMID- 3539777 TI - Recollections of Dr. Peter Gorer. PMID- 3539779 TI - Working with Gorer, 1957-1960. PMID- 3539781 TI - H2-receptor antagonists and drug interactions. PMID- 3539782 TI - Controlled comparison of ranitidine and cimetidine in patients of duodenal ulcer, gastric ulcer and reflux esophagitis: a multicentre study. PMID- 3539780 TI - Qa alloantigen expression on functional T lymphocytes from spleen and thymus. AB - The cell-surface expression of the class I alloantigen Qa-2 was analyzed on resting and activated spleen and thymus cells using cytotoxic elimination and immunofluorescence and flow cytometry. Spleen cells activated by mitogens or alloantigen were homogeneously positive for cell surface Qa-2, but activated splenic T cells expressed only about one-third as much Qa-2 per cell as did nonstimulated T cells. These data correlated with the ability to perform cytotoxic elimination with Qa-2-specific monoclonal antibodies (mAbs) in that cytotoxic T lymphocyte (CTL) activity was completely abrogated by pretreatment of spleen cells prior to in vitro culture but was only partially eliminated by treatment of CTL effectors. Qa-2-positive cells constituted only a small subpopulation of fresh normal thymocytes, but were enriched (greater than 40% positive) among cortisone-resistant thymocytes (CRT). These Qa-2-positive CRT contained mature thymocytes as defined by Ly phenotype Ly-2-, Ly-1hi. When normal thymocytes were treated with Qa-2-specific mAb and complement prior to in vitro sensitization for generation of allogeneic CTL, CTL activity was completely abrogated despite the fact that the fraction of cells eliminated were undetectable as assessed by cell recovery. CTL effectors from alloantigen stimulated thymocytes were also susceptible to cytotoxic elimination with Qa-2 specific mAb. These data suggest that the Qa-2 molecule may serve not only as a marker on resting and activated peripheral T cells, but also as a unique marker for functionally mature T cells in the thymus. PMID- 3539783 TI - Controlled comparison of ranitidine and cimetidine in patients of duodenal ulcer, gastric ulcer and reflux esophagitis: a multicentre study. PMID- 3539784 TI - Carcinogenicity of selected vinyl compounds, some aldehydes, haloethyl nitrosoureas and furocoumarins: an overview. PMID- 3539785 TI - The role of cyclic nucleic acid adducts in the mutational specificity of malondialdehyde and beta-substituted acroleins in Salmonella. PMID- 3539786 TI - Structure-activity relationships of alpha, beta-unsaturated carbonylic compounds. AB - The mutagenicity and probably the carcinogenicity of alpha, beta-unsaturated carbonylic compounds such as acrolein are based on direct genotoxic interaction with nucleic acid bases via Michael addition or Schiff's base formation. Alkyl and aryl substitution at the alpha and beta carbon atoms reduces or abolishes the mutagenic potential whereas halogen substitution in either position increases mutagenicity. These structure-activity relationships can be predicted from theoretical considerations of well-known electron shift mechanisms. The formation of alpha, beta-unsaturated carbonyls from allylic halides (or similar types of compounds with appropriate leaving groups) has been experimentally demonstrated with appropriate metabolites of allyl bromide in in rats. PMID- 3539787 TI - Methylglyoxal in beverages and foods: its mutagenicity and carcinogenicity. AB - Methylglyoxal was found to induce mutations in Salmonella typhimurium strains TA100, TA102 and TA104, gene conversion in Saccharomyces cerevisiae strain D7, and diphtheria toxin resistance mutation in Chinese hamster lung cells. Methylglyoxal was detected in coffee, whiskey, a soft drink, toasted bread and soy sauce. The mutagenicity of methylglyoxal was suppressed by sulfite, cysteine, glutathione and dithiothreitol, and enhanced by hydrogen peroxide. Methylglyoxal induced sarcomas in rats at the site of its subcutaneous injection. PMID- 3539788 TI - Evaluation of the mutagenicity of 1,N6-ethenoadenine- and 3,N4-ethenocytosine nucleosides in Salmonella typhimurium. AB - To provide supporting evidence for the hypothetical involvement of etheno derivative formation in DNA in chloroacetaldehyde-mediated mutagenesis, etheno nucleosides were examined for their direct-acting mutagenicity in Salmonella typhimurium strain TA100. The results, however, have shown that 1,N6 ethenoadenosine, 1,N6-ethenodeoxyadenosine, 3,N4-ethenocytidine and 3,N4 ethenodeoxycytidine lack mutagenicity in this test system. A lesson learned in this study is that 3,N4-ethenocytosine nucleosides prepared synthetically or obtained from commercial sources can give false positive mutagenicity due to mutagenic contaminants. PMID- 3539789 TI - Genetic effects of DNA mono- and diadducts photoinduced by furocoumarins in eukaryotic cells. AB - The genotoxic activity of two bifunctional furocoumarins, 8- and 5 methoxypsoralen (8-MOP and 5-MOP), and the newly developed monofunctional furocoumarin, 7-methyl-pyrido(3,4-c)psoralen (MePyPs), was determined in diploid yeast. In parallel experiments, the DNA photobinding capacity of the compounds was estimated. This capacity was, in decreasing order, MePyPs greater than 5-MOP greater than 8-MOP. The lesions induced by 8- and 5-MOP, which consist of a mixture of mono- and diadducts, were found to be more genotoxic than the monoadducts induced by MePyPs. A difference in specificity of MePyPs-induced lesions was observed for the induction of mutations and mitotic gene conversion. In Chinese hamster V79 cells, 5-MOP showed a higher DNA photobinding activity than 8-MOP. In spite of this, 5-MOP-induced lesions were less genotoxic, on a one to-one basis, than those induced by 8-MOP. An analysis of the DNA cross-linking capacity of the two furocoumarins in V79 cells by alkaline elution suggests that, at a given dose of 365-nm radiation, 5-MOP produces more photoadducts than 8-MOP but the same number of DNA cross-links, and the ratio of mono- to diadducts induced is higher for samples treated with 5-MOP than for those treated with 8 MOP. This may offer an explanation for differences observed in the mutagenic and carcinogenic activity of these compounds. PMID- 3539790 TI - Mutagenic and promutagenic properties of DNA adducts formed by vinyl chloride metabolites. AB - Published results and work from this laboratory permit the characterization of the possible promutagenic lesions induced by chloroethylene oxide (CEO) and chloroacetaldehyde (CAA), both known as bifunctional alkylating metabolites of vinyl chloride (VC). The mutagenic effectiveness of CEO and CAA in Escherichia coli, when compared to their nucleophilic selectivity, suggests that the critical target site in DNA bases is not an oxygen atom, and/or that the reaction mechanism of CEO and CAA is different from a simple alkylation. CEO-mutagenicity in E. coli is recA-independent, and CEO preferentially induces GC----AT transitions; accordingly, the mutagenicity of CEO in bacteria may result mainly from a miscoding guanosine or cytosine adduct. Two observations argue against the role of 1,N6-ethenoadenine (epsilon A) and 3,N4-ethenocytosine (epsilon C) in VC induced mutagenesis/carcinogenesis: i) the lack of detection in double-stranded DNA in vivo and in vitro; ii) the inconsistency between mutational specificity of CEO and miscoding properties of epsilon A and epsilon C. The lack of miscoding properties of 7-(2-oxoethyl)guanine (oxet-G), the major in-vivo VC-DNA adduct, suggests a minor miscoding base adduct. Several lines of evidence point to N4-(2 chlorovinyl)cytosine as one possible putative promutagenic lesion produced by VC, but this compound has yet to be identified in DNA. PMID- 3539791 TI - Mutagenesis and repair of O6-substituted guanines. AB - The mutagenic activity of O6-methylguanine has been investigated using a single stranded M13mp8 phage DNA molecule in which a single O6-methylguanine residue was positioned in the unique recognition site for the restriction endonuclease, Pst I. After introduction of this vector into Escherichia coli, progeny phage were produced, of which 0.4% were mutated in their Pst I site. To determine the impact of DNA repair on mutagenesis, levels of O6-methylguanine-DNA methyltransferase (an O6-methylguanine repair protein) were depleted in host cells by treatment with N-methyl-N'-nitro-N-nitrosoguanidine prior to viral DNA uptake. In these cells, the mutation frequency due to O6-methylguanine increased with increasing N methyl-N'-nitro-N-nitrosoguanidine dose (the highest mutation frequency observed was 20%). DNA sequence analysis of mutant genomes revealed that O6-methylguanine induced G to A transitions, exclusively. PMID- 3539792 TI - Monoclonal antibody-based immunoanalytical methods for detection of carcinogen modified DNA components. AB - Hybridoma cell lines secreting monoclonal antibodies (Mab) directed against the products formed by reaction of alkylating N-nitroso carcinogens with DNA have been established by fusion of rat or mouse myeloma cells, respectively, with spleen cells of rats or mice immunized either with conjugates of various alkyl ribonucleosides with suitable carrier proteins, or with alkylated DNA electrostatically complexed to carrier proteins. Due to their high affinity and specificity, some of these Mab detect very low amounts of the respective alkyl deoxynucleosides (e.g., O6-methyl-2'-deoxyguanosine, O6-ethyl-2'-deoxyguanosine, O6-n-butyl-2'-deoxyguanosine, O6-isopropyl-2'-deoxyguanosine, O4-methyl 2'deoxythymidine, O4-ethyl-2'-deoxythymidine) and can be used in various types of immunoassays. With a competitive radioimmunoassay (RIA), specific DNA alkylation products can be quantitated in hydrolysates of cellular DNA, in body fluids, or in urine. The RIA is routinely applicable, reproducible, and sufficiently sensitive to permit the quantitation of femtomole amounts of modified nucleosides in small samples of DNA. When the alkyl-deoxynucleosides in question are separated from bulk DNA by high-performance liquid chromatography prior to analysis by RIA, very low levels of modification in DNA can be detected. The immuno-slot-blot (ISB), a noncompetitive solid-phase immunoassay, is more sensitive than the RIA. For analysis by ISB, alkylated DNA is heat-denatured and immobilized on nitrocellulose filters prior to exposure to the respective Mab and subsequent binding of a second (125I-labelled or biotinylated) antibody. In immunocytological analysis (ICA), the binding of Mab to alkyl-deoxynucleosides is visualized in individual cells by immunostaining of denatured nuclear DNA in situ (direct immunofluorescence; peroxidase-staining).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539793 TI - An orally active inhibitor of renin. AB - A potent renin inhibitor, U-71038 (Boc-Pro-Phe-N-MeHis-Leu psi[CHOHCH2]Val-Ile Amp), was tested for oral effectiveness. Enzyme kinetic studies indicated that U 71038 was a competitive inhibitor of hog renin with an inhibitor constant (Ki) value of 12 nM. Intravenous as well as oral administration of U-71038 to anesthetized, ganglion-blocked rats infused with hog renin elicited dose-related hypotensive responses. Intravenous administration of U-71038 to conscious, sodium depleted monkeys caused dose-related decreases of blood pressure and plasma renin activity without affecting heart rate. Similarly, the oral administration of U 71038 at 50 mg/kg to conscious, sodium-depleted monkeys elicited a pronounced hypotension and decrease in plasma renin activity that persisted for 5 hours. The hypotensive responses elicited by intravenous and oral administration of U-71038 to hog renin-infused rats and sodium-depleted monkeys were shown to be due entirely to inhibition of the renin-angiotensin system. A comparison of the results obtained after the intravenous administration of U-71038 with the results obtained after the oral administration of U-71038 implied that at least 10% of the orally administered U-71038 must have been absorbed to cause the observed effects in hog renin-infused rats and sodium-depleted monkeys. The studies demonstrated that an inhibitor of renin with a long duration of action and with oral effectiveness is a feasible entity. PMID- 3539794 TI - Antihypertensive drugs inhibit hypertension-associated aortic DNA synthesis in the rat. AB - The effect of antihypertensive drug treatment on aortic DNA synthesis was examined in rats with two-kidney, one clip renal hypertension and in spontaneously hypertensive rats (SHR). In two-kidney, one clip hypertensive rats, hypertension developed over a 2-week period. Four days after clipping the renal artery, during the onset of hypertension, there was an increase in aortic DNA synthesis. Aortic DNA synthesis was also increased 3 weeks later, when hypertension had been established. Captopril, hydralazine, and verapamil were each able to prevent the increase in aortic DNA synthesis and the rise in blood pressure when given throughout the first 5 days of the developing phase of hypertension, or when given to rats with established hypertension. Drug treatment of sham-operated rats had no significant effect on DNA synthesis, although blood pressure was decreased. There were no differences in blood pressure or aortic DNA synthesis in 4-week-old SHR, as compared with age-matched Wistar-Kyoto (WKY) controls or normal Wistar rats. At 17 weeks of age, when hypertension was established, aortic DNA synthesis was significantly enhanced in the SHR. Captopril or hydralazine treatment was able to reduce blood pressure and DNA synthesis to levels seen in the WKY. At 21 weeks of age, DNA synthesis in the SHR had declined to the same levels as in the WKY. Captopril, hydralazine, and verapamil may have a common ability to reduce intracellular calcium and therefore inhibit DNA synthesis. In support of this, ouabain treatment, which increases intracellular calcium by inhibiting the Na+-K+ pump, produced a significant increase in the rate of DNA synthesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539795 TI - Suppression of adrenal renin in Dahl salt-sensitive rats. AB - We previously showed that adrenal renin is highest in the rat zona glomerulosa (ZG) and that low sodium or high potassium and nephrectomy increase adrenal ZG renin and aldosterone. Dahl salt-sensitive rats (S) have been shown to have lower plasma renin activity and plasma aldosterone and higher plasma 18-hydroxy-11 deoxycorticosterone than Dahl salt-resistant rats (R). In this study we assess the possible role of adrenal ZG renin in the suppression of aldosterone in S rats. Adrenal ZG renin was significantly decreased in S as compared with R rats even at 6 weeks of age, when both S and R rats are still normotensive (S = 7.2 +/ 0.2, R = 18.0 +/- 1.6 ng angiotensin I/mg protein/hr). Adrenal ZG aldosterone was also significantly lower in S than in R rats (S = 21.1 +/- 4.3, R = 39.5 +/- 3.6 ng/mg protein). Furthermore, the rise in adrenal ZG renin and aldosterone after nephrectomy in S rats was significantly less than that in R rats. To determine if the suppressed adrenal ZG renin of S rats is due to volume expansion, we studied the effect of a sodium-deficient diet on adrenal ZG renin in S and R rats. After 2 weeks of a sodium-deficient diet S rats had significantly lower basal adrenal ZG renin than did R rats (S = 7.6 +/- 0.4, R = 21.7 +/- 1.9 ng angiotensin I/mg protein/hr) and a marked blunting of the adrenal ZG renin response to nephrectomy (S = 13.6 +/- 1.1, DR = 167 +/- 16.1 ng angiotensin I/mg protein/hr).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539796 TI - Felodipine, blood pressure, and cardiovascular reflexes in hypertensive humans. AB - The influence of acute and chronic treatment with felodipine on ambulatory intra arterial blood pressure, certain cardiac reflexes, and plasma renin activity was studied in nine patients with essential hypertension. Acute oral administration of the drug caused a significant reduction in blood pressure associated with an increase in heart rate mediated by the sinoaortic baroreceptor-heart rate reflex. After 1 week of treatment reflex resetting had occurred, returning heart rate to normal despite continuing blood pressure reduction. This effect was maintained throughout 6 weeks of treatment. Withdrawal of treatment was followed by return of the blood pressure to control levels associated with significant bradycardia caused by reflex reactivation at its reset level. No change was observed in response to tilting or Valsalva's maneuver or in plasma renin activity. Ambulatory intra-arterial data suggested that the clinically useful antihypertensive action of felodipine persists for 9 hours. PMID- 3539797 TI - Nonenzymatic glycosylation of proteins and protease activities in granulation tissues in experimental diabetes. AB - Serum proteins and hemoglobins show increased nonenzymatic glycosylation in diabetes mellitus. The measure of glycosylated proteins, particularly hemoglobin, is considered to be a preferred indicator in the control of diabetes. In a study of diabetes and inflammation, we assessed the extent of nonenzymatic glycosylation of proteins of granulation tissue from diabetic rats. Five, seven, and ten days after carrageenan injection, the granuloma proteins were extracted. Nonenzymatic glycosylation was measured in soluble and insoluble granuloma proteins by thiobarbituric acid assay. Protease activities and free amino groups were assayed in soluble extracts. Nonenzymatic glycosylation in soluble proteins of both groups reached a maximum on the seventh day. However, nonenzymatic glycosylation in soluble proteins of the diabetic granulomas was significantly greater than the controls on days five and seven. During the days after granuloma induction, nonenzymatic glycosylation in the insoluble granuloma tissue proteins gradually decreased without any significant differences between controls and diabetics. Significant decreases in the free amino groups in soluble proteins of the diabetic tissues were noted. Greater activities of cathepsins B and D were noted in diabetic tissues over controls. These observations suggest that, in addition to increased proteolysis, increased nonenzymatic glycosylation of tissue proteins could be associated with the impaired process of wound healing in diabetics. PMID- 3539798 TI - Characterization of neuraminidases produced by various serotypes of group B streptococci. AB - Neuraminidase produced by 11 strains of group B streptococci (GBS), from serotypes Ia, Ib, Ic, II, and III, were characterized according to molecular weight, antigenic identity, and substrate specificity. Following growth in a chemically defined medium, ammonium sulfate-concentrated culture supernatants were assayed for activity with bovine submaxillary mucin as substrate. Neuraminidase produced by GBS strain 122 (serotype III) was purified by a combination of salt fractionation, affinity chromatography with Affi-Gel Blue, ion-exchange chromatography with DEAE-cellulose, and gel filtration on Sephadex G 200. Purified neuraminidase was used to immunize rabbits, and the resultant antiserum reduced the activity of purified neuraminidase from strain 122 by 87.7%. The antiserum also reduced the activity of neuraminidases produced by the other four serotypes by between 78.3 and 90%. Molecular weight estimates of the neuraminidases produced by the various serotypes were obtained by gel filtration chromatography on Sephadex G-200. The molecular weights obtained for the neuraminidases from the representative strains of each serotype ranged from 110,000 to 180,000. In addition, all of the GBS neuraminidases examined (regardless of the producing serotype) were active only on bovine submaxillary mucin. On the basis of these results, it appears that the neuraminidases produced by different GBS serotypes are quite similar. PMID- 3539799 TI - Functional characterization of extracellular vesicles produced by Bacteroides gingivalis. AB - Extracellular vesicles of Bacteroides gingivalis (type strain 33277) were isolated, and some of their biological activities were characterized. The vesicles were obtained from a 2-day culture after ammonium sulfate precipitation, differential centrifugation, and dialysis. When viewed by electron microscopy, vesicles of approximately 50 nm predominated. The results indicated that the enriched vesicle fraction had a high proteolytic activity against collagen, Azocoll, and N-alpha-benzoyl-DL-arginine p-nitroanilide. The polypeptide pattern of the vesicles was similar but not identical to that of the outer membrane. The membrane vesicles could also promote bacterial adherence between homologous cells as well as mediate attachment between two noncoaggregating bacterial species. These vesicles could thus play an important role in periodontal diseases by serving as a vehicle for toxins and various proteolytic enzymes, as well as being involved in adherence. PMID- 3539800 TI - Effect of acetylation on arthropathic activity of group A streptococcal peptidoglycan-polysaccharide fragments. AB - Purified group A streptococcal peptidoglycan-polysaccharide (PG-PS) fragments were either de-O-acylated, or acetylated and then de-O-acylated to yield N acetylated PG-PS. Native PG-PS was poorly degraded, N-acetylated PG-PS was extensively degraded, and de-O-acylated PG-PS was only slightly degraded by hen egg white lysozyme. N-acetylated PG-PS was also extensively degraded by human lysozyme and partially degraded by rat serum or rat liver extract. After a single intraperitoneal injection of rats with a sterile, aqueous suspension, all PG-PS preparations induced acute arthritis. The acute arthritis induced by N-acetylated PG-PS was significantly more severe than that induced by native PG-PS; that induced by de-O-acylated PG-PS was of intermediate severity. After the acute reaction, rats injected with native PG-PS developed chronic relapsing erosive synovitis which remained severe for the duration of the experiment (83 days). In contrast, joint inflammation induced by N-acetylated PG-PS resolved within 6 weeks with little evidence of recurrent disease. Chronic arthritis induced by de O-acylated PG-PS was of intermediate severity. In another assay of arthropathic activity, the arthritis in all rat ankle joints, which had been injected directly with native PG-PS, could be reactivated 3 weeks later by the intravenous injection of a small dose of PG. In contrast, only 50% of the joints initially injected with de-O-acylated PG-PS and none of the joints injected with N acetylated PG-PS could be reactivated. These studies support the concepts that the resistance of PG-PS to muralytic digestion is crucial for chronic arthropathic activity and that the nature and degree of PG acetylation are important molecular determinants of the phlogistic activities of PG-PS polymers. PMID- 3539801 TI - Glycoprotein recognition mediates attachment of Plasmodium chabaudi to mouse erythrocytes. AB - The interaction between Plasmodium falciparum merozoites and human erythrocytes is mediated by specific parasite proteins and sialoglycoproteins (SGPs) on the surface of the host cell. To investigate whether a similar mechanism functions in rodent malaria, a series of experiments was performed to identify the proteins involved in the interaction of Plasmodium chabaudi parasites and mouse erythrocytes. Labeled parasite proteins incubated with purified mouse SGP bound specifically to glycoprotein 2.1. Two parasite proteins (72 and 126 kilodaltons [kDa]) were coprecipitated with antibody directed to mouse erythrocyte membrane proteins. The lower band (72 kDa) as well as a band of 105 kDa were also observed to bind to N-acetyl-D-galactosamine affinity columns, suggesting a carbohydrate component in the binding of these parasites to erythrocytes. These experiments indicate that P. chabaudi possesses specific proteins which recognized SGP on the surface of murine erythrocytes in a manner similar to that of the merozoites of P. falciparum. Thus P. chabaudi in mice may provide an in vivo model of the human parasite for testing ways to inhibit merozoite recognition and invasion of host cells. PMID- 3539802 TI - Presence and expression of aerobactin genes in virulent avian strains of Escherichia coli. AB - Virulent and nonvirulent isolates of avian Escherichia coli were tested for the presence of aerobactin genes by colony hybridization with a specific gene probe constructed from plasmid pABN1 (A. Bindereif and J. B. Neilands, J. Bacteriol. 153:1111-1113, 1983). Positive hybridization with the gene probe was highly correlated with virulence, as measured by the 50% lethal dose of the strains for chicks. Evidence for the expression of aerobactin genes in the virulent strains was obtained by demonstrating their susceptibility to cloacin DF13, which binds to the same receptor that binds aerobactin, and their ability to produce aerobactin, as revealed by cross-feeding the E. coli mutant WO987 (aroB fepA iuc iut+), which is unable to synthesize but capable of taking up aerobactin. We suggest that the production of aerobactin is involved in the virulence of avian septicemic E. coli. PMID- 3539803 TI - Formation of transmural complement pores in serum-sensitive Escherichia coli. AB - The binding of C9 at 0 and 37 degrees C to viable Escherichia coli K-12 cells carrying C5b-8 complexes was quantified. At low temperature, limited average binding of only 1 to 1.4 molecules of C9 per C8 molecule occurred, whereas 6 to 8 C9 molecules were bound per C8 molecule at 37 degrees C. Despite incorporation of C9 into C5b-9 complexes at 0 degrees C, these terminal complexes caused no loss of bacterial viability even when present in very large numbers (1,000 to 1,500 per CFU) on the bacterial cells. In contrast, generation of 50 to 100 C5b-9 complexes carrying multiple C9 molecules per CFU caused loss of viability. The failure of C5b-81C91 complexes to generate transmural pores was confirmed by measurements of o-nitrophenyl-beta-D-galactoside influx into the cells. Whereas treatment of C5b-8-laden cells with C9 at 32 degrees C caused virtually instantaneous influx of the marker, almost no influx was registered in cells receiving C9 at 0 degrees C. When cells carrying C5b-7 were brought into the stationary phase and given C8 and C9 at 32 degrees C, a C9-dependent disruption of the outer membrane permeability barrier immediately occurred as demonstrated by cleavage of a chromogenic substrate by periplasmic beta-lactamase. In sharp contrast, o-nitrophenyl-beta-D-galactoside influx was markedly retarded over a prolonged period, with abrupt permeability increases of the inner membrane toward this molecule being noted just before bacterial cell division occurred. We conclude that killing of E. coli requires binding of C5b-9 complexes containing C9 oligomers to the outer membrane and suggest that formation of pores in the inner membrane occurs when these complexes are "hit" by transiently forming zones of bioadhesion. Formation of the latter may be a dynamic process that is accentuated during cell division and quiescent during the stationary phase. PMID- 3539804 TI - Role of the A subunit of pertussis toxin in alteration of Chinese hamster ovary cell morphology. AB - The mechanism by which pertussis toxin induces morphological changes in Chinese hamster ovary cells was studied to determine whether the resulting clustered growth pattern is due to toxin-catalyzed ADP-ribosylation of a cellular substrate. While pertussis toxin was extremely potent in inducing morphological changes in Chinese hamster ovary cells, preparations of isolated A subunit or B oligomer exhibited greatly reduced activity. The clustered growth response of these cells correlated with ADP-ribosylation of a 41-kilodalton cellular substrate for the toxin in that the toxin concentration and time of exposure to the toxin required for ADP-ribosylation were the same as those needed for alterations in cellular morphology. Moreover, pertussis toxin modified by either chemical or photolytic methods exhibited similar decreases in the ability to ADP ribosylate the cellular substrate and alter cell morphology. These results suggest that clustering of Chinese hamster ovary cells is due to toxin-catalyzed ADP-ribosylation of a 41-kilodalton substrate. Therefore, alteration in Chinese hamster ovary cell morphology can be used as a measure of toxin activity. This assay should prove to be a useful tool in the development and evaluation of new pertussis vaccines. PMID- 3539805 TI - Purification, partial characterization, and identification of a skin-reactive protein antigen of Mycobacterium bovis BCG. AB - An immunogenic and skin-reactive protein called P64 was purified from Sauton zinc deficient culture filtrate of Mycobacterium bovis BCG by using successively hydrophobic chromatography on phenyl-Sepharose, ion exchange on DEAE-Sephacel, and molecular sieving on Sephadex G-200. The final P64 preparation was found to be homogeneous based on several analyses. Protein P64 was a constituent of BCG cells since it was present in soluble cellular extract from normally grown BCG cells. It represented 8 to 9% of the soluble proteins of the extract and appeared as the major soluble protein antigen of BCG. This protein was found to have a molecular weight of 64,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, but in molecular sieving it eluted at a volume corresponding to a molecular weight of 246,000. An abnormal UV spectrum was observed for this protein. Its amino acid composition showed an abundance of acidic amino acids (or their amides). Aromatic amino acids represented only 3% of the total amino acid residues. The NH2-terminal amino acid sequence of this protein (10 amino acids) was determined. Its sugar content measured with the phenol-sulfuric acid test was lower than 0.3% (wt/wt.) Isolated P64 was tested by various crossed immunoelectrophoresis techniques and was shown to correspond to antigen 82 in the reference system for BCG antigens. The protein antigen P64 elicited a delayed cutaneous reaction in guinea pigs sensitized with either living or heat-killed BCG. Its potency in skin reaction was, respectively, two- and threefold that of the BCG purified protein derivative. The two types of sensitization used for skin test reactions promoted significant immunoglobulin G antibody production against the protein antigen P64 in guinea pigs 7 weeks after sensitization. PMID- 3539806 TI - Production of an extracellular toxic complex by various strains of Klebsiella pneumoniae. AB - Six isolates of Klebsiella pneumoniae (two serotype 1 isolates and a capsular variant of one of these, and two serotype 2 isolates and a capsular variant of one of these) possessing various degrees of virulence in rats and mice were examined for their in vitro production of an extracellular toxic complex (ETC). The ETC has been shown to be lethal for and produce extensive lung pathology in mice. This compound has been shown to be composed of capsular polysaccharide, lipopolysaccharide, and a small amount of protein. All six isolates produced the ETC. Immunization of experimental animals with sublethal doses of the ETC was protective against both homologous and heterologous strains, and this protection was due to antibody production. An examination of the various phases of growth of K. pneumoniae showed that there was extracellular release of the component parts of the ETC occurring during all phases of growth. The presence of the ETC in the supernatant fluids was due to actual release of this material as opposed to cell lysis. Antibodies to the lipopolysaccharide portion (which has been shown to possess the observed toxicity) of the ETC were protective against the homologous bacterium. PMID- 3539807 TI - Requirement of a properly acylated beta(1-6)-D-glucosamine disaccharide bisphosphate structure for efficient manifestation of full endotoxic and associated bioactivities of lipid A. AB - Several synthetic acylated glucosamine monophosphates, with structures corresponding to the nonreducing or reducing moiety of the lipid A of the Escherichia coli or Salmonella minnesota type, and a synthetic compound corresponding to a biosynthetic disaccharide lipid A precursor (designated Ia or IVA) were examined for their endotoxic and related bioactivities in comparison with those of the synthetic and bacterial parent molecules, i.e., acylated beta(1 6)-D-glucosamine disaccharide bisphosphates. Some of the test monosaccharide compounds were definitely active in most of the in vitro assays. Their activities, except for complement activation, however, were weaker than those of the reference compounds, synthetic and bacterial acylated disaccharide bisphosphates. The differences between the test monosaccharide and disaccharide compounds were much more apparent in in vivo assays, in which the test acylated glucosamine monophosphates were scarcely active, though some test compounds exhibited weak lethal toxicity in galactosamine-loaded mice and were weakly active in pyrogenicity, immunoadjuvant activity, and possible tumor necrosis factor and alpha and beta interferon-inducing ability in Mycobacterium bovis BCG- and Propionibacterium acnes-primed mice, respectively. Mixture at an equimolar ratio of acyl glucosamine monophosphates, each of which has the structure of the reducing or nonreducing moiety of the reference disaccharide compound, did not restore the endotoxic or associated bioactivities of the corresponding parent molecules. No essential differences in bioactivity were noted between synthetic and bacterial monosaccharide compounds, i.e., lipid X, whose structure corresponds to the reducing moiety of E. coli-type lipid A. PMID- 3539808 TI - Adhesion of enteropathogenic Escherichia coli to human intestinal enterocytes and cultured human intestinal mucosa. AB - The adhesion of classic enteropathogenic Escherichia coli (EPEC) strains of human origin to isolated human small intestinal enterocytes and cultured small intestinal mucosa was investigated. An adhesion assay with isolated human enterocytes prepared from duodenal biopsy samples was developed and tested with EPEC strains known to cause diarrhea in healthy adult volunteers. In the assay a mean of 53 and 55% of enterocytes had brush border-adherent E. coli E2348 (O127;H6) and E851 (O142:H6), respectively, whereas the value for a nonpathogenic control strain and a plasmid-cured derivative of strain E2348 was 0%. A collection of 17 EPEC strains was also tested for the ability to colonize cultured human duodenal mucosa. Extensive colonization occurred with 13 strains, including serogroups O55, O86, O111, O114, O119, O127, O128, and O142; and in each case electron microscopic examination of colonized mucosa revealed the characteristic histopathological lesion reported by others in natural and experimental EPEC infections. EPEC strains were seen to adhere intimately to the enterocyte surface, causing localized destruction of microvilli. The plasmid cured derivative of strain E2348, which colonized cultured mucosa much less efficiently than the parent strain, nevertheless produced an identical lesion, indicating that plasmid-encoded factors are not essential for adhesion and the brush border-damaging property of EPEC. PMID- 3539809 TI - Tear and serum antibody response to Chlamydia trachomatis antigens during acute chlamydial conjunctivitis in monkeys as determined by immunoblotting. AB - In this study, we examined the temporal antibody response by immunoblotting analysis in tears and sera of three cynomolgus monkeys (Macaca fasicularis) with primary acute Chlamydia trachomatis serovar B conjunctivitis. The objective was to identify chlamydial antigens stimulating antibody during the host responses in the course of this self-limiting infection with the rationale that they may be protective antigens. The major outer membrane protein (MOMP), lipopolysaccharide (LPS), and polypeptides of 60 and 68 kilodaltons (kDa) were the predominant antigens recognized by immunoglobulin A (IgA) in monkey tears. Tear IgA antibody specific for the MOMP was first detected 14 days postinfection, whereas tear IgA reactive with LPS or the 68- and 60-kDa polypeptides was first detectable on day 21. Tear IgA antibodies specific for each of these antigens persisted in tears through day 56, 4 weeks after both peak clinical disease and recovery of the organism from the conjunctivae. In contrast, tear IgG antibodies peaked at approximately 28 days postinfection, the time of maximal inflammatory response. The IgG response in monkey sera was similar to that observed for tear antibodies, in that the MOMP, 60-, and 68-kDa polypeptides were the primary immunogens. The exception was that IgG antibody against these antigens was detected 1 week later than that observed for tear IgA antibodies. Of three monkeys that responded with tear IgA antibody against LPS, one did not have detectable serum IgG LPS antibody. The specificity of the tear IgA antibody response of monkeys was determined by immunoblotting nine other C. trachomatis serovars in addition to the homologous B serovar. The tear IgA response to the MOMP was predominantly B complex subspecies-specific (serovars B, Ba, D, and E), whereas the response to chlamydial LPS was found to be species-specific. The significance of these observations in relation to previous vaccine studies in nonhuman primates is discussed. PMID- 3539810 TI - Antimicrobial prophylaxis in transurethral surgery. PMID- 3539812 TI - Chlorhexidine: antibacterial action and bacterial resistance. AB - Chlorhexidine is a clinically important antiseptic, disinfectant and preservative. It is a potent membrane-active agent against bacteria and inhibits outgrowth, but not germination, of bacterial spores, although it is not sporicidal. It shows high activity against wild-type and outer membrane mutants of Escherichia coli but some gram-negative bacteria are resistant to chlorhexidine by mechanisms not yet fully understood, although they appear to involve the outer, rather than the inner, membrane. PMID- 3539814 TI - Perioperative stroke: the noncardiac surgery patient. AB - This chapter reviewed the mechanisms and manifestations of transient and irreversible cerebral ischemia and the current experimental approaches to attenuate ischemic neuronal injury. Patients with signs or symptoms of cerebral ischemia are likely to have abnormal cerebrovascular dynamics, with areas of cerebrum at risk, and may be at an increased risk of stroke after general or vascular surgery. Such patients also have a very high frequency of associated cardiac disease. In this chapter, guidelines for anesthetic management of patients with symptomatic CVD undergoing noncardiac surgery were based on current understanding of the pathophysiology of cerebral ischemia. Nonetheless, the available data indicate that most perioperative strokes occur in the postoperative period and appear to be thromboembolic in nature. The existence of neither asymptomatic carotid bruits nor intraoperative hypotension appears to be associated with the occurrence of perioperative stroke. PMID- 3539811 TI - Transmission of human immunodeficiency virus (HIV/HTLV-III/LAV): a review. AB - The literature on the transmission of human immunodeficiency virus (HIV/HTLV III/LAV) is reviewed. HIV spreads by vertical transmission and by iatrogenic transmission (transfer of blood or blood-containing products), by infected needles among i.v. drug users and, more rarely, among health care workers, but mainly by sexual contact. In Western countries the virus is mainly spread by passive anal intercourse among homosexuals and seldom by heterosexual intercourse. In African countries, however, the virus is mainly spread by heterosexual intercourse, probably because of other, concurring sexually transmitted diseases. Some preventive measures are discussed. PMID- 3539813 TI - Specificity and sensitivity of anti-HTLV-III/LAV determinations with a recombinant antigen competitive ELISA. PMID- 3539815 TI - Neurological complications of cardiovascular surgery: I. Procedures involving the carotid arteries and abdominal aorta. PMID- 3539816 TI - Neurological complications of cardiovascular surgery: II. Procedures involving the heart and thoracic aorta. PMID- 3539817 TI - Recognition, management, and prevention of neuropsychological dysfunction after operation. PMID- 3539818 TI - Postanesthetic cognitive and psychomotor impairment. PMID- 3539819 TI - Awareness and recall. AB - Awareness and recall under anesthesia is a complication that appears to be related to the use of muscle relaxants. While little is known about unconscious awareness and its physical and psychological consequences, it is well known that recall can result in traumatic psychological sequelae under certain circumstances. The anesthesiologist must be aware of the possibility of awareness before it occurs and either try to avoid it or explain to the patient the possibility of awareness and the circumstances under which it might occur. In the event of unexpected awareness, the anesthesiologist must deal with the patient in an honest and forthright manner. Failure to do so may lead to dire psychological consequences for the patient and legal consequences for the anesthesiologist. PMID- 3539820 TI - The epididymis and male fertility. A symposium report. PMID- 3539821 TI - The effect of doxycycline in infertile couples with male accessory gland infection: a double blind prospective study. AB - Male accessory gland infection (MAGI, epididymo-prostato-vesiculitis) with abnormal semen quality was rarely the only abnormality in infertile couples since it occurred in no more than 1.6% of 2871 couples evaluated in 7 centres during a 3-year period. Both partners of 33 infertile couples with no other demonstrable abnormality than abnormal semen and MAGI consented to participate in a double blind trial and were treated with either doxycycline, 100 mg/day for 1 month (20 couples) or placebo (13 couples). Follow-up during a total of 175 couple-months included semen analysis and the recording of pregnancy. Pregnancy occurred in 2 of the doxycycline-treated couples (10%) and in 1 of the placebo treated couples (8%), corresponding with conception rates per month of 1.9% and 1.5%, respectively. Sperm motility and, to a lesser extent, morphology showed improvement in both groups. Evidence of infection, namely increased numbers of white blood cells and positive sperm culture, disappeared in both the doxycycline treated and placebo group. It is concluded that features of MAGI in semen may regress spontaneously and are not influenced by the doxycycline treatment. The concomitant improvement of sperm motility and morphology still does not seem to enhance the probability of conception. PMID- 3539822 TI - Immunohistochemical and ultrastructural study of Sertoli cells in androgen insensitivity. AB - The ultrastructure of a perfusion-fixed gonad in a case of androgen insensitivity was studied using thin sections and freeze-fracture replicas. The distribution and arrangement of intermediate filaments in Sertoli cells was visualized immunohistochemically using an antibody against vimentin. Leydig cells lacked Reinke crystals, but contained all of the cytoplasmic organelles involved in steroid synthesis and additionally several lysosomes. The basement membrane and the basal lamina of the testicular tubules were considerably thickened. The testicular tubules consisted of gonocytes and Sertoli cells which had an immature nuclear structure, incomplete development of intercellular junctions and a primitive distribution pattern of intermediate cytoplasmic filaments. The previously reported differences in electron density of Sertoli cell cytoplasm are a non-specific feature without significance to Sertoli cell maturation. PMID- 3539823 TI - Unsuitability of monoclonal antibodies to oncogene proteins for anti-tumour drug targeting. AB - Monoclonal antibodies (MAbs) to ras, sis, erb-B, src, myb and myc oncoproteins were evaluated for their potential to target anti-cancer drugs to malignant cells. Each antibody was tested for reactivity against both fixed and viable cultured human tumour cells by immunofluorescence, and all reacted against a variety of fixed tumour cell preparations. Reactions were also observed against fixed non-malignant cells. None, however, reacted significantly with viable cells. Two antibodies (against ras and myc proteins) were tested for their ability to localize to tumour xenografts in nude mice, and conjugates were constructed by linking these antibodies to methotrexate using human serum albumin as an intermediate carrier. Neither antibody localized to tumour in vivo, and the methotrexate conjugates were not significantly cytotoxic for tumour cells in vitro, in contrast to similar conjugates simultaneously prepared with a proven anti-tumour MAb (791T/36). It was concluded that currently available MAbs to oncogene proteins are not suitable vectors for targeting cytotoxic agents to tumour cells. PMID- 3539824 TI - UICC Multidisciplinary Project on breast cancer. Management of early and advanced breast cancer. PMID- 3539825 TI - Shedding of GD2 ganglioside by human neuroblastoma. AB - Substantial concentrations of the cell-surface glycosphingolipid, the disialoganglioside GD2, are uniformly present in human neuroblastoma tumors. This ganglioside can also be detected in the plasma of patients with neuroblastoma by direct thin-layer chromatographic analysis. Among 32 neuroblastoma patients in all clinical stages studied prior to the initiation of treatment, 27 (84%) showed measurably elevated plasma concentrations of GD2 (greater than or equal to 50 pmol/ml). The mean level (545 +/- 108 pmol/ml) was more than 50 times the normal plasma GD2 concentration of less than or equal to 10 pmol/ml. Circulating GD2 was not detected in the plasma of patients with the related, more differentiated tumors, ganglioneuroblastoma and ganglioneuroma, indicating an association of the shedding of this ganglioside with the undifferentiated phenotype. Circulating GD2 diminished in patients in response to therapy, and reappeared in patients whose disease recurred. The results suggest that the sequential determination of circulating GD2 will be of value in monitoring individual patients with neuroblastoma. PMID- 3539826 TI - Incidence and prevention of supraventricular tachyarrhythmias after coronary bypass surgery. AB - Supraventricular tachyarrhythmias are a frequent complication encountered after coronary artery bypass grafting. A retrospective survey of 102 consecutive patients undergoing exclusive bypass grafting at St. Mary's Hospital supplemented by a review of 16 published reports over a period of 10 years revealed a mean incidence of post-operative tachyarrhythmia of 33.4% in 1344 patients (range 11.4 100%). One hundred and thirty two patients undergoing exclusive bypass surgery, were randomised prospectively in double blind fashion to receive either oral timolol or matched placebo approximately 24 hours after surgery. In the 66 patients receiving timolol, there was a significant reduction of post-operative arrhythmias compared to the 66 patients receiving placebo: from 19.7 to 7.5% (P less than 0.05). Of all arrhythmias, two thirds appeared under 48 hours after surgery. In the timolol group, 4 patients developed systemic hypotension. This was readily reversed by withdrawing the drug. No other side effects were noted. The use of oral timolol after coronary artery surgery significantly lowers the incidence of post-operative supraventricular arrhythmias. PMID- 3539827 TI - Atrioventricular septal defects: cross-sectional echocardiographic and morphologic comparisons. AB - We examined the cross-sectional echocardiographic findings of 171 patients with atrioventricular septal defects. The echocardiographic findings were confirmed by angiography, surgery and/or autopsy. The echocardiographic findings determined whether the common atrioventricular junction was guarded by a common valve or separate right and left valves. In addition, we were able to judge whether the bridging leaflets were related to the septal structures so as to permit both interatrial and interventricular communications [127 cases] or whether the interatrial communication ("ostium primum atrial septal defect") [43 cases] or an interventricular communication [1 case] existed in isolation. Defects existing with a common atrioventricular valve could be further classified as having minimal bridging of the antero-superior leaflet (Rastelli Type A [113 cases]); intermediate bridging (Rastelli Type B [3 cases]); or extreme bridging (Rastelli Type C [11 cases]). Of the patients with Down's syndrome, 9 had separate right and left valves while 66 had a common valve, all the latter existing in the setting of minimal bridging of the antero-superior leaflet. In the overall group, there were 9 cases having an unbalanced ventricular mass, 5 with right ventricular dominance and 4 with left dominance. Other associated defects were common. The echocardiographic findings were supplemented by pulsed Doppler examination. Atrioventricular valve insufficiency, when mild, was frequently demonstrated only in the right atrium just above the leaflets of the atrioventricular valve. When there was more severe valve insufficiency the regurgitant jet could be detected for greater distances behind the atrioventricular valve and in either or both atria, but more frequently in the left atrium. As might be anticipated in view of the complexity of the lesion, a combined imaging approach yielded the most accurate results. PMID- 3539828 TI - Effects of diltiazem hydrochloride in diabetics. AB - The effects of diltiazem hydrochloride on insulin secretion and glucose tolerance were studied in diabetic subjects treated with dietary management alone for their glycemic control. Sixteen diabetic subjects with heart complaints and/or abnormal electrocardiographic findings which were compatible with diagnosis of ischemic heart disease were given diltiazem hydrochloride 90 mg daily for a mean of 9.3 +/ 1.0 (SE) months and oral 100 g glucose tolerance tests (o-GTT) were performed before and after the administration of diltiazem hydrochloride. As a control group, 14 diabetic patients with roughly the same level of fasting blood glucose and the same degree of glucose intolerance were selected, and in these patients oral 100 g glucose tolerance tests were also performed before and after a mean follow up period of 12.6 +/- 1.5 months. Although improvement in glucose tolerance was observed at the end of the trial in the group of patients with diltiazem hydrochloride, control group also showed improved glucose tolerance and there was no significant difference in the change of glucose tolerance between both groups. No significant change of IRI response in oral 100 g glucose tolerance test was observed in both groups. We could, therefore, conclude from these observations that diltiazem hydrochloride with usual clinical dosage dose not exert unfavourable effects on glucose tolerance and insulin secretion in the mild diabetic patients. PMID- 3539829 TI - Dietary fat modulation of immune response. PMID- 3539830 TI - Immunostimulation of blood monocyte function by RU 41.740 (Biostim) in patients with chronic bronchitis. AB - RU 41.740 (Biostim), a glycoprotein extract from Klebsiella pneumoniae, which is effective in heightening resistance to experimental infections in animals, was examined with regard to influence on human blood monocyte function in vitro after administration to patients with chronic bronchitis in a randomized, double-blind clinical trial. Twelve patients were given Biostim orally (seven patients received 8 mg daily and five patients received 2 mg daily) while eight patients received placebo. In the Biostim group monocyte phagocytosis increased from 1.4 yeast cells per monocyte before therapy to 3.1 yeast cells per monocyte after 1 month (P less than 0.05) with no further increase after 3 months. Monocyte candidacidal activity increased in the Biostim group from 51% before therapy to 69% after 1 month (P less than 0.05) with a decrease to 57% after 3 months. As expected, placebo had no significant effect on monocyte functions. There was no difference between the improvement in the high dose vs the low dose group. These results suggest that Biostim exerts part of its immunostimulatory property by stimulating blood monocyte antimicrobial function. PMID- 3539831 TI - Effect of muscular activity on the turnover rate of actin and myosin heavy and light chains in different types of skeletal muscle. I. Changes in the turnover rate of myosin and actin during and after single-bout physical activity. AB - During a single-bout of 6-h swimming, myosin heavy chain (HC) and actin in m. gastrocnemius turned over more slowly than they did in the pre-exercise period, whereas the turnover rate of myosin light chain (LC) increased; 48 h after swimming, actin and myosin HC had a significantly higher turnover rate, but the turnover rate of myosin LC remained at the pre-exercise level. Exercise caused a remarkable decrease in the incorporation of the 14C leucine into actin and myosin HC, but an increase in the incorporation into myosin LC. An elevation of the synthesis rate of actin and myosin HC was observed 48 h after exercise. Myofibrillar proteinase activity at alkaline pH reached its maximum level during exercise, but the same was observed for the proteolytic activity at acid pH 6 h and at neutral pH 24 h after exercise. PMID- 3539832 TI - Filaggrin. PMID- 3539834 TI - Pemphigus with characteristics of dermatitis herpetiformis. A long-term follow-up of five patients. AB - Five patients had a form of pemphigus which in its early stages resembled dermatitis herpetiform, although the immunofluorescent findings were typical of pemphigus. Potassium iodide tests, performed for the first time in such patients, showed positive results in two patients. Follow-ups ranging from 5 to 14 years have shown a benign course with low to absent dosages of steroids. PMID- 3539833 TI - Tumors of the vulva. PMID- 3539835 TI - Bibliography of secondary sources on the history of dermatology. II. Obituaries and biographies in English journals supplemented through 1985. PMID- 3539836 TI - Effects of Solcoderm. AB - The effects of treatment and depths of penetration of a 5-fluorouracil and salicylic acid preparation (Solcoderm) were studied in 24 patients treated for basal cell carcinoma with this compound. Two thirds of the patients in our study showed islands of residual tumor in the dermis following treatment, whereas total disappearance of the tumor was observed in one third. The depth of the fibrotic changes induced by the drug varied from 0.34 to 0.40 cm for the morphea type of basal cell carcinoma and from 0.52 to 0.88 cm for the conventional types. It is recommended that treatment with this compound be reserved only for superficial basal cell carcinomas and that it be avoided altogether in basal cell carcinomas of the morphea type. PMID- 3539837 TI - Partial wound closure combined with marsupialization for repair of selected cutaneous surgical defects. AB - A useful technique for the management of selected surgical defects that cannot be primarily closed in their entirety is presented. PMID- 3539838 TI - Who was Wickham and what are his striae? PMID- 3539840 TI - Synthesis of 14C-labelled peptides by asymmetric reduction of dehydroamino acids. AB - The labelled dehydroamino acid, 2-N-acetylamino-3-(2-naphthyl)-3-[14C]-acrylic acid was prepared at 52.8 mCi/mmol from Ba14CO3. Asymmetric reduction of this precursor with hydrogen in the presence of the chiral homogeneous catalyst (S,S) BPPMRh+ afforded N-acetyl-D-3-(2-naphthyl)-3-[14C]-alanine in greater than 98% optical yield. This unnatural amino acid was used in a solution phase synthesis of 2 14C-labelled LHRH analogs, [N-Ac-D-3-[14 C] Nal1 D-p-Cl-Phe2, D-Trp3,D hArg(Et2)6, D-Ala10] LHRH and [D-3-[14C] Nal6] LHRH having specific activities in excess of 50 mCi/mmol. PMID- 3539839 TI - Complex of subtilisin BPN' with Streptomyces subtilisin inhibitor. Complex formation concomitant with change in reducibility of disulfide bonds in the inhibitor. AB - Structure of the complex of Streptomyces subtilisin inhibitor (SSI) with subtilisin BPN' was studied by examining the thermal denaturation and reducibility of disulfide bonds. The denaturation temperature of the complex was significantly higher than that of the enzyme. Two disulfide bonds localized in the inhibitor side were completely reduced in the complex, whereas only one of them was reduced in the free SSI. Gel filtration of the reduced complex solution showed clearly that the main products of reduction of the complex were two peptide fragments of SSI divided at the active site. The resistive disulfide bond in the complexed inhibitor became accessible as a result of a large conformational change due to splitting of the half-reduced inhibitor. PMID- 3539841 TI - Enzymatic semisynthesis of [LeuB30] insulin. AB - Experimental conditions for the preparation of [LeuB30] insulin by coupling of des-AlaB30 insulin with Leu-OBu(t) were determined using Achromobacter protease I and trypsin as catalysts. Successful coupling required a large excess of the amine component (0.8 M), a high concentration of organic cosolvent (35-50%) and neutral pH of the reaction mixture. The coupling yield of Achromobacter protease I after 24 h at 37 degrees C was almost the same or a little higher than that at 25 degrees C. With trypsin, the coupling yield at 37 degrees C after 24 h was considerably lower than at 25 degrees C. This was partly ascribed to the difference in concentration of organic cosolvent at 37 degrees C and 25 degrees C; 35% and 50%, respectively, or possibly of enzyme stability at these temperatures. The maximum product yield was about 90% with both enzymes under optimal conditions. A preparative scale experiment was performed with Achromobacter protease I; the yield of [LeuB30] insulin was 51% using porcine insulin as the starting material. This semisynthetic insulin was identified by HPLC and amino acid analysis. No difference was observed in CD spectra between [LeuB30] insulin and human insulin. PMID- 3539842 TI - Acute anterior uveitis and conjunctivitis following Yersinia infection in children. AB - We studied characteristics of ocular inflammation associated with yersinia infection in six children, three boys and three girls, ranging in age between 4 and 14 years. Four patients developed acute anterior uveitis with aqueous flare and cells, small keratic precipitates, cells in the vitreous, and occasionally with fibrinous exudates, posterior synechiae and macular edema. The uveitis was unilateral in two patients and bilateral in two. In three 10- to 14-year-old patients the uveitis resolved during corticosteroid treatment in 3 to 8 (mean 6) weeks. In a 4-year-old girl with positive antinuclear antibody titers bilateral uveitis lasted for 17 weeks. Two uveitis patients had recurrent episodes. Two patients had mucopurulent bilateral mild conjunctivitis which resolved in 3 to 5 days. All patients had symptoms of reactive arthritis and one had sacroiliitis. All tested patients were HLA-B27 positive. Our results indicate that in HLA-B27 positive children, especially after the age of 10 years, yersinia infection may occasionally trigger reactive iritis or conjunctivitis which often occur together with other HLA-B27 associated rheumatic diseases. PMID- 3539843 TI - Radiosensitization of Chinese hamster cells by oxygen and misonidazole at low X ray doses. AB - The radiosensitization of Chinese hamster V79 cells in vitro by air and misonidazole at low X-ray doses (0.2-6.0 Gy) had been studied. These survival data, together with high-dose data, were fitted to the linear quadratic model ln S = -(alpha D + beta D2), deriving estimates of alpha and beta by six different methods to illustrate the influence of the statistical treatment on the values so derived. This in vitro study clearly demonstrated that the survival parameters alpha and beta are dependent to some degree on the method of analysis of the raw survival data; however, their ratios, the values of oxygen enhancement ratios (OERs) and radiosensitizer enhancement ratios (SERs) derived from the different methods, are similar. All methods of analysis give reduced OERs at low radiation doses for combined low- and high-dose X-ray data. However, the OERs are still appreciably high, ranging from 2.45 to 2.50 for an oxic dose of 2 Gy. All methods of analysis gave reduced SERs at low doses for combined low and high X-ray dose data for hypoxic cells irradiated in 1 mmol dm-3 misonidazole. At survival levels corresponding to doses of 2 Gy in the presence of 1 mmol dm-3 misonidazole and SERs ranged from 1.2 to 1.5. PMID- 3539845 TI - Acquired immune deficiency syndrome: an overview of central nervous system complications and neuropsychological sequelae. AB - The Acquired Immune Deficiency Syndrome (AIDS) has been associated with a series of central nervous system (CNS) complications, including focal and nonfocal neurological indications. Overall, the most common form of CNS dysfunction is diffuse cerebral atrophy pathologically characterized by neuronal loss, glial nodules, and microfocal demyelination. Consequent neuropsychological deficits present an insidious course initially typified by poor memory and concentration, along with psychomotor retardation and blunted affect which resembles psychological depression. Gradually over several weeks to months, patients exhibit marked global cognitive impairment and can become severely disoriented and delusional. Clinical research relevant to these CNS complications and neuropsychological sequelae are reviewed. PMID- 3539844 TI - The gastrointestinal absorption of organically bound forms of plutonium in fed and fasted hamsters. AB - Values of about 0.005-0.01 per cent were obtained for the absorption in fed hamsters of plutonium ingested as Pu4+ citrate, isocitrate, phytate and malate complexes and Pu3+ ascorbate compared with about 0.003-0.004 per cent for Pu4+ nitrate. Replacing drinking water with tea did not affect the result for Pu4+ nitrate. Fasting hamsters for 8 h before the administration of plutonium citrate increased absorption to 0.1-0.2 per cent. An extra period of fasting for 4 h after administration did not lead to a further increase in absorption. Similar values were also obtained when plutonium citrate was administered after a 24 h fast, followed either by immediate access to food or a further 4 h fast. In hamsters fasted for 24 h before administration of either Pu3+ ascorbate or Pu4+ nitrate, about 6-7 per cent of the ingested plutonium was retained in the gastrointestinal tract after one week. At three weeks after ingestion of Pu3+ ascorbate, gastrointestinal retention had fallen 100-fold without an increase in absorption. PMID- 3539846 TI - Meditation as a clinical intervention strategy: a brief review. PMID- 3539847 TI - The Societe du Magnetisme de la Nouvelle-Orleans: its place in the early history of hypnosis in America. PMID- 3539848 TI - Salmonellosis in the marine environment. A review and commentary. AB - Marine cetaceans (whales and dolphins), pinnipeds (seals and sea lions), reptiles (turtles and crocodyles), fish and shellfish, and fish-eating birds have been found to harbor salmonellae. In some of these animals, clinical salmonellosis has been demonstrated, but in many cases, the isolated salmonellae may have been an opportunistic pathogen with the illness or death of the host due to other causes. On the basis of the few reports in the literature, marine reptiles (turtles and crocodyles), fish, and shellfish appear to be passive carriers of salmonellae and demonstrate no clinical disease. All of these animals constitute a potential source of salmonellosis in man and his domestic animals. The role of wild and domestic terrestrial animals and fresh water aquatic animals in the transmission of salmonellosis to man has been recognized for many years. The situation with regard to the marine (saltwater) animals has never been adequately investigated or reported. In the past, much reliance has been placed on the ability of saline waters to inhibit or destroy human pathogens, including the salmonellae. Whether this effect is chemical, physical or biological has been studied since the late nineteenth century, and the investigators have found a number of factors affecting both the inhibition and stimulation of growth of salmonellae in saline waters. Salmonellae have been isolated from or found to survive in seawater with salinities as high as 3.5 percent. Marine animals in many parts of the world have been found harboring salmonellae. PMID- 3539849 TI - Leptospirosis in Hawaii: shifting trends in exposure, 1907-1984. AB - Leptospirosis was first recognized as an occupational disease of sugar plantation workers in Hawaii in 1907. Since then, shifts have been noted in the animal transmission cycles, the occupational groups at risk, and an increasing recognition of cases associated with avocational exposure. Surveys of the small mammal populations indicate rats, mice, and mongooses are the most important vectors in Hawaii. Serologic surveys of workers in high-risk occupations show antibody prevalence rates ranging from 12 to 82 percent. The epidemiology of leptospirosis in Hawaii is described, based on 182 cases reported to the Hawaii Department of Health from 1970-1984. The most common infecting serovar was mankarso in the Icterohaemorrhagiae serogroup; other serovars in the Icterohaemorrhagiae group were also frequently implicated as causing disease. The manifestations of disease noted by physicians in Hawaii are similar to those observed in the continental U.S. Fever, myalgia, and headache were the most common symptoms reported in the majority of cases in Hawaii; jaundice was noted in the records of 24 percent. Recommendations made to interrupt the cycle of transmission and reduce the chances of exposure in occupational settings include the control of rodent populations and vaccination of domestic animals. Personal hygiene among workers is to be encouraged, and the development of prophylactic measures is suggested either by immunization or by chemoprophylaxis. PMID- 3539850 TI - Minimizing antimicrobial resistance in hospital bacteria: can switching or cycling drugs help? PMID- 3539851 TI - Prevention of nosocomial infections in marrow transplant patients: a prospective randomized comparison of systemic antibiotics versus granulocyte transfusions. AB - One hundred twelve patients with hematologic malignancies underwent marrow transplantation from HLA-matched sibling donors and were randomized to receive either prophylactic granulocyte transfusions (PG, 67 patients) or prophylactic systemic antibiotics (PSA, 45 patients) as prophylaxis against nosocomial infections. Patients were treated in conventional hospital rooms and studied until day 100 post-transplant. For the entire study period, 26 patients (39%) in the PG group developed septicemia compared to 15 patients (33%) in the PSA group. Twenty-eight patients (42%) in the PG group developed local major infections compared to 19 patients (42%) in the PSA group. Ten patients (15%) in the PG group developed viral interstitial pneumonitis compared to 6 patients (13%) in the PSA group. None of these differences were statistically significant. There was no difference in the incidence of bacterial or fungal infections or viral interstitial pneumonitis between the two groups during the granulocytopenic or post-engraftment period. There was no difference in the incidence and severity of graft-versus-host-disease (GVHD). Inability to carry out the prophylaxis was frequent in the PG group, with complications necessitating discontinuance of transfusion in 24% of the recipients and 13% of the donors. The use of PG as an infection prophylaxis modality in marrow transplantation is not supported by this study, as it is difficult to carry out and because PG did not show any advantage over the use of PSA in preventing nosocomial infections. PMID- 3539852 TI - Diarrheal disease in the hospitalized patient. PMID- 3539853 TI - Remodeling of nucleoproteins during gametogenesis, fertilization, and early development. PMID- 3539854 TI - Establishment of the mechanism of cytokinesis in animal cells. AB - The division mechanism is fixed in the surface during anaphase or about 4 minutes before furrowing begins in cylindrical cells. Under experimental conditions, the minimum time that the mitotic apparatus must act upon the surface is about 1 minute. The stimulus period is followed by a latent period of 2-3 minutes. The time of furrow formation can be advanced or delayed by manipulating the surface and the mitotic apparatus. Since furrows can be elicited long after normal division would have been completed, it is suggested that the brevity of the normal interaction period is not a consequence of the constitution of the interactants. The component of the mitotic apparatus that establishes the furrow moves from the region of the mitotic axis to the surface at 6-8 microns/minute, The components of the mitotic apparatus that are essential for furrow establishment are confined to the achromatic regions. In spherical cells with large asters, the spindles are not required, although the spindle's ability to establish furrows in spherical cells can be demonstrated by changing the cell's geometry. In nonspherical cells with small asters, the spindle is probably the normal active agent. Although the ability of the mitotic apparatus to establish furrows can be diminished or abolished by measures that reduce its overall size, there are no decisive data concerning which of its ultrastructural components play essential roles in cytokinesis. The effect of changing the geometrical relation between the mitotic apparatus and the surface differs according to the region affected. Division can be blocked or impeded only by changing the relation between the equatorial surface and the mitotic apparatus. The ability of the mitotic apparatus to establish furrows is diminished by increasing the distance between the astral centers and also by increasing the distance between the mitotic axis and the equatorial surface. The cleavage block that results from reduction in size of the mitotic apparatus can be reversed only by decreasing the distance from the mitotic axis to the equatorial surface. Artificial constrictions imposed in other regions are ineffective. The normal distance relation between the astral centers and the equatorial and polar surfaces in spherical eggs is not required for division. Cleavage can occur when the dimensional relations are reversed. Both the surface and the mitotic apparatus can interact to establish furrows after exposure to measures that disrupt their normal organization. Single, isolated asters can cause furrow-like constrictions. Their immediate effect is to cause local contraction in nearby surface.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539855 TI - Toward a comprehensive three-dimensional model of the contractile system of vertebrate smooth muscle cells. PMID- 3539857 TI - [New aspects in gluten-sensitive enteropathy]. PMID- 3539856 TI - [Therapy of cholelithiasis]. PMID- 3539858 TI - [Adaptive forms of the small intestine mucosa and their clinical significance]. PMID- 3539859 TI - [Invasive forms of non-typhoid salmonelloses]. PMID- 3539860 TI - Case histories of cardiac transplantation and artificial heart program. PMID- 3539861 TI - The hazards of smoking. PMID- 3539862 TI - Biographical sketches--69. Stensen. PMID- 3539863 TI - Biographical sketches--69. Robert Spencer Dyer Lyons 1826-1886: a centenary tribute. PMID- 3539864 TI - Rapid methods for identification of Legionella--a review. PMID- 3539866 TI - Predisposition of the asthmatic child to legionellosis? AB - The prevalence of seropositivity to Legionella spp. was studied in 184 children with bronchial asthma and in 80 control children, age- and sex-matched, without respiratory tract infections. The sera were examined by indirect immunofluorescence with antigens of six Legionella spp. The asthmatic children showed a significantly higher percentage of seroreactions to L. pneumophila than did the control children. In the asthmatic children, no association was found between age, sex, onset of asthmatic symptoms, living conditions, corticosteroid treatment, or exposure to aerosols and seropositivity to Legionella. No correlation could be found between the asthma severity score and the titer of serum antibodies to L. pneumophila. None of the 32 sera with titers of 256 or higher were reactive for Legionella-specific IgE antibodies. L. pneumophila antigen was detected in the urine of three children by an enzyme-linked immunosorbent assay (ELISA). The high prevalence of antibodies to L. pneumophila found in children with bronchial asthma, together with the detection of antigen in the urine of some of them, suggest that this group of children are highly susceptible to Legionnaires' Disease. PMID- 3539865 TI - Discrimination between clinical and environmental strains of Legionella pneumophila by a monoclonal antibody. AB - Legionellae are widely spread in natural and man-made habitats. In many instances contaminated tap water has been linked to sporadic or endemic cases of human pulmonary infections, but it is not known why, in spite of frequent occurrence, legionellae only rarely cause disease. Monoclonal antibodies against Legionella pneumophila serogroup 1 (Philadelphia 1) were prepared in order to distinguish between subtypes of this serogroup. Balb/c mice were immunized i.v. three times with heat inactivated bacteria. Antibody formation was detected by an enzyme linked immunosorbent assay (ELISA) technique using peroxidase-conjugated antimouse IgG. Spleen cells were then fused with NS-1 myeloma cells and cloned by limiting dilution. Four monoclonal antibodies were studied in detail. The study included 47 strains of L. pneumophila: 19 strains were of human origin and 28 were isolated from different environmental sources. Most were from tap water, but none from natural habitats. All strains belonged to serogroup 1 as defined by direct immunofluorescence (DFA) using monospecific FITC-labelled polyclonal antisera from rabbits. The strains were further characterized by beta-lactamase production, activity of catalase, oxidase and proteases, analysis of ubiquinones, and demonstration of membrane protein patterns by sodium dodecyl sulphate polyacrylamide gel electrophoresis. A strong homogenicity between all the strains could be revealed by these methods independent of their origin. One of the monoclonal antibodies (B-1) was able to distinguish between human and environmental isolates. Eighteen of the 19 human strains reacted very strongly in DFA using antimouse immunoglobulin. No reaction, however, was seen with all of the environmental strains. Immunoblots were performed for characterization of the distinguishing feature using membrane complexes of all strains on nitrocellulose strips. The blots were incubated with antibody B-1, and immune complexes were detected by 125I-protein A. Broad intense blackening was seen between 22 and 70 kilodalton. This result suggests that no single protein, but rather a smaller component such as an oligosaccharide attached to constituents of different molecular weights, might be responsible for the discriminating reaction. PMID- 3539867 TI - Serological studies of legionellosis in New Zealand. AB - The service performed by the Legionella Reference Laboratory in New Zealand over the last 4 years is described. During this period the number of antigens used in the indirect fluorescent antibody test increased from 4 to 19. The percentage of patients diagnosed has risen concomitantly. Species or serogroups found particularly frequently included L. pneumophila serogroup (SG) 6, L. micdadei, L. jordanis and L. longbeachae SG 1. Cultural studies and direct fluorescent antibody (DFA) studies were also performed. In addition to other species or serogroups, L. dumoffii was isolated from a patient and L. oakridgensis was observed by DFA in a postmortem specimen. PMID- 3539868 TI - Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia. AB - The prevalence of antibodies to 13 Legionella antigens was compared in three populations: 583 blood donors, 140 tuberculosis patients and 66 patients with acute non-legionellosis pneumonia. Antibody levels were determined by indirect immunofluorescence (IFA) using formalin-fixed antigens prepared from bacteria developed in embryonated hen yolk sac. The very weak prevalence of anti-L. pneumophila antibodies in a healthy population [almost 0 for serogroups (SG) 2, 3, 4 and 5; 1.5% for SG 6 and a maximum of 2.5% for SG 1 at a titer of 1: 16] confirms the criteria that have been recommended by the Centers for Disease control, USA. For the other legionellae studied, these criteria cannot be applied due to a higher prevalence in healthy populations (14.5% with levels of 1: 16-32 and 1% with levels of 1: 64-128 for L. bozemanii and progressively decreasing by as much as 2% for the other species: L. micdadei, L. longbeachae, L. gormanii, L. dumoffii and L. jordanis), in tuberculosis patients (12.1% with a level at 1: 64 128 for L. bozemanii, and for the same titer, 9.2% for L. gormanii, 5.7% for L. micdadei, 5% for L. longbeachae 2), and also in acute pneumonia (2 to 3.3% with levels of 1: 64-128 for L. longbeachae 1 and 2, L. jordanis, L. dumoffii, L. micdadei and L. bozemanii). Although the significance of these prevalences remains to be discussed, with formalin-fixed antigens, it seems reasonable for these species to assign a threshold of 1: 256 for the presumptive serodiagnosis following seroconversion. PMID- 3539869 TI - Use of infant and child corneas for grafting. AB - Six corneal transplants, for which donor material was taken from infants or children, were grafted in adults with different types of corneal pathology. Acceptable mean keratometric readings of 45.8 diopters were obtained 6 months after surgery, very similar to those of grafted corneas taken from adults. After 3 years of follow-up, we found complications similar to those of corneas taken from adult donors. No technical problems were encountered while using infants' or children's donor material. We suggest that this type of donor be considered for corneal transplantation in countries where sufficient adult corneas are not available. PMID- 3539871 TI - Ultrasonography in the study of pathological conditions of the hip. AB - The authors describe the use of real-time ultrasonography in the investigation of the hip joint. The study involved 25 patients with traumatic, inflammatory or degenerative lesions. It was possible to evaluate effusion and capsular changes in 13 cases and to correlate these findings with the type of pathology involved. The ultrasonographic findings in the patients with degenerative or inflammatory joint disease were confirmed at operation. The method described is simple, quick and devoid of risk to the patient. It is therefore a useful investigation in the study of disorders of the hip joint. PMID- 3539870 TI - Ultrasonography in the evaluation of osteogenesis in fractures treated with Hoffmann external fixation. AB - The possibilities of ultrasonography demonstrating periosteal callus and osteogenesis at the fracture focus are described. Illustrative cases are presented and the advantages of this technique are discussed. It is emphasized that ultrasonography is a noninvasive technique that may be repeated as often as is necessary. It provides images of appositional periosteal callus much earlier than radiography, thus facilitating early evaluation of the treatment employed. PMID- 3539872 TI - Experimental studies on peripheral nerve repair following early or delayed suture. AB - Early suture of the sciatic nerve in rats was compared with delayed suture performed after 2 weeks. The distal tract of the nerve was studied morphologically using semifine sections and computerised measurements of the number and diameters of regenerated fibres, and electrophysiologically by the measurement of nerve velocity conduction. The morphological examination did not reveal any substantial difference, while the velocity conduction tests showed better reinnervation following early suture. PMID- 3539873 TI - [Acyclovir in mycosis fungoides and lymphomatoid papulosis]. AB - A survey is given on 23 patients (10 of our own, 13 reported in personal communications and in the literature) suffering from lymphoproliferative diseases and treated with acyclovir (ACV). In 5 patients (3 of 18 with cutaneous T-cell lymphomas, 2 of 5 with lymphomatoid papulosis) partial remission could be achieved. Since herpes simplex virus, cytomegalovirus and viruses like Epstein Barr and varicella-zoster do not play an etiologic role and since HTLV-I virus, due to its lack of thymidine kinase, cannot activate ACV, the following mechanisms should be discussed regarding the possible effectiveness of ACV in lymphoproliferative diseases: a direct cytopathic effect; activation of ACV by the thymidine kinase of viruses not yet detected in cutaneous lymphoproliferative disorders; ACV activation by cellular thymidine kinase, which has been found to be elevated in lymphoproliferative disorders. Preliminary clinical observations suggest that ACV may exhibit an antiproliferative effect intravenously in some patients with lymphomatoid papulosis. PMID- 3539874 TI - [Immunohistochemical methods in the diagnosis and differential diagnosis of mesenchymal skin tumors]. AB - TNM classification, including staging and grading, cannot replace histogenetic classification of mesenchymal skin tumors; moreover, histogenetic classification is the basis for correct interpretation of the morphological criteria of malignancy. Histogenetic tumor classification can be improved by special methods, such as immunohistochemical studies of routinely formalin-fixed, paraffin embedded material; such studies are especially advantageous in tumor diagnosis. Immunohistochemical methods are also useful in classifying less well differentiated mesenchymal tumors, which otherwise would be descriptively designated as round-celled, spindle-celled, pleomorphic, myxoid, epitheloid or pericytomalike sarcomas. Moreover, further knowledge can also be acquired about tumors with characteristic structure, but uncertain histogenesis. A prerequisite for optimal results is careful comparison of the morphological findings with routine (H&E) strains and immunohistochemical reactions. Thus, overinterpretation and misinterpretation can also be avoided in artefacts which, if misinterpreted, could have grave consequences. PMID- 3539875 TI - Cranioplasty with a silicone prosthesis and split rib grafts. AB - A method to reconstruct visible cranioplasty defects involving the anterior cranium with the durability of bone and the exacting contours of the custom silicone implant is described. This technique is simple, quick, and does not require intraoperative assessment of subtle contours. The patient has a rigid underlying bony support with a perfectly contoured external surface. In patients with cranioplasty involving the cranium anterior to the hairline, we take advantage of both split rib grafts and a silicone prosthesis in one stage to obtain optimal results. PMID- 3539876 TI - Cartilage grafts--present status. AB - Cartilage grafts have been in use for almost a century and have proved their usefulness. Many questions about immunology, survival, growth, and role of perichondrium are still debated. We are presenting a review of the literature and of our experimental work on cartilage grafts. Ear cartilage was transplanted from 28 young New Zealand rabbits subcutaneously in the chest walls. The grafts were divided into 1) bare cartilage, 2) perichondrium, 3) cartilage covered with perichondrium on one side, and 4) cartilage covered with perichondrium on both sides. The grafts were measured in length and weight before transplantation, and at 2 and 4 months after transplantation; they were compared to a control piece of cartilage tagged in situ. Histologic examination was performed on all retrieved grafts. Transplanted cartilage survival was good in over 75% of cases; however, cartilage production from perichondrium was minimal and no growth was noticed in any of the grafts. PMID- 3539877 TI - Hemimandibulectomy without bone grafting: report of a case. AB - Some patients require hemimandibulectomy who are poor candidates for reconstructive surgery or who do not want to subject themselves to multiple surgical episodes. With the use of an articulated external skeletal fixation appliance, near-normal esthetics and function can be achieved in these patients without bone grafting. A report of one such case is presented. PMID- 3539878 TI - Nosocomial infections related to four methods of hemodynamic monitoring. PMID- 3539879 TI - Topical injury from chemical agents: initial treatment. AB - Many products capable of producing chemical burns are now available. The prognosis of a patient injured by chemicals is dependent on the rapidity of treatment. There are many types of chemical agents each with its own specific properties. The local reactions and systemic effects of these chemicals vary as does their counteragents. Knowledge of the chemicals, the types of injuries they produce, and appropriate treatment for each is essential to ensure appropriate assessment, treatment, and safety. PMID- 3539880 TI - Kawasaki disease: what is this puzzling childhood illness? PMID- 3539882 TI - Mitral valve prolapse: self-care needs, nursing diagnoses, and interventions. PMID- 3539881 TI - Cardiac amyloidosis. PMID- 3539883 TI - Comparison of two methods of labeling proteins with 111In. AB - DTPA N-hydroxysuccinimide pentaester (DHSE) can be used as an alternative to bicyclic anhydride for coupling proteins with DTPA. However, in-vitro analysis of labeled proteins coupled with DHSE compared to bicyclic anhydride showed more high molecular weight product and less serum stability. We studied the magnitude of these differences in vivo by coupling HSA and IgG with DTPA using both methods, labeling with 111In, and analyzing the biodistribution in mice. The results of this analysis showed comparable activity in the liver, kidneys and blood. PMID- 3539884 TI - Serum stability of 67Cu chelates: comparison with 111In and 57Co. AB - Simple chelates and chelate conjugated monoclonal antibodies labeled with 111In, 57Co and 67Cu demonstrate marked differences in stability when exposed to a serum environment. Among these radiometals, on DTPA, the order of stability is 111In greater than 57Co much greater than 67Cu. On benzyl-EDTA, the order of stability is 111In congruent to 57Co much greater than 67Cu. Among those investigated, the only serum stable 67Cu chelate found was 67Cu-TETA. The order of stability observed for 57Co vs 67Cu is contrary to published equilibrium constants. These in vitro studies suggest that the in vivo behavior of metal chelates exposed to a complex molecular environment may not be predicted by classically determined equilibrium constants. PMID- 3539886 TI - Treatment of progressive posthemorrhagic hydrocephalus with temporary external ventricular drainage. Preliminary results. AB - Peri-intraventricular hemorrhage (PIVH) is a major problem of preterm neonates: over 40% of infants with birth weight less than 1500 g have been found to experience this disorder. The posthemorrhagic hydrocephalus (PHH) is generally believed to occur secondary to obliterative posterior fossa arachnoiditis. Its management in critically ill premature infants with multiple medical problems has thus become quite significant. This paper reports the results of the placement of a temporary external ventricular drainage in three patients in whom progressive ventricular dilatation began within two weeks after severe neonatal PIVH. In all patients the hydrocephalus and increased intracranial pressure were controlled within three weeks of treatment. One infant died from other problems associated with his prematurity. Early demonstration of progressive ventricular dilatation by ultrasound and prompt external drainage has been found to be a safe initial method to treat PHH in preterm infants. PMID- 3539885 TI - Bacterial meningitis in infants two to six weeks old. AB - We reviewed our experience with bacterial meningitis in older neonates (2 to 6 weeks of age) during a five-year period. Seventeen patients with bacterial meningitis were diagnosed and treated. Bacteria recovered from the cerebral spinal fluid (CSF) included pneumococci (29%), E. coli and meningococci (23% each), group B streptococci (12%), Enterobacter and H. influenzae (6% each). There were no cases of Listeria monocytogenes. The mean duration of symptoms before admission was 3.1 days. The mortality rate was high (30%), and 36% of the patients had significant neurologic residua. Our study shows that this specific age group is different from newborns or older infants. Therefore, the initial selection of antibiotics for the treatment of meningitis in this age group should include antibiotics that are effective across this spectrum of potential pathogens. PMID- 3539887 TI - Cell-cell recognition and compatibility between heterogenic and homogenic incompatibility. PMID- 3539888 TI - Centric fission in Microtus oeconomus. A new locality in south east Norway. PMID- 3539889 TI - Thermodynamic relations and human energy exchange. PMID- 3539890 TI - Immunohistochemical localization of a specific ileal peptide in the pig. AB - The tissue distribution of a polypeptide purified from pig ileal mucosa tentatively called porcine ileal polypeptide (PIP) and known to have potent acid secretagogue activity has been studied with immunohistochemical methods together with extraction of different tissues followed by radioimmunoassay for PIP content. Histochemically the peptide is found in superficial epithelial cells in the mucosa of the distal 20% of the small intestine and to some extent in the mucosa of the urinary tract. There is no staining of goblet cells or crypt cells. The staining in the urinary tract mucosa is due to antigenic peptides with Mr identical to PIP. While the presence of PIP in the ileum is compatible with a function as an enterooxyntin, it is not possible at present to explain the physiologic role of PIP entirely as a hormone regulating acid secretion in light of the immunohistochemical distribution. PMID- 3539892 TI - Nuclear origin of progesterone receptor of the chick oviduct cytosol. An immunoelectron microscopic study. AB - Progesterone receptor (PR) was studied immunoelectron microscopically from fixed vibratome sections of the chick oviduct and biochemically from the fractionated oviduct homogenate. Immunoelectron microscopically both unoccupied and occupied PR were localized inside the nuclei. Only a few cells showed PR immunoreactivity in the endoplasmic reticulum which probably represents newly synthetized PR. Biochemically unoccupied PR was in the cytosol fraction. The cytosol and nuclear PR as well as the non-transformed 8S-form and the transformed 4S-forms of cytosol PR were recognized by the anti-PR antibody (IgG-RB). The lack of PR immunostaining in the cytoplasm is therefore not due to lack of recognition by IgG-RB. We propose that in the chick oviduct progesterone receptor is a nuclear protein but synthetized in the endoplasmic reticulum. PMID- 3539891 TI - Existence and coexistence of peptides in nerves of the mammalian ovary and oviduct demonstrated by immunocytochemistry. AB - The immunocytochemical distribution of substance P (SP), gastrin releasing peptide (GRP), vasoactive intestinal polypeptide (VIP), peptide histidine isoleucine (PHI), and neuropeptide Y (NPY) was studied in the ovary and the Fallopian tube (oviduct) of rats, guinea-pigs, cows, pigs and humans. Generally, the nerve supply was better developed in the oviduct than in the ovary. GRP fibers were most scarce in all tissues. Nerves containing SP were particularly numerous in the oviduct of rat and guinea-pig, supplying the muscular wall and blood vessels. VIP and PHI coexisted in dense plexuses of nerves, not only around blood vessels but also in the follicular wall and the interstitial gland of the ovary, as well as within the smooth muscle layers and subepithelially in the oviduct. The general distribution of NPY was similar, but these immunoreactive nerves were even more numerous. Sequential staining for dopamine-beta-hydroxylase and NPY together with results of chemical sympathectomy with 6-hydroxydopamine suggested that NPY was stored in the noradrenergic sympathetic nerves. PMID- 3539894 TI - Immunocytochemical study of the distribution of S-100 protein in the parathyroid gland of rats and guinea pigs. AB - The distribution of S-100 protein in the parathyroid cells of normal and hypercalcaemic rats and guinea pigs was investigated. Previous studies had shown that the applied antibodies detect only the beta subunit of S-100 protein. S-100 protein was found in all parathyroid cells of rats aged between 1 and 720 days. In adult guinea pigs, S-100 protein was detectable in only a small proportion of parathyroid cells. The level of S-100 protein in individual cells exhibited considerable variation, particularly in guinea pig. Hypercalcaemia did not affect the distribution of S-100 protein in the parathyroid cells of either rats or guinea pigs. In both species, the presence of small groups of parathyroid cells in the central fragments of thyroid lobes was often noted. PMID- 3539893 TI - Colloidal gold-labeled insulin complex. Characterization and binding to adipocytes. AB - Biologically active insulin gold complex was used as an ultrastructural marker to study insulin binding sites, uptake, and internalization in isolated rat adipocytes. The preparation conditions for monodispersed particles, ca. 16 nm in diameter and loaded with approximately 100 insulin molecules, are reported. The complex is stable for at least six weeks. Single particles or small clusters were scattered across the cell membrane. The distribution of unbound receptors seemed to be independent of the extensive system of pre-existing surface connected vesicles in adipocytes. The uptake of particles took place predominantly via non coated pinocytotic invaginations; clathrin-coated pits did not seem to be important for this process. Lysosome-like structures contained aggregates of 10 15 particles. These data suggest that insulin gold complex is a useful marker for the specific labeling of insulin binding sites. PMID- 3539895 TI - Biochemical studies on a factor isolated from Klebsiella K43-BTS1 that cross reacts with cells from HLA-B27 positive patients with ankylosing spondylitis. AB - A component of the cell walls of certain enteric bacteria has been identified that cross-reacts with an HLA-B27-associated cell-surface structure on lymphocytes and other cell types from patients with ankylosing spondylitis. This component, or "modifying factor," from one particular organism, Klebsiella K43 BTS1, has been studied in detail. A purification scheme has been developed using preparative electrofocusing and gel-permeation high performance liquid chromatography techniques and the purified material used in various characterization studies. A previous study demonstrated that the modifying factor has an approximate molecular weight of 30,000 and an isoelectric point of 5.4 5.5. In this study two-dimensional gel electrophoresis experiments demonstrated that the modifying factor is associated with a single protein component of the cell wall of this organism. Pronase and papain destroyed the modifying factor activity whereas trypsin and alpha-chymotrypsin degraded the factor into smaller fragments without destroying its ability to modify B27+ AS- lymphocytes. Neuraminidase did not affect the modifying factor itself but did affect B27+ AS- lymphocytes such that they became unresponsive to modification. Sugar inhibition studies suggested that sugar groups are probably not involved in the function of the modifying factor. The availability of purified modifying factor should permit more detailed chemical analyses as well as functional studies to determine the significance of this molecule to the pathogenesis of ankylosing spondylitis. PMID- 3539896 TI - Idiopathic pulmonary fibrosis associated with high-titer antibodies against nuclear ribonucleoprotein (nRNP): report of 3 cases. PMID- 3539897 TI - An analysis of the radiation related morbidity observed in a randomized trial of neutron therapy for bladder cancer. AB - This report is an analysis of the morbidity in the bladder and bowel observed in a randomized trial of d(15)+Be neutrons versus megavoltage photons in the treatment of bladder cancer. Acute reactions in the bladder and bowel were significantly worse after photon therapy. Of the patients treated with photons 45.7% had severe reactions in the bladder compared with 10.6% after neutron therapy (p less than 0.001). Severe acute bowel reactions were observed in 8.5% of the patients after photon therapy compared with 3.8% after neutron therapy (p less than 0.05). Late reactions were significantly worse after neutrons. Severe late reactions in the bladder were seen in 58.5% of patients after neutron therapy and in 40.5% after photon therapy (p less than 0.05). In the bowel they were observed in 53.3% of patients after neutron therapy compared with 8% after photon therapy (p less than 0.0001). The disparity in the degree of early and late complications makes assessment of RBE values difficult. It is estimated that for bladder morbidity the RBE value, for photon dose fractions of 2.75 Gy, is less than 3.3 for early reactions and equal to 3.4 for late effects. The respective RBE values for early and late effects in the bowel are less than 3.4 and 3.8. PMID- 3539898 TI - An outcome study of the RTOG Cancer Control program. AB - The Cancer Control program, funded by the National Cancer Institute, was initiated with the goal of involving community hospitals in multi-institutional clinical trials. The Radiation Therapy Oncology Group (RTOG) began participating in this program in 1976. This investigation compares the survival of patients treated by protocol in RTOG Full Member versus Cancer Control institutions between 1976 and 1985. The RTOG has 28 Full Members which are major treatment centers and enter at least 50 patients on RTOG protocols each year. The 11 Cancer Control members, which are mostly community hospitals, must enter at least 12 patients on RTOG protocols each year. A comparison of survival between Full Members and Cancer Control members was made for five RTOG studies. No difference in data quality or protocol compliance was observed for these studies between Cancer Control and Full Member institutions. Overall survival comparisons, as well as comparisons adjusted for prognostic factors, were made for each of the five studies. No differences in survival between Cancer Control and Full Members were observed in either analysis. PMID- 3539900 TI - Pregnancy diagnosis in swine: a comparison of the accuracies of mechanical and endocrine tests with return to estrus. AB - The relative accuracies of various commercially available detection procedures in the evaluation of pregnancy status were evaluated in 51 sows of mixed parity. Sows were mated 1 to 3 times during estrus to one or more boars. A blood sample was obtained from each sow between 19 and 23 days after estrus (first day of estrus = day 1) and again between 26 and 30 days and was analyzed by radioimmunoassay for content of progesterone and estrone sulfate, respectively. Sows were considered pregnant if progesterone concentrations were greater than 5 ng/ml and if estrone sulfate concentrations were greater than 0.5 ng/ml. At daily intervals, sows were exposed to mature, sexually aggressive boars and observed for signs of estrus. Between 31 and 35 days of gestation, sows were evaluated for pregnancy by use of the following mechanical devices: a Doppler ultrasound pregnancy detector fitted with an abdominal probe, the Doppler detector with a rectal probe, an amplitude-depth ultrasound pregnancy detector (diode ruler), and another amplitude-depth ultrasound detector from a different manufacturer (oscilloscope). Relative to the proportion of sows that farrowed, the overall accuracies of the techniques were returns to estrus, 98%; estrone sulfate, 92%; progesterone, 92%; Doppler with rectal probe, 86%; Doppler with abdominal probe, 86%; diode ruler amplitude-depth ultrasound, 73%; and oscilloscope amplitude depth ultrasound, 86%. Estrus detection resulted in the lowest prevalence of sows that were predicted to farrow, but did not subsequently farrow (false-positive diagnoses) and the lowest prevalence of sows that were not predicted to farrow, but subsequently did farrow (false-negative diagnoses).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3539899 TI - Antoine Lacassagne. PMID- 3539901 TI - Antibacterial activity of BMY-28142, a novel broad-spectrum cephalosporin. AB - BMY-28142, 7-[(Z)-2-(2-aminothiazol-4-yl)-2-methoxyiminoacetamido]-3- (1 methylpyrrolidinio)methyl-3-cephem-4-carboxylate, exhibited a well-balanced, extended-spectrum of antibacterial activity both in vitro and in vivo. Against Staphylococci and Streptococci, BMY-28142 was about four to ten times more active than ceftazidime and comparable to cefotaxime. Most Enterobacteriaceae were more susceptible to BMY-28142 than to ceftazidime, though strains of Pseudomonas aeruginosa were slightly more sensitive to ceftazidime. BMY-28142 showed potent activity against Gram-negative bacteria resistant to ceftazidime and/or cefotaxime. Bactericidal activity of BMY-28142 against 10 strains of P. aeruginosa was superior to that of ceftazidime. In bacterial infection models in mice, BMY-28142 was more effective than ceftazidime against three Gram-positive and three Gram-negative pathogens. The anti-pseudomonal in vivo activity of BMY 28142 was nearly comparable to that of ceftazidime. The blood levels and urinary excretion rates of BMY-28142 in mice were similar to those of ceftazidime. PMID- 3539902 TI - Organ of Corti surface preparations for computer-assisted morphometry. AB - This paper describes a relatively rapid method (67 h) for producing surface preparations of the organ of Corti that are suitable for a computer-assisted morphometric analysis of cochlear hair cells. On day 1, a cochlea was fixed in OsO4, dehydrated in ethanol and infiltrated with an Epon-like plastic (Medcast). On day 2, the Medcast within the cochlea was polymerized at 60 degrees C in an oven. On day 3, the complete organ of Corti was dissected into approximately 20 segments which were trimmed and mounted on a slide in Medcast. Two 400 mesh transmission electron microscope grids are mounted at the apical and basal ends of the organ of Corti. These grids served as reference points for the establishment of an independent X, Y coordinate system on the slide by a computer assisted light microscope. The segments were permanently attached to the slide by polymerization of the Medcast at 60 degrees C for approximately 15 h. At the beginning of day 4, the organ of Corti surface preparation was ready for examination by light microscopy or could be further sectioned and examined by transmission electron microscopy. PMID- 3539903 TI - Effect of fasting neonatal piglets on blood hormone and metabolite profiles and on skeletal muscle metabolism. AB - A pair of weight-matched piglets was identified at birth in each of six litters. One member of the pair was allowed to suckle for 24 h while the other was fasted. Serum concentrations of insulin, thyroxine (T4), somatomedin-C (RIA) and somatomedin-like activity (bioassay) were non-detectable or lower in non-suckled piglets when compared with suckled piglets. The converse situation was found for serum growth hormone (GH) levels, i.e., GH levels were higher (P less than .01) in non-suckled piglets. Triiodothyronine (T3) concentration was not influenced by nutritional status. Serum concentrations of fructose and of free fatty acids were not influenced by fasting (P greater than .05), but glucose and triacylglycerol serum levels were lower (P less than .01, P less than .05, respectively) in the non-suckled group. The biceps femoris muscle of the non-suckled group weighed less (P less than .05) and contained less RNA (P less than .01) and protein (P less than .07), but DNA and dry matter were similar between groups. Rates of glucose oxidation to CO2 (with [1-14C] glucose tracer, P less than .01; with [6,14C] glucose tracer, P less than .09) and incorporation into glycogen (P less than .01) and of palmitate esterification into triacylglycerol (P less than .01) were reduced by fasting. However, the rates of glycolytic flux and of palmitate oxidation to CO2 (expressed per mg protein) were not affected by fasting. The rate of glucose incorporated into glycogen was reduced (P less than .05) by the presence of palmitate in the muscle of suckled piglets. A dose-dependent decrease in somatomedin-like activity with increased concentration of serum from non suckled piglets in the cartilage disc bioassay suggested that the production of growth inhibitors accompanied the loss of nutrient availability. The biceps femoris muscle responded to the fast by conserving fatty acid for oxidation as an energy source rather than for incorporation into triacylglycerol or phospholipid. The reduction in glucose oxidation to CO2, but maintenance of glycolytic flux rates, may be important to production of lactate, which can be used by the brain and heart as an energy source. It was suggested that the metabolic adaptations of pig skeletal muscle to the fasted state may be critical to survival. PMID- 3539904 TI - Factors affecting starch digestibility with special emphasis on sorghum and corn. AB - Starch exists inside the endosperm of cereals enmeshed in a protein matrix, which is particularly strong in sorghum and corn. Starch digestibility is affected by the plant species, the extent of starch-protein interaction, the physical form of the granule, inhibitors such as tannins, and the type of starch. Among the cereals, sorghum generally has the lowest starch digestibility. The resistance to digestive action of the hard peripheral endosperm layer is largely responsible for this effect. Processing methods such as steam-flaking and reconstitution are effective in raising sorghum digestibility to near that of corn. Waxy sorghum shows consistently higher feeding value than normal sorghum. Both the starch granules and the protein matrix around them are more digestible in waxy grain. The development of new heterowaxy or waxy sorghum hybrids may further increase sorghum feed efficiency. PMID- 3539905 TI - Limits to starch digestion in the ruminant small intestine. AB - Site and extent of starch digestion by ruminant animals varies with species, grain type and processing method. Based on a review of 40 different experiments with cattle, between 18 and 42% of the dietary starch from corn and sorghum grains fed to cattle reaches the small intestine for digestion. With more extensive grain processing, a smaller quantity of starch reaches the small intestine. In the small intestine, from 47 to 88% of the presented starch is digested, while in the large intestine, 33 to 62% of the presented starch is digested. Though limits to digestion in and absorption from the small intestine can be demonstrated by infusing starch and glucose into the duodenum, enzymatic capacity does not appear to limit intestinal starch digestion since no plateau in the amount of starch disappearing from the small intestine is detected with typical diets. Yet, extent of digestion is incomplete. Other factors, such as time and surface exposure may limit small intestinal digestion of starch. Processing methods to reduce particle size or alter the protein matrix, which cements starch granules together, will increase the extent of digestion both in the rumen and in the small intestine. Performance data from growing cattle fed processed corn and sorghum grains indicate that starch was used 42% more efficiently if it was digested in the small intestine rather than in the rumen. Though total tract starch digestibility is of primary concern, results support the concept that energetic efficiency of growing ruminants is greater if starch is digested in the small intestine rather than in the rumen. PMID- 3539906 TI - Grain processing effects on starch utilization by ruminants. AB - Starch utilization may be markedly enhanced by proper grain processing; however, extent of improvement is primarily dependent upon the ruminant species, grain source and method of processing. Grain processing has less impact on starch digestion by sheep than cattle. The magnitude of improvement is inverse to the starch digestion values for nonprocessed (or minimally processed) grains. Utilization of sorghum grain starch is improved most by extensive processing, and then corn, with little improvement in barley starch digestion. Studies comparing processing effects on barley or wheat starch utilization by cattle were not found. Steam-flaking consistently improves digestibility of starch by cattle fed corn- or sorghum grain-based diets over whole, ground or dry-rolled processes. Other extensive processing methods appear to enhance starch digestibility of corn and sorghum grain to a similar extent as steam-flaking, but comparative data are too limited to quantitate adequately effects of these methods. This improvement in starch utilization appears to be the primary reason for enhanced feed conversion of cattle fed diets high in these processed grains. The major site of cereal grain starch digestion is usually the rumen. Processing increases microbial degradation of starch in the rumen and decreases amounts of starch digested post-ruminally. Rates of in vitro amylolytic attack of starch in cereal grains by both ruminal microbial and pancreatic enzyme sources are improved by processing methods employing proper combinations of moisture, heat and pressure. In vitro and in situ studies suggest that much of the increase in ruminal starch fermentation with steam-flaking is due to changes in starch granular structure, which produces additive effects beyond those of decreasing particle size. Thus, efficiency of ruminal starch fermentation by cattle appears to be improved by proper processing of corn and sorghum grain. Processing and grain source studies both suggest that maximal total tract starch digestibility is positively related to the extent of digestion in the rumen. PMID- 3539907 TI - Drug resistance in the opportunistic pathogens Candida albicans and Candida glabrata. AB - There are three major classes of antifungal drug used to treat patients suffering from topical and systemic infections caused by Candida albicans. Both the polyene macrolide antibiotics and the synthetic imidazole derivatives interact with membranes of sensitive organisms causing an impairment of function and cessation of growth. It is possible to obtain mutants of C. albicans resistant to these drugs but they are not a clinical problem. This may result from the fact that the organism is diploid with no haploid stage in its life cycle and the interaction of these compounds with their target is complex involving a number of membrane constituents. In contrast the occurrence of strains of C. albicans resistant to 5 fluorocytosine is a serious clinical problem. Here partial resistance is associated with heterozygosity at the locus coding for UMP pyrophosphorylase. Mitotic segregation can give rise to homozygous resistance in strains where the enzyme is completely absent. This is analogous to acyclovir resistance in herpes simplex virus where resistance is associated with loss of the virus encoded thymidine kinase. PMID- 3539909 TI - An open trial of auranofin (oral gold preparation) in rheumatoid arthritis. PMID- 3539910 TI - To treat or not to treat--the implications of the M.R.C. trial of therapeutic intervention in mild hypertension. PMID- 3539908 TI - Abdominal aortic aneurysms: distribution of elastin, collagen I and III, and intermediate filament proteins desmin and vimentin--a comparison of familial and nonfamilial aneurysms. AB - The aortic walls of patients with abdominal aortic aneurysms (AAA) and of healthy controls were examined for elastin, collagen I and III, and the intermediate filament proteins desmin and vimentin by immunohistochemical, enzyme histochemical, and routine histological techniques. The morphology of the aneurysmatic walls varied considerably from case to case, but many pathological changes were seen in all cases, e.g., extensive atherosclerotic plaques in the intima, prominent alterations in amount and organization of the elastic lamellae in the media, and an increase of connective tissue. Both collagen I and III were present in all the aneurysmatic walls. The smooth muscle cells in all the aortic walls showed a marked heterogeneity with respect to the morphological appearance, the enzyme histochemical features, and the content of desmin and vimentin. Vimentin occurred in some intimal, medial muscle, and adventitial cells of both the controls and the AAA patients. Desmin occurred in some of the intimal, medial, and adventitial muscle cells of both the controls and the AAA patients. All the cells with desmin in the intima and media also contained vimentin. Thus, smooth muscle cells in the walls of both the normal human abdominal aorta and aneurysms contained either vimentin, desmin, or both. This variability may be explained by the presence of different phenotypes of smooth muscle cells and could be of significance for the development of atherosclerosis and aneurysms. Of special interest was the finding that 5 of the 24 AAA patients studied had blood relatives with the same disease, suggesting a hereditary influence. However, no systematic differences between the morphological appearance of the aneurysmatic walls in familial and nonfamilial AAA could be detected. PMID- 3539911 TI - Thrombocytopenic purpura in Plasmodium falciparum malaria. PMID- 3539912 TI - In vitro system for molybdopterin biosynthesis. AB - A high-Mr fraction present in chl+ and chlA1 strains of Escherichia coli synthesizes molybdopterin (MPT) from the low-Mr fraction of several MPT-deficient mutants. Using this in vitro complementation as an assay, we have partially characterized the high-Mr fraction as a protein, termed MPT converting factor, of Mr 45,000, distinguishable from the Mo cofactor carrier protein of similar Mr by its absolute requirement for the low-Mr fraction of a non-chlA1 mutant in the nit 1 reconstitution assay. MPT converting factor was rapidly inactivated in the absence of a reduced sulfhydryl compound. Anaerobic incubation of MPT converting factor with trypsin destroyed its activity. High-performance liquid chromatographic analysis of alkaline KMnO4 oxidation products demonstrated that the factor did not contain any bound pterin. Since mutants lacking MPT converting factor are not auxotrophs for folate or riboflavin, the factor appears to be distinct from known pteridine biosynthetic enzymes in E. coli. We have partially purified and characterized the low-Mr fractions as probable MPT precursors. Several distinct precursors were separable by high-performance liquid chromatography. Like MPT activity, precursor activity was oxygen sensitive. Precursor activity was not correlated with levels of L-threo-neopterin, a major pterin of unknown function in E. coli. Precursor activity was correlated with levels of a new 6-alkylpterin, compound Z, produced by acidic iodine oxidation. Compound Z has the properties expected of an oxidized MPT precursor. PMID- 3539913 TI - Organization of developing Escherichia coli colonies viewed by scanning electron microscopy. AB - Colony growth was initiated by inoculating minimal glucose agar with 1 microliter. spots of a plasmid-free Escherichia coli culture and incubating at 32 degrees C. Inoculations took place over a 3-day period, at the end of which the plates were fixed and dried for scanning electron microscopy. In this way, it was possible to examine the surfaces of colonies ranging in age from 0 to 68 h. Macroscopically, the colonies were organized into different concentric zones, and several morphological features could be seen to develop over this period. These included a shallow depression ring marking the site of inoculation, a deeper indentation ring whose position moved outward as the colony grew, an expanding plateau region between the two rings, a mound outside the indentation ring, and a flat brim extending onto the substrate which was either present or absent at different times. Microscopically, a variety of cell morphologies and cell arrangements were detected. Upon inoculation, the bacteria accumulated at the periphery of the inoculation spot but showed no other kind of order. For the first 7.5 h, all bacteria were rod shaped; at the end of this initial phase, a high degree of alignment was seen in the cells at the colony edge. By 24.5 h, both shorter more ovoid cells and longer filaments had begun to appear, and large multicellular arrays had formed. At later stages of colony development, morphologically distinguishable zones involving cells of different shapes and sizes had formed, and these zones often marked the boundaries of macroscopic features. The edges were particularly interesting and at 68 h displayed very sharp saw-toothed boundaries between concentrically organized groups of bacteria. There were some transient irregularities in the concentric organizations of growing colonies, and one colony had entered upon a distinct developmental pathway. PMID- 3539914 TI - "White-opaque transition": a second high-frequency switching system in Candida albicans. AB - A second high-frequency switching system was identified in selected pathogenic strains in the dimorphic yeast Candida albicans. In the characterized strain WO 1, cells switched heritably, reversibly, and at a high frequency (approximately 10(-2] between two phenotypes readily distinguishable by the size, shape, and color of colonies formed on agar at 25 degrees C. In this system, referred to as the "white-opaque transition," cells formed either "white" hemispherical colonies, which were similar to the ones formed by standard laboratory strains of C. albicans, or "opaque" colonies, which were larger, flatter, and grey. At least three other heritable colony phenotypes were generated by WO-1 and included one irregular-wrinkle and two fuzzy colony phenotypes. The basis of the white-opaque transition appears to be a fundamental difference in cellular morphology. White cells were similar in shape, size, and budding pattern to cells of common laboratory strains. In dramatic contrast, opaque cells were bean shaped and exhibited three times the volume and twice the mass of white cells, even though these alternative phenotypes contained the same amount of DNA and a single nucleus in the log phase. In addition to differences in morphology, white and opaque cells differed in their generation time, in their sensitivity to low and high temperatures, and in their capacity to form hypae. The possible molecular mechanisms involved in high-frequency switching in the white-opaque transition are considered. PMID- 3539915 TI - Induction of the nodA promoter of Rhizobium leguminosarum Sym plasmid pRL1JI by plant flavanones and flavones. AB - An expression vector containing the Rhizobium leguminosarum nodA promoter cloned in front of the Escherichia coli lacZ gene was used to characterize the properties of the R. leguminosarum nodA gene-inducing compound(s) present in sterile root exudate of the host plant Vicia sativa L. subsp. nigra (L.). The major inducing compound was flavonoid in nature, most likely a flavanone. The commercially available flavonoids naringenin (5,7,4'-trihydroxyflavanone), eriodictyol (5,7,3'4'-tetrahydroxyflavanone), apigenin (5,7,4' trihydroxyflavone), and luteolin (5,7,3',4'-tetrahydroxyflavone) induced the nodA promoter to the same level as the root exudate. On the basis of chromatographic properties, it was concluded that none of these compounds is identical to the inducer that is present in root exudate. The induction of the nodA promoter by root exudate and by the most effective inducer naringenin was very similar, as judged from the genetic requirements and the kinetics of induction. PMID- 3539916 TI - Cytochemical localization of lipopolysaccharides during peptidoglycan degradation of Escherichia coli cells. AB - The cytochemical reaction of Thiery [J. P. Thiery, J. Microsc. (Paris) 6:987 1018, 1976] was applied to several Escherichia coli strains having different lipopolysaccharide molecular structures. The granular deposit obtained strongly suggested that part of the R core exposed on the outer membrane was responsible for the staining. As this procedure specifically stains the outer membrane, it was possible to demonstrate that, in E. coli K-12, changes in lipopolysaccharide distribution occurred during autolysis and lysozyme treatment. PMID- 3539917 TI - Expression of bioluminescence by Escherichia coli containing recombinant Vibrio harveyi DNA. AB - When isogenic strains of Escherichia coli, RR1 (rec+) and HB101 (recA), were transformed with mapped recombinant plasmids known to contain Vibrio harveyi luciferase genes and large regions of DNA flanking on both sides, a small percentage (0.005%) of the colonies expressed high levels of luminescence (up to 10(12) quanta s-1 ml-1) in the absence of added aldehyde. The altered ability to express light was found to be due to a mutation in the host and not to an alteration in the recombinant DNA. When these bright colonies were cured of plasmid, they could be retransformed with cloned V. harveyi gene fragments in cis and in trans to yield luminescent colonies at 100% frequency. The maximum length of V. harveyi DNA required to produce light-emitting E. coli was shorter (6.3 kilobase pairs) than that required for expression of the V. fischeri system in E. coli. Cell extracts from bright clones contained wild-type levels of activity for the heteropolymeric (alpha beta) luciferase; fatty acid labeling revealed the presence of the three acylated polypeptides of the fatty acid reductase system which is involved in aldehyde biosynthesis for the luminescence reaction. The increased light emission in the mutant bacteria appeared to arise in part from production of higher levels of polycistronic mRNAs coding for luciferase. PMID- 3539918 TI - Differential induction of heat shock, SOS, and oxidation stress regulons and accumulation of nucleotides in Escherichia coli. AB - Heat and various inhibitory chemicals were tested in Escherichia coli for the ability to cause accumulation of adenylylated nucleotides and to induce proteins of the heat shock (htpR-controlled), the oxidation stress (oxyR-controlled), and the SOS (lexA-controlled) regulons. Under the conditions used, heat and ethanol initiated solely a heat shock response, hydrogen peroxide and 6-amino-7-chloro 5,8-dioxoquinoline (ACDQ) induced primarily an oxidation stress response and secondarily an SOS response, nalidixic acid and puromycin induced primarily an SOS and secondarily a heat shock response, isoleucine restriction induced a poor heat shock response, and CdCl2 strongly induced all three stress responses. ACDQ, CdCl2, and H2O2 each stimulated the synthesis of approximately 35 proteins by factors of 5- to 50-fold, and the heat shock, oxidation stress, and SOS regulons constituted a minor fraction of the overall cellular response. The pattern of accumulation of adenylylated nucleotides during these treatments was inconsistent with a simple role for these nucleotides as alarmones sufficient for triggering the heat shock response, but was consistent with a role in the oxyR-mediated response. PMID- 3539919 TI - New regulatory features of the promoters of an Escherichia coli rRNA gene. AB - Recombinant plasmids were constructed by fusing either promoter p1 or p2 or both promoters of the rrnB gene of Escherichia coli to a DNA fragment coding for the N terminal alpha-peptide of beta-galactosidase. These plasmids contained various lengths of the 5'-leader region of rRNA as the 5'-terminal end of the alpha peptide messenger. In some cases the entire 5'-terminal rRNA-coding sequence was removed, and alpha-peptide synthesis was governed by rac promoters formed by fusion of rrnBp2 and lac promoters. By measuring the level of alpha peptide, conclusions could be drawn about the activities of the promoters under various physiological conditions. It was found that the rate of transcription starting from promoter p1 or p2 might vary more than 10-fold during the growth cycle, showing a sharp maximum during outgrowth from the stationary phase into exponential growth or during nutritional shift-up. The target sequence of this regulation was localized to the leader region of the rrnB gene. PMID- 3539920 TI - Regions of Salmonella typhimurium flagellin essential for its polymerization and excretion. AB - Immunological methods were used to examine the flagellin production of Salmonella typhimurium strains that carried a mutation in one of the two possible genes for flagellin (H1 or H2) and also were incapable of expressing the other gene. Some mutants produced flagellin that was excreted into the culture medium; others accumulated flagellin intracellularly. These two phenotypes were detected in both H1 and H2 mutants. The mutation sites were mapped on the corresponding deletion map (consisting of 21 segments in the case of H1 and 31 segments in the case of H2). H1 and H2 mutations causing excretion of flagellin were clustered mainly in segment 12 and segment 6 from the proximal end, respectively, suggesting that the corresponding segments of the flagellins play a role in polymerization. Mutations causing accumulation in the cytoplasm were clustered in segments 19 to 21 of the H1 map and in segments 25 to 29 of the H2 map, suggesting that an essential region for flagellin transport exists toward the C terminus of flagellin. PMID- 3539921 TI - Mechanism and regulation of phosphate transport in Streptococcus pyogenes. AB - In contrast to results reported with other bacteria, uptake of 32Pi in Streptococcus pyogenes was found to occur rapidly in starved cultures and to be strongly and immediately inhibited by addition of exogenous glycolytic energy sources (such as glucose) and nonglycolytic sources of ATP (such as arginine). Preincubation of starved cells with NaF, iodoacetate, or arsenate eliminated the inhibiting effect of glucose but not that of arginine. In accordance with the hypothesis that transport was attributable to Pi-Pi exchange, uptake and efflux of 32Pi in the presence of trans unlabeled Pi exhibited similar characteristics and were largely eliminated by reduction of the trans Pi concentration. Neither process was inhibited appreciably by pretreatment of cells with ionophores or metabolic inhibitors, but both processes were abolished by exposure to p chloromercuribenzoate. Inhibition by both exogenous energy sources resulted in a reduction in the maximal velocity of transport (Vmax). Whereas arginine also caused a shift in the apparent Michaelis-Menten constant (Km) to larger values, glucose did not alter the Km. On the basis of the results reported, we propose that the rate of Pi exchange is determined positively by the intracellular and extracellular concentrations of Pi and negatively by ATP or metabolites thereof. The mechanism of ATP action is unknown but could involve either covalent or noncovalent modification of the carrier protein. PMID- 3539922 TI - Cloning of the genes involved in synthesis of coenzyme pyrrolo-quinoline-quinone from Acinetobacter calcoaceticus. AB - Mutants of Acinetobacter calcoaceticus LMD79.41 were isolated that are defective in the synthesis of the coenzyme pyrrolo-quinoline-quinone (PQQ). A gene bank of the wild-type. A. calcoaceticus genome was constructed with the binary plasmid system pLV21-RP4 delta Km. The DNA of A. calcoaceticus LMD79.41 was partially digested with Sau3A, and fragments of about 15 kilobases were inserted into the BamHI site of pLV21. The hybrid plasmids maintained in Escherichia coli were transferred by conjugation to the PQQ- mutants of A. calcoaceticus. One hybrid plasmid was isolated that complements all isolated PQQ- mutants. Subcloning of this plasmid in the vector pRK290 resulted in an insert of 5 kilobases on which at least four different genes involved in PQQ synthesis could be indicated. With Tn5 insertions the four PQQ genes were mapped, and it was shown that these genes are most probably located in three operons. PMID- 3539923 TI - Nucleotide sequence of the gene encoding the nitrogenase iron protein of Thiobacillus ferrooxidans. AB - The DNA sequence was determined for the cloned Thiobacillus ferrooxidans nifH and part of the nifD genes. A putative T. ferrooxidans nifH promoter was identified whose sequences showed perfect consensus with those of the Klebsiella pneumoniae nif promoter. Two putative consensus upstream activator sequences were also identified. The amino acid sequence was deduced from the DNA sequence. In a comparison of nifH DNA sequences from T. ferrooxidans and eight other nitrogen fixing microbes, a Rhizobium sp. isolated from Parasponia andersonii showed the greatest homology (74%) and Clostridium pasteurianum (nifH 1) showed the least homology (54%). In a comparison of the amino acid sequences of the Fe proteins, the Rhizobium sp. and Rhizobium japonicum showed the greatest homology (both 86%) and C. pasteurianum (nifH 1 gene product) demonstrated the least homology (56%) to the T. ferrooxidans Fe protein. PMID- 3539924 TI - Intracellular 5',5'-dinucleoside polyphosphate levels remain constant during the Escherichia coli cell cycle. AB - All AppppN and ApppN nucleotides (N = A, C, G, or U) occur in Escherichia coli. Measured cellular concentrations were 2.42 microM AppppA, 0.61 microM AppppC, 0.95 microM AppppG, 1.17 microM AppppU, 0.47 microM ApppA, 0.14 microM ApppC, 0.20 microM ApppG, and 0.12 microM ApppU. These concentrations remained constant during the cell cycle in synchronized exponentially growing cells. PMID- 3539925 TI - uvrC gene function has no specific role in repair of N-2-aminofluorene adducts. AB - In Escherichia coli, plasmid DNA modified with N-2-aminofluorene adducts survived equally well in wild-type, uvrA, or uvrB strains. Increased sensitivity was found in uvrC and uvrD strains. Moreover, N-2-aminofluorene-mediated toxicity in the uvrC background was reversed when an additional uvrA mutation was introduced into the strain. PMID- 3539926 TI - Isolation and characterization of a substitution mutation in the ompR gene of Salmonella typhimurium LT2. AB - The expression of the genes ompC and ompF encoding major outer membrane proteins is dependent on the ompR-envZ operon. Here we describe the isolation and characterization of an ompR mutation, a single-base-pair change, that results in an Arg-to-Cys substitution. When present in multiple copies, the mutant allele conferred a dominant OmpC- OmpF+ phenotype. Furthermore, the mutant allele exhibited allele-specific negative complementation with other ompR mutations. This ability, together with its dominant character, suggested that the OmpR protein is capable of multimerization. PMID- 3539928 TI - Effect of growth rate and cell shape on the peptidoglycan composition in Escherichia coli. AB - The muropeptide composition of peptidoglycan from Escherichia coli W7 cultivated at different growth rates in chemostat cultures was compared by using high pressure liquid chromatography. At a low growth rate (D = 0.1 h-1), about 40% more covalently bound lipoprotein and at least twofold more diaminopimelyl diaminopimelic acid cross-bridges were found than at a high growth rate (D = 0.8 h-1). The total degree of cross-linkage was only slightly increased, and the fraction of trimeric muropeptides and the average length of the glycan chains were not changed significantly. Analysis of the peptidoglycan from a morphological variant strain of W7 revealed that the altered peptidoglycan composition in slowly growing W7 cells was not correlated with the observation that these cells, due to their decreased cell length, were relatively enriched in polar material. In fact, our results suggested that peptidoglycan forming cell poles is chemically identical to that forming lateral wall. PMID- 3539927 TI - Flagellar variation in Serratia marcescens is associated with color variation. AB - The pigmented enterobacterium Serratia marcescens, an opportunistic pathogen, shows a striking variation of its red color. Different strains differ greatly both in color and in the frequency with which they produce color variants. Within a strain, the variations occur at constant rates and are reversible. During an investigation of this phenomenon we observed that variation of a 39-kilodalton protein in S. marcescens 274 is closely associated with color variation. Using antibodies to this protein we identified it as being a component of the bacterial flagella. Variation of surface proteins often provides an organism with alternate offense-defense strategies for survival in a challenging environment. The pigment, in association with flagella, may provide such a function for S. marcescens. PMID- 3539929 TI - Glucose and insulin co-regulate the glucose transport system in primary cultured adipocytes. A new mechanism of insulin resistance. AB - We have previously shown in primary cultured rat adipocytes that insulin acts at receptor and multiple postreceptor sites to decrease insulin's subsequent ability to stimulate glucose transport. To examine whether D-glucose can regulate glucose transport activity and whether it has a role in insulin-induced insulin resistance, we cultured cells for 24 h in the absence and presence of various glucose and insulin concentrations. After washing cells and allowing the glucose transport system to deactivate, we measured basal and maximally insulin stimulated 2-deoxyglucose uptake rates (37 degrees C) and cell surface insulin binding (16 degrees C). Alone, incubation with D-glucose had no effect on basal or maximal glucose transport activity, and incubation with insulin, in the absence of glucose, decreased maximal (but not basal) glucose transport rates only 18% at the highest preincubation concentration (50 ng/ml). However, in combination, D-glucose (1-20 mM) markedly enhanced the long-term ability of insulin (1-50 ng/ml) to decrease glucose transport rates in a dose-responsive manner. For example, at 50 ng/ml preincubation insulin concentration, the maximal glucose transport rate fell from 18 to 63%, and the basal uptake rate fell by 89%, as the preincubation D-glucose level was increased from 0 to 20 mM. Moreover, D-glucose more effectively promoted decreases in basal glucose uptake (Ki = 2.2 +/- 0.4 mM) compared with maximal transport rates (Ki = 4.1 +/- 0.4 mM) at all preincubation insulin concentrations (1-50 ng/ml). Similar results were obtained when initial rates of 3-O-methylglucose uptake were used to measure glucose transport. D-glucose, in contrast, did not influence insulin-induced receptor loss. In other studies, D-mannose and D-glucosamine could substitute for D-glucose to promote the insulin-induced changes in glucose transport, but other substrates such as L-glucose, L-arabinase, D-fructose, pyruvate, and maltose were without effect. Also, non-metabolized substrates which competitively inhibit D glucose uptake (3-O-methylglucose, cytochalasin B) blocked the D-glucose plus insulin effect.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539930 TI - Crystallization of ricin A chain obtained from a cloned gene expressed in Escherichia coli. AB - Ricin is a heterodimeric toxin of the form AB, where B is a lectin which binds cell surfaces, triggering endocytosis. The B chain then aids the A chain in escaping from the endosome. The A chain enzymatically attacks and inactivates ribosomes, thereby killing the intoxicated cell. We have recently solved the three-dimensional structure of whole ricin. Here we report that the A chain, expressed from a gene cloned into Escherichia coli has been crystallized in a suitable form for high resolution x-ray analysis. The crystals are monoclinic space group P2(1) with a = 42.6, b = 68.1, c = 50.2 A and beta = 112.9 degrees. There is evidence that the A chain undergoes a conformational change, resulting in activation, when it is released from the B chain. Comparison of the two structures should facilitate an analysis of this process. PMID- 3539931 TI - Purification of an insulin-related factor secreted by a teratoma-derived mesodermal cell line. AB - Insulin-related factor (IRF), a polypeptide secreted by the mouse teratoma derived cell line (1246-3A), was purified 3210-fold to homogeneity from 1246-3A conditioned medium using a rapid three-step procedure including cation-exchange chromatography, immunoaffinity chromatography using a monoclonal antibody against porcine insulin coupled to an agarose gel support, and reverse phase high performance liquid chromatography. 10 micrograms of IRF was purified from 6 liters of 1246-3A conditioned medium. Pure IRF appeared as a single band with the same mobility as insulin by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. IRF stimulates cell proliferation of insulin-dependent cell line 1246 and competes with 125I-insulin for binding to 1246 cells; half-maximal growth stimulation and binding competition were achieved at an IRF concentration of 6.5 ng/ml (1.3 nM) and 25 ng/ml (4 nM), respectively, comparable with those for bovine insulin. The biochemical, biological, and immunological characteristics of IRF, as well as its amino acid composition, strongly suggest that it is closely related to pancreatic insulin in structure and function. PMID- 3539932 TI - Dissociation of insulin-stimulated glucose transport from the translocation of glucose carriers in rat adipose cells. AB - Cycloheximide, a potent inhibitor of protein synthesis, has been used to examine the relationship between recruitment of hexose carriers and the activation of glucose transport by insulin in rat adipocytes. Adipocytes were preincubated +/- cycloheximide for 90 min then +/- insulin for a further 30 min. We measured 3-O methylglucose uptake in intact cells and in isolated plasma membrane vesicles. The concentration of glucose transporters in plasma membranes and low density microsomes was measured using a cytochalasin B binding assay. Cycloheximide had no affect on basal or insulin-stimulated 3-O-methylglucose uptake in intact cells or in plasma membrane vesicles. However, the number of glucose carriers in plasma membranes prepared from cells incubated with cycloheximide and insulin was markedly reduced compared to that from cells incubated with insulin alone (14 and 34 pmol/mg protein, respectively). Incubation of cells with cycloheximide alone did not change the concentration of glucose carriers in either plasma membranes or in low density microsomes compared to control cells. When isolated membranes were analyzed with an antiserum prepared against human erythrocyte glucose transporter, decreased cross-reactivity was observed in plasma membranes prepared from cycloheximide/insulin-treated cells compared to those from insulin cells. The present findings indicate that incubation of adipocytes with cycloheximide greatly reduces the number of hexose carriers in the plasma membrane of insulin stimulated cells. Despite this reduction, insulin is still able to maximally stimulate glucose uptake. Thus, these data suggest an apparent dissociation between insulin stimulation of glucose transport activity and the recruitment of glucose carriers by the hormone. PMID- 3539933 TI - The labile nature of the insulin signal(s) for the stimulation of DNA synthesis in mouse lens epithelial and 3T3 cells. AB - A kinetic study was carried out to assess the stability of the intracellular signal(s) generated by insulin in quiescent cells for the stimulation of DNA synthesis. Using murine lens epithelial cells and Swiss 3T3 cells in culture, it was found that insulin stimulated DNA synthesis after a lag of 14.5 h. If, however, 6 h after the addition of insulin to the cells, the insulin-containing media were totally removed, followed by the addition of fresh media (even if insulin was returned to the medium within approximately 10 min), a 14.5-h lag still remained after insulin readdition before DNA synthesis started. In another set of experiments, the insulin was removed after 6 h by diluting its concentration approximately 60,000-fold. In this case, if insulin was at the diluted concentration for approximately 60 min before being added back, a full 14.5 h was necessary for the start of DNA synthesis. The half-time for loss of signal was 2 +/- 1 min for total washout and 18.4 +/- 0.5 min for the dilution experiment. These results indicate that the intracellular signal(s) for DNA synthesis produced by the binding of insulin to its cellular receptor are extremely transitory in nature. The signal disappears at approximately the same rate that insulin dissociates from the receptor. Thus, insulin must be constantly binding to the membrane receptor in order to keep the key signal(s) at a high enough level for the cell to progress on to S phase. Early events, such as specific protein synthesis, changes in ion flux, changes in cellular metabolism, and changes in cellular pH, may be essential, but they are not sufficient to cause a cell to progress on to S phase. Addition of sodium vanadate to the cell is found to stabilize the messenger such that there is no loss of signal when insulin is removed. These data are consistent with the tyrosine-phosphorylated insulin receptor or a product of its action being the signal. PMID- 3539934 TI - Active site of the enzyme which demethylates receptors during bacterial chemotaxis. AB - The CheB methylesterase catalyzes the hydrolysis of glutamyl methyl esters in bacterial chemoreceptor proteins. Studies with residue-specific inhibitors suggest that a cysteine residue is required. The nucleotide sequence of the cheB gene predicts a 349-amino acid protein with cysteine residues at positions 207 and 309. Oligonucleotide-directed mutagenesis was used to change each cysteine to an alanine. Whereas the Cys207-Ala mutation had essentially no effect on esterase activity, the Cys309-Ala mutation caused a complete inactivation of the enzyme. Cys309 is located adjacent to a sequence of amino acids which is characteristic of the beta-alpha-beta motif found in a number of nucleotide binding proteins associated with receptor function in vertebrate tissues. A central feature of this structure is Gly-X-Gly-X-X-Gly. Mutation of the second glycine in this region (Gly284) to a valine also caused a complete loss of esterase activity. PMID- 3539935 TI - Catalytic-regulatory subunit interactions and allosteric effects in aspartate transcarbamylase. AB - The x-ray structure of the unliganded aspartate transcarbamylase reveals that Arg 113 of the catalytic chain is involved in an important set of interactions at the interface between the catalytic and regulatory subunits (Honzatko, R.B., Crawford, J.L., Monaco, H.L., Ladner, J.E., Edwards, B.F.P., Evans, D.R., Warren, S.G., Wiley, D.C., Ladner, R.C., and Lipscomb, W. N. (1982) J. Mol. Biol. 160, 219-263). In order to disturb this interaction, site-directed mutagenesis has been used to replace Arg-113 with glycine. This modification results in a substantial weakening of the interface between the catalytic and regulatory subunits leading to a high tendency for dissociation. The unliganded mutant enzyme exhibits a pH dependence and a sensitivity toward mercurials analogous to that obtained for the relaxed conformation of the wild-type enzyme. Moreover, the presence of saturating concentrations of aspartate is accompanied by only a slight shift in the optimal pH for activity. The bisubstrate analog N (phosphonacetyl)-L-aspartate induces a 2-fold increase in the sulfhydryl reactivity as compared to the 4-fold increase observed for the wild-type enzyme. Despite this change in the interactions at the interface between the catalytic and regulatory subunits, the mutant enzyme still retains homotropic and heterotropic effects and exhibits a normal affinity for aspartate. Together these data show that a substantial weakening of the catalytic-regulatory interface can occur without altering the allosteric properties of the enzyme. These results also indicate that the intersubunit interactions involving Arg-113, between the polar domain of the catalytic chain and the zinc domain of the regulatory chain, do not participate in the homotropic cooperativity of the enzyme. PMID- 3539936 TI - The interaction of yeast citrate synthase with yeast mitochondrial inner membranes. AB - The specific interaction of yeast citrate synthase with yeast mitochondrial inner membranes was characterized with respect to saturability of binding, pH optimum, effect of ionic strength, temperature response, and inhibition by oxalacetate. The binding ability of the inner membranes is inhibited by proteolysis and heat treatment, which implies that the membrane component(s) responsible for binding is a protein. A protein fraction from inner membranes when added to liposomes will bind citrate synthase. In addition, the binding of yeast fumarase, mitochondrial malate dehydrogenase, and cytosolic malate dehydrogenase to yeast inner membranes was examined. For these studies the yeast mitochondrial matrix enzymes, citrate synthase (from two types of yeast), malate dehydrogenase, and fumarase, as well as cytosolic malate dehydrogenase, were purified using rapid new techniques. PMID- 3539937 TI - Determination of the nucleotide sequence for the exonuclease I structural gene (sbcB) of Escherichia coli K12. AB - The complete nucleotide sequence of the structural gene for Escherichia coli exonuclease I has been determined. The coding region corresponds to a 465-amino acid protein with molecular weight of 53,174. The partial amino acid sequence of purified exonuclease I agrees with that predicted by the DNA sequence. Two putative weak promoters have been localized by S1 nuclease analysis. The sbcB coding sequence contains many non-optimal codons, characteristic of many poorly expressed E. coli genes. PMID- 3539938 TI - Changes in the concentration of the calcium-binding parvalbumin in cross reinnervated rat muscles. Comparison of biochemical with physiological and histochemical parameters. AB - The fast extensor digitorum longus (EDL) and the slow soleus (SOL) muscles were cross-reinnervated in both directions in the rat. During the following transformation of muscle type properties, the expression of the Ca2+-binding parvalbumin (parvalbumin, Mr = 12,000) was investigated. The combined biochemical, histochemical, and physiological results demonstrated that the amount of parvalbumin decreased in the fast to slow (X-EDL) and increased in the slow to fast (X-SOL) transformation. Alterations of parvalbumin-mRNA levels were similar to changes found at the protein level, indicating a tight transcriptional regulation of the parvalbumin expression. The close correlation, however, between parvalbumin and relaxation speed found in normal muscles had changed after cross reinnervation. After the altered nervous input, a slow contracting/slow relaxing muscle may even contain more parvalbumin than a fast contracting/fast relaxing one. The expression of parvalbumin may depend on the nerve-muscle interaction, and parvalbumin may thus be used as a sensitive marker for early stages of muscular transformation and neurological disorders. PMID- 3539940 TI - Action mechanism of Escherichia coli DNA photolyase. II. Role of the chromophores in catalysis. AB - DNA photolyase repairs pyrimidine dimers in DNA in a reaction that requires visible light. Photolyase from Escherichia coli is normally isolated as a blue protein and contains 2 chromophores: a blue FAD radical plus a second chromophore that exhibits an absorption maximum at 360 nm when free in solution. Oxidation of the FAD radical is accompanied by a reversible loss of activity which is proportional to the fraction of the enzyme flavin converted to FADox. Quantitative reduction of the radical to fully reduced FAD causes a 3-fold increase in activity. The results show that a reduced flavin is required for activity and suggest that flavin may act as an electron donor in catalysis. Comparison of the absorption spectrum calculated for the protein-bound second chromophore (lambda max = 390 nm) with fluorescence data and with the relative action spectrum for dimer repair indicates that the second chromophore is the fluorophore in photolyase and that it does act as a sensitizer in catalysis. On the other hand, enzyme preparations containing diminished amounts of the second chromophore do not exhibit correspondingly lower activity. This suggests that reduced flavin may also act as a sensitizer in catalysis. The blue color of the enzyme is lost upon reduction of the FAD radical. The fully reduced E. coli enzyme exhibits absorption and fluorescence properties very similar to yeast photolyase. This indicates that the two enzymes probably contain similar chromophores but are isolated in different forms with respect to the redox state of the flavin. PMID- 3539939 TI - Action mechanism of Escherichia coli DNA photolyase. I. Formation of the enzyme substrate complex. AB - Escherichia coli DNA photolyase (photoreactivating enzyme) is a flavoprotein. The enzyme binds to DNA containing pyrimidine dimers in a light-independent step and, upon illumination with 300-600 nm radiation, catalyzes the photosensitized cleavage of the cyclobutane ring thus restoring the integrity of the DNA. We have studied the binding reaction using the techniques of nitrocellulose filter binding and flash photolysis. The enzyme binds to dimer-containing DNA with an association rate constant k1 estimated by two different methods to be 1.4 X 10(6) to 4.2 X 10(6) M-1 S-1. The dissociation of the enzyme from dimer-containing DNA displays biphasic kinetics; for the rapidly dissociating class of complexes k2 = 2-3 X 10(-2) S-1, while for the more slowly dissociating class k2 = 1.3 X 10(-3) to 6 X 10(-4) S-1. The equilibrium association constant KA, as determined by the nitrocellulose filter binding assay and the flash photolysis assay, was 4.7 X 10(7) to 6 X 10(7) M-1, in reasonable agreement with the values predicted from k1 and k2. From the dependence of the association constant on ionic strength we conclude that the enzyme contacts no more than two phosphodiester bonds upon binding; this strongly suggests that the pyrimidine dimer is the main structural determinant of specific photolyase-DNA interaction and that nonspecific ionic interactions do not contribute significantly to substrate binding. PMID- 3539941 TI - Action mechanism of Escherichia coli DNA photolyase. III. Photolysis of the enzyme-substrate complex and the absolute action spectrum. AB - The absolute action spectrum of Escherichia coli DNA photolyase was determined in vitro. In vivo the photoreactivation cross-section (epsilon phi) is 2.4 X 10(4) M 1 cm-1 suggesting that the quantum yield (phi) is about 1.0 if one assumes that the enzyme has the same spectral properties (e.g. epsilon 384 = 1.8 X 10(4) M-1 cm-1) in vivo as those of the enzyme purified to homogeneity. The relative action spectrum of the pure enzyme (blue enzyme that contains FAD neutral semiquinone radical) agrees with the relative action spectrum for photoreactivation of E. coli, having lambda max = 384 nm. However, the absolute action spectrum of the blue enzyme yields a photoreactivation cross-section (epsilon phi = 1.2 X 10(3) at 384 nm) that is 20-fold lower than the in vivo values indicative of an apparent lower quantum yield (phi approximately equal to 0.07) in vitro. Reducing the enzyme with dithionite results in reduction of the flavin semiquinone and a concomitant 12-15-fold increase in the quantum yield. These results suggest that the flavin cofactor of the enzyme is fully reduced in vivo and that, upon absorption of a single photon in the 300-500 nm range, the photolyase chromophore (which consists of reduced FAD plus the second chromophore) donates an electron to the pyrimidine dimer causing its reversal to two pyrimidines. The reduced chromophore is regenerated at the end of the photochemical step thus enabling the enzyme to act catalytically.+ PMID- 3539942 TI - Alteration of the cytoplasmic domain of the membrane-spanning glycoprotein p62 of Semliki Forest virus does not affect its polar distribution in established lines of Madin-Darby canine kidney cells. AB - Expression of the Semliki Forest virus p62/E2 protein was studied in the polarized epithelial cell line Madin-Darby canine kidney (MDCK). After infection this transmembrane protein, together with the other spike subunit E1, accumulates at the basolateral surface of MDCK cells (Fuller, S. D., C.-H. von Bonsdorff, and K. Simons, 1985, EMBO (Eur. Mol. Biol. Organ.) J., 4:2475-2485). The cDNAs encoding truncated forms of the protein were used to stably transform MDCK cells to examine the role of subunit oligomerization (E1-E2) and the cytoplasmic domain of p62/E2 in directed transport to the basolateral surface. The biochemical characteristics and polarity of the expressed proteins were studied using cell monolayers grown on nitrocellulose filters. A wild-type form of p62/E2, in the absence of E1, and two forms having either 15 or 3 of the wild-type 31-amino acid carboxyl cytoplasmic domain were all localized to the basolateral surface. These results indicate that the cytoplasmic domain of E2 does not contain the information essential for directed transport to the plasma membrane, and imply that this information resides in either the lumenal and/or membrane-spanning segments of this transmembrane protein. PMID- 3539943 TI - A novel cadherin cell adhesion molecule: its expression patterns associated with implantation and organogenesis of mouse embryos. AB - The Ca2+-dependent cell adhesion molecules, termed cadherins, were previously divided into two subclasses, E- and N-types, with different adhesive specificity. In this study, we identified a novel class of cadherin, termed P-cadherin, using a visceral endoderm cell line PSA5-E. This cadherin was a 118,000-D glycoprotein and distinct from E- and N-cadherins in immunological specificity and molecular mass. In accord with these findings, cells with P-cadherin did not cross-adhere with cells with E-cadherin. P-Cadherin first appeared in developing mouse embryos in the extraembryonic ectoderm and the visceral endoderm at the egg cylinder stage and later was expressed in various tissues. The placenta and the uterine decidua most abundantly expressed this cadherin. The expression of P-cadherin was transient in many tissues, and its permanent expression was limited to certain tissues such as the epidermis, the mesothelium, and the corneal endothelium. When the tissue distribution of P-cadherin was compared with that of E-cadherin, we found that: each cadherin displayed a unique spatio-temporal pattern of expression; P-cadherin was co-expressed with E-cadherin in local regions of various tissues; and onset or termination of expression of P-cadherin was closely associated with connection or segregation of cell layers, as found with other cadherins. These results suggested that differential expression of multiple classes of cadherins play a role in implantation and morphogenesis of embryos by providing cells with heterogenous adhesive specificity. PMID- 3539944 TI - Immunocytochemical studies of endothelial cells in vivo. I. The presence of desmin only, or of desmin plus vimentin, or vimentin only, in the endothelial cells of different capillaries of the adult chicken. AB - It is currently believed that the intermediate filaments of endothelial cells contain vimentin subunits exclusively. This inference, however, is derived from studies of only a few types of endothelial cells. By double indirect immunofluorescence and immunoelectron microscopy, we have now examined the endothelial cells of the micro- and macrovasculature of a variety of tissues and organs of adult chicken in vivo for their content of desmin and vimentin. Endothelial cells of the peritubular capillary in the renal cortex, the hepatic sinusoid, and the splenic sinusoid were found to contain only desmin; those of the exocrine pancreas capillary contained both desmin and vimentin; and the endothelial cells of the macrovasculatures and of all the other microvasculatures examined, including the vasa recta of the renal medulla, contained only vimentin. Such heterogeneity suggests that different types of adult chicken endothelial cells may have different embryological origins. To the extent that desmin and vimentin intermediate filaments may be functionally distinct, these results also suggest that different capillary endothelial cells may have different functional properties. PMID- 3539945 TI - A monoclonal antibody against alpha-smooth muscle actin: a new probe for smooth muscle differentiation. AB - A monoclonal antibody (anti-alpha sm-1) recognizing exclusively alpha-smooth muscle actin was selected and characterized after immunization of BALB/c mice with the NH2-terminal synthetic decapeptide of alpha-smooth muscle actin coupled to keyhole limpet hemocyanin. Anti-alpha sm-1 helped in distinguishing smooth muscle cells from fibroblasts in mixed cultures such as rat dermal fibroblasts and chicken embryo fibroblasts. In the aortic media, it recognized a hitherto unknown population of cells negative for alpha-smooth muscle actin and for desmin. In 5-d-old rats, this population is about half of the medial cells and becomes only 8 +/- 5% in 6-wk-old animals. In cultures of rat aortic media SMCs, there is a progressive increase of this cell population together with a progressive decrease in the number of alpha-smooth muscle actin-containing stress fibers per cell. Double immunofluorescent studies carried out with anti-alpha sm 1 and anti-desmin antibodies in several organs revealed a heterogeneity of stromal cells. Desmin-negative, alpha-smooth muscle actin-positive cells were found in the rat intestinal muscularis mucosae and in the dermis around hair follicles. Moreover, desmin-positive, alpha-smooth muscle actin-negative cells were identified in the intestinal submucosa, rat testis interstitium, and uterine stroma. alpha-Smooth muscle actin was also found in myoepithelial cells of mammary and salivary glands, which are known to express cytokeratins. Finally, alpha-smooth muscle actin is present in stromal cells of mammary carcinomas, previously considered fibroblastic in nature. Thus, anti-alpha sm-1 antibody appears to be a powerful probe in the study of smooth muscle differentiation in normal and pathological conditions. PMID- 3539946 TI - A monoclonal antibody against the nucleus reveals the presence of a common protein in the nuclear envelope, the perichromosomal region, and cytoplasmic vesicles. AB - A monoclonal antibody that recognizes antigenic determinants on the nucleus of cultured mammalian cells was isolated. Immunofluorescence studies using this antibody showed that the recognized antigen was present not only on the nucleus but also in cytoplasmic vesicles of interphase cells and in the perichromosomal region of mitotic cells. Premature chromosome condensation analysis showed that the reactive site for this monoclonal antibody could be detected in the perichromosomal region during the G2 and M phases, but not during the G1 and S phases. Finally, immunoblot analysis showed that this monoclonal antibody prepared against the nucleus recognized a protein of approximately 40 kD both in the cytoplasm and in the perichromosomal regions. PMID- 3539947 TI - Acetylated alpha-tubulin in Physarum: immunological characterization of the isotype and its usage in particular microtubular organelles. AB - We have used monoclonal antibodies specific for acetylated and unacetylated alpha tubulin to characterize the acetylated alpha-tubulin isotype of Physarum polycephalum, its expression in the life cycle, and its localization in particular microtubular organelles. We have used the monoclonal antibody 6-11B-1 (Piperno, G., and M. T. Fuller, 1985, J. Cell Biol., 101:2085-2094) as the probe for acetylated alpha-tubulin and have provided a biochemical characterization of the monoclonal antibody KMP-1 as a probe for unacetylated tubulin in Physarum. Concomitant use of these two probes has allowed us to characterize the acetylated alpha-tubulin of Physarum as the alpha 3 isotype. We have detected this acetylated alpha 3 tubulin isotype in both the flagellate and in the myxameba, but not in the plasmodium. In the flagellate, acetylated tubulin is present in both the flagellar axonemes and in an extensive array of cytoplasmic microtubules. The extensive arrangement of acetylated cytoplasmic microtubules and the flagellar axonemes are elaborated during the myxameba-flagellate transformation. In the myxameba, acetylated tubulin is not present in the cytoplasmic microtubules nor in the mitotic spindle microtubules, but is associated with the two centrioles of this cell. These findings, taken together with the apparent absence of acetylated alpha-tubulin in the ephemeral microtubules of the plasmodium suggest a natural correspondence between the presence of acetylated alpha-tubulin and microtubule organelles that are intrinsically stable or cross-linked. PMID- 3539948 TI - The nerve gap. Theory and clinical practice. AB - In peripheral nerve surgery, the term "gap" means the distance between the two stumps of a transected peripheral nerve without further specification. The factors that contribute to the formation of a gap are analyzed in this paper. It becomes clear that the gap formed by a true nerve defect has a different meaning than a gap formed by elastic retraction. The final length of a particular nerve gap in an extremity is decisively influenced by the joint position. Therefore, the question arises regarding how a nerve adapts to the length difference during limb motion, which can be estimated for the median nerve during flexion and extension of the elbow joint with approximately 10 cm in an adult patient. Three mechanisms play an important role: true elongation of the length of the nerve in the relaxed state against elastic forces; movement of the nerve trunk in the longitudinal direction; and increase and decrease of the tissue relaxation at the level of the nerve trunk (relaxed course) and the nerve fibers (change in the undulated course). The efficiency of this mechanism partially depends on the ability of the nerve to move against the surrounding tissue. This ability is provided by the loose connective tissue around the nerve (adventitia, conjunctiva nervorum, perineurium). Only if this movement is possible, traction forces to elongate the nerve are distributed over the whole length of the nerve and are kept minimal for each particular segment. Adhesions of the nerve trunk at the site of repair prevent an equal distribution of forces and cause an unfavorable rise of traction forces at certain segments, according to the anatomic site. True elongation of the nerve, therefore, has only a limited application in overcoming a gap. Alternatives are rerouting, limb-shortening, and nerve-grafting. Today, the most reliable technique is the use of autologous cutaneous nerve segments as free nerve grafts. Advantages and disadvantages of "vascularized" nerve grafts are discussed. The use of neuromatous neurotization to overcome a gap is still in an experimental state. PMID- 3539949 TI - Biosynthesis of nuclear proteins after stimulation of quiescent Swiss mouse 3T3 cells. AB - Stimulation of quiescent Swiss mouse 3T3 fibroblasts either by serum or by the low molecular weight hormones, prostaglandin F2 alpha and insulin, induces DNA synthesis after a lag period of about 15 h. Following restimulation by serum or these pure hormones there is an overall increase of two- to fourfold in the rate of biosynthesis of nuclear proteins. In addition, there is a relative decrease in some proteins (Mr = 200 X 10(3), pI 6.0-6.5), while others increase (e.g. actin). Two polypeptides show specific correlations with the exit from G0. The synthesis of p30 (Mr = 30 X 10(3), pI 5.2) is at a maximum within 5 h of restimulation, while the synthesis of p36 (Mr = 36 X 10(3), pI = 4.25) is first seen at 10-20 h after restimulation. Synthesis of p36 correlates well with the initiation of DNA synthesis. The synthesis of both proteins is stimulated by serum and by the hormones. Thus there are common biosynthetic responses to different stimuli indicating convergent pathways leading to DNA biosynthesis. Addition of hydrocortisone with the growth-stimulatory hormones inhibits both entry into the S phase and biosynthesis of p36. In contrast, hydrocortisone does not alter the biosynthesis of p30. This 'early' protein, p30, is different from the products of both c-fos and c-myc. Therefore, we have identified two specific components that might participate in the regulation of cell proliferation. PMID- 3539950 TI - Either exogenous or endogenous fibronectin can promote adherence of human endothelial cells. AB - Recently, we have presented evidence that proliferating blood vessels produce and deposit fibronectin in situ during the angiogenesis of wound repair. This report extends these observations by demonstrating that human endothelial cells from both large and small vessels depend on fibronectin for their adherence in vitro. Endothelial cells were grown from human umbilical veins (HUVEC) by the method of Gimbrone and from the microvasculature of human omentum by the method of Kern, Knedler and Eckel. Second-passage cells were plated into microtitre wells that had been coated with 100 micrograms ml-1 of fibronectin, types I and III collagen, type IV collagen or laminin. After a 3-h incubation, adherent cells were solubilized with Zap-Isoton and quantified on a Coulter Counter. Under normal culture conditions HUVEC showed no preference for fibronectin substrates while microvascular cells always demonstrated a striking preference for fibronectin substrates. However, when HUVEC were exposed to 2.5 or 25 micrograms ml-1 of cycloheximide for 4 h before and during the adherence assays, the adherence to fibronectin was 50-200% greater than to types I and III collagen. Immunofluorescence studies showed that while HUVEC expressed a large quantity of surface fibronectin, microvascular cells expressed very little. Metabolic labelling studies confirmed that HUVEC cultures had substantial quantities of fibronectin in their cell layer while microvascular cells did not. In antibody blocking experiments, preincubation of fibronectin-coated surfaces with anti fibronectin antibodies totally blocked microvascular cell adhesion but only abrogated HUVEC adherence by 50%, presumably since these latter cells were able to deposit additional fibronectin onto the surface during the 3 h assay period. In the presence of cycloheximide anti-fibronectin antibodies totally blocked HUVEC adherence. These results demonstrate that both endothelial cell types rely, at least in part, on fibronectin for adherence in vitro. HUVEC can synthesize, secrete and deposit enough fibronectin for their adherence in vitro, while microvascular cells rely on an exogenous source of fibronectin under these culture conditions. Thus, the increased blood vessel fibronectin observed during angiogenesis in vivo may mediate adherence of the proliferating and migrating endothelial cells. PMID- 3539952 TI - Gland cells in Hydra: cell cycle kinetics and development. AB - The proliferative capacity of gland cells in Hydra attenuata was investigated. The results indicate that both gland cell proliferation and interstitial cell differentiation to gland cells contribute to the maintenance of the whole population. On the basis of [3H]thymidine incorporation and nuclear DNA measurements, gland cells consist of at least three different populations. One population consists of rapidly proliferating cells with a cell cycle of about 72 h. These cells are distributed throughout the body column. In the lower gastric region there is a population of non-cycling cells in G2 while in the upper gastric region there is a population of non-cycling cells in G1. About half the G1 population becomes a new antigen, SEC 1, which is typical of mucus cells. PMID- 3539951 TI - Widespread occurrence of anti-troponin T crossreactive components in non-muscle cells. AB - Using a monoclonal antibody generated against striated muscle troponin T, we previously noted the presence of crossreactive components in smooth muscle and non-muscle cells. Since the presence of troponin T in tissues other than striated muscle is controversial, we sought to establish the nature of the crossreaction and to determine the extent of its occurrence. For this study, indirect immunofluorescence microscopy and immunoblot analyses were performed. Crossreactive material was found in diverse cells from the animal, plant and fungal kingdoms. On the basis of morphological distributions, both microtubule associated and non-microtubule-associated components were revealed. Microtubule associated components of animal cell lines included a 35 X 10(3) Mr protein, similar in electrophoretic mobility to skeletal troponin T (37 X 10(3) Mr). Reactive components of comparable mobility were observed in immunoblots of brain and cerebellar homogenates. Filamentous staining was observed in a variety of mammalian cells in culture and in cells of vertebrate tissues. Chick cerebellar tissue showed reactions in the neurites of the molecular layer and granule cell bodies. In the plant kingdom, examination of the onion root-tip cells indicated an association of crossreactive components with interphase cortical microtubules, preprophase bands, the mitotic spindle and phragmoplast microtubules. In the fungal kingdom, both interphase and mitotic spindle microtubules in a cellular slime mould were reactive. Non-microtubule-associated components were observed in the centrosphere regions of mitotic sea-urchin eggs, in mitotic and interphase plasmodia of Physarum polycephalum, and in trichocysts and basal bodies of Paramecium tetraurelia. In all systems examined, the troponin T crossreactive components were located in regions or on structures of possible Ca2+ or calmodulin activity, suggesting a possible functional similarity to troponin T. PMID- 3539953 TI - Stress management: grazing the clinical turf. PMID- 3539954 TI - Nursing and hospitals: sacred pasture or corral? PMID- 3539955 TI - Thirty years of child psychology: a selective review. AB - A selective review of the literature in child psychology over the last 30 years reveals substantial changes in methodology, in analysis and the interpretation of findings. Evidence on the multifactorial nature of development is drawn from genetic/environmental research, longitudinal studies and a consideration of potential long-term effects of early experience, including planned intervention. It is increasingly recognized that individuals play some part in causing their own development, via ongoing transactional processes. Eight themes form the basis for discussion, including the belated emergence of Piaget's theory and the changing outlook for the mentally retarded. In addition, the explosion of research upon infancy and the growing influence of behavioural psychology are noted. PMID- 3539956 TI - Child psychiatry in Britain--the last 30 years. AB - The development of child and adolescent psychiatry over the last thirty years is described with emphasis on the ideas and concepts which have become a characteristic feature of clinical practice and research. Aspects of training, innovations in practice and the relationship with paediatrics are discussed and the growing participation in international bodies concerned with mental health is outlined. The specialty is now well established and is attracting physicians of high calibre to its ranks. Multidisciplinary collaboration is still a strong feature but has taken a different form in the light of new developments in clinical and developmental child psychology and psychiatric social work. PMID- 3539958 TI - The development of an M antibody capture ELISA for rubella IgM. AB - An M antibody capture enzyme-linked immunosorbent assay for rubella IgM was developed. The enzyme label was prepared from a monoclonal antibody raised against rubella haemagglutinin (Tedder et al., 1982). Paired sera from acute rubella infections and vaccines as well as sera from blood donors, antenatal patients and patients whose sera contained rheumatoid factor and patients with acute non-rubella infections were tested by this method. PMID- 3539957 TI - In vitro detection of canine distemper virus nucleic acid with a virus-specific cDNA probe by dot-blot and in situ hybridization. AB - A cDNA library was prepared from canine distemper viral (CDV) messenger RNA (mRNA) derived from Vero cells lytically infected with the Onderstepoort strain (Ond) of CDV. A 300 base pair insert was identified which, by Northern blot analysis and Sanger sequence data, was shown to be specific to the nucleocapsid gene. The nucleocapsid (NC) clone was radiolabelled with 32P using nick translation and used to detect viral RNA in both dot-blot and in situ preparations of Vero cells lytically infected with Onderstepoort CDV (Ond-CDV) and immortalized mink lung cells persistently infected with racoon origin CDV (CCL64-RCDV). Dot-blot hybridization results paralleled immunofluorescent results in the lytically infected cells. In 18 persistently infected cell lines from the RCDV-CCL64 parental stock, 13 lines were positive and two were negative on both immunofluorescence and dot-blot hybridization analysis for CDV antigen and RNA, respectively. Viral nucleic acid was detected in these persistently infected cells, where as few as 1.9% of the members of a line were positive on immunofluorescence. A dot-blot autoradiographic signal was obtained in three lines which were negative for CDV antigen. CDV RNA was detected in both lytically and persistently infected cell lines by in situ hybridization, where decreasing probe length was important in increasing the sensitivity of this assay. Viral RNA was detected in over 90% of the lytically infected cells, where only 70% were positive for viral antigen by immunofluorescence. PMID- 3539959 TI - A new method for extracting circular and supercoiled genome segments from cytoplasmic polyhedrosis virus. AB - The genome of a cytoplasmic polyhedrosis virus (CPV) consisting of 10 segments was extracted by a new two-step extraction method. The results from polyacrylamide gel electrophoresis, phenol and diepoxybutane treatment and electron microscopic examination indicated the extracted genome segments to have circular and supercoiled structures as genome-protein(s) complexes. Multiple cycles of the transcription of each segmented genome of CPV may take place on the circular structure of the segment. PMID- 3539960 TI - Demonstration of calicivirus in human faeces by immunosorbent and immunogold labelling electron microscopy methods. AB - Immunosorbent electron microscopy (ISEM) and immuno-gold staining (IGS) electron microscopy methods have been applied to human faeces, shown by direct electron microscopy (EM) to contain calicivirus. Caliciviruses were successfully trapped on grids coated with positive rabbit or human antisera against calicivirus, but not with negative sera. Caliciviruses were specifically labelled with gold particles, when treated with positive rabbit or human antisera against calicivirus followed by protein A-gold and goat anti-rabbit or anti-human IgG gold conjugates in an indirect method in suspension. Goat anti-human IgM gold complexes did not react with the available antisera. Attempts to label caliciviruses trapped on the grids were unsuccessful. No cross-reactions were observed with Norwalk agent-like particles, hepatitis A virus or poliovirus type 3 by any of the methods. The results indicate that ISEM and IGS may be useful techniques for detection and identification of small viruses present in low concentrations in faeces. PMID- 3539961 TI - Standardized methods of causality assessment for suspected adverse drug reactions. PMID- 3539962 TI - Diseases and disorders of aging: an hypothesis. AB - The definition of two classes of age-associated diseases and disorders (age dependent and age-related) is offered to provide an utilitarian hypothesis with preventive, therapeutic, and research implications. Age-dependent diseases and disorders are defined as those whose pathogenesis appears to involve the normal aging of the host. Mortality and morbidity from age-dependent diseases and disorders (e.g. coronary artery disease and Alzheimer's disease) increase exponentially. Age-related diseases and disorders, on the other hand, have a temporal relationship to the host but are not necessarily related to aging processes. They occur at a specific age and then decline in frequency or continue at less than an exponential rate of increase (e.g. multiple sclerosis and amyotrophic lateral sclerosis). A model is presented for this hypothesis which relates aging processes to age-dependent diseases and disorders. PMID- 3539963 TI - A game of numbers: re-appraisal of antihypertensive drug therapy. PMID- 3539964 TI - Sudden death and the decline in coronary heart disease mortality. PMID- 3539965 TI - Genetic and environmental factors in human carcinogenesis. PMID- 3539966 TI - Nutritional and endocrine factors in reproductive organ cancers: opportunities for primary prevention. PMID- 3539967 TI - Epidemiology of uterine cervical cancer. AB - The epidemiology of cervical cancer presents a number of unique challenges, mainly with respect to disentangling correlated factors and to elucidating biological mechanisms. The available evidence suggests a complex multifactorial etiology, although the relative contributions of risk factors and their interactions remain obscure. Infectious agents are strongly suspected, but as yet not conclusively identified. It is also unclear whether there are subgroups of women or periods of life that are most susceptible to the action of infectious agents, and the contribution of the "male factor" needs to be defined. Several epidemiologic leads can be pursued through biochemical and molecular techniques. Most promising is the recent evidence linking certain HPV types to cervical abnormalities, including cancer, and newly developed probes can be incorporated into epidemiologic studies to evaluate an array of risk factors. Endocrine and metabolic assays may be helpful in clarifying the role of exogenous and possibly endogenous hormones. The effects of cigarette smoking may be further evaluated by studying constituents of tobacco smoke and their metabolites in cervical mucus. Finally, the relationship of diet to cervical cancer should be assessed by examining the levels of micronutrients, trace minerals, and other nutritional indices in body tissues and fluids, as well as through interview data. An understanding of cervical cancer etiology will require a better identification of risk factors for precursor lesions as well as factors that enhance their progression to invasive cancer. Through studies that focus on disease stage and time-related events, it should be possible to clarify the multi-stage processes involved in cervical carcinogenesis, and those factors that may inhibit as well as promote transition rates. The protective effects of screening programs deserve further attention, and research into dietary factors may lead in time to nutritional intervention. Investigation by cell type should also be pursued to define the epidemiology of the rarely occurring adenocarcinomas and adenosquamous carcinomas of the cervix. Finally, preventive strategies should be targeted to high-risk populations, especially those of the lower socioeconomic classes and with limited access to medical care. The need for a renewed focus on epidemiology and prevention is emphasized by recent increases in exposure to several postulated risk factors, including sexual promiscuity, oral contraceptives, and smoking.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3539968 TI - Screening for cancer: issues and future directions. PMID- 3539969 TI - Epidemiology of Alzheimer's disease and other dementing illnesses. PMID- 3539970 TI - Emerging issues in infectious disease epidemiology. PMID- 3539971 TI - Etiology and prevention of acquired immunodeficiency syndrome: the path of interdisciplinary research. PMID- 3539973 TI - Abraham M Lilienfeld. Bibliography. PMID- 3539974 TI - Epidemiology and the public health movement. PMID- 3539975 TI - The interface of genetics and epidemiology. PMID- 3539972 TI - Evaluating and monitoring the safety and efficacy of drug therapy and surgery. PMID- 3539976 TI - Host and environmental interactions in diabetes mellitus. AB - A number of current issues in diabetes research are reviewed from an epidemiologic viewpoint. Though many advances have been made in our understanding of the causes of insulin-dependent diabetes mellitus (IDDM), there are many unresolved issues which could benefit from epidemiologic research. These include study of the 36-fold geographic variation in IDDM incidence seen across the world, perhaps by the development of registries, and the placing into a population perspective recent genetic and autoimmune findings concerning IDDM etiology. Epidemiologic considerations should also be incorporated into future trials of immunotherapy for IDDM. Despite considerable research, very little is known about risk factors and genetic environmental interactions in non-insulin dependent diabetes. Large scale prospective epidemiologic studies are, therefore, needed to delineate the potential roles of factors such as diet and physical activity, and how these interact with genetic predisposition. PMID- 3539977 TI - Antibodies against denatured and reduced thyroid microsomal antigen in autoimmune thyroid disease. AB - Different antigenic determinants on thyroid microsomal antigen (MAg) could induce different antibodies, which, in turn, could have differing importance in the pathogenesis of autoimmune thyroid disease. In this study we demonstrated three types of microsomal antibodies (MAbs) present in serum of patients with autoimmune thyroid disease by Western blot analysis. These MAbs reacted with native, denatured, and denatured and reduced MAg. Methods for detecting the MAbs were developed, and the clinical significance of these Abs was analyzed in 197 patients with thyroid disorders. For measurement of Ab against native and denatured MAg, an enzyme-linked immunosorbent assay, in which wells were coated with untreated or sodium dodecyl sulfate-denatured MAg, was used. For measurement of Ab against denatured and reduced MAg, 6% SDS-polyacrylamide gel electrophoresis followed by Western blot analysis was used. Native MAb enzyme linked immunosorbent assay values correlated highly with microsomal hemagglutination titers, but patients with high titers of Ab against native MAg did not necessarily have Ab against denatured MAg or reduced MAg. Abs against denatured MAg or denatured and reduced MAg were found in patients with Hashimoto's disease (28.8% and 13.6%) and Graves' disease (22.4% and 11.2%). The percentage of patients with positive denatured and reduced MAb was higher in Graves' disease patients who had a longer sick interval or who developed hypothyroidism after radioiodine treatment. This study provides the first clear demonstration that MAbs are heterogeneous. The data suggest that antibodies against denatured or denatured and reduced MAg may be related to destruction of the thyroid gland. PMID- 3539978 TI - Human anti-estrogen receptor antibodies: assay, characterization, and age- and sex-related differences. AB - A binding assay was developed to measure the estrogen receptor (ER)-binding activity in serum. The method employed immunoglobulin G (IgG) adsorption with protein A-bearing Staphylococcus aureus cells before incubation with tritium labeled ER. Specificity studies employing chromatographic and electrophoretic analyses suggested that an IgG antibody (Anti-ER) was responsible for the serum activity. Anti-ER was found in human, rat, and mouse serum and exhibited species cross-reactivity. The antibody recognized both the 8S and 5S forms of the ER. Anti-ER was measured in 262 individuals ranging in age from 1-85 yr. The antibody was detected in all serum samples examined, suggesting its natural occurrence. When the study group was divided into three arbitrary age groups (young, 1-13 yr; middle age, 13-51 yr; older, greater than 51 yr), significant differences in levels of antibody were found, with highest levels in the young, followed by the elderly, and lowest levels in the middle years. An examination of sex- as well as age-related differences in the population revealed a striking sex difference. Thus, the young male population had a lower level of antibody than the corresponding female population, and these levels in males declined throughout life to reach their lowest point in old age, whereas the high levels in young females declined in middle years and then increased significantly in the elderly. We postulate that the antibody is a subgroup of IgG of multifactorial etiology. The idiotypic network theory offers an explanation for the occurrence of these antibodies in normal serum, whereas an autoimmune mechanism could account for the secondary rise of anti-ER in the aging female population. PMID- 3539979 TI - Gonadotropin-independent precocious puberty ("testotoxicosis"): influence of maturational status on response to ketoconazole. AB - Three boys, 5.0-7.4 yr of age, with clinical and biochemical features consistent with familial gonadotropin-independent precocious puberty ("testotoxicosis") were treated with the antifungal drug ketoconazole in a dose of 200 mg every 8 h. Serum testosterone levels fell significantly within 24 h in all three patients, with reciprocal changes in serum 17-hydroxyprogesterone, consistent with inhibition of C17-20 lyase activity. However, after 1-3 months of continuing treatment, an "escape" phenomenon occurred, characterized by progressive increases in serum LH, FSH, and testosterone concentrations. Furthermore, for the first time, a marked pubertal-type LH response was found after GnRH administration in contrast to the absent response consistently found in all patients before ketoconazole therapy. Combination treatment with ketoconazole and the GnRH analog buserelin resulted in restoration of pituitary and gonadal hormone concentrations to the upper range of normal for prepubertal children. We hypothesize that the advanced state of maturation of the boys in this study [mean bone age, 13.2 +/- 0.8 (+/- SE) yr] was the major contributing factor to this escape, with the set-point of the GnRH pulse generator (gonadostat) functioning at the adult level of sensitivity. Such escape may limit the successful use of ketoconazole alone. These data together with evidence of normal testosterone responses to hCG during ketoconazole therapy indicate that in testotoxicosis, pituitary and gonadal receptors are functionally intact, with appropriate negative feedback relationships. PMID- 3539980 TI - Reduction of hyperinsulinemia and insulin resistance by opiate receptor blockade in the polycystic ovary syndrome with acanthosis nigricans. AB - We previously reported that circulating beta-endorphin levels are increased in obese hirsute women and that plasma immunoreactive insulin (IRI) levels are increased in proportion to the degree of hyperandrogenism in women with the polycystic ovary (PCO) syndrome. We, therefore, tested the hypothesis that endogenous opiates are at least partially responsible for the hyperinsulinemia and insulin resistance in this syndrome. In the first study, acute naloxone administration significantly reduced the plasma IRI response and IRI/glucose ratio in three euglycemic obese women with PCO and acanthosis nigricans (AN) and marked insulin resistance, but did not alter the glucose response. Naloxone had no effect on these parameters in the normal weight control subjects. In the second study, nalmefene, a new, orally active opiate antagonist, reduced IRI and the IRI/glucose ratio in four women with PCO-AN and marked hyperinsulinemia in a randomized, double blind, crossover protocol. We conclude that endogenous opiates are at least partially responsible for the hyperinsulinemia and insulin resistance in PCO-AN. PMID- 3539982 TI - Interlaboratory evaluation of indirect enzyme-linked immunosorbent assay, antibody capture enzyme-linked immunosorbent assay, and immunoblotting for detection of immunoglobulin M antibodies to Toxoplasma gondii. AB - One hundred and fifteen serum samples from healthy laboratory personnel and 50 consecutive samples from 19 patients with anamnestic clinical signs of toxoplasmosis were assayed by four laboratories for the presence of immunoglobulin M antibodies to Toxoplasma gondii by an indirect enzyme-linked immunosorbent assay (ELISA), an antibody capture assay with peroxidase-labeled toxoplasma antigen, and an immunoblotting assay. In addition, a commercially available antibody capture ELISA was used. Highly significant correlation coefficients were obtained between the four laboratories and the commercial test. The indirect ELISA and antibody capture ELISA showed equal sensitivity in detection of immunoglobulin M antibodies to toxoplasma in early-stage serum samples. However, in this study, the antibody capture assay discriminated better between serum samples obtained at early or late stages of toxoplasma infection. PMID- 3539981 TI - In-hospital source of airborne Penicillium species spores. AB - Between 16 July and 1 October 1984, prospectively monitored corridor air samples from a bone marrow transplant station revealed a marked increase in airborne thermotolerant Penicillium spores. Simultaneous cultures of outside air showed lower spore counts, which were unchanged before, during, and after the corridor outburst, establishing that the source was within the hospital. Although the corridor was equipped with recirculating high-efficiency particulate air filtration units which provided 16 air changes per h, the mean corridor air count rose to 64.4 thermotolerant Penicillium CFU/m3 during the outburst period. The in hospital source was ultimately traced to rotting cabinet wood enclosing a sink with leaking pipes in the medication room. It produced approximately 5.5 X 10(5) thermotolerant Penicillium CFU/h. In a patient room supplied by corridor air, an in-room recirculating high-efficiency particulate air filter reduced the mean thermotolerant Penicillium count to 2.2 CFU/m3. No patient illness or colonization occurred as a result of this event, although the cabinet wood, after sterilization, was shown to sustain abundant growth of Aspergillus fumigatus and Aspergillus flavus. Wet organic substrates should be avoided in hospital areas with immunosuppressed patients. PMID- 3539983 TI - Comparative study of synthetic oligonucleotide and cloned polynucleotide enterotoxin gene probes to identify enterotoxigenic Escherichia coli. AB - Escherichia coli isolated from 2,126 children in Thailand and the Philippines was examined for enterotoxin production and for DNA hybridization with synthetic oligonucleotide and cloned polynucleotide enterotoxin gene probes. A total of 233 infections with E. coli that were detected by one or more of these assays were identified. Of the infections, 75% (164/233) were identified by all three methods. An additional 18% (43/233) were identified by two of three methods. Isolates from 10% (19/183) of infections with E. coli that hybridized with both the oligonucleotide and cloned enterotoxin gene probes were nontoxigenic, as determined by the Y1 adrenal cell and suckling mouse assays. Although synthetic oligonucleotide probes to detect enterotoxigenic E. coli are more uniform and easier to use than cloned enterotoxin gene probes, the heat-labile toxin oligo probe used in this study did not identify 13% (11/87) of infections with E. coli that produced heat-labile toxin, as identified with the Y1 adrenal cell assay and the cloned enterotoxin gene probe. Synthetic oligonucleotide probes enable laboratories with only minimal equipment to use DNA hybridization assays to identify enterotoxigenic E. coli. PMID- 3539984 TI - Production of Escherichia coli STa-like heat-stable enterotoxin by Citrobacter freundii isolated from humans. AB - Citrobacter species are often present in the stools of children and are generally considered a normal component of the intestinal microflora. Previous reports suggested that they might act as enteric pathogens. Aiming at defining the role of Citrobacter species in inducing diarrhea, we looked for their presence in the stools of 328 children with diarrhea and in 108 controls. Citrobacter strains were isolated from 46 patients (14%) and 7 controls (6.5%) (P less than 0.05). All isolates were tested for heat-stable (ST) and heat-labile (LT) enterotoxin. No LT-producing organisms were found. Three C. freundii strains, all isolated from children with diarrhea, elaborated an enterotoxin detected by the suckling mouse assay. A crude extract was prepared by acetone precipitation and a sequential ultrafiltration technique. The enterotoxin was heat stable, and its estimated molecular weight was between 2,000 and 10,000. Citrobacter enterotoxin was soluble in methanol and stable at acid and neutral pHs but not above pH 8, and its activity was destroyed by treatment with 2-mercaptoethanol. Citrobacter enterotoxin was inactive in the 18-h rabbit ileal loop test. All these characteristics closely resemble STa produced by Escherichia coli. The time course of Citrobacter enterotoxin-induced intestinal secretion in suckling mice was similar to that of E. coli STa. The enterotoxin produced by C. freundii cross reacted with monoclonal antibodies raised against E. coli STa. These results suggest that C. freundii is capable of inducing diarrhea through the production of an E. coli-like STa, and its presence in the stools of patients with diarrhea should be considered as that of a possible etiologic agent. PMID- 3539985 TI - Enzyme-linked immunosorbent assay to detect Shiga toxin of Shigella dysenteriae and related toxins. AB - A sandwich enzyme-linked immunosorbent assay (ELISA) was developed for detection of Shiga toxin. Four species of Shigella, Escherichia coli, and Vibro parahaemolyticus were tested for production of Shiga or Shiga-like toxin by ELISA and Vero cell bioassay. In the ELISA, most strains of S. dysenteriae and some strains of E. coli isolated from traveler's diarrhea were positive. These ELISA positive strains were positive by Vero cell bioassay without exception. Some E. coli strains and most V. parahaemolyticus strains were toxic to Vero cells, although they were negative in the ELISA. Much of the cytotoxic activity was not neutralized by anti-Shiga toxin antiserum. The newly developed sandwich ELISA is specific and can be a substitute for the cumbersome Vero cell bioassay. PMID- 3539986 TI - Fluorescence detection of Cryptosporidium oocysts in human fecal specimens by using monoclonal antibodies. AB - With the discovery that the coccidian parasite Cryptosporidium sp. can cause severe symptoms in humans, implementation of many diagnostic techniques rapidly followed. The infection is self-limiting in patients with normal immune systems but chronic in the immunosuppressed patient. With the eventual development and use of therapeutic agents, it will become very important to find Cryptosporidium sp., even in low numbers, in fecal specimens. Production of a highly specific and sensitive antibody by use of cloning techniques has provided another diagnostic tool. Formalinized positive human fecal specimens (n = 99) and negative specimens (n = 198), of which 115 contained yeastlike fungi and other organisms, were tested in blind trials by use of a monoclonal antibody. Sensitivity was 100% with 3- to 4+ fluorescence on all cryptosporidial oocysts, both in light and heavy infections. The organisms were round and easily visible (4 to 6 micron), showing apple-green to yellow fluorescence against a dark background free of nonspecific fluorescence. Specificity was also 100% with all 99 positive Cryptosporidium sp. specimens exhibiting fluorescence and all 198 negative specimens showing no fluorescence. All positive and negative specimens were previously confirmed by the hot modified acid-fast technique. However, seven specimens previously considered negative by this acid-fast method were positive by the monoclonal antibody technique. These specimens were confirmed as positive, after extensive examination of additional smears prepared by the modified hot acid-fast method revealed rare organisms, emphasizing the increased sensitivity of the monoclonal antibody technique. Since acid-fast stains do not always consistently stain all oocysts, the increased sensitivity of the monoclonal reagent provides an excellent screening method. PMID- 3539987 TI - Cytotoxic necrotizing factor production by hemolytic strains of Escherichia coli causing extraintestinal infections. AB - Two hundred and nineteen strains of Escherichia coli from extraintestinal infections and feces of healthy subjects were examined for hemolysin (Hly) and cytotoxic necrotizing factor (CNF) production and for mannose-resistant hemagglutination. Of 105 strains from extraintestinal infections, 42 (40.0%) were positive for production of both Hly and CNF, and 21 (20.0%) were positive for Hly alone; on the contrary, only 1 Hly- and CNF-positive strain and 2 Hly-positive strains were found among 114 strains from normal stools. CNF production was not found to occur among the nonhemolytic strains, confirming the close association existing between these toxic factors. Hemolytic strains positive for CNF showed mannose-resistant hemagglutination less frequently than did Hly-positive, CNF negative strains (25.6 versus 82.6%), suggesting the existence of two distinct classes among hemolytic strains of E. coli. PMID- 3539988 TI - Comparison of Sabouraud dextrose and Pagano-Levin agar media for detection and isolation of yeasts from oral samples. AB - The sensitivities of Sabouraud dextrose agar and modified Pagano-Levin agar for the primary isolation of yeasts and the recovery of multiple yeast species from single clinical samples were compared by using oral-rinse samples. Although there was a highly significant positive correlation between the numbers of yeasts recovered from both media, modified Pagano-Levin agar was far superior in detecting multiple yeast species in a single sample. Of 150 oral samples containing yeasts, 23 (15.3%) contained more than one yeast species. The most frequent combination of different yeasts was Candida albicans and Torulopsis glabrata. PMID- 3539990 TI - Comparison of paraffin baiting and conventional culture techniques for isolation of Nocardia asteroides from sputum. AB - Of 1,510 sputum samples examined from 1,016 patients with bronchopulmonary disorders, Nocardia asteroides was isolated from 67 samples by paraffin baiting, as compared with only 30 isolations by the conventional technique of culturing on Sabouraud dextrose agar. This higher efficacy of the paraffin bait technique was found to be statistically significant (P less than 0.001). PMID- 3539989 TI - Rapid identification of mycoplasmas by indirect immunoperoxidase test using small square filter paper. AB - The indirect immunoperoxidase test using small, square filter paper was used for rapid identification of mycoplasmas. Colonies of type strains of 22 mycoplasma species, 3 acholeplasma species, and three Ureaplasma diversum serogroups were stained by this test with high sensitivity and specificity. All of 49 isolates from bovine materials and cell cultures were easily identified by this test, and the results agreed with those obtained by growth inhibition test. Use of filter paper made it possible to add different kinds of antisera or conjugates to the same agar plate simultaneously and also to save antiserum and conjugate. This test proved to be a simple and useful technique for rapid identification of many mycoplasma species grown on agar medium. PMID- 3539991 TI - Determination of immune status in patients with low antibody titers for rubella virus. AB - Three assays for detection of rubella antibodies, Rubella G (fluorescence immunoassay [FIA]), Rubacell (passive hemagglutination), and Rubaquick (passive hemagglutination with rotation), were compared with hemagglutination inhibition. A total of 100 serum specimens were selected, 68 of which had an FIA value of less than or equal to 25. On initial testing, among the four tests, there was agreement for 88 specimens for assignment of rubella immune status. On repeat testing, all the results agreed by the hemagglutination inhibition, passive hemagglutination, and passive hemagglutination rotation methods, and only one discrepant specimen remained by FIA. PMID- 3539992 TI - Modified indirect immunofluorescence test for serotyping large numbers of Ureaplasma urealyticum clinical isolates. AB - A technical modification of the indirect immunofluorescence test for serotyping Ureaplasma urealyticum clinical isolates is described. The use of a tissue culture plate filled with ureaplasma agar made the serotyping easier to perform and proved to be very handy, especially for performance of large series. PMID- 3539993 TI - Accuracy of single radial hemolysis test for rubella immunity when internal reference standards are used to estimate antibody levels. AB - The accuracy and reproducibility of antibody levels obtained by single radial hemolysis with six internal reference sera were evaluated. The test was performed in a clinical laboratory for routine assessment of immunity to rubella infection over a period of 1 year. A linear relationship exists between the antibody titer (expressed in log dilution) and zone diameters. In 43 of 44 test runs the correlation coefficient of the standard curve was over 0.990. Prediction limits of 95% around the curve showed that on replication of the test, zone diameters could be found within less than half a doubling-dilution step. The antibody level can thus be determined more accurately by the single radial hemolysis test than in the conventional hemagglutination inhibition test. This is particularly important in assessing immunity when antibody titers are low, since the hemagglutination inhibition test is less reliable then. The use of standard sera calibrated international units would render results of different laboratories comparable and allow standardization at threshold values. PMID- 3539994 TI - Identification with monoclonal antibodies of hemolysin produced by clinical isolates of Escherichia coli. AB - Murine monoclonal antibodies were generated against the 107,000-dalton hemolysin encoded by the hemolytic determinant from Escherichia coli LE 2001, and colony blotting was used to assay for production of the hemolysin by 35 hemolytic strains of E. coli and other hemolytic members of the family Enterobacteriaceae of clinical origin. All hemolytic E. coli strains gave positive reactions with two monoclonal antibodies. In contrast, none of the hemolytic, non-E. coli isolates yielded positive colony blots. In addition, Western blotting showed that the hemolysins produced by all clinical E. coli isolates had a similar molecular weight of about 107,000. Discrete antigenic variation may occur in the molecule, since a third monoclonal antibody did not react with the hemolysin from a number of wild-type E. coli strains. Western blot analysis was used to assess the presence of immunoglobulin G (IgG), IgA, and IgM antibodies to E. coli hemolysin in human sera. All 20 of the tested sera from healthy adults contained antibodies to the toxin, with various constellations among the antibody classes. In contrast, sera from five of eight infants aged 8 to 36 months contained no antihemolysin antibodies. We conclude that the 107,000-dalton hemolysin of E. coli is a widespread immunogen that is produced by most or all hemolytic E. coli strains in the human host. PMID- 3539995 TI - Enzyme-linked immunosorbent assay for Potomac horse fever disease. AB - An enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) and IgM in natural and experimental infections of equids with Ehrlichia risticii was developed. Ehrlichial organisms purified from an infected mouse macrophage cell line were used as the antigen. IgM was separated from serum IgG by the expedient of spun-column chromatography, allowing the use of an indirect ELISA for quantitation of both IgG and IgM in the test sera. Among 16 paired sera from horses exhibiting clinical signs of Potomac horse fever, 8 were positive by the indirect fluorescent-antibody test (IFA), 11 were positive by the IgG ELISA, and 8 were positive by the IgM ELISA. All IFA-positive specimens were positive by the IgG ELISA, which appeared to be more sensitive than the IFA. In all cases, the IgG ELISA alone would have sufficed for diagnosis when acute- and convalescent phase sera were available. When 26 single acute- or convalescent-phase serum samples were tested, the IFA detected 8, the IgG ELISA detected 10, and the IgM ELISA detected 6 positive serum specimens. The kinetics of IgG and IgM responses as determined by ELISA in two experimentally infected ponies which survived infection and challenges revealed that specific IgM was short-lived, falling to undetectable levels by day 60 postinoculation, whereas specific IgG persisted for more than 1 year. IgM and IgG were detected as early as days 1 and 10, respectively, postinoculation. The results suggest that the ELISA is more sensitive than the IFA and that the IgM ELISA may provide a means for early diagnosis of Potomac horse fever at or before the onset of clinical signs. PMID- 3539996 TI - Clinical evaluation of the Vitek Neisseria-Haemophilus Identification card. AB - A clinical evaluation of the Vitek Neisseria-Haemophilus Identification (NHI) card (Vitek Systems, Inc., Hazelwood, Mo.) was performed with 480 clinical isolates and stock strains of Neisseria spp., Haemophilus spp., and other fastidious microorganisms included in the data base of the system. Identifications obtained with the NHI card were compared with those determined by conventional methods. The card identified 83.2% of 244 Neisseria spp. and Branhamella catarrhalis, 54.9% of 164 Haemophilus spp., and 84.7% of 72 fastidious gram-negative species with no further testing required. Some isolates produced good confidence-marginal separation identifications, in which the correct identification was listed with one or two other possible identifications and extra tests were required and suggested. When isolates producing good confidence-marginal separation identifications were included, correct identifications of these organism groups increased to 97.1, 92.7, and 94.4%, respectively. Among the commonly isolated microorganisms, the NHI card identified 99.1% of 110 N. gonorrhoeae, 98.5% of 68 N. meningitidis, 93.9% of 98 H. influenzae, and 95.6% of 46 H. parainfluenzae strains. All of these organisms produced excellent to very good confidence level identifications except for H. influenzae biotypes II, III, and VII, for which hemolytic reactions were required for differentiation from H. haemolyticus. The NHI card reliably identified other fastidious gram-negative species, including H. aphrophilus, Eikenella corrodens, Gardnerella vaginalis, and Kingella denitrificans. PMID- 3539997 TI - Premarket evaluation of IDS RapID SS/u system for identification of urine isolates. AB - A total of 170 fresh clinical urine isolates were tested with a premarket configuration of the RapID SS/u system (Innovative Diagnostic Systems, Inc., Atlanta, Ga.), a qualitative micromethod for the identification of selected organisms commonly isolated from urine specimens. Results were compared with those obtained with conventional methods of identifying gram-positive isolates and with the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.), utilizing Gram-Negative Identification cards for the identification of gram-negative rods. Organisms representing 12 taxa were included in the study. Of the 170 isolates, 163 (95.9%) were correctly identified. A total of 144 strains (84.7%) were correctly identified without additional testing, whereas 19 isolates (11.2%) required further testing. Seven isolates (4.1%) were incorrectly identified. The SS/u system required minimal hands-on time inoculate and interpret reactions. Discrepancies most often occurred with regard to misinterpretation of Escherichia coli and Enterobacter sp. as Citrobacter sp. The IDS RapID SS/u system may indeed prove valuable for the rapid manual identification of urine isolates. PMID- 3539998 TI - Aspergillus fumigatus-specific antibodies in allergic bronchopulmonary aspergillosis and aspergilloma: evidence for a polyclonal antibody response. AB - Patients with the Aspergillus-induced diseases allergic bronchopulmonary aspergillosis (ABPA), aspergilloma (fungus ball), and Aspergillus skin test positive asthma were differentiated immunologically by radioimmunoassay based on their total immunoglobulin E (IgE) and Aspergillus fumigatus-specific IgE levels. In this study, a new, highly sensitive biotin-avidin-linked immunosorbent assay was used to evaluate A. fumigatus-specific antibodies of all immunoglobulin classes. Studied populations included 13 patients with ABPA, 12 with aspergilloma, 9 with Aspergillus skin test-positive asthma, and 9 normal individuals without asthma. A. fumigatus-specific antibodies of all classes were elevated in patients with ABPA, variably elevated in those with aspergilloma, and lowest in the other two groups. This assay demonstrated significantly higher specific IgE antibody levels in the ABPA group over those of the other groups, even with 1:1,000 dilutions of the sera. This study demonstrated that ABPA is a disease characterized by a polyclonal antibody response to Aspergillus antigen and not just a response to IgE and IgG antibody classes. The measurement of other antibody classes, particularly IgD and IgA, could enhance the immunodiagnosis of ABPA. The biotin-avidin-linked immunosorbent assay was found to be a highly sensitive assay that can be a clinically useful alternative to radioimmunoassay in the measurement of A. fumigatus-specific antibodies. PMID- 3539999 TI - Thalassemic erythrocytes inhibit in vitro growth of Plasmodium falciparum. AB - Blood specimens from 100 thalassemic patients were screened in vitro for inhibitory effects on growth and multiplication of Plasmodium falciparum. The culture medium mixture designated REM consisted of 9 volumes of minimum essential medium (GIBCO Laboratories, Grand Island, N.Y.) and 1 volume of RPMI 1640 (GIBCO) supplemented with 10% heat-inactivated human serum. Parasite multiplication in erythrocytes containing normal hemoglobin cultured in RPMI or REM was similar. Significant reduction in parasite multiplication rates was observed in erythrocytes containing abnormal hemoglobin when these were cultured in REM. The degree of reduction in five types of thalassemic erythrocytes was in the following descending order: hemoglobin H disease with Hb Constant Spring, classical hemoglobin H disease, beta(0)-thalassemia-hemoglobin E in which blood harbored a high percentage of hemoglobin F-containing cells, beta (0)-thalassemia hemoglobin E in which blood harbored few hemoglobin F-containing cells, and beta thalassemia heterozygous variant. PMID- 3540000 TI - Cobas-Bact system for identification of members of the family Enterobacteriaceae in 4 h 20 min. AB - The Cobas-Bact (Roche Diagnostics, Basel, Switzerland) new rotor for the identification (ID) in 4 h 20 min of 33 members of the family Enterobacteriaceae to genus and species level was evaluated by testing 444 strains of which 398 belonged to common species and 46 belonged to rare species of Enterobacteriaceae. Each strain was identified by the API 20E system (Analytab Products, Plainview, N.Y.), and additional discriminating tests were set up if necessary. Only first choice ID were considered in this study and were classified either as high confidence ID (normalized likelihood, greater than or equal to 80%) or as low confidence ID (normalized likelihood, less than 80%) requiring additional tests for confirmation. The data were analyzed by two versions of Cobas-Bact software. With the first version of the software (SW8446), the overall accuracy of Cobas Bact was 95.5% (424 correct ID of 444). When restricted to high-confidence ID it rose to 99.4% (350 of 352) for the common species and 96.9% (31 of 32) for the rare species. Only three strains of the high-confidence group were misidentified. Sixty ID were considered unacceptable because of their low confidence. Using the first software version (SW8446) they represented 12% (46 of 398) of the common species (17 typical strains, 10 Shigella species, 10 inactive Escherichia coli strains, and 9 rare biotypes) and 30% (14 of 46) of the rare species. The same data analyzed by the new version (SW8524) of the Cobas-Bact software resulted in an overall accuracy of 93.9% (417 correct ID). The number of high-confidence ID rose to 401, of which 392 (97.7%) were accurate. The decrease in low-confidence ID (43 versus 60) was mainly due to the Shigella species. In conclusion the accuracy of Cobas-Bact identification system was very good when restricted to high-confidence ID. The Cobas-Bact performance for rare species ID was poorer, but the small number of strains tested does not allow definitive conclusions. PMID- 3540003 TI - 100 years of muscle research at Heidelberg. The Kuhne-Erb-Hoffmann Symposium, Heidelberg, 25-27 March, 1986. PMID- 3540001 TI - Comparative sensitivity of 125I-protein A and enzyme-conjugated antibodies for detection of immunoblotted proteins. AB - Immunoblotting is a powerful technique for the detection of small amounts of immunologically interesting proteins in unpurified preparations. Iodinated protein A (PA) has been widely used as a second antibody for detection of proteins; however, it does not bind equally well to immunoglobulins from different species nor does it bind to all subclasses of immunoglobulin G (IgG). We compared the sensitivity of [125I]PA with those of both horseradish peroxidase conjugated second antibodies (HRP) and glucose oxidase-anti-glucose oxidase (GAG) soluble complexes for visualizing bovine serum albumin, human IgG, or human C3 which was either dot blotted or electroblotted to nitrocellulose. [125I]PA was uniformly 10- to 100-fold less sensitive than either HRP or GAG. GAG was more sensitive than HRP except for C3 (electroblotting) and bovine serum albumin and IgG (dot blotting), in which they were equivalent. In general, dot blotting was 10- to 1,000-fold more sensitive than electroblotting. Although relative sensitivities varied depending on the proteins analyzed and the antisera used, GAG appeared to be superior to [125I]PA and HRP for detection of immunoblotted proteins. PMID- 3540002 TI - Variations in Western blot banding patterns of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus. AB - Serum samples from 27 patients infected with human T-cell lymphotropic virus type III (14 with acquired immune deficiency syndrome [AIDS] and 13 with AIDS-related complex) were examined for antibodies to viral proteins by the Western blot method and with four different commercial solid-phase enzyme-linked immunosorbent assays (ELISAs). Virus-specific bands on blots at molecular masses of 64, 55, 53, 41, 31, 24, and 17 kilodaltons were observed. Rank correlation matrices were calculated to relate the intensity of viral bands, stage of illness, and ELISA kit optical densities (ODs). Groups of bands tended to covary in intensity: p17, p24, and p55 (gag gene products); p53 and p64 (pol gene products); and p31 (pol/endonuclease gene product) and p41 (env gene product). Blots of sera from AIDS-related complex patients usually showed strong activity against all viral proteins, while those of sera from AIDS patients characteristically showed strong reactivity only at the pol/endonuclease and env bands. For one ELISA kit (Abbott Laboratories, North Chicago, Ill.), ODs correlated well with the env and pol band intensity scores, while ELISA ODs with other kits (from Litton Industries, Sunnyvale, Calif.; Electro-Nucleonics, Inc., Fairfield, N.J.; and E.I. du Pont de Nemours & Co., Inc., Wilmington, Del.) correlated closely with gag band intensity scores. We conclude that human T-cell lymphotropic virus type III Western blot patterns are determined by (i) viral protein processing pathways and (ii) the stage of illness of the patient and may reflect (iii) the ELISA method used for serum screening. PMID- 3540005 TI - A monoclonal antibody against a novel intracellular neural antigen expressed differentially in neural cell types. AB - A monoclonal antibody, GTE52, was isolated from a fusion of myeloma cells with the lymphocytes of a mouse immunised with enzymatically dissociated guinea-pig trigeminal ganglion cells. GTE52 was found to stain the nuclei of satellite cells and Schwann cells, but not neurones, in the peripheral nervous system of guinea pig and mouse. In the central nervous system GTE52 labelled glia and some neurones. Double-labelling experiments on primary cultures of optic nerve using antibodies to glial fibrillary acidic protein, galactocerebroside and fibronectin showed that GTE52 labelled a sub-population of astrocyte glia, possibly corresponding to the type 2 astrocytes, oligodendrocytes and not fibroblasts. Adult non-neural tissue was not stained by GTE52 with the exception of the smooth muscle of the gut. However, during development of the guinea-pig the antigen recognised by GTE52 was expressed in all cells of 16-day embryos but was lost from the tissues studied, which were not stained in the adult, from about embryonic day 60 onwards. PMID- 3540006 TI - T cell subsets and Ia-positive cells in the sciatic nerve during the course of experimental allergic neuritis. AB - The changes of T cell subsets and Ia-positive cells in the sciatic nerve during the course of experimental allergic neuritis (EAN) in Lewis rats were studied using immunohistochemical techniques. OX-6+ Ia-positive cells and W3/13+ total T cells were found at the clinical onset of EAN. OX-6+ cells were more numerous than W3/13+ cells during all phases of the disease. In the acute phase, more W3/25+ helper T cells were found than OX-8+ suppressor/cytotoxic T cells in the sciatic nerve. In the recovery phase, W3/25+ cells were slightly fewer than OX-8+ cells. It is suggested that these changes in T cell subsets and Ia-positive cells are related to the self-limiting monophasic course of EAN. PMID- 3540007 TI - An isoelectric focusing overlay study of the humoral immune response in Theiler's virus demyelinating disease. AB - Oligoclonal immunoglobulin G (IgG) bands are a frequent feature of inflammatory diseases of the central nervous system (CNS). In multiple sclerosis (MS), cerebrospinal fluid (CSF) oligoclonal IgG bands are a potential clue to the pathogenesis of the disease; however, their particular antigenic target is unknown. We sought to characterize the IgG response in an experimental CNS persistent demyelinating infection by isoelectric focusing (IEF) studies of serum and CSF from mice infected with Theiler's murine encephalomyelitis virus (TMEV). Following IEF, we used a new technique in order to identify TMEV-specific antibodies; focused immunoglobulins were blotted onto nitrocellulose paper which was then overlaid with radiolabeled virus. Autoradiograms showed that most of the TMEV antibody was locally synthesized within the CNS since CSF, but not serum, TMEV antibody had an anodal distribution. CSF IEF TMEV antibody spectrotypes were very similar, presumably because the CSFs were collected from the same inbred mouse strain. CSF TMEV antibody displayed less restricted heterogeneity than the very restricted cathodal CSF oligoclonal IgG bands seen in MS. The new IEF immunoblotting antigen overlay technique will be a powerful detection system to probe for the antigenic target against which MS CSF IgG may be directed. PMID- 3540004 TI - The role of tropomyosin-troponin in the regulation of skeletal muscle contraction. AB - Steric blocking of actin-myosin interaction by tropomyosin has been a working hypothesis in the study of the regulation of skeletal muscle contraction, yet the simple movement of actin-associated tropomyosin from a myosin-blocking position (relaxation) to a nonblocking position (contraction) cannot adequately account for all of the biophysical and biochemical observations which have been made to date. Ambiguous assignment of tropomyosin positions on actin during contraction, due in part to the limited resolution of reconstruction techniques, may also hint at a real lack of clearcut 'on' and 'off' positioning of tropomyosin and tropomyosin-troponin complex. Recent biochemical evidence suggests processes relatively independent of tropomyosin-troponin may have a governing effect on contraction, involving kinetic constraints on actin-myosin interaction influenced by the binding of ATP and the intermediates of ATP hydrolysis. Based on our current understanding put forth in this review, it is clear that regulatory interactions in muscle contraction do not consist solely of steric effects but involve kinetic factors as well. Where the latter are being defined in systems reconstituted from purified proteins and their fragments, the steric components of regulation are most clearly observed in studies of structurally more intact physiologic systems (e.g. intact or skinned whole muscle fibres). The fine detail of the processes and their interplay remains an intriguing question. Likewise, the precise physical relationship of myosin with actin in the crossbridge cycle continues to elude definition. Refinement of several methodologies (X-ray crystallography, three-dimensional reconstruction, time-resolved X-ray diffraction) will increase the potential for detailing the molecular basis of the regulation of muscle contraction. PMID- 3540008 TI - Detection of tissue kallikrein in the bronchoalveolar lavage fluid of asthmatic subjects. AB - Kininogenase activity was detected by cleavage of radiolabeled substrate (125I high molecular weight kininogen [HMWK]) in 22 of 24 bronchoalveolar lavage (BAL) fluid samples from 17 asthmatics who either responded to aerosolized allergen challenge or had symptoms of active asthma. In contrast, six of seven normal controls lacked enzymatic activity. Levels of free immunoreactive kinin found in BAL fluid correlated with the presence of kininogenase activity (P = 0.002). The cleavage pattern of 125I-HMWK by the BAL fluid kininogenase (a dominant 65,000 mol wt fragment), and synthetic inhibitor profile (phe-phe-arg-CH2Cl and phenylmethylsulfonyl fluoride) were compatible with a tissue kallikrein. Peak kininogenase activity eluted at an apparent molecular weight of 20,000-34,000 by HPLC gel filtration. Its antigenic identity was established by immunoblotting with anti-human urinary kallikrein antibody and its activity was inhibited by this antibody. Lysylbradykinin was generated during incubation of fractionated BAL fluid and purified HMWK, the characteristic cleavage product of the tissue kallikreins. We conclude that elevated amounts of tissue kallikrein and kinin are present in the bronchoalveolar spaces of asthmatic subjects. Kinin generation may contribute to the asthmatic response directly through edema formation and smooth muscle contraction and by augmenting release and/or production of preformed (histamine) and secondary mediators such as leukotrienes and platelet-activating factor. PMID- 3540009 TI - Lipolysis during fasting. Decreased suppression by insulin and increased stimulation by epinephrine. AB - These studies were designed to determine whether the insulin resistance of fasting extends to its antilipolytic effects and whether fasting enhances the lipolytic effects of adrenergic stimulation independent of changes in plasma hormone and substrate concentrations. Palmitate flux was determined isotopically ([1-14C]palmitate) before and during epinephrine infusion in normal volunteers after a 14-h (day 1) and an 84-h (day 4) fast. Using a pancreatic clamp, constant plasma hormone and glucose concentrations were achieved on both study days in seven subjects. Six subjects were infused with saline and served as controls. During the pancreatic clamp, palmitate flux was greater (P less than 0.01) on day 4 than day 1, despite similar plasma insulin, glucagon, growth hormone, cortisol, epinephrine, norepinephrine, and glucose concentrations. The lipolytic response to epinephrine was greater (P less than 0.05) on day 4 than day 1 in both groups of subjects. In conclusion, lipolysis during fasting is less completely suppressed by insulin and more readily stimulated by epinephrine. PMID- 3540011 TI - Effects of endothelial cell growth factor on bone remodelling in vitro. AB - Endothelial cell growth factor (ECGF) alpha was studied for its effects on bone formation in cultured fetal rat calvariae and on bone resorption in cultured fetal rat long bones. ECGF at 0.1-100 ng/ml stimulated [3H]thymidine incorporation into DNA, an effect enhanced by heparin. Treatment with ECGF for 24 h decreased the incorporation of [3H]proline into collagen but treatment for 48 96 h increased collagen and noncollagen protein synthesis, an effect that was concomitant with an increase in DNA content. ECGF did not alter collagen degradation in calvariae or 45Ca release from long bones, which indicated it had no effect on bone resorption. Although ECGF increased prostaglandin E2 concentrations, its effect on DNA synthesis was not prostaglandin-mediated. In conclusion, ECGF stimulates calvarial DNA synthesis, which is an effect that results in a generalized increase in protein synthesis, but ECGF has no effect on matrix degradation or bone resorption. PMID- 3540010 TI - Decreased kinase activity of insulin receptors from adipocytes of non-insulin dependent diabetic subjects. AB - The tyrosine kinase activity of the insulin receptor was examined with partially purified insulin receptors from adipocytes obtained from 13 lean nondiabetics, 14 obese nondiabetics, and 13 obese subjects with non-insulin-dependent diabetes (NIDDM). Incubation of receptors at 4 degrees C with [gamma-32P]ATP and insulin resulted in a maximal 10-12-fold increase in autophosphorylation of the 92-kDa beta-subunit of the receptor with a half maximal effect at 1-3 ng/ml free insulin. Insulin receptor kinase activity in the three experimental groups was measured by means of both autophosphorylation and phosphorylation of the exogenous substrate Glu4:Tyr1. In the absence of insulin, autophosphorylation and Glu4:Tyr1 phosphorylation activities, measured with equal numbers of insulin receptors, were comparable among the three groups. In contrast, insulin stimulated kinase activity was comparable in the control and obese subjects, but was reduced by approximately 50% in the NIDDM group. These findings indicate that the decrease in kinase activity in NIDDM resulted from a reduction in coupling efficiency between insulin binding and activation of the receptor kinase. The insulin receptor kinase defects observed in NIDDM could be etiologically related to insulin resistance in NIDDM and the pathogenesis of the diabetic state. PMID- 3540012 TI - c-myc gene inactivation during induced maturation of HL-60 cells. Transcriptional repression and loss of a specific DNAse I hypersensitive site. AB - The c-myc proto-oncogene is amplified and expressed at high levels in HL-60 cells, a cell line derived from a patient with acute promyelocytic leukemia. Upon induction to terminal maturation, expression of c-myc is greatly reduced. We have studied the level of gene expression at which the change in c-myc expression is controlled and the changes in chromatin configuration that accompany the repression of myc expression. We report here that the repression of myc expression with induced maturation is controlled at the level of transcription, and that reduced expression is accompanied by the loss of a single DNAse I hypersensitive site 0.9 kilobase pair upstream from the gene. PMID- 3540013 TI - Expression of blood group antigens in urinary tract tumours: prospective fluorescence study using cryostat sections of fresh frozen tissues. AB - Cryostat sections of fresh frozen tissues were used in a prospective study of blood group H and A antigen fluorescence in 73 transitional cell carcinomas of the bladder. The aim was to evaluate antigen expression without subjecting the tumour tissues to organic solvents that extract blood group active glycolipids. Deletion of the genetically predicted antigen was twice as common in tumours of pT1 or greater stage than those of pTa stage and also twice as common in poorly differentiated than in moderately well differentiated tumours. The considerable heterogeneity and overlap, however, in patterns of reactivity in tumours of various histopathological stages and grades and the effect of secretor status on antigenicity meant that there was no obvious antigenic feature that correlated precisely with invasive stage or differentiation grade. It remains to be determined whether the antigen positive and antigen negative tumours represent different disease entities with differing clinical courses. Our results indicate, however, that studies of the blood group antigens in urinary tract tumours are more likely to be of value in research into biochemical disorders in the neoplastic process than in routine clinical assessment as a guide to treatment. PMID- 3540014 TI - IgA deposition in alcoholic liver disease. AB - Immunoglobulin deposition in alcoholic and non-alcoholic liver disease was studied using an indirect immunoperoxidase technique. A continuous pattern of IgA deposition, with IgA outlining the sinusoids, was shown to be a specific and sensitive marker for liver disease caused by alcohol in both cirrhotic and non cirrhotic livers. The sensitivity was lowest in cases of alcoholic disease showing fatty change alone. In one case it was possible to show the absence of IgA in liver disease caused by a drug, which was histologically indistinguishable from alcoholic hepatitis. PMID- 3540015 TI - Antineuron specific enolase staining reactions in sarcomas and carcinomas: its lack of neuroendocrine specificity. AB - A commercially available polyclonal antiserum (Dakopatts) raised against bovine neuron specific enolase (NSE) was reacted with 197 sarcomas, 32 carcinomas, 11 carcinoid tumours and 20 malignant melanomas to assess its specificity for neuroendocrine tumours. All the tumours had been fixed in formalin and embedded in paraffin. Positive tumour cells were found in two of 11 squamous cell carcinomas, one of 11 adenocarcinomas, 10 of 10 oat cell carcinomas, 11 of 11 carcinoid tumours, 16 of 20 malignant melanomas, four of seven clear cell sarcomas, nine of 25 leiomyosarcomas, four of 22 rhabdomyosarcomas, one of seven angiosarcomas and one of 20 synovial sarcomas. PMID- 3540017 TI - Terminal transferase positive cells in testicular biopsy specimens from boys with acute lymphoblastic leukaemia. AB - Thirty nine testicular biopsy samples from 37 boys with acute lymphoblastic leukaemia were examined histologically and analysed for the presence of terminal deoxynucleotidyl transferase (TdT) positive cells. Immunological and histological findings correlated in 35 samples. Thirty boys with histologically and immunologically negative biopsy specimens stopped treatment, two subsequently relapsed in the testis, and five relapsed in the marrow. This examination of samples for TdT positive cells did not improve the precision of early diagnosis of testicular relapse. PMID- 3540016 TI - Monoclonal antibody binding to congophilic elements in human Alzheimer brain. AB - Immunohistochemical studies, using a monoclonal antibody, SMP, raised in a mouse against aged human peripheral blood white cells, are described. This antibody reacts with dendritic reticulum cells in lymph node and tonsil, and, in Alzheimer brain, with argyrophilic plaques, neurofibrillary tangles, and cerebral vascular amyloid. PMID- 3540018 TI - New method for typing coagulase negative staphylococci. PMID- 3540019 TI - The non-specific theory in microbial etiology of inflammatory periodontal diseases. AB - In the absence of toothbrushing, the gingival crevice is colonized by a complex indigenous microflora causing gingivitis, a non-specific inflammation. Subgingival plaque may develop by downgrowth into the inflamed pocket of those micro-organisms from supragingival plaque which can multiply there. By direct microscopy, increased proportions of motile rods and spirochetes have been found in diseased pockets. Cultures on selective media have demonstrated increased prevalence of various gram-negative rods. Cultures on non-selective media have revealed the complexity and variability of the subgingival microflora, comprising more than 200 species. Destructive periodontitis is the result of subgingival colonization, which is favored by such ecological changes as plaque accumulation, gingivitis, and gingival exudate. These changes increase the numbers of micro organisms and alter their proportions, but no single species appears in active sites which is not also commonly present in inactive sites. The subgingival micro organisms have several virulence factors which promote colonization of the pockets, destroy host defense mechanisms, and provoke inflammation. It appears that different combinations of indigenous bacteria, rather than just a single species, can produce the pathogenic potential necessary to cause progression from gingivitis to destructive periodontitis. PMID- 3540020 TI - The combined effects of plaque and physical stress on periodontal tissues. AB - Experiments have been performed in beagle dogs in attempts to evaluate the effect of orthodontic- and jiggling-type trauma on the supporting structures of premolars. The results reported have unanimously demonstrated that in situations where orthodontic or jiggling forces were inflicted on teeth with a normal periodontium, or on teeth with overt signs of gingivitis, the periodontal ligament tissue reacted by transitory signs of inflammation. These phenomena occurred without a concomitant loss of connective tissue attachment and development of pathologically deepened periodontal pockets. If the jiggling trauma was inflicted on teeth with an ongoing plaque-associated, destructive periodontitis, the resulting inflammatory reactions caused enhanced loss of attachment and angular bony defects. Furthermore, orthodontic tilting movements of teeth (intrusion) in a plaque-infected dentition may shift a supragingivally located plaque into a subgingival position resulting in periodontal tissue breakdown. PMID- 3540021 TI - The relative importance of plaque and occlusion in periodontal disease. AB - A series of studies has investigated interactions between periodontal trauma and marginal periodontitis in relation to the initiation, progression and treatment of periodontal disease. Lesions of trauma in the periodontal ligament do not initiate the loss of connective tissue attachment characteristic of marginal periodontitis. Studies conducted in squirrel monkeys and beagle dogs in which jiggling forces were superimposed upon an established marginal periodontitis reported increased loss of alveolar bone, but the accelerated loss of attachment which occurred in the dog model did not occur in the monkey model. In order to clarify the relative importance of inflammation and tooth mobility in the treatment of advanced periodontal disease, periodontal responses were evaluated after removing combinations of traumatic and inflammatory components. Elimination of trauma in the presence of existing marginal inflammation did not reduce tooth mobility or increase bone volume. Osseous regeneration and decreased tooth mobility occurred after resolving both components; however, similar findings occurred after resolving inflammation in the presence of continued tooth mobility. After resolution of inflammation, remaining tooth mobility does not result in increased loss of connective tissue attachment. On a clinical level for periodontal disease treatment, the findings place decreased emphasis upon management of tooth mobility and increased emphasis upon resolution of marginal inflammation. PMID- 3540022 TI - Cellular and soluble mediator components of the local immune response to dental plaque. AB - The host immune response to dental plaque products leads to altered levels of activity by several types of cells involved in host defence. Cells of the periodontium which contribute to the supporting tissues of the teeth may be directly damaged by cellular attack, or their activity may be modulated by a range of soluble mediators released by host immune cells. These changes contribute to the modification of the tooth-supporting tissue which is seen in chronic inflammatory periodontal disease. PMID- 3540023 TI - Is antibiotic therapy justified in the treatment of human chronic inflammatory periodontal disease? AB - New insight into the possible involvement of specific bacteria in the etiology of periodontal disease has stimulated interest in antibiotic therapy. However, current knowledge does not allow the designation of one or more pathogens in periodontal diseases. Some bacteria are considered suspected periodontal pathogens due to their predominance in the pocket and their potential pathogenicity, yet they all appear to be indigenous bacteria. For this reason, one can question the rationale for the use of antibiotics in the treatment of periodontal disease since the theoretical basis for their application seems small. Several reports of clinical trials in which antibiotics were administered as an adjunct to scaling and rootplaning in adult periodontitis conclude with encouraging statements concerning bacterial inhibition and the cure of inflammatory periodontal disease. However, the data are conflicting and mostly negative. Antibiotic treatment in combination with scaling and rootplaning in juvenile periodontitis and refractory adult periodontitis has shown some benefit, but the clinical trials were not sufficiently controlled to permit conclusions. So far, antibiotics have been applied as a last resort in order to supplement the non-specific approach of mechanical root debridement, but it can be doubted whether this approach offers any benefit in the long run. PMID- 3540024 TI - Metronidazole: a double-blind trial in untreated human periodontal disease. AB - The effect of metronidazole was assessed in 20 subjects with untreated periodontitis, in a double-blind trial. Subjects received a 1-week course of drug or placebo immediately after baseline examination, and were reassessed 1 month and 3 months later. A 0.25 N constant force probe and darkfield microscopy were used. At 1 month, a difference was observed between the deepest individual pockets in experimental and control groups, with regard to change in probing depth and the proportions of non-motile organisms. At 3 months, differences were observed in 1-3 mm baseline pockets, where a greater proportion of control pockets increased in probing depth, and in 4-6 mm pockets, where a greater proportion of baseline bleeding pockets had ceased to bleed in the experimental group. The differences were of limited clinical significance when compared to studies where metronidazole was used as an adjunct to other therapy, and the results were equivocal with regard to the specific plaque hypothesis, since inhibition of connective tissue attachment loss was not unambiguously demonstrable. PMID- 3540025 TI - A follow-up study 3 years after metronidazole therapy for chronic periodontal disease. AB - In a previous study, a double-blind between subject comparison of the effects of metronidazole and placebo tablets was completed over 22 weeks in 45 subjects with chronic periodontal disease ranging in severity from moderate (PI = 2.0-3.9) to high (PI = 4.0-6.0). The results showed a significantly greater reduction in the mean probing depth of pockets with the use of metronidazole, but this reduction was apparent only in subjects with severe periodontal disease (PI = 4.0-6.0). 3 years later, 28 subjects attended. All groups still showed statistically significant improvements in all parameters when compared with those at the first visit. However, when compared with those at the end of the trial, there were statistically significant increases in gingival bleeding and calculus scores. An increase in plaque levels was also observed but this was not statistically significant. When subjects with moderate and severe periodontal disease were grouped together, there were no significant differences in any of the parameters between test and control groups. Moreover, the significantly greater reductions in mean probing depth of pockets, achieved with the use of metronidazole in the severe group at the end of the trial, had disappeared after 3 years. However, in subjects with mild disease, statistically significant reductions in pocket probing depth, not originally apparent, were observed 3 years later. PMID- 3540027 TI - Modes of application of anti-plaque chemicals. AB - Because interdental and subgingival sites are relatively inaccessible to mouthrinsing, they necessitate alternative methods of application of anti-plaque chemicals. These include routine oral hygiene aids, surfactants to enhance uptake and retention of antimicrobials, gels and periodontal dressings. The principal modes of application that have received attention recently, apart from the systemic route, are syringe and pulsated jet irrigation and slow release compounds. Slow release devices currently receiving attention may be classified as membrane diffusion, solution of drug in polymer and solid drug dispersed in polymer matrix. The most widespread dental instance of a slow release device appears to be the use of varnishes and resins to carry fluoride. Recent attempts at devising improved methods of antimicrobial application include the testing of materials for their biodegradability or for their potential to adhere to mucosal surfaces. It is concluded that the potential exists for antimicrobials applied directly to the site of intended action to contribute significantly to dental health, particularly when employed as components of practical oral hygiene regimes. PMID- 3540026 TI - Chlorhexidine compared with other locally delivered antimicrobials. A short review. AB - Based on the association of bacterial plaque with the initiation of chronic gingivitis and progression of chronic periodontitis, chemical antiplaque agents have been employed both in prevention of periodontal disease and its treatment. In supragingival plaque control regimens, chlorhexidine has not been superceded as a chemical anti-plaque agent, although other compounds have been shown to be useful. The local side-effects of chlorhexidine and other cationic antiseptics, however, limit their long-term use for prevention. Extrinsic tooth staining in particular remains the greatest problem. Short-term anti-plaque uses for chlorhexidine include as an adjunct to mechanical cleaning in the initial oral hygiene phase of treatment, in situations where mechanical oral hygiene is difficult, including postsurgery, intermaxillary fixation, fixed orthodontic therapy, physically and mentally handicapped individuals, systemic diseases with oral manifestations such as leukaemia. More recent interest in chlorhexidine has resulted from the delivery of compounds subgingivally in the treatment of chronic periodontitis. Such methods have extended the use of chlorhexidine into areas inaccessible to the action of antimicrobial drugs delivered locally by conventional means, such as tooth brushing or mouth rinsing. Available evidence suggests that chlorhexidine may not be as effective as some antimicrobial drugs whose activity is more specific for those organisms considered particularly pathogenic to the periodontal tissues. PMID- 3540028 TI - Chemotherapy in juvenile periodontitis. AB - Juvenile periodontitis has been described as a separate entity among the human periodontal diseases. Several forms of the disease based on the number and types of involved teeth as well as the age of the patient have been reported. The present review deals with the "classical" localized juvenile periodontitis (LJP). The etiology of LJP has been explained according to 3 theories: (1) a genetic (hereditary) defect in the host defense mechanism; (2) a specific infection; (3) a combination of 1 and 2. In all 3 alternatives, bacterial infection is the direct cause of the breakdown of the tissues. This is supported by reports of success following therapy aimed at eliminating the microbial challenge. Arguments favoring the use of chemotherapeutic agents as an adjunct to mechanical debridement, or instead of it, as well as arguments against such use are discussed. The conclusion seems to be dependent on which of the 3 theories of etiology the arguments are related to. If antibiotics are to be used, the choice of drug would depend on the sensitivity of the suspected pathogen(s). At present tetracycline seems to be the one suggested by most authors, but routine use of antibiotics in the treatment of LJP does not seem necessary and is not recommended. PMID- 3540029 TI - A decade of developments in diuretic drug therapy. AB - New diuretics introduced into clinical medicine during the past decade include potent new loop diuretics such as bumetanide and piretanide, the uricosuric indanyloxyacetic acid derivative indacrinone, and a new generation of sulfamoyl diuretics such as indapamide and xipamide, which are recommended primarily for the treatment of hypertension. Pharmacokinetic studies of individual diuretics have demonstrated that the diuretic and natriuretic responses to the newer agents generally follow the plasma drug concentration-time curves and urinary drug excretion rates. Therapeutic monitoring can therefore be achieved in most patients with edema or hypertension by close clinical observation and laboratory analysis of plasma electrolyte and creatinine concentrations and urinary electrolyte excretion rates. Interest in the mechanisms involved in the renal and extrarenal vascular actions of the newer diuretics has led to a better understanding of how changes in venous compliance, peripheral vascular resistance, and renal blood flow distribution may contribute to the overall therapeutic response to these agents, especially in patients with severe congestive heart failure, renal insufficiency with low glomerular filtration rates, and hypertension with cardiorenal complications. Adverse reactions to modern diuretics, which are mainly an extension of their renal pharmacodynamic effects, have proved to be minimal, provided that the dosage is adjusted to meet but not exceed individual patient requirements. However, the long-term consequences of prolonged periods of diuretic-induced alterations in plasma potassium levels, and metabolic effects that include elevated blood lipids, are still under investigation. PMID- 3540030 TI - Cyclosporine absorption following orthotopic liver transplantation. AB - Blood concentrations of cyclosporine were determined in adult and pediatric patients following orthotopic liver transplantation to quantitate cyclosporine blood clearance and oral absorption. Seventeen bioavailability studies were performed following transplantation surgery in nine children and seven adults. The intravenous cyclosporine study was performed following an average dose of 2.1 mg/kg. The patients were again studied when they received the same intravenous dose plus an oral dose of cyclosporine of 8.6 mg/kg or an oral dose alone. Blood samples were collected and analyzed for cyclosporine using high-performance liquid chromatography. Cyclosporine blood clearance ranged from 29 to 203 mL/min (1.9-21.5 mL/min/kg) in children and from 253 to 680 mL/min (3.2-7.6 mL/min/kg) in adults. The mean cyclosporine clearance value was 9.3 mL/min/kg in the pediatric patients and 5.5 mL/min/kg in the adults. Cyclosporine bioavailability was less than 5% in six studies on five pediatric patients in the immediate postoperative period. The bioavailability varied from 8% to 60% in adult liver transplant patients (mean, 27%). We conclude that: cyclosporine clearance is highly variable between patients, pediatric patients clear the drug more rapidly than adults and therefore need a higher cyclosporine dose on a body weight basis, cyclosporine is poorly and variably absorbed in liver transplant patients, and cyclosporine blood concentration monitoring is essential following orthotopic liver transplantation. PMID- 3540031 TI - Renal cyclosporine clearance in marrow transplant recipients: age-related variation. AB - Cyclosporine is extensively metabolized in the liver and is subject to biliary elimination. Although only a small amount of the drug is eliminated unchanged in the urine, urine concentrations of the drug are much higher than blood or serum concentrations known to be associated with renal toxicity. Renal clearance (CL) of cyclosporine may be a sensitive correlate of nephrotoxicity, but renal CL studies of cyclosporine have not been reported in transplant patients. Therefore, we studied the renal CL of cyclosporine in 21 patients (median age, 27 yr) with hematologic malignancies undergoing allogeneic bone marrow transplantation. All patients received cyclosporine for prophylaxis or treatment of acute graft vs host disease. At the time of the study, all patients had normal renal function, as determined by serum creatinine concentration. Urine and serum cyclosporine concentrations were measured by high-performance liquid chromatography. Renal cyclosporine CL in different patients ranged from 1.8 to 79.8 mL/min. However, serial renal CL studies performed one week apart in two patients showed minimal intrapatient variability. Patients 25 years old or younger had a higher mean renal cyclosporine CL (39.7 mL/min) than older patients (17.9 mL/min) (P less than .05). These data show that renal cyclosporine CL is related to age and that renal CL in marrow transplant recipients is higher than the reported mean value in non-marrow-transplant patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540032 TI - A multiple-dose comparison of ketorolac tromethamine with diflunisal and placebo in postmeniscectomy pain. AB - The efficacy of oral ketorolac 5 mg and 10 mg taken qid was compared in a randomized double-blind study with that of oral diflunisal 500 mg bid (interleaved with placebo twice daily) and of placebo, in 120 patients suffering at least moderate pain following meniscectomy. The trial comprised two phases: (1) an acute phase (the first postoperative day) and (2) a chronic phase (days 2 5 postoperatively). Acutely, pain was assessed before drug administration, and then 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, and 9.0 hours after the first dose. The second of the four daily doses was administered at four hours after the first dose. During the chronic phase, pain was assessed using visual analogue scales at 8 AM and 4 PM daily. The acute phase results show that all the active treatments were statistically significantly superior to placebo but were not distinguished from each other. Over the chronic phase, ketorolac 5 mg and placebo showed similar results, with diflunisal showing the least pain relief and ketorolac 10 mg the most. All the active treatments showed a low incidence of side effects and, in an overall evaluation, no one treatment was distinguishable. Ketorolac would seem to be an acceptable therapy for acute postoperative pain. PMID- 3540033 TI - A double-blind, parallel comparison of ketoprofen, aspirin, and placebo in patients with postpartum pain. AB - Our purpose was to evaluate the analgesic efficacy of single oral doses of ketoprofen 25, 50, and 100 mg compared with aspirin 650 mg and placebo in the relief of moderate to severe postepisiotomy, uterine cramping, or cesarean section pain. One hundred and fifty-six patients participated in a randomized, double-blind, stratified, parallel-group study. They were observed over a six hour period by one nurse-observer. Several of the standard summary measures of analgesia were derived from the interview data, including the sum of pain intensity differences (SPID) and the sum of the hourly relief values (TOTAL). The study showed significant differences between aspirin and placebo for four-hour SPID and several other parameters and between ketoprofen at all dose levels and placebo for the four- and six-hour SPID and many other parameters. The two higher doses of ketoprofen were significantly more effective than aspirin as as assessed by the four- and six-hour SPID, TOTAL, and other summary measures. The low dose of ketoprofen, although not significantly different from aspirin for SPID and TOTAL, showed a significantly faster onset of relief and had a better global rating. This study suggests that 50 mg of ketoprofen may be the clinical dose of choice as an analgesic. There were no adverse effects reported. PMID- 3540034 TI - The shrinking autonomy of the practicing physician and its impact on quality. PMID- 3540035 TI - The distribution of dopamine immunoreactivity in the forebrain and midbrain of the lizard Gekko gecko: an immunohistochemical study with antibodies against dopamine. AB - The distribution of dopamine (DA) immunoreactivity in the forebrain and the midbrain of the lizard Gekko gecko was studied by using recently developed antibodies against DA. Dopamine-containing cells were found around the glomeruli of the olfactory bulb, in several parts of the periventricular hypothalamic nucleus, in the periventricular organ, the ependymal wall of the infundibular recess, the lateral hypothalamic area and the pretectal posterodorsal nucleus of the diencephalon, and in the ventral tegmental area, the substantia nigra, and the presumed reptilian equivalent of the mammalian A8 cell group of the mesencephalon. Dopaminergic fibers and terminals were observed throughout the whole brain, but particularly in the diencephalon and the telencephalon. The nucleus accumbens appears to have the most dense innervation, but also the striatum, amygdaloid complex, olfactory tubercle, septum, and dorsal ventricular ridge (especially its superficial zone) show numerous DA-containing fibers and terminals. Except for the lateral cortex, cortical areas are not densely innervated by DA fibers. In several respects DA distribution in the gekkonid brain differs from that in other reptiles studied. For instance, in the Gekko the dorsal ventricular ridge is densely innervated by DA fibers, whereas in turtles and crocodiles the same structure shows only weak catecholaminergic histofluorescence. When compared to the distribution of DA immunoreactivity in mammals, it appears that the DA system in the gekkonid telencephalon resembles the distribution of DA in the limbic forebrain and striatum of mammals. Whether these similarities in distribution of DA also imply similarities in function will be discussed. PMID- 3540036 TI - Immunohistochemical study on the development of serotoninergic neurons in the chick: I. Distribution of cell bodies and fibers in the brain. AB - The ontogenetic development of the serotoninergic system in the embryonic as well as in posthatching chick brain was studied with an indirect immunohistochemical technique with the aid of a specific antibody to serotonin (5-hydroxytryptamine). By embryonic day 4, rostral and caudal groups of serotonin-immunoreactive cell populations appeared in the mesencephalon and rostral and caudal rhombencephalon. At this stage, the rostral group had a considerable number of labelled cells that sent axons toward more rostral parts of brain, whereas the caudal group consisted of a small number of scattered serotonin-immunoreactive cells. The number of serotonin-positive cells increased with development, such that by embryonic day 8 almost all the serotoninergic cell groups found in the adult chick were already present. Serotoninergic-positive cells appeared in the paraventricular organ of the diencephalon as early as embryonic day 10. Judging from the cytoarchitectural organization of serotonin-immunoreactive cells, all of the serotoninergic cell groups in the chick brain seemed to be fully developed by embryonic day 16. On embryonic day 4, serotonin-immunoreactive fibers were found to enter into the marginal layer of the mesencephalon. Subsequently, serotonin-positive fibers ascended in the marginal layer of the brainstem up to the levels of the diencephalon and to the telencephalon on embryonic day 6 and 8, respectively. Serotonin-positive fibers, which first began to penetrate into the mantle layer on embryonic day 8, reached to the rostral pole of the telencephalon by embryonic day 10. In general, serotonin fibers were found in almost all brain regions by embryonic day 16. However, "terminal formation" in some nuclei did not seem to begin until the late embryonic or posthatching period. These observations indicate that the initial development of serotoninergic cell groups occurs during the first half of the 20th day of the incubation period of the chick. However, a longer time, ranging from early embryonic to posthatching stages, is necessary for the complete development of the serotoninergic projections. PMID- 3540037 TI - Immunohistochemical study on the development of serotoninergic neurons in the chick: II. Distribution of cell bodies and fibers in the spinal cord. AB - Developmental changes of serotonin (5-hydroxytryptamine) neurons and fibers in the spinal cord of the embryo and posthatching chick were studied with immunohistochemical techniques with the aid of an antibody against serotonin. The first serotonin-immunoreactive fibers were found in the marginal layer of the cervical and lumbar spinal cord on embryonic days 6 and 8, respectively. There was a time lag of a few days between the first appearance of serotonin fibers in the marginal layer (embryonic days 6-8) and the time of penetration of serotonin fibers into the mantle layer (embryonic day 8 or older). The developments of serotonin innervation in the rostral parts of the spinal cord precedes that of caudal regions. Serotonin fibers penetrating into the mantle layer of the lumbar spinal cord were first found in lamina VII on embryonic day 8, whereas there were no serotonin-immunoreactive fibers in lamina IX by embryonic day 10. Large differences were found between embryonic day 16 and posthatching day 5 with regard to the density of serotonin varicosities and fibers in lamina IX, where profiles of soma and large-sized dendrites were heavily covered with varicosities. Laminae I and II first received serotonin fibers on embryonic day 16 and had a much denser innervation by posthatching day 5. There were no traces of serotonin fibers in lamina III in the stages examined up to posthatching day 5. Serotonin fibers were located in the lateral and ventral marginal layers in all specimens examined; only a few fibers were found in the dorsal marginal layer. Although few, serotonin-immunoreactive cell bodies were found in an area around the central canal of all animals from embryonic day 8 to adult. Some of these were located in the ependymal layer and sent processes toward the central canal; there were a small number of cells with long, fine processes. Serotonin immunoreactive fibers in the spinal cord were not altered in regions rostral to the spinal transection, whereas all the serotoninergic fibers of the supraspinal origin were eliminated in the spinal cord caudal to the gap. PMID- 3540038 TI - Transient midline raphe glial structure in the developing rat. AB - A major glial structure is present during development within the midline raphe of the midbrain, hindbrain, and cervical spinal cord of the rat. It is composed of great numbers of glial cell bodies lying immediately ventral to the cerebral ventricular system and the large radial processes extending from these cells toward the ventral surface of the brain roughly within the midsagittal plane. There is also a smaller group of glial cells on the dorsal surface of the aqueduct and the central canal whose processes extend to the dorsal surface of the brain. The entire structure exhibits an intensely positive immunoreactivity with the antibody to the S-100 protein, a nervous-system-specific protein found primarily in the cytoplasm of astrocytes. This immunoreactivity makes possible a clear visualization of the extent, magnitude, and continuity of this structure from at least embryonic day 15, the first age examined, until postnatal days 7-8, when it is no longer visible by this technique. This glial structure has several prominent morphological characteristics. During prenatal and early postnatal development the fibers forming the ventral aspect of the structure in the midbrain and hindbrain are formed into two parallel plates on either side of the midline with S-100-negative tissue between the plates. As development progresses, S-100-positive fibers are continually added so that the plates become thicker at the expense of the nonstaining intervening area. By postnatal day 4 only a single midline plate of fibers is visible, occupying the entire midline raphe. In the region of the pontine flexure the entire structure takes on a distinctly pleated configuration. This fact produces a curious "sine wave" appearance when the plane of section crosses these vertical pleats. At postnatal day 5 the structure begins to disappear, and it is no longer visible by 7-8 days postnatal. This glial structure does not stain with antisera to glial fibrillary acidic protein, a protein associated with fibrous astrocytes, or routine cell stains such as cresyl violet. With these techniques the raphe area appears essentially devoid of identifiable cellular elements. PMID- 3540039 TI - Immunohistochemical identification of noradrenaline- and adrenaline- synthesizing neurons in the cat ventrolateral medulla. AB - The distribution and morphology of cell bodies containing the catecholamine biosynthetic enzymes dopamine-beta-hydroxylase (DBH) and phenylethanolamine N methyltransferase (PNMT) in the ventrolateral medulla (VLM) of the cat were studied immunohistochemically after intracisternal administration of colchicine. Perikarya immunoreactive to DBH were found throughout the VLM extending from approximately the spinomedullary junction to the level of the superior olivary nucleus. In the caudal VLM DBH neurons were found primarily in the region immediately dorsal to the lateral reticular nucleus (LRN), although a few scattered DBH neurons were also found near the ventral surface of the medulla in and around the parvicellular division of the LRN. These DBH neurons in the caudal VLM were generally fusiform, fusiform-bipolar, or multipolar, with a mean somal area of 422 +/- 32 microns2, and with two to four branching processes. In the rostral VLM DBH neurons formed three distinct groups: one group was found in the nucleus paragigantocellularis lateralis in the region just ventromedial to the retrofacial nucleus (RFN) near the ventrolateral surface of the medulla; the second group was found in the region dorsomedial to the rostral aspects of the nucleus ambiguous and the RFN, and the third group was found in the region along the lateral aspect of the superior olivary nucleus. Perikarya immunoreactive to the adrenaline-synthesizing enzyme PNMT were localized to a more restricted region of the VLM that extended from approximately the rostral aspect of the caudal third of the inferior olivary complex (level of the obex) to the caudal pole of the facial nucleus. These PNMT neurons were fusiform or multipolar with a mean somal area of 273 +/- 21 microns2, and with two to five branching processes. The location, size, shape, and numbers of PNMT-immunoreactive neurons corresponded closely to the rostral groups of DBH neurons, with the exception of the group found along the lateral aspect of the superior olivary nucleus. These data indicate that noradrenaline-synthesizing neurons are primarily found in the caudal VLM and in the region near the superior olivary nucleus, whereas catecholamine neurons in the rostral VLM between these two noradrenergic cell groups synthesize adrenaline. As the VLM has previously been shown to have direct connections with spinal cord, brainstem, and hypothalamic areas implicated in cardiovascular and neuroendocrine regulation, this suggests that DBH- and PNMT synthesizing neurons are components of neuronal circuits involved in these homeostatic mechanisms. PMID- 3540040 TI - A cholinergic projection to the rat superior colliculus demonstrated by retrograde transport of horseradish peroxidase and choline acetyltransferase immunohistochemistry. AB - Acetylcholinesterase (AChE) has been localized by histochemistry in the superior colliculus and in the tegmentum of the caudal midbrain and rostral pons of the rat. The pattern of AChE localization in the superior colliculus was characterized by homogeneous staining in the superficial layers and patchlike staining in the intermediate gray layer. In the tegmentum, AChE was localized in the pedunculopontine nucleus (PPN), beginning rostrally at the caudal pole of the substantia nigra and extending caudally to the level of the parabrachial nuclei, and in the lateral dorsal tegmental nucleus (LDTN) of the central gray. The localization of AChE in these nuclei overlapped the distribution of neurons stained by immunohistochemistry using an antibody to choline acetyltransferase (ChAT), the synthesizing enzyme of the neurotransmitter acetylcholine. Other neighboring areas that were stained with AChE, but that did not contain ChAT immunoreactive neurons, included the microcellular tegmental nucleus and the ventral tegmental nucleus. Neurons in the PPN and LDTN were determined to be potential sources of the cholinergic projection to the intermediate gray layer of the rat superior colliculus by double labelling with retrograde transport of horseradish peroxidase (HRP) combined with the immunohistochemical localization of ChAT. Three populations of neurons were identified. A predominantly ipsilateral ChAT-immunoreactive population was located in the pars compacta subdivision of PPN (PPNpc). Retrograde HRP-labelled neurons in the pars dissipata subdivision of the PPN (PPNpd), located ventral to the superior cerebellar peduncle (SCP) at the level of the inferior colliculus, composed a second population that was predominantly contralateral but was not ChAT immunoreactive. A third population of retrogradely labelled neurons was predominantly ipsilateral and ChAT immunoreactive and was located in the LDTN. These findings compared favorably with the full extent of the projection from this tegmental region revealed by retrograde transport of HRP from the superior colliculus when more compatible fixation and chromogen procedures were used. The results suggest that the PPN and the LDTN are two sources of the cholinergic input to the superior colliculus. Since the PPN also has extensive efferent, and afferent, connections with basal-ganglia-related structures, this cholinergic excitatory input to the superior colliculus, like the GABA-ergic inhibitory input from the substantia nigra pars reticulata, may provide the basis for an additional influence of the basal ganglia on visuomotor behavior. PMID- 3540041 TI - Localization of gamma-aminobutyric acid (GABA) in type 3 cells and demonstration of their source to F2 terminals in the cat lateral geniculate nucleus: a Golgi electron-microscopic GABA-immunocytochemical study. AB - Postembedding immunocytochemistry with a gamma-aminobutyric acid (GABA) antiserum was done on semithin sections of cat lateral geniculate nucleus (LGN) previously processed with the rapid-Golgi and gold-toning procedures, to determine which of the three main morphological types (1, 2,3) of neurons in the A-laminae show immunoreactivity and are, therefore, presumably GABAergic. Only type 3 cells were found to be GABA positive. These cells were characterized by small somata and few, scarcely branched dendrites bearing almost exclusively appendages with long slender stalks. Some of these cells have extensive filiform "axonlike" processes originating from different regions of dendrites and having appendages similar to those originating directly from dendrites. Many of these Golgi gold-toned impregnated dendritic appendages of type 3 cells were analyzed in the electron microscope and were identified as typical F2 terminals by their content of pleomorphic synaptic vesicles; by being postsynaptic to retinal (RLP), cortical (RSD), and perigeniculate (F1) terminals; and by being presynaptic to dendrites. In addition, since it was previously demonstrated that glutamic acid decarboxylase (GAD) and GABA-positive cells are not retrogradely labeled with horseradish peroxidase (HRP) from the visual cortex, the present results, by showing that GABA-positive cells have type 3 morphology, provide supporting evidence for the interneuronal nature of type 3 cells in cat LGN. PMID- 3540042 TI - Olivocochlear neurons in the squirrel monkey brainstem. AB - Centrifugal projections from the brain to the cochlea have been well described in rodents and cats. In order to gain a better understanding of the general mammalian features of this efferent projection system--the olivocochlear (OC) system--we have begun to extend its description to other mammalian orders, particularly primates. This report describes the origin, cellular morphology, and cholinergic nature of OC neurons in squirrel monkey. Olivocochlear neurons were identified after cochlear injection and subsequent retrograde transport of one of the tracers, horseradish peroxidase, True Blue, or Diamidino Yellow. One series of sections was processed to demonstrate the tracer and an adjacent series was processed to demonstrate acetylcholinesterase (AChE). In some cases, a series of sections was immunohistochemically processed to identify the presence of choline acetyltransferase (CAT), the synthesizing enzyme for acetylcholine. Approximately 1,700-1,800 OC neurons were contained in five distinct regions surrounding the major nuclei of the superior olivary complex (SOC), namely: dorsal to medial superior olive (MSO); between MSO and lateral superior olive (LSO); lateral to LSO; medial to SOC; and in the ventral nucleus of the trapezoid body (VTB). These neurons were larger in the regions dorsal to MSO, lateral to LSO, and within VTB; they tended to be smaller in the regions between MSO and LSO and medial to SOC. Neuronal shapes varied among regions and included oval, elongate, round, and multipolar cells. In further support of their cholinergic nature as implied by AChE reactivity, OC neurons also stained positively for the cholinergic marker, CAT. PMID- 3540043 TI - Distribution of noradrenaline in the brain of the teleost Gasterosteus aculeatus L.: an immunohistochemical analysis. AB - The distribution of noradrenergic neurons in the brain of the three-spined stickleback was demonstrated with the indirect peroxidase-antiperoxidase (PAP) immunohistochemical method with antibodies against a noradrenaline-bovine serum albumin conjugate. Noradrenergic neuronal somata were exclusively located in the isthmal area of the brain stem and in the lower medulla. Noradrenergic varicose axons innervate the reticular formation, motor nuclei, and interpeduncular nucleus of the brain stem, the hypothalamus and habenular nuclei, various parts of the area dorsalis telencephali (forebrain pallium), and the olfactory bulbs. Scattered noradrenergic axons were observed in the optic tectum and in various parts of the cerebellum. It is concluded that the isthmal cell group of the stickleback is, on topological and cytoarchitectonic grounds, equivalent to the ventral portion of the locus coeruleus/subcoeruleus area of amniotes, but that its efferent connections display features characteristic both of those originating in the locus coeruleus, and in the lateral tegmental cell groups of mammals. PMID- 3540044 TI - Assessment of cognitive factors in chronic pain: a worthwhile enterprise? PMID- 3540045 TI - Bonding strengths of etched porcelain discs and three different bonding agents. AB - Forty porcelain disks were resin bonded to etched base metal surfaces to measure tensile bond strengths. One metal surface was bonded to each porcelain surface, making each test specimen "sandwiched", with a porcelain disk between two metal surfaces. The mean bond strength values of the Conclude group was 3017 +/- 869 psi. The mean for the Mar-Bond group was 3747 +/- 693 psi, and the mean for the two Chameleon groups combined was 3172 +/- 544 psi. No two groups were significantly different. PMID- 3540046 TI - Anterior space maintainer and regainer. PMID- 3540047 TI - Postdermabrasion leukoderma. AB - Three patients developed leukoderma following dermabrasion during an attempt to correct the scarring sustained after a thermal burn injury several years previously. Two of the patients were successfully repigmented with autologous minigrafting and epidermal suction grafts. PMID- 3540048 TI - Identification of basal cell carcinomas by means of monoclonal antibodies C50 and C241. AB - The monoclonal antibodies C50 and C241 with specificities for the carcinoma associated carbohydrate structures sialylated Lea and sialosyllactotetraose, respectively, were used in the indirect immunofluorescent test for demonstration of malignant cells in patients with basal cell carcinoma (BCC). Among a total of 36 patients with BCC, 33 were positive with the MAb C50, and 30 with the MAb C241. All of five patients with premalignant conditions were positive with both antibodies, whereas none of 31 control individuals (biopsies from normal skin or from patients with non-malignant conditions) showed a positive reaction. It is suggested that the technique described may provide a convenient tool for evaluation of samples obtained by microscopically controlled surgery of BCC as well as being an adjunct to conventional light microscopy in pathologic-anatomic diagnosis of potentially malignant disease of the skin. PMID- 3540050 TI - Survey of the prognosis for dermatomyositis, with special reference to its association with malignancy and pulmonary fibrosis. PMID- 3540049 TI - Pseudocyst of the auricle: compression suture therapy. AB - Pseudocyst of the auricle is an uncommon, asymptomatic swelling of the ear, resulting from an accumulation of fluid within an unlined intracartilaginous cavity. Numerous therapeutic approaches have been employed in the past with variable success. In this paper we utilized a procedure comprising aspiration of the cystic structure followed by compression with bolstered sutures, with complete resolution of the lesion. PMID- 3540051 TI - Maintenance of epidermal structures of psoriatic skin in organ culture. PMID- 3540052 TI - Interrelationship between biliary dyskinesia and chronic urticaria, chronic eczema and atopic dermatitis. PMID- 3540053 TI - Induction of pemphigoid lesions in neonatal mice. PMID- 3540054 TI - Increased C5a anaphylatoxin in the sera of psoriatic patients and patients with inflammatory dermatoses. PMID- 3540055 TI - A monocyte-aggregating factor in the sera of patients with sarcoidosis. PMID- 3540056 TI - Protein AL origin in amyloidosis cutis nodularis atrophicans. PMID- 3540058 TI - Domperidone-induced systemic lupus-like syndrome. PMID- 3540057 TI - Eccrine tubular adenoma--a histopathological, histochemical, and ultrastructural study. PMID- 3540060 TI - Common bile nevus of the upper lip--a possible relationship to Mongolian spot. PMID- 3540059 TI - Case of epidermodysplasia verruciformis within a 12-year-follow-up. PMID- 3540061 TI - Enzyme activities in cytoplasm, mitochondria and peroxisomes in dermatofibrosarcoma protuberans. PMID- 3540062 TI - Two autopsy cases of recessive dystrophic epidermolysis bullosa and an analysis of recorded cases in Japan. PMID- 3540064 TI - The doctor-nurse relationship: an historical perspective. AB - The purpose of this historical research was to explore the evolution of the doctor-nurse relationship. Specifically, older nurses were interviewed regarding their nursing interactions with physicians approximately 50 years ago. A grounded theory approach was employed to analyse the data. Inherent to the difficulties nurses experienced was the dominant power position assumed by doctors in the health profession. The data give added insights into the development of this relationship. It was found that because nurses were educated primarily by doctors and because they were hired by doctors if they were considered to be 'good' nurses, a sex role stereotype of the nurse emerged. Historically these roles have influenced and continued to influence the nursing profession. PMID- 3540063 TI - Nosocomial gram-negative pneumonia in critically ill patients. A 3-year experience with a novel therapeutic regimen. AB - The efficacy of selective decontamination of the oral cavity and GI-tract in the treatment of established gram-negative pneumonia in critically ill patients was evaluated in a prospective open trial. 25 patients with pneumonia caused by Enterobacteriaceae or Pseudomonadaceae were studied. All patients were mechanically ventilated (range 2-60 days). Non-absorbable antibiotics (polymyxin E 100 mg, tobramycin 80 mg, amphotericin B 500 mg) were administered through the nasogastric tube four times a day. The oral cavity was decontaminated with an ointment containing 2% of the same antibiotics, applied to the buccal mucosa four times a day. For systemic therapy a combination of tobramycin (3-6 mg X kg-1) with either cefotaxim (50-100 mg X kg-1) or ceftazidime (100 mg X kg-1) was given both intravenously and by aerosol (50% IV dose/5 ml saline) four times a day. Eradication of pathogens from the respiratory tract was achieved in 24 patients within 9 days (median 5 days). The cure rate was 96%. Two patients had a relapse. Neither recolonization with resistant organisms nor supra-infections were found for the remaining period of mechanical ventilation (up to 60 days), also after systemic/aerosol therapy had been discontinued. Only 3 patients died (12%). PMID- 3540065 TI - Impact of doctoral programs on nursing education. PMID- 3540066 TI - A treasury of dentistry. A causerie on scurvy. PMID- 3540068 TI - The Presidents. Percy Toumine Phillips 1958-1959. PMID- 3540067 TI - Four Fellows receive Gies Award. PMID- 3540069 TI - Dentistry on stamps (Mark Twain). PMID- 3540070 TI - Noninvasive evaluation of the effect of timolol on left ventricular performance after myocardial infarction and the consequence for prognosis. AB - Left ventricular performance was evaluated noninvasively in 111 patients participating at one study center in the Norwegian Multicenter Study on Timolol After Myocardial Infarction. Systolic time intervals were measured in 55 patients treated with timolol and in 56 patients receiving placebo. Measurements were made before randomization, and after 1, 3 and 12 months of treatment. During the treatment period, the pre-ejection period/left ventricular ejection time ratio was significantly lower in the timolol-treated group, indicating better left ventricular function than in the placebo-treated patients. In the 27 patients who died during the follow-up period of 50 to 72 months, there was a significant increase in the pre-ejection period/left ventricular ejection time ratio from baseline to the last performed recording, indicating a deterioration in left ventricular performance in these patients. No such change occurred in the group that survived the entire follow-up period. Deterioration of left ventricular function is related to a high long-term mortality rate after myocardial infarction, and left ventricular function is better preserved in patients treated with timolol than in patients receiving placebo. PMID- 3540071 TI - Acute non-Q wave myocardial infarction associated with early ST segment elevation: evidence for spontaneous coronary reperfusion and implications for thrombolytic trials. AB - The clinical significance of early ST segment elevation in patients with non-Q wave infarction is unknown. Therefore, 150 consecutive patients with creatine kinase isoenzyme-confirmed acute uncomplicated myocardial infarction who had ST segment elevation of 1 mm or more in at least two contiguous leads on the admission electrocardiogram were analyzed. None received thrombolytic therapy or acute coronary angioplasty. Predischarge angiography, radionuclide ventriculography and exercise thallium-201 scintigraphy were performed 10 +/- 3 days after myocardial infarction. Based on serial electrocardiograms (on days 1, 2, 3 and 10), all 150 infarcts were classified as Q wave (n = 115 [77%]) or non-Q wave (n = 35 [23%]). Although patients with Q wave infarction exhibited greater ST elevation, the amount observed in the non-Q wave group was appreciable, as reflected by the number of leads with ST elevation (3.8 +/- 1.8 versus 3.1 +/- 1.2, p = 0.007) and the sum of the ST elevation (9.6 +/- 7.4 versus 6.2 +/- 6.2 mm, p = 0.016). When compared with the Q wave group, patients with non-Q wave infarction had a shorter time to peak creatine kinase (23.0 +/- 9.1 versus 15.8 +/- 7.9 hours, p = 0.0001), a higher infarct vessel patency rate (24 versus 57%, p = 0.001), lower peak creatine kinase values based on 4 hour sampling (1,372 +/- 964 versus 664 +/- 924 IU/liter, p = 0.0002) and a higher left ventricular ejection fraction (46 +/- 12% versus 54 +/- 9%, p = 0.0003).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540072 TI - A prospective placebo-controlled double-blind multicenter trial of intravenous streptokinase in acute myocardial infarction (ISAM): long-term mortality and morbidity. AB - Long-term mortality and morbidity of 1,741 patients with acute myocardial infarction, treated with intravenous streptokinase (1.5 million IU/h) or placebo, was assessed in a double-blind placebo-controlled trial (ISAM). At the 7 month follow-up, 94 (10.9%) of the 859 patients in the streptokinase group and 98 (11.1%) of the 882 patients in the placebo group had died; at an average follow up of 21 months, 14.4% of the streptokinase group and 16.1% of the placebo group had died. The differences were not statistically significant. Long-term mortality was slightly higher in patients with anterior myocardial infarction and streptokinase treatment (20.1 versus 18.4%) and lower in patients with inferior myocardial infarction (10.2 versus 14.2%). Patients with previous myocardial infarction had a higher long-term mortality rate with streptokinase (34.9 versus 21.5% with placebo, p = 0.03). At 7 months, there were significantly more cases of reinfarction in the streptokinase group (7.2 versus 4.5%, p = 0.02). It is concluded that despite a significant limitation of infarct size by intravenous streptokinase, long-term mortality is only slightly reduced and reinfarction is significantly more frequent. Both findings suggest the need for complementary therapy such as revascularization procedures after thrombolysis. PMID- 3540073 TI - Use of ultrafast computed tomography to quantitate regional myocardial perfusion: a preliminary report. AB - The purpose of this study was to assess the potential for rapid acquisition computed axial tomography (Imatron C-100) to quantify regional myocardial perfusion. Myocardial and left ventricular cavity contrast clearance curves were constructed after injecting nonionic contrast (1 ml/kg over 2 to 3 seconds) into the inferior vena cava of six anesthetized, closed chest dogs (n = 14). Independent myocardial perfusion measurements were obtained by coincident injection of radiolabeled microspheres into the left atrium during control, intermediate and maximal myocardial vasodilation with adenosine (0.5 to 1.0 mg/kg per min, intravenously, respectively). At each flow state, 40 serial short-axis scans of the left ventricle were taken near end-diastole at the midpapillary muscle level. Contrast clearance curves were generated and analyzed from the left ventricular cavity and posterior papillary muscle regions after excluding contrast recirculation and minimizing partial volume effects. The area under the curve (gamma variate function) was determined for a region of interest placed within the left ventricular cavity. Characteristics of contrast clearance data from the posterior papillary muscle region that were evaluated included the peak myocardial opacification, area under the contrast clearance curve and a contrast clearance time defined by the full width/half maximal extent of the clearance curve. Myocardial perfusion (microspheres) ranged from 35 to 450 ml/100 g per min (mean 167 +/- 125). Two flow algorithms derived from characteristics of the contrast clearance curves showed a good correlation with regional myocardial flow determined by microspheres: the ratio of the peak myocardial opacification from baseline to the area under the left ventricular cavity curve (r = 0.7, p less than 0.001, SEE = 44.4 ml/min), and the ratio of the left ventricular cavity to posterior papillary muscle curve areas divided by the full width/half maximal contrast transit time in the region of the posterior papillary muscle (r = 0.82, p less than 0.001, SEE = 52.2 ml/100 g per min). The form of these two flow algorithms was derived from classical indicator dilution theory. In conclusion, indices derived from these data correlated well with regional myocardial perfusion in the posterior papillary muscle region of the dog as assessed by microspheres. This approach offers promise for the quantitation of regional myocardial perfusion and myocardial flow reserve in patients. PMID- 3540074 TI - Relationship between stimulant effect, electroencephalogram, and clinical neurological findings in hyperactive children. PMID- 3540075 TI - Promethazine treatment of children with Attention Deficit Disorder with Hyperactivity--ineffective and unpleasant. PMID- 3540076 TI - Self blood glucose monitoring: an adjunct to dietary and insulin management of the patient with diabetes. AB - The primary goal of diabetes management is to maintain blood glucose as near to normal as possible. Composition, size, and spacing of meals and snacks all have a substantial impact on blood glucose fluctuations and can be altered to improve glycemic control. Recent research studies focusing on the blood glucose response of various carbohydrate containing foods have found that responses vary considerably. Because the glucose response is influenced by numerous factors, it is difficult to predict how specific individuals will respond to a particular food. A technique known as self-blood glucose monitoring can be used by patients with diabetes to quantitate their own postprandial glucose rise from various foods. The technique itself is portable and relatively simple and is an accurate means of obtaining blood glucose values without using a clinical laboratory. Self blood testing provides the patient with immediate feedback on the impact of dietary manipulation. Blood glucose records can be used in conjunction with diet records to make adjustments in the type and amount of food or insulin dose that would elicit the best glycemic response. The dietitian thus plays an integral role in identifying patterns in the blood glucose profile and assisting the patient in making intelligent dietary choices to improve diabetes control. PMID- 3540077 TI - Age-related changes in carcinogen metabolism. PMID- 3540078 TI - The immunofluorescence localization of glutamate decarboxylase in the rat superior cervical ganglion. AB - The immunofluorescence localization of glutamate decarboxylase (GAD, EC 4.1.1.15) has been determined in the superior cervical ganglion of the rat. Immunoreactivity was confined to clusters of small cells whose size is similar to that of the dopaminergic small intensely fluorescent (SIF) cells. In serial sections tested for GAD immunofluorescence and catecholamine histofluorescence there was no evidence of co-localization. These results suggest that a separate population of gamma-aminobutyric acid (GABA) synthesizing cells is present in the rat superior cervical ganglion. PMID- 3540079 TI - Impaired insulin response to glucose but not to arginine in heroin addicts. AB - Plasma glucose, insulin, glucagon and growth hormone responses to both oral glucose and iv arginine were evaluated in 15 heroin addicts and 15 control subjects matched for age, sex and weight. The heroin users had an exaggerated rise in plasma glucose concentrations following oral sugar, which persisted until the end of the study (102 +/- 5 mg/dl in addicts vs 72 +/- 3 mg/dl in controls at 240 min, p less than 0.01) and significantly lower insulin responses (insulin peak 28 +/- 4 microU/ml in addicts vs 67 +/- 8 microU/ml in controls, p less than 0.01). The inhibitory effect of glucose on glucagon concentrations was less evident in addicts than in controls. The responses of plasma glucose, insulin and glucagon to arginine were not significantly different between addicts and controls, while the growth hormone rise was significantly greater in addicts. These results demonstrate that heroin users have impaired insulin secretion to oral glucose but not to arginine and suggest that: the impaired insulin secretion in heroin addicts is not dependent on beta-cell exhaustion, and a selective inhibition of glucose-induced insulin secretion is operative in these subjects, as it happens in patients with noninsulin-dependent diabetes mellitus. PMID- 3540080 TI - Further evidence that insulin metabolism is a major determinant of peripheral insulin response to oral glucose in subjects with mild glucose intolerance. AB - In mild glucose intolerance plasma concentration of C-peptide seems to give an estimate of pancreatic B cell secretion more reliable than plasma insulin itself. In the present study we measured the plasma levels of insulin and C-peptide after oral glucose load in 100 mildly glucose intolerant subjects, focusing our attention on high and low insulin responders. According to an insulin incremental area after oral glucose higher or lower than the mean +/- SD of the mean, 16 subjects were classified as "high insulin responders", and 17 as "low insulin responders". The two groups were similar for sex, age and bw. Mean insulin incremental area was almost 9-fold greater in high insulin responders than in low insulin responders (0.88 +/- 0.03 vs 0.10 +/- 0.01 pmol/ml min, p less than 0.001). Also mean C-peptide incremental area was significantly greater in high insulin responders than in low insulin responders, but the differences between the two groups were smaller. Indeed, mean C-peptide area was approximately 2.5 fold greater in high insulin responders than in low insulin responders (1.58 +/- 0.12 vs 0.66 +/- 0.07 pmol/ml min, p less than 0.001). These results give further support to the concept that in mild glucose intolerance insulin metabolism is a major determinant of peripheral insulin response to oral glucose load. PMID- 3540081 TI - Effect of domperidone on the release of insulin after intravenous glucose load in man. AB - To determine whether the blockade of the dopaminergic system is capable of modifying glucose-induced insulin release in man, the responses of insulin to an iv glucose load were measured at various domperidone infusion rates. The infusion of 5 micrograms/kg/min of domperidone increased significantly plasma insulin levels during the acute phase of glucose-induced insulin release and lowered plasma glucose values at 50 and 60 min; the k of glucose disappearance improved significantly. At lower domperidone infusion rates the acute increment of insulin after glucose load was indistinguishable from the response observed at 5 micrograms/kg/min until 0.5 microgram/kg/min, while similar responses in control and experimental tests were observed at 0.25 microgram/kg/min. A group of subjects was submitted to an arginine load in order to establish whether the effect observed with domperidone was specific for the glucose-induced insulin release; but, this time, we did not observe any significant effect during the domperidone-induced dopaminergic blockade. Furthermore, we also measured the plasma prolactin levels, to see whether the specific and well known effect of domperidone on prolactin release matches with the effect on beta-cell function. As far as prolactin is concerned, we observed a dose response effect of domperidone infusion, with a detectable elevation of prolactin at infusion rate of 0.25 microgram/kg/min. Since domperidone is a specific antagonist of dopamine D2-receptors, we propose that dopamine might exert a specific inhibiting effect on glucose-induced insulin release through this class of dopamine receptors. PMID- 3540083 TI - Human growth hormone treatment and Creutzfeldt-Jakob disease. PMID- 3540084 TI - Exercise training of men at retirement: a clinical trial. AB - The effects of one year of exercise training on cardiorespiratory fitness, levels of daily leisure activity, and blood lipids (cholesterol and high density lipoproteins) were studied in a prospective, randomized clinical trial. Two hundred and twenty-four men aged 55 to 65 years volunteered for the study and were randomly allocated to a control (n = 111) or an activity (n = 113) group with stratification on blue or white collar job classification. After the attrition due to loss to follow-up, 100 men remained in each of the control and activity groups. The exercising men met an average of 2.5 times per week over the year and their VO2 max or peak VO2 (ml X kg-1 X min-1) increased significantly (p = .001, 11%) compared with controls. There were no significant changes in maximal heart rate (155 bpm) and respiratory exchange ratio (1.1), although ventilation (80 to 90 l X min-1) increased significantly in the trained group. In addition, the VO2 at a heart rate of 125 bpm increased significantly (p less than .001) in the trained group (14.7%) over that observed in the control (1.9%). There were no significant differences between the groups with respect to the remaining end points. PMID- 3540085 TI - The role of bacterial adherence in urinary tract infections in elderly adults. AB - In an attempt to clarify host factors responsible for the acquisition of bacteriuria in elderly adults, bacterial adherence to uroepithelial cells obtained from 83 elderly participants and 40 young controls was studied. Seven uropathogenic strains of E. coli expressing different adhesions were used. Bacteria adhered significantly better to cells of young women than young men (p less than .0001) and elderly women than elderly men (p less than .03). The greatest adherence was in young women and the least in young men. In women without bacteriuria, aging was not associated with increased susceptibility to bacterial attachment. Moreover, there was no increase in the adherence of E. coil strains to uroepithelial cells of bacteriuric elderly women in comparison to abacteriuric elderly women. In men, however, aging was associated with increased bacterial adherence (p less than .02). Susceptibility to bacterial adherence does not appear to be responsible for the increased frequency of E. coli bacteriuria in elderly women but may be a permissive factor in elderly men. PMID- 3540082 TI - New concepts in the regulation of hypothalamic gonadotropin releasing hormone (GnRH) secretion. PMID- 3540086 TI - [Tubal physiology: structures and functions]. AB - The three structures of the Fallopian tubes that are involved in the initial steps in reproduction have been studied as well as the influence that the hormone environment has on each one of them. They are, the epithelium, the intra-luminal fluid and the musculature. The so-called cyclical process of "ciliation and deciliation" of ciliated cells has not been clearly shown. Although the number of ciliated cells does play a definite role in fertility, it seems that coordinated ciliary motility is not absolutely indispensable. Anions at the ends of the cilia do have a role. Tubal muscle function is conditioned by several factors, some of which work together: steroids: when the oestrogen phase is dominant, electrical activity of the muscle is better coordinated and it moves more frequently and with synchronous mechanical activity; prostaglandins: PGF2 alpha produces a stimulating action on tubal muscle segments. The results as far as PGE2 and PGI2 are contradictory; tubal innervation is mainly sympathetic and prodominates at the isthmo-ampullary junction. There are still many unknown factors concerning the role of the tubal structures in human female reproduction: active transport of spermatozoa has not been worked out properly; tubal fluid seems to play a role in survival, capacitation and in the acrosome reaction of spermatozoa; the anionic sites that are present at the ends of the cilia could play an important role in oocyte pick-up; the cilia, the flow of fluid in the lumen and muscular peristalsis do influence ampullary transport of the oocyte; tubal fluid is not indispensable for fertilisation; the migration of the oocyte across the isthmus does seem to be under hormonal influence. PMID- 3540087 TI - [Recording of fetal movements during pregnancy. Aid to the diagnosis and prognosis ascertained by Tococinon]. AB - Objective recording of fetal movements has become operational since the use of the tococinon. At the beginning of pregnancy, from the twelfth week of amenorrhoea onwards, aberrant values seem to be linked to several factors such as mother's anxiety, urinary infection and anesthesia. If they are repeated that suggests there are abnormalities, such as trisomies or malformations in the central nervous system, and implies that other diagnostic methods must be used to make the diagnosis such as ultrasound or amniocentesis. A new definition for lowered activity by the fetus is proposed for the end of pregnancy. If these recordings are repeated before or at the same time as other signs of fetal distress have been found we must think of pathological features such as intrauterine growth retardation, post-maturity, infections, rhesus incompatibility and diabetes. Pharmacological influences, too, have to be thought of and they are usually correlated with rises in the fetal pulse rate and with using the apparatus when the patient is walking about. PMID- 3540088 TI - Promotion of tobacco products: issues and policy options. AB - During the past year, several prominent voluntary health organizations and professional medical associations have called for a ban on all forms of promotion of tobacco products. The proposal raises complex issues, ranging from determination of the effects of tobacco promotion to assessment of the constitutionality of banning advertising of a legal product. We identify the issues that underlie the concern of health professionals, review evidence addressing these issues, and describe and discuss frequently mentioned policy options, especially the ban proposal. PMID- 3540089 TI - A proposal to regulate the manner of tobacco advertising. AB - If the U.S. is to achieve the goal of reducing the initiation of smoking among adolescents, it must implement a system of tobacco advertising regulation as one component of a comprehensive prevention program. This paper proposes a system of advertising regulation which is grounded in the relevant legal, information processing, and media effects theories. PMID- 3540090 TI - Antishock trousers: a collective review. AB - Antishock trousers have become an integral part of emergency medical care for many traumatic and life-threatening emergencies. This article represents a summary of the current state of knowledge concerning the use of this device. A brief history of the development of antishock garments is discussed. This is followed by a discussion of human clinical studies and results of clinical research on hemodynamics, respiration, use in head injury, and effects on vascular hemostasis. Indications, contraindications, complications, and recommended procedure for use are discussed. Based on randomized prospective studies, antishock garments have not, as yet, been shown to improve patient morbidity or mortality. Proper use of antishock garments requires an understanding of both their function and their limitations. PMID- 3540091 TI - JF Pantridge: starting hearts out of hospital. PMID- 3540092 TI - History and emergency medicine. PMID- 3540093 TI - Metered-dose aerosolized bronchodilators in prehospital care: a feasibility study. AB - The prehospital use of aerosolized bronchodilators was studied in 50 adult patients with bronchospasm. The specific beta 2-agonist, albuterol, was discharged from a metered-dose inhaler (MDI) into the Inhal-aid reservoir delivery device. No serious adverse effects were encountered, although a substantial proportion of the patients (36%) had difficulty utilizing the device. Ability to use the system properly correlated with improvement in symptoms; inability to use the device was most clearly related to severity of clinical presentation. It is concluded that the use of aerosolized bronchodilators is feasible in prehospital care and most useful in patients with mild or moderately severe symptoms. PMID- 3540094 TI - Pseudofolliculitis barbae with keloids. AB - Pseudofolliculitis barbae is a common cutaneous infection occurring in the bearded area of the face of black men. The infection is caused by ingrown hairs that produce an inflammatory foreign body reaction characterized by papules and pustules at the point of hair penetration that may result in permanent scarring, usually in grooved patterns, and occasionally in keloids. The purpose of this article is to describe the successful treatment of a patient with pseudofolliculitis with keloids that was based on the pathophysiology of the disease and the biology of wound repair. PMID- 3540095 TI - Pig's foot holder for wound-repair training. AB - A special pig's foot holder has been developed for wound-repair teaching sessions. It has been designed to stabilize the pig's foot without obstructing the physician's view of the wound. PMID- 3540096 TI - Computer diagnosis in jaundice. Bayes' rule founded on 1002 consecutive cases. AB - Extensive clinical and clinical chemical information was collected from 1002 consecutive jaundiced patients. Initial selection of variables based on Chi 2 tests or Mann-Whitney U-test allowed the removal of 64 of the 107 variables originally collected. A further selection of variables was carried out using a modified version of Bayes' rule thus reducing the number of variables from 43 to 22. Of the 982 patients with a final diagnosis 743 patients (76%) could be classified correctly into one of 13 diagnostic categories. The Bayes' rule was also applied to a test group of a further 110 jaundiced patients and found to perform equally well: of 108 patients with a final diagnosis 81 (75%) were correctly classified. A comparison between the clinician's diagnosis and the computer-aided diagnosis according to Bayes' rule demonstrated agreement with regard to one of the 13 diagnostic alternatives in 734 patients (75%), of whom 81 patients were wrongly diagnosed. In the test group agreement upon diagnosis was found in 80 patients (74%). By plausibly combining the computer-aided and the clinician's preliminary diagnoses, more correct classifications were obtained than with either method alone. Many diagnostic modalities such as ultrasound examination, CT-scan, and direct cholangiography are at hand today for the differential diagnosis of jaundice. Computer-aided diagnosis using Bayes' rule has proved a reliable tool for the clinician and can be used in the planning of a diagnostic strategy for the individual jaundiced patient. PMID- 3540097 TI - The treatment of refractory ascites by the LeVeen shunt. A multi-centre controlled trial (57 patients). AB - A multi-centre random trial of 57 cases of alcoholic cirrhosis with refractory ascites was carried out; 29 patients received a LeVeen shunt and 28 were treated by conventional medical therapy. The effectiveness of the LeVeen shunt in reducing ascites was good in the first month, but was not different from conventional medical therapy by the end of one year. Complications were significantly more frequent in the surgical group. Of the 29 patients fitted with a LeVeen shunt, 25 developed one or more complications. Of the 28 patients in the medical control group, only 8 developed complications. The mortality rate of the two groups also differed significantly. Twelve patients in the surgical group (41%) died in the course of the first month against only 5 (18%) in the medical control group. By the end of one year, the mortality rate of the two groups was almost identical: 23 (79%) and 21 (75%) respectively. These observations confirm the poor prognosis for refractory ascites in cases of alcoholic cirrhosis and the inadvisability of attempting to treat it by implanting a LeVeen shunt. PMID- 3540099 TI - Computer-aided diagnosis in jaundice and liver disease. PMID- 3540098 TI - Gallstone recurrence after medical dissolution. An overestimated threat? AB - We assessed gallstone recurrence rate in 42 patients diagnosed as having complete gallstone dissolution on bile acid therapy. By contrast with most previous studies, this diagnosis was based on ultrasound as well as on radiology, and only patients having their first gallstone recurrence were included in the study. Patients were followed for periods varying from 6 months to 7 years (median 30 months). Eleven patients had recurrences, giving an overall recurrence rate of 26%. A life analysis table was constructed by an actuarial method to compensate for the different lengths of follow-up in individual patients. Corrected recurrence rates by life table analysis were 15%, 21%, 25%, 36%, 45%, 45% and 45% at 1, 2, 3, 4, 5, 6 and 7 years respectively; for the same time intervals, cumulative recurrence rate overestimated the risk of gallstone recurrence (14%, 22%, 31%, 50%, 61%, 79% and 92%). We conclude that previous figures for recurrence rate have been an overestimate; but recurrence rate remains substantial over the first 5 years, and then levels off. PMID- 3540100 TI - The significance of the pre-S region of the hepatitis B virus. PMID- 3540101 TI - Alkaline proteinase localization in myoblasts. AB - Recent interest in elucidating the role of non-lysosomal proteases in intracellular protein catabolism in muscle has led to various investigations with three alkaline proteases: a trypsin-like, a chymotrypsin-like, and a high molecular weight cysteine proteinase. Although in vitro biochemical assays have revealed the catabolic potential of at least two of these proteases, confirmation of their presence in muscle cells has been difficult. In this study immunohistochemical techniques were employed to localize each of these proteases in rat myoblasts. Antisera against the trypsin-like and chymotrypsin-like proteinase (both serine proteinases) showed strong localization in the cytoplasm immediately around the nucleus. Both also stained chromatin material in the nucleus of these cells. Fluorescent localization of the high molecular weight cysteine proteinase (Proteinase I) also appeared to be cell-associated in the myoblasts. The use of myoblasts in cell culture sections of whole muscle was advantageous, since localization of the proteases could be assessed in the absence of other cell types. PMID- 3540102 TI - Monoclonal antibodies to antigens abnormally expressed in breast cancer. AB - We report the production, screening, and characterization of ten murine monoclonal antibodies directed at antigens that are expressed abnormally in human breast tumors. Immunoperoxidase staining of frozen and fixed tissues shows the antigens to be present at low levels on the luminal membrane of normal breast cells and at high levels in the cytoplasm and surface membrane of breast tumor cells. The ten antibodies appear to recognize six different epitopes on the basis of their quantitative differences in reactivity against four antigen preparations, as measured by ELISA. Immunoblots show that eight of the ten antibodies recognize a 300,000 MW molecule from breast tumor preparations; six of these antibodies also react with a second molecule from the same tumor preparations of 280,000 MW. Seven antibodies react with an antigen from milk fat globule membrane of 330,000 MW. It therefore appears that the two molecules from tumor tissue and the one molecule from normal tissue share common epitopes. Selected antibodies were tested for reactivity against 25 primary breast tumors and 14 pairs of primary and metastatic breast tumors. Three antibodies have broad reactivity and stain more than 80% of primary tumors; the three other antibodies identify subsets of those tumors. Results of staining pairs of primary and metastatic lesions show that metastases continue to express antigens of the primary lesion in a high percentage of cells. PMID- 3540103 TI - Intracellular localization of thymosin alpha 1 by immunoelectron microscopy using a monoclonal antibody. AB - Distribution of thymosin alpha 1 in normal mice (OF1) or autoimmune mice (NZB) was investigated using immunocytochemical techniques on sections of GMA- and Epon embedded mouse thymuses. A monoclonal antibody directed against synthetic thymosin alpha 1 was used. With the immunofluorescence assay, patchy staining of thymosin alpha 1 was found in the cytoplasm of epithelial cells of the subcapsullary and medullary zones of OF1 thymus. In NZB thymus, the fluorescent pattern was less precisely localized. At the electron microscopic level, immunolabeling of Epon-embedded ultra-thin sections revealed ferritin in some vacuoles of epithelial cells. Ferritin labeling in OF1 thymus was found in several small vacuoles of the same cell, but was present in large, dense vacuoles in NZB thymus. These differences might reflect differences in the secretory process of thymic hormone. PMID- 3540104 TI - Tartrate-resistant acid phosphatase in bone and cartilage following decalcification and cold-embedding in plastic. AB - Tartrate-resistant acid phosphatase (TRAP) has been proposed as a cytochemical marker for osteoclasts. We have developed an improved technique for the localization of TRAP in rat and mouse bone and cartilage. This procedure employs JB-4 plastic as the embedding medium, permits decalcification, and results in improved morphology compared with frozen sections. Peritoneal lavage cells were used to determine the appropriate isomer and concentration of tartrate necessary for inhibition of tartrate-sensitive acid phosphatase. After incubation in medium containing 50 mM L(+)-tartaric acid, osteoclasts and chondroclasts were heavily stained with reaction product. On the basis of their relative sensitivity to tartrate inhibition, three populations of mononuclear cells could also be distinguished. These three populations may represent: heavily stained osteoclast/chondroclast precursors; sparsely stained osteoblast-like cells lining the bone surface; and unstained cells of monocyte-macrophage lineage. Our results are consistent with the use of TRAP as a histochemical marker for study of the osteoclast. PMID- 3540106 TI - [Bisynaptic connection in an insulin-producing B-cell]. AB - The islets of Langerhans of the dog are an example of a close combination of endocrine and nerve tissue. Our figure shows the innervation of a insulin producing B cell by a cholinergic and a peptidergic axon simultaneously. PMID- 3540105 TI - Serotonin and norepinephrine content in brain structures of rats with experimental and transplantation-compensated diabetes. AB - The development of alloxan-induced diabetes in rats is shown to be accompanied by a decrease in the norepinephrine (NE) and serotonin (5-OT) content in the neocortex and caudal segment of the brain stem. Simultaneously the intensity of 3H-leucine labelling of the brain tissue was decreased. The attempt to compensate the diabetic syndrome in rats by transplanting the embryonic pancreas (EP) into the anterior chamber of the eye (ACE) was successful. All the animals with the adapted transplant showed a return of the monoamine level to the normal, a decrease in urine glucose, as well as normalization of protein synthesis by the 14th-20th days. PMID- 3540107 TI - CRF-like immunoreactive system in the quail brain. AB - Nerve cells and fibres immunoreactive for synthetic ovine corticotropin releasing factor were shown to be present in several brain areas of the quail by use of immunocytochemical techniques. CRF-like immunoreactive cell bodies are mainly clustered in the hypothalamic paraventricular nucleus, in the telencephalic nucleus accumbens and in the mesencephalic periventricular grey. The external zone of the anterior median eminence contains a rich network of immunoreactive fibers. CRF-like immunopositive fibers are not restricted to circumventricular organs, but have been observed in several prosencephalic regions and in close proximity of large vasotocin-containing neurons in the supraoptic and paraventricular regions. These observations suggest that, in birds, CRF-like material might be not only involved in the hypothalamic control of anterior pituitary hormone secretion, but also in different functions likely related to neurotransmission or neuromodulation. PMID- 3540108 TI - Immunohistochemical study of the distribution of vasotocin reacting neurons in avian diencephalon. AB - Vasotocin (VT)- and neurophysin (NPH)-containing neurons were immunocytochemically demonstrated in the diencephalon of the Japanese quail (Coturnix coturnix japonica), domestic fowl (Gallus gallus), and Pekin duck (Anas platyrhynchos). In these three avian species, the immunoreactive cells are similarly distributed into three different diencephalic regions: lateral (L), periventricular (P), and dorsal diencephalic (DD). A different number of cell clusters can be easily identified in each region according to its topographical location. Interspecific differences depend on the total number of immunoreactive cells, the cell sizes and the density in each cell cluster. Present results show that the nomenclature of the VT-system originally proposed for the pigeon can be easily applied to all the avian species so far topographically studied. The group nomenclature based only upon the location of immunoreactive elements may avoid potentially inaccurate mammalian homologies, and makes easier the comparison between studies performed in different birds. PMID- 3540109 TI - Outbreak of Legionnaires' disease in Glasgow Royal Infirmary: microbiological aspects. AB - The bacteriological investigation of an outbreak of Legionnaires' disease in Glasgow Royal Infirmary affecting 16 patients is described. Most of the patients had been treated in high-dependency areas on two floors of the hospital supplied by the same two air-conditioned ventilation systems. The source of infection was traced to contamination of a cooling tower from which a plume of spray discharged into the intake vents of the two ventilation systems. Rubber grommets within the cooling tower probably provided a nidus of infection there. The control and management of the outbreak are discussed: a policy of frankness about the course and progress of the investigations was adopted and helped to allay anxiety on the part of both staff and media. PMID- 3540110 TI - Speciation, serotyping, antimicrobial sensitivity and plasmid content of Proteeae from the environment of calf-rearing units in South West England. AB - A survey was undertaken of the occurrence, serotype, antimicrobial sensitivity and plasmid content of members of the tribe Proteeae in the environment of two calf-rearing units in the county of Avon in South West England. Examples of the following species were found: Proteus mirabilis, Prot. vulgaris, Prot. vulgaris Biogroup 2, Morganella morganii, Providencia stuartii, Prov. alcalifaciens and Prov. rettgeri. A wide range of serotypes was found, many having been previously reported from nosocomial isolates. A total of 15% of isolates carried plasmids; six pairs of isolates were identified which had identical serotypes but different patterns of plasmid carriage. The antimicrobial sensitivity of the isolates was generally similar to isolates of Proteeae from humans. Although no truly aminoglycoside-resistant isolates were found, some isolates of Prov. stuartii and Prov. rettgeri had MIC's higher than the other isolates to gentamicin and netilmicin, suggesting the presence of low levels of the enzyme AAC 2'. The study demonstrates that there is a considerable diversity of species and types of Proteeae associated with calves and their environment. It seems likely that a potential cause of colonization of the human gut by Proteeae is the consumption of meat. PMID- 3540111 TI - Characterization of plasmids conferring resistance to gentamicin and apramycin in strains of Salmonella typhimurium phage type 204c isolated in Britain. AB - In Salmonella typhimurium phage type 204c isolated in Britain, gentamicin resistance is specified by plasmids of the I1 compatibility group which also confer resistance to apramycin. These plasmids have been subdivided into three types within the I1 group on the basis of their antibiotic resistance specificity, their ability to produce colicin Ib and their restriction enzyme digest fragmentation patterns. All three have been identified in strains from cattle, but as yet only two types have been found in strains from humans. It is suggested that the use of apramycin in animal husbandry is responsible for the appearance of gentamicin resistance in multiresistant strains of phage type 204c, a phage type already epidemic in bovine animals and with an increasing incidence in humans. PMID- 3540112 TI - Apramycin and gentamicin resistance in Escherichia coli and salmonellas isolated from farm animals. AB - Since the aminoglycoside antibiotic apramycin was licensed for veterinary use in 1980, all isolates of Escherichia coli and salmonellas received at the Central Veterinary Laboratory have been monitored for resistance to apramycin and the related antibiotic gentamicin. During the period 1982-4, the incidence of resistance in E. coli to apramycin increased from 0.6% in 1982 to 2.6% in 1984. In salmonellas the incidence of resistance to apramycin increased from 0.1% in 1982 to 1.4% in 1984. Resistance to both apramycin and gentamicin was detected in six different salmonella serotypes, although an isolate of Salmonella thompson from poultry was resistant to gentamicin but not apramycin. Most of the cultures were isolated from pigs, although the incidence of apramycin resistance in S. typhimurium (DT 204C) from calves has shown a recent dramatic increase. All the isolates with one exception produced the enzyme aminoglycoside 3-N acetyltransferase IV (ACC(3)IV). The resistance was transferable by conjugation in most of the strains examined, and the plasmids specifying the resistance have been found to belong to a number of different incompatibility groups. Plasmids from three E. coli strains were compatible with all the reference plasmids and belonged to a previously undescribed group which was investigated further. It is suggested that bacteria from humans should be examined for resistance to apramycin and gentamicin to determine the possibility of the antibiotic resistance bacteria, and their genes, spreading from animals to humans. PMID- 3540113 TI - A one-year survey of nosocomial bacteraemia at a Danish university hospital. AB - A 1-year prospective study of nosocomial bacteraemia was performed at Hvidovre Hospital with special reference to frequency, focus of infection and prognosis. All patients were examined clinically in order to confirm the bacteraemia. In total, 98 hospital-acquired bacteraemias were observed, giving an incidence rate of 0.28%. Bacteraemia due to Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis predominated. The overall mortality was 38%; 65% of the patients with S. aureus bacteraemia died, 25% due to the bacteraemia. The most common types of infection were urinary tract infections and intravenous catheter infections. Fifty-five of the bacteraemias were caused by foreign bodies, mostly urinary catheters and intravenous catheters, and in 14 cases the focus was unknown. The patient population was severely ill patients. We conclude that nosocomial bacteraemia occurs specially in severely ill patients often preceded by indwelling urinary or intravenous catheters. The patients seldom die due to the bacteraemia, but they die with concomitant bacteraemia. PMID- 3540114 TI - The survival of Escherichia coli in an aerosol at air temperatures of 15 and 30 degrees C and a range of humidities. AB - The survival of Escherichia coli in an aerosol was studied at several temperatures and over a range of relative humidities using a Henderson apparatus. Death occurred in two phases, the first lasting approximately 1 min; in the second the number of viable microorganisms declined exponentially. E. coli was robust and remained viable for many hours. Death was most rapid at low humidities (less than 50% r.h.) at 15 and 30 degrees C, with half-lives of 14 and 3 min respectively. In humid conditions the half-lives were much longer, approximately 83 and 14 min respectively. Based on this work, preliminary recommendations for the climate of livestock buildings can now be given to control the airborne spread of E. coli. PMID- 3540115 TI - Capture-ELISA for serum IgM antibody to respiratory syncytial virus. AB - A four-component solid-phase capture enzyme immunoassay was set up to test for serum IgM antibody to respiratory syncytial (RS) virus and was compared with immunofluorescence assay (IFA). A total of 128 young children with acute respiratory infections were studied. Thirty-six were shown to be RS virus positive by the detection of RS virus in nasopharyngeal secretions and 92 were RS virus-negative. A serum specimen was collected after admission to the hospital (days 0-4) and a further specimen was obtained during days 10-14. Out of 36 RS virus-positive patients, 28 (77.7%) were found to be positive for IgM by both capture-ELISA and IFA. Out of 92 RS virus-negative patients 5 (5.4%) were IgM positive. Four false-positive results were obtained by IFA due to the presence of rheumatoid factor. The capture-ELISA was shown to be a reliable technique in detecting specific IgM antibody to RS virus. PMID- 3540116 TI - Slow pressor mechanisms in hypertension: a role for hypertrophy of resistance vessels? PMID- 3540117 TI - Circadian rhythm of plasma renin activity in older normal and essential hypertensive men: relation with inactive renin, aldosterone, cortisol and REM sleep. AB - The 24-h pattern of plasma renin activity (PRA), inactive renin (IR), plasma aldosterone (PA) and cortisol was studied in 13 normal men and 12 male patients with essential hypertension, all of whom were older than 55 years. Following gradual habituation over 4 days to the sleep laboratory and intravenous lines, blood samples were obtained every 2 h between 0900-2100 h and every 30 min between 2100-0900 h, during which sleep was also monitored. Plasma renin activity showed a circadian rhythm in both groups, but mean levels were lower in the hypertensive subjects (0.92 +/- 0.03 versus 1.41 +/- 0.06 ng/ml per h). The circadian rhythm of PRA in older men appeared to follow the same pattern described in younger individuals. Rapid eye movement (REM) sleep was associated with a small decrease in PRA, but this link was only evident in the normotensive group. Mean 24-h IR levels were also lower in the hypertensive group (7.26 +/- 0.18 versus 15.10 +/- 0.47 ng/ml per h) but were not affected by clock-time and generally showed no association with the 24-h PRA cycle. Mean 24-h PA was closely related to cortisol but not to PRA in both groups. Mean PA levels of the two groups were similar. Thus, the PA:PRA ratio was higher in the hypertensive group. The higher basal PA:PRA ratio in older hypertensives that emerged over the 24-h study period may reflect increased sensitivity of the adrenal gland to angiotensin II (ANG II) in hypertension of the elderly. PMID- 3540118 TI - Plasma renin activity and aldosterone levels during captopril administration. PMID- 3540119 TI - Suppression of anti-mouse immunoglobulin antibodies in subhuman primates receiving murine monoclonal antibodies against T cell antigens. AB - Murine monoclonal antibodies stimulate the production of human anti-mouse immunoglobulin antibodies (AMIA) when administered to patients. This limits their long-term usefulness as therapeutic and diagnostic agents. We report the use of three maneuvers to suppress AMIA against T cell-specific monoclonal antibodies in cynomolgus monkeys. Twelve monkeys received daily i.v. infusions of 1 mg each of anti-Leu-2a, -3a, and -5 on days 1 through 10. One group (control) received no suppressive regimen. The second group received cyclosporine, 12.5 mg/kg daily on days -7 to +14. The third group (PI) were passively immunized with 0.4 ml of hyperimmune monkey AMIA serum on days -7, -1, 2, 4, 6, and 8. The fourth group (TLI) received 1700 rad fractionated total lymphoid irradiation ending on day -1. The animals treated with TLI were markedly delayed in the onset of AMIA, which was suppressed to less than 1% of the control group. The AMIA specific for the constant region of animals receiving PI was also suppressed to one-third of control. The majority of the AMIA in all the animals was anti-idiotypic and wholly anti-idiotypic in the TLI animals. PMID- 3540120 TI - Idiotypy of human anti-Candida albicans antibodies: recurrence, presence of a cross-reactive autoanti-idiotypic-like activity, and role in the induction of specific in vitro antibody response. AB - Rabbit anti-idiotypic antibodies (L12) were raised against human anti-mannan of Candida albicans (CA) antibodies isolated from the serum of a normal donor. The absorbed anti-idiotypic antiserum bound to donor anti-CA mannan antibodies but not to control immunoglobulins. Binding was inhibited by CA mannan but not by other polysaccharide antigens. L12 was shown to cross-react with anti-CA mannan isolated antibodies or with anti-CA antibody-containing sera from individuals unrelated to the donor. IgG fraction isolated from the donor serum was repeatedly absorbed on CA mannan Sepharose to remove anti-mannan antibodies. This IgG fraction (named autoanti-idiotypic fraction) blocked, in a dose-dependent fashion, the binding of rabbit anti-idiotype to donor anti-CA mannan antibodies. Moreover, this CP-depleted IgG fraction cross-reacted with public idiotypic determinants of unrelated anti-CA mannan antibodies. Finally, L12 induced sensitized lymphocytes to produce anti-CA mannan antibodies in vitro in the absence of antigen. PMID- 3540121 TI - Graft vs graft reaction resulting in the elimination of maternal cells in a SCID patient with maternofetal GVHd after an HLA identical bone marrow transplantation. AB - In a young girl with a severe combined immunodeficiency, the presence of circulating maternal T lymphocytes was proven by HLA typing. Manifestations of skin graft vs host disease were associated with the persistence of maternal cells. The patient received an HLA identical bone marrow transplantation from her brother without any conditioning. The bone marrow transplantation was quickly followed by a transient and dramatic increase in skin lesions associated with fever and the finding of a high number of circulating lymphocytes and eosinophils. Lymphocytes were shown to be of donor origin and exerted a spontaneous cytotoxic activity toward maternal cells. This activity progressively disappeared within 90 days, whereas maternal cells were no longer detected in patient's blood, and skin graft vs host disease was resolved within 8 wk. Cytotoxic activity was proven to be mediated by donor T lymphocytes specific for the mother's HLA antigens. The cytotoxic activity was demonstrated to be specific for the HLA class I molecules of the mother not shared with her daughter (HLA A1, B17) as shown by the use of a series of HLA typed cells as targets. In addition, cold K562 target cells did not block the cytotoxic activity, and the kinetics of the cytotoxic activity did not correlate with that of natural killer activity emergence after the bone marrow transplantation. Patient's serum did not contain antibodies toward maternal specific HLA class I antigen. Cytotoxic activity was totally blocked by anti-T3 monoclonal antibodies and partially by anti-T8 and anti-T4. It is thus likely that donor origin cytotoxic T lymphocytes were promptly activated after bone marrow transplantation and provoked the elimination of the maternal graft after a transient exacerbation of graft vs host disease manifestations. This observation represents one of the first examples of the possible role in vivo of allogeneic cytotoxic lymphocytes in humans. PMID- 3540122 TI - Protective monoclonal antibodies recognize epitopes located on the major outer membrane protein of Chlamydia trachomatis. AB - A panel of monoclonal antibodies (MAb) was generated against Chlamydia trachomatis serovar B, an etiologic agent of blinding trachoma. The specificities of MAb were determined by dot blot assay by using viable elementary bodies of 13 C. trachomatis serovars and two C. psittaci strains. The dot blot assay was used to identify those antigens that were unique and immunoaccessible on the chlamydial surface. MAb were identified that recognized bi-specific (serovars B and Ba) or subspecies-specific (various B complex serovars) surface-exposed antigenic determinants that were either resistant or sensitive to heat denaturation (56 degrees C, 30 min). All of the MAb recognized the major outer membrane protein as determined by either immunoblotting or radioimmunoprecipitation. MAb specific for immunoaccessible major outer membrane protein epitopes protected mice from toxic death after i.v. injection of B serovar elementary bodies and neutralized the infectivity of the organism for monkey eyes. In contrast, MAb reactive against non-immunoaccessible subspecies- or species-specific major outer membrane protein epitopes or against an immunoaccessible genus-specific epitope located on chlamydial lipopolysaccharide did not protect mice from toxic death or neutralize infectivity of the parasite for monkey eyes. These data suggest that those major outer membrane protein antigenic determinants that are serovar or serogroup specific and are accessible to antibody on the chlamydial cell surface may be useful as a recombinant subunit vaccine for trachoma. PMID- 3540123 TI - Molecular mechanisms involved in T cell activation. I. Evidence for independent signal-transducing pathways in lymphokine production vs proliferation in cloned cytotoxic T lymphocytes. AB - It is well-established that activated T cells proliferate in response to interleukin 2 (IL 2) and produce various soluble lymphokines such as macrophage activating factor (MAF) in response to antigen. Prior to investigating the molecular events involved in signaling the initiation of these responses in cloned murine cytotoxic T lymphocytes (CTL), we determined whether these responses could occur independently, and we established for each response the time during which signal transducing mechanisms may function. It was found that this cloned CTL population was in a resting state (G1 phase of cell cycle) 7 days after stimulation with antigen plus IL 2. At this time, the incubation of these resting CTL with IL 2 for 4 to 6 hr resulted in a maximal proliferative response that was not accompanied by the production of MAF. Conversely, the incubation of resting CTL with antigen or lectin (in the absence of IL 2) for at least 8 hr resulted in the maximal production of MAF at 24 hr without inducing a proliferative response. In addition, antigen or lectin, but not IL 2, triggered an immediate (less than 1 min) and sustained (at least 8 hr) mobilization of intracellular calcium. The kinetics of this calcium response paralleled the minimum time (8 hr) that was required for resting CTL to interact with either antigen or lectin in order to produce maximal titers of MAF. These results indicate that proliferation and lymphokine (MAF) production in cloned murine CTL are independent events. In these resting CTL, the signal mechanisms that mediate the production of lymphokines are most likely restricted to the initial 8 hr of stimulation by antigen or lectin and involve the rapid and prolonged mobilization of cytoplasmic calcium. Proliferative signals, however, are probably complete within 4 to 6 hr after stimulation by IL 2 and do not involve readily demonstrable fluxes of cytoplasmic calcium, as determined by the fluorescent calcium probe Quin 2. PMID- 3540124 TI - Molecular mechanisms involved in T cell activation. II. The phosphatidylinositol signal-transducing mechanism mediates antigen-induced lymphokine production but not interleukin 2-induced proliferation in cloned cytotoxic T lymphocytes. AB - The phospholipid metabolism of cloned murine cytotoxic T lymphocytes (CTL) was examined under conditions in which the induction of proliferation by interleukin 2 (IL 2) and the stimulated production of lymphokine (macrophage-activating factor (MAF] by concanavalin A (Con A) and specific antigen occurred independently of each other. Activation of the CTL by either of the latter two stimuli resulted in changes in the metabolism of phosphatidylinositol (PI) that were early (less than 2.5 min), specific, and prolonged (6 to 8 hr). These changes were primarily characterized by an increase in phosphatidic acid (PA) and PI, with a decrease in phosphatidylinositol-4,5-bisphosphate. The duration of these phospholipid responses, particularly PA and PI, approximated the minimum time of CTL-stimulus interaction required to produce maximal titers of MAF. No changes were observed in other major classes of phospholipids during 8 hr of continuous stimulation. Stimulation with an irrelevant antigen had no effect on CTL phospholipid metabolism. In contrast to specific antigen or Con A, the T cell growth factor IL 2 failed to elicit specific and early biosynthetic responses from PA and PI. Instead, there were nonspecific biosynthetic responses from all major phospholipid classes (including phosphatidylcholine and phosphatidylethanolamine, as well as PA and PI) which occurred between 1 and 6 hr after IL 2 stimulation. Both 1,2-diacylglycerol (DAG) and inositol phosphates (IP), the hydrolytic products of PI turnover, were produced in response to MAF inducing stimuli, but neither were detected in response to the proliferative stimulus IL 2. Together, these results indicate that the hydrolysis of PI and the concomitant production of the putative second messengers DAG and IP are involved in signaling the production of lymphokines (MAF) by CTL. On the other hand, the failure of IL 2 to elicit a full-spectrum PI response suggests that signals mediating CTL proliferation may utilize an alternate and still undefined pathway. PMID- 3540125 TI - An adjuvant formulation that selectively elicits the formation of antibodies of protective isotypes and of cell-mediated immunity. AB - Adjuvants are required to elicit protective immune responses with bacterial toxoids, inactivated viruses and subunit antigens produced by recombinant DNA technology. Some adjuvants, such as muramyl dipeptide (MDP) analog formulations, preferentially induce the formation of antibodies of isotypes that interact with complement and antibody-dependent effector cells, and do not elicit reaginic antibodies. Aluminum salts and mineral oil emulsions increase antibody formation but not cell-mediated immunity (CMI), whereas MDP formulations also elicit CMI. Adjuvants such as MDP and lipopolysaccharide (LPS) stimulate the production by accessory cells of IL-1 that increases the circulation of lymphocytes through draining lymph nodes and act as a growth factor for lymphocytes. Vehicles such as mineral oil emulsions, liposomes and Pluronic polymer formulations provide large surface areas on which antigens can be retained in a two-dimensional matrix, from which they can readily be transferred to antigen-presenting cells. The development of an adjuvant formulation able to elicit the formation of protective antibodies and CMI without unacceptable side effects is described. PMID- 3540126 TI - Specific IgE antibodies to reactive dye-albumin conjugates. AB - Hypersensitivity to reactive dye powders has been recognised for a number of years, although the extent of sensitisation amongst dye house operatives and the immunochemistry of the dye molecules has not been investigated. We have developed a radioallergosorbent test (RAST) to detect specific IgE to reactive dye-human serum albumin (HSA) conjugates. From a total of 19 dye-HSA conjugates, positive RASTs were found in six workers with allergic symptoms associated with dye exposure, while six asymptomatic case-matched controls were negative. Sera with raised total IgE (up to 4300 kU/l) from unexposed workers gave negative results except for two conjugates which gave a weak positive at 4300 kU/l and one which gave weak positives at all concentrations tested (750-4300 kU/l). RAST demonstrated that the antibody was specific for the complete dye-HSA conjugate. Substitution of bovine serum albumin (BSA) for HSA in the conjugate markedly reduced immunoreactivity and free hapten gave lower inhibition than the complete conjugate. Comparison of the dye-HSA RAST with a RAST using dyed discs showed that the latter did not correlate well with symptoms and was influenced by the total IgE concentration. PMID- 3540127 TI - Dot-immunobinding assay with monoclonal anti-IgE antibodies for the detection and quantitation of human IgE. AB - This paper describes a dot immunobinding assay for determining total human IgE with a tandem of monoclonal anti-IgE antibodies. Minute quantities of monoclonal anti-IgE antibodies were adsorbed on nitrocellulose discs. IgE bound to this solid phase monoclonal anti-IgE antibody was detected by a second monoclonal antibody conjugated with horseradish peroxidase. Using 4-chloro-1-naphthol as a chromogen results in a stable colour reaction that can be semiquantitatively analysed by the naked eye. The colour intensities of the reaction were also analysed by densitometry, yielding a very reproducible quantitation of human serum IgE. Using a serum dilution of 1:50, IgE could be detected in the range of 12.5-2500 U/ml. Using non-diluted serum samples IgE levels between 0.05-50 U/ml were reproducibly measured. Total serum IgE as determined by this dot assay correlated very well with IgE determinations performed by the commercial PRIST assay. PMID- 3540128 TI - Discrimination of human cytotoxic lymphocytes from regulatory and B-lymphocytes by orthogonal light scattering. AB - Light scattering properties of human lymphocyte subpopulations selected by immunofluorescence were studied with a flow cytometer. Regulatory and B lymphocytes showed a low orthogonal light scatter signal, whereas cytotoxic lymphocytes identified with leu-7, leu-11 and leu-15 revealed a large orthogonal light scatter signal. Two populations in light scatter histograms could be observed with monoclonal antibodies directed against determinants present on both regulatory and cytotoxic lymphocytes. By analysis of the lymphocytes of 16 individuals we found a linear relation between the number of cells with a large orthogonal light scattering and the number of cytotoxic lymphocytes identified with leu-7, leu-11 and leu-15. These observations demonstrate physical differences between cytotoxic lymphocytes and regulatory and B lymphocytes. Moreover, the results suggest a method to estimate the amount of cytotoxic lymphocytes without using monoclonal antibodies. PMID- 3540129 TI - A study to correlate the quality of articulated linguopalatal consonant sounds with the thickness of the palatal part of a denture base. PMID- 3540130 TI - The impact of molecular biology on the diagnosis and treatment of infection. PMID- 3540132 TI - Visceral leishmaniasis in a renal transplant recipient: a diagnostic and therapeutic challenge. PMID- 3540131 TI - Aeromonas hydrophila peritonitis in a renal transplant recipient. PMID- 3540133 TI - [Diffuse inverted micropapillomatosis of the upper excretory tract. Apropos of a case. Review of the literature]. AB - We have reported diffuse endophytic lesions that we have defined as being an inverted micropapillomatosis. There are benign proliferative lesions that we can classify between the Von Brunn nets and the other proliferative urothelial lesions. PMID- 3540134 TI - [How to evaluate functional values of the kidney]. PMID- 3540136 TI - Further evidence for the self-reproducing capacity of Langerhans cells in human skin. AB - The limited number of Langerhans cells (LC) in the epidermis is one of the main reasons for the technical difficulties in resolving the question of LC kinetics. In the present paper, we describe a method to evaluate the LC replication potential in epidermis. The procedure is based on the specific incorporation of bromodeoxyuridine (BrdU), a thymidine analogue, into the DNA during the S-phase of the cell cycle. Mice, bearing human skin grafts, were injected s.c. every 6 h for up to 17 days with BrdU. At different times, the incorporated BrdU as well as the human epidermal LC were revealed on skin sections using anti-BrdU and OKT-6 monoclonal antibodies, respectively. After 6 h, 4.9% of the LC were labeled with BrdU. Then, the number of OKT-6(+) BrdU(+) cells increased in a linear manner and achieved 34% at 120 h, 67% at 240 h, and 94% at 400 h during the course of continuous labeling procedures. Based on this result we calculated a total cell cycle time of 392 h (16.3 days) and 12 h for the S-phase for human epidermal LC. Applying this technique, we were able to show also that 48 h after local treatment with 12-O-tetradecanoylphorbol-13-acetate or after stripping, the number of BrdU-labeled LC was considerably increased. Furthermore, after i.p. injection of colchicine in the nude mouse, human epidermal LC undergoing mitosis were evidenced by electron microscopy in the graft. From these results we conclude that the LC are actively cycling--therewith a self-reproducing cell population in human epidermis. PMID- 3540135 TI - Keratinocyte expression of MHC class II antigens in allergic sensitization and challenge reactions and in irritant contact dermatitis. AB - Keratinocytes expressed major histocompatibility complex class II antigens during the development of irritant contact dermatitis, and during the induction of contact hypersensitivity, as well as in established allergic contact dermatitis. A battery of anti-class II monoclonal antibodies, some of which are specific for class II subregion products (DP, DQ, DR), was used in an immunohistochemical study of the sequential changes in the allergic challenge reactions to dinitrochlorobenzene (DNCB) and nickel, the irritant response to anthralin, and the induction of sensitization to DNCB. The induction of keratinocyte class II expression paralleled the influx of Leu-3a+ T cells into the skin and had occurred by 24 or 48 h in each type of reaction. Differential expression of class II subregion products on keratinocytes was noted: DR was the most frequently expressed molecule, followed by DP and DQ, although in the irritant response, DP expression was not observed. The importance of these observations can be decided only by functional studies. PMID- 3540137 TI - Serodiagnosis of invasive aspergillosis in patients with hematologic malignancy: validation of the Aspergillus fumigatus antigen radioimmunoassay. AB - Six hundred sixteen sera from 79 hematology patients admitted on 152 occasions were analyzed for validation of the Aspergillus fumigatus antigen radioimmunoassay (RIA). Invasive aspergillosis developed on 24 admissions of 22 patients. Maximal antigenic activity was significantly higher in patients with invasive aspergillosis than in controls (P less than .0005). At the level of antigenic activity selected as the cutoff value, the sensitivity of the RIA was 74%, the specificity 90%, the positive predictive value 82%, and the negative predictive value 85%. Antigen was detected before invasive aspergillosis was suspected during 30% of admissions and before pathological or even preliminary microbiological evidence for disease in 46%. In 17 (77%) of the 22 episodes of pulmonary aspergillosis, the RIA would have been the first positive diagnostic test for aspergillosis or would have confirmed a diagnosis established by other means. Overall, the test would have been of clinical usefulness in diagnosis, management, and prognosis in 80% of 16 fatal cases. PMID- 3540138 TI - Fulminant necrotizing fasciitis and nonsteroidal anti-inflammatory drugs. PMID- 3540139 TI - B subunit-whole cell and whole cell-only oral vaccines against cholera: studies on reactogenicity and immunogenicity. AB - We conducted a randomized trial among persons in rural Bangladesh to evaluate the side effects and immunogenicity of orally administered B subunit-killed whole cell (BS-WC) and killed whole cell-only (WC) cholera vaccines and a killed Escherichia coli strain K12 placebo proposed for field testing. Three doses of BS WC, WC, E. coli, or a control agent were given with antacid to 1,257 women (aged greater than 15 years) and children (aged to to 15 years). The four groups exhibited no statistically significant differences in occurrence of symptoms after each dose, and rises in titers of vibriocidal (VC) antibodies to Inaba and Ogawa were twofold higher for vaccinees than for controls (P less than .001). Half of the persons with fourfold or greater VC responses to WC responded after the first dose; many additional patients, particularly young children, responded after subsequent doses. In contrast, 89% of persons who responded to BS-WC with twofold or greater rises in titer of IgG antibodies to cholera toxin did so after the first dose. After the third dose, vaccinees exhibited a fivefold higher rise in titer than did controls (P less than .001); a dose-to-dose booster effect was most evident in young children. PMID- 3540141 TI - Lipase activity in Mycobacterium leprae--an indicator of metabolic function. AB - Presence of lipase, in Mycobacterium leprae obtained from human nodules and infected armadillo tissues, has been detected by demonstrating the ability of the bacteria to hydrolyze tributyrin. This capacity is expressed during incubation of the bacteria with the substrate and needs a source of carbon and other energy metabolites. The activity is blocked by anti M. leprae drug rifampicin. It is concluded that expression of lipase activity is a metabolic event of M. leprae, while they are maintained in an energy providing medium. PMID- 3540140 TI - Clinical response to aminoglycoside therapy: importance of the ratio of peak concentration to minimal inhibitory concentration. AB - In an examination of the relationships among plasma aminoglycoside concentrations, the minimal inhibitory concentration (MIC) for the infecting organism, and therapeutic outcome, data were analyzed from 236 patients with gram negative bacterial infections who were participants in four clinical trials of gentamicin, tobramycin, and amikacin. Clinical response to therapy occurred in 188 (80%) patients. Elevated maximal and mean peak aminoglycoside concentration/MIC ratios were strongly associated with clinical response (P less than .00001 and P less than .0001, respectively). A graded dose-response effect was found between an increasing maximal peak concentration/MIC ratio and clinical response. By logistic regression the peak concentration/MIC ratios were associated significantly with clinical response after adjustment for underlying severity of illness and other factors correlated with response. These results demonstrate that a high peak concentration relative to the MIC for the infecting organism is a major determinant of the clinical response to aminoglycoside therapy. PMID- 3540142 TI - Sciatic nerve in experimental leprosy. AB - Swiss albino mice were inoculated with Mycobacterium leprae obtained from untreated lepromatous patients. Histopathological study of sciatic nerves showed no abnormality. However a few free acid fast bacilli (AFB) were detected in the sciatic nerves taken from the inoculated limbs during the early stages of infection, suggesting the nerve-fibre route of travel as seen in humans in experimental leprosy, too. PMID- 3540143 TI - ADCC function in Mycobacterium leprae inoculated normal and immunosuppressed mice. AB - Normal and immunosuppressed mice were inoculated with Mycobacterium leprae obtained from untreated lepromatous patients. Besides monitoring the AFB counts in the footpads at 3,6 and 9 months post inoculation, antibody dependent cellular cytotoxicity (ADCC) function was studied. The ADCC function seen to be largely unaltered in the M. leprae infected animals, comparable to the observation made in human leprosy. PMID- 3540144 TI - Mycobacterium leprae: metabolically competent, but microbe-dependent; indications for in vitro cultivation. PMID- 3540145 TI - Report on three decades of leprosy control work in T. Narsipur by GMLF. Gandhi Memorial Leprosy Foundation. PMID- 3540146 TI - Tumour microcirculation as a target for hyperthermia. AB - A great number of investigators have, independently, shown that tumour blood flow is affected by a hyperthermic treatment to a larger extent than normal tissue blood flow. While the majority of the studies on experimental tumours show a decrease and even a lapse in blood flow within the microcirculation during or after hyperthermia, the data on human tumours are less conclusive. Some of the investigators do not find a decrease in circulation, while others do. Obviously, this is an important field of investigation in the clinical application of hyperthermia because a shut down of the circulation would not only facilitate tumour heating (by reducing venous outflow, this reducing the 'heat clearance' from the tumour), but would also facilitate tumour cell destruction. The same holds for alterations that occur subsequently to the circulatory changes, like a heat-induced decrease of tissue pO2 and pH. If the frequently reported circulatory collapse of the tumour circulation could selectively be stimulated by, e.g. acidification or by vasoactive agents, hyperthermic treatment of patients would possibly be greatly facilitated and intensified. In hyperthermic tumour therapy a number of complex processes and interactions takes place, especially when the treatment is performed in combination with radiation therapy. One of them represents the group of processes related to the random probability of cell sterilization of individual tumour cells resulting in exponential survival curves which are typically evaluated with e.g. cell survival assays. This aspect has not been the issue of this paper. The other group of processes deals with the heat-induced changes in the micro-physiology of tumours and normal tissues which, as discussed before, may not only enhance the exponential cell kill, but which may also culminate in vascular collapse with the ensuing necrosis of the tumour tissue in the areas affected. If this takes place, a process of bulk killing of tumour cells results, rather than the random type of cell sterilization. At present it is not clear to what extent the various separate mechanisms contribute to the total effect of tumour control. With all these considerations in mind, one should be aware of the fact that effects, secondary to heat-induced vascular stasis alone will never be efficient enough to eliminate all tumour cells, even though a heat reservoir is created. This is so because some malignant cells will inevitably have already infiltrated normal, surrounding structures and will therefore not be affected by changes in the tumour vascular bed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540147 TI - Site and disease selection for hyperthermia clinical trials. AB - Significant progress has been made in the past 20 years in understanding the biological basis of hyperthermia-induced cytotoxicity, thermoenhancement of radiation therapy and chemotherapy, and in the development of clinically applicable microwave, radiofrequency, ultrasound and thermometry equipment. Numerous uncontrolled trials have suggested strongly that hyperthermia in conjunction with radiation therapy or chemotherapy may contribute to improved local control rates for recurrent or metastatic cancer without excessive morbidity. Carefully designed and well-controlled site and disease-specific prospective randomized trials with standardized hyperthermia and radiation therapy techniques, adequate thermometry, precise end points for tumour control and normal tissue toxicity are now essential to establish the role of hyperthermia in cancer management. Criteria for tumour site selection will be explored for trials employing radiation therapy and local-regional hyperthermia. Examples of sites selected will be presented which represent areas that can, with current technology, usually be adequately heated, and in which significant patient benefit may result from improved local-regional control. PMID- 3540148 TI - The application of thermal dose in clinical trials. AB - When large human tumours are heated, spatial temperature (T) variation is high and poorly predictable with current hyperthermia technology. Invasive thermometry is thus necessary to document efficacy, and thermal mapping or multisensor thermometry can increase the yield of information without increasing the extent of invasiveness. The amount of temperature, time and spatial (T, t, x) data generated in a typical treatment is overwhelming, but can be made comprehensible by the application of thermal dose (TD) analysis. The isoeffective basis of the analysis reviewed here is likely to be modified as more biophysical information becomes available but, at present, serves the purpose of data condensation and treatment comparison. Real-time TD analysis may help to assure treatment reproducibility and may assist in discerning thermal dose-response relationships in prospective clinical trials. PMID- 3540149 TI - Estimation of therapeutic gain in clinical trials involving hyperthermia and radiotherapy. AB - It is clear from discussions in this paper that phase III testing of hyperthermia in human patients must proceed in a cautious and stepwise fashion. Because of the risks of increasing late effects, either due to direct thermal damage or thermo radiosensitization of normal tissues, it is not prudent to proceed with such testing in sites where there is a risk of excessive normal tissue heating. The correlations between temperature and prognosis in heated tumours implies that sites and techniques should be chosen where the chance of achieving relatively uniform heating are maximized. Methods of quality assurance are of equal importance and need to be carefully designed. Even then, retrospective analyses with temperature variations used as prognostic covariates are essential. Other factors, such as tumour volume and radiotherapy dose should be carefully controlled in experimental and control groups. Finally, protocol compliance is a real problem which will cause problems in interpretation of results, especially in studies designed to look at hyperthermic time-dose fractionation. PMID- 3540151 TI - [Differentiation of sexuality in Chlamydomonas]. PMID- 3540152 TI - [Cell-adhesion molecules in the cellular slime molds]. PMID- 3540150 TI - The use of a Rochette-type bridge in a periodontally-compromised patient. PMID- 3540154 TI - [Urinary trehalase activity during normal pregnancy: tubular dysfunctions]. AB - By measuring urinary trehalase which is localized in renal brush borders, we examined whether tubular dysfunction occurred or not during and after normal pregnancy. Urinary trehalase activity in 1st trimester, 2nd trimester, and 3rd trimester was increased significantly as compared with the controls (=non pregnant women) (p less than 0.01). After delivery, urinary trehalase activity in puerperal 5th day was decreased to the level of the 1st trimester, and the activity of puerperal on the 30th day was in the range of the control value. Urinary beta 2-microglobulin (beta 2-MG) in the 1st trimester and 2nd trimester was not increased significantly as compared with the controls. Urinary beta 2-MG in the 3rd trimester, however, was significantly higher than that in the controls. After delivery, the value for beta 2-MG in puerperal on the 5th day was not decreased significantly as compared with the 3rd trimester, and in puerperal on the 30th day, urinary beta 2-MG was decreased to the control value. Urinary N acetyl-beta-D-glucosaminidase (NAG) in the 3rd trimester was significantly higher than that in the controls (p less than 0.01) and in the 1st trimester (p less than 0.02). After delivery, a significant decrease was observed in urinary NAG between 5th puerperal day and the 3rd trimester. Moreover, urinary NAG on the 30th puerperal day was the level of the controls. On the basis of these results, it is inferred that tubular dysfunction is observed during normal pregnancy. PMID- 3540153 TI - [Ultrasonographic studies on endometrial carcinoma]. AB - Pre-operative ultrasonographic examinations on endometrial carcinoma were carried out in 34 cases in Tokushima University Hospital for 9 years since 1976. The results were compared with post-operative histological findings. The cancer mass was seen as higher echoic part than normal myometrium and its characteristic echo patterns were grouped into 5 types (4 cases of anechoic, 3 of linear, 4 of cystic, 14 of small mass and 9 of large mass). Small and large mass types were seen in 86% of the cases whose cervix, pelvic lymph nodes or parametrium were involved. The degree of myometrial invasion could be estimated by measuring the thickness of the myometrial echo uninvolved, and its coefficient correlation was 0.65. Depending on the increase in tumor echo size, myometrial invasion sometimes developed more deeply. Cervical involvements were estimated accurately in 86% by ultrasonography. Ultrasonographic estimation of the invasion on endometrial carcinoma was thought to be useful. PMID- 3540155 TI - Ultrasonography for the diagnosis of adenomyosis. AB - An accurate preoperative diagnosis of uterine adenomyosis is often difficult. We reviewed our experience with ultrasound evaluation of this pathological entity. Patients with histologically proven adenomyosis were studied to determine the usefulness of ultrasound for the preoperative diagnosis of this entity. In patients with adenomyosis, variable ultrasound patterns are seen, namely, enlargement of the uterus, irregular vesicular spaces within the myometrium, and an acoustically enhanced posterior wall of the uterus. However, leiomyoma had a similar echopattern. Based on five cases of histologically extensive adenomyoasis, an accurate diagnosis of adenomyosis proved feasible when ultrasonography showed all three ultrasonic patterns mentioned above, associated with a retroverted uterus or possible adhesions between the uterus and structures in close proximity, nodule or outgrowth in the region of the uterosacral ligaments or in combination, as frequently found in conjunction with external endometriosis. The ultrasonographical demonstration of endometrial cyst of the ovary may contribute to an accurate diagnosis of adenomyosis. PMID- 3540156 TI - [Bacteriological studies of periodontal pockets with moderate periodontitis associated with initial periodontal preparations]. PMID- 3540157 TI - [Glycosaminoglycans in the gingival crevicular fluid in experimental periodontitis in dogs]. PMID- 3540158 TI - [Response of the periodontal tissue to E. coli endotoxin injections in immunized and non-immunized rats]. PMID- 3540159 TI - [A case of insulin autoimmune syndrome with transient islet cell surface antibodies accompanied by liver cirrhosis]. PMID- 3540160 TI - [Familial diabetes due to abnormal insulin]. PMID- 3540161 TI - Studies on tendon healing. A comparison between suturing techniques. AB - An experimental study comparing Kessler's and Tsuge's techniques for tendon suture was undertaken in dogs. Both second and fifth flexor digitorum profundi tendons of the left forepaw were divided in the segment corresponding to zone 2 of human hands. Following division, the tendons to the second digit were repaired by Kessler's technique and those to the fifth digit by Tsuge's method. Results were evaluated by means of standard and polarized--light microscopy, intravascular dye injections and tensile strength tests. Both ordinary and polarized--light microscopy showed that a microscopical gap develops between the tendon ends, being filled in with healing tissue which undergoes progressive maturation. The tensile strength tests showed that the deformation (elongation) progress directly with load, up to the point of rupture; the suture thread does not interfere with this. Furthermore, strength increases with time. Intravascular dye injection showed that a net of newly formed blood vessels develops at the site of section and suture, previously destitute of macroscopical vessels. The new vessels tended to redistribute them selves to resemble the pattern in normally vascularized regions. It was not possible to detect, by means of the methods employed, any important difference between Kessler's and Tsuge's techniques for tendon suture. PMID- 3540162 TI - Gas Man--an example of goal oriented computer-assisted teaching which results in learning. AB - Gas Man is an educational computer simulation program. The goal of the program is for the user to learn the theory and application of inhalation anesthesia uptake and distribution. The program and accompanying text are designed to be used by medical students, pharmacy students, anesthesia residents, nurses, practicing anesthesiologists, and medical equipment technicians and engineers. After using the program, the learner should understand the time course of patient response to inhalation anesthesia. He should know the factors which influence patient response and be able to predict their impact in specific situations. The key to Gas Man's success are: A well-defined and valid educational goal, teaching anesthesia uptake and distribution. An identifiable and testable set of educational objectives. A specific set of learner tasks to achieve those objectives, the actual simulation exercises. The appropriate educational medium, computer simulation and graphics. Effective software implementation, the Gas Man Program. PMID- 3540163 TI - Effectiveness of Sepharose-bound trypsin versus liquid-phase trypsin plus benzamidine for activation of inactive renin in human plasma. AB - We compared the effectiveness of two techniques involving the use of the enzyme trypsin to activate inactive renin in human plasma. Both these methods were developed to optimize activation with trypsin by preventing the possible destruction of activated renin by trypsin itself. In one method, an antitryptic agent such as benzamidine is added to plasma, concomitantly with trypsin (liquid phase). In the other a low concentration of Sepharose-bound (immobilized) trypsin is used. In six plasma samples we have found that trypsin (1.5 mg/ml) activation, with or without benzamidine (0.8 mg/ml), yielded similar values of activated renin (11.0 +/- 2.7 vs. 11.3 +/- 2.3 ng/ml/hr). However, the addition of immobilized trypsin to pool plasma pretreated with trypsin plus benzamidine caused a further increase in plasma renin activity (PRA); in contrast, the addition of trypsin and benzamidine to pool plasma pretreated with immobilized trypsin caused a decrease in PRA. In 17 plasma samples from patients with essential hypertension we found that the inactive renin values were always higher after treatment with immobilized trypsin than with trypsin plus benzamidine (9.0 +/- 0.7 vs. 6.1 +/- 0.5 ng/ml/hr, P less than 0.01); moreover, there was a positive correlation between the differences in the values of inactive renin measured with the two methods and the values obtained with immobilized trypsin (r = 0.64, P less than 0.01). Therefore, the activation with immobilized trypsin is more effective than that with liquid-phase trypsin, alone or in combination with benzamidine, in converting inactive renin in human plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540164 TI - New enzyme immunoassay of fibrin-fibrinogen degradation products in plasma using a monoclonal antibody. AB - In several diseases, such as disseminated intravascular coagulation, fibrin fibrinogen degradation products (FDP) can be detected when serum is used. To avoid the use of serum with the risk of falsely positive and negative results, and to quantitatively measure routinely low levels of FDP in plasma, we developed a solid-phase enzyme immunoassay (EIA), using a monoclonal antibody (No. FDP-14). It reacts specifically with FDP, but not with the parent fibrinogen-fibrin molecule. To raise the monoclonal antibodies we injected into mice a whole mixture of fibrin degradation products isolated after complete lysis of a human blood clot by tissue-type plasminogen activator, because there is a chance that such products resemble FDP in patients' blood more closely than antigens derived from purified fibrinogen. The EIA developed is a two-step assay ("cap-tag procedure"), in which the monoclonal antibody is attached to the wells of microtiter plates. The monoclonal antibody is specific for a neoantigenic determinant in the fragment E moiety, exposed after degradation of fibrinogen fibrin by plasmin. The assay discriminates neither between degradation products of fibrinogen and fibrin nor between fibrin degradation products that are or are not cross-linked. It is not disturbed by the presence of fibrinogen or fibrin monomer in plasma. The assay is accurate above 60 ng FDP per milliliter and has a detection limit down to approximately 10 ng FDP per milliliter when the supernatant of a lysed blood clot is used as calibration material. In frozen, then thawed plasma specimens from normal individuals, FDP values varied between 30 and 110 ng/ml. Plasma of patients with disseminated intravascular coagulation and of patients receiving thrombolytic therapy had increased FDP values. In patients with ovarian carcinoma, FDP concentrations in plasma varied with the clinical course of the disease. Results indicate that the EIA for FDP in plasma is promising as a diagnostic tool in different clinical situations. PMID- 3540165 TI - The social integration of learning disabled students from self-contained to mainstream elementary school settings. PMID- 3540166 TI - Sociometric status and solitary play of LD boys and girls. PMID- 3540167 TI - Phonological processing abilities and reading: implications for disabled readers. PMID- 3540169 TI - Mandibular ridge augmentation by visor osteotomy combined with a subperiosteal rib graft. AB - A technique is described of true rebuilding of the mandibular crest using a combination of the visor-osteotomy (Harle, 1975) and a subperiosteal rib graft (Obwegeser, 1963 b). A preliminary report on 25 patients with a mean follow-up of 30 months leads to the following conclusions: the resorption in the anterior part ist 52% of the initial gain after 43 months. In the lateral regions 61% is lost. This compares favourably with other techniques. Impairment of sensibility, although usually acceptable, is the main drawback of the procedure. PMID- 3540168 TI - On computer-assisted analysis of biological sequences: proline punctuation, consensus sequences, and apolipoprotein repeats. AB - During the past several years, the use of computer programs in the analysis of protein and DNA sequences has become commonplace. In all but the simplest procedures, the ability to critically review the results obtained with computer methods requires a basic knowledge of the algorithms employed (and the assumptions upon which they are based), an awareness of the capabilities and limitations of the particular program that implements an algorithm, and some familiarity with probability and statistics. We describe a number of computer methods that have been applied to the analysis of apolipoprotein sequences. We discuss the suitability of these methods for particular problems, how the choice of initial "parameters" can affect the results, and what the results can tell us about protein or gene sequences. We also identify some outstanding problems of apolipoprotein sequence analysis where further work is needed. PMID- 3540170 TI - Burkitt's lymphoma of the jaws in Lagos. Ten-year review. AB - This paper presents a review of Burkitt's lymphoma of the jaws seen at the Lagos University Teaching Hospital. The debate on certain aspects of the disease, particularly the pathogenesis, has also been reviewed, while the experience gained in the management has been included. PMID- 3540173 TI - Prevalence and significance of ventricular tachyarrhythmias in the general population. PMID- 3540171 TI - Mill and the right to remain uninformed. AB - In a recent article in the Journal of Medicine and Philosophy, David Ost (1984) claims that patients do not have a right to waive their right to information. He argues that patients cannot make informed rational decisions without full information and thus, a right to waive information would involve a right to avoid one's responsibility to act as an autonomous moral agent. In support of his position, Ost cites a passage from Mill. Yet, a correct interpretation of the passage in question would support one's right to remain uninformed in certain situations. If the information would hurt one's chances for survival or hurt one's ability to make calm, rational decisions, then one not only does not have a duty to find out the information, but one's exercising one's right to remain uninformed may be the only rational course of action to take. PMID- 3540172 TI - Vitamin B12 and vitamin B12 binding protein in cerebrospinal fluid of patients with Plasmodium falciparum cerebral malaria. PMID- 3540174 TI - A modified treadmill exercise protocol for computer-assisted analysis of the ST segment/heart rate slope: methods and reproducibility. AB - A new treadmill exercise protocol, modified from the standard Bruce method, was designed to improve ST segment/heart rate slope accuracy and applicability by reducing heart rate increments between exercise stages. In 150 patients exercised according to the new protocol and in 150 patients exercised according to the Bruce protocol, similar exercise tolerance and similar overall heart rate, systolic blood pressure and double product responses to exercise were observed. The mean increment in heart rate between exercise stages of the new protocol was ten beats/minute, which was significantly lower than the 27 beats/minute/stage found with the Bruce protocol. The accuracy of computer-measured ST segment depression was validated by comparison with physician measurement in a separate subgroup of patients with angina pectoris, and serial testing demonstrated stronger interest reproducibility for the ST segment/heart rate slope than for either measured ST segment depression, peak heart rate achieved or duration of exercise. PMID- 3540175 TI - Experiences from the use of twenty-four precordial chest leads in suspected acute myocardial infarction. AB - In 671 patients with suspected acute myocardial infarction (MI) and no previous MI, precordial mapping with a grid containing 24 chest leads was performed within a few hours (mean = 4.8 hours; range 0-42 hours) after arrival in hospital and four days later. In 76% of the patients the criteria for definite MI, based on serum enzymes and a 12 lead standard electrocardiogram, were fulfilled. Among patients classified as having no definite MI, 2% had abnormal Q-waves on mapping on the fourth day; among patients classified as having a subendocardial MI (no abnormal Q-waves in the 12 standard leads), 7% had abnormal Q-waves on mapping on the fourth day. In patients who subsequently developed anterior MI, changes in the sum of Q-waves and the sum of R-waves were observed for more than 12 hours after onset of pain. ST-elevations defined from a normal population were seen in the initial recording in 60% of patients with anterior MI. Among those in whom the first recording was performed less than or equal to 4 hours after onset of pain, ST elevation was initially seen in 72%. A positive correlation was observed between the initial ST elevation and severity of chest pain, incidence of congestive heart failure and two-year mortality rate. We thus conclude that some further information regarding presence of Q-waves can be obtained in about 5% of patients with suspected acute MI from an increased number of precordial leads.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540176 TI - Regeneration from half lower arms in the axolotl. AB - A technique involving grafting of pieces of skin from the head onto the limb in order to isolate halves of the limb is described. This technique was used to isolate posterior, anterior, dorsal and ventral halves of the lower arm. All halves produced regenerates but no part of the limb was able to produce a high proportion of regenerates with a complete pattern of skeletal structures. Posterior half stumps regenerated limbs with a mean digit number of 2.7 and had a normal dorsoventral muscle pattern. Anterior half stumps produced a high proportion of single-digit regenerates and had a mean digit number of 1.3. Dorsal and ventral half stumps regenerated limbs with a mean digit number of 2.8 and 2.3 respectively. Hypomorphic regenerates from dorsal and ventral half stumps often had only dorsal or ventral muscle. These results are in contrast to those from the upper arm (Wigmore & Holder, 1985) where a complete skeletal and muscular pattern regenerated from posterior and dorsal halves and hypomorphic regenerates were obtained from anterior and ventral half limbs. PMID- 3540177 TI - The cellular origin of fibronectin in the basement membrane zone of developing tooth. AB - The cellular source of fibronectin in the dental epitheliomesenchymal interface was studied in interspecies combinations of mouse and quail tissue. Species specific fibronectin antibodies were produced by immunizing rabbits with purified mouse or chicken fibronectin and by absorbing both antisera with purified heterologous fibronectin and insoluble tissue extract. The absorbed antisera to mouse and chicken fibronectin showed fluorescent staining only in mouse and chicken tissue sections, respectively, but not vice versa. When the mouse mesenchymal dental papilla was combined and cultured either with the mouse enamel organ or with the quail pharyngeal epithelium, mesenchymal cell differentiation was initiated and typical alignment of mesenchymal cells along the basement membrane was seen. Examination with transmission electron microscope revealed a typical bilaminar basal lamina with adherent fibrillar matrix on its mesenchymal aspect. Immunofluorescent localization of fibronectin with the mouse-specific fibronectin antiserum showed a brilliant staining in the mesenchymal tissue and in the basement membrane zone. When the chicken-specific fibronectin antiserum was used, no staining was detected in either tissue recombinations. We have suggested earlier that fibronectin in the dental basement membrane plays an important role during the differentiation of mesenchymal cells into odontoblasts. The present study demonstrates that fibronectin in the basement membrane of the developing tooth is produced exclusively by the differentiating mesenchymal cells. PMID- 3540178 TI - Phenolic glycolipid-I of Mycobacterium leprae induces general suppression of in vitro concanavalin A responses unrelated to leprosy type. AB - Using a costimulant assay, in vitro Con A responses of patients across the leprosy spectrum were found to be markedly suppressed by phenolic glycolipid-I (PGL-I), a unique antigen of M. leprae. The degree of inducible suppression as well as the number of leprosy patients showing suppression of mitogenic responses was higher with PGL-I as compared with integral M. leprae (p less than 0.05 to less than 0.01). Both untreated lepromatous (60%) as well as tuberculoid leprosy (67%) patients showed significant suppression ranging from 13 to 64% and 12 to 79%, respectively. Thus, PGL-I appears to have a universal suppressive effect on Con A responses and is unlikely to play a central role in determining the leprosy spectrum. PMID- 3540179 TI - Computerized electrocardiogram interpretations: are they useful for the family physician? AB - Computerized electrocardiogram (ECG) interpretation programs have become increasingly popular in this country, especially in hospital settings. In general, they reliably calculate heart rate, intervals, and mean QRS axis. When the computer interprets an ECG as normal, it is usually correct. The second opinion provided by computerized readings further benefits the primary care physician by suggesting findings not initially considered, and by forcing careful scrutiny of the original interpretation. Speed of interpretation may be greatly increased, particularly for the more experienced electrocardiographer who has a high volume of tracings to interpret. Each computer statement, however, must be carefully overread by the physician, for failure to do so may result in overlooking significant electrocardiographic findings. It is important that the family physician appreciate the strengths and weaknesses of computerized ECG interpretations so that he or she derives the greatest benefit from this diagnostic tool. PMID- 3540180 TI - Dyspareunia: an integrated approach to assessment and diagnosis. AB - Dyspareunia, or painful intercourse, is frequently referred to as the most common female sexual dysfunction. It can occur singly or be manifested in combination with other psychosexual disorders. Diagnosis of dyspareunia is appropriate in cases in which the experience of pain is persistent and severe. There has been little agreement concerning the origin of dyspareunia. Organic conditions and psychological variables have alternately been presented as major factors in causality. There is a presumed high incidence of physical disease associated with dyspareunia when compared with other female sexual dysfunctions. In the majority of cases, however, organic factors are thought to be rare in contrast with sexual issues and interpersonal or intrapsychic difficulties as a cause of continuing problems. The finding of an organic basis for dyspareunia does not rule out emotional or psychogenic causes. Thorough and extensive gynecologic and psychological evaluation is essential in cases of dyspareunia. The etiology of dyspareunia should be viewed on a continuum from primarily physical to primarily psychological with many women falling in the middle area. PMID- 3540182 TI - UCR fee schedule: the moral dilemma of it all. PMID- 3540181 TI - Differences between early- and late-maturing genotypes of the platyfish (Xiphophorus maculatus) in the morphometry of their immunoreactive luteinizing hormone releasing hormone-containing cells: a developmental study. AB - Immunoreactive luteinizing hormone releasing hormone (ir-LHRH) containing perikarya, brain nuclei, and pituitary cells were studied during the postnatal development of male sibling platyfish (Xiphophorus maculatus) genetically determined to reach puberty at two different ages using immunocytochemical, cytological, and morphometric methods. Ir-LHRH-containing perikarya first appear in the nucleus olfactoretinalis (NOR) at 5 weeks of age in early maturers and at 11 weeks in late maturers at a maximum number which is similar in both genotypes and remains constant into adulthood. The dimensions of the NOR and its perikarya increase up to the initiation of sexual maturation (gonopodial stage 2) in both genotypes. In the nucleus preopticus periventricularis (NPP), ir-perikarya appear at stage 2 and are maximum in number at maturity (stage 6) when early maturers have 50% more than late maturers. Measurements for the NPP increase between 1 week and stage 6 in both genotypes. In the nucleus lateralis tuberis (NLT), ir perikarya appear soon after stage 2 in early maturers but are never seen in late maturers. Late maturers also have fewer ir-LHRH containing pituitary cells than early maturers. In both genotypes, measurements for the NLT increase to stage 2 and then decrease to stage 6. During sexual development there are differences between early- and late-maturing genotypes in the morphometry of their LHRH containing brain centers. The timing of sexual development creates significant differences in the cytological and cytometric characteristics of the three ir LHRH-containing brain nuclei in fish of the same age but different genotype. Our results also show that for both genotypes there is a positive correlation between the total number of ir-LHRH brain neurons and the total number of ir-pituitary cells and both are lower for late maturers at every age and stage. PMID- 3540183 TI - Growth response of rat brain astrocytes cell line in a serum-free, chemically defined medium. PMID- 3540184 TI - [Effects of 24-hour continuous intravenous infusion of maltose in type II diabetics]. PMID- 3540185 TI - [Bronchoscopic protected catheter brush for the diagnosis of pulmonary infection]. PMID- 3540186 TI - Study of alpha-D-glucosidase activity in patients with Pompe's disease. PMID- 3540187 TI - A probability matrix for the identification of gram-negative, aerobic, non fermentative bacteria that grow on nutrient agar. AB - Results of the identification of 621 strains of Gram-negative, aerobic, non fermentative bacteria by a computer-based probabilistic method are given. Although many of the strains were atypical and have caused difficulty in identification in the medical diagnostic laboratory, the identification rate on this matrix was 91.5%. PMID- 3540188 TI - Comparative esterase electrophoretic polymorphism of Escherichia coli isolates obtained from animal and human sources. AB - To determine whether enzyme electrophoretic polymorphism in Escherichia coli populations was influenced by environmental background, the mobilities of four electrophoretically variable esterases (A, B, C and I) were examined. The distinction between isolates was established by significant differences in the electrophoretic distribution and the genetic diversity coefficient of individual esterases. Principal components analysis on each population and on all strains revealed three groups of allozymes. The first, characterized by slow electrophoretic mobilities of esterase B, was frequently observed in strains obtained from human extra-intestinal infections and rarely in commensal organisms. The second, characterized by fast mobilities of esterases A and B, was frequently found in animal isolates. The third, characterized by prominence of the most common mobilities of esterases B and A, was recovered in all populations. These results were confirmed by discriminant analysis. Among the 610 strains investigated, 316 electrophoretic types (distinctive combinations of allozymes of the four varieties of esterases) were distinguished, illustrating high esterase polymorphism. PMID- 3540189 TI - Highly pathogenic strains of Escherichia coli revealed by the distinct electrophoretic patterns of carboxylesterase B. AB - One hundred and ninety one strains of Escherichia coli isolated from extra intestinal infections and 85 strains isolated from the stools of healthy human beings were compared for electrophoretic mobility and isoelectric point of carboxylesterase B, and for production of alpha-haemolysin and the presence of mannose resistant haemagglutinin. Fast and slow electrophoretic mobilities were distinguished among the strains. The frequency of strains showing slow mobilities was considerably higher when they originated from extra-intestinal infections (40%) than when they were obtained from the stools of healthy individuals (7%). In a two-dimensional electrophoretic profile, the fast and slow mobility variants of carboxylesterase B were resolved into two patterns, B1 and B2, respectively. The frequency of pathogenic strains that concomitantly produced alpha-haemolysin and mannose resistant haemagglutinin was 48.7% for strains of pattern B2 but only 2.8% for strains of pattern B1. Thus, the electrophoretic pattern B2 of carboxylesterase B appears to be a molecular marker for a group of highly pathogenic E. coli strains which are frequently implicated in extra-intestinal infections. PMID- 3540190 TI - Incompatibility between E colicin plasmids. AB - We have tested the ability of pairs of colicin E plasmids to replicate stably in the same cell line. Although many of the pairs of E colicin plasmids were compatible, plasmids ColE3-CA38, ColE7-K317 and ColE8-J were mutually incompatible, as were ColE5-099, ColE6-CT14 and ColE9-J. Incompatibility between ColE6-CT14 and ColE5-099 or ColE9-J was asymmetrical, whereas incompatibility between the other plasmid pairs was symmetrical. PMID- 3540191 TI - Effect of osmotic stress on the ultrastructure and viability of the yeast Saccharomyces cerevisiae. AB - Exposure of the yeast Saccharomyces cerevisiae to hypertonic solutions of non permeating compounds resulted in cell shrinkage, without plasmolysis. The relationship between cell volume and osmolality was non-linear; between 1 and 4 osM there was a plateau in cell volume, with apparently a resistance to further shrinkage; beyond 4 osM cell volume was reduced further. The loss of viability of S. cerevisiae after hypertonic stress was directly related to the reduction in cell volume in the shrunken state. The plasma membrane is often considered to be the primary site of osmotic injury, but on resuspension from a hypertonic stress, which would have resulted in a major loss of viability, all cells were osmotically responsive. The effects of osmotic stress on mitochondrial activity and structure were investigated using the fluorescent probe rhodamine 123. The patterns of rhodamine staining were altered only after extreme stress and are assumed to be a pathological feature rather than a primary cause of injury. Changes in the ultrastructure of the cell envelope were examined by freeze fracture and scanning electron microscopy. In shrunken cells the wall increased in thickness, the outer surface remained unaltered, whilst the cytoplasmic side buckled with irregular projections into the cytoplasm. On return to isotonic solutions these structural alterations were reversible, suggesting a considerable degree of plasticity of the wall. However, the rate of enzyme digestion of the wall may have been modified, indicating that changes in wall structure persist. PMID- 3540192 TI - Differences in actin localization during bud and hypha formation in the yeast Candida albicans. AB - Stationary phase cells of Candida albicans can form either a bud or a hypha, depending upon the pH of the medium into which they are released. At low pH, cells form an ellipsoidal bud and at high pH, cells form an elongated hypha. By staining cells with rhodamine-conjugated phalloidin, we have compared the dynamics of actin localization during the formation of buds and hyphae. Before evagination, actin granules were distributed throughout the cytoplasmic cortex in both budding and hypha-forming cells. Just before evagination, actin granules clustered at the site of evagination, then filled the early evagination in both budding and hypha-forming cells. With continued bud growth, the actin granules then redistributed throughout the cytoplasmic cortex. In marked contrast, with continued hyphal growth, the majority of actin granules clustered at the hyphal apex. This distinct difference in actin granule localization may be related to the distinct differences in the expansion zones of the cell wall recently demonstrated between growing buds and hyphae. The spatial and temporal dynamics of the large neck actin granules and of actin fibres are also described. PMID- 3540193 TI - Water stress plating hypersensitivity of yeasts. AB - Saccharomyces cerevisiae, when growing exponentially in batch culture, passed through a phase in which, on average, one cell in 10(4) survived plating onto a low water activity (aw) agar medium. Stationary phase cultures were resistant as were all other species tested, with the exception of Candida krusei. In continuous culture, S. cerevisiae was more resistant at low than at high dilution rates. Plating at low aw was lethal to those cells that were not protected by an adequate content of compatible solute. In naturally resistant yeasts and in S. cerevisiae that had been exposed to an adaptation process, the compatible solute was one or more types of polyhydric alcohol. Resistance in stationary phase was attributable to a different cause. PMID- 3540194 TI - The traT protein is able to normalize the phenotype of a plasmid-carried permeability mutation of Salmonella typhimurium. AB - The isolation of different classes of antibiotic-supersensitive outer membrane permeability mutants of Salmonella typhimurium has been described previously (Sukupolvi et al., 1984, Journal of Bacteriology 159, 704-712). One of these, the SS-A mutation, sensitizes the bacteria to gentian violet and to hydrophobic antibiotics. The phenotype of the SS-A mutant was restored to normal when a cloned fragment of the F plasmid, or the R plasmid R6-5, carrying the genes traS, T and D was introduced on a multicopy plasmid. The introduction of a plasmid carrying only the traT gene showed that this gene was sufficient to restore the phenotype. Only clones with functioning traT (irrespective of copy number) restored the normal antibiotic-resistant phenotype in the SS-A mutant. An incompatibility test using a donor strain which carried transposon Tn10 in the 60 MDa plasmid of S. typhimurium and a recipient in which Tn5 was placed close to the SS-A mutation indicated that the SS-A mutation was located in the 60 MDa virulence plasmid (previously called the cryptic plasmid) of S. typhimurium. The introduction of the large virulence plasmid carrying the SS-A mutant allele into wild-type S. typhimurium or Escherichia coli resulted in strains with a phenotype identical to that of the original SS-A mutant. PMID- 3540195 TI - Nuclear suppressors of the mitochondrial mutation oxi1-V25 in Saccharomyces cerevisiae. Genetic analysis of the suppressors: absence of complementation between non-allelic mutants. AB - Ten informational nuclear suppressors of the oxi1- mitochondrial mutation of Saccharomyces cerevisiae are recessive. They are linked to each other, but their allelism is uncertain. Some of them unfavourably affect functions of standard (mit+) mitochondrial genomes. One suppressor severely impairs or entirely prevents mitochondrial functions of the spore clones carrying it. The spectrum of mit- mutations on which these suppressors act is similar to that exhibited by nam3-1. In double heterozygotes namx/NAM3+, NAM+x/nam3-1 the oxi1- (and box3-) mutation is suppressed, yet one of our suppressors (R705) and nam3-1 show independent segregation in tetrads. This indicates that there may be absence of complementation between non-allelic suppressors. PMID- 3540197 TI - Cord factor is associated with the maintenance of the chronic inflammatory reaction caused by mycobacteria. AB - The distribution of an aqueous suspension of cord factor (CF) from Mycobacterium bovis BCG in several mouse organs was examined after intravenous injection, and the correlation between evolution of the inflammatory granulomatous reaction and the presence of CF in these organs was determined. CF was preferentially deposited in the lungs and liver, and the kinetics of the pulmonary and hepatic inflammatory reaction, evaluated by determining the indices for these organs, showed a gradual increase on day 2 after injection, reached a peak around the fifth day, and declined thereafter. Histological analysis showed that on day 5 both the lungs and the liver were diffusely damaged by a mononuclear inflammatory infiltrate arranged in a granulomatous manner and consisting predominantly of histiocytes. CF elimination was more marked in the liver than in the lungs: 2 d after injection 76% of the material deposited in the liver had been eliminated. Little or no CF was detected in the liver and lungs by day 16, when the inflammatory reaction was also substantially decreased. A second CF dose administered 8 d after the first exacerbated the inflammatory process in both the lungs and the liver, indicating that the intensity of this process depends on CF concentration in the lesion site. PMID- 3540196 TI - Transport and hydrolysis of peptides in Saccharomyces cerevisiae. AB - The transport and hydrolysis of several radioactive di- and tripeptides in Saccharomyces cerevisiae was studied. A peptide-transport-deficient mutant isolated on the basis of its resistance to nikkomycin Z lost most of its capacity to take up di- and tripeptides. The transport kinetics of [14C]methionylglycine, [14C]methionylsarcosine and [3H]nikkomycin Z indicated that peptide transport is not dependent on intracellular hydrolysis. Intact cells had some peptidase activity towards methionylsarcosine but not towards nikkomycin Z. The relationship between this activity and peptide transport is discussed. PMID- 3540198 TI - Suppression by the ColV,I-K94 plasmid of a growth lesion in ompA mutants of Escherichia coli. AB - Organisms of three independently isolated ompA mutants of Escherichia coli failed to form colonies on glucose minimal agar (glucose MA) at 44 degrees C after growth in glucose minimal salts medium at 37 degrees C, although all three strains formed colonies on nutrient agar at 44 degrees C. Supplementation of the glucose MA with individual amino acids including L-methionine and/or L-cysteine did not allow colony formation at 44 degrees C, although addition of 0.1% Casamino acids was effective; replacement of glucose with other energy sources or ammonium ions with glutamate also did not allow growth at 44 degrees C. The failure to form colonies at 44 degrees C was not due to killing of the organisms, because colonies were formed if plates of the ompA mutant initially incubated at 44 degrees C were shifted to 30 degrees C after 16 h. Introduction of the ColV, I K94 plasmid into P678-54 ompA, 1131 ompA or an ompC ompA mutant suppressed the 44 degrees C growth lesion, but other plasmids (F lac, R483ColIa, RI, ColB-K98, R124) tested in P678-54 ompA did not. Growth of the ColV, I-K94+ derivative at 44 degrees C was due to a suppressing effect of the plasmid rather than to introduction of the plasmid into a variant with normal or altered OmpA protein. An attempt was made to ascertain which component(s) encoded by ColV, I-K94 was (were) responsible for allowing growth at 44 degrees C. Transfer components appeared unlikely to be involved and plasmids which conferred individual colicins (plus the corresponding immunity component) did not suppress.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540199 TI - Cloning and expression of the pepD gene of Escherichia coli. AB - Peptidase D of Escherichia coli, cleaving the unusual dipeptide carnosine, was found to be encoded by the ColE1 hybrid plasmid pLC44-11. From this plasmid the pepD gene was subcloned into small vectors. As shown by successive reduction of the flanking sequences of genomic DNA, the order of genes in the region at 6 min of the E. coli K12 map is phoE, pepD, in the clockwise orientation. Insertional inactivation of the pepD gene and expression of recombinant plasmids in maxicells allowed the identification of the pepD product as a 52 kDa protein. Comparison with the 100 kDa protein molecular mass determined by gel filtration suggests that active peptidase D is probably a dimer. PMID- 3540200 TI - Phenotypic characteristics of a slow-growing, nongerminating variant of Candida albicans. AB - Some of the phenotypic characteristics of a slow-growing, nongerminating variant of a commonly studied strain of Candida albicans are described. The variant arose as a chance isolate. The rate of occurrence was about 0 X 1% and the reversion rate was about 1 per 10(6) cells. The colony size was typically smaller than that of the parent and the yeast cells tended not to separate from one another so that catenulate strands of cells (pseudohyphae) were formed. Under standard conditions the generation time of the small-colony variant in liquid shake cultures was about twice that of the parental strain. Growth of the variant was suppressed by antimycin A, indicating that the small colony form was not the consequence of a defect in the cytochrome system. The colony size of the variant was not influenced by chlorobenzotriazole, which suggested that adenine metabolism was not involved in the small-colony phenotype. The pseudohyphal growth pattern was not relieved by high concentrations of utilizable carbohydrates, which means the catenulate microscopic appearance of the yeast cells was not simply an exaggeration of the normal growth pattern of isolates of C. albicans but more probably represented the growth of a cell-cycle mutant defective at the cell separation step. The cytoplasmic proteins of the variant and the parent were very similar though some unique peptides were displayed by each. PMID- 3540201 TI - Dimorphism-associated variations in the lipid composition of Candida albicans. AB - Yeast and mycelial forms of Candida albicans ATCC 10231, growing together in 12 h and in 96 h cultures, were separated and their lipids were extracted and characterized. The total lipid content of the yeast forms was always lower than that of the mycelial forms. In 12 h cultures the lipids from the two morphological forms consisted mainly of polar compounds, viz, phospholipids and glycolipids. In 96 h cultures both the yeast and mycelial forms accumulated substantial amounts of apolar compounds, mainly steryl esters and triacylglycerols. The mycelial forms were more active than the yeast forms in this respect. Major differences in the lipid composition between the two morphological forms involved the contents of sterols and complex lipids that contain sterols. As a rule, the yeast lipids contained much larger proportions of free sterols than the mycelial lipids. However, the mycelial lipids contained several times more sterols than the yeast forms but bound as steryl glycosides, esterified steryl glycosides and steryl esters. Steryl glycosides and esterified steryl glycosides occurred in yeast lipids only in traces, if at all. The major steryl glycoside in the mycelial forms was unequivocally identified as cholesteryl mannoside. At both phases of growth the apolar and polar lipid fractions from the mycelial forms contained higher levels of polyunsaturated fatty acids (18:2 and 18:3) but lower levels of oleic acid (18:1) than the corresponding fractions from the yeast forms. The lipid content and composition of 12 h and 96 h yeast and mycelial forms of C. albicans KCCC 14172, a clinical isolate, were almost identical with those of C. albicans ATCC 10231. PMID- 3540202 TI - Isolation of a mycelial mutant of Candida albicans. AB - A mutant of Candida albicans strain MEN, which was unable to produce mycelia in SSV medium and in horse serum at 37 degrees C, was isolated by a physical separation procedure. The mutant was shown to be derived from the parental strain by growth and morphology studies, sugar uptake and fermentation patterns, and the presence of genetic markers. PMID- 3540203 TI - The lipid composition of azole-sensitive and azole-resistant strains of Candida albicans. AB - The lipid compositions of two azole-sensitive (A and B2630) and two azole resistant (AD and KB) strains of the opportunistic fungal pathogen Candida albicans were studied by using several lipid extraction procedures: no differences were observed between the lipid content or total phospholipid/neutral lipid ratios of the four strains. All contained phosphatidylethanolamine, phosphatidylcholine, phosphatidylinositol and phosphatidylserine as major phospholipids, with smaller amounts of phosphatidylglycerol and diphosphatidylglycerol; the relative proportions of these lipids differed between all four strains. The fatty acid composition of each major phospholipid within each strain differed, and there were also interstrain differences. A marked effect of culture growth phase in batch culture on lipid composition was observed. The major neutral lipids in each strain were triacylglycerol, non esterified sterol and non-esterified fatty acid. The fatty acid compositions of the three fatty-acid-containing neutral lipids were distinct from each other and the phospholipids, and there were also interstrain differences. All strains possessed (lyso)phospholipase activity, which was non-specific. The proportions of triacylglycerol and non-esterified fatty acid did not vary between strains, but the azole-resistant strains AD and KB contained more non-esterified sterol, giving them a phospholipid/sterol ratio approximately half that of azole sensitive strains. There appeared to be a relationship between the phospholipid/sterol ratio of exponentially growing sensitive strains and their ability to take up azole; this did not extend to the resistant strains, which either did not take up azole (AD and KB) or took it up at a faster rate (Darlington) than sensitive strains. PMID- 3540204 TI - Extracellular oligosaccharides and low-Mr polysaccharides containing (1----2) beta-D-glucosidic linkages from strains of Xanthomonas, Escherichia coli and Klebsiella pneumoniae. AB - One strain each of Xanthomonas campestris and 'Xanthomonas phaseoli', three strains of 'Xanthomonas oryzae', and five strains each of Escherichia coli and Klebsiella pneumoniae were found to produce a mixture of (1----2)-beta-D-gluco oligosaccharides and/or low-Mr (1----2)-beta-D-glucans in their culture media. The saccharides from the strains of Xanthomonas were all composed of unbranched, linear (1----2)-beta-D-glucosaccharides with degrees of polymerization (DPs) of 8 to about 20, and a cyclic (1----2)-beta-D-glucan (DP16) containing one (1----6) linkage and one alpha-linkage. The saccharides produced by the five strains of E. coli and four strains of K. pneumoniae were glucans with branches at O-6, and DPs of 10 to 15, whereas one strain of K. pneumoniae produced unbranched linear (1--- 2)-beta-D-glucosaccharides with DPs of 6 to about 20. PMID- 3540206 TI - A genetic and biochemical analysis of the role of gluconeogenesis in sporulation of Saccharomyces cerevisiae. AB - The requirement for gluconeogenesis and the pentose phosphate pathway in sporulation of Saccharomyces cerevisiae was investigated using homozygous diploids with mutations in selected portions of the respective metabolic pathways. Mutations affecting the genes FBA1 (fructose-1,6-bisphosphate aldolase), GPM1 (phosphoglycerate mutase) and ZWF1 (glucose-6-phosphate dehydrogenase) were used. Homozygous diploids bearing either fba1-11 or gpm1 mutations were asporogenous, indicating an absolute requirement for gluconeogenesis in sporulation. A strain homozygous for the zwf1 mutation sporulated, but at a reduced level compared to the wild-type. Homozygous spd1-1 mutations restored the ability to sporulate in fba1-11 homozygous diploids; this is believed to occur as a consequence of reduced NH+4 levels in spd1-1-bearing strains, the reduced intracellular NH+4 content serving to promote gluconeogenesis via the residual low levels of enzyme activity present in such mutants. PMID- 3540205 TI - The role of surface polysaccharide in determining the resistance of Serratia marcescens to serum killing. AB - Two O14:H12 strains of Serratia marcescens with different sensitivities to killing by normal pooled human serum were investigated. Complement binding, studied by measuring hydrophobicity and using rocket immunoelectrophoresis with anti-human C3, showed the sensitive cells (S1220) rapidly bound and fixed complement whereas the resistant cells (4444-60) bound less C3b. The strains had identical membrane protein composition. Crossed immunoelectrophoresis suggested that in S1220 cells the polysaccharide material including LPS was less antigenic and present in smaller amounts than in 4444-60 cells. This was confirmed by examining extracted polysaccharide material chemically and by SDS-PAGE. The resistant strain had 33% more phenol-extractable polysaccharide material than the sensitive strain, possibly comprising LPS with longer O antigen chain lengths, or a microcapsule of O antigen polysaccharide. Extra polysaccharide material on the surface of the resistant strain prevents complement components binding and reaching the hydrophobic membrane where lytic lesions occur. PMID- 3540207 TI - Structural differences between subtype A and B strains of respiratory syncytial virus. AB - Differences in the properties of homologous intracellular structural components of eight strains of subtype A and eight strains of subtype B of human respiratory syncytial (RS) virus were examined. The size of the fusion (F) protein cleavage products and the phosphoprotein (P) showed systematic differences between virus strains representing the two subtypes. The apparent mol. wt. in SDS polyacrylamide gels under reducing conditions was 48,000 (48K) and 46K to 47K for the cleavage product F1 in subtype A and B strains, respectively. The size of the F2 protein was 18K to 20K. The subtype B strains showed a slightly higher mol. wt. of this protein compared to the subtype A strains. The size of the P protein was 36K in subtype A strains, but only 34K in subtype B strains. Variations also occurred in the size of the glycoprotein (G) and the 22K to 24K structural protein. These variations did not correlate with the virus subtypes, but were strain-specific. The size of non-glycosylated forms of the F protein cleavage products was determined by use of material from tunicamycin-treated cells. A 44K to 45K non-glycosylated form of the F1 protein was detected with subtype A virus strains, but the corresponding protein of subtype B strains was not reproducibly identified, presumably due to instability in the absence of glycosylation or altered antigenicity. Monoclonal antibody immunosorbent-bound viral glycoproteins were partially digested with proteases. The pattern of breakdown products of the F1 protein was distinctly different between subtype A and B strains, but it was similar among strains of the same subtype. No subtype-specific pattern was seen in proteolytic digests of monoclonal antibody-bound G protein. PMID- 3540208 TI - [Hemoglobinopathies and related syndromes. General introduction. Personal experience in Africa and Europe]. PMID- 3540209 TI - [Hemolytic anemia caused by congenital anomalies of the erythrocyte membrane]. PMID- 3540211 TI - Replication of hepatitis B virus in culture systems with adult human hepatocytes. AB - We developed a technique for isolation and primary culture of adult human hepatocytes from surgical liver biopsy specimens by in situ perfusion and a shaking method. Cultured hepatocytes were maintained in monolayers for more than three weeks and showed morphological and functional characteristics in vivo. The cultured human hepatocytes were inoculated with hepatitis B virus (HBV). Hepatitis B surface antigen (HBsAg) in the medium was detected for about three weeks after inoculation, which was longer than that reported in previous studies. In one case of high attachment efficiency, hepatitis B e antigen (HBeAg) was detected in the medium five to eight days after inoculation. HBsAg and HBeAg were also detected in the extracts of inoculated human hepatocytes. Immunofluorescence study revealed HBsAg in 20-30% of hepatocytes and hepatitis B core antigen (HBcAg) in 2-3% of the cultured human hepatocytes four days after inoculation. Free HBV DNA was identified in the human hepatocytes for at least two weeks after inoculation, although single-stranded HBV DNA was not detected. These studies suggest that HBsAg was actively produced and that HBV replicated in a small number of inoculated adult human hepatocytes in primary culture. However, further improvement of culture systems is needed for active replication of HBV in vitro. PMID- 3540212 TI - Controlled clinical trial of acyclovir in chronic hepatitis B virus infection. AB - A randomised, controlled trial comparing acyclovir, 45 mg/kg/day as a continuous IV infusion for 28 days, with no other therapy, was carried out in 30 stable HBsAg carriers seropositive for HBeAg for more than 6 months. Twenty-eight had hepatitis B virus DNA-polymerase activity and/or hepatitis B virus DNA in serum at entry into the study. There were no significant adverse effects of therapy. At 12 months, seroconversion from HBeAg to anti-HBe had occurred in four of 15 treated patients, one of whom had also developed anti-HBs, compared with only one of 15 in the untreated group (95% confidence limits 12% and 51%). Seroconversion from HBeAg to anti-HBe was accompanied by return of serum liver function tests to normal and improved liver histology. The results of this study indicate that acyclovir is of no significant benefit in chronic HBeAg carriers with stable disease. PMID- 3540210 TI - Prenatal diagnosis of inherited hemoglobinopathies. AB - In this paper we reviewed the different methods presently available for prenatal diagnosis of hemoglobin disorders and the impact of this technology in the control of beta-thalassemia in several Mediterranean populations. The vast majority of the inherited hemoglobinopathies can now be detected in the fetus by amniocyte or trophoblast DNA analysis. alpha-thalassemias, delta beta thalassemias and gamma delta beta-thalassemias, which are usually caused by a gross structural rearrangement of the DNA, may be directly detected by Southern blot analysis. Only a few beta-thalassemia lesions are caused by gene deletion or affect a restriction recognition site and thus may be directly identified by this method. The major part of beta-thalassemia are due to single nucleotide substitution, small deletion or addition which do not alter a restriction recognition site. These mutations may be directly detected by complementary oligonucleotide probes. Alternatively, when normal or affected children are available, fetal diagnosis may be accomplished by linkage analysis with polymorphic restriction sites. Fetal blood analysis is used at present time for those cases presenting too late in the pregnancy for characterization of the molecular defect and in prospective parents in whom the defect is not known. Introduction of prenatal diagnosis in combination with carrier screening in several mediterranean populations led to a consistent reduction in the incidence of homozygous beta-thalassemia. PMID- 3540213 TI - The American Society for Neurochemistry (ASN): antecedents, founding, and early years. AB - Events leading to and the influences on the founding of the American Society for Neurochemistry are recounted, with emphasis on early activities of neurochemists in the United States, as well as the international activities, that led to the founding of both the International and American societies (in 1965 and 1969, respectively). The founding of the American Society for Neurochemistry in the period 1968-1969 and its first annual meeting in 1970 are described, together with significant developments during the early years of the Society. PMID- 3540214 TI - Taurine biosynthesis in rat brain: a new specific and sensitive microassay of cysteine sulfinate decarboxylase (CSDI) activity through selective immunotrapping and its use for distribution studies. AB - Cysteine sulfinate decarboxylase (CSD), the putative biosynthetic enzyme for taurine, has been shown to exist in two forms in rat brain, respectively CSDI and CSDII, one of which (CSDII) is considered to be in fact glutamate decarboxylase (GAD). CSDI assay after immunotrapping was made possible by using an anti-CSD antiserum raised in sheep immunized with a partially purified CSD fraction from liver. This antiserum immunoprecipitated both liver CSD and brain CSDI activities with the same affinity but did not inhibit their enzymatic activities. The immunotrapping of CSDI was selective without any contamination by GAD/CSDII activity. The immunotrapped CSD activity, which corresponded exactly to the amount of CSD not precipitated by a GAD/CSDII antiserum, was not inhibited by a specific irreversible GAD inhibitor. A quantitative, selective and sensitive assay was thus developed by measuring CSD activity on the solid phase after immunotrapping. Kinetic parameters of the immunotrapped enzyme remained unchanged. CSDI activity represented only a fraction, around 20% with saturating concentration of substrate, of the total CSD activity in rat brain homogenate. This indicates that most studies on total CSD activity dealt essentially with CSDII activity that is indeed GAD. Regional and subcellular distributions of CSDI have been determined. CSDI activity was about threefold higher in the richest (cerebellum) compared to the poorest (striatum) region without any correlation with GAD/CSDII distribution. Subcellular distribution showed a fourfold enrichment of CSDI activity in the synaptosomal fraction. The precise role of CSDI and CSDII in the biosynthesis of taurine in vivo remains to be elucidated. PMID- 3540215 TI - Immunocytochemical characterization of glutamate dehydrogenase in the cerebellum of the rat. AB - The immunocytochemical distribution of glutamate dehydrogenase was studied in the cerebellum of the rat using antibodies made in rabbit and guinea pig against antigen purified from bovine liver. Antiserum was found to block partially enzymatic activity both of the purified enzyme and of extracts of the rat cerebellum. Using immunoblots of proteins of rat cerebellum, a major immunoreactive protein and several minor immunoreactive proteins were detected with antiserum. Only a single immunoreactive protein was detected using affinity purified antibody preparations. This protein migrates with a molecular weight identical to that of the subunit of glutamate dehydrogenase. Further evidence that the antibodies were selective for glutamate dehydrogenase in rat cerebellum was obtained through peptide mapping. Purified glutamate dehydrogenase and the immunoreactive protein from rat cerebellum generated similar patterns of immunoreactive peptides. No significant cross-reaction was observed with glutamine synthetase. Immunocytochemistry was done on cryostat- and Vibratome-cut sections of the cerebellum of rats that had been perfused with cold 4% paraformaldehyde. Glial cells were found to be the most immunoreactive structures throughout the cerebellum. Most apparent was the intense labeling of Bergmann glial cell bodies and fibers. In the granule cell layer, heavy labeling of astrocytes was seen. Purkinje and granule cell bodies were only lightly immunoreactive, whereas stellate, basket, and Golgi cells were unlabeled. Labeling of presynaptic terminals was not apparent. These findings suggest that glutamate dehydrogenase, like glutamine synthetase, is enriched in glia relative to neurons. PMID- 3540216 TI - Sensitivity and specificity of single and combined tumour markers in the diagnosis of leptomeningeal metastasis from breast cancer. AB - The clinical efficacy of four laboratory tests in detecting leptomeningeal metastases in 57 patients with breast carcinoma was assessed. The sensitivity and specificity of beta-glucuronidase, beta 2-microglobulin, carcinoembryonic antigen and lactate dehydrogenase in cerebrospinal fluid were determined. As a single test beta-glucuronidase was the most sensitive (93%) and specific (93%) for discriminating between leptomeningeal metastases and other CNS metastases from breast cancer. Lactate dehydrogenase was the next most useful marker. Both beta 2 microglobulin and carcinoembryonic antigen had a sensitivity of 60%. More specific results were achieved by combining beta-glucuronidase and lactate dehydrogenase. CSF beta-glucuronidase may be useful by itself and in combination with lactate dehydrogenase in the detection of leptomeningeal metastases from breast carcinoma. PMID- 3540218 TI - Immunocytochemically-stained vasopressin binding sites in rat brain. Ventricular application of vasopressin/Accurel in the Brattleboro rat. AB - An immunocytochemical procedure was developed to localize binding sites for vasopressin (VP) in the brain of Brattleboro (di/di) rats after 2 weeks of continuous ventricular administration of the peptide. Accurel-polypropylene tubing loaded with 0.15, 1.5 or 15 micrograms vasopressin was implanted into the lateral ventricle. Subsequently, bound VP was detected immunocytochemically in 2 distinct patterns: in perineuronal structures and dots between cells, in the lateral septum (dorsorostral part), striatum, cingulate cortex, granular cells of the dentate gyrus of the hippocampus, pyramidal cells of CA1 and CA3 hippocampal areas and around cerebellar Purkinje cells. The high dose (15 micrograms) loaded implants revealed the most intense staining; in the cytoplasm of neuronal cell bodies in the lateral and medial septum, striatum, cingulate cortex, bed nucleus of the stria terminalis, organum vasculosum of the laminae terminalis and locus coeruleus. The most intense staining in cell bodies was observed in brains which had low-loaded implants (0.15-1.5 microgram). A variety of controls, proved that no aspecific uptake was involved in the present procedure. The distribution of VP binding sites was only partly coincident with known sites of VP fiber innervation, and largely agrees with data obtained by autoradiographic techniques for [3H]VP binding. The present immunocytochemical technique gave a higher resolution than the currently used autoradiographic techniques. The differences in pattern and intensity of staining due to increasing the dosage rate of the in vivo vasopressin treatment, might mean that the current procedure retains preferentially either low or high affinity populations of binding sites depending on the implanted dose. PMID- 3540217 TI - Immunocytochemical analysis of myosin heavy chains in human fetal skeletal muscles. AB - Quadriceps muscle samples from human fetuses (10 weeks of gestation to term) were studied using immunocytochemical methods with monoclonal antibodies against fetal, adult-slow and adult-fast B myosin heavy chains. The monoclonal antibodies were selected for their virtually exclusive specificity for a particular isomyosin and used to investigate the expression of different myosin heavy chains during fetal development of muscle fibres. Concomitant studies of the myofibrillary ATPase pattern of muscle fibres were carried out. A fetal-specific myosin was persistently expressed during fetal life but at a continuously decreasing rate. Adult-slow myosin was observed in a small pool of muscle fibres, histochemically undifferentiated, in fetuses of 14-16 weeks of gestation. However, adult isomyosins appeared intensively only in the late fetal period, progressively replacing fetal myosin. The genes coding for adult-slow myosin are expressed earlier that those coding for adult-fast myosin. Myosin heavy chains specific for the neonatal period were not demonstrated with the antibodies used in this study. The contribution, provided by the present study, to the knowledge of the sequence of events in the expression of myosin heavy chains during normal muscle development, may allow a better understanding of eventual myosin changes which may occur in genetic muscle disorders. PMID- 3540219 TI - Stimulation of human PMNs in vitro by a succinimide molecular complex of methylfurylbutyrolactone. AB - The immunopotentiating effects on human neutrophils of a new synthetic immune biological response modifer were studied. The compound is a succinimide crystalline molecular complex of methylfurylbutyrolactone (MFBL). The MFBL succinimide (MFBL-S) derivative was tested for its in vitro effects on polymorphonuclear leukocyte (PMN) functions. At microgram quantities, MFBL-S stimulated a twofold increase in: directed migration of PMNs; adherence to nylon; and uptake of E. coli lipopolysaccharide. The MFBL-S enhanced phagocytosis by PMNs of S. epidermidis and E. coli. Additionally, intracellular killing of S. epidermidis by MFBL-S treated PMNs was significantly increased at all doses studied, whereas killing of E. coli was only significantly different from controls at concentrations of 10 micrograms/ml. PMID- 3540220 TI - In memoriam. Peter Wilhelm Lampert, M.D. (1929-1986). PMID- 3540221 TI - Cardiodynamics of hypertension: a guide to selection of therapy. PMID- 3540222 TI - A new sustained-release formulation of verapamil in the treatment of hypertension. AB - The study was carried out in 24 patients with mild to moderate essential hypertension to assess the antihypertensive efficiency and tolerability of a new sustained-release formulation of verapamil (tablets containing 240 mg). The trial was conducted as a single-blind crossover study for periods of 4 weeks, preceded by a 2-week placebo period, comparing sustained-release verapamil twice daily with instant-release verapamil (conventional tablets of 80 mg) mg) 160 mg twice daily. Both regimens induced a significant reduction in blood pressure and heart rate, and this effect was (particularly for sustained-release verapamil) significant from the very first day of treatment. Both formulations were well tolerated. The pharmacokinetic data obtained and the even blood pressure reduction achieved demonstrate that this new verapamil formulation has sustained release characteristics and is sufficient as a twice-daily medication in mild/moderate essential hypertension. PMID- 3540223 TI - Efficacy of sustained-release verapamil: automatic ambulatory blood pressure monitoring. AB - The potential antihypertensive effect of sustained-release (SR) verapamil was compared to immediate-release (IR) verapamil in a group of patients with essential hypertension. All patients were withdrawn from their previous antihypertensive medication(s) and were entered into an open-label IR verapamil study (dose varying from 80 to 120 mg TID). Patients were subsequently randomized in a double-blind fashion to continue the same dose of IR verapamil or an equivalent dose of SR verapamil. Automatic ambulatory blood pressure recordings were carried out with a Del Mar Avionics PIII Unit in eight patients who were randomized into the SR group. An initial 24-hour recording was performed on the IR verapamil group during the open-label phase and repeated following treatment with SR verapamil. Mean 24-hour systolic blood pressure (SPB) and diastolic blood pressure (DBP) were 143 +/- 18 mmHg and 89 +/- 6 mmHg, respectively, on IR verapamil and 142 +/- 22 and 90 +/- 6 mmHg, respectively, on SR verapamil. There were no statistically significant differences noted between the two groups. Mean SBP and DBP varied similarly during waking and sleeping periods with IR and SR verapamil: With IR verapamil, SBP was 139 +/- 18 and 124 +/- 20 mmHg and DBP was 92 +/- 11 and 84 +/- 13 mmHg during waking and sleeping hours, respectively; with SR verapamil, SBP was 138 +/- 21 and 122 +/- 22 mmHg and DBP 92 +/- 10 and 80 +/- 10 mmHg during waking and sleeping hours, respectively. DBP was less than or equal to 90 mmHg in approximately 70% and 60% of patients in the IR verapamil and SR verapamil groups, respectively. Trough plasma levels of 92 +/- 44 and 67 +/- 32 ng/ml were measured by HPLC, 2 and 4 weeks, respectively, after treatment with IR verapamil. During a similar time interval, SR verapamil revealed plasma levels of 64 +/- 59 and 92 +/- 57 ng/ml, respectively. No correlation between change in DBP and plasma level of verapamil was demonstrated. No significant change in heart rate was observed during the 4-week period. In summary, verapamil is an effective antihypertensive medication and can be administered once a day as a slow-releasing preparation; it is most useful in patients in whom adrenergic blocking drugs are indicated. PMID- 3540224 TI - The impact of dietary sodium intake on the hypotensive response of verapamil in essential hypertension. PMID- 3540225 TI - Therapeutic implications from clinical trials for the treatment of hypertension. PMID- 3540226 TI - Pharmacology and mechanisms of action of calcium-channel blockers. AB - The calcium-channel blockers represent a group of organic chemical structures that share the ability to inhibit Ca2+ entry into excitable cells. In coronary and peripheral arterial smooth muscle and the heart, inhibition of Ca2+ entry blunts the ability of Ca2+ to serve as an intracellular messenger. Thus, calcium channel blockers are smooth-muscle dilators and have a negative inotropic effect on the working myocardial cells of the atria and ventricles. Calcium-channel blockers also have effects on impulse formation and conduction in some regions of the heart. A fast, Na+-dependent ionic current is responsible for the upstroke of the action potential in the working cells of the atria and ventricles and in the rapidly conducting cells of the His-Purkinje system, so that the calcium-channel blockers do not inhibit conduction in these cells. In the sinoatrial and atrioventricular nodes, where depolarization is due primarily to a Ca2+-dependent slow inward current, the calcium-channel blockers slow the sinus pacemaker and inhibit atrioventricular conduction. The actions of different calcium-channel blockers are not always similar; for example, nifedipine is much more potent as an inhibitor of calcium channels in smooth muscle than in the heart, whereas verapamil and diltiazem are approximately equipotent in heart and vascular smooth muscle. It is likely that the calcium-channel blockers reach their specific binding sites in membranes by first dissolving in the phospholipid bilayer, after which they may interact with hydrophobic regions of proteins that make up, or regulate, these channels. Further knowledge of these molecular properties should facilitate the development of new calcium-channel blockers with improved specificity. PMID- 3540227 TI - Calcium-channel blockers for hypertensive emergencies. PMID- 3540228 TI - Racial difference in response to antihypertensive drugs. A focus on verapamil. PMID- 3540229 TI - Evaluation of verapamil in the treatment of hypertension. AB - Two separate randomized double-blind, crossover trials were carried out in hypertensive patients to evaluate the antihypertensive efficacy and safety of verapamil. In the first study, verapamil, in doses of 120 mg three times daily, was compared with pindolol, in doses of 7.5 mg twice daily. A thiazide diuretic was given with both drugs. In another study, verapamil, in doses of 160 mg twice daily, was compared with 200 mg twice daily of labetalol in hypertensive patients with coexisting chronic obstructive lung disease. Blood pressure fell equally with these drugs, and neither of the drugs caused significant side effects. Labetalol significantly reduced both forced expiration volume at 1s (FEV1) and forced vital capacity (FVC), suggesting a bronchoconstrictor effect. Verapamil was devoid of any such effect. Verapamil did not affect plasma renin concentration. PMID- 3540230 TI - Multimodality imaging of the thyroid and parathyroid glands. AB - Nuclear imaging of the thyroid and parathyroid glands has evolved from early radionuclide rectilinear thyroid scanning to the recently developed dual isotope subtraction technique for detecting parathyroid lesions. At the same time, x-ray fluorescent scanning, ultrasound, x-ray computed tomography, and magnetic resonance imaging have improved identification of these endocrine organs. The appropriate use and relative role of these imaging modalities in the investigation of patients with thyroid and parathyroid diseases is discussed. PMID- 3540232 TI - Clinical utility of imaging cell labels: radiolabeled red cells, white cells and platelets. PMID- 3540231 TI - Energy-dependent imaging in digital radiography: a review on acquisition, processing and display techniques. PMID- 3540233 TI - Childbirth in the eighties: what next? When alternatives become mainstream. PMID- 3540234 TI - Influence of diets with different levels of protein and energy on liver albumin content in the rat. AB - The influence of protein ingestion on liver albumin synthesis and albumin content was investigated in rats fed protein as a meal (90% casein) given apart from the other dietary components provided ad libitum. In this condition, protein ingestion rapidly stimulates liver total protein synthesis. Separately fed rats were studied 6 and 20 h after the protein meal. Control rats fed mixed diets containing 13 or 80% casein were killed either during the absorptive (night) or postabsorptive (light) periods. The ratio of hepatic albumin synthesis to total protein synthesis remained fairly constant (12-15%) in all groups, indicating that albumin synthesis paralleled total protein synthesis. Liver albumin content measured in microsomes by immunonephelometry was significantly higher in separately fed rats killed 6 h postmeal than in those killed after 20 h. In rats fed 13% casein, the liver albumin content remained high regardless of the time of killing. In rats fed 80% casein, the albumin content was higher during the absorptive period than during the postabsorptive period. Immunoperoxidase staining of the hepatocyte organelles involved in albumin synthesis, especially the Golgi apparatus, was more intense for separately fed rats killed 6 h postmeal than for those killed after 20 h. Livers of rats fed 13% casein also exhibited a pattern indicative of high hepatocyte albumin content, whereas livers of rats fed 80% casein contained less. These results show that, in separate feeding, wide circadian variations of albumin synthesis run parallel to changes in liver albumin content. PMID- 3540235 TI - Screening for primary aldosteronism: hypokalemia in hypertensive patients. AB - A serum potassium determination is usually recommended for new hypertensive patients as a screening test for primary aldosteronism and as a baseline for drug therapy. Since hypokalemia is not specific for aldosteronism, the authors assessed its use and limitations as a screening test in nine reported studies of 303 patients with aldosterone-producing adenomas (n = 252) or adrenal hyperplasia (n = 51). The optimal potassium cutoff level and the predictive ability of hypokalemia to detect aldosteronism were analyzed in a primary care setting with different diseases, test characteristics, and prevalences. Optimal screening for primary aldosteronism occurred at serum potassium less than 3.2 mEq/l in a primary care, low-prevalence population, and at higher potassium levels in higher prevalence populations. Other screening tests, such as urinary aldosterone levels and plasma renin activity, showed lower individual test performance characteristics, but when combined were similar in performance to serum potassium measurement. PMID- 3540237 TI - Iliac bone grafting: review of 160 consecutive cases. AB - A series of 160 consecutive iliac bone graft cases involving harvesting of either a superior medial, lateral, or full-thickness graft was reviewed to study the associated morbidity. The histories were examined for indication of infection, wound breakdown, pain, blood loss, and length of hospital stay. Although there were few problems associated with any procedure, those patients with superior medial grafts had less blood loss and ambulated earlier. All patients were asked to complete a mail-in questionnaire that reported postoperative pain, neurologic problems, ambulation difficulties, and subjective appearance of the surgical scar. Overall, the patients' acceptance of the procedure and their perception of the outcome was favorable. PMID- 3540236 TI - Pelvic inflammatory disease: current concepts and treatment guidelines. PMID- 3540238 TI - Effects of pre- and postoperative irradiation on the healing of bone grafts in the rabbit. AB - Healing of cellular bone grafts irradiated at various times in the postsurgical course was compared to the healing characteristics of bone grafts placed into already irradiated tissue and to controls of irradiated host mandible in a rabbit model. Physical graft consolidation was assessed by load stress characteristics and serial histologic examination. Results indicated that grafts placed into already irradiated tissues failed to form bone in both phases of expected regeneration resulting in structurally weakened and histologically deficient ossicles. Bone grafts irradiated after placement were tolerant of irradiation. Bone grafts irradiated after four weeks were found to be less affected by irradiation than those irradiated within the first four weeks, forming an ossicle structurally and histologically superior to that of bone ossicles developed from grafts placed into irradiated tissues. PMID- 3540240 TI - The instantaneous centre of rotation of a fixed unilateral distal extension partial denture. AB - A photographic technique was used to determine the instantaneous centre of rotation of a fixed unilateral distal extension partial denture and the teeth to which it was attached. The teeth involved were the lower canine and first premolar. When the two crowns were splinted together to provide support, both vertical and lateral saddle movement was reduced. Saddle support using only the first premolar produced a centre of rotation in the sagittal plane below the canine crown--which became located anterior to the canine when the two supporting teeth were splinted together. In the coronal plane, canine support produced an axis of rotation buccal to, and outside the confines of, the model; splinting of the canine and first premolar caused the centre of rotation in this plane to be located buccally and superior to the abutment tooth roots. The more posteriorly the saddle was loaded, the greater was the magnitude of the resultant movement. PMID- 3540239 TI - Common migraine: a review and proposal for a non-vascular aetiology. AB - A brief review of the literature related to migraine headaches is presented. Information is presented on the epidemiology and diagnostic criteria of migraine headaches and is followed by a discussion on the problems inherent in the current classification system. Previously proposed vascular mechanisms of common migraine are discussed in the light of recent non-supporting data and a possible link between common migraine and orofacial pain dysfunction syndromes is proposed. The role of oral behavioural patterns and related muscular/temporomandibular joint problems are advanced as probable factors related to common migraine. The discussion focuses on the need to distinguish classic from common migraine headache sufferers in assessment and treatment outcome studies, as well as suggesting future avenues of research. PMID- 3540241 TI - The effect of partial denture design on abutment tooth and saddle movement. AB - A laboratory investigation designed to simulate the effect of loads applied to a free-end saddle partial denture was carried out. Abutment tooth and also saddle movement were monitored using a photogrammetric method. Loads applied to the denture saddle were transmitted through the occlusal rest and also the clasp components causing movement of both denture saddle and the abutment tooth. The direction of abutment tooth movement was towards the mesial, whether the occlusal rest was situated on the mesial or distal aspect of the tooth crown. It was also evident that the design of the clasp unit used affects the magnitude and direction of abutment tooth movement. PMID- 3540243 TI - Granulocyte markers in histopathology: a review. PMID- 3540242 TI - Effects of experimental loss of teeth on the temporomandibular joint. AB - A review is presented of the effects of loss of teeth, with impaired occlusal stabilization, on the temporomandibular joint in experimental animals. Loss of teeth, with subsequent abnormal loading of the temporomandibular joint, leads to histomorphological, pathological and pathophysiological changes in the articular cartilages, the articular disc, the synovium, and the bony articular components. The severity of the changes increases with increasing age, and an existing arthritis of the joint is aggravated by impaired occlusal stabilization. The experimentally induced changes resemble those in human subjects with extensive loss or extensive attrition of teeth. PMID- 3540244 TI - The demonstration of B-cell, T-cell and myeloid antigens in paraffin sections. AB - The monoclonal antibodies MB1 and MT1, which detect B cells and T cells respectively, have been applied to human lymphoid tissues. The distribution of staining within paraffin sections was compared with that observed using frozen sections and was found to be identical. The antibodies were then applied to paraffin sections of 19 B-cell lymphomas and 10 T-cell lesions in which full immunophenotyping had been performed. The B lymphomas all consisted of a large majority of MB1 positive cells with a variable infiltrate of small MT1 positive lymphocytes. The T cell lesions consisted of MT1 positive cells with few MB1 positive cells except in residual B cell areas of lymph nodes. In paraffin sections from cases of Hodgkin's disease anti-Leu M1 identified Reed-Sternberg cells and their variants and MB1 and MT1 showed a similar distribution of B cells and T cells to that demonstrated in previous studies using frozen sections. The results show that MB1 and MT1 are useful markers for B and T cells in routinely fixed paraffin embedded tissue. In conjunction with anti-Leu M1 they provide a valuable panel of antisera for the examination of lymph nodes and other biopsies when frozen tissue is not available. PMID- 3540245 TI - Somatic gene therapy for human disease: background and prospects. Part I. PMID- 3540246 TI - Effect of age and serum creatinine on endogenous digoxin-like substances in infants and children. AB - An apparent digoxin-like immunoreactive substance(s) (DLIS) was evaluated in 374 pediatric patients, 0 to 72 months of age, not receiving digoxin. The relationship between DLIS presence or concentration and age, weight, gender, race, and serum creatinine was investigated. Twenty-seven percent of patients had a positive apparent DLIS concentration (greater than or equal to 0.2 ng/ml). The mean +/- SD concentration of DLIS in the positive group was 0.39 +/- 0.18 ng/ml (range 0.2 to 1.37 ng/ml). Patients in the DLIS-positive group were younger than those in the negative group (P less than 0.01). Although a greater percentage of infants younger than 6 months of age had measurable DLIS, the mean DLIS concentrations, when present, were not significantly different for all age groups (P greater than 0.05). No significant relationship was found between race or gender and DLIS. A weakly positive correlation between serum creatinine concentration and DLIS was noted (r = 0.22, P less than 0.03), but elevated serum creatinine measurements (greater than 0.6 mg/dL) did not correlate with DLIS concentration. These results support the hypothesis that the presence of DLIS is age related, but DLIS appears to be present in a much larger and older population of pediatric patients than previously reported. PMID- 3540248 TI - Observation, history, and physical examination in diagnosis of serious illnesses in febrile children less than or equal to 24 months. AB - To determine if observational assessment performed in a systematic manner adds to the efficacy of the traditional history and physical examination in detecting serious illnesses in febrile children, and to determine the sensitivity of the combined evaluation, we studied consecutive patients less than or equal to 24 months of age seen for evaluation of fever at the Primary Care Center-Emergency Room (PCC-ER) of the Yale-New Haven Hospital (n = 143) and a suburban private practice (n = 207). An attending pediatrician performed the observation using the previously reported Acute Illness Observation Scales (AIOS). Subsequently, the history and physical examination were done by an attending pediatrician, and findings were scored as to whether they suggested the presence of a serious illness. Thirty-six patients, 28 in the PCC-ER and eight in the private practice, had a serious illness. The combined AIOS, history, and physical examination had a higher sensitivity and r correlation for serious illness than did the traditional history and physical examination. Three children with serious illnesses, all of whom had no abnormalities on history and physical examination, were identified only by use of AIOS. We conclude that assessment of appearance in a child with fever, when performed in a careful, integrated, stepwise fashion, improves the sensitivity of the history and physical examination in detecting serious illnesses in febrile children. PMID- 3540247 TI - Early recurrences of otitis media: reinfection or relapse? AB - In a prospective study, 36 (35%) of 103 patients had early recurrence of acute otitis media. We wished to identify risk factors for early recurrences (those recurring within 1 month of initial diagnosis) and to determine if the second episode was caused by the same pathogen (relapse) or a new organism (reinfection). When the same bacterial species was recovered in both episodes, Streptococcus pneumoniae were serotyped and Haemophilus influenzae were classified by biotypes and by electrophoretic pattern of the outer membrane proteins. Twenty-nine patients underwent tympanocentesis at the time of the recurrent episode. In 13, no pathogen was recovered either initially or at the time of recurrence. Twelve (75%) of the remaining 16 patients had reinfection; only four (25%) had relapse. Thus, early recurrences of acute otitis media were more often caused by a new organism. This finding suggests that underlying susceptibility to middle ear infection is important in the development of recurrent otitis media. Pediatricians should not assume that early recurrences are necessarily the result of failure of initial treatment. Tympanocentesis may be helpful in this setting to aid in choosing appropriate antibiotic therapy. PMID- 3540249 TI - Group B streptococcal carriage and disease: a 6-year prospective study. AB - A prospective study of group B streptococcal (GBS) carriage and disease was conducted over 6 years. Carriage rates at delivery for mothers and infants were 20% and 12%, respectively. Forty-five cases of GBS disease occurred in infants, 24 "early-onset" disease and 21 "late-onset" disease. The combined attack rate for early and late disease was 3.3 per 1000 live births over the 6 years. The rate of early-onset disease was highest in infants found to be heavily colonized at birth: 50 per 1000 live births. Twenty-three of 24 had evidence of intrauterine-acquired infection. All GBS serotypes were represented. Preterm delivery, prolonged labor, premature rupture of membranes, and maternal infection enhanced the risk of early disease. Septicemia was the predominant form of late onset disease (15 of 21 cases); GBS type III accounted for 19 of 21 cases. Ten of 21 infants with late infections were colonized at birth with the GBS type that subsequently caused disease. Thus a maternal source of infection was identified in 34 of the 45 infants. These data reveal consistent year-to-year carriage and disease rates in the study population. PMID- 3540250 TI - Long-term renal risk factors in children with meningomyelocele. AB - We studied renal function and structure in 42 patients with meningomyelocele, 28 treated with intermittent catheterization and 14 with ileal loop diversion. Patients were observed for a minimum of 60 months. Nine of the 28 patients who underwent intermittent catheterization had evidence of unilateral or bilateral reflux, and all patients with ileal loop diversion had free ureteral reflux. Bacteriuria was present in 38% +/- 5% of cultures obtained from patients with catheterization and in 70% +/- 7% of cultures from those with diversion (P less than 0.001). Four (14%) of 28 patients with catheterization had worsening renal function or anatomic appearance by intravenous pyelogram, and required a diversion. Three (28%) of 14 patients with diversion had changes in renal structure or function. Eight of 31 patients from both groups studied with voiding cystourethrography before the onset of therapy had small, noncompliant, trabeculated bladders; all seven patients who had worsening in function or anatomic appearance were from this subset (P less than 0.01). None of the patients with flaccid or distensible bladders demonstrated these changes. Renal disease was unrelated to the level of neurologic function. A small, noncompliant, trabeculated bladder is a risk factor associated with loss of renal function in patients with meningomyelocele. PMID- 3540251 TI - Development of lung antioxidant enzyme system in late gestation: possible implications for the prematurely born infant. PMID- 3540252 TI - Airborne bacteria sampling: the effect of dehydration and sampling time. PMID- 3540253 TI - Particulate matter in parenteral products: a review. PMID- 3540254 TI - Biological indicators in the pharmaceutical and the medical device industry. PMID- 3540255 TI - Golan memorial lecture. Nutritional regulation of immunity and infection: from epidemiology to phenomenology to clinical practice. AB - Malnutrition is the most common cause of acquired immune dysfunction worldwide. Nutritional deficiencies, excesses, and imbalances influence specific components of the immune system. The severity of immunological impairment depends upon the extent and nature of undernutrition, the presence of infection, and the age of onset of nutritional deprivation. Profound immunological changes occur in children with marasmus and kwashiorkor as well as in deficiencies of vitamins A, E, B6, folate, zinc, iron, copper, and selenium. On the other hand, obesity and excessive intake of several vitamins, minerals, cholesterol, and polyunsaturated fatty acids also impair immunocompetence. These epidemiological observations and immunological phenomena are of practical significance in clinical practice. PMID- 3540256 TI - Prostaglandins in disorders of the intestinal tract: a review. AB - Prostaglandins (PGs) are natural oxygenated products of polyunsaturated fatty acids. They have multiple effects on the gastrointestinal tract. Their major physiological roles in the intestine are the promotion of solute and water secretion and the control of bowel motility. Prostaglandins have a role in the pathogenesis of diarrhea in a wide spectrum of gastrointestinal disorders. The effects and the potential contribution of PGs in various gastrointestinal disorders are discussed, and therapeutic modalities in these disorders are reviewed. PMID- 3540257 TI - Choledochal cysts: heterogeneity of clinical presentation. AB - Over a 12-year period, 23 children were diagnosed as having choledochal cysts, of which 22 were type I and one was type II. The triad of right upper-quadrant abdominal pain, right upper-quadrant abdominal mass, and cholestatic jaundice was present in only four of 23 (17%). Mean time from the onset of symptoms to establishing the correct diagnosis was 20 months, and in one child the diagnosis was established only at autopsy. Six children had histologic evidence of biliary cirrhosis, and three developed portal hypertension despite surgical intervention. Both ultrasonography of the abdomen and endoscopic retrograde cholangiopancreatography (ERCP) were useful methods in establishing the diagnosis, but both tests did result in false negatives. Choledochal cysts are treatable causes of cholestatic jaundice in infants and children, but the intermittent and variable nature of their presentation renders clinical diagnosis difficult. PMID- 3540259 TI - Mesenchyme-dependent differentiation of epithelial progenitor cells in the gut. AB - The digestive tract and the gut as a paradigm represents an attractive system for the study of mechanisms involved in the differentiation of two types of progenitor cells: the endodermal cells during embryonic life and the undifferentiated crypt cells during epithelial renewal of the adult intestine. The morphological and functional events that accompany the differentiation processes of progenitor cells into the polarized epithelial cell types characteristic of the intestine appear comparable in both situations (1,2). During organogenesis of the gut, histological observations underlined a close relationship between epithelial cells and their underlying mesenchymal cells (3,4). Developmental biologists have emphasized experimentally the importance of interactions between the endoderm and mesenchyme during organogenesis of the digestive tract. In the adult intestine, gastroenterologists have focused their attention on a specialized mesenchymal cell type (the pericryptal fibroblasts) that displays, like epithelial cells, proliferative activities and migrating properties. The aim of this review is to provide current knowledge on epithelial mesenchymal interactions during ontogenesis of the digestive tract and also to relate some experiments supporting the view of the perpetuation of epithelial mesenchymal interactions beyond embryonic life. PMID- 3540258 TI - Ontogeny of EGF receptors during postnatal development of mouse small intestine. AB - This study was aimed at characterizing epidermal growth factor (EGF) receptors during postnatal development of the maturing mouse small intestine at a time when this tissue is in the constant presence of high levels of intraluminal EGF. Binding studies with [125I]EGF on isolated epithelial cells demonstrate the continued presence of EGF receptors along the entire length of the small intestine with minimal binding at birth (3.67 +/- 0.30%/mg protein) and increasing steadily throughout postnatal life to reach adult values (10.39 +/- 0.90%/mg protein) by the 26th day, with maximum binding on the 21st day (13.4 +/- 2.2%/mg protein). This EGF binding pattern is similar for all three segments studied but was more pronounced for duodenum and jejunum, especially from day 14 on when binding capacity is more elevated in the proximal segments than in the ileum. Competition-inhibition curves of [125I]EGF by EGF reveal the presence of two classes of binding sites for which the number of sites and affinity constants are lower at birth than in adults. The continued presence of EGF receptors in mouse small intestine throughout the postnatal period thus provides support for the possible role of EGF as a modulator in the functional development of the maturing gastrointestinal (GI) tract. PMID- 3540260 TI - Subcellular localization of class I (A,B,C) and class II (DR and DQ) MHC antigens in jejunal epithelium of children with coeliac disease. AB - Thin frozen sections of 11 jejunal biopsies from 10 children at different stages of coeliac disease were stained by immunofluorescence technique using a panel of anti-HLA class I (A, B, C) and anti-HLA class II (DR and DQ) monoclonal antibodies. On the epithelium of flattened mucosa, in contrast with control sections, the intensity of the labeling on the basolateral membranes with both anti-class I and class II DR antibodies decreased strongly from the bottom to the upper part of the crypts, and no bright patchy staining was observed on the apical part of enterocytes with anti-HLA DR antibodies. Numerous cells with large granules expressing class I and class II DR antigens were found in the epithelium of the small intestine. Children with a fully recovered mucosa expressed MHC antigens identical to those previously observed in normal epithelium. On the other hand, children with intermediate mucosal lesions showed the presence of MHC antigens in varying degrees. The results of this report indicate that immunological mechanisms may play a prominent role in coeliac disease. PMID- 3540261 TI - Portal vein measurement by ultrasonography in patients with long-standing cystic fibrosis: preliminary observations. AB - Adult cystic fibrosis (CF) patients are increasingly diagnosed with hepatic cirrhosis, cholecystitis, and cholelithiasis. A continuing diagnostic problem is the early detection of cirrhosis prior to diffuse liver involvement. Sonography has been used in evaluating the pancreas, gallbladder, liver, and spleen in cystic fibrosis patients. We used a real-time mechanical sector scanner to study the portal veins in adult CF patients randomly selected from our CF population and correlated the portal vein diameters with liver function studies. A measurement greater than 12 mm was interpreted as a probable sign of portal hypertension. Of 21 patients studied, 14 had portal veins that measured greater than 12 mm, and 12 patients had (although not necessarily at the time of the exam) elevated serum alkaline phosphatase levels. Three patients had associated splenomegaly and thrombocytopenia, and 10 patients also exhibited cholelithiasis and abnormal gallbladders on sonography. Initial results indicate that portal vein measurement may be a sensitive indicator of early portal hypertension. Sonography may, thus, isolate patients at high risk for possible future complications. Serial sonograms can be performed easily in evaluating the progress of liver disease. PMID- 3540262 TI - Umbilical artery clot in the neonate: spontaneous resolution. AB - Ultrasound has proved to be an effective means of monitoring umbilical artery catheters in the neonate for clot formation. Once a large clot has formed, it usually takes several weeks to months before it completely disappears. This is a report of a large clot that spontaneously resolved in ten days. PMID- 3540263 TI - Streptococcal sepsis presenting as acute abdomen in a child with transient hypogammaglobulinemia of infancy. AB - Group A streptococcal sepsis was documented in a child who presented with an acute abdomen. Massive retroperitoneal edema was observed at laparotomy with no focus of infection. Immunologic evaluation revealed low serum immunoglobulins and deficient in vitro IgG synthesis consistent with transient hypogammaglobulinemia of infancy. Unusual or severe infections in infancy should be evaluated for congenital immunologic disease. PMID- 3540265 TI - Excellence in search of recognition. PMID- 3540264 TI - Abscess of the falciform ligament in a child with a ventriculoperitoneal shunt. AB - Falciform ligament abscess resulting from an infected ventriculoperitoneal shunt has not previously been described. This unusual type of abscess should be considered in a patient with an infected ventriculoperitoneal shunt who presents with epigastric tenderness. Signs of peritonitis may not be present if the abscess is localized. Imaging studies such as ultrasound or CT scan may frequently establish the diagnosis. PMID- 3540266 TI - The physiologic approach to the management of gastric esophageal reflux. PMID- 3540268 TI - Technical consideration in management of renovascular hypertension in an infant with double renal arteries. AB - Renovascular hypertension is a curable disease that has recently been recognized with increasing frequency. A renal scan in a 1-month-old hypertensive white male showed diminished function of the right kidney, and his peripheral vein renin was elevated. Multiple antihypertensive medications failed to control his hypertension, and right kidney function deteriorated. An arteriogram showed two stenotic renal arteries supplying the right kidney. The smaller inferior artery supplied 35% of the kidney. Selective vein renin levels were greater than 15,000 ng/dL on the right side. Technical considerations in the repair of this lesion included midline transabdominal incision to expose the abdominal aorta and the inferior vena cava; dissection of inferior vena cava (IVC) with division of selected lumbar veins; full mobilization of right kidney and transsection of both renal arteries and the renal vein; perfusion of kidney via each renal artery with cold Sach's solution after resection of arterial stenoses; end-to-side microvascular anastomosis of the smaller (2 mm) renal artery to the main renal artery at the hilum with 10-0 nylon over in situ perfusion cannula; renal artery passed under the IVC to the aorta; and right kidney autotransplanted to a new site on the abdominal aorta with an end-to-side (5.0 mm) renal artery to the aorta and an end-to-side renal vein to IVC anastomosis. Following revascularization, perfusion was excellent and the blood pressure returned to normal. At 6 months follow-up, selective renal vein renins were normal and an arteriogram showed no stenosis. Meticulous dissection, cold perfusion, microvascular anastomosis, and autotransplantation salvaged this kidney and resolved the hypertension. PMID- 3540267 TI - Ureteropelvic junction obstruction in the fetus. AB - Ureteropelvic junction (UPJ) obstruction is being detected with increasing frequency before birth. To clarify the natural history of fetal UPJ obstruction, we reviewed our experience managing 28 fetuses; there were 16 bilateral cases for a total of 44 renal units. None required decompression before birth. We found that fetal bilateral UPJ obstruction is associated with significant morbidity and mortality; resolution of fetal hydronephrosis secondary to UPJ obstruction is rare; antenatal diagnosis of UPJ obstruction improves clinical management by allowing early detection and appropriate treatment of otherwise clinically undetectable disease; oligohydramnios in the mature fetus with bilateral UPJ obstruction is an indication for early delivery and immediate repair; and prenatally diagnosed UPJ obstructions should be repaired as early as possible after birth. PMID- 3540269 TI - Timelines in the history of pediatric surgery. PMID- 3540270 TI - Omphalocele closure: surgical technique with preservation of the amniotic sac. AB - The ideal surgical closure for large omphaloceles remains controversial. Most techniques described advocate removal of the amniotic sac prior to repair of the abdominal wall defect. Herein, the authors describe a surgical technique preserving the amniotic sac, which has distinct advantages in achieving safe and rapid closure of the omphalocele by primary or secondary means in selected patients. PMID- 3540272 TI - Biliary atresia in the newborn. AB - A prenatal sonographic diagnosis of extrahepatic biliary atresia was made and, 76 hours after birth, operatively confirmed. A standard Kasai operation was performed, with the exception of the use of an ancillary appendiceal conduit to provide biliary drainage of an independent bile duct draining the right anterior hepatic segment. Hepatic and ductal histology were identical to those usually found in biliary atresia in a 6- to 8-week-old infant. The child is well at 16 months. PMID- 3540271 TI - Cyclo-oxygenase products mediate hypoxic pulmonary hypertension. AB - High-risk infants with a fetal pattern of circulation demonstrate hyperactivity of the pulmonary vascular bed in response to stimuli including mucous plugging, atelectasis, and endotrachial tube suctioning. The resultant increase in pulmonary vascular resistance (PVR) leads to pulmonary hypertension, severe right to-left shunting, and hypoxemia. Stimuli that trigger pulmonary hypertension cause hypoxia, suggesting the importance of hypoxic pulmonary vasoconstriction (HPV). Although many humoral mediators of HPV have been hypothesized, none have been proven. This study investigates the possible role of the cyclo-oxygenase derivatives thromboxane A2 and prostacyclin as determinants of hypoxic pulmonary hypertension. Open-chested lambs were ventilated with 13% O2 prior to and following treatment with OKY 046, a selective thromboxane inhibitor. In untreated lambs, the partial pressure of arterial oxygen fell from 80 +/- 27 (mean +/- SD) to 35 +/- 13 mm HG (P less than .01). The mean arterial pressure (MAP) remained at 50 +/- 7 mm HG, and the cardiac output (CO) was unchanged at 0.8 +/- 0.2 L/min. The mean pulmonary arterial pressure (MPAP) rose from 11 +/- 4 to 20 +/- 4 mm HG (P less than .01) whereas the PVR increased 70% (P less than .01). TxB2 rose from 147 +/- 85 to 271 +/- 154 pg/mL (P less than .05), and 6-keto-PGF1 alpha rose from 105 +/- 96 to 142 +/- 110 pg/mL. These substances are the hydrolysis products of TxA2 and prostacyclin respectively. In animals treated with OKY 046 prior to ventilation with 13% O2, values for MAP, CO, and PVR were similar to those of the nontreatment period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540273 TI - Characterization of the pyrogenicity of two different lipopolysaccharides and their lipid A-bovine serum albumin complexes. AB - In order to elucidate the dependency of pyrogenicity of lipopolysaccharide (LPS) on the lipid A structure, we investigated the pyrogenicity of both LPS and lipid A prepared from Mima polymorpha var. oxidans which is deficient in 3 hydroxymyristic acids linked to the 3-hydroxy group of other fatty acids. LPS and lipid A were also prepared as reference compounds from Escherichia coli UKT-B. Furthermore, the establishment of reliable indices for pyrogenicity was undertaken. The following results were obtained. The correlation in linearity was demonstrated between maximal increase in body temperature (delta Tmax) and dose of LPS or lipid A complexed with bovine serum albumin (BSA). The dose-response curves based on delta Tmax were more reliable statistically than the Fever Index 4h representing the area under fever curves for 4 h. The minimum pyrogenic dose (MPD) of E. coli LPS was 1.6 X 10(-3) micrograms/kg i.v. In contrast, the MPD of M. polymorpha LPS was 7.0 X 10(-3) micrograms/kg i.v. By intracisternal injection, the MPD of E. coli LPS was 2.5 X 10(-6) micrograms/kg and that of M. polymorpha LPS 1.0 X 10(-4) micrograms/kg. The end points of Limulus amoebocyte lysate gelation were 10(-5) micrograms/ml in E. coli LPS and 10(-3) micrograms/ml in M. polymorpha LPS. The MPDs of lipid A/BSA complexes by i.v. injection were 0.15 micrograms/kg in E. coli and 2.5 micrograms/kg in M. polymorpha. The rabbits immunized with E. coli lipid A/BSA complex acquired pyrogenic tolerance to the parent LPS but the cross tolerance to M. polymorpha LPS was not observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540274 TI - Projective technique: a way of getting "hidden" information: Part I. PMID- 3540275 TI - [Studies on macrolides and new antibiotics]. PMID- 3540277 TI - Ultrasonography in the first trimester of pregnancy in Indian patients. PMID- 3540276 TI - Mutagenic activity of four furocoumarins: angelicin, 4,5'-dimethyl-angelicin, psoralen and 8-methyl-psoralen on V79 Chinese hamster cells. AB - Four furocoumarins, two having a linear structure (psoralen and 8-methyl psoralen) and two having an angular structure (angelicin and 4,5'-dimethyl angelicin), were studied for their mutagenic activity in the HGPRT system on V79 chinese hamster cells in culture (V79/HGPRT system). All the four drugs, when activated by near-ultraviolet (NUV) light, were effective in inducing HGPRT mutants. Their efficiency ranked in the following order: 8-methyl-psoralen greater than psoralen = 4,5-dimethylangelicin greater than angelicin. PMID- 3540278 TI - Characteristics of membrane protein phosphorylation in Plasmodium berghei infected mouse erythrocytes. AB - Membrane protein phosphorylation in Plasmodium berghei-infected erythrocytes was studied by incubating intact cells with (32P)orthophosphate and incubating isolated membrane with (gamma-32P)ATP. Phosphorylated proteins were detected by autoradiography after sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis or isoelectric focusing followed by gel electrophoresis. New phosphorylated proteins were found in membrane from infected erythrocytes, including a protein with electrophoretic mobility identical to band 5, with Mr 43,000. The molar ratio of phosphate to protein ranged between 0.1 and 0.5. Isoelectric focusing-SDS polyacrylamide gel electrophoresis, peptide mapping, extractability properties, and reduction of susceptibility to DNase I inhibition suggested that this protein is phosphorylated actin. In contrast, spectrin phosphorylation in infected erythrocytes was mostly unchanged. PMID- 3540279 TI - The 200th anniversary of "O.F.M., 1786": a tribute to the first comprehensive taxonomic treatment of the protozoa. PMID- 3540280 TI - Sequence of the small subunit ribosomal RNA gene expressed in the bloodstream stages of Plasmodium berghei: evolutionary implications. AB - We have determined the complete nucleotide sequence of the coding region of the small subunit rRNA gene expressed by bloodstream stages of the apicomplexan Plasmodium berghei. It is 2059 nucleotides long. Elements contributing to its relatively large size are all concentrated in regions known to be variable in length among eukaryotes. In a phylogenetic tree constructed from pairwise comparisons of eukaryotic small subunit rRNA sequences, the apicomplexan line branches at a rather early point in eukaryotic evolution before any multicellular kingdoms had yet appeared. PMID- 3540281 TI - The use of prophylactic antibiotics in colorectal surgery: a prospective trial. PMID- 3540283 TI - Effect of irradiation on serum T4 level and response of thyroid gland to exogenous TSH in rats. PMID- 3540282 TI - D-amino acid in irradiated and aged mouse. PMID- 3540284 TI - Mutational DNA base sequence changes in plasmid damaged at a specific region by ultraviolet light. PMID- 3540285 TI - [Magnetic resonance imaging of aortic aneurysm]. AB - Magnetic resonance (MR) imaging in 16 patients with aortic aneurysm used a field of 5,000 Gauss and spin echo multisection imaging with two echos. Results were compared retrospectively with those of echotomography, computed tomography and angiography. Surgical exploration allowed correlation with histopathology in 13 patients. The external diameter of aneurysm and of its residual lumen and length of aneurysm were in each case evaluated precisely by MR. In patients with abdominal aneurysm, MR images identified the limits of the aneurysm in relation to renal and iliac arteries. In aneurysms of thoracic aorta, synchronization of signal with an ECG and longitudinal imaging provided data on relations of aneurysm with supraaortic trunks. In 2 patients with extensive, partially thrombosed thoracic and abdominal aorta aneurysm, MR imaging could not eliminate a diagnosis of aortic dissection with thrombosed false lumen. Finally, aortic wall calcifications were never apparent on MR images. PMID- 3540286 TI - [Radiological studies in the preoperative diagnosis of cystic cystadenoma of the kidney]. AB - Investigations in 7 patients with cystadenoma (5 cases) or cystadenocarcinoma (2 cases) of kidney included intravenous urography, ultrasonography, arteriography and in 4 cases, computed tomography imaging. All these examinations, and particularly ultrasound imaging, provided strongly suggestive evidence of the diagnosis, as seen on images as a single parenchymatous mass constituted of "cystic" formations separated by partitions of variable thickness. Possible differential diagnosis includes necrotic cancer, hydatid or blood-containing cysts. Unfortunately, these different imaging techniques fail to distinguish between thick wall cystadenoma and cystadenocarcinoma, positive diagnosis requiring histology. Preoperative recognition of cystadenoma allows initial conservative surgery to be performed, followed by secondary operation if histology reserves an unpleasant surprise. PMID- 3540287 TI - [Adrenal cystic lymphangioma. Report of a case]. AB - A case of right adrenal cystic lymphangioma in a 34-year-old women is reported. The unilocular and large form of this structure raised a twin problem: its origin and its nature. The place of ultrasonography and of computed tomography is predominant in the investigation of cystic structures of the adrenal. The etiological diagnosis is in fact based upon histopathology or, in certain cases, percutaneous puncture. PMID- 3540288 TI - [Echographic aspects of Crohn's disease. Apropos of 42 studies]. AB - Thirty two patients with confirmed Crohn's disease were examined from october 1983 to may 1985 by ultrasound (42 examinations) and by Conventional Contrast Radiology (Barium Contrast Studies). The well-know "target" pattern is the most frequent feature (88%) which is characteristic of the thickening bowel wall. The thickening is more important for the small bowel wall than the large bowel wall. But the "target" pattern is not the single pattern of inflammation involving the bowel. We also find a "rosette" pattern. This third ring is hypo or hyperechogenic or more complex. Other infrequent features are noted: solid abdominal masses, distended loops, luminal narrowing, fistula and stiffness. Because sonography is noninvasive and simple to perform without radiation exposure, it must often be used as the initial diagnostic tool and as the follow up test for young people. PMID- 3540289 TI - [Hepatic pseudo-nodule of diaphragmatic origin. Apropos of 6 cases]. AB - Ultrasound images in 6 patients with hyperechogenic "pseudo-nodules" of diaphragmatic origin were analyzed. In each case the findings corresponded to variations in curve of right diaphragmatic dome on radiology, but these diaphragmatic bumps were not associated routinely by a pseudo-nodule. A semiologic explanation for the formation of the ultrasound image is suggested. PMID- 3540290 TI - [Carcinosarcoma of the gallbladder. Echographic and anatomopathological diagnosis. Apropos of a case with review of the literature]. AB - Precise diagnosis of carcinosarcoma of gallbladder, a rare tumor, is based on histopathology since clinical and epidemiologic elements fail to differentiate it from other gallbladder cancers. Ultrasound imaging is the most effective radiodiagnostic technique since it allows visualization of the tumor and suggests the presence of a carcinosarcoma when a polypoid or vegetating mass is detected within the gallbladder. PMID- 3540292 TI - [Pseudotumoral xanthogranulomatous pyelonephritis. Apropos of a case]. AB - Xanthogranulomatous pyelonephritis may, rarely, occur as a renal tumour syndrome (simulating mainly a renal cell carcinoma). We report one case. The diagnosis is often difficult (even with surgical findings) and frequently a histological surprise. This points out the importance of identifying it in preoperative staging; the diagnosis may be suggested by the association of chronic pyelonephritis, renal stones and hypovascular renal tumour syndrome without specificity at sonography and CT. PMID- 3540291 TI - [digital angiography via intravenous route in the study of the transplanted kidney artery]. AB - Results of 351 intravenous digital subtraction angiographs (AN) of transplanted kidneys emphasized reliability of this examination for detection of renal artery stenosis. A prospective study of 219 patients (188 interpretable AN) showed significant stenosis of grafted artery in 22% of cases: 17% of the 126 patients with normal blood pressure and 34% of the 62 cases of hypertension. Digital subtraction allows, with a single injection, assessment of renal artery, nephrogram and excretory cavities, but it is not a substitute for conventional intravenous urography 1 to 2 months after grafting. PMID- 3540293 TI - [Echographic aspects of collections of fluid in the gallbladder space following cholecystectomy. Apropos of 11 cases]. AB - Fifty seven patients (51 women and 6 men) undergoing cholecystectomy had ultra sound evaluation on the 3rd, 5th, 7th and 9th post-operative days. In all the cases, the right upper quadrant has been observed correctly with a phased array 3.5 MHg transducer. Eleven of the fifty seven patients (19%) were found to have fluid collection in the gallbladder fossa. The collection has a rounded or an oval configuration, in the proportion of 11 and 55 mm, surrounded by an echogenic area. These fluid collections were of no clinical and biological significance and disappeared in 2 or 4 days time. The authors discuss the relationship between the presence of fluid and the use of drains or different surgical techniques. PMID- 3540294 TI - [Abdominopelvic recurrence of leiomyosarcoma. Echographic aspects apropos of 19 cases]. AB - The recurrence rate after initial surgery of pelvis and abdominal leiomyosarcomas is significant. Quick but silent growth of these tumors requires a regular and frequent follow-up in order to improve the prognosis. Ultrasonography is the simplest way for such a follow-up. We present our experience about 23 operated cases of leiomyosarcomas followed by ultrason; 19 of them recurred with 1 to 6 abdominal and/or pelvic masses. The echographic patterns of recurrences are detailed. PMID- 3540296 TI - [Weber-Christian syndrome and pancreatic involvement. Apropos of a case with review of the literature]. AB - The Weber-Christian syndrome associates generalized nodular inflammatory panniculitis with osteoarticular manifestations. Pathogenesis of this rare affection is still obscure but a pancreatic origin has been reported in the literature. A case is presented having the particular features of being revealed by a subacute episode of chronic pancreatitis, and by the intensity of radiologic bony manifestations. PMID- 3540295 TI - [Intrathoracic and retroperitoneal plasmacytomas in multiple IgA myeloma]. AB - A case of multiple myeloma of bone with retroperitoneal extension is reported and results of ultrasound and computed tomography imaging in this affection discussed. The tumoral mass can be evaluated with precision due to the reliability of CT scan imaging in the diagnosis of bony lesions and a positive diagnosis made and follow up reviews of changes in extra-osseous myelomatous masses conducted by combined ultrasound and CT scan imaging. PMID- 3540297 TI - Relationship of migraine headache and stroke to oral contraceptive use. AB - Are oral contraceptive users who also suffer from migraine headaches at higher risk of having a cerebrovascular accident? The data are inconclusive in establishing that women who used the relatively higher-dose pills prescribed in the 1960s have a higher risk of either thrombotic or hemorrhagic stroke. Furthermore, a review of the literature does not support the belief that those women who use oral contraceptives have a higher incidence of migraine headache. The available data do not indicate that migraine headache is necessarily a contraindication to prescribing oral contraceptives. PMID- 3540298 TI - Psychological medicine redivivus: concept and communication. PMID- 3540299 TI - Who discovered that intestinal worm infections could be diagnosed by finding eggs in the faeces? PMID- 3540300 TI - A field trial comparing the efficacy of sulphamonomethoxine, penicillin, and tarantula poison in the treatment of pododermatitis circumspecta of cattle. AB - Nearly 80% of 87 cattle suffering for the first time from pododermatitis circumspecta were cured by each of the three drugs under test. Sixty and 73% of those cured by sulphamonomethoxine and penicillin, respectively, and 29% of those cured by the tarantula poison (Theranekron), showed relapses within 6 months. Of the 92 cattle with previous records of pododermatitis circumspecta, sulphamonomethoxine cured 44%, penicillin 73% and Theranekron 32%. Of the latter three groups 72-80% showed relapses within the subsequent 6 months. The results of surgical treatments were, possibly, improved by the prior administration of Theranekron. In addition, in a pilot trial, the demarcation of a gangreneous udder half of a goat suffering from blue-bag, appeared to be accelerated by the parenteral administration of Theranekron. PMID- 3540302 TI - Comparing the number of journals available for publication of papers by faculty members in the clinical specialties. PMID- 3540301 TI - A controlled experiment in teaching students to respond to patients' emotional concerns. AB - Medical education faces increasing criticism because of the perception that it is difficult to produce physicians who are both technically competent and compassionate. One approach to addressing this problem is to train physicians to address the emotional concerns that patients experience as a result of their medical problems. Results of the authors' randomized, controlled experiment in training medical students to respond to patients' emotional concerns provide evidence of the efficacy and feasibility of such training. Only students who received small-group instruction in addition to large-group lectures exhibited statistically significant (p less than .001) improvement in their ability to respond to the emotional concerns of patients in hypothetical cases. The students who received only the lectures exhibited significant improvement (p less than .001) in their preference for responses that addressed patients' emotional concerns but not in their responses to written, hypothetical patient cases. Even though these students' preferences for responses to emotional concerns on the average did increase significantly, the preferences were significantly (p less than .001) less favorable than the preferences of the students who received small group instruction. The small group instruction consisted of both interviews with elderly nursing home residents, who served as simulated patients, and structured practice and review sessions. PMID- 3540303 TI - Coagulase-negative staphylococci. PMID- 3540304 TI - Relationship of toxin production to species in the genus Aeromonas. AB - Ninety-five strains of Aeromonas were divided into three species--A. sobria, A. hydrophila and A. caviae--on the basis of results in 13 biochemical tests. The minimum number of tests necessary to distinguish these species was determined. Culture filtrate of the strains were tested for cytotoxin and cytotonin, haemolysin and protease. One filtrate with high-titre cytotoxin, haemolysin and protease activities was subjected to gel filtration on Sephadex G75 and isoelectric focussing. Of the five cell lines tested, Vero cells were most sensitive to the cytotoxin; no reproducible cytotonic effects were observed. The haemolysin effect appeared to be equivalent to cytotoxin. At least two distinct protease activities were found that might be responsible for the cytotonic effects described. Cytotoxin production was species related; it was present in A. sobria and A. hydrophila but not in A. caviae. PMID- 3540306 TI - Septicaemia caused by cysteine-requiring isolates of Escherichia coli. AB - The clinical and bacteriological findings in five cases of septicaemia with cysteine-requiring isolates of Escherichia coli are reported. Infections with these nutritionally-dependent organisms have been found previously in the urinary tract only, associated usually with chronic rather than acute conditions. The urinary tract was considered to be the source of the septicaemia in our patients and that site should be investigated when such strains are isolated from blood cultures. When first isolated the organisms characteristically form small translucent colonies on media deficient in appropriate growth factors. Their nutritional requirement for cysteine can be determined by a simple auxanographic technique, thereby enabling the appropriate supplementation of media necessary for reliable identification and antibiotic-sensitivity testing. PMID- 3540305 TI - Electronmicroscopy studies on the opsonic role of antiserum and the subsequent destruction of Salmonellae within murine inflammatory leukocytes. AB - Inbred female C3H mice were given, by intraperitoneal injection, 4 X 10(7) virulent Salmonella typhimurium organisms opsonised with specific antiserum. Peritoneal washings were obtained between 1.5 and 24 h after injection and examined by electronmicroscopy. Opsonised salmonellae were ingested rapidly by peritoneal exudate cells and were digested rapidly. The presence of antibody facilitated the phagocytic efficiency of the host cells. Destruction of ingested bacteria appeared to be an innate capacity of the host phagocytes independent of the presence of antibody. PMID- 3540307 TI - Use of monoclonal antibodies to human lymphocytes to identify lymphocyte subsets in lymph nodes of the rhesus monkey and the dog. AB - Using commercially available monoclonal antibodies that bind to human lymphocyte subsets, we examined lymph nodes from the rhesus monkey and the dog for their binding ability to these monoclonal antibodies. The avidin biotin-peroxidase immunostaining procedure was used, and the following antibodies were reactive in the rhesus monkey: Leu 4, Leu 3a, OKT4, Leu 2a, OKT8, T8, Leu 5b, T11, Leu 14, B1, and Leu 12. No immunoreactivity was observed in the dog lymph node except for moderate reactivity of OKT8. The following antibodies failed to react in both the rhesus monkey and the dog: OKT3, T1, T2, T1B, T4, T8A, Pan B, and T29/33. Kappa and lambda immunoglobulin light chains were positive in both the dog and monkey. PMID- 3540308 TI - Changing coronary heart disease risk-factor status: the effects of three behavioral programs. AB - Seventy-five persons (57 male and 18 female) with a high risk of coronary heart disease (CHD) were randomly assigned in equal numbers to three 8-week behavioral treatment programs. All three treatments were designed to alter simultaneously a number of risk-elevating behavior patterns, in the expectation that change in any one behavior pattern would reinforce change in others. Weight, blood pressure, and aerobic fitness were regularly assessed in all subjects. Serum lipids were also measured, but less frequently. All three interventions produced significant beneficial changes in the major objective measures, and the changes were well maintained after 12 months. The most improved group exhibited the following mean changes: weight loss of 9.2 kg, reductions in blood pressure of 12.9/8.8 mm Hg, improvement in aerobic capacity of 33%, reduction in serum cholesterol of 0.45 mmol/liter, and reduction in current overall CHD risk of 41%. The effectiveness of the interventions was positively related to the degree to which the programs emphasized training in, and detailed application of, behavioral change principles. PMID- 3540309 TI - Comparative efficacy of behavioral stress management versus propranolol in reducing psychophysiological reactivity in post-myocardial infarction patients. AB - The present study compared the relative efficacy of a behavioral stress management procedure versus a pharmacologic method (the beta-blocker propranolol) in reducing psychophysiological reactivity in post-myocardial infarction (MI) patients. A pretreatment-posttreatment assessment design was used, with 10 patients participating in six separate sessions. The first session involved evaluating psychophysiological reactivity to an emotional stressor (a public speaking task). The subsequent five sessions involved the administration of the respective treatments, either stress management or drug. The patients were randomly assigned to each treatment group. The public-speaking stressor was readministered after the last treatment session. Results demonstrated that behavioral stress management reduced psychophysiological reactivity to public speaking to the same level seen with propranolol. The findings suggest that this nonpharmacological approach could be of use when beta-blocker therapy is not desired, not practical, or medically contraindicated. PMID- 3540310 TI - Protein-DNA interactions and nuclease-sensitive regions determine nucleosome positions on yeast plasmid chromatin. AB - To study mechanisms of nucleosome positioning, small circular plasmids were constructed, assembled into chromatin in vivo in Saccharomyces cerevisiae, and their chromatin structures were analysed with respect to positions of nucleosomes and nuclease-sensitive regions. Plasmids used include insertions of the URA3 gene into the TRP1 gene of the TRP1ARS1 circular plasmid in the same (TRURAP) or opposite (TRARUP) orientation. The URA3 gene has six precisely positioned, stable nucleosomes flanked by nuclease-sensitive regions at the 5' and 3' ends of the gene. Three of these nucleosome positions do not depend on the flanking nuclease sensitive regions, since they are formed at similar positions in a derivative plasmid (TUmidL) that contains the middle of the URA3 sequence but not the 5' and 3' ends. These positions are probably due to protein-DNA interactions. In both TRURAP and TRARUP, the positions of the nucleosomes on the TRP1 gene were, however, shifted compared with the positions on the parental TRP1ARS1 circle and TUmidL. These changes are interpreted to be due to changes in the positions of flanking nuclease-sensitive regions that might act as boundaries to position nucleosomes. Thus, two independent mechanisms for nucleosome positioning have been demonstrated in vivo. The ARS1 region contains the 3' end of the TRP1 gene and the putative origin of replication. Since in TRURAP and TRARUP the TRP1 gene is interrupted, but the ARS1 region remains nuclease sensitive, this non nucleosomal conformation of the ARS1 region probably reflects a chromatin structure important for replication. PMID- 3540311 TI - Contact areas of the turnip yellow mosaic virus tRNA-like structure interacting with yeast valyl-tRNA synthetase. AB - The tRNA-like structure of turnip yellow mosaic virus is known to be efficiently recognized and aminoacylated by valyl-tRNA synthetase. The present work reports domains in the isolated tRNA-like fragment (159 terminal nucleotides at the 3' end of the two viral RNAs) in contact with purified yeast valyl-tRNA synthetase. These domains were determined in protection experiments using chemical and enzymatic structural probes. In addition, new data, re-enforcing the validity of the tertiary folding model for the native RNA, are given. In particular, at the level of the amino acid accepting arm it was found that the two phosphate groups flanking the three guanine residues of loop I are inaccessible to ethylnitrosourea. This is in agreement with a higher-order structure of this loop involving "pseudo knotting", as proposed by Rietveld et al. (1982). Valyl-tRNA synthetase efficiently protects the viral RNA against digestion by single-strand specific S1 nuclease at the level of the anticodon loop. With cobra venom ribonuclease, specific for double-stranded regions of RNA, protection was detected on both sides of the anticodon arm and at the 5'-ends of loop I, a region that is involved in the building up of the acceptor arm. Loop II, which is topologically homologous to the T-loop of canonical tRNA was likewise protected. Weak protection was observed between arms I and II, and at the 3'-side of arm V. This arm, located at the 5'-side of arm IV (homologous to the D-arm of tRNA), does not participate in the pseudo-knotted model of the valine acceptor arm. Ethylnitrosourea was used to determine the phosphates of the tRNA-like structure in close contact with the synthetase. These are grouped in several stretches scattered over the RNA molecule. In agreement with the nuclease digestion results, protected phosphates are located in arms I, II, and III. Additionally, this chemical probe permits detection of other protected phosphates on the 3' side of arm IV and on both sides of arm V. When displayed in the three dimensional model of the tRNA-like structure, protected areas are localized on both limbs of the L-shaped RNA. It appears that valyl-tRNA synthetase embraces the entire tRNA-like structure. This is reminiscent of the interaction model of canonical yeast tRNAVal with its cognate synthetase. PMID- 3540312 TI - Novel regulatory mutants of the phosphate regulon in Escherichia coli K-12. AB - New pleiotropic mutants were isolated that express either the phoA, psiE or psiO promoter constitutively and simultaneously alter bacterial alkaline phosphatase regulation, carbon utilization or ultraviolet light sensitivity. To do this, Lac+ mutants were isolated from strains with the appropriate lacZ transcriptional fusions. Over 300 independent mutants were characterized, and all that constitutively express phoA map in phoR, phoU, the phosphate-specific transport system or a new locus called phoF. However, only phoU mutants express both phoA and psiE constitutively. Carbohydrate-utilizing mutants that show constitutive expression of psiE and psiO map in cya, crp and, possibly, crr. Also, numerous ultraviolet-light-sensitive mutants were discovered that show increased psiO expression and map in lon. Some other mutations that lead to constitutive psiO expression (which is normally induced either by phosphate, nitrogen or carbon starvation or anoxia) show decreased expression of phoA. Also, several mutants were found that show an unusual metastable character affecting psiO or phoA transcription. In these, colonies spontaneously switch between an induced and repressed "state" with respect to lac or bacterial alkaline phosphatase expression. In some, the clonal variation of the lactose phenotype or bacterial alkaline phosphatase synthesis is recA-independent and phenotypically resembles phase variation in Salmonella typhimurium. The latter class are called "phase mutants". The mutants are discussed in terms of protein-nucleic acid interactions and/or possible changes in the DNA, i.e. modifications or rearrangements, within the phosphate gene system, that are physiologically regulated. PMID- 3540313 TI - Prosthetic and insertion techniques for the submergible expandable-retention endosteal implants. PMID- 3540314 TI - The IMZ endosseous two phase implant system: a complete oral rehabilitation treatment concept. PMID- 3540315 TI - A new concept: CODAR (complete osteointegrated dento-alveolar replacement) and a corresponding dental implant design (Flexiroot). PMID- 3540316 TI - Intramucosal inserts--the submerged healing concept. PMID- 3540317 TI - Assignment of genes for human monoamine oxidases A and B to the X chromosome. AB - Monoclonal antibodies that immunoprecipitate human monoamine oxidase (MAO) A or human MAO B, but not the corresponding mouse enzymes, were used to assay for the presence of immunoprecipitable MAO A or MAO B (presumably coded by the respective human genes) in mouse-human hybrid somatic cell lines containing small numbers of human chromosomes. The results were as follow: Extracts of a human lymphoblastoid x mouse hepatoma hybrid line that retained the human X chromosome contained immunoprecipitable MAO B, while a similar hybrid line that contained the same human chromosomes, except for the human X, did not. Extracts of a human fibroblast x mouse neuroblastoma hybrid cell line, whose human chromosomal material consisted solely of the X, contained both immunoprecipitable MAO A and MAO B. Extracts of a related hybrid line, whose human chromosomal material consisted solely of an autonomous fragment and a fragment translocated to a mouse chromosome, contained immunoprecipitable MAO A. However, the level of immunoprecipitable MAO B activity in extracts of this hybrid was low or undetectable. Among extracts of 33 human fibroblast x mouse hepatoma hybrids that had been selected for expression of the X-linked human enzyme HPRT, 60% contained immunoprecipitable MAO B. This figure was comparable to the 58% that expressed the X-linked human isozyme for glucose-6-phosphate dehydrogenase (G6PD). When 11 of these hybrid lines, which contained immunoprecipitable MAO B and human HPRT, were selected for loss of HPRT, all lost immunoprecipitable MAO B in addition to HPRT. These data demonstrate that genes controlling the expression of MAO A and MAO B, which can be immunoprecipitated with the human-specific monoclonal antibodies, are located on the human X chromosome. Properties of the immunological epitopes recognized by the monoclonal antibodies suggest that the X linked genes detected in this study are probably structural genes for the enzymes. PMID- 3540318 TI - Metabolic fate of 125I-labeled batroxobin in rats and dogs. AB - 125I-Labeled batroxobin was prepared and following its intravenous and subcutaneous administrations to rats and dogs, the blood radioactivity was determined. In the both species following the intravenous injections, the decrease in radioactivity was biexponential. Following subcutaneous administration, radioactivity became maximal at 6h and decreased in a manner similar to that of the beta-phase of the intravenous injection. The blood concentration of fibrinogen in dogs was also determined. After the intravenous injection, fibrinogen became undetectable 1h later, and appeared again in the blood at 24h. After the subcutaneous injection, the decrease was not so rapid. Fibrinogen resumed its original levels at 7 day after the administration in both the routes. Radioactivity after the both injections was excreted generally in the urine in about the same amounts. The total urinary and fecal excretions in rats and dogs were 80 and 95%, respectively. The distribution of radioactivity in the tissues was examined by counting technique and whole-body autoradiography. Radioactivity predominantly accumulated in the thyroid and stomach and could also be found in the kidneys and liver in fair amounts. The distribution patterns of radioactivity for both the routes of administrations and also for male and pregnant rats were basically the same. In fetus rats, a slight distribution was noted. From the results of gel filtration chromatography and trichloroacetic acid fractionation, [125I] batroxobin was metabolized soon after the administration to afford low molecular substances such as 125I-ion in the plasma and urine. PMID- 3540319 TI - Concurrent chloroquine- and Fansidar-resistant Plasmodium falciparum: an imported case into Zimbabwe. AB - A case of concurrent chloroquine- and Fransidar-resistant Plasmodium falciparum malaria imported into Zimbabwe by an adult male Zimbabwean from either Malawi or Mozambique is reported. The epidemiological and chemotherapeutic implications are discussed. PMID- 3540320 TI - New methods of endocrine management of prostatic cancer. PMID- 3540321 TI - Re: Incidental hydronephrosis on bone scintigraphy: sonographic verification. PMID- 3540322 TI - Assessment of clinical renal preservation by phosphorus-31 magnetic resonance spectroscopy. AB - To evaluate the role of magnetic resonance spectroscopy (MRS) and to develop surface coils for assessing cadaveric renal viability during hypothermic storage, we used the monophosphate/inorganic phosphate ratio (MP/Pi) to monitor phosphorous metabolites in intact kidneys during various renal preservation maneuvers. Eighteen canine kidneys and 16 cadaveric kidneys were studied as follows: Group 1 (N = 4) in situ kidneys were monitored by implanted MRS coils; Group 1 (N = 4) ex vivo kidneys were immediately attached to vascular cannulas and monitored by MRS surface coils during normothermic perfusion; Group 3 (N = 4) kidneys were removed, cold-flushed and, after 24 hours of 4C storage, monitored by MRS surface coils before and during four hours of reperfusion via vascular cannulas; Group 4 (N = 6) kidneys were removed, cold-flushed and monitored by surface coils during cold storage up to 72 hours. In addition, 16 cadaveric kidneys were studied while in sterile cold-storage containers. Postoperative renal function was followed in recipient patients. The MP/Pi ratios in Group 1 kidneys correlated with the ability to regenerate adenosine triphosphate (ATP). Groups 2 and 3 showed similar regeneration of ATP and MP/Pi after postischemic reperfusion, and the signal-to-noise ratios of the surface coils were better than those in the implanted coils in Group 1. Surface-coil monitoring in Group 4 kidneys showed predictable decay rates of MP/Pi during one to 72 hours of cold storage; in contrast, simultaneous cortical medullary microcirculation studies with 99mTc-macroaggregated albumin were inconclusive. Human cadaveric kidneys with high MP levels were associated with excellent renal function after transplantation, while those with low MP (less than or equal to 0.50) were associated with nonviability. We conclude that MRS is a practical and safe diagnostic modality for clinical transplantation. PMID- 3540323 TI - The microcosm of the arterial wall--a plea for research. PMID- 3540324 TI - Intensive chemotherapy with autologous marrow transplantation is effective against some resistant tumors. PMID- 3540325 TI - A community hospital payment experiment outperforms national experience. The Hospital Experimental Payment program in Rochester, NY. AB - Since January 1980, the hospitals in the Rochester, NY, area have been operating under a community-wide revenue cap. This prospective payment system features local administration and control and is the first time a group of hospitals have committed themselves to a comprehensive regional financing system. This system differs from other prospective payment programs in that it covers both inpatient and outpatient care and offers incentives for ambulatory treatment whenever clinically appropriate. In the first five years of this program, the increase in Rochester area hospital expenses was 46%, compared with 52% for New York State hospitals and 68% for US hospitals at large. Further, the financial position of the Rochester hospitals improved, showing an operating margin of 2.6%, compared with a figure of-15.8% for New York State hospitals at large. A community-wide assessment showed no evidence of a reduction in the quality of or access to care. This community system for hospital payment and planning merits serious consideration for areas wishing to realize high-quality care at an affordable cost through a balanced combination of self-regulation, cooperation, and competition. PMID- 3540326 TI - Leads from the MMWR. Multiply resistant shigellosis in a day-care center--Texas. PMID- 3540328 TI - The initial impact of AIDS on public health law in the United States--1986. PMID- 3540327 TI - Sexual practices and risk of infection by the human immunodeficiency virus. The San Francisco Men's Health Study. AB - The San Francisco Men's Health Study is a prospective study of the epidemiology and natural history of the acquired immunodeficiency syndrome in a cohort of 1034 single men, 25 to 54 years of age, recruited by multistage probability sampling. At entry, June 1984 through January 1985, the seropositivity rate for human immunodeficiency virus (HIV) infection among homosexual/bisexual study participants was 48.5%. No heterosexual participants were HIV seropositive. Among homosexual/bisexual men reporting no male sexual partners in the two years before entry into the study, seropositivity was 17.6%. For those reporting more than 50 partners, seropositivity was 70.8%. Only receptive anal/genital contact had a significantly elevated risk of HIV infection. Douching was the only ancillary sexual practice that contributed significantly to risk of infection. PMID- 3540329 TI - Detection and management of mental health problems of older patients by primary care providers. AB - Evidence is accruing that older individuals receive little attention for mental health problems and that any attention that is given is most often within the primary care setting. A randomized clinical trial was carried out at a primary care clinic of The Johns Hopkins University, Baltimore, testing the ability of feedback of the results of a screening instrument (the General Health Questionnaire) to increase awareness in clinicians of the emotional and psychological problems of their patients. This report contrasts those aged 65 years and older with younger patients. Detection and management of mental morbidity were lower for older individuals, but the feedback intervention increased the likelihood of attention to these problems. This was not true for younger patients. Detection was significantly higher for older patients when screening data were made available, as was management, although the latter difference was not statistically significant. There was evidence as well that the intervention moved clinicians to greater congruence with their older patients in the perception that current mental health problems existed. These findings have important implications for primary care. PMID- 3540331 TI - Leads from the MMWR. Increasing rate of Salmonella enteritidis infections in the northeastern United States. PMID- 3540330 TI - Tricyclic antidepressant overdose. A review. AB - Significant advances in diagnosis and management of tricyclic antidepressant overdose have occurred in recent years. This article reviews epidemiologic, pharmacologic, and therapeutic information to provide a systematic approach to these potentially life-threatening overdoses. The tricyclics are discussed as a group, with individual drugs specified when established differences exist. PMID- 3540332 TI - Medicare risk contracting. Lessons from an unsuccessful demonstration. AB - The Tax Equity and Fiscal Responsibility Act of 1982 provided a full-risk Medicare capitation financing option for health maintenance organizations and competitive medical plans. Two rounds of demonstrations were conducted, followed by the publication of final regulations in January 1985. The first-round demonstration at Marshfield, Wis, was operational for 28 months. Thirty-seven percent of all resident beneficiaries enrolled. Aggregate losses exceeded $3 million (11.6% of revenue). Management implemented increasingly more stringent utilization review. Overall hospital utilization declined 261.7 days per 1000 from fiscal year 1981 to 1982; nonetheless, federal reimbursement was insufficient to meet program costs and the demonstration was terminated. The central reimbursement method used in Medicare risk contracting (adjusted average per capita cost) does not adequately control for enrollment selection, unmet medical need, or recent regional cost variations. Reimbursement set at 95% of estimated fee-for-service costs does not recognize, and in the long run will not support, an efficiently operating delivery system. PMID- 3540333 TI - Skeletal muscle function and metabolism in obese women. AB - A possible mechanism to regulate body weight during a high calorie intake may be an increased metabolic rate in skeletal muscle. To approach this hypothesis the energy metabolites, ATP, phosphocreatine, creatine, glycogen and lactate were measured in biopsies from the quadriceps femoris muscle. Concomitantly the function of the adductor pollicis muscle was studied as assessed after electrical stimulation of the ulnar nerve. The muscle function variables were, force of contraction at 5, 10, 20, and 50 Hz of stimulation, relaxation rate, and endurance. Eight obese women were studied before gastroplastic surgery and 6 months postoperatively and a weight loss of 19.4 +/- 3.4% (mean +/- SEM). Preoperatively ATP, phosphocreatine, glycogen, and lactate were significantly decreased and the same pattern was found postoperatively. These findings can be related to a low production of energy-rich phosphates or a high energy utilization. Both pre- and postoperatively there was, a decreased force of contraction at 10 Hz of stimulation (p less than 0.001), a faster relaxation rate (p less than 0.01) and a normal endurance. These functional results indicate a high metabolic rate. At admission a decreased serum insulin level indicated a moderate insulin resistance which was normalized after the weight loss. The triiodothyronine concentration was normal before and after operation. In conclusion our findings of changed muscle energy metabolite concentrations and altered muscle function indicate a high metabolic rate in skeletal muscle in obese women. This may be an adaptation in skeletal muscle energy metabolism to a high body weight. PMID- 3540335 TI - [Experimental study of dual-mode independent lung ventilation with HFJV]. PMID- 3540334 TI - [Changes in 2-3 diphosphoglycerate in red blood cell and oxygen affinity of hemoglobin in potassium-depleted rats]. PMID- 3540336 TI - [Anesthetic management of a patient with renal transplantation]. PMID- 3540337 TI - [Influence of cefroxadine dry syrup on intestinal bacterial flora]. AB - Influence of cefroxadine (CXD) dry syrup on intestinal bacterial flora was studied in mice infected with 4 species of bacteria, namely, Escherichia coli, Enterococcus faecalis, Bacteroides fragilis and Bifidobacterium breve, and in pediatric patients having infections in the respiratory tract and cutaneous/soft tissues. The results were summarized as follows: CXD dry syrup was administered for 5 consecutive days to mice infected with the 4 species. No considerable changes were observed in levels of bacteria in the feces and in different parts of digestive tracts. Eleven pediatric patients were orally administered with 30 54 mg/kg of CXD dry syrup a day for 7-15 consecutive days. Symptom of diarrhea was noted in 2 patients. Dominant species of the intestinal flora such as E. coli, Bifidobacterium, and Bacteroides sometimes decreased in patients treated with CXD dry syrup. In general, however, decreases in numbers of these bacteria were insignificant. Changes of intestinal flora in patients treated with CXD dry syrup were apparently smaller than those treated with ampicillin and were similar to those treated with cephalexin or amoxicillin. PMID- 3540338 TI - [Bacteriological, pharmacokinetic and clinical evaluations of ceftriaxone in the pediatric field. Pediatric study group of ceftriaxone]. AB - Ceftriaxone (CTRX), a new injectable cephem antibiotic agent, was evaluated bacteriologically and clinically for its efficacy and safety in the pediatric field by a study group organized with pediatricians from all over the country. The following are a summary of the results of the evaluation. Antibacterial effects: The inhibition of growth was attained for over 90% of strains of K. pneumoniae, H. influenzae and Salmonella spp. at the concentration of 0.10 micrograms/ml and of strains of S. pneumoniae and E. coli at the concentration of 2.0 micrograms/ml. The CTRX was proved to have excellent antibacterial effects. Absorption and excretion: Thirty minutes after one shot intravenous administration with 10, 20, 40 and 50 mg/kg of CTRX, its serum levels were 73, 124, 169 and 190 micrograms/ml, respectively, a clear tendency of dose-response relationship being noticed. The serum levels decreased only gradually and stayed as high as 10 to 20 micrograms/ml even after 12 hours. The half-lives of the drug were 5.5, 6.3, 6.0 and 4.7 hours for the 4 different dose levels, respectively. Following the intravenous injection with 10, 20 and 40 mg/kg, the urinary excretion rates were 55, 52 and 54%, respectively. Following the one shot intravenous administration or by the drip infusion for 30 minutes with about 50 mg/kg, CTRX levels in the cerebrospinal fluid ranged from 1 to 20.3 micrograms/ml in case of purulent meningitis (5 to 10 micrograms/ml in most cases). CLINICAL RESULTS: A total of 322 cases was enrolled. The efficacy of CTRX was evaluated in 295 cases out of the 322, excluding drop-outs and the cases which did not meet the protocols. The clinical efficacy rate was 94% of 191 cases where the causative bacteria were identified, CTRX being "excellent" in 108 cases and "effective" in 72. In the remaining 104 cases where the causative bacteria were not identified, the efficacy rate was 92%, CTRX being "excellent" in 42 cases and "effective" in 54. Furthermore, the efficacy rate was 89% of 18 cases infected with more than one kind of bacteria. The drug showed "excellent" or better effectiveness in 88% of 75 cases which had not responded to other antibiotics. Bacteriologically, 174 out of 216 strains (93%) which were judged to be causative bacteria disappeared with the use of CTRX. Eighty-five percent of 53 strains which had not responded to other antibiotics disappeared by the CTRX treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540339 TI - [A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants. A study of ceftazidime in the perinatal co-research group]. AB - Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 micrograms/ml at 6 hours after the injection. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6%. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1%. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9% in 156 cases. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as 'eradicated', 3 'persisted' and 3 'unknown' with eradication rate of 92.7%. Replacement of organisms (superinfection) was observed in 3 cases. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2%), i.e., 3 cases of diarrhea (1.7%) and 1 case of rash (0.6%), and abnormal laboratory findings were observed in a total of 14 cases (7.8%), i.e., increase in eosinophiles count in 8 (4.5%), elevation of GOT in 3 (1.7%), increase in platelet, elevation of GOT . GPT, and elevation of GOT . GPT . BUN in 1 case each (0.6%). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540340 TI - [Clinical and pharmacokinetic evaluation of ceftazidime in neonates and young infants]. AB - Seventeen newborn and young infants including 6 premature infants were treated with ceftazidime (CAZ) and the clinical efficacy and side effects were evaluated. Ages of the patients ranged from zero to 55 days, and their body weights ranged from 1.35 to 3.87 kg. Doses of CAZ ranged 10-50 mg/kg every 6 to 12 hours for 3 to 14 days. Twelve infants with infections including meningitis, sepsis, pneumonia and urinary tract infections, were considered to have responded to the CAZ treatment. Among them, results were excellent in 2, good in 9 and fair in 1 patient. The drug was well tolerated, but 1 had diarrhea and 3 patients had eosinophilia among the 17 patients. The pharmacokinetics of CAZ was studied in 22 patients including 11 premature infants. Their ages ranged from 1 to 60 days, and body weights ranged from 0.85 to 3.96 kg. Serum concentrations in 7 patients ranged from 24.2-38.5 micrograms/ml at 30 minutes after single doses of 10 mg/kg intravenous bolus injections and 4.36-12.4 micrograms/ml at 6 hours. Mean elimination half-lives of the drug were 3.20 hours in 2 patients under 7 days of age and 2.31 hours in 5 patients from 7 days of age or older. In 8 patients, serum concentrations ranged 32.6-57.9 micrograms/ml at 30 minutes and 8.10-20.7 micrograms/ml at 6 hours after single doses of 20 mg/kg. Elimination half-lives were 3.53 hours in 4 patients under 7 days of age and 2.79 hours in 4 patients from 7 days of age or older.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540341 TI - [Clinical evaluation of ceftazidime in the treatment of neonatal infections]. AB - Ceftazidime (CAZ) was evaluated for its safety and efficacy in 27 newborns. Four confirmed cases of bacterial infections were cured by the CAZ therapy (efficacy rate 100%). The CAZ was assessed as effective in sepsis (2) and urinary tract infections (2). Main pathogens which responded to CAZ were Escherichia coli, Enterobacter cloacae and Acinetobacter anitratum. As adverse effects, elevations of GOT and GPT (1 case) were found to be associated with the CAZ therapy. Half lives of the serum levels in mature infants were 1.93-3.52 hours, and those in low birth weight infants were 2.92-4.17 hours. Penetration into the cerebrospinal fluid in 1 case of viral meningitis was satisfactory. The data suggest that CAZ is a safe and effective injectable antibiotic when used in newborn with infection caused by CAZ-susceptible bacteria. PMID- 3540342 TI - [Fundamental and clinical evaluation of ceftazidime in neonates and premature infants]. AB - Fundamental and clinical evaluation of ceftazidime (CAZ) were carried out in neonates and premature infants, and the results obtained are summarized below. Serum concentrations of CAZ after administration of 20 mg/kg were satisfactorily high regardless of the route of administration; bolus intravenous injection or 1 hour intravenous drip infusion. Like other cephem antibiotics, half-lives tended to be shorter as day-ages of subject became higher. Although there were some differences in urinary recovery rates between different dosage groups, they were generally high. Clinical efficacy was either excellent or good in all 21 assessable cases. In 23 cases examined for adverse effects, diarrhea was observed in 1 case, and elevation of GOT and GPT, in another case. PMID- 3540343 TI - [Pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants]. AB - Pharmacokinetics and clinical efficacy of ceftazidime (CAZ) were evaluated in neonates. The results obtained are summarized below. After a bolus intravenous injection of 20 mg/kg CAZ to neonates, peak serum concentrations ranged 55.1-97.4 micrograms/ml with the mean half-life of 2.26 hours in neonates with birth weight of 2,500 g or more, and 59.3-60.7 micrograms/ml with half-lives ranging from 3.98 to 4.22 hours in neonates weighing less than 2,500 g at birth. In the time-course observation, it was noted that the half-life at 2 days after birth was longer than half-lives observed on 4 and 9 days after birth. Four cases were given CAZ for treatment, and 3 cases for prophylaxis of infections, and the clinical efficacy was either excellent or good in all of the cases. Neither adverse effects nor abnormal laboratory findings were observed except rash in 1 case. Intestinal flora was examined in 5 cases. It was found that the effect of CAZ was less than that of LMOX, although some delay was seen in the growth of intestinal flora. There was no vitamin K deficiency in any of 6 cases examined. PMID- 3540345 TI - [Fundamental and clinical studies on ceftazidime in neonates and premature infants]. AB - Ceftazidime (CAZ) was administered to 34 full-term and premature infants aged 0 27 days with various bacterial infections in a dose of 10 or 20 mg/kg by intravenous bolus injection, and plasma concentrations and urinary recovery rates in these subjects during recovery periods were studied. Because of the small number of the cases recruited, neonates were not divided into the full-term and the premature group, but into 3 groups based on day-age: 0-3 days, 4-7 days, and 8 days or older. Concentrations and rates of transfer of CAZ into cerebrospinal fluid (CSF) were determined in 2 cases, and biliary concentrations in another case. A clinical evaluation of CAZ was performed in 12 male and 6 female infants aged 1 day to 4 months and 19 days, including 2 each with purulent meningitis, pneumonia and pyelonephritis, 3 with septicemia, 1 each with septicemia suspected, cholangitis, osteomyelitis, bronchopneumonia, staphylococcal scaled skin syndrome, and acute enterocolitis and 3 for prophylactic use. Plasma concentrations and urinary recovery rates of CAZ The intravenous bolus injection at 10 mg/kg. Peak plasma concentrations of CAZ were obtained at the first collection (30 minutes) of blood samples or 1 hour in all 3 groups, ranging from 23.3 to 26.9 micrograms/ml with no significant variations, plasma concentrations then slowly decreased, and were still 6.04-9.88 micrograms/ml even at 6 hours after the administration. The half-lives of CAZ in plasma tended to be shorter in older day-age neonates, with mean half-lives being 3.59, 2.50 and 2.50 hours for the youngest. The intravenous bolus injection at 20 mg/kg. Peak concentrations were obtained at the first collection of blood samples in all 3 groups (0-3 days: 15 minutes, the others: 30 minutes), being 54.8, 39.9 and 43.8 micrograms/ml, respectively, then slowly decreased and were still 10.4-15.7 micrograms/ml even at 6 hours after the administration. Inter-age differences in half-lives were marked, i.e., 3.6 hours in 0-3-day group, 3.48 hours in 4-7-day group and 2.75 hours in 8-day or older group. Urinary recovery rates were about 40-60% without reference to day-age neonates. CSF concentrations About 50 mg/kg of CAZ was given to each of 2 cases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540344 TI - [Fundamental and clinical evaluations of ceftazidime in neonates]. AB - Ceftazidime (CAZ) intravenous injection was evaluated from fundamental and clinical aspects in neonates, and the results obtained are summarized below. Following a 60-minute intravenous drip infusion of CAZ at 10 mg/kg, the peak serum level was 19.8 micrograms/ml at 30 minutes after the completion of the infusion(half-life: 2.75 hours). Following 30 to 60-minute intravenous drip infusions of CAZ at 20 mg/kg, the mean peak serum levels of CAZ were 33.1-33.0 micrograms/ml. Mean levels at 6 hours were 5.2-6.7 micrograms/ml (half-life: 1.6 4.1 hours). Following 30 to 60-minute intravenous drip infusions of CAZ at 25-30 mg/kg, peak serum levels were 51.7-64.6 micrograms/ml (half-life: 1.6-2.05 hours). Dose response relationship was clearly observed in peak serum levels after intravenous drip infusion, and half-lives of serum CAZ levels in neonates aged 0-10 days tended to be longer than those in infants. Following intravenous administration of CAZ at 20-30 mg/kg, urinary excretion rates during the first 6 hours were 18.7-66.5%, and the rates were low in neonates compared to those in infants and children. Following a 60-minute intravenous drip infusion of CAZ at 28.7 mg/kg, the cerebrospinal fluid level was 5.0 micrograms/ml at 3 hours, the ratio of cerebrospinal fluid level to serum level was 22.5%. Eleven neonates were subjected to the present study. Clinical efficacy of CAZ was excellent in sepsis caused by A. anitratus, which showed higher sensitivity to CAZ compared with other cephem antibiotics of the third generation. In all of the other cases, including those of pertussis and acute urinary tract infections and in the prophylaxis of amniotic infection, clinical efficacy of CAZ was excellent or good. S. epidermidis, E. coli and A. anitratus, identified from cultures of pharynx, urine or blood, were rapidly eliminated during the CAZ treatment. Doses of CAZ used in the present study were 29-133 mg/kg/day, mostly in the range of 40 60 mg/kg/day. Durations of treatment ranged from 3 to 10 days. Neither systemic nor local adverse effect was observed, nor was any abnormality observed in laboratory findings. PMID- 3540346 TI - [Fundamental and clinical evaluations of ceftazidime in neonates]. AB - Evaluations of ceftazidime (CAZ) in a few different categories were carried out in neonates. Single doses of 20 mg/kg of CAZ were administered to 8 neonates (day age range: 1-26) and 3 infants (day-age range: 45-119) by bolus intravenous injection. Mean serum concentrations of CAZ at 15, 30 min., 1, 2, 4 hours and 6 hours were 51.6 +/- 9.2, 48.1 +/- 8.7, 47.9 +/- 7.8, 38.2 +/- 6.5, 20.2 +/- 4.0 micrograms/ml, and 15.3 +/- 5.8 micrograms/ml, respectively, in the neonates, and 51.1 +/- 10.3, 44.7 +/- 6.8, 35.5 +/- 4.1, 21.4 +/- 2.0, 8.6 +/- 1.0 micrograms/ml and 3.5 +/- 0.8 micrograms/ml, respectively, in the infants. Mean half-lives of CAZ in serum were 2.87 +/- 0.77 hours in the neonates and 1.39 +/- 0.10 hours in the infants, and mean urinary recovery rates in the first 6 hours were 60.5 +/- 16.0%, and 76.8 +/- 39.6% in the neonates and the infants, respectively. When individual differences are taken into consideration, no significant difference exists among 30-minute serum concentrations of neonates of different day-ages, and these concentrations were not significantly different from those in infants and older children. Half-lives of CAZ in sera decreased rapidly with the advances of the day-ages of the neonates, and the half-life at an age of 1-month should be similar to that in older children. The CAZ was administered to 2 cases of suspected sepsis, 7 of acute pneumonia, 1 of acute pyelonephritis, 1 of cellulitis, and 2 of idiopathic respiratory distress syndrome, and clinical efficacies were excellent in all the cases except for 2 cases excluded from the assessment. S. pyogenes (1), E. coli (1) and S. aureus (1) suspected as causative organisms were eradicated by the treatment with CAZ. Neither clinical adverse effects nor abnormal laboratory findings were observed in any case. From the above results, CAZ is considered to be an antibiotic with high efficacy and safety in the treatment of neonates. PMID- 3540347 TI - [Pharmacokinetic studies on ceftazidime in neonates]. AB - The pharmacokinetics of ceftazidime (CAZ) were investigated in neonates. The following was a summary of the results obtained. Mean peak serum levels of CAZ reached at 15 minutes after intravenous administrations at single doses of 10 mg/kg were 31.7 micrograms/ml in 1-day-old neonates and 31.4 micrograms/ml in a 13-day-old neonate. Mean serum levels at 6 hours after administrations were 8.97 micrograms/ml and 5.26 micrograms/ml in the 1-day-old and the 13-day-old, respectively. Mean half-lives of CAZ in sera were 3.29 hours in the 1-day-old and 2.24 hours in the 13-day-old. In a 4-day-old neonate, the serum level of CAZ reached a peak of 25.4 micrograms/ml at 1 hour and was 5.75 micrograms/ml at 6 hours; the half-life was 2.41 hours. Peak serum levels of CAZ reached at 15 minutes after intravenous administrations at single doses of 20 mg/kg were 46.3 micrograms/ml in a 3-day-old neonate and 80.6 micrograms/ml in a 7-day-old neonate. The serum levels at 6 hours after administration were 12.2 micrograms/ml and 10.4 micrograms/ml, in the 3-day-old and the 7-day-old, respectively. Half lives of CAZ in sera were 3.02 hours in the 3-day-old and 2.08 hours in the 7-day old. In 4-day-old neonates, mean serum levels were 52.5 micrograms/ml at 15 minutes and 14.6 micrograms/ml at 6 hours after administration and the half-life was 2.76 hours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540348 TI - [Clinical evaluation of ceftazidime in infections in neonates and premature infants]. AB - Ceftazidime (CAZ) was evaluated in the treatment of infections in neonates and premature infants. In 1 mature neonate (age: 14 days) administered with 30.3 mg/kg of CAZ by a single bolus intravenous injection, the serum concentration of CAZ was 50 micrograms/ml at 30 minutes after the dosing, and the elimination half life was 1.38 hours. The urinary recovery rate of administered CAZ during the first 6 hours was 52.9%. In 6 neonates (mean gestational period: 37.8 weeks, mean birth weight: 2,508 g, mean age: 3.7 days) administered with ca. 20 mg/kg of CAZ by single bolus intravenous injections, the mean serum concentration of CAZ was 63.6 micrograms/ml at 30 minutes after the dosing, and the half-life was 3.78 hours. In 3 out of the above 6 neonates, the mean urinary recovery rate of CAZ during the first 6 hours was 59.8%. Five neonates and 2 infants with infections were given 18.4-65.9 mg/kg of CAZ b.i.d.-q.i.d. by intravenous injections. One of these cases was excluded from an evaluation for clinical efficacy, because CAZ was given only for 2 days. In the remaining 6 cases, clinical efficacy was excellent in 1 case of urinary tract infection (E. coli + E. faecalis), good in 3 cases of pneumonia (P. aeruginosa + K. pneumoniae: 1, P. aeruginosa: 1, and causative organism unknown: 1), and poor in 1 case of sepsis (S. aureus). In 1 case of asphyxia neonatorum contaminated with meconium, CAZ was used prophylactically, resulting with no infection. No clinically adverse effect was observed. Also no abnormality was observed in laboratory analyses in the 6 cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540350 TI - [Fundamental and clinical studies on ceftazidime in pediatric surgery]. AB - Fundamental and clinical studies of ceftazidime (CAZ) were performed in pediatric surgery. The results obtained were summarized below. Serum and urinary levels of CAZ were measured in 5 patients following injection (CAZ: 10 or 20 mg/kg, intravenous bolus injection). Highest levels in serum were observed within 30 minutes, 30.4 micrograms/ml and 49.5-62.9 micrograms/ml with 10 mg/kg and 20 mg/kg doses, respectively. Then serum levels of CAZ decreased gradually except in 1 case with a metabolic disease, and serum half-lives (T 1/2) were 1.19-1.88 hours for the high doses. The highest levels in urine were observed in 0-2 hours, and the urinary recovery rate was 59-100%. The bile levels were also measured in 3 patients who underwent radical operations of congenital biliary atresia (CBA). Highest levels of CAZ in bile, 4.47-9.66 micrograms/ml, were noted in 0-2 or 2-4 hours following injection. Recovery rates for 8 hours were 0.11, 0.17 and 0.20% for the 3 patients. The CAZ was administrated to 7 patients for prophylaxis of the postoperative infection (5 cases) or to treat ascending cholangitis in CBA (2 cases). Clinical results were good in 4, fair in 1, poor in 1 and unknown in 1. No clinical and laboratory side effect due to the administration of CAZ was observed. It is concluded that CAZ is a safe and effective antibiotic in pediatric surgery. PMID- 3540349 TI - [Fundamental and clinical evaluations of ceftazidime in neonates and premature infants]. AB - Ceftazidime (CAZ) was administered to 24 neonates and premature infants aged 0-31 days in a dose of 10 mg/kg or 20 mg/kg by an intravenous bolus injection, and plasma concentration, urinary concentration and urinary recovery rate during the first 6 hours after the administration were determined. The CAZ was also administered to a total of 43 patients consisting of neonates, premature infants and infants at ages ranging from 0 day to 1 year 9 months (21 suffering or suspectedly suffering with various bacterial infections, and 22 treated for prophylaxis of infections), by intravenous bolus injections in a mean daily dose of 59.6 mg/kg in 2 to 4 divided doses for 9 days on the average. The clinical efficacy, prophylactic effects and bacteriological response were evaluated. Adverse effects of the drug were examined in 65 cases including 22 drop-out cases, and in some of them, abnormal laboratory findings were also examined. The results obtained are summarized as follows: Patients given 10 mg/kg of CAZ were divided into 5 groups on the basis of age: 0-3 days, 4-7 days, 8-14 days, 15-21 days, and 29 days and older, and mean peak plasma concentrations of CAZ were 40.7, 43.1, 37.1, 38.0 and 35.6 micrograms/ml, respectively, at 5 minutes after administration, with no significant difference. Mean AUC values were higher in younger-age groups, i.e. 189.9, 170.8, 159.1, 135.3 and 134.4 micrograms X hr/ml for the 5 different day-age groups, respectively, and mean half-lives of CAZ in plasma tended to be longer in younger-age groups, i.e. 3.16, 3.05, 2.84, 2.44 and 2.43 hours for the 5 groups, respectively. Patients given 20 mg/kg of CAZ were divided into 4 groups also on the basis of age: 0-3 days, 4-7 days, 8-14 days, and 15-21 days, and mean peak plasma concentrations for the 4 day-age groups were 72.9, 73.3, 70.0 and 78.4 micrograms/ml, respectively, at 5 minutes after administration, without any difference among these groups. Mean AUC values were 429.9, 327.3, 279.3 and 302.1 micrograms X hr/ml for the 4 groups, respectively, with the highest AUC in the youngest-age group. Dose response was observed in mean peak plasma concentrations and mean AUCs when 10 mg/kg and 20 mg/kg dose groups were compared for similar day-age patients. Mean half-lives of CAZ in plasma were 4.01, 3.51, 3.00 and 3.07 hours, the longest being in the youngest age group.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540351 TI - [Clinical and laboratory evaluations of ceftazidime in perinatal use. A study of ceftazidime in the perinatal co-research group]. AB - Efficacy and safety of ceftazidime (CAZ) in women during the perinatal period and their neonates were evaluated by a perinatal co-research group, and the results obtained were summarized as follows. Following an intravenous bolus injection or a drip infusion of CAZ from 1 g to 2 g, CAZ was transferred to maternal serum, umbilical cord serum and amniotic fluid rapidly and effectively. In 31 cases of perinatal infections, clinical efficacy was excellent in 10 cases, good in 18 and poor in 3, with an efficacy rate of 90.3%. In 85 cases given CAZ for prophylaxis of infections accompanying premature rupture of the membrane or following cesarean section, prophylactic effects were noted in 81 cases (efficacy rate: 95.3%). Neither adverse effects, nor abnormal laboratory findings were observed in any case. Also, no abnormalities in total serum bilirubin were observed in any neonates. From the above results, CAZ is considered to be a safe and useful drug for infections in women in perinatal period, usually in a unit dose of 1 g twice daily, or if necessary, 2 g twice daily. PMID- 3540352 TI - [Fundamental and clinical evaluation of ceftazidime in perinatal studies]. AB - In a chemotherapy of perinatal infections, the safety of mothers and their neonates and the transfer of a drug to amniotic fluid and fetus as well as its bacteriological efficacy are some of the important factors. In the present study, the authors have carried out a pharmacokinetic evaluation on the transfer of ceftazidime (CAZ), a new cephalosporin, to amniotic fluid and umbilical cord serum, and also a clinical study on its efficacy and safety in 3 cases of perinatal infections. Transfer ratios of CAZ to umbilical serum and to amniotic fluid were 25.3-46.5% and 0.6-17.5% (of maternal serum), respectively, after 1 g of CAZ was administered by bolus intravenous injection, and 24.3-85.8% and 1.6 17.5% (of maternal serum), respectively, after 2 g of CAZ was administered by bolus intravenous injection. These levels were high enough to expect that CAZ is an effective antibiotic both for treatment and prophylaxis of intrauterine fetal infections. Out of the 3 cases treated with CAZ, clinical efficacy was good in 2 cases which did not respond to other antibiotics. CAZ was considered to be clinically effective, although the number of cases treated was small. No abnormalities were observed at all either in subjective symptoms or objective findings in laboratory findings such as hepatic and renal functions of mothers, or neonates. This confirmed the high safety of CAZ. As earlier reports indicate, CAZ has a broad-spectrum of antibacterial activity against various bacteria including Gram-negative organisms and anaerobes, and shows a good transfer into intrauterine tissues, and high clinical efficacy in the field of obstetrics and gynecology.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540353 TI - [Ceftazidime: placental transfer and pharmacokinetic parameters in the third trimester pregnancy]. AB - Ceftazidime (CAZ), a newly developed cephalosporin with very high stability to beta-lactamase, was evaluated for its transfer into fetus and amniotic fluid in the third trimester pregnancy, following a single bolus intravenous injection at a dose of 1 g. In subjects with various conditions (background factors) standardized, concentrations of CAZ in maternal venous blood, venous and arterial blood in umbilical cord, and amniotic fluid were determined. High concentration of CAZ (10 micrograms/ml or higher) was found to be maintained in fetal blood and amniotic fluid for ca. 4 hours and ca. 8 hours, respectively, after intravenous injection, showing good placental transfer of CAZ. In view of MICs of CAZ, satisfactory clinical efficacy is expected in perinatal infections. PMID- 3540354 TI - [Pharmacokinetic and clinical studies of ceftazidime in perinatal period]. AB - Pharmacokinetic studies and clinical evaluations of ceftazidime (CAZ) were carried out in perinatal mothers and infants, and following results were obtained. The CAZ was promptly absorbed after intravenous injection or intravenous drip infusion in pregnant women, producing dose-related peak serum levels. Placental transference to the fetus was good. After intravenous injection or intravenous drip infusion of 1.0-2.0 g of CAZ, drug concentration in umbilical serum and amniotic fluid exceeded MICs of CAZ against main pathogenic organisms. Levels of CAZ in umbilical serum ranged 0.2-15.6 micrograms/ml after 1.0 g intravenous injection or intravenous drip infusion, and 0.7-27.2 micrograms/ml after 2.0 g intravenous injection, and those in amniotic fluid were 1.4-21.3 micrograms/ml after 1.0 g administration and 2.0-27.0 micrograms/ml after 2.0 g administration. According to the above results, it is possible to successfully prevent or treat perinatal infections by twice a day administration of CAZ at 1.0 2.0 g/dose. Clinically, CAZ was effective in the treatment of perinatal infections and the prophylaxis of intrauterine amniotic infection without any side effect. Moreover, newborn infants delivered from mothers receiving CAZ treatment did not have any abnormalities in laboratory test. The penetration of CAZ into mother's milk was low, thus the transfer of CAZ from milk to newborn infants should be low. The above results demonstrated that CAZ is a clinically useful antibiotic for the prophylaxis and the treatment of perinatal infections. PMID- 3540355 TI - [Fundamental and clinical evaluation of ceftazidime in the perinatal period]. AB - Following an intravenous injection of ceftazidime (CAZ) 1 g, the ratio of transfer of the drug into a fetus was 59.9%, and umbilical serum concentrations of the drug reached the peak of 18.2 micrograms/ml at 1.5 hours, and were slightly higher than maternal serum concentrations at 2.93 hours and after, with half-life of 1.37 hours, the same as in maternal serum. Following an intravenous injection of CAZ 1 g, concentrations of CAZ in mother's milk at 2 hours after injection were 1.16 micrograms/ml on the 4th day of the treatment of CAZ, and 0.86 micrograms/ml on the 7th day. The CAZ was administered to cases of premature rupture of membrane. The prophylactic efficacy against puerperal infections in mothers was 92%, and that against fetal infections in neonates was 96.7%. The CAZ was also administered after cesarean section, and the prophylactic efficacy against postoperative infections was 93.3%. Neither subjective/objective adverse effects nor abnormal laboratory findings for which CAZ was suspected were observed in any mothers or neonates. From the above results demonstrating satisfactory maternal transfer into fetuses and the high degree of safety in fetuses and neonates, as well as its high antibacterial activity, CAZ is considered to be a useful drug for the treatment of perinatal infections. PMID- 3540356 TI - [Fundamental and clinical studies on ceftazidime in the perinatal period]. AB - Fundamental and clinical studies were carried out on ceftazidime (CAZ) in the perinatal period, and the results obtained were summarized below. Following bolus intravenous injection of CAZ 2 g, maternal serum concentrations of CAZ were as high as 145.3 +/- 17.2 micrograms/ml (mean +/- S.D.) at about 10 minutes, and then gradually decreased to 46.7 micrograms/ml at 2 hours, 5.31 micrograms/ml at 5 hours and 4 minutes, and 1.54 micrograms/ml at 11 hours and 10 minutes. The CAZ was detected in umbilical cord serum immediately after the administration, and concentrations were 31.0 +/- 1.54 micrograms/ml at about 10 minutes. Although the concentrations gradually decreased thereafter, they were higher than those in maternal serum at 3 hours and later and was 3.00 micrograms/ml at 11 hours and 10 minutes. The CAZ was detected in amniotic fluid a little later than in umbilical cord serum, and concentrations of CAZ in amniotic fluid were as low as 1.50 +/- 0.67 micrograms/ml at about 10 minutes after the administration. Concentrations then gradually increased to 12.8 micrograms/ml at 2 hours and 26.5 micrograms/ml at 5 hours and 4 minutes, and even at 11 hours and 10 minutes, they were as high as 14.2 micrograms/ml. The above results demonstrated that the transfer of CAZ through placental barrier was very rapid and satisfactory. Also, CAZ showed good transfer into amniotic fluid, as well as sufficient retention, and was considered to be an effective antibiotic for prophylaxis of both fetal infections and amniotic fluid infections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540357 TI - [A study on ceftazidime in the perinatal period]. AB - Ceftazidime (CAZ), a new cephem antibiotic with high activity against Gram negative bacteria, has been investigated for use in mothers in perinatal period, and the results obtained are summarized below. Into maternal serum, umbilical cord serum and amniotic fluid, CAZ showed good transfer after intravenous administration of 1 g or 2 g into mothers, and no adverse effect appeared in their neonates. The CAZ is a very useful antibiotic for the prophylaxis and the treatment of perinatal infections at a dose level of 1-2 g per day. PMID- 3540358 TI - [Basic and clinical studies of cefotiam in neonates and premature infants]. AB - The effect of cefotiam (CTM) on neonates and premature infants was examined in basic and clinical studies. Minimum inhibitory concentrations of CTM against 190 clinically isolated strains kept by this department were investigated. This drug was found to have a strong antibacterial effect against Escherichia coli, Klebsiella spp., Proteus mirabilis and Streptococcus agalactiae, Staphylococcus aureus and Staphylococcus epidermidis, although some strains were resistant. The CTM was given to 0-3, 4-7, and greater than or equal to 8 day-old premature infants and neonates by intravenous injection at the dose of 20 mg/kg, and we studied changes in serum CTM levels over time. Mean serum CTM levels were 62.3 micrograms/ml at 15 minutes and 16.4 micrograms/ml at 6 hours after the injection, with the half-life of 3.6 hours, for the 0-3 day-old premature infants. They were 38.5 micrograms/ml at 15 minutes and 10.1 micrograms/ml at 6 hours, with the half-life of 2.9 hours, for the 0-3 day-old neonates. Those levels were 22.5 micrograms/ml at 15 minutes and 2.9 micrograms/ml at 6 hours, with the half-life of 1.9 hours, for the 4-7 day-old neonates, and 51.8 micrograms/ml at 15 minutes and 1.0 micrograms/ml at 6 hours, with the half-life of 1.1 hours, for the greater than or equal to 8 day-old neonates. The CTM was given to 0-3 and greater than or equal to 8 day-old premature infants and neonates by 1-hour intravenous drip infusion at the dose of 20 mg/kg, and changes in serum CTM levels after the infusion were followed. The 0-3 day-old premature infant (there was only one subject) had a peak serum CTM level of 21.0 micrograms/ml 1 hour after the start of the infusion (that is, at the time of its completion), with the level decreased to 8.6 micrograms/ml at 7 hours and the half-life was 5.4 hours. The mean peak serum CTM level in 0-3 day-old neonates were 36.7 micrograms/ml at 1 hour, which decreased to a mean of 7.0 micrograms/ml at 7 hours; the half-life was 2.3 hours.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540359 TI - [Kinetics and possible mechanism of thermotolerance: a review]. AB - Thermotolerance examined in vitro studies was reviewed in related to their kinetics, modifying factors and also the possible mechanisms. Heat treatments which reduce the survivals at same level at different temperature 42, 43, 44, 45 degrees C induces a same degree of thermotolerance and the thermotolerance decayed in same manner. These findings showed that thermotolerance induced by acute hyperthermia and that by chronic hyperthermia are not different in the nature. Examinations of heat sensitivities and kinetics of thermotolerance among different cell lines indicated that there is a possible relationship between the cellular sensitivity to heat and the magnitude of thermotolerance. The HSP has been found to be the most likely related factor in thermotolerance. But, their functions have not yet been clearly observed. Further research on HSP and thermotolerance is necessary to elucidate the possible mechanism of thermotolerance development. PMID- 3540360 TI - [Immunoreactive carcinoembryonic antigens in gastric juice collected during endoscopy--their usefulness in the diagnosis of gastric cancer]. AB - In the 109 subjects adopted for study, 52 involving gastric cancer and 57 noncancerous gastric disease, immunoreactive CEA (GI-SEA) in the gastric juice collected during endoscopy was measured by enzyme immunoassay using polyclonal (P group) and monoclonal (M group) antibodies against CEA. The results are outlined below. The mean value and the positivity of GI-CEA was the highest in advanced gastric cancer, followed by early gastric cancer and noncancerous gastric disease, in that order, and a particularly significant difference (P less than 0.001) was noted (in both the P and M groups) between the former two and the latter. In the GI-CEA of gastric cancer, high positivity was manifested regardless of the histological type, though the average values show that, in the case of the P group, high positivity manifested itself in undifferentiated adenocarcinoma, while in the case of the M group, it applied to differentiated adenocarcinoma. Moreover, no correlation was found between the size of the lesion and the positivity, though even with small lesions of less than 2 cm, there was an indication of probable high positivity. The values recorded for the P and M groups showed a close correlation between the two, except for the GI-CEA value of the histological type. However, for the M group, the positivity and GI-CEA value both tended to be low. The above results suggest that measurement of GI-CEA is of great help in the diagnosis of gastric cancer and that the use of polyclonal antibodies is appropriate for screening and early diagnosis. PMID- 3540362 TI - [Successful bone marrow transplantation in aplastic anemia in platelet transfusion refractory status]. PMID- 3540361 TI - [Sialylated Lewis x as a tumor-associated antigen in stomach cancer]. AB - Sialylated Lewis (S-Lex) has been studied histologically and serologically in stomach cancer by the CSLEX1 monoclonal antibody. S-Lex was expressed in 73.9% of 46 stomach cancer tissues, 29.4% of metaplastic parts adjacent to cancer, and none of six gastric ulcer tissues including metaplasia. Serologically positive percentages were as follows: 26.0% of 100 stomach cancers, 0.9% of 322 benign diseases, and 0.7% of 280 healthy donors in the sera, as well as 72.4% of 29 ascites of stomach cancers and 5.3% of 17 effusions of benign diseases. These findings demonstrate that S-Lex possesses a potential usefulness as a tumor marker in stomach cancer. PMID- 3540363 TI - [Tissue affinity of pathogens: invasion of pathogens--intestines]. PMID- 3540364 TI - [Tissue affinity of pathogens: 2. Invasion of pathogens--invasion of bacteria into the urinary tract--special reference to factor analysis of susceptibility during pregnancy]. PMID- 3540366 TI - [The defense mechanism and its weakening: modification of the defense mechanism by microbes--increase of sensitivity to bacterial endotoxins by bacterial components]. PMID- 3540365 TI - [The defense mechanism and its weakening: the defense mechanism by cellular immunity]. PMID- 3540369 TI - [Reye's syndrome and salicylic acids]. PMID- 3540368 TI - [Klebsiella infection--special reference to problems viewed from bacteriology]. PMID- 3540367 TI - [Chemical components of pathogens and the mechanism of their virulence: chemical components of pathogens and their etiologic significance]. PMID- 3540370 TI - [Non-gonococcal urethritis: new sexually transmitted diseases--etiology, diagnosis and therapy]. PMID- 3540371 TI - [Methicillin-resistant Staphylococcus aureus]. PMID- 3540372 TI - A trial of chemotherapy for lung cancer in short-term hospitalization. AB - Recently the number of patients with lung cancer who receive chemotherapy has been increasing rapidly. Therefore it has become difficult to treat all patients with advanced lung cancer on the basis of accurate protocol in long-term hospitalization. Accordingly we tried to treat patients within one week in each of a number of chemotherapy protocols (short-term hospitalization) and to follow them in the outpatient department. We were able to accept 61 admissions of 38 patients for chemotherapy from June to December 1985. Thus it was possible to take care of more than three times as many patients as could be cared for by long term hospitalization for chemotherapy. Three patients could not be discharged within one week and eight had to be readmitted because of leucopenia, thrombocytopenia, or dehydration. It was considered to be possible to decrease the number of such patients by more careful and appropriate hydration and to detect them by appropriate intervals of examination in the outpatient department. We concluded that short-term hospitalization is one of the methods which can make chemotherapy of lung cancer more effective. PMID- 3540373 TI - [Application of personal computer for interpretation system of clinical pathophysiology in patients with Graves' disease]. PMID- 3540374 TI - [Relation between hospital information system and clinical laboratory system--on physiological tests system]. PMID- 3540376 TI - [Liver cirrhosis]. PMID- 3540375 TI - [Studies on an enzyme immunoassay of rat albumin and its application]. PMID- 3540378 TI - [A case of splenic peliosis]. PMID- 3540377 TI - [A case of splenic inflammatory pseudotumor]. PMID- 3540379 TI - [Exposure dose of digital subtraction angiography--patient's dose and angiographer's dose]. PMID- 3540381 TI - [Urinary excretion of N-acetyl-beta-D-glucosaminidase and beta 2-microglobulin in people living in a cadmium-polluted area]. PMID- 3540380 TI - [Partial purification and characteristics of an acid proteinase from Trichophyton mentagrophytes]. PMID- 3540382 TI - [Fundamental methods for current three-dimensional display of medical images]. PMID- 3540383 TI - Unexpected death of a young man suspected of having diabetes mellitus. PMID- 3540384 TI - [Medicolegal documental materials chronologically arranged in the Meiji era (7)]. PMID- 3540385 TI - [History of midwifery practice. 17. Dismissal by GHQ of Dr. Segi, then the head of Maternal and Child Health Section, Ministry of Health and Welfare]. PMID- 3540386 TI - [Changes in the midwifery profession. 18. The view on the midwifery profession held by the PHW (Public Health and Welfare Section of General Headquarters]. PMID- 3540387 TI - [Cellular immunology and renal disease]. PMID- 3540389 TI - [Observation on clinical nursing training: involvement of instructors in planning of clinical training]. PMID- 3540388 TI - Immunologic mechanisms in renal disease--an overview. PMID- 3540390 TI - The enhancing effects of amastatin, phosphoramidon and captopril on the potency of [Met5]-enkephalin in rat vas deferens. AB - The enkephalin-inactivating enzymes in rat vas deferens were studied by using the relatively specific inhibitor of each enzyme. The results showed that the rat vas deferens, like the other three preparations, guinea-pig ileum, mouse vas deferens and striatal membranes of guinea-pig brain, which had been investigated previously, contained three distinct enkephalin-hydrolyzing peptidases. Additionally, the enkephalin-hydrolyzing aminopeptidase, endopeptidase-24.11 and peptidyl dipeptidase A in rat vas deferens were found to be inhibited maximally with 1 microM of amastatin, 1 microM of phosphoramidon and 1 microM of captopril, respectively. In contrast to these three enzymes, both L-tyrosyl-L-tyrosine sensitive dipeptidyl aminopeptidase and D-phenylalanine-sensitive carboxypeptidase were suggested not to be involved significantly in the inactivation of exogenously given enkephalin in rat vas deferens. The characteristics of the enkephalin-degradative enzymes in rat vas deferens were discussed in terms of their similarities to and differences from those in the other preparations. PMID- 3540391 TI - Rociverine citrate: a new spasmolytic agent, potentially useful in the treatment of urinary bladder hyperreflexia. AB - Rociverine citrate was evaluated for its ability to affect the motility of rat urinary bladder, in vitro and in vivo, in comparison with flavoxate hydrochloride. Rociverine counteracted both methacholine- and high K+-induced tonic contractions of bladder strips. In anaesthetized rats, intravenous rociverine inhibited dose-dependently frequency and amplitude of the distension induced rhythmic contractions (DIRCs) of urinary bladder and counteracted the topical high K+-induced pressure increase in the same organ. Orally administered rociverine produced a dose-related reversal of the reserpine-induced detrusor hyperreflexia in anaesthetized rats. In each of these experimental models rociverine was more effective than flavoxate. These results point to the usefulness of rociverine in the treatment of urinary bladder motility disorders. PMID- 3540392 TI - [Changes in pulmonary artery pressure after left lung allotransplantation in dogs]. PMID- 3540393 TI - [The adapter for the T-TAC technic]. PMID- 3540394 TI - [Usefulness of digital subtraction angiography in evaluation of patency of aortocoronary bypass graft]. PMID- 3540395 TI - [A case of full thickness chest wall resection reconstructed with Marlex polyethylene mesh, transposed omentum and a split-skin-graft in local recurrence breast cancer]. PMID- 3540396 TI - [A study of gastric emptying in gastric and duodenal ulcers]. AB - In the examination of gastric emptying using radioisotopic techniques, three areas of interest were established, i.e. the entire gastric, proximal gastric and antral area, and gastric emptying abnormalities in cases of gastric and duodenal ulcers and their mechanism were studied by analyzing gastric emptying curves obtained from these areas. Results were summerized as follows: In highly localized gastric ulcers at active stage, compared to healthy subjects, gastric emptying in the entire gastric area was accelerated, the movement of the contents from the proximal gastric area to the antral area was accelerated, and the movement from the proximal to the antral was greater than that from the antral to the duodenum during the first three minutes after start of the measurement. Hence, in highly localized gastric ulcers at active stage, it is believed that gastric emptying in the entire is accelerated as the movement from the proximal to the antral is accelerated. In low localized gastric ulcers at active stage, compared to healthy subjects, gastric emptying in the entire was not observed in the first minute and gastric emptying was delayed once it started, the movement from the proximal to the antral was fast as in healthy subjects in the first 17 minutes or so, and in the first seven minutes, the movement from the proximal to the antral was greater than that from the antral to the duodenum. Hence, in low localized gastric ulcers at active stage, it is believed that gastric emptying in the entire becomes delayed as the gastric emptying activity in the antral is lowered. In duodenal ulcers at active stage, compared to healthy subjects, gastric emptying in the entire was accelerated, the movement from the proximal to the antral was accelerated, and during the measurement, the movement from the antral to the duodenum was greater than that from the proximal to the antral. Hence, in duodenal ulcers at active stage, it is believed that gastric emptying in the entire is accelerated as gastric emptying ability of the entire becomes excited along with that in the proximal and antral. At healing stage, gastric emptying was found to be closer to that of healthy subjects than at active stage. PMID- 3540397 TI - [Clinical studies of urogenital infections with Chlamydia trachomatis. Report 2. The epidemiology of chlamydial infections in Okayama district in Japan and detection of antibodies to chlamydiae in the sera of patients with infertility by means of the microplate immunofluorescence antibody technique (MFA)]. PMID- 3540398 TI - [Clinical studies of urogenital infections with Chlamydia trachomatis. Report 3. Detection of antibodies to chlamydiae in the sera of patients with urogenital infections by means of the microplate immunofluorescence antibody technic (MFA) and detection of Chlamydia trachomatis in the patient's urethra by the culture method and the direct specimen test (MicroTrak)]. PMID- 3540399 TI - [Factors influencing the outcome of renal transplantation--multivariate analysis of preoperative factors]. PMID- 3540400 TI - Emergency Nurses Association/National Flight Nurses Association joint position paper: staffing of critical care air medical transport services. PMID- 3540402 TI - A victim speaks out. PMID- 3540401 TI - Recognition of excellence in emergency nursing. PMID- 3540403 TI - A child with a stab wound to the heart. PMID- 3540404 TI - Emergency care of the patient with myxedema coma. PMID- 3540405 TI - External cardiac pacing in the emergency department. PMID- 3540406 TI - Transthoracic pacing in the emergency department. PMID- 3540407 TI - Magnetic resonance imaging: an overview and safety considerations. PMID- 3540408 TI - Prehospital nurse clinician: job description and evaluation tool. PMID- 3540409 TI - An ED nursing documentation tool and the process of planned change. PMID- 3540410 TI - Complex partial seizures (temporal lobe epilepsy). PMID- 3540411 TI - Guideline for monitoring parameters for commonly used intravenous drugs in the ED setting. PMID- 3540412 TI - Physical restraint in the emergency department: a case study. PMID- 3540413 TI - Standardized care plans. Laceration, pharyngitis, and otalgia. PMID- 3540414 TI - An asthmatic preschooler: assessing respiratory distress. PMID- 3540416 TI - Assistant medical director, 1985 World Games: an emergency nurse becomes an advocate for deaf persons. PMID- 3540415 TI - Thoughts on a pediatric arrest. PMID- 3540418 TI - Establishment of four mouse hybridoma cell lines producing monoclonal antibodies reactive with ras oncogene product p21. AB - With the use of proteins derived from Escherichia coli cells expressing the v-H ras gene product as immunogens and an enzyme-linked immunosorbent assay with whole cells for a screening method, 4 BALB/c mouse hybridoma cell lines (rp-12, rp-28, rp-35, and rp-38) were isolated that produced monoclonal antibodies (MoAbs) showing higher reactivity with murine ras gene-activated cell lines than with normal cell lines. All the MoAbs complexed p21ras from the ras gene activated cell lines in Western immunoblot analysis and demonstrated a binding property of p21ras to guanine nucleotides. The indirect immunofluorescence assay revealed that MoAbs rp-12 and rp-28 stained the murine and human H- or K-ras activated cell lines, and MoAbs rp-35 and rp-38 not only stained these cell lines but also weakly stained a human N-ras-activated cell line. All these MoAbs stained the murine fibroblast lines with lower intensity, but they did not stain a human fibroblast line. Further, positive reactions with MoAb rp-12 were seen against human melanomas, but there was no reaction against nevi. The rp-12, rp 28, rp-35, and rp-38 antibodies are useful additions to the MoAbs reacting with p21ras reported previously. PMID- 3540417 TI - (Auto)antibodies in human breast cancer sera against antigens associated with breast cancer cells, detected by immunoblotting. AB - Sera of patients with breast cancer (as well as control normal sera and sera of patients with ovarian cancer or melanoma) were screened for the presence of antibodies against antigens expressed by the MDA breast cancer cell line. The techniques employed were radioimmunoassay with radioiodinated protein A and immunodotting with peroxidase-conjugated anti-human immunoglobulin antibodies. Sera reacting strongly by immunodotting were subsequently tested against antigens of the MDA and T47D cell lines in immunoblotting experiments. Both the breast cancer and the control sera yielded highly complex band patterns, which varied from serum to serum. The cancer sera differed from the normal sera, however, as they produced in most cases one or several bands that were distinctly stronger than the others. One of the strong bands, in fact a doublet of approximately 50 kilodaltons (kd), was produced preferentially (although not exclusively) when breast cancer sera were reacted with T47D cell membrane antigens. Absorption of selected sera with normal tissue or MDA antigens abolished or greatly reduced the intensity of some of the bands. It is concluded that, with the possible exception of the 50-kd band, most (probably all) of the bands seen in immunoblots resulted from the binding of autoantibodies to normal antigens expressed by the breast cancer cell lines. The main difference between cancer and normal sera would seem to be an increased content of autoantibodies in cancer, the specificity of these autoantibodies varying, however, from serum to serum. PMID- 3540419 TI - [Chlamydia trachomatis and herpes simplex virus infections during pregnancy]. PMID- 3540420 TI - Nursing research--through literature review. PMID- 3540421 TI - Arma's obstetrical nurse. PMID- 3540422 TI - [Use of intravenous digital substraction angiography in reconstructive surgery of peripheral arteries]. PMID- 3540423 TI - [Calcium metabolism and cardiac insufficiency]. PMID- 3540424 TI - [Comparison of the surgical and nonsurgical treatment of primary vesico-ureteral renal reflux--an international reflux study]. PMID- 3540425 TI - [Ultrasonic diagnosis of diseases of the abdominal aorta and its branches]. PMID- 3540426 TI - [Use of the surgical thread oktselon in end-to-end tracheal anastomosis]. PMID- 3540428 TI - [Methods of reconstructing fenestrated and wedge-shaped tracheal defects]. PMID- 3540427 TI - [Experience with occlusion of the left main bronchus in bronchial fistula]. PMID- 3540429 TI - [Treatment of pulmonary echinococcosis]. PMID- 3540430 TI - [Gunshot wounds of the major blood vessels]. PMID- 3540431 TI - [Successful treatment of esophageal injuries at a regional hospital]. PMID- 3540432 TI - [A modified organ suturing instrument]. PMID- 3540433 TI - [Pedagogical activity of Prof. V.A. Karavaev]. PMID- 3540434 TI - [The 40th anniversary of the Ukrainian Scientific Society of Forensic Medicine]. PMID- 3540435 TI - [Extensive lymphadenectomy in the surgical treatment of cancer of the stomach (review of the literature)]. PMID- 3540436 TI - [Preventive lymphadenectomy in stage I melanoma of the skin (review of the literature)]. PMID- 3540437 TI - [N.V. Sklifosovskii and his contribution to military surgery]. PMID- 3540438 TI - [Ophthalmologic examinations using the SMI Multitest computer system]. PMID- 3540439 TI - [Immunologic aspects in the diagnosis of uveal melanoma]. PMID- 3540440 TI - [From the bibliographer's files (XXVII). 75 years ago]. PMID- 3540441 TI - [Ultrasonic picture of vitreous hemorrhage]. PMID- 3540442 TI - [From the bibliographer's files (XXVIII). 50 years ago]. PMID- 3540443 TI - [Regula Reinhart is leaving the Swiss Nursing Association]. PMID- 3540444 TI - [Edwige Pittet, French editor from 1977-1984 has died]. PMID- 3540445 TI - [Tasks of neuroradiology]. PMID- 3540447 TI - Breeding of wild-caught rodent cricetidae Holochilus brasiliensis under laboratory conditions. AB - The breeding of wild-caught rodent Holochilus brasiliensis (Desmarest, 1819) was studied under laboratory conditions. The mean gestation length was 28.4 days. Litter size ranged from one to five. Males matured at 2-3 months and females at 2 4.5 months of age. The oestrous cycle lasted 6-8 days. Eleven pairs observed over 6-13 months increased to a population of 276 individuals (153 males and 123 females). PMID- 3540446 TI - [A short history of diabetes mellitus]. PMID- 3540448 TI - Comparison of the evolving histopathology of early and late cutaneous and asthmatic responses in rabbits after a single antigen challenge. AB - Histopathologic changes during the immediate cutaneous response (ICR) and late cutaneous response (LCR) to antigen challenge in allergic humans include dermal edema in the ICR (15 to 30 minutes) followed by increasing cellular infiltration in the LCR (6 hours and more). No description of the evolving histopathologic changes that occur during an immediate asthmatic response (IAR) followed by a late asthmatic response (LAR) exists in either clinical studies or animal models. We examined cutaneous and pulmonary histopathology at 1/2, 6, 24, and 48 hours as well as 7 days after simultaneous intradermal and aerosol antigen challenge of rabbits immunize with Alternaria tenuis extract. Nonimmunized rabbits challenged with Alternaria tenuis extract and immunized rabbits challenged with normal saline served as controls. Immediate wheal and flare responses followed by a LCR were seen in immunized but not control animals. Pulmonary function tests documented immediate and LAR in immunized but not control animals. Thirty minutes after antigen challenge of sensitized animals (ICR and IAR), both dermal sites and large airway submucosal sites had interstitial edema and vessel dilatation while small airways were essentially normal. At 6 hours after challenge, the dermal and large airway submucosal sites of immune animals (LCR and LAR) demonstrated a moderate mixed leukocyte infiltrate as well as residual edema. Additionally, bronchioles and pulmonary vessel adventitia from these responding animals had an intense and widespread leukocyte infiltration. At 24 and 48 hours, immune challenged animals but not controls had a marked mixed cellular infiltrate near skin vessels and near the bronchioles and pulmonary vessels with little or no residual interstitial edema. At 7 days, three of four animals showed resolution of the inflammation while the fourth showed minimal residual changes. Morphometric analysis of airway inflammation substantiated these qualitative observations and demonstrated that the granulocytes around airways of immune rabbits were a mixture of neutrophils and eosinophils at 6 hours, but were predominantly eosinophils at 48 hours. Immunofluorescent studies of skin and lung tissue did not demonstrate any granular or linear deposition of immunoglobulin or complement at the sites of inflammation, however, fibrin deposition was noted in the skin and lungs of immune rabbits. These observations show that immunized rabbits challenged with antigen develop cutaneous and pulmonary inflammation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540449 TI - Lysosomal characteristics of human renin-containing granules. PMID- 3540450 TI - A single autoantigen in Goodpasture's syndrome identified by a monoclonal antibody to human glomerular basement membrane. AB - A mouse monoclonal antibody (P1) to the autoantigenic component of human glomerular basement membrane (GBM) was used to study the immunochemistry and tissue distribution of the Goodpasture antigen and the specificity of the human autoimmune response in Goodpasture's syndrome (anti-GBM disease). In solid phase assays, monoclonal antibody P1 bound to collagenase-solubilized human GBM (the ligand used in assays for human autoantibody), but not to other biochemically defined components of basement membrane. On Western blotting, P1 bound to the same 6 bands in solubilized GBM (between 26 and 58 kilodaltons with major bands at 26 and 54 kilodaltons) that were recognized by sera from all 42 patients studied with anti-GBM disease. Preincubation with sera from 8/8 patients blocked the subsequent binding of P1 from 83 to 89% on densitometer scanning of the Western blot; and preincubation with P1 blocked the binding of sera from 6/6 patients from 58 to 89%. Indirect immunofluorescence and immunoperoxidase studies revealed that the pattern of binding of P1 was identical to that of antibody eluted from the kidneys of a patient with Goodpasture's syndrome; there was linear binding to GBM, Bowman's capsule, and distal tubular basement membrane. In addition, P1 bound to basement membranes in lung and choroid plexus, and to membranes of the lens capsule, choroid, and retina of the eye and cochlea, but not to other organs studied. It is concluded that there is a single major autoantigenic component of human GBM (the Goodpasture antigen), which is present on fragments of different molecular weight in the collagenase digest. This antigen is distributed throughout well-defined basement membranes known to be involved in both Goodpasture's and Alport's syndromes. Human anti-GBM antibodies bind to the same (or closely related) determinants which are recognized by P1, demonstrating that the autoimmune response in Goodpasture's syndrome is of highly restricted specificity. PMID- 3540451 TI - Marrow ablative doses of gamma-irradiation and protracted changes in peripheral lymph node microvasculature of murine and human bone marrow transplant recipients. AB - Gamma-irradiation has been extensively utilized as a bone marrow ablative agent during human bone marrow transplantation. Although the effects of ionizing radiation on lymphoid and hematopoietic cells are well documented, little is currently known about its effect on the nonhematopoietic tissues which are important for the restoration of normal immune function. The vast majority of lymphocyte movement into peripheral lymph nodes takes place via the bloodstream and requires a specific receptor-ligand interaction between the lymphocyte and anatomically distinct postcapillary venules. Due to the importance of lymphocyte recirculation in the initiation and amplification of immune responses, an understanding of the radiosensitivity of the postcapillary venules may provide insight into the pathogenesis of the immune deficiencies commonly seen after bone marrow transplantation. Our studies disclosed that the ability of normal blood borne lymphocytes to enter peripheral lymph nodes was markedly depressed (less than 50% of normal) in mice which had been exposed to 7.5 Gy of gamma irradiation. This radiation-induced effect lasted longer than 6 months after irradiation and syngeneic reconstitution, and its magnitude was radiation-dose dependent. Immunochemical staining of the lymph node microvasculature with the monoclonal antibody MECA-325 established that the radiation protocol induced persistent anatomic changes in the lymphocyte-receptive areas of endothelium (high endothelial venules). These vessels developed the appearance of endothelial cell proliferation. Electron microscopy demonstrated significant intracellular edema, with virtual occlusion of many microvascular lumens by edematous endothelial cells. Lymph nodes from human bone marrow transplant recipients were found to exhibit similar ultrastructural changes. These studies for the first time demonstrate that doses of irradiation similar to those used to prepare bone marrow transplant recipients can have significant anatomic and functional sequellae on host endothelial cells. PMID- 3540452 TI - System for continuous high-resolution measurement of distances in the eye. AB - We describe a new system for accurate measurement of intraocular distances; it is used in conjunction with standard A-scan ultrasound equipment. A processing unit has been developed which enables selection of time intervals between echoes. Up to four intervals can be chosen and simultaneously measured. The output of the system is derived from a pulse duration-to-voltage converter which presents an output voltage proportional to the selected time interval. In this way variations in intraocular distances larger than about 0.01 mm can be detected. PMID- 3540453 TI - Interdependence of pulse wave variables in the human fetal aorta. AB - The problem of inferring the state of fetal circulation from diameter pulse waves in the descending aorta was studied with the aid of statistical methods in 12 fetuses in late uncomplicated gestation. By means of a phase-locked, echo tracking ultrasound technique, aorta diameter-time waveforms and pulse propagation velocities were measured. In a factor analysis, three independent factors explained 75% of the total variance of variables in the waveforms. Relationships between some of the variables and biophysical events are suggested; they await confirmation from animal experiments, in order to develop a practical method for assessing fetal circulation. PMID- 3540454 TI - The basic difference in catalyses by serine and cysteine proteinases resides in charge stabilization in the transition state. AB - Besides the mechanistic similarities, in particular acylenzyme formation, kinetic investigations and X-ray diffraction studies have revealed some differences between the mechanisms of serine and cysteine proteinases: general base-catalysis in acylation, catalytic contribution by oxyanion binding, and a negatively charged catalytic triad in serine proteinases, but not in cysteine proteinases. In this paper we point out that all these differences are related and connected with the mode of stabilization of the zwitterionic species developing in the transition state of the reactions. In the case of serine proteinases this charge separation requires facilitation by the oxyanion binding and the negative charge of the catalytic triad. On the other hand cysteine proteinases do not require such contributions as they are capable of stabilizing the ion-pair even in the ground state of the reaction. Therefore, cysteine proteinases, in contrast to serine proteinases, may be regarded as "activated" enzymes. PMID- 3540455 TI - Autoperfusion of the heart and lungs for preservation during distant procurement. AB - A modified autoperfusing Starling preparation was used to provide pulmonary and coronary blood flow to extend the period of preservation for heart-lung transplantation. Twenty successful donations were achieved, 14 performed, and both the heart and lungs were well preserved in 14 of them. In four recipients it was not possible to assess the adequacy of preservation. In one recipient the preservation was not satisfactory, and in another the selection of the donor was responsible for poor cardiac function. Ten patients are alive who would not be were it not for this technique. PMID- 3540457 TI - Strategies and logic of cardioplegic delivery to prevent, avoid, and reverse ischemic and reperfusion damage. PMID- 3540456 TI - Cardiac release of prostacyclin and thromboxane A2 during coronary revascularization. AB - Cardiac surgery stimulates the systemic synthesis of prostacyclin and thromboxane A2, but the cardiac release of these prostanoids has been reported infrequently. Fifty-four patients undergoing elective coronary artery bypass had coronary sinus catheters inserted to evaluate the cardiac release of the stable metabolites of prostacyclin (6-keto-prostaglandin F1 alpha) and thromboxane A2 (thromboxane B2). Arterial concentrations of 6-keto-prostaglandin F1 alpha and thromboxane B2 were elevated after cardiac cannulation and during cardiopulmonary bypass. The cardiac release of 6-keto-prostaglandin F1 alpha was observed after cannulation and during, but not after, cardiopulmonary bypass. Cardiac thromboxane B2 release was detected after cross-clamp release and persisted during the early postoperative period when cardiac 6-keto-prostaglandin F1 alpha release was no longer detectable. Cardiopulmonary bypass stimulated the systemic production of thromboxane and prostacyclin. The cardiac release of thromboxane was unopposed by cardiac prostacyclin production in the early postoperative period and may contribute to reperfusion injury. PMID- 3540458 TI - Cold storage of the rat heart for transplantation. Two types of solution required for optimal preservation. AB - Two solutions, our cardioplegic solution and Collins' solution, were tested with regard to preservation of the heart under deep hypothermia before transplantation. The setup used was the isolated perfused working rat heart model and 4 hours of preservation at 0 degree C. The following three groups were prepared: Group 1: the heart was arrested with the cardioplegic solution (potassium: 20 mmol/L, sodium: 87 mmol/L) and then flushed with and stored in Collins' solution (potassium: 117 mmol/L, sodium: 10 mmol/L); Group 2: the heart was arrested with and stored in Collins' solution; and Group 3: the heart was arrested with and stored in the cardioplegic solution. The recovery of cardiac function was more satisfactory in Group 1 than in Groups 2 and 3. The increase in lactate was greater, and adenosine triphosphate and total adenine nucleotide were more depleted during storage in Group 2 than in Groups 1 and 3. In Group 3 myocardial sodium accumulation and potassium depletion during storage were greater than in Groups 1 and 2, and myocardial sodium and calcium overload after reperfusion were greater than in Group 1. Myocardial calcium overload after reperfusion in Group 2 was also greater than that in Group 1. These findings plus coronary vascular resistance analysis revealed that Collins' solution damages the heart during arrest procedures and that the cardioplegic solution is less effective for storage of the arrested heart under deep hypothermia. Therefore the heart should be first arrested with the cardioplegic solution and then flushed with and kept in Collins' solution for simple cold storage. PMID- 3540459 TI - Biopsy assessment of fifty hearts during transplantation. AB - The aim of the study was to evaluate myocardial protection during the transportation of human donor hearts stored at 4 degrees C in crystalloid cardioplegic solution. Biopsies were performed on 50 donor hearts before excision and at four subsequent time intervals during transplantation. Quantitative birefringence measurements on cryostat sections of the left ventricular biopsy specimens were used to assess myocardial function. Fifteen donor hearts had poor birefringence assessments before excision, and 67% received inotropic support after implantation; 22 deteriorated during transportation, and 50% received inotropic support; 13 were unchanged throughout the procedure, and none required inotropic support. This study demonstrates the need for improved protection of donor hearts during transportation and recommends the use of rigorous criteria in the selection of these hearts. PMID- 3540460 TI - Amsacrine: a review. AB - Amsacrine is an acridine derivative that has been extensively evaluated for its antitumor activity in recent years. Amsacrine is active in the treatment of acute leukemias and lymphomas but largely ineffective in solid tumors. In acute myelogenous leukemia, amsacrine is as effective as the two most active drugs, cytarabine and daunorubicin and can produce complete remissions in patients refractory to these drugs. The addition of amsacrine to the limited therapeutic armamentarium for this disease offers the potential for improved remission rates and remission duration. PMID- 3540461 TI - Hodgkin disease: malignancy, inflammation and abnormal immunity. AB - The effect of Hodgkin disease cells on the surrounding environment is complex. In the light of recent findings on growth factors and oncogenes a hypothesis on Hodgkin disease is presented. The interrelation of three main features of Hodgkin disease: malignancy, inflammation and abnormal immunity may be explained by the local secretion of platelet-derived growth factor like substances and interleukin 1 like substances by malignant Hodgkin disease cells. PMID- 3540462 TI - Immunological typing of acute lymphoblastic leukemia: concurrent analysis by flow cytofluorometry and immunocytology. AB - For 60 cases of acute lymphoblastic leukemia (ALL) immunological typing was done concurrently by the avidin-biotin-peroxidase method using cytocentrifuged smears and by flow cytofluorometry for the study of surface antigens. The use of a large panel of antibodies detecting differentiation antigens allowed us to sub-classify 57/60 cases as 43 B-lineage ALLs and 14 T-lineage ALLs. The two types of ALL can be accurately distinguished by the expression of the antigens recognized by the antibodies of the clusters of differentiation CD19 (B4) and CD7 (Leu 9). Almost perfect agreement was obtained between the results of the two methods for antigens DR, CD10 (cALLA;J5) and CD7. A number of discordances were observed with other antigens [CD19 (B4), CD20 (B1), CD22 (To15), CD1 (T6), CD2 (T11), CD4 (T4), CD8 (T8), CD3 (T3), T9, T10]. In spite of these discordances, the avidin-biotin peroxidase method can predict the lineage involved in most ALLs with a high degree of reliability. Nevertheless, for weakly expressed surface antigens (such as B4 and B1) the immunocytological method is less sensitive than flow cytofluorometry and can only approximately determine the stage of differentiation of neoplastic cells. Furthermore, the existence of cases which are at the same time negative with flow cytofluorometry and positive with immunocytology is consistent with the intracytoplasmic expression of certain differentiation antigens. Thus in the course of lymphoid differentiation, intra-cytoplasmic expression of T3, To15 and possibly J5 precedes their expression at the cell surface. PMID- 3540464 TI - History of neuromorphometry. AB - The history of morphometry begins in the middle of the last century. At the turn of the century impulses had decreased. The alterations arising during the preparation of the tissues were almost unknown. For example, the dogma of the loss of neurons during aging was conditioned by age-dependent histological shringage of the brain. Beginning in the thirties of this century new thoughts have given impulses to new morphometric investigation. In the neurosciences important impulses came from Bok. In 1961 Elias introduced the term "stereology" as a new interdisciplinary science in order to communicate the different developments. Since 1970 the computer and image analysis have brought a new dimension to morphometric research. This paper describes some neuromorphometrical developments. An increasing accuracy of results regarding density and amount of neurons can be estimated with facilitated counting procedures. A similar development can be observed for the estimation of neuronal sizes and their size distribution as well as for the volume-parts of the average perikaryon volume fraction (grey cell coefficient). The morphometry of dendritic tree and the ultrastructure of neuropil are briefly mentioned. PMID- 3540463 TI - Standard conditioning regimen and T-depleted donor bone marrow for transplantation in chronic myeloid leukemia. AB - Between January 1984 to June 1985, 18 Ph1 positive chronic myeloid leukemia (CML) patients in chronic phase (CP) underwent allogeneic bone marrow transplantation (BMT) from HLA identical and MLC negative siblings. The median age was 32.5 yr and median disease duration of CML at time of BMT was 19.3 months. The pretransplant conditioning regimen consisted of cyclophosphamide (CTX) (120 mg/kg) and 10.20 Gy total body irradiation (TBI) at 6 doses of 1.7 Gy each, administered in 3 daily fractions over 2 days at a dose rate of 15-20 cGy/min. To prevent graft-vs-host disease (GvHD) we used methotrexate (MTX) in one patient and cyclosporin-A (CYA) in the other 17 patients. In addition to CYA, given until day +365, 10 patients received donor marrow depleted of T cells with CAMPATH-1. The residual marrow lymphocytes were always less than 1%. The rate of engraftment was significantly correlated with the number of nucleated cells infused. Neither GvHD nor graft failure were observed among CAMPATH-1 patients. In this group one cytogenetic and one hematologic relapse occurred. The overall actuarial survival at 24 months is 78%. Of the 10 patients treated with donor marrow depleted of T cells, 9 are alive after a median follow-up of 9 months (range 5-18), with an actuarial survival of 90%. Of the other 8 patients transplanted with untreated marrow, 5 are alive after a median follow-up of 19.3 months (range 3.7-24) and the actuarial survival is 63.8%. This pilot study seems to demonstrate that T cell depletion of donor bone marrow with CAMPATH-1 is effective to prevent GvHD, while the risk of graft failure can be avoided using a "standard" conditioning regimen including a fractionated TBI with a fast dose rate and a prolonged administration of CYA at the maximum tolerable dosage. While the high frequency of relapses suggests the employ of more aggressive anti-leukemic conditioning regimens in CAMPATH-1 treated marrow recipients. PMID- 3540465 TI - Bivariate linear models in neurobiology: problems of concept and methodology. AB - Bivariate linear models, used to describe morphological and functional characteristics between two sets of observations, are examined both in concept and in application. This paper focuses on the underlying assumptions and statistics of the method most frequently used: ordinary linear regression, principal axis and standard major axis. It is shown how the choice of method should depend on: the purpose of the analysis and the a priori assumptions regarding the residual variance. It appears that none of the methods has a universal application. Differences among the models discussed are illustrated by a bivariate morphometric analysis of cerebrocortical regions in primates. PMID- 3540466 TI - The metric analysis of three-dimensional dendritic tree patterns: a methodological review. AB - Metric analysis methods used to study neuronal arborizations are reviewed and discussed. The analysis methods considered are those examining the spatial orientation and density of the whole dendritic field of a neuron, the metrics of dendritic segments and the bifurcation angles. General variables indicating the size of the soma and the dendritic field are indicated. In addition, the instrumentation used for providing 3-dimensional data for metric analyses and the shrinkage of Golgi-stained neurons are discussed. PMID- 3540467 TI - Descriptive and comparative analysis of geometrical properties of neuronal tree structures. AB - The morphology of neurons is an important factor for the identification and the study of the changes that occur in the nervous system during development or as a result of disease or an experimental treatment. A number of methods to describe the topological aspects of neuronal morphology is discussed. Furthermore it is illustrated how different groups of neurons can be compared. Although both topological and metrical aspects are considered in the comparative sections emphasis is put on counting instead of measuring. Our intention is to present quick and easy methods that are applicable to camera lucida drawings. PMID- 3540468 TI - Morphometry of size/volume variables and comparison of their bivariate relations in the nervous system under different conditions. AB - Comparison of the different approximation equations and procedures to estimate the volume of a brain region with an irregular shape contained in parallel sections indicates that the 'basic volume estimator' using systematic section is very efficient and sufficiently accurate. Important in estimating the volume is the correction for shrinkage and the accuracy of the section thickness determination. Methods to estimate thickness of section are outlined, and the method of differential focusing is discussed. In the Appendix, the corrections are described for overestimation of the volume by overprojection of the cross sectional area and underestimation by underprojection when the size of cross sectional area changes non-negligibly within sections. Statistical techniques to compare bivariate linear relations of different groups are reviewed. Emphasis is laid on Model II regression techniques that are used when the two variables considered are both subject to biological variation and measurement error. A new Model II procedure is proposed to compare the coincidence of the slopes of bivariate distributions and to test whether or not an experimental bivariate sample deviates significantly from a control sample when only the control group shows a significant bivariate linear relationship. PMID- 3540469 TI - A quantitative approach to cytoarchitectonics: software and hardware aspects of a system for the evaluation and analysis of structural inhomogeneities in nervous tissue. AB - Cytoarchitectonic studies are based on the analysis of structural inhomogeneities in nervous tissue. Boundaries of brain regions are established where local structural properties such as numerical cell density, size, shape or orientation change. The measurement of these properties from histological sections with automatic devices is biased due to the thickness of the sections. In this study, the grey level index (GLI) is measured with a TV-based image analyzer from routine histological sections. This parameter is a biased estimate of the volume density of Nissl-positive structures. The histological section is digitized into GLI values by a computer-controlled scanning procedure. The result is stored in an image matrix which is processed by digital filtering in order to visualize the laminar pattern. GLI statistics of brain regions are evaluated from the pictorial data by delineating these regions with a cursor on a hard copy fixed to digitizer. Information from a series of sections is stored in a standardized data file and combined by specific application programs. PMID- 3540471 TI - A critical evaluation of methods for estimating the numerical density of synapses. AB - Several methods for estimating the numerical density (NV) of particles are described. The usefulness and the limitations of different methods with respect to the estimation of synaptic densities are discussed. These methods are: the discrete unfolding technique, the serial section technique and the disector technique. From the results it is concluded that it is not advisable to use an unfolding technique to estimate the number and size of synapses since all sorts of assumptions regarding the shape, truncation and overprojection are hazardous. Consistently lower values for NV were obtained with the disector technique compared with the results of the serial section technique. This difference, obtained with two unbiased techniques, is discussed. The main conclusion with respect to this point is that both techniques can be used to estimate synaptic densities, provided a reliable estimate of the section thickness is obtained and an appropriate sampling procedure is used. PMID- 3540470 TI - The impact of recent stereological advances on quantitative studies of the nervous system. AB - The usefulness of a number of new stereological principles for unbiased estimation of particle number and sizes and sampling of particles is illustrated together with a novel principle for unbiased estimation of anisotropic surfaces. The examples include descriptions of estimators of neurone and synapse number and sizes, synapse gradients, neurone point patterns in three-dimensional space, capillary surface area, and perikarya volumes. A major advantage of the methods is the possibility to carry out the estimation procedures in specified, well characterized regions or layers of the brain. Some general statistical and stereological problems are briefly discussed. PMID- 3540472 TI - A method for common undercutting of interactive regions in rat cerebral cortex. AB - A method is described by which several cortical areas can be isolated from subcortical afferent and corticofugal efferent connections, but the operation leaves associative and commissural connections with each other and with non isolated areas intact. The common isolation of interactive cortical regions offers new possibilities to study morphologically, biochemically and electrophysiologically the complex process of synaptic reorganization and cortical functions in the absence of subcortical afferent and efferent connections. PMID- 3540473 TI - A stereotaxic method for small animals using experimentally determined reference profiles. AB - In bats conventional stereotaxic methods do not yield sufficient positional accuracy to allow reliable recordings and tracer injections in subnuclei of the auditory system. In a newly developed stereotaxic system experimentally measured patterns of skull profile lines are used to define the animal's brain position with an accuracy of +/- 100 microns. By combining the neurophysiological stereotaxic procedure with a standardization of the neuroanatomical processing of the brains, the location of recordings, stimulations or injections can be readily transformed into brain atlas coordinates. This facilitates the compilation and comparison of data within and among animals. The system is not restricted to use in bats and can be readily adapted to other experimental animals. PMID- 3540475 TI - [Use of ultrasound in the diagnosis of genital endometriosis]. AB - A comparison was made between ultrasound and clinical findings in 45 patients with patients with adenomyosis. In patients with ovarian endometriosis ultrasound showed a cystic ovarian endometriosis ultrasound showed a cystic ovarian tumour in 27 patients, a mixed ovarian tumour in 5 patients, and a solid ovarian tumour in 3 patients, then polycystic ovaries in 5 patients, while in 4 patients the ultrasound finding was negative. In patients with adenomyosis, ultrasound suggested an uterus metriticus 9 times, a myoma 5 times, while cystic islets in the myometrium were found in two cases. The findings described are not specific to endometriosis. PMID- 3540474 TI - A simple method for quantitative electroencephalographic assessment of drugs with convulsant and anticonvulsant properties. AB - A simple, inexpensive and reliable microcomputer-assisted method to detect and quantify abnormal EEG spiking is described. High frequency wave forms (20-40 Hz) with high amplitude are discriminated using a beta-2 bandpass filter and a threshold comparater. The spikes are then compiled and reported by an Apple II+ microcomputer. The method was validated by measuring seizures generated by intraperitoneal injection of pentylenetetrazol (PTZ), by microinjection of excitatory amino acids into the dorsal hippocampus, and by the antagonism of these seizures by diazepam and 2-amino-7-phosphono heptanoic acid, respectively. PMID- 3540476 TI - Morton: pioneer in the use of ether. PMID- 3540477 TI - The lifetime risks and costs of nursing home use among the elderly. AB - In this paper, we estimate the risk of an individual of entering a nursing home throughout the aging process. We then estimate the expected lifetime costs of nursing home use both for an individual and for society as a whole. The model is based on double-decrement life-table analysis. Data are taken from a 1977 survey of 4,400 Medicare beneficiaries. At age 65, the upper bound for the lifetime risk of entering a nursing home is 43.1%. The risk of entering a nursing home increases with age until around age 80. At about age 85, the risk begins to decline significantly. At almost all ages, the lifetime risk of entry for females is twice that of males. The expected lifetime costs of nursing home care across all ages are between $10,500 and $13,600. These costs are distributed very unequally. Only 13% of the elderly account for 90% of all nursing home expenditures. Given current life expectancy, the expected annual cost per person over age 65 is between $532 and $760. In the year 2000, the expected annual average costs of nursing home care per elderly person will range from $450 to $650. The decline in the average annual cost per person reflects shifts in the age structure and increased life expectancy. These figures need not represent an unmanageable burden on society's resources. Figures presented here help establish the feasibility and desirability of long-term care risk-sharing arrangements among the elderly, like long-term care insurance, life care communities, and other models. PMID- 3540479 TI - [The lung transplant]. PMID- 3540478 TI - [Toward the standardization of pancreatic islet cell antibodies]. PMID- 3540480 TI - [Renal post-transplant recurrence of segmental and focal hyalinosis. Its treatment with plasmapheresis]. PMID- 3540481 TI - [Aspergillus pulmonary infection. Diagnosis using transthoracic aspiration puncture]. PMID- 3540482 TI - [Treatment of arterial hypertension]. PMID- 3540483 TI - [Bacterial meningitis in childhood]. PMID- 3540484 TI - [Hepato-renal polycystosis in adults (type III Potter)]. PMID- 3540486 TI - Sigmund Freud's 'Dora': a case of mistaken identity. PMID- 3540485 TI - [Controlled study of 637 patients with tuberculosis. Diagnosis and therapeutic results with 9- and 6-month regimens]. PMID- 3540487 TI - [Endoscopic B-mode sonography of the neck. Preliminary findings]. AB - This is the first report about cross-sectional echography of the parapharyngeal and paraoesophageal neck tissue by using an endoscopically positioned ultrasound linear-array transducer system. Technique and initial clinical results are demonstrated. Transcutaneous and endoscopic B-mode-sonographic findings are compared. Small tumours of parapharyngeal and paraoesophageal space can be detected by endosonography. Scars, oedema, and tumour can be differentiated. In addition to transcutaneous B-mode-echography, endoscopic echography can optimise the follow-up of head and neck tumours. PMID- 3540488 TI - [Surgical treatment of snoring by correction of nasal and oropharyngeal obstruction]. AB - 32 patients with habitual snoring and 2 patients with obstructive sleep apnea syndrome underwent nasal and/or palatopharyngeal surgery. 12 patients with combined nasal septoplasty, submucous resection of the inferior turbinate bones and palatopharyngoplasty gained total relief from snoring. The same result was achieved in 10 children with removal of extremes of tonsillar and adenoid enlargement. From 7 patients with nasal surgery alone 4 experienced total improvement in the snoring, 3 perceived no long-term relief. 3 adults with PPP alone gained some change in their snoring. Uvulectomy in 2 adults had no influence on the snoring situation. PMID- 3540489 TI - [Phagocytosis and transport of injected teflon paste. An animal experiment study]. AB - Submucosal injections of teflon paste (suspension of teflon in glycerin) are used for therapy of ENT diseases. Little is known about the fate of the injected teflon particles. Is teflon phagocytosed and removed? Teflon paste was injected into the peritoneum of mice. After 48 days, we have found many teflon particles in peritoneal macrophages, in microphages and macrophages of regional lymph nodes and the spleen, and in Kupffer cells of the liver. We assume that phagocytosis and removal of the injected teflon particles occur in the patient, too. The particles are indigestible and, therefore, may block the phagocytic system. Phagocytes containing teflon induce local inflammation and fibrosis. Conclusive information about late effects is not available. PMID- 3540490 TI - [Was Beethoven's deafness caused by Paget's disease? Report of findings and study of skull fragments of Ludwig van Beethoven]. AB - Paget's disease of bone (osteitis deformans) has been repeatedly named as a possible cause for Ludwig van Beethoven's deafness. In 1985 a descendent of Franz Romeo Seligmann (a Viennese medical historian who in 1863 had studied Beethoven's mortal remains on the occasion of their relocation) presented to us three bone fragments allegedly from Beethoven's cranium. They represented fragments of the left parietal bone and the occiputum. It was possible to prove nearly with certainty that these bone fragments actually are Beethoven's. They did not show signs of Paget's disease of bone. It must therefore be concluded that Beethoven's deafness was not caused by Paget's osteitis deformans. PMID- 3540491 TI - Preoperative localization of parathyroid adenomas. AB - Patients with primary hyperparathyroidism have a parathyroid adenoma approximately 80% of the time. Preoperative localization of parathyroid adenomas has been significantly improved by the utilization of high resolution (high frequency) real-time ultrasound. This technique was accurate in 14 (78%) of the 18 cases in our series. There were four false negatives and no false positives. This imaging technique can routinely identify lesions less than 1 cm. High resolution real-time ultrasound is fast, safe, and cost effective. It is an ideal screening test for the preoperative localization of parathyroid adenomas. PMID- 3540492 TI - Cephaloceles. AB - The meningoceles and encephaloceles of the calvaria and base of the skull are reviewed with regard to origin and local behavior. An additional variant is added to the subgroup of nasopharyngeal cephaloceles, the basioccipital nasopharyngeal cephalocele, which only recently has become recognized. The clinical importance, techniques for its identification, and surgical management are discussed with the aid of a case report. PMID- 3540493 TI - How might Mycobacterium leprae enter the body? PMID- 3540494 TI - Antimycobacterial antibodies in Dasypus novemcinctus infected with Mycobacterium leprae and their correlation with the serum levels of lactate dehydrogenase. PMID- 3540496 TI - Survey for primary dapsone resistance in Cuba. PMID- 3540497 TI - The killing of Mycobacterium leprae in mice by various dietary concentrations of dapsone and rifampicin. PMID- 3540495 TI - Antigens of Mycobacterium leprae in urine during treatment of patients with lepromatous leprosy. PMID- 3540498 TI - [The combined effect of 4'-epidoxorubicin and irradiation in vitro]. PMID- 3540499 TI - [An improved method for isolation of salmonellae from human feces]. PMID- 3540500 TI - [Prenatal measurement of fetal blood flow in normal pregnancy]. PMID- 3540501 TI - [New findings on the etiopathogenesis of atopic dermatitis]. PMID- 3540502 TI - Free radicals: a potential pathogenic mechanism in inherited muscular dystrophy. AB - Despite years of intensive work, the biochemical defect responsible for the pathogenesis of inherited muscular dystrophy has not been identified either in humans or animal models. This review examines evidence in support of the hypothesis that free radicals may be responsible for muscle degeneration in this disorder. A variety of cellular abnormalities noted in dystrophic muscles can be accounted for by free radical mediated damage. In addition, chemical by-products associated with free radical damage are found in dystrophic muscle tissue from humans and animals with this disease. Various enzymatic antioxidant systems can be enhanced as a normal cellular response to oxidative stress, and such changes are seen both in dystrophic muscle cells and certain other tissues of dystrophic animals. An increased level of free radical damage would follow from either: enhanced production of free radical species, or a deficient component of the cellular antioxidant system, such as vitamin E. The free radical hypothesis of muscular dystrophy can account for data supporting several alternative theories of the pathogenesis of this disease, as well as other observations which have not previously been explained. PMID- 3540503 TI - Usefulness of Ficoll in electric field-mediated cell fusion. AB - Electrofusion is a technique that enables the production of new cell types with desired properties to be done. Ehrlich ascites tumor cells are fused by means of an electric field. Under too harsh external field strength or pulse length conditions, however, membrane breakdown leads to a loss of cellular cytoplasm. Addition of the high polymer Ficoll to the fusion medium increases its density and osmotic pressure, thus preventing cytoplasm from running out and, therefore, maintaining cell viability. Fusion between cells of different sizes is made possible or facilitated by means of Ficoll, as big cells do not lose their cytoplasm under conditions required for enhancing membrane permeability of the small cells. In presence of the proteolytic enzyme pronase, addition of Ficoll to the fusion medium further raises the fusion percentage compared to the exclusive addition of pronase. The fusion of cells of different densities is also greatly facilitated and its percentage increased by addition of Ficoll, thus obviating the necessity to perform electrofusion under conditions of microgravity. PMID- 3540504 TI - Effects of propranolol, clonidine and hydrochlorothiazide treatment and abrupt discontinuation on central and peripheral noradrenergic activity in essential hypertension. AB - This study was undertaken to investigate further the CNS actions of commonly employed antihypertensive drugs. Measurements of cerebrospinal fluid (CSF) and plasma catecholamines (CA) were made in an attempt to estimate the activity of central and peripheral noradrenergic neurons during treatment with or after abrupt discontinuation of treatment with clonidine (CLO), propranolol (PRO), hydrochlorothiazide (HCTZ) or placebo, in patients with essential hypertension. A randomized, parallel, placebo-controlled, single-blind design was employed. BP reductions equal to or greater than 10 mmHg were observed with CLO (0.36 +/- 0.07 mg daily), PRO (160 mg +/- 0 mg daily) or HCTZ (70 +/- 12 mg daily). CLO reduced plasma norepinephrine (NE) by 64% and PRO increased it by 25%. Neither HCTZ nor placebo modified plasma NE. Plasma renin activity (PRA) was reduced by PRO (51%, P less than 0.01) and CLO (35%, P less than 0.05). CSF-NE levels (pg/ml) were significantly lower in the CLO group (CLO: 175 +/- 23; PRO: 278 +/- 35; HCTZ: 255 +/- 34; placebo: 203 +/- 7). PMID- 3540505 TI - Induction of microsomal cytochrome P-450 enzymes: the first Bernard B. Brodie lecture at Pennsylvania State University. PMID- 3540506 TI - Trace amounts of ganglioside GM1 in human milk inhibit enterotoxins from Vibrio cholerae and Escherichia coli. AB - Gangliosides were isolated from human milk fat and purified by silica gel column chromatography and high performance liquid chromatography (HPLC). Low amounts of the ganglioside GM1, detected by high performance thin layer chromatography (HPTLC)-immunoassay, were found in all fractions with enterotoxin-inhibitory activity, while fractions without GM1 were inactive. It is concluded that GM1 is responsible for enterotoxin-inhibitory activity in the ganglioside fraction from human milk. PMID- 3540507 TI - Yohimbine reduces morphine tolerance in guinea-pig ileum. AB - Opiates are known to inhibit electrically-evoked twitches of longitudinal muscle myenteric plexus strips from guinea-pig ileum. When this preparation was incubated with morphine for 1 h tolerance developed to the inhibitory effect, since dose-response curves were shifted to the right. In the present study, the effects of alpha-2 adrenergic agents on the tolerance induced by morphine in this preparation was investigated. Addition of yohimbine 10 microM (but not 0.1 or 1 microM) to the incubating medium reduced the magnitude of opiate tolerance. This effect did not appear in the presence of the alpha-2 agonists clonidine or guanfacine (10 microM). Our results provide evidence of the longitudinal muscle myenteric plexus as a useful model for the study of the relationship between morphine tolerance and alpha-2 adrenergic mechanisms. PMID- 3540509 TI - Desaturation of fatty acids in Trypanosoma cruzi. AB - Uptake and metabolism of saturated (16:0, 18:0) and unsaturated [18:1(n-9), 18:2(n-6), 18:3(n-3)] fatty acids by cultured epimastigotes of Trypanosoma cruzi were studied. Between 17.5 and 33.5% of the total radioactivity of [1-14C]labeled fatty acids initially added to the culture medium was incorporated into the lipids of T. cruzi and mostly choline and ethanolamine phospholipids. As demonstrated by argentation thin layer chromatography, gas liquid chromatography and ozonolysis of the fatty acids synthesized, exogenous palmitic acid was elongated to stearic acid, and the latter was desaturated to oleic acid and 18:2 fatty acid. The 18:2 fatty acid was tentatively identified as linoleic acid with the first bond in the delta 9 position and the second bond toward the terminal methyl end. Exogenous stearic acid was also desaturated to oleic and 18:2 fatty acid, while oleic acid was only converted into 18:2. All of the saturated and unsaturated fatty acids investigated were also converted to a small extent (2-4%) into polyunsaturated fatty acids. No radioactive aldehyde methyl ester fragments of less than nine carbon atoms were detected after ozonolysis of any of the fatty acids studied. These results demonstrate the existence of delta 9 and either delta 12 or delta 15 desaturases, or both, in T. cruzi and suggest that delta 6 desaturase or other desaturases of the animal type are likely absent in cultured forms of this organism. PMID- 3540508 TI - Altered metabolism and cell surface expression of glycosphingolipids caused by vitamin E in cultured murine (K3T3) reticulum sarcoma cells. AB - Vitamin E caused a generalized reduction in the metabolism and cell surface expression of glycosphingolipids (GSL) in cultured Kirsten murine sarcoma virus transformed nonproducer (K3T3) cells. Metabolism of gangliosides was decreased two- to fourfold in cells treated for 72 hr with 1 and 2 micrograms/ml but not with 12 micrograms/ml vitamin E compared to control cultures. This was demonstrated by a quantitative reduction in precursor 3H-galactose label incorporated in ganglioside fraction and further substantiated by thin layer chromatography of colorimetrically and radiochemically detected GSL homologues. The composition of neutral GSL homologues was only slightly changed. The cell surface expressions of sialoglycoconjugates, analyzed by selective periodate borotritide labeling, were also diminished quantitatively. These results are discussed in light of a previously demonstrated increase in antigenicity of K3T3 cells treated with vitamin E and the reduced tumorigenicity of these cells when transplanted into mice fed vitamin E-supplemented diets. PMID- 3540510 TI - Regional anesthesia for renal transplantation. PMID- 3540511 TI - Anesthesia management in malnutritional patients. PMID- 3540512 TI - [Hemoglobin level--a prognostic factor of the effectiveness of metronidazole in radiotherapy of cancer of the cervix uteri]. AB - A clinical trial was performed in 339 patients with Stages IIB, IIIB cervical carcinoma to test the effect of radiotherapy in combination with metronidazole. When the overall material was evaluated, no significant difference in the local clearance rate of tumors in metronidazole-treated and untreated patients was revealed. However, when the case material was subdivided into a group of anemic patients (hemoglobin less than 120 g/l) and a group of patients with normal hemoglobin levels (hemoglobin greater than 120 g/l) the data indicated that metronidazole therapy improved significantly the results in the anemic patients. The results in the non-anemic patients were not influenced, to any significant extent, by the drug. PMID- 3540513 TI - [Clonogenic capacity and proliferative activity of the cells of malignant tumors of the bones]. AB - The authors presented their first results of tumor cell cloning in 48 patients with malignant bone tumors. Colony growth was observed in 32 patients. Colony formation efficacy, expressed in the number of grown colonies per 10(5) tumor cells incubated in the culture, varied greatly (from 0.4 to 90.7) in different patients. Rather a high colony forming capacity of tumor cells was prognostically unfavorable. Tumor cells in the patients with malignant bone tumors were characterized by a low proliferative activity: the ratio of DNA-synthesizing cells evaluated by immunofluorescence or flow cytometry in 14 examinees was an average of 3.3% varying in different patients from 0 to 8.0%. No distinct correlation between tumor cell colony forming capacity and proliferative activity was revealed in the patients. PMID- 3540514 TI - [Clinico-biological aspects of radiation pathology of mononuclear phagocytes]. PMID- 3540515 TI - [Peculiarities of tumor blood supply and their role in radiotherapy, hyperthermia and hyperglycemia]. PMID- 3540516 TI - [Specific antibodies in technics of radioimmunological analysis]. PMID- 3540517 TI - Lead intoxication. AB - Lead intoxication was recognised as early as 2000 BC and the widespread use of lead has been a cause of endemic chronic plumbism in several societies throughout history. In the twentieth century, lead intoxication is still a common problem. In children it is largely due to ingestion of pica and environmental exposure, whereas adult groups at greatest risk are the industrially exposed: thus, screening of these workers should be undertaken at regular intervals. The clinical features of lead intoxication are nonspecific and often go unrecognised. The early manifestations are largely neuropsychiatric, followed by more significant disturbances of the central and peripheral nervous systems, symptomatic gastrointestinal, musculoskeletal, haematological and endocrine abnormalities. The association of lead poisoning with renal disease is well documented and must be considered, particularly if there is associated hypertension and/or gout. Blood lead concentrations are an unreliable predictor of body lead stores as they are indicative only of recent exposure. Haematological parameters have been used to assess those at risk of toxicity, but although more reliable than blood concentrations, they also fail to predict those patients at risk of toxicity. The recommended assessment for patients with suspected lead intoxication is a calcium disodium edetate chelation test, which is a sensitive marker for assessing body stores and subsequent intoxication. In children the dosage should be 50 mg/kg up to 1000 mg, and in adults 1000 mg administered intravenously or 2000 mg intramuscularly in divided doses 12 hours apart with subsequent 72 hour urinary lead estimations. Lead excretion levels greater than 350 micrograms/72 hours should be considered as suggestive of intoxication, particularly if supported by historical, clinical or biochemical evidence of lead exposure. Treatment of patients with positive chelation tests involves symptomatic treatment and a course of chelation therapy utilising calcium disodium edetate in doses similar to those used for testing, and in the more severely intoxicated patient, the addition of dimercaprol in doses of 75 mg/m2 every 4 hours to a total of 300 mg/m2/day. The safety of these treatment regimens is well documented. PMID- 3540518 TI - Clinical features and management of self-poisoning with newer antidepressants. AB - Over the last decade a number of antidepressants have been introduced which differ either chemically, pharmacologically or toxicologically from established tricyclic and monoamine oxidase drugs. Of those presently available, maprotiline is similar in toxicity to tricyclic antidepressants perhaps causing convulsions more frequently. Lofepramine is metabolised to desmethylimipramine, but the limited clinical experience so far suggests that toxicity is less severe than with other tricyclic antidepressants. Amoxapine causes coma, convulsions and less frequently renal failure, but electrocardiographic abnormalities are uncommon. Mianserin and trazodone both cause drowsiness and more infrequently deeper grades of coma. Alprazolam produces the typical benzodiazepine overdose symptoms of drowsiness and floppiness. There is as yet insufficient clinical data to comment on the specific toxicity of fluoxetine and fluvoxamine. There are many more new antidepressants in various stages of development and it is likely that several of these will be marketed. Since their individual toxicities differ it is essential that monitoring of their overdose effects should be undertaken. PMID- 3540519 TI - Vincristine neurotoxicity. Pathophysiology and management. AB - Vincristine is an antineoplastic drug with a broad spectrum of activity against haematological malignancies and childhood sarcomas. Besides useful activity, it lacks the usual emetic and myelotoxicity of anticancer drugs, but its use is limited by neurotoxicity. The neurotoxicity commonly manifests as reduced motility of the intestines resulting in constipation, and peripheral neuropathy which is predominantly sensory in nature. The early symptoms include numbness and tingling of hands and feet which is accompanied by loss of deep tendon reflexes. In its more severe form, muscle weakness develops which is more marked in distal muscles of the hands and feet. Other manifestations of neurotoxicity include ocular palsies, hoarseness of voice, and autonomic neuropathy in the form of postural hypotension and atony of the urinary bladder. The neurotoxicity is dose related and cumulative with repeated dosage such that the drug therapy has to be stopped after a cumulative dose of 30 to 50 mg. The neurotoxicity is usually reversible on interruption of the therapy, but the recovery is slow and takes several months. There are no specific antidotes which have established usefulness against neurotoxicity. PMID- 3540520 TI - Drug-induced psychiatric disorders and their management. AB - Psychiatric disorders induced by drugs are of most concern when they occur in the context of therapeutic use of a drug. Such iatrogenic psychiatric disturbances may interfere considerably with the treatment of the primary illness and may cause concern to patients, their relatives and the medical staff. Because many drugs are often used simultaneously in seriously ill patients, it may be difficult to be sure which drug may have been responsible. The best procedure is to remove those drugs which are most probable causes of the psychiatric disturbances as well as any drugs that are not truly essential for the treatment of the patient. Problems involved in evaluating the relationship between use of drugs and psychiatric disorders are considerable. Many reports are isolated cases and the denominators which might provide some idea of the potential risk are unknown. Many relationships are still controversial, such as the association of depression with sedatives, antihypertensives and oral contraceptives. Areas of uncertainty are great. Psychomotor impairment may be caused by a drug that can alter consciousness, or any drugs that can produce more delineated psychiatric syndromes. Sedative drugs are those most commonly associated with psychomotor impairment, and may include psychotherapeutic drugs, sedative antihistamines, narcotic analgesics and, of course, the widely used social drug, alcohol. Delirious states are most often associated with drugs that possess central anticholinergic actions. These include not only drugs clearly identified as anticholinergics, but also tricyclic antidepressants and anti-Parkinson drugs. Cimetidine, which is often used parenterally in seriously ill patients, is also a prominent cause. Delirium is most often seen in elderly patients and in those who have received rather large doses of drugs. The association of schizophrenic-like psychoses with dopaminomimetic drugs tends to support the prevailing dopamine hypothesis of schizophrenia. Levodopa, the dopamine precursor, and bromocriptine, a direct dopamine agonist, are examples of such relationships. Abuse of social drugs has also been thought to provide a useful model of schizophrenia. Hallucinogens are probably a rather poor model, abuse of amphetamines may provide a better model, and possibly the best is the psychotic state elicited by phencyclidine. Manic reactions are clinically difficult to differentiate from schizophrenic-like psychoses and are often produced by similar drugs. Corticosteroids may produce either manic or schizophrenic-like disorders, as well as occasionally confusion and depression.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540521 TI - Medication-induced oesophageal injury. Survey of the literature. AB - This is a review of the 127 cases of drug-induced oesophagitis reported in the English language literature since 1970. The most common symptoms reported were retrosternal pain, odynophagia, and dysphagia. Most cases were self-limited and symptoms resolved in 7 to 10 days with symptomatic therapy. Occasionally, severe odynophagia or dysphagia necessitated hospitalisation. Emepronium bromide, tetracycline and its derivatives, potassium chloride, and quinidine account for 89% of the reported cases of medication-induced oesophageal injury. 14 other medications have been reported to injure the oesophagus. Serious sequelae, including death, have been linked to potassium-induced oesophageal injury. With other medications, however, serious complications were rare. The diagnostic study of choice is endoscopy; an air-contrast barium swallow may also detect the often subtle mucosal abnormalities produced by medication injury. However, the diagnosis does not require confirmation by radiographical or endoscopic means in all cases, and the history alone may be sufficient to make the diagnosis in uncomplicated cases. Medication-induced oesophageal injury is preventable if pills are taken with an adequate amount of fluid and if the practice of taking medications immediately before bedtime is avoided. PMID- 3540522 TI - [Role of the nurse in preparing the patient for an ultrasonic study of the digestive organs]. PMID- 3540523 TI - A comparison of continuous with interrupted sutures in microvascular anastomosis. AB - Microvascular anastomoses were performed on rat common carotid arteries using either continuous or interrupted sutures. The contralateral common carotid artery was ligated to create a demand situation. At 6 months, there was no statistically significant difference between the diameters of vessels anastomosed with continuous sutures and those with interrupted sutures. PMID- 3540525 TI - Microsurgical extramucous ureteroureterostomy in rats. AB - The purpose of this study was to perfect the microsurgical technique of ureteroureterostomy in rats as a contribution to reconstructive surgery of the urinary tract in congenital malformations in newborns and infants. Microsurgical ureteroureterostomy was performed in 100 rats with Nylon and Vicryl 10-0 and 11-0 swaged on a BV-6 and BV-8 needle. Postoperative investigation of renal function and permeability of the anastomoses was realized by macroscopic examination and by IM urography. The healing of the anastomoses was studied at different intervals after operation by histologic and scanning electron microscopic evaluation. Results include 1) per primam healing without stenosis in 98% of the cases; 2) urine proof anastomosis achieved to avoid scarification; 3) extramucous sutures preferable to prevent leakage and also crystallization that rapidly occurs in the rat and 4) tubing or nephrostomy is unnecessary. PMID- 3540524 TI - Sodium hyaluronate as an aid in microvascular surgery. AB - The purpose of this study was to compare the suture of a microvascular anastomosis with and without the aid of sodium hyaluronate. The divided femoral arteries of ten Sprague-Dawley rats were sutured using sodium hyaluronate on one side. Operating time, bleeding, and patency rates were studied and compared. No significant differences were found in the measured parameters. However, the clinical impression is that the use of sodium hyaluronate facilitates the suture of a microanastomosis. PMID- 3540526 TI - Behavior of triatomines (Hemiptera: Reduviidae) vectors of Chagas' disease. I. Courtship and copulation of Panstrongylus megistus (Burm., 1835) in the laboratory. AB - A study of the courtship and copulation behavior of Panstrongylus megistus was carried out in the laboratory. Fifty-five newly-fed virgin couples were used. Experiments were performed during the day (9:00 to 12:00 a.m.) and at night (7:00 to 10:00 p.m.). Behavior was recorded by direct observation and was found to consist of the following sequence of behavioral patterns: the male approached the female and jumped on her or mounted her; he took on a dorsolateral position and immobilized the female dorsally and ventrally with his three pairs of legs; the male genital was placed below those of the female; the paramers of the male immobilized the female's genitals; copulation started. The couple joined by the iniciative of the male. The female could be receptive and accept copulation, or nonreceptive and reject the male. Copulation occurred more often on the occasion of the first attempt by the male. Duration of copulation was X = 29.3 +/- 9.3 min (CV = 83%). No behavioral differences were observed between couples tested during the day or at night. PMID- 3540527 TI - Chronic murine myocarditis due to Trypanosoma cruzi--an ultrastructural study and immunochemical characterization of cardiac interstitial matrix. AB - In an attempt to define the mouse-model for chronic Chagas' disease, a serological, histopathological and ultrastructural study as well as immunotyping of myocardium collagenic matrix were performed on Swiss mice, chronically infected with Trypanosoma cruzi strains: 21 SF and Mambai (Type II); PMN and Bolivia (Type III), spontaneously surviving after 154 to 468 days of infection. Haemagglutination and indirect immunofluorescence tests showed high titres of specific antibodies. The ultrastructural study disclosed the cellular constitution of the inflammatory infiltrate showing the predominance of monocytes, macrophages with intense phagocytic activity, fibroblasts, myofibroblasts and abundant collagen matrix suggesting the association of the inflammatory process with fibrogenesis in chronic chagasic cardiomyopathy. Arteriolar and blood capillary alterations together with dissociation of cardiac cells from the capillary wall by edema and inflammation were related to ultrastructural lesions of myocardial cells. Rupture of parasitized cardiac myocells contribute to intensify the inflammatory process in focal areas. Collagen immunotyping showed the predominance of Types III and IV collagen. Collagen degradation and phagocytosis were present suggesting a reversibility of the fibrous process. The mouse model seems to be valuable in the study of the pathogenetic mechanisms in Chagas cardiomyopathy, providing that T. cruzi strains of low virulence and high pathogenicity are used. PMID- 3540528 TI - CL 64,855, a potent anti-Trypanosoma cruzi drug, is also mutagenic in the Salmonella/microsome assay. AB - The nitroimidazole-tiadiazole derivative CL 64,855 (2-amino-5-(1-methyl-5-nitro-2 imidazolyl)-1,3,4-thiadiazole, a potent anti-trypanosomal drug, was assayed in a short-term bacterial mutagenicity test with Salmonella typhimurium strains TA 98, TA 100 and TA 102. Results indicate that CL 64,855 is a potent frameshift mutagen detected by strains TA 98 and TA 102. CL 64,855 was able to revert the indicators strains at concentrations as low as 0.1 micrograms/plate. Metabolic activation experiments with rat liver microsomal fractions did not increase the mutagenic action of CL 64,855. PMID- 3540529 TI - Mutant EF-Tu increases missense error in vitro. AB - We have studied the consequences of mutational alteration in the structure of EF Tu on the missense errors and proofreading activity of bacterial ribosomes in vitro. Our data show that the EF-Tu Bo mutant form of EF-Tu (van der Meide et al. 1983a) is inactive in polypeptide synthesis on the ribosome, even though it binds aminoacyl-tRNA. A second mutant form, EF-Tu Ar (van der Meide et al. 1983a), is active in polypeptide synthesis but supports a much higher messense incorporation with either leucine isoacceptor 2 or leucine isoacceptor 4 in the in vitro system. Further analysis of the kinetic basis of this enhanced missense frequency revealed that the mutation responsible for the alteration in EF-Tu Ar increases the errors at both the proofreading step and the initial selection. In this respect the effect of this particular mutation is similar to the mode of action of the antibiotic kanamycin (Jelenc and Kurland 1984). PMID- 3540530 TI - Complementation analysis of the wild-type and mutant ompR genes exhibiting different phenotypes of osmoregulation of the ompF and ompC genes of Escherichia coli. AB - Expression of the ompF and ompC genes, which encode the major outer membrane proteins, OmpF and OmpC, respectively, is affected in a reciprocal manner by the osmolarity of the growth medium. This osmoregulation is mediated by the OmpR protein, a positive regulator of both genes, which is encoded by the ompR gene. Structural and functional properties of this regulatory protein were studied through complementation analysis of the wild-type and five mutant ompR genes that exhibited differences in osmoregulation of the expression of the OmpF and OmpC proteins. Complementation was carried out with combinations of a host strain and a plasmid, each of which carried either the wild-type or a mutant ompR gene. In some combinations, negative complementation was observed. For example, ompR1, a deletion mutation with an OmpF- OmpC- phenotype, was dominant to OmpF+ or OmpC+ phenotypes conferred by other ompR genes. Positive complementation of two mutant ompR genes was also observed in other combinations, when the two mutations were distantly located from each other on the OmpR protein. These results, together with other observations, support the view that the OmpR protein has a two-domain structure, each domain exhibiting a different role in the expression of the OmpF and OmpC proteins, and that this protein takes a multimeric structure as a functional unit. PMID- 3540531 TI - Structure and function of dnaQ and mutD mutators of Escherichia coli. AB - The nucleotide sequences of the recessive dnaQ49 and the dominant mutD5 mutator were determined. The dnaQ49 mutator has a single base substitution in the dnaQ gene, thus causing one amino acid change, 96Val (GTG)----Gly (GGG), in the DnaQ protein (epsilon subunit of DNA polymerase III holoenzyme). The mutD5 mutator possesses two base substitutions in the same gene, resulting in two amino acid changes, 73Leu (TTG)----Trp (TGG) and 164Ala (GCA)----Val (GTA), which were designated the mutD52 and mutD51 mutations, respectively. Construction of chimaeric genes carrying one or two of these mutations revealed: either mutD51 or mutD52 alone causes the dominant mutator phenotype when present in a multi-copy plasmid; mutator phenotype when present in a low-copy plasmid; the dominant mutD51 mutator activity is suppressed by the dnaQ49 mutation when both mutations are present in the same gene. Based on these findings, we devised a model for the action of these mutators. PMID- 3540532 TI - Properties of glucose uptake in vegetative and sporulating cells of Saccharomyces cerevisiae. AB - The effect of digitonin, acetic acid, urea and ethanol treatment on the glucose uptake of vegetative cells and of sporulating cells (3 h after transfer to sporulation medium) was examined in Saccharomyces cerevisiae. Both glucose uptake activities decreased at a similar rate, and a slightly different rate, in treatment with various concentrations of digitonin and of acetic acid, respectively, at 25 degrees C for 10 min. The glucose uptake activity of the sporulating cells was much more stable to urea treatment than that of the vegetative cells; the activity decreased about 36% and 76% in the sporulating cells and the vegetative cells, respectively, under conditions of 2.5 M urea at 25 degrees C for 10 min. The glucose uptake activity of the vegetative cells was more stable to ethanol treatment than that of the sporulating cells; the activity decreased about 56% and 88% in the vegetative cells and the sporulating cells, respectively, in 25% ethanol at 25 degrees C for 10 min. PMID- 3540533 TI - Uptake of nystatin by protoplasts of sensitive and resistant cells of Saccharomyces cerevisiae. AB - The uptake of nystatin by protoplasts derived from sensitive and resistant cells of Saccharomyces cerevisiae has been studied as a function of nystatin concentration, temperature and pH. The presence or absence of glucose in the uptake experiments was also studied. Activation energies (Ea) for nystatin uptake revealed profound differences between protoplasts derived from sensitive and resistant cells. Those for the latter closely resembled their whole cell counterparts. The values of Ea for the uptake of nystatin under all the conditions studied indicate the importance of the cell wall in the uptake process. PMID- 3540534 TI - Immunological detection of hCG-like substances in aerobic bacteria of both tumour and non-tumour origin. AB - Production of hormone-like substances by prokaryotes and unicellular eukaryotes, as well as the presence of a human chorionic gonadotropin-like substance in the serum of individuals with malignancies, have been previously established. To determine the presence and distribution of the production of human chorionic gonadotropin (hCG) among aerobic bacteria, fourteen strains of bacteria of both tumour and non-tumour origin were examined using enzyme-linked immunosorbent assay (ELISA), immunofluorescence, and indirect immunoperoxidase techniques. Of the six bacterial strains tested, half of the tumour-isolates produced an hCG like substance while non-tumour associated strains of the same species did not do so. Virulent strains of two mycobacterial species also gave high positive values while avirulent Mycobacterium tuberculosis strains (H37Ra) yielded low or negative values. The production of hCG-like substances by mycobacteria, for which no tumour association is known, indicates that tumour association is neither a prerequisite nor a requirement for production of hCG. It appears that the presence of hCG-like substances is a variable character among bacterial species, suggesting that it may have been conserved throughout evolutionary history. PMID- 3540535 TI - Synthesis of basement membrane-specific macromolecules by cultured human microvascular endothelial cells isolated from skin of diabetic and nondiabetic subjects. AB - Microvascular endothelial cells isolated from abdominal skin of diabetic and nondiabetic adults were maintained in culture by serial passage. Both cell types showed typical endothelial cell morphology, expressed factor VII-associated antigen, contained Weibel-Palade bodies, and produced an extensive subendothelial extracellular matrix containing type IV (basement membrane) procollagen. Biosynthetic studies using radioactive amino acids indicated that under the conditions of cell culture the matrix proteins newly synthesized by MEC of both cell types were similar in type and amount. Both cell types produced type IV procollagen, laminin, and fibronectin, which were deposited in the matrix. Electron microscopy showed that the matrices of both cell types had a similar multilayered, discontinuous, filamentous ultrastructure. Immunoperoxidase staining showed type IV collagen to be distributed similarly, in a fibrillar meshwork, in both matrices. The extractability of individual matrix macromolecules from both matrices was identical; 4 M urea or guanidine-HCl partially removed fibronectin and thrombospondin, but reducing agent was required to solubilize type IV procollagen. The results suggest that diabetic microangiopathy is not due to an inherent defect in the endothelium, and that this in vitro system may be useful for examining environmental factors possibly involved in its development. PMID- 3540536 TI - Antigens associated with various cytotoxic activities of murine peripheral macrophages. AB - BCG- or glucan-elicited murine peripheral macrophages released a cytotoxin in the presence of loach egg lectin, whereas proteose peptone-, glycogen-, or thioglycollate-elicited or resident macrophages did not. The macrophages that released cytotoxin coincided with those that showed lectin-dependent macrophage mediated cytolysis (LDMC) in response to loach egg lectin. The cytotoxin released by BCG-elicited macrophages in response to loach egg lectin had a molecular weight of 55 K daltons. The macrophages that released cytotoxin and other cytotoxic macrophages such as those that showed LDMC- and antibody-dependent macrophage-mediated cytolysis (ADMC) were examined by using several antibodies to surface antigens of macrophages. The results showed that murine peripheral macrophages could be divided into three types. Resident macrophages (Type I) which had common macrophage antigens (Mac-1 and B12) showed only LDMC in response to wheat germ agglutinin. Some elicited macrophages (Type II) were asialo GM1 positive and showed both ADMC and LDMC in response to wheat germ agglutinin. Activated macrophages (Type III) showed LDMC in response to loach egg lectin and cytotoxin-release, but had no antigen detectable with monoclonal anti-macrophage antibody (C14). These three types of macrophages were clearly distinguished diagrammatically by their roof-shaped, rocket-shaped and irregular-shaped profiles of activities and antigens. These data suggest that several selected surface antigens of macrophages are associated with distinct cytotoxic stages of peripheral macrophages. PMID- 3540537 TI - Immunofluorescence test with Rickettsia montana for serologic diagnosis of rickettsial infection of the spotted fever group in Shikoku, Japan. PMID- 3540538 TI - Lipid metabolism in endotoxic rats: decrease in hepatic triglyceride lipase activity. AB - Studies were conducted to investigate the effect of E. coli endotoxin administration on hepatic triglyceride lipase (H-TGL) activity in rats, since H TGL activity is known to behave differently from lipoprotein lipase (LPL) activity in various situations. Plasma triglyceride and free fatty acid concentrations were markedly elevated in animals after injection of endotoxin. Cholesterol and phospholipids were also increased significantly. Lipoprotein analysis by ultracentrifugation showed that the most pronounced increase of lipoproteins was in the VLDL and IDL fractions. Triglyceride lipase activities in post-heparin plasma were markedly decreased. A selective assay for H-TGL activity using a specific antibody revealed that this enzyme as well as LPL is significantly decreased (26% of control) in endotoxic animals. Thus, the increase of VLDL and IDL appears to result from the decrease of both of LPL and H-TGL. PMID- 3540539 TI - Mycobacterial plasmids: screening and possible relationship to antibiotic resistance in Mycobacterium avium/Mycobacterium intracellulare. PMID- 3540540 TI - Penicillins and related drugs. PMID- 3540541 TI - The fascinating history of bezoars. AB - The word "bezoar" is derived from the Arabic "bazahr" or "badzehr", which means antidote or counter-poison; animal bezoars were widely used in medicine until the 18th century. Trichobezoars (hair), phytobezoars (vegetable matter) or combinations of both (trichophytobezoars) may be found in the gastrointestinal tract of humans. While the prevalence of bezoars in humans is low, mortality rates may be as high as 30% if they remain untreated, mainly through gastrointestinal bleeding, destruction or perforation. Endoscopic treatment of gastric bezoars has made inroads into the traditional treatment of bezoars by surgical removal. PMID- 3540542 TI - Dyspepsia and non-ulcer dyspepsia: an historical perspective. AB - Dyspepsia or indigestion is one of the most common disorders that is managed by general practitioners and gastroenterologists. Non-ulcer dyspepsia can be defined as upper abdominal pain or nausea in patients in whom endoscopy reveals no evidence of peptic ulceration or gastric cancer. Non-ulcer dyspepsia is a heterogeneous disorder and can be the result of such diverse entities as the irritable bowel syndrome, duodenitis or gastro-oesophageal reflux, or may be idiopathic ("essential" dyspepsia). This review traces the development of modern thought on dyspepsia and non-ulcer dyspepsia, from the 16th century to the present. PMID- 3540543 TI - The urological vagaries of two famous patients. PMID- 3540544 TI - Overuse syndrome in musicians--100 years ago. An historical review. AB - Overuse syndrome in musicians was extensively reported 100 years ago. The clinical features and results of treatment, which were recorded in considerable detail, match well the condition that is described today. The medical literature that is reviewed here extends from 1830 to 1911 and includes 21 books and 54 articles from the English language literature, apart from two exceptions; however, the writers of the day themselves reviewed French, German and Italian literature on the subject. The disorder was said to result from the overuse of the affected parts. Two theories of aetiology, not necessarily mutually exclusive, were argued. The central theory regarded the lesion as being in the central nervous system, the peripheral theory implied a primary muscle disorder. No serious case was put forward for a psychogenic origin, though emotional factors were believed to aggravate the condition. Advances in musical instrument manufacture--particularly the development of the concert piano and the clarinet- may have played a part in the prevalence of overuse syndrome in musicians. Total rest from the mechanical use of the hand was the only effective treatment recorded. PMID- 3540545 TI - A medical history of Franz Liszt. PMID- 3540546 TI - Australian doctors and the visual arts. Part 6. Photography. AB - This is the final article in this series. In previous articles the contributions of doctors in Australia as painters, sculptors, writers on art and supporters of art galleries and artists have been discussed. Photography is very much a fine art form, and several outstanding doctor-photographers are discussed in this article. PMID- 3540548 TI - Outpatient initiation of insulin therapy in patients with diabetes mellitus. AB - Before insulin therapy is begun, patients with diabetes are often admitted to hospital. In a retrospective study we have reviewed the initiation of insulin therapy in 54 unselected outpatients (12 of whom were insulin-dependent), when the initial stabilization of therapy was performed predominantly by nurse educators. Most patients found the procedure satisfactory; only one subject indicated dissatisfaction with the regimen and only two indicated that they would have preferred admission to hospital. No patient experienced an acute hypoglycaemic or hyperglycaemic problem that required admission to hospital nor was emergency intervention required during the 12 months that followed the initial stabilization period of insulin therapy. Metabolic control, as measured by glycosylated haemoglobin levels, improved in the majority of both insulin dependent and non-insulin-dependent patients after 12 months of insulin therapy. A retrospective cost analysis that compared the cost of the outpatient procedure with the cost (hospital-bed costs only) of initiating insulin therapy in a similar group of patients who were admitted to hospital, indicated a saving of $1857 for each outpatient. We conclude that the outpatient initiation of insulin therapy is feasible where the facilities for education about diabetes exist, that it is safe, achieves satisfactory metabolic control, is acceptable to most patients, and offers a considerable saving in costs. PMID- 3540547 TI - Aplastic anaemia in childhood: prognosis and approach to therapy. AB - Thirty-four children with aplastic anaemia who presented between 1964 and 1984 are reviewed. Their ages ranged from one to 13 years (median, seven years). Twelve children had constitutional aplasia; nine of 11 children had responded to androgen and corticosteroid therapy. However, by actuarial analysis, only 48% would survive at five years and only 16% after 10 years. Twenty-two children had acquired aplasia; in 16 children this had no obvious cause. By means of the criteria of the International Aplastic Anemia Study Group, patients were categorized into severe and non-severe groups at diagnosis. Severe disease was present at diagnosis in nine of 22 children with acquired aplasia but in no child with constitutional disease. Two patients with severe acquired aplasia showed a transient response to androgen or corticosteroid therapy, whereas five of nine children with acquired aplasia which was not severe showed a sustained response to such therapy. A significant difference in survival times was seen between severe and non-severe groups at five years; two (17%) of nine children with severe aplasia survived, compared with eight (67%) of 12 children with non-severe aplasia. Three children with severe aplasia who were treated with antilymphocyte globulin showed no improvement. Of five children who underwent bone-marrow transplantation for severe or progressive disease, four survived. It is concluded that bone-marrow transplantation, as a matter of urgency, is the treatment of choice for severe acquired aplastic anaemia; it is also recommended for mild acquired or constitutional aplasia when progressive disease is present or where transfusion therapy will be required. Antilymphocyte globulin is an alternative form of treatment for acquired disease. Androgen therapy is effective in the treatment of non-severe acquired and constitutional aplastic anaemia. PMID- 3540549 TI - The pharmacokinetics of corticosteroid agents. PMID- 3540550 TI - Peliosis hepatis in a renal transplant recipient and in a haemodialysis patient. AB - Peliosis hepatis is described in a renal transplant recipient and in a patient who was receiving long-term haemodialysis. This uncommon liver lesion has been reported in a number of patients, including 18 renal transplant recipients and two patients with chronic renal failure. However, its cause, clinical features, natural history and clinical significance remain to be determined. We emphasize that, although it is rare, peliosis hepatis should be considered in long-term haemodialysis and renal transplant patients who exhibit hepatomegaly and/or splenomegaly and/or disordered liver function (in particular, elevation of hepatic alkaline phosphatase levels). PMID- 3540551 TI - Malarial prophylaxis with chloroquine/proguanil. PMID- 3540552 TI - Radionuclide cisternography in the diagnosis and management of cerebrospinal fluid leaks: the test of choice. AB - While leakage of cerebrospinal fluid is an intermittent and usually short-lived phenomenon, it may be fatal. The difficulty of making this diagnosis has led to the adoption of many diagnostic procedures. Fifteen patients have been studied by radionuclide cisternography with the concomitant use of nasal pledgets. Six of the studies showed cerebrospinal fluid leakage; the sensitivity of the technique was 100%. The site of leakage was confirmed surgically in three of the patients. No other technique offers comparable sensitivity with high patient acceptance and low morbidity. PMID- 3540553 TI - [Application of dynamic electrocardiography in occupational medicine]. PMID- 3540554 TI - Etretinate for psoriasis. PMID- 3540555 TI - Rudolf Virchow: the physician as politician. PMID- 3540556 TI - [Main results of carrying out the branch program to develop and put into practice the scientific bases for the complete and permanent elimination of malaria in the USSR]. PMID- 3540557 TI - [Malaria in pregnant women--native inhabitants of the Congo--and its treatment using quinimax and fansidar]. PMID- 3540558 TI - [Optimization of the chemotherapy of echinococcal disease (the current state of the problem and the means for its resolution)]. PMID- 3540559 TI - [New Soviet anthelmintic medamine: the results of clinical trials in intestinal nematodiases]. PMID- 3540560 TI - [Methods of reproducing a model of larval multilocular echinococcosis with a primary lesion of the liver or the lungs]. PMID- 3540562 TI - [Prediction of the parasitological situation in the area of influence of water reservoirs]. PMID- 3540561 TI - [Anthropogenic factors in the transformation of natural foci of echinococcosis]. PMID- 3540564 TI - [The effect of construction materials of fixed dentures on changes in the gingiva]. PMID- 3540563 TI - [Current status of the chemotherapy of echinococcosis (a review of the literature)]. PMID- 3540565 TI - [Functional values of dentures anchored by implants]. PMID- 3540566 TI - [Dr. Milos-Misa Ciric, pneumophthisiologist (1893-1979)]. PMID- 3540567 TI - Diagnostic effects of edge sharpening filtration and magnification on digitally subtracted renal images. AB - The improved appearance of digital radiographs filtered to improve local contrast and sharpen edges has not increased acceptance of these images by radiologists. Furthermore, many radiologists assert that correct diagnosis is not improved with these filtered images. This study was designed to test this assertion for digital subtraction angiograms (DSA) of renal images. Four experiments are described. First, phantom studies identified filters and their parameters thought likely to be acceptable and useful in diagnosing renal images formed by DSA. Second, these filters and parameters were then tested on medical images to assess their acceptance by radiologists. Third, display modes of windowing, positive/negative presentation, and magnification were varied for filtered and unfiltered images to assess preferences of radiologists. Fourth, filtered and unfiltered magnified images were used to test improved diagnosis. In the final experiment, 148 images from 33 renal studies (15 normal, 18 abnormal) were magnified, gray level windowed, and filtered. Diagnosis was not improved by the two edge sharpening filters tested. PMID- 3540568 TI - Principles and clinical validity of the biomagnetic method. AB - We present a review of the basic principles of the biomagnetic method, and of the most significant results obtained in the measurement of magnetic fields of the human heart and brain. Particular emphasis is given to the applications of the technique which are providing important progress to clinical investigation. We also point out the present technological perspectives and suggest areas where further efforts can be particularly convenient. PMID- 3540570 TI - Biology of Borrelia species. PMID- 3540572 TI - Encapsulated anaerobic bacteria in synergistic infections. PMID- 3540569 TI - Role of Streptococcus mutans in human dental decay. PMID- 3540575 TI - [Natural history of muscular dystrophy inferred from a multicenter trial and the results of a dietetic trial]. PMID- 3540577 TI - [Anterior fetal duplication with dicephalus. Description of a clinical case]. PMID- 3540576 TI - [Descriptive epidemiology of congenital malformations of the urinary tract. An Italian Multicenter Study on Congenital Malformations]. PMID- 3540574 TI - Acetone-butanol fermentation revisited. PMID- 3540579 TI - The corporate transformation of medicine in Minnesota: group think-- an interview with George Halvorson, President and Chief Executive Officer, and with Dr. Paul Brat, Medical Director, Group Health, Inc. PMID- 3540578 TI - [Non-enzymatic glycosylation of proteins]. PMID- 3540573 TI - Cryptosporidium spp. and cryptosporidiosis. PMID- 3540581 TI - [Small bridges with inlay and attachment: the prosthetic solution for limited tooth gaps]. PMID- 3540580 TI - [Dental fractures. A critical review of the literature and the presentation of clinical cases]. PMID- 3540583 TI - [Bonding and debonding: the in vivo and in vitro changes in the surface enamel]. PMID- 3540582 TI - [Mercury contamination in dentistry. A synthetic review]. PMID- 3540584 TI - Neuroendocrine syndromes of the hypothalamus. AB - These brief reviews of selected neuroendocrine or hypothalamic syndromes reinforce several important concepts. Although the hypothalamus may be relatively inaccessible to the neurologic clinician, it is, paradoxically, the region of the CNS that most closely communicates with virtually all other physiologic systems. This is evident by the fact that hypothalamic dysfunction is frequently associated with "non-neurologic" symptoms such as manifestations of endocrine, gastrointestinal, or gynecologic disease. Traditionally, the hypothalamus has been difficult to study, and progress in understanding hypothalamic disorders has been slow in both neuropathology as well as clinical neurology. Nevertheless, as neurology evolves from a descriptive specialty into one increasingly characterized by therapeutic intervention, the challenge of clinical hypothalamic disease offers many exciting possibilities to the neuropharmacologist, neuroendocrinologist, and all astute bedside clinicians. PMID- 3540585 TI - Neuroimaging in neuroendocrine diseases. AB - The neuroimaging findings in diverse types of juxtasellar pathologic processes are reviewed, with particular emphasis on the role of CT in their diagnosis. PMID- 3540586 TI - Management of pituitary tumors. AB - Pituitary adenomas represent the only true adenomas of the cranial cavity. In 1000 asymptomatic pituitary glands examined at autopsy, there was a 22.4 per cent incidence of undetected microadenomas. Advances in diagnostic endocrinology, in radiologic imaging, and in surgical and medical treatments have brought many more patients to the attention of the authors. Over the last 10 years, their treatment approaches have evolved to those presented in this article. PMID- 3540588 TI - 1986 roster: Mississippi Dental Association. PMID- 3540587 TI - Hormones and epilepsy. AB - The complex interactions of neurosecretions with the developing brain suggest that it has multiple site and time-specific vulnerabilities that may contribute to the pathogenesis of several forms of epilepsy, yet, on the other hand, may provide several new forms of therapy. Catamenial seizures can be clearly related to hormonal changes, although other factors are important, such as altered drug metabolism during menses. Progesterone appears to be especially effective in treating seizures. Optimal forms of treatment for catamenial epilepsy have not been established; however, several forms of progesterone are available and may be helpful, including those in oral contraceptives. Special care in the selection of oral contraceptives may be an important adjunct in caring for women with epilepsy. Altered secretion of neurohormones suggests important clues to the sexual dysfunction and psychopathology associated with temporal lobe epilepsy. New approaches to these patients include the clinical evaluation for sexual dysfunction along with the measurement of prolactin, testosterone, LH, and FSH levels, and treatment of sexual dysfunction by the effective use of anticonvulsants. Elevated plasma hormones (especially prolactin) following seizures can help to distinguish true seizures from pseudoseizures. Effects of anticonvulsant drugs on endocrine function are important, particularly with respect to their ability to lower the efficacy of oral contraceptives by competitive binding. A number of hormonal changes have been described with several drugs, which suggest that their complex central and peripheral effects might help to explain some aspects of normal hormone activity as well as some common side effects of the drugs. PMID- 3540571 TI - Ff coliphages: structural and functional relationships. PMID- 3540589 TI - UV light-induced cyclobutane pyrimidine dimers are mutagenic in mammalian cells. AB - We used a simian virus 40-based shuttle vector plasmid, pZ189, to determine the role of pyrimidine cyclobutane dimers in UV light-induced mutagenesis in monkey cells. The vector DNA was UV irradiated and then introduced into monkey cells by transfection. After replication, vector DNA was recovered from the cells and tested for mutations in its supF suppressor tRNA marker gene by transformation of Escherichia coli carrying a nonsense mutation in the beta-galactosidase gene. When the irradiated vector was treated with E. coli photolyase prior to transfection, pyrimidine cyclobutane dimers were removed selectively. Removal of approximately 90% of the pyrimidine cyclobutane dimers increased the biological activity of the vector by 75% and reduced its mutation frequency by 80%. Sequence analysis of 72 mutants recovered indicated that there were significantly fewer tandem double-base changes and G X C----A X T transitions (particularly at CC sites) after photoreactivation of the DNA. UV-induced photoproducts remained (although at greatly reduced levels) at all pyr-pyr sites after photoreactivation, but there was a relative increase in photoproducts at CC and TC sites and a relative decrease at TT and CT sites, presumably due to a persistence of (6-4) photoproducts at some CC and TC sites. These observations are consistent with the fact that mutations were found after photoreactivation at many sites at which only cyclobutane dimers would be expected to occur. From these results we conclude that UV-induced pyrimidine cyclobutane dimers are mutagenic in DNA replicated in monkey cells. PMID- 3540590 TI - Identification of the crossover site during FLP-mediated recombination in the Saccharomyces cerevisiae plasmid 2 microns circle. AB - The FLP protein of the Saccharomyces cerevisiae plasmid 2 microns circle catalyzes site-specific recombination between two repeated segments present on the plasmid. In this paper we present results of experiments we performed to define more precisely the features of the FLP recognition target site, which we propose to designate FRT, and to determine the actual recombination crossover point in vivo. We found that essential sequences for the recombination event are limited to an 8-base-pair core sequence and two 13-base-pair repeated units immediately flanking it. This is the region identified as the FLP binding site in vitro and at which FLP protein promotes specific single-strand cleavages (B. J. Andrews, G. A. Proteau, L. G. Beatty, and P. D. Sadowski, Cell 40:795-803, 1985; J. F. Senecoff, R. C. Bruckner, and M. M. Cox, Proc. Natl. Acad. Sci. USA 82:7270 7274, 1985). Mutations within the core domain can be suppressed by the presence of the identical mutation in the chromatid with which it recombines. However, mutations outside the core are not similarly suppressed. We found that strand exchange during FLP recombination occurs most of the time within the core region, proceeding through a heteroduplex intermediate. Finally, we found that most FLP mediated events are reciprocal exchanges and that FLP-catalyzed gene conversions occur at low frequency. The low level of gene conversion associated with FLP recombination suggests that it proceeds by a breakage-joining reaction and that the two events are concerted. PMID- 3540591 TI - Novel promoter upstream of the human c-myc gene and regulation of c-myc expression in B-cell lymphomas. AB - A new promoter of the human c-myc gene called P0, with multiple RNA start sites, was mapped over 500 bases upstream of the two previously identified promoters, P1 and P2. Sequencing full-length cDNA clones of P0 RNAs revealed two open reading frames upstream of that for the P64c-myc protein. P0 RNA is located on polyribosomes and released by puromycin, indicating that it functions as an mRNA. In vitro translation of RNA synthesized from the cloned cDNAs predicts that P0 transcripts are translated into a novel 12.5-kilodalton protein corresponding to the first open reading frame. The regulation of P0 RNA was studied in the B-cell lymphoma cell line Manca, in which only the translocated c-myc allele lacking exon 1 was thought to be active. However, we found that P0 transcription and the DNase I-hypersensitive site associated with this promoter persist on the untranslocated allele, even though P1/P2 transcription as measured by a nuclear runoff assay was repressed. These results suggest that allelic exclusion of c-myc expression in this B-cell lymphoma is caused by a repression of transcription which is specific to the P1/P2 promoters. We previously reported a block to elongation of transcription near the 3' end of exon 1 in the wild-type c-myc gene, which results in an excess of exon 1 over exon 2 transcription (5a). In contrast, we found that in the Daudi B-cell lymphoma, which retains exon 1 in the active allele, equimolar transcription of exons 1 and 2 occurs. This result suggests a model for the activation of c-myc in B-cell lymphomas. PMID- 3540592 TI - Saccharomyces cerevisiae nuclear fusion requires prior activation by alpha factor. AB - We have developed a protocol for efficient fusion of spheroplasts of the same mating type. Nuclear fusion in this whole-cell system is also efficient and closely parallels nuclear fusion in heterosexual mating of intact cells. In the spheroplast fusion system, nuclear fusion is dependent on both the KAR1 gene and prior exposure to alpha factor. The major products of nuclear fusion in the spheroplast fusion assay were true diploids that were homozygous at the mating type locus. An additional 10% of the products were cells of ploidy greater than diploid. The dependence of nuclear fusion on alpha factor treatment could not be replaced by synchronization in G1 by mutations in CDC28 and CDC35 or by prior arrest in stationary phase. These data suggest that nuclear fusion is not a constitutive function of the nucleus, but rather is specifically induced by mating hormone. PMID- 3540594 TI - Coinfection with viruses carrying the v-Ha-ras and v-myc oncogenes leads to growth factor independence by an indirect mechanism. AB - The concomitant expression of certain oncogenes can transform normal diploid rodent cells into transplantable tumorigenic cells. The mechanism by which these oncogenes collaborate is unclear. Recent findings (M. Oshimura, T. M. Gilmer, and J. C. Barrett, Nature [London] 316:636-639, 1985) raise the possibility that karyotypic changes, including monosomy for chromosome 15, are required to induce tumorigenicity in Syrian hamster embryo cells transfected in vitro with v-Ha-ras and v-myc DNAs. We studied the effect of the oncogenes v-Ha-ras and v-myc, introduced by viral infection, on murine hematopoietic cells. The induction of growth factor independence by the two oncogenes was used as an in vitro correlate of tumorigenicity. After a period of reduced growth rate reminiscent of the growth rate of cells in crisis, the doubly infected cells became growth factor independent. These cells showed a great variability in their karyotypes. PMID- 3540593 TI - Expression of c-sis and platelet-derived growth factor in in vitro-transformed glioma cells from rat brain tissue transplacentally treated with ethylnitrosourea. AB - Long-term culturing of brain cells from neonatal BD-IX rats after transplacental treatment with N-ethyl-N-nitrosourea (ENU) results in malignantly transformed cells after a lag period of about 250 days. During culturing, the brain cells undergo a sequence of morphological changes. We examined oncogene expression in cultured cells from ENU-treated animals and found that transformed glioma cells differ from premalignant glial cells by containing high levels of c-sis transcripts. We also report that the transformed cells synthesize functional platelet-derived growth factor. Because glial cells have receptors for platelet derived growth factor, we propose that an autocrine mechanism plays an important role in ENU-induced brain tumorigenesis. PMID- 3540595 TI - Expression of the denV gene of coliphage T4 in UV-sensitive rad mutants of Saccharomyces cerevisiae. AB - A plasmid containing the denV gene from bacteriophage T4, under the control of the yeast alcohol dehydrogenase I (ADC1) promoter, conferred a substantial increase in UV resistance in the UV-sensitive Saccharomyces cerevisiae mutants rad1-2 and rad3-2. The UV resistance of the denV+ yeast cells was cell cycle dependent and correlated well with the level of the denV gene product as measured by immunoblotting and by a photoreversal assay for pyrimidine dimer-DNA glycosylase activity. PMID- 3540596 TI - Null mutations in the SNF3 gene of Saccharomyces cerevisiae cause a different phenotype than do previously isolated missense mutations. AB - Missense mutations in the SNF3 gene of Saccharomyces cerevisiae were previously found to cause defects in both glucose repression and derepression of the SUC2 (invertase) gene. In addition, the growth properties of snf3 mutants suggested that they were defective in uptake of glucose and fructose. We have cloned the SNF3 gene by complementation and demonstrated linkage of the cloned DNA to the chromosomal SNF3 locus. The gene encodes a 3-kilobase poly(A)-containing RNA, which was fivefold more abundant in cells deprived of glucose. The SNF3 gene was disrupted at its chromosomal locus by several methods to create null mutations. Disruption resulted in growth phenotypes consistent with a defect in glucose uptake. Surprisingly, gene disruption did not cause aberrant regulation of SUC2 expression. We discuss possible mechanisms by which abnormal SNF3 gene products encoded by missense alleles could perturb regulatory functions. PMID- 3540597 TI - Saccharomyces cerevisiae centromere CEN11 does not induce chromosome instability when integrated into the Aspergillus nidulans genome. AB - We constructed Aspergillus nidulans transformation plasmids containing the A. nidulans argB+ gene and either containing or lacking centromeric DNA from Saccharomyces cerevisiae chromosome XI (CEN11). The plasmids transformed an argB Aspergillus strain to arginine independence at indistinguishable frequencies. Stable haploid transformants were obtained with both plasmids, and strains were identified in which the plasmids had integrated into chromosome III by homologous recombination at the argB locus. Plasmid DNA was recovered from a transformant containing CEN11, and the sequence of the essential portion of CEN11 was determined to be unaltered. The transformants were further characterized by using them to construct heterozygous diploids and then testing the diploids for preferential loss of the plasmid-containing chromosomes. The CEN11 sequence had little or no effect on chromosome stability. Thus, CEN11 does not prevent chromosomal integration of plasmid DNA and probably lacks centromere activity in Aspergillus spp. PMID- 3540598 TI - Molecular analysis of SNF2 and SNF5, genes required for expression of glucose repressible genes in Saccharomyces cerevisiae. AB - The SNF2 and SNF5 genes are required for derepression of SUC2 and other glucose repressible genes of Saccharomyces cerevisiae in response to glucose deprivation. Previous genetic evidence suggested that SNF2 and SNF5 have functionally related roles. We cloned both genes by complementation and showed that the cloned DNA was tightly linked to the corresponding chromosomal locus. Both genes in multiple copy complemented only the cognate snf mutation. The SNF2 gene encodes a 5.7 kilobase RNA, and the SNF5 gene encodes a 3-kilobase RNA. Both RNAs contained poly(A) and were present in low abundance. Neither was regulated by glucose repression, and the level of SNF2 RNA was not dependent on SNF5 function or vice versa. Disruption of either gene at its chromosomal locus still allowed low-level derepression of secreted invertase activity, suggesting that these genes are required for high-level expression but are not directly involved in regulation. Further evidence was the finding that snf2 and snf5 mutants failed to derepress acid phosphatase, which is not regulated by glucose repression. The SNF2 and SNF5 functions were required for derepression of SUC2 mRNA. PMID- 3540599 TI - Mitotic gene conversion lengths, coconversion patterns, and the incidence of reciprocal recombination in a Saccharomyces cerevisiae plasmid system. AB - Plasmids capable of undergoing genetic exchange in mitotically dividing Saccharomyces cerevisiae cells were used to measure the length of gene conversion events, to determine patterns of coconversion when multiple markers were present, and to correlate the incidence of reciprocal recombination with the length of conversion tracts. To construct such plasmids, restriction site linkers were inserted both within the HIS3 gene and in the flanking sequences, and two different his3- alleles were placed in a vector. Characterization of the genetic exchanges in these plasmids showed that most occur with the conversion of one his3- allele. Many of these events included coconversions in which more than one marker along the allelic sequence was replaced. The frequency of coconversion decreased with the distance between two markers such that markers further than 1 kilobase apart were infrequently coconverted. From these results the average length of conversion was determined to be approximately 0.5 kilobase. Examination of coconversions involving three or more markers revealed an almost obligatory, simultaneous coconversion pattern of all markers. Thus, when two markers which flank an intervening marker are converted, the intervening marker is 20 times more likely to be converted than to remain unchanged. The results of these studies also showed that the incidence of reciprocal recombination, which accompanies more than 20% of the conversion events, is more frequent when the conversion tract is longer than average. PMID- 3540600 TI - Genetically essential and nonessential alpha-tubulin genes specify functionally interchangeable proteins. AB - Microtubules in yeast are essential components of the mitotic and meiotic spindles and are essential for nuclear movement during cell division and mating. The relative importance in these processes of the two divergent alpha-tubulin genes of the budding yeast Saccharomyces cerevisiae, TUB1 and TUB3, was examined through the construction of null mutations and by increasing their copy number on chromosomes and on plasmids. Experiments with null alleles of TUB3 showed that TUB3 was not essential for mitosis, meiosis, or mating. Null alleles of TUB3, however, did cause several phenotypes, including hypersensitivity to the antimicrotubule drug benomyl and poor spore viability. On the other hand, the TUB1 gene was essential for growth of normal haploid cells. Even in diploids heterozygous for a TUB1 null allele, several dominant phenotypes were evident, including slow growth and poor sporulation. This functional difference between the two genes is apparently due to different levels of expression, because extra copies of either gene could suppress the defects caused by a null mutation in the other. We conclude that in spite of the 10% divergence between the products of the two genes, there is no essential qualitative functional difference between them. PMID- 3540601 TI - Constitutive and inducible Saccharomyces cerevisiae promoters: evidence for two distinct molecular mechanisms. AB - his3 and pet56 are adjacent Saccharomyces cerevisiae genes that are transcribed in opposite directions from initiation sites that are separated by 200 base pairs. Under normal growth conditions, in which his3 and pet56 are transcribed at similar basal levels, a poly(dA-dT) sequence located between the genes serves as the upstream promoter element for both. In contrast, his3 but not pet56 transcription is induced during conditions of amino acid starvation, even though the critical regulatory site is located upstream of both respective TATA regions. Moreover, only one of the two normal his3 initiation sites is subject to induction. From genetic and biochemical evidence, I suggest that the his3-pet56 intergenic region contains constitutive and inducible promoters with different properties. In particular, two classes of TATA elements, constitutive (Tc) and regulatory (Tr), can be distinguished by their ability to respond to upstream regulatory elements, by their effects on the selection of initiation sites, and by their physical structure in nuclear chromatin. Constitutive and inducible his3 transcription is mediated by distinct promoters representing each class, whereas pet56 transcription is mediated by a constitutive promoter. Molecular mechanisms for these different kinds of S. cerevisiae promoters are proposed. PMID- 3540602 TI - The evolutionarily conserved repetitive sequence d(TG.AC)n promotes reciprocal exchange and generates unusual recombinant tetrads during yeast meiosis. AB - We have studied the genetic behavior of the alternating copolymer d(TG.AC)n inserted into a defined position in the genome of the yeast Saccharomyces cerevisiae. When d(TG.AC)n sequences were present at the HIS3 locus on homologous chromosomes, diploid cells undergoing meiosis generated an excess of tetrads containing reciprocally recombined products with crossover points close to the repetitive DNA insert. Most of these tetrads exhibited gene conversion of a d(TG.AC)n insert. However, the insertion of d(TG.AC)n sequences had no effect on the frequency of gene conversion of closely linked marker genes. Surprisingly, when d(TG.AC)n sequences were present on only one homolog at the HIS3 locus, one half of the tetrads exhibiting nonparental segregation for marker genes that flanked the repetitive DNA insert were very unusual and appeared to have arisen by multiple recombination events in the vicinity of the d(TG.AC)n insert. Similar multiply recombinant tetrads were seen in crosses in which d(TG.AC)n sequences were present on both homologs. Combined, the data strongly suggest that d(TG.AC)n sequences significantly enhance reciprocal meiotic recombination and may be important in causing multiple recombination events to occur within a relatively small region of the yeast chromosome. Molecular evidence is presented that clearly documents the postmeiotic segregation of an 80-base stretch of d(TG.AC)n. PMID- 3540604 TI - Constitutive RNA synthesis for the yeast activator ADR1 and identification of the ADR1-5c mutation: implications in posttranslational control of ADR1. AB - The regulation of mRNA production for the yeast positive activator ADR1, a gene required for the expression of the glucose-repressible alcohol dehydrogenase (ADH II), was studied. ADR1 mRNA levels did not vary when yeasts were switched from glucose- to ethanol-containing medium, while ADH II expression increased 100 fold. The mRNA for the ADR1-5c allele, which augments ADH II expression 60-fold during glucose repression, was not present in greater abundance than ADR1 mRNA. Additionally, the ccr1-1 allele, which blocks ADH2 mRNA formation and partially suppresses the ADR1-5c phenotype, did not alter the levels of ADR1 mRNA. These results indicate that ADR1 is not transcriptionally controlled. To determine the character of the ADR1-5c mutation, the region containing the mutation was identified and sequenced. At base pair +683 a G-to-A transition was detected in the ADR1 coding sequence which would result in the substitution of a lysine residue for an arginine at amino acid 228. The location of the ADR1-5c mutation in the interior of the ADR1 coding sequences suggests that it enhances the activity of an extant but inactive ADR1 protein rather than increases the abundance of ADR1 by altered translation of its mRNA. The ADR1-5c mutation occurs in a region of the polypeptide corresponding to a cyclic AMP-dependent protein kinase phosphorylation recognition sequence. The potential role of reversible phosphorylation in the posttranslational regulation of ADR1 is discussed. PMID- 3540603 TI - Multiple GCD genes required for repression of GCN4, a transcriptional activator of amino acid biosynthetic genes in Saccharomyces cerevisiae. AB - GCN4 encodes a positive regulator of multiple unlinked genes encoding amino acid biosynthetic enzymes in Saccharomyces cerevisiae. Expression of GCN4 is coupled to amino acid availability by a control mechanism involving GCD1 as a negative effector and GCN1, GCN2, and GCN3 as positive effectors of GCN4 expression. We used reversion of a gcn2 gcn3 double mutation to isolate new alleles of GCD1 and mutations in four additional GCD genes which we designate GCD10, GCD11, GCD12, and GCD13. All of the mutations lead to constitutive derepression of HIS4 transcription in the absence of the GCN2+ and GCN3+ alleles. By contrast, the gcd mutations require the wild-type GCN4 allele for their derepressing effect, suggesting that each acts by influencing the level of GCN4 activity in the cell. Consistent with this interpretation, mutations in each GCD gene lead to constitutive derepression of a GCN4::lacZ gene fusion. Thus, at least five gene products are required to maintain the normal repressed level of GCN4 expression in nonstarvation conditions. Interestingly, the gcd mutations are pleiotropic and also affect growth rate in nonstarvation conditions. In addition, certain alleles lead to a loss of M double-stranded RNA required for the killer phenotype. This pleiotropy suggests that the GCD gene products contribute to an essential cellular function, in addition to, or in conjunction with, their role in GCN4 regulation. PMID- 3540607 TI - Negative regulation of the Saccharomyces cerevisiae ANB1 gene by heme, as mediated by the ROX1 gene product. AB - In Saccharomyces cerevisiae the anaerobic (oxygen-repressed) ANB1 gene and a group of aerobic (oxygen-induced) genes are coordinately regulated by the ROX1 gene. We report here that heme, known as an inducer of aerobic genes, also causes inhibition of ANB1 expression. Thus, in combination with the ROX1 gene product heme has an opposite effect on the expression of anaerobic and aerobic genes. Accumulation of ANB1 mRNA was sharply decreased in anaerobic cells grown in the presence of heme. This effect must operate at the level of transcription since heme also inhibited accumulation of CYC1 mRNA from an ANB1-CYC1 fusion. Heme precursors did not appear to function either as inhibitors or as activators. Oxygen itself also had no effect on transcription of ANB1. Repression by heme cannot be attributed to the respiratory competence conferred by heme since both ANB1 and the aerobic genes tr-1 and CYC1 were regulated normally in [rho 0] mutants. The results are consistent with a classical allosteric coeffector function for heme, although more indirect explanations are tenable. A role for the ROX1 gene product in transcriptional regulation can be inferred from the observation that there was no inhibition of ANB1 expression by heme in rox1 mutants. Judging from this epistasis the rox1 phenotype is not due to a defect in heme production; this would indicate that the ROX1 factor functions by mediating the effect of heme on transcription. PMID- 3540606 TI - Sequence analysis of temperature-sensitive mutations in the Saccharomyces cerevisiae gene CDC28. AB - Eleven independently isolated temperature-sensitive mutations in the cell division cycle gene CDC28 were mapped with respect to the DNA sequence of the wild-type gene and then sequenced to determine the precise nature of each mutation. The set yielded six different point mutations, each of which predicts a single amino acid substitution in the CDC28 product. The positions of the mutations did not correlate in any obvious way with observable biological characteristics of the mutant alleles. When the positions of substitutions were collated with a predicted secondary structural analysis of the CDC28 protein kinase, they were found to correlate strongly with probable regions of structural transition. PMID- 3540605 TI - Effects of null mutations in the hexokinase genes of Saccharomyces cerevisiae on catabolite repression. AB - Saccharomyces cerevisiae has two homologous hexokinases, I and II; they are 78% identical at the amino acid level. Either enzyme allows yeast cells to ferment fructose. Mutant strains without any hexokinase can still grow on glucose by using a third enzyme, glucokinase. Hexokinase II has been implicated in the control of catabolite repression in yeasts. We constructed null mutations in both hexokinase genes, HXK1 and HXK2, and studied their effect on the fermentation of fructose and on catabolite repression of three different genes in yeasts: SUC2, CYC1, and GAL10. The results indicate that hxk1 or hxk2 single null mutants can ferment fructose but that hxk1 hxk2 double mutants cannot. The hxk2 single mutant, as well as the double mutant, failed to show catabolite repression in all three systems, while the hxk1 null mutation had little or no effect on catabolite repression. PMID- 3540608 TI - Activation of ras p21 transforming properties associated with an increase in the release rate of bound guanine nucleotide. AB - An Ala-to-Thr substitution at position 59 activates the transforming properties of the p21ras protein without impairment of GTPase activity, a biochemical alteration associated with other activating mutations. To investigate the basis for the transforming properties of the Thr-59 mutant, we characterized guanine nucleotide release. This reaction exhibited a slow rate and stringent temperature requirements. To further dissect the release reaction, we used monoclonal antibodies directed against different epitopes of the p21 molecule. One monoclonal specifically interfered with nucleotide release, while others which recognized different regions of the molecule blocked nucleotide binding. Mutants with the Thr-59 substitution exhibited a three- to ninefold-higher rate of GDP and GTP release than normal p21 or mutants with other activating lesions. This alteration in the Thr-59 mutant would have the effect of increasing its rate of nucleotide exchange. In an intracellular environment with a high GTP/GDP ratio, this would favor the association of GTP with the Thr-59 mutant. Consistent with knowledge of known G-regulatory proteins, these findings support a model in which the p21-GTP complex is the biologically active form of the p21 protein. PMID- 3540609 TI - In vivo evidence for posttranslational translocation and signal cleavage of the killer preprotoxin of Saccharomyces cerevisiae. AB - A full-length cDNA of the M1 double-stranded RNA killer preprotoxin coding region successfully directed the synthesis of secreted K1 toxin when expressed in Saccharomyces cerevisiae from a plasmid vector. Three protein species immunoreactive with antitoxin antiserum were detected intracellularly in transformants harboring this killer cDNA plasmid. These toxin precursor species were characterized by using secretory-defective hosts, by comparative electrophoretic mobilities, and by tunicamycin susceptibility. Such studies indicate that these three protein species represent intermediates generated by signal cleavage of the preprotoxin and its subsequent glycosylation and provide evidence that these events occur posttranslationally. PMID- 3540610 TI - Efficient expression of the Saccharomyces cerevisiae PGK gene depends on an upstream activation sequence but does not require TATA sequences. AB - The Saccharomyces cerevisiae PGK (phosphoglycerate kinase) gene encodes one of the most abundant mRNA and protein species in the cell. To identify the promoter sequences required for the efficient expression of PGK, we undertook a detailed internal deletion analysis of the 5' noncoding region of the gene. Our analysis revealed that PGK has an upstream activation sequence (UASPGK) located between 402 and 479 nucleotides upstream from the initiating ATG sequence which is required for full transcriptional activity. Deletion of this sequence caused a marked reduction in the levels of PGK transcription. We showed that PGK has no requirement for TATA sequences; deletion of one or both potential TATA sequences had no effect on either the levels of PGK expression or the accuracy of transcription initiation. We also showed that the UASPGK functions as efficiently when in the inverted orientation and that it can enhance transcription when placed upstream of a TRP1-IFN fusion gene comprising the promoter of TRP1 fused to the coding region of human interferon alpha-2. PMID- 3540611 TI - The SPS4 gene of Saccharomyces cerevisiae encodes a major sporulation-specific mRNA. AB - The SPS4 gene of Saccharomyces cerevisiae, a sporulation-specific gene identified previously in a differential hybridization screen of a genomic yeast DNA library, has been characterized further. The protein encoded by this gene was inferred from its nucleotide sequence to be 38,600 daltons with an isoelectric pH of 8.2. Consistent with this, two-dimensional polyacrylamide gel electrophoresis of the in vitro translation products of RNA purified by hybridization with the cloned SPS4 DNA indicated that the SPS4 gene product is a 39-kilodalton, basic protein. This protein was found to be identical in size and charge to a major, sporulation specific protein identified in a two-dimensional polyacrylamide gel electrophoretic comparison of the in vitro translation products of total RNA from sporulating MATa/MAT alpha cells and asporogenous MAT alpha/MAT alpha cells. A MATa/MAT alpha strain homozygous for a partial deletion of the SPS4 gene appeared, however, to be unaffected in its ability to form viable ascospores. PMID- 3540612 TI - Isolation of tobacco DNA segments with plant promoter activity. AB - We constructed a promoter probe vector, pGVL120, to isolate plant DNA segments with promoter activity in tobacco. Plant nuclear DNA Sau3A fragments were inserted in front of the npt-II sequence, and a mixture of recombinant plasmids was mobilized to Agrobacterium sp. and used to transform tobacco protoplasts. By kanamycin selection, transformed plant cell lines containing NPT-II T-DNAs were isolated. Eight of these cell lines were regenerated and analyzed for the levels of NPT-II activity in stem, root, midrib, and leaf. These levels demonstrated novel regulation patterns in each isolate. One cell line, T20, was analyzed in detail and found to contain four different T-DNAs. One of the recloned T-DNAs, T20-2, contains an insert of 401 base pairs in front of the NPT-II sequence, and by reintroducing this T-DNA into plant cells we could demonstrate that this insert provides a promoter sequence. The NPT-II enzyme activity under the control of the P20 promoter is especially high in stem and root, but low in leaf and callus, both in the originally isolated T20 plant and in independently isolated transformants with the T20-2 T-DNA. PMID- 3540613 TI - Expression of the c-myc proto-oncogene during development of Xenopus laevis. AB - We isolated and characterized Xenopus laevis c-myc cDNAs from an oocyte-specific library. These cDNA clones encompass 2.35 kilobases of the X. laevis c-myc RNA and contain the entire coding domain of 1,257 nucleotides of the 419-amino acid long X. laevis c-myc protein. The 2.7-kilobase X. laevis c-myc mRNA is expressed in the oocyte, maintained in the egg, and is present throughout the early cleavage stages of embryogenesis. At the time of transcriptional activation in the embryo the c-myc RNA levels show a significant decline and then reaccumulate continuously throughout the remainder of premorphogenic development. At the early neurula stage of embryogenesis the pattern of c-myc RNA expression is elevated in the mesoderm with respect to the endoderm and ectoderm. In the adult X. laevis the c-myc mRNA is expressed in some (e.g., skin, muscle) but not all differentiated tissues. The X. laevis c-myc protein migrates as a doublet of 61,000- and 64,000-dalton species. Both species are phosphorylated in oocytes and somatic cells, exhibit extremely short half-lives of less than 30 min, and are localized to the nuclear fraction of somatic cells. By contrast, the oocyte protein shows both cytoplasmic and germinal vesicle distribution and appears to be stable. PMID- 3540614 TI - Mitochondrial and nonmitochondrial citrate synthases in Saccharomyces cerevisiae are encoded by distinct homologous genes. AB - Saccharomyces cerevisiae contains two genes, CIT1 and CIT2, encoding functional citrate synthase (K.-S. Kim, M. S. Rosenkrantz, and L. Guarente, Mol. Cell. Biol. 6:1936-1942, 1986). We show here that CIT2 encodes a nonmitochondrial form of citrate synthase. The DNA sequence of CIT2 presented provides a possible explanation for why the CIT2 product, unlike the CIT1 product, fails to be imported into mitochondria. While the products of these two genes are highly homologous, they diverge strikingly at their amino termini. The amino terminus of the CIT1 primary translation product extends 39 residues beyond the amino termini of Escherichia coli and porcine citrate synthases. This extension consists of a typical mitochondrial targeting motif. The amino terminus of the CIT2 primary translation product extends 20 residues beyond the amino termini of the E. coli and porcine enzymes. The CIT2-encoded extension is not homologous to that of CIT1, resulting in a nonmitochondrial localization of the product. The CIT2 encoded extension, however, does bear certain similarities to mitochondrial targeting sequences. The possible role of this sequence in targeting this CIT2 product to a nonmitochondrial organelle is discussed. PMID- 3540616 TI - HLA-DR allogenotyping using exon-specific cDNA probes and application of rapid minigel methods. AB - The construction of exon-specific HLA-DR beta cDNA clones and their application as DNA or RNA hybridization probes in DR allogenotyping are described. Using a probe derived from the beta 2, transmembrane, cytoplasmic and 3'-untranslated exons of the DR beta chain gene (pRTV1), it is possible to discriminate between DR alleles using the restriction endonucleases TaqI or BamHI. Micro-scale chromosomal DNA isolation procedures, used in conjunction with Southern blot analysis in minigels, facilitate the rapid identification of DR allogenotypes without significant loss of hybridization signal resolution. PMID- 3540617 TI - Characterization of two mouse myeloma X sheep lymphocyte cell lines secreting sheep antibody. AB - Two mouse X sheep interspecific cell hybrids were obtained by fusing mouse myeloma cell line Sp2/O. Ag14 with sheep lymphocytes obtained from a lymph node antigenically stimulated with azo-benzene arsonate-ovalbumin (ABA-ova). The interspecific cell lines were characterized using immunochemical, karyotypic and molecular DNA techniques. Both cell lines secreted sheep IgG1 antibody specific for the ABA haptenic determinant. Karyotypic analysis revealed that cell lines 4.11 and 11.9 had modal chromosome numbers of 91 and 106, respectively. Although C-banded spreads confirmed that fusion between sheep and mouse cells had occurred, it was not possible to differentiate sheep from mouse chromosomes. However, DNA hybridization techniques showed that each line contained sheep repetitive sequence DNA. It was calculated that cell line 11.9 contained 17640 copies while cell line 4.11 contained 734 copies of the previously characterized sheep satellite DNA. PMID- 3540619 TI - The anti-melanoma activity of inulin in mice. AB - Finely divided, insoluble inulin (gamma polymorph), given intraperitoneally (i.p.) to C57BL mice 1-3 days after i.p. B16 melanoma cells, very significantly increased their mean survival time (MST) in low doses (less than or equal to 40 and less than or equal to 100 micrograms/mouse in 50 and 80% of tests, respectively). The gamma inulin was pure and free of endotoxin and soluble inulin, and was developed as a potent reagent specific for activating the alternative pathway of complement (APC). Its antitumour action paralleled its in vitro APC activation, namely, both activities were sharply dose-dependent up to a threshold dose above which they were dose-independent; dissolved inulin was inactive in vitro and in vivo, decreased the MST of the mice and in a mixture antagonized the in vitro and in vivo activities of gamma inulin; the more soluble (alpha) polymorphs were active in proportion to their gamma content but the effects were blocked at higher doses presumably by dissolved inulin. In addition, depletion of host APC with cobra venom factor or inulin before giving B16 cells increased their malignancy and abrogated the subsequent antitumour action of gamma inulin. The minimum i.p. dose of gamma inulin found to activate serum APC in vivo was 50 micrograms (2.5 mg/kg), i.e. close to the minimum antitumour dose. These close correlations and the specificity of the reagent indicate that activation in vivo of the APC (cellular or humoral) is an important first contact in stimulating host antitumour defences in this mouse model. PMID- 3540618 TI - Preparation and characterization of a "pan-reactive" rabbit anti-mouse T-cell receptor antiserum. AB - A pan-reactive xenoantiserum to the mouse T-cell receptor was prepared by immunization of a rabbit with affinity purified mouse T-cell receptor material. The T-cell receptor of the chicken ovalbumin/IAd specific T-cell hybridoma, DO 11.10, was isolated by affinity chromatography using the clone-specific monoclonal antibody, KJ1-26. Immunoprecipitation with the rabbit antiserum and subsequent SDS-PAGE analysis of the material precipitated from lysates of surface radioiodinated T cells revealed the heterodimeric structure characteristic of the T-cell receptor from virtually every T-cell source examined. Flow cytofluorometric analysis of normal peripheral T cells and mature thymocytes of BALB/c and SJL mice indicated that most all T cells bear antigenic determinants recognized by the rabbit anti-mouse T-cell receptor antibodies. The AKR thymoma, BW5147, a common fusion parent used to generate functional T-cell hybridomas, notably lacks surface expression of a T-cell receptor molecule. PMID- 3540620 TI - [Beta 2 microglobulin in the serum as a parameter of glomerular kidney function in the first days of life]. AB - Though serum creatinine is a very reliable parameter for predicting glomerular filtration rate in infancy, this does not apply to the first hours and days of life. As there is no placental barrier for creatinine, serum creatinine at birth reflects maternal renal function at the moment of delivery and, during the first days of life, establishment of the steady state condition between creatinine serum level and actual infantile glomerular filtration rate. Serum creatinine levels of cord blood and maternal blood in term and preterm infants of 25-42 weeks gestational age are almost identical (maternal blood 0.82 +/- 0.34 mg-%, cord blood 0.87 +/- 0.34 mg-%, n = 77, r = 0.94), whereas there is no correlation between maternal and infantile beta 2-microglobulin concentrations (maternal blood 2.1 + 1 mg/1, cord blood 3.3 +/- 0.6 mg/l, n = 78, r = 0.05). There is no free diaplacental exchange for this low molecular weight protein. The determination of cord blood beta 2-microglobulin levels therefore predicts the newborn's renal function independently of the mother's. It is possible to differentiate between prenatal and perinatal genesis of renal damage in case of renal failure in the newborn, and to study the elimination of creatinine preloading in maternal renal insufficiency. Although we are not yet able to give an exact quantitative prediction of glomerular filtration rate by determining beta 2-microglobulin we believe it to be the best parameter of glomerular renal function in this age-group. PMID- 3540615 TI - Molecular cloning of chromosome I DNA from Saccharomyces cerevisiae: isolation and characterization of the CDC24 gene and adjacent regions of the chromosome. AB - Molecular cloning techniques were used to isolate and characterize the DNA including and surrounding the CDC24 and PYK1 genes on the left arm of chromosome I of the yeast Saccharomyces cerevisiae. A plasmid that complemented a temperature-sensitive cdc24 mutation was isolated from a yeast genomic DNA library in a shuttle vector. Plasmids containing pyk1-complementing DNA were obtained from other investigators. Several lines of evidence (including one-step gene replacement experiments) demonstrated that the complementing plasmids contained the bona fide CDC24 and PYK1 genes. These sequences were then used to isolate additional DNA from chromosome I by probing a yeast genomic DNA library in a lambda vector. A total of 28 kilobases (kb) of contiguous DNA surrounding the CDC24 and PYK1 genes was isolated, and a restriction map was determined. Electron microscopy of R-loop-containing DNA and RNA blot hybridization analyses indicated that an 18-kb segment contained at least seven transcribed regions, only three of which corresponded to previously known genes (CDC24, PYK1, and CYC3). Southern blot hybridization experiments suggested that none of the genes in this region was duplicated elsewhere in the yeast genome. The centers of CDC24 and PYK1 were only approximately 7.5 kb apart, although the genetic map distance between them is approximately 13 centimorgans. As previous studies with S. cerevisiae have indicated that 1 centimorgan generally corresponds to approximately 3 kb, the region between CDC24 and PYK1 appears to undergo meiotic recombination at an unusually high frequency. PMID- 3540621 TI - [An unusual case of invagination]. AB - Intussusception is an usual pediatric problem in the first two years of life. Nevertheless, it may occur in older children as well, but then often with an uncharacteristic history and atypical x-ray findings. Even symptoms lasting over weeks or months do not exclude intussusception. Ultrasonography is a useful diagnostic approach. In difficult cases endoscopy is indicated. PMID- 3540622 TI - Central monoaminergic and opioidergic regulation of thyroid function and its ontogenic differentiation. PMID- 3540623 TI - Androgen metabolism in the brain: role in sexual differentiation and in the control of gonadotropin secretion. PMID- 3540624 TI - Hypothalamic control of reproductive function: ontogenetic aspects. PMID- 3540625 TI - [The bonding of an adhesive resin to fluoride-treated human dentin]. PMID- 3540626 TI - [Effect of the surface roughness of abutment teeth on the elevation of complete cast crowns]. PMID- 3540627 TI - [A case report of the prosthetic treatment of a patient with a retropositioned maxilla due to fracture]. PMID- 3540628 TI - [Basic studies on the Konus crown using a finite element method. 1. Studies on the analytic method and its validity]. PMID- 3540629 TI - [Use of a self-cured 4-META adhesive resin for removable denture. Reinforcing effect of wire used in denture repair]. PMID- 3540630 TI - [Oro-lingual contours of the clinical crown of the upper 1st molar]. PMID- 3540631 TI - [A basic study on root surface area]. PMID- 3540632 TI - [Dental use of an X-ray subtraction technic--sharpening of the tomogram]. PMID- 3540633 TI - [Functional characteristics of plasmids of Shigella sonnei 47 strains]. AB - The phenotypic characteristics of Shigella sonnei strain 47 containing 7 plasmids of low molecular weight and 2 plasmids 60-100 Md large have been studied. The strains of Escherichia coli containing the single plasmids or plasmid groups from Shigella sonnei have been obtained by transformation and conjugation. The comparison of phenotypes of the obtained strains has helped to find the plasmid location of the determinants for streptomycin resistance (P7), genes for colicinogenicity and colicin immunity (P5), the enzymes of host cell specificity system Sso47I (P6), Sso47II (P4), and the genes for the conjugative DNA transfer (P9). Escherichia coli strains producing individual restriction enzymes SsoI and SsoII have been isolated. PMID- 3540634 TI - [Genetic regulation of plasmid transfer in gram-negative bacteria]. AB - The data are reviewed on the genetic structure and regulation of tra-genes activity controlling the conjugative transfer of F, F-like plasmids as well as the transfer of some other bacterial plasmids. The effect of the systems inhibiting the conjugational transfer (fin-systems) of F and a number of derepressed F-like plasmids has been characterized on the basis of data obtained by the authors or published data. Possible mechanisms for the systems functioning in the regulation of tra-genes activity are discussed as well as the prospects of their further study. PMID- 3540635 TI - [Conjugation transfer of the bireplicon plasmid pSPA044 into Rhizobiaceae bacteria]. AB - We have demonstrated the possibility of hybrid plasmid pSPA044 conjugative transfer from E. coli cells into different Rhizobium species. The bireplicon plasmid, constructed earlier in our laboratory, consisting of pBR325 and HindIII fragment 13 of the nopaline plasmid pTiC58 was mobilized for transfer by the helper plasmid pRK2013 with the frequency about 10(-4). We conclude the hybrid plasmid pSPA044 to be able to replicate stably in Rhizobiaceae cells. PMID- 3540636 TI - [Microcins: their nature and genetic determination]. AB - A number of gram-negative bacteria are capable of synthesizing the low molecular mass antibiotics microcins, the substances with molecular masses up to 10 000 D possessing a broad range of antibiotic activity. The synthesis is not lethal for the producing cells and is not induced by DNA-damaging agents. The investigated microcins are either of oligopeptide nature or are analogues of methionine. Five types of microcins have been described. The A- and C-types of microcins inhibit protein synthesis, microcins B suppress DNA replication, microcins D and F affect cellular energy potential. Microcin synthesis and immunity to microcins are shown to be plasmid mediated. The role of microcins in ecology of enterobacteria and the ranking among bacterial antibiotics are discussed. PMID- 3540637 TI - [Genosystematics of yeasts of Zygofabospora Kudriavzev emend. G. Naumov genus]. AB - The data on comparative study of genomes by the genetic and molecular biology methods have permitted to identify yeasts generum Zygofabospora Kudriavzev emend. G. Naumov as a system of biological species. The generum is composed of hybridizable species mainly. PMID- 3540638 TI - [Uracil in DNA]. AB - The data confirming the formation of dUMP residues in DNA to be a continuous process taking place in the living cells are reviewed. All living organisms produce specific enzymes repairing the lesion of this type. The possible ways for uracil incorporation into DNA are described. The main of them are as follows: cytosine deamination in DNA molecules and utilization of dUTP by DNA polymerases during replication. The spontaneous mutability, the decrease in chain length of the newly synthesized DNA and the increase in recombination frequencies are discussed as possible consequences of this phenomenon. PMID- 3540639 TI - [Lethal effect of formaldehyde on Escherichia coli strains carrying or lacking the plasmid pKM101]. AB - The presence of plasmid pKM101 in Escherichia coli cells results in a slight increase in their sensitivity of lethal effect of formaldehyde. Plasmid ability to sensitize bacterial cells to formaldehyde inactivation is controlled by some chromosomal (uvrE, uvrA, recA) and plasmid-borne (mucAB) genes and depends on SOS DNA repair activity. Plasmid pKM101 is capable of decreasing the level of repair reliability of DNA damaged by formaldehyde thus causing increased bacterial sensitivity to this agent. PMID- 3540640 TI - [Effect of mutation crp11 in the 3',5'-cyclic adenosine monophosphate receptor on the expression of the udp gene in Escherichia coli K12 strains deficient for transcription termination factors (rho ts15)]. AB - The suppression of temperature sensitive phenotype caused by mutation rho ts 15, making cells deficient in transcription termination, but mutation crp11 impairing the cAMP-receptor protein (cap) restores transcription termination on IS3 sequence in galactose operon and on the site before the promoter of udp gene in strains crp11 rho ts15. The obtained data suggest the direct interaction between factor Rho and cAMP-CAP complex in transcription process. PMID- 3540641 TI - [Optimization of conditions for preparation of the solid phase of infected cells in the immunoenzyme analysis of monoclonal antibodies]. AB - The conditions of immunoenzyme assay have been studied on the solid state phase of infected cells using the model of monoclonal antibodies MAK-14-7 to the virus of Venezuelan equine encephalomyelitis (VVEE) and monoclonal antibodies OKA-1 to vaccine virus in the systems of VNK-21 cells or 4647 cells infected by VVEE, or HeLa cells infected by vaccine virus. The titer of monoclonal antibodies detected grows with the dose of infected cells fixed in the holes of micropanel used for reaction and with the multiplicity of infection. The most intensive and contrasting dyeing of conjugate has been registered when the cells have been fixed with 0.25% glutaraldehyde 24 h after infection. The titers of ascytic preparations of monoclonal antibodies MAK-14-7 and OKA-1 under the optimal conditions of immunoenzyme assay reaction on the solid phase of infected cells present 1 : 10 000 and 1 : 100 000. PMID- 3540642 TI - [The use of a dot immunoenzyme method for detection of viral antigens]. AB - The technique of dot immunoenzyme detection has been elaborated for viral antigens identification. The investigated samples (extracts of infected cells, fractions obtained during viruses and viral proteins purification) are placed in nitrocellulose filters, the free binding sites are blocked and then treated with specific immune serum. The formed antigen-antibody complexes are detected using antispecies immunoglobulins or protein A from Staphylococcus aureus, conjugated with horseradish peroxidase. The brown dots appear at samples location containing the viral antigens. Sensitivity of the technique is 1 ng of protein per sample as tested using adenoviral antigens. PMID- 3540643 TI - Mutagenic and genotoxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin, a review. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin is one of the most toxic and highly stable compounds known in the environment. Due to uncontrolled exothermic reactions during manufacture of 2,4,5-T and other chlorophenoxy compounds, TCDD is released in the environment. The importance of determining the hazards to human health from dioxin became apparent because of its severe adverse health effects. 'Agent Orange' which is a mixture of 2,4,5-T and 2,4-D has been extensively used during the late Vietnam War. In this review an attempt has been made to evaluate the mutagenic and genotoxic effects of 2,3,7,8-TCDD as known at present. PMID- 3540644 TI - Mechanistic aspects on chemical induction of spindle disturbances and abnormal chromosome numbers. AB - Work on the chemical induction of spindle disturbances and abnormal chromosome numbers, and work on the composition and biochemistry of the spindle are reviewed. Some early investigations have shown that there is an unspecific mechanism for chemical induction of spindle disturbances. This mechanism is based on the interaction of compounds with cellular hydrophobic compartments. Some compounds act differently and are more active than predicted from their lipophilic character. Selected compounds of that kind and their possible mechanisms of action are discussed. Changes in sulfhydryl and ATP levels, oxidative damage of membranes and impaired control of cytoplasmic Ca2+ levels are discussed in this context. PMID- 3540645 TI - Deployment of short-term assays for the detection of carcinogens; genetic and molecular considerations. AB - The deployment of short-term assays for the detection of carcinogens inevitably has to be based on the genetic alterations actually involved in carcinogenesis. This paper gives an overview of oncogene activation and other mutagenic events connected with cancer induction. It is emphasized that there are indications of DNA alterations in carcinogenicity, which are not in accordance with "conventional" mutations and mutation frequencies, as measured by short-term assays of point mutations, chromosome aberrations and numerical chromosome changes. This discrepancy between DNA alterations in carcinogenicity and the endpoints of short-term assays in current use include transpositions, insertion mutations, polygene mutations, gene amplifications and DNA methylations. Furthermore, tumourigenicity may imply an induction of a genetic instability, followed by a cascade of genetic alterations. The evaluation of short-term assays for carcinogenesis mostly involves two correlations that is, between mutation and animal cancer data on the one hand and between animal cancer data and human carcinogenicity on the other. It should be stressed that animal bioassays for cancer in general imply tests specifically for the property of chemicals to function as complete carcinogens, which may be a rather poor reflection of the actual situation in human populations. The primary aim of short-term mutagenicity assays is to provide evidence as to whether a compound can be expected to cause mutations in humans, and such evidence has to be considered seriously even against a background of negative cancer data. For the evaluation of data from short-term assays the massive amount of empirical data from different assays should be used and new computer systems in that direction can be expected to provide improved predictions of carcinogenicity. PMID- 3540646 TI - Mutagenicity, carcinogenicity and teratogenicity of zinc. AB - Zinc is a common element in the human environment and constitutes an important trace element intervening in many biological processes. Toxicity of zinc is low; zinc deficiency represents, however, a hazard for human health. Zinc is not mutagenic and has little, if any, clastogenic properties. Zinc can induce tumours but only following local application, and does not represent a carcinogenic risk to man. It is still uncertain whether zinc can cause malignant transformation but zinc is needed for cellular proliferation of existing tumours and tumour growth is retarded by zinc deficiency. Zinc is not teratogenic; it can, in fact, avert teratogenicity of other agents. Conversely, zinc deficiency may be harmful to the developing organism. PMID- 3540647 TI - Mechanisms of synergism in the mutagenicity of cadmium and N-methyl-N-nitrosourea in Salmonella typhimurium: the effect of pH. AB - Cadmium enhances the mutagenic effect of N-methyl-N-nitrosourea (MNU) in a synergistic manner in Salmonella typhimurium. In the range of doses that yield synergistic effects, it is by itself highly cytotoxic and only weakly mutagenic. A decrease in pH from 7 to 6 markedly decreases cadmium toxicity, causing a 4 fold increase in the surviving fraction. The same shift in pH markedly increases the dose-dependent mutagenesis of MNU, whether MNU is acting alone or in combination with cadmium and increases the synergism at lower doses of cadmium. Thus, the synergism appears to depend on the mutagenicity of MNU and not on the cytotoxicity of Cd. The combined mutagenic effect of Cd and MNU is comparable in tester strain TA1535 and TA100, which contains the error-prone (SOS) repair enhancing pKM101 plasmid. Thus the synergistic effect of cadmium is not enhanced by the induction of SOS processing. The hydrolysis of MNU is higher at pH 7 than at pH 6 but cadmium has no effect on the rate of MNU hydrolysis at either pH, and therefore does not influence the concentration of the active electrophile of MNU. Cadmium does not enhance the mutagenesis of ethylnitrosourea, the ethylating analogue of MNU, indicating that the synergism is specific for methylated DNA lesions. These data suggest that cadmium acts either directly by modifying the nature or indirectly by inhibiting the repair of methylation damage. PMID- 3540648 TI - SCE levels in Bloom-syndrome cells at very low bromodeoxyuridine (BrdU) concentrations: monoclonal anti-BrdU antibody. AB - A stable staining procedure of sister-chromatid differentiation (SCD) using a monoclonal antibromodeoxyuridine (BrdU) antibody was newly established by combining it with the immunoperoxidase reaction (3,3'-diaminobenzidine, DAB reaction). This procedure permitted detection of SCD and SCE at very low BrdU concentrations. SCD was not usually observed below 2.0 micrograms/ml BrdU with flame-dried chromosome slides. When chromosome slides were prepared by air-drying over 37 degrees C warm water, SCD was detected at 10.0, 5.0, 1.0, 0.5, 0.3 and 0.2 micrograms/ml BrdU with FPG and even at 0.1 microgram/ml BrdU with the antibody technique. SCE levels were evaluated using the antibody technique and endomitotic analysis with FPG at low BrdU concentrations (1.0, 0.5, 0.3, 0.2 microgram/ml) in two BS B-lymphoblastoid cell lines (LCLs). Even though the BS SCE level was approximately 70 per cell at 10 micrograms/ml, the value decreased to the level of 20-30 SCE per cell at 0.1 microgram/ml with the antibody technique. In BrdU-labelled BS endomitoses, single SCEs highly decreased with BrdU concentrations (130-140 level at 10 micrograms/ml: 38-60 level at 0.2 microgram/ml), when compared to the rare twin SCE values (3-6 SCE level) at all BrdU concentrations. These findings conclusively indicate that the spontaneous baseline SCE in BS B-lymphoblastoid cells is low and most BS SCEs are caused by BrdU. PMID- 3540649 TI - Lethal and mutagenic effects of 8-methoxypsoralen-induced lesions on plasmid DNA. AB - The genotoxic effect of 8-methoxypsoralen damages (monoadducts and crosslinks) on plasmid DNA was studied. pBR322 DNA was treated with several concentrations of 8 methoxypsoralen plus fixed UVA light irradiation. After transformation into E. coli cells with different repair capacities (uvrA, recA and wild-type), plasmid survival and mutagenesis in ampicillin- and tetracycline-resistant genes were analysed. Results showed that crosslinks were extremely lethal in all 3 strains; indeed, it seemed that they were not repaired even in proficient bacteria. Monoadducts were also found to be lethal although they were removed to some extent by the excision-repair pathway (uvrA-dependent). Damaged plasmid DNA appeared to induce mutagenic repair, but only in the wild-type strain. In order to study the influence of the SOS response on plasmid recovery, preirradiation of the host cells was also performed. Preirradiation of the uvrA or wild-type strains significantly increased plasmid recovery. Consistent with the expectations of SOS repair, no effect was observed in preirradiated recA cells. Plasmid recovery in the excision-deficient strain was mainly achieved by the mutagenic repair of some fraction of the lesions, probably monoadducts. The greatest increase in plasmid recovery was found in the wild-type strain. This likely involved the repair of monoadducts and some fraction of the crosslinks. We conclude that repair in preirradiated repair-proficient cells is carried out mainly by an error-free pathway, suggesting enhancement of the excision repair promoted by the induction of SOS functions. PMID- 3540650 TI - Detection of point-mutation mutagens in Aspergillus nidulans: comparison of methionine suppressors and arginine resistance induction by fungicides. AB - In the present study we describe the effect of 4 fungicides on the induction of point mutations in strains biA1 methG1 (induction of methionine suppressors) and 118 (induction of arginine resistance) of Aspergillus nidulans. Captan, which was used as a known mutagen, Daconil 2787 and Dithane M-45 were effective in inducing these mutations, whereas the fungicide Cercobin caused no significant increase in the induction frequency of the point mutations selected. Actually, a decrease in the frequency of methionine suppressors was observed in relation to those occurring spontaneously. However, this effect could not be considered antimutagenic because the revertants were more sensitive to the fungicide than the biA1 methG1 strain. Although the induction of methionine suppressors was more convenient because it permits the visualization of several morphological types, the 118 strain system also proved to be effective in detecting point-mutation induction. PMID- 3540651 TI - A model for the recA-dependent repair of excision gaps in UV-irradiated Escherichia coli. AB - We have tested and supported the hypothesis that, in UV-irradiated Escherichia coli, recA-dependent nucleotide excision repair only functions in the replicated portion of the chromosome (i.e., where sister duplexes exist). Using a dnaA(Ts) mutation to align the chromosomes (i.e., all rounds of DNA replication were completed, and new rounds could not be initiated), we studied the genetic control of excision repair (measured as the repair of excision gaps in DNA) in cells with unreplicated chromosomes, and also in cells with partially replicated chromosomes. The excision repair that occurred in cells with unreplicated chromosomes was recA independent, but the excision repair that occurred in cells with partially replicated chromosomes was partially recA dependent. We found no evidence of interchromosomal recombination in recA-dependent excision repair. The majority of this recA-dependent excision repair was recF dependent, and a small portion was recB dependent. The recF and recB genes are suggested to function in excision repair in a manner similar to their function in postreplication repair, i.e., in the replicated portion of a chromosome, the RecF pathway repairs gaps, and the RecB pathway repairs the DNA double-strand breaks that arise at unrepaired gaps. PMID- 3540652 TI - Further characterization of an E. coli strain resistant to the toxic and mutagenic action of cis-diamminedichloroplatinum(II). AB - An increased resistance to the toxic and mutagenic activity of the antitumor drug cis-diamminedichloroplatinum(II) (cis-DDP) in the E. coli strain BS21 compared to its wild-type parent, F26, has been reported. This resistance was neither due to different binding of cis-DDP to DNA nor to adaptive DNA repair (Germanier et al., 1984). In the present work, we found that mutation of the uvrA, recA and polA genes did not abolish the resistance of BS21 to the toxic action of cis-DDP. The lower mutability of BS21 was not influenced by the polA mutation, while uvrA greatly reduced and recA eliminated the mutagenic activity of cis-DDP in both strains. Treatment of BS21 and F26 with equal doses of cis-DDP produced the same initial number of platinum-DNA lesions. Little excision repair was detected in vivo in either strain during 6-h post-treatment incubation, the F26 strain being the most efficient of the two for this process. In contrast, F26 and BS21 were transformed identically by pBR322 DNA which had been treated with cis-DDP in vitro. Analysis of the platinum-DNA adducts which were formed between cis-DDP and salmon sperm DNA in the buffer conditions of this experiment suggests that plasmid DNA contains 80% monofunctional adducts and 20% bifunctional bis-guanine adducts. These data indicate that the selective toxicity and mutagenicity of these two strains in vivo are neither a result of different numbers of Pt-DNA lesions nor of their repair. The selectivity disappeared when the two bacterial strains were transformed by pBR322 DNA containing identical platinum-DNA lesions, suggesting that the biochemical events which process platinum-DNA lesions are the same in both strains. Hence, it appears that cis-DDP may form qualitatively different platinum-DNA adducts in the BS21 and F26 strains which are responsible for the different toxicity and mutagenicity. PMID- 3540653 TI - Effect of pKM101 plasmid on lethal and mutagenic damage in UV-irradiated E. coli strains. AB - Introduction of the R-factor plasmid pKM101 increased resistance to UV-killing in uvr lexA(Ind-) recA+ strains of E. coli K12 as well as B, while their UV mutability was not affected. Similar effects were also observed in those strains when the 18-B plasmid (a pBR322 derivative carrying the region (about 5 kb) of the 35.4 kb pKM101 plasmid) was introduced. The muc genes which are considered to be involved in error-prone repair are contained in 18-B. These results suggest the possibility that the pKM101 effect requires the host recA gene and a common genetic region, including the muc genes, in both plasmids and is associated with some unmutable repair systems. PMID- 3540654 TI - Chemical carcinogens. A review and analysis of the literature of selected chemicals and the establishment of the Gene-Tox Carcinogen Data Base. A report of the U.S. Environmental Protection Agency Gene-Tox Program. AB - The literature on 506 selected chemicals has been evaluated for evidence that these chemicals induce tumors in experimental animals and this assessment comprises the Gene-Tox Carcinogen Data Base. Three major sources of information were used to create this evaluated data base: all 185 chemicals determined by the International Agency for Research on Cancer to have Sufficient evidence of carcinogenic activity in experimental animals, 28 selected chemicals bioassayed for carcinogenic activity by the National Toxicology Program/National Cancer Institute and found to induce tumors in mice and rats, and 293 selected chemicals which had been evaluated in genetic toxicology and related bioassays as determined from previous Gene-Tox reports. The literature data on the 239 chemicals were analyzed by the Gene-Tox Carcinogenesis Panel in an organized, rational and consistent manner. Criteria were established to assess individual studies employing single chemicals and 4 categories of response were developed: Positive, Negative, Inconclusive (Equivocal) and Inconclusive. After evaluating each of the individual studies on the 293 chemicals, the Panel placed each of the 506 chemicals in an overall classification category based on the strength of the evidence indicating the presence or absence of carcinogenic effects. An 8 category decision scheme was established using a modified version of the International Agency for Research on Cancer approach. This scheme included two categories of Positive (Sufficient and Limited), two categories of Negative (Sufficient and Limited), a category of Equivocal (the evidence of carcinogenicity from well-conducted and well-reported lifetime studies had uncertain significance and was neither clearly positive nor negative), and three categories of Inadequate (the evidence of carcinogenicity was insufficient to make a decision, however, the data suggested a positive or negative indication). Of the 506 chemicals in the Gene-Tox Carcinogen Data Base, 252 were evaluated as Sufficient Positive, 99 as Limited Positive, 40 as Sufficient Negative, 21 as Limited Negative, 1 as Equivocal, 13 as Inadequate with the data suggesting a positive indication, 32 as Inadequate with the data suggesting a negative indication, and 48 Inadequate with the data not suggesting any indication of activity. This data base was analyzed and examined according to chemical class, using a 29 chemical class scheme.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540656 TI - Effects of the antimutagen cinnamaldehyde on reversion and survival of selected Salmonella tester strains. AB - The antimutagenic activity of trans-cinnamaldehyde (C6H5CH = CHCHO) on chemically induced mutagenesis has been shown in E. coli. Using the Ames Salmonella typhimurium tester strains TA1535 (hisG46 uvrB rfa) and TA100 (TA1535/pKM101), the effects of cinnamaldehyde on spontaneous reversions and reversions induced by 4-nitroquinoline-N-oxide(4NQO) and ethyl methanesulfonate (EMS) have been examined. To observe the effect of cinnamaldehyde in the absence of functional muc genes, a third strain, TA1535/pGW201 (pKM101 muc140: :Tn5) was included in the testing. Modifications of the standard Ames test procedures and direct plating techniques were employed to study the "antimutagenic" response exerted by cinnamaldehyde. In all strains tested, concentrations of cinnamaldehyde up to 25 micrograms/ml slightly decreased the number of spontaneous reversions and induced reversions were more markedly reduced. The decreases in the numbers of 4NQO induced revertants were greater than those decreases which occurred for EMS induced reversions. There was no effect on viability in 1% (v/v) nutrient broth supplemented minimal medium containing 5-25 micrograms/ml of cinnamaldehyde. Cinnamaldehyde did not display any mucAB dependent or independent specificity against the mutagens used. On minimal medium supplemented with histidine and biotin, concentrations of cinnamaldehyde above 10 micrograms/ml were lethal for the strains tested. When the test medium was supplemented with 1-5% (v/v) liquid nutrient broth, viability was not affected at concentrations up to 25 micrograms/ml. For both TA100 and TA1535 the presence of 20 micrograms/ml of cinnamaldehyde in 1% (v/v) liquid nutrient broth-supplemented minimal glucose broth extended the lag phase for 2-4 h with no effect on survival. Depending on the test procedure employed, decreases in numbers of revertants may reflect lethality rather than antimutagenesis. When used to test for antimutagenesis rather than mutagenesis, modifications of the standard Ames test procedure may mimic an antimutagenic response due to a decrease in the total number of revertants seen even though enough cells survive to produce a background lawn. PMID- 3540655 TI - Mutagenicity of nitracrine analogues in Salmonella typhimurium: mutational specificity and activation by bacterial enzymes and rat-liver S9. AB - The mutagenic potential of 9-[(3-dimethylaminopropyl)amino]-acridine and its 1 (nitracrine), 2-, 3- and 4-nitro derivatives was studied in several strains of Salmonella typhimurium, using a plate-incorporation assay. In view of the potential importance of DNA binding and nitro group reduction, binding constants and redox potentials were determined. The parent compound was mutagenic only in the frameshift tester strain TA1537, and this effect was not enhanced by the plasmid pKM101. Each of the nitroarenes showed significant activity in S. typhimurium strains TA1537 and TA1538, and this mutagenicity was enhanced by the presence of plasmid pKM101. All caused reversion of the base-pair substitution allele in hisG46 in strain TA100 and this effect was either largely or totally dependent upon the plasmid. The frameshift mutagenic effects of the 3-nitro and 4 nitro compounds appeared to be little dependent upon the classical nitroreductase which is deficient in strain TA98NR, or transacetylase enzyme lacking in strain TA98/1,8-DNP6, whereas the activity of the 1-nitro compound depended partly on that nitroreductase enzyme, and that of the 2-nitro compound on having both activities present. In the latter two cases, the mutagenic effects of the compounds could not be restored by the addition of an S9 mix of mammalian enzymes. Mutagenicity data were compared with physicochemical parameters. The results do not distinguish between the view that the orientation of the nitro group with respect to the aromatic plane dictates mutagenic potential, and the earlier view that the nitro group redox potential is important. However, the extraordinary mutagenic potency of the 1-NO2 derivative is not explainable by its physicochemical properties alone. PMID- 3540658 TI - Aneuploidy induced by nocodazole or ethyl acetate is suppressed by dimethyl sulfoxide. AB - Nocodazole and ethyl acetate have previously been shown to be potent inducers of aneuploidy in Saccharomyces cerevisiae. The elevation in aneuploidy frequency induced by high doses of these compounds was reduced in a dose-response manner in the presence of increasing concentrations of dimethyl sulfoxide. These results imply that compounds dissolved in dimethyl sulfoxide which either are weak inducers of aneuploidy or are of unknown potency may register as false negatives in routine screening procedures. PMID- 3540657 TI - Effects of chemical combinations on the induction of aneuploidy in Saccharomyces cerevisiae. AB - Nocodazole, ethyl acetate, acetone and methyl ethyl ketone all are known to induce aneuploidy. Treatment of yeast strain D61.M with mixtures containing ineffective low levels of nocodazole and ineffective low levels of these solvents was highly effective in inducing aneuploidy. Ineffective low levels of nocodazole mixed with ineffective low levels of methyl 2-benzimidazolecarbamate also gave elevated frequencies of aneuploidy. Dimethyl formamide, a solvent that does not induce aneuploidy, mixed with low levels of nocodazole gave no increase in aneuploidy frequency above those levels seen in controls. PMID- 3540659 TI - Nitrous acid induced damage in T7 DNA and phage. AB - T7 phage was exposed to 56 mM nitrous acid at pH 4.6 causing a 90% decrease in survival for each 10 min duration of exposure. The survival of phage made by encapsulating nitrous acid treated DNA into empty phage heads was nearly the same as the survival of phage exposed to nitrous acid in vivo. In contrast to previous reports, growth of SOS-induced wild-type E.coli showed no increase in survival. The survival of nitrous acid treated phage was not lowered when grown on E.coli strains deficient in DNA polymerase I, exonuclease III, and the uvrA component of the nucleotide excision-repair endonuclease. Therefore, these enzymes are not vital for repair of nitrous acid induced damage in bacteriophage T7. PMID- 3540660 TI - Chloral hydrate, methylmercury hydroxide and ethidium bromide affect chromosomal segregation during meiosis of Saccharomyces cerevisiae. PMID- 3540661 TI - Tricyclic drugs: potent mutagenicity of traces of a nitroarene formed in the reaction of opipramol with nitrite. AB - The tricyclic psychotropic drug opipramol (Insidon) reacts in vitro with sodium nitrite in acidic solution to form products including mutagens for Salmonella typhimurium TA98 and TA100. Two aspects are particularly noteworthy. The strong mutagenicity of the crude reaction mixture is almost exclusively due to a compound which is present only in trace quantities (less than 0.1%). This mutagen was identified as a nitroarene, 4-[3-(2-nitro-9-(10H)-acridinon-10-yl)propyl]-1 piperazine-ethanol . Hence, while the formation of carcinogenic N-nitroso compounds from the interaction of nitrogen-containing compounds with nitrite is well known, the present study demonstrates the formation of a highly mutagenic C nitro compound in the presence of nitrite. PMID- 3540662 TI - A case of chromoblastomycosis: with special reference to the mycology of the isolated Exophiala jeanselmei. PMID- 3540663 TI - A case of cerebrospinal fluid shunt colonization and obstruction by Candida albicans. PMID- 3540664 TI - The effect of ciclopiroxolamine investigated by means of the freeze-fracture technique. PMID- 3540665 TI - Temporary use of the Jarvik-7 total artificial heart before transplantation. AB - Between October 24, 1985, and July 31, 1986, the Jarvik-7 total artificial heart was implanted into six moribund patients in an attempt to test its potential as a bridge from almost certain death to cardiac transplantation. Four of these patients are now well and at home after implantation of the device and subsequent cardiac transplantation. Before transplantation, one patient died with sepsis and multiorgan failure that preceded implantation of the artificial heart. Another patient died with acute rejection 60 days after cardiac transplantation. Fifty two days of total mechanical support with the artificial heart were accumulated in these six patients, and although the device worked flawlessly and no clinically apparent thromboembolic events occurred, each artificial heart contained areas of macroscopic aggregations of platelets and thrombi. The results of this trial indicate that in properly selected cases, direct benefit to the patient can be obtained when the Jarvik-7 artificial heart is used as a bridge to transplantation. PMID- 3540666 TI - The cell biology of experimental pancreatitis. PMID- 3540667 TI - History of electrocardiography. PMID- 3540668 TI - Does calcium supplementation prevent postmenopausal bone loss? A double-blind, controlled clinical study. AB - During a two-year study, we examined the effect of calcium supplementation on postmenopausal bone loss in 43 women in the early postmenopausal period who were assigned to one of three treatment groups: percutaneous 17 beta-estradiol (combined with progesterone during the second year), oral calcium (2000 mg daily), and placebo. All participants were examined every three months. Bone mineral content in the forearm (measured by single-photon absorptiometry) and in the entire body and spine (measured by dual-photon absorptiometry) remained constant in the estrogen-treated group but decreased significantly in the groups receiving calcium and placebo. In the calcium-treated group, we observed a tendency toward a slowed loss of compact bone (in the proximal forearm and total skeleton) as compared with the placebo group, while the rate of loss of trabecular bone (the distal forearm and spine) was the same as in the placebo group. Our preliminary data suggest that calcium supplementation in the dosage we used is not as effective as estrogen therapy for the prevention of early postmenopausal bone loss. Calcium supplementation may have had a minor effect on the loss of cortical bone, but it had no effect on the trabecular bone. PMID- 3540669 TI - Bone mineral screening for osteoporosis. PMID- 3540670 TI - Decision analysis. PMID- 3540671 TI - Early diagnosis of HIV infection in the neonate. PMID- 3540672 TI - Transparently blinded trials of methysergide. PMID- 3540674 TI - Two new cases of cutaneous alternariosis with a review of the literature. AB - Two cases of cutaneous phaeohyphomycosis due to Alternaria tenuissima in patients affected with primitive myeloproliferative syndrome and lymphocytic lymphoma respectively are reported. Following a review of the specific literature, the authors discuss the etiopathogenic mechanisms, the clinical and histologic aspects of the lesions and the therapeutic problems. PMID- 3540673 TI - Primary cutaneous cryptococcosis. AB - A 7-year-old boy, without apparent underlying disease, but with a non-specific failure in his cellular immunity, developed a cutaneous lesion on the left retroauricular area with spontaneous healing. Mycologic study revealed Cryptococcus neoformans, a capsule deficient strain, as the etiologic agent. PMID- 3540675 TI - In vivo and in vitro studies with an atypical, rhinotropic isolate of Cryptococcus neoformans. AB - An atypical isolate of Cryptococcus neoformans was investigated because of its consistent and reproducible production of gross nasal pathology following i.v. injection in Swiss albino mice. Dose response to graded concentrations ranging from 1 X 10(2)-1 X 10(7) cells/mouse yielded an LD50 of 1.4 X 10(3) cells/mouse for the atypical rhinotropic strain H140 which was significantly less virulent (p less than 0.01) than our reference strain of Cryptococcus neoformans. There was no significant difference in mortality following the injection of in vitro vs. in vivo passed inoculum. As early as two weeks after inoculation, this strain produced gross nasal enlargement to approximately 2-3 X normal dimensions with granulomatous and ulcerated lesions. The LD60 resulted in the greatest percentage of nasal involvement (85%). C. neoformans was demonstrated by culture and histopathology in the noses, brains, lungs, livers and kidneys. A temperature selection was indicated by findings of a lower temperature minimum for subcultures isolated from the noses relative to those isolated from the brain, and by the fact that the most densely populated organs following intraperitoneal injection were the testes. This route of inoculation resulted in cutaneous nasal involvement in a manner analogous to that following i.v. injection. The atypical isolate was unable to assimilate trehalose or raffinose but otherwise was entirely consistent with identification as C. neoformans and produced characteristic CNS and general organ system disease in addition to the rhinotropic cutaneous manifestations. The model characterized here in normal mice may be of value in studies of fungal dermotropism. PMID- 3540676 TI - Evaluation of a fluorescent method (fluorescein diacetate and ethidium bromide solution) in the study of the viability Cryptococcus neoformans strains. AB - The effectiveness of the fluorescent viability test (fluorescein diacetate-FDA and ethidium bromide-EB-solution) compared to the plaque counting test (Miles & Misra M & M) was performed on 10 samples of Cryptococcus neoformans cultivated in Sabouraud dextrose agar at 25 degrees C. The optimum incubation period of 50 minutes was determined. Growth curves of the fungal strains studied based on the mean cell number were drawn for both the FDA & EB and M & M methods. The statistical evaluation (Student's T test) of the average sum of the viable cell counts showed that the FDA-EB method is more sensitive than the M & M test for the studied species. The growth curves of the samples usually followed a homogeneous pattern comparable to other non-dimorphic fungi. PMID- 3540677 TI - [Fat metabolism in growth-selected laboratory mice]. AB - The object of the present study was to characterize the selection-conditioned differentiation of the biological performance of laboratory mice having been selected for 13 generations at the age of 6 weeks to body mass (Du-6) as well as simultaneously to body mass and high physical capacity (Du-6 + LB) by parameters of fat metabolism. The improved physical capacity with unchanged body composition (Du-6 + LB) coincides with increasing activity of dehydrogenases supplying NADPH (glucose-6-phosphate-dehydrogenase, 6-phosphate-gluconate-dehydrogenase, NADP malate-dehydrogenase, NADP-isocitrate-dehydrogenase) in the liver. The doubling of the fat content of the body (Du-6) was accompanied by a significant increase of the G-6-PDH- and fatty-acid synthetase activity in the fatty tissue. Furthermore, the growth-selected animals showed an intensified transformation of 14C-glucose substrate in the lipids of the epididymal fatty tissues occurring especially at the selection age (42nd day) as well as at the earlier date of ontogenesis (32nd day). The insulin stimulation capacity of the fat cells as to the glucose incorporation, however, remained unchanged. PMID- 3540678 TI - History of the caesarean section. PMID- 3540679 TI - Preparation for labour. PMID- 3540681 TI - A hand-operated indexing system: "the knitting needle computer". PMID- 3540680 TI - [Realistic planning inside a nursing service]. PMID- 3540682 TI - [South African nursing journals: an overview]. PMID- 3540683 TI - Forty years of genetic recombination in bacteria. A fortieth anniversary reminiscence. PMID- 3540684 TI - Forty years of genetic recombination in bacteria. Postmature scientific discovery? PMID- 3540685 TI - A new way of enhancing the thermostability of proteases. AB - Thermostability of enzyme can be enhanced by single amino acid substitutions. Recent advances in genetic engineering have made it possible to create novel proteins in a predictable manner where structural information for the protein is available. This 'protein engineering' has already been used to enhance enzyme thermostability, but it is usually not clear which amino acid substitutions should be made. We consider that the following approach should be helpful in engineering proteins with enhanced thermostability: highly conserved residues should be left unchanged; the sequences of known mesophilic and thermophilic proteins should be used to suggest the kinds of changes likely to increase thermostability; and substitutions should be made that increase internal hydrophobicity and that stabilize helices for strong internal packing. We describe here the use of this approach to alter the thermostability of the thermostable neutral protease of Bacillus stearothermophilus, the sequence of which is known. Surprisingly we find that a single mutation that decreases thermostability can require two mutations that increase stability to compensate for it. The effects on stability are not additive, suggesting cooperativity. PMID- 3540687 TI - [Spontaneous subcapsular splenic hemorrhage in infectious mononucleosis; diagnosis and therapy]. PMID- 3540686 TI - John Borden Graham: scholar, educator, humanitarian. PMID- 3540688 TI - Efficacy and immunogenicity of human and monocomponent porcine insulin: a randomized double-blind study in diabetic patients previously treated with insulin. PMID- 3540689 TI - Early dialysis and renal transplantation. PMID- 3540690 TI - A blind controlled trial of phase-contrast microscopy by two observers for evaluating the source of haematuria. AB - Two observers, unaware of each other's findings and of the diagnosis, examined red cells in the urine of 109 patients by phase-contrast microscopy. All specimens were examined uncentrifuged by inverted microscopy, and 48 of the 109 were also examined under a light microscope after centrifugation. We were unable to confirm with either method the close correlation between red-cell morphology and diagnosis reported in previous studies, and our 2 observers differed in their interpretation on 38% of occasions. Proteinuria associated with the presence of casts in uncentrifuged urine examined by inverted microscopy was a better indication than red-cell morphology of renal parenchymal disease. PMID- 3540691 TI - Tubulointerstitial disease in lupus nephritis: relationship to immune deposits, interstitial inflammation, glomerular changes, renal function, and prognosis. AB - The interrelationships between tubulointerstitial immune deposits (TID), interstitial inflammation, glomerular changes, renal function, and prognosis were assessed in the renal biopsies from 93 patients with lupus nephritis. The prevalence of TID was 33% by immunofluorescence and 23% by electron microscopy. Although predominantly detected along and within tubular basement membranes, extraglomerular immune deposits were also present in the wall of renal interstitial capillaries and small arteries as well as in Bowman's capsule. The prevalence of TID correlated with the activity of glomerular lesions and, to a lesser extent, with the severity of proliferative lupus nephritis (WHO classes II IV). TID were much less common in the membranous form (WHO class V). The severity of interstitial inflammation correlated with the degree of renal insufficiency and was an accurate prognostic indicator of progressive deterioration of renal function. However, there was no correlation between prevalence of TID and prevalence and severity of interstitial inflammation, suggesting that the latter is not necessarily secondary to the presence of immune complexes and that other pathogenetic mechanisms may be involved. PMID- 3540692 TI - Plasma fibronectin levels in patients with chronic uremia. AB - Plasma fibronectin (FN) concentration was measured in patients with idiopathic glomerulonephritis (GN) with or without impaired renal function, in uremic patients undergoing periodic hemodialysis and in renal transplant patients before and after an acute rejection crisis. Results show normal FN levels in idiopathic GN and in renal transplant patients with normal renal function, while significantly lower levels were found in GN with severe renal damage, in uremia before and after dialysis, and in renal transplant patients during acute and chronic graft rejection. Significant correlations between high serum creatinine values and low plasma FN levels were found in renal transplant patients. These findings suggest that the kidney may influence FN levels in the blood since acute (rejection crisis) and chronic renal failure (uremia) cause low concentrations of this protein, while levels tend to return to normal values in patients with uremia after renal transplantation. We hypothesize that the normal kidney removes or perhaps degrades some substances or hormones that may control the release or synthesis of FN. These substances are not dialyzed by cellophane membranes since low plasma FN levels persist after periodic hemodialysis. Only the renal graft provokes an increase of FN in the blood stream. PMID- 3540693 TI - Non-ketotic hyperosmolar diabetic pre-coma due to pancreatitis in a boy on continuous ambulatory peritoneal dialysis. AB - An unusual case of diabetes secondary to acute pancreatitis in a boy with end stage renal failure receiving continuous ambulatory peritoneal dialysis (CAPD) is described. A hyperglycaemic, hyperosmolar pre-coma developed, aggravated by associated hypercalcaemia. The glucose content of the dialysis fluid contributed to the hyperglycaemia, which settled as the pancreatitis resolved and lower glucose concentration dialysis fluid was used. Our experience suggests that pancreatic dysfunction should be considered where significant hyperglycaemia occurs during peritoneal dialysis. PMID- 3540694 TI - Captopril-induced proteinuria in hypertensive psoriatic patients. AB - We have previously reported on a high prevalence of high renin essential hypertension in psoriasis. Since angiotensin-converting enzyme (ACE) was also reported to be increased in some psoriatics, we found it rational to treat 10 patients with hypertension and diffuse psoriasis with captopril at a dose of 25 mg t.i.d. Five patients had high PRA levels and in 1 of them serum ACE was also increased. Serum creatinine, BUN and urinalysis were normal in all of them. SPB fell from 163 +/- 3 to 138 +/- 3 and DBP from 107 +/- 3 to 86 +/- 2 mm Hg after 1 month of captopril treatment. A surprising clinical improvement of the cutaneous lesions occurred in 3 patients previously resistant to every local or systemic treatment. Unfortunately, however, 3 patients developed heavy proteinuria (greater than 2 g/day) which disappeared after captopril discontinuation. The unexpected incidence of reversible proteinuria induced by low doses of captopril in our patients recommends a careful monitoring of the renal function every time this drug is employed in the treatment of hypertension in a psoriatic. PMID- 3540695 TI - Synovial amyloidosis of beta 2-microglobulin type in patients undergoing long term hemodialysis. PMID- 3540696 TI - Beta 2-microglobulin level of cyst fluid in uremic acquired cystic disease of the kidney. PMID- 3540697 TI - [In blood transfusions before kidney grafts, must we select donors HLA-compatible with the recipient or take donors at random?]. PMID- 3540698 TI - A biphasic excitatory response of hippocampal neurons to gonadotropin-releasing hormone. AB - Central gonadotropin-releasing hormone (GnRH) injected intraventricularly (IVT) has been shown to facilitate rat sexual behavior. To elucidate the brain mechanisms of GnRH action, we have applied GnRH to hippocampal brain slices in vitro. Using intracellular recording from 40 hippocampal CA1 pyramidal neurons, we have found GnRH to elicit predominantly excitation. There are two types of excitatory responses. One is a short-latency, short-duration response and the second a long-latency, long-duration response. These responses were characteristic of GnRH and not peptides generally because angiotensin II, which also had an excitatory effect, had only long-latency, short-duration effects. The neural response to GnRH may be involved in the initiation of the behavioral response since the termination of the long-duration response coincides with the onset of the behavior. PMID- 3540699 TI - Hypothalamic localization of multiunit electrical activity associated with pulsatile LH release in the rhesus monkey. AB - Abrupt increases in electrical activity can be recorded from the medial basal hypothalamus of the rhesus monkey and these bursts are correlated with a pulse of LH release from the anterior pituitary. In this study we have localized the tips of the electrodes from which such electrical activity can be recorded and have attempted to correlate the placement with the presence of immunoreactive LHRH neurons and axons. Electrodes associated with bursting activity were found as far rostral as the suprachiasmatic nucleus and as far caudal as the premammillary nuclei. The majority were found in the medial basal hypothalamus including the region of the arcuate nucleus, the retrochiasmatic zone and the dorsal aspect of the median eminence. The tips of the electrodes were associated with either LHRH neurons or axon bundles. Negative electrodes (those not associated with bursting electrical activity) which did not exit through the ventral surface of the brain nor enter the ventricle were found in the same regions of the hypothalamus as positive electrodes. Although it is tempting to associate the bursting electrical activity with the LHRH neurosecretory system, such a correlation cannot yet be made. PMID- 3540700 TI - Glucocorticoid implants around the hypothalamic paraventricular nucleus prevent the increase of corticotropin-releasing factor and arginine vasopressin immunostaining induced by adrenalectomy. AB - The site of inhibitory action of glucocorticoids on the hypothalamic corticotropin-releasing factor (CRF) and arginine vasopressin (AVP) was studied using a combination of glucocorticoid implantation and immunohistochemistry. Adrenalectomy increased the number and the staining intensity of the neurons containing CRF-like immunoreactivity in the anterior and medial parvicellular subdivisions of the paraventricular nucleus (PVN) and induced the appearance of AVP-like immunoreactivity in the same cell population. These effects of adrenalectomy were inhibited only by those dexamethasone implants which were placed close to the PVN. Unilateral implantation of dexamethasone into the PVN inhibited the adrenalectomy-induced changes in CRF and AVP immunostaining only on the implanted side. Dexamethasone implants placed into the hippocampus decreased the effect of adrenalectomy in the PVN while similar implants into the amygdala and cerebral cortex were ineffective. These results suggest that the primary site of glucocorticoid feedback inhibition on the hypothalamic secretagogues of adrenocorticotropin is the PVN. PMID- 3540701 TI - Comparative distribution of vasopressin and oxytocin neurons in the rat brain using a double-label procedure. AB - The distribution of vasopressin (VP) and oxytocin (OT) neurons in the rat supraoptic (SON), paraventricular (PVN), and accessory magnocellular (AMN) nuclei was studied by localizing both peptides on the same section with a double immunocytochemical staining procedure employing specific monoclonal antibodies (MAB). This procedure allows us to visualize the distribution of one cell type relative to the other. In the rostral SON, VP cells lie dorsal and medial to the OT cells. Near the mid-point of the nucleus along its rostral-caudal length, there is a transition zone in which the two cell types are mixed. Proceeding caudalward, the relative locations of OT and VP cells are exchanged so that most of VP cells are located in the ventral and medial sector of the nucleus, whereas the OT cells are situated dorsal and lateral. However, there is no absolute segregation of the two types of cells anywhere in the nucleus. In the anterior part of the PVN a rostral group (rPVN) of cells composed of a medial portion and a lateral wing can be recognized. Nearly all of the cells in the rPVN are oxytocin-containing. The rPVN is separated from the next group, the middle PVN (mPVN), by a cell poor zone of about 100-150 micron. The mPVN contains both OT and VP neurons. As one proceeds caudally, the OT cells extend in the rostrocaudal direction from an anterior and ventromedial location, forming a shell around a core of VP neurons. In the most caudal PVN (cPVN), a triangular cell group characterized by fusiform cells with long-beaded processes can be distinguished from the more rounded cells of the remaining PVN. Many fusiform cells in the cPVN appear to send their axons to the posterior perifornical nucleus and the nucleus of the medial forebrain bundle. Other fusiform cells of the cPVN are oriented in a rostral-caudal plane and are situated more medially in this subdivision. The dendrites of these cells project into the mPVN while their posterior processes, most of which also appear to be dendrites, project caudally along a medial route. PMID- 3540703 TI - Ultrasonography of the normal fetal brain. AB - Since the early 1960s it has been possible to identify the fetal head using A mode ultrasound. The introduction of high-resolution, real-time, gray-scale ultrasound in the mid-to-late 1970s first enabled the routine display of subtle internal anatomy. Using presently available equipment, the fetus can be imaged from 7 weeks after the last menstrual period until term and the internal anatomy of the fetal head can be detected after 11-12 weeks. The ultrasonic anatomy of the normal fetal head throughout the second and third trimesters is discussed, as are the normal changes taking place with growth. PMID- 3540702 TI - Biosynthesis of immunoreactive luteinizing hormone in the rat central nervous system. PMID- 3540705 TI - The fetal spine. AB - Ultrasonography has made it possible to evaluate the fetal spine in utero. Vertebral ossifications are demonstrable by ultrasonography in the early second trimester. Most spinal defects are apparent by 20-22 weeks menstrual age. Early detection of spinal anomalies allows for parental counseling and appropriate obstetrical management. Real-time equipment allows the fetal spine to be examined in parasagittal, transverse and coronal planes. The transverse plane provides the best view of the three ossification centers that form each fetal vertebra. Evaluation of the neural arch ossifications in the transverse view is crucial in detecting spina bifida defects. Ultrasonography of the fetal spine complements the use of alpha-fetoprotein levels in screening for neural tube defects. Examination of the fetal spine is also important in detecting vertebral ossification defects, particularly in cases of short-limbed dwarfs and infants of diabetic mothers. PMID- 3540704 TI - Diagnosis of brain neuropathology in utero. AB - The fetal brain can be evaluated very effectively with high-resolution real-time ultrasound equipment. This paper reviews normal fetal brain anatomy with specific emphasis on artifacts of ultrasound scanning of the brain. A review of the developmental abnormalities seen in utero include ventriculomegaly, anencephaly, encephalocele, meningomyelocele, Dandy-Walker syndrome, holoprosencephaly, craniosynostosis, microcephaly, and agenesis of the corpus callosum. The destructive lesions reviewed include hydranencephaly, infection, intracranial hemorrhage, and mass lesion. Identification of these abnormalities can be extremely helpful in providing the patients with management options and providing the obstetrician with information which can help in obstetric and neonatal therapy. PMID- 3540706 TI - Sonography of the normal neonatal head. Supratentorial structures: state-of-the art imaging. AB - Advances in ultrasound equipment now permit display of anatomic structures not previously shown. Correlation of sonograms obtained in vivo with gross and myelin stained sections of human autopsy material facilitates understanding of these new images. PMID- 3540707 TI - Sonography of congenital malformations of the brain. AB - A variety of congenital malformations of the brain can be diagnosed by cranial sonography. Those which alter macroscopic morphology can be recognized, the findings are similar to those seen on computed tomography and pneumoencephalography. The findings in the Chiari II malformation, agenesis of the corpus callosum, the Dandy-Walker syndrome, holoprosencephaly, lissencephaly, schizencephaly, tuberous sclerosis, and arteriovenous malformations are described in this chapter. PMID- 3540708 TI - Sonography of intracranial infection in infants and children. AB - Congenital and acquired infections of the central nervous system (CNS) pose a significant threat to the developing brain, even in the face of appropriate medical treatment. During the past five years, a number of reports have described the ultrasound features of intracranial infection, including echogenic sulci, extra-axial fluid collections, ventricular enlargement, calcifications, abnormal parenchymal echogenicity, abscess formation, cystic degeneration of the brain parenchyma, intraventricular echogenicity, ventricular septations and irregularity and prominence of the ventricular walls. These features permit ultrasound diagnosis of intracranial infection and help to guide decisions affecting patient management. PMID- 3540709 TI - Neurosonography of hydrocephalus in infants. AB - Transfontanel cranial ultrasonography reliably delineates ventricular size and anatomy in small infants. In these children, it is an excellent primary imaging technique for evaluation of the many clinical problems related to ventricular dilatation. Sonography can be useful for: detecting ventriculomegaly, differentiating nonobstructive ventricular dilatation from obstructive enlargement (hydrocephalus), determining the cause of hydrocephalus; aiding in the temporary management of patients with hydrocephalus; and aiding in the management of patients with permanent ventricular shunts. PMID- 3540710 TI - Tumors and cysts. AB - "Congenital" tumors that cause hydrocephalus early in life are large masses and can easily be detected by ultrasound. CT is better for differentiating among the diverse types of mass lesions and is performed after screening by ultrasound. In our experience, ultrasound has proved successful for visualizing all of the intracranial cysts except those in the temporal fossa. Most patients with temporal fossa cysts, however, have other symptoms and signs, such as asymmetric head and seizures that lead to further investigation and correct diagnosis despite the failure to identify the temporal cysts by ultrasound. With newer and better ultrasound equipment, the detection of temporal fossa arachnoid cysts will be improved. We believe that neurosonography should be the initial tool for investigating infants and neonates who present with large heads or abnormally rapid increase in head size. PMID- 3540712 TI - Ultrasound evaluation of septo-optic dysplasia in the new born. Report of a case. AB - A newborn female child with hypothermia, tachypnoea and poor Agpar scores was demonstrated to have absent septum pellucidum, partial agenesis of the corpus callosum and misshapen left lateral ventricle on ultrasound examination. Fundoscopic examination noted hypoplastic optic discs. Given the appropriate clinical setting and fundoscopic examination, cranial ultrasound can be the preliminary evaluation for septo-optic dysplasia and related anomalies in infants with open fontanelles. PMID- 3540711 TI - Sonography of the premature brain: intracranial hemorrhage and periventricular leukomalacia. AB - Sonography is very important when evaluating the pre-term central nervous system and can help in the diagnosis of certain diseases. PMID- 3540713 TI - Ultrasonic anatomy of the normal neonatal and infant spine: correlation with cryomicrotome sections and CT. AB - High resolution computed neurosonography now displays the details of the spinal canal, subarachnoid space, spinal cord and some emerging nerve roots in axial and sagittal planes. Those familiar with this anatomy may use sonography to detect spinal pathology. PMID- 3540715 TI - Intraoperative cranial sonography. AB - The use of real time ultrasound in the neurosurgical operating room can enhance the ability to localize intracerebral masses, allow accurate needle biopsies, diminish the amount of potential damage to normal brain tissue, show the results of tumor resection, and help in the placement of ventricular and cyst shunts. The end result makes the surgical procedure faster, safer, and more accurate. PMID- 3540714 TI - Real-time sonographic display of caudal spinal anomalies. AB - Real-time computerized ultrasonography with 3.5 and 5.0 MHz sector and linear array transducers (Acuson) depicts spinal anatomy and pathology more clearly than was possible with previous ultrasonic equipment. Split screen (dual image) techniques display increased lengths of spine in a single image. Articulated arm, B-mode sonography remains useful for older patients in whom the pathology lies far from the transducer and in a few post-operative patients in whom dense scar frustrates real-time examination. Sonography is a very useful screening tool for subcutaneous pathology, meningoceles and lipomas, but, thus far, has failed to demonstrate consistently the presence of hydromyelia, intracanalicular (epi)dermoid tumors and dermal sinus stalks ascending toward conus medullaris. PMID- 3540716 TI - Intraoperative sonography in spinal surgery: current state of the art. AB - Intraoperative spinal sonography (IOSS) has significant impact on the surgical management of spinal lesions. This paper describes the techniques involved, illustrates the sonographic anatomy of the spinal canal and its contents and discusses the role of IOSS in the surgical management of spinal trauma, spinal tumors, spinal stenosis and congenital anomalies. PMID- 3540717 TI - Sonography of the postoperative brain: a report on 2 years of experience. AB - Thirty-seven patients were examined by post-operative high resolution real-time ultrasound over a period of 2 years. Useful data were obtained in all cases but the quality of information obtained was directly related to the size of the cranial window. In each patient, the first sonogram was performed during the 10th to 12th postoperative day to assess ventricular size and midline shift and any fluid collections present. This initial sonogram then served as a baseline study for further follow-up. Subsequent sonograms provided different information about tumor response to chemotherapy and/or irradiation, information not readily obtained by computed tomography. PMID- 3540718 TI - Transcutaneous sonography of the postoperative spine. AB - Transcutaneous sonography of the spine was performed in 83 patients with prior laminectomies for tumors of the spinal canal and the spinal cord. These patients presented with signs or symptoms of recurrent tumor. When the spinal cord could be visualized, the sonographic examination provided information about the presence or absence of tumor, the character (solid or complex) of the tumor and its location, and associated findings in the extramedullary space. The correlation of the transcutaneous sonograms with other imaging methods and with intraoperative sonographic and surgical findings was excellent. Nonvisualization of the spinal cord was found to be related to age with a higher success rate (70% visualized) in the pediatric age group (to age 21) than in the adult group (52% visualized). A very short laminectomy was also found to cause problems in visualizing the full extent of a recurrent tumor. Nonetheless, the simplicity of the technique and the amount of information that can be gained from it make it a very valuable adjunct to other imaging methods for the postoperative spine. For the pediatric age group, it should be one of the first diagnostic methods employed. PMID- 3540720 TI - Neuropeptide Y in the adrenal gland: characterization, distribution and drug effects. AB - The occurrence of neuropeptide Y-like immunoreactivity in the adrenal gland was investigated by means of radioimmunoassay, chromatography and immunohistochemistry. The adrenal levels of neuropeptide Y-like immunoreactivity varied considerably between species with lowest amounts in the rat and highest in the cow where immunoreactivity was observed in chromaffin cells and nerve fibres in the capsule and cortex. The distribution of neuropeptide Y-like immunoreactivity in the cow medulla overlapped that of enkephalin-like immunoreactivity. Chromatographic characterisation of rat and cow adrenal extracts showed that the majority of the neuropeptide Y-like immunoreactivity was similar in molecular weight and solubility properties to porcine neuropeptide Y. Rat adrenal contained additional material some of which may represent oxidised neuropeptide Y. The administration of insulin and reserpine to rats in vivo showed that the turnover of adrenal neuropeptide Y-like immunoreactivity is regulated by the splanchnic nerve. Splanchnic activation following insulin induced hypoglycaemia elicited a 60% depletion of neuropeptide Y-like immunoreactivity 2 h post insulin injection. A smaller (maximum 40%) depletion of neuropeptide Y-like immunoreactivity was measured 24 h after reserpine injections which may be explained by splanchnic activation. Five days after reserpine injections the levels of adrenal neuropeptide Y-like immunoreactivity were increased to 200% of control levels and remained slightly elevated at 25 days. Adrenal enkephalin-like immunoreactivity showed similar but not identical changes following reserpine. The reserpine-induced elevation in neuropeptide Y-like immunoreactivity at the 5-day time point was abolished in rats with a chronic bilateral splanchnectomy. This evidence indicates that neuropeptide Y may be considered as a new adrenal medullary hormone. PMID- 3540719 TI - Standardized echography of the eye and orbit. AB - Standardized echography (pioneered and developed by Dr. Karl Ossoinig) is a state of-the-art method of diagnostic ophthalmic ultrasound. More than sixty (60) orbital and periorbital and eighty (80) intraocular conditions may be detected and differentiated with high reliability. Optimal results can be expected when specified instrumentation and techniques are used by a well trained examiner. Specific instrumentation to be used includes standardized A-scan (i.e. Kretztechnik 7200MA/Ophthascan S), contact B-scan and Doppler instrumentation. A systematic approach to intraocular and orbital examinations includes use of the specific basic examination and special examination techniques. Once a lesion is detected with the basic examination, a variety of acoustic criteria are determined with topographic, quantitative and kinetic examination techniques for lesion differentiation, localization and measurement. In the globe, standardized echography is useful in both opaque media, where fundus view is obscured or prevented, and in clear media as a supplement to the ophthalmoscopic examination. Standardized echography is also useful in the evaluation of orbital and periorbital disease. Mass-like lesions, extraocular muscle and optic nerve conditions may be detected, differentiated and accurately measured. PMID- 3540721 TI - The terminal nerve projects centrally in the hamster. AB - The projections of the peripheral and intracerebral portions of the hamster terminal nerve were examined with lesion and immunocytochemical techniques. After transection, proximal processes of the terminal nerve accumulate luteinizing hormone-releasing hormone-immunoreactive material, while the distal processes disintegrate and are no longer stained. It thus becomes possible to determine the direction of conduction of terminal nerve axons. The results of transection at the level of the cribriform plate, along the olfactory bulb, and in the ventral forebrain were all consistent in indicating a centripetal direction of conduction. Immunoreactive material collected distal to the lesion at each of these levels. All peripheral lesions eliminated processes coursing into and through the terminal ganglion at the base of the ventral forebrain. These lesions left intact, however, the terminal ganglion projections to the accessory olfactory bulb and ventral forebrain. These results indicate a centripetal projection from terminal neurons in the nasal cavity, along the olfactory bulbs and within the terminal ganglion to successively more caudal levels. This suggests that neural messages are conveyed from nasal cavity to the brain through this route. Because immunoreactive fibers were found within the sensory epithelium of the vomeronasal organ a sensory and/or sensory modulatory action is suggested. PMID- 3540722 TI - Acetylcholinesterase and luteinizing hormone-releasing hormone distinguish separate populations of terminal nerve neurons. AB - The terminal nerve is composed of a morphologically heterogeneous population of unipolar, bipolar and multipolar neurons located in the nasal and intracranial cavities of vertebrates. The question has arisen as to whether these neurons are neurochemically heterogeneous and therefore possibly functionally different as well. Among the substances localized in the terminal nerve are acetylcholinesterase and luteinizing hormone-releasing hormone-like immunoreactive material. We have developed a double-label procedure, combining immunocytochemistry and enzyme histochemistry to determine whether these two substances are localized within different populations of terminal nerve neurons. Compatibility of the two procedures was accomplished by modifications of the fixative and primary antibody solutions. In the immunocytochemical step, the avidin-biotin-peroxidase complex coupled to a new chromogen, Chromo-red, produced a bright red reaction product in neurons containing luteinizing hormone-releasing hormone-like material. This reaction product was easily differentiated from the black silver-intensified acetylcholinesterase label. In both neonatal and adult preparations, a large population of terminal neurons contained the acetylcholinesterase label only, whereas a smaller population contained both acetylcholinesterase and luteinizing hormone-releasing hormone-like material. The acetylcholinesterase-containing population of neurons was concentrated peripherally and included multipolar neurons. In contrast neurons with the two substances co-localized were unipolar or bipolar and were concentrated centrally. The simultaneous visualization of acetylcholinesterase and luteinizing hormone releasing hormone-like material in the same tissue section enable the differentiation of two separate neurochemically defined populations of terminal neurons. The distribution of these two neuronal types was the same in neonatal and adult animals. These data provide support for a functional diversity of terminal neurons. PMID- 3540723 TI - Synaptic relationships of a type of GABA-immunoreactive neuron (clutch cell), spiny stellate cells and lateral geniculate nucleus afferents in layer IVC of the monkey striate cortex. AB - The precise stimulus specificity of striate cortical neurons is strongly influenced by processes involving gamma-aminobutyric acid (GABA). In the visual cortex of the monkey most afferents from the lateral geniculate nucleus terminate in layer IVC. We identified a type of smooth dendritic neuron (clutch cell) that was immunoreactive for GABA, and whose Golgi-impregnated dendrites and axon were largely restricted to layer IVC beta. The slightly ovoid somata were 8-12 micron by 12-15 micron and the dendritic field was often elongated, extending 80-200 micron in one dimension. The axonal field was 100-150 micron in diameter and densely packed with large bulbous boutons. Although mainly located in IVC beta both the dendritic and axonal processes entered IVC alpha. Fine structural features of GABA-immunoreactive and-impregnated clutch cells and impregnated spiny stellate cells were compared. Clutch cells had more cytoplasm, more densely packed mitochondria and endoplasmic reticulum, and made type II as opposed to type I synapses. A random sample of 159 elements postsynaptic to three clutch cells showed that they mainly terminated on dendritic shafts (43.8-58.5%) and spines (20.8-46.3%), rather than somata (10-17%). The majority of the postsynaptic targets were characteristic of spiny stellate cells. This was directly demonstrated by studying synaptic contacts between an identified GABA positive clutch cell and the dendrites and soma of an identified spiny stellate cell. The termination of clutch cells mainly on dendrites and spines of spiny stellate cells suggests that they interact with other inputs to the same cells. Following an electrolytic lesion in the ipsilateral lateral geniculate nucleus we examined the distribution of degenerating terminals on three identified spiny stellate neurons in layer IVC beta. Out of eight synapses from the lateral geniculate nucleus one was on a dendritic shaft, the rest on spines. Only a small fraction of all synapses on the cells were from degenerating boutons. A clutch cell within the area of dense terminal degeneration was not contacted by terminals from the lateral geniculate nucleus. The results show that layer IVC in the monkey has a specialized GABAergic neuron that terminates on spiny stellate cells monosynaptically innervated from the lateral geniculate nucleus. Possible functions of clutch cells may include inhibitory gating of geniculate input to cortex; maintenance of the antagonistic subregions in the receptive fields; and the creation from single opponent of double colour opponent receptive fields. PMID- 3540724 TI - Colocalization of gamma-aminobutyric acid and acetylcholinesterase in rodent cortical neurons. AB - We have previously demonstrated that neurons of the rat cerebral cortex which stain positively for acetylcholinesterase are not likely to be cholinergic since they do not colocalize with choline acetyltransferase immunoreactivity [Levey, Rye, Wainer, Mufson and Mesulam (1984) Neuroscience 9, 9-22]. These noncholinergic acetylcholinesterase-positive cells were similar in morphology to cortical neurons which localize gamma-aminobutyric acid or glutamate decarboxylase immunoreactivity. In order to investigate the possibility that the two substances may be colocalized to the same cortical neurons, gamma aminobutyric acid immunohistochemistry and acetylcholinesterase histochemistry were combined in single sections of rat cerebral cortex. We found that 18% of gamma-aminobutyric acid-immunoreactive cortical neurons are also acetylcholinesterase-positive, and about 36% of acetylcholinesterase-positive cells are gamma-aminobutyric acid-immunoreactive. Neurons which colocalized both substances were multipolar and bipolar neurons in cortical laminae II-VI and were observed in every cortical area examined. The possibility that gamma-aminobutyric acid-immunoreactive/acetylcholinesterase-positive cortical neurons may be postsynaptic targets of cholinergic afferents to the cerebral cortex is discussed. PMID- 3540725 TI - Lymphocytic adenohypophysitis causing pituitary mass. AB - Lymphocytic infiltration of the anterior pituitary is a rare complication of pregnancy, which has been reported in 18 cases. Symptoms begin in the last trimester or soon after delivery. Radiologically, an expanding mass in the sella may result in suprasellar extension. We studied a case in which there was CT evidence of a pituitary mass 2 weeks postpartum, and biopsy confirmed the diagnosis. PMID- 3540727 TI - [B-mode echography for high resolution of the carotid axis]. PMID- 3540728 TI - [Angiography in the study of carotid pathology]. PMID- 3540726 TI - [The Doppler technic in the diagnosis of extracranial carotid disease]. PMID- 3540729 TI - [The role of Doppler, B-mode and duplex scanning echography in the diagnosis of arteriopathy of the subclavian-vertebral axis]. PMID- 3540730 TI - [Medicine and Piedmontese physicians in the late 19th century]. PMID- 3540731 TI - [Cefotiam, a new cephalosporin. Microbiological research, preliminary evaluation of its effect on phagocytosis and clinical multicenter research]. AB - After a brief review of the data on cefotiam in the literature the report presents the results of microbiological research, a preliminary study into the drug's possible actions on phagocytosis and a polycentric clinical study of 93 cases of broncho-pleuro-pulmonary pathology and one sinusitis of the jaw. In vitro cefotiam was found to have an excellent inhibitory effect on gram positive and gram negative bacteria with MICs50 and 90 respectively 0.2 and 0.8 mcg/ml V. Staph. aureus, Str. pyogenes. E. Coli, K. pneumoniae and Pr. mirabilis. A dose dependent increase in phagocytosis was noted. The clinical response was excellent with 90.43% (88/94) of the cases achieving clinical and radiological cure or very much improved. Cefotiam was very well tolerated with the appearance of 2/94 skin rashes (2.12%). The liver and kidney parameters showed no change at the end of treatment. No increase in enzymuria was noted during treatment with cefotiam. PMID- 3540732 TI - [Echographic evaluation of large pelvic swellings. Clinical experience]. PMID- 3540733 TI - Comparison of phlebitis rates with Buretrol and Harvard Mini-Infuser for administration of i.v. piggyback medications. PMID- 3540734 TI - Nicotine-induced increases in brain luteinizing hormone releasing hormone-like immunoreactivity and in serum luteinizing hormone levels of the male rat. AB - By means of radioimmunoassay procedures luteinizing hormone releasing hormone (LHRH)-, Metenkephalin- and somatostatin-like immunoreactivities have been measured in discrete hypothalamic and preoptic nuclei as well as serum luteinizing hormone (LH) levels. Nicotine (2 mg/kg, i.p.) produced after 5 min a significant and selective increase in LHRH-like immunoreactivity in the median eminence and in the medial preoptic nucleus, associated with increases in serum LH levels but without any changes in Met-enkephalin and somatostatin-like immunoreactivities in the median eminence. The results indicate that the nicotine induced activation of LHRH-immunoreactive neurons involves an enhanced processing of the precursor peptide to LHRH. PMID- 3540735 TI - Computer-assisted instruction: is it really your best choice? PMID- 3540736 TI - Livestock toxicosis, slobbers, locoism, and the indolizidine alkaloids. PMID- 3540737 TI - The evolution of serum lipoproteins in infancy. PMID- 3540738 TI - Nutrition classics. Journal of the American Chemical Society, Vol. 79, March 20, 1957: No. 6. Determination of structure of beta,delta-dihydroxy-beta methylvaleric acid. By Donald E. Wolf, Carl H. Hoffman, Paul E. Aldrich, Helen R. Skeggs, Lemuel D. Wright and Karl Folkers. PMID- 3540739 TI - Zinc and fetal alcohol syndrome: another dimension. PMID- 3540740 TI - Bone loss in amenorrheic athletes. PMID- 3540741 TI - Kinetics of insulin action in obesity. PMID- 3540742 TI - Nutrition classics. The observations of Sir Richard Hawkins, knight, in his voyage into the South Sea, anno Domini, 1593. PMID- 3540743 TI - Vitamin D and insulin secretion. PMID- 3540744 TI - Regulation of aromatic amino acid catabolism. PMID- 3540746 TI - Rose: a case of terminal pain. PMID- 3540745 TI - Alternative methods of pain relief. PMID- 3540747 TI - Preventing, recognizing, and treating diabetic shock (continuing education credit). PMID- 3540748 TI - Is balance billing doomed? PMID- 3540749 TI - Polycythemia rubra vera. PMID- 3540750 TI - A historical overview of the recognition of appendicitis--Part I. PMID- 3540751 TI - Nurses' past mirrors nursing's future. PMID- 3540752 TI - Creating a transplanted abutment. A case report. PMID- 3540753 TI - Osseointegration: an overview. PMID- 3540754 TI - A critical review of the "osseointegrated" literature. PMID- 3540755 TI - Leslie W. Seldin, 1987 President of the DSSNY. PMID- 3540756 TI - On the possibility of swallowed or inhaled dental objects. PMID- 3540757 TI - A history of drills and drilling. PMID- 3540758 TI - Replication by silicone impression materials in crown and bridge construction. PMID- 3540759 TI - Vesicouterine fistula--a review. AB - Ninety-two cases of vesicouterine fistula reported in the world literature since 1908 are reviewed. The lesion was rarely seen before 1947. It usually followed a vaginal operative delivery and the usual complaint was total urinary incontinence. Diagnosis was most often made indirectly by seeing urine or dye pass through an intact external cervical os. Management usually involved a vaginal, surgical approach to repair. Since 1947, vesicouterine fistula, while not common, is no longer rare. It occurs most often after low segment cesarean section. While urinary incontinence may occur, the major symptom is cyclic hematuria (menouria). The diagnosis is best made by hysterogram performed with a short-tipped cannula. Management consists of an abdominal, surgical approach, the technique of which varies with the patient's need for future reproductive capacity. PMID- 3540760 TI - Abnormal pregnancy sonogram: selective indication for fetal karyotype. AB - The inability to make a definitive diagnosis in the fetus with a sonographically identified abnormality often results in parental and physician uncertainty. An antenatal chromosome evaluation could resolve this uncertainty. Forty-one fetuses with an abnormal ultrasound examination were tested for karyotypic abnormality using a variety of specimens. Nearly one-third (13 of 41) of these fetuses had various chromosome abnormalities. There were only seven survivors in this series, underscoring the often poor prognosis when a significant ultrasound defect is detected antenatally. Knowledge of the fetal chromosome constitution in the setting of an abnormal ultrasound has important epidemiologic, cost-benefit, counseling, and pregnancy management implications. PMID- 3540761 TI - Polyhydramnios: ultrasonically detected prevalence and neonatal outcome. AB - During obstetric ultrasound examinations of 10,214 patients at a tertiary perinatal unit, 102 cases of mild to severe polyhydramnios were detected, a prevalence rate of 1.04%. When referred patients were excluded, a prevalence rate of 0.93% was obtained. An etiology for polyhydramnios was apparent in 16.5% of patients with mild polyhydramnios. When polyhydramnios was characterized as moderate or severe, a definable cause was determined in 21 of 23 patients (91.3%). PMID- 3540762 TI - Atypical squamous cells in Papanicolaou smears. AB - Between 1980 and 1984, 406 patients were referred to Tripler Army Medical Center's cervical clinic for the evaluation of atypical squamous cells in a Papanicolaou smear. Their evaluation included repeating the smear, colposcopy in all cases, colposcopically directed biopsies, and/or endocervical curettage in 70%. The results of the repeat Papanicolaou smear in 400 patients were 274 (68.5%) negative, 77 (19%) atypical squamous cells, 40 (10%) cervical intraepithelial neoplasia (CIN) 1, seven (2%) CIN 2, and two (0.5%) CIN 3. No invasive cancer was detected. Dysplasia was documented histopathologically in 18.7%, but a repeat smear was reported as negative in 10.9% of patients with biopsy-proven dysplasia. A Papanicolaou smear report of atypical squamous cells should not be considered normal, and further evaluation of the patient is required. If colposcopy is impractical, serial follow-up smears are recommended. PMID- 3540763 TI - Perinatal management and outcome of fetal ventriculomegaly. AB - In 20 consecutive cases of fetal ventriculomegaly, diagnosed by antenatal ultrasound examination, hydrocephalus was isolated in six patients (30%) and was associated with other anomalies in 14 (70%). There were no false positive diagnoses of fetal ventriculomegaly in this series. Fetal structural and/or chromosome abnormalities were diagnosed antenatally in 11 of the 14 patients (78.5%) with postnatally documented anomalies. In ten patients (50%), isolated fetal ventriculomegaly or ventriculomegaly associated with spina bifida was diagnosed antenatally, and the perinatal management consisted of frequent ultrasound examinations, weekly fetal biophysical profiles, and delivery by cesarean section after documenting fetal lung maturity. Ventriculo-amniotic shunt placement was not part of the management. The outcomes were induced abortion, four patients (20%); intrapartum death, two patients (10%); postnatal death, five patients (25%); and currently alive, nine patients (45%). PMID- 3540765 TI - [The hygienic pontic]. PMID- 3540764 TI - Acupuncture for the management of primary dysmenorrhea. AB - The effectiveness of acupuncture in managing the pain of primary dysmenorrhea was investigated in a randomized and controlled prospective clinical study. Forty three women were followed for one year in one of four groups: the Real Acupuncture group was given appropriate acupuncture and the Placebo Acupuncture group was given random point acupuncture on a weekly basis for three menstrual cycles; the Standard Control group was followed without medical or acupuncture intervention; the Visitation Control group had monthly nonacupuncture visits with the project physician for three cycles. In the Real Acupuncture group, 10 of 11 (90.9%) women showed improvement; in the Placebo Acupuncture group, 4 of 11 (36.4%); in the Standard Control group, 2 of 11 (18.2%); and in the Visitation Control group 1 of 10 (10%). There was a 41% reduction of analgesic medication used by the women in the Real Acupuncture group after their treatment series, and no change or increased use of medication seen in the other groups. PMID- 3540766 TI - [Stress analysis of the alveolar bone in applying a T-shaped plate implant to a free-end bridge using a 2-dimensional photoelastic method]. PMID- 3540767 TI - [2-dimensional photoelastic stress analysis of the alveolar bone in applying a screw-type implant to a 4-unit bridge]. PMID- 3540768 TI - Concepts on free-end extension removable partial dentures. PMID- 3540769 TI - The scleral yoke suture for anterior segment surgery. AB - A safe effective method of global control during anterior segment surgery is presented. The method used in 1184 consecutive cases was the scleral yoke traction suture adapted from a method often used in strabismus surgery. The incidence of postoperative ptosis severe enough to require surgical correction is presented in that group as well as in a group of 591 consecutive cataract extractions utilizing the classic superior rectus traction surgery. The principle advantages of this method as compared to the classic superior rectus traction suture are pointed out, with emphasis on the reduction of postoperative ptosis. PMID- 3540770 TI - Clinical and immunological results of corneal allograft rejection. AB - Of 111 episodes of graft rejection in 66 patients, 62 responded to therapy with graft clearing (responders); 49 did not (non-responders). Both groups were of similar age, sex, and etiology; both had a similar rate of glaucoma and a similar rate of previous grafting. In responders the graft reaction was shorter in duration (2.2 vs. 5.6 wks. p less than 0.005), and it was necessary to increase the number of glaucoma medications more often in non-responders compared to responders (41% vs. 19%, p less than 0.02). The interval from surgery to reaction was similar in responders and non-responders (18.2 vs. 13.3 mos., p greater than 0.1). An epithelial rejection line was present in 11% of responders, but was not present in non-responders (p less than 0.05). Lymphocytotoxic antibody development correlated with rejection in 16 of 64 episodes. Patients who responded to treatment were more frequently asymptomatic (p less than 0.05) or were treated earlier following the onset of symptoms compared to non-responders (p less than 0.0001). PMID- 3540771 TI - Long-term results of keratoplasty in eyes with intraocular lenses. AB - We present a retrospective study of our patients who had penetrating keratoplasty in eyes which had intraocular lenses in situ. Our results show that although the short-term result was good with any kind of intraocular lenses, the long-term (more than five years) graft survival was better if intraocular lenses with pre iridial optics were removed and/or replaced at the time of the grafting with posterior chamber lenses. PMID- 3540772 TI - Management of mandibular trauma with rigid internal fixation. AB - The use of rigid internal fixation has become an acceptable method for the treatment of fractures and continuity defects of the mandible. This technique has a wide variety of applications, including stabilization of mandibular segments for the application of bone grafts. The primary advantage of rigid fixation is that it obviates the need for maxillomandibular fixation associated with the treatment of mandibular trauma by traditional methods. This article reviews twenty cases in which rigid internal fixation was used for the treatment of fractures and continuity defects of the mandible. In only one case was early removal of the implant necessary as a result of infection. PMID- 3540773 TI - Intentional replantation. AB - Intentional replantation is an accepted endodontic procedure for treating teeth in cases in which intracanal and/or surgical endodontic treatments are not recommended. Although not a frequently used technique, intentional replantation is a treatment option that dentists should consider. An unusual case is described in which intentional replantation was required to maintain the tooth in the dentition. A 31 month follow-up evaluation revealed an asymptomatic, functional tooth with no radiographic signs of pathosis. PMID- 3540774 TI - Management of malunion and nonunion of the tibia. AB - When treating acute tibial shaft fractures, every attempt should be made to prevent malunion or nonunion of the tibia. When these complications occur, tibial osteotomy and intramedullary nailing is a functional treatment alternative when infection is not present. Treatment of an infected nonunion usually requires staged protocol using several surgical procedures to effect an acceptable outcome. PMID- 3540775 TI - Subtrochanteric-intertrochanteric femoral fractures. AB - Subtrochanteric fractures can be managed effectively with newer techniques and implants. If the proximal fragment is intact and includes the lesser trochanter, an interlocking intramedullary nail is indicated. If there is inter subtrochanteric comminution, a screw-plate device with bone graft, or a Zickel nail should be used. PMID- 3540776 TI - Management of open grade III tibial fractures. AB - The successful management of grade III tibial injuries integrates an organized injury assessment schema, debridement, stabilization, and reconstruction protocols that assure maximal functional results. PMID- 3540777 TI - [Clinical experience with trans-cervical chorion biopsy]. PMID- 3540779 TI - [Esztergom in World War I (Janos Fonyo)]. PMID- 3540778 TI - [Ultrasonic diagnosis of the gastrointestinal system]. PMID- 3540780 TI - [Documents of the founding of the Koranyi Hospital for Indigents]. PMID- 3540781 TI - [In memory of Endre Steinmetz, M.D]. PMID- 3540782 TI - [Antibiotic resistance and plasmid profile of E. coli and Klebsiella strains isolated from hospitalized patients under prolonged antibiotic therapy]. PMID- 3540783 TI - [In vivo evaluation of the effectiveness of a cefamandole-tobramycin combination]. PMID- 3540784 TI - [Long-term effect of disulfiram implants in chronic alcoholics]. PMID- 3540785 TI - [Lessons for the present, learned from the creative work of Markusovszky]. PMID- 3540786 TI - [Kosztolanyi's radiotherapy in Stockholm]. PMID- 3540787 TI - [In memory of Istvan Gyory (1861-1954)]. PMID- 3540789 TI - [Ultrasonic diagnosis of subcortical cystic leukomalacia]. PMID- 3540788 TI - [Growth hormone secretion in diabetic patients under intensive insulin treatment]. PMID- 3540790 TI - [Comparative evaluation of ultrasonic studies and invasive methods for the imaging of the bilio-pancreatic ducts]. PMID- 3540791 TI - [Centenary of Tivadar Huzella's birth]. PMID- 3540792 TI - [Andras Fay and public health in Hungary]. PMID- 3540793 TI - [Diurnal shifts of 2,3-diphosphoglycerate in diabetics and healthy subjects]. PMID- 3540794 TI - [Breast feeding in the hospital]. PMID- 3540795 TI - [Nursing a patient with diabetes mellitus--supplement to nursing documentation]. PMID- 3540796 TI - Soft tissue tumors: unusual forms. AB - A variety of soft tissue tumors can occur in the head and neck area. Because, with the possible exception of rhabdomyosarcoma, they are seen less often in these sites than in the trunk and extremities, they can pose special problems in diagnosis, classification, and management. PMID- 3540797 TI - NonHodgkin's lymphomas of the upper aerodigestive tract and salivary glands. AB - The symptoms, signs, diagnosis, work-up, pathology, and treatment of nonHodgkin's lymphomas of the upper aerodigestive tract and salivary glands are described. PMID- 3540798 TI - Radiation therapy for nonsquamous tumors of the head and neck. AB - Recent advances in the understanding of the natural history and modes of spread of the nonsquamous malignancies of the head and neck region have delineated an important role for radiotherapy in their management. The indications for primary radiotherapy include malignant lymphoma of the thyroid, idiopathic midline granuloma, midline malignant reticulosis, extramedullary plasmacytomas, esthesioneuroblastomas, and locally aggressive benign tumors, such as glomus tumors, angiofibromas, and hemangiomas. Although the traditional treatment for malignant melanoma is surgery, indications are emerging for high-dose radiotherapy, either as the only modality or in addition to surgery. Combined radiotherapy and chemotherapy is the treatment choice for nonHodgkin's lymphomas of the Waldeyer's ring and for Ewing's sarcomas. High-grade soft tissue sarcomas and salivary gland malignancies are best treated with surgery and postoperative radiotherapy. The use of megavoltage photons and electrons, custom-made blocks delineating the treatment volume, tissue compensators, patient immobilization devices, and simulator-aided treatment planning are mandatory to achieve loco regional control and to minimize the treatment-related morbidity. PMID- 3540799 TI - Hemangiomas, lymphangiomas, and vascular malformations of the head and neck. AB - The etiology, diagnosis, and treatment modalities of common and not so common vascular malformations of the head and neck are discussed in this article. PMID- 3540800 TI - The role of pituitary hormones, growth factors and insulin in the regulation of fetal growth. PMID- 3540801 TI - Normal and abnormal testicular descent. PMID- 3540802 TI - Varicocele and its role in male infertility. PMID- 3540804 TI - Immunological disorders of human pregnancy. AB - Three types of disorders of human pregnancy with a possible immune etiology have been discussed. Pre-eclampsia and recurrent abortion may result from a failure of a maternal immunoregulatory response to trophoblast but the evidence is incomplete and circumstantial. There are several fetal problems which may arise because of transfer of maternal allo-, iso-, or autoantibodies to the fetus. Third, maternal graft-versus-fetal-host disease occurs rarely and may present in a delayed and incomplete way as severe combined immunodeficiency. PMID- 3540803 TI - Sexual and reproductive problems of paraplegic men. PMID- 3540805 TI - Role of the pineal gland and melatonin in seasonal reproductive function in mammals. PMID- 3540806 TI - Hormonal control of ovarian luteal cells. PMID- 3540807 TI - Embryo manipulation in farm animals. PMID- 3540808 TI - The reproductive biology of prolific sheep breeds. PMID- 3540809 TI - Parturition. PMID- 3540810 TI - Psychological aspects of painful medical conditions in children. I. Developmental aspects and assessment. AB - The assessment and development of pain in children is reviewed in the first part of a two-part series. Assessment of pain in children has relied on self-report measures that have included visual analogue procedures using concrete stimuli for ratings. Behavioral assessment procedures are more sophisticated, but research on behavioral assessment of pediatric pain has begun to emergy only recently. There has been very little research on the developmental aspects of pain tolerance and pain threshold in children. There are preliminary indications that children's thoughts and attitudes about pain may change with age in a manner that contributes to more intense feelings of pain in adolescence than childhood. Children undergoing painful medical procedures show declining emotional outbursts with age and increasing signs of self-control and muscular rigidity. Possibilities for integrating the study of the developmental aspects of pain with social learning theory, cognitive developmental theory, and the psychology of physical symptom perception are discussed. PMID- 3540811 TI - Psychological aspects of painful medical conditions in children. II. Personality factors, family characteristics and treatment. AB - In part II of a two-part series, the psychological aspects of painful medical conditions and their treatment are reviewed. While considerable attention has been devoted to the study of personality, family characteristics, treatment of recurrent abdominal pain, growing pains and headaches, with few exceptions these studies have significant methodological problems. Studies of the psychological aspects of pain associated with such pediatric disorders as cancer, sickle cell anemia, juvenile rheumatoid arthritis, and burns are generally only beginning to emerge, but at least a few of the single-case studies show appropriate attention to methodology. Areas needing further research are discussed. PMID- 3540812 TI - Analgesic sensitivity of two post-partum pain models. AB - Post-partum uterine cramping and episiotomy pain are established, frequently used, clinical pain models for efficacy trials of investigational new analgesic agents. To determine the respective assay sensitivity of these two models in assessing relative efficacy, we reviewed data from 6 phase II, randomized, stratified, parallel, placebo-controlled, double-blind, single-dose studies involving hospitalized women with moderate or severe post-partum uterine cramping (332 patients) or episiotomy pain (434 patients). Using subjective reports as indices of response, patients rated pain intensity and relief at periodic interviews for 6-7 h. Post-partum uterine cramping showed excellent assay sensitivity for detecting differences among peripherally acting analgesics. In the same clinical trial this model could discriminate between a new drug and aspirin 650 mg, a standard reference analgesic, and between 2 graded doses of the new active agent (i.e., good upside sensitivity). In addition the uterine cramp model showed separation between placebo and all active agents (i.e., good downside sensitivity). Episiotomy pain demonstrated similar upside and downside discrimination in clinical trials of several weak centrally acting drugs. These data suggest that post-partum cramping is an excellent pain model for analgesic investigation of new non-steroidal anti-inflammatory drugs, and episiotomy pain for new weak narcotic and opioid analgesics. PMID- 3540813 TI - The effects of transcutaneous electrical nerve stimulation on post-cesarean pain. AB - The purpose of this study was to examine the effect of continuous transcutaneous electrical nerve stimulation (TENS) near the incision site on post-cesarean pain and on analgesic intake during the early postoperative period. This investigation utilised a 2-group (TENS-treated and placebo TENS-treated), single-blind experimental design. Eighteen multiparous women, each having undergone an elective cesarean delivery, participated in the study. Nine patients received TENS and nine placebo stimulation. The treatment was continuous through to the third day following the day of surgery. The McGill Pain Questionnaire was used to estimate the three most frequent types of post-cesarean-associated pain, and records of the patients' analgesic intake were obtained from hospital charts. The results suggest that TENS was significantly more effective than placebo TENS in reducing cutaneous, movement-associated incisional pain. However, pain resulting from internal structures, i.e., deep pain, afterbirth pain (due to uterine contractions), and the somatic pain associated with decreased peristalsis (gas pains) were not amenable to TENS. No significant differences in analgesic intake were observed. The possible reasons for these findings are discussed. PMID- 3540814 TI - Evidence for the involvement of cerebral renin-angiotensin system (RAS) in stress analgesia. AB - Studies concerning variations of the central renin-angiotensin system (RAS) during immobilization stress in rats have shown a significant increase in renin like activity in the hypothalamus and fronto-parietal cortex, together with a definite decrease in the hypophysis and pineal gland. The resultant stress analgesia is blocked by the previous administration of naloxone and saralasin (angiotensin II antagonist). The intracerebral administration of renin and angiotensin II produces an increase in latencies to thermoalgesic stimuli; this is reduced, as is immobilization stress, by naloxone and saralasin. Both chemical hypophysectomy obtained by dexamethasone pretreatment as well as surgical epiphysectomy block the stress-induced analgesia. The experimental data obtained argue in favour of the participation of the cerebral RAS in stress analgesia through the indirect mechanism of release of opioid peptides. PMID- 3540815 TI - The psychologic effects of immobilization on the pediatric orthopaedic patient (continuing education credit). PMID- 3540816 TI - Inhibition of malarial invasion by intracellular antibodies against intrinsic membrane proteins in the red cell. AB - It has previously been shown that antibodies against the transmembrane proteins, band 3 and glycophorin A, inhibit entry of the merozoite into the red cell and, in the case of band 3, it was established that attachment of the parasite to the cell is not prevented. We have found that antibodies against the cytoplasmic domains of band 3 and of glycophorin A, when present in the interior of resealed ghosts of human red cells, also inhibit invasion by P. falciparum. It is inferred that attachment of the merozoite to the red cell causes structural effects that are transduced to the membrane cytoskeleton and the antibodies against transmembrane proteins interfere with the invasion sequence at this level. PMID- 3540818 TI - Immunochemical analysis of Taenia taeniaeformis antigens expressed in Escherichia coli. AB - Previously we reported the isolation of several Escherichia coli clones expressing fragments of Taenia taeniaeformis antigens as beta-galactosidase fused proteins (Bowtell, Saint, Rickard & Mitchell, 1984). Here we describe the isolation of additional antigen-expressing clones from a larval cDNA library and the assignment of these clones to 7 antigen families. These were isolated with a polyspecific rabbit antiserum raised to the oncosphere. Since this serum was capable of reacting with a large number of antigens, it was important to develop techniques for rapidly determining the identity of the native T. taeniaeformis molecule corresponding to a cloned antigen gene. These included active immunization of rabbits with fused proteins and several techniques involving affinity purification on immobilized fused proteins. The reactivity of the antigen-positive clones with sera from humans infected with related parasites was also assessed. Finally, immunization of mice with several fused proteins failed to protect against subsequent infection, although antigens previously identified as candidate host-protective antigens (Bowtell, Mitchell, Anders, Lightowlers & Rickard, 1983) have yet to be identified in the expression library. PMID- 3540817 TI - Antigenic characterization of adult Wuchereria bancrofti filarial nematodes. AB - Adult Wuchereria bancrofti were recovered from infected Presbytis cristatus monkeys and radio-isotope labelled extrinsically with 125I and in vitro with [35S]methionine. 125I labelling of the surface of adult W. bancrofti permitted a comparison between the major surface antigens of this species and those from the related lymphatic filariae, Brugia malayi and B. pahangi. All species bear a prominent Mr 29,000 surface antigen but among the differences observed were the strongly labelled molecules with Mr 58,000 and 67,000 in W. bancrofti which are extremely faint in the Brugia species. The [35S]methionine label was effectively incorporated into somatic parasite proteins in vitro although it was not possible to identify any secreted proteins in this way. The antigenicity of these products was investigated using a variety of sera from homologous and heterologous infections and the immunoprecipitation patterns highlighted particular differences between somatic proteins of male and female worms. One secreted antigen was detected, however, by virtue of its phosphorylcholine epitopes, in the culture medium of mixed adult worms; medium from male W. bancrofti adults was negative although homogenates of either sex of adult W. bancrofti were strongly positive in the same system. PMID- 3540819 TI - [Mechanisms of the effect of specific immunotherapy (hyposensitization) in atopic diseases]. PMID- 3540820 TI - [The scientist, the teacher and the man (on the 90th anniversary of the birth of N.N. Sirotinin)]. PMID- 3540822 TI - Blood group antigens on fetal red cells obtained by umbilical vein puncture under ultrasound guidance: a rapid hemagglutination test to check for contamination with maternal blood. AB - Seventy-two fetal blood samples obtained by umbilical vein puncture under ultrasound guidance for prenatal diagnosis and monitoring purposes were tested for the expression of 38 blood group antigens. The gestational age at sampling ranged from 18 to 34 wk with 76% of fetuses between 20 and 25 wk. Compared to adult red blood cells, the following antigens showed either abnormally decreased frequency, or significantly reduced expression: A, B, A1, H, Lua, Lub, Lea, Leb, P1, P, and I. Selected anti-I and anti-i cold agglutinins, active at room temperature, were used at appropriate dilution, in a rapid slide or spin test to check for possible mixture of the sample with maternal blood and were shown to detect contaminations up to 5%. The test has proved particularly helpful for immediate and in process assessment of foetal origin of the sampled blood. PMID- 3540821 TI - [Free-radical oxidation and its role in the pathogenesis of inflammation, ischemia and stress]. PMID- 3540823 TI - The catecholamine response to hypoglycemia in children with isolated growth hormone deficiency syndromes and multiple pituitary hormone defects. AB - We examined the catecholamine response to insulin-induced hypoglycemia in 46 short children evaluated for growth hormone (GH) deficiency by both pharmacologic stimulation and integrated concentration of GH. Twelve patients had quantitatively normal GH secretion by both pharmacologic stimulation and integrated concentration of GH (GHNORM). Twenty-two patients had normal GH to pharmacologic stimulation but subnormal integrated concentration of GH (GHND). Twelve patients had GH deficiency by both tests (GHD): six had isolated GH deficiency (GHD type 1) and six had multiple hormone deficiencies (GHD type 2). There was no significant difference between the peak epinephrine, norepinephrine, and cortisol responses of GH-NORM, GHND, and GHD type 1 patients. The mean peak epinephrine response of GHD type 2 patients was significantly lower (564 +/- 561 pg/ml, p less than 0.03) compared to the other patient groups. There was no significant difference between the peak norepinephrine levels between GHD type 2 patients and the remaining groups. There was no correlation between decrease in blood glucose and either increase in growth hormone, catecholamine, or cortisol concentrations. There was a significant correlation between log peak epinephrine and peak cortisol response (r = 0.53, p less than 0.0002) of the 46 subjects. Neither the basal nor stimulated catecholamine levels correlated with the integrated concentration of cortisol. We conclude that isolated GH deficiency is not associated with impairment of the catecholamine response to hypoglycemia; impairment of the epinephrine response to hypoglycemia is only associated with multiple pituitary hormone deficiencies; in children, the degree of glucose lowering is not correlated with the magnitude of peak GH, catecholamine, or cortisol responses. PMID- 3540824 TI - Lymphocyte subsets identified by monoclonal antibodies in healthy children. AB - The distributions of lymphocyte subsets and monocytes in the peripheral blood mononuclear leukocytes of 72 normal children from 2 months to 13 5/12 yr were examined using quantitative immunofluorescence analysis with monoclonal antibodies. Distinct decreases with age were found in the total leukocyte counts, the percentages and the absolute numbers of peripheral blood mononuclear leukocytes. The percentages of Leu-2a+ cells, Leu-7+ cells, and Leu-M3+ cells significantly increased with age, whereas the percentages of Leu-3a+ cells, Leu 4+ cells, and 2H7+ cells significantly decreased with age. As a result, ratios of Leu-3a+/Leu-2a+ decreased with age. No prominent differences with age were found in the proportions of Leu-10+ cells and HLA-DR+ cells. PMID- 3540825 TI - Lack of toxicity of oral and intrapulmonary group B streptococcal lipoteichoic acid. AB - Lipoteichoic acid (LTA) was prepared from type III group B streptococci and administered by topical oral application or intravenous or intratracheal injection in weanling and adult white New Zealand rabbits. Tritiated [3H]LTA in tissues and body fluids was measured by scintillation spectrometry. Five minutes to 120 h after intravenous injection of 10 mg (17 x 10(6) dpm) of [3H]LTA, none was present in blood. Combined urine and fecal excretion peaked at 24 h and decreased over 5 days. There was no effect on collagen-induced platelet aggregation. [3H]LTA concentrations were greatest in colon, bone, stomach, and skin 1 day after intravenous injection. After a 5-mg oral dose (8.5 x 10(6) dpm) in an adult animal, fecal excretion peaked at 24 h and decreased after 4 days. No systemic absorption was noted. No [3H]LTA was found in any of seven tissues examined at autopsy 3 days after 1 to 5 mg/kg oral doses in weanling animals with normal or traumatized buccal mucosa. No effect was noted on platelet aggregation or serum complement, there was no increase in the incidence of nephrocalcinosis and the buccal mucosa remained histologically normal. Intratracheal injection of 0.5 to 2.5 mg/kg of LTA resulted in no tachypnea or alteration in blood gases. All animals remained healthy after LTA administration. The absence of toxicity and absorption in animals suggests that studies could be performed in humans to evaluate the safety and efficacy of oral LTA. PMID- 3540826 TI - Decreased baseline beta-lactamase production and inducibility associated with increased piperacillin susceptibility of Pseudomonas cepacia isolated from children with cystic fibrosis. AB - The incidence of pulmonary infections in children with cystic fibrosis caused by Pseudomonas cepacia, an organism which may possess an inducible beta-lactamase, has increased since 1978. Seven of 13 sputum isolates of P. cepacia from children with cystic fibrosis were classified as inducible by quantitative enzyme production following preincubation with 100, 200, or 400 micrograms/ml of cefoxitin. The recovery of inducible strains tended to be associated with recent ceftazidime therapy. Susceptibility to aztreonam, ceftazidime, and piperacillin alone or combined with the beta-lactamase inhibitors. YTR 830 or sulbactam, and isoelectric focusing for beta-lactamase were performed. Inducible isolates produced significantly more beta-lactamase than noninducible strains with or without the addition of cefoxitin. Noninducible isolates were more susceptible than inducible isolates to 8 micrograms/ml of piperacillin, a difference that was eliminated with the addition of either beta-lactamase inhibitor. Twelve of 13 strains produced a beta-lactamase band in the pH range of 7.9-8.1; no differences in satellite patterns were noted between the two groups of organisms. Increased production of beta-lactamase in the absence of an inducer may account for piperacillin resistance in P. cepacia in children with cystic fibrosis. PMID- 3540827 TI - The comparison of myocardial dysfunction in three forms of experimental septic shock. AB - A rabbit model of septic shock was used to determine if myocardial dysfunction is a common component of shock due to diverse neonatal pathogens, and prostaglandins modulate septic myocardial dysfunction. The infusion of heat-killed Escherichia coli (group I), Haemophilus influenzae (group II), or Staphylococcus epidermidis (group III) produced significant decreases in the first derivative of left ventricular pressure with respect to time (p less than 0.05). Each organism also produced significant changes in mean arterial pressure, cardiac output, and heart rate, while pulmonary artery pressure was altered in groups I and III. Saline infused control animals (group IV) exhibited no significant changes in any hemodynamic variable. Blood gas variables were not significantly changed in any group. These cardiovascular changes appeared dependent on arachidonic acid metabolism since indomethacin pretreatment prevented the cardiovascular changes induced by bacterial infusion. These results suggest that septic myocardial dysfunction is a common component of gram-negative and gram-positive septic shock, and that myocardial dysfunction is modulated by prostaglandin products. PMID- 3540828 TI - Complement activation in cystic fibrosis respiratory fluids: in vivo and in vitro generation of C5a and chemotactic activity. AB - Experiments performed in vitro have demonstrated that leukocyte neutral proteases produce an important mediator of inflammation, C5a, by proteolysis of the C5 component of the complement system. Cystic fibrosis (CF) lung fluids were characterized by high levels of neutrophils (39% of total cells versus 2% in normals) and contained significantly elevated amounts of elastolytic activity (mean 17.7 ng/micrograms total protein) compared to the lung fluids obtained from normal volunteers (0.2 ng elastolytic activity/micrograms protein, p = 0.001). The objective of these studies was to determine if complement activation and complement-derived chemotactic activity are present in CF lung fluids. C3c peptide representing activation of C3 could not be identified in the bronchial alveolar lung lavage fluids of normal subjects but was readily identified by means of crossed immunoelectrophoresis in CF lung fluids (n = 9, mean 49% of C3); the mean level of C3 was decreased in CF lung specimens. Chemotactic activity was significantly elevated in lung fluids of the CF patients when compared to normal lung fluids. Using gel-filtration chromatography and a sensitive radioimmunoassay the chemotaxin present in CF specimens was identified as the anaphylatoxin C5a. C5a levels in the bronchial-alveolar lavage fluids of CF patients was inversely related to volume in liters expired in 1 s of a forced expiratory maneuver expressed as a percent of vital capacity determined from a forced expiratory maneuver (r = -0.72). Because there was a direct relationship between the total elastolytic activity present in CF airways and the concentration of C5a (r = 0.97, p = 0.03), it was postulated that airway proteases with elastolytic activity also cleave C5, nonimmunologically producing C5a. Detailed inhibition assays revealed that much of the total elastolytic activity had the inhibition profile of a serine proteinase. The levels of the serine proteinases were closely correlated with the numbers of neutrophilic leukocytes present per ml of lavage fluid (r = 0.7, p = 0.05). However, inhibitors of leukocyte serine proteases did not prevent the generation of additional chemotactic activity and the proteolysis of radiolabeled C5 substrate was not prevented by inhibitors of neutrophil elastase. Although the purified metalloelastase of Pseudomonas aeruginosa was active on cell-bound and free C5 yielding C5a, inhibition of this bacterial protease in CF lung fluids only partially blocked cleavage of the alpha- and beta chains of C5.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540829 TI - Effect of insulin on leucine kinetics in maple syrup urine disease. AB - Leucine turnover was measured using [1-14C] L-leucine in three patients with classical maple syrup urine disease. There was measurable leucine oxidation although it was lower than in normal adults. Leucine production rate was greater than normal in all three patients with an increased rate of incorporation of leucine into protein and increased protein catabolism. These fluxes were both relatively insensitive to exogenous insulin. PMID- 3540830 TI - [Use of cefadroxil in respiratory tract infections in children]. PMID- 3540831 TI - [Autologous bone marrow transplantation as an attempt to maintain complete remission in a child with lymphoblastic leukemia]. PMID- 3540832 TI - [Clinical evaluation of zaditen in the treatment of recurrent obstructive bronchitis in young children]. PMID- 3540833 TI - Genitalia in children's drawings: an association with sexual abuse. AB - Many sexual abuse victims have been observed to draw genitalia on human figures. To test the hypothesis that sexually abused children draw genitalia on human figures more often than do nonabused children, drawings from 57 children, 3 through 7 years of age, who were referred to child protective services as alleged sexual abuse victims, were compared with drawings from an age-, sex-, race-, and socioeconomically matched group of 55 nonabused children receiving well-child care in medical settings. A standardized procedure to obtain drawings was followed by a structured interview to collect demographic, past medical, and developmental information. Five evaluators unaware of the children's backgrounds independently examined drawings for the presence or absence of five body parts; there was 94% agreement for all body parts and 93% agreement for genitalia. Eight children were excluded from the analysis because they only scribbled (n = 5) or because evaluators could not agree on whether genitalia were present in their drawings (n = 3). Ten percent (5/52) of the alleged sexual abuse victims and 2% (1/52) of the comparison children drew genitalia (P = .10, one-tailed Fisher exact test). The estimated relative risk was 5.4; that is, alleged sexual abuse victims were 5.4 times more likely to draw genitalia than were comparison children. Children known to have been sexually abused were 6.8 times more likely to draw genitalia than were comparison children (P = .07, one-tailed Fisher exact test).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540834 TI - Experience with heart transplantation in children. AB - Between March 1981 and March 1986, 200 orthotopic heart transplantations were performed at the University of Pittsburgh. Fourteen of those procedures were carried out in children 2 to 16 years of age. Two children received combined liver and heart transplants; one because of familial hypercholesterolemia with associated ischemic heart disease, and the other because of dilated cardiomyopathy associated with intrahepatic biliary atresia. Eight patients had dilated cardiomyopathy, and two had myocarditis. Two had heart transplantations for congenital heart disease: one had multiple muscular ventricular septal defects repaired in infancy and had an associated cardiomyopathy, and the other developed a cardiomyopathic ventricle from a congenital right coronary artery to right atrial fistula. Chronic immune suppression consisted 0.2 to 0.5 mg/kg/d of prednisone and 5 to 50 mg/kg/d cyclosporine, with the addition of antithymocyte globulin for unresolved moderate or severe acute rejection. There were three early postoperative deaths: one from intracranial bleeding, one from Pseudomonas mediastinitis, and one from ischemic injury to transplanted organs. Early postoperative complications included reversible renal failure, hypertension, and seizures. Late problems were related to allograft rejection and side effects of cyclosporine and corticosteroids. Significant rejection episodes occurred in all patients surviving longer than 2 weeks, with seven requiring antithymocyte globulin. Two patients died 8 months following transplantation of severe acute and chronic rejection; another patient required retransplantation for ischemic cardiomyopathy resulting from chronic rejection but subsequently died of recurring rejection 3 months after the second transplantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540837 TI - [Principles and methods for the physical fitness training of children]. PMID- 3540835 TI - Randomized controlled trial of exogenous surfactant for the treatment of hyaline membrane disease. AB - We conducted a prospective, randomized, unblinded, controlled trial of exogenous bovine surfactant (surfactant TA) in premature infants requiring ventilator support for the treatment of severe hyaline membrane disease. Forty-one low birth weight infants with severe hyaline membrane disease were randomly assigned to saline or surfactant therapy and treated within eight hours of birth. Significant improvements in oxygenation (increased arterial/alveolar PO2) and respiratory support (decreased mean airway pressure) were seen in the group receiving surfactant within four hours after treatment. These improvements were maintained in the surfactant-treated infants, who also had fewer pneumothoraces and fewer number of days in environments of fractional inspiratory oxygen greater than 0.4 mm Hg. No problems were associated with administration of surfactant, and no acute side effects were detected. We conclude that exogenous surfactant, administered early in the course of severe hyaline membrane disease, is an effective therapy that can diminish the amount of respiratory support required during the first 48 hours of life. PMID- 3540836 TI - Oral vitamin E supplementation for the prevention of anemia in premature infants: a controlled trial. AB - Serum vitamin E levels are reduced in newborn infants. It has been reported that this deficiency is responsible, in part, for the development of anemia in premature infants during the first 6 weeks of life. The efficacy of vitamin E supplementation for the prevention of anemia in premature infants has been studied in a randomized, controlled, and blinded trial. Premature infants whose birth weights were less than 1,500 g were given, by gavage, 25 IU of dl-alpha tocopherol or a similar volume of the drug vehicle. Treatment was continued for the first 6 weeks of life. A total of 178 infants were studied. Vitamin E levels were significantly higher in a supplemented group by day 3 and for the remainder of the 6-week period. At 6 weeks of age, there was no significant difference between the supplemented and unsupplemented groups in hemoglobin concentration, reticulocyte and platelet counts, or erythrocyte morphology. It is concluded that there is no evidence to support a policy of administering vitamin E to premature infants to prevent the anemia of prematurity. PMID- 3540838 TI - [Treatment of an asporogenous anaerobic infection in children]. PMID- 3540839 TI - Admiral Rozhestvensky charts the course of a textbook--the story of the Maximow Bloom-Fawcett "Histology". PMID- 3540840 TI - Phenomenological classification systems: the case of DSM-III. PMID- 3540841 TI - Alexis Carrel and Carl Beck--a historical footnote. PMID- 3540842 TI - Louis Pasteur and "le rage"--100 years ago. PMID- 3540843 TI - Malaria--yesterday, today, and tomorrow. PMID- 3540844 TI - [Ultrasonically guided percutaneous transhepatic gallbladder drainage (US guided PTGBD)--method and results]. PMID- 3540845 TI - [Ultrasonographic findings of thyroid tumors]. PMID- 3540846 TI - [Efficacy of intra-arterial digital subtraction angiography in patients with chronic renal failure]. PMID- 3540847 TI - [Transcatheter arterial embolization in postpartum hemorrhage]. PMID- 3540848 TI - Ultrasonographically undetectable cavernous hemangioma of the liver: can all hemangioma be detected by ultrasonography? PMID- 3540849 TI - [Ultrasonically guided liver biopsy in patients with malignant lymphoma--tissue biopsy by 21 guage modified Menghini needle]. PMID- 3540850 TI - [CT-guided stereotactic cerebral irradiation by linear accelerator]. PMID- 3540851 TI - Licensure and titling in nursing and society: a historical perspective. PMID- 3540852 TI - Cell types and their immunological functions in bovine mammary tissues and secretions--a review of the literature. AB - In this work the literature concerning cells related to bovine mammary gland defence mechanisms has been reviewed. The cells considered in this review include leucocytes from mammary secretions, leucocytes located in the mammary tissues, and nonsecretory epithelial cells which line the teat and the lactiferous sinuses of the udder. The mammary secretions and tissues basically contain three types of cells: polymorphonuclear leucocytes, macrophages, and lymphocytes. The number of each type of cell varies, depending on the physiological and pathological states of the udder, and all cell functions are associated with the immuno-defence mechanisms of the mammary gland. PMID- 3540854 TI - Sequence of the chloroplast-encoded psbA gene for the QB polypeptide of petunia. PMID- 3540853 TI - Cloning, expression and sequencing the molybdenum-pterin binding protein (mop) gene of Clostridium pasteurianum in Escherichia coli. AB - mop is the structural gene for the molybdenum-pterin binding protein, which is the major molybdenum binding protein in Clostridium pastuerianum. The mop gene was detected by immunoscreening genomic libraries of C. pastuerianum and identified by determining the nucleotide sequence of the cloned insert of clostridial DNA. The deduced amino acid sequence of an open reading frame proved to be identical to the first twelve residues of purified Mop. The DNA sequence flanking the mop gene contains promoter-like consensus sequences which are probably responsible for the expression of Mop in Escherichia coli. The deduced amino acid composition shows that the protein is hydrophobic, lacks aromatic and cysteine residues and has a calculated molecular weight of 7,038. The N-terminal amino acid sequence of Mop has sequence homology with DNA binding proteins. The pattern and type of residues in the N-terminal region suggest it forms the helix turn-helix structure observed in DNA binding proteins. We propose that Mop may be a regulatory protein binding the anabolic source of molybdenum. PMID- 3540855 TI - Sequence of the chloroplast-encoded psbA gene for the QB polypeptide of alfalfa. PMID- 3540856 TI - Organization of Plasmodium falciparum genome: II. Sequence analysis of falci element. PMID- 3540858 TI - Nurses at war: in remembrance. PMID- 3540859 TI - All in the genes. PMID- 3540857 TI - Clinical results of immunoscintigraphy in a variety of malignant tumors with special reference to immunohistochemistry. AB - Radioimmunoscintigraphy was performed in 52 patients with a variety of malignant tumors (colorectal, melanoma, lung, testicular, ovarian, bladder, carcinoid). Respective antibodies or their F(ab')2 fragments against CEA (n = 23), melanoma antigen 225.28 S (n = 18), TPA (n = 4), beta HCG (n = 5) and HMFG2 (n = 2) were selected by immunohistochemistry of the primary tumor. Most patients were suspected of recurrence or of hitherto unknown distant or local metastases. Overall accuracy was 61% (32/52). False negatives amounted to 33% (17/52). Useful additional clinical information-not available by CT, ultrasonics or serum levels of tumor markers-was obtained in 17 out of 52 patients (= 33%). From these results it seems obvious that antibodies used for radioimmunoscintigraphy should be selected on the basis of immunohistochemistry. PMID- 3540860 TI - The student's flexible friend. PMID- 3540861 TI - Infant care: teething troubles. PMID- 3540862 TI - Gestational diabetes. PMID- 3540863 TI - Hard times. PMID- 3540864 TI - [Insulin treatment today]. PMID- 3540865 TI - Interleukin-2: an overview. PMID- 3540866 TI - Clinical trials with IL-2. PMID- 3540867 TI - Implementation of an RIL-2/LAK cell clinical trial: a nursing perspective. PMID- 3540868 TI - Long-term complications of allogeneic bone marrow transplantation: nursing implications. PMID- 3540869 TI - Survey of graduate programs in cancer nursing. PMID- 3540870 TI - Analgesic efficacy of meclofenamate sodium in episiotomy pain. AB - Meclofenamate sodium was compared, double-blind, with codeine and placebo for the treatment of acute episiotomy pain. One hundred sixty-eight women with moderate or severe episiotomy pain after normal delivery were assigned randomly to one of four treatment groups: one received meclofenamate sodium 200 mg at dose 1 and 100 mg at doses 2 and 3; one received meclofenamate sodium 100 mg at dose 1 and 50 mg at doses 2 and 3; one received codeine 60 mg at all three doses; and one received placebo at all three doses. Efficacy measurements were evaluated periodically for 6 hours after medication. After the first administration, both doses of meclofenamate sodium were significantly superior to placebo and to codeine from 2 6 hours in pain intensity difference and pain relief. For second and third doses, data were available for too few patients to allow valid analysis and interpretation. Adverse effects occurred in 4 patients in each meclofenamate sodium group, and in 8 in the codeine group and in 6 in the placebo group. The study indicates that single 100- and 200-mg doses of meclofenamate sodium are as safe as, and significantly more effective than, codeine 60 mg or placebo for episiotomy pain. PMID- 3540871 TI - Analgesic effect of naproxen sodium, codeine, a naproxen-codeine combination and aspirin on the postoperative pain of oral surgery. AB - In a double-blind study, 198 outpatients with pain after oral surgery were randomly assigned to treatment with a single oral dose of naproxen sodium 550 mg, codeine sulfate 60 mg, a combination of naproxen sodium 550 mg with codeine sulfate 60 mg, aspirin 650 mg or placebo. Using a self-rating record, subjects rated their pain and its relief hourly for 12 hours after medication. Orthogonal contrasts for the four treatments making up the factorial component showed that the naproxen effect was significant for every measurement of total and peak analgesia; the codeine effect was significant for total and peak pain relief and patients' overall evaluation. The naproxen-codeine interaction was not statistically significant for any measure, which suggests that the analgesic effect of the combination represents the additive effect of its constituents. Based on pairwise comparisons, aspirin was significantly superior to placebo for most measures of effect, naproxen was significantly superior to both aspirin and codeine for all measures and the combination was significantly superior to naproxen for patients' overall evaluation. No more patients experienced adverse effects with aspirin or naproxen than with placebo, but significantly more patients receiving the codeine-containing treatments experienced adverse effects than those receiving aspirin and naproxen. PMID- 3540872 TI - A double-blind study comparing single dose of intramuscularly injected zomepirac to meperidine in the treatment of postoperative pain. AB - Eighty-eight patients with moderate or severe postoperative pain were entered into a double-blind, single-injection trial designed to assess the analgesic efficacy of intramuscular zomepirac 100 mg. Patients were randomly selected to receive zomepirac injection, meperidine 100 mg or meperidine 50 mg. By most criteria of analgesic efficacy, zomepirac was superior to meperidine 50 mg and as effective as meperidine 100 mg. In terms of peak analgesia (and of patients' global evaluations), both meperidine 100 mg and zomepirac were superior to meperidine 50 mg. Total analgesia provided by zomepirac was greater than that with meperidine 100 mg, which was greater than that with meperidine 50 mg. Significantly fewer patients needed remedication during the observation period, and mean time to remedication was significantly longer for the zomepirac group than for either meperidine group. No serious adverse effects were reported. PMID- 3540874 TI - Analgesic efficacy of amfenac, aspirin and placebo after extraction of impacted teeth. AB - Amfenac, an arylacetic acid derivative, is a new investigational, nonsteroidal antiinflammatory agent that has exhibited analgesic properties superior to those of phenylbutazone in animals. This double-blind, randomized, parallel study was an early clinical trial to evaluate the analgesic efficacy of one oral dose of amfenac 100 mg compared to aspirin 600 mg and placebo in 120 subjects with moderate to severe pain after extraction of impacted molar teeth. Self-evaluated subjective pain intensity and relief reports for 4 hours were used as indexes of response. Analgesic effects of amfenac were significantly superior to those of placebo (p less than 0.001) and aspirin (p less than 0.05) by most measurements. Aspirin 600 mg was superior to placebo based on total pain relief and global scores (p less than 0.05). Compared with aspirin 600 mg, amfenac 100 mg provided greater and faster analgesia, lasting at least for 4 hours. Ordinal pain intensity scores correlated well with the visual pain analog scale. Seven (17.5%) patients taking amfenac compared to 5 (12.5%) taking placebo reported minor adverse effects). PMID- 3540873 TI - Crossover trials in clinical analgesic assays: studies of buprenorphine and morphine. AB - Analgesic studies of buprenorphine, a thebaine derivative and potent partial narcotic agonist, were carried out in patients with cancer who had postoperative or chronic pain. Intramuscular buprenorphine was compared with intramuscular morphine in a series of sequentially related, twin crossover assays and was found to be about 25 times as potent as morphine. Side effects were essentially morphine-like. In a second assay, the acceptability and analgesic activity of sublingual buprenorphine was studied in a 6-dose, balanced, incomplete block assay, a modification of the twin crossover design employed in the all intramuscular trial. Sublingual buprenorphine was found to be about 15 times as potent as intramuscular morphine and was well accepted by our patients. The 4 dose twin crossover trial in which doses are adjusted sequentially is more flexible in that a wide range of doses may be studied, but it lacks the ability of the 6-dose design to provide estimates of the curvature of the dose-response slopes of the study drugs. When first-dose-only data were analyzed as parallel group assays, the main difference in results compared with the crossover studies was a decrease in efficiency and sensitivity. PMID- 3540875 TI - Analgesic effect of an aspirin-codeine-butalbital-caffeine combination and an acetaminophen-codeine combination in postoperative oral surgery pain. AB - The efficacy of an aspirin-caffeine-codeine-butalbital combination was compared to an acetaminophen-codeine combination and placebo in outpatients who had moderate or severe pain after the surgical removal of impacted third molars. Using a self-rating record, patients rated their pain, relief, anxiety and relaxation hourly for up to 6 hours after medicating. Each active medication was significantly superior to placebo for measures of analgesia and relaxation. Although the butalbital-containing combination provided consistently greater analgesia, the differences between active medications were not statistically significant. The acetaminophen-codeine combination significantly reduced anxiety; however, the butalbital containing combination did not. The results of this study suggest that female patients may have greater efficacy than male patients. All adverse effects were transitory and consistent with the known pharmacologic profiles of the study medications or the backup analgesic. PMID- 3540878 TI - Antidepressants in chronic pain: a review of efficacy. AB - Antidepressant drugs have gained widespread clinical usage alone or as adjuncts in the treatment of chronic pain disorders. Of 17 controlled studies of antidepressants in chronic pain, 13 demonstrated significant pain relief with antidepressants compared to placebo. These studies were too different from one another to allow any general conclusions concerning efficacy, however. Five studies of either migraine or chronic tension headache all demonstrated superior efficacy of antidepressants versus placebo, while those of back and arthritic pain yielded mixed results. Of 3 studies of pain of several etiologies, 2 failed to demonstrate efficacy of antidepressants over placebo. These studies do not provide answers to many clinical questions on the use of antidepressants for chronic pain, such as drug of choice or appropriate dosage. Rather, they suggest that these agents may be beneficial in some patients with chronic pain. PMID- 3540877 TI - Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. AB - Ketorolac tromethamine is a new injectable nonnarcotic analgesic. In a parallel, double-blind study, the analgesic efficacies of single intramuscular doses of ketorolac 10, 30 and 90 mg were compared with those of morphine sulfate 6 and 12 mg. Two hundred forty-one patients were categorized according to type of surgical procedure and severity of pain. Pain intensity and pain relief were assessed for 6 hours by scoring standard verbal and visual analog scales. Patients receiving ketorolac 10, 30 or 90 mg or morphine (MS) 12 mg all had significantly better pain relief in almost all measurements performed than those receiving MS 6 mg (p less than 0.05). Ketorolac 10 and 30 mg were as effective as morphine 12 mg during the entire 6-hour observation period, and ketorolac 90 mg was more effective than morphine 12 mg during the entire 6 hours. Patients with pain related to major surgery (e.g., cholecystectomy and abdominal hysterectomy) were better able to distinguish analgesic potency of morphine than those having less traumatic procedures (e.g., tendon and ligament repairs). PMID- 3540876 TI - Ketorolac versus aspirin for postpartum uterine pain. AB - Ketorolac tromethamine, a new nonsteroidal antiinflammatory analgesic, was evaluated for relative efficacy, safety and time course of analgesia in a stratified, randomized, parallel, double-blind trial. The study involved 120 hospitalized women (4 groups of 30) with moderate or severe postpartum uterine pain treated with single oral doses of ketorolac 5 mg and 10 mg, aspirin 650 mg or placebo. At regular interviews for 6 hours patients rated pain intensity, pain relief and side effects. Significant differences (p less than or equal to 0.05, two-tailed) occurred among the 4 treatments for various measurements of summed and peak analgesia. Ketorolac 10 mg was significantly superior to placebo in 5 of 5 major efficacy measurements, and aspirin was significantly superior in 3 of 5. Ketorolac 10 mg gave the highest mean rating for summed pain intensity differences (13.6, p = 0.0002 versus placebo), followed by aspirin (11.9, p = 0.012), ketorolac 5 mg (10.9, p = 0.072) and placebo (8.6). With ketorolac 10 mg and 5 mg and aspirin, analgesia lasted 6 hours, with peak efficacy at 3 hours. Side effects were not significant. Our results suggested a positive dose-response relationship for ketorolac. Compared to aspirin, ketorolac 10 mg induced equal or more analgesia, whereas ketorolac 5 mg was near the minimum effective dose and seemed less effective than aspirin. PMID- 3540879 TI - The analgesic efficacy of suprofen in periodontal and oral surgical pain. AB - Suprofen is a new, orally effective nonsteroidal antiinflammatory analgesic of the propionic acid chemical class. Three separate single-dose studies were performed to evaluate the efficacy of suprofen in acute pain associated with periodontal surgery and removal of impacted third molars. Study medications were: A--suprofen 200 mg, codeine 60 mg, propoxyphene HCl 65 mg, and placebo; B- suprofen 400 mg and 200 mg, aspirin 650 mg, and placebo; C--suprofen 400 mg and 200 mg, aspirin 650 mg with codeine 60 mg, aspirin 650 mg alone, and placebo. Analgesic and side effect data were collected over a 6-hour period after patients medicated for moderate to severe pain. All studies were randomized, double blinded, and parallel-group in design. Suprofen was significantly more effective than codeine 60 mg, propoxyphene HCl 65 mg, and aspirin 650 mg. Suprofen 400 mg appeared to be clinically more effective than the aspirin-codeine combination and the difference was statistically significant for most of the analgesic variables. Of the 224 patients who received suprofen in the 3 studies, 16 reported drowsiness and 1 reported constipation. PMID- 3540880 TI - [Ultrasonographic studies of lymph nodes and parenchymal organs of the abdominal cavity in malignant lymphomas]. PMID- 3540881 TI - [Clinical significance of disorders of drug kinetics in liver diseases]. PMID- 3540882 TI - [Opioid regulation of the secretion of pituitary hormones. I. Hormones of the anterior lobe of the pituitary]. PMID- 3540883 TI - [Opioid regulation of the secretion of pituitary hormones. II. Hormones of the posterior lobe of the pituitary]. PMID- 3540884 TI - Circulatory effects of fetal cardiac arrhythmias. AB - The circulatory consequences of cardiac arrhythmia and its compensatory mechanisms were examined in utero in 37 fetuses. A combined real-time and 2-MHz pulsed Doppler technique was used to measure blood velocity for waveform analysis and flow estimation in the descending thoracic aorta of the fetuses. The pattern of blood velocity in the inferior vena cava was studied to classify the arrhythmia. Despite severe cardiac arrhythmias the aortic blood flow was within normal limits in all but one fetus which had associated cardiac malformation and congestive failure. The rising slope and the peak value of the maximum aortic velocity were significantly increased in the postpremature beats and in fetuses with atrioventricular block. The results support the validity of Frank-Starling's law for the fetal myocardium. PMID- 3540885 TI - Ultrasonography as a screening procedure in children with urinary tract infection. AB - Renal ultrasonography, excretory urography and radionuclide-voiding cystography or conventional voiding cystourethrography were performed in 76 children with urinary tract infection. Forty children had functional or anatomical abnormalities. Twenty-eight children had vesicoureteral reflux and 12 children had an obstructive lesion. All 12 children with obstructive lesions as well as 4 children with reflux and hydronephrosis required corrective surgery. Ultrasonography as the initial procedure detected 14 of these cases and the other 2 were discovered in voiding cystourethrography. Our data and those in the literature suggest that renal ultrasonography may be the method of choice in children with urinary tract infection. This is followed by voiding cystourethrography or radionuclide-voiding cystography. Excretory urography is not necessary in the initial evaluation of these patients, but it should be utilized when the other imaging methods show an abnormality and more detailed anatomical visualization of the upper urinary tract is required. Using this protocol in children with urinary tract infection, unnecessary radiation, discomfort and expense will be avoided. PMID- 3540886 TI - Clinical performance and effect on treatment rates of latex agglutination testing for streptococcal pharyngitis in an emergency department. AB - Of 556 children with symptoms of streptococcal pharyngitis in a pediatric hospital emergency department, 38.8% had positive results on either a rapid latex agglutination test or throat culture for Group A Streptococcus. Twenty-six percent of patients with negative latex agglutination test results had growth on culture of a paired specimen. Under the best assumption rapid test sensitivity was 44.9%. The treatment rate (84%) for cases detected by the rapid test was markedly higher than the rate (44%) for cases detected only by culture (P less than 0.001), presumably because the rapid test result is available sooner. We conclude that: the rapid test had a lower sensitivity in routine use in our pediatric emergency department population than in previous reports from research settings; and using the rapid test in addition to culture can significantly increase treatment rates. PMID- 3540887 TI - Low prevalence of Chlamydia trachomatis in the oropharynx of adolescents. AB - This study determined the prevalence rates of Chlamydia trachomatis infection in the oropharynx of adolescents with and without pharyngitis. One hundred teenagers with and without symptoms of pharyngitis were cultured for C. trachomatis. Swabs were taken from the oropharynx and tonsillar areas for direct fluorescent antibody assay and cell culture. Of the 100 adolescents enrolled in the study 55% had a history of pharyngitis and 45% had no pharyngeal symptoms; 29% were male and 71% were female. The mean age was 15.5 years. Forty-two percent had a history of sexual intercourse, and 11.5% described a history of oral-genital sex. Only one 14-year-old female with a 2-week history of a sore throat had a positive culture. Her direct fluorescent antibody assay was inconclusive and the throat culture for Group A Streptococcus was negative. She had no history of sexual activity. The overall prevalence rate in the 100 adolescents was 1% with a 1.8% prevalence in the symptomatic group and 0 in the asymptomatic group. Of the symptomatic adolescents 39 had cultures for Group A Streptococcus and 8 (20.5%) were positive. The results of this study suggest that C. trachomatis is a rare inhabitant of the oropharynx in adolescents and is not a common cause of pharyngitis. PMID- 3540888 TI - Pyogenic arthritis in infants and children: a review of 95 cases. AB - The clinical and laboratory findings of 95 children with pyogenic arthritis were reviewed to assess etiologic agents, diagnostic tools and results of therapy. Despite obtaining specimens from multiple sites for culture and using antigen detection tests only 64% of patients had an etiologic agent determined. Haemophilus influenzae type b was the most common causative agent identified and 82% of such cases occurred in children between 6 and 24 months of age. Infection due to Staphylococcus aureus was not confined to any age group. Results of laboratory tests which measure inflammatory response were not always abnormal. Platelet count and sedimentation rate frequently rose as clinical improvement occurred. Roentgenograms and radionuclide studies were of little benefit. Therapy included immediate decompression of the joint space, articular rest and use of antibiotics delivered parenterally. Ninety percent of 70 patients who were followed for 1 month to 5 years (mean, 15.5 months) were cured. Eight children had clinically significant sequelae which affected length of extremity, stability of articulations and range of movement. Development of sequelae was significantly associated with infection at age less than 6 months, delay of 4 or more days in institution of medical or surgery treatment, infection due to S. aureus and most strikingly the involvement of the hip or shoulder with concomitant presence of osteomyelitis. PMID- 3540889 TI - Transient formation of precipitations in the gallbladder associated with ceftriaxone therapy. PMID- 3540890 TI - A cluster of late onset group B streptococcal infections in low birth weight premature infants: no evidence for horizontal transmission. PMID- 3540891 TI - Diagnosis and management of children with streptococcal pharyngitis. AB - Physicians must be aware that rheumatic fever can no longer be considered a disease of the past and be prepared to diagnose and treat promptly children with streptococcal pharyngitis. Although the rapid diagnostic kits for detecting Group A streptococci in pharyngeal swabs are not perfect, they can be useful to the practitioner if positive because the specificity of the test is excellent. Thus, a child with pharyngitis who has a positive rapid test should be treated immediately to shorten the period of morbidity and to reduce the risk of nonsuppurative sequelae. Upon completion of a 10-day treatment course there is usually no reason to reculture the pharynx if the child is asymptomatic. Recurrence of symptoms is an indication to perform another culture and to retreat with either benzathine penicillin G or erythromycin depending on compliance of the patient and the agent used initially for therapy. Eradication of Group A streptococci from the pharynx of children who are carriers is usually a difficult and unnecessary task. When eradication is indicated, such as when the carrier has had contact with a person who had rheumatic fever, rifampin should be added to the penicillin regimen (Table 4). PMID- 3540892 TI - Some aspects of the diagnosis and management of urinary tract infection in children and adolescents. AB - While areas of disagreement continue to exist about certain details related to the diagnosis and treatment of UTI, it is possible to devise reasonable approaches to these problems that can be shown to be effective and do not harm the patient on a short or long term basis. PMID- 3540893 TI - Ureaplasmas of humans: with emphasis upon maternal and neonatal infections. Proceedings of an international symposium of the International Organization for Mycoplasmology. Seattle, Washington, October 10-12, 1985. Tribute to Dr. Maurice Charles Shepard. PMID- 3540894 TI - Ureaplasma urealyticum: history and progress. PMID- 3540895 TI - Colonization of the endometrium and fallopian tubes with Ureaplasma urealyticum. AB - Ureaplasma urealyticum, a common microorganism in the lower genital tract of sexually active women, has been associated with infertility and pelvic inflammatory disease. While some studies suggest a casual relationship for U. urealyticum and infertility, well-designed, controlled studies do not confirm such a pathogenic role. U. urealyticum is recovered from the upper genital tract of patients with acute pelvic inflammatory disease in a small number of cases. The studies reviewed in this paper do not confirm a definite pathogenic role for U. urealyticum in infertility or acute pelvic inflammatory disease. PMID- 3540897 TI - Possible role of Ureaplasma urealyticum in preterm premature rupture of the fetal membranes. AB - Preterm labor and preterm premature rupture of the membranes (PROM) remain important and potentially preventable causes of prematurity. Colonization with Ureaplasma urealyticum has been associated with prematurity and other adverse pregnancy outcomes in several case-control studies. However, prospective studies have not found an association between maternal colonization with U. urealyticum and PROM or prematurity. Differences in study design, failure to identify and adjust for other potential risk factors for prematurity and the frequency of concurrent genital infections with other pathogens make the interpretation of these studies difficult. Recent studies suggest that the increased intravaginal concentration of U. urealyticum and other microorganisms associated with bacterial vaginosis may be associated with PROM, preterm labor and amniotic fluid infection and may be a more important determinant of adverse pregnancy outcome than the simple qualitative recovery of the microorganisms from the maternal genital tract. PMID- 3540896 TI - Role of Ureaplasma urealyticum in amnionitis. AB - Ureaplasma urealyticum is commonly isolated from the amniotic fluid of unselected individuals with intact membranes at the time of cesarean section even prior to onset of labor. The risk of placental infection increases with onset of labor, rupture of membranes and number of vaginal examinations. Qualitative cultures of women with clinical signs of intraamniotic infection and matched controls indicate that U. urealyticum can be found in 50% of amniotic fluid samples of both groups thus suggesting that it may not be a cause of clinical amnionitis. To gain further understanding of the potential role of this organism, we performed amniotic fluid and blood cultures and measured serologic responses by enzyme linked immunosorbent assay in women with clinical intraamniotic infection and matched controls. U. urealyticum was the single most common bacterial species isolated from maternal blood and amniotic fluid but the isolation rate did not differ between symptomatic and asymptomatic women. Also other known pathogenic bacteria were often isolated from amniotic fluids containing ureaplasmas. However, the marked difference in serologic response between symptomatic and asymptomatic women and the occurrence of ureaplasmemia in some suggest that in certain individuals U. urealyticum may be a cause of clinical amnionitis. Serologic responsiveness, ureaplasmemia and isolation of ureaplasmas in pure culture from amniotic fluid of some asymptomatic women suggest that U. urealyticum may also be a cause of clinically silent amnionitis. Previous studies have shown a significant association between chorioamnionitis documented by histopathology and isolation of U. urealyticum from the placenta or infant but not the maternal cervix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540898 TI - Ureaplasma urealyticum as a cause of postpartum fever. AB - Mycoplasma hominis has been shown to cause a postpartum fever in nonimmune women and among the approximately 5% of febrile postpartum women who have the organism isolated from the blood. Ureaplasma urealyticum causes postpartum fever in the 20% of febrile women with U. urealyticum alone isolated from the endometrium. About 5% of febrile postpartum women have U. urealyticum isolated from the blood. These data suggest that both genital mycoplasmas can cause postpartum fever. PMID- 3540899 TI - Evaluation of the role of Ureaplasma urealyticum in infertility. AB - The involvement of Ureaplasma urealyticum in male infertility has been suggested in 10 studies in which strains were found more often in the semen of infertile than fertile men and/or were associated with poor motility or other abnormalities. In contrast these findings have not been supported by those of an equal number of other studies. Ureaplasmas adhere to sperm and therefore have an opportunity to affect them. The numbers of organisms present in semen samples suggest that such a direct effect is unlikely but the question of whether metabolic byproducts affect sperm and whether ureaplasmas cause structural damage to the male genital tract remains unanswered. Ureaplasmas have been isolated from the genital tracts of women of infertile couples more often than from those of women of fertile couples by some but not all investigators and antibiotic therapy has also provided conflicting results. Two groups of workers have reported improvements in sperm motility and quality and increased conception rates in couples rendered Ureaplasma-negative by tetracycline administration. Such observations are provocative but have to be viewed against the failure of other investigators to note similar improvements in conception rates in studies where some attention was paid to controlling them. It should be noted, however, that the beneficial effect of an antibiotic may not be seen clearly if ureaplasmas are responsible for only a small subset of infertility cases. PMID- 3540900 TI - Low birth weight and maternal colonization with genital mycoplasmas. PMID- 3540901 TI - Ureaplasma urealyticum and its possible role in pneumonia during the neonatal period and infancy. PMID- 3540902 TI - Taxonomy and host distribution of the ureaplasmas. PMID- 3540903 TI - DNA homologies and serologic relationships among ureaplasmas from various hosts. AB - The available data on the serologic and genomic relationships among the established and unspeciated Ureaplasma species and serovars isolated from various hosts can be summarized as follows. Ureaplasma urealyticum (human) is composed of 14 serovars separated into two genomic clusters. Ureaplasma diversum (bovine) is antigenically complex, has three serologic clusters and requires the three representative antisera to identify all U. diversum strains. The nonhuman primate strains form four serologic groups, and each serogroup is composed of strains isolated from primates belonging to one of four distinct zoologic primate families. The ovine-caprine strains have two serologic clusters. Canine strains form four serologic clusters but serovars 1 and 2 are closely related by DNA homology. Avian strains belong to one serogroup with two genomic clusters. The DNA homology data indicate that phenotypic information alone, including antigenic serotypic data, is not always adequate for species designation among the ureaplasmas and that comparative analyses of the genome provide invaluable data for establishing new species. Although there are only two established species, the published data support the contention that the nonhuman primate, ovine caprine, canine, feline and avian ureaplasmas are genomically and phenotypically distinct from each other based on the serologic, polyacrylamide gel electrophoresis protein and DNA cleavage patterns and DNA homology studies and that these ureaplasmas from various hosts may represent new species or subspecies within the genus. PMID- 3540904 TI - Genetic relatedness among Ureaplasma urealyticum serotypes (serovars). AB - Fourteen serotypes (serovars) are currently recognized in the species Ureaplasma urealyticum. DNA-DNA hybridization tests, cleavage of genomic DNA by restriction endonucleases, and polyacrylamide gel electrophoresis of cell proteins indicate that the U. urealyticum serotypes fall into two genotypically distinct, but related, clusters. Southern hybridization tests of mycoplasmal ribosomal RNA gene probes with DNAs of the various serotypes digested by restriction endonucleases showed that the U. urealyticum chromosome carries two sets (operons) of ribosomal RNA genes. However, the hybridization patterns produced by the serotypes showed differences which were most pronounced among serotypes belonging to the two different clusters. PMID- 3540905 TI - Potential virulence factors of Ureaplasma urealyticum. AB - Our understanding of the pathogenic potential of Ureaplasma urealyticum awaits further characterization of the species. This review adds recently published findings to the previously established properties of this myocoplasma. PMID- 3540906 TI - Clinical antibiotic resistance of Ureaplasma urealyticum. AB - The antibiotic sensitivity of strains of Ureaplasma urealyticum is measured usually by a metabolism inhibition technique. Antibiotic-resistant strains have been detected, usually not by testing many randomly collected strains but by testing organisms recovered from patients after treatment. On this selection basis about 10% of strains isolated between 1973 and 1976 from patients with nongonococcal urethritis attending sexually transmitted disease clinics in London were resistant to tetracyclines, as were strains isolated in 1983 to 1984. Such resistant strains are not confined to population groups that receive tetracyclines frequently and have been found in widespread geographic locations. About 40% of tetracycline-resistant strains in the London area also are resistant to erythromycin in contrast to about 10% of tetracycline-sensitive strains. Development of resistance to tetracycline, erythromycin, rosaramicin and spectinomycin by a Ureaplasma strain (serovar 2) isolated from a hypogammaglobulinemic patient in the United Kingdom has been seen following successive treatment with these antibiotics, but multiple antibiotic resistance of this kind must be rare. PMID- 3540907 TI - TetM tetracycline-resistant determinants in Ureaplasma urealyticum. AB - Ureaplasma urealyticum is an organism usually considered susceptible to tetracycline, with a minimal inhibitory concentration of 1 microgram/ml or less. Sixty-three clinical strains of U. urealyticum and serovars 1 through 9 were screened for resistance to tetracycline. Thirteen clinical isolates of U. urealyticum and one serovar (9) were resistant to high levels of tetracycline. They differed from each other on sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels and immunoblotting. All 14 strains contained DNA sequences homologous to the streptococcal determinant tetM which suggests the spread of this gene to the genus Ureaplasma. PMID- 3540908 TI - Ureaplasmas of human: with emphasis upon maternal and neonatal infections. Future considerations: maternal and neonatal aspects. PMID- 3540909 TI - Identification of His5,Trp7,Tyr8-GnRH (chicken GnRH II) in amphibian brain. AB - GnRH immunoreactive and bioactive peptides in Xenopus laevis brain extract were investigated by high performance liquid chromatography (HPLC), radioimmunoassay with region-specific antisera raised against GnRH (mammalian), His5,Trp7,Tyr8 GnRH (chicken II) and Tyr3,Leu5,Glu6,Trp7,Lys8-GnRH (lamprey), and by assessment of biological activity. Two immunoreactive peptides eluted in the same positions as GnRH and His5,Trp7,Tyr8-GnRH respectively in HPLC systems which were specifically designed to separate four known natural vertebrate GnRHs (mammalian, chicken I and II, salmon). The immunological properties of these two immunoreactive peaks, determined by relative interaction with three region specific antisera raised against mammalian GnRH and two specific His5,Trp7,Tyr8 GnRH antisera, were identical to those of GnRH and His5,Trp7,Tyr8-GnRH. The immunoreactive peak co-eluting with His5,Trp7,Tyr8-GnRH represented approximately one-third of the total brain GnRH. Both immunoreactive peaks stimulated luteinizing hormone (LH) release in a chicken dispersed pituitary cell bioassay, and the amounts of LH release stimulated by the two peaks were appropriate for these peaks being GnRH and His5,Trp7,Tyr8-GnRH. A small hydrophobic peak with GnRH immunoreactivity eluted in the same position as Trp7,Leu8-GnRH (salmon), while Gln8-GnRH (chicken I) and lamprey GnRH were not detected. Two additional rather hydrophilic peptides cross-reacted with a COOH-terminus-directed antiserum and had LH-releasing activity. LH-releasing activity was also detected in hydrophobic HPLC fractions. In summary, these data provide evidence for the presence of both GnRH and a second peptide with properties identical to His5,Trp7,Tyr8-GnRH in X. laevis brain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540910 TI - Co-existence of CRF and vasopressin immunoreactivity in parvocellular paraventricular neurons of rat hypothalamus. AB - New dual immunocytochemical staining procedures were used in the same tissue section to elucidate the distribution and co-existence of CRF and vasopressin in parvocellular neuronal perikarya in the paraventricular nucleus (PVN) of rat hypothalamus. CRF immunostained cells were for the most part concentrated in the medial parvocellular component of PVN. Few vasopressin-immunoreactive (ir) neurons were seen in this area in the normal and colchicine-treated animals. Vasopressin-containing neurons predominated in the magnocellular component of PVN. In the adrenalectomized and adrenalectomized-colchicine-treated animals, a dense accumulation of vasopressin-ir cells were observed in the medial parvocellular area of PVN; this region is normally vasopressin-ir poor and CRF-ir rich. The vasopressin immunostained cells appeared to have an anatomical distribution similar to that seen for CRF-containing cell bodies. Results of this study unequivocally establish the co-existence of vasopressin and CRF in the same parvocellular perikarya of PVN following pertubation of the pituitary-adrenal axis. PMID- 3540911 TI - Localization of choline acetyltransferase and vasoactive intestinal polypeptide like immunoreactivity in the nervus terminalis of the fetal and neonatal rat. AB - Ganglia of the nervus terminalis have been shown to contain luteinizing hormone releasing hormone (LHRH) immunoreactive cells in several mammalian species. These cells are always accompanied by clusters of cells non-immunoreactive to antiserum to LHRH. Using immunocytochemical procedures, we found choline acetyltransferase (ChAT) and vasoactive intestinal polypeptide (VIP) present in cell bodies and in nerve processes throughout the peripheral, intracranial and central projections of the nervus terminalis. In addition, a dense plexus of substance P (SP) immunoreactive fibers was seen in the nasal mucosa surrounding the nasal glandular acini and blood vessels. A number of SP reactive fibers were traced with the olfactory nerves through the cribriform plate of the ethmoid bone and appeared to enter the brain in the area of the central roots of the nervus terminalis. PMID- 3540913 TI - [Mammography and other visual methods in the diagnosis of breast diseases]. PMID- 3540912 TI - Endogenous opiates: 1985. AB - This paper is the eighth installment of our annual review of research involving the endogenous opiate peptides. It is restricted to the non-analgesic and behavioral studies of the opiate peptides published in 1985. The specific topics this year include stress, tolerance and dependence, eating, drinking and alcohol consumption, gastrointestinal and renal activity, mental illness, learning and memory, cardiovascular responses, respiration and thermoregulation, seizures and neurological disorders, activity, and some other selected topics. PMID- 3540915 TI - [The search for an "ideal" surgical dressing]. AB - Trials of a new occlusive dressing, Op-site (Smith Nephew), were conducted on a group of patients. Op-site is a fine, transparent, elastic, self-adhesive polyurethan film. Although non-porous and therefore water- and bacteria-proof, it is permeable to gases. The existing dressings fulfil only a few of the criteria of an "ideal" dressing and in some cases actually interfere with the healthy process. The main disadvantages are: the disturbance of newly formed epithelium, when many dressings are removed, their fibres become embedded in the new tissues and cause inflammation and delayed healing. Few dressings are true bacterial barriers and the hazard of infection of the wound is always present. Recent studies of the mechanism of wound healing have indicated that a moist, not dry surrounding provides the optimum conditions for wound repair. Healing under Op site is said to be quicker because the serous exudate permits unhindered migration of new cells across the wound bed and prevents cellular dehydration. In contrast, under dry conditions healing is delayed because the new skin cells must first cleave a path through dehydrated dermis before migrating across the wound. The Op-site wound dressing can be readily applied over the joints and allows complete freedom of movement. The skin remains dry and the wound moist, providing the ideal environment for rapid healing. The film does not adhere to the moist wound and can therefore be removed without damage to the newly formed epidermis. The adhesive is low allergic. Finally, the wound can be assessed without removing the transparent Op-site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3540914 TI - [Use of fibrin glue in tracheal surgery. Experimental studies]. AB - The experimental studies were undertaken in order to estimate the suitability of fibrin sealant in tracheal surgery and the compare tissue reactivity after using cyanoacrylic and fibrin adhesives. 14 piglets of the Poland white breed, weighing up to 25 kg, were used in the study. Under general tracheal anesthesis the tracheal wall was cut open by incision on the mid-line on the neck between the III-IV tubular cartilages along 3/4 of its circumference. The lips of the incision were closed by one atraumatic suture and tightened by fibrin sealant. Piglets dissecting examinations were carried out after 24 hours, 3, 7, 14, 30, 60 and 90 days after the operation. The results were estimated by macro- and microscopic studies. Comparative studies were carried out on the basis of our own similar experimental studies by means of cyanoacrylates. It was found that the Immuno fibrin adhesive is a very useful new material for tightening the tracheal wounds. The Immuno fibrin adhesive, in comparison with cyanoacrylates, has very good biological qualities, does not cause marginal tissue necrosis and increased chronic inflammatory changes. Fibrin sealant undergoes complete elimination from the wound after 7-10 days and is replaced by connective tissue. PMID- 3540916 TI - [Laboratory moulding of Metaplex for stomatologic use]. AB - The features of plasticization of Metapleks were used in order to make plates for dentures. Metaplex was subjected to various methods of moulding. After laboratory studies it was found that the method of vacuum moulding is not suitable. Metaplex may be moulded on plaster models by external pressure, or mechanically by use of stamp. PMID- 3540917 TI - The treatment of hypertension in the elderly. PMID- 3540918 TI - Twice daily tripotassium dicitrato bismuthate in the treatment of duodenal ulceration. AB - Fifty three patients with endoscopically proven duodenal ulceration have cooperated in a clinical trial to compare the ulcer healing effect of tripotassium dicitrato bismuthate (TDB) at standard dosage administered either twice or four times daily. No statistically significant difference has been found to exist between ulcer healing in the two groups at 4 weeks (72% and 67%, P = 0.944) or at 8 weeks (92% and 81%, P = 0.504) and it is concluded that twice daily TDB maintains the effectiveness of the drug and has advantages for patient compliance. PMID- 3540920 TI - Pseudo-splenomegaly as a result of subphrenic abscess. AB - A case of left-sided subphrenic abscess, secondary to perforation of a carcinoma of stomach, is described. The patient presented with a palpable spleen which was shown to be normal in size but displaced by the subphrenic collection. The importance of correct interpretation of this physical sign is discussed. PMID- 3540919 TI - Non-steroidal anti-inflammatory agents and the gastrointestinal tract. PMID- 3540921 TI - Colorectal lymphoma simulating inflammatory colitis and diagnosed by immunohistochemistry. AB - Lymphomatous colitis is probably an uncommon syndrome but its recognition may be of importance to patients under the care of gastroenterologists or oncologists. The case of an elderly man with lymphocytic lymphoma who developed lymphomatous colitis 6 years after initial presentation is reported. PMID- 3540922 TI - Mefenamic acid-induced bullous pemphigoid. AB - A 52 year old man developed bullous pemphigoid, Coombs' positive haemolytic anaemia and diarrhoea related to the use of mefenamic acid. Clinical manifestation of the bullous pemphigoid, haemolytic anaemia and diarrhoea resolved following discontinuation of the mefenamic acid. Mefenamic acid should be added to the list of agents that are known to induce bullous pemphigoid. PMID- 3540923 TI - Hormonal and biochemical responses to transcendental meditation. PMID- 3540924 TI - Paediatric gastroenterology: lessons of inborn errors. PMID- 3540925 TI - Vitamin E--its role in neurological function. AB - Studies in patients with abetalipoproteinaemia, other chronic and severe fat malabsorptive states and a selective defect in vitamin E absorption, together with neuropathological studies in the vitamin E deficient human, monkey and rat indicate that vitamin E is important for normal neurological function. Appropriate vitamin E supplementation is, therefore, advisable for all patients with chronic fat malabsorption who have low serum vitamin E concentrations. Serum vitamin E concentrations should also be measured in patients with spinocerebellar disorders, whatever the aetiology. PMID- 3540927 TI - Teratogenic inborn errors of metabolism. AB - Most children with inborn errors of metabolism are born healthy without malformations as the fetus is protected by the metabolic activity of the placenta. However, certain inborn errors of the fetus have teratogenic effects although the mechanisms responsible for the malformations are not generally understood. Inborn errors in the mother may also be teratogenic. The adverse effects of these may be reduced by improved metabolic control of the biochemical disorder. PMID- 3540926 TI - Pteridines and mono-amines: relevance to neurological damage. AB - Patients with phenylalanine hydroxylase deficiency show increased concentrations of biopterins and neopterins, and reduced concentrations of serotonin and catecholamines, when phenylalanine concentrations are raised. The pterin rise reflects increased synthesis of dihydroneopterin and tetrahydrobiopterin, and the amine fall a reduction in amine synthesis due to inhibition by phenylalanine of tyrosine and tryptophan transport into neurones. The pterin and amine changes appear to be independent of each other and are present in the central nervous system as well as the periphery; they disappear when phenylalanine concentrations are reduced to normal. Patients with arginase deficiency show a similar amine disturbance but have normal pterin levels. The amine changes probably contribute neurological symptoms but pterin disturbance is not known to affect brain function. Patients with defective biopterin metabolism exhibit severely impaired amine synthesis due to tetrahydrobiopterin deficiency. Pterin concentrations vary with the site of the defect. Symptoms include profound hypokinesis and other features of basal ganglia disease. Neither symptoms nor amine changes are relieved by controlling phenylalanine concentrations. Patients with dihydropteridine reductase (DHPR) deficiency accumulate dihydrobiopterins and develop secondary folate deficiency which resembles that occurring in patients with defective 5,10-methylene tetrahydrofolate reductase activity. The latter disorder is also associated with Parkinsonism and defective amine and pterin turnover in the central nervous system, and a demyelinating illness occurs in both disorders. In DHPR deficiency cerebral calcification may develop in a similar distribution to that seen in congenital folate malabsorption and methotrexate toxicity. Symptoms are ameliorated by therapy with 5 formyltetrahydrofolate but exacerbated by folic acid. PMID- 3540929 TI - Festschrift for Professor Otto Wolff. PMID- 3540928 TI - Recently recognized chromosomal defects of clinical importance. AB - We review those conditions which have recently been recognized to be associated with small, sometimes difficult to detect, chromosomal abnormalities. These include the Prader-Willi syndrome and X-linked mental retardation. PMID- 3540931 TI - Childhood prevention of coronary heart disease. PMID- 3540930 TI - Some aspects of obesity in childhood. PMID- 3540932 TI - Haemorrhagic endovasculitis of the placenta: a review with clinical correlation. AB - Haemorrhagic endovasculitis (HEV) is a recently described vasodestructive process within the placenta. Similarities to several forms of thrombotic microangiopathy are evident. Clinical studies have shown strong associations between HEV, still birth and intrauterine growth retardation (IUGR). Liveborn infants, with affected placentae, evaluated at the age of five, exhibit a high incidence of neurological abnormalities. HEV has been recurrent in successive pregnancies in some patients. Clinicopathological processes, which appear to be associated with HEV, include the presence of chronic villitis (VUA) and maternal hypertension. Viral- and/or Mycoplasma-type particles have been identified in a number of affected placentae examined by electron microscopy. Associated pathological events suggest an infectious aetiology possibly acting in concert with an environmental toxin. Biochemical factors and alterations of immune response within the maternal placental-fetal unit may be involved. PMID- 3540933 TI - New scientific opportunities and old obstacles in vaccine development. AB - The present status of and priorities for vaccine development are described, and the historical conditions under which vaccines have been developed are contrasted with newer technologies for such development. Current programs, the opportunities they present, and the obstacles to their implementation are summarized. PMID- 3540934 TI - Nucleotide binding by a 24-residue peptide from the RecA protein of Escherichia coli. AB - We have recently demonstrated that two ATP analog affinity labels, 8 azidoadenosine 5'-triphosphate (N3ATP) and 5'-p-fluorosulfonylbenzoyladenosine (5'FSBA), covalently modify RecA protein of Escherichia coli at a specific tyrosine residue (Tyr-264) located within a 24-residue tryptic peptide (T-31) spanning residues 257-280. Here we show that N3ATP efficiently modifies purified peptide T-31 and show that the interaction is specific by the following criteria: photolabeling of peptide T-31 is saturable with respect to the N3ATP concentration; photolabeling is competitive with ATP and adenosine but not with adenine, UTP, or TTP; and other peptides derived from RecA protein were poor substrates for photolabeling except for one fragment that showed a nonspecific interaction with the photoaffinity analog. Analysis of N3ATP-modified T-31 shows that the photolabel attaches to more than one site within the peptide. These data argue that peptide T-31 contains some sites of contact for adenine and ribose moieties of ATP when it is bound to RecA protein. PMID- 3540935 TI - Similar biochemical changes associated with multidrug resistance in human breast cancer cells and carcinogen-induced resistance to xenobiotics in rats. AB - MCF7 human breast cancer cells selected for resistance to doxorubicin (adriamycin; DoxR) have developed the phenotype of multidrug resistance. Multidrug resistance in DoxR MCF7 cells (called AdrR MCF7 cell line in previous publications) is associated with biochemical changes similar to those induced by carcinogens in rat hyperplastic liver nodules (HNs) and associated with resistance to xenobiotics in that system. In HNs and DoxR cells, exposure to a single agent results in the selection of cells that are cross-resistant to a wide variety of structurally dissimilar toxic agents. Resistance in both systems is associated with decreases in intracellular accumulation of toxins and changes in phase I (decreased cytochrome P1-450) and phase II (increased glutathione transferase and glucuronyltransferase) drug-metabolizing activities. In HNs and DoxR cells, resistance is associated with the induction of relatively stable levels of an immunologically related anionic glutathione transferase isozyme (EC 2.5.1.18). The finding of similar biochemical changes associated with the development of resistance to various xenobiotics in HNs and to many naturally occurring antineoplastic agents and at least one carcinogen (benzo[a]pyrene) in DoxR MCF7 cells suggests that the mechanisms of resistance in these two models may be similar. PMID- 3540936 TI - Promoter domain mediates guanosine tetraphosphate activation of the histidine operon. AB - We have analyzed the effects of the "alarmone" guanosine 5'-diphosphate 3' diphosphate (ppGpp) on regulation of the Salmonella typhimurium histidine operon in vitro. Expression of the wild-type promoter, measured in a DNA-dependent transcription-translation system, was strongly dependent on ppGpp; addition of ppGpp stimulated his expression 22-fold with plasmid DNA templates. Oligonucleotide-directed, site-specific mutations that increase the homology of the -10 hexamer to the consensus sequence of the E sigma 70 promoters dramatically increased his expression in the absence of ppGpp and reduced the stimulation to less than a factor of 2. A deletion mutation that alters the sequence between the -10 hexamer and the start point of transcription, generated by BAL-31 nuclease, affected ppGpp regulation in a similar manner. We propose that the -10 hexamer sequence and the adjacent downstream region are both important in regulating transcription by ppGpp. Mechanisms to account for activation and repression of transcription by ppGpp are discussed. PMID- 3540937 TI - Stimulation of human neuroblastoma DNA polymerase alpha and primase activities by a protein factor isolated from rat liver chromatin. AB - Nuclear protein factor type 1 (NPF-1) that simulates IMR-32 primase-associated DNA polymerase alpha 1 and alpha 2 activities has been purified from a high-salt extract of liver chromatin from 6-month-old rats. The final purified factor lacks DNA polymerase alpha, RNA polymerase, and DNA-unwinding or topoisomerase type I activities. The stimulatory activity is destroyed by trypsin (60 min at 37 degrees C), DNase II (60 min at 37 degrees C), and heat treatment (2 min at 68 degrees C). The 125I-labeled NPF-1 does not bind to activated calf thymus DNA or poly(dC). However, it forms a ternary complex with DNA in the presence of DNA polymerase alpha-primase complex (alpha 1 and alpha 2). The ternary complex sediments on sucrose density gradient as a heavier band (11S). The NPF-1 also stimulates (2.5-fold) primase-catalyzed incorporation of GMP and dGMP from the corresponding triphosphates on poly(dC) template even in the presence of a high concentration of alpha-amanitin (400 micrograms/ml). The labeled duplex containing the poly(dC) template, [32P]-GTP, and [3H]dGTP loses 80% of the 32P label and 70% of the 3H label after treatment with 0.3 M KOH and DNase I, respectively. The products were isolated from reaction mixtures incubated with and without NPF-1 and subjected to alkaline sucrose-density-gradient sedimentation analysis. The results suggest that the rate of synthesis of DNA short chains is increased in the presence of NPF-1 without a concomitant increase in the chain length of the newly synthesized products. PMID- 3540938 TI - The mRNA coding for the secreted protease transin is expressed more abundantly in malignant than in benign tumors. AB - Transin RNA is a 1.9-kilobase RNA transcript induced by oncogenes in rat embryo fibroblast cell lines. We show that RNA species complementary to a cloned transin cDNA are present in mouse skin squamous cell carcinomas induced by a classical initiation-promotion protocol but not in premalignant, benign papillomas or in normal epidermis. A single application of a tumor promoting phorbol ester to normal epidermis elicits a transient increase in these RNA levels. Transin RNA encodes a secreted protease, an activity consistent with a functional role for enhanced expression of transin RNA in the progression of benign, encapsulated tumors to malignant, invasive carcinomas. PMID- 3540939 TI - Conserved protein domains in a myosin heavy chain gene from Dictyostelium discoideum. AB - The 2116-amino acid myosin heavy chain sequence from Dictyostelium discoideum was determined from DNA sequence analysis of the cloned gene. The gene product can be divided into two distinct regions, a globular head region and a long alpha helical, rod-like tail. In comparisons with nematode and mammalian muscle myosins, specific areas of the head region are highly conserved. These areas presumably reflect conserved functional and structural domains. Certain features that are present in the head region of nematode and mammalian muscle myosins, and that have been assumed to be important for myosin function, are missing in the Dictyostelium myosin sequence. The protein sequence of the Dictyostelium tail region is very poorly conserved with respect to the other myosins but displays the periodicities similar to those of muscle myosins. These periodicities are believed to play a role in filament formation. The 196-residue repeating unit that determines the 14.3-nm repeat seen in muscle thick filaments, the 28-residue charge repeating unit, and the 1,4 hydrophobic repeat previously described for the nematode myosin are all present in the Dictyostelium myosin rod sequence, suggesting that the filament structures of muscle and Dictyostelium myosins must be similar. PMID- 3540940 TI - Synthesis, bacterial expression, and mutagenesis of the gene coding for mammalian cytochrome b5. AB - We have totally synthesized a gene that codes for rat hepatic cytochrome b5. The 5' flanking region was designed for efficient expression of this gene in Escherichia coli by incorporating an optimum ribosome binding site and spacer region. Both a soluble form, analogous to the protease-treated microsomal protein, as well as the complete cytochrome with hydrophobic membrane anchor, was constructed and expressed. Transformants with the gene for the soluble protein overproduce authentic cytochrome b5 to a level of 8% of the total cell protein. The complete cytochrome is expressed to a lesser extent with most of the protein found in the cell membrane fraction. This represents complete synthesis and bacterial expression of a mammalian metalloprotein gene. Cytochrome b5 is normally a six-coordinate low spin heme protein with histidine-39 and histidine 63 as axial ligands. We have replaced histidine-63 with a methionine residue by cassette mutagenesis, utilizing specific restriction enzyme sites engineered into the synthetic gene. The resultant protein has histidine-39 as sole axial ligand and is five-coordinate high spin in the ferric resting state, as indicated by optical and electron spin resonance spectroscopy. The ability to generate mutant cytochrome b5 in high yield is a crucial step in understanding heme protein folding, protein-protein recognition and binding, and biological electron transfer processes. PMID- 3540941 TI - Insulin and growth factor effects on c-fos expression in normal and protein kinase C-deficient 3T3-L1 fibroblasts and adipocytes. AB - We investigated the expression of the protooncogene c-fos in 3T3-L1 fibroblasts and adipocytes in response to a variety of growth-promoting agents in normal cells and in cells preincubated with phorbol esters to deplete them of protein kinase C. There was a rapid accumulation of c-fos mRNA in fibroblasts and adipocytes treated with phorbol 12-myristate 13-acetate, platelet-derived growth factor, fibroblast growth factor, fetal calf serum, bombesin, and insulin, especially in the adipocytes. Phorbol 12-myristate 13-acetate pretreatment abolished the increase in c-fos mRNA due to additional phorbol 12-myristate 13 acetate treatment and decreased but did not eliminate the ability of platelet derived growth factor, fibroblast growth factor, fetal calf serum, bombesin, and insulin to stimulate c-fos mRNA. These data suggested that c-fos mRNA could be induced in serum-deprived 3T3-L1 fibroblasts and adipocytes by at least two separate pathways, one involving protein kinase C and the other independent of protein kinase C. In the very insulin-sensitive 3T3-L1 adipocytes, insulin rapidly and transiently increased c-fos expression (c-fos mRNA appeared by 15 min and disappeared after 60 min) via interaction with its own cellular receptor, rather than by interacting with receptors for one of the insulin-like growth factors. Cycloheximide treatment in combination with insulin or phorbol 12 myristate 13-acetate resulted in superinduction of c-fos mRNA. We conclude that insulin can rapidly stimulate c-fos mRNA accumulation in 3T3-L1 adipocytes and that part of the growth factor-stimulated increase in this mRNA that occurs in protein kinase C-deficient cells may be due to activation of a pathway similar or identical to that activated by insulin. PMID- 3540942 TI - Expression of human HSP70 during the synthetic phase of the cell cycle. AB - Expression of the major heat shock and stress-induced protein, HSP70, is under complex regulatory control in human cells. In addition to being induced by physiological stress such as heat shock or transition metals, the HSP70 gene is induced by serum stimulation and immortalizing products of the adenovirus E1A 13S and polyoma large tumor antigen genes. Here we show that expression of the human HSP70 gene is tightly regulated during the cell cycle. Using selective mitotic detachment, a noninductive method to obtain synchronous populations of HeLa cells, we show that levels of HSP70 mRNA rapidly increase 10- to 15-fold upon entry into S phase and decline by late S and G2. A transient increase in HSP70 synthesis is detected during early S phase. The subcellular localization of HSP70 varies throughout the cell cycle; the protein is diffusely distributed in the nucleus and cytoplasm in G1, localized in the nucleus in S, and again diffusely distributed in G2 cells. We suggest that the temporal pattern of HSP70 expression during S phase, the nuclear localization, and activation by trans-acting immortalizing proteins indicate a role for HSP70 in the nucleus of replicating cells. PMID- 3540943 TI - Direct introduction of genes into rats and expression of the genes. AB - A method of introducing actively expressed genes into intact mammals is described. DNA precipitated with calcium phosphate has been injected intraperitoneally into newborn rats. The injected genes have been taken up and expressed by the animal tissues. To examine the generality of the method we have injected newborn rats with the chloramphenicol acetyltransferase prokaryotic gene fused with various viral and cellular gene promoters and the gene for hepatitis B surface antigen, and we observed appearance of chloramphenicol acetyltransferase activity and hepatitis B surface antigen in liver and spleen. In addition, administration of genes coding for hormones (insulin or growth hormone) resulted in their expression. PMID- 3540944 TI - Rho-dependent transcription termination of a bacterial operon is antagonized by an extrachromosomal gene product. AB - The psu gene product of "phasmid" (phage-plasmid) P4 acts as a transcription antitermination factor in trans and in cis, respectively, within the morphogenic operons of its P2 phage helper during lytic viral development and on P4 itself during the establishment stage of its alternative mode of propagation as a plasmid. Here we show that psu also antagonizes activity of the Escherichia coli transcription termination factor rho at the terminator of the trp operon. Such a finding provides to our knowledge the first direct evidence for antitermination activity at a known rho-dependent site by the psu gene product. It also reveals an example of an extrachromosomal gene product that acts on specific sites of three different genomes to regulate expression of unlinked families of genes. PMID- 3540945 TI - Human c-myb protooncogene: nucleotide sequence of cDNA and organization of the genomic locus. AB - We have isolated cDNA clones of the human c-myb mRNA that contain approximately 3.4 kilobases of the approximately 3.8-kilobase mRNA sequence. Nucleotide sequence analysis shows that the c-myb mRNA contains an open reading frame of 1920 nucleotides, which could encode a 72-kDa protein. The cDNA nucleotide sequence and the predicted amino acid sequence of the c-myb protein are highly homologous to the corresponding chicken and mouse proteins. In particular, a region toward the NH2 terminus of the protein containing a 3-fold tandem repeat of 51 residues is evolutionarily conserved and is the only region of homology with the Drosophila c-myb protein. This region may represent a functionally important structure, most likely the DNA-binding domain. cDNA clones have been used to isolate genomic clones and to define a preliminary intron/exon organization of the c-myb gene. Identification of 5' and 3' coding and noncoding exons indicates that the human c-myb locus spans a 40-kilobase region. PMID- 3540946 TI - Isolation of a cDNA for human acid alpha-glucosidase and detection of genetic heterogeneity for mRNA in three alpha-glucosidase-deficient patients. AB - Lysosomal acid alpha-glucosidase (EC 3.2.1.3) hydrolyzes 1,4-linked alpha-D glucose polymers present in glycogen. Genetic deficiency of acid alpha glucosidase results in glycogen-storage disease type II, encompassing a spectrum of disorders of varying severity. To study the molecular basis for this heterogeneity, we sought to clone the coding sequence for human acid alpha glucosidase. We screened 10(6) recombinant phage from a human liver cDNA expression library with an affinity-purified polyclonal antibody to human acid alpha-glucosidase. When we retested positive phage for reactivity to monoclonal antibodies, we identified a single phage, containing a 2-kilobase (kb) cDNA insert, that reacted with both polyclonal and monoclonal antibodies. The 2-kb cDNA hybridized to a 20-kb EcoRI fragment of human genomic DNA. This 20-kb EcoRI fragment was present only in DNA from somatic cell hybrids that retained the human chromosome 17 segment q21-q23, which contains the gene for human acid alpha glucosidase. The cDNA also hybridized to a 3.4-kb mRNA, consistent with the size (approximately 105 kDa) of the acid alpha-glucosidase protein. Finally, in one of two infantile-onset acid alpha-glucosidase-deficient cell lines tested, the 3.4 kb mRNA was not detectable, whereas in an adult-onset cell line, an mRNA of reduced size and amount was found. Examination of DNA digested with restriction enzymes did not reveal any major deletions in the genomic DNA of these patients. PMID- 3540947 TI - Positive and negative roles of an initiator protein at an origin of replication. AB - The properties of mutants in the pir gene of plasmid R6K have suggested that the pi protein plays a dual role; it is required for replication to occur and also plays a role in the negative control of the plasmid copy number. In our present study, we have found that the pi level in cell extracts of Escherichia coli strains containing R6K derivatives is surprisingly high (approximately equal to 10(4) dimers per cell) and that this level is not altered in cells carrying high copy number pir mutants. The wild-type and a high copy mutant (Cos405) pir gene were inserted downstream of promoters of different strengths to measure the copy number of an R6K gamma replicon as a function of a 1000-fold range of intracellular pi concentrations. The data demonstrate that reducing the intracellular level of pi to 5% of its normal value can result in a substantial increase in copy number of a gamma origin replicon and that a pi level less than 1% of normal is still permissive for replication. Conversely, increasing the pi level even a few-fold above normal results in a marked inhibition of replication of plasmids containing a single, two, or all three of the R6K origins (alpha, beta, and gamma). We have also shown that the replication inhibition mediated by excess pi is greatly reduced by the pir405 Cos mutation. These results demonstrate that the total level of pi protein is not rate-limiting for a gamma replicon. We have also determined the sensitivity of the pir gene promoter to a wide range of pi concentrations. The activity of this promoter is stimulated by very low pi levels and is almost entirely inhibited when the protein is overproduced 2-fold. PMID- 3540949 TI - T-cell receptor alpha-chain gene is split in a human T-cell leukemia cell line with a t(11;14)(p15;q11). AB - Chromosomal rearrangements in malignant T-cell disease frequently involve the chromosome bands containing the T-cell receptor genes. The RPMI 8402 cell line, which was established from the leukemia cells of a patient with T-cell acute lymphoblastic leukemia, is characterized by a translocation involving chromosome 14 (band q11) and chromosome 11 (band p15) [t(11;14)(p15;q11)]. By using in situ chromosomal hybridization and Southern blot analysis to examine RPMI 8402 cells, we determined that the break at 14q11 occurs within the variable region sequences of the T-cell receptor alpha-chain gene (TCRA); the break at 11p15 occurs between the HRAS1 gene and the genes for insulin and the insulin-like growth factor 2. These results suggest that the TCRA sequences activate a cellular gene located at 11p15 in malignant T-cell disorders. PMID- 3540948 TI - Oncostatin M: a growth regulator produced by differentiated histiocytic lymphoma cells. AB - A polypeptide termed oncostatin M, which inhibits the replication of A375 melanoma and other human tumor cells, but not normal human fibroblasts, has been isolated from serum-free supernatants of U-937 histiocytic lymphoma cells that have been induced to differentiate into macrophage-like cells following treatment with the phorbol ester phorbol 12-myristate 13-acetate. No such growth inhibitory activity is detected in the supernatant of untreated U-937 cells, indicating that the protein is induced or increased in expression in the phorbol ester-induced differentiated cells. Oncostatin M is stable between pH 2 and 11 and after heating for 1 hr at 56 degrees C but is not stable at 90 degrees C. Purification of oncostatin M has been achieved by gel chromatography and reversed-phase HPLC, using sequentially acetonitrile and n-propanol in the presence of aqueous trifluoroacetic acid. The apparent molecular weight of oncostatin M is approximately 18,000, as determined by gel chromatography, and 28,000, as determined by polyacrylamide gel electrophoresis. The amino-terminal amino acid sequence of the purified polypeptide has been determined. No substantial sequence homology between oncostatin M and other proteins was found, including other tumor cell inhibitory proteins produced by mononuclear cells. Oncostatin M, therefore, appears to represent a distinct cell growth regulator. PMID- 3540951 TI - Overlapping cDNA clones define the complete coding region for the P210c-abl gene product associated with chronic myelogenous leukemia cells containing the Philadelphia chromosome. AB - The Philadelphia chromosome, observed in greater than 90% of patients with chronic myelogenous leukemia, results from a reciprocal translocation between chromosomes 9 and 22. The translocation breakpoint on chromosome 9 occurs near the ABL gene and correlates with the production of a chronic myelogenous leukemia specific 8.5-kilobase ABL-related mRNA species accompanied by a structurally altered ABL protein (P210c-abl). The N-terminal sequence of the protein is derived from the BCR gene on chromosome 22. We have isolated overlapping cDNA clones from the K-562 cell line corresponding to approximately 8.5 kilobases of mRNA and have sequenced 2550 nucleotides at the 5' end. Our results indicate that the 5' end of the 8.5-kilobase mRNA consists of greater than 400 nucleotides of noncoding sequence that are greater than 80% G + C rich. Based on our sequence analysis, we propose that initiation of translation occurs at nucleotide 471, such that the initial 927 amino acids of P210c-abl are derived from BCR sequences. Our cDNA clones thus define the complete coding sequences for the P210c-abl gene product. PMID- 3540950 TI - Loss of insulin response to glucose but not arginine during the development of autoimmune diabetes in BB/W rats: relationships to islet volume and glucose transport rate. AB - The insulin and glucagon responses to 10 mM glucose and 10 mM arginine were studied in pancreata isolated from nondiabetic diabetes-prone and diabetes resistant BB/W rats at 60, 80, and 140 days of age and in diabetic BB/W rats on the 1st and 14th days of their diabetes. In the former group the insulin response to glucose declined progressively with age (r = -0.575; P less than 0.01) and at 140 days was significantly below age-matched diabetes-resistant controls (P less than 0.05). The insulin response to arginine did not decline with age in either group. For diabetic rats, on the first day of the diabetes, the insulin response to glucose was absent but the response to arginine did not differ from nondiabetic controls. On day 14 responses to glucose and arginine were both absent. The glucagon response to arginine showed no trend despite a decline in baseline glucagon secretion. Endocrine tissue in nondiabetic diabetes-prone rats made up 0.8 +/- 0.2% of the pancreas at 60 days of age and 0.52 +/- 0.22% at 140 days of age; the latter was significantly less than in 140-day-old diabetes resistant controls (P less than 0.05). In diabetic rats on the 1st and 14th days of diabetes endocrine tissue was 0.2 +/- 0.1% and 0.07 +/- 0.02%, respectively. The glucose transport rate in islets isolated on the first day of diabetes was profoundly reduced compared to age-matched nondiabetic diabetes-prone controls. Thus, a population of arginine-responsive, glucose-unresponsive islets with low glucose transport rates is present at the onset of overt diabetes in BB/W rats. PMID- 3540952 TI - Blue-light reception in Phycomyces phototropism: evidence for two photosystems operating in low- and high-intensity ranges. AB - Phototropism in the fungus Phycomyces is mediated by two photosystems that are optimized for the low-intensity region (below 10(-6) W X m-2) and the high intensity region (above 10(-6) W X m-2). These photosystems can be distinguished under special experimental conditions, in which sporangiophores grown in the dark are suddenly exposed to continuous unilateral light. With this treatment, the bending occurs in two steps. Below 10(-6) W X m-2, an early-response component (15-min latency) and a late-response component (50- to 70-min latency) are observed that are mediated by photosystem I. Above 10(-6) W X m-2, the early component is augmented by an intermediate component with a 40-min delay that is mediated by photosystem II. The two photosystems are distinguished further by their wavelength sensitivities and adaptation kinetics. Photosystem I is more effective at 334, 347, and 550 nm than photosystem II, but it is less effective at 383 nm. At wavelength 450 nm, the dark-adaptation kinetics associated with photosystem I are approximately half as fast as those associated with photosystem II. However, the light-adaptation kinetics of photosystem I are approximately equal to 3 times faster than the kinetics associated with photosystem II. The existence of two photosystems clarifies several behavioral features of Phycomyces and helps explain how the sporangiophore can manage the full range of 10 decades. PMID- 3540953 TI - Insulin rapidly stimulates phosphorylation of a 46-kDa membrane protein on tyrosine residues as well as phosphorylation of several soluble proteins in intact fat cells. AB - It is speculated that the transmission of an insulin signal across the plasma membrane of cells occurs through activation of the tyrosine-specific receptor kinase, autophosphorylation of the receptor, and subsequent phosphorylation of unidentified substrates in the cell. In an attempt to identify possible substrates, we labeled intact rat fat cells with [32P]orthophosphate and used an antiphosphotyrosine antibody to identify proteins that become phosphorylated on tyrosine residues in an insulin-stimulated way. In the membrane fraction of the fat cells, we found, in addition to the 95-kDa beta-subunit of the receptor, a 46 kDa phosphoprotein that is phosphorylated exclusively on tyrosine residues. This protein is not immunoprecipitated by antibodies against different regions of the insulin receptor and its HPLC tryptic peptide map is different from the tryptic peptide map of the insulin receptor, suggesting that it is not derived from the receptor beta-subunit. Insulin stimulates the tyrosine phosphorylation of the 46 kDa protein within 150 sec in the intact cell 3- to 4-fold in a dose-dependent way at insulin concentrations between 0.5 nM and 100 nM. The insulin effect starts after 30 sec, is maximal at 150 sec, and declines to almost basal values by 5 min. Furthermore, the antiphosphotyrosine antibody precipitated at least five proteins in the soluble fraction of the fat cell. Insulin (0.5 nM, 100 nM) stimulated within 2 min the 32P incorporation into a 116-kDa band, a 62-kDa band, and three bands between 45 kDa and 50 kDa 2- to 10-fold. We suggest that the 46 kDa membrane protein and possibly also the soluble proteins are endogenous substrates of the receptor tyrosine kinase in fat cells and that their phosphorylation is an early step in insulin signal transmission. PMID- 3540954 TI - Gangliosides as bimodal regulators of cell growth. AB - The B subunit of cholera toxin, which binds specifically to several molecules of ganglioside galactosyl-(beta 1----3)-N-acetylgalactosyminyl(beta 1----4)-[N- acetylneuraminyl(alpha 2----3)]-galactosyl(beta 1----4)glucosyl(beta 1----1) ceramide (GM1) on the cell surface, stimulated DNA synthesis and cell division in quiescent, nontransformed mouse 3T3 cells in a dose-dependent manner. In addition, the B subunit potentiated the response of the 3T3 cells to other mitogens, such as epidermal growth factor, platelet-derived growth factor, and insulin. This synergistic effect indicates that the B subunit does not act identically to any of these growth factors but probably modulates a common effector system crucial for cell proliferation. In distinct contrast, the B subunit inhibited the growth of ras-transformed 3T3 cells as well as rapidly dividing normal 3T3 cells. Thus, the same cells, depending on their state of growth, exhibited a bimodal response to the B subunit. We conclude that endogenous gangliosides may be bimodal regulators of positive and negative signals for cell growth. PMID- 3540955 TI - Transfection with plasmid pSV2gptEJ induces chromosome rearrangements in CHEF cells. AB - In previous cytogenetic studies, trisomy for 3q was found to be the most frequent chromosome change associated with induced tumorigenicity by a variety of agents in Chinese hamster cells. Here we describe similar chromosome changes in 11 lines of CHEF/18 cells transfected with the mutant c-Ha-ras containing plasmid pSV2gptEJ. All 11 lines contained the transfected EJ gene and expressed increased levels of p21, the EJ gene product. Ten of the 11 lines were tumorigenic and all but 2 of these were trisomic for all or part of 3q. One line remained diploid and was nontumorigenic despite expressing elevated p21. Two tumorigenic lines from "hit-and-run" transfection with pSV2gpt were shown to express only control levels of p21, but they were trisomic for 3q. These results show that increased p21 expression is neither necessary nor sufficient for inducing tumorigenicity of CHEF cells. We propose that tumorigenicity in the transfected CHEF/18 cells of this study was induced by chromosome rearrangements, especially trisomy for 3q, that occurred at increased frequencies following transfection with pSV2gptEJ. PMID- 3540956 TI - Induction of DNA synthesis in isolated nuclei by cytoplasmic factors: inhibition by protease inhibitors. AB - Cytoplasmic extracts from spontaneously proliferating and mitogen-activated lymphoid cells contain a protein factor called ADR (activator of DNA replication) that induces DNA synthesis in isolated quiescent nuclei. ADR-containing preparations have proteolytic activity, as indicated by their ability to degrade fibrin in a plasminogen-independent and plasminogen-dependent manner. In addition, aprotinin, a nonspecific protease inhibitor, abrogates ADR-induced DNA synthesis in a dose-dependent fashion. Preincubation studies demonstrated that the effect of aprotinin is not due to its suppressive effects on the nuclei themselves. Other protease inhibitors such as leupeptin, p-aminobenzamidine, and N-alpha-tosyllysine chloromethyl ketone are also inhibitory, but soybean trypsin inhibitor is without effect. ADR activity can be removed from active extracts by adsorption with aprotinin-conjugated agarose beads and can be recovered by elution with an acetate buffer (pH 5). These findings are consistent with the interpretation that the initiation of DNA synthesis in resting nuclei may be protease dependent and, further, that the cytoplasmic stimulatory factor we have called ADR may be a protease itself. PMID- 3540957 TI - Shared active sites in oligomeric enzymes: model studies with defective mutants of aspartate transcarbamoylase produced by site-directed mutagenesis. AB - Many oligomeric enzymes are functional only in the assembled form, and it is often difficult to determine unambiguously why monomers are inactive. In some cases individual monomers cannot fold into stable correct ("native") conformations without contributions from interchain interactions. For other oligomers, catalysis requires the contributions of amino acid residues at the interface between adjacent polypeptide chains, and monomers are inactive because they cannot form complete active sites. A test for the presence of shared sites was devised that is based on the formation of active hybrid oligomers from appropriate inactive parental mutants produced by site-directed mutagenesis. This approach was applied in a study of the catalytic trimer of aspartate transcarbamoylase (aspartate carbamoyltransferase, EC 2.1.3.2) from Escherichia coli, using three mutants, in which Ser-52 was replaced by His, Lys-84 by Gln, or His-134 by Ala. Hybrid trimers formed from the virtually inactive Ser and Lys mutants were 10(5) more active than the parental proteins, and the specific activities of each hybrid were about 33% that of the wild-type trimer, as expected for the scheme based on shared sites. Hybrids from the His and Lys mutants had comparable specific activities. Moreover, one hybrid with approximately 33% activity had one high-affinity binding site for a bisubstrate analog as compared to about three for wild-type trimer. As a further test, hybrids were also formed from wild-type and double-mutant (Lys-84----Gln and His 134----Ala) trimers. The hybrid containing two chains with the double mutation and one wild-type chain had very little activity, and that composed of one double mutant and two wild-type chains had 32% the specific activity of wild-type trimers. This negative complementation experiment is in quantitative accord with the scheme based on shared sites at or near the interfaces between adjacent chains. The techniques used to demonstrate shared active sites in the catalytic subunits of aspartate transcarbamoylase can be applied generally to various types of oligomers (dimers, tetramers, etc.) to determine whether the participation of amino acid residues from adjoining chains is essential for forming active sites in oligomeric enzymes. PMID- 3540959 TI - Molecular basis for group B beta-hemolytic streptococcal disease. AB - Group B beta-hemolytic Streptococcus (GBS) is a major pathogen affecting newborns. We have investigated the molecular mechanism underlying the respiratory distress induced in sheep after intravenous injection of a toxin produced by this organism. The pathophysiological response is characterized by pulmonary hypertension, followed by granulocytopenia and increased pulmonary vascular permeability to protein. 31P NMR studies of GBS toxin and model components before and after reductive alkaline hydrolysis demonstrated that phosphodiester residues are an integral part of the GBS toxin. Reductive alkaline treatment cleaves phosphate esters from secondary and primary alcohols and renders GBS toxin nontoxic in the sheep model and inactive as a mediator of elastase release in vitro from isolated human granulocytes. We propose that the interaction of cellular receptors with mannosyl phosphodiester groups plays an essential role in the pathophysiological response to GBS toxin. PMID- 3540958 TI - Acute insulin action requires insulin receptor kinase activity: introduction of an inhibitory monoclonal antibody into mammalian cells blocks the rapid effects of insulin. AB - The role of the insulin receptor tyrosine kinase (protein-tyrosine kinase, EC 2.7.1.112) in various rapid insulin effects was studied by injecting four different cell types (by osmotic lysis of pinocytotic vesicles) with a monoclonal antibody that specifically inhibits the kinase activity of the insulin receptor and the closely related receptor for insulin-like growth factor (IGF)-I. Injection of this inhibitory antibody resulted in a decreased ability of insulin to stimulate the uptake of 2-deoxyglucose in Chinese hamster ovary cells and freshly isolated rat adipocytes, ribosomal protein S6 phosphorylation in CHO cells, and glycogen synthesis in the human hepatoma cell line HepG2. The ability of insulin, IGF-I, and IGF-II to stimulate glucose uptake in TA1 mouse adipocytes was also inhibited. Studies with CHO cells demonstrated that these effects of the inhibitory antibody were specific, since there was no change in phorbol ester stimulated glucose uptake and injection of a noninhibiting antibody to the kinase had no effect on insulin action. These studies indicate that the tyrosine kinase activity of the insulin receptor is important in mediating several rapid insulin effects in a variety of different cell types. PMID- 3540960 TI - Escherichia coli formylmethionine tRNA: mutations in GGGCCC sequence conserved in anticodon stem of initiator tRNAs affect initiation of protein synthesis and conformation of anticodon loop. AB - We have generated mutants of Escherichia coli formylmethionine initiator tRNA in which one, two, and all three G X C base pairs in the GGGCCC sequence in the anticodon stem are changed to those found in E. coli elongator methionine tRNA. Overproduction of the mutant tRNAs using M13 recombinants as an expression vector and development of a one-step purification scheme allowed us to purify, characterize, and analyze the function of the mutant tRNAs. After aminoacylation and formylation, the function of mutant formylmethionyl tRNAs was analyzed in an MS2 RNA-directed in vitro protein-synthesizing system, in AUG-dependent ribosomal P site binding, and in initiation factor binding. The mutant tRNAs show progressive loss of activity in initiation, the mutant with all three G X C base pairs substituted being the least active. The mutations affect binding to the ribosomal P site. None of the mutations affects binding to initiation factor 2. We also show that there is a progressive increase in accessibility of phosphodiester bonds in the anticodon loop of the three mutants to S1 nuclease, such that the cleavage pattern of the mutant with all three G X C base-pair changes resembles that of elongator tRNAs. These results are consistent with the notion that the contiguous G X C base pairs in the anticodon stem of initiator tRNAs impart on the anticodon loop a unique conformation, which may be important in targeting the initiator tRNA to the ribosomal P site during initiation of protein synthesis. PMID- 3540961 TI - DNA base changes and alkylation following in vivo exposure of Escherichia coli to N-methyl-N-nitrosourea or N-ethyl-N-nitrosourea. AB - Dideoxy chain-termination DNA sequencing was used to determine the specific DNA base changes induced after in vivo exposure of Escherichia coli to N-methyl-N nitrosourea (MNU) and N-ethyl-N-nitrosourea (ENU) using the xanthine guanine phosphoribosyltransferase (gpt) gene as the genetic target. The resultant mutation spectra were compared with the levels of O6-alkylguanine and O4 alkylthymidine in genomic DNA immediately after exposure. All (39/39) of the MNU induced mutations were G X C----A X T transitions. In contrast, 24/33 point mutations isolated following ENU treatment were G X C----A X T transitions, 7/33 were A X T----G X C transitions, 1/33 was a G X C----C X G transversion, and 1/33 was an A X T----C X G transversion. Three large insertions, probably of spontaneous origin, were also isolated. O4-alkylthymidine/O6-alkylguanine ratios were 0.014 for MNU and 0.28 for ENU. These data suggest that the difference in the mutation spectrum of MNU versus ENU may be attributed, in part, to the different ratio of O6-alkylguanine versus O4-alkylthymidine produced in the DNA. Of the G X C----A X T transitions, 82% of the MNU- and 71% of the ENU-induced mutations occurred at the middle guanine of the sequence 5'-GG(A or T)-3'. PMID- 3540962 TI - Substrate specificity of the chymotrypsin-like protease in secretory granules isolated from rat mast cells. AB - The substrate specificity of rat mast cell protease I (RMCP I), a chymotrypsin like serine protease localized in the secretory granules of mast cells, was compared to that of bovine alpha-chymotrypsin by using several peptide and protein substrates of known amino acid sequences. Although the overall specificities of the two proteases appeared similar, subtle but significant differences were observed. RMCP I was more prone than chymotrypsin to hydrolyze peptide bonds consisting of Leu-Xaa or two hydrophobic residues--e.g., Phe-Phe. Additionally, the hydrolysis of angiotensin I catalyzed by chymotrypsin, but not by RMCP I, resulted in the generation of angiotensin II as an intermediate product. In contrast to the solubilized enzyme, the RMCP I activity within the insoluble granules was completely stable for at least 2 months in suitable buffers at pH 8.0 or pH 7.2, at 4 degrees C. Carboxypeptidase A activity associated with isolated mast cell granules was completely inhibited by 10 mM o phenanthroline. Polypeptides smaller than apomyoglobin (17,199 Da) were rapidly hydrolyzed by granule-bound RMCP I, whereas apomyoglobin and other larger proteins were not hydrolyzed. In contrast, the free protease readily hydrolyzed the larger proteins. Neither normal rat serum nor alpha 1-antitrypsin, both of which inhibited the activity of free RMCP I, was effective in inhibiting granule associated RMCP I. The results indicate that granule-bound RMCP I is not released into solution from isolated secretory granules under physiological conditions of ionic strength and pH and that the granule structure limits the size of proteins that can be hydrolyzed by the protease. PMID- 3540963 TI - Membrane association of proline dehydrogenase in Escherichia coli is redox dependent. AB - The PutA protein, product of the Escherichia coli gene putA, has two functions essential for proline utilization and for the regulation of putP and putA expression: as the peripheral membrane flavoprotein, proline dehydrogenase (EC 1.5.99.8), it transfers electrons from proline to the respiratory chain, and, as a repressor, it controls expression of genes putP and putA in response to proline supply. Association of proline dehydrogenase with the membrane was shown to require the simultaneous presence of the soluble enzyme, membranes, and proline. The kinetics of that association, monitored by following proline oxidation in a coupled enzyme assay system, were not altered when the transmembrane proton gradient generated during proline oxidation was dissipated by a proton ionophore. However, D-lactate or NADH could replace proline as a promoter of proline dehydrogenase-membrane association under anaerobic reaction conditions. These data imply that reduction of proline dehydrogenase and/or a membrane constituent promotes enzyme-membrane association. A biochemical mechanism is suggested whereby the concentration of proline dehydrogenase associated with the respiratory chain would be determined by proline supply. PMID- 3540964 TI - Malonyl-CoA binding site and the overt carnitine palmitoyltransferase activity reside on the opposite sides of the outer mitochondrial membrane. AB - The overt carnitine palmitoyltransferase (palmitoyl-CoA:L-carnitine O palmitoyltransferase, EC 2.3.1.21) activity of intact mitochondria from rat heart and liver was found to be resistant to the action of proteases such as Nagarse (subtilisin, EC 3.4.21.14). Nagarse under the same conditions, however, greatly decreased the malonyl-CoA inhibition of carnitine palmitoyltransferase activity, the high-affinity binding of malonyl-CoA to mitochondria, and the ability of malonyl-CoA to shift to the right the sigmoid activity curve of carnitine palmitoyltransferase observed with variations in palmitoyl-CoA concentration. No noticeable effect of Nagarse pretreatment was observed on the binding of octanoyl CoA to mitochondria. Subfractionation of liver mitochondria using a combination of swelling, shrinking, and density gradient centrifugation yielded a membrane fraction in which the specific activities of the outer membrane marker enzymes were enriched greater than or equal to 16-fold together with a near-parallel enrichment of malonyl-CoA-inhibitable carnitine palmitoyltransferase activity. The percent recovery of this carnitine palmitoyltransferase in the outer membrane vesicles also matched that of the known outer membrane markers. The carnitine palmitoyltransferase activity of these out-side-out vesicles became susceptible to added Nagarse only on their cosonication. These findings show that whereas the malonyl-CoA binding site relevant to the inhibition of carnitine palmitoyltransferase is situated on the outer side of the outer membrane, the overt carnitine palmitoyltransferase activity resides on the inner side of the outer membrane. PMID- 3540965 TI - Covalent structure of biodegradative threonine dehydratase of Escherichia coli: homology with other dehydratases. AB - The 987-base-pair coding region of the tdc gene of Escherichia coli K-12 encoding biodegradative threonine dehydratase [Tdc; L-threonine hydro-lyase (deaminating), EC 4.2.1.16], previously cloned in this laboratory, was sequenced. The deduced polypeptide consists of 329 amino acid residues with a calculated Mr of 35,238. Although the purified enzyme was shown to contain tryptophan, no tryptophan codon was found in the tdc reading frame. Incubation of purified Tdc with [14C]tryptophan revealed apparent "covalent" binding of tryptophan, indicating posttranslational modification of the enzyme. A heptapeptide, 54Thr-55Gly-56Ser 57Phe-58Lys-59Ile- 60Arg, was found to contain Lys-58, which binds pyridoxal phosphate coenzyme. A comparison of amino acid sequences between the Tdc polypeptide and the biosynthetic threonine dehydratases of yeast (encoded by ILV1) and E. coli (encoded by ilvA) and the E. coli D-serine dehydratase (DsdA, encoded by dsdA) revealed various extents of homology: five domains of the Tdc polypeptide were 63-93% homologous with the yeast enzyme, and three of these same regions were 80% homologous with the biosynthetic E. coli dehydratase; two different domains showed 67% and 83% homology with DsdA. In addition, two other sequences were highly conserved in all four proteins, one of which was shown to contain the conserved lysine residue that binds pyridoxal phosphate in the Tdc and DsdA polypeptides. These observations suggest that, despite their diverse origin and metabolic significance, these enzymes may have evolved from a common ancestral protein. PMID- 3540966 TI - Molecular cloning and nucleotide sequence of cDNA for human liver arginase. AB - Arginase (EC 3.5.3.1) catalyzes the last step of the urea cycle in the liver of ureotelic animals. Inherited deficiency of the enzyme results in argininemia, an autosomal recessive disorder characterized by hyperammonemia. To facilitate investigation of the enzyme and gene structures and to elucidate the nature of the mutation in argininemia, we isolated cDNA clones for human liver arginase. Oligo(dT)-primed and random primer human liver cDNA libraries in lambda gt11 were screened using isolated rat arginase cDNA as a probe. Two of the positive clones, designated lambda hARG6 and lambda hARG109, contained an overlapping cDNA sequence with an open reading frame encoding a polypeptide of 322 amino acid residues (predicted Mr, 34,732), a 5'-untranslated sequence of 56 base pairs, a 3'-untranslated sequence of 423 base pairs, and a poly(A) segment. Arginase activity was detected in Escherichia coli cells transformed with the plasmid carrying lambda hARG6 cDNA insert. RNA gel blot analysis of human liver RNA showed a single mRNA of 1.6 kilobases. The predicted amino acid sequence of human liver arginase is 87% and 41% identical with those of the rat liver and yeast enzymes, respectively. There are several highly conserved segments among the human, rat, and yeast enzymes. PMID- 3540967 TI - Ultrastructural evidence for the accumulation of insulin in nuclei of intact 3T3 L1 adipocytes by an insulin-receptor mediated process. AB - Monomeric ferritin-labeled insulin (Fm-Ins), a biologically active, electron dense marker of occupied insulin receptors, was used to characterize the internalization of insulin in 3T3-L1 adipocytes. Fm-Ins bound specifically to insulin receptors and was internalized in a time- and temperature-dependent manner. Fm-Ins was found in cytoplasmic vesicles within 5-10 min at 37 degrees C and subsequently was observed in multivesicular bodies and lysosomes. In addition, small amounts of Fm-Ins were associated with nuclei after 30 min. The number of Fm-Ins particles observed in nuclei continued to increase in a time dependent manner until at least 90 min. In the nucleus, several Fm-Ins particles usually were found in the same general location--near nuclear pores, associated with the periphery of the condensed chromatin. Addition of a 250-fold excess of unlabeled insulin or incubation at 15 degrees C reduced the number of Fm-Ins particles found in nuclei after 90 min by 99% or 92%, respectively. Nuclear accumulation of unlabeled ferritin was only 2% of that found with Fm-Ins after 90 min at 37 degrees C. Biochemical experiments utilizing 125I-labeled insulin and subcellular fractionation indicated that intact 3T3-L1 adipocytes internalized insulin rapidly and that approximately equal to 3% of the internalized ligand accumulated in nuclei after 1 hr. These data provide biochemical and high resolution ultrastructural evidence that 3T3-L1 adipocytes accumulate potentially significant amounts of insulin in nuclei by an insulin receptor-mediated process. The transport of insulin or the insulin-receptor complex to nuclei in this cell or in others may be directly involved in the long-term biological effects of insulin--in particular, in the control of DNA and RNA synthesis. PMID- 3540968 TI - Human anti-endoplasmic reticulum autoantibodies appearing in a drug-induced hepatitis are directed against a human liver cytochrome P-450 that hydroxylates the drug. AB - "Anti-liver/kidney microsome" (anti-LKM) autoantibodies have been found in the serum of patients with cryptogenic chronic hepatitis and with immunoallergic drug induced hepatitis, such as those induced by halothane or by tienilic acid (called anti-LKM2 in this case). So far the nature of the human microsomal macromolecules recognized by these antibodies has not been determined. Here we show, by using immunoblot techniques, that among the macromolecules present in human adult liver microsomes, one protein called cytochrome P-450-8 is specifically recognized by most sera of patients containing anti-LKM2 antibodies but not by control serum. Human fetal liver microsomes that do not contain cytochrome P-450-8 are not recognized by the anti-LKM2 antibodies. It is also shown that anti-cytochrome P 450-8 antibodies as well as human serum containing anti-LKM2 antibodies specifically inhibit the hydroxylation of tienilic acid by human liver microsomes. These results indicate that anti-LKM2 antibodies appearing in patients with hepatitis and concomitant administration of tienilic acid are directed against a cytochrome P-450 isoenzyme that catalyzes the metabolic oxidation of this drug. This suggests a possible mechanism for the appearance of anti-organelle antibodies in a drug-induced hepatitis. PMID- 3540970 TI - Update on the effects of vitamins A, C, and E and selenium on carcinogenesis. AB - The effects of vitamins A, C, and E and of selenium on carcinogenesis are briefly summarized and updated. These vitamins and minerals were selected because they have been studied extensively in recent years with a variety of carcinogenesis models. The consumption of vitamin A and its precursors (carotenoids) has been negatively correlated with cancer at a number of sites, particularly the lung. Animal investigations on vitamin A involvement in carcinogenesis have generally been of three types: those assessing the effect of vitamin A deficiency, the effect of excess vitamin A, or the effect of supplementation with synthetic analogs of vitamin A. Vitamin A deficiency had no effect on salivary gland carcinogenesis, enhanced urinary bladder, lung, and liver carcinogenesis, and inhibited colon carcinogenesis. Excess of various forms of vitamin A enhanced or inhibited skin tumorigenesis, inhibited mammary carcinogenesis in rats (but not in mice), and carcinogenesis of the forestomach, liver, and urinary bladder (with one model, but not with another), or enhanced or did not influence lung carcinogenesis. Vitamin A analogs have enhanced or inhibited skin tumorigenesis, inhibited salivary gland, mammary, and urinary bladder carcinogenesis, enhanced tracheal and liver carcinogenesis, and either enhanced or inhibited pancreas carcinogenesis, depending upon the model employed. Although retinoids have been shown to inhibit carcinogenesis at many sites, numerous negative studies have been reported and some reports have indicated enhanced carcinogenesis. The most convincing evidence for the involvement of vitamin C in cancer prevention is the ability of ascorbic acid to prevent formation of nitrosamine and of other N nitroso compounds. In addition vitamin C supplementation was shown to inhibit skin, nose, tracheal, lung, and kidney carcinogenesis, to either not influence or enhance skin, mammary gland, and colon carcinogenesis, and to enhance urinary bladder carcinogenesis, when given as sodium ascorbate, but not when given as ascorbic acid. Like vitamin C, vitamin E can inhibit nitrosation. Vitamin E was shown to inhibit skin, cheek pouch, and forestomach carcinogenesis, to enhance or inhibit colon carcinogenesis, and to have no effect on or to inhibit mammary gland carcinogenesis, depending upon the method of vitamin E administration or the level of dietary selenium or dietary fat. Selenium effects on carcinogenesis have been recently reviewed and the present discussion only updates this area by indicating that enhancement of carcinogenesis by dietary selenium supplements has been observed in the liver, pancreas, and skin.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540971 TI - Hormonal regulation of protein kinase C in the mouse mammary gland. AB - The hormonal regulation of protein kinase C (PKC) induction over 3 to 14 days was investigated in the mouse mammary gland in vitro and in vivo. In intact mice, estradiol (1 microgram/mouse injected daily for 2 weeks) stimulated PKC activity 70%, while progesterone (1 mg/mouse injected daily) inhibited it by 30%. Prolactin, whose levels were elevated for 2 weeks by two pituitary isografts, had no effect. When mammary gland explants were cultured in insulin and cortisol, the further addition of estradiol (1 ng/ml), progesterone (1 microgram/ml), or prolactin (1 microgram/ml) did not alter PKC activity after 3 days. These data suggest the following conclusions: although previous studies have implicated prolactin in the transient, calcium-phospholipid activation of PKC, it does not appear to elevate total levels of this kinase over prolonged periods. In contrast, the sex steroids do appear to affect long-term levels of this kinase; furthermore, this latter effect may be indirect. PMID- 3540969 TI - Niemann-pick variant disorders: comparison of errors of cellular cholesterol homeostasis in group D and group C fibroblasts. AB - Fluorescence microscopic examination of filipin-stained cultured skin fibroblasts derived from two brothers with group D Niemann-Pick disease revealed abnormal storage of low density lipoprotein (LDL)-derived cholesterol. LDL stimulation of intracellular cholesteryl ester synthesis was severely compromised in the Niemann Pick D fibroblasts, as it also was in fibroblasts obtained from Niemann-Pick C patients. Cholesteryl ester synthesis was intermediately deficient in cells derived from an obligate group-D heterozygous carrier. Activity of acyl CoA:cholesterol acyltransferase was within the normal range in cell-free extracts of both LDL-depleted and LDL-supplemented cultures of Niemann-Pick C and D fibroblasts. Incubation of Niemann-Pick D fibroblasts with LDL did not lead to as high a level of intracellular cholesterol accumulation as the excessive storage observed with Niemann-Pick C fibroblasts. These findings suggest that the Niemann Pick variant disorders may represent a family of specific and possibly individual mutations that disrupt cellular cholesterol homeostasis. PMID- 3540973 TI - Permeation of endogenous IgG with an anionic subpopulation into glomerular basement membrane in rat. AB - Conflicting results of previous electron microscopy studies and concerns about the validity of immunoperoxidase technique employed in those studies to accurately localize endogenous IgG in rat glomerular basement membrane (GBM) prompted us to use other techniques to answer the following question: Does endogenous IgG permeate the matrix of GBM? Immunofluorescence, radioimmunoassay (RIA), isoelectric focusing, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), and immunodetection on Western blots were used to detect endogenous IgG in GBM. Direct immunofluorescence of normal frozen rat kidney sections prepared from in vivo perfused kidney showed endogenous IgG in a linear pattern of staining in the GBM. RIA for rat IgG found the IgG content of collagenase-solubilized GBM to be 0.48% of the dry weight. Immunodetection for rat IgG on Western blots of SDS-PAGE-separated GBM demonstrated endogenous IgG in purified collagenase-solubilized GBM. IgG was detected as an intact molecule with covalently linked light and heavy chains and not as small immunoreactive catabolic fragments. Isoelectric focusing followed by immunodetection on Western blot showed that part of the endogenous IgG in GBM was anionic. The results clearly show that under normal conditions, endogenous IgG can permeate into the collagen matrix of GBM in rat and that some of this IgG is more anionic than the IgG in serum. These findings may assist in understanding the transit of autoantibodies to subepithelial glomerular antigens located beneath the matrix of GBM in membranous glomerulonephropathy. PMID- 3540972 TI - The role of circulating antigen in the formation of immune deposits in experimental membranous nephropathy. AB - To investigate the role of circulating antigen in the formation of subepithelial immune deposits in the Heymann rat model of membranous nephropathy, the renal uptake and site of renal deposition of intravenously injected renal tubular antigen (F X 1A) was studied. F X 1A, (15, 30, 60, and 600 micrograms) radiolabeled with 125I, and bovine serum albumin (BSA; 15 micrograms) labeled with 131I were intravenously injected into naive rats. Plasma clearance and organ uptake of brush border antigens were determined. Of the injected F X 1A, 75% was cleared from the circulation by 1 hr as compared to 10% of the BSA. Uptake of F X 1A by heart, lung, and spleen was less than 1% at all doses studied. Renal uptake of F X 1A (29.8 micrograms/g tissue) was greater than that for liver (4.75 micrograms/g), spleen, heart, and lung (each less than 1 microgram/g tissue). Evaluation of washed renal homogenate and isolated glomeruli confirmed specific tissue-associated F X 1A antigen. Direct immunofluorescence demonstrated deposits of F X 1A antigen along the glomerular capillary wall in animals injected with F X 1A. Small scattered electron dense deposits were demonstrated in the subepithelial space. Similar binding could be reproduced in vitro by incubating cryostat sections of normal rat kidney or isolated glomeruli with solubilized F X 1A antigens. Direct binding of a tubular antigen to a constituent of the glomerulus could initiate in situ immune complex formation, and may explain the variably demonstrable "cross-reactivity" of the Heymann antibody with the glomerular capillary wall. PMID- 3540974 TI - Potassium-sparing effect of trilostane in hydrochlorothiazide-treated rats and dogs. AB - Trilostane, which inhibits three beta-hydroxysteroid dehydrogenase and aldosterone synthesis in rats and monkeys, significantly attenuated the oral potassium-wasting effect of hydrochlorothiazide (HCTZ) in rats and dogs when coadministered with the diuretic. The steroid reduced the kaliuretic and enhanced the natriuretic (and hyperreninemic) activity of HCTZ in rats, thereby promoting the urinary sodium/potassium ratio. Trilostane completely prevented HCTZ-induced hypokalemia in dogs and tended to reduce the degree of secondary aldosteronism. The combination also promoted hematocrit of dogs by 8% and decreased serum Na+ concentration by 7 meq/liter. When administered alone, trilostane increased canine serum potassium levels slightly and promoted rat urinary Na+/K+ ratio. Results confirm previous reports of antikaliuretic activity of trilostane in diuretic-treated rats. Further, the data indicate that frank hypokalemia induced in dogs by hydrochlorothiazide can be prevented by adjunctive trilostane therapy without eliciting hyperkalemia. PMID- 3540977 TI - Solvents and the liver. PMID- 3540975 TI - Failure of naloxone to influence surgical reversal of two-kidney, one-clip hypertension in the rat. AB - The rapid fall in blood pressure after removal of the constricting clip in two kidney one-clip (2K-1C) hypertension in the rat is not fully explained by inhibition of the renin-angiotensin system or change in sodium balance. It has been postulated that compounds released in the renal venous effluent following unclipping of 2K-1C rats have a central opiate-like action and endogenous opioids are recognized to have profound hypotensive properties. To investigate this, we removed the clip from, or performed a sham operation in, early phase (less than 6 weeks) 2K-1C hypertensive rats during an infusion of naloxone, an opioid antagonist, or vehicle alone. The infusion of naloxone did not affect the pattern of blood pressure fall in either unclipped or sham-operated rats. Both naloxone treated and control groups were similarly normotensive at 24 hr postoperation, the MAP being significantly lower than in the sham-operated groups, which regained previously hypertensive levels. Heart rate was unchanged 24 hr postoperatively in all groups. Morphine-induced bradycardia and hypotension were significantly reduced by naloxone infusion. Thus, naloxone infusion had no effect on blood pressure or heart rate in either the sham-operated or the unclipped groups, indicating that endogenous opioids do not have a major role in the reversal of renovascular hypertension under these circumstances. PMID- 3540976 TI - Acute solvent intoxication. PMID- 3540978 TI - Solvents and the kidney. AB - The final facts, necessary to establish a certain association between light to moderate organic solvent exposure and kidney disease, have not yet been presented. The methodologic difficulties and flaws from which most of the studies suffer contribute to this situation. On the other hand the results certainly do not exclude the possibility of such an association. The mechanisms behind HC causing renal disease are obscure. A direct toxic effect does not seem probable considering the frequent exposure to HC in modern society and the fairly low incidence of this disease. The possibility of the solvents initiating, mediating or in some other way taking part in immunologic reactions appears more attractive. The general impression after reviewing the presented investigations is, that the possibility of a causal association between moderate hydrocarbon exposure and renal disease must be considered substantial. The indications are strong enough to state that individuals with signs of renal dysfunction or manifest renal disease should not be exposed to organic solvents. PMID- 3540979 TI - Cancer hazard from exposure to solvents. PMID- 3540980 TI - Application of psychometric techniques in the assessment of solvent toxicity. PMID- 3540981 TI - Solvent containing processes and work practices: environmental observations. AB - Even though there has been a shift toward water-based or fully solid systems, organic solvents still comprise a significant occupational health hazard. Fortunately, exposure levels can nowadays be effectively controlled by proper enclosures and ventilation in most remaining applications of organic solvents, and, generally taken, the development of occupational health conditions has been favorable on the workplaces using organic solvents. When as many as 24.2% of the 2639 solvent measurements carried out by the Institute of Occupational Health in Finland exceeded the occupational health standards between 1971 and 1976, such non-compliance levels were detected only in 3.0% of the 2823 samples taken between 1977 and 1980 (Skytta, 1978; Kokko, 1982). The persons dealing with occupational health problems in workplaces should also be aware of the possible existence of solvent misuse. This may not develop into the level of solvent sniffing, but into a milder addiction. The workers adopt working habits that cause unnecessary exposure. Repeatedly found exceptionally high concentration levels in biological exposure tests are an indication of a possible abuse. PMID- 3540982 TI - Symptoms and signs in solvent exposed populations. PMID- 3540983 TI - Occupational solvent poisoning: clinical aspects. PMID- 3540984 TI - Danish work environment regulation of organic solvents: an attempt to evaluate the effects. PMID- 3540985 TI - Uptake and distribution of common industrial solvents. PMID- 3540986 TI - Metabolism and excretion of organic solvents. PMID- 3540988 TI - Transplantation approaches to graft rejection. Proceedings of the XVIII annual scientific symposium of the American Red Cross, Washington, D.C., April 28-30, 1986. PMID- 3540987 TI - Metabolic interactions between organic solvents and other chemicals. PMID- 3540989 TI - Transplant rejection: an overview from the clinical perspective. PMID- 3540990 TI - Graft-versus-host disease after marrow transplantation. AB - In random bred species including dog and man, a marrow graft from a donor genetically identical for the major histocompatibility complex is followed by significant graft-versus-host disease (GVHD) in 30% to 50% of the recipients despite the administration of postgrafting immunosuppression. Controlled trials comparing the immunosuppressive drugs methotrexate or cyclosporine have shown no differences in long-term survival, although cyclosporine reduces the incidence of mucositis and is associated with somewhat earlier engraftment. Observations in the canine model indicating efficacy of combining a brief course of methotrexate with the cyclosporine regimen are now being confirmed in patients with early results indicating a reduction in GVHD and an improved survival. In both species failure to administer immunosuppression after grafting is associated with a high incidence of acute GVHD and an adverse effect on survival. Removal of donor T cells from the marrow inoculum reduces the incidence of acute GVHD but at the risk of a higher likelihood of subsequent graft failure and maybe even leukemic recurrence. Results of studies in canine and human chimeras agree with murine data indicating a principal role for T cells in the pathogenic mechanism of GVHD. Chimera lymphocytes (of donor origin) from dogs and patients with acute GVHD show proliferative responses to previously stored host cells, and lymphocytes cytotoxic to host target cells are seen in patients with GVHD. Observations indicate a direct, rather than an indirect, role for T cells in GVHD. "Specific" suppressor cells may be responsible for maintaining stable graft-host tolerance while "nonspecific" suppressor cells may play a role in the impaired immune defenses in patients with chronic GVHD. Chronic GVHD, which resembles systemic collagen vascular disease, occurs in approximately 40% of HLA-identical recipients, particularly following acute GVHD and is more frequent in older patients. Efforts to treat both acute and chronic GVHD with prednisone, antithymocyte globulin, cyclosporine and azathioprine are only unpredictably effective. Data in dogs pointed out the feasibility of transplants from partially matched related donors or matched unrelated donors, an approach that is now being pursued in human patients. Marrow grafts from HLA-partially matched family members resulted in a higher incidence of acute GVHD. There was no difference in acute GVHD comparing class I to class II antigen differences and long term survival was influenced by patient age and disease status rather than HLA incompatibility.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3540991 TI - Recipient treatment to overcome the allograft reaction, with special reference to nature's own solution. AB - The 6th decade of this century was particularly important for transplantation immunology. The universality of allograft rejection by normal hosts had won general acceptance and, experimentally, several means of abrogating host reactivity to allografts were discovered. These included sub-lethal whole body irradiation, administration of certain corticosteroid hormones and inoculation of very young animals with living cellular inocula from the future graft donor- i.e., classic, neonatal tolerance. The latter was particularly important since it indicated the feasibility of a specific, permanent solution to the clinical allograft problem. Radiation and drug-induced tolerance in adult subjects came along and chemical immunosuppressants, which led to successful clinical use of azathioprine. The important rediscovery of ALS pointed towards the development and clinical application of monoclonal antibodies many years later. With the development of immunogenetics and transplantation biology came recognition that the conceptus is a highly successful allograft, raising the question of how it is able to withstand rejection by its immunocompetent mother for the duration of pregnancy. Hopefully, knowledge of the principle(s) involved when they are finally elucidated will be applicable to clinical allograft recipients. Although functional hypoantigenicity of the syncytial trophoblast probably plays a major role in protecting the allogeneic conceptus, a strong case now exists that local, cell-based, immunosuppressive and immunoprotective activity within the placenta and decidua, mediated by suppressor and other cells, is important. PMID- 3540992 TI - Transfusion pretreatment of renal transplant patients. PMID- 3540993 TI - OKT3 monoclonal antibody reversal of acute renal allograft rejection unresponsive to conventional immunosuppressive treatments. PMID- 3540994 TI - Vitrification: a new approach to organ cryopreservation. PMID- 3540995 TI - Destructive and protective effects of antibody on transplants in humans: practical and theoretical considerations. AB - Clearly the pioneering studies on hyperacute rejection, which lead to the concept of antibody-mediated injury to transplants, still present challenges to the clinician today. It is obvious that tests for antibodies before and after transplantation must be further refined to more reliably distinguish among destructive, protective and innocuous antibodies. The current crossmatch tests detect antibodies to donor lymphocytes, but lymphocytes may not always represent adequately the antigenic composition of the tissue that will be transplanted. Moreover the distribution of antigens in transplanted tissues must be considered in relation to the functional anatomy of the organs in order to understand the ultimate effects of antibodies on specific transplants. Thus some antibodies that produce a positive crossmatch may be safely ignored because they exert either a beneficial or no effect on the organ that is to be transplanted, while other antibodies that remain undetected by crossmatches on lymphocytes may damage some types of transplants. Moreover, the balance between protective and destructive antibodies is not dynamic; with time potentially dangerous antibody responses may be inhibited by a variety of autoregulatory mechanisms, some of which may be mediated by antibodies. Regulatory as well as cytotoxic antibody production may be actively stimulated by pretransplant blood transfusions. These antibody mediated immune responses probably are magnified in the clinical setting by our current therapeutic immunosuppressive drugs which have more impact on cell mediated immunity than on antibody-mediated mechanisms. New immunosuppressive interventions devised to inhibit undesired antibody-mediated immune responses might be of benefit to those patients who fail to respond to current rejection therapy as well as to patients who have pre-existing antibodies and are waiting for transplants. PMID- 3540996 TI - The relevance of experimental studies to clinical practice in renal transplantation. PMID- 3540997 TI - Increased release of prostaglandins from the mesenteric vascular bed of diabetic animals: the effects of glucose and insulin. AB - To study prostaglandin (PG) metabolism in peripheral vascular beds, PGs and TxB2 released from perfused mesenteric tissues were measured in both normal and streptozotocin (STZ)-induced diabetic rats. The release of 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), thromboxane B2 (TxB2) and prostaglandin E2 (PGE2) was significantly increased in mesenteric vascular beds from diabetics in comparison with control rats. The 6-keto-PGF1 alpha/TxB2 ratio was decreased in diabetics. In order to clarify the mechanism of this imbalanced synthesis of eicosanoids, we infused buffer with 500 mg/dl glucose which was similar to the concentration of blood glucose in the diabetic rats. In response to this high glucose concentration, TxB2 released into the effluent from the mesenteric beds of normal animals was increased to the diabetic level. The release of the other PGs was not changed significantly. The 6-keto-PGF1 alpha/TxB2 ratio was decreased in control rats perfused with buffer containing 500 mg/dl glucose. We also investigated the effect of insulin (50 and 100 microU/ml) in the diabetic mesenteric vascular beds, but there were no changes in prostaglandin or TxB2 release. These data suggest that a high glucose level may have an important role in regulating TxA2 synthesis and in modulating the balance between PGI2 and TxA2 in diabetes. It is postulated that an increase in the micro-circulation of PGI2 may partially be protective against the progression of angiopathy. PMID- 3540998 TI - Influence of type IIa, IIb and IV-hyperlipoproteinemia on platelet prostaglandin sensitivity, plasma thromboxane B2 and platelet half-life. AB - It is generally accepted that in hyperlipoproteinemia (HLP) the vascular prostacyclin formation is diminished. We wondered, whether HLP is also associated with changes in platelet sensitivity to antiaggregatory prostaglandins. Therefore, we examined the platelet sensitivity to the prostaglandins PGI2 and PGD2 as well as plasma thromboxane B2 (TXB2)-levels in 24 patients with HLP type IIa, IIb and IV. We found a marked decrease of platelet sensitivity to PGI2 in all the patients examined, which was more pronounced in type IIb than in types IIa and IV. Platelet sensitivity to PGD2 showed no difference in the hyperlipemic patients. Plasma TXB2-levels were significantly increased in comparison to a control group, the changes being most pronounced in patients with type IV HLP. Platelet half-life was significantly shortened in the HLP-patients. This in-vivo platelet function parameter was found to be reduced in patients with type IIa HLP to the greatest extent. Our findings suggest that platelet deposition in HLP is promoted not only by diminished vascular PGI2-formation, but also by decreased sensitivity of the platelets to antiaggregatory prostaglandins. The high TXB2 levels and the shortened platelet half-life reflect the in-vivo activated platelet population in these patients. PMID- 3540999 TI - Prostacyclin formation around human abdominal aortic ostia. AB - Earlier studies have demonstrated an age dependent effect in the extent of sudanophilic and atherosclerotic lesions around aortic ostia in men. As prostacyclin may be a key determinant in the development of atherosclerosis we examined its formation around abdominal aortic ostia (coeliac, superior mesenteric and inferior mesenteric arteries) in-vitro. Prostacyclin formation was higher distal to the orifice as compared to proximal areas, but without reaching the level of significance. Prostacyclin formation was always higher in females than in males and in nonsmokers than in smokers, showing the greatest difference distal to the ostium, but again without significance. From the limited number of vessels examined, no trend for an age dependency can be noted. The relation between prostacyclin generation and morphological data is discussed. PMID- 3541000 TI - Antihypertensive effect of dietary sunflowerseed oil and linseed oil in spontaneously hypertensive rats during a multigeneration feeding study. AB - Semisynthetic diets enriched with polyunsaturated fatty acids (30 en% sunflowerseed oil or linseed oil) reduced hypertension development in spontaneously hypertensive rats (SHR) compared with control SHR fed on a regular rat chow. The effect was most markedly expressed in the 3rd and 4th generations of a four generation feeding period. PGI2-like production from isolated, pulsatingly perfused aorta preparations was reduced in linseed oil but not in sunflowerseed oil fed rats. Effects on blood pressure and PGI2-like production were abolished when the semisynthetic diets were changed for regular chow (5th and 6th generations). PMID- 3541001 TI - A method of determination of human plasma HMW and LMW kininogen levels by bradykinin enzyme immunoassay. PMID- 3541002 TI - [Progress in the field of drug development. 19]. PMID- 3541004 TI - [Johann Hieronymus Kniphofs' "Botanica in Originali"--a rare herbal of the 18th century]. PMID- 3541003 TI - [The influence of the Trommsdorff pharmacist family on scientists at Erfurt Academy]. PMID- 3541005 TI - Drug interaction between guanfacine and nonsteroidal antiinflammatory drugs in dogs. AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to attenuate the hypotensive actions of various antihypertensive agents. This experimental study in dogs was undertaken to find out whether NSAIDs modified the pharmacological actions of an antihypertensive drug, guanfacine. Indomethacin and enphenamic acid significantly prolonged the initial hypertensive response and blunted the subsequent hypotension produced by intravenous guanfacine. Ibuprofen and acetyl salicylic acid also interacted in a similar manner, but to a lesser extent. Phenylbutazone, on the other hand, caused a blunting of the pressor response and potentiated the hypotension following guanfacine. When indomethacin was given intracerebroventricularly, there was no interaction. These results suggest the necessity of monitoring hypertensive subjects taking guanfacine when NSAIDs are co-administered. PMID- 3541006 TI - [Sister Urszula]. PMID- 3541007 TI - [Antonina Komecka-Wojtowicz]. PMID- 3541008 TI - [Years of war and occupation]. PMID- 3541009 TI - Growth potential in suture bone inlay grafts: a comparison of vascularized and free calvarial bone grafts. AB - The present study investigates transsutural growth in vascularized and free calvarial bone grafts and notes the effects of such growth on craniofacial development. The temporalis myoosseous flap served as a model of vascularized graft. In ten 8-week-old dogs, a standardized skeletal defect, including a segment of the zygomatico-maxillary suture, was created. The defect was reconstructed with a vascularized graft in half the animals and a corresponding free graft in the remaining animals. Growth was assessed by means of serial cephalometric radiography and direct osteometry. Vascularized bone grafts demonstrated persistent transsutural growth following transplantation. Growth at the recipient site was preserved, resulting in less restriction of vertical maxillary development. PMID- 3541010 TI - Long-term survival of a free split-thickness skin graft on a large seroma. AB - A free skin graft about 12 cm in diameter transplanted after excision of a Bowen's carcinoma on the back totally survived for a long period on seroma and was confirmed to have revascularization from the host skin margin. Repeated evacuations of the fluid and subsequent pressure dressings failed to cause adherence of the graft to the bed, even on the thirty-ninth postoperative day. Histologic examination of the graft and the bed revealed partial epithelialization on the face-to-face surfaces, to which no adherence was attributed. The incomprehensible phenomenon in this unusual clinical case evokes a new interest in the mechanism of free skin graft survival, particularly in the phase of serum imbibition. PMID- 3541011 TI - Growth potential in onlay bone grafts: a comparison of vascularized and free calvarial bone and suture bone grafts. AB - Vascularized bone grafts are characterized by a viable cell population with osteogenic potential. These features suggest that continued growth can be anticipated following vascularized membranous bone transfer in a growing craniofacial skeleton. The present paper compares the potential for appositional bone growth in vascularized and free calvarial onlay bone grafts. In seven 8-week old beagles, growth was assessed by direct caliper measurements of graft dimensions intraoperatively and 16 weeks postoperatively. Vascularized grafts demonstrated a 50 to 60 percent increase in size in all dimensions compared to 10 to 20 percent growth in free grafts (p less than 0.01). Microradiography revealed preservation of calvarial bony architecture and minimal resorption in vascularized grafts, while triple-fluorochrome labeling confirmed subperiosteal appositional bone formation. Free grafts were characterized by significant resorption and a delay in subperiosteal bone formation. PMID- 3541012 TI - The lymphatic system: an historical perspective. PMID- 3541013 TI - Rapid testing for streptococcal pharyngitis. AB - Within the past 2 years, new technology has become available to office laboratories that permits a 10-minute laboratory diagnosis of a group A streptococcal infection in patients who present with sore throats. The availability of the test result while the patient is in the office can be a great improvement compared with waiting 1 to 2 days for a throat culture report. In addition, these rapid tests may be easier for office staff to read than traditional agar plates. A physician who incorporates rapid testing for streptococcal infection in the office laboratory should perform appropriate quality controls to be confident that the test method is working. The rapid streptococcal tests are the first of a new generation of microbiology immunoassays available to office laboratories. PMID- 3541014 TI - Update on pregnancy testing. AB - Laboratory testing is an extension of the physical examination, reaching sites that are otherwise inaccessible to the examiner. Pregnancy testing is one such diagnostic extension. Like physical examination, it must be used carefully. In choosing a pregnancy test for office use, many factors must be considered, so that accurate information will be available for patient management. Such factors as the technical skills and training of the office staff performing the test, shelf life of the test, need to refrigerate reagents, and frequency of usage are all important considerations. Test results must always be correlated with specific patients and clinical findings, and at times, doubts may be allayed by simply retesting patients with negative or equivocal results at a later time (currently a matter of days instead of weeks). Recent developments in pregnancy testing have been directed toward improved sensitivity and specificity, as well as speed, simplicity, and reduced cost. The clinical issue of greatest interest to most primary care physicians is the early diagnosis of normal pregnancy, where "early" may be defined as prior to the first missed menses. Diagnosis in the first 21 days of gestation is currently possible with more sensitive methods, and especially with enzyme-linked immunoassay. In this regard, because of its easy methodology and basic reliability, the enzyme-linked immunoassay may well become the new standard for office pregnancy testing. PMID- 3541015 TI - Automated office hematology instruments. AB - Evaluation of an automated hematology instrument begins with analysis of one's practice needs, followed by analysis of initial start-up costs, cost of maintenance, and staffing. In one situation, the decision to purchase an automated instrument may allow personnel working with low-efficiency pipetting and slide chamber counting time to assist in other functions of the clinic. In another practice, an automated counter may permit in-office complete blood counts to be added to the workload of current staff. These instruments are more than time-saving conveniences. They can facilitate clinical decision making and monitoring for complications of disease and therapy by making it easier for the physician to obtain reliable hematologic results. They can generate additional practice income and reduce patient cost by improving the quality and efficiency of medical care. PMID- 3541016 TI - Office laboratory evaluation of fluid, electrolyte, and acid-base disorders. AB - Fluid, electrolyte, and acid-base disorders are common entities in office practice and usually require laboratory studies for complete evaluation. Many common studies (for example, dipstick urinalysis) that are ubiquitous to the office laboratory can provide significant preliminary information concerning the presence and nature of these disorders. New levels of precision in the evaluation of fluid, electrolyte, and acid-base disorders have recently been added to the office laboratory with the development of relatively inexpensive, reliable, and easy-to-operate chemical analytic systems. These systems now provide many studies conveniently to the office practice that once required the support of hospital or commercial laboratories. PMID- 3541017 TI - [The thinking of patients with schizophrenia as an expression of disorders of information processing]. PMID- 3541018 TI - [Borderline personality disorders--current development of the concept]. PMID- 3541019 TI - The triangle of medical care. PMID- 3541020 TI - Use of gene transfer techniques to study neuropeptide gene regulation. PMID- 3541021 TI - Prediction of relapse in schizophrenia. PMID- 3541023 TI - [The saw frame in orthodontic technic]. PMID- 3541022 TI - The Caribbean Primate Research Center. PMID- 3541024 TI - Toxic variability and radiation potentiation by Rh(III) complexes in Salmonella typhimurium cells. AB - Stationary-phase cells of Salmonella typhimurium were irradiated in phosphate buffered saline in the presence of rhodium complexes to test for the potentiation of radiation-induced cell killing. Eleven Rh complexes, two Rh(I) and nine Rh(III), were tested. Seven Rh(III) complexes were found to be radiation potentiators; six potentiate only under hypoxic conditions, and one potentiates under both hypoxic and oxic conditions. Four of these seven Rh(III) complexes demonstrate potentiation that is 2 to 13 times greater than the sensitization caused by oxygen. Irradiating cells in Ham's F-12 culture medium rather than in phosphate-buffered saline eliminates this latter hypoxic radiation potentiation. None of the seven Rh(III) radiation potentiators are directly toxic to cells. However, four complexes were tested for hypoxic radiation-induced cytocidal toxicity, and three were found to be toxic after irradiation. The efficiency of this toxicity is not sufficient to account for the observed radiation potentiation. It is suggested that both reductive and oxidative free radical events are involved in the spectrum of Rh(III) potentiation observed. PMID- 3541025 TI - Myometrial invasion by endometrial carcinoma: sonographic assessment. AB - The depth of myometrial invasion by endometrial carcinoma was evaluated using real-time sonography (US) in 20 patients with histologically proved adenocarcinoma of the endometrium. In 14 of 20 (70%) cases, US-based estimation of the depth of myometrial invasion was within 10% of the actual measurement in the gross specimen. The US-based estimation of tumor invasion was low in seven patients, high in four patients, and agreed with pathologic findings (+/- 5%) in nine patients. In four patients with polypoid intraluminal extension of tumor, a deeply invasive tumor was suspected on US but was not found on pathologic examination. In 12 superficially invasive tumors, the continuity of the demarcating subendometrial halo was intact in nine and incomplete in three. In six patients with deeply invasive tumors, this zone was partially disrupted in four, totally disrupted in one, and intact in one. Errors of estimation of the depth of myometrial invasion on US most frequently occurred when a tumor had a significant intraluminal polypoid extension. Demonstration of a subendometrial halo usually indicated superficial invasion, whereas the absence of a halo was frequently associated with deep invasion. PMID- 3541026 TI - Adnexal masses: MR imaging observations at 1.5 T, with US and CT correlation. AB - To assess the role of 1.5-T magnetic resonance (MR) imaging in evaluation of the adnexa, 43 consecutive examinations that revealed 61 adnexal masses were retrospectively reviewed. T1- and T2-weighted images in coronal, axial, and/or sagittal planes were included. Available ultrasound (US) (n = 30) and/or computed tomographic (CT) (n = 9) scans were then correlated with the MR images. On T2 weighted images at least part of all adnexal masses was of higher signal intensity than surrounding muscle and adipose tissue, and therefore the adnexal masses were best seen with these sequences. T1-weighted imaging improved tissue characterization by revealing signal characteristics of fat in teratomas and characteristics of blood in endometriomas or hemorrhagic cysts, pelvic inflammatory disease, ovarian carcinomas, serous cystadenomas, and teratomas. MR imaging provided additional information or increased diagnostic confidence in 25 of 30 patients who underwent US or CT. MR imaging is a promising problem-solving modality after US in the study of adnexal abnormalities. PMID- 3541027 TI - Renal allograft rejection: evaluation by Doppler US and MR imaging. AB - A prospective study compared the efficacy of Doppler ultrasonography (US) and magnetic resonance (MR) imaging in evaluating 38 renal allografts, with specific attention to transplant rejection. Forty-three Doppler US and 42 MR examinations were performed and interpreted. Histologic correlation was obtained from 22 biopsy or nephrectomy specimens. Clinical correlation or a response to instituted therapy was used as confirmation in the remaining allografts. Accuracy in identifying cyclosporine toxicity or acute tubular necrosis could not be evaluated because there were few such cases, with concomitant rejection in most. The ability to predict and identify presence or absence of rejection was not affected by different serum creatinine values. Doppler US was significantly superior to MR imaging in identifying allograft rejection, demonstrating a higher sensitivity (95% vs. 70%), specificity (95% vs. 73%), and accuracy (95% vs. 71%). Because of its low cost and accessibility, Doppler US should become the primary modality for renal transplant screening. PMID- 3541028 TI - Partial, combined cortical and medullary nephrocalcinosis: US and CT patterns in AIDS-associated MAI infection. AB - An unusual pattern of nephrocalcinosis associated with Mycobacterium avium intracellulare infection and asymmetrically involving the renal cortex and medulla in a patient with acquired immunodeficiency syndrome (AIDS) is reported. This pattern, "partial nephrocalcinosis," differs from the increased parenchymal echogenicity seen on ultrasound and the parenchymal calcification noted on computed tomography that result from other causes. Partial nephrocalcinosis should suggest an infection such as one caused by M. avium-intracellulare. PMID- 3541029 TI - Breast masses: US-guided fine-needle aspiration biopsy. AB - Real-time ultrasonography (US) was used to guide fine-needle aspiration biopsy of 111 breast masses and three axillary lymph nodes. The masses included 51 (45%) nonpalpable lesions. Two different guidance techniques were used, with satisfactory results. Lesions less than 1 cm in diameter could be accurately aspirated, and the method allowed quick and accurate cytologic characterization of solid breast masses. The sensitivity of the cytologic diagnosis of malignancy was 92%, and the specificity was 93%. US-guided fine-needle aspiration biopsy of breast masses should be routinely performed, since it can lead to earlier and cost-effective diagnosis of breast carcinoma at virtually no risk. Because of the accuracy of real-time US guidance, negative cytologic findings (i.e., satisfactory smears with benign cells) should be considered highly reliable in ruling out malignancy. PMID- 3541030 TI - Non-western patterns of biliary stones and the role of ascariasis. AB - Biliary calculi of a non-Western pattern were detected in 15 patients on real time sonography performed over a 3-year period in a center serving a predominantly "Cape colored" (mixed race) population in South Africa. In two patients definite calculi were detected only in the common bile duct or gallbladder, but there was strong imaging and clinical evidence that the calculi were secondary to ascariasis. Twelve patients had intrahepatic calculi, predominantly left-sided, and evidence of past or present ascariasis. In at least five of the 12, biliary ascariasis was found at sonography or surgery. These fourteen patients reported recurrent, acute attacks of pain and cholangitis over a period of years. The symptoms were often difficult to distinguish clinically from those of uncomplicated intestinal or biliary ascariasis. The 15th patient had no evidence of ascariasis. Intrahepatic calculi were evenly distributed throughout both lobes and were clinically silent. Only one of the 13 patients with definite intrahepatic calculi had evidence of gallbladder calculi. PMID- 3541031 TI - Gastrointestinal teratomas: CT and US appearance with pathologic correlation. AB - Gastrointestinal teratomas are uncommon, benign neoplasms that occur primarily in children. A retrospective review of five cases (two gastric, one pancreatic, one mesenteric, and one in the lesser omentum) is presented with emphasis on the computed tomographic and ultrasonographic appearances. Principal findings are a well-defined mass with separate cystic and solid components of varying proportions, discrete areas with densities similar to that of fat, or coarse, globular calcifications within the solid component. Recognition of these findings may allow the radiologist to make a correct preoperative diagnosis of teratoma. PMID- 3541032 TI - Choosing contrast media for the evaluation of the gastrointestinal tract of neonates and infants. PMID- 3541033 TI - Diagnosis of internal jugular vein thrombosis. AB - Six patients, aged 14-83 years, were shown by computed tomography (CT) to have thromboses of the internal jugular vein. In all cases, medical attention was sought only after a delay (4-21 days). In no case was the provisional clinical diagnosis correct, with working diagnoses ranging from abscess to neoplasm. A wide variety of likely causes was discovered, including venous catheters, local malignancy, infective cervical adenopathy, and polycythemia. CT showed distended veins with enhancing walls, low-attenuation intraluminal filling defects, and swelling of the adjacent soft tissues. Four of the six patients also underwent ultrasound examinations, which showed the veins to be distended and nonpulsatile, with internal echoes. Both modalities proved reliable and accurate. Because of the subtle and often non-specific clinical findings, it is likely that more clinically unsuspected cases will be encountered by the radiologist. PMID- 3541034 TI - Carotid bifurcation disease: prediction of ulceration with B-mode US. AB - The presence of carotid ulceration was assessed by two readers for 55 B-mode ultrasound (US) studies. Intact surgical specimens were available for comparison. Ulceration was considered present if the following criteria were obtained: a continuous contour showing focal depression, a well-defined break in the surface 1 mm or more across, a well-defined back wall at the base of the depression, and an anechoic area within the plaque which extended to the surface and was 1 mm or more deep. Using these criteria, the two readers agreed on the diagnosis for 47 studies. When the surgical specimen was used as a reference standard, the accuracy of B-mode US was 60%, its sensitivity was 39%, and its specificity was 72%. Since the impact of scan quality was ruled out by using only scans on which the two readers agreed, the poor results must be attributed to the lack of definitive US criteria. A second review of the scans, with the readers looking only for a heterogeneous echo pattern, revealed that appearance had no higher correlation with ulceration at surgery than any of the original criteria had. PMID- 3541035 TI - Unilateral hypertrophic osteoarthropathy in a patient with an infected axillary axillary bypass graft. AB - Hypertrophic osteoarthropathy (HO) is a specific clinicoradiologic entity, the most common cause of which is the presence of pulmonary lesions. Eight cases of aortic graft infection and aortoenteric fistulae in association with HO have been recognized. A case of an infected axillary-axillary graft presenting as unilateral HO of the upper limb is reported, and its unusual features are used to postulate a mechanism underlying HO. PMID- 3541036 TI - Hypnosis, nonvolitional responding, and multiple personality: a social psychological perspective. PMID- 3541037 TI - The relationship of personality to environmental vulnerability and proenvironmental orientation. PMID- 3541038 TI - Psychological markers of vulnerability to schizophrenia: research and future directions. PMID- 3541039 TI - Expression of plasmid-coded mutant ribosomal RNA in E. coli: choice of plasmid vectors and gene expression systems. PMID- 3541041 TI - Aspects of the growth and regulation of the filamentous phages. PMID- 3541040 TI - Replication of superhelical DNAs in vitro. PMID- 3541042 TI - Regulation of protein synthesis by phosphorylation of ribosomal protein S6 and aminoacyl-tRNA synthetases. PMID- 3541043 TI - The primary DNA sequence determines in vitro methylation by mammalian DNA methyltransferases. PMID- 3541044 TI - Antemortem laboratory diagnosis of Alzheimer's disease. AB - The accuracy of diagnosis for AD by conventional clinical and laboratory means is in the order of 80%. Neurophysiological techniques (EEG, evoked potentials) show abnormalities in AD that could prove to be useful for diagnosis after pharmacological challenges. CSF analysis show a reduction of the concentration of various neuropeptides, reduction shared by other types of dementias. Among the existing imaging techniques PET using 18F-fluorodeoxyglucose is the most diagnostic in AD because of the early and often asymmetrical decrease in parietotemporal metabolic activity. Cortical biopsy with histological and biochemical analysis can provide an accurate in vivo diagnosis of AD. PMID- 3541045 TI - Abnormalities of regional brain metabolism in Alzheimer's disease and their relation to functional impairment. AB - Resting brain metabolism in patients with Alzheimer's disease (AD) has consistently been demonstrated to be reduced. Moreover, the magnitude of the reduction is related to the severity of dementia. Positron emission tomography (PET), which provides regional metabolic rates for glucose in cross-sectional slices of brain, has demonstrated three alterations in AD that are related to functional deficits. First, whole brain metabolic rate is reduced, and these reductions are related to overall severity of dementia. Second, regional metabolic rates in the association cortices demonstrate relatively greater reductions than are observed in the primary sensory and motor cortices, corresponding to marked impairment of higher cognitive function and relative sparing of sensory and motor function. Third, regional metabolic rates in the association cortices demonstrate increased left-right asymmetry relative to controls. Greater metabolic asymmetry is accompanied by disproportionate neuropsychological deficits in either language or visuospatial function, depending on whether the left or right cerebral hemisphere, respectively, has a lower metabolic rate. PMID- 3541046 TI - Senile dementia and Alzheimer's disease. Brain blood flow and metabolism. AB - Dementia of Alzheimer type is not form of accelerated aging. Blood flow, oxygen consumption and glucose utilization of the normally aged brain are maintained unchanged from the 3rd to the 7th decade of life. Thereafter, these parameters may decrease. Brain blood flow and oxidative metabolism is reduced in dementia of Alzheimer type and thus is different from the aged-matched mentally healthy subjects. There is evidence that the predominant impairment among these parameters may occur in cerebral glucose metabolism. This disturbance may precede changes in cerebral oxygen consumption and blood flow. Cerebral hypometabolism of glucose is accentuated in the temporo-parietal cortex. This finding may be helpful in diagnosing dementia of Alzheimer type. PMID- 3541047 TI - Neuroimaging and psychopharmacology in the diagnosis and treatment of dementia. AB - Contributions of noninvasive brain imaging technologies to the diagnosis of organic dementias with special reference to Alzheimer's disease are reviewed. Included among the different techniques are: a. computed tomography b. magnetic resonance imaging c. positron emission tomography. Biochemical hypotheses with possible relevance to the pathogenesis of Alzheimer's disease are presented and their therapeutic implications are discussed. Included among the different hypotheses are: a. interference with protein synthesis b. acetylcholine deficiency c. aluminum deposition. Present status of the pharmacotherapy of Alzheimer's disease is outlined. PMID- 3541048 TI - Positron emission tomography and the possible origins of cytopathology in Alzheimer's disease. AB - The local cerebral metabolic rate for glucose (LCMRgl), as determined by positron emission tomography (PET), declines in the cerebral cortex in Alzheimer's disease; the severity of the decline parallels the severity of the dementia and correlates with regional cortical neuronal loss and glial proliferation. The cholinergic cells of the medial basal forebrain show a pathological dropout in Alzheimer's disease which accounts for the decline in choline acetyltransferase in the cerebral cortex and hippocampus. It is proposed that these cholinergic cells serve both as an acquisition and readout device for memory; reconstruction of real time events can thus be created in the areas of neocortex where consciousness resides. Alzheimer's disease may have a toxic, genetic or infectious origin; electron microscopic evidence is presented for the possible presence of viral particles of the double stranded DNA type in Alzheimer's brain tissue. PMID- 3541049 TI - Pharmacotherapy in Alzheimer's disease: basis and rationale. AB - Alzheimer's disease is a slowly progressive disorder involving deterioration of both intellect and personality. The neuropathological features of Alzheimer's disease include abundant neurocortical senile plaques and neurofibrillary tangles. Drug therapies of Alzheimer's disease have been based on empirical observations of the signs and symptoms of the disease and have included the use of hypnotics to reverse insomnia or inverse sleep rhythms; anxiolytics to relieve anxiety, tension and restlessness antipsychotics to "tranquilize" or control psychotic symptoms, such as delusions and hallucinations; stimulants to overcome withdrawn behavior or lethargy; and lastly, antidepressants to control depression. Our growing knowledge of neuropathological and neurochemical changes associated with normal aging and Alzheimer's disease has made it possible to explore and develop pharmacologically-based therapies in Alzheimer's disease. Recent research has revealed behavioral symptoms associated with underlying biochemical changes in either the cholinergic, dopaminergic/ GABAergic (gama aminobutyric acid) noradrenergic, serotoninergic, neurochemical and/or neuropeptidergic systems. Pharmacological strategies involving manipulation of these systems as a means of relieving Alzheimer's disease symptoms will be reviewed from several perspectives, e.g., those involving transmitter substitution, enzyme inhibition and direct specific receptor stimulation. PMID- 3541050 TI - Prospective strategies for cholinergic interventions in Alzheimer's disease. AB - The cholinergic hypothesis of memory dysfunction has guided most of the recent proposals for treating the primary symptoms of AD. The efficacy of these treatments has been severely limited. This review examines two major lines of evidence which suggest that the cholinergic hypothesis may have to be expanded and revised. The cholinergic hypothesis focuses on pre-synaptic defects. It assumes cholinoceptive neurons would function normally with adequate stimulation. Evidence is not sufficient to support this assumption. In addition, dissociations have been demonstrated between muscarinic receptor number and functional response of cholinoceptive neurons. Various measures are proposed to investigate the functional integrity of muscarinic receptors in AD patients. AD often has been characterized as a disorder produced by generalized cholinergic hypoactivity. Evidence for cortisol hypersecretion, abnormal dexamethasone suppression, and the occurrence of depressive symptoms, motoric dysfunction and sleep abnormalities in AD patients is more consistent with regional cholinergic hyperactivity than generalized hypoactivity. Resolution of these discrepancies could shed new light on the pathophysiology and treatment strategies for AD. Cholinoceptive neurons could be hypersensitive, subsensitive or have unaltered responsivity. These options would have very different treatment implications. New developments in outcome assessment which are capable of discriminating varieties of differential response to treatment can spur treatment development and improve quality of care for patients with complex disorders such as AD. PMID- 3541051 TI - Olfaction and Alzheimer's disease. AB - Disturbances in the sense of smell may be important both clinically and theoretically in Alzheimer's disease. Initial evidence of poor olfactory recognition performance in Alzheimer's and parkinsonian dementias was followed by two reports which corroborated olfactory dysfunction in Alzheimer's disease. The neuroanatomical and neurochemical bases for this disturbance are discussed. Despite an abundance of preclinical and clinical data linking olfaction with acetylcholine, a preliminary study failed to show any effect of scopolamine on olfactory thresholds. Two of the olfaction-Alzheimer's studies found significantly better performance in other demented groups (alcoholics and patients with vascular dementia), suggesting possible utility in the differential diagnostic workup. The effect of aging per se on olfactory performance cannot be assessed without rigorous control for cognitive dysfunction in sampled populations. PMID- 3541052 TI - Naltrexone and Alzheimer's disease. AB - Naltrexone, an oral opiate antagonist, was administered to nine patients with a diagnosis of Alzheimer's-type dementia (ATD) in a two-phase design: an open dose ranging phase and a double-blind placebo-controlled trial for patients who showed improvement during the open phase. After a three day placebo (baseline) period, patients received increasing doses of naltrexone over two weeks up to a maximum daily dose of 100 mg. Assessments were made at baseline and at daily dose of 5 mg, 50 mg and 100 mg. Testing was done 2 to 4 hours after medication was administered. Any patient who showed cognitive/behavioral improvement on a given dose of naltrexone was then treated with this dosage in a double-blind crossover comparison to placebo. Criteria for inclusion in the double-blind phase consisted of improvement on three behavioral scales and at least one cognitive test on a given dose of naltrexone. Each double-blind phase followed a one-week washout and was two weeks long. Two of the nine patients demonstrated apparent cognitive enhancement on 100 mg daily of naltrexone and were then tested in the double blind crossover period. Only one of these patients improved during active naltrexone administration. We conclude that the opiate antagonist naltrexone in a dosage range of 5-100 mg daily is not efficacious in ATD. PMID- 3541053 TI - Energy metabolism in demented brain. AB - The term dementia refers to a number of very complicated disorders of the brain with several morphological, biochemical and functional alterations. Several alterations occur in Alzheimer's disease. They include alteration in neurotransmitters related substances and changes in brain metabolic rate. Changes in metabolic activity are among the earliest and best documented of all modification reported in Alzheimer's brain. They appear to be correlate with the severity of the disease, and to be more marked in specific areas of the brain which appear to be clinically more involved. In this report will be discussed the observations on changes of cerebral glucose metabolic rate, cerebral oxygen consumption, cerebral blood flow reported in vivo in demented patients. The observations of changes in energy metabolism related enzymes and the relationship between these changes and those in neurotransmitters related substances will be also reviewed. PMID- 3541054 TI - Pharmacologic modelling of Alzheimer's disease. AB - Evidence pointing to the central role of the cholinergic system in normal human memory function and disorders such as Alzheimer's disease has grown tremendously in recent years. Anticholinergic and non-cholinergic agents have been found to create transient memory impairments in young adults which mimic the changes associated with normal aging or amnesia. The rationale for using scopolamine, a centrally active anticholinergic agent, as a pharmacologic probe of memory function is reviewed using data from studies in animals and humans. The cognitive functioning of normal elderly controls given scopolamine is compared to the baseline functioning of patients with Alzheimer's disease, followed by a discussion of the use of scopolamine as a modelling agent for dementia. PMID- 3541055 TI - The localization of central cholinergic neurons. AB - Over the past decade our understanding of the localization of central cholinergic neurons has greatly increased. Interest in these systems has also intensified due to the involvement of cholinergic mechanisms in Alzheimer's disease. The distribution of central cholinergic neurons is reviewed, focusing on recent work in experimental animals. The pharmacohistochemical procedure for acetylcholinesterase and the development of antibodies to choline acetyltransferase are two of the major technical advances that have shaped our knowledge of the distribution of central cholinergic neurons. The results, advantages and limitations of both techniques are discussed. A discussion of the phenomenon of coexistence of acetylcholine with neuroactive peptides in central neurons is also included. PMID- 3541056 TI - Cholinergic receptors in aging and Alzheimer's disease. AB - Although Alzheimer's disease (AD) is a disorder involving multiple neurotransmitter systems, the basal forebrain cholinergic system (Ch system) is severely and consistently affected in this condition. In both animals and man, the nature of age-associated alterations in the Ch system is unclear. In addition, available studies of cholinergic receptors in AD and aging are not consistent. In normal aging, the density of muscarinic cholinergic receptors (MCR) is reported to be either unchanged or decreased. In AD, increased, unchanged, or decreased densities have been reported. Recently, a subtype of MCR (M2), thought to be located presynaptically, has been reported to be reduced in neocortex and amygdala. In both AD and aging, nicotinic cholinergic receptors (NCR) have not been adequately studied. Our recent studies using [3H] acetylcholine and [3H] nicotine have demonstrated a reduction in NCR in AD. Possible explanations for some of the inconsistent findings are discussed, and directions for future studies are suggested. PMID- 3541058 TI - [Transforming growth factor]. PMID- 3541057 TI - [Chromosome translocation in hemopoietic tumor and oncogene activation]. PMID- 3541059 TI - [Origins and development of laboratory mice: application of wild mice to breeding of new laboratory strains]. PMID- 3541060 TI - Effects of dexamethasone on prostacyclin biosynthesis in rabbit mesothelial cells. AB - We investigated whether glucocorticoids reduce the formation of arachidonic acid metabolites in a non myeloid cell type, the mesothelial cell, which is functionally and embryologically related to the vascular endothelial cell and which forms almost exclusively prostacyclin from arachidonic acid. Preincubation of rabbit mesothelial cells with 2.5 microM dexamethasone suppressed basal as well as bradykinin- or thrombin-stimulated prostacyclin biosynthesis. In further experiments bradykinin was selected as stimulus. The inhibition by dexamethasone was dose-dependent between 0.025 and 2.5 microM. The minimum contact period required for expression of this effect was 30 min and after a contact period of 60 to 120 min the inhibition reached a maximum, but was never complete. After 240 min, sufficient activity was secreted in the extracellular medium for inhibition of the prostacyclin formation in untreated cells. Experiments with cycloheximide were somewhat confused by its direct effects on prostacyclin biosynthesis, but still suggested that the anti-prostacyclin effect of dexamethasone required de novo protein biosynthesis. Our experiments indicate that glucocorticoids induce the formation of lipocortin-like factor(s) in non-phagocytic mesothelial cells, thereby suppressing the formation of prostacyclin, their main arachidonic metabolite. PMID- 3541061 TI - Histamine releases PGI2 from human pulmonary artery. AB - Histamine caused a triphasic response of human pulmonary artery strips in vitro, consisting of a small initial contraction followed by pronounced relaxation preceding a second contractile response. These characteristics were not seen with other contractile stimuli including 5-hydroxytryptamine, leukotriene D4, and KCl. The relaxant component of this response was ablated by removal of endothelium from the vascular strips or by pretreatment of the tissue with 1 microM indomethacin. Measurement of the PGI2 degradation product 6-keto-PGF1 alpha in supernatants from histamine-challenged tissues confirmed the synthesis of PGI2. Supernatants from unstimulated or leukotriene-challenged tissues contained no detectable amounts of 6-keto-PGF1 alpha. The histamine H1 antagonist diphenydramine inhibited both the contractile and relaxant responses to histamine whereas the H2 antagonist cimetidine affected neither component. The released PGI2 significantly altered the dose-response curve to histamine without inhibiting the maximal contractile responses. We conclude that histamine induces PGI2 formation from pulmonary arterial endothelium via an H1 receptor. PMID- 3541062 TI - The effect of endocervical PGE2-gel (Prepidil) gel on plasma levels of 13,14 dihydro-15-keto-PGE2 (PGEM) in women at term. AB - Term pregnant patients undergoing preinduction cervical softening were randomized to receive no treatment (controls) or 0.5 mg PGE2-triacetin gel (Prepidil gel) endocervically. Plasma samples containing PGEM collected 4 hrs post-treatment and converted to the stable bicyclo degradation product (bicyclo-PGEM) were assayed by RIA. Positive clinical effect (responders) during 12 hrs after treatment (Bishop score increase greater than or equal to 3, in labor or delivered) were assessed. All evaluations were blind. In nonresponders (n = 35), the means of the bicyclo-PGEM variables (mean, maximum, area under the curve) were all about 18% higher in gel-treated patients (n = 6) than controls (n.s.). In responders (n = 38), the variables were all about 80% higher in gel-treated women (n = 32) than controls (p less than .01). In controls (n = 35), the responders (n = 6) had 50% higher levels than nonresponders (n.s.). In the gel-treated women (n V 38), responders (n = 32) had about 140% higher levels than nonresponders (less than .01). The results suggest that both exogenous and endogenous bicyclo-PGEM were measured. Differences in pairwise comparisons suggest that there may be substantially less exogenous bicyclo-PGEM in the gel nonresponders than in gel responders or substantially more endogenous bicyclo-PGEM in gel responders than in control-responders. PMID- 3541063 TI - [Presence of autoantibodies and the clinical course of systemic lupus erythematosus]. PMID- 3541065 TI - Femoral angiography assisted by Doppler stethoscope in a patient with total occlusion of the lower abdominal aorta. PMID- 3541064 TI - [Pathophysiologic basis of crural ulcers]. PMID- 3541066 TI - Purification and characterization of luteinizing hormone-releasing hormone from codfish brain. AB - We have purified luteinizing hormone-releasing hormone (LH-RH) from codfish brain and have demonstrated its identity with salmon LH-RH (sLH-RH). An antiserum raised against sLH-RH was used in a specific radioimmunoassay (RIA) to monitor purification and to manufacture an immunoaffinity chromatography column for the initial purification step. The cross-reactivity of the sLH-RH RIA with mammalian LH-RH was 0.1%. Acid extracts of codfish brains were sequentially purified by immunoaffinity chromatography, gel-filtration chromatography, and three steps of reverse-phase HPLC. The purified material and synthetic sLH-RH coeluted on reverse-phase HPLC and exhibited similar biological activity in a dispersed pituitary cell bioassay. Furthermore, the amino acid composition of the purified material was identical to salmon LH-RH. These results suggest that there is structural conservation of LH-RH between these species of teleost fish. PMID- 3541067 TI - [Echotomography in Crohn disease]. AB - The authors report their experience in 40 patients with intestinal Crohn's disease, who underwent both abdominal ultrasound scanning and double-contrast small bowel enema. The various echographic patterns are described, found in the different phases during the evolution of Crohn's disease, underlying the importance of ultrasound in evaluating the real degree of bowel wall thickening and the exo-enteral space, only indirectly appreciated with X-ray examination. PMID- 3541068 TI - [Total body irradiation in the conditioning of autologous bone marrow transplants in acute leukemias and lymphomas]. AB - From january 1984 to may 1986, 31 patients, 15 ANLL, 8 ALL (in remission status) and 8 NHL (6 in remission, 2 in relapse) have been treated with chemo radiotherapy [cyclophosphamide 60 mg/kg X 2 days + total body irradiation (TBI): 10 Gy/1 fr. in ANLL and NHL patients, 12 Gy/3 fr./3 days with 4 Gy boost testicular dose in ALL] and autologous bone marrow transplantation (BMT). Seventeen patients are alive, 16 in remission: 9 (60%) ANLL, 2 (25%) ALL, 5 (62%) NHL (median 8+ months, follow up 1+/29+); 2 patients presented interstitial pneumonitis (6.45%). In this series, very good results have been achieved in ANLL, where no relapse was noted, encouraging achievements in NHL, with 2/6 relapses; unsatisfactory results in ALL, with 4/8 relapse. Advantages and disadvantages of autologous relative to allogenic BMT, and of conditioning regimen with or without TBI are discussed. PMID- 3541069 TI - [Treatment of neuroblastoma: role of total body irradiation]. AB - Advanced neuroblastoma, scarcely responsive to conventional therapies, can take advantage of high dose chemio-radiotherapic treatment followed by bone marrow transplant. Nineteen young patients underwent an ablative chemotherapy with high dose Vincristine and Melphalan plus Total Body Irradiation in Genoa, Italy; all of them underwent autologous bone marrow transplantation. Fourteen children were in complete remission (CR), 5 had residual disease. Thirteen are alive after a median of 7 months following transplant; 9 are in CR; 4 have disease; 1 died for toxicity; 5 for relapse. The results seem to suggest that ablative therapy should be given to patients in CR. Toxicity was not remarkable mainly as far as TBI is concerned. PMID- 3541071 TI - [Role of ultrasonography in the diagnosis of non-epithelial neoplasms of the stomach. Considerations apropos of 2 cases]. PMID- 3541070 TI - [Echotomographic aspects of the post-menopausal uterus after prolonged treatment with tamoxifen]. PMID- 3541072 TI - [Associazione Italiana di Radiologia Medica e Medicina Nucleare. Official directory of members updated to 31 December 1986]. PMID- 3541073 TI - [Endometritis. III--Microorganisms]. PMID- 3541074 TI - [Extra-intestinal cycle of Trypanosoma cruzi in triatomines]. PMID- 3541076 TI - [Irradiation of bone homografts. Their use following tumor resection. Apropos of 4 cases]. AB - Since 1978 gamma irradiation has been used for sterilization of bone allografts. The radiation source used was Co 60 (2.5 to 3 megarads). Which was applied at the Atomic Centre of Saclay. The technique of sterilization is absolutely reliable at relatively low cost. It allows pieces of bone from cadavers to be harvested several hours after death, without special aseptic precautions. It appears to diminish antigenicity of the graft very little and incorporation is perhaps slowed down. The grafts did not become radioactive. The graft is carefully packed and frozen as soon as it is taken from the cadaver. Freezing is continued during the irradiation process and the graft may then be stored for several months. This technique was used for reconstruction after tumor resection twice in the knee, once in the pelvis and once in the fibula. There was no postoperative infection. Scintigraphy showed satisfactory incorporation. In one case of replacement of the femoral condyle the cartilage of the graft was replaced by the intact articular cartilage of the patient. Later, this articular cartilage was shown to be necrotic and a total prosthesis was inserted. The fibular graft was secondarily complicated by a fracture. Sterilization using irradiation makes bone harvesting in cadavers easier and allows bone banks to be established. It should lead to more extensive use of allograft bone. PMID- 3541075 TI - [A new method for making transparent teeth]. PMID- 3541077 TI - [Massive allografts cold-preserved and radiation-sterilized]. AB - Thirty massive bone allografts measuring between 7 and 30 centimeters and banked after freezing at -30 degrees centigrade and sterilization by Beta irradiation (2.5 to 3.5 megarads) were implanted. Ninety eight grafts were for reconstructions after a tumour resection and two were used for the treatment of femoral non-union and for reconstruction after removal of a prosthesis. In fifteen instances the only goal was to restore bone stability--six arthrodeses, seven replacements of diaphyseal or metaphyseal section and two iliac bone lesions. In fifteen other cases the aim was to preserve mobility (10 knees, 2 hips and 3 shoulders). Among these cases, a prosthesis was added in 9 knees and 2 hips and the graft was used alone in three shoulders and one knee. The average follow-up is too short to assess the incidence of recurrence, but it is long enough to note that there has been no case of post-operative infection. The authors considered that this is thanks to the use of sterilization by irradiation. Bone union was seen in 26 out of 30 cases at the diaphyseal--graft junction and in eight cases out of nine at the epiphyseal--graft junction. Three cases are pure diaphyseal replacements, did not unite. Two recurrent fractures of the graft at the third and fourth month united later. Scintigraphy showed that revascularization may take place after three months, thanks to the peripheral muscle which reattach to the graft spontaneously. This could be demonstrated by biopsy made during a second surgical procedure. A search for anti-HLA anti-bodies in the serum was positive on three occasions. PMID- 3541078 TI - [A mass in the right hypochondrium with gas in its interior]. PMID- 3541079 TI - [Effect of postprandial exercise in type I diabetes: comparison between the continuous-infusion insulin pump and intensified conventional therapy]. PMID- 3541081 TI - [Reduction of the size of a myocardial infarction using thrombolytic treatment. A myth impossible to dispel?]. PMID- 3541080 TI - [Heart transplantation]. PMID- 3541082 TI - [Transposition of the great arteries. Clinical, morphologic and functional characteristics of surgical importance]. PMID- 3541083 TI - [Diagnostic and therapeutic criteria in amebic liver abscess]. PMID- 3541084 TI - [Hepatic polycystosis]. PMID- 3541085 TI - [Model for acquired immunodeficiency caused by anesthesia and surgical procedures. Effect of treatment with thymopoietin pentapeptide (TP5)]. PMID- 3541086 TI - [New etiopathologic and therapeutic perspectives in ureteral colic. Evaluation of clinical experience with diclofenac sodium and indomethacin]. PMID- 3541087 TI - [Current concepts on the hypothesis of the cholinergic etiology of Alzheimer's disease ]. PMID- 3541088 TI - Control of gene expression by steroid hormones. AB - The mechanism of action of steroid hormones involves their interaction with tissue-specific binding sites, and results in a precise modulation of gene expression. Both high-affinity receptors and secondary binding sites exist for steroid hormones in target tissues. Only steroid-receptor complexes were, in several cases, clearly shown to directly regulate transcription by interacting with DNA region(s) close to steroid-controlled genes. However other indications suggest that steroid hormones could also modulate transcription by altering chromatin conformation. These modifications encompass post-traductional modifications of histones and non-histone proteins, as well as changes in the pattern of histone variants. Beside transcription, there are also evidences that steroid hormones can modulate gene expression by regulating some RNA processing events. Whether high-affinity receptors or secondary binding sites directly regulate these events is not known. These observations however suggest that several levels of control might exist for steroid hormones to precisely regulate gene expression. PMID- 3541089 TI - [Bibliographic review: Quantitative variations and metabolism of lipids in adipose tissue and the liver during the gestation-lactation cycle. 1. In the rat]. AB - This comprehensive review describes changes in body lipids, energy balance, and metabolic pathways and endocrine regulations in the adipose tissues and liver of rats during pregnancy and lactation. These profiles are discussed in relation to litter size, food intake and diet composition; the interactions between mechanisms that are teleophoretic (direct nutrients to the gravid uterus or to the mammary gland) and homeostatic (insure the maintenance of the mother organism) have been emphasized. PMID- 3541090 TI - [Lipases of the digestive system]. AB - Studies on gastrointestinal lipolysis have underestimated several important points. In view of recent in vitro data obtained in our laboratories, this review focuses on the role of gastric lipolysis during fat digestion. Polyclonal antibodies generated from purified rat lingual lipase were used to screen a cDNA library prepared from mRNA isolated from the serous glands of rat tongue cloned in E. coli expression vectors. A cDNA clone was isolated and the nucleotide and predicted amino acid sequences obtained. Comparison with the N-terminal amino acid sequence of the purified enzyme confirmed the identity of the cDNA. The amino acid sequence of rat lingual lipase consisted of 377 residues and showed little homology with porcine pancreatic lipase, apart from a short region containing a serine residue at an analogous position to the Ser 152 of the porcine enzyme. Human gastric lipase activity on tributyrin emulsion was detected only in the presence of amphiphiles. This behaviour was in sharp contrast with the strong inhibitory effect of amphiphiles observed on pure pancreatic lipase. To reveal human gastric lipase activity, amphiphiles must be added to human gastric lipase in order to prevent irreversible interfacial denaturation. Human gastric lipase activity was found to be restricted to triacylglycerol/water surface tensions ranging from 8 to 13 dynes/cm. All amphiphiles which decrease interfacial tension to less than 8 dynes/cm act as irreversible inhibitors of human gastric lipase in the absence or presence of bile salts. Our results confirm that human gastric lipase is capable of hydrolysing triacylglycerol in the presence of the bile salts concentration prevailing in the upper small intestine and in the presence of alimentary proteins. These observations could explain the high dietary lipid absorption observed under pancreatic lipase deficiency. PMID- 3541091 TI - Effect of long-term treatment with sobrerol on the exacerbations of chronic bronchitis. AB - 706 chronic bronchitic patients were admitted to a double-blind controlled multicenter study to evaluate the effect of the prolonged administration of sobrerol on exacerbations, clinical signs and respiratory function indexes. Patients were treated at random with sobrerol 300 mg b.i.d. or placebo b.i.d. for 3 consecutive months during the winter of 1983/1984. At the beginning of the study, sex, body surface, smoking habits, environment, anti-influenzal vaccination, concomitant pathologies and therapies, respiratory anamnesis, clinical condition and spirometric indexes were equivalent in the two groups. Among the patients admitted to the study, 76% of the sobrerol group did not complain of any exacerbations compared to 58% of the placebo group (p less than 0.001), moreover the risk of exacerbation was about twice higher than with the drug. The use of antibiotics was equivalent in the two groups, whilst the consumption of bronchodilators/theophyllines was markedly lower in the sobrerol group. The response of the clinical signs (dyspnea and auscultatory semeiotics) and of the spirometric indexes (RV, VC and FEV1) to therapy, was significantly higher in the patients treated with sobrerol compared to the placebo group. The opinion expressed by the experimenter and by the patient at the end of each month of treatment was again in favor of sobrerol. Side effects, which were minor and no different from those claimed by the patients treated with placebo, and the hematological and hematochemical assessments, carried out before and after treatment, support the good tolerance of sobrerol. These results let us hope for a more appropriate use of the mucus-regulating agents, particularly in the chronic bronchopulmonary pathologies for which these drugs seem to represent the most rational care. PMID- 3541092 TI - [Receptors in the respiratory tract and their reflex effects]. PMID- 3541093 TI - [Doppler echocardiography--theoretical basis and current status in clinical application]. PMID- 3541094 TI - [Antimicrobial removal device]. PMID- 3541095 TI - The effects of ventilation with positive end-expiratory pressure on the bronchial circulation. AB - We studied the effects of ventilation with 10 cm H2O PEEP for 2 h in dogs with temporary unilateral pulmonary arterial occlusion (TUPAO) on bronchial blood flow to the occluded lung using the microsphere dispersion technique. We found that blood flow to the occluded left lung in dogs was 9.9 ml/min (0.122 ml X min-1 X g 1). Within 30 min following the addition of 10 cm H2O PEEP blood flow fell by 70 80% (to 2.3 ml/min) caused both by a 3-fold decrease in vascular conductance and a 25% fall in systemic blood pressure. The reduction in left bronchial blood flow persisted for at least 2 h. We conclude from these data that ventilation with PEEP in the presence of pulmonary artery occlusion has a severe, persistent adverse effect on bronchial blood flow. This reduction in bronchial blood flow is beyond what can be explained by the changes in airway pressure. The additional increase in bronchial vascular resistance may be caused by the increase in lung volume, by reflex bronchial vasoconstriction, or by release of mediators locally. PMID- 3541096 TI - [The cochlear implant]. PMID- 3541098 TI - Isolation of small plasmid from a deletion mutant of R100 in Escherichia coli K 12 strains. PMID- 3541099 TI - [Characterization of different strains of Brucella canis]. PMID- 3541097 TI - [Evidence of Chlamydia trachomatis infection in Costa Rica]. PMID- 3541100 TI - [Effect of culture conditions on the production of trichothecenes in strains of Fusarium]. PMID- 3541101 TI - [Aneurysm or false aneurysm of the interauricular septum disclosed by 2 cerebral embolisms]. AB - The authors report a case of solitary aneurysm of the interatrial septum documented by ultrasonography and angiography and revealed by two transient cerebral ischaemic accidents unexplainable by other causes. At surgery, performed later, the interatrial septum was redundant, and Botallo's foramen was about 17 millimetres in diameter, but no sacciform cavity was found. The reasons for the discrepancy between imaging techniques and operative findings and the mechanism of systemic embolism are discussed. PMID- 3541102 TI - [Approach to the patient with bronchial cancer by the practicing physician]. PMID- 3541103 TI - [At the origin of the great university institutes of Liege: the old "Quartier de Beche"]. PMID- 3541104 TI - [Expansion of the university on the right bank at the end of the 19th century]. PMID- 3541105 TI - [Edouard Van Beneden, biologist and stoic]. PMID- 3541106 TI - [One hundred years of marine biology and biological oceanography at the Edouard Van Beneden Institute of Zoology]. PMID- 3541107 TI - [Attempt at a panoramic view of one hundred years of scientific research at the Edouard Van Beneden Zoologic Institute]. PMID- 3541108 TI - [The Liege school of comparative physiology and biochemistry. History and development]. PMID- 3541110 TI - [Leon Fredericq and scientific medicine in Belgium]. PMID- 3541109 TI - [Modern cytogenetics and its applications]. PMID- 3541111 TI - [Leon Fredericq and the concept of regulation in the physiology of living systems]. PMID- 3541112 TI - [Upon re-reading Leon Fredericq]. PMID- 3541113 TI - [Marcel Florkin (1900-1979)]. PMID- 3541114 TI - [Z. M. Bacq, founder of comparative pharmacology]. PMID- 3541115 TI - [Combined kidney-pancreas graft in terminal diabetic nephropathy. Report on the first transplantation performed at the University of Liege]. PMID- 3541117 TI - [[The image of the physician in the turn-of-the-century caricature]. PMID- 3541116 TI - Immunoreactive glutamic acid decarboxylase in the trigeminal nucleus caudalis of the cat: a light- and electron-microscopic analysis. AB - This study used antisera directed against glutamic acid decarboxylase (GAD), the biosynthetic enzyme for gamma-aminobutyric acid (GABA), to examine the light- and electron-microscopic distribution of presumed GABA-ergic synapses in the medullary homologue of the cat spinal dorsal horn, the trigeminal nucleus caudalis. At the light-microscopic level, immunoreactive terminals were concentrated in the superficial dorsal horn, laminae I and II. Colchicine was generally ineffective in revealing the distribution of cell bodies. However, in two successful cases, the majority of labeled cells were found in the magnocellular layer, ventral to the substantia gelatinosa, a region that had a lower density of immunoreactive terminals. Other labeled neurons were scattered in laminae I and II. A variety of synaptic arrangements were found at the electron-microscopic level. These derived from two types of labeled terminals. One contained both small round vesicles and large dense-cored vesicles. The second contained small round and pleomorphic vesicles. Some immunoreactive GAD terminals contained a few flat vesicles. Labeled terminals predominantly formed axodendritic synapses, via symmetrical contacts. Several axoaxonic arrangements were also observed. In most cases, the GAD terminal (which did not contain dense cored vesicles) was presynaptic to another vesicle-containing profile, including the scalloped central terminal thought to derive from primary afferents. Another population of labeled GAD terminals was found postsynaptic to unlabeled vesicle containing profiles, including central terminals. These data indicate that inhibitory GABA-ergic controls in the trigeminal nucleus caudalis involve both presynaptic and postsynaptic mechanisms and are probably mediated via direct contacts onto ascending projection neurons, as well as via synaptic contacts onto nociceptive primary afferent fibers. The transmission of nociceptive messages by neurons of the spinal cord dorsal horn and trigeminal nucleus caudalis is subject to a variety of segmental and supraspinal controls. Pharmacological and electrophysiological studies have implicated the biogenic amines serotonin and norepinephrine, and the endogenous opioid peptides enkephalin and dynorphin, in those controls (Basbaum and Fields, 1978, 1984; Basbaum et al., 1983; Basbaum, 1985).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3541118 TI - [HIV serodiagnosis in practice]. PMID- 3541119 TI - [1686--the fistula of the Sun King]. PMID- 3541120 TI - Pneumocystis carinii and Toxoplasma gondii infections in patients with AIDS. AB - Pneumocystis carinii and Toxoplasma gondii are the commonest protozoans causing infections in patients with acquired immunodeficiency syndrome (AIDS). P. carinii is almost exclusively a pulmonary pathogen and caused the commonest serious infection experienced by AIDS patients. The clinical findings are those of progressive pneumonia. Diagnosis requires microscopic examination of lower respiratory secretions or lung tissue. Pentamidine or combinations of trimethoprim and sulfamethoxazole are equally effective (85% recovery), but about one-half of patients thus treated experience severe toxicity. T. gondii infections occur primarily in the brain; patients present with focal seizures or neurologic deficit and have focal abnormalities as assessed by computed tomography. Serologic tests for toxoplasmosis are rarely diagnostic in AIDS patients, and most patients are treated empirically with a combination of pyrimethamine and sulfonamide. Less invasive diagnostic tests and better chemotherapeutic agents are required for both pneumocystosis and toxoplasmosis. PMID- 3541121 TI - Cryptosporidium and cryptosporidiosis. AB - Cryptosporidium is a newly recognized human pathogen associated with severe enteritis and, perhaps, cholecystitis in immunocompromised patients, particularly those with the acquired immunodeficiency syndrome, and significant, though self limited, diarrheal illness in the immunocompetent host. As more physicians look for this pathogen, the number of reported cases of cryptosporidiosis continues to increase. Although the prevalence of cryptosporidiosis in humans is not yet known, recent studies suggest that it is a common cause of diarrhea worldwide, particularly in young children. The pathogenic mechanisms by which Cryptosporidium causes enteritis and the factors of human host defense essential for eradication of this parasite have not been delineated. Acid-fast staining of stool is a quick and reliable way of diagnosing cryptosporidiosis. Although a vast array of therapeutic agents has been tried for this disease, there is currently no known effective therapy for cryptosporidial infection. PMID- 3541122 TI - Mycobacterial infections in AIDS patients, with an emphasis on the Mycobacterium avium complex. AB - Serious infections caused by the Mycobacterium avium complex (MAC) have been increasingly recognized over the last three decades. However, the epidemic of the acquired immunodeficiency syndrome (AIDS) has increased interest in these infections. Disseminated mycobacterial disease is common in patients with AIDS, and MAC is the predominant bacterial isolate. Indeed, at UCLA Medical Center, MAC organisms are now the predominant isolates in both AIDS- and non-AIDS-associated mycobacterial disease. MAC lung infections have been difficult to treat. Complex regimens employing four to six drugs are not clearly effective and are usually associated with considerable toxicity. Treatment of MAC infections in patients with AIDS has been particularly frustrating, and evidence that treatment can either eradicate disease or prolong life is limited. MAC organisms are invariably resistant to traditional antituberculosis medications. We have examined a variety of other compounds, and our findings, based on both in vitro and animal-model studies, have identified drugs which, when used in combination, are potentially of therapeutic utility. PMID- 3541123 TI - Syphilis, historical and actual: cultural geography of a disease. AB - Nineteenth-century Russian physicians identified two forms of syphilis, venereal and endemic, which they associated with the difference between city and country life. Modern medical authorities have generally rejected Victorian ideas of nonvenereal contagion, but students of preindustrial societies have found evidence that endemic syphilis does in fact occur. Because it was hard to distinguish one form from the other, however, prerevolutionary Russian doctors allowed their cultural preconceptions to guide them where evidence was weak. Their view of syphilis thus provides the historian with a remarkable guide to attitudes toward class, gender, and social change. Modern neglect of the nonvenereal variant demonstrates not merely the progress of scientific knowledge but also the cultural restriction on our own view of the world. PMID- 3541124 TI - Pathogenesis and treatment of acute hematogenous osteomyelitis: evaluation of current views with reference to an animal model. AB - Antibiotic therapy and surgical drainage of the bone are the most commonly accepted forms of therapy for acute hematogenous osteomyelitis; the efficacy of these two treatment modalities, however, has not been fully established. Treatment regimens remain empiric and open to much controversy. Many contentious issues concerning the management of this disease have arisen because the natural history of the untreated condition has not been properly understood, because therapeutic regimens alternative to those empirically initiated and perpetuated have not been adequately tested, and because most follow-up studies have dealt with small numbers of patients over relatively short periods. A highly reproducible animal model of acute hematogenous osteomyelitis was developed and utilized in a reexamination of issues regarding the natural history and pathology of the disease and the influence of appropriate treatment. PMID- 3541126 TI - Perinatal echovirus infection: insights from a literature review of 61 cases of serious infection and 16 outbreaks in nurseries. AB - A review of literature published before June 1985 revealed 61 reported cases of neonatal echovirus infection at a nonmucosal site, including 43 cases (70%) due to echovirus 11. Onset of disease occurred between the third and fifth days of life in 63% of cases, indicating that most infections are acquired in the immediate perinatal period rather than in utero. Mortality was higher in infants with severe hepatitis (83%) than in infants with infection of the central nervous system (19%). Acute illness occurred within one week before delivery in 68% of the mothers of nonnosocomially infected infants. There was a trend (P = .11) towards a higher mortality rate for infants born by cesarian section than for those delivered vaginally. In the 11 nosocomially acquired cases, the onset of infection was later and the mortality rate lower. In 16 outbreaks in nurseries, 206 infants developed illness attributed to echovirus infection. Attack rates of clinical disease were 22%-52% and illness was generally mild. In four outbreaks, six index cases were identified as infants who had acquired infection from their mothers; five of these infants had severe disease and three died. The 24 infants subsequently infected by nosocomial spread in these outbreaks had milder disease; three (12%) died. Thus, whereas acute illness in the mother before birth often precedes neonatal echovirus infection and infections transmitted vertically from mother to infant may be severe, postnatal transmission of the same serotype results in milder disease. PMID- 3541125 TI - Group B streptococcal bacteremia in men. AB - Twenty-three episodes of bacteremia due to group B Streptococcus (GBS) in men were reviewed for both clinical and microbiologic features. The commonest sources of bacteremia were infections of the respiratory tract (seven cases), skin (five cases), urinary tract (four cases), and intravenous access sites (four cases). Sixteen (70%) of the cases of bacteremia were hospital acquired, and 10 (43%) were polymicrobial (seven with Staphylococcus aureus). GBS bacteremia was generally low-grade and brief as assessed by the percentage and persistence of positive blood cultures. Among patients bacteremic with GBS alone, there were no instances of shock or metastatic suppuration and only one death as a direct result of sepsis. Overall however, nine other patients died of their underlying disease during the same hospitalization. GBS bacteremia in men is, in itself, generally a moderate infection, but it is often found as part of more complex sepsis in hospitalized patients with serious, often fatal, predisposing illnesses. PMID- 3541127 TI - The enlarging spectrum of tick-borne spirochetoses: R. R. Parker Memorial Address. AB - The author reviews his changing interest in tick-borne spirochetoses during his career (1951-1985) as a medical entomologist at the U.S. Public Health Service's Rocky Mountain Laboratory. The discoveries of relapsing fevers in the western United States in the 1930s and 1940s led to well-supported epidemiologic research, including studies on the relationships between vectors and spirochetes. When tick-borne relapsing fever in the United States was shown to be a relatively rare and readily treatable disease, financial support was withdrawn, and ongoing research was limited or terminated. Interest in relapsing fever spirochetes, particularly the relation to the relapse phenomenon in animal hosts, resurfaced in the 1960s and 1970s with the introduction of immunofluorescence assays and with the development of Kelly's medium for continuous cultivation of certain spirochetes. This interest increased significantly in 1981 when the author discovered a tick-borne spirochete to be the causative agent of Lyme disease and of several clinically related disorders in Europe. The discovery of this agent, now known as Borrelia burgdorferi, has led not only to intensive clinical, epidemiologic, and ecologic investigations in the United States and abroad but also to the identification of molecular and immunochemical techniques necessary for the study of the complex biology of tick-borne spirochetes. Reference is also made to a new species of Borrelia that may be the etiologic agent of epizootic bovine abortion in the western United States. PMID- 3541128 TI - Cryptogenic group A streptococcal bacteremia: experience at an urban general hospital and review of the literature. AB - The clinical features of group A beta-hemolytic streptococcal sepsis were studied in 15 consecutive patients seen at an urban general hospital over a two-year period. Although 14 of the 15 patients had underlying disease, no patient had malignancy and none had undergone immunosuppressive therapy. Only one infection was nosocomially acquired. Mortality was 20%. Bacteremia arose from a cutaneous infection in 10 cases, from pneumonia in two, and from the urinary tract in one. Streptococcal bacteremia was unexpected in the remaining patients, two women who presented with severe abdominal pain. Unlike most other patients described in the literature, neither woman had an identifiable primary focus of infection. A review of the literature for potential sources of group A streptococcal bacteremia revealed that this pathogen is not part of the indigenous flora of the normal host at any body site. PMID- 3541129 TI - Trichosporon beigelii infection: a review. AB - During a 10-year period from 1974 to 1984, 19 patients at M. D. Anderson Hospital and Tumor Institute in Houston had invasive infection due to Trichosporon beigelii. Infection was manifested as either a nonspecific febrile illness or pneumonia, and the diagnosis was not suspected before death in 25% of the patients. The majority were neutropenic at the onset of infection, and recovery was directly related to resolution of myelosuppression. The overall mortality rate was 74%. The majority of patients had polymicrobial infections. Twenty-four additional cases reported in the medical literature indicate that this pathogen is an increasingly important cause of mortality in immunosuppressed patients. In both the present series and the cases reported in the literature, the majority of neutropenic patients with disseminated T. beigelii infection died, despite antifungal therapy. Only those patients whose neutropenia resolved following remission of their leukemia recovered. PMID- 3541130 TI - Nontyphoid salmonellosis in patients with total hip replacement: report of four cases and review of the literature. AB - Five episodes of nontyphoid salmonella infection following total hip replacement in four patients were studied. In three patients the infection occurred in the immediate postoperative period while prophylactic antibiotics were being administered. The fourth patient had bilateral total hip replacements five years apart with two nontyphoid salmonella infections, one immediately after the first operation (during antibiotic prophylaxis) and the second four years after the second operation. In addition to local infection, clinical manifestations included fever (all patients), diarrhea (three patients), deep prosthetic infection (two patients), and shock with disseminated intravascular coagulation and acute renal failure (one patient). In addition to antibiotic therapy, removal of the prosthesis was necessary for cure in three patients. All patients recovered. Hematogenous spread was thought likely in all cases. Four of five salmonella isolates were resistant to ampicillin and chloramphenicol. A review of the English-language literature yielded information on five additional cases of nontyhpoid salmonella infection after total hip replacement in four patients. PMID- 3541131 TI - Prospects for the prevention and therapy of infections with the human immunodeficiency virus. AB - The current epidemic of acquired immunodeficiency syndrome (AIDS) poses a major threat to our population. Urgently needed are both a vaccine to prevent infection with the etiologic retrovirus, human immunodeficiency virus (HIV), and safe, effective antiviral agents to treat those individuals already infected. The elucidation of viral replicative mechanisms has allowed the development and testing of several agents active against HIV in vitro. Inhibitors of reverse transcriptase that have demonstrated activity include azidothymidine, phosphonoformate, antimoniotungstate (HPA-23), and suramin. Ribavirin and recombinant interferon alpha-A (IFN-alpha-A) also inhibit HIV replication, although their mechanisms of action are less clear. All of these compounds are undergoing early clinical trials in patients with HIV infection. The identification of immunogenic viral proteins may allow the development of one or more subunit vaccines against HIV. Studies are underway to clone appropriate viral genes and incorporate the expressed proteins into vectors for administration. Laboratory models, e.g., chimpanzees, will be inoculated with candidate vaccines and, if successful, this will be followed by clinical trials for safety and efficacy in appropriate human populations seronegative for HIV. Although important problems, such as virus envelope protein variability, need to be addressed, efforts to develop effective vaccines may well prove successful in the years ahead. PMID- 3541132 TI - Classification of beta-lactamases. AB - Traditionally, the classification of beta-lactamases has followed the general principles of describing enzymes by the characterization of their activity against substrates. New types of beta-lactam structures with therapeutic relevance have emerged, necessitating more specific substrate profiles. Biophysical characterization, i.e., primarily isoelectric focusing, has greatly improved classification, particularly of nonchromosomal beta-lactamases. The classification of beta-lactamases of both gram-positive and gram-negative organisms is reviewed and updated by adding data on recently discovered enzymes. Data on amino acid sequence and molecular structure that are available for an increasing number of beta-lactamases will gradually be incorporated into the established system. In addition, the introduction of evolutionary aspects should serve to modify the existing system, which to date has been based on arbitrarily selected characteristics. PMID- 3541133 TI - Role of beta-lactamases in the resistance of gram-negative bacilli to beta-lactam antibiotics. AB - Few studies in animal models or humans have been performed to prove that the mechanism of resistance to beta-lactam antibiotics in the presence of beta lactamases is similar in vivo and in vitro. In vivo, it seems likely that different parameters will influence each other: the penetration of the antibiotic into the site of infection; the stability of the drug; and the organism responsible for the infection, which affects the type and amount of beta lactamase released into the environment. In vitro, the different enzymatic parameters responsible for the inactivation of various compounds have been well defined. However, overall resistance to beta-lactams in the presence of beta lactamase may also be influenced by the function of the outer membrane in gram negative bacteria. PMID- 3541134 TI - An overview of the response of bacteria to beta-lactam antibiotics. AB - A great variety exists in the ways bacteria respond to beta-lactam antibiotics. The responses of gram-positive cocci and gram-negative bacilli are fundamentally different, and beta-lactam antibiotics vary widely in their ability to penetrate to the target proteins, to bind to those proteins, and to withstand hydrolysis by enzymes that the organism may possess. Continuous turbidimetric monitoring offers a simple means by which the response of bacterial cultures can be followed in undisturbed test conditions. Microscopy of the cultures permits the turbidimetric record to be related to morphologic changes elicited by the antibiotic. Such studies reveal that cephalosporins can often evoke a transient response in bacteria that are completely unaffected by penicillins; beta-lactamase inhibitors appear to be more effective when they build on such a partial response. PMID- 3541135 TI - Mechanisms of beta-lactam resistance in anaerobic bacteria. AB - The known mechanisms of beta-lactam resistance in anaerobic bacteria involve production of beta-lactamases, alteration of penicillin-binding proteins, and blocking of the penetration of beta-lactams through the outer membranes. The most important factor in beta-lactam resistance is the production of beta-lactamase. beta-Lactamases in various Bacteroides, Fusobacterium, and Clostridium species have been described. beta-Lactam resistance in Bacteroides fragilis is most commonly mediated by the production of beta-lactamase, primarily of the cephalosporinase type. Studies have also shown that B. fragilis can produce a penicillinase that inactivates piperacillin and carbenicillin. Enzymes that inactivate cefoxitin and imipenem have also been found in B. fragilis. The nonfragilis Bacteroides species produce beta-lactamases mainly of the penicillinase type. Recently a penicillinase from Fusobacterium nucleatum has been characterized. Among the clostridia, Clostridium butyricum, clostridium clostridiiforme and Clostridium ramosum have been shown to produce penicillinases. PMID- 3541136 TI - Antibiotic resistance in Haemophilus influenzae: epidemiology, mechanisms, and therapeutic possibilities. AB - The prevalence of antibiotic resistance in Haemophilus influenzae is increasing. The encapsulated strains of group b are the strains that are most important in the pathogenesis of severe systemic infections, and it is in this group that the incidence of resistance is highest. Strains simultaneously resistant to ampicillin, chloramphenicol, and tetracycline are rare but have been isolated in several parts of the world. Transferable antibiotic resistance is well documented, and both small (3.6 megadaltons) and large (38-42 megadaltons) plasmids mediating beta-lactamase and chloramphenicol acetyltransferase production and tetracycline resistance have been detected in H. influenzae. The possibilities for treatment of infections due to such organisms include the use of the newer cephalosporins, of a combination of a beta-lactamase inhibitor and ampicillin, and of alternate agents such as minocycline and trimethoprim. Sporadic strains resistant to these agents have also been reported. PMID- 3541137 TI - Reflex control of the human cardiovascular system. PMID- 3541138 TI - Vascular capacitance: its control and importance. PMID- 3541139 TI - Electrical breakdown, electropermeabilization and electrofusion. PMID- 3541140 TI - [Hyperparathyroidism and pregnancy. Review of the literature]. AB - This review of the literature includes 92 cases of hyperparathyroidism associated with pregnancy since 1930. Hyperparathyroidism is rare during pregnancy and often remains asymptomatic. Thus, a fetal death or an episode of neonatal tetany may reveal a maternal hyperparathyroidism. Determination of the calcium blood levels at the slighest maternal symptom, or a posteriori, in view of complications of pregnancy or in the neonatal period, must enable to entertain the diagnosis of this disease. If the diagnosis is made during pregnancy, the surgical treatment of choice is easier during the second trimester. Most frequently, the excision of a parathyroid adenoma responsible for the symptoms, prevents maternal and neonatal complications. PMID- 3541141 TI - [Endocrine gastroenterology. Generalities]. PMID- 3541142 TI - [Treatment with levamisole of infection by Mansonella ozzardi]. PMID- 3541143 TI - Immunoserology of malaria. PMID- 3541144 TI - Immunopathologic studies in myocardial biopsies of patients with Chagas' disease and idiopathic cardiomyopathy. PMID- 3541145 TI - Assays of pancreatic B cell secretory products: utility in investigative and clinical diabetology. PMID- 3541146 TI - Beta 2-microglobulin in urine and serum determined by a micro-ELISA technique. AB - An enzyme-linked immunoadsorbent assay for the determination of beta 2 microglobulin in serum and urine using microtest plates as solid phase is described. All reagents are commercially available. The assay has a high capacity and it is inexpensive using only 3% of the amounts of antibodies required in a previously described ELISA based on tubes as solid phase. PMID- 3541147 TI - Light microscopic study of giant tubules in bovine dentin. AB - Demineralized, H-E stained longitudinal and transversal sections of unerupted permanent incisors from 1/2-3-yr-old calves were studied by light microscopy. The most incisal dentin in all teeth was characterized by a regular pattern of straight axially oriented giant tubules situated in the axiomesiodistal plane with interglobular dentin between them. In younger teeth, the pulpal part of every giant tubule contained an afferent and an efferent blood vessel, forming a hairpin loop and being surrounded by basophil cells. Incisal to the blood vessel loops, cells enbedded in an eosinophil matrix were present in the giant tubule lumina, showing increasing degenerative changes incisally. In older teeth there was a mesiodistally extended eosinophil dentin band near the pulp, with few, irregularly arranged, tortuous dentinal and giant tubules, the latter containing single blood vessels accompanied by pulpal cells. Isolated degenerating odontoblasts in lacunar cavities were seen in the transition area of the normal circumpulpal dentin and the eosinophil dentin band. A hypothesis on the initiation and subsequent development of giant tubules is presented. PMID- 3541148 TI - Maxillary expansion of unilateral cross-bite in preschool children. AB - The influence of a low force appliance on the maxilla in correction of unilateral cross-bite was studied clinically and radiographically in 29 preschool children following a standardized treatment schedule. Four weeks' expansion was followed by a 4-wk retention and a 12-wk postretention period. Inter- and intraobserver evaluations of the reliability of the measurements on radiographs were performed. In all children but one the cross-bites were corrected after 4 wk of expansion. The mean maxillary expansion was 3.3 mm in the second molar and 1.3 mm in the canine region, but decreased to 1.5 mm and 1.0 mm, respectively, at the end of the postretention period without relapse of the corrected malocclusion. No significant remaining orthopedic effects could be registered on radiographs by this low force appliance used. The modified quad helix appliance was found to be suitable for correction of unilateral cross-bite in the primary dentition and was well tolerated by the children. PMID- 3541149 TI - The endocrine pancreas aspects of beta-cell function in relation to morphology, insulin secretion and insulin content. PMID- 3541150 TI - Immunoarchitecture of the regenerating rat spleen: effects of partial splenectomy and heterotopic autotransplantation. AB - To investigate the microstructure of in situ (eutopic) and autotransplanted (ectopic) splenic remnants, adult Sprague-Dawley rats were studied 60 days after subtotal (approximately 80%) splenectomy, total splenectomy followed by single or multiple remnant intraperitoneal autotransplantation, or sham operation. Total nucleated cell counts were determined in excised splenic remnants, and immunohistochemical staining using monoclonal antibodies to rat B- and T-cell antigens was performed in serial tissue sections. Immunoarchitecture of eutopic remnants was indistinguishable from that of intact spleens and total nucleated cell counts remained proportional to weight. In contrast, ectopic remnants showed sparsity and abnormal mixing of B and T lymphocyte subpopulations with widespread loss of follicles and periarteriolar lymphoid sheaths in addition to lower density and marked reduction of total nucleated cells. These findings provide immunohistologic evidence that preservation of intact vasculature is critical to splenic architecture, which may account in part for the demonstrable functional inferiority of ectopic remnants. PMID- 3541151 TI - Ultrastructural studies of intercellular contacts (junctions) in bone marrow. A review. AB - This paper reviews ultrastructural studies of the intercellular contacts or junctions between cells of the bone marrow. Studies using tannic acid and glutaraldehyde as a fixative have shown pentalaminar complexes between many types of cells in marrow of mice and chicks. These intercellular contacts occur between adjacent stromal cells, between stromal cells and developing blood cells and, in marrow of mice, between migrating blood cells and cells of the sinusoidal wall. Because of their location and widespread occurrence, it is believed these contacts may represent a type of adherent junction helping to maintain an orderly arrangement of blood cells and stromal cells in the marrow. Migrating blood cells may use these contacts as anchoring sites during locomotion toward the sinusoids and in crossing the sinusoidal wall. On the other hand, since these junctions resemble gap junctions of other tissues, one should not exclude the possibility that they are involved in cellular communication. Freeze-fracture and lanthanum impregnation studies have failed to demonstrate these junctions in marrow. Studies using ruthenium red have shown apparent sites of attachment between cells of the marrow, but it is not known whether these sites correspond to the intercellular contacts seen in tannic acid preparations. PMID- 3541152 TI - Preparation methods for quantitative electron probe X-ray microanalysis of rat exocrine pancreas: a review. AB - Pancreatic acinar cells are thought to secrete a fluid containing digestive enzymes and electrolytes and use e.g. calcium as a second messenger upon stimulation. Together with their pronounced morphological polarity, they provide a model system to study the effect of different preparation methods for quantitative biological electron probe X-ray microanalysis (EPXMA) of ultrathin sections. Several preparation methods i.e., freeze-drying and plastic-embedding, freeze-substitution (2 days) and freeze-drying of ultrathin cryosections have been applied to examine the retention of sodium, magnesium, phosphorus, sulfur, (chlorine), potassium and calcium in subcellular compartments (basal cytoplasm, apical cytoplasm, mitochondria and zymogen granules). In freeze-substituted samples the phosphorus, potassium and sulfur concentrations were 2-3 times lower in all compartments compared to freeze-dried, plastic-embedded samples. Intracellular potassium-to-sodium ratios obtained on frozen substituted and frozen-dried, plastic-embedded samples were considerably lower than for cryosections. Element gradients between adjacent organelles were large in frozen dried cryosections, smaller in frozen-dried plastic- embedded samples and insignificant in frozen-substituted samples. PMID- 3541153 TI - The determination of wet weight concentrations of elements in freeze-dried cryosections from biological cells. AB - Energy dispersive X-ray microanalysis in STEM (scanning transmission electron microscope) of freeze-dried cryosections from biological cells provides information on the subcellular element distribution in terms of dry weight concentration. The local dry weight content in the range of 5-50%, respectively the local water content within 50 to 95%, in different subcellular compartments can be determined by measuring the darkfield intensity by means of an annular detector in STEM. Calibration is done by measuring the darkfield intensity of similarly prepared cryosections from dextran-water-solutions in varying concentration. Thus, by combining the X-ray microanalytical data evaluated by the continuum method with the STEM darkfield values, wet weight concentrations of elements in subcellular compartments are obtained. The method was applied to fibroblast cells in suspension. The reliability of this method is compared with other techniques to measure mass and intracellular water by electron microscope methods. PMID- 3541155 TI - Lack of regional surface differences in mouse bladder urothelium: a scanning electron microscopic study. AB - The surface structures of mouse urinary bladder epithelium, the urothelium, were examined in SEM. The entire surface area of both a moderately and a well stretched bladder were studied. No regional differences were found in either case. The moderately stretched bladder showed deep folds, while the well stretched bladder had only small folds giving the bladder an accordion-like appearance. In both bladders the typical surface structures were microridges arranged in a honeycomb-like pattern. The present study indicates that focal or regional differences found in bladders treated with chemicals or exposed to radiation are a result of the treatment itself, and not of differences normally occurring in the urothelium. PMID- 3541154 TI - Intrauterine device (IUD) associated pathology: a review of pathogenic mechanisms. AB - This paper summarizes our studies of IUD-related disease with those previously published by others. Our data are based upon 51 IUDs and 42 index cases of IUD related disease demonstrating specific processes. Gross, dissecting microscope, scanning electron microscope and X-ray microanalysis examinations were made of selected IUDs and associated tissues. Tissue associated with the IUDs revealed inflammation in 59.4%, calcific material in 6.3% and no abnormality in 34.4%. IUD associated tissue responses were accompanied by changes of the IUD; these changes involved deposition of substances upon the IUD surface and degradation of the IUD itself. Disintegration of the IUD, its string or both, has been repeatedly observed. The material deposited upon the surface of the IUD included proteins and calcium salts. The changes which involve the IUD and the host appear to be operative in the genesis of IUD-related disease. Inflammatory changes and infections are the most common IUD-related disease processes and are also the mechanisms commonly associated with the most serious complications of IUD use, reproductive failure and death. We propose that serious IUD-related disease is caused by or is a direct consequence of processes which alter the IUD and which potentiate inflammation and infection. A model amenable to testing is proposed. PMID- 3541156 TI - Particle probe analysis in the study of skin physiology. AB - The basic function of the epidermis is to provide a barrier which will separate the body compartment from the environment thus protecting the organism from excessive loss of water and to hinder the entrance of noxious agents. A continuous renewal of the actual barrier makes it possible to fulfil these requirements. Using particle probe analysis, electron microprobe (EMP) and proton microprobe (PMP) analysis we have demonstrated the feasibility of these techniques in the study of skin physiology. The results reported here have been obtained on quench frozen skin specimens inertly prepared by cryotechniques to produce freeze-dried sections presenting cross sections of the skin. The distribution of Na and K is compatible with the idea that the Na/K pump of the cell membranes is dysfunctional above the basal cell layer. The phosphorus distribution over the epidermal cross section coincides with a previously shown phospholipid distribution. S and mass distributions correspond to the results of the keratin synthesis of the epidermis. Calcium displays a profile over the epidermis which is compatible with recent data obtained on the calcium dependence of the differentiation of epidermal cells in culture. Also this distribution corresponds to recent data obtained by histochemical methods at transmission electron microscope resolution. Zn and Fe have been shown to reside mainly in the basal cell layer of the normal epidermis but are found in high amounts in the outer cell layers of the epidermis in hyperproliferative paralesional psoriasis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541157 TI - The three-dimensional microstructure of the liver. A review by scanning electron microscopy. AB - The improvement in scanning electron microscopy (SEM) techniques has permitted us to describe the microstructure of the liver. By SEM, the liver peritoneal surface is composed of flat mesothelial cells possessing microvilli and cilia. Hepatic sinusoids connect the portal vessels with the terminal branches of the hepatic vein (central veins). Endothelial cells of the portal space arteries are elongated and arranged longitudinally, while those of the central and portal veins are polygonal and flattened, possessing microvilli. The sinusoidal endothelial cells show both small fenestrations (sieve plates), up to 200 nm in diameter, and large ones, up to 1 micron. Within the sinusoids are seen bridging structures, covered by fenestrated endothelium, seeming to have a fibrillar core. Kupffer cells resemble macrophages, showing microvilli, blebs, lamellipodia and filopodia. Within the Space of Disse are seen the fat-storing cells, having laminar dendritic projections. The polyhedral liver cell faces the Space of Disse (vascular pole) or faces an adjacent hepatocyte (biliary pole). Vascular facets are evenly covered by microvilli. Biliary facets show a central longitudinal depression, bordered by microvilli (bile hemicanaliculi). Canaliculoductular junction and bile duct epithelia show blebs, microvilli and cilia. Up to now, fetal liver and liver pathology have been scarcely investigated by SEM: in the future, they can be successfully approached by three-dimensional studies. PMID- 3541158 TI - Topical modes in the preparation of human spleen specimens for routine scanning electron microscopy studies. AB - Various preparatory techniques were used to improve scanning electron microscopy images of the fine structure of vascular, cellular, and cordalreticular components of normal human spleens. The progressive method of fixation (GTGO) applied in the present study, allowed air drying of the tissues and rendered the specimens conductive even in newly fractured surfaces. Vascular perfusion proved necessary only in studies of the splenic blood vessels, while a simple immersion of tissue blocks in the washing solution resulted in better images of the white pulps. Interstitial (transsplenic) perfusion was found to be superior to vascular perfusion for routine preparation of spleen tissues, and freeze-cracking did not necessarily lead to improved images of the specimen's surfaces. Combined with proper washing and shaping protocols, the GTGO procedure is shown to be a superior mode of specimen preparation, abolishing most traditional artifacts and obtaining clear images of the complex splenic tissue. PMID- 3541160 TI - Proton microprobe analysis in biology. AB - This paper is intended as an introduction to the field of proton microprobe analysis with special emphasis on applications in biological sciences. It is mainly intended for users of electron microscopes equipped with microprobes or other analytical equipment. The basic principles of Particle Induced X-ray Emission analysis are discussed as well as the instrumental requirements for the proton microprobe. The analytical characteristics including quantification procedures are compared with those of the electron microprobe and a review is given of various analytical applications of the proton microprobe within biology and medicine. PMID- 3541159 TI - The developmental features of marrow stroma in ectopic bone marrow implants. AB - Implantation of bits of marrow in ectopic sites is followed by reorganization of tissue and the formation of a hemopoietic nodule surrounded by a shell of bone. This regenerative process is reminiscent of marrow ontogeny and the model can serve to study marrow ontogeny in a relatively short period of time. Early events during this regeneration were studied by scanning (SEM) and transmission electron microscopy (TEM). Within 24 hours the implant elicited an angiogenic reaction and new vessels penetrated the implant. Intense circulation, thus established, divested the implant from hemopoietic cells, leaving the stroma behind. Stromal cells proliferated and the impetus for this proliferation appeared to result from an impulse caused by the presence of bony fragments outside and within the stromal cells. Previous studies of this model have not appreciated the presence of non-viable bone in the implant, although the fact that non-viable bone can trigger osteogenesis and new bone marrow formation is well-known. This experimental model lends itself to the study of the interrelationship of hemopoietic cells and their supporting stroma as well as the interrelationship of bone and hemopoiesis. PMID- 3541161 TI - Scanning electron microscopic study of the surface of feline gastric epithelium: a simple method of removing the coating material. AB - Scanning electron microscopic examination of the gastric surface epithelial cells is often hindered by the presence of a coating material. Several methods for removal of coating material on feline gastric mucosa were utilized. The cleansed tissues were evaluated using the scanning electron microscope to assess damage caused by the use of various cleansing methods to surface epithelial cells. The stretched stomach washed several times, including rubbing the mucosal surface with gloved fingers, yielded the best results with no apparent damage to the surface epithelial cells. Flushing unstretched stomachs with saline only did not adequately remove coating material. Flushing unstretched stomachs with saline while stroking the surface with a cotton tipped applicator stick removed debris but damaged the surface epithelium. PMID- 3541162 TI - Beam voltage effects in the study of embedded biological materials by secondary electron detectors. AB - Thin and semithin sections were extensively examined by the secondary electron (SE) detector in a conventional scanning electron microscope (SEM), and in a transmission electron microscope with a scanning attachment (STEM). Various parameters, in particular the beam voltage, were shown to affect the final SE image (SEI). As for SEM observation, a surface contrast was imaged at low primary electron (PE) voltages (0.6-2 kV), whereas a subsurface contrast predominated at higher energies (15-30 kV). In STEM, significant differences were not detected by varying the PE in the 20-100 kV range. Surface and subsurface information was simultaneously imaged even though the SEI were better resolved at the highest energy. PMID- 3541163 TI - The regeneration of adrenergic nerves in a free microvascular groin flap in the rat. AB - The regeneration of adrenergic nerves in free microvascular groin flaps in the rat was investigated. The adrenergic nerves were revealed with glyoxylic acid induced fluorescence and with formaldehyde-induced fluorescence methods. In the control specimens taken from the contralateral groin, adrenergic nerves were seen in the erector pili muscles and as networks around arteries and arterioles. In the free flap four weeks postoperatively, a few regenerating adrenergic nerves were observed at the margins under the flap and following the pedicle. Eight weeks postoperatively many tiny regenerating nerves were observed to invade the flap at the margins and under it. Many regenerating nerves were observed to reinnervate the artery and vein, forming a nerve plexus in the pedicle. The number of single nerve fibres invading the flap at the margins decreased sixteen weeks postoperatively, but more nerves were observed along arterioles in the flap and pedicle. Twenty-four weeks postoperatively some regenerating adrenergic nerves were observed around arteries and arterioles in different areas in the flap and in erector pili muscles. A rich network of nerves remained around the pedicle. However, the reinnervation of the vasculature of the flap remained patchy and inadequate, and many arteries and arterioles remained without innervation. PMID- 3541164 TI - The free scapular flap. An alternative to conventional flaps on the upper extremity. AB - The free scapular flap was used as an alternative to a conventional pedicle flap in resurfacing scarred areas and padding major nerve trunks on the upper extremities in a series of 8 patients. The free flap proved to be rather reliable (one failure), convenient to the patients and cheaper for the Health Service than a conventional flap. PMID- 3541165 TI - Effects of sulindac and naproxen in patients with chronic glomerular disease. AB - Eight patients with chronic glomerulonephritis were treated with either naproxen or sulindac in an open randomized study to observe their effects on the urinary excretion of prostaglandins and renal function. Both drugs were given for 7 days. Naproxen caused a decrease (p less than 0.01) of 80% in prostaglandin PGE2 and decrease (p less than 0.01) of 55% in prostaglandin PGF2 alpha. Sulindac caused a decrease (p = 0.01) of 37% in PGE2 and a decrease (p less than 0.05) in PGF2 alpha of 13%. The decrease in urinary excretion of prostaglandins were greater (p less than 0.05) during the naproxen treatment. Naproxen caused a decrease (p less than 0.05) in 24-hour creatinine clearance of 14 ml/min, an increase (p less than 0.05) in plasma urea of 1.0 mmol/l, an increase (p less than 0.05) in plasma potassium of 0.4 mmol/l and a decrease (p less than 0.01) in 24-hour urinary excretion of albumin of 11 mumol. Sulindac did not change any of these parameters significantly. In conclusion, sulindac affects renal prostaglandin synthesis to a significantly minor degree than naproxen and contrary to naproxen it does not influence the renal function in patients with chronic glomerular disease. PMID- 3541166 TI - A double blind comparison of naproxen and sulindac in female patients with heart failure. AB - The objective of this investigation was to study the effects of the two NSAIDs sulindac and naproxen on renal hemodynamics and excretion of water, salt and the prostacyclin metabolite 6-keto-PGF1 alpha in patients with well controlled congestive heart failure. Ten elderly females with congestive heart failure treated with oral furosemide were given four doses of sulindac and naproxen every twelve hours after a control day in a double-blind cross-over fashion. Naproxen significantly decreased the urinary excretion of water (19%), sodium (26%), chloride (26%), 6-keto-PGF1 alpha (76%) and decreased osmolal clearance by 18%. Sulindac had no significant effect on those parameters. There were no significant changes in glomerular filtration rate, renal blood flow, plasma renin activity, plasma aldosterone, free-water clearance or clearance of furosemide with either treatment. We conclude that renal prostaglandins are involved in the control of sodium excretion and urinary volume in patients with congestive heart failure even if renal hemodynamics are unaffected. Sulindac seems to be a selective inhibitor of extrarenal cyclooxygenase and consequently an appropriate drug for patients who require both diuretics and anti-inflammatory therapy. PMID- 3541167 TI - The arthritic patient with hypertension: selection of an NSAID. AB - Vasodilator prostaglandins produced in the renal medulla have a role in blood pressure regulation, beyond modulation of sodium and water retention. Systemic vasodilation resulting from effects of renomedullary prostaglandins lowers systemic vascular resistance, and administration of NSAIDs elevates blood pressure in hypertensive patients treated with diuretics and/or beta blockers, in patients with myocardial infarction, and in patients taking sympathomimetic agents such as phenylpropanolamine. Aspirin, which appears in the urine as salicylic acid (which has no effect on cyclooxygenase) has not been implicated as a drug which attenuates blood pressure control. Similarly, sulindac, the active sulfide metabolite of which is not filtered, does not inhibit renal synthesis of prostaglandins, though given in doses sufficient to inhibit serum thromboxane and 6-keto PGF 1-alpha. In a double-blind complete crossover study of blood pressure and renal function in hypertensive patients controlled with timolol hydrochlorothiazide, sulindac lowered blood pressure significantly, whereas naproxen and piroxicam significantly raised blood pressure, in the absence of any effect on GFR, plasma renin, weight, creatinine clearance, or urinary sodium. It is suggested that for arthritic patients with hypertension, the NSAIDs of choice are aspirin and sulindac. PMID- 3541168 TI - Effect of Clinoril (sulindac, MSD), piroxicam and placebo on the hypotensive effect of propranolol in patients with mild to moderate essential hypertension. AB - One hundred ten patients of both sexes with mild to moderate essential hypertension were studied in this double-blind, multicenter study. In the double blind portion of this study, which covered weeks 11 to 14, 71 patients were evaluated to determine the effect of Clinoril (sulindac, MSD), piroxicam, and placebo on the hypotensive effect of propranolol. All 110 patients were considered for safety evaluation. Patients treated with propranolol alone were distributed randomly into three groups (Clinoril, piroxicam and placebo) and compared in a 15-week study with four periods (I through IV). Having fulfilled the criteria for hypertension (I) and having been successfully controlled with propranolol alone (II), patients were entered into a double-blind period (III) comparing the three drug treatments during four weeks followed by one week of propranolol alone (IV). During period III, patients treated with piroxicam had significantly greater (p less than 0.05) increases in supine and standing diastolic blood pressure than patients treated with Clinoril. No clinical difference was shown between patients treated with Clinoril and placebo. At the end of period IV patients treated with piroxicam maintained the increase in their diastolic blood pressure, in contrast to Clinoril and placebo where no clinical difference was noted. Significantly more patients treated with piroxicam than Clinoril had a 10 mmHg or greater increase of their supine diastolic blood pressure. These results show that Clinoril does not blunt the antihypertensive effect of propranolol in patients with mild to moderate hypertension in contrast to piroxicam. This is an extension of a report previously published in Advances in Therapy, Vol. 2, No. 4, July/August 1985.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541169 TI - A trial of cyclophosphamide in ankylosing spondylitis with involvement of peripheral joints and high disease activity. AB - In 12 patients with ankylosing spondylitis with involvement of the peripheral joints and high activity of the disease process, cyclophosphamide was given in intravenous doses of 200 mg every second day for 3 weeks, followed by oral doses of 100 mg once weekly for 3 months to a total dose of 3 300 mg. Before this treatment and after 18-24 months the following clinical parameters were determined: spinal mobility, degree of intensity of spinal and articular pains, and the number of involved joints. After the treatment an evident clinical improvement was observed, with decreased values of the laboratory indices of the disease activity. Apart moderate erythrocyturia in one case and transient leukopenia in another case, no other side effects were observed. The improvement in cases with coexistent amyloidosis was relatively small. PMID- 3541170 TI - Serum IgA to enterobacteria in ankylosing spondylitis. AB - The aetiology of ankylosing spondylitis (AS) may involve certain enterobacteria. It is therefore interesting that serum polymeric IgA, a precursor of secretory IgA, was statistically elevated in active AS (n = 35) and that levels were comparable to those found in yersiniosis (n = 12); this might indicate antigenic stimulation by bacteria which are present in the intestines of AS patients. However, specific serum IgA to the incriminated enterobacteria Klebsiella, Shigella and Yersinia, as determined by ELISA, was not raised in the above AS patients. Nor were these titres raised in patients with idiopathic reactive arthritis (n = 21). In contrast, yersiniosis (n = 12) and shigellosis (n = 96) patients displayed marked increases in specific serum IgA titres to the respective infectants. It is proposed that AS may involve a set of enterobacteria rather than a few suspected species. Thus, despite the lack of raised group averages, screening of individual patients for specific IgA to several indicated bacteria might disclose whether or not raised serum IgA is related to enterobacterial activity. Apart from this, the above supports other reports indicating that serum IgA may be a useful parameter to assist in monitoring of disease activity in AS. Finally, it is suggested that study of a homogeneous group of reactive arthritis patients might facilitate aetiological research of seronegative arthropathies such as AS. PMID- 3541171 TI - A review of experimental evidence for the carcinogenicity of man-made vitreous fibers. AB - This paper reviews experimental studies on the carcinogenicity of man-made vitreous fibers. Long-term inhalation studies using several animal species and dust preparations of fibrous glass, rock wool or slag wool have produced little evidence of pulmonary fibrosis or pulmonary tumors. While some intratracheal injection studies found almost no pathological changes in lung tissue, some showed that pulmonary fibrosis can occur. Only one intratracheal injection study has reported that vitreous fibers can be carcinogenic; in contrast, many workers have reported that, following intrapleural or intraperitoneal injection, man-made vitreous fibers are highly carcinogenic, and tumor production appears to be closely related to fiber size. In vitro tests confirm that vitreous fibers can be toxic and can cause neoplastic transformation of cultured cells. The discrepancies between some experimental studies probably result from the relatively high solubility of most vitreous fibers. It seems likely that, while these fibers can survive in body cavities long enough to cause tumor production, they dissolve in lung tissue fast enough to have relatively little harmful effect. Rock-wool fibers appear more durable than glass- or slag-wool fibers, and, with similar fiber numbers and sizes in any dust cloud, this material is the most likely to have harmful potential. PMID- 3541172 TI - [In vivo detection of alloreactive T cells of the donor in graft versus host disease]. AB - A male patient with severe aplastic anemia who had rejected a first T cell depleted graft from his HLA-identical sister was retransplanted from the same donor without T cell depletion and using an intensified conditioning regimen. After 8 weeks acute graft versus host disease (GVHD) developed and peripheral blood mononuclear cells (PBMC) were obtained. After in vitro restimulation and following limiting dilution cloning, 15 proliferative (PLT) and 25 cytolytic (CTL) T cell lines specific for host PBMC but unreactive to donor PBMC were isolated. Only 1 of 10 clones which could be expanded sufficiently for testing recognized a target cell (haploidentical sister), and in only 4 instances could a restriction element be found in a panel study (3 times HLA-A2; once HLA-BW49) of 13 unrelated stimulators. Of the 8 CTL clones testable after expansion, none showed a clear restriction and none recognized any of the family cells. Our data demonstrate that anti-patient reactive PLT and CTL lines can be found in PBMC. In no instance was segregation with HLA found. Only HLA-class I restriction was detectable. PMID- 3541173 TI - [Budd-Chiari syndrome and Vaquez disease: apropos of a case. Results of medical and surgical treatment of Budd-Chiari syndrome]. AB - A case is reported of polycythaemia vera associated with Budd-Chiari syndrome. Anticoagulant treatment produced a favorable outcome. A review of the literature prompts the conclusion that in the context of polycythaemia vera surgery does not produce better results than a purely medical approach. We therefore feel that in the type of patient we report, anticoagulation should be maintained for as long as possible. PMID- 3541174 TI - [Historical notes on the therapy of depression]. AB - Melancholy originally had another meaning from the present one. Only since the last century has melancholy taken on the meaning of severe depression. The Arabs were the first to introduce special wards for the mentally ill in their hospitals in the 8th and 9th centuries. In the West, mental wards in general hospitals have been known since the 13th century only. In the Renaissance dietary measures played an important part in the treatment of depression. Lean meat, fresh eggs, freshwater fish and particularly grapes were recommended. In the 17th and 18th centuries music therapy against depression came back into favour after being used in ancient times. In the 19th century opium was recommended and held its ground well into the middle of our century. Various methods and drugs were recommended and used for the therapy of depression in the 19th century, such as baths and massage, ferrous iodide, arsenic, ergot, strophantin, and cinchona. Actual antidepressants have been known only for approximately 30 years. The classic papers concerning therapy with lithium salts date back to the years 1948/49. It is a little known fact, however, that lithium salts had been used as prophylactic treatment against periodic depression 50 years earlier. PMID- 3541175 TI - [Clinical demonstrations. Fever difficult to diagnose. An unusual hypereosinophilia]. PMID- 3541176 TI - [Confederation recognition of the dentist as a medical profession in Switzerland]. PMID- 3541178 TI - [Modern views on the respiratory center in mammals]. PMID- 3541177 TI - [Anatomic and neurophysiologic studies on nucleus raphe magnus]. PMID- 3541179 TI - [Contraception by inhibitors of acrosomal proteinase]. PMID- 3541180 TI - [Role of the ovarian nerves in reproductive function]. PMID- 3541181 TI - [Biochemical studies on scorpion mammalian neurotoxins]. PMID- 3541182 TI - [Arachidonic acid metabolism of leukocytes]. PMID- 3541183 TI - [Endothelium-derived vascular relaxing factor]. PMID- 3541185 TI - [Adaptative cytoprotection of the gastric mucosa and its mechanism]. PMID- 3541184 TI - [Blood platelet membrane glycoproteins]. PMID- 3541186 TI - [Neuropeptide Y]. PMID- 3541187 TI - [Corticotropin releasing factor]. PMID- 3541188 TI - [Prof. Zhou Qi-yuan, a Chinese biochemist]. PMID- 3541190 TI - [Brainstem descending inhibition and its neuronal circuitry in spinal dorsal horn]. PMID- 3541189 TI - [Cytoprotection: one of the physiological functions of regulatory peptides?]. PMID- 3541191 TI - [Role of inositol 1,4,5-trisphosphate in the cellular signal transductional system]. PMID- 3541192 TI - [Structural organization and function of fatty acid synthetase]. PMID- 3541193 TI - [Oncogenes and oncogenesis]. PMID- 3541194 TI - [Promoting heat acclimatization and improving heat tolerance by training]. PMID- 3541195 TI - [Local regulation of testis function]. PMID- 3541196 TI - [Computer analysis on two-dimensional polyacrylamide gel electrophoresis]. PMID- 3541197 TI - [Effects of serotonin on the sympathetic pre- and post-ganglionic neurons]. PMID- 3541198 TI - [Myocardial infarct size and infarct expansion]. PMID- 3541199 TI - [Is the brain unresponsive to thyroid hormones?]. PMID- 3541200 TI - The AIDS virus. PMID- 3541201 TI - Conservative management of the injured spleen in children. AB - Five children under 11 years of age with traumatic rupture of the spleen were treated conservatively (non-operatively) and showed recovery of the injured spleen after an initial period of instability. The progress was monitored clinically, ultrasonically and with radionuclide scans. PMID- 3541202 TI - The role of 99mTc HIDA cholescintigraphy in the diagnosis of acute gallbladder disease: comparison with oral cholecystography and ultrasonography. AB - Fifty-four patients with suspected acute cholecystitis underwent 99mTc HIDA cholescintigraphy, ultrasonography and oral cholecystography. The correct diagnosis was reached in 49 patients by cholescintigraphy (91%) in 35 (65%) by ultrasonography and in 45 (83%) by oral cholecystography. 99mTc HIDA cholescintigraphy provides a rapid accurate diagnosis with minimal discomfort to the patient and is the investigation of choice for patients with symptoms of acute gallbladder disease, particularly if early cholecystectomy is to be considered. PMID- 3541203 TI - Unique forms of the abl tyrosine kinase distinguish Ph1-positive CML from Ph1 positive ALL. AB - In the Philadelphia chromosome (Ph1) of chronic myelogenous leukemia (CML), the c abl gene on chromosome 9 is translocated to bcr on chromosome 22. This results in the expression of a chimeric bcr-abl message that encodes the P210bcr-abl tyrosine kinase. The cells of 10% of acute lymphocytic leukemia patients (ALL) carry a cytogenetically similar Ph1 translocation. We report that Ph1-positive ALL cells express unique abl-derived tyrosine kinases of 185 and 180 kilodaltons that are distinct from the bcr-abl-derived P210 protein of CML. The appearance of the 185/180-kilodalton proteins correlates with the expression of a novel 6.5 kilobase messenger RNA. Thus, similar genetic translocations in two different leukemias result in the expression of distinct c-abl-derived products. PMID- 3541204 TI - The molecular genetics of cancer. AB - The search for genetic damage in neoplastic cells now occupies a central place in cancer research. Diverse examples of such damage are in hand, and they in turn hint at biochemical explanations for neoplastic growth. The way may be open to solve the riddles of how normal cells govern their replication and why cancer cells do not. PMID- 3541205 TI - Many random sequences functionally replace the secretion signal sequence of yeast invertase. AB - In the process of protein secretion, amino-terminal signal sequences are key recognition elements; however, the relation between the primary sequence of an amino-terminal peptide and its ability to function as an export signal remains obscure. The limits of variation permitted for functional signal sequences were determined by replacement of the normal signal sequence of Saccharomyces cerevisiae invertase with essentially random peptide sequences. Since about one fifth of these sequences can function as an export signal the specificity with which signal sequences are recognized must be very low. PMID- 3541206 TI - Yeast KEX2 protease has the properties of a human proalbumin converting enzyme. AB - Several classes of proteolytic enzymes have been proposed to have a role in the processing of precursor forms of proproteins at paired basic amino acid residues. In higher eukaryotes, a single endopeptidase has yet to fulfill the necessary criteria as the physiologically relevant convertase. The observation of proalbumin circulating in a child with a bleeding disorder caused by an unusual alpha 1-antitrypsin mutation led to speculation that the presence of this alpha 1 antitrypsin mutant was inhibitory to the convertase. This provided an additional means of characterizing the processing enzyme. In this study the yeast KEX2 enzyme, a calcium-dependent thiol protease, was found to have all the properties expected for this processing enzyme. KEX2 correctly recognized and cleaved the prosequence in proalbumin. In addition, KEX2 was specifically inhibited by the mutant alpha 1-antitrypsin but not by other serine protease inhibitors. PMID- 3541207 TI - Pulmonary thromboembolism: current status report on the role of nuclear medicine. AB - The normal perfusion study continues indisputably to rule out the presence of pulmonary embolism (PE) with reasonable certainty. However, the abnormal perfusion study requires additional specificity. Many retrospective and one prospective correlation of contrast pulmonary angiography (CPA) have largely substantiated the efficacy of ventilation imaging and increasing specificity, especially with a high-probability (HP) interpretation to approximately a 90% predictive value. In most studies, the predictive value of a low-probability (LP) interpretation also approaches 90%. Intermediate-probability (IP) ventilation perfusion (V-P) studies are the most frequent reason for performing pulmonary angiography, although LP studies with a stated prior clinical HP should also have CPA. Ventilation imaging technique is not as uniformly established as for perfusion studies, leading to some continued variability in interpretative criteria; yet criteria proposed by Biello and his colleagues have begun to be widely adopted. Aerosol inhalation imaging is developing, but has not been widely used, while problems continue with central airways deposition. The importance of contemporary correlative chest x-rays (CXR) especially when normal, have been emphasized, as well as new findings of the import of serial post-V-P CXRs, especially in HP studies without CPA or negative CPA. CPA continues to be the most specific diagnostic test for PE when properly performed, and is complimented and enhanced by use of prior V-P findings; although it is clear that too few CPAs are being performed. Consequently, there has been too much clinical dependence on V-P imaging. The value of prospective clinical probability estimates in patient management has been better substantiated. Reemphasis on thromboembolism as a systemic disease with use of some objective evaluation of the presence of peripheral thrombosis is becoming a part of clinical rationale, with the integrated long-leg radionuclide venograms (RNV) being one of the reasonable approaches. Multicenter studies have demonstrated, contrary to prior contentions, that V-P imaging leads to a significant net reduction and use of anticoagulants, as well as having overall significant efficacy in effecting patient management in suspected PE. Some of the controversies surrounding V-P imaging are expected to be resolved with the completion of the ongoing multiinstitute Prospective Investigation of Pulmonary Embolic Diagnosis (PIOPED) study.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3541208 TI - Measurement of pulmonary epithelial permeability with 99mTc-DTPA aerosol. AB - The rate at which inhaled aerosol of 99mTc-diethylenetriamine pentaacetate (DTPA) leaves the lung by diffusion into the vascular space can be measured with a gamma camera or simple probe. In normal humans, 99mTc-DTPA clears from the lung with a half time of about 80 minutes. Many acute and chronic conditions that alter the integrity of the pulmonary epithelium cause an increased clearance rate. Thus cigarette smoking, alveolitis from a variety of causes, adult respiratory distress syndrome (ARDS), and hyaline membrane disease (HMD) in the infant have all been shown to be associated with rapid pulmonary clearance of 99mTc-DTPA. Rapid clearance is also promoted by increased lung volume and decreased surfactant activity. Although the mechanism of increased clearance in pathological states is not known, the 99mTc-DTPA lung-clearance technique has great potential clinically, particularly in patients at risk from ARDS and HMD and in the diagnosis and follow-up of alveolitis. PMID- 3541209 TI - The role of nuclear medicine in pulmonary neoplastic processes. AB - It has been demonstrated that the single most important factor in determining survival in patients with bronchogenic carcinoma is the extent of spread of metastasis from the primary lesion. This explains the extensive efforts in developing accurate staging tests for pulmonary tumors, both primary and metastatic, with special emphasis on the determination of pulmonary hilar and mediastinal spread of disease. Continued improvements in nuclear medicine instrumentation along with the development of tumor specific radiopharmaceuticals, as well as agents that have the capability of tracking tumor viability, have changed the orientation of scintigraphic techniques in the evaluation of pulmonary neoplastic processes. Gallium scintigraphy is no longer considered as a primary imaging modality in the staging of pulmonary tumors, and in most institutions has been replaced by computed tomography (CT) for this purpose. It has been demonstrated that gallium, relative to other imaging modalities, is a sensitive indicator of hilar spread of tumor. However, because of the normally high background activity within the sternum and spine, mediastinal abnormalities are poorly detected. Since most pulmonary tumors metastasize via regional nodes to the pulmonary hilum and then to the mediastinum, the high sensitivity for the detection of pulmonary hilar abnormalities and the high specificity for mediastinal lesion detection suggest that gallium scintigraphy is a valuable adjunctive test when used appropriately. Thallium 201 as a tumor agent is being studied by several institutions. Preliminary results indicate a high degree of sensitivity for the detection of pulmonary hilar and mediastinal lesions and there are early indications that thallium is a promising agent to evaluate tumor viability. With the development of new generation monoclonal antibodies, the prospects for highly sensitive and specific agents for detecting hilar and mediastinal spread of tumor is extremely encouraging. CT and NMR have made major contributions to the noninvasive workup of patients with bronchogenic carcinoma. Neither modality has been demonstrated to be accurate enough to adequately evaluate this patient population. Thus, there is a critical need for new noninvasive tests that will accurately assess the status of the patient so that appropriate therapy can be instituted. PMID- 3541210 TI - Minimal breast cancer: a clinically meaningful term? PMID- 3541212 TI - The role of new imaging modalities in staging and follow-up of breast cancer. PMID- 3541211 TI - Monoclonal antibodies and breast cancer. PMID- 3541213 TI - The clinical investigator and the evolution of the treatment of primary breast cancer. PMID- 3541214 TI - Conservative surgery: the American experience. PMID- 3541215 TI - Conservative surgery and radiation therapy for early breast cancer: results, controversies, and unsolved problems. PMID- 3541216 TI - Strategies in the treatment of Hodgkin's disease. AB - The current treatment methods for the four stages of the four histologic subtypes of Hodgkin's disease are described. In the last several years, the use of radiotherapy and combination chemotherapy has dramatically improved the prognosis of patients with even the most advanced stages of disease. However, toxicity remains a problem. Gonadal function is adversely affected in many patients, and the risk of subsequent acute leukemia or myelodysplastic syndrome is about 10% at 10 years after treatment. There have been few trials of biologic response modifiers in Hodgkin's disease, and the results show no advantage over chemotherapy and radiotherapy. Newer therapeutic approaches will need to be devised, both to reduce toxicity and to improve the response of the relatively small number of patients who do not achieve a durable remission with present treatment. PMID- 3541217 TI - Alpha-interferon treatment of cutaneous T cell lymphoma and chronic lymphocytic leukemia. AB - The interferons represent an important first member of a family of biological 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. alpha interferon is the most extensively studied interferon species. While 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 patients with cutaneous T cell lymphoma (CTCL) (mycosis fungoides and the Sezary syndrome), a response rate of 45%, with 10% complete responses, was seen in patients treated with recombinant alpha-interferon at the National Cancer Institute (NCI). Interferon appears to be one of the most effective single agents for cutaneous T cell lymphoma. Current trials include further phase II trials to determine whether lower doses of alpha-interferon will be as effective as the high doses used in the previously reported studies. Additional trials include phase III trials where interferons are included in combination with chemotherapy agents, as well as using interferon in the adjuvant setting. Results for patients with chronic lymphocytic leukemia (CLL) were not as encouraging. A response rate of 15% was reported for crude and recombinant alpha-interferon in studies outside the NCI, and in our trial, only two of 18 patients (11%) had brief partial responses to recombinant alpha-interferon. PMID- 3541219 TI - Therapeutic approaches to the treatment of hairy cell leukemia. AB - Although a rare disease, hairy cell leukemia has great biologic and clinical significance. New therapeutic options of alpha-interferon and pentostatin have challenged the role of splenectomy in the overall management of the disease. alpha-Interferon can now be considered the treatment of choice for patients who progress after splenectomy, and it may also be considered as initial treatment in selected patients. Future clinical trials will focus on the relative efficacies of alpha-interferon and pentostatin, their potential for sequential or combined use, and the role of splenectomy. PMID- 3541218 TI - Alpha-interferon in the treatment of nodular lymphomas. AB - Patients with nodular lymphoma initially respond to a number of therapies but relapse is common and inexorable with time, and despite further therapy, most patients will ultimately die of their lymphoma. The recent demonstration of their sensitivity to alpha-interferon is promising. The importance of this human antitumor effect is that it is presumably based on mechanisms different from conventional agents. Phase I trials of various doses and schedules of recombinant alpha-interferon have shown that effective serum levels can be obtained by intramuscular (IM), intravenous (IV), or subcutaneous (SC) routes. Virtually all patients experienced some degree of acute toxicity manifested by fever, chills, myalgia, and headache. Tolerance usually developed to acute adverse effects within the first few weeks of therapy, regardless of dose or schedule. Fatigue and anorexia were the most important adverse reactions, occurring during the first two weeks of treatment and generally persisting for the duration of therapy. Occasional adverse effects relating to the central nervous and cardiovascular systems have been reported. Primary laboratory abnormalities observed during treatment include decreases in hematologic parameters and elevations of liver function tests. The clinical efficacy of alpha-interferon, both natural and recombinant, has been demonstrated in both untreated and heavily pretreated patients with nodular lymphoma. The response rate has approached 50% in recent studies; however, less than half were complete responders. Future directions include combination of interferon with cytotoxic agents or other biological response modifiers and use as adjuvant therapy. PMID- 3541220 TI - Amniotic fluid volume and its relationship to fetal fluid balance: review of experimental data. AB - The studies described above collectively suggest that, whenever there is a decrease in fluid balance in the fetus, both fetal urine flow and tracheal secretion into the amniotic space are decreased. Conversely, when fetal hydration is increased, both urine and tracheal flows into the amniotic fluid may be increased. These observations suggest the hypothesis that, except under pathological conditions, aberrations in amniotic fluid volume may be the consequence of the existing state of hydration of the fetus. In addition, it appears that under many circumstances, these deviations from normal in fetal fluid balance may be due to maternal influences. Of course, the concept that fetal fluid balance is the primary factor determining amniotic fluid volume needs to be modified to incorporate transmembrane fluxes. However, these fluxes have yet to be documented as they relate to amniotic fluid volume and its regulation. PMID- 3541222 TI - Amnionic fluid: a source for fetal evaluation. PMID- 3541221 TI - Development of fetal and neonatal renal function. AB - The development of renal function in the human is an amazingly intricate and complex process. In the vast majority of preterm and term babies, renal development and function are adequate to meet the homeostatic needs of the rapidly growing infant. However, when normal renal development does not occur the effects can be devastating. Pioneering work in the assessment and treatment of fetal renal anomalies has been carried out, but it appears that further studies will be necessary to demonstrate whether widespread applicability of this technology is indicated. PMID- 3541224 TI - Fetal pulmonary development and abnormalities of amniotic fluid volume. PMID- 3541223 TI - An overview of hydramnios. AB - Hydramnios, defined as a volume of amniotic fluid in excess of 2,000 mL, is frequently diagnosed in contemporary obstetric practice by ultrasound. A pocket of amniotic fluid in excess of 8 cm X 1 cm is a satisfactory upper limit of normal volume using ultrasound. The etiology of hydramnios is not clear cut, but there is a significant 20% association with fetal anomaly. Maternal complications are rare, while fetal complications are usually related to an underlying anomaly or preterm birth. There is no specific treatment for hydramnios apart from drainage, which should be performed if maternal symptoms are sufficiently distressing. Perinatal outcome is generally determined by gestation at delivery or fetal anomaly. PMID- 3541226 TI - Mechanisms of production and clearance of amniotic fluid. PMID- 3541225 TI - Amnionic fluid volume in prolonged pregnancy. AB - The evidence implicating reduced amnionic fluid volume as a major problem in prolonged pregnancy seems clear. Oligohydramnios serves to explain the association of umbilical cord compression fetal heart rate patterns in labors complicated by fetal distress and such cord entrapment may even explain the release of meconium into the amnionic fluid. Ultrasonic assessment of amnionic fluid volume, regardless of the definition of oligohydramnios used, appears to single out the prolonged pregnancy where the fetus is at risk. Important questions remain as to how best to quantify fluid volume using sonography and, importantly, whether normal amnionic fluid volume reliably predicts fetal well being for a predictable period of time. That is, oligohydramnios diagnosed using ultrasound seems meaningful, but whether a normal fluid volume permits safe expectant management needs further evaluation. This is particularly relevant if the liquor volume may subside within 24 to 48 hours as reported by Beischer et al. Unfortunately, the mechanisms by which amnionic fluid volume decreases in prolonged pregnancies remain unknown. As in Ballantyne's time, we still do not know ". . . what functions the fetus is performing during these accessory weeks . . . nor how he is performing them . . . ." But we have learned that oligohydramnios has a central role in producing some of the fetal complications associated with prolonged pregnancy. PMID- 3541227 TI - The presence of yeasts in urine. PMID- 3541228 TI - [Dispensary nurse--the first nurse receiving continuing education in Sweden]. PMID- 3541229 TI - [A home for all times (Caroline Wijk)]. PMID- 3541230 TI - Health care in a declining economy: the case of Zambia. AB - The severe and worsening economic crisis in Zambia has set into motion various adjustment measures (subsidy withdrawal or reduction, adjustment of exchange rates, import control, a foreign exchange auction system and retrenchment of government expenditure) which is making it increasingly difficult for the government to maintain the network of health and other social services developed in the 20 years since Independence. The situation became critical particularly after the decline of copper prices which provided Zambia with 90% of its foreign exchange earnings. The resulting fall in the GNP along with rapid inflation, population growth and urbanization has had a number of consequences for health care delivery. These effects are described with particular attention to health manpower/facilities, disease morbidity, malnutrition, expenditure patterns and health policy. Finally, some proposed strategies being considered by the government are presented. PMID- 3541231 TI - [Practical information on AIDS]. PMID- 3541232 TI - [A missed opportunity at the beginning of the profession of psychiatric nurse]. PMID- 3541234 TI - [Critical review of evaluation technic applied to cleft lip and palate infants]. PMID- 3541235 TI - The problem of stuttering: where are we in 1986? PMID- 3541233 TI - [The nurse facing sleeping disorders in hospitalized patients]. PMID- 3541236 TI - Ultrasonography in the diagnosis of pyloric stenosis. AB - We evaluated 101 children for hypertrophic pyloric stenosis (HPS) at Arkansas Children's Hospital. Diagnosis was based upon a palpable epigastric "olive" characteristic of HPS, or sonographic measurements of the pylorus. In 28 children, the diagnosis was confirmed by physical examination alone; the remaining 73 had ultrasound examination. Pyloric measurements included muscle thickness, transverse diameter, and total length. Pyloric function was also studied during examination. Using a thickness of less than 4 mm, a diameter of less than 13 mm, and a length of less than 17 mm as normal criteria, 31 cases of HPS were correctly diagnosed by ultrasonography. In the remaining 42, no pyloric abnormality could be demonstrated on further evaluation. PMID- 3541237 TI - The binge-purge syndrome: a common albeit unappreciated cause of acid-base and fluid-electrolyte disturbances. AB - The binge-purge syndrome (bulimarexia) is one of the four major eating disorders. It is a very important entity with which all clinicians should have some familiarity. This is true not only because of its frequency and the potential severity of several of its numerous complications, but because it has become one of the common masqueraders of modern medicine. Indeed, nephrologists may become interested in and involved with patients having this disorder because of their frequent fluid-electrolyte and acid-base disturbances, particularly hypokalemia and metabolic alkalosis, which initially often cause considerable diagnostic confusion. This paper presents an overall view of the binge-purge syndrome, with focus on several of its nephrologic aspects. PMID- 3541238 TI - Male sexual dysfunction: evaluation and treatment. AB - This review of the causes of erectile dysfunction and the salient points involving the history and physical examination outlines the studies necessary to distinguish between organic and psychologic causes and to further delineate the specific organic causes. Various types of treatment for organic dysfunction, such as oral, intramuscular, or intracorporeal pharmacologic manipulation and artificial external penile devices, provide alternatives to internal prostheses. The types of prostheses available and the complications associated with each are thoroughly reviewed, followed by a brief outline of the future for the treatment of erectile dysfunction. PMID- 3541241 TI - [Participation of the medical workers of the Kama River region in the revolution of 1905-1907]. PMID- 3541240 TI - [Development of public health in Bulgaria]. PMID- 3541239 TI - Aphorisms: wisdom for all seasons. PMID- 3541243 TI - [P. I. Bokov--physician and revolutionary of the 1860s]. PMID- 3541242 TI - [Development of public health and the training of medical personnel in Bashkiria]. PMID- 3541244 TI - [History of the Botkin Clinical Hospital in Moscow]. PMID- 3541245 TI - [Catergen in the treatment of chronic liver diseases]. PMID- 3541246 TI - [Role of alcoholic intoxication in the etiology of sudden death]. PMID- 3541247 TI - [Interintestinal anastomoses using suturing devices (a review of the foreign literature)]. PMID- 3541248 TI - [Varicose veins of the lower extremities in pregnancy]. PMID- 3541249 TI - [Dr. Jan Bedrna and Czechoslovak urology]. PMID- 3541250 TI - [The incidence of urinary fistulae in 478 renal transplants]. PMID- 3541251 TI - [Percutaneous treatment of renal cysts]. PMID- 3541253 TI - The beginnings of thoracic surgery. PMID- 3541252 TI - [Transabdominal ultrasonic study in the diagnosis of tumors of the urinary bladder]. PMID- 3541254 TI - Interpretation of endomyocardial biopsy after heart transplantation. Potentially confusing factors. AB - Histological examination of the myocardium by endomyocardial biopsy is a standard method of monitoring the presence of acute rejection in the transplanted heart. The histopathological consequences of the biopsy procedure itself have been investigated in non-transplanted hearts in the baboon. Organization of thrombus, necrosis of myocytes adjacent to the biopsy site, and mononuclear cells (including T lymphocytes) surrounding the biopsy site appear after biopsy; should a subsequent biopsy be taken from this area, these appearances may be confused with the appearances associated with acute or resolving cardiac rejection. This problem has been encountered in the clinical transplant programme. Observations on the myocardial histopathological changes resulting from brain death and from parasitic infestation, both of which may also lead to confusion in the interpretation of endomyocardial biopsies, are also presented. Awareness of these factors in patients with heart transplants should lead to caution in the interpretation of the histopathological features and may avoid unnecessary extra immunosuppression early after transplantation. Observations indicate that endomyocardial biopsy should not be the sole method of monitoring for the development of acute rejection. PMID- 3541255 TI - Hyperkalaemia secondary to hypo-aldosteronism. A report of 2 cases differentiating hyperreninaemic from hyporeninaemic hypo-aldosteronism. AB - Hypo-aldosteronism has been considered an important pathophysiological mechanism in the development of hyperkalaemia. This may occur as a consequence of defective regulatory mechanisms in the plasma renin-angiotensin-aldosterone system. Two case reports of hyperkalaemia are described which illustrate the differentiation of hyperreninaemic from hyporeninaemic hypo-aldosteronism. Laboratory investigations, together with measurements of plasma renin activity and aldosterone concentrations during adrenocorticotrophic hormone stimulation and sodium depletion, demonstrated this difference. Appropriate therapy with fludrocortisone (Florinef; Squibb) and furosemide (Lasix; Hoechst) respectively returned the situation to normal. PMID- 3541256 TI - [Doctoral programs in the United States--continued evolution of nursing science]. PMID- 3541257 TI - A temporary nontoxic lubricant for a synthetic absorbable suture. AB - Synthetic absorbable sutures have been coated with lubricants to improve their handling characteristics. A unique surfactant, poloxamer 188, has been used to coat the surface of the polyglycolic acid sutures. This lubricant was chosen because it does not damage the tissues defenses of the host and invite infection. Since poloxamer 188 is readily soluble in aqueous solutions, it is rapidly absorbed in the tissue environment resulting in an uncoated suture that displays increased knot security. The coating of polyglactin 910 is also minimally reactive in tissues and does not damage tissue defense. In contrast with the coated polyglycolic acid sutures, the knot security of the coated polyglactin 910 sutures is not altered by exposure to an aqueous environment or implantation. The increased knot security of the coated polyglycolic acid suture after implantation is considered to be a distinct clinical advantage over that of the coated polyglactin 910 sutures. PMID- 3541258 TI - A nonobstructing closure for perforated ulcers of the duodenum. PMID- 3541259 TI - A modified technique for perineal colorectal, coloanal or ileoanal anastomosis with the EEA stapler. AB - A new technique of using the EEA stapler for perineal colorectal, coloanal and ileoanal anastomoses has been described. This technique is of greatest use in very low anterior resection and in rectal procedentia. PMID- 3541260 TI - Intraperitoneal chemotherapy for malignant diseases of the gastrointestinal tract. PMID- 3541261 TI - "Survey of Ophthalmology" major reviews, chronological list, 1971-1986. PMID- 3541262 TI - Corticosteroid-induced cataracts. AB - The association linking corticosteroid therapy with the development of posterior subcapsular cataracts has been well documented. These drugs are widely used therapeutically, principally to capitalize on their ability to inhibit inflammatory responses. The literature on corticosteroid-induced posterior subcapsular cataracts is reviewed here. Data from the previously published series and individual lens susceptibility to corticoids do not allow the establishment of a direct factor relating cataract formation to corticosteroid dose and the duration of therapy; however, significant progress has been made in elucidating the mechanism by which corticoids bring about the development of these opacities. Exploration into the development of these lesions has shed light on the similarities these opacities share with other cataracts, especially with regard to location and pathogenesis. PMID- 3541263 TI - Management of diabetes mellitus. AB - The past decade has seen a rapid advancement in our understanding of diabetes and in our ability to treat it. A new diagnostic classification has been established. Guidelines for diet therapy have been revised. New oral hypoglycemic agents have been approved for use, and the rationale for using oral agents expanded. Insulin therapy has been expanded by development of human insulin and new modes of injection, including insulin pumps. Several new techniques are available for monitoring control of diabetes. PMID- 3541264 TI - Ocular phototoxicity: guidelines for selecting sunglasses. AB - Within the last two decades appreciable laboratory and epidemiologic evidence has accumulated to support the notion that near ultraviolet radiation and lower wavelength visible light may be hazardous to the human lens and retina. However, a substantial number of commercially available sunglasses are being manufactured without apparent regard for these potential hazards. This review surveys the mechanism(s) for phototoxic damage to the eye, outlines persons at potentially greatest risk of injury, and summarizes recommendations for the selection of optimally efficient sunglasses. PMID- 3541266 TI - Hypermetabolism, organ failure, and metabolic support. AB - The hypermetabolism organ failure complex remains the predominant reason for both prolonged stay and death in the surgical intensive care unit. What was perceived as isolated organ failure, such as adult respiratory distress syndrome, is now seen as part of the systemic response to injury and repair. Sepsis has become the systemic inflammatory response due to invading microorganisms. What was once perceived as diagnostic of sepsis has been recognized after severe perfusion deficits and in the presence of continuing sources of dead and injured tissue. The transition to organ failure is usually a distinct clinical event and probably represents the onset of clinical hepatic failure. Once present, the organ failure syndrome has a high mortality rate. From a treatment perspective, it is recognized that there is probably no "magic bullet"; that regimens will probably be time dependent and "multiple drug"; and that the best treatment is prevention. Malnutrition, as opposed to changes in body composition that occur as a result of disease process, has become a recognized cofactor in morbidity and death in patients with persistent hypermetabolism and organ failure. The metabolic processes of hypermetabolism have become increasingly categorized and understood. The result has been the development of metabolic support principles that are distinct from those of nutritional support and are designed to prevent the end organ changes of malnutrition and the development of substrate-limited metabolism, to support organ structure and function, and to attempt to arrest the metabolic processes. The initial problem was to learn to do no harm, an outcome reasonably achieved. In addition, several beneficial results have been recognized including new techniques to better support total body protein synthesis, hepatic protein synthesis, and energy production. Techniques to better support organ structure and function are being tested. No techniques are currently available to control proteolysis and the redistribution of skeletal muscle nitrogen. A great deal of research is still necessary in this field, which is still in its infancy. PMID- 3541265 TI - Metastatic bacterial endophthalmitis: a contemporary reappraisal. AB - Metastatic bacterial endophthalmitis remains a challenge to the clinician despite the success of antibiotics in reducing its frequency and severity. Controversy currently surrounds the management of this condition because of uncertainty about the value of and indications for vitreous surgery. We review 72 cases of metastatic endophthalmitis from the past decade, including five not previously published. The spectrum of causative bacteria changed significantly during this period, with displacement of meningococcus by Bacillus cereus as the most frequently reported agent and an increasing incidence of infection by organisms of low pathogenicity in immunologically compromised hosts. We propose a new classification scheme for metastatic endophthalmitis based on the location (anterior or posterior segment) and extent (focal or diffuse) of the primary intraocular infection. Focal and anterior cases appear to have a good prognosis, while posterior diffuse disease nearly always leads to blindness. Our analysis of outcomes suggests that systemic antibiotics are more valuable in metastatic than in postoperative or traumatic endophthalmitis and that intraocular antibiotic injection and vitrectomy make only a limited contribution to successful treatment in metastatic infection. We recommend a clinical approach to metastatic endophthalmitis that minimizes exposure of patients to the risks of invasive procedures. PMID- 3541267 TI - Moxalactam as single-agent prophylaxis in the prevention of wound infection following colon surgery. AB - A single agent systemic antibiotic (moxalactam) when used prophylactically in patients undergoing colon surgery was associated with a wound infection rate comparable to that achieved by a combination of oral neomycin and intravenous metronidazole. The data obtained demonstrated that the reduced infection rate was not the result of a reduction in the bacterial content of the colon alone but due to the prophylactic agents used for elective colon surgery. PMID- 3541268 TI - The effect of operative ischemia in murine cardiac transplantation: isograft control studies. AB - Isograft studies were performed in the murine model of cardiac transplantation to investigate the morphologic effects of operative ischemia. Primarily vascularized CBA mouse hearts were grafted heterotopically into the recipient CBA mouse's abdomen with standard microsurgical techniques. After ischemia times of 30 and 60 minutes, histologic examination showed minimal myocardial damage, with necrosis or scarring occupying less than 5% of the cross-sectional area of hearts bisected from apex to base after grafts had been removed on the seventh day after transplantation. Maximal ischemic damage was seen at 7 days after transplantation after 120 minutes of ischemia, with more than 30% myocardial necrosis or scarring of myocardial tissue. Isografts performed with ischemia times of less than 60 minutes were followed for more than 100 days. All hearts showed a fine, generalized, perimyocytic fibrosis, which was maximal at 28 days after transplantation and did not progress thereafter. These results will serve as important control measures for future studies in this model because ischemic damage must be considered in examining histologic samples from long-surviving cardiac allografts maintained in immunosuppressed recipients. PMID- 3541269 TI - [Nurses on the offensive. Broad ADP expert knowledge monopoly]. PMID- 3541270 TI - [NovoPen--a new treatment principle in diabetes]. PMID- 3541272 TI - [Diabetes mellitus and the digestive organs]. PMID- 3541271 TI - [A great Scandinavian nurse leader retires (Toini Nousiainen)]. PMID- 3541273 TI - [Lymphopathic HTLV-III-LAV infection and acquired immunodeficiency syndrome]. PMID- 3541274 TI - [Comparative effectiveness of levamisole and vaccine in the complex treatment of patients with brucellosis]. AB - The clinical efficacy of levamisole was compared to that of vaccine in a controlled trial of a combined treatment performed in 311 patients with acute and subacute brucellosis. As compared with vaccine, levamisole appeared effective in the treatment of active forms of brucellosis both during the control of the active process and later in convalescence. The use of levamisole permitted reducing the percentage of the chronic forms of the disease. When administered for active forms of brucellosis vaccine did not turn superior to levamisole. PMID- 3541275 TI - Identification of Dh/+ and Dh/Dh embryos through close linkage of Dh and peptidase-3. AB - The close linkage between the genes Dominant hemimelia (Dh) and peptidase-3 (Pep 3) has been determined in 65 informative matings with the recombination frequency of 3.8%. Progeny testing showed that nonpenetrance does occur in Dh/+ adults. The presence of the "slow" and "fast" variants of Pep-3 can be determined in homogenates of kidney tissue as well as in a portion of the day 10 and 11 embryos. In a litter of embryos born to an informative mating, those which are Dh/Dh, Dh/+, and +/+ can be distinguished by the presence of the Pep-3 allele known to be in coupling with the Dh gene. This technique makes it possible to identify and to study the limb malformations and other phenotypic effects of Dh during their development and before the limb deformity is visible. PMID- 3541276 TI - Teratology Society members, 1986-1987. PMID- 3541277 TI - European Teratology Society members, 1986-1987. PMID- 3541278 TI - Medicine in Texas: the struggle with yellow fever, 1839-1903. PMID- 3541279 TI - The relationship between von Willebrand factor antigen and fibronectin in human plasma, endothelial cells and fibroblasts in culture. AB - The distribution of von Willebrand factor antigen (vWFAg) and fibronectin (Fn) in endothelial cells and in fibroblasts in culture was examined using immunohistological methods. Extracellular matrices were studied after removal of cells by mild hypotonic lysis. Co-distribution of these antigens was also examined after culture of fibroblasts in the presence of endothelial cell conditioned medium or of exogenous vWFAg. The presence of intracellular vWFAg and its association with extracellular Fn in confluent endothelial cells was confirmed. Furthermore, both antigens were detected in matrices from fibroblasts grown in the presence of human plasma and endothelial cell medium. vWFAg was not found, however, in the absence of endothelial cell conditioned medium or in experiments using human serum in place of plasma. Cross-linking of vWFAg was examined using quantitative and qualitative electrophoretic methods. Levels of vWFAg in serum from patients with severe Haemophilia A were approximately 50% of those found in the corresponding plasma. Furthermore, vWFAg was reduced to similar levels in serum from normal blood to which heparin was added. The lowest levels of vWFAg were found in the presence of sufficient heparin to totally inhibit the formation of fibrin. In contrast, levels of Fn remained unchanged in these circumstances. The results did not support the view that vWFAg was cross linked to Fn in plasma by thrombin-activated factor XIII. In addition, immunoelectrophoresis of cultured endothelial cell products did not demonstrate cross-linking of vWFAg to Fn. The data are consistent with the concept that deposition of vWFAg on the subendothelium is dependent on viable endothelial cells or on another product of these cells. PMID- 3541280 TI - Proteolysis of bovine and human prothrombin and of bovine factor X by rat mast cell proteinase. AB - The alpha-chymotrypsin-like proteinase from rat peritoneal mast cells (RMCP I) rapidly destroyed the normal clotting activity of purified, calcium-free, bovine prothrombin, human prothrombin and bovine factor X and simultaneously removed similar N-terminal peptides (Mr approximately 5,000) from both prothrombin and the 'light' chain of factor X. The amino acid composition of the peptides agreed with the known composition of the regions of the respective parent molecules where gamma-carboxyglutamic acid residues are situated. Ca2+ ions protected each of the proteins from proteolysis and loss of procoagulant activity. Prolonged incubation in the standard physiological assay medium used for prothrombin or treatment with Echis carinatus venom indicated that the thrombogenic portion of prothrombin survived proteolysis by RMCP I. This restricted proteolysis was confirmed by electrophoretic analysis. PMID- 3541281 TI - Mechanism of the cytoprotective effect of prostaglandin I2 and its analogue in human platelets. AB - The responsiveness of washed human platelets to thrombin was well preserved up to 72 and 96 hours, when they were stored at 4 degrees C with prostaglandin I2 (PGI2) and its stable analogue OP-41483, respectively, while the washed platelets stored with sodium citrate completely lost their responsiveness to thrombin at 48 hours. The effect of PGI2 or the analogue on the resting level of intraplatelet Ca2+ concentration ([Ca2+]i) was investigated, utilizing fluorescent Ca2+ indicator quin 2. PGI2 lowered the resting [Ca2+]i in a dose related manner in the presence or absence of the extracellular Ca2+. The similar results were obtained when OP-41483 was added to the quin 2 loaded platelets. From these results, it was concluded that the lowering of the resting [Ca2+]i may be the prerequisite for the cytoprotective effect of PGI2 or OP-41483. PMID- 3541282 TI - Effect of fibrinogen degradation products on production of hepatocyte stimulating factor by a macrophage cell line (P388D1). AB - Hepatocyte Stimulating Factor (HSF) is a monocyte/macrophage-derived regulatory protein which stimulates the hepatic synthesis of several plasma proteins. Plasminolytic peptides of fibrinogen or fibrin were tested for their ability to stimulate the secretion of HSF in an established macrophage cell line (P388D1). One of the peptides, fragment D, induced the production of HSF in the cells in a dose-dependent manner, while intact fibrinogen did not. A hierarchy of potency was established for the major plasminolytic fragments which is as follows: D greater than or equal to DD greater than X greater than or equal to E. Fragment D had no effect on production of interleukin-1, a potent monokine released by P388D1 cells. Taken together these results demonstrate that fragment D is a specific and potent inducer of HSF in P388D1 cells. PMID- 3541283 TI - Determination of urokinase in the urine of healthy volunteers and patients with renal diseases. AB - A sensitive enzyme immunoassay was developed for the determination of urokinase in the plasma and urine. Normal human urine contained 2.68 +/- 0.36 u/ml of UK. Gel filtration of the mixture of normal urine resulted in 2 peaks in the profile, one with molecular weight of 32,000 and the other with molecular weight of 22,000. Patients with glomerulonephritis had higher UK levels. Kidneys with minimal changes and mild type or with the inactive phase of systemic lupus erythematosus (SLE) secreted relatively high levels of UK in the urine. PMID- 3541284 TI - [Piroxicam and naproxen in arthrosis. A double-blind, comparative multicenter study in general practice]. PMID- 3541285 TI - [Is moderate sodium restriction an effective antihypertensive treatment? A hemodynamic long-term study]. PMID- 3541287 TI - [Amoxicillin in the treatment of gonorrhea. A reevaluation of the national guidelines]. PMID- 3541286 TI - [Reconstruction of the mandible using vascularized transplants. A new method in Norway]. PMID- 3541288 TI - Thiomolybdates: mediators of molybdenum toxicity and enzyme inhibitors. AB - The evidence for a role for thiomolybdates in the important ruminant disease syndromes of molybdenosis and Mo-induced hypocuprosis is outlined and present knowledge of their chemistry and metabolism in vivo is reviewed in an attempt to provide a less empirical basis for their toxicology. The compounds are novel enzyme inhibitors in vitro and have also been used therapeutically, apparently successfully, in the treatment of Wilson's disease. While the changes which occur in vivo are complex they can be best understood in terms of an alteration in the affinities for copper of some of the competing ligands, including albumin, which leads to a change in the distribution of copper between the different systemic pools and an overall depletion. PMID- 3541289 TI - Safety of pyridoxine--a review of human and animal studies. AB - A literature review was conducted on adverse effects associated with administration of high oral doses of pyridoxine (vitamin B6) to animals and man. The human data suggest that doses of pyridoxine greater than 500 mg/day for prolonged periods of time can result in sensory nerve damage. Doses less than 500 mg/day appear to be safe on the basis of literature reports where the compound was administered for periods ranging from 6 months to 6 years. PMID- 3541290 TI - Urinary trehalase activity and renal brush-border damage in inhabitants of a cadmium-polluted area (Jinzu River basin). AB - Elevated urinary trehalase activity was observed in the inhabitants of the Jinzu River basin. Urinary trehalase activity was correlated with other urinalysis components, such as beta 2-microglobulin, glucose, amino nitrogen, and cadmium, of which a high level was observed in cadmium-polluted areas as compared with the reference area. Renal trehalase is specifically localized in tubular brush borders [M. Nakano, J. Histochem. Cytochem., 30 (1982) 1243-1248]. From these results it is inferred that tubular brush-border damage occurs in inhabitants of the Jinzu River basin. PMID- 3541291 TI - Preparation of whole rabbit knee joints for microscopic examination. AB - A paraffin embedding method to prepare whole rabbit knee joints for histological examination is described. This method provides good quality microscopic sections thin enough for the study of cellular detail and does not require prolonged processing. When examining pathologic changes in experimental arthritis, it is advantageous to be able to examine the intact joint with the structural relations of the joint components preserved. Sections of the whole joint provide numerous areas where bone, cartilage and synovium are contiguous for examination. Having obtained poor results using methods recommended for small bony specimens, we modified several existing procedures to obtain a reliable method for preparing excellent microscopic sections of the whole rabbit knee joint. PMID- 3541293 TI - A technique for examining the same hair specimen by scanning and transmission electron microscopy. PMID- 3541292 TI - Giemsa stain applied to deplasticized sections to identify pancreatic islet cells. AB - A new application of the Giemsa stain to demonstrate endocrine cells in deplasticized sections of Epon embedded material is described. Its application to the pancreas of Rana temporaria is illustrated. The technique does not require postfixation with OsO4 and is easily performed in 30 min. It allows the easy identification of three types of endocrine cells (A, B, and D). A cells, preferentially located at the islet periphery, stain purple-blue. B cells, which occupy the interior of the islet, display a lilac color. D cells give a strong purple color; they are located both in the periphery of the islets and scattered among acinar cells. Positive identification of the cell types was made by immunocytochemistry and electron microscopy. PMID- 3541294 TI - Glycol methacrylate sections of the crystalline lens. PMID- 3541295 TI - [Experience in using metal ceramic prostheses in anomalies in size and shape of the anterior teeth in adults]. PMID- 3541296 TI - [Formulation of dental instruction in the 19th century. An attempt at scientific examination]. PMID- 3541297 TI - [Indications and effectiveness of combined fixed and removable dentures in partially edentulous dentitions]. PMID- 3541298 TI - [Effect of methods and materials of cast and modeling preparations on the dimensional stability of working models for fixed dentures with special reference to processing with Gisadent NCA]. PMID- 3541299 TI - [Diagnosis of human age by the microstructural characteristics of the hard dental tissues]. PMID- 3541300 TI - Suicides in the Nazi concentration camps. AB - On the basis of psychiatric interviews with 69 former prisoners of the Auschwitz Birkenau concentration camp, this paper describes the circumstances, motives, and ways of committing suicide in the camp. The interview made it clear that thousands of prisoners perished by suicide. The number of committed suicides was larger than that of attempted suicides. The most frequent types of suicide victims were prisoners of Jewish descent, foreigners, white-collar workers, and old people. The most common motives of suicides were depressive reactions; anxiety; somatic illnesses; the threat of death; emotional motives; loss of emotional support; beatings and tortures; and patriotic and altruistic motives. The most common methods of committing suicide were flinging oneself onto the electrified wires surrounding the camp, hanging, poisoning, cutting one's veins, and drowning. There were also cases of mass suicides, chiefly in the women's camp. Suicides committed from patriotic or altruistic motives testified to the fact that human beings were able to preserve their dignity even in the face of death. PMID- 3541301 TI - Phenotypic characterization of the thymus microenvironment study of the human thymus architecture. AB - Phenotypic characterization of the human thymic microenvironment shows the heterogeneity of the epithelial component. Using monoclonal antibody L191, we define here a new antigen common to the flat epithelial cells lining up the thymic capsule and septum, stellate epithelial cells from the subcapsular area and the medulla (M), but lacking on stellate epithelial cells from the inner cortex. Thus, this cell population can be characterized by a series of antigens (TE-4 and P19--shared with HTLV--previously described by B. Haynes et al.) which reflect a common differentiation program--including neuroendocrine specialization -with remarkable differences in the expression of these antigens, occurring during ontogeny and after birth. Another Ab we obtained shows particularities in the cytoskeletal organization of this cell population. Finally the organization of the mesenchymal component was also investigated with a third, anticollagen, antibody. A striking observation we made, using these antibodies, was the relationship between the thymic septum and flat epithelial cells with medullary and Hassal's body (HB) epithelial cells: septae deeply penetrate the medulla so that flat epithelial cells come into direct contact with medullary epithelial cells; in addition, HB are in close contact with the deepest portion of the septae, often separated solely by a single stellate cell. This architectural organization might be related to the differentiation--regeneration process of the thymic epithelium. PMID- 3541302 TI - Development of the ciliary body: a brief review. AB - The ciliary body is an important component in the tissue interactions that occur during the normal development of the eye. The ciliary epithelium is induced by the lens from the rim of the optic cup and probably reciprocates by determining the position of the germinative zone of the lens. The ciliary epithelium is also likely to induce the differentiation of the ciliary muscle and stroma from the surrounding neural crest-derived mesenchyme. Intraocular pressure plays a major role in co-ordinating the growth and morphogenesis of many ocular tissues, including the ciliary body. A central question addressed in this review is whether this pressure is generated by the early activity of the ciliary epithelium or by the growth and osmotic activity of the vitreous body. PMID- 3541303 TI - Prostaglandins and other eicosanoids: their ocular transport, pharmacokinetics, and therapeutic effects. AB - Since prostaglandins (PGs) were originally discovered in the eye in a search for the mediators of the ocular irritative responses, it is not surprising that the first decade of research on the ocular effects of these autacoids concentrated on their potential role in inflammation and other pathological processes. It is clear that PGs, like most other biologically active compounds, can have pathological effects when introduced into the eye in sufficiently high doses. More recent studies indicate, however, that PGs are also involved in the normal physiological processes of the eye, and that some PGs effectively reduce intraocular pressure and may actually moderate rather than mediate ocular inflammation. We must therefore consider the eicosanoids as a new class of potential ocular therapeutic agents. This paper reviews the evidence that these autacoids are actively transported by some tissues, including the ciliary epithelium, and considers the role of such transport processes in the ocular and systemic pharmacokinetics of endogenous eicosanoids and their therapeutically applied prodrugs. PMID- 3541304 TI - Congenital glaucoma--diagnosis and management. AB - A brief review is presented based on the structural classification of congenital glaucoma by Hoskins and Shaffer. The degree of angle deformation and anterior segment changes are subgrouped by trabecular dysgenesis, irido-trabecular dysgenesis, and irido-corneo-trabecular dysgenesis. Typical examples for these entities are presented, and the pathophysiology is discussed. Problems in early diagnosis including modern approaches, like ultrasonography, direct manometry, are emphasised and the choices of surgical procedures with the pros and cons in the different conditions outlined. The prognosis of the disease depends on the time of manifestation and the experience of the surgeon who performs the appropriate operations. Some data on the prevalence of the disease is also presented. PMID- 3541305 TI - Strategies in Doppler ultrasound. AB - A computer based system integrating a continuous wave 10 MHz Doppler ultrasound system with a standardising electrocardiographic record has been developed and tested. Data storage and duplication are intrinsic elements in the system which also includes on line analysis of the data. The electrocardiograph permits exact timing and standardisation of the pulse wave forms. The results can be displayed and printed. The controlled data provides a valid basis for comparison. Data obtained from patients suffering from amaurosis fugax are presented and discussed. PMID- 3541306 TI - Brain stem and cerebellar deficits in eye movement control. AB - Recent experimental studies allow more precise functional-anatomical correlations in patients with ocular motor disorders. The abducens nucleus contains two groups of cells that together subserve ipsilateral horizontal conjugate gaze: Motoneurons with axons that innervate the lateral rectus and internuclear neurons with axons that cross the midline, ascend in the medial longitudinal fasciculus (MLF) and impinge upon medial rectus motoneurons. The pontine paramedian reticular formation (PPRF) contains burst neurons for horizontal saccades. The rostral interstitial nucleus of the MLF (riMLF) in the midbrain contains burst neurons for vertical saccades. The dorsal lateral pontine nuclei are important for relaying smooth pursuit commands from the cerebrum to the cerebellar flocculus. The medial vestibular nuclei contain neurons important for eccentric gaze-holding. The cerebellar flocculus is also important for gaze-holding as well as for smooth pursuit and the control of the amplitude and direction of vestibular responses. The cerebellar nodulus is important for controlling the duration of vestibular responses. The cerebellar dorsal vermis (and underlying deep nuclei) are important for controlling saccade accuracy. PMID- 3541307 TI - Tropical clinical epidemiology--'a new name for an old art'. PMID- 3541308 TI - Additional data on Trypanosoma cruzi isozymic strains encountered in Bolivian domestic transmission cycles. AB - We have collected in Bolivia 212 stocks of Trypanosoma cruzi from domestic transmission cycles and have assayed for nine enzyme systems (11 gene loci). Only a few different isozyme profiles exist, without recombination between them, a situation also encountered in previous Bolivian samples. The 212 stocks, combined with 207 stocks previously studied, have been analysed to uncover any spatial patterns. The frequency of heterozygous strains (2 and 2a) decreases westwards and with increasing altitude. Given that longitude and altitude are correlated with each other, it is not possible to decide which of these two geographic variables is the relevant one, or if both are. These associations might be due to climatic factors. Studies by other authors have shown, however, that heterozygous strains are rare or absent in the Amazon Basin, which is at low altitude. PMID- 3541309 TI - Qinghaosu resistance in rodent malaria. AB - Resistance to qinghaosu (artemisinin) developed rapidly in a chloroquine resistant line of Plasmodium yoelii (NS) passaged in mice, but was not produced in chloroquine-sensitive P. berghei. Development of resistance took place in an apparently stepwise fashion. After removal of drug selection pressure some resistance was lost which was regained rapidly within three passages when drug pressure was reapplied. The resistant QS line was cross-resistant to two reduced derivatives of artemisinin but not to propoxycarbonyl dihydroartemisinin or artesunate. No significant resistance was shown against primaquine, pyrimethamine, cycloguanil or pyrimethamine-sulphadoxine, but resistance to chloroquine was enhanced and marked resistance to quinine, mefloquine and amodiaquine was noted. It is suggested that the unusual cross-resistance pattern of the strain relates to changes in membrane characteristics. PMID- 3541311 TI - A simple procedure for using schistosomula in immunofluorescence studies. PMID- 3541310 TI - Chloroquine-resistant falciparum malaria in Punjab (northern India) PMID- 3541312 TI - Immunohistologic labeling as an indicator of liver allograft rejection. AB - Monoclonal antibodies were used to identify T-helper cells (TH) and T suppressor/cytotoxic cells (TS/C) in biopsy specimens obtained 7, 21, 90, 180, and 365 days postoperatively, and during episodes of graft dysfunction, from 34 consecutive liver transplant patients treated with cyclosporine and steroids. Rejection was diagnosed by the presence of appropriate laboratory and light microscopic findings and at least 8 weeks of follow-up to exclude other causes of graft dysfunction. Four immunohistologic patterns were seen--no labeled cells (No), only lobular TS/C, only portal TH, and a portal mixture of TH and TS/C (mix). Of 36 specimens with the No or only lobular TS/C pattern, 29 were not associated with rejection. Of the 39 specimens with the portal TH or portal Mix pattern, 33 were associated with a rejection episode. In addition, in nine specimens from patients with no biochemical or routine histologic evidence of rejection, the presence of portal TH or a portal mix indicated immunologic rejection 5 days to 5 weeks before biochemical and routine histologic evidence of it was manifested. Immunohistologic labeling appears to be an early indicator of liver allograft rejection. PMID- 3541313 TI - An assessment of Nva2-cyclosporine in primate cardiac transplantation. AB - The immunosuppressive potency, hepatotoxicity, and nephrotoxicity of Norvaline2 cyclosporine (Nva2-CsA), an analog of cyclosporine (CsA), were tested in a primate cardiac transplant model. After orthotopic cardiac transplantation in cynomolgus monkeys, immunosuppression was maintained with 16 mg/kg/day of either CsA or Nva2-CsA given intramuscularly in two divided daily doses. Immunosuppression was augmented with i.m. methyl-prednisolone, 1.0 mg/kg/day, which was tapered weekly by .1 mg/kg/day to a maintenance dose of .1 mg/kg/day. A group of 6 untransplanted monkeys were treated for a year with this dose of either CsA or Nva2-CsA and steroids. Renal biopsies were performed at one year. Among the transplanted monkeys, mean survival was 77.3 +/- 73 days for the CsA group and 16 +/- 8 days for the Nva2-CsA group. All 11 animals in the Nva2-CsA group died of cardiac rejection, but only 7 of 10 treated with CsA died of rejection. There was mild hepatic and renal dysfunction in both treatment groups, but no significant difference between groups as judged by blood urea nitrogen, creatinine, total bilirubin, serum glutamic oxaloacetic transaminate, and alkaline phosphatase. Cyclosporine levels were significantly higher in the CsA group. There were important morphological changes in both groups on histological examination of the kidneys, with proximal tubular vacuolation and enlargement of the juxtaglomerular apparatus predominating. It is concluded that Nva2-CsA is a less effective immunosuppressant than CsA when given parenterally in equal doses. PMID- 3541314 TI - Pretransplant conditioning with donor-specific transfusions using heated blood and cyclosporine. Preservation of the transfusion effect in the absence of sensitization. AB - Previous studies from our laboratory showed that pretransplant conditioning with fresh donor-specific blood (DST) combined with cyclosporine (CsA) resulted in long-term prolongation of ACI heterotopic cardiac allografts in LEW recipients treated with subtherapeutic doses of CsA. The concomitant administration of CsA profoundly reduced but did not eliminate the DST-induced sensitization. The purpose of the present study was to investigate in the ACI-to-LEW cardiac allograft model whether heat-treatment of the blood would further reduce the sensitizing potential of DST while maintaining their benefits in our protocol. Fresh heparinized ACI blood was heated at 45 degrees C for 60 min. Then 1.5 ml was administered i.v. to LEW rats on day -8 with respect to grafting (day 0). Controls received heat-treated BUF blood. Donor heat-treated blood (HT-DST), unlike fresh blood, did not induce a humoral cytotoxic response and resulted in the prolongation of cardiac allograft survival (13.2 +/- 2.7 vs. 7.2 +/- 1.0; P less than 0.01). Treatment of HT-DST recipients with postoperative subtherapeutic doses of CsA (2.5 mg/kg/day x 30) extended graft survival (46.6 +/- 22.0 vs. 7.7 +/- 2.0 days; P less than 0.01). The combined pretransplant administration of HT DST and CsA followed by posttransplant subtherapeutic doses of CsA led to long term prolongation of cardiac grafts (122.0 +/- 73.0 vs. 31.7 +/- 22.0 days; P less than 0.01). These studies demonstrate that heat-treatment of allogeneic blood eliminates the humoral responses to DST and actually enhances their beneficial effects in terms of graft survival. Such effects can be dramatically increased by CsA. The possible mechanism of these phenomena are discussed. PMID- 3541316 TI - Coagulation factor XIII A and B subunits in bone marrow and liver transplantation. AB - The polymorphism of the coagulation factor XIIIA and B subunits was determined before and after bone marrow or liver transplantation. It could be shown that the FXIIIA phenotype of the recipient was replaced by donor phenotype after bone marrow transplantation, whereas the phenotype of FXIIIB remained of recipient origin. In contrast, the FXIIIB phenotype changed to donor type after orthotopic liver transplantation but not the FXIIIA phenotype. The results indicate that the FXIIIA protein is produced in hemopoiesis, most likely in megakaryocytes and FXIIIB protein in the liver. Depending on the site of synthesis, FXIII alleles can be used as a marker in engraftment of FXIIIA-incompatible bone marrow transplantation or as a marker in FXIIIB-incompatible orthotopic liver transplantation. PMID- 3541315 TI - Examination of the clonal deletion hypothesis following transfusions in rat cardiac transplants. AB - To test the clonal deletion hypothesis, different levels of immunization were carried out by 0, 1, 2, or 3 transfusions preoperatively, together with 10 methods of immunosuppression. In this way, it was hoped that we could determine the optimal way to immunize and the optimal immunosuppressant treatment to deactivate the responding cells. With the Buffalo-to-Lewis rat heart allograft model, the control mean survival rate was 7 days. Rats with 2 or 3 transfusions had 5- and 12-day survival rates, respectively. If azathioprine was given in addition before grafting, 19- and 18-day survival rates were seen, and if azathioprine was given after grafting, extended survivals of 33 and 34 days were achieved. The longest survival rate of greater than 52 days was obtained by a single transfusion and 25 mg/kg/day of cyclophosphamide given before transplantation. Splenectomy following 2 or 3 transfusions prolonged survival rates to 16-18 days, suggesting that mechanical removal of immunized cells is somewhat effective. Most of the antibody produced by one transfusion was IgM, as were antibodies that resulted from transfusions followed by azathioprine. It is possible that reduction of IgG-producing cells is important. These results are consistent with the clonal deletion theory, although they do not necessarily provide final proof. The experiments suggest that the optimal transfusion effect may be obtained with minimal immunization (1 transfusion) and proper immunosuppression before transplantation. PMID- 3541317 TI - Hemolytic anemia resulting from autoantibodies produced by the donor's lymphocytes after renal transplantation. PMID- 3541318 TI - Cyclosporine-pretreated renal allografts. PMID- 3541319 TI - Human fetal pancreas--a potential source for transplantation. AB - Human fetal pancreas (HFP) represents an ideal tissue source for transplantation into diabetic patients. Transplantation of HFP lacks many of the technical problems associated with whole organ transplantation and HFP is readily available. In order to proceed with clinical HFP transplantation it must be demonstrated that HFP can reverse experimentally induced diabetes, that HFP can respond to glucose challenge in a manner similar to adult tissue, and that the immunogenicity of HFP can be reduced. We transplanted HFP (13-17 weeks gestational age) beneath the kidney capsule of streptozotocin-induced diabetic BALB/c nu/nu mice. Within 6 to 8 weeks following transplantation, 6 out of 7 (88%) animals became normoglycemic. Oral glucose tolerance tests were performed to determine in vivo graft function. Results in cured animals were identical to those of normal BALB/c nu/nu mice. In vitro insulin response to glucose challenge demonstrated that grafted HFP was capable of insulin secretion in the presence of high glucose while fresh fetal tissue was not. Human passenger leukocytes, identified immunohistologically at various times after transplantation with monoclonal antibodies to HLA-DR and Leu 10, were greatly reduced by 32 weeks posttransplant. Our data demonstrate that HFP will differentiate and mature in the diabetic nude mouse and that human passenger leukocyte content can be reduced. These findings suggest that HFP is functionally suitable for transplantation into diabetic patients. PMID- 3541320 TI - Hepatobiliary and pancreatic complications of cyclosporine therapy in 466 renal transplant recipients. AB - Two hundred twenty-eight patients from a total of 466 (49%) receiving renal allografts under cyclosporine/prednisone (CsA/Pred) immunosuppression experienced at least one episode of posttransplant hepatotoxicity. All patients were documented to have normal serum bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), lactic acid dehydrogenase (LDH), and alkaline phosphatase (AP), as well as negative results of biliary ultrasound and upper gastrointestinal contrast examinations prior to transplantation. Hepatotoxic episodes usually were self-limited (82%), and generally occurred during the very early posttransplant period (76%). Liver function abnormalities included hyperbilirubinemia (48% of patients), elevated SGOT (47%), SGPT (73%), LDH (84%), and AP (59%). The CsA serum trough radioimmunoassay (RIA) was relatively high among hepatotoxic patients with a mean value of 225 +/- 17 ng/ml. Pharmacokinetic parameters, including bioavailability and drug clearance, were significantly altered among this group of patients. The management strategy of CsA dose reduction was effective; however, 11 patients (2.4%) developed biliary calculous disease posttransplant while under CsA/Pred immunosuppression. Seven patients had cholelithiasis, and two patients underwent choledochoduodenostomy because of primary choledocholithiasis. The results contrast with 279 renal transplant recipients from an overlapping nonrandomized group treated with azathioprine (Aza)/Pred in whom cholelithiasis was not identified. Pancreatic abnormalities were relatively common, but clinical pancreatic disease occurred in only six patients. There were two episodes of acute pancreatitis, three patients developed pancreatic abscess, and one patient developed a pancreatic pseudocyst. The apparent proclivity of CsA-treated patients to develop biliary calculous disease, and the occurrence of serious pancreatic complications in a small percentage of patients did not affect the majority of CsA-treated patients. They may, however, represent important problems associated with the use of this immunosuppressive agent. PMID- 3541321 TI - Biliary tract complications in human orthotopic liver transplantation. AB - The results of 393 consecutive orthotopic liver transplants in 313 patients were reviewed to determine the incidence of primary biliary tract complications. There were 52 biliary tract complications in 393 grafts (13.2%), and 5 directly related deaths. Choledochojejunostomy over an internal stent to a Roux-en-Y limb of proximal jejunum (RYCJ-S) was the most frequently used technique (175 cases) and the most successful with only 9 technical failures (5.2%). Choledochocholedochostomy over a T tube (CC-T) was used in 159 cases and was successful in all but 20 cases (12.6%). Other methods of reconstruction were associated with high failure rates or technical complexity that do not justify their use. Biliary leak and obstruction were the most common complications. Leakage after CC-T at the T tube exit site was usually directly repaired, but anastomotic leakage required conversion to RYCJ-S. Obstruction may be relieved by percutaneous balloon dilatation but definitive treatment also usually required conversion to RYCJ-S. The most common complication after RYCJ-S is functional obstruction by a retained stent, which has a low morbidity but may necessitate surgical removal. Anastomotic leaks, which occurred in 2 cases, were successfully managed by revision of the choledochojejunostomy. PMID- 3541322 TI - 72-hour preservation of the canine pancreas. AB - A new flushout solution for preservation of the pancreas was tested in the dog model of segmental pancreas autotransplantation. The solution osmolality was 320 mOsm/L, K+ = 120 mM, Na+ = 30 mM, and it contained the anion, lactobionate, and raffinose as impermeants to the cell. Preservation times studied were 48 and 72 hr. The pancreas was flushed out with about 250 ml of the new solution and stored at 0 degrees C. Dogs were monitored postoperatively for blood glucose and intravenous glucose tolerance (IVGTT). Results were compared with control (no preservation) segmental pancreas autotransplants. Dogs receiving pancreases stored for 48 or 72 hr were normoglycemic on day one and remained normoglycemic for at least 28 days, or until time of sacrifice. Two of four dogs with pancreases stored for 48 hr were sacrificed on day 14 with normal IVGTT for histology. The remaining two dogs had normal pancreatic function for 28 days. Two of eight dogs receiving pancreas grafts after 72-hr cold storage died of causes unrelated to the pancreas graft, which was still functioning at the time of death. Six dogs remained normoglycemic and had a normal IVGTT at least for 28 days. This study demonstrates the feasibility of preserving the pancreas for three days for transplantation. PMID- 3541323 TI - Renal transplantation done safely without prior chronic dialysis therapy. AB - The complications, cost, and inconvenience associated with pretransplant hemodialysis and peritoneal dialysis would be minimized if transplantation were instituted without prior dialysis. That preuremic transplantation is safe and efficacious in patients with immanent end-stage renal disease has not been established. All 1742 consecutive primary renal transplants performed at the University of Minnesota during the 16.5 year period from January 1968 through July 1984 were reviewed to determine whether graft and patient survival were adversely affected by transplantation prior to dialytic therapy. In the overall group of primary renal transplants, no differences in actuarial graft or patient survival were noted with or without prior dialysis. Likewise, outcome was not affected by the pretransplant dialysis status in recipients of allografts from HLA-identical mismatched living-related donors. However, in cadaveric transplantation graft function appeared to be adversely affected by transplantation prior to dialysis, with 52% vs. 66% two-year graft function for nondialyzed vs. chronically dialyzed recipients, respectively (P = 0.15). Patient survival was significantly (P = .04) decreased in the nondialyzed group, with 66% vs. 80% two-year survival in the chronic dialysis group. However, nearly all of the nondialyzed, cadaveric recipients were diabetic. The outcome of transplantation was found to be identical in these patients, as compared with chronically dialyzed diabetic recipients of cadaveric grafts. Thus, the apparent detrimental effect of predialytic transplantation in the cadaver group was due to the preponderance of diabetics in the nondialyzed group. Since July 1984, a single-armed therapeutic trial of combination therapy with azathioprine, prednisone, antilymphoblast globulin (ALG), and cyclosporine has been undertaken, Since that time, 36 primary graft recipients were transplanted prior to dialysis. Of these 36, 35 currently have a functioning graft. Thus, transplantation prior to chronic dialysis is safe irrespective of donor source, or choice of immunosuppressive agents. PMID- 3541324 TI - Liver transplantation without venous bypass. AB - Fifty consecutive orthotopic liver transplants were performed without venous bypass in 41 recipients. Seven patients were transplanted twice and one patient received 3 transplants. The average age of the recipients was 37 years. The commonest indications for transplantation were primary biliary cirrhosis and cirrhosis from chronic active hepatitis. Fifty-eight percent of the recipients had undergone previous upper abdominal surgery. During the anhepatic period systolic blood pressure decreased by 21% to an average of 98 mm. of mercury. Cardiac output decreased by 52% to a mean (+/- SEM) of 3.89 +/- 0.21 L/min., and there was a doubling of the systemic vascular resistance. The hemodynamic alterations promptly returned to preclamping levels following hepatic revascularization. The average intraoperative transfusion requirements were 13 units of packed red blood cells, 9.6 units of platelets, 14.5 units of plasma and 6.6 L of crystalloid. Patients with previous surgery and retransplants required an average of 13 and 17 units of packed red blood cells, respectively. There was no deterioration in renal function in the postoperative period and no patient required hemodialysis. The 30 day survival was 87.8%. The 90-day and one-year actuarial survival is 80.5% and 68.8%, respectively. It is concluded that venous bypass is not necessary as a routine in orthotopic liver transplantation. PMID- 3541325 TI - The beneficial effect of pretransplant blood transfusions in cyclosporine-treated cadaver renal allograft recipients. AB - 212 cyclosporine-treated recipients of mismatched first cadaveric renal allografts are evaluated with respect to the effect of pretransplant random blood transfusions. It is determined that transfusions do not effect patient survival or morbidity. Pretransplant random blood transfusions correlate with significantly improved allograft success. There is also a trend, although not statistically significant, for further improvement of allograft survival with increasing numbers of transfusions. The transfusion effect is not related to the time at which the transfusions are given up to 2 years prior to transplantation. Transfused patients have a higher percent reactive antibody (PRA) than untransfused patients, but this does not cause them to wait for a cadaveric allograft significantly longer than the untransfused patients. Rejections are less severe in transfused patients. It is concluded that cyclosporine-treated recipients of first cadaveric renal allografts benefit from pretransplant blood transfusions. PMID- 3541326 TI - Multivariate analysis of risk factors impacting on immediate and eventual cadaver allograft survival in cyclosporine-treated recipients. AB - A multivariate analysis dissected the impact of donor procurement variables, immunologic risk factors, and alternate cyclosporine and prednisone induction immunosuppressive regimens on the early and eventual function of 303 consecutive cadaveric renal allografts. Primarily warm, but to a slight extent cold, ischemia time had an adverse impact on allograft function, as did the requirement for vasopressor or diuretic therapy. The occurrence of initial graft non-function adversely affected the probability of three-month graft survival, but did not alter either the longevity of organs, which subsequently recovered function, or patient mortality rate. The major immunologic risk factor was a second or multiple transplant, which was associated with an increased incidence of early graft failure, and impaired renal function in successful transplants. Correlations with HLA-B and DR matching were reflected in the quality of renal function, but not in graft survival rates. Cyclosporine (CsA) administration by continuous intravenous infusion, in order to avert initial elevated mean three day, serum radioimmunoassay drug levels reduced the incidence of initial graft non-function. High levels were also associated with impaired early and eventual renal function. Rapid posttransplant taper of corticosteroids to 30 mg prednisone by day six was associated with a greater incidence of rejection episodes and early graft failure than a taper that achieved 30 mg prednisone at 60 days. Both the serum creatinine value and the degree of hypertension observed at one month afforded good prognostic indices of eventual graft survival. Therefore, renal allografts in CsA-treated patients were sensitive not only to adverse donor and immunologic risk factors, but also to excessive CsA drug levels in the early postoperative period. These findings suggest an induction immunosuppressive strategy utilizing slightly higher initial doses of steroids for CsA-sparing during the first three days, followed by increased, but judicious, administration of CsA to achieve steroid-sparing by virtue of effective rejection prophylaxis. PMID- 3541327 TI - Metabolic effects of urinary diversion of exocrine secretions in pancreatic transplantation. AB - We have compared the metabolic consequences of two forms of exocrine drainage for pancreaticoduodenal transplant, duodenojejunostomy (DJ) and duodenocystostomy (DC). DC offered the advantage of avoiding opening of the recipient small intestine with its potential for wound sepsis, as well as a reliable method for early detection of pancreatic rejection as measured by an abrupt fall in urinary amylase and bicarbonate concentration. However, DC led to a large urinary loss of bicarbonate with a concomitant mild metabolic acidosis. During periods of renal dysfunction, the patients with DC developed severe hyperchloremic acidosis. Use of DC for pancreatic exocrine diversion may require patients to take supplemental bicarbonate even with a well-functioning renal transplant. PMID- 3541328 TI - Increased expression of class I major histocompatibility complex antigens on hepatocytes in rejecting human liver allografts. AB - We studied hepatocellular expression of major histocompatibility (MHC) antigens in 43 serial liver transplant biopsies from 22 patients (42 percutaneous, 1 autopsy specimen), 4 normal liver biopsies, and 8 percutaneous biopsies of diseased livers from non-liver-transplant patients. Frozen tissue sections were stained by an indirect immunofluorescence technique using monoclonal antibodies (MCAb) that recognize nonpolymorphic human class I or class II MHC determinants. Ethidium bromide was used to stain nuclei and rhodamine-conjugated anti-basement membrane antibodies to delineate epithelial and vascular structures. HLA-DR antigens recognized by MCAb OKIa1 and I2 were not detected on hepatocytes but were detected on the bile duct epithelium in 7 of 27 transplant biopsies, including 5 with acute rejection and 1 with chronic liver disease that later progressed to chronic rejection. HLA-A, B, C antigens recognized by MCAb 34/28 intensely stained cells lining the liver sinusoids but were negative on hepatocytes in 4 normal liver biopsies and 7 of 8 non-transplant biopsies. Expression of class I MHC antigens on hepatocyte membranes was increased in 17 of 21 (81%) biopsies from patients with acute rejection, in 4 of 4 with chronic transplant liver disease, but in only 3 of 18 (17%) biopsies from patients with no rejection (chi square = 8.62, P less than 0.01). Our observations demonstrate increased expression of MHC class I antigens in association with acute rejection in human orthotopic liver transplantation. Histologic resolution of the rejection episode is generally followed by a decrease in hepatocyte class I antigen expression. Further analysis of this response may have value in assessing the severity of the rejection and effectiveness of treatment. PMID- 3541329 TI - Hepatic transplantation into sensitized recipients. Demonstration of hyperacute rejection. AB - Hepatic transplantation into humorally presensitized patients has occasionally been performed without reported accelerated rejection. To study survival of orthotopic hepatic transplants in sensitized recipients a series of studies in rats were performed. Lewis rats sensitized by three successive skin grafts from fully allogeneic ACI strain donors then underwent orthotopic hepatic transplantation from ACI donors. Nine of ten recipients died within 4 hr with bleeding from the liver surface. By comparison, nine unsensitized recipients survived a mean of 10.7 +/- 0.5 days before succumbing with cellular rejection. Death of the sensitized recipients was not due to coagulopathy or technical failure. Histological studies of hyperacutely rejected livers demonstrated marked hemorrhage, edema, congestion, and necrosis within the hepatic parenchyma. There was a relative lack of cellular infiltrate compared with livers rejected by unsensitized recipients. Immunofluorescent staining showed IgG bound to perivascular tissues and sinusoids, and complement bound to perivascular tissue. Serum from presensitized, but not control, recipients showed a high titer of donor-specific, complement-dependent cytotoxic activity. It is concluded that hyperacute rejection of hepatic transplants can occur in sensitized rats and is mediated by a humoral mechanism. The immunohistopathology of this process is described. PMID- 3541330 TI - Sequential antilymphoblast globulin and cyclosporine for renal transplantation. AB - The nephrotoxic effects of cyclosporine (CsA) seem to be augmented by co-existing renal injury. A high rate of prolonged delayed function (acute tubular necrosis [ATN]) and non-function (NF) has been associated with the use of CsA prior to and following renal transplantation. Cyclosporine has also been associated with a slower recovery of allograft function and poor baseline renal function even in allografts that function immediately compared with conventionally treated recipients. In 1983 we hypothesized that the rate of ATN and NF following renal transplantation could be decreased and more normal kidney function achieved if renal injury was resolved before adding the nephrotoxic effects of CsA. A group of 300 nonsplenectomized, uremic recipients have received 304 renal transplants and have been initially immunosuppressed with azathioprine, prednisone, and Minnesota antilymphoblast globulin (ALG) prior to starting maintenance CsA and prednisone. The incidence of NF has been 1.9% and the development of ATN has been 7.6% following transplantation with sequential use of ALG and CsA. Other benefits to the renal recipient have also occurred with use of this immunotherapy protocol. Renal allograft survival for recipients of first, second, and third renal allografts has been higher than that generally reported with cyclosporine and prednisone alone. Rejection episodes have been infrequent during the first six months posttransplant, as 75% and 62% of first and second renal allograft recipients have remained rejection-free. Clinically significant infectious complications were infrequent. No cadaver recipient has developed a lymphoma. Moreover, the initial hospitalization following transplantation with sequential ALG/CsA has been short and generally uncomplicated. We conclude that sequential ALG/CsA following renal transplantation provides excellent early posttransplant immunosuppression while avoiding the nephrotoxic effects of CsA and also provides the steroid and infection-sparing benefits derived from maintenance CsA therapy. PMID- 3541331 TI - [The origin of the eukaryotic cell. IV. The general hypothesis of the autogenous origin of eukaryotes]. AB - The general hypothesis of autogenous (non-symbiotic) origin of the eukaryotic cell summarises some hypotheses explaining possible ways of the origin of main components and organelles of such a cell (the primary unicellular protist). Six hypothesises are suggested. Arising of the eukaryotic surface membrane of protist (cell) as a result of modification of its lipidoacidic composition, when most of synblocks and ensembles of eukaryotic enzymes sink into the cytoplasm (due to membrane vesiculation). Establishment of eukaryotic cytoplasm on the basis of successive formation of two locomotory-supporting apparates: the primary one (microtrabecular system), and the second one (cytoskeleton). Arising of the nucleus from a polyheteronomous nucleoid of proeukaryotes. A combinatorical hypothesis of mitosis formation. Polyheteronucleoid hypothesis of the origin of the mitochondria and chloroplasts. Arising of the flagellum from the contractile tentacle-like organelle, whose axoneme is made of single microtubules. A close interrelation and interaction in the process of evolution is noted between surface membranes, the cytoplasm and the nucleus. In accord a principles of block construction and heterochrony (see: Seravin, 1986r), the author explains the preservation of prokaryotic signs of organization in some components (and organelles) of eukaryotic cell (and protists). PMID- 3541332 TI - [The relationship of the processes of recovery from thermal and radiation damage in yeast cells]. AB - Synergistic enhancement coefficient (SEC) achieves the maximum value within 2-3 hours of holding overheated (50 degrees C) and gamma-irradiated diploid cells of Sacch. cerevisiae in water at 28 degrees C; further holding leads to SEC dropping almost to the initial value. The maximum in the curve involved disappears if gamma-irradiated (overheated) cells were held in water at 28 degrees C for 2-3 hours before hyperthermic treatment (gamma-irradiation). There is no maximum in the curve discussed for haploid yeast cells, which are incapable of "rapid" post irradiation recovering. The experimental data are interpreted from the point of view of reversible inhibition of yeast post-irradiation recovery by hyperthermia. PMID- 3541333 TI - Doppler ultrasound in the neonate. AB - The use of Doppler ultrasound to assess both the changing haemodynamics of the neonatal circulation and the perfusion of the brain is reviewed. The brain is particularly susceptible to both ischaemic and haemorrhagic injury in preterm and asphyxiated infants. However, the unique characteristics of the transitional neonatal circulation, and of the cerebral vasculature, pose considerable problems in the interpretation of Doppler signals from intracranial arteries. A volumetric Doppler method which eliminates some of those problems is discussed. The same method allows full assessment of the cardiovascular status of the newborn infant, including estimation of ductal shunting and left ventricular output. Doppler ultrasound, if used with a full understanding of the inherant assumptions and limitations of the particular methodology, is likely to prove invaluable in investigating pathological cerebral and cardiac vascular events in the newborn. PMID- 3541334 TI - Frequency dependence of ultrasound attenuation and backscatter in breast tissue. AB - Attenuation and backscatter of ultrasound in human breast tissues were measured over the frequency range relevant to breast imaging (3-7 MHz). The first step in the measurement process consisted of generating an ultrasound attenuation image of a macroscopic slice of excised breast tissue. This image depicted the various tissue constituents in the samples so that a region of homogeneous tissue could be selected for further investigation. Ultrasound signals used in the computation of the frequency dependent attenuation and backscatter coefficients were then collected from several points within this region of interest. The measured attenuation and backscatter were averaged over all the points in the region of interest and plotted as functions of frequency which ranged from 3 to 7 MHz. The results showed that the attenuation coefficient of homogeneous regions of infiltrating duct carcinoma was higher than that of fat but somewhat less than that of fibrous and parenchymal tissues. On the other hand the backscattering coefficient of ductal carcinoma samples was similar to that of fat but much lower than the backscatter coefficient of parenchymal tissue. The discriminability of the different breast tissue types under these measures, as well as the relevance of the results to clinical imaging are discussed. PMID- 3541335 TI - Bibliography of biomedical ultrasound. No. 59. PMID- 3541336 TI - [Mixed freeze preserved heterologous/autologous full-thickness transplants following 3d degree burns in animal experiments]. AB - On five minipigs third-degree burns were applied. The surgical skin coverage was established after escharectomie by freeze-preserved heterological/autological intermingled full-thickness skin grafts. The freeze-preservation of the Makaka skin (full-thickness skin) was achieved in a commercially available freezer at 27 degrees C. We could not observe a accelerated or even complete re epithelialization as it is described in the Chinese papers. The burnwunds healt in form of scare areas covering about half of the previously burned area. PMID- 3541337 TI - [Telethermographic studies of the wound suture in animal experiments]. AB - It is known from clinical practice that the healing of wounds is influenced by the type of wound suture applied. In general, the scar resulting from an intracutaneous suture looks better than that produced by an uninterrupted suture or by knotted suture. With respect to the appearance of the scar, the intracutaneous suture is normally superior to other wound sutures. As suggested by the results of our investigations, this may be due to an undisturbed microcirculation within the wound. Thermovision shows that a local temperature increase appears sooner in a wound closed by intracutaneous suture, whereas the temperature increases more slowly in case of uninterrupted or knotted suture. We suppose that the alterations of microcirculation in a wound closed by one of the latter types of wound suture can be considered as disturbance in blood circulation which may be followed by healing disturbances and proliferations of connective tissue. PMID- 3541339 TI - [The treatment of diabetes mellitus, 1922-1986: from the triumph of curative medicine to the challenge of preventive medicine]. PMID- 3541338 TI - [Management of ligament injuries of the anterior ankle joint with ligament suture and a joint plaster cast]. AB - Treatment of ligamentous injuries of the ankle joint by sutures functionplaster. 139 patients had been checked up after treatment by suturing and functionplaster because of ruptures of ligaments of the ankle joint. Four days after a funktionplaster has been applied the leg has been fully loaded. Four weeks later the plaster was taken off. At this time the ankle joint can be fully loaded and is mobile. 127 patients were absolutely restored, ten patients had slight complaints, in one case a slight instability has been remaining. One patient showed a ligament rupture of the ankle joint following newer distorsion. Twelve persons had superficial wound necroses. In one case there was an infection of the wound, the time of treatment was 78 days. This patient complains of pains by loading. PMID- 3541341 TI - Posterior ledge at the bladder neck: crucial diagnostic role of ultrasonography. AB - A posterior ledge at the bladder neck was seen in 158 patients (107 of whom were undergoing intermittent catheterization) on a sonographic voiding cystourethrogram. In 117 patients, the ledge was 0.5 cm or longer; 66 patients were on intermittent catheterization, and 51 experienced difficulty with catheterization, including vigorous bleeding in 4. Ledges less than 0.5 cm were discovered in 41 patients, all on intermittent catheterization, none of whom had difficulty with this procedure. The duration of intermittent catheterization and of detrusor-sphincter dyssynergia was shown statistically to be an important factor leading to the formation of the longer obstructing ledges (P less than 0.0005, Mann-Whitney test). Sphincterotomies were performed in 74 patients through the periurethral striated sphincter at 10 and 2 o'clock and extended to the bladder neck. The operation was a success in 73 (98%), all of whom were catheter-free, and in all of whom sonography revealed that the ledge had receded and the catheter was no longer obstructed. PMID- 3541340 TI - [Acute lymphoblastic and nonlymphoblastic leukemia in 1st complete remission: consolidation treatment by intensive radio-chemotherapy followed by transplantation of HLA-A, B and Dr compatible allogeneic bone marrow]. PMID- 3541342 TI - Parametric imaging applied to renal digital subtraction angiography: establishment of normal ranges. AB - Digital subtraction angiography is able to provide simultaneous information on renal structure and function. Thirteen normal patients were investigated. Parametric analysis was performed and a set of normal ranges was established for T-1/2 max, T-max, and renal-artery-to-renal-vein peak-to-peak transit time. Cases are presented to show that the technique is capable of identifying the normal kidney and differentiating it from abnormalities of intrarenal perfusion based on the detailed analysis of the vascular nephrogram. PMID- 3541343 TI - Bladder leiomyoma: advantages of sonography over computed tomography. AB - The complementary use of sonography in the evaluation of a bladder-base leiomyoma is reported. Sonography, as compared to computed tomography, was able to document the solid nature of the tumor, its submucosal location, and determined the site of origin and exact relationship to adjacent organs by virtue of the ability to image in multiple planes. The sonographic appearance of a submucosal, solid lobulated bladder-base mass is suggestive of a leiomyoma. PMID- 3541344 TI - Acute vesiculitis and its prostatic complications caused by E. coli in the rat. AB - Injection of solutions of E. coli leads to vesiculitis which regresses spontaneously, and to interstitial prostatitis. Castration preceding experimental injection of a bacterial solution modifies the progression of the vesiculitis which then becomes chronic. Infection does not seem to diffuse via the lympathic system, even after castration. PMID- 3541345 TI - Adrenal myelolipoma: clinical, radiologic, and histologic features. AB - The adrenal myelolipoma is a benign, endocrinologically inactive tumor whose histologic structure consists of mature adipose tissue with foci of hematopoietic cells. A case is presented of a seventy-one-year-old woman in whom the diagnosis was established preoperatively by means of sonography, computerized tomography, and magnetic resonance tomography. In a review of the literature, the radiologic profile is discussed, and based on the analysis of 59 surgically treated cases a therapy recommendation is given. PMID- 3541347 TI - Ectopic prostatic glands in bulbar urethra. Immunoperoxidase study. AB - Ectopic prostatic glands in the bulbar urethra of a sixty-year-old man were identified by an indirect immunoperoxidase stain for prostatic acid phosphatase. Cystoscopically the appearances were those of "urethritis" without the polypoid appearance previously reported in cases of ectopic prostatic tissue. PMID- 3541346 TI - Amoxicillin/clavulanate in urinary tract infection. AB - A new beta-lactamase-stable oral antibiotic (Augmentin) has been found to be effective in the treatment of urinary tract infections (uncomplicated and complicated, recurrent, and nosocomial) and bacteriuria. The literature is reviewed. PMID- 3541348 TI - New operative technique for ileal conduit: purse-string suture of proximal end of isolated ileal segment. PMID- 3541349 TI - Ultrasonography in urinary incontinence. AB - Linear array ultrasound techniques were utilized in place of conventional radiologic procedures to study the dynamics of the urethrovesical junction and proximal urethra in patients with urinary incontinence. This ultrasound procedure provided an objective demonstration of the mobility of the urethrovesical junction and documented the presence of an anatomic defect. It aided in the selection of patients suitable for surgical correction of stress incontinence and their postoperative follow-up. Ultrasound was also employed to demonstrate uninhibited detrusor contractions in patients with vesical instability. PMID- 3541350 TI - Emphysematous pyelonephritis. AB - A case of emphysematous pyelonephritis which was diagnosed by conventional radiology and confirmed by ultrasonography, computed tomography, and surgery is described. The etiology and pathogenesis of this severe infection are discussed, and the usefulness of the various noninvasive radiologic methods for the diagnosis and management of the infection is reviewed. PMID- 3541351 TI - [Necrosis of the stomach wall following selective proximal vagotomy]. PMID- 3541352 TI - [Cystoid dilatation of the common bile duct]. PMID- 3541353 TI - [Surgical treatment of complicated postbulbar duodenal ulcers]. PMID- 3541354 TI - [Modified operation in extrasphincteral rectal fistulae]. PMID- 3541356 TI - Shigella from ovine faeces. PMID- 3541355 TI - [Use of epsilon-aminocaproic acid for treating granulating burn wounds]. AB - Results of the application of synthetic inhibitor of proteolytic enzymes epsilon aminocaproic acid in the treatment of granulating burn wounds are described. High effectiveness of the aminocaproic acid in healing of granulating wounds after burns is shown as well as in preparing great granulating burn wounds for autodermoplasty and the take of transplanted autodermic flaps. PMID- 3541357 TI - Anorexia during febrile conditions in dwarf goats. The effect of diazepam, flurbiprofen and naloxone. AB - The most common sign of febrile diseases is anorexia, which develops at a time when adequate caloric and micronutrient availability may be critical. In order to study the relationship of fever and anorexia, feed intake in dwarf goats was studied under conditions of fever and antipyresis. Furthermore, experiments were done to establish whether a feed intake stimulant would override the anorexia during febrile conditions. Infection with Ehrlichia phagocytophila and i.v. injection of Escherichia coli endotoxin (0(111) B4, 0.1 microgram/kg body weight) both resulted in increased rectal temperatures and significant reductions in feed intake. Administration of the antipyretic drug flurbiprofen (1 mg/kg) to febrile animals inhibited the temperature responses, but food intake was still suppressed. Diazepam (0.06 mg/kg), a feed intake stimulant, did not override the anorexia associated with fever. Blocking the febrile response of E. coli LPS injected goats with flurbiprofen plus diazepam or with flurbiprofen plus naloxone (0.1 mg/kg) did not antagonise their reduced feed intake either. The effects of these drugs and of endotoxin on rumen motility adds an interesting aspect to their activities in the CNS, since the CNS has been shown to regulate various aspects of forestomach motility, which in turn could alter feeding behaviour. Moreover, our findings are consistent with the hypothesis that the suppression of feed intake might depend on the release of interleukin-1. PMID- 3541358 TI - [Complex radiodiagnosis of acute diseases of the biliary tract]. PMID- 3541359 TI - [Complex roentgenologic and ultrasonic diagnosis of pancreatic pseudocyst]. PMID- 3541360 TI - [Integrated echoroentgenologic study of palpable tumors of the abdominal cavity in adults and children]. PMID- 3541361 TI - [Ultrasonic scanning in the diagnosis of diseases of the abdominal cavity and retroperitoneal space (review of the literature)]. PMID- 3541362 TI - [Current roentgenodiagnosis of peptic ulcer (lecture II)]. PMID- 3541363 TI - Effect of infection of the genital tract on the concentration of IgG and albumin in bull serum and semen. AB - Bovine IgG and albumin concentrations were determined from serum and semen of 59 bulls that were divided into 4 groups: 35 non-infected bulls (Group 1); 10 with vesiculitis due to Corynebacterium pyogenes (Group 2); 10 bulls with orchitis due to Chlamydia psittaci (Group 3); and 4 bulls with infectious vesiculitis (Group 4) sampled both before and after antibiotic treatment. Serum IgG concentrations (25 mg/ml approximately) were similar in non-infected (Gp 1) and infected bulls (Gp 2,3,4) whereas serum albumin concentrations were greater in infected than in non-infected bulls (51 mg/ml vs.41 mg/ml; p less than 0.01). By contrast, both semen IgG and albumin concentrations in infected bulls (0.47 and 0.54 mg/ml respectively) were significantly different from those of non-infected bulls (0.14 and 0.32 mg/ml; p less than 0.01). In addition, bulls with chlamydial orchitis had both semen (but not serum) IgG and albumin levels higher than those suffering from vesiculitis (p less than 0.01). Antibiotic therapy led to recovery and simultaneously to decreased concentrations of semen IgG and albumin. These results strongly suggest a local IgG synthesis or selective diffusion after such genital infections and further indicate that semen IgG and albumin assays could be a new and valuable tool for diagnosis and evaluation of genital infections. PMID- 3541364 TI - Effects of stable dust on farm animals--a review. AB - The relationship between air quality--its dust content--and respiratory diseases of animals in the food industry and otherwise is examined. The correlation between dust content and incidence of disease in farm animals is also discussed. Lesions caused either directly or indirectly by dust-transported microorganisms are reviewed. Effects of dust on animal performance are included. This review is an attempt to compile available information on the natural occurrence of stable dust and the possibilities for its measurement and control. PMID- 3541365 TI - An overview of aflatoxicosis of poultry: its characteristics, prevention and reduction. AB - Aflatoxicosis represents one of the serious diseases of poultry, livestock and other animals. The cause of this disease in poultry and other food-producing animals has been attributed to the ingestion of various feeds contaminated with A. flavus. This toxigenic fungus is known to produce a group of extremely toxic metabolites, of which aflatoxin B1 (AFB1) is most potent. Avian species especially chicks, goslings, ducklings and turkey poults are most susceptible to AFB1 toxicity. The toxic effects of AFB1 are mainly localized in liver as manifested by hepatic necrosis, bile duct proliferation, icterus and hemorrhage. Chronic toxicity in those birds is characterized by loss of weight, decline in feed efficiency, drop in egg production and increased susceptibility to infections. The incidence of hepatocellular tumors, particularly in ducklings, is considered to be one of the serious consequences of aflatoxicosis. Even though prevention and avoidance are the best way to control aflatoxicosis, natural contamination of crops with A. flavus is sometimes unavoidable. Such aflatoxin contaminated feeds can be decontaminated using various methods which mainly focus on physical removal or chemical inactivation of the toxins in the feeds. Moreover, dietary additives such as activated charcoal, phenobarbital, cysteine, glutathione, betacarotene, fisetin and selenium have also been reported to be effective in the reduction of aflatoxicosis in poultry. PMID- 3541366 TI - The influence of the administration of sow's milk on the post-weaning excretion of hemolytic E. coli in the pig. AB - The postweaning excretion rate of hemolytic E. coli was determined in piglets from herds affected with edema disease and on control farms. No distinct difference in rate of excretion was observed. A split litter trial was set up to evaluate the importance of sow's milk in the postweaning rise of fecal hemolytic E. coli. 525 ml of sow's milk a day, mixed with the feed, completely inhibited that postweaning rise, even after oral challenge with a pathogenic strain. PMID- 3541368 TI - [The early diagnosis of malaria]. PMID- 3541367 TI - [Voenno-meditsinskii zhurnal as a source of information on current problems in surgery]. PMID- 3541369 TI - [Current trends in the creation of drugs]. PMID- 3541370 TI - [Students of the Military Medical Academy--members of the military and combat organization of the Russian Social Democratic Workers' Party (on the 80th anniversary of the 1905-1907 revolution in Russia)]. PMID- 3541371 TI - [Methods for the plastic repair of defects in the bones of the skull]. PMID- 3541373 TI - [Encyclopedia of military medicine]. PMID- 3541372 TI - [A. A. Charukovskii's book, "Military Field Medicine" (on the 150th anniversary of its publication)]. PMID- 3541374 TI - [Modern dressings for burn wounds]. PMID- 3541375 TI - [Use of the plasmid profile in the study of epidemic digestive toxic infections]. PMID- 3541376 TI - [Historical origins of present-day deontological postulates in oncology]. PMID- 3541377 TI - [Possibility of fortifying milk nutrient mixtures for children with lactoglobulin against E. coli and Proteus]. AB - Sweet milk nutrient mixtures, biologically active additives (BAA) and lactic acid ferments, intended for child nutrition, were enriched with the immune preparation lactoglobulin against E. coli and Proteus. Serological and immunochemical investigations of hemagglutinating activity and other characteristics of lactoglobulin in the enriched milk mixtures and BAA evidenced that the preparation retained its full value during the technological process and in the period of storage. No signs of lactoglobulin degradation during the production of a test batch of the milk mixture and BAA were detected, and a high hemagglutinating activity with respect to enteropathogenic E. coli and Proteus was recorded. This permitted the author to recommend the lactoglobulin-enriched sweet mixtures for prevention of acute intestinal infections and dysbacteriosis in young children. The in vitro study of the lactoglobulin interaction with pure cultures of lactobacillus and bifidobacteria showed its inertness to eubacteria. Four strains studied retained their growth and acid-forming properties after combined incubation with lactoglobulin and did not inhibit its activity. A conclusion has been made on the possibility of enrichment of lactic acid products, intended for child nutrition, with lactoglobulin against E. coli and Proteus. PMID- 3541379 TI - [Biological role of zinc and the manifestations of its deficiency in the body]. PMID- 3541378 TI - [Effect of inorganic fluoride compounds on the body in various types of nutrition]. PMID- 3541380 TI - Modified packed red cells and the development of the circle pack. PMID- 3541381 TI - Additive system approach in blood transfusion: birth of the SAG and Sagman systems. PMID- 3541382 TI - [HLA antigen system of patients with diseases of the kidneys and urinary tract (a review of the literature)]. PMID- 3541383 TI - [Use of DIP-02 dialyzers in preparing patients for a kidney allograft]. PMID- 3541384 TI - [Immunofluorescence research on the permeability of the kidney biological barriers for serum proteins]. PMID- 3541385 TI - [Vaccination against respiratory syncytial infection]. PMID- 3541386 TI - [Possibility of detecting the matrix protein of the influenza virus in intact and disrupted virions by immunoenzyme analysis and immune electron microscopy]. AB - ELISA and immune electron microscopy were used to study possible causes of the detection of antigenic reactivity of influenza virus matrix protein in purified virus suspension directly adsorbed on polystyrene. No interaction of antibody to M protein with the surface of virus and subvirus particles was observed. The process of virus sorption on polystyrene for a long period was shown not to lead to disruption of intact virus particles, and the detection of the internal matrix protein in preparations of purified influenza virus was due only to the presence of partially or completely destroyed virions in the viral suspension. PMID- 3541388 TI - The artificial heart--progress, problems, prognosis. PMID- 3541389 TI - Changing physician payment for Medicare patients. Projected effects on the quality of care. AB - Congress and the Reagan Administration, in an effort to "contain" costs, are considering changes in the way physicians are paid when they care for Medicare patients. By examining the effects on quality of care of several alternative ways physicians might be paid, including modified fee for service, physician diagnosis related groups and capitation through health maintenance organizations, we can predict the kinds of effects on quality of care most likely to occur and the kinds of patients most likely to be affected. Under each of the payment alternatives, poorer and sicker patients are at greatest risk for reduced access to care and quality of care. These findings underline the need for rigorous experiments to assess the effects of changes in physician payment on quality of care and the need for monitoring and assurance of quality in a new payment system. PMID- 3541390 TI - Prophylactic regimens in colorectal surgery: an open, randomized, consecutive trial on metronidazole used alone or in combination with ampicillin or doxycycline. PMID- 3541387 TI - Plasma ferritin determination as a diagnostic tool. AB - Plasma ferritin is a secretory component of intracellular ferritin synthesis. In normal persons its amount reflects the size of iron stores. A decrease to less than 12 mug per liter indicates iron deficiency. Increased iron stores are associated with an increased plasma ferritin level. Various other conditions, however, can increase the plasma ferritin concentration including increased metabolism, inflammation, tissue damage and neoplastic disease. The use of the plasma ferritin determination in diagnosing iron overload depends on excluding these other causes, leaving storage iron as the only explanation for the increased plasma ferritin. It is then necessary to establish the parenchymal nature of the iron overload by showing an elevated transferrin saturation and, if elevated, the more definitive liver biopsy should be done. PMID- 3541391 TI - Reactive intermediates in pesticide metabolism: peracid oxidations as possible biomimetic models. AB - Reactive intermediates generated by metabolic epoxidation, N-oxidation and S oxidation are often identical to those obtained on peracid oxidation as illustrated by studies with a variety of pesticides. Epoxidation reactions carried out metabolically or with peracids lead to transitory or unstable epoxychrysanthemic acid, epoxycyclopentenolone and epoxyfuran derivatives from pyrethroids, and geranyl-derived diepoxides and epoxydiols from juvenoids. N Oxidation with microsomal oxidases or peracids activates hydroxylamine ether proinsecticides and dimethylphosphoramide and aminodiphenyl ether promutagens, but the peracid system is not always a suitable biomimetic model. Sulphoxidations with peracids appear to give the same reactive intermediates as those involved in metabolism of S-alkyl thiocarbamate and S-methyl-triazinone herbicides, S chloroallyl promutagens, and S-propyl phosphorothiolate and phosphinyliminodithiolane proinsecticides. PMID- 3541392 TI - The metabolism of fungicides. AB - Of the three main groups of pesticides (insecticides, fungicides and herbicides), fungicides have probably the longest history, dating back to the accidental discovery in 1882 of Bordeaux mixture and the value of copper-based preparations for the control of vine downy mildew disease. In more recent times a wide range of fungicides have become available, including compounds with not only protectant but systemic activity, and total world-wide sales in 1983 were estimated at 2.8 billion dollars. This review attempts to summarize the current state of knowledge as it relates to the metabolism in animals and plants of examples of several of the major fungicide groups. Specifically the metabolism of maneb, mancozeb, zineb, captan, chlorothalonil, benomyl, triadimefon, triadimenol and cymoxanil are discussed. PMID- 3541393 TI - Comparative aspects of herbicide metabolism. AB - Herbicides are the economically most important group of pesticides, and such activity occurs in a wide range of chemical structural classes. Studies of the metabolism of herbicides involve a great number of organisms and test systems to provide information of value for assessing the nature of potential residues in human foods of plant and animal origin, metabolism-toxicity relationships in mammals in view of potential human exposure, and in plants in view of biological selectivity, and the environmental fate in soil and aquatic systems. Some of the objectives pursued in an industrial metabolism laboratory and the problems confronted when elaborating its contribution to the safety assessment of a pesticide are briefly described with special reference to metabolism-selectivity relationships in plants and the significance of plant metabolites to animals. PMID- 3541394 TI - Role of intestinal flora in metabolism of agrochemicals conjugated with glutathione. AB - Intestinal processes which mediate the metabolic fate of glutathione conjugates of xenobiotics are reviewed. The role of the intestinal microflora in the metabolism of premercapturic acid pathway metabolites is discussed. The possible significance of mercapturic acid pathway metabolite catabolism in the bioaccumulation of methylthio-containing residues in the environment is presented. PMID- 3541396 TI - Metabolic aspects of antioxidants and preservatives. AB - The use of chemical preservatives serves to ensure the nutritional adequacy, palatability and safety of processed foods and beverages. The toxicity of some of the more ubiquitous antimicrobial agents (sorbic acid, p-hydroxybenzoates, sulphur dioxide) and antioxidants (propyl gallate, butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT] is reviewed together with the role of metabolic data in assessing the 'safety-in-use' of these and other food additives. PMID- 3541395 TI - The metabolism of intense sweeteners. AB - Three organic acids (saccharin, acesulfame-K and cyclamate) are used or have been used extensively as intense sweeteners. Once absorbed from the gut they are eliminated, largely in the urine, without undergoing metabolism. Early studies using radiolabelled saccharin indicated the existence of limited metabolism, but this was not confirmed by later more extensive studies using highly purified compound. Metabolism could not be induced by a variety of pretreatments. Following an initial report of the presence of traces of cyclohexylamine in the urines of subjects given cyclamate, it was shown that chronic administration of the sweetener caused the induction of extensive metabolism. The metabolism, which showed wide inter- and intra-individual variability was performed the gut microflora. The peptide sweeteners (aspartame and thaumatin) are metabolized to their constituent amino acids in the gastro intestinal tract, prior to absorption. As such they are incorporated into normal intermediary metabolism and their low-calorie applications derive from their intense sweetness. PMID- 3541397 TI - Special issue of Xenobiotica from the ISSX (International Society for the Study of Xenobiotics) First European Meeting on Foreign Compound Metabolism, Malta, 1985. Dedicated to Prof. Eric Boyland to mark his 80th birthday. PMID- 3541398 TI - Eric Boyland--a pioneer in cancer biochemistry. PMID- 3541400 TI - Pathways involved in the metabolism and activation of polycyclic hydrocarbons. AB - The metabolism and activation of the polycyclic aromatic hydrocarbons has been reviewed and the original contributions made to this area by Professor E. Boyland have been placed in context. The reactions involved in the formation, via epoxides, of hydroxylated derivatives have been outlined and conjugations with glucuronic and sulphuric acids and with glutathione have been discussed. Examples of secondary hydroxylation reactions have been given and the possible role that phenolic hydroxyl groups may play in activating epoxides considered. Mechanism by which polycyclic hydrocarbons are activated by metabolism to epoxides of various types have been included, mainly by reference to benzo[a]pyrene, benz[a]anthracene and chrysene. The tissue and species specific effects of polycyclic hydrocarbons have been referred to and the tissues that may act as targets in man for the initiation of malignancy by polycyclic hydrocarbons mentioned. PMID- 3541399 TI - The metabolism of foreign compounds and the induction of cancer. PMID- 3541402 TI - Detoxication reactions of glutathione and glutathione transferases. PMID- 3541401 TI - The metabolism of aromatic amines. AB - Aromatic amines are of general interest in drug metabolism and some are a health hazard, particularly as bladder carcinogens. Conditions for the biological ring- and N-oxidation of aniline and its derivatives are reviewed. The metabolism of 2 naphthylamine and aminobiphenyls and the involvement of metabolites of aromatic amines in bladder cancer is discussed. PMID- 3541403 TI - Prodrugs in cancer chemotherapy. PMID- 3541404 TI - Insecticide metabolism and selective toxicity. AB - Current research is focused on means to improve the environmental acceptability and selective toxicity of existing classes of insecticides and the search for new and species selective modes of insecticidal action. The study of species differences in metabolism and its modulation by changes in chemical structure is a vital component of this effort. The importance of metabolism is illustrated by examples from the major classes of insect control chemicals, namely organophosphorus and carbamate insecticides, DDT, pyrethroids and insect growth regulators. PMID- 3541406 TI - Hemodynamics and pathophysiology of hypertension in different stages of chronic renal parenchymal disease. PMID- 3541405 TI - Enzymology of protein methylation. PMID- 3541407 TI - A commemoration of the fiftieth anniversary of the Connecticut Tumor Registry. Selected papers from the Yale Symposium on Cancer Epidemiology Today and the International Agency for Cancer Research Symposium on Cancer Registries and Multiple Primary Tumors. December 9-12, 1985. PMID- 3541408 TI - The first fifty years of the Connecticut Tumor Registry: reminiscences and prospects. AB - The first fifty years of the Connecticut Tumor Registry (1935-1985) have seen unprecedented progress in the collection of standardized data on cancer patients and in the processing of these data, from paper documents to punch cards and magnetic tapes. The need for collecting such information was first recognized, in the early 1930s, by a group of physicians, health professionals, and laymen in New Haven who observed alarming increases in cancer rates and poor survival of cancer patients in this city. This paper recalls the growth and development of the registry and the role played by the Connecticut legislature, the State Medical Society, the Connecticut Department of Health, and the National Cancer Institute in this process. For half a century, the registry has provided assistance to practitioners, hospitals, and research scientists, not only in Connecticut but across the country and around the world. By making available reliable data on incidence and survival, the registry has played a key role in patient management, clinical trials, and etiologic studies. It has also demonstrated the value and served as an exemplary model of a population-based registry. At this juncture in its history, prospects for the future of the Connecticut Tumor Registry appear bright. Its data base will be an essential resource for the recently established Cancer Control Research Unit (CCRU) in the state and for new intervention studies by investigators at Yale, the University of Connecticut, and the State Health Department. PMID- 3541410 TI - [Health risks caused by asbestos--review of references]. PMID- 3541409 TI - Multiple primary cancers in Connecticut, 1935-82. AB - Recently, the National Cancer Institute published a comprehensive monograph on multiple primary cancers in Connecticut and Denmark. This paper summarizes some of the observations made on the Connecticut population. Data compiled by the Connecticut Tumor Registry have extended our knowledge about the patterns of multiple primary cancers, especially among long-term survivors of cancer and among patients with relatively rare tumors about which little information currently exists. When compared with the general Connecticut population, cancer patients had a 31 percent (RR = 1.31) increased risk of developing a second cancer and a 23 percent (RR = 1.23) elevated risk of second cancer at a different site from the first. Common environmental exposures seemed responsible for the excess occurrence of many second cancers, particularly those related to cigarette smoking, alcohol consumption, or both. For example, persons with epithelial cancers of the lung, larynx, esophagus, buccal cavity, and pharynx were particularly prone to develop new cancers in the same or contiguous tissue throughout their lifetimes. Cancers of the colon, uterine corpus, breast, and ovary frequently occurred together, suggesting underlying hormonal or dietary influences. Only patients with prostate cancer were at significantly low risk for second cancer development; this might be an artifact of case finding, since advanced age at initial diagnosis was generally associated with an underascertainment of second cancers. Radiotherapy may have caused rectal and other cancer among patients with cancers of the female genital tract, and leukemia among patients with uterine corpus cancer. Chemotherapy with alkylating agents probably contributed to the excess of acute nonlymphocytic leukemia following multiple myeloma or cancers of the breast and ovary. Genetic susceptibility seemed to explain some tumor complexes, such as the multiple occurrences of cutaneous melanoma and the excess of bone cancer following retinoblastoma. Research into multiple cancer syndromes should enhance our understanding of carcinogenic factors and mechanisms and the development of strategies for cancer prevention and control. PMID- 3541412 TI - [Scarring linear IgA dermatosis in the adult]. AB - A 54-year-old woman had a six-months history of a scarring blistering disease with clinical signs of dermatitis herpetiformis and bullous pemphigoid. Direct immunofluorescence examination showed homogeneously linear deposits of IgA along the dermo-epidermal junction. Electron microscopic studies revealed blistering above and beneath the lamina densa. Referring to this new case of a scarring linear IgA disease we discuss some other forms of scarring bullous diseases in adults. PMID- 3541411 TI - [Historical aspects of the conservative treatment of gallstone disease]. AB - On the basis of several selected instances a short review of the role internal therapy in the history of cholelithiasis is given. The multifarious medicamentous, physical and dietetic measures remained for centuries the only, though not always satisfying therapeutic alternative to operation. Thereby is also referred to the misuse which was done by irresponsible physicians and laymen even in the field of the treatment of gall-stones. Only the flowering of the operative medicine compelled the internal medicine towards the end of the 19th century to give the supremacy over to surgery, because only this part of medicine was able to remove the causes of the disease. With the development of new chemolitholytic substances and the crushing of the stone on endoscopic and extracorporal way new perspectives again begin to limn themselves in the conservative treatment of cholelithiasis. PMID- 3541413 TI - [In vitro model of the re-epithelialization of defects]. AB - Epidermal cells taken from guinea pigs were cultured on collagen in order to study the processes comparable to reepithelialization of wounds by means of time lapse cinematography and electron microscopy. Attachment and spreading of the cells are essential for the following cell proliferation. Immediately after seeding, the cells move in streams and rotate around their axes. Flattened cells show cytoplasmic streaming and ameboid movement as they continuously alter their shapes (10-25 microns/h). The cells actively form intercellular bridges, which favor the confluence of the cells. In the present study, the phases of attachment, intercellular association, and formation of colonies have been classified and related to the activity of the DNA synthesis, as it was indicated by 3H-thymidine incorporation. PMID- 3541414 TI - Equal anti-ischemic properties of isosorbide dinitrate plus verapamil and isosorbide dinitrate plus propranolol. A randomized, double-blind and crossover study. AB - Although nitrates are the basic treatment for patients with ischemic heart disease and numerous clinical studies have compared the anti-ischemic effects of different combinations with beta-blockers and/or calcium antagonists, no study is known on a controlled intraindividual comparison of the combination nitrate plus beta-blocker with the combination nitrate plus a heart rate-decreasing calcium antagonist. Therefore we performed a randomized, double-blind and crossover study to compare the effects of 80 mg isosorbide dinitrate in slow-release form (ISDN, once-daily) plus 120 mg verapamil (t.i.d.) with those of 80 mg ISDN plus 80 mg propranolol (b.i.d.). After these two phases of 3 weeks' duration respectively, patients received the combination of all three drugs with the same dosages in a single-blind manner. In addition to the standard inclusion criteria, a pathological exercise-ECG even after ISDN was required as well as a left ventricular ejection fraction (EF) of greater than or equal to 35%. This protocol could be completed in 26 of the 30 enrolled patients. The combination ISDN plus verapamil proved to exert the same anti-ischemic effects as the combination ISDN plus propranolol. The triple therapy showed a further improvement of exercise induced ischemia without deterioration of the EF at rest or during exercise. Even though only this triple therapy led to an optimal anti-ischemic result in about one third of the patients, it should be initiated cautiously, since symptomatic bradycardia may occur. PMID- 3541416 TI - [Organic nitrates and prostaglandins in the cardiovascular system]. AB - The beneficial effect of organic nitrates in acute myocardial ischemia is commonly explained by their hemodynamic actions, especially the dilatation of venous capacitance vessels. Recent studies have shown an inhibition of platelet function by organic nitrates ex vivo but not in vitro. Antiplatelet activities of organic nitrates might represent an additional mechanism, independent of vascular actions which might eventually involve stimulation of prostacyclin formation by the vessel wall. In vitro experiments on isolated coronary artery preparations have demonstrated stimulation of PGI2 as well as inhibition of platelet thromboxane synthesis by a number of organic nitrates. Optimal stimulation requires the presence of a free nitro group in the molecule at a particular steric position and can be suppressed by a number of inhibitors, including corticosteroids, indomethacin and methylene blue. Administration of the organic nitrate teopranitol to healthy volunteers is associated with depressed platelet secretion ex vivo which is not seen with the compound in vitro. It is concluded that further clinical elucidation of the PGI2-related mechanism in the action of organic nitrates in patients appears to be both necessary and useful. PMID- 3541415 TI - [Anti-angina action and tolerance of isosorbide-5-mononitrate or nifedipine in retard form]. AB - Twelve patients with stable angina and reproducible depression of the ST-segment during bicycle exercise of at least 0.15 mV were assessed in a double-blind randomized cross-over study. Patients were treated either with 50 mg isosorbide-5 mononitrate (IS-5-MN) daily or 2 X 20 mg nifedipine retard daily or the combination of both drugs for 2 weeks. The sum of ST-segment depression at maximal exercise was reduced by nifedipine and IS-5-MN to the same amount, while ST-segment reduction was highest during treatment with the combination of both drugs. The best exercise duration and maximal working capacity were also recorded during combination treatment. However, patient appreciation concerning efficacy and side-effects was best with nifedipine, slightly worse with IS-5-MN, and only one patient judged the combination of both drugs as good. PMID- 3541417 TI - The therapeutic role of isosorbide-5-mononitrate+ in stable and unstable angina pectoris. AB - Various studies on the pharmacodynamic and clinical properties of isosorbide-5 mononitrate (IS-5-MN) indicate that this drug is effective in the treatment of stable angina pectoris. Acute and chronic studies, in fact, show an improved performance and an amelioration of the clinical status in patients under treatment. On the other hand, acute studies on vasospastic and mixed angina, two common clinical manifestations of coronary artery disease, have demonstrated the capability of IS-5-MN in preventing episodes of transient myocardial ischemia. In analogy with other forms of nitrates, it is clear that IS-5-MN has a positive effect both on the coronary tree (preventing vasoconstriction) and on those hemodynamic parameters which influence the myocardial oxygen demand (reducing myocardial oxygen consumption). Further information is needed, however, to clarify the issue of tolerance development after chronic administration; so far it appears that tolerance may develop when patients are treated with doses of IS 5-MN greater than 20 mg t.i.d.. On the basis of the clinical studies carried out with IS-5-MN, and its favourable pharmacological profile, it is foreseeable that this drug will have an increasing role in the treatment of angina pectoris. PMID- 3541418 TI - [Avoidance of tolerance development to long term therapy with nitrates through correct dosage]. AB - Tolerance development to organic nitrates, with respect to blood pressure reduction and precipitation of headache, had been assumed for almost a century but it was not until 1980 that the anti-ischemic effect was proven to be subject to this phenomenon, in a placebo-controlled, double-blind study carried out by our group exemplarily employing long-term treatment with isosorbide dinitrate (ISDN) in sustained-release form. Subsequent studies showed that tolerance development was also incurred during administration of ISDN, nonsustained-release form, 40 mg q.i.d. and on application of transdermal nitroglycerin patch systems. Both changes in the pharmacokinetics and activation of counter-regulatory mechanisms can be excluded as meaningful etiologic factors for the development of nitrate tolerance. It must be assumed that intracellular changes in the target organ which are associated with a diminished responsiveness for guanylate cyclase activation are at the basis of tolerance development. Prerequisite, according to laboratory experiments and clinical observations, are high concentrations of nitrates. After development of tolerance, on allowing a nitrate-free interval to intervene, the attenuated effects rapidly resume. Consequently, we investigated the hypothesis that tolerance could be avoided by an intermittent administration of nitrates which prevented accumulation of high serum concentrations. This was confirmed in two placebo-controlled, double-blind studies. Both during treatment with 20 mg ISDN in the morning and at midday as well as with the once-daily administration of 120 mg ISDN sustained-release form in the morning, there was an unequivocal anti-ischemic effect without tolerance development together with a significant reduction in the rate of anginal attacks and nitrate consumption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541419 TI - [Long term therapy of coronary heart disease with 120 mg slow release isosorbide dinitrate once a day. Study of duration of action and development of tolerance]. AB - Twenty-one patients (3 women, 18 males, mean age 55.7 +/- 6 years) with coronary heart disease proven by coronary angiography entered a double blind randomised study with isosorbide dinitrate slow release 120 mg once a day. 2, 12 and 24 hours after acute medication patients underwent a symptom-limited exercise-ECG. The following parameters were measured: ST-depression, blood pressure, heart rate and working capacity. After one week of therapy the same parameters were measured to look for the development of tolerance. Two and twelve hours after acute medication working capacity increased to 220% and 139% respectively. After 24 hours there was no statistically significant effect. The sum of ST-depression in three leads decreased from 4.85 +/- 3.02 mV to 1.87 +/- 0.96 mV (38.5%; p less than 0.05) 2 hours after medication, and to 2.10 +/- 1.73 mV 12 hours after medication. 24 hours after medication there was still a slight but not significant reduction of ST-depression. There was no statistically significant effect in the placebo group. After one week of therapy there was a slight reduction of action, but no development of tolerance. PMID- 3541420 TI - [Intraindividual dose-response relationship of sustained-release Elantan]. AB - Fifteen patients with coronary artery disease and stable angina pectoris were included in a double-blind, randomized, cross-over study. The patients received 25, 50 and 100 mg isosorbide-5-mononitrate, as well as a placebo, for subsequent one week periods. On the 7th day of each treatment period, 8 h after medication, an exercise test was performed. A highly significant (p less than 0.001) and dose dependent reduction of the sum of the ST-segment depression was observed at similar work loads: 28.6%, 46% and 63.5% decreases occurred with the 25, 50 and 100 mg isosorbide-5-mononitrate doses, respectively. Compared to placebo, the frequency of anginal attacks and the consumption of nitroglycerin also decreased highly significantly (p less than 0.001) with all three doses. Isosorbide-5 mononitrate plasma levels (8 h post-application) increased linearly with the dose; amounting to 228 +/- 53, 485 +/- 93 and 991 +/- 177 ng/ml at the 25, 50 and 100 mg doses of the sustained-release medication forms, respectively. PMID- 3541422 TI - Scanning electron microscopic study on isolated islets. I. A new isolation method of pancreatic islets. PMID- 3541421 TI - Enhanced platelet sensitivity to prostacyclin after isosorbide-5-mononitrate in patients with stable angina pectoris. AB - Recently the possibility that nitrates inhibit platelet function in man has been explored in vitro and in vivo. We have studied the effect of isosorbide-5 mononitrate (ISMN), a stable and long-acting organic nitrate, on platelet function in vivo. Given orally within the current therapeutic range, the drug has practically no effect on platelet aggregation nor thromboxane generation in platelet-rich plasma in response to ADP, collagen, arachidonate, epinephrine and PAF. Synergistic effects of prostacyclin and ISMN on inhibition of ADP-induced platelet aggregation have been observed. Thus, local inhibition of platelet aggregation might not have been detectable, due to the short half-life in vitro of prostacyclin. PMID- 3541423 TI - 14C-desferrioxamine B: uptake into erythrocytes infected with Plasmodium falciparum. AB - Plasmodium falciparum-infected human erythrocytes (early trophozoite stages) and non-infected erythrocytes were incubated in 1.7 mM 14C-desferrioxamine B (specific activity 1 microCi/2.6 mg desferrioxamine B). After 270 min the cells were washed and the radioactivity was measured in the cell pellet and, after lysis, in cytoplasm and membranes. The results indicate that Desferrioxamine B can the red blood cell and pass through the parasite membrane and that the parasites are killed by the intracellular action of the chelator. PMID- 3541425 TI - Orally administrable brucellosis vaccine: Brucella suis strain 2 vaccine. AB - An orally administrable brucellosis vaccine, Brucella suis strain 2 vaccine was developed in China. The characteristics and merits of the vaccine are described. It is effective for oral vaccination of sheep, goats, cattle and pigs and has been widely used for prevention of animal brucellosis in China over the past 15 years. About 30-40 million doses of the vaccine are produced every year. PMID- 3541424 TI - Immunity to Litomosoides carinii in Mastomys natalensis. II. Effects of chemotherapeutically abbreviated and postpatent primary infections on challenges with various stages of the parasite. AB - Naive Mastomys natalensis, Litomosoides carinii-infected M. natalensis at a postpatent stage of the infection and L. carinii-infected M. natalensis treated chemotherapeutically with furazolidone (FUR), FUR and diethylcarbamazine (FUR/DEC) or amoscanate (AMOS) were challenged by either injection or implantation of 40 third stage larvae (L3, s.c.), 40 fourth stage larvae (L4, 16 days old, i.p.), 20 male and 20 female preadult worms (36 days old, i.p.), 12 adult female worms (i.p.) or 6 X 10(6) microfilariae/kg (i.v.). Microfilaraemia in animals challenged at a postpatent stage (independent of the kind of challenge), was either totally suppressed or at least greatly reduced. Necropsy of L3-challenged animals showed that neither the length of the worms nor their content of morphologically intact, intrauterine stages was affected. Infected, treated animals challenged with developing stages (L3, L4 and preadult worms) showed reduced levels of microfilaraemia (by up to 75%). Dissection of AMOS treated, L3-challenged animals showed that both the developmental rate and the fertility of the worms were affected. Microfilaraemia was also reduced after implantation of adult worms into treated animals. This was independent of the interval between treatment and challenge (44-150 days) except in animals challenged 10 days after AMOS-treatment, which showed no difference from naive controls. However, infected, treated M. natalensis, cotton rats and gerbils did not develop immunity against intravenously injected blood microfilariae. PMID- 3541427 TI - Hepatitis B immunization of newborns according to a two dose protocol. AB - Experimental hepatitis B immunization trial in newborns was carried out in Burundi. Newborns were randomly divided into vaccine and control groups. Vaccinated newborns were given two injections of hepatitis B vaccine: one at birth and another 2 months later. A booster dose was given at 12 months of age. Results obtained show that two months after the second dose of HB vaccine, 96.8% of the vaccinated babies had anti-HBs; at the age of one year this figure had fallen to 83.8%. Six months after the booster dose, 95.6% were anti-HBs positive, with a geometric mean titre of 214 mIU ml-1. The anti-HBs responses in these infants was compared to those observed in previous studies performed in Senegal in infants (same protocol) or in newborns (3 dose protocol). The anti-HBs responses were lower in terms of mean titre values in neonates who received the two dose protocol than in older children and in neonates who received three doses at one month intervals. Vaccine efficacy was monitored during a two year period in neonates both immunized and nonimmunized. Protective efficacy was found to be 100% if considering HBsAg positive events and 75% if considering all HBV events (HBsAg and/or anti-HBc positive). PMID- 3541426 TI - Intradermal hepatitis B vaccination in an abbreviated schedule. AB - Two low-dose intradermal regimens for hepatitis B vaccination were compared with the standard 1 ml dose administered intramuscularly to healthy, 22-42 year old individuals. All regimens were administered in an abbreviated time schedule. Nineteen individuals (ID-1 group) received three 0.1 ml (2 micrograms) doses intradermally at times 0, 1 month and 4 months. Twenty-four individuals (ID-2 group) received two injections of 0.2 ml (4 micrograms) each intradermally at time 0 and one 0.1 ml (2 micrograms) injection 4 months later. Twenty individuals (IM group) received the recommended three 1.0 ml (20 micrograms) doses intramuscularly at times 0, 1 month, and 4 months. No significant adverse reactions were attributable to the intradermal administration of vaccine although the majority of vaccinees developed small areas of induration and hyperpigmentation at the injection site that persisted for several months. One month following the last injection, all vaccinees had developed anti-HBsAg antibodies. One hundred percent of ID-1 and IM vaccinees and 95% of ID-2 vaccinees had protective levels of antibody (greater than or equal to 10 mIU ml 1). The geometric mean titre (GMT) for the IM group (2692 mIU ml-1) was somewhat higher than for the ID-1 (1230 mIU ml-1) and the ID-2 (851 mlU ml-1) groups, but the differences were not statistically significant. Since anti-HBs antibodies are thought to confer protection against hepatitis B, these results suggest that a shortened regimen of intradermal vaccine may be effective in healthy adults. However, no efficacy study has yet been done with intradermal hepatitis B vaccine. PMID- 3541428 TI - An evaluation of second generation tissue culture rabies vaccines for use in man: a four-vaccine comparative immunogenicity study using a pre-exposure vaccination schedule and an abbreviated 2-1-1 postexposure schedule. AB - In a double-blind comparative trial the immunogenicity of three new tissue culture rabies vaccines was evaluated, using a commercial human diploid cell vaccine (HDCV) lot as the reference. Two different vaccination regimens, a pre exposure schedule, and an abbreviated 2-1-1 postexposure schedule (two doses of the vaccine applied bilaterally on day 0, with subsequent single doses given on days 7 and 21) were employed. In both, two of the new vaccines, purified chick embryo cell vaccine and purified Vero rabies vaccine, induced an antibody response equivalent to that of HDCV, while the geometric mean titres for the fetal bovine kidney cell vaccine were somewhat lower. The 2-1-1 regimen, a candidate regimen for economical rabies postexposure treatment, evoked a rapid and high titre antibody response with all four vaccines, peaking on day 14. PMID- 3541429 TI - Preliminary studies on the development of a vaccine for Pneumocystis carinii. I. Immunological and biochemical characterization. AB - Initial progress has been made toward the development of an experimental vaccine or immunostimulant for Pneumocystis carinii. Antigen derived from cell culture propagated P. carinii proved to be a potent immunogen in the rabbit and antibody thus produced demonstrated identity with intact murine and human lung-derived P. carinii organisms. Reactivity of the antibody with P. carinii soluble antigen in the blood of rats and human subjects with P. carinii pneumonitis (PCP) was demonstrated by the Ouchterlony technique, by counterimmunoelectrophoresis (CIE) and by latex particle agglutination (LPA). Murine-derived P. carinii antigen was utilized in an enzyme-linked immunosorbent assay (ELISA) for anti-P. carinii IgG and IgM produced in immunized rabbits and for human IgG antibody against P. carinii. Preliminary biochemical analysis of whole and solubilized cysts has been carried out, as well as slab gel electrophoresis and immunoblot profiling of solubilized organisms and naturally-occurring P. carinii antigen(s) in the blood of humans and rats with PCP. These studies represent an initial step toward the development of a vaccine or immunostimulant against PCP. PMID- 3541430 TI - [Learn more about history (Florence Nightingale)]. PMID- 3541432 TI - [Members of the Swiss Society of Angiology]. PMID- 3541431 TI - [Development and growth of the Swiss Society of Angiology 1961-1986]. PMID- 3541433 TI - New trends and methods in vascular pathology. An outlook into the future. PMID- 3541434 TI - [History of angiology, a twisted path in a labyrinth]. PMID- 3541435 TI - [Arterial reconstructions in the treatment of peripheral arterial occlusive disease. A historical retrospect]. PMID- 3541436 TI - [History of microcirculation from the clinical viewpoint]. PMID- 3541437 TI - [Historical aspects of the development of phlebologic therapy]. PMID- 3541438 TI - [Prevention of thrombosis in the first 3d of the 20th century. A retrospect]. PMID- 3541439 TI - [The history of phlebography]. PMID- 3541440 TI - [The founding and development of Russian schools of research on the physiology of aging]. PMID- 3541441 TI - [Current achievements, problems and prospects in the study of hereditary enzymopathies in humans]. PMID- 3541442 TI - Postinfectious glomerulonephritis. Subtypes, clinico-pathological correlations, and follow-up studies. AB - APGN (WHO: diffuse endocapillary proliferative glomerulonephritis) has long been considered one of the best described kidney afflictions, clinically characterized by the sudden development of a nephritic syndrome after a latency period following a nasopharyngeal infection or pyoderma. Proliferation of mesangial and endothelial cells in the endocapillary space, aggregation of polymorphonuclear granulocytes in the capillary lumina, and deposition of predominantly subepithelial immune complexes on the glomerular basement membrane (so-called "humps") are to the present day considered characteristic of renal morphology. However, the nature of the antigen (or antigens) as well as the determining mechanisms in the pathogenesis of APGN still are unclear. Considerable disagreement also exists regarding the prognosis. An analysis of APGN is once again presented to elucidate whether the morphological picture of APGN is really as uniform as has been generally assumed. A large number of kidney biopsies was examined and subjected to the triad of light microscopy (LM), immunofluorescence microscopy (IFM) and electron microscopy (EM). The findings, which were recorded at an early stage of APGN in all cases (i.e. during the first 9 weeks), were related to clinical data, age (childhood or adulthood), and etiology (e.g. streptococci, staphylococci). In addition, clinical and morphological follow-up over a period of up to 10 years in those cases, which had been carefully documented in the early stages, afforded an insight into the dynamics and the prognosis of APGN. Light microscopy of APGN showed a certain spectrum of variation even during the rather limited period of 9 weeks, due to the varying number of granulocytes and a varying degree of cell proliferation, as we could show semiquantitatively. With the triad of methods, especially by IFM and EM, three separate morphological patterns were distinguishable: the starry sky pattern, the garland pattern and the mesangial pattern. Based on clinico pathological correlations, these patterns were shown to permit the nosological subdivision of APGN. The following features merit special emphasis: The starry sky pattern occurred most often during the first few weeks, the mesangial pattern increased in frequency after the 3rd week, and the garland pattern could occur at any time. In the starry sky and garland patterns immunoglobulins (mainly IgG) generally appeared in combination with C 3. The mesangial pattern was characterized by C 3 appearing alone. These three immunohistological patterns, which also showed transitional and combined forms, had certain characteristic features by electron microscopy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3541443 TI - Variation in the temporal expression of overlapping baculovirus transcripts. AB - To investigate gene expression from the Autographa californica nuclear polyhydrolysis virus genome (AcNPV), complementary DNA (cDNA) was synthesized from polyadenylated RNA transcribed at 2 h and 10 h postinfection (p.i.) and then cloned into Escherichia coli using plasmid pUC-9. Eighteen 2 h cDNA plasmids were homologous to five distinct regions of the viral genome, while forty-nine 10 h cDNA plasmids were homologous to 15 regions including the five regions transcribed at 2 h. Temporal expression of polyadenylated RNA transcribed from diverse regions of the genome was examined using Northern blot hybridization with the above 2 and 10 h cDNA probes. All regions displayed overlapping sets of RNAs. In addition to HindIII-I/EcoRI-F (IF) and HindIII-B2/EcoRI-H (B2H), several, but not all, regions showed a sequential appearance of higher molecular weight RNAs as the infection progressed. Each overlapping set of RNAs exhibited unique characteristics including variations in the number of overlapping transcripts, their temporal regulation, and their relative abundance during the course of infection. PMID- 3541444 TI - In vitro encapsidation of plasmid DNA into human adenovirus empty capsids. AB - Plasmid DNA, added to extracts of human adenovirus type 3-infected HeLa cells, binds to empty viral capsids and can be purified using cesium density gradient centrifugation. The fraction of DNA bound depends on the amount of DNA added to the extract, and the capsid partially protects the bound DNA from digestion by DNase I. This capsid binding of plasmid DNA does not require the presence of the adenovirus DNA packaging sequence. However, the presence of the adenovirus packaging sequence in the plasmid results in better protection of the bound plasmid molecule from cellular nucleases. PMID- 3541446 TI - [What is still considered optimal today will be considered obsolete tomorrow]. PMID- 3541445 TI - [The early history of child and adolescent psychiatry. A review of research on historical aspects of the concepts of child psychiatric thought and processes]. AB - This sociohistorical essay attempts to trace back to the enlightenment the roots of contemporary child psychiatry. Five examples are used for illustrative purposes: the emergence of the concepts of human development, classification, compensation for deficits and psychohygiene (now mental hygiene), and the problems arising from the differentiation of schooling. Historical considerations provide numerous reasons for regarding child psychiatry as a medical specialty. These arguments would seem to outweight any need, deriving from economic pressure, to defend this field as an entity separate from its "parent disciplines" (pediatrics, psychiatry and psychosomatic medicine). PMID- 3541448 TI - [Geriatric aspects in dental prosthetics]. PMID- 3541447 TI - [Dentistry at the time of Frederick the Great]. PMID- 3541450 TI - [Malignant lymphoma of the eye]. AB - A case of primary malignant lymphoma of the eye in a 78-year-old woman is reported. A centroblastic non-Hodgkin lymphoma showed prominent involvement of the retina with massive serous retinal detachment. A review of the literature is given. PMID- 3541449 TI - [Delta virus superinfection in a patient with chronic viral hepatitis B]. AB - Hepatitis-Delta virus is a defective RNA virus enclosing the Delta antigen and genome within a coat of hepatitis B surface antigen (HBsAg). Prevalence of Delta virus is limited to individuals with hepatitis B infection. Two modes of infection have been identified: coinfection with hepatitis virus B of healthy individuals and superinfection of HBsAg carriers. In a prospective study of 485 liver biopsies from HBsAg seropositive patients, 320 non-replicative HBsAg carriers (without evidence of core antigen) were discovered. In only one of these cases could a Delta virus superinfection be confirmed by immunohistology. It caused a shift from a preexisting chronic persistent to a chronic active hepatitis. This is the first case of chronic Delta virus infection confirmed by immunhistology in the G.D.R. PMID- 3541452 TI - [Experiences with 1-piece cast bridge technics]. PMID- 3541451 TI - [The history of the Charite Pathology Museum, Berlin. 2. The collection of deformed specimens ("monsters")]. AB - The collection of human and animal anomalies which was legally required in Prussia in the 18th and 19th centuries is described. A governmental order given to physicians in 1776, initiated the collection. The regulations were further elaborated later. The actual working of the program is illustrated using examples and the route by which such preparations reached the Pathologic Museum, opened in 1899 in the Charite, is described. PMID- 3541453 TI - [The Konus crown--follow up and clinical evaluation]. PMID- 3541454 TI - [Accuracy of 1-piece cast bridges using Gisadent NCA]. PMID- 3541455 TI - Taxonomy of Staphylococcus aureus. PMID- 3541456 TI - [Microcalorimetric study of Salmonella]. AB - We investigated the heat production of 42 different Salmonella strains belonging to the serogroups A, B, C, D and E. Using Columbia- and Brain Heart Infusion Broth as growth media, we found 3 different types of heat profiles. Salmonella typhi and Salmonella choleraesuis showed thermograms which differed in shape from the remaining serotypes. The thermograms of one Salmonella dublin isolate which showed an atypical biochemical behaviour could not be put into proper relation to one of these 3 microcalorimetric types. PMID- 3541457 TI - Uterine secretions induce phagocytosis of Escherichia coli by neutrophils. AB - Phagocytosis of Escherichia coli by neutrophils was induced in the presence of uterine secretions. The phagocytosis-inducing activity of uterine secretions was not changed by heat-treatment (56 degrees C for 30 min). The phagocytosis inducing activity of uterine secretions from rabbits treated with estradiol-17 beta was slightly higher than that from control rabbits treated with vehicle. On the other hand, administration of progesterone significantly depressed phagocytosis-inducing activity of uterine secretions, and the inhibitory effect of progesterone was not affected by estradiol-17 beta. Neutrophils pretreated with uterine secretions did not phagocytize intact bacteria; in contrast, bacteria pretreated with uterine secretions were phagocytized by intact neutrophils. The present results suggest that there are heat-stable opsonins in uterine secretions which induce phagocytosis of bacteria by neutrophils, and that estrogen slightly enhances the opsonic activity of uterine secretions but progesterone depresses it and inhibits the promoting effect of estrogen. PMID- 3541458 TI - Effects of anti-Bacteroides-antibodies on Escherichia coli and different Bacteroides species in vitro and vivo. AB - Bacteroides species are known to cause synergistic pathogenicity in mixed infections with Enterobacteriaceae. In vitro studies showed that anaerobes may compete with aerobes for opsonisation thus interfering with the phagocytosis and killing of the latter by leukocytes. The present study investigated the effect of anti-Bacteroides-antibodies on in vitro phagocytosis of E. coli and on experimental mixed infections. It was shown that in vitro, B. fragilis suppressed the phagocytosis of E. coli by leukocytes only moderately. The addition of specific antibodies to the phagocytosis mixture could enhance this effect. However, antibodies in the absence of B. fragilis were also active suggesting a nonspecific mechanism such as blockade of Fc receptors. Prophylactic treatment with the immunoglobulin preparations failed to protect mice from experimental infections with E. coli and Bacteroides species. PMID- 3541459 TI - Adherence of vaginal and pharyngeal strains of group B streptococci to human vaginal and pharyngeal epithelial cells. AB - In vitro tests for adherence to human vaginal and pharyngeal epithelial cells were used to study the problem of tissue-specific tropism in group B streptococci (GBS). Twenty-two vaginal or pharyngeal clinical isolates of GBS (serotypes Ia, Ib, II, and III) were used. No significant differences in adherence to vaginal and pharyngeal epithelial cells were found between GBS from both sources: statistical analysis furnished no evidence for tissue-specific tropism. Serotype III vaginal GBS adhered better to vaginal and pharyngeal epithelial cells than did serotype III GBS strains isolated from the pharynx. However, pronounced differences in the level of adherence were found among strains of the same serotypes and from the same sources. Thus, the results obtained suggest that differences in adherence may rather be strain-dependent that type-dependent. PMID- 3541460 TI - [In vitro model for the study of the concentration kinetics of antibiotic combinations and their antibacterial activity]. AB - The concentration kinetics of combinations of antibiotics similar to those taking place after i.v. administration was simulated in an in vitro model taking into account the different half-life periods of the antibiotics. A hose pump was used for continuous supply of sterile nutrient to a liquid bacterial culture containing both antibiotics in a preselected concentration and for removal of fluid from the system at an identical flow rate. To account for the different half-life periods of the antibiotics, a solution containing the antibiotic having a longer half-life in a corresponding concentration was continuously added by pumping. Samples were taken at fixed intervals to determine bacterial counts and check the expected concentrations of active substance did not contain antibiotics. This model has been developed to enable a determination of the dynamic relationship between the course of concentrations of antibiotics and their antibacterial activity. To permit a statement on the synergistic, indifferent or antagonistic activity of the combination, in analogy to the FIC indices in the checkerboard technique, the relative reduction of the bacterial count by the combination as compared to the individual components at time t was calculated. The model has been demonstrated by the example of the combined action of azlocillin and gentamicin against a strain of Klebsiella pneumoniae. In a simple way, the model permits any increase in the number of combination partners having different half-life periods. The mathematical development of the model is explained in detail. PMID- 3541461 TI - Cultivation of Plasmodium falciparum using animal serum (horse, calf and bovine) as human serum substitute. AB - Horse, calf and bovine serum were successfully used as human serum substitutes in the in vitro cultivation of Plasmodium falciparum. Positive results were obtained only after gradually adapting the parasites to the substitute serum. Adapted lines were established within 4-5 weeks. 10% horse serum was observed to be the best substitute with growth rates comparable or even surprising that obtained in human serum. Pure calf or bovine serum supported stable growths of 20-30% less which was enhanced to comparable levels after addition of 1% glucose-peptone to the medium. Direct transfers of adapted cultures to human serum showed enhanced growth rates. Lower growth rates of adapted cultures (i.e. horse serum-adapted cultures) in other substitute sera (i.e. calf or bovine sera) were improved in subsequent subcultures. Similarly, there were no adverse effects when they were returned back to the substitute serum they were originally adapted to. PMID- 3541463 TI - [1 of the causes of a change in viability of Escherichia coli L1 in air]. AB - The possibility of changing the fatty acid composition of lipids in E. coli strain BB 20-14 by the introduction of ready lipid vesicles obtained from other E. coli strains into the growth medium has been established. Using E. coli strain BB 20-14 as an example, the dependence of the viability of bacteria on their fatty acid composition has been demonstrated. PMID- 3541462 TI - [Staphylococcal toxic shock exotoxin (its isolation and characteristics)]. AB - The method for obtaining the preparation of toxic shock exotoxin (TSE) has been developed. This method comprises the following operations: the sorption of the toxin from the culture fluid on Amberlite CG-50, elution, dialysis, gel chromatography in a column with biogel P-2, isoelectric focusing, and gel chromatography in a column with Sephadex G-75. TSE is a relatively thermostable protein with a molecular weight of 24,000. Its isoelectric point is 7.2. Monospecific antiserum to TSE with precipitating antibody titer equal to 1:16, identical to the reference serum (M. S. Bergdoll), has been prepared. This antiserum has shown no cross reactions with the homogeneous preparations of staphylococcal enterotoxins. PMID- 3541465 TI - [Characteristics of erythrocyte diagnostic agents studied using optical methods]. AB - The quantitative characterization of erythrocyte diagnosticums (ED) has been made by optical methods (light microscopy with the use of an image analyzer, model Magiscan 2, and the opacity spectrum technique). The following parameters of ED have been determined: the average of the major axis (5.25 +/- 0.57 micron for ED from Shigella sonnei and 5.53 +/- 0.50 micron for ED from Shigella flexneri), the ratio of semiaxes (p approximately equal to 3), the major axis length distribution, the refractive index (1.076 +/- 0.002). For controlling the concentration of ED the use of the opacity spectrum technique is recommended. PMID- 3541464 TI - [Ultrastructural study of intestinal bacteria grown on Endo- and Levine-type nutrient media based on nonfood raw materials]. AB - The comparative electron-microscopic study of several test strains (Salmonella typhi H-901, Shigella flexneri la 8516, and Escherichia coli 055) grown in experimental Endo and Levine media prepared on the basis of raw materials unsuitable for human consumption and in commonly used similar media prepared on the basis of sprat hydrolysate has shown the test strains grown in media containing aminopeptide and fodder yeast hydrolysate to retain their typical ultrastructure, which confirms the possibility of using these protein bases for the preparation of Endo and Levine media. PMID- 3541466 TI - [Hybridomas synthesizing monoclonal antibodies to Bordetella pertussis toxins]. AB - Hybridomas synthetizing monoclonal antibodies (McAb) to B. pertussis toxin (BPT) and endotoxin, or lipopolysaccharide (LPS), were obtained. The specificity of McAb to BPT was confirmed in the leukocytosis-stimulating factor neutralization test. Two hybridomas synthetized McAb, seemingly active against the common determinant of BPT and LPS. The McAb of one hybridoma reacted with the crude extract of BPT. PMID- 3541468 TI - [Effect of intestinal microflora on the pathogenesis of cholera intoxication]. AB - Germ-free minipigs, previously treated with bacteroids, develop cholinergic reaction after the intragastric administration of Vibrio cholerae exotoxin. The intensity of this reaction, disturbances in homeostasis, and the character of morphological changes depend on the dose of choleragen, the bacteroid strain, and the presence of the concomitant (Escherichia coli) and residual microflora in the intestine. PMID- 3541467 TI - [Chromosomal changes in patients with acute dysentery and their relation to immunologic shifts]. AB - The correlation between the dynamics of the occurrence of the class of lymphocytes without chromosomal associations and with two associating acrocentric chromosomes (CL0 + 2) and the course of the disease, as well as the development of immunity in patients with acute dysentery, has been detected. The positive correlation between the occurrence of CL0 + 2 and cell-mediated immunity reactions presupposes the possibility of using this cytogenetic characteristic for evaluating the cell-mediated immunoreactivity of lymphocytes. No essential changes in the frequency of chromosomal aberrations in lymphocytes have been found to occur at all periods of observation. PMID- 3541469 TI - [Bacteria of the genus Moraxella. Their systematics, differential diagnosis and the present status of the problem]. PMID- 3541470 TI - [Manifestations of genotypic and phenotypic heterogeneity in populations of Shigella sonnei and of humans at different phases of the development of the epidemic process]. AB - The study of the structure and developmental dynamics of S. sonnei populations and the state of local immunity to this infection in children under school age has revealed that the interaction of the heterogeneous populations of the parasite and the host is the internal motive force of the self-regulating phasic development of the epidemic process. In the course of this process complementary changes in the virulence of the infective agent and in the immunoresistance of children are generated on the basis of negative feed-back. PMID- 3541471 TI - [Phenomenology and molecular mechanisms of Shigella sonnei dissociation: its variability in model in vivo and in vitro systems]. AB - The dynamics of the accumulation of phase II S. sonnei in the infectious process in germ-free rats, during cultivation and in subcultures was studied. The in vivo variability of S. sonnei showed a sharply defined phasic character of the process with the periods of the apparent absence of phase II, the increase of its occurrence and stabilization with the preservation of S-forms in minor amounts. Kanamycin-resistant phase II accumulated in vivo more rapidly than in vitro. Cultivation with sodium desoxycholate was found to accelerate the process of disassociation. The characteristic feature of all dissociants detected in all systems was their plasmid profile: in phase I, plasmids of 120 and 60 Md, as well as small plasmids, were detected; in phase II disassociants, plasmid with a molecular weight of 120 Md was absent. The restriction analysis of total plasmid DNA by means of restrictase EcoR1 showed the absence of 3 fragments in phase II while other 13 fragments were retained. These results open prospects for the molecular cloning of the gene antigen of phase II. PMID- 3541472 TI - [Epidemiological monitoring in salmonellosis]. AB - The use of a model DZ-26 computer for the current analysis of salmonellosis and for processing laboratory data is analyzed. PMID- 3541473 TI - [Mechanism of glucose tolerance disorders in tumors located in the sellar diencephalic area]. AB - Clinical and biochemical examination carried out in 20 patients with tumors of the sellar-diencephalic area and 10 healthy persons revealed a dependence between functional disorders of the thalamus and hypophysis and the pancreatic beta cells, which was attended by the development of obesity in patients with large endosuprasellar tumors of the hypophysis and diminution of glucose tolerance in all patients. Hyperinsulinemia revealed during intravenous glucose tolerance test and reduced glucose tolerance are evidence of relative insular insufficiency and substantiate pathogenetically the inclusion of insulin in the complex of intensive therapy applied in the early postoperative treatment of patients with tumors located in the sellar-diencephalic area. PMID- 3541475 TI - [Identification of nuclei of the pretectal area during stereotaxic surgery for spastic torticollis]. AB - The neurons of mesencephalic nuclear structures were studied by microelectrode techniques for functional identification of the interstitial nucleus of Cajal during 18 stereotaxic operations on patients with torticollis. It is shown that the use of microneuronography for functional identification of structures of the pretectal region and mesencephalic structures bordering it is promising. The functional cellular complexes of these structures which respond selectively to voluntary movements of the eyes and head, rapid voluntary movements of the eyes, fixation and maintenance of the gaze, and combined movements of the eyes and head are characterized for the first time. In comparison with intracerebral radiological guiding points, the registration of these data makes possible intraoperative active search for functional neuronographically identified zones linked with the pathological mechanisms of torticollis and the performance of selective destruction with minimum volume of damage. PMID- 3541477 TI - CRNA reimbursement legislation continues to move. PMID- 3541476 TI - [Atypical method of suturing the median and ulnar nerves after extensive injuries]. PMID- 3541474 TI - [Use of the microelectrode method for differentiation of white matter from thalamic nuclei during stereotaxic procedures]. AB - Two hundred and three neurograms were recorded from the ventrolateral and reticular nuclei of the thalamus in 29 patients. Pulsed neuron activity was encountered in 116 cases. Reactions to motor tests were recorded from 26 neurons. The authors constructed maps of the location of the cerebral areas studied in relation to the main intracerebral guiding points. A large number of cells (44%) with rhythmic pulsed discharges with a frequency of 3-7 Hz were found in patients with parkinsonism and double athetosis. A great variability of background and induced activity of the thalamic nuclei under similar conditions of study was revealed. PMID- 3541478 TI - Anesthetic implications of the acquired immunodeficiency syndrome (AIDS): Part I. PMID- 3541479 TI - Council on Accreditation of Nurse Anesthesia Educational Programs/Schools. List of recognized educational programs/schools/w/revisions (current status as of December, 1986). PMID- 3541481 TI - A specific histochemical marker (lectin Ricinus communis agglutinin-1) for normal human microglia, and application to routine histopathology. AB - Microglia were demonstrated in paraffin-embedded human nervous tissues with an avidin-biotin peroxidase method and Ricinus communis agglutinin-1 (RCA-1). Specific staining was observed in cell bodies and processes of microglia. Although endothelial cells and blood cells reacted with RCA-1, they were easily distinguished morphologically from microglia. Astrocytes, oligodendrocytes, and neurons did not react with RCA-1. These results suggest that RCA-1 can be used as a new histochemical marker for microglia in normal human brain. PMID- 3541480 TI - S-antigen immunoreactivity in human pineal glands and pineal parenchymal tumors. A monoclonal antibody study. AB - Using a four-step immunoperoxidase (PAP) method and the monoclonal antibody MAbA9 C6 (MAbA9-C6), which defines an epitope of the retinal S-antigen (S-Ag), we investigated the S-Ag immunoreactivity in human fetal, newborn, infantile and adult pineal glands and in 13 human pineal parenchymal tumors. S-Ag immunoreactivity was demonstrated in a few cells in one of the four fetal and in both infantile glands. Eight of nine adult pineal glands contained isolated MAbA9 C6-positive cells. In two of seven pineocytomas showing neuronal or gangliogliomatous differentiation a few scattered cells displayed S-Ag positivity; two of four pineoblastomas contained small groups of strongly immunoreactive neoplastic cells; two malignant pineocytomas did not demonstrate any S-Ag immunoreactivity. Our results indicate that isolated cells in human pineal gland retain some of the cytochemical characteristics of photoreceptor cells recognized by the MAbA9-C6, and that S-Ag immunoreactivity may be occasionally expressed in pineal parenchymal tumors. PMID- 3541483 TI - Pitfalls in sonographic imaging of the incompetent uterine cervix. AB - Artifacts interfering with sonographic imaging of the uterine cervix in pregnancy are described. Increasing the amount of fluid in the urinary bladder closes the cervix and alters the configuration of the lower uterine segment, while increased intra-uterine pressure results in reciprocal changes. Angulation of the transducer and manual pressure thereon distort sonographic findings. It is concluded that, contrary to recent reports in the literature, sonography cannot reliably demonstrate changes in cervical compliance during pregnancy. Vaginal examination remains the ultimate diagnostic modality for the diagnosis of the incompetent cervix, while sonography may be used as an adjunct only. PMID- 3541482 TI - Pregnancy following kidney transplantation. AB - Following kidney transplantation, 20 women gave birth to 24 infants after the 28th gestational week. All babies were singletons, alive, and free from malformations. The mean weight was 2,595 g (range 1,420-3,200 g) and the mean gestational age was 37.8 weeks (range 32-40 weeks). The cesarean section rate was 75%. On dividing the patients into low- and high-risk groups, the rate of pre eclampsia, prematurity, and intra-uterine growth retardation was 2-3 times as high in the high-risk as in the low-risk group. No patients experienced graft rejection during the pregnancy but, within 3 months after delivery, two rejection episodes occurred. Later, a further 5 patients experienced graft rejection. All infants developed normally. We conclude that pregnancy following renal transplantation generally has a normal outcome and that the function of the transplanted kidney is unaffected by the pregnancy. PMID- 3541484 TI - The Nordic contribution to the English language twin literature. AB - This project was inspired by the extensive contribution of Nordic researchers to the English language twin literature. The purpose of the study was to compile a source bibliography of twin literature written at Nordic institutions. The bibliography compiled as a supplement for this paper provides as complete a survey as is possible to obtain in the United States. Our search began with a Medline Computer data base. To make our survey more complete, we cross-referenced and added to this using the Index Medicus, the National Institute of Mental Health Bibliography, Excerpta Medica, specific article references, references provided by Nordic university libraries and Gedda's Estudio dei Gemelli. The full bibliography of 313 references is available at no cost from the Center for the study of multiple Birth, Rm. 476, 333 E. Superior, Chicago, Ill. 60611, U.S.A. PMID- 3541485 TI - Intra-uterine growth retardation and gestational age. AB - This is a 5-year material of all singleton SGA (small for gestational age) infants born at the University Hospital in Lund, 1977-81, with a long-term follow up. After the introduction of routine ultrasound scanning for all pregnancies in weeks 17 and 32 (1980-81), the rate of SGA-diagnosis before birth increased from 54.6% to 74.5% and the long-term outcome improved for term SGA infants. All women were treated according to a uniform policy regarding the termination of pregnancy -even in the early preterm period, if signs of fetal jeopardy appeared. More than half of all infants born before gestational week 34 died (40.0%) or showed major neurological handicap (16.0%) in spite of all being delivered by cesarean section. The corresponding figures for infants born in weeks 34-36 were 8.3% (deaths) and 8.3% (major handicaps); the cesarean section rate in this group was 83.3%. Term SGA-infants had an excellent outcome, with a low rate both for postnatal death (0.5%) and for major handicaps (2.0%). The results suggest that despite a high rate of antenatal diagnosis of intra-uterine growth retardation, and a uniform management of the pregnancy and the newborn, the high rate of cesarean delivery, and also intensive neonatal care, preterm SGA-infants are exposed to a greater risk of death or severe handicap. PMID- 3541486 TI - Maternal smoking reduces prostacyclin formation in human umbilical arteries. A study on strictly selected pregnancies. AB - Production of prostacyclin (PGI2)-like activity in umbilical arteries in vitro was evaluated in 38 selected newborn infants. Nineteen of the mothers of these infants were habitual smokers and the remaining 19 were non-smokers. To rule out the possibility of disturbing effects of drugs or other factors, the newborn infants and their mothers fulfilled strict criteria regarding normality and control of drug intake. The infants of habitual smokers (greater than 5 cigarettes/day) (n=19) were compared with a control group (n = 19) with non smoking mothers. Smokers' babies had lower birth weights than the controls (3,500 +/- 440 vs 3,900 +/- 420 g, p less than 0.001). Production of PGI2-like activity was estimated by a bioassay technique. Umbilical arteries of smokers' infants produced significantly less PGI2-like activity (139 +/- 78 ng/g arterial tissue) than those of the controls (201 +/- 87 ng/g) (p less than 0.05). As expected, the two groups differed highly significantly regarding serum levels of markers for exposure to cigarette smoke, but these levels did not correlate to formation of PGI2. Decreased production of PGI2-like activity in umbilical vessels might have an impact on nutritive blood flow and oxygen transport, especially in situations of asphyxia. PMID- 3541487 TI - Ultrasonic diagnosis of fetal ascites and toxoplasmosis. AB - The ultrasonic diagnosis of fetal ascites caused by Toxoplasma Gondii is presented. When a diagnosis of fetal ascites without obvious etiological malformation is established, toxoplasmosis should be suspected. A serological test should be performed, in view of the possibility of antenatal treatment of the fetus. PMID- 3541488 TI - Surveillance of the cervix by ultrasonography at cervical incompetence. AB - Three patients with cervical incompetence were followed by repeated ultrasonic examination of the cervix in the second and third trimesters. Cervical incompetence can be easily guided according to the ultrasonic appearance of the cervix, thereby avoiding vaginal palpation. PMID- 3541489 TI - [Osteoporosis. Latest findings in the literature]. PMID- 3541491 TI - Embryonal rhabdomyosarcoma in nude mice and in vitro. AB - A transplantable tumor strain designated YNnu and a cultured cell line designated YN were established from the human paratesticular rhabdomyosarcoma of a 15-year old boy. In vitro the cells showed ultrastructural features of immature mesenchymal cells, and a few cells were labeled by antibodies to myoglobin and/or desmin. In nude mice, the cells became to contain numerous myofibrils with Z bands, and considerable number of cells reacted with anti-myoglobin and/or anti desmin antibodies. We conclude that spindle-shaped or small round cells are the most immature rhabdomyoblast with multiplicity for cellular differentiation. PMID- 3541490 TI - Blast crisis of chronic myelogenous leukemia. Morphologic and immunological features. AB - The morphological and immunological features of 22 patients with transformation of Philadelphia chromosome (Ph1) positive chronic myelogenous leukemia (CML) were evaluated. Patterns of differentiation in blast crisis were as follows: myeloblastic 5 cases, lymphoblastic 6 cases, basophil differentiation 4 cases, monoblastic 3 cases, megakaryoblastic 1 case, and mixed 3 cases (myeloblastic and lymphoblastic, monoblastic and lymphoblastic and panmyelosis). Three cases were diagnosed as acute lymphoblastic leukemia (ALL) in early stage. After complete remission was achieved rapidly with vincristine and prednisolone, the hematological findings showed CML features. The immunological phenotype of lymphoblasts in lymphoid crisis was Ia+, CALLA+, surface and intracytoplasmic immunoglobulin negative. It was suggested that the neoplastic cells in two cases had B cell differentiation because of B1 or B4 positive. The terminal deoxynucleodidyl transferase (TdT) activity was examined by immunoperoxidase and immunofluorescence techniques on 11 cases. All TdT+ cells were the small lymphoid cells in 5 cases of lymphoid crisis and one case in mixed type. Heterogeneity of the terminal phase of CML was recognized. It was thus suggested that blast crisis of CML occurred in the pluripotent stem cell. PMID- 3541492 TI - Clear cell chondrosarcoma. A report of two cases and review of literature. AB - Two cases of clear cell chondrosarcoma located in the distal femur and proximal humerus are reported. Both patients were men aged 35 and 51 years. Their initial symptom was a pathologic fracture. Roentgenographically, one patient showed a purely lytic lesion and another lytic with centrally radiodensity. Microscopic examination revealed that the tumor cells have a centrally placed vesicular nucleus surrounded by a clear cytoplasm, with distinct boundaries. Their cytoplasm stained with S-100 protein by the peroxidase-antiperoxidase method. We found 36 reported cases (including the two reported here), and delineated the clinico-pathologic characteristics of the disease. PMID- 3541493 TI - Neoplastic nature of argyrophil cells in urachal adenocarcinoma. AB - The histological, histochemical and electron microscopic features of the metastatic tumors of an urachal adenocarcinoma, were presented. Metastatic tumor nodules in the lungs and brain as well as the primary tumor showed tubular adenocarcinoma containing many argyrophil cells. Immunoperoxidase examination revealed three kind of endocrine cells which contained different endocrine hormones. Electron microscopic examination showed small, round endocrine granules in the endocrine cells and desmosome-like complexes in between these cells and the adjacent glandular neoplastic cells. These findings suggested that the endocrine cells were neoplastic in nature and originated from primitive neoplastic cells as well as glandular neoplastic cells. PMID- 3541494 TI - Effects of captopril on the urinary excretion of prostanoids and kallikrein in spontaneously hypertensive rats. AB - The possible roles of vasodilatory prostanoids and the kallikrein-kinin system in the antihypertensive action of the angiotensin-converting enzyme (kininase II) inhibitor captopril were examined in spontaneously hypertensive rats. Captopril (20, 50 or 100 mg/kg daily orally) reduced blood pressure markedly and dose dependently. It also increased water consumption and urine excretion, measured on the 5th day of treatment. The 24-hr urinary excretion of PGE2 was not changed, whereas that of PGF2 alpha and TxB2 tended to be enhanced. A clear increase, significant with all doses of captopril, occurred in the urinary excretion of 6 keto-PGF1 alpha. Kallikrein excretion in urine was suppressed by the two larger doses of captopril. The markedly augmented urinary excretion of 6-keto-PGF1 alpha, the stable metabolite of vasodilatory prostacyclin (PGI2), suggests that increased prostacyclin production may participate in the antihypertensive mechanism of captopril. Vasodilatory kinins can also contribute, since the captopril-induced decrease in kallikrein may reflect accumulation of kinins due to their reduced metabolism. PMID- 3541495 TI - Muscarinic receptor density in the rat urinary bladder after denervation, hypertrophy and urinary diversion. AB - Parasympathetic denervation of the urinary bladder results in supersensitivity to muscarinic agonists and in bladder hypertrophy. In the present study, the effects of denervation on the muscarinic receptors in the rat bladder were investigated, using a receptor binding technique with (-)3H-QNB as radioligand. The density of muscarinic receptors was increased in denervated, hypertrophied bladders but it was decreased, below that in control bladders, when the development of hypertrophy was prevented by urinary diversion. A decreased receptor density was also found in innervated bladders after urinary diversion, whereas the receptor density was unaffected by hypertrophy alone. Competition experiments with methacholine revealed no changes in the agonist binding properties of the receptors. When the present data are combined with those in previous functional studies, it seems unlikely that the muscarinic receptors in the bladder are involved in the development of supersensitivity. It is suggested that the density of muscarinic receptors in the bladder may be related to the bladder function. PMID- 3541496 TI - Mobile intraventricular cyst of the third ventricle treated with stereotactic puncture. Report of a case. AB - A case of a pedunculated arachnoid cyst within the third ventricle is presented. The cyst was small so as not to appear as a significant expanding lesion on CT. The clinical history, however, suggested intermittent increase of the intracranial pressure. On CT there was some widening of the lateral and third ventricles, while the fourth ventricle had normal width. This finding in combination with the clinical history prompted further neuroradiologic examinations, including pneumoencephalography and ventriculography. The presence of a pedunculated mobile cystic lesion within the third ventricle was shown and its nature further elucidated by stereotactic puncture combined with contrast injection into the cyst. After emptying of the cyst, the patient has been free of symptoms during an observation time of 2 years. The diagnostic and differential diagnostic aspects are discussed and the value of traditional neuroradiologic methods emphasized. PMID- 3541497 TI - Ultrasonic guidance for percutaneous puncture and drainage in acute cholecystitis. AB - Thirteen patients presenting with acute cholecystitis and considered high surgical risks were treated with a percutaneous needling procedure under ultrasonic guidance. The gallbladder was drained following simple needle puncture in six cases while a drainage catheter was inserted in seven. A premedication of 0.5 mg of atropine and 50 mg of pethidine was given. The gallbladder became decompressed in all cases, and pain was instantly relieved. Impacted stones were freed from the cystic duct in two cases and from the papilla of Vater in another two cases. The patients' condition improved and elective cholecystectomy was performed in four cases, while a further three patients await surgery. In five cases the acute stage of the disease subsided; surgical treatment was refrained from because of gallbladder carcinoma with metastases in one patient and other diseases in the remainder. One patient died of gastric carcinoma. One patient with ischemic heart disease had systemic hypotension for six hours after the drainage and one had slight haemorrhage for four hours. No other complications were noted. In addition, the procedure was also carried out as a diagnostic study in one patient in whom the site of bile leakage was determined by filling the biliary tree with contrast medium from the gallbladder. Guided aspiration and percutaneous drainage of the gallbladder is helpful in patients with severe acute cholecystitis attended with a high surgical risk. PMID- 3541498 TI - Interleukin 1 and the pathogenesis of inflammatory diseases. PMID- 3541499 TI - Acupuncture in severe, stable angina pectoris: a randomized trial. AB - Twenty-six patients with stable angina pectoris, resistant to medical treatment, were randomized to either active or sham acupuncture in a single-blind design. Sham acupuncture was defined as the insertion of needles in a point within the same spinal segments as the active acupuncture, but outside the Chinese meridian system. The effect was evaluated from anginal attack rate, nitroglycerin consumption and exercise tests. Compared to patients receiving sham acupuncture the patients receiving active acupuncture increased cardiac work capacity significantly, expressed as dPRP (difference in pressure-rate-product between rest and maximum exercise) and maximal PRP during exercise (p less than 0.001). None of the other variables showed any significant difference between the two groups. Concerning exercise tolerance the median difference was 138 Wmin (95% confidence limits - 12.5 to 325 Wmin), concerning anginal attack rate the median difference was 29.5% (95% confidence limits 55% to -11%) and with regard to nitroglycerin consumption the median difference was 5% (95% confidence limits +67% to -44%). No significant effect of sham treatment was observed, no adverse effect was observed. We suggest that acupuncture may improve cardiac work capacity in patients with angina pectoris, refractory to medical treatment. PMID- 3541500 TI - Effects of beta 1-adrenoceptor blockade in the treatment of hypertension during pregnancy in diabetic women. AB - The effects of beta 1-blockade were investigated in 18 hypertensive pregnant diabetic women. The same women served as controls, covering a period just before therapy. The blood pressure was reduced in 14 women (p less than 0.01). The change in blood glucose homeostasis was statistically not different from the control period. Insulin doses were not affected. The fetal heart rate was affected by therapy, causing a decrease in baseline rate (p less than 0.05) and in acceleration amplitude (p less than 0.05). Although the incidence of suspect fetal distress, intrauterine growth retardation and preterm delivery was high, all surviving infants had normal Apgar scores at 5 and 10 min. Perinatal mortality consisted of one stillbirth. Except for respiratory problems, the incidence of neonatal complications was low. All survivors were healthy at follow up. We found beta 1-blockade to be effective and safe in this group of high-risk pregnancies, and suggest it as an alternative for anti-hypertensive therapy in diabetic pregnancy. PMID- 3541501 TI - Ketoconazole is effective against the chronic mucocutaneous candidosis of autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED). AB - Ketoconazole was administered as a single daily oral dose of 200 mg to 12 patients with chronic mucocutaneous candidosis (CMC) of autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED). The study was double blind and placebo-controlled, with 4-month therapy periods and crossover, and transfer to open-label ketoconazole therapy in cases of failure. During the double-blind trial, all six initially ketoconazole-treated patients showed a clear clinical and mycological improvement. In contrast there was no change or worsening in the initially placebo-treated group (p = 0.001). Oral candidosis cleared up in all patients, but more rapidly (less than 2 weeks) in those aged less than 25 years than in older patients (4-10 weeks; p = 0.001). Similarly, nail candidosis improved more rapidly in the younger group. All patients had a recurrence of the candidosis during 36-48 months of post-therapy follow-up. The recurrences likewise responded to ketoconazole. In one patient serum transaminase activities were transiently and marginally elevated during 2-6 weeks of therapy. PMID- 3541502 TI - Thyroid function after surgical treatment of nontoxic goitre. A randomized study of postoperative thyroxine administration. AB - Following thyroid resection for nontoxic goitre, 29 euthyroid patients were randomly allocated to no medication or to 0.2 mg levothyroxine daily (17 and 12 patients). The two groups were comparable in age, sex, extent of surgery and thyroid pathology. The patients were free from other endocrine disorders and had no other medication. Serum TSH, T4 and T3 were measured and T3-resin test performed preoperatively and 14 days and 3, 6, 12 and 18 months postoperatively. All values were within normal range. Only at the 3-month follow-up could statistically significant intergroup differences be observed, with T4 higher in the thyroxine-treated and TSH higher in the untreated group, but the outset values were thereafter regained. The T3 values in both groups were slightly reduced immediately after the operation. There was no recurrence of goitre in the 18-month observation period, and none of the findings suggested that routine thyroxine treatment is of value after resection of nontoxic goitre "in Denmark". PMID- 3541503 TI - On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment. AB - Thrombotest (TT) values were studied in patients fed an ordinary diet and on continuous and well controlled warfarin therapy because of deep venous thrombosis or pulmonary embolism. The aim was to characterize the effect of single and multiple administrations (daily during one week) of vitamin K1 (Konakion), vitamin K-rich vegetables such as spinach and broccoli, and table wine. Single administration of 250 micrograms vitamin K1, 250 g spinach, 250 g broccoli and 37.5 cl wine did not result in TT-values outside the therapeutic range. However, when Konakion, broccoli and spinach were given daily during one week the TT values tended to rise above the therapeutic limit, requiring dose adjustment. On the basis of this study it appears that excessive intake of vitamin K-rich food and a moderate intake of alcohol on one occasion may be permitted during anticoagulant therapy. PMID- 3541504 TI - Cavum vergae cyst as a cause of hydrocephalus, "almost forgotten"? Successful stereotactic treatment. AB - Cavum vergae cysts (CVC) are cerebral midline malformations, which usually have no clinical manifestations. In rare cases, however, non-communicating cysts can cause hydrocephalus by obstruction of the aqueduct. Initially, from 1930 to 1960 operative treatment consisted in open cysto-ventriculostomy, i.e. establishing a communication between CVC and the ventricles, via a transventricular approach. In the era of CT, symptomatic treatment of the hydrocephalus by ventriculo-atrial or ventriculo-peritoneal shunts is preferred. All the wellknown complications of shunting are encountered. Based on the experience of our cases of CVC with clinical manifestations, we here propose a definitive causal treatment which can be achieved by draining the cyst contents into the ventricles via a stereotactically introduced catheter. PMID- 3541506 TI - Prognosis and prediction of outcome in comatose head injured patients. AB - Recent studies on the prognosis of comatose head injured patients have identified single powerful prognostic features at various time points during the first month after onset of coma. Using appropriate statistical methods even more powerful combinations of prognostic features can be selected. At each time point, optimal prediction requires sets of only 3 to 5 features. These features include depth and duration of coma as assessed by the Glasgow Coma Scale, pupil reactivity to light, age in decades, and spontaneous and reflex eye movements. In individual new patients, bedside predictions are now possible, e.g. using a booklet with prognosis tables like the one used in Rotterdam. Doctors actually learn by using these tables as they retain some of the information. However, the main application is that these tables permit one to evaluate whether differences in survival rates in different centres with different management regimes are due to a difference in management efficacy or to a difference in initial severity of injury. PMID- 3541507 TI - CBF in head injury. AB - In the last few years the possibility of measuring CBF by means of intravenous isotop injection technique and portable monitor has made the use of measuring CBF in the clinical setting of the brain injured patient of current interest. However, knowledge about the hemodynamics of the head trauma is inevitable for the interpretation of the CBF results. In this communication a short outline of the results obtained during the last decades studies about the hemodynamic of the damaged brain is given. The essence of these studies seems to be: The local level of CBF do not indicate the severity of the brain injury, as low as well as high flow may be seen initially in severely injured brain tissue. The oxygen uptake (CMRO2) is related to the severity of the brain trauma, as low CMRO2 correlate to poor clinical condition. In severely damaged brain tissue the autoregulation may appear normal (false autoregulation) whereas the autoregulation in moderately damaged tissue may appear impaired for weeks. The carbon dioxide response (CO2) is only impaired if the brain tissue is severely damaged. Thus, low CMRO2 and dissociation between apparently normal autoregulation and impaired CO2 response seem to predict poor outcome. PMID- 3541505 TI - Colloid cysts of the third ventricle. Open operative approach or stereotactic aspiration? AB - Colloid cysts of the third ventricle can cause hydrocephalus if they grow to the point where they occlude the foramina interventricularia. The operative approach via a craniotomy used to be the common method of treating these lesions. Now, in the era of CT- and MR-scanning, stereotactic aspiration should be preferred as an ideal method of simultaneously diagnosing and treating colloid cysts. Unlike open surgery, aspiration of colloid masses poses hardly any risk for the patient. Ten cases successfully treated by this technique are presented. PMID- 3541508 TI - Protein inhibitors of serine proteinases--mechanism and classification. AB - Protein proteinase inhibitors are widely distributed in plants, animals and microorganisms. They can be conveniently grouped since most frequently they inhibit proteinases belonging only to a single mechanistic class. Protein inhibitors of serine proteinases have been most extensively studied. They are strictly competitive inhibitors forming 1:1 complexes with the enzymes they inhibit. In these complexes, all activities of the enzyme are completely abolished. The inhibitors are substrates for the enzyme they inhibit at a unique peptide bond called the reactive site peptide bond (one for each inhibitory domain). However, compared to normal substrates where the enzyme-substrate and enzyme-product complexes dissociate very readily here, the complexes are very stable. Serine proteinase inhibitors can be divided into at least 13 families. Within each family the position of the reactive site and the closure of disulfide bridges can be inferred by homology. In enzyme-inhibitor complexes, about 10-15 residues of the inhibitor are in contact with the enzyme. Their specific nature strongly affects both the strength and the specificity of enzyme-inhibitor interaction. In all cases where the sequences of many inhibitors from the same family can be compared, the contact residues are not strongly conserved--instead, they are hypervariable. This raises major problems but also offers huge opportunities to those concerned with the role of inhibitors in biology and in medicine. PMID- 3541509 TI - Protease inhibitors in plant foods: content and inactivation. PMID- 3541511 TI - Control of plasma HDL levels after plasmapheresis. PMID- 3541510 TI - Severe hypoalphalipoproteinemia induced by a combination of probucol and clofibrate. AB - Observation of a markedly depressed HDL-cholesterol (5 mg/dL) in a patient with familial hypercholesterolemia (FH) receiving probucol (1 g/day) and clofibrate (2 g/day) prompted a review of all cases treated by this combination at our lipid clinic. Hypoalphalipoproteinemia (HDL-C less than 15 mg/dL) developed in 19 of 28 (70%) hyperlipidemic subjects who received this combination for an average of 1.5 years. This effect was sustained and reversible; it did not occur on either drug alone and was manifested on average 17 weeks after the combination was started. Plasma triglycerides increased significantly in most of those patients susceptible to this reduction in HDL-C. Plasma apolipoprotein A-I was decreased 82%, in proportion to the HDL-C fall, whereas apo A-II was lowered 65%. Since apo C-III concentrations tended to be high, the apo A-I/C-III ratio was markedly depressed. Apo E levels were unchanged and apo B levels reflected the high LDL concentrations of the underlying disease. An intermediate response was observed in subjects whose HDL-C remained well above 15 mg/dL on the combination. No deleterious side-effects could be attributed directly to the administration of the combined drugs in this high-risk group. One patient actually showed complete regression of xanthelasma and extensor tendon xanthomas of the finger on the combination. A parallel is drawn with Fish-Eye disease and the presence of the apolipoprotein A-I Milano variant, where similar HDL-C levels are observed in the absence of an increased atherogenic risk. It is mandatory to monitor plasma HDL-C in hypercholesterolemic patients treated with this combination, otherwise the pronounced HDL-deficiency could go unnoticed. PMID- 3541512 TI - Lecithin: cholesterol acyltransferase, a review and immunochemical studies. PMID- 3541513 TI - Metabolic interrelationships of HDL subclasses. PMID- 3541514 TI - Lecithin: cholesterol acyltransferase (LCAT) deficiency syndromes. PMID- 3541515 TI - Inhibition and activation of cholesteryl ester transfer and its significance in plasma cholesterol metabolism. PMID- 3541516 TI - Apolipoprotein C-II deficiency. PMID- 3541518 TI - The genetics and molecular biology of apolipoprotein CII. PMID- 3541517 TI - Primary lipoprotein lipase deficiency. AB - The enzyme lipoprotein lipase plays a central role in the processing of energy in the form of calorically dense triglyceride. Classical LPL deficiency usually presents in childhood with the multiple manifestations related to chylomicronemia. Many patients with genetic variations have been noted who differ in one of many ways from the classical patients. With the development of techniques to measure enzyme mass and to study gene expression, the molecular defects in each of these families should become evident. PMID- 3541519 TI - The apo E-system: genetic control of plasma lipoprotein concentration. PMID- 3541520 TI - The role of apolipoprotein E in modulating the metabolism of apolipoprotein B-48 and apolipoprotein B-100 containing lipoproteins in humans. PMID- 3541522 TI - Modifications and degradation of high density lipoproteins. AB - It is evident that lipoprotein modifications, degradation and clearance from plasma and interstitial compartments involves both cellular and extracellular processing. Cellular uptake of the intact particle as a whole and/or selective removal of constituent apoproteins and lipids by various parenchymal cells goes on continuously. Regulation of these processes undoubtedly varies tissue to tissue and much remains to be clarified in human tissues in vivo. The metabolic effects of chemical, proteolytic, and lipolytic modification of lipoproteins secondary to transient cellular encounters (e.g. during transit through endothelial barriers, or reversible binding to cells) on apolipoprotein clearance remains to be defined. It is likely that multiple post-secretory modifications occur and together represent subtle regulatory events that modulate lipid shuttle functions and cellular targetting properties of HDL particles. PMID- 3541521 TI - Speciation of HDL. PMID- 3541523 TI - HDL binding to human adipocyte plasma membranes: regional variation in omental and subcutaneous depots. PMID- 3541524 TI - Clinical, nutritional and biochemical consequences of apolipoprotein B deficiency. PMID- 3541526 TI - A family study of hypoalphalipoproteinemia. PMID- 3541525 TI - Familial hypoalphalipoproteinemia. PMID- 3541528 TI - Vitamin E in neonatology. AB - It is difficult to maintain an objective attitude toward the use of vitamin E in neonatology. On the one hand, the desire to ameliorate iatrogenic diseases, such as BPD and ROP, makes one grasp hopefully at any theory or clinical trial that suggests a role for vitamin E in decreasing the handicaps that patients take with them from the intensive care nursery. On the other hand, when the question of toxicity arises, one tends to be negative, remembering the unfortunate experiences with oxygen, chloramphenicol, sulfisoxazole, and now, E-Ferol Aqueous Solution. We like to think that if this review had been written 2 years ago, our conclusions, based on the analysis of the data, would have been the same. But, probably, in the absence of data on the severe toxicity of one vitamin E preparation, we would have been more liberal in our recommendations for the use of vitamin E in neonatology. At this time, however, any use of supplemental vitamin E beyond the guidelines of the American Academy of Pediatrics cannot be recommended. Nor can the monitoring of blood Vitamin E levels be recommended as an assurance of nontoxic tissue concentrations in sick, premature infants. All physicians caring for premature infants are urged to review their nursery policies to make sure that excessive doses of vitamin E are not being administered. It is hoped that additional clinical trials will provide more definite answers to the questions about the efficacy of vitamin E in ROP and IVH. PMID- 3541527 TI - Vitamin D in infancy and childhood: factors determining vitamin D status. AB - Gestational age, age, race, sex, maternal influences, diet, and environmental factors affect vitamin D and calcium metabolism. These specific factors are only beginning to be understood in the infant and child, a period in which there are rapidly changing stresses related to growth and skeletal development. The adaptability of the infant and child to face these challenges and maintain calcium homeostasis is a remarkable testament to the inherent capabilities of the vitamin D- and calcium-regulating system. PMID- 3541529 TI - Nutritional factors and progression of chronic renal failure. PMID- 3541531 TI - Inherited metabolic disease in the newborn: approach to diagnosis and treatment. PMID- 3541530 TI - Epilepsy and education: the pediatrician's expanding role. AB - School systems, teachers, health systems, and physicians are striving to assist students to reach their full potential. Physicians have an understanding of seizures and medications that should be shared with teachers. In turn, teachers know what parts of students' learning seem to be affected by their epilepsy; they also work with students every day and this gives them a unique perspective of changes in the patient's status. Epilepsy can profoundly affect the student patient, the school, and the home. Pediatricians are in the unique position to share medical information with teachers and parents. By sharing this information, physicians encourage collaboration. Increased collaboration, in turn, helps to reduce the myths and fears surrounding epilepsy. It provides teachers with the information they use to plan instructional programs, and it improves physicians' decisions regarding diagnosis and treatment. Physician/teacher collaboration is generally advocated for patients-students in the "devastated" and the "compromised" groups. Collaboration is not necessary in patients without problems and it is probably preferable not to risk stigmatizing otherwise intact children by attaching the label "epilepsy" to them. When collaboration is indicated, teachers will need some way of organizing information about students' seizure, educational, medical, and psychosocial background. The appendix contains a list of questions grouped according to these categories. If teachers can answer these questions they will be well on the way to resolving the problems confronting the student with epilepsy. It is hoped that physicians will be available and willing to assist teachers and that teachers will seek their assistance. PMID- 3541532 TI - Human teratogenicity. PMID- 3541533 TI - The maladroit adolescent: learning disorders and attentional deficits. AB - Being maladroit in a society with increasing emphasis on performance is a formidable challenge to adolescent development. Helping maladroit adolescents achieve optimal potential is a challenge for physicians, educators, and others involved in their care. The first steps for professionals are recognizing SLD and ADD and understanding the configurations of these problems as they apply to adolescents and adults. Educators can prioritize academic concerns and evaluate and provide intervention strategies. Physicians can review new pharmacologic data and follow-up studies to help formulate clinical judgments, particularly around the area of medication. Along with counselors, physicians will provide better longitudinal care when aware of the social and behavioral outcomes reported for patients similar to theirs. Finally, awareness of resources facilitates multidisciplinary communication and provides access for patients and clients to needed medical, educational, and support resources. There has always been a sense of advocacy among those working with the adolescent whose exaggerated maladroitness stems from a problem with learning or attention. Perhaps this review will provide a data base from which advocacy can expand to specific action. That has been our goal. PMID- 3541534 TI - Chlamydia trachomatis infections of infants and children. PMID- 3541535 TI - Imaging procedures in pediatrics. AB - To demonstrate the use of these multiple techniques, one might consider algorithms that are available for various disorders. It is worth pointing out that for imaging of specific abnormalities, they must be evaluated in light of the skill and interest of available personnel and on the equipment that is available. For example, in acute upper abdominal trauma in children the following is one diagnostic route: With no substantial suspicion of brain injury and after evaluation by an attending surgeon; With upper abdominal injury limited reasonably clearly to the kidneys, renal vessels, and ureters: Intravenous sonography; With upper abdominal injury limited reasonably clearly to the liver, spleen, or both: Liver/spleen scintigraphy; With substantial suspicion that the injury is not limited to the kidneys or the liver and spleen: Enhanced CT of upper abdomen; With a suspicion of brain injury sufficient to require CT of the head: CT scan, and if there is abdominal injury as well, contrast enhanced CT of the upper abdomen; Again it is to be emphasized that this diagnostic route (as well as the ones in Figures 1 and 2) represents an approach and is used in the context of this chapter to illustrate the role of the various imaging techniques that are available to the diagnosis of one pediatric problem. PMID- 3541536 TI - Cystinosis coming of age. PMID- 3541537 TI - Regulatory and cytoskeletal proteins of vertebrate skeletal muscle. PMID- 3541538 TI - Molecular mechanisms of protein secretion: the role of the signal sequence. PMID- 3541539 TI - Vibrational spectroscopy and conformation of peptides, polypeptides, and proteins. PMID- 3541540 TI - Celsus on old age. PMID- 3541541 TI - [Nerve regeneration in the cornea after penetrating keratoplasty in the rabbit, with reference to their relationship to basal laminae]. PMID- 3541542 TI - [Study on therapy with prostaglandins in choroidal vascular disorders. I. Effect of prostaglandin I2 on choroidal circulation]. PMID- 3541543 TI - The effect of a bacterial endotoxin or cloprostenol on the clinical status and hormonal levels in 80-100 days pregnant gilts. PMID- 3541545 TI - Improvement of the teflonized slides used in the immunofluorescent antibody technique. PMID- 3541544 TI - Luteinizing hormone (LH) response to different doses of synthetic gonadotropin releasing hormone (GnRH) in prepubertal gilts. PMID- 3541546 TI - Natural history of the obstructed rabbit appendix: observations with radiography, sonography, and CT. AB - Chronic (1-3 months' duration) appendiceal obstruction was induced in 11 rabbits to assess the pathologic consequences and to study the associated radiologic, sonographic, and CT findings. Three pathologic/radiologic groups resulted with approximately equal frequency. In group A, the abscess was characterized by inflammatory cells in the lumen and wall of the appendix without mucin production. Calcification was shown radiographically, and sonography showed an anechoic or complex pattern. Group B, the "mixed response," was characterized by an intact hyperplastic mucosa, mucin secretion, and inflammatory debris in the lumen. Occasional calcification was present radiographically, and sonography showed a complex or hypoechoic pattern. In group C, true mucoceles had an intact hyperplastic mucosa, a mucin-filled lumen, and minimal inflammation. These were anechoic on sonography except for mobile foci of inflammatory debris. Chronic obstruction of the appendix results in a spectrum of pathologic responses with varying degrees of either inflammation and mucosal destruction or mucosal hyperplasia and mucin secretion. An abscess results when infection overwhelms the host's inflammatory responses. If the bacteria are destroyed by these defenses, a mucocele forms. An intermediate situation occurs when there is a mixed response with chronic inflammatory changes and an intact mucosa. This finding supports the existence of chronic appendicitis in humans. PMID- 3541547 TI - Sonography in the diagnosis of acute renal allograft rejection and cyclosporine nephrotoxicity. AB - High-resolution real-time sonography was used at the time an allograft biopsy was performed on 58 renal transplant recipients to elucidate the cause of posttransplantation decline in renal function. These procedures were performed within 3 months of transplantation. Fifty-four out of 58 patients were on a cyclosporine-steroid regimen. Acute rejection was diagnosed if one or more of the following findings was present on sonogram: transplant swelling, increased conspicuity of the medullary pyramids, medullary pyramid enlargement, decreased renal-sinus fat, and pelvi-infundibular thickening. Correlation of sonography and histopathologic findings showed that sonography cannot be used independently to diagnose rejection or to distinguish between cyclosporine nephrotoxicity and rejection. A creatinine level of 2.5 mg/dl was then randomly selected as a threshold level to possibly improve the sonographic results, anticipating that above this threshold an abnormal sonogram would invariably be recorded in the presence of rejection. This threshold was not found to be discriminatory. Only at a higher threshold level of creatinine (6.9 mg/dl or more) was there 100% correlation between acute rejection and the presence of abnormal sonographic findings. Furthermore, whereas most patients with four or five abnormal sonographic criteria tended to have acute rejection, this group of patients constituted a minority and, even within this group, sonography was not entirely reliable in detecting transplant rejection. PMID- 3541549 TI - Digital subtraction arthrography of the temporomandibular joint. PMID- 3541548 TI - Polyorchidism: evaluation by MR. PMID- 3541550 TI - Sonographic analysis of the fetus with ureteropelvic junction obstruction. AB - Twenty-five fetuses with ureteropelvic junction obstruction were evaluated to determine the likelihood of progression of hydronephrosis in utero, and the outcome for the neonate. Such information may alter prenatal as well as perinatal management. These observations showed that the degree of dilatation in utero is likely to be greater than that observed postnatally; the degree of dilatation does not necessarily correlate with renal functional impairment measured postnatally; significant progression of dilatation in utero is relatively uncommon, especially in unilateral cases; and uretero-pelvic junction obstruction, even when bilateral, is unlikely to be fatal. Of 21 live newborn infants with follow-up, 14 required surgery and seven were placed under observation. PMID- 3541551 TI - Main-stem bronchial atresia: intrauterine sonographic diagnosis. PMID- 3541553 TI - Imaging of renal masses. PMID- 3541552 TI - The pathophysiology and treatment of sinusitis. AB - When faced with the diagnosis of sinusitis, the physician should carefully review the clinical setting from which the condition arose, its potential origins, as well as initiate management. In most instances, medical management will suffice for acute and subacute disease although some surgical intervention is occasionally helpful. If nasal polyps are present with radiographic evidence of sinus obstruction, standard medical treatment is initiated with the addition of systemic corticosteroids once the suppurative component is controlled. A lack of response in each of these circumstances is evaluated on an ongoing basis. If successful treatment is seen clinically, repeat radiographs with those views which best reveal the sinus involved are obtained in approximately 6 weeks to hopefully demonstrate normality. Persistent radiographic abnormalities can then be either treated surgically or, if clinical judgement dictates, further medical management can be pursued. However, in the chronic phase of sinusitis or after the patient has been followed with persistent abnormalities for over three months, irreversibly diseased mucosa is generally present and surgical intervention is commonly indicated. We would like to emphasize that during the course of treatment, frequently consider the origin of the sinusitis. Commonly it is infectious (e. g. viral) and no further investigation is necessary. However, anatomic abnormalities or systemic disease may be present whose correction can prevent the recurrence of acute sinusitis or, more importantly, the evolution into chronic irreversible sinus disease. PMID- 3541556 TI - Ambulatory electrocardiography and computer technology--practical advantages. AB - Ambulatory electrocardiography has employed computer technology for more than two decades. This review pertains to current state-of-the-art interaction between ambulatory electrocardiography and computer technology with regard to data analysis, quantitation and standardization, data formatting, data storage and retrieval, and comparative interpretation of ambulatory ECGs. This report also addresses evolving techniques expected in the near future. PMID- 3541555 TI - Review of echocardiographically diagnosed right heart entrapment of pulmonary emboli-in-transit with emphasis on management. AB - 2DE permits detection of thromboemboli transiently entrapped in the right heart chambers while en route to the pulmonary arteries. Review of the 49 cases recorded to date reveals that the supple elongated clot produces a 2DE picture--a mass of changing configuration and striking mobility--that is highly characteristic. Since emboli that become entrapped are large, when managed by medical measures alone they have an attendant mortality rate of 50%, usually soon after 2DE diagnosis, upon completion of pulmonary embolization. Death occurred in 8 of 16 patients treated with anticoagulants, thrombolytic agents, or antiaggregants and in 6 of 13 who received supportive measures only. Of 20 patients referred for surgery (cardiotomy and, in 17, pulmonary embolectomy), only three died, two of them failures of preceding anticoagulant treatment. These data indicate that thromboemboli entrapped in the right heart chambers are best handled as a surgical emergency. PMID- 3541554 TI - Prostacyclin protects ischemic reperfused myocardium in the dog by inhibition of neutrophil activation. AB - Prostacyclin (PGI2) and the stable PGI2 analogue SC39902 (6,9 alpha-epoxy,5S fluoro-11 alpha, 15S-dehydroxyprosta-6,13E-dien-1-oic acid, sodium salt) were studied in anesthetized open-chest dogs subjected to 90 minutes of left circumflex coronary artery (LCCA) occlusion and 6 hours of reperfusion. PGI2 (50 ng/kg/min, infused into the left atrium) reduced infarct mass by 59% compared to control, but SC39902 (1.5 micrograms/kg/min) failed to produce a significant reduction in infarct size. Both PGI2 and SC39902 reduced mean arterial blood pressure, heart rate, and rate-pressure product to the same extent. Regional myocardial blood flow measured with radiolabelled tracer microspheres did not demonstrate an increase in regional blood flow to the ischemic myocardium during the 90 minutes of LCCA occlusion in the PGI2 and control treatment groups. Canine neutrophils were isolated from whole blood and activated with opsonized zymosan. PGI2 produced a concentration-dependent inhibition of neutrophil activation as measured by superoxide production in vitro, whereas SC39902 failed to effectively inhibit neutrophil activation. Neutrophil migration into inflammatory skin lesions was effectively attenuated when dogs were pretreated with PGI2 (50 ng/kg/min, intravenously). Therefore, it is suggested that the cytoprotective effect of PGI2 during myocardial ischemia and reperfusion is related to an inhibition of neutrophil migration and the production of cytotoxic activated oxygen species. PMID- 3541557 TI - Aneurysm of the ascending aorta associated with sternal cleft, cutaneous hemangioma, and occlusion of the right innominate artery in a neonate. PMID- 3541558 TI - The substrate and the trigger: the role of myocardial vulnerability in sudden cardiac death. PMID- 3541559 TI - For peptide drugs like insulin: new protective coat for oral administration. PMID- 3541560 TI - Hospital conditions of participation for Medicare and Medicaid programs--final rule. PMID- 3541561 TI - Community pharmacy in Arizona's prepaid Medicaid program. PMID- 3541562 TI - Miles Standish: forensic pioneer and Indiana tooth-sleuth. PMID- 3541564 TI - Glucose and insulin responses to manufactured and whole-food snacks. AB - To determine whether realistic snacks containing added sugar evoke excessive insulin responses, 10 healthy subjects consumed four different snack meals, similar in fat and total energy content. Two snacks were based on sugary, manufactured products (chocolate-coated candy bar; cola drink with crisps) and two on whole foods (raisins and peanuts; bananas and peanuts). After the processed-food snacks, plasma-glucose levels tended to rise higher and to fall lower than after the whole-food snacks. The area under the plasma insulin curve was 70% greater after the manufactured snacks than after the raisin-peanut snack. The banana-peanut snack evoked an intermediate insulin response. One subject had pathological insulinaemia after both manufactured snacks but normal responses after both whole-food snacks. These findings suggest that foods and drinks containing added fiber-depleted sugars stress and sometimes overwhelm homeostatic mechanisms but also suggest that the insulin response to food is influenced by the physical state of the food. PMID- 3541563 TI - Review of toxicology of inorganic lead. PMID- 3541565 TI - Slowly digested and absorbed carbohydrate in traditional bushfoods: a protective factor against diabetes? AB - The aim of this study was to compare the digestibility and metabolic responses of western foods with traditional staples of two populations that show a susceptibility to diabetes, namely Australian Aborigines and Pacific islanders. Rate of starch digestion was studied in vitro in 37 foods (20 Australian Aboriginal bushfoods, 10 Pacific island foods, and 7 western foods), and rate of absorption of 9 foods (8 bushfoods and 1 western food) was studied in human volunteers. In vitro studies showed that 23 of 30 traditional foods were digested more slowly than 7 western foods. Six of 8 bushfoods produced significantly smaller areas under 3-h postprandial plasma glucose curves than potatoes in seven healthy Caucasian volunteers. There was a good correlation between starch digestibility and plasma glucose response. Our findings are consistent with the hypothesis that carbohydrate in traditional diets is slowly digested and absorbed and may once have been protective against diabetes. PMID- 3541567 TI - Enhancement of mammary tumorigenesis by dietary fat: review of potential mechanisms. PMID- 3541566 TI - Historical perspective: calories and energy expenditure in carcinogenesis. PMID- 3541568 TI - Obesity and carcinogenesis: historical perspective. PMID- 3541569 TI - Adipose tissue as a source of hormones. AB - Obesity is known to increase the risk for cancer of the reproductive tract in women. The mechanism underlying this association can be explained by increased estrogenic stimulus to estrogen-target tissues as the result of three factors. First, increased adrenal secretory activity makes more androgen precursors available for conversion to estrogen in peripheral tissues. Second, the efficiency of conversion of androstenedione (A) to estrone (E1), is elevated in obese subjects because adipose tissue is the major tissue site of conversion. Third, plasma levels of SHBG, which binds estradiol (E2), are depressed in obese subjects and greater than normal amounts of serum estradiol are therefore available to target tissues from the circulation. Recent studies have shown that the levels of estrogens and other steroid hormones in breast fluids are much higher than in serum, which may be the result of local synthesis or increased uptake from the circulation. No differences in estrogen levels of breast fluid have been found between normal women and those with breast disease. A possible explanation may be differences in the levels of estrogen antagonists, such as progesterone. PMID- 3541570 TI - Fat and colon cancer: how firm is the epidemiologic evidence? PMID- 3541571 TI - Feasibility studies of a low-fat diet to prevent or retard breast cancer. PMID- 3541572 TI - Blood as the earliest drug, its substitutes, preparations and latest position. AB - Blood was soul and Redness its active principle when red substances were rich in soul-content. But soul was a substance whence blood became a drug which donated soul to treat wounds and incurable diseases. Its redness as life-force, but also as substance, could prolong life. A drug made from human blood could treat serious wounds and as a life saving drug was also a drug of fertility. The latest use of blood appears as syrup haemoglobin while the latest use of human blood would be blood transfusion. PMID- 3541573 TI - Opuntia streptacantha: a coadjutor in the treatment of diabetes mellitus. AB - This report describes the effect produced by the complementary daily administration of Opuntia streptacantha sap to a diabetic volunteer being under treatment with chlorpropamide. The plant product improved remarkably the general symptomatology of the patient as well as his insulin and glucose blood levels. PMID- 3541574 TI - Multiple methods for platelet enumeration. Observation of a newly introduced bias. AB - After the introduction of Coulter S-Cal, a bias became apparent between platelet counts obtained from instruments calibrated with this material and those obtained from a Clay Adams Ultra-Flo. Statistical methods were used to compare platelet counts obtained from the Coulter S-Plus IV, Ortho ELT-800, Clay Adams Ultra-Flo 100, and phase microscopy. At a P value of 0.01, paired t analysis revealed statistically significant biases between the Ultra-Flo and each of the other methods. Significant biases were also found between phase microscopy and each of the other methods, although these were of a smaller magnitude. The results indicate the necessity for users of multiple platelet counting methods to conduct comprehensive interinstrument evaluations, particularly when altering methods of calibration. PMID- 3541575 TI - Philip Levine award lecture. Blood group antigens as markers for normal differentiation and malignant change in human tissues. PMID- 3541577 TI - Maxillary expansion: clinical implications. AB - Clinicians frequently expand the maxilla to correct certain malocclusions. The effects of expansion on facial structures, dentition, and periodontium are reviewed. The implications of these findings for the treatment of patients who need maxillary expansion are discussed. PMID- 3541576 TI - Measurement of plasma fibrin D-dimer levels with the use of a monoclonal antibody coupled to latex beads. AB - Recently, monoclonal antibody (DD-3B6) to fibrin D-dimer was prepared and coupled to latex beads to provide a specific test (Dimertest) for fibrinolysis. The purpose of this study was to evaluate the Dimertest assay as a clinical laboratory test for the measurement of plasma fibrin D-dimer derivatives. The Dimer-test assay specifically detected 2 micrograms/mL of purified fibrin D-dimer or fibrin D-dimer/fragment E complex added to afibrinogenemic plasma but did not detect 500 micrograms/mL of either fibrinogen fragments X, D, E, or 160 micrograms/mL cross-linked fibrinogen. The fibrin(ogen) degradation product (FDP) assays of American Dade or Wellcome Diagnostics detected 5.0 micrograms/mL of fibrin D-dimer and from 1 to 10 micrograms/mL of the other FDPs. Twenty-eight percent of 150 random plasma samples assayed from hospitalized patients were positive for fibrin D-dimer derivatives. Plasma samples from 152 patients suspected of having disseminated intravascular coagulation (DIC) were assayed for serum FDP (Wellcome Diagnostics) and plasma fibrin D-dimer derivatives. Samples from 69% of patients with serum FDP levels less than 10 micrograms/mL, and more than 90% of those with serum FDP levels greater than 10 micrograms/mL, were positive for fibrin D-dimer derivatives. Dimertest results were not modified by heparin, streptokinase, freeze-thawing, or clotting plasma. Serum fibrinogen related antigens were immunoadsorbed from Dimer-test positive sera by anti fibrinogen antibody and formalin-fixed Cowan I strain Staphylococcus aureus. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and protein blotting with the use of monoclonal antibody DD-3B6 demonstrated a protein band with similar mobility to purified D-dimer. The measurement of plasma fibrin D dimer derivatives by the Dimertest assay is a rapid, sensitive, and specific laboratory test for fibrinolysis. The Dimertest assay has proven to be a useful addition to the clinical laboratory and should be helpful in the diagnosis and management of patients with diseases associated with fibrinolysis. PMID- 3541578 TI - Graduation message to the class of '86. PMID- 3541579 TI - Malnutrition and the role of nutritional support in alcoholic liver disease. AB - Malnutrition adversely effects hepatic function and structure. In certain instances, histological changes indistinguishable from alcoholic liver disease may be seen. Alcohol is clearly a direct hepatic toxin and its results are not prevented by normal nutritional intake. The majority of patients admitted to the hospital with alcoholic liver disease are moderately to severely malnourished but find it difficult or impossible to resume an intake sufficient to repair and maintain a normal nutritional state. Malnutrition may be considered a complication of alcohol abuse which occurs simultaneously with liver damage. Repair of both nutrition and hepatic histology requires considerable time, more for the latter. Here we review the data which both incriminates and separates the effects of malnutrition and of alcohol on the liver, and review the current literature on the effect of intravenous or enteral protein-calorie supplementation on acute alcoholic liver disease. While the data suggest that improvement in conventional liver tests are accelerated somewhat by such treatment, there have been no major confirmed differences noted between treatment and control groups at 3 to 4 wk. More precise measures of liver function, as opposed to conventional tests of liver status, and longer follow-up periods will be required to substantiate the suggested beneficial effects of iv or enteral protein-calorie supplementation in acute alcoholic hepatitis. PMID- 3541581 TI - Renal transplantation in Epstein syndrome. PMID- 3541580 TI - Spontaneous bacterial peritonitis in Wilson's disease. AB - Spontaneous bacterial peritonitis associated with Wilson's disease has been previously reported in only one case. We report two cases where this infection developed and seriously complicated the course of illness. As with spontaneous bacterial peritonitis occurring with other underlying diseases, early diagnosis and treatment are critical to improved outcome. Recognition that it can occur with Wilson's disease is important, and paracentesis should be performed without delay when suspicious features are present. PMID- 3541582 TI - Analysis of cell cycle characteristics and course of the disease in ANLL. AB - The cell cycle characteristics of a newly diagnosed patient with acute nonlymphocytic leukemia (ANLL) were studied by using intravenous bromodeoxyuridine (BrdU) and our previously described "double-label" technique. The percentage of S-phase cells in the bone marrow (BM) biopsy were 25% compared to 7% from the simultaneously obtained BM aspirate. The duration of S-phase (Ts) was determined to be 4 hr and the total cell cycle time (Tc) was 16 hr. We demonstrated that the actual clinical course of this patient's illness corresponded well with the course predicted on the basis of these cell cycle measurements. Although he achieved aplasia in response to two successive courses of induction chemotherapy, leukemic cells repopulated the marrow, producing a rapidly rising PB white blood cell (WBC) count with a T1/2 of approximately 20 hr each time. It is likely that the resistance of this patient's leukemia to therapy was a result of the rapid proliferative rate of his leukemic cells and not due to the inability of chemotherapeutic agents to kill a large number of cells. Since the measurements can be completed within 48 hr, measuring Ts and Tc will provide a better understanding of the biological differences that exist between patients with ANLL. PMID- 3541583 TI - Bone marrow transplantation in a patient with myelodysplasia associated with diffuse eosinophilic fasciitis. AB - A 34-year-old man with diffuse eosinophilic fasciitis and a hypocellular myelodysplastic syndrome underwent marrow transplantation from an HLA-identical brother. Prompt hematopoietic reconstitution was observed, strongly suggesting that the marrow hypocellularity was caused by neither a serum inhibitory factor nor a microenvironmental disorder. The patient died of disseminated cytomegalovirus infection too early to evaluate the impact of hematopoietic reconstitution on the eosinophilic fasciitis. Nevertheless, marrow transplantation may offer a therapeutic option for those patients with this disorder who develop severe hematopoietic dysfunction and who have a suitable marrow donor. PMID- 3541584 TI - Monoclonal antibody technology. AB - The development, production, limitations, and uses of monoclonal antibody (MoAb) technology are presented. The first MoAbs were developed in 1975 using a process whereby the antibody-producing spleen cells of mice that had been immunized against sheep red blood cells were fused with the cells of a mouse myeloma cell line, producing hybridomas. These hybridoma cells are used to produce MoAbs, which are antibodies that will bind to only one specific target site on an antigen. Large quantities of MoAbs are grown, either in cell cultures or in the peritoneum of mice, and harvested. Although large quantities of MoAbs can be produced, these techniques are limited because of the potential for contamination by mouse viruses and the inability of the hybridomas to yield sufficient quantities of MoAbs. MoAbs are currently used in diagnostic techniques, including pregnancy tests and drug assays, as well as in tests for detecting viral and bacterial infections and cancer. MoAbs, coupled with dyes or radioactive isotopes, can be used in imaging techniques. Other possible applications of MoAbs include tissue typing, purification, therapy of cancer and autoimmune diseases, and treatment of drug toxicities. As the use of MoAbs in health care increases, pharmacists will need to have a good understanding of the functions and applications of these agents. PMID- 3541585 TI - The formulary system: brief history and 1960s perspective. Excerpted from Mirror to Hospital Pharmacy. 1964. PMID- 3541586 TI - Pneumocystis carinii pneumonia. Cytologic manifestations and rapid diagnosis in routinely prepared Papanicolaou-stained preparations. AB - In this study of 28 immunocompromised patients, it was found that Pneumocystis carinii pneumonia could be easily and reliably diagnosed by examination of routinely prepared, Papanicolaou-stained cellular samples obtained by bronchoalveolar lavage, bronchial brushing, and bronchial washing. The distinctive intra-alveolar exudate of pneumocystosis observed in lung biopsy specimens was readily discernible in all of the cellular samples that demonstrated P. carinii by special stains. The exudate was not present in any of the P. carinii-negative samples. Routinely prepared, Papanicolaou-stained cellular samples can be relied upon for the rapid diagnosis of P. carinii pneumonia. PMID- 3541587 TI - Effect of glycemic control on microvascular complications in patients with type I diabetes mellitus. AB - The relation between the control of blood glucose levels and the progression of early diabetic retinopathy and the width of skeletal muscle capillary basement membrane was studied in 54 insulin-dependent diabetic patients. After initial ophthalmologic evaluation including seven-field fundus photography and fluorescein angiography and measurement of levels of glycosylated hemoglobin and width of skeletal muscle capillary basement membrane, the patients were divided into two groups: an experimental group of 30 patients who were treated with continuous subcutaneous insulin infusion and a control group of 24 patients who continued to receive conventional treatment--usually two injections of insulin daily. After a mean follow-up period of 31.4 months, the experimental group had a significant decrease in glycosylated hemoglobin levels as compared with baseline values (mean +/- SEM, 7.2 +/- 0.3 percent versus 10.1 +/- 0.4 percent), reflecting improved control of blood glucose levels. The conventional treatment group had no change in glycosylated hemoglobin levels after a mean of 33.5 months of follow-up. With use of either a modified Early Treatment Diabetic Retinopathy Study grading system or macular microaneurysm counts, the experimental treatment group showed significantly less progression of retinopathy (p less than 0.05). The skeletal muscle capillary basement membrane width was significantly reduced only in the experimental treatment group with stable or improved retinopathy and was unchanged in the control group. There was a tendency for skeletal muscle capillary basement membrane width to increase in thickness over time in those patients whose retinopathy worsened irrespective of treatment. It is concluded that meticulous diabetic control may slow the progression of early diabetic retinopathy. Changes in skeletal muscle capillary basement membrane width may reflect the course of diabetic retinopathy. PMID- 3541588 TI - Renal mass imaging: the internist's role. AB - The busy internist will encounter numerous renal masses when ordering nonurologic imaging. Concise and quick delineation of cystic from solid masses is necessary. Cystic masses constitute the majority of these masses and once their nature is diagnosed, they require no further work-up or referral. Often, a single imaging technique is unable to confidently establish the cystic nature of a renal mass. Proper selection of an additional imaging modality will often be successful in establishing the cystic characteristics of a benign mass. Referral to a urologist is not necessary in this setting, since the internist can coordinate the imaging evaluation with proper radiologic consultation. Alternatively, when a mass is determined to be solid, urologic consultation and surgical evaluation are necessary. Minimization of the imaging sequence and hospitalization are critical in the diagnostic-related group era. Aimless wandering in the quagmire of imaging techniques is very expensive and nonproductive. Proper selection of one or two imaging tools and occasionally needle puncture should produce clarification of the cystic or solid nature of renal mass. On the basis of our experience, we have designed an imaging algorithm that provides a simple and concise approach to the diagnosis of a renal mass. It differs in design from that previously suggested by us and others because of decreased emphasis on nuclear medicine and greater emphasis on computed tomography. The more pivotal position assumed by computed tomography is based on improved scanner design and several large series attesting to the accuracy and cost-effectiveness of this imaging technique. It behooves internists to appreciate the role of various imaging tools in evaluating a renal mass. With radiologic consultation, internists should strive to confidently establish the cystic nature of a renal mass and to refer to a urologist solid masses or those whose nature remains persistently equivocal. PMID- 3541590 TI - What should patients be told prior to a medical procedure? Ethical and legal perspectives on medical informed consent. AB - Ethicists and the medicolegal system agree that patients have rights to information prior to an elective medical procedure. Yet, it is far from clear whether there is at the present time an adequate framework for informing patients. Medicolegally, court cases as early as the 1900s strongly emphasized the preservation of individual rights to information in the patient-physician relationship. Most recently, an increasing number of states use the criterion of what a "reasonable man" would want as the basis for medical informed consent. Medical ethicists also have offered general principles for consideration by physicians: the importance of patient autonomy and preferences in decisions related to their own health care. This report examines the historical development of informed consent in the United States, legal and ethical perspectives in medical informed consent, and the pragmatic issues yet to be considered by physicians in keeping their duty to inform patients prior to a medical procedure. PMID- 3541589 TI - Prorenin as a reproductive hormone. New form of the renin system. AB - Prorenin, the biosynthetic precursor of renin, is synthesized by the kidneys. Herein is reviewed recent evidence that the ovaries also secrete prorenin. It was found that prorenin is present in mature human ovarian follicular fluid in extremely high concentrations and that plasma prorenin levels increase transiently in blood during the menstrual cycle at the time of ovulation. No change in plasma active renin levels occurs at this time. Plasma prorenin level also increases 10-fold in pregnant women very soon after conception. The ovaries are apparently the source of this rise, since plasma prorenin levels did not increase in a pregnant woman with ovarian failure who received a donor egg. All of these changes in plasma prorenin levels appear to be caused by gonadotropic hormones. These results suggest a role for ovarian prorenin in human reproductive function. They may have relevance to studies of female infertility, birth control, and toxemia of pregnancy. They also suggest that a renin system exists that is regulated by changes in prorenin. PMID- 3541591 TI - Hypertension in the elderly. AB - Current data indicate that most patients over age 60 with systolic blood pressure greater than 160 mm Hg and diastolic blood pressure greater than 90 mm Hg should be treated. The current data support the use of a thiazide and potassium-sparing diuretic with the addition of a centrally acting antiadrenergic drug as needed to reduce the blood pressure to less than 160/90 mm Hg. This will reduce the morbidity and mortality, especially cerebrovascular events, severe congestive heart failure, development of severe or accelerated hypertension, nonfatal myocardial infarction, and sudden death. Those unable to take these medications or who do not have satisfactory reduction in blood pressure should have other antihypertensive drugs added or substituted to lower blood pressure to less than 160/90 mm Hg. PMID- 3541592 TI - Development of hypogammaglobulinemia in a patient with systemic lupus erythematosus. AB - This report describes a young girl in whom systemic lupus erythematosus (SLE) with normogammaglobulinemia but high serum DNA binding developed at age 10. She was subsequently treated with prednisone and intermittent cyclophosphamide for six years, and severe hypogammaglobulinemia associated with recurrent infections developed; disease remained active and serum DNA binding high. The possible contribution of treatment with cyclophosphamide to the development of hypogammaglobulinemia is discussed. PMID- 3541593 TI - Indiscretion enteritis. A Rabelaisian syndrome. AB - A 76-year-old man had small bowel obstruction and organic small bowel disease following a series of bizarre massive gustatory insults that involved food, medications, and mega-mineral-vitamin supplements. Intestinal obstruction required partial small bowel resection. The dietary indiscretions resulted in severe enteritis (indiscretion enteritis). The sequence has been termed a Rabelaisian syndrome after the great French writer and physician, Francois Rabelais, who vividly described bizarre gustatory habits. Gut injury may result from unwise oral intake of various foods and mineral supplements. PMID- 3541594 TI - Primary Hodgkin's disease of the spleen. PMID- 3541596 TI - Monotherapy of mild hypertension with nifedipine. AB - The effectiveness of nifedipine as first-line monotherapy for mild diastolic hypertension (range: 95 to 105 mm Hg) was tested in this placebo-controlled, double-blind, randomized trial. Fifty-six patients were enrolled and, after titration of the placebo or active drug, they were followed for 12 weeks. Significant declines in the sitting systolic and diastolic pressures of -19 +/- 4 mm Hg (standard error) and -13 +/- 2 mm Hg, respectively, were observed during this follow-up period. Overall, 75 percent of patients receiving active drug had diastolic pressures less than or equal to 90 mm Hg at the last treatment visit. Heart rate was not significantly changed in the sitting position during the treatment period, and the majority of patients (75 percent) showed a response to nifedipine doses of 10 or 20 mg orally three times daily in the capsule form. The levels of the systolic and diastolic pressures at entry were not predictive of the dose of nifedipine required for effective blood pressure control. PMID- 3541595 TI - Hyperventilation syndrome and asthma. AB - Hyperventilation syndrome is a common and often disabling condition. Traditional treatment consists of reassurance and anxiolytic drugs. Hyperventilation is known to precipitate an asthmatic reaction. A retrospective review of patients with hyperventilation syndrome was performed to ascertain the frequency of asthma as well as the response to bronchodilator medication. Forty-seven patients were seen. Thirty-eight were tested, and asthma was proved in 36. Two additional patients had positive clinical responses with bronchodilators. Thus, asthma was identified in 38 of 47 consecutive patients seen for hyperventilation syndrome (80 percent), and asthma was proved in 36 of 38 of patients tested (95 percent). Hyperventilation syndrome was eliminated in 29 of 35 patients (90 percent) treated with a combination of explanation and bronchodilator treatment. PMID- 3541597 TI - Calcium channel blockers in the management of hypertension in the elderly. AB - Calcium channel blockers seem to be particularly suitable for elderly hypertensive patients since these agents do not cause salt and fluid retention, postural hypotension, sedation, depression, or biochemical abnormalities. Moreover, their use is compatible with several common diseases of old age, such as diabetes, obstructive lung disease, and peripheral vascular disease. We recently conducted a study in 21 patients (average age, 79 +/- 2 years) who completed an eight-week trial with 20-mg nifedipine tablets taken twice daily. Mean blood pressure decreased from 191 +/- 2/96 +/- 2 mm Hg to 151 +/- 4/80 +/- 3 mm Hg. In 15 patients (71 percent), blood pressure decreased to less than or equal to 160/90 mm Hg; in four additional patients (19 percent), diastolic blood pressure decreased by 15 to 25 percent. Thus, there was a sustained lowering of blood pressure in 90 percent of the participants receiving nifedipine monotherapy. A review of recent studies in elderly hypertensive patients revealed similarly favorable results with calcium channel blockers given alone or in combination with other agents. The accumulating data suggest that these compounds may offer a useful new approach to the treatment of hypertension in old age. However, in these studies, the number of patients and the duration of follow-up need to be extended to confirm the favorable impression obtained thus far. PMID- 3541598 TI - Gut endocrinology: clinical and therapeutic impact. PMID- 3541599 TI - Treating hypertension. A review of clinical trials. AB - Extensive clinical trials have been carried out to test the effectiveness of antihypertensive therapy in controlling high blood pressure and in reducing the morbidity and mortality associated with hypertension and related cardiovascular and cerebrovascular disease. These trials have studied more than 40,000 individuals in programs worldwide. Although they answered many important questions, some of these trials have failed to produce conclusive results concerning certain issues, such as the results of treatment on coronary artery disease. The medical community has come to rely on clinical trials in evaluating the treatment of many different chronic diseases, and this methodology has become the accepted means of evaluating therapy. Analyses of the clinical trials on hypertension and their implications should review factors other than fatal and non-fatal end points if their results are to be useful for the practicing physician in making treatment decisions. PMID- 3541600 TI - Induction of acute corneal allograft rejection by alpha-2 interferon. AB - A 38-year-old man who underwent corneal transplantation in 1973 for treatment of a keratoconus is described. In 1982, hairy cell leukemia was diagnosed and he was treated with splenectomy followed by chlorambucil and androgen therapy. In April 1984, treatment with alpha-2 interferon was begun, and two weeks later, evidence of acute corneal allograft rejection developed. The allograft rejection responded to temporary discontinuation of alpha-interferon and the administration of topical corticosteroid. Treatment with interferon was resumed, and he has subsequently had no clinical evidence of rejection. Although the mechanism of antineoplastic activity of alpha-interferon in hairy cell leukemia is unknown, the observations described in this report suggest that clinically important immune phenomena may occur in patients undergoing interferon therapy. PMID- 3541601 TI - Microbial oncogenesis. AB - For more than a century, medical investigators have sought to incriminate microorganisms in the cause of cancer. The first scientific evidence of such a relationship came in 1911, with the first successful induction of a tumor using a cell-free extract. Since that time, considerable data have accrued linking retroviruses, herpes viruses, the hepatitis B virus, papovaviruses, and adenoviruses to various malignant neoplasms. There is also increasing evidence that certain bacteria and parasites participate as cofactors in the development of some cancers. Although proof of cause-and-effect relationships has been difficult to obtain, there can be little doubt that microorganisms occasionally play pivotal roles in the origin of some cancers. Whether attempted intervention against these cancers is best directed against the oncogenic microorganisms themselves or against other environmental cofactors is not yet clear. Nevertheless, the successful application of tumor vaccines in the prevention of Marek's disease in chickens and in modifying the outcome of oncogenic herpesvirus infections in nonhuman primates offers hope of at least limited application of microbial vaccines in the prevention of human cancer. PMID- 3541602 TI - Prazosin versus captopril as initial therapy. Effect on hypertension and lipid levels. AB - A randomized, parallel group study evaluated the safety, efficacy, and effect of the alpha blocking agent prazosin and the angiotensin converting enzyme inhibitor captopril on serum lipid levels in patients with mild to moderate hypertension. Baseline evaluations were performed on 31 patients after a four-week placebo washout period. Patients were randomly assigned to receive either prazosin (n = 15) or captopril (n = 16). Daily doses were titrated as follows: for prazosin, 1 mg two times daily to maximum of 20 mg per day; for captopril, 25 mg three times daily to a maximum of 450 mg per day. If diastolic blood pressure was not adequately controlled (less than 85 mm Hg) after four weeks of monotherapy, 1 mg of polythiazide was added to the daily regimen. There were no statistically significant differences between the drug groups for the measured variables in either the parallel or crossover phase of the study. Five of 15 prazosin-treated patients and six of 16 captopril-treated patients required the addition of thiazide to achieve blood pressure control. PMID- 3541603 TI - Benzene-induced inhibition of erythroid colony formation in vitro. AB - The erythroid colony forming unit assay technique was used to study the inhibitory effect of benzene on mouse bone marrow cell culture in vitro. The ability of vitamin B6 to prevent benzene-induced inhibition of erythroid colony formation was also tested. At concentrations equal to or higher than the lowest inhibitory concentration of benzene, pyridoxine HCl significantly prevented benzene-induced inhibition of erythroid colony formation in vitro. However, when benzene concentration was higher, the added pyridoxine HCl was ineffective in preventing benzene-induced inhibition of erythroid colony formation in vitro, even when it was preincubated with the bone marrow cells for 30 minutes prior to adding benzene. On the basis of this finding, it is proposed that benzene-induced inhibition of erythroid colony formation may involve two different mechanisms, one of which involves interaction with vitamin B6 added as pyridoxine HCl. PMID- 3541605 TI - Basic mechanisms of metastasis. AB - Metastatic disease is responsible for the majority of deaths caused by cancer. The process of metastasis is an orderly, stepwise process that results in the selection of cells that possess the capability to establish viable metastases. These cells must be locally invasive and be able to survive the physical traumas of dissemination and normal host defenses. Once metastatic cells have been arrested in a capillary bed, they must be able to invade the host organ parenchyma and survive in that milieu. Studies in a number of model systems have documented the phenotypic alterations in cells that have "metastatic potential." These differences may stem from normal tumor cell heterogeneity and surprisingly reflect only minor differences in gene expression. The role of activated oncogenes in metastasis is unclear, but a number of laboratories have documented that transfection with activated Ha-Ras results in increased metastatic potential. An increased understanding of the genetic basis of metastatic potential may suggest new directions for intervening in this deadly process. PMID- 3541606 TI - Unstable angina pectoris: the first half century: natural history, pathophysiology, and treatment. AB - Unstable angina pectoris as a distinct syndrome intermediate between chronic stable angina and acute myocardial infarction was first described about a half century ago. The incidence of death or myocardial infarction rises in the first few months after destabilization of angina. Hemodynamic, scintigraphic, and arteriographic studies in the last 15 years have shown that unstable angina is chiefly due to "dynamic" coronary stenoses, transient reversible limitations in coronary blood flow caused by a complex interaction between coronary vasoconstriction, transient platelet plugging, and transient thrombosis. The trigger for the onset of dynamic coronary stenoses is probably acute changes in coronary arterial morphology in or near atherosclerotic plaques making those areas more thrombogenic. A large fraction of patients with unstable angina restabilize initially with medical management. The role of beta blockers is unclear, but they may protect against development of coronary events for patients with unstable angina similar to that reported for patients with myocardial infarction. Nitrates and calcium blockers are probably superior to beta blockers in restabilization of angina, but protection against coronary events has not yet been demonstrated clearly. Further investigation is needed to distinguish the relative benefits of a two-drug (heart rate-limiting calcium blocker plus nitrates) regimen vs. a three-drug regimen including beta blocker. There is no basis for emergency coronary bypass surgery to prevent myocardial infarction or death. Urgent surgery should be limited to patients who do not stabilize readily with medical therapy. One third or more of the patients who initially restabilize with medical therapy will require coronary revascularization in the year after unstable angina because of severe angina. An antithrombotic regimen of aspirin (or possibly heparin) reduces the incidence of progression to death or myocardial infarction. Two important future directions for research should be promising: development of better antithrombotic regimens other than aspirin alone for protection against coronary events; and improved ability to distinguish the patients who initially respond to medical therapy who are at low risk for later severe angina from those at higher risk. PMID- 3541604 TI - Secretory antibody following oral influenza immunization. AB - Secretory IgA antibody may be important in protection against respiratory viral infections, and the concept of a common mucosal immune system offers the theoretical basis for the convenient stimulation of this antibody. Therefore, the oral route was compared with intramuscular injection in a double-blind, placebo controlled study in young healthy volunteers. A killed influenza vaccine, given in enteric-coated capsules (total of 98 ug hemagglutinin of A/Bangkok) led to significant salivary and nasal IgA antibody rises in a 4-week period. The preimmunization titers in secretions were inversely correlated with the antibody rise after immunization. The orally administered vaccine was associated with no more side effects than placebo, in contradistinction to reactions following the intramuscular route. The latter route also was without significant effect in regard to a stimulation of secretory antibodies. The observed simultaneous induction of antibodies in saliva and nasal secretions following oral administration of killed vaccine gives further evidence of a common mucosal immune system and its possible clinical use. PMID- 3541607 TI - Prenatal ultrasonographic features of the Pena-Shokeir I syndrome and the trisomy 18 syndrome. AB - The prenatal ultrasonographic features found in two cases each of the Pena Shokeir I and the trisomy 18 syndromes are described. All four cases were referred for ultrasonographic evaluation of polyhydramnios, clinically detected in the third trimester. A detailed ultrasonographic study of the craniofacial structures, intrathoracic organs, and limbs showed scalp edema, multiple ankyloses, camptodactyly, rocker-bottom feet, cardiac arrhythmias, and lung hypoplasia. Chromosome analysis showed trisomy 18 in two cases; in the other two cases the diagnosis of the Pena-Shokeir I was confirmed after delivery. The similarity of the two syndromes with respect to ultrasound findings is discussed. PMID- 3541608 TI - Torts of wrongful birth and wrongful life: a review. AB - During the past half century reproductive and prenatal technologies have become increasingly sophisticated and accessible to the public. As prospective parents have become more knowledgeable about the various reproductive options available, there has evolved a body of jurisprudence that has defined and defended the exclusive right of individuals to make their own decisions about conceiving and bearing children. This right is now protected under the constitutional umbrella of the right to privacy. If this right is violated through the negligence of one or more health care providers, the allegedly injured parents may sue for the wrongful birth of an unplanned or a defective child. Similarly, a defective child may sue for wrongful life. Both plaintiff parents and plaintiff child seek to recover monetary damages as compensation for their alleged injuries. In wrongful birth cases judicial opinions have moved from an earlier "blessings rationale" through a series of "benefits" cases toward more recent "burdens" decisions. In early suits for wrongful life the courts often held that the child had no valid cause of action and could therefore not be heard in court. More recently, however, some courts have recognized the validity of actions for wrongful life and have decided in favor of the defective children. The most recent judicial decisions suggest that courts may be following a trend to decide in favor of plaintiff parents and children at the expense of the defendant health care providers. PMID- 3541609 TI - Avoiding wrongful birth and wrongful life suits. PMID- 3541611 TI - Biodisposition of tertatolol in man: a review. AB - Tertatolol is rapidly (tmax: 1.25 h) and totally absorbed by the gastro intestinal tract with a low presystemic metabolism, and the bioavailability (60%) is not affected by food intake. Although clearance is low (130 ml/min), half-life is short (3 h) due to a restricted volume of distribution. Tertatolol is extensively metabolized (99%) to 9 metabolites with three equally important pathways, sulfoxidation, hydroxylation and conjugation. The half-life is not altered in hypertensive patients. It is increased in the elderly (7 h) and in patients with renal failure (9 h, irrespective of creatinine levels). However, considering the once-daily regimen, the recommended dose (5 mg/24 h) does not need to be altered in these patients. In hepatic disease, the modifications of pharmacokinetic parameters correlate with the severity (t1/2 = 14.5 h in the severe group). Taking into account the extensive metabolism of the drug, this justifies halving the dose in patients with cirrhosis and prothrombin time less than 70%. The kinetics are linear over a 10-fold dosage range and, after repeated dosing, there is no accumulation. Despite the short half-life, and because of a flat plasma level response curve, beta-blockade continues for 24 h following a 5 mg dose. PMID- 3541610 TI - Analysis of Pena Shokeir phenotype. AB - At this point in time, we recognize that "Pena Shokeir" is not a diagnosis or a specific syndrome but rather a description of a phenotype produced by fetal akinesia or decreased in utero movement. In its "full blown" form, it is characterized by polyhydramnios, intrauterine growth retardation, pulmonary hypoplasia, craniofacial and limb anomalies, congenital contractures, short umbilical cord, and lethality. From the cases thus far reported, we would anticipate that the phenotype is present in a very heterogeneous group of disorders--heterogeneous both with regard to the specific anomalies present and with regard to the causes (which must include many environmental agents and multiple genetic forms). One challenge for the future is to better describe and delineate specific entities. In the meantime, we would do well to use the terms "Pena Shokeir phenotype" or "fetal akinesia/hypokinesia sequence," which do not imply a single entity. There are many practical aspects of recognizing this phenotype. The presence of any one of the cardinal signs of the fetal akinesia/hypokinesia sequence should alert the physician to look for the other associated anomalies, since specific treatment may be indicated, and catch-up or compensatory growth may occur, if given a chance. The ability to provide prenatal diagnosis and perhaps prenatal treatment in the future may allow us to alter dramatically the natural history of some cases. In others, we need to establish when treatment is possible and when it gives no benefit. Perhaps the most important insight gained from the study of the fetal akinesia sequence is the reaffirmation of the concept that function is an integral part of normal development. Specific structures do not develop in isolation but are part of a carefully timed and integrated system. The "use" of a structure in utero is necessary for its continuing and normal development. The old adage "use it or lose it" seems to apply just as appropriately to prenatal normal development as it does in the crusty adult world of politics, business, and academia. PMID- 3541612 TI - Renal blood flow in man with essential hypertension. AB - Abnormalities in renal blood flow in man with sustained essential hypertension are reviewed with emphasis on four points: renal blood flow is decreased not only per unit square meter but also as a fraction of cardiac output, a result which is not observed in other organs, the relationship between cardiac output and renal blood flow is reset, so that restriction of arteriolar renal vessels is dominantly preglomerular in origin, the renal abnormalities may be reversed by alpha-blockade, suggesting an important contribution of the autonomic nervous system, and, finally, the normal sodium balance in steady-state conditions is achieved through adaptive mechanisms involving the venous system and resulting in decreased venous compliance and increased postglomerular and venous hydrostatic pressures. PMID- 3541613 TI - Adjunctive magnesium sulfate infusion does not alter metabolic changes associated with ritodrine tocolysis. AB - Magnesium sulfate, an agent whose cellular actions might cause metabolic disturbances, has been used concomitantly with ritodrine hydrochloride for preterm labor tocolysis. Although the profound metabolic effects of beta adrenergic agents have been well described, the possibility that adjunctive magnesium might cause further or unexpected alterations in maternal metabolic parameters has not been fully evaluated. To investigate this question, we prospectively randomized patients, in a blinded fashion, to receive ritodrine plus placebo or ritodrine plus adjunctive magnesium sulfate for preterm labor tocolysis. Serial measurements of potassium, glucose, blood urea nitrogen, and hematocrit were obtained and compared between tocolytic treatment groups. The metabolic changes found were similar in each group and appear to result predominantly from beta-adrenergic stimulation with no apparent perturbations caused by the direct cellular actions of magnesium sulfate. From the metabolic standpoint, it appears that the clinician may use adjunctive magnesium sulfate without fear of accentuating or obscuring the expected beta-adrenergic-induced alterations in the above-mentioned maternal metabolic parameters. PMID- 3541614 TI - Immunoproteins in the endometrium: clinical correlates of the presence of complement fractions C3 and C4. AB - The presence of complement fractions C3 and C4 in endometrial tissue was studied in a consecutive series of patients undergoing diagnostic laparoscopy, to determine their specific association with endometriosis. The incidence of complement in eutopic endometrium of patients grouped according to four diagnoses was: endometriosis, 66% positive (23 of 35); active pelvic inflammatory disease, 85% positive (11 of 13); combined endometriosis with pelvic inflammatory disease, 25% positive (one of four); laparoscopically normal pelvis, 67% positive (10 of 15). These differences were not statistically significant. Complement was equally likely to be found in proliferative, secretory, menstrual, or inflammatory endometrium. Endometrial complement was found less frequently in patients with severe endometriosis as compared with those with the mild form. Among patients with endometriosis and infertility, complement was much more likely to be found in patients with primary infertility than in those with secondary infertility (p less than 0.007). In short-term follow-up of these patients, the absence of complement in the eutopic endometrium appeared to be a good predictor of subsequent pregnancies. PMID- 3541615 TI - Polyhydramnios and elevated intrauterine pressure during amnioinfusion. AB - Amnioinfusion has been demonstrated to be useful in relieving and preventing repetitive variable decelerations. There have been no reported complications. This case illustrates the potential for iatrogenic polyhydramnios and elevated intrauterine pressure during amnioinfusion. PMID- 3541616 TI - Immunohistochemical studies on collagen types in the uterine cervix in pregnant and nonpregnant states. AB - The distribution of collagen types in pregnant and nonpregnant uterine cervices was examined by immunoperoxidase staining with the use of type-specific anticollagen antibodies. The nonpregnant cervix, composed of dense fibrous tissues, was diffusely stained with antibodies to type I and type III collagens. Type IV collagen was located only in the basement membrane region. In the cervix at term pregnancy, a marked decrease in fibrous connective tissue with increased proportions of smooth muscle fibers was characteristic, forming expanded spaces in between due to edema (clear spaces) with focal infiltrations of polymorphonuclear leukocytes. Type I and type III collagens were distributed only around smooth muscle fiber bundles with some fibroblasts attached. Type IV collagen was distributed in a linear fashion delineating individual smooth muscle fibers and vascular basement membranes. A possible role of infiltrated polymorphonuclear leukocytes in the dissociation of fibrous connective tissues of the cervix at term pregnancy is discussed. PMID- 3541617 TI - A prospective study to compare serum human placental lactogen and menstrual dates for determining gestational age. AB - In a group of 575 healthy pregnant women with certain menstrual dates the estimation of the length of gestation from maternal serum human placental lactogen concentrations has been compared with gestational age calculated from the last menstrual period and ultrasonic measurements of the fetal biparietal diameter. In 412 of these patients labor started spontaneously, and the estimated dates of delivery determined by these three methods were also compared. In the range of 9 to 17 weeks of pregnancy, gestational age can be determined by human placental lactogen measurement to within 7 days (+/- 1 SD) which compares favorably with other methods. Regarding the prediction of the expected date of delivery, 88% were delivered within 2 weeks of the date predicted by last menstrual period, 82% within 2 weeks of the sonar date, and 80% by the date determined by human placental lactogen assessment. Prediction of delivery in a further group of 139 women with uncertain dates gave 73% within 2 weeks by sonar date and 69% within 2 weeks by human placental lactogen determination. We suggest human placental lactogen measurements should become part of routine antenatal care complementing rather than replacing the role of ultrasonic scanning. For those doctors and patients who wish to avoid more exposure to ultrasonic scanning than absolutely necessary, human placental lactogen estimates offer an alternative method for assessing the length of gestation. PMID- 3541619 TI - Source of prenatal care and infant birth weight: the case of a North Carolina county. AB - The impact of a comprehensive prenatal care program on the birth weights of infants born to low-income women is assessed. Women receiving care through the prenatal program of a large county public health department were compared to pregnant Medicaid-eligible women in the same county, who received prenatal care primarily from private-practice physicians. The percentage of low birth weight was 8.3 for the health department women compared with 19.3 for the Medicaid women. After differences between the two groups in race, marital status, participation in the Special Supplemental Food Program for Women, Infants, and Children (WIC), quantity of prenatal care, and other risk factors were statistically controlled, the chance of a Medicaid woman having a low-weight birth was still more than twice as great (p = 0.007). A case-management approach and greater use of services ancillary to basic obstetric medical care appear to contribute to the better birth weight outcomes in the health department. PMID- 3541618 TI - Deoxyribonucleic acid hybridization analysis for the detection of urogenital Chlamydia trachomatis infections in women. AB - The presence of Chlamydia trachomatis-related deoxyribonucleic acid sequences in endocervical specimens of 317 women was analyzed by deoxyribonucleic acid hybridization techniques with deoxyribonucleic acid from C. trachomatis used as probes. Samples from 56 of 172 high-risk patients (32.6%) and 16 of 145 low-risk patients (11.0%) contained C. trachomatis-related deoxyribonucleic acid sequences. Direct detection of chlamydial antigen with enzyme-linked immunoassay on the same patients yielded positive rates of 26.3% and 7.3% for the high- and low-risk patients, respectively. C. trachomatis culture confirmed 86.3% of deoxyribonucleic acid-positive results and 84.0% of antigen-positive results. The overall sensitivities of chlamydial deoxyribonucleic acid and antigen assays were 91.7% and 68.8%, respectively, whereas the specificities were 95.3% and 94.7%. Results also suggested that the test of the C. trachomatis deoxyribonucleic acid correlated better with the female urogenital chlamydial infections than did the antigen test of C. trachomatis. The combined results of higher sensitivity in detecting the microorganism and better correlation with disease activity may make the deoxyribonucleic acid hybridization test a useful tool for the early and accurate diagnosis of C. trachomatis infections in female patients. PMID- 3541620 TI - The efficacy of intrapartum electronic fetal monitoring. AB - With basic methodologic criteria as a framework, this report assesses the quality of the seven randomized controlled clinical trials conducted in five countries to compare a policy of routine electronic fetal monitoring with a policy of fetal heart rate monitoring by auscultation. One trial found a statistically significant decrease in the occurrence of neonatal seizures in the electronic fetal monitoring group. The trials demonstrated no other statistically significant benefit associated with the use of electronic fetal monitoring, but most reported significant increases in the rates of abdominal and vaginal operative deliveries associated with electronic fetal monitoring. Taken together, the seven trials provide valuable information about the routine use of intrapartum electronic fetal monitoring; they do not demonstrate that it is a useful screening procedure for all women in labor. PMID- 3541621 TI - Abruptio placentae: clinical management in nonacute cases. AB - One hundred thirty cases of clinically diagnosed abruptio placentae encompassing the wide range of acuity were grouped by gestational age at delivery into previable, preterm, and term divisions for comparison of demographic data, presenting symptoms, delay to delivery, mode of delivery, and delivery indications. Attention was focused on the preterm group of patients to assess the implications of presenting symptoms, the usefulness of ultrasonography, and the safety and efficacy of tocolysis. Cigarette smoking and a previous poor obstetric history were found to be more frequent in the preterm compared to the term abruptio placentae. Ultrasonic visualization of a clot was successful in 25% of the preterm patients but otherwise appeared to have little or no impact on course or management. Tocolysis for the preterm patients appeared to be beneficial in prolonging gestation and did not increase the likelihood of cesarean delivery, hemorrhage, or fetal distress. The cumulative rates of delivery following admission were compared with and without tocolysis, with and without sonographic visualization of a clot, and overall as a function of gestational age at initial hospitalization. Perinatal mortality was 17%. Inpatient management with frequent fetal heart rate monitoring, tocolysis if indicated, and timely use of cesarean delivery are advocated to promote prolongation of the pregnancy and minimized perinatal mortality. PMID- 3541622 TI - The effect of percutaneous estradiol and natural progesterone on postmenopausal bone loss. AB - The effect of percutaneous estradiol alone and combined with natural progesterone on postmenopausal bone loss was studied. A total of 57 women who had experienced a natural menopause 6 months to 3 years previously entered the study. After an initial examination the women were allocated in a blinded pattern to treatment with 3 mg of percutaneous estradiol or placebo. The code was broken after 1 year of treatment, and the women receiving estradiol continued with a cyclic addition of progesterone, whereas those receiving placebo continued with placebo. The women were examined every 3 months during the 2 years of treatment. Measurement of the bone mineral content in the forearms (single photon absorptiometry) and the spine and total skeleton (dual photon absorptiometry) showed a significant decrease of 5% to 7% in the placebo group during the 2 years of treatment, whereas it remained constant in all bone compartments in the estradiol group. Addition of progesterone did not influence the results. Biochemical estimates of calcium metabolism changed toward a premenopausal level in the estradiol group but remained unchanged in the placebo group. We conclude that percutaneous estradiol is effective as preventive therapy of postmenopausal bone loss and that addition of progesterone does not influence bone or calcium metabolism. PMID- 3541623 TI - Long-term effects of percutaneous estrogens and oral progesterone on serum lipoproteins in postmenopausal women. AB - Serum lipids and lipoproteins were examined in a group of 45 healthy postmenopausal women who were treated for 2 years with either 3 mg of percutaneous estradiol (n = 20) or placebo (n = 25). Percutaneous estradiol was given alone during the first year of treatment and in combination with oral micronized progesterone (200 mg) for 12 days of each cycle during the second year. The women were examined every 3 months throughout the 2 years. Percutaneous estrogen therapy significantly reduced total serum cholesterol and low-density lipoprotein cholesterol, whereas no significant differences were observed in serum triglycerides and high-density lipoprotein cholesterol. Addition of oral progesterone during the second year of treatment did not produce any significant alterations in serum total cholesterol or low-density lipoprotein cholesterol, both of which remained significantly reduced. Serum triglycerides remained virtually unchanged, whereas a slight but significant increase (p less than 0.05) was observed in high-density lipoprotein cholesterol levels at the end of the study period. We conclude that percutaneous estrogen administration produces changes in total serum cholesterol and low-density lipoprotein cholesterol levels similar to those observed after oral estrogen administration. However, the magnitude and time course of the response seem to be modulated by the route of administration. Addition of oral micronized progesterone does not influence the beneficial estrogenic actions on serum lipids and lipoproteins and seems to be a proper "progestogen" in percutaneous estrogen therapy. PMID- 3541624 TI - Advanced ultrasonic placental maturation in twin pregnancies. AB - The mean length of twin pregnancies is shorter than that of singleton pregnancies. The possibility that the shorter gestation of twins is associated with advanced fetal maturational changes was studied in relation to placental maturation. For this purpose, the sonographically determined placental gradings of 158 twin pregnancies and 474 singleton pregnancies were compared at different gestational ages. The percent distributions of placental grades, from I to III, were significantly different throughout the third trimester, with a preponderance of Grade III placentas in the twin group (p less than 0.001). Considering the reported association of Grade III placentas with advanced gestation as well as fetal lung maturity, the present study suggests earlier maturational changes in twin fetuses compared with singleton fetuses. PMID- 3541625 TI - Antenatal sonography of fetal malformations associated with drugs and chemicals: a guide. AB - A guide presented in this article provides the sonographer with a list of fetal malformations that have been described in association with specific drugs or chemicals and that can be visualized by current ultrasonographic techniques. PMID- 3541626 TI - Proliferation of group B streptococci in human amniotic fluid in vitro. AB - The group B Streptococcus is one of the most virulent organisms causing perinatal infection. Human amniotic fluid from the second and third trimesters was pooled and analyzed for electrolytes, protein, albumin, zinc, inorganic phosphorus, ferritin, lysozyme, and immunoglobulins. We inoculated replicates of specimens with known virulent strains of group B streptococci (893, 891, and 878) and Escherichia coli (C5) with Todd-Hewitt broth and normal saline solution used as controls. Group B streptococci strains 893 and 891 proliferated rapidly at rates similar to their rates in Todd-Hewitt Broth. Strain 878 grew at a rate slower than that of strains 893 and 891. The amniotic fluid specimens were similar with respect to factors reported as inhibitory to bacterial proliferation. Second- and third-trimester amniotic fluid supports the growth of group B streptococci as well as a culture medium optimized for bacterial growth. Strain-specific variance in group B streptococci growth rates in amniotic fluid may have clinical significance for those at risk for group B streptococci infection. PMID- 3541627 TI - Edward W.D. Norton. PMID- 3541628 TI - Edward W.D. Norton. Festschrift. PMID- 3541629 TI - Screening for potentially pathogenic agents in cornea donors. PMID- 3541630 TI - Fixation for keratoplasty trephination. PMID- 3541631 TI - Mooren's ulcer after penetrating keratoplasty. AB - Seventeen months after penetrating keratoplasty for pseudophakic bullous keratopathy, a patient developed severe pain and a peripheral corneal ulcer that had the characteristic clinical appearance of a Mooren's ulcer. We performed a 10 mm penetrating keratoplasty that extended from the superior margin of the previously placed graft to the inferior corneoscleral limbus to encompass the ulcerated cornea. Histopathologic examination of tissue removed at surgery disclosed that the peripheral corneal ulcer extended nearly through the entire stromal thickness and that the donor corneal stroma adjacent to the ulcer was infiltrated with lymphocytes, plasma cells, and neutrophils. The conjunctiva adjacent to the peripheral corneal ulcer was packed with plasma cells and also showed some lymphocytes and neutrophils. PMID- 3541632 TI - S-antigen immunoreactivity in trilateral retinoblastoma. AB - Using monoclonal antibody MAbA9-C6, which identifies an antigenic determinant of S-antigen retained in fixed tissue sections, we investigated S-antigen immunoreactivity in the ocular and brain tumors of four cases of trilateral retinoblastoma. In the eye, S-antigen immunoreactivity was present in all retinoblastomas examined, as well as one retinocytoma characterized by benign appearing cells including fleurettes. S-antigen immunoreactivity was focally present in two of the four brain tumors examined. Additionally, two intraocular medulloepitheliomas, one of which contained well-defined rosettes, and 16 primary intracranial tumors, including seven pineal gland tumors and nine other lesions, some of which histopathologically may resemble retinoblastoma, were examined. S antigen immunoreactivity was observed in two pineal gland tumors but not the remaining nine primary intracranial neoplasms or the two intraocular medulloepitheliomas. Our results further substantiate the immunologic relationship between the retina and the pineal gland, and tumors originating in these tissues. PMID- 3541634 TI - Occupational therapy in adult day-care (position paper). American Occupational Therapy Association. AB - Occupational therapy personnel assume central roles in adult day-care regardless of specific program emphasis. Occupational therapy focuses on health rather than illness, on what the individual can do in spite of disabilities. Several of the profession's objectives directly parallel those of adult day-care--to enable individuals to function as independently as possible despite their physical and mental limitations. To achieve this, a variety of intervention strategies are used, including remedial therapeutic activities, environmental modifications, adapted living techniques, and, when necessary, adaptation of the home environment. In this way, occupational therapy contributes significantly to the quality of life of adult day-care participants. PMID- 3541635 TI - Roles and functions of occupational therapy in adult day-care (position paper). American Occupational Therapy Association. AB - Occupational therapy's long-standing involvement in adult day-care attests to the importance of the profession's role in this setting. The functional approach used by occupational therapy helps the older person overcome multiple disablements associated with aging. Intervention promotes independence, adaptation, and the maintenance of occupational performance in self-care, work, and leisure. Working collaboratively with the day-care staff, participant, and family or care giver, occupational therapy personnel use their expertise to analyze activities and facilitate problem solving. Occupational therapy personnel may also work as administrators, activity coordinators, and consultants within the adult day-care setting. PMID- 3541633 TI - Pseudomonas corneoscleritis. AB - We evaluated three cases of Pseudomonas aeruginosa corneoscleritis, one associated with the use of contaminated eyedrops; another in an elderly, debilitated patient; and the third in a patient who had previously undergone penetrating keratoplasty. In the first two cases, control of the infection was achieved by intensive antibiotic therapy alone. The third case required evisceration of the eye following spontaneous perforation at the site of scleral involvement. Histopathologic findings showed persistence of the organism in the sclera despite intensive antibiotic therapy for six days. PMID- 3541636 TI - Roles and functions of occupational therapy in the management of patients with rheumatic diseases (position paper). American Occupational Therapy Association. AB - Occupational therapy personnel make a major contribution to the management of patients with rheumatic diseases. Their unique skills include the ability to analyze activities, educate patients in alternate ways of performing these activities, and facilitate problem solving. The education and training of occupational therapy personnel in the physical, psychological, and social aspects of physical dysfunction make them valuable members of the health care team. The ultimate goal of occupational therapy is to help the patient gain the skills to achieve a maximum level of function in life tasks. PMID- 3541637 TI - Ophthalmic applications of biofeedback. AB - Biofeedback therapy has been shown to be of value in the treatment of numerous psychological and physiological problems. In this paper, applications of biofeedback for correction of oculomotor abnormalities including strabismus, nystagmus and amblyopia, refractive error correction, reduction of intraocular pressure (IOP), and blepharospasm suppression are reviewed. PMID- 3541638 TI - Estrogen receptor analysis on biopsies and fine-needle aspirates from human breast carcinoma. Correlation of biochemical and immunohistochemical methods using monoclonal antireceptor antibodies. AB - Monoclonal antibodies against estrogen receptor (ER) were used for determination of ER status immunocytochemically in histologic specimens from 192 primary breast carcinomas. All tumors were also assayed biochemically for ER with the dextran coated charcoal method (DCC). The comparison of biochemically and immunocytochemically determined ER status showed concordant results in 80% (P less than 0.0001). In only 2 cases (1%) with low ER levels (less than 20 fmol/mg protein) immunocytochemistry failed to detect ER. ER positivity determined with a semiquantified approach based on intensity and heterogeneity of immunocytochemical staining correlated significantly with biochemically determined ER levels (P = 0.0001). In a series of fine-needle aspirates of 34 breast carcinomas sufficient cell material was available for ER immunocytochemistry (ER-ICA). Overall, the results of ER-ICA in fine-needle aspirates were concordant with ER-ICA in histologic specimens in 88% of the samples. In a few cases with weak positivity of ER-ICA in histologic specimens, ER-ICA was negative in fine-needle aspirates. In no case was there a false positive immunocytochemical ER determination in a tumor aspirate. Thus, ER-ICA seems to be a reliable assay which can be performed in histologic and cytologic specimens. PMID- 3541639 TI - Amyloid P component is not present in the glomerular basement membrane in Alport type hereditary nephritis. AB - Serum amyloid P component (SAP) is a normal plasma glycoprotein immunochemically indistinguishable from amyloid P, a glycoprotein found in all tissue amyloid deposits. SAP has also been shown to be a constituent of normal glomerular basement membrane (GBM). In this study the authors discovered a unique association between SAP and Goodpasture (GP) antigen. In those patients whose GBM lack GP antigen (those with Alport-type hereditary nephritis) SAP is also uniformly absent. Although the relationship between these two components is unknown, this association may provide clues to the abnormality of GBM in Alport type hereditary nephritis. PMID- 3541641 TI - Renal tubular immune complex formation in mice immunized with Tamm-Horsfall protein. AB - Mice were given injections of rat Tamm-Horsfall protein (TH) in order to study immune complex formation in the distal nephron. After immunization, all mice had high serum levels of antibodies to TH; immune deposits consisting of IgG antibodies to TH and TH formed at the base of cells of the thick ascending limb of the loop of Henle (ALH) and distal convoluted tubule. These basal complexes were maximal in number and size within the cortical ALH, where they often radiated toward the luminal surfaces. Although the highest anti-TH antibody titers were found in animals with the most extensive deposits, antibody levels were not directly proportional to IgG deposits or to the time after immunization. The larger immune deposits were visualized by light microscopy as PAS-positive deposits. The quantity of these deposits was proportional to the time after immunization and was directly related to anti-TH antibody levels. Electron microscopy showed that these immune deposits were present within the basal and lateral intercellular spaces of the cells of the ALH. The distribution and localization of TH within the normal mouse kidney was very similar to that in rats. However, the distribution of immune complexes within the distal nephron in mice differed from rats similarly treated with TH and indicates either species differences in the distribution and/or organization of TH associated with tubular cell surfaces or that the accessibility of distal tubules to antibodies is species-dependent. PMID- 3541640 TI - Detection of urothelial Lewis antigens with monoclonal antibodies. AB - The detectability of Lewis a and b antigens (Lea, Leb) was examined in the normal urothelium of 28 human subjects whose red blood cells (RBCs) were also tested for Lea and Leb. Mouse monoclonal antibodies as well as goat and human antisera were used on paraffin-processed and fresh-frozen tissues. Multiple biopsy specimens from the same individual were studied in order to evaluate temporal as well as topographic consistency of the results. In addition, the expression of the Lewis antigens in the appendiceal mucosa was investigated in 9 of these patients. The antibodies against Lea reacted with the urothelium of all patients with either Lea+b- or Lea-b+ RBC phenotype. None of the 5 patients with Lea-b- RBCs had Lea urothelial reactivity. The antibodies against Leb reacted with the urothelium of all patients with Lea+b- or Lea-b+ RBCs and with 2 of the 5 patients with Lea-b- RBCs. The mucin in the goblet cells of the appendiceal mucosa was positive only for the Lewis antigen that was also detectable of the individual's RBCs. These findings indicate that the expression of Lewis antigens in nonsecretory epithelia may not follow the same principles as in the blood and secretions. PMID- 3541642 TI - Influence of minor thermal injury on expression of complement receptor CR3 on human neutrophils. AB - Thermal injury is well known to inhibit functions of the circulating neutrophil related to its role in host defense against infection, but the mechanism(s) of this phenomenon are not fully understood. To gain further clues to these mechanisms, the authors have studied patients with thermal injury in terms of altered expression of neutrophil cell membrane receptors for the opsonic complement-derived ligand C3bi--complement receptor Type 3, or CR3. CR3 expression was selected for study because an increase in the number of receptors on the cell surface can be stimulated by products of complement activation known to accumulate after thermal injury and because of the role of CR3 in phagocytic and adherence functions of the neutrophil. Expression of CR3 was monitored semiquantitatively by flow cytometry with the use of a murine monoclonal antibody (OKM1) specific for an antigen (CD11) associated with this receptor. Patients evaluated were limited in this study to those with minor degrees of thermal injury (second-degree burn involving less than 20% of total body surface area) so that possible confounding effects of major injury and its complications could be eliminated. It was observed that patient neutrophil CR3 becomes significantly up regulated during the first week, as early as 1 day after injury. The maximum level of expression of CR3 averaged greater than 150% (range, 70-314%) of the respective minimum level observed for each patient. The minimum levels of expression of CR3 on patient neutrophils, reached 11-37 days after injury for 7 of 8 patients, were comparable to the level of expression of CR3 on unstimulated control neutrophils. Such temporal up-regulation of patient neutrophil CR3 suggests the early generation of stimuli of CR3 mobilization in response to thermal injury. Increased numbers of CR3 on patient neutrophils may augment microbicidal function and enhance or inhibit delivery of cells to the burn site. PMID- 3541643 TI - Secretory immune responses in human kidneys. AB - The secretory immune system has been well studied in the intestinal, bronchial, and biliary systems and breast. Tissue studies of secretory immunoglobulins in the kidney are scanty, mostly related to nephropathies with IgA. Renal tissues from 37 autopsies selected for any history of renal dysfunction were processed for immunohistologic studies on frozen sections with several antisera, including a purified rabbit anti-human secretory component (SC). By immunohistology, gel diffusion, and immunoblotting, the anti-SC antibody reacted appropriately with purified human SC, saliva, intestinal epithelium, and breast milk and did not cross-react with immunoglobulin heavy or light chains, lactoferrin, and other tissue proteins. IgA and SC were seen in tubular casts in 70% of patients, whereas less impressive staining with IgM, IgG, and albumin was seen, respectively, in 24%, 13%, and 22% of the patients. SC was present in the cytoplasm of distal tubule and Henle's loop cells in 78% of specimens. A control group of 10 healthy individuals who died suddenly showed minimal staining of casts and tubules in 2 specimens. Renal pathology in the group with IgA-SC+ casts included acute tubular necrosis (54%), severe chronic renal disease (61%), and mild chronic renal injury (38%). The group with negative IgA-SC casts included acute tubular necrosis (64%), infectious interstitial nephritis (36%), and negligible renal disease (36%). This study suggests that discrete distal segments of the nephron may have the capability of secreting SC, which is probably coupled with serum-derived IgA and incorporated into luminal tubular secretions. The low level of immunosecretions in kidneys which are normal or minimally damaged suggests that this system may need to be turned on by unknown, probably pathogenic stimulating factors. PMID- 3541645 TI - Periodontal disease in ancient populations. AB - Recent clinical and anthropological findings indicate that the conventional concept of the pathogenesis of periodontal disease requires review. The periodontal lesion has been defined as a generalised horizontal loss of crestal bone resulting from host immune and inflammatory responses triggered by the action of commensal bacteria, and the extension of gingivitis into the deeper periodontium to become periodontitis has been assumed to occur slowly but steadily over many years. Anthropological and clinical investigations reveal that the widespread loss of crestal tissue is relatively unusual and that lesions of the alveolus are commonly localised and severe. Longitudinal studies have shown that the disease progresses in bursts and is stable in both the gingivitis and periodontal modes in between the burst activity. The findings of the present study demonstrate that generalized horizontal periodontitis has been unusual and has not been responsible for tooth loss. Other factors responsible for deficient alveolar margins in dry bones have been overlooked in most studies, leading to overassessment of the incidence of periodontal disease in postmortem materials; the same assumptions have led to overassessment of periodontal disease in clinical studies and practice. PMID- 3541646 TI - Enthesopathies (lesions of muscular insertions) as indicators of the activities of neolithic Saharan populations. AB - Enthesopathies are bony lesions involving the sites of insertion of muscles or ligaments. Those caused by hyperactivity of the relevant muscles may be distinguished clearly from those of metabolic or inflammatory origin. Observations from sporting and occupational medicine indicate that specific enthesopathies are correlated with different activities. Examination of the enthesopathies present on two groups of well-preserved neolithic skeletons from separate regions of the Sahara with different paleoenvironments show that overall 20% of the skeletons presented lesions. Three different forms of enthesopathy involved the arm, principally the elbow, and may be tentatively correlated with javelin throwing, wood cutting, and archery. Two types of lesion involving the foot were observed in skeletons from a hunter-gatherer population and may be correlated with much walking or running over hard ground. I suggest that the analysis of such lesions on ancient skeletons may, in concert with other archaeological data, throw light on the activities of ancient people. PMID- 3541644 TI - Taurine protects hamster bronchioles from acute NO2-induced alterations. A histologic, ultrastructural, and freeze-fracture study. AB - In this study the authors describe the use of dietary taurine to protect hamster lung epithelium from acute nitrogen dioxide (NO2) injury. The conclusions were based on histologic, ultrastructural, and freeze-fracture analyses. Hamsters were pretreated for 14 days with 0.5% taurine in their drinking water. They were then exposed to either 7 or 30 ppm NO2 for 24 hours. The lungs from animals of these experimental groups were compared with those from hamsters treated with only NO2, and those given only taurine and with untreated controls. After treatment, hamsters were anesthetized and perfusion-fixed through the right side of the heart with a solution containing 1% glutaraldehyde, 4% paraformaldehyde, and 0.2 M cacodylate. The trachea and lungs were removed en bloc and stored overnight in cacodylate buffer at 4 C. Terminal and respiratory bronchioles, including alveolar ducts and peribronchiolar alveoli, were dissected from each lobe and processed for embedding in Epon and freeze-fracture replication. Light and transmission electron microscopy revealed the typical inflammatory cell infiltrate in the bronchiolar and alveolar duct regions in the lungs of hamsters exposed to NO2. The bronchiolar epithelium appeared flattened because of loss and breakage of cilia on ciliated cells and apical protrusions of Clara cells. Clara cell secretory granules were reduced or absent. Freeze-fracture replicas of tight junctions of bronchiolar epithelium analyzed by morphometric techniques demonstrated a reduction and fragmentation of fibrils. Only animals exposed to 30 ppm NO2 exhibited physiologic intercellular penetration of horseradish peroxidase. Hamsters pretreated with taurine and then exposed to NO2 showed none of these alterations. They exhibited the same morphologic features as the untreated controls and the hamsters treated only with taurine. On the basis of this evidence, it is suggested that prophylactic dietary taurine can prevent acute NO2-induced morphologic lung injury. Taurine may also be effective in preventing lung injury induced by other oxidant gases. PMID- 3541647 TI - Estimating mortality in skeletal populations: influence of the growth rate on the interpretation of levels and trends during the transition to agriculture. AB - Traditional paleodemographic methods of estimating mortality have been based on unrealistic assumptions about the prevalence of closed and stationary populations. When a living closed population was growing, the mean age at death of its skeletal survivors will be shifted below its true life expectancy. For declining populations, the mean age at death will be higher than true underlying life expectancy at birth. The faster the rate of growth, the larger and more curvilinear is the displacement. Mortality estimates can only be extracted from skeletal populations via an independent estimate of the growth rate. Fertility levels, however, can be estimated directly. The empirical importance of growth rate-dependent mortality estimates is demonstrated by reinterpreting mean-age-at death data from several populations before and after the agricultural revolution; with detailed consideration given to the Old World populations of Acsadi and Nemeskeri and a New World population from central Illinois. PMID- 3541648 TI - Heinz Kohut's self psychology: an overview. AB - In the 16 years since its inception, self psychology has provided a comprehensive theory of psychopathology and treatment. It has articulated a new group of developmental needs and transferences: mirroring, idealizing, and alter ego. The failure of parental empathy to meet those needs during childhood results in the inability to develop intrapsychic structures that can reliably regulate self esteem and calm the self, leaving the person overly dependent on those in the surround to provide those functions. Treatment requires careful understanding of the early failures and provides an environment in which the intrapsychic structures may belatedly and effectively develop. PMID- 3541649 TI - The discharged psychiatric patient: a review of social, social-psychological, and psychiatric correlates of outcome. AB - The authors review research over the past decade on the social, social psychological, and psychiatric correlates of community adaptation among discharged psychiatric patients. A review of 33 studies suggests that little theoretical or methodological progress has been made in identifying the factors that are conductive to the adjustment of discharged patients on their return to the community. To stimulate subsequent efforts in this area, the authors suggest applying new approaches, such as the stress process perspective that has been used to study mental health in the general population. PMID- 3541652 TI - The impact of crime on home care services. AB - A telephone survey of 49 Veterans Administration Home Care Programs found 32 programs reporting dangerous areas in their territories. Twelve excluded patients based on safety of area of residence. Programs in the eastern United States and in cities with higher rates of crime were more likely to have paired visits, escorted visits, or to exclude patients. Programs providing paired or escorted visits were less likely to exclude patients, suggesting that such policies maximize access to home care. PMID- 3541651 TI - Shigellosis outbreak associated with swimming. AB - In June 1982, an outbreak of gastrointestinal illness caused by Shigella sonnei occurred among residents of two counties in Oklahoma. A case-control study of cases and age and sex-matched controls showed an association with attendance at a southern Oklahoma lake (14/17 cases vs 3/17 controls, matched pair odds ratio [OR] 9/0, confidence interval [CI] 2.4-infinity). A survey of 85 persons who had visited the lake area showed that persons who had swum were more likely to have been ill with a gastrointestinal illness (50 per cent) than persons who had not swum (0 per cent); among those who had swum, illness was more frequent among those who reported having water in their mouths while swimming (62 per cent) than those who did not (19 per cent) (OR = 6.9, 95% CI = 2.2-21.5). No further primary lake-associated cases had onset of symptoms beyond two days of closing the reservoir. Swimming should be considered as a potential source of enteric infections. PMID- 3541650 TI - Mass media and smoking cessation: a critical review. AB - Evaluations of 40 mass media programs/campaigns designed to influence cigarette smoking were reviewed. Information/motivation programs/campaigns generally produced changes in awareness, knowledge, and attitudes. Extensive national campaigns also produced meaningful behavioral change. Programs/campaigns designed to promote some specific smoking-related action produced mixed results, depending in large part on the type of promotion involved. Mass media cessation clinics were found to be effective, with media plus social support being more effective than viewing plus printed material, and either combination being more effective than viewing alone. It was concluded that mass media health promotion programs can be more effective than many academics may have thought, but that the knowledge necessary to ensure such success is seriously lacking. Research studies, rather than simple evaluations, are needed to improve our knowledge base and build a science of mass media health promotion. PMID- 3541653 TI - Alcohol consumption among pregnant smokers: effects of a smoking cessation intervention program. AB - This study describes patterns of alcohol consumption among pregnant women who participated in a randomized clinical trial of smoking cessation intervention. Data on alcohol habits were obtained prospectively prior to the 18th week of gestation and during the 8th month of pregnancy. Average alcohol intake for both groups was reduced primarily prior to registration for prenatal care. The smoking cessation intervention reduced smoking during pregnancy but had no effect on alcohol intake. PMID- 3541654 TI - "When it rains it pours": endemic goiter, iodized salt, and David Murray Cowie, MD. PMID- 3541656 TI - Contributions of alimentary tract surgery to modern infection control. AB - The continuing contributions of alimentary tract operations to a clarification of the clinical utility of devices, procedures, and medications for control of surgical wound infection have been crucial to the advancement of modern surgical practice. Indeed, the foregoing essay has outlined several areas in which additional analysis and clarification should be able to further define valuable methods and combinations thereof. It has been the willingness of the individual surgeon oriented to the alimentary tract to include his operations and his patients in these kinds of rigid trials that have, indeed, allowed a final emergence of these useful adjuncts to the surgical armamentarium, an effect that now pervades all surgical practice. PMID- 3541655 TI - The relationship of vascularity and water content to tensile strength in a patellar tendon replacement of the anterior cruciate in dogs. AB - The methods and materials for ACL reconstruction are important issues for the practicing orthopaedic surgeon. In this study a model was developed to study the biological and biomechanical characteristics of a patellar tendon autograft used for ACL reconstruction. Specifically it was hypothesized that since vascularity of these grafts reflects their "healthiness," strength and vascularity should be inversely related in the early period after implantation. Using an over the top technique, a patellar tendon graft was placed in three groups of dogs and studied at 37, 57, and 120 days. Vascularity of the grafts was measured using technetium tagged red blood cells, and percent water by weight was determined by dessication. Tensile testing to failure was performed using an MTS machine. The grafts became more vascular, more hydrated, less stiff, and less strong (by 4 weeks) than controls. By 16 weeks the vascular response was subsiding but the grafts remained only 40% as strong as controls. Percent water increased significantly over controls for all time periods. Decrease in strength correlated poorly with vascularity but correlated well with increase in percent water. These findings suggest that the change in strength of an intraarticular ACL replacement relates more to a basic rearrangement of its collagen-ground substance relationships, and that vascularity may reflect the inflammatory response bringing about these changes. The model developed in this study serves as a basis for further studies, and the findings reveal important information about the behavior of ACL grafting materials. PMID- 3541658 TI - The history of vagotomy. AB - The anatomic characteristics of the vagus nerve were described by Galen in the second century AD, and its physiology was studied by Pavlov almost a century ago. Therapeutic possibilities of vagal denervation of the stomach was explored by several surgeons in the first quarter of this century. The most auspicious effort was that of Latarjet. The rebirth of vagotomy in 1943 by Dragstedt was based on cumulative new data supporting the concept that vagal denervation should favorably influence the clinical course of duodenal ulcer. This now proved concept renders vagotomy in some form a basic part of all operations for duodenal ulcer. The Dragstedt operation, vagotomy and pyloroplasty, is particularly useful in cases of acute bleeding and obstruction. Vagotomy and antrectomy has the lowest ulcer recurrence rate. Parietal cell vagotomy has the lowest mortality and morbidity rates and is the procedure of choice in patients with uncomplicated, intractable duodenal ulcer. PMID- 3541657 TI - Splanchnic neural regulation of insulin and glucagon secretion in the isolated perfused human pancreas. AB - The isolated perfused human pancreas was employed as a model in which electrical stimulation of the celiac mixed neural bundle was performed in the presence or absence of selective neural blockers. The insulin and glucagon responses to hyperglycemia alone or in the presence of splanchnic nerve stimulation were similar in magnitude to the results obtained in a preliminary report on isolated human pancreatic function and in studies using animal models. Stimulation of the celiac neural bundle in the presence of hyperglycemia resulted in an inhibition of insulin release and in an augmentation of glucagon release. alpha-adrenergic stimulation resulted in a strong suppression of insulin secretion and a mild suppression of glucagon secretion. beta-adrenergic fiber stimulation caused a mild augmentation of both insulin and glucagon release, whereas the cholinergic fibers strongly stimulated both alpha- and beta-cell secretion. The predominant effects of celiac neural bundle stimulation are insulin inhibition by was of an alpha-adrenergic effect and glucagon stimulation by way of a cholinergic effect. Thus, in this in vitro human model, our data confirm that the splanchnic innervation of the pancreas has a potent regulatory role on pancreatic hormone release in human subjects. PMID- 3541659 TI - Normal distribution of lysozyme- and lactoferrin-secreting cells in the chinchilla tubotympanum. AB - The distribution of the antibacterial enzyme lysozyme- and lactoferrin-secreting cells in the tubotympanum of normal chinchillas was studied using an immunohistochemical technique. The middle ear mucosa contained lysozyme-secreting cells and lactoferrin-secreting cells. The former were localized primarily in the columnar epithelium area and the latter primarily in the cuboidal epithelium area (that contains serous cells) of the transitional zone. In the eustachian tube, the lysozyme was localized in goblet cells of the mucosal epithelium and mucous cells of the glands, while lactoferrin was localized in serous cells of the glands. Our results indicate that secretory lysozyme and lactoferrin are secreted by different cell types (mucous or serous), supporting the notion of heterogeneity of the secretory cells of the tubotympanum. This finding is consistent with the concept that antibacterial enzyme secretion is an integral part of the normal mucosal defense system in the tubotympanum. PMID- 3541660 TI - Eikenella corrodens as a cause of recurrent and persistent infections of the head and neck. AB - Four patients had Eikenella corrodens infections involving the head and neck in different ways. The organism is discussed as a pathogen in mixed infections and as the predominant organism in other processes. As part of the resident microflora of mucous membrane surfaces, it is an important potential pathogen in a number of otolaryngologic clinical settings. Careful microbiological culturing and susceptibility testing reveal the causative organism and guide the antibiotic therapy. PMID- 3541661 TI - The initial evaluation of dysosmia. AB - Patients with disturbances in their sense of smell often represent a bewildering array of alternative diagnoses. The existing knowledge of olfactory disorders has been schematized into a systematic history approach toward the development of a differential diagnosis for dysosmic patients. Its components should elicit essential elements of the history which, according to the literature, have been associated with dysosmia. The ability to update the details of specific components permits it to be adapted to the needs of the individual practitioner. PMID- 3541662 TI - Distribution of serotonin-containing cell bodies in the brainstem of the human fetus determined with immunohistochemistry using antiserotonin serum. AB - The distribution of serotonin (5HT) neurons was investigated in the brainstem of 8 human fetuses ranging in age from 15 to 27 weeks of gestation. We conducted the peroxidase-antiperoxidase (PAP) immunohistochemical technique using antiserotonin serum to detect the cell bodies of 5HT-containing neurons. Positively stained 5HT neurons were clearly demonstrated in the brainstem of all fetuses examined. They varied in shape, showing round to oval cell bodies with unipolar, bipolar, or multipolar processes. A large number of 5HT neurons were located in the midline raphe nuclei. In addition, numerous 5HT neurons were observed widely in the other tegmental areas. The nuclei containing 5HT neurons were listed according to the terminology by Olszewski and Baxter for human brainstem, and an atlas was given. The distribution of 5HT neurons in the raphe nuclei of human fetuses was essentially similar to those of many mammals already reported. However, the lateral extension of 5HT neurons to the other tegmental areas beyond the midline raphe nuclei was much greater in human fetuses compared to other mammals. PMID- 3541664 TI - Cerebral dysgeneses and their influence on fetal muscle development. AB - Abnormal suprasegmental influences of the brainstem and cerebellum on the developing motor unit during the histochemical stage of muscle development (20-28 weeks gestation) may alter the rate of maturation of striated muscle or may cause abnormal proportions and relative sizes of histochemical fibre types. Such aberrations without primary myopathic or denervative changes are commonly found in children with cerebral malformations, particularly associated with cerebellar hypoplasia. Upper motor neuron disease during embryonic life may explain histochemical alterations in some nonprogressive 'congenital myopathies' such as congenital muscle fibre-type disproportion, nemaline rod disease, and central core disease. Suprasegmental factors also may contribute to some aspects of the muscle pathology in the muscular dystrophies, especially the Fukuyama type of congenital muscular dystrophy regularly associated with cerebral dysgenesis. Fibre-type predominance or delayed histochemical differentiation thus may serve as a useful marker, in the muscle biopsy, of upper motor neuron disease. During the critical period of muscle development implicated, the corticospinal tract probably is of much less importance in muscle maturation than the multiple small bulbospinal pathways which also subserve motor control in nonmammalian vertebrates. PMID- 3541665 TI - Ultrasonographic evaluation of cavum septi pellucidi and cavum Vergae. AB - Cavum septi pellucidi (CSP) and cavum Vergae (CV) are frequently found in premature and mature neonates an autopsy. We examined 116 premature infants, 45 full-term neonates and 31 healthy 1-month-old infants to clarify the incidence of CSP and CV using cranial ultrasonography through anterior fontanelle. CSP was detected in 97% of the premature infants, 56% of the full-term neonates and 29% of the 1-month-old infants. The incidence of CV was 60% in premature infants and 7% in full-term neonates. None of the 1-month-old infants were found to have CV. The size of the largest CSP observed ultrasonographically was 10 mm wide. No complicated pathological cavum was found in any subject. PMID- 3541663 TI - Sleep and sleep substances. AB - Time-consuming studies in search of an endogenously occurring sleep substance started early in this century. The historical background of this field of sleep science is briefly reviewed. The search for "sleep-promoting substance (SPS)" started in 1972. A bioassay technique was developed based on the monitoring of the circadian sleep-waking rhythm in freely moving male rats. The partially purified SPS from the brainstem of 24-h sleep-deprived rats caused a reduction in locomotor activity and an increase in both slow wave sleep and paradoxical sleep, when nocturnally administered by either the intraperitoneal or intracerebroventricular route. SPS is composed of at least 4 different effective fractions, including uridine. The sleep-inducing and sleep-maintaining potencies of several putative sleep substances were compared. Circadian variations in their effectiveness were apparent. The role of sleep substances in sleep regulation is discussed. PMID- 3541666 TI - The Child Neurology Society of China (the past and the present). PMID- 3541667 TI - In utero cerebral hemorrhage in alloimmune thrombocytopenia. AB - Central nervous system hemorrhage is a well-recognized complication of neonatal alloimmune thrombocytopenia attributed to perinatal trauma from passage through the birth canal. That central nervous system (CNS) hemorrhage can occur in utero is not as well recognized, and congenital CNS lesions have only circumstantially been linked to thrombocytopenia. We report two cases of intrauterine CNS hemorrhage shown to have occurred prenatally, resulting in porencephaly. The second case is unique in that the necropsy finding of a porencephalic cyst arising from an old hemorrhagic site pathologically confirms that the etiology of congenital CNS lesions in alloimmune thrombocytopenia is due to hemorrhage. This second case received close prenatal monitoring and yet died as a result of hemorrhage that was not detected until emergency operative delivery. A review of the literature revealed 10 cases, including two other pairs of siblings, who had CNS damage attributable to intrauterine hemorrhage. These findings indicate that congenital CNS lesions in alloimmune thrombocytopenia are due to intrauterine hemorrhage that careful obstetric and prenatal care may not identify or prevent. This fact should be included when genetic counseling is offered to alloimmunized mothers. PMID- 3541668 TI - Georg Steller: first physician in Alaska. PMID- 3541669 TI - Immune responses in alcoholic liver disease. PMID- 3541670 TI - Increased vitamin A in esophagus and other extrahepatic tissues after chronic ethanol consumption in the rat. AB - In rats fed ethanol (36% of total energy) for 1 month, vitamin A content of the esophageal mucosa was found to be increased 5-fold, compared to animals pair-fed an isocaloric control diet containing the same amount of vitamin A. Similar results were observed with diets of either lower vitamin A content or zinc supplementation. Significant increases of retinoids were also found in lungs, trachea, kidneys, and testes, but not in the eyes. These increases in extrahepatic tissues contrasted strikingly with the concomitant decrease in the liver and suggests that chronic ethanol consumption may be associated with some mobilization of vitamin A from the liver to other organs. PMID- 3541671 TI - The effect of prenatal alcohol exposure on umbilical cord length in fetal rats. AB - Umbilical cord length is reported to be a good indicator of fetal movement. This study was designed to examine the effects of chronic alcohol exposure on umbilical cord length in fetal rats. Exposure to alcohol during prenatal development was associated with shortened umbilical cord length, relative to controls. This finding was not a function of body weight differences alone and provides evidence that fetal movements may be decreased as a consequence of maternal alcohol consumption. The possible role of suppressed fetal movements in some of alcohol's teratogenic actions is also discussed. PMID- 3541672 TI - Effects of alcohol intoxication on visuospatial and verbal-contextual tests of emotion discrimination in familial risk for alcoholism. PMID- 3541673 TI - Chronic liver disease in abusers of alcohol and parenteral drugs: a report of 204 consecutive biopsy-proven cases. AB - We studied a consecutive series of 204 patients who were admitted to a hospital for addictive diseases during 40 months and who had a liver biopsy. Parenteral drug abusers (n = 34) were significantly younger than alcohol abusers (n = 23) or abusers of both (n = 147) and had lower levels of serum alkaline phosphatase, total bilirubin, and aspartate aminotransferase than the other two groups. Chronic active hepatitis and chronic persistent hepatitis were more frequent (p less than 0.001) in abusers of parenteral drugs alone, whereas cirrhosis was found most often (p less than 0.001) in abusers of both alcohol and parenteral drugs. Cirrhosis was present in 10 of 39 (26%) simultaneous abusers of alcohol and parenteral drugs compared with 58 of 96 (60%) alcohol-abusing former parenteral drug abusers (p less than 0.001). Methadone maintenance treatment was not associated with cirrhosis. Thus, methadone-maintained patients who abuse alcohol and develop cirrhosis should remain in methadone maintenance treatment and receive concomitant alcoholism treatment. Also, these data further support the hypothesis that abusers of both alcohol and parenteral drugs have an increased risk of developing cirrhosis. PMID- 3541674 TI - Effects of acute ethanol administration on neocortical inhibition. AB - The hypothesis that acutely administered ethanol could interfere with neocortical recurrent inhibition (RI) was supported. The large surface negative wave in response to antidromic stimulation of the cerebral peduncle represents a summation of inhibitory postsynaptic potentials, a measure of RI. In acute experiments on adult rats, blood alcohol levels of less than about 120 mg/100 ml slightly facilitated the surface negative wave. Higher blood alcohol levels always blocked the surface negative response. Stimulation of the somatosensory thalamic relay nuclei produced a cortical response on which ethanol had a moderate blocking effect. Conditioning-test procedures revealed that cerebral peduncle stimulation strongly blocked the thalamocortical (test) response, especially after ethanol, but thalamic stimulation (conditioning) had no effect upon the surface negative wave. This demonstrates a differential effect on the two cortical processes. Cortical RI seems to be especially sensitive to blood alcohol level, but the function of cortical RI is complex. By way of acting on RI, ethanol likely affects control of sensory input and cortical sensory organization as well as selectivity and magnitude of motor discharge. PMID- 3541675 TI - Effects of chronic ethanol treatment on neocortex. AB - Neocortical inhibition and neuronal morphology were studied in rats following chronic ethanol treatment (CET). In terminal acute experiments, spontaneous neuronal discharges in pair-fed and naive rats were inhibited by epicortical stimulation, a procedure known to produce postsynaptic inhibition. Few units in CET rats were inhibited by such stimulation. Cortical recurrent inhibition, indicated by a surface-negative potential in response to antidromic stimulation of the cerebral peduncle, was little affected by a challenge dose of ethanol, compared with the response in pair-fed animals. Recurrent inhibition involves inhibitory interneurons. CET apparently made inhibitory interneurons and inhibitory postsynaptic receptors less responsive to ethanol. Apical dendritic spines on some portions of pyramidal neurons increased in number with CET. This could reflect a compensatory growth in neurons not damaged by CET. The overall observations are consistent with ethanol affecting one or more specific systems of cortical motor control as opposed to its presumed general disinhibitory effect. PMID- 3541677 TI - New instrument using gas sensors for the quantitative analysis of ethanol in biological liquids. AB - A gas sensor was built into an instrument to measure ethanol in biological liquids by determining head space ethanol concentrations without chromatography. The analysis of plasma, urine, and whole blood containing ethanol over the range 20-640 mg/dl determined by this novel instrument is fast (30 sec), accurate (r = 0.99), and precise (coefficients of variation 0.6-1.8%) when compared with gas chromatography. The addition of alcohol dehydrogenase, beta-nicotinamide adenine dinucleotide, and semicarbazide to samples allows ethanol to be distinguished from other alcohols. The instrument can be built and operated at modest costs thus allowing its use in multiple settings. PMID- 3541678 TI - Prolonged feeding of ethanol to the young growing guinea pig. III. Effect on the synthesis of the myocardial contractile proteins. AB - Prolonged ingestion of ethanol may lead to a cardiomyopathy, and studies in the experimental animal have demonstrated alterations in protein metabolism. These changes include depression of protein synthesis with acetaldehyde in the acute experiment, in vitro, and after chronic ethanol ingestion in vivo. The present studies were initiated to see if the inhibition of protein synthesis following prolonged ethanol ingestion involved myocardial contractile proteins. Newly weaned guinea pigs, weighing 350 g, were placed on a regimen of normal laboratory diet with 10% ethanol in the drinking water. Calorie-matched controls, drinking dextromaltose in the water, were simultaneously run. After 40 weeks of ingesting 10% ethanol in the drinking water, hearts from growing guinea pigs were removed and synthesis of myocardial contractile proteins (myosin heavy chains, light chains (LC1, LC2), actin, and tropomyosin) assayed in vitro with 3H-labeled amino acids. With aging, there was a decrease in the rates of synthesis of all the contractile proteins. After 40 weeks of ethanol ingestion, the synthetic rates of myosin heavy and light chains and tropomyosin were the same as in calorie-matched controls, but the synthetic rate of actin was significantly decreased by 20% (p less than 0.01). This decrease in actin synthesis may be the first indication of ultimate inhibition of synthesis of all the contractile proteins which may lead to myofibrillar disorganization and vacuolization reported after chronic ethanol ingestion. PMID- 3541680 TI - Directory of accredited organizations, approved programs/offerings, and accredited continuing education certificate programs preparing nurse practitioners: Fall 1986. PMID- 3541679 TI - Degradation of acetaldehyde produced by the nonalcohol dehydrogenase pathway. AB - Acetaldehyde (Ac-CHO) is produced via the oxidation of ethanol by two different pathways; alcohol dehydrogenase (ADH) and non-ADH systems. However, degradation of Ac-CHO in the liver, especially with respect to the relative amounts produced by the two pathways, remains unclear. In order to clarify the metabolic fates of Ac-CHO produced by the two pathways, the ethanol metabolic rate (EMR) and hepatic Ac-CHO levels in the rats fed an alcohol-containing or control diet for 4 weeks were determined after a single administration or constant infusion of ethanol, with or without 4-methylpyrazole pretreatment. The EMR was increased in chronic alcoholic rats and decreased by treatment with 4-methylpyrazole. Consequently, blood and hepatic Ac-CHO levels were low in the pyrazole-treated rats in both the single dose and infusion experiments. Hepatic Ac-CHO levels and EMR were well correlated in both experiments. However, the correlations were curve linear and the slopes of the regression lines in the pyrazole-treated rats were steeper than those in the nontreated rats. When the ratios of hepatic Ac-CHO (subtracted by a constant which was obtained from the correlation equations for the curvilinear fit of hepatic Ac-CHO levels and EMR) to EMR were calculated, they were significantly higher in the pyrazole-treated rats than in the nontreated rats of the perfusion experiment, without relation to chronic alcohol ingestion. These results suggest that Ac-CHO produced by the non-ADH pathway degrades more slowly than that produced by the ADH pathway in the liver. PMID- 3541676 TI - Oxidation of ethanol to acetaldehyde by bronchopulmonary washings: role of bacteria. AB - The synergistic effects of tobacco smoking and alcohol consumption on the incidence of upper respiratory cancer may be linked to their common ability to produce acetaldehyde, an irritant and potential mutagen. Since alcohol consumption in most individuals results in very low concentrations of acetaldehyde in the blood, we determined whether bronchopulmonary cellular components are capable of oxidizing ethanol to acetaldehyde. We found that significant production of acetaldehyde occurred in vitro after incubation of human bronchopulmonary washings with 25 mM ethanol. Acetaldehyde production was increased in active smokers and related to microorganisms in the bronchopulmonary tract. It was abolished by preincubation of the washings with antibiotics and was reproduced in vitro with Streptococcus pneumoniae. Normal pulmonary cells in bronchopulmonary washings did not produce acetaldehyde from ethanol. PMID- 3541681 TI - Automated thermometric enzyme immunoassay of human proinsulin produced by Escherichia coli. AB - We have determined and monitored the production and release of human proinsulin by genetically engineered Escherichia coli cells. Several M9 media samples were analyzed sequentially after centrifugation with the aid of a rapid automated flow through thermometric enzyme-linked immunosorbent assay (TELISA) system. The response time was 7 min after sample injection and a single assay was complete after 13 min. Insulin concentrations in the range of 0.1-50 micrograms/ml could be determined. The TELISA method correlated well with conventional radioimmunoassay determinations. Standard curves were reproducible over a period of several days even when the immobilized antibody column was stored at 25 degrees C in the enzyme thermistor unit. Thus, immediate assay start up was possible. PMID- 3541682 TI - Preparative ion-exchange high-performance liquid chromatography of bacterial ribosomal proteins. AB - We have developed analytical and preparative ion-exchange HPLC methods for the separation of bacterial ribosomal proteins. Proteins separated by the TSK SP-5-PW column were identified with reverse-phase HPLC and gel electrophoresis. The 21 proteins of the small ribosomal subunit were resolved into 18 peaks, and the 32 large ribosomal subunit proteins produced 25 distinct peaks. All peaks containing more than one protein were resolved using reverse-phase HPLC. Peak volumes were typically a few milliliters. Separation times were 90 min for analytical and 5 h for preparative columns. Preparative-scale sample loads ranged from 100 to 400 mg. Overall recovery efficiency for 30S and 50S subunit proteins was approximately 100%. 30S ribosomal subunit proteins purified by this method were shown to be fully capable of participating in vitro reassembly to form intact, active ribosomal subunits. PMID- 3541683 TI - [In memory of Prof. Rainer Horst Lange]. PMID- 3541684 TI - Toward computerized morphometric facilities: a review of 58 software packages for computer-aided three-dimensional reconstruction, quantification, and picture generation from parallel serial sections. AB - This review gives an inventory of 58 computer-aided three-dimensional reconstruction applications in the domain of biomedical research. It is devoted to the formulation of a set of recommendations thought to be necessary for improved performance of software packages in this field. These recommendations can be used to select packages and to guide future developments of existing reconstruction systems. The survey is restricted to three-dimensional reconstructions based upon a series of parallel sections of an object. Subjects treated are programming languages, resolution and sampling, input preparation, realignment, local deformation of slices, numerical quantifications, topological complexity, internal representation, display complexity (hidden surfaces, shading, smoothing), structure extraction, descriptive elements, database, data compression, time efficiency of systems and algorithms, hardware configuration, input devices, input media, interactive aids, display devices, and output devices. Information for this survey comes from articles that appeared between 1965 and 1985. PMID- 3541685 TI - [Smoking damages male fertility]. AB - It is concluded from a survey on the world literature: Smoking damages the male fertility. Smoker should therefore stop the smoking not only in respect to their own health but from sense of responsibility for the future generation too. The most important reasons for this conclusions are: Tobacco smoke contains numerous mutagenic substances. They reach the male gonads via the blood. They show their mutagenic action here openly much more stronger than on egg-cells because the spermatogenesis continues over the whole male reproductive period whereas the formation of eggs is already completed in the fetal phase. The majority of studies indicates to a damaging effect also on the number and/or the motility and morphology of spermatozoa by strong smoking during a longer time. Especially smoking husbands with infertile marriages the urgent advice therefore should be given to stop smoking. Weighty epidemiological and experimental results suggest a teratogenic action in the offspring by smoking of fathers too - independently for the smoking customs of the mother. A verification and extension of these results are very desirable. PMID- 3541686 TI - Calcitonin in human seminal plasma and its localization on human spermatozoa. AB - We determined the calcitonin (CT) levels in peripheral plasma and in seminal fluid of 15 normal human subjects: the concentration of the hormone in seminal fluid was about 30 times higher than the concentration found in peripheral plasma. We also studied the localization of calcitonin on human spermatozoa by means of an indirect immunofluorescent technique, using an anti-human CT rabbit serum and a fluorescein-isothiocyanate conjugated goat anti-rabbit immunoglobulins serum. A bright fluorescence was observed at the middle piece and neck, while the tail's principal piece was weakly stained. With an anti-human CT rabbit serum pre-absorbed with human CT no fluorescent staining was detectable. These findings demonstrate that calcitonin is localized onto spermatozoa and suggest a potential role for calcitonin in the calcium dependent-mechanisms of spermatozoa. PMID- 3541687 TI - Immunohistochemical localization of enkephalins in adult rat testis: evidence for a gonadotrophin control. AB - The recent detection of immunoreactive POMC derived peptides in the male reproductive tract raised the possibility that these hormones might regulate reproductive function. In addition, a variety of studies suggested that POMC derived peptides have paracrine effects in the testis. In this present study, after HCG addition to the organ culture medium, Sertoli cells cytoplasma became immunoreactive with the enkephalins antisera. PMID- 3541688 TI - Assessment of effect of various modes of premedication on acid aspiration risk factors in outpatient surgery. PMID- 3541689 TI - Intercostal blocks with local infiltration anesthesia for extracorporeal shock wave lithotripsy. PMID- 3541690 TI - No involvement of antidiuretic hormone in acute antidiuresis during PEEP ventilation in humans. AB - Decreased urinary output (Vu ml/min) after institution of PEEP is attributed to a variety of mechanisms including decreased cardiac output and renal blood flow (RBF), activation of neurohormonal reflexes, increased catecholamines, plasma renin activity (PRA), and antidiuretic hormone (ADH) release. To evaluate these factors, seven normovolemic patients (36 yr +/- 13 SD), free of preexisting lung, cardiac, or renal disease, requiring continuous mandatory ventilation for neurologic reasons were studied. The authors measured or calculated: total blood volume (TBV) (51Cr); right atrial, pulmonary arterial, pulmonary wedge, and systemic pressures, cardiac index (CI); renal plasma flow (RPF) (iodohippurate sodium 131I [131I PAH] clearance); glomerular filtration rate (GFR) (creatinine clearance), free water clearance (CH2O), osmolal clearance (Cosm), fractional excretion of sodium (FENa+) and potassium (FEK+); and plasma renin activity (PRA) (ng X ml-1 X h-1), plasma ADH (pg/ml; radioimmunoassay), epinephrine (E in pg/ml), and norepinephrine (NE in pg/ml) (double-isotope radioenzymatic assay). Two conditions were studied after 90-min steady state: 1) zero PEEP (ZEEP); and 2) 15 cmH2O PEEP. PEEP caused a significant decrease in CI (-21%; P less than 0.01) and RPF (-19%; P less than 0.05) without significant decrease in GFR. A significant decrease in Vu (-55%; P less than 0.05), FENa+ (-39%; P less than 0.05) and Cosm (-36%; P less than 0.25) occurred without modification in CH2O. Plasma ADH remained in the normal range and did not increase when PEEP was applied.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541691 TI - Effect of streptozotocin-induced diabetes in the rat on the metabolism of fluorinated volatile anesthetics. AB - Three weeks after dosing male Fischer 344 rats with streptozotocin to induce diabetes, enflurane was administered ip, and 1 h later, fluoride levels were measured in plasma and livers were removed. Hepatic microsomes were prepared, and the oxidative defluorination of enflurane, isoflurane, and methoxyflurane and the reductive defluorination of halothane were measured in vitro. In diabetic rats the defluorination of enflurane was increased 3.4-fold over control levels in vivo and 2.7-fold in vitro. Insulin treatment prevented these effects. In vitro metabolism of isoflurane by livers from diabetic rats was 2.5-fold greater than by livers from control rats, but defluorination of methoxyflurane and of halothane was not altered. The results show that streptozotocin-induced diabetes in rats enhances the defluorination of enflurane and of isoflurane but not of methoxyflurane or halothane. PMID- 3541692 TI - Early use of the Cushing-Codman anesthesia record. PMID- 3541693 TI - First wartime use of surgical anesthesia. PMID- 3541694 TI - Venous air embolism and cesarean sections. PMID- 3541695 TI - [Evaluation of supra-aortic branches using Doppler C.W. ultrasonography and the angioscope]. PMID- 3541696 TI - [Renal transplant. Experience in 320 cases]. PMID- 3541697 TI - Diffuse bullous eruption in a 3-month-old infant. PMID- 3541698 TI - The relationship between airway obstruction and bronchial hyperreactivity in childhood asthma. AB - We performed a methacholine challenge on 118 asthmatic children to determine the relationship between airway obstruction and the degree of airway hyperreactivity. There was no significant correlation between the baseline forced expiratory volume in one second (FEV1) and the PC20 for methacholine (r = .2, P less than .05). We concluded that airway hyperreactivity in asthmatic children does not increase with increasing airway obstruction. PMID- 3541699 TI - Asthma in children: emergency management. AB - We review the pathophysiological alterations at work in asthma and outline pharmacological agents that are available for emergency therapeutic intervention, offering some general principles for management. A combined overview of predictors of outcome in asthmatic episodes in children also is presented. PMID- 3541700 TI - Organophosphate poisoning. AB - Organophosphate insecticides have become increasingly popular for agricultural, industrial, and home use and represent a significant potential health risk. We have reviewed the history, pathophysiology, clinical presentation, laboratory findings, differential diagnosis, therapy, and complications of toxic exposure to organophosphates. Promp recognition and aggressive treatment of acute intoxication are essential in order to minimize the morbidity and mortality from these potentially lethal compounds. PMID- 3541701 TI - Omental panniculitis: an unusual cause of acute appendiceal syndrome. AB - We report the case of a 41-year-old patient with no history of abdominal symptoms who presented with an acute painful syndrome of the right flank and iliac fossa suggesting acute appendicitis. The diagnosis of panniculitis of the great omentum was suggested preoperatively by the particular aspect of omental fat observed by abdominal sonography and computed tomography. A subvoval omentum resection was performed and the outcome was uneventful. PMID- 3541702 TI - Endotoxin-induced changes in the hemostatic system in neonatal calves: the effect of antiserum to a mutant Escherichia coli (J-5). AB - Changes in the hemostatic system were studied in 22 neonatal calves given a small dosage of Escherichia coli endotoxin (0.5 microgram/kg) by slow (5-hour) IV infusion. The effect of pretreatment with an antiserum to mutant of E coli O111:B4 (J-5) was evaluated. The platelet count, plasma fibrinogen concentration, prothrombin time, and activated partial thromboplastin time changed significantly from base line during and after endotoxin infusions in all calves. The mean platelet count was significantly decreased from 1 through 24 hours after endotoxin infusion was started. Mean plasma fibrinogen was decreased 2 through 12 hours after endotoxin infusion was started. The mean prothrombin time and activated partial thromboplastin time were significantly greater than base line at 3 to 6 hours and 3 to 12 hours, respectively, after endotoxin infusion was started. Serum concentration of fibrinolytic degradation products remained less than 10 micrograms/ml. Bovine J-5 antiserum did not prevent the endotoxin-induced changes in the hemostatic system of these neonatal calves. PMID- 3541704 TI - Ultrasonographic evaluation of normal boar testicles. AB - The testicles of 14 Landrace boars (7 at 9 months of age and 7 at 15 months of age) were measured and examined by routine physical examination. Semen analysis was done. The testicles were then examined and measured by B-mode ultrasonography. The ultrasonographic appearance and measurements were compared with the physical measurements and the semen analysis. Seminiferous epithelial area (SEA) data were obtained after the testicles were surgically removed. These data were compared with the ultrasonographic data and the other physical data. A correlation could not be found between semen analysis and either physical or ultrasonographic data or between SEA data and semen analysis. Significant differences were found between the 9-month-old and the 15-month-old boars relative to 5 measurements: SEA, tunica albuginea thickness, testicular diameter, testicular length, and epididymal diameter. A ratio of 4:1 was found between each of the average physical measurements (scrotal diameter, testicular-epididymal circumference, testicular-epididymal length) and ultrasonographic measurements of testicular diameter. A ratio of 2.6:1 was found between testicular diameter and epididymal tail diameter (cranial to caudal). PMID- 3541703 TI - Endotoxin-induced changes in plasma concentrations of thromboxane and prostacyclin in neonatal calves given antiserum to a mutant Escherichia coli (J 5). AB - Plasma concentrations of the stable hydrolysis products of thromboxane (Tx) A2, TxB2, and prostacyclin (6-keto-prostaglandin F1 alpha; PGF1 alpha) were evaluated in 22 neonatal calves given endotoxin (0.5 microgram/kg) by slow IV infusion over a 5-hour period. The effect of pretreatment with bovine antiserum to a mutant of Escherichia coli O111:B4 (J-5) on plasma concentrations of these eicosanoids was determined. Plasma concentrations of TxB2 and 6-keto-PGF1 alpha were increased in response to endotoxin infusion. The mean plasma concentrations of TxB2 peaked 1 hour after endotoxin infusion began and was significantly increased from base line through 8 hours. Mean plasma 6-keto-PGF1 alpha concentration increased more slowly and was increased from base line only at 2 hours after endotoxin infusion began. Administration of bovine J-5 antiserum had no significant effect on endotoxin-induced thromboxane and prostacyclin production. PMID- 3541705 TI - Characterization of Tritrichomonas foetus antigens, using bovine antiserum. AB - Tritrichomonas foetus antigens were identified, using the serum of an Angus heifer that had been repeatedly immunized with suspensions of 1 X 10(8) organisms in Freund's complete adjuvant. Antibody activity against T foetus was determined by dot-blot analysis, using horse-radish peroxidase-conjugated anti-bovine immunoglobulin to detect bound antibody. The antiserum contained antibodies against surface and flagellar components of live or fixed T foetus, as determined by use of immunofluorescence. The antiserum reacted with approximately 38 proteins in a pool of 55 to 60 components resolvable by polyacrylamide-gel electrophoresis of T foetus extracts. PMID- 3541706 TI - Endotoxemia in neonatal calves given antiserum to a mutant Escherichia coli (J 5). AB - Endotoxemia was characterized in neonatal calves given a small amount of colostrum and smooth Escherichia coli endotoxin by small-dosage (0.5 microgram/kg of body weight), slow (5-hour) IV infusion to mimic natural conditions. Responses were compared among 22 calves freely allotted to groups treated with saline solution (group I), preimmunization plasma (PP, group II), or antiserum to the rough mutant of E coli O111:B4 (J-5, group III) before endotoxin was infused. Bovine J-5 antiserum was produced by immunization of 4 cattle with J-5 boiled cell bacterin. The antiserum titers of immunoglobulin (Ig) M, IgG1, and IgG2 to the J-5 boiled cells, as determined by enzyme-linked immunosorbent assay, were 240, 7,680, and 960, respectively. The PP had enzyme-linked immunosorbent assay titers to J-5 of 240, 480, and 60 of IgM, IgG1, and IgG2, respectively. Endotoxemia in the 3 groups was characterized by significant (P less than 0.05) time-related changes in rectal temperature, heart rate, respiratory rate, capillary refill time, oral mucous membranes, nose moistness, scleral injection, attitude, PCV, total plasma protein concentration, WBC count and differential, plasma glucose, and lactate concentrations. The only significant treatment effects on clinical or laboratory values were higher mean total plasma protein concentrations in groups II and III 10 to 30 hours after endotoxin infusion was started than that in group I and increasing mean most-severe attitude abnormality score in groups I, III, and II (P less than 0.05). The administration of bovine J 5 antiserum to neonatal calves resulted in significantly higher serum IgG1 and IgG2 titers to J-5 boiled cells (P less than 0.05), and cross-reactive IgG2 to the challenge endotoxin (P less than 0.01) than did treatment with PP or saline solution; however, this antiserum did not mitigate the effects of sublethal endotoxemia. There was a significant negative correlation between IgG2 to J-5 at base line and the mean attitude abnormality score at 4.5 hours after infusion was started (P less than 0.05). PMID- 3541708 TI - Dome epithelial M cells dissociated from rabbit gut-associated lymphoid tissues. AB - Dome and dome epithelial cells were selectively dissociated from gut-associated lymphoid tissues of rabbits. Sequential tissue washes in dithiothreitol, EDTA, and collagenase removed the dome epithelium, without disrupting the follicles or villi, and provided a cell suspension containing 74 +/- 6% lymphocytes, 9 +/- 4% columnar epithelial cells, 10 +/- 7% tangible-body macrophages, and 4 +/- 2% M cells (follicle-associated epithelial cells). The last mentioned cells were characterized by transmission electron microscopy as large (20 to 55 microns diameter) cuboidal, round, or oval cells with eccentric nuclei and thin membranous processes surrounding empty vacuoles. The M cells were occasionally joined together by tight junctions. Histochemical and immunocytochemical analyses of M cells with the light microscope showed that they were devoid of immunoglobulins and negative for T-cell antigen and secretory component and had no detectable alkaline phosphatase or endogenous peroxidase activity. The M cells had few vacuoles with faint acid phosphatase activity; nonspecific neutral esterase was abundant. Possible uses for dome and dome epithelial cells are discussed. PMID- 3541707 TI - Use of sodium deoxycholate to extract cell wall components of virulent Mycobacterium bovis. AB - Mycobacterium bovis ATCC No. 19210 was grown on Middlebrook 7H-10 medium with pyruvate. Cells were harvested, and extracts were prepared, using 2% sodium deoxycholate (DOC) and 0.003M EDTA (in 0.1M Tris-HCl, 0.15M NaCl with 0.02% sodium azide [pH 8.4]). Phenylmethylsulfonyl fluoride was added, and the cells were extracted for 48 hours at 4 C. Cells were removed by centrifugation at 10,000 X g for 30 minutes. The supernatant was filter sterilized and separated into 2 fractions (peak A and peak B) by size-exclusion chromatography. The nonfractionated DOC extract and DOC peak A elicited delayed-type hypersensitivity responses at each of the protein concentrations tested (0.5, 1.5, and 4.5 micrograms) in M bovis-sensitized guinea pigs; responses were not detected, using DOC peak B. Significant differences were detected for each of the antigens when enzyme-linked immunosorbent assay values were compared, using sera from cattle before and 10 months after they were exposed to M bovis (P less than 0.01). PMID- 3541709 TI - An in vivo model for the study of Bordetella avium adherence to tracheal mucosa in turkeys. AB - An in vivo model was developed for studies characterizing the adherence of Bordetella avium to the tracheal mucosa of turkeys. Three-week-old turkeys were anesthetized, and the cervical part of the trachea was isolated after tracheostomy was done. A hemostat was applied craniad to the tracheostomy site to occlude the tracheal lumen. Isolated tracheal segments were filled with an aqueous bacterial inoculum for 1 minute, and then excess inoculum and the hemostat were removed. After 1 hour, a 1-cm section was excised from each tracheal segment, and adherent viable bacteria were quantified. Modifications of the procedure were evaluated to produce a model that was technically simple to do, economical, and reproducible. To examine the validity of the model, adherence of B avium was compared with that of Escherichia coli and Staphylococcus aureus. Adherence of B avium to tracheal mucosa was 17 times greater than that with E coli and 1,550 times greater than that with S aureus. Colonization of the tracheal mucosa by B avium was demonstrated in tracheal sections obtained 6 hours after filling with bacterial inoculum. Because the ciliary clearance mechanism of the tracheal segments remained functional, washing of the tracheal lumen had no effect on numbers of associated bacteria. An important advantage of this model over in vitro models is the excellent preservation of the tracheal mucosal surface. PMID- 3541710 TI - Bill would improve access to RN care. PMID- 3541711 TI - Community Nursing Act will benefit consumers. PMID- 3541712 TI - The National Institutes of Health Intermittent Positive Pressure Breathing trial- pathology studies. III. The diagnosis of emphysema. AB - In an attempt to predict the severity of emphysema in patients with moderately severe and severe chronic air-flow obstruction, antemortem pulmonary function data, including spirometry, subdivisions of lung volumes, diffusing capacity (transfer factor) for carbon monoxide, and elastic recoil were assessed in 46 patients who were autopsied during the National Institutes of Health Intermittent Positive Pressure Breathing Clinical Trial and we compared these to the morphologic severity of emphysema. The severity of emphysema was graded by the panel grading method using whole lung, paper-mounted (Gough-Wentworth) sections and the mean linear intercept (Lm). The FEV1 and FEF25-75 of the FVC, the DLCO, the diffusing capacity for carbon monoxide, and subdivisions of lung volumes showed significant but low order correlations with the emphysema score and Lm. Total lung capacity, determined by plethysmography, was better related to emphysema in this study than in others in which TLC was measured by helium dilution. Volume-pressure data fitted to the exponential equation (V = A - Be-KP) yielded a low order, but a significant relationship between Lm and the exponential constant (K), but not between K and the panel emphysema score. We conclude that the recognition of the presence and severity of emphysema continues to require a multivariate approach including clinical history, assessment of air flow obstruction via routine spirometry, radiologic assessment of the lung with emphasis on total lung capacity, and evaluation of the diffusing capacity for carbon monoxide. PMID- 3541713 TI - Treatment of respiratory failure during sleep in patients with neuromuscular disease. Positive-pressure ventilation through a nose mask. AB - Severe nocturnal hypoxemia may occur in patients with respiratory muscle weakness caused by neuromuscular disorders. Negative pressure ventilators may be partially effective in these patients but can cause upper airway obstructive apneas. We examined the effectiveness of positive pressure ventilation through a nose mask in preventing nocturnal hypoxemia and compared it with negative pressure systems. We reasoned that nasal positive pressure would provide stability for the upper airway. Five patients with neuromuscular disorders underwent a series of all night sleep studies under control conditions, negative pressure ventilation, and positive pressure ventilation through a comfortable nose mask. Sleep staging and respiratory variables were monitored during all studies. Daytime awake lung function, respiratory muscle strength, and arterial blood gases were also measured. The severe hypoxemia and hypercapnia that occurred under control conditions were prevented by positive pressure ventilation through a nose mask. Negative pressure ventilation improved NREM ventilation in all patients, but did not prevent severe oxyhemoglobin desaturation, which occurred during REM sleep. Negative pressure ventilation appears to contribute to upper airways obstruction during REM sleep as evidenced by cessation of air flow, reduced chest wall movements, falls in arterial oxyhemoglobin saturation, and hypercapnia. With treatment, daytime PaO2 improved from a mean of 70 to 83 mm Hg, and PaCO2 decreased from a mean of 61 to 46 mm Hg. We conclude that nasally applied positive pressure ventilation is a highly effective method of providing nocturnal assisted ventilation because it stabilizes the oropharyngeal airway. PMID- 3541714 TI - The bronchodilator effect of caffeine in adult asthmatics. AB - Caffeine has been reported to result in bronchodilation in asthmatic children. Our study was designed to assess the effect of caffeine on pulmonary function in adults with asthma. We studied 8 patients: 4 men and 4 women with previously documented airway reactivity. A randomized, double-blind cross-over was used. The patients received either placebo or 5 mg/kg of caffeine in solution orally, and FEV1, FVC, FEF25-75, Vmax25 and blood for caffeine concentrations were taken at several time points for as long as 8 h after the drink. RESULTS: there was a significant difference between caffeine and placebo for percent change in FEV1 with peak change at 1.5 h. There was also a significant difference for percent change in FEF25-75 with peak occurring at 4 h. Percent change in Vmax25 was significantly different at 3.0 h only. Peak caffeine concentration of 8.7 +/- 1.7 micrograms/ml occurred at 1 h. The data indicate that caffeine at a dose of 5 mg/kg can produce significant percentage improvement in FEV1, FEF25-75, and Vmax25 in adult asthmatics. PMID- 3541715 TI - Bradykinin-induced bronchoconstriction in humans. Mode of action. AB - The effect of bradykinin was studied by inhalation in normal and asthmatic human subjects, as well as on human bronchial smooth muscle in vitro. Bradykinin caused cough and retrosternal discomfort in all subjects and bronchoconstriction in asthmatic subjects. Bradykinin was approximately 10 times more potent than histamine and methacholine, and there was a significant correlation between the subjects' sensitivity to histamine and bradykinin. Bradykinin-induced bronchoconstriction was prolonged when compared with that of histamine and the C fiber stimulant capsaicin. This bronchoconstriction was subject to tachyphylaxis, which was also associated with desensitization of the subjects to inhaled histamine. The provocative dose causing a 35% fall in specific airway conductance (PD35) was unaffected by aspirin (1 g orally). However, ipratropium bromide (0.25 mg by nebulizer) significantly inhibited the effect of bradykinin, the PD35 being 0.8 mumol (range, 0.16 to 3.4) and 0.15 mumol (range, 0.047 to 1.15) after active dose and placebo, respectively (p less than 0.05). Likewise, cromolyn sodium (40 mg dry powder) also significantly reduced response to bradykinin, with a PD35 of 0.04 mumol (range, 0.13 to 0.31) after placebo and 0.39 mumol (range, 0.05 to 4.45) after SCG (p less than 0.05). Bradykinin only weakly constricted human bronchial smooth muscle in vitro. Bradykinin at 10(-4) caused only 21.5 +/- 5.5% of the maximal carbamylcholine contraction in 11 of 18 airways. Captopril did not enhance the effect of bradykinin. Bradykinin is a potent bronchoconstrictor of human airways in vivo, acting in part through cholinergic mechanisms but not because of the formation of prostaglandins. PMID- 3541716 TI - Airway responses to aerosolized methacholine in the cat. Effects of partial or complete vagosympathectomy. AB - To explore the role of airway innervation as a determinant of airway responsiveness to inhaled cholinergic agonists, we studied the effects of partial or complete section of the cervical vagosympathetic trunk on the magnitude of methacholine-induced bronchoconstriction in the chloralose-urethane-anesthetized, mechanically ventilated cat. An initial concentration-response curve to methacholine was constructed to identify the concentration required to cause a twofold to threefold rise in mean pulmonary resistance (RL). Using this concentration, 3 consecutive challenges (C1, C2, and C3) were then performed at 30-min intervals in 4 groups of cats. After a control challenge (C1), the parasympathetic (n = 9), sympathetic (n = 6), or both branches (n = 4) of the cervical vagosympathetic trunks were sectioned. Sham cats (n = 7) showed reproducible increases in RL (C1, delta RL = 15.1 +/- 2.7 cm H2O X 1(-1) X s; C2, delta RL = 15.7 +/- 3.0; C3, delta RL = 13.1 +/- 2.9; mean +/- 1 SE). After parasympathectomy there was an increase in responsiveness after C3 (C1, delta RL = 15.0 +/- 4.3; C2, delta RL = 16.4 +/- 6.4; C3, delta RL = 29.9 +/- 11.6; p less than 0.01). Sympathectomy and vagosympathectomy did not significantly alter responsiveness. The results suggest that vagally mediated inhibitory influences modulate the bronchial response to aerosolized methacholine in the cat. PMID- 3541717 TI - Bronchoalveolar lavage. AB - In formulating a reasonable position about the clinical use of BAL and its analysis, one must acknowledge that it is still an experimental procedure that needs further assessment, and it must continue to be included as part of patient research protocols. Therefore, neither the patient nor his/her insurance carrier should foot the bill, yet. The cost involved in analysis of BAL fluid and serum raises another consideration about how many things need to be measured and what tests give the essential information and are the most discriminating. Clearly, all of the assays suggested by some of the BAL results given in table 2 are not necessary. The cell count and the differential count, indicating the relative percentage of lymphocytes among the respiratory cells, and monoclonal antibody staining to distinguish the various T-cell subtypes give most of the essential cell information that relates to activity of alveolitis and to diagnosis in the interstitial lung diseases. Finding a very high percentage of lymphocytes in BAL fluid shifts the differential diagnosis in an unknown diffuse interstitial lung disease to the possibility of a granulomatous process, especially sarcoidosis or hypersensitivity pneumonitis; whereas elevated PMN with about 3% eosinophils also present suggests possible idiopathic pulmonary fibrosis. Many of the protein and enzyme assays have a role in describing immunopathogenesis, but are rarely measured until a few days after the procedure. Some quite sophisticated cell mediators can be measured, such as interleukin-2 produced by helper T-lymphocytes and many macrophage effector substances that may give more precise information than just cell counts and various immunoglobulin values. These assays require complex biochemical and cell culture work and are only available in special research laboratories, limiting the availability of such tests. Thus, it is not easy to suggest just what tests should be conducted with BAL cells and fluid to tailor costs yet give comprehensive clinical information, too. The use of BAL to obtain cells and proteins lining the alveolar space in many ways is still in its infancy, and new applications are being sought for a substantial list of lung diseases. Just the tip of the iceberg has been investigated, and much more may remain to be uncovered. PMID- 3541718 TI - Inhalation of endotoxin stimulates alveolar macrophage production of platelet activating factor. AB - The production of PAF was studied in alveolar macrophages (AM) and neutrophils recovered by bronchial lavage from guinea pigs exposed to aerosolized bacterial endotoxin (lipopolysaccharide, LPS). The amount of cell-associated PAF was estimated by measuring serotonin release from rabbit platelets. An increased and dose-related production was found in AM for as long as 2 h after a 40-min exposure. No production was detectable after 4 h. Prolonging the exposure did not prolong the response. When a second exposure was given, no PAF could be detected until the time interval between the 2 exposures was 72 h. The amount of neutrophils in lung lavage fluid was elevated about 100 times at 4 h after the exposure, but only a minor PAF production was found in these cells. In view of the role of LPS-contaminated dusts for the development of human lung disease, particularly airway constriction, the role of PAF needs to be further investigated. PMID- 3541720 TI - Physicians as politicians and statesmen. An unaccustomed role. Can it be done? PMID- 3541719 TI - Role of 5-hydroxytryptamine in endotoxin-induced respiratory failure of pigs. AB - The porcine pulmonary vascular and airway responses to exogenous 5 hydroxytryptamine (5-HT), norepinephrine, prostaglandin F2 alpha (PGF2 alpha), and angiotensin II were evaluated before and after ketanserin, a 5-HT2 receptor antagonist. Ketanserin blocked the 5-HT-induced increases in airway and pulmonary artery pressures, whereas the increases in airway and pulmonary artery pressures caused by norepinephrine, PGF2 alpha, or angiotensin II were not significantly modified by ketanserin, indicating a relatively high degree of specificity for 5 HT2 receptors. The role of endogenous 5-HT in mediating endotoxin-induced respiratory failure was evaluated by treating pigs with ketanserin. Escherichia coli endotoxin (055-B5) was infused intravenously into anesthetized 10- to 14-wk old pigs at 5 micrograms/kg the first h, followed by 2 micrograms/kg/h for 3.5 h. Ketanserin was infused at 300 micrograms/kg before endotoxin plus 67 micrograms/kg/h during endotoxemia. During Phase 1 (i.e., 0 to 2 h), the endotoxin-induced increases in pulmonary vascular resistance and room air alveolar-arterial oxygen difference and the decreased cardiac index and lung dynamic compliance were not significantly modified by ketanserin. However, during Phase 2 (i.e., 2 to 4.5 h) endotoxemia, ketanserin attenuated the endotoxin induced pulmonary hypertension and the increases in pulmonary vascular resistance, alveolar dead space ventilation, and alveolar-arterial oxygen difference. Ketanserin also attenuated the Phase 2 bronchoconstriction and the decreased cardiac index, but did not modify the endotoxin-induced increase in alveolar-capillary permeability. These results indicate that 5-HT plays little or no role in mediating the early (i.e., less than 2 h) response to endotoxin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541721 TI - [Adrenal hematoma of familial presentation]. PMID- 3541722 TI - Sternotomy infections with Mycoplasma hominis. AB - Mycoplasma hominis caused sternal wound infections with mediastinitis in three patients. One infection occurred in a nonimmunocompromised man after coronary artery bypass grafting. The wound did not heal after repeated debridement, closed irrigation of the mediastinum with povidone-iodine solution, and antimycoplasmal chemotherapy; muscle flap grafting was eventually required. Two infections occurred in recipients of heart-lung transplants after the isolation of mycoplasma from bronchial secretions. Although no Mycoplasma species were isolated after specific antimycoplasmal therapy was begun, the wounds still did not heal. Both patients died of other complications. Infection of wounds after sternotomy is another of an increasing number of infections caused by M. hominis in the normal and immunocompromised host. Familiarity with the morphologic characteristics of M. hominis on bacteriologic culture media may increase the recognition of this pathogen in atypical clinical settings. PMID- 3541723 TI - Infectious complications in heart transplant recipients receiving cyclosporine and corticosteroids. AB - The rate of infectious complications differed significantly in two groups of heart transplant recipients who received different immunosuppressive regimens. Compared with patients who received conventional immunosuppression, patients treated with cyclosporine had a lower rate of infectious complications, and the contribution of infection to observed mortality was lower. Herpes simplex virus caused less morbidity and there were fewer active cytomegalovirus infections in seropositive recipients treated with cyclosporine. The incidence of bacterial pulmonary infections and associated bacteremia also decreased impressively. A decrease in nocardial infections was offset by a rise in those due to Legionella species. The frequency of aspergillosis was decreased by 54% in the cyclosporine treated group, but half of these infections disseminated beyond the lung and such dissemination was always fatal. Infections with Pneumocystis carinii were significantly less common with cyclosporine-based immunosuppression. Screening serologic tests for toxoplasma should be done routinely and consideration given to prophylaxis in heart transplant recipients at high risk. PMID- 3541724 TI - Ciprofloxacin or trimethoprim-sulfamethoxazole as initial therapy for travelers' diarrhea. A placebo-controlled, randomized trial. AB - The efficacy of ciprofloxacin was compared with that of trimethoprim sulfamethoxazole in a placebo-controlled trial of the 5-day treatment of acute diarrhea among 181 adults recently arrived in Guadalajara, Mexico. Both antimicrobial agents were significantly (p less than 0.0001) more efficacious than placebo in the treatment of diarrhea, with the average duration of diarrhea being 29, 20, and 81 hours, respectively, in the ciprofloxacin, trimethoprim sulfamethoxazole, and placebo treatment groups. The antimicrobial agents were also more efficacious than placebo in treating diarrhea caused by enterotoxigenic Escherichia coli, invasive enteropathogens, and unknown pathogens. Both antimicrobials were effective in treating mild-to-moderate and moderate-to-severe disease, and both were well tolerated. Ciprofloxacin appears to be a logical alternative to trimethoprim-sulfamethoxazole in the initial treatment of acute travelers' diarrhea. PMID- 3541725 TI - Transmission of human immunodeficiency virus by transplantation of a renal allograft, with development of the acquired immunodeficiency syndrome. PMID- 3541726 TI - Blood cultures. AB - We reviewed the literature on the performance of the blood culture as a diagnostic test and analyzed the data with Bayes' theorem to find the optimal number of cultures to draw. The blood culture is unusually dependent on physician behavior (use of sterile technique, the number and timing of cultures, volume of blood drawn) and on their clinical judgment (estimating the pretest probability of bacteremia, anticipating the causative pathogen, interpreting the results). Because there is no independent "gold-standard" procedure against which to evaluate this test, sensitivity and specificity can only be approximated. Sensitivity can be maximized by doing multiple cultures containing at least 10 mL of blood per set. Specificity can be maximized by adhering strictly to aseptic techniques and by requiring that multiple sets be positive for the series to be considered positive when the anticipated pathogens are also common contaminants. Two or three blood culture sets almost always suffice to establish or rule out bacteremia, although on some occasions obtaining more than three sets of cultures is indicated. One set is rarely, if ever, sufficient. PMID- 3541727 TI - Decision analysis: a progress report. AB - Since its introduction into medicine 15 years ago, decision analysis has been applied to difficult clinical problems. Several important advances have made the process more practical and acceptable: computer programs that eliminate the need for burdensome calculations, improved techniques for designing analytic models, the ability to carry out sensitivity analyses over several dimensions simultaneously, and the elaboration of clinically relevant measures of utility. Using these techniques, analysts have addressed many important clinical issues including screening for and prevention of disease, tradeoffs among tests and treatments, and the interpretation of clinical data under conditions of uncertainty. Problems with the approach remain and applications have not been extensive, but decision analysis is evolving as a powerful clinical tool and gradually is gaining acceptance in medical practice. PMID- 3541729 TI - Graduate medical education: who will pay how much for what? PMID- 3541728 TI - A century of American rheumatology. AB - In reviewing the development of rheumatology in the United States, I begin with the understanding of rheumatic diseases in the previous century and then consider subsequent scientific and organizational events that were important in the creation of rheumatology as a recognized medical specialty. The perception had to evolve that rheumatic diseases can be analyzed beyond their gross clinical description and that effective therapy is possible. The virtual coincidence of the discoveries of the rheumatoid factor, the lupus erythematosus cell, and cortisone in 1948-49 satisfied these requirements. The publicity that was generated is considered to have been most responsible for the unusually abrupt recognition of rheumatology as a specialty. PMID- 3541730 TI - A fatal arrhythmia undetected by a computerized cardiac monitor. PMID- 3541731 TI - [Distress and anxiety in the psychopathology of Pierre Janet]. AB - For P. Janet, there exists a progressive evolution in behaviours. Reflex at the start, with immediate response, they become delayed with secondary behaviours appearing grafted upon primary behaviours. They are the feelings which allow a more and more precise adaptation to physical and social reality. Having started, as did Freud, from psychical traumatism P. Janet is not interested in subconscious but particularly studies the psychological deficiencies which traumatism causes or brings to the foreground. He makes an exhaustive study of those deficiencies under the name of feeling of lack and void. Neurotics, unable to assimilate or master their traumatisms, lose their sense of the present, of reality, and of Action. They only live in day-dreams and abstract ideas. This deviation of behaviour reaches its, pitch with the melancholic. The melancholic, riveted to his past can no longer change as is the case with the patients of Minkowski. It is every day the same old story. Any idea having to do with the future is received as abominable and catastrophic. Consequently, everything appears to them as deadly and they have such a fright of action that it results in systematical reversal of action. Instead of living, they only long for death. As in Suzan Urban's theatre, as described by Bingwanger, the melancholic has the behaviour of a trapped animal. He desperately looks for a way out and turns from side to side, but finds himself systematically trapped back once more. He looks passive and inhibited, but here we have to deal with an active inhibition. The melancholic is not resigned. He would like to come out of his mental situation, but is unable to react. PMID- 3541732 TI - [Brief analytic psychotherapies. I. Historical and conceptual foundations]. AB - From a pragmatic standpoint where the essential aim lies in the therapeutic efficacy within a relatively short duration, brief dynamic psychotherapies have progressively emerged from the psychoanalytic trend, which they come from. Yet, they are unambiguously connected with psychoanalysis in so far they use its theoretical frame as well as some of its technical aspects, particularly transference interpretation. PMID- 3541733 TI - [Similarities and differences between DSM III and French psychiatric practice]. PMID- 3541734 TI - Honorary plenary lecture: History of in vivo analysis of brain functions elicited from its inner and outer surfaces. PMID- 3541735 TI - Catecholamine release within the striatum of the freely moving rat. AB - The push-pull method was used in conscious rats in two different types of experiments. In the first, intranigral application of GABAergic agonists was shown to produce both contralateral circling and [3H]dopamine efflux from the ipsilateral striatum. In the second experiment, MK-801, a novel experimental compound, was found to be dissimilar from amphetamine insofar as it does not produce the release of [3H]dopamine from the striatum during its local application. This novel agent presents an intriguing profile of activity whose mechanism of action remains to be fully elucidated. The usefulness of the push pull method in helping to resolve a complicated behavioral-neurochemical question as well as a tool for studying neuropharmacological effects of novel agents is clear. The development of new and more sensitive HPLC assay techniques should soon alleviate the need for radiolabeling endogenous catecholamine stores and should greatly further advance the usefulness of this technique. PMID- 3541736 TI - Synaptic organization in the oculomotor nucleus. PMID- 3541737 TI - Release of proteins, enzymes, and the neuroactive peptides, enkephalins, from the striatum of the freely moving rat. PMID- 3541738 TI - Push-pull perfusion of the hypothalamus and the caudate nucleus in conscious, unrestrained animals. AB - The present results further confirm the usefulness of the push-pull cannula to study the in vivo activity of several neural systems in conscious, freely moving animals. However, it is evident that the inflammatory reaction to the local injury induced by the cannula may have different consequences in the function of a particular brain area. In the caudate nucleus, the responsiveness of the dopaminergic terminals of the nigrostriatal DA system to local infusion of AMPH was clearly reduced after the first two to three weeks post cannula implant. In contrast, in the hypothalamus of the rat and the rabbit, the spontaneous fluctuating activity of the LHRH pulse generator remained unaffected during a two to three month period when several perfusions could be performed in the same animal. Further studies will be required to establish the reasons for such marked differences in response to injury of these two brain structures. Various neurochemicals can be measured simultaneously from the hypothalamus of conscious rabbits. The present results indicate that NE hypothalamic impulse flow increases during the afternoon whereas the impulse flow of DA (as estimated by DOPAC output) decreases or does not change. In rabbit No. 2, simultaneous measurement of hypothalamic NE release and LHRH release indicates an absence of correlation. In sharp contrast, the simultaneous measurement of prostaglandin E2 release and LHRH release from the hypothalamus of rabbit 2-ER revealed a closer association between these two neuronal events. Apparently the push-pull technique can be used to examine long-term seasonal as well as circadian (extended 24 hr perfusion) spontaneous changes in the activity of the LHRH pulse generator in individual animals. It seems that seasonal changes characterize the function of the rabbit LHRH pulse generator. Lastly, physiological doses of progesterone infused for short times directly into the hypothalamus of female rabbit stimulate the LHRH pulse generator of this species with marked increases in the amplitude of the LHRH signal. In conclusion, the PPP technique coupled to HPLC-EC and RIA procedures to measure localized release of neurotransmitters, metabolites, and neuropeptides simultaneously in the same perfusate samples from discrete brain areas appears to be a powerful technique in furthering our knowledge of the in vivo local neurochemistry of the brain of conscious, freely moving animals. PMID- 3541739 TI - Sleep factors released from brain of unrestrained cats: a critical appraisal. PMID- 3541740 TI - In vivo measurement of [3H]GABA release: an approach to the study of the regulation of GABA-containing neurons in the basal ganglia and associated structures in the cat and the rat. PMID- 3541742 TI - Voltammetric detection of dopamine release in the rat corpus striatum. PMID- 3541741 TI - Single unit activity of brain monoamine-containing neurons in freely moving animals. PMID- 3541743 TI - Nidation. A symposium held in honor of Professor M.C. Shelesnyak. Montreal, Quebec, Canada, July 22, 1985. PMID- 3541744 TI - Role of the corpus luteum in controlling implantation in mustelid carnivores. AB - The studies that have been reviewed in this paper indicate that the ovaries of mustelids play an essential role in induction of blastocyst implantation. Moreover, the data suggest that CL are the primary source of a hormone, which acts in conjunction with progesterone, to initiate the chain of events leading to implantation. The identity of this luteal factor is unknown; however, existing evidence suggests that it may not be a steroid. PMID- 3541745 TI - Uterine receptivity for nidation. PMID- 3541746 TI - Prostaglandins and uterine sensitization for the decidual cell reaction. PMID- 3541747 TI - A history of research on nidation. PMID- 3541748 TI - Hormonal control of adipogenesis. AB - The concept that hormonal substances can alter the expression of entire developmental programs is in itself not particularly new. The ability to define conditions under which a specific hormone can precociously activate the differentiation of a well-defined population of cells and under which another hormone can both block and reverse such a developmental progression, however, provides a major step forward toward unraveling the biochemical events that define the transition from a committed precursor to a fully differentiated cell. Further analysis of the molecular events initiated by glucocorticoids and TNF should provide insights into the control of adipogenesis and may generate a foundation for understanding the mechanisms by which other cells enter a particular differentiative lineage. In a more applied sense, such knowledge may also provide a rational approach to controlling metabolic disease syndromes related to adipogenesis gone awry such as obesity-associated diabetes and cachexia. PMID- 3541749 TI - Tissue-specific expression of pancreatic genes in transgenic mice. PMID- 3541750 TI - Structural relationships in glycogen phosphorylases. PMID- 3541751 TI - Structure and expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase. PMID- 3541752 TI - Recombinant retroviruses in transgenic mice. PMID- 3541754 TI - Multihormonal regulation of milk protein gene expression. PMID- 3541753 TI - Regulation of genes for enzymes involved in fatty acid synthesis. AB - The levels of malic enzyme and fatty acid synthase are increased by feeding and decreased by starvation in liver in vivo and are increased by triiodothyronine and decreased by glucagon in hepatocytes in culture. Cloned malic enzyme and fatty acid synthase cDNAs are being used to analyze regulation of these unique genes. Dietary regulation of both enzymes occurs at pretranslational steps. Increased transcription and increased mRNA stability contribute about equally to a 20-fold increase in malic enzyme mRNA level when starved ducklings are refed. In contrast, a 10-fold increase in the level of fatty acid synthase mRNA is largely accounted for by increased transcription of this gene. In chick-embryo hepatocytes incubated in serum-free medium containing insulin, triiodothyronine causes a greater than 10-fold increase in levels of both malic enzyme and fatty acid synthase mRNAs. Kinetic and inhibitor experiments suggest a protein intermediate in the increases of malic enzyme and fatty acid synthase mRNAs caused by triiodothyronine. For malic enzyme, the stimulation by triiodothyronine is predominantly posttranscriptional. Glucagon decreases the level of malic enzyme mRNA by 90 to 95%, with regulation occurring at a posttranscriptional step. Inhibitor experiments suggest that stimulation of the degradation of malic enzyme mRNA is partially responsible. Glucagon inhibited fatty acid synthase mRNA level by less than 50%; the inhibited step has not been identified. Thus, the coordinated regulation of malic enzyme and fatty acid synthase proteins by nutritional state may involve different hormones regulating at different points. A surprisingly large component of the regulation is posttranscriptional. PMID- 3541755 TI - Regulation and structure of murine malic enzyme mRNA. PMID- 3541756 TI - [Comparison between microcervicoscopic and histologic diagnosis in 120 cases of cervical intraepithelial neoplasms]. PMID- 3541757 TI - [Serum protease inhibitors (alpha 1-antitrypsin and alpha 1-antichymotrypsin) in the normal human placenta. An immunohistochemical study]. PMID- 3541759 TI - [Vesiculo-bullous lupus erythematosus. Immuno-electronic study]. AB - The authors present a case suggesting either bullous systemic lupus erythematosus of dermatitis herpetiformis. An immunoelectron microscopic study located the immunoglobulin deposits beneath the cutaneous basement membrane zone. The nosological problem of possible relationship between systemic lupus erythematosus and epidermolysis bullosa acquisita is discussed. PMID- 3541758 TI - [Value of cutaneous immunofluorescence in the etiological diagnosis of a disease with antinuclear antibodies]. PMID- 3541760 TI - [Bullous pemphigoid with pemphigus type antibodies in vivo. 2 cases]. AB - Pemphigus vulgaris, whether of the vulgaris or foliaceus variety, and bullous pemphigoid (BP) are two groups of auto-immune bullous diseases which in most cases can easily be differentiated on the basis of clinical, histological and, mainly, immunopathological data. Like cicatricial pemphigoid, BP may be accompanied with circulating pemphigus-like antibodies (PLA) which are not detected in vivo by direct immunofluorescence (IF). However, a true pemphigus-BP association, as reported first by Chorzelski et al., is exceptional. Two cases of BP immunolabelled with pemphigus-like antibodies at direct IF are reported, raising a discussion on this particular association. The first case concerns a 62 year old man presenting with extensive psoriasis treated with salicylated vaseline and topical corticosteroids. The patients was admitted for a disseminated, symmetrical and pruriginous bullous eruption made up of tense bullae on healthy and psoriatic skin or on an urticarial background, without Nikolsky's sign. Pathological examination of a recent bulla showed subepidermal detachment without acantholysis. Direct cutaneous IF revealed linear labelling of the basement membrane zone with IgG, C3 and C1q, and labelling of the inter cellular substance of the epidermis with IgG. Indirect IF on O+ human skin demonstrated antibodies of the pemphigoid type (1/128) and of the pemphigus type (1/64). Standard laboratory examinations only showed moderate blood eosinophilia (950/mm3) and a rise in total IgE. Under systemic corticosteroid therapy (prednisone 1 mg/kg/day) and azathioprine (2 mg/kg/day) the bullae rapidly disappeared.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541761 TI - [Side-effects of retinoids]. PMID- 3541762 TI - [What's today's view of manic-depressive disease in children?]. PMID- 3541763 TI - [Clinical trial of a clavulanic acid-amoxicillin combination in urinary infections in children]. PMID- 3541764 TI - [Biostim prevention of recurrent respiratory infections in children. A double blind versus placebo study]. PMID- 3541765 TI - [Pharmacochemical study of a new series of powerful mutagenic and carcinogenic reagents: the 2-nitronaphthofurans]. PMID- 3541766 TI - [Bilateral adrenal cortex malignancies in children. Apropos of a case]. PMID- 3541767 TI - [Giant hemangioma associated with thrombopenia in a child (Kasabach-Merritt syndrome). Apropos of a case]. PMID- 3541769 TI - Measurement of plasma amylase activity. PMID- 3541768 TI - [Efficacy and tolerance of a bepridil challenge dose. A double-blind multicenter study]. PMID- 3541770 TI - Assays for prolactin: guidelines for the provision of a clinical biochemistry service. AB - This paper summarises the views of the authors on the provision of a prolactin assay service. We discuss the pathophysiology of prolactin secretion and the clinical indications that arise from that. We cover the rather complex issue of the definition of normal and elevated prolactin levels. From these considerations, certain guidelines on the analytical performance of prolactin assays and their provision in a clinical biochemistry service are given. The extent to which currently available methods and performance as revealed by the UK External Quality Assessment Scheme (EQAS) match these guidelines are described and certain conclusions are reached. Finally, probable future developments are briefly discussed. The main conclusions and recommendations are as follows: Reagents of appropriate quality are available to enable prolactin immunoassays to be provided in UK clinical biochemistry laboratories. These are provided either separately or in the form of kits from both commercial and NHS sources. There is no requirement for individual laboratories to undertake their own antiserum production or prolactin iodination. Acceptable performance (as defined using internal QC procedures and the UK EQAS) is achievable using these reagents/kits, although one commercial kit shows a consistent marked negative bias. Reference ranges, including 'normal ranges', show considerable between-centre variability. Many centres have not established their own ranges, even those using in-house methods. Reference ranges for use in clinical biochemistry laboratories are proposed in this report. Some general guidance on the provision of a prolactin service is given, although this does not differ in principle from that appropriate for other peptide hormone analytes. There is no evidence that centres with small workloads perform any worse than average, although it may be more cost efficient for such centres to send the samples elsewhere. As with other peptide analytes, non-isotopic immunometric methodology is likely to replace current radioimmunoassay methods in the near future. PMID- 3541771 TI - Flow cytometry in the diagnosis in hematologic diseases. AB - Because of recent advances in instrumentation, immunological reagents, and methods for measuring a variety of cell constituents and functions, there has been increasing interest in clinical applications of flow cytometry. Several commercially available flow cytometers and a growing list of monoclonal antibodies make it feasible for clinical laboratories to apply this technology for phenotyping leukocytes in leukemias, lymphomas, immunological disorders, transplant patients, and infectious diseases. The ability to measure cell constituents such as deoxyribonucleic acid (DNA), ribonucleic acid (RNA), proteins, enzymes, and hormone receptors has added to the list of applications. Use in conjunction with simultaneous phenotyping with monoclonal antibodies makes such measurements even more valuable. Phenotyping specimens from a large number of patients with lymphomas and leukemias, the AIDS related complex, and other immunological disorders, has demonstrated the value of flow cytometry in diagnosis and patient management. PMID- 3541772 TI - Granular tricalcium phosphate in large cancellous defects. AB - Tricalcium phosphate (TCP) is a porous ceramic which has biological properties of being non-reactive and resorbable, and acts as a scaffolding for bone ingrowth, undergoing progressive degradation and replacement by bone. Tricalcium phosphate has been shown to be comparable to autogenous bone graft in small periodontal defects. However, orthopedic defects are much larger. This prompted us to review the bone ingrowth potential in large cancellous bone defects (up to 12 cm3) in adult pigs. To quantitate bone ingrowth potential, three skeletally mature pigs had metaphyseal defects created in the tibia and femur of each hind limb, for 12 total sites. Twelve-cc defects in the distal femur and eight cc defects in the proximal tibia were made. Bone curetted was saved to be used as autogenous graft in the control, while the other ipsilateral defect was packed with tricalcium phosphate. Four months following the initial defect, the opposite hind extremity was similarly operated. All animals were sacrificed at nine months. Specimens were imbedded in methyl-methacrylate, cut at 120 microns, and stained. The quantity of regenerated bone was measured by histomorphometric techniques. Qualitative assessment at four months revealed absence of inflammation and TCP surrounded by trabecular bone, which was uniformly viable. There was very little TCP left by nine months. Quantitative analysis revealed the tibias to have a higher percent net bone replacement with TCP as compared to the control (32 percent versus 13 percent). The femoral TCP-filled defects were comparable to autogenous bone (both measured 29 percent).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541773 TI - Clinical trial of young red blood cells prepared by apheresis. AB - Transfusion of young red blood cells (YRBC) with prolonged survival should result in increased intervals between transfusions and, therefore, decreased transfusion associated iron loading. A prospective clinical trial comparing YRBC transfusions prepared by apheresis versus washed or frozen red cell transfusions was performed in five children with transfusion-dependent thalassemia. A total of 152 YRBC units, evaluated by reticulocyte enrichment and pyruvate kinase activity, were transfused. While a slightly longer interval between transfusions was observed during the time period of YRBC versus the time period after (30.0 +/- 1.5 days versus 27.9 +/- 1.1 days, respectively, p less than 0.02), there was no associated decrease in mg of iron transfused per kg. The effectiveness of transfused YRBC units was less than predicted by in vitro and in vivo studies. PMID- 3541774 TI - Aging phenomena and osteoarthritis: cause or coincidence? Claude P. Brown memorial lecture. AB - Osteoarthritis is an ubiquitous disease, primarily occurring in older individuals. Any attempt to explain the disease in terms of biologic aging must first define the basic pathology of the disease, accurately classify the clinicopathologic variants of the disease, and develop a scientific approach to the recognition of the pathologic physiology of any known precursor states. This epidemiologic information must insure comparability between populations of patients or animals under study, since significant differences in susceptibility among groups do exist. Cumulative environmental influences on joints do have pathophysiologic consequences but require careful study to isolate cause and effect from coincidental occurrences. Musculoskeletal aging itself is a complex process including both post-synthetic changes in the extracellular matrix macromolecules and alteration of phenotypic expression by the connective tissue cells themselves. In contrast to older assertions that chondrocytes are terminally differentiated cells incapable of replication, evidence has accumulated that chondrocytes proliferate in vivo and in vitro under appropriate conditions. Studies in several laboratories have confirmed that articular chondrocytes from aged animals both proliferate and synthesize macromolecules in a fashion similar to comparable cells extracted from young animals. Further studies are necessary before osteoarthritis can be definitively separated into aging-dependent and aging-independent categories. PMID- 3541776 TI - [Role of endogenous opioid peptides in the regulation of pituitary secretions]. AB - Identification of modulatory properties of morphine on certain hormonal secretions and that of opiate-receptor specific endogenous ligands has stimulated research in many fields, including role of opioid peptides in hypophysial secretion regulation. Availability of long-acting agonists and of antagonists of opioid peptides has provided data on their pharmacologic effects and possible role in hormonal physiology. The aim of the present report is to provide an update review of the influence of opioid peptides in hypophysial secretion regulation, while accepting that multiplicity of peptides and receptors does not allow formal conclusions to be drawn. At pharmacologic doses, opioid agonists stimulate prolactin and growth hormone secretion whereas that of LH and ACTH is inhibited. Secretion of TSH is little modified and that of ADH is stimulus related. The opioid peptides are involved physiologically in the multifactorial regulation of gonadotropin secretion, other hypophysial secretions being mainly unaffected. Finally, "hypothalamic" amenorrhea appears to be the only pathologic model for which opioid peptides can be implicated. Finer analysis of physiologic role of endogenous opioid systems and their possible pathologic effects requires availability of selective agonists and notably antagonists. PMID- 3541775 TI - [Innocuousness of the limited reuse of injection materials by insulin-dependent diabetics]. AB - A survey was conducted in 120 insulin-dependent diabetics to determine their routine daily procedure for insulin injection and the possible reuse of the material employed. Aseptic precautions were usually sufficient, half of the diabetic patients (51.6%) conforming with the overall rules for hygiene generally recommended. Spontaneous reuse of injection material was rare (10/120), and local incidents as a result of reuse infrequent: pain from the 3rd injection in 2 patients and an abdominal abscess in a third case due to total lack of asepsis rules. Insulin injections in 37 insulin-dependent diabetics admitted to hospital care were administered throughout their stay by means of plastic syringes and needles used 3 times consecutively. The mean number of needles-syringes used per diabetic was 7.3, representing a total of 813 injections. Infectious sequelae were not observed and minor local incidents (pain, pruritus) were rare and unrelated to the reuse of equipment. Limited reuse, under satisfactory conditions of asepsis, of material termed for "once only use" appears to be free from risk particularly with respect to infection. Generalization of this practice will provide substantial economy in the treatment of diabetes. PMID- 3541777 TI - The Irish Famine and its sequel: population structure changes in the Ards Peninsula, Co. Down, 1841-1911. AB - Using censal data, the population structure of the Ards Peninsula, Co. Down was investigated from 1841 to 1911. During the study period there were highly significant declines at townland level in the mean total population, population density, number and proportion of inhabited houses, household size and deviations in the male/female ratio. The potential genetic effects of the changes, mediated via reduced effective population sizes, were exacerbated by marked differences in the patterns of population structure variation by religion. It is suggested that the current high incidence of recessive genetic disorders in the Northern Irish can be ascribed, at least in part, to these post-Famine events. PMID- 3541778 TI - Cancer in ataxia-telangiectasia patients: analysis of factors leading to radiation--induced and spontaneous tumors. AB - Persons with the genetic, autosomal recessive human disorder ataxia telangiectasia (A-T) have a predisposition to cancer, though the reason for this is not understood. Studies carried out in recent years have provided evidence that cultured skin fibroblasts from A-T patients are hypersensitive to X radiation and radiomimetic drugs. These cells were also found to release a clastogenic factor and an angiogenesis-like factor into the conditioned medium. Similar factors present in the plasma of A-T patients may be the cause of chromosomael breakage and blood vessel proliferation respectively. It is suggested to that continual chromosomal breakage in lymphocytes, induced by the clastogenic factor, leads to a selection of T or B lymphocytes with neoplastic properties. Future studies should be directed towards skin Langerhans cells to determine their role in the immune deficiency and their interaction with other cellular elements in the skin of A-T patients. Furthermore, T and B lymphocytes from A-T patients with tumors should be cultivated in vitro to study the nature of the activated oncogenes and the possible role of viruses in blood neoplasms in A-T patients. PMID- 3541779 TI - Immunohistochemical study of the ras oncogene expression in human breast lesions. AB - An immunohistochemical study of ras oncogene expression in human breast lesions was carried out using a monoclonal antibody, Y13 259, to the ras encoded p21 protein. A total of 75 cases of breast disease examined included: 33 simple and complex cystic disease; 22 simple and hyperplastic fibroadenomas; 18 ductal, lobular and mixed carcinomas and 2 in situ carcinomas. Most of the complex cystic disease, hyperplastic fibroadenomas and all types of carcinomas showed high p21 expression as indicated by staining intensity. These results suggest that elevated ras expression may play an important role in the development of some premalignant and malignant breast lesions. PMID- 3541780 TI - Immunostaining of colorectal cancer with monoclonal anti-CEA antibodies compared to serum and tumor CEA content. AB - Carcinoembryonic antigen was measured in serum and in extracts from 37 colorectal tumors and we found a poor correlation between circulating and tumor CEA. Monoclonal antiCEA antibodies were used in indirect immunoperoxidase staining of the corresponding formalin fixed tissue sections. We found that serum CEA measurement had a sensitivity of only 41.9% as compared to 90.3% for the immunohistochemical staining. The positive and negative predictive values for immunostaining were respectively 96.6% and 72.7%. Immunohistochemical staining of tissue sections with monoclonal anti CEA coupled to other biochemical or immunological assays could be a useful adjunct for the diagnosis of premalignant or slightly modified tissues. PMID- 3541781 TI - Problems in in vitro determination of antibiotic tolerance in clinical isolates. PMID- 3541782 TI - Modulation of bacteriolysis by cooperative effects of penicillin-binding proteins 1a and 3 in Escherichia coli. AB - Escherichia coli characteristically lyses upon treatment with most beta-lactam antimicrobial agents. In contrast, an investigational aminothiazole cephem, CGP 31523A, produced a new combination of antibacterial effects: it was highly bactericidal without causing cell wall degradation or lysis. Killing was associated with the formation of vacuolated filaments. Because the compound bound to penicillin-binding proteins (PBPs) 1a and 3, we investigated the role of PBP 3 in modulation of lysis caused by inhibition of PBP 1a. A temperature-sensitive mutant with a nonfunctional PBP 3 lysed when treated with CGP 31523A. The combination of a PBP 1 inhibitor (cefsulodin) and a PBP 3 inhibitor (aztreonam) also caused filamentation and death without lysis of wild-type cells over a narrow concentration range. We conclude that cooperative effects between PBPs in E. coli can lead to a dissociation of bacterial killing and lysis. PMID- 3541783 TI - Contribution of two different mechanisms to erythromycin resistance in Escherichia coli. AB - Escherichia coli BM2570 was resistant to high levels of erythromycin by two different mechanisms. The two genes conferring resistance to erythromycin in BM2570 were carried by a 150-kilobase self-transferable plasmid, pIP1527, and were cloned separately in E. coli. A single polypeptide with an Mr of 27,000 was encoded by the gene erxA and conferred high-level resistance to macrolide, lincosamide, and streptogramin B-type antibiotics by a mechanism other than drug inactivation. This resistance phenotype, not previously reported for a clinical isolate of enterobacteria, was probably due to modification of the ribosomes. The gene ereB encoded an enzyme with an Mr of 51,000 which inactivated erythromycin and oleandomycin. The two different mechanisms specified by erxA and ereB contributed in more than an additive fashion to the high level of resistance to erythromycin conferred by plasmid pIP1527 to E. coli BM2570. PMID- 3541785 TI - Effect of palatable diet on growth, caloric intake and endocrine-metabolic profile in weanling rats with dorsomedial hypothalamic lesions. AB - Weanling male Sprague-Dawley rats received bilateral electrolytic lesions in the dorsomedial hypothalamic nuclei (DMNL rats); sham-operated rats served as controls. All animals were fed lab chow for 15 postoperative days. At that time they were subdivided into two groups each. One DMNL and one control group continued to be fed lab chow until the termination of the experiment on postoperative day 116. A second DMNL and control group were fed a high-fat diet and 32% sucrose solution (HF/SS diet). All DMNL rats showed reduced body weight and linear growth, but the HF/SS diet depressed these parameters further below the levels of the chow-fed groups. Both DMNL and control rats fed HF/SS had more carcass fat, heavier epididymal fat pads, more carcass fat per calories eaten, higher plasma levels of glucose, glycerol and free fatty acids but lower insulin levels than chow-fed DMNL rats and controls. This occurred in the face of lower body weights and caloric intake. Neither growth hormone nor insulin showed lesion effects. Rats with DMNL exhibited the same inverse relationship between plasma insulin and free fatty acids as controls. The data indicate that DMNL rats respond to the HF/SS diet essentially like sham-operated controls, i.e., they develop dietary obesity. Although they do show some small deficits, their lipogenic capacity is actually significantly greater than that of HF/SS-diet fed controls. PMID- 3541784 TI - Effect of calmodulin inhibitors on viability and mitochondrial potential of Plasmodium falciparum in culture. AB - Calmodulin inhibitors are toxic for a variety of protozoa. Chlorpromazine, calmidazolium, and trifluoperazine inhibited the incorporation of [3H]hypoxanthine and [3H]phenylalanine into Plasmodium falciparum organisms in cultures with 50% inhibitory concentrations varying from 5.1 microM (with calmidazolium) to 48 microM (with chlorpromazine), the former being more sensitive than the latter. However, these concentrations also immediately dissipated rhodamine 123 from the parasite mitochondrion. Similar concentrations inhibit other protozoa, as well as mammalian cells, and the possibility that mitochondrial function rather than that of calmodulin is the target of these drugs should be considered. PMID- 3541786 TI - Polyamine binding sites on Escherichia coli ribosomes. AB - To determine the binding sites of polyamines on Escherichia coli ribosomes, ribosomal proteins crosslinked with polyamines through bifunctional reagents were analyzed. When 1,5-difluoro-2,4-dinitrobenzene was used as a crosslinking reagent, spermine was bound to S3, S8, S9, L1, L2, L3, L5, L6, L13, L18, L24, and L27 proteins. When dimethyl suberimidate was used, spermine was bound to S1, S3, S4, S5, S7, S8, S9, S15, L1, L2, L3, L6, L18, and L24 proteins. In addition to crosslinking with the above proteins, spermidine, when crosslinked with dimethyl suberimidate, bound to S2, S14, S20, L4, L5, L9, L13, and L16 proteins. The relationship between the binding site(s) of polyamines on ribosomes and the function of polyamines is discussed. PMID- 3541787 TI - Purification and characterization of aldo-keto reductases from gerbil liver: immunochemical evidence for related proteins in other mammalian species. AB - We purified a hepatic aldehyde reductase (AR1) and two carbonyl reductases (CR1, CR2) from the Mongolian gerbil, an animal recently shown to closely resemble man in its metabolism of a carbonyl containing organochlorine pesticide. The apparent molecular weights of AR1, CR1, and CR2 were 40,700, 33,000, and 34,700, respectively. Typical of similar enzymes in other species, gerbil AR1 reduced aliphatic and aromatic aldehydes and was inhibited by phenobarbital or valproate, whereas CR1 and CR2 catalyzed the reduction of aromatic aldehydes and ketones as well as quinones and were inhibited by p-chloromercuribenzoate, mercuric chloride, or pyrazole. All three enzymes were insensitive to metal chelating agents and utilized NADPH as their cofactor. CR1 was unique in being equally active with NADH as its cofactor. Antibodies raised against CR1 reacted with purified CR1 and CR2, but not with AR1, as judged by immunoblot analyses. There were three immunochemically related proteins in gerbil liver cytosol (30 to 35 kDa range) recognized by the anti-CR1 IgG. Similar immunoblot analyses of hepatic cytosolic proteins from other mammalian species revealed immunoreactive proteins only in the hamster, the rabbit, and man, and not in the rat, the mouse, or the guinea pig. Quantitative immunoblot analyses of human liver cytosol from seven patients revealed three immunoreactive proteins. These were present in unequal and varying concentrations, although there were only small interindividual differences in the total concentration of the immunoreactive proteins. We conclude that there are multiple molecular forms of immunochemically related hepatic carbonyl reductases in the gerbil and in some other mammalian species, including man. PMID- 3541788 TI - Characterization of an enzyme that is capable of processing pro-gonadotropin releasing hormone protein. AB - A new membrane bound protease has been identified in bovine hypothalamic neurosecretory granules using synthetic substrates that we prepared based on the sequence in pro-gonadotropin-releasing hormone protein that overlaps gonadotropin releasing hormone and gonadotropin-associated peptide (thought to be prolactin releasing hormone-inhibiting hormone). The enzyme was solubilized from neurosecretory granules using the detergent Triton X-100 and was further purified by high-performance gel permeation liquid chromatography. The enzyme hydrolyzes the Arg-2-naphthylamide (NA) bond of benzoyl(Bz)-Gly-Leu-Arg-Pro-Gly-Gly-Lys-Arg 2-NA which contains two likely processing sites, Arg-Pro and Lys-Arg. On the basis of the ratio of Vmax to Km as a measure of substrate specificity, Bz-Gly Leu-Arg-Pro-Gly-Gly-Lys-Arg-2-NA is about 50-fold better than Bz-Gly-Gly-Lys-Arg 2-NA. Bz-Leu-Arg-2-NA and Bz-Gly-Leu-Arg-Pro-Gly-Gly are not hydrolyzed. The pH optimum for hydrolysis is 7.2 (Bz-Gly-Gly-Lys-Arg-2-NA substrate). As determined by gel permeation chromatography, the apparent molecular weight of the enzyme depends on the chromatography conditions; in the absence of NaCl, the Mr is approximately equal to 160,000 but is approximately equal to 80,000 if NaCl is included in the eluting buffer. After high-performance gel permeation liquid chromatography, the peak fraction containing the enzyme was lyophilized and then subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis; silver staining revealed a single protein band, Mr approximately equal to 70,000. PMID- 3541790 TI - [Quality of life in patients with advanced cancer]. AB - Advances in cancer chemotherapy have brought about significant improvement in the overall survival expectation for many malignant diseases. However, most current clinical trials only evaluate the duration of survival, the response rate of the tumor to treatment, or simply report the obvious side effects. Quality of life study is an emerging science of particular relevance to clinical cancer. The development of valid and reliable quality of life assessment may influence the clinical trials process. Furthermore, it may be possible to compare the effects of alternative treatment on both the quality and duration of survival. Developing interest in the quality of life is reflected in the increasing number of references dealing with this problem. However, several points must be resolved before measurement of the quality of life of cancer patients can be used for these purposes, including the design of a method of measurement, evaluation of the method, etc. The selection of an appropriate scope of inquiry is also important. In this report, current views on the quality of life in patients with advanced cancer are briefly reviewed, and the attempts of our Tokyo Cancer Chemotherapy Cooperative Study Group are also introduced. PMID- 3541789 TI - Characterization of phosphomannan-protein complexes isolated from viable cells of yeast and mycelial forms of Candida albicans NIH B-792 strain by the action of Zymolyase-100T. AB - The isolation of phosphomannan-protein complexes from the viable cells of yeast (Y) and mycelial (M) forms of Candida albicans NIH B-792 strain was conducted by treatment with Zymolyase-100T followed by fractional precipitation with cetyltrimethylammonium bromide. The M-form complex was found to contain smaller amount of phosphate (1.3%) than that of the Y-form complex (1.6%). Proton magnetic resonance (PMR) spectra of these complexes indicated that the content of beta-1,2-linked oligomannosyl and nonreducing terminal alpha-1,3-linked mannopyranosyl residues in the M-form complex was lower than that of the Y-form complex. With hot 10 mM HCl, the Y-form complex released a mixture of oligosaccharides ranging from mannose to mannoheptaose, while the M-form complex produced lower oligosaccharides, from mannose to mannotetraose. Upon acetolysis, the acid-modified complex of the M form gave mainly mannotetraose, while that of the Y form produced mainly mannopentaose and mannohexaose in addition to mannotetraose. The average length of branching moieties of the mannan of Y-form cells was therefore longer than that of M-form cells. These results indicate that the Y to M transformation of this C. albicans strain accompanies the suppression of enzyme activity concerning the biosynthesis of mannan such as beta-1,2- and alpha-1,3-mannosyltransferases to synthesize the phosphomannan-protein complex containing mannan moiety with incomplete structure. PMID- 3541791 TI - [Determination of serum DU-PAN-2 by enzyme immunoassay in patients with various digestive cancers]. AB - In order to evaluate the usefulness of serum DU-PAN-2, we determined this antigen in 384 patients with various malignancies and in 215 patients with benign diseases using a sandwich enzyme immunoassay system (Kyowa Medex Co.). Elevated DU-PAN-2 levels (greater than 400 U/ml) were observed in 55% of hepatocellular cancers, 50% of pancreatic cancers, and 43% of biliary tract cancers. On the other hand, most false-positive cases with benign diseases were observed in patients with liver injury, especially in the acute phase of acute hepatitis, chronic active hepatitis, and liver cirrhosis. However, in only a few cases with other benign diseases including pancreatitis, increased levels were found. Moreover, among the pancreatic cancer or biliary tract cancer patients studied, DU-PAN-2 was positive in 7 of the 19 CA 19-9-negative (less than 37 U/ml) patients and 32 of the 68 CEA-negative (less than 5 ng/ml) patients. These results indicate that the assay of DU-PAN-2 by EIA may have diagnostic usefulness in digestive cancer, especially pancreatic cancer or biliary tract cancer. PMID- 3541793 TI - [Bone marrow transplantation for pediatric patients: review of progress]. PMID- 3541792 TI - [Phase II study of prednimustine in follicular lymphoma and chronic lymphocytic leukemia]. AB - A phase II study of Prednimustine (PMN) was conducted for follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL). PMN at a dose of 40-60 mg/body, p.o. every day, was administered to 17 patients with FL and 4 with CLL. The dose and schedule of PMN was modified according to hematological toxicity. Among the 17 patients with FL, there were 6 (35.3%) CRs and 7 (41.2%) PRs, with a high response rate of 76.5%. Among the 4 patients with CLL, there were 2 PRs and one case which showed clinical improvement. PMN was effective for cases of FL and CLL refractory to alkylating agents, and therefore the result suggested a lack of clinical cross-resistance to these agents. As to the side effects observed in patients with FL, mild leukopenia (median of lowest count 3,150/mm3) occurred. One case experienced anorexia, while increased appetite was observed in 4 cases. We conclude that PMN is effective for FL and CLL, and that in addition, it has an advantage in that its mild side effects allow long-term administration through outpatient clinics, so that the quality of life for patients is not impaired. PMID- 3541794 TI - Crusted (Norwegian) scabies. Occurrence in a child undergoing a bone marrow transplant. AB - A case of crusted (Norwegian) scabies is reported in a child who was a recipient of a bone marrow transplant. The infestation is presumed to have predated the bone marrow transplant and continued asymptomatically during chemotherapy and total body x-irradiation in preparation for transplant. The child was asymptomatic until 23 days after transplantation, when bone marrow engraftment was attained. The altered host-parasite relationship is emphasized by the observation that the onset of symptomatic pruritus coincided with successful engraftment. PMID- 3541795 TI - Spider bites. AB - Spiders are a ubiquitous component of the fauna of North America. At least 50 to 60 species in the United States are known to bite humans, although in most cases, the diagnosis is never suspected nor is treatment necessary. A few species of spiders are capable of causing necrotic wounds and, occasionally, death. This review is intended to provide an overview of the recent advances in the diagnosis and treatment of spider bites, as well as a compilation of the many species of spiders that have been reported to give clinically important bites. PMID- 3541798 TI - Therapeutic options in end-stage renal disease: a preliminary report. PMID- 3541797 TI - [Pyeloureteral cholesteatoma in the polycystic kidney. Report of a new case]. PMID- 3541796 TI - [Diagnostic methods in chronic prostatitis. True value of the biochemical patterns of semen, ultrasonics and the bacteriological workup]. PMID- 3541799 TI - Impact of religious beliefs on medical care. PMID- 3541800 TI - The optimal treatment of patients with bleeding esophageal varices. PMID- 3541801 TI - T-lymphocyte subsets in renal allograft recipients treated with cyclosporine and azathioprine. AB - Thirty-nine renal allograft recipients were prospectively studied to determine the quantitative effects of different immunosuppression protocols on T-cell subsets (total lymphocytes [T3], helper/inducer [T4] and suppressor/cytotoxic [T8]). Eighteen patients were initially immunosuppressed with only azathioprine and prednisone but required subsequent treatment for rejection by the addition of antithymocyte globulin (ATG) (Upjohn, Kalamazoo, MI) or conversion to cyclosporine. Three of these patients had ATG-resistant rejections and were treated with the monoclonal antibody ORTHO OKT3 (ORTHO Pharmaceuticals, Raritan, NJ). Twenty-one patients were treated only with cyclosporine and prednisone. Plasma levels of cyclosporine, as determined by high-performance liquid chromatography, were kept in the range of 50-100 ng/mL (mean: 78.1 +/- 52.1). One patient had a lymphoma, two patients had failed grafts, and three patients converted their cytomegalovirus titers. The results demonstrate that the immunosuppressive agents, azathioprine, prednisone, and cyclosporine, have an additive effect in depressing the T-lymphocytes and their subsets. In addition, ATG and cyclosporine had a more selective ablation of the T4 subset, resulting in a reversal of the T4/T8 ratios. This depression was independent of the plasma level of cyclosporine. Finally, the pan T-cell monoclonal antibody OKT3 led to severe depletion of all T-cell subsets but resulted in a normal T4/T8 ratio. In conclusion, immunosuppressive agents have a variable effect on T-lymphocytes and their subsets that cannot be adequately characterized by the T4/T8 ratio alone, but which should be quantitatively assessed by examining all subsets. PMID- 3541802 TI - Spontaneous free perforation and perforated abscess in 30 patients with Crohn's disease. AB - Spontaneous free perforation is an uncommon event in the natural history of Crohn's disease. It occurred in 21 of 1415 patients (1.5%) admitted with Crohn's disease to The Mount Sinai Hospital between 1960 and 1983. The mean duration from onset of Crohn's disease to occurrence of perforation was 3.3 years. Ten patients had small bowel perforation, ten patients had large bowel perforation, and one patient had simultaneous perforation of both ileum and cecum. The incidence of perforation in disease segments of small bowel was 1.0% (jejunum 6.0%, ileum 0.7%), and in the colon, 1.3%. Besides the 21 patients with spontaneous free perforation, an additional nine patients had spontaneous free rupture of an abscess into the peritoneal cavity. The mean duration from onset of Crohn's disease to rupture of abscess was 8.5 years. All 30 patients had surgery within 24 hours of perforation or rupture. All 21 patients with spontaneous free perforations survived, as did all but one of the nine patients with perforated abscess. The cornerstone of the treatment of ileocolonic lesions perforating into the general peritoneal cavity is proximal diversion with delayed reconstruction of intestinal continuity whenever possible. With perforation of the small bowel, primary reanastomosis is possible in selected patients. PMID- 3541803 TI - Single-dose chemoprophylaxis in elective colorectal surgery. A comparison between doxycycline plus metronidazole and doxycycline. AB - In a prospective, randomized double-blind study either 400 mg of doxycycline + 1500 mg of metronidazole (D + M) or 400 mg of doxycycline (D) alone were given intravenously as a single preoperative dose to patients admitted for elective colorectal surgery. A comparison of the rate of postoperative septic complications was made. After excluding drop-out patients, 261 patients remained for evaluation. In 135 patients with D + M treatment there were four postoperative septic complications (3.0%). In 126 patients with D treatment 20 septic complications related to the surgical procedure occurred (15.9%). The difference is highly significant (p less than 0.005). Most postoperative infections were superficial wound infections (14 of 24 patients), and the mean hospital stay in the two treatment groups was equal. Bacteriologic studies showed a highly significant reduction in anaerobes in cultures from perioperative intra abdominal fluid in the D + M treatment group. The study has thus showed that the addition of metronidazole, an efficient agent against anaerobic bacteria, to an antimicrobial agent against aerobic bacteria significantly reduces postoperative septic complications in elective colorectal surgery. PMID- 3541804 TI - Insulin and glucagon production in experimental cirrhosis. AB - The release of insulin and glucagon in cirrhotic rats was examined. Rats were made cirrhotic by a combination treatment of carbon tetrachloride (CCl4) and phenobarbitone. Liver cirrhosis was verified by histologic findings. Both basal and stimulated release of insulin from isolated pancreatic islets, in vitro, were decreased significantly in cirrhotic rats, as compared with control rats. Basal, but not stimulated, levels of glucagon, in vitro, were reduced significantly in cirrhotic rats. Circulating levels of plasma insulin, glucagon, glucose, bilirubin, and amylase levels were unaffected in cirrhotic rats when compared with control rats. There were no signs of pancreatitis. The results indicated that the release of insulin and glucagon is depressed in cirrhotic rats and in rats treated with phenobarbitone and CCl4. Clearance of circulating insulin and glucagon by the liver was apparently reduced, since circulating levels of insulin and glucagon were unaltered in all treated rats. PMID- 3541805 TI - Effects of combinations of quinoline-containing antimalarials on Plasmodium falciparum in culture. AB - Combinations of mefloquine, quinine, amodiaquine, chloroquine and 3 methylchloroquine were tested against chloroquine-resistant and -sensitive strains of Plasmodium falciparum in culture. All these drugs had purely additive interactions in both strains, except for mefloquine. Combinations of mefloquine with any of the other drugs always resulted in subadditive or inhibitory action. PMID- 3541806 TI - Inhibition of in vitro growth of Plasmodium falciparum by a brief exposure to the cationic rhodamine dyes. AB - The effects of eight permeant fluorescent dyes on the in vitro growth of Plasmodium falciparum was investigated. First, P. falciparum-infected human erythrocytes were synchronized with D-sorbitol and treated with the cationic fluorescent dye rhodamine 123 at 37 degrees C for 30 minutes, and the growth of the treated parasites monitored by examining daily parasitaemias. Rhodamine 123 inhibited the parasite growth at more than 5 microM, the 50% effective concentration being 6 microM. Ring forms and trophozoites were more susceptible to the dye than schizonts. The development of dye-treated ring forms and trophozoites to schizonts was greatly inhibited, and so few new ring forms were produced. In contrast, the dye-treated schizonts produced a large number of new ring forms, though to a slightly lesser extent than untreated schizonts. The rhodamine 123-induced growth inhibition was partially reversed by treating the dye-pre-exposed infected erythrocytes with the proton ionophore carbonyl-cyanide m-chlorophenylhydrazone, which dissipates transmembrane proton gradients. A survey of seven other fluorescent dyes demonstrated that the cationic dyes, including rhodamine 123, rhodamine 6G, rhodamine 6G perchlorate and rhodamine 3B perchlorate, exerted the growth inhibitory effect, whereas the neutral dyes rhodamine B, rhodamine 110, and rhodamine 19 perchlorate, and the anionic dye fluorescein, did not. Fluorescent microscopy revealed that P. falciparum accumulated the cationic dyes but not the neutral and anionic dyes. These results indicate that the cationic rhodamine dyes, which accumulated in the parasite, inhibit the growth of P. falciparum. PMID- 3541807 TI - A study of Legionnaire's disease in Zambia. AB - Legionnaire's disease has only rarely been reported in Africa. Following a case of pneumonia which was suggestive of Legionnaire's disease, a serological survey of people in the same community showed a titre of 1:256 or more in 10% of 73 sera examined by the indirect fluorescent antibody test using heat-inactivated antigen. However, on retesting using formolized yolk-sac antigen these results could not be substantiated. A further study of 105 patients with pneumonia failed to show a rising antibody titre using acute and convalescent serum. PMID- 3541808 TI - Differentiation of infective larvae of Brugia malayi and Wuchereria bancrofti by scanning electron microscopy. AB - A comparative scanning electron microscopy of the infective (third stage) larva of Wuchereria bancrofti and Brugia malayi revealed the following features: The lateral caudal papillae in both species are rounded and the terminal papilla is relatively pointed and smaller. The caudal papillae in W. bancrofti are more protruding while in B. malayi they are flattened. The lateral caudal papillae in B. malayi have an indentation around their bases which is absent in W. bancrofti. This is the most useful distinguishing feature and easily recognizable. The oral opening and the cephalic papillae in both the species are similar and not useful for differentiation. PMID- 3541809 TI - Density-dependent perception of triatomine bug bites. AB - Pots containing different densities of Rhodnius prolixus were strapped on to the upper and lower arms and legs of six human volunteers. Analysis of the volunteers' perception of the bugs' probing activity showed a clear linear trend of perception according to bug density. Comparison with other results suggests that in humans as well as other vertebrate hosts, density dependent irritation from the bug bites and consequent disturbance and interruption of bugs' feeding could provide the mechanism by which bug development and population density is normally regulated. PMID- 3541810 TI - The interaction of the naphthoquinone derivative menoctone and dihydrofolate reductase inhibitors on Plasmodium falciparum in vitro. PMID- 3541811 TI - An improved technique for the closure of ventricular septal defect in ventricular inversion. AB - An improved technique for the closure of ventricular septal defect associated with ventricular inversion through the anatomically left ventricle is described. The technique consists of placing a patch completely on the anatomically right ventricular side with modified horizontal mattress sutures all around the defect. This technique was applied successfully in 2 patients with no ensuing conduction disturbance. The details of the technique are reported. PMID- 3541812 TI - Pleural mesothelioma. AB - Pleural mesotheliomas are uncommon tumors. Correct diagnosis of the benign variant is rarely made preoperatively, and resection is the treatment of choice and is curative. Malignant pleural mesotheliomas are locally aggressive and difficult to treat. They may be seen clinically as localized pleural tumors or as diffuse pleural disease with effusion and encasement of the lung and obliteration of the pleural space. The localized forms of malignant mesotheliomas are fibrosarcomatous. Their diagnosis and treatment do not differ from those for soft part sarcomas seen elsewhere. Wide en-bloc excision is the treatment of choice and can be curative. The diffuse forms of malignant mesotheliomas are mainly epithelial. Treatment is generally unsatisfactory, and long-term survival is rare. Two surgical approaches are currently available: an extrapleural pneumonectomy and a pleurectomy with irradiation. The authors favor the latter approach because of its wider applicability, lower morbidity rate, and better survival advantage. Steps in selecting the best surgical mode of treatment are presented. PMID- 3541813 TI - Right ventricular function: a comparison between blood and crystalloid cardioplegia. AB - Blood cardioplegia resulted in better left ventricular (LV) function than crystalloid cardioplegia after elective coronary artery bypass operations. However, most methods of cardioplegic delivery may not adequately cool and protect the right ventricle, and right ventricular (RV) dysfunction may limit hemodynamic recovery. Therefore, RV and LV temperatures were measured intraoperatively and RV and LV function were evaluated postoperatively in 80 patients with double-vessel or triple-vessel coronary artery disease who were randomized to receive either blood cardioplegia or crystalloid cardioplegia. Myocardial performance, systolic function, and diastolic function were assessed with nuclear ventriculography by evaluating the response to volume loading. Preoperatively the groups were similar. Intraoperatively, blood cardioplegia resulted in significantly warmer LV and RV temperatures (left ventricle: 15.5 degrees +/- 0.2 degrees C with blood cardioplegia and 12.6 degrees +/- 0.3 degrees C with crystalloid cardioplegia [p less than .0001]; right ventricle: 18.3 degrees +/- 0.3 degrees C with blood cardioplegia and 15.1 degrees +/- 0.3 degrees C with crystalloid cardioplegia [p less than .0001]). Postoperatively, blood cardioplegia resulted in better LV performance (higher LV stroke work index at a similar LV end-diastolic volume index [EDVI]) (p = .01), better LV systolic function (similar systolic blood pressures at smaller LV end-systolic volume indexes [ESVI]), (p = .04), and improved LV diastolic function (lower left atrial pressures at similar LVEDVIs) (p = .03).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541814 TI - Extended esophageal myotomy and short total fundoplication hernia repair in diffuse esophageal spasm: five-year review in 34 patients. AB - Diffuse esophageal spasm (DES) is a rare disease, and its surgical management is controversial. There are seven major reported series totaling 148 patients and six operative variations depending on the extent of myotomy and whether or not a hernia repair should be added. There are no five-year follow-up reports. In the present study of 34 patients followed for at least five years, all had a myotomy from the apex of the chest through the high-pressure zone and all had a total fundoplication hernia repair, 16 with gastroplasty and 16 with a standard Nissen fundoplication. The length of the completion fundoplication is reduced to less than 0.5 cm to avoid problems of overcompetence. There were no operative deaths. Follow-up is 100% by clinical history, 82.4% by radiology, and 61.8% by manometry. Radiological follow-up showed no recurrence or reflux, although 1 patient had esophageal mucus retention. Thirty patients (88.2%) are eating normally without dysphagia or spontaneous pain. Two patients (5.9%) have mild dysphagia, and 1 of them also has mild spontaneous pain. One patient has major residual dysphagia, which is being treated conservatively, and 1 has required colon interposition. Good-quality results have been achieved in 94% of patients now followed 5 to 10.7 years. PMID- 3541815 TI - The renin-angiotensin system is not responsible for hypertension following coronary artery bypass grafting. AB - Systemic hypertension following coronary artery bypass graft (CABG) procedures has been reported to occur in 15% to 80% of cases. Previous reports have implicated the renin-angiotensin system as being responsible, at least in part, for this phenomenon. In this prospective study, 18 previously normotensive subjects were studied before, during, and after CABG. In 4 patients (22%), paroxysmal postoperative hypertension developed (systolic blood pressure greater than 150 mm Hg). There were no differences between the normotensive and hypertensive groups in plasma renin activity, angiotensin II level, or aldosterone level. Despite the trend toward elevation of these variables during cardiopulmonary bypass (CPB), all had returned to control levels within two hours after CPB, whether or not hypertension developed. Serum norepinephrine levels were elevated (.10 greater than p greater than .05) in the hypertensive group at the time hypertension developed. No other relationship or pattern could be defined to distinguish the hypertensive from the normotensive group. The renin angiotensin system does not appear to be responsible for paroxysmal hypertension following CABG. PMID- 3541816 TI - Acute and subacute CNS effects of milacemide in elderly people: double-blind, placebo-controlled quantitative EEG and psychometric investigations. AB - In a double-blind, placebo-controlled study the encephalotropic and psychotropic properties of acutely and chronically administered milacemide--a new derivative of glycine showing anti-convulsant action by increasing GABA concentrations and endogenous glycine pools in the brain--were investigated in 12 elderly subjects in their late sixties. Each subject had a treatment period of 2 weeks (with 400 mg b.i.d. and 1,200 mg b.i.d. orally administered in week 1 and 2, respectively) and another period of 2 weeks with placebo. A treatment-free interval of 1 week was introduced in between. EEG-recordings, psychometric and psychophysiological tests as well as evaluation of pulse, blood pressure and side effects were carried out at the hours 0, 2, 4, 6 and 8 after the administration of one single dose of 400 mg or placebo (acute effect), after 1 week's and 2 weeks' chronic administration (chronic effect), as well as after one additional superimposed dosage of 400 mg and 1,200 mg on days 8 and 15 of chronic treatment, respectively (super-imposed effect). Computer-assisted spectral analysis of the EEG demonstrated after single doses of 400 mg milacemide significant changes in the resting EEG indicative of improvement in vigilance (beta augmentation, acceleration of the beta centroid), while in the vigilance-controlled recording condition a dissociative vigilance shift occurred seen also after antidepressants of the amitriptyline and imipramine type (increase of both delta/theta and beta activity, decrease of alpha activity). One week chronic treatment resulted in the same V- and R-EEG profiles. However, after the 2nd weeks' treatment with higher doses as well as after one additional superimposed dosage of 1,200 mg milacemide both V- and R-EEG recordings demonstrated dissociative vigilance shifts. Time/treatment-efficacy calculations showed the chronic effect to be more pronounced than the acute effect, which peaked in the 2nd hour after oral drug administration. Psychometric analyses exhibited in noopsychic variables a significant improvement in intellectual and mnestic performance but even more so in the thymopsyche an improvement in subjective well-being and affectivity. Psychophysiological tests showed a decrease in CFF, while static and dynamic pupillometry and skin conductance measures remained unchanged. Pulse rate, systolic and diastolic blood pressure were not altered. The findings are discussed in the light of the involvement of GABA in the pathogenesis and treatment of affective disorders. PMID- 3541817 TI - [Status of malarial endemic in Nosy-Be in February, 1984]. PMID- 3541818 TI - [Drug sensitivity of malaria in Madagascar. Comparison in vivo and in vitro of the effects of chloroquine and amodiaquine on P. falciparum in 1984]. PMID- 3541819 TI - Double-blind comparison of amantadine and bromocriptine for ambulatory withdrawal from cocaine dependence. AB - Amantadine hydrochloride and bromocriptine mesylate were compared on a double blind basis for withdrawal from cocaine dependence. Both amantadine and bromocriptine appear effective in alleviating the symptoms of cocaine withdrawal. In doses higher than previously reported, however, bromocriptine caused enough side effects to produce treatment dropouts; neither drug produced euphoria. Amantadine appears to primarily exert its therapeutic influence by releasing dopamine and norepinephrine from neuronal storage sites that are depleted by chronic cocaine dependence, and bromocriptine acts as a dopamine agonist and stimulates dopamine receptors. PMID- 3541820 TI - Diet and lung cancer. A review of the epidemiologic evidence in humans. AB - We reviewed the human epidemiologic studies of the possible protective effect against lung cancer of various dietary constituents, including preformed vitamin A, carotene, vitamin E, selenium, and vitamin C. Beta carotene has strong potential as a protective agent, though constituents of green and yellow vegetables other than carotene may account for the reduced cancer incidence observed in many studies. Selenium also deserves attention as a potential chemopreventive nutrient, though data are limited. Data on vitamin E are sparse and inconclusive, and there is little evidence that vitamin C provides protection against human lung cancer. It is likely that cessation of cigarette smoking would have a far greater influence on reducing lung cancer incidence than any known dietary modification. PMID- 3541821 TI - Biology of aging. Current state of knowledge. AB - The nature of the primary aging processes has yet to be defined. Mortality and aspects of longevity (eg, life expectancy) do not provide significant information about aging. The maximum life span potential of a species does provide information about the comparative rate of aging between species, however, and also is a good marker for evaluating interventions aimed at modulating the rate of aging in a particular species. Physiological deterioration occurs with age, but it is not known how much is due to aging per se and how much is secondary to age-related disease and life-style. There are similar reservations about the changes in body composition that have been noted with increasing age. Many diseases are age related in terms of prevalence, but how these diseases relate to the primary aging processes remains to be defined. Finally, many claims have been made concerning interventions that will retard the aging processes; of these, only food restriction in rodents has been unequivocally shown to retard the aging processes of a mammalian species. PMID- 3541822 TI - Comparison of sublingual captopril and nifedipine in hypertensive crises. PMID- 3541823 TI - Beta-blockers and mortality after myocardial infarction. PMID- 3541825 TI - Inoculation of blood culture bottles with ascitic fluid. Improved detection of spontaneous bacterial peritonitis. AB - The observation that only 42% of the cases of suspected spontaneous bacterial peritonitis at the University of New Mexico, Albuquerque, had positive cultures prompted a change in ascitic fluid culture technique such that a large volume (10 mL in toto) of ascitic fluid was inoculated into blood culture bottles at the bedside. This new method of culture increased the percentage of cases with positive cultures to 91% and decreased the interval between inoculation of the culture and detection of bacterial growth. This is a more sensitive method of culture than the conventional method in detecting spontaneous bacterial peritonitis. PMID- 3541824 TI - Lipid-soluble and water-soluble beta-blockers. Comparison of the central nervous system depressant effect. AB - The sedative effects of a relatively lipid-soluble and a water-soluble beta blocker were compared in 20 male hypertensives, 30 to 60 years old. In a blinded, randomized, crossover study, critical flash fusion frequency and computerized Stroop Word Test were used to assess psychomotor function parameters during a drug-free control day and then following 14 days of either metoprolol, 150 mg daily, or atenolol, 100 mg daily, treatment. Both drugs caused subtle but significant reductions in both parameters of sedation (critical flash fusion frequency and computerized Stroop Word Testing). Sedation was significantly related to serum concentrations of both drugs. The maximum drug-induced change was 17.2% +/- 9% for metoprolol and 19.6% +/- 3% for atenolol. The duration of effect was six hours after atenolol and two hours after metoprolol. Blood pressure control for all patients was similar during both treatment phases. These results demonstrate that relative lipid solubility does not reliably predict the neurologic effects of beta-blockers. The intensity of drug-induced sedation was similar, but the water-soluble agent produced a longer duration of sedative activity. PMID- 3541826 TI - [Prevention of vasospasm following subarachnoid hemorrhage using a thromboxane A2 synthetase inhibitor (OKY-046)--clinical study among multiple institutions]. PMID- 3541827 TI - Ethylene formation by cell-free extracts of Escherichia coli. AB - The pathway leading to the formation of ethylene as a secondary metabolite from methionine by Escherichia coli strain B SPAO has been investigated. Methionine was converted to 2-oxo-4-methylthiobutyric acid (KMBA) by a soluble transaminase enzyme. 2-Hydroxy-4-methylthiobutyric acid (HMBA) was also a product, but is probably not an intermediate in the ethylene-forming pathway. KMBA was converted to ethylene, methanethiol and probably carbon dioxide by a soluble enzyme system requiring the presence of NAD(P)H, Fe3+ chelated to EDTA, and oxygen. In the absence of added NAD(P)H, ethylene formation by cell-free extracts from KMBA was stimulated by glucose. The transaminase enzyme may allow the amino group to be salvaged from methionine as a source of nitrogen for growth. As in the plant system, ethylene produced by E. coli was derived from the C-3 and C-4 atoms of methionine, but the pathway of formation was different. It seems possible that ethylene production by bacteria might generally occur via the route seen in E. coli. PMID- 3541828 TI - [Mucoviscidosis: 30 years of incomplete progress. Homage to Andre Hennequet]. PMID- 3541829 TI - [End-stage renal insufficiency in children less than 4 months old. Survey of the French Pediatric Nephrology Club]. AB - One hundred and eleven cases of children with end-stage renal failure prior to 4 years of age were collected from a survey of the French Pediatric Nephrology Club. Clinical and epidemiological data stress the importance of certain etiologies such as 40 cases of renal hypoplasia. The necessity of planning extracorporeal dialysis from the first year of life in 37% of patients demonstrates the importance of difficulties to be overcome. The treatments used for the 82 treated children show the interest of conservative management. However, peritoneal dialysis remains the first treatment of choice (52 times). Besides the problems of hemodialysis vascular approach, related to the small caliber of vessels, the complications of the clearance techniques did not appear to be more frequent than in older children. Use of transplantation is not negligible as 25% of transplanted patients were under 4 years of age; however none was under one year or weighted less than 8 kg. Transplantation remains ultimate treatment, even more so as the actuarial survival at 5 years is clearly worse for children submitted to hemodialysis (68%) than to transplantation (91%) (p less than 0.05). PMID- 3541831 TI - [Philosophical conditions of the relation between medicine and natural magic and astrology in the 15th and 16th centuries]. PMID- 3541830 TI - Imipramine in prepubertal major depressive disorders. AB - The potential effectiveness of imipramine hydrochloride (up to 5 mg/kg/d) was investigated in 53 prepubertal children suffering from major depressive disorder. Two complementary strategies were used simultaneously: a five-week, double-blind, placebo-controlled design (N = 38), and a plasma level/clinical response study (N = 30). Fifteen of the 16 children randomly assigned to active drug in the first study also participated in the second. Subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children and diagnosed according to unmodified Research Diagnostic Criteria. Response rates in the double-blind study were similar in both groups (imipramine, 56%; placebo, 68%). In the plasma level study, total maintenance plasma level (imipramine plus desipramine) was found to positively and linearly predict clinical response of the depressive syndrome (P less than .003). No evidence of a curvilinear relationship was found. Depressive hallucinations during the episode negatively predicted clinical response (P less than .05). Weight-corrected imipramine dosage did not predict either clinical response or plasma level in the individual subject. No predictors of response were found in the placebo group. These results suggest that the mean imipramine dosage was too low, and that future double blind, placebo-controlled studies of imipramine in prepubertal major depression should include plasma level titration to above 150 ng/mL and an initial placebo washout period. PMID- 3541832 TI - [Selected aphorisms of Prof. Ludwik Hirszfeld]. PMID- 3541833 TI - [Polish physicians--graduates of the University of Vienna. IV. Letters N-R]. PMID- 3541834 TI - [The history of the Polfa pharmaceutical plants in Pabianice. II. Chemical plants in Pabianice as investment companies 1899-1918]. PMID- 3541835 TI - [Jozef Frank and Jedrzej Sniadecki versus the doctrine of John Brown]. PMID- 3541836 TI - [Dr. Michal Nowacki (1798-1865), the first physician of Lazienki Bankowe and the Summer Hospital in Ciechocinek and St. Anthony's County Hospital in Wloclawek]. PMID- 3541838 TI - [The history of surgery in Jaroslaw]. PMID- 3541837 TI - [Prof. Johann Wilhelm Heinrich Schlecht (1881-1953)]. PMID- 3541839 TI - [The independent teaching of ophthalmology at Prussian universities]. PMID- 3541840 TI - [Medical teaching at the patient's bedside before and after the German language publications of the Polish neurologist Goldflam]. PMID- 3541841 TI - [The collection of moulages at the Wroclaw Dermatologic Clinic as a document and a learning aid]. PMID- 3541842 TI - Immunocytochemical studies on the pancreatic islets of the ratfish Chimaera monstrosa. AB - The islet cells and nerves in the pancreas of the ratfish Chimaera monstrosa were examined immunocytochemically by using antisera against mammalian brain-gut peptides. Five types of islet cells were recognized. The B and D cells reacted to anti-insulin and anti-somatostatin sera, respectively. The A and X cells exhibited glucagon-like immunoreactivities. The N-terminal anti-glucagon serum reacted both to the A and the X cells, while the C-terminal anti-glucagon serum bound specifically to the X cells. These results suggested that the X cells contained pancreatic-type glucagon, whereas the A cells, an enteroglucagon (glicentin)-like substance. A fifth type of endocrine cell was scattered in the islets and contained serotonin-like immunoreactivity. Two kinds of peptide nerves were identified. Vasoactive intestinal polypeptide (VIP)-immunoreactive neuronal somata were located in the intrapancreatic ganglia. Nerve fibers and terminals containing VIP-like immunoreactivities occurred in the pericapillary space surrounding the islets. Gastrin releasing peptide (GRP)-immunoreactive nerve somata and fibers were scattered along the margins of the islets. The pericapillary arrangement of these nerve terminals suggests a hemocrine release of the peptides. PMID- 3541843 TI - Lipopolysaccharides of flagellated and non-flagellated Proteus vulgaris strains. AB - Lipopolysaccharides from two strains of Proteus vulgaris were analyzed. One strain (08) was motile, giving swarming growth on solid media and the other (04)- non-flagellated, not able to swarm. Both lipopolysaccharides appeared to be heterogeneous and were separated into two fractions each. Yield, chemical composition and SDS-polyacrylamide gel electrophoresis showed differences between fractions in percentage content of 0-specific and R-core polysaccharides. Relation between ability to swarming growth of Proteus strains and heterogeneity of their lipopolysaccharides is also discussed. PMID- 3541844 TI - Scientific medicine and Systeme International units. AB - The Systeme International, a modern version of the metric system, is being introduced into American medicine. The most compelling reason for this is that a worldwide standardization of weights and measures is taking place, and American medicine should take part in this process. A subsidiary advantage is that units of measurement used in clinical laboratories throughout the United States will be standardized as well. It is possible that expressing concentrations in moles per liter rather than as weight per volume will reveal clinically useful chemical relationships, but this remains unproved. Transition to Systeme International units will require use of different reference ranges, and there will be a potential for serious misinterpretation of laboratory data unless well-planned educational programs are instituted before the change. PMID- 3541846 TI - Group B streptococcal breast abscess. AB - A 22-year-old women was admitted to the hospital with a large, tender supraareolar mass of her right breast. Cultures of the purulent aspirate yielded beta-hemolytic group B streptococcus. Surgical incision and drainage, together with therapy with erythromycin ethylsuccinate in this penicillin-allergic patient, resulted in cure. This is the first report, to our knowledge, of group B streptococcus causing human breast abscess. PMID- 3541845 TI - Advantage of Fontana-Masson stain in capsule-deficient cryptococcal infection. AB - We describe light and electron microscopic findings in three cases of pulmonary infection caused by capsule-deficient Cryptococcus neoformans (CDCN) and emphasize the value of the Fontana-Masson silver (FMS) stain in diagnosing cryptococcosis. Capsule-deficient C neoformans infections, including coccidioidomycosis, histoplasmosis, typical cryptococcosis, blastomycosis, candidiasis, and pneumocystosis were used as controls. Several stains including mucicarmine, alcian blue, and FMS were done on tissue sections from all of the above mentioned infections. It was found that while the FMS stain was positive only in the organisms of CDCN and typical C neoformans, the mucicarmine was positive only in typical C neoformans. The negativity of the mucicarmine in the organisms of CDCN reflected the absence of capsular material as demonstrated by ultrastructural study. Therefore, when fungal cultures are not available or are negative, and tissue mucicarmine is negative, the FMS stain is a valuable alternative for use on tissue sections. It may be used, along with routine fungal stains, when a yeast-forming fungal infection is suspected. PMID- 3541847 TI - The development of tests of thyroid function. PMID- 3541848 TI - Occurrence of exoerythrocytic schizonts in the liver, adrenal glands and endocardium of mice infected with erythrocytic stages of Plasmodium berghei. PMID- 3541849 TI - Macrophages and translymphatic absorption represent the first line of host defense of the peritoneal cavity. AB - To quantitate the host defenses of the rat peritoneal cavity, nonviable radiolabeled Escherichia coli were injected intraperitoneally and clearance, leukocyte influx, and phagocytosis were examined. Macrophages (MCs) were present initially and remained relatively constant in number. The polymorphonuclear leukocyte (PMN) response began at one to two hours and was maximal at 24 to 72 hours. A previously unidentified inoculum-dependent PMN response was defined. Clearance and phagocytosis were extremely rapid, and few (less than 3%) free bacteria were present after two hours. Phagocytic activity of MCs and PMNs was identical, but MCs were numerically predominant initially and thus accounted for the majority of early phagocytosis. Thus, MC phagocytosis and clearance represent the primary line of host peritoneal defenses. We hypothesize that the subsequent inoculum-dependent PMN response may have evolved to cope with those larger inocula for which this initial response is inadequate. PMID- 3541850 TI - Abdominal midline incision closure. PMID- 3541851 TI - Complement-mediated neutrophil activation in sepsis- and trauma-related adult respiratory distress syndrome. Clarification with radioaerosol lung scans. AB - Complement-mediated neutrophil activation (CMNA) has been proposed as an important pathogenic mechanism causing acute microvascular lung injury in the adult respiratory distress syndrome (ARDS). To clarify the relationship between CMNA and evolving lung injury, we studied 26 patients with multiple trauma and sepsis within 24 hours of risk establishment for ARDS. Pulmonary alveolar capillary permeability (PACP) was quantified as the clearance rate of a particulate radioaerosol. Seventeen patients (65%) had increased PACP (six developed ARDS) while nine (35%) had normal PACP (none developed ARDS; clearance rates of 3.4%/min and 1.5%/min, respectively). These patients, regardless of evidence of early lung injury, had elevated plasma C3adesArg levels and neutrophil chemotactic desensitization to C5a/C5adesArg. Plasma C3adesArg levels correlated weakly, but significantly, with PACP. Thus, CMNA may be a necessary, but not a sufficient, pathogenic mechanism in the evolution of ARDS. PMID- 3541852 TI - Microbiologic prediction of abdominal surgical wound infection. AB - We compared two methods of estimating parietal bacterial contamination during abdominal operations. Duplicate swabs were taken from the subcutaneous tissues at the end of 817 operations; one was transported to the Department of Microbiology in Stuart's thioglycollate medium and the other immediately incubated in Robertson's cooked meat broth in the operating room suite and subsequently subcultured. The broth cultures revealed significantly more isolations of potentially pathogenic bacteria and more accurately predicted the likelihood of wound infection. In particular, when visceral cultures were positive, broth culture of wound swabs predicted a major wound infection rate of 0% when sterile, 4.8% when a single pathogenic species was cultured, and 10.1% when two or more were cultured. The corresponding figures for thioglycollate-transported swabs were 1.0%, 10.5%, and 12.9%. We conclude that broth cultures of parietal swabs allow accurate identification of patients at risk of infection from bacterial contamination of the wound during operation. PMID- 3541853 TI - Surface biofilm disruption. Enhanced recovery of microorganisms from vascular prostheses. AB - Ultrasonic oscillation (sonication) of explanted vascular prosthetic graft material can disrupt surface biofilms and increase the recovery of adherent microorganisms. Recovery of microorganisms from vascular grafts was studied in a canine model of Staphylococcus epidermidis graft contamination (N = 26) and on graft material excised from patients undergoing femoral anastomotic pseudoaneurysm repair (N = 7). Surface biofilm disruption by sonication significantly increased the incidence of positive cultures of excised graft material compared with broth (P less than .010) and blood agar plate (P less than .005) culture techniques. The S epidermidis was recovered from 31% of the canine vascular grafts and 100% of the clinical specimens. The in vitro production of a glycocalyx "slime" was demonstrated in 73% of the recovered staphylococcal strains. The formation of an adherent bacteria biofilm on implanted vascular prostheses is not an uncommon occurrence and is an important factor in the pathogenesis of anastomotic pseudoaneurysm formation and late graft infection. PMID- 3541855 TI - Skeletal microcirculatory responses to hyperdynamic Escherichia coli sepsis in unanesthetized rats. AB - To determine the microvascular site of vasodilation during hyperdynamic sepsis, we measured arteriolar and venular responses to live Escherichia coli bacteremia in the rat cremaster muscle by direct in vivo videomicroscopy. Our data indicate that cardiac output (by thermodilution) increased, systemic vascular resistance decreased, and a differential arteriolar response occurred, with constriction of large arterioles and dilation of small terminal arterioles. We conclude that dilation of small terminal arterioles in skeletal muscle could contribute to decreased systemic vascular resistance during hyperdynamic sepsis. This may be an appropriate response to increased oxygen demand or decreased tissue utilization of oxygen. Alternatively, small-arteriole dilation may be an inappropriate response and secondary to release of vasoactive inflammatory mediators. If the latter is true, there is a potential therapeutic role for selective manipulation of the tone of small terminal arterioles in hyperdynamic sepsis. PMID- 3541854 TI - Role of the macrophage in the translocation of intestinal bacteria. AB - To clarify the role of the macrophage in the translocation of intestinal bacteria, groups (n = 10) of Swiss Webster mice (Immunocompetent) and C3H/HeJ mice (macrophage defective) were given bacitracin/streptomycin in their drinking water to eliminate the majority of the intestinal microflora. These mice were then "monoassociated" with a streptomycin-resistant strain of Escherichia coli. Forty-eight hours later, E coli was present in all animals at a concentration of 10(11)/g of cecum. In four separate experiments, E coli was recovered from 100% of the mesenteric lymph nodes (MLNs) of the immunocompetent Swiss Webster mice and from 10%, 40%, 30%, and 50% of the MLNs of macrophage-defective C3H/HeJ mice. Swiss Webster mice were then similarly monoassociated by antibiotic decontamination followed by administration of antibiotic-resistant, fluorescein labeled E coli in their drinking water; cohort groups of mice were given fluorescein-labeled latex beads (1 micron in diameter) in their drinking water. Two, four, and 11 days later, the MLNs were removed and single cell suspensions were analyzed in the fluorescence-activated cell sorter. The fluorescein label was detected exclusively in the macrophage (esterase-positive) population. These results support the hypothesis that intestinal macrophages may play a key role in the transport of intestinal particles (including bacteria) into extraintestinal sites. PMID- 3541856 TI - The proposed family Toroviridae: agents of enteric infections. Brief review. PMID- 3541857 TI - [Arachidonic acid cascade--with special reference to SRS-A]. PMID- 3541858 TI - Binding of islet cell cytoplasmic antibody from insulin-dependent diabetes mellitus patients and plant lectin (Maclura pomifera agglutinin) to pancreas islet cells. PMID- 3541859 TI - [The problem of the functional morphology of the cerebrospinal fluid circulatory system and its development in the works of M. A. Baron and his disciples]. PMID- 3541860 TI - [Nikolai Fedotovich Mel'nikov-Razvedenkov (on the 120th anniversary of his birth: little known details of well-known facts)]. PMID- 3541861 TI - [The use of corticosteroids in Guillain-Barre syndrome: study of 51 cases]. AB - This is a retrospective analysis of 51 patients admitted to the Hospital de Base do Distrito Federal (Brasilia, Brazil), with the Guillain-Barre syndrome, from 1974 to 1984. Eighteen patients were treated with corticosteroids (prednisone or dexamethasone), whereas 33 did not receive such treatment. The clinical course (degree of recovery, sequelae, complications, causa mortis) and the length of the hospital stay were compared in these two groups. It is concluded that the use of corticosteroids did not have a major effect on the clinical course of the illness. Moreover, the only two cases of relapses occurred in patients that had been treated with corticosteroids. PMID- 3541862 TI - [Tethered spinal cord syndrome: report of 2 cases]. AB - The tethered spinal cord syndrome is a disease that is part of the group of spinal dysraphisms, that was recently recognized as an individualized nosological entity, yet not frequently diagnosed among us. It is characterized by shortening and thickening of the filum terminale which prevents the ascent of the spinal cord into spinal canal, the conus medularis abnormally remaining in a low place. It is associated in all cases with spina bifida. The diagnosis is simple, once the disease is suspected. It is manifested by progressive motor or sensory deficit in the legs, urinary incontinence, scoliosis and leg or back pain, specially in young children. The plain lumbosacral RX always shows spina bifida. Myelography makes the diagnostic. It shows, basically, the negative image of the thickened filum terminale and the low placed conus medularis. Other exams which can help are the computerized tomography and the ultra-sound of the spinal cord. The surgical treatment is very simple and heals without sequels if done in due time. It consists in a sectioning of the filum terminale through laminectomy. Two cases diagnosed and treated at Hospital da Baleia, from Fundacao Benjamin Guimaracs, Belo Horizonte, are reported in this paper. PMID- 3541863 TI - The ninth Hastings lecture. Spectrum. PMID- 3541864 TI - Effect of leupeptin, a protease inhibitor, on dopa decarboxylase and protease activities in homogenates of submandibular salivary glands from young rats. AB - Dopa-decarboxylase activity was high at 2-3 weeks of age, low at 5-6 weeks, and very low in adult rats; protease activity increased with age. Trypsin-like proteases, which decrease dopa-decarboxylase activity, were detected in the gland and were inhibited by a protease inhibitor, leupeptin. High concentrations (20 mg/ml) of leupeptin increased dopa-decarboxylase activity in the glands of adult rats to the level found at 5-6 weeks of age. The low activity of dopa decarboxylase in adult gland may be due in part to endogenous proteases. PMID- 3541865 TI - Effect of a protease derived from the oral bacterium Bacteroides loescheii on the inhibition of calcium-phosphate precipitation by human parotid saliva. AB - A protease from the culture fluid of this microorganism was purified and characterized using DEAE-Sephadex and chromatofocusing and classified as a thiol protease with a mol. wt estimated as 27,500. It abolished the inhibitory activity of parotid saliva on the precipitation of calcium phosphate from supersaturated solutions. Such proteases may contribute to dental calculus formation. PMID- 3541866 TI - Effect on experimental palatal candidosis in the Wistar rat of removal and re insertion of acrylic appliances. AB - Palatal candidosis was produced by inoculating Candida albicans 3091 (serotype A) under an acrylic appliance. Two weeks was allowed for infection to occur. Removal of the appliance for a further period of 2 weeks resulted in complete resolution of the lesion histologically but Candida organisms could still be recovered from the mucosal surface. Re-fitting these appliances at the end of this recovery period, without subsequent inoculation, produced a recrudescence of palatal candidosis after a further 2 weeks. One possible explanation is that C. albicans was encouraged to change from the commensal to the pathogenic form in the presence of the palatal appliance. PMID- 3541868 TI - Complications of semiflexible, closed-loop anterior chamber intraocular lenses. AB - Anterior chamber intraocular lenses (IOLs) provided good visual rehabilitation of aphakia in a majority of patients. An increasing number of eyes with closed-loop, semiflexible anterior chamber implants are now being seen with decreased vision due to corneal edema and persistent cystoid macular edema. We evaluated 53 such eyes in 52 patients who presented with decreased vision one to 51 months (average, 15 months) after lens implantation. The most frequent lens implanted was the Surgidev Style 10 Leiske IOL. Surgery for IOL removal or exchange with or without penetrating keratoplasty was performed in 34 (64%) of 53 eyes; visual acuity recovery ranged from 20/20 to hand motions (average, 20/80). Despite clear corneal grafts in 24 (92%) of the 26 eyes that underwent corneal transplantation, visual acuity of 20/40 or better was obtained in only nine eyes (26%). Based on the intractable inflammatory sequelae associated with anterior chamber closed loop IOLs, we strongly urge discontinuation of their use. PMID- 3541867 TI - Refractive keratoplasty in monkeys using intracorneal lenses of various refractive indexes. AB - The refractive power of the cornea can be altered with an intracorneal lens when it is inserted within a freehand lamellar-pocket incision. The effectiveness of the implant in altering the refractive power of the cornea depends on the refractive index of the intracorneal lens, since little change in the anterior corneal curvature occurs. Thirteen nonhuman primate eyes received intracorneal lenses made of synthetic polymers with refractive indexes ranging from 1.3686 to 1.633. The lidofilcon-B hydrogel (refractive index, 1.3686) lenses created no significant alteration in the refractive power of the cornea. The polymethylmethacrylate (refractive index, 1.4900D) and polysulfone (refractive index, 1.633) lenses created a predictable and significant alteration of corneal power that increased with each implant with a successively higher refractive index. The polymethylmethacrylate lens created a refractive alteration that was approximately 31% of the lens power in air. The polysulfone lens created a corneal power alteration that was approximately 40% of the lens power in air. PMID- 3541869 TI - Penetrating keratoplasty for pseudophakic corneal edema with exchange of intraocular lenses. AB - We studied one eye in each of 25 consecutive patients with pseudophakic corneal edema. Each patient underwent a penetrating keratoplasty with exchange of intraocular lenses and was followed up for 12 to 38 months (mean, 18.7 months). The corneal graft remained clear in 22 (88%) eyes, but only eight eyes (32%) had acuity of 20/40 or better; nine eyes (36%) manifested cystoid macular edema, and six eyes (24%) had degenerative maculopathy. Elevated intraocular pressure was present in 12 eyes after surgery, with three eyes manifesting visual field loss; in all eyes the condition was controlled medically. Peripheral anterior synechiae appeared postoperatively in two eyes. We now treat severe cases of pseudophakic corneal edema with a penetrating keratoplasty, meticulous anterior vitrectomy, gonioplasty, iridoplasty, and exchange of intraocular lenses, employing a flexible-loop anterior chamber lens or a posterior chamber lens sutured to the iris. PMID- 3541871 TI - Is it really a urinary tract infection? PMID- 3541870 TI - Why do some epikeratoplasties fail? AB - We performed a morphologic analysis of nine epikeratoplasty lenticules that were removed due to nonhealing epithelial defects, interface opacity, and/or haze of the donor lenticule. Structural abnormalities were found in all layers of the donor lenticules, with the major changes being present in the surface epithelium and Bowman's layer. Significant changes in the stromal collagen were documented. Similar changes were found in a previous analysis of never-used, factory-prepared lenticules that had been prepared following the use of a corneal press and a lyophilization process. This study suggests that the presently used process of tissue preparation may be deleterious to the structure of the donor lenticule and may adversely affect surface reepithelialization. The placement of the lenticule above the recipient's Bowman layer may be an additional retardant to postoperative reepithelialization. PMID- 3541873 TI - Inverted mattress suture for perineal skin. PMID- 3541872 TI - Cardiac transplantation in Australia. PMID- 3541874 TI - A brief history of acupuncture. PMID- 3541875 TI - The impact of leukemia status at the time of HLA-identical sibling marrow transplantation on subsequent complication rate and survival of adults with acute leukemia. AB - Between March 1981 and March 1985, 76 patients with acute leukemia were treated with cyclophosphamide (120 mg/kg), 12 or 14 Gy total body irradiation, and an HLA identical sibling marrow transplant. Forty-seven patients had acute non lymphoblastic leukemia (ANLL) and 29 had acute lymphoblastic leukemia (ALL). Forty-one were transplanted during first remission and 28 during or after first relapse of their disease. An additional six patients were transplanted because their leukemia was refractory to conventional cytotoxic chemotherapy, and one was transplanted as initial therapy. Actuarial 42 month survival for those transplanted during first remission was 47% and for those transplanted in first relapse or later it was 22% (p = 0.02). There was no difference in either group between those with ANLL and those with ALL. Two of the six patients with refractory leukemia are alive more than 22 and more than 15 months after the transplant. The incidence of acute graft-versus-host disease and interstitial pneumonitis was 90% and 39%, respectively, for the first remission group, and 96% and 37% for those transplanted in first relapse or later. There was no significant difference in transplant-related mortality between the two groups (29% and 43%, respectively). The leukemia recurrence rate, however, was 13% for those transplanted in first remission and 67% for those transplanted in first relapse or later (p = 0.0003). Thus, the major factor determining the incidence of leukemia recurrence and survival after transplant was the status of the leukemia at the time of transplantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3541876 TI - Aplastic anemia: analysis of two methods of treatment. AB - Between 1981 and 1985, 27 patients with aplastic anemia have been treated by immunosuppression with antilymphocyte globulin and prednisolone or allogeneic bone marrow transplantation. Fifteen have undergone bone marrow transplantation and have an actuarial survival at 54 months of 65% +/- 12% (95% confidence limits). There have been four deaths from graft rejection, septicemia (two), and graft-versus-host disease. Twelve have received antilymphocyte globulin and have an actuarial survival at 56 months of 67% +/- 21%. Five of these now have a normal blood count and two have had good partial responses and are self supporting. Of the five non-responders, three survived, two with persistent aplasia and one after allogeneic bone marrow transplantation. Two are dead, one of hemorrhage and one after mismatched bone marrow transplantation. In this study antilymphocyte globulin produced survival equivalent to bone marrow transplantation although only 58% of patients had a response to the antilymphocyte globulin. The advantages and disadvantages of these two methods of treatment are discussed. PMID- 3541877 TI - Serum cholesterol and coronary heart disease: implications of recent intervention studies. PMID- 3541879 TI - Surgery of pelviureteric obstruction in 101 children over one year of age. AB - One hundred and one children over 1 year of age have had surgery for pelviureteric obstruction over an 11 year period. The common clinical features were abdominal pain, urinary infection or haematuria, but a number presented as an incidental finding. Less commonly, the patients presented with an abdominal mass or with hypertension. The diagnosis was usually made on intravenous pyelography (IVP) but in the latter part of the series, renal nuclide scan (RNS) and ultrasonography (US) were preferred. Ninety-three patients had a unilateral pyeloplasty, three had bilateral pyeloplasty and five had nephrectomy or heminephrectomy. Whereas initially nephrostomy drainage was used in the majority of patients after pyeloplasty, a trend away from nephrostomy evolved in the latter part of the series. With experience, the incidence of postoperative complications was also reduced and there was a reduction in the period of hospitalization. Clinical results were consistently satisfactory. Postoperative assessment after pyeloplasty was made by IVP and/or RNS and also US. A review of these investigations showed that RNS provided more factual information of the result when compared with the IVP. PMID- 3541878 TI - Interactions between non-steroidal anti-inflammatory drugs and antihypertensives and diuretics. AB - Non-steroidal anti-inflammatory drugs (NSAIDs) may increase blood pressure and antagonise the effects of antihypertensive agents. They can cause salt and water retention and an increase in extracellular volume. NSAIDs also cause a decrease in prostaglandin synthesis in blood vessel walls which removes a direct vasodilatory influence and also increases the vascular response to vasoconstrictor stimuli. The hypotensive effects of frusemide and captopril are due in part to their stimulation of prostaglandin synthesis. Hence the antagonism of the hypotensive effect of these agents is probably due to NSAID-induced inhibition of prostaglandin synthesis. However, the interactions of NSAIDs with the other antihypertensive agents may not be related to inhibition of antihypertensive-induced release of prostaglandin but to independent and opposing actions of the NSAIDs on the various physiological mechanisms which regulate blood pressure. Clinicians should remain alert to these potential drug interactions. PMID- 3541880 TI - Aspiration drainage of splenic abscesses. AB - The successful use of guided percutaneous needle aspiration in the management of four patients with solitary splenic abscess is described. Two patients had needle aspiration alone and two patients, with large splenic abscesses, had drainage tubes inserted. The procedures were well tolerated and allowed rapid microbiological diagnosis with selection of appropriate antibiotic therapy. The techniques were useful in patients felt to be poor anaesthetic risks, and the complications of splenectomy were avoided. PMID- 3541881 TI - Reconstruction of the mandible with autogenous bone following treatment for squamous carcinoma. AB - In a series of 24 patients treated for squamous carcinoma of the oral cavity and oropharynx, 26 mandibular reconstructions using 27 grafts or flaps were performed. Reconstruction was immediate in 23 cases and delayed in three. There were five 'simple' bone grafts, 10 pedicled compound myocutaneous flaps, and 12 vascularized free compound flaps. Operative mortality was 12% and complication rate 65%, but 70% of the grafts survived till death or follow-up of the patients. Three 'simple' bone grafts failed and were removed. Three of five compound pectoralis major flaps failed along with one of five pedicled compound latissimus dorsi flaps. Only one vascularized free compound flap was lost. The major cause of graft failure was intra-oral suture line dehiscence exposing the bone to saliva. Under these circumstances, bone graft necrosis occurred when blood supply to the bone was poor--viz. 'simple' grafts and compound pectoralis major flaps. The vascularized free compound flaps were most reliable but the need for jaw preservation where possible and better patient selection are recognized. PMID- 3541882 TI - Controlled clinical trial of ranitidine in bleeding peptic ulcer. AB - One hundred and two patients were entered into a controlled, randomized clinical trial to assess the value of ranitidine versus placebo, given immediately after entry to hospital to modify the outcome of patients admitted to hospital with acute bleeding from peptic ulceration of the stomach or duodenum. The results indicated that ranitidine could not significantly modify the blood requirements, rebleeding rate or operation rate in this patient population during the initial hospital admission. PMID- 3541883 TI - Single-hand tying of the surgeon's or friction knot. AB - Described is a new method for single-hand tying of the Surgeon's or Friction Knot, which is essentially a modification of the basic knot-tying technique, involving the formation of an inside loop. It is recommended for obtaining secure knots with synthetic suture materials. PMID- 3541884 TI - Hyperacute Escherichia coli mastitis of cattle in the immediate post-partum period. AB - The pathology of hyperacute coliform mastitis was studied in 5 post-parturient cows. In all infected quarters infiltration of neutrophils was negligible. In all except one case there was severe damage to the ductular and secretory system, involving most areas of the gland. Bacteria were dense in infected alveoli, and there was evidence of substantial phagocytosis of bacteria by the secretory epithelium. The exception showed a large lesion in the middle of the gland from which the spread was ductular; other infections were consistent with spread via the teat canal. The organisms were largely confined to the ductular/secretary lumen and there was little invasion of the parenchyma. The severity of the disease was considered due to the absence of the inflammatory response seen in mid lactation. PMID- 3541886 TI - An evaluation of pregnancy testing in sheep using a real-time ultrasound scanner. PMID- 3541885 TI - Serological cross-reactivity between Hammondia hammondi and Toxoplasma gondii in experimentally inoculated sheep. PMID- 3541887 TI - Use of a modified 7H-11 agar to increase growth rate of Mycobacterium bovis from bovine tissues. PMID- 3541888 TI - Pathological gambling. AB - According to DSM-III criteria, pathological gambling is now recognised as a mental illness. Epidemiological data suggest that the incidence of this disorder in the general population varies from 0.5% to 1%. However, until recently, psychiatrists and clinical psychologists have tended to neglect the problem because of a lack of understanding of its aetiology and management. This paper describes pathological gambling and presents an overview of current psychiatric treatments. It concludes that behavioural interventions are the most effective treatments for compulsive gamblers. PMID- 3541890 TI - Laudatio for Dr. J.S. Garrow, winner of the ISFE prize 1985. PMID- 3541889 TI - Pharmacological approaches to the regulation of fat metabolism. AB - There are a variety of methods whereby pharmacotherapy can induce weight loss. These include reducing food intake, impairing absorption of nutrients, inhibiting lipid biosynthesis and increasing energy expenditure. Various drugs are currently being evaluated which exert these modes of action. There are a large number of existing thermogenic drugs, though for one reason or another, they do not appear to be of practical value in the management of obesity. Three novel agents are BRL 26830A, LY 104 119 and RO 16-8714. These agents are chemically similar and all have lipolytic effects particularly in brown adipose tissue. BRL 26830A has been evaluated in man with conflicting results. The possible advantages and limitations of thermogenic agents in human obesity are discussed. Although the animal results are encouraging, it is advisable to take a cautious view regarding their therapeutic potential. PMID- 3541891 TI - Genetic studies of low-abundance human plasma proteins. I. Microheterogeneity of zinc-alpha 2-glycoprotein in biological fluids. AB - A high-resolution isoelectric focusing technique followed by immunoblotting has been utilized to determine the microheterogeneity of zinc-alpha 2-glycoprotein in a large number of plasma samples from U.S. Caucasians, Blacks, and Eskimos. With the exception of one Black individual, all samples were found to contain an invariant multiple-banded pattern which, after desialylation, was reduced to a single band, suggesting that the microheterogeneity observed is due to differences in the sialic acid content of a single protein product. The asialo forms of the variant sample consist of two distinct bands, consistent with the occurrence of a rare genetic variant at the zinc-alpha 2-glycoprotein structural locus. Unfortunately family studies were not feasible. In addition to plasma, the present technique has been applied to detection of zinc-alpha 2-glycoprotein microheterogeneity in amniotic fluid, saliva, and tears. The amniotic fluid pattern is identical to that present in plasma. However, the patterns observed in saliva and tears are different from each other as well as from that in plasma and could be controlled by separate loci. PMID- 3541893 TI - Molecular cloning of two cysteine proteinases from paw-paw (Carica papaya). AB - Two cDNA clones for plant cysteine proteinases have been isolated from a Carica papaya (paw-paw, papaya) leaf tissue cDNA library by using a mixture of 16 synthetic oligodeoxyribonucleotides as a hybridization probe. The inserted regions are 311 and 440 base-pairs in length and have the potential to encode a region corresponding to the C-terminal region of two proteins which are homologous with the known plant cysteine proteinases and the mammalian thiol cathepsins. One of the sequences shows a high (greater than 77%) homology with the plant cysteine proteinase papain, the other is closely related to papaya chymopapain. One sequence contains all, and the other most, of the 3' untranslated region of the mRNA. The inserts were used as specific probes in Northern Blot analyses giving an estimated size for the two mRNA species of 1.45 kilobases. PMID- 3541892 TI - Site-directed mutagenesis. PMID- 3541894 TI - The action of human articular-cartilage metalloproteinase on proteoglycan and link protein. Similarities between products of degradation in situ and in vitro. AB - Interleukin 1 stimulation of human articular cartilage in organ culture produced the concomitant release of proteoglycan fragments and latent metalloproteinase. The released fragments ranged in size from that of almost intact proteoglycan subunits to the product of limiting digestion generated by the activated metalloproteinase. None of the fragments possessed the ability to interact with hyaluronic acid. Analysis of proteoglycan aggregate digested with the activated metalloproteinase showed that isolated hyaluronic acid-binding regions were produced from the proteoglycan subunits, and that the two higher-Mr link-protein components (Mr 48,000 and 44,000) were converted into the lowest-Mr component (Mr 41,000). Link protein extracted from cartilage under stimulation with interleukin 1 showed a similar conversion. These results suggest that interleukin 1 stimulates the release of latent metalloproteinase from chondrocytes and that a proportion of the enzyme is activated in situ in the cartilage matrix. The mode of action of the activated enzyme is compatible with a role in the changes in proteoglycan structure seen in aging. PMID- 3541896 TI - Glucose-induced accumulation of inositol trisphosphates in isolated pancreatic islets. Predominance of the 1,3,4-isomer. AB - Anion-exchange h.p.l.c. analysis of [3H]inositol phosphates derived from glucose stimulated isolated pancreatic islets that had been prelabelled with myo [3H]inositol revealed that the predominant inositol trisphosphate was the 1,3,4 isomer [Ins(1,3,4)P3]. The 1,4,5-isomer [Ins(1,4,5)P3] was also detectable, as was a more polar inositol phosphate with the chromatographic properties of inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P4]. Glucose-induced accumulation of Ins(1,3,4)P3 was augmented by Li+ and occurred after maximal accumulation of Ins(1,4,5)P3. These findings suggest a possible role for Ins(1,3,4)P3 or its probable precursor Ins(1,3,4,5)P4 in stimulus-secretion coupling in pancreatic islets. PMID- 3541895 TI - An inhibitory role for polyamines in protein kinase C activation and insulin secretion in mouse pancreatic islets. AB - The occurrence and function of polyamines in protein kinase C activation and insulin secretion in mouse pancreatic islets were studied. Determination of polyamines in mouse islets revealed 0.9 +/- 0.3 (mean +/- S.E.M., n = 6) pmol of putrescine, 11.7 +/- 3.2 (8) pmol of spermidine and 3.7 +/- 0.6 (8) pmol of spermine per islet, corresponding to intracellular concentrations of 0.3-0.5 mM putrescine, 3.9-5.9 mM-spermidine and 1.2-1.9 mM-spermine in mouse islets. Stimulation of insulin secretion by glucose, the phorbol ester 12-O tetradecanoylphorbol 13-acetate (TPA) or the sulphonylurea glibenclamide did not affect these polyamine contents. In accordance with a role for protein kinase C in insulin secretion, TPA stimulated both protein kinase C activity and insulin secretion. Stimulation of insulin secretion by TPA was dependent on a non stimulatory concentration of glucose and was further potentiated by stimulatory concentrations of glucose, glibenclamide or 3-isobutyl-1-methylxanthine, suggesting that protein kinase C activation, Ca2+ mobilization and cyclic AMP accumulation are all needed for full secretory response of mouse islets. Spermidine (5 mM) and spermine (1.5 mM) at concentrations found in islets inhibited protein kinase C stimulated by TPA + phosphatidylserine by 55% and 45% respectively. Putrescine (0.5 mM) was without effect, but inhibited the enzyme at higher concentrations (2-10 mM). Inhibition of protein kinase C by polyamines showed competition with Ca2+, and Ca2+ influx in response to glucose or glibenclamide prevented inhibition of insulin secretion by exogenous polyamines at concentrations where they did not affect glucose oxidation. It is suggested that inhibition of protein kinase C by polyamines may be of significance for regulation of insulin secretion in vivo and that Ca2+ influx may function by displacing inhibitory polyamines bound to phosphatidylserine in membranes. PMID- 3541897 TI - Insulin binding to cultured adult hepatocytes. Effects of bacitracin and chloroquine on the nature of cell-associated radioactivity. AB - Sephadex (G-50 fine grade)-gel chromatography and trichloroacetic acid (TCA) precipitation were used to investigate the effects of chloroquine and bacitracin on the nature of cell-associated radioactivity in studies on the binding and degradation of 125I-insulin in cultured rat hepatocytes. Sephadex peak I, eluted with the void volume, increased with hepatocyte incubation time and comprised 6% of total cell-bound radioactivity at 120 min. However, all radioactivity in this peak was due to unspecific binding. Peak II, corresponding to intact insulin, represented 95% of specifically cell-associated label at 5 min and decreased to 77% at 120 min. Peak III, containing the final low-Mr degradation products, increased with incubation time (22% of specifically bound label at 120 min). The TCA-precipitable and TCA-soluble fractions of hepatocytes extracted with 0.1% SDS were within 4-7% of the proportions of radioactivity in peaks II and III respectively. Scatchard plots based on insulin-binding data from Sephadex chromatography or TCA precipitation were identical. Dissociation studies revealed that at least 75% of the intact insulin associated with the hepatocytes was bound to receptors at the cell surface. Bacitracin increased the proportion of cell associated intact hormone and decreased that of ligand degraded when analysed by either Sephadex chromatography or TCA precipitation. The proportion of surface bound to internalized intact hormone remained unaltered, indicating that bacitracin acted predominantly at the cell surface. In the presence of chloroquine, which dramatically increased the contribution of peak I to specific binding, 'intact' insulin was substantially overestimated when determined as the TCA-precipitable fraction. In addition, all peak I material and 50% of cell associated label in peak II was trapped intracellularly, thereby pointing to the lysosomal or prelysosomal site of action of this drug. PMID- 3541898 TI - The thylakoid membranes of higher plant chloroplasts. PMID- 3541900 TI - Application of high-performance liquid chromatography to the purification and characterization of ribosomal protein L3 from trichodermin-resistant yeast mutants. AB - A new h.p.l.c. cation-exchange method has been used to separate proteins from 60S ribosomal subunits prepared from strains of Saccharomyces cerevisiae sensitive or resistant to trichodermin. Ribosomal protein L3 was identified in column eluates by one-dimensional and two-dimensional gel electrophoresis and purified further by reverse-phase h.p.l.c. The protein was cleaved with CNBr and the products were analysed, again by reverse-phase h.p.l.c. A marked difference was observed in the peptide profiles between preparations from trichodermin-sensitive and trichodermin-resistant yeast strains. These results provide the first direct demonstration that, in yeast, mutationally induced resistance to trichodermin can alter the covalent structure of ribosomal protein L3. They convincingly demonstrate the potential of the experimental technique for the rapid and preparative separation of a selected yeast ribosomal protein and its subsequent characterization. PMID- 3541899 TI - Contrasting response of protein degradation to starvation and insulin as measured by release of N tau-methylhistidine or phenylalanine from the perfused rat heart. AB - An isotope-dilution method is described for the measurement of N tau methylhistidine release from the perfused rat heart. We argue that release of N tau-methylhistidine is indicative of cardiac actin degradation. N tau Methylhistidine release is compared with phenylalanine release in the presence of cycloheximide (phenylalanine release being a measure of degradation of mixed proteins). In hearts perfused with glucose plus acetate, the rate of actin degradation was increased by starvation and was not inhibited by insulin. In contrast, the rate of mixed-protein degradation was decreased by starvation and was inhibited by insulin. The fractional rate of degradation of mixed proteins in hearts from fed or starved rats was greater than that for actin. It is suggested that there are at least two pools of intracellular protein, the degradation rates of which differ in terms of their response to insulin and starvation. PMID- 3541902 TI - The identification of a major product of the degradation of insulin by 'insulin proteinase' (EC 3.4.22.11). AB - We have studied a major product in the degradation of insulin by insulin proteinase (EC 3.4.22.11). Semisynthetic [[3H]PheB1]insulin and [[3H]GlyA1]insulin were used in the experiments. The structure of the fragment was deduced by observing the chromatographic and electrophoretic migration of the label both before and after further digestion of the fragment with proteinases of known specificity, with and without additional treatment by performic acid. Ambiguities were resolved by studying the behaviour of authentic fragments of known structure, isolated and characterized after digestion of intact insulin by proteinases of known specificity. We conclude that a major product in the degradation of insulin by insulin proteinase consists of a truncated section of the A chain, joined by the disulphide bridge B7-A7 to a truncated section of the B chain. The A-chain fragment consists most probably of residues A1-A13, and the B-chain fragment consists most probably of residues B1-B9. The similarity between this fragment and that found by other workers when insulin is degraded by intact hepatocytes is significant in the light of proposals that insulin proteinase is a possible participant in the physiological degradation of insulin by target cells. PMID- 3541901 TI - Structural and functional relationships between fumarase and aspartase. Nucleotide sequences of the fumarase (fumC) and aspartase (aspA) genes of Escherichia coli K12. AB - The nucleotide sequences of two segments of DNA (2250 and 2921 base-pairs) containing the functionally related fumarase (fumC) and aspartase (aspA) genes of Escherichia coli K12 were determined. The fumC structural gene comprises 1398 base-pairs (466 codons, excluding the initiation codon), and it encodes a polypeptide of Mr 50353 that resembles the fumarases of Bacillus subtilis 168 (citG-gene product), rat liver and pig heart. The fumC gene starts 140 base-pairs downstream of the structurally-unrelated fumA gene, but there is no evidence that both genes form part of the same operon. The aspA structural gene comprises 1431 base-pairs (477 codons excluding the initiation codon), and it encodes a polypeptide of Mr 52190, similar to that predicted from maxicell studies and for the enzyme from E. coli W. Remarkable homologies were found between the primary structures of the fumarase (fumC and citG) and aspartase (aspA) genes and their products, suggesting close structural and evolutionary relationships. PMID- 3541903 TI - Quantification in vivo of the effects of insulin on glucose utilization in individual tissues of warm- and cold-acclimated rats. AB - Cold-acclimation of rats (3 weeks, 4 degrees C) had no effect on basal rates of glucose production or utilization. Under euglycaemic-clamp conditions, in which the circulating insulin concentration was increased by approx. 50 microunits/ml, cold-acclimated rats showed a greater increase in glucose utilization and a greater suppression of endogenous glucose production. Tissue sites of glucose utilization were investigated by using a tracer dose of 2-deoxy-D-[14C]glucose and a glucose metabolic index determined for each tissue. In 5 h-starved warm acclimated rats, heart had the highest glucose metabolic index. This was increased further by both cold-acclimation and insulin treatment. The glucose metabolic index of skeletal muscle was 3.5-14-fold lower than that of heart, but, as a result of the large muscle mass, skeletal muscle made the largest contribution to whole-body glucose utilization. White and brown adipose tissue had low glucose metabolic indices in warm-acclimated rats under basal conditions, and the indices were not increased by the insulin treatment. However, cold acclimation produced a significant increase in the glucose metabolic index of brown adipose tissue, but not of white adipose tissue. In contrast with the warm acclimated rats, insulin treatment of cold-acclimated rats resulted in a marked increase in the glucose metabolic index of brown adipose tissue. The results provide evidence that cold-acclimation produces a selective alteration in the insulin-sensitivity of brown adipose tissue. PMID- 3541905 TI - Nomenclature: protease, proteinase and peptidase. PMID- 3541904 TI - A systematic series of synthetic chromophoric substrates for aspartic proteinases. AB - The hydrolysis of the chromogenic peptide Pro-Thr-Glu-Phe-Phe(4-NO2)-Arg-Leu at the Phe-Phe(4-NO2) bond by nine aspartic proteinases of animal origin and seven enzymes from micro-organisms is described [Phe(4-NO2) is p-nitro-L phenylalanine]. A further series of six peptides was synthesized in which the residue in the P3 position was systematically varied from hydrophobic to hydrophilic. The Phe-Phe(4-NO2) bond was established as the only peptide bond cleaved, and kinetic constants were obtained for the hydrolysis of these peptide substrates by a representative selection of aspartic proteinases of animal and microbial origin. The value of these water-soluble substrates for structure function investigations is discussed. PMID- 3541906 TI - Partial amino acid sequence of human pancreatic stone protein, a novel pancreatic secretory protein. AB - Pancreatic stone protein (PSP) is the major organic component of human pancreatic stones. With the use of monoclonal antibody immunoadsorbents, five immunoreactive forms (PSP-S) with close Mr values (14,000-19,000) were isolated from normal pancreatic juice. By CM-Trisacryl M chromatography the lowest-Mr form (PSP-S1) was separated from the others and some of its molecular characteristics were investigated. The Mr of the PSP-S1 polypeptide chain calculated from the amino acid composition was about 16,100. The N-terminal sequences (40 residues) of PSP and PSP-S1 are identical, which suggests that the peptide backbone is the same for both of these polypeptides. The PSP-S1 sequence was determined up to residue 65 and was found to be different from all other known protein sequences. PMID- 3541908 TI - Changes in proteinase activities and subcellular distribution during inactivation of alcohol oxidase in Candida boidinii. AB - Adaptation of methanol-grown Candida boidinii to ethanol utilization was accompanied by an increase in proteolytic activities, which behaved like known vacuolar enzymes. Degradation of alcohol oxidase protein was partially prevented by the serine proteinase inhibitor phenylmethanesulphonyl fluoride, but not by the carboxyl proteinase inhibitor pepstatin. Fractionation of cell-free extracts, by high-speed zonal centrifugation, of methanol-grown C. boidinii showed non sedimentable and sedimentable proteolytic activities. Naturally occurring inhibitors of vacuolar proteinases were non-sedimentable. Fractionation of extracts prepared from methanol-grown cells which had been adapted to ethanol utilization for 5 h revealed significant changes in the sedimentability and distribution of proteolytic and acid phosphatase activities. These results suggest the possible involvement of a vacuolar process during alcohol oxidase degradation. PMID- 3541907 TI - The lipoprotein lipase of white adipose tissue. Changes in the adipocyte cell surface content of enzyme in response to extracellular effectors in vitro. AB - An indirect labelled-second-antibody cellular immunoassay for adipocyte surface lipoprotein lipase was used to assess the changes that occurred during the incubation of cells in the presence and absence of effectors. In the absence of any specific effectors, the amount of immunodetectable lipoprotein lipase present at the surface of adipocytes remained constant throughout the 4 h incubation period at 37 degrees C. Under such conditions total cellular enzyme activity also remained constant, with no activity appearing in the medium. In the presence of heparin, cell-surface immunodetectable lipoprotein lipase increased by up to 20%, whereas in the presence of cycloheximide they decreased by up to 60%. Thus the obvious turnover of enzyme from this cell-surface site was found to be relatively rapid and dependent for its replenishment, at least in part, on protein synthesis. In the presence of insulin alone, a substantial increase in cell surface lipoprotein lipase protein occurred, only part of which was dependent on protein synthesis. The total cellular activity of lipoprotein lipase was unaffected by the presence of insulin. The insulin-dependent increase in cell surface enzyme was potentiated somewhat in the presence of dexamethasone, which was not shown to exert any independent effect. Glucagon, adrenaline and theophylline all produced a significant decline in the cell-surface immunodetectable lipoprotein lipase, which in the case examined (adrenaline) was partially additive with regard to the independent effect of cycloheximide. Cell surface immunodetectable lipoprotein lipase amounts were decreased significantly when cells were incubated in the presence of either colchicine or tunicamycin. The concerted way in which cell-surface lipoprotein lipase altered during the incubations of adipocytes in the presence of effectors suggested that the translocation of enzyme to and from this cellular site was dependent on hormonal action and the integrity of intracellular protein-transport mechanisms. PMID- 3541909 TI - Localization and biosynthesis of polyamines in insulin-producing cells. AB - Two recently developed fluorescence cytochemical methods, specific for spermidine and spermine, were used to localize polyamines in the endocrine pancreas. The polyamines were restricted to the insulin-producing beta-cells and were mainly associated with the secretory granules. Chemical polyamine determinations carried out on isolated rat and mouse pancreatic islets revealed large amounts of polyamines. Compared with extracts of whole pancreas, the islets contained very high concentrations of spermine relative to spermidine. Biosynthesis of polyamines from [3H]ornithine or from [3H]putrescine in isolated islets was significantly stimulated at high glucose concentrations. Moreover, significant incorporation of label from [3H]putrescine was also detected in gamma aminobutyric acid. This incorporation, however, was not stimulated by high glucose. Possible roles for polyamines associated with the secretory granules in insulin-producing cells are discussed. PMID- 3541910 TI - Characterization of the receptor for cholera toxin and Escherichia coli heat labile toxin in rabbit intestinal brush borders. AB - 125I-labelled heat-labile toxin (from Escherichia coli) and 125I-labelled cholera toxin bound to immobilized ganglioside GM1 and Balb/c 3T3 cell membranes with identical specificities, i.e. each toxin inhibited binding of the other. Binding of both toxins to Balb/c 3T3 cell membranes was saturable, with 50% of maximal binding occurring at 0.3 nM for cholera toxin and 1.1 nM for heat-labile toxin, and the number of sites for each toxin was similar. The results suggest that both toxins recognize the same receptor, namely ganglioside GM1. In contrast, binding of 125I-heat-labile toxin to rabbit intestinal brush borders at 0 degree C was not inhibited by cholera toxin, although heat-labile toxin inhibited 125I-cholera toxin binding. In addition, there were 3-10-fold more binding sites for heat labile toxin than for cholera toxin. At 37 degrees C cholera toxin, but more particularly its B-subunit, did significantly inhibit 125I-heat-labile toxin binding. Binding of 125I-cholera toxin was saturable, with 50% maximal of binding occurring at 1-2 nM, and was quantitatively inhibited by 10(-8) M unlabelled toxin or B-subunit. By contrast, binding of 125I-heat-labile toxin was non saturable (up to 5 nM), and 2 X 10(-7) M unlabelled B-subunit was required to quantitatively inhibit binding. Neuraminidase treatment of brush borders increased 125I-cholera toxin but not heat-labile toxin binding. Extensive digestion of membranes with Streptomyces griseus proteinase or papain did not decrease the binding of either toxin. The additional binding sites for heat labile toxin are not gangliosides. Thin-layer chromatograms of gangliosides which were overlayed with 125I-labelled toxins showed that binding of both toxins was largely restricted to ganglioside GM1. However, 125I-heat-labile toxin was able to bind to brush-border galactoproteins resolved by SDS/polyacrylamide-gel electrophoresis and transferred to nitrocellulose. PMID- 3541911 TI - Coypu insulin. Primary structure, conformation and biological properties of a hystricomorph rodent insulin. AB - Insulin from a hystricomorph rodent, coypu (Myocaster coypus), was isolated and purified to near homogeneity. Like the other insulins that have been characterized in this Suborder of Rodentia, coypu insulin also exhibits a very low (3%) biological potency, relative to pig insulin, on lipogenesis in isolated rat fat-cells. The receptor-binding affinity is significantly higher (5-8%) in rat fat-cells, in rat liver plasma membranes and in pig liver cells, indicating that the efficacy of coypu insulin on receptors is about 2-fold lower than that of pig insulin. The primary structures of the oxidized A- and B-chains were determined, and our sequence analysis confirms a previous report [Smith (1972) Diabetes 21, Suppl. 2, 457-460] that the C-terminus of the A-chain is extended by a single residue (i.e. aspartate-A22), in contrast with most other insulin sequences, which terminate at residue A21. In spite of a large number of amino acid substitutions (relative to mammalian insulins), computer-graphics model building studies suggest a similar spatial arrangement for coypu insulin to that for pig insulin. The substitution of the zinc-co-ordinating site (B10-His----Gln) along with various substitutions on the intermolecular surfaces involved in the formation of higher aggregates are consistent with the observation that this insulin is predominantly 'monomeric' in nature. The c.d. spectrum of coypu insulin is relatively similar to those of casiragua insulin and of bovine insulin at low concentration. PMID- 3541912 TI - The overexpression and complete amino acid sequence of Escherichia coli 3 dehydroquinase. AB - The enzyme 3-dehydroquinase was purified in milligram quantities from an overproducing strain of Escherichia coli. The amino acid sequence was deduced from the nucleotide sequence of the aroD gene and confirmed by determining the amino acid composition of the overproduced enzyme and its N-terminal amino acid sequence. The complete polypeptide chain consists of 240 amino acid residues and has a calculated subunit Mr of 26,377. Transcript mapping revealed that aroD is a typical monocistronic gene. PMID- 3541913 TI - A novel isoform of cytoplasmic actin that binds poly-L-proline. AB - An actin-like protein was purified to apparent homogeneity from chick-embryo homogenates and chick-embryo fibroblasts by the use of poly-L-proline-agarose affinity chromatography; we therefore refer to this protein as PBP (poly-L proline-binding protein). PBP binds to deoxyribonuclease-agarose, co-migrates with known actin standards on SDS/polyacrylamide-gel electrophoresis, and has an amino acid composition similar to that of actin. Linear peptide maps after digestion with Staphylococcus aureus proteinase reveal its apparent homology with gamma-actin; however, isoelectric-focusing experiments show that PBP is clearly more acidic than any of the three major isoforms of actin. PBP polymerizes in the presence of ATP to form fibrillar structures resembling actin paracrystalline aggregates. In chick-embryo fibroblasts, immunofluorescence with antibodies to PBP shows that its distribution is cytoplasmic: perinuclear staining of the cytoplasm, generalized cytoplasmic staining and peripheral fibrillar structures are evident. In contrast, antibodies specific for the (alpha, gamma)-actins reveal the typical stress fibre structures characteristic of fibroblastic cells. PBP appears to constitute a novel isoform of cellular actin, distinct from the known actin isoforms in terms of its lower isoelectric point, its ability to bind poly-L-proline and its distinct subcellular localization. PMID- 3541914 TI - Homology within the N-terminal extension of cysteine proteinases. PMID- 3541916 TI - Mitogenic agents induce redistribution of transferrin receptors from internal pools to the cell surface. AB - Incubation of serum-growth HeLa cells in serum-free medium causes a rapid (t1/2 3 min) 30-60% decrease in the binding of 125I-diferric transferrin to the cell surface. Addition of fetal bovine serum to cells in serum-free medium results in a rapid (t1/2 3 min) and concentration-dependent increase in binding activity. The loss or gain in ligand binding is a result of changes in surface receptor number rather than an alteration in ligand-receptor affinity. A variety of hormones (insulin, insulin-like growth factor, interleukin 1 and platelet-derived factor) were found to mimic the effect of serum on receptor number. The alteration in surface receptor number was found to be calcium-dependent. Changes in surface receptor number were independent of either receptor biosynthetic rate or the absolute cellular content of receptors. The effect of insulin or serum on Hela cell transferrin receptor distribution was unaffected by the presence of transferrin, demonstrating that receptor distribution in this cell type is ligand independent. The ability of serum or insulin to modify surface transferrin receptor number was also observed in mouse L-cells, human skin fibroblasts, and J774 macrophage tumour cells. However, transferrin receptors on K562 and Epstein Barr virus-transformed human lymphoblasts were unaltered by these agents. The quantities of receptors whose distribution is predominantly on the surface (i.e. epidermal growth factor or low density lipoprotein receptor) were unaltered by addition of the mitogenic agents. These results extend our previous studies [H.S. Wiley & J. Kaplan (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 7456-7460] demonstrating that mitogenic agents can induce redistribution of receptor pools in selected cell types. PMID- 3541915 TI - The insulin-like effect of sodium vanadate on adipocyte glucose transport is mediated at a post-insulin-receptor level. AB - Sodium vanadate has several insulin-like effects. To determine whether vanadate acts via the insulin receptor, I investigated the effect of vanadate on glucose transport (2-deoxyglucose uptake) in adipocytes that had been treated to decrease the number of insulin receptors. Trypsin (100 micrograms/ml) caused greater than 95% loss of 125I-insulin binding and rendered glucose transport resistant to both insulin and an anti-insulin-receptor antibody. However, vanadate caused an 8-fold increase in the transport rate [EC50 (concn. giving 50% of maximum effect) 0.2 mM] in both control and trypsin-treated cells, demonstrating that the insulin receptor does not have to be intact for vanadate to stimulate glucose transport. Insulin receptors were depleted by treatment of adipocytes with insulin (100 ng/ml) in the presence of Tris (which blocks receptor recycling). A 2 h treatment caused 60% loss of receptors, and a shift to the right in the dose-response curve for insulin stimulation of glucose transport (EC50 0.3 ng of insulin/ml in controls, 1.2 ng/ml in treated cells). The response to vanadate was again unaffected. Treatment with insulin for 4 h caused a 67% decrease in insulin binding and, in addition to the rightward shift in the insulin dose-response curve, a decrease in basal and maximal transport rates (which cannot be explained by decreased insulin receptor number). The EC50 of vanadate was again equal in control and treated cells, but glucose transport in the presence of a maximally effective concentration of vanadate (1 mM) was decreased. I conclude that the effect of vanadate on glucose transport is independent of the insulin receptor. Induction of a post-receptor defect (which may be a decrease in the total number of cellular glucose transporters) by prolonged exposure to insulin decreases the potency of a maximally effective concentration of vanadate. The findings demonstrate that vanadate stimulates glucose transport by an effect at a level distal to the insulin receptor. PMID- 3541918 TI - Fluorescence technique for comparative studies of substrate-binding subsites in serine proteinases. Application to subtilisins. AB - A fluorescence technique for comparative studies of substrate-binding subsites in serine proteinases is described. It consists of: selective labelling of the corresponding subsites with a fluorescent group by using N alpha-dansyl(5 dimethylaminonaphthalene-1-sulphonyl)ated peptide chloromethanes containing different numbers of amino acid residues, and probing the immediate environment of the subsites by quenching experiments using ionic and neutral quenchers. Intramolecular distances between the subsites and particular chromophores can be also determined. The technique is of general applicability to all serine proteinases. The above mentioned approach was applied to two proteinases: subtilisin Novo and mesentericopeptidase. It was concluded that the substrate binding site of mesentericopeptidase is considerably more polar than that of subtilisin Novo. Intramolecular distances between the labelled subsites and tryptophan residues in the two proteinases were determined. PMID- 3541917 TI - A role for calcium in the breakdown of inositol phospholipids in intact and digitonin-permeabilized pancreatic islets. AB - Glucose (20 mM) and 4-methyl-2-oxopentanoate (10 mM) both caused a pronounced stimulation of insulin release and of [3H]inositol phosphate production in rat pancreatic islets prelabelled with myo-[3H]inositol. Secretory responses to these nutrients were markedly impaired by lowering the Ca2+ concentration of the incubation medium to 10(-4)M or less, whereas stimulated inositol phosphate production was sensitive to Ca2+ within the range 10(-6)-10(-4)M. Inositol phosphate formation in response to carbamoylcholine was also found to be dependent on the presence of 10(-5)M-Ca2+ or above. Raising the concentration of K+ in the medium resulted in a progressive, Ca2+-dependent stimulation of inositol phosphate production in islets, although no significant stimulation of insulin release was observed. In islets prelabelled with myo[3H]inositol, then permeabilized by exposure to digitonin, [3H]inositol phosphate production could be triggered by raising the Ca2+ concentration from 10(-7) to 10(-5)M. This effect was dependent on the concentration of ATP and the presence of Li+, and involved detectable increases in the levels of InsP3 and InsP2 as well as InsP. A potentiation of inositol phosphate production by carbamoylcholine was observed in permeabilized islets at lower Ca2+ concentrations, although nutrient stimuli were ineffective. No significant effects were observed with guanine nucleotides or with neomycin, although NADH produced a modest increase and adriamycin a small inhibition of inositol phosphate production in permeabilized islets. These results strongly suggest that Ca2+ ions play an important role in the stimulation of inositol lipid metabolism in islets in response to nutrient secretagogues, and that inositide breakdown may actually be triggered by Ca2+ entry into the islet cells. PMID- 3541920 TI - Effect of intracellular alkalinization on pancreatic islet calcium uptake and insulin secretion. AB - Microdissected beta-cell-rich pancreatic islets of ob/ob mice were used in studies of the relationship between intracellular pH (pHi) and 45Ca2+ uptake and insulin release. Stepwise increases in extracellular pH (pHo) from 6.80 to 8.00 resulted in a parallel, although less pronounced, elevation of pHi from 7.24 to 7.69. Experimental conditions that alkalinize the islet cell interior, i.e. addition of 5 mM-NH4+, sudden withdrawal of extracellular bicarbonate buffer or increase in pHo, induced insulin secretion in the absence of other types of secretory stimulation (1 mM-D-glucose). Intracellular acidification by lowering pHo below 7.40 or sudden addition of bicarbonate buffer did not induce insulin secretion. The removal of extracellular bicarbonate buffer, increase in pHo from 7.40 to 8.00, or the addition of 5 mM-L-5-hydroxytryptophan or 5 mM-NH4+, which all alkalinize the islet cells and induce insulin secretion, also increased the La3+-non-displaceable 45Ca2+ uptake in the presence of 1 mM-D-glucose. The results suggest that intracellular alkalinization in beta-cells can trigger insulin secretion. Taken together with the fact that D-glucose increases pHi in the islet cells, the results also point to the possibility that alkalinization may be a link in the stimulus-secretion coupling sequence in beta-cells. PMID- 3541921 TI - Prostacyclin synthesis by vascular tissue. Effect of extracellular Ca2+. AB - Prostacyclin (PGI2) synthesis in vascular tissue is stimulated by free Ca2+. Concentrations in excess of 4 mM result in a sustained release of PGI2, but not other prostanoids, from rat aorta. This effect arises by increased synthesis of PGI2 and not through the inhibition of its metabolism. Physico-chemical examination of serum and plasma extract has indicated that much of the PGI2 stimulating activity reported for human serum derives from the presence of free Ca2+. PMID- 3541919 TI - New flavins for old: artificial flavins as active site probes of flavoproteins. PMID- 3541922 TI - Electron transfer to nitrogenase. Characterization of flavodoxin from Azotobacter chroococcum and comparison of its redox potentials with those of flavodoxins from Azotobacter vinelandii and Klebsiella pneumoniae (nifF-gene product). AB - Flavodoxin in the hydroquinone state acts as an electron donor to nitrogenase in several nitrogen-fixing organisms. The mid-point potentials for the oxidized semiquinone and semiquinone-hydroquinone couples of flavodoxins isolated from facultative anaerobe Klebsiella pneumoniae (nifF-gene product, KpFld) and the obligate aerobe Azotobacter chroococcum (AcFld) were determined as a function of pH. The mid-point potentials of the semiquinone-hydroquinone couples of KpFld and AcFld are essentially independent of pH over the range pH 7-9, being -422 mV and 522 mV (normal hydrogen electrode) at pH 7.5 respectively. The mid-point potentials of the quinone-semiquinone couples at pH 7.5 are -200 mV (KpFld) and 133 mV (AcFld) with delta Em/pH of -65 +/- 4 mV (KpFld) and -55 +/- 2 mV (AcFld) over the range pH 7.0-9.5. This indicates that reduction of the quinone is coupled to protonation to yield a neutral semiquinone. The significance of these values with respect to electron transport to nitrogenase is discussed. The amino acid compositions, the N- and C-terminal amino acid sequences and the u.v. visible spectra of KpFld and AcFld were determined and are compared with published data for flavodoxins isolated from Azotobacter vinelandii. PMID- 3541923 TI - Guanine nucleotide regulation of phospholipase C activity in permeabilized rabbit neutrophils. Inhibition by pertussis toxin and sensitization to submicromolar calcium concentrations. AB - Rabbit neutrophils labelled with [3H]inositol and permeabilized with saponin produced [3H]inositol trisphosphate (InsP3) when incubated with stable analogues of GTP or millimolar concentrations of Ca2+. [3H]InsP3 production elicited by guanosine 5'-[gamma-thio]triphosphate was enhanced by the chemoattractant formylmethionyl-leucyl-phenylalanine and inhibited by pertussis-toxin pretreatment. A pertussis-toxin-sensitive stimulation of [3H]InsP3 concentration was also observed with guanosine 5'-[beta gamma-imido]triphosphate, but not with guanosine 5'-[beta-thio]diphosphate or GTP. Millimolar Ca2+ alone was sufficient to stimulate [3H]InsP3 production; however, in the presence of guanosine 5' [gamma-thio]triphosphate, the Ca2+ dose-response curve was shifted to submicromolar concentrations. These findings directly confirm the role of a pertussis-toxin-sensitive guanine nucleotide regulatory protein (G protein) in chemoattractant-stimulated phospholipase C activity in rabbit neutrophils. Moreover, the ability of guanine nucleotides to sensitize phospholipase C to physiologically relevant Ca2+ concentrations suggests that the role of the activated G protein may be to enhance the apparent affinity of phospholipase C for Ca2+ and thus to activate the enzyme without an increase in the Ca2+ concentration. PMID- 3541925 TI - Partial purification and characterization of masking protein for beta-type transforming growth factor from rat platelets. AB - beta-Transforming growth factor (TGF-beta) is stored in platelets and secreted as a high molecular weight latent form associated with a carrier protein of about 440 KD. This carrier protein could be separated from TGF-beta in 1 N acetic acid and could again mask the activity of TGF-beta under neutral conditions. Therefore, it was named the masking protein of TGF-beta. The masking protein was separated from TGF-beta by gel filtration on a Sephacryl S-300 column or by anion exchanger FPLC on a Mono Q column in the presence of 6 M urea. Partially purified masking protein from rat platelets neutralized the activity of TGF-beta dose dependently and was effective at 0.3 microgram/ml. This masking protein could also mask the activity of human TGF-beta, suggesting that it was not species specific. The masking protein was a heat- and acid-stable protein, but was inactivated by treatment with dithiothreitol. The Physiological role of the masking protein in the mechanisms of wound healing and liver regeneration is discussed. PMID- 3541926 TI - Reassembly of c-myc and relaxation of c-fos nucleosomes during differentiation of human leukemic (HL-60) cells. AB - Human promyelocytic leukemic (HL-60) cells have amplified c-myc protooncogene sequences which lead to an elevated level of c-myc gene expression. Induction of HL-60 cells by phorbol esters to undergo monocytic differentiation results in the suppression of c-myc, but the activation of c-fos gene transcription. Chromatin structures of c-myc and c-fos were compared by measuring their sequences in nucleosome-associated DNA fragments. These nucleosomal particles were released from chromatin by micrococcal nuclease digestion and subsequently analyzed with two dimensional gel electrophoresis. C-myc related sequences were detected in nucleosomal DNA fragments of differentiated cells only, while the c-fos related sequences were found in nucleosomal DNAs of noninduced HL-60 cells. Since the enzyme preferentially digests relaxed DNAs, these results suggest that nucleosomal subunits of c-myc and c-fos chromatin are relaxed during the state of active transcription, and reassembled once their transcription is repressed. PMID- 3541924 TI - Two forms of phosphatidylinositol-specific phospholipase C from bovine brain. AB - Two immunologically distinct forms of phosphoinositide-specific phospholipase C were purified to near homogeneity from bovine brain. Their molecular weights determined by SDS-PAGE are 150,000 (enzyme I) and 145,000 (enzyme II), respectively. Under a nondenaturing condition, purified enzyme I exists mainly in dimeric form and as tetramer to a small extent, while enzyme II is predominantly in monomer, to a small extent as dimer and to a very small extent as trimer. Multiple forms of phosphoinositide-specific phospholipase C in brain tissue described in the literature might be, therefore attributed to the oligomerization of the two independent forms. PMID- 3541927 TI - Evidence for catalytic site cysteine and histidine by chemical modification of beta-hydroxy-beta-methylglutaryl-coenzyme A reductase. AB - S-(4-Bromo-2,3-dioxobutyl)-coenzyme A inactivates both yeast and rat liver beta hydroxy-beta-methylglutaryl-coenzyme A reductase. The inactivation is irreversible, complete in 15 s, and proportional to the concentration of the reagent. beta-Hydroxy-beta-methylglutaryl-CoA provides protection against inactivation, whereas NADPH does not. Inactivation is attributed to reaction with an essential cysteine at the beta-hydroxy-beta-methylglutaryl-CoA binding site. Experiments with other active site-directed reagents confirm the involvement of a cysteine and support the presence of an active-site histidine, but rule out the participation of arginine or serine. PMID- 3541928 TI - Induction of cytochrome P-450c in hematopoietic cells of fetal liver. AB - The transplacental inductive effect of beta-naphthoflavone (beta NF) on cytochrome P-450 isozymes was studied in separate hematopoietic and hepatocyte cells from fetal rat liver. Two fractions of dispersed fetal liver cells were isolated by Ficoll-Paque centrifugation and shown by histologic examination to be enriched in erythroblasts and hepatocytes, respectively. beta NF treatment increased ethoxyresorufin-O-deethylase activity 250-fold in both erythroblast and hepatocyte cell fractions. Polyacrylamide gel electrophoresis and immunostaining techniques showed the induction of cytochrome P-450c, but not P-450d, in erythroblast and hepatocyte fractions. PMID- 3541929 TI - Demonstration of immunohistochemical and immunochemical cross-reactivity of L histidine and L-dopa decarboxylases using antibodies against the two enzymes. AB - Both rat L-histidine decarboxylase (HDC) and guinea-pig L-DOPA decarboxylase (DDC) were shown immunohistochemically and immunochemically to react with anti rat HDC antibody. No cross-reaction was observed in immunoprecipitation experiments, but both anti-rat HDC antibody and anti-rat DDC antibody immunostained neurons in the substantia nigra, raphe nucleus and locus coeruleus of guinea-pig brain. Moreover, on immunoblotting, anti-rat HDC antibody recognized not only rat HDC but also guinea-pig DDC, but not rat DDC. However, anti-rat DDC antibody showed no immunohistochemical or immunochemical cross reactivity with rat HDC. PMID- 3541930 TI - Mitochondrial malate dehydrogenase and its precursor have different conformations. AB - Antiserum prepared against the denatured form of mammalian malate dehydrogenase was found to immunoprecipitate the denatured but not the native form of the mature enzyme. In contrast, the antiserum immunoprecipitated the enzyme's precursor, synthesized in a rabbit reticulocyte lysate, either before or after denaturation. The mature form of the enzyme but not the precursor bound to an affinity column of 5'-AMP-Sepharose. These results indicate that the mature and precursor forms of malate dehydrogenase have different conformations. PMID- 3541931 TI - Inhibitory effects of beta 2-microglobulin on in vitro calcification of osteoblastic cells. AB - Elevated levels of aluminum and beta 2-microglobulin have been demonstrated in chronic dialysis patients. The role of aluminum in the pathogenesis of renal osteodystrophy has also been shown. We report on the effects of beta 2 microglobulin on calcification in vitro using osteoblastic cells, clone MC3T3-El. At concentrations comparable to those in plasma of chronic dialysis patients, both beta 2-microglobulin and aluminum suppressed calcification while collagen synthesis and alkaline phosphatase activity were maintained. These observations may be related to the impaired bone mineralization frequently observed in chronic dialysis patients. PMID- 3541932 TI - Cachectin/TNF as well as interleukin-1 induces prostacyclin synthesis in cultured vascular endothelial cells. AB - Cachectin/tumor necrosis factor (cachectin/TNF) has been shown to be capable of stimulating prostacyclin (PGI2) production by vascular endothelial cells in vitro. The stimulation of PGI2 by cachectin/TNF is comparable to that observed with interleukin-1, the monokine previously suggested to be the principal mediator of this effect. The ability of cachectin/TNF to stimulate PGI2 production suggests that it may play a role in producing depressed blood pressure or shock. If so, it might be possible to prevent such adverse effects with the aid of anti-inflammatory agents. PMID- 3541933 TI - Induction of 2-carboxybenzaldehyde reductase by phenobarbital in primary culture of rat hepatocytes. AB - When rats were treated with phenobarbital (PB), the activity of CBA reductase, which catalyzes the conversion of 2-carboxybenzaldehyde (CBA) to 2 hydroxymethylbenzoic acid (HMB), in the liver was markedly enhanced. Likewise, addition of PB to the primary culture of rat hepatocytes increased the activity of CBA reductase. The enzyme recovered from cell lysate of cultured cells showed the same characteristics in molecular and catalytic properties as the enzyme purified from the livers of the rats treated with PB. Experiments with cycloheximide suggest that de novo synthesis of the enzyme protein is enhanced by PB in primary culture. PMID- 3541934 TI - Receptor-mediated photo-cytotoxicity: synthesis of a photoactivatable psoralen derivative conjugated to insulin. AB - 4'-Aminomethyl-4,5',8-trimethylpsoralen has been chemically conjugated to insulin using a carbodiimide derivative. The psoralen moiety retains its photochemical reactivity as evidenced by its ability to crosslink DNA after exposure to long wavelength ultraviolet light (UVA, 320-400 nm). This chimeric molecule has been used to selectively kill a population of lymphocytes whose expression of insulin receptors has been stimulated with phytohemagglutinin. Insulin carries the psoralen into the cell via receptor-mediated endocytosis, where it is subsequently activated by exposure to UVA light. The UVA induced activity of AMT insulin can be blocked by the presence of native insulin. The viability of unstimulated lymphocytes was not affected by AMT-insulin and UVA light. The hybrid insulin-psoralen molecule may be a prototype for a family of phototoxic drugs which can be selectively delivered to subsets of lymphocytes. PMID- 3541935 TI - Expression of the proto-oncogenes C-H-ras and N-ras in early second trimester human fetal tissues. AB - Tissues from human fetuses of 12-18 weeks gestational age were examined for expression of c-oncogenes. Dot blot hybridization showed that N-ras and C-H-ras were expressed to varying degrees in all tissues. Some of the tissues were further examined by Northern blot hybridization, and transcripts of approximately 2.2 Kb and 5.2 Kb were detected using N-ras cDNA probe. A further transcript of approximately 1.4 Kb was observed when the same blot was hybridized to C-H-ras cDNA probe. No hybridization was detected between the fetal tissues and c-K-ras, c-myc, v-erb, c-fos, c-sis and c-src. PMID- 3541936 TI - Interaction between actin and HMM. AB - It is shown that the interaction between actin and HMM results in a rapid precipitation of acto-HMM gel upon addition of MgATP. This is a simple demonstration of the idea that the formation of myosin filaments is not essential for mechanochemical reaction (muscle contraction) to occur and that the soluble myosin heads are competent to interact with actin to produce mechanical effect. Our findings also strongly support earlier suggestion that each head of one HMM molecule is able to bind to a different actin filament. PMID- 3541937 TI - The two binding sites for DCMU in Photosystem II. AB - Measurements on the fluorescence induction of Triton X-100 extracted Photosystem II (PSII) particles confirmed the existence of the two sites of inhibition in PSII for the herbicide DCMU. The two sites were located on the reducing and oxidizing sides of PSII, respectively. The inhibition on the oxidizing side, unlike that on the reducing side which was of the "none or all" type, was found only to slow down the electron donation at low concentrations of DCMU. The results also suggested that the inhibitions of DCMU at these two sites were mutually exclusive, i.e., the binding on one site prevented the binding on the other site. PMID- 3541938 TI - In vitro formation of amyloid fibrils from two synthetic peptides of different lengths homologous to Alzheimer's disease beta-protein. AB - Two synthetic peptides corresponding to the reported 28-residue sequence of Alzheimer's Disease beta-protein (SP28) and to residues 12-28 (SP17) were used to form fibrils in vitro. Synthetic fibrils bound Congo Red and closely resembled amyloid fibrils isolated from leptomeninges and senile plaques of Alzheimer's brain by electron microscopy. A polyclonal antiserum to SP28 specifically decorated both synthetic and native amyloid by colloidal gold immunoelectron microscopy. Amyloid fibrils isolated from tissue were insoluble on SDS Polyacrylamide gels, and tended to aggregate while synthetic amyloid fibrils were completely solubilized, releasing only monomers of SP28 and SP17. Anti-SP28 immunostained cerebrovascular and plaque core amyloid, but not neurofibrillary tangles, in tissue section. Western blot analysis showed that anti-SP28 reacted with a 4 kDa band released from amyloid core-enriched preparations and leptomeninges. By contrast, a 16 kDa band corresponding to the tetramer of beta protein was not recognized. These data suggest that as little as a 17 residue sequence of beta-protein may be required to form fibrils and that the complete sequence of the 4 kDa beta-protein may be important in determining insolubility and the formation of intermediate size polymers. PMID- 3541939 TI - Diamide exposure, thermal resistance, and synthesis of stress (heat shock) proteins. AB - Chinese hamster ovary (CHO) cells were treated with the thiol oxidant diamide for 1 hr at 37 degrees, incubated in diamide-free medium for 4 hr at 37 degrees, and then exposed to hyperthermic treatment (43 degrees) or assayed for the presence of 110, 90 and 66 kilodalton (kD) stress (heat shock) proteins. Cellular inactivation produced by the hyperthermic treatment was measured using colony formation as the end point. Low concentrations of diamide, which did not result in depletion of intracellular GSH, induced a moderate degree of protection against thermal toxicity but did not affect the pattern of protein synthesis. Exposure to 0.4 mM diamide, which reduced intracellular GSH concentrations by 50 60%, significantly reduced the rate of hyperthermic cellular inactivation. This occurred coincidentally with the synthesis of stress proteins of approximate molecular weights of 110, 90 and 66 kD. Furthermore, this concentration of diamide protected cells from thermal inhibition of protein synthesis. These results indicate that thiol oxidation by diamide can induce both the development of thermal resistance to cellular inactivation and the synthesis of stress proteins. PMID- 3541940 TI - Specific, high-affinity bradykinin binding by purified porcine kidney post proline cleaving enzyme. AB - Post-proline cleaving enzyme (PPCE) was purified from porcine kidney cytosol. The purified enzyme bound [125I-Tyr5]-bradykinin but neither [125I-Tyr1]-kallidin nor [125I-Tyr8]-bradykinin. Scatchard analysis of the data was consistent with a single class of binding sites with a Kassoc = 1.3 +/- 0.1 X 10(8) M-1. The optimal pH for [125I-Tyr5]-bradykinin binding was 6.8. The specificity of binding was evaluated with sixty-seven bradykinin analogs. The catalytic activity of the enzyme was measured with N-benzyloxycarbonyl-Gly-Pro-methylcoumarinyl-7-amide (Z Gly-Pro-MCA). The optimal pH for hydrolysis of this substrate was broad and centered at 8.3. The apparent Km and Vmax were obtained from Lineweaver and Burk plots and were 4.8 +/- 0.4 X 10(-5) M and 42 +/- 5 mumoles X mg-1 X min-1 respectively. The IC50 values for bradykinin, diisopropylfluorophosphate (DFP), and N-benzyloxycarbonyl-Pro-Prolinal (Z-Pro-Prolinal) to inhibit Z-Gly-Pro-MCA hydrolysis by PPCE were 5.9 +/- 1.4 X 10(-7) M, 8.8 +/- 3.1 X 10(-7) and 7.9 +/- 0.3 X 10(-9) M respectively. Corresponding values for inhibition of [125I-Tyr5] bradykinin binding by PPCE were 5.1 +/- 2.3 X 10(-9) M, 1.2 +/- 0.3 X 10(-6) M and 1.4 +/- 0.6 X 10(-8) M. PMID- 3541941 TI - Relationship between binding affinity, retention and sensitivity of human rhabdomyosarcoma xenografts to Vinca alkaloids. AB - Xenografts of human rhabdomyosarcoma (RMS) have been derived that differ in their degree of sensitivity to Vinca alkaloids. Lines Rh12 and Rh18 demonstrated, respectively, high and moderate sensitivity to vincristine (VCR), but showed little responsiveness to vinblastine (VLB) in vivo. Rh18/VCR-3, a subline of Rh18 selected for resistance to VCR under in situ conditions, was insensitive to further challenge with VCR. Resistance was associated with elimination of the agent in a biphasic manner, whereas sensitivity to VCR corresponded to very prolonged drug retention in sensitive neoplastic tissues. The initial half-times for drug retention in tumors in vivo (t1/2 alpha) correlated with the degree of sensitivity of tumors to Vinca alkaloids, decreasing t1/2 alpha being associated with decreased sensitivity. A single binding species was observed when membrane free supernatant fractions were incubated at 37 degrees for 15 min with 10.4 nM [3H]VCR and analyzed by gel filtration HPLC. The protein eluted with a retention time of 57 min and corresponded to a molecular weight (Mr) of approximately 113,000 daltons, agreeing very closely with the Mr of dimeric tubulin (approximately equal to 110,000 daltons). Two fractions were collected and eluted on a one-dimensional denaturing gel. Proteins were transferred subsequently to nitrocellulose and probed with an 125I-labeled monoclonal antibody specific for beta-tubulins. Only the fraction containing bound [3H]VCR contained tubulin. Estimates for the dissociation constants (Kd) for the binding affinity of VCR and VLB in crude, membrane-free supernatant fractions from RMS xenografts were obtained by computer curve fitting using a mathematical binding model. Data fitted a two-site binding model, with Kd values for the high-affinity site ranging from 61 to 160 nM, and for the low-affinity site, from 42 to 94 microM. At physiologically achievable drug concentrations, the relationship between binding affinity, drug retention and tumor sensitivity was examined further. A close relationship was apparent between the Kd values for VCR in Rh12, Rh18 and Rh18/VCR-3 tumor supernatant fractions and VLB in Rh12 preparations, and t1/2 alpha values for drug retention. Prolonged drug retention correlated with a low binding constant. As t1/2 alpha decreased, binding affinity also decreased, as demonstrated by an increase in the Kd value. Consequently, the tightness of drug binding in tumors also correlated with the degree of sensitivity of the xenografts to Vinca alkaloids.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3541942 TI - [Biospecific chromatography of lipolytic enzymes and methods for determining their activity]. AB - The review concerns application of affinity chromatography for isolation of phospholipases and lipases, as well as the methods for determining their activities. Main emphasis is laid on the preparation of biospecific supports with lipid ligands as well as on development of new methods for assaying lipolytic activity. PMID- 3541943 TI - Antibodies to DNA. A perspective. PMID- 3541944 TI - Alterations in a cartilage matrix glycoprotein in canine osteoarthritis. AB - A number of biochemical abnormalities have been described in osteoarthritic (OA) cartilage, but little study has been devoted to changes in the noncollagenous, nonproteoglycan proteins of cartilage in this condition. Using a canine model of OA produced by transection of the anterior cruciate ligament of the knee, we have demonstrated that distinct alterations occur in a 550,000-dalton cartilage matrix glycoprotein in OA canine cartilage. This protein is a major protein constituent of normal articular cartilage. Fragments which are immunologically cross-reactive with the 550,000-dalton protein were more abundant in OA cartilage than in normal articular cartilage. Immunofluorescence studies revealed that staining with specific antiserum to the protein was absent in OA cartilage. This was the only noncollagenous, nonproteoglycan protein noted to undergo significant changes in this model of OA. PMID- 3541945 TI - Growth factors and the pathogenesis of atherosclerosis. PMID- 3541946 TI - Twice daily administration of beclomethasone dipropionate dry-powder in the management of chronic asthma. AB - In a double-blind cross-over study beclomethasone dipropionate inhaled as a dry powder in a dose of 400 micrograms twice daily was compared with a conventional aerosol in a dose of 100 micrograms four times daily in 16 outpatients with chronic asthma. Each of the 2 treatments lasted for 4 weeks. There was no significant difference with respect to daily peak expiratory flow rates, symptom scores, bronchodilator usages and other lung function measurements between the 2 treatments. Tetracosactrin tests were within normal limits and no clinical oral candidiasis was observed throughout the study. In conclusion, beclomethasone dipropionate dry-power given twice daily was effective for the control of asthma and could be recommended for patients with poor drug compliance. PMID- 3541948 TI - Immunologic tools to decipher efficacy of BCG immunotherapy in advanced breast cancer: a one year follow up study. AB - We report the clinical outcome of conventional therapy and BCG immunisation therapy for 40 patients with advanced breast carcinoma. The clinical outcome was better for the 20 patients receiving BCG immunisation therapy. All patients were assessed for cell mediated immunologic competence before starting treatment and after completion of treatment. Thereafter they were followed for one year. Those patients who showed good local response to BCG vaccination before starting therapy had better prognosis, and those for whom anergy to PPD and DNCB could be reversed by BCG immunotherapy showed clinical improvement. Another interesting finding was that IgA was the predominating immunoglobulin located in normal breast tissue and benign breast tumours while IgG was deposited in most of the malignant breast tumour. This indicated that malignant tumours of the breast jeopardise the secretory immune system of the mammary gland. PMID- 3541949 TI - HLA and tuberculosis--a reappraisal. PMID- 3541947 TI - Juvenile blistering diseases: the problems of diagnosis and treatment. AB - Correct clinical diagnosis in cases of chronic, relapsing, non-hereditary, blistering diseases in childhood could not be made without the aid of histopathology and immunofluorescence, since the morphology and the distribution of the lesions of bullous pemphigoid (BP), linear IgA bullous dermatosis (LAD) and dermatitis herpetiformis (DH) may be similar. Histopathology was helpful in about half of the cases. The results of immunopathology were very useful for the final diagnosis. Of twenty-one cases of juvenile blistering diseases, two cases which showed IgG on direct test with circulating antibodies were BP; three cases with deposition of IgG but without circulating antibodies were probably BP; three cases were either BP or LAD (IgG and IgA on direct test without circulating antibodies); nine cases were definite LAD (linear IgA only); one case which showed granular IgA in the dermal papillae and linear IgA was DH; and the last three cases were probably LAD and BP with non-immunoreactant deposits. Regardless of the diagnosis, dapsone and co-trimoxazole controlled eight cases and could be discontinued without relapse, while the other six cases were maintained on dapsone therapy alone. Prednisolone, when added in cases of poor response to either dapsone or co-trimoxazole, caused remission and was discontinued in three out of the five cases. Two cases were lost to follow up. PMID- 3541950 TI - Memories of the early days of arthroscopy. PMID- 3541951 TI - Suture and immobilization of acute peripheral injuries of the meniscus in rabbits. AB - A comparative study of suturing or nonsuturing with or without immobilization of acute peripheral injuries to the medial meniscus of rabbits is reported. Artificial injuries to both knees of 44 male China Blue-Violet rabbits were sutured or left unsutured. One knee joint of each rabbit was immobilized postoperatively for 6 weeks. The maximum breaking strength was measured, pathologic examinations were performed, and healed areas were measured. The results showed that there was greater healed area, higher maximum breaking strength, earlier matured scar tissue formation, and more regular fiber alignment in the treatment groups with simple immobilization of the knee joint. These results were superior to suturing plus immobilization, suggesting that external immobilization of the knee joint is the key to the treatment of acute peripheral injuries of the meniscus. It may be the procedure of choice for clinical orthopedists dealing with such injuries. The measurement of the meniscus healed area and maximum breaking strength and the use of new material with this method of immobilization were introduced by the authors. PMID- 3541952 TI - [Historical beginnings of local anesthesia in dentistry]. PMID- 3541953 TI - [The use of cast abutment posts for the reconstruction of devitalized teeth]. PMID- 3541954 TI - [Selective grinding in the laboratory]. PMID- 3541955 TI - [Prosthetic reconstruction after periodontal treatment]. PMID- 3541956 TI - [A color for every age]. PMID- 3541957 TI - [Prosthetic rehabilitation in a clinical case]. PMID- 3541958 TI - [It is not the tooth it seems to be]. PMID- 3541960 TI - [Electrophysiological mechanisms of the anti-arrhythmia action of ethacizin]. PMID- 3541959 TI - [2-dimensional computed echocardiography. The potentials and limitations of the method in determining the global and local contractile function of the left ventricle]. AB - To study the possibilities of two-dimensional echocardiography (2EchoCG) in evaluating total and regional left ventricular contractility using computerized quantification as compared to biplane contrast ventriculography (CVG) 50 subjects were examined. There was a good correlation between the values of the end diastolic and end-systolic volumes and the ejection fraction obtained by the two techniques (r = 0.79-0.86) when the volume parameters were calculated by the disk method using Simpson's rule. When the "area-length" method of calculation was used the correlation factors were somewhat lower; 2EchoCG was shown to underestimate the volume parameters and the ejection fraction as compared to CVC. The analysis of regional contractility determined by the method of area changes in a floating axis system revealed high sensitivity and specificity of 2EchoCG as compared to CVG data, the sensitivity being highest when the lateral and septal left ventricular regional contractility was analyzed and lowest when decreased regional contractility was revealed in the inferior area. PMID- 3541961 TI - [Doppler echocardiography: the potentials for qualitative and quantitative hemodynamic analysis]. PMID- 3541962 TI - [Results of the clinical study of a new anti-arrhythmia preparation allapinin]. AB - The results of the trial point to a potent and protracted antiarrhythmic effect of allapinin equally pronounced with both intravenous and oral administration to patients with ventricular and supraventricular premature beats. The side effects of the drug in acute tests and during short-term course therapy are not significant. PMID- 3541963 TI - [Comparative evaluation of the anti-arrhythmia effectiveness of mezotrin and izoptin]. AB - Isoptin and mesotrin (a new hypothetical calcium antagonist) were administered to 30 patients with frequent and persistent premature beats (22 patients with premature ventricular beats and 8 patients with premature supraventricular beats). The antiarrhythmic activity of mesotrin was nearly twice as high as that of isoptin, the antiarrhythmic effect being achieved in 63 and 33% of patients, respectively, which was especially distinct in ventricular rhythm disturbances (64 and 27%, respectively). The effective dose of mesotrin was approximately 2.5 mg/kg. Isoptin produced the greatest effect on atrio-ventricular conduction, while mesotrin to a great extent influenced atrial and ventricular conduction. Certain side effects of mesotrin were observed, consisting in slight euphoria, ventigo and heavyheadedness subduing spontaneously 10-15 minutes after administering the drug. Care should be taken when administering the drug to patients with sick sinus syndrome because of the possibility of its arrest. PMID- 3541964 TI - [Clinical approval of dalargin--a new agent for treating peptic ulcer]. PMID- 3541965 TI - Organization of haematopoietic stem cells and their relationship to mastocytopoiesis. AB - Haematopoiesis is a dynamic process in which differentiated blood cells are regularly replaced by the proliferation and differentiation of stem cells. Two types of haematopoietic stem cells (HSC) can be distinguished: totiopotent HSC capable of giving rise to cells of all haematopoietic lineages, and pluripotent HSC capable of giving rise only to the myeloid lineages. HSC are characterized by their capacity for self-renewal and differentiation in committed stem cells determined towards one of the haematopoietic lineages. These committed stem cells, also named progenitor cells or colony-forming units (CFU), have the capacity to give rise, in semi-solid medium, to colonies composed of differentiated cells. It has recently been shown that mast cells originate from a pluripotent HSC and that CFU Baso/Masto can be detected from murine and human bone marrow and blood cells. The in vivo regulation of the proliferation and differentiation of HSC is not well known. Several studies have emphasized the role of the haematopoietic microenvironment and of long- and short-range factors in such regulation. The in vitro growth of HSC is strictly dependent on growth factors, also named CSF (colony-stimulating factors) and interleukin (IL), in particular IL3. IL3 is a glycoprotein which induces the proliferation and differentiation of pluripotent and committed HSC and which seems to have a preferential role in mast cell regulation. PMID- 3541966 TI - Gut mucosal mast cells: origin, traffic and differentiation in mice and rats. PMID- 3541967 TI - Histamine-producing cell-stimulating factor (HCSF) and interleukin-3 (IL3). PMID- 3541968 TI - Gut mucosal mast cells and goblet cells during acute graft-versus-host disease in rats. AB - Intestinal inflammation occurs in both nematode infections and graft-versus-host disease (GVHD). In nematode infections, this involves the proliferation of mucosal mast cells (MMC) and goblet cells (GC). To examine MMC and GC responses in GVHD, female Lewis rats were given allogeneic bone marrow (BM). Each animal received 1,020 rads and, one day later, 6 X 10(7) ACI BM cells plus 2 X 10(7) ACI spleen cells i.v. Control rats received 6 X 10(7) BM cells. On days 4, 8, 12, 16 and 20 post-transplant, rats were sacrificed and their intestines removed and prepared for histological examination of MMC and GC. Cells in 10 villus-crypt units (VCU) of the gut were counted for each animal. Skin and tongue were also removed and examined to determine the degree of GVHD. GVHD was first evident on day 8 in allogeneic BM recipients and progressed thereafter. No evidence of GVHD was seen in syngeneic BM recipients. Rats receiving allogeneic BM showed a 10 fold increase from day 12 to day 20 (p less than 0.01). Rats receiving syngeneic BM showed no significant change in MMC through the 20th day. In animals with GVHD, GC decreased by day 12 and remained lower than control animals during the subsequent 8 days. It was concluded that, similar to nematode infection, MMC proliferation is a feature of GVHD. In contrast, GC do not appear to proliferate in an acute GVHD. PMID- 3541969 TI - Mast cells and tumour growth. PMID- 3541970 TI - Inflammatory cell subpopulations in chronic otitis media. The Langerhans' cells. AB - Langerhans' cells (LCs) were studied in chronic otitis media by the immunoperoxidase technique and monoclonal antibodies. The LCs were a regular finding in ear canal skin, Shrapnell's membrane, thin and thick cholesteatoma epithelium, and open cavity skin; OKT6-positive cells were also found in smaller numbers in subepithelial connective tissue and lymphoid follicles, and in cuboidal secretory epithelium. The HLA-DR antibodies are less suitable for identification of LCs because many lymphoid cells express this antigen. Langerhans' cells form an important part of the immune defense system of the skin, which lacks the humoral secretory IgA defense mechanism of the mucous membranes. There is no proof that LCs are connected with the keratinization process and the possible reformation of cholesteatoma. PMID- 3541971 TI - Intermediate filament expression in human fetal olfactory epithelium. AB - Antibodies to intermediate filaments and to desmoplakin were used to investigate the histogenetic origin of the olfactory neuroepithelium. Intermediate-filaments are tissue-specific molecular cytoskeletal markers; desmoplakin is the major desmosomal protein. The olfactory epithelia of eight human fetuses, aged 7 to 10 weeks (fertilization age) were immunofluorescently labeled with antibodies to the five classes of intermediate-filament proteins and to desmoplakin. Positive immunoreactivity to keratin and to desmoplakin was observed; both results indicate the epithelial nature of this tissue. The absence of neurofilaments and glial-fibrillary acidic protein in the tissue containing sensory neurons and gliallike supporting cells is a unique feature, and may be related to the fact that olfactory neuroepithelium, like other epithelia, undergoes continuous turnover. PMID- 3541972 TI - Induction chemotherapy in advanced head and neck cancer. A Radiation Therapy Oncology Group Study. AB - Cisplatin (cis-platinum, 100 mg/m2) and fluorouracil (1000 mg/m2/d), for 120 hours' infusion every three weeks for three courses, produced a 93% overall response rate and a 54% complete clinical response at the single-institution level. The same combination was tested in the Radiation Therapy Oncology Group to evaluate the effectiveness and feasibility of this combination. An overall response rate of 86% was obtained, with a 38% complete clinical response. Only 27 of 42 patients completed planned surgery. Compliance with chemotherapy and radiation therapy was substantially better. No additional morbidity after surgical resection or postoperative radiation therapy was identified as secondary to the induction chemotherapy. We conclude that the combination of cisplatin and fluorouracil infusion is effective, with high complete clinical response rate in patients with advanced, previously untreated head and neck carcinoma. PMID- 3541973 TI - Evidence for a defective thiol protease inhibitor in skeletal muscle of mice with hereditary muscular dystrophy. AB - The thiol protease inhibitor (TPI-d) from hind-limb skeletal muscle of dystrophic 60-day-old male mice (strain 129/ReJ/dy) has been purified to apparent homogeneity and compared with the thiol protease inhibitor (TPI-n) from hind-limb skeletal muscle of normal 60-day-old male littermates. While both TPI-d and TPI-n displayed identical properties on sodium dodecyl sulfate-polyacrylamide gels (14,800 relative mass), analytical isoelectric focusing gels (pI 4.5), and high performance liquid chromatography columns, TPI-d was unable to inhibit papain and cathepsin B after purification by isoelectric focusing. However, a component in the purified TPI-d preparation with an isoelectric point of 4.9 initially masked the functional state of TPI-d, using papain when assayed with the test proteases papain and cathepsins H and L. This inhibitory component was absent from TPI-n preparations. Pure TPI-d was also unable to inhibit in vitro myosin hydrolysis by cathepsin B, whereas TPI-n completely blocked cathepsin B catalyzed myosin hydrolysis. Given the central role of the thiol proteases, especially cathepsin B, in intracellular protein metabolism and the possibility that uncontrolled thiol protease activity in muscle leads to muscle protein breakdown and dystrophy, our data suggest that a modified (defective) thiol protease inhibitor (TPI-d) may be (one of) the end product(s) of the dystrophy gene in mice with the hereditary form of the disease. PMID- 3541974 TI - Two satisfactory methods for purification of human acrosin. AB - Acrosin has been purified from human sperm cells by two alternative procedures which give purer products and in higher yields than could be achieved previously. The products were characterized by their molecular weight, catalytic action, sensitivity to inhibitors, and reaction with a polyclonal anti-acrosin antibody. After acid extraction of the cells, one method involves removal of acrosin inhibitors by vacuum dialysis, followed by affinity chromatography on a soybean trypsin inhibitor (SBTI) column, and therefore requires that the acrosin be in an active form capable of binding to the inhibitor. The other method involves affinity chromatography on a column of a monoclonal anti-acrosin antibody (MAb) and can be used to provide either active or proenzyme forms of acrosin, by choice of extraction conditions and inclusion of appropriate inhibitors. The yield of human acrosin from the SBTI method was 104% and from the MAb column was 75%. It is hoped that these procedures will make the very scarce human acrosin more readily available for further study. PMID- 3541975 TI - Yeast enolase carboxyl modification using Woodward's reagent K. AB - Yeast enolase is inactivated by Woodward's reagent K. Substantial protection is afforded by binding of 1 mol of "conformational" metal ion/subunit. Inactivation is correlated with modification of 13 carboxyl groups/subunit in the absence of conformational metal ion and 17 in its presence. Ten tryptic peptides labeled by Woodward's reagent K can be isolated, mostly from the C-terminal half of the protein. The changes in reactivity of these peptides produced by conformational metal ion suggest direct coordination to Glu-181 together with a contraction of the protein. PMID- 3541976 TI - Colocalization of sulfogalactosylacylalkylglycerol (SGG) and its binding protein during spermatogenesis and sperm maturation. Topology of SGG defines a new testicular germ cell membrane domain. AB - By use of double-labelling indirect immunofluorescence, we have shown that the major mammalian testicular glycolipid sulfogalactosylacylalkylglycerol (SGG) and a membrane protein, previously shown to bind specifically to SGG in vitro, are colocalized on the surface of rat testicular germ cells during spermatogenesis. SGG is restricted to convoluted membrane domains within these cells. Thus, the binding affinity in vitro is reflected in the cell surface topology. The topological relationship between these two antigens was also studied during epididymal sperm maturation. Whereas these antigens were colocalized in caput spermatozoa (on the middle and principal piece of the tail and on the concave surface of the head), the distribution of the binding protein was altered for cauda sperm in that the convex surface of the sperm head was now strongly labelled. These studies illustrate the dynamic nature of protein-glycolipid interactions during germ cell differentiation. PMID- 3541977 TI - [Effect of captopril on glucose metabolism in hypertensive subjects with type II diabetes mellitus]. PMID- 3541978 TI - Corneal graft survival: a retrospective Australian study. AB - Four hundred and forty-eight consecutive corneal grafts are analysed and their survival calculated using the actuarial life-table method. Overall survival at two years is 81 +/- 4% and at five years is 65 +/- 5%. Within diagnostic subgroups keratoconus has the best prognosis. Previous graft failure and recipient corneal vascularization are shown to have a negative effect on graft survival. Sex of patient, urgency of operation and use of combined procedures do not affect survival and second regrafts fare no worse than first regrafts. The use of the actuarial life-table method of analysing graft survival is discussed and its importance emphasized. PMID- 3541979 TI - Adjustable sutures in strabismus surgery: a personal series of cases. AB - A personal series of 77 separate primary adjustable suture procedures performed on 69 patients is analysed. Adjustable suture surgery was performed on patients over ten years of age undergoing rectus muscle surgery, and a few selected younger patients. The ages ranged from 7 to 74 years. A 24-month-old infant who had a two-stage-anaesthesia is included in the series. Thirty-eight of the 69 patients were reoperations. Of the 77 primary procedures, 48 (62.3%) required postoperative adjustment; 29 (37.7%) were tied down without adjustment. Sixty-two of the 69 patients (89.8%) achieved a "cure". A further four patients (5.8%) were initially in desired alignment, but deteriorated within the follow-up period. Three of these were successfully reoperated. Of the three primary failures (4.4%) two were reoperated with one achieving orthophoria. Apart from alignment failure in the primary procedure, complications were minimal. Current follow-up periods range from one to 24 months. PMID- 3541980 TI - Dermis-fat graft: evolution of a living prosthesis. AB - Over the past two years 15 dermis-fat grafts were performed. Ten were primary grafts, two were implanted because of migrated implants, two for extruding implants and one to correct deep superior sulcus recession. Our experience showed dermis-fat grafts to be an effective method of correcting orbital volume deficit, of maintaining satisfactory prosthetic motility and of preventing the development of conjunctival deficiency. In primary dermis-fat grafts fat atrophy was less than 10%, whilst in secondary implants fat atrophy was less than 30%. Complications were minimal in our small series. PMID- 3541981 TI - The Ophthalmological Society of New Zealand 39th scientific conference, 1985. The beginning of The Chase: the embryological career of Ida Mann. PMID- 3541982 TI - Kinetic comparisons of amniotic fluid inactive renin and renal renin using synthetic and human renin substrates. AB - Inactive renin has been isolated from pooled amniotic fluid and purified approximately 642-fold. Prior to activation the isolates had approximately 4% of the activity found after activation. The observation is similar to that reported for inactive renin from chorionic cell culture and suggests a placental origin of amniotic fluid inactive renin. Using plasma from an estrogen-treated woman, renin substrate was recovered free of renin and inactive renin and a portion was separated into NMW and HMW components. The NMW form constituted approximately 93% and the HMW form approximately 7% of the renin substrate. Amniotic fluid inactive renin was used for determinations of enzyme-substrate kinetics with the pooled, NMW, and HMW plasma substrate and tetradecapeptide synthetic substrate, and the results were compared to similar determinations using standard renal renin. Using synthetic substrate, the kinetics of renal renin and amniotic fluid inactive renin before and after activation were similar. The kinetics of renal renin with pooled, NMW, and HMW plasma substrate were also similar. Amniotic fluid inactive renin had a lower Km with pooled than with NMW substrate, however, which resulted from a significantly smaller Km with HMW component. Although the affinity constants with pooled substrate were not different for renin and inactive renin, the Km of inactive renin was significantly less with the HMW component of plasma renin substrate. The observations are compatible with a role for placental inactive renin in normal pregnancy and suggest the possibility of a further role in hypertensive pregnancy. PMID- 3541983 TI - [Ultrasonographic study of the organization of sucking and swallowing functions in infants: emphasis on the evaluation of M-mode]. PMID- 3541984 TI - Insulin replacement: current concepts. PMID- 3541985 TI - Coagulation problems in artificial organs. PMID- 3541986 TI - Morphological and histochemical events during first bone formation in embryonic chick limbs. AB - Staged embryos from White Leghorn chicken eggs were used to assemble a detailed morphological, cellular and molecular picture of the complex events of first-bone formation. To provide these details, light and electron microscopic, histochemical and immunocytochemical techniques were used to establish a temporal sequence for long bone development in chick wing and leg from Hamburger-Hamilton stage 29 through stage 35. Three distinctive cell regions can be morphologically identified by stage 28 (leg) or 29 (wing) at the mid-diaphysis. These regions are: 1. an outer grouping of loose mesenchymal and myogenic cells, 2. an osteoprogenitor layer which will later divide to maintain this progenitor layer in a brickwork or stacked configuration and to produce round, tightly packed osteoblasts, and 3. a core (rod) of cartilage. First bone is laid down just outside the cartilage core, initially as a layer of Type I collagen-rich osteoid which later becomes mineralized. Vascular elements then come to reside above this mineral layer, and osteoid is laid down between vascular elements and eventually above them to form a second layer of trabecular bone. As this radial formation of layers of bone is progressing, so too is the proximal and distal expansion of the first bone forming process. A model is presented which considers that chondrogenic and osteogenic cell commitment occur simultaneously in early limb development and that it is the expression of the osteogenic phenotype which governs the boundaries of cartilage development. Importantly, the vasculature plays a key role in the patterning of bone formation well before it enters the cartilaginous core at stage 35 and participates in the erosion of the core. While this report is restricted to events occurring through stage 35, it relies on data presented in a companion report detailing later bone development and remodeling (Pechak et al; Bone 1986) and emphasizes that the cartilage model does not provide the scaffolding for bone but rather defines the marrow space. PMID- 3541987 TI - Bone particles from osteopetrotic mice not cured by bone marrow transplants are resorbed in normal littermates. AB - Osteosclerotic (oc/oc) and osteopetrotic (op/op) mice are not cured by bone marrow transplantation from normal littermates. The possibility that this is due to production of poorly resorbable bone was examined by comparing the fate of mutant and normal bone particles implanted subcutaneously in normal hosts. Bone, removed aseptically from calvarial and tibial sites of normal littermates and mutants, was cleaned of adherent soft tissue, ground and sieved to a particle size of 70-300 micron. Aliquots (17-20 mg) of bone from each phenotype of each stock were pelleted and implanted beneath the anterior thoracic skin of normal littermates for two weeks. Particle density in tissue sections was determined as percent of field by a point-counting method. Giant cell response was recorded as number per high-power field. Percent bone present initially was determined in pellets implanted for less than 24 hr. Bone particles were reduced in each pellet with time, about 25% of the original volume being removed in two weeks. No statistically significant differences were noted in the rates of disappearance of mutant and normal bone or in the percentage or number of giant cells in implants of mutant and normal bone in either stock. Furthermore, these values were not different from identical studies in microphthalmic mice, an osteopetrotic stock cured by bone marrow transplantation. These data suggest that the failure of osteopetrotic and osteosclerotic mice to be cured by bone marrow transplants from normal littermates is not due to the presence of unresorbable bone. PMID- 3541988 TI - The potential clinical consequences of the new dentine-bonding resins. PMID- 3541990 TI - 'Debetur Providentiae securitas': armorial bearings for the DPS. PMID- 3541991 TI - The retention in dentine of wider pitch self-shearing dentine pins. PMID- 3541989 TI - The burning mouth sensation related to the wearing of acrylic dentures: an investigation. PMID- 3541992 TI - A three-part sectional design for an upper removable partial denture with an anterior modification. PMID- 3541993 TI - The prospects for vaccination against dental caries. PMID- 3541994 TI - Winifred Mary McKenzie 1906-1986. A tribute. PMID- 3541996 TI - British Cardiac Society--Golden Jubilee. PMID- 3541995 TI - Untreated heart failure: clinical and neuroendocrine effects of introducing diuretics. AB - The clinical and neuroendocrine response to diuretic treatment was assessed at rest and on exercise in 12 patients with heart failure. Before treatment all patients were limited by breathlessness on exercise; one was oedematous. Plasma renin activity and aldosterone were normal but plasma noradrenaline was raised both at rest and on exercise. After one month's treatment with frusemide (40 mg) and amiloride (5 mg) weight was significantly reduced by a mean of 3.5 kg and exercise capacity had doubled. Plasma noradrenaline fell to normal at rest but remained abnormally raised on exercise. Plasma renin activity and aldosterone increased significantly both at rest and on exercise. Diuretics bring about a considerable clinical improvement in patients with chronic heart failure but they stimulate the renin-angiotensin system. Activation of the renin-angiotensin system in moderate heart failure occurs as a response to diuretic treatment rather than as a result of the disease process itself. PMID- 3541998 TI - New life, new hope. PMID- 3541997 TI - Fever after acute myocardial infarction in patients treated with intravenous timolol or placebo. AB - Body temperature was studied in 65 patients admitted to hospital within four hours of the onset of symptoms of acute myocardial infarction. Thirty three patients had been randomly assigned to intravenous timolol treatment and 32 to placebo treatment. Infarct evolution was assessed by continuous vectorcardiography and creatine kinase release. Maximum and mean temperatures during the first eight days were significantly lower in the timolol group, who were discharged from hospital one day earlier. Eight patients in the placebo group had temperatures of greater than 39 degrees compared with one in the timolol group. Both the mean temperature and the maximum temperature correlated significantly with indices of infarct size and ischaemic area as estimated by cumulative creatine kinase release, QRS vector difference, and ST vector magnitude. The results were consistent with the view that reduction of infarct size may partly explain the reduced pyrexial response after timolol treatment. Other mechanisms are probably also involved in larger infarcts. Because high fever has detrimental haemodynamic effects in acute myocardial infarction, reduction of this response may be beneficial. The results support the early use of beta adrenoceptor blockade in acute myocardial infarction. PMID- 3541999 TI - Cost effective patient care--by using a library? PMID- 3542000 TI - What's happening in history. PMID- 3542001 TI - A study of the effect of cadexomer iodine in the treatment of venous leg ulcers. PMID- 3542002 TI - Multiple sclerosis and MaxEPA. PMID- 3542003 TI - A controlled trial of danazol in the treatment of multiple recurrent breast cysts. PMID- 3542004 TI - A double-blind, endoscopically assessed evaluation of a bismuth subnitrate preparation (Roter) and cimetidine in the treatment of duodenal ulcer. PMID- 3542005 TI - Magnetic microspheres and monoclonal antibodies for the depletion of neuroblastoma cells from bone marrow: experiences, improvements and observations. AB - Improvements to the original procedure of using a panel of monoclonal antibodies and magnetic microspheres for the depletion of tumour cells from bone marrow are described. These include a completely disposable system for the magnetic depletion of tumour cells coated with magnetic microspheres. Properties of a new series of microspheres are compared with the old M330 beads in their ability to deplete neuroblasts from both model systems and 50 bone marrows harvested from Stage IV neuroblastoma patients. Using human neuroblastoma cell lines labelled with the DNA intercalating, Hoechst dye 33342 a 5% tumour contamination can routinely be removed from 5 X 10(6) - 5 X 10(7) nucleated cells. Analysis of the 50 purged marrows revealed that 10 were visibly contaminated with tumour (by conventional cytology and immunological procedures). In all but one case, tumour cells were removed. In this instance the tumour:bead ratio fell to 1:4 indicating the importance of maintaining a sufficient number of beads in the system. Red cell contamination of marrow was also kept extremely low so preventing possible physical blockade of bead:tumour cell interaction. Marrow engraftment was rapid in this group, apart from patients who had been exposed to high doses of alkylating agents prior to autografting. PMID- 3542008 TI - Production of a neutrophil chemotactic factor by endotoxin stimulated alveolar macrophages in vitro. AB - Alveolar macrophages (AM) isolated from normal guinea-pigs and from those chronically exposed to endotoxin (LPS) were cultured in the presence of various concentrations of LPS (from 0.5 ng to 5 micrograms/ml). The presence of a neutrophil chemotactic factor (NCF) in culture supernatants was tested in migrations chambers. Contamination of all reagents has been tested using LAL test (Limulus Amoebocyte Lysate). The results indicate a production of NCF with low LPS concentrations (0.5 and 5 ng/ml) within the first 6 h of incubation: when larger doses are used the response decreases and a significant inhibition is observed with 5 micrograms LPS/ml (P less than or equal to 0.05). When contaminated medium was used, all responses observed were three times higher than with LPS-free medium (P less than or equal to 0.01). However, the response pattern was the same. AM from chronically exposed animals exhibit the same response patterns: the magnitude of NCF production was higher than with normal AM but not significantly. The data suggests that initial conditions of AM in vitro or in vivo with reference to LPS contamination have to be determined as they are of importance when AM NCF production has to be tested. PMID- 3542006 TI - Radioimmunotherapy of malignancy using antibody targeted radionuclides. AB - Antibodies directed against tumour associated antigens provide a means for delivering preferentially cytotoxic radionuclides to the cells of primary and secondary tumours. The factors that influence the effectiveness of the radiation in the tumour compared with its effect on the radiosensitive normal tissues include the specificity of the antibody, the distribution of targeted energy within the tumour and the host's response to the injected foreign antibody. Recently some encouraging results from clinical trials of radioimmunotherapy have been reported in the literature. There is a continual search for more avid and specific antibodies, and the techniques of genetic engineering are being applied to the problem of reducing the antigenicity and mass of the carrier antibody. The improved efficiency of the labelled antibody needs to be supplemented by an identification of those tumours most likely to respond to this form of therapy. PMID- 3542007 TI - Evaluation of a monoclonal antibody to ras peptide, RAP-5, claimed to bind preferentially to cells of infiltrating carcinomas. AB - RAP-5, a monoclonal antibody raised against a p21ras peptide, has been claimed to show immunohistochemical localisation of cells with infiltrative properties in human tumours. We confirmed that this antibody reveals pronounced cellular heterogeneity in human colonic neoplasms but could find no obvious relationship to infiltrative activity. RAP-5 bound to many different cell types, neoplastic and normal. In order to clarify the specificities of RAP-5 we applied it to two cell lines: nontumorigenic hamster fibroblasts in which ras expression is barely detectable, and a vigorously tumorigenic line derived from these fibroblasts by insertion of the human mutated Ha-ras oncogene in a high expression vector. Another antibody to p21ras, Y13-259, clearly distinguished between these cell lines both on immunoblots and immunocytochemically, but RAP-5 did not. Rather, it bound to proteins of a variety of molecular weights in both cell lines. The results show that RAP-5 is unlikely to be a useful reagent for detection of ras associated proteins in human tissues. PMID- 3542009 TI - Passive Heymann nephritis in pre- and post-natal rats. AB - Passive Heymann nephritis (PHN) was induced in pre- and post-natal rats by a single intra-peritoneal injection of 0.2 ml of a rabbit anti-rat kidney fraction 3 (rKF3) antibody. Immune complex formation occurred only in those glomeruli or parts of glomeruli which were open to the circulation. Double staining of kidney sections for the glomerular nephritogenic antigen and rabbit IgG, 2 days after the injection of the antibody showed an identical distribution of both components in the glomeruli. In rats killed more than 4 days after the injection of the anti rKF3 antibody, the nephritogenic antigen could be demonstrated in the subcapsular glomeruli, in the absence of rabbit IgG; and the same applied when the kidneys had reached maturity. When the injected antibody was expected to be present in the circulation, no nephritogenic antigen was demonstrated in the glomeruli in the absence of the heterologous IgG. These observations indicate that the nephritogenic antigen appears in the glomerulus at the same time as the glomerular capillary loops open to the circulation. Unlike PHN in the adult rat, the immune complexes in the glomeruli of neonatal rats do not persist longer than 84 days. PMID- 3542010 TI - Cyclosporin A treatment of severe psoriasis. PMID- 3542011 TI - Alpha interferons in B-cell neoplasms. PMID- 3542012 TI - Ultrasonic demonstration of clinical and subclinical hepatic venous thrombosis in paroxysmal nocturnal haemoglobinuria. AB - Extensive hepatic venous thrombosis was demonstrated by ultrasonic scanning in three patients with paroxysmal nocturnal haemoglobinuria (PNH). The ultrasonography results were confirmed by X-ray venography. Two of these patients were without clinical symptoms of hepatic involvement apart from a slight increase in transaminases. This study indicates, firstly, that ultrasonic scanning is a rapid and reliable diagnostic tool in monitoring patients for this serious and often fatal complication, and, secondly, that hepatic venous thrombosis may be a more common complication in PNH than previously assumed. PMID- 3542013 TI - Proposed serum standard for human serum vitamin B12 assay. International Committee for Standardization in Haematology (ICSH). PMID- 3542015 TI - Ultrasonography for early detection of ovarian carcinoma. AB - Ultrasound scan for detection of ovarian enlargements was performed in a target group of out-patients attending the clinic for various reasons in the 40-70 years range. Overall 805 women were examined, in 99% of whom the ovaries and/or their vessels could be identified. Pathological findings were suspected in 83 patients at the first scan, and were confirmed in 50 after a repeat scan, 39 of whom subsequently underwent surgery. Various ovarian lesions were found in 35 women, including five mucinous and serous cystadenomas, one carcinoma, two borderline tumours, and a cancer of the caecum. None of the borderline or malignant ovarian lesions were found by manual pelvic examination. Ultrasound screening appears to be a useful diagnostic aid, though its usefulness might be further improved if other risk factors such as heredity and period of ovulatory activity are taken into consideration. PMID- 3542014 TI - The predictive value of fetal breathing movements in the outcome of premature labour. AB - Fetal breathing movements (FBM) were assessed in 28 pregnant women, presenting with uterine contractions before 34 weeks gestation. External tocometry was used to determine uterine contractions objectively. The first group consisted of 17 patients, treated by tocolytics after the ultrasound scanning showed absence of FBM. The second group comprised 11 patients with FBM present, who were observed only. In the first group nine women were delivered within 1 week, whereas in the second group no patient was delivered in that period, all of them being discharged. In patients with premature contractions the presence of FBM seems to indicate that the pregnancy will continue while absence of FBM foreshadows early delivery. PMID- 3542016 TI - Desmoplastic malignant melanoma masquerading as chalazion. AB - Desmoplastic malignant melanoma is a rare and highly malignant tumour, which usually occurs in the head and neck. This is demonstrated by a case history of a patient with this lesion on the lower lid, which has not been previously described in the British ophthalmological literature. The lesion often presents considerable problems of histological diagnosis. PMID- 3542017 TI - 1H NMR studies on bovine cyclophilin: preliminary structural characterization of this specific cyclosporin A binding protein. AB - High-field 1H NMR spectroscopy has been used to study the conformation of the cytosolic cyclosporin A binding protein cyclophilin. For the drug-free form of cyclophilin, spectral editing methods in conjunction with a pH titration were used to identify all four His residues present in the protein, and two dimensional COSY and RELAY spectroscopy was used to elucidate the scalar connectivities in the aromatic and upfield methyl regions of the spectrum. From these scalar connectivities, it was possible to distinguish between inter- and intraresidue dipolar interactions within the aromatic and upfield methyl regions of cyclophilin in the NOESY spectrum. The results of this analysis showed extensive interresidue cross-relaxation among and between these latter spectral regions indicative of the proximal relationships of several of these residues and the presence of a hydrophobic core within cyclophilin. PMID- 3542018 TI - Relationship between cytostatic activity of oxazolopyridocarbazoles and accessibility of DNA intercalation sites in living bacteria. AB - The ability of oxazolopyridocarbazole (OPC) derivatives to interact with DNA in living bacteria through reversible intercalation has been determined by using as probes their selective mutagenic effect on Salmonella typhimurium TA 1977 and TA 1537 as detected by frame-shift-1 reversion, the absence of intervention of the error-prone repair system on the mutagenic efficiency, the absence of induction of the SOS functions, and the absence of effect of recA and uvrB mutations on their bacteriostatic properties. Involvement of simple reversible intercalation as the event responsible for the bacteriostatic effect of the drugs has been further investigated by the establishment of a significant correlation between the maximum number of accessible intercalating sites in living bacteria and the bacteriostatic effect expressed in terms of the ED50. This correlation has been established by using bacteria spontaneously exhibiting different sensitivities toward the drugs as well as a resistant strain obtained by adaptation in the presence of increasing amounts of isopropyl-OPC. The number of intercalating sites in living bacteria was determined by using the change in the fluorescence properties of the drugs upon binding to intercalating sites. The results obtained clearly demonstrate that the number of intercalating sites is the parameter that controls the bacteriostatic effect of the drugs, indicating that DNA is the target for these drugs and that reversible intercalation is responsible for the cytostatic effect. PMID- 3542019 TI - Comparison of aspartate transcarbamoylases from wheat germ and Escherichia coli: functionally identical histidines in nonhomologous local sequences. AB - Aspartate transcarbamoylase (ATCase) from wheat germ and the catalytic subunit of the enzyme from Escherichia coli are trimers of similar size. The former is a regulatory enzyme in its trimeric state, while the latter is a component of a complex regulatory dodecamer. In a comparison of the two enzymes, reaction with diethyl pyrocarbonate revealed a highly active, essential histidine residue in each case. The two histidines (i.e., one in each enzyme) behaved nearly identically with respect to the following functional properties: kinetics of acylation (ethoxyformylation) and concomitant inactivation; kinetics of deacylation by hydroxylamine and concomitant reactivation; hyperbolic dependence of the apparent first-order rate constant (kapp) on diethyl pyrocarbonate concentration; pH dependence of kapp; failure of active-center ligands to protect the residue against diethyl pyrocarbonate, producing instead near-identical increases in the inactivation rate. These similarities point to an essential, highly conserved histidine in each enzyme, in a functional microenvironment that has changed relatively little since the divergence of plants and bacteria. Ethoxyformylated peptides were isolated from tryptic digests of the two inactivated enzymes. Sequencing of the major labeled peptide in each case showed the wheat and E. coli histidines embedded in nonhomologous primary segments, suggesting that, contrary to expectation, these segments are not part of the conserved microenvironment. In the case of the E. coli enzyme, the essential residue was identified as His-134 in the known sequence, which has a potential catalytic role on crystallographic evidence [Krause, K. L., Volz, K. W., & Lipscomb, W. N. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 1643-1647]. A second, much less reactive histidine was identified as His-64.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542020 TI - Chemical modification of tryptophan residues in Escherichia coli succinyl-CoA synthetase. Effect on structure and enzyme activity. AB - Succinyl-CoA synthetase of Escherichia coli is an alpha 2 beta 2 protein containing active sites at the interfaces between alpha- and beta-subunits. The alpha-subunit contains a histidine residue that is phosphorylated during the reaction. The beta-subunit binds coenzyme A and probably succinate [see Nishimura, J. S. (1986) Adv. Enzymol. Relat. Areas Mol. Biol. 58, 141-172]. Chemical modification studies have been conducted in order to more clearly define functions of each subunit. Tryptophan residues of the enzyme were modified by treatment with N-bromosuccinimide at pH 7. There was a linear relationship between loss of enzyme activity and tryptophan modified. At one tryptophan residue modified per beta-subunit, 100% of the enzyme activity was lost. In this enzyme sample, one methionine residue in each alpha- and beta-subunit was oxidized to methionine sulfoxide, although loss of enzyme activity could not be related in a linear manner to the formation of this residue. Subunits were prepared from enzyme that was inactivated 50% by N-bromosuccinimide with 0.5 tryptophan modified per beta-subunit but with insignificant modification of methionine residues in either subunit. Small decreases in the tyrosine and histidine content were observed in the alpha-subunit but not in the beta-subunit. In this case, modified beta-subunit when mixed with unmodified alpha-subunit gave a population of molecules that was 50% as active as the refolded, unmodified control but was only slightly changed with respect to phosphorylation capacity and unchanged with respect to rate of phosphorylation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542021 TI - Bacterial organomercurial lyase: overproduction, isolation, and characterization. AB - Organomercurial lyase mediates the first of two steps in the microbial detoxification of organomercurial salts. This enzyme encoded on the plasmid R831 obtained from Escherichia coli J53-1 has been overproduced to the level of 3% of the soluble cell protein in E. coli by a construction using the T7 promoter. The enzyme has been purified to homogeneity in quantity in three steps. It is a monomer of Mr 22,400 with no detectable cofactors or metal ions. It catalyzes the protonolysis of the C-Hg bond in a wide range of organomercurial salts (primary, secondary, tertiary, alkyl, vinyl, allyl, and aryl) to the hydrocarbon and mercuric ion with turnover rates in the range of 1-240 min-1. PMID- 3542022 TI - Mechanistic studies of a protonolytic organomercurial cleaving enzyme: bacterial organomercurial lyase. AB - Mechanistic studies of the protonolytic carbon-mercury bond cleavage by organomercurial lyase from Escherichia coli (R831) suggest that the reaction proceeds via an SE2 pathway. Studies with stereochemically defined substrates cis 2-butenyl-2-mercuric chloride (1) and endo-norbornyl-2-mercuric bromide (2) reveal that a high degree of configurational retention occurs during the bond cleavage, while studies with exo-3-acetoxynortricyclyl-5-mercuric bromide (3) and cis-exo-2-acetoxy-bicyclo[2.2.1]hept-5-enyl-3-mercuric bromide (4) show that the protonolysis proceeds without accompanying skeletal rearrangement. Kinetic data for the enzymatic reactions of cis-2-butenyl-2-mercuric chloride (1) and trans-1 propenyl-1-mercuric chloride (6) indicate that these substrates show enhanced reaction rates of ca. 10-200-fold over alkylvinylmercurials and unsubstituted vinylmercurials, suggesting that the olefinic methyl substituent may stabilize an intermediate bearing some positive charge. Enzymatic reaction of 2-butenyl-1 mercuric bromide (5) yields a 72/23/5 mixture of 1-butene/trans-2-butene/cis-2 butene, indicative of intervening SE2' cleavage. The observation of significant solvent deuterium isotope effects at pH 7.4 of Vmax (H2O)/Vmax(D2O) = 2.1 for cis 2-butenyl-2-mercuric chloride (1) turnover and Vmax(H2O)/Vmax(D2O) = 4.9 for ethylmercuric chloride turnover provides additional support for a kinetically important proton delivery. Finally, the stoichiometric formation of butene and Hg(II) from 1 and methane and Hg(II) from methylmercuric chloride eliminates the possibility of an SN1 solvolytic mechanism. As the first well-characterized enzymatic reaction of an organometallic substrate and the first example of an enzyme-mediated SE2 reaction the organomercurial lyase catalyzed carbon-mercury bond cleavage provides an arena for investigating novel enzyme structure-function relationships. PMID- 3542024 TI - Isotope exchange at equilibrium studies with rat muscle adenylosuccinate synthetase. AB - The kinetic mechanism of rat muscle adenylosuccinate synthetase was studied by determining the rates of isotope exchange at equilibrium. A random sequential binding mechanism was indicated for both the forward and reverse reactions. Aspartate, adenylosuccinate, GDP, and Pi were determined to bind in rapid equilibrium. GTP exchanges with both GDP and Pi at the same rate, which is similar to the exchange rate of IMP with adenylosuccinate. Aspartate exchanges with adenylosuccinate at a higher rate than does IMP over the range of concentrations tested. The slower IMP and GTP exchange rates suggest a forward binding mechanism containing a preferred path in which the quaternary complex is most often formed by aspartate binding to the E-GTP-IMP complex. This preferred path is consistent with an interaction between IMP and GTP in the absence of aspartate as determined by isotope scrambling experiments [Bass, M. B., Fromm, H. J., & Rudolph, F. B. (1984) J. Biol. Chem. 259, 12330-12333]. However, the products of such an interaction are tightly bound to the enzyme as no partial exchange reactions between adenylosuccinate and aspartate in the presence or absence of Pi were detected. PMID- 3542025 TI - Permeable membrane/mass spectrometric measurement of solvent 1H/2H, 12C/13C, and 16O/18O kinetic isotope effects associated with alpha-chymotrypsin deacylation: evidence for reaction mechanism plasticity. AB - We have measured, by permeable membrane/mass spectrometry, the 16O/18O, 12C/13C, and solvent H2O/D2O kinetic isotope effects (kie) associated with acyl-alpha chymotrypsin hydrolysis and transesterification. The hydrolysis of alpha chymotrypsinyl 2-furoate has a 12C/13C kie of approximately 1.06. Transesterification of the same acyl enzyme shows 16O/18O, 12C/13C, and solvent H2O/D2O kinetic isotope effects of 1.015 (0.003), 1.01-1.02, and 2.226 (0.007), respectively. From the temperature independence of the 16O/18O transesterification kinetic isotope effect and kinetic data reported elsewhere [Wang, C.-L. A., Calvo, K. C., & Klapper, M. H. (1981) Biochemistry 20, 1401 1408], we conclude that there are two active forms of acylchymotrypsin. We also propose that formation of the tetrahedral intermediate is the rate-limiting step in both hydrolysis and transesterification and that the position of the transition state in the transesterification is closer to the starting enzyme ester while that for the hydrolytic reaction is closer to the tetrahedral intermediate. These results are discussed in terms of reaction mechanism plasticity. PMID- 3542023 TI - Nuclear magnetic resonance study of the state of protonation of inhibitors bound to mutant dihydrofolate reductase lacking the active-site carboxyl. AB - 13C nuclear magnetic resonance spectra have been obtained for complexes of [2 13C]methotrexate and [2-13C]trimethoprim with wild-type dihydrofolate reductase (DHFR) from Escherichia coli and with two mutant enzymes in which aspartic acid 27 is replaced by asparagine and by serine, respectively. In both the wild-type and mutated enzymes, exchange between the free inhibitor and the enzyme-complexed inhibitor is slow on the NMR time scale; hence, despite the considerably increased dissociation constants for binary complexes with the enzymes, the dissociation rate remains small relative to the frequency separation of the resonances. In all cases but one, the pKa of an inhibitor that is complexed to enzyme differs greatly from that of the free inhibitor. However, while the pKa of both inhibitors in complexes with the wild-type enzyme is elevated to above 10, the pKa of the inhibitors complexed with the Asn-27 and Ser-27 enzymes is lowered to a value below 4. Exact determinations of bound pKa values are limited by the solubility of the enzyme and the dissociation constants of the complexes. The single exception to these general conclusions is the ternary complex of the Ser 27 DHFR with trimethoprim and NADPH. In this complex, both free and enzyme complexed trimethoprim exhibit similar pKa values (approximately equal to 7.6). However, both the exchange between free and enzyme-complexed inhibitor and the protonation of the enzyme-complexed inhibitor are slow in the NMR time scale, so that the spectra reveal three resonances corresponding to free inhibitor, to protonated enzyme-complexed inhibitor, and to unprotonated enzyme-complexed inhibitor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542026 TI - Effect of magnesium ion on the structure of the 5S RNA from Escherichia coli. An imino proton magnetic resonance study of the helix I, IV, and V regions of the molecule. AB - The imino proton nuclear magnetic resonance spectrum of Escherichia coli 5S ribonucleic acid (RNA) changes when the Mg2+ ion concentration drops below physiological levels. The transition between the physiological and low magnesium spectral forms of 5S RNA has a midpoint at approximately 0.3 mM Mg2+. Many of the most conspicuous changes observed in the downfield spectrum of 5S RNA as the magnesium concentration is reduced are due to adjustments in the structures of helices I and IV and the disappearance of resonances originating in helix V. The binding of ribosomal protein L25 to 5S RNA in the absence of magnesium stabilizes helix V structures. PMID- 3542027 TI - Incorporation of a synthetic mitochondrial signal peptide into charged and uncharged phospholipid monolayers. AB - The interaction of the chemically synthesized 25-residue signal peptide of subunit IV of yeast cytochrome c oxidase with synthetic and natural phospholipids was studied by using a monolayer technique. Incorporation of the peptide into phospholipid monolayers was measured as surface area increase at constant surface pressure. The peptide was readily soluble in aqueous buffer, yet spontaneously inserted from an aqueous subphase into phospholipid monolayers up to limiting pressures of 30-40 mN/m. The incorporation of the positively charged peptide was strongly enhanced by the presence of negatively charged phospholipids. The molecular area of the signal peptide in monolayers was determined with a 14C labeled signal peptide and was 560 +/- 170 A2. This is consistent with a 25 residue alpha-helical peptide incorporating with its long axis parallel to the plane of the monolayer. Incorporation isotherms into synthetic phosphatidylcholine and phosphatidylglycerol monolayers at different charge densities were analyzed in terms of a simple incorporation/binding model, involving partitioning of the peptide into the monolayer and an in-plane binding reaction of the negatively charged phospholipids to the partitioned peptide. PMID- 3542028 TI - Uniform preparations of large unilamellar vesicles containing anionic lipids. AB - A general procedure for the preparation of large unilamellar vesicles of selected sizes has been developed. The procedure consists of dissolving the lipid in organic solvent, washing with mild acid, removing the solvent, adding salt (0.15 M KCl) solution, and adjusting the pH (raising it to about pH 10 and lowering it immediately to pH 7.55). The procedure takes less than 30 min. The resulting unilamellar vesicles are of a single size with a rather low standard deviation. The sizes of these preparations range between 150 and 1000 nm in diameter. Sizes and polydispersities were measured to within 1-2% by photon correlation spectroscopy. Vesicle size varies with the phospholipid structure, the composition of the phospholipid mixture, the ionic strength of the medium, the alkyl chain composition, the cholesterol content of the phospholipid mixture, and the timing of the pH adjustment procedure. Uniform preparations of vesicles have been obtained from the dioleoyl esters of phosphatidic acid, phosphatidylglycerol, phosphatidylethanolamine, and phosphatidylserine, from diphytanyl ethers of glycolipid sulfate, phosphatidylglycerol, phosphatidylglycerol phosphate, and phosphatidylglycerol sulfate, from bovine liver phosphatidylinositol, from Escherichia coli phosphatidylethanolamine, from membrane lipid extracts from E. coli and Holabacterium cutirubrum, and from dodecanesulfonate-alkanol mixtures and free oleic acid. The preparation of unilamellar vesicles from oleic acid is novel, and the size range is 600-3000 nm; the preparations are relatively uniform. Vesicles of phospholipids in which sucrose and trehalose replace salt as the impermeant do not differ significantly from those prepared in pentaerythritol. PMID- 3542029 TI - Equilibrium and kinetic measurements of the conformational transition of thioredoxin in urea. AB - Addition of urea to solutions of Escherichia coli thioredoxin results in a cooperative unfolding of the protein centered at 6.7 M urea at 25 degrees C and 5.1 M urea at 2 degrees C and neutral pH as judged by changes in tryptophan fluorescence emission, far-ultraviolet circular dichroism, and exclusion chromatography. Kinetic profiles of changes in tryptophan fluorescence emission intensity were analyzed following either manual or stopped-flow mixing to initiate unfolding or refolding. Unfolding of the native protein occurs in a single kinetic phase whose time constant is markedly dependent on urea concentration. Refolding of the urea-denatured protein occurs in a multiplicity of kinetic phases whose time constants and fractional amplitudes are also dependent upon urea concentration. Urea gradient gel electrophoretic and exclusion chromatographic measurements suggest the transient accumulation of at least one and likely two compact nativelike intermediate conformations during refolding. Simulations of both electrophoretic and chromatographic results suggest that the intermediate conformations are generated by the concerted action of the middle and fast refolding phases. PMID- 3542030 TI - Amino acid sequence of the sex steroid binding protein of human blood plasma. AB - The amino acid sequence of the sex steroid binding protein (SBP) from human plasma has been determined. The SBP subunit consists of a 373-residue polypeptide chain containing two disulfide bonds and three oligosaccharide chains. The sequence was solved primarily by analysis of peptides derived by cleavage at either lysyl or methionyl residues. In our preparations, approximately half of the protein molecules have the amino-terminal sequence Arg-Pro-Val-Leu-Pro; the other half lack Arg-Pro and begin with the valine. Preparations of Hammond et al. [Hammond, G. L., Robinson, P. A., Sugino, H., Ward, D. N., & Finne, J. (1986) J. Steroid Biochem. 24, 815] have an additional leucine at the amino terminus, making a total of 373 residues in the chain. Oligosaccharide chains are placed at Thr-7 and at Asn residues 351 and 367. The two disulfide bonds connect Cys-164 to Cys-188 and Cys-333 to Cys-361. The reported heterogeneity of preparations of the molecule may result in part from the amino-terminal microheterogeneity, in part from variations in the oligosaccharide moieties, and possibly in part from rearrangements involving cyclic imide formation in two Asn-Gly sequences. Certain hydrophobic segments are suggested as possible components of the steroid-binding sites. The protein shows no homology either with the cDNA-derived sequences of the estrogen and glucocorticoid receptors found by others to be homologous with each other or with any other protein sequence in the 1986 data base. PMID- 3542031 TI - Cross-linking of myosin subfragment 1 and heavy meromyosin by use of vanadate and a bis(adenosine 5'-triphosphate) analogue. AB - The synthesis of a divalent ATP analogue [3,3'-dithiobis[3'(2')-O-[6 (propionylamino)hexanoyl]adenosine 5'-triphosphate] (bis22ATP)] is described in which two molecules of ATP are linked via esterification of their 3'(2') hydroxyls to the linear dicarboxylic acid 3,3'-dithiobis[N-(5-carboxypentyl) propionamide] [[HO2C(CH2)5NHC(O)(CH2)2S-]2]. This linkage introduces 22 atoms (a maximum of approximately 2.8 nm) between the ribose oxygens of two ATP molecules. Myosin subfragment 1 (SF1) or heavy meromyosin (HMM) readily cleave bis22ATP to bis22ADP. Upon subsequent addition of excess vanadate ion, both enzymes are rapidly inactivated by formation of a stable vanadate-bis22ADP complex at the active site. By adjustment of the reaction conditions, dimers of SF1 or HMM, both cross-linked with bis22ADP-vanadate, could be prepared. Dimers of SF1 could be separated from monomers by sucrose gradient centrifugation but not by gel filtration. These observations imply that the average Stokes radius of the dimer approximates that of the monomer, a result predicted only for monomers linked approximately side by side. Conversely, dimers of HMM were separated from HMM monomers by gel filtration, reflecting an increase in their Stokes radii. This increase, however, prevented resolution of HMM dimers from monomers by sucrose gradient centrifugation. These results and the molecular dimensions of bis22ATP suggest that the 3'-(2')-hydroxyl of ATP is no more than 1.3 nm from the surface of myosin and suggest further in the simplest interpretation that the active site is most likely located near the middle of the heads of myosin. Analytical sedimentation velocity experiments were performed in order to compare the sedimentation coefficient (s0(20),w) of the SF1 dimer formed by cross-linking to values predicted from ellipsoidal models of the dimer. The observed s0(20),w of the dimer was much closer to the range predicted for a side-to-side arrangement of SF1 monomers than the range predicted for two monomers linked end to end, a result consistent with the active site location suggested above. During the course of these experiments, unmodified SF1 was used as a control, and its sedimentation behavior was reexamined. We have corroborated the finding that the s0(20),w displayed by SF1 can be affected to a limited extent by the particular experimental parameters employed during centrifugation [Morel, J. E., & Garrigos, M. (1982) Biochemistry 21, 2679-2686].(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542032 TI - Reaction of some macrolide antibiotics with the ribosome. Labeling of the binding site components. AB - Radioactive carbomycin A, niddamycin, tylosin, and spiramycin, but not erythromycin, can be covalently bound to Escherichia coli ribosomes by incubation at 37 degrees C. The incorporation of radioactivity into the particles is inhibited by SH- and activated double bond containing compounds but not by amino groups, suggesting that the reactions may take place by addition to the double bond present in the reactive antibiotics. This thermic reaction must be different from the photoreaction described for some of these macrolides [Tejedor, F., & Ballesta, J. P. G. (1985) Biochemistry 24, 467-472] since tylosin, which is not photoincorporated, is thermically bound to ribosomes. Most of the radioactivity is incorporated into the ribosomal proteins. Two-dimensional gel electrophoresis of proteins labeled by carbomycin A, niddamycin, and tylosin indicates that about 40% of the radioactivity is bound to protein L27; the rest is distributed among several other proteins such as L8, L2, and S12, to differing extents depending on the drug used. These results indicate, in accordance with previous data, that protein L27 plays an important role in the macrolide binding site, confirming that these drugs bind near the peptidyl transferase center of the ribosome. PMID- 3542033 TI - 15N NMR spectroscopy of hydrogen-bonding interactions in the active site of serine proteases: evidence for a moving histidine mechanism. AB - Nitrogen-15 NMR spectroscopy has been used to study the hydrogen-bonding interactions involving the histidyl residue in the catalytic triad of alpha-lytic protease in the resting enzyme and in the transition-state or tetrahedral intermediate analogue complexes formed with phenylmethanesulfonyl fluoride and diisopropyl fluorophosphate. The 15N shifts indicate that a strong hydrogen bond links the active site histidine and serine residues in the resting enzyme in solution. This result is at odds with interpretations of the X-ray diffraction data of alpha-lytic protease and of other serine proteases, which indicate that the serine and histidine residues are too far apart and not properly aligned for the formation of a hydrogen bond. In addition, the nitrogen-15 shifts demonstrate that protonation of the histidine imidazole ring at low pH in the transition state or tetrahedral intermediate analogue complexes formed with phenylmethanesulfonyl fluoride and diisopropyl fluorophosphate triggers the disruption of the aspartate-histidine hydrogen bond. These results suggest a catalytic mechanism involving directed movement of the imidazole ring of the active site histidyl residue. PMID- 3542034 TI - Two-dimensional 1H NMR studies of histidine-containing protein from Escherichia coli. 1. Sequential resonance assignments. AB - Two-dimensional NMR studies at 500 MHz have been performed on the histidine containing protein (HPr) from Escherichia coli. HPr is one of the phosphocarrier proteins involved in the bacterial phosphoenolpyruvate:sugar phosphotransferase system that is responsible for the concomitant phosphorylation and translocation of a number of sugars. Sequential resonance assignments of HPr are complete. The conventional method of sequential assignments involving J-correlated spectroscopy (COSY) and nuclear Overhauser spectroscopy (NOESY) has been supplemented by optimized relayed coherence transfer spectroscopy (RELAY) to help overcome the spectral overlap that is inevitable in the spectra of proteins the size of HPr. RELAY experiments were performed in H2O to obtain NH-C beta H connectivities and in D2O to obtain C alpha H-C gamma H connectivities. The abundance of relayed coherence transfer peaks in the two experiments greatly aided in the assignment process of the complicated protein spectrum. The assignments lay the groundwork for the determination of the solution structure of HPr, as described in the accompanying paper [Klevit, R. E., & Waygood, E. B. (1986) Biochemistry (third paper of three in this issue)]. PMID- 3542035 TI - Two-dimensional 1H NMR studies of histidine-containing protein from Escherichia coli. 2. Leucine resonance assignments by long-range coherence transfer. AB - Sequence-specific assignments of the NH, C alpha H, and C beta H resonances in the NMR spectrum of the histidine-containing protein (HPr) from Escherichia coli are complete [Klevit, R. E., Drobny, G. P., & Waygood, E. B. (1986) Biochemistry (first paper of three in this issue)]. In addition, the C gamma H3 resonances of valyl, threonyl, and isoleucyl residues have been assigned by two-dimensional relayed coherence transfer (RELAY) experiments. In order to rigorously assign the resonances from longer side chains such as leucines, long-range transfer experiments have been applied to HPr. Coherence transfers via isotropic mixing within large spin systems were accomplished by multiple pulse trains applied during the mixing time of a two-dimensional experiment. PMID- 3542036 TI - Two-dimensional 1H NMR studies of histidine-containing protein from Escherichia coli. 3. Secondary and tertiary structure as determined by NMR. AB - Sequence-specific resonance assignments of the 1H NMR spectrum of the 85-residue histidine-containing phosphocarrier protein (HPr) are complete [Klevit, R. E., Drobny, G. P., & Waygood, E. B. (1986) Biochemistry (first paper of three in this issue)]. Additional side-chain assignments have been made with long-range coherence transfer experiments [Klevit, R. E., & Drobny, G. P. (1986) Biochemistry (second paper of three in this issue)]. In this paper, the NMR assignments were used to determine the secondary structure and the tertiary folding of HPr in solution. The secondary structural elements of the protein were determined by visual inspection of the pattern of nearest-neighbor nuclear Overhauser effects (NOEs) and the presence of persistent amide resonances. Escherichia coli HPr consists of four beta-strands, three alpha-helices, four reverse turns, and several regions of extended backbone structure. Long-range NOEs, especially among side-chain protons, were used to determine the tertiary structure of the protein by use of the secondary structural components. The four beta-strands form a single antiparallel beta-pleated sheet. The hydrophobic faces of the alpha-helices interact to form a hydrophobic core and sit above the hydrophobic face of the beta-sheet, forming an open-face beta-sheet sandwich structure. The active site histidine, His-15, is on a short kinked segment of backbone that is accessible to the solvent. The positively charged phosphorylation site (His-15 and Arg-17) interacts with the negatively charged carboxyl terminus of the protein (Glu-85).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542037 TI - Escherichia coli single-strand binding protein forms multiple, distinct complexes with single-stranded DNA. AB - Four distinct binding modes for the interaction of Escherichia coli single-strand binding (SSB) protein with single-stranded (ss) DNA have been identified on the basis of quantitative titrations that monitor the quenching of the SSB protein fluorescence upon binding to the homopolynucleotide poly(dT) over a range of MgCl2 and NaCl concentrations at 25 and 37 degrees C. This is the first observation of multiple binding modes for a single protein binding to DNA. These results extend previous studies performed in NaCl (25 degrees C, pH 8.1), in which two distinct SSB-ss DNA binding modes possessing site sizes of 33 and 65 nucleotides per bound SSB tetramer were observed [Lohman, T.M., & Overman, L. B. (1985) J. Biol. Chem. 260, 3594-3603]. Each of these binding modes differs in the number of nucleotides occluded upon interaction with ss DNA (i.e., site size). Along with the previously observed modes with site sizes of 35 +/- 2 and 65 +/- 3 nucleotides per tetramer, a third distinct binding mode, at 25 degrees C, has been identified, possessing a site size of 56 +/- 3 nucleotides per bound SSB tetramer, which is stable over a wide range of MgCl2 concentrations. At 37 degrees C, a fourth binding mode is observed, possessing a site size of 40 +/- 2 nucleotides per tetramer, although this mode is observable only over a small range of salt concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542038 TI - Magnesium requirements for guanosine 5'-O-(3-thiotriphosphate) induced assembly of microtubule protein and tubulin. AB - Two conflicting interpretations on the role of guanosine 5'-O-(3 thiotriphosphate) (GTP gamma S) in microtubule protein and tubulin assembly have been previously reported. One study finds that GTP gamma S promotes assembly while another study reports that GTP gamma S is a potent inhibitor of microtubule assembly. We have examined the potential role of Mg2+ to learn if the conflicting interpretations are due to a metal effect. Turbidity, electron microscopy, and nucleotide binding and hydrolysis were used to analyze the effect of the Mg2+ concentration on GTP gamma S-induced assembly of microtubule protein (tubulin + microtubule-associated proteins) in the presence of buffer +/- 30% glycerol and in buffer with GTP added before or after GTP gamma S. GTP gamma S substantially lowers the Mg2+ concentration required to induce cross-linked or clustered rings of tubulin. These cross-linked rings do not assemble well into microtubules, and GTP only partially restores microtubule assembly. However, taxol will promote GTP gamma S-induced cross-linked rings of microtubule protein to assemble into microtubules. The effect of GTP gamma S on microtubule protein assembly in the presence of Zn2+ with and without added Mg2+ suggests that GTP gamma S also effects the formation of Zn2+-induced sheet aggregates. Purified tubulin was used in assembly experiments with Mg2+, Zn2+, and taxol to better understand GTP gamma S interactions with tubulin. The optimal Mg2+ concentration for assembly of tubulin is lower with GTP gamma S than with GTP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542039 TI - Characterization of a membrane-associated 3,3',5-triiodo-L-thyronine binding protein by use of monoclonal antibodies. AB - Four mouse hybridoma cell lines have been isolated which secrete antibodies to the membrane-associated thyroid hormone binding protein (Mr 55,000) from human epidermoid carcinoma A431 cells. J6 is rat specific; J2 is human and monkey specific; J8 and J9 have a wider specificity and react with similar thyroid hormone binding proteins (p55) from human, monkey, rat, and hamster. None of these antibodies reacts with mouse cells. J2, J6, and J9 are of the IgG1k class, and J8 is an IgAk antibody. p55 was characterized by using these monoclonal antibodies. It is not posttranslationally processed by glycosylation, phosphorylation, or sulfation. It has a cellular degradation rate t1/2 approximately equal to 3.2 h. Using immunofluorescence and electron microscopic immunocytochemistry, p55 was found to be associated with the lumenal face of the endoplasmic reticulum and nuclear envelope. When cell homogenates were prepared, significant amounts of p55 were released into the 110000g supernatant, indicating that p55 is loosely associated with the endoplasmic reticulum and nuclear envelope. PMID- 3542040 TI - Reduction of cytochrome b in mitochondria from yeast lacking coenzyme Q. AB - Mitochondria isolated from coenzyme Q deficient yeast cells had no detectable NADH:cytochrome c reductase or succinate:cytochrome c reductase but had comparable amounts of cytochromes b and c1 as wild-type mitochondria. Addition of succinate to the mutant mitochondria resulted in a slight reduction of cytochrome b; however, the subsequent addition of antimycin resulted in a biphasic reduction of cytochrome b, leading to reduction of 68% of the total dithionite-reducible cytochrome b. No "red" shift in the absorption maximum was observed, and no cytochrome c1 was reduced. The addition of either myxothiazol or alkylhydroxynaphthoquinone blocked the reduction of cytochrome b observed with succinate and antimycin, suggesting that the reduction of cytochrome b-562 in the mitochondria lacking coenzyme Q may proceed by a pathway involving cytochrome b at center o where these inhibitors block. Cyanide did not prevent the reduction of cytochrome b by succinate and antimycin the the mutant mitochondria. These results suggest that the succinate dehydrogenase complex can transfer electrons directly to cytochrome b in the absence of coenzyme Q in a reaction that is enhanced by antimycin. Reduced dichlorophenolindophenol (DCIP) acted as an effective bypass of the antimycin block in complex III, resulting in oxygen uptake with succinate in antimycin-treated mitochondria. By contrast, reduced DCIP did not restore oxygen uptake in the mutant mitochondria, suggesting that coenzyme Q is necessary for the bypass. The addition of low concentrations of DCIP to both wild-type and mutant mitochondria reduced with succinate in the presence of antimycin resulted in a rapid oxidation of cytochrome b perhaps by the pathway involving center o, which does not require coenzyme Q. PMID- 3542041 TI - Reconstitution of Escherichia coli ribosomes containing puromycin-modified S14: functional effects of the photoaffinity labeling of a protein essential for tRNA binding. AB - In previous work we have shown that puromycin photoaffinity labels two proteins, L23 and S14, from separate sites of high affinity on Escherichia coli ribosomes [Jaynes, E. N., Jr., Grant, P. G., Giangrande, G., Wieder, R., & Cooperman, B. S. (1978) Biochemistry 17, 561-569; Weitzmann, C. J., & Cooperman, B. S. (1985) Biochemistry 24, 2268-2274], that puromycin-modified S14 is separable from native S14 by reverse-phase high-performance liquid chromatography (RP-HPLC), and that ribosomal proteins prepared by RP-HPLC can be reconstituted into active 30S subunits [Kerlavage, A. R., Weitzmann, C. J., & Cooperman, B. S. (1984) J. Chromatogr. 317, 201-212]. In this work we definitively identify puromycin modified S14 by tryptic fingerprinting, an analysis that also provides evidence that the single tryptophan-containing peptide in S14 is the site of puromycin photoincorporation. We show that reconstituted 30S subunits, in which all of the S14 present is stoichiometrically modified with puromycin and all other ribosomal components are present in unmodified form, lack Phe-tRNAPhe binding activity and further that 70S ribosomes containing such reconstituted 30S subunits have substantially diminished binding activity to both the A and P sites, as differentiated through use of tetracycline. Suitable control experiments strongly indicate that this loss of activity is a direct consequence of puromycin photoincorporation. PMID- 3542042 TI - Amino acid sequence of rabbit skeletal muscle myosin light chain kinase. AB - The amino acid sequence of the amino-terminal, 235-residue segment of rabbit skeletal muscle myosin light chain kinase has been determined. Together with the carboxyl-terminal segment previously described [Takio, K., Blumenthal, D. K., Edelman, A. M., Walsh, K. A., Krebs, E. G., & Titani, K. (1985) Biochemistry 24, 6028], the present work completes the 603-residue sequence of this protein. The amino-terminal segment that has been analyzed herein corresponds to a domain reported to be of highly asymmetrical shape and as yet unknown function. Secondary structure calculations failed to provide any evidence of alpha-helix or beta-structures, but polyproline II like helical structure is possible. Sequence analysis indicates the presence of approximately equal quantities of two isoforms differing in a single amino acid replacement. Unexpected difficulties were encountered in the present sequence analysis due to the presence of acid-labile Asp-Pro bonds and to five separable variants of a blocked 21-residue amino terminal peptide, arising from rearrangement at an Asn-Gly bond. PMID- 3542043 TI - Conformational studies by 1H nuclear magnetic resonance of the trypsin chymotrypsin inhibitor B-III from peanuts and its enzymatically modified derivative. AB - The conformation of the peanut inhibitor B-III was investigated by 1H NMR at 500 MHz. Resonances for about 30% of the residues were assigned and/or identified by conventional and two-dimensional 1H NMR measurements. The conformation of the modified inhibitor B-IIIRS, obtained by the cleavage of the peptide bonds of B III at the first reactive site, Arg(10)-Arg(11), and second reactive site, Arg (37)-Ser(38), was also investigated. Edman degradation was used to identify resonances of the residues adjoining the scissile sites. A comparison of the behavior of the resonances corresponding to Ala(12), Tyr(15), Phe(16), and Thr(37) in B-III and B-IIIRS indicated that the only conformational differences between the two proteins were those from the S-S loops containing the two reactive sites. From the similar behavior of Leu(7), Phe(24), His(26), Ala(29), five valine, and four threonine resonances in both proteins, it is suggested that the S-S loops that do not contain a scissile bond (the core region of the inhibitor) were rigid. Thus, no conformational change of the core region was observed upon cleavage of the reactive sites. PMID- 3542044 TI - Catalytic hydrogenation of fatty acyl chains in plasma membranes; effect on membrane lipid fluidity and expression of cell surface antigens. AB - Optimal reaction conditions were established for hydrogenation of plasma membranes of living murine GRSL leukemia cells, using the water-soluble catalyst Pd(QS)2 (QS, sulphonated alizarine; C14H6O7NaS). Under these conditions more than 80% of the cells remained viable. Analysis by gas chromatography revealed that hydrogenation occurred predominantly in the 18:2, 20:4 and 22:6 fatty acyl chains of the membrane phospholipids. Under the same conditions hydrogenation was also performed in purified plasma membranes from GRSL cells and from rat liver, and in liposomes prepared from the total lipid extracts of these membranes. Hydrogenation increased the lipid structural order parameter in the membranes, as measured by fluorescence polarization. This increase was more pronounced in the liposomes (46%) than in the plasma membranes (17-25%). Hydrogenation increased the expression of a 15 kDa antigen on the surface of viable GRSL cells, as measured in a Fluorescence Activated Cell Sorter, using monoclonal antibodies. The expression of four other antigens, among which H-2k, was not or much less affected by this treatment. PMID- 3542045 TI - The influence of maltoporin affinity on the transport of maltose and maltohexaose into Escherichia coli. AB - The kinetics of maltose transport and its inhibition by maltohexaose were investigated using Escherichia coli strains with engineered modifications of maltoporin. The permeation of lactose through maltoporin was also measured, as well as its inhibition by maltohexaose. Based on these results, the role of the maltoporin binding site in transport was evaluated. PMID- 3542047 TI - Reactivity of essential histidine residues in EF-Tu.GDP and EF-Tu.GTP from Escherichia coli. AB - The microenvironment of histidine residues located in the binding site of elongation factor EF-Tu from Escherichia coli for the 3' terminus of aminoacyl tRNA is altered during transition of EF-Tu.GDP to EF-Tu.GTP. PMID- 3542046 TI - Lipid and temperature dependence of the kinetic and thermodynamic parameters for active amino acid transport in Escherichia coli K1060. AB - The influence of membrane physical state on the kinetic and thermodynamic parameters for the active transport systems for two amino acids has been investigated in Escherichia coli K1060, an unsaturated fatty acid auxotrophic mutant. The apparent Michaelis constant (Km) for the uptake of L-[14C]glutamine (0.05 to 0.08 microM) or L-[14C]proline (1 microM approx.) is invariant with temperature for this mutant grown on elaidate (18:1t), palmitelaidate (16:1t), oleate (18:1c), palmitoleate (16:1c) and linoleate (18:2c,c). Arrhenius plots of the maximum velocities (Vmax) for L-glutamine transport in cells grown on 16:1t, 18:1c and 16:1c are biphasic within a limited temperature range peculiar to each UFA supplementation. Above an upper temperature limit also displayed by 18:1t and 18:2c,c-cells, Vmax decreases with temperature. A characteristic temperature (Tb) marks the point of intersection of the biphasic slope of the Arrhenius plots, and activation energy (Ea) is lower above than below Tb. Differential thermal analysis considered with membrane lipid fatty acyl profiles indicates that the upper temperature limit is governed by both membrane lipid acyl chain fluidity and heterogeneity, while Tb is governed by fluidity alone. Data on L-proline transport Vmax are similar, but the upper temperature limit and Tb are each shifted to lower temperatures relative to L-glutamine. We suggest that membrane defects related to energy-coupling and caused by abnormal fluidity and physical state are responsible for the peculiar temperature dependences of Vmax for these active transport processes. PMID- 3542048 TI - Nonspecific inhibition of Escherichia coli ornithine decarboxylase by various ribosomal proteins: detection of a new ribosomal protein possessing strong antizyme activity. AB - Escherichia coli ornithine decarboxylase (L-ornithine carboxy-lyase, EC 4.1.1.17) was found to be inhibited by several basic proteins. When ribosomal proteins were tested, major ribosomal proteins, with the exceptions of S1, S5, S6, S8, S10, L3, L5, L6, L7/L12, L8, L9 and L10 proteins, showed antizyme activity in addition to the recognized antizymes (S20/L26 and L34 proteins). Furthermore, it was found that L20 protein and a new ribosomal protein, tentatively named X1 protein and bound to 50 S ribosomal subunits, showed stronger antizyme activity than S20/L26 and L34 proteins. The antizyme activity of S20/L26 and L34 proteins was at most 10% of the total antizyme activity of ribosomal proteins. Several basic polypeptides also showed antizyme activity in the order polyarginine greater than protamine greater than histone greater than polylysine. Ribosomal proteins and basic polypeptides inhibited ornithine decarboxylase activity competitively. Ribosome-bound antizymes were inactive as antizymes, and antizyme inhibition of ornithine decarboxylase was eliminated by ribosomes. When E. coli extracts were separated into ribosomes and 100,000 X g supernatant fraction, no significant antizyme activity was observed in the supernatant fraction. Results of these in vitro experiments infer that basic antizymes may not function as inhibitors of ornithine decarboxylase in vivo. PMID- 3542049 TI - Determination of the structure of the carbohydrate chains of acid alpha glucosidase from human placenta. AB - Acid alpha-glucosidase (alpha-D-glucoside glucohydrolase, EC 3.2.1.20) from human placenta (70 and 76 kDa) was found to contain 4 N-glycosidic carbohydrate chains per molecule. Sugar analysis of purified enzyme revealed the presence of mannose, N-acetylglucosamine and fucose at a molar ratio of 5.0:2.0:0.6. In addition, trace amounts of galactose and N-acetylneuraminic acid were detected. The sugar chains were liberated from the polypeptides by the hydrazinolysis procedure and subsequently fractionated by gel filtration and HPLC. Purified compounds were investigated by 500-MHz 1H-NMR spectroscopy. Oligomannoside-type chains of intermediate size, e.g., Man5GlcNAcGlcNAc-ol and Man7GlcNAcGlcNAc-ol, and N-type chains of smaller size e.g., Man2-3GlcNAc[Fuc]0-1GlcNAc-ol, were demonstrated to be present at a ratio of 2:3. In addition, a small amount of sialylated N acetyllactosamine-type chains has been found. The possible biosynthetic route of the fucose-containing small-size chains is discussed. PMID- 3542050 TI - Purification and characterization of NADP-linked acetoacetyl-CoA reductase from Zoogloea ramigera I-16-M. AB - An NADP-linked acetoacetyl-CoA reductase was purified to electrophoretic homogeneity from Zoogloea ramigera I-16-M, a poly(3-hydroxybutyrate)-accumulating bacterium. The purified enzyme showed specific activity of 412 mumol acetoacetyl CoA reduced per min per mg protein, which constituted an 880-fold purification compared to the crude extract, with a 32% yield. Electrophoretic analysis of the purified enzyme which had been cross-linked with dimethylsuberimidate showed that the native enzyme (Mr 92,000) is a tetramer of four identical subunits (Mr 25,500). Among the various D-(-)- and L-(+)-3-hydroxyacyl-CoAs tested, the purified enzyme oxidized only D-(-)-3-hydroxybutyryl-CoA and to a lesser extent D (-)-3-hydroxyvaleryl-CoA in the presence of NADP+. The antiserum prepared against the purified enzyme completely inhibited poly(3-hydroxybutyrate) synthesis from acetyl-CoA by a crude extract of Z. ramigera I-16-M cells. These findings indicate that this enzyme plays an indispensable role as the supplier of D-(-)-3 hydroxybutyryl-CoA in poly(3-hydroxybutyrate) synthesis in this bacterium. PMID- 3542051 TI - Lysosomal and cytosolic sialidases in rabbit alveolar macrophages: demonstration of increased lysosomal activity after in vivo activation with bacillus Calmette Guerin. AB - Sialidase activity was assayed in homogenized rabbit alveolar macrophages using a fluorogenic substrate: sodium 4-methylumbelliferyl-alpha-D-neuraminate. After differential centrifugation one acid-active enzyme (optimum pH 4.2) was detected in the 16,000 X g pellet that contained lysosomes, mitochondria and peroxisomes. A second activity, with an optimum pH of 5.4, was found in the cytosolic fraction. The acid-active sialidase accounted for more than 95% of the total sialidase activity in crude homogenate. When alveolar macrophages were collected from rabbits stimulated with bacillus Calmette-Guerin (BCG), the acid-active sialidase specific activity was increased 2.5-fold whereas other lysosomal enzymes such as N-acetylglucosaminidase and beta-galactosidase were stable. The cytosolic sialidase activity did not change. PMID- 3542053 TI - Purification and properties of a human plasma endogenous modulator for the platelet tricyclic binding/serotonin transport complex. AB - An endogenous modulator for the site labeled by [3H]imipramine which is putatively coupled to the serotonin transporter in human platelets was isolated and purified from plasma. Procedures included sequential chromatography on Cibacron blue-Sepharose 4B, concanavalin A-Sepharose 4B, Mono Q HR 10/10 anion exchange, DuPont GF-250 gel permeation and Mono S HR 5/5 cation exchange columns. The purified modulator is a protein of Mr 45,000 with a very acidic pK (less than 3) and sensitive to various proteinases but heat- and acid-stable. This protein inhibited [3H]imipramine binding to platelet membranes competitively (IC50 approximately 6 microM) and enhanced serotonin uptake in fresh human platelets (EC50 approximately 7 microM). Various physicochemical properties, including chromatographic, electrophoretic and immunological as well as amino acid composition analysis revealed that the isolated protein is most probably the human alpha 1-acid glycoprotein. PMID- 3542052 TI - The inhibitory effect of dithiothreitol on the assembly of the filamentous phage fd. AB - Assembly of the filamentous phage fd is preceded by the formation of a complex between the viral single-stranded (ss) DNA and the virally coded gene 5 protein (gene 5 protein-ssDNA complex). The presence of 5 mM dithiothreitol in the growth medium prevents phage production; however, phage infection, phage DNA replication and phage genome expression are still observed. In contrast, the gene 5 protein ssDNA complex is not formed in the presence of dithiothreitol in vivo, although the complex is not affected by the disulfide reducing agent in vitro. Furthermore, host lipid composition is altered by growth in the presence of dithiothreitol. The zwitterionic lipid, phosphatidylethanolamine, increases while the cationic phospholipid content, cardiolipin and phosphatidylglycerol, decreases. This suggests a role for lipids or membranous structures in the process of gene 5 protein-ssDNA complex formation. PMID- 3542054 TI - Expectancy effects on relaxation instructions: physiological and self-report indices. AB - Two sessions of relaxation instructions were administered under high and low expectancy conditions. Fifty-four college students scoring high on a self-report measure of anxiety served as subjects. Live and taped abbreviated progressive muscle relaxation instructions and a self-relaxation condition were equally effective in reducing within-session self-report and physiological indices of anxiety. High expectancy instructions led to greater reductions in heart rate than did low expectancy instructions. Factors controlling anxiety reduction during relaxation therapies are discussed. PMID- 3542055 TI - Live and taped relaxation instructions: effects of procedural variables. AB - Two experiments were designed to assess the effects of relaxation training, therapist presence or absence, live versus taped voice, and response-contingent versus noncontingent instructional progress on measures of subjective relaxation and frontal EMG. In the first experiment, it was found that subjects receiving taped instructions showed greater within-session subjective relaxation and lowering of within-session frontal EMG than subjects in a control condition. No differential training effects of therapist presence or absence was noted. In a second experiment, no significant differences in relaxation measures were found between subjects receiving live, response-contingent instructions and subjects receiving live, noncontingent instructions. Moreover, no meaningful differences in relaxation measures were found between subjects receiving live and taped instructions. PMID- 3542056 TI - [Study of the surface of Escherichia coli ribosomes and ribosomal particles by the tritium bombardment method]. AB - A new technique of atomic tritium bombardment has been used to study the surface topography of Escherichia coli ribosomes and ribosomal subunits. The technique provides for the labeling of proteins exposed on the surface of ribosomal particles, the extent of protein labeling being proportional to the degree of exposure. The following proteins were considerably tritiated in the 70S ribosomes: S1, S4, S7, S9 and/or S11, S12 and/or L20, S13, S18, S20, S21, L1, L5, L6, L7/L12, L10, L11, L16, L17, L24, L26 and L27. A conclusion is drawn that these proteins are exposed on the ribosome surface to an essentially greater extent than the others. Dissociation of 70S ribosomes into the ribosomal subunits by decreasing Mg2+ concentration does not lead to the exposure of additional ribosomal proteins. This implies that there are no proteins on the contacting surfaces of the subunits. However, if a mixture of subunits has been subjected to centrifugation in a low Mg2+ concentration at high concentrations of a monovalent cation, proteins S3, S5, S7, S14, S18 and L16 are more exposed on the surface of the isolated 30S and 50S subunits than in the subunit mixture or in the 70S ribosomes. The exposure of additional proteins is explained by distortion of the native quaternary structure of ribosomal subunits as a result of the separation procedure. Reassociation of isolated subunits at high Mg2+ concentration results in shielding of proteins S3, S5, S7 and S18 and can be explained by reconstitution of the intact 30S subunit structure. PMID- 3542057 TI - [Functional carboxylic group in the active center of transketolase]. AB - Baker's yeast transketolase is rapidly inactivated in the presence of carboxylic group modifiers, i.e., 1-ethyl-3(3'-dimethylaminopropyl)-carbodiimide or Woodward's reagent K. This inactivation is due to modification of the carboxylic group in the enzyme active center. The essential groups localized in the two active centers of transketolase differ in the rate of modification; accordingly, the inactivation kinetics appears as biphasic. A complete loss of the enzyme activity occurs as a result of modification of one carboxylic group per enzyme active center. The pKa value of modifiable groups is equal to about 6.5. This modification decreases by two orders of magnitude the affinity of the substrate for the active center. The carboxylic groups are not directly involved in the interaction with the substrates; their modification does not significantly affect the coenzyme binding. It is supposed that these groups are responsible for the deprotonation of the second carbon in the thiamine pyrophosphate thiazolium ring. PMID- 3542058 TI - [Biological role of histidine-containing dipeptides]. AB - The biological role of histidine-containing dipeptides is reviewed. The role of carnosine and anserine in muscle function is discussed from the evolutionary viewpoint. Evidence on the antioxidative effect of carnosine and its protection of biological membranes against lipid peroxidation-induced damages is presented. The effects of presently known natural antioxidative agents and carnosine on lipid peroxidation are compared. Carnosine has been shown to be a more universal protector of membranes as compared to free radical scavengers. PMID- 3542059 TI - [Succinate-ubiquinone reductase site of the respiratory chain]. AB - Data on succinate-ubiquinone reductase are critically reviewed. The structural and catalytic properties of succinate dehydrogenase and succinate-ubiquinone reductase are compared. The redox components, active centers and proteins involved in the enzyme interaction with ubiquinone are described. Some structural and kinetic features of the succinate-ubiquinone reductase as the respiratory chain component and feasible mechanisms of regulation of the succinate-ubiquinone reductase activity are discussed. PMID- 3542060 TI - [Glycogen phosphorylase of skeletal muscles]. AB - A review is given on the affinity modification of pyridoxal phosphate and AMP binding sites as well as on the chemical modification of essential amino acid residues of phosphorylase (histidine residue of the substrate-binding site and cysteine residue of the coenzyme-binding site). The role of allosteric effectors (AMP and glucose-6-phosphate) and functionally important centers of the protein in conformational transitions of rabbit muscle phosphorylase b is discussed. The kinetic properties of rabbit and bovine muscle phosphorylase are compared. Bovine muscle phosphorylase is shown to be a partly phosphorylated form of the enzyme. Some peculiarities of the pH-dependence of kinetic behaviour of the hybrid form of the bovine muscle enzyme are discussed. PMID- 3542061 TI - [Troponin from the myocardium and skeletal muscles: structure and properties]. AB - The literary and experimental data on the structure and properties of cardiac and skeletal muscle troponin are reviewed. The cation--binding sites of cardiac and skeletal muscle troponin C are distinguished by specificity; the sites localized in the C-terminal part of the protein molecule can bind both Ca2+ and Mg2+, whereas the sites localized at the N-end specifically bind Ca2+. The use of bifunctional reagents revealed a number of helical sites within the structure of cardiac troponin C (residues 84-92 and 150-158) and of skeletal muscle troponin C (residues 90-98 and 125-136). A comparison of experimental data with the results of an X-ray analysis testifies to the presence in the central part of the troponin C molecule of a long alpha-helical sequence responsible for troponin C interaction with the inhibiting peptide of troponin I. The efficiency of interaction of troponin components depends on Ca2+ concentration; the integrity of the overall troponin complex is mainly provided for by troponin C interaction with troponin I and by troponin I interaction with troponin T. The interaction between troponins T and C is relatively weak, especially in the case of cardiac troponin components. Both skeletal and cardiac muscles synthesize several troponin T isoforms differing in length and amino acid composition of N-terminal 40-60 member peptides. Troponin T isoforms can undergo phosphorylation by several protein kinases. The single site of troponin T which exists in a phosphorylated state in vivo (residue Ser-1) undergoes phosphorylation by specific protein kinase (troponin T kinase) related to casein kinases II. It was assumed that the phosphorylation of Ser-1 residue of troponin T as well as the synthesis of troponin T isoforms differing in the structure of the N-terminal peptide, provides for the regulation of interaction between two neighbouring tropomyosin molecules. PMID- 3542062 TI - [Transketolase: structure and mechanism of action]. AB - The structure and mechanism of action of transketolase are reviewed, with the primary emphasis laid on the baker's yeast enzyme. The oligomeric structure of transketolase, the interaction of the coenzyme with the apoenzyme and the role of phosphate groups in the substrate interaction with the protein have been studied. The role of essential groups of apotransketolase in the binding of the coenzyme, substrates as well as in the catalytic act are described. The peculiarities of formation of the enzyme active center are discussed. PMID- 3542063 TI - [The role of oligomeric structure in the functioning of D-glyceraldehyde-3 phosphate dehydrogenase]. AB - The review summarizes the results of a study on the functional role of subunit interactions in a tetrameric glyceraldehyde-3-phosphate dehydrogenase molecule. A conformational asymmetry preexistent in the apoenzyme was shown to be detectable with the use of fluorescent cationic probes. Experimental evidence is presented which points to an interaction of the enzyme active centers in the course of productive E-acyl-NADH complex formation in the forward reaction. The matrix immobilized oligomeric and subunit forms of the enzyme were used to demonstrate that the quaternary structure is not a prerequisite for the catalytic activity. Due to subunit interactions within the oligomeric enzyme molecule the functioning of a monomer is under the control exerted by the neighbouring subunits. An association of monomers into a dimer is sufficient to create a cooperative system; the mutual influence of subunits becomes more complex in a trimeric and a tetrameric enzyme species. An isolated dimer exhibits the effect of half-of-the sites reactivity and catalytic cooperativity of the active centers. Both the tetrameric and dimeric enzyme forms probably catalyze the reaction of 1,3 diphosphoglycerate reductive dephosphorylation via a mechanism of the flip-flop type. The catalytic cooperativity of the enzyme active centers can be controlled by some factors of the intracellular environment (e.g., by protein-protein interactions with a functionally related enzyme). Thus, the role of subunit cooperativity in the glyceraldehyde-3-phosphate dehydrogenase molecule is suggested to constitute one of the mechanisms of regulation of the enzyme functioning. PMID- 3542064 TI - [Dehydrogenases of alpha-keto acids from pigeon breast muscle]. AB - The structure, function and regulation of pyruvate dehydrogenase and alpha ketoglutarate dehydrogenase complexes from pigeon breast muscle are reviewed. The nature of essential groups involved in the formation of active centers of the first components of the complexes, i.e., pyruvate dehydrogenase and alpha ketoglutarate dehydrogenase, is described. The catalytic mechanism of the pyruvate dehydrogenase reaction and the peculiarities of cooperative interactions of the active centers of the above enzymes are discussed. PMID- 3542065 TI - [Demographic genetic approach in anthropologic research. II. A method for calculating the coefficient of consanguinity in a complex nongraphic pedigree]. AB - A simplified method of manual calculation for inbreeding coefficient (and/or relationship) from complicated pedigree tables presented in a nongraphic mode is offered. The method is based on the use of positional dual codes of ancestors in which all genealogical links of the proband are reflected. PMID- 3542066 TI - Gluconeogenesis in late fetal and early neonatal life. AB - Birth in most mammalian species represents an abrupt change from a high carbohydrate and low-fat diet to a high-fat and low-carbohydrate diet. Gluconeogenesis is absent from the liver of the fetus of well fed mothers, but can be induced prematurely by prolonged fasting of the mother. Gluconeogenesis increases rapidly in the liver of newborn mammals in parallel with the appearance of phosphoenolpyruvate carboxykinase (PEPCK), the rate-limiting enzyme of this pathway. The rise in plasma glucagon and the fall in plasma insulin which occur immediately after birth are the main determinants of liver PEPCK induction. When liver PEPCK has reached its adult value, i.e. 24 h after birth, other factors are involved in the regulation of hepatic gluconeogensis. In order to maintain a high gluconeogenic rate, the newborn liver must be supplied with sufficient amount of gluconeogenic substrates and free fatty acids. An active hepatic fatty acid oxidation is necessary to support hepatic gluconeogenesis by providing essential cofactors such as acetyl CoA and NADH. The relevance of animal studies for the understanding of neonatal glucose homeostasis in man is discussed. PMID- 3542067 TI - Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes. AB - The objective of this paper is to review the extent and mechanisms of lipoprotein alterations in pregnancy, present new data relating to placental lipid transport in normal humans and diabetic animals and consider possible effects on fetal growth and development in normal and diabetic pregnancy. The concentration of all lipoprotein fractions increases during pregnancy. VLDL cholesterol and triglyceride increase 2.5-fold over prepregnancy levels and LDL cholesterol increases 1.6-fold, all with peak levels at term. HDL cholesterol is maximally increased in midgestation by 1.45-fold and subsequently declines to 1.15-fold at term. The mechanisms of these lipoprotein changes have not been studied in humans but the hypertriglyceridemia in animal models is related to enhanced VLDL entry into the circulation. In addition, diminished adipose tissue lipoprotein lipase (LPL) activity in late gestation may cause a rerouting of triglyceride fatty acids to other tissues such as muscle and uterus for oxidation, rather than storage, since triglyceride transport is not reduced in pregnancy. All of these changes appear to be sex hormone mediated. In diabetic pregnancies, the available data indicate that triglyceride concentrations are increased and HDL cholesterol concentrations are decreased with reference to lipoproteins in nondiabetic pregnant women. Previously unpublished data show that a transplacental FFA gradient exists across the umbilical circulation in the direction of the fetus and is proportional to the maternal FFA concentration. No gradient is seen for triglyceride or total plasma cholesterol. However, transport of unmeasured amounts of triglyceride fatty acids may still occur via placental LPL and be exaggerated in diabetes where LPL declines in adipose tissue but not in placenta. The mechanism of transplacental cholesterol transport remains to be defined. Preliminary studies suggest that it depends on HDL as well as LDL since both can provide cholesterol for placental progesterone synthesis. In addition, fetal weight and length are associated with maternal apoproteins A-I and A-II, both major apoproteins of HDL. By lowering HDL in pregnancy, diabetes mellitus could negatively affect these relationships. In conclusion, sex hormone mediated modifications of lipoprotein physiology are described in pregnancy which may enhance triglyceride fatty acid transport to muscle for oxidation and LDL and HDL cholesterol delivery to growing maternal and fetal tissues, a process that diabetes could globally disrupt. PMID- 3542069 TI - Effect of weaning on different diets on hepatic gluconeogenesis in the rat. AB - The capacity of gluconeogenesis from lactate (10 mmol/l) was studied on isolated hepatocytes in 15-day-old suckling and in 28-day-old rats weaned at the age of 19 days on various diets. Weaning on a high-fat carbohydrate-free diet allowed to maintain a high gluconeogenic rate. By contrast, as soon as the carbohydrate content of the weaning diet was sufficient to meet the glucose needs of the newborn, the gluconeogenic capacity was reduced. The amount of fat in the weaning diet had no influence on the gluconeogenic capacity. Changes in the hepatic gluconeogenic rate at weaning were inversely correlated with the plasma insulin/glucagon molar ratio. PMID- 3542070 TI - Are Mendel's results really too close? PMID- 3542071 TI - Implantation, menstruation and inflammation. PMID- 3542068 TI - Phenotypic heterogeneity within the circulating human neonatal T4-positive T cell subset. AB - An indirect immunofluorescence staining technique was employed to evaluate the TQ1 and 5/9 monoclonal antibody lymphocyte reactivity in 10 cord blood mononuclear cell (MC) preparations enriched of E-rosette-forming cells (E+). Ten adult E+ MC populations were used as controls. Unfractionated T4+ cord and adult MC positively selected by panning procedure were also assayed. The results of these experiments, taken together, suggest that there is an overexpanded neonatal T cell subset which displays a previously unrecognized immunophenotype (T4+, TQ1+, 5/9+). Whether these lymphocytes are involved in the wellknown fetal maternal immunosuppressive mechanisms of whether they are a further example of neonatal phenotypic immaturity remains to be elucidated. PMID- 3542072 TI - The experimental manipulation of ageing by diet. PMID- 3542074 TI - [ATP generation by the plasma membranes of human placental cells as affected by insulin and epidermal growth factor]. AB - Transient ATP synthesized by preparations enriched with plasmatic membranes of particles from the human placenta in the presence of insulin (4 micrograms/ml) and epidermal growth factor (1 microgram/ml) within 1 min after the addition of hormones at 30 degrees C, was isolated by means of chromatography on Dowex 1 X 8. ATP was synthesized in a medium containing Tris-HCl buffer, pH 7.5, ADP, Mg2+, and Pi during NADH-dependent oxidation in the presence of cytochrome C and oxygen. The amount of ATP was 10(-9) mole/mg protein/min. Quantitative assessment of ATP in lyophilized product was carried out by means of fluorimetry (excitation wavelength--360 nm; emission wavelength--460 nm) of NADH formed during coupled enzymatic reactions involving hexokinase and glucose-6-phosphate dehydrogenase. A possible biological role of peptide growth factor-stimulated formation of transient ATP in plasmatic membranes is discussed. PMID- 3542073 TI - Theoretical studies on the electrical activity of pancreatic beta-cells as a function of glucose. AB - The electrical activity of pancreatic beta-cells, which has been closely correlated both with intracellular Ca2+ concentration and insulin release, is characterized by a biphasic response to glucose and bursts of spiking action potentials. Recent voltage clamp and single channel patch clamp experiments have identified several transmembrane ionic channels that may play key roles in the electrophysiological behavior of beta-cells. There is a hypothesis that Ca2+ activated K+ channels are responsible for both the resting potential during low glucose concentration and the silent phase during bursting. The discovery of the ATP-inactivated K+ channel raises the possibility that the current for this latter K+ channel may dominate the resting potential, while the Ca2+-activated K+ current dominates the silent phase potential between bursts. The recent discovery that Ca2+-activated K+ channels are pH sensitive raises an interesting possibility for the biphasic electrical response. In this paper, numerical methods are presented for evaluating these hypotheses against experimental evidence. PMID- 3542075 TI - [Effect of prostacyclin on the cerebral vessels and its pharmacological modification]. AB - The ability of prostacyclin to relax human brain arteries contracted by different vasotropic agents has been investigated. Prostacyclin relaxation effect was less marked in atherosclerotically damaged vessels. Nifedipine was demonstrated to potentiate relaxation effect of prostacyclin at the level of sarcolemmal calcium transport, while cavinton and dipyridamole had an analogous influence, redistributing calcium in the intracellular stores. The potentiating effect of these drugs was also less pronounced in affected vessels, which might be connected to the depression of transport ATPase activity in the vascular smooth muscle cells. PMID- 3542076 TI - [Evaluation of the size of the microsphere loss from the myocardium in rats in a chronic experiment]. AB - The loss of radioactive microspheres (15 microns in diameter) from the rat myocardium was investigated during chronic experiment. Microspheres were injected to donor rats, the hearts were removed 20-30 min later and the number of microspheres trapped in the heart was determined on gamma-counter. After that the hearts were transplanted into the abdominal cavity of recipient rats using microsurgery technique. 5-24 days later the recipients were killed, the transplanted hearts were removed and radioactivity was measured again. It was shown that not more than 10% of microspheres were lost from the myocardium over a 5-24-day period, with the value of microsphere loss independent of the time period. PMID- 3542077 TI - The kinetics of immune reconstitution after human marrow transplantation. AB - Human marrow transplantation for the treatment of malignant and nonmalignant disorders is becoming an established modality of therapy. As in any aggressive therapeutic modality, the benefits must be balanced with the risks of the therapy. The aggressive chemoradiotherapy used to prepare patients for marrow transplantation creates a transient immunodeficiency disorder postgrafting until the transferred donor marrow reestablishes a competent immune system. Immune reconstitution posttransplant follows a general pattern developing from immature to mature immune functions. Immune reactivity during the first month postgrafting is extremely low. Cytotoxic and phagocytic functions recover by day 100, while more specialized and cooperative functions of T and B cells remain impaired up to one year or more postgrafting. After the first year postgrafting, the various components of the immune systems of most healthy marrow recipients begin to work synchronously, whereas the immune systems of recipients with chronic graft-v-host disease (GVHD) remain crippled. Recent evidence shows that transfer of specific immunity from marrow donors to marrow recipients plays a role in reestablishing immunocompetence. Transferred antigen-specific immunity may explain why more recipients do not die from overwhelming infections. PMID- 3542078 TI - Successful graft-versus-host disease prevention without graft failure in 32 HLA identical allogeneic bone marrow transplantations with marrow depleted of T cells by monoclonal antibodies and complement. AB - Thirty-two patients with acute leukemia, chronic granulocytic leukemia, or multiple myeloma received a T lymphocyte-depleted HLA-identical marrow. After being treated with pan-T monoclonal antibodies (MoAbs) and one round of baby rabbit complement, the mean percentage of T cell depletion was 94% +/- 4%. The number of residual viable T cell infused to the patient was 0.99 +/- 0.65 X 10(6) per kg body weight. The patients were conditioned with fractionated total body irradiation (TBI) (12 Gy) preceding high doses of cyclophosphamide (120 mg/kg). Methotrexate was used as an additional immunosuppressant in the first ten patients. For the following 22 patients no posttransplant immunoprophylaxis was administered. Eight patients died within three months due to complications related to transplantation. Engraftment was achieved in all evaluable patients, and no patient has a late graft failure. The proof of total chimerism was established in 24 patients. Twenty-four of 27 evaluable patients (88%) did not have an acute graft-v-host disease (GVHD) greater than grade 0 to 1. Two patients had a grade 2 (skin only), and one patient had a grade 4 acute GVHD (the latter had only 80% of T cell depletion). A medullary relapse occurred in 11 patients (nine of them had previously been defined as "high risk leukemia"). Our data suggest that it may not be necessary to deplete nearly all T cells to prevent acute GVHD in recipients of HLA-identical marrow. PMID- 3542079 TI - Altered plasma membrane phospholipid organization in Plasmodium falciparum infected human erythrocytes. AB - The intraerythrocytic development of the malaria parasite is accompanied by distinct morphological and biochemical changes in the host cell membrane, yet little is known about development-related alterations in the transbilayer organization of membrane phospholipids in parasitized cells. This question was examined in human red cells infected with Plasmodium falciparum. Normal red cells were infected with strain FCR3 or with clonal derivatives that either produce (K+) or do not produce (K-) knobby protuberances on the infected red cells. Parasitized cells were harvested at various stages of parasite development, and the bilayer orientation of red cell membrane phospholipids was determined chemically using 2,4,6-trinitrobenzene sulphonic acid (TNBS) or enzymatically using bee venom phospholipase A2 (PLA2) and sphingomyelinase C (SMC). We found that parasite development was accompanied by distinct alterations in the red cell membrane transbilayer distribution of phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidylserine (PS). Increases in the exoplasmic membrane leaflet exposure of PE and PS were larger in the late-stage parasitized cells than in the early-stage parasitized cells. Similar results were obtained for PE membrane distribution using either chemical (TNBS) or enzymatic (PLA2 plus SMC) methods, although changes in PS distribution were observed only with TNBS. Uninfected cohort cells derived from mixed populations of infected and uninfected cells exhibited normal patterns of membrane phospholipid organization. The observed alterations in P falciparum-infected red cell membrane phospholipid distribution, which is independent of the presence or absence of knobby protuberances, might be associated with the drastic changes in cell membrane permeability and susceptibility to early hemolysis observed in the late stages of parasite development. PMID- 3542080 TI - Hematologic engraftment and immune reconstitution posttransplantation with anti B1 purged autologous bone marrow. AB - Hematologic engraftment and immune reconstitution were examined in patients who received cyclophosphamide and total body irradiation therapy followed by infusion of autologous bone marrow purged with anti-B1 monoclonal antibody (MoAb) and complement as therapy for non-Hodgkin's lymphoma. Hematologic engraftment was prompt with return of greater than or equal to 0.5 X 10(3)/microL granulocytes and greater than or equal to 2 X 10(4)/microL platelets at a median of 26 and 29 days posttransplant, respectively. Immunologic reconstitution, in contrast, was prolonged. Normal numbers of circulating B cells were consistently noted by five months posttransplant, whereas return of normal immunoglobulin levels in some patients did not occur for one year. Normal numbers of T cells were evident within the first month posttransplant, but a reversed T4:T8 ratio persisted in some patients up to three years. In vitro responses of either B cells to triggers of activation or of T cells to mitogens and antigens were not normal for at least three months posttransplant. Natural killer (NK) cells predominated early after transplant and may demonstrate cytotoxicity against tumor cells. Our studies demonstrate that transplantation with anti-B1 purged autologous bone marrow results in complete hematologic and delayed immunologic engraftment. No significant acute or chronic clinical toxicities have been observed. PMID- 3542081 TI - Structural polymorphism of glycophorins demonstrated by immunoblotting techniques. AB - We have explored the polymorphism of the glycophorin system in the human erythrocyte membrane using the immunoblotting techniques and examining 52 individuals selected without prior bias as to their serologic state and ten documented serologic variants of M, N, S, s blood group system. Polyclonal antisera to alpha glycophorin and to alpha glycophorin CNBr carboxyl terminal fragment C (residues 82-131) and M and N specific monoclonal antibodies (MoAbs) were used. The first two reagents detect specific regions of the alpha glycophorin molecule and all electrophoretically resolved species of glycophorins immunologically related to alpha and delta glycophorins (delta glycophorin, [alpha-delta] hybrids and other glycophorins with an alteration in the carboxyl terminal segment); the M and N MoAbs identified the glycophorin species containing or lacking the M or N determinant in the amino terminal octapeptide structures. We find that immunoblotting confirmed in all cases the serologically determined phenotype; we also find that polymorphic forms of the glycophorin system are relatively infrequent; immunoblotting, independent from serologic testing, was capable of detecting five mutants, two most likely S-s-U-phenotypes; a new glycophorin species was detected in normal red cells with both antiglycophorin and antipeptide C sera, which is not evident with MoAbs; immunoblots of known glycophorin variants (En(a-), U-, Mg, Mi I, II, III, V, and Sta) confirmed but also extended our knowledge of the abnormal glycophorins involved; and the He+ and Wrb(-) cells showed normal patterns. PMID- 3542083 TI - G6PD in Plasmodium-infected erythrocytes. PMID- 3542082 TI - Modulation of endothelial cell functions by different molecular species of interleukin 1. AB - Different molecular species of interleukin 1 (IL 1) were examined for the spectrum of responses elicited in human endothelial cells (HEC), including synthesis of prostacyclin (PGI2), tissue-type procoagulant activity (PCA), platelet activating factor (PAF), and plasminogen activator inhibitor (PA-I). The IL 1 preparations utilized for the present study included a natural, partially purified IL 1, a preparation purified to homogeneity with extensive homology with the derived aminoacid IL 1 beta (pI7) sequence denominated "22K factor," murine recombinant IL 1 alpha, human recombinant IL 1 alpha (pI5) and beta (pI7). Natural, partially purified IL 1, a mixture of alpha and beta species, induced the entire spectrum of responses in HEC. Production of PA-I was elicited by all forms of IL 1 tested. PGI2 and PCA were elicited by "22K factor" and by human recombinant IL 1 beta and alpha but not by murine recombinant IL 1 alpha. PAF synthesis was stimulated by murine and human recombinant IL 1 alpha but not by human recombinant IL 1 beta and 22K factor. Thus the available different molecular forms of IL 1 elicit largely but not completely overlapping patterns of responses in HEC. The IL 1 pathway of regulation of HEC functions might provide a basis for novel strategies in therapeutically oriented research on vessel wall disorders. PMID- 3542085 TI - Monoclonal IgG gammopathy in a case of pustular psoriasis. A ten year follow-up. PMID- 3542086 TI - Psychiatric aspects of sexual abuse. AB - Sexual abuse of children and adolescents has become an increasingly publicized phenomenon. Psychiatrists and other mental health professionals are often called upon to evaluate and treat children and adolescents who may have been sexually abused, to provide counseling or treatment to the families of such children, and to provide reports and testimony for proceedings about such cases in the child protection system, the criminal justice system, and in custody disputes. Clarity regarding the medical, psychiatric, and legal aspects of sexual abuse is essential in carrying out such professional activities and in evaluating and formulating research on sexual abuse. In this paper current knowledge regarding these aspects of sexual abuse is summarized, and the role of psychiatrists in clinical and forensic work involving allegations of sexual abuse is discussed. PMID- 3542087 TI - Comparison of forced oscillometry and forced expirations for measuring dose related responses to inhaled methacholine in asthmatic children. AB - The forced oscillation technique (FOT) is a lung function method which is applicable from the age of 2.5 years onwards, because only passive co-operation is needed. We used the method as described by Landser et al. The aim of this study was to compare indices of bronchial responsiveness obtained by FOT (Rrs6, Rrs, dRrs/df, Xrs), with indices derived from maximal and partial expiratory flow volume curves (MEFV25, PEFV25, FEV1). Bronchial responsiveness was assessed by methacholine inhalation. Threshold dose (TD), i.e. the dose which caused a 2 SD change from baseline lung function, and provocation dose (PD), i.e. the dose which caused a 20% fall in FEV1, a 40% fall in MEFV25 and PEFV25 and a 40% increase in Rrs and Rrs6, were determined. We found that the indices derived from forced oscillometry compared well to those from maximal and partial flow-volume curves. PD20 FEV1 and PD40 Rrs6 were highly correlated (r = 0.84). TD appeared to be as good as PD to measure bronchial responsiveness and is preferred to PD because of the lower dose needed and limited bronchoconstriction obtained. PMID- 3542084 TI - Myelodysplastic syndromes: their history, evolution and relation to acute myeloid leukaemia. AB - The myelodysplastic syndromes (MDS) constitute a heterogeneous group of clonal disorders arising from a multipotent haemopoietic progenitor which share a leukaemic propensity, 30% of cases culminating in acute myeloid leukaemia (AML). Their pathogenesis probably entails multiple steps, phenotypic progression being determined by either expansion or evolution of the abnormal clone. The clonal origin of certain cases of de novo AML is analogous to that of MDS and evidence that they share a common pathogenesis and distinct biological characteristics is beginning to emerge. PMID- 3542088 TI - Bronchoconstriction due to isocapnic cold air inhalation minimally influences bronchial hyperresponsiveness to methacholine in asthmatic subjects. AB - The aim of this study was to investigate if bronchial hyperresponsiveness to methacholine could be influenced by a previous bronchoconstriction due to isocapnic inhalation of cold air. Twelve adult asthmatic subjects in a clinical steady state were seen on four different days in a randomized way according to three different sequences. After assessment of spirometry, bronchial responsiveness to inhaled methacholine was determined on each occasion by the provocative concentration causing a fall of 20% in FEV1 (PC20). On two occasions, the methacholine test was preceded by the inhalation of dry cold air which caused significant (greater than 20% change in FEV1) bronchoconstriction. The methacholine test was performed after functional recovery. There was a significant (t = 2.53; p less than 0.05) but minimal (mean changes of 0.65 single two-fold concentration difference) reduction in PC20 after cold air inhalation. It is concluded that cold air-induced bronchoconstriction causes significant but minimal changes in bronchial responsiveness to methacholine in asthmatic subjects. PMID- 3542089 TI - Respiratory clearance of solutes. PMID- 3542090 TI - Mutagenicity of nifurtimox and benznidazole in the Salmonella/microsome assay. AB - The genetic activities of two widely used anti-Trypanosoma cruzi drugs, nifurtimox and benznidazole, were investigated. The Salmonella mutagenicity (Ames) test was used to evaluate the mutagenic activity of both drugs. Nifurtimox and benznidazole preferentially induced backward mutations in the base substitution mutagen indicator strain TA100. The observed mutation rates for both drugs were linear over a wide concentration range. Maximum mutagenic activity was obtained at 35 and 100 micrograms per plate for nifurtimox and benznidazole, respectively. No increase in the mutagenic activity of either drug was observed in the presence of rat liver microsomal extracts. Survival experiments revealed that nifurtimox was at least four times more toxic than benznidazole for the Salmonella indicator strain. PMID- 3542091 TI - Comparison of the subacute effects of a new glucocorticoid, deflazacort, and prednisone on the hypothalamic-pituitary-adrenal axis of normal subjects. AB - The effects of deflazacort (DFL), a new oxazoline derivative of prednisolone, were compared with those of prednisone (Pd) by measuring plasma cortisol (F) levels as an index of the function of the hypothalamic-pituitary-adrenal (HPA) axis. Twelve normal volunteers received each glucocorticoid for 16 to 24 days in a double-blind cross-over trial with random allocation of subjects to treatment with DFL (24 mg/day) and Pd (20 mg/day) in clinically equivalent doses, with a washout period from 20 to 45 days between administration of the glucocorticoids. The following tests were performed in a randomized sequence: cortisol (F) circadian rhythm, insulin tolerance test (ITT), lysine-vasopressin (LVP) and B1 24 ACTH stimulation. Despite basal F suppression by DFL, the relative maximum F response (maximum F increment above basal/basal x 100) was significantly greater than control for the ITT and ACTH tests and was similar to the control after intramuscular injection of LVP, suggesting that the responses were appropriate for the basal F levels, with the HPA being reset at a lower level. After Pd, despite higher basal F levels, the F diurnal rhythm disappeared and there was no significant response to ITT, LVP or ACTH, indicating that the limiting factor in the HPA response was the reduced adrenal F production independent of the effects on the steroid-sensitive tissues of the brain including the pituitary. PMID- 3542092 TI - Differential assessment and the treatment of alcoholism. AB - The major objective of this study was to investigate the hypothesis that more effective alcoholism treatment would result from the provision of differential therapy, based on a differential assessment of psychopathology. A total of 135 alcoholics (125 male, 10 female), in-patients of a large psychiatric hospital in Co. Londonderry, Northern Ireland, were allocated to one of three psychopathological subgroups on the basis of their scores on the anxiety, depression and socialization factors of the Clinical Analysis Questionnaire (n = 45 in each group). Fifteen patients from each subgroup were assigned to one of two experimental treatment conditions or a control group. Experimental treatment Group 1 received therapy directed toward their psychopathology, while experimental treatment Group 2 received therapy directed toward their drinking behaviour per se. Therapeutic procedures were behavioural. The control group received only supportive counselling. The results at follow-up nine months later revealed that differences in improvement rates across groups were not statistically significant. A number of subsidiary hypotheses were also investigated and significant differences were found between the three psychopathological subgroups on factors relating to aetiology, course of alcoholism and prognosis. PMID- 3542093 TI - [Effect of maternal diabetes on the enteropancreatic system of the rat fetus]. PMID- 3542095 TI - J. Y. Simpson's early articles on chloroform. PMID- 3542094 TI - Exercise and hypertension. PMID- 3542096 TI - Thomas Hodgkin and Benjamin Guy Babington: friendly rivals and career parallels. PMID- 3542097 TI - Byrd's "running". PMID- 3542098 TI - A diamond jubilee. PMID- 3542099 TI - Bloodletting in talmudic times. PMID- 3542100 TI - Transplantation. Kidneys. AB - Nearly 2000 patients each year commence renal replacement therapy in the UK. Renal transplantation offers a return to a near-normal lifestyle and has considerable financial advantages over long-term dialysis. Recent developments have increased the success rate to nearly 90%, and there is a real need to improve the supply of cadaver kidneys available for transplantation. PMID- 3542101 TI - Transplantation. The liver. AB - Liver transplantation has been described as one of the most difficult of surgical operations. But in a few major centres throughout the world good results follow this procedure and patients otherwise condemned to an early and miserable death can enjoy a happy life once more. PMID- 3542102 TI - Transplantation. Pancreas. AB - Significant progress has been made in the management of diabetes mellitus treated by pancreas transplantation since the first unsuccessful attempts in the late 1960s. Continuing advances in surgical techniques, immunosuppression and the diagnosis of rejection have resulted in improved patient and graft survival, but the optimal timing and method have still to be decided. PMID- 3542103 TI - Modern management of heart failure. AB - The biochemistry and pathophysiology of ventricular dysfunction leading to cardiac failure, and the importance of abnormal peripheral haemodynamics and altered neurohumoral mechanisms, are now better understood. Treatment has been rationalised and the place of vasodilators, particularly converting-enzyme inhibitors, has been established. There is no evidence that prognosis has been improved despite symptomatic improvement in the patient with heart failure. PMID- 3542104 TI - Doppler ultrasound and digital vascular imaging. AB - There have been many major advances in imaging techniques over the last decade. Of these, intravenous digital vascular imaging (IV DVI) and duplex Doppler ultrasound allow the outpatient investigation of many types of vascular disease which previously could only be studied by more hazardous angiographic methods requiring admission to hospital. This article compares the uses of these techniques in the outpatient investigation of vascular diseases. PMID- 3542105 TI - Stimulation and suppression of renin release from incubations of rat renal cortex by factors affecting calcium flux. AB - Inhibition of renin secretion from incubations of rat kidney cortex by angiotensin II (AII), ouabain and K+ depletion, depended on the presence of external Ca2+. AII inhibition of isoprenaline-stimulated renin secretion was only partially dependent on external Ca2+. Ouabain and K+ depletion inhibited isoprenaline-stimulated renin release but only in the presence of external Ca2+. Since, in Ca2+-free medium, isoprenaline stimulated renin release when the Na+/K+ ATPase was blocked, isoprenaline probably does not act through the Na+/K+-ATPase. Lanthanum blocked the stimulation of renin release by isoprenaline. Ethylenediamine tetra-acetic acid (EDTA) and ethyleneglycol-bis-(beta-amino-ethyl ether) N,N'-tetra-acetic acid (EGTA) increased renin secretion to a similar degree in Ca2+- and Mg2+-free buffer. When Mg2+ was present the effect of EGTA, but not EDTA, was considerably reduced. Verapamil reduced the fall in basal renin secretion in normal but not Ca2+-free buffer. Verapamil did not block the inhibitory effects of AII or ouabain and did not alter the stimulation of renin secretion by isoprenaline. Bay K 8644 inhibited renin secretion from cortex incubated in medium containing 15 mM K+ and this was dependent on extracellular Ca2+. In normal buffer (5.9 mM K+) Bay K 8644 increased renin secretion. PMID- 3542106 TI - Structure-activity relationships of alloxan-like compounds derived from uric acid. AB - The diabetogenic activity of a range of alloxan-like compounds derived from uric acid has been investigated. The classes of derivatives were: 5-substituted isouric acids; 4,5-disubstituted-4, 5-dihydrouric acids; 5-substituted-pseudouric acids; salts of dehydro-uramil hydrate; salts of dehydro-isouramil hydrate; alloxan derivatives. Compounds were tested by intravenous injection into rats and diabetogenic activity assessed by production of persistent hyperglycaemia and glycosuria. The only essential structural feature common to all active compounds was the presence of a quinonoid pyrimidine system or its hydrated equivalent. The presence of the five-membered ring of uric acid (or an opened form thereof) did not abolish and in some compounds enhanced diabetogenic activity. PMID- 3542107 TI - On the mechanisms of kappa-opioid-induced diuresis. AB - In conscious saline loaded rats, the kappa-opioid agonists tifluadom, U50488, and ethylketocyclazocine, given subcutaneously, induced a characteristic diuresis which could be antagonized by naloxone. Bilateral adrenal demedullation significantly reduced adrenal gland catecholamine content and plasma adrenaline levels, but did not significantly affect plasma corticosterone levels, indicating that the adrenal cortex remained both intact and functional. Seven days following bilateral adrenal demedullation, the subcutaneous administration of the kappa agonists no longer induced diuresis. However, demedullation did not affect the diuretic response to frusemide or clonidine, nor did it affect the antidiuretic response induced by the mu-opioid agonists morphine and buprenorphine. Adrenal catecholamines do not appear to be involved in kappa-opioid-induced diuresis, since pretreatment with propranolol, prazosin and idazoxan did not affect the diuretic response in intact animals. The results indicate a link between the adrenal medulla and kappa-opioid-induced diuresis and suggest that a peripheral mechanism may also be involved in mediating this effect. PMID- 3542108 TI - Unilateral obstruction of septate uterus: computed tomography and ultrasound appearances. PMID- 3542109 TI - Sonographic and computed tomographic findings in Canavan's disease. PMID- 3542110 TI - A toxicity and pharmacokinetic study in man of the hypoxic-cell radiosensitiser RSU-1069. PMID- 3542112 TI - Diagnosis of testicular torsion using Doppler ultrasonic examination. AB - The differential diagnosis of acute scrotum in an emergency is difficult and the diagnosis is rarely certain. Moreover, torsion is often diagnosed too late to save the testis involved. The Doppler ultrasonic flowmeter has enabled us to make a correct and rapid diagnosis of acute scrotum and has reduced the number of negative scrotal explorations. It seemed logical to use the Doppler flowmeter in the diagnosis of torsion of the testis, since testicular blood flow should be diminished in torsion and unaffected in most other intrascrotal conditions. The testes lend themselves to the use of this instrument because they are accessible and because one testis can be used as a control in the qualitative evaluation of the sound of the testicular blood flow. PMID- 3542111 TI - Predictive value of 99mTc-DTPA renography studies under conditions of maximal diuresis for the functional outcome of reconstructive surgery in children with obstructive uropathy. AB - Renographic studies under standardised conditions of maximal diuresis provoked by infusion of hypotonic saline and frusemide were made on 51 patients with 54 dilated upper urinary tract systems in order to distinguish obstructed from non obstructed systems. Of the 23 systems judged on clinical and radiological grounds to be obstructed only 12 were in fact obstructed following infusion of hypotonic saline and frusemide. In 10 of these systems (10 patients) an Anderson-Hynes pyeloplasty was carried out. All systems showed improved renal function after operation and the renographic pattern became non-obstructed. PMID- 3542113 TI - Endogenous vasopressin and baroreflex mechanisms. AB - This article reviews the anatomical and functional evidence for ascending pathways from specific brain regions to the PVN and SON which could influence AVP release. The majority of evidence favours the main projection being from a region in the caudal VLM which may coincide with the noradrenergic neurons of the A1 cell group. However, the transmitter(s) involved have yet to be identified, and whether the pathway is excitatory and/or inhibitory remains to be fully resolved. Anatomical and functional evidence is reviewed for descending projections from the SON and PVN to specific brain regions involved in cardiovascular control, and their possible involvement in baroreflex mechanisms is discussed. However, there is little unequivocal evidence that AVP is the main neurotransmitter utilized by descending projections from PVN to NTS and DMX. While, in some situations, circulating endogenous AVP exerts cardiovascular effects, details of its putative influences on baroreflex mechanisms are lacking. PMID- 3542114 TI - The organization and development of the hippocampal mossy fiber system. AB - The anatomical organization and development of the hippocampal mossy fiber system has been reviewed with special reference to its organization in the common laboratory rat. The mossy fibers originate from the granule cells of the dentate granular layer and the few granule cells found scattered in the dentate molecular layer and hilus. Via a complex system of collaterals the mossy fibers terminate on several types of neurons in the hilus, e.g. the basket cells and the mossy cells. Upon leaving the hilus to pass into Ammon's horn, the mossy fibers converge to form a distinct band of fibers that terminates on the proximal part of the apical and basal dendrites of the pyramidal and basket cells of the regio inferior. In some mammalian species the mossy fibers may continue into the adjacent part of the regio superior. Despite differences in the number of granule cells and pyramidal cells at different septotemporal levels this organization is relatively uniform along the septotemporal extent of the hippocampus. During development the mossy fibers grow out in a sequential manner that matches the pattern of neurogenesis and the aggregation of the cells of origin. From the level at which they originate, the fibers diverge along the septotemporal axis in such a way that the oldest granule cells have the most extensive projections. The adult topographic organization, which is already apparent at the earliest developmental stages, is thus formed in a stepwise fashion. It is concluded that the organization of the hippocampal mossy fibers indicates that neuronal specificity should not be explained by cellular recognition alone, but rather as the cumulated product of the preceding sequence of developmental events that include neurogenesis, migration, aggregation and directed axonal outgrowth. PMID- 3542115 TI - Function of the ventrolateral medulla in the control of the circulation. AB - The CNS control of the cardiovascular system involves the coordination of a series of complex neural mechanisms which integrate afferent information from a variety of peripheral receptors and produce control signals to effector organs for appropriate physiological responses. Although it is generally thought that these control signals are generated by a network of neural circuits that are widely distributed in the CNS, over the last two decades a considerable body of experimental evidence has accumulated suggesting that several of these circuits involve neurons found on or near the ventral surface of the medulla oblongata. Neurons in the VLM have been shown to be involved in the maintenance of vasomotor tone, in baroreceptor and chemoreceptor (central and peripheral) reflex mechanisms, in mediating the CIR and somatosympathetic reflexes and in the control of the secretion of vasopressin. These physiological functions of VLM neurons have been supported by neuroanatomical and electrophysiological studies demonstrating direct connections with a number of central structures previously implicated in the control of the circulation, including the IML, the site of origin of sympathetic preganglionic axons, and the SON and PVH, the site of origin of neurohypophyseal projecting axons containing AVP. Considerable suggestive evidence has also been obtained regarding the chemical messengers involved in transmitting information from VLM neurons to other central structures. There have been developments suggesting a role for monoamines and neuropeptides in mediating the neural and humoral control of SAP by neurons in the VLM. This review presents a synthesis of the literature suggesting a main role for VLM neurons in the control of the circulation. PMID- 3542116 TI - Astrocytic reactivity and intermediate filament metabolism in experimental autoimmune encephalomyelitis: the effect of suppression with prazosin. AB - In either actively or passively transferred experimental autoimmune encephalomyelitis (EAE), increased immunocytochemical staining of glial fibrillary acidic protein (GFAP) in astrocytes was detected early in the disease process in both the gray and white matter of the spinal cord. Staining was not restricted to areas of perivascular mononuclear infiltration, and was observed at all levels of the cord. This enhanced staining pattern was delayed in rats in which clinical signs of EAE had been suppressed by treatment with the alpha 1 adrenoceptor antagonist prazosin. This glial reaction in EAE was not accompanied by increased GFAP synthesis, as measured by in vitro labeling of spinal cord slices, nor an increase in GFAP content, as measured by densitometry of intermediate filament fractions separated by polyacrylamide gel electrophoresis. Total protein synthesis was increased, with vimentin being labeled especially heavily; in prazosin-treated EAE animals, the increase in total protein synthesis was reduced and delayed. PMID- 3542117 TI - The distribution of calcineurin in rat brain by light and electron microscopic immunohistochemistry and enzyme-immunoassay. AB - Calcineurin is the calcium (divalent cations)-dependent calmodulin-stimulated phosphoprotein phosphatase which is capable of dephosphorylating various substrate proteins. The subcellular and regional distribution of calcineurin in the rat brain has been studied by light and electron microscopic immunohistochemistry using antiserum against calcineurin. Immunoreactivity was observed in many neurons but was not detected in glial cells, such as astrocytes, oligodendrocytes and ependymal cells by the PAP method. Light microscopy demonstrates strong immunoreactivity in neuronal somata and neurites. By electron microscopy, calcineurin immunoreactivity was found to be present in dendrites including postsynaptic densities, somata, spines, axons and terminals. Calcineurin immunoreactivity was present in neurons throughout the brain, but a marked regional variation in strength of the immunoreactivity was observed. The caudatoputamen, hippocampal formation, and substantia nigra were strongly stained. Cerebral and cerebellar neocortex showed moderate immunoreactivity. In substantia nigra and globus pallidus, only neurites were stained, but neuronal somata not. The staining of the substantia nigra was thought to be due to that of the nerve terminals originating from the caudatoputamen, in view of the findings by cerebral hemitransection and electron microscopic immunohistochemistry. We developed an enzyme-immunoassay (EIA) for calcineurin. The sensitivity of the EIA was 1 ng (13 fmol) of calcineurin. We determined the level of calcineurin in various regions of the rat brain. The caudate nucleus, putamen and hippocampal formation showed a high concentration of calcineurin. The results are consistent with those obtained by immunohistochemistry. PMID- 3542118 TI - Neurotensin immunoreactive structures in the human infant striatum, septum, amygdala and cerebral cortex. AB - Neurotensin immunoreactive (NT-IR) neuronal perikarya are present in small numbers in the bed nucleus of the stria terminalis, lateral olfactory stria, substantia innominata, caudate nucleus and putamen of the human infant forebrain. Larger numbers of perikarya are present in the amygdala and related structures. NT-IR axons are present in the medial septal area, bed nucleus of the stria terminalis, caudate nucleus, putamen and amygdala. The cerebral cortex contains a rich network of NT axons with an accentuation in layer II. This network appears to be derived from bundles of axons which traverse the deep white matter from the thalamus. PMID- 3542119 TI - Neurophysiology of limbic system pathways in the rat: projections from the subicular complex and hippocampus to the entorhinal cortex. AB - We studied the responses of rat entorhinal neurons to electrical stimulation of the dentate gyrus, hippocampus and subicular complex. Three main results were obtained. Excitatory postsynaptic potentials were recorded in entorhinal neurons in response to electrical stimulation. Cell in layers II, III and V of the entorhinal cortex were responsive. Frequency potentiation of excitatory responses was observed when 10/s stimulation was used. Excitatory responses were followed by inhibitory postsynaptic potentials. The results provide evidence for an excitatory projection from the hippocampus and subiculum to the entorhinal cortex, and are consistent with the existence of feed-forward inhibition of entorhinal principal neurons. PMID- 3542120 TI - Insulin inhibits specific norepinephrine uptake in neuronal cultures from rat brain. AB - Neuronal cells in primary culture have been demonstrated to possess specific insulin receptors (Boyd et al., J. Biol. Chem., 260 (1985) 15880-15884). Incubation of these cultures with insulin causes a dose-dependent inhibition of maprotiline-sensitive [3H]norepinephrine uptake. Maximum inhibition of 95% of maprotiline-sensitive norepinephrine uptake was observed at an insulin concentration of 167 nM with an ED50 of 30 nM. Competition-inhibition and Scatchard analysis of the insulin binding data suggested that maprotiline competed for high-affinity insulin receptors. These observations suggest that both insulin and maprotiline specifically inhibit neuronal norepinephrine uptake possibly involving insulin receptors. PMID- 3542121 TI - The GABAergic striatonigral neurons of the cat: demonstration by double peroxidase labeling. AB - GABAergic striatonigral neurons were demonstrated in the adult cat by the specific double peroxidase labeling of a transmitter marker with an agranular appearance (GAD, the synthetic enzyme of GABA) and a connectivity marker with a granular appearance (WGA-HRP). Each marker was associated with different organelles confined to the perikaryal cytoplasm of neurons. GABAergic striatonigral neurons were of medium size, high frequency and wide location in the rostral caudate nucleus and putamen based on correlative light and electron microscopic identification. These cells had somatic and/or proximal dendritic spines and folded nuclear envelopes in some cases. They received GABAergic axosomatic and axodendritic inputs with symmetric synaptic specializations. They were also contacted by axosomatic, axodendritic and axospinous terminals with asymmetric synaptic specializations. These results indicate that the GABAergic striatonigral neurons are, for the most part, medium spiny cells that also emit intrastriatal axonal collaterals. Their intra- and extrastriatal axons mediate inhibitory postsynaptic influences on their targets. Their degeneration might contribute to the GABAergic deficits found in the basal ganglia in Huntington's disease. PMID- 3542122 TI - Immunohistochemical demonstration of neurotensin in striatal neurons of the cat, with particular reference to coexistence with enkephalin. AB - Neurotensin-like immunoreactivity (NT-LI) was visualized in medium-sized, spiny neurons of the caudate nucleus (Cd) and putamen (Put) in colchicine-treated cats by the indirect immunoperoxidase method. In serial sections alternately immunostained for NT and enkephalin (Enk), coexistence of NT-LI and Enk-LI was revealed in about 50% of NT-neurons and about 50% of Enk-neurons in Cd and Put. PMID- 3542123 TI - Effect of proteases and their inhibitors on neurite outgrowth from neonatal mouse sensory ganglia in culture. AB - Developing neurons and Schwann cells have been shown to secrete proteases. The influence of these proteases on neurite outgrowth by cultured sensory ganglia was examined by adding specific protease inhibitors. Neonatal mouse dorsal root ganglia were cultured directly on tissue-culture plastic dishes in serum-free N2 medium with different protease inhibitors. Soybean trypsin inhibitor was found to double the extent of neurite outgrowth by 4 days in vitro. Ovomucoid trypsin inhibitor and leupeptin also increased neurite outgrowth, while alpha 1 antitrypsin, antipain and phenylmethylsulfonyl fluoride elicited a smaller effect. Furthermore, added trypsin or thrombin inhibited neurite outgrowth and the inhibition could be reversed by soybean trypsin inhibitor, while exogenous plasminogen or urokinase were inhibitory only at high concentrations. Thus neurite outgrowth probably requires a closely regulated system of protease secretion and protease inhibitor production. PMID- 3542124 TI - Enkephalinergic projection from the ventromedial hypothalamic nucleus to the midbrain central gray matter in the rat: an immunocytochemical analysis. AB - The projection of enkephalin-like immunoreactive (EnkI) neurons in the ventromedial hypothalamic nucleus (VMH) in the rat was investigated using immunocytochemistry. These neurons project to the dorsal portion of the midbrain central gray matter (DCG), because the destruction of the VMH resulted in a marked ipsilateral reduction of EnkI fibers there. Destruction of the dorsomedial portion of the VMH caused the appearance of fibers accumulating EnkI ventrolateral to the lesion and these fibers could be traced to the ventrolateral portion of the VMH where many EnkI neurons were concentrated. Transection of the brain at the level of the premammillary nucleus, mammillary body and superior colliculus caused the appearance of fibers accumulating EnkI in the posterior hypothalamic nucleus (PH), central gray matter medial to the fasciculus retroflexus Mynert and in the DCG, respectively. We concluded that the axons from these neurons first project dorsomedially to situate in the PH. These fibers ran caudodorsally and entered into the dorsal longitudinal fasciculus in the DCG at the midbrain. PMID- 3542126 TI - Non-Purkinje cell GABAergic innervation of the deep cerebellar nuclei: a quantitative immunocytochemical study in C57BL and in Purkinje cell degeneration mutant mice. AB - Purkinje cell degeneration (pcd) mutant mice, 3-4 months old, were used to identify and quantify the non-Purkinje cell GABAergic innervation of deep cerebellar nuclei. Glutamic acid decarboxylase (GAD) immunoreactive structures appeared as dark dots throughout the 4 nuclei. Ultrastructural examination confirmed that each dot corresponded to an axon terminal. GAD-labeled boutons were large, contained tightly packed flattened vesicles and established Gray type II synapses with all nuclear neuronal populations. Thus, cytological criteria did not distinguish between Purkinje cell and non-Purkinje cell GAD-positive nerve terminals, since they shared many common features. The number of GAD immunoreactive axon terminals in the deep nuclei of pcd cerebella was compared to that of normal C57BL mice. Despite an almost complete disappearance of Purkinje cells in the pcd mouse (less than 0.05% of these neurons remained in the mutants), the surface density of GAD-positive nerve terminals in the deep nuclear region was 37% of control value. Taking into account a volumetric decrease of 58% for the deep nuclei of the mutant cerebellum, we estimated the percentage of GAD positive boutons innervating these nuclei to be 15% of normal values. This important residual innervation of the deep nuclei might arise from local GABAergic neurons, which were identified in the normal and mutant cerebella by immunostaining with an anti-GABA antibody. PMID- 3542125 TI - Naloxone-insensitive potentiation of neurotensin hypothermic effect by the enkephalinase inhibitor thiorphan. AB - The hypothermic effect of neurotensin (0.1 microgram) injected i.c.v. in mice is potentiated by the enkephalinase inhibitor thiorphan (10 micrograms, i.c.v.). This potentiation is not reversed by systemic naloxone. The hypothermic effect of neurotensin is not modified by the amino-peptidase inhibitor bestatin (50 micrograms, i.c.v.) nor by the angiotensin-converting enzyme inhibitor captopril (50 micrograms, i.c.v.). These data indicate the involvement of enkephalinase in the inactivation of neurotensin, at least when it is injected i.c.v. PMID- 3542127 TI - GABA immunoreactivity in the thalamic reticular nucleus of the rat. A light and electron microscopical study. AB - The thalamic reticular nucleus (TRN) of the rat has been studied immunocytochemically using an antiserum against the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Combined light and electron microscopic investigations by means of peroxidase-antiperoxidase and immunogold labeling show that this nucleus contains a homogeneous population of GABA-immunoreactive neurons receiving extensive GABAergic connections suggestive of self-inhibitory inputs. PMID- 3542128 TI - Short-term control of feeding: limitation of the glucostatic theory. AB - In the rat, the short-term effect on spontaneous feeding of intravenous administration of either glucose or glucose plus insulin was investigated. The infusions lasted 4 hours and covered 170% of rats's previously measured spontaneous caloric intake, while control infusions of saline and saline plus insulin were also made. Feeding patterns in subjects' home cages were recorded. Glycaemia and glycosuria were measured in order to asses glucose utilization. When it was infused alone, glucose was utilized at 95% and so covered 160% of oral caloric requirements, while the reduction of oral intake was only 40%. When insulin was co-infused with glucose, utilization reached 100% and oral feeding was reduced by 70%. Saline infusions did not affect oral feeding, and insulin brought about the expected increase in feeding. It is proposed that the mechanism which sustains feeding should depend on multiple macronutrients utilization rather than on one specific chemical family. Furthermore, the fact that insulin has a clear-cut effect, despite its lipogenetic, i.e., metabolite-sequestering properties, favors the ischymetric hypothesis (based on cellular power production), rather than the energostatic one (based on yields of nutrients). PMID- 3542129 TI - Dietary self-selection in diabetic rats: an overview. AB - The literature concerning dietary self-selection patterns of diabetic rats is reviewed and compared with new data. There is agreement among the various investigators as to the dietary choices observed following induction of diabetes, regardless of the diabetogenic treatment used. That is, moderately diabetic rats select a high fat, low carbohydrate diet, whereas more severely diabetic animals consume high protein, low carbohydrate diets with little change in fat consumption relative to nondiabetic controls. Even very midly diabetic rats reduce carbohydrate intake. Evaluation of metabolic status of diabetics suggests that with severe diabetes, the beneficial reduction of plasma glucose seen with consumption of a high fat diet may be offset by extreme elevations in ketone and triglyceride levels. Moreover, the hypothesis that diabetic rats are insensitive to carbohydrate calories seems weakened by evidence of reduced food intake following carbohydrate consumption either in solutions or as a gastric load. These findings are discussed in terms of "dietary wisdom" as first proposed by Richter. PMID- 3542131 TI - [Occurrence of L.A.V. infection in drug addicts in the northern suburbs of Paris]. PMID- 3542130 TI - Large changes in food intake in diabetic rats fed high-fat and low-fat diets. AB - Groups of male Sprague-Dawley rats were predominantly fed either a high-fat or a high-carbohydrate (CHO) diet. For designated 2-day periods, their diets were switched. After baseline measurements of food and water intake, the rats were made diabetic by injections of either 40 or 46-50 mg/kg streptozotocin. Food and water intake gradually increased over a 15-day period for rats on the CHO diet. Whenever the diets were switched, many of the rats showed large changes in food and fluid intake. Body weight showed a gradual decline, but the rats retained half of the dissectable abdominal body fat at sacrifice. Measurements of plasma glucose, insulin and glucagon proved that the rats were diabetic. The changes in average food intake were reasonably consistent with the "utilizable fuel" theory for the control of food intake assuming that the CHO component of each diet was non-utilizable. The distribution of the fat/CHO utilizable fuel ratio in both experiments was flat and non-normal showing that some rats ate as much of the high fat diet as the high CHO diet. Other rats tended to avoid the high fat to an extent that was greater than predicted by the theory, suggesting that the fat diet may have caused malaise. Thus, the individual rat data did not provide strong support for the "utilizable fuel" theory. PMID- 3542133 TI - [Schools and society]. PMID- 3542132 TI - [Sleep apnea syndrome in adults: its limits and importance of diagnosis ]. PMID- 3542134 TI - [Beginning of compulsory school attendance]. PMID- 3542135 TI - [Scholastic life. The right to be different]. PMID- 3542136 TI - [School-related problems in consultation of adolescents]. PMID- 3542137 TI - [Reflections of a teacher]. PMID- 3542138 TI - [Respective roles of atheroma and hypertension in the etiology of cerebrovascular disorders]. PMID- 3542139 TI - [Dispensing of medicinal plants and the herbalists]. PMID- 3542140 TI - [Cranial nerve vascular syndromes caused by ischemia, cerebral trunk excepted]. PMID- 3542141 TI - Analysis of the cell membrane proteolytic enzymes of the B16, F1, F10, and BL6 melanoma and their role in target cell destruction. AB - The tumor-induced red blood cell (RBC) cytolysis assay has been used to demonstrate that three B16 melanoma sublines, the F1, F10, and BL6, cause the cytolysis of normal red blood cells in vitro. RBC cytolysis was inhibited for all three sublines by metalloprotease inhibitors. Cell membrane preparations have been prepared for all three sublines and tumor cell membrane-induced RBC cytolysis was also shown to be inhibited by metalloprotease inhibitors. The F10 and BL6 sublines were shown to have cell membrane-bound proteases. The BL6 subline has a cell membrane enriched in an enzyme with a trypsin-like arginine specificity. The trypsin-like protease may have a metal dependence. The BL6 subline has a collagenolytic cell membrane enzymes and a chymotrypsin-like cell membrane enzyme. B16 cell membrane enzymes may be responsible for RBC cytolysis in vitro in a process requiring divalent cations. PMID- 3542142 TI - Advances in rational combination chemotherapy. AB - Due to the high frequency of micro- or macrometastatic disease at the time of diagnosis of cancer, and to the increasing prevalence of cancer in this country, the use of chemotherapy to evoke cure or prolongation of survival has become critically important. In addition, the growth kinetics of large tumor burdens and the high probability of drug-resistant cells in a tumor mass at the time of diagnosis necessitate combinations of chemotherapeutic agents rather than single agents as the most effective mode of treatment. Since there are 40 to 50 active anticancer drugs now utilized, and since synergy between drug combinations is often dose and/or schedule dependent, the number of possible drug combinations and permutations is vast. Thus, screening for effective drug combinations requires a rational approach which will allow for accurate predictions of synergy. Most advances in this scientific approach have utilized biochemical modulation in conjunction with in vitro cytotoxicity assays, in particular, clonogenic assays. Such an approach has generated a number of drug combinations, such as sequential MTX-5FU, with widely applicable clinical efficacy. The continued use of biochemical modulation should rapidly generate new effective drug combinations which will, hopefully, allow us to cure even those cancers presently considered incurable. PMID- 3542143 TI - Commentary on September 1985 NIH Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer. AB - The conservative recommendations of the second (1985) NIH Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer may result in needless premature deaths. The failure to recommend chemotherapy for high-risk postmenopausal patients is contrary to current practice among American oncologists. A recent Chemotherapy Foundation survey of medical oncologists revealed that 75% employed adjuvant polychemotherapy for high-risk postmenopausal women. Valid statistical data supporting the survival benefit of tamoxifen are derived from both Stage I and Stage II postmenopausal patients. While recommending tamoxifen as treatment of choice for Stage II, the Consensus lost an opportunity to encourage increased survival in Stage I patients and also discouraged chemoprevention trials such as those now underway in England. The curative potential of chemotherapy for high-risk women regardless of age was ignored despite several large studies ongoing now for 8-19 years which indicate 10-27% increased disease-free survival. As many as 10,000-15,000 lives per year could be saved in the United States by more realistic recommendations and the application of early aggressive chemotherapy for high-risk patients and tamoxifen for Stage I postmenopausal patients. PMID- 3542144 TI - [Removal of multiple organs for transplantation]. PMID- 3542145 TI - [A controlled trial of ornithine alpha-ketoglutarate in neuro-traumatology]. PMID- 3542146 TI - [Anesthesia in subjects sensitive to malignant hyperthermia]. PMID- 3542147 TI - A study of factors affecting the dental care of an elderly population in Bath Health District. PMID- 3542148 TI - [Role of the lateral pterygoid muscle in the onset phase of temporomandibular joint pain-dysfunction syndrome]. PMID- 3542149 TI - [Results of 5 years' exclusive use in fixed prosthetics of a high-precision alginate. An original impression technic]. PMID- 3542150 TI - [Affinity and antagonism of alginate materials and model plaster. Clinical aspects of improved materials]. PMID- 3542152 TI - [Mechanical properties of the metal frameworks of removable partial dentures. Contribution of thermal treatment]. PMID- 3542151 TI - [Clinical aspects of retention in the anterior region]. PMID- 3542153 TI - Genevieve Cooke. PMID- 3542154 TI - The hydrodynamic impression technique. PMID- 3542155 TI - Calcifying epithelial odontogenic tumor (Pindborg tumor). Review of the literature and case report. PMID- 3542156 TI - Problems associated with edentulism among the elderly. PMID- 3542157 TI - Visibility and prestige of occupations and the importance of dental appearance. PMID- 3542158 TI - Demand and supply of dental services: an economic perspective. PMID- 3542159 TI - Alberta dental practitioner establishes unique winery. PMID- 3542160 TI - Our founding fathers. The Canadian Ophthalmological Society. PMID- 3542161 TI - Glucose oxidation in white adipose tissue from BIO 14.6 dystrophic hamsters. AB - In studies of glucose oxidation in white retroperitoneal adipose tissue of BIO 14.6 dystrophic and F1B normal hamsters aged 55-67 and 368-379 days, no difference was found in the basal state of radiolabelled 14CO2 production using either D-[6-14C]glucose or D-[1-14C]glucose. When C6-labelled glucose was used, insulin induced a slightly greater increase in glucose oxidation in dystrophic adipose tissue at both ages. When C1-labelled glucose was used, insulin enhanced glucose oxidation in dystrophic tissue more than twice normal in tissues from young animals and five times normal in tissues from the old ones. The increase in oxidation with D-[1-14C]glucose likely represents enhanced activity of the pentose phosphate pathway, which has also been observed in certain tissues of other animals with inherited skeletal-muscle degeneration. The change can probably be classified as being compensatory, an attempt by tissues to maintain functional integrity. PMID- 3542162 TI - Escherichia coli gastroenteritis: making sense of the new acronyms. Infectious Diseases and Immunization Committee, Canadian Paediatric Society. PMID- 3542163 TI - In vivo methods of standardization. PMID- 3542164 TI - Standardized extracts, trees. AB - Sensitization to pollen from wind-pollinated trees causes significant allergy problems during springtime. The magnitude of prevalence is comparable with and, in some areas, even higher than grass pollen allergy. The symptom periods are often prolonged by cross-reactivity among species and sometimes families as well as by simultaneous sensitivity to several trees, pollinating at different times. There is a need for standardized extracts to improve diagnostic precision and treatment efficacy. A substantial amount of immunochemical data on the allergens from Betulaceae species, particularly Betula (birches), are available. Relevant methods to quantitatively and qualitatively measure the allergens of birch pollen extracts are clearly reproducible in laboratories around the world. By international collaboration, such work has generated an IS that has been accepted by the IUIS Subcommittee on Allergen Standardization. The IS is a yardstick for authorities, manufacturers, and researchers that is carefully specified in terms of 1 major and a few intermediate allergens, and also of total biologic activity by RAST inhibition. A meaningful declaration of biologic activity in vivo is awaited. As yet, only a few clinical trials have been undertaken with standardized tree pollen extracts. These are, however, highly interesting, particularly those that now have started with an oral route of administration. PMID- 3542165 TI - Pathology of pulmonary sarcoidosis. PMID- 3542167 TI - Ocular sarcoidosis. PMID- 3542166 TI - Pulmonary sarcoidosis: steroid treatment. PMID- 3542168 TI - Sarcoidosis of the head and neck. PMID- 3542169 TI - Cardiac sarcoidosis. PMID- 3542170 TI - Sarcoidosis in various organs. PMID- 3542171 TI - The Kveim-Siltzbach test. PMID- 3542172 TI - Cutaneous sarcoidosis: definitions and types of lesions. PMID- 3542174 TI - The diagnosis and differential diagnosis of cutaneous sarcoidosis. PMID- 3542173 TI - Immunologic studies on cutaneous lesions in sarcoidosis. PMID- 3542175 TI - Erythema nodosum. PMID- 3542176 TI - Pulmonary sarcoidosis: radiographic features. PMID- 3542177 TI - Contraception and diabetes mellitus. PMID- 3542178 TI - The impact of AIDS on artificial insemination by donor. AB - Artificial insemination by donor (AID) provides a necessary service to a significant number of infertile couples. Its practice has been well controlled in Australia by careful donor screening and selection of suitable recipients. The potential for transmission of several infectious diseases has demanded a vigorous protocol for donor assessment and a strong movement away from the use of fresh semen. The description of human immunodeficiency virus (HIV) transmission by AID has increased the need for vigilance and has mandated, both by common sense and by Health Department Requirement (in Australia), the universal use of frozen donations. Antibody testing for HIV is not fail safe and must be supported by a carefully constructed lifestyle declaration form and a drive to recruit monogamous donors. The recruitment of sufficient donors has always been a problem and the advent of the HIV has not helped. Whilst transmission to laboratory staff appears to represent an extremely low risk, this possibility has required the development of safety protocols and appropriate staff training. This review outlines the current problems of running an AID programme given the knowledge that the HIV can be maintained in liquid nitrogen and transmitted atraumatically to a recipient. PMID- 3542179 TI - Polypharmacy in psychiatry: update and future trends. AB - Psychoactive drug combinations continue to be controversial. The concept of "polypharmacy", a pejorative and meaningless term, nevertheless gave rise to useful surveys on combined drug use, to methods of monitoring and controlling multiple drug use, and to a small number of studies which imply that a few psychoactive drug-drug combinations are rational. This paper updates the contributions to these areas since two major reviews of the subject were published in the early 1980's. It highlights common pitfalls in the survey-taking process. Finally, it suggests future useful avenues of study and research, wherein it is hoped that the studies will be more rational than the term "polypharmacy". PMID- 3542180 TI - Family therapy--where are we, and where are we going? AB - There has been considerable growth and development in the field of family assessment and therapy over the past thirty years. This management approach provides a useful tool in the assessment, management and treatment of children, adolescents and families with various psychiatric disorders and mental health problems. This paper provides a broad overview and a critical evaluation of the present state of the art, paying particular attention to the integration and present status of clinical practice, theoretical models, research, teaching and training programs. Based on the emerging trends, directions for the future are suggested including an exploration of the integration of different therapeutic modalities. Finally, the practical problems associated with the teaching of these approaches in General Psychiatry Training Programs are addressed. PMID- 3542181 TI - Rapid cycling disorders and the role of combined lithium and haloperidol decanoate. PMID- 3542182 TI - Thoracotomy for pulmonary metastatic osteosarcoma. An analysis of prognostic indicators of survival. AB - Removal of pulmonary metastases of osteosarcoma by thoracotomy is an accepted treatment; however, few investigators have analyzed the value of various prognostic factors in estimating survival. A review of all patients undergoing thoracotomy for recurrent osteosarcoma with pulmonary metastases treated at St. Jude Children's Research Hospital is reported. Since 1968, two thirds (39/59) of all patients who developed pulmonary metastases have had a total of 66 thoracotomies. Nine patients are alive with no evidence of disease, and six additional patients are alive with disease. Analyzed in 39 evaluable patients, the prognostic factors that correlate with survival by univariate analysis are: sex, number of nodules detected radiographically and resected, completeness of resection, and tumor location (bilateral versus unilateral). By Cox regression analysis, only sex and the number of nodules detected either radiographically or during surgery, and resected, had statistically significant correlation with survival. Thoracotomy is curative for some patients with pulmonary metastatic osteosarcoma and Prognostic factors predictive for survival are defined. PMID- 3542183 TI - Interferon in the treatment of hairy cell leukemia. AB - An ongoing multicenter study has confirmed earlier observations that interferon alfa-2b (Intron A, Schering Corp., Kenilworth, NJ) is effective in the treatment of hairy cell leukemia (HCL). The 212 evaluable subjects in this trial received 2 X 10(6) U/m2 of interferon alfa-2b subcutaneously, on an outpatient basis, three times a week for 1 year. Of this group, 166 had previously undergone splenectomy, and 94 had received chemotherapy; 96% had more than 50% hairy cells in the bone marrow. Objective responses (complete, partial, and minor) were recorded in 89% of the study group and were characterized by a marked reduction in infections as well as in the need for transfusions. Complete response, defined as a normal complete blood count (CBC) and less than 5% hairy cells in the marrow, was achieved in 4% of the subjects. Partial responses (normal CBC) were attained in 74%, and minor responses (normalization of subnormal hematocrits or granulocyte or platelet counts) in 11%. Normalization of CBC usually did not occur until after 2 to 5 months of therapy. Results were comparable in splenectomized and nonsplenectomized patients. After 1 year of treatment, the responders were randomized to continue therapy for 6 months or to stop treatment and remain under observation. Preliminary findings have shown no significant differences in the incidence or time to progression of disease in the two groups, but additional data will be required before conclusions can be reached with regard to the need for maintenance therapy. Overall, the results of this study indicate that interferon alfa-2b is well tolerated, produces durable responses, and dramatically improves the quality of life in a high percentage of patients with progressive HCL. PMID- 3542184 TI - Interferon in renal cell carcinoma. The UCLA experience. AB - Three sequential studies of alpha interferon were performed in a total of 84 evaluable patients with metastatic renal cell carcinoma. In Study I, conducted from 1981 to 1982, 43 patients received human leukocyte alpha interferon (IFN alpha) 3 X 10(6) U/day, 5 days per week for 12 weeks. In Study II, performed in 1983, vinblastine (0.1 mg/kg/week) was added to the same IFN alpha regimen in 22 subjects. Study III, held from 1984 to 1985, evaluated the effects of escalating doses of interferon alfa-2a (from 3 to 36 X 10(6) U/day) administered 5 days per week to 19 patients. Overall, complete (CR) and partial responses (PR) totaled 17% (14%, 14%, and 26% in Studies I-III, respectively). Median survival of all patients was 49 weeks. Median survival appeared to be superior in the third study, likely because of the patient mix (skewed toward a Karnofsky performance status of 10, disease-free interval longer than 1 year, and disease confined to the lung). Those prognostic factors were also found to correlate with improved median survival in the total group of 84 patients. Likewise, response to therapy was linked to prolonged survival; patients with CR, PR, or minimal responses had a median survival of 72 weeks. In all the favorable subgroups, responders had better outcomes than nonresponders, but it was not clear whether response to therapy merely selected out patients with better initial prognoses or actually led to improved survival. PMID- 3542186 TI - The use of a panel of monoclonal antibodies in pediatric oncology. AB - A panel of monoclonal antibodies including antibodies against neuroectodermal antigens, (UJ13A, UJ127.11, UJ181.4), leukocytes (2D1), intermediate filament antigens cytokeratin (LE61), Vimentin, Desmin (Labsystems, Helsinki, Finland), myoglobin, and neurofilament (155) antigens were assessed for their use as an adjunct to light microscopy in pediatric pathology, with particular emphasis on the "small round cell" tumors. One hundred thirty-four tumors were studied using immunofluorescence and immunoperoxidase techniques. The differentiation of neuroblastoma from lymphoma proved to have a clear-cut immunologic profile, as did the rhabdomyosarcomas, which showed consistent positivity with neuroectodermal antibody UJ13A and in positive binding with antidesmin. Ewing's sarcoma did not give a clear immunohistologic pattern with these antibodies. This panel was shown to have been a valuable aid to diagnosis in 12% of cases studied. The future use of such a panel for routine diagnostic use is discussed, but it is emphasized that the binding pattern of these tumors is often heterogeneous, and examination in conjunction with conventional histology is essential if the correct conclusions are to be made. PMID- 3542185 TI - Clinical overview of alpha interferon. Studies and future directions. AB - The clinical development of the alpha interferons has now progressed through initial Phase I and II trials into extensive controlled clinical trial designs. Alpha interferon has been a prototype of other biological agents that are now in clinical development. These agents operate through fundamentally different mechanisms of action than conventional chemotherapy and have produced a unique profile of side effects as well as response patterns. Time to response is generally longer than with chemotherapy, and dose-response and schedule dependency questions continue to be explored for most tumor types. Although response rates have been low against most solid tumors when alpha interferon is used as a single agent, it has demonstrated a surprisingly wide range of efficacy in hematologic malignancies. These include tumors of presumed B-cell, T-cell, and myeloid lineages. In some diseases, e.g., hairy cell leukemia and chronic myelogenous leukemia, alpha interferon is broadly effective; it appears to considerably reduce or occasionally eliminate the malignant clone while normalizing the peripheral blood counts in most patients. In other diseases, alpha interferon appears destined to play a major role as part of combination therapy or in maintenance or consolidation therapy. In other disease settings, alpha interferon's role continues to be explored as part of combination therapy, adjuvant therapy, or as local-regional therapy. The full potential of alpha interferon as an antineoplastic agent will not be determined for many years. In this paper, the results from the first 5 years of widespread clinical testing are reviewed. PMID- 3542187 TI - Immunocytochemical markers of uncommon pancreatic tumors. Acinar cell carcinoma, pancreatoblastoma, and solid cystic (papillary-cystic) tumor. AB - Nine acinar cell carcinomas of the pancreas, 2 pancreatoblastomas, 16 solid cystic (papillary-cystic) tumors, and 20 ductal adenocarcinomas were immunocytochemically investigated using antisera against four pancreatic enzymes (alpha-amylase, lipase, trypsinogen, chymotrypsinogen), four pancreatic hormones, neuron specific enolase (NSE), alpha-1-antitrypsin (AAT), carcinoembryonic antigen (CEA), and CA 19-9. Lipase, trypsinogen, and chymotrypsinogen, but no alpha-amylase were detected in all acinar cell carcinomas and pancreatoblastomas. In contrast, solid-cystic tumors (SCT) were negative for pancreatic enzymes but 2 of 16 stained with NSE. No neuroendocrine granules or pancreatic hormones could be demonstrated. AAT was found in all tumors except ductal adenocarcinomas, which stained with CEA and CA 19-9. The study established pancreatic enzymes (except alpha-amylase) as immunocytochemical markers for acinar cell carcinomas and pancreatoblastomas. There is as yet no marker specific for SCT, which would elucidate the obscure histogenetic origin and phenotypic differentiation of these tumors. PMID- 3542188 TI - Rhabdomyoma of the retroperitoneum. A report of a tumor with both adult and fetal characteristics: a study by light and electron microscopy, histochemistry, and immunochemistry. AB - An unusual benign tumor of skeletal muscle origin is described. The tumor was located in the left retroperitoneum of a newborn female. The tumor contained features of both an adult and fetal rhabdomyoma when studied by light and electron microscopy, immunocytochemistry, and histochemistry. This is the only report of this type of neoplasm in the literature. PMID- 3542189 TI - Differences between first and subsequent fevers during prolonged neutropenia. AB - Fever during neutropenia before engraftment was studied in 86 consecutively treated patients undergoing allogeneic bone marrow transplantation. Eighty-four of the 86 patients experienced 132 febrile episodes. Only 26% of the patients had one fever which resolved with antibiotics. The rest required modification of antimicrobial therapy because of refractory fever (32%) or recurrent fevers (42%). The 121 fevers which occurred during neutropenia were analyzed to determine differences between first and subsequent fevers (79 and 42 episodes, respectively). The frequency of sepsis (23%) and defervescence (64%) did not differ between first and subsequent fevers. Presumed localized infection (PLI) was identified in 75% of first fever but in only 28% of subsequent fevers (P = 0.000002). Of the PLI identified, oropharyngeal mucosal disease accounted for 68% during first fever but only 38% during subsequent fevers (P = 0.02). Although sepsis in first fever was more frequently associated with PLI than sepsis in subsequent fevers (61% versus 10%, P = 0.01), overall, patients with PLI had a lower frequency of sepsis than those without (17% versus 32%, P = 0.04). Gram negative pathogens were uniformly gentamicin sensitive in sepsis during first fever but were mostly gentamicin-resistant in sepsis during subsequent fevers (P = 0.01). PMID- 3542190 TI - History of the hospice movement. PMID- 3542191 TI - Induction of transformed cells to terminal differentiation and the modulation of gene expression. PMID- 3542192 TI - Radiochemical detection of dihydrodiol dehydrogenase: distribution of the enzyme in male Sprague-Dawley rat tissues and its sensitivity to inhibition by indomethacin and 6-medroxyprogesterone acetate. AB - Dihydrodiol dehydrogenase (EC 1.3.1.20) catalyzes the NADP+-dependent oxidation of (-)-7R,8R-dihydroxy-dihydro-benzo(a)pyrene and (+)-7S,8S-dihydroxy-dihydro benzo(a)pyrene, which are potent proximate carcinogens (Smithgall, Harvey, and Penning, J. Biol. Chem., 261: 6184-6191, 1986). Using benzenedihydrodiol [(+) trans-1,2-dihydroxy-3,5-cyclohexadiene] as a model substrate for these reactions, dihydrodiol dehydrogenase can be assayed in rat liver cytosol by measuring the change in absorbance of the pyridine nucleotide. This method lacks the sensitivity to detect the enzyme in extrahepatic tissues. Here we describe a sensitive radiochemical assay for dihydrodiol dehydrogenase in which the oxidation of benzenedihydrodiol to pyrocatechol is coupled to O-methylation catalyzed by catechol-O-methyltransferase (EC 2.1.1.6). In this manner the pyrocatechol formed in the oxidation step can be radiolabeled using S adenosyl[methyl-3H]methionine as methyl donor. The resulting tritiated product, guaiacol, is readily extracted into toluene and quantified by scintillation counting. Using S-adenosyl[methyl-3H]methionine at a specific activity of 0.1 microCi/nmol, the assay provides a 5000-fold increase in sensitivity over the existing spectrophotometric method. The radiochemical assay was validated by comparing the Km and Vmax values obtained for the 40-75% (NH4)2SO4 fraction of rat liver cytosol with those measured spectrophotometrically. There was close agreement between values determined radiochemically (Km = 0.77 +/- 0.11 mM, Vmax = 2.14 +/- 0.13 nmol/min/mg protein) and determined spectrophotometrically (Km = 0.96 +/- 0.10 mM, Vmax = 6.31 +/- 0.50 nmol/min/mg protein). Using the radiochemical method, dihydrodiol dehydrogenase activity was detected in extrahepatic sites of polycyclic aromatic hydro-carbon metabolism: lung greater than small intestine greater than testis greater than bladder greater than prostate. Specific activities varied over 50-fold (0.866-0.017 nmol/min/mg protein) and did not show a strict inverse correlation with organ susceptibility to PAH-induced chemical carcinogenesis. Four tissues predominantly concerned with trans-dihydrodiol oxidation (liver, lung, small intestine, and testis) contain dihydrodiol dehydrogenase which is potently inhibited by indomethacin, two of these tissues (liver and small intestine) contain dehydrogenase sensitive to inhibition by 6-medroxyprogesterone acetate. These observations suggest that indomethacin and 6-medroxyprogesterone acetate may prevent the oxidation of trans dihydrodiol proximate carcinogens in major tissues involved in their further metabolism and activation. PMID- 3542193 TI - Mutagenic metabolites in urine and feces of rats fed with 2-amino-3,8 dimethylimidazo[4,5-f]quinoxaline, a carcinogenic mutagen present in cooked meat. AB - To study the in vivo fate of 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), a carcinogenic mutagen present in cooked meat, rats were fed MeIQx in the diet and their urine and feces were analyzed for the metabolites. The isolation procedure included specific adsorption of MeIQx derivatives to blue cotton and subsequent fractionations by thin layer chromatography on silica gel and by high pressure liquid chromatography. Attention was focused on mutagenically active metabolites. Three metabolites were isolated from the urine, and their structures were elucidated on the basis of 1H nuclear magnetic resonance, ultraviolet, and mass spectra. The first metabolite characterized was 2-amino-8-hydroxymethyl-3-methylimidazo[4,5-f]quinoxaline (Compound I), the second was 2-acetylamino-3,8-dimethylimidazo[4,5-f]quinoxaline (Compound II), and the third was 2-amino-8-methylimidazo[4,5-f]quinoxaline (Compound III). Compound I was isolated also from the feces. Compounds I-III were mutagenic to Salmonella typhimurium TA98 with metabolic activation. The mutagenic potency of Compounds I and II was as high as that of MeIQx, and that of Compound III was much lower than that of MeIQx. PMID- 3542194 TI - Two new monoclonal antibodies, Lym-1 and Lym-2, reactive with human B-lymphocytes and derived tumors, with immunodiagnostic and immunotherapeutic potential. AB - Two new monoclonal antibodies (Lym-1 and Lym-2), reactive with the cell surface of B-lymphocytes and derived tumors, have been produced using tumor cell nuclei preparations as immunogens. Specificity screens using live cell radioimmunoassay techniques with 52 well-characterized human lymphoma and leukemia cell lines showed that both Lym-1 and Lym-2 bound to cell lines of B-cell lineage but were unreactive with those of T-cell, myeloid, or erythroid derivation. The B-cell specificity of these reagents was confirmed on 36 lymphoma and 15 leukemia biopsy specimens by using immunoperoxidase or immunofluorescence techniques. Additionally, flow cytometric analysis of 22 lymphoma biopsies showed that the majority of B-cell tumors were Lym-1 and/or Lym-2 positive and that within a given biopsy, a high percentage of the malignant cell population was stained. In both the immunoperoxidase and flow cytometric studies, reactive T-cells or T-cell lymphomas were consistently negative with the exception of Hodgkin's disease tissues which, in some instances, showed a higher than expected positivity with Lym-1 and Lym-2. Approximately 40% of B-cell chronic lymphocytic leukemias were found to be positive with Lym-1 while 80% were positive with Lym-2. Immunoperoxidase staining of frozen sections of human lymphoid tissues showed that both Lym-1 and Lym-2 stained germinal center and mantle zone B-lymphocytes as well as interfollicular histiocytes. Flow cytometric analysis of normal peripheral blood demonstrated specific staining of B-cells which comprised approximately 8% of circulating lymphocytes. Immunoperoxidase staining of nonlymphoid human organs and tissues revealed weak reactivity of Lym-1 with surface colonic epithelium only. Consistent with these findings, 35 solid tumor cell lines of diverse nature were found unreactive with both Lym-1 and Lym-2. Although standard techniques have thus far failed to identify the antigen recognized by Lym-2, the membrane antigen which binds Lym-1 has been shown by immunoprecipitation and competitive radioimmunoassay studies to be a polymorphic variant of the HLA-Dr antigen. Solid-phase radioimmunoassay techniques have shown that the antigens recognized by Lym-1 and Lym-2 are not significantly modulated after antibody exposure nor shed into the circulation of lymphoma patients. Finally, using iodine-125 labeled preparations of purified Lym-1 and Lym-2, we have determined that both reagents have a relatively large number of antibody binding sites per tumor cell and increased avidity for lymphoma cells when compared to normal and reactive lymph node B-cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542195 TI - Discrimination between benign and malignant cells of melanocytic lineage by two novel antigens, a glycoprotein with a molecular weight of 113,000 and a protein with a molecular weight of 76,000. AB - The present study describes two novel antigens, a glycoprotein with a molecular weight of 113,000 and a protein with a molecular weight of 76,000, which are associated with the transformed phenotype of melanocytes. The monoclonal antibodies (MoAb) MUC18 and MUC54, raised against human malignant melanoma, were selected for differential reactivity with normal and neoplastic cells of melanocyte lineage. The antigen defined by MoAb MUC18 is a membrane bound monomeric sialylated glycoprotein with an apparent molecular weight of 113,000. In contrast to the broad reactivity with melanomas, isolated nevus nests were stained in only 1 of 55 nevi investigated. No staining of MoAb MUC18 was observed in a large variety of surgically removed normal and tumor tissues except for smooth muscle cells of the blood vessel wall and hair follicles. MoAb MUC54 immunoprecipitated a cytoplasmic monomeric protein with an apparent molecular weight of 76,000. By immunoperoxidase staining, the antigen was demonstrated on a large number of melanomas and in addition on 1 of 36 nevocellular, 3 of 4 Spitz, and 5 of 14 dysplastic nevi. The Mr 76,000 protein was found in a number of epithelial tissues and various types of neoplasms. Both antibodies presented in this study define structural changes in the antigenic profile of melanocytes occurring during carcinogenesis. PMID- 3542196 TI - c-Ki-ras gene amplification and malignant behavior in murine embryonal carcinoma cell lines. AB - Embryonal carcinoma (EC) cells are malignant components of murine teratoma tumors. To extend our earlier findings concerning c-Ki-ras amplification in the embryonal carcinoma PCC4 cell line, we examined the c-Ki-ras protooncogene and its expression in other EC cell lines. We report here that c-Ki-ras amplification is not a general feature of EC cell lines since neither PCC3, PCC6, nor F9 cell lines have an amplified copy number of this protooncogene. Furthermore, molecular analysis of three independently passaged PCC4 cell lines showed marked heterogeneity for c-Ki-ras amplification. Two PCC4 cell lines showed amplified copy number and elevated expression of c-Ki-ras whereas the original one does not, suggesting that this gene amplification occurred through laboratory passage. Malignancy in syngeneic mice of PCC4 with or without an amplified c-Ki-ras gene was also examined. Our results indicate that c-Ki-ras amplification alone is not a determining factor in the malignant behavior of EC cells. PMID- 3542197 TI - Mammary cancer antigen recognized by monoclonal antibody B72.3 in apocrine metaplasia of the human breast. AB - Monoclonal antibody B72.3 recognizing a pan-associated carcinoma antigen expressed also in metastatic human breast cancer cells has been tested using the avidin-biotin peroxidase method applied to paraffin-embedded sections in 50 samples of mammary tissue showing apocrine metaplasia and in 58 cases of other mild or severe focal epithelial proliferative changes of the breast, including mostly in situ lobular or ductal carcinomas collateral to clinical cancer removed after radical mastectomy. The antigen detected by this antibody was present in the apocrine cells of 48 cases (96%). In the majority of these cases the reactivity was localized on the luminal border of the apocrine cells and in the luminal secretion. But ten cases showed positive staining also in the cell cytoplasm either focal or diffuse. The normal structures and mild focal hyperplastic changes collateral to clinical cancer were, in the majority of the cases (43 of 55), negative, and, when positive, displayed positivity only at the luminal border. By contrast, the independent foci of in situ carcinoma (17 of 31 examined), the intraduct papillomas (seven cases of 14), and the intraductal component of breast carcinoma (seven cases of 17) were positive, displaying a cytoplasmic focal or diffuse staining. In conclusion, mammary apocrine metaplasia, a metaplastic change of the normal epithelium that has been associated with increased breast cancer risk, shares antigens in common with breast cancer cells and/or with cells showing severe atypia. The possible clinical significance of the site of antigenic expression (cytoplasm or luminal border) needs further investigation. PMID- 3542198 TI - Identification and characterization of a unique tumor-associated surface antigen on L1210 leukemia cells recognized by semisyngeneic antisera. AB - The tumor-associated surface antigen on L1210 leukemia cells was studied by immunofluorescence staining and immunoprecipitation. Anti-L1210 serum was prepared in BALB/c X DBA/2 F1 mice by priming with a hybrid of L1210 and human Lesch-Nyhan fibroblast cells and hyperimmunizing with L1210 leukemia cells. This hyperimmune serum was able to demonstrate specific surface fluorescence on L1210 cells, while the antiserum did not react with various mouse tumor cell lines, normal lymphoid tissues, or mitogen-activated lymphoid cells. The anti-L1210 serum immunoprecipitated a single polypeptide with a molecular weight of 90,000 from 125I-labeled L1210 cells. The expression of this antigen was enhanced by tumor-promoting agent and heat shock treatment. The biological significance of the L1210-specific cell surface antigen is discussed. PMID- 3542199 TI - Inhibition of messenger RNA transcriptional activity in ML-1 human myeloblastic leukemia cell nuclei by antiserum to a c-myb-specific peptide. AB - Antiserum to a synthetic peptide that defines a hydrophilic region within the putative c-myb translation product was prepared in the rabbit. In lysates from exponentially growing ML-1, human myeloblastic leukemia cells, the antiserum ("anti-myb") reacted with five proteins of Mr 58,000, 75,000, 85,000, 90,000 and 105,000. Of these, only p75 and a trace of p85 were detected, by immunoblotting, in extracts derived from ML-1 cell nuclei. The proteins p58, p75 and p90 were present in readily detectable amounts only in the relatively immature myeloid cell lines ML-1 and HL-60, whereas in the more mature myeloid cell line THP-1 and in the lymphoid line BALL-1 only traces of these proteins were found. p85 and p105 were detected in lysates from all cell lines tested, including myeloid and lymphoid leukemia cells and mouse 3T3 cells. In lysates from ML-1 cells induced to differentiate to monocyte/macrophages or to granulocytes, the concentrations of p58 and p75 decreased in parallel with the cell population moving to maturity; in completely mature populations these two proteins were no longer detectable. In ML-1 cells arrested in G1 by serum depletion, the amount of p58 and p75 and to a smaller extent that of p90 was decreased, whereas the concentration of p85 and p105 remained unchanged. In nuclei from exponentially growing ML-1 cells, the antiserum or its derived immunoglobulin fraction ("anti-myb IgG") inhibited mRNA transcriptional activity by 30%. DNA synthesis was not affected. In contrast, in nuclei from differentiated ML-1 cells, the mRNA transcriptional activity was not significantly inhibited by anti-myb IgG. Similarly, in nuclei from ML-1 cells arrested largely in G1 by serum depletion for 2 days, mRNA transcriptional activity was inhibited by only 11%. Upon supplementation with serum, the mRNA transcriptional activity inhibitable by anti-myb IgG increased in parallel with the increasing rate of cell growth. The difference in total mRNA transcriptional activity observed in nuclei from cells of different growth rate was accounted for by the difference in transcriptional activity inhibitable by anti-myb IgG.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542200 TI - Analysis of prolactin and growth hormone production in hyperplastic and neoplastic rat pituitary tissues by the hemolytic plaque assay. AB - The reverse hemolytic plaque assay (RHPA) was used to detect hormone release from cultured normal, hyperplastic, and neoplastic rat pituitary cells. Hyperplastic pituitary cells were produced by s.c. diethylstilbestrol (DES) treatment (10 mg in Silastic tubes) for 3, 6, and 9 weeks. Neoplastic pituitary cells from rats with MtT/W15 transplantable tumors treated with DES for 3 weeks were also analyzed. Aliquots of the same cells were also analyzed by immunocytochemical staining. DES treatment resulted in an increase in prolactin (PRL)-producing cells in hyperplastic pituitaries compared to untreated pituitaries after 9 weeks of treatment by the RHPA [61.2 +/- 5.2 (SE) versus 32 +/- 3.0] and by immunocytochemical staining [70.9 +/- 2.4 versus 36 +/- 1.4]. The percentage of mammosomatotropic cells decreased from 11.3 +/- 3.8 to 4.2 +/- 2.6% in pituitary cells from these same groups of animals. After 3 weeks of DES treatment in rats with MtT/W15 tumor, there was an increase in growth hormone (GH)-producing cells and a decrease in PRL-producing cells when analyzed by the RHPA (control: percentage of GH, 36.3 +/- 6.2; percentage of PRL, 39.0 +/- 1.6 versus DES treated tumors: percentage of GH of 68.2 +/- 1.9; and percentage of PRL, 3.2 +/- 1.8%). The percentage of mammosomatotropic cells declined from 12.4 +/- 2.3 to 0.77 +/- 2.4%. A combined procedure of RHPA followed by immunocytochemical staining on the same slides also revealed a decline in mammosomatotropic cells after chronic DES treatment in hyperplastic and neoplastic MtT/W15 tumor cells. These results show that DES has different effects on PRL and GH secretion and storage in hyperplastic pituitary and in the MtT/W15 pituitary tumor cells. PMID- 3542201 TI - Absence of testicular protection by a gonadotropin-releasing hormone analogue against cyclophosphamide-induced testicular cytotoxicity in the mouse. AB - Protection of testicular integrity against damage from cyclophosphamide (CY) by simultaneous treatment with a gonadotropin-releasing hormone (GnRH) analogue was reported in BALB/c mice (L.M. Glode et al., Lancet, 1: 1132-1134, 1981). This approach has been used as the basis for clinical trials in various treatment centers (D. H. Johnson et al., Blood, 65:832-836, 1985) in an attempt to prevent iatrogenic sterility in males. This study aims at duplicating the original findings and obtaining quantitative data on spermatogonial killing by CY, and possible protection by GnRH, of differentiating and stem cell spermatogonia. Mice were treated with 23 daily injections of 0.4 micrograms D-leucine-6 GnRH, and with 200 mg/kg CY on Days 8, 15, and 22. Three additional groups of mice received phosphate-buffered saline and bovine serum albumin only, GnRH only, and CY only. Animals were killed at 29 days after the last injection to determine the number of late spermatids in testicular homogenates, and at 56 days for histological measurement of the ratio of elongated spermatids to Sertoli cells in the tubules. The twenty-ninth day assay was a measure of damage to differentiating spermatogonia, whose killing results in temporary sterility. The fifty-sixth day point assay assessed damage to stem spermatogonia, whose killing results in long term or permanent sterility. Sperm counts at 29 days were identical in saline treated control mice and GnRH-treated mice; no sperm were present in the CY treated mice, both with and without GnRH. Thus, killing of differentiating spermatogonia by CY is not prevented by GnRH treatment. Similarly, counts of spermatids at 56 days showed no difference between saline- and GnRH-treated groups; a reduction to approximately 40% of control counts was observed equally with CY and CY plus GnRH treatments. Since GnRH treatment did not alter spermatogonial kinetics in BALB/c mice, it is not surprising that it did not protect against CY-induced damage. Thus, the mouse is not a suitable model for analyzing such effects of GnRH on spermatogenesis, and further studies in other experimental animals are needed if they are to be used as a rationale for clinical administration of GnRH to cancer patients. PMID- 3542204 TI - Recent advances in the treatment of cerebellar ataxias. PMID- 3542202 TI - The autoimmune nature of cancer. AB - Four different kinds of data from the 3-methylcholanthrene-induced sarcoma system of the mouse show that the immune system stimulates oncogenesis; i.e., the presence of a tumor-specific immune reaction is a positive aid to tumor development. It seems proper, therefore, to consider cancer, at least in part, an autoimmune disease. PMID- 3542203 TI - MPTP: current concepts and controversies. PMID- 3542205 TI - Domperidone and Parkinson's disease. PMID- 3542206 TI - Treatment of postherpetic neuralgia. PMID- 3542207 TI - Hammering away at solid tumors. PMID- 3542208 TI - High-dose combination alkylating agent preparative regimen with autologous bone marrow support: the Dana-Farber Cancer Institute/Beth Israel Hospital experience. AB - Fifty-nine patients received 61 courses of cyclophosphamide, cisplatin, and carmustine combined. The phase I study consisted of seven dose escalations. Dose levels 5 and 6 also included the attempted addition of melphalan at 40 and 80 mg/m2. The maximum tolerated dose for the three-drug combination was 5620 mg/m2 of cyclophosphamide, 165 mg/m2 of cisplatin, and 600 mg/m2 of carmustine. The dose-limiting toxic effect was fatal veno-occlusive disease of the liver in two of five patients treated at the highest dose level. Veno-occlusive disease of the liver was fatal in two of 40 patients treated at Dose level 4, the maximum tolerated dose. The median time to recovery of polymorphonuclear leukocyte counts to greater than 500/microliters and platelet counts to transfusion independence greater than 20,000/microliters was 19 and 22 days, respectively, after marrow reinfusion. Other toxic effects observed included postdischarge pulmonary toxicity, which appeared to respond to prednisone therapy. Thus, this combination of alkylating agents can be combined at close to the transplant dose of each individual agent. The response rate was high despite considerable prior treatment in most patients. Of 16 evaluable patients with breast cancer, 15 responded (six complete responses). Of six evaluable patients with sarcoma, six responded (one complete response). While patients with melanoma had had no prior treatment, 11 of 17 patients responded (65%). There are currently three patients who are disease-free. Two patients with melanoma were rendered disease-free by excisional biopsy of the only remaining nodule after good partial response, and a patient with metastatic breast cancer remains disease-free after a complete response at 36+ months. PMID- 3542209 TI - Phase II trial of carboplatin in advanced malignant melanoma. AB - Twenty-six evaluable patients with metastatic malignant melanoma who had not received prior chemotherapy were treated in a phase II study with carboplatin (CBDCA), 400 mg/m2 iv every 4 weeks. There were five partial responses of 3, 3+, 5, 7+, and 12+ months' duration. Thrombocytopenia was the dose-limiting toxicity; ten patients had transient platelet count depressions to less than 75,000/mm3. Mild to moderate nausea and/or vomiting occurred in 15 patients. Renal, auditory, and neurologic toxic effects were not encountered. Since the response rate of 19% (95% confidence limits, 8%-38%) is similar to that noted for dacarbazine, carboplatin, singly and in combination with other agents, needs further evaluation in patients with malignant melanoma. PMID- 3542211 TI - Mouthbreather's gingivitis: a clinicopathologic review. PMID- 3542210 TI - Pilot study of cyclophosphamide plus carboplatin in advanced ovarian carcinoma. AB - Six patients with histologically proven stage III-IV ovarian carcinoma received carboplatin (CBDCA) (150 mg/m2) plus cyclophosphamide (1000 mg/m2) monthly for 1 year unless disease progressed earlier. Six other patients received CBDCA (225 mg/m2) with the same cyclophosphamide dose monthly. Continued treatment with the higher CBDCA dose was not tolerable because of myelosuppression, but no other dose-limiting toxic effect was observed. Complete tumor regression was proven at secondary laparotomy in six of the 12 patients, and five of these remain disease free from 26+ to 28+ months after beginning chemotherapy. PMID- 3542212 TI - Dr. C. Edmund Kells, Jr., Genius of dentistry (part I). PMID- 3542213 TI - [100 years since the birth of Dr. Frantisek Hajek]. PMID- 3542214 TI - [A reminiscence of Prof. Rudolf Jedlicka]. PMID- 3542215 TI - [New possibilities in the diagnosis of the state of fetoplacental circulation and its use in clinical fetal pharmacology]. PMID- 3542216 TI - [Testimony on the last years of Jan Purkinje]. PMID- 3542218 TI - [The medical museum in Prague]. PMID- 3542217 TI - [Interleukin 2]. PMID- 3542219 TI - [30 years of the Endocrinology Research Institute of the Czech Ministry of Health]. PMID- 3542220 TI - [Use of total heart replacement in clinical practice. Importance of experimental preparation in relation to legal, ethical and social aspects]. PMID- 3542221 TI - [Intranasal administration of chlornidine gel in hypertension]. PMID- 3542222 TI - [Emergency health services in the border regions]. PMID- 3542223 TI - [History of child health care in Ostrava]. PMID- 3542224 TI - Computerized telethermographic assessment in migraine, with particular reference to the prodromal phase. AB - We have studied the angular orbit and supraorbital arteries in 58 patients with classic migraine (36 females, 22 males; age (means), 43.5 years). A Dorex telethermograph apparatus, which utilizes the infrared radiations emitted by a patient, was used. The individual is placed at standard distance, and the temperature and humidity of the environment are kept constant. Three thermographic tests were performed in each patient: the first in basal condition, the other during the visual and/or sensory aura, and the last during the pain phase. The skin temperature levels decreased during the prodromal phase and increased during the migraine attack as compared with the levels obtained in basal conditions. There were significant asymmetries during the pain phase. PMID- 3542225 TI - Disassembly and reassembly of nuclei in cell-free systems. PMID- 3542226 TI - Eukaryotic protein modification and membrane attachment via phosphatidylinositol. PMID- 3542228 TI - Magnetic retention for overdentures and partials. PMID- 3542227 TI - Cell cycle control of the yeast HO gene: cis- and trans-acting regulators. AB - In this paper, we investigate the role of a short repeated sequence (CACGA4) in the cell-cycle regulation of HO. We show that this sequence activates transcription of a heterologous gene in a cell-cycle-dependent fashion indistinguishable from that of the wild-type HO promoter. We also show that, in addition to SWI1 through SWI5, at least five other genes (SWI6 through SWI10) are required for HO transcription. These genes fit into three distinct classes with respect to their targets within the HO promoter. SWI4 and SWI6 are specifically required for CACGA4-mediated activation of transcription. SWI1, SWI2, and SWI5 are required for transcription from sequences physically separate from and independent of the CACGA4 sequences. SWI3 may be required for both. Since all the SWI genes are required for HO transcription, the HO promoter must contain at least two essential upstream activation sequences, which are affected by different trans-acting factors and are subject to different types of control. PMID- 3542229 TI - Osseointegration promises much for future of dental implants. PMID- 3542230 TI - Macrophage defect and inflammatory cell recruitment dysfunction in Salmonella susceptible C3H/HeJ mice. AB - C3H/HeJ mice are homozygous for the Lpsd allele and, as a consequence, are hyporesponsive to all of the biological effects of bacterial lipopolysaccharide (LPS) that have been studied. These mice die in the early phase of infection when inoculated with virulent Salmonella. This susceptibility is also regulated by the Lpsd allele. The mechanism of Lpsd-conferred Salmonella susceptibility was evaluated in these studies. The response of C3H/HeJ mice to S. typhimurium strains of differing virulence was compared in a series of in vivo experiments to the response of: endotoxin-responsive (Lpsn) mice that carry another Salmonella susceptibility gene (Itys) and endotoxin-responsive mice that carry a Salmonella resistance gene (Ityr). The C3H/HeJ mice (genotype Lpsd/Ityr) were more resistant than Lpsn/Itys mice to strains of S. typhimurium of reduced virulence but less resistant than Lpsn/Ityr mice. In addition, C3H/HeJ macrophages cultured in vitro were less able to contain net salmonellae multiplication than were macrophages from Lpsn/Ityr mice. Moreover, histopathological findings revealed that S. typhimurium-infected Lpsn/Ityr animals recruited an abnormally low number of cells into their livers compared to either Lpsn/Ityr mice or Lpsn/Itys mice. These data suggest that the susceptibility of C3H/HeJ mice may be the result of at least two Lpsd-encoded defects: a decreased capacity of macrophages to restrict Salmonella growth and a reduced recruitment of inflammatory cells into liver. PMID- 3542231 TI - Bacillary growth, interleukin 2 production defect, and specific antibody secretion governed by different genetical factors in mice infected subcutaneously with Mycobacterium lepraemurium. AB - Different mouse strains were infected subcutaneously in the footpad with 10(7) Mycobacterium lepraemurium (MLM). At various stages of the infection, the number of acid-fast bacilli (AFB) in different organs, spleen cell interleukin 2 production, and specific IgM and IgG serum antibodies to MLM sonicate were assessed. Strains were separable into two distinct groups depending on the number of AFB recovered from the different organs, without any obvious influence of the Bcg gene. Thus C57BL/6, DBA/2, (C57BL/6 X DBA/2)F1 and C3H/Pas mice belonged to the high resistance group and DBA/1, BALB/c, and CBA strains to the low resistance group. Interleukin 2 production was depressed only in C57BL/6 and C3H/Pas mice. Anti-MLM antibody response also markedly varied according to strains, in terms of antibody titers, Ig class distribution, and species specificity, but with a different genetic pattern from that observed for MLM growth control. PMID- 3542232 TI - Autoantibodies against bromelainized mouse erythrocyte: strain distribution of serum idiotype expression and relative peritoneal cell activity. AB - Previously, we demonstrated that the naturally occurring mouse autoantibodies directed against bromelainized mouse red blood cells (BrMRBC) comprised a family of structurally related molecules bearing a common idiotypic determinant (CP) based on structural and idiotypic analysis of a series of anti-BrMRBC monoclonal autoantibodies derived from a fusion of peritoneal cells (PerC) with plasmacytomas. In the present studies, we have evaluated the quantitative expression of circulating CP idiotype related to autoantibodies against BrMRBC in relation to specific PerC anti-BrMRBC plaque-forming activity in an individual mouse of different strains. The data presented here show no direct relationship between serum CP idiotype expression and PerC anti-BrMRBC plaque-forming activity in an individual mouse of all strains tested. However, the circulating CP idiotype content is higher in strains, viz., CBA/J, NZB, C3H, BXSB, and Biozzi high responder (H) mice which exhibit a high perC autoantibody secretory activity against BrMRBC. The strains such as BALB/c, DBA2, SJL/J, CBA/N, and Biozzi low responder (L) express little or no circulating CP idiotype with a corresponding small or no PerC anti-BrMRBC activity. Furthermore, the PerC "auto"-immune phenomenon is markedly expressed in the normal CBA/J strain since these mice show a higher percentage ratio of CP idiotype over serum IgM (2.68%) as well as highest PerC anti-BrMRBC plaque-forming activity (11,319 +/- 18,029 plaques per million viable cells) compared to other normal and autoimmune strains tested. Nevertheless, the highest circulating serum CP idiotype (49.4 micrograms/ml) is observed in the autoimmune NZB mouse. The immunodeficient CBA/N mice fail to express detectable levels of CP idiotype in their serum. The experiments conducted in genetically selected outbred Biozzi (H and L) strain have revealed remarkable differences in serum CP idiotype expression as well as PerC anti BrMRBC plaque-forming activity in these two lines. The expression of mouse PerC "auto"-immune phenomenon and quantitative circulation of CP idiotype in the serum seem to be related to regulatory mechanisms as for sheep erythrocytes and other natural antigens earlier demonstrated to be under polygenic regulation in Biozzi (H and L) mice. PMID- 3542233 TI - Neonatal tolerance induction in the thymus to MHC-class II-associated antigens. I. Preferential induction of tolerance to Mls antigens and resistance to allo-MHC antigens. AB - Neonatal tolerance inducibility of self-major histocompatibility complex (MHC) class II-associated antigens was compared with that of allo-class II antigens. BALB/c (H-2d, Mlsb) mice, less than 24 hr after birth, were intravenously injected with bone marrow cells of either (BALB/c X DBA/2)F1 (H-2d, Mlsb/a, semiallogeneic at the Mls locus) or (BALB/c X B10.BR)F1 (H-2d/k, Mlsb; semiallogeneic at the MHC), as antigens. The mice were tested for in vivo immune activity of class II-reactive T cells by means of the popliteal lymph node swelling assay. They developed tolerance, irrespective of type of antigens, showing profoundly suppressed host-versus-graft reaction, and those tolerized to the allo-MHC antigens accepted skin grafts of the corresponding allogeneic mice. In the thymus and spleen of the Mls-tolerant mice, antigen-specific class II reactive T-cell activity was completely abolished, without the apparent involvement of suppressor cells. In contrast, the activity in allo-MHC-tolerant mice was not reduced in either thymus or peripheral lymphoid organs, suggesting that systemic hyporesponsiveness is attributable to reversible suppression of immune competent cells. The resistance for cell-level tolerance induction to allo class II antigens may not be ascribed to the active participation of allo-MHC antigens in prevention of or in escape from tolerance induction or both, since an injection of bone marrow cells of both Mls and H-2-semiallogeneic (DBA/2 X B10.BR)F1 (H-2d/k, Mlsa/b) mice could induce tolerance to Mlsa-H-2d antigens in newborn thymus cells. PMID- 3542234 TI - Neonatal tolerance induction in the thymus to MHC-class II-associated antigens. II. Significance of MHC antigens in anti-Mls tolerance. AB - Specificity of anti-Mlsa tolerance induced in BALB/c (H-2d, Mlsb) neonates was investigated by a popliteal lymph node (PLN)-swelling assay for the local graft versus-host (GVH) reaction by injecting tolerant thymus cells into the footpads of several types of F1 hybrid mice. When thymus cells were obtained from 1-week old normal BALB/c, they evoked enlargement of PLNs of (BALB/c X DBA/2)F1 (H-2d, Mlsb/a) [CDF1] recipients and of other hybrid recipients, heterozygous in Mlsa,c,d alleles, irrespective of the major histocompatibility complex (MHC) haplotypes. The same thymus cells did not cause the response in MHC-heterozygous F1 hybrids when the hybrids were homozygous in Mlsb, identical with BALB/c mice. Therefore, the PLN response to Mls antigens, known to be closely associated with MHC-class II antigens, was not directed to the class II antigens themselves. This enabled us to examine the effects of MHC on tolerance induction to the Mls antigens. When BALB/c neonates were injected with CDF1 bone marrow cells, complete tolerance to Mlsa-H-2d antigens of CDF1 cells was induced in the thymus, while responsiveness to Mlsa antigens in the context of H-2k and H-2b antigens, was not affected. This indicates MHC-restriction of neonatal tolerance to Mls antigens. Furthermore, when Mls and H-2-heterozygous (BALB/c X AKR)F1 (H-2d/k, Mlsb/a) bone marrow cells served as the tolerogen, thymus cells of BALB/c neonates were also tolerized to Mlsa-H-2k antigens as well as to Mlsa-H-2d antigens, which suggests the involvement of MHC, probably class II antigens of tolerance-inducing cells. PMID- 3542235 TI - Contrasting feature in the repopulation of host-type T cells in the spleens of F1 ---P and P----F1 radiation bone marrow chimeras. AB - The regeneration and persistence of host- and donor-derived T cells were examined in the thymus as well as the spleen of mouse radiation bone marrow chimeras of two semiallogeneic combinations (F1----P, P----F1) with different Thy-1 markers on T cells of donor and host origins. An unexpectedly large number of host-type T cells were recovered from the spleens of F1----P chimeras, amounting to as high as 45 and 25% of total T cells at 6 and 14 weeks after bone marrow transplantation (BMT), respectively. To the contrary, the residual host-type T cells in the spleens of P----F1 chimeras disappeared quickly, resulting in less than 0.1% of total T cells at 6 weeks after BMT. It was also revealed that the number of host-type T cells in the spleens of F1----P chimeras decreased in proportion to increase of radiation dose given to the recipients. PMID- 3542236 TI - Antigen-specific augmentation of delayed-type hypersensitivity by immune serum factor in mice: augmentation of anti-tumor cytostatic activity. AB - A humoral factor capable of augmenting delayed-type hypersensitivity antigen specificity (DAF) is present in the serum of mice sensitized with heterologous erythrocytes to induce a delayed footpad reaction (DFR). In the present study, a similar factor was identified when xenogeneic tumor cells were used as antigens. This factor also could augment the in vitro anti-tumor cytostatic activity against homologous tumor cells, which correlated with in vivo DFR to the same tumor cells. The cytostatic activity augmented by the transfer of this factor had the following characteristics: The activity appeared in the whole peritoneal exudate cells (PEC) from serum recipients at 4 days after the antigenic challenge. Such an activity was revealed in the collaboration of plastic dish nonadherent and -adherent PEC as the primary and final effectors, respectively. The appearance of primary effector cells for such an activity was also accelerated in spleen and lymph node cells. However, a sufficient number of macrophages were always required as the final effectors in their functional expression. These primary effectors were sensitized T lymphocytes which produced lymphokine(s) such as macrophage-activating factor(s) and which contributed to this augmented cytostatic activity through the activation of macrophages. Thus, this immune serum factor seems to exert functional expression by accelerating the generation of lymphokine-producing delayed-type T lymphocytes, which is also responsible for cytostatic anti-tumor immunity. PMID- 3542237 TI - Evidence for involvement of serine proteases in the late stages of the natural killer cell lytic reaction. AB - An irreversible inhibitor (L-1-tosylamide-2-phenylethyl-chloromethylketone) and substrate (N-acetyl-L-tyrosineethylester) of the neutral serine protease chymotrypsin were evaluated for their effects on the natural killer cell lytic reaction sequence. During direct cell-mediated cytolysis these inhibitors had no effect on natural killer cell binding to target cells but were able to inhibit the "trigger" mechanism which initiates killing. In addition, they inhibited later calcium-dependent events in the lytic reaction and killer cell-independent lysis. These findings suggest that serine proteases may be required during several stages of natural killer cell lysis, including calcium-dependent programming as well as the actual lethal hit. PMID- 3542238 TI - T-cell depletion of allogeneic bone marrow prevents acceleration of graft-versus host disease induced by exogenous interleukin 2. AB - Highly purified human recombinant interleukin 2 (IL-2) markedly accelerated lethal GVHD in the H-2-identical B10.BR----CBA combination, but had no effect when the donor cells were depleted of mature (Thy-1.2-positive) T lymphocytes, indicating a strong immunopotentiating effect of IL-2 on mature T cells causing GVHD. In the same donor-host combination, IL-2 did not influence the recovery from the post-transplantation bone marrow aplasia. The results suggest that IL-2 could be considered for adjuvant hormonal therapy to enhance immune recovery in recipients of T-cell-depleted allogeneic marrow. PMID- 3542239 TI - Thymic epithelium in vitro. III. Cytokine production by a thymic epithelial subset. AB - We have previously shown that two populations of thymic epithelium can be separated in culture on the basis of their differential growth rates and their adherence to the culture substratum, and maintained as long-term, morphologically distinct cell cultures, TECs and TECL. We have also described the effects of supernatants from the small epithelial cell (TESs) on the proliferative responses of thymocytes cocultured with mitogen and TESs over a 72-hr period. We now describe the effects in thymic epithelial supernatants (TESL) of soluble factors produced by TECL (the large epithelial cell) on thymocytes costimulated with mitogen and compare their effects to those derived from TECs. Both TESL and TESs suppress optimally stimulated thymocytes and enhance the proliferative responses of suboptimally stimulated thymocytes over a 72-hr period. The suppressive activities produced by TECL and TECs appear distinct, based upon markedly different molecular weights, but have similar sensitivities to heat treatment. The enhancing activities are of similar molecular weight, but have different sensitivities to heat treatment. In addition, TECL synthesize four- to fivefold less PGE2 than TECs. These results provide additional distinctions between the two cell types, and taken in conjunction with data on the anatomic distribution of similar cells, suggest that although they have similar functional effects in vitro, they may prove to have separable roles in vivo. PMID- 3542240 TI - A model for in vitro proliferation of undifferentiated bovine mammary epithelial cells. AB - A method for culturing bovine undifferentiated mammary epithelial cells embedded in collagen gels is described. Cell growth was quantitated by incorporation of tritiated thymidine. Maximal rate of incorporation was achieved in media supplemented with sera, however considerable growth was observed in serum-free medium supplemented with insulin, transferrin and selenium. The growth promoting effect of insulin was maximally expressed only at high nonphysiological concentrations. PMID- 3542241 TI - Intranuclear development of Plasmodium berghei in liver cells. PMID- 3542242 TI - Is the hemidesmosome a half desmosome? An immunological comparison of mammalian desmosomes and hemidesmosomes. AB - Although the mammalian epidermal basal cell hemidesmosome bears some superficial resemblance to one half of a desmosome at the ultrastructural level, examination of the structure of the electron-dense submembranous plaques of the hemidesmosome and desmosome reveals that they differ with respect to their overall morphology and dimensions. Based on these findings, we wondered whether components of the desmosome are present in the hemidesmosome. In order to determine this we prepared a number of stratified squamous epithelial tissues for indirect immunofluorescence using antibody preparations directed against known desmosome components including desmoplakin and certain glycoproteins. These antibody preparations do not show reaction with hemidesmosomes by indirect immunofluorescence criteria. We have also utilized bullous pemphigoid (BP) autoantibodies that have been shown to recognize hemidesmosomes in mammalian skin cells [Mutasim et al., J. Invest. Derm., 84:47-53, 1985]. Double label indirect immunofluorescence observations of neonatal mouse skin prepared using desmoplakin antibodies and BP autoantibodies reveal that hemidesmosomes that are stained by the BP autoantibodies are not recognized by the desmoplakin antibodies. We confirmed these findings at the ultrastructural level by indirect immunogold localization of desmoplakin antibodies and BP autoantibodies. Therefore, the hemidesmosome does not appear to be one half of a desmosome and may possess a very different molecular organization relative to the desmosome. We raise the possibility that the variability between the hemidesmosome and desmosome that we detect at the morphological and immunological level may reflect the functional differences of these two types of junctions. PMID- 3542243 TI - Cyclodextrins in drug carrier systems. AB - One of the important characteristics of cyclodextrins is the formation of an inclusion complex with a variety of drug molecules in solution and in the solid state. As a consequence of intensive basic research, exhaustive toxic studies, and realization of industrial production during the past decade, there seem to be no more barriers for the practical application of natural cyclodextrins in the biomedical field. Recently, a number of cyclodextrin derivatives and cyclodextrin polymers have been prepared to obtain better inclusion abilities than parent cyclodextrins. The natural cyclodextrins and their synthetic derivatives have been successfully utilized to improve various drug properties, such as solubility, dissolution and release rates, stability, or bioavailability. In addition, the enhancement of drug activity, selective transfer, or the reduction of side effects has been achieved by means of inclusion complexation. The drug cyclodextrin complex is generally formed outside of the body and, after administration, it dissociates, releasing the drug into the organism in a fast and nearly uniform manner. In the biomedical application of cyclodextrins, therefore, particular attention should be directed to the magnitude of the stability constant of the inclusion complex. In the case of parenteral application, a rather limited amount of work has been done because the cyclodextrins in the drug carrier systems have to be more effectively designed to compete with various biological components in the circulatory system. However, the works published thus far apparently indicate that the inclusion phenomena of cyclodextrin analogs may allow the rational design of drug formulation and that the combination of molecular encapsulation with other carrier systems will become a very effective and valuable method for the development of a new drug delivery system in the near future. PMID- 3542244 TI - Synthetic carriers of oxygen. AB - During the last decade, construction of artificial carriers of oxygen for transfusion purposes has evolved in three main directions, which can be reviewed as follows. The first approach consists of modifying hemoglobin (Hb), the natural oxygen carrier, in order to lower its oxygen affinity and increase its intravascular persistence. To achieve this aim, two basic procedures have been used: molecular and environmental modification. In the first case, Hb is modified with chemical reagents; the second requires encapsulation of Hb to obtain artificial erythrocytes. The second approach is based on the use of synthetic oxygen-carrying chelates that mimic the oxygenation function of Hb. The main products in this class are metalloporphyrins, whose chemical environment is designed to render them efficient as reversible carriers of oxygen in vivo. Finally, the third approach deals with the perfluorochemicals used in emulsified form. Perfluorochemical liquids are excellent gas solvents, but some problems remain unsolved with regard to their development as oxygen carriers in vivo: low O2 dissolving capacity, toxicity, and excretion. PMID- 3542245 TI - Fate and behavior of liposomes in vivo: a review of controlling factors. AB - Of fundamental importance in the design of a therapeutic drug carrier system is a thorough understanding of the factors which control its fate in the living animal. The use of liposomes as a carrier system able to improve the therapeutic efficacy of a wide range of drugs, requires manipulation of its physical characteristics, thereby influencing in vivo behavior. This review brings together findings of recent studies which describe how liposomal stability and clearance in vivo are controlled by the architecture of the vesicles themselves which in turn, via interaction with humoral factors, controls the fate in terms of tissue distribution of the carrier and its contents. Based on these studies, a rationale for liposome design aimed at in vivo drug delivery is discussed. PMID- 3542246 TI - The extracellular matrix of stratum corneum: role of lipids in normal and pathological function. AB - The mammalian stratum corneum, formerly treated as a homogeneous film, is now more properly viewed as a two-compartment system. The cornified cell is protein enriched and lipid-depleted, lying embedded in an expanded extracellular matrix of highly nonpolar lipids. Because of its strategic location between the cornified layer, this lipid matrix is responsible for many phenomena related to the permeability barrier, as well as cohesion and desquamation. Thus, manipulation of this compartment could lead to enhanced drug delivery and improved lubrication, as well. PMID- 3542247 TI - Motor evoked potentials in CNS trauma. AB - The evolving techniques of motor evoked potential (MEP) monitoring are reviewed here with reference to their application in clinical and experimental CNS trauma, and with particular relevance to spinal cord injury. Transcutaneous electrical stimulation of the motor cortex for analysis of descending pathways has been developed over the past 6 years in a number of centers. It has now been greatly augmented by the introduction of magnetic stimulation technology. The MEP offers a valuable insight into the physiological status of motor tracts within the spinal cord and is applicable to conscious patients, intraoperative monitoring, and animal studies. It is seen as complementary to somatosensory evoked potential monitoring rather than an alternative or replacement for it. The chief limitations of the technique, common to all evoked potential methods, are the restricted information content, and the need for rigorous electrophysiological interpretation of the resulting signals, if meaningful diagnostic data are to be extracted. PMID- 3542248 TI - Ca paradox in neural injury: a hypothesis. AB - The deleterious effects of Ca ionic entry into neurons has been speculated to be a final common pathway of cell death. However, a direct cause-effect relationship between Ca and neuronal death has been difficult to establish. Cells dying from any cause will accumulate Ca. The entry of Ca into neurons and the subsequent pathological changes associated with Ca entry consequently may be manifestations rather than causes of cell death. Recent work showing that extracellular Ca ionic activity becomes profoundly depressed in injured spinal cord and ischemic cerebral cortex prompted a new hypothesis on Ca mediated damage. We propose that the initial fall in extracellular Ca activity, resulting from the death of some cells in the tissue, increases the susceptibility of the surviving cells to Ca entry when extracellular Ca activity levels normalize and that this accounts for part of the secondary damage that has been observed in neural injury models. Such a phenomenon has been described in cardiac tissues. Dubbed Ca paradox, this phenomenon occurs when heart cells are perfused with Ca-free solutions for several minutes followed by the return to normal Ca-containing solutions. The cardiac cells die and undergo physiological, morphological, biochemical, and other changes. The evidence supporting a Ca paradox phenomenon in injured neural tissues is summarized. The therapeutic implications of Ca paradox in neural tissue injury are discussed. PMID- 3542249 TI - [In remembrance of J.E. Purkinje]. PMID- 3542250 TI - [When did Bedrich Smetana die and from what mental disorder?]. PMID- 3542252 TI - [Roentgenologic study of the skeletal remains of King Ladislav Pohrobka]. PMID- 3542251 TI - [The development of phoniatrics in Czechoslovakia]. PMID- 3542253 TI - Evaluation of the cochleovestibular function in patients treated with carboplatin for ovarian carcinoma. AB - Carboplatin (JM8), a new cisdiamminodichloroplatin (CDDP) analogue, has exhibited the same antitumor as CDDP. In our pilot study, aiming at optimizing the dosage of this drug in a combination regimen with other chemotherapics, we planned to evaluate the existence of drug related damage on cochleo-vestibular structures. The study was performed on 9 patients suffering from advanced ovarian carcinoma. The results obtained in our study showed that patients undergoing carboplatin chemotherapy do not require an audiometric check-up. In order to assess definitely the existence of vestibular toxicity of this drug, larger studies planned to test JM8 in a high-dosage regimen are desirable. PMID- 3542254 TI - Current issues in the treatment of colorectal cancer. AB - For colorectal cancers that are confined to the bowel wall with uninvolved nodes, surgery alone is curative in most patients, and adjuvant treatment is usually not indicated. A combined modality approach for the initial treatment of many rectal and selected colonic carcinomas is based on data that "radical" operations do not necessarily prevent either local regrowth or distant failures and acceptance of a significant palliative but infrequent curative role for irradiation and chemotherapy when such failures occur. Published data for rectal cancer indicates that local recurrence can be markedly reduced by moderate to high dose pre- and post-operative irradiation +/- chemotherapy. For colon cancer, data from pilot trials suggest that post-operative irradiation may reduce local recurrence by stage when compared with surgery alone analyses, but randomized trials are needed. With locally advanced disease, aggressive treatment combinations appear to increase both local control and survival, but much interaction is required between involved physicians. PMID- 3542255 TI - Asbestos-related malignancy. AB - Due to the known association with asbestos exposure, malignant mesothelioma has assumed an importance out of proportion to its incidence in the American population (2.2 per million). Patients present with chest pain, shortness of breath, or both. The initial chest X-ray generally reveals a large unilateral pleural effusion. A large piece of tissue obtained via open biopsy is usually required for histologic diagnosis. Investigational approaches include multiple needle biopsies obtained for electron microscopy, as well as for immunoperoxidase staining for keratin and CEA. The tumor characteristically remains localized until late in its course. The treatment of mesothelioma remains unsatisfactory. However, anecdotes report long-term disease-free survival after intensive treatment. Palliation with a response rate of up to 30% to various chemotherapeutic regimens has been reported by a number of investigators. PMID- 3542256 TI - [Bacteriological study of shigellosis in the Lake Kivu area (Central Africa). Developments in the last 15 years (1968-1983)]. AB - 1913 Shigella strains were isolated from 1968 to 1983 in lake Kivu area (Central Africa). Distribution and evolution of serotypes, biotypes and antibiotypes were studied. The majority of serotypes and biotypes were stable. However, few of these strains showed variations, among them Shigella dysenteriae serotype 1, causing epidemic dysenteriae since 1981. Epidemiologic survey of shigellosis in Kivu seems to be rather underdeveloped (4 bacteriology laboratories for an area of 10 million inhabitants) and the number of registered cases is probably underestimated. This problem is threatening the public health and coordination of laboratory activities, either local or regional, should be improved. PMID- 3542257 TI - [Malaria in Vanuatu. Recent epidemiological data]. AB - The Republic of Vanuatu, ex-Condominium of New-Hebrides, is an archipelago in the South Pacific, between Solomon Islands and New-Caledonia. Although the health system is quite satisfactory, malaria has become the major health problem in the whole country. Its epidemiological characteristics are reviewed, and particularly the biology of the only known vector, the Anopheles farauti complex. A sudden and severe aggravation of the malaria morbidity since 1980 is then evidenced. This increase of the yearly incidence (from 21% to 183% between 1980 and 1984) has privileged the rising of Plasmodium falciparum which reached 75% of the national paraside index. Moreover, it has clearly followed a geographical progression from north to south within the group during the four years. Various possible causes to this alarming situation are examined, among which the emergence of chloroquin resistant strains of P. falciparum, and the possibility of modifications in the vector's population, particularly hold the attention. PMID- 3542258 TI - [Drug resistance of Plasmodium falciparum in Congo. I. In vivo study with 10 and 25 mg/kg of chloroquine (235 tests)]. AB - An evaluation of chloroquine resistance in P. falciparum was conducted in four different areas of the People's Republic of the Congo during the months of October and November 1985. Using the simplified seven day in vivo test protocol, 235 tests were completed in 92 children aged three months to five years seen at the Maternal Child Health Clinics (54 children were treated by a single dose at 10 mg/kg and 38 children were treated by the three day dose of 25 mg/kg) and 143 school children aged six to 12 years (70 treated by 10 mg/kg and 73 treated by 25 mg/kg). In three of the zones (Brazzaville, the forest mountains of the Mayombe and Chaillu), a high level of resistance was found in the percentage of children with asexual forms of P. falciparum parasites (1 000 leucocytes) in the blood smears. After 7 days, the percentage of positive results in children treated by 10 mg/kg was found to be 65.5% and 29.3% for children treated by 25 mg/kg. Failure rates, independent of parasite density, were less in school aged children. A significant number of observations seems to be Type II resistance. The situation is more favorable in the fourth area of Likouala, a region of flooded forests in the north of the country. PMID- 3542259 TI - [Difficult diagnosis of the plasmodial species]. AB - We reported a case of malaria in a 37 years-old French woman. The first crisis occurred 8 months after coming back from an endemic area. Plasmodium falciparum was the responsible species. After 3 months' clinical latence, the patient had a new malarial crisis, but P. vivax malaria. Pictures of polyparasitism and the almost total absence of Schuffner granulations were noted. This double malaria infection and the involvement of atypical plasmodial strains are discussed. PMID- 3542260 TI - [Error in the interpretation of echography in a case of retinoblastoma]. PMID- 3542261 TI - [Surveillance of nonenucleated choroidal melanoma]. PMID- 3542262 TI - [Comparison of data given by the Friedmann analyzer and Octopus 2000 automatic perimeter. Apropos of a case]. PMID- 3542263 TI - [Radiation retinopathy after brain irradiation for a bone marrow graft]. PMID- 3542264 TI - [Intensive chemotherapy with bone marrow grafts]. PMID- 3542265 TI - [CT scan-assisted stereotaxis. A new diagnostic and therapeutic approach in neurosurgery]. PMID- 3542266 TI - [Hereditary anomalies of hemoglobin: from the routine hematologic test to applied molecular genetics]. PMID- 3542267 TI - Sensitivity to quinine and mefloquine of Plasmodium falciparum in Thailand. AB - Between 1982 and 1984 a regimen consisting of quinine and tetracycline was routinely used in Thailand to treat outpatients with microscopically confirmed falciparum malaria. Due to compliance problems associated with the 7-day multiple dose regimen, there was a recrudescence rate of approximately 30%. Studies carried out in 1982 and 1984 in four areas of Thailand indicated that there was a significant decrease in the sensitivity of Plasmodium falciparum to quinine. A significant, though less marked, reduction in the sensitivity of P. falciparum to the structurally related drug mefloquine was also observed, although this compound was not operationally deployed in Thailand before 1985. These findings emphasize the need to replace the long multiple-dose quinine regimen by an effective, acceptable, single-dose treatment. PMID- 3542268 TI - Preliminary observations of intraperitoneal carboplatin pharmacokinetics during a phase I study of the Northern California Oncology Group. AB - The pharmacokinetic behavior of carboplatin administered by the i.p. route at a dose of 200 mg/m2 was studied during five courses of therapy in four patients with ovarian cancer. A regional pharmacologic advantage was noted with carboplatin administered by this route, with peak peritoneal fluid concentrations 18-fold those in plasma, and area under the curve (AUC) for the peritoneum showing a 18-fold and 6-fold increase over plasma AUC at 4 and 24 h, respectively. The mean residence time of total platinum in the peritoneum was 4.7 h. Approximately 10% and 40% of plasma platinum was protein bound at 4 and 24 h after treatment, respectively, whereas peritoneal fluid platinum showed minimal protein binding. Peak plasma platinum levels were comparable to those recorded in previous studies with i.v. doses of carboplatin. Peritoneal clearance of carboplatin in these four patients appeared to be less than that previously reported for cisplatin. Further studies are in progress with higher doses of i.p. carboplatin. PMID- 3542269 TI - Urinary beta 2-microglobulin: early indicator of high dose cisdiamminedichloroplatinum nephrotoxicity? Influence of furosemide. AB - To evaluate the efficacy of beta 2-microglobulin as an indicator of cisplatinum nephrotoxicity, creatinine clearance and urinary beta 2-microglobulin were measured in 19 patients during 5 h after administration of a single dose of 80 mg/m2 cisplatinum. Eleven patients received furosemide as a concomitant therapy. Serum creatinine and beta 2-microglobulin remained unchanged. A decrease of creatinine clearance was observed. Urinary beta 2-microglobulin increased between 1 and 3 h after administration. This suggests transient tubular damage immediately after the treatment course. The concomitant administration of furosemide does not modify these results. However, patients who developed long term nephrotoxicity had no early rise of urinary beta 2-microglobulin excretion; thus, it is not possible to predict cumulative nephrotoxicity by measuring beta 2 microglobulin immediately after the first course of high-dose cisplatinum. PMID- 3542270 TI - Phase II trial of carboplatin (JM8) in treatment of patients with malignant mesothelioma. AB - Seventeen patients with malignant mesothelioma were treated in a phase II study with carboplatin, a cisplatin analogue without significant nephrotoxicity or neurotoxicity. The drug was given in a dose of 300-400 mg/m2 by i.v. infusion, repeating at 28-day intervals. One patient achieved a complete clinical and radiological remission of 15 months' duration, and a second patient achieved a partial response of 11 months' duration (overall response rate 12%; overall response rate in previously untreated patients 20%). Four other previously untreated patients achieved symptomatic relief. Treatment was well tolerated without severe side-effects. Carboplatin, like most other cytotoxic drugs, is active only in a small minority of patients with mesothelioma, but its ability to achieve occasional good responses and frequent symptomatic relief, combined with low toxicity, may justify a short therapeutic trial in patients whose tumour is symptomatic. PMID- 3542271 TI - A phase II study of the platinum analogues JM8 and JM9 in malignant pleural mesothelioma. AB - The platinum analogues JM8 and JM9 were assigned randomly to 16 patients with pleural mesothelioma. Nine patients received JM8 and seven received JM9. Two of nine (22%) JM8-treated patients had objective responses (confidence limits 2.8% 60.0%, 95% confidence level). JM9 was more emetogenic than JM8, but not to a significant level. However, patients who received JM9 significantly preferred this drug to be given on an inpatient basis, in contrast with patients receiving JM8, who received the majority of courses as outpatients. Primary cytotoxic drug resistance is a major obstacle to successful treatment of mesothelioma, and phase II studies of novel agents should continue in an effort to circumvent this problem. PMID- 3542272 TI - Benzidine activation in the Ames test: roles of hepatic N-acetyltransferase and other cytosolic and microsomal factors. AB - Benzidine (BZ) is a known animal and human carcinogen, and is mutagenic in the Ames test using strain TA 98. Several workers have shown that hepatic S9 fraction from hamster is much more effective than is rat S9, as an activation system for BZ in the Ames test. We show that rat microsomal fraction inhibits hamster S9 activation of BZ. Hamster microsomal fraction, supplemented with glucose-6 phosphate dehydrogenase (G6PdeH), gives a BZ dose-dependent mutagenic response, in the absence of cytosolic fraction. Rat microsomal fraction, in contrast, gives relatively little activation, under comparable conditions. Activation was enhanced when hamster or rat cytosol was added back to a mixture of hamster microsomes and G6PdeH. When strain TA 98 was replaced by strain TA 98/1,8-DNP6, very little activation of BZ was observed. Partially purified mouse liver acetyltransferase effectively activated BZ to mutagenic products in the presence of acetyl coenzyme A (CoASAc)/hamster microsomes/G6PdeH. Hamster and rat liver cytosol contain a CoASAc-dependent as well as a CoASAc-independent cytosolic activating factor of BZ. Hamster but not rat microsomal activation of BZ is enhanced in the presence of CoASAc. The biochemical mechanisms of BZ activation in the Ames test are discussed in light of these results. PMID- 3542273 TI - Genotoxicity of fecapentaene-12 in bacterial and mammalian cell assay systems. AB - Fecapentaene-12 (Fec-12), a compound thought to be responsible for much of the mutagenicity in fecal extracts from groups at high risk for colon cancer, was assayed for genotoxic potential in a battery of bacterial and mammalian cell short-term assays. This compound demonstrated significant mutagenic activity with Salmonella typhimurium tester strains TA104, TA100 and TA98, inducing approximately 1400, 700 and 100 revertants/micrograms, respectively. Fec-12 caused dose-dependent increases in unscheduled DNA synthesis in both rat hepatocytes and human fibroblasts, indicating its potential genotoxicity to mammalian as well as bacterial cells. Finally, Fec-12 had the ability to induce neoplastic transformation in mouse BALB/c 3T3 cells in the absence of exogenous metabolic activation. PMID- 3542274 TI - Increased glucose metabolism by epitrochlearis muscle removed from endotoxin treated rats. AB - In this study glucose metabolism was assessed in epitrochlearis muscle taken from control and endotoxin-treated rats. Endotoxin (1 mg/100 g) or saline was administered i.v. to rats and the epitrochlearis muscle was removed 3 hr later for in vitro incubation. Glycolysis, determined as 3H2O production from [2-3H] glucose, was increased 45% in muscle taken from endotoxin-treated rats compared to control animals. Glycogen synthesis, assessed by the incorporation of [U-14C] glucose into glycogen, was similarly elevated. Glycolysis and glycogen synthesis were stimulated by insulin in a dose-dependent manner. Muscles removed from endotoxin-treated rats were slightly more sensitive to insulin, but at the highest dose of insulin used, differences between muscles from control and endotoxemic rats remained similar to differences seen without insulin. Endotoxin induced changes in glucose metabolism were not reversed by the presence of indomethacin, indicating that prostaglandin production is not responsible for these changes. Thus, endotoxemia results in changes in glucose metabolism in skeletal muscle that are retained in vitro in the absence or presence of insulin. PMID- 3542275 TI - Effects of methylprednisolone on renal nerve response to stimulation of medullary pressor area in endotoxin-induced hypotension. AB - The purpose of this study was to determine the effects of glucocorticoids on central sympathetic outflow during endotoxic hypotension in anesthetized rabbits. All animals were given E. coli endotoxin (1 mg/kg) intravenously. In the control group, mean blood pressure (MBP) fell significantly after endotoxin. Endotoxin also caused a significant reduction of renal nerve activity (NA) simultaneously with a decrease in MBP. Peak responses in MBP and NA to repetitive stimulation of the medullary pressor area were attenuated significantly 60 min after endotoxin. Both peak and total activities of renal nerve discharges (RNDe) evoked by the electrical stimulation of the medullary pressor area were significantly reduced. There were no significant differences in the time course changes in the above parameters between the control group and the treated group. Following a vehicle injection in the control group, these parameters decreased by endotoxin progressively declined until the end of the experiment. When methylprednisolone (MPSS, 30 mg/kg) was injected intravenously 60 min after endotoxin, decreases in MBP and NA induced by endotoxin recovered gradually toward preendotoxin levels. Thirty minutes after MPSS administration levels of MBP and NA were significantly higher than those in the control group. Responsiveness in MBP and NA to the repetitive stimulation of the medullary pressor area increased significantly after the treatment with MPSS. Peak activities of RNDe 30 min after MPSS were augmented significantly and total activities of RNDe recovered to preendotoxin levels. Both endotoxin and MPSS did not affect MBP, NA, and RNDe responses following stimulation of the thoracic sympathetic chain. These findings suggest that methylprednisolone may have improved the impaired central blood pressure regulatory circuits during endotoxic hypotension through a facilitation of neuronal excitability, resulting in an enhancement of central sympathetic outflow. PMID- 3542276 TI - Effect of methylprednisolone, indomethacin, and diethylcarbamazine on survival rate following trauma and sepsis in rats. AB - The role of steroids in the treatment of sepsis and septic shock remains controversial, and it is not known if a possible beneficial effect is due to inhibition of the cyclooxygenase or lipoxygenase pathway of arachidonic acid metabolism. In this investigation we studied the effect of methylprednisolone (MP), the cyclooxygenase inhibitor indomethacin (IM), and the lipoxygenase inhibitor diethylcarbamazine (DE) on survival rate in an experimental trauma sepsis model in rats consisting of laparotomy and intravenous infusion of live E. coli. Groups of rats received saline (control) or MP (30 mg/kg) intravenously 30 min before or after induction of trauma-sepsis. In other groups of animals IM (4 mg/kg) or DE (0.2 mmol/kg) was administered intravenously 30 min before trauma sepsis. Survival rate was significantly improved by MP or DE given 30 min before trauma-sepsis while the other treatments did not affect the outcome. The results indicate that the beneficial effect of MP on survival rate in the present trauma sepsis model did not reflect inhibited prostaglandin synthesis but might have been due to inhibited production of leukotrienes. PMID- 3542277 TI - Autoregulation of blood flow. PMID- 3542278 TI - Maintenance of cerebral circulation during hemorrhagic hypotension in newborn pigs: role of prostanoids. AB - The possibility that the prostanoid system contributes to the capability of the newborn piglet to maintain cerebral blood flow and cerebral metabolic rate during hypotension was investigated. The effect of hemorrhage on net (arterial-to venous) cerebral prostacyclin production and the effects of indomethacin on cerebral hemodynamic response to hemorrhage and on the cerebral oxygen utilization following hemorrhage were determined in chronically instrumented, unanesthetized newborn pigs. Hemorrhage decreased arterial pressure about 35% but did not affect cerebral blood flow or cerebral O2 consumption. Hemorrhage was accompanied by an increase in net cerebral 6-keto-PGF1 alpha production from 4.0 +/- 1.1 to 15.3 +/- 4.9 ng/100g X min (mean +/- SEM). Indomethacin treatment of piglets following hemorrhage inhibited the net cerebral production of 6-keto-PGF1 alpha and caused a decrease in blood flow (approximately equal to 40%) to all brain regions within 20 minutes. The decrease in cerebral blood flow was the result of an increase in cerebral vascular resistance of 57 and 180%, 20 and 40 minutes post treatment, respectively. Cerebral O2 consumption was reduced from 2.5 +/- 0.3 ml/100 g X min to 1.5 +/- 0.3 ml/100 g X min 20 minutes following treatment of hemorrhaged piglets with indomethacin and to 1.1 +/- 0.3 ml/100 g X min 40 minutes after treatment. Six of 8 piglets for whom the data were recorded that were administered indomethacin following hemorrhage became comatose with cerebral O2 consumption of 0.4 +/- 0.1 ml O2/100 g X min by 40 minutes after treatment. These data are consistent with the hypothesis that the prostanoid system contributes to the maintenance of cerebral blood flow and cerebral metabolic rate during hypotension in the newborn. PMID- 3542280 TI - [Comparison of heterologous adult filarial antigens in detecting serum antibodies in Bancroftian filariasis patients by indirect fluorescent antibody test]. PMID- 3542279 TI - Inhibition of cyclic flow variations in stenosed canine coronary arteries by thromboxane A2/prostaglandin H2 receptor antagonists. AB - We tested the hypothesis that thromboxane A2 and thromboxane A2/PGH2 receptor occupation are important in mediating cyclical reductions in coronary blood flow (CFVs) in concentrically narrowed canine coronary arteries. Two potent and selective thromboxane A2/PGH2 receptor antagonists, SQ29,548 and SQ28,668 eliminated CFVs and restored a normal pattern of blood flow through the severely narrowed vessels in 77 and 75% of the dogs, respectively. CFVs were eliminated within several minutes of an intravenous bolus injection of SQ29,548 or SQ28,688. A continuous infusion of SQ29,548 (0.2 mg/kg X min) prevented the recurrence of CFVs throughout the duration of its infusion. Left atrial infusion of the thromboxane A2 mimetic, U46619, restored CFVs in 5 of 8 SQ29,548-treated and in 5 of 7 SQ28,668-treated dogs. Circulating concentrations of the stable metabolites of TxA2 and PGI2, TxB2 and 6-keto-PGF1 alpha, respectively, were unaffected by administration of SQ29,548. However, stenosed vascular segments of the left anterior descending coronary artery (LAD) of SQ29,548-treated dogs produced significantly less thromboxane A2 than comparable segments from untreated dogs. Morphologic studies showed that stenosed coronary arteries in which CFVs had been abolished by either SQ29,548 or SQ28,668 had relatively few adherent platelets, whereas comparable coronary segments removed from untreated animals had relatively large, platelet-rich mural thrombi. SQ29,548 did not alter the synthesis of TxB2 by platelets. 6-keto-PGF1 alpha concentrations in the stenosed LAD and nonstenosed circumflex coronary arteries were not altered by SQ29,548 administration. These data suggest that the thromboxane A2/PGH2 receptor antagonists, SQ29,548 and SQ28,688, inhibit cyclic reductions in coronary blood flow in this model by preventing the accumulation of platelets at the site of a critical coronary arterial stenosis. The data also suggest that TxA2 is important in mediating the interaction between platelets and the constricted coronary artery that is responsible for the development and maintenance of CFVs in this experimental model. PMID- 3542281 TI - [Detection of malarial antibody level by indirect fluorescent antibody test in an endemic area of Anhui]. PMID- 3542282 TI - [Electron microscopic study on the invasion of erythrocytes by Plasmodium berghei merozoites]. PMID- 3542283 TI - [A preliminary study on morphological features of Plasmodium vivax in the northern part of Hunan Province]. PMID- 3542284 TI - Intramyocardial variability in integrated backscatter: effects of coronary occlusion and reperfusion. AB - The present study was undertaken to characterize regional myocardial alterations of reflected ultrasound during the cardiac cycle in normal, ischemic, and postischemic reperfused myocardium. Time-averaged integrated backscatter (IB) and cardiac cycle-dependent amplitude modulation were measured from subepicardial, midmyocardial, and subendocardial regions of the left ventricular apex and the midportion of the right ventricular free wall under normal conditions (n = 5), after 1 hr of 100% acute left anterior descending (LAD) occlusion (n = 8), and after 15 min LAD occlusion plus 120 min reperfusion (n = 5) in anesthetized, ventilated open-chest dogs. A significant increase in time-averaged IB was observed in the subepicardium, the midmyocardium, and the subendocardium during ischemia and reperfusion, but there was no intramyocardial variability. Cardiac cycle-dependent amplitude modulation of IB was significantly higher in the normal subendocardium than in the subepicardium (4.3 +/- 0.6 vs 2.9 +/- 0.8 dB, p less than .01) and midmyocardium (2.8 +/- .05 dB, p less than .01). This transmural gradient in amplitude modulation was abolished during ischemia and reperfusion. We conclude that cardiac cycle-dependent amplitude modulation in IB has a transmural dependence in the normal myocardium and this is abolished during acute myocardial ischemia. PMID- 3542285 TI - Detection and confirmation of cocaine use by chromatographic analysis for methylecgonine in urine. AB - Methylecgonine is a common metabolite of cocaine in man. We prepared methylecgonine and developed thin-layer chromatographic and gas-chromatographic methods for its detection in urine. Seventy urine specimens from our drug screening laboratory were tested by our method and by EMIT. Both methods were positive for 26 urines, and both were negative for 42 urines. The other two urines were shown to contain cocaine by GC/MS, and no detectable metabolites. We thus demonstrated that detection of methylecgonine and cocaine is as sensitive a test for cocaine use as EMIT. PMID- 3542286 TI - Four immunoassay methods and standards compared for measuring fibronectin. AB - Several companies have developed commercial kits to measure plasma fibronectin rapidly and inexpensively with readily available laboratory equipment. In two of these kits (Cooper Biomedical and Boehringer-Mannheim) an immunoturbidimetric method is used. In a third kit (Biomedical Technologies, Inc.) an enzyme immunoassay method is used. To evaluate these commercial kits for fibronectin assay, we selected nephelometry as a comparison method for ranking the kits with regard to precision and accuracy. We also compared antibody and fibronectin cross reactivity. The antibodies from various manufacturers appear similar, but the fibronectin standards from different sources showed significant variation. Rate nephelometry and the Boehringer-Mannheim kit had the best within-run precision (CVs of 0.38% and 5.5% respectively). Between-run precision for nephelometry was excellent (CV = 1.9%) and somewhat high for the Boehringer-Mannheim kit (CV = 15.4%). This study demonstrates a need for further standardization of antigen (fibronectin) and antibody in commercial kits and the development of suitable stable quality-control material. PMID- 3542287 TI - The theophylline method of the Abbott "Vision" analyzer evaluated. AB - We evaluated the analytical performance of the Abbott "Vision" analyzer for theophylline measurement. The within-day precision (CV) was 1.8% and 3.1% at theophylline concentrations of 15.2 and 25.2 mg/L, respectively; between-day precision was 3.5% and 4.8% at 14.9 and 24.4 mg/L, respectively. Bilirubin (143 mg/L) and triglyceride (7.4 g/L) did not interfere, but hemoglobin caused lower values for apparent theophylline, the magnitude of the decrease being proportional to the hemoglobin concentration. At the cutoff concentration of 1 g/L programmed into the instrument by the manufacturer, hemoglobin reduced the theophylline value by less than 10%. Results by the Vision method (y) compared well with those by the "TDX" procedure (x): r = 0.98, y = 0.978x - 0.270 mg/L. The Vision method gave comparable theophylline values for serum, plasma, and whole-blood samples. We also validated analytically and clinically that capillary blood samples collected by finger stick can be used interchangeably with blood samples collected by venipuncture for monitoring theophylline therapy. PMID- 3542288 TI - Screening for cerebrotendinous xanthomatosis by using an enzymatic assay for 7 alpha-hydroxylated steroids in urine. AB - We used a commercial enzymatic kit for measuring 7 alpha-hydroxylated bile acids to screen urines from normal subjects, liver-transplant recipients, and patients with various liver diseases, cerebro-hepato-renal syndrome, or cerebrotendinous xanthomatosis (CTX). Because of their high concentrations of 7 alpha-hydroxylated compounds excreted, the CTX patients were clearly distinguished from all other groups except for a slight overlap with the patients with cerebro-hepato-renal syndrome and liver-transplant recipients. Gas chromatography for bile alcohols completed the differential diagnosis. PMID- 3542289 TI - Automated and manual quantitative assays of choriogonadotropin in serum compared. AB - We found the analytical performance of a rapid, automated assay of human choriogonadotropin (hCG) in serum, the Stratus hCG Fluorometric Enzyme Immunoassay, superior to a widely used manual assay for hCG (Hybritech Tandem-E hCG). The two assays were comparable in sensitivity; recovery; cross reactivity with lutropin, follitropin, and thyrotropin; and freedom from interference from hemoglobin and bilirubin. Patient-correlation studies indicated good quantitative agreement [Stratus hCG = (1.08 X Tandem hCG) - 4.3 int. units/L]. However, intra- and interassay precision was substantially better with the Stratus hCG assay, and this may allow earlier confirmation of pregnancy. PMID- 3542290 TI - Electrophoretic mobility, concentration, and activity of alpha 1-antitrypsin in serum of patients undergoing bone-marrow transplantation. AB - We have observed an electrophoretically abnormal, nonfunctional species of alpha 1-antitrypsin in serum from patients who were receiving bone-marrow transplants for treatment of leukemia or aplastic anemia. Three of four patients in whose serum this protein appeared died soon after; the fourth recovered, and the disappearance of the abnormal alpha 1-antitrypsin paralleled his recovery. This suggests that the inability to maintain functional activity of alpha 1 antitrypsin predisposes patients to life-threatening complications during recovery from bone-marrow transplants. PMID- 3542292 TI - More on immunoturbidimetry of urinary albumin. PMID- 3542291 TI - Israel Mordecai Rabinowitch (1890-1983): a father of clinical chemistry in Canada. PMID- 3542293 TI - Analog vs non-analog free T4 assay: effect of sample dilution. PMID- 3542294 TI - Rapid, economical immunoturbidimetric method for microalbuminuria. PMID- 3542295 TI - Potential of monoclonal antibodies to improve therapeutic monitoring of cyclosporine. AB - We show that monitoring of cyclosporine by immunoassay could be improved by using monoclonal antibodies (MAbs) of restricted specificity instead of polyclonal antisera that recognize both unmodified cyclosporine and its metabolites. MAbs with high affinity for cyclosporine have been prepared and characterized. We tested their ability to discriminate between native cyclosporine and its metabolites in indirect solid-phase enzyme immunoassay with a set of cyclosporine metabolites modified at residues 1, 4, 6, and 9 (corresponding to the six known sites of metabolism of cyclosporine). All the metabolites tested were detected by MAb1 at least 15- to 1000-fold less well than unmodified cyclosporine. A second MAb recognized unmodified cyclosporine and most of its metabolites equally well. Both MAbs retained their activity when coupled to alkaline phosphatase and could therefore be used in a direct solid-phase enzyme immunoassay. PMID- 3542297 TI - Microbiological assay for vitamin B12 with use of a colistin-sulfate-resistant organism. AB - In this simplified microbiological assay for serum vitamin B12, Lactobacillus leichmanii (NCIB 8117) adapted to tolerate high concentrations (500 mg/L) of the polymyxin antibiotic colistin sulfate is used. Results were similar in parallel experiments in which we used both the parent strain of L. leichmanii (NCIB 8117), and the new adapted strain. Evaluation of assay performance showed excellent analytical recovery of added cyanocobalamin (97%, SD 3%) and good interassay and intra-assay precision (CV less than 5%). This modified assay system obviates the need to sterilize culture medium and glassware. Consequently, assay manipulations may be carried out openly, without aseptic precautions. Moreover, this adapted organism would be suitable for use in an automated microbiological assay system. PMID- 3542296 TI - Two indirect tests of exocrine pancreatic function evaluated. AB - We describe and evaluate two frequently used indirect methods for assessing exocrine pancreatic function: the N-benzoyl-L-tyrosyl-p-aminobenzoic acid test (NBT-PABA) and the pancreolauryl test. In both procedures, the patient is orally administered a substrate that is metabolized into two or more products by pancreatic enzymes. At least one of the reaction products is absorbed from the gut, conjugated, and excreted in urine, where it can be measured. Both tests can be used in the diagnosis and monitoring of cystic fibrosis, chronic pancreatitis, and pancreatic carcinoma, and in monitoring pancreatic enzyme replacement therapy to determine the appropriate dose. In comparison with the NBT-PABA procedure, the pancreolauryl test seems to have better specificity and sensitivity, undergoes almost no interference from other drugs or serum compounds, requires no complex hydrolytic conditions, and is independent of renal function. PMID- 3542298 TI - Free and total insulin as determined after precipitation with polyethylene glycol: analytical characteristics and effects of sample handling and storage. AB - We evaluated results of radioimmunoassays of free and total insulin after precipitation of endogenous antibodies with polyethylene glycol (PEG), and we investigated the influence of collection time, temperature, and storage in heparin- cr EDTA-treated plasma or serum on results for free insulin. Analytical recovery of free insulin was 99.3%, of total insulin 96.4%. For free insulin, assay precision (CV) was 4.0-13.0% (intra-assay) and 7.8-10.7% (inter-assay); for total insulin, 3.6-9.5% and 6.6-11.7%, respectively. Free insulin decreased in plasma (p less than 0.05) and serum (p less than 0.01) at room temperature after 3 h and in promptly analyzed serum (p less than 0.01). Storage of samples at -20 degrees C increased the concentration of free insulin in plasma (p less than 0.025) and serum (p less than 0.005), whereas the free insulin content of supernates after PEG precipitation was stable, except for a slight decrease in serum samples (p less than 0.02). We conclude that, for radioimmunoassay of free and total insulin, plasma should be used, treated with PEG without delay; supernates then are analytically stable for as long as 26 weeks at -20 degrees C. PMID- 3542299 TI - Plasma iron and transferrin iron-binding capacity evaluated by colorimetric and immunoprecipitation methods. AB - We evaluated plasma iron (PI) and total iron-binding capacity (TIBC) or transferrin in normal individuals and in patients with iron imbalance. The standard colorimetric measurements of PI and TIBC and the standard isotope dilution measurement of TIBC were compared with an immunoprecipitation method and also with immunoelectrophoresis of transferrin. PI concentrations as measured by the standard and immunoprecipitation methods agreed closely for all individuals except those with saturated transferrin, where nontransferrin iron increased the results in the standard assay. This excess iron in saturated plasma may be derived from either free iron or iron-bearing ferritin. There were also differences in TIBC between the two methods. Iron-deficient sera gave higher values for transferrin when measured by immunoelectrophoresis. Unsaturated iron binding capacity was increased in the isotope-dilution method in some iron saturated plasma, compounding errors when added to erroneously high PI values to compute TIBC. Perhaps some exchange of iron occurred between added iron and transferrin iron in the isotope-dilution method. These measurements confirm the accuracy of the standard colorimetric method of measuring PI and TIBC except in iron-saturated plasma. However, the greater specificity of a polyclonal immunoprecipitation method of measuring PI and TIBC makes it particularly useful in differentiating transferrin-bound iron from nontransferrin iron. PMID- 3542300 TI - Solid-phase enzyme immunoassay of terminal deoxynucleotidyl transferase evaluated. AB - We evaluated a newly developed solid-phase immunoassay (EIA) of terminal deoxynucleotidyl transferase (TdT, EC 2.7.7.3) and compared it with the enzymatic assay of TdT involving DNA polymerase. We assessed the precision, performance characteristics, and clinical efficacy of the EIA procedure, using 249 specimens of peripheral blood and bone marrow and 118 specimens of whole blood. On linear regression analysis of results for these 249 samples as measured by the two procedures, the correlation coefficient was 0.87. Distribution of TdT in mononuclear cells isolated from whole blood and bone marrow of subjects in several disease categories indicated good concordance between the two assay procedures. The EIA procedure is precise, can be performed on whole blood without first isolating mononuclear cells, is nonisotopic, and shows potential as a quantitative indicator for the differential diagnosis and monitoring of human leukemia. PMID- 3542302 TI - Quality assurance in changing times: proposals for reform and research in the clinical laboratory field. AB - The U.S. Department of Health and Human Services recently commissioned a comprehensive analysis of the effectiveness and appropriateness of federal clinical regulations. The analysis found that many federal regulations are technically obsolescent and many may be operationally unnecessary as a result of changing laboratory technology and changed federal reimbursement policies. Among changes recommended by the HHS-funded analysis are: the regulatory classification system based upon physical location of laboratories is no longer appropriate and should be replaced with a classification system reflecting laboratory functions; a single, uniform set of federal regulations should be developed that covers all civilian laboratories receiving federal reimbursement or operating in interstate commerce; a revised federal regulatory system should emphasize measures of performance such as personnel and inspection requirements; and clinical laboratory regulations should be based upon objective data to the maximum extent possible. PMID- 3542301 TI - Proteinuria in health and disease assessed by measuring the urinary protein/creatinine ratio. AB - We measured daily excretion rates for urinary protein and the ratios of urinary protein to creatinine in 24-h urines and in untimed urines in 60 healthy adults, 30 patients with kidney disease, and 22 kidney-transplant recipients. The ratios for urinary protein/creatinine, mg/g, in untimed urines and in 24-h urines from the same subjects were closely correlated (r = 0.97) for rates of protein excretion ranging from normal (mean 44 mg/day) to nephrotic (maximum 19,300 mg/day). Because urinary protein/creatinine in healthy subjects never exceeded 100 mg/g, we propose that a ratio of less than 100 mg/g in untimed urines, obtained in the absence of exercise, fever, or other evidence of urinary tract disease, is a criterion of normal kidney function. Among patients with nephrotic syndrome (urinary protein excretion rate greater than or equal to 4000 mg/day), urinary protein/creatinine ratios always exceeded 2000 mg/g in both 24-h and untimed urines. Intermediate urinary protein/creatinine ratios (100 to 2000 mg/g) may reflect any type of kidney disease. PMID- 3542303 TI - Treatment variables affecting facial growth in complete unilateral cleft lip and palate. PMID- 3542305 TI - Non-specific binding of insulin in an equilibrium binding assay of insulin antibodies. AB - In liquid phase assays for insulin binding antibodies (IBA), total binding of insulin is composed of specific and non-specific binding (NSB). Sometimes NSB is determined in serum of healthy individuals and then subtracted from total binding of IBA positive serum to obtain specific binding. This method does not take into account that NSB might vary from plasma to plasma. This possibility was investigated by means of a computerised non-linear curve fitting routine for the evaluation of measurement results of an (equilibrium) binding assay for IBA, which yields estimates of NSB for each plasma individually. From each of 19 insulin treated diabetic patients, 4 blood samples, taken at different points in time, were available for IBA and NSB measurement. It was found that inter-patient variance of NSB exceeded within-patient variance (p less than 0.01) and, in a number of instances, within-patient variance was greater than experimental variance. Our results indicate that it is advisable to use methods of IBA evaluation that take these NSB variations into account. PMID- 3542307 TI - Autoantibodies to thyroid hormones: association with falsely low hormone levels measured by 'Amerlex' assay. AB - Autoantibodies to thyroxine (T4) and tri-iodothyronine (T3) were found in a 21-yr old thyrotoxic woman who had paradoxically low T4 and T3 as measured in the 'Amerlex' solid phase radio-immunoassay. Though rare, thyroid hormone antibodies should be suspected if anomalous thyroid function results are obtained and alternate assay procedures used. PMID- 3542306 TI - Assay of human pancreatic lipase in biological fluids using a non-competitive enzyme immunoassay. AB - A sandwich enzyme immunoassay has been developed for human pancreatic lipase 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. Good parallelism was observed with the curves obtained from standard lipase and lipase present in serum, pancreatic juice and duodenal contents, demonstrating that the assay may be used to measure the level of the protein in different biological fluids. Mean values of lipase in human sera were 12.3 +/- 6.8 micrograms/l in adults and 4.5 +/- 2.7 in newborns. In all cases a good correlation was found in serum between the catalytic activity and the enzyme immunoassay. Lipase is detectable in amniotic fluids at the 18th week of pregnancy but at a very low level (0.95 +/- 0.32 microgram/l). In pancreatic juices, lipase concentration was 14.6% of the total protein content. A study on cystic fibrosis patients showed a poor correlation between blood pancreatic lipase concentration and fat malabsorption underlying the difficulty in assessing pancreatic function by the measurement of serum pancreatic enzymes. The use of the lipase assay in duodenal contents would permit better assessment of pancreatic function in patients presenting a severe or borderline defect in fat digestion and absorption. PMID- 3542304 TI - Multiple forms of acid and alkaline phosphatases: genetics, expression and tissue specific modification. PMID- 3542308 TI - Effect of the partial beta-agonist prenalterol on plasma renin activity in patients with left ventricular failure. AB - Beta agonist therapy for heart failure has been disappointing, perhaps because of renin induced aldosteronism. To investigate this possibility we measured plasma renin activity (PRA) in 23 patients (17 male, 6 female, age 41-70) with New York Heart Association stage III heart failure due to ischaemic heart disease in a placebo controlled trial over one month. All patients received constant doses of digoxin and diuretics throughout the trial. Compliance was confirmed in all patients by digoxin and prenalterol assay. In a preliminary (dose titration) study of 9 patients there was a progressive, but non-significant rise of mean PRA from 14.8 to 17.6 and 27.7 ng/ml per h with doses of 20, 50 and 100 mg of prenalterol, respectively. After one month of treatment with prenalterol (n = 11), PRA was 12.8 +/- 2.4 (SEM) ng/ml per h which was not significantly different from the initial level of 14.4 +/- 2.3 ng/ml per h (n.s.). The placebo group (n = 12) results were 13.8 +/- 4.2 ng/ml per h at entry and 14.4 +/- 5.2 ng/ml per h at one month (n.s.). These results indicate that PRA is elevated by acute treatment with the partial beta agonist prenalterol but stimulation of renin secretion does not appear to occur with chronic therapy. PMID- 3542309 TI - Quantitative modelling of endocrine diseases as exemplified by diabetes. PMID- 3542310 TI - Exencephaly in human fetuses. AB - In some anencephalic fetuses exposed neural tissue mass of varied size can be demonstrated. This is known as exencephaly. The authors diagnosed by ultrasound 10 typical exencephalic cases prenatally between 14 and 21 weeks of gestation. Nine singular pregnancies were terminated and in the twin pregnancy a selective feticide of the exencephalic co-twin was carried out. The pregnancy continued to term and a healthy newborn infant and a fetus papyraceus were born. The mummified co-twin was anencephalic and showed only the remnants of the exposed brain. Authors suggest that, as in experiments with animals, the exencephaly in humans, by the degeneration of the exposed neural tissue converts to anencephaly and in this process the macrophages in fetal circulation and in the amniotic fluid may play a significant role. The large number of these actively phagocytic macrophages can be demonstrated in the amniotic fluid samples from exencephalic fetuses. PMID- 3542311 TI - The immunopathology of hypopigmented mycosis fungoides. PMID- 3542312 TI - Skin immunofluorescence in the diagnosis of primary bullous diseases--a review of 279 cases. PMID- 3542313 TI - Dermatology and Edinburgh. PMID- 3542315 TI - Monoclonal antibody against bacterial lipopolysaccharide cross-reacts with DNA histone. AB - Monoclonal antibodies to bacterial lipopolysaccharide (LPS) were prepared by fusing spleen cells from BALB/c mice immunized with Salmonella Minnesota Re 595 LPS to the mouse myeloma cell line P3U1. One of them, designated RS01, revealed a strong positive antinuclear activity and reacted with DNA-histone. RS01 also bound specifically to Salmonella Minnesota Re 595 LPS and eliminated the biological activity of LPS. The Salmonella completely inhibited the ANA activity of RS01 and DNA-histone blocked the reactivity of RS01 with LPS. Thus, it is clear that an anti-LPS monoclonal antibody, RS01 cross-reacts with DNA-histone. PMID- 3542316 TI - Mitogenic activity of extracellular cationic products produced by group A streptococci; analysis of the lymphocyte response. AB - The cationic fraction (isoelectric point greater than 8.5) of supernatant products of group A streptococcal cultures exerted a strong mitogenic effect on human peripheral lymphocytes at concentrations as low as 1 ng/well. Incorporation rates were highest at concentrations of 1-10 micrograms; rabbit peripheral lymphocytes also responded strongly, only a weak response was seen with mouse peripheral lymphocytes and rabbit thymocytes. Purified OKT4 positive (T helper) and OKT8 positive (T suppressor) lymphocyte subpopulations both responded, the former more strongly. Although accessory cells (monocytes) were not absolutely necessary, in their presence higher incorporation of 3H-thymidine was observed. Isolated B cells did not respond. PMID- 3542314 TI - Interactions of viruses with the immune system. PMID- 3542317 TI - Macrophage cytotoxicity in lethal and non-lethal murine malaria and the effect of vaccination. AB - We investigated the development of cell-mediated immunity in lethal and non lethal malarial infections by assaying the cytotoxic activity of spleen cells for L929 tumour cells at different times after infection of mice with the lethal P. berghei, a lethal variant of Plasmodium yoelii and the non-lethal P. yoelii and P. chabaudi. In all cases the cytotoxicity increased to a peak during the first week and then diminished but the time of the peak varied with the infection; its activity was lowest with P. berghei. A second peak occurred in the non-lethal infections at the time of recovery. A protective vaccine accelerated and enhanced the early peak of cytotoxicity. The activity was mediated by adherent phagocytic cells, probably through the release of tumour necrosis factor (TNF) by macrophages since it was inhibited by antiserum against recombinant mouse TNF and did not destroy TNF-resistant L929 cells. Its induction was not dependent on T cells since it occurred in T cell-deficient mice infected with non-lethal P. yoelii. However, the accelerated increase associated with vaccination could be adoptively transferred by spleen lymphocytes from vaccinated mice. PMID- 3542318 TI - Aberrant expression of HLA-DR antigen on valvular fibroblasts from patients with active rheumatic carditis. AB - Immunofluorescence and immunoperoxidase staining was used to investigate the expression of Class II major histocompatibility antigens in myocardial tissue of 16 patients with acute rheumatic carditis. Aberrant expression of HLA-DR was examined using monoclonal anti-Ia antibodies and was detected on the valvular fibroblasts of those valves with ongoing active carditis. Sections of myocardial and valvular tissue from normal controls or from patients dying of other cardiac diseases did not express HLA-DR. The aberrant expression of HLA-DR on valvular fibroblasts could be important in triggering autoimmune destruction in that these cells could present self-antigens to sensitized T-lymphocytes which could initiate autoantibody production or direct destruction of local tissue. PMID- 3542319 TI - In vivo immunopotentiating activity of thymopentin in aging humans: increase of IL-2 production. AB - The effect of thymopentin (TP-5) treatment on lymphocyte immune functions has been investigated in immunocompromised aged subjects. TP-5 was able to improve the cutaneous delayed hypersensitivity (CDH) to recall antigens and the proliferative response to phytohemagglutinin (PHA), concanavalin A, and Pokeweed (PWM) as well as the PHA-induced interleukin-2 (Il-2) production. On the other hand, no detectable changes were induced by TP-5 treatment either on PWM-induced immunoglobulin synthesis or on lymphocyte subsets identified by monoclonal antibodies. Our results suggest that the enhancement of Il-2 synthesis might be a crucial mechanism of the immunopharmacological action of TP-5 in aging humans. PMID- 3542320 TI - Glomerular binding sites for peanut agglutinin in acute poststreptococcal glomerulonephritis. AB - Streptococcal neuraminidase may be responsible for the development of auto-immune reactivity in acute poststreptococcal glomerulonephritis (APSGN). Neuraminidase may react with immunoglobulins in the circulation and with sialic acid-rich sites in the endothelial and epithelial glomerular capillary, therefore, extrinsic or intrinsic sialic acid-depleted substrate may be localized in the glomeruli. We studied renal biopsies from 17 patients with APSGN, 48 patients with other renal pathologies and 2 normal kidneys for the capacity to bind fluorescein-labelled peanut agglutinin (PNA) lectin. PNA has specificity for galactosyl radicals which are exposed after sialic acid removal. We similarly studied the kidneys of rats at intervals ranging from hours to 32 days after an intravenous injection of 0.02 units of neuraminidase per g of body weight. Five biopsies of APSGN patients and 2 biopsies from patients with renal pathologies different from APSGN showed glomerular PNA binding. Of APSGN patients, 4 corresponded to the 5 patients biopsied within 30 days of the beginning of the disease and only 1 biopsy was positive in the 12 patients who were biopsied later. The PNA binding predominated in the mesangium and the pattern was irregular and speckled. These findings suggest that sialic-acid depleted material is present in the glomeruli, early in the course of APSGN. PMID- 3542321 TI - The effect of hemodialysis, vitamin D metabolites and renal transplantation on the skeletal demineralization associated with renal osteodystrophy: a computerized histomorphometric analysis. AB - Twenty-three patients with end-stage renal failure treated by hemodialysis or transplantation were followed for up to 10 years. Sequential full thickness iliac crest bone biopsies were obtained to assess the effects on bone disease of hemodialysis, treatment with 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] and 24,25-dihydroxycholecalciferol [24,25-(OH)2D3] and renal transplantation. The biopsies were analyzed by a computerized histomorphometric technique which allowed accurate measurements of calcified bone and osteoid areas. Serum aluminum and parathyroid hormone concentrations were also monitored. Hemodialysis was associated with a loss of calcified bone and an increase in osteoid areas. The progressive bone loss was arrested but not reversed following treatment with either 1,25-(OH)2D3 or 24,25-(OH)2D3. Osteoid area was unchanged or reduced following treatment with 1,25-(OH)2D3 in all but three patients who had serum aluminum concentrations in excess of 5 mumol/l. 24,25-(OH)2D3 was not effective in reducing osteoid area, and combined treatment with 1,25 and 24,25-(OH)2D3 had no effect beyond that expected with 1,25-(OH)2D3 alone. Bone biopsies showed loss of calcified bone and an increase in osteoid areas one year and more after successful renal transplantation in five patients. Nineteen of the 23 patients developed serum aluminum concentrations greater than 3 mumol/l, probably because of the use of oral aluminum hydroxide as a phosphate binding agent. In these patients serum parathyroid hormone concentrations greater than 600 pg/ml appeared to prevent the development of osteopenia. PMID- 3542322 TI - Acute glomerulonephritis: three episodes demonstrated by light and electron microscopy, and immunofluorescence studies--a case report. AB - The patient, a white boy, had 3 episodes of recurrent acute glomerulonephritis at 7, 12 and 17 years of age. The episodes were preceded by impetigo and there was a good clinical and laboratorial recovery after all of them. Renal biopsies were performed during the acute episodes, and the light, immunofluorescence and electron microscopy studies showed only lesions typical of acute glomerulonephritis. Four months after the third episode another renal biopsy demonstrated only lesions compatible with the subsiding stages of acute glomerulonephritis. PMID- 3542324 TI - Harris H. Branham. PMID- 3542323 TI - Effects of furosemide and slow-release furosemide on thoracic fluid volumes. AB - Transthoracic electrical impedance (TEI) was used to assess the relative effectiveness of a 60 mg sustained-release furosemide preparation (FR) and a 40 mg standard furosemide tablet (F), in reducing the fluid content in the thoracic cavity. A double-blind crossover study was performed, in which 12 men with a history of one or more myocardial infarctions and mild left heart failure treated with 40 mg furosemide once daily participated. The trial, lasting 28 days, was divided into two 14-day periods. Each participant received one active drug and one placebo preparation daily, the same regimen being maintained for 14 days, when the active substances were switched. TEI, body weight, serum potassium, sodium, creatinine, and urate were measured immediately prior to the start of the study, after 14 days, and at the end of the study. TEI was measured at frequencies of 1 and 100 kHz with a constant current of 100 microA, during a period of one hour following an intravenous injection of 40 mg furosemide, when the urine volumes were measured also. TEI and urine production after the furosemide injections were similar irrespective of the drug preparation. No evidence of treatment period interaction was seen. No significant differences were demonstrated in body weight and blood chemistry during the trial. These results suggest clinical equipotency of the two preparations in mild left heart failure. PMID- 3542326 TI - The future of molecular medicine and clinical research. An international symposium in honor of Dr Jacques Genest. PMID- 3542327 TI - Ethics in clinical research and clinical practice. PMID- 3542325 TI - Superiority of methylprednisolone sodium succinate over low dose metoclopramide hydrochloride in the prevention of nausea and vomiting produced by cancer chemotherapy. AB - Methylprednisolone sodium succinate and metoclopramide were compared for their efficacy, tolerance, and safety in the prevention of nausea and vomiting induced by moderately emetogenic chemotherapy in patients with cancer. Previously untreated patients about to receive at least 2 cycles of identical chemotherapy were entered into a study using a randomized, double-blind, crossover design. Patients were given either 250 mg of methylprednisolone or 10 mg of metoclopramide intravenously before the first cycle of chemotherapy and were then crossed over to receive the alternate medication before the second cycle of chemotherapy. Prochlorperazine was prescribed in both cycles for postchemotherapy nausea and vomiting. After each treatment cycle patients recorded the degree of nausea, drowsiness and anxiety, the number of episodes of vomiting experienced, and the amount of prochlorperazine taken. After the second treatment cycle patients recorded their preference for either the first or the second antiemetic medication with respect to nausea, vomiting, and overall effectiveness. Of 157 patients entered into the study, 115 were fully appraisable. Methylprednisolone was superior to metoclopramide in preventing nausea and vomiting and in decreasing anxiety and the amount of prochlorperazine used. A majority of the patients expressing a preference preferred methylprednisolone to metoclopramide for control of nausea (p = 0.003), control of vomiting (p = 0.0006), and overall effectiveness (p = 0.00004). There were few side-effects. We conclude that methylprednisolone may have some utility as an antiemetic in patients receiving moderately emetogenic chemotherapy, and who are treated as outpatients. PMID- 3542328 TI - Models of peptide biosynthesis: the molecular and cellular basis of insulin production. PMID- 3542329 TI - Reconstruction of the thumb. AB - Based on 25 years of experience (1960-1984) with 188 cases, six approaches to thumb reconstruction are categorized as follows: pollicization using the index finger; pollicization using a finger stump; free transplant of a toe to reconstruct the thumb; reconstruction of the thumb by bone grafting and free flap transfer from the great toe with the nail; reconstruction of the thumb by turning up the skin over the dorsum of the stump and lengthening with bone grafting, and reconstruction of the thumb with bone grafting and tubular skin grafting. A well reconstructed thumb should be in proper position with good stability, have good sensation, be of proper length, and have a satisfactory aesthetic appearance. Proper selection of patients, based on the level of thumb loss, condition of other fingers, and age, occupation, and activities of the patient, is a key to successful reconstruction of the thumb. Care must be taken to avoid excessive interference with the original function of the donor site. PMID- 3542330 TI - The prevention of adhesions after laminectomy. Adverse results of Zenoderm implantations into laminectomy sites in rabbits. AB - Zenoderm (Ethicon Ltd., Edinburgh, Scotland) is porcine skin dermis specially treated so as to be weakly antigenic when implanted. Its use as an extradural spinal and nerve root membrane to reduce postoperative adhesions after laminectomy was tested in 22 rabbits with laminectomy in the second and fourth lumbar vertebra. The sites were reviewed histologically two to 36 weeks after operation. Histologic sections showed that Zenoderm was initially surrounded by hematoma that organized into fibrous tissue and, later, bone. When Zenoderm was placed immediately adjacent to the dura, dense adhesions formed, which were slower to resolve than those in the control sites. The rate of Zenoderm resorption was variable. In general, Zenoderm did not excite excessive fibrous tissue formation and was slowly replaced by bone. Contrary to the experience of others, it was unusual to find adhesions between the laminectomy site, and the dura began disappearing after six to nine weeks. In rabbits, Zenoderm is unlikely to prevent adhesions forming after lumbar disc surgery. The resorption rate is variable, and laminectomy sites are unsuitable for the investigation of material for the prevention of spinal dural adhesions. PMID- 3542331 TI - Recent advances in microlymphatic surgery in China. AB - Development and advances in clinical and research work on limb lymphedema in China has progressed rapidly in recent years. The authors first performed successful lymphaticovenous anastomosis using the operating microscope for limb lymphedema in China in May, 1979. By 1983, surgery on 48 lymphedematous limbs in the authors' clinic had given good results in one-third of the cases. By the same year, 185 limbs with lymphedema were treated by lymphaticovenous anastomosis throughout China with excellent results achieved in 72.9% of the cases. Lymphology was investigated using animal models, intraluminal pressure, and venous graft substitution of lymphatics. PMID- 3542332 TI - The founders of orthopedic surgery in China. Chi-Mao Meng, Hsien-Chi Fang, and Yan-Qing Ye. PMID- 3542333 TI - Surgical treatment of primary tumors of the sacrum. AB - Fifty-four patients were surgically treated for primary tumors of the sacrum. The ratio of men to women was 2:1, and most patients were from 30-50 years of age. Nearly half the tumors were chordomas, and the others were mostly giant cell tumors and neurofibromas. Proven malignancy was present in less than 10%. The operative and postoperative mortality was 11%, wound infection 11%, delayed wound healing 11%, and the immediate success rate 89%. A follow-up study of 33 cases for more than two years showed that 25 patients were living and well, providing a survival rate of 75.7%. Except for malignant tumors, preservation of upper sacral nerve roots was possible and necessary in the majority of low grade and benign tumors. Ligation of both internal iliac arteries and a temporary block of the common iliac arteries or aorta minimized bleeding. Injury to veins must be carefully avoided. Postoperative X-ray treatment appeared helpful in reducing recurrences, especially in upper sacral tumors where nerve root compression had to be relieved. PMID- 3542334 TI - Plasma exchange in hands of the neurologist. PMID- 3542335 TI - Pharmacokinetics of high-dose metoclopramide in cancer patients. AB - The introduction of new cytotoxic drug regimens has been associated with an increase in the incidence and severity of adverse effects. This in turn has highlighted the need for more effective adjuvant therapy. The use of metoclopramide for the prophylaxis of nausea and vomiting, in high intravenous doses (50 to 1000 mg), has become established since 1981. As a lipid-soluble drug, metoclopramide has a large volume of distribution. The reported mean values after high doses range between 2.8 and 4.6 L/kg. The mean values for total body clearance and terminal half-life range from 0.31 to 0.69 L/kg/h and from 4.5 to 8.8 hours, respectively. The values of these pharmacokinetic parameters are essentially similar to those obtained after conventional doses (less than 50mg). Pharmacokinetic parameters appear unaffected by age, although no high-dose study has been conducted in children. Bodyweight is apparently correlated with clearance. An influence of renal function indices on terminal half-life and clearance has been shown, which is rather surprising since renal clearance accounts for only 20% of the total clearance. No thorough investigations exist which examine the influence of hepatic disease, cancer type and cytotoxic drug regimen on the disposition of metoclopramide. A relationship between dose (or concentration) and therapeutic or adverse effects of metoclopramide is outlined. The therapeutic benefit of high doses (up to 14 mg/kg) may be dependent on age, and on the combination of cytotoxic drugs. The advantages of high doses of metoclopramide are most apparent when the drug is used as protection against the adverse effects of high doses of cisplatin (greater than 60 mg/m2). Despite considerable pharmacokinetic variability, intravenous administration of high doses of metoclopramide is relatively safe due to its large therapeutic index. PMID- 3542338 TI - The clinical relevance of protein binding and tissue concentrations in antimicrobial therapy. AB - The relevance of protein binding, molecular size and lipophilicity to tissue penetration of antimicrobials is discussed, and the clinical relevance of tissue penetration of these agents is assessed. In order to assess the relevance of any factor on the clinical outcome of a group of infections it is necessary to obtain some form of dose response; i.e. the dose has to be (intentionally or otherwise) titrated down until negative responses are seen. Information on clinical failures tends not to be reported, hence useful data are difficult to obtain. The relevance of protein binding to the microbiological activity of a drug is important and the use of some highly bound agents in readily assessable diseases is illustrated with a few examples: the poor efficacy of fusidic acid in gonorrhoea, when high failure rates are found with doses of 2g; ceftriaxone in gonorrhoea, at doses (25mg) with which one would expect cures, is associated with significant failures; the failure of cefoperazone in serious illness can be related to the degree of protein binding. The degree of tissue penetration (protein binding apart) is related to clinical efficacy in urinary tract infections (where ample evidence is available), chest infections (where the data are somewhat fewer but probably convincing) and meningitis where experimental data are firm but clinical information less readily available. PMID- 3542340 TI - Psychiatric liaison to liver transplant recipients. AB - Child psychiatric consultants perform psychiatric assessment and liaison among various clinical services. Execution of these familiar roles for pediatric liver transplantation recipients exposes unfamiliar and difficult bioethical problems. Administrative problems arise if the recipient's suitability is too narrowly evaluated. Assessment may be time-limited. The intensive care unit environment and the VIP characteristics of child transplantation patients may distort observations and constrain opportunities for preventive preoperative psychologic management. Unnecessary psychiatric complications may ensue, which imperil the transplantation surgery. The primary caretakers may have an extraordinary emotional investment, so liaison is pressured. Three cases are presented to illustrate these points. Medical ethical perspectives and the limitations of medical training to prepare physicians to perceive them are indicated. That these limitations also affect the psychiatrist is acknowledged, and a clinical research approach is suggested. PMID- 3542336 TI - Clinical pharmacokinetics of verapamil, nifedipine and diltiazem. AB - The calcium antagonists diltiazem, nifedipine and verapamil are widely used in the treatment of coronary heart disease, arterial hypertension, certain supraventricular tachyarrhythmias and obstructive hypertrophic cardiomyopathy. During recent years their pharmacokinetic properties and metabolism have been studied in more detail. Although these 3 calcium antagonists exhibit great diversity in chemical structure, they exhibit common pharmacokinetic properties. These drugs are extensively metabolised and only traces of unchanged drugs are eliminated in urine. Their systemic plasma clearances are high and dependent on liver blood flow. Therefore, their bioavailabilities (diltiazem 40 to 50%; nifedipine 40 to 50%; verapamil 10 to 30%) are low despite almost complete absorption following oral administration. During long term treatment, oral clearance decreases and bioavailability increases due to saturation of hepatic first-pass metabolism. Pronounced intra- and inter-individual variations in clearance and bioavailability are observed. In patients with liver cirrhosis the various pharmacokinetic parameters are grossly altered. Clearance decreases, elimination half-life is substantially prolonged, and bioavailability more than doubles. In addition, the volume of distribution increases. Whereas renal disease has no impact on the pharmacokinetics of diltiazem and verapamil, elimination half-life of nifedipine increases in relation to the degree of renal impairment due to an increase in volume of distribution. Systemic clearance, however, remains unchanged. The data so far available indicate that the plasma concentrations of these drugs correlate with both their electrophysiological and haemodynamic effects. However, no effective therapeutic plasma concentration range has been firmly established. As reliable clinical end-points are available for dose titration of calcium antagonists, it is doubtful whether therapeutic drug monitoring will be of great value. Calcium antagonists are often administered in combination with a variety of other drugs. Thus, the potential for both pharmacodynamic and pharmacokinetic drug interaction exists. The interaction between digoxin and these drugs is of clinical importance. Verapamil and diltiazem cause a significant increase in plasma digoxin concentrations. In contrast, nifedipine does not lead to a significant increase in the plasma digoxin concentration. The mechanism responsible for this interaction is inhibition of both renal and non-renal digoxin clearance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542341 TI - Intracellular calcium: friend or foe? PMID- 3542339 TI - Clinical pharmacokinetics and pharmacodynamics of warfarin. Understanding the dose-effect relationship. AB - The simplest complete system accounting for the time-course of changes in the prothrombin time induced by warfarin requires the combination of 4 independent models: A pharmacokinetic model for the absorption, distribution, and elimination of warfarin. Warfarin is essentially completely absorbed, reaching a maximum plasma concentration between 2 and 6 hours. It distributes into a small volume of distribution (10 L/70kg) and is eliminated by hepatic metabolism with a very small clearance (0.2 L/h/70kg). The elimination half-life is about 35 hours. A pharmacodynamic model for the effect of warfarin on the synthesis of clotting factors (prothrombin complex). Prothrombin complex synthesis is inhibited 50% at a warfarin concentration of about 1.5 mg/L. Warfarin concentrations associated with therapeutic anticoagulation are of similar magnitude. A physiological model for the synthesis and degradation of the prothrombin complex. The synthesis rate is about 5%/h/70kg and the elimination half-life estimated from changes in prothrombin time is approximately 17 hours. On average it will take 3 days for the anticoagulant effect of warfarin to reach a stable value when warfarin concentrations are constant. A model for the relationship between the activity of prothrombin complex and the prothrombin time. In general there is a hyperbolic relationship between these quantities. Its exact shape depends upon the method used for measuring the prothrombin time. Attempts to integrate these models into a single system have used essentially the same pharmacokinetic, physiological, and prothrombin activity models. Four distinct pharmacodynamic models have been proposed: linear, log-linear, power and Emax. One might be preferred on theoretical grounds (Emax) but its performance is not clearly different from the others. Empirical methods for warfarin dose prediction as well as those based on the combined pharmacokinetic-pharmacodynamic-physiological-prothrombin system have been proposed. Only one (which was also the first) [Sheiner 1969] has been adequately described and compared with the performance of an unaided physician. The programme compared favourably with decisions made by those physicians normally responsible for adjusting warfarin dose, but was not tested prospectively. A sizeable body of theoretical and experimental observations has contributed to our understanding of the warfarin dose-effect relationship. It remains to be demonstrated that any alternative method is superior to the traditional empirical approach to warfarin dose adjustment. PMID- 3542343 TI - Hiatus hernia. PMID- 3542342 TI - Adrenergic control of plasma magnesium in man. AB - Regulation of magnesium balance is poorly understood. However, hypomagnesaemia has been reported in patients in clinical situations where circulating catecholamines are raised including myocardial infarction, cardiac surgery and insulin-induced hypoglycaemia stress tests. The effects of L-adrenaline infusions, sufficient to achieve pathophysiological levels of adrenaline, and of therapeutic intravenous infusions of salbutamol, a beta 2-agonist, on plasma magnesium, plasma potassium, plasma glucose and plasma insulin levels were studied in a placebo-controlled design in eight normal subjects. Plasma magnesium levels fell significantly during the adrenaline infusion and also during the salbutamol infusion, though more slowly. In a 1 h period of observation after cessation of the infusions no recovery of plasma magnesium levels was seen. Significant falls in plasma potassium levels were also observed during both infusions with spontaneous recovery within 30 min after the infusions. No significant changes in plasma insulin levels occurred with either salbutamol or L adrenaline compared with control. Plasma glucose levels rose significantly during the adrenaline infusion. The study suggests that both L-adrenaline and salbutamol cause shifts in plasma magnesium which are not mediated by insulin. We propose that intracellular shifts of magnesium occur as a result of beta-adrenergic stimulation. PMID- 3542344 TI - Recent advances in antiviral therapy. AB - Virus replication is described, and the clinical trials and indications for amantadine, rimantadine, vidarabine, vidarabine phosphate, acyclovir, ribavirin, and other promising antiviral agents are reviewed. Amantadine and rimantadine are useful for the treatment and prophylaxis of viral influenza A infections. Vidarabine is a second-line agent and is effective for the treatment of herpes simplex encephalitis, neonatal herpes simplex types 1 and 2, and varicella-zoster infections. Vidarabine phosphate (also known as vidarabine monophosphate) has a similar spectrum of activity and can be administered in smaller volumes than vidarabine. Acyclovir has demonstrated clinical efficacy for chickenpox, shingles (herpes zoster), genital herpes, and other herpes simplex infections. Acyclovir is also useful for the suppression of herpes infections. Systemically administered ribavirin is indicated for the treatment of Lassa fever. Aerosol ribavirin is effective for the treatment of respiratory syncytial virus pneumonia in children and infants and influenza A infections in adults. Only acyclovir, amantadine, ribavirin, and vidarabine are used in clinical practice. Vidarabine phosphate and investigational agents such as rimantadine, ganciclovir (DHPG, BW B759U), phosphonoformate, and bromovinyl-deoxyuridine (BVDU) need further investigation. PMID- 3542345 TI - Short-course drug therapy for tuberculosis. AB - The cost, patient compliance considerations, and toxicity of short-course chemotherapy (SCC) and conventional 18- to 24-month treatment regimens for pulmonary tuberculosis are compared; studies of the efficacy of SCC regimens are evaluated; and the future of SCC in the United States is examined. SCC is defined as treatment for nine months or less. A definite advantage of SCC over conventional therapy in terms of cost, patient compliance, or adverse effects has not been established. A series of studies conducted by the East African-British Medical Research Council documented the efficacy of various six-month, multiple drug regimens that contain rifampin and verified the sterilizing activity of pyrazinamide during the first two months of therapy. The studies of the Hong Kong Chest Service and British Medical Research Council documented the efficacy of several intermittent drug regimens. Acceptable relapse rates were achieved with streptomycin, isoniazid, and pyrazinamide given two or three times a week for four or six months, preceded by a two-month, multiple-drug, daily regimen, and various four-drug, pyrazinamide-containing intermittent regimens. The benefit of pyrazinamide in reducing the relapse rate with SCC was confirmed by studies of the British Thoracic and Tuberculosis Association. Few studies of SCC have been conducted in the United States. Treatment practices in the United States are becoming more uniform, and SCC is being used more frequently for uncomplicated pulmonary tuberculosis. SCC will probably be used more widely in the future. Current guidelines of the Centers for Disease Control recommend treatment for nine months with isoniazid and rifampin, plus ethambutol in areas where resistance to isoniazid is common. In vitro data suggest that the addition of pyrazinamide may be more effective, but clinical experience with this drug in the United States is limited. PMID- 3542337 TI - Free drug concentration monitoring in clinical practice. Rationale and current status. AB - Recent advances in techniques to determine free drug concentrations have lead to a substantial increase in the monitoring of this parameter in clinical practice. The majority of drug binding to macromolecules in serum can be accounted for by association with albumin and alpha 1-acid glycoprotein. Albumin is the primary binding protein for acidic drugs, while binding to alpha 1-acid glycoprotein is more commonly observed with basic lipophilic agents. Alterations in the concentrations of either of these macromolecules can result in significant changes in free fraction. Diseases such as cirrhosis, nephrotic syndrome and malnourishment can result in hypoalbuminaemia. Burn injury, cancer, chronic pain syndrome, myocardial infarction, inflammatory diseases and trauma are all associated with elevations in the concentration of alpha 1-acid glycoprotein. Treatment with a number of drugs has also been shown to increase alpha 1-acid glycoprotein serum concentrations. A wide variety of biological fluids have been examined for their ability to provide an estimation of free drug concentration at receptor sites. The most useful fluid for estimating free drug concentrations appears to be plasma or serum, with subsequent treatment of the sample to separate free and bound drug by an appropriate technique. The two most widely used methods are equilibrium dialysis and ultrafiltration. Of these two, ultrafiltration has the greatest utility clinically because it is rapid and relatively simple. The major difficulty associated with this method involves the binding of drug to the ultrafilters, but significant progress has been made in solving this problem. Several authors have endorsed the routine use of free drug concentration monitoring. Data examining the clinical usefulness of free drug concentration monitoring for phenytoin, carbamazepine, valproic acid, disopyramide and lignocaine (lidocaine) are reviewed. While available evidence suggests that free concentrations may correlate with clinical effects better than total drug concentrations, there are insufficient data to justify the recommendation of the routine use of free drug concentration monitoring for any of these agents at present. PMID- 3542346 TI - Comparison of single-dose moxalactam and a three-dose regimen of cefoxitin for prophylaxis in vaginal hysterectomy. AB - In patients undergoing vaginal hysterectomy, prophylactic use of a single dose of moxalactam was compared with use of a standard three-dose regimen of cefoxitin for efficacy and for rate of postoperative colonization of the vaginal cuff with resistant bacteria. In a prospective, randomized study, patients hospitalized for vaginal hysterectomy received either cefoxitin sodium 2 g intramuscularly on call to the operating room followed by 2 g intravenously every six hours for two additional doses or a single dose of moxalactam disodium 2 g intramuscularly on call. Cultures of the meatal area and of urine were obtained preoperatively; postoperatively, cultures of urine, of the vaginal cuff, and of any site or fluid presumed to be infected were obtained. Data were evaluated for 38 patients in the moxalactam group and 40 patients in the cefoxitin group. There was no significant difference in the incidence of infectious morbidity (7.5% of cefoxitin-treated patients and 10.5% of moxalactam-treated patients). Infectious morbidity was not related to age, length of surgery, or estimated blood loss. The incidence of febrile morbidity was not significantly different (7.5% of the cefoxitin group and 13.2% of the moxalactam group). Colonization of the vaginal cuff with resistant organisms occurred in 70% of cefoxitin patients and 71% of moxalactam patients and was a poor predictor of infectious morbidity. In these 78 women undergoing vaginal hysterectomy, single-dose moxalactam and a three-dose regimen of cefoxitin were equally effective for surgical prophylaxis. PMID- 3542347 TI - [Physical and pharmacologic measures in the prophylaxis of deep venous thrombosis]. PMID- 3542348 TI - [Development and prevention of diabetic microangiopathy: is blood sugar compensation enough?]. PMID- 3542349 TI - [Fibrocystic mastopathy. Physiopathology, clinical manifestations and therapy]. PMID- 3542350 TI - Lyme disease. AB - Although initially considered a localized epidemic form of arthritis. Lyme disease is now known to have protean manifestation (skin, joint, heart, nervous system) and worldwide distribution. It is caused by infection with the spirochaete Borrelia burgdorferi and is transmitted by a variety of hard ticks and, in some localities, fleas. Antigenic variation between isolates may determine the differences in clinical expression observed between cases in North America and Europe. The reservoir in the animal kingdom is primarily in deer and mice but house pets have also been implicated. The disease is easily treated with oral antibiotics (tetracycline or penicillin) at an early stage but requires parenteral penicillin and can become refractory to medication at late stages. Prompt diagnosis assures the best outcome. Whereas the classic rash, erythema chronicum migrans, is pathognomonic, diagnosis in its absence may rest on serological tests. Bacteriological isolation is seldom successful and is lengthy (Shrestha et al, 1985). Since cloning of the DNA for several of B. burgdorferi antigens has been accomplished, utilization of hybridization techniques may allow rapid detection of the presence of the organism and confirm difficult cases in the future. PMID- 3542351 TI - Animal models of infectious arthritis. AB - The results from animal studies of bacterial joint infection have demonstrated pathogenic changes in synovium, cartilage, and bone which lead to joint destruction. Mechanisms responsible for the changes in these articular components remain to be more completely defined in order to develop methods to prevent articular destruction. Eradication of the active infectious process with early institution of antibiotics and adequate drainage is required but is not sufficient to prevent chronic destructive processes initiated by the acute bacterial infection. Biochemical effects of changes in the anabolic and catabolic functions of the cells in bone, cartilage, and synovium and the control mechanisms for these functions undoubtedly hold the key to prevention of destruction in infectious arthritis. Much less is understood about the pathogenic changes and mechanisms in infections caused by anaerobic bacteria, mycobacteria, fungi or viruses. Application of advances in immunological, morphological and biochemical techniques to animal models of infectious arthritis provides the opportunity to increase understanding of pathogenic mechanisms and to develop innovative methods of treatment. PMID- 3542352 TI - Bacterial infection of the superficial subcutaneous bursae. PMID- 3542353 TI - Imaging of septic arthritis. PMID- 3542354 TI - The role of arthroscopy in the diagnosis and management of the septic joint. PMID- 3542355 TI - A comparison of medical drainage (needle aspiration) and surgical drainage (arthrotomy or arthroscopy) in the initial treatment of infected joints. AB - Acute infectious arthritis remains a clinical emergency where early diagnosis and appropriate therapy are essential to a successful outcome. The therapeutic requirements for a successful outcome include early diagnosis, appropriate antibiotics, joint mobilization and adequate drainage. The method of drainage can be medical with needle aspiration or surgical with arthroscopic or open surgical debridement. The literature review presented in this chapter supports the value of the initial use of medical therapy in the management of the acutely infected joint, with surgical drainage reserved for failure of medical management or for initial drainage of hip infections where needle aspiration is difficult. PMID- 3542356 TI - Infections associated with prosthetic joints. PMID- 3542357 TI - Problems associated with the infected total hip arthroplasty. PMID- 3542358 TI - Enzyme immunoassay for the quantitation of immunoglobulin M class antibodies to Salmonella minnesota R595 and Escherichia coli J5 lipopolysaccharides. AB - The level of human immunoglobulin (IgM) in plasma specific for the lipopolysaccharide of Salmonella minnesota R595 (R595 LPS) and Escherichia coli J5 (J5 LPS) was quantitated by an enzyme immunoassay (EIA) in which purified antigen is adsorbed directly onto polystyrene-acrylic copolymer cuvettes. Highly purified anti-J5 and R595 LPS specific IgM prepared by ion-exchange resin, gel filtration, and affinity resin chromatography were used as standards. The levels of specific IgM were determined in 200 plasma samples obtained from normal donors. Anti-R595 IgM levels varied from less than 30 micrograms/ml (91%), from 30 to 100 micrograms/ml (8.5%), and greater than 100 micrograms/ml (0.5%). Anti J5 IgM levels in 68% of the donor plasmas were less than or equal to 5 micrograms/ml. The levels in 30.5% of the donor plasmas ranged from 6 to 100 micrograms/ml; the remaining 1.5% had greater than 100 micrograms/ml anti-J5 IgM. Specific IgM levels in four lots of normal pooled plasma each consisting of about 10,000 L averaged 12.7 micrograms/ml and 13.3 micrograms/ml for R595 and J5, respectively. The assay was modified to quantitate rabbit plasma as well. For this purpose, the EIA has been performed on microtiter plates, and the core LPS was fixed onto the wells by chemical treatment with glutaraldehyde which results in higher stability and retention of the antigen in the wells. Specificity of the EIA was demonstrated by the absence of significant cross reactivity between R595 IgM and J5 LPS and between J5 IgM and R595 LPS, furthermore, we only observed partial adsorption (approximately 25%-33%) of the R595 and J5 IgM by Pseudomonas aeruginosa LPS, a wild type endotoxin. The described quantitative assay is useful for both scientific studies and clinical investigations. PMID- 3542359 TI - Rapid identification of group A streptococci by the Strep-A-Fluor system. AB - Group A streptococci can be rapidly identified by the Strep-A-Fluor system (Bio Spec Inc., Dublin, CA), which uses a specific aminopeptidase to hydrolize L pyrrolidonyl-beta-naphthylamide. In pure subcultured colonies and in isolated colonies from primary culture plates, the Strep-A-Fluor system had 100% sensitivity and 100% specificity compared with the results of Streptex latex agglutination (Wellcome Research Laboratories, Research Triangle Park, NC). However, in mixed culture from primary culture plates, the sensitivity and specificity were 73% and 95%, respectively. Furthermore, in a routine laboratory setting, the sensitivity was only 91% both from pure subcultured colonies and from isolated colonies from primary culture plates. Contamination with organism other than group A streptococci that are capable of hydrolyzing L-pyrrolidonyl beta-naphthylamide may explain the low specificity in mixed culture. Deterioration of the buffer reagent due to prolonged use may account for the low sensitivity in a routine laboratory setting. PMID- 3542361 TI - Replacing the clockwork model of medicine. PMID- 3542360 TI - Retention of sealants over carious and sound tooth surfaces. AB - Bacteriologic and clinical studies suggest that sealants can be used therapeutically on incipient caries of the enamel. The present study was designed to explore this approach further by determining whether there is a difference in retention rates on sound or carious tooth surfaces sealed for the first time as well as resealed surfaces. A total of 1766 teeth were sealed for subjects 12-14 yr of age of which 120 were judged to be carious. Mouths were divided sagittally on a random basis and an ultraviolet light activated resin with a filler or an autopolymerizing resin without a filler was placed on contralateral surfaces of all molar and premolar teeth. The effects of sealant type, caries status, arch and tooth type on retention over a 2-yr period were tested using Mantel-Haenszel statistics. At the end of 1 yr, 88% of the teeth sealed with the autopolymerizing resin were judged to be completely intact compared to 82% of the teeth filled with the ultraviolet light resin. At the end of the second year the retention rates were 84% and 75% respectively. The retention rates for carious and sound teeth at the end of both years were almost identical. Overall, premolars had a 15% more favorable retention rate than molars. There were minimal differences between arches although maxillary premolars had approximately a 5% higher retention rate than mandibular premolars. The reverse was true for molar teeth. Retention of sealants at the end of the second year (resealed after 1 yr) was 4% less than comparable teeth sealed initially. PMID- 3542362 TI - Effects of pre- and postpubertal social experience on sexual and social behavior in male and female brown lemmings (Lemmus sibiricus). AB - The effects of prepubertal social contact and postpubertal mating experience on sexual behavior were examined in male and female brown lemmings (Lemmus sibiricus). Subjects of both sexes were either isolated at weaning (18 days) or then housed with siblings for another 10 days before being isolated. Before testing for sexual behavior at the age of 75 days, half of each group of males received a series of exposures to estrous females and half of each group of females was housed with a stud male. The results of mating tests indicated that whereas prior sexual experience facilitated subsequent copulatory behavior in both sexes, prepubertal interactions subsequently facilitated contact social and sexual behavior in males but did not increase the behavioral scores of females, which engaged in high levels of sexual behavior regardless of prepubertal experience. The effect of prior copulatory activity on male sexual performance could not be attributed to increasing age (i.e., maturational processes) because the behavior of males tested once but at different ages did not differ appreciably. Prepubertal social interaction appeared to predispose males to benefit from sexual experience later in life. PMID- 3542363 TI - Biochemistry and biology of anaphylatoxins. AB - The molecular architecture of anaphylatoxins has been explored on several levels. Primary, secondary and tertiary structural parameters that dictate function of the C3a, C4a and C5a molecules are being elucidated with the aid of comparative sequence analyses, physical measurements and organic syntheses. Although C3a, C4a and C5a are biologically distinct mediators, as defined by their unique receptor systems, a common genetic origin is apparent from conserved features in their primary structures. Evidence is now available which suggests that similarities in the folding pattern of the anaphylatoxins may dictate a concensus conformation for each factor. We have learned from synthetic peptide studies that the binding (e.g. effector) site in anaphylatoxin molecules exists as a linear sequence contained in the C-terminal portion of the polypeptide. What is also evident is that a preferred conformation is defined for the binding site requiring a proper side chain orientation for optimal bioactivity. It is proposed that folding of the native structure stabilizes this conformation at the binding site. The binding site in C3a contains the essential residues LGLAR folded in an irregular or pseudo-beta-turn and stabilized by an adjacent alpha-helical segment. It is proposed that the alpha-helical segment influences orientation of the side chain residues in the 'binding site'. A similar model is evolving for C5a based on synthetic C5a peptides that express both spasmogenic and chemotactic activities. This helix turn model promises to be representative of an essential structural feature that determines anaphylatoxin activity. We believe that these models contribute significantly to our understanding of the molecular relationships between structure and function for these humoral mediators of inflammation. PMID- 3542364 TI - Modulation of the immune response by anaphylatoxins. AB - Bioactive C3a and C5a fragments derived from the human complement compounds C3 and C5, respectively, possess immunoregulatory activities. C3a and C5a differentially influence in vitro immune function. C3a was found to be a potent suppressor of antigen-specific and polyclonal antibody responses. In contrast, C3a was unable to suppress antigen-or mitogen-induced B and T cell proliferation. Analyses of synthetic peptides based on the sequences of C3a revealed that the carboxy-terminal region of the molecule is responsible for immunosuppression. C3a mediated suppression occurs through the activation of a nonspecific suppressor T cell pathway. In contrast to the results obtained with C3a, C5a was found to augment both in vitro humoral and cell-mediated immune responses. Regulation of immune function by complement components may form part of an in vitro nonspecific immunoregulatory network. PMID- 3542365 TI - Clinical utility of complement anaphylatoxin assays. AB - Meaningful quantitation of complement activation is difficult by conventional techniques, because of the dynamic equilibrium status of complement components. Assays for complement-derived split products have been useful adjuncts, but until recently have been cumbersome and only semiquantitative. The recent introduction of superior assay methods, especially immunoassays for the complement derived anaphylatoxins, has enhanced such study by allowing more sensitivity, specificity and reproducibility. Such assays are already being applied to the study of diseases in which complement activation may play a role, as well as to the evaluation of biocompatibility of various prosthetic materials and drugs. 'Beside' clinical utility of the tests is still limited, but may grow rapidly if assays are devised which are capable of more rapid and less expensive performance. PMID- 3542366 TI - High resolution DSA: experimental and clinical evaluation. AB - The DSA system has been upgraded for capabilities of slow scan video technique and progressive T.V. read-out of 1024 X 1024 matrix with 10 bits of depth. A square wave test pattern made of lead bar demonstrated moderate improvement in spatial resolution, but imaging of a Burger-Rose phantom revealed no significant increase in contrast resolution. Clinical study of various angiograms with intraarterial injections showed that there was slight improvement in the visibility of the vessels, especially small arterial branches, while there was no increase in visibility of the veins. There were no cases in which diagnoses were altered by application of high resolution DSA. With future improvements of the image intensifiers, DSA with 1024 X 1024 matrix may reveal its potential advantage, especially when coupled to larger image intensifiers such as 12 or 14 in. PMID- 3542368 TI - [150 years since the dawn of nursing: a visit to Kaiserswerth]. PMID- 3542367 TI - Biplane digital subtraction angiography. AB - Biplane digital subtraction angiography was performed by placing a rapid switch between the anteroposterior and lateral T.V. cameras and the A-D converter. Alternate exposures from two X-ray tubes were employed. Excellent anteroposterior and lateral DSA was obtained especially for the brain and neck. Although there was more time required for positioning, biplane imaging saved the second or the third injection in many occasions. The technique has been especially valuable for intravenous DSA of the brain and the neck. PMID- 3542369 TI - High-frequency ultrasound measurement of patch test reactions. AB - 53 patients who produced 34 positive patch test reactions (+/- 15, +10, ++4, +++5) had their reactions read by a high-frequency pulsed ultrasonic (A-scan) dermal depth detector with a resolution of 0.05 mm. The positive reactions were compared with both random and regional controls. The machine could not differentiate between + or +/- reactions from the control readings. However, for 75% of ++ cases and 80% of +++ cases, a significant change was confirmed by the detector. It is concluded that the high-frequency ultrasound method is of little use in confirming or quantifying of positive patch test results. PMID- 3542370 TI - Neutral steroid metabolites in body fluids of patients with uremia and after renal transplantation. PMID- 3542371 TI - Renin substrate (angiotensinogen) as a possible erythropoietin precursor. PMID- 3542372 TI - Mechanisms of abnormal carbohydrate metabolism in uremia. PMID- 3542373 TI - Partial correction of lipid disturbances by insulin in experimental renal failure. PMID- 3542374 TI - Uremia, parathyroid hormone and carbohydrate intolerance. PMID- 3542375 TI - Low protein diet in chronic uremia: a historical survey. PMID- 3542376 TI - Preliminary experience on dietary management of chronic renal failure. PMID- 3542377 TI - Two years' experience with protein restriction in chronic renal failure. PMID- 3542378 TI - Influence of low protein diet supplemented with amino acids and keto acids on the progression of chronic renal failure. PMID- 3542379 TI - Low protein diet in children with chronic renal failure. PMID- 3542380 TI - Experimental models to assess the influence of low protein diets on the progression of chronic renal failure. PMID- 3542381 TI - Influence of the underlying renal disease on the rate of progression. PMID- 3542382 TI - Adaptation of a fluorescent immunoassay for canine haptoglobin. AB - The development and adaptation of a fluorescent immunoassay for determining changes in canine haptoglobin levels is described. Levels of canine haptoglobin determined by the fluorescent immunoassay from a group of healthy dog sera (68.0 mg/dl) compared favorably to the haptoglobin levels determined by a spectrophotometric method (74.5 mg/dl). The fluorescent immunoassay offered several advantages over currently used methods for determining levels of canine haptoglobin in serum. PMID- 3542383 TI - Adjuvant therapy of breast cancer: compliance and data validity in a multicenter trial. AB - Multicenter clinical trials are often large and complex, involving many institutions and investigators. The organizational structure is of vital importance in conducting and coordinating such trials. The present article describes the organization of a multicenter trial of adjuvant therapy of breast cancer. The trial is conducted since 1978 and involves all 15 hospitals in the Southern Swedish Health Care Region. The paper also describes methods of determining patient accrual rate, compliance with entrance criteria, diagnostic procedures, treatment, and follow-up. Comparison of data obtained from a population-based regional tumor registry revealed an accrual rate of more than 80%. Compliance with entrance criteria varied between the treatment groups from 85% to 97%. No patients were lost to follow-up. Compliance with diagnostic procedures and treatment was generally good. Reporting of recurrences was in accordance with data from patients' records in 98% of patients. One hundred thirteen patients died during the first 5 years of study. Twenty-one of these deaths were not reported to the secretariat. This strongly illustrates the necessity of matching to a population register before presenting data of such trials. PMID- 3542384 TI - The Oxford Database of Perinatal Trials: developing a register of published reports of controlled trials. AB - A database of perinatal trials is currently being established to provide a resource for reviews of the safety and efficacy of interventions used in perinatal care and to foster cooperative and coordinated research efforts in the perinatal field. The database will ultimately comprise four main elements: a register of published reports of trials; a register of unpublished trials; a register of ongoing and planned trials; and data derived from pooled overviews (meta-analyses) of trials. This article describes the development of the first of these four elements. PMID- 3542385 TI - Alterations in regional blood flow during positive end-expiratory pressure ventilation. AB - PEEP improves the gas-exchange abnormalities that accompany adult respiratory distress syndrome (ARDS). However, since PEEP decreases cardiac output, it may also alter regional blood flow and therefore, substrate delivery to specific organs. To test this hypothesis, radiolabeled 15-mu microspheres were used to directly quantify the effects of mechanical ventilation with PEEP on regional blood flow to individual organs in animals. Mechanical ventilation alone produced a -21.2 +/- 3.6% and a -28.1 +/- 5.2% decrease in cardiac output at 30 and 60 min, respectively. The addition of 14 cm H2O PEEP resulted in little further reduction in cardiac output at 30 and 60 min (-28 +/- 2.3% and -36.4 +/- 4.9%, respectively). However, 25 cm H2O PEEP reduced markedly (p less than .01) cardiac output (-59.2 +/- 6.1% at 30 min and -55.1 +/- 4.0% at 60 min). Although blood flows to the kidney and brain were maintained, decreases in cardiac output were invariably accompanied by proportional decreases in blood flow to the heart. Intravascular volume expansion with saline (20 ml/kg) during 14 cm H2O PEEP significantly improved cardiac output (3.23 +/- 0.34 to 4.22 +/- 0.13 L/min; p less than .01) and proportionately increased blood flow to several regional vascular beds, including the heart. These data suggest that PEEP decreases cardiac output to produce reversible alterations in blood flow to a number of regional vascular beds. These PEEP-induced alterations in regional blood flow may have important implications for the development of multiple-organ failure in ARDS patients. PMID- 3542386 TI - Traumatic respiratory insufficiency: comparison of conventional mechanical ventilation to high-frequency positive pressure with low-rate ventilation. AB - Eleven patients suffering severe traumatic respiratory insufficiency were mechanically ventilated using a new system which combined high-frequency positive pressure ventilation (HFPPV) with low-rate conventional mechanical ventilation (LRCMV). Ten similar patients were ventilated by conventional mechanical ventilation (CMV) with PEEP. HFPPV patients were fully conscious and cooperative during ventilation and did not need sedatives or muscle relaxants. Arterial oxygenation was significantly (p less than .005) better in HFPPV than CMV patients (89.91 +/- 10.24 vs. 78.43 +/- 11.13 torr, respectively), and pulmonary shunt was also better in the HFPPV group (13.1 +/- 4.7% vs. 20.4 +/- 6.4%, p less than .01). Moreover, inspired oxygen concentrations were lower (PaO2/FIO2 197.8 +/- 51.3 in the HFPPV group vs. 130 +/- 46.6 in the CMV group, p less than .005) and the time required for mechanical ventilation was shorter (4.2 +/- 0.91 vs. 6.1 +/- 0.8 days, p less than .1). All HFPPV patients immediately began breathing spontaneously when they were disconnected from the ventilator. We suggest this method as a better ventilatory mode for patients suffering traumatic respiratory insufficiency. PMID- 3542387 TI - Reinventing the triangular wheel. PMID- 3542388 TI - Evaluation of renal angiomyolipoma by traditional and modern imaging in a case of tuberous sclerosis. AB - Renal angiomyolipoma is known to affect mainly patients with tuberous sclerosis, although it can be found in a significant number of otherwise normal individuals. Few cases have been published in which angiomyolipoma and renal cell carcinoma occurred in the same kidney. In such cases the radiologist may be asked if it is possible to distinguish between the two tumors in the same kidney. The present case report describes systemic traditional and modern imaging of huge bilateral angiomyolipoma in tuberous sclerosis. The analysis of the data implies that, although the diagnosis of angiomyolipoma can be established with noninvasive techniques only, it is impossible to distinguish between the two mentioned tumors if they coexist in the same kidney, even if all available imaging techniques are used. PMID- 3542389 TI - Retrocaval ureter: computed tomography and ultrasound appearance. AB - The computed tomography and sonography appearance of retrocaval ureter is correlated with findings on intravenous urography. Computed tomography is recommended as the imaging procedure of choice to confirm the diagnosis of retrocaval ureter. PMID- 3542390 TI - An intrinsic membrane glycoprotein of the lens. AB - A major glycoprotein of relative molecular weight of 130,000 daltons of chick lens cell membranes was identified by Concanavalin-A staining and enriched for by Con A-Sepharose chromatography. Using both Con A binding and immunological analyses with a specific polyclonal antibody, the glycoprotein was detected in chick lens epithelium, annular pad, cortex and nucleus. Localization to the plasma membranes of lens cells was demonstrated by immunofluorescence. A similar protein, which cross-reacts with the antibody to the chick protein and also binds Con A was demonstrated in human and bovine lenses. PMID- 3542391 TI - Transplantation of cultured human neonatal corneal endothelium. AB - Human neonatal corneal endothelial cells were successfully maintained in tissue culture, morphologically resembling adult corneal endothelium. Eyebank donor corneas were obtained, denuded of their native endothelium and seeded with a suspension of the cultivated neonatal endothelial cells. After 48 hours, the eye bank tissue was then transplanted into the eyes of Rhesus monkeys. Over a five month period, five of eight transplants cleared, with a mean central corneal thickness of 0.480 mm and endothelial cell densities ranging from 560 to 1650 cells/mm2. All control eyes without donor endothelium remained cloudy. In the experimental group three eyes initially thinned but subsequently became edematous. Further studies are needed to improve the seeding procedure and to assess the long-term viability of transplanted endothelium. PMID- 3542393 TI - Problem solving in medical education: can it be taught? PMID- 3542392 TI - The American family in crisis: implications for children. PMID- 3542394 TI - Construction and evaluation of an artificial ileocecal valve. PMID- 3542395 TI - A new method of hepatic preservation using pulsatile perfusion and allopurinol. PMID- 3542396 TI - T-lymphocyte subsets in renal allograft recipients undergoing different immunosuppression protocols. PMID- 3542397 TI - Linear IgA bullous disease in a patient with transitional cell carcinoma of the bladder. AB - Four proven and two suspected cases of linear IgA bullous disease with underlying malignancies have been reported in the literature. A fifth case associated with transitional cell carcinoma of the bladder is presented, and adult linear IgA bullous disease is reviewed. PMID- 3542398 TI - Centromere pattern in different mouse seminiferous tubule cells. AB - Centromere arrangement in different mouse seminiferous tubule cells was analyzed using an anticentromere antiserum from a patient with the CREST syndrome of scleroderma. A peptide of 18 kd was recognized by this serum on immunoblotting of mouse nuclear proteins from seminiferous tubule cells. In the cells studied by immunofluorescence, different patterns of centromere arrangement were observed. A speckled arrangement of centromeres was found in spermatogonia, double spots corresponding to meiotic bivalents were found in pachytene cells, and clusters of a haploid numer of centromeres were found in early and acrosome phase spermatids. In Sertoli cells, only three centromeric spots were detected, corresponding to the nucleolar organizer chromosome pairs. A relationship between the functional stage of the cell and the arrangement of and conformational changes in the centromeres is considered. PMID- 3542399 TI - [An evaluation test of the masticatory system of human remnants incinerated (1100 700 B.C.) in the Furmany village, province of Tarnobrzeg]. PMID- 3542400 TI - [A new technic for the partial amputation of the pulp chamber in tooth diseases in growing patients]. PMID- 3542401 TI - Systemic corticosteroids in stable chronic obstructive pulmonary disease. Do they work? PMID- 3542403 TI - Conventional and high frequency controlled mechanical ventilation in patients with left ventricular dysfunction and pulmonary edema. AB - The cardiopulmonary effects of conventional controlled mechanical ventilation (CMV), high frequency controlled mechanical ventilation (HFV), and intermittent mandatory ventilation (IMV) were compared in nine patients with ischemic left ventricular dysfunction and pulmonary edema. Ventilatory support during IMV and CMV was adjusted by changing the ventilator rate while tidal volume was maintained at 12 ml/kg. HFV was produced at a frequency of 100 cycles/min and an I/E ratio of 1:2. End-expiratory airway pressure and inspired oxygen concentration were maintained constant. The three ventilatory modes produced similar mean airway, transpulmonary, and intra-thoracic pressures. Mechanical control of respiration required hyperventilation during both CMV and HFV. Arterial blood oxygenation, heart rate, vascular pressures, cardiac output, and myocardial ischemia were unaffected by the changes in ventilation. Decreased arteriovenous oxygen content difference (p less than 0.05) and increased mixed venous oxygen content (p less than 0.05) suggested improved systemic blood flow during IMV. Controlled ventilation by conventional means or with a high frequency technique had no detectable advantage over partial ventilatory support with IMV during cardiopulmonary failure stabilized with vasoactive therapy and continuous positive airway pressure. PMID- 3542402 TI - Magnetic resonance imaging in young adults with cystic fibrosis. AB - It is difficult to distinguish between atelectasis, mucoid impaction, and peribronchial inflammation on chest roentgenograms (CXR) in patients with cystic fibrosis (CF). Differentiation between hilar adenopathy and prominent pulmonary vessels is also sometimes difficult. We studied 16 young adults with CF using both magnetic resonance imaging (MRI) and CXR to evaluate the usefulness of MRI in this clinical context. The same patients were studied with abdominal ultrasound and MRI for evaluation of the pancreas, gallbladder, liver, and spleen. The MRI was superior to CXR in detecting hilar and mediastinal adenopathy and in differentiating nodes from prominent vessels. It was useful in the evaluation of bronchiectasis. The CXR was superior for assessing infiltrates, hyperinflation, sternal bowing, volume loss, and hilar retraction. The MRI was only slightly better than sonography in depicting fatty infiltration of the pancreas. The modalities were equally effective in detecting hepatosplenomegaly and signs of portal hypertension. Gallbladder evaluation was far superior with sonography. PMID- 3542404 TI - Chest tubes. Indications, technique, management and complications. PMID- 3542405 TI - Steroids in COPD. The scripture according to Albert. PMID- 3542406 TI - The development of chromosomally coded beta-lactamase production by Escherichia coli after in vitro selection with ampicillin, cefoxitin and ceftriaxone. AB - Subclones of Escherichia coli K12 921 which produced a chromosomal beta-lactamase were naturally selected in vitro with ampicillin, cefoxitin and ceftriaxone. The selected subclones were identical with respect to beta-lactamase production, resistance spectrum and resistance level, regardless of the selection agent. A ceftriaxone selection following an ampicillin selection led to higher ceftriaxone resistance. The beta-lactamase which was formed hydrolysed ceftriaxone to a measurable extent. After incubation of ceftriaxone with the beta-lactamase, the hydrolysed degradation product was demonstrated by thin-layer chromatography. PMID- 3542407 TI - Passive protection of NMRI mice with commercial, intravenously applicable human immunoglobulin IgG preparations against Serratia marcescens. AB - Three commercial, intravenously applicable human immunoglobulin IgG preparations (Gamma-Venin, Polyglobin, and Sandoglobulin) revealed low-titered O-agglutinins against the majority of 22 O-antigen reference strains of Serratia marcescens The three IgG preparations passively protected NMRI mice against intraperitoneal challenge with 8 of 19 selected, serologically defined O-antigen reference strains and clinical, nosocomially significant isolates of S. marcescens. PMID- 3542408 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542409 TI - [Apical resection of multi-rooted teeth. Coronal-radicular amputation: technics and significance]. PMID- 3542410 TI - [They have some too!...]. PMID- 3542411 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542412 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542413 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542415 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542414 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542416 TI - [Healing arts in Rome. Medicine--surgery--dentistry. 1]. PMID- 3542417 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542418 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3542419 TI - [Thoraco-scapular arthrodesis in facioscapulohumeral dystrophy]. PMID- 3542420 TI - [Parosteal lipoma of the distal third of the femur. Clinical, echotomographic and tomodensitometric considerations]. PMID- 3542421 TI - [Incidence of stab injuries of the heart in the clinic and forensic autopsy practice. Experiences with 6 surgical procedures]. AB - During a period when 6 patients were operated following a cardiac stab wound 4 patients survived the procedure. In 45 persons forensic autopsies were performed. The analysis of both groups elucidate that successful treatment is possible if pericardial tamponade inhibits free bleeding into the cavity of the thorax. But this situation must be treated very quickly avoiding cardiac arrest due to cardial blockage. In contrast to the autopsies in the clinical group no atrial wounds or incisions of coronary arteries were observed. PMID- 3542423 TI - [Fusion correction of polydactyly]. AB - Polydactyly is the most common aesthetic hand anomaly. Its surgical correction is indicated for aesthetic, but especially for functional reasons. Independent of the degree and location (pre- or postaxial) of the anomaly the creation of one single unit, which corresponds to the functional as well as to the cosmetical demands is the main purpose of the operative correction. The principle of this operative procedure is the fusion of the two fingers by using all existent structures. Therefore and due to the individuality of each case of polydactyly only after clear exposure identification of soft tissue structures is possible. Resecting procedures of bony and soft tissue structures which are performed before the fusion shall therefore be performed after the exposure and by preservation of all structures, which are necessary for growth, function, sensibility and blood supply. Using these principles clinical experiences which were made with this method are demonstrated while also postoperative results are shown. PMID- 3542422 TI - [Autologous spongiosa as an antibiotic carrier in the treatment of osteitis]. AB - The treatment of osteomyelitis essentially depends on a bactericidal concentration of antibiotic in bone tissue with an appropriate spectrum. Ciprofloxacin is effective against the main organisms causing osteomyelitis (staphylococcus aureus, pseudomonas aeruginosa) at low MIC. We investigated the concentration of ciprofloxacin in human bone. After a single dose (200 mg ciprofloxacin i.v., preoperatively) the concentration in cortical bone was 6.9 +/ 0.8 mcg/g and 9.7 +/- 0.8 mcg/g in cancellous bone. In any case the concentration of ciprofloxacin exceeded the MIC for staph. aureus and pseudomonas aeruginosa. For the treatment of osteomyelitis we transferred the antibiotic bound to autologous cancellous bone grafts to the site of inflammation after surgical debridement. First clinical results are documented. PMID- 3542424 TI - [Intrahepatic bile duct cysts]. AB - Because of the risk of carcinoma, choledochal cysts always should be completely removed. If the cyst is extrahepatic, this should not offer any problem. Radical excision of an intrahepatic cyst, however, can present as a major problem and is in fact not always achievable. The anatomical situation (involvement of both lobes of the liver) or the general condition of a patient can force us to limit the surgical procedure. We report our experience with 5 cases of intrahepatic choledochal cyst, emphasizing the difficulties of achieving the before mentioned therapeutic goal. Details on today's pathogenetic theories and classification of choledochal cysts are reported from the literature. PMID- 3542425 TI - [The therapeutic effect of defibrase on patients with an acute stage of chronic cor pulmonale]. PMID- 3542426 TI - [Advances in the studies of cretinism in China]. PMID- 3542427 TI - [The diagnostic value of digital subtraction angiography in cerebrovascular disease]. PMID- 3542428 TI - [The effect of diltiazem and nifedipine, alone or in combination, on exercise performance, myocardial ischemia and left ventricular function in patients with chronic stable effort angina: a double-blind, randomized and placebo-controlled clinical study]. PMID- 3542429 TI - [Present status of the clinical uses of albendazole]. PMID- 3542430 TI - [A bacteriological and helminthological investigation on a sewage-irrigated area in Beijing suburb]. PMID- 3542431 TI - [Prevention of dental caries]. PMID- 3542432 TI - [Tuberculosis after renal transplantation]. PMID- 3542433 TI - [Advances in the study of the sleep apnea syndrome]. PMID- 3542434 TI - [Pathogenesis of the sleep apnea syndrome]. PMID- 3542436 TI - Comparison of helium-neon and dye lasers for the excitation of allophycocyanin. AB - Allophycocyanin (APC) has a broad absorption spectrum permitting several different lasers to be used to excite this dye in a flow cytometer. A comparison was made between a dye laser and a helium-neon (HeNe) laser for the excitation of APC as an immunofluorescent chromophore. The ratio of fluorescence of stained to unstained lymphocytes (signal to background) was used to assess differences in sensitivity. In determining the best wavelength for operating the dye laser, it was found that there was little difference in the ability to separate the positive-labelled cells from the unstained cells using 600 nm or 633 nm light for excitation of APC. A study of the effect of laser power on the signal to background identified a nonlinear relationship. It was found that the sensitivity obtained with 47 mW of 633 nm light from a HeNe laser was near the maximum attainable. This sensitivity was comparable to that obtained using phycoerythrin as an immunofluorescence chromophore. APC had the added advantage of being applicable to the study of highly autofluorescent cells. Exciting this chromophore using red light dramatically decreased the autofluorescence observed even on alveolar macrophages. PMID- 3542437 TI - Local tumor recurrence after curative resection for rectal cancer. A ten-hospital review. AB - Local tumor recurrence rates after curative rectal cancer surgery with the end-to end anastomosis stapler (EEA) are reportedly high. Therefore, a retrospective review in ten Yale-affiliated hospitals was undertaken to establish the outcome of surgical resection for rectal cancer in this patient population. Of those 373 patients who had had curative resections, 192 (52 percent) were abdominoperineal resections (APR); 105 patients (28 percent) had restorative resections with sutured anastomoses, and the EEA stapler was used in 76 patients (20 percent). There was an equal distribution of tumors in the various Dukes' stages in all three procedures. Local tumor recurrence was: APR 19 percent, SUT 17 percent, and EEA 24 percent, but local tumor recurrence was more frequent after EEA than APR for tumors 7 to 10 cm from the anal verge (32 vs. 13 percent, respectively, P less than 0.05), and the time to recurrence was least in EEA patients. It is concluded that local tumor recurrence is higher than expected for all three procedures and that the EEA stapler was associated with a greater risk of local tumor recurrence. These findings are attributed to surgeon-related technical operative factors rather than to the nature of the tumors themselves. PMID- 3542435 TI - Flow cytometric analysis of Chlamydia trachomatis interaction with L cells. AB - Immunofluorescent staining and flow cytometric analysis have been investigated as means of studying the early stages of in vitro infection of Chlamydia trachomatis. The lymphogranuloma venereum strain of C. trachomatis was grown in vitro in L cells, fixed in p-formaldehyde, stained with fluorescein isothiocyanate (FITC)-conjugated monoclonal antibody to the chlamydial major outer membrane protein, and analyzed flow cytometrically. Infected cells stained 50-100 times more intensely than uninfected cells, and they could easily be discriminated by flow analysis. The number of infected cells and the fluorescence intensity of individual cells were proportional to the multiplicity of infection. The attachment of purified elementary bodies to L cells could be analyzed by immunofluorescence and flow cytometry. Cells exposed to 0.26 inclusion-forming units/cell could be discriminated from an unexposed population. Flow analysis of purified elementary bodies was possible after fluorescent staining with the aid of a laser-based cytometer and gating on low volume. PMID- 3542438 TI - Initial clinical experience with a biofragmentable ring for sutureless bowel anastomosis. AB - Twenty-seven patients have had bowel anastomoses with a biofragmentable ring for sutureless bowel anastomosis. There were no complications associated with the anastomotic technique. One patient developed an ischemic stricture on the proximal side of the anastomosis due to compromised circulation. There was no leakage. Technical factors regarding the BAR anastomosis are described. A properly placed purse-string suture is of primary importance. Advantages appear to be a more rapid and easy anastomosis with better healing. PMID- 3542439 TI - Classic articles in colonic and rectal surgery. John Blair Deaver 1855-1931. Lumbar versus iliac colotomy. PMID- 3542440 TI - Classic articles in colonic and rectal surgery. James Luke 1799-1881. A case of obstruction of the colon, relieved by an operation performed at the groin. PMID- 3542441 TI - Double-blind crossover trial of prostaglandin E2 in postgastrectomy reflux gastritis. AB - Excessive Enterogastric reflux following partial gastrectomy is believed to be responsible for bilious regurgitation, vomiting, nausea, and epigastric pain. At endoscopy, striking erythema and inflammatory changes of the gastric mucosa may be seen. The nonsurgical treatment for this syndrome is unsatisfactory. Because of the potential pathogenetic role of regurgitating bile acids, lysolecithin, and pancreatic secretions, it seemed relevant to find out whether prostaglandin E2 (PGE2) in a dose of 0.5 mg qid could protect the gastric mucosa from further damage and thereby lead to symptomatic improvement. The results of this controlled doubled-blind crossover trial, comparing PGE2 and placebo, in the treatment of postgastrectomy reflux gastritis reveal no significant differences between PGE2 and placebo with regard to symptoms, endoscopic features, and histologic evidence of inflammatory changes. Thus, prostaglandin E2 in the dose used appears incapable of improving postgastrectomy reflux gastritis in patients with mild to moderate degrees of this entity. PMID- 3542443 TI - Preservation of mucus in situ in rat colon. AB - Mucus, a hydrated complex consisting mainly of glycoproteins, forms a layer over the epithelial surface of the gastrointestinal tract. The usual preparative procedures for histological and scanning electron microscopic examination of the gut result in the loss or distortion of this mucus layer. Careful evaluation of two new methods reported to stabilize the mucus layer showed that acrolein vapor did not provide adequate fixation, but application of heat-inactivated antiserum raised in rabbits against rat colon mucus reliably preserved a continuous layer closely adherent to the epithelium. This stabilized layer is continuous with the mucus in the colonic crypts. PMID- 3542442 TI - Immunoelectron microscopic localization of HLA-DR antigen in control small intestine and colon and in inflammatory bowel disease. AB - We have elucidated the distribution of I2 (HLA-DR) antigen in control and inflammatory bowel disease specimens, using immunoelectron microscopic methods. Control small intestinal epithelium and inflammatory bowel disease epithelium expressed 12 antigen, while control colonic epithelium did not. I2 expression by enterocytes was more frequent on the lateral and basal surface than on the microvillus surface. Two of three M cells in control ileum expressed I2 antigen. I2-positive intraepithelial lymphocytes were rarely detected in both control and disease specimens. I2-positive lamina propria lymphocytes were significantly increased in inflammatory bowel disease, while I2-positive lamina propria lymphocytes were virtually absent in control specimens. I2-positive mononuclear cells in the intestinal lamina propria were largely macrophages and monocytes in both control and inflammatory bowel disease specimens. I2-positive mononuclear cells resembling dendritic cells were not detected in control or disease specimens. Furthermore, there were no significant morphological differences in I2 positive or -negative macrophages and monocytes in control and disease specimens. The expression of I2 antigen on Schwann cells was detected more frequently in disease specimens than in control specimens. Capillary endothelia of both control and disease specimens expressed I2 antigen. We demonstrate that I2 expression is present on surface membranes of both immune and nonimmune cells of the intestine and colon and show that this expression is more prominent in inflammatory bowel disease than in control intestine and colon. Further studies are required to determine whether this finding is meaningful in terms of antigen presentation and whether this apparent "immune activation" is involved in the pathogenesis of inflammatory bowel disease. PMID- 3542444 TI - Intestinal plasma cell alterations in acquired immunodeficiency syndrome. AB - Immunofluorescence studies of plasma cells were performed on small intestinal and colonic biopsies obtained from a series of patients with acquired immunodeficiency syndrome or the "AIDS related complex" plus homosexual male and heterosexual controls. The AIDS group was significantly depleted of IgA plasma cells compared to the control groups. In contrast, the numbers of IgM plasma cells were increased in the AIDS and homosexual control groups compared to the heterosexuals. Plasma cell fluorescence intensities for IgA and IgM were decreased in the AIDS patients, implying less cytoplasmic immunoglobulin per cell. The frequency of IgA plasma cell depletion did not differ in men and women, patients with opportunistic infections or Kaposi's sarcoma, or in patients with and without gastrointestinal symptoms. The extent of IgA plasma cell depletion did not correlate with serum IgA concentrations. IgA plasma cell numbers also did not correlate with selected parameters of nutritional status and intestinal absorption. Studies of salivary IgA output demonstrated decreased secretion of soluble IgA in AIDS patients, and an increased secretion of IgA in particulate form. These results suggest that abnormalities in IgA secretion occur in AIDS and might influence its clinical manifestations. PMID- 3542445 TI - Acute and short term effects of intestinal alpha-glucosidase inhibition on gut hormone responses in man. AB - The effect of 50-, 100-, 200-, and 400-mg oral doses of acarbose, a competitive inhibitor of intestinal alpha-glucosidases, on the postprandial release of gut and pancreatic hormones after a 2.2 MJ carbohydrate-rich mixed test meal was determined in five normal subjects according to a double-blind, Latin-square protocol. All the doses of acarbose tested slowed the postprandial plasma glucose rise, without evidence of dose dependency, while maximal inhibition of integrated insulin and gastric inhibitory polypeptide responses to 31 +/- 8% and 28 +/- 7% of control values, respectively, was obtained at the 400-mg dose. The enteroglucagon response was increased to a maximum of 905 +/- 262% of control at the 200-mg dose, and total motilin responses were slightly but not significantly elevated. After one week of regular acarbose administration at 100 mg three times daily, the effects of the 100-mg dose on insulin and enteroglucagon responses were slightly enhanced, and there was no evidence of intestinal adaptation in the form of diminished postprandial endocrine responses. The observed effects are attributed to impairment of carbohydrate digestion in the upper small intestine and suggest that the optimal ratio of desired to unwanted effects is obtained at low doses of acarbose. PMID- 3542448 TI - Subcutaneous insulin infusion: change in basal infusion rate has no immediate effect on insulin absorption rate. AB - Eight insulin-dependent diabetic patients were simultaneously given subcutaneous infusions (1.12 IU/h each) of 125I-labeled Actrapid insulin in each side of the abdominal wall. After 24 h of infusion, the size of the infused insulin depots was measured by external counting for 5 h. The basal infusion rate was then doubled in one side and halved in the other for the next 4 h. Finally, 1.12 IU/h of insulin was given in both sides of the abdominal wall for an additional 3 h. The changes in the size of the depots were measured, and the absorption rates for each hour were calculated. During the first 5 h of infusion, the depot size was almost constant (approximately 5 IU) with an absorption rate that equaled the infusion rate. Doubling the infusion rate led to a significant increase in depot size, but the absorption rate remained unchanged for the first 3 h, and only thereafter was a significant increase seen. When the infusion rate was reduced to the initial 1.12 IU/h, the absorption rate remained elevated during the next 3 h. Correspondingly, when the infusion rate was decreased, the depot size also decreased, but the absorption rate remained unchanged for the first 3 h. The results show that a change in the basal insulin infusion rate does not lead to any immediate change in the insulin absorption rate. This should be considered when planning an insulin-infusion program that includes alteration(s) in the basal-rate setting. PMID- 3542447 TI - Antidiarrheal therapy. Prospects for new agents. AB - Successful treatment of severe diarrhea has traditionally relied upon opiates or opiate derivatives. Recent advances in our understanding of intestinal fluid and electrolyte absorption have provided the opportunity to develop therapeutic agents specific for various points in the secretory and absorptive process. Present and proposed antidiarrheal agents, in addition to antimotility activity, will be capable of stimulating intestinal fluid absorption, inhibiting intestinal fluid secretion, or both. The mechanism(s) of action and clinical implications for proposed antidiarrheal agents are reviewed. PMID- 3542450 TI - Dissociation of insulin absorption and blood flow during massage of a subcutaneous injection site. AB - Nine healthy volunteers with normal body weights were injected subcutaneously with 125I-labeled soluble human insulin (10 U) in one thigh and 133Xe in the contralateral thigh for the measurement of subcutaneous blood flow on 2 consecutive mornings. On one of the days, standardized massage of both injection sites was performed for 30 min starting 30 min after insulin injection. Serum insulin and plasma glucose were determined intermittently before, during, and after massage, and elimination of radioactivities was monitored continuously by external detectors. During massage, the first-order elimination rate constants of 125I increased approximately sixfold compared with the rise during control (0.19 +/- 0.04 to 0.88 +/- 0.15%/min during the last 15 min of the massage vs. 0.21 +/- 0.03 to 0.32 +/- 0.03%/min during control). Serum insulin increased from 13.8 +/- 1.8 mU/L before massage to a maximal value of 56.4 +/- 8.7 mU/L 10 min after massage (vs. 15.3 +/- 3.0 and 19.7 +/- 2.2 mU/L during control). Plasma glucose fell significantly faster on the massage day, from 10 min after massage onward. No significant alteration in the subcutaneous blood flow was found during or after massage. The results suggest that the pronounced enhancement of insulin absorption induced by massage of the injection site is mainly not blood flow mediated. PMID- 3542446 TI - Bile duct carcinoma in patients with ulcerative colitis. Relationship to sclerosing cholangitis: report of six cases and review of the literature. AB - Six cases of bile duct carcinoma were encountered among 1207 patients with ulcerative colitis, a prevalence rate of 0.5%. The relative risk of bile duct carcinoma in patients with ulcerative colitis was 31.3. Colitis was extensive in all six patients with a mean duration of 23.2 years before the diagnosis of carcinoma. The mean age at the diagnosis of carcinoma was 38.5 years. Three patients had undergone colectomy 5-16 years earlier, and in four patients pericholangitis and sclerosing cholangitis preexisted. The tumors, histologically adenocarcinomas, were located in the common bile duct in five patients and in the hepatic duct in one. The mean survival was 11.8 months (one patient is still alive with recurrent carcinoma). Pericholangitis and sclerosing cholangitis is a frequent preexisting lesion in patients with bile duct carcinoma complicating ulcerative colitis and may be considered a premalignant lesion in these patients. Both sclerosing cholangitis and bile duct carcinoma are rare in Crohn's disease. PMID- 3542449 TI - Overnight interruption of wearing insulin pump: substitution dose and injection site of insulin. AB - Discontinuing wear of the insulin pump for short periods enhances the feasibility of continuous subcutaneous insulin infusion (CSII) therapy. Because insulin requirements differ during pump and injection therapy, we studied the optimal substitution dose and injection site in seven type I diabetic patients to compensate for the overnight (2100-0730 h) interruption of CSII. The missed basal continuous infusion dose was replaced by injecting intermediate-acting insulin subcutaneously in three different ways: 1.5 times the dose in the abdomen, twice the dose in the abdomen, and twice the dose in the buttock. During CSII, glycemia remained unchanged throughout the night. Both 1.5 times and twice the replacement doses injected in the abdomen resulted in an initial decline in blood glucose with hypoglycemia in two patients followed by a rebound rise. When the replacement dose of 1.5 times was used, blood glucose rose by 4.9 +/- 1.2 mM overnight (P less than .02). These changes after abdominal injection were associated with a rapid early absorption of injected insulin with hypoinsulinemia in the morning. With twice the replacement dose injected in the buttock, insulin absorption was slower, fluctuations in nocturnal glycemia were minor, and the blood glucose level at 0730 h was similar to that of the previous night. There was a significant inverse correlation between blood glucose and serum free insulin levels in the early morning (r = - .60, P less than .01). In conclusion, a substitution dose of 1.5 times to twice the missed basal infusion rate injected in the buttock compensates for the overnight interruption of CSII without risk of major fluctuations in blood glucose levels or nocturnal hypoglycemia. PMID- 3542451 TI - Free-insulin profiles after intraperitoneal, intramuscular, and subcutaneous insulin administration. AB - The aim of our study was to compare the time course of plasma free-insulin appearance after injection of equal amounts of insulin into the peritoneal cavity above and below the transverse mesocolon, intramuscularly, and subcutaneously. Seven nondiabetic subjects undergoing cholecystectomy received in random sequence 0.2 IU/kg of insulin into the peritoneal cavity above or below the transverse mesocolon. Concentrations of plasma free insulin were compared with those obtained from seven other nondiabetic subjects after repeated injections of equal amounts of insulin intramuscularly and subcutaneously. Intraperitoneal insulin above the transverse mesocolon yielded a faster rise of free insulin, peaking at 15 min, whereas intraperitoneal insulin below the transverse mesocolon produced a somewhat slower rise, peaking at 30 min. The area under the curves between 0 and 15 min was greater after the injection above than below the transverse mesocolon (P less than .05). Intramuscular and subcutaneous insulin injections resulted in a slower rise of plasma free insulin, peaking at 60 and 90 min, respectively. We conclude that the pattern of insulin appearance in the plasma resembles more closely physiologic events after intraperitoneal than after subcutaneous or intramuscular insulin administration. PMID- 3542452 TI - Assessing effect of mixing insulins by glucose-clamp technique in subjects with diabetes mellitus. AB - The glucose-clamp technique was used to assess the effect on insulin activity of mixing clinically relevant doses of short- and longer-acting insulins in insulin treated diabetic subjects. Mixtures of porcine regular and lente insulins resulted in a reduction in activity of the mixture compared with separate injection that was more apparent with premixing for 5 min before injecting than with premixing for 2 min. These findings were not explained by differences in volume of the injected insulin preparations. Mixing of porcine regular and bovine ultralente insulins for 2 min before injecting resulted in a reduced activity compared with separate injection. No difference in activity was obvious for porcine regular and NPH insulins given separately or premixed for 5 min. A reduction of activity during the 1st h after injection was observed when separate injection of one brand of these insulins (Velosulin or Insulatard) was compared with the manufactured mixture (Mixtard). These results indicate that premixing regular and NPH insulins in a 1-to-2 ratio does not alter the biological activity compared with separate administration of the insulins. However, the mixing of regular and insulin-zinc suspensions results in a loss of insulin activity, the magnitude of which depends on the time between mixing and injecting the insulin. The clinical significance of the effect of mixing on the efficacy of subcutaneous insulin therapy should be considered in the context that this is only one of many factors that may affect the activity of subcutaneously injected insulin. PMID- 3542453 TI - Effects of mixing short- and intermediate-acting insulins on absorption course and biologic effect of short-acting preparation. AB - The effects of mixing short- and intermediate-acting insulins (Actrapid MC and Monotard MC) were studied in seven diabetic patients. On different days, 0.16 IU/kg of Actrapid and 0.24 IU/kg of Monotard were administered to each subject in separate injections and combined in the same syringe. Free-insulin curves and the biologic effect of insulin, assessed by the glucose-clamp technique, were compared. The absorption rate of regular insulin was higher when injected separately from the intermediate-acting preparation: the incremental areas of free insulin above basal levels, up to 90 min after the administration of the hormone, were 32 +/- 5 vs. 21 +/- 3 microU X ml-1 X min-1 (P less than .02). In the same period, glucose infused to sustain glycemia showed no significant differences (2.8 +/- 0.4 vs. 2.4 +/- 0.3 mg X kg-1 X min-1 after the administration of insulin in separate and combined injection, respectively). The difference in insulin profiles is not translated into a significant difference in glucose requirement. This might be a consequence of a flattening of the insulin dose-response curve due to insulin resistance of diabetic subjects. The slight delay in insulin action of Actrapid when mixed with Monotard is probably irrelevant in clinical practice. PMID- 3542454 TI - Ketonuria in hospitalized patients with non-insulin-dependent diabetes mellitus. AB - Physicians routinely order urinary ketone testing for most patients with diabetes mellitus upon hospitalization, even in the absence of a history of diabetic ketoacidosis. To determine whether testing for urinary ketones is clinically useful in patients with non-insulin-dependent diabetes mellitus (NIDDM), a retrospective review was undertaken of 152 charts of patients admitted to the hospital during a 6-mo period with the diagnosis of diabetes mellitus. Of the 135 patients with NIDDM, 96% had routine testing performed for urinary ketones. Surprisingly, 26% of the patients with NIDDM had positive urine ketones at some time during hospitalization, and the degree of ketonuria was markedly greater did not reflect diabetic ketoacidosis. Ketonuria was accompanied by significant hyperglycemia and most likely reflects relative insulinopenia. Only 23% of the episodes of ketonuria were acknowledged in the progress notes. Although NIDDM patients who had ketonuria in the hospital were more likely to be transiently treated with insulin than patients without ketonuria, in no instance did the progress notes state that a diagnostic test or change in therapy was ordered because of the presence of a positive test for urinary ketones. The primary goal for therapy of patients with NIDDM should remain good control of blood glucose. In the hospitalized patient in whom frequent blood glucose determinations are made, it is not clear that urinary ketone testing needs to be routinely done. PMID- 3542456 TI - Comparison of insulin levels after injection by jet stream and disposable insulin syringe. AB - Intermediate-acting biosynthetic human (NPH) insulin was administered by disposable insulin syringe into the right upper thigh of nine insulin-dependent diabetic youths. Seven days later, the same amount and type of NPH insulin was given in the same anatomic site with a Medi-Jector II, which delivers insulin as a jet stream. Blood was collected before insulin injection and at hourly intervals subsequently for the measurement of glucose and insulin. The total serum insulin measured before the first morning dose with the needle and syringe and the Medi-Jector II was 41.2 +/- 10.7 microU/ml and 46.2 +/- 10.7 microU/ml, respectively. During the next 9 h, the areas under the respective total insulin curves were not different, but the area under the free-insulin curve after jet injection was greater than the free-insulin area after needle injection (P less than .01). The ratio of free/total serum insulin was 0.31 +/- 0.02 after needle injection and 0.40 +/- 0.03 after jet injection (P less than .0025). The peak of total insulin concentration occurred 4.2 h after jet injection of NPH: 1 h earlier than the peak after needle injection. The plasma glucose at time zero was 197 +/- 15 mg/dl before needle injection and 242 +/- 19 mg/dl before jet injection. Although the diet consumed by each subject on the 2nd study day was identical to that of the 1st day, the mean glucose increase was greater after needle-injected insulin than after jet-spray injection. This indicates that the greater amount of free insulin observed after jet-injected insulin had a direct effect in lowering the plasma glucose. Jet injection may reduce insulin requirements by increasing the availability of free insulin. PMID- 3542455 TI - Insulin action in insulin-dependent diabetics after short-term thiazide therapy. AB - The influence of short-term thiazide treatment on peripheral tissue and liver sensitivity to insulin in insulin-dependent diabetes mellitus was determined by the euglycemic insulin clamp technique. A sequential three-step hyperinsulinemic clamp was performed in six insulin-dependent diabetics before and after 2 wk of hydroflumethiazide (HFT) administration in a daily dose of 75 mg. Insulin was infused at rates of 0.5, 2.0, and 4.0 mU X kg-1 X min-1, and each dose was given for at least 120 min. Glucose uptake during the last 30 min of each step was almost identical in the two situations (2.7 +/- 0.6 vs. 2.4 +/- 0.5 mg X kg-1 X min-1, 9.6 +/- 0.9 vs. 9.7 +/- 1.2 mg X kg-1 X min-1, and 12.0 +/- 1.3 vs. 12.6 +/- 1.5 mg X kg-1 X min-1). Serum insulin levels were also similar, and blood glucose was kept at 100 +/- 3, 99 +/- 4, and 97 +/- 3 mg/dl before thiazides and at 93 +/- 6, 93 +/- 6, and 94 +/- 6 mg/dl after thiazides. Another five insulin dependent diabetics were infused with tritiated glucose followed by insulin infusion at two rates: 0.45 and 1.0 mU X kg-1 X min-1. Basal glucose output was comparable before and after thiazides (3.63 +/- 0.24 vs. 2.97 +/- 0.26 mg X kg-1 X min-1), as was the liver response to increasing insulin concentrations. The metabolic state as assessed by HbA1c and fasting blood glucose did not differ in the two experiments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542457 TI - Lessons from studies of insulin pharmacokinetics. PMID- 3542458 TI - Silicone oil released from disposable insulin syringes. PMID- 3542459 TI - Locus of control and the control of diabetes. PMID- 3542460 TI - New, improved glucagon emergency kit. PMID- 3542461 TI - [Reversible reorganization of the cytoskeleton of cultured cells induced by 12-O tetradecanoylphorbol-13-acetate]. PMID- 3542463 TI - [Indications for liver transplantation]. PMID- 3542462 TI - [Molecular mechanism of the therapeutic effect of low-intensity laser irradiation]. PMID- 3542464 TI - [Diagnosis in the myelodysplastic syndrome]. PMID- 3542465 TI - [Therapy in the myelodysplastic syndrome]. PMID- 3542466 TI - [Ultrahigh-dosage cytostatics--their possible use in acute leukemias?]. PMID- 3542468 TI - [Therapy of paraquat poisoning]. PMID- 3542469 TI - [Sonography in prehepatic portal vein occlusion]. AB - In a retrospective analysis, the sonographic findings of 125 patients with prehepatic portal hypertension (of these 76 with condition after varix bleeding) were evaluated. The main cause were portal venous thromboses after umbilical venous catheter; 98% of these patients had a case history of hemorrhages. Of 113 cases with portal vein thrombosis, 54% had a cavernomatous transformation of the portal vein, 87% of them had a varix hemorrhage. In 12 patients with isolated lienal vein stenosis, no hemorrhage had occurred so far. All portal vein thromboses were correctly diagnosed by sonography. Besides the detection of thromboses, only in 5% of all cases no sonographically identifiable collaterals of the portal system were present; such collateral vessels could be imaged in 94% of the patients with endoscopic detection of varices. Sonography can be used as a screening method in suspicion of portal hypertension of prehepatic origin. PMID- 3542470 TI - [Perioperative antibiotic prophylaxis in heart and vascular surgery. A prospective randomized comparative study with cefazolin and ceftriaxone]. AB - Two different forms of cephalosporin prophylaxis were investigated in a prospective randomized comparative study: a one-day cefazoline prophylaxis (Kefzol 0.5 g every six hours) and a single dose of ceftriaxone (Rocephin 2 g). A total of 541 patients were included in the study over 10 months: 272 in the cefazoline (CFZ) group and 269 in the ceftriaxone (CRO) group. The patients were checked postoperatively for an infection. The total rate of infections was 4.7%; 4.6% in the CFZ group and 4.8% in the CRO group. A wound infection occurred in 1.1% of the cases, in 0.4% of the CFZ group and in 1.8% of the CRO group. Septicemia was diagnosed in 1.5% of the operated patients; in 1.2% of the patients treated with CFZ and in 1.8% of the patients treated with CRO. 1.3% of the patients developed pneumonia, 1.8% in the CFZ and 0.8% in the CRO group. Only one patient had a urinary tract infection (CFZ group). Furthermore, two double infections occurred in the CFZ group. A double infection was observed only once in the CRO group. Fever of unclear etiology developed in 3.6% of the patients in both groups. There was no statistically significant difference with regard to the rate of infection between the two groups. A single administration of ceftriaxone prophylaxis is accordingly just as effective as a one-day cefazoline prophylaxis. Despite reduction of the antibiotic application, the rate of infection has not risen in the last five years. The single application is advantageous compared to longer-term applications. PMID- 3542467 TI - [Diagnosis of paraquat poisoning]. PMID- 3542472 TI - [Spontaneous thrombocyte aggregation and blood sugar profile in children with diabetes mellitus type I treated with human and porcine insulin]. AB - In a three-year bicentric cross-sectional investigation on type I diabetic children aged between 6 and 18 years, blood sugar profiles and spontaneous thrombocyte aggregation were reported besides anamnestic and clinical data. In the children treated with human insulin, raised spontaneous thrombocyte aggregation was significantly more frequent than in those treated with porcine insulin. At the same time, blood sugar fluctuation from day to day measured between 7 and 9 a.m. tended to be raised in the children treated with human insulin; the fluctuation in the diurnal profile measured over 14 days was indeed very much greater. Since the two groups were comparable as to sex distribution, age, duration of disease, quality of compensation, application and dose of insulin, the greater fluctuation of blood sugar in the children treated with human insulin appears to be the cause for the raised spontaneous thrombocyte aggregation. PMID- 3542471 TI - [Anxiety and depression in incurable patients and the dying]. PMID- 3542473 TI - [The acute scrotum in children]. PMID- 3542474 TI - [Shockwave lithotripsy of gallbladder stones]. PMID- 3542475 TI - [The duration of afterbirth expulsion in cattle]. PMID- 3542476 TI - [Incidence and transmission of Campylobacter jejuni/coli in the production of young fattening poultry. 2. Study of the characterization, resistance behavior and pathogenicity of Campylobacter jejuni/coli in poultry]. PMID- 3542477 TI - [Immunoglobulin absorption in calves following the administration of cattle blood through a stomach tube]. PMID- 3542478 TI - [Occurrence and growth dynamics of the cystic corpora lutea in the estrus cycle of cattle and their hormone profile]. PMID- 3542479 TI - [Current problems in feed consultation in veterinary medicine. 6. Damage to the horse caused by animal feed]. PMID- 3542480 TI - [Treatment of heart arrest by endotracheal administration of adrenaline in the horse]. PMID- 3542482 TI - [Animal welfare aspects in the control of wild urban pigeons]. PMID- 3542481 TI - [Excretion of chlortetracycline in rainbow trout]. PMID- 3542483 TI - [Salmonellosis and salmonella excretion--a challenge for meat hygiene]. PMID- 3542484 TI - [Prevention of animal diseases in the tropics--evaluation and perspectives]. PMID- 3542486 TI - A historical review of the use of bone and cartilage in otologic surgery. PMID- 3542487 TI - Bone grafts. PMID- 3542488 TI - Bone grafts in orthognathic and craniofacial surgery. PMID- 3542489 TI - Frontal sinus reconstruction with bone or cartilage grafts. PMID- 3542485 TI - Cefadroxil. A review of its antibacterial, pharmacokinetic and therapeutic properties in comparison with cephalexin and cephradine. AB - Cefadroxil is an oral cephalosporin which is similar to cephalexin and cephradine in structure and spectrum of antibacterial activity, but has different pharmacokinetic properties. Not only does cefadroxil exhibit a longer serum half life, and thus a prolonged duration of activity, but it is virtually unaffected by simultaneous food intake. The concentrations of cefadroxil attained in body tissues and fluids are also higher and more sustained than those of cephalexin and cephradine. These characteristics permit the administration of cefadroxil during meals on a once-daily or twice-daily basis, thus encouraging patient compliance which often determines the successful management of out-patient infections. Many studies have established the efficacy of the administration of once- or twice-daily cefadroxil, compared with regimens of cephalexin or cephradine given 4 times daily, in the management of infections in the respiratory tract, urinary tract, skin and soft tissues, and bones and joints. PMID- 3542490 TI - Implants in nasal surgery. PMID- 3542491 TI - Mandibular reconstruction. PMID- 3542492 TI - Bone and cartilage in the repair of laryngotracheal stenosis. PMID- 3542494 TI - The value of border moulding for retention of impression. PMID- 3542493 TI - Ethamsylate reduces immunoreactive prostacyclin metabolite in low birthweight infants with respiratory distress syndrome. AB - Measurement of 6 ketoprostaglandin F1 alpha was made by radioimmunoassay during the first 3 days of life in 33 infants with respiratory distress syndrome who were subjects in a double blind controlled trial of ethamsylate for the prevention of intraventricular haemorrhage. Levels of 6-ketoprostaglandin F1 alpha were significantly lower on the first and second days of life in babies receiving ethamsylate. There was a reduction in the incidence of intraventricular haemorrhage in the treated group. High levels of prostacyclin metabolite are found in babies who develop haemorrhage, and reduction of prostacyclin synthetase activity may be the mode of action of this drug in vivo. PMID- 3542495 TI - The effect of removable partial denture design on the amount of dental plaque formation. PMID- 3542497 TI - [Use of preparations of microbial origin for stimulating antitumor resistance]. AB - Results of application of the preparations made of mycobacteria, clostridia, staphylococci and streptococci, lactobacteria, Salmonella, Streptomyces and other are analyzed. Researchers in different countries pay great attention to the antitumour activity of capsular and somatic antigens of a microbic cell, its separate anatomical structures, enzymes, lipids, polypeptides and especially polysaccharides. The action of bacterial preparations and factors restraining their application in clinical oncology are considered. PMID- 3542496 TI - [Colchicine therapy of fibrosing liver diseases--report of a randomized double blind study]. AB - It is reported on results of a double blind study of colchicine therapy in fibrotic liver diseases over a period of three years. The study includes 74 probands; 37 of them had been treated after randomization for five days a week with 4 X 0,25 mg/d colchicine, 37 with placebo. 53 probands attained the 12th month of treatment, 43 of them 24th, 24 probands were in the study for 36 months. 3 diagnoses groups had been formed with regard to the histological grades of fibrosis: chronic hepatitis (without structural transformation); structural liver transformation/moderate liver cirrhosis; severe liver cirrhosis. In 38 cases the disease was caused by alcohol. 45 data had been studied (clinical results, paraclinical data concerning hepatological diagnostic and connective tissue metabolism and morphologic data). The biometric evaluation was carried out with the stage variant analysis by Friedman. Rebiopsies have been carried out in 40 probands after 1 year, in 4 probands after 2 years. 4 data (Serumalbumine, Gamma GT, ALAT, KP) showed significant changes in the colchicine-group as well as in the placebo-group. In both therapy groups the morphologic supervisions of the fibrosis grades (rebiopsies) showed improvements, no changes, and deterioration about in the same frequency. In this study there was no effectiveness of colchicine on the course of fibrotic liver diseases to be stated. Concerning the contradictions in the recent literature and probable the insufficient colchicine dose, the authors recommend further studies on colchicine therapy in liver diseases with incipient i.e. reversible fibrosis. PMID- 3542498 TI - [Nonspecific gamma-esterase in the tissues in endometrial cancer]. AB - Malignization of endometrium is accompanied by an increase in the production of nonspecific tissue gamma-esterase (NTE). NTE content in uterine tissues and mucus of patients with cancer of endometrium correlates with a degree of differentiation, spreading and depth of tumour cell invasion into the myometrium. The synthesis of NTE occurs in epithelial cells of the endometrium glands which secrete it into the uterus cavity. PMID- 3542500 TI - Intracerebroventricular infusion of insulin alters the behavior of rats not related to food intake. AB - Intracerebroventricular (i.c.v.) administration of a low dose of insulin strongly increased hot-plate latencies in rats, while no alteration was found in the duration of hexobarbital-induced sleep of the animals. The amount of insulin applied did not significantly change blood glucose and insulin levels and did not evoke any apparent effects on body temperature of animals. PMID- 3542499 TI - [Factors affecting 3H-thymidine incorporation into cells synthesizing DNA]. AB - Potential sources of errors in 3H-thymidine use in cell proliferation studies are reviewed. Many factors affect the uptake of this agent into newly synthesized DNA: predominance of denovo and salvage pathways of thymidilate biosynthesis, activity of certain enzymes, size of thymidilate and TTP endogenous pools, differences in 3H-thymidine utilization rate during S-period, its catabolism in cell and tissue culture systems, degradation by bacteria, its reutilization in vivo and in vitro, effects of the isotope activity, of the exposition time of autoradiographs and of the beta-particles absorbance in the specimen. Practical recommendations are given to avoid these errors. PMID- 3542501 TI - The effect of insulin concentration on retroendocytosis in isolated rat adipocytes. AB - After internalization by isolated rat adipocytes, insulin can be degraded or released intact from the cell, a process termed retroendocytosis. To determine whether the amount of ligand entering the cell could modulate its ultimate intracellular disposition, adipocytes were incubated with 0.4-25 ng/ml radiolabeled insulin for 20 min at 37 C to reach steady state binding and internalization. After this, surface bound insulin was removed by acid extraction and the cells were reincubated in insulin-free 37 C buffer. The fractional rate of release of internalized cell associated radioactivity was similar at all insulin concentrations. However, insulin enhanced the appearance of trichloroacetic acid (TCA)-precipitable material in a dose-dependent manner reaching a maximum at an insulin concentration of 10 ng/ml. At 0.4 ng/ml insulin, 18 +/- 2% of the released radioactivity was TCA precipitable whereas 36 +/- 3% was precipitable at 25 ng/ml. Sephadex G-50 gel chromatography and reverse phase HPLC analysis of the reincubation medium confirmed TCA-precipitable material was intact insulin. To further investigate the dual pathways of intracellular insulin processing, adipocytes were incubated with 0.4 and 25 ng/ml insulin for 20 min, acid extracted to remove surface receptor insulin, and solubilized. Sephadex G-50 and HPLC analysis revealed that proportionately less insulin intermediates and low molecular weight degradation products are found in cells incubated at the higher insulin concentrations. In conclusion, as adipocytes internalize more insulin, less is converted into insulin intermediates and low molecular weight degradation products and more is diverted to retroendocytosis. PMID- 3542502 TI - Characterization of an islet carboxypeptidase B involved in prohormone processing. AB - An islet carboxypeptidase B-like enzyme (CP B) has been identified and characterized in secretory granules of anglerfish islets. By employing several different column chromatography methods (gel filtration, ion exchange, and hydroxylapatite), it was determined that the islet secretory granules contained only one detectable CP B. This enzyme is present in both secretory granule- and microsome-enriched subcellular fractions and is membrane associated at pH 5.2. The specific activity of the islet CP B was approximately 4-fold higher in the secretory granule- and microsome-enriched subcellular fractions than in the lysosome-enriched fraction. It is a metallo-enzyme that is stimulated by Co++, and has a pH optimum in the range of 5.2-6.2. The isoelectric point of the islet CP B is at pH 4.9. The enzyme is a glycoprotein and has an approximate molecular size of Mr 30,000 by gel filtration. The substrate analogs guanidinoethylmercaptosuccinic acid, guanidinopropylsuccinic acid, and aminopropylmercaptosuccinic acid competitively inhibited the islet CP B with inhibition constant (Ki) values of 23, 21, and 230 nM, respectively. In experiments employing purified prohormone substrates it was demonstrated that the action of a CP B-like enzyme was required for the complete processing of anglerfish proinsulin and prosomatostatin-II. These results indicate that the anglerfish islet CP B is involved in prohormone processing and has properties which are very similar to those of enkephalin convertase. PMID- 3542503 TI - Partial purification of a hypothalamic factor that inhibits gonadotropin releasing hormone-stimulated luteinizing hormone release. AB - A protein that suppresses GnRH-stimulated LH release from dispersed rat anterior pituitary cells was purified from rat hypothalami by chromatography on Sephadex G 25, carboxymethyl cellulose, and high performance gel permeation. The final increase in inhibitory activity was 214-fold. The inhibitor is a glycoprotein with an apparent mol wt of 12,252 +/- 638, as determined by gel permeation on HPLC and electrophoreses as a monomer after treatment with 8 M urea. The inhibitor has a Stokes radius of 16 A, an S value of 2.14 +/- 0.08, an isoelectric point value near 4.1, and a frictional ratio of 1.05. A preliminary amino acid composition is presented. PMID- 3542504 TI - Hormonal regulation of the peripubertal surge of insulin-like growth factor-I in the rat. AB - The marked increase in circulating insulin-like growth factor-I (IGF-I) levels during puberty observed in primates indicates an important functional relationship between hypothalamic-pituitary gonadal function and hormonal regulation of peripubertal circulating IGF-I levels. Recent studies demonstrating local production and secretion of gonadal peptides including IGF-I suggest that increased circulating IGF-I levels during puberty might be due to direct gonadal secretion of IGF-I or alternatively to indirect effects of increased gonadal steroid secretion on nongonadal tissues including the hypothalamus, pituitary, and liver. We therefore studied the effects of prepubertal castration on the pubertal IGF-I surge and demonstrate that castration provokes a further increase rather than ablation of the pubertal IGF-I surge in the rat. Furthermore, neonatal treatment with monosodium glutamate, a hypothalamic neurotoxin, abolishes the pubertal IGF-I surge when commenced on postnatal day 1 but not on day 5, whereas treatment with a GnRH antagonist commencing within 12 h of birth significantly reduces but does not abolish the pubertal IGF-I surge. We therefore propose that the pubertal IGF-I surge in the rat is not due to direct gonadal secretion of IGF-I or other gonadal hormones during puberty but may involve hypothalamic and/or hepatic programming by events during prenatal or very early postnatal life. PMID- 3542506 TI - Morphological studies of the canine pituitary luteinizing hormone (LH) cells after long-term treatment with the LH-releasing hormone (LHRH) agonist [D Trp6]LHRH ethylamide. AB - Since treatment with LHRH agonists (LHRH-A) cause changes in LH secretion which are similar in both man and dog, we have studied cytological changes occurring in canine LH cells after chronic administration of an LHRH-A, [D-Trp6] LHRH ethylamide. At the light microscopic level, LH cells were distributed evenly in the gland, but showed a decrease in cell surface area of 10% after 1 month and 23% after 4 months of daily injection of 50 micrograms LHRH-A. At the electron microscopic level, the gonadotrophs from control animals were characterized by the presence of two types of secretory granules and a dilatation of the rough endoplasmic reticulum. Immunostaining for LH was localized only to secretory granules. LHRH-A administration caused the appearance of glycogen in the cytoplasm. Four months after cessation of the treatment, the gonadotrophs showed a normal cytological appearance, thus indicating full reversibility of the morphological changes induced by long-term treatment with an LHRH-A. PMID- 3542505 TI - Cytosolic free calcium levels in cultured pituitary cells separated by centrifugal elutriation: effect of gonadotropin-releasing hormone. AB - The cytosolic concentration of free Ca2+ ([Ca2+]i) in normal rat pituitary cells separated by centrifugal elutriation was monitored with the fluorescent Ca2+ indicator Quin 2. GnRH (10(-7) M) induced a rapid rise (6-8 sec) in the gonadotroph's [Ca2+]i, followed by a plateau phase of prolonged elevated [Ca2+]i which lasted about 15 min. The stimulatory effect of GnRH was dose dependent, with an ED50 of 10(-9) M, and was blocked by the potent antagonist [Dp Glu1,pclPhe2,DTrp3.6]GnRH. GnRH elevated [Ca2+]i only in gonadotroph-enriched cell fractions, whereas TRH and GH-releasing factor (GRF) elevated [Ca2+]i in mammotroph- and somatotroph-enriched cells fractions, respectively. A rapid increase (first phase) in [Ca2+]i induced by GnRH was observed in Ca2+-free medium containing EGTA, but this rapid phase was terminated within 2 min. Readdition of Ca2+ to the medium induced a second slower rise in [Ca2+]i (plateau phase). Addition of K+ caused a rapid rise in [Ca2+]i, which was dependent on extracellular Ca2+, but was not affected by prior stimulation with GnRH. On the other hand, stimulation of gonadotroph's [Ca2+]i response by GnRH desensitized the cells to a subsequent GnRH challenge within the time frame studied. These findings indicate an elevation of [Ca2+]i induced by GnRH, TRH, and GRF in their respective separated target cells in the rat pituitary. The rise in [Ca2+]i in GnRH-stimulated gonadotrophs originates partly from intracellular Ca2+ pools and partly from influx of Ca2+ across the cell membrane. PMID- 3542507 TI - Analysis of the disruptive action of an epididymal protease and the stabilizing influence of molybdate on nondenatured and denatured glucocorticoid receptor. AB - The nucleomyofibrillar fraction of epididymides from sexually mature rabbits contains a novel leupeptin-sensitive protease that disrupts the oligomeric conformation of cytosolic estrogen and progesterone receptors, and molybdate inhibits this process. In this report we used the AtT-20 cell glucocorticoid receptor as substrate and performed analyses under nondenaturing vs. denaturing conditions to further investigate the effects of the epididymal protease and molybdate on steroid receptor structure. Analysis on low salt sucrose gradients indicated that the protease partially converted the oligomeric (9-10S) glucocorticoid receptor to several more slowly sedimenting forms (3-7S), and this effect was not observed in the presence of molybdate. Paradoxically, gradient analysis under high salt conditions revealed that the protease induced a discrete, quantitative and molybdate-insensitive conversion of the 4-5S steroid binding subunit to a 3S form. Further studies were done using denaturing polyacrylamide gel electrophoretic analysis of receptor that had been labeled covalently with [3H]dexamethasone 21-mesylate and partially purified by DNA/cellulose chromatography. At 0-4 C, the protease cleaved the steroid-binding subunit (mol wt, 96,900) of the receptor to a single steroid-labeled fragment (mol wt, 42,600). Under these conditions, digestion was complete within 30-60 min and was inhibited by leupeptin, but was unaffected by thiol-reactive reagents or molybdate. The epididymal protease and alpha-chymotrypsin produced steroid labeled receptor fragments that were indistinguishable in size, shared an epitope recognized by our BuGR-2 monoclonal antibody, and retained DNA-binding activity. Despite the apparent similarity of these two enzymes, they are distinct, since the chymotrypsin-dependent cleavage event was not inhibited by leupeptin. These studies show that the epididymal protease attacks a site on the steroid-binding subunit of glucocorticoid receptors as well as estrogen and progestin receptors. It also appears that the cleavage site is situated close to that most readily attacked by alpha-chymotrypsin. Finally, our data provide independent confirmation of a recent report indicating that molybdate ions interact directly with the cytosolic steroid receptor to stabilize its oligomeric structure even after proteolysis within the steroid-binding subunit. PMID- 3542508 TI - Recombinant deoxyribonucleic acid-derived 22K- and 20K-human growth hormone generate equivalent diabetogenic effects during chronic infusion in dogs. AB - Chronic administration of human GH (mol wt, 22,000; 22K-hGH) is known to generate insulin resistance in dogs. However, recent hypotheses claim that diabetogenicity may be attributable to smaller weight contaminants or fragments not found in purified lower weight hGH (mol wt, 20,000; 20K-hGH) also secreted by the pituitary. In this study, we examined the effects of chronic (12-day) low dose (0.02 mg/kg X day) infusion of recombinant DNA-derived methionyl 22K- and 20K-hGH on glucose tolerance in conscious dogs. Minimal model analysis of the frequently sampled iv glucose tolerance tests quantified insulin sensitivity and glucose effectiveness, the ability of glucose per se to normalize its own concentration. Infusion of 22K-hGH, raising plasma hGH levels to 3.8 +/- 0.6 ng/ml, resulted in an elevation in fasting glucose levels after 2 days of infusion (104 +/- 1 vs. pre-hGH 97 +/- 2 mg/dl; P less than 0.01), but the effect was transient. No change was noted during 20K-hGH treatment (P greater than 0.2). Mildly elevated fasting insulin levels were observed in both 22K- and 20K-hGH-treated dogs (P less than 0.04 and 0.03, respectively). However, despite maintenance of adequate glucose tolerance during both infusions (P greater than 0.07), marked insulin resistance was apparent; insulin sensitivity dropped from 9.7 +/- 2.4 and 11.2 +/ 2.1 X 10(-4) min-1/(microU/ml) in 22K- and 20K-hGH-treated dogs, to 2.5 and 2.8 X 10(-4) min-1/(microU/ml), a drop of 75% (P less than 0.01 and 0.001). Insulin resistance persisted throughout the infusion period, slowly returning to pre-hGH treatment levels in 22K-hGH-treated dogs during recovery. Insulin resistance persisted 3 days after cessation of 20K-hGH treatment (day 15), but returned to pre-hGH levels by day 25. Integrated glucose-stimulated insulin release was enhanced after 2 days of 22K- or 20K-hGH treatment (P less than 0.03 and less than 0.05), but the effect was transient. Maintenance of normal glucose tolerance in the face of severe insulin resistance and only transiently elevated insulin response was possible because glucose effectiveness remained unchanged. In conclusion, despite minimal effects of low dose hGH infusion on glucose tolerance and fasting glucose and insulin levels, 22K- and 20K-hGH are equipotent in generating severe insulin resistance and potentiating glucose-stimulated insulin release. PMID- 3542509 TI - Comparative biological properties of lamprey gonadotropin-releasing hormone in vertebrates. AB - The biological activities of lamprey GnRH were determined in the lamprey, chicken, sheep, and rat. Lamprey GnRH elevated plasma steroid levels and stimulated ovulation in the lamprey, but had little or no LH-releasing activity in chicken and sheep pituitary bioassays or effect on GnRH receptor-binding activity in the rat pituitary. The lamprey GnRH molecule is structurally distinct from other known vertebrate GnRHs and is the first identified molecule in this family to have different amino acids in the third and sixth positions. These data suggest that the presence of Tyr3 or Glu6 in lamprey GnRH may account for the lack of biological activity in the representatives of the two different vertebrate classes investigated in this study. PMID- 3542510 TI - Commercially available preparations of porcine glucose-dependent insulinotropic polypeptide (GIP) contain a biologically inactive GIP-fragment and cholecystokinin-33/-39. AB - Commercially available preparations of natural porcine glucose-dependent insulinotropic polypeptide (GIP) were subjected to reverse phase HPLC. The material was found to give rise to 4 peaks which were characterized by HPLC retention time and N-terminal sequence analysis. They represented: intact porcine GIP(1-42), 58% (wt/wt); the GIP-fragment des-tyr-ala-GIP(3-42), 32% (wt/wt); cholecystokinin (CCK)-33 2% (wt/wt); CCK-39 2% (wt/wt). HPLC-pure GIP(1-42) stimulated insulin release in rat isolated pre-cultured pancreatic islets in the presence of 16.7 mM glucose up to 240% vs. control, whereas the fragment des-tyr ala-GIP(3-42) did neither increase insulin release nor exhibit antagonistic activity to GIP(1-42) at 100 ng/ml. These results indicate that commercially available porcine GIP-preparations may contain the biologically inactive des-tyr ala-GIP(3-42) in high amounts, and in addition may be contaminated by CCK peptides. HPLC-characterization of these peptide preparations prior to any biological study is crucial. PMID- 3542511 TI - In memoriam: Mortimer B. Lipsett, M.D. PMID- 3542513 TI - Corticotropin-releasing factor decreases plasma luteinizing hormone levels in female rats by inhibiting gonadotropin-releasing hormone release into hypophysial portal circulation. AB - To evaluate whether the hypothalamus is the site of action of CRF in inhibiting LH levels in female rats, we measured hypophysial-portal blood concentrations of immunoreactive GnRH (irGnRH) after the central injection of CRF. Ovine CRF (0.1, 1.0, 2.0, and 5.0 nmol) was injected intracerebroventricularly to intact rats on the afternoon of proestrus and in long term ovariectomized (OVX) rats in the presence or in absence of estradiol benzoate (OVX + EB). CRF injection decreased the amplitude of the proestrous irGnRH surge without affecting presurge levels. CRF (0.1 nmol) attenuated the afternoon irGnRH surge in OVX + EB rats; higher doses of CRF blocked this surge and decreased nonsurge irGnRH levels. No dose related alterations of irGnRH levels were observed in OVX rats; only the highest dose of CRF was active. For comparison, plasma LH concentrations were measured after a single dose of CRF (2 nmol) in rats under the same experimental conditions. While CRF decreased LH concentrations in anesthetized proestrous and OVX + EB rats, it was inactive in OVX rats. In contrast, CRF injection in awake rats did decrease LH concentrations in all experimental conditions, suggesting that in OVX rats, the anesthetic (Saffan) used during portal blood collection affected CRF action on LH secretion. Indeed, the observation that the LH response to opiate receptor blockade with naloxone (2.5 mg/kg) in anesthetized OVX rats was different compared to that in awake rats suggested that the ineffectiveness of CRF to decrease irGnRH and LH in OVX anesthetized rats was related to the action of the anesthetic on the opioid system. The existence of a putative CRF opioid interaction in the inhibitory control of LH secretion was supported by the effectiveness of naloxone to reverse the CRF-induced decrease in LH levels in EB treated and untreated OVX rats. These results indicate that CRF attenuates LH secretion by a central action to inhibit irGnRH release into the hypophysial portal circulation and that this action is independent of basal concentrations of irGnRH and/or LH. Moreover, the present results support the involvement of endogenous opioids in mediating the effect of CRF on LH secretion. PMID- 3542514 TI - Inhibitory action of ethanol on luteinizing hormone secretion by rat anterior pituitary cells in culture. AB - Ethanol (EtOH) inhibits LH secretion in humans and animals. In these studies we examined the gonadotroph as a possible site of action of EtOH by treating cultured pituitary cells with several concentrations of EtOH (200, 400, or 800 mg/100 ml) for 4 days. Cells were incubated for 2 h with LHRH on the last day of the experiment. Whereas basal LH release was unaffected over the 4 days of EtOH treatment, the LH response to LHRH was inhibited by EtOH in a dose-related fashion. Inhibitory responses at the lowest concentration of EtOH (200 mg/100 ml) occurred inconsistently. At the highest concentration (800 mg/100 ml), the curve of log LHRH dose vs. LH release had a lower maximum and was shifted to the right of that for untreated cells. Total LH content and total number of cells attached to the culture wells were unchanged after EtOH treatment. These data suggest that EtOH at high concentrations can lower the responsiveness of the gonadotroph to LHRH. PMID- 3542512 TI - Regulation of deoxyribonucleic acid synthesis in cultured porcine granulosa cells by growth factors and hormones. AB - To assess the potential role of hormones and growth factors in ovarian follicular growth, we have developed a simple method for the evaluation of DNA synthesis in cultured porcine granulosa cells. Optimal conditions were found to entail newly established cultures that were growth arrested by serum deprivation and then treated with growth-promoting agents. Such treatment resulted in an easily quantitated 3- to 30-fold increase in [3H]thymidine incorporation into trichloroacetic acid-precipitable macromolecules. The radioactivity incorporated was localized to the DNA band on cesium chloride gradients and showed excellent correlation with labeling indices. Insulin, multiplication-stimulating activity, epidermal growth factor (EGF), platelet-derived growth factor, and ovarian follicular fluid were potent stimulators of DNA synthesis in this assay. While EGF and insulin effects were additive, indicating discrete modes of action, the effects of insulin and multiplication-stimulating activity were not additive at maximally effective concentrations. In contrast to the effects of these stimulatory substances, BSA and porcine relaxin were devoid of mitogenic activity under these circumstances. The major trophic hormones implicated in follicular growth, FSH, LH, and estradiol, as well as the cAMP analog 8-bromo-cAMP were without mitogenic effects. Instead, treatment with LH, 8-bromo-cAMP, and the combination of estradiol and FSH resulted in a distinct decrease in DNA synthesis. These data confirm and extend previous evidence of the mitogenic action of insulin-like peptides and EGF, and suggest that the hormones generally believed to regulate granulosa cell replication in vivo lack direct mitogenic effects in vitro. PMID- 3542515 TI - Paraventricular nucleus mediates prolactin secretory responses to restraint stress, ether stress, and 5-hydroxy-L-tryptophan injection in the rat. AB - The role of the paraventricular nucleus (PVN) in mediating acute stimulatory PRL responses was investigated in conscious male rats. Electrolytic lesions, verified histologically at autopsy, were stereotaxically made in the PVN region, and sham lesions were made in control rats. Blood was obtained through a chronically indwelling catheter in the right atrium. PVN-lesioned (PVL) rats showed significantly lower T3 levels 1 week after surgery (less than 34.4 ng/dl) compared with sham (mean +/- SEM, 91.2 +/- 5.0 ng/dl) and intact (86.8 +/- 2.0 ng/dl) animals, verifying a lesion in the PVN. T3 was restored to normal (95.6 +/ 1.8 ng/dl) by daily sc administration of T4 (10 micrograms/kg BW) for at least 4 days before the day of the experiments. Basal PRL levels in PVL rats did not differ significantly from those in control or sham-lesioned animals. In response to restraint stress, plasma PRL levels of PVL rats did not rise, in contrast to marked elevation in PRL in sham and intact rats [PRL levels (mean +/- SEM; nanograms per ml), basal to peak: PVL, 4.3 +/- 0.3 to 4.5 +/- 0.4; sham, 4.5 +/- 0.5 to 47.0 +/- 4.1; intact, 4.0 +/- 0.3 to 46.3 +/- 4.9]. PVL also resulted in the complete inhibition of PRL secretion induced by 30-min inhalation of ether (basal to peak: PVL, 3.3 +/- 0.3 to 4.5 +/- 0.2; sham, 5.7 +/- 0.8 to 19.9 +/- 0.9; intact, 3.3 +/- 0.4 to 27.9 +/- 4.0). The stimulatory effect on plasma PRL in sham and intact rats by one iv bolus injection of the serotonin precursor 5 hydroxy-L-tryptophan (5-HTP; 10 mg/kg BW) was completely abolished in PVL animals (basal to peak: PVL, 3.7 +/- 0.6 to 5.2 +/- 1.4; sham, 6.7 +/- 0.6 to 36.0 +/- 0.5; intact, 4.1 +/- 1.2 to 33.3 +/- 3.2). In contrast to the marked alteration in PRL regulation, PVL rats exhibited a typical ultradian rhythm of plasma GH secretion during a 6-h observation period and increased release of GH induced by iv injection of 5-HTP [GH (nanograms per ml), basal to peak; PVL, 4.5 +/- 0.6 to 21.0 +/- 4.9; sham, 3.7 +/- 0.3 to 18.4 +/- 4.4; intact, 2.9 +/- 0.1 to 17.8 +/- 3.5]. These findings indicate that PRL responses to stress and to serotonin act through the PVN, the site of origin of several putative PRL-releasing factors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542516 TI - Influence of the oral hypoglycemic agent linogliride (McN-3935) on insulin secretion from isolated rat islets of Langerhans. AB - The influence of a new orally effective hypoglycemic compound, linogliride (McN 3935), on insulin release from isolated perifused rat islets was investigated. At a concentration of 100 microM, linogliride was without effect on insulin secretion in the absence of glucose. While 5.5 mM glucose alone produced a weak secretagogue effect, the secretory response was dramatically (5- to 6-fold) increased by the addition of 100 microM linogliride. This concentration of linogliride did not affect the conversion of [5-3H]glucose to 3H2O, a measure of the rate of glycolysis by the islet. Insulin secretion in response to the combination of 100 microM linogliride and 5.5 mM glucose was abolished by the omission of extracellular calcium. Mannoheptulose (10 mM), an inhibitor of glucose phosphorylation and glucose-stimulated insulin secretion, markedly attenuated the insulinotropic effect of linogliride in parallel with reduced glucose usage. Paradoxically, in the presence of another metabolic inhibitor, 2 deoxyglucose (10 mM), the insulinotropic effect of linogliride (100 microM) in the presence of 5.5 mM glucose was not diminished despite the reduced glucose usage. Linogliride significantly increased the secretory response to other secretagogues, including 2.5 mM D-glyceraldehyde, 15 mM N-acetylglucosamine, 10 mM leucine, and 100 nM of the phorbol ester 12-O-tetradecanoylphorbol-13-acetate. These data suggest that linogliride amplifies a cellular signal generated during beta-cell activation by various stimulants. PMID- 3542518 TI - Root canal posts--some prosthodontic aspects. PMID- 3542517 TI - Neuropeptide Y enhances the release of luteinizing hormone (LH) induced by LH releasing hormone. AB - Depending upon the steroid hormonal milieu, centrally administered neuropeptide Y (NPY) exerts differential effects on the release of LH. Ovarian hormones also effect the concentrations of NPY in hypothalamic nuclei, and some of the changes are similar to those caused by LHRH. The present studies tested whether NPY acts directly on the pituitary gland, either alone or in combination with LHRH, to modify LH secretion. Hemipituitary fragments obtained from ovariectomized rats were incubated in medium 199, and the in vitro effects on LH release of LHRH, NPY, or the two peptides together were assessed. As expected, LHRH (10(-9)-10(-7) M) produced a dose-dependent release of LH, whereas NPY alone had a lesser stimulatory effect at concentrations of 10(-7) or 10(-6) M. On the other hand, 10(-6) M NPY significantly enhanced LH release in response to 10(-9) M LHRH. A potentiation by NPY of the LHRH-induced LH response was observed in an anterior pituitary cell culture system. Cells from the pituitaries of ovariectomized rats were dispersed and cultured for 3 days in medium 199 with BSA, gentamicin, horse serum, and fetal calf serum. During a 3-h incubation, NPY alone (10(-9)-10(-7) M) failed to affect LH release, but significantly potentiated the release induced by 10(-9) or 10(-8) M LHRH. These findings are in accord with the hypothesis that hypothalamic NPY neurons may participate in the regulation of LH secretion in the rat and indicate that one of the mechanisms of its action may be to increase the pituitary LH response to LHRH. PMID- 3542519 TI - External root resorption in patients with secondary bone-grafting of alveolar clefts. PMID- 3542521 TI - Detection of mutagenic activity in the urine of rodents treated with p rosaniline. AB - p-Rosaniline was fed to male and female Fischer 344 rats and B6C3F1 mice at doses of 1,000 and 2,000 ppm for male rats and 500 and 1,000 ppm for female rats and mice of both sexes. Urine was collected overnight at 1-wk intervals over a 4-wk treatment period and frozen until its use in the mutagenicity assay. The neat urine was tested in triplicate without S-9 on Salmonella tester strains TA98, TA100, TA1535, and TA1537 at 0.75, 0.5, 0.2, and 0.05 ml per plate. When sufficient urine was available, samples were tested on TA100 in the presence of S 9. Either urine samples were pretreated for 18 hr at 37 degrees C with beta glucuronidase, or the deconjugating enzyme was added to the top agar at the time of plating in the mutagenicity assay (non-pretreatment). Direct-acting mutagenic activity was detected on TA98 in the urine from male mice, but only when using the non-pretreatment deconjugation method. No direct-acting mutagenic activity was detected in the urine of male and female rats and female mice; however, in the presence of S-9, mutagenic activity was observed in the urine of male rats and in the urine of male and female mice regardless of the deconjugation method used. The non-pretreatment method was superior for detecting direct acting mutagenic activity, and the pretreatment method was superior for detecting mutagenic activity requiring metabolic activation by S-9. PMID- 3542520 TI - Genotoxicity studies of methyl isocyanate in Salmonella, Drosophila, and cultured Chinese hamster ovary cells. AB - The genotoxic effects of methyl isocyanate (MIC) were investigated using four short-term tests: the Salmonella reversion assay (Ames test), the Drosophila sex linked recessive lethal assay, and the sister chromatid exchange (SCE) and chromosomal aberration assays in cultured Chinese hamster ovary (CHO) cells. No evidence was found for the induction of mutations in either Salmonella or Drosophila. MIC did, however, induce SCEs and chromosomal aberrations in CHO cells both in the presence and absence of Aroclor-induced rat liver S-9. PMID- 3542523 TI - In vivo induction of sister chromatid exchanges in mice by nitrosated coal dust extract. AB - The genotoxicity of coal dust extract nitrosated with sodium nitrite (NaNO2) was investigated in mice with the in vivo sister chromatid exchange (SCE) assay system. The SCEs in bone marrow cells of mice were examined following single and double oral dosings of coal dust extract, NaNO2, and nitrosated coal dust extract. Coal dust extract and NaNO2 separately did not cause significant increases of SCEs either in single or in double dosings. Nitrosated coal dust extract in single doses did not increase SCEs but in two doses significant increases in SCEs were observed (P less than 0.02). The mutagenicity of the same extracts was tested in Salmonella typhimurium with the Ames tester strain TA98. Coal dust extract was either non- or weakly mutagenic and NaNO2 was nonmutagenic. The nitrosated coal dust extract caused pronouced increases in his+ revertants both with and without rat liver S9 activation. These findings provide additional evidence that nitrosation of ingested coal dust which may occur in the stomach environment could be one of the factors leading to the higher incidence of gastric cancer in coal miners. PMID- 3542524 TI - Potential health hazard of use of mercury in dentistry: critical review of the literature. AB - This report examines recent publications on the health hazards associated with the use of mercury in dentistry with emphasis on the release of mercury vapor from silver-amalgam restorations. While there is consistent evidence indicating release of mercury vapor from the restorations during chewing, tooth brushing, and other oral activities, proof of a causal link of this specific source of the heavy metal to any major human health problem is lacking. Several gaps in our knowledge of the metabolism of mercury vapor in the human militate against accurate prediction of the potential health significance of chronic exposure to this source of mercury, and some relevant lines of research have been recommended. PMID- 3542522 TI - Effects of exposure to NO2 on dome formation in alveolar epithelial cell monolayers. AB - Primary cultured monolayers of rat Type II pneumocytes were used to investigate the effects of NO2 on alveolar epithelial barrier properties. Such monlayers form fluid-filled domes which are thought to result from active solute transport from medium to substratum, with water following passively. Using dome formation as a transport marker, 5-day-old cultures were directly exposed to 30 ppm NO2 in 5% CO2/air at 25 degrees C by cyclically tilting culture plates from side to side such that both halves of the monolayer were exposed during each cycle. Exposures consisted of 10 cycles of 4 min each (2 min per side), for a cell exposure time of 20 min. Control plates were simultaneously exposed to 5% CO2/air under identical conditions. Twenty-four hours after exposure, NO2-exposed monolayers exhibited significant decreases in dome density and individual dome volume as compared to controls. By 48 hr postexposure, differences between NO2-exposed and control values were less but remained significant. Control monolayers were essentially unaffected by exposure to 5% CO2/air. These results show that short term sublethal exposures to NO2 produce a decrease in dome formation in Type II alveolar epithelial cell monolayers. This finding is most likely due to a decrease in the active transepithelial sodium transport rate and/or an increase in the permeability of cell membranes or tight junctions. PMID- 3542525 TI - Toxicologic interactions between ozone and bacterial endotoxin. AB - The effects of acute exposure of mice to bacterial lipopolysaccharide (LPS), the endotoxin of gram negative microorganisms, and ozone (O3) have been investigated. Intraperitoneal (ip) administration of 5 mg/kg LPS to CD-1 mice followed by exposure to 15 ppm O3 for 1.5 hr produced synergistic effects as measured by pulmonary edemagenesis and lethality assays. In contrast, ip administration of 0.1-1.6 mg/kg LPS to CD-1 mice over 5 consecutive days, a dose regimen resulting in LPS tolerance, protected against a lethal challenge of 20 ppm O3 for 3 hr. A statistically significant increase in catalase and glutathione peroxidase activity was measured in homogenates of lungs obtained from CD-1 mice receiving a tolerance-inducing regimen of LPS. These results demonstrate that two, distinct toxicologic interactions can occur between O3 and bacterial LPS. Synergism between these agents could explain, in part, the increased susceptibility of O3 exposed animals to respiratory infection with gram negative microorganisms. Protection resulting from LPS-induced increases in pulmonary antioxidant activity provides additional evidence that O3 and, possibly, LPS mediate their toxicity through oxidative mechanisms. PMID- 3542526 TI - Human lung post-proline endopeptidase: purification and action on vasoactive peptides. AB - Post-proline endopeptidase (PPE, EC 3.4.21.26) was purified 3,450 times from human lung. PPE was routinely assayed with the artificial substrate, carbobenzoxy glycyl-L-prolyl-p-nitroanilide (Z-Gly-Pro-pNA). The pH optimum was 7.4, and the Mr was 77,000. Thiol blocking agents were strongly inhibitory but serine blocking agents were not inhibitory. No metal ions were required for activity, but heavy metal ions such as Hg2+, Cu2+, Cd2+, and Zn2+ completely inactivated the enzyme. Both dithiothreitol (DTT) and ethylenediaminetetraacetic acid (EDTA) were required to stabilize PPE activity. Michaelis constant values for Z-Gly-Pro-pNA and carbobenzoxy-glycyl-L-prolyl-2-naphthylamide were 0.36 and 0.10 mmol/l, respectively. PPE cleaved vasoactive peptides including bradykinin (BK) and des (Arg9)-BK (Pro3-Gly4 and Pro7-Phe8 bonds), angiotensins I and II (Pro7-Phe8 bond), substance P (Pro4-Gln5 bond), and oxytocin (Pro7-Leu8 bond). Each of these peptides inhibited PPE-catalyzed hydrolysis of Z-Gly-Pro-pNA competitively. BK had the lowest Ki value (2.35 mumol/l) and oxytocin had the highest Ki value (84.0 mumol/l). PPE was not inhibited by captopril, a potent inhibitor of angiotensin converting enzyme, which also cleaves the Pro7-Phe8 bond of BK. PMID- 3542527 TI - Assessing daily management in childhood diabetes. AB - One hundred sixty-eight patients with childhood diabetes (6 to 19 years of age) and their parents participated in 24-hr recall interviews concerning daily diabetes management behavior. Each patient and parent was interviewed independently on three separate occasions. The information obtained was used to construct measures of 13 different adherence behaviors. Parent-patient agreement was good to excellent for most of the 13 behaviors. Agreement was influenced by the patient's age, with the most consistently high parent-child agreement found in the 10- to 15-year-old age group. Factor analysis of the 13 adherence behaviors resulted in a five-factor solution accounting for 70.6% of the variance. Adherence in childhood diabetes appears to be a complex construct, consisting of at least five different components unrelated to each other. Teenagers in this sample were less adherent than their younger counterparts on most of the adherence measures studied. PMID- 3542528 TI - Efficacy of human chorionic gonadotrophin and gonadotrophin releasing hormone for hastening ovulation in thoroughbred mares. AB - Plasma progesterone levels were measured daily to determine the accuracy of diagnosing ovulation by rectal palpation carried out every other day; 81.5 per cent mares injected with human chorionic gonadotrophin showed increases of progesterone more than 1 ng/ml by 72 h after injection compared with 65 per cent of mares injected with gonadotrophin releasing hormone (GnRH) or saline. Mating at ovulation achieved a 74 per cent pregnancy rate in mares given hCG compared with 50 per cent given GnRH and 45 per cent controls. Diagnosis of ovulation per rectum on the basis of a pit in the ovarian surface or the presence of a soft friable structure was found to be accurate in 91 per cent of cases. Diagnosis based on the presence of a firm plum-like structure or the disappearance of a previously identified follicle at a given site was 60 per cent accurate. In cases of rectal diagnosis of non-ovulation 38 per cent had actually ovulated based on a rise in progesterone more than 1 ng/ml and a further 19 per cent showed a rise in progesterone by 24 h after the diagnosis. The use of hCG may improve conception rates by synchronisation of ovulation and mating and where rectal palpation of the ovaries remains the only basis for timed mating. PMID- 3542529 TI - Fluorescence-activated cell analysis of P-fimbriae receptor accessibility on uroepithelial cells of patients with renal scarring. AB - Pyelonephritogenic Escherichia coli possess P-fimbriae that bind to uroepithelial cells by recognizing a receptor containing the alpha-D-Galp-(1-4)-beta-D-Galp carbohydrate structure. The accessibility of P-fimbriae receptors was determined using uroepithelial cells from 19 female patients with verified renal scarring and a history of febrile urinary tract infection, and 13 healthy controls. The binding of fluorescein isothiocyanate labeled P-fimbriated Escherichia coli to a large number of uroepithelial cells from each individual was studied using the method of fluorescence-activated cell sorting analysis, which allows examination of a large number of cells and selection of cells of a given size. The uroepithelial cells from the patients exhibited a significantly higher binding capacity to P-fimbriated Escherichia coli than did uroepithelial cells from healthy controls (p less than 0.01). The determination of P-fimbriae receptor accessibility on uroepithelial cells may be useful for detecting risk groups among patients with recurrent urinary tract infections. PMID- 3542530 TI - Sensitivity testing with ketoconazole in an assay containing Candida albicans, human polymorphonuclear leukocytes and serum. PMID- 3542531 TI - Identification of staphylococci by the API Staph, Sceptor, Rosco and simplified lyogroup systems. PMID- 3542532 TI - Laboratory and epidemiologic experience with methicillin-resistant Staphylococcus aureus in the USA. AB - Methicillin-resistant Staphylococcus aureus (MRSA) was a rare occurrence in US hospitals until the mid-1970s. Since that time outbreaks of MRSA infection have been reported in both large and small hospitals, in rehabilitation facilities, and in nursing homes. Transmission has been documented not only between hospitals, but between long-term care facilities and hospitals, and between the community and hospitals. Patient-to-patient spread within hospitals appears to result from transient colonization of the hands of health care workers, with colonized or infected patients being the intrahospital reservoir for the organisms. The best opportunity for control of outbreaks of MRSA infection within hospitals may depend on the rapid recognition of newly admitted patients who are colonized or infected. The laboratory plays a crucial role in this by providing prompt and accurate information indicating the presence of MRSA. Susceptibility test methods found to be most reliable for detecting MRSA in the USA include the broth microdilution MIC determination (performed in salt-supplemented broth), the Bauer-Kirby test with slight modification, or oxacillin-salt agar screening plates. PMID- 3542533 TI - DNA synthesis in vivo and in vitro in Escherichia coli irradiated with ultraviolet light. AB - DNA synthesis was followed in vivo and in permeable Escherichia coli after ultraviolet light irradiation, irradiation and incubation in a growth medium containing chloramphenicol and in unirradiated cells. In vitro, replicative type DNA synthesis was partially restored after incubation of cells in medium containing chloramphenicol, but not in vivo. The DNA was pulse-labeled in permeable cells in the presence of deoxyribonucleoside triphosphates and ribonucleoside triphosphates. dCTP was replaced by 5-Hg-dCTP as a substrate for DNA synthesis. Hg-DNA was separated from cellular nucleic acids on thiol-agarose affinity columns. The 5' termini of newly synthesized DNA were analyzed after treatment with alkaline phosphatase and rephosphorylation with polynucleotide kinase and [gamma-32P]ATP. DNA synthesis in unirradiated permeable E. coli represents a replicative process dependent on ATP and inhibited by novobiocin. About 70% of the nascent DNA carried terminally labeled RNA moiety at its 5' end. In vitro DNA synthesis in irradiated cells was suppressed and hardly influenced by the presence of ATP or novobiocin. The 5'-RNA content of this cell population was less than 5%. PMID- 3542535 TI - The effects of acebutolol alone and in combination with furosemide or hydralazine in experimentally induced hypertensive G-minipigs. AB - Experimentally induced hypertensive G-minipigs were used for assessing the antihypertensive effects of acebutolol, a cardioselective beta-adrenergic blocking agent. In the acute experiment, six females were used. Acebutolol (3 mg/kg, i.v.) alone or in combination with furosemide (1 mg/kg, i.v.) or hydralazine (1 mg/kg, i.v.) was administered through an implanted catheter. In the chronic experiments, five females received oral acebutolol (100-200 mg/day). The blood pressure, heart rate, plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were used as parameters. In the acute experiment, there were no marked changes in the blood pressure or heart rate during the nondosing period. Acebutolol alone caused a marked decrease in the blood pressure and heart rate. In the two combination tests, combined administration with acebutolol and furosemide had a greater effect on the blood pressure and heart rate than did acebutolol alone. A combined acebutolol and hydralazine regimen caused a slight reduction not only in the blood pressure, but also in the heart rate compared with acebutolol alone. PRA and PAC remained essentially constant, with minor fluctuations, throughout the nondosing period. Following the injection of acebutolol alone, PRA showed an elevation with a significant rise after three hours and PAC showed a tendency to increase. PRA and PAC generally tended to increase in the case of combined administration with furosemide or hydralazine, but these tendencies were less conspicuous than with acebutolol alone. On the other hand, chronic treatment with acebutolol produced a significant decrease in the heart rate from two weeks after the administration and in the blood pressure from four weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542534 TI - Pharmacokinetics of primaquine in patients with P. vivax malaria. AB - The pharmacokinetics of primaquine (PQ) and its major carboxylic acid metabolite (PQC) have been studied in seven Indian patients with P. vivax malaria following PQ 15 mg/day p.o. for 14 days. After a single oral dose on Day 1, a mean peak blood concentration of 50.7 ng/ml PQ was attained after 2.3 h, which declined monoexponentially with a half-life of 5.6 h. The mean total body clearance was 37.6 l/h and the volume of distribution was 292 l. The mean renal excretion (0-24 h) of the drug was only 0.54% of the dose and renal clearance was 0.189 l/h. Following chronic administration, none of the pharmacokinetic parameters was affected, and a steady state blood concentration of 2.5-4.2 ng/ml PQ was attained. After the first dose of PQ, PQC had a mean area under the blood concentration - time curve 11-fold higher than that of the parent drug. In contrast to the rapid distribution and elimination of PQ, the metabolite showed a longer mean residence time and accumulation in the body. The mean Cmax and AUC of the metabolite on Day 14 were 48 and 40% higher than the corresponding Day 1 values. The metabolite could not be detected in urine at any time in any patient. PQ and its metabolite did not show any accumulation in blood cells. PMID- 3542536 TI - Fine structure of the mandibular gland in Japanese field vole (Microtus montebelli). AB - The mandibular glands of the Japanese field vole were examined by light microscopy, and transmission and scanning electron microscopies. The acinar cells contained light and coarse secretory granules, and reacted with PAS and stained slightly with AB; they were considered to be seromucous in nature. The acinar epithelium was composed of light and dark cells containing many secretory granules. The intercalated duct cells consisted of light cells possessing a few dense granules. A few cytoplasmic crystalloides of moderate density were observed in occasional light cells. The striated ducts were comprized of two distinct portions, a secretory portion and a typical striated portion without secretory granules. The epithelium secretory portion consisted of light and dark cells containing acidophilic granules and exhibited a sexual dimorphism in these granules: The male epithelia contained the granules of low to high densities, while the female epithelia had only dense granules being smaller than those in the males. The epithelium of typical striated portion was composed of light and dark cells containing fine vacuoles and vesicles. PMID- 3542537 TI - Absence of insulitis and overt diabetes in athymic nude mice with NOD genetic background. AB - NOD mice spontaneously develop diabetic syndrome similar to that of insulin dependent diabetes mellitus in man. Insulitis, i.e., lymphocytic infiltration into the pancreatic islets is the etiologic pathological lesion in the development of diabetes mellitus in NOD mice. In the present study, we examined the role of the T cell in the development of insulitis and overt diabetes in NOD mice using NOD athymic and euthymic congenic mice. None of the NOD athymic mice developed insulitis at 9 weeks of age or overt diabetes up to 30 weeks of age. In contrast, NOD euthymic littermates showed almost the same incidences of insulitis and overt diabetes as those of NOD mice. These observations suggest that T cells are essential for the development of insulitis and overt diabetes in NOD mice. PMID- 3542538 TI - Proteoglycans in normal and neoplastic monocytes. AB - 35S proteoglycans produced by normal and neoplastic (U-937) monocytes after a 20 h pulse with [35S]sulfate in vitro have been isolated and compared. Both cell types produce exclusively chondroitin sulfate proteoglycan (CSPG), which are released into the medium and are not contained within the cells. The neoplastic cell-derived molecules were much larger in molecular size, due to the substitution of galactosaminoglycan chains, with an approximate Mr of 60,000. The corresponding chains in monocyte CSPG had an Mr of approx. 20,000. The latter chains were also found to be more sulfated than their neoplastic counterparts. PMID- 3542539 TI - Protein biosynthesis changes in Trypanosoma cruzi induced by supra-optimal temperature. AB - Early during vertebrate infection, T. cruzi is exposed to the host blood at an elevated temperature. Bearing this in mind, the pattern of protein synthesis of two parasite forms was examined. SDS-PAGE of heated organisms showed an increase in at least four proteins (103, 92, 75 and 61 kD). The temperature effect is also manifested in cells whose RNA synthesis is reduced by actinomycin D treatment. The synthesis of the '29 degrees proteins' is inhibited at 40 degrees C in organisms growing in culture medium; when the organisms were maintained in serum, the inhibition was not observed. The inhibitory effect observed at 40 degrees C was reversed when the temperature was shifted to 29 degrees C. These proteins were synthesized for 180 min at 37 degrees C or 360 min at 40 degrees C. The increased protein synthesis manifested at 37 degrees C had decreased 45 min after the temperature was lowered to 29 degrees C. When the cells were pre-incubated at 40 degrees C and shifted to 29 degrees C, the synthesis of the heat-induced proteins proceeded for at least 180 min. This pattern of heat induction in epimastigotes and trypomastigotes is the same irrespective of whether the incubation medium is LIT (for epimastigotes), M-16 (for trypomastigotes), or when serum was used for both cell types. PMID- 3542540 TI - Levels of synthesis of primate-specific nuclear proteins differ between growth arrested and proliferating cells. AB - A monoclonal antibody that reacts specifically with the proliferation-sensitive nuclear proteins, isoelectric focusing (IEF) 8Z30 and 8Z31 (molecular weight (MW), 76,000 charge variants, HeLa protein catalogue number) has been characterized. As determined by indirect immunofluorescence, the antibody stains the nucleolus and nucleoplasm of interphase-cultured cells of primate origin, but does not react with cells of other species. Proteins having similar MWs and isoelectric points as the human or monkey (primates) proteins were not observed in cultured cells of the following species: aves, bat, dog, dolphin, goat, hamster, mink, mouse, pisces, potoroo, rabbit and rat. Quantitative two dimensional (2D) gel electrophoretic analysis of [35S]methionine-labeled proteins synthesized by normal (quiescent, proliferating) and SV40-transformed human MRC-5 fibroblasts revealed significant differences in the levels of synthesis of both IEF 8Z30 and 8Z31. In quiescent cells the main labelled product corresponded to IEF 8Z31 (ratio IEF 8Z31/8Z30, 2.3), while in the transformed cells the major product was IEF 8Z30 (ratio, 0.62). Normal proliferating fibroblasts exhibited similar levels of both proteins (ratio, 1.21). Combined levels of synthesis of both proteins were 1.50 and 1.20 times as high in the transformed cells as in the quiescent and proliferating cells, respectively. Similar results were observed in other pairs of normal and transformed human cells, such as WI38/WI38 SV40 and amnion/AMA. Modulation of the levels of synthesis of these proteins may play a role in cell proliferation. PMID- 3542541 TI - Research update: report from a workshop on cell biology of retinal detachment. PMID- 3542542 TI - Expression of intracellular biochemical defects of lymphocytes in aging: proposal of a general aging mechanism which is not cell-specific. AB - There is a decline in immune capacity with age which is expressed on the organismic level by association with numerous immune-related diseases, on the cellular level by impaired mitogenesis, on the biochemical level by impaired metabolic pathways, and on the molecular level by decreased protein synthesis and degradation. Defects in various cofactors such as calcium and several nucleotides also occur and may be related to the impaired enzyme function during mitogenesis in the aged. The central cause for decreased mitogenesis in the aged could be a decrease in protein synthesis which appears to cause impaired enzyme induction. This impaired enzyme induction accounts in part for the decreased glycolytic flux and DNA synthesis in these cells. Decreased protein synthesis also has been associated with a decreased synthesis of lymphokines which help these cells to proliferate. Numerous other intracellular age-related defects of lymphocytes also occur which may collectively play important interdependent roles in the impaired lymphocyte function of the aged. A potential general underlying mechanism of cellular senescence is proposed based on a genetic "slowing-cycle" effect of transcription, translation, and enzyme induction with immunosenescence presented as an example of an expression of these basic defects. PMID- 3542543 TI - Decrease in number of hippocampal gamma-aminobutyric acid (GABA) immunoreactive cells in the rat kindling model of epilepsy. AB - Daily repeated tetanic electrical stimulation (kindling) of hippocampus or other brain structures leads to progressive increase in epileptiform activity. Since kindling may involve changes in the inhibitory neurotransmitter gamma aminobutyric acid (GABA), the distribution of this amino acid was studied. A significant decrease in number of GABA immunoreactive positive cell bodies in stimulated CA1 region of the rat hippocampus compared to the contralateral side was found. PMID- 3542545 TI - Wet dog shakes in limbic versus generalized seizures. AB - Wet dog shake behavior was studied in different models of epilepsy in the rat. Numerous wet dog shakes were associated with limbic seizures in the course of focal epilepsy induced by kindling stimulations or local injections of kainic or quisqualic acid and progressively disappeared during generalization. On the contrary, they were never observed in models of generalized epilepsy. This study suggests that the number of wet dog shakes may be an index of the progression of limbic seizures toward generalization. PMID- 3542544 TI - Behavioural effects of human fetal dopamine neurons grafted in a rat model of Parkinson's disease. AB - The ventral mesencephalon, containing the developing dopaminergic neurons of the substantia nigra-ventral tegmental region, was obtained from aborted human fetuses of 9-19 weeks of gestation. The tissue was grafted into the striatum of rats previously subjected to a 6-hydroxydopamine lesion of the mesostriatal dopamine pathway. The graft recipients were immunosuppressed by daily injections of Cyclosporin A. Amphetamine-induced motor asymmetry was reduced, and finally totally reversed, only in rats receiving grafts from the 9-week old fetal donor. The fluorescence microscopic analysis revealed large numbers of surviving dopamine neurons, and extensive fiber outgrowth into the host striatum, in these rats. By contrast, rats receiving grafts from 11-19 week old donors had at most only few surviving dopamine neurons. These results indicate that human fetal mesencephalic tissue may be an efficient source of dopamine neurons for functional intracerebral grafting in patients with Parkinson's disease. PMID- 3542546 TI - Plasmodium falciparum: inhibition in vitro with lactoferrin, desferriferrithiocin, and desferricrocin. AB - The microbial iron chelators desferriferrithiocin and desferricrocin as well as human lactoferrin were tested in vitro against Plasmodium falciparum. The microbial chelators inhibit the growth of P. falciparum in a dose dependent way. Parasite multiplication is stopped at 25-30 microM desferriferrithiocin, whereas 60-90 microM desferricrocin are needed to exhibit the same effect. After iron saturation, the microbial chelators are ineffective. Human lactoferrin (30 microM), both iron free and iron saturated, inhibits P. falciparum. A 3-day preincubation of host erythrocytes with iron free and iron saturated lactoferrin prior to infection enhances this effect, which is therefore attributed to lactoferrin bound iron. It has been suggested that the lactoferrin/iron complex generates oxygen free radicals, which may cause membrane damage of both erythrocyte and parasite. This process can be considered to lead to growth inhibition of the parasite. PMID- 3542547 TI - Trypanosoma cruzi: ultrastructural visualization of fibronectin bound to culture forms. PMID- 3542549 TI - Plasmodium falciparum: identification and localization of a knob protein antigen expressed by a cDNA clone. AB - Differential screening of cDNA libraries constructed from knobby and predominantly knobless Plasmodium falciparum isolates, identified the sequence SD17. Chromosome blotting experiments have shown that this sequence, which is located on chromosome 2 of most isolates, was deleted in the cloned parasite line E12 of the FCQ27/PNG isolate. Here we show that erythrocytes infected with the SD17-containing cloned line D10 have typical knob structures on their surfaces, whereas those infected with the line E12 lack knobs. An expression clone was constructed from SD17 and used to affinity purify antibodies from the sera of individuals living in areas of Papua New Guinea where malaria is endemic. The antibodies reacted in immunoblotting experiments with a single polypeptide that varied in Mr from 85,000 to 105,000 among different isolates. The antigen was not expressed in the knobless clone E12. Postembedding immunoelectron microscopy showed localization of the antigen over the knobs of FC27 and two other isolates, largely on the cytoplasmic side. We conclude that the parasite antigen corresponding to clone SD17 is a knob protein. PMID- 3542548 TI - Fasciola hepatica: action in vitro of triclabendazole on immature and adult stages. AB - Under in vitro conditions in a balanced salt solution, triclabendazole was found to accumulate in significant amounts in both immature (3 week old) and adult Fasciola hepatica. A viable parasite was needed to concentrate the drug, but a high percentage of the compound was also bound by the dead worm. The drug could penetrate into liver flukes even when the oral route had been closed off by ligation, indicating that the drug can be taken up by transtegumentary absorption. A 24 hr exposure to triclabendazole, at 10-25 microM concentrations, was found to result in a strong inhibition of the parasite's motility. This effect was paralleled by dramatic changes in the worm's resting tegumental membrane potential. The onset of these actions was found to develop very slowly, and high drug levels had to accumulate within the parasite to initiate its immobilization. In addition to drug concentration and incubation time, physiological alterations observed were also dependent on other culture conditions, such as the presence or absence of serum albumin and the drug tissue/medium ratio. Biochemical examinations showed that triclabendazole significantly stimulated glucose derived acetate and propionate formation by adult liver flukes. Adenosine triphosphate levels were not changed even in the presence of high triclabendazole concentrations (25 microM). Likewise, the activities of various membrane associated adenosine triphosphatases were not altered by the drug. However, the ability of the drug to inhibit colchicine binding to microtubular protein purified from adult liver flukes suggested an interference of the drug with microtubular structure and function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542550 TI - Increased degradation in rat liver induced by antilipolytic agents: a model for studying autophagy and protein degradation in liver? AB - A dramatic increase in the plasma glucagon/insulin ratio can be induced by treating fasted rats with antilipolytic drugs (e.g., with 3,5-dimethylpyrazole, 12 mg/kg body wt). These hormone changes are the physiologically appropriate response to a rapid decrease in free fatty acids and glucose plasma levels. Under this experimental condition, many vacuolated lysosomes can be observed at the electron microscopic level as early as 30 min and autophagic vacuoles are detectable in the liver cells 1 hr after the administration of the drug. By 1 hr and 45 min, vacuoles often contain recognizable peroxisomes. At the biochemical level, liver proteolysis in vitro is increased significantly. Very interestingly, changes in peroxisomal (but not mitochondrial or reticulum or cytosolic) enzyme activities are detected that are preventable by the administration of glutamine (i.e., of an inhibitor of proteolysis in vivo) but not by an isocaloric amount of glycine or alanine. It is concluded that the administration of antilipolytic agents to fasted animals may provide a convenient (i.e., an inexpensive, highly reproducible and timable) physiologic model to study hormone-induced autophagy in liver cells. PMID- 3542551 TI - Flow cytometric quantification of cholesteryl ester-containing "foam" cells. I. Analysis of aortas from normolipidemic swine. AB - We have quantified using flow cytometry foam cells of aortas from normolipidemic swine varying in age from 6 months to 12 years. These swine were maintained throughout their lives on a low-fat, cholesterol-free diet. Intimal-medial tissues removed from the swine aortas were enzymatically dissociated to prepare Formalin-fixed cell suspensions. Foam cells were labeled by specific staining of their intracellular cholesteryl ester using the fluorescent dye filipin. This was carried out by first removing cellular unesterified cholesterol with ethanol, then enzymatically hydrolyzing cellular cholesteryl ester, and finally staining with filipin the unesterified cholesterol derived from hydrolysis of cholesteryl ester. Results of flow cytometric analysis indicated that thoracic foam cell densities of female swine became more variable and tended to increase with age. It appeared that there were two subgroups of female swine with either high or low levels of thoracic foam cells. A similar finding was not observed for abdominal foam cells in female swine nor for thoracic or abdominal foam cells in the smaller number of older male swine. Abdominal foam cell densities in younger males, however, also appeared to be comprised of low and high foam cell groups. Foam cell densities did not correlate with serum cholesterol or triglyceride levels. However, a genetic basis for some of the variability in foam cell densities among these animals was suggested by the observation that females with high thoracic foam cell densities had greater commonality among ancestors than did females with low thoracic foam cell densities. PMID- 3542553 TI - Familial Creutzfeldt-Jakob disease in France: epidemiological implications. AB - Of 329 patients dying of Creutzfeldt-Jakob disease (CJD) in continental France between 1968 and 1982, 19 (6%) were familial cases. Genealogical investigation permitted the identification of 19 additional cases, bringing the total number of familial CJD cases reported here to 38. There are 6 definitely affected families, yielding an average of 6.3 cases per family. Mediterranean Jews account for one third of all the cases, with Tunisian Jews constituting two-thirds of this ethnic group. Males and females are equally affected. The overall rate of occurrence (47.3%) is consistent with autosomal dominant transmission, but wide variations in individual pedigrees (26.7%-80%) leave this hypothesis open to scrutiny. Age at death is 10 to 15 years lower in familial than in sporadic CJD, suggesting the possible inheritance of "short incubation" genes in certain CJD families. Disease duration is longer in familial than in sporadic CJD, but this could be the effect of ascertainment bias. There is no evidence for maternal lineage. While members of a given family tend to die within the same age bracket, our data fail to discriminate between vertical transmission and common source exposure as hypothetical transmission mechanisms within affected families. CJD occurrence in a woman related by marriage to an unaffected branch of a CJD family, but who was raised in early childhood by the affected branch, argues in favor of horizontal transmission early in life. Analysis of death intervals and geographic/temporal separations suggests minimal incubation periods of up to 43 years. A family combining clinico-pathological features of CJD and the Gerstmann-Straussler syndrome (GSS) indicates a nosological relationship between the two. The "genetic susceptibility" of members of CJD-affected families may be due to accelerated derepression of normally repressed host genes, coding for abnormal amyloid-type proteins. Accumulation of these proteins may play an important role in the pathogenesis of CJD and scrapie, and constitute a common pathogenetic mechanism in several neurological diseases, including Alzheimer's disease (AD) and senile dementia of the Alzheimer type (SDAT). PMID- 3542552 TI - Hyalohyphomycosis and phaeohyphomycosis: two global disease entities of public health importance. AB - Two relatively new opportunistic diseases--hyalohyphomycosis and phaeohyphomycosis--are the byproduct, in most cases, of the progress being made in combating microbial and non-microbial diseases. Immunologically impaired hosts have become vulnerable to infection by fungi that were long considered to be innocuous. The currently known etiologic agents of these two diseases are listed and pertinent literature references are cited. The basic histologic differences between phaeohyphomycosis and chromoblastomycosis was emphasized and illustrated. PMID- 3542554 TI - Rapid method for purification of Clostridium botulinum type C neurotoxin by high performance liquid chromatography (HPLC). AB - The culture supernatant of Clostridium botulinum type C, concentrated by addition of RNA, acid precipitation and subsequent protamine treatment was used as starting material for rapid purification of L toxin (mol. wt. ca. 500K) and M toxin (mol. wt. ca. 350K) of C1 neurotoxin by ion-exchange chromatography on a Mono S column by fast performance liquid chromatography (FPLC). L and M toxins were highly purified further by gel permeation chromatography through a TSK G3000SW column at pH 6.0 by high performance liquid chromatography (HPLC). Purified S toxin (mol. wt. ca. 150K, C1 neurotoxin without a nontoxic component) was then obtained from L toxin rapidly by gel permeation chromatography at pH 7.3 through a TSK G3000SW column by HPLC. Purified S toxin was also obtained rapidly from M and L toxins by ion-exchange chromatography on a Mono Q column at pH 8.0 using an FPLC system. The purified preparations of L, M and S toxins gave single bands on conventional polyacrylamide gel electrophoresis, and had specific activities of 2.8, 6.7, and 14-21 X 10(7) LD50/mg N, respectively, in mice. On immunoelectrophoresis, purified S toxin gave a single arc against anti-crude toxin serum. The yield of toxicity as L and M toxins was 73.1% (32.5% as L toxin and 40.6% as M toxin) from the protamine-treated concentrated culture supernatant. The recovery of toxicity as S toxin from purified L or M toxin was almost 100% (97.6-100% of L toxin and 97.5% of M toxin). These procedures provide a rapid method for purifying L and M toxins, which have stable toxicities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542555 TI - Relationship between immune system and gram-negative bacteria, binding of Salmonella pullorum-gallinarum to chicken lymphocytes. AB - Salmonella pullorum-gallinarum binding to chicken lymphocytes has been evaluated in individuals of different age (1-20 wks). Bacterial adherence has been studied on lymphoid cells recovered from thymus, spleen, bursa and peripheral blood. Binding was age-dependent and neuraminidase treatment of lymphoid cells led to an increase of adherence. In addition, by using two monoclonal antibodies, the CT-1, which defines thymocytes and the M-4 which identifies surface IgM and an avian homologue of mammalian IgD on B lymphocytes, distribution of Salmonella pullorum gallinarum binding to T and B lymphocytes has been analyzed. Results show that either T lymphocytes or B lymphocytes have the capacity to form rosettes with Salmonella. In particular, B cells from bursa and spleen display the highest capacity of adherence to bacteria, this supporting the defence function which has been attributed to bursa of Fabricius. PMID- 3542556 TI - Some biological activities of Eikenella corrodens major outer membrane proteins. AB - Major outer membrane proteins of Eikenella corrodens, an organism frequently isolated from patients with periodontal disease, were tested for some biological activities. Mouse peritoneal macrophages, exposed at low concentrations of the above-mentioned proteins (between 0.05 and 5 micrograms/ml), showed evident and marked morphological modifications consisting of increases in the size and vacuolation of the cells. Higher concentrations showed a toxic effect. Low concentrations resulted in a selective release of lysosomal enzymes without any significant release of lactatedehydrogenase, and cytoplasmic marker; while concentrations of 25-50 micrograms/ml, which were toxic in trypan-blue exclusion test, increased LDH release. Eikenella corrodens major proteins increased the platelet aggregation of ADP and thrombin. The residual complement activity of serum samples incubated with various amounts of proteins at 37 degrees C for 30 minutes appeared strongly reduced with respect to controls, thus showing a consumption of the complement components. These results suggested that Eikenella corrodens major proteins may play a role in the development of periodontal lesions. PMID- 3542557 TI - Epidemiological study of surgical wound infections. AB - The present report describes the results obtained in an epidemiological study of surgical wound infections through a continuous and active epidemiological surveillance program lasting one year and which covered all the Surgical Services of the University Clinical Hospital. The number of infections studied was 217, with an overall infection rate of 3%. The majority of the infections (46.5%) were detected in the General Surgery Service. Regarding the infection rate by Services, the highest corresponded to the Urology Service, with a rate of 10%. In 26% of the cases, other hospital-acquired infections occurred in patients who underwent a surgical operation. The microorganisms responsible for the infections observed were mainly Gram-negative (67%), and within these the most commonly isolated were E. coli and Proteus spp.. PMID- 3542559 TI - Medicaid expenditures for newborns. PMID- 3542558 TI - Estimating the public costs of teenage childbearing. AB - A formula for making national, state and local estimates of the cost to the public of teenage childbearing is derived from a review of 12 studies. The formula is then applied to U.S. data. The calculations yield a single-year cost for 1985 of $16.65 billion paid through three programs--Aid to Families with Dependent Children, food stamps and Medicaid--for women who first gave birth as teenagers. The calculations also show that the public will pay an average of $13,902 over the next 20 years for the family begun by each first birth to a teenager in 1985 and $5.16 billion over the same period for the families of all teenagers experiencing a first birth in 1985. If all teenage births were delayed until the mother was 20 or older, the potential savings to the public would be $5,560 for each birth delayed and $2.06 billion for the entire cohort of teenagers who would otherwise have had a first birth in 1985. PMID- 3542560 TI - Mitotic inhibitors arrest the growth of Plasmodium falciparum. AB - We report that the mitotic inhibitor, vinblastine (VLB), is highly toxic to the malarial parasite, Plasmodium falciparum. In cultures in vitro growth is inhibited by 50% at a VLB level of about 28 nM, and totally abolished at a level of 100 nM. By tests on synchronized cultures we have found that the effect of VLB takes place at the trophozoite stage. Colcemid also inhibits schizogony with somewhat different kinetics. By mutagenesis with nitrosoguanidine followed by VLB selection we have isolated a VLB-resistant mutant which exhibits cross-resistance to vincristine. These data suggest a critical role of microtubules in the asexual schizogonic cycle of P. falciparum. PMID- 3542561 TI - Accessibility of phosphodiester bonds in the yeast ribosomal 5 S RNA protein complex. AB - The tertiary structure of the protein-associated yeast ribosomal 5 S RNA was examined using ethylnitrosourea reactivity as a probe for phosphodiester bonds. A reduced reactivity was consistently observed in at least nine residues within four distinct regions of the RNA sequence. Seven of these were also observed in three regions of the free RNA molecule while two, A27 and G30, were only present in the ribonucleoprotein complex. The results strongly suggest that the tertiary structure of the free eukaryotic 5 S RNA is largely conserved in the 5 S RNA protein complex although it appears to be further stabilized in interaction with the ribosomal protein. PMID- 3542562 TI - The complete amino acid sequences of the 5 S rRNA binding proteins L5 and L18 from the moderate thermophile Bacillus stearothermophilus ribosome. AB - The complete amino acid sequences of the 5 S rRNA binding proteins L5 and L18 isolated from ribosomes of the moderate thermophile Bacillus stearothermophilus are presented. This has been achieved by the sequence analysis of peptides derived by enzymatic digestions with trypsin, chymotrypsin, pepsin, and Staphylococcus aureus protease, as well as by chemical cleavage with cyanogen bromide. The proteins L5 and L18 consist of 179 and 120 amino acid residues, and have Mr values of 20,163 and 13,473, respectively. A comparison of the sequences with their counterparts from the Escherichia coli ribosome reveals 59% identical residues for L5, and 53% for L18. For both proteins, the distribution of conserved regions is not random along the protein chains: some regions are highly conserved while others are not. The regions which are conserved during evolution may be important for the interaction with the 5 S rRNA molecule. PMID- 3542563 TI - The complete amino acid sequence of ribosomal protein S12 from Bacillus stearothermophilus. AB - The amino acid sequence of ribosomal protein S12 from Bacillus stearothermophilus has been completely determined. The sequence data were mainly obtained by manual sequencing of peptides derived from digestion with trypsin, Staphylococcus aureas protease and pepsin. A few overlaps of tryptic peptides were established by DNA sequence analysis of a chromosomal fragment containing the rpsL gene coding for ribosomal protein S12. The protein contains 138 amino acid residues and has an Mr of 15,208. Comparison of this sequence with the sequences of the ribosomal S12 proteins from E. coli as well as from Euglena, tobacco and liverwort chloroplasts shows that 75% of the amino acid residues are identical within the S12 proteins of all four species. Therefore, S12 is the most strongly conserved ribosomal protein known so far. PMID- 3542564 TI - c-Ha-ras gene products are potent inhibitors of cathepsins B and L. AB - c-Ha-ras proteins produced by Escherichia coli inhibited the activities of cathepsins B and L which had been partially purified from rat kidney. Furthermore, amino acid sequence homology between c-Ha-ras proteins and thiol proteinase inhibitors has been found. PMID- 3542565 TI - Role of tryptophan 54 in the binding of E. coli single-stranded DNA-binding protein to single-stranded polynucleotides. AB - Fluorescence and optical detection of triplet state magnetic resonance spectroscopy have been employed to study the complexes formed by single-stranded polynucleotides with both E. coli single-stranded DNA-binding protein and an E. coli ssb gene product in which Trp-54 is replaced by phenylalanine using site specific oligonucleotide mutagenesis. Our results strongly suggest the involvement of Trp-54 in stabilizing the protein-nucleic acid complexes via stacking interactions of the aromatic residue with the nucleotide bases. PMID- 3542566 TI - Truncated glucagon-like peptide I, an insulin-releasing hormone from the distal gut. AB - By hydrophobic gel permeation and high pressure liquid chromatography we isolated from pig intestinal mucosa a peptide which corresponds to proglucagon 78-107 as suggested by chromatography and determination of its N-terminal sequence. Natural and synthetic proglucagon 78-107 dose dependently and potently increased insulin secretion from the isolated perfused pig pancreas. Proglucagon 78-107 also secreted by the small intestine may participate in the hormonal control of insulin secretion. PMID- 3542568 TI - Rat liver membranes contain a 120 kDa glycoprotein which serves as a substrate for the tyrosine kinases of the receptors for insulin and epidermal growth factor. AB - The receptors for insulin and epidermal growth factor possess tyrosine-specific protein kinase activity which may play a role in mediating the biological actions of these two peptides. We have identified a 120 kDa glycoprotein (pp120) in rat liver plasma membranes which can be phosphorylated by the insulin receptor in a cell-free system and in intact cultured hepatoma cells. In the present report, we have demonstrated in a cell-free system that solubilized epidermal growth factor receptors can phosphorylate tyrosine residues in pp120. PMID- 3542567 TI - Correlation among sites of limited proteolysis, enzyme accessibility and segmental mobility. AB - The relationship among accessibility to an enzyme, flexibility, and limited proteolysis was explored. Regions accessible to large probes, comparable in size to proteolytic enzymes, were computed in the crystallographic structures of thermolysin, trypsinogen and ribonuclease. Positions of these accessible regions were compared with sites of autolytic/proteolytic attacks, and with locations of flexible backbone segments. All the proteolytic sites were found to be exceptionally accessible. Most of them were also flexible, but at least one prominent site in trypsinogen appeared to be rigid. Thus, surface exposure seems to be more essential to proteolysis than flexibility. PMID- 3542569 TI - RNA polymerase molecules initiating transcription at tandem promoters can collide and cause premature transcription termination. AB - Using purified E. coli RNA polymerase we have studied the transcription in vitro of a series of DNA fragments carrying two tandemly arranged promoters, where the corresponding transcription start points were separated by 263, 138, 83 and 78 base pairs. In the case where the transcription start points are 83 base pairs apart, there is an interaction between RNA polymerase molecules transcribing from the two promoters. This interaction results in premature termination of the upstream transcript at a precise site. We propose that this is the result of RNA polymerase transcribing from the upstream promoter bumping into polymerase at the downstream promoter. The interaction between the two polymerase molecules is crucially dependent on the distance between the two promoters. PMID- 3542570 TI - Vapor-phase modification of sulfhydryl groups in proteins. AB - Proteins and peptides are readily and specifically modified at their sulfhydryl groups by the vapors of a mixture of 4-vinylpyridine and tributylphosphine. The phenylthiohydantoin derivative of S-beta-(4-pyridylethyl)cysteine formed during sequence analysis is easily detectable in current identification systems. PMID- 3542571 TI - The inflammatory reaction in the airways in an animal model of the late asthmatic response. AB - The late asthmatic response is defined as airway obstruction that occurs hours after antigen exposure in some atopic asthmatics. The importance of this reaction is that the airway obstruction may be severe, prolonged, and difficult to control unless corticosteroids are employed. In addition, this response may lead to an increase in airway reactivity. To investigate the immunopathogenesis of this disorder, an animal model in rabbits was developed. In this model, antigen specific IgE was associated with the late asthmatic response and antigen-specific IgG was associated with blunting of the reaction. Antigen challenge of immune rabbits led to edema within the large airways shortly after antigen exposure, with infiltration of inflammatory cells (neutrophils and eosinophils) into the large and small airways during the late response. The infiltrates became more mononuclear with time and resolved over 10 days. As in humans, the late response was associated with an increase in airway reactivity and correlated temporally with infiltration of the airways with neutrophils and eosinophils. The contribution of granulocytic cells to the airway responses to antigen was studied by granulocyte depletion, which prevented both the late response and the heightened airway reactivity. In addition, transfusion of a neutrophil-rich population of white cells into granulocytopenic immune rabbits restored both responses. Thus, in this animal model, the antigen-induced late asthmatic response and subsequent increase in airway reactivity were dependent on the presence of granulocytes at the time of exposure to antigen. PMID- 3542572 TI - Thromboxane A2 in health and disease. PMID- 3542573 TI - Pharmacology of thromboxane synthetase inhibitors. AB - Several selective and potent thromboxane synthetase inhibitors have now been described. In this paper I shall summarize their effects on platelet aggregation, endotoxin- and thrombin-induced pulmonary hypertension, the Forssman reaction induced thrombocytopenia, and the rat tail vein bleeding time. Although any clinical utility of thromboxane synthetase inhibition remains to be demonstrated, it may be useful in conditions where vasoconstriction or vasospasm are involved, particularly where platelet activation is a contributing factor. PMID- 3542574 TI - Opioids in the regulation of food intake and energy expenditure. AB - This paper and the following four papers summarize a symposium on the role of opioids in regulation of feeding, body weight, and energy expenditure. The central sites of opioid action are discussed, as is opioid activity in invertebrates, large animals, and humans. This paper provides a historical review of developments in the field from the early concepts of an endogenous opioid system to the current understanding of multiple receptor types and their interaction in regulating ingestive behavior. Opioids from all three opioid families may stimulate food intake, and some evidence exists that opioids may stimulate energy expenditure. Eating and drinking behavior is very complex and involves a number of components. Our understanding of the role of opioids in this process is shallow, and future research must be designed carefully to evaluate individual components of ingestive behavior. PMID- 3542576 TI - Central representation of visceral function. AB - Recent studies of the visceral sensory system, using both electrophysiological and neuroanatomical methods, indicate that there is representation of multiple visceral modalities at all levels of the central nervous system. In the nucleus of the solitary tract gustatory afferents are represented rostrally, and general visceral afferents caudally. At the pontine relay, the parabrachial nucleus, the gustatory afferents are represented medially, and the general visceral afferents laterally. Although the evidence for anatomical separation of visceral projections is incomplete for the hypothalamus and amygdala, the visceral sensory thalamus and cortex are viscerotopically organized. The results indicate that the ascending visceral sensory system is viscerotopically organized at all levels of the brain, and that this information is important for the integration of autonomic responses at all levels of the neuroaxis. PMID- 3542575 TI - Central structures involved in opioid-induced feeding. AB - This paper summarizes efforts to identify structures involved in the opioid regulation of feeding. Many opioid agonists and antagonists increase or decrease food intake when injected centrally, which suggests, but alone does not prove, that the opioid feeding system is located within the brain. Some conditions of hunger and feeding cause changes in opioid peptide levels in certain brain areas, notably the hypothalamus, which may indicate that the areas are components of this opioid system. Lesion studies have also identified some potentially important structures, inasmuch as lesions of these structures reduce the effectiveness of opioid agonists or antagonists to alter food intake. Finally, microinjection studies have mapped the brain in terms of the effects on feeding of opioid agonists and antagonists. Results of different types of studies are consistent in suggesting that parts of the hypothalamus, particularly the paraventricular and ventromedial nuclei and the lateral hypothalamic area, are important components of the opioid feeding system. PMID- 3542577 TI - Opioid regulation of food intake and body weight in humans. AB - Relatively few studies of humans have evaluated the effects of opioids on food intake and body weight. Most have focused on the potential role of opioids in the etiology of obesity. Measurements of endogenous opioids in plasma or spinal fluid of humans reveal higher levels, particularly of beta-endorphin, in obese subjects. Opioid agonists such as methadone and butorphanol tartrate stimulate food intake, and all studies with naloxone, an opioid antagonist, demonstrate a reduction of short-term food intake in obese or lean humans. Long-term studies with naltrexone, an antagonist similar to naloxone, show no effect on food intake or body weight. Opioid agonists or antagonists have little effect on nutrient selection in humans. The effects on feeding-related hormones is equivocal. Further studies with more specific opioid receptor activities are needed. PMID- 3542578 TI - Interaction of the formed elements of blood with the coronary vasculature in vivo. AB - Considerable attention is being given to the interactions that occur among blood platelets, neutrophils, and the vascular endothelium. There is an increasing awareness that the various blood elements interact in the process of thrombus formation and vascular occlusion. In addition, interactions among these cells can lead to the formation and release of vasoactive substances that have the potential to modulate regional blood flow. This review focuses on the coronary vascular bed and an assessment of how cell-cell interactions, under normal physiological conditions as well as in the presence of myocardial injury, may lead to alterations in coronary vascular resistance and myocardial function. Should related events be operative in human clinical states of disease, the circulating elements of the blood may serve as targets in the development of therapeutic interventions to regulate myocardial blood flow. PMID- 3542579 TI - Role of platelet and vascular eicosanoids in the pathophysiology of ischemic heart disease. AB - The role of platelet and vascular arachidonate metabolism in ischemic heart disease can be derived from direct measurements and/or inhibitor trials. Direct measurements have yielded somewhat conflicting results, largely related to analytical problems and ex vivo platelet activation during blood sampling. On the other hand, inhibitor trials have clearly established the following: 1) thromboxane (TX) A2-dependent platelet activation plays an important role in the dynamic process of coronary thrombosis in unstable angina, 2) TXA2 does not appear to mediate coronary vasospasm, as seen in variant angina, 3) endogenous prostacyclin (PGI2) is not released in response to myocardial ischemia and is unlikely to regulate coronary blood flow, and 4) exogenous PGI2 is of limited therapeutic benefit. The demonstration that low-dose aspirin (0.5-1.0 mg/(kg X day] is a selective inhibitor of TXA2-dependent platelet function provides a conceptual and practical framework for the rational design of future trials. Moreover, the identification of major enzymatic metabolites of TXB2 in plasma (11 dehydro-TXB2) and urine (2,3-dinor-TXB2) and development of appropriate analytical techniques offer the opportunity for better defining the pathophysiological role of TXA2 in humans. PMID- 3542581 TI - Origin of the American Physiological Society. PMID- 3542580 TI - Acute inflammation in gram-negative infection: endotoxin, interleukin 1, tumor necrosis factor, and neutrophils. AB - Experimental bacterial infection of the dermis induced with gram-negative microorganisms is associated with an acute inflammatory reaction, which represents the principal local defense against spread of the infection. When the inflammatory reaction is quantitated with radiolabeled cells and proteins, the kinetics resemble acute inflammation induced with other agents, such as immune complexes or chemotaxins. There is an interrelationship between the components or events of the inflammatory reaction; inasmuch as vascular injury is neutrophil dependent, neutrophils must migrate to the site where the bacteria multiply. In neutropenic animals there is no such emigration and bacterial multiplication is not inhibited. The microorganisms shed endotoxin, which in turn induces secretion of interleukin 1 (IL 1) and probably tumor necrosis factor. Endotoxin is the most potent agent (10(-15) mol vs. 10(-12) mol of C5ades Arg) capable of inducing a neutrophil influx. Desensitization or tachyphylaxis of the tissues (probably of postcapillary venular endothelium) to IL 1 seems to control cessation of the neutrophil influx (also in vitro evidence). Phagocytosis of the bacteria by neutrophils is associated with release of oxygen radicals and lysosomal proteases from the neutrophils. These are instrumental in eliciting microvascular injury, which is characterized by enhanced vasopermeability, hemorrhage, and thrombosis. PMID- 3542582 TI - The beginnings of the American Society of Biological Chemists. PMID- 3542583 TI - The American Society for Pharmacology and Experimental Therapeutics. PMID- 3542584 TI - History of the American Association of Pathologists. PMID- 3542585 TI - The American Institute of Nutrition. PMID- 3542586 TI - The development of immunology in America. PMID- 3542587 TI - The history of the Federation of American Societies for Experimental Biology. PMID- 3542588 TI - Vasomotor control: functional hyperemia and beyond. AB - Historically, functional hyperemia has been viewed largely as an interaction between a parenchymal cell and its associated microvasculature. Locally released metabolites have been thought to produce relaxation of the smooth muscle and a vasodilation that increases blood flow in proportion to metabolic need. This symposium report presents evidence from a variety of disciplines and a number of different types of biological preparations that demonstrates that functional hyperemia is a complex process involving several classes of microvessels including capillaries, arterioles, and small arteries. These vessels do not function independently but are coordinated by a complex set of interrelations involving at least three different modes of interaction between parenchymal cells and the various segments of the vascular bed. These are local metabolic effects, propagated effects extending over long segments of the vasculature, and flow dependent vasodilation induced by local changes in blood flow. In addition to these acute responses to metabolic demand it appears that tissues may be capable of more long-term structural alterations of the arterial and arteriolar network in response to sustained changes in the relationship between supply and demand. The vascular bed appears to be able to adapt either by increasing the maximal anatomic diameter of the large arteries or by inserting new arterioles into the parenchyma. Thus, classical functional hyperemia appears to be but one manifestation of a multifaceted process leading to highly coordinated responses of many vascular elements, resulting finally in vascular patterns that are optimized to meet parenchymal cell demands. PMID- 3542590 TI - [Acute leukemia]. PMID- 3542589 TI - New techniques for studying digestion and absorption of nutrients by ruminants. AB - Physical constraints on ruminal digestion have received concentrated research attention in the past 10 years. With scanning electron microscopy, microbial attack and digestion of forage components in the rumen have been observed. Limits to passage through the digestive tract have been explored with digesta flow markers and particle-sizing devices. Diet composition analysis has been simplified by near-IR reflectance. NMR procedures, and histological indexing. Rumen microbial function and genetics are being examined by new procedures and genetically altered microbes are being used for production of specific nutrients. Isolated microbial enzymes are being used in feed analysis. The site of digestion in vivo has received detailed attention with new cannula designs, digesta flow markers, and constitutive microbial markers. Ruminants are being maintained by intragastric or i.v. infusion of purified nutrients to quantitate nutrient requirements. Static and dynamic models of digestive function are aiding in the interpretation of research data. Unfortunately, many new procedures have not been critically standardized against traditional methods. The complexity of certain new techniques and models complicates critical review, publication, and comprehension of research results. The most important laboratory tool for increasing research knowledge is still the alert, fertile human imagination. PMID- 3542591 TI - [Physicians--Decembrists]. PMID- 3542592 TI - Patient complains of blisters. PMID- 3542593 TI - [The effect of glucose concentrations on the functional maturation of monolayer cultured B cells of neonatal rat pancreases]. AB - The effect of glucose concentration in medium on the functional maturation of developing B cells was studied in pancreatic monolayer cultures of the neonatal rat. After a 3-day treatment with 10 microM iodoacetic acid in TCM 199 medium containing 5.5 mM glucose to selectively delete fibroblasts, the monolayer cultures were kept in the medium with either 5.5 mM glucose or 16.7 mM glucose for up to a total of 12 days. They were then perifused several times so that the phasic insulin secretion could be examined. On day 0, untreated B cells showed a monophasic insulin secretion in response to a 16.7 mM single dose of glucose, whereas in the presence of 200 nM 12-o-tetradecanoyl phorbol-13-acetate, 10 microM forskolin, 1 mM 3-isobutyl-1-methylxanthine or 40 microM lysophosphatidylcholine, the same dose of glucose stimulated insulin secretion in a biphasic fashion. Further, 20 mg/dl sodium salicylate, 100 microM tetracaine or 100 microM p-bromophenacylbromide used concurrently with 16.7 mM glucose also induced a biphasic insulin secretion, but their ability to stimulate insulin secretion was less than that of the other drugs mentioned above. Also, B cells on day 3 that had been exposed to iodoacetic acid responded to glucose in a similar manner to that of B cells on day 0, and the response to 10 mM of either leucine or 2-ketoisocaproate was monophasic. By contrast, B cells that had been kept in 5.5 mM glucose on day 7 responded in a biphasic fashion, not only to 16.7 mM glucose but also to 10 mM of either leucine or 2-ketoisocaproate. The biphasic pattern evoked by glucose was still preserved in magnitude on day 15, whereas the response to leucine and 2-ketoisocaproate decreased to one-third that of B cells on day 7. On the other hand, when the concentration of 16.7 mM glucose was present in the medium, B cells on day 7 showed a biphasic pattern of insulin secretion in response to 16.7 mM glucose, although the magnitude of the response was quantitatively less than that of B cells in a physiological concentration of glucose. And again the response to 10 mM of either leucine or 2-ketoisocaproate appeared monophasic. On day 15, an increased response to secretagogues with a biphasic pattern of insulin secretion was observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542594 TI - [An analysis of islet cell surface antigen defined by monoclonal islet cell surface antibody 5C12]. AB - Monoclonal antibody 3A4 to islet cell surface antigen has been previously established in our laboratory, using hybridization of spleen lymphocytes from non obese diabetic (NOD) mice transferred into immunologically incompetent recipient mice. In the present study, monoclonal islet cell surface antibody 5C12 could be newly obtained in the 10:1 ratio of NOD mice spleen cells and mouse myeloma cells (SP2/0) without any modifications. Protein A radioligand assay and indirect immunofluorescence on living cells showed that 5C12 antibody reacted to normal rat islet cells and cultured rat insulinoma cells (RIN-r), but not to cultured lymphocytes (Bri-7, IM-9) and Chang-liver cells. Analysis of 125I-labeled antibody binding revealed that unlabeled 5C12 effectively inhibited subsequent 125I-5C12 binding to RIN-r cells, whereas unlabeled 3A4 did not. The scatchard plot from these data showed the curvilinearity, and about 150,000 binding sites to antibody per RIN-r cell were counted. The treatment of RIN-r cells with papain and neuraminidase reduced the binding of 5C12 to RIN-r cells, whereas the effect of trypsin was not observed. Immunoprecipitation of 125I-labeled insulinoma cell lysates followed by SDS-PAGE and autoradiography indicated that 5C12 recognized 105K dalton cell surface protein in RIN-r cells. Immunoblotting also showed that 5C12 antibody recognized 105K dalton cell surface protein in RIN-r cells. These results demonstrated that 5C12 was an important tool for clarifying the immunoresponse against certain antigenic determinants on pancreatic B cells. Furthermore, 5C12 has not only qualitatively and quantitatively improved diagnostic methodology, but it may also provide new reagents useful to the treatment and prevention of type 1 diabetes. PMID- 3542596 TI - Lecithin determination in foods and drugs by an amperometric enzymatic sensor. AB - A new enzymatic-amperometric method for the determination of lecithin as an additive in foods and as a component of commercial drugs is proposed. The method is based on a detector realized with two enzymes, choline oxidase and phospholipase D, the former immobilized, the latter free in solution, and by an oxygen Clark electrode. The experimental conditions were investigated in order to obtain wide applications with different samples. Extraction or dissolution of the samples in ethanol proved satisfactory. The precision of the method was found to be about 1.5%, inaccuracy less than or equal to 4%. Correlation between the proposed enzymatic-amperometric method and an enzymatic-spectrophotometric reference method was satisfactory. PMID- 3542595 TI - [Mechanism of the blunted glucagon response to insulin-induced hypoglycemia in diabetics]. AB - It has been widely reported that dysfunctions of pancreatic A-cell occur in diabetics. Since these pancreatic A-cell dysfunctions are not normalized by conventional insulin injection treatment, they were thought to be a primary defect of diabetes mellitus. Recently it was found that paradoxic glucagon secretion to oral glucose and excessive glucagon response to i.v. arginine could be perfectly normalized if strict blood glucose regulations were achieved with appropriate insulin treatment. However, there has been no report on the perfect normalization of glucagon secretion in response to insulin-induced hypoglycemia in diabetics. In this report, to elucidate the precise significance of A-cell function in hypoglycemia in diabetics, the effect of long-term strict glycemic regulations and the importance of intact autonomic nerve function on hypoglycemia induced glucagon secretion were studied. In experiments on hypoglycemia-induced glucagon secretion in diabetics, 0.2 to 0.3 U/kg of regular insulin injection were usually employed to overcome the hyperglycemia and insulin resistance. However, hyperinsulinemia has been demonstrated to suppress A-cell function in experiments using the euglycemic clamp technique. Therefore, the effect of plasma insulin concentrations after insulin injections was first studied in 7 healthy volunteers by injecting insulin at doses of 0.1 U/kg and 0.3 U/kg. In this experiment with 0.3 U/kg of insulin, the rate of fall in glycemia and the nadir of blood glucose were made similar to that with 0.1 U/kg of insulin by using glucose clamp technique with artificial endocrine pancreas. The plasma glucagon response after 0.3 U/kg of insulin was significantly suppressed as compared to that after 0.1 U/kg of insulin. From these experiments, it was concluded that not only hypoglycemic stimuli but also plasma insulin concentrations are important factors for demonstrating significant glucagon secretion in response to insulin induced hypoglycemia. Second, the effects of strict glycemic control and autonomic nerve function on hypoglycemia-induced glucagon secretion were studied. Regular insulin at a dose of 0.1 U/kg was injected in an i.v. bolus form into 21 insulin-dependent (IDDM) and 22 noninsulin-dependent (NIDDM) diabetics before and one to three months after strict glycemic control with multiple insulin injection therapy or continuous subcutaneous insulin infusion therapy. To reduce fasting blood glucose level and to obtain the same hypoglycemic stimuli, overnight insulin infusion at a basal dose was undertaken in IDDM who showed hyperglycemia before strict glycemic regulations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542597 TI - Population and the invisible hand. PMID- 3542600 TI - [Double-T clasp attachment. Precise--cost effective--easily repaired]. PMID- 3542598 TI - Patterns and determinants of infant mortality in developed nations, 1950-1975. PMID- 3542601 TI - [Melting using high speed, high frequency equipment with buffering-gas methods]. PMID- 3542599 TI - Fertility trends, excess mortality, and the Great Irish Famine. AB - This paper has developed estimates of the age-specific mortality rates prevailing during the Great Irish Famine and has analyzed fertility trends during the 25 years before the Famine. Our calculations confirm that 1 million Irish people perished as a result of this disaster. This figure does not include the deaths among the 1.3 million emigrants who left Ireland during the Famine period. The Famine produced a significant drop in the fertility rate, and we estimate that more than 300,000 births did not take place as a result of the Famine. The effects were especially severe on the very young and the very old, a result echoed in the findings of demographic analyses of other famines. Our procedure permits a reconstruction of the Irish population by age and sex during the period 1821-1841. In addition, it yields year-by-year estimates of the birth rate over this period. We estimate that the rate fell by about 14 percent, a result robust to our assumptions regarding emigration. Economic historians have debated this issue, and we hope that our evidence, although preliminary, will be of assistance. Our analysis also permits year-by-year reconstruction of Irish population totals for the period 1821-1851. Two years are of particular interest. Virtually all recent writers, with the notable exception of Lee (1981), have suggested that the 1831 census returns overestimated the actual population resident in Ireland at that date. Our reconstruction supports the validity of the 1831 census figure. We obtain a total of 7,847,000, which is in good agreement with the disputed census figure of 7,767,000. But perhaps the most interesting figure is the population total for the end of 1845, the highest ever achieved in Ireland. We estimate that the population on the eve of the Great Famine was 8,525,000. Throughout the paper we have tried to highlight those areas in which the data are unreliable, unavailable, or distorted. We have tried to devise cross checks for consistency and to test the sensitivity of the results to a range of assumptions. A case in point concerns the age-sex profile and volume of emigration to England, Scotland, and Wales. Additional work at the micro level would be helpful here. More solid evidence on Famine births would also be helpful. The parish registers we have sampled certainly provide a clue to trends, but we have only made a start in that respect. A much more comprehensive survey is needed to convey the national picture.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542602 TI - [Improved bonding with silanes. An advance in dental technology]. PMID- 3542604 TI - [Kuwata technic, 2. Optimal function by FGP-registration]. PMID- 3542603 TI - [The crown of the profession. The Masters' test for over 30 years]. PMID- 3542605 TI - [News from the Munich Master-Casting. Masters test work 1984]. PMID- 3542606 TI - [Alternative materials. Their usefulness becomes evident first in the office]. PMID- 3542607 TI - [Preparation of full porcelain crowns. Firing on a fire-resistant die]. PMID- 3542609 TI - [Margin characteristics of cast crowns. From preparation to fitting]. PMID- 3542608 TI - [Failure with a silicon material--experiences with a 2-material prosthesis]. PMID- 3542610 TI - New muscle relaxants in outpatient anesthesiology. AB - The ideal neuromuscular blocking drug for dental and other outpatient procedures would be nondepolarizing (therefore reversible), highly potent, have a rapid onset and short duration of action, be highly specific for the nicotinic acetylcholine receptor, be eliminated independently of renal or hepatic metabolism, and have minimal side effects such as tachycardia and histamine release. The newer neuromuscular blocking drugs vecuronium and atracurium approach this ideal much more closely than the older drugs curare, metocurine, and gallamine. Aside from considerations of slightly higher cost, the neuromuscular blocking agents of choice remain succinylcholine for rapid, short lived paralysis, vecuronium and atracurium for relaxation of 15- to 60-minute duration and when cardiovascular stability is vital, and pancuronium for longer surgical procedures. Vecuronium and atracurium have achieved and will continue to achieve predominance in the anesthetic management of the short-procedure patient. PMID- 3542612 TI - Captopril-induced lichen planus pemphigoides with pemphigus-like features. A case report. AB - We report a case of a bullous lichenoid eruption due to the intake of captopril. Clinical, histological, direct immunofluorescence and ultrastructural features were consistent with the diagnosis of lichen planus pemphigoides. In addition, the in vivo immunological study also revealed an intercellular fluorescence, similar to that seen in pemphigus. Complex drug-induced cutaneous reactions have been previously reported with other drugs, especially with D-penicillamine, which bears chemical similarities with captopril. However, such a drug-induced mixed pattern of lichen planus pemphigoides with pemphigus-like features has never been reported. PMID- 3542611 TI - Anesthetic management. Historical, present, future. AB - This article deals with specific agents that either have been or are being employed for the production of general anesthesia or sedative states for the control of pain or anxiety in the dental setting. Change, progress, trends, and contributions to the field of dental anesthesia made by dentists are stressed. In addition, a brief synopsis of the most popular present-day techniques and agents is discussed. Finally, the future of the field of dental anesthesia and the role to be played by dentists is considered. PMID- 3542614 TI - Association of vesiculobullous eruptions with mycosis fungoides. AB - Mycosis fungoides (MF) is, on extremely rare occasions, associated with vesiculobullous eruptions. This report describes clinical, histological and immunohistochemical findings of a case of MF with vesiculobullous lesions. Characteristic features of our case included: bullous lesions evolving rapidly in 12-24 h with severe itch on erythematous and normal-appearing skin; a positive Nikolsky sign; an intraepidermal blister; direct and indirect immunofluorescence stainings were all negative with IgG, IgA, IgM and C3, and atypical lymphocytes in the infiltrates were of helper/inducer T cell type. PMID- 3542616 TI - Self-cure acrylic resins: some chairside applications. PMID- 3542613 TI - Importance of the dermal-epidermal junction and recent advances. AB - The zone of human skin between the epidermis and dermis is called the dermal epidermal junction (DEJ). The importance of the DEJ is outlined and three new areas of research involving the DEJ are reviewed: the intracellular pool of bullous pemphigoid antigen, the interactions between fibronectin and keratinocytes and the epidermolysis bullosa acquisita antigen. PMID- 3542615 TI - Pseudotail associated with spinal dysraphism. AB - A 5-year-old girl had a caudal appendage and her left buttock was larger than the righ buttock. X-ray examination revealed spina bifida and bony defect of sacrum; computed tomography demonstrated the extension of the tumor from subcutaneous tissue to the spinal canal. Histologically, the pseudotail contained lobulated fatty tissue which was consistent with lipoma. It emphasizes the fact that even lesions that are not situated in the median line should be carefully explored before excision. PMID- 3542617 TI - The role of body fat in insulin sensitivity of endurance athletes. AB - The purpose of the study was to assess the role of adiposity in the enhanced insulin sensitivity observed in endurance athletes (EA). An oral glucose tolerance test (75 g glucose) was administered to nine EA and to 23 sedentary subjects (SS). Two different strategies were used to investigate the problem. First, body composition indicators and Vo2max were correlated with the delta insulin and delta glucose areas measured for 180 minutes following glucose ingestion. These correlation analyses were performed for the two groups combined (n = 32). No significant correlations were observed between either fat weight or percent body fat versus delta insulin, delta glucose or delta glucose/delta insulin areas. Moreover, no significant correlation was observed between the several subcutaneous fat indicators and delta insulin, delta glucose and delta glucose/delta insulin areas. The second strategy consisted of comparing EA to SS when percent body fat difference was eliminated. This was achieved by two different methods, first by covariance analysis and second by comparing subsamples of trained and non-trained subjects paired with respect to percent body fat. These two comparisons revealed that even when adiposity was equal between the groups, a significantly greater insulin sensitivity was observed in the EA group (p less than 0.01). The present results suggest that adiposity is not the determining factor for the increased insulin sensitivity of trained subjects. PMID- 3542618 TI - Effect of two periods with intensified insulin treatment on B-cell function during the first 18 months of type 1 (insulin-dependent) diabetes mellitus. AB - Fifteen consecutive type 1 (insulin-dependent) diabetics were randomized within 24 hrs of diagnosis of the disease into two groups for treatment: group A (N = 9) was treated conventionally with one or two daily doses of insulin, group B (N = 6) was treated with nine daily injections of fast-acting insulin for ten days after diagnosis and for 7 days after 15 months duration of diabetes. For remaining time group B was treated conventionally like group A. The mean diurnal blood glucose concentration during the initial ten days of insulin treatment was 11.7 +/- 0.5 mmol/l (mean +/- SEM) in group A and 6.4 +/- 0.3 mmol/l in group B (P less than 0.01) and 6.0 +/- 0.3 mmol/l in group B during the 7 days with intensified treatment 15 months later. B-cell function was assessed from the C peptide response to a standard meal 17 and 14 days and 3, 6, 9, 12, 15 and 18 months after start of insulin treatment. After 14 days the C-peptide response was significantly higher (60%) in group B than in group A (P less than 0.05). The second period with strict control improved B-cell function in 4 out of 5 patients with B-cell function. At no test other than after 14 days was there any difference in B-cell function between the groups. Short-term improvement of glycaemic control at onset of disease and after the remission period seem without effect on the long-term outcome of B-cell function in type 1 (insulin-dependent) diabetics. PMID- 3542619 TI - Cholesterol and bile acid metabolism in middle-aged diabetics. AB - Serum lipoproteins, bile and kinetics and net steroid balance were studied in 22 diet-treated and 5 insulin-treated patients with noninsulin-dependent diabetes mellitus, in 6 patients with insulin-dependent diabetes mellitus and in 15 normoglycemic controls. All subjects were middle-aged and the patients were hyperglycemic. Some of the diet-treated patients suffered from obesity and/or dyslipoproteinaemia mainly characterized by elevated levels of triglycerides and cholesterol in VLDL (very low-density lipoproteins). The diet-treated patients had enhanced fractional turnover of both cholic acid and chenodeoxycholic acid but bile acid formation was within the control range in all groups of patients. As the most significant finding net steroid balance (total cholesterogenesis) was raised in the diet-treated patients. Bile acid kinetics and net steroid balance were normal in insulin-treated patients irrespective of type of diabetes. PMID- 3542620 TI - A signal-processing research facility and its application to the processing of fetal phonocardiographic signals for heart rate estimation. AB - Part 1 of this paper describes a real-time medical signal-processing research facility which is being developed at Edinburgh University. Part 2 describes the application of this facility to the estimation of fetal heart rate from phonocardiographic signals using a new frequency-domain estimation algorithm. PMID- 3542622 TI - New diagnostic and technical aspects of fetal phonocardiography. AB - A new generation of instruments designed to record the fetal phonocardiogram is discussed, as are new methods of time-domain and frequency-domain processing of the fetal phonocardiogram. Using these techniques, detailed information can be obtained about both fetal and maternal cardiovascular conditions. PMID- 3542621 TI - The measurement of fetal systolic time intervals: lessons from ultrasound. AB - Fetal systolic time intervals (pre-ejection period, iso-volumetric contraction time and ventricular ejection time) can be measured using Doppler ultrasound to detect valve movements and the fetal ECG to indicate the onset of ventricular depolarisation. Continuous recordings of FSTI, fetal heart rate and uterine activity depict changes reflecting progressive cord compression and have the potential for providing improved differentiation of late and variable decelerations. However, the continual adjustment of the ultrasound transducer required to maintain a good signal limits the technique. Recent improvements in phono indicate that this may provide a useful alternative, provided that suitable signal-processing is developed. PMID- 3542624 TI - Vaginosonographic guided chorionic villi needle biopsy (transvaginal chorionic villi sampling). PMID- 3542623 TI - Controlled trial of ultrasound screening for light for gestational age (LGA) infants in late pregnancy. AB - The study included 3311 pregnant women: 1570 in the screened group and 1741 in the unscreened group. In the screened group, ultrasound was offered routinely in the 32nd and 37th week of pregnancy, at which time the fetal biparietal diameter (BPD) and the abdominal mean diameter (AD) were measured. If, after the first ultrasound examination, the estimated weight was less than 85% of the expected mean birthweight, a finding of light for gestational age (LGA) was suspected and the ultrasound examination was repeated in the 34th week. In the screened group 6.5% of the women were at risk at the final ultrasound examination (the sensitivity was 38%) and the predictive values of abnormal and normal weight deviation were 60% and 93%, with a specificity of 97% and a relative risk of 9. Ultrasound was offered to the unscreened group only in cases of clinical concern (23% of the women). In the unscreened group 34% of the 158 LGA infants had ultrasound performed before delivery because of clinical concern. By including pregnancies induced before ultrasound could be performed, 45% of the LGA infants in the unscreened group were suspected before delivery. No significant difference between the rate of induction, instrumental deliveries and caesarean sections was found between the two groups. No benefit in terms of decreased incidence of infants with low Apgar score and acidosis was achieved. PMID- 3542626 TI - Haemodynamic abnormalities in hypertensive patients: a review of the influence of vasodilating drugs. AB - Mean arterial pressure is determined primarily by cardiac output and total peripheral resistance, in addition to blood volume and compliance of the arterial system. The regulation of these determinants occurs via reflex neurogenic mechanisms and metabolic or humoral mechanisms. The haemodynamic situation in the early stages of arterial hypertension is characterized by a slight hypercirculatory state due to a moderate increase in heart rate and cardiac output, whereas the total peripheral resistance is increased only moderately, if at all. In later stages, however, a progressive increase in total peripheral resistance prevails, accompanied by a decrease in left ventricular performance due to the development of left ventricular hypertrophy, changes in ventricle geometry and coronary heart disease. A pharmacologically-induced decrease of total peripheral resistance by means of vasodilators, therefore, represents a logical approach to therapy, at least of advanced hypertension. Vasodilators can be classified into three categories: those with preferential activity on the arterial resistance vessels, eg hydralazine, diazoxide, minoxidil; those with preferential activity on venous capacitance vessels, eg organic nitrates; and those with activities on both branches, eg sodium nitroprusside, urapidil, prazosin and other a-blockers. Brief reference is made to new and possibly more acceptable vasodilators--in particular carvedilol and prizidilol. PMID- 3542625 TI - Description of and treatment to inhibit the rejection of human split-thickness skin grafts by congenitally athymic (nude) rats. AB - Gradual rejection of topically engrafted human split-thickness skin grafts (HSTSG) occurred in greater than 90% of congenitally athymic (nude) rats between 21 and 42 days of grafting. Engraftment and rejection of HSTSG is accompanied by a partial restoration of some cell-mediated immune components, the mixed lymphocyte response and lysis of human target cells. Histologic features of the rejection process were those seen in a host-versus-graft reaction. Immunofluorescent analysis of skin undergoing rejection demonstrated IgG at the basement membrane zone in most grafts. Nude rats rejecting HSTSG had circulating IgG which bound to the basement membrane zone and blood vessels of human skin. Nude rats treated with cyclosporine injections for 21 days had an enhanced survival of HSTSG, 120 or more days. PMID- 3542627 TI - Effect of clonidine on insulin secretion: a case report. AB - We have recently seen a case of non-insulin-dependent diabetes mellitus with hypertension in which chronic treatment with oral clonidine gave rise to elevation of blood glucose and decreased insulin secretion. When the response of insulin secretion to glucose administration during clonidine therapy was compared with that after 12 days of wash-out for clonidine in this patient (who was then receiving phentolamine mesylate), there was a marked suppression of insulin secretion to stimulation by intravenous glucose during oral clonidine therapy. This result indicates that the decreased insulin secretion associated with oral clonidine therapy is very unlikely to be due to any direct action of clonidine on beta cells of the pancreatic islets and may be due to suppression of catecholamine release via central alpha-adrenergic receptor stimulation. PMID- 3542628 TI - Effect of fenticonazole in vaginal candidiasis: a double-blind clinical trial versus clotrimazole. AB - Fenticonazole is an imidazole derivative which possesses a broad spectrum antimycotic activity, including activity against Candida albicans. Its therapeutic activity and tolerability have been evaluated, in a double-blind clinical trial versus clotrimazole, in 54 patients affected by mycologically confirmed symptomatic vaginal candidiasis. Both drugs were administered intravaginally as a cream once a day for 7 days. Assessment was by laboratory mycological investigations and symptomatic evaluation. Patients 'cured' at the end of the trial were re-evaluated after 4-6 weeks for possible relapses. Both treatments resulted in a progressive, statistically significant reduction in vaginal symptoms (itching and discharge) and in elimination of Candida in more than 95% of patients. When 'cured' patients were reassessed 4-6 weeks after therapy, relapses occurred in four patients after fenticonazole treatment, but in none following clotrimazole treatment. This apparent difference between treatments is far from being statistically significant and, therefore, may have been a chance occurrence. It should also be noted that patients from the fenticonazole group had a previous history of significantly more frequent episodes of candidiasis suggesting that they may have been at greater risk of re infection than patients from the control group. The tolerance of both treatments was excellent since no local or systemic signs or symptoms of toxicity were reported. An equally high efficacy and safety for both drugs in the elimination of symptoms and objective evidence of vaginal candidiasis is indicated. PMID- 3542629 TI - Aromatic amino acids and pancreatic islet function: a comparison of L-tryptophan and L-5-hydroxytryptophan. AB - L-Tryptophan (4 mM) did not affect insulin release at 3 mM glucose but strongly potentiated glucose-induced (10 mM) insulin release in microdissected ob/ob mouse islets. The effect was concentration dependent with half-maximum at about 5 mM. 10 mM L-glutamate also enhanced the effect of 10 mM D-glucose on insulin release but L-phenylalanine, L-tyrosine, L-alanine, glycine and L-glutamine did not. 0.1 mM benserazide and 0.1 mM alpha-monofluoromethyldopa did not inhibit the effect of L-tryptophan. 1 mM aminooxyacetate reduced the potentiating effect of L tryptophan but not that of L-5-hydroxytryptophan. 10 mM indole pyruvate stimulated basal insulin release but inhibited the effect of glucose. 10 mM L glutamine did not enhance the stimulatory effect of indole pyruvate. 10 mM L-5 hydroxytryptophan reduced the effect of 10 mM L-glutamine on glucose oxidation. L 5-Hydroxytryptophan did not influence 14CO2 production from islets preloaded with [14C]glutamine but reduced the oxidation rate when [14C]glutamine was present in the incubation medium. Both L-tryptophan and L-5-hydroxytryptophan potentiate insulin release. The underlying mechanisms probably differ but do not seem to involve transaminations. The effect of L-5-hydroxytryptophan may be coupled to the activity of aromatic L-amino acid decarboxylase. PMID- 3542630 TI - Electrophysiological test of an amphiphilic beta-structure in LHRH action. AB - Micropipettes were used to record electrical activity from single neurons in hypothalamic tissue slices, in the hypothalamic arcuate nucleus (ARC), and in the periventricular and suprachiasmatic preoptic nuclei (POA). Responses were measured following in vitro application of luteinizing hormone releasing hormone (LHRH), and two analogues: LHRH models 1 and 3. Model 1 (pyroGlu-His-Trp-Ser-Phe Thr-Ile-Lys-Ile-ThrNH2) had amino acid substitutions in residues 5-10 designed to form an amphiphilic beta-strand structure. Model 3 (pyroGlu-His-Trp-Ser-Phe-Gly Ile-Lys-Pro-SerNH2) was also designed to possess amphiphilic characteristics, but also more closely to resemble the native peptide. Electrical recording results showed that LHRH was able both to excite or inhibit different hypothalamic neurons, and that it was more effective in the preoptic area than in the arcuate nucleus. Responses to LHRH model 3 were strongly correlated with responses to LHRH, in their occurrence and their direction, for both of the brain regions studied. Moreover, LHRH models 1 and 3 also retained the neuromodulatory effects of LHRH on cellular responses to norepinephrine and serotonin. Thus, LHRH analogues, designed to possess an amphiphilic beta-structure, preserved some of the properties of LHRH when tested electrophysiologically in the central nervous system. PMID- 3542631 TI - Restoration of the A cell response to glucose in isolated rat islets of Langerhans. AB - This study investigated the modulatory effects of forskolin, phorbol 12-myristate 13-acetate (PMA) and arginine on pancreatic glucagon secretion in response to changes in glucose concentrations. Glucose, on its own (0, 5, 9 and 18 mM), did not modify glucagon secretion from A cell-rich isolated rat islets of Langerhans. In the presence of 20 microM forskolin, glucagon release was stimulated dose dependently on lowering the external glucose concentration to 0 mM. Sensitivity to glucose was achieved in the presence of either PMA or arginine; both agents also significantly enhanced glucagon release at all glucose concentrations tested. The response of the B cells in these experiments were as expected from the available literature. These results indicate that the endogenous rate of glucagon secretion in the isolated islet preparation was minimal and was insensitive to glucose, sensitivity of the A cells to glucose could be restored by either arginine or agents which alter the concentration or activity of proposed cellular second messengers. PMID- 3542632 TI - Genetics of glucocorticoid receptors. AB - The lymphocytolytic effect of glucocorticoids has been used for isolating receptor mutants. They fall into several groups with defects either in the hormone binding domain or the DNA binding domain or with part of the receptor polypeptide missing. These truncated receptors have increased binding affinity for general DNA and are synthesized from 5'-truncated messages. In addition, a phenotype has been identified in which a receptor allele, although apparently normal, is shut-off with no gene product detectable. The wild-type receptor polypeptide of about 95,000 molecular weight is synthesized from two mRNAs of 7 kb and 5 kb which differ in the lengths of their 3'-untranslated regions. A receptor model with three linearly arranged and functionally distinct domains is discussed. The DNA binding domain is rich in basic amino acids and cysteines and is located in the middle of the polypeptide. This region has the highest degree of homology with the estrogen receptor and with the v-erb-A oncogene product. PMID- 3542633 TI - Immunochemical analysis of protein isoforms in thick myofilaments of regenerating skeletal muscle. AB - The expression of myosin heavy chain (MHC) and C-protein isoforms has been examined immunocytochemically in regenerating skeletal muscles of adult chickens. Two, five, and eight days after focal freeze injury to the anterior latissimus dorsi (ALD) and posterior latissimus dorsi (PLD) muscles, cryostat sections of injured and control tissues were reacted with a series of monoclonal antibodies previously shown to specifically bind MHC or C-protein isoforms in adult or embryonic muscles. We observed that during the course of regeneration in each of these muscles there was a reproducible sequence of antigenic changes consistent with differential isoform expression for these two proteins. These isoform switches appear to be tissue specific; i.e., the isoforms of MHC and C-protein which are expressed during the regeneration of a "slow" muscle (ALD) differ from those which are synthesized in a regenerating "fast" muscle (PLD). Evidence has been obtained for the transient expression of a "fast-type" MHC and C-protein during ALD regeneration. Furthermore, during early stages of PLD regeneration this muscle contains MHCs which antigenically resemble those found in the pectoralis muscle at embryonic and early posthatch stages of development. Both regenerating muscles express an isoform of C-protein which appears immunochemically identical to that normally expressed in embryonic and adult cardiac muscle. These results support the concept that isoform transitions in regenerating skeletal muscles qualitatively resemble those found in developing muscles but differences may exist in temporal and tissue-specific patterns of gene expression. PMID- 3542634 TI - Expression of myosin heavy chain isoforms in regenerating myotubes of innervated and denervated chicken pectoral muscle. AB - Monoclonal antibodies were prepared to stage-specific chicken pectoral muscle myosin heavy chain isoforms. From comparison of serial sections reacted with these antibodies, the myosin heavy chain isoform composition of individual myofibers was determined in denervated pectoral muscle and in regenerating myotubes that developed following cold injury of normal and denervated muscle. It was found that the neonatal myosin heavy chain reappeared in most myofibers following denervation of the pectoral muscle. Regenerating myotubes in both innervated and denervated muscle expressed all of the myosin heavy chain isoforms which have thus far been characterized in developing pectoral muscle. However, the neonatal and adult myosin heavy chains appeared more rapidly in regenerating myotubes compared to myofibers in developing muscle. While the initial expression of these isoforms in the regenerating areas was similar in innervated and denervated muscles, the neonatal myosin heavy chain did not disappear from noninnervated regenerating fibers. These results indicate that innervation is not required for the appearance of fast myosin heavy chain isoforms, but that the nerve plays some role in the repression of the neonatal myosin heavy chain. PMID- 3542636 TI - Pioneer growth cone behavior at a differentiating limb segment boundary in the grasshopper embryo. AB - The first neurons to extend axons through embryonic grasshopper limbs are a pair of sibling pioneer neurons. After migrating proximally along the limb axis, the pioneer growth cones normally make an abrupt ventral turn. In some cases (less than 20%) this turn is directly toward the proximo-ventrally located Cx1 guidepost neurons. However, in the majority of cases (greater than 80%) the pioneer growth cones make a more acute ventral turn along a single circumferential line which lies distal to the Cx1 neurons. Growth cones from other afferent neurons orient along the same line. Growth cones can extend along this line around more than half of the circumference of the limb and can grow in either direction along it. The circumferential line appears to be the prospective trochanter-coxa segment boundary. Afferent axons on the segment boundary leave it and contact the proximo-ventrally located Cx1 neurons. The site at which pioneer growth cones leave the boundary is variable and appears to be the point from which filopodial contact with Cx1 cells is first established. In addition to the trochanter-coxa segment boundary, the pioneer growth cones and axons also respond to the tibia-femur and femur-trochanter segment boundaries. The role of segment boundaries as barriers to growth cone movement and the effect of such barriers on the timing and placement of differentiation of pioneer neurons are discussed. PMID- 3542635 TI - Identification of a specialized extracellular matrix component in Drosophila imaginal discs. AB - We have generated a monoclonal antibody that recognizes a major component of a specialized extracellular matrix in Drosophila imaginal discs. In mature larvae, antibody binding is observed almost exclusively on imaginal discs. On the basal surface of the thoracic discs, the antigen is localized to particular regions of the epithelium, and ultrastructural studies indicate that the antigen is found in a fibrous network secreted between the cells and the basal lamina. The localized expression indicates that the matrix is not simply related to disc differentiation, as all regions of the columnar disc epithelium are determined to secrete adult cuticle. A correlation of the antigen distribution with known developmental events leads us to propose that the antigen-containing network provides an extensible matrix for the rapid elongation of the disc epithelium during evagination; consistent with this, the antigen is a component of the matrix between the dorsal and ventral surfaces of the evaginated wing pouch. The antigen is very large (greater than 5 X 10(5) Da), can be labeled metabolically with methionine and sulfate, and is digested by chondroitinase ABC; these biochemical characteristics indicate that the antigen is a proteoglycan. PMID- 3542637 TI - Pathfinding by pioneer neurons in isolated, opened and mesoderm-free limb buds of embryonic grasshoppers. AB - The Ti1 afferent neurons are the first neurons to undergo axonogenesis in limb buds of embryonic grasshoppers. Their growth cones pioneer a stereotyped pathway through the limb which becomes the route of one of the major leg nerve trunks. The growth cones appear to be oriented by several kinds of guidance cues, including guidepost neurons, a developing limb segment boundary, and an additional proximally orienting cue(s). In the experiments reported here, we have investigated the possible nature and source of proximally orienting and segment boundary cues by surgical manipulations of the limb. Before the onset of pioneer axonogenesis, limbs were isolated from the body, opened longitudinally and pinned out flat, or stripped of mesoderm. Pioneer axon routes in cultured, surgically manipulated limb buds were compared to routes in cultured control limbs. The results indicate that proximal extension of pioneer growth cones along the limb axis does not require (during the period of growth) tissue extrinsic to the limb, contact guidance by the limb contour, an axial electrical field, a diffusion gradient generated by a localized source, mesodermal cells, or guidepost neurons; adequate guidance information for proximal growth apparently can be provided by the limb epidermal epithelium (including the basal lamina) and/or by internal polarity of the pioneer neurons. Adequate guidance information for the segment boundary portion of the pioneer route apparently can be provided by the limb epithelium. PMID- 3542638 TI - Alkaline phosphatase activity in the membrane of Xenopus laevis oocytes: effects of steroids, insulin, and inhibitors during meiosis reinitiation. AB - The mechanism of steroid hormone-induced reinitiation of meiosis in Xenopus laevis oocytes in vitro involves interaction of the hormone with an ooplasma membrane receptor and early changes of enzymatic activities (adenylate cyclase, p48 protein kinase). In full-grown (stage 6) oocytes, we have observed cytochemically, at the ultrastructural level, alkaline phosphatase activity in the ooplasma membrane of microvilli, its decrease by 2 hr of progesterone action, and its complete disappearance at the time of germinal vesicle breakdown (GVBD). Insulin (30 micrograms/ml) also provoked a decrease of phosphatase activity, although it did not promote GVBD under these circumstances. When oocytes were exposed simultaneously to progesterone (1 microM) and insulin (30 micrograms/ml), the enzymatic activity disappeared earlier than with any one of them, correlating with the faster occurrence of GVBD. Inhibitors of alkaline phosphatase activity and competitive substrates potentiated progesterone action on GVBD. Insulin and beta-glycerophosphate potentiating activities were additive. These results suggest that the ooplasma membrane alkaline phosphatase may be implicated in the course of reinitiation of meiosis in X. laevis oocytes. PMID- 3542639 TI - Neural cell adhesion molecule expression in Xenopus embryos. AB - The spatiotemporal pattern of expression of the neural cell adhesion molecule NCAM was mapped immunohistochemically in embryos of the frog Xenopus, from blastula to early swimming stages, using a polyclonal antibody that recognizes Xenopus NCAM. The neural plate stage was the earliest at which NCAM could be detected. The initial sites of NCAM immunoreactivity were neural ectoderm, somitic mesoderm, and chordamesoderm. During formation of the neural tube, NCAM immunoreactivity became restricted to the neuroectoderm and its derivatives. During closure of the neural tube and for 2-4 hr thereafter, NCAM was expressed in a distinctive radial pattern in coronal sections of the neural tube. NCAM was observed in neural crest cells before migration and after formation of cranial and spinal ganglia. During the period of initial neurite outgrowth, NCAM became concentrated in the developing central nerve fiber pathways. NCAM was seen on peripheral nerves from the time of their initial outgrowth and it was strongly expressed at neuromuscular junctions during the period of their formation. These results show that NCAM is expressed after neural induction and functions during morphogenesis of the neural plate and tube, some neural crest derivatives, development of nerve fiber tracts, and formation of neuromuscular connections. PMID- 3542640 TI - Divergent effects of early hydrocortisone treatment on behavioral and brain development in meadow and pine voles. AB - Developmental effects of a single hydrocortisone (HC) injection (80 micrograms/g on day 2 postnatal) were compared in two closely related species, meadow voles (Microtus pennsylvanicus) and pine voles (M. pinetorum). Effects of hormone administration were assessed in terms of the development of swimming behavior (head/nose position and front paw movement), alterations in social interactions (spatial location with respect to a stimulus animal), and by changes in somatic and brain growth. Although adult patterns of swimming behavior were found to be quantitatively different in meadow and pine voles, normal maturation in both species involved a progressive elevation of head/nose position along with a gradual inhibition of front paw movement. Compared with saline controls, HC treated meadow voles showed an accelerated attainment of their adult pattern, whereas hormone-treated pine voles displayed a retardation in their swimming development. HC administration similarly led to increased body weights in developing meadow voles but decreased body weights in young pine voles. There was a tendency for hormone-treated meadow voles to spend more time near a stimulus animal than their control counterparts, whereas the opposite was observed for pine voles. In both species, the HC group displayed decreased cerebral and cerebellar weights in adulthood, whereas other organs were generally unaffected by hormone administration. Neurochemical analyses revealed no treatment effects or treatment by species interactions with respect to cerebral DNA levels. On the other hand, treated meadow voles but not pine voles showed an elevated concentration of sulfatide, a myelin-related lipid. These results are the first to demonstrate divergent behavioral and neurochemical effects of early glucocorticoid administration in closely related species studied under the same conditions. Furthermore, in accordance with earlier experiments on rats, swimming behavior was shown to be a useful measure for assessing changes in neuromuscular maturation. PMID- 3542642 TI - Free covalent aggregates of therapeutic insulin in blood of insulin-dependent diabetics. AB - Immunoreactive insulin (IRI) in the circulation of diabetics using insulin includes a 12,000-Mr covalent aggregate of insulin. In this study, both free and bound IRI were measured in nine type I diabetics who were treated sequentially for 3 wk with constant doses of conventional beef-pork, biosynthetic human, and beef-pork insulins (phases 1, 2, and 3, respectively). The aggregate accounted for 19 +/- 5.7, 38 +/- 7.7, and 26 +/- 7% of bound IRI, and 19 +/- 8.3, 35 +/- 7.3, and 31 +/- 5.0% of free IRI during phases 1, 2, and 3, respectively. Taken as concentrations (microU/ml), the absolute amounts of aggregate in the bound fraction were significantly (P less than .001) greater than those that were free, whereas the ratios of aggregate to monomer within each pool were similar (P greater than .1). The relative and absolute amounts of the insulin aggregate during each of the three treatment phases (compared by analysis of variance) were indistinguishable (P greater than 0.5). However, the aggregate was overestimated by a factor of approximately 2 when measurements were made on the basis of an insulin-monomer standard. We conclude that both the bound and free fractions of IRI contain insulin aggregate. Overreactivity of the aggregate in the radioimmunoassay contributes to the so-called hyperinsulinism of type I diabetes. As with insulin monomer, most of the 12,000-Mr aggregate is bound to antibodies. Because some of the aggregate is free, its biologic consequences must be assessed. PMID- 3542641 TI - Effect of stress hormones on splanchnic substrate and insulin disposal after glucose ingestion in healthy humans. AB - To compare cortisol and epinephrine action on oral glucose tolerance, healthy humans were infused with either cortisol (0.1 mg X kg-1 X h-1), epinephrine (5.4 micrograms X kg-1 X h-1), or saline before and after a 75-g glucose load, thereby elevating the respective plasma hormone concentrations into the pathophysiologic range. In the basal state, epinephrine increased arterial concentrations of glucose, beta-hydroxybutyrate, and free fatty acids (FFA) as well as splanchnic output of glucose and beta-hydroxybutyrate and splanchnic FFA more than cortisol. Postprandially, C-peptide release and hyperinsulinemia were blunted by epinephrine initially and increased less thereafter than during cortisol infusion. The rise in arterial glucose after glucose ingestion as calculated by the area under the curve was more marked (P less than .01) after epinephrine [( 1.90 +/- 0.08 M) 150 min] and cortisol [( 1.41 +/- 0.05 M) 150 min] than in the control study [( 1.07 +/- 0.04 M) 150 min]. In parallel, the stress hormones induced an almost identical 24 and 31% rise in mean splanchnic glucose output versus control values (normal, 44.8 +/- 2.5; cortisol, 55.3 +/- 3.3; epinephrine, 58.9 +/- 6.9 g/150 min). The associated rise in arterial concentrations and splanchnic output of insulin above control values was considerably greater during cortisol but unchanged during epinephrine exposure. Epinephrine but not cortisol induced a rise versus the control study in splanchnic uptake of lactate and FFA, as well as in pyruvate output, whereas plasma beta-hydroxybutyrate and acetoacetate remained unchanged. The postprandial splanchnic glucose output-to splanchnic C-peptide output ratio did not differ from normal during epinephrine but was reduced (P less than .01) during cortisol administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542643 TI - Effects of heparin on insulin binding and biological activity. AB - The effect of heparin, a polyanionic glycosaminoglycan known to alter the function of many proteins, on insulin binding and bioactivity was studied. Cultured human lymphocytes (IM-9) were incubated with varying concentrations of heparin, then extensively washed, and 125I-labeled insulin binding was measured. Heparin at concentrations used clinically for anticoagulation (1-50 U/ml) inhibited binding in a dose-dependent manner; 50% inhibition of binding occurred with 5-10 U/ml. Scatchard analysis indicated that the decrease in binding was due to a decrease in both the affinity and the apparent number of available insulin receptors. The effect occurred within 10 min at 22 degrees C and persisted even after the cells were extensively washed. Inhibition of insulin binding also occurred when cells were preincubated with heparinized plasma or heparinized serum but not when cells were incubated with normal serum or plasma from blood anticoagulated with EDTA. By contrast, other polyanions and polycations, e.g., poly-L-glutamic acid, poly-L-lysine, succinylated poly-L-lysine, and histone, did not inhibit binding. Heparin also inhibited insulin binding in Epstein-Barr (EB) virus-transformed lymphocytes but had no effect on insulin binding to isolated adipocytes, human erythrocytes, or intact hepatoma cells. When isolated adipocytes were incubated with heparin, there was a dose-dependent inhibition of insulin-stimulated glucose oxidation and, to a lesser extent, of basal glucose oxidation. Although heparin has no effect on insulin binding to intact hepatoma cells, heparin inhibited both insulin binding and insulin-stimulated autophosphorylation in receptors solubilized from these cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542644 TI - Plasma insulin response among Nauruans. Prediction of deterioration in glucose tolerance over 6 yr. AB - A longitudinal study of 266 randomly selected nondiabetic Nauruans [215 with normal tolerance and 51 with impaired glucose tolerance (IGT)] over 6 yr showed that deterioration in glucose tolerance status had occurred in 61 subjects. Of the subjects with initially normal tolerance, 34 (16%) progressed to IGT and 14 (6.5%) progressed to diabetes. Thirteen of the subjects with IGT (25%) progressed to diabetes. Subjects were examined in 1975 through 1976, and follow-up examinations were performed in 1982. After age, a high 2-h plasma insulin response to a glucose load was the factor most predictive of progression from normal tolerance to both diabetes (P less than .001) and IGT (P less than .01). Both a high 2-h glucose level and greater obesity independently predicted progression from IGT, and a diminished 2-h insulin response just failed to significantly improve the model (P less than .06). The negative parameter of the insulin response associated with deterioration from IGT differed significantly (P less than .01) from the positive-parameter estimate of the response associated with progression to diabetes from normal tolerance (P less than .01), implying a qualitative difference between these nondiabetic subgroups. The use of a glucose insulin interaction term to predict progression to diabetes for all nondiabetic subjects confirmed this difference; this term's addition improved the model (P less than .01), and progression to diabetes was associated with a high insulin response for 2-h glucose less than 7.8 mM but a low response for 2-h glucose greater than 7.8 mM. PMID- 3542646 TI - Studies of midaglizole (DG-5128). A new type of oral hypoglycemic drug in healthy subjects. AB - Midaglizole (DG-5128), 2-[2-(4,5-dihydro-1H-imidazol-2-yl)-1-phenylethyl]pyridine dihydrochloride sesquihydrate, is a novel alpha 2-adrenoceptor antagonist. Its effects on plasma glucose, immunoreactive insulin (IRI), and immunoreactive glucagon (IRG) in healthy male volunteers were investigated. Volunteers received single oral administrations of midaglizole (150-500 mg), multiple increasing oral administration on 3 separate days (150-300 mg 3 times daily), or successive daily oral administration for 1 wk (200 mg 3 times daily). The hypoglycemic action of midaglizole was observed within 0.5-1.0 h after its administration and thereafter for 5 h. The maximum hypoglycemic effect was found 1.0-1.5 h after administration. Midaglizole decreased postprandial hyperglycemia in a dose dependent manner. In the fasting state, midaglizole significantly increased IRI secretion and suppressed IRG secretion. Midaglizole inhibited epinephrine-induced platelet aggregation after successive administration for 1 wk (200 mg 3 times daily). The plasma half-life of midaglizole was only 3 h, and the drug was rapidly excreted into the urine and feces, with greater than 80% in its unchanged form, within 24 h. Midaglizole did not affect the results of any clinical or laboratory tests performed. Our data indicate that midaglizole is a possible hypoglycemic agent. Further clinical investigations are required to confirm its effects on diabetes mellitus. PMID- 3542645 TI - Opposite effects of D-glucose and a nonmetabolized analogue of L-leucine on respiration and secretion in insulin-producing tumoral cells (RINm5F). AB - D-Glucose increased the cytosolic NADH/NAD+ ratio (but not the cytosolic NADPH/NADP+ ratio), augmented O2 uptake, raised the ATP/ADP ratio, decreased 86Rb outflow, and stimulated insulin release in tumoral insulin-producing cells of the RINm5F line. L-Leucine and 4-methyl-2-oxopentanoate also stimulated insulin secretion. In the RINm5F cells, as in normal islet cells, the nonmetabolized analogue of L-leucine, 2-aminobicyclo[2,2,1]heptane-2-carboxylic acid (BCH), activated glutamate dehydrogenase, augmented L-[U-14C]glutamine oxidation, and induced a more reduced state of cytosolic redox couples. However, in sharp contrast to either its effect in normal islet cells or that of D-glucose in the tumoral cells, BCH severely decreased O2 uptake, lowered the ATP/ADP ratio, increased 86Rb outflow, and inhibited insulin release in the RINm5F cells. These findings are interpreted to support the concept that the rate of ATP generation represents an essential determinant of the secretory response of insulin producing cells to nutrient secretagogues. PMID- 3542648 TI - Major histocompatibility complex restriction of T-lymphocyte responses to islet cell antigens in IDDM rats. AB - BBUF rats, derived from BB rats, spontaneously develop a form of insulin dependent diabetes mellitus (IDDM) associated with infiltration of the islets of Langerhans by lymphocytes (insulitis). BBUF rats bear the RT1u major histocompatibility complex (MHC) haplotype that we have shown to be necessary for the expression of this form of IDDM. A T-lymphocyte line obtained from the pancreas of a diabetic rat (UPCC.5) and three T-lymphocyte hybridomas derived by fusing T-lymphocytes of BBUF rats (MUS1.2, MUS1.13, and MUP3.21) respond to islet cell antigens in an MHC-restricted way. UPCC.5 responds to a combination of islet cell antigens (ICAg) and antigen-presenting cells by proliferation, whereas the T hybridoma responses are detected on the basis of IL-2 production in a similar assay. This study reveals that an antiserum against mu-haplotype MHC antigens or a monoclonal antibody against the product of the D class II subregion of the rat MHC could inhibit ICAg recognition. A monoclonal antibody against the product of the B class II MHC subregion of the rat was not inhibitory. These results suggest that RT1.D antigens (analogous to human DR and mouse I-E) restrict islet cell recognition in this rat model of spontaneous IDDM. PMID- 3542647 TI - Insulin action in obese non-insulin-dependent diabetics and in their isolated adipocytes before and after weight loss. AB - To determine the effects of weight loss on insulin action in patients with non insulin-dependent diabetes mellitus (NIDDM) and in their isolated adipocytes, we studied nine weight-stabilized Pima Indians [7 females and 2 males; age 39 +/- 3 yr; wt 99.9 +/- 8.2 kg; body fat 39 +/- 2% (means +/- SE)] before and after a 6.7 +/- 1.3-kg weight loss and decrease in fasting plasma glucose from 250 +/- 11 to 148 +/- 15 mg/dl. In vivo insulin action was measured during a 3-insulin-step, hyperglycemic (approximately 310 mg/dl) clamp with somatostatin (250 micrograms/h). At a clamp plasma insulin concentration of 10 microU/ml, glucose disposal rates did not change after weight loss; at approximately 100 microU/ml, glucose disposal rates increased by 21% [from 4.3 +/- 0.2 to 5.3 +/- 0.4 mg X min 1 X kg-1 of fat-free mass (FFM), P less than .01] mostly due to increased carbohydrate oxidation rates (2.0 +/- 0.3 to 2.8 +/- 0.3 mg X min-1 X kg-1 FFM, P less than .02); at 2400 microU/ml, glucose disposal rates increased by 37% (11.4 +/- 0.6 to 15.6 +/- 1.4 mg X min-1 X kg-1 FFM, P less than .02) mostly due to increased nonoxidative carbohydrate disposal rates or storage (7.5 +/- 0.6 to 10.9 +/- 1.3 mg X min-1 X kg-1 FFM, P less than .04). Sensitivity of glucose disposal to insulin in the physiologic range (measured as change in glucose disposal rate per unit change in insulin concentration between clamps at approximately 10 and approximately 100 microU/ml) was very low in these diabetic subjects and did not change after weight loss. Adipocyte cell size, basal and maximal insulin-stimulated glucose transport, and half-maximal rate for transport did not change after weight loss. The data suggest that insulin in the physiologic range has no apparent effect on glucose disposal in patients with NIDDM before or after weight loss. However, a moderate weight loss is associated with enhanced capacity to transport and metabolize glucose in vivo. The discrepancy between in vivo and in vitro results suggests that the adipocyte may not always reflect in vivo insulin action. Diabetes 36:227-36, 1987. PMID- 3542649 TI - Self-association of insulin. Its pH dependence and effect of plasma. AB - We investigated some self-association properties of monocomponent porcine insulin with a simple and novel procedure that for the first time permits the association properties of insulin to be studied in mixed protein solutions. With this semiquantitative procedure, the monomer form of insulin was separated from aggregates during centrifuge desalting on Sephadex G-25. The proportion of monomer in solutions of insulin was estimated by monitoring [125I]monoiodoinsulin recovery off the gel. The self-association properties of insulin were studied in plasma with this procedure over the concentration range of physiologically circulating levels to storage concentrations of the hormone. We estimated the equilibrium constant for the formation of dimers to be 1.5 X 10(4)/M in pooled human plasma at pH 7.4 and 37 degrees C. This estimate was indistinguishable from that obtained for insulin in a defined phosphate-albumin buffer under similar conditions. This result provides direct confirmation that insulin is not associated with a circulating serum binding protein(s) and that insulin is present predominantly as a monomer in plasma. We also used the method to investigate the self-association properties of insulin over a wide pH range. The equilibrium constant for the formation of dimers decreased only 6-fold over a 9.2 pH unit increase from pH 2 to 11.2 but almost 200-fold for the additional 1.5 pH unit increase from pH 11.2 to 12.7. We conclude that a residue of pK 12 is critical to the maintenance of the quaternary structure of insulin. We assign this role to the single B22-arginyl residue in insulin. PMID- 3542650 TI - Failure of genetically selected miniature swine to model NIDDM. AB - Ten young adult miniature swine from a line reported to be genetically selected for glucose intolerance and eight normal controls were obtained from Colorado State University. They were consecutively exposed to 4 mo of a high-fiber, low fat standard swine diet; 4 mo of a high-sucrose, high-fat, low-fiber diabetogenic diet; and 4 mo of excess diabetogenic diet for obesification. Results of oral glucose tolerance and intravenous insulin tolerance tests conducted at the end of each regimen were compared. Hyperglycemia was not observed in any animals after any manipulation. Insulin sensitivity was also not influenced by diet. We conclude that F7 low-K miniature swine from this colony fail to model human non insulin-dependent diabetes. PMID- 3542651 TI - Growth hormone regulation of somatomedin C/insulin-like growth factor I production and DNA replication in fetal rat islets in tissue culture. AB - The regulation of DNA replication by growth hormone and the production of somatomedin C/insulin-like growth factor I (SM-C/IGF-I) and insulin by fetal rat islets in culture has been studied. Islets were cultured for 3 days in medium containing 2.7 or 16.7 mM glucose, various concentrations of fetal calf serum (FCS), and 100-1000 ng/ml human growth hormone (GH). DNA replication was determined by incorporation of [3H]thymidine into islet DNA; SM-C/IGF-I and insulin secreted into the medium were measured by specific radioimmunoassays. Glucose caused a twofold stimulation of islet DNA replication in medium containing greater than or equal to 1% FCS but failed to stimulate DNA replication at lower serum concentrations. In the presence of 16.7 mM glucose, GH (100-1000 ng/ml) stimulated DNA replication at all serum concentrations. In medium containing 2.7 mM glucose, GH was stimulatory only in the presence of 1% FCS. Somatomedin C/IGF-I release into the culture medium could be detected in all experimental groups. Glucose alone did not affect SM-C/IGF-I release, and in serum concentrations less than 0.1% FCS, GH also failed to increase the release of the peptide. In medium containing 1% FCS and 16.7 mM glucose, 100-1000 ng/ml GH caused a 50-100% increase in SM-C/IGF-I release into the medium. Addition of 100 ng/ml exogenous SM-C/IGF-I to medium containing 16.7 mM glucose and 0.1-1.0% FCS caused a twofold stimulation of the islet DNA replication. This effect could be abolished by the addition of an antibody to SM-C/IGF-I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542652 TI - Glucose counterregulation in pre-school-age diabetic children with recurrent hypoglycemia during conventional treatment. AB - To determine whether immature or defective glucose counterregulation was responsible for the severe recurrent hypoglycemic episodes (3.6 per patient per year) observed during conventional therapy (CT) in six pre-school-age diabetic children, we investigated their metabolic and hormonal responses to insulin infusion (40 mU/kg i.v. for 60 min). Counterregulation was considered adequate because no patient experienced symptoms requiring discontinuation of the test, and blood glucose (BG) nadirs averaged 42 +/- 5 mg/dl. Glucose production rate decreased from 4.2 +/- 0.2 to 2.6 +/- 0.6 mg X kg-1 X min-1. Blood 3 hydroxybutyrate levels were elevated (approximately 3 mM) and did not change during insulin infusion. The responses of epinephrine (from 137 +/- 37 to 393 +/- 143 pg/ml), norepinephrine (from 145 +/- 33 to 347 +/- 152 pg/ml), and growth hormone (from 6.0 +/- 1.5 to 20.3 +/- 5.1 ng/ml) were normal for this age group. As previously observed in diabetic adults, glucagon response was deficient (from 117 +/- 30 to 114 +/- 18 pg/ml). The six children were subsequently treated with continuous subcutaneous insulin infusion (CSII), which resulted in a 20-fold decrease in the number of severe hypoglycemic reactions. Predisposition to severe hypoglycemia in this subset of diabetic children, which remains a refractory problem even after considerable efforts have been made to decrease them, may thus be sharply decreased with CSII therapy. During this therapy, a significant inverse correlation appeared between the individual frequency of BG values less than 40 mg/dl and BG nadir during the insulin infusion test (r = .94, P less than .001). PMID- 3542653 TI - Adverse effects of insulin antibodies on postprandial plasma glucose and insulin profiles in diabetic patients without immune insulin resistance. Implications for intensive insulin regimens. AB - To assess the possible influence of moderate titer insulin antibodies on diabetic glycemic control, we examined insulin-antibody equilibrium binding characteristics, postprandial glucose tolerance, and plasma free-insulin profiles after subcutaneous injection of both porcine and human insulin (0.15 U/kg) in 12 patients with insulin-dependent diabetes mellitus under conditions stimulating intensive insulin therapy. The patients' antibodies bound porcine and human insulin indistinguishably, and their plasma glucose and free-insulin profiles after ingestion of a standard meal were similar with both insulins. Initial increases in plasma free-insulin levels after injection of both insulins were negatively correlated with both insulin-antibody binding (r = -.55, P less than .006) and postprandial hyperglycemia (peak level r = -.56, P less than .006); the latter was positively correlated with insulin-antibody binding (r = .48, P less than .02). The effects of insulin antibodies on postprandial plasma free-insulin and glucose levels could be accounted for substantially by the association constant of the high-affinity insulin-antibody binding sites (K1); patients in the highest quartile for K1 had significantly slower initial increments in plasma free insulin (0.31 +/- 0.04 vs. 0.46 +/- 0.06 microU/min, P less than .05) and greater postprandial hyperglycemia (peak value 237 +/- 10 vs. 166 +/- 12 mg/dl, P less than .001) than patients in the lowest quartile. We conclude that moderate insulin-antibody titers commonly found in insulin-treated patients can slow the early increase in plasma free insulin after subcutaneous injection and that this impairs postprandial glucose tolerance; such an effect may limit the effectiveness of intensive insulin therapy. PMID- 3542654 TI - Hyperinsulinemia does not compensate for peripheral insulin resistance in obesity. AB - Based on previous steady-state measures of the biologic activity of insulin, it was thought that postprandial hyperinsulinemia in obesity compensated for insulin resistance. However, we recently demonstrated kinetic defects in insulin action in insulin-resistant nondiabetic obese subjects: activation of insulin-stimulated glucose disposal was slower and deactivation was faster in obese than in normal subjects. In view of these kinetic defects in peripheral insulin action and of the fact that insulin is normally secreted in a phasic manner after meals, we postulated that the hyperinsulinemia of obesity does not compensate for insulin resistance and that the abnormal kinetics of insulin action in obesity are functionally important. To test this hypothesis, oral glucose tolerance tests (OGTTs) were performed in five control (mean age, 33 +/- 2 yr) and five obese (mean age, 41 +/- 5 yr) subjects. All controls had normal glucose tolerance; two obese subjects had normal and three had impaired glucose tolerance. After the results of the OGTTs were available, euglycemic clamp studies were performed in which insulin was infused in a phasic stepped fashion to mimic the rise and fall of mean peripheral insulin levels during the OGTTs. Each subject was clamped at both the "normal" and "obese" OGTT insulin profiles. During the OGTT, glucose and insulin levels were significantly elevated in the obese subjects compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542655 TI - New, simple insulin-receptor assay with universal application to solubilized insulin receptors and receptors in broken and intact cells. AB - A new, simple insulin-receptor-binding assay has been devised. The assay is based on the separation of free and receptor-bound 125I-labeled insulin in 80% ethanol. It was found that the insulin-receptor complex was fully stable at this ethanol concentration, regardless of the source of the receptor employed. The assay has been evaluated with solubilized insulin receptors and membrane-bound receptors from human placenta and porcine liver as well as intact cells with the IM-9 cell line. The assay is simple, rapid, and has large capacity. Comparisons of the ethanol-based assay to the conventionally employed assays with polyethylene glycol or microfuge centrifugation for the separation of free and bound 125I insulin revealed large discrepancies between the assays. The ethanol-based assay always appeared to provide a better separation. Microfuge centrifugation of placental membranes precipitated approximately 3% of the ethanol-precipitable insulin-receptor complex, while polyethylene glycol precipitation of solubilized insulin receptors varied between 40 and 80% of the ethanol precipitability, depending on the receptor concentration employed. PMID- 3542656 TI - Quantitative analysis of pancreatic proinsulin mRNA in genetically diabetic (db/db) mice. AB - C57BL/KsJ db/db mice develop hyperphagic obesity and nonketotic diabetes similar to non-insulin-dependent diabetes mellitus in humans. Initially the mice demonstrate an abundant beta-cell mass and hyperinsulinemia, which is followed by apparent beta-cell loss. As an index of insulin synthesis, this study assesses pancreatic proinsulin mRNA, measured by dot hybridization to cloned cDNA, during the development of diabetes in the mice. Changes in proinsulin mRNA from 5 to 13 wk of age are compared with serum insulin, pancreatic insulin content, and blood glucose. In control (+/db) mice, total proinsulin mRNA and pancreatic insulin content increased with age. Both changes were proportional to an increase in body weight. Obesity, hyperglycemia, and hyperinsulinemia were evident in diabetic (db/db) mice at 5 wk of age. Although pancreatic insulin content was comparable to that in the +/db controls at 5 wk, a fourfold relative elevation of proinsulin mRNA was observed. Despite an increase in body weight, proinsulin mRNA concentration and total proinsulin mRNA fell to levels similar to those of the control mice at 10 and 13 wk, associated with a loss of hyperinsulinemia, a mild decrease in pancreatic insulin content, and a marked increased in fasting blood glucose. A separate group of db/db mice was pair fed with the +/db controls from 4 to 13 wk. These diet-restricted diabetic mice were heavier than control mice and gained weight with age, but they weighed less than the unrestricted mice at all ages. Compared with the unrestricted db/db mice, a more modest fasting hyperglycemia was apparent, and a persistent hyperinsulinemia was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542657 TI - Lilly lecture 1986. Genes, generator of diversity, glycoconjugates, and autoimmune beta-cell insufficiency in type I diabetes. PMID- 3542659 TI - Cutting times and grinding rates of various crown and bridge metals. PMID- 3542658 TI - Morphologic and functional changes in sympathetic nerve relationships with pancreatic alpha-cells after destruction of beta-cells in rats. AB - Insulin-dependent diabetes mellitus (IDDM) in humans is accompanied by an attenuation of the response of glucagon to hypoglycemia. To identify an animal model of IDDM with alpha-cell unresponsiveness to glucopenia in which to pursue morphologic and in vitro functional investigation of the lesion, pancreases isolated from rats with IDDM induced by streptozocin (STZ) or occurring spontaneously in BB/W rats were perfused with buffer containing 150, 25, and 150 mg/dl of glucose. In both forms of IDDM the normal glucagon rise during glucopenia was markedly impaired, suggesting an abnormality comparable to that of human IDDM. Studies of the insular sympathetic apparatus were conducted in these rat models. Electron-microscopic examination of peri-insular nerve endings disclosed no discernible abnormality in either form of rat IDDM. However, morphometric analysis of contacts between [3H]norepinephrine-labeled sympathetic nerve terminals and alpha-cells in pancreases from STZ-induced diabetic (STZ-D) rats revealed a 65-70% reduction in direct contacts. An 80% reduction in the number of nerve endings (not labeled) in direct contact with alpha-cells was also noted in the BB/W diabetic rats. Norepinephrine reuptake, studied only in the STZ D group, was not impaired. The availability of local endogenous norepinephrine to alpha-cells and their sensitivity to exogenous norepinephrine was determined by perfusing 2, 5, or 10 micrograms/ml of tyramine, a releaser of endogenous norepinephrine, and norepinephrine at a concentration that in pancreases from nondiabetic rats gave a quantitatively similar glucagon response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542660 TI - A laboratory evaluation of three etching solutions. PMID- 3542661 TI - Tensile bond strength of dentin adhesives. PMID- 3542662 TI - Ag-Pd alloys for resin-bonded retainers. PMID- 3542663 TI - Microleakage of several tooth-colored restorative materials in cervical cavities. A comparative study in vitro. PMID- 3542665 TI - Dentin permeability to phosphoric acid: effect of treatment with bonding resin. PMID- 3542664 TI - Fluoride release from and tensile bond strength of Ketac-Fil and Ketac-Silver to enamel and dentin. PMID- 3542667 TI - Clinical study of two luting cements used on student-treated patients: final report. PMID- 3542668 TI - Early shear and tensile strength of composite to etched alloy. PMID- 3542666 TI - Dentin bonding agents: correlation of early bond strength with margin gaps. PMID- 3542669 TI - Diabetic control and microvascular complications: the near-normoglycaemic experience. PMID- 3542670 TI - Salivary insulin concentrations in type 2 (non-insulin-dependent) diabetic patients and obese non-diabetic subjects: relationship to changes in plasma insulin levels after an oral glucose load. AB - The presence of immunoreactive insulin in saliva and its relationship to plasma immunoreactive insulin was investigated in healthy subjects, newly diagnosed non obese Type 2 (non-insulin-dependent) diabetic patients and obese non-diabetic subjects, basally and after an oral glucose tolerance test. The mean +/- SEM fasting values of plasma and salivary immunoreactive insulin were significantly higher in diabetic patients and obese non-diabetic subjects than in normal volunteers (p less than 0.05). During the glucose challenge, the increase of salivary insulin was related with that of plasma in the three groups of subjects, with a time lag in normal and obese subjects. In normal volunteers, plasma and salivary peak values were respectively 49.5 +/- 13.4 microU/ml (p less than 0.05 vs obese subjects) at 60 min and 12.0 +/- 3.3 microU/min (p less than 0.05 vs obese subjects) at 120 min; in diabetic patients, the values were 51.7 +/- 5.6 microU/ml (p less than 0.05 vs obese subjects) and 14.6 +/- 4.1 microU/min at 120 min; in obese subjects, the peak value for plasma insulin was 111.5 +/- 40.1 microU/ml at 90 min and for salivary insulin 15.6 +/- 5.1 microU/min at 120 min. A positive linear relationship was shown between plasma and salivary insulin during the oral glucose tolerance test. The identity of salivary insulin was assessed by reversed-phase HPLC. We conclude that salivary immunoreactive insulin can be found in Type 2 diabetic patients and in obese non-diabetic subjects, as well as normal volunteers, that plasma and salivary insulin are related after a glucose load, and that differences exist in salivary insulin secretion patterns among the three groups of subjects. PMID- 3542671 TI - Heterogeneity of insulin responses: phases leading to type 2 (non-insulin dependent) diabetes mellitus in the rhesus monkey. AB - To determine the natural history of the development of Type 2 (non-insulin dependent) diabetes mellitus, basal plasma insulin and glucose levels and responses to intravenous glucose tolerance tests were determined over a period of 6 years in 42 adult male rhesus monkeys (Macaca mulatta). Among the 28 obese monkeys (percent body fat greater than 22%) over the age of 10 years, 9 developed overt Type 2 diabetes (fasting plasma glucose, greater than 7.8 mmol/l, and reduced glucose disappearance rates, KG less than 1.5), and 14 monkeys have shown progressive changes which suggest that they may also become diabetic. Application of a highly constant antecedent diet and a consistent 16-h fast minimized experimental variability, and permitted the identification of 8 phases in the progression from normal lean young adult to overt Type 2 diabetes. The earliest changes which could be detected were a slight increase followed by a progressive rise in fasting plasma insulin levels and an increased insulin secretion in response to a glucose stimulus. These events preceded by several years the onset of a gradual deterioration of glucose tolerance. We found that hyper-, normo-, or hypoinsulinaemia could be associated with normoglycaemia or varying degrees of hyperglycaemia; however, the prospective longitudinal study of individual monkeys clearly identified this apparent heterogeneity of plasma insulin and glucose levels as reflecting sequential changes in a continuum of events preceding or accompanying the development of impaired glucose tolerance and Type 2 diabetes mellitus. PMID- 3542672 TI - Semi-quantitative assessment of anti-insulin total IgG and IgG sub-classes in insulin-immunized patients using a highly sensitive immunochemical micromethod. AB - An immunochemical micromethod was designed to estimate total IgG and IgG sub classes of anti-insulin antibodies in immunized diabetic patients. Insulin, immobilized on a solid phase, was allowed to react with serum samples containing anti-insulin antibodies. Bound anti-insulin IgG interacted with mouse monoclonal antibodies specific for total IgG or for each IgG isotype. The fixation of mouse monoclonal antibody was subsequently detected using a horseradish peroxidase conjugated rabbit anti-mouse IgG in the presence of a chromogenic substrate. The test was standardized by an immunocapture assay utilizing coated rabbit anti human IgG and known concentrations of purified human myelomatous proteins of each sub-class. Results of anti-insulin IgG and anti-insulin IgG sub-classes assay could therefore be expressed in ng equivalent myelomatous proteins per ml of serum. Analysis of serum samples from 24 insulin-immunized diabetic patients revealed a quasi absence of IgG2 anti-insulin antibodies and an increase of the relative abundance of the other three anti-insulin IgG isotypes. In our series, anti-insulin IgG1 was predominant, followed by IgG3 (in 17/24 patients) or IgG4 (in 7/24). Insulin immunization was deduced to be of polyclonal nature, the isotype pattern of which is not representative of the relative proportion of IgG sub-classes in whole normal serum. PMID- 3542673 TI - Induction of class II MHC antigens in vitro on pancreatic B cells isolated from BB/E rats. AB - The ability of recombinant Interferon-gamma to induce class II expression in vitro on pancreatic islet B cells has been investigated by exposing islets isolated from BB/E and normal Wistar rats to Interferon-gamma and then staining successively with monoclonal antibodies specific for rat class II MHC antigens and insulin. Induction of class II expression was never observed on islet cells obtained from either normal Wistar rats or rats from the BB/E low diabetes incidence (less than 2%) subline. In contrast, pancreatic B cells from rats from the BB/E high diabetes incidence (60-70%) subline expressed class II antigen following culture with Interferon-gamma. PMID- 3542674 TI - Occurrence of oral Candida albicans and other yeast-like fungi in edentulous patients in geriatric units in Iceland. PMID- 3542675 TI - Factors influencing prosthetic rehabilitation of edentulousness. PMID- 3542676 TI - A study on chewing efficiency in denture wearers with different types of artificial teeth. PMID- 3542677 TI - A plan for oral health research in aging: a collaborative project of the National Institute on Aging, the National Institute of Dental Research and the Veterans Administration. PMID- 3542678 TI - Acute periodontal infection associated with dental prostheses during cancer chemotherapy. PMID- 3542680 TI - Prevention of cancer of the colon--a review of faecal occult blood screening. PMID- 3542681 TI - Frequent attenders--a review. AB - Frequent attenders form a distinct group in any general or family practice. The physical, psychological and social factors associated with frequent attendance together with the means used for their identification are reviewed. The need for an approach which takes all these factors into account in order to best care for the patient's health is stressed. PMID- 3542679 TI - Fixed partial dentures: the use of a gothic arch tracer for jaw relations. PMID- 3542683 TI - [Effects of digestive hormones on the normal and pathological motility of the small intestine]. PMID- 3542682 TI - [Role of the digestive tract immune system in the control of bacterial translocation in gnotoxenic mice]. AB - The aim of this work was to study the role of gut associated lymphoid tissue in the control of bacterial translocation. Two strains of Escherichia coli were orally inoculated to 71 axenic mice. Ten days after, the 2 initial strains and 2 others, resulting from plasmidic exchanges, were present in the digestive tract of the mice which were divided in two groups: the first group (n = 41) received one intraperitoneal injection of cyclophosphamide 100 mg/kg; the second control group (n = 30) received isotonic saline. The following parameters were studied 3, 5 and 9 days after the injection: the population level of the 4 strains in the caecum, their translocation to mesenteric lymph nodes, liver, spleen and circulating blood, the density per unit surface of lamina propria plasma cells and intraepithelial lymphocytes in duodenal and caecal mucosae. The population in each strain found in the caecum was different from the 3 others but similar within the two groups of animals and remained unchanged with time. In the control group, bacterial translocation to the mesenteric lymph nodes decreased (p less than 0.01), while the density of plasma cells increased (p less than 0.01) from the 3rd to the 9th days. In the cyclophosphamide treated group, translocation to the mesenteric lymph nodes increased (p less than 0.01), while the density of intestinal plasma cells decreased (p less than 0.05) from the 3rd to the 9th days. Density of intraepithelial lymphocytes did not vary with time in each group and from one group to another. Bacterial translocation to liver, spleen and systemic blood was weak and did not increase in the treated group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542684 TI - [Lipid peroxidation, free radicals and alcoholic liver diseases]. PMID- 3542685 TI - [Ulcerative colitis caused by Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome]. AB - The authors report a case of ulcerative colitis due to Histoplasma capsulatum in a previously healthy 35 year-old french geologist with acquired immune deficiency syndrome (AIDS). Gomori-Grocott and PAS stains and indirect immunofluorescence revealed Histoplasma capsulatum in colonic biopsies. The search for LAV antibody was positive. T-lymphocyte analysis revealed 10/mm3 OKT4 with OKT4/OKT8 ratio of 0.16. Histoplasmosis should be considered in subjects with ulcerative colitis according to the epidemiological context. In patients with AIDS relapses after discontinuation of treatment are to be expected and suppressive therapy with an imidazole derivative should probably be continued indefinitely. PMID- 3542686 TI - [The irresistible advent of hepatic transplantation]. PMID- 3542687 TI - [What is the potential number of indications for liver grafts in France per year?]. AB - The progress recently made in liver transplantation requires an estimation of the potential number of cases per year in France. The study of French Death Rate per age group, compared with either formal, discutable or aleatory indications of transplantation, is a valuable basis for that calculation. It confirms the relative scarcity of the potential number of liver transplantations, which can be estimated at between 2 or 3 per year and per million inhabitants. PMID- 3542689 TI - [Colonic response to eating. Regulation and anomalies]. PMID- 3542688 TI - [Tolerance of hepatic allografts]. PMID- 3542690 TI - [Hysterosonography and its significance in the diagnosis of endometrial cancer]. AB - Hysterosonography is a method which enables the macroscopic spread of endometrial carcinomas in the uterus to be demonstrated. It is not a substitute for histologic findings. It only furnishes information about conditions within the organ, not beyond it. Compared to other image-producing methods used hitherto, this is the first which enables the extent of spread of the tumor to be determined macroscopically, for information purposes, prior to therapy. It is thus possible to plan the surgical procedure individually, and, if radiotherapy is employed, to determine exactly the target volume for intracavitary therapy. PMID- 3542691 TI - [External version of breech presentation--a possibility for lowering the rate of cesarean section and infant morbidity]. AB - Between 1979 and 1985 a total of 8641 children were born at the gynecological clinic in Winterthur, 388 of them (4.5%) from breech presentation. All of these were evaluated with regard to external version, and conditions for an attempt at version were satisfied in 97 cases. The principal prerequisite was a gestational age of at least 37 weeks. External version was accomplished in 39 of the 97 cases (40.2%). Complications encountered were drops in fetal heart tone or bradycardias in 26 cases (26.8%); the attempt at version was abandoned for this reason in 22 cases. In one case premature detachment of the normally implanted placenta occurred 6 days after successful external version, and in one case an emergency cesarean section had to be performed owing to persistent bradycardia. In a further case intrauterine fetal death was established 18 hours after successful version on the basis of an absence of fetal movement, though no cause of death could be found. Among the 39 cases in which version was successful a cesarean section was only necessary in one (2.5%), as opposed to 21 in the 58 cases (36.2%) in which the attempt at version failed. Neonatal fetal condition (Apgar score and umbilical blood gas analysis) revealed that neonates born from vertex presentation are subject to very considerably less stress. The international literature is discussed and compared. It is found that there has been a change of trend from a tendency to reject external version in the 1970s to a majority favoring it in the 1980s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542692 TI - [Twin pregnancy and labor only at a hospital center?]. AB - Concentrating the medical risk in hospital centres only is a demand that is being raised time and again, and it may be quite justified to some extent. The question is where to draw the line in respect of best possible medical care. The multiplicity of parameters involved makes it practically impossible to set up a hard-and-fast rule. However, the moral compulsion remains to justify the decision for shouldering a risk, by conducting a quantitative transversal comparative study. We compiled data on pregnancies and twin births at a medium-sized obstetric hospital. A transversal comparison of our results with those of major size hospital centres justifies that our hospital willingly took the risk of responsibility for twin care: Perinatal mortality is comparatively on the low side with 6.3%, whereas perinatal morbidity as established by studying the pH values, the Apgar scores, and the frequency rate of transferring the twins to the neonatology ward, is quite comparable. The article presents the guidelines laid down by us in respect of supervising parturition in twin births and discusses the enhanced risk and the measures resulting thereform. PMID- 3542693 TI - [Sonographic demonstration of a via falsa formation with imminent uterine rupture in uterus duplex unicollis]. AB - The diagnosis of a via falsa abnormality of uterus duplex unicollis by ultrasound is reported in a case of unclear gynecological examination finding. PMID- 3542695 TI - [Sonography of postoperative complications]. AB - Postoperative complications can be localised and identified via sonography. This is of special interest in haematomas and abscesses situated subfascially or in the true pelvis, where they often produce misleading clinical signs and symptoms. Of equal importance is the detection of an intraperitoneal or subperitoneal haemorrhage and an estimation of its amount, even if it is only a rough estimate. Effective therapy can be instituted as soon as an exact diagnosis has been established. PMID- 3542694 TI - [Complicated pregnancy course following kidney transplantation]. AB - During the last decade the rate of pregnancies in renal transplant recipients has been increasing. Now as before severe and unexpected complications can occur. After treatment with Dihydralazine in combination with Fenoterol we observed a drastic deterioration of kidney and heart function in one of our patients. Therefore such a drug combination does not seem to be recommendable for renal transplant recipients. PMID- 3542697 TI - [Differential diagnosis in lymphadenopathies]. PMID- 3542696 TI - [Experimental study of the protective activity of the plasma from donors immunized with an enterobacterial vaccine]. PMID- 3542698 TI - [Detection of antithrombocyte and anti-HLA antibodies by the methods of thrombocyte migration inhibition and immunofluorescence]. PMID- 3542699 TI - Immunofluorescent detection and localization of thyroxine in blood of adult amphibians. AB - Indirect immunofluorescent staining was used to detect and localize thyroxine (T4) in blood smears from different species of adult amphibians, namely, Rana pipiens, Rana catesbeiana, Bufo marinus, Xenopus laevis, and Notopthalmus viridescens. Fluorescence, indicative of T4, was observed in both plasma and erythrocytes (RBC) from all individuals of the five species studied. It was weak and diffuse in the plasma and in the cytoplasm of the RBC but was intense in the nuclei (especially the nuclear perimeter) of these cells. The finding of intracellular T4 suggests that thyroid hormone may be of some physiological importance in adult amphibians. PMID- 3542701 TI - In memoriam Grace E. Pickford (1902-1986). PMID- 3542700 TI - Altered glucagon release in biotin deficiency. AB - Classical biotin deficiency in young chickens is characterized by a reduction in the activity of liver biotin-dependent enzymes which thus impairs gluconeogenesis during periods of food withdrawal. Because the normal bird maintains an elevated fasting blood glucose level, the ability of the classically biotin-deficient animal to resist changes induced by fasting has not been established. Whether the release of insulin and/or glucagon is affected by biotin deficiency has not been investigated and so determining the importance of these hormones in maintaining fasting glucose levels as well as their ability to respond to a challenge is the objective of the present study. Experimental animals (15-week-old cockerels) were fed a biotin-deficient diet for 9 weeks while control animals (n = 8) were pair fed biotin-supplemented diets. Before fasting, concentrations of plasma glucose, insulin, and glucagon were not different between the two groups. After 72 h of fasting basal glucose levels remained the same in both groups and concentrations of plasma insulin were equally suppressed but concentrations of glucagon were significantly elevated in biotin-deficient animals (P less than 0.025). Ten minutes after an iv glucose challenge the magnitude of the increase in plasma insulin concentrations was equivalent for both groups of animals whereas the magnitude of the decline in plasma glucagon concentrations was greater for biotin deficient birds. Twenty minutes after a protein challenge (purified casein diet) the levels of plasma glucagon in both groups were maximally increased although the concentrations remained elevated only in control animals. In conclusion the release of insulin and glucagon is not impaired in biotin-deficient animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542702 TI - [Function of crossing-over]. AB - The literature data are considered concerning the significance of genetic recombination and crossing over. An obvious result of recombination is production of the genotypically diverse offspring, but the main role of recombination consists of combining the genes from diverging subspecies and races, thus maintaining a rather wide ecological potential of a species. This effect of recombination substantiates the tendency for increasing complexity of organic forms in progressive evolution. Accordingly, evolution is considered as a chain of recombinational "syntheses". The literature data treating crossing over as a mechanism of DNA repair are discussed. This function of crossing over is interpreted, based on a notion implying, from the composition of genetic code, that a crystalline associate composed of bases as free molecules precedes the appearance of DNA in evolution. The stability of the crystalline associate of bases was due to "balanced" distribution of bases for their electrochemical properties. The degeneracy of genetic code seems to provide possibility of construction of the electrostatically "balanced" base sequences in highly expressed bacterial genes. Crossing over possibly recovers "balanced" distribution of bases for their electrochemical properties and thus "repairs" a high level of heterocatalytic DNA activity. PMID- 3542703 TI - [The genetic Rec system of homologous recombination in Escherichia coli]. AB - A review of modern data on genetic and biochemical bases of the Rec system is presented. Taking into consideration the final result of recombination, that is the preferential way of integration of donor DNA into recipient chromosome, it is proposed to distinguish three main pathways of homologous recombination RecBC (recF- recipient genotype), RecF (recBC- sbcB- sbcC-) and SOS. A recBC nuclease unwinds a donor linear DNA duplex to create the 3'-single-stranded end which was shown to be responsible for the initiation of recombination with the help of RecA protein. As a result, integration of single- and double-stranded donor fragments into recipient chromosome takes place in full accordance with the Meselson Radding model. The peculiarity of the RecF pathway is its ability to promote recombination between two DNA closed ring structures. The SOS way is characterized by frequent single-stranded DNA exchanges. Both pathways are interconnected. The SOS way is regarded here as an extreme situation of the RecF one. PMID- 3542704 TI - [Substitution of RNA-polymerase sigma-subunits and transcription regulation]. AB - Recent data on regulation of gene activity in bacteria by substitution of RNA polymerase sigma subunits are reviewed. The htpR gene which controls the switch on of the Escherichia coli heat-shock protein synthesis codes for sigma 32 subunit. sigma 32-containing RNA polymerase transcribes the heat-shock genes in vitro from specific promoters of no use for RNA polymerase containing the major sigma 70 subunit. Several minor sigma subunits have been found in Bacillus subtilis vegetative cells, in addition to the major sigma 55 subunit, differing in the specificity of promoter recognition. Many B. subtilis genes are controlled by tandemly located promoters recognized by RNA polymerases carrying different sigma subunits. sigma 29 subunit is encoded by spoIIG gene and is probably involved in the regulation of sporulation. Specific sigma subunits for transcribing "middle" or "late" genes are encoded by a number of phages. PMID- 3542705 TI - [Actinomycetes--the test-organisms of genetic engineering]. AB - The paper contains a short review of the data on using the methods of genetic engineering in studies of genetics and molecular biology in Streptomyces. The techniques of DNA introduction into actinomycetes and wide-spread vectors are briefly described. The origin of the actinomycete plasmids as chromosomal segments capable of autonomous replication is discussed. In this view, it is suggested that genetic instability in actinomycetes is connected with excision of specific DNA sequences from the chromosome at frequencies characteristic of recombination events. Also, amplification of short DNA segments within the chromosome resulting in tandem repeats is a consequence of unequal crossing over between direct repeats flanking the amplifying DNA and, possibly, of induction of replication of this DNA. The data on molecular cloning of actinomycete genes for primary metabolism and those for resistance to and biosynthesis of antibiotics, on using actinomycetes as the hosts for foreign genes to be expressed, as well as on analysis of nucleotide sequences of actinomycete DNA, are presented. PMID- 3542706 TI - [Genome organization of the plasmid of IncQ/P4 group and its vector derivatives]. AB - The genome organization and functioning of IncQ/P4 plasmids are reviewed. Based on these plasmids, cloning vectors have been constructed for broad host range of gram-negative bacteria. Together with one- and two-replicon vectors for cloning via insertion inactivation of markers, specialized plasmid vectors are described: cosmids, promoter-probe vectors, vectors for direct selection of recombinant molecules. Examples of using broad host range vectors for gene cloning and expression in non-enteric gram-negative bacteria are presented. PMID- 3542707 TI - [Various characteristics of gene localization in eukaryotic chromosomes. Formulation of a problem and analysis of non-random localization of mating type loci in fungi]. AB - We have denoted two possible models of gene order evolution as the "card" and "chess" models. The first suggests random shuffling of genes during evolution, the second--non-random gene transposition, gene order being checked by natural selection. We discuss here localization of the mating type locus in fungal genomes. In 8 of 10 genetically well studied species of ascomycetous fungi, the mating type locus is linked to a centromere; in one species, it segregates regularly during the second meiotic division, and only one species does not show any regularity in the mating type locus segregation. Centromeric linkage of the mating type locus maintains heterozygosity of all centromeric genome regions during intratetrad fertilization observed in some fungi. Non-random localization of mating type locus can be considered as the means for conservation of heterozygosity. PMID- 3542708 TI - [Hybridization of cells of the same mating type in Saccharomyces yeasts]. AB - The problem of mating-type switches in heterothallic yeast cells was investigated. 93% of non-mating hybrids were obtained in a X a crosses. The hybrids obtained in alpha X alpha crosses expressed alpha-mating type predominantly. Hybrids with no major rearrangements or loss of chromosome III were detected among these hybrids. In the selective system for cytoduction in a X a crosses the significant part of all cytoductants were alpha-maters, i.e. those originated through a----alpha switches. In alpha X alpha crosses alpha cytoductants were predominantly obtained either spontaneously or after UV irradiation, though the frequency of cytoductants after UV-irradiation exceeded the control value several times. So, we developed the method for selection of mating-type "switchers" (a in equilibrium alpha), avoiding the diploid stage, and demonstrated the possibility of hybridization among the alpha-cells without hereditary changes at the MAT locus. PMID- 3542709 TI - [Mutants of Escherichia coli K-12 with increased resistance to ionizing radiation. VI. Increased radioresistance and heat shock proteins]. AB - By means of one-dimensional electrophoresis, it is shown that in radiation resistant Gamr444 and Gamr445 mutants of Escherichia coli K-12 high-molecular weight heat shock proteins are hyperproduced at 32-37 degrees C and are induced more intensively during heat shock (in comparison to the parental wild-type strain AB1157). When the missense htpR15 mutation of the positive regulatory htpR gene for heat shock proteins was introduced by transduction into the genome of the Gamr444 mutant, its enhanced radiation-resistance disappeared but could be restored upon introduction of pKV3 plasmid bearing the htpR+ gene. These data show that heat shock proteins are participating in the enhanced radioresistance of Gamr mutants. PMID- 3542710 TI - [A new vector for cloning of genes and replicons in yeasts]. AB - A novel Escherichia coli-Saccharomyces cerevisiae shuttle vector lambda MAN78 has been constructed. The vector contains phage lambda 47.1 DNA, Sacch. cerevisiae chromosomal segment with TRP1 gene and the yeast ARS1 replicator. This vector may be propagated as a phage and, similar to parental lambda 47.1, allows direct selection of large DNA inserts (15-24 kbp) in E. coli. lambda MAN78 can efficiently transform LiCl-treated yeast cells (3-5 X 10(3) transformants per 1 microgram DNA). Replication of hybrid molecules in E. coli cells does not influence the ability of the molecules to transform yeast cells and replicate in the cells. PMID- 3542711 TI - [Genetic analysis of mitochondrial rho-mutability in Saccharomyces. III. Comparative analysis of the effect of various nuclear srm mutations and disomy for chromosome IV on rho-mutagenesis]. AB - Different combinations of modifying genes which enhance the rho- mutability of haploid yeast cells are shown to be suppressible by the srm1, srm2, srm3 mutations and by the disomy for chromosome IV. The srm1 mutation leads to dramatic decrease in both the spontaneous and ethidium-bromide induced rho- mutability. Other srm mutations studied and the disomy appear to cause relatively moderate quantitative changes in the spontaneous rho- mutation rate and to have no significant effect on mutation induction by ethidium bromide. Neither additivity nor synergism was revealed by the analysis of the interaction between the srm mutations. We suggest that in Saccharomyces an efficient mechanism of the rho- mutagenesis operates which can be directly affected by the srm1 mutation and more or less modified by other srm mutations under study and by the disomy for chromosome IV. PMID- 3542712 TI - Characterisation of an mRNA encoding a human ribosomal protein homologous to the yeast L44 ribosomal protein. AB - We describe the isolation and characterisation of a full-length cDNA sequence (pZH-21) of a human ribosomal protein (rp) mRNA isolated from a cDNA library constructed from the human ZR-75-1 mammary tumour cell-line. The predicted protein is highly basic and shows 72% homology at the amino acid (aa) level with yeast rp L44. Comparative RNA blotting of ZR-75-1 poly(A)+ RNA isolated from cells cultured in the presence of the anti-oestrogen tamoxifen demonstrates the presence of a number of mRNA species whose concentration is elevated co ordinately 5-6-fold in the presence of 17beta-oestradiol. Insulin in the presence of tamoxifen, also enhanced rp mRNA levels suggesting increased levels are a reflection of cell proliferation as opposed to specific hormonal regulation. Genomic analysis demonstrates the presence of a family of related human sequences, and homology with rat and guinea pig rp genes, but not yeast DNA. The conservation of rp aa sequence, in the absence of detectable homology at the nucleotide (nt) level, points to an important common functional role of the L44 protein in ribosome structure and function in man and yeast. PMID- 3542713 TI - Isolation of a cytochrome P-450 structural gene from Saccharomyces cerevisiae. AB - We have transformed a Saccharomyces cerevisiae host with an S. cerevisiae genomic library contained in the shuttle vector YEp24 and screened the resultant transformants for resistance to ketoconazole (Kc), an inhibitor of the cytochrome P-450 (P-450) enzyme lanosterol 14 alpha-demethylase. Two plasmids were isolated which transformed yeast to both increased resistance to Kc and increased levels of total P-450. Hybrid-selection and immunoprecipitation experiments showed that these plasmids, pVK1 and pVK2, contained the structural gene for an S. cerevisiae P-450. This conclusion was confirmed by the nucleotide sequence of a portion of pVK2, which revealed an open reading frame encoding a characteristic P-450 heme binding region. PMID- 3542714 TI - The nucleotide sequence of a cDNA clone containing the entire coding region for mouse X-chromosome-linked phosphoglycerate kinase. AB - A clone containing cDNA for X chromosome-linked phosphoglycerate kinase (PGK-1) was isolated from a mouse myeloma cDNA library. The nucleotide (nt) sequence of the cDNA has been determined, and the amino acid (aa) sequence of the enzyme thereby deduced. At the nt level, the coding region of mouse PGK cDNA has 93% homology with human X-linked cDNA and 60% homology with the yeast gene. Mouse PGK 1 protein contains 416 aa and is 98%, 96% and 64% homologous with human, horse, and yeast enzyme sequences, respectively. PMID- 3542715 TI - Versatile kanamycin-resistance cartridges for vector construction in Escherichia coli. AB - To generate polylinker sequences which can be transferred together with an adjacent selectable marker, two plasmids (pWW-84 and pWW-97) were constructed which contain a kanamycin-resistance gene (KmR) flanked by various restriction sites. From these plasmids KmR-cartridges can be obtained as EcoRI, BamHI, SalI, AccI or HincII fragments for insertion into the appropriate restriction site of any plasmid. The following restriction sites can be introduced with these cartridges: BamHI, SalI (AccI, HincII), EcoRI, SacI, SphI and KpnI (Asp718) all adjacent to KmR, XhoI and HindIII, both within KmR. If desired, KmR can be removed by PstI digestion and religation, creating a single PstI site and leaving all adjacent sites intact. PMID- 3542716 TI - Unusually high-level expression of a foreign gene (hepatitis B virus core antigen) in Saccharomyces cerevisiae. AB - As a model system for the study of factors affecting gene expression, hepatitis B virus core antigen (HBcAg) has been expressed in the yeast Saccharomyces cerevisiae. The singularly high levels of expression achieved are approx. 40% of the soluble yeast protein. The HBcAg polypeptides are present as 28-nm particles which are morphologically indistinguishable from HBcAg particles in human plasma and are highly immunogenic in mice. The plasmid construction employed to achieve these very high levels of expression utilizes the constitutively active yeast promoter from the GAP491 gene which is fused in a way that all non-translated sequences flanking the HBcAg coding region are yeast-derived. Hybrid constructions containing 3'-nontranslated viral DNA (yeast 5') or 5' nontranslated viral DNA (yeast 3') as well as a construction with both 5'- and 3' nontranslated viral DNA also have been made. A comparison of these constructions for levels of HBcAg expression indicates that the strongest contributor to the high levels of protein is the presence of 5'-flanking sequences which are yeast derived; secondarily, a significant improvement can be achieved if the 3' flanking sequences also are yeast-derived. The high abundance of HBcAg in the highest producer is explicable in part on the basis of the very high stability in yeast cells of HBcAg polypeptides. Analysis of the HBcAg coding sequence reveals a very low index of codon bias for S. cerevisiae, largely discounting codon usage as a contributor to the high level of protein obtained. PMID- 3542717 TI - Molecular cloning and regulation of the expression of the MET2 gene of Saccharomyces cerevisiae. AB - The MET2 gene of Saccharomyces cerevisiae, which codes for homoserine-O acetyltransferase, a key enzyme in methionine biosynthesis, was isolated by complementation of a met2 mutant strain of S. cerevisiae with a yeast gene bank. A 3.9-kb genomic fragment contains the entire gene, as demonstrated by genetic and molecular analysis of the integrative transformants. A polyadenylated mRNA of 1700 nt is detected by Northern blot hybridization with a MET2 probe. The level of this mRNA decreases by addition of exogenous methionine or of S adenosylmethionine, suggesting a transcriptional regulation. The level of specific mRNA and the enzyme activity found in transformants that bear the MET2 gene on a multicopy plasmid suggest that also a post-transcriptional regulatory mechanism may be operative in budding yeast. PMID- 3542718 TI - Cloning of open reading frames and promoters from the Saccharomyces cerevisiae genome: construction of genomic libraries of random small fragments. AB - We have developed a novel efficient method, carrier-facilitated insertion, to insert small (150-600 bp) DNA fragments into plasmid vectors. This method employs a carrier segment of vector DNA to circumvent the difficulties in ligating two fragments together to generate a recombinant circle efficiently. We have used carrier-facilitated insertion to construct three genomic libraries of random (DNase I-generated) fragments from the Saccharomyces cerevisiae genome. One of these was an expression library, and the other two were promoter-cloning libraries. 87-90% of the Escherichia coli colonies in each library contained recombinant plasmids, and less than 3% of the recombinants contained more than one insert. Detection of open reading frames among the inserts in the expression library was accomplished by testing for beta-galactosidase activity. This methodology, unencumbered by the intrinsic disproportionality of cDNA libraries, can be used to identify and clone DNA that codes for a specific antigenic determinant. When used in combination with a method to detect and isolate random constitutive, repressible and inducible yeast promoters, these libraries should permit a comprehensive analysis of the yeast genome and its expression. PMID- 3542719 TI - Conservation and antigenicity of N-terminal sequences of GP185 from different Plasmodium falciparum isolates. AB - Complementary DNA (cDNA) clones for GP185, a major antigenically diverse glycoprotein of Plasmodium falciparum, were isolated from a cDNA library of the Honduras I/CDC (Honduras I) isolate, and 1052 bp were sequenced. The expression of cDNA fragments in Escherichia coli using the vector pCQV2 allowed verification of the reading frame. This GP185 cDNA sequence, like the cDNA sequence for a homologous gene of the K1 isolate [Hall et al., Nature 311 (1984) 379-382], codes for a polypeptide which is truncated due to multiple, in-frame stop codons. This polypeptide corresponds to the N-terminal 15% of the proposed coding region of the GP185 gene [Holder et al., Nature 317 (1985) 270-273]. Comparison of the nucleotide sequences for the GP185 gene of Honduras I and five other isolates indicated that there are two areas of conserved DNA sequence, one of 310 bp (beginning 181 bp upstream from the proposed initiation codon) and the other of greater than or equal to 360 bp (located entirely within the coding region), separated by a region encoding isolate-specific tandem amino acid repeats. Rat antiserum was raised to a fusion protein derived from the conserved regions and the intervening repeat region of this Honduras I protein. This antiserum bound GP185 on immunoblots of the homologous Honduras I isolate and the heterologous K1 isolate, which has different tandem repeats. Serum from owl monkeys and humans previously infected with P. falciparum reacted with the fusion protein on immunoblots demonstrating that determinants in the N-terminal 15% of GP185 were immunogenic in infected individuals and suggesting that some of these sites are conserved among isolates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542720 TI - Molecular cloning and characterization of the MET6 gene of Saccharomyces cerevisiae. AB - A yeast DNA fragment complementing the met6 mutation in yeast (Saccharomyces cerevisiae) was cloned in a shuttle vector, Yep13, by transforming a yeast host with plasmid DNA prepared from yeast gene bank CV13 of K. Nasmyth. A restriction map of a 6-kb Sau3A insert was constructed. A 2.6-kb fragment (Sau3A-BamHI) complementing the mutation was found by subcloning. Evidence that the DNA fragment contains the yeast MET6 gene was obtained by genomic integration. A 2.5 kb transcript is found both in wild-type (wt) and met6 yeast strains by Northern blotting experiments, indicating that the mutation acts at posttranscriptional level. The rate of transcription for the integrant lies between the values observed for the wt and mutant strains. The functional gene product seems to be involved in negative regulation of transcription of the MET6 gene. PMID- 3542721 TI - Construction of LYS2 cartridges for use in genetic manipulations of Saccharomyces cerevisiae. AB - Linker arrays were added to the 5' and 3' boundaries of the Saccharomyces cerevisiae LYS2 gene, which allow the generation of 18 LYS2 cartridges with different sticky ends. As it was necessary to define the beginning and the end of the approx. 4.5-kb LYS2 gene, we sequenced 1 kb of its 5' and 1.5 kb of its 3' region and mapped the mRNA start point. The open reading frame (ORF) found by this analysis was proven to be the LYS2 ORF by exchanging the sequences upstream from the presumptive ATG with the S. cerevisiae CYC1 promoter and subsequent demonstration of LYS2 expression in vivo. The proper functioning of the LYS2 cartridges was demonstrated by the transformation of lys2 mutant strains to Lys+ prototrophy using plasmids furnished with a LYS2 cartridge. PMID- 3542722 TI - Mike, a chimeric filamentous phage designed for the separate production of either DNA strand of pKUN vector plasmids by F+ cells. AB - To enable the separate production of either DNA strand of recombinant pKUN plasmids [Peeters et al., Gene 41 (1986) 39-46] by conjugation-deficient F+ cells a chimeric Ff/IKe filamentous phage, Mike, has been constructed. Its genome contains the functions required for asymmetric DNA replication from the N-plasmid specific filamentous phage IKe, and the functions required for host cell penetration, single-stranded DNA accumulation, phage assembly, and secretion from the F-plasmid specific filamentous phage Ff (i.e. M13, fl, or fd). PMID- 3542723 TI - Anticoagulants in the prevention of embolic stroke. Part I. AB - Cardiac lesions among those at high risk of cerebral emboli include: atrial fibrillation, rheumatic mitral valve disease, acute myocardial infarction, prosthetic heart valves, and idiopathic dilated cardiomyopathy. Many of these patients can be protected from cerebral infarction by anticoagulants. Following a cardiac embolic stroke, CT scans are critical in deciding for whom and at what time anticoagulation should be considered. From studies of CT and cerebrovascular pathology, it has become clear that it is the cerebral infarct rather than the arterial occlusion that provides the key piece of information in deciding whether and when anticoagulants should be considered for the secondary prevention of cardiac emboli among patients who present with a clinical stroke. PMID- 3542725 TI - Cardiopulmonary disorders during sleep: diagnosis and management. AB - Sleep-related breathing disorders may contribute to the nocturnal peak in human mortality. Nocturnal hypoxia has been associated with serious ventricular tachyarrhythmias as well as life-threatening bradyarrhythmias. Obesity and snoring, both of which increase with age, have been identified as risk factors for sleep-related breathing disorders, as have hypertension and heart disease. PMID- 3542726 TI - Newer antibiotics: their place in geriatric care. Part II. AB - The pharmaceutical industry has addressed the problem of combating infections caused by gram-negative aerobic bacilli with the development of newer penicillins and a novel class of antibiotics known as the carbapenems. These compounds represent the culmination of years of research designed to overcome bacterial resistance mediated by inactivating enzymes, called beta-lactamases. These latter enzymes, contained within the gram-negative aerobic bacilli, have the capacity to hydrolyze select penicillins to inactive derivatives. We outline the therapeutic indications and limitations of these newer antibiotics. PMID- 3542724 TI - Diuretics and alternative drugs in geriatric hypertension. AB - Thiazide diuretics are the preferred initial therapy in the majority of elderly hypertensive patients--based upon efficacy and long-term safety data. Alternative therapies may be used in subjects with persistent gout, impotence, fatigue, or electrolyte disturbances. In patients with ischemic heart disease and/or angina, beta adrenergic inhibitors or calcium entry blockers are acceptable initial therapy. Converting enzyme inhibitors may be especially useful in hypertensives with congestive heart failure. The combination of small dose diuretic therapy and one of the above alternative drugs has an important place in the treatment of the elderly hypertensive. PMID- 3542727 TI - [Hygienic evaluation of global Kr-85]. PMID- 3542728 TI - [Survival of Proteus vulgaris in soil contaminated by diesel fuel]. PMID- 3542729 TI - Change in type A behavior a year after retirement. PMID- 3542730 TI - Why won't physicians make nursing home visits? PMID- 3542731 TI - A case study of HMO Medicare enrollment. PMID- 3542732 TI - Character and aging in Moll Flanders. PMID- 3542733 TI - [Cytologic verification of spontaneous ovulation monitored by ultrasonography]. PMID- 3542734 TI - [The contribution of Polish gynecologists to the control of female genital neoplasms]. PMID- 3542735 TI - The effect of chronic hyperinsulinemia on ovine fetal growth. AB - Infusion of exogenous insulin for 18 days to seven ovine twin fetuses caused hyperinsulinemia (31.0 +/- 6.9 microU/ml) when each was compared to its sham infused twin (6.6 +/- 0.7 microU/ml). The hyperinsulinemic fetuses also had lower arterial serum glucose concentrations (0.77 +/- 0.07 mM) than their sham-infused controls (1.10 +/- 0.04 mM). There were no significant changes in fetal weight or height attributable to insulin infusion. Our methods would have detected a 12% difference in fetal weight; therefore, the lack of effect of insulin on fetal weights was not due to excessive variability of the difference in weights between twins. Hyperinsulinemia increased the myocardial cellular contents of protein and RNA, which suggested that myocardial hypertrophy occurred; however, heart weight itself was not significantly increased. This apparent contradiction may be due to considerable variability in heart weight. From the above data, we conclude that 19 days of documented ovine fetal hyperinsulinemia does not increase the growth rate of the nearterm ovine fetus. PMID- 3542736 TI - [Pleural aspergillosis]. PMID- 3542737 TI - [Aortic valvuloplasty in patients with an interventricular septal defect complicated by aortic valve insufficiency]. PMID- 3542738 TI - [Congenital aneurysm of the sinus of Valsalva]. PMID- 3542739 TI - [Reconstruction of the mitral valve in avulsion of the chordae from the anterior cusp]. PMID- 3542741 TI - Ultrasound scanning and 99mTc sulphur colloid scintigraphy in diagnosis of Budd Chiari syndrome. AB - Ultrasound scanning and 99mTc sulphur colloid scintigraphy are widely used in the diagnosis of the Budd-Chiari syndrome and have been compared at the time of presentation in 18 patients in whom the diagnosis was subsequently confirmed by histology and hepatic venography. Ultrasound was diagnostic in 16 (87%). The findings seen most often included hepatic vein abnormalities, caudate lobe hypertrophy with decreased reflectivity and compression of the inferior vena cava. Additional information not shown by scintigraphy included intracaval tumour, or thrombosis, and concomitant portal vein thrombosis. Although scintigraphic abnormalities were present in all patients, only in three (17%) was the 'classical' appearance of increased uptake and/or enlargement of the caudate lobe present. In one patient with nonspecific abnormalities on ultrasound, scintigraphy gave a positive diagnosis and it is in such cases that scintigraphy should continue to be used. PMID- 3542740 TI - Seropositivity in Dutch Crohn's disease patients against primed nude mouse lymph nodes, and the difference with lymphocytotoxic antibodies. AB - Sera from patients with Crohn's disease have been reported to show positive immunofluorescence with lymph nodes of nude mice primed with a filtrate of intestinal tissue affected with Crohn's disease. An indirect immunofluorescence assay was used to test sera of 63 unrelated patients with Crohn's disease, 21 with ulcerative colitis and 36 control subjects against lymph nodes of athymic nude (nu/nu) mice which had been injected with Crohn's disease and ulcerative colitis intestinal tissue filtrates. Forty nine per cent of Crohn's disease patients, 10% of ulcerative colitis patients and 3% of control sera reacted against lymph nodes of mice injected injected with ulcerative colitis intestinal tissue filtrates, 18% of Crohn's disease sera were with intestinal tissue homogenate from Dutch Crohn's patients. With the lymph nodes of mice injected with ulcerative colitis intestinal tissue filtrates, 18% of Crohn's disease sera were positive, whereas all ulcerative colitis and control sera were negative. Lymph nodes from 18 of the 19 mice injected with Crohn's disease tissue filtrates reacted with Crohn's disease sera, whereas only three of these 19 mice reacted with ulcerative colitis sera. A comparative study, carried out in parallel with Crohn's disease filtrate induced hyperplastic lymph nodes from the Bilthoven colony (W2) and from the New York colony (E671) using sera from 54 Crohn's disease patients from Leiden, showed immunoreactivity with 44 and 57% of the Crohn's disease sera against the two hyperplastic lymph nodes. Thirty six of the 54 Crohn's disease sera (67%) reacted with either or both lymph nodes. Only 11% of the Crohn's disease sera which were examined for immunofluorescence and lymphocytotoxic antibodies had lymphocytotoxic antibodies, whereas 40% and 46% of the same sera showed positive immunofluorescence against E671 and W2, respectively. Absorption studies indicated that lymphocytotoxic antibodies activity and the immunofluorescence against the primed nude mouse lymph node are mediated by different serum antibodies in Crohn's disease. The reproducibility of the nude mouse immunofluorescence test system for a preferential immunoreactivity of Crohn's disease sera against Crohn's disease tissue primed murine lymph nodes has been confirmed by the present study. Further studies are necessary to find out whether crossreactive antigen(s) as recognised by some of the Crohn's disease sera in mice injected with ulcerative colitis tissue filtrate is similar to the antigen(s) detected by Crohn's disease sera in mice injected with Crohn's disease tissue filtrates. PMID- 3542743 TI - Doxorubicin-cisplatin-vinblastine combination chemotherapy of advanced endometrial carcinoma: a Southwest Oncology Group Study. AB - A combination of doxorubicin (30 mg/m2 iv), cisplatin (50 mg/m2 iv), and vinblastine (5 mg/m2 iv) repeated every 3-4 weeks was used to treat 55 patients with advanced stage III or IV or recurrent disease. Of the 42 fully evaluable patients, there were 3 complete responders (7%) and 10 partial responders (24%). Responses were of short duration (median of 8 months, range 3-15 months) and the median survival of all evaluable patients was only 10 months from the start of therapy. Leukopenia was the major toxicity and was at least moderate in two thirds of patients. We conclude that the addition of cisplatin and vinblastine to doxorubicin does not improve the clinical utility of doxorubicin in patients with advanced endometrial cancer. PMID- 3542742 TI - Pain control: an experiment with imagery. PMID- 3542745 TI - [Reconstruction of flexor tendons following prognostically unfavorable injuries in the "no man's land" of the hand using transplantation of a tendon-tendon sheath unit--preliminary report]. AB - For the reconstruction of injured flexor tendons with a bad prognosis in "no man's land", the authors used a composite flexor tendon graft from the foot. In one case, first in the literature, they carried out the transplantation with microvessel anastomosis. They modified the method proposed by Chacha in 1974 in several ways. On the basis of their favourable results they propose the method for reconstruction after flexor tendon injuries with a poor prognosis. PMID- 3542746 TI - [Early mechanical strength of sutures of the finger flexor tendons]. AB - The authors observed the behaviour of flexor tendon repair under the influence of distracting loads. The methods of Bunnell, Kleinert and Kessler, who use the imbedded suture, were compared with the method of Becker, in which an external cross suture is used. The authors tested their own technique, using transplants or implants of corium, fascia, dura mater and polyester net, internally in the tendons, fastening them with an external cross suture. In the authors' technique the disruption of the tenorrhaphy occurs only with forces much greater than those needed for treatment by controlled mobilization. PMID- 3542744 TI - [A new method for the reconstruction of injured flexor tendons of the hand: tendons and tendon sheath reconstruction in 2 stages]. AB - The authors have developed a new two-stage method of flexor tendon reconstruction for injuries in the critical zone of the hand. In the first phase of the secondary operation, they preserve the intact portions of tendon sheath. They replace the scarred tendon sheath: small retinacular defects with autologous vein grafts, larger pulley defects with fascial grafts. A silicon rubber rod is placed in the reconstructed tendon sheath. In the second stage of the operation, after six weeks generally, an autologous tendon is placed in the reconstructed tendon sheath. The authors present their material and results: In 12 of 18 flexor tendon reconstructions they achieved excellent or good results. Therefore, they propose their method for reconstructing injured flexor tendons with an unfavourable prognosis. PMID- 3542747 TI - [Use of a fascia flap of the forearm in soft tissue defects of the extremities]. AB - The forearm flap can be used as a free fascial flap alone, thereby avoiding the displeasing scar arising at the donor site which has been covered in split-skin grafting. A case of a free fascial flap in a burn injury of the lower leg is demonstrated. PMID- 3542748 TI - [History of the surgical treatment of decubitus ulcers]. AB - A retrospective presentation of the development of surgical treatment for pressure sores is given. Experimental research is described for the etiology and pathogenesis of decubital ulcers. Typical localizations and predisposing factors for pressure sores are mentioned. PMID- 3542749 TI - [Ultrasonography in the diagnosis of abdominal aortic aneurysms]. PMID- 3542750 TI - [Prognosis and survival in chronic lymphocytic leukemia]. PMID- 3542751 TI - [Prostaglandins and the kidney]. PMID- 3542752 TI - [Enuresis nocturna in young adults]. PMID- 3542753 TI - [Enterovirus infections in infants in the first weeks of life]. PMID- 3542754 TI - [Diaphragmatic hernia--perinatal aspects]. PMID- 3542755 TI - Methodology for studying antioxidant activity and mechanisms of action of antioxidants. AB - A brief survey of the main reactions involved in lipid peroxidation and of the principal methods used for the detection of lipid peroxidation in authentic food, in model systems and in biological material is given. The reaction of phenolic antioxidants with various radicals generated during lipid peroxidation and the synergism between individual antioxidants are outlined. The biological consequences of lipid peroxidation and the protective properties of antioxidants are discussed. In addition, the scavenger action of antioxidants toward inorganic oxygen radicals is described, and it is demonstrated that propyl gallate surpasses butylated hydroxyanisole and butylated hydroxytoluene in its capacity to remove hydroxyl radicals and superoxide radicals from aqueous model media and from biological material. Biochemical actions of antioxidants that may be involved in the anti-carcinogenic and proliferation-stimulating effects of antioxidants in vivo are listed. PMID- 3542756 TI - Occurrence of lipid oxidation products in foods. AB - Lipid oxidation products are ubiquitous in foods, although much variation exists in the levels present. Although these levels are generally low, the problem of lipid oxidation severely compromises the quality of some foods and limits the shelf-life of others. Lipid oxidation represents a key barrier in the development of new food products and processes, especially convenience items and processes required to manufacture them. Deleterious changes in foods caused by lipid oxidation include loss of flavour, development of off-flavours, loss of colour, nutrient value and functionally, and the accumulation of compounds which may be detrimental to the health of consumers. All foods that contain lipids are susceptible to oxidation but especially affected are foods which are dehydrated, subjected to high temperatures or cooked and subsequently stored, e.g. dehydrated eggs, cheeses and meats, foods fried in frying oils, and cooked (uncured) meats. Specific examples of compounds which are of health concern include lipid peroxides and the free radicals involved in their formation and propagation, malonaldehyde, and several cholesterol oxidation products. Coronary artery disease (CAD) may be in part caused by the consumption of lipid oxidation products. PMID- 3542757 TI - An assessment of the safety of tocopherols as food additives. AB - This paper is a critical review of data relevant to the safety of tocopherols as food additives. Tocopherols are considered from the standpoint of their chemical physical properties, occurrence in nature and use in commercial products. Dietary intake and kinetic and metabolic data, as well as biological activity and interactions with other vitamins, are also examined. The subjects discussed include acute, subchronic and chronic toxicity data, reproduction and teratogenesis studies, and observations in humans following high intakes of tocopherols. On the basis of the comprehensive experimental and clinical data available on alpha-tocopherol, the chemical and biological similarity of the alpha-, beta-, gamma- and delta-tocopherols and the information available on the levels of tocopherols used as food antioxidants, it is concluded that tocopherols are safe food additives. PMID- 3542758 TI - Toxicology of tert-butylhydroquinone (TBHQ). AB - This paper traces the history of the EEC Scientific Committee for Food's examination of available toxicological data on tert-butylhydroquinone (TBHQ). Studies of mutagenicity, metabolism, enzyme activities, reproduction and long term toxicity and carcinogenicity are reviewed. The author concludes that dose level is an important factor in the induction of forestomach tumours. Further long-term toxicity testing of TBHQ is needed to evaluate its genotoxicity. However, since information is not available, an attempt is made to calculate the 'safety' margin between actual intake by man and the conventional no-effect level in dogs and rats. PMID- 3542760 TI - Forestomach carcinogens: possible mechanisms of action. AB - A brief review indicates that a considerable number of compounds induce forestomach tumours in different species. Naturally occurring forestomach tumours are rare (an incidence of less than 1%) in rats and mice, but they do occur in hamsters with incidences up to 12%. Most forestomach carcinogens are known to be genotoxic, although a few non-genotoxic substances are also able to induce this type of tumour. The promoting and inhibiting action of substances in a two-stage forestomach tumour model is described. Morphologically the development of tumours is characterized by early lesions such as epithelial damage, hyperplasia and hyperkeratosis, which at a later stage progress to strong diffuse hyperplasia, dysplasia, papilloma and squamous-cell carcinoma. Possible mechanisms of action of non-genotoxic forestomach carcinogens are described, and the relevance to man is discussed. Since humans have no squamous epithelium in the stomach, the potential risk from non-genotoxic forestomach carcinogens involves exposure of the mouth, pharynx and oesophagus at dose levels that exert irritating action. It seems very unlikely that exposure to concentrations far below those having irritating potential is hazardous to man. PMID- 3542759 TI - Toxicology of gallates: a review and evaluation. AB - The propyl, octyl and dodecyl esters of gallic acid have been studied extensively in a large number of animal experiments involving oral dosing. Experimental data on general toxicity and studies on reproduction, teratogenicity and mutagenicity are also available. Most of the key toxicity studies, however, date back to the 1950s, do not meet current standards of toxicity testing and do not provide evidence for carcinogenic or mutagenic action of the gallates. Mutagenicity studies with octyl gallate and dodecyl gallate are lacking. The biokinetics of propyl gallate apparently differ from those of octyl and dodecyl gallate, the octyl and dodecyl esters being absorbed and hydrolysed to a lesser degree than the propyl ester. In toxicity studies with propyl gallate, growth retardation, anaemia, kidney and liver changes and hyperplasia of the forestomach were the most prominent effects at dose levels above 10,000 mg/kg feed. At 5000 mg/kg feed, liver enzyme induction was seen. In the available studies with octyl gallate or dodecyl gallate as the test compound, effects were found at 3000 mg/kg feed or higher levels. In studies performed with the various gallates, no effects were observed at a dose level of 1000 mg/kg feed, a level that was adopted as the no-effect level by the FAO/WHO Joint Expert Committee on Food Additives (JECFA) in 1976. This committee established an acceptable daily intake (ADI) for man of 0.2 mg/kg body weight (as a sum of propyl, octyl and dodecyl gallates). A re evaluation of the toxicity of gallates indicates that a 'classic' long-term toxicity study of propyl gallate meeting current standards is required. As yet, the available toxicological evidence indicates that gallates may be used safely as antioxidants. PMID- 3542761 TI - Protective effects of 2(3)-tert-butyl-4-hydroxyanisole on chemical carcinogenesis. AB - 2(3)-tert-Butyl-4-hydroxyanisole (2(3)-BHA) inhibits the action of a broad spectrum of carcinogens, mutagens and tumour promoters. This review discusses available information on four mechanisms by which 2(3)-BHA brings about these inhibitory effects. The first mechanism is induction of increased activities of enzyme systems having the capacity to detoxify carcinogenic compounds. The second is an alteration of the cytochrome P-450 system, resulting in metabolism of carcinogens to less carcinogenic metabolites. The third is the antioxidant effect of 2(3)-BHA. The fourth is poorly defined and relates to experiments in which 2(3)-BHA inhibits carcinogenesis when administered subsequent to the carcinogen. PMID- 3542762 TI - Comparative metabolism of BHA, BHT and other phenolic antioxidants and its toxicological relevance. AB - Following oral administration, butylated hydroxyanisole (BHA) is absorbed and rapidly excreted by the rat, rabbit and man, with little evidence of long-term tissue storage. The major metabolic pathways for BHA are conjugation (phase 2) reactions, oxidative metabolism (O-demethylation) being relatively unimportant. In the dog, the extent of absorption and urinary excretion is less, and oxidative metabolism is more important than in other species. In contrast, butylated hydroxytoluene (BHT) is cleared less rapidly from most species, enterohepatic circulation being partly responsible for the delay. Tissue accumulation is also greater for BHT than for BHA. Oxidative metabolism (phase 1 reactions) mediated by the microsomal monooxygenase system is the major route for BHT degradation; oxidation of the ring methyl group predominates in the rat, rabbit and monkey, and oxidation of the tert-butyl groups in man. Gallates and 2-tert butylhydroquinone are mainly metabolized by non-oxidative pathways (methylation or conjugation with sulphate and glucuronic acid). The different biological properties of these compounds may be related to the differences in their absorption and metabolic disposition. Thus, whereas BHT, which is metabolized by oxidation reactions, is an inducer of the microsomal mono-oxygenase system, the other phenolic antioxidants, including BHA, are only weak inducers. PMID- 3542764 TI - Mutagen formation in the reaction of Maillard browning products, 2-acetylpyrrole and its analogues, with nitrite. AB - Three 2-substituted pyrroles (2-acetylpyrrole, pyrrole-2-carboxaldehyde and pyrrole-2-carboxylic acid), which are products of the Maillard browning reaction, were reacted with nitrite in buffer solution (pH 3) at 50 degrees C for 24 hr. The reaction mixtures were extracted with methylene chloride and the extracts were tested for mutagenicity using Salmonella typhimurium strains TA97, TA98, TA100, TA102 and TA104, with and without S-9 metabolic activation. The methylene chloride extract of the 2-acetylpyrrole-nitrite reaction mixture showed strong mutagenicity to all the tester strains, both in the presence and absence of S-9 mix. The reaction product of pyrrole-2-carboxaldehyde with nitrite only gave a weak mutagenic response with strain TA100, while the pyrrole-2-carboxylic acid nitrite reaction product did not produce a mutagenic response in any of the tester strains. Two mutagenically active fractions, separated by thin-layer chromatography, were found in the reaction of 2-acetylpyrrole with nitrite. The formation of mutagenic products in the latter reaction was found to vary with reaction pH, time and temperature, with nitrite level and with 2-acetylpyrrole concentration. PMID- 3542763 TI - Epigenetic promoting effects of butylated hydroxyanisole. AB - Studies on the potential genotoxicity and epigenetic effects of BHA are reviewed. BHA was not DNA-reactive, but studies showed that it did have an effect on membrane systems, blocking exchange between hepatocytes and epithelial cells. The available data strongly suggest that BHA is an epigenetic carcinogen that produces forestomach neoplasms through a promoting effect. Standard food safety procedures are suggested as appropriate for setting safe levels of exposure. PMID- 3542765 TI - [Inhibin-FSH releasing hormone. Must we revise our concept of the regulation of the hypophyseal-gonadal axis?]. PMID- 3542767 TI - [Prevention of migraine with retard dihydroergotamine. Results of a multicenter study in 643 patients]. PMID- 3542766 TI - [Treatment of decreasing cardiac performance. Therapy using standardized crataegus extract in advanced age]. PMID- 3542768 TI - [Increased endogenous dopamine activity in diabetes mellitus. Inhibition of plasma renin activity, aldosterone and prolactin secretion]. PMID- 3542769 TI - [Immune modulation therapy in type I diabetes mellitus]. PMID- 3542770 TI - Grading scores and survivorship functions in liver cirrhosis: a comparative statistical analysis of various predictive models. AB - In a group of followed-up liver cirrhotics we evaluated the reliability of prognostic estimates predicted on the basis of a previously described multivariate statistical model (MSM). In the same subjects we also compared theoretical survival estimates obtained by fitting some other liver cirrhosis grading scores (Child-Turcotte's, McCormick's and Orrego's) to prognostic purposes. No statistical difference between actual and MSM-estimated survivorship functions was found (employing a life-table method with Logrank test), thus confirming the prognostic reliability of this multivariate classification model. Such a global and prognosis-correlated index may be recommendable both for comparing different groups of patients, and for assessing treatment effectiveness. Or results also substantially confirm the other investigated classificative methods such as reliable liver cirrhosis severity indexes, although their use for prognostic purposes seems to be less suitable. PMID- 3542771 TI - Patient compliance with intensive antacid treatment. A multi-centre study. AB - Patient compliance with respect to a liquid antacid (Novaluzid) was examined in an open multicentre study. The study included 186 patients with various upper gastrointestinal conditions. The patients were randomly assigned to either 2 or 4 weeks' treatment with 10 ml Novaluzid 1 and 3 hours after each meal and at bedtime. They were not informed that they were taking part in a study. The compliance was high, with no difference between the two groups; 82% and 79%, respectively, and showed no dependency on patient age, diagnosis or previous use of antacids. PMID- 3542772 TI - Prostacyclin in patients with peptic gastric ulcers--a placebo controlled study. AB - A double-blind study on prostacyclin (5 ng/kg/min infused i.v. for 5 hrs per day during 6 consecutive days) for the treatment of peptic gastric ulcers was carried out in thirty patients (15 prostacyclin, 15 placebo). Gastroscopy and its scoring was performed 1-2 days before the treatment, as well as a day and a week after the course of treatment was completed. Basal acid output (BAO) and pentagastrin stimulated release of gastric acid (maximum acid output MAO; peak acid output PAO) were measured before the treatment, during the third infusion, and one day after all the infusions had been completed. At the same time the basal release of bicarbonate into gastric juice was determined. Prostacyclin significantly accelerated healing of the ulcers at the end point of the study. Simultaneously, in the prostacyclin-treated patients an increase in bicarbonate release into gastric juice was noted, although the acidity of gastric juice was not changed. Our study shows a cytoprotective action of prostacyclin on a damaged human gastric mucosa. PMID- 3542773 TI - Endoscopic treatment of ascariasis causing acute obstructive cholangitis. AB - Ascariasis lumbricoides is one of the most common helminthic infections in developing countries. Biliary ascariasis presents with recurrent cholangitis and sometimes with liver abscesses. We report the case of a young Philippino worker in Saudi Arabia who presented with obstructive jaundice, cholangitis and liver abscesses secondary to biliary tract ascariasis. The diagnosis was made at endoscopic retrograde cholangio-pancreatography (ERCP) and the obstructing worms were removed with a Dormia basket after endoscopic sphincterotomy at this procedure. Full resolution of the biliary and hepatic sepsis followed. Urgent ERCP and endoscopic decompression of the biliary system in biliary ascariasis is recommended. PMID- 3542774 TI - Subtypes of antimitochondrial antibodies in primary biliary cirrhosis before and after orthotopic liver transplantation. AB - Antimitochondrial antibodies are markers for primary biliary cirrhosis and probably reflect a specific defect in immunoregulation underlying this disease. Antimitochondrial antibodies and their primary biliary cirrhosis-specific subtypes were tested before and up to 6 years after orthotopic liver transplantation. Sera from 31 consecutive patients were tested, 15 patients had primary biliary cirrhosis and 16 non-primary biliary cirrhosis. Antimitochondrial antibodies were investigated under code by immunofluorescence, and primary biliary cirrhosis-specific subtypes were determined by radioimmunoassay (anti p62, anti-p48) and complement fixation test (anti-M2, anti-M4, anti-M8). Before orthotopic liver transplantation, antimitochondrial antibodies were detected by immunofluorescence in 13 of 15 patients with primary biliary cirrhosis. Of these patients, 12 were positive for anti-p62 and 8 for anti-p48. Ten patients were positive for anti-M2, 4 patients for anti-M4 and 7 patients for anti-M8. Two primary biliary cirrhosis patients and all non-primary biliary cirrhosis patients were negative with all tests. One month after orthotopic liver transplantation, antimitochondrial antibodies titers declined or became negative by antimitochondrial antibodies immunofluorescence, 3 patients became negative by radioimmunoassay for anti-p62 and 1 for anti-p48. With complement fixation test, 4 patients became negative for anti-M2, 2 for anti-M4 and 4 for anti-M8. Antimitochondrial antibody titer reduction observed 1 month after orthotopic liver transplantation remained unchanged in most sera during the following years. A rise was observed in two patients after 4 and 5 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542775 TI - Hemodynamic effects of a clonidine-induced decrease in sympathetic tone in patients with cirrhosis. AB - A decrease in plasma noradrenaline--a reflection of sympathetic nervous system activity--by clonidine, a centrally acting alpha 2-agonist, could reduce the hyperdynamic circulation observed in cirrhosis and may thereby decrease portal hypertension. Plasma noradrenaline concentration and plasma renin activity as well as systemic and splanchnic hemodynamics were measured in 12 patients with cirrhosis and ascites before and after administration of either 150 micrograms of clonidine or placebo. Plasma noradrenaline concentration significantly decreased in all patients after clonidine administration, whereas plasma renin activity did not change significantly. There were statistically significant reductions of cardiac output (-17.4%), mean arterial pressure (-12.2%), hepatic venous pressure gradient (-19.7%) and azygos blood flow (-26.6%) after administration of clonidine. No significant correlation was found between the reduction of plasma noradrenaline concentration and changes in systemic or splanchnic hemodynamics. Hepatic blood flow was not changed by clonidine. Placebo administration had no effect on any laboratory or hemodynamic measurement. We conclude that the reduction in sympathetic nervous system activity by clonidine and the subsequent decrease in the hyperdynamic circulation suggests that sympathetic overactivity contributes to the circulatory derangements in patients with cirrhosis. PMID- 3542777 TI - Role of plasma membrane ligand-binding proteins in the hepatocellular uptake of albumin-bound organic anions. PMID- 3542776 TI - Reye's syndrome: current concepts. AB - Despite greater than 23 years of study, an incomplete understanding of the etiology, epidemiology and pathogenesis of Reye's syndrome persists. Better understanding of the disease has been hampered by the lack of a good animal model on which hypotheses of its pathogenesis could be tested. Human studies indicate that a primary mitochondrial injury may lead to complex metabolic disturbances that produce the observed pathophysiology. Specific directions regarding avenues for future research should pursue two lines: a good animal model still needs to be developed in which the biochemical and morphologic alterations identified in Reye's syndrome are duplicated. This model should include an antecedent viral illness but may not require aspirin exposure as an essential ingredient. With the identification of a satisfactory model, specific questions about the roles of environmental toxins or medications may be answered. Study of noncomatose cases of Reye's syndrome should continue. The specific emphasis should be to delineate what factors (NH3, free fatty acids and dicarboxylic acids) may be implicated in the pathogenesis of the CNS disease with the hopes of devising strategies for more effective treatment of encephalopathy and its attendant morbidity and mortality. PMID- 3542778 TI - Recurrent disease in patients with liver transplantation: when does it occur and how can we be sure? PMID- 3542779 TI - Histopathology of early and late human allograft rejection. PMID- 3542780 TI - Antibody to liver membrane antigens in chronic active hepatitis. IV. Exclusion of specific reactivity to polypeptides and glycolipids by immunoblotting. AB - The reactivity of sera was examined in patients with autoimmune chronic active hepatitis and other liver diseases by immunoblotting. Polypeptides and glycolipids of liver plasma membrane, liver-specific lipoprotein and kidney membrane were separated and probed with sera from patients and from a rabbit immunized with mouse liver plasma membrane. Chronic active hepatitis sera reacted with a number of polypeptides in the liver plasma membrane preparations; similar but weaker reactivity was observed with sera from patients with other diseases and in some healthy subjects. Chronic active hepatitis sera did not react with glycolipids from liver plasma membrane. The immune rabbit serum reacted with two polypeptides of 180 kd present in liver plasma membrane but absent from kidney membrane, with two polypeptides of 50 kd which were nonliver-specific but species specific, and with three major glycolipid components of liver plasma membrane: this reactivity thus differed markedly from that of the chronic active hepatitis sera. In studies using dot-blotting, it was found that solubilization of liver plasma membrane in detergents resulted in a marked reduction of the reactivity to liver plasma membrane of chronic active hepatitis sera, but little change in the reactivity of the chronic active hepatitis and other sera with liver-specific lipoprotein by immunoblotting indicated that liver-specific lipoprotein consisted of constituents of liver plasma membrane together with intracellular proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542781 TI - Alcoholic liver injury: defenestration in noncirrhotic livers--a scanning electron microscopic study. AB - The fenestration of hepatic sinusoidal endothelial cells in 15 needle biopsies obtained from chronic alcoholics without cirrhosis was studied by scanning electron microscopy. As compared to nonalcoholics, a significant reduction in the number of fenestrae and porosity of the sinusoidal lining wall (fractional area of fenestrae) was observed in acinar Zone 3, both in biopsies with and without Zone 3 fibrosis as judged by light microscopy. A significant reduction of porosity as shown in this study may influence the blood hepatocytic exchange and contribute to the alcohol-induced liver injury. PMID- 3542782 TI - Characteristics of serum IgA and liver IgA deposits in alcoholic liver disease. AB - Patients with alcoholic liver disease frequently reveal an increase in IgA serum concentration and IgA deposits in a continuous pattern along hepatic sinusoids. We investigated whether the hepatic IgA deposits are a passive reflection of changes in concentration or composition of IgA in the circulation, or represent a distinct effect of alcohol on the liver. Forty-one patients with alcoholic liver disease (daily alcohol intake at least 50 gm for more than five consecutive years) were compared with 41 patients with nonalcoholic liver disease. Patients in both groups were matched for serum IgA and histopathological changes in the liver biopsy. IgA deposits in the liver were found in 78% of the alcoholic patients and in 12% of the nonalcoholic patients. The presence of deposits was not related to histopathological changes in the liver or to the serum IgA concentration. In serum IgA subclass distribution, alcoholic patients differed from nonalcoholic patients by a slight but significant shift to IgA2; in contrast, the hepatic IgA deposits in alcoholic patients were almost of the IgA1 subclass. Serum secretory component (which is an equivalent of serum secretory IgA) was elevated in both alcoholic and nonalcoholic patients; patients with a liver biopsy revealing hepatitis showed the highest level. In contrast, the hepatic deposits did not contain secretory component. We conclude that the continuous deposits of IgA along liver sinusoids are not a passive reflection of changes in concentration or composition of circulating IgA, but may represent a distinct effect of alcohol on the liver related to the role of this organ in IgA metabolism. PMID- 3542783 TI - Expression of the pancreatic elastase I gene in transgenic mice. PMID- 3542784 TI - Collecting duct carcinoma of the kidney. AB - Six cases of renal epithelial neoplasms, which show atypical histological features previously described in cases of collecting duct carcinomas, are presented. The tumours were of a tubulo-papillary architecture, arose in the renal medulla and showed prominent infiltrating tubules with an associated desmoplastic reaction. Atypical hyperplastic changes were present in the medullary collecting ducts in five cases. PMID- 3542785 TI - Immunohistological demonstration of factors XIIIa and XIIIs in reactive and neoplastic fibroblastic and fibro-histiocytic lesions. AB - Factor XIII sub-units a and s (XIIIa and XIIIb) have been localized previously in fibroblasts of the liver and in other tissues. An immunoperoxidase technique was used to localize these factors in benign and malignant fibroblastic and fibro histiocytic lesions. Positive staining was present in cells in almost all of the benign and fibro-histiocytic lesions but was reduced in the malignant group. However, the pattern of staining was not sufficiently consistent to justify the use of the factors XIII as diagnostic markers in soft tissue neoplasia. PMID- 3542786 TI - Spinal cord compression as the first presentation of lymphoma--a review of 15 cases. AB - Fifteen cases are described in which the first presentation of lymphoma was acute spinal cord compression. Lymphoma was diagnosed in laminectomy biopsy specimens using a combination of conventional histological techniques and immunohistochemistry. The patients were predominantly middle-aged or elderly men, some of whom were subsequently shown to have disseminated lymphoma. In other cases, however, the disease was apparently localized to the spine. The tumours consisted of 11 B-cell diffuse follicle centre cell lymphomas, three T-cell lymphomas and one lymphoblastic lymphoma. Following treatment, generally by laminectomy and radiotherapy, some patients have made good recoveries, especially where the disease was localized in the spine. PMID- 3542788 TI - Medical spending to increase 10%: Commerce Dept. PMID- 3542787 TI - HCFA rethinking substandard care COBRA provision. PMID- 3542789 TI - Capitation poses multiple problems, say RAB members. PMID- 3542790 TI - Hospitals gang up on copying rule. PMID- 3542791 TI - Physician DRGs? PhysPRC's Ginsburg says no. PMID- 3542792 TI - Reaction to physician payment proposal mixed. PMID- 3542793 TI - Administration seeks cap on Medicaid outlays. PMID- 3542795 TI - Profit margin data agitate industry. PMID- 3542794 TI - HHS pushing for Medicaid HMOs. PMID- 3542796 TI - HCFA outlines 1987 legislative Medicare agenda. PMID- 3542797 TI - LA Medicaid cut illegal: hospitals. PMID- 3542798 TI - [Photoelastic analysis of stress on alveolar bone in the abutment of the fixed bridge under vertical loading]. PMID- 3542799 TI - [An investigation on gallstones with gray-scale ultrasound]. PMID- 3542800 TI - Inherited abnormalities of the platelet membrane and secretory granules. AB - Platelet stimulus-activation-contraction-secretion coupling is linked to fundamental modifications in the biochemistry and ultrastructure of the platelet surface and the membranes enclosing storage organelles. It is not surprising, therefore, that membrane defects are common in platelets from patients with inherited hemorrhagic disorders caused by platelet dysfunction. In fact, it might be stated that all inherited disorders of platelet function are related directly or indirectly to abnormalities of membranes. The current review discusses the state of knowledge on inherited platelet membrane defects of the cell surface and storage organelles. PMID- 3542801 TI - Primary adenocarcinoma of the seminal vesicle. AB - A rare case of primary adenocarcinoma of the seminal vesicle is examined in an 87 year-old Japanese man. Neoplastic cells, especially poorly differentiated cells, showed a positive reaction with periodic acid-Schiff reagent and anti carcinoembryonic antigen. Neoplastic cells invaded the bladder wall but not the prostate. No other primary tumor was demonstrated. PMID- 3542802 TI - Coexistent Wegener's granulomatosis and anti-glomerular basement membrane disease. AB - Wegener's granulomatosis and Goodpasture's syndrome represent two major causes of a pulmonary-renal syndrome. We describe the clinical course and morphologic features of a patient in whom pulmonary manifestations of Wegener's granulomatosis developed and were followed six months later by anti-glomerular basement membrane disease. Although we regard this as a unique and probably fortuitous association, a genetic predisposition or a secondary form of anti-GBM disease cannot be excluded. PMID- 3542803 TI - Detection of Duchenne muscular dystrophy carriers: quantitative echography and creatine kinasemia. AB - Data obtained from simultaneous determinations of serum creatine-kinase levels and estimation of ultrasound attenuation values in muscles greatly improved the detection of obligate carriers of Duchenne muscular dystrophy than when only one of these methods was employed alone. Eleven carriers out of 19 had a high creatine-kinasemia level and nine carriers out of 19 had a high (abnormal) attenuation value. Because of the limited overlapping between the two parameters studied, we were able to recognize 17 obligate carriers out of the 19. This indicates that the parameters studied concern different features of the disease, and the practical and theoretical considerations are discussed. The techniques are discussed together with molecular genetic investigations. PMID- 3542804 TI - 123I radiolabeling of monoclonal antibodies for in vivo procedures. AB - When labeled to monoclonal antibodies (MAbs) or their fragments, 123I can be used for imaging or for predicting the treatment potential and radiation dosimetry of 131I labeled to the same molecular species. Because 123I (p,5n) from the Crocker Nuclear Laboratory is in dilute solution, when compared with commercial 125I of labeling grade, we have evaluated labeling parameters using Chloramine-T as the oxidant and derived an optimum set of labeling conditions that provide a 60-80% radiochemical yield of highly immunoreactive antibody. When Lym-1, an IgG-2a murine antibody against human lymphoma, was used, yields of labeled immunoglobulin were decreased by protein or Chloramine-T concentrations less than 0.4 microgram/microliter and 0.8 microgram/microliter, respectively; denaturation of the immunoglobulin occurred when the Chloramine-T concentration was greater than 1.0 microgram/microliter. Optimum labeling occurred at pH 7-8 with deleterious effects when the pH was below 5 or above 10. An optimum method for labeling antibodies with multimillicurie amounts of 123I (less than one iodine atom per 100 antibody molecules) is described. Some of the observations derived from this study are also applicable to the preparation of treatment doses of 131I labeled antibodies, wherein the amount of antibody can be a restrictive factor. PMID- 3542805 TI - A monoclonal anti-neuroblastoma antibody that discriminates between human nonhematopoietic and hematopoietic cell types. AB - A murine IgG2a monoclonal antibody, termed 6-19, was characterized in terms of its ability to bind to human cell lines and tissues. The hybridoma was selected for antibody binding to multiple human neuroblastoma cultured cell lines but not to peripheral blood mononuclear cells. 6-19 binds to the cell surface of all cultured human nonhematopoietic tumor cell lines tested, to cultured human fibroblasts and endothelial cells, and to nonhematopoietic tumors of many types. It does not bind detectably to any hematopoietic cells, leukemia cells, or lymphomas. In the presence of complement, 6-19 is very cytotoxic to cultured human neuroblastoma cells but not to bone marrow granulocyte-macrophage colony forming cells. The 6-19 monoclonal antibody may prove useful in the identification or destruction of tumor and stromal cells in bone marrow. PMID- 3542806 TI - A nonneutralizing human IgM monoclonal antibody inhibiting hemagglutination of H3N2 influenza A strains. AB - A mouse-human hybridoma has been produced by fusing human splenocytes from a Cooley's anemia patient with the murine myeloma P3-NS1/1-Ag 4-1. The hybridoma is stable after 18 months and secretes human IgM. The antibody reacts with some H3N2 influenza A strains and detects an epitope that is part of the hemagglutinin antigen, but does not affect virus infectivity. PMID- 3542808 TI - Clinical application of lymphokines and cytokines. PMID- 3542807 TI - Production of a monoclonal antibody against a human osteosarcoma xenograft. AB - Monoclonal antibodies (MAbs) against a human sarcoma xenograft carried in BALB/c nu/nu mice were produced by immunizing BALB/c mice with tumor cells and fusing their spleens with the SP2/O-Ag 14 mouse myeloma cell line. Hybridoma supernatants were screened using cryostat tissue sections and an immunoperoxidase reaction for ability to stain osteosarcoma xenograft tumor cells but not tonsil lymphocytes. Of 73 supernatants tested, 19 reacted with both osteosarcoma tumor cells and lymphocytes, while three reacted only with osteosarcoma. One of the latter hybridomas was cloned by limiting dilution to establish a line producing an IgG1 MAb (OS-1). By immunoperoxidase, this MAb stained tumor cells in surgical biopsies of primary (6 of 7) and metastatic (1) osteosarcomas and showed limited cross-reactivity with other tumors. It also cross-reacted with some basement membranes, endothelium and muscular media of blood vessels, and smooth muscle, but not with parenchymal cells of various normal tissues. This MAb may prove useful for the immunohistochemical confirmation of a diagnosis of osteosarcoma in surgical pathology. PMID- 3542809 TI - Hemopoietic effects of purified bacterially synthesized multi-CSF in normal and marrow-transplanted mice. AB - Normal adult mice and irradiated, marrow-transplanted mice were injected three times daily for 6 days with 200 ng purified bacterially synthesized recombinant Multi-CSF. Normal mice responded with increased peritoneal macrophages, eosinophils and neutrophils, spleen weight increases and major increases in spleen mast cells and hemopoietic progenitor cells. Irradiated, marrow transplanted mice failed to develop large increases in peritoneal cell numbers but did show rises in spleen weight, marrow cellularity and spleen and marrow progenitor cell levels. The results confirm data indicating a regulatory role for Multi-CSF in vivo and suggest that Multi-CSF may be of some value in accelerating hemopoietic regeneration following marrow transplantation. PMID- 3542810 TI - Characterization and biological effects of recombinant human erythropoietin. AB - Human recombinant erythropoietin (rHuEPO) has been purified to apparent homogeneity and compared to purified human urinary erythropoietin (EPO). Both the purified natural and recombinant EPO preparations were characterized in a competition radioimmunoassay (RIA), the exhypoxic polycythemic mouse bioassay, in vitro tissue culture bioassays using bone marrow cells, and by Western analysis. In the immunological and biological activity assays, the rHuEPO shows a dose response which parallels that of the natural hormone. By Western analysis, the recombinant and human urinary EPO migrate identically. Administration of rHuEPO increases the hematocrit of normal mice in a dose-dependent manner. Additionally, the rHuEPO is able to increase the hematocrit of rats made uremic as a result of subtotal nephrectomy. In summary, by all criteria examined, the rHuEPO is biologically active and equivalent to the natural hormone. PMID- 3542811 TI - Beta 2-microglobulin: a prognostic parameter for graft survival after renal transplantation. AB - The determination of beta 2-microglobulin has recently been proposed as a promising diagnostic method to monitor the state of renal allografts. Elevated levels of beta 2MG in the serum and/or urine allow the substantiation of the diagnosis of an acute graft rejection and are helpful in distinguishing acute tubular necrosis from a rejection reaction. In this paper, the usefulness of beta 2MG serum levels is evaluated, not only during the immediate post-operation phase but also for the long-term prognosis of renal allografts. The immunosuppression treatment included methylprednisolone and azathioprine in all the presented patients. The data indicate that a rapid normalization of beta 2MGSL within 6 days, even if the decrease is interrupted by re-elevation due to acute rejection episodes or inflammatory diseases, represents a good long-term prognosis for kidney allografts. PMID- 3542812 TI - Augmentation of antibody responses of mice to inhaled protein antigens by simultaneously inhaled bacterial lipopolysaccharides. AB - Serum antibody responses of mice to repeatedly inhaled protein antigens such as bovine serum albumin and ovalbumin, plus or minus bacterial lipopolysaccharide (LPS) in the form of an aerosol were studied. Results showed that the levels of responses to inhaled protein antigens varied, depending on the mouse strain antigen combination and that LPS inhaled simultaneously with the antigens definitely augmented the responses which were not otherwise very high. LPS extracted from Klebsiella O3 (LPS-K) but not LPS from Escherichia coli O55 (LPS E), which was inhaled at the time of initial inhalation of antigen, significantly intensified the priming for the secondary antibody response to the antigen subsequently inhaled. Both LPS-K and LPS-E, however, definitely acted to augment the response when they were inhaled repeatedly together with the antigen. Oral administration of antigen or antigen plus LPS-K did not induce any detectable antibody response in our experiment, ruling out the possibility that the antigen and LPS stimulated the immune system via alimentary canal rather than via lung. Tissue distribution of the radioactivity soon after inhalation of 131I-labeled antigen and decay speed of the radioactivity were not significantly changed by LPS-K inhaled simultaneously. This suggested that the augmentation of responses was not mediated by the action of LPS to modulate the air-blood barrier against the entry of antigen via lung. All the results prove for the first time that inhaled LPS displays a definite adjuvant action on antibody responses to inhaled antigens. PMID- 3542813 TI - The IgA subclass responses of human lymphocytes to B-cell activators. AB - The induction of IgA synthesis in normal peripheral blood lymphocytes cultured in the presence of 5 different B-cell activators was studied by immunofluorescence using monoclonal antibodies to the two subclasses. The surface phenotype of normal cells after overnight culture in the absence of mitogen showed a mean ratio IgA1:IgA2 of 2.7:1; cells with cytoplasmic IgA were very rare. Results obtained on different donors after stimulation showed considerable variation; IgA1 was the predominant subclass in Epstein-Barr virus-stimulated cultures, whereas pokeweed mitogen induced a predominantly IgA2 response; cells stimulated with Staphylococcus aureus, Branhamella catarrhalis and lipopolysaccharide and unstimulated cells showed a 1:1 ratio of the subclasses. It is concluded that in this system IgA subclass expression is a function of the activator employed. PMID- 3542814 TI - Blood culture updated. PMID- 3542815 TI - Genes, genies and public health. PMID- 3542817 TI - Changing bacteriological patterns in neonatal septicaemia. PMID- 3542818 TI - Neonatal septicemia. PMID- 3542816 TI - Fetal phenotypic analysis. PMID- 3542819 TI - Reproducibility of echocardiographic left ventricular measurements. AB - Serial echocardiograms with acceptable reproducibility of measurements may be produced by careful performance and interpretation of the studies. The following recommendations have been shown to enhance reproducibility. Strict adherence to quality control is necessary to generate echocardiograms of the highest technical quality. Sonographers should be aware of the definition of a technically adequate study--including correct beam or plane angulation and continuous visualization of interfaces--and seek this ideal in every study. Participation by the sonographer in performance of measurements enhances recognition of the requirements for accurate quantitative echocardiography. Regular machine calibration is a prerequisite to accurate quantitative echocardiography. Considerable effort must be made to standardize the position of each acoustic window and angulation from which the patient is imaged--with deviation from these norms being recorded for future reference. If at all possible, measurements should be taken at end expiration. If that is not possible, measurement of several consecutive beats will limit the impact of respiratory variation. A uniform convention of measurement should be adopted. The best candidates for M-mode measurements are the American Society of Echocardiography recommendations for general measurement and the Penn convention for calculation of M-mode left ventricular mass. Further data is needed to determine which approaches to two-dimensional measurements best combine accuracy and reproducibility. Interpretation of echocardiograms may be made most reproducible by measuring pertinent parameters from multiple beats and using the mean as the result and by having at least two readers interpret each echocardiogram, possibly with two separate readings by each reader. PMID- 3542820 TI - Doppler echocardiographic assessment of left ventricular systolic and diastolic function in mild hypertension. AB - Abnormalities in left ventricular (LV) wall thickness and mass have been demonstrated in patients with mild hypertension utilizing M-mode echocardiography. In addition, studies using radionuclide angiography have demonstrated abnormalities in early diastolic LV filling in asymptomatic hypertensive patients with normal ejection fraction and cardiac output. Recently, Doppler recordings of flow velocity in the ascending aorta and through the mitral valve have been shown to provide useful information about LV function. To determine whether flow abnormalities could be detected in patients with mild hypertension, we recorded Doppler aortic and mitral valve flow velocities in 21 men with mild hypertension. Casual systolic blood pressure was 147 +/- 18 mm Hg (mean +/- SD) and diastolic blood pressure was 96 +/- 9 mm Hg. LV mass (310 +/- 75 g) was elevated (i.e., above the 95% normal prediction interval) in 8 of 19 patients who underwent M-mode echocardiography; LV ejection fraction was normal in all patients (mean, 80%). As in previous studies in normal subjects, we found in these hypertensive patients an inverse correlation between age and both aortic peak flow velocity (r = -0.51, p less than 0.05) and transmitral early diastolic peak flow velocity (r = -0.44, p less than 0.05) and a positive relationship between age and mitral valve late diastolic peak flow velocity (r = 0.73, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542821 TI - Predictive value of BCG test. PMID- 3542822 TI - Rapid diagnosis of viral agents by indirect immunofluorescent antibody technique in acute respiratory infections. PMID- 3542824 TI - [Bonded ceramic inlays]. PMID- 3542823 TI - [The immediately bonded splint]. PMID- 3542825 TI - [Periodontal disease and antimicrobial treatment]. PMID- 3542826 TI - A randomized trial on the effect of isotonic amino acid infusion on postoperative complications and short life plasma protein concentrations. AB - In a randomized clinical study 30 patients with high risk surgical procedures were distributed to receive either standard fluid-therapy (n = 14) or an isotonic amino acid solution (n = 16) during five days. The patients were evaluated pre- and postoperatively using: anthropometric parameters: body weight, biceps and triceps skinfold thickness, and mid arm circumference; biochemical parameters: albumin, prealbumin, transferrin, retinol-binding protein, total iron-binding capacity, and cholesterol; and delayed cutaneous hypersensitivity. Clinical outcome and complications were also recorded. Positive ketonuria was obtained soon in the treatment group after 24 h. Mean daily nitrogen balance was better in the protein sparing group (-3.8 g vs -9.3 g) p less than 0.02. No differences were observed between both groups in the postoperative plasma protein levels. There were no significant differences in delayed cutaneous reactivity nor anthropometric parameters between both groups; and mortality and morbidity were similar. The present study lends little support for substituting the routine D5W and saline postoperative fluid regime. No clinical advantage of amino acids over standard fluids could be appreciated indicating that the much less expensive conventional solutions should not be replaced by amino acids, at least in routine postoperative cases. PMID- 3542827 TI - The Canadian Association of Auxiliary Nurses: history, organization, objectives. PMID- 3542828 TI - [Zeitschrift fur Stomatologie, Volume XXXI, 1933: Crisis in orthodontics. By Albin Oppenheim]. PMID- 3542829 TI - Ionic requirements for entry of Shiga toxin from Shigella dysenteriae 1 into cells. AB - The ionic requirements for entry of Shiga toxin into cells were examined by measuring inhibition of protein synthesis after short-term incubations with toxin. The sensitivity of Vero cells and HeLa cells to Shiga toxin was strongly dependent on the divalent cation present. Vero cells were most sensitive in the presence of CaCl2 and SrCl2, whereas HeLa cells were equally sensitive in the presence of MgCl2, SrCl2, and CaCl2. Both cell lines were protected by BaCl2, CoCl2, and MnCl2. Inhibitors of Ca2+ transport, like verapamil, D600, and Co2+ as well as the calcium-ionophores A23187 and ionomycin, protected both cell lines. HEp-2 cells were protected against Shiga toxin by a high concentration of potassium in the medium as well as by potassium depletion of the cells. Substitution of chloride in the medium with slowly permeable anions, like SO42- and SCN-, protected the cells against Shiga toxin. High concentrations of the ionophore nigericin that increase pH of acidic intracellular vesicles did not protect Vero cells against Shiga toxin. Shiga Toxin X-114 at pH values below 4.5. This binding was shifted to higher pH values after pretreatment of the toxin with dithiothreitol. The results indicate that Ca2+ transport through physiologically occurring Ca2+ channels is required for entry of Shiga toxin into cells. Furthermore, the sensitivity of cells of Shiga toxin is strongly dependent on the anions present. PMID- 3542830 TI - Association and dissociation of Escherichia coli heat-stable enterotoxin from rat brush border membrane receptors. AB - Escherichia coli heat-stable enterotoxin (ST) binds to receptors on rat intestinal cells and brush border membranes (BBM). We devised experiments to examine the reversibility of ST binding. We found that both 125I-labeled ST and native ST were spontaneously dissociable from the BBM receptor. Radiolabeled ST bound to BBM was also dissociated by the addition of avid goat anti-ST antiserum. Furthermore, using a computer program for analysis of ligand binding, we calculated an apparent Ka of 10(8) liters/mol from competitive inhibition and saturation-binding data. This is significantly lower than the value previously reported by others. Our findings, of a lower Ka and a reversible ST-binding process, suggest that a therapeutic strategy of removing bound ST from its receptor or competing with the enterocyte receptor for unbound ST might be successful in terminating ST-induced secretion. PMID- 3542832 TI - Protection of Babesia bigemina-immune animals against subsequent challenge with virulent Babesia bovis. AB - Two groups of cattle, one previously exposed to Babesia bigemina and one not, were challenged with Babesia bovis. The group previously infected with Babesia bigemina was only mildly affected upon challenge with B. bovis, whereas four of five of the other group were severely affected. Immunoblotting studies performed in both homologous and heterologous systems showed that there were polypeptides of similar molecular weight in both species, but species-specific polypeptides were demonstrated only in B. bovis by the homologous B. bovis reaction. B. bovis antisera reacted avidly with B. bigemina-infected erythrocytes in fluorescent antibody assays. In contrast, B. bigemina antisera did not cross-react with B. bovis-infected erythrocytes. Two groups of splenectomized calves were immunized with an enriched antigen fraction of B. bigemina. A third group was immunized by infection with B. bigemina and treatment with a drug. One of the groups of calves immunized with the antigenic fraction of B. bigemina, the group immunized by infection with B. bigemina, and a control group were challenged with B. bovis. All control calves died, whereas 50% of the calves immunized by infection with B. bigemina and 75% of the animals immunized with the B. bigemina antigen survived. The second group immunized with the B. bigemina antigen and a control group were challenged with B. bigemina. All control animals died by day 6, whereas 50% of the vaccinates survived, the deaths occurring on days 8 and 11. The nature of the probable protective mechanism is discussed. PMID- 3542831 TI - Inhibition of malaria parasite invasion of human erythrocytes by a lymphocyte membrane polypeptide. AB - Extraction by boiling of the buffy coat of human blood yields a protein solution which inhibits the propagation of the human malaria parasite Plasmodium falciparum in culture with a 50% inhibitory dose of 105 micrograms of protein per ml. The inhibitory activity is associated exclusively with the lymphocytes and affects solely the invasion of erythrocytes by free merozoites. Boiled extracts of isolated lymphocytes had a 50% inhibitory dose of 22 micrograms/ml. Fractionation of surface-labeled or pronase-treated lymphocytes revealed that the antimalarial lymphocyte factor is associated with the intracellular aspect of the membrane fraction and is probably not involved in the host defense system against malaria. Further purification by salt extraction, ion-exchange chromatography, molecular gel filtration, and electroelution from lithium dodecyl sulfate polyacrylamide gels resulted in 300- to 550-fold purification, i.e., a 50% inhibitory dose of 40 to 70 ng/ml. All inhibitory fractions contained a 48 kilodalton polypeptide which eluted from a gel filtration column as a 400 kilodalton species, implying multimeric association. Some 6,000 molecules of the 48-kilodalton polypeptide bind with high affinity to one merozoite, the free form of the parasite. The Kd of 0.1 to 0.5 nM for the binding of the 48-kilodalton polypeptide correlated well with the 50% inhibitory dose of 0.3 to 0.4 nM obtained with purified active antimalarial lymphocyte factor. We therefore suggest that the 48-kilodalton polypeptide partially purified from lymphocyte membranes is the antimalarial lymphocyte factor and that it exerts its inhibitory activity by binding to merozoites, thereby preventing their invasion into erythrocytes. The antimalarial lymphocyte factor or a polypeptide sequence thereof could serve for further probing of invasion at the molecular level. PMID- 3542834 TI - Expression of staphylococcal enterotoxin C1 in Escherichia coli. AB - The structural gene encoding staphylococcal enterotoxin C1 was cloned into Escherichia coli and localized on a 1.5-kilobase HindIII-ClaI DNA fragment by subcloning. The toxin was partially purified from E. coli clones and shown to be immunologically identical to enterotoxin C1 from Staphylococcus aureus. The cloned toxin also had the same molecular weight (26,000) and charge heterogeneity as staphylococcus-derived enterotoxin. Toxins from both sources were equally biologically active. PMID- 3542833 TI - Purification and characterization of a protease from Bacteroides gingivalis 381. AB - An intracellular membrane-free, trypsinlike protease was isolated from cells of Bacteroides gingivalis 381. The protease was extracted from the cells by ultrasonic treatment and was purified about 250-fold with a recovery of 2% by sequential procedures. The properties of the protease were as follows: its optimal pH was 8.5; its activity was almost completely lost on incubation at 50 degrees C for 15 min; its activity was inhibited by diisopropylfluorophosphate, p toluenesulfonyl-L-lysine chloromethyl ketone hydrochloride, leupeptin, Mn2+, Cu2+, and Zn2+; it hydrolyzed casein, azocasein, N-alpha-benzoyl-DL-arginine-p nitroanilide (BAPNA), bovine serum albumin, azocoll, and gelatin, but not N-alpha benzoyl-DL-lysine-p-nitroanilide or human serum immunoglobulin A; its molecular weight was estimated as 45,000 by gel filtration and 50,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis; and its Km values for azocasein and BAPNA were 1.11% and 0.19 mM, respectively. PMID- 3542835 TI - Comparative study of Vibrio cholerae non-O1 protease and soluble hemagglutinin with those of Vibrio cholerae O1. AB - Protease and soluble hemagglutinating activities produced by a non-O1 Vibrio cholerae strain isolated from a patient with diarrhea were compared with similar activities produced by V. cholerae O1. The soluble protease activities were indistinguishable in heat stability, immunodiffusion, inhibition by antiserum, and electrophoretic analysis. On the other hand, the soluble hemagglutinating activities of both strains were not completely identical. The hemagglutinating activity of the non-O1 V. cholerae strain was not inhibited by Zincov; it was more sensitive to inhibition by normal serum, and it had an unusual pattern of heat stability. Heating at 100 degrees C resulted in some recovery of activity of a sample previously inactivated by heating at 60 degrees C. PMID- 3542837 TI - Oral health care: more than caries and periodontal disease. A survey of epidemiological studies on oral disease. AB - A review is presented of the epidemiology of the common oral diseases other than dental caries and periodontal disease. It appears that conditions, such as masticatory dysfunction, traumatic dental and maxillofacial injuries, impactions and oral mucosal disease each normally affect one-quarter to one-half of populations examined. To plan and achieve total oral health care, it is, therefore, necessary to take these conditions into account. As no study to date appears to have registered the total oral health care needs for a given population in either developing or industrialized countries it is suggested that such investigations should be undertaken now by WHO and/or FDI. Only when this total information is at hand can a rational oral health policy be developed. PMID- 3542836 TI - Aromatic alpha-glycosides of mannose are powerful inhibitors of the adherence of type 1 fimbriated Escherichia coli to yeast and intestinal epithelial cells. AB - Adherence of bacteria via their surface lectins to host epithelial cells is considered an important initial event in bacterial pathogenesis. Mannose-specific (type 1) fimbriae are among the most commonly found lectins in enterobacteria. We studied the effect of aromatic alpha-glycosides of mannose on the agglutination of mannan-containing yeasts by different strains of Escherichia coli and on the adherence of the bacteria to guinea pig ileal epithelial cells. In both systems these compounds were considerably more effective inhibitors than methyl alpha mannoside, with 4-methylumbelliferyl alpha-mannoside and p-nitro-o-chlorophenyl alpha-mannoside being the strongest inhibitors. Both compounds were approximately 400-times stronger inhibitors of yeast agglutination by E. coli O128 than was methyl alpha-mannoside and 1,000- and 470-fold stronger, respectively, than was methyl alpha-mannoside in inhibiting the adherence of the bacteria to ileal epithelial cells. 4-Methylumbelliferyl alpha-mannoside was 540 to 1,000 times more effective in inhibiting yeast agglutination by four additional strains of mannose-specific E. coli. It was also more efficient than methyl alpha-mannoside in removing adherent E. coli O128 from ileal epithelial cells. Our results provide further evidence that type 1 fimbriae of E. coli possess a hydrophobic region next to the mannose-binding site. The results suggest that 4 methylumbelliferyl alpha-mannoside and p-nitro-o-chlorophenyl alpha-mannoside are good candidates for the design of therapeutic agents that may prevent adherence in vivo and infection by E. coli strains that express type 1 fimbriae. PMID- 3542840 TI - Apical displacement of a gutta-percha cone on cementation of a post and core. PMID- 3542839 TI - Post crowns: a review. PMID- 3542838 TI - Tensile bond strength of fluorosed Kenyan teeth using the acid etch technique. AB - Tensile bond strength tests were performed on 120 enamel specimens equally distributed over 'normal' American, 'normal' Kenyan and fluorosed Kenyan teeth. The mean tensile bond strength for American teeth was 59.08 +/- 15.81 kg/cm2, for normal Kenyan teeth 41.52 +/- 14.64 kg/cm2 and for fluorosed Kenyan teeth prior to removing the surface layer 49.20 +/- 17.67 kg/cm2. There was an increase in the adhesive bond strength for fluorosed teeth after first grinding and polishing with a green stone followed by pumice (58.84 +/- 20.65 kg/cm2). The coefficients of variation were 27% for fluorosed Kenyan teeth prior to grinding and 35% after grinding. The tested etching times varied from 60 to 150 s. The normal Kenyan teeth had the lowest tensile bond strength. This may have been due to the inability to etch adequately these teeth in 60 s. The increase in tensile bond strength indicates removal of the surface layer of fluorosed enamel by grinding then acid etching may improve the bond strength. PMID- 3542842 TI - A simple algorithm for assisting medical diagnosis. AB - This is a description of an algorithm to assist in the selection of the most probable diagnosis of a given patient. This algorithm is based on the comparison of a scaled column vector of the symptoms displayed by the patient, and of each column of symptoms appearing in a disease matrix. Moreover, the same algorithm gives the degree of similarity of the diseases compared by the differential diagnosis, as well as the hierarchic order of the symptoms that characterise any disease. PMID- 3542841 TI - Antigenic stimulation with proteins of cow's milk via the oral route in guinea pigs and rats. 2. Antibodies to beta-lactoglobulin secreted into the alimentary canal and serum. AB - The intestinal contents of guinea pigs and rats on a milk-drinking diet were examined for mucosal-secreted antibody to beta-lactoglobulin. Assay of the immunoglobulin content of duodenum, jejunum and ileum of the guinea pig gave geometric means of 70, 90 and 95 micrograms/ml. In the rat, where isotype specific antiglobulin reagents were available, similar figures were obtained but it could be shown that the vast majority was IgA. Passive haemagglutination titres up to 1,000 of secreted anti-beta-lactoglobulin antibody (resistant to the endogenous proteases in the intestinal contents) were measured in guinea pigs. Fifteen days after cessation of milk-drinking, the antibody had dropped to undetectable levels. No such antibody could be shown in rats. Rats also failed to develop detectable serum antibody whereas, the guinea pigs had passive haemagglutination titres in the order of 16,000. PMID- 3542844 TI - The immune basis of dosage-induced reversal of the rank-order of strain susceptibility to MCA. AB - Even AHH-inducible mouse strains vary in their susceptibilities to MCA sarcomagenesis. Previous work showed that the rank-order of strain susceptibility depended upon the dosage of MCA; the strain most susceptible to a high dose became the least susceptible to a low one and vice versa. We now confirm our previous findings and test the hypothesis that the reversal, with dosage, of the rank-order of relative strain-susceptibility has an immunological basis. This was tested in two ways: by examining the effect of immunosuppression on strain susceptibility to sarcomagenesis and by transplanting parental bone marrow into irradiated F1 hybrid to see if the relative MCA-susceptibility characteristics of the parental donors could be transferred. The results of both studies suggest that the rank-order-reversal phenomenon is caused, at least in part, by differences in the immunological reactivities of the strains. Inasmuch as immunosuppression inhibited the response of the C3 mice to a high dose of carcinogen, but facilitated carcinogenesis among the B6, the level of innate immune capacity most conducive to high-dose carcinogenesis is apparently intermediate between the levels of these two strains. PMID- 3542845 TI - Applications of relaxation/mental imagery (self-hypnosis) in pediatric emergencies. PMID- 3542843 TI - Presence of circulating antibodies against cellular protein p53 in a notable proportion of children with B-cell lymphoma. AB - Serum samples taken from children bearing a wide variety of tumors were screened for the presence of circulating antibodies against the cellular tumor antigen p53. There was a significant correlation (p less than 0.001, n = 119) between the presence of such antibodies and the occurrence of cancer; 12% of the sera tested were positive. These sera were derived from children with a wide range of tumor types. In particular, 21% of the sera obtained from children suffering from a B cell lymphoma contained anti-p53 antibodies. We were not able to establish a correlation between the secretion of p53-reactive antibodies and any other parameters, such as the age or sex of the child, presence of metastasis, stage or prognosis of disease, or treatment regimen. These results therefore show that the development of p53 immunogenicity is associated with a wide range of neoplastic diseases in children, and in particular with the presence of a B-cell lymphoma. PMID- 3542846 TI - The "urge to classify" the drug user: a review of classifications by pattern of abuse. AB - Attempts to classify drug abusers are divided into three main categories: psychiatric classifications, psychosocial classifications and classifications by pattern of abuse. The present article focuses on pattern of abuse classifications which are divided into two subcategories: by substance of abuse and by degree of involvement. The various groups of these classifications are reviewed and their potential uses are discussed. The review indicates that classifications by substance of abuse may be useful for administrative and theoretical purposes, while their clinical uses are limited to medical emergencies. On the other hand, classifications by degree of involvement are useful for initial treatment planning and for predicting treatment outcomes. The authors conclude that for a thorough treatment planning and for better understanding of the addiction process, psychosocial classifications may be the most useful approach. PMID- 3542848 TI - Non-steroidal antiinflammatory drug therapy: advantages and disadvantages of long half-life drugs versus slow-release formulations. AB - A single daily administration of non-steroidal antiinflammatory drugs is widely recognized as the best dose regimen in chronic diseases such as degenerative osteoarthropathy, in inflammatory affections of the skeletal muscles, etc. Biomedical research has therefore developed drugs characterized either by a long half-life or available in a slow-release formulation. Isoxicam, piroxicam and benoxaprofen, which possess long half-lives, were compared with diclofenac sodium, indomethacin and ketoprofen, in their slow-release formulations, in terms of pharmacodynamics, pharmacokinetics and toxicity. Isoxicam, piroxicam and diclofenac showed excellent long lasting antiinflammatory properties: however the evidence showed that in cases of mild or severe renal pathology, drugs in their slow-release formulations are to be preferred. PMID- 3542847 TI - Effects of unemployment on drinking behavior: a review of the relevant evidence. AB - Although it is often asserted that drinking and drinking problems are likely to increase as a consequence of unemployment, there is little evidence at present to support such a view. However, reasons why such a relationship might be expected may be derived from the literature on the social, psychological, and health effects of unemployment and also from the relationship between drinking behavior and occupation. It is argued that any competent investigation must consider the stages of unemployment and a number of psychological and demographic variables which may moderate the effects of unemployment on drinking. Finally, two specific hypotheses are identified and requirements for future research suggested. PMID- 3542849 TI - Treatment of symptoms of rhinopharyngitis in children with a new anti inflammatory agent. AB - An open trial of piroxicam, a new nonsteroidal anti-inflammatory agent with long lasting analgesic and antipyretic activities, was carried out on 49 children as outpatients with viral rhinopharyngitis. Piroxicam administered once daily as an oral suspension gave significant improvement in all parameters, both respiratory (nasal obstruction and discharge, hoarseness, sore throat) and general (headache, dysphagia). A lowering in body temperature was also observed. Recovery seemed to have a more favourable trend in patients treated with piroxicam than to previous treatments. Tolerability of piroxicam was satisfactory in all but six patients who showed only slight transitory side-effects. PMID- 3542850 TI - Flurbiprofen versus ASA in influenza symptomatology: a double-blind study. AB - The effectiveness and safety of flurbiprofen 100 mg b.i.d. vs acetylsalicylic acid (ASA) 500 mg b.i.d. were evaluated in a 4-day double-blind study in 30 patients suffering from influenza. The antipyretic effect of flurbiprofen was similar to that of ASA. Upper and lower respiratory symptoms, gastrointestinal symptoms, articular and muscular pain and asthenia were improved by both drugs. Only one patient on ASA discontinued the treatment. PMID- 3542851 TI - Double-blind controlled clinical evaluation of effectiveness of zidometacin by oral and rectal route in osteoarthritis. AB - Twenty patients were treated with zidometacin by either the oral or the rectal route in a double-blind, short-term, balanced cross-over study, using the techniques of the double dummy. They suffered from osteoarthritis of the hip or knee or both. Zidometacin was administered at the daily doses of 400 mg p.o., and 600 mg by rectal route. The duration of each treatment was ten days. Zidometacin either as capsules or as suppositories showed a statistically significant influence on pain and functional indices even in this short-term evaluation. The side-effects reported by patients were three cases of dizziness and one case of nausea with capsules and one case of anal burning with suppositories, none of them requiring the interruption of the treatment. PMID- 3542852 TI - Improved insulin sensitivity in carbohydrate and lipid metabolism after physical training. AB - To estimate physical training effects quantitatively, the relationship between tissue sensitivity to exogenous insulin (glucose metabolism determined by euglycemic insulin-clamp technique) and maximal oxygen uptake (VO2 max) was defined in 9 well-trained athletes and 14 untrained subjects with normal glucose tolerance. Tissue sensitivity to exogenous insulin in the athletes was significantly higher than in the controls (P less than 0.001). Seven untrained subjects continued the physical exercise program. After physical training for 1 month, glucose metabolism increased from 40.3 +/- 3.9 mumol/kg/min to 42.2 +/- 4.4 mumol/kg/min (P less than 0.05) and VO2 max also increased significantly (P less than 0.05). During euglycemic hyperinsulinemia, both plasma FFA (P less than 0.001) and glycerol (P less than 0.05) decreased rapidly after physical training. Glucose metabolism directly correlated with VO2 max (P less than 0.001). These results suggest that the euglycemic insulin-clamp technique provides a reliable estimate of training effects, tissue sensitivity to physiologic hyperinsulinemia is 46% higher in trained athletes, and physical training improves insulin sensitivity not only in glucose metabolism but also in lipid metabolism. PMID- 3542853 TI - Jogging causes a significant increase in platelet sensitivity to prostacyclin. AB - Platelet function and platelet sensitivity to PGI2 was studied before and after jogging in seven males and four females in good health. The ADP-induced (1 microM) aggregation, being always increased after physical activity, showed during the entire follow-up period of 12 months a significant decrease at rest and after exercise compared with baseline values. The change in the aggregation response was significant for t alpha at month 1 and for delta tmax at month 2 after starting the jogging. The platelet sensitivity to PGI2, being always diminished after exercise, also increased significantly during the entire follow up period compared with baseline levels. In contrast to the ADP-induced changes, the changes in platelet sensitivity were significant already at week 2. Our findings indicate that daily physical activity causes a significant improvement in platelet function and reduces platelet activation. PMID- 3542854 TI - The illusions of law--psychoanalysis and jurisprudence in historical perspective. PMID- 3542856 TI - The punitive uses of the insanity defense: the trial for treason of Edward Oxford (1840). PMID- 3542855 TI - From mad-doctor to forensic witness: the evolution of early English court psychiatry. PMID- 3542857 TI - Isaac Ray's "Project of a Law" and the 19th century debate over involuntary commitment. PMID- 3542858 TI - A historical appraisal of America's experience with "pyromania"--a diagnosis in search of a disorder. AB - When "pyromania" from 1840-1890 is reviewed, it stands out as a concept that at first found favor in an era of moral insanity and moral treatment. During this period pyromania was variously labeled as a form of monomania, moral insanity, impulsive mania, or instinctive mania. As early as 1850, and clearly after the Civil War, however, controversial arguments regarding the locus of personal responsibilty emerged. Arguments were put forward that there could be diseased brains but not diseased minds. Without the proof of an organic lesion in the brain, fire-setting became an act whose locus rested in the individual's moral fabric, and in this historical context became a nonmedical concern punishable by law. Pyromania, at the hands of those physicians who limited insanity to disorders of the brain, might have received the same fate as other diseases of the mind or will: it could have simply been dismissed. But it lingered. The period 1880-1917 witnessed professional attention directed toward prophylaxis, mental hygiene, and a reorientation of American psychiatry toward an endorsement of psychotherapy (Sicherman, 1980). Attention to pyromania was more quiescent than it had been. The development of psychoanalytic theory which followed allowed for the re-emergence of pyromania as a disease entity. The diagnosis then flourished from 1924 until 1957, with descriptions of it including: an irresistible impulse, a urethra-erotic character trait, an obsession, or a psychosexually based impulse neurosis. The period of 1924-1985 can be viewed as a repetition of the period between 1840-1890 in terms of the evolution of the place of pyromania in the lexicon of psychiatry, of its existence as a disease entity, and of its implications for personal responsibility for destructive acts. Supported at the outset of this later period as a disease, this time grounded in psychoanalytic rather than moral theories of responsibility, it loses favor as the psychobiologic position ascends. And like the preceding period, the conception of pyromania as a specific disorder wanes but never dies, as advocacy for the psychodynamic (replacing moral) approach diminishes but does not disappear. The cyclical nature of pyromania has parallels in cycles of reform in standards of civil commitment (Livermore, Malmquist & Meehl, 1958; Dershowitz, 1974), in the use of physical therapies and medications (Tourney, 1967; Mora, 1974), in treatment of the chronically mentally ill (Deutsch, 1949; Morrissey & Goldman, 1984), and in institutional practices (Treffert, 1967; Morrissey, Goldman & Klerman (1980).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3542859 TI - The New York Medico-Legal Society: legitimating the union of law and psychiatry (1867-1918). PMID- 3542860 TI - Criminological appraisals of psychiatric explanations of crime: 1936-1950. PMID- 3542861 TI - Xeroderma pigmentosum. PMID- 3542862 TI - Clinical variants of pemphigoid. PMID- 3542863 TI - Immunoreactivity of involucrin in cervical condyloma and intraepithelial neoplasia. AB - Ninety-three cervical conization specimens with condyloma or intraepithelial neoplasia were stained by the peroxidase-antiperoxidase technique for involucrin. Diffuse, homogeneous suprabasal staining was observed in the ectocervical squamous mucosa and mature squamous metaplasia. In immature squamous metaplasia, staining was limited to cells with apparent squamous differentiation. Although diffusely reactive in the upper layers of condyloma and cervical intraepithelial neoplasia (CIN) grade I, the stain was uneven in the former and lacking in the parabasal layers of the latter. The staining intensity, distribution, and pattern were more variable in CIN grade II and grade III. With increasing severity, a patchy pattern with a mixture of reactive and nonreactive cells predominated. Although immunoreactivity with involucrin could not distinguish immature squamous metaplasia from neoplasia, the staining patterns in CIN correlated with extent of disease, degree of squamous differentiation, and cellular disorganization. PMID- 3542864 TI - Fat distribution and adipose tissue metabolism in non-obese male black African and Caucasian subjects. AB - Twenty-four male black African (25.5 +/- 3.0, mean +/- s.d., years of age) and 24 male Caucasian (21.5 +/- 3.6) subjects, ascertained as sedentary individuals, participated in this study designed to determine whether there were racial differences in fat distribution and adipose tissue metabolism while controlling the differences in body fat. An adipose tissue biopsy was obtained from the suprailiac region for the determination of basal (BL), epinephrine submaximal 10( 4) M (ESML) and maximal 10(-3) M (EML) stimulated lipolysis, basal (BLG) and maximal insulin 9 microU/ml (ILG) stimulated lipogenesis and heparin releasable lipoprotein lipase (LPL) activity. Body density was determined through underwater weighing procedures and body fat derived with the Siri equation. The following skinfolds were also measured: triceps, biceps, subscapular, abdomen, suprailiac, front thigh and medial calf. Caucasians were matched with the black Africans for age, body weight and body density. Results indicated that when Caucasians and black Africans of similar percentage body fat were compared, no significant differences were observed in the total amount of subcutaneous fat, fat distribution and suprailiac mean fat cell size. Moreover, no significant differences were observed between the two groups for BL, BLG, and ILG of adipose tissue. However, black Africans had higher (P less than 0.01) epinephrine stimulated lipolytic values (ESML and EML) and LPL activity (P less than 0.01) than the Caucasian subjects. These results suggest that for a comparable level of fatness and similar fat morphology and distribution, there are racial differences in adipose tissue metabolism. PMID- 3542865 TI - Harold Victor Whitlock. PMID- 3542866 TI - Inhibition of lysosomal fusion by Trypanosoma cruzi in peritoneal macrophages. PMID- 3542868 TI - The kidney in heart disease. PMID- 3542867 TI - Community acquired infections in children on maintenance cyclosporine therapy. AB - Cyclosporine has profound immunosuppressive properties. We reviewed our experience of community acquired infections in 62 children who received the drug from 2 to 36 months. 36 children received the drug for a renal transplant for a mean of 18 months. There were 3 minor and one major episode of infection in this group. The frequency of both minor and major infections in cyclosporine recipients was significantly lower when compared with a group of renal recipients treated with azathioprine. 26 children received cyclosporine for 2 months for resistant nephrotic syndrome. This group had one major and one minor episode of infection. Despite the relative safety of cyclosporine recipients from infectious complications, a more prolonged follow up is necessary. PMID- 3542869 TI - Chronic renal failure in children. AB - It is important to appreciate that the recent advances in nutritional management over the past two decades (19-22) have added to the longevity and the "joie de vivre" of children with chronic renal failure. The significant advances in vitamin D therapy and new treatment of complications in long-term maintenance dialysis have provided the pediatric nephrologist with new avenues of management. PMID- 3542870 TI - Multifocal neurological impairment caused by infection-induced rise in blood lithium and amitriptyline. AB - We present the case of a thirty-eight-year-old woman who developed a febrile illness which was associated with a rise of blood lithium and amitriptyline, and subsequently suffered permanent neurological impairment, implicating CNS dysfunction at several levels. Medical, laboratory, radiological and neuropsychological findings are described, and the attribution of the syndrome is discussed. It is crucial to emphasize that the authors are not challenging the frequently useful combination of lithium and antidepressants. Rather, we urge psychiatrists to be vigilant when such patients develop febrile illnesses. PMID- 3542871 TI - Transplant failure does not compromise quality of life in end-stage renal disease. AB - Data from three separate quality of life studies of end-stage renal disease patients investigated the hypothesis that those patients who have previously experienced the failure of a transplanted kidney are characterized by lower levels of life quality than are patients who have not. Multivariate data analyses uniformly failed to support this hypothesis. Likely explanations for the discrepancy between these and other contradictory findings as well as clinical and research implications are presented. PMID- 3542873 TI - Orthodontics: a solution for the advanced periodontal or restorative problem. PMID- 3542872 TI - Efficiency of scaling of the molar furcation area with and without surgical access. PMID- 3542874 TI - Electrophysiological testing in neuroophthalmology. PMID- 3542875 TI - Neuroradiological imaging techniques. PMID- 3542876 TI - Neuroendocrine-ontogenetic mechanism of aging: toward an integrated theory of aging. PMID- 3542877 TI - [Experimental acute pancreatitis]. PMID- 3542878 TI - [New developments in gastrointestinal motility]. PMID- 3542879 TI - [Recurrent subileus: an early symptom of a non-Hodgkin lymphoma of the small intestine]. PMID- 3542880 TI - [A 47-year-old patient with tachyarrhythmia, retrosternal pain and dyspnea following provoked vomiting]. PMID- 3542881 TI - Morphology of quisqualate-induced neurotoxicity in the chicken retina. AB - In this study, the acute neurotoxic effects of quisqualic acid on the chick retina were examined 2 hr or 2 days following intravitreal injections of either 100 or 200 nmol quisqualic acid (QUIS). Both doses resulted in marked nuclear pyknosis and cytoplasmic swelling of a large population of cells located in the inner aspect of the inner nuclear layer, consistent with amacrine cells. The associated swelling of the inner plexiform layer was primarily due to swollen processes of amacrine cells. Also affected was a row of cells located in the outer margin of the inner nuclear layer, consistent with horizontal cells. Ganglion cells developed hyperchromic, vacuolated cytoplasm. Bipolar cells appeared to be spared from damage at these doses. Electron microscopy of photoreceptor synapses revealed that QUIS was associated with a decrease in the relative frequency of long synaptic ribbons and an increase in the frequency of short ribbons, granular ribbons, "synaptic stalks," and paranuclear granules. After 2 days survival, most ganglion cells and some amacrine cells appeared normal, while degeneration was observed in a small number of photoreceptors. Remaining photoreceptor terminals appeared normal. QUIS may provide a useful tool in understanding the dynamics of normal photoreceptor ribbon turnover. The results are also discussed in relation to other known classes of excitatory amino acids. PMID- 3542883 TI - On presentation of the Proctor Medal of the Association for Research in Vision and Ophthalmology to Dr. Denis A. Baylor. PMID- 3542884 TI - Digital subtraction angiography. Update, 1986. PMID- 3542882 TI - On presentation of the Friedenwald Award of the Association for Research in Vision and Ophthalmology to Dr. Joram Piatigorsky. PMID- 3542887 TI - Improvement in diabetic control on complete withdrawal of inappropriately prescribed insulin. PMID- 3542886 TI - Dentin-bonding systems: a brief review. PMID- 3542889 TI - Biographical sketches--70. Bert. PMID- 3542890 TI - The use of non-essential drugs, alcohol and cigarettes during pregnancy. PMID- 3542888 TI - Imaging in emphysematous pyelonephritis--the use of indium-111 labelled leucocyte scanning and computed tomography. PMID- 3542885 TI - A comparison of clearance and arteriovenous extraction techniques for measurements of renal hemodynamic functions. AB - No previous studies have directly compared timed urine collections (UV/P) vs. arteriovenous (A-V) extraction methods for determination of renal function in whole kidney preparations. We examined different markers and techniques for assessing renal plasma flow (RPF), filtration fraction (FF), and glomerular filtration rate (GFR) in both steady-state and rapidly changing conditions following 2 ml/kg bolus intravenous injections of either Renografin 76% (meglumine/sodium diatrizoate-76%) or hypertonic mannitol 25%. During steady state conditions, excellent correlations were obtained when comparing markers and techniques. Thus, timed urinary clearances of inulin vs. 99m-technetium DTPA (Tc) had a correlation coefficient (R) of .96 (P less than .01; n = 16), and the A-V extraction technique of inulin vs. Tc as determinants of GFR showed a correlation of R = .98 (P less than .01; n = 15). The timed urinary clearance of inulin vs. the A-V extraction of inulin for glomerular filtration gave a correlation of R = .93 (P less than .01; n = 15). The clearance of para-aminohippurate (PAH) divided by the extraction of PAH vs. flow determinations using the electromagnetic flowmeter gave a correlation of R = .92 (P less than .01; n = 16). The anticipated decrease in GFR following contrast medium and hypertonic mannitol was observed using the A-V extraction technique, whereas an artifactual, exaggerated increase in GFR was observed using the timed urine collection technique. Similarly, we noted an exaggerated increase in RPF using CPAH/EPAH as the methodology. We conclude that rapid changes in renal hemodynamics may be measured accurately using the A-V extraction technique but not with clearance techniques requiring timed urine collections. PMID- 3542891 TI - Dialysis and transplantation for diabetic nephropathy: the Dublin experience 1977 1985. PMID- 3542892 TI - Two patients with congenital plasmodium falciparum malaria. PMID- 3542893 TI - Biographical sketches--71. Horner. PMID- 3542894 TI - The discovery of resistance. Historical accounts and scientific careers. PMID- 3542895 TI - Treadmilling or fragmentation? A proposed repair mechanism for actin filaments. AB - A review of the literature concerning "treadmilling" and fragmentation of actin filaments indicates that these two processes take place under similar conditions and that the mere difference of critical concentration at the two ends of the actin filaments is not a sufficient prerequisite for the exchange of actin monomers with polymer subunits. The hypothesis is made that fragmentation is the main prerequisite for the exchange. A repair mechanism for actin filaments is also presented. PMID- 3542896 TI - Molecular studies on DNA sequences coding for factor VII and factor XII of human coagulation. AB - In this paper are described the immunological and molecular procedures that have allowed the identification and the nucleotide sequence characterization of recombinant cDNA coding for factor XII of human coagulation and have suggested the possible identification of other cDNA clones as coding for factor VII of human coagulation. PMID- 3542898 TI - From TB to AIDS: value conflicts in reporting disease. PMID- 3542897 TI - IgG1,3 and 4 oligoclonal bands in multiple sclerosis and other neurological diseases. AB - Cerebrospinal fluid (CSF) samples from 10 patients with Multiple Sclerosis (MS) and 7 with other neurological diseases (OND) were studied in order to detect oligoclonal restriction of IgG subclasses 1,3 and 4. Agarose isoelectric focusing (AGA-IEF) followed by Western capillary blotting and immunoperoxidase staining with specific monoclonal antibodies were used. All MS samples showed oligoclonal IgG1 and 6 of them also had IgG3 or IgG4 bands. In the OND group only patients with subacute sclerosing panencephalitis (SSPE) and Guillain-Barre disease (GBD) showed CSF oligoclonal patterns for IgG subclasses. Our results demonstrate that in MS CSF other IgG subclasses beside IgG1 may display an oligoclonal pattern. The finding of more than one subclass in the same band indicates a microheterogeneous composition of these oligoclonal bands. PMID- 3542900 TI - Early history of the Hawaii Academy of General Practice. PMID- 3542899 TI - The constitutional balance between health and liberty. PMID- 3542901 TI - [Lyme borreliosis]. AB - Lyme borreliosis has in common features with another spirochetosis, syphilis, e.g. the development in three stages and the occurrence of reinfection and congenital infection. The European variant (erythema migrans disease in the broader sense) initially more often seems to have a mild course than in the United States, but lymphocytoma, Bannwarth syndrome and acrodermatitis chronica atrophicans seem to be more common in Europe. Administration of tetracycline for stage 1 and of parenteral penicillin G in high doses for stages 2 and 3 and during pregnancy is recommended. PMID- 3542903 TI - [Pseudolymphoma following cosmetic tattooing]. PMID- 3542905 TI - [The Lasix sonogram for the functional elucidation of ureteral outflow obstruction]. PMID- 3542902 TI - [Paraffin granuloma of the penis]. AB - Granulomatous foreign-body reactions following paraffin injections can produce diagnostic difficulties, especially if the patient denies the injections. The paraffin injections serve to enlarge the penis and are mostly performed by psychiatrically patients. Undesired side effects that can occur are solid granulomatous infiltrations or penis deviation with impotentia coeundi. On the basis of a case report, the different motives of the patients and the therapeutic possibilities are presented. PMID- 3542906 TI - [The functional sonogram--its value in the noninvasive elucidation of congenital ureteral obstructions]. PMID- 3542904 TI - Radionuclide export by deer mice at a solid radioactive waste disposal area in southeastern Idaho. AB - Concentrations of 90Sr, 137Cs, 238Pu, 239+240Pu, and 241Am in deer mice tissues collected from a radioactive waste disposal area in southeastern Idaho were significantly (p less than 0.05) higher than those from a control area. The highest concentrations of Pu and Am occurred in pelts of deer mice inhabiting an area which had elevated surface and subsurface soil concentrations of these nuclides as compared to other Subsurface Disposal Area locations. Therefore, transuranic contamination in tissues likely originated from both soil depths. However, 137Cs and 90Sr in tissues likely originated from subsurface areas, since surface soils were below background concentrations for these nuclides. Based on a minimum of 6160 deer mice inhabiting the 36-ha waste disposal area over a 1-yr period, a total minimum inventory of 22.8 mu Ci radioactivity was contained in deer mice tissues. Of this estimate, 22.7 mu Ci activity was due to the radionuclides 90Sr and 137Cs. An estimated total of 8.4 mu Ci was transported from the disposal area in mice dispersing from the area. A calculated annual radionuclide inventory of 28.8 mu Ci in deer mice feces was deposited in and around the radioactive waste disposal area. Deer mice inhabiting the SDA are a mode of radionuclide uptake and transport; however, the environmental consequences of this transport mechanism are likely minimal. The results for deer mice, which make up 69% of the small mammal biomass, are discussed in relation to other small mammals within the disposal area. Other modes of transport associated with the deer mice, such as radionuclides in excavated soils associated with burrowing activities and predation, are also discussed. PMID- 3542907 TI - New positive inotropic agents. PMID- 3542909 TI - A tribute to Dr. Szilagyi. PMID- 3542908 TI - Status of cardiac transplantation with a report of the first year's experience at Henry Ford Hospital. PMID- 3542910 TI - Histochemical demonstration of mycobacterial antigen, specific antibody and complement in the lesions of tuberculosis. AB - Lesions were studied histochemically for mycobacterial antigen, its specific antibody and complement in 31 patients with recently-diagnosed tuberculosis. The results were related to a histological spectrum that correlated with bacterial load. The form, localization and persistence of antigen were found to be as significant as the amount. In high-resistant cases, the antigen was mainly soluble, a form which was non-toxic when ingested by macrophages but associated with tissue damage when bound to connective tissue. There was no close contact between plasma cells and antigen. However, in cases with moderate resistance, where plasma cells and antigen intermingled freely, necrosis with karyorrhexis and polymorph infiltration was associated with deposition of antigen, antibody and complement at the same sites, indicating the probability of immune complex formation in these lesions. In low-resistant cases, extensive necrosis was attributed partly to high levels of extracellular antigen. The correlation between immunological circumstances and the manifold forms of necrosis validated these forms as the basis for a histological spectrum in tuberculosis. PMID- 3542911 TI - Use of non-absorbable markers in studies of human nutrient absorption. AB - Neutron activation analysis signifies a new era in the methodology of studies on nutrient utilization in humans. Yet the classical metabolic balance technique incorporating inert, non-absorbable markers will continue to be an invaluable tool for such studies. This review describes the use and abuse of a number of 'classical' inert markers, and describes the potential use of radioactive and naturally-occurring isotopes, and of heavy metals. The paucity of data critically appraising markers in infant balance trials is apparent. The comparative merits of conventional markers--carmine, polyethylene glycol 4000, chromium oxide- should be assessed. Indeed, it might be argued that the advancing knowledge on the use of naturally occurring isotopes in adults should make similar studies on infants a priority. PMID- 3542912 TI - [Management of septal perforations by rotationplasty of the septal mucosa]. AB - A unilateral mucosal flap from the septum with a wide pedicle and an axial blood supply was used for closure of septal perforations. In special cases this procedure was combined with a labial-buccal flap. 18 patients with perforations of different sizes were treated resulting in a permanent and complete closure in 12 cases. Relief of complaints was also noticed in the six patients with residual perforations. We therefore conclude that diminution and shifting of the perforation may be sufficient to relieve symptoms. The technique proved to be a safe and physiological procedure for the patients with septal perforations. PMID- 3542913 TI - Nonrandom association of cellular antigens with HTLV-III virions. AB - Retroviruses are known to incorporate cellular antigens as they bud from infected cells. To identify the cellular antigens that associate with the AIDS-retrovirus, we evaluated a preparation of HTLV-III antigens with a panel of monoclonal antibodies reactive with a variety of antigens expressed on the H9 T-cell line used to produce the virus. Only monoclonal antibodies that identified HLA class II antigens, beta-2 microglobulin, and a single anti-HLA class-I antibody were reactive in an ELISA of solubilized HTLV-III virus. No reactivity was seen with 11 monoclonal antibodies to T-cell antigens or with five antibodies to determinants on HLA class-I A or B molecules. These data suggest that on H9 cells the association of budding HTLV-III virions with cellular antigens may be a nonrandom process in which some HLA antigens, particularly class-II antigens, are selectively incorporated into the viral envelope. It is possible that a selective association of HLA class II antigens with budding HTLV-III virions may also occur for T cells infected in vivo, and could have relevance for the pathogenesis of this virus. PMID- 3542914 TI - Presentation of soluble antigen to human T cells by products of multiple HLA linked loci: analysis of antigen presentation by a panel of cloned, autologous, HLA-mutant Epstein-Barr virus-transformed lymphoblastoid cell lines. AB - Epstein-Barr virus-transformed human B lymphoblastoid cell lines (EBV-LCL) can present soluble antigens to antigen-primed T lymphocytes. In this study, we used HLA antigen-loss mutants of an EBV-LCL line (LCL 721) to demonstrate that the presentation of a soluble antigen from Candida albicans (CAN) by EBV-LCL to primed T cells can be restricted by multiple HLA determinants. Haplotype-deletion mutants that contained only the maternal or only the paternal HLA-haplotype were used to demonstrate the preferential role of autologous HLA antigens in presenting soluble antigens to Candida-primed T cells from the donor of LCL-721, and to T cells from her mother and father. Immunoselected mutants of LCL-721 showing a variety of distinct phenotypes that are deficient in HLA-DR, DQ, or DP antigen expression were tested as antigen-presenting cells. The antigen presenting ability of these class II deficient EBV-LCL variants weakened with progressive loss of class II HLA determinants expressed on the cell surface. Our study, therefore, provides evidence for multiple HLA restriction determinants, including HLA-DR, DQ, and DP. Furthermore, LCL lacking all HLA-DR, DQ, and DP expression because of homozygous deletion of these MHC class II genes still presented CAN and Tetanus toxid (TET), although to a much lesser degree than presented by LCL-721. This suggests that determinants other than DR, DQ, and DP which are expressed on these EBV-LCL may also function as restriction elements for the proliferative T-cell response to soluble antigens. PMID- 3542915 TI - CT body stereotaxic system for placement of needle arrays. AB - A new CT body stereotaxic system that is particularly suited to multiple placements of needles precisely in parallel is described. By scanning through a right triangle placed on the patient's skin, the stereotaxic method defines an entry point for the first needle placement. 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 the complex approaches from one scan plane to another can be made to place needle arrays through inaccessible lesions, for instance, beneath the diaphragm. Animal and phantom studies have shown that placement of multiple needle arrays in parallel from CT scan data is possible. PMID- 3542916 TI - Hyperfractionated photon radiation therapy in the treatment of advanced squamous cell carcinoma of the oral cavity, pharynx, larynx, and sinuses, using radiation therapy as the only planned modality: (preliminary report) by the Radiation Therapy Oncology Group (RTOG). AB - From August 1979 to June 1983, the RTOG conducted a prospective Phase III study that compared a standard schedule with five fractions per week of 180 to 200 cGy per day to a total dose of 6600-7380 cGy, with a hyperfractionation regimen consisting of two fractions of 120 cGy per day, separated by a rest period of 3 to 6 hours for a total of 6000 cGy. A total of 210 patients were entered, of which 187 are analyzed. Complete initial tumor clearance in the head and neck was achieved by radiotherapy in 61% of the patients assigned to the standard schedules and in 59% of those assigned to the continuous hyperfractionation schedule; surgical salvage contributed towards achieving complete response in 5% and 7% of patients, respectively. The Kaplan-Meier estimates for loco-regional control of tumor at 1 and 2 years was 39% and 29% for the standard schedules, and 43% and 30% for the hyperfractionation schedule. The endpoints examined to evaluate therapeutic effects do not indicate that the stated hyperfractionation schedule is different than the standard RTOG treatment schedule for head and neck cancer. Acute normal tissue reactions appear to be more severe with the hyperfractionation schedule but the incidence of late reactions is similar in both groups. There is a tendency toward more severe acute reactions when the interval between the two fractions per day is 4.5 hrs or less in comparison to intervals longer than 4.5 hrs. PMID- 3542917 TI - Differential response by adolescents to naproxen sodium therapy for spasmodic and congestive dysmenorrhea. AB - The purpose of this study was to determine whether adolescents with "spasmodic" dysmenorrhea (SD) versus "congestive" dysmenorrhea (CD) respond differently to naproxen sodium therapy. Forty-five females ages 12-18 years were pretested and randomly assigned in a double-blind fashion to one of five treatment regimens of various dosages of naproxen sodium and placebo. Subjects were posttested at one, two, and three months. Subjects with initial Menstrual Symptom Questionnaire (MSQ) scores of greater than or equal to 76 were classified as SD (n = 28) and those with scores of less than or equal to 75 were classified as CD (n = 17). Subjects with SD had a significant (p less than or equal to 0.05) reduction in MSQ scores after the first month of naproxen sodium therapy. By the second month, the degree of reduction was associated with a loading dose of 550 mg of naproxen sodium. Subjects with CD had a dose-related (p less than or equal to 0.05) response to naproxen sodium therapy that appeared to be influenced by other factors. At the first month follow-up, greater post menarchal age and parents' education were associated with increased symptom relief following naproxen sodium therapy (p less than or equal to 0.05). At the second month, CD subjects with increased life crisis events and lower self-concepts had more severe symptoms following naproxen sodium therapy (p less than 0.05). Our subjects with SD symptoms had a greater response to naproxen sodium therapy than those with CD symptoms. PMID- 3542918 TI - Dysfunctional uterine bleeding associated with 45X/47XXX mosaicism and Von Willebrand's disease. AB - This report describes a patient with Turner's mosaicism (45X/47XXX) who presented with short stature and heavy menstrual bleeding. Pelvic ultrasound revealed the presence of a large right cystic ovary; the left ovary was not visualized. Coagulation evaluation demonstrated Von Willebrand's disease. PMID- 3542920 TI - A tribute to John Y. Kim, DDS, FACD (1906-1986). PMID- 3542919 TI - Polypeptide composition of the mammalian tectorial membrane. AB - The effects of the enzymes collagenase, pepsin, chondroitinase ABC and keratanase on the polypeptide composition of the mammalian tectorial membrane have been analysed using one dimensional SDS-polyacrylamide gel electrophoresis (SDS-PAGE). After reduction at least ten polypeptides can be consistently and clearly recognized in SDS gels with molecular weights relative to globular protein standards of 245, 235, 190, 165, 155, 145, 100, 93, 60-73 and 35-49 kDa. With the exception of the 60-73 and 35-49 kDa bands all these polypeptides are sensitive to digestion with bacterial collagenase. The 235, 165, 155, 145 and 93 kDa bands also resist degradation by cold, acidic pepsin. Amino acid analysis of whole tectorial membranes demonstrates that glycine accounts for nearly 25% of the total amino acid content, that proline, hydroxyproline and hydroxylysine are present and that amine sugars can be detected in fairly high concentrations. Estimates based on hydroxyproline content suggest that collagens account for 25 50% of the total tectorial membrane protein. Immunoblotting techniques demonstrate the presence of polypeptides cross reacting with antisera to Type II collagen, Type IX collagen and Type V collagen. Results from immunohistochemical studies confirm that these polypeptides are present in the tectorial membrane and are not contaminants of the isolation procedure. Collagenase treatment of tectorial membranes reveals the presence of an additional non-collagenous polypeptide with an apparent molecular weight of 173 kDa on 7.5% polyacrylamide gels, and polydisperse high molecular weight material spreading over a broad range at the top of the gels. This high molecular weight material and the 173, 60 73 and 35-49 kDa non-collagenous polypeptides are pepsin sensitive and all bind wheat germ agglutinin (WGA) suggesting that they contain N-acetyl glucosamine. The 173 kDa band also binds soybean agglutinin (SBA) suggesting the presence of N acetyl galactosamine. In the absence of reducing agent the 173 and 60-73 kDa bands are no longer observed and high molecular weight material forming a broad band at the top of the separating gel is seen. The electrophoretic behaviour of this non-collagenous, glycosylated, disulphide bonded, high molecular weight material is altered by treatment with keratanase but not by chondroitinase ABC. The results of this study indicate the tectorial membrane contains at least three different collagen types and, in addition to these collagenous proteins, several non-collagenous, glycosylated polypeptides that may account for as much as 50% of the total tectorial membrane protein. PMID- 3542921 TI - Osseointegration for restorative dentists. Part IV: Fabrication of the mandibular tissue integrated prosthesis. PMID- 3542922 TI - The action of various venoms on Escherichia coli. AB - The antibacterial activity of honeybee venom (Apis mellifera), three snake venoms (Naja naja sputatrix, Vipera russellii and Crotalus adamanteus) and the polypeptide melittin was investigated against Escherichia coli. Minimum inhibitory concentration values, cell lysis and alterations in cell permeability were determined and action against E. coli was in the order: A. mellifera venom greater than melittin greater than N. naja sputatrix venom much greater than V. russellii venom greater than C. adamanteus venom. Cellular damage by A. mellifera and N. naja sputatrix venoms was evident in electron micrographs. PMID- 3542923 TI - Elevation of the heat resistance of Salmonella typhimurium by sublethal heat shock. AB - The survival of Salmonella typhimurium after a standard heat challenge at 55 degrees C for 25 min increased by several orders of magnitude when cells grown at 37 degrees C were pre-incubated at 42 degrees, 45 degrees or 48 degrees C before heating at the higher temperature. Heat resistance increased rapidly after the temperature shift, reaching near maximum levels within 30 min. Elevated heat resistance persisted for at least 10 h. Pre-incubation of cells at 48 degrees C for 30 min increased their resistance to subsequent heating at 50 degrees, 52 degrees, 55 degrees, 57 degrees or 59 degrees C. Survival curves of resistant cells were curvilinear. Estimated times for a '7D' inactivation increased by 2.6- to 20-fold compared with cells not pre-incubated before heat challenge. PMID- 3542924 TI - Elimination of plasmids by enoxacin and ofloxacin at near inhibitory concentrations. AB - The abilities of the 4-quinolones enoxacin and ofloxacin, inhibitors of DNA gyrase subunit A, to eliminate plasmids from Escherichia coli have been studied in a narrow concentration range just below the MIC. These compounds cured most efficiently at the highest concentration which still allows cell growth and produced 20% to 100% plasmid-free cells, depending upon the plasmid tested. Higher concentrations were required to eliminate plasmids from a gyrANalr strain, consistent with their higher MICs, but maximal curing frequencies were similar to those obtained with the Nals strain. Kinetics of plasmid elimination indicated that plasmid loss occurred by inhibition of plasmid replication, which seems to be somewhat more sensitive to the action of 4-quinolones than chromosome replication. Low or high curing frequencies with a given curing agent seem to be a property of the plasmid tested. PMID- 3542925 TI - Penetration of ceftazidime into the rabbit respiratory tract. AB - A procedure is described for the direct collection of bronchial or tracheal fluid samples on to paper discs. Using the procedure, the pharmacokinetics of ceftazidime in rabbit bronchial and tracheal fluids were compared with those in the respective wall tissue samples and in lung tissue. Concentrations appearing in lung tissue were approximately half those seen in bronchial or tracheal fluid or bronchial and tracheal wall tissue. Concentrations in these latter compartments were, in turn, four- to six-fold lower at all times than simultaneously-measured serum levels. The shape of the concentration/time curves were similar for all compartments sampled. The half life values were 63 to 64 min for respiratory tract concentrations and 59 min for serum levels. Percentage penetration from serum into the various compartments was 20.8% for bronchial fluid, 19.9% for tracheal fluid, 22.4% for bronchial wall, 20.0% for tracheal wall and 11.3% for lung tissue. PMID- 3542927 TI - Ciprofloxacin treatment of recurrent Salmonella typhimurium septicaemia in a patient with acquired immune deficiency syndrome. PMID- 3542926 TI - Evaluation of ceftazidime in experimental Klebsiella pneumoniae pneumonia: comparison with other antibiotics and measurement of its penetration into respiratory tissues and secretions. AB - The activity of ceftazidime was examined in a murine model of Klebsiella pneumoniae pneumonia in which the antibiotic was administered subcutaneously 6 h after intranasal infection and then twice daily for the next three days (i.e. seven doses). In a series of experiments using this test, the dose of ceftazidime giving 50% survival relative to controls (SD50) ranged from 1.0-9.0 mg/kg/dose while the dose required to reduce the log10 cfu/lung by 50% (CD50) ranged from 24 64 mg/kg/dose. Ceftazidime was considerably more effective than cefotiam, amoxycillin-clavulanic acid or kanamycin in the test. Pharmacokinetic studies with ceftazidime showed that no differences in respiratory tract penetration existed between uninfected mice and mice infected for 48 h with K. pneumoniae. The percentage penetration of ceftazidime from serum was 73% for pleural fluid, 44% for tracheal fluid, 27% for tracheal wall tissue and 17% for whole lung tissue after a subcutaneous injection of 100 mg/kg. At this dose, ceftazidime remained at supra-MIC concentrations for 2-3 h in all compartments examined. PMID- 3542928 TI - Biological activities specified by antibiotic resistance plasmids. AB - Bacteria can display resistance to a wide spectrum of noxious agents and environmental conditions, and these properties are often mediated by genes located on extrachromosomal DNA elements called plasmids. Replication, vertical and horizontal transmission and evolution of these elements are discussed, and examples of the genes responsible for the resistance phenotypes are given. Selective forces that drive the evolution of new combinations of bacterial properties of particular importance in clinical situations are analysed. PMID- 3542929 TI - Beta-lactam antibiotics and selection of resistance: speculation on the evolution of R-plasmids. AB - In this paper we describe two genetic mechanisms which are responsible for the development of resistance to third-generation cephalosporins. One is a plasmid mediated mechanism involving a mutation in the SHV-1-gene towards the production of the beta-lactamase SHV-2 which has increased affinity for these antibiotics. The other is chromosomally mediated and occurs at high frequency by mutation of inducible beta-lactamase-genes, leading to derepressed production of the enzyme. Together with other examples of resistance genes these two mechanisms lead us to a hypothesis about the evolution of beta-lactamase producing bacteria. PMID- 3542930 TI - Ecological factors influencing the transfer of plasmids in vitro and in vivo. AB - Plasmid transfer in the gut depends on the concentrations of recipient and donor bacteria and on their fertility. The main determining factors for the former are flow rate, concentration of limiting substrate, growth rates, adhesion, contamination and segregation and of the latter plasmid content, growth phase, and ecological conditions. These factors have to be measured with experimental models, and included in mathematical models, to estimate their relative incidence. PMID- 3542931 TI - R plasmid transfer. AB - This paper is a brief survey of the systems of genetic exchange in bacteria relevant to the spread of antibiotic resistance genes. Emphasis is given to those systems most likely to be important in nature, particularly conjugation. Several recently described examples of conjugation in Gram-positive bacteria are discussed and contrasted with the better studied examples in Gram-negative bacteria. PMID- 3542932 TI - Resistant bacteria in the normal human flora. AB - The occurrence of antibiotic-resistant bacteria in the normal human flora has been documented by many groups over the last 20 years. These studies are surveyed and the reasons for the occurrence of resistant bacteria in the normal flora are discussed. The need for surveys in the 1980s using modern molecular techniques to characterize mechanisms of resistance is suggested. PMID- 3542933 TI - Some aspects of the occurrence of resistant bacteria in the normal animal flora. AB - The paper outlines some of the problems encountered in assessing the occurrence of antibiotic resistance in the normal flora of animals, using Escherichia coli as an example. Additional information is provided on the occurrence and mechanisms of resistance in Clostridium perfringens, Pasteurella haemolytica and Staphylococcus aureus, and some of the factors which may affect this resistance. The paper concludes with general considerations about the choice of organism, the sample size and the desirability of designing standard protocols. PMID- 3542934 TI - Antibiotic resistance in aquatic bacteria. AB - Antibiotics are used extensively in medicine and agriculture, and some of the resistant bacteria which develop find their way into lakes and rivers. It was decided to use antibiotic resistance as a convenient marker to study gene transfer in the natural environment. However, a preliminary survey of Windermere showed that there was a higher incidence of resistance in the bacteria isolated from the lake water than from the sewage effluent discharging into the lake. This unexpected result was followed by the more surprising finding that the incidence of resistance was even higher in the bacterial populations of two remote upland tarns. The results have important implications for those involved in examining the spread of antibiotic resistance into remote environments. Some of the technical problems in determining the antibiotic resistance profiles of aquatic bacteria are discussed. PMID- 3542935 TI - Preliminary observations on the influence of antibiotics on the ecology of Escherichia coli and the enterococci in the faecal flora of healthy young chickens. AB - Two separate replicated experiments are described. In the first the influence of oxytetracycline on the Escherichia coli flora was assessed, while in the second the effect of tylosin on the enterococci was investigated. In both experiments the administration of the antibiotic was associated with an increase in the average proportion of isolates resistant to the agent although in experiment 1 the agent had no apparent influence on either the total number of E. coli strains, differentiated by biotype and resistance pattern, or the number of 'new' strains per sampling. On the other hand significant differences were noted between the two replicates and also in relation to the age of the birds. In the second experiment fewer enterococcal strains were isolated from the birds dosed with tylosin but since fewer strains on average were isolated from the samples collected prior to dosing it is probable that this difference was due to factors other than the influence of the antibiotic. The enterococci were speciated and the two most commonly isolated were Streptococcus faecalis and S. faecium. The isolation rate of each was expressed as a proportion of the total number of enterococcal isolates per sample and when considered in relation to both dosing and the age of the bird the interaction dosing X age was statistically significant for both species. However, the differences did not appear particularly great and it was possible that the differences were of no practical importance from an ecological point of view. PMID- 3542936 TI - R plasmids in Salmonella typhimurium in the United Kingdom. AB - In the United Kingdom, R plasmids are common in bovine-associated phage types of Salmonella typhimurium and in particular in strains of phage type 204c (DT204c); all strains of this type carry at least three R plasmids. Gentamicin resistance appeared in DT204c in 1983 and plasmids conferring resistance to gentamicin also code for resistance to apramycin. Three types of apramycin-gentamicin resistance plasmid have been identified. PMID- 3542937 TI - Flow of resistance genes in the environment and from animals to man. AB - Some antibiotic-resistant bacteria occur naturally in the environment but many arise by contamination with human and animal excreta in sewage, slurry and manure. These may be ingested as contaminants of water, animal feeds and cultivated foods or, in the case of animals, by licking their environment. Gene transfer has been demonstrated in voided calf faeces and the resultant transconjugants, subsequently ingested, colonized the calf gut. Identified strains of antibiotic-resistant Escherichia coli have been traced from the gut contents of pigs, calves and chickens to carcasses at slaughter and ultimately shown to colonize the gut of a human volunteer handling and eating the meat. Similarly, antibiotic-resistant strains of Salmonella typhimurium phage type DT204c, have been isolated from calves and humans indicating a possible zoonotic spread. The significance of these observations is discussed. PMID- 3542938 TI - Epidemiology of antibiotic resistance in Staphylococcus aureus. AB - The genetic equipment of Staphylococcus aureus is at least as comprehensive as other organisms. Transposons provide the potential for reassortment of genes between plasmids and the chromosome. At least six different mechanisms of gene transfer between cells are documented in vitro. Phage-mediated conjugation is the transfer mechanism most likely to occur between staphylococci in nature. MRSA have evolved from a single clone and are now heterogeneous in properties. Some may show decreased virulence. The origin of new resistant determinants is likely to be other human cultures of Staph. aureus rather than an animal staphylococcal reservoir. PMID- 3542939 TI - Epidemiology of trimethoprim resistance. AB - Trimethoprim resistance in the Enterobacteriaceae has been dominated by the spread of two genes encoding different dihydrofolate reductases (types IA and II). The original carriage of these genes was by transferable bacterial plasmids. Now, however, one of these genes is often found to be located on the bacterial chromosome. Two new plasmid-mediated dihydrofolate reductases have been identified. One of these enzymes (type IV) confers a low degree of insusceptibility but is inducible, to give levels 600 times higher than the bacterial host enzyme. The technique used to demonstrate the plasmids that carry the gene for this enzyme suggests that they would not be identified by the plasmid transfer methods in current use. PMID- 3542940 TI - Induction of chromosomal beta-lactamase expression in enterobacteria. AB - Enterobacteria and Pseudomonas express evolutionarily related chromosomally encoded beta-lactamases. These enzymes have a high affinity for modern cephalosporins, and beta-lactamase overproduction is the most important factor in the development of resistance against such drugs. In some species the beta lactamase is produced constitutively at a low level, and mutations to high expression occur only infrequently. In other species beta-lactamase synthesis can be induced by beta-lactams, and mutation to constitutive overexpression of the enzyme is a frequent event. We discuss the current knowledge concerning the genetic basis of the two different modes of beta-lactamase regulation, as well as the mechanisms through which a high level of beta-lactamase synthesis is reached. PMID- 3542941 TI - Genetic and biochemical basis of tetracycline resistance. AB - Properties of several, well characterized, tetracycline resistance determinants were compared. The determinants in Tn1721 and Tn10 (both from Gram-negative bacteria) each contain two genes; one encodes a repressor that regulates both its own transcription and that of a membrane protein that confers resistance by promoting efflux of the drug. Determinants from Gram-positive bacteria also encode efflux proteins, but expression of resistance is probably regulated by translational attenuation. The likely tetracycline binding site (a common dipeptide) in each efflux protein was predicted. The presence of the common binding site is consistent with the ability of an efflux protein originating in Bacillus species to be expressed in Escherichia coli. PMID- 3542942 TI - A comparative study of ciprofloxacin and trimethoprim in the treatment of urinary tract infections in geriatric patients. AB - A prospective, comparative clinical trial of ciprofloxacin (100 mg bd) versus trimethoprim (200 mg bd), both for five days, was carried out in 40 geriatric patients with urinary tract infection. Thirty-two could be assessed for drug efficacy, and all forty for toxicity studies. Both drugs were equally safe, and ciprofloxacin was at least as effective as trimethoprim as far as clinical response was concerned. Ciprofloxacin appeared more effective in eradication of bacteria. Antibacterial activity was found in urine and faeces up to five days after stopping ciprofloxacin therapy. PMID- 3542943 TI - Ciprofloxacin therapy in complicated urinary tract infections caused by Pseudomonas aeruginosa and other resistant bacteria. AB - Thirty courses of ciprofloxacin were given to 28 patients with complicated urinary tract infections mainly caused by Pseudomonas aeruginosa. All patients had severe underlying abnormalities and infection usually followed urethral catheterization. The infecting organisms were eradicated from the urine of all patients during therapy and 89% were still clear five to nine days after treatment. At one month follow up the cure rate had fallen to 64%. An increase in resistance to ciprofloxacin was seen in three of the ten failures in infections caused by Ps. aeruginosa. Therapy was well tolerated and few side effects were seen. Ciprofloxacin is a valuable addition to the range of antimicrobial agents available for the treatment of Ps. aeruginosa urinary tract infections particularly in domiciliary practice. PMID- 3542944 TI - Ciprofloxacin in the treatment of gonorrhoea and non-gonococcal urethritis. AB - The treatment of gonococcal infections by quinolones is reviewed. Acrosoxacin is effective, but side effects are relatively common. Ciprofloxacin is effective in single dosage against urogenital gonococcal infections, and probably also against rectal and pharyngeal infections. It is effective against infections by penicillinase-producing Neisseria gonorrhoeae. In vitro, ciprofloxacin is active against Chlamydia trachomatis, and preliminary results indicate that this drug may be of value in the treatment of non-gonococcal urethritis and chlamydial infection. No major side effects of ciprofloxacin therapy in patients with these infections have been reported. PMID- 3542945 TI - Ciprofloxacin: an overview of adverse experiences. AB - This review summarizes adverse reactions probably or possibly attributable to oral ciprofloxacin therapy in worldwide clinical experience involving over 6500 patients. In Europe and Japan the overall incidence of adverse reactions amongst patients receiving ciprofloxacin is reported to be 3.0% and 6.5%, respectively. An increased incidence (13.4%) has been reported from the U.S.A., possibly relating to the use of higher dosages. Very few reactions have necessitated withdrawal of treatment. The most common adverse effects involve the gastro intestinal system (2-8% of patients treated) and usually comprise nausea, vomiting, diarrhoea and abdominal discomfort. CNS effects are seen in 1-4% of patients but are usually minor dizziness or mild headache only. Hypersensitivity reactions, most commonly skin rashes or pruritus, affect about 1% of patients. There is little evidence of significant haematological or biochemical toxicity, other than a few reports of transient neutropenia and the finding, in a minority of clinical studies, of equally transient, usually trivial and invariably reversible elevations of serum aminotransferases. Serious, ciprofloxacin-related toxicity has been observed in only three patients: one who developed pseudomembranous colitis, another who developed interstitial nephritis and a third who had a grand-mal convulsion during concomitant administration of theophylline. Ciprofloxacin appears to have an excellent safety profile. PMID- 3542947 TI - Morphological and biochemical changes in Escherichia coli after exposure to ciprofloxacin. AB - Examination of morphological and biochemical changes in Escherichia coli KL-16 after exposure to ciprofloxacin revealed distinct concentration-dependent responses. At levels close to the MIC extensive filamentation was seen, whereas at the most bactericidal concentration cells were elongated but not filamented. At higher concentrations ovoid cells were seen. Some cells showed surface vacuoles, but no significant leakage of cell contents was detected. Filamentation and vacuolation were shown to make only a minor contribution to ciprofloxacin induced cell death, and the data indicate that there are two or more mechanisms involved in the lethal action of ciprofloxacin. PMID- 3542946 TI - The mode of action of 4-quinolones and possible mechanisms of resistance. AB - Supercoiling of bacterial DNA, mediated by DNA gyrase, is essential to enable bacteria to accommodate their very long chromosomes within the cell envelope. Bacterial DNA gyrase, unlike the comparable mammalian enzyme, is susceptible to 4 quinolone antimicrobials. All 4-quinolones share this action, but ciprofloxacin, norfloxacin and ofloxacin possess an additional killing mechanism which vastly increases their potency. The occurrence of this second mechanism may also explain the lower frequencies (in populations of Escherichia coli KL 16) of mutants resistant to these three quinolones (less than 10(-12)) compared with other quinolones (10(-10)-10(-8)). No mutant was encountered that was resistant to peak serum concentrations of ciprofloxacin, norfloxacin or ofloxacin, or resistant to attainable urine concentrations of these or of acrosoxacin, flumequine, enoxacin, oxolinic acid or pipemidic acid. Mutational resistance may not necessarily lead to therapeutic resistance to 4-quinolones in E. coli. PMID- 3542948 TI - Effect of ciprofloxacin on intracellular organisms: in-vitro and in-vivo studies. AB - Ciprofloxacin is taken up rapidly by both human neutrophils and mouse peritoneal macrophages. It does not appear to be bound firmly within the cell and can be eluted readily if the extracellular concentration is lowered. Uptake does not depend on an active transport mechanism. Intracellular ciprofloxacin is biologically active reducing the survival of intracellular Staphylococcus aureus and Mycobacterium fortuitum, in vitro. In vivo, ciprofloxacin was effective in treating a murine systemic infection with an intracellular pathogen Salmonella typhimurium. The progress of infection in sensitive mice with no natural immunity was delayed by ciprofloxacin although at the dosage used the mice were not cured. These results suggested that clinical studies in patients infected by intracellular pathogens are warranted and that ciprofloxacin may have an important role in the treatment of this type of infection. PMID- 3542949 TI - Animal models: the in-vivo evaluation of ciprofloxacin. AB - Ciprofloxacin has been extensively investigated in various animal models of infection. These studies have demonstrated ciprofloxacin to possess in-vivo activity comparable to its activity previously demonstrated in vitro. The reported investigations have shown ciprofloxacin to be equal or superior to all other agents tested for Gram-negative, as well as most Gram-positive bacteria. These studies have also demonstrated that in-vitro susceptibility testing correlates well with in-vivo therapeutic outcome, in the animal models. The reported information has provided new directions for use of this agent, including the possibility for the use of ciprofloxacin as a replacement for aminoglycosides in combination therapy of serious enterococcal infections. PMID- 3542950 TI - The effect of quinolone antibacterials on the gastrointestinal flora compared with that of other antibacterials. AB - Although there is limited information on some of the newer quinolones it is likely that all such agents have a similar effect on the faecal flora. Ciprofloxacin seems to be best studied, and typical changes include regular and complete suppression of the enterobacteria and a slight diminution of enterococci. Total counts of anaerobic flora remain virtually unchanged, although small reductions have been noted in some studies for bacteroids, anaerobic cocci, fusobacteria and anaerobic non-sporing Gram-positive bacilli. Overgrowth of yeasts was not seen except when administration was prolonged. The results so far suggest that the newer quinolones will have a useful role in selective gut decontamination, the prevention of reinfection of the urinary tract, and the treatment of intestinal infection. Such early clinical results as have been published confirm this view. Of the other antibacterial agents discussed only some recent cephalosporins (cefotaxime, ceftazidime), aztreonam, cotrimoxazole and aminoglycosides have effects on the faecal flora similar to those of the newer quinolones. The remaining agents either have little or no effect or produce changes, such as a marked reduction in anaerobic flora, which are generally considered to be undesirable. PMID- 3542951 TI - Total lung capacity does not change during methacholine-stimulated airway narrowing. AB - The accurate measurement of changes in flow rates from partial flow-volume curves depends on their measurement at the same lung volume. This lung volume can be standardized from total lung capacity (TLC) if this does not change at the same time. We examined the effect of methacholine-stimulated maximal airway narrowing [change in mean forced expiratory volume in 1 s (delta FEV1) = 26.4%] on TLC, measured by whole-body plethysmography, in 10 normal subjects and of moderate airway narrowing (mean delta FEV1 = 34.9%) in 10 asthmatics. The TLC changed from 5.88 to 6.03 liters in normal subjects (P greater than 0.05) and from 6.92 to 6.95 liters (P greater than 0.5) in asthmatics. The results of this study suggest that TLC does not change significantly after methacholine-stimulated maximal airway narrowing in normal subjects and after moderate narrowing in asthmatics. PMID- 3542952 TI - Methacholine-induced airway reactivity of inbred rats. AB - Dose-response curves to inhaled aerosolized methacholine chloride (MCh) were obtained in anesthetized spontaneously breathing rats. Thirty rats (10/strain), randomly selected from highly inbred ACI, Lewis (L), and Brown Norway (BN) strains and 40 rats (20/strain) from similarly inbred Wistar-Furth (WF) and Buffalo (Buf) strains were studied. Airway responses were quantitated from changes in pulmonary resistance (RL) and airway reactivity was calculated as the dose of MCh required to increase RL to 150% (ED150RL) and 200% (ED200RL) of base line. There were no statistically significant differences in ED150RL and ED200RL among the five rat strains. Large interindividual variability was present as evidenced by 128-fold differences in ED150RL and ED200RL between the least and most sensitive animal of the same strain. In contrast, seven animals studied repeatedly on different days had values of ED150RL that differed by an average of only 2.9-fold (range 1.6-5.3). Thirteen rats that were studied on two occasions separated by an interval of 3 mo showed no systematic changes in airway reactivity. We conclude that airway reactivity to inhaled methacholine in anesthetized nose-breathing rats is not strain related, and despite animals of a given strain being genetically identical, the variability in airway reactivity within strains suggests that environmental rather than genetic factors are the major determinants of that reactivity. PMID- 3542954 TI - Potential and advantages of immunochemical methods for analysis of foods. AB - The technique of immunochemical analysis, including the principles involved, is described and the various types of assay are discussed. Application of these methods to the analysis of foods for residues of pesticides, contaminants, drug residues, and natural constituents is reviewed. Compared with conventional methods, immunoassays offer similar detection limits and greatly simplified sample preparation procedures. PMID- 3542953 TI - Differentiation of newborn rat adipocyte precursors in defined serum-free medium. AB - Newborn rat adipocyte precursors, isolated from inguinal fat pads of 2 day-old NBR rats proliferate and undergo adipose differentiation in defined medium in the absence of serum when cultivated on polylysine coated dishes in DME-F12 medium supplemented with fibronectin, insulin, transferrin and FGF. After 7 days in culture in these conditions, 90% of the cells have undergone differentiation as measured by the increase of G3PDH specific activity and by the accumulation of triglycerides in their cytoplasm. In contrast, the cells cultivated in the presence of 10% fetal bovine serum, have a limited ability to differentiate. These results indicate that newborn rat adipocyte precursors from inguinal fat pads do not require the presence of an undefined adipogenic factor in order to differentiate in culture. In contrast, proliferation and differentiation are dependent on the presence of insulin in the culture medium. Moreover, the data presented in this paper show that the rat adipocyte precursor culture represents a rapid and reproducible system for investigating the processes of adipose tissue development and for studying the negative and positive regulators of the adipose differentiation in a controlled environment. PMID- 3542955 TI - Quantitative aqueous ammonium ion analysis by transmission infrared spectroscopy. AB - An investigation was undertaken to determine whether ammonium ion could be quantitated in aqueous solution by using commercially available infrared filter instruments such as the Multispec M1 analyzer. Ammonium salt solutions were scanned using an infrared spectrophotometer modified specifically to facilitate the study of aqueous systems and were shown to have 2 main absorption bands at 3.49 microns (2865 cm-1) and 6.89 microns (1451 cm-1). The 3.49 microns band did not correspond to any individual band noted in the literature and was concluded to be a composite of fundamental bands and Fermi resonances due to hydrogen bonding affecting the ion in solution. The response of the 6.89 microns band to NH4+ concentration was approximately twice that of the 3.49 microns band, and quantitation of the ammonium ion was assessed by the dual wavelength method as employed in filter-based commercial infrared analyzers. Good quantitation was obtained using 5.56 microns as a reference wavelength, and the slope of the standard curve of ammonium sulfate was not significantly affected by pH in the pH 3-8 region. A 6.86 microns sample filter and a 5.56 microns reference filter were installed in a Multispec M1 analyzer and a linear response was obtained for concentrations of up to 0.6% ammonium sulfate. Accurately weighed samples of ammonium sulfate were converted to ammonia by using the micro-Kjeldahl procedure and then distilled into standard acid, diluted to volume, and assessed by titration and transmission infrared analysis. The infrared method was more accurate than the titration method in replicating the initial weights.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542956 TI - Purge and trap method for determination of fumigants in whole grains, milled grain products, and intermediate grain-based foods. AB - A method developed for the determination of 1,2-dibromoethane in whole grains and grain-based products has been modified and expanded to include 8 other fumigants. Samples are stirred with water and purged with nitrogen for 0.5 h in a water bath at 100 degrees C. The fumigants are collected on a trap composed of Tenax TA and XAD-4 resin, eluted with hexane, and determined by gas chromatography (GC) using electron capture detection or Hall electrolytic conductivity detection. Flame photometric detection in the sulfur mode is used to determine carbon disulfide. Thick-film, wide-bore capillary columns were used exclusively in both the determination and confirmation of the halogenated fumigants. The higher levels of fumigants are also confirmed by full scan GC/mass spectrometry. Samples are analyzed for carbon disulfide, methylene chloride, chloroform, 1,2 dichloroethane, methyl chloroform, carbon tetrachloride, trichloroethylene, 1,2 dibromoethane, and tetrachloroethylene. A total of 25 whole grains, milled grain products, and intermediate grain-based foods analyzed by this method contained fumigant levels up to 51 ppm (carbon tetrachloride in wheat). Recoveries from fortified samples ranged from 82 to 104%. Chromatograms from this purge and trap method are clean, so that low parts per billion and sub-parts per billion levels can be quantitated for the halogenated analytes. The quantitation level for carbon disulfide is 12 ppb. PMID- 3542958 TI - Combined hyper- and anechoic liver metastases in two cases of ileal carcinoid tumor. PMID- 3542957 TI - Autism, mental retardation, and chromosomal abnormalities. AB - There are reports of sex chromosomal abnormalities including XXY, XYY, and fragile X karyotypes in autistic individuals, but structural autosomal defects have rarely been reported. This paper presents four patients with autism, mental retardation, minor dysmorphic features, and structural autosomal defects. These patients shared autistic features including fascination with inanimate objects, catastrophic reactions to changes in their environment or their daily routine, echolalia, and poor relatedness; IQ scores indicate mild to severe retardation. Their autosomal abnormalities included inversion/duplications of 3p and 16q, 5p+, and 17p-. Parental chromosomes were all normal. Chromosomal analysis should be performed on mentally retarded, autistic individuals, especially those with minor physical anomalies and no specific etiology for their retardation. PMID- 3542959 TI - Identification of glycoprotein components of alpha-agglutinin, a cell adhesion protein from Saccharomyces cerevisiae. AB - Several glycoproteins which inhibit the agglutinability of Saccharomyces cerevisiae mating type a cells were partially purified from extracts of mating type alpha cells. These proteins, called alpha-agglutinin, were labeled with 125I Bolton-Hunter reagent. The labeled alpha-agglutinin showed specific binding to a cells. Such specific binding approached saturation with respect to agglutinin or cells and was inhibited in the presence of excess unlabeled alpha-agglutinin. Nonspecific binding was similar in a and alpha cells, was neither saturable nor competable, and was three- to fourfold less than the specific binding to a cells at maximum tested agglutinin concentrations. The major a-specific binding species had a low electrophoretic mobility in sodium dodecyl sulfate-polyacrylamide gels and had an apparent molecular weight of 155,000 by rate zonal centrifugation. Endo-N-acetylglucosaminidase H digestion of the purified glycoprotein complex converted the low-mobility material to four major and several minor bands which were resolved by polyacrylamide gel electrophoresis. All but two minor peptides bound specifically to a cells. Analyses of agglutinin from mnn mutants confirmed the deglycosylation results in suggesting that the N-linked carbohydrate portion of alpha-agglutinin was not necessary for activity. PMID- 3542960 TI - Interaction of alpha-agglutinin with Saccharomyces cerevisiae a cells. AB - Binding of Saccharomyces cerevisiae alpha-agglutinin to target a cells was assayed by agglutination inhibition and 125I-alpha-agglutinin binding. The assays showed characteristics of equilibrium binding, namely saturability, competability, and the establishment of a kinetic endpoint in the presence of free alpha-agglutinin and free receptor. The binding was heterogeneous, displaying strong binding (10(9) liters/mol) and a weaker interaction. There were about 2 X 10(4) strong binding sites per a cell. Denaturing gels displayed identical labeled species binding to the a cells in the weak and strong interactions. Furthermore, weakly bound material could subsequently bind tightly to fresh a cells, implying that the same species of alpha-agglutinin was bound in the two states. PMID- 3542961 TI - Repair of N-methyl-N'-nitro-N-nitrosoguanidine-induced DNA damage by ABC excinuclease. AB - Escherichia coli has several overlapping DNA repair pathways which act in concert to eliminate the DNA damage caused by a diverse array of physical and chemical agents. The ABC excinuclease which is encoded by the uvrA, uvrB, and uvrC genes mediates both the incision and excision steps of nucleotide excision repair. Traditionally, this repair pathway has been assumed to be active against DNA adducts that cause major helical distortions. To determine the level of helical deformity required for recognition and repair by ABC excinuclease, we have evaluated the substrate specificity of this enzyme by using DNA damaged by N methyl-N'-nitro-N-nitrosoguanidine. ABC excinuclease incised methylated DNA in vitro in a dose-dependent manner in a reaction that was ATP dependent and specific for the fully reconstituted enzyme. In vivo studies with various alkylation repair-deficient mutants indicated that the excinuclease participated in the repair of DNA damage induced by N-methyl-N'-nitro-N-nitrosoguanidine. PMID- 3542962 TI - Feedback inhibition of ammonium (methylammonium) ion transport in Escherichia coli by glutamine and glutamine analogs. AB - When cultured with glutamate or glutamine as the nitrogen source, Escherichia coli expresses a specific ammonium (methylammonium) transport system. Over 95% of the methylammonium transport activity in washed cells was blocked by incubation with 100 microM L-glutamine in the presence of chloramphenicol (100 micrograms/ml). The time course for the onset of this glutamine inhibition followed a first-order rate expression with a t1/2 of 2.8 min. The inhibition of transport by L-glutamine was noncompetitive (Ki = 18 microM) with respect to the [14C]methylammonium substrate. D-Glutamine had no significant effect. The glutamine analogs gamma-L-glutamyl hydroxamate (Ki = 360 microM) and gamma-L glutamyl hydrazide (Ki = 800 microM) were also noncompetitive inhibitors of methylammonium transport, suggesting that glutamine metabolism is not required. The role of the intracellular glutamine pool in the regulation of ammonium transport was investigated by using mutants carrying defects in the operon of glnP, the gene for the glutamine transporter. The glnP mutants had normal rates of methylammonium transport but were refractory to glutamine inhibition. Glycylglycine, a noncompetitive inhibitor of methylammonium uptake in wild-type cells (Ki = 43 microM), was equipotent in blocking transport in glnP mutants. Although ammonium transport is also subject to repression by growth of E. coli in the presence of ammonia, this phenomenon is unrelated to glutamine inhibition. A GlnL RegC mutant which constitutively expressed ammonium transport activity exhibited a sensitivity to glutamine inhibition similar to that of wild-type cells. These findings indicate that ammonium transport in E. coli is regulated by the internal glutamine pool via feedback inhibition. PMID- 3542963 TI - Roles of the divergent branches of the meta-cleavage pathway in the degradation of benzoate and substituted benzoates. AB - The TOL plasmid-specified meta-cleavage pathway for the oxidative catabolism of benzoate and toluates branches at the ring cleavage products of catechols and reconverges later at 2-oxopent-4-enoate or its corresponding substituted derivatives. The hydrolytic branch of the pathway involves the direct formation of 2-oxopent-4-enoate or its derivatives, whereas the oxalocrotonate branch involves three enzymatic steps effected by a dehydrogenase, an isomerase, and a decarboxylase, which produce the same compounds. Evidence is presented which shows that benzoate and p-toluate can, under certain circumstances, be catabolized by the hydrolytic branch. However, in a fully functional pathway, only m-toluate is dissimilated via this branch, and benzoate and p-toluate are catabolized almost exclusively by the oxalocrotonate branch. The biochemical basis of this selectivity was found to reside in the high affinity of the dehydrogenase for ring fission products derived from benzoate and p-toluate and its inability to attack the ring fission product derived from m-toluate. Although isomerization of 4-oxalocrotonate occurs spontaneously in vitro, enzymatic isomerization was found to be essential for effective functioning of this branch of the pathway in vivo. PMID- 3542965 TI - Operator-constitutive mutations of the Escherichia coli metF gene. AB - The Escherichia coli metF gene codes for 5,10-methylene-tetrahydrofolate reductase, the enzyme that leads to the formation of N-methyltetrahydrofolate, supplying the methyl group of methionine. Transcription of metF, as well as most of the methionine genes, is repressed by the metJ gene product complexed with S adenosylmethionine. A metF'-'lacZ gene fusion was used to isolate mutants that have altered expression from the metF promoter. The nucleotide sequences of the metF regulatory region from five such mutants were determined. The mutations were located in the region previously defined as the potential target of the methionine repressor by its similarity to other binding sites. The mutationally defined metF operator thus consists of a 40-base-pair-long region, with five 8 base-pair imperfect palindromes spanning the metF transcription start. The altered operators do not recognize the purified repressor in an in vitro transcription-translation system, although the repressor binds efficiently to the metF wild-type operator. PMID- 3542964 TI - Fatty acid metabolism in sn-glycerol-3-phosphate acyltransferase (plsB) mutants. AB - Fatty acid metabolism was examined in Escherichia coli plsB mutants that were conditionally defective in sn-glycerol-3-phosphate acyltransferase activity. The fatty acids synthesized when acyl transfer to glycerol-3-phosphate was inhibited were preferentially transferred to phosphatidylglycerol. A comparison of the ratio of phospholipid species labeled with 32Pi and [3H]acetate in the presence and absence of glycerol-3-phosphate indicated that [3H]acetate incorporation into phosphatidylglycerol was due to fatty acid turnover. A significant contraction of the acetyl coenzyme A pool after glycerol-3-phosphate starvation of the plsB mutant precluded the quantitative assessment of the rate of phosphatidylglycerol fatty acid labeling. Fatty acid chain length in membrane phospholipids increased as the concentration of the glycerol-3-phosphate growth supplement decreased, and after the abrupt cessation of phospholipid biosynthesis abnormally long chain fatty acids were excreted into the growth medium. These data suggest that the acyl moieties of phosphatidylglycerol are metabolically active, and that competition between fatty acid elongation and acyl transfer is an important determinant of the acyl chain length in membrane phospholipids. PMID- 3542966 TI - Transfer of phosphoethanolamine residues from phosphatidylethanolamine to the membrane-derived oligosaccharides of Escherichia coli. AB - The membrane-derived oligosaccharides (MDO) of Escherichia coli are periplasmic constituents composed of glucose residues linked by beta-1,2 and beta-1,6 glycosidic bonds. MDO are substituted with phosphoglycerol, phosphoethanolamine, and succinic acid moieties. The phosphoglycerol residues present on MDO are derived from phosphatidylglycerol (B. J. Jackson and E. P. Kennedy, J. Biol. Chem. 258:2394-2398, 1983), but evidence as to the source of the phosphoethanolamine residues has been lacking. We now report that phosphatidylethanolamine, exogenously added to intact cells of E. coli, provides a source of phosphoethanolamine residues that are transferred to MDO. The biosynthesis of phosphoethanolamine-labeled MDO is osmotically regulated, with maximum synthesis occurring during growth in medium of low osmolarity. PMID- 3542967 TI - Cloning of genes from members of the family Enterobacteriaceae with mini-Mu bacteriophage containing plasmid replicons. AB - An in vivo cloning system that uses derivatives of the Escherichia coli bacteriophage Mu with plasmid replicons has been extended to five different species of the family Enterobacteriaceae. Mu and these mini-Mu replicon elements were introduced into strains of E. coli, Shigella flexneri, Salmonella typhimurium, Citrobacter freundii, and Proteus mirabilis by infection, by transformation, or by conjugation with newly constructed broad-host-range plasmids containing insertions of these elements. Lysates from these cells, lysogenic for Mu and mini-Mu elements, were used to infect sensitive recipient strains of E. coli, S. typhimurium, and C. freundii. Drug-resistant transductants had mini-Mu replicon elements with inserts of different DNA sequences. All of the lysogens made could be induced to yield high phage titers, including those coming from strains that were resistant to Mu and Mu derivatives. Clones of 10 particular genes were isolated by their ability to complement specific mutations in the recipient strains, even in the presence of the E. coli K-12 restriction system. Some of the mini-Mu replicon elements used contained lac gene fusing segments and resulted in fusions of the lac operon to control regions in the cloned sequences. PMID- 3542968 TI - Verification of the protein in the outer membrane of Bdellovibrio bacteriovorus as the OmpF protein of its Escherichia coli prey. AB - Two research groups showed that several Bdellovibrio strains incorporated into their outer membranes intact OmpF porin proteins derived from their Escherichia coli prey. These results could not be reproduced by another group using Bdellovibrio bacteriovorus 109J. They showed that a major protein appearing in the Bdellovibrio Triton X-100-insoluble outer membrane was coded for by the bdellovibrios. We reconciled these results by examining the strain used by this group and by reviving a freeze-dried culture of strain 109J which had been stored for almost 9 years. B. bacteriovorus 109J failed to acquire substantial amounts of the OmpF protein from E. coli ML35, and a protein coded for by the bdellovibrios was expressed in its place. However, B. bacteriovorus 109J incorporated the OmpF protein from rough K-12 strains of E. coli, and the revived 9-year-old culture of B. bacteriovorus 109J incorporated more of the OmpF protein from the smooth E. coli ML35 than did its contemporary counterpart. The protein isolated from the outer membrane of the bdellovibrios was identified as the OmpF protein of E. coli by its protease peptide profile on sodium dodecyl sulfate polyacrylamide gel electrophoresis and by Western blot analysis. This confirmed that bdellovibrios relocalize outer membrane proteins from their prey, but relocalization may be an unstable trait which can be influenced by the prey. PMID- 3542970 TI - Effect of cell cycle position on thermotolerance in Saccharomyces cerevisiae. AB - We showed that the heat killing curve for exponentially growing Saccharomyces cerevisiae was biphasic. This suggests two populations of cells with different thermal killing characteristics. When exponentially growing cells separated into cell cycle-specific fractions via centrifugal elutriation were heat shocked, the fractions enriched in small unbudded cells showed greater resistance to heat killing than did other cell cycle fractions. Cells arrested as unbudded cells fell into two groups on the basis of thermotolerance. Sulfur-starved cells and the temperature-sensitive mutants cdc25, cdc33, and cdc35 arrested as unbudded cells were in a thermotolerant state. Alpha-factor-treated cells arrested in a thermosensitive state, as did the temperature-sensitive mutant cdc36 when grown at the restrictive temperature. cdc7, which arrested at the G1-S boundary, arrested in a thermosensitive state. Our results suggest that there is a subpopulation of unbudded cells in exponentially growing cultures that is in G0 and not in G1 and that some but not all methods which cause arrest as unbudded cells lead to arrest in G0 as opposed to G1. It has been shown previously that yeast cells acquire thermotolerance to a subsequent challenge at an otherwise lethal temperature during a preincubation at 36 degrees C. We showed that this acquisition of thermotolerance was corrected temporally with a transient increase in the percentage of unbudded cells during the preincubation at 36 degrees C. The results suggest a relationship between the heat shock phenomenon and the cell cycle in S. cerevisiae and relate thermotolerance to transient as well as to more prolonged residence in the G0 state. PMID- 3542969 TI - Constitutive expression of the SOS response in recA718 mutants of Escherichia coli requires amplification of RecA718 protein. AB - In recA718 lexA+ strains of Escherichia coli, induction of the SOS response requires DNA damage. This implies that RecA718 protein, like RecA+ protein, must be converted, by a process initiated by the damage, to an activated form (RecA) to promote cleavage of LexA, the cellular repressor of SOS genes. However, when LexA repressor activity was abolished by a lexA-defective mutation [lexA(Def)], strains carrying the recA718 gene (but not recA+) showed strong SOS mutator activity and were able to undergo stable DNA replication in the absence of DNA damage (two SOS functions known to require RecA activity even when cleavage of LexA is not necessary). lambda lysogens of recA718 lexA(Def) strains exhibited mass induction of prophage, indicative of constitutive ability to cleave lambda repressor. When the cloned recA718 allele was present in a lexA+ strain on a plasmid, SOS mutator activity and beta-galactosidase synthesis under LexA control were expressed in proportion to the plasmid copy number. We conclude that RecA718 is capable of becoming activated without DNA damage for cleavage of LexA and lambda repressor, but only if it is amplified above its base-line level in lexA+ strains. At amplified levels, RecA718 was also constitutively activated for its roles in SOS mutagenesis and stable DNA replication. The nucleotide sequence of recA718 reveals two base substitutions relative to the recA+ sequence. We propose that the first allows the protein to become activated constitutively, whereas the second partially suppresses this capability. PMID- 3542971 TI - Loss of aldehyde dehydrogenase in an Escherichia coli mutant selected for growth on the rare sugar L-galactose. AB - Escherichia coli K-12 converts L-fucose to dihydroxyacetone phosphate (C-1 to C 3) and L-lactaldehyde (C-4 to C-6) by a pathway specified by the fuc regulon. Aerobically, L-lactaldehyde serves as a carbon and energy source by the action of an aldehyde dehydrogenase of broad specificity; the product, L-lactate, is then converted to pyruvate. Anaerobically, L-lactaldehyde serves as an electron acceptor to regenerate NAD from NADH by the action of an oxidoreductase; the reduced product, L-12-propanediol, is excreted. A strain selected for growth on L galactose (a structural analog of L-fucose) acquired a broadened inducer specificity because of an altered fucR gene encoding the activator protein for the fuc regulon (Y. Zhu and E. C. C. Lin, J. Mol. Evol. 23:259-266, 1986). In this study, a second mutation that abolished aldehyde dehydrogenase activity was discovered. The L-fucose pathway converts L-galactose to dihydroxyacetone phosphate and L-glyceraldehyde. Aldehyde dehydrogenase then converts L glyceraldehyde to L-glycerate, which is toxic. Loss of the dehydrogenase averts the toxicity during growth on L-galactose, but reduces by one-half the aerobic growth yield on L-fucose. When mutant cells induced in the L-fucose system were incubated with radioactive L-fucose, accumulation of radioactivity occurred if the substrate was labeled at C-1 but not if it was labeled C-6. Complete aerobic utilization of carbons 4 through 6 of L-fucose depends not only on an adequate activity of aldehyde dehydrogenase to trap L-lactaldehyde as its anionic acid but also on the lack of L-1,2-propanediol oxidoreductase activity, which converts L lactaldehyde to a readily excreted alcohol. PMID- 3542973 TI - Part of respiratory nitrate reductase of Klebsiella aerogenes is intimately associated with the peptidoglycan. AB - Lysozyme digestion and sonication of sodium dodecyl sulfate (SDS)-purified Klebsiella aerogenes murein sacculi resulted in the quantitative release of both subunits of nitrate reductase, as well as a number of other cytoplasmic membrane polypeptides (5.2%, by weight, of the total membrane proteins). Similar results were obtained after lysozyme digestion of SDS-prepared peptidoglycan fragments, which excluded the phenomenon of simple trapping of the polypeptides by the surrounding peptidoglycan matrix. About 28% of membrane-bound nitrate reductase appears to be tightly associated with the peptidoglycan. Additional evidence for this association was demonstrated by positive immunogold labeling of SDS-murein sacculi and thin sections of plasmolyzed bacteria. Qualitative amino acid analysis of trypsin-treated sacculi, a tryptic product of holo-nitrate reductase, and amino- and carboxypeptidase digests of both nitrate reductase subunits indicated the possible existence of a terminal anchoring peptide containing the following amino acids: (Gly)n, Trp, Ser, Pro, Ile, Leu, Phe, Cys, Tyr, Asp, and Lys. PMID- 3542972 TI - Repression and catabolite gene activation in the araBAD operon. AB - Catabolite gene activation of the araBAD operon was examined by using catabolite gene activator protein (CAP) site deletion mutants. A high-affinity CAP-binding site between the divergently orientated araBAD and araC operons has been previously identified by DNase I footprinting techniques. Subsequent experiments disagreed as to whether this site is directly involved in stimulating araBAD expression. In this paper, we present data showing that deletions generated by in vitro mutagenesis of the CAP site led to a five- to sixfold reduction in single copy araBAD promoter activity in vivo. We concluded that catabolite gene activation of araBAD involves this CAP site. The hypothesis that CAP stimulates the araBAD promoter primarily by relieving repression was then tested. The upstream operator araO2 was required for repression, but we observed that the magnitude of CAP stimulation was unaffected by the presence or absence of araO2. We concluded that CAP plays no role in relieving repression. Other experiments showed that when CAP binds it induces a bend in the ara DNA; similar bending has been reported upon CAP binding to lac DNA. This conformational change in the DNA may be essential to the mechanism of CAP activation. PMID- 3542975 TI - An alkaline shift induces the heat shock response in Escherichia coli. AB - Activation of heat shock response was observed after an alkaline shift of extracellular pH: it peaked at 5 to 10 min, as was previously reported for the heat-induced response, and was dependent on a functional rpoH gene, which is the positive regulator of the heat shock response. An induction of over sixfold was observed for dnaK and groE. The response was induced by the alkalization of extracellular pH but not by the alkalization of intracellular pH. An acidic shift of extracellular pH failed to activate the heat shock response, showing that the response is specific to the alkaline shift. PMID- 3542974 TI - Mechanism of nitrogenase switch-off by oxygen. AB - Oxygen caused a reversible inhibition (switch-off) of nitrogenase activity in whole cells of four strains of diazotrophs, the facultative anaerobe Klebsiella pneumoniae and three strains of photosynthetic bacteria (Rhodopseudomonas sphaeroides f. sp. denitrificans and Rhodopseudomonas capsulata strains AD2 and BK5). In K. pneumoniae 50% inhibition of acetylene reduction was attained at an O2 concentration of 0.37 microM. Cyanide (90 microM), which did not affect acetylene reduction but inhibited whole-cell respiration by 60 to 70%, shifted the O2 concentration that caused 50% inhibition of nitrogenase activity to 2.9 microM. A mutant strain of K. pneumoniae, strain AH11, has a respiration rate that is 65 to 75% higher than that of the wild type, but its nitrogenase activity is similar to wild-type activity. Acetylene reduction by whole cells of this mutant was inhibited 50% by 0.20 microM O2. Inhibition by CN- of 40 to 50% of the O2 uptake in the mutant shifted the O2 concentration that caused 50% inhibition of nitrogenase to 1.58 microM. Thus, when the respiration rates were lower, higher oxygen concentrations were required to inhibit nitrogenase. Reversible inhibition of nitrogenase activity in vivo was caused under anaerobic conditions by other electron acceptors. Addition of 2 mM sulfite to cell suspensions of R. capsulata B10 and R. sphaeroides inhibited nitrogenase activity. Nitrite also inhibited acetylene reduction in whole cells of the photodenitrifier R. sphaeroides but not in R. capsulata B10, which is not capable of enzymatic reduction of NO2-. Lower concentrations of NO2- were required to inhibit the activity in NO3- -grown cells, which have higher activities of nitrite reductase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3542976 TI - Conversion of the alpha component of penicillin-binding protein 1b to the beta component in Escherichia coli. AB - Among components alpha, beta, and gamma of penicillin-binding protein 1b, the alpha and gamma components were confirmed to represent the primary gene products by agreement of their N-terminal amino acid sequences with those predicted from the nucleotide sequence of the ponB (penicillin-binding protein 1b) gene with exclusion of the first methionine in each component. The generation of beta occurred primarily after cell disruption, and the simultaneous loss of alpha suggested the conversion of alpha to beta. The N-terminal amino acid sequence analyzed for beta showed that the conversion was due to the removal of 24 amino acids from the N terminus of alpha. PMID- 3542977 TI - Genetic expression of enzyme I activity of the phosphoenolpyruvate:sugar phosphotransferase system in ptsHI deletion strains of Salmonella typhimurium. AB - Mutants expressing a novel enzyme I of the phosphoenolpyruvate:sugar phosphotransferase system, termed enzyme I, were isolated from strains of Salmonella typhimurium which were deleted for the HPr and enzyme I structural genes. The mutations lay in a newly defined gene, termed ptsJ, which mapped on the S. typhimurium chromosome between the ptsHI operon and the cysA gene. PMID- 3542979 TI - Control of phoR-dependent bacterial alkaline phosphatase clonal variation by the phoM region. AB - phoR mutants with the wild-type Escherichia coli K-12 Var+ phoM region showed clonal variation of bacterial alkaline phosphatase synthesis, whereas mutants with the pho-510 Var- allele did not. The pho-510 mutation is responsible for the phoR mutant constitutive phenotype and probably arose in E. coli K-12 58F+ after X-ray mutagenesis over 40 years ago. I propose that the phoM region controls a change in state of bacterial alkaline phosphatase synthesis, at least in phoR mutants. Four possible molecular mechanisms for how phoM may act are discussed. PMID- 3542978 TI - Evidence for regulation of gluconeogenesis by the fructose phosphotransferase system in Salmonella typhimurium. AB - A genetic locus designated fruR, previously mapped to min 3 on the Salmonella typhimurium chromosome, gave rise to constitutive expression of the fructose (fru) regulon and pleiotropically prevented growth on all Krebs cycle intermediates. Regulatory effects of fruR were independent of cyclic AMP and its receptor protein and did not prevent uptake of Krebs cycle intermediates. Instead, the phosphotransferase system appeared to regulate gluconeogenesis by controlling the activities of phosphoenolpyruvate carboxykinase and phosphoenolpyruvate synthase. PMID- 3542980 TI - Acetohydroxy acid synthase I is required for isoleucine and valine biosynthesis by Salmonella typhimurium LT2 during growth on acetate or long-chain fatty acids. AB - Salmonella typhimurium LT2 normally expresses two acetohydroxy acid synthases (AHAS I and AHAS II). The function of AHAS I in this organism was unclear, since AHAS I-deficient (ilvBN) mutants of LT2 grew well on glucose or succinate minimal media, whereas AHAS II-deficient (ilvGM) mutants requried isoleucine for normal growth on glucose minimal media. We report that AHAS I-deficient mutants of S. typhimurium required isoleucine and valine for growth on acetate or oleate minimal media, whereas AHAS II-deficient mutants were able to grow on these media without isoleucine supplementation. PMID- 3542982 TI - Clinical effectiveness of oral and parenteral rapid neuroleptization. AB - A random assignment, double-blind, placebo-controlled evaluation was used to compare the effectiveness of rapid parenteral injections of fluphenazine hydrochloride with that of oral doses of the same drug in 16 patients with acute psychotic illnesses. Doses of fluphenazine hydrochloride were much higher in the parenteral neuroleptization group than in the oral administration group during the acute phase, although oral doses were equivalent during the continuation phase. The rate of improvement was not different for the two groups, but the rate of extrapyramidal side effects was higher in the parenteral neuroleptization group. The results suggest that rapid parenteral neuroleptization for the acute treatment of psychosis offers more risks than benefits. PMID- 3542981 TI - Comparison of alprazolam and imipramine for treatment of outpatient depression. AB - A 6-week double-blind comparison of the therapeutic efficacy of alprazolam and imipramine in 90 depressed psychiatric outpatients revealed a significantly superior response to alprazolam in the first 2 weeks of treatment as measured by total scores on the Hamilton Rating Scale for Depression and the Brief Psychiatric Rating Scale. Further analyses revealed that all significant differences could be accounted for by the superior effect of alprazolam on sleep disturbance. By the end of Weeks 4 and 6, no significant differences in therapeutic response between the two treatment groups were noted, with patients in both groups evidencing improvement on all measures. A differentially high dropout rate among patients in the imipramine treatment group posed a problem for interpretation of results in the latter weeks of treatment. PMID- 3542983 TI - Hydergine for schizophrenia. PMID- 3542984 TI - Implications of restrictive diagnosis for compliance to antidepressant drug therapy: alprazolam versus imipramine. AB - Early dropouts from a double-blind comparison of the therapeutic efficacy of alprazolam and imipramine were examined. The dropout rate across the total sample of 99 analyzable outpatients with major depression was 3 times higher in the imipramine treatment group. Although essentially all patients met DSM-III criteria for major depressive episode, only two thirds of the total sample met the restrictive Feighner criteria for primary depressive disorder. Early termination in the imipramine group was concentrated in the group of depressed outpatients who failed to satisfy the Feighner criteria. Implications of these and other recently reported results for choice of drug treatment for depressed psychiatric outpatients are discussed. PMID- 3542985 TI - Therapeutic response to phenelzine in patients with panic disorder and agoraphobia with panic attacks. AB - The therapeutic response to phenelzine sulfate was evaluated during 6 months' treatment of 35 outpatients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks. The possible influence of nonspecific predictors of drug efficacy and some biochemical parameters were investigated. Therapeutic response was assessed on standardized rating scales. Agoraphobic patients showed a significantly higher frequency of panic attacks when compared to the subjects with uncomplicated panic disorder. Phenelzine treatment blocked panic attacks in 100% of the patients with panic disorder and in 94.7% of the agoraphobics. Anticipatory anxiety and avoidant behavior improved markedly, although not statistically significantly, in 73.6% of the agoraphobics. PMID- 3542986 TI - Proteolysis of apoprotein B during the transfer of very low density lipoprotein from hens' blood to egg yolk. AB - We report an example of the enzymic cleavage of an apoprotein B (apoB), the main apoprotein in the very low density lipoprotein (VLDL) of laying hens' blood, in a normal biological process, the formation of egg yolk. Plasma VLDL was labeled in vivo with 3H-amino acids, isolated by centrifuging, and injected into another laying hen. Yolk VLDL was isolated and its apoproteins were separated. ApoB was not detected in this lipoprotein. Most of the label originally in apoB was distributed among four smaller yolk apoproteins, apovitellenins III to VI, which are a large proportion of the apoproteins of VLDL in yolk. This distribution of 3H suggested that 80% of apoB was cleaved at three places. One yolk apoprotein, apovitellenin II, was not labeled, indicating that it did not originate from an apoprotein in plasma VLDL. The site for cleavage of apoB in the ovarian tissue has not been determined, but cleavage may occur during receptor-mediated endocytosis. The pattern of cleavage of apoB during transfer to yolk was not imitated by some known proteolytic enzymes. PMID- 3542987 TI - Identification of a possible nucleotide binding site in CheW, a protein required for sensory transduction in bacterial chemotaxis. AB - CheW is an essential component of the system which mediates chemotaxis in Salmonella typhimurium and Escherichia coli. Here we report the nucleotide sequence of the cheW gene as well as the purification and characterization of the CheW protein. The DNA sequence predicts a protein of 18,000 molecular weight. The pure protein exhibits an apparent molecular weight of 18,000 during sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Molecular sieve chromatography under nondenaturing conditions indicates a molecular weight of approximately 35,000, however. This result suggests that CheW is a homodimer. The predicted amino acid sequence between Thr-128 and Asp-160 fits a consensus exhibited by many proteins which bind purine nucleotides. PMID- 3542988 TI - Amino acid sequences of a-factor mating peptides from Saccharomyces cerevisiae. AB - The molecular structure of a-factor, the mating hormone produced by mating type a cells of Saccharomyces cerevisiae, has been investigated. In culture filtrates of a cells four oligopeptides (a1 to a4) exhibiting a-factor activity have been found. These peptides have been isolated and their amino acid sequences have been determined. The a-factor peptides comprise two (apparently identical) pairs, a1/a2 and a3/a4, which differ in an interchange at position 6 of a valine in a1/a2 for a leucine in a3/a4. a1 and a4, which can be obtained by oxidation with H2O2 of purified a2 and a3, respectively, obviously represent oxidation artifacts formed under the conditions of culture. The amino acid sequences determined for the a-factor peptides are Tyr-Ile-Ile-Lys-Gly-Val Leu-Phe-Trp-Asp-Pro-Ala-Cys. Several lines of evidence suggest that the carboxyl-terminal cysteine residue is S-alkylated by a hydrophobic moiety. PMID- 3542989 TI - Complete amino acid sequence of human serum cholinesterase. AB - The complete amino acid sequence of human serum cholinesterase (choline esterase II (unspecific), EC 3.1.1.8) was determined by Edman degradation of purified peptides. The protein contains 574 amino acids per subunit and nine carbohydrate chains attached to 9 asparagines. The four subunits of cholinesterase appear to be identical. The active site serine is the 198th residue from the amino terminus. The sequence of human serum cholinesterase is 53.8% identical with the sequence of acetylcholinesterase from Torpedo californica and 28% identical with the carboxyl-terminal portion of bovine thyroglobulin. PMID- 3542990 TI - Functions of isolated domains of methionyl-tRNA synthetase from an extreme thermophile, Thermus thermophilus HB8. AB - Methionyl-tRNA synthetase (MetRS, 2 X 75 kDa) was purified to homogeneity from an extreme thermophile, Thermus thermophilus HB8. The polypeptide chain of MetRS was cleaved by limited digestion with trypsin into four domains: T1 (29 kDa), T2 (23 kDa), T3 (14.5 kDa), and T4 (7.5 kDa), which were aligned in that order. MetRS was also cleaved into similar fragments with a variety of other proteases. Domains T1, T2, T3, and T4 were isolated by column chromatography. "Tandem domain" T1-T2 (56 kDa) is fully active in the aminoacylation of tRNA and is further cleaved with trypsin into domains T1 and T2. Domain T1 is the smallest aminoacylation unit so far reported. Domain T2 (enzymatically inactive) interacts with tRNAMetf, as found by UV-induced cross-linking. Isolated domain T3 forms a dimer and is responsible for the dimer assembly of two protomers in MetRS. Domain T4 is a flexible tail of MetRS. These domains, in particular T1 and T2, will be important for detailed structure analyses in relation to aminoacylation activity. PMID- 3542991 TI - Use of directed mutagenesis to probe the role of tyrosine 198 in the catalytic mechanism of carboxypeptidase A. AB - Derivatization of Tyr198 in carboxypeptidase A (CPA) results in lowered catalytic activity toward peptide substrates (Cueni, L., and Riordan, J.F. (1978) Biochemistry 17, 1834-1842). We have synthesized via directed mutagenesis a rat CPA variant [Phe198] CPA containing a Tyr198-to-Phe substitution in order to test whether the phenolic hydroxyl plays a critical role in catalysis. A double mutant [Phe193, Phe248]CPA in which both Tyr198 and Tyr248 have been replaced by phenylalanine has also been engineered. Enzymatic characterization of [Phe198]CPA indicates that the Tyr198 hydroxyl is not obligatory for the hydrolysis of peptide and ester substrates. Furthermore, parallel studies with [Phe198, Phe248]CPA show that simultaneous removal of both the Tyr198 and Tyr248 hydroxyls does not abolish catalytic activity. Analysis of the acetylated derivatives of [Phe198]CPA, [Phe248]CPA, and [Phe198, Phe248]CPA establishes that Tyr198 and Tyr248 are the active site tyrosines which are modified by N-acetylimidazole. In addition, the perturbations of enzymatic activity which accompany acetylation of native CPA can be largely assigned to derivatization of Tyr248. The changes in the kinetic constants of substrate hydrolysis due to the Tyr198-to-Phe substitution are manifested as small decreases in the kcat values, but the Km values are essentially unaffected. This exclusive effect on the kcat values suggests that the Tyr198 hydroxyl participates in catalysis by stabilizing the rate-determining transition-state complex. PMID- 3542992 TI - Multihormonal regulation of transcription of the tryptophan 2,3-dioxygenase gene in primary cultures of adult rat hepatocytes with special reference to the presence of a transcriptional protein mediating the action of glucocorticoids. AB - For study of hormonal regulation of gene expression of tryptophan 2,3-dioxygenase (EC 1. 13. 11. 11, TO), a DNA clone containing a sequence complementary to TO mRNA was prepared with TO mRNA from rat liver enriched 62-fold by immunoadsorption. Primary cultures of adult rat hepatocytes were treated with dexamethasone, and the amount of TO mRNA was measured by RNA dot-blot hybridization with this TO cDNA. Dexamethasone induced this TO mRNA 7-fold, while their treatments with dexamethasone plus glucagon induced the TO mRNA 18-fold. This induction of TO mRNA by dexamethasone plus glucagon was inhibited by insulin or epinephrine. Studies on transcription in isolated nuclei showed that these hormonal changes in the level of TO mRNA were caused by changes in the rate of transcription of the TO gene. Thus, expression of TO in the liver is regulated multihormonally at the transcriptional step. There was a long lag period before stimulation of transcription of the TO gene by dexamethasone in hepatocytes cultured for 20 h: the maximal rate was attained after 6-8 h. The lag time depended on the culture time without dexamethasone and was shorter after shorter culture of the cells. This finding suggested that a transcriptional factor that was lost during culture mediated the action of glucocorticoids. Consistent with this idea, cycloheximide or puromycin almost completely blocked enhanced transcription of the TO gene by dexamethasone after a 20-h culture, but not after a 2-h culture. These findings indicate that a short-lived transcriptional protein, which is also regulated by glucocorticoids, mediates their effect on expression of the TO gene. PMID- 3542993 TI - Scanning transmission electron microscopic study of alpha-ketoglutarate dehydrogenase complex from Escherichia coli. AB - The alpha-ketoglutarate dehydrogenase complex was resolved into its three component enzymes: alpha-ketoglutarate dehydrogenase (E1), dihydrolipoyl transsuccinylase (E2), and dihydrolipoyl dehydrogenase. Subcomplexes were prepared in vitro by incubating the resolved E2, a 24-subunit cube-shaped molecule, with E1 (dimeric). The morphology and mass of the subcomplexes were determined by scanning transmission electron microscopy of negatively stained and of freeze-dried specimens. Images of both negative stained and freeze-dried subcomplexes were consistent with E1 binding at or near the midpoints of the edges of the E2 molecule. Mass analysis of the freeze-dried specimen showed that at least 95% of E1 remains in the dimeric state (or as two closely juxtaposed monomers) when it binds to E2. PMID- 3542994 TI - A yeast plasmid partitioning protein is a karyoskeletal component. AB - The Saccharomyces yeast plasmid, 2-micron circle, encodes a partitioning system that ensures equidistribution of plasmid molecules to both progeny following cell division. This system consists of two proteins encoded in plasmid genes REP1 and REP2 and a cis-active noncoding locus, designated REP3. We have raised antibodies against a REP1 beta-galactosidase fusion protein and used them to identify the authentic REP1 protein in plasmid-bearing yeast cells. We find that REP1 protein is located exclusively in the nucleus and co-purifies with a karyoskeletal protein subfraction operationally and morphologically equivalent to the nuclear matrix-pore complex-lamina fraction of higher cells. The carboxyl half of the REP1 protein exhibits strong sequence homology to myosin heavy chain, vimentin, and nuclear lamins A and C, indicating a fibrous structure for the protein. From these observations, we suggest that REP1 protein may promote plasmid partitioning by intercalating into the nuclear lamina of the host cell to provide dispersed anchorage sites for attachment of plasmid molecules. PMID- 3542995 TI - The primary structure of iron-superoxide dismutase from Photobacterium leiognathi. AB - The complete amino acid sequence of iron-superoxide dismutase from Photobacterium leiognathi was determined. The sequence was deduced following characterization of the peptides obtained from tryptic, chymotryptic, and Staphylococcus aureus V-8 protease digests of the apoprotein. The amino acid sequence listed below is made up of 193 residues. It is the first complete sequence to be determined for an iron-superoxide dismutase. The iron-superoxide dismutase shows the same order of homology with the manganese-superoxide dismutases as these enzymes show among themselves. No homology was observed with the copper/zinc-containing class of superoxide dismutases. Ala-Phe-Glu-Leu-Pro-Ala-Leu-Pro-Phe-Ala-Met-Asn-Ala-Leu Glu-Pro-His-Ile- Ser-Gln-Glu-Thr-Leu-Glu-Tyr-His-Tyr-Gly-Lys-His-His-Asn-Thr-Tyr Val-Val- Lys-Leu-Asn-Gly-Leu-Val-Glu-Gly-Thr-Glu-Leu-Ala-Glu-Lys-Ser-Leu-Glu-Glu- Ile-Ile-Lys-Thr-Ser-Thr-Gly-Gly-Val-Phe-Asn-Asn-Ala-Ala-Gln-Val-Trp-Asn- His-Thr Phe-Tyr-Trp-Asn-Cys-Leu-Ala-Pro-Asn-Ala-Gly-Gly-Glu-Pro-Thr-Gly- Glu-Val-Ala-Ala Ala-Ile-Glu-Lys-Ala-Phe-Gly-Ser-Phe-Ala-Glu-Phe-Lys-Ala- Lys-Phe-Thr-Asp-Ser-Ala Ile-Asn-Asn-Phe-Gly-Ser-Ser-Trp-Thr-Trp-Leu-Val- Lys-Asn-Ala-Asn-Gly-Ser-Leu-Ala Ile-Val-Asn-Thr-Ser-Asn-Ala-Gly-Cys-Pro- Ile-Thr-Glu-Glu-Gly-Val-Thr-Pro-Leu-Leu Thr-Val-Asp-Leu-Trp-Glu-His-Ala- Tyr-Tyr-Ile-Asp-Tyr-Arg-Asn-Leu-Arg-Pro-Ser-Tyr Met-Asp-Gly-Phe-Trp-Ala- Leu-Val-Asn-Trp-Asp-Phe-Val-Ser-Lys-Asn-Leu-Ala-Ala. PMID- 3542996 TI - Characterization of pure human renal renin. Evidence for a subunit structure. AB - Renin was completely purified from human kidney cortex employing a rapid three 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 (-CH2-NH instead of -CO-NH-) between Leu5-Leu6, Three kg of cortex dissected from 10 kg of human cadaver kidney yielded 1.7 +/- 0.5 mg of protein (mean +/- S.E. for five procedures) with a specific activity of 1094 +/- 166 Goldblatt units/mg of protein and an overall recovery of 52 +/- 2%. Both gel filtration high performance liquid chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) revealed a molecular weight of 44,000, although Mr = 22,000 and 18,000 bands were also identified by SDS-PAGE. The pH optima with sheep angiotensinogen were 5.5 and 7.8 and the Km was 0.31 microM. With pure human substrate the pH optimum was 6.0 and the Km was 1.15 microM. Enzyme activity was inhibited by two different anti-human renal renin antibodies. Amino terminal sequencing demonstrated a leucine residue at the 1-position. Sequencing of 15 additional amino acids agreed with that predicted from the gene sequence and indicated that prorenin is converted to renin following cleavage at the carboxyl end of two basic residues, Lys-2 Arg-1. As with SDS-PAGE analysis, high performance liquid chromatography in the presence of 6 M urea demonstrated Mr = 44,000, 22,000, and 18,000 bands. Immunoblot studies revealed that all of these bands cross-reacted with antihuman renin antibody. Amino-terminal sequencing indicated the Mm = 22,000 band is the amino terminus and the Mr = 18,000 band the carboxyl terminus of Mr = 44,000 renin. In the aqueous phase, these subunits bound to H-77 suggesting that they represent components of the active enzyme complex. Unlike mouse renin, there was no evidence of disulfide bonds. These results raise the question of whether human renin circulates as a subunit aggregation as well as a single chain protein. This may serve as a possible mechanism to regulate renin activity in plasma and tissues. PMID- 3542997 TI - The primary structure of rat ribosomal protein L19. A determination from the sequence of nucleotides in a cDNA and from the sequence of amino acids in the protein. AB - The covalent structure of rat ribosomal protein L19 was inferred from the sequence of nucleotides in a recombinant cDNA and confirmed from the sequence of amino acids in a portion of the protein. Ribosomal protein L19 contains 196 amino acids and has a molecular weight of 26,971. There are indications that a segment of 23 residues in rat L19 is related to sequences of the same length in Escherichia coli ribosomal proteins L30, L18, and S2. PMID- 3542998 TI - Insulin-stimulated diacylglycerol production results from the hydrolysis of a novel phosphatidylinositol glycan. AB - We recently described the insulin-dependent release of a carbohydrate substance from plasma membranes which regulated certain intracellular enzymes (Saltiel, A. R., and Cuatrecasas, P. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 5793-5797). This enzyme-modulating substance appeared to arise from the phosphodiesterase hydrolysis of a novel inositol-containing glycolipid. This is supported by observations that insulin stimulated the rapid generation of [3H]myristate labeled diacylglycerol in cultured BC3Hl myocytes. Myristoyl diacylglycerol production in these cells was unaffected by epinephrine, although arachidonate labeled diacylglycerol was rapidly produced in response to stimulation by this alpha-1 adrenergic agent. The production of distinct species of diacylglycerol was apparently due to hormonally specific hydrolysis of different precursors. A novel glycolipid was identified on silica TLC or high pressure liquid chromatography which served as a substrate for the insulin-stimulated phosphodiesterase reaction. This glycolipid was metabolically labeled with radioactive inositol, glucosamine, and myristic acid, suggesting a phosphatidylinositol (PI)-glycan structure. Treatment of this glycolipid with a PI-specific phospholipase C resulted in the generation of two products: an inositol phosphate-glycan which modulated the activity of the low Km cAMP phosphodiesterase and myristoyl diacylglycerol. Insulin caused the rapid hydrolysis of the PI-glycan, which was then apparently resynthesized. These data further suggest that insulin stimulates the activity of a phospholipase C which selectively hydrolyzes a novel PI-glycan, releasing a carbohydrate enzyme modulator as well as a unique species of diacylglycerol. PMID- 3542999 TI - Novel aspects of gonadotropin-releasing hormone action on inositol polyphosphate metabolism in cultured pituitary gonadotrophs. AB - The hypothalamic neuropeptide gonadotropin-releasing hormone (GnRH) stimulates luteinizing hormone secretion via receptor-mediated activation of phosphoinositide hydrolysis to yield inositol phosphates and diacylglycerol. Application of anion-exchange high-performance liquid chromatography together with absorbance and radiochemical flow detection has enabled both the characterization and quantitative estimation of pituitary cell inositol phosphates and phosphoinositides. In cultured pituitary cells, GnRH caused a rapid and progressive rise in the formation of inositol 1,4,5-trisphosphate and of higher polyphosphoinositols corresponding to inositol tetrakisphosphate, pentakisphosphate, and hexakisphosphate. The inositol 1,4,5-trisphosphate formed during GnRH action was dephosphorylated predominantly via inositol 4 monophosphate rather than the expected metabolite, inositol 1-monophosphate. The catabolism of inositol 4-monophosphate, like that of inositol 1-monophosphate, was inhibited by lithium. For these reasons and because it was the major metabolite of [3H] inositol 1,4,5-trisphosphate in permeabilized gonadotrophs, inositol 4-monophosphate appears to represent a specific marker for ligand stimulated inositol polyphosphate formation and metabolism. The marked and sustained elevations of inositol 4-monophosphate and inositol 1,4-bisphosphate in GnRH-stimulated gonadotrophs indicate that polyphosphoinositides rather than phosphatidylinositol are the preferred substrates of phospholipase C during GnRH action. PMID- 3543000 TI - Metabolism of 32-hydroxy-24,25-dihydrolanosterol by purified cytochrome P-45014DM from yeast. Evidence for contribution of the cytochrome to whole process of lanosterol 14 alpha-demethylation. AB - Metabolism of 32-hydroxy-24,25-dihydrolanosterol (lanost-8-ene-3 beta,32-diol), a posturated intermediate of the 14 alpha-demethylation (removal of C-32) of 24,25 dihydrolanosterol (lanost-8-en-3 beta-ol), by a reconstituted system consisting of yeast cytochrome P-450 which catalyzes lanosterol 14 alpha-demethylation (cytochrome P-45014DM) (Yoshida, Y., and Aoyama, Y. (1984) J. Biol. Chem. 259, 1655-1660 and Aoyama, Y., Yoshida, Y., and Sato, R. (1984) J. Biol. Chem. 259, 1661-1666) and NADPH-cytochrome P-450 reductase was studied. The reconstituted system converted both 32-hydroxy-24,25-dihydrolanosterol and 24,25 dihydrolanosterol to 4,4-dimethyl-5 alpha-cholesta-8,14-dien-3 beta-ol, the 14 alpha-demethylated product of the latter. The metabolism of these compounds was inhibited by a low concentration of ketoconazole which is a potent cytochrome P 45014DM inhibitor. Affinity of cytochrome P-45014DM for 32-hydroxy-24,25 dihydrolanosterol was about 20 times higher than for 24,25-dihydrolanosterol and the cytochrome metabolized the former about 4 times faster than the latter under the experimental conditions. Spectral analysis suggested that the 32-hydroxyl group of 32-hydroxy-24,25-dihydrolanosterol interacted with the heme iron of the oxidized cytochrome and this interaction might support the high affinity of this compound for the cytochrome. These lines of evidence indicate that 32-hydroxy 24,25-dihydrolanosterol is the intermediate of the 14 alpha-demethylation of 24,25-dihydrolanosterol by cytochrome P-45014DM. It is also clear that the cytochrome catalyzes further metabolism of the 32-hydroxylated intermediate to the 14 alpha-demethylated product with higher efficiency than the 32 hydroxylation of the substrate. Cytochrome P-45014DM is thus classified as lanosterol C14-C32 lyase. PMID- 3543001 TI - Specific Vinca alkaloid-binding polypeptides identified in calf brain by photoaffinity labeling. AB - A radioactive, photoactive Vinca alkaloid, N-(p-azido-[3,5-3H]-benzoyl)-N'-beta aminoethylvindesine [( 3H]NABV) with pharmacological and biological activities similar to vinblastine was synthesized and used to identify specific Vinca alkaloid macromolecular interactions in calf brain homogenate by photoaffinity labeling. The most prominent photolabeled species were 54.3- and 21.5-kDa polypeptides. The Vinca alkaloid-binding specificity of these polypeptides was confirmed by competitive blocking of specific photolabeling by vinblastine but not by colchicine or daunorubicin. The 54.3- and 21.5-kDa polypeptides exhibited specific half-maximum saturable photolabeling at 2.1 and 0.95 X 10(-7) M [3H]NABV, respectively. Relative vinblastine and NABV association constants (Ka vinblastine/Ka NABV) for the 54.3- and 21.5-kDa polypeptides were estimated to be 0.86 and 1.4, respectively. The 54.3-kDa component was found in both high speed (100,000 X g; 1 h) pellet and supernatant fractions, whereas the 21.5-kDa component was located primarily in the high speed pellet. Photolabeling of both components was maximal after 12-min UV light exposure, linear up to 120 micrograms of homogenate protein and only slightly affected by the nitrene scavenger p-aminobenzoic acid. The 54.3-kDa polypeptides of [3H]NABV-photolabeled calf brain high speed supernatant and detergent-solubilized high speed pellet fractions were identified as tubulin subunits by immunoprecipitation with monoclonal antibodies to alpha- or beta-tubulin subunits. Although the identity and function of the 21.5-kDa polypeptide is not known, this polypeptide may have a role in membrane-related effects of the Vinca alkaloids. These results demonstrate that [3H]NABV is an attractive tool for identifying and characterizing specific high affinity vinblastine cellular polypeptide acceptors which may initiate or mediate known and unknown mechanisms of Vinca alkaloid action. PMID- 3543002 TI - Stable binding of recA protein to duplex DNA. Unraveling a paradox. AB - recA protein binding to duplex DNA is a complicated, multistep process. The final product of this process is a stably bound complex of recA protein and extensively unwound double-stranded DNA. recA monomers within the complex hydrolyze ATP with an apparent kcat of approximately 19-22 min-1. Once the final binding state is achieved, binding and ATP hydrolysis by this complex becomes pH independent. The weak binding of recA protein to duplex DNA reported in previous studies does not, therefore, reflect an intrinsically unfavorable binding equilibrium. Instead, this apparent weak binding reflects a slow step in the association pathway. The rate-limiting step in this process involves the initiation rather than the propagation of DNA binding and unwinding. This step exhibits no dependence on recA protein concentration at pH 7.5. Extension or propagation of the recA filament is fast relative to the overall process. Initiation of binding is pH dependent and represents a prominent kinetic barrier at pH 7.5. ATP hydrolysis occurs only after the duplex DNA is unwound. The binding density of recA protein on double-stranded DNA is approximately one monomer/4 base pairs. A model for this process is presented. These results provide an explanation for several paradoxical observations about recA protein-promoted DNA strand exchange. In particular, they demonstrate that there is no thermodynamic requirement for dissociation of recA protein from the heteroduplex DNA product of strand exchange. PMID- 3543003 TI - recA protein binding to the heteroduplex product of DNA strand exchange. AB - Following DNA strand exchange, recA protein remains associated with the heteroduplex DNA product of the reaction. This association exists without significant changes (as measured by nuclease protection, topological state of the heteroduplex DNA, and rates of ATP hydrolysis) for at least 30 min after strand exchange is complete. The heteroduplex DNA is unwound as a result of this association to an extent at least as great as the unwinding observed when recA protein is bound to duplex DNA at pH 6.35. The extensive unwinding, in combination with the rates of ATP hydrolysis reported elsewhere, provide evidence that recA protein binding is contiguous throughout the heteroduplex DNA. This binding is disrupted upon challenge with heterologous single-stranded DNA, with rapid migration of recA protein to the challenging DNA. These results are discussed in relation to the mechanism of recA protein-promoted branch migration. PMID- 3543004 TI - Human pituitary tryptase: molecular forms, NH2-terminal sequence, immunocytochemical localization, and specificity with prohormone and fluorogenic substrates. AB - A human pituitary-derived serine protease, immunologically identical to human lung tryptase (Smith, T. J., Hougland, M.W., and Johnson, D.A. (1984) J. Biol. Chem. 259, 11046-11051), was found immunohistochemically to be associated with mast cells present in pituitary connective tissue. Western blotting combined with sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicated the presence of multiple forms: a major Mr 36,300 form and three minor forms with Mr 32,400, 33,400, and 34,600. Two major forms with Mr 35,600 and 34,100 were detected by affinity labeling with 125I-D-Tyr-Glu-Phe-Lys-Arg-CH2Cl. Treatment of the pituitary tryptase preparation with N-glycosidase F indicated that some of the molecular weight heterogeneity results from N-linked glycosylation. The multiple molecular weight forms appear to have the same NH2-terminal sequence: Ile-Val-Gly Gly-Gln-Glu-Ala-Pro. Pituitary tryptase has an apparent Mr = 110,000 by gel filtration on Sephadex G-200 in the presence of 0.3 M NaCl, indicating that the enzyme may be a tetramer of Mr = 32,400-36,300 subunits. However, this quaternary structure was not stable to gradient polyacrylamide gel electrophoresis. Human pituitary tryptase was so reactive toward synthetic tripeptide coumarin containing substrates containing a pair of basic amino acids at the site of cleavage such as benzyloxylcarbonyl-L-Ala-L-Lys-L-Arg-4-methylcoumarin-7-amide (k cat/Km = 2.38 X 10(8) M-1 s-1) that Briggs-Haldane kinetics may apply. The reversible inhibitor NaCl at a concentration of 1 M decreased the k cat/Km for benzyloxylcarbonyl-L-Ala-L-Lys-L-Arg-4-methylcoumarin-7-amide to 6.53 X 10(6) M-1 s-1, which reflected a 100-fold increase in apparent Km. Based on active site titration with fluorescein mono-p-guanidinobenzoate hydrochloride, NaCl had no effect on the number of accessible active sites. Substrate specificity studies with prohormones indicated that pituitary tryptase has a preference for cleaving COOH-terminal to arginine or lysine residues which are preceded by a proline residue 4 or 6 residues NH2-terminal to the site of cleavage. PMID- 3543005 TI - Protein translocation into Escherichia coli membrane vesicles is inhibited by functional synthetic signal peptides. AB - A synthetic peptide corresponding to the signal sequence of wild type Escherichia coli lambda-receptor protein (LamB) inhibits in vitro translocation of precursors of both alkaline phosphatase and outer membrane protein A into E. coli membrane vesicles (half-maximal inhibition at 1-2 microM). By contrast, the inhibitory effect was nearly absent in a synthetic peptide corresponding to the signal sequence from a mutant strain that harbors a deletion mutation in the LamB signal region and displays an export-defective phenotype for this protein in vivo. Two peptides derived from pseudorevertant strains that arose from the deletion mutant and exported LamB in vivo were found to inhibit in vitro translocation with effectiveness that correlated with their in vivo export ability. Controls indicated that these synthetic signal peptides did not disrupt the E. coli membrane vesicles. These results can be interpreted to indicate that the presequences of exported proteins interact specifically with a receptor either in the E. coli inner membrane or in the cytoplasmic fraction. However, biophysical data for the family of signal peptides studied here reveal that they will spontaneously insert into a lipid membrane at concentrations comparable to those that cause inhibition. Hence, an indirect effect mediated by the lipid bilayer of the membrane must be considered. PMID- 3543006 TI - Degradation of serum amyloid A by isolated perfused rat liver. AB - Degradation of serum amyloid A (SAA) was studied in the isolated perfused rat liver. Radioiodinated SAA was reconstituted with high density lipoproteins (HDL) and administered to rats. Plasma was taken 1 h later, and the HDL were isolated for use as tracer. HDL-bound 125I-SAA was cleared from the plasma of intact animals at a rate similar to SAA in native human HDL. Catabolism of SAA and HDL apoproteins was studied in parallel in the perfused liver. In a 3-h perfusion, 21% of SAA was degraded in contrast to 13% of apoC-III, 7% of apoA-I, and 6% of apoA-II. SAA1 (47% in 3 h) was degraded more rapidly than SAA5 (37%) although their in vivo clearance rates were similar. Degradation of SAA was inhibited when lipoproteins were added to the perfusate. At a protein concentration of 0.15 mg/ml, low density lipoproteins inhibited 47%, HDL 62%, and SAA-rich HDL 75%. Lipid-free normal HDL (0.3 mg/ml perfusate) did not appreciably affect SAA degradation; however, delipidated SAA-rich HDL (0.3 mg of protein/ml; 0.02 mg of SAA/ml) inhibited SAA degradation by 40%. Isolated perfused mouse liver proved more effective than rat liver in degrading SAA (5.3% versus 2.8%/g of liver/h). Degradation appeared to be mediated by cell-associated enzymes since perfusate, which had been recirculated through the liver for 3 h, accounted for less than 15% of the total degradation. Partial (38%) hepatectomy did not significantly reduce apoA-I clearance but reduced that of SAA by 16%, providing additional evidence for hepatic SAA catabolism. We conclude from these studies that SAA is catabolized independently of other HDL proteins, that association with lipoproteins retards SAA clearance, and that SAA catabolism is, in part, a specific process. PMID- 3543008 TI - Interaction between liposomes and sarcotoxin IA, a potent antibacterial protein of Sarcophaga peregrina (flesh fly). AB - The direct interaction between phospholipids and sarcotoxin IA, a potent bactericidal protein of Sarcophaga peregrina, was studied using authentic sarcotoxin IA, its synthetic derivatives, and various liposomes. Results showed that sarcotoxin IA interacted with liposomes constituted from acidic phospholipids, resulting in the release of glucose trapped in these liposomes. The amidated carboxyl-terminal of this protein was found to be important for this interaction. Liposomes constituted from total phospholipids of Escherichia coli became less susceptible to sarcotoxin IA with an increase in their cholesterol content. Since bacterial membranes do not contain cholesterol, this finding may partly explain the selective toxicity of sarcotoxin I to bacteria. PMID- 3543009 TI - RNA polymerase. Limit cognate primer for initiation and stable ternary complex formation. AB - Various lengths of oligoribonucleotides corresponding to regions flanking the initiation site of the A1 promoter of the T7 delta D111 template were examined in order to determine their ability to function as primers of transcription for the DNA-dependent RNA polymerase from Escherichia coli. The oligoribonucleotides which functioned as primers were also examined as precursors for the formation of a stable ternary complex (enzyme X DNA template X oligoribonucleotide product) by systematically extending each primer with one or more specific cognate substrate nucleotide triphosphates. A stable ternary complex (resistant to a salt jump challenge) was formed whenever the primer oligoribonucleotide and augmenting nucleotide triphosphate(s) allowed the formation of the normal third phosphodiester bond of the transcript to occur on the enzyme surface. An oligoribonucleotide (a cognate having the correct base-pairing substituents) containing the preformed third phosphodiester bond does not function as a primer. For example the cognate oligoribonucleotide corresponding to the region flanking the A1 promoter of the T7 delta D111 is: formula; see text The limit primer is the oligoribonucleotide trimer AUC (+1...+3). Other acceptable primers are constructed by adding to this limit primer, cognate bases in the negative registry. The oligonucleotide containing one base added to this limit primer in the positive registry (e.g. AUCG) is completely inactive as a primer. We have also demonstrated these phenomena for the A2 and the A3 promoter of the T7 template. PMID- 3543007 TI - Guanosine 5'-O-(thiotriphosphate)-dependent inositol trisphosphate formation in membranes is inhibited by phorbol ester and protein kinase C. AB - Phosphoinositide hydrolysis was studied in a washed membrane preparation of 1321N1 astrocytoma cells prelabeled with [3H]inositol. GTP gamma S stimulated the formation of [3H]inositol mono-, bis-, and trisphosphate ([3H]InsP, [3H]InsP2, and [3H]InsP3) with a half-maximal effect on [3H]InsP formation at 5 microM. Carbachol increased the accumulation of [3H]inositol phosphates only in the presence of added guanine nucleotide. Calcium increased [3H]InsP3 accumulation over a range of concentrations (10 nM-3 mM free calcium). When 1321N1 cells were treated with phorbol ester (100 nM 4 beta-phorbol 12 beta-myristate 13 alpha acetate (PMA)) prior to preparation of the membranes, the maximal [3H]InsP formation induced by GTP gamma S or GTP gamma S plus carbachol was decreased by 50-75%. In contrast, the response to a maximal calcium concentration presumed to activate phospholipase C directly was minimally inhibited (approximately 15%). PMA treatment did not affect muscarinic receptor affinity for carbachol or the effect of GTP on agonist binding. PMA treatment was also without effect on the breakdown of exogenous [3H]InsP3 in homogenates, permeabilized cells, and membranes, indicating that the InsP3-phosphatase was not the site of phorbol ester action. PMA treatment inhibited [3H] InsP3 formation only in membranes and not in cytosol prepared from the same cells, suggesting a membrane site of PMA action. Membranes were also required to demonstrate GTP gamma S-stimulated [3H]InsP3 formation although calcium-stimulated [3H]InsP3 formation was demonstrable in both membranes and cytosol. The addition of purified protein kinase C to the membranes mimicked the effect of PMA treatment to decrease GTP gamma S-stimulated [3H]InsP3 production. These data indicate that the effect of PMA on phosphoinositide metabolism is demonstrable in a cell-free system and that it can be mimicked by protein kinase C. We suggest that the ability of PMA to block GTP gamma S-stimulated formation of [3H]InsP3 results from inhibition of the G protein interaction with phospholipase C. PMID- 3543010 TI - The differential effect on two hybrid proteins of deletion mutations within the hydrophobic region of the Escherichia coli OmpA signal peptide. AB - Oligonucleotide-directed site-specific mutagenesis was used to systematically shorten the hydrophobic region within the signal peptide of the Escherichia coli outer membrane protein OmpA. DNA encoding the wild type and mutant OmpA signal peptides were then fused in frame to DNA encoding the mature regions of Staphylococcus aureus nuclease A and TEM beta-lactamase. The ability of these signal peptides to direct processing of the resulting hybrid proteins was dependent on both their length and the protein to which they were fused. Deletion of two or more residues progressively slowed processing of pro-OmpA-nuclease. By contrast, pro-OmpA-beta-lactamase was less sensitive to the length of the hydrophobic region than to the nature of the deleted residue(s). Deletion of an Ala residue tended to reduce processing efficiency of pro-OmpA-beta-lactamase, while deletion of an Ile residue, together with the Ala residue, resulted in improvement. The loss of either 3 or 4 residues abolished processing of both hybrids. These data indicate that both the length as well as the identity of residues in the hydrophobic region are important. The relative importance of these two factors depends on the mature region of the protein being secreted. PMID- 3543011 TI - The beta subunit dissociates readily from the Escherichia coli DNA polymerase III holoenzyme. AB - Purified DNA polymerase III holoenzyme (holoenzyme) was separated by glycerol gradient sedimentation into the beta subunit and the subassembly that lacks it (pol III). In the presence of ATP, beta subunit dimer dissociated from holoenzyme with a KD of 1 nM; in the absence of ATP, the KD was greater than 5 nM. The beta subunit was known to remain tightly associated in the holoenzyme upon formation of an initiation complex with a primed template and during the course of replication. With separation from the template, holoenzyme dissociated into beta and pol III. Cycling to a new template depended on the reformation of holoenzyme. Holoenzyme was in equilibrium with pol III and the beta subunit in crude enzyme fractions as well as in pure preparations. PMID- 3543012 TI - Stacking interactions of tryptophan residues and nucleotide bases in complexes formed between Escherichia coli single-stranded DNA binding protein and heavy atom-modified poly(uridylic) acid. A study by optically detected magnetic resonance spectroscopy. AB - The complexes formed between Escherichia coli single-stranded DNA binding protein (SSBP) and the heavy atom-modified single-stranded polynucleotides poly(5-BrU) and poly(5-HgU) are investigated using optically detected magnetic resonance (ODMR) methods. In these complexes the triplet state properties of the tryptophan residues are subjected to the external heavy atom effect generated by bromine and mercury atoms and are characterized by a shortened triplet state lifetime and the appearance of the otherwise dark [D] + [E] slow passage ODMR signal. These features provide direct evidence for close range interactions between tryptophan residue(s) and the nucleotide bases in the complexes. The extent of the triplet state lifetime reduction in the case of the SSBP-poly(5-HgU) complex together with steric considerations of the complex structure is consistent only with a van der Waals contact between the perturbed molecule and the heavy atom perturber by means of a stacking interaction. Fast passage ODMR measurements show a lifetime for a sublevel of the perturbed tryptophan chromophore(s) in this complex on the order of 1 ms. The amplitude-modulated phosphorescence microwave double resonance technique captures selectively the broadened and red-shifted phosphorescence spectrum of the heavy atom-perturbed tryptophan residue(s). This work supports a model for the binding of SSBP to single-stranded polynucleotides in which the bases are inserted into hydrophobic regions of the protein, where they are likely to undergo stacking interactions with the indole moiety of buried tryptophan residues. PMID- 3543013 TI - Identification of the carbohydrate receptor for Shiga toxin produced by Shigella dysenteriae type 1. AB - The binding of Shiga toxin isolated from the bacterium Shigella dysenteriae type 1 to a series of glycolipids and to cells or cell homogenates has been studied. Bound toxin was detected using either 125I-labeled toxin or specific monoclonal antibody and 125I-labeled anti-antibody. Overlay of toxin on thin-layer chromatograms with separated glycolipids and binding to glycolipids coated in microtiter wells established that the toxin specifically bound to Gal alpha 1 4Gal beta (galabiose) placed terminally or internally in the oligosaccharide chain. No glycolipid shown to lack this sequence binds the toxin. Most of the glycolipids with internally placed galabiose were not active, indicating a sterical hindrance for toxin access to the binding epitope. Binding of toxin to HeLa cells in monolayers could be inhibited by preincubation of the toxin with galabiose covalently linked to bovine serum albumin (BSA), but not with free oligosaccharides containing galabiose or with lactose coupled to BSA. This demonstrated that the inhibition is specifically dependent on galabiose and requires multivalency of the disaccharide to be efficient. The inhibitory effect was successively enhanced by increasing the substitution on BSA (7, 18, and 25 mol of galabiose/mol of BSA). The BSA-coupled galabiose could also prevent the cytotoxic effect on HeLa cells (detachment of killed cells). There are cell lines with a dense number of receptor sites, but which are resistant to toxin action (uptake and inhibition of protein synthesis) which may suggest two types of receptor substances which are functionally different and unevenly expressed. In analogy with the mechanism earlier formulated for cholera toxin, we propose glycolipid-bound, bilayer-close galabiose as the functional receptor for membrane penetration of the toxin, while galabiose bound in glycoproteins affords binding sites but is not able to mediate penetration. PMID- 3543014 TI - Identification of a 55-kDa high-affinity calmodulin-binding protein from Electrophorus electricus. AB - A high-affinity calcium-dependent calmodulin-binding protein (CaMBP) has been isolated from Electrophorus electricus main electric organ. This 55-kDa CaMBP has been purified to homogeneity by ion exchange and calmodulin-Sepharose affinity chromatography and electrophoretic elution from preparative sodium dodecyl sulfate-polyacrylamide gels. Antibodies against the 55-kDa CaMBP were raised in sheep and were affinity purified. A 47-kDa high-affinity CaMBP species was demonstrated by limited protease digestion and immunoblot analysis to be derived from the 55-kDa CaMBP. The 55-kDa CaMBP has also been isolated from skeletal muscle. It is not detectable by immunoblot analysis in nonexcitable tissues. Characterization of the 55-kDa high-affinity calmodulin-acceptor protein may further elucidate the role of calcium-calmodulin in the regulation of bioelectricity. PMID- 3543015 TI - Promoter selectivity of Escherichia coli RNA polymerase. Purification and properties of holoenzyme containing the heat-shock sigma subunit. AB - An RNA polymerase holoenzyme containing sigma 32, the heat-shock sigma subunit, has been purified from heat-shocked Escherichia coli cells, and its functional properties including the promoter selectivity have been analyzed using the in vitro mixed transcription system. The holoenzyme correctly recognized a heat shock promoter for the groE gene and efficiently initiated transcription at the same site as that found in vivo. The enzyme was, however, unable to recognize the promoters which are usually transcribed by the regular holoenzyme (E sigma 70), such as tufB, nusA, supP, lacUV5, araS, rpsA, recA, rplJ, dnaQ, rnh, and trp promoters. On the other hand, the regular holoenzyme did not recognize the groE promoter. These observations altogether indicate that strict difference exists in the promoter selectivity between two molecular species of the RNA polymerase holoenzyme. The groE transcription in vitro was not affected significantly within the temperature range from 32 to 42 degrees C. The two sigma subunits could be replaced in vitro on the same core enzyme, supporting the view that the spectrum of gene expression in E. coli is under a dynamic control by intracellular levels of individual sigma subunits. PMID- 3543016 TI - The mechanism of matrix vesicle formation. Studies on the composition of chondrocyte microvilli and on the effects of microfilament-perturbing agents on cellular vesiculation. AB - The mechanism of matrix vesicle (MV) formation by growth plate chondrocytes in primary cell culture was assessed both by using drugs which interfere with assembly or disassembly of microfilaments and microtubules, as well as by comparison of the composition of chondrocyte microvilli with MV. Cytochalasin D, which is known to inhibit assembly of actin microfilaments, was found to stimulate the release of alkaline phosphatase-rich MV. This stimulatory effect was confirmed by studies with [3H]palmitate- and 32P-prelabeled cells which showed that cytochalasin D enhanced the release of labeled MV. In contrast, phalloidin, which blocks disassembly of microfilaments, suppressed release of cellular alkaline phosphatase into MV. The phospholipid composition of vesicles released by cells treated with cytochalasin D and phalloidin was virtually identical with that of the controls. In contrast, colchicine, which interferes with the assembly of microtubules, was found to cause fragmentation of the cells, producing large vesicles significantly different in lipid composition from MV. Microscopic studies revealed that cytochalasin D caused marked rounding and retraction of the cells, with evidence of actin withdrawal from the cell periphery. This led to cell surface blebbing and formation of small zeiotic bodies at the tips of cell processes. In contrast, phalloidin enhanced and stabilized the actin network within the cells. Chemical analysis of microvilli prepared from isolated chondrocytes revealed high levels of alkaline phosphatase and a phospholipid composition almost identical to MV. Electrophoretic profiles of microvillar proteins were again like that of MV, except for the presence of high levels of actin. This cytoskeletal protein was nondetectable in MV. Taken together with the effects of the drugs, the data indicate that cell surface microvilli are the precursors of MV and that retraction of the supporting microfilament network is essential for the release of these structures. PMID- 3543017 TI - Ultrasound imaging as a screening study for malignant soft-tissue tumors. AB - Fifty patients who had a palpable soft-tissue mass and an apparently normal radiograph were studied with ultrasound imaging before excision or biopsy of the lesion was done. As shown by the sonograms, thirty-five lesions had a discrete echo pattern (usually reduced echoes and a clearly defined lesional margin) and fifteen had an ill defined pattern (similar to the pattern of the surrounding normal tissues with no definable lesional margin). Fourteen lesions were malignant and thirty-six, benign. The sonograms of all fourteen malignant lesions showed a discrete pattern, while the sonograms of the benign ones showed twenty one discrete and fifteen ill defined patterns. Therefore, the malignant lesions produced a discrete pattern in every instance, and every lesion that produced an ill defined pattern was benign. Fourteen of the fifty lesions were cystic; of these, thirteen were benign and one was malignant. The sonograms correctly identified the cyst in seven of the thirteen benign lesions and in the one malignant cystic lesion. Based on these findings, we concluded that all palpable soft-tissue masses that appear to be discrete on a sonogram should be diagnosed without delay by examination of a specimen taken at biopsy, whereas lesions that have an ill defined appearance on a sonogram may be assumed to be benign and may safely be observed in selected patients. PMID- 3543018 TI - Traumatic segmental bone defects in the upper extremity. Treatment with exposed grafts of corticocancellous bone. AB - We treated twenty-two consecutive patients for an open fracture and segmental loss of bone in the upper extremity by delayed insertion of a graft of iliac corticocancellous bone. All of the wounds were left open and healed by secondary intention. Sixteen patients (nineteen grafts) had long-term follow-up. Ten injuries were secondary to a gunshot wound. The ten patients (twelve grafts) who had an injury to the hand were followed for an average of 24.1 months. No patient in this group had an infection, and all had primary union after an average of 13.3 weeks. Nine had a satisfactory result. The other six patients (seven grafts) had an injury to the arm or forearm and were followed for an average of 30.2 months. There were four non-unions, one refracture, and no persistent infections. The final result was satisfactory in five and unsatisfactory in one patient. Fourteen of the nineteen grafts were inserted within seventeen days after the initial injury. All nine of the grafts in the hand that were inserted early did well, but three of the other five (in the arm or forearm) became infected. The method that was used in the patients who had an open injury of the hand allowed early active motion and quick rehabilitation. The exposed cortical bone was not prone to infection. The technique has limited application in patients who have an open injury of the arm or forearm because of a high incidence of complications. PMID- 3543019 TI - Failed total knee arthroplasty treated by arthrodesis of the knee using the Ace Fischer apparatus. AB - Twenty-eight patients were treated for a failed total knee arthroplasty by arthrodesis with a new type of biplane external fixator. The reasons for failure of the total knee arthroplasty were sepsis in twenty-five patients, loosening in one, pain of unknown etiology in one, and fibrous ankylosis in one. The mean duration of fixation with pins was 112 days. In twenty knees, arthrodesis occurred without further treatment. One knee fused after the application of dual plates, and one united after treatment with electrical stimulation. Of the remaining six patients, one had an above-the-knee amputation for persistent non union and five had a persistent pseudarthrosis. The extent of loss of bone appeared to be the most important factor influencing union of the primary arthrodesis. One patient who had a solid union of the arthrodesis had a persistent non-union after a fracture at the site of a femoral pin. The rate of success of 68 per cent that was achieved with the device that we used is similar to the rates obtained with the use of older external fixators. PMID- 3543020 TI - Quantitation of chondrocyte performance in growth-plate cartilage during longitudinal bone growth. AB - The longitudinal growth of bone depends on the activities of individual chondrocytes of the growth plate. Each chondrocyte remains in a fixed location throughout its life, and there accomplishes all of its functions. Although a cell may perform several or all of its activities simultaneously, one of these will usually predominate during a particular phase of its life. The two most prominent stages are those of cellular proliferation and hypertrophy (including the mineralization of matrix) before the resorption of tissue during vascular invasion. By applying recently developed stereological procedures and improved methods for the fixation of cartilage, we compared cellular shape modulation, various ultrastructural parameters (surface areas or volumes of endoplasmic reticulum, Golgi membranes, and mitochondria), the production of matrix, and cellular turnover for proliferating and hypertrophic chondrocytes within the proximal tibial growth plate of the rat. By the late hypertrophic stage, fourfold and tenfold increases in the mean cellular height and volume, respectively, and a threefold increase in the mean volume of the matrix per cell were achieved. The high metabolic activity of hypertrophic cells was reflected by a twofold to fivefold increase in the mean cellular surface area of rough endoplasmic reticulum, the Golgi membranes, and the mean cellular mitochondrial volume. Rates of longitudinal growth were determined by fluorochrome labeling and incident light fluorescence microscopy. Using these values and the stereological estimators describing cellular height, the rates of cellular turnover were calculated. The rapid progression of the vascular invasion front was found to eliminate, for each column of cells, one chondrocyte every three hours; that is, eight cells a day. The maintenance of a steady-state structure for growth-plate cartilage in rats in a steady state of growth thus necessitates efficient compensation for these losses, which is achieved by a high rate of cellular proliferation and rapid hypertrophy. PMID- 3543021 TI - Late innominate vein thrombosis. Unusual complication following sternal closure. AB - An unusual complication of the median sternotomy is reported. A 37-year-old male experienced a left innominate vein thrombosis 20 months after surgery. The combined treatment consisting of local infusion with Urokinase, surgical removal of the wire and balloon catheter dilatation, was completely successful. PMID- 3543022 TI - Phosphorylation, glycosylation, and proteolytic activity of the 52-kD estrogen induced protein secreted by MCF7 cells. AB - We have studied the posttranslational modifications of the 52-kD protein, an estrogen-regulated autocrine mitogen secreted by several human breast cancer cells in culture (Westley, B., and H. Rochefort, 1980, Cell, 20:353-362). The secreted 52-kD protein was found to be phosphorylated mostly (94%) on high mannose N-linked oligosaccharide chains, and mannose-6-phosphate signals were identified. The phosphate signal was totally removed by alkaline phosphatase hydrolysis. The secreted 52-kD protein was partly taken up by MCF7 cells via mannose-6-phosphate receptors and processed into 48- and 34-kD protein moieties as with lysosomal hydrolases. By electron microscopy, immunoperoxidase staining revealed most of the reactive proteins in lysosomes. After complete purification by immunoaffinity chromatography, we identified both the secreted 52-kD protein and its processed cellular forms as aspartic and acidic proteinases specifically inhibited by pepstatin. The 52-kD protease is secreted in breast cancer cells under its inactive proenzyme form, which can be autoactivated at acidic pH with a slight decrease of molecular mass. The enzyme of breast cancer cells, when compared with cathepsin D(s) of normal tissue, was found to be similar in molecular weight, enzymatic activities (inhibitors, substrates, specific activities), and immunoreactivity. However, the 52-kD protein and its cellular processed forms of breast cancer cells were totally sensitive to endo-beta-N acetylglucosaminidase H (Endo H), whereas several cellular cathepsin D(s) of normal tissue were partially Endo H-resistant. This difference, in addition to others concerning tissue distribution, mitogenic activity and hormonal regulation, strongly suggests that the 52-kD cathepsin D-like enzyme of breast cancer cells is different from previously described cathepsin D(s). The 52-kD estrogen-induced lysosomal proteinase may have important functions in facilitating the mammary cancer cells to proliferate, migrate, and metastasize. PMID- 3543023 TI - Mesosecrin: a secreted glycoprotein produced in abundance by human mesothelial, endothelial, and kidney epithelial cells in culture. AB - Human mesothelial cells, endothelial cells, and type II kidney epithelial cells growing in culture devote approximately 3% of their total protein synthesis to the production of an Mr approximately 46-kD, pI 7.1, secreted glycoprotein (designated Sp46). Fibroblasts make about 1/10th as much Sp46 as these cell types, and their synthesis is dependent upon hydrocortisone. Keratinocytes, urothelial cells, conjunctival epithelial cells, and mammary epithelial cells do not make detectable amounts of Sp46. Mesothelial cells secrete Sp46 onto the substratum, and from there it is subsequently released into the medium. Immunofluorescence analysis using specific antisera discloses that Sp46 is deposited beneath cells as a fine coating on the substratum. In sparse cultures, Sp46 is detected in trails behind motile cells. In contrast, secreted fibronectin coalesces into fibers, most of which remain in contact with and on top of the cells; thus Sp46 does not preferentially bind to fibronectin. About 6 kD of the mass of human Sp46 is N-linked oligosaccharide, which is terminally sialated before secretion. Sp46 has a low glycine content, indicating that it is not a collagenlike protein. Its NH2-terminal sequence over the first 40 amino acids does not resemble any protein for which sequence information is available. Sp46 appears to be a novel extracellular glycoprotein, high-level constitutive expression of which is restricted to mesoderm-derived epithelial and endothelial cells. We therefore propose for it the name "mesosecrin." PMID- 3543024 TI - Dynamic and stable populations of microtubules in cells. AB - Using a new immunocytochemical technique, we have visualized the spatial arrangement of those microtubules in cells that are stable to biotin-tubulin incorporation after microinjection. Cells fixed at various periods of time after injection were exposed to antibody to biotinylated tubulin and several layers of secondary antibodies; these layers prevented reaction of biotin-containing microtubules with antitubulin antibodies. The microtubules that had not incorporated biotin-tubulin could then be stained with anti-tubulin and a fluorescent secondary antibody. In BSC1 cells, most microtubules in the cell exchange with a half-time of 10 min. A separate population of microtubules can be detected, using the above techniques, that are stable to exchange for 1 h or more; these have a characteristic pericentrosomal spatial arrangement as compared to the majority of dynamic microtubules. Unlike the dynamic microtubules, most of the stable microtubules are nongrowing. The average BSC-1 cell contains approximately 700 microtubules: approximately 500 growing at 4 micron min-1, 100 shrinking at approximately 20 micron min-1, and approximately 100 that are relatively more stable to exchange. The potential significance of these stable microtubules is discussed. PMID- 3543025 TI - Distribution of acetylated alpha-tubulin in Physarum polycephalum. AB - The expression and cytological distribution of acetylated alpha-tubulin was investigated in Physarum polycephalum. A monoclonal antibody specific for acetylated alpha-tubulin, 6-11B-1 (Piperno, G., and M. T. Fuller, 1985, J. Cell Biol., 101:2085-2094), was used to screen for this protein during three different stages of the Physarum life cycle--the amoeba, the flagellate, and the plasmodium. Western blots of two-dimensional gels of amoebal and flagellate proteins reveal that this antibody recognizes the alpha 3 tubulin isotype, which was previously shown to be formed by posttranslational modification (Green, L. L., and W. F. Dove, 1984, Mol. Cell. Biol., 4:1706-1711). Double-label immunofluorescence demonstrates that, in the flagellate, acetylated alpha-tubulin is localized in the flagella and flagellar cone. Similar experiments with amoebae interestingly reveal that only within the microtubule organizing center (MTOC) are there detectable amounts of acetylated alpha-tubulin. In contrast, the plasmodial stage gives no evidence for acetylated alpha-tubulin by Western blotting or by immunofluorescence. PMID- 3543026 TI - Extension of neurites on axons is impaired by antibodies against specific neural cell surface glycoproteins. AB - We have developed an in vitro assay which measures the ability of growth cones to extend on an axonal substrate. Neurite lengths were compared in the presence or absence of monovalent antibodies against specific neural cell surface glycoproteins. Fab fragments of antibodies against the neural cell adhesion molecule, NCAM, have an insignificant effect on the lengths of neurites elongating on either an axonal substrate or a laminin substrate. Fab fragments of polyclonal antibodies against two new neural cell surface antigens, defined by mAb G4 and mAb F11, decrease the lengths of neurites elongating on an axonal substrate, but have no effect on the lengths of neurites elongating on a laminin substrate. G4 antigen is related to mouse L1, while F11 antigen appears to be distinct from all known neural cell surface glycoproteins. Our results suggest that the G4 and F11 antigens help to promote the extension of growth cones on axons. PMID- 3543027 TI - Quantitation of protein kinase C by immunoblot--expression in different cell lines and response to phorbol esters. AB - Antisera have been raised against human protein kinase C and also against a synthetic peptide based on the sequence of the bovine brain enzyme (LLNQEE GEYYNVPIPE). These antibodies react with protein kinase C from a number of species (human, murine, rat, rabbit, bovine), indicating substantial conservation of epitopes. These antisera have been used to quantitate directly protein kinase C by immunoblot analysis. We show here that there is a strict correlation between the levels of immunoreactive polypeptide and extractable calcium- and phospholipid-dependent kinase activity for various cell lines. Treatment of murine, rat, and human cells with phorbol dibutyrate was found to deplete levels of immunoreactive protein kinase C severely. A detailed study of the time course of this depletion in Swiss 3T3 cells shows that it follows precisely the loss of extractable activity. On exposure to 400 nM phorbol 12,13-dibutyrate protein kinase C was essentially undetectable by 40 hours; the half-life of this down regulation was 6.7 hours. This data thus demonstrate that the loss of immunoreactive protein kinase C and of extractable calcium- and phospholipid dependent kinase activity precisely parallels the phorbol ester induced down regulation of binding and responsiveness in Swiss 3T3 cells. PMID- 3543028 TI - Differentiation-associated decrease in muscarinic receptor sensitivity in human neuroblastoma cells. AB - Muscarinic receptor-linked increases in intracellular free Ca2+ as measured with quin-2 and Ca2+ release from monolayers of cells have been measured in the human neuroblastoma cell line SH-SY5Y. Induction of differentiation with the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) leads to a decrease in the sensitivity of the cells to low concentrations of agonists with respect to the induced increase in cytosolic free Ca2+ and stimulation of Ca2+ efflux. No decrease in agonist binding affinity was observed when the displacement of a labelled antagonist, 3H-NMS, by a non-labelled agonist was studied. PMID- 3543029 TI - Interactions of serine proteases with cultured fibroblasts. AB - This review summarizes the mechanisms by which several serine proteases, particularly urokinase, thrombin, and elastase, interact with cultured fibroblasts. Many of these studies were prompted by findings that interactions of these proteases with cells and the extracellular matrix are important in a number of physiologic and pathologic processes. Two main pathways have been identified for specific interactions of these proteases with fibroblasts. One involves surface binding sites for the free protease that appear to bind only one particular protease. An unusual feature collectively shared by the binding sites for urokinase, thrombin, and elastase is that the bound protease is not detectably internalized by the fibroblasts. The other pathway by which serine proteases interact with fibroblasts involves proteins named protease nexins (PNs). Three PNs have been identified. They are secreted by fibroblasts and inhibit certain serine proteases by forming a covalent complex with the protease catalytic site serine. The complexes then bind back to the fibroblasts via the PN portion of the complex and are internalized and degraded. Recent studies showing that the fibroblast surface and extracellular matrix accelerate the inactivation of thrombin by PN-1 support the hypothesis that the PNs control protease activity at and near the cell surface. The PNs differ from plasma protease inhibitors in their molecular properties, absence in plasma, site of synthesis, and site of clearance of the inhibitor:protease complexes. PMID- 3543030 TI - Transforming growth factor-alpha: structure and biological activities. PMID- 3543031 TI - Protein chemistry-nuclear magnetic resonance approach to mapping functional domains in single-stranded DNA binding proteins. PMID- 3543032 TI - Biochemical aspects of bupivacaine-induced acute muscle degradation. AB - A single injection of a local anaesthetic, bupivacaine, into the soleus muscle of adult rat has a severe mytoxic effect, i.e. rapid dissolution of myofilaments and degradation of myofibrillar proteins shortly after injection. Increased lysosomal enzymes were observed in homogenates of affected muscle. The activity of potent proteolytic enzyme, cathepsins B and L (assayed against a new synthetic substrate succinyl-Tyr-Met-naphthylamide), gradually increased and reached a plateau value that was 11-fold greater than the control 48 h after bupivacaine injection. The chronological change in the activity of cathepsins B and L was reflected in the myofibrillar protein pattern in bupivacaine-treated muscle. To determine whether the increase in lysosomal peptide hydrolases is due to activation of muscle lysosomes or not, mononuclear cells were separated from both injected and control muscles. The activity of cathepsins B and L in the lysate from injured muscle was 180-fold higher than the control. Affinity-purified antibody was used to study the intracellular localization of cathepsin B by immunohistochemical procedures. The results were consistent with the biochemical observation that the main source of cathepsin B in muscle homogenates was infiltrated mononuclear cells. Therefore, we conclude that the increased lysosomal enzymes may be derived mainly from mononuclear cells (macrophages), not from muscle lysosomes, in bupivacaine induced acute muscle degeneration. PMID- 3543035 TI - Abuse of the elderly: a review. PMID- 3543034 TI - Intra- and extracellular distribution of an endogenous lectin during erythropoiesis. AB - An endogenous beta-galactoside-specific lectin has previously been isolated from rabbit bone marrow. The quantification of extracted lectin now indicates that approximately 75% of the lectin is intracellular in marrow. Indirect immunofluorescence studies show the extracellular lectin is associated with the erythroblast cell surface and is also found in some acellular areas of the marrow stroma. At enucleation, lectin surrounds the extruded nucleus while some residual lectin is observed in the cytoplasm of circulating reticulocytes and erythrocytes. PMID- 3543033 TI - Spontaneous and induced dome formation by two clonal cell populations derived from a human adenocarcinoma cell line, HT29. AB - The replacement of glucose by galactose in the culture medium resulted in partial structural and functional enterocytic differentiation of HT29 cells. In order to characterize populations of homogeneously differentiated HT29 cells we have selected two clonal cell lines HT29-D4 and HT29-D9 with the following functional and structural characteristics when grown in a galactose-containing medium: the two clonal cell populations were permanently morphologically differentiated as shown by the presence of mature junctional complexes and a well-organized brush border (especially for HT29-D4 cells); HT29-D4 and HT29-D9 cells were able to form domes early in confluency, which indicated a functional state of differentiation; the process of differentiation was fully reversible when glucose was added to the culture medium. The induction of domes was investigated in these two cell populations and we demonstrated for the first time that proteolytic enzymes are potent inducers of dome formation. The architecture of domes either obtained spontaneously or induced by proteolytic enzymes was not maintained in the presence of ouabain (a specific inhibitor of the Na+/K+-ATPase). In conclusion, HT29-D4 and HT29-D9 cells can be maintained permanently in a differentiated state in a glucose-free medium and were able to form domes at confluency. The observation that proteolytic enzymes were able to induce dome formation can help in the comprehension of the mechanism involved in the establishment of the differentiated state. PMID- 3543036 TI - [Surgery of duodenal ulcer. In decline?]. AB - The authors report their experience of the surgical treatment of duodenal ulcer disease and its complications over a 10 year period (1976-1986), i.e. 336 cases from a group of 10748 digestive tract endoscopies performed and 1126 duodenal ulcers identified (10.4%). The efficacy of new types of medical treatment (anti secretory drugs, endoscopic hemostasis techniques, prostaglandins) and the improved follow-up of patients tend, despite the value and proven safety of Parietal-cell Vagotomy (elective procedure in 76% of the group), to modify: the epidemiological aspect of the disease in the sense of a decrease in the rate of ulcers with complications related to stenosis and perforation; the therapeutic aspect with more limited surgical indications. Is this the end of surgery for duodenal ulcer and its complications? PMID- 3543037 TI - [Value of short prophylactic antibiotherapy in thoracic and vascular surgery. Comparative randomized double-blind study of 3 and 8 injections of cefamandole]. AB - The subject of whether an optimal duration of prophylactic antibiotic therapy exists was evaluated by comparing results of short and medium-term treatment in aseptic surgery during a double-blind, randomized, prospective trial in 507 patients undergoing vascular or thoracic operations. Patients were randomly allocated to receive either 3 injections of cefamandole: at induction of anesthesia and after 4 and 10 hours (251 cases) or 8 injections of the same antibiotic: at induction of anesthesia, after 4 hours and then every 6 hours up to 40 hours (256 cases). Evaluation on discharge showed that among the 251 patients receiving 3 injections, 21 (8.33%) were infected while in the group treated with 8 injections (256 cases) 25 (9.8%) were infected. The X2 was 0.25 and there is a lack of statistically significant difference between treatments. Duration of prophylactic antibiotic therapy can be shortened, without loss of efficacy in thoracic or vascular aseptic surgery, to reduce selection of resistant germs and to lower costs. PMID- 3543038 TI - [Transdiaphragmatic approach to the supraceliac aorta. Surgical anatomy and operative technic]. AB - The surgical anatomy and the practical modalities of the trans-peritoneal diaphragmatic approach of the low thoracic aorta have been studied on the basis of 40 consecutive dissections. The trans-diaphragmatic approach of the supra celiac aorta can be performed: either through a restrictive way, by dissociation of the muscular fibers of the posterior angle of the oesophagal hiatus, thus allowing the access to a mean 30 mm long part of supra-celiac aorta, large enough to perform a complete aortic clamping; either through an extensive way, by medial sagittal section, in front of the aorta of the muscular fibers of the posterior angle of the oesophagal hiatus and of the arcate ligament, thus permetting this exposure of a longer aortic part (60 mm on a average) and the realization of more important aortic procedures. These may be performed with a lateral aortic clamp, on account of the large diameter of the aorta at this level (30 mm on an average). PMID- 3543039 TI - Preparative reversed-phase high-performance liquid chromatography of iodinated insulin retaining full biological activity. AB - Insulin monoiodinated in Tyr A14, A19, B16 and B26 can be separated from insulin and diiodoinsulins using reversed-phase high-performance liquid chromatography on LiChrosorb RP-18 columns. Monoiodoinsulins with high and low specific activities were isolated from a number of buffer systems without any reduction in binding affinity and biological activity in isolated rat fat cells. The reason for the previously observed reduction in the binding affinity was probably column bleeding, i.e., chemical degradation of the column support. PMID- 3543040 TI - Rapid purification of antisteroid antibodies by high-performance liquid affinity chromatography. AB - An adsorbent for the high-performance affinity chromatography of antisteroid antibodies was prepared, based on a commercial pre-packed column. The column contained activated microparticulate silica beads bearing epoxide functions, on which the steroid dexamethasone was covalently linked. The column was used successfully for the rapid and complete isolation of several hundred microgram amounts of specific antidexamethasone antibodies from rabbit antisera. The practical aspects of the purification procedure, especially the optimization of the washing and of the elution steps, are detailed. Despite non-biospecific elution with 20% acetonitrile in an acidic buffer, the purification yield was very satisfactory and the biological activity of the purified immunoglobulins appeared excellent. PMID- 3543041 TI - Liquid column chromatography. PMID- 3543042 TI - Gas chromatography. PMID- 3543044 TI - Electrophoresis. PMID- 3543043 TI - Planar chromatography. PMID- 3543045 TI - Overpressured thin-layer chromatography. AB - The properties, apparatus and applications of overpressured thin-layer chromatography (OPTLC) have been reviewed. In the Introduction planar chromatography has been briefly characterized, with particular attention to TLC. The general properties of OPTLC and methods of development of chromatograms in this technique have been then given. The construction of chambers and equipment for OPTLC has been described, paying attention to two-dimensional columns. The properties of chambers for OPTLC have been characterized considering the flow of eluent, sorbent-eluent interactions and the efficiency of various systems. OPTLC, TLC and HPTLC have been compared and also a comparison between OPTLC with a constant (linear) eluent flow-rate and with a decreasing eluent flow-rate has been made. Analytical applications of OPTLC have been described and examples of separations of mixtures have been given. PMID- 3543046 TI - Table of reduced mobility values from ambient pressure ion mobility spectrometry. AB - This review presents a list of reduced ion mobilities that have been measured under ambient pressure conditions and reported in the open literature during the 16-year period of 1970-1985. Ions reported are listed in order of increasing reduced mobility along with the name of the parent compound, the reduced mobility of additional product ions observed in the spectrum, the carrier and drift gases, the temperature of the drift region and the reference where the data were reported. Also, ions that have been identified by mass spectrometry are indicated with an asterisk. PMID- 3543047 TI - General problems associated with the analysis of amino acids by automated ion exchange chromatography. AB - Some of the general problems commonly encountered with the analysis of amino acids have been described. These include problems associated with the preparation and storage of samples prior to analysis and those associated with the analytical stage itself. The effects on the accuracy of the determination of amino acids have been discussed, together with possible solutions to some of the problems. PMID- 3543048 TI - Determination of hydrophobic parameters by reversed-phase liquid chromatography: theory, experimental techniques, and application in studies on quantitative structure-activity relationships. AB - The use of RPLC retention parameters as descriptors of the hydrophobic nature of bioactive compounds has been evaluated. The relationship between the capacity factor, measured on n-alkyl-bonded stationary phases using binary eluents, and the n-octanol-water partition coefficient has been illustrated experimentally and theoretically. It is suggested that retention parameters, in particular the capacity factor (log kw) obtained by extrapolation of retention data from binary eluents to 100% water, could successfully replace the n-octanol-water partition coefficient in studies on quantitative structure-activity relationship, and that their use may result in a better correlation with biological data. PMID- 3543049 TI - Mortality in the beta blocker heart attack trial: circumstances surrounding death. AB - In the Beta Blocker Heart Attack Trial, a double blind, randomized, controlled study, patients taking propranolol (180 or 240 mg/day) initiated 5-21 days post myocardial infarction had 26% fewer deaths than those taking placebo over a 25 month (mean) followup. Detailed analysis of the circumstances surrounding the BHAT deaths failed to reveal any striking difference between propranolol and placebo in the type of clinical event preceding death, the incidence and type of acute and prodromal signs and symptoms, the location of death, the activity preceding death or the percentage of deaths that were sudden or instantaneous, suggesting that propranolol may exert an "across the board" effect and improve survival by a combination of mechanisms. An unexpected finding was that the protective effect of propranolol appeared to occur during the hours of 10 p.m. to 7 a.m. PMID- 3543050 TI - The ultrastructural location of C-protein, X-protein and H-protein in rabbit muscle. AB - Purified antibodies to the thick filament accessory proteins, C-protein, X protein and H-protein, have been used to label fibres of three rabbit muscles, psoas (containing mainly fast white fibres), soleus (containing mainly slow red fibres) and plantaris (a muscle of mixed fibre type) and their location has been examined by electron microscopy. These accessory proteins are present on one or more of a set of eleven transverse stripes about 43 nm apart that have been observed previously in each half A-band. Each protein has a limited set of characteristic distributions. H-protein is present on stripe 3 (counting from the M-line) in the majority of psoas fibres but is absent in soleus and plantaris muscle. C-protein can occur on stripes 4-11 (the commonest pattern seen in psoas); on stripes 5-11 (in psoas and plantaris); on stripes 3 together with stripes 5-11 (in plantaris); or on none (in red fibres of all three muscles). X protein can occur on stripes 3-11 in the red fibres of all three muscles; on stripe 4 only (in psoas and plantaris); on stripes 3 and 4 (in psoas and plantaris) or on none. Stripes labelled with anti-X are wider than those labelled with anti-C and consist of a doublet with an internal spacing of 16 nm. The patterns for the three accessory proteins, while overlapping, are in no case identical; this suggests the proteins do not simply substitute for one another. The precise axial positions of the anti-C labelled stripes differ from those of the anti-X stripes; the anti-X stripes lie about 8-9 nm further from the M-line than the corresponding anti-C stripes. This implies that the inner member of an X protein doublet lies in a very similar position to a C-protein stripe. The anti-H labelled stripe seen in most psoas fibres lies 14 nm nearer the M-line than stripe 3 of the anti-X labelled array in psoas red fibres and is staggered from a continuation of the C-protein array by about 4 nm. The labelling patterns were constant within a fibre and suggest a very precise assembly mechanism. The number of classes of fibre, as defined by the accessory proteins present and their arrangement, exceeds the number of fibre types presently recognized. PMID- 3543051 TI - Trends and issues in the provision of home health care: local governments in a competitive environment. PMID- 3543053 TI - Relationship of insulin binding and insulin-stimulated tyrosine kinase activity is altered in type II diabetes. AB - The insulin receptor contains an alpha subunit with insulin binding properties and a beta subunit with insulin-stimulated tyrosine kinase function. Preparations containing insulin and insulinlike growth factor I (IGF-I) receptors were obtained from solubilized human red cell membranes by affinity chromatography. After separate assays for insulin binding and insulin-stimulated tyrosine kinase activities, a high degree of correlation was found between these activities in preparations from normals and diabetics. Identical studies using IGF-I as the ligand showed a lesser degree of correlation. We compared 24 normal subjects and 14 untreated type II diabetics and found significant diminution in the slope of the line coupling insulin binding and insulin-stimulated kinase activities in the diabetics. This difference was not observed in a similar study of IGF-I-related activities. Compared to normal controls, untreated type II diabetics have reduced tyrosine kinase activity stimulated per unit insulin binding. PMID- 3543054 TI - Hyperglucagonemia and insulin-mediated glucose metabolism. AB - The effect of chronic physiologic hyperglucagonemia on basal and insulin-mediated glucose metabolism was evaluated in normal subjects, using the euglycemic insulin clamp technique (+50, +100, and +500 microU/ml). After glucagon infusion fasting glucose increased from 76 +/- 4 to 93 +/- 2 mg/dl and hepatic glucose production (HGP) rose from 1.96 +/- 0.08 to 2.25 +/- 0.08 mg/kg X min (P less than 0.001). Basal glucose oxidation after glucagon increased (P less than 0.05) and correlated inversely with decreased free fatty acid concentrations (r = -0.94; P less than 0.01) and decreased lipid oxidation (r = -0.75; P less than 0.01). Suppression of HGP and stimulation of total glucose disposal were impaired at each insulin step after glucagon (P less than 0.05-0.01). The reduction in insulin-mediated glucose uptake was entirely due to diminished non-oxidative glucose utilization. Glucagon infusion also caused a decrease in basal lipid oxidation and an enhanced ability of insulin to inhibit lipid oxidation and augment lipid synthesis. These results suggest that hyperglucagonemia may contribute to the disturbances in glucose and lipid metabolism in some diabetic patients. PMID- 3543055 TI - Monocyte-T lymphocyte interaction for regulation of insulin receptors of the activated T lymphocyte. AB - During activation the lymphocyte attains functional insulin receptors with precise regulation, a consequence of insulin concentration manipulations. These studies test the hypothesis that insulin receptor (+) monocytes monitor insulin concentrations, so instructing the T lymphocytes. Monocyte-enriched populations were incubated with insulin (0-10(-6) M) followed by co-culture with T lymphocytes and an activating stimulus. A dose-related fall in T lymphocyte insulin receptor binding was observed that was specific for the monocyte as the signalling cell and for insulin as the signal received. Monocytes from normal volunteers during a euglycemic, hyperinsulinemic clamp were cultured with T lymphocytes and an activating stimulus. A decline in specific insulin receptor binding on T lymphocytes was observed, which Scatchard analysis demonstrated to be a consequence of reduction in receptor numbers. These studies demonstrate that the receptor (+) monocyte perceives the concentration of insulin and passes this information to T lymphocytes regulating the number of activation-induced insulin receptors. The interplay between the monocyte and T lymphocyte parallels the interaction of these cell types for recognition of antigen. PMID- 3543056 TI - Dichloroacetate inhibits glycolysis and augments insulin-stimulated glycogen synthesis in rat muscle. AB - The decrease in plasma lactate during dichloroacetate (DCA) treatment is attributed to stimulation of lactate oxidation. To determine whether DCA also inhibits lactate production, we measured glucose metabolism in muscles of fed and fasted rats incubated with DCA and insulin. DCA increased glucose-6-phosphate, an allosteric modifier of glycogen synthase, approximately 50% and increased muscle glycogen synthesis and glycogen content greater than 25%. Lactate release fell; inhibition of glycolysis accounted for greater than 80% of the decrease. This was associated with a decrease in intracellular AMP, but no change in citrate or ATP. When lactate oxidation was increased by raising extracellular lactate, glycolysis decreased (r = - 0.91), suggesting that lactate oxidation regulates glycolysis. When muscle lactate production was greatly stimulated by thermal injury, DCA increased glycogen synthesis, normalized glycogen content, and inhibited glycolysis, thereby reducing lactate release. The major effect of DCA on lactate metabolism in muscle is to inhibit glycolysis. PMID- 3543052 TI - Secretory products of macrophages. PMID- 3543059 TI - A rapid enzyme immunoassay for measurement of HBK in blood. AB - An enzyme immunoassay has been developed for the measurement of HBK (4-amino-2 hydroxybutylyldibekacin) a new semisynthetic aminoglycoside antibiotic. Antisera were raised in rabbits by immunization with HBK conjugated to bovine serum albumin (BSA). 3'-Eno-HBK conjugated to alkaline phosphatase (ALP) was used as an enzyme labeled antigen. The antibody-bound drug was separated from free using goat anti-rabbit IgG serum. The assay can be completed within one hr by co incubating the first and the second antibody. The present immunoassay allows detection of 10 ng HBK per ml of serum, and is applicable for monitoring HBK level in blood. HBK concentrations in human sera were determined by the immunoassay during and after infusion and the levels were compared with those determined by high performance liquid chromatography (HPLC) and antimicrobial assay. PMID- 3543058 TI - Increased single strand breaks in DNA of lymphocytes from diabetic subjects. AB - Certain aspects of the chronic complications of diabetes suggest that, with time, the abnormal metabolic milieu leads to irreversible changes in some cell populations. Since we have previously observed that high glucose concentrations induce an increase in single strand breaks in the DNA of cultured human endothelial cells, we have investigated whether the same abnormality occurs in cells derived from the in vivo diabetic environment. Peripheral blood lymphocytes obtained from 21 type I diabetic patients and age- and sex-matched controls were tested for rate of unwinding in alkali (a measure of DNA single strand breaks). The patients were subdivided into two groups on the basis of glycohemoglobin values above or below 9%. The group with glycohemoglobin values of 12.9 +/- 2.4% (mean +/- SD), but not the group with glycohemoglobin values of 7.4 +/- 1.5%, showed accelerated unwinding of lymphocyte DNA when compared to controls (P less than 0.01). These studies suggest that poorly controlled diabetes may result in DNA lesions, whose impact on long-term complications deserves to be investigated. PMID- 3543057 TI - Insulinotropin: glucagon-like peptide I (7-37) co-encoded in the glucagon gene is a potent stimulator of insulin release in the perfused rat pancreas. AB - Insulin secretion is controlled by a complex set of factors that include not only glucose but amino acids, catecholamines, and intestinal hormones. We report that a novel glucagon-like peptide, co-encoded with glucagon in the glucagon gene is a potent insulinotropic factor. The glucagon gene encodes a proglucagon that contains in its sequence glucagon and additional glucagon-like peptides (GLPs). These GLPs are liberated from proglucagon in both the pancreas and intestines. GLP-I exists in at least two forms: 37 amino acids GLP-I(1-37), and 31 amino acids, GLP-I(7-37). We studied the effects of synthetic GLP-Is on insulin secretion in the isolated perfused rat pancreas. In the presence of 6.6 mM glucose, GLP-I(7-37) is a potent stimulator of insulin secretion at concentrations as low as 5 X 10(-11) M (3- to 10-fold increases over basal). GLP I(1-37) had no effect on insulin secretion even at concentrations as high as 5 X 10(-7) M. The earlier demonstration of specific liberation of GLP-I(7-37) in the intestine and pancreas, and the magnitude of the insulinotropic effect at such low concentrations, suggest that GLP-I(7-37) participates in the physiological regulation of insulin secretion. PMID- 3543060 TI - Capture and detection of carcinoembryonic antigen on antibody coated beads used in enzyme immunoassay. AB - We have evaluated antibody coated beads for capture and detection of carcinoembryonic antigen (CEA). Assay parameters of time, temperature, buffer molarity, specificity of antibody on the bead and reagent addition sequence have been studied. Optimal assay kinetics occurred at a temperature of 45 degrees C and a buffer molarity of 0.1M or above. The type and quantity of antibody on the bead surface were also critical to optimal CEA detection. Beads coated with baboon or goat anti-CEA antibody were able to capture a higher percentage of CEA than monoclonal mouse anti-CEA antibody or guinea pig anti-CEA antibody. The sequence of addition of CEA, anti-CEA antibody coated bead, and anti-CEA-horse radish peroxidase conjugate was important for optimal CEA detection. Formation of an immune complex of CEA with the anti-CEA horse radish peroxidase conjugate prior to capture of the CEA on an antibody bead resulted in the optimal detection of CEA. PMID- 3543061 TI - Questioning the clinical usefulness of projective psychological tests for children. PMID- 3543062 TI - Behavioral group treatment of test anxiety: an evaluation study. AB - A report is given of a behavioral group training of test anxiety with secondary school students. The selection of the students, the methods of evaluation, and the treatment program are described. The training takes eight sessions plus homework assignments. The results were established by repeated administration of (test) anxiety inventories. After treatment, scores on test anxiety decreased significantly. Comparison of the test scores of the waiting-list control group with those of the trained group shows improvement at retesting. At follow-up after 12 weeks, decrease in anxiety in the trained group was even greater and performance improvement became evident. PMID- 3543063 TI - Behavioral analysis of a case of psychogenic nausea and vomiting. AB - A case of psychogenic nausea and vomiting is described. Multiple determinants of the disorder are hypothesized. The transcript indicates a characteristic sequence of behavioral/physiological events in these episodes. A multi-component treatment program was instituted with good results. PMID- 3543066 TI - An evaluation of basic periodontal therapy using sonic and ultrasonic scalers. AB - 10 adult patients with periodontitis were treated with oral hygiene instruction and a single episode of supra- and subgingival debridement using either a sonic or an ultrasonic instrument in a split-mouth design. The clinical response was evaluated by measurements of dental plaque, bleeding on probing, probing depths, and probing attachment levels taken at baseline and every 3rd month for 12 months. An improvement of periodontal conditions was observed during the initial 3-6 month period followed by a stabilization of parameters. No difference in clinical response could be observed between sites treated with the sonic or ultrasonic instruments. PMID- 3543065 TI - Immunolocalization of cathepsin D in normal and neoplastic human tissues. AB - The aspartic proteinase cathepsin D was purified from human spleen and localised in various formalin fixed paraffin embedded human tissues using the peroxidase antiperoxidase (PAP) technique. Cathepsin D was shown not only in macrophages but also in other connective tissue cells, and in epithelium. It was present in spleen (littoral cells and cells within Malpighian bodies), liver (hepatocytes and Kupffer cells), lung (alveolar macrophages and bronchial epithelium), brain (neurones), lymph nodes (histiocytes in germinal centres, sinusoid lining cells) and stomach (parietal and mucous neck cells). Cathepsin D was also found in carcinomas of bronchus, stomach, colon, kidney, breast, ovary, bladder and pancreas, both in neoplastic epithelium and in stromal cells, but was seldom present in connective tissue neoplasms. A group of malignant lymphomas also contained the enzyme within scattered cells. The distribution of cathepsin D seems to be much wider than that of the structurally related aspartic proteinases pepsin, gastricsin, and renin. PMID- 3543064 TI - DNA analysis in human disease. AB - The analysis of human DNA using recombinant DNA technology is fast becoming an integral part of the diagnosis, assessment, and prevention of inherited and somatic genetic disease. The rationale underlying these methods of analysis is discussed, and the nature and extent of mutational change in heritable disorders and neoplastic development is outlined. PMID- 3543067 TI - Antimicrobial properties of 2 aliphatic amines and chlorhexidine in vitro and in saliva. AB - The surfactants tetradecylamine, hexadecylamine and chlorhexidine have been compared with regard to their ability to inhibit microbial growth. Antibacterial activity was assessed by tube dilution methods. Tetradecylamine and chlorhexidine were similar in antibacterial activity, being effective at low concentrations against most organisms tested. Hexadecylamine also inhibited growth but at higher concentrations. Viable counts of salivary organisms were monitored in volunteers over 48 h after one rinse with the agents. The initial reduction in numbers of total viable salivary bacteria and streptococci by tetradecylamine and of streptococci by hexadecylamine had disappeared 3 h after a single mouth rinse, but the reduction in numbers of all salivary bacteria by chlorhexidine was more prolonged. PMID- 3543068 TI - Longitudinal quantitative radiodensitometric study of treated and untreated lower molar furcation involvements. AB - 38 first or second lower molars from 16 patients showing furcation involvements of degrees 1 and 2 were treated after motivation and hygiene instruction, either by subgingival curettage, or by the modified Widman surgical procedure or by furcation plasty. The plaque index, the gingival index of inflammation and the depth of interproximal and interradicular pockets were recorded before and up to 1 year after the 3 therapeutical procedures. The above clinical indices were also followed for 2 years in 15 lower molars from 7 untreated patients. A quantitative radiographical analysis of the interradicular bone was performed in all patients, by using superposable identical radiographs and a computer-assisted photodensitometric technique. In the 3 groups of treated patients, the clinical scores were, in general, improved by the 3 therapeutic modalities. In the furcation areas, the plaque index was always higher on the lingual side, whereas the depth of "horizontal" pockets was always greater on the buccal side. Except for the lesions treated by furcation plasty, no change could be noticed clinically in the depths of vertical or horizontal penetration of a periodontal probe in the furcation areas. The quantitative radiographic analysis, however, clearly showed a loss in the first 2 mm of superficial bone during the 2 months following the 3 therapeutical procedures: this loss was followed by a statistically significant recovery and, for the group treated by curettage, even by a net gain during the 6 to 12 months following therapy. The radiographical density of the deeper layer of bone did not change in the group treated by curettage only. It showed a loss in the first 2 months following the 2 surgical procedures but a statistically significant recovery in the months thereafter. As for the group of untreated patients, at the examinations performed initially, 6 months, 1 and 2 years later, the number of plaque-free and non-bleeding sites in the furcation areas was lower on the lingual as compared to the buccal side, whereas the frequency distribution of furcation involvements was similar on both aspects. No significant changes were found in the various clinical parameters throughout the 2 years of the study. On the contrary, a significant loss of average density of the superficial layer of interradicular bone was already measured on the superposable radiographs 6 months after the initial examination and was found to increase thereafter. No changes of radiodensity could be measured for the deeper layer of bone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543069 TI - Untoward effects of fenfluramine in autistic children. AB - Several recent studies have described the benefits of fenfluramine for the symptomatic treatment of infantile autism. No large surveys of side effects of this drug have been reported in autistic children. To evaluate the untoward effects of fenfluramine in children with autism, 12 subjects were systematically studied. Medication was administered in a double-blind, placebo-controlled cross over study. Parents were trained in monitoring untoward effects. These observations were compiled in detailed daily notes. In addition, four cases describing unusual effects found in a sample of 170 patients treated with fenfluramine are also reported. In the initial 2 weeks of active drug listlessness, food refusal, and stomach upset were frequently seen. A different pattern of untoward effects was seen in the final 14 weeks of treatment. Irritability, agitation, and crying along with continued food refusal were noted. The subjects lost 2.1% of body weight during active drug phase, but there was a rebound weight gain during the subsequent placebo phase. A thorough understanding of fenfluramine's side effects and adverse reactions is necessary so as to differentiate them from the multiple symptoms inherent in the syndrome of autism. PMID- 3543070 TI - Acute surgical complications: cause, prevention, and treatment. AB - The acute complications that may result in failure of the surgical procedure are discussed. These include bleeding, hematoma, infection, dehiscence, and necrosis. The background of each is covered in detail and an attempt is made to show the interrelationships among them. The purpose of this communication is to aid in the recognition, treatment, and prevention of these acute surgical complications. PMID- 3543071 TI - Subacute cutaneous lupus erythematosus. Clinical, serologic, and immunogenetic studies of forty-nine patients seen in a nonreferral setting. AB - Subacute cutaneous lupus erythematosus has been clearly recognized as a distinct cutaneous manifestation of lupus erythematosus. Two forms have been described, an annular erythema and a papulosquamous variant. Previous data have suggested that these patients have a high incidence of mild to moderate systemic disease, anti Ro (SS-A) antibodies, and human lymphocyte antigen (HLA)-DR3, particularly the annular form. We studied forty-nine patients with subacute cutaneous lupus erythematosus seen in local private practices in our area. Lesions of chronic cutaneous lupus erythematosus were seen in 34.8% of our patients. Twenty-five patients (51%) fulfilled the American Rheumatism Association criteria for the classification of systemic lupus erythematosus, and renal disease was present in nine of these patients (including 3 with decreased function). Antibodies to Ro (SS-A) and/or La (SS-B) were present in only sixteen patients, and HLA-DR3 was found in only seventeen patients. Twenty-two patients had inactive cutaneous disease at follow-up. We concluded that our patient population with subacute cutaneous lupus erythematosus skin lesions is less distinctive than previous literature suggests. The serologic and immunogenetic correlates were not demonstrated. The full range of lupus erythematosus-related disease was seen, although most patients follow a benign course. PMID- 3543072 TI - Weekly pulse dosing schedule of fluorouracil: a new topical therapy for psoriasis. AB - We report use of a new weekly pulse dosing schedule of 5% fluorouracil under occlusion for topical treatment of recalcitrant psoriasis. This schedule eliminates the severe local toxicity reported in continuous dosing schedules. The thirteen outpatients completing this study were given continuous topical application of fluorouracil for a mean of 2 to 3 days per week; mean duration of therapy was 15.7 weeks. Eleven patients had an average of 90% clearing of actively treated lesions; 6% clearing was obtained with placebo. At 3-month follow-up examination, improvement was maintained in five patients, was maintained by at least 50% in two, and was lost in four. The five patients with remission at 3 months reported continued remission for up to an additional 8 months. This pulse dosing schedule makes topical fluorouracil under occlusion a useful, safe treatment for limited plaque psoriasis that does not respond to topical corticosteroid therapy. PMID- 3543073 TI - Therapeutic activity of lactate 12% lotion in the treatment of ichthyosis. Active versus vehicle and active versus a petrolatum cream. AB - Lactate 12% lotion was significantly more effective than both its vehicle and a petrolatum-based cream in the treatment of ichthyosis. The treatment regimen was twice-daily application for 4 weeks with evaluations weekly during the treatment period and for 2 weeks after treatment was stopped. Vulgaris, lamellar, sex linked, Netherton's, and epidermolytic hyperkeratotic forms of ichthyosis were significantly improved by treatment with lactate 12% lotion. This new therapeutic modality expands the scope and extent of ichthyotic conditions that may now be successfully treated. PMID- 3543074 TI - Bullosis diabeticorum. PMID- 3543075 TI - Transepithelial elimination in cutaneous aspergillosis. PMID- 3543076 TI - Ervin Epstein, M.D. PMID- 3543077 TI - CT and ultrasound features of post-traumatic adrenal hemorrhage. AB - Computed tomographic and ultrasound features in four cases of post-traumatic unilateral adrenal hemorrhage are reported. The CT findings consist of enlargement of the gland with hyperdensity, streaky infiltration of the periadrenal fat, and enlargement of the adjacent crus. On ultrasound the suprarenal mass appears moderately echogenic. Long-term follow-up studies show decrease of the volume of the mass, with CT and ultrasonic patterns consistent with resolving hematomas. PMID- 3543078 TI - Computed tomography of renal aspergillosis. AB - The CT and sonographic findings of a case of localized, invasive aspergillosis of the kidney are presented. PMID- 3543079 TI - Effect of serum sources and colostral whey on bovine semen quality and spermatozoa immunoglobulin G immunofluorescence. AB - Heifer, bull, fetal calf sera, and colostral whey were used to evaluate the influence of protein concentrations on percent progressive motility, head-to-head agglutination, acrosomal integrity, and immunoglobulin G immunofluorescence of bovine spermatozoa using ejaculates from 10 bulls. In the first experiment, 10% (vol/vol) addition of undiluted colostral whey resulted in the highest head-to head agglutination, acrosomal integrity, and immunoglobulin G immunofluorescence. Ten percent (vol/vol) addition of whey diluted to a protein concentration equivalent to fetal calf serum produced significantly lower agglutination, acrosomal integrity, and immunoglobulin G immunofluorescence. Fetal calf serum was unable to produce agglutination and immunoglobulin G immunofluorescence of bovine spermatozoa. Heifer and bull sera produced similar responses for all seminal measurements. In Experiment 2, unheated whey and heifer serum resulted in higher response for all variables than heat inactivated whey and heifer serum. Whey treatment produced greater spermatozoal motility, agglutination, acrosomal integrity; and immunoglobulin G immunofluorescence than treatment with heifer serum. Spermatozoal immunofluorescence indicated antibodies in normal whey, bull, and heifer serum bound to spermatozoal membranes at the acrosomal region. Colostral whey was an effective source of agglutinin factor. Normal unheated whey and heifer serum did not cause sperm damage or immobilization. PMID- 3543080 TI - Comparison of the heat resistance of bacterial lipases and proteases and the effect on ultra-high temperature milk quality. AB - Thirty-four of 49 isolates of psychrotrophic bacteria produced extracellular lipase or protease when grown in rehydrated nonfat dry milk. The cell-free crude preparation from 50% of these had either heat-resistant lipase or protease; in 30% both enzymes were heat resistant. Eight isolates were selected for further evaluation of effect on ultra-high temperature processed milk. Free fatty acids and free amino groups of milk precultured with the bacteria increased at different rates depending on the isolate. Partially purified lipase from one of these bacteria (Acinetobacter sp.) caused free fatty acids to increase following ultra-high temperature processing when the milk was stored at 10, 21, or 32 degrees C for 4 wk. The increase was temperature dependent. Lipase activity of .0012 units/ml added prior to processing caused significant increases in free fatty acid at 21 and 32 degrees C in 4 wk. PMID- 3543081 TI - Glass polyalkenoate (glass-ionomer) cements: a review. PMID- 3543082 TI - [Review of the principal dental implants used in Quebec]. PMID- 3543083 TI - [Comparative analysis of the marginal adaptation of castings in the evaluation of new systems of impression materials]. PMID- 3543084 TI - Gastrointestinal complications following renal transplantation: nursing implications. PMID- 3543086 TI - Madison Wilson Gaillard, Sr., D.D.S. September 10, 1898-September 30, 1986. PMID- 3543085 TI - [The biotechnology of protecting the environment from xenobiotics]. PMID- 3543087 TI - Joseph Francis Volker. Alabama's most distinguished adopted son. Part III--The later years as dean. PMID- 3543088 TI - The presidents. Paul Harold Jeserich 1959-1960. PMID- 3543089 TI - Surgical periodontal pocket elimination: still a justifiable objective? PMID- 3543090 TI - Dentin bonding systems: an update. Council on Dental Materials, Instruments, and Equipment. PMID- 3543091 TI - Louis F. Bishop lecture. Role of coronary artery spasm in symptomatic and silent myocardial ischemia. AB - The revival of the concept of coronary spasm has stimulated research into coronary artery disease. Observations in patients with variant angina have substantially contributed to the appreciation of painless myocardial ischemia. However, the presence or absence of pain during ischemic episodes is not related to the cause of ischemia, because painless ischemia can be observed in variant angina (caused by spasm), in effort-induced angina (caused by increased myocardial demand) and in myocardial infarction (caused by thrombosis). Continuous monitoring initially of patients with variant angina and subsequently of patients with unstable and stable angina proved that often painful and painless ischemic episodes are caused by a transient impairment of regional coronary blood flow rather than by an excessive increase of myocardial demand. The transient impairment of coronary flow appears to be caused by dynamic stenosis of epicardial coronary arteries. This most often occurs at the site of atherosclerotic plaques encroaching on the lumen to a variable extent. Dynamic stenosis can be caused by 1) "physiologic" increase of coronary tone, as in stable angina, 2) spasm, as in variant angina, and 3) thrombosis, usually in combination with "physiologic" changes in tone or with spasm, or both, as in unstable angina. The mechanisms of spasm, as typically observed in variant angina, are different from those of "physiologic" increase of tone; they appear to be related to a local alteration that makes a segment of coronary artery hyperreactive to a variety of constrictor stimuli causing only minor degrees of constriction in other coronary arteries. The nature of this abnormality, which may remain stable for months and years, is yet unknown. PMID- 3543092 TI - Comparison of diltiazem and nifedipine alone and in combination in patients with coronary artery spasm. AB - Fifteen patients with coronary artery spasm completed a double-blind placebo controlled trial comparing diltiazem and nifedipine. Increasingly, higher daily doses (diltiazem, 90 to 360 mg; nifedipine, 30 to 120 mg) were administered to achieve optimal clinical effects. Daily diaries and ambulatory electrocardiographic recordings were used to assess efficacy and side effects. Both drugs significantly decreased angina frequency compared with that in the preceding placebo period (diltiazem 1.4 +/- 0.4 [mean +/- SEM] to 0.4 +/- 0.2 episodes per day; nifedipine 1.4 +/- 0.3 to 0.4 +/- 0.1 episodes per day; both p less than 0.05). Ambulatory electrocardiographic recordings showed fewer ST shifts than were expected during all treatment periods (0.02/h recorded during placebo, none during diltiazem and 0.02/h during nifedipine therapy). Although some patients responded better to one drug than the other, neither drug resulted in a clearly superior clinical response. Diltiazem was discontinued in one patient because of urticaria, but the total number of side effects was higher with nifedipine (12 of 15 patients) than with diltiazem (5 of 15, p less than 0.01). Nine patients remained symptomatic on single drug treatment and entered open label treatment with the combination of diltiazem and nifedipine. Three patients did not tolerate the combination because of important side effects; the other six also had side effects, but these were relatively minor. Four patients received no more benefit from the combination than from a single agent; the condition of two patients improved. Both diltiazem and nifedipine provide effective antianginal therapy for coronary spasm, but diltiazem has fewer side effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543094 TI - The IgE-mediated late-phase skin response--unraveling the enigma. PMID- 3543093 TI - Long-term indoramin therapy in congestive heart failure: a double-blind, randomized, parallel placebo-controlled trial. AB - Twenty-one patients with moderately severe congestive heart failure participated in a double-blind, randomized, parallel placebo-controlled trial designed to evaluate the effects of long-term (2 months) indoramin therapy on rest and exercise hemodynamics, exercise capacity and clinical status of patients with this clinical syndrome. The long-term administration of indoramin in patients (mean dose 50 mg every 12 hours) caused a mild reduction from baseline values in supine rest mean systemic blood pressure and, after dosing, elicited a significant reduction in systemic and pulmonary vascular resistances, pulmonary capillary wedge pressure and heart rate as well as a mild increase in stroke volume. Long-term indoramin therapy caused a small decrease, as compared with baseline exercise responses, in systemic and pulmonary vascular resistance and pulmonary capillary wedge pressure at submaximal levels of exercise. It did not alter hemodynamic variables at maximal exercise, exercise capacity or overall clinical status, compared with findings at baseline or with placebo. PMID- 3543096 TI - Hospital based home care units. PMID- 3543098 TI - [Intraocular injections of antibiotics or antifungal agents in the treatment of severe eye infections]. PMID- 3543097 TI - [Intraocular penetration of collyria]. AB - Some ophthalmic solutions activity is localized at the eye's surface: they are used to manage conjunctivitis and keratitis. Some others must penetrate the eye. They are carried through the cornea. There are many factors allowing the penetration into the cornea. These factors will be studied in this paper. Bio physical and bio-chemical actions are both numerous and complex. IN CONCLUSION: the different corneal tissues have a selective solubility to ophthalmic solution components. PMID- 3543095 TI - Methacholine responsiveness increases after ultrasonically nebulized water but not after ultrasonically nebulized hypertonic saline in patients with asthma. AB - Airway obstruction can be induced in patients with asthma by the inhalation of ultrasonically nebulized aerosols of nonisotonic solutions. It is the change in osmolarity of the periciliary fluid that is believed to be the stimulus for bronchoconstriction. However, it is not known whether hyperosmolar and hypo osmolar aerosols induce asthma via the same mechanism. We have previously reported that patients with asthma have a reduction in the dose of provoking agent that induces a 20% fall in FEV1 (PD20) for methacholine after challenge with nebulized water. To determine whether hyperosmolar aerosols also increase sensitivity to methacholine, we studied 13 subjects with asthma on 3 days. On day 1, the PD20 to methacholine was determined. On day 2, a challenge with nebulized 4.5% saline was followed by a challenge with methacholine 40 to 60 minutes later. On day 3, a challenge with nebulized water was followed by a methacholine challenge. Sensitivity to methacholine was significantly increased after water (p less than 0.02) but not after 4.5% saline. Furthermore, there was no relationship between the PD20 to water and to 4.5% saline. When the Spearman's correlation coefficient was used to compare sensitivity to the challenges, there was a significant relationship between the PD20 to 4.5% saline and methacholine (p less than 0.01) but not between the PD20 to water and methacholine. These results suggest that the mechanism of asthma induced by hyperosmolar and hypo-osmolar solutions is different. PMID- 3543099 TI - [Acute ischemia of the optic nerve after retrobulbar injection]. AB - The authors present a case of acute amaurosis following a retrobulbar injection of anaesthetic. The patient was a mononephric subject in hemodialytic treatment receiving, therefore, a daily therapy by heparin. The ophthalmoscopic feature reveals a pale optic disk oedema, normal arteries and tortuous veins; the fluorescein angiography confirms the papillary oedema and the normal arterial fillings. The echographic picture shows an hematic collection through the nerve sheath. The authors analyze the main pathogenic hypothesis of the amaurosis which should be ascribed to an acute ischemia of the disk caused by the hematoma formed through the nerve sheath. The role of the general conditions of the patient, mononephric in hemodialytic treatment, is emphasized as a possible risk factor even for a retrobulbar injection. PMID- 3543100 TI - [The assisted-diagnosis by identification program, an expert system for acquired ocular hypertension in adults]. AB - Computer Aided Diagnosis by Identification packages are expert systems which proceed by iterative comparisons sign by sign between patient's cases and data encased in their clinical memory. They draw straight forward inference from thought processes analyses that lead to diagnosis: comparison between patient's own case report and acquired identified situation, error factors: ignorance or non-performance and, lastly rules to subscribe to: perfect knowledge of every kind of glaucoma and for every kind, perfect knowledge of every sign. Formalization of the problem specifies the algorithm, the miscellaneous solutions: single hypothesis and multiple hypothesis, and their respective values. In order to build up the clinical library, literature search is required to be comprehensive: treaty, reviews, papers, communications and personal case reports. Outputs are retrieved in an average time-lag of 15 seconds, and are expressed as a list from which only the physician can make out the meaning. PMID- 3543101 TI - [Retinal electrophysiology. Study of the macula]. PMID- 3543102 TI - [Acute fatty liver of pregnancy]. AB - The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy. A pre-icteric phase usually precedes the jaundice and during that time there is usually vomiting and/or nausa with abdominal pain or anarexia. In 92 per cent of case there is transient loss of consciousness with hepatic encephalopathy. Further tests show that there is more defective liver function than would be expected from the extent of cell lysis; and there is defective renal function. The worst complications are intestinal haemorrhages (48 per cent of cases)--genital bleeding (43 per cent of cases)--shock--diffuse intravascular coagulation and complications associated with coma. Maternal mortality at present runs at 25 per cent and fetal mortality at 60 per cent. The condition does not recur. Early evacuation of the uterus is recommended by most authors and does probably improve the outlook. The various hypotheses concerning the aetiology are discussed. PMID- 3543103 TI - [Familial incidence of ovarian cancer]. AB - The present study reports just 4 cases of cancer of the ovary which occurred in 3 families with a history of cancer of the ovary. The authors reviewing the literature of the last 15 years have tried to indicate the present status of knowledge of the features of ovarian familial cancer. At present, as there are no specific enzymatic, immunological, reliable genetic markers nor screening tests, the only prophylaxis that is available is bilateral oophorectomy. As the epithelium of the ovary and of the peritoneum are embryologically derived from the same sources, this prophylactic procedure cannot completely abolish the risk of the development of cancer of the peritoneum in these families. PMID- 3543105 TI - [Primary hyperparathyroidism and pregnancy. Study of a case and review of the literature]. AB - Primary hyperparathyroidism is rarely diagnosed during pregnancy. The authors report a case occurring in a patient of 32 years of age, which was diagnosed in the fourth month of pregnancy because of the appearance of acute hypercalcemia. The outcome was good after a parathyroid adenoma had been removed. There was no hypocalcemia after the operation in the mother and when the child was born at term its calcium levels were normal. A review of the literature shows how the diagnosis can be made of primary hyperparathyroidism in pregnancy and how the discovery of the condition has evolved and that surgery should be carried out in the second trimester of the pregnancy to lessen the maternal and fetal morbidity. PMID- 3543104 TI - [The French physician and judge confronting the transsexual in 1986. I. The position of French and foreign jurisprudence]. AB - The authors have searched through French and western jurisprudence about transsexualism. Thanks to their experience of how judges and magistrates have reacted they have been able to analyse the evolution of attitudes and the present day attitudes to the subject and how the condition should be treated and viewed by the law. There are only a relatively few numbers who wish to change sex but these are estimated at 1 in 50,000 to 1 in 100,000 according to different statistics. The proportion of males who want to change is 3 times greater than of females. The fact that transsexualism is a phenomenon much more often found in North America, in North Europe and in the West, and almost not at all in the third world or in socialist countries, or in the Mediterranean basin, makes one think that this is a syndrome connected with a legal attitude that allows people to dispose of their bodies in the way they wish. This in turn derives from the European Convention of the Rights of man as against those found in the legislation of individual nations in the community. The French legal system is justified in being cautious, seeing how hesitant lawyers are and how extremely prudent the French medical corps is. The reserve of jurisprudence in the U.S.A. and Canada (with the exception of two provinces) and a certain hesitation about the indications for medical treatment to convert from one sex to the other voiced by the principal pioneers of such treatment in the U.S.A. together with the absence of specific laws which cover surgical treatment and the change in the legal state (with the exception of Sweden and the Federal Republic of Germany) is to be taken along with the check that Italian law has placed on the operation recently, in 1982. As far as French law is concerned, Mme M.L. Rassat has carried out a recent and very pertinent study which makes it possible to analyse the attitude of magistrates, which until 1975 was basically very restrictive as far as demands for change in civil sex was concerned. Recently, however, they have become laxer but the Appeal Court strictly refuse to recognise the idea of psychological or psychosocial sex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543106 TI - Toe transfer to the vessels of the reversed forearm flap. AB - A 23-year-old man had a severe degloving injury of his hand, amputation of multiple fingers, and devascularization of the thumb. Primary care consisted of successful revascularization of the thumb and skin grafting of the hand. Secondary soft tissue reconstruction of the hand was done with a reverse forearm flap. This was followed by second-toe transfer to the hand, with the recipient vessels, the radial artery, and the venae comitantes of the reverse forearm flap. PMID- 3543107 TI - The hand in metastatic disease. AB - A review of the world literature shows 163 cases of tumors metastatic to the hand; we report three additional cases. The incidence of primary tumors elsewhere metastasizing to the hand is a little more than 0.1%. In over 16% of cases, a tumor of the hand was the first manifestation of a primary tumor elsewhere. The lung is the chief source, followed by the breast and the kidney. The terminal phalanges are the most frequent site of metastasis, followed by the metacarpals and the proximal phalanges. The mechanism of dissemination remains obscure. PMID- 3543108 TI - Fatal bacterial peritonitis secondary to nonobstructive colonic dilatation (Ogilvie's syndrome) in cirrhotic ascites. AB - A cirrhotic woman developed pneumococcal pneumonia with sepsis. Antibiotic therapy initially resulted in defervescence. However, nonobstructive colonic dilatation developed along with fever and clinical deterioration. Abdominal paracentesis and blood cultures revealed Escherichia coli bacterial peritonitis and bacteremia. The patient died. Autopsy revealed massive cecal mucosal ulceration, which was interpreted as the cause of the bacterial peritonitis. PMID- 3543109 TI - Pill-induced esophageal variceal hemorrhage in a patient treated with sclerotherapy. PMID- 3543110 TI - Outbreak of post-measles gastroenteritis due to Shigella dysenteriae type-I in Karsog Tehsil, District Mandi (H.P). PMID- 3543112 TI - Extensor tendon repair in the emergency department. AB - Extensor tendon lacerations of the hand are commonly seen in the emergency department. These injuries can often be definitively managed by the emergency physician who has a working knowledge of the complex extensor mechanism anatomy plus basic surgical skills. A thorough initial assessment including a tourniquet examination for adequate exposure is the key to making the complete diagnosis. Surgical indications, materials, techniques, complications, and postoperative management involved in extensor tendon repair are reviewed. The emergency physician's decision to treat or refer these injuries will depend greatly on the clinical setting, familiarity with the procedure, and the availability of and relationship with appropriate consultants. PMID- 3543111 TI - Anaphylaxis after intravenous corticosteroid administration. AB - Anaphylactic reaction to corticosteroids is an uncommon occurrence. Described is such a reaction resulting in cardiopulmonary collapse in a 66-year-old asthmatic treated with intravenous methylprednisolone. Awareness of this entity will allow for prompt and successful therapy. PMID- 3543113 TI - Therapeutic and toxic effects of digitalis: William Withering, 1785. AB - William Withering's classic description of the effects of digitalis was published in 1785. Although he was largely unaware of the drug's cardiac effects, he successfully treated many patients with congestive heart failure. He also recorded many striking examples of digitalis toxicity. This review highlights Withering's experience with "the foxglove," and summarizes modern concepts of digitalis efficacy and toxicity. PMID- 3543115 TI - Medical museum notes (Dr. John Dalton Stewart and Olga Petrova). PMID- 3543114 TI - Management of urgent hypertension: a comparison of oral treatment regimens in the emergency department. AB - Urgent hypertension is defined by severe elevations of blood pressure without associated end-organ damage. The use of parenteral agents for this entity entails intensive monitoring and the potential for significant hemodynamic complications. Therefore, various oral regimens have been studied. Herein described are mechanisms of action, pharmacokinetics, clinical efficacy, and side effects of oral agents used in the treatment of urgent hypertension. PMID- 3543116 TI - Examination of IgA1-protease activity in Bordetella. AB - A total of 43 strains of bacterial genus Bordetella was studied as to the possible extracellular enzyme production responsible for Al-immunoglobulin cleavage. This was observed to be cleaved by 9 of 21 controlled strains of B. pertussis, one of 15 strains of B. parapertussis, and one of 7 strains of B. bronchiseptica. No cleavage of G and M human immunoglobulin classes by protease positive strains of B. pertussis was evaluated. The immunochemical method altogether with polyacrylamide gel electrophoresis (PGE) with sodium dodecyl sulphate (SDS) were used to assess the IgA1 cleavage products bordetella and several compounds belonging to the heavy chain fragments were revealed. The obtained data allowed us to make a presumption that the cleavage sites of peptide chain for bordetella and meningococcal proteases were different ones. PMID- 3543118 TI - Polyclonal B cell activation by a B cell differentiation factor, B151-TRF2. III. B151-TRF2 as a B cell differentiation factor closely associated with autoimmune disease. AB - We demonstrated previously that B151K12 T cell hybridoma produces two distinct B cell differentiation factors, B151-TRF1 and B151-TRF2, capable of inducing differentiation of antigen-activated and unstimulated B cells into antibody forming cells, respectively. In the present study we investigated the pathophysiologic relation of these factors with factors obtained from MRL/MP lpr/lpr(MRL/lpr) mice and (C57BL/6 X DBA/2)F1 (BDF1) mice undergoing chronic graft-vs-host reaction (GVHR), representing a murine model of systemic lupus erythematosus with polyclonal B cell activation associated with the T cell hyperfunction. The functional and biochemical analyses revealed that B151-TRF2 like, but not B151-TRF1-like, activity was found in culture fluid supernatant (CFS) of lymphoid cells from MRL/lpr mice with lymphoproliferative syndrome. On the other hand, both B151-TRF1- and B151-TRF2-like activities were detected in CFS prepared from spleen cells of BDF1 mice undergoing chronic GVHR by the inoculation of parental DBA/2 spleen cells. Interestingly, spleen cells of BDF1 mice transferred with DBA/2 thymocytes preferentially elaborated B151-TRF1-like factor. Because BDF1 mice transferred with DBA/2 spleen cells but not with DBA/2 thymocytes developed a SLE-like syndrome exemplified by the appearance of Coombs' antibody and proteinuria, it seemed likely that production of B151-TRF2-like factor was closely associated with the onset of autoimmune disease. In fact, B151 CFS containing B151-TRF2 but not B151-TRF1 activity could induce a striking autoantibody production both in vivo and in vitro as detected by PFC responses of normal mice to bromelain-treated mouse red blood cells (BrMRBC). Moreover, it was demonstrated that in vitro anti-BrMRBC PFC responses induced by semipurified B151 TRF2 was markedly inhibited by addition of relevant anti-Ia antibody to the culture. Thus, the present study demonstrates that B151-TRF2 represents one of the B cell differentiation factors responsible for polyclonal B cell activation leading to autoantibody production. PMID- 3543117 TI - Lymphoid tissue- and inflammation-specific endothelial cell differentiation defined by monoclonal antibodies. AB - Endothelial cells play an essential role in immune responses by regulating the entry of leukocytes into lymphoid tissues and sites of inflammation. As an initial approach to analyzing endothelial cell specialization in relation to such immune function, we have produced monoclonal antibodies (MAB) against mouse lymph node endothelium. Three antibodies were selected: MECA-20, recognizing the endothelium of all blood vessels in lymphoid as well as non-lymphoid organs; MECA 217, which stains the endothelium lining large elastic arteries, but among small vessels is specific for post-capillary venules within lymphoid organs and tissues exposed to exogenous antigen, such as skin and uterus; and MECA-325, an antibody that demonstrates specificity for the specialized high endothelial venules (HEV) that control lymphocyte homing into lymph nodes and Peyer's patches. MECA-325 failed to stain vessels in any non-lymphoid organs tested. Immunoperoxidase studies of HEV in lymph node frozen sections, and of isolated high endothelial cells in suspensions, demonstrated that the antigens recognized by all three antibodies are expressed at the cell surface; those defined by MECA-20 and MECA 325 are also present in the cytoplasm. To study the regulation of the antigens defined by these MAB in relation to extra-lymphoid immune reactions, we assessed their expression in induced s.c. granulomas as a model for chronic inflammation. Small vessels in the granulomas were already stained by MECA-217 in the first days of development. In contrast MECA-325 detected postcapillary venules (which frequently displayed the morphologic characteristics of HEV) only from approximately 1 wk, in parallel with the development of a persistent mononuclear cell infiltrate including numerous lymphocytes. The selective appearance of the MECA-325 antigen on vascular endothelium supporting lymphocyte traffic in both lymphoid and extra-lymphoid sites suggests that this antigen may play an important role in the process of lymphocyte extravasation. The demonstration of lymphoid organ- and inflammation-specific microvascular antigens offers direct evidence for a complex specialization of endothelium in relation to immune stimuli, and supports the concept that microvascular differentiation may play an important role in local immune responses. PMID- 3543119 TI - T15 group A streptococcal Fc receptor binds to the same location on IgG as staphylococcal protein A and IgG rheumatoid factors. AB - Previous work has shown that IgG rheumatoid factors (RF) bind to the C gamma 2-C gamma 3 interface region of human IgG in the same area that binds staphylococcal protein A (SPA). Group A, C, and G strains of Streptococci possess Fc receptors that bind to IgG but not to fragments containing only the C gamma 2 or C gamma 3 domains. This work describes the binding site location on human IgG for the binding of the isolated Fc receptor from the T15 strain of a Group A streptococcus and its relationship to the site that binds SPA and the IgG RF. The isolated T15 Fc receptor (T15) with a molecular mass of 29.5 kD inhibited the binding of IgG RF to IgG. The binding of T15 itself to IgG was strongly inhibited by SPA (42.0 kD) and its monovalent fragment D (7 kD). Human IgG fragments consisting of the C gamma 3 domains did not inhibit the binding of T15 to IgG, whereas those with both domains were effective inhibitors. T15 did not bind to rabbit IgG fragments consisting of either the C gamma 2 or C gamma 3 domains, but did bind to those with both domains. An IgG3 myeloma protein was a poor inhibitor and has been shown to bind poorly to the IgG RF. Most IgG3 myeloma proteins did not bind to SPA. The substitution of Arg and Phe for His 435 and Tyr 436 is responsible for the poor binding of IgG3 to SPA and to the IgG RF. Chemical modification of His or Tyr on IgG reduced its ability to inhibit the binding of T15 to IgG. Reversal of the chemical modifications with hydroxylamine resulted in near complete restoration of inhibitory capacity. This information, collectively, coupled with the known positions in space of the His and Tyr residues in the C gamma 2-C gamma 3 interface region, verified that both His 435 and Tyr 436, and possibly His 310 and 433, are involved. These residues are also involved in binding SPA and the IgG RF. These data therefore indicate that the T15 Group A Streptococcal Fc receptor binds to the same location on the Fc of IgG as SPA and the IgG RF. The biologic relevance of these similarities between bacterial cell wall Fc receptors and IgG RF are not yet apparent, but suggest that RF could bear the internal image of these bacterial structures. PMID- 3543120 TI - Defective differentiation of natural killer cells in SJL mice. Role of the thymus. AB - As previously shown, three distinct phenotypes exist in murine natural killer (NK) cell activity when it is evaluated by the endogenous levels of activity and the susceptibility to augmentation by interferon (IFN) and IFN inducers. The "low" phenotype has low levels of activity which can be poorly augmented by IFN, as in mice of SJL strain. The "inducible" phenotype exhibits low endogenous levels but can vigorously respond to IFN-mediated augmentation, as in A.SW strain. The "high" NK phenotype shows high levels of endogenous activity which can be augmented to still higher levels by IFN, as in B10.S mice. Since SJL mice with congenital absence of the thymus (nude) were of the inducible type, the effect of neonatal thymectomy was examined in the present study. Neonatal thymectomy was found to convert the low phenotype of SJL mice to the inducible, mimicking the effect of nu/nu genotype. Thymectomy as late as 25 days after birth was effective, but retransplantation of a syngeneic newborn or adult thymus, or thymocytes, failed to reverse the effect of thymectomy. The poor responsiveness of NK activity to IFN in SJL, therefore, is extrinsic to the NK cell lineage and is attributable to suppression or maturational block of NK cell differentiation by the thymus during the first few weeks of neonatal life. A series of experiments with bone marrow chimeras showed that the SJL recipients did not allow the expression of inducible or high phenotype by bone marrow progenitors from allogeneic donors with either phenotype. Therefore, the SJL recipients provide an environment which suppresses not only the development of IFN-sensitive NK cell precursors, but also the levels of endogenous NK cell activity. SJL bone marrow cells gave rise to NK activity of inducible phenotype in B10.S recipients, confirming the crucial role of the environment in which NK cell differentiation takes place. PMID- 3543121 TI - Class I-like MHC molecules expressed by baboon placental syncytiotrophoblast. AB - Human placental villous trophoblast is known to be unreactive with W6/32 and other monoclonal antibodies recognizing monomorphic determinants of human class I MHC heavy chains, whereas extravillous cytotrophoblast in the placental bed is W6/32-reactive by immunohistology. We have now demonstrated, in contrast, that syncytiotrophoblast is the only cellular component of baboon early placental villous tissue which is reactive with any of these antibodies. Radioimmunoprecipitation of detergent-solubilized baboon placental membrane preparations, and subsequent SDS-PAGE, has shown the W6/32-reactive component to have an m.w. of 41,000 and to be associated with beta 2-microglobulin, whereas baboon peripheral lymphocytes express 45,000 m.w. W6/32-reactive antigens comparable with the HLA-A,B,C heavy chains of human lymphocytes. PMID- 3543122 TI - Characterization of a novel murine T cell-activating factor. AB - Purified resting peripheral lymph node T cells can be activated to produce interleukin 2 (IL 2) and to proliferate in the presence of Concanavalin A (Con A) and an apparently novel lymphokine that we call T cell activating factor (TAF). TAF is biochemically distinct from IL 1, IL 2, IL 3, and other colony stimulating factors, IL 4 (BSF-1) and interferons. Furthermore, of the recombinant and natural cytokines tested, only IL 2 and TAF are active in the TAF assay. In the presence of Con A, TAF stimulates an increase in the steady-state level of IL 2 mRNA in T cells, the secretion of active IL 2 into the culture medium, and the proliferation of the T cells. We propose that TAF is a previously undescribed molecule the function of which is to stimulate IL 2 production by T cells that have encountered antigen, and we propose that TAF has an important role in primary T cell immune responses. PMID- 3543123 TI - Association with beta 2-microglobulin controls the expression of transfected human class I genes. AB - The genes encoding HLA-B27K and HLA-B27W were transfected into murine recipient cells. A monoclonal antibody HC-10, directed against free B-locus heavy chain, was the only reagent capable of efficiently detecting the HLA-B27 heavy chains in detergent lysates. These heavy chains were devoid of sialic acid. Trace amounts of HLA-B27 could be isolated with the anti-HLA-A,-B antibody W6/32, which reacts with the heavy chain beta 2-microglobulin complex. In marked contrast, HLA-A2 and -B7 genes, when transfected, yielded easily detectable amounts of antigen precipitable with W6/32, which carried the usual complement of sialic acids. Because the alpha 3 domains of HLA-B27 and HLA-B7 and the more COOH-terminal portions are identical in amino acid sequence, structural elements in the polymorphic alpha 1 and alpha 2 domains must control association of heavy chain with beta 2-microglobulin. Introduction of a human beta 2-microglobulin gene into L cells transfected with the HLA-B27 gene rescued the expression of HLA-B27 at the cell surface, as evidenced by reactivity with W6/32, surface staining, and the presence of sialic acid on the heavy chain. PMID- 3543124 TI - Use of a DNA probe to measure the neutralization of Plasmodium berghei sporozoites by a monoclonal antibody. AB - A specific DNA probe has been used to quantify the neutralizing effects of monoclonal antibodies (3D11) against the circumsporozoite protein of Plasmodium berghei sporozoites. The amount of parasite DNA was measured in the livers of Norway Brown rats at the peak of proliferation of the exoerythrocytic forms (EEF). In vitro treatment of 1.5 X 10(5) sporozoites with 0.36 microgram/0.5 ml of whole 3D11 IgG neutralized about 90% of the sporozoite infectivity. When the dose was 3.6 micrograms no signal was detected, indicating that less than ten sporozoites developed into EEF in the liver. In contrast, 3.6 micrograms of Fab obtained from 3D11 neutralized sporozoite infectivity by only 60%. Although the neutralizing effect of 3D11 was very marked, the infected rats developed parasitemias after a prolonged delay in patency, suggesting that a small proportion of sporozoites was resistant to the effects of 3D11. The sporozoites were subjected to four cycles of 3D11-mediated selection, each one involving treatment of sporozoites with the antibodies, injection of the mixture into rats, infection of hamsters with blood stage parasites obtained from the rats, feeding of Anopheles stephensi on these hamsters, and obtaining sporozoites from the salivary glands of the infected mosquitoes. After four cycles of selection, the susceptibility of the resulting sporozoites to different concentrations of 3D11 was compared with that of nonselected sporozoites. No differences were detected, indicating that the capacity of a few sporozoites to escape the neutralizing effect of 3D11 antibodies is not inherited. PMID- 3543125 TI - Spontaneous deletion at the B2m locus: evidence for site-specific genetic rearrangement. AB - We have isolated 20 independent spontaneous mutants in the B2mb allele from a B2ma/b heterozygous murine cell line by immunoselection in vitro with a monoclonal antibody directed against the product of the B2mb allele. One class of mutants has undergone a deletion in the 5' end of the B2mb gene. The deletions appear to be identical in all of the independent clones, and extend an unknown distance upstream of the B2m gene from a region in the first intron. Southern blot analysis with the use of oligonucleotides to the wild type gene sequence mapped the breakpoint to within 39 base pairs. The high frequency of independent spontaneous mutants showing indistinguishable deletions suggests that the first intron of the B2m gene contains sequences that are highly susceptible to site specific recombinations. PMID- 3543127 TI - Cell surface molecules involved in NK recognition by cloned cytotoxic T lymphocytes. AB - Short-term treatment of cloned mouse cytotoxic T lymphocytes (CTL) with interferon (IFN) induces lytic activity for natural killer- (NK) sensitive targets. Extended culture of CTL in high concentrations of interleukin 2 induces promiscuous lytic activity in which state both NK-sensitive and NK-resistant target cells are lysed. Cold-target competition analysis showed that the development of NK activity was associated with the acquisition of binding activity for NK-sensitive but not for NK-resistant targets, whereas the development of promiscuous lytic activity was associated with the acquisition of binding activity for both types of target. Antigen-specific cytolysis was inhibited by antibodies to Ly-2, Ly-5, LFA-1 and to the V region of the T cell antigen receptor (TCR), whereas NK and promiscuous lytic activity in the same cells was resistant to inhibition by anti-Ly-2 and anti-TCR. NK activity was expressed normally against a variant NK-sensitive cell line lacking all MHC antigens. These results show that, in contrast to antigen-specific recognition, the NK and promiscuous lytic activities of CTL are expressed without participation of effector cell Ly-2 and TCR molecules or target cell MHC molecules, and are most likely mediated through novel and distinct receptor systems. PMID- 3543128 TI - Regulation of I-A expression by murine peritoneal macrophages: differences linked to the Bcg gene. AB - We previously reported that Mycobacterium bovis (strain BCG) induces continuous I A expression when injected into BCG-resistant strains of mice. We have extended this observation by showing that Corynebacterium parvum also induces continuous I A expression by macrophages from BCG-resistant but not BCG-susceptible mice. We have linked continuous expression to BCG resistance by using C.D2Ityr mice, which are congenic with BCG-susceptible BALB/c mice except for genes on a portion of chromosome 1, which contains the gene(s) for BCG resistance. Macrophages from C.D2Ityr mice continuously expressed I-A, whereas macrophages from BALB/c mice transiently expressed I-A. Continuous expression by macrophages from both Bcgr and Bcgs mice could be induced in vitro with rIFN-gamma. However, the continuous expression of I-A by macrophages from Bcgs mice required the continued presence of IFN-gamma, whereas that by Bcgr macrophages did not. The continuous expression of I-A by macrophages from Bcgs mice was also inhibited by hydrocortisone, cyclohexamide, tunicamycin, and monensin, whereas I-A expression by Bcgr macrophages was not affected. The continuous expression of I-A by macrophages from Bcgr mice did not require its continued synthesis. The significance of these findings to the induction of immunity and to antimicrobial resistance are discussed. PMID- 3543129 TI - A peripheral and central T cell antigen recognized by a monoclonal thymocytotoxic autoantibody from New Zealand black mice. AB - Naturally occurring thymocytotoxic autoantibodies (NTA) have been suggested to be the cause of thymic atrophy and T cell disorders in human and murine lupus. Definitive studies on NTA's role in the induction of SLE, however, have been lacking due to the lack of a pure source of NTA. Although it is clear that NTA are a heterogeneous group of antibodies, the nature of their antigens has remained obscure. We report the characteristics of a monoclonal NTA, designated SAG-3, which appears more reflective of the activities previously reported of serum NTA than other NTA-secreting clones. SAG-3 is an IgM autoantibody cytotoxic for 80 to 90% of thymocytes, 20 to 25% of splenic lymphocytes, 25 to 30% of lymph node cells, and less than 3% cortisol-resistant thymocytes, bone marrow, and fetal liver cells. SAG-3 is murine-specific without reactivity towards rat, hamster, or guinea pig, and appears very early in thymic development, on day 17 fetal thymocytes. SAG-3 is equally cytotoxic against several strains of mice, including both Thy-1.1 and Thy-1.2 allotypes, and the cytotoxicity is absorbed by brain but not liver cells. Reactive thymocytes occurred throughout the cortical regions of the thymus, indicating preferential affinity towards immature thymocytes. Although the serologic activities of SAG-3 suggest that Thy-1 alloantigen is its target, SAG-3 antigen is found to be distinct from Thy-1 and also from Lyt-1, Lyt-2, or L3T4 antigens. The binding of SAG-3 to thymocytes could be competitively inhibited by NTA-positive NZB sera. PMID- 3543126 TI - CTL adhesion and antigen recognition are discrete steps in the human CTL-target cell interaction. AB - Th initial step in cytolytic T lymphocyte (CTL)-mediated cytolysis involves target cell adhesion and antigen recognition. To investigate these initial events in the CTL-target interaction, we used HLA-A2- and HLA-B7-specific human CTL clones and HLA-typed B lymphoblastoid target cells. By using two different adhesion assays, we demonstrated antigen nonspecific CTL-target cell adhesion. To more precisely define the contribution of the antigen-specific receptor to CTL target cell adhesion, we used the HLA-A2, HLA-B7, and mock transfected RD target cells. Consistent with the results when using B lymphoblastoid target cells, the CTL clones demonstrated equivalent adhesions to the RD target cells whether or not they expressed HLA-A2 or HLA-B7. These results suggested that CTL-target cell adhesion occurred independent of the T cell receptor. By using the calcium sensitive dye Indo-1 and flow cytometry, we assessed CTL-target cell adhesion and CTL activation. Simultaneous measurement of adhesion and intracellular free calcium demonstrated that CTL-target cell adhesion alone did not activate CTL clones. Both CTL-target cell adhesion and the presence of the appropriate HLA target molecule were necessary for the efficient activation of human CTL. MAb inhibition studies indicated that antigen nonspecific adhesion is largely regulated by the LFA-1, CD2 (LFA-2/T11), and LFA-3 cell surface molecules. These antigen nonspecific cell-cell interaction molecules appear to play an important role in facilitating antigen recognition and subsequent target cell lysis. PMID- 3543131 TI - Identification of specific and cross-reactive antigens of Leishmania donovani chagasi by human infection sera. AB - Cloned Leishmania donovani chagasi (Ldc) promastigotes were analyzed by SDS-PAGE separation and immunoblotting with human infection sera. The patterns of antigen reactivity were compared by using sera from individuals with Ldc, Leishmania mexicana amazonensis (Lma), Trypanosoma cruzi, Mycobacterium tuberculosis, or Mycobacterium leprae infections. Sera from individuals with these infections recognized Ldc antigens in several m.w. ranges. Reactivity was due to recognition of Ldc molecules and not to Ldc culture medium components, as shown by comparing Ldc promastigotes grown in the presence or absence of fetal bovine serum (FBS), by immunoblotting of FBS, and by [35S]methionine labeling. The major findings of the study were as follows. Immunoblots with Ldc promastigotes could be used to distinguish individuals with Ldc infections from those with Lma infections. Persons with Ldc infections had antibodies to a Ldc antigen of approximately 32 to 35 kd not recognized by persons with Lma infections. Individuals cured of acute Ldc infection did not develop antibodies that differed in specificity to those present during their acute phase of infection. Ldc antigens in the 62 to 66 kd region were recognized by all individuals with Ldc or Lma infections but were not recognized by individuals in the other disease groups or by control sera. This region was found to contain at least four distinct bands, one of which appeared to be glycosylated as indicated by periodic acid-Schiff staining and concanavalin A labeling; an apparently nonglycosylated protein of 62 to 63 kd was eluted from SDS-PAGE gels and was used to diagnose Ldc infection by the ELISA. Whereas crude Ldc antigen gave false positive results with T. cruzi and mycobacteria infection sera, the eluted 62 to 63 kd protein was 100% specific and sensitive in the diagnosis of Ldc infection. PMID- 3543130 TI - Structural and antigenic characterization of a species- and promastigote-specific Leishmania mexicana amazonensis membrane protein. AB - A Leishmania mexicana amazonensis promastigote membrane glycoprotein (Mr 46,000) expressing the species-specific and promastigote-specific epitope of monoclonal antibody IX 2H7-E10(M-2) has been purified to homogeneity, and studies have been made to determine the minimum peptide fragment that retained antigenic activity. Peptide mapping experiments performed with the metabolically labeled or surface radioiodinated protein illustrated its highly folded nature and marked resistance to proteolytic digestion. The M-2 epitope was readily destroyed by limited proteolysis and/or reduction and alkylation, indicating disulfide bond involvement in its formation by at least the secondary protein structure. The stability of approximately half of the molecular mass of the protein (46kDa/M-2) was also dependent on disulfide bonding. Enzymic digests under various conditions generated a glycopolypeptide (Mr 22,000 to 27,000), extremely resistant to further enzymic digestion, that was the dominant immunogenic portion of the purified protein recognized by a specific rabbit heteroserum. No smaller or larger fragments were antigenic. Data obtained by using the radioiodinated hydrophobic probe 3-(trifluoromethyl)-3-([m-125]iodophenyl)-diazirine ([125I]TID) indicate that 46kDa/M-2 is an integral membrane protein with a component polypeptide (Mr 23,000 to 27,000), highly resistant to further enzymic cleavage and containing sequences within the external promastigote membrane. Data indicate that the [125I]TID-labeled fragment is identical to the immunodominant fragment. We suggest that hydrophobic interactions maintain the integrity of this fragment as amino acids within it fold through the parasite membrane. PMID- 3543132 TI - Monocytes accumulate on Rebuck skin window coverslips but not in skin chamber fluid. A comparative evaluation of two in vivo migration models. AB - Migration of leukocytes into an inflammatory site is an important step of host defense. The Rebuck skin window and the skin blister chamber technique allow study of the dynamics of the inflammation in vivo. The type of inflammation is basically different in each of these methods. Whereas the former technique provokes a late monocytic response, the latter technique provokes virtually no monocyte accumulation. the difference between these two types of inflammation has never been systematically studied. We describe a skin blister chamber technique with a novel multiwell device which allows the observation of cell accumulation under different conditions, i.e., in presence and in absence of a foreign body (coverslip). This method proved simple and reproducible with variability among volunteers exceeding variability of replicate chambers within a given subject. Furthermore, it confirms that no monocytes accumulate in blister chambers during the first 20 h of inflammation, whereas monocytes accumulate on skin window coverslips within the first 6 h of inflammation. Control experiments show that the continuous presence of the coverslip in the skin window is the critical element provoking accumulation of monocytes. A different degree of neutrophil degranulation in presence and absence, respectively, of a foreign body may be responsible for the different types of inflammatory response. PMID- 3543133 TI - A sensitive enzyme immunoassay for anti-thyroglobulin antibody using Fab' horseradish peroxidase conjugate. Evaluation of in vitro anti-thyroglobulin antibody synthesis by lymphocytes from patients with autoimmune thyroid disease. AB - A sensitive enzyme immunoassay (EIA) for the detection of anti-thyroglobulin (Tg) antibodies was developed using Fab'-horseradish peroxidase (HRP) conjugate. Anti Tg antibody was assayed by incubation with a thyroglobulin-coated polystyrene ball and then with affinity-purified anti-IgG Fab'-HRP conjugate. The HRP activity was assayed fluorimetrically. The sensitivity was 625 amol/tube and anti Tg antibody levels between 0.5 and 200 ng/ml could be determined. The recoveries of anti-Tg antibody added to human sera at three different concentrations were 94.2-101.0%. Both within- and between-assay coefficients of variation were below 10%. Significant correlation was observed between values by the EIA and TGHA method (Kendall's rank correlation coefficient = 0.712, P less than 0.001). The present EIA for anti-Tg antibody is sensitive enough to determine anti-Tg antibody synthesized in vitro by the lymphocytes from patients with autoimmune thyroid disease and normal subjects. The amounts of anti-Tg antibody synthesized by peripheral lymphocytes from patients with Hashimoto's disease were significantly greater than those from patients with Graves' disease, although serum levels of anti-Tg antibody were usually elevated in both groups of patients. The results obtained suggest that anti-Tg antibody is synthesized in a different manner in patients with Hashimoto's disease and in patients with Graves' disease. PMID- 3543134 TI - Quantitation of cell-surface beta 2-microglobulin (beta 2 m) using a comparative antibody inhibition assay. AB - An improved immunoenzyme assay for measuring cell-surface beta 2-microglobulin (beta 2 m) is presented in which quantitation is achieved by reference to soluble beta 2 m-induced inhibition of horseradish peroxidase-labelled rabbit antibody. Some consideration is given to kinetics of binding and dissociation, and their implications for interpretation are discussed. PMID- 3543135 TI - Methanol fixation permits flow cytometric analysis of immunofluorescent stained intracellular antigens. AB - Fixation and immunofluorescent staining methods were developed for analyzing intracellular antigens with the cell flow cytometer. Fixing cell suspensions with 100% methanol provided best preservation of morphology, lowest fluorescent background staining and most intense specific immunofluorescence. Immunoglobulins present in B cell lines that were representative of different developmental stages could be distinguished quantitatively. Fluorescence histograms were compared with fluorescence microscope presentation of stained cells. Intracellular antigens that reacted with monoclonal antibodies could also be evaluated by flow cytometry. This method was utilized to assess plasmacyte development in mouse spleen cell cultures after stimulation with lipopolysaccharide. PMID- 3543136 TI - Comparison of monoclonal and polyclonal antibodies to cotinine in nonisotopic and isotopic immunoassays. AB - Monoclonal antibodies (McAb) were used to develop nonisotopic and radioimmunoassays (RIA) for quantitative determination of the major nicotine metabolite, cotinine, in physiological fluids. ELISAs and fluorescence immunoassays were carried out in microtiter plate wells coated with a conjugate of cotinine 4'-carboxylic acid bound covalently to poly-L-lysine. The detection systems were horseradish peroxidase (HRP)-labeled staphylococcal protein A, HRP streptavidin-biotin, and biotinylated alkaline phosphatase-4-methylumbelliferyl phosphate. With the three McAb tested, I50 values ranged between 0.024-0.063 ng cotinine and as little as 0.005-0.015 ng gave 15% inhibition. These assays were 5 20 times more sensitive than similar assays using six rabbit antisera. With McAb the standard inhibition curves were steeper and complete inhibition of immune binding was achieved with approximately 1 ng cotinine. In contrast, 100-500 ng cotinine failed to give greater than 80-90% inhibition with rabbit antibodies either in the plate assays or in RIA using a 125I-labeled tyramine derivative of cotinine as the tracer. In this RIA, the sensitivity with McAb (mean I50 of 0.55 ng cotinine) was over three-fold greater than with rabbit antisera (mean I50 of 1.84 ng). The presence of antibodies directed to the amide linkage group common to the polylysine conjugate. 125I-tyramine derivative and the immunogen likely accounts for the inferior quality of assays using rabbit antisera. Consistent with this conclusion, superimposable inhibition curves were obtained in the RIA when monoclonal or rabbit antibodies were used with [3H]cotinine. Cotinine levels in saliva, serum and plasma from smokers and non-smokers determined with McAb based assays showed a strong correlation with values obtained by RIA using rabbit antisera or by gas chromatography. Properly selected McAb offer distinct advantages over conventional antisera in nonisotopic immunoassays and RIAs for cotinine as a biochemical marker of active or passive smoking. PMID- 3543138 TI - Macrophage involvement in the antitumor activity of a synthetic acyltripeptide (FK-565) against experimental lung carcinoma metastases. AB - Resident peritoneal macrophages can be activated to develop cytotoxicity against P815 mastocytoma target cells following incubation in vitro with either D-lactoyl L-alanyl-gamma-D-glutamyl-(L)-meso-diaminopimelyl-(L)-gl ycine (FK-156), heptanoyl-gamma-D-glutamyl-(L)-meso-diaminopimelyl-(D)-alani ne (FK-565), or bacterial lipopolysaccharide (LPS) at a minimum concentration of 10 micrograms/ml. Subthreshold levels of hybridoma-derived macrophage activating factor (MAF) markedly potentiated this activity. In an experimental metastasis model, subcutaneous or intraperitoneal treatment with FK-565 (1 to 10 mg/kg) markedly inhibited lung metastasis formation when administered 2-4 days prior to i.v. tumor inoculation. Moreover, this protective activity could be abrogated by the selective macrophage inhibitor, 2-chloroadenosine, suggesting that activated macrophage were responsible for the antimetastatic activity of FK-565. PMID- 3543137 TI - Identification of immunoreactive monoclonal antibody fragments for improved immunoscintigraphy. AB - Results obtained in animal models suggest that antibody fragments may have advantages over whole immunoglobulin for in vivo localisation studies. Proteolytic digestion of monoclonal antibodies may however yield a mixture of products unsuitable for in vivo use. This report describes a method whereby the immunoreactive products of antibody digestion can be identified by probing nitrocellulose blots of the gel-separated digest with the specific antigen. Optimum conditions for the production of the reactive fragments can then be determined and once identified they can be purified to homogeneity. Using this method conditions have been defined for the production of F(ab)2 and Fab fragments from a papain digest of an antibody to placental alkaline phosphatase (H17E2). In this case the antigen has enzyme activity which can be used to detect binding to the immunoreactive bands on the Western blots. In vivo experiments in nude mice carrying xenografts of a tumour expressing the H17E2 reactive antigen were performed to determine the efficacy of localisation of the purified fragments as compared to the whole antibody. As expected the absolute levels of radioactivity localised in the tumour was highest using whole antibody, whereas the F(ab)2 fragments produced the highest tumour:blood ratios. PMID- 3543139 TI - Peripheral factors in urinary continence. AB - Urinary continence is dependent upon satisfactory bladder relaxation together with adequate closure of the outflow tract. The former is mainly controlled by the interaction of the cholinergic and adrenergic mechanisms, at both central and peripheral levels. In addition, purinergic nerves, Vasoactive Intestinal Peptide (VIP), and prostaglandins may possibly play a role in the regulation of the detrusor tone. The factors responsible for closure of the outflow tract may be grouped into three local and one extrinsic mechanisms. The distal continence mechanism comprises the peri-urethral pelvic floor striated muscles, which are under somatic neural control. Their function is mainly that of active continence, produced by voluntary contraction. The proximal mechanism is that producing closure of the bladder neck, and is the consequence of the tone and arrangement of the smooth muscle fibres in this region. The intrinsic mechanism acts along the length of the female urethra (or posterior urethra in the male) and is dependent upon the functioning of several constituents of the urethral wall. The tone of both the smooth muscle (lissosphincter) and the striated muscle (rhabdosphincter) in the wall produces a centripetal force which acts upon the inner layers of the urethra, compressing them and producing a hermetic seal. These structures, the mucosa and the cushioning vascular channels in the submucosa, are of particular importance in the female, where they are hormone sensitive. The extrinsic mechanism consists of the transference of intra abdominal pressure rises via the wall of the intra-pelvic urethra, assisted by a simultaneous reflex contraction of the pelvic floor, so as to supplement the already existing closure pressure at the moment of stress.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543140 TI - [Percutaneous drainage in the treatment of kidney abscess. Apropos of 2 cases]. AB - Percutaneous drainage has rapidly become the initial procedure of choice in the treatment of most intra-abdominal and retro-peritoneal abscess. The retro peritoneal location of the urinary tract facilitates a percutaneous approach and has been found to be highly effective. We report 2 cases of successful non operative managements of renal abscess by percutaneous aspirations and systemic antibiotic therapy. PMID- 3543141 TI - [Stenosis of the renal artery as a cause of acute renal insufficiency after transplantation]. AB - Eight cases of kidney transplant recipients that developed acute renal failure are described. Arterial renal stenosis was responsabilised for the ARF. One patient was submitted to transluminar angioplasty without success and then operated. This technique was the successful treatment in another patient. Four patient were submitted to surgical correction as first therapeutic approach. Two patients received no specific treatment. From the six treated patients five had good evolution. PMID- 3543142 TI - [Treatment of hydronephrosis in newborn infants. Apropos of 18 cases diagnosed by antenatal ultrasonography]. AB - Results are reported of therapy of 18 neonates in whom obstetrical ultrasound imaging had demonstrated uni- or bilateral pyelo-caliceal dilatation due to stenosis of pyelo-ureteral junction (18 children--2 hydronephroses). Neonatal biologic, ultrasound and urographic examinations confirmed presence and assessed importance of the hydronephrosis. As a function of findings therapy consisted of immediate operation (10 neonates), delayed surgery (5 cases) or surveillance (3 cases). Severe uni- or bilateral forms, classified stage III or IV were operated upon immediately, sometimes as emergencies. Less severe cases (stage III) were operated upon after 1 to 3 months, and the minor forms (stage II) were the object of simple surveillance. The operative technique used for treatment of the hydronephros was the Andersson-Hynes operation, anastomosis in 9 cases involving microsurgical procedures. Emphasis is placed on the serious nature of these neonatal forms, often bilateral or associated with contralateral uropathy. In utero shunts during the antenatal period are excluded, therapy being decided after birth. Based on their experience, the authors underline the reliability of early microsurgical pyeloplasty which appears to be the operation of choice in neonates at the present time. PMID- 3543143 TI - Neonatal foreskin substrate has limitations for the immunofluorescent screening of monoclonal antibodies. AB - Two monoclonal antibodies to type IV collagen showed a marked decrease in the labeling of the dermal-epidermal junction of neonatal foreskin while the basement membrane around dermal blood vessels was brightly stained. In contrast, these antibodies labeled the junction and dermal blood vessels with approximately equal intensity when adult skin of nonforeskin site was used as substrate. Other antibodies to matrix molecules (bullous pemphigoid antigen, epidermolysis bullosa acquisita antigen, and laminin) showed excellent staining of both the dermal epidermal junction and dermal blood vessels in both neonatal foreskin and adult skin. Further, the ultrastructural appearance of the substrates appeared identical. The implication is that neonatal foreskin is not a good substrate to use for the routine screening of monoclonal antibodies to matrix components by indirect immunofluorescence since a "false negative" evaluation may occur. PMID- 3543144 TI - Mononuclear cell infiltrates in bullous disease. AB - Mononuclear cell subset-specific monoclonal antibodies, indirect immunoperoxidase labeling, and a specific quantification technique were used to determine the constitution of mononuclear cell infiltrates associated with bullous pemphigoid (BP), pemphigus vulgaris (PV), dermatitis herpetiformis (DH), and linear IgA bullous disease, as well as those in normal skin (NS) from healthy adult volunteers. Bullous pemphigoid and PV lesions contain significantly greater numbers of T lymphocytes (p less than 0.001), including both T helper/inducer and T cytotoxic/suppressor subsets, macrophages (p less than 0.002), and Langerhans cells (p less than 0.01), than NS or lesions of DH, supporting the concept that cell-mediated immunity is involved in bulla formation and autoantigen presentation in BP and PV. The infiltrates associated with DH lesions appear to reflect a different mechanism of autoantibody production and bulla formation. PMID- 3543145 TI - Human keratinocytes synthesize and secrete the extracellular matrix protein, thrombospondin. AB - Thrombospondin (TSP) a glycoprotein originally identified as the endogenous lectin of platelets, is also synthesized by fibroblasts, endothelial cells, pneumocytes, smooth muscle cells, and macrophages. Thrombospondin is subdivided into functional domains which bind specifically to heparin, fibronectin, collagen, and to specific cellular receptors. It is found within the basement membranes of kidney, lung, smooth muscle, and skin. Thus TSP may serve as an important link between cells and matrices. Thrombospondin also has been reported at the epidermal-dermal junction. We wished to determine whether human keratinocytes synthesize and secrete TSP. Pure human keratinocytes were grown in defined medium without fibroblast feeder layers. Immunofluorescent staining with either rabbit polyclonal or mouse monoclonal antibodies to human platelet TSP yielded specific granular staining within the cytoplasm of keratinocytes. Culture media and cellular lysates were harvested from cultures metabolically labeled with [35S]methionine. Trichloroacetic acid precipitation, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and autoradiography revealed a major labeled band comigrating with purified platelet TSP in both the media and the cellular lysates. Immunoprecipitation with either the polyclonal or the monoclonal anti-TSP antibodies followed by SDS-PAGE and autoradiography identified this band as TSP. Thus keratinocytes in culture synthesize and secrete TSP. Thrombospondin may play an important role in epidermal interactions with extracellular matrix. PMID- 3543146 TI - Parenteral chloroquine for treating falciparum malaria. AB - There is no information and therefore no consensus on how chloroquine should be administered to persons with severe malaria. Although widely considered dangerous, parenteral chloroquine is extensively used. We studied the acute disposition and toxicity of intravenous (iv), intramuscular (im), subcutaneous (sc), and oral chloroquine in 60 adult Zambian patients hospitalized with falciparum malaria. Plasma concentration profiles after parenteral administration were characterized by wide fluctuations between peak and trough values. Absorption of im and sc chloroquine was rapid, with a median time to peak concentration of 30 min and a peak plasma concentration five times higher than after oral administration. The pharmacokinetic data suggest that the acute toxicity of parenteral chloroquine is related to transiently high concentrations in blood and result from incomplete distribution out of a relatively small central compartment. Parenteral chloroquine may be administered safely by simply giving smaller, more-frequent doses than are currently used or, in the case of iv administration, by using continuous infusion. PMID- 3543147 TI - Antibody response to bacteriophage hyaluronidase in acute glomerulonephritis after group A streptococcal infection. AB - In a test of the hypothesis that lysogeny of group A streptococci by a temperate bacteriophage might confer nephritogenicity, 283 sera from 69 patients were examined for IgG and IgM antibodies to M 49 streptococcal bacteriophage hyaluronidase. The IgG and IgM response to bacteriophage hyaluronidase was greatest in M 49 streptococci-infected individuals with nephritis, but M 49 streptococci-infected subjects without nephritis also had a greater immune response than did subjects infected with serotypes other than M 49. Although antibody to bacterial hyaluronidase was detected in all Streptococcus-infected groups, antibody to M 49 streptococcal bacteriophage hyaluronidase usually was found in only M 49 streptococci-infected patients. Although the greatest IgG and IgM antibody response to bacteriophage hyaluronidase can be demonstrated in individuals with glomerulonephritis, the antibody response does not indicate a direct relation of lysogeny and nephritis because subjects with and without nephritis after M 49 streptococcal infection all had a significant rise in antibody titer. PMID- 3543149 TI - Limitations of using the plasmid pattern as an epidemiological tool for clinical isolates of Shigella sonnei. PMID- 3543148 TI - Rapid diagnosis of nocardiosis with an enzyme immunoassay. AB - Diagnosis of nocardiosis is often delayed because of the frequently nonspecific nature of the illness and because of the long incubation period required to isolate the organism in the microbiology laboratory. Past experience with serological methods for diagnosing nocardiosis have met with little success, primarily because there was no suitable antigen. Using a previously identified Nocardia asteroides-specific protein, we developed an enzyme immunoassay for the rapid diagnosis of nocardiosis. We evaluated sera from 22 patients with nocardiosis, 83 hospitalized controls, and 21 patients with tuberculosis. Twenty (91%) of the sera from patients with nocardiosis had titers of antibody greater than or equal to 1:256, whereas all of the sera from controls and from patients with tuberculosis had titers less than 1:256. This assay represents a highly sensitive and specific serodiagnostic tool for evaluating patients with possible nocardiosis. PMID- 3543150 TI - Shigellosis in Bangladesh. PMID- 3543151 TI - The territory of epidemiology: pentimento. PMID- 3543152 TI - Escherichia coli that cause diarrhea: enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent. AB - There are four major categories of diarrheagenic Escherichia coli: enterotoxigenic (a major cause of travelers' diarrhea and infant diarrhea in less developed countries), enteroinvasive (a cause of dysentery), enteropathogenic (an important cause of infant diarrhea), and enterohemorrhagic (a cause of hemorrhagic colitis and hemolytic uremic syndrome). Besides manifesting distinct clinical patterns, these categories of E. coli differ in their epidemiology and pathogenesis and in their O:H serotypes. Common features (albeit distinct for each category) include plasmid-encoded virulence properties, characteristic interactions with intestinal mucosa, and elaboration of various types of enterotoxins or cytotoxins. A less-well-defined fifth category of diarrheagenic E. coli is that of enteroadherent E. coli, so far identifiable only by their pattern of adherence to Hep-2 cells in tissue culture. PMID- 3543153 TI - New antibiotics: areas of appropriate use. AB - This has been an analysis of a number of agents whose clinical use has been approved in the past five years and of several agents that will undoubtedly be available within the next year. By the very nature of time alotted, the analysis had to be superficial. I believe that it is important to view all the agents because they cross each other in uses. I believe that areas of appropriate use exist for all of the compounds that I have discussed, and I also believe that cost and convenience will play increasingly important roles in the selection of what agent is most fitting, the definition of appropriate. In many infections it will not be possible to show a significant difference among drugs in a class, unless extremely large studies are undertaken. From my review of the literature in preparation for this meeting, I doubt these studies will be mounted. The infectious disease clinician must be familiar with all of the agents so that he or she can make judgments about which agent(s) make(s) the most sense for his/her hospital. I believe that it is fitting and proper for the infectious disease physician to appropriate the correct selection, methods of administration, and dose of antibiotic in many clinical situations, particularly ones in which parenteral agents are used. I hope the IDSA will have an impact on the proper use of the quinolones, monobactams, penems, and carbapenems. Our goal in the use of antimicrobial agents should be the selection of agents for prophylaxis, empiric therapy, and therapy for defined infections in a manner that results in cure, with reasonable cost and minimal damage to the microbial ecology. PMID- 3543154 TI - Genes encoding the alpha, beta, and gamma chains of the human T cell antigen receptor. PMID- 3543155 TI - Physiological and immunologic disturbances associated with shock in a primate model of Lassa fever. AB - The degree of cell and organ damage in clinical and histological studies of patients dying of Lassa fever has been insufficient to explain the catastrophic shock characteristic of the fatal illness. To explore this issue further, we conducted a study of the evolution of shock in three Lassa virus-infected rhesus monkeys. By the sixth day after infection, a marked, progressive reduction of in vitro platelet aggregation occurred despite normal numbers of circulating platelets and a normal platelet survival time and was accompanied by loss of prostacyclin production by postmortem endothelium. Both of these functions recovered rapidly in a surviving animal. There was no evidence of disseminated intravascular coagulation, nor were clotting factors significantly abnormal. We observed association of viral antigen with neutrophils and progressive neutrophilia. Viremia was not reduced by a brisk antibody response in our animals, and there was a general depression of response to mitogens in mixed lymphocyte stimulation assays. Our findings suggest that shock in Lassa fever is due to biochemical dysfunctions of platelets and endothelial cells and results from loss of intravascular plasma volume, effusions, and hemorrhage. PMID- 3543156 TI - Type III group B Streptococcus: functional interaction with IgG subclass antibodies. AB - The functionally active IgG subclasses and the portion of the antibody molecule mediating opsonophagocytosis of type III, group B Streptococcus (III-GBS) have not previously been investigated. Serum from a healthy adult immunized with III GBS vaccine was subjected to ion exchange chromatography, yielding 2,950 mg of IgG/dl and 1,440 micrograms of III-GBS-specific antibody/ml. Papain digestion for selective cleavage of IgG1 and IgG3 yielded an IgG2-rich pool that contained 31% of the initial IgG but 69% of the antibody to III-GBS. This pool retained opsonophagocytic activity of antibody to III-GBS at levels similar to that for the initial IgG pool. Analysis of F(ab')2 fragments of pepsin-digested IgG revealed that the level of alternative pathway-mediated opsonophagocytosis of III GBS was similar to that mediating functional activity in the initial IgG preparation. Therefore, IgG2 is an active opsonin for III-GBS, but divalency appears to be required for alternative pathway-mediated opsonophagocytosis. PMID- 3543157 TI - Mediation of serum resistance in Salmonella typhimurium by an 11-kilodalton polypeptide encoded by the cryptic plasmid. AB - A cosmid bank of the DNA (including cryptic plasmid DNA) of a virulent strain of Salmonella typhimurium was prepared in Escherichia coli K12, and clones that contained cryptic plasmid DNA were detected by probing. Two such clones expressed a new outer membrane protein of 11 kilodaltons (kDa) and were serum resistant (E. coli K12 is serum sensitive). The gene encoding the 11-kDa protein was subcloned in a 2.1-kilobase fragment and shown to mediate serum resistance in both E. coli K12 and a cryptic plasmid-free (serum-sensitive) strain of S. typhimurium. The cryptic plasmid-free S. typhimurium strain did not express normal lipopolysaccharide, but introduction of the 11-kDa protein gene into the strain rendered the strain serum resistant without restoration of normal lipopolysaccharide synthesis. The 11-kDa protein gene was not sufficient to restore either macrophage resistance or virulence to a cryptic plasmid-free strain of S. typhimurium. PMID- 3543158 TI - Purification and characterization of recombinant mouse interferon-beta. AB - Recombinant mouse interferon-beta (rMuIFN-beta) produced in Escherichia coli was purified to homogeneity and characterized. The purified protein exhibited a single band of Mr 19,900 on SDS-polyacrylamide gel electrophoresis under both reducing and nonreducing conditions, and also exhibited a single band on native polyacrylamide gel electrophoresis at pH 4.3. The observed molecular weight corresponded to that of the polypeptide moiety of natural MuIFN-beta of Mr 19,700. The amino acid composition and the amino-terminal sequence of the purified rMuIFN-beta were identical to those predicted from cDNA sequence. These results indicate that the purified protein is a nonglycosylated MuIFN-beta, which forms no disulfide-linked dimer and probably exists as a monomeric form. PMID- 3543159 TI - Three-dimensional image reconstruction of helical aggregates of trypsin modified elongation factor EF-Tu from Escherichia coli: comparison with the reconstructed image of intact EF-Tu. AB - The three-dimensional structure of trypsin-modified EF-Tu polymers was analyzed to a resolution of 30 A with electron image reconstruction techniques after negative staining. In a 70% saturated ammonium sulfate solution the modified protein forms cylindrical aggregates with a diameter of about 340 A. The repeat distance of the structure along the cylindrical axis is 448 A. The large number of subunits in one repeat hampers the assessment of the helical symmetry. The Fourier analysis and three-dimensional synthesis were therefore carried out with three different selection rules. The three reconstructed density distributions show marked differences. In all of them twofold axes perpendicular to the cylindrical axis are present. The half unit cell content of one of the reconstructions shows a striking similarity with the shape of intact EF-Tu.GDP previously proposed in a similar study. We suggest that in the assemblies investigated here dimers of trypsin-modified EF-Tu.GDP are arranged along a one start basic helix with 15.4 subunits per turn and a pitch of 64 A. The shape of the monomeric proteolyzed EF-Tu.GDP in this helical arrangement is very similar to that of the intact molecule in cylindrical assemblies studied at this resolution. PMID- 3543160 TI - A dot enzyme immunoassay for detection of IgM antibodies against phenolic glycolipid-I in sera from leprosy patients. AB - A visual dipstick dot enzyme immunoassay (EIA) for diagnosis of leprosy is described. The assay is based on detection of IgM antibodies against phenolic glycolipid (PGL-I) in sera from leprosy patients. The antigen (PGL-I or synthetic disaccharide of PGL-I) was dotted on a nitrocellulose pad stuck on a plastic strip (dipstick). Sera were used at a dilution of 1:200. Peroxidase coupled mouse anti-human IgM monoclonal antibodies were used as the conjugate. A positive test gave a blue dot against a white background. The test was highly specific for leprosy, and was quite sensitive for detection of bacilliferous (BL/LL) leprosy. The antigen dotted and preblocked dipsticks stored at room temperature upto 4 months of observation period, were unable in the assay. PMID- 3543162 TI - Retrospective analysis of smear examinations from multiple sites in multi bacillary leprosy. AB - A retrospective analysis was done on results of smears from six sites in untreated and treated multibacillary leprosy cases. The examination of three sites was found adequate to detect all multibacillary cases. PMID- 3543161 TI - Limited duration acedapsone prophylaxis in leprosy. AB - A randomized controlled chemoprophylaxis trial was carried out in Madras city using 560 disease-free household child contacts of 264 multibacillary cases as study subjects. In the study, 13 cases were diagnosed among 280 contacts who received 3 injections of acedapsone at 10 weeks interval as against 30 cases among 280 contacts who had the same number of placebo injections, during the follow-up period of 225 weeks. The difference in the incidences in the two groups was statistically significant. (X2 6.45; P less than 0.02). The protection due to the limited duration of acedapsone prophylaxis was 56.7 percent. There were no cases of multi-bacillary leprosy in either group. The efficacy of prophylaxis was significant in male children over 9 years of age and female children in the age group 1-8 years. The other prognostic factors like the infectivity status of the index cases in the household and the duration of exposure to them could have possibly influenced the effectiveness of prophylaxis in preventing progression from infection to clinical disease among the subjects studied. Their effects could not be assessed in this study. PMID- 3543163 TI - On the case report of 'Bullous reaction in leprosy'. PMID- 3543164 TI - [The immune response following open-heart surgery in infants and children- lymphocyte analysis by laser flow cytometric immunofluorescence method]. PMID- 3543165 TI - [Improvement in the clinical picture of ectopic pregnancy following use of ultrasonography]. AB - This study was proposed to evaluate the changes in the clinical picture of ectopic pregnancy in relation to the use of pelvic ultrasonography (UST). Twenty five patients who used UST were compared to 60 patients who did not. In the UST group, 20.0% of patients showed a gestational sac and embryo, 12.0% showed an embryonal heart beat, 80.0% showed an adnexal tumor and 40.0% showed an echo free space in the cul-de-sac. However, there were no cases of intrauterine gestational sacs. The incidence of patients who exhibited over 500g of intraperitoneal hemorrhage were decreased by using UST (non-UST group: 40.0%, UST group: 10.5%), also decreased was the number of patients who showed signs of a shock state (18.2%, 5.3%), who required an emergency operation (43.6%, 5.3%) and who underwent blood transfusion (49.1%, 5.3%). The average gestational period at the time when the patient underwent an operation was shortened by 4 days by using UST. These results suggest that the routine use of UST is useful for improving the clinical prognosis of ectopic pregnancy and especially in reducing risk to the patient. PMID- 3543166 TI - [Immunohistologic characterization of lymphoid cells infiltrating dysgerminoma of the ovary]. AB - Dysgerminoma of the ovary is composed of cells that resemble primordial germ cells morphologically and connective tissue stroma with lymphoid cell infiltration, the degree of which has been discussed in correlation with the prognosis. In order to characterize the lymphoid cells histochemically, a sensitive immunoperoxidase technique was applied on serial tumor tissue sections. Monoclonal antibodies used in this study were anti-HLA-ABC, anti-HLA-DR, anti-HLe 1 (leukocytes), anti-Leu-1,-4(pan T cells), anti-Leu-2a (killer/suppressor T cells), anti-Leu-3a (helper/inducer T cells), anti-Leu-12,-14 (B cells), anti-Leu M3 (monocytes/macrophages) and OKT-10 (myeloid and lymphoid precursors, thymocytes, activated T and B cells). Lymphoid cells identified morphologically on sections stained with hematoxylin-eosin were HLe-1 positive, and were therefore thought to originate in bone marrow. Most of them were also positive for Leu-1,-4, and they were composed of nearly equal numbers of Leu-2a positive cells and Leu-3a positive cells. Furthermore, the majority of the lymphoid cells were HLA-DR positive, consisting of a large number of OKT-10 positive cells and a small number of Leu-12,-14 positive cells and Leu-M3 positive cells which were mainly found in connective stroma encapsulating tumor tissue. Taken together, the lymphoid cells in the connective stroma were considered to be activated T cells. Tumor cells themselves lacked reactivity with anti-HLA-ABC or anti-HLA-DR, while lymphoid cells and connective stroma were HLA-ABC positive. PMID- 3543167 TI - [Effects of acute hypoxemia on fetal movement in the fetal lamb]. AB - Chronically instrumented pregnant models were established using 5 Dorset Rambouillet pregnant ewes with gestational age between 120 and 138 days. Observation of fetal movements were started on the 3rd postoperative day or later when recovery from the surgery to the physiological condition was confirmed by maternal and fetal biophysical parameters. Fetal movements were observed using real-time ultrasound equipment with linear-array transducer placed on the maternal abdomen. Observation encompassed the control period which lasted one hour followed by an experimental period of fetal hypoxemia created by decreasing maternal FIO2. Observation was also continued during the recovery period when the mother was re-exposed to room air. Maternal and fetal samples were periodically obtained during these periods. Frequency of fetal movements was studied in 10 minute periods under the control and hypoxemic conditions. All fetuses exhibited movements during the control period, ranging 1-42 movements/10 minutes, the mean incidence being 16.9 movements/10 minutes. During fetal hypoxemia (average PaO2 decrease: 8.6 mmHg), fetal movements were significantly reduced to 5.5 movements/10 minutes with complete cessation in some cases. In 4 animals which exhibited complete cessation of both fetal movement (FM) and fetal breathing movement (FBM), FBM disappeared before FM, and reappearance of FM was following by FBM during recovery from hypoxemia. PMID- 3543169 TI - [Diffuse panbronchiolitis]. PMID- 3543168 TI - [Diagnosis of ovarian tumors by ultrasonography and X-ray CT]. AB - A drawback in ultrasonography, an indispensable technique in imaging ovarian malignancies, is that it sometimes shows false positive for benign tumors including dermoid cyst and ovarian endometriosis. To overcome this, the concurrent use of X-Ray CT seems warrantable and this led us to carry out the study summarized below. CT was carried out on 268 of 322 ovarian cases which had undergone ultrasonography. The results obtained were as follows. Sensitivity of ultrasonography and CT in ovarian malignancies were 82% and 88% respectively. Of the cases subjected to both techniques, those who were deemed false positive were 39 in ultrasonography and 12 in CT. Ultrasonographic imagings of dermoid cyst and ovarian endometriosis were classified on the basis of their patterns. The results obtained revealed that those in which it was difficult to discriminate the image from ovarian malignancy were types V and VI in dermoid cyst and type III-C in ovarian endometriosis. In both dermoid cyst and ovarian endometriosis, nearly a 100% accuracy rate was obtainable with CT for diagnosis of benign tumors. This strongly suggested that concurrent use of CT was required, in diagnosing ovarian diseases with the V or VI and III-C patterns referred to above. PMID- 3543170 TI - [Recent medical topics on Legionnaires' disease]. PMID- 3543171 TI - [Recent medical topics on advances in the medical treatment of heart failure]. PMID- 3543172 TI - [Recent medical topics on mixed connective tissue disease (MCTD)]. PMID- 3543173 TI - [Recent medical topics on inflammatory bowel disease (IBD)]. PMID- 3543174 TI - [A case of relapsing polychondritis with islet cell antibody positive NIDDM: with special reference to a therapeutic trial with colchicine]. PMID- 3543175 TI - [Advances of bacteriological and immunological researches in periodontology]. PMID- 3543176 TI - Thorax--a program to assist in the preoperative risk assessment of patients undergoing thoracic surgery. AB - Patients who undergo thoracic surgical procedures often are at high risk. Several risk-scoring systems have been advocated; they are complex and unwieldy. Also, physicians-in-training need a teaching tool with a consistent format. A program for these needs has been written in the high-level language Modula-2 for the Macintosh Computer. The user enters height, weight and easily obtainable data. Normal values are accessed via a 'window' which is triggered by clicking the 'mouse'. When pulmonary data is entered, cardiovascular system questions are presented. The user is finally presented with entered data, calculated data and a risk estimate. Complications estimates are derived from a special LEARNER file. The program 'learns' from a constantly expanding database. PMID- 3543177 TI - Specificity of immunoglobulin E and immunoglobulin G against human (recombinant DNA) insulin in human insulin allergy and resistance. AB - Using an enzyme-linked immunosorbent assay method, we have demonstrated immunoglobulin E (IgE) and immunoglobulin G (IgG) against human (recombinant DNA) insulin in serum samples of a patient whose insulin therapy was only with human insulin. Within 12 days of initiation of human insulin for gestational diabetes, large local reactions developed in the patient in association with high levels of IgE to human insulin. As the local reactions subsided, the levels of IgE to human insulin decreased. The patient's insulin requirement was unusually high for pregnancy and tended to decrease in parallel with falling levels of IgG to human insulin, suggesting an element of immunologic insulin resistance. In addition to IgE and IgG against human insulin, we were able to demonstrate the presence of IgE and IgG against porcine and bovine insulin in the serum samples of this patient. The patient had similar immediate cutaneous reactivity to each insulin. In inhibition studies, similar amounts of porcine insulin, bovine insulin, or human insulin were found to produce 50% inhibition of human insulin binding to IgE or IgG against human insulin. Excess porcine insulin or bovine insulin resulted in total inhibition of human insulin binding to IgE or IgG. Thus even in a patient whose initial form of insulin therapy was human insulin, there was development of insulin allergy and of IgG to human insulin that may have contributed to insulin resistance. Moreover, the antigenic determinants recognized by antibody induced by human insulin may also be present on bovine insulin and porcine insulin as demonstrated in this case. PMID- 3543179 TI - Cecil James Watson, M.D. (1901-1983). PMID- 3543178 TI - Corticosterone methyloxidase II activity during hemodialysis. AB - Plasma levels of aldosterone decrease during hypokalemic hemodialysis. Our study was performed to determine whether the changes in plasma aldosterone level observed during hemodialysis are modulated by changes in corticosterone methyloxidase II activity. We measured plasma levels of adrenal zona glomerulosa steroids, for example, aldosterone and 18-hydroxycorticosterone (18-OH-B), immediately before and after 4 hours of hemodialysis (n = 8). Plasma levels of steroids originating from the adrenal zona fasciculata, for example, cortisol, corticosterone, 18-hydroxy-11-deoxycorticosterone, and 11-deoxycorticosterone, were also measured. Dialysance rates of 18-OH-B, aldosterone, and cortisol were calculated (n = 8). Plasma levels of both aldosterone (P less than 0.05) and 18 OH-B (p less than 0.01) decreased during hemodialysis. The 18-OH-B/aldosterone plasma concentration ratios did not change significantly during hemodialysis. No significant changes in plasma levels of fasciculata steroids were observed during hemodialysis. Dialysance rates for aldosterone and 18-OH-B were similar (P not significant). The dialysance of cortisol was 10-fold lower than that of aldosterone (P less than 0.01) and 18-OH-B (P less than 0.01). The relative constancy of the 18-OH-B/aldosterone plasma concentration ratios indicates that corticosterone methyloxidase II activity is normal in patients with end-stage renal disease who are maintained by hemodialysis. PMID- 3543180 TI - Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media. AB - In a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant--antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p = 0.06). PMID- 3543181 TI - Ceravital in ossiculoplasty: experimental studies and early clinical results. AB - The biocompatibility of the bioactive glass-ceramic Ceravital was investigated experimentally both in vivo and in vitro. In the former, ceramic discs were interposed in 30 rat middle ears for periods ranging from 6 weeks to 12 months. In the latter, Ceravital otological prosthesis were placed in human fibroblast culture. Reactions to the biomaterial were assessed by means of scanning electron microscopy (SEM) with chemical analysis facilities (EDAX, WDAX) and light microscopy. The interface reactions were similar in both in vivo and in vitro studies and confirmed the findings of other authors regarding the implants' biocompatibility and bioactivity. The technique of ion etching, however, enabled clear demonstration of this bioactivity on the implant surface, exposed merely to the middle-ear secretions, thus questioning the necessity of placing bone pate on the implant head at surgery, in order to encourage bioactive bonding with the overlying drum. A clinical trial of Ceravital in 128 patients with an average follow-up period of 2 years is reported. Forty per cent of these patients underwent a type II tympanoplasty, 60 per cent a type III. Though relatively short-term, the results to date have been encouraging: 88 per cent of the implants have been well-tolerated; 70 per cent of the cases have yielded a satisfactory hearing result; and only 3 per cent of the implanted prostheses have been extruded. PMID- 3543182 TI - Differentiation of rat bone marrow cells into macrophages under the influence of mouse L929 cell supernatant. AB - Bone marrow cells (BMC) flushed from femora of Lewis rats were cultured in Dulbecco's modification of Eagle's medium supplemented with mouse L929 cell supernatant as a source of colony-stimulating factor (CSF). Differentiation of macrophage progenitor cells into macrophages (M phi) and expression of various markers were kinetically assessed. The proportion of M phi increases from approximately 4% in freshly isolated BMC to 100% after 7-8 days of cell culture. These cells, termed bone marrow cell-derived macrophages (BMDM phi), adhere to and spread on plastic surface; exhibit M phi morphology; stain intensely for nonspecific esterase; are able to phagocytose latex particles, IgG-sensitized erythrocytes, and C3-coated red cells; and express receptors for IgG and C3. A subpopulation of BMDM phi expresses MHC class II antigens as demonstrated by immunofluorescence using MRC OX6 and MRC OX17 monoclonal antibodies which recognize antigens coded in the I-A or I-E subregion of the MHC, respectively. Collectively, our results show that supernatant from mouse L929 cells supports and is continuously required for proliferation and differentiation of rat BMC into typical M phi, and suggest that mouse CSF cross-reacts with the putative receptor on rat M phi. PMID- 3543184 TI - [Noninvasive diagnosis of deep venous thromboses by Doppler ultrasound]. AB - A Duplex ultrasound technique combining real time ultrasound B imaging with pulsed Doppler investigation was used for non-invasive exploration of peripheral venous trunks. A series of 72 patients (21 men and 51 women including 26 pregnant women) was investigated by the examination of deep venous trunks of upper limbs (68 cases) and of lower limbs (4 cases). Lesions were identified in 19 cases (26%), including 9 total thrombosis, 6 partial thrombosis, 3 sequelae of a previous thrombosis and 1 case of valve incontinence. Morphologic (caliber, wall, intraluminal echos) and functional (expansion, flow rate, compression) features establishing diagnosis are discussed. Phlebography findings in 8 of the 15 cases of thrombosis (total or partial) provided very satisfactor correlation, clinical correlation being considered sufficient in the other cases. This duplex technique is a reliable, reproducible and non-invasive method for diagnosis and for follow up of medical treatment of thrombophlebitis. PMID- 3543183 TI - Peripheral blood mononuclear leukocytes release a mediator(s) that induces phagocytosis of C-reactive protein-coated cells by polymorphonuclear leukocytes. AB - We studied the phagocytosis by human polymorphonuclear leukocytes (PMN) of sheep erythrocytes (E) passively sensitized with pneumococcal C-polysaccharide (E-PnC), E-PnC coated with C-reactive protein (E-PnC-CRP), and E coated with rabbit antisheep E IgG (E-IgG). PMN isolated from the blood of normal individuals failed to ingest either E-PnC or E-PnC-CRP; however, after incubation with supernatants from stimulated peripheral blood mononuclear leukocytes, glass-adherent PMN ingested E-PnC-CRP with a mean phagocytic index of 47.8 +/- 14.9 (means +/- SD, n = 9) and E-PnC to a lesser extent with a phagocytic index of 9.6 +/- 2.9 (mean +/ SD, n = 4). We also observed a statistically significant increase in the ingestion of E-IgG by lymphokine-stimulated PMN with phagocytic indices of 85.2 +/- 21.2 (mean +/- SD, n = 12) for unstimulated PMN and 158 +/- 37.1 (mean +/- SD, n = 9) for stimulated PMN. The best conditions for stimulating release of this phagocytosis-promoting mediator included exposure to phytohemagglutinin (PHA) in the presence of monocytes that had ingested IgG-coated sheep erythrocytes. The induction of phagocytosis of E-PnC-CRP was rapid, reaching a maximal level after stimulation of the adherent PMN with the conditioned media for 30 min. The factor(s) responsible for the induction of the ingestion of E-PnC CRP was less than 10,000 daltons and was heat stable (56 degrees C for 45 min). These data are similar to earlier results obtained with PMN activated by 12-0 tetradecanoyl-phorbol-13-acetate (PMA), an important contrast being that in the current studies PMN were activated by a soluble factor released from stimulated mononuclear cells under conditions simulating those in vivo. PMID- 3543185 TI - [Interruption of the vena cava inferior. A comparative study of the Adams de Weese clip and the Kimray Greenfield filter]. AB - Efficacy of two methods for interruption of inferior vena cava was compared after insertion of 95 Adams de Weese clips by the sub or trans-peritoneal route and of 72 Greenfield filters usually by a jugular approach. Introducing Greenfield's filter to produce caval interruption did not require modification of operative indications. In contrast, it allowed caval blockade to be performed in more elderly patients, generally in a poorer condition, at the price of higher mortality, due more to the clinical circumstances of the interruption rather than the caval blockade itself. Postoperative follow up showed fewer caval thromboses after Greenfield's filter (15%) than after the pericaval clip (35%). PMID- 3543186 TI - [Posttraumatic false aneurysm of the superficial temporal artery. Apropos of a case report and review of the medical literature]. AB - Traumatic false aneurysm of superficial temporal artery is infrequent. About 21 cases were published during these last fifty-three years (1932-1985) in medical literature. The authors report a case of traumatic false aneurysm in a 50 y. o. woman, having had a frontal trauma one month before. They discuss the physiopathologic mechanism of this rare lesion. False aneurysm is always secondary to an arterial wall rupture. This rupture may be complete in arterial wound or partial with disruption of intima and media in simple contusion. It depends not only on the nature and the intensity of the trauma but also on the particular topography of the artery which is prone to such a complication. PMID- 3543187 TI - Neuromusculoskeletal thermography: a valuable diagnostic tool? AB - The use of neuromusculoskeletal thermography is rapidly increasing. Recent studies have begun to document the types of diagnostic and other clinically useful information which may be derived from the procedure. This paper provides a review and summary of current research and a comparison with myelography, computerized tomography, electromyography and clinical and surgical findings in cases of presumed musculoskeletal pain syndromes. The importance of diagnostic sensitivity, specificity, positive and negative predictive value, and accuracy (validity) are discussed. In general, the literature reports high sensitivity and negative predictive value, but lower specificity and positive predictive value. The implications of these findings are examined in regard to clinical case management, with emphasis on potential usefulness to chiropractors. Although thermography appears to be a promising diagnostic tool, there remain a number of threats to the scientific validity of current research which must be accounted for in future work. PMID- 3543188 TI - Carotid body tumors. PMID- 3543189 TI - A syndrome of post-transfusion hypertension, convulsion and cerebral hemorrhage in beta-thalassemia Hb E disease: a case report with high plasma renin activity. PMID- 3543190 TI - Sonographic evaluation of neonatal jaundice. PMID- 3543191 TI - Diagnostic value of scintigraphy in biliary atresia. PMID- 3543192 TI - Liver size and serum alkaline phosphatase in normal preschool Thai children. PMID- 3543193 TI - Nutrition management of acute diarrhea in children--an overview. PMID- 3543194 TI - Ultrasound diagnosis in pediatric neurological problems. PMID- 3543195 TI - Hyperkalemic left bundle branch block and hyporeninemic hypoaldosteronism (hyperkalemic left bundle branch block). AB - A 70-year-old woman was admitted to the intensive coronary care unit with suspected myocardial infarction. During the follow-up period, the patient twice developed left bundle branch block, which was shown to be related to high serum potassium levels secondary to hyporeninemic hypoaldosteronism and moderate renal failure. PMID- 3543196 TI - Multiple injections of LH-releasing hormone into hypogonadal (hpg) mice induce the appearance of two morphologically distinct populations of gonadotrophs. AB - We have investigated the effects of multiple 2-hourly injections of LH-releasing hormone (LHRH) on the number and size of the gonadotrophs and gonadotroph secretory granules, and the lipid content of gonadotrophs in the pituitary glands of intact and gonadectomized male and female hypogonadal (hpg) mice. Gonadotrophs were identified by immunocytochemistry for LH beta, and the size and secretory status of the gonadotrophs were assessed by quantitative ultrastructural analysis of immunoidentified gonadotrophs. The administration of 60 ng LHRH by subcutaneous injection every 2 h for 15 days resulted in an increase in the number, size and granule content of LH beta-immunoidentified gonadotrophs of hpg mice to values found in normal adult mice. Large lipid droplets accumulated in 30 40% of the gonadotrophs in both male and female LHRH-treated hpg mice. Although lipid-containing gonadotrophs were larger than lipid-free cells in all LHRH treated groups irrespective of the presence or absence of gonads, a marked difference in the number, position within the cell, and size of the secretory granules between the lipid-containing and lipid-free cells was found only in the pituitary glands of intact LHRH-treated hpg females. These results demonstrate: (a) that the effects of multiple injections of LHRH on the morphology of the gonadotrophs of hpg mice is not dependent on the presence of functioning gonads, although ovarian factors are required for the full development of morphological, and hence possibly functional, heterogeneity in the gonadotroph population in female animals, and (b) that, although multiple injections of LHRH in hpg mice are more effective than single daily injections of LHRH in stimulating pituitary gonadal function, there is no obvious difference in the morphologically recognizable effects that these two modes of administration have on the pituitary gonadotrophs. PMID- 3543197 TI - Regulation of stalk and spore antigen expression in monolayer cultures of Dictyostelium discoideum by pH. AB - The terminal differentiation of Dictyostelium discoideum cells plated as monolayers with cyclic AMP is dramatically affected by developmental buffer conditions. High pH and addition of weak bases induces spore differentiation while low pH and weak acids favour stalk cell formation. In order to analyse the timing and nature of this regulation we have raised and characterized an anti stalk serum which we have used together with an anti-spore serum to monitor developmental progression in the monolayer system and to detect the phenotypic effects of pH at earlier stages of development. The stalk serum detects both polysaccharide and protein antigens expressed during the terminal stages of normal development. In monolayer culture, the stalk-specific protein antigen appears precociously, while the timing of prespore vacuole appearance is unaffected. Expression of stalk polysaccharide antigens in monolayer cultures occurs as early as 12 h and is localized in a single subset of cells or region of extracellular space within the small cell clumps that form. The effects of pH (and acid/base) on these phenotype-specific antigens can be detected early in development, shortly after their first appearance. In monolayers of wild-type V12 M2 cells, the low pH regimes appear to act more by suppressing the spore than enhancing the stalk pathway, while the high pH regimes both suppress stalk and enhance spore antigen expression. In monolayers of the sporogenous mutant HM29, low pH regimes both enhance stalk antigen and suppress spore antigen expression. These results show that extracellular pH regulates phenotypic expression during a large part of the differentiation process and is not simply restricted to terminal cytodifferentiation. PMID- 3543198 TI - Localization and release of FMRFamide-like immunoreactivity in the cerebral neuroendocrine system of Manduca sexta. AB - The distribution of FMRFamide-like immunoreactivity (FLI) in the cerebral neuroendocrine system of the moth, Manduca sexta, is described and evidence is provided for calcium-dependent release of FLI from the neurohaemal organs. FLI was detected by indirect immunofluorescence in approximately 25 bilaterally symmetrical pairs of somata in the pupal protocerebrum. In addition, FLI was observed in neurites in the brain, as well as in axons of the nervi corporis cardiaci and nervi corporis allati, and in terminals in the neurohaemal corpora cardiaca (CC) and corpora allata (CA). All immunocytochemical staining was blocked by preabsorption of the anti-FMRFamide antiserum with synthetic FMRFamide. We localized FLI to identified protocerebral neurosecretory cells (NSCs) by combining intracellular injection of Lucifer Yellow and indirect immunofluorescence. Among the NSCs in each hemisphere, FLI was observed in both group IIa (lateral) cells, in most group IIb (lateral) cells, and in two cells of group Ib (medial). FLI was extracted from the brain and neurohaemal organs and measured using radioimmunoassay (RIA). Calcium-dependent release of FLI was evoked from isolated CC-CA by high potassium depolarization in vitro and was quantified by RIA of the bathing medium. These results suggest that FLI may have a neurohormonal or neurotransmitter function in Manduca. PMID- 3543199 TI - Measurements of prednisolone and some of its metabolites, in urine of patients after orthotopic liver transplantation, as a means of monitoring prednisolone absorption. AB - In patients who had undergone orthotopic liver transplantation, malabsorption of prednisolone or increased metabolism of prednisolone was suspected. In order to rule out this possibility, urinary prednisolone, and some of its metabolites, viz prednisone and 6 beta-hydroxyprednisolone, were determined by means of a gas chromatographic assay. To evaluate this assay aliquots of a pooled urine from several of our patients were analysed in multiplicate (n = 10). Mean prednisone, prednisolone and 6 beta-hydroxyprednisolone concentrations of 1.9 mg/l, 6.3 mg/l and 4.1 mg/l, respectively, were found with the following respective day-to-day coefficients of variation: 12.3%, 5.2% and 5.3%. Amounts of prednisolone metabolites excreted in the urine of these patients were correlated with the ingested daily dose of prednisolone. It was concluded that overall absorption of prednisolone in these patients was adequate and not influenced by shortage of bile acids in the gastro-intestinal tract, or by steatorrhoea, both caused by external bile drainage. In addition there was no evidence for increased metabolism of prednisolone. PMID- 3543200 TI - Bulimia: diagnosis and management in the primary care setting. AB - Bulimia is an eating disorder characterized by episodic, uncontrollable overeating and frequently by purging after binges. It appears to afflict approximately 5 percent of female college students in the United States. Most sufferers are high-achieving but passive and unassertive young women from similarly high-achieving but disorganized families. Confusion over social roles for women is common in bulimic patients. Bulimia shows a strong association with affective disorders; depression is common in both bulimic patients and their close family members. Bulimic patients seem to have a pronounced affective vulnerability to rejection, loss, and failure. Bulimia presents a special diagnostic challenge to the primary care physician because of the paucity of clues provided by a typical review of systems and a physical examination, even a very thorough one. Making the diagnosis requires persistent and thorough history gathering and is best accomplished through special attention to the psychosocial history (particularly history of depression and substance abuse, family dynamics, and recent stressors) as well as pointed questioning regarding eating behavior. Because of the severe, potentially lethal complications that may attend bulimia (including fluid and electrolyte imbalance, cardiac conduction abnormalities, gastric rupture, pneumonia), diagnosis and appropriate referral by the primary care physician may have a critical impact on the patient's life and health. PMID- 3543202 TI - Medicare in troubled waters. PMID- 3543201 TI - Cardiac transplantation: the first year's experience at the University of Florida Shands Hospital. PMID- 3543203 TI - On the brink of disaster--the divergence of American culture and American medicine. PMID- 3543204 TI - Physician reimbursement for Medicare beneficiaries (II): Implications of regional and national fee schedules. PMID- 3543205 TI - Chernobyl bone marrow transplant expert to brief US physicians via video. PMID- 3543206 TI - Isolation and characterization of the tubular organelles induced by fumarate reductase overproduction in Escherichia coli. AB - Strains of Escherichia coli amplifying the intrinsic membrane enzyme fumarate reductase accommodate the overproduced enzyme by increasing the amount of membrane material, in the form of intracellular tubular structures. These tubules have been observed in strains harbouring multicopy frd plasmids and in ampicillin hyper-resistant strains. A procedure has been developed for isolation of tubules nearly free of cytoplasmic membrane. Using protein A-gold labelling and optical diffraction of electron micrographs, a model for tubule structure is proposed. The tubules have a lower lipid/protein ratio than the cytoplasmic membrane, with the enzyme accounting for greater than 90% of the protein in the tubules. Both cytoplasmic membranes and tubules from amplified strains are enriched in cardiolipin and have a more fluid fatty acid composition than wild-type strains. Mutants defective in cardiolipin synthesis produce tubules in response to excess fumarate reductase, but these tubules have an altered appearance, indicating that lipid-protein interactions may be important for tubule assembly. PMID- 3543208 TI - Haemoprotein b-590 (Escherichia coli), a reducible catalase and peroxidase: evidence for its close relationship to hydroperoxidase I and a 'cytochrome a1b' preparation. AB - A reducible hydroperoxidase, haemoprotein b-590, has been purified 16-fold from a soluble fraction of Escherichia coli K12, grown anaerobically with glycerol and fumarate. The Mr of the native protein, determined by gel filtration, was 331,000 although a minor, smaller species with a Mr of 188,000 was also detected; both had catalase activities. Based on the subunit Mr, determined from SDS gel electrophoresis to be 75,000, the above species are tentatively identified as tetramers and dimers, respectively. The isoelectric point of both species was 4.4. The absorption spectrum of the isolated haemoprotein is typical of ferric, high-spin haem. The A405/A280 ratio never exceeded 0.27, a value half of that obtained for E. coli hydroperoxidase I. On reduction with dithionite, the gamma, beta, and alpha bands were at 441, 559 and 590 nm respectively, the alpha-band being unusually distinct. Treatment of the reduced form with CO gave a sharp prominent gamma-band at 426 nm and caused significant shifts of the alpha and beta bands to shorter (574 and 545 nm) wavelengths. The pyridine haemochrome spectra showed the haem to be protohaem IX; the spectra were featureless between 580 and 630 nm, thus excluding the presence of haem a. However, some features of the difference spectra of the haemoprotein were reminiscent of cytochrome a1, notably the maxima in reduced minus oxidized spectra at 444 and 593 nm and the peaks and troughs in CO difference spectra at 426 and 446 nm respectively. The haemoprotein had high catalase activity: Vmax was 2.3 X 10(6) mol H2O2 (mol haem) 1 min-1 and the Km was 11 mM. At 10 mM-H2O2 the first order rate constant was 0.3 X 10(7) M-1 s-1. The haemoprotein was also a peroxidase with o-dianisidine or 2,3',6-trichloroindophenol as substrates; for the latter substrate, the Km was 0.18 mM. It is concluded that haemoprotein b-590 strongly resembles the hydroperoxidase I purified by Claiborne & Fridovich (Journal of Biological Chemistry 254, 4245-4252, 1979) and that a similar haemoprotein was mistaken for a cytochrome a1 b complex by Barrett & Sinclair (Abstracts of the 7th International Congress of Biochemistry, Tokyo, H-107, p. 907, 1967). PMID- 3543207 TI - Polyoxin D inhibits colloidal gold-wheat germ agglutinin labelling of chitin in dimorphic forms of Candida albicans. AB - Yeasts and mycelia of the pathogen Candida albicans grown in the presence of polyoxin D, a competitive inhibitor of chitin synthase, formed chains of swollen bulbous cells as observed by fluorescence microscopy. Wheat germ agglutinin (WGA) complexed to colloidal gold (Au) was used as a specific label at the ultrastructural level to visualize chitin in walls of control and polyoxin treated cells. In control cells, Au-WGA labelling was preferentially localized in the innermost wall layers and was predominant at bud scars and septa. After 4.5 h in 4 mM-polyoxin D, budding in yeasts and lateral wall growth in mycelia continued, but primary septa failed to form and no Au-WGA labelling was detected in the walls. These results demonstrated that the morphological alterations caused by polyoxin D were due to the absence of chitin, a wall component important for formation of primary septa and for maintenance of structural integrity during morphogenesis. PMID- 3543209 TI - Separation of Legionella pneumophila proteases and purification of a protease which produces lesions like those of Legionnaires' disease in guinea pig lung. AB - Six discrete protease activities were recovered from the supernatant broth of Legionella pneumophila cultures by ion-exchange chromatography. One of these demonstrated in vitro activity against collagen, casein and gelatin. When administered into the lungs of guinea-pigs this protease elicited lesions which were pathologically similar to those seen in clinical and experimentally induced Legionnaires' disease. PMID- 3543210 TI - Protein degradation by human intestinal bacteria. AB - Analysis of human gut contents showed that substantial quantities of soluble protein, ammonia and branched chain volatile fatty acids occurred throughout the large intestine [0.1-24.4 g (kg contents)-1, 7.7-66.0 mmol (kg contents)-1 and 1.5-11.1 mmol (kg contents)-1 respectively]. The presence of these metabolites suggested that substantial proteolysis was occurring. In vitro studies showed that casein and bovine serum albumin were partly degraded in slurries of human faeces over a 96 h incubation period, to produce TCA-soluble peptides, ammonia and volatile fatty acids. Proteolytic activity detected in the stools of five individuals ranged from 3.5 to 19.8 mg azocasein hydrolysed h-1 (g faecal material)-1. Washed cell and washed particulate faecal fractions accounted for 24 67% of total activity. The predominant proteolytic bacteria in the faecal samples examined were identified as Bacteroides spp. [1.0 X 10(11)-1.3 X 10(12) (g dry wt faeces)-1] and Propionibacterium spp. [1.2 X 10(8)-1.0 X 10(10) (g dry wt faeces) 1]. Other proteolytic bacteria which occurred in lesser numbers were identified as belonging to the genera Streptococcus, Clostridium, Bacillus and Staphylococcus. These results demonstrate that the gut microflora could potentially play a major role in proteolysis in the human colon. PMID- 3543211 TI - Identification, mapping, cloning and characterization of a gene (sbmA) required for microcin B17 action on Escherichia coli K12. AB - We have identified mutations in three different chromosomal genes of Escherichia coli K12 which reduce sensitivity to microcin B17. Mutations in ompF and ompR genes affected production of an outer membrane porin protein, OmpF, and resulted in reduced sensitivity to a number of other agents (colicins, bacteriophages) besides microcin B17. The third class of mutants were specifically and highly resistant to microcin B17. The mutations in these strains were mapped to a gene (sbmA), located at 8.7 min on the E. coli K12 chromosome, which is closely linked to phoA. The wild-type sbmA allele was cloned into multiple copy number plasmids, and its location within the cloned DNA fragment was further defined by mutagenesis with MiniMudII1681. These insertion mutations resulted in in-frame fusions between the sbmA and lacZ genes, thereby allowing us to determine the direction of sbmA gene transcription. Plasmids carrying these gene fusions produced low levels of beta-galactosidase, indicating that the sbmA gene is poorly expressed. We have been unable to identify the sbmA gene product, but indirect evidence indicates that it might be an envelope protein involved in microcin uptake. PMID- 3543212 TI - Cloning and expression of the succinyl-CoA synthetase genes of Escherichia coli K12. AB - The genes encoding both subunits of the succinyl-CoA synthetase of Escherichia coli have been identified as distal genes of the suc operon, which also encodes the dehydrogenase (Elo; sucA) and succinyltransferase (E2o; sucB) components of the 2-oxoglutarate dehydrogenase complex. The newly defined genes express polypeptides of 41 kDa (sucC) and 31 kDa (sucD), corresponding to the beta and alpha subunits of succinyl-CoA synthetase, respectively. The genes are thus located at 16.8 min in the E. coli linkage map, together with the citrate synthase (gltA) and succinate dehydrogenase (sdh) genes, in a cluster of nine citric acid cycle genes: gltA-sdhCDAB-sucABCD. Four deletion strains lacking all of these citric acid cycle enzymes were characterized. The succinyl-CoA synthetase activities of strains harbouring plasmids containing the sucC and sucD genes were amplified some fourfold. Further enzymological studies indicated that expression of succinyl-CoA synthetase is coordinately regulated with 2 oxoglutarate dehydrogenase. PMID- 3543213 TI - Cloning of the aconitase gene (acn) of Escherichia coli K12. AB - Lambda phages containing the aconitase gene (acn) of Escherichia coli K12 have been isolated by hybridization with an M13 probe containing part of the aconitase gene (citB) of Bacillus subtilis. Aconitase specific activities are amplified 5- to 18-fold in thermally induced lambda acn lysogens and threefold in a strain transformed with a plasmid derivative (pGS181). PMID- 3543214 TI - Phenotypic expression of the major 47 kDa surface immunogen of Treponema pallidum in virulent, tissue-cultured treponemes. AB - Specific monoclonal antibody and Western blot analysis were used to examine the phenotypic expression of the major 47 kDa surface immunogen of Treponema pallidum among organisms cultivated in vitro. Tissue-cultured treponemes synthesized the 47 kDa immunogen as well as, or better than, organisms cultivated in vivo (rabbit testicles). PMID- 3543215 TI - Expression of reovirus type 3 (Dearing) sigma 1 and sigma s polypeptides in Escherichia coli. AB - The reovirus S1 gene codes for two polypeptides: sigma 1 and sigma s. In order to characterize the structure and function of the sigma 1 polypeptide, we have expressed the sigma 1 protein in Escherichia coli. The S1 gene from mammalian reovirus type 3 (Dearing strain) and the variant K strain were subcloned into an expression vector containing the tac (trp-lac) promoter designed to express foreign gene products in E. coli efficiently. The hybrid plasmids, upon induction with isopropyl-beta-D-thiogalactopyranoside, expressed two polypeptides that were detected by [35S]methionine labelling. One of the induced proteins had a relative molecular mass (Mr) of approx. 46,000 and corresponded to sigma 1, as shown by immunoprecipitation with goat anti-reovirus antibody and a monoclonal antibody against sigma 1. The second induced protein had a Mr of approx. 12,000 and was very similar to sigma s as judged by comparative tryptic peptide map analysis. Protein sigma 1 produced in E. coli was shown to be functional as judged from its ability to bind to mouse L fibroblasts. PMID- 3543216 TI - Treatment of chronic closed head injury with psychostimulant drugs: a controlled case study and an appropriate evaluation procedure. AB - The psychostimulant drugs methylphenidate (MPH) and dextroamphetamine (DEA) have proven efficacy in clinical populations whose primary symptoms include disorders of attention, impulse control, and locomotor hyperactivity. These medications have also been shown to influence in a positive manner cognitive functioning, particularly in the areas of sustained attention and memory. In light of these facts, the psychostimulants MPH and DEA were administered in separate trials to a young man who suffered from similar symptoms secondary to a chronic closed head injury. The medication trials were double-blind, placebo-controlled, dose response studies. Cognitive functions, particularly memory and attention, improved in the active drug conditions. In addition, there was a consistent, positive drug effect across behavioral assessments. This case study emphasizes the importance of studying psychostimulant effects in patients with neuropsychological and behavioral sequelae of closed head injury; it also presents an appropriate methodology for evaluating psychostimulant effects in a clinical research setting. PMID- 3543217 TI - [The gingival sulcular fluid GSF instrument in the early diagnosis of periodontal disease]. PMID- 3543218 TI - Distribution and origin of calcitonin gene-related peptide in the rat stomach and duodenum: an immunocytochemical analysis. AB - We studied the three-dimensional distribution of structures with calcitonin gene related peptide-like immunoreactivity (CGRPI) in the rat stomach and duodenum, including the origins of these structures, using indirect immunofluorescence in both muscle strips and frozen sections. There was a very dense meshwork of CGRPI fibers in the circular and longitudinal muscle layers, and also in the myenteric and submucous plexuses of the stomach and duodenum. No CGRPI neurons were seen in the stomach, even in rats treated with colchicine; in the duodenum, there was a group of CGRPI cells in the myenteric and submucous ganglia. No regional differences were seen in the stomach and duodenum. We found by experimental manipulations that CGRPI fibers in the stomach were exclusively extrinsic in origin; some of such fibers in the duodenum were intrinsic in origin, though most were supplied by CGRPI cells outside the duodenum. PMID- 3543219 TI - Zinc metalloproteins involved in replication and transcription. AB - RNA polymerase (RPase) from E. coli contains two tightly incorporated Zn(II) ions, while the monomeric RPase from bacteriophage T7 does not contain zinc and does not require Zn(II) in the assay. One of the two Zn(II) ions can be differentially removed from E. coli RPase with p-hydroxymercuriphenylsulfonate (PMPS) combined with EDTA and thiol. The resultant Znl or ZnA RPase shows no alteration in transcription initiation and elongation rate from sigma-specific promoters. Biosynthesis of a Co2 RPase and formation of CoA RPase by similar treatment shows the tetrahedral-type Co(II) d-d absorption bands to be associated only with the Co(II) at the A site with maxima at 760 (epsilon = 800), 710 (epsilon = 900), 602 (epsilon = 1500), and 484 (epsilon = 4000) nm. Sulfur to Co(II) charge transfer bands are present at 350 (epsilon = 9600) and 370 (epsilon = 9500) nm. The absorption characteristics strongly suggest that the A site is a tetrathiolate site. While DNA polymerases do not in general appear to contain zinc, gene 32 protein (g32P) from bacteriophage T4, an accessory protein essential for DNA replication and recombination and translational control in the T4 life cycle, is a Zn(II) metalloprotein and contains 1 gram atom of tightly incorporated Zn(II). PMPS displaces the zinc by reacting with three SH groups. Apo-g32P shows markedly altered DNA binding properties. Co(II) substitution gives a protein with intense d-d transitions typical of a tetrahedral Co(II) complex with absorption maxima at 680 (epsilon = 480), 645 (epsilon = 660), 605 (epsilon = 430), 355 (epsilon = 2250), and 320 (epsilon = 3175) nm. The data support a 3 Cys, 1 His coordination site located in the middle of the DNA binding domain of g32P. Data thus far suggest that the Zn(II) binding sites in multisubunit RNA polymerases and in accessory proteins involved in polynucleotide biosynthesis are more likely to play structural or allosteric (regulatory) roles rather than directly participating in catalysis. PMID- 3543220 TI - Special issue in honor of Professor R.J.P. Williams, FRS. PMID- 3543221 TI - Inorganic biochemistry and myself. PMID- 3543222 TI - Antigenic pattern of human brain glycoproteins as described by monoclonal antibodies. AB - A battery of monoclonal antibodies was raised against a preparation of lentil lectin-binding membrane glycoproteins from human brain. Out of 26 established hybridomas, nine produced antibodies against the human Thy-1 antigen. For the remaining 17 lines, reactivity with at least six other antigens could be identified after immunoprecipitation and immunoblotting. Several of the antigens were di- or trimeric, mainly in the molecular weight range of 60-120 kDa. Two of the antibodies were reactive with high-molecular-weight aggregates and four targets for the antibody reactivity were not identifiable by immunoprecipitation of iodinated antigens. Three of the identified antigens were shown by quantitative enzyme-linked immunosorbent assay tests on various human tissues to be specifically expressed in the brain. PMID- 3543223 TI - Neurochemical and immunocytochemical studies on the distribution of N-acetyl aspartylglutamate and N-acetyl-aspartate in rat spinal cord and some peripheral nervous tissues. AB - HPLC analysis of rat spinal cord revealed a uniform distribution of N-acetyl aspartate (NAA) across both longitudinal and dorsoventral axes. In contrast, ventral cord N-acetyl-aspartylglutamate (NAAG) levels were significantly higher than those measured in dorsal halves of cervical, thoracic, and lumbar segments. Immunocytochemical studies using an affinity-purified antiserum raised against NAAG-bovine serum albumin revealed an intense staining of motoneurons within rat spinal cord. Along with the considerable NAAG content in ventral roots, these results suggest that NAAG may be concentrated in motoneurons and play a role in motor pathways. NAAG was also present in other peripheral neural tissues, including dorsal roots, dorsal root ganglia, superior cervical ganglia, and sciatic nerve. It is interesting that NAA levels in peripheral nervous tissues were lower than those in CNS structures and that NAA levels in ventral roots and sciatic nerve were lower than NAAG levels. These findings further document a lack of correlation between NAAG and NAA levels in both central and peripheral nervous tissues. Taken together, these data demonstrate the presence of NAAG in nonglutamatergic neuronal systems and suggest a more complex role of NAAG in neuronal physiology than previously postulated. PMID- 3543224 TI - S100a0 (alpha alpha) protein, a calcium-binding protein, is localized in the slow twitch muscle fiber. AB - We previously showed that, in contrast to the distribution of S100b (beta beta), S100a0 (alpha alpha) is mainly present in human skeletal and heart muscles at the level of 1-2 micrograms/mg of soluble protein and is universally distributed at high levels in skeletal and heart muscles of various mammals. To elucidate cellular and ultrastructural localizations of the alpha subunit of S100 protein (S100-alpha) in skeletal muscle, we used immunohistochemical and enzyme immunoassay methods. The immunohistochemical study revealed that S100-alpha is mainly localized in slow-twitch muscle fibers, whereas the beta subunit of S100 protein (S100-beta) was not detected in both types of muscle fibers, an observation indicating that the predominant form of S100 protein in the slow twitch muscle fiber is not S100a or S100b, but S100a0. The quantitative analysis using enzyme immunoassay corroborates the immunohistochemical finding: The S100 alpha concentration of mouse soleus muscle (mainly composed of slow-twitch muscle fibers) is about threefold higher than that of mouse rectus femoris muscle (mainly composed of fast-twitch muscle fibers). At the ultrastructural level, S100-alpha is associated with polysomes, sarcoplasmic reticulum, the plasma membrane, the pellicle around lipid droplets, the outer membrane of mitochondria, and thin and thick filaments, by immunoelectron microscopy. PMID- 3543225 TI - Accuracy of stereotaxic localisation using MRI and CT. AB - The accuracy of stereotaxic coordinates determined using the Leksell apparatus with CT and MRI was investigated using an Agar filled head phantom. Both imaging techniques were found to produce an accuracy of better than 2 mm with the exception of the Z coordinate as measured by CT (2.3 mm). This latter error is greater because of the 3 mm slice width used. Direct coronal views were used to determine Z more accurately using MRI. The measurement procedures are described and it is shown that the Leksell system of using orthogonal coordinates enables the scaling of images, which is particularly necessary with MRI, to be done easily. PMID- 3543226 TI - Embolisation techniques in neuroradiology. AB - Embolisation is a definitive treatment for selected arteriovenous fistulas, aneurysms and both extra- and intra-axial angiomatous malformations. It is an effective emergency treatment for many cases of intractable epistaxis. It is useful prior to surgery to reduce blood loss from hypervascular tumours, including juvenile angiofibromas, paragangliomas and basal meningiomas, and from angiomas or soft tissue or of bone prior to excision, dental extraction or laminectomy. Embolisation is a satisfactory palliative treatment for angiomas involving superficial tissues, in which the cosmetic effects of surgery are unlikely to be satisfactory, and of mucosal surfaces causing intractable bleeding. In inoperable tumours, embolisation can relieve pain, bleeding, pulsatile tinnitus or discomfort due to mass effect. PMID- 3543227 TI - Proteolytic enzyme activities of macrophages and lymphocytes in neurological diseases. AB - Studies showed a significant decrease in the macrophage neutral protease and lymphocyte acid protease activities in patients with multiple sclerosis in remission, a significantly decreased neutral protease activity in macrophages in patients with myasthenia gravis and a significantly decreased acid protease activity in macrophages and lymphocytes in patients with polymyositis. No remarkable abnormalities were found in patients with myotonic dystrophy. These results suggest that multiple sclerosis, myasthenia gravis and polymyositis have an abnormality in immunological function. PMID- 3543228 TI - Pseudohypertension: a diagnostic dilemma. AB - Pseudohypertension is a condition in which the indirect measurement of intra arterial pressure using a sphygmomanometer (cuff pressure) is artifactually high in comparison with directly measured intra-arterial pressure. If unrecognized, pseudohypertension may result in unwarranted and sometimes dangerous treatment. Pseudohypertension results from medial sclerosis and/or calcification of arteries, which markedly decrease their collapsibility. Both the systolic and diastolic pressures are affected. The literature concerning pseudohypertension is quite limited; indeed, the very frequency of the condition is unknown. Very high blood pressure in the absence of significant target organ impairment is an important clue to this subtype of hypertension and should lead to simple diagnostic techniques, such as Osler's maneuver (an attempt to palpate a pulseless radial artery) and radiographs of the soft tissues of the arms. The definitive diagnosis is made by comparing the intra-arterial pressure with the indirectly determined blood pressure. PMID- 3543229 TI - An abnormal response of the adrenal cortex to insulin: glucose in essential hypertension. AB - This investigation demonstrates an abnormal response to the adrenal cortex to modulation of the potassium metabolism by an intravenous infusion of insulin glucose in patients with essential hypertension. In response to insulin-glucose there was a transient decline of plasma aldosterone and plasma cortisol concentrations in control subjects with normal blood pressure, whereas a temporary increase of both hormones was found in patients with essential hypertension. Treatment with thiazide diuretics further magnified the different aldosterone response between the two groups. It is suggested that the abnormal response of patients with essential hypertension may be of significance to the understanding of the pathogenesis of this important disease. PMID- 3543231 TI - Once-daily treatment of essential hypertension with captopril. AB - After a 4- to 6-week placebo lead-in period, 382 mild-to-moderate hypertensive patients with diastolic blood pressures remaining between 92 and 109 mmHg were randomized to double-blind treatment with captopril (50 mg q.d.) (94), captopril (50 mg b.i.d.) (97), captopril (50 mg q.d.) plus hydrochlorothiazide (97), and placebo (94). After 4 weeks the captopril dosage was doubled, whereas the hydrochlorothiazide dose remained at 25 mg for an additional 4 weeks. Response to treatment was evaluated by means of blood pressure determinations at the end of 4 and 8 weeks. All three active treatment regimens reduced diastolic blood pressure more than placebo did (p less than or equal to 0.01). Patients receiving captopril with diuretic had a greater decrease in pressure than those receiving captopril alone. The once-daily captopril regimen was as effective as the twice daily regimen, although the latter employed double the daily dose. Increasing the captopril dosage during the second 4-week period resulted in a minimal addition reduction in blood pressure. Full 24-hour monitoring confirmed that the blood pressure was controlled by once-daily captopril therapy. Captopril given once daily, alone or in combination with hydrochlorothiazide, is efficacious treatment for patients with mild-to-moderate hypertension. The once-daily regimen should further enhance patient compliance. PMID- 3543230 TI - Chronic continuous PTH infusion results in hypertension in normal subjects. AB - The factors responsible for the frequent occurrence of hypertension in patients with primary hyperparathyroidism have not been elucidated. Suggested mediators have included hypercalcemia, renal insufficiency, and increased plasma renin activity. However, experimental results have not been reported in any species that test the hypothesis that sustained hypertension in this clinical syndrome is due to consequences of parathyroid hormone (PTH) excess versus unrelated factors (e.g., primary hypersecretion of other hormones, NaCl sensitivity, genetic factors). Moreover, no systematic evaluation of the renin or adrenal cortical responses to chronic PTH excess has been reported in any species. Accordingly, the present studies assessed the effects of chronic (12 days) continuous intravenous b-(1-34) PTH infusion in normal human subjects (n = 4). PTH infusion resulted in persistent hypercalcemia and hypertension, reversible during a 4-8 day recovery period. Transient but significant increases in urinary tetrahydroaldosterone excretion and plasma cortisol concentration were observed as hypercalcemia and hypertension developed. No significant changes in plasma potassium concentration or plasma renin activity were observed, suggesting that hypercalcemia-induced transient hypersecretion of ACTH was responsible for both cortisol and aldosterone responses. The present results suggest that hypertension associated with clinical primary hyperparathyroidism results from either direct or indirect effects of PTH excess, per se, and requires neither the long-term consequences/complications of the clinical disorder (e.g., severe nephrocalcinosis, renal insufficiency) nor primary hypersecretion of additional hormones. These results are consistent with the hypothesis that hypercalcemia alone or in combination with at least permissive levels of PTH can generate short term, but persistent (12 days) hypertension in human subjects and thus may be the initiating mechanism for hypertension in clinical primary hyperparathyroidism. PMID- 3543232 TI - Why has so much chemotherapy done so little in head and neck cancer? PMID- 3543233 TI - A new technique for placement of tunneled subclavian right atrial catheters: experience with 130 cases. AB - We have developed a new single step technique for placement of indwelling silastic subclavian right atrial catheters through a short subcutaneous tunnel that is simple, relatively inexpensive, and can be done in the outpatient clinic. Between December 1984 and July 1986, 130 catheters were inserted in 122 patients using this approach for a cumulative total of 8,900 catheter days. Major complications have included five catheter infections with bacteremia, two procedure-related pneumothoraces, one internal jugular vein thrombosis, and one catheter fragment embolization to the right heart (total major complication rate, 6.9%). Minor complications have included five catheter migrations, seven catheter or catheter hub leaks, and two irreversible lumen occlusions (total minor complication rate 10.8%). Damaged or malpositioned catheters can be replaced through the same subcutaneous tract using a guidewire exchange technique. When this has not been possible, we have not encountered technical difficulties (due to subclavian thrombosis or stenosis) prohibiting insertion of a new catheter, even on the same side. These catheters provide reliable venous access for patients requiring frequent blood sampling, intravenous (IV) fluid or blood product administration, chemotherapy, IV narcotics for pain control, long-term antibiotic therapy, or hyperalimentation. They are ideal for infusion of vesicant chemotherapeutic agents and for patients undergoing ambulatory outpatient infusion chemotherapy. They have a low overall morbidity rate and excellent patient acceptance. Catheter maintenance procedures are simple and non-time consuming. The same technique can be used to place multichannel catheters in patients requiring greater venous access. We now recommend early placement of these catheters in patients who will require frequent phlebotomy or drug administration during the course of their treatment. PMID- 3543234 TI - Antiemetic activity of high doses of metoclopramide combined with methylprednisolone versus metoclopramide alone in cisplatin-treated cancer patients: a randomized double-blind trial of the Italian Oncology Group for Clinical Research. AB - We designed a multicenter, double-blind randomized study to determine the safety and antiemetic effectiveness of intravenous (IV) methylprednisolone (P) combined with high-dose IV metoclopramide (MTC) v MTC alone in 200 untreated cancer patients receiving cisplatin chemotherapy. One hundred eighty-five patients were evaluable for treatment efficacy. MTC plus P was significantly superior to MTC alone in reducing the number and length of vomiting episodes (P = .001 and P = .0008, respectively) and the maximal intensity of nausea (P = .0124 with a score system; P = .0155 with a linear analogue scale) and length of nausea (P = .0056). The subgroup with a major incidence of nausea and vomiting was women, especially young women, outpatients, and those treated with higher doses of cisplatin. Side effects were low and equally distributed between the two treatment groups. We conclude that MTC plus P has greater antiemetic activity than MTC alone in patients receiving cisplatin chemotherapy. PMID- 3543235 TI - Analysis of dose intensity for adjuvant chemotherapy trials in stage II breast cancer. PMID- 3543236 TI - Adjuvant chemotherapy for osteosarcoma: a randomized prospective trial. AB - To determine the role of chemotherapy in the multidisciplinary treatment of patients with osteosarcoma, a randomized prospective trial of postoperative adjuvant chemotherapy was begun in 1981. Fifty-nine patients with nonmetastatic classic intramedullary osteosarcoma were randomized; 32 received postoperative adjuvant chemotherapy consisting of high-dose methotrexate, Adriamycin (Adria Laboratories, Columbus, OH), and BCD (bleomycin, cytoxan, actinomycin D), and 27 patients received no adjuvant chemotherapy. At a median follow-up of 2 years, there was a statistically significant improvement in both disease-free and overall survival in those who received adjuvant chemotherapy. In addition, there was no difference in the less than 20% disease-free or overall survival of patients treated in the 1970s who did not receive chemotherapy, as compared with the concurrent nontreatment controls. Therefore, with identical staging procedures, uniform surgical management, and standard pathologic evaluation, postoperative adjuvant chemotherapy definitely improves disease-free and overall survival in patients with osteosarcoma. PMID- 3543237 TI - Adjuvant chemotherapy of osteosarcoma: no runs, no hits, two men left on base. PMID- 3543238 TI - Prognostic significance of staging factors of the UICC staging system in childhood rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study (IRS-II). AB - The need for a pretreatment staging system to accurately assess programs of therapy for the various sites and stages of childhood rhabdomyosarcoma has become apparent as detailed analyses of many factors affecting prognosis and treatment choices have been accomplished through the national cooperative trial, the Intergroup Rhabdomyosarcoma Study (IRS). Initiated in 1972, the IRS has thus far used a clinicopathologic grouping system that is based heavily on therapeutic decisions, particularly on whether or not excision is accomplished and the extent of such an operation. The major problem with this and several other staging classifications now in use is that they depend on pathologic data obtained after surgical treatment has been initiated or rejected. In addition, they do not consider histologic variations of this neoplasm which may be important in estimating prognosis. The large body of clinical data now accumulated in the IRS has provided an excellent opportunity for developing a database for evaluating the International Union Against Cancer (UICC) pretreatment staging system and also the potential for using histologic categories in the staging process. The records of 505 eligible patients entered into the IRS between 1978 and 1982 were used to determine the prognostic impact of a number of pretreatment factors. These included local invasiveness of the primary neoplasm on clinical examination, tumor size, clinical status of regional nodes, clinical or radiologic evidence of distant metastases, and favorable or unfavorable histologic categories. A retrospective assessment of the relationship of these pretreatment observations to survival experience has been carried out. This retrospective study indicates definite prognostic significance for all of the individual factors used on the UICC system except clinical status of regional nodes. Also, these data serve as a basis for considering the possibility of including favorable v unfavorable histology in the pretreatment staging system now being tested prospectively in the ongoing IRS protocols. PMID- 3543240 TI - Whither carboplatin?--A replacement for or an alternative to cisplatin? PMID- 3543239 TI - Randomized comparison of cyclophosphamide, imidazole carboxamide, and adriamycin versus cyclophosphamide and adriamycin in patients with advanced stage malignant mesothelioma: a Sarcoma Intergroup Study. AB - In 1980, a consensus chemotherapy intergroup study for advanced malignant mesothelioma was initiated based on a collaborative agreement among the Eastern Cooperative Oncology Group (ECOG), the Southwest Oncology Group (SWOG), and the Southeastern Cancer Study Group (SECSG). The purpose of the study was to evaluate cyclophosphamide (500 mg/m2 day 1), imidazole carboxamide (250 mg/m2 days 1 through 5), and doxorubicin (Adriamycin; Adria Laboratories, Columbus, OH) (50 mg/m2 day 1) v cyclophosphamide (500 mg/m2) and doxorubicin (50 mg/m2) in a randomized prospective clinical trial involving 76 fully evaluable patients with advanced stages II to IV malignant mesothelioma. A total of nine responses (12%) were documented, including three complete and six partial responses. There was no significant difference in response duration or survival between treatment arms. Leukopenia (greater than 2,000/microL) was observed in 46% of patients treated with the three-drug combination and 38% of patients receiving the two-drug combination. The variables of performance status 0-1 and the absence of prior chemotherapy/radiotherapy were significant with respect to favorable impact on survival. We conclude, based on the minimal benefit observed, that the combination of cyclophosphamide and doxorubicin with or without imidazole carboxamide does not warrant further investigation in patients with advanced stage malignant mesothelioma. PMID- 3543241 TI - High-dose induction chemotherapy of metastatic breast cancer in protected environment: a prospective randomized study. AB - To test the hypothesis of whether high doses of chemotherapy in combination achieve higher response rates and longer durations of response and survival, we treated 33 pre- and perimenopausal patients with good performance status in a prospective trial with escalating doses of fluorouracil, doxorubicin and cyclophosphamide (FAC). Patients were randomly assigned to be treated within a protected environment (laminar air flow room), with prophylactic antibiotics, or in a standard hospital room. Important patient characteristics were equally distributed in the two treatment arms. A major objective response was observed in 27 of the 32 evaluable patients (84%), and 11 (34%) achieved a complete remission (CR). There was no significant difference in overall and complete response rates between the two treatment arms, nor was there a substantial difference in times to progression or survival between the groups treated in or out of the protected environment. Comparison of the results of this study with previously reported programs of FAC chemotherapy in patients with metastatic breast cancer shows that this study achieved higher overall and complete response rates. However, neither the time to progression, nor the survival of responders or the entire patient group was different from our previous experience with standard FAC chemotherapy. When the study was initiated in 1976, the proposed dose escalation represented high-dose chemotherapy. In retrospect, even the "high" doses used in this study represent only a modest increase over standard doses of chemotherapy. Much steeper dose escalations will be needed to evaluate the efficacy of high-dose chemotherapy in breast cancer, as well as the protective value of the protected environment and prophylactic antibiotics in metastatic breast cancer. PMID- 3543242 TI - A phase I-II trial of carboplatin and 5-fluorouracil combination chemotherapy in advanced carcinoma of the head and neck. AB - Twenty-nine patients with recurrent or advanced, incurable head and neck cancer were entered into a phase I-II trial of carboplatin in combination with 5 fluorouracil (5-FU), 1,000 mg/m2/d continuous intravenous (IV) infusion for five days every 28 days. The initial dose of carboplatin was 300 mg/m2 for patients with Karnofsky performance scores greater than or equal to 70%, and 240 mg/m2 for patients with scores of 50% to 60%. Subsequent doses were modified to achieve grade 2 myelo-suppression: WBC, 2,000 to 2,999 cells/microL; granulocytes, 1,000 to 1,499 cells/microL; and platelets, 50,000 to 75,000 cells/microL. Dose levels were 180, 240, 300, 360, and 420 mg/m2. Twenty-eight patients had squamous-cell cancers and one had an adenoid cystic carcinoma of the parotid. There were 26 patients with recurrent disease; 22 had received prior RT; only two had received other chemotherapy immediately before study entry. Three patients had newly diagnosed incurable stage IV disease. The median performance status was 80% (range, 60% to 90%). All patients had objectively measurable disease, and 28 were evaluable for response. There were three complete responses (CRs) and ten partial responses (PRs) (48% CR and PR); the median duration of response was 4.7 months (range, 1.5 to 15+ months). Dose-limiting toxicities were granulocytopenia, thrombocytopenia, and stomatitis. Prolonged myelosuppression delayed retreatment in eight patients and delayed 19 of 107 (18%) courses. Stomatitis occurred in 61% and diarrhea in 29%. 5-FU dosage was decreased in ten patients (36%) for grade 2 or greater stomatitis or diarrhea. Mild to moderate nausea and vomiting occurred in 66% of patient trials in which no pretreatment antiemetics were administered. Other toxicities included phlebitis from 5-FU in 71%, skin toxicity in 11%, mild alopecia in 25%, and fatigue in 54% of patients. Nephrotoxicity (creatinine greater than 2.0 mg/dL) occurred in one patient. The dose of carboplatin resulting in grade 2 toxicity was 180 mg/m2 in one patient, 240 mg/m2 in one, 300 mg/m2 in seven, 360 mg/m2 in ten, and 420 mg/m2 in one. Based on these results, we recommend a starting dose of carboplatin, 300 mg/m2, in combination with five days of continuous infusion 5-FU. In this dose and schedule, this combination was well tolerated and demonstrated antitumor activity in head and neck cancer. To confirm these promising results, a Southwest Oncology Group prospective randomized trial is in progress comparing carboplatin and 5-FU, cisplatin and 5 FU, and standard-dose weekly methotrexate in recurrent-disease patients. PMID- 3543243 TI - High-dose carboplatin in refractory ovarian cancer patients. AB - Thirty previously treated refractory ovarian cancer patients, all of whom received prior therapy with cisplatin, were treated in a phase II trial with high dose carboplatin (800 mg/m2 per cycle with cycles administered every 35 days). Patients were treated with high-dose carboplatin when they were no longer responding to prior therapy or had relapsed after an initial response. Objective responses were achieved in eight of 30 patients (27%) while ten patients had minor responses or stable disease. No responses were observed from high-dose carboplatin in patients who had progressive disease during prior therapy with a cisplatin-based regimen. The primary toxicity of high-dose carboplatin was myelosuppression with a median WBC nadir of 0.6 and a median platelet nadir of 6,500 after the first cycle of therapy. Myelosuppression was not particularly cumulative as 78% of patients were able to receive either 100% or 75% of the projected dose even with the fourth cycle of high-dose carboplatin. The gastrointestinal (GI) toxicity of carboplatin was mild and there was no clinically apparent nephrotoxicity or neurotoxicity. These results demonstrate that: there is marked cross-resistance between cisplatin and carboplatin, and high-dose carboplatin may be a potential alternative to high-dose cisplatin in the treatment of ovarian cancer patients. PMID- 3543244 TI - Malignant lymphoma: cardiac involvement at initial presentation. AB - Malignant lymphoma rarely involves the heart at initial presentation. We have cared for nine cases in the past 8 years. The median age was 45 years (range, 27 to 68). Initial presenting symptoms included chest pain in four, gastrointestinal (GI) symptoms in three, and constitutional "B" symptoms in two. Echocardiography was the most useful noninvasive procedure, and was abnormal in the eight cases studied. Echocardiographic findings included pericardial effusion in six, and mass lesions within the heart in five. Morphologically, the lymphoma was high grade small noncleaved in four, immunoblastic sarcoma in one, and diffuse large cell type in four. Clinical staging workup revealed widely disseminated disease in seven. In spite of multiagent chemotherapy, survival was short (median, 1.5 months). Interestingly, four of these patients were homosexual or bisexual men, who fulfill the criteria for acquired immune deficiency syndrome (AIDS). PMID- 3543245 TI - High-dose chemoradiotherapy with bone marrow transplantation as consolidation treatment in neuroblastoma: an unselected group of stage IV patients over 1 year of age. AB - Since January 1983, 56 consecutive children over 1 year of age with stage IV neuroblastoma entered an aggressive protocol, including chemotherapy, radiation therapy, and bone marrow transplantation. The induction protocol included platinum and epipodophyllotoxin (VM-26), alternating with cyclophosphamide, Adriamycin (Adria Laboratories, Columbus, OH), and vincristine (PE/CADO). Surgery was performed after 2 to 4 months, and consolidation with intensive chemoradiotherapy and bone marrow transplantation (BMT) was performed within 12 months of diagnosis. The combination of vincristine, melphalan and total body irradiation (TBI) was used before BMT, and no further treatment was administered before progression. With the exception of two allografts, autologous BMT (ABMT) was given in all cases and was purged using an immunomagnetic procedure (Kemshead technique) in 32 of 35 cases, and a chemical procedure in three of 35. Of the 56 patients, 45 were evaluable. Of those, 23 were grafted in partial remission (PR), and 14 were grafted in either complete remission (CR) or very good partial remission (VGPR). The acute toxic death rate was 19%, the relapse rate was 32%, and the progressive disease rate was 19%. The progression-free survival in the CR/VGPR group (ie, 44% at 32 months post-diagnosis) and in the PR group (13% at 32 months) was not significantly different (P greater than .05). At 24 months, the overall survival of the 56 unselected patients was 39% compared with 12% for comparable patients previously treated by our group (P less than .005). PMID- 3543246 TI - 5-Fluorouracil and folinic acid in the treatment of metastatic colorectal cancer: a randomized comparison. A Southwest Oncology Group Study. AB - In order to determine the clinical applicability of the in vitro observation of enhanced cytotoxicity of 5-fluorouracil (5-FU) in the presence of excess reduced folates, the Southwest Oncology Group (SWOG) performed a randomized trial evaluating two dose schedules of 5-FU and folinic acid (FA) in 128 patients with metastatic colorectal cancer. Of 125 eligible patients, 62 were randomized to receive bolus FA (200 mg/m2 days 1 through 4) in addition to 5-FU (1,000 mg/m2 days 1 through 4) by continuous four-day infusion (infusion arm), while 63 were randomized to receive bolus FA (200 mg/m2 days 1 through 5) in addition to 5-FU (325 mg/m2 days 1 through 5) by bolus injection (bolus arm). The toxicities of the two schedules differed, with stomatitis being more severe in the infusion arm and leukopenia being more severe in the bolus arm. The response rates and survival data for the two arms are nearly identical. The median survival of patients on the infusion arm is 11.0 months and of patients on the bolus arm, 10.3 months. The infusion arm produced one complete response (CR) and 12 partial responses (PRs), for a major response rate of 21% of eligible patients. The bolus arm produced three CRs and 11 PRs, for a major response rate of 22% of eligible patients. The response rate produced is minimally superior to recent cooperative group studies of colorectal cancer, but the response rate and survival experience are within the range of experience for treatment with 5-FU alone. PMID- 3543247 TI - Recombinant alfa interferon in renal cell carcinoma: a randomized trial of two routes of administration. AB - Ninety-seven patients with recurrent or metastatic renal cell carcinoma were randomized to receive recombinant interferon (IFN) alfa-2b (Intron A; Schering Plough, Kenilworth, NJ) by either the subcutaneous (SC) or intravenous (IV) route. The SC dosage was 2 X 10(6) IU/m2 three times weekly, and the IV dose 30 X 10(6) IU/m2 for five consecutive days every 3 weeks. Dose escalation to a maximum of 10 X 10(6) IU/m2 SC and 50 X 10(6) IU/m2 IV was allowed for patients with minimal or absent toxicity. Five of 51 of the SC-treated patients (10%) and three of 46 of the IV-treated patients (7%) had a partial response (PR) or complete response (CR). Patients with prior nephrectomy, no prior treatment, and lack of bone metastases were most likely to respond, and a retrospective analysis of this subgroup revealed a 23% response rate. Achievement of response took from 3 weeks to 11 months, while response duration lasted from 3 to 31+ months. All responders had prior nephrectomy; six of eight had no prior chemotherapy or hormonal therapy; five had lung metastases, and none had bone metastases. Regardless of route, almost all patients developed a flu-like syndrome; however, grade 3 or greater toxicity was much more common for IV-treated patients. This trial demonstrates modest, but definite antitumor activity for recombinant interferon in advanced renal cell carcinoma. SC administration with lower dose and toxicity is as effective as treatment administered IV. PMID- 3543248 TI - Collapse of growth cone structure on contact with specific neurites in culture. AB - We have studied the morphology of embryonic chick retinal and sympathetic growth cones as they meet retinal and sympathetic neurites grown in culture. Growth cones preserve their normal morphology and ability to locomote when retinal growth cones contact retinal neurites or when sympathetic growth cones contact sympathetic neurites. Growth cones collapse and their motility ceases when retinal growth cones contact sympathetic neurites or when sympathetic growth cones contact retinal neurites. Collapse was never observed before a growth cone touched a neurite. As a growth cone collapses, the neurite it leads retracts. After a brief pause, a new growth cone is organized and extension recommences. These results suggest that contact-mediated inhibition of locomotion could play a role in growth cone guidance. PMID- 3543249 TI - GABA-immunoreactivity in inhibitory motor neurons of the nematode Ascaris. AB - We have used GABA-specific antisera to detect GABA-immunoreactivity in the motor neurons of the ventral nerve cord of Ascaris. We find that a subset of the individually identifiable commissures of motor neurons is specifically stained. On the basis of the location and morphology of stained commissures and of the location of stained cell bodies in the ventral nerve cord, we conclude that the labeled neurons comprise all members of the VI (inhibiting ventral muscle; 13 cells) and DI (inhibiting dorsal muscle; 6 cells) classes of inhibitory motor neurons (Stretton et al., 1978; Walrond et al., 1985). This result supports previous suggestions (e.g., del Castillo et al., 1964b) that GABA is the neurotransmitter released by the inhibitory motor neurons of nematodes. In the anterior part of the animal, the inhibitory motor neuron commissures have small branches in the sublateral nerve cords that have not been previously described: VI commissures have dorsal sublateral branches, while DI cells have ventral branches. Posterior VI neurons have branches in the lateral nerve cords. PMID- 3543250 TI - Topographic mapping of motor pools onto skeletal muscles. AB - We have studied the segmental innervation of 2 rat skeletal muscles, the diaphragm and the serratus anterior. Both muscles are thin, flat, and composed of several sectors that form a clear rostrocaudal progression. Each is innervated through a single nerve, which is in turn supplied by motor neurons from several cervical spinal segments. Using intracellular recording, we found that in both cases, the rostrocaudal axis of the motor pool is systematically mapped onto the rostrocaudal axis of the muscle's surface. For the diaphragm, electrophysiological results were confirmed by immunohistochemical identification of denervated fibers following section of single ventral roots and by retrograde labeling of motoneurons following localized application of fluorescent dyes. In addition, an immunohistochemical method was used to study the arrangement of motor axons in the phrenic nerve, which supplies the diaphragm, and to show that contributions from individual ventral roots are compartmentalized within this nerve. We suggest that segmental ordering of axons in the nerve, axonal guidance at branch points in the nerve, and positional labels within the muscle may all contribute to the rostrocaudal mapping of motor pools onto muscle. PMID- 3543251 TI - An ultrastructural study of GABA-immunoreactive neurons and terminals in the septum of the rat. AB - The fine structure and types of contact made by GABAergic elements in the septal nuclei were studied at the electronmicroscopic level by means of peroxidase immunocytochemistry, using anti-GABA antibodies. Observations were made on normal and colchicine-injected rats. GABA-immunoreactivity was distributed within somata, dendrites, axonal varicosities and terminals, and myelinated axons. The peroxidase reaction product was diffuse in the cytoplasm; cytoplasmic organelles were generally devoid of immunoreactivity, while showing a strong reaction on the outer surface of their membrane. GABA-immunoreactive (GABA-I) neurons were small (10 microns on average) to medium (20 microns) in size, with round or multipolar cell bodies. Additionally, labeled large (30 microns) cells were observed within the myelinated fibers of the medial septal nucleus after intraseptal administration of colchicine. No difference in the ultrastructural features and distribution of the immunoreactivity of the 2 kinds of cell was noticed, except for a higher number of synaptic contacts on large neurons of the medial septum. GABA-I cells of the medial and lateral nuclei received synapses on their soma and dendrites, made by both immunonegative and GABA-I terminals. Nonimmunoreactive boutons contacting GABA-I cell bodies were of 2 types: those containing small, clear synaptic vesicles and those that additionally contained large dense vesicles. Synaptic vesicles of GABA-I boutons were rarely labeled internally, but showed varying electron densities. Synapses made by GABA-I boutons on GABA-I or unlabeled somata and dendrites were always of symmetrical type. Synapses made by non-GABA-I boutons on GABA-I cells were either symmetrical or asymmetrical. PMID- 3543252 TI - In vitro drug sensitivity testing in human gliomas. AB - In vitro drug sensitivity assays have been developed with the goal of predicting the clinical response to chemotherapy. The colony-forming assay, radiolabeled precursor inhibition assay, and microcytotoxicity assay are most commonly used. In retrospective studies, the assays correctly predict clinical response to a chemotherapeutic agent in 50% to 70% of patients and predict clinical resistance in nearly 100% of patients. All of the assays suffer from technical and theoretical problems. In vitro assays depend on cell culture and therefore do not entirely simulate in vivo conditions. Heterogeneity in chemosensitivity is commonly found and can complicate the interpretation of results. Further investigation is needed to determine if these assays will be able to select prospective chemotherapy for patients. The malignant origin of the cells in culture must be verified if meaningful conclusions are to be made. PMID- 3543253 TI - Changing concepts in the treatment of colloid cysts. An 11-year experience in the CT era. AB - Since computerized tomography (CT) scanning became available at the University Health Center of Pittsburgh in July, 1975, 17 patients have undergone removal of colloid cysts of the third ventricle by transfrontal, transcallosal, or stereotaxic surgery. All patients presented with symptoms and signs of increased intracranial pressure; CT scanning proved to be the best neurodiagnostic test to define the colloid cysts. Since the development of CT-guided stereotaxic surgery, the authors have preferentially performed stereotaxic aspiration in seven patients; three of these subsequently required craniotomies to remove residual cysts producing persistent symptoms. The viscosity of the intracystic colloid material and/or displacement of the cyst away from the aspiration needle were reasons for unsuccessful aspiration; the CT appearance did not correlate with the ability to aspirate the lesion by the sterotaxic technique. Postoperative patency of the ventricular system was documented by intraoperative CT ventriculography performed during stereotaxic surgery. Removal of the cyst wall was not necessary. Because of the low associated morbidity rate, percutaneous stereotaxic aspiration is recommended as the initial treatment of choice for colloid cysts of the third ventricle. If stereotaxic aspiration fails and symptoms persist, craniotomy should be performed. PMID- 3543254 TI - A new approach in the treatment of hydrocephalus. AB - To date, most patients suffering from hydrocephalus have been treated by insertion of differential-pressure valves that have fairly constant resistance. Since intracranial pressure (ICP) is a variable parameter (depending on such factors as patient's position and rapid eye movement sleep) and since cerebrospinal fluid (CSF) secretion is almost constant, it may be assumed that some shunt complications are related to too much or too little CSF drainage. The authors suggest a new approach to treating hydrocephalus, the aim of which is to provide CSF drainage at or below the CSF secretion rate within a physiological ICP range. This concept has led the authors to develop a three-stage valve system. The first stage consists of a medium-pressure low-resistance valve that operates as a conventional differential-pressure valve until the flow through the shunt reaches a mean value of 20 ml/hr. A second stage consists of a variable resistance flow regulator that maintains flow between 20 and 30 ml/hr at differential pressures of 80 to 350 mm H2O. The third stage is a safety device that operates at differential pressures above 350 mm H2O (inducing a rapid increase in CSF flow rate) and therefore prevents hyper-elevated ICP. An in vitro study is described that demonstrates the capability of this system to maintain flow rates close to CSF production under a range of pressures similar to those observed under various human physiological and postural conditions. Promising clinical results in 19 patients shunted with this valve are summarized. PMID- 3543256 TI - Reevaluating the efficacy of intra-arterial BCNU. PMID- 3543255 TI - Hormone production in clinically nonfunctioning pituitary adenomas. AB - Pituitary tumors in which no excess hormone secretion can be identified clinically have been considered as nonfunctioning or null-cell adenomas. Immunocytochemical data presented here suggest that many of these tumors contain subunits of the glycoprotein hormones. Of 160 patients referred for pituitary surgery, 37 (23%) had no evidence of excess hormone secretion on preoperative endocrine evaluation. Immunocytochemical staining of these tumors was carried out using antibodies specific for prolactin, growth hormone, adrenocorticotropic hormone, the beta subunits of luteinizing hormone (beta-LH), follicle-stimulating hormone (beta-FSH), and thyroid-stimulating hormone (beta-TSH), and the alpha subunit. One or more of these pituitary hormones were detected in 73% of cases. The alpha and beta subunits were detected most frequently, being found in 68% of cases; 27% had staining for one or more beta subunits and 37.9% had staining for both alpha and beta subunits. The incidence was: beta-FSH in 58%, beta-LH in 47%, beta-TSH in 33%, and the alpha subunit in 42%. Staining for multiple glycoprotein hormones was common (52%), and mixed glycoprotein hormones and prolactin cell types were found in 16% of cases. These data suggest that most apparently nonfunctioning pituitary tumors contain immunoreactive hormones and the majority of these are subunits of the glycoprotein hormones. Since the glycoprotein hormone beta subunits must combine with the alpha subunit to produce biologically active hormones, the production of the subunits alone may not have endocrine manifestations. PMID- 3543257 TI - Evaluation of health aspects of sugars contained in carbohydrate sweeteners. Report of Sugars Task Force, 1986. AB - A critical review composed of two parts: estimates of present levels of sugars intake and of recent trends in nutritive carbohydrate sweetener content of the food supply and a review of recent scientific literature addressing potentially adverse health effects associated with sugars consumption. The review contains an executive summary, an appendix with 75 tables summarizing the estimation of sugars intake of U.S. population groups, and over one thousand citations. PMID- 3543258 TI - Wendell H. Griffith (1895-1968). Biographical sketch. AB - Wendell Griffith made an indelible impression on his students, his colleagues and the broad field of the nutrition sciences. He was the prototype of the physiological chemist studying intricate problems of intermediary metabolism in the whole animal or human body. His early scientific reports on choline and amino acid metabolism set a high standard for intellectual precision and literary clarity. Dr. Griffith's last research paper was entitled "The Present Knowledge of Methyl Groups in Nutrition" and appeared in Nutrition Reviews in 1968. In this paper he reviews the substance of figure 2, which depicts the advancement in knowledge of choline metabolism, methyl biosynthesis, and transmethylation during his career. It is fortunate that Dr. Griffith was able to witness many of the developments in a field that he had pioneered. If he were alive today, he would be delighted to see how much further this field has moved. Wendell Griffith was a complete man. He combined the traits of high intelligence with a selfless patience and kindness, uncommon in productive scientists. His lucid and absorbing lectures were a joy to his students. Furthermore, he was a mentor with warmth and charm in his relationships to his graduate students and young faculty members and was a superb role model for them. After they left his department he was most supportive. Part of his own rejuvenation, I am sure, occurred in the out-of-doors where he loved to garden, hike and fish. Griff did not grow old, or it seemed he did not. He died at the age of 72 in Baltimore from a brain tumor that was of relatively sudden onset, and is buried in Oak Hill cemetery in Kirkwood, MO, a suburb of St. Louis. He enriched the lives of all of us who had the good fortune to know him. Moreover, his work lives on to stimulate the minds of all serious students of biochemistry and nutrition. PMID- 3543259 TI - Problems and pitfalls in animal experiments designed to establish dietary requirements for essential nutrients. AB - Problems are encountered in nutrition research designed to establish nutrient requirements. A nutrient requirement must be defined in terms of a specific criterion of response for animals of a given age, weight, sex and body composition. The experimental diet employed must be carefully defined in terms of protein source and level, energy source and level and a multitude of biological availability factors, both negative (e.g., phytate and fiber) and positive (e.g., anabolic bioactivity). Also precursor materials may contribute nutrient bioactivity to the diet. Having considered these factors, the data obtained must be subjected to appropriate statistical methods that will allow objective rather than subjective estimation of the maxima or minima being sought (i.e., the "requirement"). PMID- 3543260 TI - Effect of bovine growth hormone administration on metabolism of growing Hereford heifers: protein and lipid metabolism and plasma concentrations of metabolites and hormones. AB - The objectives were to determine the effects of daily injection of bovine growth hormone (bGH) on the metabolism of [1-14C]leucine and [1-14C]palmitate and on hormone and metabolite concentrations in growing Hereford heifers. The experimental design was a 28-d single reversal with two 14-d injection periods of placebo or bGH. Energy intake was restricted to a level slightly above maintenance. Injection of bGH did not affect circulating concentrations of glucose, beta-hydroxybutyrate, urea nitrogen, prolactin, triiodothyronine or thyroxine. Plasma concentrations of insulin and nonesterified fatty acids (NEFA) were chronically elevated whereas leucine concentration was chronically decreased after 1 wk of bGH injection compared to placebo injection. Leucine oxidation was lower and whole-body protein synthesis was higher during bGH injection than during placebo injection. There were increases in both total irreversible loss and oxidation of NEFA during bGH injection compared to placebo injection. These results suggest mobilization of stored fatty acids and increased reliance on NEFA to provide energy for cellular processes. The dual and reciprocal effects of bGH on nitrogen and NEFA metabolism demonstrate its role as a homeorhetic regulator, affecting metabolism of several body tissues to support lean body accretion in Hereford heifers at near-maintenance intake of metabolizable energy. PMID- 3543261 TI - Changes in energy metabolite and regulatory hormone concentrations and net fluxes across splanchnic and peripheral tissues in fed and progressively fasted ewes. AB - Effects of fasting on glucose, ketone bodies, free fatty acids (FFA), insulin and glucagon metabolism were studied in eight fed, five 1-d-fasted and five 3-d fasted ewes. The 3-d fast decreased blood glucose from 55 to 49 mg/dl due to a 40% reduction in its splanchnic output. Plasma FFA increased from 280 to 872 and 912 microM in 1- and 3-d-fasted ewes concomitant with increased omental and peripheral release. Hepatic uptake of FFA increased three- and fourfold and was concentration-dependent. Consequently, hepatic release of acetoacetate and beta hydroxybutyrate increased from -43 and 276 to 90 and 1304 mumol/min, respectively, in 3-d-fasted ewes. Alimentary ketogenesis ceased entirely due to lack of substrate and gut tissue was actually utilizing both ketone bodies by d 3 of fast. Lower hindquarter utilization of both ketone bodies increased with increasing circulating concentrations. Insulin seemed to be the major mechanism of regulation of glucose, FFA and ketone body metabolism since pancreatic production and arterial concentrations of insulin decreased with progressive fasting. No changes were observed in glucagon concentrations or net fluxes, and therefore the role of glucagon was passive and secondary to that of insulin. PMID- 3543262 TI - Dynamics of recovery of body composition after overfeeding, food restriction or starvation of mature female rats. AB - In this study we examined the body composition of rats recovering from overfeeding, underfeeding or starvation. Female rats (220 g) were fed 160%, 100% or 40% of control intake, by stomach tube, until the 40% rats had lost 50 g. Other rats were starved to lose 50 g. Carcass composition was measured on one group from each treatment. The remaining rats returned to ad libitum feeding. The 160% rats were hypophagic and lost weight. Starved and 40% rats were hyperphagic and gained weight. Serum insulin increased with increased food intake. T4 was depressed by food restriction. T3 and T4 increased during weight loss in 160% rats. Carcass composition of rats from each treatment was determined at progressive stages of recovery. Overfed rats had gained 7 g of protein and 43 g of fat. Protein was soon lost but fat was still significantly increased after 44 d of recovery. Starved and restricted rats had lost 11 g of protein and 28 g of fat. Starved rats regained protein earlier than body fat. Restricted rats recovered body fat much earlier than body protein or weight. Body protein and fat may have individual regulatory mechanisms that work together to control body weight. PMID- 3543263 TI - Nutritional design for repletion of liver and muscle glycogen during endurance exercise without inhibiting lipolysis. AB - The effects of fructose (F), a glycogen precursor, and arginine (A), a stimulator of insulin secretion, on glycogen stores in liver and skeletal muscle and lipolysis were studied in endurance exercising rats, in comparison with that of glucose (G) and A. The addition of citrate (C), which previously has been shown to stimulate liver and muscle glycogen repletion after exhaustive exercise, was also tested. Rats were meal-fed twice daily and underwent treadmill running 6 days a week for 3 weeks (experiment 1) or treadmill running for 3 days and the usual voluntary wheel running of 3 days a week for 5 weeks (experiment 2). On the final days of experiments, rats were given one of the following water solutions; a 3.3 g F + 0.5 g A per kg bw, a 3.3 g G + 0.5 g A per kg bw and water (experiment 1) and a 3.3 g F + 0.5 g A + 0.5 g C per kg bw (experiment 2), at the 1.5 h point during a 3 h treadmill running course at 26 and 32.5 m/min up a 7 degree incline, respectively. There was a significant reduction in liver and soleus muscle glycogen during the period of exercise. The administration of either F + A or G + A during exercise was useful in preventing the further depletion of liver and muscle glycogen stores. The administration of G + A significantly suppressed an increased adipose tissue lipolysis caused by exercise, when compared with that of either F + A or water (experiment 1). The addition of C to F + A appeared to spare more soleus and liver glycogen stores during exercise, when compared with G + A (experiment 2). PMID- 3543264 TI - Use of a single thyroxine test to evaluate ambulatory medical patients for suspected hypothyroidism. AB - Previous recommendations for the use of thyroid function tests to diagnose patients with possible hypothyroidism have discounted the value of a total thyroxine (T4) test because many clinically hypothyroid patients have T4 levels that fall within the "normal" range. The authors examined the predictive value of a total T4 measurement in the evaluation of ambulatory general medical patients suspected of having hypothyroidism. Pregnant patients and those who were taking medications that interfere with thyroid homeostasis were excluded. Simultaneous T4 and thyrotropin (TSH) tests of 93 consecutive outpatients suspected to have hypothyroidism but found to be euthyroid and 27 patients discovered to be hypothyroid (TSH greater than 10 microU/ml) were examined. A T4 of 7.0 microliter/dl or less had a sensitivity of 93% with a false-positive rate of 19%. A T4 greater than 8.0 microgram/dl appeared to exclude hypothyroidism (negative posttest probability of 100%). It may be possible to achieve cost savings without loss of diagnostic accuracy by using a single total T4 measurement for the initial evaluation of suspected hypothyroidism in selected outpatients. PMID- 3543266 TI - Adults with community-acquired bacteremias in two suburban hospitals: factors predicting outcome. AB - In a suburban hospital, 38 adult patients with community-acquired bacteremic infections and without "rapidly fatal" disease were studied. In univariate analyses, the 31 patients discharged alive had higher initial temperatures, blood pressures, and calcium and albumin values, and lower immature leukocyte counts, and were treated sooner with appropriate antibiotics than those who died. With the exception of time elapsed before appropriate treatment, these factors were used in discriminant analysis to identify patients who would die during hospital admission from bacteremic infection. The resulting model, which had a sensitivity of 71% and a specificity of 68% in the first group of patients, was validated in a second cohort with a sensitivity of 40% and a specificity of 69%. This analysis presents a model that may allow clinicians to assess the risk of death from community-acquired bacteremic infections. PMID- 3543265 TI - Corticosteroids in stable chronic obstructive pulmonary disease: reappraisal of efficacy. AB - Although systemic corticosteroids are widely used in treating stable chronic obstructive pulmonary disease (COPD), the evidence for their efficacy is still disputed. To reappraise this evidence, the authors used a new analytic strategy in which the 14 available randomized clinical trials were evaluated according to a methodologic "review of systems" and an examination of the statistical precision of the outcome results. Although none of the trials satisfied all of the methodologic criteria for both validity and clinical pertinence, the trials finding steroids efficacious were generally better designed and more statistically precise than trials failing to show efficacy. The authors propose a set of five main methodologic guidelines that require a stable baseline state, a crossover design with suitable washout, adequate doses of corticosteroids, pragmatic designs, and comprehensive choices of outcome events. Attention to these guidelines can help improve both design and evaluation for future trials of systemic steroids for stable COPD. PMID- 3543267 TI - Generalized lymphadenopathy. PMID- 3543268 TI - The characteristics and hospital course of patients admitted for presumed acute pyelonephritis. AB - To study the characteristics and hospital courses of patients hospitalized for presumed acute pyelonephritis, the authors analyzed 185 cases. Judged by explicit clinical and laboratory criteria, 54% of the patients definitely had pyelonephritis, 22% probably had pyelonephritis, 9% possibly had pyelonephritis, and 16% did not have pyelonephritis. In pretreatment urine cultures, 79% of patients had a single pathogen and 77% had colony counts of 100,000 or more organisms per ml. Non-Escherichia coli infections and positive blood cultures were the only two independent predictors of the concomitant renal stones or genitourinary tract abnormalities that were found in 29% of patients with pyelonephritis. About 15% of all patients continued to have temperatures greater than or equal to 101 degrees F 48 hours after the initiation of antibiotic therapy, but persistent fever did not correlate with a history of prior urinary tract infection, the presence of resistant pathogens, renal stones, or genitourinary tract abnormalities. The authors conclude that many of these patients did not have pyelonephritis, and that certain characteristics correlate with the presence of underlying anatomic abnormalities. PMID- 3543269 TI - Routine total skin examination to detect malignant melanoma. PMID- 3543271 TI - The acid-etched-bonded anterior bridge: prosthodontic management of an adolescent cleft palate patient. PMID- 3543270 TI - Leaders in medicine: George Richard Russell, M.D. PMID- 3543272 TI - Bond strength provided by addition silicone impression material adhesives. PMID- 3543273 TI - A study of intermediate lobe differentiation in the human pituitary gland. AB - The immunohistochemical demonstration of neurofilament (NF) polypeptide was used to identify nerves in a series of 17 pituitary adenomas. NF-positive fibres were present in two out of five corticotroph adenomas sited deep in the anterior lobe, in one out of five sited in the intermediate zone and in two out of seven non corticotroph adenomas. Such nerve fibres were often seen in relation to blood vessels. The distribution of alpha-MSH immunoreactive cells was examined in 25 normal pituitaries and in 23 cases of Cushing's disease. Such cells were scattered throughout the normal gland and there was no increase in numbers in pregnancy. alpha-MSH was demonstrated in 18 corticotroph adenomas in Cushing's disease. There was no correlation with the site of the tumour or the presence of nerve fibres. alpha-MSH cells were distributed normally in the para-adenomatous gland. Crooke's hyaline change and alpha-MSH coexisted in some corticotrophs. These findings support the concept that 'intermediate lobe' function, as found in animals, has no discrete anatomical location in man. PMID- 3543274 TI - The Kupffer cell in experimental extrahepatic cholestasis in the rat--a light microscopy, immunohistochemical and electron microscopy study. AB - Kupffer cell phagocytic function is reduced in the presence of obstructive jaundice. To investigate possible mechanisms we report a study of the rat liver in extrahepatic cholestasis, using light microscopy, immunohistochemistry and electron microscopy, Immunohistochemistry was performed with monoclonal antibodies specific for rat Kupffer cells ED 1, ED 2 and ED 3 and monoclonal antibodies directed against class II antigens of the rat major histocompatibility complex Ox 3 and Ox 6. Extrahepatic cholestasis was produced by bile duct ligation. In bile duct ligated animals light microscopy showed proliferation of bile ductules and an increase in sinusoidal cells. Immunohistochemistry with ED 1, ED 2 and ED 3 demonstrated a marked increase in the number of positive cells, but few of these cells were positive with Ox 3 and Ox 6, whereas the proliferating bile ductules were strongly positive. Electron microscopy revealed two homogeneous granular substances within the sinusoidal lumen and loss of the space of Disse. Despite a reduction in Kupffer cell phagocytic function in obstructive jaundice there is an increase in Kupffer cells, but these cells appear to be in an inactivated state as few express class II antigens on their surface. Furthermore the granular substance within the space of Disse may interfere with function. PMID- 3543275 TI - The cellular composition of human lymph nodes after allogenic bone marrow transplantation: an immunohistological study. AB - Using immunohistological techniques, the cellular composition of lymph nodes was assessed in 18 patients who had died 15 to 326 days after allogeneic bone marrow transplantation for leukaemia. The lymph nodes showed reduced cellularity of the cortex and paracortex, dilated sinuses and no lymphoid follicles. The majority of leucocytes were T lymphocytes with an inversion of the normal T4:T8 ratio. No cells were detected expressing immature cortical thymocyte antigens, using NA1/34 and OKT10, but an excess of T11 (E rosette receptor)+ cells over the sum of T4+, T8+ and HNK1+ cells raised the possibility of the presence of immature cells. B lymphocytes were extremely rare and present as clusters in only two patients. Despite this, plasma cells were prominent in many cases and their number increased with time post transplant. The predominant immunoglobulin heavy chain class was IgA in seven cases, IgG in three cases, IgM in two cases and IgE in one case with no relationship between dominant class and days post transplant. In patients with graft-versus-host disease (GvHD), there was a significantly lower T4:T8 ratio but no increase in expression of lymphocyte activation markers. Pyknotic leucocytes were present in half of the cases with GvHD and none of the other cases. No differences were detected in patients who had received marrow purged with monoclonal antibodies (Campath-I or UCHT1). Chimeric studies on three recipients of one haplotype matched marrow, using a monoclonal antibody specific for HLA-A2 and A28 antigens, showed a significant influx of donor cells by 56 days but this did not appear to be an immediate prelude to full morphological reconstitution. PMID- 3543276 TI - Immunocytochemical application of monoclonal antibodies to rat liver glucocorticoid receptor. AB - Seven per cent (10/145) of hybridomas raised against partially purified activated glucocorticoid receptor from rat liver produced monoclonal antibody to receptor. Six IgM secreting clones selected for further investigation bound equally well to activated and non-activated receptor from fresh rat liver, but significantly less well (11-25 per cent) to receptor from frozen rat liver. No interaction was found with oestrogen receptor from rat uterus but extensive cross reaction occurred with progesterone receptor. Although none of the antibodies bound to glucocorticoid receptor from human or porcine liver or lymphoid cells, several cross-reacted with mouse liver glucocorticoid receptor. Immunoelectroblotting of proteins from fresh and frozen rat liver cytosol showed the antibodies bound to 90,000 and 40,000 MW forms of receptor respectively. Immunostaining of both frozen and paraffin embedded sections of rat tissue showed that receptor is preserved during fixation and processing of tissues. Using both indirect immunoperoxidase and immunogold silver staining methods, the pattern of receptor staining observed correlates with the known glucocorticoid responsiveness of the tissues studied. PMID- 3543277 TI - T-zone lymphoma with predominance of 'plasmacytoid T-cells' associated with myelomonocytic leukaemia--a distinct clinicopathological entity. AB - In this paper we present a further case of a new clinicopathological entity combining a rare type of non-Hodgkin lymphoma with a myelomonocytic leukaemia. The characteristic feature of the lymphoma is massive infiltration of the T-zones of lymph nodes by plasmacytoid cells originally described by Lennert in non specific lymphadenitis. Two lymphoma cases of this type have recently been published, by Muller-Hermelink et al. who named the cells 'plasmacytoid T-cells' (PTC), and by Prasthofer et al. These three cases have similar clinical and pathological features and appear to form a distinct clinicopathological entity. In contrast to the two previously published cases the present lymphoma also contained irregular lymphoid cells accompanying the PTC in the lymph node lesion and focally infiltrating the bone marrow. An accumulation of polytypic IgG positive plasma cells was observed in the remaining lymph node follicles. Immunohistological analysis with a range of monoclonal antibodies showed the PTC of our case to be CD5(T1)+, CD4(T4)+, CD3(T3)-, CD8(T8)-, CD2(T11)-, and CD25(TAC)-, but HLA-DR+ and transferrin receptor positive. The nature of this peculiar lymphoid lesion and its relationship to myelomonocytic leukaemia are discussed. PMID- 3543278 TI - Randomized trial of high-frequency jet ventilation versus conventional ventilation in respiratory distress syndrome. AB - To compare high-frequency jet ventilation (HFJV) with pressure-limited time cycled conventional ventilation (CV), we randomized 41 infants with clinical and radiographic evidence of respiratory distress syndrome during the first day of life to receive either HFJV or CV. Standardized ventilatory protocols were used for 48 hours, after which CV was administered to both groups. Despite comparable oxygenation (arterial/alveolar oxygen tension ratio), mean airway pressure was lower in the HFJV group (9 +/- 2 vs 13 +/- 2 cm H2O, P less than 0.001), and thus the arterial/alveolar oxygen tension ratio corrected for mean airway pressure was improved in the HFJV group (P less than 0.05). PaCO2 was lower during HFJV (37 +/ 3 vs 42 +/- 3 mm Hg, P less than 0.05) despite a comparable peak inspiratory pressure. The incidence of air leaks, progression of intraventricular hemorrhage, and mortality during the 48-hour period did not differ between the two groups. Bronchoscopies in eight infants given HFJV and five given CV revealed no microscopic evidence of necrotizing tracheobronchitis, but one infant given HFJV had evidence of necrotizing tracheitis at autopsy. We conclude that for 48 hours during the acute stage of respiratory distress syndrome, HFJV can maintain adequate gas exchange at lower mean airway pressure than during CV, without an increase in the incidence of side effects. PMID- 3543279 TI - A review of protonephridial excretory systems in Acanthocephala. AB - Our present understanding of the excretory system of Acanthocephala is largely the result of work done by 5 German scholars: Kaiser, Schepotieff, Meyer, Kilian, and von Haffner. Present studies indicate that a protonephridial system is restricted to the family Oligacanthorhynchidae. However, many members of this family have not had a protonephridial system described. Three nephridial designs have been described: 1) dendritic type, organized as branches of a tree where each final branch terminates in a ciliated bulb; 2) capsular type, in which all ciliated bulbs empty directly into a common chamber; and 3) rudimentary type, consisting of a single cell with a patent ciliary pouch but no ducts to the outside. The first 2 types are a syncytia with 3 nuclei located in the capsule or stem wall and none in the flame bulbs. These excretory systems consist of 2 clusters of flame bulbs that empty separately into an expandable excretory bladder which in turn empties into ducts of the reproductive system. This urogenital system empties to the outside through a gonopore located at the tip of the penis in males and the posterior terminus of the vagina in females. Cilia occur in certain excretory tubes, depending on sex and species, but are unknown in the excretory bladder or ducts leading into it. The rudimentary type consists of a cell whose posterior extension terminates near the bursal lumen, but it is not known if this is significant for the discharge of material. There is no information on the physiology or biochemistry of the excretory system or its products. PMID- 3543280 TI - Comparative studies on the infectivity of Plasmodium berghei gametocytes and ookinetes for gnotobiotic and xenobiotic Anopheles stephensi. AB - Previous studies indicated that gnotobiotic Anopheles stephensi mosquitoes were less susceptible to infection with Plasmodium berghei than xenobiotic ones (Munderloh and Kurtti, 1985). Groups of 100 to 200 mosquitoes were fed on infected hamsters, heparinized gametocytemic blood (via a membrane feeder), and in vitro-formed ookinetes suspended in blood (membrane feeder). Xenobiotic A. stephensi were readily infected by all 3 routes. Gnotobiotic mosquitoes consistently acquired infection after engorging on hamsters (average level of infected females in 8 experiments: 54.1%), but the parasite yield was low (average number of oocysts per infected female: 21.6). In 7 experiments where gnotobiotic A. stephensi were membrane-fed infected hamster blood, an average of only 8.8% of the females became infected, harboring a mean of 2.4 oocysts, and in 7 additional cases no infection was achieved. This pattern was reversed when gnotobiotic A. stephensi were fed ookinetes. A larger proportion of them became infected (mean level of infection in 8 experiments: 76.2%) and they acquired a higher mean number of oocysts per female (94.4) than did xenobiotic mosquitoes. Thus, gnotobiotic A. stephensi are as able as xenobiotic ones to support the sporogonic development of P. berghei, but are less able to support ookinete development. PMID- 3543281 TI - The karyotype of Plasmodium falciparum determined by ultrastructural serial sectioning and 3D reconstruction. AB - The karyotype of the erythrocytic stages of Plasmodium falciparum was determined to be 14 by counting the number of kinetochores in the mitotic spindle of young schizonts. Fourteen pairs of kinetochores were identified in 3-dimensional reconstructions of the spindle derived from serial longitudinal and transverse sections. Kinetochores were ovoid (45 X 25 nm) in transverse sections, measured 100 nm in longitudinal section, and were heptalaminate in structure. A pair of spindle microtubules passed through each kinetochore. In schizonts at anaphase, each pole of the mitotic spindle consisted of paired kinetic centers inserted on the nuclear membrane. The kinetic centers resembled nuclear pores, but were more electron dense and were associated with spherical masses of an electron-dense cytoplasmic material. PMID- 3543282 TI - Use of parasite antigen detection to monitor the success of drug therapy in Dirofilaria immitis-infected dogs. AB - Recently the authors developed a monoclonal antibody-based enzyme immunoassay for circulating Dirofilaria immitis antigen and demonstrated its utility as a diagnostic tool for canine dirofilariasis. In the present study, serum parasite antigen measurements were used to monitor the success of thiacetarsamide therapy in 2 controlled trials that involved 24 naturally infected dogs. Parasite antigen levels correlated significantly with adult worm burdens in untreated control dogs. Antigen levels fell dramatically by 8 wk after treatment in successfully treated dogs and were undetectable 12 wk after treatment in dogs that were parasitologically cured. Microfilarial counts exhibited seasonal periodicity in both treated and control dogs and were not useful in monitoring the success of adulticide therapy. Parasite antigen detection is quite useful in monitoring the efficacy of adulticide therapy for dogs infected with D. immitis. This approach may lead to improved clinical use of thiacetarsamide, and it should facilitate evaluation of new drugs for this important infection. PMID- 3543284 TI - Measurement of gingival crevicular fluid conductivity, in vivo. AB - It has been shown that the ionic concentration of gingival crevicular fluid (GCF) rises with increases in the inflammation of the surrounding tissue. Because measurement of this increase might be useful for clinical assessment of periodontal status and because the sampling of this fluid is difficult in the typical clinical environment, attempts were made to measure the conductivity of GCF in vivo using a fabricated conductivity probe. Preliminary results suggest that statistically significant correlations may exist between certain clinical indices and GCF conductivity. A correlation could be shown when comparing the Gingival Index and the measured conductivity of GCF, but the correlation may be too low to be of biologic relevance, possibly due to the use of pooled samples. The use of an ion-specific probe and the study of site-specific periodontal lesions are suggested to develop more definitive data than this pilot study provided. PMID- 3543283 TI - Treatment of localized juvenile periodontitis (periodontosis). A review. AB - Localized juvenile periodontitis is a disease of the adolescent periodontium characterized by rapid alveolar destruction around molar and incisor teeth of the permanent dentition. Early treatment methods were variable and often empirical due to lack of knowledge concerning etiology. Elucidation of factors associated with the disease has led to different therapeutic approaches. A comprehensive review of these modalities is presented. PMID- 3543285 TI - Comparative effectiveness of ultrasonic and hand scaling for the removal of subgingival plaque and calculus. AB - The purpose of the study was two-fold: to determine the nature of stainable deposits on periodontally diseased root surfaces subsequent to in vivo scaling and root planing procedures, and to quantify the distribution of residual plaque on instrumented root surfaces. Thirty molar and 30 nonmolar teeth which were condemned for periodontal or prosthetic reasons and had proximal probing depths of 4 to 7 mm were treated. Half of these were instrumented with I.U. curettes and the other half with an ultrasonic scaling device. Instrumentation was continued until the root surface felt hard and smooth to an explorer tip. The location of the gingival margin was recorded by notching the treated proximal surface with a No. 1/2 round bur. Twenty control teeth, 10 molar and 10 nonmolar, were extracted without instrumentation. Control and experimental teeth were irrigated with saline and stored in a 2.5% glutaraldehyde fixative solution until the time of assessment. All teeth were stained with a 0.5% solution of toluidine blue, and the amount of residual stained material and calculus was assessed under the stereomicroscope using an eyepiece fitted with a 10 X 10 optical grid. Stained deposits were marked by placing small V-shaped notches in the adjacent root surface as an aid to identification after the specimens were processed for scanning electron microscopic (SEM) examination. The nature of stained deposits on selected teeth was then characterized using the SEM. Treated root surfaces were also surveyed in detail to assess the quantity and extent of residual plaque deposits. The findings showed that although a large percentage of the treated proximal root surface may possess stainable deposits, these surfaces were often unexpectedly free of microbial organisms. In this study, the majority of stained deposits were composed of adherent fibrin and instrumentation debris. When bacterial plaque was present, it was usually found in small "mini-colonies" smaller than 0.5 mm across. Such findings cast doubt on the validity of using histologic and disclosing stains as an indicator for the presence of bacterial plaque immediately after instrumentation. Although only partially effective in removing subgingival calculus, both methods of instrumentation in this study appeared to be remarkably effective in bacterial debridement of subgingival root surfaces. PMID- 3543286 TI - Psychosomatic diseases and the Rorschach test. AB - Despite numerous efforts to identify a Rorschach profile uniquely associated with and helpful in diagnosing psychosomatic conditions, none has been demonstrated to exist. Although certain Rorschach characteristics have been consistently observed in studies of patients with psychosomatic diseases and can shed light on personality features of these individuals, similar characteristics are encountered in a variety of other conditions as well. This state of affairs is attributable not to short-comings in the Rorschach test, but rather to inadequate conceptualization and categorization of psychosomatic disease. PMID- 3543288 TI - The Stress Tolerance Test. AB - The Stress Tolerance Test combines principles and concepts from the Rorschach and TAT methods. Subjects write answers to standard questions about their impressions of slide-projected pictures of dramatic combat scenes designed to elicit stress responses among military personnel. Developed during World War II, this instrument has had little subsequent use. Its potential for yielding useful assessment information is illustrated in hopes of reawakening interest in it. PMID- 3543287 TI - Clinical and statistical prediction: a retrospective and would-be integrative perspective. AB - One of the early participants in the clinical-statistical controversy describes his effort to mediate the dispute and to direct attention to the underlying issues, to most of which the box scores were irrelevant. A previously undiscussed undercurrent of the controversy is the conflict between different metaphysical world views, the history of which for the past few hundred years is quickly sketched. The mechanist metaphysics of behaviorism, which has long been dominant in American mainstream psychology, favors objective and statistical approaches and discourages interest in judgement, an issue that nevertheless refuses to go away. Systems philosophy is proposed as an integrative alternative. PMID- 3543289 TI - ["Carrier" or "modulated distribution" forms, new systems for drug administration]. PMID- 3543291 TI - Projective technique: a way of getting "hidden" information: Part II. PMID- 3543290 TI - [Phytotherapeutic products and the cardiovascular system]. PMID- 3543292 TI - [Initial chemical events caused by carcinogenic heterocyclic amines and molecular design of anti-tumor agents]. PMID- 3543293 TI - Physiological studies on pBR 322 DNA amplification in an Escherichia coli relA strain. AB - Amino acid limitation leads in E. coli relA cells which cannot synthesize guanosine tetraphosphate (ppGpp) under these conditions to an amplification of pBR 322 DNA. We previously proposed that ppGpp produced in E. coli relA+ cells subjected to amino acid limitation inhibits pBR 322 DNA replication (Hecker et al. 1983). In further experiments it was established that an E. coli relA strain shows plasmid amplification during amino acid limitation (arginine, threonine, leucine or histidine) only in the presence of sufficient concentrations of phosphate, ammonia and glucose. Plasmid amplification does not occur if ammonia or phosphate is depleted. We suggest that glucose, ammonia and phosphate are needed for nucleotide and deoxynucleotide synthesis as the essential prerequisite for plasmid amplification. The activity of beta-lactamase was determined as an indicator for the expression of plasmid-encoded genes. The enzyme activity remains on a low level during plasmid amplification because of arginine exhaustion. A remarkable increase in the activity of beta-lactamase was observed after resumption of growth of relA cells containing amplified plasmid DNA. The plasmid content decreased as the cells continued to grow. We found that plasmid amplification and expression of plasmid-localized genes are opposite reactions which do not occur at the same time. PMID- 3543294 TI - Painful plantar scars. PMID- 3543295 TI - [Periodontal preparation of supporting teeth]. PMID- 3543296 TI - [Current data on prosthetic-periodontal relation in the cervical area]. PMID- 3543297 TI - [Focus on inter-radicular lesions]. PMID- 3543298 TI - Effects of low doses of aspirin and dipyridamole on platelet aggregation in the dog coronary artery. AB - The circumflex coronary artery of pentobarbital-anesthetized dogs was partially obstructed with an externally applied rigid plastic band. Platelet aggregation at the site of stenosis caused a gradual decline in blood flow in the artery, which was monitored with an electromagnetic flow probe placed proximally to the obstructor. The effects of drugs on platelet aggregation were evaluated by monitoring changes in both the rate and the degree of decline in blood flow. In most dogs, aspirin inhibited intravascular platelet aggregation (ED50 = 1 mg/kg). Dipyridamole, even at doses that severely depressed blood pressure (1 mg/kg), had no effect on platelet aggregation. However, in dogs that had been pretreated with a low dose of dipyridamole (0.2 mg/kg), the antiaggregatory activity of aspirin was enhanced. This potentiation was evident only at low doses of aspirin (0.03 and 0.1 mg/kg), where the drug was 10 times more active; at high aspirin doses, which depressed vascular cyclooxygenase, no potentiation was seen. Further evidence that the mechanism of this synergism may depend on endogenous prostacyclin production at the site of the partial obstruction was seen when cyclooxygenase inhibitors applied topically on the exposed artery eliminated the antiaggregatory effect of low doses of aspirin. It is important to note that the protective effect of dipyridamole and low-dose aspirin was less than that seen at the high doses of aspirin alone, suggesting that the theoretical benefits of platelet-specific doses of aspirin may be overstated. PMID- 3543299 TI - Effect of synthetic metalloprotease inhibitors on cartilage autolysis in vitro. AB - The role of chondrocyte metalloprotease (CMP) in mediating cartilage autolysis was studied. Proteoglycan (PG) release and synthesis by rabbit articular cartilage explants were measured. After a 1-day preculture in control medium, 3.3 X 10(-6) M retinoic acid (RET) treatment for 1 day stimulated PG release several fold. RET also caused a large decrease in PG synthesis that returned to the control level after a 3-day recovery period. The effect on PG synthesis was observed at serum levels of 5 and 0.05%. The effect of RET on PG release required protein synthesis, inasmuch as it was lost in cultures maintained in media without amino acids or in a low volume of media. Interleukin-1 (IL-1) and lipopolysaccharide (LPS) treatment for 2 days also stimulated PG release. More PG was released after RET than after IL-1 or LPS, and only RET produced an effect that was evident by day 1. The amount of CMP that produced the same size effect on PG release as these stimulators was below the detection level of PG protease assays. Three potent CMP inhibitors reduced RET-, IL-1- and LPS-stimulated PG release to control levels. These inhibitors did not block another action of RET on chondrocytes, namely the inhibition of PG synthesis by RET immediately after treatment. The inhibitors did not act by reducing cell viability, because recovery of the rate of PG synthesis 3 days post-treatment occurred in inhibitor treated cultures. These studies suggest that CMP is involved in cartilage autolysis that is stimulated by RET and IL-1. PMID- 3543300 TI - Effects of vanadate on in vivo myocardial reactivity to norepinephrine in diabetic rats. AB - Myocardial contractile function is often depressed in patients with diabetes mellitus. Vanadate is an essential trace element that has purportedly an insulin like action and has been suggested as a therapeutic agent for the treatment of diabetes mellitus. The purpose of the present study was to compare the prophylactic efficacy of oral vanadate therapy (0.8 mg of sodium orthovanadate per milliliter drinking water) to that of insulin treatment (5 units/day s.c.) in terms of its ability to reduce or prevent the progressive cardiodepression that occurs in untreated diabetes mellitus. Diabetes was induced in male rats by i.v. streptozotocin injection (50 mg/kg). Diabetes rats were assigned randomly to one of three regimens for 8 weeks: untreated, insulin-treated or vanadate-treated. Noninjected rats served as controls. In vivo myocardial contractile function was measured under basal conditions and after i.v. norepinephrine infusions in ketamine-xylazine-anesthetized rats using a miniature catheter-tip pressure transducer inserted in the right carotid artery and advanced into the left ventricle. Vanadate and insulin treatment resulted in comparable increases in body weight and reductions in plasma glucose, which were improved relative to untreated diabetics. These findings suggest that vanadium may possess an insulin like action. Basal in vivo myocardial contractile performance was depressed significantly in untreated diabetic rats as compared to control and insulin treated diabetic rats. The contractile performance of vanadate-treated diabetic rats was in between untreated diabetic and control groups. In vivo myocardial reactivity to norepinephrine based on assessments of left intraventricular developed pressure, positive and negative dP/dt and delta dP/dt was depressed significantly in untreated diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543301 TI - An investigation of the potential biohazards associated with asbestos-substitute casting ring liners. PMID- 3543302 TI - Improving reversible hydrocolloid impressions of subgingival areas. AB - The causes usually given for not having success with reversible hydrocolloid are that the impression material that goes beyond the subgingival margins often tears on removal and that the syringe material sets too fast. Both of these problems can be overcome and an extremely high rate of success can be obtained by following the technique described. PMID- 3543303 TI - Metal framework design for an onlay removable partial denture. PMID- 3543304 TI - A silicone rubber spacer for processed resilient liner in removable prosthodontics. PMID- 3543305 TI - Recording and reproducing the tilt of a cast on a surveyor. PMID- 3543306 TI - Use of a special matrix system for constructing amalgam and composite cores. PMID- 3543308 TI - Bonding of dental porcelain to ceramic-metal alloys. AB - The bond strength of porcelain to the four gold alloys and the three nonprecious alloys was tested with a simplified pull test method, having wide test surfaces. The tests showed that all gold alloys tested were suitable for fusing porcelain. The bond strength in nonprecious alloys was somewhat lower and the location of the fracture lines was more variable. It seems that nonprecious alloys are more sensitive to laboratory procedures. The bond strength and the location of the fracture line had a good correlation in all metal alloys. PMID- 3543307 TI - Comparison of fracture strength of porcelain-veneered-to-high noble and base metal alloys. AB - Sixty crowns were cast from a commercial high noble and base metal alloy. The porcelain applied to the crowns was fired 10 times and fractured under gradual application of load. The fracture strength of the porcelain-veneered-to-base metal and high noble alloys subjected to repeated firings was compared. The results were: The fracture strength of porcelain-veneered-to-high noble alloys remained relatively constant for five firings but decreased significantly as the firings increased to 10. Ten firings did not significantly affect the fracture strength of porcelain-veneered-to-base metal alloys. Porcelain-veneered-to-base metal alloy crowns had a higher fracture strength compared with high noble alloy crowns. PMID- 3543309 TI - Saliva contamination and resin bonding of etched metal retainers. AB - This study was performed to determine how preapplication of unfilled resin and subsequent saliva contamination would affect the shear strength of the etched metal resin-bonded retainer. There was no significant difference in the shear strength of the metal-resin bond among experimental groups when the metal retainer was bonded in the routine manner, when unfilled resin was applied and allowed to polymerize before bonding of filled resin, or when saliva contamination occurred before the addition of filled resin. Preapplication of unfilled resin to etched metal retainers may serve as a means of protecting the etched metal surface for routine try-in of "Maryland bridges" before final cementation. PMID- 3543310 TI - Effect of electrodeposition of gold on porcelain-to-metal bond strength. AB - The effect of electrodeposition of two different thicknesses of gold on porcelain metal bond strength with three different base metal alloys was determined and compared to a control high gold alloy. The following conclusions can be drawn. Mean porcelain-metal bond strengths of all four alloys were in the same range when conventional porcelain application techniques were used. However, the base metal porcelain-metal bond is clinically suspect because of adhesive failure through the porcelain-metal interface. A thin 180A gold coat increased the porcelain-metal bond strength and generally resulted in cohesive failure through the porcelain. A thicker gold coat (720A) decreased the bond strength and generally resulted in adhesive failure. The mechanism of action of the gold coat on bond strength is likely its effect on the oxide layer on the surface of the base metal alloy. PMID- 3543311 TI - The effect of clinical remount procedures on the comfort and success of complete dentures. AB - Fifteen patients were treated with complete dentures in a routine manner that included a clinical remount. A second group of 15 was treated in the identical manner except that the clinical remount was not performed. The occlusal patterns of all dentures were recorded in the patient's mouths at delivery and again 1 week later by using a photoelastic membrane to provide a permanent record. The presence or absence of soreness was also noted for each patient during the week after delivery. Results indicate that clinical remounts significantly reduced the incidence of soreness, preserved the occlusal force, and reduced the changes in occlusal patterns of the dentures. Although both cusped and flat teeth were used in both treatment groups, no significant differences were noted in relation to either form on the basis of the indices studied. PMID- 3543312 TI - Saliva: a significant factor in removable prosthodontic treatment. PMID- 3543313 TI - Abutment tooth movement related to fit of a removable partial denture. PMID- 3543314 TI - Autogenous bone grafts for atrophic edentulous mandibles: a final report. AB - While autogenous bone augmentations for atrophic edentulous mandibles are not the ideal solution for this problem, we do not share the pessimism of other investigators. The average loss of bone over the 92-month observation period was 60% for this small sample of eight patients. However, there was an 81% gain in bone height in the premolar-molar regions when compared with presurgical measurements. Seven of the eight patients believed these procedures were beneficial. PMID- 3543315 TI - Resin-bonded retainers with custom-made precision attachment for anterior alveolar ridge defect in patients with cleft. AB - A resin-bonded retainer with a custom-made attachment is an acceptable alternative for patients who have narrow anterior alveolar ridge defects. This restoration facilitates hygiene and satisfies the requirements of form, fit, function, and esthetics. PMID- 3543316 TI - Evaluation of occlusal force in patients with obturator defects. PMID- 3543317 TI - A simplified technique for the tooth preparation of onlay castings. AB - A time-tested technique has been described for preparing teeth to receive a tissue tolerant casting. The technique uses a programmed, systematic approach with instruments that leave tooth surfaces smooth with no irregularities. PMID- 3543318 TI - Control of echolocation pulses by neurons of the nucleus ambiguus in the rufous horseshoe bat, Rhinolophus rouxi. I. Single unit recordings in the ventral motor nucleus of the laryngeal nerves in spontaneously vocalizing bats. AB - The vocal motor control of the larynx was studied with single unit recordings from the efferent motor nucleus (nucleus ambiguus) in the CF-FM-bat Rhinolophus rouxi, spontaneously emitting echolocation sounds. The experiments were performed in a stereotaxic apparatus that allowed differentiation of activities in the recorded nucleus depending on the electrode position (Fig. 1). Echolocation calls and respiration activity were monitored simultaneously, thus it was possible to compare the time course of the motor control activity during respiration with and without concurrent vocalization. Unit discharges were classified as laryngeal motoneuron activity according to their correlation with the time course (onset and end) of echolocation calls and their discharge rate as: Pre-off-tonic, pre off-phasic, off-pauser, off-tonic, on-chopper, on-tonic, prior-tonic and inhibitory (Fig. 4). The on-chopper and on-tonic discharge patterns were assigned to the motor activity of the lateral cricoarytenoid muscle and the off-pauser and off-tonic discharge patterns to the motor activity of the posterior cricoarytenoid muscle controlling the time course of vocal pulses. Motoneuron activities recorded under the condition of systematically shifted frequencies in the emitted echolocation calls were investigated in Doppler-shift compensating bats responding to electronically simulated echoes. Of all neurons classified as motor control, only units of the pre-off-tonic discharge type (cricothyroid muscle) changed their activity with frequency shifts in the vocalized pulses; they showed a positive linear correlation with the emitted sound frequency (Fig. 6). In addition, single unit activities in strict synchronization to vocalization were recorded, that by their low discharge rate were not valid as motor control, and were considered to represent activities of interneurons or internuclear neurons connecting the nucleus ambiguus with other vocalization- and respiration centers (Fig. 3c). Electric lesions in the brain stem and iontophoretically applied horseradish peroxidase (HRP) served as references for localization and morphological identification of the recording sites in cell stained brain slices. PMID- 3543319 TI - A pre-clinician's view of osteo-arthritis. PMID- 3543320 TI - Bacteriology swabs during appendectomy: sample sites and transport media. PMID- 3543321 TI - Fergusson and Syme of Edinburgh, 1838. PMID- 3543322 TI - An unusual case of duodenocolic fistula. PMID- 3543323 TI - [Ultrasonics in abdominal emergencies. Results of a series of 179 cases]. AB - The study of a series of 179 emergency ultrasonic examinations showed a sensitivity of 97% and a specificity of 98%. Such results confirm the reliability of real-time sonography in the assessment of the acute abdomen, obstructive intestinal syndromes still requiring mainly conventional procedures. With this exception, the part of ultrasound in the diagnostic and the therapeutic strategies is essential. Associated to plain X-ray films, it enables one to curb down the number of other imaging procedures, such as IVP, angiography, or CT. Emergency ultrasound, particularly in traumatology, requires trained, competent radiologists. Performant machines should be available in admittance and intensive care wards. PMID- 3543324 TI - [An x-ray computed tomographic study of peritoneal ligaments and various mesos]. AB - The CT analysis of peritoneal ligaments and mesos is possible thanks to the fluid contrast introduced by ascites, but also by identification of their contents: fat and opacified vascular elements. Ascites renders easy the display of the falciform ligament. Other displayed ligaments are the smaller omentum, the gastrosplenic ligament, the splenopancreatic ligament, the phrenolienal and phrenocolonic ligaments, the mesocolon, the mesosigmoid, the mesentery and the broad ligaments. The radioanatomic patterns of those peritoneal elements are depicted. PMID- 3543325 TI - [Radiology in Tunisia. Current evaluation, prospects for the future]. PMID- 3543326 TI - [Extension to the ultrasonic study of supra- and subphrenic spaces of plate shaped probes initially destined for intracavitary sonography. Research on thoraco-abdominal fluid collections in non-mobilizable patients]. AB - The authors describe an original application of real time transducers--initially intended for intracavitary sonography--in thoraco-abdominal scanning. The stic form probe can be easily slipped under the patient. It is then possible to realize a scan with an upward beam. In the postero-anterior scan, the patient is placed in a supine position. He is motionless. We achieve a better visualization of the liquid collections, since their accumulation is declivious. The method allows a wider sonographic window for thoraco-abdominal and diaphragmatic investigation in sonography. PMID- 3543327 TI - [Inflammatory aneurysm of the aorta. Value of x-ray computed tomography and ultrasonography in the diagnosis of a case and review of the literature]. AB - Until recently inflammatory aneurysm of the aorta was discovered only at the time of surgery and confirmed by the pathologist. New imaging modalities, such as ultrasound and CT-scan now enable the radiologist to diagnose this entity before surgery, thus leading to a better surgical planning and reducing the operative morbidity. The authors report a case of inflammatory aneurysm of the aorta and review the literature on this entity. PMID- 3543328 TI - Testing models of insulin binding in rat adipocytes using network thermodynamic computer simulations. AB - Many different models have been proposed to explain the complex binding behavior of insulin to its receptor, but a systematic comparison of models with experimental results is lacking. We have used network thermodynamic computer simulations to compare models of insulin binding against the results of several experimental tests designed to differentiate between the models. Six models of insulin binding were tested (simple, diffusion-reaction, conversion, dissociation, heterogeneous site, and two-step intramembrane) against results reported in the literature for isolated rat adipocytes. Although still a matter of experimental controversy, the criteria selected for modeling were curvilinear Scatchard plots, bi-or multi-exponential dissociation, insulin-accelerated dissociation, lack of dependence of the overall dissociation constant on receptor number, and receptor reserve. Using a given set of parameter values most appropriate for each model, none was able to account for all of the observed experimental results. This indicates both the complexity of the binding reaction and the need for further model development. The approach of using computer simulations to systematically test models against experimental results affords not only insight into the critical features of a model enabling it to pass a test, but also indicates potential experiments which might differentiate between models. PMID- 3543329 TI - In-vitro culture of hamster epididymal epithelium and induction of sperm motility. AB - Epithelium from the proximal corpus region of the epididymis of adult hamsters was cultured in modified RPMI 1640 medium supplemented with growth factors and androgens at 37 degrees C in 5% CO2 in air. Prepared plaques of epithelium formed spheres of tissue with epithelial cells outermost. At the light and electron microscope level, these epithelial balls displayed morphology consistent with continued secretory and absorptive function. After 3-5 days, cultured cells either plated out over the bottom of plastic wells or formed vesicles which expanded as their interior became fluid filled. Spermatozoa recovered from the caput epididymidis were co-cultured with epithelium. After 8 and 24 h, a proportion of spermatozoa (30%) exhibited slow but persistent flagellum beats with slow progressive motility. Spermatozoa in control incubations were immotile. This change in motility pattern would suggest that some sperm maturation processes had occurred in vitro. PMID- 3543331 TI - Current aspects of Leydig cell function and its regulation. AB - Recent findings on Leydig cell function and its regulation are discussed. Regulatory mechanisms at different organizational levels, i.e. at the level of the pituitary, the testis and the intracellular elements, are briefly reviewed as well as the transmission and the modulation of the hormonal signal at the Leydig cell membrane. Special emphasis is given to local paracrine and autocrine regulatory interactions operating at the level of the testis. PMID- 3543330 TI - In-vitro development of the fertilizing ability of hamster epididymal spermatozoa after co-culture with epithelium from the proximal cauda epididymidis. AB - The epididymides of adult male hamsters were surgically ligated at the junction of the distal corpus and proximal cauda regions. After 3 days, spermatozoa recovered from the distal corpus displayed greater progressive motility and head to head agglutination in capacitating medium than did those from intact controls, but had low fertilizing ability (3% fertilization rate) in vitro or in vivo. When these spermatozoa were incubated for 6 h with epithelial cells from the proximal cauda epididymidis, previously cultured for 3 days, they maintained motility and exhibited a significant increase in fertilizing ability (30% and 29% in vitro and in vivo respectively). The fertilizing ability of distal corpus spermatozoa incubated with 3-day-old cultures without androgens, or 8-12-day-old epithelial cells with fibroblast overgrowth, or without epithelial cells, remained low (5%). Increase in sperm fertilizing ability was associated with increased sperm binding to the zona pellucida in vitro. These results demonstrate that, under suitable culture conditions, the final stages in the development of hamster sperm fertilizing ability can be achieved in vitro. Factors secreted by cultured epithelium from the proximal cauda epididymidis are implicated in this maturation process. PMID- 3543332 TI - Seasonal variations in the pituitary response to LHRH in the brown hare (Lepus europaeus). AB - In the brown hare, fertile mating takes place from the beginning of December to September. Pituitary and ovarian response to a monthly i.v. injection of 5 micrograms LHRH was studied from September 1983 to October 1984 in 2 groups of 6 hares. The basal concentrations of LH remained undetectable until the end of January, rose from 0.23 +/- 0.14 ng/ml from February to a maximum of 1.44 +/- 0.57 ng/ml in July. LHRH injection was always followed by a release of LH. Between September and December, the LH value peaked 15 min after injection and returned to basal concentrations 2 h later. From January, this pattern altered and a second peak of LH appeared 2 h after injection. Peak levels 15 min after LHRH were around 10 ng/ml between September and December, increased from 47.0 +/- 8.0 ng/ml in January to 106 +/- 33 ng/ml in July and decreased in August (69.4 +/ 10.6 ng/ml). The values of the second peak rose from 11.0 +/- 2.2 ng/ml in January to 90.6 +/- 12.4 ng/ml between March and July and decreased in August (24.5 +/- 5.1 ng/ml). The LH surge induced by LHRH was always followed by a transient rise in progesterone. During the breeding season, this progesterone secretion increased considerably. Ovulation was possible between January and August and the number of ovulating females was maximum between March and July. The amount and duration of progesterone secretion during the resulting pseudopregnancies increased during the breeding season. PMID- 3543333 TI - Immunolocalization of cholesterol side-chain-cleavage cytochrome P-450 and 17 alpha-hydroxylase cytochrome P-450 in bovine ovarian follicles. AB - Follicles were collected from cows and processed for electron microscopy and for immunofluorescent staining at the light microscope level. Key regulatory steroidogenic enzymes cholesterol side-chain-cleavage cytochrome P-450 (P-450scc) and 17 alpha-hydroxylase cytochrome P-450 (P-45017 alpha) were immunolocalized using specific IgG fractions raised against these enzymes. In larger follicles in which the theca interna had differentiated, positive staining for cytochromes P 450scc and P-450(17) alpha was observed in the cells of the theca interna. Electron microscopic examination showed that these cells were rich in endoplasmic reticulum, mainly rough, and had moderate numbers of mitochondria with tubular and lamellar cristae. Positive staining was also present in the theca of follicles undergoing atresia. Positive staining for cytochrome P-450(17) alpha was not observed in the membrana granulosa but cytochrome P-450scc was present in the membrana granulosa in some follicles, particularly in the larger antral follicles. By contrast, positive staining for both enzymes was not observed in stroma, surface epithelium or in small preantral follicles in which the theca interna had not differentiated. These results indicate good agreement between the type(s) of steroidogenic enzyme(s) present in tissues and the type(s) of steroid hormone(s) produced. It is concluded that regulation of steroid hormone production involves, at least in part, regulation of the levels of steroidogenic enzymes. PMID- 3543334 TI - Immunolocalization of cholesterol side-chain-cleavage cytochrome P-450 and ultrastructural studies of bovine corpora lutea. AB - Corpora lutea were collected from cows at four stages of the luteal phase and prepared for immunostaining at the light microscope level. Other corpora lutea, which were fully developed, were dispersed by collagenase treatment and freshly isolated and cultured cells were processed for immunostaining. Electron microscopy was carried out on mature corpora lutea and freshly isolated cells. Positive staining for cholesterol side-chain-cleavage cytochrome P-450 (P 450scc), an inner-mitochondrial membrane enzyme considered to catalyse the rate limiting step in the conversion of cholesterol to progesterone, was observed in all corpora lutea. The intensity of staining was much greater in mature corpora lutea than in young or regressing corpora lutea. Only small and large luteal cells stained positively and cells of the vasculature and other connective tissue elements did not. When cells were cultured and had become flatter, the intensity of immunostaining was observed to be greater in large luteal cells than in small luteal cells which was interpreted to be due, in part, to the greater volume density of mitochondria in these cells. In some cultured small luteal cells the pattern of immunostaining appeared as whorls of strands encircling the nucleus. This pattern was interpreted as a three-dimensional network of mitochondria organized into 'strands', more than one mitochondrion in cross-section, perhaps formed during the process of attachment and elongation of the cells. Further observations made at the electron microscope level, included the presence of close (5-8 nm) contacts with interconnecting septa between small luteal cells in tissue. PMID- 3543335 TI - Immunogold co-localization of ovine placental lactogen and the antigen recognized by the SBU-3 monoclonal antibody in sheep placental granules. AB - Ovine placental lactogen and the SBU-3 antigen (derived from a trophoblast membrane preparation), two proteins of widely different structure, function and destination, were shown by ultrastructural immunogold techniques to localize in identical structures in the sheep placentome throughout most of pregnancy. Both were restricted to the ultrastructurally similar membrane-bounded granules in the chorionic fetal binucleate cell and the syncytium at the fetomaternal interface. The Golgi body from which the granules form was also doubly labelled but only in the binucleate cell, never the syncytium. This provides further evidence that the binucleate cells migrate and fuse to form the syncytium. The two proteins were homogeneously distributed in the granules and would be released together by exocytosis. Only the lactogen reaches the fetal and maternal circulations so the SBU-3 may have some more local function. In early pregnancy the SBU-3 antigen is found by itself in the granules, indicating that the association with the lactogenic hormone is not obligatory. Neither antigen was found consistently in the otherwise ultrastructurally similar interplacentomal binucleate cell granules, corroborating the presence of two functional populations of binucleate cells. PMID- 3543336 TI - Monoclonal antibodies recognize a cell surface marker of epithelial differentiation in the rabbit reproductive tract. AB - Monoclonal antibodies against the cell surface were produced by immunizing mice with endometrial scrapings prepared from 6-day pregnant rabbits. Spleen cells from an immune mouse were fused with myeloma cells and cultured by standard hybridoma technology methods. Hybridoma supernatants were screened for reaction with the apical epithelial surface by immunohistochemistry on frozen sections of uterus from 6-day pregnant rabbits, and positive colonies were cloned by limiting dilution. Ascites fluid was produced in mice from hybridoma clones that gave a consistent pattern of apical epithelial surface staining through 6 sub-clonings. Antibodies in the ascites fluid were tested by immunohistochemistry on frozen sections of uterus, oviduct, lung, liver and kidney from nonpregnant or 6-day pregnant rabbits. At a dilution of 1:5000, the antibodies recognized an antigen that was specific to the apical surface of luminal but not glandular epithelium of the 6-day pregnant uterus and could not be detected in the nonpregnant uterine epithelium. At higher concentrations of antibody (1:100 to 1:1000), crossreaction was seen with antigens in stromal and myometrial cells of pregnant and nonpregnant uterus. At a dilution of 1:5000, the antibody also crossreacted with some components of lung, liver and kidney but without discriminating between the two reproductive states. In the oviduct, staining of the surface epithelium was specific to the pregnant state. We conclude that this monoclonal antibody has a high affinity for a luminal epithelial cell surface antigen in the reproductive tract of the pregnant rabbit and shows multiple organ reactivity with other tissues that is not affected by pregnancy. This antigen will provide a useful cell surface marker of epithelial differentiation in the progestational reproductive tract. PMID- 3543337 TI - Induction of oestrus and ovulation in anoestrous fallow deer (Dama dama) by using progesterone and GnRH treatment. AB - Fourteen seasonally anoestrous, non-lactating fallow does were each treated with an intravaginal progesterone device for 14 days followed by a subcutaneously implanted osmotic minipump delivering synthetic GnRH at doses of 125 ng/h (7 does) or 250 ng/h (7 does) for up to 7 days, about 6 weeks before the natural breeding season. One doe (low delivery rate) lost its intravaginal device and 6 of the remaining does (46.2%) exhibited oestrus between 71 and 120 h after progesterone withdrawal/minipump insertion. Only one of these does received the low GnRH delivery rate and 5 received the high rate. Serum progesterone profiles indicated that an induced oestrus was followed by apparently normal luteal development. Does which did not exhibit oestrus failed to show a luteal response. Only 1 doe conceived at induced oestrus, producing a viable female fawn 6 weeks before the start of the natural fawning season. The remaining does returned to an anoestrous state until the onset of the natural breeding season. PMID- 3543339 TI - Induction of multifocal lesions of the testis by passive transfer of immune cells. AB - Spleen cells obtained from Wistar rats bearing a multifocal damage of the testis that had been induced by an antiserum against a non-collagenous fraction of basement membranes, were able to transfer similar testicular lesions into normal recipients. Damage was characterized by multiple foci of seminiferous tubules with different degrees of cell sloughing and a mild interstitial mononuclear cell infiltrate. The incidence of testicular damage in the transferred recipients was 83%, while in the control group of rats transferred with spleen cells from donors that had been injected with normal rabbit serum only 4% of the animals presented mild lesions. In order to determine which lymphocyte subpopulations were effective in transferring the disease, rat spleen cells were treated with murine monoclonal antibodies W3/25 and OX8 or with a rabbit anti-rat IgG serum and complement, before the transfer. A multifocal damage of the testes, indistinguishable from that obtained with the untreated spleen cells was transferred in 50% and 25% of the rats injected with spleen cells depleted in B or in T lymphocytes, respectively. The most severe lesions were observed in the rats transferred with cell populations depleted in B cells. PMID- 3543338 TI - Qualitative differences in sperm antibody responses in mice of different inbred strains and sexes. AB - To better understand the immunogenetic basis and potential pathological consequences of anti-sperm humoral immunity, age-matched female mice of 9 different inbred strains were immunized with syngeneic sperm and were tested for qualitative (specificity) and quantitative (titer) antibody differences by radioimmunoassay, immunofluorescence and immunoblot techniques. All mice developed antisperm antibodies, although titers varied considerably between inbred strains. Antisperm antibodies produced in this study did not cross-react with membrane antigens on thymocytes, brain or immature testicular germ cells. Immunoblot tests identified 17 major sperm antigen bands; this approach also revealed considerable inter- and intra-strain variation in antisperm antibody specificities among female mice. In a parallel study C57BL/6 male mice demonstrated significantly lower antisperm antibody titers and an absence of response to certain sperm antigens in immunoblot tests when compared to age matched females of the same inbred strain. These findings provide evidence that genetic factors (including sex) interact with environmental (nongenetic) factors in the control of immune responses to sperm antigens. PMID- 3543340 TI - 'Background' Ig-secreting cells in pregnant germfree mice fed a chemically defined ultrafiltered diet. AB - During syngeneic pregnancy the numbers of 'spontaneously' occurring ('background') Ig-secreting cells were determined in the spleen, bone marrow (BM) and mesenteric lymph nodes (MLN) of BALB/c mice that were kept under germfree conditions and fed a low molecular weight synthetic diet (GF-CD), SPF BALB/c mice fed autoclaved natural ingredient (SPF-NI) and conventional BALB/c mice fed natural ingredient (CV-NI). 'Background' Ig-secreting cells were enumerated in the protein A plaque assay and the specificity repertoire of the IgM-secreting cells was determined with plaque assays specific for differently haptenized sheep red blood cells (SRBC). The numbers of 'background' Ig-secreting cells, especially the IgG- and IgA-secreting cells, are very much reduced in the BM and MLN of GF-CD mice as compared to SPF-NI and CV-NI mice. During pregnancy the total number of Ig-secreting cells increased in all lymphoid organs tested, but the proportional increase was most prominent for the IgG- and IgA-secreting cells in the BM and MLN of the GF-CD mice. This increase could only be due to their pregnant state since all environmental antigenic influences are excluded in GF-CD mice. No changes were found in the background specificity repertoire of the IgM secreting cells during pregnancy. This suggests a polyclonal activation of the Ig secreting cells during pregnancy. The reason for this activation remains obscure, but it has to be endogenous. Pregnancy apparently induces a new steady state of the immune system, which can be most properly investigated in GF-CD mice. PMID- 3543341 TI - Antenatal diagnosis and obstetric management of Dandy-Walker syndrome. AB - Real-time ultrasound equipment has the potential for investigating the fetal neural axis and allows the diagnosis of many anomalies arising from this area. Five cases of Dandy-Walker syndrome, one of the major causes of congenital hydrocephalus, were diagnosed antenatally. In all cases ultrasound allowed specific recognition of the defect in the cerebellar vermis. This defect connected the fourth ventricle to a posterior fossa cyst in four cases and to an occipital meningocele in one case. In three cases the diagnosis was made prior to viability, and the parents elected termination of pregnancy. In two cases recognized in the third trimester, neurosurgical care was provided soon after delivery. PMID- 3543342 TI - Butoconazole vaginal cream in the treatment of vulvovaginal candidiasis. Comparison with miconazole nitrate and placebo. AB - A double-blind, parallel study was conducted comparing a new imidazole derivative, butoconazole nitrate, with placebo and miconazole nitrate for the treatment of vulvovaginal candidiasis. Patients were randomly assigned to six treatment regimens. Butoconazole was found to be an effective antifungal agent in both the six- and three-day treatment schedules. The incidence of local side effects from both tested imidazoles was low. PMID- 3543343 TI - Severe nonimmune fetal hydrops with fetal survival. A case report. AB - A case of severe idiopathic nonimmune fetal hydrops spontaneously resolved after delivery with only basic supportive therapy. This case emphasizes that natural occurrences occasionally are responsible for successes attributed to invasive intrauterine treatments. PMID- 3543344 TI - Intrauterine demise of two fetuses in an unsuspected triplet pregnancy. A case report. AB - Triplet pregnancy is an uncommon event. The chance that one or more fetuses will suffer intrauterine death in such a pregnancy is one in six, yet the mechanism of those fetal deaths is poorly understood. This paper reports on the delivery of a surviving triplet after the demise, many weeks apart, of the other two fetuses in an unrecognized triplet pregnancy. PMID- 3543345 TI - Fetal outcome after intraamniotic hemorrhage with placental abruption. A report of three cases. AB - In three cases of placental abruption with intraamniotic hemorrhage, ultrasonographic assessment of the intrauterine environment assisted in diagnosing and grading the degree of abruption. In cases of grade 1B abruption, observation, rather than prompt delivery, is recommended if the fetus is grossly immature. PMID- 3543346 TI - Consent, communication and responsibility. PMID- 3543347 TI - Towards no incisional hernias: lateral paramedian versus midline incisions. AB - A prospective randomized controlled clinical trial is reported which compares midline with lateral paramedian incisions in relation to the development of incisional hernias at one year. Of 431 patients randomized, 329 were available for assessment one year later. Two patients suffered burst abdomen, both being in the lateral paramedian group. Twenty-two incisional hernias occurred, 2 in the lateral paramedian group and 20 in the midline group (P less than 0.001). Of the two types of incision, the lateral paramedian incision takes longer to perform, requires a longer incision, rarely results in dehiscence, and does confer protection against incisional hernia. PMID- 3543349 TI - Biblical ills and remedies. PMID- 3543348 TI - Management of urinary outflow obstruction after pelvic surgery: a review. PMID- 3543350 TI - Rendu-Osler-Weber disease: a triple eponymous title lives on. PMID- 3543352 TI - Diet and the prevention of dental caries. PMID- 3543351 TI - The relation between plaque and dental caries. PMID- 3543354 TI - Basis for the use of topical and systemic fluorides in caries prevention. PMID- 3543353 TI - Fluoride dentifrices: the basis for the decline in caries prevalence. PMID- 3543355 TI - Plaque control as a scientific basis for the prevention of dental caries. PMID- 3543356 TI - [Cutaneous absorption of chemicals]. AB - Chemicals have become indispensible for the maintenance of health in animals and man. The route of administration of each medicament is decided by factors such as site of desired action, chemistry of the active ingredient, age and species of the patient, and frequency of administration (or desired duration of activity). In situations where the oral and hypodermic routes, which are used most frequently, are inadequate or unsatisfactory, dermal application can provide a valuable alternative method to achieve systemic activity. Examples of formulations currently available for dermal application contain diverse chemicals and are intended for a variety of purposes, such as crufomate against cattle grubs, fenthion against cattle lice, levamisole against gastrointestinal nematodes, nitroglycerine for angina pectoris, and scopolamine for motion sickness. The skin acts as a barrier to penetration by chemicals and micro organisms by virtue of its morphology and chemical composition. Chemicals which do penetrate, do not necessarily pass through the appendages (hair follicles and gland ducts), but mostly penetrate through the interjacent epidermis, either through the cells, or via the intracellular spaces. These spaces have recently been shown by electron microscopy to be filled by an amorphous substance which exudes on the skin surface in convex ridges. This substance has a lipid nature, but is not hydrophobic as is often accepted. For a chemical to be able to penetrate the skin, it must be partially water and lipid soluble, polar, and weakly ionizing. A variety of factors can possibly affect the permeability of skin for a chemical. These include species differences in morphology (skin thickness, tightness of intercellular junctions, density of hair follicles and other appendages), biochemistry, and physiology; seasonal and climatic variations; and differences between breeds and genders. Species differences in skin permeability are largely unpredictable and inconsistent. An observed difference between two species for one chemical cannot necessarily be extrapolated to another.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543357 TI - Drug development for senile cognitive decline. PMID- 3543358 TI - Pepstatin analogues as novel renin inhibitors. AB - Pepstatin analogues corresponding to the general formula A-X-Y-Sta-Ala-Sta-R were synthesized in solution phase. Various changes in the nature of the A, X, and Y groups were made to improve the inhibitory potency against human plasma renin activity. The results were interpreted by use of the active-site model based on the sequence of human angiotensinogen. The tert-butyloxycarbonyl group and the isovaleryl group were found to be the most effective acyl groups (A). The analogues having a Phe residue in place of Val1 (X) and His or amino acid with an aliphatic side chain such as norleucine or norvaline in the Y position showed the highest inhibition of human plasma renin activity with IC50 values of about 10( 8)M. Esterification or amidification of the carboxyl group of the C-terminal statine did not change the inhibitory potency. The selectivity for rat, dog, pig, and monkey plasma renin of the most interesting compounds was studied. PMID- 3543359 TI - 31P nuclear magnetic resonance spectroscopic observation of the intracellular transformations of oncostatic cyclophosphamide metabolites. AB - 31P NMR spectroscopy was used to directly monitor, for the first time, the intracellular chemistry of the ultimate active metabolite of cyclophosphamide, namely, phosphoramide mustard. These NMR studies utilized a human histiocytic lymphoma cell line (U937), embedded in agarose gel threads, and perfused with medium containing synthetically derived metabolites (4-hydroxycyclophosphamide, aldophosphamide, and phosphoramide mustard). Metabolites 2 or 3 or both readily crossed the cell membrane; in contrast, the membrane was relatively impermeable to 4. Intracellular concentrations of 4 could, therefore, be attributed primarily to the intracellular fragmentation of 3. Signals suggestive of either carboxyphosphamide or 4-ketophosphamide were not detected. Spectral data were used to calculate a rate constant of (5.4 +/- 0.3) X 10(-3) min-1 for the intracellular disappearance of 4 at 23 degrees C. The intracellular pH was determined to be 7.1 from the chemical shift of the internal inorganic phosphate signal. PMID- 3543360 TI - Studies in potential filaricides. 18. Synthesis of 2,2'-disubstituted 5,5' dibenzimidazolyl ketones and related compounds as potential anthelmintics. AB - A series of 2,2'-disubstituted 5,5'-dibenzimidazolyl ketones and related compounds have been synthesized of which 2,2'-bis(carbomethoxyamino)-5,5' dibenzimidazolyl ketone exhibited a broad spectrum of anthelmintic activity in experimental animals. At doses of 10-50 mg/kg given intraperitoneally, 5 killed 100% of the adult worms of Litomosoides carinii, Dipetalonema viteae, and Brugia malayi. By the oral route the macrofilaricidal efficacy of 5 was 97-100% at 100 200 mg/kg X 5 days. The treated animals showed gradual disappearance of microfilariae and before autopsy they became amicrofilariaemic. Some of the compounds also showed 100% efficacy against the human hookworms and tapeworm, Ancylostoma ceylanicum in hamsters, and Hymenolepis nana in rats at a single oral dose of 50-250 mg/kg. Compound 5 was also effective against Syphacia obvelata in mice at a single oral dose of 100 mg/kg and was found to be well tolerated by mice up to an oral dose of 2500 mg/kg. PMID- 3543362 TI - Central serotonin receptors as targets for drug research. PMID- 3543361 TI - Isolation, synthesis, and antitumor evaluation of spirohydantoin aziridine, a mutagenic metabolite of spirohydantoin mustard. AB - Spirohydantoin mustard (SHM), a central nervous system directed nitrogen mustard with anticancer activity, was metabolized in the presence of mouse liver postmitochondrial supernatant (9000g fraction) to a nonpolar alkylating metabolite. The metabolite was isolated by thin-layer chromatography of chloroform or ethyl acetate extracts of incubation mixtures, and its structure was established by mass spectral analysis, synthesis, and cochromatography. The metabolite, spirohydantoin aziridine, was mutagenic for Salmonella typhimurium TA1535 in the Ames assay but inactive as an antitumor agent against P388 leukemia in vivo. PMID- 3543363 TI - Structural alterations that differentially affect the mutagenic and antitrichomonal activities of 5-nitroimidazoles. AB - Two approaches have been used to develop nonmutagenic 5-nitroimidazoles. Both approaches are based on knowledge of the likely mechanisms by which this class of compounds cause mutagenicity. The first approach involved incorporating readily oxidizable gallate derivatives into the molecule. In one case, a very weakly mutagenic active antitrichomonal agent was obtained. The second approach involved incorporating a substituent at the C4 position of the ring. This generally resulted in a large reduction in mutagenicity and a lowering of antitrichomonal activity in vitro. In certain cases, however, mutagenicity was dramatically reduced while moderate antitrichomonal activity was retained. For example, 1,2 dimethyl-4-(2-hydroxyethyl)-5-nitroimidazole (5) showed good antitrichomonal activity in vitro (ED50 = 2 micrograms/kg) while possessing only 4% of the mutagenicity of metronidazole. PMID- 3543364 TI - Antiradiation compounds. 20. 1-Methylquinolinium(and pyridinium)-2-dithioacetic acid derivatives. AB - A new class of radiation-protective compounds has been found in the bis(methylthio) and methylthio amino derivatives of 1-methylquinolinium- and 1 methylpyridinium-2-dithioacetic acids. The compounds gave good protection to mice vs. 1000-rad gamma-radiation in ip doses of 10 mg/kg or less, much lower than those required for the aminoalkyl thiols (approximately 150-600 mg/kg). The dithioacetic acid zwitterions were prepared from the base-catalyzed reaction of carbon disulfide with quinaldine and picoline methiodides, and the bis(methylthio) derivatives resulted from reaction with methyl iodide at room temperature. Replacement of one methylthio moiety took place readily on reaction of the bis(methylthio) derivatives with 1 molar equiv of an amine. The best protective activity was found with the methylthio piperidino derivative in both the quinolinium and pyridinium series. PMID- 3543365 TI - Structure-activity relationships of sparsomycin and its analogues. Inhibition of peptide bond formation in cell-free systems and of L1210 and bacterial cell growth. AB - The biological activity of 14 analogues of sparsomycin (1) was studied in cell free systems of Escherichia coli, Saccharomyces cerevisiae, and Sulfolobus solfataricus by measuring the inhibition of protein synthesis. The inhibition of L1210 colony formation in soft agar and bacterial cell growth in solid as well as in liquid medium was also examined. Each analogue possesses not more than two structural modifications of the sparsomycin molecule. This enabled us to determine unambiguously several structural and stereochemical features that are required for an optimal biological activity in these assays. Sparsomycin, having the SCRS chirality, is the most potent of the four possible stereoisomers. The results obtained with compounds 5-7 indicate that the presence of an oxygen atom on the S (alpha) atom is essential. Substitution of the bivalent sulfur atom by a CH2 group (10) or of the SCH3 moiety by a Cl atom (12) affects the activity of the molecule partially. Compound 12 is surprisingly active against intact cells. Substitution of the C(6)-CH3 group by a H(14) reduces the activity of the molecule. Isomerization of the trans double bond into the cis double bond yields cis-sparsomycin (15), which is inactive. The hydrophobic derivatives 8, 9, and 11 are considerably more active than sparsomycin; thus the ribosomal binding site for sparsomycin may have a hydrophobic character. PMID- 3543366 TI - Comparison of aminoglycoside antibiotics with respect to uptake and lethal activity in Escherichia coli. AB - Forty-five aminoglycoside antibiotics and related compounds were compared for their ability to induce the accumulation of dihydrostreptomycin in Escherichia coli K12. The common aminoglycosides and a streptothricin antibiotic all induced enhanced uptake within a relatively narrow concentration range. These concentrations were lethal to the bacteria. Comparison of aminoacyl derivatives of tobramycin and apramycin, the latter synthesized utilizing transition-metal cations to selectively control the site of substitution, revealed that 1-N aminoacyl modifications resulted in an increased ability to induce enhanced uptake. 2'-N-Aminoacyl modifications were also effective at inducing enhanced uptake, albeit without noticeable improvement over parent. The findings from this structure-activity comparison support the proposition that aminoglycosides share a common critical target (most likely the ribosome), which, when acted upon, results in both drug accumulation and killing. PMID- 3543367 TI - Genetic disorders of collagen. AB - Osteogenesis imperfecta, Ehlers-Danlos syndrome, and Marfan syndrome form a group of genetic disorders of connective tissue. These disorders exhibit remarkable clinical heterogeneity which reflects their underlying biochemical and molecular differences. Defects in collagen types I and III have been found in all three syndromes. PMID- 3543369 TI - The Abraham Flexner Award for Distinguished Service to Medical Education. David E. Rogers, M.D. PMID- 3543370 TI - The AAMC Award for Distinguished Research in the Biomedical Sciences. Paul C. Lauterbur, Ph.D. PMID- 3543368 TI - Noonan syndrome. PMID- 3543371 TI - Alan Gregg memorial lecture. In the eye of a hurricane. PMID- 3543372 TI - Enhanced clearance of Candida albicans from lung after intratracheal immunization. AB - The comparative effect of immunization by intratracheal and intraperitoneal routes was assessed against intratracheal challenge with Candida albicans. When mice were immunized intratracheally with 5 X 10(6) cfu of viable or heat-killed C. albicans 2 weeks before challenge, they showed an enhanced resistance against intratracheal challenge with C. albicans, in spite of a decrease in phagocytosis of C. albicans in vitro by alveolar macrophages from intratracheally immunized mice. In these mice, 100% survival and an accelerated elimination of C. albicans from their lungs were observed after intratracheal challenge with C. albicans. In contrast, intratracheal immunization with same high dose of viable or heat-killed C. albicans 1 week before challenge, and intraperitoneal immunization with same high or low doses of viable or heat-killed C. albicans 1 or 2 weeks before intratracheal challenge with C. albicans, could not induce such high resistance against intratracheal challenge with same high dose of viable C. albicans. Comparing to normal and intraperitoneally immunized mice, number of C. albicans recovered from the lung 48 hr after challenge was approximately 100 fold smaller in mice immunized by intratracheal route 2 weeks before challenge. When cellular response was determined by bronchoalveolar lavage after intratracheal inoculation of C. albicans, a prominent recruitment of polymorphonuclear cells was observed 12 and 36 hr after challenge in control mice, intraperitoneally and intratracheally immunized mice. Among these groups, sustained polymorphonuclear cell recruitment by 72 hr after challenge was seen only in the group immunized by intratracheal route with high dose of heat-killed C. albicans 2 weeks before challenge.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543373 TI - Immunosuppression and sperm antibody formation in men with prostatitis. AB - 16 men with chronic prostatitis were evaluated immunologically in order to examine possible relationships between prostate infection, defective cellular immune responses and the occurrence of sperm antibodies. Peripheral blood mononuclear cells (PBMN) from 14 of 16 (88%) patients exhibited reduced or absent responses in vitro when incubated with an extract of Candida albicans. PBMN proliferation in response to the mitogen Concanavalin A (Con A) was reduced in 5 of 16 (31%) men. In addition, sera from 6 patients inhibited the Candida-induced proliferative response of control PBMC; 2 of these sera also reduced the Con A directed response. Sperm antibodies, evaluated by an enzyme-linked immunosorbent assay (ELISA) using fresh motile spermatozoa, were found in 9 of 16 (56%) patients. PBMC responses were reduced in all, and suppressive sera present in 5, of the men with sperm antibodies. IgG antibodies predominated. 4 of the sera positive by ELISA also agglutinated spermatozoa. Levels of IgG sperm antibodies were correlated with the degree of immunosuppression by patient sera (p less than 0.02). These data suggest that decreased cellular immunity and enhanced humoral reactivity to sperm are common in men with chronic prostatitis. Both may contribute to an increased rate of prostatic infection in these men. PMID- 3543376 TI - Mutagenesis originating in site-specific DNA damage. AB - Covalent monoadducts are the major types of gene damage after exposure to chemical mutagens and carcinogens. These and other damage structures together give rise to the spectrum of mutations that includes base-pair substitutions, insertions and deletions. In this study we introduced the bulky adduct guanine-8 aminofluorene into defined sites on one or both strands of the lactose operator. After insertion into plasmid pBR322 and replication in Escherichia coli COEC40, operator mutants were recognized on 5-bromo,4-chloro,3-indolyl-beta-D-galactoside plates and by hybridization probing. Out of ten randomly selected mutants, nine were single-base deletions and one was a two-base deletion. All mutations were at the site of modification or immediately adjacent to that site. If modifications were placed into both plasmid strands, preventing excision repair, operator mutants comprised close to 100% of operator-containing plasmids. PMID- 3543377 TI - Yeast HIS3 expression in Escherichia coli depends upon fortuitous homology between eukaryotic and prokaryotic promoter elements. AB - The yeast imidazoleglycerolphosphate dehydratase gene HIS3, when introduced into Escherichia coli, is transcribed and translated with sufficient fidelity to produce functional enzyme. The following lines of evidence indicate that E. coli RNA polymerase recognizes a particular region of HIS3 DNA as a promoter sequence. First, this promoter contains nucleotide sequences that resemble the canonical prokaryotic promoter elements, the -10 and -35 regions. Second, HIS3 transcription in vitro by E. coli RNA polymerase is initiated at the predicted site downstream from the conserved sequences. Third, deletion mutations that successively encroach upon the 5' end of the HIS3 gene indicate that the promoter is necessary and sufficient for expression in E. coli. Fourth, a single base-pair change that behaves as an "up-promoter" mutation alters the -35 region such that it becomes identical with the consensus sequence. Because the -10 region of this promoter coincides with the TATA promoter element that is necessary for expression in yeast cells, it is possible directly to compare prokaryotic and eukaryotic promoter function. Analysis of 51 deletion and substitution mutations indicates that the patterns of mutant phenotypes are quite different for each organism. Therefore, although prokaryotic -10 regions are similar in sequence to eukaryotic TATA elements and although the same his3 region serves both functions, it appears that this represents an evolutionary coincidence whose current functional basis is minimal. The evolutionary significance of the homology between prokaryotic and eukaryotic promoter elements is discussed. PMID- 3543378 TI - Morphogenesis of the long tail fibers of bacteriophage T2 involves proteolytic processing of the polypeptide (gene product 37) constituting the distal part of the fiber. AB - Gene 37 of phage T2 codes for a protein that, as a dimer, constitutes the most distal, receptor-recognizing part of its long tail fibers. It was found that, from a plasmid carrying a fragment of gene 37 that lacked a region of the gene encoding 87 CO2H-terminal amino acid residues, a protein was expressed that was slightly larger than that present in the phage. This size difference could not be accounted for. The missing region of gene 37 and also gene 38 (which codes for the auxiliary protein required for dimerization of protein 37) were cloned. Plasmids were constructed with gene 37, or gene 37 together with gene 38, under inducible control. Independent of the presence of the latter gene, a protein was produced that had the same size as protein 37 in the phage. A pulse-chase experiment revealed that a precursor of protein 37 is synthesized and processed such that approximately 120 amino acid residues, most likely CO2H-terminal, are removed. Therefore, the protein produced from the truncated gene was larger because it cannot be processed. This fact also solved an old puzzle: an amber fragment of protein 37 of phage T2 had been found to be larger than the mature protein. The amber codon could be located 24 codons away from the normal stop codon. Obviously, the fragment cannot be processed. The existence of this fragment demonstrates that processing occurs during phage maturation. PMID- 3543375 TI - 31P NMR analysis of intracellular pH of Swiss Mouse 3T3 cells: effects of extracellular Na+ and K+ and mitogenic stimulation. AB - Swiss mouse 3T3 cells grown on microcarrier beads were superfused with electrolyte solution during continuous NMR analysis. Conventional 31P and 19F probes of intracellular pH (pHc) were found to be impracticable. Cells were therefore superfused with 1 to 4 mM 2-deoxyglucose, producing a large intracellular, pH-sensitive signal of 2-deoxyglucose phosphate (2DGP). The intracellular incorporation of 2DGP inhibited the Embden-Meyerhof pathway. However, intracellular ATP was at least in part retained and the cellular responsivity to changes in extracellular ionic composition and to the application of growth factors proved intact. Transient replacement of external Na+ with choline or K+ reversibly acidified the intracellular fluids. Quiescent cells and mitogenically stimulated cells displayed the same dependence of shifts in pHc on external Na+ concentration (CoNa). PHc also depended on intracellular Na+ concentration (CcNa). Increasing ccNa by withdrawing external K+ (thereby inhibiting the Na,K-pump) caused reversible intracellular acidification; subsequently reducing CoNa produced a larger acid shift in pHc than with external K+ present. Comparison of separate preparations indicated that pHc was higher in stimulated than in quiescent cells. Transient administration of mitogens also reversibly alkalinized quiescent cells studied continuously. This study documents the feasibility of monitoring pHc of Swiss mouse 3T3 cells using 31P NMR analysis of 2DGP. The results support the concept of a Na/H antiport operative in these cells, both in quiescence and after mitogenic stimulation. The data document by an independent technique that cytoplasmic alkalinization is an early event in mitogenesis, and that full activity of the Embden-Meyerhof pathway is not required for the expression of this event. PMID- 3543374 TI - Acetylcholine receptor kinetics: chemical kinetics. PMID- 3543379 TI - Preliminary X-ray data for aspartate aminotransferase from Escherichia coli. AB - Crystals of the aspartate aminotransferase from Escherichia coli (aspC gene product) have been examined by X-ray analysis. The crystals grow as elongated rectangular prisms, with the symmetry of space group C2221. Unit cell dimensions are a = 156 A, b = 87.6 A, c = 80.6 A and alpha = beta = gamma = 90 degrees. There is one protein subunit of molecular weight 43,600 per asymmetric unit. PMID- 3543380 TI - Cardiovascular pathology in renal transplant recipients. AB - Various cardiovascular complications are among the major causes of mortality in renal transplant recipients. The authors examined the cardiovascular findings from necropsy of 18 renal transplant patients. All but three of the patients showed one or more pathological abnormalities. Five patients exhibited severe coronary arteriosclerosis with acute myocardial infarction with a history of myocardial infarction noted in four patients. In addition, one patient showed moderate and two showed mild coronary arteriosclerosis. Also prevalent were left ventricular (LV) hypertrophy (10/18), right ventricular (RV) hypertrophy (7/18), LV dilatation (4/18), RV dilatation (8/18), left atrial dilatation (3/18), and right atrial dilatation (6/18). Valvular abnormalities consisted of dilatations of mitral ring (1/18), pulmonic valve (2/18), and tricuspid valve (3/18). Pericarditis was found in two patients and aortic atherosclerosis in ten patients. Findings on routine chest roentgenograms and electrocardiograms did not always correspond with the anatomical findings noted on necropsy examination. The results demonstrate a marked increase in the incidence of various cardiac abnormalities in renal transplant recipients. PMID- 3543383 TI - [Electron microscopic studies of the islands of Langerhans in the rat. The B cell and the capillaries]. PMID- 3543381 TI - Acute soft tissue infection in intravenous drug abusers: its differential diagnosis by ultrasonography. AB - Portable, real-time, B-mode ultrasonography was used by surgeons to diagnose acute soft tissue infections in intravenous drug abusers. It was helpful in differentiating simple cellulitis from abscess and in detecting pseudoaneurysm and thrombophlebitis. The authors conclude that ultrasonography as an initial diagnostic method for these types of lesions provides both early diagnosis and early treatment, thereby shortening hospital stay and reducing complications. PMID- 3543382 TI - Correlation of nitroaromatic compounds with the mutagenic activity of coal fly ash. AB - Stack-collected fly-ash particles from a commercial pulverized-coal power plant were extracted with 60/40 w/w benzene-methanol to remove as much of the organic fraction as possible. The extract was sequentially fractionated on a series of high-performance liquid chromatography columns, and the Salmonella bacterial mutagenicity assay using both normal and nitroreductase-deficient strains was used to localize the most mutagenic fractions. Selected fractions were analyzed by a variety of techniques, including gas chromatography with dual-flame ionization and thermionic nitrogen-phosphorus detectors, gas chromatography-mass spectrometry, direct-probe low-resolution or low-voltage mass spectrometry, and high-resolution mass spectrometry. Mutagenicity data indicated that nitroorganic compounds were the primary mutagens in all samples submitted for chemical analysis. A series of homologous alkylated nitrophenanthrenes appear to be important mutagens in one major fraction, while alkylated nitrofluorenones appear to be the dominant mutagens in a second major fraction. No nitro compounds were identified in a third major fraction. In addition to the nitro compounds, substantial amounts of fluorenones were also found, although these are not believed to contribute to the direct-acting mutagenic activity of the samples. PMID- 3543384 TI - Epidemiology of the emergence and spread of drug-resistant falciparum malaria in South-East Asia and Australasia. AB - A review is presented of the development of drug-resistant malaria in Pailin on the Thai-Kampuchean border and its spread to other parts of the region and beyond. Resistance of P. falciparum to chloroquine appears to have emerged in this area in the early 1960s and evidence of resistance to the combination of sulfadoxine and pyrimethamine and to the combination of diaphenylsulfone and pyrimethamine came from the same area towards the end of the same decade. The factors leading to the emergence and increase of drug resistance appear to have been: the continuous introduction of non-immune migrants to a hyperendemic malaria area, an increase in already intense transmission resulting from the living and working conditions of the migrants and prolonged drug pressure resulting from individual drug consumption and mass drug administration, particularly from the medicated salt project which covered the area in which resistance emerged. These conditions lead to the selection of resistant mutants. Moreover, resistant parasites were exposed to multiple and increasing doses of chloroquine, pyrimethamine and sulfathiazole during repeated passages through non immune hosts who were being treated for primary attacks, early recrudescences and reinfections. This probably resulted in increasing the degree of resistance and in the selection of parasites resistant to sulfathiazole with cross-resistance to other sulfonamides. In Irian Jaya, Indonesian New Guinea, where there had been a chloroquinized salt project, the level of chloroquine resistance was much lower than in Pailin; this is associated with the absence of a non-immune population and the lower dose of chloroquine base used in the salt. The spread of chloroquine resistance is then discussed. At first resistance was found only in three foci in South-East Asia where A. balabacensis is the vector of malaria. It then spread to all A. balabacensis areas, and finally to areas outside the area of distribution of A. balabacensis. The spread of resistance is found to be favoured by the presence of the vector A. balabacensis and by the introduction of a non-immune population. PMID- 3543386 TI - Fetal facial abnormalities identified during obstetric sonography. AB - The orbits and, if readily accessible, the facial profile were visualized as part of a brief fetal anatomy survey during approximately 7100 low-risk and high-risk obstetric sonographic examinations. This examination identified 17 facial abnormalities in 11 fetuses. There were seven abnormalities of the eyes, including three instances of absence of both eyes, two of hypertelorism, one of proptosis, and one of relative prominence. There were seven abnormalities of the nose, including three instances of marked flattening, one of absence, one of a proboscis, one of a single nostril, and one of a sunken appearance. There were two abnormally small chins. There was one marked cleft that involved the nose, lip, and palate. At least two fetuses with abnormal faces were missed entirely and coexistent facial abnormalities were missed in another three fetuses. Of the 11 fetuses with facial abnormalities identified, eight had other structural abnormalities as well, and the other three had either polyhydramnios or a history of teratogen exposure. A brief facial examination done as part of the fetal anatomy survey helps to identify abnormalities in high-risk fetuses but is considerably less productive in low-risk fetuses. PMID- 3543385 TI - Chloroquine-resistant falciparum malaria from East Africa. AB - Seven patients (one black African and six white Europeans) developed chloroquine resistant falciparum malaria in East Africa. In vitro studies confirmed chloroquine resistance in three patients, but the parasites failed to grow in the other four patients. Six patients were cured by sequential quinine and Fansidar, one by sequential quinine and mefloquine. PMID- 3543387 TI - Sonographic evaluation of platelet aggregate retention in a vortex within a simulated venous sinus. AB - To examine the possible role of venous-valve pockets in enhancing platelet aggregate retention and deposition, in vitro experiments using real-time ultrasonography were performed in a venous-sinus flow model under controlled flow conditions. In each of 10 experiments, adenosine diphosphate (ADP)-induced platelet aggregates in plasma were circulated in both test and control models at upstream shear rates from 60 to 0 sec-1. High-resolution, real-time, B-mode ultrasonography was used to detect and measure the platelet aggregates. Vortex flow was observed in all poststenotic segments, particularly in the sinuses. With reduced shear rates, platelet aggregates increased in size within the vortices and subsequently deposited in the dependent poststenotic tube surface, especially in the sinuses. In conclusion, this study using real-time ultrasonography indicates that the presence of a venous sinus greatly accentuates vortex formation, which, in turn, augments the retention and deposition of platelet aggregates. This relation may provide an explanation for mechanisms that would cause thrombosis to originate in venous-valve pockets. PMID- 3543388 TI - Lobar holoprosencephaly with hydrocephalus: antenatal demonstration and differential diagnosis. PMID- 3543390 TI - An unusual anatomic location of pancreatic masses. AB - By use of accepted criteria, all masses anterior to the splenic vein are thought to arise from the pancreas, whereas all masses posterior to the vein are attributed to other retroperitoneal organs. Three patients with pancreatic masses are presented. Since the mass was posterior to the splenic vein in these cases, a pancreatic origin did not originally suggest itself. PMID- 3543392 TI - In utero sonographic demonstration of a caput succedaneum. PMID- 3543391 TI - Intrapartum fetal weight estimation: a comparison of three formulae. AB - To determine the relative accuracy of fetal weight estimation using the biparietal diameter (BPD), the abdominal circumference (AC), and the femur length (FL) in three formulae (BPD/AC, FL/AC, and BPD/AC/FL), 63 patients in labor were examined. All patients delivered within 24 hours of ultrasound examination. A good correlation was found between the estimated fetal weight and the actual birth weight, using the three formulae: BPD/AC (r = 0.96); FL/AC (r = 0.95); and BPD/AC/FL (r = 0.96). The FL/AC formula overestimated fetal weight (P less than 0.01), however, particularly in fetuses weighing more than 2000 g. The mean percentage error with the BPD/AC formula was 0.99 per cent, 3.82 per cent with the FL/AC, and 2.43 per cent with the BPD/AC/FL formula. This study showed that although all three formulae were comparable, the best estimation of the birth weight was obtained when either the BPD/AC or the BPD/AC/FL formulae were used. Additionally, the results demonstrate that reliable estimates of fetal weight can be made even at term or in laboring patients. PMID- 3543393 TI - Sonographic features of rupture of the pregnant uterus. PMID- 3543389 TI - Sonography of hemorrhagic cysts with computed tomographic correlation. AB - Hemorrhagic cysts have a potential for malignancy. The sonographic appearance is not pathognomonic. Three cases of benign hemorrhagic renal cysts defined sonographically demonstrate a varied appearance. Computed tomography, angiography, and aspiration offer additional clarification, but surgery is the procedure of choice for a definitive diagnosis, because aspiration of a septated lesion may fail to define malignant cytology in a separate compartment and, in addition, cytologies can be falsely negative. PMID- 3543394 TI - Antenatal sonographic appearance of omphalomesenteric duct cyst. PMID- 3543396 TI - Sonographic terminology: hypoechoic vs. sonolucent. PMID- 3543395 TI - Calibration of automated water-path breast ultrasound scanners. AB - Simple calibration procedures that can be performed by a technologist for Ausonics, Labsonics, and Technicare automated water-path breast scanners are described. These procedures can be applied to each unit to test transducer resolution, slice thickness, and sensitivity. Quality control has ensured consistent and reliable operation of these units and has helped technologists to describe specific problems to service engineers. PMID- 3543397 TI - Clinical pharmacology of mecillinam in calves. AB - The minimal inhibitory concentrations (MIC) of mecillinam, a novel beta amidinopenicillanic acid derivative with unusual activity against Gram-negative bacteria, were compared with the MIC of cephazolin, cephalothin, amoxycillin, oxytetracycline, chloramphenicol, dihydrostreptomycin, neomycin, kanamycin, gentamicin and sulfadoxin/trimethoprim (TMP) against pathogenic Gram-negative bacteria recovered from neonatal calves. The MIC values of mecillinam ranged between 0.05 microgram/ml and 12.5 micrograms/ml, and the MIC90 values were 1.56 micrograms/ml and 3.12 micrograms/ml. The activity of mecillinam against salmonella, Escherichia coli and Pasteurella multocida was similar to or slightly greater than the activities of the first-generation cephalosporins, gentamicin and sulfa/TMP. Mecillinam concentrations less than or equal to 3.12 micrograms/ml inhibited the growth of the majority of isolates which were resistant (MIC90 greater than 100 micrograms/ml) to the other antibiotics studied. The minimum bactericidal concentration (MBC) values of mecillinam were two- to three-fold higher than the MIC values. The two-compartment open model was appropriate for the analysis of serum mecillinam concentrations measured after intravenous administration. The distribution half-life (t1/2 alpha) was 11.7 min, the elimination half-life (t1/2 beta) was 53.3 min, and the apparent volume of distribution (Vd (area)) and the distribution volume at steady state (Vd (ss)) were 0.568 and 0.896 l/kg, respectively. The drug was quickly absorbed after intramuscular (i.m.) injection; peak serum drug concentrations were directly related to the dose administered. They were obtained 30 min after treatment and the i.m. t1/2 was approximately 65 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543398 TI - Two of the three influenza viral polymerase proteins expressed by using baculovirus vectors form a complex in insect cells. AB - Each of the influenza virus polymerase (P) genes PB1, PB2, and PA was inserted into a baculovirus vector under the control of the polyhedrin promoter. In insect (Spodoptera frugiperda) cells infected by each baculovirus recombinant containing a P gene insert, a large amount of the encoded P protein was synthesized. Gel electrophoretic analysis of the total proteins in infected cells revealed the presence of a new protein band corresponding to the encoded P protein that was abundant enough to be stained with Coomassie blue. In cells infected simultaneously with both the PB1 and PB2 baculovirus recombinants, a PB1-PB2 complex was formed that was immunoprecipitated with an antiserum specific for either PB1 or PB2. In cells infected simultaneously with all three P baculovirus recombinants, a PB1-PB2 complex lacking the PA protein was formed. Formation of this PB1-PB2 complex partially mimics events that occur in influenza virus infected cells, where all three P proteins form a complex with each other (B. M. Detjen, C. St. Angelo, M. G. Katze, and R. M. Krug, J. Virol. 61:16-22, 1987). These results indicate that the ability of PB1 and PB2 to form a complex is an intrinsic property of these two proteins that does not require the participation of other influenza viral gene products. Possible reasons for the absence of the PA protein from the immunoprecipitable P protein complex in insect cells infected by the three P baculovirus recombinants are discussed. PMID- 3543399 TI - Identification of two new bacteriophage T4 genes that may have roles in transcription and DNA replication. AB - We have identified two bacteriophage T4 genes, 45.1 and 45.2, that map in the intergenic space between phage replication genes 46 (which encodes a recombination initiation protein) and 45 (which encodes a bifunctional protein required in replication and transcription). The existence of genes 45.1 and 45.2 had not been previously recognized by mutation analysis of the T4 genome. We cloned the T4 gene 45.1/45.2 segment, determined its nucleotide sequence, and expressed its two reading frames at high levels in bacterial plasmids. The results predicted molecular weights of 11,400 (100 amino acids) for gp45.1 and 7,500 (62 amino acids) for gp45.2. We also determined that in T4-infected Escherichia coli, genes 45.1 and 45.2 are cotranscribed with their distal neighbor, gene 45, by at least one mode of transcription. In an accompanying report (K. P. Williams, G. A. Kassavetis, F. S. Esch, and E. P. Geiduschek, J. Virol. 61:600-603, 1987), it is shown that the product of gene 45.1 is the so called T4-induced 15K protein, an RNA polymerase-binding protein of unknown role in phage development. Possibly, T4 genes 45.2, 45.1, and 45 constitute an operon for host RNA polymerase-binding phage proteins. Jointly with Williams et al., we propose the term rpb (RNA polymerase-binding) to refer to T4 genes whose products bind to the host RNA polymerase and have adopted the name rpbA for T4 gene 45.1. PMID- 3543400 TI - The genome of lipid-containing bacteriophage PRD1, which infects gram-negative bacteria, contains long, inverted terminal repeats. AB - The bacteriophage PRD1 is a lipid-bearing phage that infects a wide variety of gram-negative bacteria, including Escherichia coli and Salmonella typhimurium when they contain the appropriate plasmid. It contains a linear duplex DNA molecule that is covalently bound by its 5' ends to a terminal protein. We report here that the PRD1 genome contains a 111-base-pair terminal inverted repeat which does not bear homology to that of any known linear duplex DNAs with terminal proteins. We further report that its 3' termini are susceptible to enzymatic digestion by exonuclease III. PMID- 3543401 TI - Expression of the art gene protein of human T-lymphotropic virus type III (HTLV III/LAV) in bacteria. AB - Human T-lymphotropic virus type III (HTLV-III/LAV or HIV) contains a gene designated art (anti-repressor transactivator). Here, we report the expression of the art gene product in bacteria and show that the 20-kilodalton (kDa) bacterially expressed art protein is recognized by serum of a patient. The bacterially synthesized art protein competed in an immunological reaction with a 20-kDa protein produced in HTLV-III/LAV-infected lymphocytes. Antiserum to a synthetic oligopeptide corresponding to a sequence in the second exon of the art gene also precipitated the 20-kDa protein in HTLV-III/LAV-infected cells. These results demonstrate that the 20-kDa art gene product is expressed in cell lines that produce HTLV-III/LAV virions. PMID- 3543402 TI - Location, transcription, and sequence of a baculovirus gene encoding a small arginine-rich polypeptide. AB - The nucleotide sequence of the cDNA of an abundant late 0.5-kilobase transcript of Autographa californica nuclear polyhedrosis virus revealed a small open reading frame encoding an arginine-rich 6.9-kilodalton protein. The predicted amino acid composition of the 6.9-kilodalton protein was essentially identical to that of the core protein of viral nucleocapsids. The precise location of the 5' and 3' ends of the transcript were confirmed by S1 nuclease and primer extension analyses. Multiple overlapping transcripts through this region include three early and three abundant late RNAs which are transcribed counterclockwise and one transient RNA which is transcribed clockwise with respect to the physical map of the virus. PMID- 3543403 TI - Expression of hepatitis B virus surface and core antigens: influences of pre-S and precore sequences. AB - Amphotropic retroviral expression systems were used to synthesize hepatitis B virus surface antigen (HBsAg) and core antigen. The vectors permitted establishment of cell lines which expressed antigen from either the retroviral long terminal repeat or the mouse metallothionein-I promoter. HBsAgs were synthesized containing no pre-S sequences, pre-S(2) sequences alone, or pre-S(1) plus pre-S(2) sequences. Inclusion of pre-S(2) sequences did not affect the secretion or density of HBsAg particles but did reduce their mass by approximately 30%. Addition of pre-S(1) sequences almost completely abolished secretion of HBsAg and resulted in its localization in an aqueous-nonextractable pre- or early-Golgi cellular compartment. HBsAg was localized to the cytoplasm of the cell. This localization was unaffected by the presence of pre-S sequences in the antigen. Cell lines synthesizing hepatitis B antigens from core DNA fragments, containing or not containing precore sequences, secreted hepatitis B e antigen. However, the absence of precore DNA sequences resulted in additional synthesis of hepatitis core antigen, which was predominantly nuclear in localization. PMID- 3543405 TI - Preservation of 32 human kidneys by simple cold storage for more than 48 hours. AB - Transplant centers are reluctant to use kidneys stored cold for more than 48 hours. During a 6-year interval we transplanted 32 kidneys preserved by intracellular electrolyte flushing that were stored cold for 48.2 to 61.4 hours. Of the recipients 91 per cent required dialysis within 1 week after transplantation. The mean serum creatinine nadir within 1 month was 3.0 mg. per dl. and graft survival at 1 month was 81 per cent. Short-term kidney graft function was not influenced significantly by the addition of magnesium sulfate to the flush solutions or by cyclosporin immunosuppression. The 1 and 2-year actuarial kidney graft survival rates were 72 and 58 per cent, respectively. The 1 and 2-year mean serum creatinine levels were 1.9 and 1.6 mg. per dl., respectively. Kidneys can be transplanted successfully after 48 hours of simple cold storage following flushing with an ice-cold intracellular electrolyte solution. PMID- 3543404 TI - Humoral immune responsiveness in duck hepatitis B virus-infected ducks. AB - Immunofluorescence assays with fixed tissue sections were used to characterize antibody reactivity in sera obtained from duck hepatitis B virus-infected ducks. Under conditions of experimental infection, antibody to core antigen but not to surface antigen was detectable. A majority of the ducks infected at 8 days after hatching and a minority of those infected at 1 day after hatching showed a transient anti-core antigen humoral response; this response was stronger in the antibody-positive ducks infected on day 8 than in those infected on day 1. Antiviral antibody was not detected in the sera of ducks congenitally infected with duck hepatitis B virus. Several of the infected ducks, but none of the uninfected ducks, exhibited autoantibody reactivity for alpha-islet-cell associated antigen. PMID- 3543406 TI - Suprapubic urethropexy: management with a transvesical exposure. AB - Opening the bladder allows for excellent exposure and more accurate placement of sutures for correction of stress urinary incontinence. The results of our first 100 cases with a minimum 3-year followup are presented. Because of the high success rate with minimal morbidity or complications we recommend this procedure as the operation of choice for surgical correction of stress urinary incontinence. PMID- 3543407 TI - Caliceal obstruction owing to a large parapelvic cyst: excretory urography, ultrasound and computerized tomography findings. AB - Benign parapelvic cysts are a common finding on radiology studies. Rarely, a parapelvic cyst may enlarge enough to obstruct the renal calices. We report a case in which computerized tomography following an excretory urogram and ultrasound proved to be especially helpful in the noninvasive evaluation of an obstructing parapelvic cyst. PMID- 3543408 TI - Malacoplakia presenting as a pseudotumor of the bladder in cadaveric renal transplantation. AB - Genitourinary malacoplakia in renal transplant patients is rare. We report a case of malacoplakia of the bladder, which presented as a vesical tumor. PMID- 3543410 TI - Fournier's gangrene: a complication of penile prosthetic implantation in a renal transplant patient. AB - The management of erectile impotence in renal transplant patients remains problematical. The enhanced risk of surgical infection in this immunosuppressed patient population must be addressed if prosthetic implantation is contemplated. A case of Fournier's gangrene (synergistic necrotizing gangrene of the genitalia) following implantation of a Small-Carrion penile prosthesis is reported. This potentially life-threatening infection demonstrates graphically the surgical infection risk of this population and suggests extreme caution before proceeding with a prosthetic operation in this unique subset of impotent patients. PMID- 3543409 TI - A technique of maintaining penile prosthesis position to prevent proximal migration. AB - A technique for proximal reconstruction of the corpora cavernosa using a synthetic vascular graft fashioned into a cup is described. In 6 cases this procedure was critical and successful in the repair of the corpora cavernosa associated with the placement of a penile prosthesis. PMID- 3543411 TI - Re: Short-term prophylactic antibiotics in patients undergoing prostatectomy: report of a double-blind randomized trial with 2 intravenous doses of cefotaxime. PMID- 3543412 TI - Vaginal immunization against induced cystitis in monkeys. AB - Cynomolgus monkeys received either vaginal immunization with formalin-killed E. coli or vaginal instillation of excipient without the bacteria. At 2, 7, 14 and 21 days after induction of a urinary tract infection with live E. coli, immunized monkeys showed enhanced clearance of bacteriuria compared to non-immunized controls. Immunized monkeys also showed increased levels of urinary anti-E. coli IgA and IgG after the immunizing and infecting procedures. Induction of heightened local immunity by vaginal immunization may lessen host susceptibility to urinary tract infections. PMID- 3543413 TI - Role of neutrophil chemotaxis in the pathogenesis of urinary tract infection. AB - Status of neutrophil chemotaxis was evaluated in seventeen infants and children with acute urinary tract infection. Four different chemotactic factors including those generated by patient's own invading pathogens were studied against patient cells. Chemotactic migration was found to be depressed during active infection and gradually returned to normal after successful eradication of the organisms. During a second episode of UTI chemotaxis again became defective. Inhibition of neutrophil chemotaxis seems to be at least one mechanism in the pathogenesis of UTI. Counteracting the suppression may play a role in modifying the inflammatory process and/or enhancing recovery during therapy. PMID- 3543414 TI - New techniques enable 'heartless' lung transplants. PMID- 3543415 TI - Do it to yourself section. The Kane surgery. PMID- 3543416 TI - Disulfiram treatment of alcoholism. PMID- 3543417 TI - Jejunal entrapment of a gastric balloon. PMID- 3543418 TI - Starting insulin therapy in outpatients. PMID- 3543420 TI - Androgen-producing hilus cell tumor of the ovary. Detection in a postmenopausal woman by duplex Doppler scanning. PMID- 3543419 TI - Use of claims data systems to evaluate health care outcomes. Mortality and reoperation following prostatectomy. AB - Data maintained by medical insurance plans can be used to evaluate the incidence of death and nonfatal complications following medical care, to test hypotheses about the outcomes of care, and to identify hospitals with unusually high or low death rates. These uses are illustrated for prostatectomy, utilizing claims data from the Maine Medicare and Manitoba Health Services Commission files. The study shows important differences in death rates between individual hospitals and higher cumulative probability of reoperation following transurethral compared with open prostatectomy. The advantages of claims data are low cost, ease of patient follow-up over long periods, and the absence of reporting bias. The limitations are the adequacy of the data used to control for patient comorbidity and the lack of outcome information on functional status. The effective use of claims data for monitoring requires the active participation of physicians in improving the data base and interpreting the findings. PMID- 3543421 TI - Yersinia hepatic abscesses subsequent to long-term iron therapy. AB - A 71-year-old woman who had been receiving iron injections for at least ten years was admitted to the Dr Everett Chalmers Hospital, Fredericton, New Brunswick. The initial diagnosis was metastatic tumors in the liver, but after further evaluation, the initial diagnosis was corrected to multiple hepatic abscesses due to Yersinia enterocolitica. The liver biopsy showed abundant iron deposition. With the appropriate antibiotic treatment, the patient recovered. PMID- 3543422 TI - Leads from the MMWR. Rapidly progressive dementia in a patient who received a cadaveric dura mater graft. PMID- 3543423 TI - Toxic shock syndrome: back to the future. PMID- 3543424 TI - Indirect immunofluorescence assays can readily detect antibodies to the human immunodeficiency virus. PMID- 3543425 TI - Diabetogenic effect of pentamidine. PMID- 3543426 TI - Legionnaires' disease acquired within the homes of two patients. Link to the home water supply. AB - Two patients with sporadic community-acquired legionnaires' disease are described. Legionella pneumophila was isolated from sputum specimens, and seroconversion of antibody titers was demonstrated for both patients. Legionella pneumophila was also recovered from the residential water supply of both patients. In each case, the serogroup of the environmental organism matched that of the infecting organism. In one patient, serogroup 3 was isolated--a rare cause of legionnaires' disease, and in the second case, monoclonal antibody testing confirmed that the serogroup 1 organisms isolated from sputum and residential water supply samples were identical. The incubation period of legionnaires' disease is presumed to be up to two weeks. Because of medical problems, both patients had been confined to their homes for the entire two weeks before the onset of symptoms. This is the first report that links acquisition of community acquired legionnaires' disease to contaminated water supplies within the homes of susceptible patients. PMID- 3543427 TI - Effects of insulin on pressor responsiveness and baroreflex function in diabetes mellitus. AB - The effects of insulin on pressor responsiveness to alpha agonist (phenylephrine) and angiotensin II, and baroreflex function were studied in fifteen diabetic patients without autonomic neuropathy. The dose of phenylephrine required to increase systolic pressure by 25 mmHg (PD25) was significantly increased from 38 +/- 7 to 62 +/- 9 micrograms (p less than 0.05) after IV injection of 4 U of Actrapid monocomponent insulin. The dose of angiotensin II required to increase systolic pressure by 30 mmHg (AD30) was also increased from 0.29 +/- 0.07 to 0.48 +/- 0.10 micrograms (p less than 0.01). Following insulin administration, the dose-response curves for phenylephrine and angiotensin II were shifted to the right. The baroreflex sensitivity was not affected by insulin. In contrast, there was no significant change in PD25, AD30 or baroreflex sensitivity after the injection of saline. These results suggest that insulin attenuates the pressor responsiveness to alpha agonist and angiotensin II, which may be one of the significant mechanisms in insulin-induced vasodilation. PMID- 3543428 TI - [Effect of trimethaphan-induced hypotension on carbohydrate metabolism]. PMID- 3543430 TI - [Antibiotic susceptibility of bacteria isolated from surgical infections (first report)]. AB - In vitro activities of several antimicrobial agents against bacterial pathogens isolated from patients with primary and postoperative infections were investigated in 1982 and 1983. Antimicrobial agents examined were as follows: sulbenicillin (SBPC), piperacillin (PIPC), cephalothin (CET), cefazolin (CEZ), cefmetazole (CMZ), cefotiam (CTM), cefoperazone (CPZ), cefotaxime (CTX), ceftizoxime (CZX), cefmenoxime (CMX), latamoxef (LMOX), lincomycin (LCM), gentamicin (GM) and amikacin (AMK). Specimens for bacterial isolation included plus, fluid drawn by centesis, or bile. Blood samples of septicemia were excluded. The antimicrobial activities of these drugs were determined by the agar plate dilution method of the Japanese Society of Chemotherapy. There were 123 strains obtained in the 1982 survey and 252 strains in the 1983 survey. Little or no differences were seen in frequencies of isolation between the isolates of principal species in 1982 and those in 1983. Isolation frequencies of pathogens in primary infections were, in an order of decreasing frequency, E. coli (25.6%), anaerobes (21.1%), Streptococcus sp. (14.3%), Staphylococcus sp. (11.3%); in postoperative infections, Streptococcus sp. was most frequent (28.6%), followed by Pseudomonas sp. (17.6%), anaerobes (12.6%), E. coli (10.9%), Staphylococcus (10.1%). Against S. aureus, CEZ, CTM, LCM and GM had similar degree of activity with CET being somewhat more active. CMX was the most active drug among the third generation cephems tested against S. aureus. No strain was CTM, CEZ, and LCM resistant at the same time. Over 90% of E. coli, were sensitive to CTX, CZX and CMX, inhibited by 0.10 microgram/ml, while E. coli were slightly less susceptible to CPZ and LMOX. Penicillins were not very active against K. pneumoniae, and only 60% of K. pneumoniae were inhibited by PIPC at concentrations of 12.5 micrograms/ml. Third generation cephems, CTX, CMX and CZX, proved highly active against K. pneumoniae; over 90% of K. pneumoniae was inhibited by CTX, CMX and CZX at a concentration of 0.10 microgram/ml. About 60% of P. aeruginosa was inhibited by 3.13 micrograms/ml of PIPC and GM but was resistant to SBPC. This survey should be very useful for the selection of an appropriate drug for prophylaxis if the frequencies of incidences of pathogens in postoperative infections are taken into account in selecting the most active antibiotic agent(s) against the most frequent genus, genera and species of pathogens. PMID- 3543429 TI - [Antibacterial activity of cephem antibiotics against isolates from clinical specimens at the Yokohama City University Hospital]. AB - Minimum inhibitory concentrations (MICs) of cephem antibiotics against 405 strains belonging to 17 species of clinical isolates were investigated using the standard method of the Japanese Congress of Chemotherapy. The results obtained are summarized below. Cephem antibiotics showed weak antibacterial activities against Enterococcus sp., B. fragilis and S. marcescens. S. pneumoniae, S. agalactiae, E. coli, K. pneumoniae and P. mirabilis were susceptible to cephem antibiotics. Cephem antibiotics of the 1st and the 2nd generations showed weak antibacterial activity against Citrobacter sp. and E. cloacae, while cephem antibiotics of 3rd generation had a good antibacterial activity against these species. Cephem antibiotics of the 2nd and the 3rd generations showed high antibacterial activity against H. influenzae and indole positive Proteus group. Cefoperazone showed high antibacterial activity against P. aeruginosa. Resistance to latamoxef, ceftizoxime and cefoxitin was observed among Staphylococcus sp., while the MICs of other antibiotics against Staphylococcus sp. were fairly low. Number of strains resistant to the 3rd cephem antibiotics seems to be increasing because the 3rd generation of cephem antibiotics have been used frequently. Further investigation will be required on resistant organism to these antibiotics including beta-lactamase producing strains. PMID- 3543431 TI - [A study of the disc sensitivity test for cephapirin]. AB - Susceptibility of 203 strains of 34 bacterial species or subspecies to cephapirin (CEPR) was determined by the 2-fold agar dilution method in parallel with the determination of inhibition zone diameter in the single-disc method. These experiments demonstrated a significant correlation between the MIC by the dilution method and the diameter of inhibition zone determined by the conventional assay using an over-night (about 16 hours) incubation, the delayed assay (about 24 hours incubation), or the rapid assay (after 3-4 or 5-6 hours incubation), hence applicability of the single-disc assay for CEPR was confirmed. An analysis of the data obtained using CEPR discs (each containing 30 micrograms) revealed that primary regression equations were as follows: D (diameter, mm) = 25.8-9.7 log MIC (microgram/ml) in the conventional assay; D = 31.2-12.3 log MIC in the delayed assay; D = 21.7-7.1 log MIC in the 5-6-hour rapid assay and D = 17.9-5.0 log MIC in the 3-4-hour rapid assay, and especially for beta-lactamase producing Staphylococci, they were: D = 24.9-9.2 log MIC in the conventional assay, D = 20.4-7.4 log MIC in the 5-6-hour rapid assay and D = 17.5-5.8 log MIC in the 3-4-hour rapid assay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543432 TI - [A double-blind comparative study on the efficacy of S6472, cefaclor, in the treatment of bacterial bronchitis]. AB - Clinical efficacy and safety of S6472 (long active cefaclor (CCL)) and CCL were compared by a double-blind study using 248 patients with bacterial bronchitis. Patients were orally administered with either 375 mg of S6472 2 times or 250 mg of CCL 3 times daily for 7 days, and the following results were obtained. Clinical efficacy judged by a committee: The efficacy rates on acute bronchitis were 87.2% for S6472 and 82.6% for CCL, and the efficacy rates on chronic bronchitis were 70.3% for S 6472 and 64.7% for CCL. There was no significant difference between the 2 drugs in clinical efficacy. Clinical efficacy judged by doctors in charge: Results of the clinical efficacy judged by doctors in charge were similar to the efficacy judged by the committee. Bacteriological efficacy judged by the committee: Eradication rate for the S6472 group was 71.1% (32 of 45 patients) and that for the CCL group was 67.4% (29 of 43 patients). There was no significant difference between the 2 drugs in the bacteriological efficacy. Side effects and abnormal laboratory findings: Side effects were observed in 5 cases (4.2%) in the S6472 group and in 5 cases (4.0%) in the CCL group. These side effects, however, were not serious, and no remarkable abnormal laboratory values were observed. There was no significant difference between the 2 drugs in the incidence of side effects or abnormal laboratory findings. Clinical utility: When the clinical utility was expressed by the utility rate (very useful and useful), it was 79.5% in the S6472 group (117 patients) and 76.2% in the CCL group (122 patients) (judged by the committee). When the utility was judged by doctors in charge, it was 73.3% in S6472 group (120 patients) and 71.4% in CCL group (126 patients). From the above results, it has been concluded that S6472 taken twice daily is equivalent to CCL in effectiveness on bacterial bronchitis. PMID- 3543434 TI - [Clinical evaluation of serum beta 2-microglobulin in squamous cell carcinoma of the lung]. AB - The clinical usefulness of measuring serum beta 2-microglobulin (BMG) and squamous cell carcinoma-related antigen (SCC-Ag) was studied, and it was found that both were elevated in patients with squamous cell carcinoma of the lung. In squamous cell carcinoma, serum BMG was high in patients who were more than 65 years old, whereas it was not raised in those with other histological types or with benign respiratory diseases. This increase in BMG, however, was thought to correlate with the clinical stage rather than with aging. The rise of BMG was suggested, similar to the rise of SCC Ag, to be specific to squamous cell carcinoma of the lung. PMID- 3543433 TI - [Clinical evaluation of cefoperazone in lower respiratory tract infections]. AB - Clinical evaluation and kinetics in serum of cefoperazone (CPZ) in patients with lower respiratory tract infections have been conducted as a multicenter trial participated by 20 institutions in Kyushu area during a period of 8 months from October 1984 to May 1985. Mean serum CPZ levels up to 4 hours following the end of intravenous infusion of either 1 or 2 g CPZ remained higher than the MIC80 of CPZ against major causative organisms of lower respiratory tract infections such as H. influenzae, P. aeruginosa, K. pneumoniae, and S. pneumoniae. Serum half lives of CPZ following intravenous infusion were prolonged in the elderly and in patients who showed moderate liver or kidney dysfunction, but did not exceed twofold of normal value. Clinical efficacy rates of CPZ were 82.9% (34/41) against pneumonia, 80% (4/5) against lung abscess, 88.9% (32/36) against acute exacerbation of chronic bronchitis, 66.7% (2/3) against panbronchiolitis, 100% (1/1) against acute bronchitis, and 85.7% (12/14), 64.3% (9/14) and 70.0% (7/10) against infections concurrent to chronic respiratory diseases, pulmonary emphysema and bronchiectasis, respectively. The overall efficacy rate was 81.5% (101/124). Bacteriological eradication rates against P. aeruginosa, H. influenzae and S. pneumoniae were 60% (6/10), 88.9% (8/9) and 100% (3/3), respectively. The overall eradication rate including polymicrobial infection was 67.5% (27/40). The clinical efficacy rate of CPZ in patients with underlying diseases such as lung cancer, pulmonary tuberculosis, and pneumoconiosis, etc. was not significantly different from the efficacy rate in patients without these underlying diseases. Of 20 patients who failed to respond to previous antibiotic treatments, 13 were effectively treated by CPZ. Adverse reactions occurred in 6.7% (11/164) of the patients, and consisted primarily of rash, fever, diarrhea and loose stool. Laboratory abnormalities were seen in 5 patients during the study. These included elevations of S-GOT and S-GPT, eosinophilia and neutropenia. CPZ is a very useful drug in the treatment of lower respiratory tract infections because of its excellent clinical efficacy and rare incidence of abnormal accumulations in sera following the recommended 2-4 g/day administration even in the elderly. PMID- 3543435 TI - [Mitoxantrone as combination chemotherapy in patients with acute leukemia. Tokai Blood Cancer Study Group]. PMID- 3543437 TI - [Changes in immunoglobulins in association with immune complex formation]. PMID- 3543436 TI - [Evaluation of danazol therapy in chronic refractory idiopathic thrombocytopenic purpura]. PMID- 3543438 TI - [Determination of immune complex levels--with special reference to C1q and the anti-antibody method]. PMID- 3543441 TI - [High-performance liquid chromatographic method for plasma or serum level monitoring of lidocaine and its active metabolites]. PMID- 3543440 TI - [Detection of immune complexes using C3 receptors on human erythrocytes]. PMID- 3543439 TI - [Determination of immune complex levels using the Fc receptor of guinea pig peritoneal cells]. PMID- 3543443 TI - [Medicolegal documental materials chronologically arranged in the Meiji Era (6)]. PMID- 3543442 TI - A combination of sulfamonomethoxine and pyrimethamine versus other drugs for the treatment of malaria. AB - Sixty-eight cases of vivax and 30 cases of falciparum malaria patients were treated with a combination of sulfamonomethoxine-pyrimethamine (MP tablet with 500 mg of sulfamonomethoxine and 25 mg of pyrimethamine) and the results were compared with those with chloroquine, Fansidar and quinine. Vivax malaria: Fever and parasites were cleared by the 4th day of treatment in 94 and 92% of the patients, respectively. Chloroquine was the most effective drug and Fansidar and MP tablets shared the next position. Falciparum malaria: Fever and asexual parasites were cleared by the 4th day of treatment in 67 and 78% of the patients, respectively. MP tablets were effective in chloroquine-resistant falciparum malaria contracted in Kalimantan (Indonesia) and Oceanian countries (Vanuatu etc.). Fever and parasite clearance times were shorter with chloroquine or with Fansidar than with MP tablets. Defective preschizonts used to appear following administration of MP tablets both in vivax and falciparum malarias. They were the premonitory laboratory indications that the asexual parasites will be soon eradicated. PMID- 3543444 TI - [Changes in the midwifery functions. 19. The re-training seminar on midwifery organized by Ms. Mathison]. PMID- 3543445 TI - [Immunofluorescent studies on Henoch-Schonlein purpura nephritis and IgA nephropathy in children]. PMID- 3543446 TI - [A study on the analytical methods of proteins in unconcentrated urine]. PMID- 3543447 TI - Inhibitory effect of human urinary trypsin inhibitor (urinastatin) on lysosomal thiol proteinases. AB - Effects of human urinary trypsin inhibitor, urinastatin, a compound clinically prescribed for treatment of acute pancreatitis, on lysosomal thiol proteinases were studied. Urinastatin had inhibitory effect on the activities of cathepsins B and H in vitro. In the experimental acute pancreatitis induced by a closed duodenal loop, urinastatin prevented the enhancement of esterolytic activity and the activities of cathepsins B and H. Urinastatin also improved the activities of inhibitors of cathepsins B and H in the case of pancreatitis. PMID- 3543448 TI - [Roots of nursing in pioneer public health nursing. 10. A pioneer nurse in wilderness of Hokkaido]. PMID- 3543449 TI - [Two resected cases of pulmonary aspergillosis coincidentally accompanied by a solid tumor]. PMID- 3543450 TI - [Vasodilator therapy of chronic cor pulmonale]. PMID- 3543451 TI - [Six-year experience with sonometrics of the prostate. I: Contribution of sonometrics to diagnosis]. PMID- 3543452 TI - [Urinary undiversion using autotransplantation--a case report]. PMID- 3543453 TI - Unique proliferation-associated marker expressed on activated and transformed human cells defined by monoclonal antibody. AB - The expression, tissue distribution, and preliminary characterization of a cell surface molecule, apparently a glycolipid, recognized by a monoclonal antibody, anti-PAA, were described. This antibody (anti-PAA) was produced by the fusion of myeloma cells NS-1 with spleen cells from a BALB/c mouse, which were sensitized with activated human T-cells generated by allogeneic stimulation in mixed lymphocyte culture (MLC). Resting human peripheral blood T-cells, B-cells, and monocytes demonstrated weak anti-PAA binding. Binding of proliferating T-cells (phytohemagglutinin- and MLC-activated T-cells) and thymocytes to anti-PAA was two to six times greater than that of resting T-cells. A fifteenfold-increased binding was observed with acute lymphocytic leukemia T-cell lines. Epstein-Barr virus-transformed B-cell lines bound anti-PAA up to sixteenfold greater than resting B-cells. Tumor cell lines of various nonlymphoid origins demonstrated marked reactivity with this antibody. Both benign and malignant cells in hyperplastic tissues, of various origins, bound anti-PAA, whereas their normal, nonproliferating counterparts did not. Normal proliferating cells in these tissues, including cells of the placental chorionic villi and trophoblasts, also bound anti-PAA. Of all lymphoid and nonlymphoid cell lines examined, only chronic lymphocytic leukemia (CLL) cells and some cell lines derived from Burkitt's lymphoma showed weak or no binding. This antibody also failed to react with a variety of nonprimate cell lines. Anti-PAA antibody did not immunoprecipitate any protein from lymphoid tumor cell lines to which it demonstrated a quantitatively high degree of binding, nor did protease treatment of these lines decrease antibody binding. Anti-PAA did, however, bind to glycolipids extracted from these cell lines. Binding of this monoclonal antibody to a minor neutral glycolipid, isolated from the erythroleukemia cell line K562, was about sixfold greater than that of any other K562 neutral glycolipid or ganglioside. Anti-PAA demonstrated weak or undetectable binding to purified, predominant, lymphoid cell membrane's neutral glycolipids and gangliosides. The monoclonal antibody anti-PAA appeared, therefore, to recognize a unique, proliferation-associated, neutral glycolipid present on normal as well as on benign and malignant proliferating cells. The antigen appeared to be universally expressed on proliferating cells from all human tissues with the exception of some Burkitt's cell lines and CLL cells. Nonhuman cell lines, except those for closely related primates, did not express PAA. PMID- 3543454 TI - Pathologic anatomy and patterns of occurrence of hepatic neoplasms, putative preneoplastic lesions, and other idiopathic hepatic conditions in English sole (Parophrys vetulus) from Puget Sound, Washington. AB - A comprehensive description of the histopathologic characteristics of a spectrum of idiopathic lesions in feral English sole (Parophrys vetulus), a bottom dwelling flatfish, from Puget Sound, Washington State, is presented. Among these lesions are unique degenerative conditions, regeneration, storage disorders, foci of hepatocellular alteration (putative preneoplastic lesions), hepatocellular and biliary neoplasms, and nonneoplastic proliferative conditions, all of which morphologically resemble the lesions induced by various hepatocarcinogens hepatotoxins in experimental exposures of fish and/or rodents. Results from a statistical analysis of the patterns of co-occurrence of these lesions in English sole are consistent with the concept, developed from experimental studies of liver carcinogenesis in rodents, that there are morphologically identifiable steps representing progression toward hepatic neoplasms. This is the first study in which it has been possible to demonstrate a close morphological congruity between a set of idiopathic hepatic lesions in any feral population and an established series of hepatic lesions inducible in rodents by certain hepatocarcinogens under laboratory conditions. Since sediments from the habitats occupied by the fish in this study have been shown to contain multiple hepatocarcinogens, the findings strengthen cumulative evidence that English sole are useful as indicators of exposure to hepatocarcinogens in aquatic environments. PMID- 3543455 TI - [History of nursing: Nagano Jikei Hospital and Miss Smith]. PMID- 3543456 TI - [Early ventricular repolarization syndrome]. PMID- 3543457 TI - [Cardioscreen-2--an automated dialog system for multipurpose and cardiological screening]. PMID- 3543458 TI - [Serial testing of anti-arrhythmia preparations using the intracardiac electrophysiological study of patients with reciprocal paroxysmal tachycardias]. AB - Diagnostic investigation of 36 patients with reciprocal paroxysmal tachycardias, using intracardiac electrophysiologic tests, revealed supraventricular paroxysmal tachycardia in 29 patients, and ventricular paroxysmal tachycardia in 7. Serial trials of antiarrhythmic drugs in acute experiments with simultaneous electrophysiologic studies made possible efficient medication in 80% of the patients. A high correlation was demonstrated between the results of acute antiarrhythmic drug tests and subsequent long-term treatment. Ritmilen proved particularly effective in patients with paroxysmal tachycardias in the presence of the ventricular pre-excitation syndrome, while cordarone and etmozin were most effective antiarrhythmic drugs for reciprocal ventricular tachycardias. No preferential antiarrhythmic agent could be established for patients with reciprocal paroxysmal tachycardias due to double atrioventricular conduction. PMID- 3543459 TI - [Electrophysiological study of the cardiotropic action of phenothiazine derivative anti-arrhythmia preparations]. AB - Cardiotropic action of antiarrhythmic agents etmozin and etacizin, phenothiazine derivatives, was studied electrophysiologically in 42 mongrel dogs (using isolated heart and intact body models). Etmozin produced no direct effect on sinus node function, whereas etacizin suppressed it in isolated hearts. Etmozin and etacizin significantly affected the atrial, atrioventricular-node and His Purkinje conduction time, having no basic effect on the duration of respective refractory periods. Therefore, they can be referred to antiarrhythmic agents, group 1, subclass C. The magnitude and pattern of etmozin-and etacizin-induced electrophysiologic changes in the isolated heart and the integrated system are basically similar, an evidence of cardiotropic effects of these drugs. The model of an isolated dog heart perfused by a donor dog's blood can be used for the assessment of cardiotropic effects of drugs in preclinical trials of new antiarrhythmic agents. PMID- 3543460 TI - [Prerequisites for automating electrocardiography]. PMID- 3543461 TI - [Complications following a segmental pancreatic autograft]. PMID- 3543462 TI - [Intraoperative ultrasonic study of the pancreas]. PMID- 3543463 TI - [Pathogenesis, basic simulation principles and surgical treatment of pancreatitis. II. The pathogenesis of acute and chronic pancreatitis based on experimental data and the results of clinical observations]. PMID- 3543464 TI - [Ectopy of the pancreas]. PMID- 3543465 TI - [Crohn's disease (a review of the literature)]. PMID- 3543466 TI - [Role of N. V. Sklifosovskii in the growth of medical education in Russia]. PMID- 3543467 TI - [I. F. Moier (on the 200th anniversary of his birth)]. PMID- 3543468 TI - [Cutaneo-plastic surgery of finger injuries at a trauma center]. PMID- 3543469 TI - [Reinforcement of the posterior wall of the bronchial stump using teflon fabric following pulmonary resection]. PMID- 3543470 TI - [Diminution of myopia following operation of macular hole-induced retinal detachment]. AB - This paper presents an assessment of the diminution of myopia in 25 eyes after surgery according to the technique of G. P. Theodossiadis for retinal detachment due to a macular hole. The procedure consists in the stretching and fixation of a silicone sponge at the posterior pole and dispenses entirely with either cryocoagulation or light coagulation. The sponge is stretched and fixed to the sclera at both ends (12 and 6 o'clock), far from the posterior pole. The scleral protrusion thus obtained in the macular area leads to a considerable diminution of the high myopia usually present in such cases. The reduction of myopia is proportionate to the degree of protrusion of the scleral buckle, which in turn depends on the stretching of the sponge and on the amount of subretinal fluid released. PMID- 3543471 TI - [The histopathology of keratoconus posticus circumscriptus]. AB - The histopathology of keratoconus posticus circumscriptus is described. On the basis of electron microscopic studies a corneal development anomaly may be suspected. This hypothesis is also supported by the intercellular junctions (gap junctions) between the basal epithelial cells and the differences in the diameters of the collagen fibers (10-30 nm). The disturbance in fibrillogenesis is the result of stromal cell degeneration. PMID- 3543473 TI - [Outbreak of latent malaria following splenectomy for trauma]. PMID- 3543472 TI - Fine-needle biopsy of parathyroid adenomas. AB - High-resolution real-time sonography was performed in 15 cases of clinically and chemically suspected primary hyperparathyroidism and in 20 patients with different thyroid nodules. The suspected enlarged parathyroid glands and the thyroid nodules were percutaneously punctured under sonographic control. Concentrations of parathyroid hormone, human thyroglobulin, and human calcitonin were measured in the aspirate, and immunocytology was performed. The mean concentration of the aspirated parathyroid hormone in the parathyroid glands was 4,013.6 pmol/l +/- 4,519 (SD) as compared with 14.9 pmol/l +/- 8.7 in the thyroid nodules. Thyroglobulin was present in the aspirated fluid of parathyroid adenomas located behind the thyroid (mean +/- SD, 398.1 ng/ml +/- 317). In comparison, the aspirated thyroglobulin from the thyroid nodules averaged 9,689.7 ng/ml +/- 3,732. Immunocytology for parathyroid hormone was positive in 14 of the 15 biopsied specimens. Of 15 patients who were scanned for suspected hyperparathyroidism, six had concomitant thyroid nodules. It is concluded that the measurement of high concentrations of parathyroid hormone in the aspirate from a cervical mass, with sonographic control of needle position and/or positive immunocytology provides absolute localization of parathyroid tissue. PMID- 3543474 TI - [Current clinical problems of suppurative-septic complications in surgery]. PMID- 3543475 TI - [An outstanding scientist, surgeon and pedagogue (on the 150th anniversary of the birth of N. V. Sklifosovskii)]. PMID- 3543476 TI - [Epitaphs in the history of medicine]. PMID- 3543477 TI - [Creators of medical thermometry (on the 300th anniversary of the birth of Gabriel Daniel Fahrenheit--24 May 1686 and on the 350th anniversary of the death of Santorio Santorio--22 February 1636)]. PMID- 3543478 TI - [Adhesive disease of the peritoneum]. PMID- 3543479 TI - [Peptide hormonal regulators of the digestive system]. PMID- 3543480 TI - [The pedagogical works of Nikolai Ivanovich Pirogov and their importance for training medical specialists]. PMID- 3543481 TI - [Use of ultrasound in surgical diseases of the organs of the hepatopancreatoduodenal area]. PMID- 3543482 TI - [Ultrasonic and intraoperative diagnosis of diseases of the gallbladder and pancreas]. PMID- 3543483 TI - [Development of the Soviet system of the medical selection of cosmonauts (the hospital stage)]. AB - The system of medical selection of Soviet cosmonauts stemmed from that used in aviation medicine, particularly medical expertise of the flying personnel. Selection in the hospital included two-stage detailed clinical and physiological examinations using various provocative tests. The system of medical selection and clarification of medical requirements was improved and refined through regular observations over candidates and cosmonauts and careful analysis of their grounding due to medical problems. The American and Soviet systems of selection used at an early stage of space programs are compared and similarities and differences between them are indicated. PMID- 3543484 TI - [Carbohydrate hydrolysis, transport and utilization during limited motor activity in rats]. AB - Carbohydrate hydrolysis, transport and utilization were investigated in rats exposed to diminished motor activity for 90 days. Glycemic curves were examined using provocative tests with equivalent quantities (1.5 g/kg body weight) of poly , oligo- and monosaccharides (starch, maltose, glucose). Simultaneously, carbohydrases were measured in the homogenates of the pancreas, duodenal mucosa and small intestine as well as radioimmune insulin and glucagon were determined in blood. In the course of hypokinesia carbohydrate hydrolysis, transport and utilization varied in a different manner. At the beginning of exposure the activity of carbohydrases responsible for carbohydrate hydrolysis in the cavity and membranes increased which was accompanied by hyperglycemia and rapid utilization of carbohydrates. This is associated with nonspecific reactions to hypokinesia and higher requirements of the body for the energy substrate. By hypokinesia day 30 carbohydrate hydrolysis and transport were inhibited, hypoglycemia developed but glucose utilization remained unchanged. At a later stage of exposure the system of carbohydrate hydrolysis and transport showed an adaptive reaction; inhibition of pancreatic amylase was accompanied by accelerated enzyme transport in the small intestine and glucose resorption. In this situation the glycemic curves became extended suggesting a delay in glucose utilization. The latter was induced by changes in the endocrine compartment of the pancreas. PMID- 3543485 TI - [Effect of space flight factors on hemopoiesis]. AB - Published data concerning space flight effects upon hemopoiesis are discussed. Possible pathogenetic mechanisms of hemopoietic changes in response to space flight effects are described. PMID- 3543488 TI - Leukocyte functions. AB - Knowledge concerning leukocyte functions has increased enormously over the last two decades, largely because techniques have become available to assess them. It has provided insights into many disease entities, as well as on immunologic functioning as a whole. In addition to some classical clinical entities, such as severe combined immunodeficiency disease and chronic granulomatous disease, new entities have been discovered and described, in which subtle disturbances in white blood cell function are sufficient to cause disease. Furthermore, much has been learned about the effect of drugs and disease conditions on leukocyte functions. This review is not intended as a comprehensive description of white blood cell function testing, rather, it is meant to provide a practical guide for clinical laboratories. Therefore only those functional tests are presented which have a direct impact on patient management. These are primarily those functional derangements in white cells which either define a disease entity or without which a diagnosis cannot be made. Granulocytes, monocytes, and lymphocytes will be discussed separately. A short review of their physiology and function is presented to provide a context for the further discussion of their dysfunctions. This discussion of dysfunction and the techniques for laboratory testing thereof includes the evaluation of diagnostic usefulness and implications for patient management. Clinically, the most important granulocyte defects involve chemotaxis, respiratory burst, and intracellular microbial killing. Defects of granulocyte chemotaxis define the lazy leukocyte syndrome, Job's syndrome, and a series of relatively rare idiopathic neutrophil disorders. In addition, chemotaxis is a relatively easily measured sign of actin dysfunction. Defective generation of the respiratory burst with consequent impaired microbial killing defines chronic granulomatous disease and its variants as well as glutathione peroxidase deficiency. The most reliable clinical laboratory testing of granulocyte chemotaxis is performed by using granulocyte migration in response to a chemoattractant, either across a filter or in agarose. For clinical testing of respiratory burst, nitroblue tetrazolium (NBT) reduction is simple, quantitative, and has recently been adapted to automated measurement. Direct measurement of microbial killing is generally not indicated, since clinically important defects are recognized by measurement of respiratory burst generation. Although the monocyte's functions are numerous, they are somewhat less well characterized than those of granulocytes and lymphocytes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543486 TI - [Direct and mediated action of a permanent magnetic field on biological objects]. AB - The effect of a constant magnetic field (CMF) of H = 2.3 X 10(5) A/m (2900 Oe) on the viability and radiosensitivity of E. coli B and the effect of magnetically activated water (MAW) on the radioresistance of rats were examined. The exposure did not influence the growth kinetics of E. coli B. Cell cultivation in the magnetically pretreated nutrient medium enhanced the bacterial growth. Preliminary exposure of bacterial cells to a CMF for 24 and 48 hrs increased and that for 72 hrs decreased their radioresistance. Twice a day the experimental weanlings were given MAW and the controls--tap water. The postradiation longevity of the MAW rats proved extended as compared to that of the controls. The MAW rats showed a greater osmotic stability of erythrocytes, a higher concentration of nucleic acids, and a larger count of leucocytes. PMID- 3543490 TI - The Greenville Hospital System. PMID- 3543487 TI - [Radiosensitivity of Escherichia coli following irradiation in a permanent magnetic field]. PMID- 3543489 TI - Rat pulmonary artery restructuring and pulmonary hypertension induced by continuous Escherichia coli endotoxin infusion. AB - We have studied the effect of continuous endotoxin infusion on rat pulmonary structure and function (69.4 ng/100 gm body weight/min for 24 hours). After 6 days of endotoxin infusion, lack of filling of pre- and intraacinar arteries was evident on pulmonary arteriograms. Microscopy demonstrated lumen narrowing in preacinar arteries and occlusion of intraacinar arteries. Morphometry of patent intraacinar arteries established dilation and increased wall muscle. Widespread alveolar wall injury was evident. After 24 hours of infusion, pulmonary artery pressure was raised (delta 9 mmHg; p less than or equal to 0.001); it then fell but was again increased by day 6 (delta 6 mmHg; p less than or equal to 0.05). Pulmonary vascular resistance was markedly increased at 24 hours (day 0 = 0.1 +/- 0.011 dyne/sec/cm-5; 24 hours endotoxin = 0.572 +/- 0.102 dyne/sec/cm-5; p less than or equal to 0.02). It remained elevated during the infusion period but was not significant. At day 6 the alveolar-arterial oxygen diffusion gradient (A aDO2) was increased (day 0 = 19.6 +/- 1.39 mmHg, day 6 endotoxin = 33.8 +/- 0.1 mmHg; p less than or equal to 0.001). The arterial oxygen tension (PaO2) was decreased (day 0 = 86.5 +/- 1.8 mmHg, day 6 endotoxin = 74 +/- 2.52 mmHg; p less than or equal to 0.05), as was the arterial carbon dioxide tension (PaCO2) (day 0 = 36.0 +/- 0.73 mmHg, day 6 endotoxin = 30 +/- 1.9 mmHg; p less than or equal to 0.05). Thrombocytopenia occurred during the first 72 hours of infusion (day 0 = 7.41 +/- 0.41 X 10(5)/mm3, day 1 endotoxin = 2.43 +/- 0.30 X 10(5)/mm3, day 3 endotoxin = 2.32 +/- 0.31 X 10(5)/mm3; p less than or equal to 0.001) but by day 6 the platelet count had returned to basal levels (9.9 +/- 0.65 X 10(5)/mm3). Endotoxin increased the number of leukocytes in peripheral blood (day 0 = 12.8 +/ 1.2 X 10(3)/mm3, day 3 endotoxin = 17.0 +/- 1.86 X 10(3)/mm3, day 6 endotoxin = 22.5 +/- 1.8 X 10(3)/mm3; p less than or equal to 0.01 for day 6). Plasma concentrations of 6-keto-prostaglandin F1 alpha decreased during the first 24 hours of infusion (day 0 = 0.56 +/- 0.076 ng/ml, 24 hours endotoxin = 0.27 +/- 0.026 ng/ml; p less than or equal to 0.05) and thromboxane (TX) B2 in the first 15 hours (day 0 = 0.23 +/- 0.058 ng/ml, 15 hours endotoxin = 0.09 +/- 0.14 ng/ml; p less than or equal to 0.05).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543491 TI - The Columbia Hospital of Richland County. PMID- 3543492 TI - A non-denominational service. PMID- 3543493 TI - Joel Roberts Poinsett. PMID- 3543494 TI - A synthesis of research on nutrition education at the elementary school level. AB - This literature review emphasizes the importance of teacher training, teaching strategies, parental involvement, curricular concerns, administrative support, and social/cultural factors on the impact of nutrition education programs at the elementary school level. The characteristics, implementation, and effectiveness of selected elementary nutrition education programs are reviewed, and instructional methods and materials shown effective through research are identified and discussed. PMID- 3543495 TI - Evaluation of Syva EMIT Toxicological Serum Tricyclic Antidepressant Assay. AB - Tricyclic antidepressant (TCA) overdose is a common, potentially life-threatening finding in patients seen in emergency departments. There is a need to rapidly differentiate the TCA overdose from others in the emergency unit population. The Syva EMIT Toxicological Serum Tricyclic Antidepressant Assay for serum tricyclic antidepressant levels on 87 patients being evaluated for possible TCA overdose in the emergency department of the University of Cincinnati Hospital was examined. Serum tricyclic antidepressant concentrations were also determined by high performance liquid chromatography (HPLC), and comprehensive urine drug screening was performed by several methods. The EMIT assay correctly identified all 53 negative patients whose TCA levels were less than 300 ng/mL. The remaining 34 patients had positive TCA levels greater than 300 ng/mL by EMIT; however, 22 were confirmed by HPLC. Phenothiazines and phenothiazine metabolites were present in the remaining 12 unconfirmed patients, indicating a cross reaction with this class of drugs. It was concluded that the assay is useful to exclude the presence of serious TCA ingestion when a result of less than 300 ng/mL is obtained. However, a result of greater than 300 ng/mL is not specific for TCAs only, as evidenced by the cross reactions obtained with phenothiazines. PMID- 3543496 TI - Speech quality measurement and the management of stuttering. AB - This paper reviews the various approaches that have been made toward the investigation of speech quality in stuttering treatment. The review takes into account the findings of relevant perceptual and acoustic investigations in the area of normal communication skills and voice disorders. Similar consideration is given to investigations on the stutter-free speech of stutterers where the contribution and relevance of this research to the search for a reliable and viable measure of speech quality is discussed. The review concludes with an overview of some promising findings from recent studies on the use of listener ratings of speech naturalness in the measurement and modification of untreated and treated stutterers. Some avenues for research and issues that have emerged from these studies are also discussed. PMID- 3543497 TI - Blood flow measurement in the canine pancreas. AB - Blood flow in the anesthetized animal has been measured indirectly by plethysmography and directly with the stromuhr, venous outflow, and electromagnetic flow techniques. Tissue perfusion in the gland has been assessed qualitatively with thermocouples and quantitatively by isotope fractionation, the distribution of microspheres, hydrogen desaturation, and clearance of either 133Xe or 85Kr. The results of these investigations have been conflicting as there is a large variation in both flow and perfusion measurements, not only overall but also in the values reported by each technique (Table 1). Taking all methods into account flow measurements have been recorded from 9 to 63 (mean 29.8) ml/min, and 10 to 200 (mean 66.1) ml/min/100 g. The mean percentage of the cardiac output distributed to the pancreas is 1.28. Some of these differences are due to various drawbacks associated with each of the techniques; some are almost certainly due to variations in the surgical preparations, and others are undoubtedly caused by the complexity of the pancreatic circulation. Measurements of perfusion in different regions of the pancreas of individual dogs show no difference if all vessels are intact, but accessory vessel ligation affects perfusion in certain areas. In ambulant dogs the studies suggest that pancreatic blood flow is higher than in the anesthetized animal. This is probably true despite inaccuracies associated with each of the techniques. In addition to this drawback there is also the problem of obtaining measurements with the dogs in a relaxed state. It is probably for this reason that the majority of investigators have preferred to examine blood flow and perfusion in the canine pancreas in the anesthetized animal. It is not possible to make a definitive statement regarding the best model and measurement technique available to measure blood flow or tissue perfusion in the canine pancreas. The choice should undoubtedly be governed by the aims of the proposed study. In studies of tissue perfusion in the intact gland, it is obviously preferable that all vessels should be intact, as division of any vessels supplying the gland has been shown to affect perfusion in certain areas. Measurements in such a preparation could be taken using the 85Kr clearance technique, with a flow probe placed around the gastroduodenal artery to ensure stable flow during measurements. It is difficult to assess total arterial blood flow to the whole gland due to the number of vessels supplying the organ.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543498 TI - Comparison of hepatic protein synthesis in vivo versus in vitro in the tumor bearing rat. AB - We have used the model of the freshly isolated hepatocyte to study liver metabolism in a rat tumor model and have reported elevations in the rates of protein synthesis, gluconeogenesis, alanine transport, and oxygen utilization by the tumor-influenced hepatocyte. While the metabolic activity of the isolated hepatocyte has been taken to reflect metabolism in the in vivo state, this assumption has not been validated. In the present study, we measure hepatic protein synthesis in vivo using a flooding dose of tracer amino acid, and in vitro in hepatocytes freshly isolated from tumor-bearing (TB) and pair-fed control rats. Increased protein synthesis was observed for the TB rats using both methods of analysis. However, the degree of stimulation seen in the TB animals was much greater in the in vitro assay than in the in vivo approach, suggesting that absolute protein synthetic rates in vitro must be interpreted with caution when extrapolating to the in vivo state. PMID- 3543499 TI - Structure and bioactivity of the amino-terminal fragment of pro-opiomelanocortin. AB - The primary sequence of the amino-terminal or 16 K fragment (16 K) of pro opiomelanocortin (POMC) is highly conserved throughout the mammals. This suggests an important biological role for this peptide. We have performed studies to determine the structure, biosynthetic origin and bioactivity of this pituitary peptide. A comprehensive study of all the biosynthetic derivatives of POMC in the neurointermediate lobe of the rat and mouse pituitary was undertaken. Inspection of the amino acid composition of these peptides indicated that cleavage at all available dibasic processing sites within POMC is essentially complete except for Arg49-Lys50 within the 1-74 16 K fragment (16 K1-74). Only about 50% of 16 K1-74 was found to be processed to give rise to the extreme amino-terminal 1 to 49 sequence (16 K1-49) and the carboxyl-terminal 50 to 74 sequence (Lys1 gamma 3 melanotropin). Sufficient 16 K1-77 and 16 K1-49 was purified from bovine posterior pituitaries in order to determine if there are any structural features controlling the limited degree of processing of 16 K within the intermediate lobe. Both bovine 16 K1-77 and 16 K1-49 were found to have cystine bridges linking cystine residues 2 and 24 and linking cystine residues 8 and 20. While 16 K1-77 was found to be O-glycosylated at threonine45 and N-glycosylated as asparagine65, 16 K1-49 was found to have no carbohydrate content. Thus the presence of O-glycosylation at threonine45 apparently inhibits cleavage at -Arg49 Lys50-. Lys1 gamma 3 MSH 16 K1-74 and 16 K1-49 purified from rat neurointermediate pituitaries were tested for their ability to potentiate the action of corticotropin (ACTH) in an isolated rat adrenal cell bioassay. None of the 16 K-related peptides showed any intrinsic steroidogenic activity. Experiments were performed in which dispersed adrenal cells were incubated with serial dilutions of ACTH. Constant amounts of test peptides were added in concentrations ranging from 10 pM to 5 nM. Lys1 gamma 3 MSH potentiated the steroidogenic activity of ACTH by up to 2-fold with an ED50 of approx 0.5 nM. 16 K1-49 showed no ability to potentiate the action of ACTH. In contrast the most highly glycosylated form of 16 K1-74 potentiated the action of ACTH by up to 6 fold. PMID- 3543500 TI - Steroidal modulation of the regulatory neuropeptides: luteinizing hormone releasing hormone, neuropeptide Y and endogenous opioid peptides. AB - Recent studies show that a large number of neuropeptides may play important roles in the hypothalamic control of reproduction and related sexual, feeding and locomotor behaviours. Based on the evidence summarized here we propose that gonadal steroids may exert a "trophic" influence on the regulatory peptides namely LHRH, NPY and EOP locally in the hypothalamus. PMID- 3543501 TI - The design and use of sex-steroid antagonists. PMID- 3543502 TI - Studies on the mechanisms of action of progesterone antagonists. AB - Antigestagens of RU-38.486-type were investigated in different pregnancy models reflecting either "endometrial" or "myometrial" effects. All antigestagens were found effective inhibitors of nidation in guinea pigs. This was evidence for a role of embryonic progesterone in the earliest events of nidation. No comparable inhibition could be obtained by ovariectomy. A more complex pharmacology was found around day 43 p.c. when the abortion was brought about by expulsion. RU 38.486 had marginal activity only. Antigestagens with reduced anti-glucocorticoid activity tended to induce abortions more effectively and faster. Some antigestagen-prostaglandin combinations were found of extreme abortifacient activity. Surprisingly it seemed that anti-glucocorticoid properties in addition to (or rather than) antigestagenic activities bring about this synergism with prostaglandin. The employed guinea pig model for pregnancy termination thus characterized two types of antigestagens: ideal ones for monotherapy or combined use with prostaglandin, respectively. Antigestagens induced a highly sensitive myometrium to prostaglandin-stimulation (Sulprostone) and a marked softening and dilatation of the cervix. Antigestagens perfectly prime the genital tract for oxytocic stimuli, they do not overcome the arrested uterine prostaglandin secretion of the pregnant uterus at the same time. PMID- 3543503 TI - The effect of ionizing radiation on the primate pancreas: an endocrine and morphologic study. AB - In this study we evaluated the endocrine, biochemical, and haematological derangements as well as pancreatic and histological changes of the bonemarrow in the primate following external fractionated subtotal marrow irradiation without bonemarrow reconstitution. The irradiation was administered in preparation for pancreatic transplantation. Two groups of animals (ten in each group) received 800 rad (8 Gy) and 1,000 rad (10 Gy) respectively over 4 to 5 weeks. A maximum of 200 rads (2 Gy) were administered weekly as photons from a 6 MV linear accelerator. During irradiation the animals remained normoglycaemic in the presence of transiently elevated liver enzymes and serum amylase values, which returned to normal on completion of the irradiation. Insulin release was significantly reduced in both groups during irradiation and was associated with minimally decreased K-values in the presence of mild glucose intolerance. Pancreatic light morphologic changes included structural changes of both exocrine and endocrine elements and included necrosis of the islet cells and acinar tissue. Islet histology demonstrated striking cytocavitary network changes of alpha and beta cells, including degranulation, vacuolization, mitochondrial destruction, and an increase in lysosomes. A hypoplastic bonemarrow ranging from moderate to severe was observed in all irradiated recipients. Near total fractionated body irradiation in the primate is therefore associated with elevated liver enzymes, pancytopenia, transient hyperamylasaemia, hypoinsulinaemia, a varying degree of pancreatitis, and bonemarrow hypoplasia. PMID- 3543504 TI - Carcinoma of the extrahepatic bile ducts: a postmortem study of 65 cases and review of the literature. AB - From 1950 to 1982, 65 patients with carcinoma of the extrahepatic bile ducts were autopsied in the Institute of Pathology of the University of Dusseldorf. The average age of men was 64.5 years and that of women was 70 years. The ratio of men to women was 1 to 1.71. The greatest number of tumors was found in the common bile duct (40.1%), followed by the hepatic ducts (29.2%) and the confluence of the common hepatic duct with the cystic duct (27.7%). Adenocarcinomas of various differentiation were found in 96.7% of the cases and anaplastic carcinoma in 3.3%. Metastases were present in 49 cases (75.4%). Cholelithiasis was found in 51% of the cases. The results of the present postmortem study are compared with the literature. PMID- 3543505 TI - The Museum of Materia Medica of Paris. AB - The Museum of Materia Medica of Paris is very rich with a collection of about 22,000 specimens. During the last few years, the efforts have been much more devoted to teaching by means of annotated displays and exhibits. PMID- 3543506 TI - Technique of successful lung transplantation in humans. AB - We have performed five single lung transplantations for end-stage pulmonary fibrosis, with four long-term survivors. Two patients underwent right lung transplantation and two underwent left lung transplantation. The procedure is performed with one lung anesthesia, although cardiopulmonary bypass is available on standby if required. Donor and recipient procedures are performed in adjacent operating rooms. On the basis of laboratory studies, a pedicle of omentum is wrapped around the bronchial anastomosis after its completion to restore bronchial artery circulation and protect the anastomosis. The four patients were discharge from the hospital within 4 to 6 weeks and three returned to normal employment at 3 months. Success in these cases is attributed to careful patient selection, use of cyclosporine, and use of an omental pedicle to protect and improve healing of the bronchial anastomosis. PMID- 3543508 TI - Historical development of traditional Chinese medicine in West Germany. PMID- 3543507 TI - Mitral valvuloplasty and repair for infective endocarditis. AB - The traditional therapy for acute bacterial endocarditis of the mitral valve refractory to medical treatment is valve replacement. Successful valvuloplasty may be feasible in selected cases, in which the infection is limited to a small portion of the mitral valve anulus. The following report describes a case in which valvuloplasty with excision of the affected valve was performed successfully with no recurrence of infection over a 3-year follow-up period. PMID- 3543509 TI - "Prime minister in the mountains"--the ancient physician Tao HongJing. PMID- 3543510 TI - Alterations of HLe-1 (T200) fluorescence intensity on acute lymphoblastic leukemia cells may relate to therapeutic outcome. AB - Quantitative differences in HLe-1 expression were studied on normal lymphocytes and lymphoblasts of patients with acute lymphoblastic leukemia (ALL). A relationship was found between quantitative antigen expression and therapeutic outcome. Alterations in fluorescence intensity (FI) were demonstrated using quantitative flow cytometric methods and the monoclonal antibody (MoAb) anti HLe 1 (T200). Lymphoblasts from patients with ALL produced FI peaks ranging form channel 17 to 112 (mean 68; n = 28), while normal lymphoid cells were at FI channel 127 +/- 3 (n = 121). Patients with the dimmest-staining lymphoblasts (channels 17-50) responded better to therapy than those with brighter-staining cells (channels 50-100). Data from this pilot study suggests that the FI of malignant lymphoblasts has implications in the clinical response to therapy. PMID- 3543511 TI - Induction of insulin receptor expression of human leukemic cells by 1 alpha, 25 dihydroxyvitamin D3. AB - The HL-60 and U-937 leukemic cell line and explants of fresh human leukemia cells were differentiated in vitro by incubation with 1 alpha, 25 dihydroxyvitamin D3 (Vit D). Morphologic change to monocytes was demonstrated in the promyelocytic (HL-60) line but not in the U-937 line and four of five leukemic cells. One patient with chronic granulocytic leukemia in the myeloid blast phase had incomplete morphologic change with Vit D treatment. In all cells studied, an increase in specific insulin receptor binding was independent of morphologic maturation. An increase in insulin receptor expression by Vit D was an early monocytic membrane marker dissociated from morphologic and functional alterations. PMID- 3543512 TI - Unresolved questions of renal magnesium homeostasis. AB - While the basic tenets of Mg handling by the mammalian kidney have been clearly outlined, Mg homeostasis in the body, the mechanism of extracellular fluid Mg regulation by the kidneys, and the regulation of intracellular Mg concentrations are largely unknown. Only a small fraction of total body Mg is present in the extracellular fluid and handled by the kidney, raising the question whether other organs, intestine, muscle and bone participate in Mg balance as well. In view of the tight regulation of Mg concentration in the plasma and the life-threatening derangements when plasma Mg concentration falls outside the physiological range it is surprising that a hormone responsible for general Mg homeostasis has not yet been identified. A hormone or factor which regulates tubular Mg reabsorption and hence renal Mg excretion is suspected, but it has not been found in any animal. Renal regulation of extracellular Mg involves filtration at the glomerulus and reabsorption in the proximal tubule and the thick ascending limb of the loop of Henle, where respectively, 30 and 60% of the filtered Mg load are reabsorbed. In the nongrowing individual the quantities of Mg excreted match the quantities absorbed from the gut. Mechanisms of tubular Mg transport are largely unknown for lack of understanding of Mg transport across epithelial cell membranes. The unexplored nature of Mg physiology can be attributed to analytical limitations. However, with the advent of a new Mg exchanger suitable for microelectrode work and with the use of Mg-sensitive dyes, Mg research is about to enter the renaissance period. PMID- 3543513 TI - Renal handling of magnesium: drug and hormone interactions. AB - Magnesium is the fourth most abundant cation in the human body and the second most common cation in the intracellular fluid. The abundance and distribution of this divalent cation implies an essential role of magnesium in intracellular metabolism. Although no single homeostatic control has been demonstrated for magnesium, the cellular availability of this cation is closely regulated by the gastrointestinal tract, kidney and bone. The purpose of this review is to survey some of the events involved in renal magnesium handling. The excretory side of magnesium balance involves appropriate changes in renal magnesium handling. Present evidence suggests that the renal handling of magnesium is normally a filtration-reabsorption process. Experimental support for secretion remains unconvincing. Renal magnesium reabsorption has distinctive features when compared with that of sodium and calcium. The concentration of magnesium in the proximal tubule rises 1.5 times greater than the glomerular filtrate. Some 20-30% of the filtered magnesium is reabsorbed in the proximal tubule compared to the fractional absorption of sodium or calcium of 50-60%. Although the fractional reabsorption of magnesium is only half that of sodium, it changes in parallel with that of sodium in response to changes in extracellular fluid volume. The major portion of filtered magnesium (some 65%) is reabsorbed in the loop of Henle, mainly in the thick ascending limb. Recent evidence suggests that magnesium reabsorption in the ascending limb may be voltage-dependent and secondary to active sodium chloride reabsorption. Evidence also suggests an important competition between magnesium and calcium for transport at the basolateral surface of the ascending limb cell. The loop of Henle appears to be the major nephron site where magnesium reabsorption is controlled. The principal factors which alter magnesium reabsorption in the loop include parathyroid hormone, changes in plasma magnesium and calcium concentration and the loop diuretics. About 10% of the filtered magnesium is delivered into the distal nephron where only a small fraction of the filtered magnesium is reabsorbed and the transport capacity is readily exceeded with increased magnesium delivery. A number of drugs have been shown to alter magnesium handling; these include antibiotics such as gentamicin, antineoplastic agents such as cisplatin and immunological suppressive drugs such as cyclosporin. The cellular alterations of these diverse drugs leading to renal magnesium wasting are not well understood. PMID- 3543514 TI - Magnesium and potassium-sparing diuretics. AB - One of the most common and serious side effects of diuretic therapy is in increased urinary loss of K. Another, although less well publicized, side effect of diuretic therapy is excessive urinary loss of Mg. In examining the effects of diuretics on Mg and K metabolism, the following factors should be taken into account: site of action and duration of action of diuretics, duration of treatment and dosage used, concurrent drug therapy, underlying disease conditions and dietary intake of Mg. Diuretics acting in the proximal tubule tend to have only minor effects on Mg excretion. Loop-blocking diuretics, however, cause major urinary losses of Mg. The Mg-wasting effects of loop-blocking diuretics have been demonstrated in large numbers of experimental and clinical studies, and the findings are consistent with micropuncture studies in laboratory animals which indicate the loop of Henle as the major site of Mg reabsorption. The effects of thiazide diuretics on Mg excretion are less well established than those of loop blocking diuretics. Experimental studies demonstrate that thiazides have little or no direct effect on Mg transport in the nephron. However, some clinical studies indicate that thiazide treatment may induce Mg loss. This may be secondary to alterations in the renin-angiotensin-aldosterone system and in the calcium and parathyroid hormone and may be contributed to by concurrent drug treatment and the underlying disease conditions. K-sparing diuretics are usually administered concomitantly with more potent diuretics to counteract diuretic induced K depletion. These agents act in the late distal tubule and collecting duct. Evidence has accumulated in recent years indicating that these drugs may also exert some Mg-sparing properties. Experimental and clinical investigations from our own laboratories and from other investigators will be reviewed. In animal studies, a dose-response relationship has been established for the actions of amiloride in reducing fractional excretion of Mg and K during furosemide induced diuresis. The effects of amiloride on Mg excretion are less than those on K excretion, and this is compatible with the different handling of K and Mg in the distal tubule and collecting duct. The effects of aldosterone antagonists on Mg excretion are less well established than those of amiloride. Some recent studies indicate that converting-enzyme inhibitors may also influence Mg and K metabolism. The Mg-sparing actions of drugs may have important therapeutic implications. PMID- 3543515 TI - Pattern of changes in certain parameters of protease-antiprotease equilibrium during acute pancreatitis in human. PMID- 3543517 TI - History of the Medical Faculty at the University of Poznan and the Academy of Medicine. PMID- 3543516 TI - Pancreatic proteolytic and inhibitory activity during acute experimental pancreatitis in rats with reference to heparin treatment. PMID- 3543519 TI - Magnetic resonance imaging-based computer-assisted stereotactic resection of the hippocampus and amygdala in patients with temporal lobe epilepsy. AB - In patients with medically intractable complex partial seizures of temporal lobe origin, stereotactic amygdalohippocampectomy can now provide excellent results. Target structures can be accurately identified and completely resected with use of a carbon dioxide laser. In a series of 18 patients who underwent this computer interactive procedure, all experienced a cessation or dramatic reduction in frequency of seizure activity. Because the inferior optic radiations are disrupted with use of the posterolateral approach, nondisabling postoperative visual field deficits always ensue. In addition, two of our patients who underwent left-sided procedures had transient minor speech problems, perhaps attributable to postoperative swelling of the lateral temporal lobe. Patients in whom a surface electroencephalogram discloses a posterior temporal focus of seizure activity are candidates for stereotactic amygdalohippocampectomy. PMID- 3543518 TI - Professor Jozef Babinski (1857-1932)--pioneer of contemporary classical neurology. PMID- 3543521 TI - Early Arabian physician describes pulmonary circulation. PMID- 3543520 TI - Marine fish oils: role in prevention of coronary artery disease. AB - Since the early 1970s, investigators have been interested in the relationship between dietary marine fish oils and plasma lipoproteins. Previous studies have shown that consumption of a diet rich in marine fatty acids results in altered lipid profiles, prolonged bleeding times, reduced platelet aggregation, and decreased blood pressure, but the precise mechanisms of action must be examined further. These findings, however, have led to the conclusion that dietary marine fish oils may be of benefit in the prevention of coronary artery disease. Before specific recommendations can be made about their general use, further studies of their long-term efficacy and toxicity must be conducted. PMID- 3543522 TI - Glucocorticoid action on connective tissue: from molecular mechanisms to clinical practice. AB - Glucocorticosteroids are highly effective in treating various acute and chronic diseases, but their long-term use is often accompanied by side effects, such as osteoporosis of skeleton and bones and atrophy of the skin. Clinically, many of these side effects involve changes in connective tissue. Glucocorticoid effects on connective tissue metabolism are, however, sometimes beneficial for instance, in the treatment of keloids or autoimmune connective tissue diseases. Recent advances in the biochemical technology have provided tools to examine the molecular mechanisms by which glucocorticoids affect connective tissue. These studies have shown distinct alterations in the extracellular matrix as a result of glucocorticoid treatment. This knowledge is useful for the further development of glucocorticosteroids with desirable action spectrum and with minimal side effects. PMID- 3543524 TI - Endothelium--an organized monolayer of highly specialized cells. AB - Research on endothelial cells has expanded in near exponential fashion during the last few years and has become a noteworthy field of both clinical and experimental investigation. Endothelium is indisputably a highly specialized tissue which mediates and controls many physiological and pathological processes. It can no longer be regarded as a passive semipermeable barrier between blood and tissues. The endothelial cell--the structural unit of endothelium--is, consequently, a metabolically highly active cell with many unique characteristics. PMID- 3543523 TI - Cultivation of endothelial cells: limitations and perspectives. AB - Different research areas might gain from the use of cultured endothelial cells. An understanding of how endothelial cells interact with hormones, plasma constituents and drugs, could make a fresh contribution to knowledge of the functional and pharmacological responses of different organs. In vitro cultures of EC are an easy tool for these studies. The culture medium can be artificially modified and the biological responses monitored. This technique, however, still presents limitations. These are: the relatively few cells that can be obtained; the limited number of vascular districts that can be used as cell sources; and the functional modifications of the cells when kept in tissue culture. PMID- 3543525 TI - The Monterey County Health Initiative. A post-mortem analysis of a California Medicaid demonstration project. AB - Twenty months after the California State Department of Health Services turned its Medicaid program in Monterey County over to a local health care authority, the Monterey County Health Initiative (MCHI), the state terminated the pilot project in favor of a return to fee-for-service reimbursement. The MCHI, plagued from its inception with shaky provider support and a flawed program design, failed to demonstrate its anticipated cost savings. The key features of this failure were overly generous fees for primary case managers, inadequate utilization control measures, a general hesitancy to assume the necessary gatekeeper function, and a management information system that was not fully operational until well into the implementation of the program. Policy implications and recommendations for future state-sponsored Medicaid demonstration projects are discussed. PMID- 3543526 TI - Immunoglobulins and growth factors in hematology and oncology. A symposium in honor of Jan G. Waldenstrom. 29-30 May 1986. PMID- 3543527 TI - Immunotoxin therapy of malignant melanoma. AB - Current standard therapies for metastatic malignant melanoma are poor, and surgical excision of disease remains the cornerstone of melanoma management. Unmodified monoclonal antibodies have been used therapeutically in this, and other, malignancies, but results have been disappointing. This has led to attempts to improve the efficacy of monoclonal antibodies by using them to target therapeutic modalities to tumors. These therapeutic modalities include chemotherapeutic, radiotherapeutic and cytotoxic agents. An example of the latter is ricin A-chain, which is so potent that it has been reported that one molecule of it entering the cytosol is sufficient to cause cell death. Preclinical studies support the potential of immunotoxins as effective therapy for malignancy. A phase I-II trial of immunotoxin therapy of malignant melanoma has been completed and a trial to determine clinical efficacy has been implemented. PMID- 3543528 TI - DNA rearrangements in human B- and T-cell malignancies. AB - During normal differentiation lymphocytes rearrange immunoglobulin and T lymphocyte receptor genes. The identification of a rearrangement pattern may serve as a unique clonotypic marker of a lymphoid tumor and can also be used to identify the cellular origin of the neoplasia. The cloning of abnormal breakpoints has resulted in detailed information on the inter-chromosomal translocation process and has also provided probes, which specifically identify abnormal translocations. The use of inter-chromosomal translocation-specific probes in conjunction with immunoglobulin and T-cell receptor gene probes makes it possible not only to prove monoclonality but also to provide strong evidence for neoplasia. PMID- 3543529 TI - Physiologic and molecular biology of erythropoietin. AB - The gene for erythropoietin, the first growth and differentiation factor to be identified, has now been cloned and a recombinant erythropoietin is ready for clinical trials. This molecular achievement has also led to the identification of its mRNA in liver and especially in kidney tissue and here in the extra glomerular fraction. A radioimmune assay has been developed and its shows, as anticipated, low levels of erythropoietin in patients with kidney disease. However, in all other anemias, including the anemias of cancer, the levels of erythropoietin do not seem to be affected by the kind of disease but only by the degree of anemic hypoxia. The action of recombinant erythropoietin appears to be directed at surface receptors which increase in density on progenitor cells as they mature from early BFU-E to late CFU-E. These findings have led to an updating but not to a radical change in our concept of the feedback circuit which controls red cell production and the size of the red cell mass. PMID- 3543530 TI - Hematopoietic growth and differentiation factors and the reversibility of malignancy: cell differentiation and by-passing of genetic defects in leukemia. AB - Our development of systems for the in vitro cloning and clonal differentiation of normal hematopoietic cells made it possible to identify: the factors that regulate growth and differentiation of these normal cells; the changes in the normal development program that result in leukemia, and how to reverse malignancy in leukemic cells. I have mainly used myeloid cells as a model system. Normal hematopoietic cells require different proteins to induce growth (growth factors) and differentiation (differentiation factors). There is a multigene family for these factors. Identification of these factors and their interaction has shown how growth and differentiation can be normally coupled. The development of leukemia involves the uncoupling of growth and differentiation. This can occur by changing the requirement for growth without blocking cell response to the normal inducers of differentiation. Addition of normal differentiation factors to these malignant cells still induces their normal differentiation, and the mature cells are then no longer malignant. Genetic changes which inhibit differentiation by normal differentiation factors can occur in the progression of leukemia, but even these leukemic cells may still be induced to differentiate by other compounds, including low doses of compounds now being used in cancer therapy, that can induce differentiation by alternative pathways. The differentiation of leukemic to mature cells results in the reversion of malignancy by by-passing genetic changes that produce the malignant phenotype. We have obtained this differentiation of leukemic cells in vitro and in vivo, and by-passing genetic defects by inducing differentiation can be a useful approach to therapy. PMID- 3543531 TI - Platelet-derived growth factor as a mediator of normal and neoplastic cell proliferation. AB - Human platelet-derived growth factor is the major mitogen in serum for connective tissue-derived cells in culture. The factor is 30,000 mol. wt protein composed of two disulphide-linked polypeptide chains, named A and B. The B-chain is virtually identical to part of the transforming protein of simian sarcoma virus (SSV), implying that SSV-transformation is mediated by a PDGF-like growth factor. This notion is supported by the finding that specific as well as nonspecific inhibitors of PDGF-action (PDGF antibodies and suramin, respectively) are efficient inhibitors of SSV-transformation and revert the transformed phenotype of SSV-transformed cells. Expression of the genes encoding the PDGF subunits and production of PDGF-like growth factors is a common feature of human sarcoma cell lines, suggesting a role of PDGF in the pathogenesis of sarcomas, although direct support in favor of this notion is lacking. An involvement of PDGF in autocrine and paracrine stimulation of normal cell growth is suggested by the finding that responsive (arterial smooth muscle cells and placental cytotrophoblasts) as well as nonresponsive (endothelial cells and macrophages) cells produce PDGF-like growth factors. In conclusion, PDGF-like growth factors may be widely implicated in normal as well as neoplastic growth processes. PMID- 3543533 TI - The predictive value of steroid hormone receptor analysis in breast, endometrial and ovarian cancer. AB - The predictive value of female sex steroid, estrogen and progesterone, receptor (ER and PR, respectively) assays in breast, endometrial and ovarian cancer is reviewed with emphasis on comparative aspects of these malignant tumors in relation to their hormone dependency. The endocrine etiology of these three tumor types seems to be at least partly different, and so is the expression of these receptors in normal and malignant tissues of the breast, endometrium and ovary. There is a tendency for decreased receptor concentrations and disappearance of these receptors in association with advancement of these malignancies. There is also a decrease in the presence and concentrations of ER and PR in relation to loss of differentiation in breast and endometrial cancer. Receptor analyses have an established position in the selection of patients with advanced breast cancer for endocrine treatment, and they give promise of a similar application in endometrial cancer and in endometrioid cancer of the ovary. It is not clear whether the disease-free interval is related to the presence or concentrations of ER or PR as such in the tumor tissue. There is better survival in breast cancer patients with receptor-positive tumors, which might be due to a response to endocrine treatment. The same seems to be true for patients with endometrial cancer. Future progress in the application of female sex steroid receptor analyses in breast, endometrial and ovarian cancer needs additional controlled clinical trials and more highly developed receptor assays. PMID- 3543535 TI - [Acute and prophylactic treatment of peptic ulcer with zinc acexamate or cimetidine]. PMID- 3543536 TI - [Septic arthritis]. PMID- 3543534 TI - Thymosins and anti-thymosins: properties and clinical applications. AB - For years, scientists have searched for ways to trigger the body's own defenses against cancer and other diseases associated with abnormal immunity. This search has led to the discovery of a number of important new biological and chemical substances that augment, direct or restore many of the normal defenses of the body. These substances are in essence the natural drugs of the body that endow us with immunity and resistance to disease. Now called biological response modifiers (BRMs), most of these 'new medicines', such as thymosins, lymphokines, and interferons, occur naturally in the body, while others, synthetic immunomodulators and thymomimetic agents (drugs that mimic thymic function) have been created in the laboratory. Previously, therapeutic drug development in this area relied upon chemical synthesis or introduction of bacterial adjuvants, or modified viral compounds and substances, which were foreign to the body. Therefore, they did not and do not rely upon or use the body's natural immune and biological response systems for protection against disease, function and response to the environment. Although scientists have known about BRMs for years, isolating and purifying them so that they could be used to treat diseases has been extremely difficult. Many of these substances, such as the lymphokines, occur in the body in minute amounts and normally do not circulate in the blood. The development of new technologies for isolation and large scale synthesis, e.g. solid phase peptide synthesis, high-pressure liquid chromatography microsequencing and genetic engineering, has now permitted scientists to isolate, purify, and synthesize BRMs in sufficiently large quantities to allow human clinical trials. In this paper we will focus on the potential clinical applications of the thymosins and anti-thymosins. PMID- 3543538 TI - The physiology of the menopause. AB - The decline and eventual cessation of estrogen production by the ovary at menopause are reflected physiologically in tissues with estrogen receptors. The rate of decline of hormones is quite variable and often relates to symptoms experienced. At menopause women still have one third of their life expectancy ahead of them. The physician must determine which symptoms are aging, physiologic changes resulting from estrogen deprivation and which may herald more serious pathology in need of diagnosis and treatment. The knowledgeable physician can give good explanation, which is sometimes as beneficial as medications. Hormone replacement therapy may improve physiologic function of some tissues and relieve symptoms. When hormones are given for clear indications in as safe a method as possible and with adequate monitoring, the woman will have her symptoms relieved and will be grateful for her sense of well-being and ability to enjoy life. PMID- 3543532 TI - Glucocorticoid mechanism of action: monoclonal antibodies as experimental tools. AB - In order to provide a further insight into glucocorticoid receptor (GR)-mediated action of glucocorticoid hormones, we produced ten monoclonal antibodies against rat GR. In studies combining physicochemical separation methods with antibody methodology, we established that the molybdate-stabilised GR contains one steroid binding monomer. Using a monoclonal anti-GR antibody-based immunoaffinity chromatographic procedure, we purified two non-ligand-binding proteins, with molecular weights of 80,000 and 90,000, present in the molybdate-stabilised GR complex. These proteins are not recognised by monoclonal antibodies directed against GR. The possible relation of these two proteins to heat shock proteins remains to be established. Immunohistochemical studies of GR in the central nervous system of the rat provided new information on the distribution of GR, particularly in the hypothalamus. Studies of intracellular receptor localisation in rat brain after endocrine manipulations gave results in support of the classical concept of translocation of GR from cytoplasm to cell nucleus. Studies with a cell culture system also supported the existence of GR in the cytoplasm as well as in the cell nucleus. PMID- 3543539 TI - Nutrition: calcium, cholesterol, and calories. AB - Good nutrition is an important part of promoting and maintaining the health of postmenopausal women. Nutrients of particular concern to this population include calcium, fat, and cholesterol and total energy. Patient education should include both background information about the role of nutrition in health and practical guidance about food choices. PMID- 3543537 TI - The aging ovary. AB - Aging of the human ovary is a continuous process that begins intra utero with the demise of the first crop of oocytes. The process continues throughout life with the relentless attrition of the oocyte's capital through three fundamental events: follicle degeneration or atresia, corpus luteum formation, and transformation of varying cell populations from atretic and luteal complexes into stromal cells. The ultimate consequence of ovarian aging is the modulation of this organ from a follicle-rich, cyclic secretor of estrogen and progesterone to a stroma-rich, noncyclic, low secretor of androgen. Other structural features of the "aged" ovary, such as obliterative arteriolar sclerosis and surface epithelium cysts, indicate that obvious involution is admixed with persisting ovarian activity. It appears, then, that even after the reproductive period has ended, the human ovary is still a viable organ. The contribution of this organ to the overall well-being of the postmenopausal woman remains to be defined. PMID- 3543540 TI - Physical fitness for the mature woman. AB - The ability to perform physical activity, whether at work or as recreation, is an important aspect of human experience for men and women of all ages. The extension of the range of physical power output that characterizes improvement in "physical fitness" is a desirable goal for all. It helps to make physical activity more enjoyable and less fatiguing, it can facilitate the learning of new skills and may actually improve cognitive functions, and it decreases the likelihood of physical injury and helps to speed recovery from injury. A sound mind in a sound body has been a medical ideal since Greek and Roman times. For a continuing state of good health, all systems--physical, mental, and spiritual--should be exercised in harmony. At the beginning of the twentieth century, the average life span for women was barely 5 years beyond the menopause. Menopause heralded the twilight years of life and enhanced susceptibility to disease and deterioration of health. Today, women look forward to 25 additional years, a full one third of a lifetime; menopause now heralds potential promise, adventure, and exploration, an exciting new phase of the life cycle. Exercise represents a vital part of a prescription to maximize quality of life throughout this period. Physical conditioning cannot be expected to complete reverse the unrelenting effects of passing time, but it appears that it can substantially modify this process. Functional losses that in the past have been attributed only to age may, in fact, represent a combined effect of biologic aging and physical inactivity. Exercise helps to maintain the physiologic adaptations that support an enhanced biologic reserve in body systems that tend to lose reserve capacity with advancing age. "If you don't use it, you lose it!," and its positive corollary, "If you use it, you enthuse it!," may be maxims that imply a natural law of deep consequence. An optimal diet and suitably vigorous activity are advisable for all women as they enter the postmenopausal phase of life. Every mature woman ought to carefully consider choosing to pursue an appropriate goal: active participation in a specific exercise program under medical supervision. The health care system should be fully responsive to the special needs of the mature woman, and the importance of providing programs of physical activity designed to address these needs should be recognized. For the postmenopausal woman, the advantages of achieving a state of physical fitness are many.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543541 TI - Hormonal replacement therapy: benefits, risks, doses. AB - This chapter presents information on the indications for the use of post menopausal hormone therapy. Side effects and risks of this form of therapy are also summarized. Recommendations are made concerning the clinical management of patients receiving hormone treatment. PMID- 3543542 TI - Postmenopausal osteoporosis. AB - Osteoporosis is a major public health problem, particularly for the postmenopausal woman. With the withdrawal of estrogen at menopause, bone resorption begins to exceed formation in remodeling cycles and bone mass is inexorably lost. Clearly, preventing postmenopausal osteoporosis is the aim of management. Individuals with risk factors for developing this condition should have noninvasive bone density determination and should be considered for preventive regimens. Therapeutic options for prevention include calcium, estrogen, and exercise. Once osteoporosis is established, therapeutic options may include those listed previously as well as fluoride and other modalities currently under investigation. PMID- 3543543 TI - Postmenopausal bleeding: etiology, evaluation, and management. AB - Postmenopausal bleeding can be an alarming symptom for both the patient and the physician because, although in a majority of these cases no pathology is present, the risk of malignancy must be considered. It is important for the physician to fully understand the pathophysiology, differential diagnosis, and the methods of evaluating and treating this disorder in order to ensure the health and comfort of the patient. PMID- 3543544 TI - The psychiatric disorders of midlife. AB - The midlife phase of adult development, once viewed as a period of stagnation and involution, is now seen as a time with the potential for significant psychologic growth and development. The concept that women's psychologic health and physical health are closely tied to her reproductive function is coming under close scrutiny. The menopause is only one variable, along with other biologic, psychologic, and sociocultural stressors, that increases the individual woman's vulnerability to several psychiatric disorders. Careful attention to the patient's presenting symptoms and the specific diagnostic criteria for psychiatric illnesses allows for accurate diagnosis and treatment and avoids the pitfall of attributing these symptoms to the "menopausal syndrome." PMID- 3543545 TI - Sexuality during the menopause. AB - Although the evidence is not conclusive, overall many sexual changes seem to occur in the climacteric years. It would be easy to propagate and perpetuate longstanding beliefs and myths that would do a great disservice to all of the women to whom our care is dedicated. In the coming years it is hoped that we shall learn more about how to understand these changes. In recent years the International Menopause Society has actively encouraged work in this area. An entire issue of its journal Maturitas is devoted to a series of scientific papers on sexuality in the climacteric years. For those who desire further reading that issue is strongly recommended. All medical professionals who come into contact with women during the climacteric years should be prepared to ask about sexuality and to deal with any concerns that arise. Taking a good sexual history along with a good general medical history and full social background is the best starting point for coping with these concerns. How to take a comprehensive sexual history is well described by Munjack and Oziel. Of course, it is not usual to take this full history on every woman with menopause symptoms. A few key questions should identify the woman who has sexual problems and facilitate selection of appropriate questioning for each patient (Table 2). Often, taking such a history allows the physician to identify a problem area that may be helped by medication or, more often, by education and simple office counseling. When it is clear that these simple approaches will not be adequate, the physician should have good resources for referral to the appropriate specialist, whether it be gynecologist, menopause center, psychologist, family therapist, or sex therapist. PMID- 3543546 TI - Sleep disorders. AB - Advancements in sleep research have led to the development of new standards of what is normal sleep and arousal and new diagnostic tests for the detection of sleep disorders. Millions of adults have frequent or chronic complaints about the quality and quantity of their sleep. Sleep complaints increase with increasing age and are more common in women than in men and in women over 45 than in younger women. Sedative-hypnotic drugs are taken more frequently by women than men, and the incidence of use increases with increasing age. Studies of sleep and sleep disturbances during the perimenopausal period suggest that difficulty falling asleep and frequent nocturnal awakenings result from hormonal changes, vasomotor symptoms, and possibly psychologic factors. Other causes for sleep complaints in menopausal and postmenopausal women are occult sleep disorders, especially periodic leg movements in sleep and sleep apnea syndrome. Sleeping pills are inappropriate for most patients with sleep complaints. If sleep difficulties persist after a trial of good sleep hygiene, further evaluation at a sleep disorders center is indicated. PMID- 3543547 TI - [Classification and therapy of lesions caused by endemic pemphigus foliaceus of the scalp. Apropos of 12 cases]. PMID- 3543548 TI - [Malignant acanthosis nigricans. Presentation of a case and a study of its incidence]. AB - In the Regional Hospital "Victor Lazarte Echegaray" of Trujillo, Peru, it was made a study in order to determine the frequency of the acanthosis nigricans, associate to cancer (malignant acanthosis nigricans), during january 1978 to october 1983, and a case was founded in a patient of 62 years old, who had advanced adenocarcinoma gastric of one year and a half of evolution. The dermatosis was manifested with the neoplasia, which corresponds to a generalized form, with hyperkeratosis palmo plantar, with whole loss of the axillary hair and only part of the pubic region, the mucous membranes were not affected. The patient survived 3 months after the diagnostic were made. PMID- 3543549 TI - [Study of the circulating lymphocytes populations in systemic scleroderma, chronic discoid lupus erythematosus and dermatomyositis]. AB - The authors studied the peripheral blood lymphocytes in any autoimmune diseases. In scleroderma the T-lymphocytes and ratio T4/T8 are decreased and B-lymphocytes are normal. In the LEDC the T-lymphocytes are decreased and B-lymphocytes are increased. In dermatomyositis the B-lymphocytes are increased and T-lymphocytes are decreased, the ratio T4/T8 is normal. PMID- 3543550 TI - [Pseudoxanthoma elasticum]. AB - Four young female patients with Pseudodixanthome elasticum are reported, corresponding to the Gronblad and Strandberg syndrome. The dysplastic derangement of the elastic fibers with a potentially systemic compromise is considered, which explains the multiorganic character of the disease. We conferred to the skin changes the means of a marker that obligates an exhaustive study and follow-up of the patients to make visceral affectations. PMID- 3543551 TI - [Merkel cell carcinoma with metastasis to the bone marrow]. AB - The information concerning the concept of Merkel cell-neuron as a mechanoreceptor is revised. We are presenting an autopsy case in which a Merkel cell carcinoma infiltrated bone marrow and provoked its hypoplasia. An analysis of the literature let us see that the behavior of this neoplasia can be quiescent, but also could be very aggressive, with development of distant metastasis to lymph node, skin, liver, brain, bone and lung. These tumors can give origin to a paraneoplasic syndrome. PMID- 3543553 TI - [Prevalence of superficial mycoses in the adult population of the Brazil-Colombia frontier]. AB - A microbiological study was performed in the adult population of tier Brazil Colombia, a very damp place with warm weather. It was observed a higher prevalence of P. versicolor (41.5%) and candidiasis (28.09%), followed by P. hortai and E. floccosum. The T. Tonsurans was the principal agent of the trichophitics of the hair. It's a higher prevalence of superficial mycosis was observed in the male. PMID- 3543552 TI - [Infantile acro-localized papulo-vesicular syndromes]. AB - Seven observations of papulo-vesicular acrolocated syndromes in males between 6 months and three years age. Clinical, histological and nosological aspects are commented in according to Gianotti's words and last reports about this disease. PMID- 3543554 TI - [Centrifugal annular erythema and African trypanosomiasis. Trypanid ]. AB - The skin symptoms of trypanosomiasis in children are reviewed following report of one case of African trypanosomiasis (T. Gambiense). Trypanids, existing in 10-20% of patients during blood and lymphatic dissemination, appear are transient centrifugal annular erythemas made of few elements located on the trunk and roots of arms and thighs. Centrifugal annular erythema in a context of severe infections disease in a exposed subject coming from and endemic zone constitutes a characteristic diagnostic element. PMID- 3543555 TI - [Transient acantholytic dermatosis. Presentation of a case]. AB - A case of DAT is presented and the literature is reviewed. The authors verify the limitation of the present therapeutics and they discuss the possible pathogenic mechanism. They also say that "unspecific" lesions resistant to conventional therapy, and mostly localized in the trunk of middle-aged patients may suggest the diagnosis of DAT if biopsy is performed in these cases there probably will be a higher incidence of the disease. As far as we know this is the first brazilian case of DAT reported. PMID- 3543556 TI - [Basal cell nevus syndrome. Apropos of 2 new cases]. AB - Two cases affected by the nevoid basal cell carcinoma syndrome are reported herein with multiple basal cell carcinomas on exposed areas, with the previous appearance of pigmented macules on which a morphological transformation was shown with the presence of erythematous papules and plaques in a ring-like, formation made up of epitheliomatous pearls, giving the appearance of lesional polymorphism. The clinical pathological diagnosis of epithelioma basocellular is confirmed. In both patients, numerous pits on the hands and feet are shown without noticeable subjective symptoms; one of the biopsies reveals a carcinoma of basal cells in the epidermis underlying the pit. A detailed study is carried out on both families with the existence of different osseous anomalies, without finding cutaneous stigmas. The treatments carried out are checked bringing in our experience with the locally applied 5-FU. It is clearly obvious that UV light is a key factor in these two cases. PMID- 3543557 TI - [Chronic mucocutaneous candidiasis. Cutaneous expression of immunologic anomalies. Report of a case]. AB - A case of an 8 year old girl with granulomatous candidiasis and impaired cell mediated immunity, is presented. The pathogenesis, associated diseases and the treatment of chronic mucocutaneous candidiasis are discussed. PMID- 3543558 TI - Despair behaviour: a tool in experimental psychopharmacology. A review. PMID- 3543559 TI - Insanity and its treatment in Islamic society. PMID- 3543560 TI - Patients and practitioners. Lay perceptions of medicine in pre-industrial society. PMID- 3543561 TI - Medicine and pneumatology: Henry More, Richard Baxter, and Francis Glisson's Treatise on the Energetic Nature of Substance. PMID- 3543562 TI - The history of the therapeutic use of crude penicillin. PMID- 3543563 TI - The milk option. An aspect of the history of the infant welfare movement in England 1898-1908. PMID- 3543564 TI - Archibald Pitcairne and Newtonian medicine. PMID- 3543565 TI - Some perceptions of mental disorder in pre-Petrine Russia. PMID- 3543566 TI - [The man behind the syndrome: Joe Vincent Meigs. History-making in the gynecology of the 20th century]. PMID- 3543567 TI - [The man behind the syndrome: Eli Moschkowitz. In hospitals people should be treated, not the disease]. PMID- 3543568 TI - [The discoverer of the renin-angiotensin system trained generations in creative thinking (Robert Tigerstedt)]. PMID- 3543570 TI - [Swedish physicians on the Parnassus]. PMID- 3543569 TI - [Yearning for new knowledge is important even if it concerns only our own health]. PMID- 3543573 TI - [Surgical indications in struma nodules]. AB - From 1980 to 1985 1,839 patients with thyroid nodules were investigated. 98% of them showed ultrasonic patterns of either echo-poor or complex structures, 85% of the nodules were scintigraphically cold, in 10% (n = 182) cytological findings were positive or at least suspect. Of these 182 patients 60 underwent operation, whereas 122 were followed up continuously. In 35 of 60 patients operated histological examination confirmed thyroid carcinomas. The combination of echo poor, cold nodules and cytological positive or suspect findings urgently requires operation. PMID- 3543572 TI - [Penetrating heart injuries]. AB - Penetrating cardiac injuries provide the surgeon until nowadays with a challenging problem due to a high mortality rate. Depending on the mechanism of trauma and the time interval less than 20% of the patients with severe wounds of the heart reach the hospital alive. Methods of managing these wounds are controversial. Pericardiocentesis has more a diagnostic than a therapeutic value. Emergency thoracotomy will help reduce the mortality even in agonal and decompensation patients. With respect to the literature and 31 own cases the diagnosis, the operative management and the results will be discussed. PMID- 3543571 TI - [Clinical relevance of sonography in acute diagnosis of perforated gastroduodenal ulcers]. AB - In a prospective unselected series of 22 patients with perforated gastroduodenal ulcers the diagnostic efficacy of clinical and radiologic data was modest. In eight patients only (approximately 36%), clinical data yielded sufficient evidence; in 16 patients (approximately 73%), plain X-ray demonstrated subphrenic gas. Sonography was proven to be a major advance, especially rewarding in the diagnosis of perforations with negative plain X-ray. Gastric distention and stomach wall edema are unspecific sonographic criteria, whereas objectivation of a pathologic stomach "cockade" in the presence of free gas, extraluminary ingesta or echofree fluid in the peritoneal cavity are pathognomonic data. These criteria yielded a definite diagnosis in 16 patients (approximately 73%) including four patients with negative X-ray. The combined analysis of radiologic and sonographic findings yielded an immediate correct diagnosis in 20 patients (approximately 91%). PMID- 3543574 TI - [Surgical indications in penetrating aneurysm of the abdominal aorta in advanced age]. AB - Leaking abdominal aortic aneurysms must be considered as acute symptomatic aneurysms. Mainly in the very old patient the natural course of the disease is very doubtful. Therefore surgical repair seems to be necessary in nearly all cases. Special operative techniques such as tube resection as well as inlay technique are able to reduce the operative risk. Pharmacological control of blood pressure during surgery is as necessary as postoperative intensive care treatment. PMID- 3543575 TI - [Under what conditions can splenic rupture be treated conservatively?]. AB - In children even a certain splenic rupture allows an expectant attitude provided that circulation is stable, abdominal symptoms recede, and an intensive care over several days including ultrasound sonography is assured. We were able to proceed in this manner in five out of 37 children; without an operation we reached the restitution of the spleen. PMID- 3543576 TI - [Decision aids in determining therapy of breast cancer by preoperative staging using sonography and computerized tomography]. AB - In a prospective study the preoperative ultrasonography of 54 cases of carcinoma of the breast was able to predict the pTNM staging precisely in 83.3% for tumor size and in 72.3% for lymphnode metastases. Multicentric-multifocal carcinomas were diagnosed by ultrasonography in 10 of 13 patients, better than by mammography (6 of 13). The CAT scan is indicated only in advanced tumor stages. The preoperative staging by ultrasonography enables with more precision planning and differentiated therapy of the carcinoma of the breast, especially in view of breast-preserving therapy. PMID- 3543578 TI - [Surgical indications in ileus]. AB - Criteria of indication for operative treatment of ileus have not very much changed through the last years. Operation as soon as possible will bring the best results. Hence in most of the cases a temporary stoma can be avoided in favour of primary anastomosis. In case of recurrent ileus careful enterolysis is of great importance. Affixiation of the small intestine and application of tubes have not proved to be of value. They do not prevent relapse, are attended with complications and render every future operation difficult. PMID- 3543577 TI - [Prevention of thromboembolism with heparin-DHE--safety and trends]. AB - Perioperative thrombosis prophylaxis with low dose heparin-DHE. Efficiently protects against thromboembolic complications. Side effect such as haemorrhage or vasospasms are rarely seen. The known contraindications of DHE have been respected strictly. The latest development is low molecular heparin which has been tried out and evaluated on the ground of a controlled double blind study of 259 patients undergoing general surgery. The study shows the following advantages: thrombosis prophylaxis by one injection pro die only. This means less work for the staff and lower costs. Further studies on low molecular heparin are necessary. PMID- 3543580 TI - [Evaluation of real-time sonography in the pretherapeutic staging of malignant tumors of the tongue and mouth floor]. AB - Based on our three years experience with about 200 transcutaneous real-time sonographies of the tongue and the floor of mouth, an assessment of the determination of size and site of 38 pretherapeutically examined malignant tumours (35 squamous cell carcinomas) was made. The patients were examined in reclined position, the head retroflected. Curved array transducers of 5 or 7.5 MHz and a silicon elastomer block as interface turned out to be optimal. All tumours could be detected by sonography as hypoechoic, more or less homogeneous, ill-defined areas. Two thirds of the tumour ulcerations could be seen as hard hyperechoic reflexes within the hypoechoic areas. When comparing the maximal diameter of tumours of the 20 operated patients, we found an agreement (5 mm tolerance) of sonography with the surgical specimen in 14 of 20 tumours (70%), of sonography with the clinically estimated diameter in 10 of 20 tumours (50%), whereas the clinically estimated diameter was in agreement with the surgical specimen in only 8 of 20 tumours (40%). A peritumoral inflammatory infiltration can simulate a larger tumour size in sonography. The extent of tumours within the tongue, to the floor of mouth, the lateral pharyngeal wall and the preepiglottic space was documented correctly in most cases. In three cases a previously unknown spread across the midline was found sonographically. Including the sonographic findings in the TNM classification, 5 T1 tumours would have been staged as T2 and one T3 tumour as T4. Inflammatory diseases of the tongue can show the same sonomorphology as malignant tumours. PMID- 3543582 TI - The use of the mesher to improve split-thickness skin graft survival. PMID- 3543579 TI - [Indications for preventive sclerosing treatment of esophageal varices]. AB - There is no doubt that patients with liver cirrhosis, large esophageal varices and extremely elevated intraesophageal variceal pressure have a high risk of variceal bleeding. Telangiectasias on the top of large varices, extremely elevated wedged hepatic venous pressure and a severe reduction of clotting factors are probable risk factors for a variceal hemorrhage, too. Several of these risk factors were analysed in a prospective controlled randomized trial. Endoscopic sclerosis was not only able to reduce the frequency of variceal bleeding but also to prolong life significantly. Thus the value of such risk factors for variceal hemorrhage in patients with liver cirrhosis is well established. PMID- 3543581 TI - [Use of allogeneic septal cartilage in the correction of saddle nose]. AB - It is reported about the intraseptal implantation of allogeneic cartilago quadrangularis for the correction of saddle nose in the case of eleven patients. The indication for the implantation were non sufficient residuals of the behind septum for a substitution plastic. The sagging of the noses was caused by iatrogenic in 6 and traumatic influences in 5 cases. The conservation of the septal cartilage was carried out in Cialit 1:5000. All the septa healed in without any reaction and obtained satisfactory functional and cosmetic results. PMID- 3543583 TI - [Are there new aspects in the therapy of primary biliary cirrhosis?]. PMID- 3543584 TI - Correlation among endothelial cell shape, F-actin arrangement, and prostacyclin synthesis. AB - Though many factors have been identified which modulate prostacyclin (PGI2) synthesis, there is little information on cellular mechanisms whereby endothelial cells (EC) regulate their basal eicosanoid metabolism. Using substrates of various adhesive capacities, bovine and porcine aortic EC shape and cytoskeletal F-actin arrangement could be modulated. Staining with rhodamine-phalloidin (R-P) permitted analysis of F-actin arrangement, while differences in cell shape were determined by measurement of cell perimeter surface area (CPSA). Spectrophotoflurometric measurements were used to quantitate the R-P binding capacity of the cultures. Cultures of reduced CPSA (225.2 +/- 13.5 mu2) generated the highest levels of basal PGl2 (6.14 +/- 0.51 pg/ug cell protein); had a diffuse arrangement of F-actin and an increased binding capacity for R-P (463.55 +/- 50.58 nmoles/ug cell protein). Cultures of enlarged CPSA (1399.3 +/- 148.3 mu2), with many actin cables and a significantly reduced (p less than 0.001) R-P binding capacity (74.941 +/- 11.79 nmoles/ug of cell protein) produced significantly smaller (p less than 0.001) basal quantities of PGl2 (1.33 +/- 0.14 pg/ug cell protein). Similarly, arachidonic acid stimulation of cultures of reduced CPSA resulted in an increased synthesis of PGl2 when compared to stimulated cultures of enlarged cells. These findings suggest a role for cell shape and the cytoskeleton in the mechanism controlling PGl2 production and indicate that alteration of the arrangement of F-actin may be of importance in regulation of EC eicosanoid metabolism. PMID- 3543585 TI - Glucagon-like peptide-1 and the entero-insular axis in obese hyperglycaemic (ob/ob) mice. AB - The intestines of obese hyperglycaemic (ob/ob) mice contain greatly increased amounts of glucagon-like immunoreactive peptides. To investigate their role in the increased activity of the entero-insular axis of these mice, the insulin releasing effect of glucagon-like peptide-1 (GLP-1) was examined in 24 hour fasted 12-15 weeks old ob/ob mice under conditions of basal and elevated glycaemia. Compared with glucagon (100 micrograms/kg ip), which produce an approximately 3-fold increase in basal plasma glucose and insulin concentrations, GLP-1 (100 micrograms/kg ip) produce a very small (less than 1 fold) increase in plasma insulin, with no significant change in plasma glucose. The insulin releasing effect of glucagon, but not GLP-1 was increased by administration in combination with glucose (2 g/kg ip). The results indicate that GLP-1, which exhibits considerable sequence homology with glucagon, exerts only a weak insulin releasing effect without a significant hyperglycaemic effect in ob/ob mice. Thus GLP-1 is unlikely to be an important endocrine component of the two over-active entero-insular axis in ob/ob mice. PMID- 3543586 TI - N-methyl-D-aspartate produces discriminative stimuli in rats. AB - Male Sprague Dawley rats were trained to discriminate an interoceptive effect associated with a subconvulsant dose (30 mg/kg i.p.) of the excitatory amino acid receptor agonist, N-methyl-D-aspartate (NMDA). Approximately 60% of the rats learned to discriminate this compound from saline in 45 +/- 5 sessions, and the stimuli were dose dependent (ED50 value = 13.6 mg/kg i.p.). The specific NMDA receptor antagonist, 3-[+/-)-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP), blocked NMDA-induced discriminative stimuli with an ED50 value equal to 2 mg/kg i.p., confirming that the NMDA cue is mediated by activation of NMDA receptors. Through the use of NMDA discriminative stimuli, the consequences of NMDA excitation can be studied in vivo and compounds with potential NMDA antagonist properties can be identified. PMID- 3543587 TI - Derangement in the study of derangement: a review of the literature on the new psychiatric commitment laws. PMID- 3543588 TI - Demonstration of leprosy bacilli in the eyes of experimentally infected armadillos: a comparison of five melanin bleaching methods. PMID- 3543590 TI - A sterility testing method for blood products. PMID- 3543589 TI - Comparison of five ovine isolates of Chlamydia psittaci: an evaluation of three cell culture treatments. PMID- 3543591 TI - Bacterial contamination of blood for transfusion: a study of the growth characteristics of four implicated organisms. PMID- 3543592 TI - Purpose-made enzyme conjugates for quantitative immunoassays. PMID- 3543593 TI - Normal monocyte sub-populations defined by monoclonal antibodies and alpha naphthyl acetate esterase cytochemistry. PMID- 3543594 TI - Identifying actinomyces. PMID- 3543595 TI - Polymerisation of LR Gold resin using white light. PMID- 3543596 TI - Medicare coverage for cyclosporine. PMID- 3543597 TI - [Thermoradiotherapy of cancer: the status of the problem and prospects]. PMID- 3543598 TI - [Whole-body hyperthermia and hyperglycemia in the combined treatment of rectal cancer]. AB - The paper is concerned with the results of combined therapy of 210 rectal cancer patients (stage III1 using hyperthermia, hyperglycemia and monochemotherapy (5 FU), and 6 patients with metastatic liver cancer who received intraportal chemotherapy. A selective damaging effect of hyperglycemia on a tumor cell was revealed. The use of hyperglycemia-hyperthermia-chemotherapy in the preoperative period was substantiated, the 3-year survival of 69 patients who had received single sessions of hyperthermia-hyperglycemia-monochemotherapy, was 77%. Positive results of intraportal administration of 5-FU were noted in the patients with metastatic liver cancer. PMID- 3543599 TI - Cardiac arrest: a simulation program. PMID- 3543600 TI - A program for evaluating depression. PMID- 3543601 TI - Computer-stored medical records: their time is nigh. PMID- 3543602 TI - [The Nikolai Ivanovich Priogov Museum-Estate in Vinnitsa]. PMID- 3543603 TI - [Antipsychiatry and "antimedicine" of Italian Brownism. Possible analogy between 2 scientific-cultural "revolutions"]. PMID- 3543604 TI - [Pharmacokinetics of antimalarials: quinine and mefloquine, halofantrine, qinghaosu, amino-4-quinolines]. AB - The development of new sensitive and specific assays (HPLC) have enabled the pharmacokinetics of antimalarial drugs to be studied. Parameters such as half life distribution volume, clearance and bioavailability, are defined. In healthy subjects, quinine is rapidly eliminated (t1/2 beta: 6-12 h). Hepatic biotransformation accounts for approximately 80% of its total clearance. In malaria, the pharmacokinetic properties of quinine (decrease in the apparent volume of distribution, prolongation of the t1/2 beta, reduction in systemic clearance), are altered in proportion to the severity of infection. Red cell concentrations and plasma binding are increased. Parenteral quinine should be given by slow intravenous infusion and a loading dose is recommended in severe infections. Chloroquine (t1/2 beta: 6-50 days) and mefloquine (t1/2 beta: 6-33 days) have extensive tissue distribution and prolonged activity after a single dose. Both drugs are concentrated in erythrocytes and are bound considerably to plasma proteins. Amodiaquine is not found in the blood after oral administration. Hepatic biotransformation accounts for almost all orally administered drug. Its antiplasmodial activity is thus almost entirely due to monodesethylamodiaquine, the main metabolite. In healthy subjects, the t1/2 beta of this metabolite is 9 to 18 days in plasma. Amodiaquine is concentrated in erythrocytes. The protein binding of this drug has not been studied to date. For prophylaxis, it has been suggested that the dosage of 10 mg/kg/wk should be spread over the week (3.5 mg/kg every other day, or 1.5 every day). Halofantrine has an elimination half life of between 1.3 and 6.6 days. This drug has been suggested as a single-dose treatment. No pharmacokinetic studies of qinghaosu have been reported in humans. In rabbits, the elimination half-life in plasma was found to be 40 min. Although rapidly eliminated, this drug appears to be highly effective. More information is required on the pharmacokinetics of these drugs in malaria, during pregnancy, in children and in renal and hepatic failure. PMID- 3543605 TI - [Three successive cases of salmonella meningitis in Gabon]. AB - In a two months period Salmonella ajiobo and S. typhimurium (twice) were isolated from cloudy cerebrospinal fluids (CSF) of children less than one year old. No other cases of Salmonella meningitis occurred in a 2 year survey of meningitis in Franceville, a semi-rural community in southeastern Gabon. One case was fatal and the case with S. ajiobo needed a prolonged course since the CSF was not sterilized even after 6 days of therapy. PMID- 3543606 TI - [Somatotrophic response to hypoglycemic stimulus in patients with acromegaly. Effect of bromocriptine]. PMID- 3543607 TI - [Relation between urinary tract infections and reversible rejection episodes in renal transplantation]. PMID- 3543608 TI - Pre- and post-prandial plasma levels of intermediate density lipoproteins in type 2 diabetic female patients. PMID- 3543609 TI - [Clinical pharmacodynamics of tiaprofenic acid]. PMID- 3543611 TI - The morbid anatomy of the human genome: a review of gene mapping in clinical medicine (2). PMID- 3543610 TI - Geographic patterns of allele frequencies in Calomys musculinus reservoir-host of Junin virus. PMID- 3543612 TI - [The state of dentition and health maintenance in workers 35-44 years of age from selected industrial plants]. AB - The study involved 347 workers (232 men and 115 women) aged 35-44 from four big industrial plants in the area of Szczecin. Selected dental health indices and questionnaires filled by the workers have been analysed. The results were compared with the data obtained from the International Collaborative Study of Dental Manpower Systems in relation to Oral Health Status (so called "general population"). The study demonstrated differences in the DMF and M data between the test and the general populations. No differences in D and F numbers have been shown. Thus, the index of caries treatment requirements was similar in both populations. The awareness of caries treatment need was lower in the industrial than in the general population. The percentage of workers in demand of dentures was higher in the industrial than in the general population. The questionnaire study demonstrated that the test group more frequently applied--within last year- for dental care. Also, the availability of dental dispensaries was evaluated better by the workers as compared to controls. PMID- 3543613 TI - Altered C-peptide/insulin molar ratios and glucose turnover rates after stimulation in nondiabetic offsprings of type II diabetic patients. AB - We evaluated the serum glucose/insulin/C-peptide dynamics and C-peptide/insulin molar ratios during sequential standard meal and intravenous (IV) glucagon testing for 240 minutes in eight genetically predisposed but nondiabetic female offsprings of type II diabetic patients and seven weight-matched, normal female controls. Glucose turnover rates and metabolic clearance rates of glucose (MCRG) were also determined isotopically by the D-[3-3H]glucose infusion technique. All the subjects had normal fasting serum glucose and glycosylated hemoglobin (HbA1) values. After meal ingestion, mean serum glucose concentrations were not different except for 120 to 180 minute values, which were significantly higher in the offsprings v controls. After intravenous glucagon infusion, percent maximum increments of glucose were no different. Mean basal immunoreactive insulin (IRI) levels were significantly (P less than 0.02) higher in the nondiabetic offsprings v controls. Following meal ingestion, mean IRI rose to a peak at 40 minutes in both groups, but values were significantly (P less than 0.001) higher in the offsprings v controls. After glucagon administration, the percent maximum increment was significantly (P less than 0.05) lower in the offsprings v controls. Despite exaggerated IRI levels in the offsprings, the mean fasting and stimulated C-peptide levels were identical in both groups throughout the study period. Basal and stimulated C-peptide/IRI molar ratios were quantitatively lower but qualitatively no different in the nondiabetic offsprings v controls throughout the study period. Mean basal hepatic glucose output (HGO) was higher but not statistically different in the offsprings compared with the controls (2.10 +/- 0.28 v 1.65 +/- 0.15 mg/kg X min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543614 TI - Glucose homeostasis in magnesium-deficient rats. AB - Glucose homeostasis was studied in rats fed diets containing 750,200, or 100 mg/kg Mg for 6 to 8 weeks, from the age of 4 weeks. Weight gain of the rats receiving 200 and 100 mg/kg diets was decreased. This resulted from both a lower food intake and reduced effectiveness of the ingested food. Fed or fasting plasma glucose levels were similar in the three groups. During an intravenous glucose tolerance test, the rate of glucose disappearance was higher in Mg 100 rats than in controls. By contrast, during an oral glucose tolerance test, the rise in plasma glucose was greater and more sustained in Mg 100 rats. During both tests, the insulin response was markedly lower in Mg-deficient rats than in controls. This could be partially due to the reduced insulin content of the pancreas of these animals. The impairment of tolerance to oral glucose was corrected by 5 weeks on a high-Mg diet. After intravenous injection of insulin, the fall in plasma glucose levels was also slightly more pronounced in Mg 100 rats. During no test did we observe a significant difference between glucose or insulin responses in Mg 200 or Mg 750 rats. These results, thus, show that chronic Mg deficiency alters several parameters of glucose homeostasis in the rat. PMID- 3543616 TI - Clinical pharmacology of sulfonylureas. AB - Sulfonylureas seem to have similar mechanisms of action, including an acceleration and increase of insulin secretion, an increase of the systemic availability of insulin, and probably indirectly, an increase of insulin action. Sulfonylureas may postpone the development of impaired glucose tolerance (IGT) to manifest non-insulin-dependent diabetes mellitus (NIDDM), and all NIDDM subjects should benefit from sulfonylurea treatment except those in whom insulin secretion has been attenuated. The most effective use is the combination of diet restriction and sulfonylurea introduced in NIDDM subjects soon after transition from IGT to NIDDM. A simple screening procedure has been devised to find the subjects at this early stage. Newer sulfonylureas, such as glipizide and glyburide, are more potent than the older ones, such as tolbutamide and chlorpropamide. During chronic treatment, glipizide and glyburide seem to be equally effective in reducing blood glucose levels, and they do so without causing a chronic elevation of insulin secretion, signifying that they do not increase the risk of pancreatic B cell exhaustion. Glipizide has rapid and complete absorption, as well as a rapid distribution and elimination. This may explain why it is less liable than other sulfonylureas to provoke long-lasting hypoglycemia, which is the major danger when using sulfonylureas. Despite its rapid elimination, 7.5 to 15 mg glipizide can be administered once daily without loss of therapeutic efficacy. This may be due in part to enterohepatic recirculation of the drug in response to meals. The therapeutic efficacy is increased if glipizide is received half an hour before breakfast. PMID- 3543615 TI - The contribution of gluconeogenesis to glycogen repletion during glucose infusion in endotoxemia. AB - Glycogen repletion rates in liver and skeletal muscle were quantitated, and the contribution of gluconeogenesis to hepatic glycogen repletion and glucose output were determined during glucose infusion in hemodynamically stable endotoxemic animals. Four hours after the injection of endotoxin (or saline), rats were infused with 235 mumol/min/kg of glucose (or saline) containing [6-3H]-glucose for up to four additional hours. Glucose infusion increased the plasma glucose concentration, which plateaued between 14 to 17 mmol/L, in the control rats. The glucose concentration of the endotoxin group receiving glucose was consistently greater than in control rats and failed to reach a plateau. The rate of muscle glycogen synthesis was not altered after endotoxin, but hepatic glycogen repletion was decreased by 55%. The percentage of glycogen repletion derived directly from blood glucose in liver and muscle was similar in control and endotoxin-treated rats receiving glucose. Therefore, the direct incorporation of glucose into glycogen appeared to predominate over the contribution by gluconeogenesis. However, gluconeogenesis continued during the glucose infusion in both control and endotoxemic animals. The calculated rate of total gluconeogenesis was 160% higher in the endotoxin glucose-infused rats compared to the control animals receiving glucose. This increase was due primarily to the attenuated suppression of hepatic glucose output in the endotoxin group (52 +/- 4%) compared to controls (84 +/- 3%). Thus, gluconeogenically derived glucose-6 phosphate appears to be diverted from hepatic glycogen storage to glucose output in endotoxin-treated rats during glucose infusion. PMID- 3543617 TI - Determining the most appropriate treatment for patients with non-insulin dependent diabetes mellitus. AB - Today it is possible, with the available treatment armamentarium, for a physician to rationally choose a strategy to be customized to patients with type II diabetes. The keystone of treatment is a good nutritional plan that provides for proper nutrition as well as appropriate weight loss. Exercise is also a useful adjunct. When diet therapy is unsuccessful, the use of oral sulfonylureas may be indicated. These agents have been shown to stimulate insulin release, to reduce hepatic glucose output, to potentiate insulin action in a postreceptor mechanism, and to have a modest effect in increasing insulin receptors. The first-generation compounds have a 70% success rate within the first 5 years after initiating therapy. However, these agents can have undesirable side effects. The second generation agents, such as glipizide, offer the advantages of high efficacy, inactive metabolites, nonionic binding, and low reported alcohol flushing. Many patients who fail on first-generation agents may respond to second-generation drugs. Insulin therapy can be used if the patient fails on an oral agent. PMID- 3543618 TI - Monitoring and controlling the patient with non-insulin-dependent diabetes mellitus. AB - While the prevention of acute metabolic decompensation is no longer a serious problem in treating patients with non-insulin-dependent diabetes mellitus (NIDDM), target organ complications can have serious consequences, including blindness, renal failure, neuropathy, amputation, coronary artery disease, and stroke. The bulk of current evidence suggests that these complications can be minimized or perhaps even avoided by carefully monitoring and controlling the patient's blood glucose levels. Although criteria and standards of control differ widely in various centers, in general acceptable-to-good control in the NIDDM patient would consist of average fasting blood glucose (FBG) levels of less than 140 mg/dL and peak postprandial glucoses of less than 220 to 250 mg/dL. Treatment aimed at attaining these blood glucose levels should begin with dietary management and exercise prescription. General health measurements such as control of blood pressure and avoidance of smoking are especially important in the diabetic patient. When these approaches prove ineffectual, the addition of an oral hypoglycemic agent, preferably a second-generation sulfonylurea is indicated. Glipizide and glyburide are both excellent drug choices, although glyburide may cause hypoglycemia in older patients due to its longer half-life and especially in those with renal insufficiency because of accumulation of biologically active metabolites. In certain well-selected cases, the addition of insulin to oral sulfonylurea therapy may offer improved results over the use of either therapeutic modality alone. The advent of self blood glucose monitoring and periodic glycohemoglobin assessments, now well established in diabetic management, represents a major step forward in the endeavor to optimize standards of blood glucose control in the diabetic population. PMID- 3543619 TI - Functional interactions in vivo between suppressor tRNA and mutationally altered ribosomal protein S4. AB - Ribosomal mutants (rpsD) which are associated with a generally increased translational ambiguity were investigated for their effects in vivo on individual tRNA species using suppressor tRNAs as models. It was found that nonsense suppression is either increased, unaffected or decreased depending on the codon context and the rpsD allele involved as well as the nature of the suppressor tRNA. Missense suppression of AGA and AGG by glyT(SuAGA/G) tRNA as well as UGG by glyT(SuUGG-8) tRNA is unaffected whereas suppression of UGG by glyT(SuUGA/G) or glyV(SuUGA/G) tRNA is decreased in the presence of an rpsD mutation. The effects on suppressor tRNA are thus not correlated with the ribosomal ambiguity (Ram) phenotype of the rpsD mutants used in this study. It is suggested that the mutationally altered ribosomes are changed in functional interactions with the suppressor tRNA itself rather than with the competing translational release factor(s) or cognate aminoacyl tRNA. The structure of suppressor tRNA, particularly the anticodon loop, and the suppressed codon as well as the codon context determine the allele specific functional interactions with these ribosomal mutations. PMID- 3543620 TI - Genetic analysis of Aspergillus nidulans AmdS+ transformants. AB - To correlate the genetic background of the Aspergillus nidulans amdS deletion strain MH1277 with the integrational behaviour of transforming vectors, classical genetic methods were used to construct AmdS- strains in which whole chromosomes had been exchanged with those of a master strain. Progeny strains were transformed to the AmdS+ phenotype with vector p3SR2. From Southern analysis it was concluded that transformants from all constructions contained tandemly repeated, multiple copy inserts of vector DNA as found for MH1277-derived AmdS+ transformants. AmdS+ transformants of MH1277 were analysed genetically to prove that the transformant phenotype is genome linked and that transformation by integration can take place on various chromosomes. In one case the AmdS+ property showed linkage to both chromosomes II and IV, due to a chromosomal translocation. Sexual analysis of two transformants with AmdS+ insertions on the same chromosome revealed a considerable instability of the AmdS+ phenotype in one of the strains upon selfing. Due to this instability no decisive answer could be given for the degree of linkage between the AmdS+ insertions in these transformants. PMID- 3543621 TI - Alteration by mutation of the control by oxygen of the nar operon in Escherichia coli. AB - A nar-lac operon fusion was used to isolate a mutant in which the expression of the nar operon was no longer repressed by oxygen. The nard mutation, located upstream of the nar structural genes, was found to be cis dominant; it led to independence from the Fnr protein which, in the wild-type strain, exerts a strict positive control on the nar operon. Both other known controls, nitrate induction and autoregulation, were unaffected. It is proposed that molecular oxygen controls the expression of nar via Fnr and that the nard mutation affects the Fnr binding site of the narGHI control region. PMID- 3543622 TI - A naturally occurring large chromosomal inversion in Escherichia coli K12. AB - Strain 1485IN and its derivatives were found to have a large inversion extending to about 35% of the chromosome. Because of this, the question arose as to whether 1485IN had arisen from an Escherichia coli strain other than K12. However, 1485IN had a flagellar antigen and a restriction-modification system indistinguishable from those of W3110, a major line of K12, and had retained an amber suppressor and lambda sensitivity that are characteristics of W1485 from which this strain seems to have arisen. Strain 1485IN had acquired proline auxotrophy, but showed the same growth rate as W1485 in nutrient broth at 37 degrees C. Interrupted matings with Hfr strains of 1485IN revealed a gene arrangement of nalA-gal-trp his-lac-proA-thrleu-ilv, in which gal, trp, and his were on the inverted segment. The termini of the inversion were inferred to be situated between tsx (9.5 min) and purE (12 min) and between his (44 min) and cdd (46.5 min). PMID- 3543623 TI - [Mycoviruses associated with the killer character in yeasts]. PMID- 3543624 TI - Culture conditions for stimulating cholera toxin production by Vibrio cholerae O1 El Tor. AB - A method that stimulates cholera toxin (CT) production by Vibrio cholerae O1 biotype El Tor (El Tor vibrios) to the level of several micrograms per ml in the culture fluid was established. Such a large amount of CT was obtained by the following method: El Tor vibrios were cultured in AKI medium (1.5% Bacto peptone, 0.4% yeast extract-Difco, 0.5% NaCl, 0.3% NaHCO3) at 37 C for 4 hr in a stationary test tube and then for 16 hr in a shaken flask, with inoculum sizes of 10(5) to 10(7)/ml. With this method, 35 strains out of 60 examined produced 2 to 16 micrograms/ml of CT as determined by the reversed passive latex agglutination test (RPLA). Thirty-three randomly selected strains out of the 60 produced reasonable amounts of rabbit skin vascular permeability factor, reflecting the amount of CT titrated with RPLA. PMID- 3543625 TI - In vitro hexagonal assembly of lipopolysaccharide of Escherichia coli K-12. AB - We examined Escherichia coli K-12 lipopolysaccharide (LPS), which is known to be an R-form LPS, for its ability to form a hexagonal lattice structure in vitro. The LPS from E. coli K-12 strain JE1011 did not form a hexagonal lattice structure when it was precipitated by addition of two volumes of 10 mM MgCl2 ethanol, but it did form such a structure when it was electrodialyzed and then converted to the magnesium or calcium salt form. The lattice constant of the magnesium salt form was 15.2 +/- 0.3 nm and that of the calcium salt form 18.5 +/ 0.3 nm. Since prior treatment of the LPS with proteinase K in the presence of sodium dodecyl sulfate did not affect its capability of hexagonal assembly, the lattice formation by the LPS does not require the presence of proteins. PMID- 3543626 TI - Microimmunofluorescence using Terasaki plates and direct plate freezing method- rapid and reliable screening system of hybridomas. AB - Microimmunofluorescence using Terasaki plates and a direct plate freezing method were combined for effective screening of hybridoma supernatants. The microplates, in which the fused cells (myeloma and spleen cells) were cultured and hybridoma colonies were growing, were frozen after harvest of supernatants and saved at -80 C for several weeks without affecting antibody production ability of hybridomas. Microimmunofluorescence was performed in Terasaki plates on which target cells were attached by poly-L-lysine and glutaraldehyde or by short time culture of the cells in Terasaki plates. The direct plate freezing method prevented initial hybridoma cells from changes or disappearance of antibody productions during screening of hybridoma supernatants; the microimmunofluorescence staining method permits fast and detailed estimation of specificity of antibodies of hybridomas by saving time and minimal consumption of supernatant for checking. The combination of these two methods is a powerful tool for obtaining desired monoclonal antibodies. PMID- 3543627 TI - Sixth Dame Rosalind Paget Memorial Lecture. "The evolution of midwifery education". PMID- 3543628 TI - [Fluoride is 100 years old]. PMID- 3543629 TI - The mechanism underlying sudden death from electric shock. AB - Much has been written on the effects of electric shock on the body. However, in those cases in which victims become pulseless and therefore die suddenly, the underlying event has assuredly been ventricular fibrillation. In this condition of the heart, all of the muscle fibers of the ventricles, the main pumping chambers, contract and relax randomly and pump no blood. Simple protracted cardiac arrest, in this circumstance, is most unlikely. It generally is believed that only low-frequency alternating current can induce ventricular fibrillation; this assumption is invalid, because a single pulse of current applied to the body, as well as high-frequency current, can induce ventricular fibrillation. The important variables are the type and magnitude of the current and the manner in which it is applied to the body. To date, the current pathway has received too little attention. This article reviews the various mechanisms by which a single shock or a train of pulses can induce ventricular fibrillation. PMID- 3543630 TI - [Therapy in dwarfism. Use of genetically produced growth hormone in practice]. PMID- 3543631 TI - A new noninvasive quantitative method for fracture diagnosis. AB - Due to insufficient diagnostic possibilities the removal of the fixation in many cases is still a gamble with the patient as a loser. The urgent need for a sensitive and harmless method that can assist radiology can be met by new ultrasonic approach. Results of animal investigations are presented that prove that ultrasonic callus analysis (UCA) can be a useful tool for diagnosis of the fracture-healing progress, which provides efficient quantitative parameters for diagnosis and a new objective stability criterion. PMID- 3543632 TI - Ultrasonic medical imaging, current techniques and future developments. AB - A review is given of a theoretical frame work, that is pre-eminently suited for both narrowband and broadband acoustic echo-techniques as used in seismic exploration, medical imaging and nondestructive inspection. It is shown that conventional focussing represents a simplified acoustic inversion process. A discussion is given on practical aspects of vertical and lateral resolution. Ultimate limits are indicated for the medical situation. It is argued that the new generation of medical imaging systems will consist of digital 'workstations' under full software control. By those workstations advanced data gathering, image reconstruction, image processing as well as tissue characterization will be handled. PMID- 3543633 TI - Intracoronary thrombolysis in acute myocardial infarction. A review. PMID- 3543634 TI - [From rural practice to the Mecca of medicine: the Mayo Clinic]. PMID- 3543635 TI - The Charles R. Kleeman Festschrift. PMID- 3543636 TI - Hypophosphatemia in long-term renal transplant recipients: effects on bone histology and 1,25-dihydroxycholecalciferol. AB - The effects of long-term hypophosphatemia were studied in 10 renal transplant recipients with persistent hypophosphatemia. The renal transplant recipients are 3-14 years (mean 8.7 +/- 4 years) post transplantation. The mean (+/- SD) serum calcium, phosphate, and creatinine levels are 9.66 +/- 0.42, 2.29 +/- 0.16, and 1.47 +/- 0.23 mg/dl, respectively. Carboxy (C)-terminal parathyroid hormone (PTH) is elevated in 8 hypophosphatemic renal transplant recipients. The mean 1,25 dihydroxycholecalciferol [1,25(OH)2D3] level is 33 +/- 20 pg/ml (normal 19-55 pg/ml) compared to 42 +/- 0.6 pg/ml (NS) in 4 normophosphatemic renal transplant recipients with comparable renal function. The 1,25(OH)2D3 level correlates with C-PTH (p less than 0.01) but not serum phosphate. Anterior iliac crest bone biopsies were obtained in all 10 hypophosphatemic renal transplant recipients. Histomorphometric analysis of osteoblastic osteoid, total surface osteoid, bone osteoclast interface, total resorption, osteoclasts/mm2, osteoid seam width, and relative osteoid volume are not significantly different from normals. Trabecular bone volume is decreased (15.6 +/- 5.7 vs. 23 +/- 5%, p less than 0.01). Comparison of dynamic parameters with normal reveals no differences in appositional and bone formation rate. In summary, in hypophosphatemic renal transplant recipients: hypophosphatemia does not produce osteomalacia; hyperparathyroidism is often observed, and plasma 1,25(OH)2D3 levels, in general, remain in the normal range. PMID- 3543637 TI - Reduced phosphate reabsorption unrelated to parathyroid hormone after renal transplantation: implications for the pathogenesis of hyperparathyroidism in chronic renal failure. AB - We measured nephrogenous cyclic adenosine monophosphate (NcAMP) excretion, an in vivo bioassay for endogenous parathyroid hormone (PTH) secretion, and renal phosphate threshold (TmP/GFR) in 33 renal allograft recipients with stable renal function (creatinine clearance greater than or equal to 60 ml/min/1.73 m2 body surface area, 6 months or more post-transplant) and in 9 kidney donors. Sixteen patients had normal parathyroid function, 8 had hypercalcemic hyperparathyroidism and 9 had normocalcemic hyperparathyroidism; the latter were apparently resistant to the hypercalcemic actions of endogenous PTH, but the cause for this was not apparent. In all four subject groups, TmP/GFR was significantly and similarly lower (by 0.8-1.0 mg/dl) than predicted by multiple regression on age, sex, corrected plasma calcium and NcAMP (determined in 306 subjects spanning a wide range of parathyroid function) indicating a major PTH-independent mechanism for reducing phosphate reabsorption in the presence of a single kidney. In all four groups the contribution of this mechanism to the observed depression of TmP/GFR was substantially greater than the contribution of increased PTH secretion. In all groups, but more so in the recipients than in the donors, fasting urinary phosphate excretion/GFR was increased, so that fasting plasma phosphate, although reduced, did not accurately reflect the severity of the defect in phosphate reabsorption. We conclude that the dominant mechanism for the adaptive decrease in renal tubular phosphate transport in response to nephron reduction does not require the participation of PTH and is manifest in the presence of fasting hypophosphatemia. PMID- 3543638 TI - Cerebral edema complicating nonketotic hyperosmolar coma. AB - Cerebral edema as a complication of the therapy of diabetic coma has been described for over 50 years, although modern awareness dates to about 1967. Almost all cases have occurred in patients with diabetic ketoacidosis (DKA). Although a few cases of cerebral edema have been reported in patients with nonketotic hyperosmolar coma (NKHC), these are in general not well documented by either autopsy data of cat scans. Over a period of 9 years, I have encountered 5 patients who developed cerebral edema as a complication of the therapy of NKHC. The initial plasma glucose in these patients was 1,496 +/- (SD) 296 mg/dl and plasma osmolality was 382 +/- 29 mosm/kg. All had depression of sensorium to at least a stupor (stage I coma or greater). All were treated with intravenous insulin and either 77 or 154 mM NaCl, and plasma glucose fell at a mean rate of 38 mg/dl/h. In all patients, plasma glucose fell below 250 mg/dl (mean of 18 +/- 66 mg/dl) and all patients experienced increased depression of sensorium, elevated csf pressure, and brain swelling as diagnosed by cat scanning. Therapy with various combinations of glucose, mannitol and steroids were without effect. In 1 patient, insertion of a subdural intracranial screw lowered intracranial pressure from 24 to 3 cm of H2O. Three of the 5 patients died and 2 remain in a persistent vegetative state, 1 of whom is also quadriplegic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543639 TI - Imipenem: a novel carbapenem antibiotic. PMID- 3543640 TI - [Premedication in outpatient dental surgery under local anesthesia]. PMID- 3543642 TI - [Radiological pictures of benign tumors of the jaws]. PMID- 3543641 TI - [Clinical efficacy of clofoctol in treating odontogenic infections]. PMID- 3543643 TI - [Principles of the science of construction in removable and fixed prosthetic reconstructions. II. The authors' own research]. PMID- 3543644 TI - [Cheilognathopalatoschisis and secondary bone grafts in the alveolar process. The surgical and orthognathodontic considerations]. PMID- 3543646 TI - [Surgery of the liver--past, present and future]. AB - Recent advances in hepatic surgery were reviewed, accompanying our original works, as follows. Segmental anatomy of the liver, including vascular anatomy of the caudate lobe. Typical hepatic lobectomy and radical surgery for hilar carcinoma of the liver. Interruption of the hepatic artery and the portal vein branch, and their clinical significance. Indication and results of hepatic surgery, including primary liver cancer, metastatic liver cancer and localized benign disease of the liver, such as liver cyst, hemangioma, liver abscess and hepatolithiasis. Evaluation of the functional reserve of the liver and operative risk, especially preoperative evaluation of the functional reserve of the remnant liver and long-term prognosis. Furthermore, the progress in the future was expected, mainly on artificial liver, orthotopic partial liver transplantation with donor living and super-extended hepatic resection. PMID- 3543645 TI - Drug therapy for anxiety. PMID- 3543649 TI - 3H-DOB (4-bromo-2,5-dimethoxyphenylisopropylamine) labels a guanyl nucleotide sensitive state of cortical 5-HT2 receptors. AB - 3H-(+/-)-4-Bromo-2,5-dimethoxyphenylisopropylamine (3H-DOB), a putative agonist radioligand, was synthesized and used to label 5-HT2 receptors in a particulate fraction prepared from rat frontal cortex tissue homogenates. The specific binding (defined by the difference in 3H-DOB binding in the presence and absence of 10(-6) M cinanserin, a potent and specific 5-HT2 antagonist) displayed high affinity (KD = 4.1 X 10(-10) M) and saturability with a Bmax of 17.9 fmol/mg of protein. The distribution of specific 3H-DOB binding in nine brain regions correlated closely with the distribution of 3H-ketanserin (an antagonist radioligand)-labeled 5-HT2 receptors. Competition studies in frontal cortex homogenates using a variety of compounds revealed a distinct 5-HT2 receptor pharmacology. A series of 5-HT2 antagonists exhibited high affinities in competition studies for specific 3H-DOB binding. The absolute potencies of these antagonists as well as their order of potencies closely correlated with their potencies in competing for 3H-ketanserin-labeled brain 5-HT2 receptors. A series of 5-HT2 agonists also exhibited high affinities in competition studies for specific 3H-DOB binding. Although the order of potencies of these agonists was similar to their order in competing for 3H-ketanserin-labeled brain 5-HT2 receptors, the agonists displayed 10-100-fold higher affinities for the 3H-DOB labeled sites than for the 3H-ketanserin-labeled sites. The level of specific 3H DOB binding in the frontal cortex homogenates was approximately 5% of the levels of 3H-ketanserin-labeled 5-HT2 receptors (358 fmol/mg of protein). Taken together, these results indicate that 3H-DOB labels a subset of brain 5-HT2 receptors that has high affinity for agonists as well as antagonists); 3H ketanserin appears to label both subsets of brain 5-HT2 receptors. Antagonists apparently do not discriminate between these two subsets of 5-HT2 receptors. 3H DOB specific binding to 5-HT2 receptors was potently inhibited by guanosine 5' (beta, gamma-imido)triphosphate and guanosine 5'-O-(3-thio)triphosphate (nonhydrolyzable derivatives of GTP) with IC50 values of 42 and 21 nM, respectively, whereas adenosine 5'-(beta, gamma-imido)triphosphate and adenosine 5'-O-(3-thio)triphosphate (nonhydrolyzable derivatives of ATP) had no effect. In summary, 3H-DOB specific binding displays the pharmacological characteristics of a 5-HT2 receptor.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543647 TI - Altered regulation of cytochrome P-450 enzymes in choline-deficient cirrhotic male rat liver: impaired regulation and activity of the male-specific androst-4 ene-3,17-dione 16 alpha-hydroxylase, cytochrome P-450UT-A, in hepatic cirrhosis. AB - Total microsomal cytochrome P-450 levels were decreased, to about 50% of control, in liver of male rats made cirrhotic by the prolonged intake of a choline deficient diet. We have suggested previously that this decrease in cytochrome P 450 levels is not a generalized one, but is selective for certain forms of the enzyme. In the present study, levels of six cytochrome P-450 forms including the sex-specific cytochrome P-450 forms, P-450UT-A, P-450PCN-E, and P-450UT-l, were quantitated immunochemically in hepatic microsomes prepared from control and cirrhotic male rats and were related to changes in the regioselectivity of cytochrome P-450-mediated androst-4-ene-3,17-dione hydroxylation in these fractions. The principal finding of this study was that the male-specific androst 4-ene-3,17-dione 16 alpha-hydroxylase was decreased in cirrhotic microsomes to about 20% of control. The content of P-450UT-A decreased concurrently from about 0.40 to less than 0.01 nmol/mg of microsomal protein. Other pathways of androst-4 ene-3,17-dione hydroxylation were also affected, but to different extents than the 16 alpha-hydroxylase. 6 beta-Hydroxylation decreased in cirrhotic microsomes to about 45% of control, despite a marked decrease in P-450PCN-E from 0.27 to less than 0.002 nmol/mg of microsomal protein. The rate of androst-4-ene-3,17 dione 7 alpha-hydroxylation underwent a less pronounced reduction in cirrhosis to about two-thirds of control microsomal activity, and levels of the cytochrome P 450 associated with this activity, P-450UT-F, were decreased in proportion with the decrease in total microsomal cytochrome P-450. 16 beta-Hydroxylase activity was unaffected by the cirrhotogenic process. From spectral binding studies it was apparent that androst-4-ene-3,17-dione elicited a high affinity type I interaction in control microsomal fractions (Ks = 4.5 microM), whereas no interaction was apparent in cirrhotic liver microsomes. Levels of three other forms of cytochrome P-450--P-450PB-C (a constitutive form inducible by phenobarbital), P-450ISF-G (a major isosafrole-inducible form), and P-450UT-I (the major female sexually-differentiated isozyme)--were apparently unaltered in cirrhosis. These findings are consistent with the assertion that specific forms of cytochrome P-450 are subject to altered regulation in hepatic cirrhosis. PMID- 3543648 TI - Characterization of a rat liver cytochrome P-450UT-H cDNA clone and comparison of mRNA levels with catalytic activity. AB - A rat liver cDNA library was prepared using the expression vector bacteriophage lambda gt11 and plaques were screened using polyclonal antibodies raised to purified rat liver cytochrome P-450UT-H, the major enzyme involved in debrisoquine 4-hydroxylation, bufuralol 1'-hydroxylation, and sparteine delta 5 oxidation. A clone was selected which contained a 1.3-kb insert. The Escherichia coli beta-galactosidase fusion protein had a molecular weight greater than that of native beta-galactosidase (and reacted with anti-P-450UT-H after electrophoresis) and was also shown to compete with microsomal P-450UT-H for anti P-450UT-H, partially relieving catalytic inhibition by anti-P-450UT-H in rat liver microsomes. Hybrid selection experiments with the cloned cDNA also support the view that the insert is related to P-450UT-H. mRNA electrophoresis/hybridization experiments indicated that the 1.3-kb cDNA probe recognized primarily only a single size class of mRNA (2.0 kb) in rat liver. mRNA blotting and in vitro translation/immunoprecipitation experiments both indicated that levels of P-450UT-H mRNA are similar in male and female Sprague-Dawley rats. Dark Agouti strain rats of both sexes contained significantly less P-450UT-H mRNA than did Sprague-Dawley rats and the females had approximately one-half the level of the males. These results are consonant with sex and strain differences in measured levels of P-450UT-H and bufuralol 1'-hydroxylase and sparteine delta 5 oxidase activities. Analysis of genomic DNA indicated that several DNA restriction fragments hybridized to this partial length cDNA; no differences were found between the rat strains and sexes. The results suggest that the basis for the variation in P-450UT-H and its activities among rat strains and sexes is at the level of mRNA concentrations. PMID- 3543650 TI - Erythrocyte-mediated microinjection of horseradish peroxidase into BHK cells. Subcellular localization by light and electron microscopy. AB - In order to establish the distribution with time of proteins microinjected into mammalian cells, horseradish peroxidase (HRP) was microinjected into baby hamster kidney (BHK) cells using chicken erythrocyte ghosts. At time intervals following initiation of fusion between ghosts and target cells, samples were fixed with aldehydes and the peroxidase visualized by reaction with diaminobenzidine and viewing by light and electron microscopy. At 10 min, the reaction product was observed within the cytoplasm of 60% of the microinjected cells, but was excluded from the nucleus and membranous organelles. In the other 40% of microinjected cells, the reaction product was also observed within the nucleus. At 30 min, the reaction product was observed to be evenly distributed throughout the cell, including the nucleus but excluded from organelles. By 6 h, the reaction product was present almost exclusively within the nucleus of 63% of microinjected cells. At all time points, 20-30% of the erythrocytes ghosts appear to have been taken up by cells by phagocytosis rather than fusion, as evidenced by the presence of peroxidase reaction product within intact and fragmented erythrocyte ghosts in the cytoplasm of target cells. Cells incubated with a lanthanum solution following fusion excluded this electron dense tracer, indicating that the cytoplasmic compartment is not opened during exposure to polyethylene glycol. PMID- 3543651 TI - Regulatory aspects of the colchicine interactions with tubulin. AB - Limited proteolysis of tubulin with subtilisin results in the cleavage of both tubulin subunits yielding S-tubulin heterodimer and 4 kDa peptide fragments containing the carboxyl-terminal domains of alpha- and beta-polypeptide chains. S tubulin binds colchicine and the characterization of the binding of colchicine to S-tubulin molecules showed a decreased rate of decay of colchicine binding activity as compared to that of undigested tubulin. However, S-tubulin exhibited a lower colchicine binding constant than tubulin. Peptide fragments resulting from the controlled tryptic proteolysis of both pure tubulin and S-tubulin were purified by filtration chromatography and presented a strong colchicine binding activity with association constants of 4.5 X 10(6) and 2.7 X 10(6) M-1, respectively. Furthermore, these studies support our initial findings on the localization of the tubulin site for colchicine (Serrano L, Avila J, Maccioni RB: J Biol Chem 259:6607-6611, 1984) and define the colchicine binding domain in a domain of alpha-subunit from the point of limited tryptic cleavage to the site of subtilisin controlled proteolysis of that tubulin subunit. On the basis of these alterations in the interaction of colchicine upon removal of the C-terminal moiety of tubulin and since no change in the number of binding sites was found after subtilisin digestion, we suggest that the carboxyl-terminal region of tubulin subunits modulates the binding of colchicine. PMID- 3543652 TI - Glutathione status and sensitivity to GSH-reacting compounds of Escherichia coli strains deficient in glutathione metabolism and/or catalase activity. AB - The intracellular concentrations of total glutathione, GSSG and protein X S-SG, the total excreted glutathione concentration, and the susceptibility towards GSH reacting compounds were assayed in strains of Escherichia coli deficient in biosynthesis and/or reduction of glutathione. A deficiency in glutathione reductase displaced the glutathione status towards the oxidized forms. This displacement was more clearly appreciated in strains additionally deficient in glutathione biosynthesis. A deficiency in catalase activity also produced an increase in the oxidation of glutathione. The most severe changes were observed in the concentrations of protein-glutathione mixed disulfides and in the amount of glutathione excreted to the medium. Increased sensitivities towards compounds known to interact with cellular GSH were observed in glutathione reductase deficient strains, although these effects were enhanced in strains additionally deficient in GSH biosynthesis. PMID- 3543653 TI - Actin distribution patterns in patients with adenomatosis of colon and rectum. AB - The actin cytoskeleton was examined in cultured skin fibroblasts of control individuals and patients with adenomatosis of colon and rectum using a fluorescent dye specific for F-actin, NBD-phallacidin. We confirmed that the actin distribution pattern differs significantly between the group of controls and the group of patients. However, the method is not practicable for the diagnosis of individual patients due to the number of false positives and negatives to be expected. PMID- 3543655 TI - [Splicing. 2. Splicing of mRNA in the cell nucleus]. AB - The mosaic structure of genes is shown for three out of four known types of RNAs, namely transfer, ribosomal and messenger. At least three different splicing mechanisms are involved in maturation of transcripts of these genes, two of them had been described in the previous review. Well-developed effective in vitro splicing systems permit to provide a scheme for the nuclear pre-mRNA maturation processes which take place presumably in specific ribonucleoprotein complex particles. Alternative splicing character of these pre-mRNAs, yields in increased variety of the encoded proteins. PMID- 3543654 TI - Synthesis of somatomedin C/insulin-like growth factor I by human placenta. AB - We have reported the presence of insulin-related poly A+ RNA sequences in human placenta by RNA to DNA hybridization. In this study we have used a monoclonal antibody to somatomedin C/insulin-like growth factor I (Sm-C/IGF-I) to identify somatomedin-like proteins whose synthesis is directed by placental mRNA. Poly A+ RNA from first trimester and term placenta was translated in a cell-free system using micrococcal nuclease-treated reticulocyte-lysate and [35S]methionine as a label. From 2.0 X 10(6) cpm of specifically incorporated [35S]methionine labeled protein, an immunoprecipitate with an apparent molecular weight of 14,000 represented about 0.1% of total radioactivity in the translational products of poly A+ RNA of first trimester placenta. A less prominent band (0.006%) of the same apparent molecular weight was also evident from translational products of term placental mRNAs. This protein could be competed with either acromegalic serum or synthetic Sm-C/IGF-I when added prior to immunoprecipitation. Translational products synthesized from mRNA of term placenta showed a second labeled band of 24,000 daltons. This band was less effectively competed by acromegalic serum and not competed with either Sm-C/IGF-I or IGF-II and therefore its identity is uncertain. A protein similar to Sm-C/IGF-I is, therefore synthesized in first trimester placenta and to a lesser extent at term, suggesting developmental changes in Sm-C/IGF-I synthesis. Because Sm-C/IGF-I may act in a paracrine fashion, our findings suggest a role for Sm-C/IGF-I in growth of the placenta during early gestation. PMID- 3543657 TI - [Autocatalytic nature of "slow virus infections"]. AB - A concept that considers the causative nature of the so-called "slow virus infections", causing syndromes of spongiform encephalopathies in man and animals as a chain autocatalytic process is put forward. According to this concept, PrP(27-30) protein, isolated recently from the brains of scrapie-infected animals, is a C-terminal domain of the normal protein component of brain tissue which is a latent zimogen. Certain clinical and experimental data are discussed within the framework of this concept. Exogenous proteinases are presumed to be capable of triggering such a chain autocatalytic process in the brains of susceptible animals. Indeed, in one of our experiments, a subtoxic dose of pronase injected into mouse brain induced the development of a syndrome indistinguishable from spongiform encephalopathy in its clinical and pathomorphological manifestations. The probable role of neuron-specific proteins of intermediate filaments in such pathological processes is discussed. It seems possible that spongiform encephalopathies are particular cases of pathological processes that have catalytic nature. Presumably, the Alzheimer disease has such a catalytic causative nature. PMID- 3543656 TI - [Plasmid R1drd-19-mediated superoligomerization of the plasmid pACYC184in the recB mutant of Escherichia coli K12]. AB - It was found that monomers of the pACYC184 plasmid undergo superoligomerization in a recB mutant of Escherichia coli K12 which is deficient in ATP-dependent RecBC nuclease and carries the drug resistance plasmid R1drd-19. The observed effect is specifically related to the ability of R1drd-19 to determine an ATP dependent exonucleolytic activity which is functionally similar but not identical to the RecBC nuclease. The oligomerization of pACYC184 is accompanied by the formation of high-order circular structures, and this leads to elimination of the plasmid from cells growing under non-selective conditions. PMID- 3543658 TI - [Expansion of the median palatal suture: proposal of a method]. PMID- 3543660 TI - [Cholesterol accumulation in radicular cyst fluid--participation of heat-stable cholesterol binding protein]. PMID- 3543659 TI - Heterosexual transmission of human T lymphotropic virus type III: syphilis revisited. PMID- 3543661 TI - [A new retentive system using a hemispherical pontic form]. PMID- 3543662 TI - [Transformation of Hansenula polymorpha, Pichia guilliermondii, Williopsis saturnus yeasts by a plasmid carrying the ADE2 gene of Saccharomyces cerevisiae]. AB - Red adenine-dependent mutants of Hansenula polymorpha, Pichia guilliermondii, Williopsis saturnus yeasts have been transformed by the plasmid pYE (ADE2) 2 DNA containing ADE2 gene from Saccharomyces cerevisiae. The analysis of two P. guilliermondii Ade+-transformants has revealed the integration of pYE (ADE2)2 sequence into the recipient strain genome and partial restoration of the deficient function. PMID- 3543663 TI - Mutagenicity of halogenated and other substituted dinitrobenzenes in Salmonella typhimurium TA100 and derivatives deficient in glutathione (TA100/GSH-) and nitroreductase (TA100NR). AB - In a previous study, it was shown that 1-chloro-2,4-dinitrobenzene (CDNB) was less mutagenic in a glutathione (GSH)-deficient derivative of Salmonella typhimurium TA100 (TA100/GSH-) than in TA100 itself, suggesting that the mutagenicity of the compound is dependent on GSH, possibly mediated by the action of a bacterial nitroreductase(s) on the CDNB-GSH conjugate. In the present study a series of mutagenicity tests were performed to determine how CDNB could be activated after reaction with GSH. In liquid preincubation assays, strains TA100, TA100/GSH- and TA100NR, a nitroreductase-deficient derivative of TA100, were treated with CDNB and its fluoro and bromo analogues (FDNB and BDNB), further with its GSH conjugate (S-GSH-DNB) and possible metabolic products, such as S cysteine-dinitrobenzene (S-Cys-DNB) and S-methyl-dinitrobenzene (S-methyl-DNB), and with 2 more analogues, O-methyl-dinitrobenzene (O-methyl-DNB) and dinitrobenzene (DNB). CDNB, FDNB and BDNB were found to be mutagenic in TA100 and TA100NR, while TA100/GSH- was much less sensitive to the mutagenic action of these halogenated dinitrobenzenes. DNB, O-methyl-DNB, S-methyl-DNB and S-Cys-DNB induced equal numbers of His+ revertants in TA100 and TA100/GSH-, but were not mutagenic in TA100NR. S-GSH-DNB showed no mutagenic activity in any of the 3 strains under the present experimental conditions. These results suggest that the halogenated aromatics may react with bacterial DNA and produce pre-mutagenic alterations according to 2 mechanisms: direct attack on the DNA through nucleophilic substitution (SN2) of the halogen atoms; activation through GSH conjugation and subsequent nitroreduction of the conjugate or its metabolic products to more reactive intermediates. PMID- 3543664 TI - Comparative mutagenicity of halogenated pyridines in the Salmonella typhimurium/mammalian microsome test. AB - The Salmonella/microsome assay with strains TA97, TA98, TA100 and TA102 was used to examine the potential mutagenicity and structure-activity of 16 mono- and di halogenated pyridines. The chemical reactivity of the halopyridines suggests that nucleophilic displacement of halogens can occur with halogens at positions 2, 4 and 6 being displaced in addition-elimination reactions. 2-Chloropyridine gave a positive result with rat-liver metabolic activation, and 2-fluoropyridine gave equivocal results under these conditions. Mutagenic responses were also obtained with 2-chloromethyl pyridine and 3-chloromethyl pyridine, in both the presence and absence of rat-liver S9. These results suggest that the halogenated pyridines, especially with halogens at the 2-position, and singly on a methyl substituent, have mutagenic activity in the Salmonella assay. PMID- 3543665 TI - Monitoring the exposure of rats to 2-acetylaminofluorene by the estimation of mutagenic activity in excreta, sister-chromatid exchanges in peripheral blood cells and DNA adducts in peripheral blood, liver and spleen. AB - The sensitivity of various methods suitable for biomonitoring the exposure to genotoxicants was compared in an animal model. The results were related to the presence of genotoxic effects in the target organ. Groups of male Wistar rats were given one oral dose of 0, 0.1, 10 or 200 mg 2-acetylaminofluorene (2-AAF)/5 ml dimethyl sulphoxide/kg body weight. Peripheral blood cells, excreta, liver and spleen were collected at different time intervals after dosing. Mutagenicity in urine and extracts of faeces was determined using the Ames test with Salmonella typhimurium TA98 with and without S9 and with and without beta-glucuronidase. Genotoxic effects were studied by measuring DNA-adduct formation in lymphocytes, liver and spleen, and sister-chromatid exchanges (SCEs) in lymphocytes. DNA adducts were measured with immunochemical techniques and postlabelling methods. Mutagenicity in urine and faeces, collected during the first 24 h after treatment, was detected at 2-AAF doses of 1 mg/kg b.w. and higher. At these doses DNA adducts also became apparent in the liver, the main target organ for tumour induction by 2-AAF. The adduct detected appeared to be the N-(deoxyguanosin-8-yl) 2-AAF adduct. There was no evidence of the presence of any other types of DNA adducts. At doses of 1 and 10 mg/kg b.w. no mutagenicity was detected in excreta collected during the second and third day after dosing. The DNA-adduct level in liver cells of the 1 mg/kg b.w. group was maximal 24 h after dosing. At 200 mg/kg b.w. a delay in excretion of mutagenicity with urine and faeces was seen and at 10 and 200 mg/kg b.w. the amount of DNA adducts continued to increase with time after dosing. At 24 and 48 h after treatment with 10 mg, the adduct levels were of the same order of magnitude as those found after the 20-fold higher dose. This points to overloading of the metabolizing system which in combination with the enterohepatic circulation, may lead to an increased retention of 2-AAF in the body. A slightly increased incidence of SCEs of doubtful significance was seen in lymphocytes, but only at the very high dose of 200 mg/kg b.w. No DNA adducts could be detected in blood lymphocytes or spleen cells at any of the dose levels applied, either with the immunochemical or with the postlabelling method.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543666 TI - Induction of genetic tandem duplications in Salmonella by polycyclic aromatic hydrocarbon and amine carcinogens. AB - 6 polycyclic aromatic hydrocarbon or similar amine carcinogens were tested as inducers of genetic tandem duplications in a rough strain of Salmonella typhimurium. When metabolically activated by rat-liver microsomes, all 6 were active in inducing genetic tandem duplications, yielding from over 3 times to almost 14 times as many tandem duplicants per viable bacterium as did concurrent uninduced control cultures. These results extend the number and chemical diversity of carcinogens shown to induce genetic duplications in bacterial tester systems. We suggest that polycyclic hydrocarbon carcinogens may act in carcinogenesis by inducing genetic duplications or other genetic rearrangements. Duplication induction may be a useful genetic endpoint for screening potential carcinogens. PMID- 3543667 TI - Mutagenicity of pan residues and gravy from fried meat. AB - Lean pork meat was fried with or without the addition of frying-fat at 200 or 250 degrees C. The pan residues were collected by washing the hot pan with boiling water. When producing thickened gravy the water was substituted by a mixture of water and flour, milk and flour or cream and flour. The basic extracts were tested for mutagenicity in Ames' Salmonella test on strain TA98 with the addition of S9 mix. High amounts of mutagenicity were found in all samples. The amounts of mutagenicity in the pan residues were at a comparable level of the amounts found in the meat crusts. Thickening of the gravy caused only small changes in the mutagenicity. PMID- 3543668 TI - Mutagenic activity of nitro-substituted cyclopenta-fused polycyclic aromatic hydrocarbons towards Salmonella typhimurium. AB - Cyclopenta-fused isomers of pyrene and benz[a]anthracene, nitrated on the etheno bridge, were synthesized and tested in the Ames plate-incorporation assay. Since enzymatic reduction, if it occurs in these compounds, would form arylhydroxylamines which in turn would form highly stabilized arylnitrenium ions, we hoped to test the hypothesis that the direct-acting mutagenic activity of nitroPAH is correlated with the degree of stabilization of the electrophilic intermediate. We found that these compounds are mutagenic (1-9 rev/nmole in Salmonella typhimurium TA98) and do not require S9 activation. However, this activity is substantially lower than that of other nitroPAH of comparable size such as 1-nitropyrene (250-300 rev/nmole). The reasons for this comparative lack of activity are discussed with reference to current theories regarding structure activity relationships of nitroPAH. PMID- 3543669 TI - A comparison of the genetic activity of pyrvinium pamoate with that of several other anthelmintic drugs in Saccharomyces cerevisiae. AB - Several anthelmintic drugs that are used routinely in oxyuriasis therapy were analyzed for genotoxicity in a diploid mitotic recombination and gene conversion assay (strain D5 of Saccharomyces cerevisiae), and in a haploid yeast reversion assay (strain XV185-14C). Piperazine citrate, piperazine adipate, mebendazole and thiabendazole did not appear to be genotoxic in either yeast strain. Pyrvinium pamoate induced the reversion of the missense, nonsense and frameshift alleles in strain XV185-14C, whereas pyrantel pamoate induced only the reversion of the frameshift allele. Pyrvinium pamoate was recombinogenic in strain D5, and there is an indication that pyrantel pamoate, at the lowest dose that was tested, might induce gene conversion or aneuploidy. PMID- 3543670 TI - Lipid alterations induced by nifurtimox in Trypanosoma cruzi. AB - The influence of growth in the presence of nifurtimox on total lipids of Trypanosoma cruzi epimastigotes was determined. Nifurtimox-treated organisms showed greater amounts of unsaturated fatty acids as compared with control cells. 18:2 was the major component in the total esterified lipid fraction. Similar results were observed on the free fatty acid composition as detected by trimethylsilyl derivatization of the total lipids. PMID- 3543671 TI - Strain variation in the circumsporozoite protein gene of Plasmodium falciparum. AB - The complete nucleotide sequence of the cloned circumsporozoite protein gene of the Plasmodium falciparum Wellcome (West African) isolate has been determined. The sequence shows two striking differences from that of the published Brazilian strain; the total number of tandem 12 base pair repeats is 46 compared to 41, and the 5' coding region contains an additional 30 nucleotides. From Southern blot experiments, two out of four cloned Thai lines also have a similar, higher number of repeats. Heterogeneity in the CSP gene repeat region and in the length of the 5' coding region allows the strains to be classed into three groups, with the Wellcome strain being indistinguishable from the Thai line T9-94. PMID- 3543672 TI - Effect of tunicamycin on the extracellular acid phosphatase of Leishmania donovani promastigotes. AB - Inhibition of replication of Leishmania donovani promastigotes in axenic culture medium by tunicamycin, an inhibitor of asparagine linked protein glycosylation, depends upon the cell density of the culture at the time of addition of tunicamycin as well as upon the concentration of tunicamycin itself. Parasite multiplication in cultures with initial densities of less than or equal to 1 X 10(6) cells ml-1 and a tunicamycin concentration of 1 microgram ml-1 was limited to 2-3 replications, but this limitation was not observed in cultures with initial densities greater than or equal to 2 X 10(6) cells ml-1. Under conditions in which tunicamycin inhibited parasite growth and protein synthesis by only 15% and 6%, respectively, there was a greater than 90% reduction in the level of secreted acid phosphatase activity in comparison to control cultures. The extracellular acid phosphatase activity remaining in tunicamycin treated cultures was electrophoretically distinct from that found in control cultures. No significant decrease in the amount of [35S]methionine incorporated into acid insoluble products in the supernatant of tunicamycin treated cultures was observed, and a radiolabeled protein with an electrophoretic Mr of 97,000 was immunoprecipitated from this supernatant by an anti extracellular acid phosphatase antiserum. It was concluded that the L. donovani extracellular acid phosphatase, previously shown to be a mannose containing glycoprotein, contains N linked oligosaccharides which are necessary for maintenance of its catalytic activity, but not its secretion. PMID- 3543673 TI - Maturity-onset diabetes of youth in black Americans. AB - Twelve of 129 black patients with youth-onset diabetes were identified as having an unusual clinical course, with apparent insulin dependence at the time of presentation followed by absence of dependence months to years later. This atypical form of diabetes was found in at least two generations in 9 of the 12 families of the propositi. Fourteen of the diabetic relatives, as well as the 12 propositi, were studied. Islet-cell autoantibodies were not found in any of the patients, and thyroid microsomal auto-antibodies were found in only one. The frequencies of the insulin-dependent-diabetes-associated antigens HLA-DR3 and DR4 were not increased among the propositi, and diabetes did not cosegregate with HLA haplotypes in the informative families. Insulin secretion, as measured by C peptide responses to a liquid mixed meal (Sustacal), was intermediate between secretion in nondiabetic controls and that in patients with classic insulin dependent diabetes. Peripheral-blood monocytes expressed increased numbers of insulin receptors as well as decreased empty-site affinities. The atypical form of diabetes in black Americans can be distinguished from classically defined insulin-dependent diabetes and may be best classified as a form of maturity-onset diabetes of youth. PMID- 3543674 TI - Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy. Preliminary results. AB - Systemically disseminated cutaneous T-cell lymphoma is generally resistant to chemotherapy and radiotherapy. We tested a treatment involving the extracorporeal photoactivation of biologically inert methoxsalen (8-methoxypsoralen) by ultraviolet A energy to a form that covalently cross-links DNA. After oral administration of methoxsalen, a lymphocyte-enriched blood fraction was exposed to ultraviolet A (1 to 2 J per square centimeter) and then returned to the patient. The combination of ultraviolet A and methoxsalen caused an 88 +/- 5 percent loss of viability of target lymphocytes, whereas the drug alone was inactive. Twenty-seven of 37 patients with otherwise resistant cutaneous T-cell lymphoma responded to the treatment, with an average 64 percent decrease in cutaneous involvement after 22 +/- 10 weeks (mean +/- SD). The responding group included 8 of 10 patients with lymph-node involvement, 24 of 29 with exfoliative erythroderma, and 20 of 28 whose disease was resistant to standard chemotherapy. Side effects that often occur with standard chemotherapy, such as bone marrow suppression, gastrointestinal erosions, and hair loss, did not occur. Although the mechanism of the beneficial effect is uncertain, an immune reaction to the infused damaged cells may have restricted the activity of the abnormal T cells. This preliminary study suggests that extracorporeal photochemotherapy is a promising treatment for widespread cutaneous T-cell lymphoma. PMID- 3543675 TI - A computer data base for information on cancer treatment. AB - The Physician Data Query (PDQ) system is a clinically oriented computer data base developed to make recent information on cancer treatment widely available to the medical community. It represents an effort by the National Cancer Institute to promote diffusion of information about the treatment of cancer throughout the country, facilitate access to clinical trials, and accelerate the practical application of advances in research. The computer system provides information about state-of-the-art cancer treatment, which is updated monthly by an editorial board. It also includes a file of active cancer-research protocols and a directory of physicians and organizations providing cancer care to which physicians can gain access by geographic location as well as other features. PDQ was designed for physicians who may not be familiar with computers, to permit them to search for and display information without learning a specialized search language. PDQ uses a computer mainframe, which allows a large amount of data to be stored and made available to physicians rapidly and accurately. Transmission of information about cancer over commercial telecommunication networks gives health professionals access to PDQ by means of a computer terminal and local telephone lines. PMID- 3543676 TI - The changing climate of medical practice. What future for primary care private practice? PMID- 3543677 TI - Cachectin: more than a tumor necrosis factor. PMID- 3543678 TI - Antibiotic therapy in cancer patients with fever and neutropenia. PMID- 3543679 TI - The effects of biosynthetic human proinsulin on carbohydrate metabolism in non insulin-dependent diabetes mellitus. AB - We compared the glucose-lowering effect of proinsulin, the precursor molecule of insulin, with that of insulin itself. In patients with non-insulin-dependent diabetes mellitus (NIDDM) in whom proinsulin (0.2 U per kilogram of body weight) was subcutaneously injected at 9 a.m., fasting glucose levels (247 +/- 22 mg per deciliter [+/- SEM]) became normal within six hours and elevated rates of hepatic glucose output were lowered. The response to regular insulin (0.2 U per kilogram) was of similar magnitude but faster. Glucose clearance was stimulated less by proinsulin, reflecting its preferential action in suppressing glucose output. Hypoglycemia occurred in five of nine insulin-treated patients, but in only one of nine proinsulin-treated patients. After proinsulin injection at bedtime (30.5 +/- 4 U), serum proinsulin concentrations reached a peak by five hours and declined gradually thereafter. Fasting hepatic glucose output became normal, and euglycemia was sustained without overnight hypoglycemia. Proinsulin reduced plasma glucose more effectively than an equal unit dosage of NPH insulin, but since higher doses of NPH insulin were not used, no conclusions could be drawn about the relative desirability of these preparations for clinical use. We conclude that subcutaneously injected proinsulin has prolonged pharmacokinetics in plasma and can normalize plasma glucose in NIDDM characterized by severe hyperglycemia; as compared with the hypoglycemic effects of regular insulin, those of proinsulin are mostly due to suppression of hepatic glucose output, with little stimulation of glucose disposal and less hypoglycemia; and proinsulin may have a role in the treatment of NIDDM. PMID- 3543680 TI - Amiodarone. PMID- 3543681 TI - Liver transplantation in older patients. PMID- 3543682 TI - Primary biliary cirrhosis. PMID- 3543683 TI - Development of antiretroviral therapy for the acquired immunodeficiency syndrome and related disorders. A progress report. AB - We review the rationale for, and progress in, the development of antiviral therapy for the acquired immunodeficiency syndrome (AIDS). A consideration of the replicative cycle of the human immunodeficiency virus (HIV) can lead to the identification of several steps that represent potential targets for antiretroviral therapy, and several substances that can inhibit the replication of HIV in vitro have already been identified. The 2',3'-dideoxynucleosides are a class of nucleoside analogues in which the 3'-hydroxy group is modified so that it cannot form phosphodiester linkages for nucleic acid chains. Some are potent in vitro inhibitors of HIV replication, possibly acting as chain terminators of viral DNA during reverse transcription. One of these dideoxynucleoside analogues, 3'-azido-2',3'-dideoxythymidine (AZT), has now been administered for up to 18 months to patients with AIDS. The drug has been shown to improve immunologic function, to reverse, at least partially, HIV-induced neurologic dysfunction in some patients, and to improve certain other clinical abnormalities associated with AIDS. The principal toxic effect associated with AZT is dose-dependent suppression of bone marrow, resulting particularly in anemia and leukopenia; however, most patients in whom this toxic effect occurs can subsequently tolerate a lower dose of the drug. The demonstration that AZT can be beneficial in patients with AIDS has removed some of the uncertainty about the rationale for an antiretroviral intervention in HIV infection. PMID- 3543684 TI - CMI description of pathogenic fungi and bacteria. PMID- 3543685 TI - Evolutionary adaptations. Aristotle's theory of mammalian teat number is confirmed. PMID- 3543686 TI - Non-tolerance and autoantibodies to a transgenic self antigen expressed in pancreatic beta cells. AB - Transgenic mice expressing simian virus 40 T antigen under control of the insulin gene regulatory region vary in their response to this protein. Each lineage is characteristically either tolerant to T antigen, or not, in which case autoantibodies arise with high frequency, and lymphocytes infiltrate and disrupt the pancreatic islets. Both non-tolerance and the autoimmune response appear to result from delayed onset of T antigen expression during beta cell development. PMID- 3543687 TI - Astrocytes induce blood-brain barrier properties in endothelial cells. AB - The highly impermeable tight junctions between endothelial cells forming the capillaries and venules in the central nervous system (CNS) of higher vertebrates are thought to be responsible for the blood-brain barrier that impedes the passive diffusion of solutes from the blood into the extracellular space of the CNS. The ability of CNS endothelial cells to form a blood-brain barrier is not intrinsic to these cells but instead is induced by the CNS environment: Stewart and Wiley demonstrated that when avascular tissue from 3-day-old quail brain is transplanted into the coelomic cavity of chick embryos, the chick endothelial cells that vascularize the quail brain grafts form a competent blood-brain barrier; on the other hand, when avascular embryonic quail coelomic grafts are transplanted into embryonic chick brain, the chick endothelial cells that invade the mesenchymal tissue grafts form leaky capillaries and venules. It is, however, not known which cells in the CNS are responsible for inducing endothelial cells to form the tight junctions characteristic of the blood-brain barrier. Astrocytes are the most likely candidates since their processes form endfeet that collectively surround CNS microvessels. In this report we provide direct evidence that astrocytes are capable of inducing blood-brain barrier properties in non neural endothelial cells in vivo. PMID- 3543688 TI - First human AIDS vaccine trial goes ahead without official OK. PMID- 3543689 TI - A cytosolic protein contains a cryptic mitochondrial targeting signal. AB - Cytosolic dihydrofolate reductase from mouse contains a cryptic mitochondrial targeting sequence. If this sequence is attached to the amino terminus of 'passenger' proteins which by themselves cannot enter mitochondria, the resulting fusion proteins are transported into yeast mitochondria. PMID- 3543690 TI - Role of Staphylococcus protease in the development of influenza pneumonia. AB - In influenza the combined virus-bacterial pneumonia is approximately three times more common than primary viral pneumonia. The bacteria most commonly involved are Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae. S. aureus co-infection is reported to have a fatality rate of up to 42% (ref. 2). It is thought that virus infection in the respiratory tract favours growth conditions for bacteria. In this letter data are presented which show that some S. aureus strains secrete a protease which exerts a decisive influence on the outcome of influenza virus infection in mice by cleavage activation of the virus haemagglutinin. PMID- 3543691 TI - Transient cells of the developing mammalian telencephalon are peptide immunoreactive neurons. AB - In the development of the mammalian telencephalon, the genesis of neurons destined for the various layers of the cerebral cortex is preceded by the generation of a population of cells that comes to reside in the subplate and marginal zones (see ref. 2 for nomenclature). In the cat, these cells are present in large numbers during development, when their location is correlated with the arrival and accumulation of ingrowing axonal systems and with synapses. However, as the brain matures, the cells disappear and the white matter and layer 1 of the adult emerge. Their disappearance occurs in concert with the invasion of the cortical plate by the axonal systems and with the elimination of the synapses from the subplate. Here we report that the subplate cells have properties typical of mature neurons. They have the ultrastructural appearance of neurons and receive synaptic contacts. They also have long projections and are immunoreactive for MAP2 (microtubule associated protein 2). Further, subpopulations are immunoreactive for one of several neuropeptides. These observations suggest that during the fetal and early postnatal development of the mammalian telencephalon the subplate cells function as neurons in synaptic circuitry that disappears by adulthood. PMID- 3543692 TI - A novel c-abl protein product in Philadelphia-positive acute lymphoblastic leukaemia. AB - Activation of cellular proto-oncogenes as a result of chromosomal abnormalities has been implicated in the development of some human malignancies. Perhaps one of the most striking examples of this association occurs in chronic myelogenous leukaemia, where the Philadelphia (Ph) translocation results in substitution of the 5' end of the c-abl proto-oncogene with bcr gene sequences. A unique hybrid bcr-abl message is produced. As the Ph translocation is also present in some patients with acute lymphoblastic leukaemia, we initiated studies to determine if similar genomic events occur in these two different forms of Ph-positive leukaemia. Here we report that the Ph translocation in acute lymphoblastic leukaemia can result in production of a novel aberrant c-abl protein that is distinct from the bcr-abl protein found in Ph-positive chronic myelogenous leukaemia. Our observations suggest that alternative mechanisms of activation of c-abl exist, and may be important in the development of human acute lymphoid rather than chronic myeloid malignancies. PMID- 3543693 TI - Mammalian and bacterial sugar transport proteins are homologous. AB - The uptake of a sugar across the boundary membrane is a primary event in the nutrition of most cells, but the hydrophobic nature of the transport proteins involved makes them difficult to characterize. Their amino-acid sequences can, however, be determined by cloning and sequencing the corresponding gene (or complementary DNA). We have determined the sequences of the arabinose-H+ and xylose-H+ membrane transport proteins of Escherichia coli. They are homologous with each other and, unexpectedly, with the glucose transporters of human hepatoma and rat brain cells. All four proteins share similarities with the E. coli citrate transporter. Comparisons of their sequences and hydropathic profiles yield insights into their structure, functionally important residues and possible evolutionary relationships. There is little apparent homology with the lactose-H+ (LacY) or melibiose-Na+ (MelB) transport proteins of E. coli. PMID- 3543694 TI - Photofootprinting in vivo detects transcription-dependent changes in yeast TATA boxes. AB - To elucidate critical steps in the transcription initiation process, we have devised a protocol for obtaining information about DNA structure and DNA-protein interactions at nucleotide level resolution from intact yeast cells. Our procedure combines the ultraviolet light 'footprinting' method developed by Becker and Wang with the 'genomic sequencing' technique described by Church and Gilbert. Using this approach we were able to detect the binding of GAL 4 protein at sites within the upstream activating sequence (UASG) previously mapped using other in vivo and in vitro foot-printing procedures. We also observed transcription-dependent changes in sensitivity of DNA to ultraviolet-induced covalent modification at several positions between the upstream activating sequence and the transcription initiation sites of the GAL 1 and GAL 10 genes. The most prominent of these changes occurs at a common site within the putative 'TATA' boxes of the two genes. Ultraviolet modification at this site is enhanced only in transcriptionally active promoters. PMID- 3543695 TI - Binding of a non-beta-lactam antibiotic to penicillin-binding proteins. AB - In the search for new beta-lactam antibiotics of natural origin, the discoveries of cephamycins and sulfazecins (monobactams) were important turning points in that they accelerated many screening efforts aimed at other new compounds. In our target-directed screening for beta-lactam antibiotics using beta-lactam hypersensitive mutants, we have examined Gram-negative bacteria isolated from natural habitats and have recently reported several types of beta-lactam antibiotics such as cephabacins and formadicins. Here we report a novel antibiotic, lactivicin, found using this system. Although lactivicin has various biological activities commonly observed in beta-lactam antibiotics, it does not possess a beta-lactam ring in its molecule, but has the unique structure of a dicyclic dipeptide. PMID- 3543696 TI - Pay-as-you-go trials anger government cancer researchers. PMID- 3543697 TI - Magnetic field provokes the increase of prostacyclin in aorta of rats. PMID- 3543698 TI - Detection of genotoxic properties of mycotoxins with the SOS chromotest. PMID- 3543701 TI - [A family with meningococcal infections]. PMID- 3543700 TI - Spermicides and sexually transmitted diseases: new perspectives. PMID- 3543703 TI - [Dr. B.H. Sajet, sociologist-physician of stature]. PMID- 3543702 TI - [Prenatal diagnosis of cystic fibrosis]. PMID- 3543699 TI - Protective effect of prostaglandins D2, E1 and I2 against cerebral hypoxia/anoxia in mice. AB - The protective effect of prostaglandins (PGs) against cerebral hypoxia/anoxia was investigated with a variety of experimental models in relation to their CNS depressant effects in mice. Furthermore, the effect of PGs on the changes of cerebral energy metabolites and cyclic nucleotide was examined in hypoxic mice. Mice were given s.c. doses of PGs 30 min before tests. Among the PGs tested, treatment with PGD2, PGE1 and PGI2 Na showed a consistent and dose-dependent protection against cerebral anoxia induced by all models studied: histotoxic anoxia by KCN, hypobaric hypoxia, normobaric hypoxia and decapitation-induced gasping. However, PGA1, PGA2, PGB1, PGB2, PGE2, PGF1 alpha, PGF2 alpha and 6-keto PGF1 alpha at a dose of 3 mg/kg were without effect against normobaric hypoxia and gasping duration. The three PGs, i.e. PGD2, PGE1 and PGI2 which showed anti hypoxic effects decreased locomotor activity and potentiated hexobarbital-induced sleep. On the other hand, PGE2, PGA1, PGA2 and PGB2 also caused a decrease in locomotor activity. Similarly, PGE2 and PGA1 caused a potentiation of hexobarbital-induced sleep, but interestingly they did not cause clear-cut increase in cerebral resistance to hypoxia, in contrast with the former three PGs. Thus general depression of CNS function appears not to be responsible for the PGD2-, PGE1- and PGI2-induced increase in cerebral resistance to hypoxia. The levels of Cr-P and ATP were significantly reduced and those of ADP and AMP were markedly elevated in hypoxic brain, resulting in a decrease in a calculated energy charge potential. The lactate level and lactate/pyruvate ratio increased and the glucose level decreased markedly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543704 TI - Pre-screening of carcinogens by studying of DNA synthesis inhibition and gene mutations in mammalian cells. AB - The ability to induce gene mutations at the HGPRT locus in Chinese hamster V79 cells and to inhibit DNA synthesis in human EUE cells has been followed in eighteen chemical substances and ultraviolet light. The aim was to determine whether following of inhibition of DNA synthesis in impaired human cells may serve as an indicator of the mutagenicity of the relevant chemical substance. The results permit us to assume that following of DNA synthesis, the so-called DNA inhibition test provides a preliminary information on the genotoxicity of the chemical substance, although the degree of inhibition of DNA synthesis need not necessarily denote the measure of the mutagenic effect of the substance. As certain further tests, utilising in vitro mammalian cells, so also the DNA inhibition test yields a certain percentage of false positive results. Hence, it is important to combine this test with further express in vitro tests on the level of mammalian cells. PMID- 3543705 TI - The effect of the prophylactic use of absorbable and non-absorbable antibiotics on the incidence of urinary tract infections in recipients of cadaveric kidney transplants. PMID- 3543706 TI - Liver transplantation in Groningen--long-term survivors in the first cohort. PMID- 3543707 TI - High-dosage chemotherapy with autologous bone marrow reinfusion in the treatment of patients with solid tumours. The Groningen experience, 1981-1986. PMID- 3543708 TI - What is the basis for the use of steroids in the treatment of idiopathic membranous nephropathy? AB - In the past 30 years steroids have been widely employed in the management of primary glomerulopathies. At variance with 'minimal-change nephropathy', in which glucocorticoids are of well-known value, in other forms of immune-mediated glomerulopathies and particularly in idiopathic 'membranous glomerulopathy' results of controlled trials are inadequate or controversial. Retrospective analysis of the data reported in the literature indicates a beneficial effect in some series but appears disappointing in others. Certainly the use of high-dose steroids for a prolonged period of time can expose the patients to serious side effects. The aim of the present review is to critically evaluate the results obtained with the use of steroids in the treatment of 'membranous glomerulopathy' and reexamine the rationale of their use in the light of the new information on the glucocorticoids mechanism of action on the immune system. PMID- 3543709 TI - Phase contrast microscopy of the urine sediment for the diagnosis of glomerular and nonglomerular bleeding-data in children and adults with normal creatinine clearance. AB - In a pediatric and in an adult group of patients with hematuria and normal creatinine clearance overnight urine examination was carried out on 2 nonconsecutive days by means of phase contrast microscopy by two independent observers working in two different institutions. In this way it was possible to distinguish between patients on the basis of dysmorphic (glomerular) and isomorphic (nonglomerular) red cells in urine and to correlate the findings with the final diagnosis. A clear-cut indication (more than 80% of isomorphic and/or dysmorphic red cells) was obtained in 163 patients (102 of pediatric age) and final diagnosis of hematuria correlated with red-cell microscopy findings in 96.4% of glomerular diseases and in all cases of nonglomerular origin. Mixed hematuria (50-75% of dysmorphic red cells) was found in 2 cases of renal tuberculosis, 2 cases of polycystic kidney disease and in 1 child with viral meningoencephalitis with a bladder stone. The data indicate that the method is safe and accurate but further experience must be gathered for the many etiologies of glomerular and nonglomerular diseases hitherto not studied. PMID- 3543710 TI - Unusual complication in a patient with renal transplantation: cerebral cysticercosis. AB - A patient with cadaveric renal transplantation was diagnosed by brain-computed tomography and ELISA as having neurocysticercosis in the CSF. Complete cure was achieved after praziquantel therapy. Function of the allograft was not affected. PMID- 3543711 TI - Renin and blood volume in chronic renal failure: a comparison with essential hypertension. AB - Sixty-five patients with advanced chronic renal failure (CRF) but a normal extracellular fluid volume (ECFV), including 31 dialysis patients, were studied. Plasma volume, blood volume (BV), plasma renin activity (PRA), and mean arterial pressure were measured to examine whether hypertension (when present) is renin dependent, or whether it is related to an abnormal distribution of ECFV between the intra- and extravascular spaces. PRA was higher in dialysis than nondialysis patients, but the incidence of hypertension was the same. In both groups hypertensive patients with normal PRA and normotensive patients with elevated PRA were present. The patients were compared to 65 patients with essential hypertension (EH) and 56 normals. The BV and BV-to-interstitial fluid volume ratio were similar in these groups. We found no decreased BV in patients with EH as has previously been reported by others, possibly because we used an appropriate normalization index and matched control groups. In sum, hypertension in CRF patients with a normal ECFV cannot always be explained by elevated renin levels. In this respect, CRF patients resemble patients with EH. An abnormal extracellular fluid distribution does not seem to be involved in the maintenance of hypertension. PMID- 3543712 TI - Non-fatal leishmaniasis in a renal transplant recipient. PMID- 3543713 TI - About the treatment of lymphocele. PMID- 3543714 TI - [Polar coordinates for Talairach's stereotaxic system. Use of Reichert's stereotaxic system arcs with Talairach's frame]. AB - A description of the adaptation of Riechert's stereotactic aiming--bows to the stereotactic frame of Talairach is given. The combination facilitates the use of polar coordinates in the orthogonal system of Talairach for targets in the midline and near to the midline such as tumors, nuclei of the thalamus for example. PMID- 3543715 TI - Comparison of the behavioral effects of neurotoxic and systemically toxic agents: how discriminatory are behavioral tests of neurotoxicity? AB - The behavioral effects of carbon tetrachloride-produced impairment of liver function, insulin-produced reduction of plasma glucose levels, and the reduction of food and water intake have been evaluated. Considerable similarity was found among the behavioral effects of systemically toxic agents, three neurotoxicants (triethyltin, acrylamide, and 2,5-hexanedione), and the neuroleptic drug haloperidol. Measure of motor strength differentiated neurotoxic from non neurotoxic compounds, while measures of motor activity were equally sensitive to neurotoxic, systemically toxic, and non-neurotoxic agents. These findings demonstrate the importance of assessing systemic toxicity before drawing conclusions about the neurotoxicity of a behaviorally active compound. PMID- 3543716 TI - Copper stimulation of LHRH release from median eminence explants. II. A process dependent on chloride transport. AB - We have previously shown that chelated copper stimulates LHRH release from explants of the median eminence area (MEA). Characteristics of this release process are: ligand and metal specificity, the involvement of a limited number of copper interactive sites, and a lack of dependence on extracellular calcium. Since chloride transport is essential for exocytosis of peptides and biogenic amines, we wished to ascertain if chloride transport is essential for the process of CuHis-stimulated release of LHRH. MEA explants were incubated for 15 min with 100 microM CuHis (phase I) and then for 15 min in copper-free medium (phase II) and LHRH released into the medium was evaluated by RIA. In the presence of 136 mM Cl, CuHis stimulated the release of LHRH from a basal level of 5 +/- 0.4 pg/15 min per MEA to 17 +/- 0.9 pg during phase I and to 30 +/- 1.2 pg during phase II. In the absence of Cl-, the CuHis-stimulated release of LHRH during phases I and II was inhibited by 80 and 90%, respectively. In the presence of 136 mM Cl- and the anion transport inhibitor SITS (4-acetamido-4'-isothiocyanostilbene-2,2' disulfonic acid) the stimulated release was completely inhibited in both phases. When the selectivity of this release process for monovalent anions was tested, the effectiveness of the anions in supporting CuHis-stimulated LHRH release was in this decreasing order: Cl- greater than Br- greater than SCN- = acetate greater than I- = isethionate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543717 TI - Colocalization of peptide histidine isoleucine amine and corticotropin-releasing factor immunoreactivity in neurons of the rat hypothalamus: a surprising artefact. AB - Indirect immunocytochemistry of corticotropin-releasing factor (CRF) and peptide histidine isoleucine amide (PHI) was performed by the use of antibodies raised to CRF and PHI. The staining intensity was quantitated by using an automated microfluorimeter. CRF and PHI immunoreactive fibres showed a similar pattern of distribution in the zona externa of the median eminence of the rat hypothalamus. Administration of colchicine (50 micrograms i.c.v.) resulted in the appearance of PHI and CRF immunoreactive cell bodies in the parvocellular part of the paraventricular nucleus. The PHI immunoreactive cell bodies were of low intensity and less abundant than those stained with the CRF antisera. Microfluorimetric measurements of the immunostaining in the median eminence showed parallel changes of PHI and CRF immunostaining after adrenalectomy, administration of reserpine and/or pargyline. In order to evaluate whether these data demonstrate that PHI and CRF are colocalized in hypothalamic neurons, we studied the specificity of PHI immunostaining by the use of a nonbiological gelatin model. Although CRF and PHI do not show structural homologies, the PHI antisera caused staining of PHI containing gels (range: 0.001-1 microM) but also of rat CRF (rCRF)-containing gels (range: 10-300 microM). In addition, preincubation of one of the PHI antisera with PHI or rCRF both caused a concentration-dependent quenching of the immunostaining in PHI- and CRF-containing gels and in preparations of the median eminence. Again, higher concentrations of rCRF (100 microM) than PHI (0.1 microM) were needed to show immunoinhibition, suggesting that the PHI antiserum has much lower avidity for native and fixed rCRF than for native and fixed PHI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543718 TI - Gonadotropin-releasing hormone-like immunoreactivity in rat placenta. AB - The concentration of gonadotropin-releasing hormone (GnRH) in the placenta, maternal plasma and fetal hypothalamus was measured in rats during days 13-21 of gestation. A substantial amount of GnRH was detectable in the extract of placenta and maternal plasma samples collected between days 13 and 21 and in the extract of fetal hypothalamus collected between days 19 and 21 of pregnancy. The GnRH level in the placenta and fetal hypothalamus, but not in plasma, fluctuated significantly during pregnancy. The level of GnRH gradually decreased in the placenta but increased in the fetal hypothalamus as the pregnancy proceeded. After gel filtration of placental extract, GnRH eluted in the same position as synthetic GnRH and hypothalamic GnRH. Dilution of placental extracts produced a displacement curve parallel to that of GnRH and hypothalamic extracts. These results indicate that GnRH is present in the placenta and that placental GnRH may have a role in the maintenance of pregnancy in rats. PMID- 3543720 TI - Positive rolandic sharp waves and periventricular leukomalacia in the newborn. AB - Four cases of periventricular ischemia without hemorrhage in premature infants are described in which positive rolandic sharp waves (PRSW) were predominant in the electroencephalogram (EEG). These findings suggest the relationship of PRSW to periventricular ischemia rather than to intraventricular hemorrhage, per se, as has been considered by most investigations in the past. These PRSW can provide an early indication of periventricular leukomalacia. PMID- 3543719 TI - Morphological evidence that luteinizing hormone-releasing hormone neurons participate in the suppression by estradiol of pituitary luteinizing hormone secretion in ovariectomized rats. AB - Morphological characteristics of LHRH neurons identified by immunocytochemistry were studied using light and electron microscopy in female rats in which estradiol was replaced at the time of ovariectomy ('pseudo-intact' rats) or 3 weeks after ovariectomy (long-term ovariectomized, estradiol-treated). While estradiol levels were equivalent in these two groups, the rise in LH after ovariectomy was prevented by the immediate administration in the pseudo-intact rats, while the augmented plasma LH levels present three weeks following ovariectomy were only reduced by 50% as a result of delayed estradiol treatment. The LHRH content of the medial basal hypothalamus (MBH) including the median eminence (ME) was greater in pseudo-intact females than in untreated long-term ovariectomized control females or long-term ovariectomized, estradiol-treated females, both 1 and 14 days after estradiol exposure. Immunocytochemistry revealed fewer LHRH-immunopositive neuronal processes coursing throughout the MBH and terminating in the ME of long-term ovariectomized, estradiol-treated rats compared to those in pseudo-intact rats. However, within individual neurovascular terminals in the ME, image analysis revealed that the area of reaction product was greater in long-term ovariectomized, estradiol-treated animals. Equivalent amounts of LHRH were assayed in the MBH within each group of animals by several LHRH antisera regardless of their different binding requirements (R42, IJ29 and A R743), suggesting that the predominant moiety present in neuronal terminals is the fully mature decapeptide. In contrast, in the preoptic area-anterior hypothalamus (POA-AH) these antisera assayed amounts of LHRH that varied as a function of binding characteristics, although the quantities did not vary with the estradiol treatment schedule. Immunocytochemical results paralleled these assay data; antisera requiring an interior sequence of amino acids (A-R743 and A R419) detected approximately 3 times as many immunoreactive perikarya in the POA AH as did an antiserum requiring the free amidated C terminal (IJ29). The estradiol treatment schedules had no effect on the total number of LHRH immunopositive neurons detected by each antiserum or the distribution of LHRH immunopositive neuronal perikarya. These data support the hypothesis that the predominant moieties present in neuronal cell bodies are precursor forms. The fine-structural characteristics of LHRH-immunopositive neuronal cell bodies are consistent with greater secretory and biosynthetic activity in LHRH neurons of long-term ovariectomized, estradiol-treated rats.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543721 TI - Laser-assisted microsurgical anastomosis. AB - A low power carbon dioxide laser was used to perform 212 end-to-end laser assisted microvascular anastomoses (LAMA) of femoral arteries (mean diameter, 1.2 mm) in Sprague-Dawley rats. Eighty-two conventional microvascular suture anastomoses (CMSA) utilizing 10-0 monofilament interrupted sutures were done for comparison of techniques and wound healing. The mean duration of each anastomosis procedure was 16 minutes for the LAMA repairs, compared to an average of 27 minutes for the CMSA repairs (P less than 0.05). All anastomoses were patent at the completion of the procedure. Each laser-assisted anastomosis required an average of seven intermittent laser exposures of 0.1 to 0.3 seconds each with approximately 80 mW of CO2 (wavelength = 10.6 micron) radiation at a spot size of 150 micron. A patency rate of 95% was obtained on the LAMA vessels (202 of 212) compared to 96% for the CMSA repairs (79 of 82). A total of 14 aneurysms were noted in the LAMA group (7%) compared to 11 in the CMSA (13%). All aneurysms were in patent vessels. Histological analysis indicates that the progression of wound healing of LAMA and CMSA anastomoses follows similar paths chronologically and morphologically with increased scar tissue formation around the suture. Scanning electron microscopy confirms the comparable luminal healing of the LAMA and CMSA vessels, with complete reendothelialization occurring by 3 weeks postoperatively. The tensile strength of the LAMA repair, although low immediately after operation, is comparable to that of the intact artery at 21 days. These findings suggest that a low energy carbon dioxide microsurgical laser has potential beneficial clinical application for anastomosis of small vessels. PMID- 3543722 TI - Prediction of outcome and the management of severe head injuries: the attitudes of neurosurgeons. AB - We gave a questionnaire to a multinational group of 59 neurosurgeons to discover their views about certain aspects of predictions of outcome after severe head injury. Although there was wide variation in the opinions expressed, a majority of clinicians agreed that estimations of prognosis are possible within 3 days of severe head injury, that these estimates influence some of their management decisions, and that computer predictions should be at least as reliable as those of an experienced clinician. The findings suggest that clinicians may be receptive to the use of computerized predictions of outcome, but also indicate that many other factors influence difficult clinical decisions. PMID- 3543723 TI - Magnetic and electrical transcranial brain stimulation: physiological mechanisms and clinical applications. AB - The human brain can be stimulated by electric shocks or by brief intense magnetic fields. The latter cause only a trivial scalp sensation. Stimuli exciting the motor cortex cause contralateral muscle responses, but the threshold for excitation is markedly reduced by slight voluntary contraction of the target muscle. For small hand muscles, the overall latency from scalp to muscle is shorter by 1.8 ms when electrical stimuli are used than when stimuli are magnetic. Central motor conduction time (CMCT) can be estimated by stimulating over the scalp and then over the cervical area. In healthy subjects, the CMCT is 6.1 +/- 0.8 (SD) (n = 29). Physiological studies have shown that the facilitation of responses in hand muscles produced by voluntary contraction is also present when contralateral muscles are used, but not when a leg muscle is contracted. The mechanism of facilitation may involve neural activity at both spinal and cortical levels. Single motor units can be caused to discharge by threshold brain stimuli. These motor units are the same ones activated first during weak voluntary contractions. Clinical studies have shown that the CMCT may be greatly prolonged in patients with multiple sclerosis and that subclinical motor pathway lesions can be detected. Central conduction may also be abnormal in patients with motor neuron disease and cervical myelopathy. Side effects have not been encountered with either type of stimulator. PMID- 3543724 TI - Evaluation of conduction in central motor pathways: techniques, pathophysiology, and clinical interpretation. AB - This communication summarizes the highlights of this symposium and reviews our current understanding of the clinical neurophysiology of conduction in central motor pathways produced by transcranial or direct brain stimulation. Direct (D wave) and indirect (I wave) volleys of descending impulses in the pyramidal system result from motor cortex stimulation and determine the measured responses. The advantages and disadvantages of the electrical and the magnetic stimulating modalities are assessed. The increased latency produced by magnetic as opposed to electrical stimulation is considered. Present clinical applications are discussed. The safety record is encouraging, but has aspects that must be addressed. Potential problems of the interpretation of motor evoked potentials in patients with central nervous system disease are emphasized in light of the pathophysiological mechanism underlying these potentials. PMID- 3543725 TI - Interstitial brachytherapy of malignant brain tumors using computed tomography guided stereotaxis and available imaging software: technical report. AB - The implantation of radioactive sources into malignant intraaxial brain tumors, interstitial brachytherapy, is a theoretically attractive treatment for these nearly uniformly fatal lesions. Optimal application of this treatment modality requires careful preoperative planning, computer-assisted dosimetry, and computed tomography-guided stereotactic implantation of the isotope-bearing catheters. A method is presented by which available computed tomographic imaging software can be used with a standard radiotherapy treatment planning computer and the Brown Roberts-Wells stereotactic system for preoperative imaging, dosimetry planning, and brachytherapy catheter insertion. Dedicated computer facilities are not required, making this method available to any neurosurgeon with access to a current generation computed tomographic scanner. PMID- 3543726 TI - Review of descending motor pathways involved with transcranial stimulation. AB - The anatomical basis of the pyramidal tract is reviewed with respect to its proposed role in the conduction of the motor evoked potential. The fiber diameter profiles are discussed in relation to the measured conduction velocities of the corticospinal tract in humans. Stimulus parameters utilized to obtain the motor evoked potential are reviewed in relation to the laterality of response, response threshold, and properties of spatial and temporal summation. A discussion of the major descending tracts involved with walking as opposed to fine distal use of the digits is undertaken in the context of the possible prognostic capabilities of the motor evoked potential. PMID- 3543727 TI - Physiological basis of motor effects of a transient stimulus to cerebral cortex. AB - This contribution includes a selective review of previously published material, findings from some new experiments, and discussion of some relationships between animal and recent human data. The major questions are: What descends from the cerebral cortex after a brief surface stimulus? What explains the various components of the corticofugal discharge? What are the motor consequences of the corticofugal discharge, and what are the effects of lesions on both? The focus is on the corticospinal system, which through its monosynaptic connection with alpha motoneurons of distal muscles accounts for the short latency movements after a transient cortical stimulus. The pyramidal and lateral corticospinal tract response in monkey or cat to a surface stimulus applied to area 4 is a direct (D) wave conducted in fast axons followed by several indirect (I) waves with a period of greater than 1 ms. Although computer summing reveals, at increasing amplitudes, D and I waves in recordings from nuchal skin, vertebra, and surface of the spinal cord, "killed end" recording is essential to reveal the true extent of I relative to D waves. The D wave might result from excitation of: the initial segment (IS), i.e., the classical spike trigger zone; the first or deeper nodes in white matter; or arborizations of the axon collaterals in gray matter. Under different circumstances, each of these modes of excitation can be effective. Thus, with threshold stimulation through separated bipolar electrodes, intracellular recording from pyramidal tract (PT) and uninvaded motor cortical neurons shows that D activation usually occurs when the membrane potential immediately before the stimulus is relatively depolarized, implying excitation of the IS region, i.e., close to the site of synaptic transfer. A monopolar surface (+) stimulus at the appropriate focus usually generates a D wave at weaker intensity than does a surface (-) stimulus. However, if a little above threshold, stimuli of either polarity generate both D and I waves, but the ratio of D:I amplitude is usually greater with surface (+) stimulation. A theoretical estimate of the depth of excitation by a surface (+) stimulus was consistent with threshold excitation occurring at the first node. Slow PT neurons are excited by surface stimulation, but trivially contribute to population PT or corticospinal recordings. Intracellular recording from PT neurons identifies a monosynaptic excitatory postsynaptic potential as the cause of the first I wave, the period between successive I waves reflecting single delays for synaptic discharge.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543728 TI - Classics in neurology. Benjamin Winslow Dudley and the surgical treatment of epilepsy. PMID- 3543729 TI - [Efficacy of a randomized treatment with intravenous streptokinase in evolving myocardial infarction. In-hospital clinical and radionuclide evaluation and a follow-up]. PMID- 3543731 TI - [Study of carotid flow and cerebral circulatory impedance using Doppler computerized spectral analysis. Evaluation of the effect of buflomedil]. PMID- 3543730 TI - [Prevention of deep venous thrombosis with low-dose heparin in patients with acute uncomplicated myocardial infarct: double-blind controlled study]. PMID- 3543732 TI - [Systolic-diastolic function of the left ventricle and flowmetry of the lower limbs in the treatment of moderate essential arterial hypertension with atenolol chlorthalidone]. PMID- 3543733 TI - [Treatment of severe asthma attacks by continuous distending pressure]. PMID- 3543734 TI - [CPAP with face mask in severe acute asthma. Description of a clinical case]. PMID- 3543735 TI - [Hepatocellular transplant in the treatment of acute hepatic failure. An experimental study in rats]. PMID- 3543736 TI - [Flail chest: physiopathological and therapeutic considerations]. PMID- 3543737 TI - [Role of echography in the diagnosis of abdominal hydatid disease]. PMID- 3543739 TI - [Echographic study in evaluating gastrointestinal pathology]. AB - The echographic study of the gastrointestinal tract is hampered by the presence of gas that prevents the long-range penetration of the ultrasound beam. However the presence of a mass with a central echogenic region surrounded by a sonolucent wall of over 1.5 cm is characteristic of intestinal pathologies. A study of 23 patients with gastrointestinal disorders in whom echography revealed specific pictures is presented. PMID- 3543738 TI - Use of horseshoe kidneys for transplantation. AB - Report of a case in which a horseshoe kidney was divided and transplanted into two recipients. The literature on transplantation of horseshoe kidneys is reviewed. This renal anomaly is not a contra-indication to its use for transplantation. PMID- 3543741 TI - [Intrahepatic presinusoidal portal hypertension in a female patient with chronic lymphatic leukemia]. AB - A rare case of intrahepatic presinusoidal portal hypertension, due to massive infiltration of portal zones by chronic lymphatic leukaemia, revealed by sonographic patent umbilical vein, is reported. Sonographic patent umbilical vein which is considered specific for portal hypertension in liver cirrhosis may be present in myeloproliferative syndromes with liver involvement too. PMID- 3543740 TI - [Serum ferritin levels in patients with hemolymphopathies and solid neoplasms in an advanced phase: a comparison with healthy subjects and liver cirrhosis patients]. AB - The immunoenzyme method was used to measure serum ferritin levels in 55 patients with haemolymphopathies and advanced solid tumours. Patients were divided into five groups according to tumour type. 50 healthy subjects and 12 patients with cirrhosis of the liver were also studied. In 76% of the cancer patients ferritin levels were significantly higher than in the control group of healthy subjects (p less than 0.01). Only 8 of the patients studied had primary or secondary liver tumours. None of the cancer patients showed clinical or blood chemical signs of current acute or chronic liver disease. Furthermore 13 of the cancer patients had severe anaemia and were given multiple transfusions during hospitalisation. All the groups studied showed a significant (p less than 0.01) increase in mean ferritinaemia levels compared to the healthy control groups. There was also a significant difference between the mean value encountered in the liver cancer and cirrhosis groups. Both groups also showed significantly higher levels than the control group. In contrast no significant differences were noted between the mean values encountered in the individual cancer groups by means of variance analysis. PMID- 3543742 TI - [General cardiocirculatory effects in chronic respiratory insufficiency]. AB - Blood gas and haemodynamic changes caused by chronic respiratory insufficiency affect the right ventricle and produce chronic cor pulmonale. Equally important but less well known modifications affect the left ventricle and the general circulation and are the subject of the present report. Hypoxemia, hypercapnia and acidosis caused by severe hypoxia create functional disturbances in both ventricles that are manifested in a volume overload that added to other major malfunctions provoke congestive heart failure. The coronary circulation is affected by metabolic factors, perfusion alterations, right ventricular hypertrophy and concomitant coronary lesions. Advanced respiratory insufficiency caused by poorly compensated respiratory acidosis and metabolic acidosis reduces cardiac output and frequency so that tissue perfusion is compromised. Furthermore alterations in transmembrane electrolytic concentrations produce repeated multifocal ventricular arrhythmias that expose the patient to the risk of sudden death. Cardiac failure is reflected in other organs like the kidney and the central nervous system and also contributes to tissue and cerebral hypoxia. The later depresses the respiratory centres and develops into often irreversible coma. A better knowledge of these elements may contribute to the development of appropriate treatment. PMID- 3543743 TI - [Correlation between the metabolic follow-up and diabetic retinopathy]. AB - The state of the fundus oculi was investigated in 40 insulin-dependent and 20 non insulin dependent diabetics. In both groups the state of the fundus oculi was correlated with total cholesterol, LDL, HDL, glycosylated haemoglobin, platelet adhesiveness, triglycerides and duration of the disease. In the case of insulin dependent diabetics a correlation was also sought with daily doses of insulin. The fundus oculi was normal in 21/40 insulin-dependent and 14/20 non-insulin dependent subjects. Multiple regression showed a positive correlation between insulin-HbA doses and duration of the disease and the fundus oculi. Simple liner regression showed a negative correlation between insulin doses and fundus, a tendentially positive correlation between platelet adhesion and fundus. A positive correlation between LDL-platelet adhesion and fundus was also shown in the non-insulin-dependent subjects. These results suggest that factors held to influence macroangiopathy also have an effect on macroangiopathy, that the check up of diabetics is important for the prevention of retinopathy, that insulin doses should be strictly limited to the necessary amount for the control of diabetes since excess is as harmful as insufficiency. PMID- 3543744 TI - [Comparative study of the in vitro activity of 5 new antibiotics on strains isolated from urinary infections]. AB - In vitro activity of Cefotaxime, Ceftriaxone, Ceftazidime, Piperacillin and Netilmicin against 189 urinary isolates of Enterobacteriaceae, Pseudomonas and Enterococcus has been evaluated. To assess the minimal inhibitory concentrations (MIC), the broth dilution method and the Sensititre system were employed. No considerable differences were found between the two methods. Cefotaxime showed the highest activity against Enterobacteriaceae, the great majority of the isolates being susceptible to 1 microgram/ml or less. Piperacillin showed good activity against Enterococci. Ceftazidime resulted the most active against Pseudomonas. PMID- 3543745 TI - [Use of quantitative methods in gynecologic histopathology]. PMID- 3543746 TI - [Prenatal diagnosis of ileal obstruction using echography]. PMID- 3543747 TI - Neuroanatomical evidence of reinnervation in primate allografted (transplanted) skin during cyclosporine immunosuppression. AB - Histological evidence is presented documenting the reinnervation of sensory mechanoreceptors across major histocompatibility barriers in allografted primate (baboon) skin. Meissner and pacinian corpuscles, as well as hair follicles, showed a spectrum of reinnervation by host axons. Our light and electron microscopic evidence to date has suggested that allografted Merkel cells did not survive transplantation. This, and other instances of tissue and receptor destruction resulting from histoincompatibility, indicated marked differences when skin allografts were compared to autografts with respect to the ability of host axons to locate and reinnervate sensory mechanoreceptors. PMID- 3543748 TI - Localization of N-acetylaspartylglutamate-like immunoreactivity in selected areas of the rat brain. AB - N-acetylaspartylglutamate (NAAG) was detected immunohistochemically in the rat brain using an antiserum which recognizes carbodiimide-fixed NAAG. NAAG-like immunoreactivity is described in 5 areas of the brain; olfactory bulb, septal nuclear area, lateral geniculate nucleus, superior colliculus and the entorhinal cortex/hippocampal formation. Mitral cells of the olfactory bulb and neurons concentrated in the medial septum were densely immunostained. A dense population of immunoreactive puncta was found in the superior colliculus and lateral geniculate nucleus (LGN). The LGN also contained immunoreactive neurons. The entorhinal cortex contained numerous immunoreactive cells in layers II-III while the hippocampus had few neurons that were NAAG-positive. PMID- 3543749 TI - Enhancement of insulin and glucagon secretion by arginine after hepatic vagotomy. AB - The hepatic vagus nerve consists of mostly afferent fibers in the rat, and is a major afferent pathway between the liver and the medulla. The present study was carried out to examine the role of the hepatic branch of the vagus nerve in secretion of insulin and glucagon after intraperitoneal injection of arginine (1 g/kg body wt.) in rats. Measurements were made one week after section of this branch. Intraperitoneal arginine enhanced both plasma insulin and glucagon concentrations; more in hepatic-vagotomized than in sham-vagotomized rats. The results suggest that inhibition of the secretion of insulin and glucagon after arginine stimulation is mediated by the hepatic branch of the vagus nerve. The existence of 'sensors' in the liver for arginine, or its derivatives, is proposed as an explanation for the inhibition of the secretion of insulin and glucagon by the hepatic vagus nerve. PMID- 3543750 TI - Stability of [D-Trp11]-neurotensin to rat brain peptidases. AB - The stability of neurotensin (NT) and a potent, long lasting analogue, [D-Trp11] NT, to rat brain peptidases was compared by incubating the peptides with subcellular fractions (synaptosomes, synaptic membranes) and a purified endopeptidase from rat brain. Degradation of the peptides with time was followed by high performance liquid chromatography (HPLC). The rates of degradation (pmol/min/mg prot.) in synaptosomes were 890 (NT) and 59 [D-Trp11]-NT), and in synaptic membranes were 1180 (NT) and 12 ([D-Trp11]-NT). The main products of the degradation of [D-Trp11]-NT by synaptic peptidases (isolated by HPLC and characterized by amino acid analysis) were the 1-3, 1-4 and 6-13 fragments implying cleavage of [D-Trp11]-NT at the Tyr3-Glu4, Glu4-Asn5 and Asn5-Lys6 bonds. The rates of degradation of NT and [D-Trp11]-NT by the purified endopeptidase from rat brain were 27.2 and 0.76 pmol/min/microliter of enzyme solution respectively. This endopeptidase, which hydrolyses NT at Arg8-Arg9, may be responsible along with other endopeptidases for NT degradation at nerve terminals. PMID- 3543751 TI - Immunocytochemical localization of serotonin in intracellularly analyzed and dye injected ganglion cells of the turtle retina. AB - Combining intracellular recording techniques with immunocytochemistry revealed the existence of serotonin within a few ganglion cells of the turtle retina. Lucifer yellow was intracellularly injected into physiologically classified ganglion cells. Sections containing labeled somata were subsequently incubated with an antibody directed against serotonin and immunoreactivity was revealed using horseradish peroxidase as a marker. In 3 ganglion cells the two markers were co-localized. These cells ramified in layers 2 and 3 of the inner plexiform layer and produced color opponent ON-OFF photoresponses. PMID- 3543752 TI - Bibliography. Neurotoxicology. PMID- 3543753 TI - Nurse practitioner research: issues in practice and theory. AB - Since the inception of the nurse practitioner role, numerous studies have focused on the characteristics of NPs, including their educational preparation, their practice settings, demographic characteristics of clients, cost analysis, and the quality of services within a medical context. The two major conclusions of the majority of these studies have been that the delivery of health care by nurse practitioners has been fully accepted by patients, and that nurse practitioners are competent in the delivery of quality care. A brief historical overview of nurse practitioners is presented; the major methodological and conceptual issues of nurse practitioner research are reviewed. Views on practice issues and nursing theory development are shared, and directions for future nurse practitioner research are explored. PMID- 3543754 TI - A life-sustaining function for REM sleep: a theory. AB - A hypothesis has been advanced that the primary function of rapid eye movement (REM) sleep is to provide periodic endogenous stimulation to the brain which serves to maintain minimum requisite levels of CNS activity throughout sleep. REM, in effect, is the mechanism used by the brain to promote and ensure recovery from sleep. Failures of REM may hinder, or in extreme cases, prevent arousal from sleep. The possibility that two fatal sleep-associated syndromes (Sudden Infant Death Syndrome and the Oriental Nocturnal Death Syndrome) may involve deficits of REM was discussed. PMID- 3543755 TI - Operant conditioning in motor and neural integration. AB - Empirical and theoretical reasons were given to investigate operant conditioning in a new, integrative approach within motor control physiology. Elements of inborn and learned behavior were presented in a framework specifying their stimuli and responses. The operant was redefined as a controlling discriminative stimulus, Sd, together with the response, R, it produces, on the basis of a previous literature of operant and instrumental research. Complex motor and neural activity were reviewed in accordance with partitioning of: responses, controlling stimulation, reinforcement, and functions of movement-produced stimulation. Schematics portrayed reinforcement principles through analysis of a fast pathway from Ia muscle spindle afferents to motor outflow. Methods were suggested to minimize operant units through selective reinforcement and establish them to defined end points of learning within composite, ongoing behavior. It was argued that operant neural mechanisms can be investigated efficiently only by starting with individual operants that are thoroughly characterized. PMID- 3543756 TI - A brief review comparing the effects of sex steroids on two forms of aggression in laboratory mice. AB - This brief review examines the roles of sex steroids in two forms of "aggression" in laboratory mice. The social conflict induced in male mice by individual housing or reproductive experience was contrasted with the attack shown by small groups of female mice on lactating intruders. Gonadectomy of males largely abolishes the former response but actually augments the latter activity in male subjects. Testosterone, estradiol and 5 alpha-dihydrotestosterone all restore social conflict in gonadectomized male mice but these sex steroids inhibit attack on lactating female intruders by gonadectomized males. The data clearly confirm that there is no simple relationship between a particular hormone and "aggression." These forms of attack may serve very different functions even though they involve similar action patterns and distributions of bites on the attacked animal. A tentative discussion is included about the roles of these activities. PMID- 3543757 TI - Health care for the elderly: the road to poverty. PMID- 3543758 TI - Clinical utility of bone mineral content measurements in the diagnosis and treatment of osteoporosis. PMID- 3543759 TI - A historical overview of the recognition of appendicitis--Part II. PMID- 3543760 TI - Patients sought for New Zealand multi-centre Parkinson's disease trial. PMID- 3543761 TI - Hyperbaric oxygen treatment in multiple sclerosis. PMID- 3543762 TI - Liver transplantation: its implications for New Zealand. PMID- 3543763 TI - Retained products of conception. PMID- 3543766 TI - Clinical significance of fetal tachypnea during antepartum biophysical testing. AB - Fetal tachypnea has been regarded as a rare finding with a poor perinatal prognosis. Eighteen cases of fetal tachypnea were noted during the biophysical tests of 200 patients. Biophysical testing consisted of concurrent ultrasound observations of fetal breathing and body movements and electronic monitoring of fetal heart rate, coupled with determinations of fetal tone and amniotic fluid volume. Fetal breathing movement frequency and rate, fetal trunkal movement frequency, and baseline fetal heart rate were analyzed on a programmed microcomputer. The mean (+/- SD) breathing rate was 68.2 +/- 6.4 breaths per minute; mean breathing frequency, 55 +/- 22.6%; mean baseline heart rate, 141 +/- 8 beats per minute; mean trunkal movement incidence, 5.5 +/- 2.6%; and mean acceleration frequency, 14.6 +/- 9.8 per hour. No fetus was apneic for more than eight minutes, and there were no significant correlations between fetal breath rates and the other biophysical parameters. There were no perinatal deaths. Seven fetuses experienced perinatal morbidity, of whom five had other abnormalities on biophysical testing. This study indicates that fetal tachypnea occurs more often than previously believed and does not generally signify fetal compromise unless other biophysical abnormalities are also present. PMID- 3543764 TI - The stability of 99Tcm-DTPA in an aerosol delivery system. AB - 99Tcm-DTPA is now widely used in aerosol nebulizers for routine ventilation lung scanning. The stability of a commercially available DTPA kit has been measured when used in an aerosol delivery system and compared with the stability when stored in the parent vial according to the manufacturer's instructions. No significant breakdown was measured up to 8 h after reconstitution in the parent vial and up to 3 h when used as an aerosol. Values of the half time of clearance of DTPA aerosols in a group of 23 patients are compared with values given in the literature. PMID- 3543767 TI - Effect on birth weight of erythromycin treatment of pregnant women. AB - To test the hypothesis that treatment with antibiotics prevents low birth weight, pregnant women whose vaginal cultures contained Ureaplasma urealyticum or Mycoplasma hominis (or both) and who gave written informed consent were treated with one of the following: identical looking capsules containing 250 mg of either erythromycin estolate or stearate (active against U urealyticum), or 150 mg of clindamycin hydrochloride (active against M hominis), or placebo, four times daily for six weeks in a randomized double-blind study. Treatment with clindamycin had no effect. Treatment with erythromycin initiated during the second trimester had no effect on mean birth weight or on the frequency of low birth-weight infants. In contrast, women whose treatment with erythromycin was initiated in the third trimester gave birth to infants with a heavier mean birth weight (3331 g) than infants born to placebo-treated women (3187 g) (P = .042). Similarly, in women whose erythromycin was begun during the third trimester, the birth rate of infants weighing 2500 g or less was 3%, whereas in women treated with placebo, the birth rate for low-birth-weight infants was 12% (P = .047). These data suggest that treatment with erythromycin during the third trimester prevents low birth weight in mycoplasma-colonized pregnant women. Whether the effect is due solely to the action of erythromycin on U urealyticum is uncertain. PMID- 3543765 TI - Therapeutic uses of gonadotropin-releasing hormone analogs. AB - Since the discovery and synthesis of gonadotropin-releasing hormone (GnRH) in 1971, numerous long-acting agonistic and antagonistic analogs have been synthesized. Agonistic analogs were found to desensitize pituitary GnRH receptors with chronic use, resulting in decreased gonadotropin secretion and a hypogonadal state. These analogs are being investigated as potential contraceptives and in the treatment of several conditions in which decreased gonadal steroid production is desired. Substantial progress has been made in these areas. The purpose of this review is to provide the clinician with data regarding the potential clinical utility of this class of peptides. PMID- 3543768 TI - Skinning vulvectomy for the treatment of multifocal vulvar intraepithelial neoplasia. AB - Of 108 women treated for vulvar intraepithelial neoplasia between 1977 and 1984 at the Irvine Medical Center, University of California, and the Memorial Medical Center of Long Beach, Women's Hospital, 48 with multifocal and/or widespread lesions underwent skinning vulvectomy and split thickness skin graft reconstruction. Six women in the skinning vulvectomy sample had early stromal invasion in the vulvectomy specimen. Recurrences at intervals of four to 87 months occurred in 13 patients undergoing this procedure. The risk of recurrence did not appear to be related to the status of the surgical margins because seven of 22 patients with involved margins experienced recurrence compared with six of 26 with uninvolved margins. PMID- 3543769 TI - Prophylactic mezlocillin in radical hysterectomy. AB - The role of prophylactic antibiotics in radical hysterectomy patients was studied in a double-blind randomized prospective study of mezlocillin (Mezlin, Miles Pharmaceuticals), a broad-spectrum semisynthetic penicillin, compared to placebo. Thirty evaluable patients received 4 g mezlocillin or saline placebo intravenously one-half hour before surgery, a second dose four to six hours later, and a final dose six hours after that. The rate of wound infection, postoperative use of additional antibiotics, fever index, and the incidence of standard febrile morbidity were all significantly lower in the mezlocillin group. Short-term perioperative prophylactic antibiotics are indicated in patients undergoing radical hysterectomy. PMID- 3543770 TI - Ritodrine in the treatment of preterm labor: second Danish multicenter study. PMID- 3543771 TI - Pyelonephritis associated with respiratory distress. AB - We present a case of pyelonephritis associated with respiratory distress and elevated liver enzymes in a pregnant patient. PMID- 3543773 TI - Diagnosis of vasa previa with ultrasonography. AB - An antepartum diagnosis of vasa previa was considered in a patient in whom ultrasound revealed pulsatile loops of cord overlying the cervical os. This diagnosis was confirmed at the time of cesarean delivery. We offer a literature review of vasa previa and make recommendations for using ultrasonography to diagnose vasa previa. PMID- 3543772 TI - Asymptomatic rupture of a rudimentary uterine horn. AB - Pregnancy in a noncommunicating rudimentary uterine horn frequently results in rupture. Uterine rupture may cause a massive intraperitoneal hemorrhage, necessitating operative intervention to control bleeding. The following is a report of an unusual patient who had an asymptomatic rupture of a rudimentary horn. PMID- 3543774 TI - Hydrocephalic fetus in an abdominal pregnancy. AB - We present an unusual case of an abortion at 20 weeks elected after a diagnosis of fetal hydrocephalus and spina bifida. Unsuccessful attempts at abortion with prostaglandin suppositories ultimately led to a diagnosis of abdominal pregnancy. This is the first reported case of an abdominal pregnancy discovered during an abortion that was elected because of an anomaly identified by ultrasound. PMID- 3543775 TI - Urticaria associated with antigonadotropin-releasing hormone antibody in a female Kallman's syndrome patient being treated with long-term pulsatile gonadotropin releasing hormone. AB - The administration of pulsatile gonadotropin-releasing hormone (GnRH) has received increasing attention as a method of inducing ovulation or initiating puberty. Few side effects have been reported, although urticarial allergic reactions have been reported in the male. An 18-year-old female with hypogonadotropic hypogonadism and anosmia due to lack of endogenous GnRH was treated for 230 days using subcutaneous GnRH in an attempt to induce physiologic puberty. Just before anticipated menarche, therapy was discontinued because of the appearance of an urticarial reaction at the injection site as well as at previous injection sites. The presence of immunoglobulin G (IgG) antibodies against GnRH were subsequently identified in the patient's serum. These results further confirm the potential for antibody production to this small natural peptide in the female not previously exposed to GnRH. Some practical considerations for this form of therapy are highlighted. PMID- 3543776 TI - Renal cell carcinoma in pregnancy. AB - A rare case of renal cell carcinoma occurring during pregnancy is described. The modalities used to make the diagnosis and the antepartum management of the patient are discussed. The case reported herein demonstrates the major diagnostic challenge of the young pregnant patient with a rare disease. PMID- 3543777 TI - 1986 Distinguished Dentist--Dr. James Mercer. PMID- 3543778 TI - [DTIC: effect on fibrinolysis and thrombocyte function]. AB - Pathogenesis of Budd-Chiari-syndrome, under treatment e.g. of malignant melanoma with DTIC (dacarbacin) is still unknown. In our investigations we could not find any hint for the hypothesis that Budd-Chiari-syndrome under DTIC is caused by hemostaseological impairment. PMID- 3543779 TI - [Early detection of cancers using ultrasound provocation of carcinoembryonic antigen]. PMID- 3543780 TI - Phase-II studies of 1,2,4-triglycidylurazol (TGU) in solid tumors. Phase-II Study Group of the Association of Medical Oncology of the German Cancer Society. PMID- 3543781 TI - [Experiences using the "thymu-skin" hair cure for the prevention of alopecia in cytostatic treatment]. PMID- 3543782 TI - Mistletoe lectins and their A and B chains. AB - Mistletoe lectins are of high biological activity. The mistletoe lectin I (ML I) is a naturally occurring conjugate of an enzyme (A chain) and a lectin (B chain). Its cytotoxicity is caused by inhibiting the protein synthesis on the ribosomal level. Prominent properties of the A chain are mitogenicity and inhibition of the protein synthesis in cell-free systems. The A chain is also a candidate for the construction of immunotoxins. The B chain as well as the intact lectins activate macrophages and release lymphocytes. They both inhibit the allergen-induced histamine release from leukocytes and the collagen-induced serotonin release from platelets. It cannot be excluded that the combination of selectively cytotoxic and immunopotentiating properties of mistletoe lectins and their chains are decisive for the therapeutic effects of mistletoe preparations. PMID- 3543784 TI - A randomized, controlled comparison of anterior and posterior periocular injection of antibiotic in the prevention of postoperative endophthalmitis. AB - A randomized, controlled, prospective comparison of the effectiveness of anterior and posterior injections of antibiotics in the prevention of endophthalmitis following cataract extraction was carried out in a village hospital in Pakistan. The study involved 77,015 cataract operations performed mainly by two surgeons. Anterior subTenon injections ("subconjunctival") and posterior subTenon injections ("retrobulbar") were equally effective in preventing postoperative infection. PMID- 3543783 TI - Recent studies on the anticancer activities of mistletoe (Viscum album) and its alkaloids. AB - Detailed methods for in vitro/in vivo evaluation of anticancer drugs, with special reference to mistletoe extracts, have been reviewed. Mistletoe extracts have been shown to possess significant antitumor activity, in vivo, against murine tumors, Lewis lung carcinoma, colon adenocarcinoma 38 and C3H mammary adenocarcinoma 16/C. Methods for the extraction of biologically active alkaloids from mistletoe and their anticancer activities are presented. The possible origin of alkaloids in mistletoe plants, and their contributions towards a mechanism of anticancer activities of mistletoe extracts, are proposed. PMID- 3543785 TI - Endothelial cell loss in different non-automated extracapsular nuclear evacuation techniques and the role of sodium hyaluronate. AB - In this study the effect of seven different non-automated nuclear evacuation techniques and the role of sodium hyaluronate (Healon) were evaluated. Thirty five cats (seven groups) and 140 human patients (seven groups) were included in the study. Each experimental animal and human group was operated using one of the seven non-automated techniques. In each animal, one eye was operated with sodium hyaluronate and the other with Balanced Saline Solution (BSS). In each human group of 20 patients during cataract extraction and IOL implantation, sodium hyaluronate was used in half of the patients and BSS was used in the remaining ten. Eyes treated with sodium hyaluronate lost approximately 50% fewer endothelial cells and had approximately 50% less increase in corneal thickness than their counterparts treated with BSS. Based on the results of the endothelial cell loss and the corneal thickness, it is concluded that the most traumatic used technique was no. 2, followed by that of no. 5. The technique no. 7 may be considered as the most atraumatic of the tested procedures. Sodium hyaluronate effectively protected the endothelium, and its routine use in cataract surgery is recommended. PMID- 3543786 TI - Classic ideas. A retrievable suture idea for anterior uveal problems. By Malcolm A. McCannel 1976. PMID- 3543787 TI - The slip knot for dacryocystorhinostomy flap closure. AB - During dacryocrystorhinostomy (DCR) surgery, anterior and/or posterior flaps are created and anastomosed with absorbable sutures. A prominent nasal bridge and recessed lacrimal crest can often make tying of the suture within a small incision difficult. We have simplified this tying process with the use of a slip knot. The knot is tied external to the incision and then slid into the operative site until the flaps are apposed. PMID- 3543788 TI - The neglect of Purkinje's technique of ophthalmoscopy prior to Helmholtz's invention of the ophthalmoscope. AB - A technique for examining the fundus of the eye was devised by Jan Evangelista Purkinje a generation before Helmholtz invented the ophthalmoscope. Yet, Purkinje's technique of ophthalmoscopy went virtually unnoticed by his contemporaries. This neglect of Purkinje's discovery has never been fully explained and warrants re-examination. PMID- 3543789 TI - The triple procedure. Refractive results. 1985 update. AB - A total of 77 triple procedures performed over a 6-year period were studied retrospectively and prospectively with the goal of producing refractive errors within 2 diopters (D) of emmetropia. Thirty-eight of 58 eyes achieved refractive errors within 2 D of emmetropia over the entire study; however, cases performed in the last 30 months achieved a mean refractive error close to emmetropia. Assuming that accurate axial length measurements were performed, the postoperative keratometry readings and, to a lesser degree, the "A" constant used in the regression formula had the greatest impact on the ultimate refractive error. Only a few cases had unacceptable refractive results possible due to inaccurate axial length measurement and/or incorrectly labeled intraocular lenses. The postoperative keratometry readings closely approximated the estimated preoperative readings that were used in the lens implant power calculation regression formula. With currently available techniques, the triple procedure appears to provide a useful modality for the correction of cases with a combined corneal opacity and a cataract. PMID- 3543790 TI - Ocular adnexal monoclonal lymphoid tumors with a favorable prognosis. AB - Fourteen patients with well- or intermediately differentiated monoclonal B lymphocytic tumors of the conjunctiva or orbit had a favorable prognosis with follow-ups of 4 to 9 years (mean and median, 7.5 years). The lesions were, for the most part, diffuse proliferations of small lymphocytes, either with round or minimally indented nuclear outlines. Mitotic activity was sparse to nonexistent; occasionally there were scattered small abortive or residual germinal centers, and some lesions exhibited lymphoplasmacytoid features and dispersed multinucleated giant cells (polykaryocytes). None of the six patients with conjunctival lesions had extraocular manifestations. An identical tumor of the submandibular gland developed in one of eight patients with orbital lesions and another patient had multiple extranodal involvements of the oropharynx, liver, and both kidneys, but after chemotherapy the patient has survived for 8 years from orbital presentation and is currently in remission. The authors believe that these low-grade tumors share many biologic resemblances to extranodal lymphoepithelial tumors of other organs (lung, gut, parotid, thyroid), which as a group have been aggregated together as mucosa-associated lymphoid tumors (MALT) and which can often remain localized to their sites of origin. PMID- 3543791 TI - "Professor" Charles Tyrrell and his ideal sight restorer. AB - Charles A. Tyrrell was a masseur who obtained his MD degree at age 57 in 1900. In addition to his private practice he was editor of several pseudomedical magazines. He also owned two proprietary ventures that he conducted on a mail order basis. One of these involved production and sale of the The Ideal Sight Restorer, a U-shaped device consisting of a rubber bulb at the base, from which on both sides arose an arm of rubber tubing capped by an ivory eye piece. The eye cups were applied to the closed eyelids and the intermittent suction produced by squeezing the rubber bulb was claimed to provide a form of ocular massage capable of curing serious eye diseases (eg. cataract and glaucoma), as well as doing away with the need for spectacles. Although his fraudulent activities and deceptive advertising practices were described on several occasions in the Journal of the American Medical Association, Dr. Tyrrell persisted in his enterprises until he died in 1918. PMID- 3543792 TI - Ophthalmic needles. An engineering analysis. AB - Mechanical engineering formulas to predict the amount of flex and the bend strength expected for surgical needles are presented. Bend strength measurements were made on ophthalmic needles produced from two different materials and several shapes. The agreement between the data derived by measurement and the theoretical predictions is excellent. The force required to penetrate porcine corneas is also measured. A needle strength/penetration force ratio was developed from the data presented in this paper. This ratio reveals that needles produced from smaller wire sizes, if optimally designed, can perform as well as existing larger needles. PMID- 3543793 TI - Hecht fascia lata needle forceps. AB - A new instrument is presented for lid tunneling, grasping, and pulling through of the fascia lata in frontalis suspension surgery for ptosis. The instrument, the Hecht Fascia Lata Needle Forceps, is a modification of the small curved hemostat. PMID- 3543794 TI - Midazolam, diazepam, and placebo as intravenous sedatives for dental surgery. AB - This study was a comparison of the sedative and amnestic properties of midazolam and diazepam when administered for relief of patient discomfort during dental surgery. It was a double-blind placebo-controlled group study, which entailed the analysis of 60 patients randomly assigned to the three groups: midazolam, diazepam, and placebo. There were 20 patients in each group. Midazolam patients showed superior performance in the parameters of sedation and amnesia when compared to patients who were administered diazepam. Both groups showed better results than the placebo group, which had the best results with the Digit Symbol Substitution Test and the Trieger Test. PMID- 3543795 TI - An amalgam tattoo causing local and systemic disease? AB - Amalgam tattoos are common oral lesions. The case presented here involved a 33 year-old woman who had had an amalgam tattoo for 2 years and complained of localized soreness and occasional swelling as well as systemic symptoms of weight loss, fatigue, sinusitis, and headaches. After excisional biopsy of the lesion, the patient's complaints ceased dramatically. It is suggested that alterations in healing due to the presence of amalgam particles led to systemic as well as local disease. PMID- 3543796 TI - Pneumomediastinum and subcutaneous emphysema following surgical extraction of mandibular third molars: three case reports. AB - Three cases of subcutaneous emphysema following surgical extraction of lower third molars are presented. In two of the cases, pneumomediastinum developed. The direct cause of these complications is the combination of the use of an air turbine dental handpiece and the flap design. The propagation of the emphysema and means for its prevention are discussed. PMID- 3543797 TI - Yeast species and biotypes associated with oral leukoplakia and lichen planus. AB - Of 36 patients, 17 had oral leukoplakia, including homogeneous and nonhomogeneous types, and 19 had reticular lesions of oral lichen planus. A sample of yeast flora in each patient was taken from the pathologic lesion as well as from normal appearing mucosa. The isolated yeasts were identified according to species level, and identification was extended beyond the species level for one species, Candida albicans, to reveal the biotype by means of the Odds and Abbott procedure comprising tests for acid and salt tolerance, proteinase production, resistance to 5-fluorocytosine and safranine, and assimilation of urea, sorbose, and citrate. Yeasts were present in the lesions of 82% of leukoplakia patients, compared to 37% of lichen planus patients, a frequency of yeasts corresponding to that in healthy adults. C. albicans was the dominating species in lesions of both diseases, constituting 82% of all yeasts in the leukoplakia lesions. In addition, the following species were identified: Candida tropicalis, Candida pintolopesii, Torulopsis glabrata, and Saccharomyces cerevisiae. Eighteen biotypes of C. albicans were encountered, the most frequently occurring biotypes being 355 and 177. Differences between C. albicans biotypes isolated from pathologic and normal mucosa were encountered in five of eleven leukoplakia patients and in one of three lichen planus patients. This indicates that the oral cavity comprises several ecologic niches for yeasts. As nonhomogeneous leukoplakias are more likely to develop into carcinoma than are homogeneous leukoplakias, it is interesting to note that the C. albicans biotypes isolated from nodular lesions (one type of nonhomogeneous leukoplakia)--biotypes 145, 175, and 575--rarely occur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543798 TI - [Cystic lesions of the femur head in coxarthrosis in adults]. PMID- 3543800 TI - [Social and vocational rehabilitation of patients following endoprosthesis of the hip joint]. PMID- 3543799 TI - [Thrombohemorrhagic syndrome in traumatology and orthopedics]. PMID- 3543801 TI - [Ultrasonic study of blood flow in the pregnant uterus and fetal blood vessels]. PMID- 3543802 TI - [Commemoration of Frigyes Verzar in the year of the centenary of his birth]. PMID- 3543803 TI - [In memoriam Lajos Ilosvay (1851-1936)]. PMID- 3543804 TI - [Experience with suturing the outer ligament of the upper ankle joint under local anesthesia]. AB - An efficient approach to the treatment of fibular ligamentous rupture is to approximate the torn edges of the ligament. Conservative management with immobilization by fixed dressings or orthopaedic footwear to maintain the foot in pronation may allow ligamentous union to occur; however, the results are relatively often unsuccessful, and delayed surgical correction is difficult and unreliable. Operative repair of the ruptured ligament is successful in the vast majority of cases, and is generally recognized as a better therapeutic approach, but it may be criticized on the grounds of the high cost of treatment, especially if general anaesthesia is used. The use of local anaesthesia offers a good compromise, as it is considerably less expensive and allows the advantages of surgical repair to be exploited. PMID- 3543805 TI - [Therapy of fresh fibular ligament ruptures]. AB - In a prospective, random study carried out at the Casualty Clinic of the University Hospital of Hannover from 15 April 1986 to 31 July 1986, 200 patients were randomly selected from four treatment groups, according to treatment: operative-immobilized (group A, n = 52), operative-functional (group B, n = 50), conservative-immobilized (group C, n = 48) and conservative-functional (group D, n = 50). Follow-up examinations were made in 92.5% of patients after 3 months and 64% after 12 months. At the 3-month and 1-year follow-ups, no statistically significant differences were found in the total evaluation (100-point checklist) Moderately significant instability (6 degrees -10 degrees talar tilt and 6-10 mm anterior talar dislocation) in the conservative groups C and D was observed only in the clinical-radiological instability test. This statistically significant difference is, however, only evident in stress tenographically confirmed dual ligament lesions. No functional physiological differences can be found after 12 months; on average, the period of incapacitation is 3 weeks shorter than with primary functional treatment, but so far there are no long-term results. Until late results are available, we conclude that conservative treatment, even for professional athletes, can be recommended as the procedure most free of risk and most economical; if at all, operative therapy should only be carried out when the instability is very serious. PMID- 3543806 TI - [Surgical therapy of chronic instability of the upper ankle joint using periostal bridle-plasty]. AB - We have used the technique of the autoplastic periostal bridle graft for operative treatment of chronic lateral instabilities of the ankle joint in 78 cases since 1978. Clinical and radiological follow-ups of 55 patients were made at two different intervals of time. In more than 90% of these there was no more evidence of instability and good or very good subjective results were obtained. The substitute ligament can be either fastened via drill holes or fixed to the bone with a screw. The autoplastic periostal bridle graft is a simple, anatomically appropriate and reliable procedure to restore the stability of the lateral ankle joint. Several renowned authors have also reported good results in the meantime. PMID- 3543808 TI - Multiple cross-reactivities amongst antigens of Plasmodium falciparum impair the development of protective immunity against malaria. AB - The majority of protein antigens of the malaria parasite Plasmodium falciparum contain short sequences that are extensively repeated in tandem arrays. Some antigens contain a single block of repeats whereas in other antigens there may be two or more blocks of related repeats. The repetitive sequences in an individual antigen may be highly conserved but more usually there is some degeneracy which occasionally is extensive. The repetitive sequences encode immunodominant epitopes to which much of the antibody response in malaria is directed. Recently, we have found that there are extensive cross-reactions amongst the epitopes encoded by related repetitive sequences. These cross-reactions may involve different blocks of repeats in the one antigen or repetitive sequences in different antigens. It is proposed that these cross-reactions interfere with the normal maturation of a high affinity antibody response in malaria by causing an abnormally high proportion of somatically-mutated B cells to be preserved during clonal expansion. PMID- 3543807 TI - [Flunisolide and beclomethasone in the treatment of non-allergic eosinophilic rhinitis]. PMID- 3543810 TI - Regional specialization of the surface of a parasitic nematode. AB - A monoclonal antibody (NIM-M7) has been prepared which reacts with a major surface antigen of adult males and females of Trichinella spiralis. This specificity is only demonstrable when the antigen is liberated by detergent solubilization of surface-labelled worms. When reacted with living adults, on the other hand, NIM-M7 reacts well with only the eversible cloaca, or copulatory bell, of the male, binding weakly, if at all, to other surface areas of male or female worms. A similar staining pattern is also given by Concanavalin A. The differential staining given by NIM-M7 must indicate a molecular difference between the organization of the same surface antigen on the cuticular surface of the copulatory bell and other areas of the worm surface. This example of regional specialization demonstrates that the nematode cuticle is not necessarily chemically uniform. PMID- 3543809 TI - Cellular mechanisms involved in recovery from acute malaria in Gambian children. AB - This paper reports the results of in vitro experiments which attempt to elucidate the mechanisms whereby Gambian children control acute infections of Plasmodium falciparum. It was shown initially that mononuclear cells from children with acute malaria, in the presence of specific antibody, caused a marked reduction in in vitro parasite growth. IgM antibodies appeared to be considerably more effective than IgG. T or B lymphocytes were ineffective in the system; adherent cells alone had some effect, but much less than the unfractionated cell population. Adherent cells were however fully effective after exposure to supernatants from T cells activated either non-specifically by phytohaemagglutinin (PHA), or specifically by P. falciparum antigens. Depression of parasite growth was also observed, independent of anti-malarial antibody. This was achieved when adherent cells from healthy Europeans, as well as those from infected children, were exposed to the supernatants from previously stimulated T cells before adding to the culture. Furthermore, intra-erythrocytic parasite death occurred after a short exposure to the supernatants of 'activated' adherent cells from both infected children and Europeans. PMID- 3543811 TI - [In vitro activity of nitroxoline on urogenital mycoplasmas]. AB - The product nitroxoline was studied in vitro for its activity towards Ureaplasma urealyticum and Mycoplasma hominis. In view of the low MIC values obtained, it seems nitroxoline could be used in the treatment of urinary infections. It is bactericidal, and should not produce resistant strains. PMID- 3543812 TI - [Renal complications of anti-cancer chemotherapy]. AB - This review is not intended as a complete study of the nephrotoxicity of chemotherapy agents used in the treatment of cancer. The number of these drugs that are cytotoxic has considerably increased in the last few years and our information is incomplete for many of them. We therefore reviewed the observations reported in the literature. Cis-platinum, streptozotocin, methotrexate at high doses, mithramycin and mitomycin are highly nephrotoxic. Other drugs, such as nitrosoureas, celiptium are less nephrotoxic while some appear to rarely induce nephrotoxicity. Anticancer drug nephrotoxicity is characterized by its particular insidiousness, its time of occurrence and its evolution. Since no clinical manifestations accompany the lesions, nephrotoxicity must be sought routinely. It can occur early or late, may be constant as of the first course or appear only after a certain cumulative dose and even occasionally after such a long interval that its cause may appear to be in doubt. The severity of this nephrotoxicity ranges from the usual first minor urinary anomalies to terminal renal failure. The pathophysiogenic mechanisms of the nephrotoxicity remain in most cases obscure. The mode of penetration into the cells is not known. There are fewer data on the interaction between the toxic agent and the cellular metabolism. In most cases, the drug itself in unchanged form does not seem to be the causative agent, which appears rather to be its metabolite. These metabolites are not always identified. Thus nephrotoxicity of antitumoral agents has not been given sufficient attention. Only better knowledge of their action within the kidney will eventually lead to progress in preventing their harmful side effects. PMID- 3543814 TI - [Recommendation of the Group for Studies on Hemostasis and Thrombosis. Toward better supervision of anticoagulant therapy by anti-vitamin K agents]. PMID- 3543815 TI - [Clostridium difficile and its cytotoxin in the stools of young hospitalized children. Influence of antibiotic treatment]. AB - Clostridium difficile has been searched in 153 stool samples from 138 children aged 0 to 12 months. We divided the population in two groups depending on the antibiotic treatment. We have found C difficile in 39 samples (25%). The colonization rate increases with age ranging from 5% before 1 month, to 36% between 1 and 6 months and 54% between 6 and 13 months. An environmental sampling yielded once C difficile. Contamination may be related to the environment. 29% of the isolates produced a cytopathic toxin. Toxin titers in infants' stools range from 1/160 to 1/10240. One only of these children had diarrhea. C difficile and its toxin does not seem to infer any signs of enteric illness with infants. The results obtained with the group of non treated infants are not significantly different from the ones of the other group: the colonization rates are 21% in the non treated group and 29% in the other group. The rate of strains yielding a cytophatic toxin is similar in the 2 groups. It seems reasonable to agree that antibiotics do not influence the settlement of C difficile in infants' intestine. PMID- 3543813 TI - [Computer technology in the interpretation of aminoglycoside determinations]. AB - Given the difficulty of interpreting the results of aminoglycoside determinations using current methods, we decided to use data processing in order to help practitioners in their prescriptions of these drugs. Our software has numerous advantages. Results can be interpreted even before obtention of the steady-state and whatever the interval between specimen taking and drug administration, which permit different modalities of blood sampling. Data storage enables the operator to make retroactive studies in order to establish better correlation between blood concentrations and side effects. This method gives practitioners the necessary pharmacological data for rapid adjustments in aminoglycosides dosage. PMID- 3543816 TI - [Characteristic parameters of the population of circulating DNA in cases of disseminated lupus erythematosus ]. AB - Important quantities of circulating DNA (up to congruent to 50 micrograms/ml) have been shown to be present in the sera of patients with serious systemic lupus erythematosus. This DNA is double-stranded, as demonstrated by colorimetric, enzymatic and biophysic tests. The circulating DNA population is made up of a main fraction at 250 base pairs and a heterogeneous tail up to 300 bases pairs, as demonstrated by electrophoretic measures on polyacrylamide gel. After hydrolysis in limited conditions with DNAse I and 32P labelling, the repartition of autoradiographed material confirms the reality of a main peak and of a more dispersed tail. PMID- 3543817 TI - [HDL2 and HDL3 cholesterol in men and women in different forms of hyperlipidemia without arterial involvement]. AB - The investigation was carried out in one hand on 54 hyperlipidemic men without arterial injury compared to 54 normolipidemic men, on the other hand on 50 hyperlipidemic women compared to 50 normolipidemic women. The hyperlipidemic subjects were separated in IIa, IIb and IV groups, according to WHO classification. Lipoprotein's separation was carried out by sequently ultracentrifugation and HDL2-HDL3 were isolated at a solvant density of 1.125 and 1.21; cholesterol was measured by enzymatic method. We observed a significant decrease of: (Formula: see text) ratio in all hyperlipidemic subjects compared to controls; but no significant variation of HDL2 and HDL3 cholesterol appeared in the three groups of hyperlipidemic subjects compared to controls; on the other hand we noted a HDL2 cholesterol greater in women than in men and this fact seems to prove a favorable action of this fraction in preventing atherosclerosis. The (Formula: see text) ratio remains the most discriminant factor of hyperlipidemia, but the: (formula: see text) ratio seems interesting and HDL2 cholesterol is always higher in women during hyperlipidemia with high risk, IIa and IIb. PMID- 3543818 TI - [Antibiotic combinations and serum concentrations: a study using a computer program]. AB - An original computer program developed to study antibiotic combinations is presented. In vitro combination effects were determined by broth microtiter checkerboard method. Inhibitory and bactericidal concentrations for each antibiotic alone and in combination were registered on a microcomputer (Apple Lisa). The program (Pascal UCSD) allowed to determine FIC and FBC index and a therapeutical index (IFT) based on reduction of concentrations under mean serum levels for the two antibiotics. An IFT less than 1 correlated to a combination of antibiotics with achievable therapeutic levels. More the IFT was low more the combination was effective. This therapeutical index was calculated for various combinations of antibiotic concentrations. PMID- 3543819 TI - [AIDS--a review of the literature]. PMID- 3543820 TI - Endocrine manifestations of critical illness in the child. AB - The stress response in humans commonly includes elevations in plasma concentrations of glucocorticoids, catecholamines, glucagon, growth hormone, aldosterone, and renin, resulting in alterations in the metabolism of glucose and other energy substrates, and in increased sodium and water retention. In severe illness, triiodothyronine and sometimes thyroxine are decreased without evidence of clinical hypothyroidism. Antidiuretic hormone may be elevated in bacterial meningitis and other central nervous system disorders, as well as in acute asthma, chronic ventilator therapy, pneumothorax, atelectasis, and postoperatively. Increased ADH concentration can lead to significant hypoosmolality and hyponatremia with adverse effects on the patient. In the setting of severe intracerebral insults, ADH may be inappropriately low, resulting in diabetes insipidus. Insulin concentrations may be inappropriately low for serum glucose concentration, or insulin may have diminished receptor responsiveness in seriously stressed patients. Either situation leads to hyperglycemia. Disturbances in calcium, phosphorus, and magnesium homeostasis may occur relatively frequently in the critically ill patient in response to therapeutic interventions, or illness-induced altered metabolism. It is not always clear when an altered metabolic or hormonal state is an appropriate response to a stress, or represents decompensation of the body's mechanisms for coping with that stress. It is important, however to recognize the common responses of the organism to severe illness, and to monitor for treatable abnormalities which occur. PMID- 3543822 TI - High frequency ventilation. AB - High frequency ventilation (HFV) presents a new respiratory therapy modality that has taught us much about the theories of gas transport in the lung. Both experimental and clinical applications are summarized. Although the future clinical role of HFV remains uncertain, pediatric applications and investigation continue at the forefront of this new technology. PMID- 3543821 TI - Current perspectives on septic shock. AB - Although septic shock may be initiated by invading microbes, it is the metabolic and immunologic host responses that determine the true pathophysiology of this common critical care illness. Currently, septic shock therapeutics emphasize empiric and symptomatic treatment. Biochemical elucidation of the septic process will ultimately result in specific interventions for this ominous intensive care syndrome. PMID- 3543823 TI - Intensive care aspects of organ transplantation in children. AB - Children will benefit from the increasing availability of transplantation techniques as treatment for end-stage kidney and liver disease. Support of these services will involve the intensivist to as great degree as these children will frequently require invasive monitoring. Hypovolemia in the postoperative period can be devastating to later graft function and must be avoided. The drugs used to induce graft tolerance have significant effects and potential major toxicities. Their use places these children at risk of serious and life-threatening bacterial, viral, fungal, and protozoan infections. A team effort is essential to the successful care of these children. The demands are great, but the goal of a return of these gravely ill children to a normal and happy life is well worth the effort. PMID- 3543825 TI - Bacterial meningitis: diagnosis and initial antibiotic therapy. AB - Despite advances in antibiotic treatment, bacterial meningitis remains a significant cause of mortality and morbidity among children. In population-based studies in the United States, the incidence of bacterial meningitis is estimated to be 4.6 to 10 per 100,000 population per year. Every year more than two thousand deaths due to bacterial meningitis are reported in the United States, most of these in previously healthy children. This article reviews diagnosis and management of this puzzling disease entity. PMID- 3543824 TI - Cerebrospinal fluid shunts. Evaluation, complications, and crisis management. AB - This article describes commonly used shunt systems and the simple methods that can be used to identify them. Evaluation of shunt system function, definition of site of shunt dysfunction, and immediate intracranial decompression therapy are discussed. Other complications of CSF shunt therapy and their treatments are also presented. PMID- 3543826 TI - Acquired immunodeficiency syndrome of childhood. AB - AIDS of childhood is reviewed in this timely article, including care of the child with infectious complications, and other current and future management concerns. PMID- 3543827 TI - Aminophylline toxicity. AB - Aminophylline therapy has undergone change in the past decade. With the changes in usage and dosage forms, the frequency of toxicity in the pediatric population, especially in adolescents, has increased dramatically. Two distinct patterns, chronic and acute, have been recognized and treatment methods for both are changing. Table 4 summarizes the emerging state-of-the-art therapy for aminophylline toxicity. Judging from the activity seen in the literature, investigation into aminophylline toxicity will continue to be a priority. We will see a greater understanding of the disease process and a refining of the therapeutic process. The ultimate goal is the elimination of mortality and the minimization of morbidity from aminophylline toxicity. PMID- 3543828 TI - Drowning, near-drowning, and ice-water submersions. AB - Drowning is the second most common cause of accidental death in children. Swimming pools and natural bodies of water close to home present the greatest risk to young children. The single most important step in the treatment of submersion accident victims is the immediate institution of resuscitative measures at the earliest possible opportunity. Ice-water submersion accidents are an important subgroup of near-drowning victims, who at times can defy predictions for outcome after profound anoxic-ischemic insults. Drowning accident prevention is an important public health measure. PMID- 3543829 TI - Adverse occurrences in the pediatric intensive care unit. AB - This article is intended to provide a review of the literature describing adverse occurrences affecting children in the intensive care unit. In addition, information related to the care of critically ill children is inferred from studies of adult or neonatal patients. Finally, areas in need of future investigation are suggested. PMID- 3543830 TI - Forced expirations against a variable resistance: a new chest physiotherapy method in cystic fibrosis. AB - Twenty patients with cystic fibrosis (CF) were trained to mobilize intrabronchial secretions by a new method of positive expiratory pressure mask (PEP mask) physiotherapy (PT). Patients repeatedly expired forcefully through the PEP mask; expiratory resistance was varied by eight different internal diameter resistors at the outlet. Forced vital capacity with the mask (FVCPEP) was determined for each resistor and was compared with the one measured without the instrument (FVC); simultaneously the sustained expiratory pressure (SEP) developed against the resistance was recorded. After training, each patient exceeded FVC with one or more resistors; "optimum" FVCPEP was 124 +/- 16% FVC at a SEP of 61 +/- 21 cm H2O. Using the PEP mask, patients cleared a higher percentage of their daily sputum volume than with conventional PT (78 +/- 22% versus 53 +/- 17%, p less than 0.01). In 11 patients (subgroup 1), multiple aspects of lung function were measured at the beginning of the study, after 10 months with PEP mask PT, after two further months without using the mask but with conventional PT, and after six more months with PEP mask PT. Results showed significantly increased expiratory flow rates, significantly decreased hyperinflation and airway instability with PEP mask PT, and a marked decline of lung function without it. The remaining nine patients (subgroup 2) entered into the same protocol; based on findings in subgroup 1 and on ethical considerations, however, the control period without PEP mask PT was then omitted, resulting in a steady and statistically significant improvement of lung function over the entire observation period. In the course of preliminary trials, two children transiently used a suboptimal resistance (FVCPEP less than FVC) and responded with a deterioration of lung function. By dilating airways and evacuating trapped gas, this method of PEP mask PT improves lung function and mucus clearance in CF. Thorough practice with the technique and frequent control of the optimal resistance are mandatory. PMID- 3543831 TI - Pulmonary hemosiderosis. PMID- 3543832 TI - Vaginal Chlamydia trachomatis prevalence in sexually abused prepurbertal girls. AB - The prevalence rate of Chlamydia trachomatis in the vagina of prepubertal sexually abused children was examined. Additionally, the culture technique was compared to direct immunofluorescence assay (DFA) for diagnosing chlamydial infections in the vaginas of prepubertal children. The study group included 50 consecutive prepubertal girls examined for sexual abuse in an urban pediatric hospital's emergency room. Vaginal swabs were obtained for culture and direct immunofluorescence assays of C trachomatis and for gonorrhea culture. Of these, 8/47 (17%) of the Chlamydia cultures, 4/43 (9.3%) of the direct immunofluorescence assay specimens, and 0/49 gonorrhea cultures were positive for Chlamydia. All patients with positive findings by direct immunofluorescence assay also had positive chlamydial cultures. Of the four other patients with positive cultures for Chlamydia, two had negative findings by direct immunofluorescence assay and two had inconclusive results reported. Twenty-nine patients had a syphilis serologic study performed, and all had negative results. There was no significant difference between the Chlamydia-positive and -negative groups with regards to age, race, nature of the abuse, frequency of abuse, and symptoms or findings on physical examination. Although not statistically significant, children with cultures positive for C trachomatis reported rectal penetration five times and vaginal penetration twice as often as those children with C trachomatis-negative results. This study demonstrates a significant prevalence of vaginal chlamydial infections in sexually abused children. Vaginal cultures for C trachomatis should be included in the medical evaluation of sexually abused girls. The culture technique was superior to the direct immunofluorescence assay in this group of patients. PMID- 3543833 TI - [Alcohol and the metabolism of the child]. PMID- 3543834 TI - [Carotid artery occlusion in meningitis due to Streptococcus B]. AB - A 14 days old neonate presented an occlusion of the right internal carotid artery complicating a Streptococcus B meningitis. We discuss the mechanism of this rare complication of purulent meningitis, usually due to hemophilus influenzae. PMID- 3543836 TI - [Prefabricated root canal posts]. PMID- 3543835 TI - Hexcelite versus plaster of Paris: a controlled trial of the below-knee walking cast. AB - Hexcelite and plaster of Paris below-knee walking casts were compared in a controlled clinical trial, involving 82 patients. Fewer bandage complications, problems and better comfort was found with Hexcelite compared to plaster of Paris (P less than 0.05). If all costs relating to materials, transportation, complications and extra visits due to these, were taken into account, plaster of Paris was found more expensive than Hexcelite. Based on the above an increased use of Hexcelite is recommended. PMID- 3543837 TI - Proximal tooth open contacts and periodontal health: evolution and current knowledge. PMID- 3543838 TI - Transport phenomena in pulsating post-stenotic vortex flow in arteries. An interactive concept of fluid-dynamic, haemorheological and biochemical processes in white thrombus formation. AB - Blood in its native state is a highly "non-Newtonian" or anomalous fluid; this notwithstanding, in its native state, all cellular and plasmatic components remain in isolation and do not interact with each other or with the endothelial cells. The rheological behaviour of flowing blood, and that of blood components during the formation of thrombi, coagulate and thrombotic deposits, can be using a three-step procedure. The present paper deals with these, by delineating: the flow conditions under which flow occurs in various vessels, in stenoses, bifurcations under the influence of variable haemodynamic and geometric conditions; the so-called "flow properties" of blood components such as apparent viscosity, behaviour in shear, their behaviour in non-laminar flow, i.e. that occurring near and at sites of secondary flow. As a subsequent step, it is necessary to design appropriate test devices to assay the rheological behaviour in vitro of blood components under closely controlled fluid-dynamic, physico chemical and biochemical conditions. The present review outlines the characteristic details of microflow in secondary flow (short-lived vortices) such as they prevail in pulsatile flow in arterial segments with "non-cylindrical configuration". In honour of the late Alexander Naumann, one of the founders of contemporary biofluid dynamics in Germany, the characteristic and functionally inseparable fluid-mechanical and rheological peculiarities of flow in eddies or vortices are termed Alexander Naumann vortex flow. They consist of a combination of high shear, recirculation and stagnation point flow. The micro-rheological, cytological and biochemical behaviour of blood platelets in such vortices is described, the integral effects of which render to the vortex the characteristics of a short-lived flow reactor for rapid pro-coagulatory processes and deposition of activated blood components onto the vessel wall. PMID- 3543840 TI - Single-stranded M13 DNA: use as a cloning vector. PMID- 3543839 TI - A rapid method for determining tRNA charging levels in vivo: analysis of yeast mutants defective in the general control of amino acid biosynthesis. AB - We describe a simple method to quantitate the intracellular levels of charged tRNA species representing all 20 amino acids. Small RNA species are isolated from yeast cells under conditions where amino acids remain bound to their cognate tRNAs. After chromatographic removal of free amino acids, the tRNAs are discharged, and the amounts of the released amino acids are then quantitated. This method was applied to yeast cells from a wild type strain and from three mutant strains that are defective both in the general control of amino acid biosynthesis and in protein synthesis. Two of these mutant strains, previously shown to be defective in the methionine or isoleucine tRNA synthetases, respectively contain undetectable amounts of charged methionine or isoleucine although their levels of the remaining 19 amino acids are similar to a wild type strain. In contrast, a gcd1 mutant strain has normal levels of all 20 amino-acyl tRNA species. Thus, gcd1 strains are defective in general control of amino acid biosynthesis for reasons other than artifactual starvation of an amino acid due to a failure in tRNA changing. PMID- 3543841 TI - Sequence and expression of four mutant aspartic acid tRNA genes from the mitochondria of Saccharomyces cerevisiae. AB - Expression of the mitochondrial tRNAAsp gene of Saccharomyces cerevisiae has been examined in five syn- mutants known to affect tRNAAsp function, and in a rho- mutant which accumulates precursor tRNAs. By comparison of wild-type versus mutant DNA sequence, the lesion in each syn- mutant has been identified as a single base change within the mitochondrial tRNAAsp structural gene. The mutant tRNAAsp genes are transcribed, and the transcripts can be processed to mature 4S size tRNAAsp. The steady-state level of each mutant tRNAAsp is lower than that of wild-type tRNAAsp. The RNA from two of the syn- mutants contained a second, slow migrating form of mitochondrial tRNAAsp which is correctly processed at the 5' end. We conclude that the lesions in the syn- mitochondrial tRNAAsp genes block neither transcription of these genes, nor 5'-end processing of the transcripts. The effect of each point mutation must be manifested at the level of 3'-end processing, or at a functional level. PMID- 3543842 TI - CAI: let the buyer beware! PMID- 3543843 TI - 'All a woman's life can bring': the domestic roots of nursing in Philadelphia, 1830-1885. PMID- 3543844 TI - 'A cooperative venture' in pursuit of professional status: a research journal for nursing. AB - Increased demand for nurses to provide post-World War II expanded health care services compelled the government to create the financial and programmatic resources necessary to meet that demand. These resources, located mainly in academic institutions, required nurses to achieve the same credentials that obtain in other academic disciplines. The research activities spawned in this process needed a publishing outlet and nurse-educators created Nursing Research to provide that outlet. But some nurses always did research of a sort. The publication of Nursing Research in 1952 signified public, institutional recognition for research in nursing. Nurses initially approached the process of research in a manner that typified quintessential nursing procedure. Intently focused on process, the editors used the journal to teach the research process, yet did not define what constituted a proper study until 1959. All but a few focused on "doing" research and following correct procedures. Researchers mainly investigated practical questions addressing day-to-day issues of interest to the investigator--whether clinician, teacher, or manager. Creative ideas were not their central concerns. Although the journal's content changed over the years, its process of socializing nurses into the intricacies of research persisted until the 1980s. How to do research, the focus of the 1950s, became what is methodology in the 1960s, what is theory and how to get funded in the 1970s. The 1980s brought to fruition the journal's professional agenda to publish fully developed, frequently funded, theory-grounded research articles of which at least half consistently reported clinical studies. Increased replication to improve predictability and wider application in nursing practice comprise the current agenda.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543845 TI - Nursing and politics: a forgotten legacy. PMID- 3543846 TI - The American Nurses' Association influence on federal funding for nursing education, 1941-1984. PMID- 3543847 TI - Missing data: nurses with their patients. PMID- 3543849 TI - From custody to community in psychiatric nursing. PMID- 3543848 TI - Left carrying the bag: experiments in visiting nursing, 1877-1909. PMID- 3543850 TI - A caring dilemma: womanhood and nursing in historical perspective. PMID- 3543851 TI - Sources and references for research in nursing history. PMID- 3543852 TI - Forging a research discipline. PMID- 3543854 TI - Nursing history: the maturing sun. PMID- 3543853 TI - Defining nursing: a historic controversy. PMID- 3543855 TI - Harold Macmillan: farewell to a friend of nursing. PMID- 3543856 TI - Bone marrow transplant--the process. PMID- 3543857 TI - Observations on the reliability and validity of the design and diet history method in the Melbourne Colorectal Cancer Study. AB - The paper is a description of, and a practical guide to, the questions, problems, and pitfalls that can arise in the planning and execution of a large-scale epidemiological study of diet and disease; this study was an eight-year project in which diet histories were collected from over 2,000 people. Qualified dietitians obtained a quantitative diet history, which covered all foods eaten in Australia, and assessed as the most representative of the previous 20 years. Because over half of both cases and controls changed their diets in the previous 20 years, the period of recall nominated varied, but this was not a major bias. There was no effect of seasonality on recall. The average duration of the interview was one hour for both cases and controls. The response rate was 84% for cases and 94% for controls, suggesting that the time for interview of the diet history method is not a deterrent for a high response rate. In general, between interviewer variation was small, although the intakes of total vegetables, cruciferous vegetables, and leafy green vegetables were the least repeatable. Between-interviewer differences were not found to affect the relative risks. Reproducibility of placing a dietary factor into a particular quintile of consumption was good for most foods, but it was lowest for cruciferous and leafy green vegetables. Interviewer bias regarding the dietary causes of colorectal cancer was not a major bias. Analysis of within-interviewer variation over time and analysis of recall bias were not major biases, as far as could be assessed in this study. Indirect validation of the nutritional data in the study (by comparison with other studies, by national per capita consumption, and by a comparison of energy intake with estimated energy requirements based on height, weight, and activity levels) suggested that the data are not an overestimate of intake. Cases and controls were both overestimating and underestimating their dietary intakes to a similar degree. For epidemiological studies of diet and disease, the quantitative diet history method as used here is recommended, particularly if the main objective of the study is to confirm hypotheses. PMID- 3543858 TI - The Lady with the Lamp (Florence Nightingale). PMID- 3543860 TI - Evolution of the matrix for Class 2 restorations. PMID- 3543859 TI - Progressive muscle relaxation as antiemetic therapy for cancer patients. PMID- 3543861 TI - Effectiveness of direct restorative materials in repairing cast restorations. PMID- 3543862 TI - Influence of dentin surface treatments on the bond strengths of dentin-lining cements. PMID- 3543863 TI - [Methods of respiratory rehabilitation in patients with chronic obstructive lung diseases]. PMID- 3543864 TI - [Prospects of using prostaglandins in the treatment of acute pancreatitis and its complications]. PMID- 3543865 TI - [Alcohol and HDL (high density lipoproteins)]. PMID- 3543866 TI - [Peripheral blood levels of insulin and C-peptide in patients with hyperthyroidism]. PMID- 3543867 TI - [Use of the immunoenzyme method for studying circulating immune complexes in idiopathic and secondary thrombocytopenia]. PMID- 3543868 TI - [Fibrinolytic treatment of acute myocardial infarction]. PMID- 3543869 TI - [Preoperative diagnosis of primary cancer of the gallbladder by ultrasonography and computerized tomography]. PMID- 3543870 TI - [Prof. Edward Szczeklik--a Polish physician and scientist 1898-1985]. PMID- 3543871 TI - Soft-tissue swelling in two neonates during prostaglandin E1 therapy. AB - Two small neonates, one with hypoplastic right heart syndrome, and the other with tetralogy of Fallot and pulmonary atresia, were treated with intravenous prostaglandin E1 (Prostyn VR, Upjohn, Kalamazoo, Michigan) for 96 and 33 days, respectively. They developed limited cortical hyperostosis, but marked soft tissue swellings in all extremities. The changes were noted after PGE1 treatment for four weeks and one week, respectively. A skin biopsy was performed in one patient and revealed edematous changes and arteriolar wall abnormalities. We add this peripheral hard edema to the list of complications of PGE1 therapy, and speculate as to its pathophysiology. PMID- 3543873 TI - Cardiac rhabdomyoma presenting as fetal hydrops. AB - Fetal hydrops and possible congenital heart disease with atrioventricular block was diagnosed one day before birth in a male infant of 35 weeks' gestation. Echocardiography and angiocardiography soon after birth revealed a cardiac tumor. The child died three days after birth. Necropsy showed tuberous sclerosis involving the heart (type-I rhabdomyoma), kidneys, retina, and central nervous system. PMID- 3543872 TI - Two-dimensional and Doppler echocardiographic features of left circumflex coronary artery to right ventricle fistula: case report and literature review. AB - We report the case of a seven-month-old infant with a clinical diagnosis of patent ductus arteriosus whose two-dimensional and Doppler echocardiographic examinations were consistent with a coronary artery fistula. At angiography, a left circumflex coronary artery to right ventricle fistula was diagnosed. Echo Doppler techniques for the noninvasive diagnosis of this lesion are discussed and the literature is reviewed. PMID- 3543874 TI - Intracardiac teratoma in an infant. AB - We report the only infant known to us who has survived surgery for a primary right ventricular teratoma. Included is a review of other reported cases of teratoma of the heart in infancy and childhood. PMID- 3543875 TI - [Value of transfontanelle ultrasonic examination of the brain in children]. PMID- 3543876 TI - [Aortic arch anomaly of the "kinking" type. Clinical and radiologic evaluation]. PMID- 3543877 TI - [Value of ultrasonic examination in cases of failure of kidney visualization by urography]. PMID- 3543879 TI - [Structure of radioisotope diagnosis in in vivo examinations conducted in Poland]. PMID- 3543878 TI - [Semiquantitative parametric analysis of renograms recorded by the ZM-703-M3 IZOLDA medical device]. PMID- 3543880 TI - [Ultrasonic examination of the spleen]. PMID- 3543881 TI - [P-31 spectroscopy and its use in biology and medicine]. PMID- 3543882 TI - [Evaluation of dental and dental DX roentgen films produced by the WZF Foton]. PMID- 3543883 TI - [A case of glioma of the brain with limited necrosis of the bone in the cranial vault]. PMID- 3543884 TI - [Carcinogenic effect of low-radiation doses in humans]. PMID- 3543886 TI - Epidemiology and the extent of mental retardation. AB - Drawing firm conclusions from various findings of epidemiologic research in the mental retardation field is fraught with seemingly endless frustration and confusion. There have been so many studies in different countries on various sized populations with dissimilar methodologies, and concepts and conditions often have been defined differently. Results from various surveys too often lack congruity, and sometimes findings are not reported until several years after the data are collected. However, these criticisms of epidemiologic studies are not meant to suggest that they are worthless or that investigators have been incompetent. Each was attempting to examine different features of particular populations under diverse circumstances, with varying resources and measurement tools, and with distinct goals in mind. It is safe to say that attempting to compare or generalize information collected in one geographic location with another can be very difficult and often unwise. If one intends to plan rationally the services for a particular geographic area, then one must use data that are derived from the population in that area. Finally, results from epidemiologic surveys have been useful in educating professionals and the general public about the extent of problems presented and experienced by persons with mental retardation. As well, this information has proved essential for properly planning and prioritizing the need for services of a diagnostic, treatment, prevention, and research nature. To improve epidemiologic research in the future, it is hoped that coordinated, multipurpose, nationwide, and international data reporting systems for the collection of uniform mental health-mental retardation data can be developed. PMID- 3543885 TI - [Use of arterial embolization through catheter in the treatment of pulmonary hemorrhage]. PMID- 3543887 TI - Prenatal diagnosis of mental retardation and its implications. AB - Prenatal diagnostic procedures and their implications are reviewed with particular reference to mental retardation. The subject has biomedical, psychosocial, ethical, and legal ramifications, and consideration is given to each of these. These issues require the attention of psychiatrists because of emotional stresses, anxieties, and conflicts engendered by the circumstances under which consideration of prenatal diagnostic procedures becomes relevant, by the undertakings themselves, and by the complex and sensitive decisions that may subsequently need to be made. PMID- 3543888 TI - Neuropsychiatric complications of mental retardation. AB - Certain aspects of mental retardation and organic brain disease are discussed: notably, psychopathology, the delayed effects of congenital infections, epilepsy, and the association between Down's syndrome and dementia. PMID- 3543889 TI - Early developmental backgrounds of autistic and mentally retarded children. Future research directions. AB - A brief account of the main diagnostic distinctions between autism and mental retardation is provided, which serves as the basis for reviewing available evidence on possible commonalities and differences in the developmental backgrounds of these two groups of children. Systematic comparisons in the histories of the two groups have rarely been undertaken, yet they are crucial for understanding the agents and processes uniquely associated with the genesis of each condition. Specific suggestions are made on some fruitful avenues for such comparative research undertakings. PMID- 3543890 TI - Disorders of language, communication, and behavior in mentally retarded children. Some ideas on their co-occurrence. AB - The thesis of this article is that deficits in language and communication contribute to behavior problems in childhood. Mentally retarded children show a range of deficits in language and communication compared with normals; they are also at increased risk for behavior problems. The evidence suggests that these deficits are quantitative rather than qualitative. In addition, these linguistic deficits may contribute independently to the development of behavior disorders insofar as the linguistic deficit interferes with the child's ability to make himself understood or to understand others. PMID- 3543891 TI - Medicolegal aspects of mental retardation. AB - This article reviews practical medicolegal issues that have arisen within the field of mental retardation. Important medicolegal issues involved in education, employment, community living, marriage, parenthood, guardianship, sterilization, and the right to treatment and refusal of treatment are discussed. Criminal issues affecting the mentally retarded are also reviewed. PMID- 3543892 TI - Psychotherapies with the mentally retarded. AB - The need for psychotherapy with the mentally retarded is evident from the high prevalence of emotional disturbance in this group. Psychotherapy can be done following the same general principles as with nonretarded persons, with modifications for the level of cognitive and language skills. Psychotherapy is effective for a broad range of problems, especially in the area of social skills. In an era of increased community placement, this area becomes an important focus for the prevention of further emotional disturbance. The paucity of research to date indicates that the various forms of psychotherapy with the mentally retarded produce favorable results. The overall outcome maximizes the contribution of the retarded to society and minimizes family pathology. Further evaluation and more systematic studies are greatly needed in order to sensitize professionals and society at large to the undeveloped potential of the retarded and their response to this form of intervention. PMID- 3543893 TI - Pharmacologic management of aggressivity and self-mutilation in the mentally retarded. AB - The use of pharmacologic agents in the control of aggression and self-mutilation in the mentally retarded is controversial but at times necessary for the implementation of behavioral treatments. The choice of drug is often empirical, as the specific etiology of aggression is generally unknown. On the other hand, certain rare conditions may be treated specifically. Controlled therapeutic studies are still lacking, as most treatments are symptomatic and nonspecific. PMID- 3543894 TI - Behavioral research in self-injury and self-stimulation. AB - This article reviews the behavioral literature on self-injury and self stimulation. Studies investigating the causes of such pathologic behavior and methods of treatment are critiqued. New, promising treatment procedures, such as "sensory extinction," are described and discussed. PMID- 3543895 TI - Research on parenting by mentally retarded persons. AB - This article focuses on research related to the assessment and training of parenting competencies of persons with mental retardation and the status of the children being raised by retarded parents. Previous findings and that of our own investigations suggest that (1) children of mentally retarded parents are at risk for language and cognitive delays, mental retardation, maltreatment, and neglect; (2) child development is highly correlated with the quality of the home environment and mother-child interactions; (3) retarded mothers provide less positive interactions with their children during play than do nonretarded mothers; and (4) retarded mothers can be taught to improve their child-rearing skills. PMID- 3543896 TI - [Cardiac tamponade]. PMID- 3543898 TI - Treatment of the bunion deformity. PMID- 3543897 TI - Morton's neuroma: a review of recent concepts. AB - A number of new concepts in the pathology, diagnosis, and management of Morton's metatarsalgia have been presented in the recent literature. Probably as many questions as answers have been generated by these publications. The taut transverse metatarsal ligament appears to play a critical role compressing the interdigital nerve but the exact pathomechanics producing the neuroma and the role of the intermetatarsal bursa remain unclear. Electrodiagnostic techniques for this condition are in the early development stage and may be clinically applicable in the near future. Support for and recommendation against the preoperative injection of the intermetatarsal bursa and interdigital nerve area have been discussed. The necessity of interdigital neurectomy has been questioned but currently in North America, simple transverse metatarsal ligament division has not been widely utilized. Continued studies along these lines should improve our understanding of Morton's metatarsalgia, increase our diagnostic accuracy, and facilitate more effective management. PMID- 3543899 TI - Mastocytosis: a review. AB - Mastocytosis refers to a spectrum of clinical and laboratory abnormalities attributable to tissue infiltration by large numbers of mast cells and to the discharge of various biologically active substances by these cells. It most commonly results in cutaneous manifestations during childhood but may develop at any age or involve almost any organ system. The treatment of mastocytosis has become considerably more practicable in recent years with the availability of agents that directly inhibit mast cells or temporarily reduce their quantity in the skin. PMID- 3543900 TI - Differential diagnosis of jaundice. Hepatocellular versus obstructive disease. AB - The patient with jaundice may be accurately diagnosed through clinical history, physical findings, and noninvasive laboratory and radiologic examinations available in most community hospitals. Ultrasonography is usually the procedure of choice in initial evaluation, but if acute cholecystitis is suspected, hepatobiliary scintigraphy is highly reliable and easy to perform. Computed tomography (CT) should be used if ultrasonography has not yielded the information needed; however, transient biliary obstruction cannot be diagnosed with CT unless ductal dilatation is present. The presence of laboratory data indicative of almost certain parenchymal liver disease should alert the physician to avoid unnecessary tests that are both costly and potentially dangerous. The final assessment of biliary duct patency may require transhepatic or retrograde cholangiography. Both procedures are effective but carry important potential complications. PMID- 3543901 TI - Therapeutic options for gallstones. AB - Patients with asymptomatic gallstones should not be considered surgical candidates; patients with defined symptoms of biliary tract disease, however, should be advised not to postpone surgery or endoscopic sphincterotomy with stone retrieval. A smaller group of patients who fulfill specific criteria may benefit from chenodiol (Chenix) therapy and long-term follow-up. Such experimental techniques as dissolution with methyl tert-butyl ether and fragmentation with extracorporeal shock waves hold exciting promise for the future. PMID- 3543902 TI - Human toxocariasis. Review with report of a probable case. AB - A 23-year-old woman with fever, myalgias, stridor, pelvic cramping, lower abdominal pain, and profound eosinophilia was presumed to have toxocariasis. An enzyme-linked immunosorbent assay titer of 1:64 and an elevated IgE level supported the diagnosis. The patient became asymptomatic without treatment, and the eosinophil count returned to normal over several months. A stool sample from her dog was found to contain Toxocara canis ova, but the patient had no history of geophagia. Presumably, she acquired infection by hand-to-mouth transmission of infectious ova after handling the dog. Toxocariasis from this type of transmission is usually not seen in an adult, but it does occur, as this case demonstrates. Thus, the primary care physician should consider toxocariasis in any patient with a suggestive clinical picture and eosinophilia. PMID- 3543904 TI - Postgraduate Medicine turns 40. Join us in the celebration. PMID- 3543903 TI - Current issues in transfusion therapy. 2. Indications for use of blood components. AB - Many factors have stimulated a recent renewal of interest in indications for and use of blood components, including red blood cells, platelets, fresh-frozen plasma, cryoprecipitate, and granulocyte concentrates. Laboratory test results often provide helpful guidelines for the decision to use blood components. In this era of cost consciousness, the most important consideration still is to treat the patient in the most expedient and beneficial way. A conservative approach with an emphasis on high-quality medical practice is to choose and use blood components with consideration of both clinical information and laboratory findings. PMID- 3543905 TI - Syphilis. Updated approach to an old disease. AB - Syphilis, a sexually transmitted disease caused by Treponema pallidum, is widespread but most common in large cities. The various stages include primary, secondary, latent, tertiary (late), and congenital syphilis and neurosyphilis. Definitive diagnosis is made by finding spirochetes on a darkfield examination of material from a chancre or moist mucosal lesion. Serologic tests for syphilis in common use in the United States include the VDRL and the FTA-ABS. Penicillin is the drug of choice for all stages of syphilis, with tetracycline or erythromycin indicated in certain patients. Accurate and prompt reporting of syphilis cases is an important factor in disease control. PMID- 3543906 TI - Essential hypertension. Matching pathophysiology and pharmacology. AB - The underlying pathophysiologic mechanisms that elevate arterial pressure differ according to the patient's age, adipose body mass, and race. However, these mechanisms represent the extremes of a continuum, and overlap among them can be encountered in some patients. A few simple clinical clues allow the physician to identify whether an increase in cardiac output, total peripheral resistance, or both is the predominant mechanism in a given patient. Antihypertensive therapy should be aimed not only at lowering arterial pressure but also, more importantly, at ameliorating the concomitant pathophysiologic abnormality. A beta adrenoreceptor blocker is the initial drug of choice in young patients with "cardiogenic hypertension." In middle-aged patients, cardiac output is usually normal and elevated total peripheral resistance becomes the hemodynamic culprit. In these patients, an angiotensin-converting enzyme (ACE) inhibitor, antiadrenergic drug, or calcium channel blocker should be given to lower total peripheral resistance without affecting cardiac output. In elderly patients, the burden on the heart should be lessened by use of an agent that lowers preload and afterload, such as an ACE inhibitor or certain of the calcium blockers. In obese patients in whom intravascular volume is expanded and in most black patients, the initial antihypertensive agent of choice remains a thiazide diuretic unless left ventricular hypertrophy is present. PMID- 3543908 TI - Treatment of chronic headache. A nonpharmacologic approach. PMID- 3543907 TI - Oral contraceptives. The benefits and the cardiovascular risks. AB - For healthy women under 25 years of age, the benefits of oral contraceptive (OC) use far outweigh the risks. Because the agents protect against such life threatening conditions as ovarian and endometrial cancer, pelvic inflammatory disease, and ectopic pregnancy, the number of deaths they prevent is larger than the number they cause. For nonsmokers up to age 40, OCs may offer more benefits than other available fertility-control methods, although for smokers 35 years of age or older, the risks of OC use outweigh the benefits. When risk factors for cardiovascular disease are taken into account in selecting OC users and when an appropriate agent is chosen, the likelihood of a cardiovascular accident is greatly reduced. The formulations containing low-dose estrogen and low-dose, low potency progestins appear to be safest, as they have fewer adverse effects on serum lipids and lipoproteins. PMID- 3543909 TI - Emergency medicine 1947-1987. A PGM retrospective. PMID- 3543910 TI - Cardiopulmonary resuscitation. Historical and future perspectives. AB - Although cardiopulmonary resuscitation (CPR) has been practiced for over a century, further study into methods for reviving victims of cardiac arrest is obviously needed. We now know that standard external CPR has numerous drawbacks, and modifications must be tested in a careful, randomized fashion. Three alternatives to standard external CPR (simultaneous compression-ventilation, interposed abdominal compression, and open-chest CPR) are currently being investigated. Of these procedures, open-chest CPR appears to show the most promise. Reproducible animal data must demonstrate the advantages of any method before widespread human studies are begun, however. If techniques seem promising in animals, well-controlled multicenter studies will be needed to verify applicability to humans. Major changes in CPR techniques should be made only after careful study, not on the basis of a limited number of reports from a single source. Resuscitation research must also extend beyond the study of techniques of cardiac massage. Although CPR is effective in some cases, clearly a person's chance of survival is directly linked to the speed of definitive care, that is, defibrillation. Research must continue into ways of providing rapid advanced cardiac care, such as home defibrillators or rapid prehospital response to the victims of cardiac arrest by those trained in advanced cardiac life support (ACLS). In addition, to counteract the problem of neurologic demise after prolonged anoxia, study of postresuscitative care must continue. Only through the combination of these measures will survival rates after cardiac arrest improve. PMID- 3543911 TI - Bromocriptine, dopamine and glaucoma. PMID- 3543912 TI - Juvenile chronic arthritis--clinical sub-groups with particular relationship to adult patterns of disease. PMID- 3543913 TI - The development of diabetes mellitus and chronic liver disease in long term chelated beta thalassaemic patients. AB - We studied 29 patients with thalassaemia major who had received intensive chelation for between 6.2 and 8.8 years. All patients had normal oral glucose tolerance tests before subcutaneous chelation therapy was introduced and 22 of 29 patients had normal liver function tests. At the end of the period of study 12 patients still had normal oral glucose tolerance (7 with normal liver function tests and 5 with chronic active hepatitis). On the other hand, 11 patients had developed impaired glucose tolerance tests (3 patients had normal liver function tests, 5 with chronic active hepatitis and 3 with cirrhosis), and 6 patients had developed frank diabetes mellitus (one with chronic active hepatitis and 5 with cirrhosis). Patients with chronic active hepatitis showed 91% positivity for one or more hepatitis B markers whilst all patients with cirrhosis were positive. Ferritin levels before subcutaneous chelation in patients with normal oral glucose tolerance tests were lower than in those patients with abnormal oral glucose tolerance or diabetes (P less than 0.05) but none had normal serum ferritin levels. In addition, a positive correlation was found between glucose area under the curve after chelation therapy and serum ferritin levels (r = 0.47, P less than 0.01). It is apparent that long term chelation therapy does not prevent the development of abnormal oral glucose tolerance in chronically transfused patients. More intensive chelation therapy is needed to prevent tissue damage. Chronic liver disease may have an important role to play in the deterioration of glucose tolerance. PMID- 3543914 TI - Pneumonia. PMID- 3543915 TI - Pathobiology of platelet-activating factors. AB - Throughout the evolution of knowledge about inflammation, a primary goal has been to understand this important biological response in sufficient depth to prevent the unwanted tissue injury that may spontaneously occur or that may coevolve to produce disease. That is, although the host defense systems normally function in a protective manner, excessive activation or alterations of the homeostatic regulation of the inflammatory responses often results in overt tissue injury and organ dysfunction. Thus, significant attention has been focused upon precise definition of the interactions of the myriad of involved cells and mediators so that interventions may be developed to block these events to prevent and control inflammatory tissue injury. PAF, as a relative newcomer to the investigative eye of experimental pathologists, is a potent proinflammatory mediator of many aspects of the complex host defense system. No doubt, its role in the initiation and maintenance of tissue injury or disease will be conclusively documented with additional research and forthcoming advances in biomedical technology. At present, however, we must be content to accept the conclusion that, while it is tempting to speculate that this unique phospholipid is involved in many different disease processes, unequivocal details to this end are lacking. Nonetheless, the spectrum of antagonists of PAF action which are currently evolving [cf. 95-100] will undoubtedly permit assessment of the putative contributions of PAF to many biological conditions associated with disease. At that time, meaningful conclusions as to the biological role of PAF in human tissue injury and disease may be provided. PMID- 3543916 TI - Human nonspecific effector leukocytes: possible function in herpes simplex virus infection. PMID- 3543917 TI - Herpes simplex virus encephalitis of the human adult: reactivation of latent brain infection. PMID- 3543918 TI - Effector functions of endothelium in inflammatory and immunologic reactions. PMID- 3543919 TI - [Possibilities in the use of gnathologic findings in the rationalization of prosthetic treatment]. PMID- 3543920 TI - [Reducing the etch time in the fissure sealing of primary molars]. PMID- 3543921 TI - [Protective effect of Sm 857 (Doqualast) in allergic bronchial asthma]. PMID- 3543922 TI - Prenatal detection of cystic fibrosis; comparative study of maltase and alkaline phosphatase activities in amniotic fluid. AB - The potential value of microvillar enzymes in the prenatal diagnosis of cystic fibrosis (CF) has previously been demonstrated and is corroborated in the present comparative study. Maltase and alkaline phosphatase (ALP) activities were studied in the amniotic fluids of 57 pregnancies with a 1 in 4 risk for CF or with a known CF outcome and in 489 controls. A simple assay for maltase activity (MU maltase) with the fluorogenic substate 4-methylumbelliferyl alpha-glucoside, offers great technical advantages and an at least equal detection rate of CF, when compared to the previously used test with maltose as substrate. Intestinal ALP was estimated either as phenylalanine inhibitable activity (PI-ALP) or as the proportions of residual activity in the presence of the inhibitors phenylalanine or homoarginine. MU-maltase and PI-ALP appeared the most successful methods: both tests were able to detect 14 of the 16 (88 per cent) pregnancies with fetal CF. Each of the two tests alone also allowed a correct prediction in 24 of the 25 pregnancies at risk but with normal outcome; however all 25 cases could be correctly predicted by a combined evaluation. It is suggested that more than one intestinal enzyme activity should be evaluated to allow optimal results in the prenatal monitoring of pregnancies at high risk for CF. PMID- 3543923 TI - [Membrane mechanisms of excretion of physiologically active substances by bacteria (review)]. AB - The review covers the evidence on the mechanisms of regulation of intracellular concentrations of low-molecular weight physiologically active substances, as well as of other intermediate or end metabolites by means of their excretion from bacterial cells. These processes can be considered as a particular level of metabolic regulation that can be called "membrane regulation". PMID- 3543924 TI - [Effect of luliberin on the secretion of luteinizing hormone as a function of the phase of menstrual cycle in intact and castrated female Papio hamadryas]. AB - A comparative study of the LH time course in response to the administration of a standard dose of LH/RF was conducted in intact and castrated female papio hamadryas to find out the relationship between hypophyseal sensitivity to LH/RF action and the level of sex steroid hormones in the peripheral blood. A bioradioimmunoassay adapted for the monkey plasma was employed to measure the level of biologically active LH in the peripheral blood plasma. A stimulating effect of LH/RF on the hypophyseal LH secretion both in intact animals in different phases of the menstrual cycle and in gonadectomized females was established. The relationship between the nature of the LH time course and the level of sex steroid hormones in the peripheral blood plasma was shown; a prolonged high level of LH reciprocal secretion into the follicular phase occurred against a background of a high and constant estradiol/progesterone ratio, and LH one-type impulse release into the luteal phase and in castrated females occurred against a background of a low value of the ratio of these hormones. PMID- 3543925 TI - [Histochemical study of enzyme activity of the exocrine and endocrine pancreas at different glucocorticoid levels in animal body]. AB - A comparative study was made of the activity of nonspecific phosphatases and lactate dehydrogenases, succinate and NADH in exocrine and endocrine pancreas in excess and deficiency of body glucocorticoids. SDH, NADH-DH and LDH activity in pancreatic acinar cells was shown to be higher than that in the endocrine epithelium but significantly lower than the activity of nonspecific phosphatases, acid phosphatase being the predominant enzyme of B-insulocytes and alkaline phosphatase the predominant enzyme of A-insulocytes. A stimulating effect of hydrocortisone physiological doses on pancreatic secretory activity was accompanied by the enhanced activity of nonspecific phosphatases and enzymes of the Krebs cycle in the exocrine epithelium and acid phosphatase, NADH-DH in B insulocytes. Large hydrocortisone doses as well as hormonal balance deficiency resulted in a decrease in the energy potential of acinar and endocrine cells. PMID- 3543926 TI - [Diagnosis of hormonally active hypophyseal tumors (review of the literature and personal data)]. PMID- 3543927 TI - [Current views on the endocrine function of ovaries under normal conditions and in various pathological states]. PMID- 3543928 TI - [Terminology, classification and diagnostic criteria of autoimmune thyroiditis]. PMID- 3543929 TI - Actin and intermediate-sized filaments of the spines and cytoskeleton of Schistosoma mansoni. AB - The organization of spines and filaments in whole worms and cytoskeletal fractions of adult Schistosoma mansoni was investigated. The ultrastructure of the spine revealed a closely packed filamentous organization of 3.5- to 5.6-nm elements and electron-lucent areas. Spines were surrounded at the base by electron-dense bodies and membrane invaginations, and covered at the tip by the syncytial surface membrane. Filaments, 7.5-11.1 nm in diameter, were closely associated with the base of the spines, between muscles, near mitochondria or nuclei, and in spaces of the subtegument. Cytoskeletal fractions prepared by homogenizing adults in Tris-HCl buffer, containing 0.6 M KCl and 1.0% Triton X 100, represented 19%-25% and 32%-38% of wet weight of males and females, respectively. The fractions contained nuclei, spines, 8 to 11 nm filaments, myofibrils, and granules. Vitellaria and egg shells were abundant in fractions from females. Six polypeptides with estimated molecular weights of 130, 96, 84, 78, 74 and 43 kdaltons were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis as the major components of the cytoskeleton. Monoclonal antibody to chicken actin (MAA) was localized predominantly in surface spines and tubercles of adult schistosomes by the indirect immunofluorescence test, while immune serum from infected mice reacted less specifically with the tegument. A 43 kdalton polypeptide with electrophoretic mobility identical to that of vertebrate actin, identified in cytoskeletal and tegumental fractions of adult worms, reacted positively with MAA on immunoblotting.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3543930 TI - Odontoblasts and nerves; just friends. PMID- 3543931 TI - Responses of pulp nerves to external irritation. PMID- 3543932 TI - Vitamin K-dependent carboxylase: possible role of the substrate "propeptide" as an intracellular recognition site. AB - The liver microsomal vitamin K-dependent carboxylase catalyzes the posttranslational conversion of specific glutamate residues to gamma carboxyglutamate residues in a limited number of proteins. A number of these proteins have been shown to contain a homologous basic amino acid-rich "propeptide" between the leader sequence and the amino terminus of the mature protein. Plasmids encoding protein C, a vitamin K-dependent protein, containing or lacking a propeptide region were constructed and the protein was expressed in Escherichia coli. The protein products were assayed as substrates in an in vitro vitamin K-dependent carboxylase system. Only proteins containing a propeptide region were substrates for the enzyme. These data support the hypothesis that this sequence of the primary gene product is an important recognition site for this processing enzyme. PMID- 3543933 TI - Control of oligomeric enzyme thermostability by protein engineering. AB - The ability to control the resistance of an enzyme to inactivation due to exposure to elevated temperatures is essential for the understanding of thermophilic behavior and for developing rational approaches to enzyme stabilization. By means of site-directed mutagenesis, point mutations have been engineered in the dimeric enzyme yeast triosephosphate isomerase that improve its thermostability. Cumulative replacement of asparagine residues at the subunit interface by residues resistant to heat-induced deterioration and approximating the geometry of asparagine (Asn-14----Thr-14 and Asn-78----Ile-78) nearly doubled the half-life of the enzyme at 100 degrees C, pH 6. Moreover, in an attempt to model the deleterious effects of deamidation, we show that replacement of interfacial Asn-78 by an aspartic acid residue increases the rate constant of irreversible thermal inactivation, drastically decreases the reversible transition temperature, and reduces the stability against dilution-induced dissociation. PMID- 3543934 TI - 3' homologous free ends are required for stable joint molecule formation by the RecA and single-stranded binding proteins of Escherichia coli. AB - The RecA protein of Escherichia coli is important for genetic recombination in vivo and can promote synapsis and strand exchange in vitro. The DNA pairing and strand exchange reactions have been well characterized in reactions with circular single strands and linear duplexes, but little is known about these two processes using substrates more characteristic of those likely to exist in the cell. Single stranded linear DNAs were prepared by separating strands of duplex molecules or by cleaving single-stranded circles at a unique restriction site created by annealing a short defined oligonucleotide to the circle. Analysis by gel electrophoresis and electron microscopy revealed that, in the presence of RecA and single-stranded binding proteins, a free 3' homologous end is essential for stable joint molecule formation between linear single-stranded and circular duplex DNA. PMID- 3543935 TI - Adenovirus type 2 endopeptidase: an unusual phosphoprotein enzyme matured by autocatalysis. AB - A 19-kDa protein, present in low copy number in purified adenovirus type 2, has been characterized. Several criteria were used to establish that this protein is neither a degradation product of the known structural proteins of the virion nor a minor, unusually modified, form of protein VII. This 19-kDa protein, unlike other virion proteins, possesses alkali-resistant phosphoamino acids. Analysis by partial proteolysis indicated that it is related to a 23-kDa phosphoprotein present in H2ts-1 virions assembled in infected cells maintained at 39 degrees C. Affinity labeling with [3H]diisopropyl fluorophosphate showed that the 19-kDa protein contains the active site for a serine protease. We, therefore, conclude that the 19-kDa protein is the active form of the adenovirus-encoded endopeptidase, defined by the H2ts-1 mutation, and is synthesized as a 23-kDa precursor that appears to mature by autocatalysis. PMID- 3543936 TI - Characterization of two members of the rho gene family from the yeast Saccharomyces cerevisiae. AB - The rho genes comprise an evolutionarily conserved family with significant homology to the ras oncogene family. Two members of the rho family were isolated from the yeast Saccharomyces cerevisiae and characterized by DNA sequence analysis. The yeast genes RHO1 and RHO2 are 70% and 57% identical, respectively, to the rho gene of the marine snail Aplysia, and they are 53% identical to each other. Inactivation of these genes showed that RHO1 is required for cell viability, while RHO2 is not an essential gene. A mutant allele of RHO1 (RHO1 His68) was constructed with a mutation analogous to one that activates the transforming potential of the human HRAS gene. Diploid strains containing RHO1 His68 in either low or high copy number are unable to sporulate, and the mutant allele is dominant over wild-type RHO1. The requirement for RHO1 cannot be circumvented by introduction of high copy number plasmids containing either the gene encoding the catalytic subunit of cAMP-dependent protein kinase or the mutant allele RAS2-Val19. Despite the conservation between the rho and ras gene families, the finding that RHO1 functions independently of the adenylate cyclase cAMP-dependent protein kinase cascade suggests that rho and ras are involved in distinct biochemical pathways. PMID- 3543938 TI - Haemophilus influenzae type b polysaccharide-protein conjugate vaccine. AB - An Haemophilus influenzae type b capsular polysaccharide-protein conjugate has been prepared. The polysaccharide was coupled to the serotype II protein of group B meningococcus through the spacer 6-aminocaproic acid using cyanogen bromide and water soluble carbodiimide. The conjugate can be shown to be reproducible and is stable and highly immunogenic in mice and African green monkeys. Clinical evaluation of this conjugate in children 3 months to 4 years of age showed that it elicited an antibody titer to the polysaccharide moiety greater than 1000 ng/ml in children 8 months of age or older. PMID- 3543939 TI - Desferrioxamine suppresses Plasmodium falciparum in Aotus monkeys. AB - Clinical observation has suggested that iron deficiency may be protective in malaria, and we have found that desferrioxamine (DF), an iron-specific chelating agent, inhibited Plasmodium falciparum growth in vitro. It was difficult to be confident that DF would be effective in an intact animal, however, because continuous exposure to DF was required in vitro and, in vivo, DF is rapidly excreted. Also, the in vitro effect of DF was overcome by addition of iron to the culture and in vivo there are potentially high local iron concentrations when iron is absorbed from the diet or released from reticuloendothelial cells. We now show that DF given by constant subcutaneous infusion does suppress parasitemia in P. falciparum-infected Aotus monkeys. PMID- 3543937 TI - Immortality of cell cultures derived from brains of mice and hamsters infected with Creutzfeldt-Jakob disease agent. AB - Isolates from six patients with Creutzfeldt-Jakob disease (CJD) were injected into various strains of hamsters and mice, and the infective agent was propagated. Serially passaged cultures were established from these CJD agent infected brains and from uninfected control brains. All healthy cultures (21 out of 21) from CJD agent-infected brains became immortal and/or transformed. In contrast only 3 out of 13 normal brain cultures became immortal, and the rest died out with serial propagation in vitro. The fact that permanent cell lines were readily derived from multiple rodent strains and all CJD isolates tested suggests that a transforming capability is an intrinsic property of CJD agents. This conclusion is supported by demonstrations of in vitro cell transformation by CJD infectious brain fractions. Although the molecular mechanism of transformation events associated with the CJD agent is not presently known, a provocative possibility is that the CJD agent has a direct effect on the host genome by mechanisms analogous to those known for slowly oncogenic retroviruses. PMID- 3543940 TI - EORTC Genitourinary Group Monograph 3: Developments in bladder cancer. Proceedings of the First International Consensus Development Conference on Guidelines for Clinical Research in Bladder Cancer. Antwerp, Belgium, June 20-22, 1985. PMID- 3543941 TI - Quality of life assessment in bladder cancer clinical trials: conceptual, methodological and practical issues. PMID- 3543942 TI - Experimental models of bladder cancer: a critical review. AB - We have reviewed critically the available models of bladder cancer, and have attempted to compare their strengths and weaknesses where appropriate data are available. Further direct comparisons of the applications of each model will be needed in order to rank them, and to identify areas of research where each model will predominate. Furthermore, more information will be needed to validate each model in the context of human disease. With the increasing range and sophistication of the tools of molecular biology, a very important future direction will be the characterisation of animal and human bladder cancer, and in particular the study of the changes from normal to neoplastic urothelium: tumor markers, chromosomal patterns and oncogenes that are associated with specific biological functions, such as invasion, metastasis and ultimate prognosis. The transfection of normal tissues by oncogenes to yield transformed or immortalised lines may be of critical importance in identifying the nature of neoplastic transformation. The use of animal tumors and xenografts, each with the availability of a physiological internal milieu (although different from human metabolic conditions) may yield useful systems for the testing of new therapeutic approaches. However, of the utmost importance is the continuing need to characterise and validate each model, to avoid multiple publications and nomenclatures pertaining to common lines, and to recognise the limitations of the heavily adapted long term cell lines in vivo and in vitro. The major deficiencies of the available lines continue to be found in the method of their application to basic research, rather than being inherent in themselves. Although there are many theoretical and practical applications of these models, it should not be forgotten that the direct study of human bladder cancer, including the appropriate processing of biopsy specimens, will remain integral to understanding the biology of this disease. PMID- 3543943 TI - Bladder tumors. Treated natural history. PMID- 3543944 TI - Prognostic factors in infiltrating bladder cancer. PMID- 3543945 TI - Response criteria phase II/phase III invasive bladder cancer. PMID- 3543946 TI - Response criteria for phase III studies of superficial bladder cancer. PMID- 3543947 TI - Pathology. PMID- 3543949 TI - Apical ectodermal ridge maintenance in ovo and in vitro. PMID- 3543948 TI - Modes of resistance to anthracyclines and other natural products. PMID- 3543950 TI - Informative molecules and induction in early embryogenesis. PMID- 3543951 TI - Hormonal/intercellular control of lung maturation. PMID- 3543952 TI - Growth factors and the embryonic kidney. PMID- 3543953 TI - Extraembryonic tissues as sources and sinks of humoral factors in development: teratocarcinoma model systems. PMID- 3543954 TI - The mechanism of chemically-induced differentiation of a mouse embryonal carcinoma cell line. PMID- 3543955 TI - Endocrine and autocrine control of growth and differentiation of teratoma-derived cell lines. PMID- 3543956 TI - Induction by physiological agents of differentiation of the human leukemia cell line HL-60 to cells with functional characteristics. PMID- 3543957 TI - The role of progenitor cells in cellular differentiation, cellular senescence and neoplastic transformation. PMID- 3543958 TI - Test of embryonic inducing factors: advantages and disadvantages of different procedures. PMID- 3543959 TI - Muscle regeneration revisited: growth factor regulation of myogenic cell replication. PMID- 3543960 TI - Environmental regulation of differentiated states of the pigmented epithelial cell: a unique culture system for studying molecular mechanisms of cell differentiation. PMID- 3543961 TI - Hormonal and environmental regulation of respiratory mucus cell differentiation. PMID- 3543962 TI - Extracellular matrix regulation of cell-cell communication and tissue-specific gene expression in primary liver cultures. AB - Epithelial-mesenchymal interactions are effected, in part, by extracellular matrix components. We have spent many years analyzing the influence of extracellular matrix, both as extracts of matrix and as purified matrix components, on the growth and differentiation of normal and neoplastic liver cells. Currently we are focused on analyzing the influence of the extracellular matrix components, glycosaminoglycans and proteoglycans. We have found that these factors induce dramatic morphological changes, are potent inducers of gap junction synthesis and can regulate tissue-specific gene expression. With respect to gap junctions: intercellular communication via gap junctions, as measured by dye and electrical coupling, disappears within 12 hrs in primary rat hepatocytes cultured in serum supplemented media or within 24 hrs in cells in a serum free, hormonally defined medium designed for hepatocytes. Glucagon and linoleic acid/BSA were the primary factors in the HDM responsible for the extended life span of the electrical coupling. Addition of proteoglycans or glycosaminoglycans to hormonally defined medium after 24 hrs resulted in reexpression of electrical and dye coupling when assayed at 96 hrs of culture. The incidence of coupling was less than 5% in hormonally defined medium alone. Coupling incidence increased to 10-30% with the addition of 10 micrograms/ml of glycosaminoglycans (i.e., hyaluronic acid, dermatan sulfate, chondroitin 4- or 6-sulfate, and iota- or kappa-carrageenan) to hormonally defined medium. By contrast, the same concentrations of chondroitin sulfate proteoglycan, dermatan sulfate proteoglycan, or lambda-carrageenan resulted in dye coupling in more than 70% of the cells, with numerous cells showing dye spread from a single injected cell (in the case of the proteoglycans). The greatest effect of those tested was elicited by the dermatan sulfate proteoglycans, which induced cell-cell communication in 90-100% of the cells. Heparins gave intermediate responses (30-50%). Western blots demonstrated that the amounts of the main intrinsic gap junction polypeptide (27 KDa) extractable from cells correlated with the degree of electrical and dye coupling. Thus, proteoglycans and glycosaminoglycans appear to elicit the formation and function of gap junctions and may thus play a role in the regulation of intercellular communication under normal and pathological conditions. With respect to gene expression: normal rat hepatocytes maintained in culture on tissue culture plastic and in serum supplemented medium lose their tissue-specific functions within hours to a few days due to loss of synthesis and to rapid degradation of tissue-specific mRNAs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3543963 TI - On the cellular communication of amphibian embryogenesis. PMID- 3543964 TI - Endothelial cell growth factor. PMID- 3543965 TI - Reflections on the evolution of the regulation of spermatogenesis. AB - We have developed the concept that mechanisms evolved very early for the modulation of spermatogenesis in response to changes in the external environment, and that these ancient control mechanisms were retained during subsequent evolution. In nearly all animals, the regulation of germinal cell development is postulated to be mediated through the control of gonadal somatic cell functions, associated with the creation and maintenance of an optimal milieu within the spermary of seminiferous tubule in which gametogenesis takes place. In primitive organisms, a small number of stages intervenes between environmental stimuli and subsequent alteration of gonadal somatic cell functions. In contrast, in more complex organisms, the number of intervening stages is greatly amplified and modulated via neuroendocrine mechanisms involving receptors, transducers, and various sorts of relays and messengers. The evolution of these neural and endocrine controls appears to have occurred in lock-step with the evolution of increasing layers of complexity of regulators of spermatogenesis. This is not unduly surprising, since the requirement to have functionally fertile male and female partners of the same species together at the same time and place would require considerable integration of behavioral and recognition mechanisms during courtship and mating. The nature of these neural mechanisms is likely to prove no less complex than that of mechanisms in the gonad required for successful gamatogenesis. The neuroendocrine regulation of spermatogenesis in starfish and in chordates is postulated to act in a manner completely homologous to the ways in which external environmental stimuli influence spermatogenesis in more primitive organisms. In both sets of cases, the gonadal somatic cells (nurse cells) are the ultimate targets which mediate the effective turning on or turning off of spermatogenesis. The hormone-responsive nurse cells are postulated to achieve this simply by creating a microenvironment in the vicinity of germinal cells which permits the expression of program required for development, or by failing to do so. In mammals, Sertoli cells and peritubular cells, only when optimally stimulated by hormones and paracine factors, are thought to form a functional unit which provides this necessary microenvironment. In less complex organisms, other nurse cell arrangements exist to nourish the syncytia of developing germ cells with the mixture of nutrients, salts, etc. required for a gametogenesis to take place in a protected milieu. PMID- 3543966 TI - Hormonal control of developmentally regulated adipose genes. PMID- 3543967 TI - Regulation of gene expression during the differentiation of 3T3-adipocytes. PMID- 3543968 TI - Cloning of muscle regulatory factors. PMID- 3543969 TI - Embryonic control of cancer. PMID- 3543970 TI - Mechanisms of cell adhesion in epithelial-mesenchymal transformations. PMID- 3543971 TI - Hormonal and non-hormonal features of selected epithelial-mesenchymal interactions during development. PMID- 3543972 TI - Circulating prostacyclin and thromboxane in patients with Graves' disease. AB - We measured plasma levels of PGI2 as 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane A2 (TXA2) as thromboxane B2 (TXB2) in patients with Graves' disease and in normal subjects. The levels of plasma 6-keto-PGF1 alpha were significantly elevated and correlated with those of serum T4 and T3, respectively, in hyperthyroid patients with Graves' disease. Significant reduction of 6-keto-PGF1 alpha levels was observed after antithyroid drug therapy. In contrast, the levels of plasma TXB2 were significantly lower in untreated patients with Graves' disease than in normal subjects. These data suggest that an elevation of plasma 6-keto-PGF1 alpha may play some additional role in pathophysiology of Graves' disease. PMID- 3543973 TI - Fluence-rate dependence of monophotonic reactions of nucleic acids in vitro and in vivo. PMID- 3543974 TI - Inactivation of phage by near-ultraviolet radiation and hydrogen peroxide. PMID- 3543976 TI - Dynamics of breathing in newborn mammals. PMID- 3543975 TI - Hormonal control of calcium metabolism during the reproductive cycle in mammals. PMID- 3543977 TI - Signal transduction and cytoskeletal activation in the neutrophil. PMID- 3543978 TI - Peripheral and spinal mechanisms of nociception. PMID- 3543979 TI - Functioning of the F-plasmid origin of replication in an Escherichia coli K12 Hfr strain during exponential growth. AB - The pattern of chromosome replication in the Escherichia coli K12 Hfr strain KL99 was investigated during exponential growth by DNA-DNA hybridization. The levels of chromosomal markers close to the point of insertion of F (near pyrC) were raised in relation to other markers by comparison with the situation in an isogenic F- strain. The data are shown to be consistent with the proposal that the integrated F plasmid was regulating its copy number by a mass-titration mechanism. PMID- 3543980 TI - Pyoderma gangrenosum: skin grafting after preparation with hyperbaric oxygen. AB - Four patients with pyoderma gangrenosum were treated with hyperbaric oxygen to prepare the wounds for skin grafting. Each wound responded to a course of daily hyperbaric oxygen with reduction of infection and increased capillary angiogenesis. During follow-up periods of 12 to 30 months, all wounds remained healed. Although the exact etiology of pyoderma gangrenosum is unknown, vasculitis with wound ischemia and infection are prominent components. Inspired oxygen partial pressures of 1100 to 1300 mmHg elevate wound oxygen tension despite relative ischemia. The impaired intracellular bacterial killing of hypoxic leukocytes is corrected during each day's 2-hour bolus of hyperbaric oxygen. Daily wound oxygenation increases collagen production by fibroblasts to support capillary angiogenesis. PMID- 3543981 TI - Decreased survival of experimental critical flaps in rats after sensory denervation with capsaicin. AB - The role of capsaicin-sensitive primary sensory neurons on the survival of experimental critical flaps was studied in the rat. Pretreatment with capsaicin, which depletes neuropeptide transmitter content from primary sensory neurons, caused a dramatic decrease in flap survival area compared to normal animals. In contrast, pretreatment with reserpine, which depletes catecholamines from adrenergic neurons, including the sympathetic post-ganglionic fibers, resulted in a significant increase in the survival area. It was concluded that both capsaicin sensitive primary sensory neurons and sympathetic postganglionic adrenergic neurons play a role in systemic vascular regulation and that intact primary sensory neurons are of importance for the survival of ischemic tissue. PMID- 3543982 TI - The causes of skin ulcerations associated with venous insufficiency: a unifying hypothesis. PMID- 3543983 TI - Reduction mammaplasty by the Robbins technique. PMID- 3543984 TI - [The personality of Stanislawa Przybyszewska in the light of her letters]. PMID- 3543985 TI - [Narcissistic personality disorders (analysis of clinical aspects)]. PMID- 3543986 TI - EOG-based recording and automated detection of sleep rapid eye movements: a critical review, and some recommendations. PMID- 3543987 TI - Overview of research in psychopharmacological treatment of the mentally ill/mentally retarded. PMID- 3543988 TI - Psychopharmacology--a recurring bibliography. PMID- 3543989 TI - [The history of psychosomatic medicine and the mind-body problem in medicine]. PMID- 3543990 TI - Preliminary study of carbamazepine in post-traumatic stress disorder. PMID- 3543991 TI - The integration of dominance and social bonding in primates. AB - Social dominance is usually viewed from the perspective of intragroup competition over access to limited resources. The present paper, while not denying the importance of such competition, discusses the dominance concept among monkeys and apes in the context of affiliative bonding, social tolerance, and the reconciliation of aggressive conflicts. Two basic proximate mechanisms are supposed to provide a link between dominance and interindividual affiliation, namely, formalization of the dominance relationship (i.e., unequivocal communication of status), and conditional reassurance (i.e., the linkage of friendly coexistence to formalization of the relationship). Ritualized submission is imposed upon losers of dominance struggles by winners; losers are offered a "choice" between continued hostility or a tolerant relationship with a clearly signalled difference in status. If these two social mechanisms are lacking, aggression is bound to have dispersive effects. In their presence, aggression becomes a well-integrated, even constructive component of social life. In some higher primates this process of integration has reached the stage where status differences are strongly attenuated. In these species, sharing and trading can take the place of overt competition. The views underlying this "reconciled hierarchy" model are only partly new, as is evident from a review of the ethological literature. Many points are illustrated with data on a large semi captive colony of chimpanzees (Pan troglodytes), particularly data related to striving for status, reconciliation behavior, and general association patterns. These observations demonstrate that relationships among adult male chimpanzees cannot be described in terms of a dichotomy between affiliative and antagonistic tendencies. Male bonding in this species has not been achieved by an elimination of aggression, but by a set of powerful buffering mechanisms that mitigate its effects. Although female chimpanzees do exhibit a potential for bonding under noncompetitive conditions, they appear to lack the buffering mechanisms of the males. PMID- 3543992 TI - Management of a Kennedy Class III with etched cast restoration: a three-year follow-up case report. PMID- 3543993 TI - The fracture of cobalt-chromium alloy removable partial dentures. PMID- 3543994 TI - The inhalation and ingestion of dentures. PMID- 3543995 TI - [Preparation of a suspended pontic bridge using electric erosion]. PMID- 3543996 TI - [An elastic obturator with a valve for the prosthetic treatment of maxillary resection defects]. PMID- 3543997 TI - [Basic principles in prosthetics: complete dentures (X)]. PMID- 3543998 TI - [Esthetics and function in complete dentures--realization of a computer-supported occlusal concept (III)]. PMID- 3543999 TI - [Optimization of the accuracy of fit of model cast and combination appliances]. PMID- 3544000 TI - [Esthetic periodontally-hygienic rehabilitation in the anterior region with McLean platinum jacket crowns]. PMID- 3544001 TI - [Phantom models on which to practice various characteristics]. PMID- 3544002 TI - [Cera-platinum technic--come, show and tell?]. PMID- 3544003 TI - [Orientation models in waxing technics]. PMID- 3544004 TI - [Model analysis for the anterior region using a biogenic pattern (I)]. PMID- 3544005 TI - [Record of an insertion alignment for a removable partial denture using a level]. PMID- 3544006 TI - [New condensation methods for ceramic]. PMID- 3544007 TI - [Wax injection in deep-drawn models: concepts and practical applications]. PMID- 3544008 TI - [Does the Silicoater method improve resin-metal bonding?]. PMID- 3544009 TI - Bile loss in the acute intestinal radiation syndrome in rats. AB - The effects of bile duct ligation (BDL), choledochostomy, bile acid sequestering within the intestinal lumen by cholestyramine, and fluid and electrolyte replacement on survival time and development of diarrhea after whole-body exposure to doses of ionizing radiation that result in death from acute intestinal injury were studied. BDL significantly prolonged survival and delayed the onset of diarrhea after exposure to 137Cs gamma rays, fission neutrons, or cyclotron-produced neutrons in the range of doses that produce intestinal death or death from a combination of intestinal and hematopoietic injuries. Cannulation of the bile duct with exteriorized bile flow (choledochostomy) to protect the irradiated intestine from the mucolytic action of bile salts did not duplicate the effect of BDL in increasing survival time. Choledochostomy without fluid replacement eliminated the occurrence of diarrhea in 15.4 Gy irradiated rats. Diarrhea did occur in irradiated animals with choledochostomy if they received duodenal injections of fluid and electrolytes to replace the fluid lost as a result of bile drainage. Duodenal injection of fluid and electrolytes, however, had no significant effect on survival time in irradiated rats. In contrast, injection of fluid and electrolytes into the peritoneal cavity of irradiated rats resulted in an increase in survival time that was comparable to that observed after BDL. Addition of antibiotics to the peritoneally injected fluid and electrolytes further increased survival time (up to 9 days). This survival time approached that seen in animals receiving the same radiation dose but which had the intestine exteriorized and shielded to minimize radiation injury to the intestine. Postmortem histological examinations of the irradiated small intestine showed mucosal regeneration in these long-term survivors receiving fluid and antibiotic therapy. In contrast, duodenal injection of cholestyramine post irradiation to bind bile acids had no effect on survival time or diarrhea incidence. The conclusions from these experiments are that BDL prolongs survival and postpones the onset of diarrhea in irradiated rats dying from acute intestinal injury primarily by slowing down the loss of fluid and electrolytes and that bile acids play no significant role. PMID- 3544010 TI - Radiation protection of Escherichia coli B/r by hydroxyl radical scavengers. AB - We have used Escherichia coli B/r to test the proposal that hydroxyl radicals (.OH) are major contributors to lethal damage when bacteria in equilibrium with air or 100% nitrogen are exposed to ionizing radiation. In addition, we have tested the hypothesis that oxygen sensitizes bacterial cells to radiation by reacting at radical sites previously formed by reactions of .OH. Our results with B/r indicate that the involvement of OH radicals in damage may have been overestimated. We believe that simple .OH removal provides B/r with only a relatively small amount of protection in N2 and air. Although some .OH scavengers can have large protective effects in air, evidence supports the tentative conclusion that these effects are not based on simple .OH removal. If this conclusion is correct, then radiation sensitization by oxygen--at least of this bacterial strain--would be unrelated to reactions of .OH. PMID- 3544012 TI - [Isolation and properties of the Ca2+, phospholipid-dependent protein kinase from the substantia grisea of the rat brain in the early stage of exposure to ionizing radiation]. AB - Ca2+, phospholipid-dependent proteinkinase was isolated from intact and exposed (1 h following whole body X-irradiation with a dose of 0.21 C/kg) gray substance of rat brain, and the dependence of this enzyme on pH and temperature, and substrate specificity were studied. Changes were shown to occur in some Ca2+, phospholipid-dependent proteinkinase properties under the effect of X-radiation while the substrate specificity remained unchanged. PMID- 3544011 TI - [Induction of unscheduled DNA synthesis in the nuclear matrix of rat hepatocytes after whole-body gamma irradiation of the animals]. AB - DNA synthesis in hepatocytes was studied by incorporation of [3H]thymidine administered to portal vein of gamma-irradiated (80 Gy) rats. It was shown that the rate of replicative DNA synthesis decreased in hepatocytes of the regenerating liver and unscheduled DNA synthesis was induced at the nuclear matrix of resting cells of the intact liver. In addition to repair synthesis, DNA synthesis resembling replicative one ("aberrant" DNA synthesis) accounts for a considerable fraction of gamma-radiation-induced synthesis of DNA at the nuclear matrix. PMID- 3544013 TI - [Action of the radiation from a neon laser and from noncoherent blue light on Escherichia coli bacteria]. AB - It was shown that under defined conditions blue light can accelerate E. coli WP2 growth. The stimulatory effect is a function of radiation dose, intensity wave length, and postirradiation incubation time. PMID- 3544015 TI - Quality control of ultrasonic scanners--a scheme for regular assessment. PMID- 3544016 TI - Pregnancy complicated by hydrops fetalis. PMID- 3544014 TI - [Effect of the irradiation conditions on the radiation inactivation of subtilisin 72]. AB - A comparative study was made of gamma-inactivation of subtilisin-72 solutions in 5 X 10(-3) M acetate buffer and 0.1 M NaCl in the presence and absence of Ca2+ ions. It was shown that the acetate buffer had a protective action, and the influence of Ca2+ ions depended on the ionic strength of the solution. In general, Ca2+ ions exerted a stabilizing effect irrespective of the subtilisin concentration in the acetate buffer, but this effect competed with the destabilizing influence of the ionic strength increased by Ca2+ ions. PMID- 3544017 TI - Disease of the skeletal system: a case study. PMID- 3544018 TI - Hydrocephaly case history. PMID- 3544019 TI - Ultrasound of the cerebral ventricles. PMID- 3544020 TI - Renal osteodystrophy: a case study. PMID- 3544021 TI - Becquerel: unit and eponym. PMID- 3544022 TI - Radiation carcinogenesis. PMID- 3544023 TI - [Injuries of the large arteries in children]. PMID- 3544024 TI - [Experiences in the use of ultrasound B scan results in the elucidation of unclear palpable abdominal lesions in children]. PMID- 3544026 TI - [Value of angiography in the diagnosis of giant cell arteritis]. AB - Two cases of giant cell arteritis are reported. Angiography was performed to obtain information about the extent of arterial lesions (case 1). In the second case angiography was a guide to diagnosis. Differential diagnostic considerations and the value of angiographic examination are discussed. PMID- 3544025 TI - [CT stereotactic biopsy in the differential diagnosis of deeply situated intracerebral hematomas]. AB - The diagnosis of intracerebral haematomas, especially of those which are relatively small, occupy little space and are deeply situated, presents considerable problems. The problem is even greater when the expected acute case history and the acute beginning of the symptoms do not occur and unusual localisations are found. The consequences of this are false diagnoses and the treatment of these patients within the framework of blanket diagnosis "intracerebral tumours" or "space occupying processes" without any confirmation of the histological diagnosis. - Using a sample of 26 patients where the histological diagnosis of non-recent intracerebral hemorrhages had been confirmed (out of a series of 818 CT-stereotactically biopsied patients punctured by us from the beginning of 1983 until the end of 1984), the problem of establishing a diagnosis is exposed. - A histological diagnoses should in any case be confirmed before any thorough and deep-reaching therapy is begun, since false diagnoses and misinterpretations can cause serious consequences for the patient. PMID- 3544027 TI - [Choledocholithiasis in a gallbladder without stones]. AB - In 4 out of 190 patients, who underwent a cholecystectomy, stones were only found in the common bile duct and none in the gallbladder. The radiological data of these 4 patients were retrospectively analysed. In 2/3 patients sonography showed a dilatation of the common bile duct, whereas stones in the common bile duct were shown by IVC in 2/2 patients, ERCP in 3/3 patients and PTC in 1/1 patients. In 1/3 patients also, in whom an ERCP had been performed, stones were suspected in the gallbladder, but could not be verified during cholecystectomy. PMID- 3544028 TI - Pulmonary arteriography: comparison of cough stimulation effects of diatrizoate and ioxaglate. AB - Twenty-five patients were observed in a prospective crossover study to determine whether the new low-osmolality contrast agents would be less prone than conventional agents to produce coughing during pulmonary arteriography. Selective left and right pulmonary arteriography (two views of each side) was performed with alternating administrations of diatrizoate sodium meglumine and ioxaglate sodium meglumine. Twenty-one patients had all four injections while four patients received injections on only one side. Sixteen of 25 patients coughed on at least one injection of diatrizoate, with three of these experiencing explosive coughing. One of 25 patients coughed with ioxaglate, and that was only minimally. This difference is statistically significant (P less than .001, on the basis of McNemar chi 2 test for paired data). When no coughing occurred, the quality of the diatrizoate and ioxaglate radiographs was indistinguishable. We conclude that ioxaglate is useful in pulmonary arteriography because of its lack of cough stimulation. PMID- 3544029 TI - Radical treatment of Hodgkin disease with radiation therapy: results of a 15-year clinical trial. The 1985 Erskine lecture. AB - In 1970, the University of Minnesota Hospitals instituted a policy for treatment of patients with stage I, II, and IIIA Hodgkin disease that required complete staging including laparotomy and extended field or total nodal radiation. Evaluation of the results of this policy in 1974 led to modifications of treatment based on analysis of disease recurrences. Since 1974, patients with large mediastinal masses or hilar disease have been treated with whole-lung or half-lung radiation. In addition, patients with stage IIIA disease with positive spleens were treated with liver irradiation. Sixty-five patients with Hodgkin disease treated with extended or total nodal fields and 126 patients treated with the radical radiation approach are evaluated. The use of this treatment modification has changed the prognostic factors and produced an improvement in recurrence-free survival that is statistically significant. The authors suggest that radical radiation therapy is the treatment of choice in patients with stage IA, IIA, or IIIA Hodgkin disease. PMID- 3544031 TI - Ectopic pregnancy: the role of sonography. PMID- 3544030 TI - Lung torsion: case report and literature review. AB - A 65-year-old woman with endobronchial carcinoma had torsion of the left upper lobe. A posteroanterior chest radiograph showed apparent atelectasis in the left upper lobe, but the lateral view disclosed an inappropriate posterior displacement of the collapsed lobe. The vasculature of the affected area showed an unusual curvature. Review of 21 examples of lung torsion disclosed no characteristic age, sex, or affected lobe. The most common associations were with previous surgery (n = 10) or a history of trauma (n = 5). The most common radiographic findings are opacification of the affected lobe (n = 12), an abnormal vascular pattern (n = 6), and an abnormal location for the atelectatic lung (n = 5). Affected lobes often show hemorrhagic infarction or necrosis. PMID- 3544032 TI - Posttransplant renal rejection: comparison of quantitative scintigraphy, US, and MR imaging. AB - Accuracy of ultrasonography (US), quantitative scintigraphy, and magnetic resonance (MR) imaging in diagnosis of acute renal allograft rejection was studied in 46 patients who underwent renal biopsy. Thirty-three patients had acute rejection; six, cyclosporine nephrotoxicity, as shown by biopsy, clinical findings, and follow-up study; two, acute tubular necrosis; and five, normal biopsy findings and renal function. Accuracy in demonstrating rejection was 72% for US and 75% for scintigraphy, indicating no significant difference between the two. MR imaging was significantly more accurate, reaching a level of 98%. However, accuracy of MR in demonstrating acute tubular necrosis in a larger number of patients is not known, and its accuracy in indicating recurrent glomerulopathy or infectious disease has not been addressed. The definitive role of MR in evaluating posttransplant renal failure is currently not established, but because of its high sensitivity in detecting renal abnormality, MR can be used for cases when results of US or scintigraphy are equivocal or contradict clinical impressions or when biopsy cannot be performed for medical reasons. PMID- 3544033 TI - Posttransplantation cyclosporine-induced lymphoproliferative disorders: clinical and radiologic manifestations. AB - Fifteen allograft transplant recipients acquired lymphoproliferative disorders after immunosuppressive therapy with cyclosporine and steroids. Many of these lymphoproliferative disorders regressed or disappeared completely after reduction of cyclosporine dose. This disease has several aspects that distinguish it from usual posttransplantation lymphomas that occur with regimens that do not contain cyclosporine. The time course from transplantation to onset of lymphoma is relatively short, with an average of approximately 8 months. Organs show a wide spectrum of abnormalities typical of other immunosuppression-associated lymphomas, but there is unique sparing of the central nervous system. The tumor is also unique in that it responds to a decrease in the cyclosporine dose. PMID- 3544035 TI - Knee arthrography: a comparison of iohexol, ioxaglate sodium meglumine, and metrizoate. AB - The arthrographic image quality and relative morbidity resulting from use of Omnipaque 300 (iohexol), Hexabrix 320 (ioxaglate sodium meglumine), and Isopaque Coronar 370 (metrizoate) were compared in a prospective double-blind study performed with 120 patients. Radiographs obtained 2, 5, 10, 15, 20, and 25 minutes after injection were judged for diagnostic quality. Relative morbidity was evaluated by the physician during the examination and later by the patient via a questionnaire. Hexabrix demonstrated the best and most persistent diagnostic quality over serial radiographs (P less than .05). Omnipaque caused significantly less postprocedural pain (P less than .05). The other types of discomfort measured did not indicate statistically significant differences in morbidity resulting from the three contrast agents. PMID- 3544034 TI - Bone marrow in leukemia and aplastic anemia: MR imaging before, during, and after treatment. AB - Serial magnetic resonance (MR) studies of the cervical bone marrow were performed in five patients undergoing bone marrow transplantation for chronic granulocytic leukemia and in four patients with aplastic anemia who were treated with antilymphocytic globulin. Findings were compared with those from a group of healthy volunteers. Chemical shift imaging techniques were used to exploit the presence of protons in fat and water in the red marrow. Characteristic changes were seen in aplastic anemia before treatment, but derivation of images representing fat and water fractions was necessary to distinguish leukemic marrow. Acute changes during the treatment of leukemia may reflect the effects of chemotherapy and radiation therapy, whereas changes in the chronic phase of both diseases may prove useful in predicting treatment outcome. MR studies are likely to be useful in the assessment and treatment of hematologic disorders. PMID- 3544036 TI - Acute suppurative tenosynovitis of the hand: diagnosis with US. AB - The sonographic findings in seven patients with surgically proved acute tenosynovitis of the hand (bacterial in six cases, of presumed viral origin in one) were reviewed. In the six patients with bacterial tenosynovitis the affected flexor tendon was larger than that of the contralateral normal digit. In five patients hypoechoic areas were identified surrounding the flexor tendon that proved to be pus at surgery. Sonography failed to depict a small amount of pus in the tendon sheath in one patient. The affected tendon of the single patient with tenosynovitis thought to be of viral origin was normal in size, but a focal tendon sheath fluid collection was detected that proved to be sterile at surgery. Sonography appears to be a useful imaging technique in the early diagnosis of acute suppurative tenosynovitis of the hand. PMID- 3544037 TI - B-cell lymphoproliferative disorders in children after bone marrow transplantation: radiologic manifestations. AB - The radiographic findings in five pediatric patients in whom unregulated B-cell lymphoproliferative disorders developed following bone marrow transplantation are described. Four patients received T-cell-depleted bone marrow from mismatched donors and one received nondepleted marrow from a matched sibling donor. These disorders are similar to B-cell lymphoproliferative disorders that have been described in other immunosuppressed hosts. They are associated with Epstein-Barr virus and range from polyclonal proliferation without cytogenetic abnormalities to monoclonal lymphoma with clonal cytogenetic changes. Unlike other postallograft lymphoproliferative processes, B-cell lymphoproliferative disorders in these patients have not responded to antiviral therapy, immunologic therapy, or chemotherapy. The radiographic patterns of disease include diffuse or focal hepatic involvement; gallbladder wall thickening; and pulmonary, soft-tissue, and basal-ganglion masses. These radiologic findings are not specific and evaluation of tissue histology is required for diagnosis. PMID- 3544038 TI - Cystic hygromas in children: sonographic-pathologic correlation. AB - The sonographic findings in eight children with surgically proved cystic hygroma were reviewed and correlated with the pathologic specimens. Six tumors occurred in the neck, one occurred in the axilla, and one involved the soft tissues of the thigh, scrotum, and pelvis. A cystic hygroma characteristically appears as a multiloculated cystic mass with septa of variable thickness that contain solid components arising from the cyst wall or the septa. Correlation of the sonogram with the pathologic specimen demonstrated that the echogenic component corresponded to a cluster of abnormal lymphatic channels, too small to be resolved with ultrasound. Large lesions had ill-defined boundaries, with cystic components dissecting between normal tissue planes. Sonographically, one can usually differentiate these tumors from other cervical masses, especially soft tissue hemangiomas. Sonography is also helpful in determining the extent of the lesion before surgery and in assessing postoperative complications and recurrences. PMID- 3544040 TI - Measurement of aortic blood flow with MR imaging: comparative study with Doppler US. AB - An innovative magnetic resonance imaging technique was applied to the measurement of blood flow in the abdominal aorta. The technique combines selective excitation and visualization from an orthogonal view. The distance that fluid has moved is directly visualized. The blood flow velocity at every 50 msec throughout the cardiac cycle was measured in a short time (about 4 minutes) using electrocardiographic gating and repeated excitations in each cycle. Measurements were compared with those obtained by Doppler ultrasound (US) as a reference. The pulsatile change of flow velocity in the cycle correlated well with the Doppler US recording. Two flow velocity indexes, peak flow velocity and the velocity integral, also showed good correlation (r = .98 for both). This method is applicable for clinical use and is useful for measurement of high flow rates, as found in arteries. PMID- 3544039 TI - Transient synovitis of the hip in children: role of US. AB - Transient synovitis of the hip remains a common diagnostic problem for the clinician. The physical signs are not pathognomonic of the condition, and the classic technical examinations are of little help. Therefore, the authors retrospectively studied the value of hip arthrosonography in 46 children with clinical symptoms suggesting pathologic hip conditions. In 20 of the 21 patients with a final diagnosis of transient synovitis, articular effusion was detected on ultrasound (US). Conventional radiography showed an increased medial joint space in only eight of these patients. Increased echogenicity of the articular fluid was found in both transient synovitis and septic arthritis. The high sensitivity of US in detecting intraarticular fluid was demonstrated by cadaver studies. PMID- 3544041 TI - Rational choice of dose: insufficient background knowledge? PMID- 3544042 TI - Sensitivity, specificity, and prognostic significance of noninvasive testing for occult or known coronary disease. PMID- 3544043 TI - Progesterone receptor binding of steroidal and nonsteroidal compounds. PMID- 3544044 TI - Mechanism-based inhibitors of monoamine oxidase. PMID- 3544045 TI - Advances in chemotherapy of malaria. PMID- 3544046 TI - [Oral antidiabetics]. PMID- 3544047 TI - Immunopharmacological approach to the study of chronic brain disorders. PMID- 3544048 TI - Recent advances in central 5-hydroxytryptamine receptor agonists and antagonists. PMID- 3544050 TI - On conformation analysis, molecular graphics, fentanyl and its derivatives. PMID- 3544049 TI - Serum electrolyte abnormalities caused by drugs. PMID- 3544051 TI - The effect of the base sequence on the fine structure of the DNA double helix. PMID- 3544052 TI - Chemical electric field effects in biological macromolecules. PMID- 3544053 TI - The structure of spherical viruses. PMID- 3544054 TI - The modelling of electrostatic interactions in the function of globular proteins. PMID- 3544055 TI - Integration of posture and locomotion in acute decerebrate cats and in awake, freely moving cats. AB - For the past 10 years, our group has been engaged in the study of posture and locomotion in decerebrate cats and in freely moving awake cats. Our initial objective was to analyse the neuronal mechanisms of locomotion from a viewpoint of "postural control". Therefore, in this review, I have focussed my attention on two major control aspects of the brain stem; one related to the interaction of posture and locomotion; and the other to initiation of locomotion. It is apparent that elucidation of the second aspect is feasible. In Fig. 15, I have summarized all the neuronal structures that have been functionally identified as being actively involved in the regulation of posture and locomotion. Obviously, contribution of the cerebello-cerebral pathways and the basal ganglia to both the postural and to the locomotor control cannot be elucidated in decerebrate preparations (Fig. 15A). These contributions can, to a certain degree, be elucidated in intact awake cats (Fig. 15B). Although it is difficult to directly compare the results obtained in the decerebrate cats with those obtained in intact cats, it has been encouraging that the selective activation of certain neuronal structures within the brain stem allowed us to evoke comparable postural and locomotor changes in both groups of preparations. It can be expected that the knowledge obtained from studies of the cerebello-cerebral pathways and of the basal ganglia, together with those that can be further obtained from studies of the brain stem, should result in the elucidation of the two major control aspects of the brain stem described above. In this sense, both the models of the decerebrate locomotor preparation and the freely moving, awake cat seem to provide an unique opportunity to study the nature and the sources of command signals that set the postural and the locomotor synergies into a single functional synergy, and even to approach elucidation of the intriguing question as to how and where volitional control signals for initiating and/or halting locomotion are organized. More than 70 years have passed since the pioneer studies by Sherrington (1906) and by Graham Brown (1911, 1914) on postural control and on locomotion, as exemplified by "decerebrate reflex standing, and stepping" and the "central rhythmic generator" relating to locomotion. Based on these discoveries, Shik, Severin and Orlovsky (1966) have made a splendid breakthrough in a wide area of investigation relating to locomotion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3544056 TI - [Chromosome banding and analysis of chromosome abnormalities]. PMID- 3544057 TI - [The gene map]. PMID- 3544058 TI - [Mammalian DNA replication at the chromosomal level]. PMID- 3544059 TI - [Chromosomal changes associated with cancer development]. PMID- 3544060 TI - [Molecular biology of the chromosomal abnormality in human cancer]. PMID- 3544062 TI - [The heritable fragile site: possible associations with mental retardation and cancer-specific chromosomal rearrangements]. PMID- 3544061 TI - [Oncogene amplification in tumor cells]. PMID- 3544063 TI - [Hereditary chromosome abnormalities and cancer]. PMID- 3544064 TI - [Cloning of Y specific repeated DNA and its use in the study of a structurally abnormal Y chromosome]. PMID- 3544065 TI - [Revolution in human gene mapping: linkage analysis using DNA polymorphisms as genetic markers]. PMID- 3544066 TI - [Microdissection and microcloning for the study of chromosomes]. PMID- 3544067 TI - [Analysis of chromosomal DNA by newly developed gel electrophoresis]. PMID- 3544068 TI - [Cell cycle and gene expression]. PMID- 3544069 TI - [Regulation of mammalian X chromosome activity]. PMID- 3544070 TI - [Isolation of mutant cells with altered chromosomal stability from mouse cell lines]. PMID- 3544071 TI - [Chromosomal changes and genetic recombination]. PMID- 3544072 TI - [Cancer therapy with monoclonal antibody]. PMID- 3544073 TI - [Fodrin--a high-molecular-weight cytoskeletal protein in brain]. PMID- 3544074 TI - [Structure and function of the major histocompatibility complex gene cluster]. PMID- 3544075 TI - When is drug treatment indicated in mild hypertension? PMID- 3544076 TI - The smoking problem. PMID- 3544077 TI - Lung cancer risk and diesel exhaust exposure. PMID- 3544078 TI - [Secretory function of the stomach, stimulated by insulin, after resection by the Rydygier method and vagotomy in duodenal ulcer]. PMID- 3544079 TI - [Various data on the pathogenesis of myelocytic leukemia--is the fusion of genetic material a cause of oncogen activation?]. PMID- 3544080 TI - [Prof. Wladyslaw Krol, physician and scientist]. PMID- 3544081 TI - The cholinergic neurotransmitter system in human memory and dementia: a review. PMID- 3544082 TI - The memory deficits in Alzheimer-type dementia: a review. PMID- 3544083 TI - Priming effects of amnesia: evidence for a dissociable memory function. PMID- 3544084 TI - Randomised study of MOPP (mustine, Oncovin, procarbazine, prednisone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease. British National Lymphoma Investigation. AB - 299 patients with stage III or IV Hodgkin's disease were randomised to receive cyclical chemotherapy with MOPP (mustine, Oncovin, procarbazine, prednisone) or LOPP (Leukeran substituted for mustine). The complete remission rates (59.9% for MOPP, 59.4% for LOPP), actuarial survival (65.7 and 68.2% at 5 years, respectively) and complete remission/relapse free survival (33.3 and 32.2% at 5 years, respectively) were similar for both groups. There were no significant differences in response data between the MOPP and LOPP groups for individual prognostic variables (histology grade, stage, age and response to treatment). Deaths in both groups were usually due to disseminated Hodgkin's disease with terminal infection; there were no infective deaths in the absence of Hodgkin's disease. The less toxic regimen of LOPP can therefore be expected to produce results similar to those seen with MOPP, and this is true regardless of the severity of the illness. PMID- 3544085 TI - Fractionated versus low dose-rate total body irradiation. Radiobiological considerations in the selection of regimes. AB - Total body irradiation (TBI) followed by bone marrow rescue is being increasingly used in the systemic treatment of acute leukaemia and some solid tumours such as neuroblastoma. Typically, these neoplasms are radiosensitive with little or no shoulder on the in vitro survival curve (n approximately equal to 1.0, Do approximately equal to 1.0 Gy). In such cases, fractionated or low-dose-rate TBI should allow preferential sparing of normal tissues. With the appropriate choice of dose rate, low-dose-rate TBI should, in principle, be radiobiologically equivalent to fractionated TBI. Calculations based on an extension to the linear quadratic model suggest that extremely low dose rates (e.g., approximately equal to 0.5 Gy h-1) might be required for equivalence to conventionally fractionated schedules. Such low dose rates would require very long treatment times (e.g., approximately equal to 24 h), which renders them impractical. For cell survival parameters of typical radiosensitive neoplasms the effects of proliferation do not alter this conclusion. These studies suggest that fractionated TBI (with high dose rates) is preferable to low-dose-rate therapy for neoplasms such as leukaemia and neuroblastoma. PMID- 3544086 TI - The "Ring" method: a semi-empirical method to calculate dose distributions of irregularly shaped photon beams. AB - The "Ring" method provides a fast dose calculation and isodose presentation for photon beams with blocks. The method takes into account the change in scatter due to the blocks at each calculation point. Firstly, the dose in a point is calculated assuming that no blocks are present. Secondly, the scatter reduction caused by the blocks is calculated and subtracted. To determine the scatter reduction the irradiated surface is divided in concentric rings around a point at the surface at the intersection with a ray line between focus and calculation point. The scatter reduction caused by blocks for each ring is calculated. The effect of scatter for rings with an outer radius greater than 15 cm where the scatter contribution is less than 1.0% is neglected. Results of the method for 4 MV photons using eight rings are presented. Comparison of dose measurements with calculations in an arrow-shaped photon field showed maximum deviations of 4.0%, using the IRREG program of Cunningham, 6.5% using the BLKINP program of Schlegel, which is based on Clarkson's method, 5.0% using the method of Wrede and 2.2% using the "Ring" method. Contrary to the first two calculation programs, the programs using the last two calculation methods provide isodose lines dose values at points. PMID- 3544087 TI - Consistency and simplicity in the determination of absorbed dose to water in high energy photon beams: a new code of practice. AB - Recent revision of exposure and air kerma standards in Standards Laboratories require a simultaneous change in physical parameters at other positions in the dosimetry chain. Adoption of new data, recommended by international organizations, will introduce changes in absorbed dose determinations in high energy photon beams using ionization chambers. A new code of practice has therefore been drafted using a consistent set of data. In this code of practice, single conversion factors are given to convert ionization chamber reading to absorbed dose to water for some types of reference ionization chamber as a function of radiation quality. Equations and recommended numerical data for the physical parameters and correction and conversion factors will be provided. PMID- 3544088 TI - Adenosine modulation of fat cell responsiveness to insulin and oxytocin. AB - We have investigated the effects of adenosine on the stimulation of glucose oxidation and lipogenesis by oxytocin and insulin in rat epididymal adipocytes. The addition of adenosine deaminase (1 U/ml) to the assay medium reduced the maximal oxytocin response (glucose oxidation and lipogenesis) to between 25 and 50% of the maximum response in control cells. The maximal response to insulin was not appreciably affected under these conditions. The addition of adenosine (10 or 30 microM) increased the cell sensitivity to oxytocin by elevating the maximum rate of oxytocin-stimulated glucose metabolism. Adenosine also increased the cell sensitivity to insulin by decreasing its ED50. A change in ED50, however, was observed only when control or adenosine-treated cells were compared to adenosine deaminase-treated cells; but not when control and adenosine-treated cells were compared. On its own, adenosine also caused an appreciable increase in both glucose oxidation and lipogenesis (ED50 approximately equal to 3 microM adenosine). The difference in the effect of adenosine on oxytocin action, compared with the effect on insulin action, points to differences in the mechanisms by which insulin and oxytocin stimulate glucose metabolism in adipocytes. PMID- 3544089 TI - Peptide YY-like immunoreactivity in the central nervous system of the rat. AB - The concentration of peptide YY (PYY)-like immunoreactivity in rat brain and spinal cord was determined by radioimmunoassay. The highest concentrations were found in the cervical spinal cord (18.1 +/- 1.3 ng/g, mean +/- S.E.M.) and in the medulla oblongata (16.3 +/- 1.5 ng/g). Lower amounts were found in the pons and in the hypothalamus. Chromatographic analysis of the PYY-like immunoreactivity from various regions of the brain revealed 95% of the immunoreactive material to be indistinguishable from synthetic porcine PYY. PYY-immunoreactive nerve cell bodies could be demonstrated by immunocytochemistry in the medulla oblongata of colchicine-treated rats, the largest group of cells being found in the midline area between and partly in the raphe pontis and obscurus nuclei. Another large group of immunoreactive cells was detected more laterally in the medial parts of the gigantocellular reticular nucleus. A few cells, finally, were seen in the dorsal parts of the medulla, including the nucleus of the solitary tract. Varicose nerve fibers displaying PYY immunoreactivity were observed in many parts of the hypothalamus, pons, medulla and spinal cord. PMID- 3544090 TI - Clinical testing of products prepared by biotechnology. AB - In summary, new therapeutic products derived from biotechnology will have to satisfy all the usual demands of regulatory agencies, plus some new requirements generated by their special nature. The chemical identity and purity of rDNA compounds will have to be assured, animal toxicity testing will be required, and sufficient data on clinical safety and efficacy will have to be gathered to justify FDA approval. In this process, empiricism will be the key word. NDAs will be approved on the basis of facts, and not theory, and that is as it should be. How costly will this process be? Part of the process is more or less under the control of the sponsor, i.e., the part leading up to the filing of the NDA. Trials can be organized and carried out efficiently or inefficiently; the difference will be measured in years and millions of dollars. The same generality can be applied to the preparation of the inevitably voluminous NDA. Two final worries: Litigation and damage awards are threatening the stability of much of our society. The trend toward holding pharmaceutical manufacturers responsible for strict product liability, not negligence, is fearsome, since it is not possible to protect oneself against harm which cannot be predicted or prevented. Unforeseen serious adverse effects with an rDNA product involving thousands of patients could spell bankruptcy for a biotechnology company. The last issue is what I will term the "biotechnology Chernobyl disaster".(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544091 TI - [Renal transplantation. Clinical aspects]. PMID- 3544092 TI - [Evaluation of glomerular filtration using 99m-Tc-DTPA]. PMID- 3544093 TI - [Diagnostic implications in the echotomographic findings in a double gallbladder. Apropos of a case]. PMID- 3544094 TI - [Standard radiography of the chest in heart transplantation. Our experience]. AB - In the cardiovascular Surgery Department of the University of Padua, where the first heart transplant operation in Italy took place in November, 14, 1985, in a period of six months, nine heart transplants have been performed. The post operative follow-up of these patients included, among other tests, a chest X-ray, which has given us many morphological and functional data concerning both the circulatory and the pulmonary systems. PMID- 3544095 TI - [Echotomography-computerized tomography integration in the tissue characterization of renal angiomyolipoma]. AB - A sonographic and a computed tomographic study of 29 patients was performed in order to assess the possibilities of these imaging techniques in tissue characterization of renal angiomyolipoma. From the review of the results the authors, confirming the very high accuracy of the two associated methods for a correct diagnosis, underline the possibility to identify the hamartoma mesenchymal components with the possibility of more prognostic and therapeutic informations. PMID- 3544096 TI - [Renal oncocytoma. A diagnostic and therapeutic problem]. AB - Renal oncocytoma is a more common entity as one may believe. Five cases and their sonographic features observed in six months are reported; in none of these cases was possible a secure diagnosis before the operation. PMID- 3544097 TI - [Renal oncocytoma. Ultrasonographic study of 4 cases]. AB - The authors report four cases of renal oncocytoma investigated by echography and proved by histology after surgery. Describing the clinical cases, after a brief review of the literature, the radiologic findings are analysed with particular regard to the sonographic signs that can preoperatively differentiate oncocytomas from carcinomas. The authors conclude that the only sonographic distinguishing feature is a quite characteristic central hyperechoic streak corresponding to the fibrous scar, frequently found in this benign tumor. PMID- 3544098 TI - [Neonatal paralysis]. PMID- 3544099 TI - [Fetal and perinatal orthopedics (the first 20 months of life)]. PMID- 3544100 TI - [Systematic study with immunofluorescence of autopsy kidneys]. PMID- 3544101 TI - [Effectiveness and tolerance of slow-release nifedipine in the treatment of moderate arterial hypertension in the elderly. A comparative multicenter study]. PMID- 3544102 TI - [Application of the Talairach stereotaxic system for the purpose of establishing a common reference plane for brain imaging technics (CAT scan, NMRI, PET scan)]. AB - Confrontation of data obtained from several modern imaging techniques (CAT Scan, NMR Scan, PET Scan) is a fundamental problem in actual neurological practice and must be correlated with histology. For that purpose, we use the referential plane of the stereotactic Talairach frame. Using teflon intraosseous buttons, the referential plane and a common zero reference point can be objectivated by CAT, NMR and/or PET Scans. A computer program gives the exact coordinates of the chosen target. These coordinates are immediately usable in the operating room for stereotactic serial biopsies. PMID- 3544103 TI - [Effect of the environment on lung growth]. PMID- 3544104 TI - [Heterogeneity of malignant bronchial tumors. Problems of histogenesis]. AB - The 1981 WHO classification of bronchial carcinoma, based on light microscopic analysis, proposed 4 principal classes: epidermoid carcinoma, adenocarcinoma, small cell carcinoma and large cell undifferentiated carcinoma. This apparently simple nosology underestimates the difficulties of classifying a good number of these tumors, due to a great diversity in appearance within the same histologic group. Experimental studies on the regeneration of bronchial epithelium, on lesions induced by irritants and carcinogens, suggest one undifferentiated cell line as the origin of all malignant proliferations, including neuro-endocrine tumours. To support this histogenetic hypothesis, an ultra-structural analysis of the carcinomas shows the existence and frequency of heterogenous forms, multi differentiated, up to the level of individual cells. The same cell line may express several ways of differentiation simultaneously (bi or tri-partite differentiation). Equally immunohistochemical methods reveal antigenic differentiation (intermediary filaments, neuro-endocrine antigens) and establish a means of identifying different cellular constituents. These two methods have allowed real progress in the diagnosis of neuro-endocrine tumours, placing them firmly with bronchial tumours and seem particularly helpful in the analysis of undifferentiated small and large cell carcinomas. By another way, one finds in the majority of bronchial tumours the different antigens expressed, certainly following their histological type in variable degrees, yet with an antigenic (phenotypic) profile showing great similarity. This is a reflection of multi differentiation in these tumours and appears as a direct consequence of their common histogenetic origin. Bronchial carcinomas are placed along a continuous spectrum of three parallel and/or simultaneous differentiations. They represent a single tumour having a tendency to express one or several ways of differentiation. PMID- 3544105 TI - [Precursors of cutaneous melanoma. Background and up-date of dysplastic nevus]. PMID- 3544106 TI - The physiology of renal magnesium handling. AB - Present evidence suggests that the renal handling of magnesium is normally a filtration-reabsorption process as evidence for secretion is unsubstantiated. Magnesium reabsorption has distinctive features when compared with that of sodium and calcium. The proximal tubule concentration of magnesium rises to levels about 1.5 times greater than the glomerular filtrate and only 20-30% of the filtered magnesium is reabsorbed in this segment. Although the fractional reabsorption of magnesium is only half that of sodium, it changes in parallel with that of sodium in response to changes in extracellular fluid volume. The major portion of filtered magnesium (some 65%) is reabsorbed in the loop of Henle and evidence indicates that the thick ascending limb is the principal segment involved in magnesium absorption. Recent observations suggests that magnesium reabsorption in the ascending limb may be voltage dependent and secondary to active sodium chloride reabsorption. The loop of Henle appears to be the major nephron site where magnesium reabsorption is regulated possibly by cAMP-mediated hormones including parathyroid hormones, calcitonin, glucagon and antidiuretic hormone. About 10% of the filtered magnesium is delivered into the distal nephron. The distal tubule reabsorbs only a small fraction of the filtered magnesium which may be regulated by the same cAMP-mediated hormones involved in control of magnesium in the loop. PMID- 3544108 TI - Endogenous opioid peptides and the control of gonadotrophin secretion. AB - The endogenous opioid peptides are a group of recently discovered compounds which occur in the brain of a wide variety of species. Originally named because of their opiate-like activity, they have since been demonstrated to have multifaceted actions, one of which appears to be the modulation of luteinising hormone (LH) secretion. Because of the prime position of LH in the ovulatory process, this role for the opioids has attracted considerable interest. Their mode of action is essentially one of suppression and they work by inhibiting the release of hypothalamic gonadotrophin releasing hormone. Through this mechanism they have been implicated in the suppression of LH secretion during the prepubertal period and the modulation of LH during the oestrous cycle. It is well established that gonadal steroids suppress LH secretion by negative feedback upon the hypothalamic-pituitary axis, and this action may be brought about, in part, through intermediary opioidergic neurones. Much of the research to date has been carried out upon laboratory rodents and primates, but there is evidence now accruing that the opioids have similar actions in domestic animals. Knowledge of the role of these compounds may therefore aid in the understanding of an area of commercial importance, namely the control of ovulation in farm livestock. PMID- 3544107 TI - Whole kidney response to reduced arterial pressure during converting enzyme inhibition in the rat. AB - Autoregulatory efficiency of renal blood flow (RBF) and glomerular filtration rate (GFR) was evaluated in male Sprague-Dawley rats during interference with the renin-angiotensin system by a converting enzyme inhibitor (CEI), captopril (3 mg X h-1 X kg-1 BW). RBF and GFR were approximately 25 (p less than 0.01) and 20% (p less than 0.02) higher, respectively, in rats infused with CEI than in control rats at spontaneous renal arterial pressure (RAP). A reduction of RAP to 100 mm Hg (within the autoregulatory range) resulted in effective autoregulation of GFR and RBF in control rats. In rats given CEI, however, the autoregulation of GFR was markedly impaired. GFR decreased by 35% (p less than 0.001), while RBF remained relatively unchanged. This caused the filtration fraction to decrease from 0.33 +/- 0.01 to 0.29 +/- 0.01 (p less than 0.001). RAP had a consistent effect on the urine flow rate, even though both GFR and RBF were well autoregulated in control rats. No significant decrease in electrolyte excretion was detected within the autoregulatory range in control rats, but during converting enzyme blockade this excretion decreased progressively as RAP was reduced, and the decrease correlated well to the reduction in GFR. In summary, these results suggest that the renin-angiotensin system plays an important intrarenal role in the autoregulation of GFR, probably through an efferent arteriolar mechanism. Furthermore, it is demonstrated that the contralateral kidney efficiently compensates in urinary electrolyte excretion for an acute unilateral reduction of RAP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544109 TI - Investigations into the biochemical mechanisms of pulmonary emphysema: effects of cigarette smoke on enzymes and anti-enzymes in the lung. AB - The mechanism(s) causing emphysema in the cigarette smoker are still poorly understood. However, circumstantial evidence is beginning to provide a tenuous link between smoking and the protease-antiprotease imbalance hypothesis. Independent effects on elastin synthesis may also be important. This triad of chemical and cellular events (leukocyte recruitment, inhibitor inactivation, depressed tissue repair) constitutes a reasonable first approximation from which to approach this complex question. PMID- 3544110 TI - Animal models of oxidant lung injury. AB - Studies in experimental animals suggest that oxygen-derived free radicals are playing an important pathophysiologic role in cell and tissue damage. Systemic activation of the complement system or deposition of immune complexes in alveolar spaces results in activation of phagocyte-dependent NADPH oxidase and subsequent release of oxygen radicals that cause acute lung injury and appearance of lipid peroxidation products in lung tissue and plasma. Since pretreatment of experimental animals with catalase, iron chelators or scavengers of hydroxyl radical results in protection from pulmonary damage, it is assumed that the hydroxyl radical is the most likely mediator of phagocyte-dependent acute lung injury. PMID- 3544111 TI - DNA damage induced by chloramphenicol and nitroso-chloramphenicol: protection by N-acetylcysteine. AB - We have previously demonstrated that nitroso-chloramphenicol (NO-CAP) in small concentrations causes the hydrolysis of isolated double stranded DNA in vitro and this action is blocked by sulfhydryl groups. The present study was designed to assess damage to isolated DNA as well as intact cells DNA and examine the protective effect of N-acetylcysteine (NAC). Using alkaline sucrose gradient sedimentation and the alkali elution technique of Kohn we were able to demonstrate DNA damage in Raji cells as well as phytohemagglutinin stimulated human lymphocytes after exposure to NO-CAP. Damage could be totally blocked by NAC. In preliminary studies we also observed that NAC protects bone marrow cells from the growth-inhibitory effects of chloramphenicol and thiamphenicol. PMID- 3544112 TI - Antiproteases and antioxidants: strategies for the pharmacologic prevention of lung destruction. AB - Proteolysis and oxidation are processes which play a central role in the pathogenesis of emphysema. Hereditary factors, including alpha 1-antitrypsin deficiency, and environmental exposures, such as to cigarette smoke, coal dust and bacteria, are associated with a high risk for the development of emphysema through their interactions with proteolytic and oxidative processes within the lung. Because of the key roles of oxidation and proteolysis, reasonable strategies for the prevention of lung destruction in high-risk individuals include such therapeutic interventions as augmentation of lung levels of alpha 1 antitrypsin and the administration of antioxidants. PMID- 3544114 TI - [How to determine the optimal dosage of a drug]. AB - Determining the optimal dosage is an important step in the development of any drug, as it will provide a basis to demonstrate the effectiveness of that drug at different dosage levels. This determination is mainly attempted in phase II, notably by means of dose-response studies, but it is obvious that data obtained at every stage in the life of the drug will provide a better approach to dosage recommendations. Several examples are discussed. PMID- 3544113 TI - Influence of the upper airway on breathing pattern and expiratory time constant in unanesthetized dog pups. AB - Unanesthetized dog pups (2 to 31 days old) respond to sudden opening of a tracheal cannula to atmospheric pressure with a marked increase in breathing frequency. This response is achieved with a 25% decrease in inspiratory and 40% decrease in expiratory times. Expiratory thyroarytenoid muscle activity increased concomitantly, while inspiratory diaphragmatic and posterior cricoarytenoid muscle activities were reduced. These responses are interpreted as a compensatory mechanism for maintenance of an elevated end-expiratory lung volume with functional loss of the upper airway. The changes in expiratory time and thyroarytenoid muscle activity were not observed when positive pressure was applied at the trachea. The expiratory time constant was assessed during spontaneous breathing. The mean value was twice as long during nasal breathing than during tracheal breathing. The nasal value was substantially increased when the thyroarytenoid muscle was active during expiration. PMID- 3544115 TI - [Biological bases for the use of ceftazidime in anti-infection therapy]. AB - The author presents the main in vitro and pharmacokinetic characteristics of ceftazidime, a third generation cephalosporin. Ceftazidime has been shown to be highly stable to most plasmid--or chromosome--mediated beta-lactamases. Several studies have demonstrated that its spectrum includes Gram-positive cocci as well as most Gram-negative bacilli, including beta-lactamase producers. Moreover, it has good in vitro activity against Gram-negative aerobic bacteria (Pseudomonas spp., Acinetobacter spp.) and frequently exerts a synergistic bactericidal action when combined with an aminoglycoside. As a result, ceftazidime displays a high intrinsic in vitro activity against most of the "difficult" strains. Pharmacokinetic studies indicate that ceftazidime exhibits metabolic stability in vivo; its elimination halflife is 1.8 hours, and about 88 to 92 p. 100 of the dose is recovered in the 24-h urine. Its extravascular distribution is excellent, with high levels being achieved in most tissues and body fluids in man. These in vitro and in vivo properties of ceftazidime suggest that this new cephalosporin should be considered a promising antibiotic for the treatment of severe infections. PMID- 3544116 TI - [Reactive arthritis. Nosological situation, incidence and diagnostic criteria]. PMID- 3544118 TI - [Myxoma of the right heart atrium detected by pericarditis of chronic development: value of bidimensional ultrasonography]. PMID- 3544117 TI - [Current treatment of esophageal varices]. PMID- 3544119 TI - [Characterization of enteroinvasive Escherichia coli in infants with acute diarrhea]. PMID- 3544120 TI - [Comparative study of the combination of trimethoprim and sulfamethopyrazine and amoxicillin in acute maxillary sinusitis]. PMID- 3544121 TI - [Acute cholecystitis: echographic diagnosis and its correlation with surgery and pathological anatomy]. PMID- 3544122 TI - [The autonomous thyroid nodule: results of treatment with radioiodine]. PMID- 3544123 TI - [Brigadier Bernardo O'Higgins and Dr. Nathaniel Miers-Cox]. PMID- 3544124 TI - [Bernardo A. Houssay (1887-1971): archetype of the university professor]. PMID- 3544125 TI - [Affective and emotional problems of the elderly encountered by the general practitioner]. PMID- 3544126 TI - [Retroperitoneal liposarcoma. Apropos of 3 cases and a review of the literature]. PMID- 3544127 TI - [Congenital malaria. Apropos of 4 new cases]. PMID- 3544128 TI - [Congenital hypothyroidism]. PMID- 3544130 TI - [Trial of xipamide in the treatment of non-complicated essential arterial hypertension]. PMID- 3544129 TI - [Subependymal and intraventricular hemorrhage in eutrophic premature infants of gestational age of 34 weeks and less]. PMID- 3544131 TI - [Specificity of anticancer treatment:aims and limits of targeting. I. Targeting carriers]. PMID- 3544132 TI - [Algodystrophy]. PMID- 3544133 TI - [Surgery in Zurich 100 years ago: the many-sided Zurich surgeon Rudolf Ulrich Kronlein]. PMID- 3544134 TI - [Cocaine addiction 100 years ago. A. Erlenmeyer: Uber Cocainsucht. Deutsche Medizinal-Zeitung, 31 May 1886]. PMID- 3544135 TI - [Fever and shivering fits]. PMID- 3544136 TI - [Medical-historical considerations on the significance of nutritional changes in a mountain village in Lower Engadin during the past 100 years]. PMID- 3544137 TI - [Alerting symptoms and exploratory examinations in endocrinology useful to practicing physicians]. PMID- 3544138 TI - [Role of the anesthetist in the multidisciplinary consultation on chronic pain]. PMID- 3544139 TI - [Role of the neurosurgeon in the multidisciplinary consultation on chronic pain]. PMID- 3544140 TI - [Preanesthetic cardiocirculatory evaluation]. PMID- 3544141 TI - Studies on the special tumor marker of cervical cancer of the uterus. AB - Although cervical cancer is the most common malignancy of the gynecologic system, very few tumor markers have been specially prepared for this disease. This article reviews some of the current investigations of those markers, particularly describing TA-4, a tumor antigen of cervical squamous cell carcinoma, which has currently been widely used in clinical practice. PMID- 3544142 TI - [Surface form in complete dentures, philosophy and principles]. PMID- 3544143 TI - Bibliography of recent literature in sleep research. PMID- 3544144 TI - Evolution of antifungal agents: past, present, and future. AB - Important progress has been achieved in antifungal chemotherapy in recent years. Two groups of drugs are now used: those produced by various organisms and those made synthetically. In the first group, only amphotericin B (1956) administered systemically is active in numerous deep mycoses. Although toxicity limits the use of amphotericin B, it is still the drug of choice for systemic mycoses. Griseofulvin was the first agent used for oral treatment of dermatophytoses. The introduction of flucytosine began a new era in chemotherapy; however, although flucytosine is orally administered and rapidly distributed, its antifungal activity is limited to cryptococcosis and systemic candidosis. The rapid induction of flucytosine-resistant mutants led to the development of treatment regimens of amphotericin B plus flucytosine. With the development of imidazole derivatives in 1969, a new generation of azole antifungal agents has emerged. Of these, only ketoconazole was orally active. New azole derivatives and triazoles have been synthesized, but only itraconazole has been successful in the treatment of superficial and deep mycoses in humans. Future trends for the development of agents with fungicidal activity, wider spectra, and better distribution are proposed. The association of immunotherapy with antifungal chemotherapy may offer new treatments for fungal infections in immunocompromised patients. PMID- 3544145 TI - [Cardiac ventriculography in dogs subjected to high frequency jet ventilation and intermittent positive pressure ventilation]. PMID- 3544146 TI - [Breast dysplasia. Review of the drugs used in its treatment]. PMID- 3544147 TI - [Combination of anti-inflammatory agents in antineoplastic chemotherapy]. PMID- 3544148 TI - Tumorigenicity of CHO glycosylation mutants in the nude mouse. PMID- 3544149 TI - Structure of human erythrocyte glycophorin C deduced from cDNA analysis. PMID- 3544150 TI - Antiprotease targeting: altered specificity of alpha 1-antitrypsin by amino acid replacement at the reactive centre. AB - Alpha-1 antitrypsin (alpha 1AT) is an efficient inhibitor of the human neutrophil proteases, elastase and cathepsin G. The reactive centre P1 residue (Met358) of alpha 1AT is important in defining the specificity of inhibition; furthermore, oxidation of this residue results in a loss of inhibitor activity. There is evidence that oxidative inactivation of alpha 1AT may be involved in the pathogenesis of pulmonary emphysema associated with cigarette smoking. We have studied the effect of a series of amino acid replacements at the active centre on the inhibition properties of alpha 1AT. The mutant proteins were produced in E. coli following in vitro mutagenesis of the alpha 1AT cDNA. Alpha-1-AT (Ile358), (Ala358) and (Val358) were efficient inhibitors of both neutrophil and pancreatic elastase, but not cathepsin G. Alpha-1-AT (Ala356, Val358) and alpha 1AT (Phe358) were specific for pancreatic elastase and cathepsin G respectively. Alpha-1-AT (Leu358) inhibited both neutrophil elastase and cathepsin G. These data show that, for effective inhibition, a potential cleavage site for the protease must be displayed at the alpha 1AT active centre. In each case, replacement of Met358 led to resistance to oxidative inactivation. Since alpha 1AT (Leu358) inhibits both neutrophil proteases and is resistant to oxidation, this variant may be of increased potential for the therapy of destructive lung disorders. PMID- 3544151 TI - Light activated crown and bridge resins. A bright future. PMID- 3544152 TI - A tribute to Seebert J. Goldowsky. PMID- 3544154 TI - Usher Parsons: the Battle of Lake Erie. PMID- 3544153 TI - The medical odyssey of James Joyce. PMID- 3544155 TI - The Rhode Island Medical Society Library--a valued treasure. PMID- 3544156 TI - A new serological reaction in patients with polymyalgia rheumatica and/or giant cell (temporal) arteritis: deposition of complement C4 and C3 components on rat kidney structures detected by indirect immunofluorescence. AB - Using indirect immunofluorescence deposition of complement C4 and C3 components to rat kidney medullary structures was demonstrated. This serological reaction (C4/C3-IFT) is regularly obtained with fresh sera of patients suffering from active polymyalgia rheumatica (PMR) and/or giant cell (temporal) arteritis (GCA). Sera of normal controls and of steroid-treated PMR and/or GCA patients in clinical remission have a negative C4/C3-IFT reaction. A positive conversion of the test in steroid-treated patients indicates enhanced disease activity. Because of its technical simplicity, C4/C3-IFT can be routinely used first, as a reliable serological marker in the primary diagnosis of PMR and/or GCA and second, as a sensitive criterion of disease activity in these patients. C4/C3-IFT reactivity is, however, not specific for GCA and/or PMR. Various systemic inflammatory diseases may have a positive reaction as well (e.g., certain viral and bacterial infections, malignant tumors, vasculitides, inflammatory joint diseases of different etiology). Recent experimental findings suggest that C-reactive protein (CRP) in patients' sera mediates an activation of the classical complement pathway resulting in a deposition of C4 and C3 complement components to certain rat kidney structures. PMID- 3544157 TI - Newer fibrinolytic agents in patients with acute myocardial infarction. AB - Fibrinolytic agents with higher specificity for fibrin in the thrombi and little systemic activation of the fibrinolytic system have been developed and tested in preliminary clinical trials of patients with acute myocardial infarction. The largest published experience available has been with recombinant tissue plasminogen activator, which seems to be more effective than streptokinase in lysing coronary thrombi. The acylated streptokinase-plasminogen complex BRL 26921 and pro-urokinase also gave promising preliminary results. All these agents, however, were accompanied by unexpectedly high incidence of systemic activation of the fibrinolytic system and by hemorrhagic complications with frequencies similar to those accompanying streptokinase. Hence, their superior clinical efficacy must be clearly proven before they are substituted for a more widely available and less expensive drug, such as streptokinase. PMID- 3544158 TI - Human eosinophil heterogeneity. AB - The aim of this review is to examine some of the most important findings pointing toward human eosinophil heterogeneity. Special importance is given to cell density, surface receptors, metabolism and response to biological products or synthetic compounds. PMID- 3544159 TI - Intermediary metabolite profiles during euglycemic glucose-insulin clamp: effects of ethanol. AB - We evaluated the effects of different doses of i.v. alcohol on tissue insulin sensitivity, by means of insulin-glucose clamp technique, in 10 young healthy men. The most important intermediary metabolites were assayed. Insulin-dependent glucose disposal was impaired at different levels of alcoholemia, probably through an impairment of the glycolytic pathway. Exogenous insulin administration does not restore the more reduced redox state caused by alcohol oxidation. Alcohol does not interfere with the antiketogenic and antilipolytic insulin effects. PMID- 3544160 TI - Screening and confirmatory tests for antibody to HTLV-III/LAV retrovirus in individuals at risk for AIDS. AB - The prevalence of specific antibodies to HTLV-III/LAV retrovirus was investigated during 1985 in a large group of subjects at risk for AIDS living in the Florence area. Two hundred and thirty-two of 774 (29.9%) intravenous drug users (IDU), 40 of 164 homosexuals (24.3%), 43 of 147 hemophiliacs (29.2%), 7 of 10 children born from IDU mothers and 4 of 88 heterosexual partners of IDU were found to be seropositive using different ELISA kits. The positivity in all serum samples showing low antibody titres and/or discordant results with different sandwich ELISA kits was confirmed by a competition ELISA assay and the Western blot technique. Serum samples from 4 of 210 hemodialyzed and from one of 17 polytransfused patients also showed positive reactions in the assays based on the sandwich principle, but gave negative results in both the competition ELISA assay and the Western blot technique. In addition, all these sera showed positive reactions using immunofluorescence and ELISA procedures that control for reactivity with H9 human cell line material used for culturing the HTLV-III/LAV retrovirus. These data demonstrate that exposure to HTLV-III/LAV retrovirus is widespread in groups of subjects at risk for AIDS living in the Florence area. Furthermore, the results of the present study suggest that, in addition to the Western blot technique, the competition ELISA assay as well as assays that control reactivity with H9 human cell line material may be of value for detecting false positive reactions due to antibody cross-reactive with human cellular components. PMID- 3544161 TI - [PLANED: a program for nurses to deal with nurses]. PMID- 3544162 TI - [Development of nursing from the viewpoint of management (in the light of the 100 issues of the Revista "ROL"]. PMID- 3544163 TI - [Nursing profession. A past with a future]. PMID- 3544164 TI - In vitro models for studying the molecular biology of carcinogenesis. AB - Although carcinogens cause various similar deleterious effects on rodent and human cells, only rodent cells can convert to malignancy in a quantitative, predictable fashion. Therefore, the control mechanisms involving indefinite proliferation and tumorigenicity are different. Human cell lines may exhibit normal or aneuploid chromosome constitutions with numerical or structural alterations frequently involving proto-oncogene loci, but fail to produce progressively growing tumors in nude mice. A new approach for obtaining human cells susceptible to malignant transformation by chemical or physical carcinogens is to use DNA from a cancer associated virus. Transfection of human papilloma virus (HPV) DNA associated with genital cancer can extend life-span of human cells; post-X-irradiated cells grow in agar suspension. Southern blot analysis of extracted DNA indicates that HPV sequences persist. Similar results are obtained with human fibroblast and epithelial cells. PMID- 3544165 TI - Rapid changes in glucose metabolism following the administration of ethionine: its role in regulating hepatic protein synthesis. AB - The relationship between the changes in portal glucagon, insulin, glucose, and hepatic protein synthesis were investigated during ethionine intoxication. There was a 50% decrease in blood glucose, a seven-fold increase in portal glucagon and a 90% increase in portal insulin, all of which coincided temporally with the inhibition of hepatic protein synthesis. When reversal of ethionine intoxication was initiated with adenine it simultaneously restored blood glucose, insulin, glucagon, and protein synthesis. Protein synthesis could not be adequately restored by glucose, but in this case hepatic ATP levels did not increase. In addition, glucose given by stomach tube prior to ethionine did not prevent the action of ethionine, though it did maintain plasma glucose levels and prevented the decrease in plasma insulin and increase in plasma glucagon. These results show that in vivo regulation of hepatic protein synthesis during ethionine intoxication is not likely to be mediated by portal insulin, glucose, and glucagon. PMID- 3544167 TI - Comparative studies on protein turnover regulations in tumor cells and host tissues: development and analysis of an experimental model. AB - The protein mass of cells and tissues is determined by the relative rates of protein synthesis (PS) and degradation (PD). A convergent modulation of both PS and PD is operated by many cell types to regulate protein accumulation and thus growth. Transformed and neoplastic cells may show markedly defective PD regulations. Yet even highly-deviated cells such as those of the transplantable Yoshida ascites hepatoma AH-130 cease growth when attaining a conspicuous population size, by operating a combined reduction of PS and acceleration of PD. As in normal cells, PD acceleration is effected through an activation of the acidic-vacuolar (lysosomal) mechanism. AH-130 tumor-bearing rats develop a markedly negative nitrogen balance early after transplantation. Tumor growth involves pronounced perturbations in host body and tissue protein metabolism. Apparently, these changes occur mostly at the level of PD rather than PS, at least in liver and skeletal muscle (gastrocnemius). These observations indicate that either tumor and host cells sense different signals for PD regulations or their thresholds for the same signals are poised differently. This model seems most suitable for further studies to elucidate which signals and mechanisms are involved in these protein metabolic perturbations and possibly, to develop the rationale for adequate corrective strategies. PMID- 3544166 TI - Interaction of halocompounds with nucleic acids. AB - The binding of epichlorohydrin, 1,2-dichloroethane, 1,2-dibromoethane, chlorobenzene, bromobenzene, and benzene to nucleic acids and proteins of different murine organs was studied in in vivo and in vitro systems. The extent of in vivo enzymatic activation of brominated compounds was higher than that of chlorinated chemicals. Aryl halides were bound mainly to liver DNA whereas interaction of alkyl halides with DNA of liver, kidney, and lung gave rise to similar binding extent. In vitro activation of all chemicals was mediated by microsomal P-450-dependent mixed function oxidase system which is present in rat and mouse liver and, in smaller amount, in mouse lung. Activation of alkyl halides by liver cytosolic GSH-transferases even occurred. The relative reactivity of chemicals in vivo, expressed as Covalent Binding Index (CBI) to rat liver DNA, was: 1,2-dibromoethane greater than bromobenzene greater than 1,2 dichloroethane greater than chlorobenzene greater than epichlorohydrin greater than benzene. On the whole, it agreed with in vitro activation of chemicals, with genotoxicity data from other short-term assays and also with oncogenicity of benzene, epichlorohydrin, 1,2-dichloroethane, and 1,2-dibromoethane. CBI values of chlorobenzene and bromobenzene gave the first clear evidence of genotoxicity and of possible carcinogenicity of these two chemicals. PMID- 3544168 TI - Different factors possibly involved in post-translational regulation of ornithine decarboxylase activity. AB - Present results concern a microsome-bound enzymatic system which has been recognized as responsible for the rapid inactivation in vitro of ornithine decarboxylase (ODC). Two different models have been investigated: a) rat liver after a single thioacetamide administration, and b) the 3924 A Morris hepatoma. In both these models we observed variations in the microsome-bound ODC inactivating capacity. In parallel, changes in ODC properties were observed. The possibility of a causal relationship between the two events is discussed. The actual role of the microsome-bound ODC-inactivating system, in ODC activity regulation in vivo cannot be established, but it remains as a fairly plausible working hypothesis. PMID- 3544170 TI - Changes in the reproductive capacity of aging female mice after irradiation with different doses of X-ray. PMID- 3544171 TI - [Sonographic detection of salivary calculi of the sublingual gland]. AB - Ultrasound (US) proved highly effective for detection and localisation of stones in salivary glands. Because of the high accuracy and the possibility to detect non-opaque stones sonography should be performed as a supplementary measure if on plain film the localisation of the calculi is questionable. In this study we report on two patients with stones in the glandula sublingualis. PMID- 3544169 TI - Immunogenetics of development and its relationship to carcinogenesis. AB - We have been exploring the classical idea that there is a close relationship between embryogenesis and carcinogenesis. The clinical literature provides evidence for a relationship among the presence of developmental anomalies, an increased incidence of cancer, and genes linked to the major histocompatibility complex (MHC). This relationship was explored experimentally by testing the possibility that rats having the growth and reproduction complex (grc), which causes developmental abnormalities, might be more susceptible to the development of cancer following exposure to a chemical carcinogen. Two groups of animals which were genetically similar except for the presence or absence of the grc were fed the carcinogen 2-aminoacetylfluorene. The animals carrying the grc developed the morphological changes associated with early cancer of the liver, whereas their normal counterparts did not. These susceptible animals also had a number of biochemical alterations, especially in cholesterol biosynthesis, which may be associated with the development of cancer. Molecular analysis of genomic DNA by blot hybridization revealed restriction fragment length polymorphism differences between the DNA from grc and grc+ rats, and these differences may be related to the differential susceptibility of the strains to cancer. PMID- 3544172 TI - [Mediterranean type of primary lymphoma in the small intestine - a diagnostic problem]. AB - In primary lymphoma of the gastro-intestinal tract radiological and clinical findings are often uncharacteristic for a long time and even tissue biopsy may be difficult to classify pathohistologically. The conclusive diagnosis of this rare entity can be established radiologically only in combination with serological, endoscopic und pathologic findings during the course of the disease. PMID- 3544173 TI - [Primary malignant lymphoma of the brain of true histiocytic origin]. AB - Primary lymphomas are rare brain tumours. A case is reported where the true histiocytic origin was proved by autopsy. The CT features and the differential diagnoses in malignant lymphomas of the brain are discussed. PMID- 3544174 TI - [Diabetes caused by insulin-receptor antibodies. Autoimmune diabetes caused by anti-islands of Langerhans immunity]. PMID- 3544175 TI - Does mumps infection play a role in the etiology and pathogenesis of insulin dependent diabetes mellitus? AB - Numerous experimental findings in animals as well as epidemiological and clinical observations support the hypothesis that certain viruses play a role in the pathogenesis of insulin-dependent diabetes mellitus (IDDM). Directly or via immune and/or autoimmune processes viruses might induce a beta-cell damage. An attempt is made to evaluate critically the arguments for the role of the mumps virus in the pathogenesis of IDDM. Based on their own experience, the authors hold the opinion that at present a causal connection between mumps infection and the development of IDDM cannot be proved beyond doubt. Prospective studies in humans including appropriate techniques of humoral and cellular immunity in relation to the beta-cell damage are required. PMID- 3544176 TI - Diagnostic value of echotomography in alcoholic liver disease. AB - In 32 patients with alcoholic liver disease a comparison was made between the classical liver morphologic changes (laparoscopic and histologic) and the echotomographic aspects, to demonstrate the diagnostic value of the latter. Though the echographic changes were nonspecific, they supply some indications on the anatomoclinical form of disease. The only element of echotomography with certain value is the differentiation between cirrhosis and the other forms: steatosis and alcoholic hepatitis. To this, some possibilities of detecting incipient fibrosis and concomitant involvement of the pancreas can also be added. PMID- 3544177 TI - [Ventricular gradient. II. Clinical section]. PMID- 3544178 TI - Comparison between a dip-slide test and plate count for determination of Streptococcus mutans infection. AB - A significant correlation was found between the results of a dip-slide test and a conventional agar-plate method for determination of the salivary Streptococcus mutants population. The growth density of S. mutans around bacitracin discs on the dip-slide was estimated and examination of the dip-slides with or without a microscope showed good agreement. The percentage of identical scores between two observers increased from 69 to 84% with the use of a microscope. Scores from dip slides inoculated with saliva by means of a cotton swab showed good agreement with those obtained with stimulated saliva. The dip-slide method is simple and reliable and can be a valuable tool in general practice for the estimation of the S. mutans infection. PMID- 3544179 TI - Clinical effects of glazing denture acrylic resin bases using an ultraviolet curing method. AB - Control of denture plaque accumulation is essential to obtain and maintain a healthy oral mucosa in denture wearers. The present study was designed to study the effect on denture plaque accumulation and denture stomatitis of coating the fitting denture surface by a glaze. Twenty-one subjects wearing complete dentures participated in the study. Glazing of the denture surface was performed using a Perma Cure System. Plaque accumulation was studied clinically and using a semiquantitative microbiologic technique. Plaque accumulation on the glazed and the non-glazed halves of the fitting denture surface was compared after 1 wk. There was significantly less plaque on the glazed half of the denture (P less than 0.001), and the calculated number of CFU of bacteria/cm2 was significantly lower from the test area of the glazed half than from the test area of the non glazed half of the denture (P less than 0.001). When the patients were re examined 1 month after the entire fitting denture surface had been glazed plaque scores, yeast scores and number of CFU of bacteria/cm2 were not significantly different from those observed before glazing. There was a reduction of the erythema of the palatal mucosa in 14/19 patients with denture-induced stomatitis. The study indicates that coating of the fitting denture surface by a glaze may be a means to improve denture cleanliness; however, the present glazing system should be further developed to produce a more uniform glazing. PMID- 3544180 TI - Role of neuropeptides in the control of gastric secretion. PMID- 3544181 TI - Pirenzepine in the treatment of reflux oesophagitis. A placebo-controlled, double blind study. AB - The efficacy of 50 mg pirenzepine twice daily in the treatment of reflux oesophagitis was compared with that of placebo in 47 patients over a period of 12 weeks. The 23 patients receiving pirenzepine experienced decreases in symptoms after 4 weeks (p less than 0.001) and 12 weeks (p less than 0.02) of treatment significantly greater than those in the 24 patients receiving placebo. The decreases in symptoms were associated with significantly less use of antacids by the pirenzepine group (p less than 0.01) during the first 4 weeks. Endoscopically, oesophagitis was healed or improved in 54.5% of patients receiving pirenzepine and in 18.2% of patients receiving placebo (p less than 0.05) after 4 weeks of treatment. After 12 weeks of treatment healing or improvement was seen in 55.0% and 35.0% of patients, respectively (difference not significant). Histologic improvement did not differ significantly between the groups. Our results suggest that pirenzepine is useful in the management of reflux oesophagitis. PMID- 3544182 TI - A randomized controlled trial of variceal compression as an adjunct to endoscopic variceal sclerosis. AB - Endoscopic variceal sclerosis is effective at eradicating oesophageal varices and prolonging survival, but early rebleeding before varices have been obliterated remains a problem. A randomized controlled trial was therefore conducted to determine whether more rapid variceal obliteration and hence a lower morbidity and mortality in the first month could be achieved by compressing the varices after the first injection of sclerosant. Forty patients bleeding from previously untreated varices were studied. There was no demonstrable benefit from post sclerosis variceal compression in terms of early death from rebleeding (compression, 3 of 19; no compression, 3 of 21 in the first month), total number of patients rebleeding (compression, 5 of 19; no compression, 6 of 21 in the first month), or speed of variceal obliteration (percentage of variceal columns obliterated at 1 month: compression, 13%; no compression, 26%). This study shows that post-sclerosis variceal compression by means of the Williams overtube and Sengstaken tamponade does not improve the efficacy of endoscopic variceal sclerosis. PMID- 3544184 TI - Gastrointestinal regulatory peptides: radioimmunoassay and biological activity. PMID- 3544183 TI - Pancreatic pseudocysts during first attack of acute pancreatitis. AB - One hundred and forty-eight patients admitted with their first episode of acute pancreatitis were examined by ultrasonography. During the acute attack 1 or more pseudocysts were found in 19 patients (13%), pancreatic abscess in 2, whereas 127 had a normal or swollen pancreas. Two small cysts resolved spontaneously, eight were cured after ultrasonically guided needle aspiration or catheter drainage, and cystogastrostomy was necessary in four cases. One patient refused treatment. Abscesses requiring surgical drainage developed in four of the patients with pseudocysts. The study showed that pseudocysts may appear as early as within 1 week of the first episode of acute pancreatitis. Some pseudocysts may resolve spontaneously, and ultrasonically guided aspiration or drainage may cure approximately half of the pseudocysts. PMID- 3544185 TI - Effects of food intake and various extrinsic hormones on portal blood flow in patients with liver cirrhosis demonstrated by pulsed Doppler with the Octoson. AB - In the fasting state the mean portal blood flow demonstrated by the pulsed Doppler system with the Octoson in liver cirrhosis (LC) patients (velocity (PV), 10.2 +/- 3.5 (mean +/- SD) cm/sec, 7.0 +/- 2.6 cm/sec/m2; flow (PF), 579 +/- 262 ml/min, 383 +/- 184 ml/min/m2 (n = 40)) was significantly lower than that in control subjects (PV, 21.2 +/- 5.2 cm/sec, 14.7 +/- 3.9 cm/sec/m2; PF, 966 +/- 344 ml/min, 667 +/- 220 ml/min/m2 (n = 40)). Food intake increased PV by 15% and PF by 15% in LC (n = 8) and increased PV by 56%, PF by 125% in controls (n = 8). Glucagon increased PV by 30% and PF by 52% in LC (n = 10) and increased PV by 50% and PF by 120% in controls (n = 8). Secretin increased PV by 44% and PF by 75% in LC (n = 9) and increased PV by 66% and PF by 142% in controls (n = 8). Vasopressin decreased PV by 42% and PF by 54% in LC (n = 9) and decreased PV by 48% and PF by 62% in controls (n = 8). Insulin, gastrin, and prostaglandin E1 had no effect in either group. PMID- 3544186 TI - Effects of pirenzepine and atropine on gastroduodenal motor patterns in duodenal ulcer patients. AB - The aim of this study was to compare the effects of pirenzepine with those of atropine a non-selective antimuscarinic agent, on gastroduodenal motor patterns in duodenal ulcer patients. Twenty patients were allocated at random to 2 groups of 10 subjects each. The drugs were administered by bolus intravenous injection as equiactive antisecretory doses of 10 mg pirenzepine and 1 mg atropine. Before and 15 min after drug administration all patients underwent a gastroduodenal manometric and reflexogenic study with a specially designed probe and three inflatable latex balloons. Both drugs significantly decreased antral and duodenal pressure, but atropine was much more effective than pirenzepine: 91 +/- 2% verus 54 +/- 9% decrease in the motility index for the antrum and 95 +/- 1% versus 49 +/- 7% for the duodenum (p less than 0.01). The antral motor threshold was not modified by either drug. The results of this study confirm the selectivity of action of pirenzepine on gastric function. PMID- 3544187 TI - Treatment of duodenal ulcer with low-dose antacids. AB - The aim of the present investigation was to compare the efficacy of a low-dose antacid (Maalox 70, 280 mmol/day) with that of the H2-receptor antagonist cimetidine (Tagamet, 200 mg three times daily and 400 mg/day) after 14 and 28 days in the treatment of duodenal ulcer. The prospective multicentre study included 171 patients with endoscopically confirmed duodenal ulcers. The patients were randomly assigned to the treatment groups with antacid containing Mg and Al hydroxide (M)(4 X 70 mmol/day; n = 86) or to the group receiving cimetidine (T) (1000 mg/day; n = 85). The two treatment groups were matched for age, sex, drinking and smoking habits, and drug use. Endoscopic examinations were carried out before the start of treatment and 14 days later. If the ulcer was still present at this time, the second endoscopic examination was done after a further 14 days. Endoscopically, the ulcer had healed at 14 days in 38.8% (M) and in 34.9% (T) and at 28 days in 80.0% (M) and 74.7% (T), respectively. The healing rate did not differ significantly between the two treatment groups. Complaints, measured as percentage of days per week with upper abdominal pain, were significantly reduced in both groups. No significant differences were found between the two treatment groups with regard to pain relief or side effects. Treatment had to be abandoned in one patient receiving antacid because of diarrhoea and in one patient receiving cimetidine because of the absence of any response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544189 TI - Long-term low-dose antacid versus cimetidine therapy in the treatment of duodenal ulcer recurrence. AB - The effect of cimetidine (400 mg at night) and of low-dose antacid (400 mg of aluminum hydroxide plus 400 mg of magnesium hydroxide four times a day) given alone or in combination was assessed in a double-blind double-dummy endoscopic trial on prevention of duodenal ulcer (DU). Seventy-five outpatients with healed DU were followed up clinically for 1 year and were checked endoscopically after 6 and 12 months of therapy or in case of symptomatic relapse. After 6 and 12 months, 25% and 41%, respectively, of patients treated with cimetidine alone experienced a relapse, compared with 42% and 54% of those treated with antacid alone and 25% and 43% of patients treated with the combination therapy. The differences are not statistically significant. No relevant side effects were observed in patients of any group. It is concluded that long-term prophylactic treatment of DU with low-dose antacid is as safe and effective as cimetidine treatment, whereas a combination of the two drugs does not achieve a therapeutic gain. PMID- 3544188 TI - Treatment of reflux oesophagitis with a carbenoxolone/antacid/alginate preparation. A double-blind controlled trial. AB - Twenty-nine patients were treated with a carbenoxolone/antacid/alginate preparation (Pyrogastrone) and 30 with antacid/alginate alone four times each day for 8 weeks, in a double-blind study, to ascertain the value of carbenoxolone in the treatment of patients with endoscopically confirmed reflux oesophagitis. Symptom review every 2 weeks and endoscopic findings every 4 weeks were converted to a 6-point grading system to facilitate statistical comparison, using a stochastic model for predicting the rate of change in grades during treatment. Carbenoxolone-treated patients showed an 82% improvement in symptom grades over 8 weeks and improved 50% faster (P less than 0.01) than did control patients, who showed a 63% improvement. Endoscopic improvement was not significantly different in the first 4 weeks, although healing was better maintained in carbenoxolone treated patients during the second 4 weeks (P less than 0.05). At the low doses used (5 X 20 mg daily) no significant side effects of carbenoxolone were encountered. Pyrogastrone should be considered as a therapeutic alternative in patients who fail to respond to routine management with antacids. PMID- 3544190 TI - Matrix effects in secondary ion mass spectrometric analysis of biological tissue. AB - We have made several observations during the course of our studies that show the presence of matrix effects in soft biological tissue and standards. The sputtering rate of gelatin is approximately twice that of epoxy resin, but the ion yield of lithium in gelatin is an order of magnitude less than in epoxy. Osmium impregnation of freeze-dried material significantly alters the localization of calcium, but not potassium and barium. The absolute count rate for calcium in osmicated tissue is increased several-fold above that in freeze dried tissue. Scanning electron microscopy of sputtered material shows the formation of cones during sputtering, which is particularly, but not exclusively, associated with melanin granules and red blood cells. These structures are known to be highly emissive for Na, K, and Ca. Boron implanted tissue also exhibits selective boron emission from melanin granules. Relative proportions of monoatomic and polyatomic emission vary in epoxy, gelatin and tissue. Ion images of carbon, chlorine and vanadium in tissue embedded with a vanadium-doped epoxy resin show variations in local regions that correspond to tissue structure. The energy distributions of common secondary ions differed somewhat in resin and two different tissue regions. These examples show the existence of potential matrix effects in soft biological tissue that involve both differential sputtering and ion yield effects. PMID- 3544191 TI - Freeze-dried embedded specimens for biological microanalysis. AB - The main problems associated with freeze-drying of biological material for electron microscopy concern the freeze-drying temperatures and times necessary to minimize artifacts. Due to the many parameters involved these problems have to be resolved experimentally. It can be shown that good morphological preservation of chemically unfixed material is possible when freeze-drying is done exclusively in a temperature range between -80 degrees C and -50 degrees C. OsO4 vapour fixation of the freeze-dried tissue is not necessary and should be avoided because it may cause ion redistribution artifacts. Embedding at low temperature of properly freeze-dried material does not seem to disturb structure and ion distribution of the freeze-dried material. Hence, sections of such freeze-dried material and embedded biological material seem to be suitable for microanalysis. Preliminary micro-analytical results obtained from sections of freeze-dried and Lowicryl K11M embedded muscle reveal an uneven distribution of potassium in the sarcomeres similar to the visualized uneven distribution of the electron dense thallium (potassium surrogate) in frozen hydrated cryosections. A comparison of different cryomethods shows that freeze-drying and embedding is the simplest way to obtain stable thin sections of chemically unfixed biological material which, for instance, may be used for future microanalytical investigation of the interaction of proteins with physiological and non-physiological ions. PMID- 3544192 TI - Scanning electron microscopy of Thebesian ostia (microdissection by ultrasonication: enzymatic digestion). AB - Thebesian vasculature provides for communication between the coronary system and the chambers of the heart. Anatomic, embryologic, physiologic, and therapeutic investigations have involved this component of cardiac anatomy from the early 18th century to the present time. The scanning electron microscope (SEM) now affords an innovative approach to the study of the ostia of these veins as they open into the chambers of the heart. The surface of the intact endocardium is continuous, whether it is treated with boric acid or not, as long as it remains intact. Enzymatic microdissection of tissues with trypsin, hyaluronidase and pronase, followed by similar treatment with boric acid, reveals continuity of successive component layers of the endocardium extending into Thebesian substructure. Thebesian tributaries are easily visualized from the ostia but the deeper capillary network of the Thebesian system is not demonstrable by this approach. Valvular structures such as might prevent retroflow during the cardiac cycle are not present. Our observations with SEM support anatomic relationships indicated by previously published work. PMID- 3544193 TI - Cryoultramicrotomy and immunocytochemistry in the analysis of muscle fine structure. AB - Cryoultramicrotomy, which avoids the use of harsh fixation procedures, deleterious dehydration and plastic embedding can be combined with immunocytochemistry to determine the ultrastructural localization of cellular proteins. Our attempts to use the cryosectioning technique in combination with immunolabelling to bridge the gap between light and electron microscopic analysis of muscle morphology have enabled us to obtain new information on fibre typing at the ultrastructural level. Furthermore, we have obtained a marked improvement in the resolution of myofibrillar structures by using semithin cryosections for fluorescence microscopy. Data are also presented on correlated light and electron microscope immunocytochemistry of myocardial intermediate filaments confirming the presence of longitudinally oriented intermediate filaments of desmin in the region of the intercalated discs of mammalian cardiac myocytes, whereas elsewhere in the myocyte the bulk of intermediate filaments of desmin is concentrated in the intermyofibrillar space at the level of the Z disc. PMID- 3544194 TI - Visualization of cytoskeletal elements and associated retroviral antigens by immunogold transmission electron microscopy of detergent extracted cells. AB - Several investigators have reported an association between the cytoskeleton and viral antigens. In our laboratory, biochemical immunofluorescence and immuno-gold electron microscopy studies were conducted on TX-100 extracted NIH/3T3 cells infected with Moloney-murine leukemia virus. Cytochalasin B treatment causes reversible microfilament disruption and a concomitant decrease in virus production. No effect on microtubules was seen. Immunogold electron microscopy reveals an association between cytoskeletal actin and the viral antigens gp70 and p15E. The results of these immunocytological and biochemical studies indicate that the cytoskeleton may play an integral role in transport and processing of viral gene-envelope products. PMID- 3544195 TI - Dissection technique for cochleas prepared for scanning electron microscopy. AB - Scanning electron microscopy (SEM) permits a three-dimensional study of the surface morphology of the organ of Corti that is very useful in evaluating the condition of the apical end of the hair cells and the stereocilia. However, some laboratories have experienced problems with curling of the basilar membrane during critical point drying of cochlear specimens prepared for SEM evaluation using the Murakami or osmium thiocarbohydrazide-procedures. This curling of the basilar membrane can obstruct the view of the reticular lamina and the ciliary ends of the hair cells. We have used a dissection method, referred to as the anchor technique, to overcome basilar membrane curling. This technique removes all the structures above the reticular lamina but leaves the basilar membrane attached to the spiral ligament and the lateral bone to which the spiral ligament is anchored. Individual cochlear turns are dissected in this manner and mounted on the same examination stub for SEM evaluation. Maintenance of the lateral attachment of the basilar membrane requires additional dissection time but eliminates the problem of curling during critical point drying. An additional benefit is that mounting the individual turns on the same examination stub facilitates evaluation and photomicroscopy of the surface morphology. The anchor technique has been used successfully on the guinea pig and should be appropriate for most mammalian cochleas. PMID- 3544196 TI - Scanning electron microscopy in bone pathology: review of methods, potential and applications. AB - This article reviews the applications of SEM methods to human bone pathologies referring to studies made at UCL. We consider the methods which may be most suitable; these prove to be not "routine" in the context of most bio-medical applications of SEM. Valuable information can be obtained from a bone sample if its edges are ground flat, before making either a matrix surface preparation by washing away all the cells or a mineralizing front preparation, by also dissolving the osteoid-for which hydrogen peroxide is recommended to produce a robust specimen. BSE contrast from a cut block surface can be used to measure bone phase volume. SE contrasts from natural surfaces (trabeculae, canals and lacunae) can be used to study forming, resting and resorbing surfaces both qualitatively and quantitatively (except in the case of histological osteomalacia, where the existence of osteoid will go undetected and reversal lines will be difficult to distinguish from recently resorbed surfaces). We also recommend the use of PMMA embedded bone blocks, which can be used as obtained from the pathologist, but are better embedded by a more rigorous procedure. BSE image analysis can be used to quantitate bone density fractions opening up a completely new investigative method for the future. Osteoid can be measured automatically using CL if the bone sample is block stained with brilliant sulphaflavine before embedding or if a scintillant is added to the embeddant. We give examples of observations made from a number of bone diseases: vitamin D resistant rickets, osteogenesis imperfecta; osteomalacia; osteoporosis; hyperparathyroidism; fluorosis; Paget's disease; tumour metastasis to bone. PMID- 3544197 TI - Review of statoconia formation in birds and original research in chicks (Gallus domesticus). AB - This paper reviews published materials on statoconia formation in birds, and emphasizes works dealing with the embryonic chick (Gallus domesticus) saccule and utricule. Histological, biochemical and histochemical aspects of forming statoconial membranes and statoconial crystals of mammals are included. Results from our work with chick embryos permitted us to conclude that statoconia probably do not form by seeding of a subunit around central core. Instead, immature statoconia may emerge already formed, from a segmenting mass of organic material that seems to be secreted by the supporting cells of the saccular and utricular maculae. Crystallization of each statoconium may involve seeding of multiple subunits around many nucleation centers in the organic matrix. Following these processes, calcium (sometimes granular) attaches to immature statoconia and become subsequently incorporated between the fibrils of the organic matrix starting at the peripheral zone and advancing toward the central core. Our transmission electron microscopy findings, histochemistry and X-ray microanalysis complements of other investigators, who used chicks with light microscopic studies. These results agree with the notion that the secretion of an organic matrix constitutes the first step toward the formation of the statoconial membrane and statoconia. We show ultrastructurally how statoconia may be assembled from the organic matrix before they acquire their characteristic geometric shapes. PMID- 3544198 TI - Methods for the detection of a specific Mycobacterium leprae antigen in the urine of leprosy patients. AB - Two methods for detecting the phenolic glycolipid, PGL-1, a Mycobacterium leprae specific molecule, in the urine of leprosy patients are described. Both methods rely on the 100-fold preconcentration of the urine, which can be accomplished by a single-step ultrafiltration procedure. The equivalent of approximately 2.5 micrograms of PGL-1/ml was detected in the urine of LL patients with an inhibition ELISA. The second method, a direct dot-blot assay on nitrocellulose paper, was much simpler and more sensitive. As little as 3 ng of antigen was detected by the dot-blot technique. PGL-1 was detected in the urine of LL patients. PMID- 3544199 TI - The protective effect of beta 1-3D-glucan-derivatized plastic beads against Escherichia coli infection in mice. AB - Pretreatment with beta-1,3-D-glucan-derivatized plastic beads conferred strong protection against Escherichia coli infection in mice. The protective effect showed a dose-response relationship to the amount of beads injected and was dependent on the time point of the injection relative to the infection with E. coli. A similar protection could be obtained in nude mice. Experiments with radioactively labelled bacteria as well as beads indicated a systemic effect of the beads. Macrophages extracted from animals treated with glucan plastic beads appeared highly stimulated. This was also true of cells that did not contain beads and presumably therefore not glucan, which seems to indicate a soluble stimulatory factor. PMID- 3544200 TI - Transmission of HIV infection to heterosexual partners but not to household contacts of seropositive haemophiliacs. AB - The prevalence of HIV antibodies in 44 heterosexual female partners and 56 nonsexual family household contacts of 61 HIV seropositive haemophiliacs (41 adults and 20 children or adolescents) was determined to evaluate the risk of transmission of HIV infection. HIV antibodies were determined by enzyme-linked immunosorbent assay and positive reactions were confirmed by Western blotting. HIV antibodies were demonstrated in 4/40 (10%) regular heterosexual partners of 40 seropositive patients with haemophilia A. Four temporary heterosexual partners of one additional seropositive haemophiliac were seronegative. 56 nonsexual household contacts including 30 parents, 13 siblings and 13 children of 29 seropositive haemophiliacs were all negative for HIV antibodies. Thus transmission of HIV occurred from seropositive haemophiliacs to their heterosexual partners but not to nonsexual household contacts. PMID- 3544202 TI - Food poisoning outbreak in Ibadan, Nigeria, due to a new phage type of Salmonella typhimurium. AB - An outbreak of food poisoning in Ibadan, Nigeria, claimed about 20 lives. A new phage type U282 of Salmonella typhimurium, the causative organism, was isolated from a sandwich filling, which yielded 4 X 10(9) viable organisms/g. The sandwiches were prepared in Lagos and kept without refrigeration until consumption next day. There is need for stricter control in the tropical developing countries of private catering agencies which imitate those of the advanced industrial countries. PMID- 3544201 TI - Group B streptococci at delivery: high count in urine increases risk for neonatal colonization. AB - Of 858 pregnant women studied in matched rectal, urethral and urine cultured specimens, 186 (22%) were found to be colonized by group B streptococci (GBS). GBS were detected significantly more often in rectal specimens (159) than in urethral specimens (108) or in urine specimens (64). This is supporting evidence for the gastrointestinal tract as the main habitat of GBS. Of 1786 women whose urine was sampled at delivery, GBS were isolated from 128 (7%), in 22 of whom (1% of the total) GBS were present in quantities greater than or equal to 10(4) colony forming units (cfu)/ml urine. Neonates born to women with greater than or equal to 10(4) cfu GBS/ml urine were apparently at greater risk for neonatal infection, as they were more commonly and more heavily colonized than were the newborns of women with lower quantities of GBS in urine, or if positive urethral or rectal specimens were considered. The incidence of preterm delivery or obstetric infection was not higher among women in whom GBS were isolated in specimens from any of the 3 sites; foetal distress was more common among their children, but not neonatal respiratory or infectious diseases of which the incidence was low and difficult to assess statistically. PMID- 3544203 TI - Nocardiosis mimicking Wegener's granulomatosis. AB - A 45-year-old man presented with persistent nasal discharge and later developed arthropathy, cutaneous vasculitis, a macular rash and radiographic lung opacities. Early relapse after starting immunosuppressive therapy consisted of new cavitating lung opacities, as seen in Wegener's granulomatosis, and subcutaneous nodules. Lymph node biopsy showed Nocardia asteroides. One month after high dose cotrimoxazole the chest X-ray was normal. PMID- 3544204 TI - Bladder tumour control by abdominal ultrasound and urine cytology. AB - A blind study comparing abdominal ultrasound and cystoscopy was carried out in 186 patients. 20 bladder tumours sized from 2 to 5 mm were overlooked. Combination with urine cytology increased the diagnostic sensitivity. In order to reduce costs and patient inconvenience in the bladder tumour control population abdominal ultrasound and urine cytology is advocated as an alternative to cystoscopy. This control modality seems safe in patients with "low-risk" bladder tumour disease. PMID- 3544206 TI - [Efficient diagnosis of pleural effusion]. AB - Under physiological conditions the pleural cavities contain a few millilitres of a fluid film with a protein content of about 1.7 g%. Because of the different capillary pressure, there is a regular flow of fluid from the parietal pleura to the visceral pleura. In cases of increased hydrostatic pressure or reduced colloid osmotic pressure in the absence of pleural disease, transudation takes place; in disturbances of permeability resulting from various types of inflammation, neoplasms or vascular disorders, and in disturbances of lymph backflow, exudates are formed. A pleural effusion is easily recognizable in typical cases. Reference is made to particular radiological manifestations which are not always correctly interpreted, viz. subpulmonary effusion, encapsulated interlobar effusion ("vanishing tumour") and predominantly mediastinal effusion. Precise examination of the neighbouring organs, together with thoracentesis and pleural biopsy, are decisive for the etiological diagnosis. When examining the effusion, it is of great importance to differentiate between transudate and exudate. Light's definition of transudate proved to be valid in this study (protein content below 3 g% and LDH index below 0.6). For the basic examination, we further recommend cytology and--to save time--tuberculosis bacteriology as well. The significance, sensitivity and specificity of various other chemical tests are discussed. For diagnostic strategy it is always necessary to take into consideration the entire clinical situation, including radiology and laboratory tests. With this proviso, a specific investigation scheme may be recommended. After application of the usual diagnostic methods, including pleural biopsy, aetiologically unclear effusions remain in about 20-25% of cases. Approximately 2/3 of these can be diagnosed by means of optimized biopsy technique under thoracoscopy and are predominantly tumoral effusions. Approximately 1/3 (5-10% of the total number) still remain unclear as "idiopathic" effusions, even after thoracoscopy. The relative importance of early diagnosis of a malignant pleural effusion is discussed. PMID- 3544205 TI - Diagnosis and treatment of renal angiomyolipoma. AB - A series of nine patients surgically treated for histologically verified renal angiomyolipoma is presented. Only one patient had extrarenal stigmata of tuberous sclerosis. No evidence of malignancy was found. In three cases a preoperative diagnosis was achieved with computed tomography (CT), use of which is recommended in evaluation of renal tumours. Six angiomyolipomas were solitary and three bilateral. Abdominal or flank pain was present in eight cases and perirenal haemorrhage in four. Solitary tumours were treated with nephrectomy. For bilateral tumour, nephrectomy and conservative renal surgery were used in two cases and bilateral nephrectomy and kidney transplantation were performed in the third case. When adipose tissue containing renal tumour is demonstrated at CT, conservative surgery should be considered. PMID- 3544207 TI - [Cytodiagnosis and marker determination in pleural effusion]. AB - Malignant cells can be identified in 70-85% of all tumor-induced serous effusions by cytological examination. Carcinoma and malignant lymphoma can be frequently found in pleural fluids, while sarcoma is rare. In many cases, morphological criteria allow these tumors to be distinguished and may even lead to identification of the primary site of carcinoma. This may be of considerable therapeutic relevance. It may however be impossible to classify undifferentiated tumors on the basis of morphology alone. In these cases a diagnosis may be established by immunocytochemical typing. The most commonly employed markers and their applications are discussed. PMID- 3544208 TI - [Acute abdomen in patients under anticoagulant treatment]. AB - Hemorrhagic complications induced by anticoagulants occur in about 10-20% of patients treated. The bleeding source is found in the gastrointestinal tract in 30%. A careful history and physical examination, in combination with radiologic evaluation, serve to localize the bleeding site and avoid unnecessary surgery. Because anticoagulated patients may have the clinical picture of acute abdomen, it is important to differentiate extra-, intra- and retroperitoneal complications. During the past ten years we have treated 16 patients with acute abdomen under anticoagulation therapy: extra-, intra- and retroperitoneal complications were found in three, nine and four cases respectively. Rectus sheath hematomas, intramural bowel hematomas and retroperitoneal hematomas primarily underwent conservative, symptomatic treatment. Only intraperitoneal hemorrhage and psoas hematomas with neurologic manifestations required early surgical treatment. After successful treatment the indication for anticoagulation therapy should be reevaluated. PMID- 3544209 TI - [Cardiovascular and metabolic changes in the antabuse-alcohol reaction: basis for the diagnosis of degree of severity]. AB - The clinical symptoms and signs, certain metabolic aspects (including ethanol, acetaldehyde and glucose concentrations in plasma) and hemodynamic parameters (cardiac rate, blood pressure and cardiac output) were assessed in 16 ambulatory alcoholics (3 female, 13 male, average age 46 years) following pretreatment with disulfiram (total dose 1.2 to 2.4 g) and oral administration of 0.2 g ethanol 94% per kg body weight. Since the only selection criterion for inclusion was a diagnosis of alcohol dependence (DSM III, 303.9), the group was heterogeneous and exhibited a variety of concomitant diseases such as alcoholic liver disease in 9, chronic bronchitis in 5 and arterial hypertension in 3. Whereas peak plasma alcohol concentrations were comparable (median: 0.33 mg/ml; range: 0.19 to 0.40) in all subjects, peak acetaldehyde levels varied over 40-fold (median 5.1 micrograms/ml; range: 0.2 to 8.8). In consequence, there were marked interindividual differences in cardiovascular reaction, in contrast to the virtually constant finding of flush, palpitations and dyspnoea. Since the decrease in peripheral vascular resistance (to a median of 46% of control) was only in part compensated by increased cardiac output (median: 161%), both systolic and diastolic blood pressures were reduced by 30 and 45 mm Hg respectively. In 4 patients systolic pressure fell to shock levels (less than 70 mm Hg). The presumed toxic effect of acetaldehyde is again supported by close correlations between acetaldehyde plasma concentrations and the changes in blood pressures and peripheral resistances. We were able to demonstrate that disulfiram induced inhibition of hepatic microsomal function - measured with the aminopyrine breath test - predicts the expected acetaldehyde peak levels following ethanol administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544210 TI - [Dentistry through changing times]. PMID- 3544211 TI - [Effectiveness of various concentrations of iodophors in artificially contaminated excised teats]. PMID- 3544212 TI - [Veterinary medicine faculty position in Berne. 2. Historical notes and biographic and bibliographic notes]. PMID- 3544213 TI - Diterpenes of marine brown algae of the family Dictyotaceae: their possible role as defense compounds and their use in chemotaxonomy. AB - Marine brown algae of the family Dictyotaceae are protected against predation. Their survival strategy is, at least in part, based on the production of chemical defenses. These compounds are diterpenes that seem to establish a specific predator-prey relationship, and which are found as food-chain markers. The use of Dictyotaceae diterpenes in chemotaxonomy is briefly discussed. PMID- 3544214 TI - Microbial pollution indicators in Brazilian tropical and subtropical marine surface waters. AB - The specificity of indicators that depend on elevated incubation temperature as a selective factor for their enumeration was questioned because of the possibility of interference from autochthonous microorganisms adapted to high ambient temperatures. Lactose-fermenting cultures isolated from fecal coliform tests of tropical marine surface waters were identified as consisting of about 70% Escherichia coli, and most of the remaining cultures being Klebsiella, Enterobacter or Citrobacter species. This confirmed the taxonomic specificity of fecal coliform tests for these waters. Fecal and total coliforms, fecal streptococcus, heterotrophic bacteria and yeast counts had correlations of above 99% confidence levels with most other microbial and chemical parameters studied. Waters with fecal coliform counts above 1000 per 100 ml had increased incidence of presumptive pathogenic yeasts, Pseudomonas aeruginosa and Salmonella. Our data support the use of coliforms or fecal streptococci as indicators of recent fecal pollution in tropical marine waters and yeast or heterotrophic bacteria counts as complementary indicator methods for these waters. PMID- 3544215 TI - Programmed gene rearrangements altering gene expression. AB - Programmed gene rearrangements are used in nature to to alter gene copy number (gene amplification and deletion), to create diversity by reassorting gene segments (as in the formation of mammalian immunoglobulin genes), or to control the expression of a set of genes that code for the same function (such as surface antigens). Two major mechanisms for expression control are DNA inversion and DNA transposition. In DNA inversion a DNA segment flips around and is rejoined by site-specific recombination, disconnecting or connecting a gene to sequences required for its expression. In DNA transposition a gene moves into an expression site where it displaces its predecessor by gene conversion. Gene rearrangements altering gene expression have mainly been found in some unicellular organisms. They allow a fraction of the organisms to preadapt to sudden changes in environment, that is, to alter properties such as surface antigens in the absence of an inducing stimulus. The antigenic variation that helps the causative agents of African trypanosomiasis, gonorrhea, and relapsing fever to elude host defense is controlled in this way. PMID- 3544216 TI - Wet-nursing boom in England explored. PMID- 3544217 TI - Splicing of messenger RNA precursors. AB - A general mechanism for the splicing of nuclear messenger RNA precursors in eukaryotic cells has been widely accepted. This mechanism, which generates lariat RNAs possessing a branch site, seems related to the RNA-catalyzed reactions of self-splicing introns. The splicing of nuclear messenger RNA precursors involves the formation of a multicomponent complex, the spliceosome. This splicing body contains at least three different small nuclear ribonucleoprotein particles (snRNPs), U2, U5, and U4 + U6. A complex containing precursor RNA and the U2 snRNP particle is a likely intermediate in the formation of the spliceosome. PMID- 3544218 TI - Leader peptidase of Escherichia coli: critical role of a small domain in membrane assembly. AB - Leader peptidase spans the Escherichia coli plasma membrane with its amino terminal domain facing the cytoplasm and its carboxyl terminus facing the periplasm. It is made without a cleavable leader sequence. The three apolar domains near the amino terminus of the peptidase are candidates for internal "signal sequences" and they anchor the protein to the lipid bilayer. Oligonucleotide-directed deletion was used to show that only the second domain has an essential function in membrane assembly. While this second apolar domain is crucial for membrane assembly, its continued function when disrupted by arginine suggests that its apolar character per se is not its only important feature. PMID- 3544219 TI - Conservation of brain amyloid proteins in aged mammals and humans with Alzheimer's disease. AB - The formation of clusters of altered axons and dendrites surrounding extracellular deposits of amyloid filaments (neuritic plaques) is a major feature of the human brain in both aging and Alzheimer's disease. A panel of antibodies against amyloid filaments and their constituent proteins from humans with Alzheimer's disease cross-reacted with neuritic plaque and cerebrovascular amyloid deposits in five other species of aged mammals, including monkey, orangutan, polar bear, and dog. Antibodies to a 28-amino acid peptide representing the partial protein sequence of the human amyloid filaments recognized the cortical and microvascular amyloid of all of the aged mammals examined. Plaque amyloid, plaque neurites, and neuronal cell bodies in the aged animals showed no reaction with antibodies to human paired helical filaments. Thus, with age, the amyloid proteins associated with progressive cortical degeneration in Alzheimer's disease are also deposited in the brains of other mammals. Aged primates can provide biochemically relevant models for principal features of Alzheimer's disease: cerebrovascular amyloidosis and neuritic plaque formation. PMID- 3544220 TI - Reversal of chloroquine resistance in Plasmodium falciparum by verapamil. AB - The parasite Plasmodium falciparum, like neoplastic cells, develops resistance to multiple structurally unrelated drugs. If the mechanisms by which P. falciparum and neoplastic cells become resistant are similar, then it may be possible to reverse the resistance in the two types of cells by the same pharmacological agents. Verapamil, a calcium channel blocker, completely reversed chloroquine resistance in two chloroquine-resistant P. falciparum clones from Southeast Asia and Brazil. Verapamil reversed chloroquine resistance at the same concentration (1 X 10(-6)M) as that at which it reversed resistance in multidrug-resistant cultured neoplastic cells. This same concentration of verapamil had no effect on chloroquine-sensitive parasites. Hence, chloroquine resistance in P. falciparum may fit the criteria for the multidrug-resistant phenotype. PMID- 3544222 TI - Splanchnic hemodynamics in chronic portal hypertension. PMID- 3544221 TI - Intrahepatic circulation in liver disease. AB - Using the multiple indicator dilution approach, events occurring in the microvascular bed can be characterized in experimental animals with different types of cirrhosis and in man. Intrahepatic shunts can be found shunting blood away from sinusoids in both cirrhotic patients and cirrhotic animals. Such shunts were present in about one-third of cirrhotic patients with portal hypertension, and occurred mainly between the portal vein and hepatic veins. In cirrhotics, portohepatic anastomoses are usually large in diameter (more than 20 micron in diameter). Collagenization of the space of Disse and the progressive transformation of sinusoids into capillary-like channels decrease the extravascular space accessible to albumin and probably to other large molecules and protein-bound substances. However, unlike findings obtained in well capillarized organs, these sinusoidal changes do not appear to limit the diffusion of sucrose, water, and lipophilic substances, such as lidocaine in the extravascular and intracellular spaces. The pattern observed for labeled sucrose curves following hepatic artery injection in cirrhotic patients could be secondary to the passage through the dense peribiliary capillary plexus originating from the enlarged arterial bed in cirrhosis. The difference in the perfusion of cirrhotic nodules with regard to the portal venous and hepatic artery routes introduces important new concepts in the overall mechanism of the elimination of endogenous and exogenous substances by the cirrhotic liver: blood entering the liver by the two afferent vessels will not flow through the same vascular bed before reaching the efferent hepatic veins. PMID- 3544223 TI - Pharmacokinetic-hemodynamic interactions in cirrhosis. PMID- 3544224 TI - Hemodynamic evaluation of the patient with portal hypertension. PMID- 3544225 TI - Hemodynamic factors involved in the development and rupture of esophageal varices: a pathophysiologic approach to treatment. PMID- 3544226 TI - Noncirrhotic intrahepatic portal hypertension. AB - Portal hypertension, widely recognized as a complication of cirrhosis, may also develop as an intrahepatic consequence of numerous hepatic disorders in the absence of cirrhosis. When gastrointestinal bleeding occurs in such cases, ruptured esophageal varices must be considered. Among chronic liver diseases, some, such as schistosomiasis, are commonly associated with portal hypertension and its complications. In others, including tuberculosis, amyloidosis, and polycystic disease, well-documented portal hypertension has been reported in only a small minority of cases. Nevertheless, because of the ever-present possibility of variceal hemorrhage whenever portal hypertension occurs, clinicians should be aware of these disorders. Acute conditions associated with noncirrhotic intrahepatic portal hypertension include acute (and particularly fulminant) viral or drug-induced hepatitis, acute alcoholic hepatitis, acute veno-occlusive disease, and acute fatty liver of pregnancy. Portal hypertension may be reversible following recovery in these settings. Particular attention is called to the increasing frequency of acute veno-occlusive disease on bone marrow transplant units, presumably as a complication of high-dose chemo- and radiotherapy. PMID- 3544227 TI - Pathogenesis of ascites formation and hepatorenal syndrome: humoral and hemodynamic factors. PMID- 3544228 TI - Management of patients with cirrhosis and ascites. PMID- 3544230 TI - Osteoporosis. PMID- 3544229 TI - Information at your fingertips: advice for the busy physician. PMID- 3544231 TI - Schizophreniform disorder: a diagnostic dilemma. AB - The DSM-III diagnostic criteria for schizophreniform disorder, mainly based on duration of symptoms, are insufficient to furnish a good treatment strategy. In recent literature, schizophreniform disorder has been grouped either with the schizophrenias or with the affective disorders. Scandinavian researchers have described two other groups of psychotic disorders that resemble schizophreniform disorder. These are the reactive psychosis and the cycloid psychosis. They were found to be different from the schizophrenias and the affective disorders. "Good prognosis" schizophrenia, which has been extensively studied and reported in the literature, is clinically very similar to schizophreniform disorder. The relatively consistent data collected in patients with good prognosis schizophrenia may provide the basis for the additional diagnostic criteria needed in DSM-III schizophreniform disorder. PMID- 3544232 TI - Hypogammaglobulinemia and pernicious anemia. AB - We have described two patients with pernicious anemia in whom incidental hypogammaglobulinemia was discovered. According to our review of 41 cases of this association reported in the literature, our patients are similar to those previously reported in their young age, the evidence for antral involvement with the atrophic gastritis, and the absence in one case of autoantibodies. They differ in their milder degree of hypogammaglobulinemia and in the previously unreported finding of improvement in gamma-globulin levels after vitamin B12 therapy. PMID- 3544233 TI - [Activities of scientific institutions evacuated to Western Siberia during World War II]. PMID- 3544234 TI - [F. V. Bervi--founder of the 1st department of surgery and x-ray consulting-room in the Donbass]. PMID- 3544235 TI - [Political, socio-economic factors and public health (review of foreign publications)]. PMID- 3544236 TI - [The history of the development of blood donorship]. PMID- 3544237 TI - [The doctoral dissertation of a great surgeon]. PMID- 3544239 TI - [Comparative evaluation of endoscopy, radionuclide and ultrasonic methods of examination in cancer of the pancreas]. PMID- 3544238 TI - [N.Kh. Ketcher--physician and active society member (on the centenary of his death)]. PMID- 3544240 TI - [Use of pharmorubicin in cancer of the breast]. PMID- 3544241 TI - [Treatment of the bronchospastic syndrome]. PMID- 3544242 TI - [Internal organ complications after tonsillectomy]. PMID- 3544243 TI - [Endralazine monotherapy in comparison with prazosin and hydralazine in arterial hypertension]. PMID- 3544244 TI - [Teonicol and trental in the treatment of duodenal ulcer]. PMID- 3544245 TI - [Characteristics of receptor systems in patients with diabetes mellitus]. PMID- 3544246 TI - [Cardio-computerized tomography]. PMID- 3544247 TI - [Problems with early transplantation in severe burns]. PMID- 3544248 TI - [History of the development of endoscopy]. PMID- 3544249 TI - Intra-uterine fetal surveillance. PMID- 3544251 TI - Unusual forms of malaria transmission. A report of 2 cases. AB - Malaria is uncommonly acquired without mosquito transmission. Two patients presenting with malaria illustrate this rare phenomenon. The first was a 1-month old child who had received an exchange blood transfusion for severe haemolytic anaemia due to ABO blood incompatibility. The second was a doctor who had taken blood from the first patient. The occurrence of both transfusion malaria and accidental malaria from the same blood transfusion must be very uncommon. PMID- 3544250 TI - Outcome of renal transplants with impaired renal function at 6 months. AB - At 6 months after kidney transplantation 59 adults with impaired renal function were divided into three groups according to their serum creatinine level: group I 150-199 mumol/l; group II 200-299 mumol/l; and group III greater than or equal to 300 mumol/l. These patients were followed up for 5 years or to graft loss when it became apparent that the eventual outcome was related to the degree of renal impairment at 6 months. Age of donor and age of recipient did not have a bearing on the eventual outcome nor did the frequency of acute tubular necrosis or rejection episodes. Patients with severely impaired renal function with serum creatinine levels greater than or equal to 300 mumol/l have a poor outlook but there are no particular prognostic features on which to base a forecast for the individual patient. PMID- 3544252 TI - Serum requirement for the multiplication of Treponema pallidum in a tissue culture system: association of growth-promoting activity with the protein fraction. AB - The nature of the serum requirement of Treponema pallidum subspecies pallidum (Nichols strain) was examined in a culture system utilizing Sf1Ep cottontail rabbit cells. In this system, significant multiplication of treponemes occurs in the presence of select lots of fetal bovine serum (FBS) or calf serum (CS) at concentrations of greater than or equal to 5% (vol/vol). Heat-inactivation of the serum greatly enhances treponemal multiplication, and normal human serum was found to be as effective as FBS in supporting the growth of T. pallidum. The protein fraction of FBS obtained by membrane ultrafiltration was capable of supporting the multiplication of T. pallidum when added to the basal tissue culture medium; an average increase of 23-fold was observed in these cultures, as compared with a mean increase of 25-fold in the 20% FBS controls. In contrast, the ultrafiltrate fraction of FBS (consisting of compounds with molecular weights of less than 10,000 daltons) did not support either growth or the retention of motility. Proteins precipitable with 25% (wt/vol) polyethylene glycol (i.e., albumin, transferrin, ceruloplasmin, and other proteins) also promoted the growth of T. pallidum. This observation provides further evidence that the required serum components are associated with the protein fraction. PMID- 3544254 TI - Staining intensities in the fluorescent treponemal antibody-absorption (FTA-Abs) test: association with the diagnosis of syphilis. AB - In 1984 the reporting system for the fluorescent treponemal antibody-absorption (FTA-Abs) test was changed by the Centers for Disease Control (CDC; Atlanta, GA) to eliminate the borderline report. Factors influencing the reliability of the FTA-Abs test results, i.e., sensitivity, specificity, prevalence of syphilis, prescreening of sera with nontreponemal tests, and reproducibility, were considered before the change in the reporting system was recommended and are reported here. The borderline report, when associated with syphilis, was most frequently also associated with the diagnosis of early primary, dark-field positive, nontreponemal test-nonreactive syphilis. Whereas elimination of the borderline report decreased the sensitivity of the FTA-Abs test as a confirmatory test from 100% to 99.5%, the specificity increased from 82.5% to 88.7%. The 1+ staining intensity had an association of approximately 5% with the diagnosis of syphilis. The changes in the reporting system were designed to assist the clinician in interpreting the results of the FTA-Abs test in those cases that present diagnostic dilemmas. PMID- 3544253 TI - IgG and IgM antibody reactivity to antigens of Treponema pallidum after treatment of syphilis. AB - The persistence or loss of IgG and IgM antibody specificities for individual polypeptides of Treponema pallidum after therapy for syphilis was examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and by the Western blot technique. Both IgG and IgM antibodies to as many as 12 treponemal antigens, including a major 47-kdalton molecule, were evident in plasma from patients with untreated primary syphilis. IgM reactivity declined rapidly and uniformly after therapy, whereas IgG persisted despite some diminution in intensity of staining. Faint-to-moderate IgM and strong IgG antibody reactivities to at least 22 treponemal antigens (12-85 kdaltons) were identified in plasma from patients with untreated secondary and early latent syphilis. Again, IgG antibody declined slightly in staining intensity after treatment but continued to show reactivity against all molecules detected initially. IgM antibody reactivity declined more rapidly and was lost entirely against some determinants, including the 14- and 12-kdalton molecules. Immunofluorescence titers of IgG and IgM antibodies to T. pallidum in sera from these patients generally correlated with results of Western blot analysis. Antibody to the 12-, 14-, and 47-kdalton molecules of T. pallidum may have potential diagnostic applications. PMID- 3544255 TI - Four serologic tests for syphilis: results with comparison of selected groups of sera. AB - The specificity of the fluorescent treponemal antibody-absorbed (FTA-Abs) test was assessed for 17 sera from syphilitic patients that were nonreactive in the Treponema pallidum immobilization (TPI) test but reactive in the FTA-Abs test. Thirty-three other sera from syphilitic patients and 19 sera from nonsyphilitic individuals were also examined by fluorescent treponemal and microhemagglutination Treponema pallidum (MHA-TP) tests and by the enzyme-linked immunosorbent assay (ELISA). Specific absorptions of sera with calf thymus DNA or Treponema pallidum biotype Reiter (Reiter treponemes) were performed. In quantitative immunofluorescence assays (IFA) with antihuman IgG and IgM conjugates, results were similar to those for reactive sera from a control group. Results of both the MHA-TP and ELISA tests supported the specificity of the FTA Abs test; reactivity in the latter was not removed by specific absorption either with calf thymus DNA or with Reiter treponemes. This evaluation suggests a format for serodiagnosis in cases in which test results are discrepant. PMID- 3544256 TI - Evaluation of sera from patients with Lyme disease in the fluorescent treponemal antibody-absorption test for syphilis. AB - To determine whether the cross-reactivity between Treponema pallidum and Borrelia burgdorferi affects the specificity of the fluorescent treponemal antibody absorption (FTA-Abs) test for syphilis, sera from patients with Lyme disease or syphilis were examined in a quantitative FTA-Abs test. Sera were diluted serially in phosphate-buffered saline, then in sorbent, and were tested with T. pallidum and B. burgdorferi antigens. Nine of 40 sera from patients with known Lyme disease were reactive at the 1:5 dilution with antigen from T. pallidum; only one serum was reactive at the 1:10 dilution. When both antigens were tested, the titer against B. burgdorferi was always higher than that against T. pallidum. Similarly, sera from patients with syphilis showed cross-reactivity with B. burgdorferi. Although reactivity could be absorbed with Treponemal phagedenis (Reiter strain), simultaneous titration with both antigens was easily performed and designated the etiologic agent. PMID- 3544257 TI - Immunochemical characterization and purification of Treponema pallidum antigen TpD expressed by Escherichia coli K12. AB - The immunochemical properties of the Treponema pallidum antigen TpD, as expressed by Escherichia coli K12, was investigated by crossed immunoelectrophoresis in which an affinity-purified antibody to this antigen was used. Two immunologically cross-reacting components of TpD with different mobility were demonstrated. Affinity-purified antibodies were used in obtaining purified TpD and in determining the cellular localization of TpD in T. pallidum by immunoelectron microscopy. TpD was localized on the surface of methanol-fixed T. pallidum. Twenty sera from patients with secondary syphilis and 20 sera from nonsyphilitics were examined in crossed immunoelectrophoresis. All sera from patients with secondary syphilis and none from nonsyphilitics contained antibodies to the TpD components. Because TpD seems to be surface associated and a major immunogen during infection with T. pallidum, this antigen might be useful for development of a vaccine against syphilis and for development of improved methods for serodiagnosis of syphilis. PMID- 3544258 TI - Kinetics of antibody response to polypeptides of pathogenic and nonpathogenic treponemes in experimental syphilis. AB - Antigenic cross-reactivity between Treponema pallidum subspecies pallidum (TP) and nonpathogenic Treponema phagedenis biotype Reiter (TR), Treponema refringens strain Noguchi (TN), and Treponema vincentii (TV) was examined by the Western immunoblotting technique in pooled sera from five rabbits infected intratesticularly with T. pallidum. Sera were obtained before infection and on days 6, 12, 20, 30, 60, and 120 after infection. The pooled preinfection sera reacted with nine polypeptides of TV, nine of TS, and five of TR. The pooled sera did not show any clear-cut reactions with TP, but some individual rabbit sera did demonstrate visible reaction with three to five polypeptides of TP. Twelve days after infection, multiple serum antibodies reacting with polypeptides of all treponemes were detected. The number of antibodies reacting with polypeptides and the intensity of reaction increased with the duration of infection; for the nonpathogenic treponemes (TV, TS, TR) 21-26 polypeptides were identified on day 30, and by day 60 a total of 21 were detected for TP. By day 120 the reaction had become less pronounced, and fewer reactive polypeptides were seen. The extent of the cross-reactivity with the three nonpathogenic treponemes reflects the complex structure of T. pallidum, which should be viewed as a mosaic of more cross reacting than strain- or species-specific antigens. PMID- 3544259 TI - [Clinical and laboratory diagnosis of lupus nephropathy in childhood]. PMID- 3544260 TI - [Kidney removal at the Turin Transplant Center]. PMID- 3544261 TI - Fire prevention in the United States. Are the home fires still burning? AB - Injury and death from burns have reached epidemic levels in the United States during the past quarter-century. Yet preventive action on both local and national administrative levels has been dismally inadequate and underfunded. Identifying and recognizing both the etiologies of burn injuries and the statistical magnitude of the problem will, it is hoped, stimulate dedication of more resources and personnel to reducing the hazards of fire and the resulting loss of life, productivity, and property in the next two decades. Public education and national awareness are first steps to creation of a consumer and popular demand worthy of national action. PMID- 3544262 TI - Nutritional considerations for the burned patient. AB - The metabolic response to injury is one of marked catabolic hormonal predominance resulting in hypermetabolism and protein wasting. Energy expenditure increases with increasing severity of injury, but reaches a maximum of twice resting energy expenditure when 50 per cent TBSA is burned. We agree with the nutritional recommendations of the group at the Boston Shriner's Burn Institute and the Massachusetts General Hospital. These include providing calories at twice the resting energy expenditure, as predicted by the Harris-Benedict equations, for patients with greater than 30 per cent BSAB; protein is provided at 2.5 gm per kg per day based on ideal body weight. It is important to recognize that these are optimal goals, but their attainment must be governed by safety considerations for the patient. It is probably safe to supplement intake with a multivitamin and vitamin C, as well as zinc, but our understanding of micronutrient therapy for stressed patients is rudimentary. PMID- 3544263 TI - Topical therapy for burns. AB - Topical antimicrobial agents can prevent or minimize burn infections and should be used from the outset in all patients who are at significant risk from sepsis- either because of their wound severity or associated comorbid factors. All of the currently available topical agents have shortcomings; some of them have appreciable toxicity. The recent shift in emphasis toward early surgical closure of extensive deep burns in great part has resulted from appreciation of the inadequacies of currently available topical agents. Topical agents cannot substitute for timely and comprehensive physiologic support of burned patients. PMID- 3544264 TI - Outpatient care of thermal injuries. AB - Minor burns that comprise the vast majority of burns requiring treatment are best managed by a simple, rational protocol. These injuries are not associated with the devastating complications seen following major thermal injury. Local infection or delayed healing often may occur as a result of overtreatment. In addition, moderate and major burns can be managed successfully on an outpatient basis following initial evaluation and stabilization. PMID- 3544265 TI - Fluid replacement in burned patients. AB - The selection of the fluid replacement for the burned patients is based on a sound understanding of the pathophysiology of the burn injury as well as a similar understanding of the properties of the various fluids available. The appropriate matching of these properties with the specific goals and necessary monitoring techniques for each patient will result in success. Those caring for the burned patient must remain both flexible and knowledgeable in order to optimize results. PMID- 3544266 TI - Pulmonary injury in burned patients. AB - Inhalation injury has emerged as the number one cause of fatality in the burn patient. Fiberoptic bronchoscopy and 133Xe scanning complement traditional clinical signs of inhalation injury and have led to discovery of a higher incidence of these injuries among patients with burns. Patients with inhalation injury typically demonstrate three stages: acute pulmonary insufficiency, pulmonary edema, and bronchopneumonia, all of which carry at least 50 per cent mortality rates. The major early pathophysiologic changes in the lungs of burned patients are related to upper-airway obstruction and lower-airway permeability edema. Treatment consists of intubation for signs of respiratory distress, pulmonary toilet, humidification of inspired air, and antibiotics for documented infection. PMID- 3544267 TI - Alterations of the host defense mechanism in burned patients. AB - The host defense mechanism against microbial infection is seriously suppressed following a major thermal injury. In this article the specific and nonspecific systems are dissected, demonstrating known sites of alteration, and laying out a rational groundwork for future intervention. PMID- 3544268 TI - Immunomodulation following burn injury. AB - Severe burn injury is accompanied by suppression of almost all the components of immunity; such suppression undoubedly contributes to infectious complications in the burned patient. There has now been substantial experimental progress made in devising approaches to prevent or minimize these immune defects; however, clinical application is still limited. PMID- 3544269 TI - Early burn excision and grafting. AB - The current state of knowledge and experience with early burn wound closure leads to some conclusions that are proved and others that are suggested. The issues that are proved include the following: Small (less than 20 per cent TBSA) full thickness burns and indeterminate (deep partial-thickness versus full-thickness) burns, if treated by an experienced surgeon, can be excised safely and grafted with a decrease in hospital stay, cost to the patient, and time away from work or school. Early excision and grafting dramatically decreases the number of painful ward debridements required by all patients. Patients with burns between 20 and 40 per cent TBSA appear to have fewer infectious wound complications and a shortened hospital stay if treated with early excision and grafting. In addition to the above conclusions, about which there is little disagreement, there are other suggestive data and clinical impressions that do not yet have "hard data" to support them. These issues include the following: Scarring is less in wounds closed early, leading to better appearance and the need for fewer reconstructive procedures. There presently is not a good measure of "cosmetic appearance," and comparative studies await an acceptable scale to measure results. Mortality from wound infection is less in patients with major burns. Because wounds exceeding the donor sites cannot be closed permanently and completely until donor sites can be reharvested, proof will come only when a durable permanent cover can be applied in a timely fashion. Data now suggest that mortality has decreased, but none of the studies has been conclusive. Mortality from other complications of major burns may decrease with early excision and grafting. Decreasing stress, hypermetabolism, and decreasing the overall bacterial load of such patients enables them to resist other complications better. The only present data supporting this conclusion, however, come from animal studies. The current state of the art suggests that small, deep burns can be excised and grafted by general or plastic surgeons in community hospitals as long as they are interested in the procedure and the hospital has the proper support facilities. Burns of cosmetically or functionally important areas (face, hands, feet, and joints) should be excised by someone with a special interest in burns, and burns in excess of 10 per cent TBSA should be excised only in facilities with excellent support facilities, including an experienced anesthesiologist, trained nursing personnel, good critical-care facilities, and a safe blood bank. PMID- 3544270 TI - [Kidney transplantation in children]. PMID- 3544271 TI - [Care of transplanted patients. Bladder and ureteral lavages]. PMID- 3544272 TI - [Attempt at understanding the psychology of transplanted children and adolescents]. PMID- 3544273 TI - [Care of transplanted patients. Case report]. PMID- 3544274 TI - Transcutaneous oxygen tension measurements in the detection of iliac and femoral arterial disease. AB - The sensitivity and specificity of the noninvasive measurement of transcutaneous oxygen tension (PtcO2) in detecting the site of vascular disease in either the iliac or superficial femoral arteries is reported herein. Patients presenting with intermittent claudication or ischemic pain at rest were studied to determine the presence or absence of iliac or femoral occlusive disease by assessing the level of PtcO2 measurements at sites above and below the knee. PtcO2 studies were assessed against changes in the arteriogram, the "gold standard" for judging peripheral arterial insufficiency. Using our criteria, PtcO2 measurements above the knee show a sensitivity rate of 86 per cent and a specificity rate of 20 per cent to detect iliac disease. PtcO2 measurements below the knee show a sensitivity rate of 91 per cent and a specificity rate of 33 per cent to detect femoral disease. The accuracy was 69 per cent and 76 per cent, respectively. The user of the test is mainly concerned with the "predictive values" which are functions of the sensitivity, specificity and prevalence of the disease. Transcutaneous oxygen measurements above and below the knee show a very good sensitivity for detecting iliac and femoral disease, indicating that they may well serve as a quick and convenient noninvasive diagnostic procedure. PMID- 3544275 TI - Deep venous thrombosis after renal transplantation. AB - Four hundred and eighty consecutive renal transplant operations performed upon adults over a ten year period were reviewed to obtain the incidence of deep venous thrombosis (DVT) or pulmonary embolism (PE), or both. Using strict objective diagnostic criteria, 40 (8.3 per cent) thrombotic events were diagnosed, comprising 25 lower limb DVT alone, 11 DVT with PE and four PE alone. Four deaths were directly attributable to PE which was the fourth major cause of death in the review period. DVT was more common on the side of the transplant but the difference was not significant. The low incidence of thrombotic events (1.7 per cent) in the first month of transplantation does not suggest that chemical prophylaxis should be used during this period. However, the peak incidence occurred in the fourth month after transplantation which may be associated with a significant rise in mean hemoglobin concentration in both the thrombotic population and a control group of transplant recipients. Patient age at the time of transplantation and predisposing events, such as prolonged bedrest, further surgical treatment and pelvic pathology, were significant risk factors. All of the patients in the thrombotic population were receiving steroids at the time of diagnosis and no thrombotic events were demonstrated in patients receiving cyclosporin alone. The results of this review suggest that chemical prophylaxis is indicated for patients more than 40 years of age, with stable renal function and receiving steroids, who undergo periods of prolonged bedrest or further surgical treatment at some time after renal transplantation. PMID- 3544276 TI - Abraham Groves. PMID- 3544277 TI - Prevention and treatment of ischemia of the liver. AB - Various modalities have been proposed to protect the liver from injury during the ischemic period or after reperfusion. Most of the drugs were administered before the onset of ischemia, but a beneficial effect of post-treatment was reported for MP, dopamine and ATP-MgCl2. Previous studies were mainly performed upon experimental animals, but hypothermia and steroids were used to protect the liver from ischemic injury in patients as well. However, no controlled clinical trials exist demonstrating the efficacy of any type of prevention or treatment in ischemia of the human liver. PMID- 3544278 TI - Lupus diseases associated with hereditary and acquired deficiencies of complement. PMID- 3544279 TI - Complement activation and complement receptors in systemic lupus erythematosus. PMID- 3544280 TI - Mechanisms of immune deposit formation in renal glomeruli. PMID- 3544282 TI - Treatment of systemic lupus erythematosus. PMID- 3544284 TI - The influence of sex hormones on the disease systemic lupus erythematosus. PMID- 3544283 TI - Passively acquired autoimmunity and the maternal fetal dyad in systemic lupus erythematosus. AB - Neonatal lupus syndromes consist of transient cutaneous and hematologic abnormalities and permanent cardiac disorders all of which result from a common pathogenetic mechanism, the passive transfer of maternal autoantibodies. Detrimental antibodies such as SSA/Ro and SSB/La gain access to the fetal circulation via the normal active transport system of the trophoblast tissue which is operative after 20 weeks gestation. Despite functional maturation of the cardiac conduction system by 16 weeks gestation, fetal bradycardias are most often encountered after this time. Several lines of evidence are advanced in this review to support the role of myocarditis as the initial consequence of autoantibody attack on the fetal heart. The end result of this inflammatory insult is permanent fibrosis manifest as complete congenital heart block (CCHB). Despite the clearly demonstrated presence of SSA/Ro and SSB/La in fetal tissues as well as their fluctuation in quantity during the cell cycle, the precise accessibility of these antigens to their respective autoantibodies in unknown at the present time. However, ultraviolet light is reported to induce cell surface expression of SSA/Ro on cultured keratinocytes. The recognition of CCHB by fetal echocardiogram is presented. The rationale for the use of dexamethasone which crosses the placenta in an active form to treat fetal immune effector functions is discussed. Intense maternal plasmapheresis in an attempt to rapidly decrease maternal autoantibodies may provide another approach to the management of CCHB. Through increasing knowledge of this model of "passively acquired pure" systemic lupus erythematosus, insights into mechanisms of tissue injury and strategies for treatment will emerge. PMID- 3544285 TI - Management of a large skull defect utilizing a vascularized free omental transfer. AB - A patient who underwent prior cranial surgery and radiation therapy and had the loss of his bone and skin flaps is presented. Basal cell carcinoma of a skin graft, placed on the dura mater and osteomyelitis of the surrounding cranium subsequently occurred. This problem of infection, neoplasia, cerebral protection, coverage, and cosmesis was managed successfully with a complex repair. The repair utilized autogenous fascia lata for the replacement of dura mater, rib and iliac crest bone for an autogenous cranioplasty, a free vascularized omental transfer for soft tissue bulk overlying the cranioplasty, and an autogenous split thickness skin graft over the omentum for coverage. Subsequent partial resorption of the autogenous cranioplasty necessitated the placement of a methyl methacrylate cranioplasty. PMID- 3544286 TI - Randomized controlled study of the effect of adjuvant immunotherapy with Picibanil on 51 malignant gliomas. AB - During the period from January 1981 to December 1983, two groups of a total of 51 patients (31 malignant astrocytomas, 17 glioblastomas, and 3 others) were treated with radioimmunochemotherapy using nimustine hydrochloride (ACNU) plus Picibanil (OK-432) (group A) and radiochemotherapy with ACNU only (group B) in a randomized controlled study. Group A consisted of 24 patients and group B of 27 patients. The differences in the background of the two groups were not statistically significant. Survival curves of both groups were shown by the Kaplan-Meier method. The postoperative survival rate at 1 year and 3 years was 70% and 30%, respectively, equal in both groups, and the differences between groups A and B were not statistically significant by the Cox-Mantel test. The side effects seen in group B were most prominent in the bone marrow, and severe leukopenia occurred. However, in group A leukopenia was suppressed after 2 months. Immunologic parameters, such as the purified protein derivative skin reaction test, did not change, but the streptococcus pyogenes Su-strain polysaccharide skin-reaction test became more positive after therapy in group A. PMID- 3544287 TI - [Principles of fractionated total body irradiation before bone marrow transplantation]. AB - The hyperfractioned total body irradiation has advantages in tumor control rate, patient tolerance and survival. The technical application is simple and easy to integrate in the daily routine of a radiotherapy department. The reduced time in the life island and the low incidence of acute reactions increases the patients quality of life. It turned out, that single dose TBI is not very suitable. This was already stated by Lester Peters in 1980. PMID- 3544281 TI - Systemic lupus erythematosus clinical issues. PMID- 3544288 TI - Therapeutic efficiency of olaquindox in gamma-irradiated mice. AB - The antibacterial agent olaquindox (2-[N-(2-Hydroxy-ethyl)carbamoyl]-3-methyl quinoxalin-1,4-dioxide) given in tap water at daily doses of 0.2 to 0.5 mg exerts beneficial effects on the body weight decrease and survival of gamma-irradiated mice. Beneficial effects are achieved especially by the postradiation administration of olaquindox. It is presumed that the mechanisms of the therapeutic effects of olaquindox are connected with its action on the composition of intestinal flora of mice. PMID- 3544289 TI - [Comparative study on myocardial damage in irradiated for a long time and nonirradiated rats after administration of FCOL]. AB - The trials were made to assess the effect of FCOL (9-alpha-fluorocortisol + Na2HPO4) and the effect of K and Mg asparaginates and their mixtures on the modifications of Ca2+, Na+, and K+ ions and of the K/Na ratio in the myocardium of rats not irradiated or submitted to permanent whole-body irradiation (gamma irradiation with 0.57 Gy per day during 25 days, total accumulated dose 14.25 Gy; the trials were performed 25 days after the irradiation). The totality of reversible and irreversible functional modifications of the myocardium, expressed by the quantitative assessment of the K/Na ratio and the concentration of Ca2+ ions, was evaluated in order to determine the cardiotoxicity or cardioprotection. It was demonstrated that irradiation alone causes a slight irreversible modification in the myocardium which is not found in non-irradiated rats. FCOL itself increases the rate of Ca2+ and Na+ ions in irradiated and non-irradiated rats, but does not influence the quantity of K+ ions. Severe irreversible myocardial damages are caused by FCOL, but these damages are considerably lower in irradiated rats. Neither in irradiated nor in non-irradiated rats, the isomers of Mg asparaginate show any protective action against the cardiotoxic effect of FCOL. The isomers of K asparaginate, also combined with Mg asparaginates, as well as the preparation Inzolen exert a demonstrable protective effect against myocardial ion modifications following to application of FCOL. The protection is more efficient in irradiated rats. PMID- 3544290 TI - [Radiation treatment of plastic induration of the penis]. AB - Between 1969 and 1984, a group of 54 patients with plastic induration of the penis was treated at the Medical Radiation Institute of the University of Tubingen. During the first years conventional X-ray irradiation was applied, and since 1974 patients were submitted to 3 or 5 MeV electron irradiation of a linear accelerator, until a total focal dose of 20 Gy was accumulated. 78% of these patients were between 50 and 60 years old. Sixteen patients suffered from a simultaneous Dupuytren contracture, one patient had a fibrosis of mamma virilis. The treatment results reached from satisfactory until very good in 69% of all cases. Complete regression or a considerable improvement was obtained for indurations in 59%, for deviations in 69%, and for erection algesia in 79%. Radiogenic damages can be excluded in case of a gonad exposition of 0.2 Gy. There were no permanent cutaneous lesions after a total focal dose of 20 Gy. The prognostic importance of an early treatment is underlined; late stages presenting ossifications can be treated only by surgery. For routine diagnosis of site, extent, and possible mineralization of the regions involved, soft ray phallography performed with the technique of mammography can be used. PMID- 3544291 TI - [Development of new positioning and adjustment aids for fractionated whole body irradiation using compensators]. AB - A new system of positioning and adjustment facilities is presented for fractionated total-body irradiation with the use of compensators, consisting of a positioning plate provided with devices for translation and rotation, a lifting device installed in the irradiation room, a transport vehicle, an individually adapted foam bed for the patient, and a fine-adjustment holding device for the compensator. The method as well as the material used are described in detail. The system does not only allow an exact reproduction of patient's position and compensator adjustment, but also reduces the time of preparation. PMID- 3544292 TI - Muscular infiltration of the limbs in Hodgkin's disease. Report of three cases. AB - Three cases of muscular infiltration by Hodgkin's disease appearing on the limbs are reported. Diagnosis was based on various imaging methods (angiography, computed tomography and ultrasonography) followed by histologic verification in two cases. The pathomechanism of muscular manifestation remains unclear, haematogenous dissemination as well as progression from lymph nodes via lymphatics may be considered. Clinical symptoms were misleading in two cases. Radiotherapy was found effective in management of muscular infiltration. PMID- 3544293 TI - Cyclosporine: immunology, pharmacology and therapeutic uses. AB - Human and animal investigations since the mid-1970s have demonstrated the effectiveness of cyclosporine (CsA) as an immunosuppressive agent. In the area of transplantation immunity, it has been shown to enhance success of renal, bone marrow, and liver transplantation. Moreover, certain models of autoimmune disease have been effectively treated with CsA, and a number of studies have reported encouraging results with CsA therapy for ocular inflammatory disorders, notably Behcet's disease. The most serious side effects of CsA are nephrotoxicity and hypertension; thus, conservative dosages of the drug and careful monitoring of renal function during treatment are recommended. The purpose of this review is to provide clinicians and researchers with a clear perspective of both the potential benefits and shortcomings of this agent. PMID- 3544294 TI - The detection and grading of cataract: an epidemiologic perspective. AB - A major limitation in epidemiologic research on the etiology of cataracts is the lack of a standardized method for detecting and grading in vivo cataracts. This article reviews both clinical and photographic methods for determining the presence and severity of cataracts. Clinical methods, involving uniform training of examining ophthalmologists and standard protocols, do not insure reproducibility in detecting or grading cataracts. Photographic methods appear to be more reliable, but more research is needed to develop methods for accurate interpretation. PMID- 3544295 TI - The origin of spectacles. AB - Every so often we receive letters to the editor commenting on a previously published paper. The following commentary is just such a letter. Its content and review are so thorough, we feel compelled to share the letter with our readers as it complements the original article on the history of glasses ("Spectacles: Past, Present and Future," March-April 1986). Modesty keeps me from further elaboration on my original article. Suffice it to say, Dr. Letocha's letter elaborates upon the issues of the date and inventory of spectacles. It stands solidly as an example of erudition in historical research. PMID- 3544296 TI - Increased protein catabolism without hypermetabolism after human orthotopic liver transplantation. AB - To evaluate the surgical stress of transplantation, resting energy expenditure (REE) and 24-hour urinary urea nitrogen (UUN) were measured in 11 patients with end-stage liver disease (ELD) before and after liver transplantation. Predicted mean basal energy expenditure as determined by the Harris-Benedict equation was 860 +/- 110 kcal/m2/day. Pretransplant mean REE was 930 +/- 130 kcal/m2/day versus 920 +/- 190 kcal/m2/day in the posttransplant period (p = NS). Pretransplant mean UUN was 7.7 +/- 3.5 gm/day versus 12.9 +/- 4.4 gm/day in the posttransplant period (p less than 0.05). It is concluded that the patients in the early period after liver transplantation are hypercatabolic (increased tissue breakdown) but not hypermetabolic (increased REE) when compared with their stable state before transplantation. PMID- 3544297 TI - The risk of deep venous thrombosis: a computerized epidemiologic approach. AB - The appropriate use of prophylactic measures to prevent deep venous thrombosis is dependent on the ability of physicians to identify high-risk patients. This problem has been the subject of numerous epidemiologic reports compiled during the last several decades. Described herein is a computerized technique to condense the literature on this subject into a form better suited for practical application. This technique comprises an interactive program that calculates a patient's relative risk of developing a thrombus on the basis of a comparative evaluation of his medical profile. The computer then reports the patient's calculated relative risk along with other information that may pertain to his risk of deep venous thrombosis. PMID- 3544298 TI - On auxiliary transplantation in acute liver failure. PMID- 3544299 TI - Stability and plasticity during chloroplast development. AB - Chloroplast development occurs during cellular development. In non-limiting conditions chloroplast development is a highly conserved process, it is also complex and involves the continuous interaction of both chloroplast and nuclear genomes. In the first part of the paper the sequential and structural changes characteristic of chloroplast division and development in angiosperms are described. The synthesis of the major chloroplast components including chlorophylls a and b, lipids, nucleic acids and the major soluble and membrane proteins are then described. Chloroplast development in biochemical terms is a quantitative accretion of additional functional units. In development from proplastid to fully mature chloroplast the molecular changes are almost exclusively quantitative and the youngest plastids that can be analysed are already photochemically fully competent. In the second part of the paper the dominant role of the nuclear genome in chloroplast development is discussed. Recent work in the author's laboratory on the synthesis and accumulation of ribulose bisphosphate carboxylase-oxygenase in the developing chloroplasts of young wheat leaves is cited to illustrate the stable genomic and genotypic differences that can be recognized. In comparisons of wheat species of differing ploidy, in hexaploid cultivars and in artificially processed genetic lines, several genomic and genotypic effects have been detected. The possibilities for future investigation are discussed. PMID- 3544300 TI - Stability of the determined state. AB - During development parts of plants become determined for specific fates which can persist in populations of dividing cells. Students of plant development have tended to favour the view that the determined state is stabilized at the supracellular level. We provide evidence for the alternative view that determination can be inherited at the cellular level. This conclusion is based on the observation that cultured cells derived from the leaf lamina and cortex of the stem of tobacco plants inherit different states of cytokinin requirement. Plant regeneration experiments show that the cytokinin-requiring (C-) state characteristic of leaf cells and the cytokinin autotrophic (C+) state characteristic of cortex cells are stable but not permanent. Progeny of both cell types can give rise to complete plants with tissues exhibiting the cytokinin requirement of comparable tissues of seed grown plants. Pith cells can shift from the C- to the C+ state by a process known as habituation. Evidence is presented that this epigenetic change is stabilized by a positive-feedback mechanism in which cytokinins appear to promote their own biosynthesis. A single dominant, Mendelian gene, H1-2, controls expression of the C- and C+ phenotypes. There are hints that this gene changes state in cultured cells at rates expected for epigenetic modifications. This suggests that the C- and C+ state can also be stabilized by genetic mechanisms. PMID- 3544301 TI - Plasticity in morphogenetic expression in plant. AB - This article discusses the plasticity of morphogenetic programmes in plants. It outlines the numerous ways in which the flowering programme can be accelerated or modified into partial flower formation and describes the differentiation of naked ovules on anthers in intact plants. The generation of embryos and flowers from cultured cells is then described and some of the properties of hypohaploids outlined. It is concluded that in vitro culture provides a useful facility for manipulating plant development and that the interaction between the nucleus and the cytoplasm may exemplify and explain the process of developmental plasticity. PMID- 3544302 TI - Cellular interactions in tissue and organ development. AB - Developmental patterns result from combinations of interactions and intracellular programmes. The purpose here is to define the roles of interactions wherever possible and to consider their major parameters, such as the timing of their action, their specificity and the distances over which they occur. The approach is one of a board survey, attempting to outline major interaction systems on the basis of information from different sources. The evidence concerning interactions that control development must come primarily from development itself. Both disturbed, as during regeneration and grafts, and normal development are relevant. Growing apices interact over relatively long distances. They reduce the development of similar apices and induce the development of axial tissues that connect them to the plant. Young shoot tissues also induce the development of root apices and vice versa. These various effects can be understood on the basis of a hormonal feedback involving auxins and cytokinins. Vascular differentiation, furthermore, is a cellular expression of these interactions. It occurs along the flow of auxin from the young tissues of the shoot towards the root apices. This flow is canalized by a positive feedback between cell polarization and the polar flow that both controls and results from this polarization. Structural relations between pholem and xylem, limitations of regeneration and the formation of rays all indicate the existence of additional, radial interactions. The fate of individual cells in development is varied and often follows no recognizable rules. This indicates interactions that operate on the size of a tissue or organ rather than on its precise cellular development. On the other hand, the continuity of plasmodesmata, wall thickenings and cytoplasmic strands demonstrate local interactions between neighbouring cells. It is concluded that, though the possibilities of developmental interactions may be bewildering, the list, when known, may not be all that long. The interactions specify orientation and quantity rather than the precise fate of cells. Their effects are gradual and they involve feedback loops. Growth factors, even known growth factors, play surprisingly large roles in cellular interactions. Such controls whose effect is gradual and general could provide a basis for developmental plasticity. PMID- 3544303 TI - Plasticity in shoot development: a biophysical view. AB - The construction and spacing of leaves can be analysed in terms of the direction of reinforcement in the walls of the organ surface. In general, growth is at right angles to the reinforcement. When, however, tissues are actively stretched by adjacent organs they apparently take on, by cell activity, reinforcement which lies in the direction of stretch. Thus reinforcement can dictate extension direction; extension direction, when imposed on a tissue, may dictate reinforcement direction. This proposed two-way relationship has been used to model the activity of shoot meristems. It produces biophysically plausible schemes for the progressive development of various leaf structures and for the cyclical revision of apical structure seen in various types of phyllotaxis. PMID- 3544304 TI - Control of shoot apical development via cell division. AB - Cell division in plants not only partitions the protoplast but also provides the architectural framework for plant form. The shape of the shoot apical meristem is produced and maintained by gradients in the rate and plane of cell division, from the summit to the base of the apical dome, which also determine the region in which primordia can be formed. In Pisum leaf initiation is mainly the result of changes in the frequency of periclinal divisions at the leaf site whereas in Silene an increase in the rate of cell division seems more important since periclinal divisions are always present. Periclinal divisions may be permissive of primordium initiation rather than causal and may define the maximum area over which primordia can form. The occurrence in Pisum and Silene of periclinal divisions which do not seem to be related to concurrent outward growth suggests that the plane of division and the direction of growth may be controlled separately and in different ways. The control of outward growth during primordium initiation may lie in the epidermis, which necessarily grows faster at the leaf site. The initial orientation of epidermal growth at the primordial site, inferred as being normal to the plane of cell division, is predominantly longitudinal in Pisum but transverse in Silene. Longitudinal growth becomes dominant later in leaf development in Silene, as in Pisum. Several lines of evidence suggest a crucial role for the epidermis in the initial stages of primordium formation although the initial orientation of division planes in it may be concerned more with the shape of the young leaf than with initiation itself. In flower initiation primordial size becomes reduced, and in Silene there are alternations of higher and lower rates of cell division in successively initiated primordial types. A fuller understanding of the role of cell division in apical growth depends on better knowledge of the functional relationships between the plane of cell division, the orientation of microtubules and wall microfibrils, and the effect that division in one cell has on its neighbours. PMID- 3544305 TI - The flowering process as an example of plastic development. AB - The field of flowering has been characterized by simplistic ideas, as exemplified by the attempts to classify plants on the basis of the kinds of environmental factors required for their transition to flower initiation and the claims that the process of flower formation in photoperiodic and cold-requiring plants is independent of correlative influences from various organs, e.g. the roots. Other examples of this simplified picture are the concept of a specific leaf-generated floral hormone and floral inhibitor and the search at the level of the meristem of a specific evocational event which would set in motion the whole sequence of other events and commit the meristem to flower initiation. Finally, there is the belief that because flower morphology is basis to species classification the morphogenesis of flowers is a rather invariable process. All these ideas are essentially erroneous and it is shown that all aspects of the flowering process are much more flexible than is usually believed. Floral induction may be completed by many, if not all, plants in several alternative sets of environmental factors. At least in some plants, the alternative inductive factors are perceived by different organs, indicating that these factors affect most probably entirely different processes. Thus, at induction, plasticity is extremely large and the fate of any shoot meristem appears to be controlled by a complex and flexible array of promoters and inhibitors arising from all plant parts. At meristem evocation, there are a number of events which are fundamentally the same in many plants, but so far no single initial critical event has been found. The various evocational changes appear to form sets of interconnected systems and this complex network seems to embody some plasticity since it has been possible to suppress experimentally some of the most universal evocational events or alter their temporal order without impairing evocation itself. At later stages, it has been observed that all the morphological characters of inflorescences and flowers may be experimentally altered. However, if the occasional and extreme malformations (monstrosities) caused by some growth substances are excluded, morphogenetic processes do not appear flexible to the point that the reproductive structures of one species are transformed into those of a taxonomically unrelated species. Thus, despite the fact that these processes are never absolutely fixed, plasticity at morphogenesis appears less than that at induction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3544306 TI - Plastic responses of leaves. AB - In their development leaves exhibit plastic responses in both shape and size. Variations in shape are often associated with changes in size also but the reverse is not always true. Plastic responses in leaf form resulting from ontogenetic or external influences are initiated very early in primordial development and are brought about by effects on the rate and direction of cell division and expansion in different regions of the primordium. Effects on leaf size are often induced over much longer periods including the phase of lamina expansion. In Phaseolus vulgaris the primary leaves exhibit increases in size when one of the pair is removed or when the stem is decapitated above the primary leaf node. These compensatory growth effects are not the result of a change in cell number but are caused by an increase in mean cell size. Cell wall extensibility is not increased by treatment and the evidence suggests that a small increase in the (turgor-wall yield stress) term may be the cause of the very rapid response to defoliation. The usefulness of leaf systems for the analysis of plastic responses of shape and size is indicated and the importance of a better understanding of the factors determining the siting and development of the cell wall is stressed. PMID- 3544307 TI - The role of electrical phenomena in tip growth, with special reference to the developmental plasticity of filamentous fern gametophytes. AB - Cell expansion in many plant structures, including algal rhizoids, fungal hyphae, root hairs, and pollen tubes, is restricted to their apical tips. Endogenous electric fields are seen to accompany polarized growth in all tip-growing cells studied to date. The extensive studies on absorptive tip-growing structures have established that positive currents enter their elongating tips, with a portion of the entry current being carried by a localized calcium influx into the extreme tip. The resulting tip-to-base gradient in calcium concentration appears to be responsible for maintaining polarized growth in these systems, although it is uncertain whether this calcium effect is mediated via either electrophoretic or cytoskeletal mechanisms. In contrast, the few electrical measurements made on photosynthetic cells suggest that the orientation of their transcellular fields is transiently or permanently reversed relative to the fields in absorptive structures. In darkness, microelectrode measurements indicate that the apical tip of the fern filament is 5 mV electronegative relative to the base of the apical cell. This cellular dipole is perceived with the vibrating probe as a focused outward current that departs from the tip region and a more diffuse inward current that enters the lateral sides of the apical cell. The tip current is predominantly composed of protons, as can be identified with various cation selective electrodes. This proton current is thought to help maintain localized wall expansion in the filament tip. Blue light mediates the major morphogenetic transition in fern gametophytes, i.e. the transition from the tip-growing filament to the planar prothallus. All the above electrical and ionic parameters change in the few minutes of irradiation before the filament tip starts lateral swelling. The plasma membrane at the extreme tip begins to hyperpolarize within 3 s, while the basal region shows a delayed, but greater response. The cellular dipole that had existed in darkness is thus abolished in 10 to 15 min after the start of irradiation. With the vibrating probe a more diffuse pattern of positive currents is observed to emerge from the tip as well as the subapical regions of the apical cell. Simultaneously, proton efflux increases in the subapical region; the resulting decrease in cell wall pH should help plasticize the lateral walls, which may, in turn, facilitate the process of lateral swelling over the next few hours.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3544308 TI - Resource allocation under poor growth conditions. A major role for growth substances in developmental plasticity. AB - This article argues that the basic function for growth substance is resource allocation under poor growth conditions. The following scheme is suggested. Plants in the wild frequently suffer a paucity of resources which result from interplant competition and ecological and local environmental variation. The strategy adopted by many plants particularly ruderals (from which crops may have evolved) to help mitigate these problems is phenotypic plasticity; the growth of the plant body is adjusted to best exploit the scarce resources and help achieve desirable growth and reproductive goals. Phenotypic plasticity requires decisions to be made concerning the diversion of scarce growth resources to one facet of development rather than another; for example, to height or leaf area rather than thickness; or, between tissues, stem rather than leaves. Growth substances are coupled to these individual facets of development. They represent a simple way in which the extent of resource diversion can be controlled. Cells in specific tissues acquire sensitivity to particular growth substances at a stage in their development when environmental variability often necessitates choices to be made. This acquisition of ontogenetic sensitivity may be all or none. It may reflect acquisition of receptor proteins coupled to specific metabolic events. However in well-nourished plants these phases of development are relatively insensitive to changes in the level of the growth substance/receptor complex. Cells become more sensitive under certain well-defined but specific circumstances, characterized by the general term, poor growth conditions. These are produced by imbalances in one or more of the major environmental (nutritional) requirements for growth, light, nitrogen, water and oxygen. Imbalance in one or more of these produces characteristic and far-reaching metabolic and protein synthesis changes which normally constrain the synthetic processes for growth but amplify metabolic events coupled to growth substances. It is the function of growth substances to circumvent some of these metabolically constraining steps and by applying a constant stimulus to one specific aspect of growth or metabolism permit continued development. The additional input of growth substances into particular facets of development ensures the better maintenance (protection) of that character when competition for resources inside the plant is severe. However competition for scarce resources ensures that continuation of one growth aspect generally leads to relative depletion of others.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3544309 TI - Morphological plasticity in fungi. AB - Fungi grow for the most part as hyphae extending at their tips. Hyphae aggregate into mycelia, the form of which is dependent on many factors but often on the density of tips which is a function of such factors as the degree of hyphal branching, anastomoses and tip and hyphal death. Some possible mechanisms behind these processes are considered. A particularly important element in tip growth and branching is the movement of protons across the plasma membrane. Certain rhythmic growth phenomena are discussed in these terms. Another important element in morphological development is water flow bringing about a redistribution of solutes within a mycelium and probably influencing wall hydration and wall extensibility. Finally, special consideration is given to development of basidiomycete vegetative mycelium where there are indications that cytoplasmic factors can modulate the expressions of the nuclear genome. PMID- 3544310 TI - The ecological significance of plasticity. AB - Plastic responses of plants to environmental factors may be placed in an ecological context by regarding them as components of sets of traits which are predictably related to habitat stability and productivity. In ephemeral plants of temporary habitats plasticity is a major component of the mechanisms which tend to sustain reproduction when these plants are exposed to stress. When perennials of more stable habitats are subjected to stress the most frequently observed effect of plastic changes in allocation is to defer reproduction, a mechanism which appears to safeguard survival of the parent plant. It is suggested that plasticity is of vital importance in resource acquisition by plants. This hypothesis is supported by the results of experiments in which the roots and shoots of plants of contrasted ecology have been subjected to controlled patchiness in resource supply. We conclude that in plants of productive habitats high morphological plasticity is part of the foraging mechanisms which project new leaves and roots into the resource-rich zones of the constantly changing environmental mosaic created by the activity of competing plants. In long-lived plants of chronically unproductive habitats plasticity is expressed primarily through reversible physiological changes. These appear to maintain the viability and functional efficiency of leaves and roots over their long life spans and facilitate exploitation of the pulses of temporary and unpredictable resource supply which are characteristic of unproductive habitats. PMID- 3544311 TI - Unstable genes in plants. AB - The fluidity of the plant genome during development and reproduction has been considered. Although some cases of differential replication have been described there is little evidence for this process playing a large part in development. However the genome flexibility in response to 'shocks' to the genome observed in flax and maize suggest that this process may be important in the generation of rapid changes in genome. These rapid changes appear to occur in particular subsets of the genome which may allow a radical but limited reorganization of the genome in response to genomic challenge. PMID- 3544312 TI - Transformation of the genomic expression of plant cells. AB - Agrobacterium-induced transformation of plant cells results from integration of T DNA of the Ti or Ri plasmids into the genome of susceptible plants. Expression of T-DNA genes induces physiological changes in transformed cells which modify normal plant development to produce proliferations characteristic of crown gall and hairy root diseases. Understanding of the molecular basis of the transformation events associated with these examples of naturally occurring genetic engineering of plant cells, has stimulated efforts to construct vectors for transferring specific genes into plants. Vector construction has progressed from the use of wild-type Ti plasmids, giving phenotypically abnormal regenerated plants, to non-oncogenic plasmids. The range of vectors now available should enable useful foreign genes to be inserted into a range of dicotyledons and monocotyledons without impairing normal plant development. PMID- 3544313 TI - [What can be done about fractured root posts?]. PMID- 3544314 TI - [The occurrence of denticles in the skulls of Nubians]. PMID- 3544315 TI - Rejection treatment with monoclonal OKT3 antibodies after renal transplantation- a case. PMID- 3544316 TI - Patterns of development in Texas hospitals, 1836-1935: preliminary survey. PMID- 3544317 TI - Natural selection, fitness entropy, and the dynamics of coevolution. AB - The coevolutionary dynamics of interacting populations were studied by combining continuous time Lotka-Volterra models of population growth with single-locus genetic models of weak selection. The effects of natural selection on population growth were evaluated using Ginzburg's fitness entropy function as a measure of the deviation of a population's initial allele frequencies from their polymorphic equilibrium values. This entropy measure was used to relate the dynamics of a community composed of evolving populations to the dynamics of a "reference community" whose populations are initially in genetic equilibrium. Specifically, a quantity called the "selective difference area" was defined as the total difference between the population size trajectories of a reference and evolving population. The selective difference area represents the amount of extra life a species would realize if the entire community were at genetic equilibrium. It was shown that this selective difference area is a simple linear function of the initial fitness entropies of each species. This prediction is independent of the strength of selection and holds for any arbitrary set of initial population densities. Numerical examples were presented to illustrate the results. Under the assumption of weak selection, a generalization for arbitrary population growth models was outlined. PMID- 3544318 TI - [New operative technics for the correction of distal hypospadias]. PMID- 3544319 TI - [Day surgery of children]. PMID- 3544321 TI - [Therapeutic follow-up of theophylline]. PMID- 3544320 TI - [Per os effects of bepridil on venous compliance in a controlled double-blind cross-over trial versus placebo]. PMID- 3544323 TI - [Pharmacokinetics of prednisolone in renal transplant patients with or without Cushing's syndrome]. PMID- 3544322 TI - [Effect of nutrition on drug bioavailability]. PMID- 3544324 TI - [Value of the treatment of arterial hypertension in the elderly subject]. PMID- 3544325 TI - [Argyria]. PMID- 3544327 TI - Effects of bacterial endotoxin and platelet activating factor (PAF) on human platelet aggregation in native whole blood. AB - The effect of bacterial endotoxins E. coli 0111:B4 or S. minnesota and platelet activating factor (1-0-alkyl-2-acetyl-SN-glycero-3-phosphorylcholine) on platelet aggregation in native whole blood (NWB) were evaluated by impedance aggregometry. In the absence of anticoagulants the patterns of impedance changes associated with aggregation were distinct from those of clotting. Both E. coli 0111:B4 and S. minnesota endotoxins shortened the time to clot formation, but impedance changes suggestive of accelerated platelet aggregation were minimal or absent. In contrast, PAF caused an increased impedance, with oscillations characteristic of aggregation, which in some instances was superseded by the smooth impedance change associated with clotting. E. coli 0111:B4 endotoxin blocked aggregation and delayed the onset of clotting after PAF, whereas S. minnesota endotoxin accelerated platelet aggregation by PAF in ten of thirteen experiments. Incubation of E. coli 0111:B4 endotoxin and PAF markedly enhanced aggregation by PAF, whereas the effect of S. minnesota was variable. Although E. coli 0111:B4 and S. minnesota endotoxins accelerated clotting but not platelet aggregation of human NWB in vitro, their interaction with PAF is complex, depending on the type of endotoxin and individual reactivity. The findings suggest that endotoxin could interact with PAF to significantly augment possible hemorrhagic and/or thrombotic complications of septic shock in humans. PMID- 3544326 TI - [Vaccination and pregnancy]. PMID- 3544329 TI - [Bulimia. A review of the literature]. PMID- 3544328 TI - In vivo measurement of the disaggregatory action of prostacyclin. A methodological study. AB - The disaggregating effect of PGI2 was measured in a modified in vivo model described by Hornstra. The arterial blood of mongrel dogs was directed through an extracorporeal filter by a roller pump, and the pressure proximal to the filter was measured. The filter became spontaneously occluded mostly by aggregates of platelets within a few minutes, and as a result the pressure before the filter increased continuously. PGI2, administered either before the filter or intravenously, produced dose-related reduction in filtration pressure. Results obtained in control experiments revealed that the rate of platelet aggregation was reproducible; neither the count of platelets in the circulating blood nor the in vitro sensitivity of platelets to ADP and PGI2 changes significantly in the course of an experiment. The technique described seems to be useful to determine the disaggregatory potency of prostacyclin and other substances. PMID- 3544331 TI - [Use of ultrasonics in pregnancy]. PMID- 3544330 TI - [Perforated peptic ulcer. Surgical treatment]. PMID- 3544332 TI - [Hans Christian Parelius. An active district physician in the 19th century]. PMID- 3544333 TI - [Prostatic cancer. Treatment with LH-RH analogs]. PMID- 3544334 TI - [Suture of isolated peripheral detachment of the menisci]. PMID- 3544335 TI - HLA phenotypes and bullous cutaneous reactions to drugs. AB - Drug induced toxic epidermal necrolysis and Stevens-Johnson syndrome are weakly associated with HLA-B12. Among patients reacting to a given drug we observed stronger links, especially for HLA-A29; B12; DR7 and sulphonamides. PMID- 3544336 TI - Effects of cisapride on the secretion of pancreatic polypeptide in healthy volunteers. AB - Plasma human pancreatic polypeptide (hPP) responses to intravenous injections of a new gastric and intestinal motility promoting agent, R51 619 (cisapride), were studied in healthy volunteers. The mean fasting concentrations of plasma hPP (39 +/- 5.4 pg/ml; mean +/- S.E.) were elevated significantly to the peak values of 118 +/- 25.1 pg/ml 30 min after the drug had been given in a dose of 4 mg over 5 min. However, plasma insulin (IRI), glucose and prolactin levels were not elevated. Atropine diminished the cisapride-induced hPP elevation, thereby suggesting that cisapride induced release of acetylcholine but had no antidopaminergic action. PMID- 3544337 TI - Immunoelectron microscopic observations on the localization of fibronectin in normal human lung. AB - The localization of fibronectin was examined in normal human lung using immunoelectron microscopy. Fibronectin staining was present not only in the endothelial, alveolar epithelial and bronchial epithelial basal laminae and associated with interstitial collagen fibrils and elastic fibers, but also in basal laminae of fibroblasts and smooth muscle cells. There was a periodicity in the staining of fibronectin on collagen fibrils. Reaction products against fibronectin were present in intracellular organelle including cisternae of smooth endoplasmic reticulum of endothelial cells and those of rough endoplasmic reticulum of fibroblasts. No other cells contained reaction products. The localization of fibronectin was compared with that of ruthenium red staining in normal human lung. The localization of fibronectin was consistent with that of proteoglycan. PMID- 3544338 TI - Structure-function relationships of phospholipases. II: Charge density distribution and the myotoxicity of presynaptically neurotoxic phospholipases. AB - The charge density distribution of 24 phospholipases A2 has been examined to identify the involvement of charged amino acid residues in the determination of the pharmacological properties of these proteins. There is no characteristic difference between the presynaptically neurotoxic and non-neurotoxic phospholipases, however, presynaptically neurotoxic phospholipases which are also myotoxic have a distinct charge distribution pattern. There is a characteristic cationic site around residues 79-87. This site has a relatively fixed position with respect to the hydrophobic 'neurotoxic' region, on the NH2 terminal side. This cationic region is located on the outer surface in the three-dimensional structure of phospholipase, just before hydrophobic helix E, and is available for interaction with membranes. Such a characteristic region is absent in non myotoxic phospholipases which are either presynaptically active or inactive. On the other hand, myotoxins, a group of non-enzymatic proteins inducing myotoxicity, also possess such characteristic regions of cationic and hydrophobic sites. PMID- 3544339 TI - Comparative enzymology of venoms from stinging Hymenoptera. AB - Venoms from 20 species of stinging Hymenoptera, including nine species of ants and nine species of social wasps, were quantitatively analyzed for the following enzymic activities: phospholipase A, hyaluronidase, lipase, esterase, protease, acid phosphatase, alkaline phosphatase and phosphodiesterase. Phospholipase and hyaluronidase were present in all the venoms, with activity levels generally higher among the wasps than the ants (P less than 0.05). Lipase was present in high activity in several social wasp venoms and one ant venom, in low levels in two other ant venoms and absent from four tested snake venoms. Two-carbon esterase activity was present in the venoms of five social wasps and one ant. Non specific protease was present at very high activity levels in the venoms of an army ant species and was also present in the venoms of a social wasp and another ant. Acid phosphatase activity was present in eight of the nine ant venoms, but was essentially absent from all the social wasp venoms. Alkaline phosphatase activity was clearly detectable in the venoms of only two species of ants. Phosphodiesterase, an enzyme not previously detected in insect venoms, was present in the venoms of three closely related ant species. Venoms with generally high enzymic activities included those of Polistes infuscatus, Vespula (V.) squamosa and Pogonomyrmex badius; those with low activities included Dolichovespula maculata, Apoica pallens and Dasymutilla lepeletierii. The 20 venoms were ranked according to overall activity levels using the eight enzyme activities plus lethal, hemolytic and pain-inducing activities. They were also compared phylogenetically using these 11 activities. PMID- 3544340 TI - Urinary mutagenicity after controlled exposure to environmental tobacco smoke (ETS). AB - 20 non-smokers on a defined diet low in polycyclic aromatic hydrocarbons (PAH) were exposed to environmental tobacco smoke (ETS) in an unventilated room for 8 h. The urinary mutagenicity in the 24-h urine samples as tested with the Salmonella (TA98) microsome assay did not significantly increase after exposure to either 10 ppm CO or 20-25 ppm CO. We conclude that exposure of non-smokers to ETS does not lead to an increase in their urinary mutagenicity, provided the exposure conditions are within a realistic range. PMID- 3544341 TI - Urinary excretion of mutagens in passive smokers. AB - Six healthy young volunteers with no history of active smoking were asked to keep on their Western diets avoiding the consumption of alcoholic beverages, excess coffee, any sort of medicament, and the known pro- and/or anti-mutagen-containing foods and drinks, 24 h before and during the experiments. They were exposed passively to cigarette smoke produced by 4 habitual smokers in an unventilated 48.6 m3 room for 8 h. The carbon monoxide concentration was 18.85 +/- 7.3 ppm during the 8-h exposure. Frameshift mutagens were isolated from 10-h urine samples using chloroform and were tested for mutagenicity in the Salmonella/mammalian microsome assay employing Salmonella typhimurium TA98. Although clearly enhanced, no significant mutagenic activity could be found with 25 ml equivalent urine/plate after passive exposure to cigarette smoke. The weak mutagenicities found were highly significant when 50 ml equivalent urine/plate was tested. No direct correlation was observed between urine mutagenicity and the urinary cotinine concentration. The results obtained are discussed with reference to inconsistent reports in the literature concerning the mutagenicity of urine after passive smoking. PMID- 3544342 TI - Mutagenic determination of passive smoking. AB - The mutagenic activity of tobacco smoke has been further investigated with the plate-incorporation method and a microsuspension technique of the Ames Salmonella assay. The microsuspension test gives a higher response than the conventional plate incorporation test. It is possible to detect environmental tobacco smoke (ETS) in moderately smoky indoor environments by collection of particulate matter with personal low volume samplers followed by particle extraction and mutagenicity testing with the microsuspension assay. PMID- 3544343 TI - Detection of IgA dominant immune complexes on peripheral blood lymphocytes in patients with IgA nephropathy. PMID- 3544344 TI - Review and current status of thrombolytic therapy with streptokinase. AB - In 1933 Streptokinase (SK) was isolated from bacterial strains of haemolytic Streptococci. Since then it has become the widest spread drug for fibrinolysis. SK, a protein, consists of 415 aminoacids and has a molecular weight of 47,000u. Together with the plasminogen (PLG) of the blood it forms activator complexes, which then convert other PLG molecules of the blood to plasmin. Plasmin attacks and dissolves fibrin deposits. As a substance produced by bacteria SK stimulates antibody formation in the body, the titer will increase during therapy, and SK lysis should be terminated after 6 days of treatment. Usually SK is administered intravascularly to treat a wide range of diseases, associated with pathological activation of hemostasis, like deep vein thrombosis, pulmonary embolism, myocardial infarction etc.. Contraindications can be traced back to the effects of SK on coagulation and the immune system. Bleeding is the most common side effect, but also a few anaphylactic reactions, caused by massive antigen-antibody precipitation have been observed. The rate of lethality of the treatment was established at 0.7% of the cases. To reduce the incidence of side effects modifications of the drug have been proposed, such as activator complex, light B chain SK, and acylated activator therapy. Compared with Urokinase, SK shows a higher rate of side effects, especially in the field of the immune system. Therapy with Urokinase can be controlled more easily. Nevertheless because of considerable price differences and logistics, SK is preferred in Europe and the USA. If strict guidelines in therapeutic use are followed, the rate of side effects of the drug can be curtailed and will be comparable to those of Urokinase. PMID- 3544345 TI - Viewing stroke pathophysiology: an analysis of contemporary methods. PMID- 3544346 TI - Bilateral occlusion of the trunk of the middle cerebral artery. Results of an international randomized trial. The EC/IC Bypass Study Group. AB - Bilateral occlusion of the middle cerebral artery (MCA) trunk theoretically should be a very severe condition, but its actual prognosis has never been studied. Nine of 1,377 patients (7 Asians, 1 Black, 1 Caucasian) from the Cooperative Study of Extracranial/Intracranial Arterial Anastomosis were found to have atherosclerotic bilateral occlusion of the middle cerebral artery (MCA) trunk before entering the trial. Three presented with a stroke followed by a contralateral stroke, two experienced a unilateral stroke, two had a unilateral stroke preceded by ipsilateral TIAs, one had a unilateral stroke preceded by TIAs on both sides and one experienced isolated unilateral TIAs. Retrograde filling to the distal MCA was universally present. During follow-up (mean: 45 months), only one (non-operated) patient had further cerebrovascular events, and ultimately a fatal stroke. One additional patient died of sepsis and one had a silent myocardial infarct. All survivors resumed their previous activities. This study shows that in bilateral MCA trunk occlusion, the long-term prognosis is reasonable in the patients who do not present with a devastating stroke. PMID- 3544347 TI - Atherosclerotic disease of the middle cerebral artery. AB - Three hundred and fifty-two patients with atherosclerotic middle cerebral artery stenosis (MCAS, 53%) or occlusion (MCAO, 47%) have been systematically studied. The study involved all patients entered into the EC/IC Bypass Study with isolated MCA disease or a tandem lesion predominating in the MCA ipsilateral to the ischemic events (18 patients with a tandem lesion of greater magnitude in the internal carotid artery were not included). The Asian patients represented 58% of all Asians entered into the EC/IC Bypass Study, whereas the white patients represented 18% of all whites and the black patients 34% of all blacks. Isolated TIAs were less frequent in MCAO (12%) than in MCAS (34%). Warning TIAs before a stroke occurred in one third of the cases. Presentation with stroke or isolated TIA was not influenced by sex, age, level of MCA obstruction, collateral circulation nor associated carotid disease. In MCAS, no major difference in presentation was found between severe and moderate stenosis. Pure motor hemiparesis occurred in 15% and pure sensory stroke in 2% of the patients with stroke and 30% of the MCA territory infarcts were small and limited to the lenticulocapsular area, confirming that so-called lacunar infarcts may be due to large vessel disease. During follow-up (42 months) of 164 medically-treated patients, further cerebrovascular events (TIA and stroke) occurred in 11.7% of the patients per year. In MCAO the stroke rate was 10.1% per patient-year and the ipsilateral infarct rate was 7.1% per patient-year. In MCAS, the stroke rate was 9.5% per patient-year and the ipsilateral stroke rate was 7.8% per patient year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544348 TI - Restenosis and occlusion after carotid surgery assessed by duplex scanning and digital subtraction angiography. AB - In a study of 140 patients operated upon with 143 carotid endarterectomies (mean follow-up time 5.2 +/- 2.3 years, range 1 month - 9.3 years), vessel morphology was examined with duplex scanning in 113 patients and with digital subtraction angiography (DSA) in 82 patients. The operative mortality was 1.4%; persisting stroke morbidity 3.6% and the combined operative mortality/morbidity 5%. During the follow-up time a further 20 patients (14.5%) died, 13 had new strokes and 14 new TIAs. By life table analysis, the annual rate of stroke including the operative period was 2.7% (1.7% on the operated side and 1.0% on the non-operated side). Fourteen new occlusions (12%) of the operated carotid artery was found and restenosis (greater than 50%) in 13 patients (11.2%). Progression of the atherosclerotic disease in the contralateral non-operated carotid artery was found in 41 patients (37%) including 3 new occlusions. Agreement DSA/duplex was 88% on the operated side and 92% on the non-operated side. New strokes or TIAs on the operated side were more common in patients with occlusions or restenosis (p less than 0.05), whereas no symptoms were referable to occlusions on the non operated side. Risk factor analysis revealed an increased risk of atherosclerotic progression on the non-operated side in smokers and those with two or more risk factors. The risk of restenosis in the operated carotid artery was higher in females (p less than 0.025). PMID- 3544350 TI - IMPS (intact months of patient survival): an analysis of the results of carotid endarterectomy. AB - The literature on carotid surgery for lesions appropriate to prior episodes of ischemia has been reviewed. Only one randomized study and six non-controlled reports give useful data (this despite more than thirty years of surgical activity in this field). When analyzed by the IMPS (intact months of patient survival) criterion, the randomized study failed to show benefit from surgery. This failure can be attributed to a high (35%) operative stroke and death rate. That sufficiently low operative stroke and death rates are readily achievable is not clear, however, only two of six relevant non-controlled series reported in the literature had operative stroke and death rates below the 10.4% level calculated as necessary for a "break-even" situation. Three of the six non controlled series contain sufficient follow-up data to permit IMPS comparison against the "standard" of the control group of the randomized study. Against this "standard" only one of the three non-controlled studies would have "shown benefit" from surgery. Barnett, Plum, and Walton have called for audits of endarterectomy results in institutions in which such surgery is performed. It is suggested that such audits be done by the IMPS method, which gives appropriate weight to the effects of operative, as well as of long-term follow-up, strokes and deaths. PMID- 3544349 TI - Inhibition of thromboxane A2 production does not improve post-ischemic brain hypoperfusion in the dog. AB - In a canine model of global brain ischemia, six dogs received a selective thromboxane A2 synthetase inhibitor, UK 38,485 (dazmagrel) before the ischemic event; six received a saline placebo. Cerebral blood flow (CBF), systolic and diastolic arterial pressure, cardiac output, pH, PaCO2, PaO2, and arterial and jugular-vein thromboxane B2 (a stable metabolite of thromboxane A2) and 6-keto PGF1 alpha (a stable metabolite of prostacyclin) were measured at baseline, after release of aortic and venae caval occlusion and at intervals up to 120 min thereafter. Treated animals showed nearly complete post-ischemic inhibition of thromboxane B2 production; control animals showed increases in jugular venous thromboxane B2. Arterial and jugular venous levels of 6-keto PGF1 alpha were significantly higher in treated animals at most post-ischemic intervals. CBF in both groups was similar to baseline values at time 0, then declined similarly in both groups by 30 min to approximately equal to 35% of baseline values where it remained thereafter. There were no significant differences in other variables at any interval. We conclude that inhibition of thromboxane A2 production does not alter post-ischemic brain hypoperfusion. PMID- 3544351 TI - Directional C-W Doppler sonography in the diagnosis of basilar artery disease. AB - Using directional continuous-wave Doppler sonography of the vertebral arteries, we have investigated 1,540 patients during the past 5 years. On the basis of unilateral and bilateral retrograde brachial angiograms in the same patients (a total of 1,989 angiograms) we have developed sonographic criteria for demonstrating a significant increase in the peripheral resistance of both distal vertebral arteries and/or the basilar artery. All 11 cases of basilar artery stenosis of at least 60% reduction in lumen diameter (as shown by angiography) exhibited an approximately 40% or higher reduction in the sum of the modified Pourcelot indices of both vertebral arteries with respect to age-matched controls. All 3 stenoses of less than 60% reduction in lumen diameter were not detected by sonography. Even a good collateral circulation through rete mirabile anastomoses did not normalize the modified Pourcelot indices. One case of a persistent primitive trigeminal artery with thin-calibered vertebral arteries was also detected by sonography. The high percent of patients with one hypoplastic vertebral artery in the group with basilar artery stenoses indicates an increased risk for atherosclerosis of the basilar and/or distal vertebral artery in these patients. All 14 angiographically verified occlusions of the basilar artery were detected by sonographic criteria independent of the occlusion localization. Thus, we believe that directional continuous-wave Doppler sonography is a reliable technique for detecting basilar artery stenoses of at least 60% reduction in lumen diameter and basilar artery occlusions. PMID- 3544352 TI - Binswanger's disease: a review. PMID- 3544354 TI - Leishmania infecting man and wild animals in Saudi Arabia. 2. Leishmania arabica n. sp. AB - Leishmania arabica n. sp., found in the rodent Psammomys obesus in the Eastern Province of Saudi Arabia, is described. This parasite, which has also been found in a feral dog in the same area, is distinguished from the common species of the Eastern Province, L. major zymodeme LON-4, on the basis of its very distinctive isoenzyme profile (zymodeme LON-64) and kinetoplast DNA. It is morphologically indistinguishable from L. major. The new parasite has not been found in man to date and its vector is so far unknown. PMID- 3544353 TI - A double-blind clinical trial for the evaluation of the therapeutical effectiveness of a calf thymus derivative (Thymomodulin) in children with recurrent respiratory infections. AB - The effectiveness of an orally administrable thymic derivative (Thymomodulin) for the treatment of the recurrent respiratory infections (RRI) in children has been studied in a double-blind clinical trial with historical comparison. In the Thymomodulin treated group a significant decrease of the monthly frequency of RRI has been observed in comparison with the previous year (P less than 0.05) and with the placebo treated group (P less than 0.002). The evaluation of the laboratory data at the beginning of the study didn't show in the two groups typical alterations of the common hematological and immunological parameters, but at the end of the trial a statistically significant increase of the levels of salivary IgA has been noticed only in the Thymomodulin treated group (P less than 0.02). PMID- 3544355 TI - Response of falciparum malaria in vivo to a standard regimen of chloroquine in Kisumu District, Western Kenya. AB - The sensitivity of Plasmodium falciparum to chloroquine was studied in 140 children in two locations in Western Kenya. The standard WHO in vivo field test was used and chloroquine phosphate 25 mg base/kg administered in divided doses over three days. In one area 13.2% of cases had recrudescent parasitaemias, while in the other area 8.2% of infections were resistant, with 3.5% having an RII pattern. The remaining isolates were sensitive to chloroquine. Further in vivo and in vitro tests in the region are needed to document the extent and level of resistance. PMID- 3544356 TI - Computer controlled affinity chromatographical purification of soluble Plasmodium falciparum antigens from supernatants of in vitro cultures. AB - Affinity chromatographic procedures are difficult to scale up from the analytical to the preparative level when the ligand used for purification is a limiting factor. A versatile, computer-controlled affinity chromatographic system is described which permits automatic repetition of the purification process and sophisticated control functions based on the ultra-violet absorbance of fluid passing through the affinity column. The system has been used for automation and scaling up of the purification of Plasmodium falciparum exoantigens. PMID- 3544358 TI - The detection of onchocercal nodules by ultrasound technique. PMID- 3544357 TI - An outbreak of Plasmodium vivax malaria among heroin users in Spain. AB - We report the first outbreak of induced malaria among heroin users in Spain, and the first one caused by Plasmodium vivax in Europe. Five drug addicts from Madrid, who had never travelled to endemic areas, were admitted to hospital with fever and splenomegaly. Four had P. vivax malaria with low parasitaemia, ranging from 1 to 3% red blood cells. The fifth case was considered a "seropositive contact" because he had fever and positive malaria indirect fluorescent antibody test but negative blood smear. The source of infection was a young drug addict, who had often travelled to Equatorial Guinea. Another heroin user with a diagnosis of malaria refused to be admitted to our hospital for further study. All had shared contaminated injection equipment. Treatment with chloroquine was effective and none had recrudescence of malaria during a mean follow-up of six months. Drug addicts with unexplained fever may have been infected by malaria transmitted by sharing injections. PMID- 3544359 TI - In vivo and in vitro susceptibility of Plasmodium falciparum to sulphadoxine/pyrimethamine in Liberia, West Africa. AB - The in vivo response of Plasmodium falciparum to standard treatment with sulphadoxine/pyrimethamine was studied in 19 hospital patients from Yekepa town with hypoendemic malaria and in 28 children, two to nine years old, living in a village with holoendemic malaria. In vitro tests were performed on eight isolates. In the hospital patients all parasites cleared with mean clearance time of 2.2 (range one to three) days and no recrudescence occurred during a 28-day follow-up period. In the village children, despite a high sporozoite inoculation rate, recurrent parasitaemias were only recorded after 28 days, suggesting a rather long-lasting prophylactic effect against reinfection by the drug combination. In vitro, inhibition of parasite multiplication was achieved by 3 X 10(-7) M sulphadoxine and 3.8 X 10(-9) M pyrimethamine. PMID- 3544360 TI - Serological observations on toxoplasmosis in Zairian AIDS patients. PMID- 3544361 TI - Treatment of imported cases of falciparum malaria in France with halofantrine. AB - Halofantrine is a 9-phenanthrenemethanol which is effective against multi-drug resistant strains of Plasmodium falciparum. It has been shown to be highly effective and extremely well tolerated in the treatment of imported cases of falciparum malaria in France. A total of 1,500 mg administered in three 500 mg doses at six-hour intervals results in a 100% cure rate in semi-immune subjects. This dosage should be repeated after 14 days to obtain the same cure rate in non immune patients. Minor clinical side effects included epigastric pains, nausea and, in one case, a skin rash. PMID- 3544362 TI - Decreased growth of Plasmodium falciparum in red cells containing haemoglobin E, a role for oxidative stress, and a sero-epidemiological correlation. AB - The in vitro growth of Plasmodium falciparum in red cells containing haemoglobin E (HbE) was studied at oxygen concentration of 5 to 20%, with and without antioxidants. Under all conditions, parasite growth decreased as the concentration of HbE increased as compared with growth in red cells containing only HbA. The decreases were proportionately greatest at the highest oxygen concentration. The antioxidant vitamin C partially reversed the decreases in growth observed in HbE-containing cells at 20% oxygen. South-east Asian refugees with HbAE or HbEE had high antimalarial IFA titres, indicative of exposure to malaria more frequently than did refugees with HbAA. The decreased growth of P. falciparum in HbE-containing red cells may reduce the severity of malaria infections, conferring a survival advantage and thus increasing the numbers of individuals with HbE in local areas of South-east Asia with high incidences of malaria. PMID- 3544363 TI - Failure of meglumine antimoniate to cure cutaneous lesions due to Leishmania major in Algeria. PMID- 3544364 TI - Is group B Streptococcus a zoonosis? PMID- 3544365 TI - Joseph Pancoast (1805-1882): Jefferson anatomist and surgeon, and his world. PMID- 3544366 TI - Thomas Hewson Bache: a forgotten Fellow of the College of Physicians of Philadelphia. PMID- 3544367 TI - Helen Brooke Taussig 1898-1986. PMID- 3544368 TI - The Jefferson Medical College connection: a letter from Sir William Osler. PMID- 3544369 TI - Specificity of enzyme immunoassay for hepatitis B core antibody used in screening blood donors. AB - Hepatitis B core antibody (anti-HBc) is currently tested by a competitive inhibition enzyme immunoassay (EIA), using recombinant DNA-produced core antigen. We have used the anti-HBc assay in routine screening of voluntary blood donors in San Francisco. The detection rate of anti-HBc was 2.08 percent. The specificity of the antibody test was established by an absorption method using purified HBc antigen (HBcAg) produced by recombinant DNA technology and covalently coupled to Sepharose 4B. Bovine serum albumin was used in the preparation of a control conjugate. The absorption test demonstrated that out of 98 anti-HBc-positive specimens, 97 could be specifically neutralized. Only one specimen was indeterminate. The absorption test was particularly useful in confirming the specificity of EIA in eight specimens inconsistently positive for anti-HBc. We conclude that the current EIA for anti-HBc is highly specific and we are of the opinion that it could be used as a rational basis for donor deferral since it gives evidence of active or previous HBV infection. PMID- 3544370 TI - False-positive enzyme-linked immunosorbent assay reactions for antibody to human immunodeficiency virus in a population of midwestern patients with congenital bleeding disorders. PMID- 3544371 TI - Infiltrating cell phenotypes and patterns associated with hepatic allograft rejection or acceptance. AB - The association of inflammatory cell infiltration with orthotopic rat liver transplant rejection was studied by immunopathologic evaluation of allografts at different time points using high- and low-responder strain combinations. PVG(RT 1c) recipients of ACI (RT-1a) liver transplants had prolonged survival (greater than 100 days) without immunosuppression. In contrast, Lewis (RT-1l) recipients of ACI liver transplants had severe acute rejection with mean survival of 10.7 +/ 0.5 days (n = 9). Graft recipients of both strain combinations, as well as control syngeneic PVG-to-PVG and Lewis-to-Lewis graft recipients were sacrificed at various time points posttransplant. Sections of livers were evaluated in a masked fashion for histologic changes as well as the extent and phenotype of cellular infiltrates, as determined by immunoperoxidase labeling using monoclonal antibodies OX1 (pan leukocyte), W3/13 (pan T cell), W3/25 (T helper cell:Th), and OX8 (T cytotoxic-suppressor:Tc-s). The results suggest that: the intensity and relative distribution of rat hepatic allograft T cell infiltrates at a given time point do not necessarily correlate with eventual outcome; the intensities of W3/25 (Th) and OX1 (pan-leukocyte) cell infiltrates parallel each other in both high- and low-responder strain combinations; the relative ratio of T cells (W3/13) to non-T cells increases over time in low-responder strains but remains relatively constant in high-responder strains during active rejection; and the relative ratio of W3/25:OX8 (Th:Tc-s) decreases in high-responder strains but increases in low-responder strains. PMID- 3544372 TI - Xenograft survival in two species combinations using total-lymphoid irradiation and cyclosporine. AB - Total lymphoid irradiation (TLI) has profound immunosuppressive actions and has been applied successfully to allotransplantation but not xenotransplantation. Cyclosporine (CsA) has not generally permitted successful xenotransplantation of organs but has not been used in combination with TLI. TLI and CsA were given alone and in combination to rats that were recipients of hamster or rabbit cardiac xenografts. Combined TLI and CsA prolonged survival of hamster-to-rat cardiac xenografts from three days in untreated controls to greater than 100 days in most recipients. TLI alone significantly prolonged rabbit to rat xenograft survival with doubling of survival time. However, combined treatment did not significantly prolong rabbit-to-rat cardiac xenograft survival compared with TLI alone. The hamster and rat are phylogenetically closely related. Transplants from hamsters to rat are concordant xenografts since the time course of unmodified rejection is similar to first-set rejection of allografts. Although the rabbit-to rat transplant is also between concordant species (average survival of untreated controls: 3.2 days) the rabbit and rat are more distantly related. These results suggest that TLI is an effective immunosuppressant when applied to cardiac xenotransplants in these animal models; that the choice of species critically affects xenograft survival when TLI and/or CsA are used for immunosuppression; and that the closely related species combination tested has markedly prolonged (greater than 100 days) survival using combined TLI and CsA. PMID- 3544374 TI - Pretransplant crossmatch status and immunoglobulin production in renal transplant recipients. AB - The factors responsible for B cell regulation in stable renal transplant patients are unknown. To examine these control mechanisms, the B cell responses to 4 mitogens (pokeweed, wheat germ agglutinin, lipopolysaccharide, and SAC-1), which are known to stimulate B cells by different mechanisms, were measured in two groups of stable long-term (greater than 1 year post-transplant) renal transplant recipients. The first group were patients who had been transplanted under conditions of a negative crossmatch on all available pretransplant sera (negative crossmatch group) and the second group were patients who might have a unique regulation of B cell function in that they had been successfully transplanted under the conditions of a negative crossmatch using sera at the time of transplant but with pretransplant sera that gave a positive donor-specific T cell crossmatch (positive crossmatch group). Stable transplant patients were found to have significantly impaired responses to all four mitogens tested. Furthermore there were no differences in the responses of the negative crossmatch patients as compared with the positive crossmatch patients. The lack of response to mitogens was not due to a lack of proliferation of cells or to a loss of viability in culture. The number of cells in culture was the same in negative crossmatch patients and controls but was significantly less than controls in positive crossmatch patients (P less than 0.001). These findings suggest an intrinsic B cell defect in all stable transplant patients, and that the degree of the impaired B cell responses is the same in positive and negative crossmatch patients. In addition in positive crossmatch patients, there is a decrease in the percentage B cells that resulted after separation on a Ficoll-Paque gradient. PMID- 3544373 TI - OKT3 treatment of steroid-resistant renal allograft rejection. AB - The monoclonal antibody, Orthoclone OKT3 (OKT3), has been used with great efficacy in a prospective multicenter trial as therapy for first rejection episodes in cadaveric donor (CD) renal allograft recipients treated with azathioprine (AZA) and prednisone (P). However, although almost all rejection episodes were reversed, recurrent rejection occurred in approximately two-thirds of OKT3-treated patients in this earlier trial; infections also occurred in about two-thirds of patients, often related to the additional immunosuppression necessary to reverse the rerejection episodes. In the current series of patients, OKT3 was used to treat rejection in CD renal graft recipients in a protocol differing from the multicenter trial in two respects: baseline immunosuppression was cyclosporine (CsA) and P or CsA, AZA, and P (probably more potent immunosuppressive combinations than the AZA and P in the multicenter trial); and OKT3 treatment was reserved for rejection episodes resistant to 3 bolus infusions of methylprednisolone (MP), 5-10 mg/kg, rather than as primary therapy for first rejection episodes. Using this protocol, 46 of 74 rejection episodes (62%) diagnosed between 3/85 and 3/86 in CD renal allograft recipients were treated successfully with MP. Of the remaining 28 steroid-resistant rejection episodes, 27 (96%) were reversed with a 7-14-day course of OKT3, 5 mg/day. Only 5 recurrent rejection episodes (19%) have been observed in the 2-14-month follow-up period after OKT3 treatment; infections have occurred in 10 patients (36%), and three grafts (11%) have been lost in OKT3 treated patients. These results suggest that recurrent rejection and subsequent infection after OKT3 is used to treat rejection may be reduced in a protocol where CD renal allograft recipients are treated with baseline immunosuppression regimens including CsA and where OKT3 is reserved for steroid-resistant rejection. This approach appears to be both more cost-effective than, and as effective therapeutically as, treating all first rejection episodes with the monoclonal antibody. PMID- 3544375 TI - The impact of diabetes on vascular complications following cadaver renal transplantation. AB - To assess the impact of diabetes on vascular complications occurring in renal transplant recipients, we compared the incidence of vascular disease in 283 non diabetic (ND) and 99 diabetic (D) patients who received primary cadaver renal transplants at our center between 1/1/76 and 12/31/85. The median observation time in the ND patients was 31 months, and in D patients it was 20 months. Both ND and D patients were subdivided into group A if they had preexisting clinical vascular disease and group B if they had no prior disease. The vascular complications between the ND and D patients were analyzed in 3 subsets: prevalence of vascular disease prior to renal transplantation; posttransplant recurrent vascular disease in group A; and posttransplant vascular disease, new, in group B. The results showed that, prior to renal transplantation, D patients have a higher prevalence of clinical vascular disease (33%), compared with ND patients (13%) (P = .00001). In group A, the recurrence rate of vascular disease after transplantation was also higher in D patients (67%) compared with ND patients (40%) (P = .05). In group B, the incidence of posttransplant vascular disease (new) was significantly higher in D patients (33%) compared with the ND patients (13%) (P = .002). Also, the amputation rate was significantly higher in D patients (18%) compared with ND patients (0.4%) (P = .000001). Our data suggest that morbidity from vascular disease is significantly increased in diabetic renal transplant recipients compared with nondiabetic patients. Such increased morbidity from vascular disease in the diabetic patients may also be observed in the period before renal transplantation. PMID- 3544377 TI - The effect of oral metoclopramide on the absorption of cyclosporine. AB - This study was performed to determine the effect of coadministered oral metoclopramide on the absorption of oral cyclosporine in 14 kidney transplant patients. The study was conducted on two consecutive days. Ten patients were studied twice, and 4 patients once, giving 24 studies. The total dosage of metoclopramide was 20 mg. The day on which metoclopramide was administered was chosen randomly. Whole-blood cyclosporine levels were analyzed by high performance liquid chromatography. Coadministration of cyclosporine with metoclopramide resulted in a significant increase in mean maximum blood concentration (567 ng/ml versus 388 ng/ml) and mean area under the blood concentration-versus-time curve (4120 ng X hr/ml versus 3370 ng X hr/ml); and a significant decrease in mean time to reach maximum concentration. The mean increase in area under the blood-concentration-versus-time curve was 29%. No significant changes were observed in the elimination of cyclosporine when it was coadministered with metoclopramide. These observations suggest that coadministered metoclopramide increased the total absorption of cyclosporine. Metoclopramide has been shown to hasten gastric emptying; since cyclosporine is absorbed predominantly in the small intestine, coadministration of metoclopramide resulted in increased bioavailability of cyclosporine. PMID- 3544376 TI - Complications of cyclosporine-prednisone immunosuppression in 402 renal allograft recipients exclusively followed at a single center for from one to five years. AB - The therapeutic efficacy of cyclosporine (CsA) as an immunosuppressive agent was complemented by a modest, long-term incidence of toxic complications in 402 renal allograft recipients engrafted one to five years prior to analysis. The overall patient and graft survivals at one year were 97% and 84% (actual), and at five years 92% and 67% (actuarial). The immunosuppressive therapeutic index was excellent: only 12% of allografts were lost from rejection, with 5% of patients succumbing to infection. While infections were common, tending to emanate in the urinary tract or to be viral in etiology, they were generally mild and readily controlled. Only four patients displayed malignancies; none succumbed to this cause. The most common toxic complication was hypertrichosis, which was accentuated in pediatric patients. While tremors occurred in 20% of patients, primarily during the first three months, other neuroectodermal complications of parethesias, depression, somnolence, and seizures were rare. Hepatotoxicity, which was noted in 50% of patients, particularly recipients of cadaveric grafts, generally was first seen as a transaminase elevation, at least partially reversible by dose-reduction and abating by the third year. Associated disturbances of cholelithiasis and pancreatitis were occasionally observed. Nephrotoxicity was the only persistent, long-term complication. Hypertension occurred in 72% of patients during the first month, 36% in the second year, and about 15% thereafter. Hyperuricemia, which occurred in about 30% of recipients during the first two years, was occasionally associated with symptomatic gout. The mean serum creatinine level remained elevated throughout the follow-up period at 1.8-1.9 mg/dl, suggesting persistent, but nonprogressive, drug-induced renal injury. The present analysis documents the relative safety of CsA for long-term therapy, and highlights the need for new approaches to ameliorate drug-induced nephrotoxicity. PMID- 3544378 TI - Effective long-term immunosuppression maintained by low cyclosporine levels in primary cadaveric renal transplant recipients. AB - Nephrotoxicity and cost are the major problems in the use of cyclosporine (CsA) in renal transplantation. Thus, maintenance of CsA levels at the lower limits of the therapeutic range is desirable. The lowest CsA level effective in preventing rejection while avoiding nephrotoxicity has not been defined. We report on 44 primary cadaveric renal transplant recipients treated with a protocol that involved a progressive reduction in the trough CsA levels. CsA was initiated at an oral dose of 15 mg/kg, and this dose was adjusted to achieve serum trough levels, as measured by radioimmunoassay, of 150-200 ng/ml during the first month, 100-150 ng/ml during the second month, 75-100 ng/ml during the third month, and 50-75 ng/ml thereafter. Patient and graft survival at 18 months were 94% and 83.6%, respectively. The mean daily CsA doses were 6.7 +/- 3.1 mg/kg at 6 months, 5.5 +/- 3.2 mg/kg at 12 months, and 4.7 +/- 2.4 mg/kg at 18 months. Corresponding trough serum CsA levels were 94 +/- 59 ng/ml, 64 +/- 22 ng/ml, and 44 +/- 21 ng/ml at 6, 12, and 18 months, respectively. Mean serum creatinine concentrations were 1.8 +/- 0.6 mg/dl at 6 months, 1.7 +/- 0.5 mg/dl at 12 months, and 1.6 +/- 0.5 mg/dl at 18 months. The mean serum creatinine concentration at 18 months was not significantly different from that of 18 conventionally treated primary cadaveric renal transplant recipients (1.6 +/- 0.5 vs. 1.4 +/- 0.4 mg/dl, P = .31). A total of 67% of patients did not have any rejection episodes under this protocol, while 71% of patients never developed CsA nephrotoxicity. No patient was taken off CsA for progressive nephrotoxicity. We conclude that trough serum CsA levels of 50-75 ng/ml, as measured by radioimmunoassay, are sufficient to maintain effective immunosuppression in the long-term management of primary cadaveric renal transplant recipients. These values are much lower than previously recommended, and this approach ameliorates chronic CsA nephrotoxicity. PMID- 3544379 TI - Immunopathologic patterns of cyclosporine deposition associated with nephrotoxicity in renal allograft biopsies. AB - Using antibody directed against cyclosporine (CsA-Ab) in an avidin-biotin-complex immunoperoxidase technique on routine formalin-fixed tissue specimens, 46 renal biopsies from CsA-treated renal allograft recipients and 23 biopsies from non-CsA treated patients were examined to identify staining patterns potentially associated with CsA nephrotoxicity (CsA-NT). All specimens were examined independently in a masked fashion by two pathologists for the intensity of (CsA Ab) specific staining for each of the four distinct patterns identified: diffuse interstitial staining (DIS, 0-3+); fine granular staining of tubular epithelium (FGS, 0-3+); coarse granular staining of tubular epithelium (CGS, 0-3+); and dark cellular staining of mononuclear inflammatory cells (DCS, 0-3+). Based on standard clinical criteria all CsA-treated patients were categorized according to the degree of CsA nephrotoxicity (grades 1-4). Significant differences in the intensity of CsA-Ab labeling were found for three of the four immunohistologic grading patterns (DIS, FGS, DCS). For the DIS and FGS patterns, cases with clinical evidence of moderate-severe CsA-NT (grades 3 and 4) had significantly higher average staining than either the slight-mild CsA-NT cases (grade 1 and 2) or the control cases (grade 0). The DCS pattern demonstrated significantly more staining in the moderate-severe CsA-NT cases than in the controls. The sum of individual scores for the DIS, FGS, and DCS immunohistologic pattern (CsA index) was also significantly higher in the moderate-severe CsA-NT cases (3.57 +/- 0.44) than in either the controls (1.73 +/- 0.23, P less than 0.05) or the slight-mild CsA-NT cases (1.98 +/- 0.27, P less than 0.05), demonstrating a specificity of 78% for identifying moderate-severe CsA nephrotoxicity. The extent of infiltration by Leu 2 (CD8; T cytotoxic-suppressor phenotype) positive cells was not significantly different between the moderate-severe versus the slight-mild CsA-NT outcome groups. However, when CsA index values were used in combination with the intensity of Leu-2-positive cell infiltrates to predict CsA-NT (CsA treated patients with high CsA-Ab staining as well as low levels of Leu-2 positive infiltrate) the specificity for identifying moderate-severe CsA-NT was 96%. These results suggest that CsA labeling of renal allograft biopsies may be useful for identifying CsA-NT, especially when considered with the nature of inflammatory cell infiltration. PMID- 3544380 TI - Results of conversion from cyclosporine to azathioprine in cadaveric renal transplantation. AB - Between December 1983 and August 1985, 110 cadaver transplants were performed at our institution. All were started on cyclosporine (CsA) and prednisone (P) for immunosuppressive therapy. Of the 110 patients, 46 were converted from CsA to azathioprine (AZA) for a variety of reasons (cost, toxicity, patient preference, prolonged dysfunction posttransplant, or nonresponsive rejection). The course and outcome of these patients are described. The only group of patients who had consistent benefit and stable course following the CsA-to-AZA switch were primary cadaver transplants with stable renal function (serum creatinine less than 2 mg/dl) who were converted an average of 7.97 months posttransplant. All other groups of patients had severe problems or graft loss postconversion. PMID- 3544381 TI - Antibodies to crossreactive HLA antigens. Evaluation by cytotoxicity, flow cytometry, and inhibition of monoclonal antibody binding. AB - Broadly sensitized patients have antibodies that react with cells from most individuals except those having HLA antigens similar to their own. In this work we addressed the question of whether crossreactive antigens could also be considered compatible. Broadly reactive sera were tested in multiple experiments against lymphocytes selectively mismatched for only one HLA-A, B antigen. Antibodies, measured by cytotoxicity and flow cytometry, were detected in most cases, and their prevalence was the same, regardless of whether the mismatched HLA antigen was crossreactive with the patient's. There were several patients bearing one of the A2, B5, or B7 crossreactive group antigens with antibodies against another antigen of the group. Anti-HLA-A2 reactivity was further evaluated by testing the inhibitory effect of broadly reactive sera on the binding of an anti-HLA-A2 monoclonal antibody. Anti-A2 reactivity measured in this assay was detected in A28-positive patients as frequently as in A28-negative patients. These results suggest that antigens of several crossreactive antigen groups are significantly immunogenic and elicit antibodies as often as noncrossreactive antigens. Further studies are necessary to evaluate other less frequent antigen combinations. PMID- 3544382 TI - The effect of first cadaver renal transplant HLA-A, B match on sensitization levels and retransplant rates following graft failure. AB - Data were collected retrospectively on all 449 first-transplant cadaver renal allograft recipients transplanted at four centers between 1/1/78 an 12/31/82 who had graft failure by 1/1/85. A total of 383 of these patients had information available regarding subsequent disposition. Of these, 182 (47.5%) were placed on an active waiting list for retransplantation. There were no associations found between placement on a waiting list and the following variables: panel reactive antibody (PRA) prior to first transplant or subsequent to graft failure, recipient age at first transplant or at the time of graft failure, recipient race, PRA after first graft loss, or HLA-A, B match of the first transplant. When stratified by level of HLA-A, B match as poor (0-1 antigen, n = 150) or good (2-4 antigens, n = 233) the poorly matched recipients as a group had a significantly lower mean PRA prior to first transplant (9.4 +/- 1.6 vs. 15.5 +/- 1.7, P less than 0.01), but a significantly higher PRA within the first year following graft failure (48.1 +/- 4.8 vs. 36.2 +/- 3.2, P less than 0.04). In addition, the poorly matched (vs. well-matched) group had a significantly higher mean increase in PRA following graft failure (45.1 +/- 4.4 vs. 33.7 +/- 3.5), and a significantly higher percentage of patients with PRA level greater than or equal to 60% within a year after graft failure (40% vs. 25%). Of the 182 patients who were placed on a waiting list, 113 (62.1%) were regrafted. As a group, regrafted patients had a significantly lower PRA within the first year following graft failure compared with the group not regrafted (33.6 +/- 3.9 vs. 54.0 +/- 5.0, P less than 0.002). Patients with a good first transplant HLA match had a higher overall regraft rate compared with those with a poor match (70.0% vs. 50.0%, P less than 0.01). Likewise, the percentage of well-matched patients regrafted within two years of first graft failure was significantly higher (55.5% vs. 32.5%, P less than 0.02). By multivariate analysis using the Cox proportional hazard model with 13 separate variables and considering all patients, the relative risk (RR) of not being regrafted was significantly (P less than 0.012) associated with poor HLA-A, B matching of the first transplant (RR = 1.7).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3544383 TI - Investigation of HTLV-3 serology in a renal transplant population. AB - From June 1977 to March 1985, 572 renal transplants were performed at The University of Texas Medical School at Houston. This represented 220 patients (151 cadaveric [CAD] and 69 living-related donor [LRD] recipients) treated with azathioprine and prednisone (Aza-Pred) and 352 patients (250 CAD and 102 LRD) treated with cyclosporine (CsA) and Pred. Sera from each recipient before and after transplant (Tx) as well as from each of their 436 donors (265 CAD and 171 LRD) were retrospectively tested for the presence of antibody to the human T cell lymphotrophic virus type III (HTLV-3) by enzyme immunoassay (EIA) and Western Blot analysis. Of the 436 donors tested, only 1/265 (0.38%) CAD donors were both EIA repeatedly reactive and Western Blot positive, whereas none of the 171 LRD were reactive. Pre-Tx, 4/401 (1.0%) CAD and 1/171 (0.6%) LRD recipient sera were EIA repeatedly reactive, however, all 5 were to be Western Blot negative. Post Tx, 4.2% of the sera (24/572, 4 LRD and 20 CAD recipients) were EIA-reactive. All 20 CAD recipient sera were subsequently found to be negative with Western Blot testing. However, 2 LRD sera (2/572, 0.35%) displayed EIA reactivity as well as Western Blot positivity. One LRD, Western-Blot-positive recipient is alive and well with a functioning allograft 39 months post-Tx, whereas the second LRD, Western Blot positive recipient died of septic complications 16 months post-Tx. Finally, the recipient of the Western-Blot-positive CAD allograft is alive with a well-functioning graft and remains EIA and Western-Blot-negative 36 months post Tx. PMID- 3544384 TI - Acute renal allograft rejection. Comparative value of ultrasound versus magnetic resonance imaging. AB - Both magnetic resonance imaging (MRI) and ultrasound (US) have been reported to be useful in differentiating between acute allograft rejection and other causes of graft dysfunction in renal transplantation. The aim of this study was to evaluate the comparative usefulness of these techniques in the assessment of patients with acutely rising serum creatinine levels. Seventeen patients with 19 episodes of acute serum creatinine elevations were evaluated for the presence of acute rejection. The ultimate diagnoses of acute rejection were based on either renal pathological findings, or the response to standard antirejection therapy. Clinical, US and MRI diagnoses were assessed independently, without knowledge of the results of the other evaluation techniques. We found that US alone was useful in diagnosing acute rejection (x2 = 4.95, P less than 0.05), and when taken in the clinical setting was an added advantage (x2 = 6.68, P less than 0.01). MRI did not increase the diagnostic accuracy significantly. PMID- 3544385 TI - Identification of donor factors predisposing to high discard rates of cadaver kidneys and increased graft loss within one year posttransplantation--SEOPF 1977 1982. South-Eastern Organ Procurement Foundation. AB - From 1977 to 1982, the South-Eastern Organ Procurement Foundation (SEOPF) conducted a prospective study to determine the fate of all cadaver kidneys retrieved by member institutions. During the study period, 6152 kidneys were retrieved, 1264 being discarded. Donor factors predisposing to wastage included AB and A blood groups, donor age greater than 30, hospitalization greater than 3 days, serum creatinine greater than 2.0 mg%, average systolic blood pressure less than 80, last-hour urine output less than 100 ml, proteinuria, heart not beating at time of nephrectomy, and kidneys not removed en bloc. Donor factors affecting graft survival rate at one year include age, length of hospitalization, last-hour urine output, and changing serum creatinine. The data suggest that certain donor kidneys are less likely than others to be transplanted depending on donor characteristics and retrieval practices. Furthermore, some of these factors have a negative impact on long-term success when kidneys are transplanted. PMID- 3544386 TI - Exacerbation of cyclosporine toxicity by concomitant administration of erythromycin. AB - Cyclosporine (CsA), an immunosuppressive drug widely used in clinical organ transplantation, causes a variety of side effects, including parenchymal complications of nephrotoxicity and hepatotoxicity. Erythromycin ethinylsuccinate (EES), a macrolide antibiotic frequently administered to transplant patients afflicted with pneumonias caused by Mycoplasma pneumoniae and Legionella pneumophila, markedly potentiated parenchymal drug toxicity in nine (three renal and six cardiac) CsA-treated allograft recipients. The mean and median blood urea nitrogen (BUN), creatinine, and total bilirubin increased upon initiation of EES treatment: in the renal recipients from 27, 1.7, and 0.5 mg/dl, respectively, before, to a mean and median of 81/101, 8.3/3.9, and 2.1/1.2 mg/dl during, and to 72/22, 1.9/1.7, and 0.6/0.5 mg/dl after cessation of EES treatment. The median serum radioimmunoassay (RIA)-determined CsA trough value of 147 ng/ml prior, rose to a zenith of 1125 ng/ml during, EES therapy. In the six cardiac recipients, the mean and median BUN, creatinine, and total bilirubin of 51/45, 1.5/1.3, 1.2/1.3 mg/dl, respectively, before, rose to 100/91, 3.7/3.6, and 2.3/2.1 mg/dl during, and fell to 49/44, 1.8/2.1, and 1.0/0.8 mg/dl after, cessation of EES. The mean serum CsA trough value of 185 ng/ml rose to 815 ng/ml during EES administration. Since EES and CsA are both metabolized by the hepatic cytochrome P450 mixed function oxidase system, simultaneous use of these two drugs may decrease CsA metabolism, with consequent elevation of blood levels and induction of CsA toxicity. Therefore, blood level monitoring and careful regulation of CsA dose are necessary, in order to achieve the safe use of EES in transplant recipients. PMID- 3544387 TI - Thin-layer chromatographic detection of cyclosporine and its metabolites in whole blood using rhodamine B and alpha-cyclodextrin. AB - High-performance thin-layer chromatography (HPTLC) has advantages for the analysis of cyclosporine (CsA) and its metabolites in peripheral blood not shared by the radioimmunoassay (RIA) or high-performance liquid chromatography (HPLC) methods. While separation by HPTLC and HPLC is based on relative hydrophobicity, HPTLC (unlike HPLC) is capable of concurrent multisample analysis without expensive instrumentation. As distinguished from RIA, HPTLC detects CsA and metabolites as separate components, and does not use radioactive reagents. A novel rhodamine B/alpha-cyclodextrin stain was developed and the characteristic retention factors (Rf values), as determined by the ratio of the migration distance of a component in relation to the solvent front, were determined for the mobile phase heptane: pyridine: ethyl acetate (100: 75: 1, v/v) on aminopropyl bonded silica gel HPTLC plates: 0.65, cyclosporin D (CsD); 0.60, CsA; 0.50, dihydrocyclosporin C (dhCsC); 0.42, metabolites M-21 and M-17; 0.40, M-1; 0.35, M E; 0.25, M-D; and 0.22, M-A. Metabolite M-18 showed migration similar to that of M-17 using a mobile phase of heptane: pyridine: acetonitrile (5:2:1, v/v) in the 0.60-0.50 range. The metabolite profiles were obtained in 8 patients receiving the drug for the first time. The HPTLC analytical technique identifies CsA and its metabolites in peripheral blood and offers advantages for pharmacologic monitoring of transplant patients. PMID- 3544389 TI - The evaluation and relevance of autolymphocytotoxic antibody in the highly presensitized patient. PMID- 3544388 TI - Expression of major histocompatibility complex antigens and replacement of donor cells by recipient ones in human liver grafts. AB - The disappearance of certain cell populations of donor origin and their replacement by recipient-specific cells constitutes a possible explanation for the relatively mild course of acute rejection despite lack of MHC compatibility in human orthotopic liver transplantation (OLT). In the present report, graft biopsies of 12 OLT patients from a total of 42 patients were studied for expression of MHC antigens after transplantation using monoclonal antibodies to HLA-ABC and HLA-DR. The patients were selected based upon donor-recipient mismatching for HLA-A2, B7, Drw52, or DQw1. Monoclonal antibodies to these 4 polymorphic HLA antigens and monoclonal antibodies to HLA-ABC and -DR were applied to frozen tissue sections and visualized using an immunoperoxidase technique. Expression of HLA-ABC and -DR on, respectively, hepatocytes and bile duct epithelium were observed in posttransplant graft conditions such as viral infections, cholangitis, and acute rejection. However, no specific pattern of MHC antigen distribution was observed for these various pathological graft conditions. Disappearance of DR-positive Kupffer cells of donor origin and immigration of recipient ones was encountered in the early posttransplant biopsies. This Kupffer cell replacement coincided with a reversible episode of acute rejection. The disappearance of highly immunogenic cellular components as HLA-DR positive Kupffer cells of graft origin may be one of the mechanisms contributing to the mild rejection response observed in human liver transplantation. PMID- 3544390 TI - The use of the cava-cava bypass in an experimental liver transplantation model. PMID- 3544391 TI - The role of natural killer cells in resistance to allogeneic and parental hybrid resistance. PMID- 3544392 TI - Erythromycin-cyclosporine interaction in renal transplant recipients. PMID- 3544393 TI - Double failure of influenza vaccination in a heart transplant patient. PMID- 3544394 TI - Thoracic-duct-to-esophagus shunt. PMID- 3544395 TI - Biomedical research for tropical health. Proceedings of a symposium on the occasion of the official opening of the N.H. Swellengrebel Laboratory of Tropical Hygiene. Amsterdam, 24 May, 1985. PMID- 3544396 TI - Gardnerella vaginalis associated vaginitis: a review. PMID- 3544397 TI - Immunohistological investigations in chronic cutaneous leishmaniasis in Saudi Arabia. AB - The distribution and numbers of IgG-, IgA-, IgM-, and lysozyme-positive cells were investigated by the immunoperoxidase method in paraffin-sections of 13 cases of chronic cutaneous leishmaniasis of low parasite load from Saudi Arabia. The majority of the peroxidase-positive plasma cells contained IgG, whereas the numbers of IgA+ and IgM+ plasma cells were not so numerous. Small groups of squamous epithelial cells showed immunoreactivity for IgG and IgA. Similar positive staining was observed extracellularly in the oedematous upper dermis, in the endothelial cells, and in the perivascular space. The activated macrophages showed strong and diffuse peroxidase staining for lysozyme, whereas epithelioid cells and multinucleated giant cells were negative or had finely granular and considerably weaker staining. It is suggested that humoral immunity also participates in the elimination of the parasites and an immunologically induced necrosis might be responsible for the ulceration of the skin in cutaneous leishmaniasis. It is also assumed that the lysozyme immunoreactivity can be a marker of the activation state of the macrophages. PMID- 3544398 TI - [The use of the polyene-resistant mutation model in Saccharomyces as a test system for detecting genetically active substances]. AB - The simple test-system has been developed to register mutagenic activity of different chemicals using a model of forward polyene-resistant mutations in Saccharomyces cerevisiae. PMID- 3544399 TI - [Decontamination of cell cultures by removing mycoplasmas: a comparison of 3 methods]. AB - Three different methods of decontamination of cell cultures from mycoplasma were compared: by macrophages in the presence of antibiotics, by ultraviolet radiation in the presence of 5-bromuridin and Hoechst-33258, by cloning of cells in the presence of antibiotics metacycline and doxicycline. Only the latter method was effective to decontaminate the cell cultures from mycoplasma. Twelve cell lines were decontaminated and tested for the presence of mycoplasma by microbiological method, by staining with the dye Hoechst-33258 and autoradiography. All the cell lines were free of mycoplasma. PMID- 3544400 TI - Simple and rapid dot-enzyme immunoassay for visual detection of rinderpest antibodies in bovine and caprine sera. AB - A modified solid phase enzyme immunoassay (EIA) is described for visual detection of anti-rinderpest virus (RPV) antibodies in cattle and goat sera. Dots of RPV antigens were adsorbed to nitrocellulose (NC) paper (hence Dot-EIA) and the adsorptive reactive sites were blocked with skim milk powder. After immersion in bovine or caprine test serum bound antibodies were reacted with a peroxidase conjugated anti-bovine or anti-caprine IgG (H & L), respectively. Positive reactions were easily visualized as red-brown dots after enzyme degradation of a substrate containing hydrogen peroxide and amino-ethylcarbazole (AEC). The Dot EIA was comparable to the serum neutralisation (SN) test in its ability to detect antibody in bovine sera seven or ten days after experimental infection (DPI) with live attenuated Kabete "O" (RBOK) strain of RPV (grown in Vero cells) by a combination of subcutaneous (s/c), intravenous (i/v) or intranasal (i/n) routes. Early (seven DPI) RPV antibodies were detected in a serum sample from one goat experimentally infected with RPV by combined s/c-i/v routes but not in another goat only infected intranasally. The specificity of the Dot-EIA was equal to that of the SN test, as serum samples, collected from these experimental animals and those inoculated with non infected Vero cell culture fluid, with SN titres of 0.3 or lower were all negative by Dot-EIA. The Dot-EIA may have potential application as a rapid, simple and economical field test in diagnosis of rinderpest, vaccination surveillance and other seroepidemiological studies. PMID- 3544401 TI - The value of immunohistological techniques in undifferentiated cancers. AB - From 1980 to 1984, we observed 144 undifferentiated cancers, of which 116 (0.9% of all cancers treated during this period) were treated in our center. Immunohistochemical study classified 130 tumors (90%), which comprised 82 non Hodgkin's lymphomas (57%), 32 carcinomas (22%), 7 melanomas (5%), 7 sarcomas (5%) and 2 others (1%). Sixty-nine patients, with the diagnostic problem of non Hodgkin's lymphoma versus carcinoma, which was solved by immunohistology, were followed up for 44 +/- 20 months. Lymphomas (57 cases) had a better clinical course than carcinomas (11 cases), and a clinical course similar to high-grade lymphomas identified by conventional histology. For 66 patients with the same problem, the treatment was started before the immunohistochemical diagnosis. This treatment was inappropriate in the light of the correct diagnosis in 16 of 66 cases (24% of all cases). PMID- 3544402 TI - Serial transplantation of a human acute T lymphoblastic leukemia into nude mice. AB - A human acute T lymphoblastic leukemia line (PF-382) was serially transplanted into nude mice. No takes were observed in untreated nude mice, whereas solid tumors were observed in splenectomized and total body, sublethally irradiated mice. The minimal tumor-inducing dose and the latency time remained unchanged after the third and fifth serial transplants. Moreover, leukemic cells recovered from the 8th in vivo passages displayed the same differentiation antigens and chromosomal markers as the in vitro PF-382 cell line used for the first transplant. This stable and well-characterized experimental system could be a new model for T-lymphocyte differentiation and immune-reactivity against human leukemias. PMID- 3544403 TI - Cancer of the pancreas: clinical outcome in 76 cases. AB - A final diagnosis of pancreatic cancer was established in 76 consecutive patients during 4 years. The clinical outcome was evaluated retrospectively, as well as clinical presentation and its impact on the rate of resectability. Even though the diagnostic techniques showed a high sensitivity, only 18.4% of patients had a radical resection performed. In 77.6% of the cases a tissue diagnosis had been obtained. However, in only 1/5 of them was the tissue proof obtained preoperatively. This review confirms that the survival of patients with pancreatic cancer is poor, with slight advantages in the few resectable cases. Therefore, an earlier diagnosis should be attempted in high-risk symptomatic patients, selected by means of nonaggressive tests and evaluated by means of more accurate diagnostic techniques, when suitable. PMID- 3544404 TI - Antitumoral activity of the oxazaphosphorine derivative, mafosfamide cyclohexylamine salt (ASTA 7557) on a murine ovarian reticular cell sarcoma and its subline resistant to cyclophosphamide. AB - The antitumor activity of mafosfamide (MFA), and its parent compound cyclophosphamide (CTX), was investigated against an ovarian reticular cell sarcoma growing i.m. in C57BI/6 mice (M5), which is very sensitive to CTX, and against a subline of this tumor (R16) resistant to CTX. MFA is the prototype of a class of oxazaphosphorines which do not require metabolic activation since under physiologic conditions they undergo rapid spontaneous hydrolyzation to the activated 4-hydroxyoxazaphosphorine and retain a spectrum of activity very similar to the parent compound. After a single dose (300 mg/kg X 1) or repeated low doses (100 mg/kg X 6) the antitumoral activity of MFA on the M5 tumor appeared comparable to or only slightly lower than CTX; the highest T/C value for median survival times was 167% in MFA-treated mice vs. 176% in the CTX group. MFA showed no activity against the R16 subline, thus indicating cross-resistance between the two drugs. Marked thickening of the glissonian capsule with compression of the lobular area of the liver, observed on i.p. administration of MFA, did not result in histopathologic abnormalities of the hepatic parenchyma. The therapeutic efficacy of MFA was similar with i.p. and the i.v. route. MFA may represent a good candidate to replace CTX in cases in which a compound acting per se, and not through metabolites, is preferred. PMID- 3544406 TI - [Isolated fever and anthrax of the kidney]. PMID- 3544405 TI - [Infections by Streptococcus group B]. PMID- 3544407 TI - [Neurospecific cytoskeletal proteins]. AB - Data available in literature on neurospecific proteins of cytoskeletal structures -microtubules, microfilaments and intermediate filaments are generalized. Properties of tissue-specific cytoskeletal proteins which are typical of nerve cells are summarized. The structure, physicochemical properties, cell localization, metabolism and function of cytoskeletal proteins are characterized. The coexpression and interaction of different cytoskeletal structures are considered. An analysis of neurospecific cytoskeletal proteins is of great practical importance for neurobiology, neurooncology, neurosurgery. The proteins can be used as markers of different pathologies in the nervous system. PMID- 3544409 TI - [The effect of lithium treatment on calcium and phosphate metabolism in man]. PMID- 3544410 TI - [Hypercalcemia in early childhood associated with cardiovascular abnormalities]. PMID- 3544408 TI - [Effect of arginine on the activity of proteolytic enzymes in the rat brain and liver]. AB - The influence of arginine on autolysis and proteolysis was studied. Arginine at the concentration of 0.5 and 1.0 microM/ml was added to the incubation mixture. Proteolytic processes were studied in the acid, neutral and alkaline media (pH 4.5; 7.4; 8.5). Autolysis was determined by incubation of the brain and liver homogenates and proteolysis by the use of bovine serum albumin as a substrate. Autolytic and proteolytic activities were calculated as an increase of Folin positive compounds or amino nitrogen in the samples. It was established that the influence in vitro of arginine on the proteolytic processes depended on pH, type of the peptide-hydrolases, to a lesser extent, on the arginine concentration and did not depend on the tissue type. Arginine displayed its regulative action in the brain and liver by the same way. The addition of arginine had an effect on autolysis and proteolysis in the neutral and alkaline media. Determination of autolytic and proteolytic activities by Folin positive compounds has shown that arginine addition into the samples decreased autolysis and proteolysis. At the same time determination of autolysis and proteolysis by amino nitrogen in the presence of arginine has shown that autolytic and proteolytic activities increased. PMID- 3544411 TI - [Calcium antagonists in Raynaud's disease]. PMID- 3544412 TI - [Ultrasonographic localization of parathyroid tumors in patients with primary hyperparathyroidism]. PMID- 3544413 TI - [Early screening of pregnant women in order to optimize the gestational age]. PMID- 3544414 TI - [Complete intravenous anesthesia for minor surgical interventions. Evaluation of the quality of anesthesia and recovery]. PMID- 3544415 TI - [Kidney donor problems. Evaluation of the extent of available cadaver kidneys]. PMID- 3544416 TI - [Positive expiratory pressure (PEP) used preventively in thoracic surgery]. PMID- 3544417 TI - [Flupentixol (Fluanxol) or diazepam in the treatment of various psychosomatic conditions. A controlled double-blind multicenter study]. PMID- 3544418 TI - [Arthroscopic suturing of menisci]. PMID- 3544419 TI - [Cocaine addiction]. PMID- 3544420 TI - [Pre-excitation syndrome. Arrhythmias caused by accessory conduction bundles]. PMID- 3544422 TI - [Metastatic occult primary cancer]. PMID- 3544421 TI - [Pulmonary side-effects of antineoplastic chemotherapy]. PMID- 3544423 TI - The use of ultrasound in developing countries. PMID- 3544424 TI - Bibliography of biomedical ultrasound. No. 60. PMID- 3544425 TI - [A lighter format and a section on continuing medical education]. PMID- 3544426 TI - [In memory of Dr. Andre Barbeau 1931-1986]. PMID- 3544427 TI - [The elderly and physical activity: reasonable estimates of its intensity]. PMID- 3544429 TI - [Integration of microcomputers (management and learning assistance) in a medical teaching unit]. PMID- 3544428 TI - [Epidemiologic surveillance and the environment. 2]. PMID- 3544430 TI - [Bone marrow toxicity due to cimetidine]. PMID- 3544431 TI - ["Anemia". An instructional aid program for medical students]. PMID- 3544432 TI - Malignant melanoma over a fifty-year period: a histological evaluation. AB - The incidence of primary cutaneous malignant melanoma is increasing in the developed countries. Cutaneous malignant melanomas diagnosed in our Department over a period of fifty years from 1930 to 1980 were examined to see if there was any change in their histological features. In 1930 and 1955, over 90% of malignant melanomas presented as tumours infiltrating deep into the subepithelial tissue. By 1980, 55% of tumours presented with deeply infiltrating lesions and only 20% occurred at a stage where adequate local excision could provide hope of a cure. There is thus a need for greater awareness among the medical profession and the public if we hope to be able to treat malignant melanomas at an early stage. PMID- 3544433 TI - The first hysterectomy in Northern Ireland? PMID- 3544434 TI - Tracing tissues with N-nitrosamine-metabolizing capacity. PMID- 3544435 TI - Methods for production and detection of monoclonal antibodies against surface components of adhesive implanting mouse blastocysts. AB - Monoclonal antibodies against mouse blastocysts in the adhesion stage of implantation were obtained by intrasplenic immunization with blastocysts either injected into the spleen after irradiation or transferred after drying on a piece of nitrocellulose paper. About 10 blastocysts were deposited at each of 4 immunizations before the spleen cells were used for hybridoma production. The supernatants obtained were examined for anti-blastocyst antibodies in indirect immunofluorescence labelling of native blastocysts and with ABC-immunoperoxidase staining either of blastocysts attached to nitrocellulose paper or of methanol fixed blastocysts. Further, sections of paraffin-embedded blastocysts were used for detection of antigens. PMID- 3544436 TI - Consideration on the history of lithogenesis. PMID- 3544437 TI - Pathophysiology of stone formation. AB - Urinary stone disease is a multifactorial disorder arising essentially from an abnormal combination of a number of urinary risk factors. In the case of calcium urolithiasis the main risk factors are a low urine volume, a high urinary pH, increased excretions of calcium, oxalate and uric acid and a low net level of inhibitory activity against the crystallization of calcium salts. The last mentioned, in turn, is dependent on the balance between the macromolecular inhibitors, including glycosaminoglycans, ribonucleic acid and acidic glycoproteins, and the promoters of crystallization such as Tamm-Horsfall mucoprotein. There is currently some debate as to whether or not an immunological factor might also be involved in the renal tubules, which results in crystals becoming bound to the renal epithelium. PMID- 3544438 TI - Clinical aspects of stone formation and conservative treatment. AB - Clinical aspects of stone formation and conservative treatment need to consider the following factors: Epidemiological studies and their knowledge are necessary as they have permitted important conclusions with the regard to risk and history of urolithiasis. Laboratory diagnosis is a prerequisite to therapy. Mode and extent of laboratory investigations depend whether or not proven measures can result. The distinction between practice and research and their demands must clearly be made. Risk-orientated laboratory parameters must be assessed from a point of view which concentrates on the possibility of therapeutic influence. Looking for and finding abnormal values is more likely to satisfy the statistician than the clinician. The choice of treatment depends not only on laboratory values but also on the individual characteristics of the patient such as sex, age, occupation and education as well as general state of health and its impairment by stone recurrence. Classic (diuresis and diet) as well as drug therapy need clear indications, where risk and benefit must be balanced individually. Therapy needs to be controlled on the one hand in order to make indications safer through increasing experience, and on the other hand to make indications preciser by the analysis of failures. PMID- 3544439 TI - Extracorporeal shock wave lithotripsy. AB - Urolithiasis represents the symptomatic manifestation of various metabolic disturbances which persist after elimination of the immediate problem, i.e., urinary stones, and may lead to the development of recurrent stones. Invasive surgical removal of recurrent stones is sometimes associated with considerable problems. Against this backdrop it is not surprising that after development (1974 1980) and clinical testing (1980-1982) at the Department of Urology of the Ludwig Maximilian University in Munich, a meanwhile clinically proven method of totally noninvasive extracorporeal lithotripsy (ESWL) has disseminated within a relatively short time (from October 1983), first in West Germany (April 1986: 20 ESWL centers) and later all over the world (April 1986: 133 ESWL centers). With the advent of ESWL and semiinvasive techniques of stone extraction (percutaneous lithotripsy, ureterorenoscopy) a transformation of the therapeutic strategy for urolithiasis has been ushered in. PMID- 3544440 TI - Rational prevention of calcium urolithiasis. AB - Considerable progress has been made regarding pathogenesis, diagnosis and conservative management of urolithiasis. The cause of the disease can now be determined in nearly 80% of the patients. New stone formation may be prevented in the majority of patients by selective medical treatment. The metabolic, physicochemical and clinical effects of diet, thiazides, allopurinol, sodium cellulose phosphate and potassium-sodium citrate (Oxalyt-C) are described in detail. Intrinsic problems involved in clinical trial with recurrent stone formers are discussed. PMID- 3544441 TI - Regulatory and legal aspects of outpatient surgery. AB - This is a brief summary of the regulatory and other legal issues that may be raised by the provision of surgery outside of the hospital environment. Despite these potential problems, however, outpatient surgery embodies significant potential for hospitals, physicians, patients, and third-party payers. Outpatient surgical facilities embody the potential to achieve two of the government's primary goals: the provision of high-quality services and the reduction of health care costs. Third-party payers, similarly, are increasingly recognizing the benefits of outpatient surgery. Some are providing "facility" payments to cover the overhead costs of such facilities, or at least, providing an add-on to physicians' professional fees, for example, UCR (usual and customary rates) plus 20 per cent, if surgery is conducted in an office setting. Health maintenance organizations and other alternative delivery systems are actively seeking to enter into contracts with ambulatory surgical centers to provide outpatient surgical services to their enrollees because HMOs and other alternative delivery systems maximize profits by decreasing inpatient hospital utilization. In the years ahead, certificate of need and other regulatory barriers to the establishment of ambulatory surgical centers may fall as states increasingly begin to reassess the costs and benefits of certificate of need programs. In short, the trend toward outpatient surgical facilities and outpatient care generally is one that is here to stay. PMID- 3544442 TI - Outpatient implantation of penile prostheses under local anesthesia. AB - Penile implantation can be accomplished safely under local anesthesia on an outpatient basis. This reduces cost and should be considered more frequently than the current practice. The techniques and routines for performing penile implantation under local anesthesia are described. PMID- 3544443 TI - [Transcutaneous puncture drainage of the kidneys under ultrasonic control in children]. PMID- 3544444 TI - [Clinico-diagnostic aspects of the use of proteases and dimexide in orchiepididymitis]. PMID- 3544445 TI - [Sclerosis of the bladder neck]. PMID- 3544446 TI - The importance of diet in urinary stones. PMID- 3544447 TI - The amino acid factor in stone formers' and normal urines. AB - The composition of amino-acids in kidney stone matrices and inhibitory materials from normal urines, reported in different independent studies has been reviewed. No obvious difference was found between the composition of amino acids from healthy and pathological sources. Studies carried out in this laboratory showed a specific marked effect of glutamic acid on the crystallization of calcium oxalate while aspartic acid and alanine affected the process very slightly. It is known that aspartic acid and alanine are transformed into glutamic acid by enzyme activity. A short survey performed in this laboratory showed that the relevant enzyme activity was relatively high in healthy urine and low in stone formers' urine. The AA factor (FAA) proposed is FAA = [Glutamic acid]/[( Aspartic acid] + [Alanine]) its value in fractions of non-potent inhibitory material and in kidney stone matrices is below 0.6. In potent portions of the inhibitory material separated from healthy people and young animals urine the value is 0.8 and above. PMID- 3544448 TI - [Percutaneous kidney surgery. Puncture and dilatation in the hands of the surgeon]. AB - The technique of puncture and dilatation "in the hands of one" is described in detail based on over 800 percutaneous operations on the kidney. All of the steps of the operation were carried out by the urologist himself. The advantages are presented and two new percutaneous instruments are introduced: a percutaneous working sheath and the lumbotome, a wire-guided, double blade knife for cutting the percutaneous tract. PMID- 3544449 TI - [Sonography--the most important study in the early detection of renal cell carcinoma]. AB - Abdominal ultrasound as a routine procedure in various nonurological diseases reveals the greatest number of incidentally diagnosed renal cell carcinomas. These tumors are representing lower tumor stage and grade offering a much better prognosis as compared to symptomatic ones. Therefore sonography is mandatory in all urological standard examinations. PMID- 3544450 TI - [Demonstration of complications caused by implantable catheter systems in regional arterial infusion therapy of tumors of the pelvis (bladder cancer). Radiologic and nuclear medicine control possibilities]. AB - Loco-regional intra-arterial infusion chemotherapy is gaining momentum in modern tumor therapy. Cytostatica are delivered by an implantable system. Because of high tissue toxicity of chemotherapy functioning of the system must be assured and controls should be simple and reliable. The system implanted in 10 pat. with bladder-cancer (p T3 a-b) was checked by radiological and radionuclide diagnostic means before each chemotherapy. Both techniques proved valuable. Good and deficient functions are demonstrated. PMID- 3544451 TI - [Pelvic lipomatosis]. PMID- 3544452 TI - Update on oncogenes and relevance in urology. PMID- 3544453 TI - Simultaneous transplant nephrectomy and ipsilateral second graft retransplantation. AB - Six cases of simultaneous transplant nephrectomy and retransplantation in the ipsilateral iliac fossa are presented. All primary grafts were lost due to chronic rejection. Patients were followed from forty-one to one hundred months after the second graft transplant. The sources for all grafts were either living related donors or cadavers. Graft nephrectomy was performed through the previous lower quadrant incision; the arterial and venous stumps of the primary grafts were used when possible. In all cases continuity of the urinary tract was reestablished with a Politano-Leadbetter ureteroneocystostomy. There appears to be no increased morbidity in any of these 6 cases, and the survival rate of the second graft is comparable to that of transplantation into the contralateral virginal fossa. Advantages of the simultaneous procedure are discussed. PMID- 3544454 TI - Infertility in spinal-cord injured male. AB - Sterility in spinal-cord injured (SCI) men is believed to be caused by ejaculatory dysfunction, genital ductal blockage secondary to infection, and/or impaired spermatogenesis. Semen from SCI men demonstrates diminished numbers of motile, morphologically normal sperm. Testicular biopsies demonstrate impaired spermatogenesis. Leydig and Sertoli cells appear to be normal. Endocrine evaluations reveal normal testosterone levels with an adequate Leydig cell reserve. Luteinizing hormone (LD) and follicle-stimulating hormone (FSH) levels are normal or high with normal or exaggerated stimulation responses. Acute depressions in testosterone, FSH, and LH levels can be seen following SCI, most markedly in quadriplegics. A normal hypothalamic-pituitary-testicular axis is implied by these findings, indicating a primary hypogonadism. Causes of impaired spermatogenesis may include local testicular temperature elevations, nondrainage of the reproductive tract, antisperm antibodies, and recurrent genitourinary infections. Treatment of infertility involves removal of these offending factors, and research is needed to correlate the impaired spermatogenesis with these factors. PMID- 3544455 TI - Diuretic renography in evaluating dilated upper urinary tract in children. AB - The diuretic renogram provides a previously unavailable noninvasive method for assessing and following urinary tract dilation of diverse cause, and defining true obstruction in children. Technetium-99m-DTPA (diethylenetriaminepentaacetic acid) is injected intravenously and a posteriorly placed gamma scintillation camera used to image the kidneys, ureters, and bladder. Furosemide is subsequently injected to stimulate a diuresis, and the washout pattern of isotope is monitored (time-activity histogram). Nonobstructive, obstructive, and poor renal function patterns were seen. Forty patients with varying degrees of hydroureteronephrosis were evaluated. Tracings were performed serially and compared with the clinical course in time, as well as with pressure flow studies and operative findings. All patients with a nonobstructed diuretic renogram did well, except for 1 boy in whom ureteropelvic obstruction developed later. Difficulty in evaluating the obstructive renogram pattern occurred only in some children with severe (grade V) hydronephrosis. Further standardization of the diuretic renogram with regard to time of diuretic injection, state of patient hydration, and regions of imaging may improve diagnostic accuracy. PMID- 3544456 TI - Finochietto hand retractors. PMID- 3544457 TI - Ultrasonography and needle aspiration in diagnosis of xanthogranulomatous pyelonephritis. AB - Xanthogranulomatous pyelonephritis may present as a renal mass which can be difficult to differentiate from a hypovascular renal tumor by intravenous pyelography or selective renal angiography. Four patients are described in whom ultrasonography with or without fine-needle aspiration suggested or confirmed the diagnosis of xanthogranulomatous pyelonephritis. PMID- 3544458 TI - [Echography in the diagnosis of paranasal sinus diseases]. PMID- 3544459 TI - Lymphocytic depletion of bursa of Fabricius and thymus in chickens inoculated with Escherichia coli. AB - Specific-pathogen-free 10-week-old chickens were inoculated via the air sac with Escherichia coli and showed lymphocytic depletion of bursa of Fabricius and thymus. In experiment I, chickens were necropsied at 12 and 24 hours, 2, 3, and 5 days after inoculation. At 12 hours after inoculation there was lymphocytic depletion in the medulla of lymphoid follicles of the bursa. At 24 hours after inoculation there was lymphocytic depletion also in the cortex of follicles and edema in interfollicular interstitium and follicular medulla. At 2 and 3 days after inoculation there were more marked lymphocytic depletion in medulla and cortex, and fibrosis in interfollicular interstitium. Partial repopulation of follicles with lymphocytes was seen at 5 days after inoculation. In the thymus, lymphocytic depletion occurred in the cortex. At 12 hours after inoculation, lymphocytic necrosis increased in number more than that of control chickens. The width of the cortex and medulla decreased. At 24 hours after inoculation, lymphocytic necrosis increased further. At 2 to 5 days after inoculation, the boundary between the cortex and medulla of lobules was obscure and cellular elements of the cortex and medulla were mingled. In experiment II, chickens were necropsied as in experiment I and also at 8 and 14 days after inoculation. The relative weights of the bursa and thymus reduced rapidly to minimal relative weights at 8 days after inoculation. At 14 days after inoculation, both bursa and thymus had normal relative weights and histological structures. These findings indicate that E. coli infection may induce transient lymphocytic depletion of lymphoid tissues in the chicken. PMID- 3544460 TI - Control of diarrhoea and septicaemia in colostrum deprived calves. PMID- 3544461 TI - Lack of effect of selenium supplementation on the incidence of weak calves in dairy herds. AB - A double blind controlled trial was carried out on four commercial dairy herds, to investigate the effect of one 50 mg injection of selenium, 10 days before parturition, on the incidence of weak calves. Although the treatment marginally increased the selenium status of treated calves it did not decrease the incidence of the weak calf syndrome. PMID- 3544462 TI - Another animal Escherichia coli cytopathic factor. PMID- 3544463 TI - Ultrasonic scanning. PMID- 3544464 TI - Immunofluorescence as a potential diagnostic method for turkey rhinotracheitis. PMID- 3544465 TI - Serological detection of phage infection in Chlamydia psittaci recovered from ducks. AB - Antiserum prepared against a phage which infects a Chlamydia psittaci isolate recovered from domestic ducks was used to screen other recent avian C psittaci isolates by indirect immunofluorescence. Two more phage infected strains from ducks were discovered. However, phage was not detected in every isolate examined from common source ducks, although such birds are likely to be infected with the same C psittaci strain. Moreover, phage could not always be demonstrated by indirect immunofluorescence in McCoy cell monolayers infected with the phage containing strain. The results suggest that phage infection is probably an integral part of duck chlamydiosis in the United Kingdom at present, but that the infection is often cryptic. PMID- 3544466 TI - Inactivated oil-adjuvant Gladysdale strain vaccine. PMID- 3544467 TI - Excretion of S typhimurium from a cow's udder. PMID- 3544468 TI - Comparison of some ovine Chlamydia psittaci isolates by indirect immunofluorescence. AB - Four ovine abortion isolates, including the A22 vaccine isolate, and an isolate from a case of lamb arthritis, were compared by indirect immunofluorescence using antisera raised in chickens and mice. Cross titrations with homologous and heterologous antisera showed a one-way reaction between the single chlamydial isolate from a lamb with arthritis and the four isolates from cases of ovine enzootic abortion. The abortion isolates could not be distinguished. PMID- 3544469 TI - Differences in fluorescent antibody staining of bovine respiratory syncytial virus-infected cells by ovine and bovine sera. AB - In indirect fluorescent antibody tests in which sera from cattle and sheep with respiratory disease problems were used to stain foetal bovine lung cells infected with a bovine respiratory syncytial virus strain, differences were noted in the pattern of fluorescence produced by some sheep sera and that produced by positive bovine sera. In serum neutralisation tests, also using a bovine respiratory syncytial virus strain, 4 of 7 sera giving this atypical pattern of fluorescence had very low neutralising antibody titres (highest 1/4), and 3 were negative. It is suggested that two related but antigenically distinguishable respiratory syncytial virus types are present in sheep, one of which is similar to bovine strains. PMID- 3544470 TI - [Diseases of the fallow deer in northeastern Bulgaria and their prevention]. AB - Stated are the values of the basic microelements in fallow deer in the region of Northeast Bulgaria as established through biogeochemical analysis. In unfavourable years metabolism is disturbed resulting in lowering the defense mechanism of the body. A number of bacterial species, and, more specifically, Escherichia coli increase their virulence and cause gastrointestinal disorders and diseases. Copper, selenium, and arsenic deficiency lead to endemic ataxia with characteristic clinical symptoms--the so-called spring diarrhea and endemic paresis. The Microsal Nesse polymicroelement preparation has been tested to prevent diseases as applied to the drinking water and to the forest and fruit silage. It contributes to strengthening the resistance of fallow deer, lowering the chronic diseases of the lungs, stomach, and intestines as well as to improving the shooting trophies. PMID- 3544472 TI - [Differentiation of strains of the swine fever virus depending on their temperature resistance at 56 degrees C and on the size of fluorescent plaques]. AB - In vitro and in vivo experiments were carried out to differentiate the virulent swine fever virus strain Vratsa and the vaccinal strains K and VP with regard to their resistance at 56 degrees C and to the size of the fluorescent plaques. The results obtained were comparable. The virulent strain was found to retain its viability at temperature of 56 degrees C for 30 min. The heated virus formed large, strongly fluorescent plaques in the infected cell cultures of pig kidney. The fluorescent cells were enlarged, and their cytoplasm was granular. The treated virus retained its pathogenic properties. Pigs inoculated with the inactivated Vratsa strain contracted the disease and died. Prior to heating the vaccinal strains formed small fluorescent plaques in cell cultures. The fluorescent cells had normal size and homogenic structure. Following heating at 56 degrees C for 15 min the vaccinal viruses retained partially their viability. Thus inactivated the viruses formed a limited number of fluorescent plaques of low intensity. PMID- 3544471 TI - [Enhanced luminescence intensity in immunofluorescent preparations following trypsin treatment]. AB - Comparative investigations were carried out on the immunofluorescent preparations of cell cultures infected with bovine viruses--rota-, corona-, respiratory syncytial, parainfluenza-3, adeno-1, and herpes-1--to test various fixatives and the effect of trypsin in raising the sensitivity of the immunofluorescence method. The effect of trypsin was manifested in fixation with formalin, ethanol, methanol, and acetone treated immunofluorescent preparations of cell cultures infected with rota- and adeno-viruses as well as in fixation with acetone of cultures infected with respiratory syncytial virus, parainfluenza-3 virus, and corona virus. Formalin, ethanol, and partly methanol were shown to be unsuitable for the purpose of fixation of cell culture preparations infected with viruses that contained a lipoprotein envelope. It was found that the treatment of immunofluorescent preparations with trypsin following fixation and prior to their treatment with conjugated antisera enhanced considerably the number of fluorescent cells and the intensity of fluorescence itself provided 0.1 per cent trypsin was used for 5 to 10 min at 37 degrees C--for cell culture preparations, and 0.1 per cent trypsin was used for 20 to 30 min at 37 degrees C--for paraffin sections of acetone-fixed tissues. PMID- 3544473 TI - [The culturing of liver cells]. PMID- 3544474 TI - Characterization of phage 18, an unstable coliphage. AB - Phage 18, a noninducible coliphage, is quite unstable and therefore difficult to study. Newly developed very gentle lysis and mounting techniques yielded isolated virions for examination by electron microscopy. The phage has a contractile tail with a length of 130 nm and an isometric head with a capsid diameter of 50 nm. Phage 18 is similar in morphology to phage P2 but is heteroimmune to it. DNA extracted from a clear-plaque mutant of phage 18 was subjected to BamHI restriction endonuclease digestion and was found to be easily distinguishable from the published restriction patterns for P2, phage 299, or phage 186 DNA. The genome size was calculated to be 33.5 kb. Using the DNA melting point, phage 18 DNA (G+C) content was determined to be 55.0% and its buoyant density was determined to be 1.715. PMID- 3544475 TI - Spontaneous reversion of a C/T transition mutation in the adenovirus endoproteinase gene. AB - A temperature-sensitive mutation (H2ts1) that abolishes the viral endoproteinase activity at the nonpermissive temperature has been mapped by marker rescue between map coordinates 59.8 and 61.9 on the adenovirus type 2 genome. The mutation has been identified by sequencing to be a C/T transition at coordinate 61.1 changing a proline residue to a leucine residue and eliminating a HaeIII restriction enzyme cleavage site (L. Yeh-Kai, G. Akusjarvi, P. Alestrom, U. Pettersson, M. Tremblay, and J. Weber, 1983, J. Mol. Biol. 167, 217-222). This feature of the mutation offered a convenient assay to distinguish between true revertants and suppressor mutations among phenotypic revertants of H2ts1. Seventeen spontaneous revertants were isolated in three independent experiments by picking plaques at 39 degrees after three passages of H2ts1 at 39 degrees in HEp2 cells. All revertants grew like wild-type virus and regained normal endoproteinase activity. The Ncol fragment encompassing the H2ts1 region was terminally labeled and subcleaved with HaeIII to determine the presence or absence of the HaeIII site at 61.1 for each revertant. All revertants had regained the HaeIII site by true reversion. We conclude that the H2ts1 mutation probably lies in a critical domain of the enzyme and is therefore not suppressible, and that the C/T transition at coordinate 61.1 is the sole cause of the H2ts1 phenotype. PMID- 3544476 TI - [The selfless labor of physicians at the Western Front]. PMID- 3544477 TI - [Systems approach and the the targeted program method in planning research and experimental design operations]. PMID- 3544478 TI - [Experience in using a conversational computer system in the functional diagnosis department of a district military hospital]. PMID- 3544479 TI - [Methodological aspects of clinical and radiation diagnosis in internal diseases (1)]. PMID- 3544480 TI - [Echoangiography of the carotid arteries using the duplex scanner in the subclinical picture of cerebrovascular disease]. PMID- 3544481 TI - [Contrast media in radiology. Present status, complications and prevention]. PMID- 3544482 TI - [Scientific bases for organizing a therapeutic health resort regimen]. PMID- 3544483 TI - [Mechanism of the action of naftusia water on acid formation in the stomach]. PMID- 3544484 TI - [Use of vitamin U electrophoresis with duodenal peptic ulcer patients]. PMID- 3544485 TI - [Biological effect of human ultraviolet irradiation]. PMID- 3544486 TI - [Enzymes of purine nucleotide metabolism as biochemical markers of the differentiation of normal and leukemic cells (review of the literature)]. PMID- 3544487 TI - [Quantitative immunoenzyme determination of fibronectin in biological fluids]. AB - Quantitative immunoenzyme assay of fibronectin in blood plasma is developed. Isolation and purification of fibronectin from human blood plasma, harvesting of specific antibodies to fibronectin, production of the antibodies and peroxidase conjugates and step-by-step procedure of the immunoenzyme assay in a "sandwich" modification are described. The assay was applied for diagnostics of several infectious and somatic diseases. PMID- 3544488 TI - [Proteolysis and malignant growth (review)]. AB - Modern data on participation of proteolytic enzymes from tissues and blood in malignant growth as well as their role in tumor invasiveness and metastatic spreading are reviewed. Alterations in content of the protein inhibitors of proteolysis occurred in tumors as well as diagnostic and prognostic significance of the inhibitors estimation in blood serum of oncological patients are considered. The experimental data on the antitumoral effect of native and synthetic inhibitors of proteolysis are discussed. PMID- 3544489 TI - [M.V. Lomonosov and medical chemistry]. PMID- 3544490 TI - [Role of DNA repair in chemical carcinogenesis]. PMID- 3544491 TI - [Ultrastructural analysis of villous tumors of the large intestine (with the use of a computer)]. AB - As a result of an analysis of the literature and the authors' electron microscopic data on 23 cases of rectal villous tumors, a standardized complex of ultrastructural features and their variants were determined. The said characteristics were used in the development of formal criteria for evaluation of the results of electron microscopic investigation of villous tumors displaying different degrees of dysplasia of the epithelium. A suitable algorithm of automatic data processing was worked out. The program in FORTRAN was read in a D3 28 mini-computer. The use of an automatic system for verification of diagnostically controversial data is suggested. PMID- 3544492 TI - [Effect of modifiers of the cytochrome P-450-dependent enzyme system of the liver on the metabolic pathways of diethylnitrosamine activation and inactivation]. AB - Pretreatment of Wistar male rats with antioxidants prevented the toxic effect of diethylnitrosamine (DENA) at LD50. Six-fold acceleration of DENA excretion and significant increase of maximum plasma concentration of a DENA metabolite nitrite were, also observed after antioxidants treatment. Liver microsomal metabolism of DNA was altered by pretreatment with another antioxidant--butylhydroxytoluene, which stimulated selectively denitrosation and inhibited dealkylation of DENA in the microsomal cytochrome P-450-dependent enzyme system. Moreover, butylhydroxytoluene treatment diminished he ability of microsomes to activate DENA to mutagenic intermediates identified in Ames' test. It was suggested that the protective effect of antioxidants against DENA toxicity may be due to the acceleration of its metabolic inactivation and the inhibition of its activation in liver cytochrome P-450-dependent systems. PMID- 3544493 TI - [Method for the bacteriological study of human embryonic liver cells intended for the treatment of cancer patients]. AB - Native and cryopreserved human embryo liver cells were stored up to be used in cancer patients with antitumor treatment-induced myelodepression. In the course of conservation and before administration, cells were bacteriologically tested after the USSR Ministry of Health standing procedures as well as in some additional serum media. As a result, both classical bacterial forms and their cell wall-degenerate organisms were identified. Contamination of biopreparations with the latter is hazardous for immunodepressive patients. PMID- 3544494 TI - Selection of plasma donors suitable for tetanus boosting. AB - As a result of a comparative trial examining the immunogenicity and clinical reactivity of two tetanus vaccines, 33 donors with high antibody levels were plasmapheresed over 6 months for the collection of tetanus hyperimmune plasma. Serial antibody assay results and the frequency of adverse reactions were analysed to define the donors most suitable for an immune plasma programme. A high proportion of boosted donors were withdrawn from plasmapheresis because of poor persistence of antibody levels. Donors most suitable for boosting appear to be males under 25 years old with a tetanus antibody level of around 8 IU/ml prior to boosting. PMID- 3544495 TI - Standardization of the processing of human bone marrow for allogeneic transplantation. AB - Allogeneic bone marrow transplantation has been undertaken within this centre on 62 patients with acute or chronic leukaemia. Employing the standard separation protocol described, all bone marrows were processed on the 2991 Blood Cell Processor to isolate the 'buffy coat' cells and subsequently the mononuclear cell component using a density separation medium of Ficoll-metrizoate. Following the mononuclear cell separation, the cells were identified for their T lymphocyte component using a combination of two murine monoclonal antibodies, MBG6 reacting with a pan T cell antigen (CD6) and RFT8 detecting the 'cytotoxic/supressor' cell antigen (CD8). The numerical results for nucleated cells, red blood cells, T lymphocytes and colony forming units-granulocyte macrophage are presented. PMID- 3544496 TI - Immune haemolysis in a renal transplant recipient due to antibodies with anti-c specificity. AB - A 55-year-old man received a cadaver kidney from a donor whose serum contained red cell antibodies with anti-c specificity. Atypical antibodies were shown to be absent from the recipient's red cells and serum at the time of transplant. Blood was not transfused during surgery. Two weeks after the transplant, the recipient developed a positive direct antiglobulin test due to antibodies with anti-c specificity. Immune haemolysis was diagnosed in the patient 3 weeks after transplant. The possible mechanisms involved in antibody formation in the recipient are discussed. PMID- 3544498 TI - Early developments in blood cell separation technology. PMID- 3544497 TI - Evaluation of a new confirmatory assay for antibodies against lymphadenopathy associated virus (LAV)/human T-lymphotropic virus type III (HTLV III). AB - We have evaluated a newly developed competitive enzyme immunoassay for the specific detection of antibodies against LAV/HTLV III envelope and core proteins. Comparative studies of sera from high-risk donors showed complete concordance between the results of the confirmatory enzyme immunoassay and immunoblot or indirect immunofluorescence techniques. Studies of sera from blood donors with a repeatedly reactive screening test for anti-LAV/HTLV III demonstrated two specimens which were positive by the confirmatory enzyme immunoassay and negative or indeterminable by immunoblotting and immunofluorescence. PMID- 3544499 TI - [Fine-needle biopsy under ultrasonic control--the results from 65 cases]. PMID- 3544500 TI - [Ultrasound, endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography in the differential diagnosis of jaundice]. PMID- 3544501 TI - [Insulin receptors in the peripheral blood mononuclear cells of patients with chronic liver diseases]. PMID- 3544502 TI - [Analysis of the results of diagnostic and therapeutic procedures under echographic control]. PMID- 3544503 TI - [Hemangioma of the liver--ultrasonic and computed tomographic correlation]. PMID- 3544504 TI - [Changes in the portal system in chronic liver diseases evaluated by ultrasonic tomography]. PMID- 3544505 TI - [Guided fine-needle biopsy of the retroperitoneum under echographic control]. PMID- 3544506 TI - Recruiting, advising, and program planning for RN/BSN students. PMID- 3544507 TI - Origins of medical informatics. AB - Medical informatics is a new knowledge domain of computer and information science, engineering and technology in all fields of health and medicine, including research, education and practice. Medical informatics has evolved over the past 30 years as medicine learned to exploit the extraordinary capabilities of the electronic digital computer to better meet its complex information needs. The first articles on this subject appeared in the 1950s, the number of publications rapidly increased in the 1960s and medical informatics was identified as a new specialty in the 1970s. PMID- 3544508 TI - The National Library of Medicine and medical informatics. AB - Medical informatics attempts to provide the theoretic and scientific basis for the use of automated information systems in biomedicine. Even though a new field, its roots are in the 19th century. The National Library of Medicine (NLM) began classifying the medical literature and publishing the Index Medicus in 1897; in the early 1960s, the growth of the index gave rise to MEDLARS, the first successful, large-scale, computerized bibliographic system. In 1971, about the time MEDLARS evolved into a nationwide on-line retrieval system known as MEDLINE, a committee of the Association of American Medical Colleges published a report calling for the NLM to exert strong leadership in developing computer applications for information transfer in medicine. The NLM has sponsored several training and research programs in this area and is now developing the concept of "centers of excellence" in medical informatics. In addition, there are a number of current research and development activities within the NLM internal and extramural programs that may influence the progress of medical informatics. PMID- 3544509 TI - The INTERNIST-1/QUICK MEDICAL REFERENCE project--status report. AB - INTERNIST-1 and its successor, QUICK MEDICAL REFERENCE (QMR), are computer programs designed to provide health care professionals with diagnostic assistance in general internal medicine. Both programs rely on the INTERNIST-1 computerized knowledge base, which comprehensively describes 570 diseases in internal medicine. The philosophies behind the development of each program differ. Whereas INTERNIST-1 functions solely as a high-powered diagnostic consultant program, the QMR program acts more as an information tool, providing users with multiple ways of reviewing and manipulating the diagnostic information in the program's knowledge base. At the lowest level, the program can be viewed as an electronic textbook of medicine. In addition, the QMR program has the ability to assist users with generating hypotheses in complex patient cases. The QMR program has not been evaluated formally as an information tool for practicing physicians. A preliminary study indicates that QMR's case-analysis capabilities are of potential benefit in most patients in internal medicine admitted for diagnostic evaluation. PMID- 3544511 TI - The computer as a tool for learning. AB - Experimenters from the beginning recognized the advantages computers might offer in medical education. Several medical schools have gained experience in such programs in automated instruction. Television images and graphic display combined with computer control and user interaction are effective for teaching problem solving. The National Board of Medical Examiners has developed patient-case simulation for examining clinical skills, and the National Library of Medicine has experimented with combining media. Advances from the field of artificial intelligence and the availability of increasingly powerful microcomputers at lower cost will aid further development. Computers will likely affect existing educational methods, adding new capabilities to laboratory exercises, to self assessment and to continuing education. PMID- 3544510 TI - Bringing the medical literature to physicians. Self-service computerized bibliographic retrieval. AB - Seven years ago physicians at the Beth Israel Hospital in Boston began doing their own searches of the medical literature. They used PaperChase, a computer program written especially for end users rather than for search librarians. The data base was initially limited to the journals shelved in the library of the Beth Israel Hospital, but it has since been expanded to include the entire MEDLINE collection of the National Library of Medicine-nearly 5 million references published in 3,400 biomedical journals dating back to 1966.PaperChase is now available throughout the United States and Canada to anyone who has a computer terminal or personal computer and a modem. No special training is needed for a successful search and there is no user's manual. Users can search by title word, "medical subject heading," author's name, journal title, year of publication, language of publication or any combination of the above. They can read abstracts on line, and they can request that a photocopy of the full text of any article be mailed to them. PMID- 3544512 TI - [Mitral valve prolapse syndrome]. PMID- 3544513 TI - [Free transplants in reconstructive surgery of the extrahepatic bile ducts]. PMID- 3544514 TI - [Prolactin secretion: current diagnosis and therapy]. PMID- 3544515 TI - [Intrauterine pregnancy following intratubal gamete transfer--a case report]. AB - Since the beginning of 1986 gamete intrafallopian transfer (GIFT) has been used in the treatment of infertile couples. Only patients in whom tubal patency has been ascertained are included in the programme. After hormonal stimulation of the ovaries and laparoscopic follicular aspiration oocytes and semen are transferred by means of catheterisation into the fallopian tubes. The first pregnancy in our department established by gamete intrafallopian transfer--and the first in Austria to our knowledge--is reported. PMID- 3544516 TI - Comparison of selective and nonselective single-dose antibiotic cover in biliary surgery. PMID- 3544517 TI - The use of blood components in patients with malignancy. PMID- 3544519 TI - Transfusion-associated acquired immunodeficiency syndrome. PMID- 3544518 TI - Transmission of diseases by blood transfusion. PMID- 3544520 TI - Acceptable hematocrit levels in surgical patients. PMID- 3544521 TI - Acute limited normovolemic hemodilution: a method for avoiding homologous transfusion. PMID- 3544522 TI - Intraoperative autotransfusion. PMID- 3544523 TI - The use of plasma substitutes with special attention to their side effects. PMID- 3544524 TI - Recent developments in the area of massive transfusion. PMID- 3544526 TI - Medicare sanction activity: a primer on "big brother's" latest look over the practitioner's shoulder. PMID- 3544525 TI - Blood transfusion: yesterday, today, and tomorrow. PMID- 3544527 TI - [Status and trends in hematology]. PMID- 3544528 TI - [Ethnopharmacology and the history of the discovery of hallucinogenic drugs from European mushrooms of the Psilocybe family]. PMID- 3544529 TI - [Fritz Frankel (1892-1944)--a friend and war companion of Georg Benjamin]. PMID- 3544530 TI - [Virulence criteria in E. coli strains isolated from river water]. PMID- 3544531 TI - [Light microscopy studies of the adherence of Escherichia coli to cultured human kidney cells]. PMID- 3544532 TI - [Comparative analysis of the use of chemotherapeutic agents and pathogen isolation in patient areas at a urologic clinic]. PMID- 3544533 TI - [Uroepithelial adherence of Escherichia coli strains in patients with chronic recurrent urinary tract infections]. PMID- 3544535 TI - [Long-term preservation of mycoplasmas in liquid nitrogen]. PMID- 3544534 TI - [Determination of the influenza A virus antigen in pharyngeal swabs using an enzyme immunoassay]. PMID- 3544536 TI - [Assessment of fungi found by bacteriologic study of patient samples]. PMID- 3544537 TI - [Comparison of various selective supplements in the cultivation of Campylobacter jejuni/coli from fecal samples]. PMID- 3544538 TI - [Theodor Escherich--a pediatrician and bacteriologist. Observations on the 100th anniversary of the discovery of the Bacterium coli commune]. PMID- 3544539 TI - [Value of sonography in assessing nodular changes of the thyroid in an endemic goiter area]. AB - In an area of endemic goiter 304 patients with an increased thyroid gland were examined by palpation, sonographically and partly scintigraphically. The average age was 37 (12-78) years, the average age of the patients with nodular changes of the thyroid gland 38-44 years. Patients with a diffuse struma were significantly younger with an average age of 33 years. A false-positive enlargement of the thyroid gland established by palpation occurred in 16.1% (n = 49/304). In the sonographic examination 148 out of 304 patients revealed a diffuse enlargement of the thyroid gland without provable nodular change. However, in about one third already more or less clearly characterized regressive changes could be observed. In 156 of the 304 patients 109 times solitary nodes and 47 times multinodular changes were established sonographically. In more than one third of all nodular goiters or one fifth of all patients examined a cyst was demonstrated sonographically. Two thirds of the sonographically established nodular changes were, however, solid. In 53 of all 304 examined patients could sonographically be established additional, unexpected nodes which had escaped the palpation and partly also the scintigraphic investigation. In 14% the node suspected by palpation could not be ascertained sonographically. According to the echo structure echo-poor and echo-equal solid nodes dominated. The frequency of carcinomata of the solid nodes was 6.7%. Apart from 4 echo-poorly and 2 complexly structured nodes a carcinoma of the thyroid gland demonstrated itself sonographically to the same echo. Finally conclusions are drawn for the diagnostics of the thyroid gland in the endemic area of goiter. PMID- 3544540 TI - [Comparative studies of IgE content of the gastric mucosa in various forms of gastritis]. AB - The problem of the pathogenetic significance of IgE-mediated inflammatory processes in simple unspecific gastritis was studied in mucosal biopsies of 396 cases with unequivocal histological classification. The results demonstrate that only in acute and erosive gastritis high IgE cell counts are found, thus, indicating a pathogenetic significance. Furthermore the statistical evaluation showed a parallel age distribution of IgE containing cells in the four biopsy groups. Mucosal biopsies from patients 40-65 years of age exhibited higher IgE cell counts than younger and older persons. These results suggest that there is a higher IgE-reactivity in the middle age. PMID- 3544541 TI - [Increase of plasma cholecystokinin by Escherichia coli endotoxin-induced shock in swine]. AB - The gastrointestinal tract is the source of numerous peptide hormones. Since the gut will be altered severely during prolonged general circulatory low flow states, the reactions of the gut hormones are of great interest. In this study 18 anesthetized pigs were put into shock states to get first informations about the changes of the plasma levels of cholecystokinin (CCK). 12 pigs (group I and II) were exposed to a general circulatory shock state by a 2-hr intravenous infusion of a sublethal dose of Escherichia coli endotoxin. 6 of them (gr. II) first received a gastroenterectomy apart from a small duodenal remnant proximal and distal to the papilla of Vater. The remaining 6 pigs (gr. III) suffered a severe hemorrhagic-hypovolemic shock over a 150-min period by arterial bleeding. Plasma CCK increased significantly (p less than 0.05) in the aorta (gr. I, II), the portal vein (gr. I, II), the superior caval vein (gr. I), and the internal jugular vein (gr. I) at the end of the 2-hr endotoxin infusion. In group II, the rise of CCK levels in the superior caval vein was also marked, but insignificant. The CCK-concentrations in the internal jugular vein were measured only in group I. By contrast, no changes in plasma CCK were seen in hemorrhagic shock (gr. III). Within each group plasma samples taken from the various blood vessels at identical time points showed no significant differences. Since the plasma concentrations of CCK remained unchanged during hemorrhagic shock, the release of CCK by E. coli endotoxin is not due to the general circulatory low flow state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544543 TI - [3d meeting of the German Association for the Study of the Liver. 30-31 January 1987, Hannover. Abstracts]. PMID- 3544542 TI - Ultrastructure of the islets of Langerhans after long-term occlusion of the pancreatic duct system. AB - The long-term effect of surgically induced atrophy and fribrosis of the exocrine parenchyma of the pancreas on the islets of Langerhans was examined electron microscopically in animal experiments in mini-pigs. Ligature of the pancreatic duct, occlusion of the pancreatic duct system with an alcoholic solution of amino acids and the combination of this occlusion with ligature of the pancreatic duct were compared. A largely similar result was found in all three experimental groups 9 months post-operatively: The islets of Langerhans are mostly subdivided into predominantly small and apparently intact islet cell complexes by peri- and intra-insular fibrosis, and, where larger islet cell complexes are found, these are, in places, also destroyed in the peripheral region. The diffusion distance between the capillaries and the endocrine cells is, in part, considerably dilated by the interposition of collagen fibres. In the capillaries, thickenings and duplications of the basement membrane, as well as swelling of the endothelial cells can be found. There are rarely signs of atrophy in the islet cells lying in clusters. Only the granular structure of the B-cells diverges from the norm. From our morphological findings a delayed and diminished hormone output after pancreatic duct occlusion can be deduced, whereby, compared to earlier short-term experiments of our own, no significant progression of the peri- and intra-insular fibrosis can be determined. PMID- 3544544 TI - [Prenatal diagnosis of thanatophoric dwarfism with cloverleaf skull]. AB - Thanatophoric dwarfism is a rare condition occurring in 1 in 100,000 births. To date, only 2 cases have been reported on in which this condition was diagnosed prenatally before the 24th week of pregnancy post menstruationem. The majority of cases reported so far were born by cesarean section. This condition can be diagnosed early by measurement of the fetal diaphyseal bones and accompanying specific diagnostic measures to establish the possible presence of malformations. The pregnancy can then be terminated if need be, and unnecessary interventions thus avoided. PMID- 3544546 TI - [Dermatologic and venerologic therapy 1946/1986]. PMID- 3544545 TI - [An unusual case: hemorrhagic bullous pemphigoid following furosemide treatment]. AB - We report on a patient suffering from chronic renal failure, who developed hemorrhagic bullous pemphigoid while being treated with Furosemide. The possible association between bullous pemphigoid, renal failure, and Furosemide ist briefly discussed. PMID- 3544547 TI - [The practice of clinical drug trials 100 years ago based on an 1890 scientific study. By C. Shirren]. AB - On the basis of a scientific study published 100 years ago, we report on the drug research then practiced regarding topical application. This paper--published by the Private Hospital for Skin Diseases of Prof. Lassar in Berlin--proves that even 100 years ago, there were practical conceptions already as clear as today. PMID- 3544548 TI - [Echocontrast ventriculography. Determination of left ventricular functional parameters with special reference to digital subtraction echocardiography]. AB - In 57 consecutive patients we examined whether digital subtraction echocardiography (DSE) is able to determine left ventricular function parameters, in particular the ejection fraction (LV-EF). The most important step in DSE consists of the subtraction of digitized grey level information of the original echocardiogram from a phase-identical contrast image. In addition LV-EF, end diastolic (EDV) and end-systolic volumes (ESV) were calculated by manual definition of endocardium in the original (Na) and contrast-echocardiograms (Ko). The results were then compared with the invasive cardiac catheterisation (Hk) data. We used 5.5% oxypolygelatine (Gelifundol S) as echo-contrast material and injected 2-4 ml as a bolus directly into the left ventricle. LV-EF calculated on the basis of automatic contour definition by DSE demonstrated a better correlation with cineangiographic data (r = 0.89, SEE 5.8% in 44 patients) than the manual input of endocardial borders in original echocardiograms (r = 0.71, SEE 8.1% in 47 patients). Good correlations were also found between EF-Ko and EF Hk with r = 0.92 and an SEE of 4.3%; because there is a good agreement between EF Ko and EF-DSE (r = 0.91, SEE 5.3%) these calculations closely approach the results of the invasive data. The EF-Na underestimates the EF-Hk markedly as a consequence of a systematic error: as compared to the contrast image the volumes of the original echocardiograms, in particular the ESV are overestimated and the ejection fraction as a derived parameter is calculated as too small. ESV-Hk versus ESV-Na: y = 0.82x + 24.4, ESV-Hk versus ESV-DSE: y = 0.88x + 37.0.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544549 TI - [Frequency analysis of the single beat electrocardiogram in the diagnosis of ventricular tachycardias]. AB - High frequency components of the surface electrocardiogram have been found in patients with sustained ventricular tachycardia. However, evaluation of these signals has required signal averaging and highly sophisticated filter techniques. In order to overcome the limitations of averaging and apriori filtering, we performed a single beat analysis of the total and terminal QRS and ST-segment of surface electrocardiograms with fast Fourier transformation (512 points, Blackman Harris window) after high gain, low noise amplification (0-300 Hz). Fourteen patients with previous myocardial infarction and spontaneous and electrically inducible sustained ventricular tachycardia, twelve patients with previous infarction but without clinical arrhythmias, and fifteen control subjects were studied. The frequency content of the terminal QRS, expressed as area under the spectral plot, was significantly lower in patients with ventricular tachycardia compared to patients without arrhythmias (p less than 0.01). The frequency content of the ST-segment in the range 10 to 40 Hz was higher in patients with ventricular tachycardia than in patients without arrhythmias and control subjects (p less than 0.01). The spectral representation at very low (0-10 Hz) and high frequencies (greater than 60 Hz) of the ST-segment and analysis of the total QRS did not allow separation of patients with ventricular tachycardia. Thus, spectral analysis of single beat electrocardiograms offers promise for the non-invasive identification of patients prone to sustained ventricular tachycardia due to coronary artery disease. PMID- 3544550 TI - [Separation of a Beall Surgitool prosthesis disk 15 years after mitral valve replacement]. AB - The case of a 46-year-old woman who survived disc embolization of a Beall Surgitool prothesis for 10 days is described. The patient presented to another hospital 15 years after implantation of a mitral valve prothesis with acute severe heart failure refractory to medical therapy. Ten days later she was referred for cardiological investigation and a missing mitral valve disc was diagnosed by echocardiography and right heart catheterization. Immediate surgical valve replacement led to a good recovery. The embolized disc was later localized by ultrasound and abdominal CT and removed from the abdominal aorta. PMID- 3544551 TI - [20 years' gerontopsychology in Germany--retrospect and prospects]. PMID- 3544552 TI - [Coping with the empty nest situation as a developmental task for the aging female--an analysis of the literature]. AB - This paper examines the widespread notions on the effect of children's departure from home. Several studies describe this situation as one of major role loss for the mother who reacts with feelings of depression and loneliness: the so-called "empty nest syndrome". Thirty studies were analyzed. There are no data which allow a generalization of such assumptions: The experience of facing the empty nest is individualistic for each woman due to her own biographical and actual factors of life context. Feelings range from loss and sadness to relief and freedom. Further empty nest research should define the term "empty nest" more thoroughly, including numerous variables about mothers' and children's life situations. Developmental counseling for middle-aged women cannot exist in standard programs with same aims for all participants, but has to begin with individual and situational determinants of each woman. PMID- 3544553 TI - The H-donator specificities of peroxidase isoenzymes concerning the peroxidase labelled enzyme immunoassay. PMID- 3544554 TI - [Carbon band implants in animal experiments. Light and transmission electron microscopy studies of biocompatibility]. AB - Part of the patella ligament was resected in rabbits and replaced by carbon fibre implants. After 1, 2, 3, 6 weeks, 3 and 12 months carbon implants with surrounding tissues as well as iliac lymph nodes were removed and examined by light- and transmission electron microscopy. Of special interest were the questions whether the carbon fibre implant, will be removed by phagocytosis and substituted by a new ligament or a adequate repair tissue? Our light- and transmission electron microscopic studies give no indication of successful removal of carbon fibres by phagocytosis. The carbon fibre implant was surrounded by dense connective tissue like a scar. In deep layers of the carbon implant was no vital dense or regular connective tissue, even not after 3 and 12 months. There is no replacement of the carbon fibre implant by a new ligament or tendon but a persistent foreign body reaction. With regard to these results it is very doubtful if good late results with ligament and tendon replacement by carbon fibre implants can be expected in patients. PMID- 3544555 TI - [Medical photography in orthopedics then and now--a historical overview]. AB - An historical overview is given about the medical photography especially in orthopaedic surgery from the beginning until modern times. Orthopaedic surgeons early found out the advantage of this method for documentation of clinical cases. More and more photography was used from the end of the 19. century until now because of its remarkable advantages. In the last years three dimensional photographic measurement has established and is acknowledged to be useful in diagnosis and follow up of deformities, especially of scoliosis. Cinematographic methods for analysis of human movement are helpful tools for diagnosis and therapy of pathologic movement. PMID- 3544556 TI - [Technic and results of rib hump resection in thoracic scoliosis]. AB - Description of operative procedure acc. to Naravcevic for treatment of rib hump in thoracal scoliosis (partial resection of ribs, segmental shifting) and of possible complications (injury of pleura). The indication for operation is only given by cosmetic and psychologic reasons. Report about 48 patients of Orthopedic University Hospital of Homburg/Saar who underwent operative treatment between 1975 and 1983. The average age at time of operation was 19.3 years. The most popular fixation of the resected ribs was by end-to-end connection and Mersilene suture. There were no severe complications. The subjective results were altogether very satisfactory. The clinical control showed and average correction of the height of the rib hump of about 50%. PMID- 3544557 TI - [Ventral intercorporal spondylodesis in lumbar instabilities]. AB - Ventral spondylodesis is said to be a useful method for the treatment of lumbar illness in combination with instability and pain. Between 1969 and 1983 62 patients of the Orthopedic University Hospital Berlin were operated for a ventral fusion of the lumbar column, excluded the Dwyer spondylodesis indicated in lumbar scoliosis. 50 of them could be re-examined. The result was good and fair in seventy per cent; the consolidation rate 62 per cent in no relation to the clinical result. Best satisfaction was got by those patient who suffered from spondylolisthesis without any compressions of sciatic nerve. Any previous operation of the nerve root with persistent symptoms lowers the aim of spondylodesis as a salvage procedure. With the experience of the surgeon the method itself is without a higher rate of complication than any other way of spondylodesis. PMID- 3544559 TI - [Coronarogenic metabolic acidosis and the problem of its pharmacological correlation]. PMID- 3544558 TI - [Functional importance of the kidney nerves]. PMID- 3544560 TI - [Individual differences in adaptation to hypoxia and cold by the criterion of body emotional-behavioral reactivity]. PMID- 3544561 TI - Medical therapy of gallstones: state of the art. PMID- 3544562 TI - Liver transplantation. PMID- 3544563 TI - The clinical crown for a transitional restoration. PMID- 3544564 TI - [Genetics--from analysis of the process of heredity to synthetic biology]. PMID- 3544565 TI - [Organ transplantation]. PMID- 3544566 TI - [Kidney transplantation--internal medicine viewpoints]. PMID- 3544567 TI - [Conventional treatment versus bone marrow transplantation in chronic myeloid leukemia. Prognosis and course of conventional treatment]. PMID- 3544568 TI - [Prognosis and course of bone marrow transplantation]. PMID- 3544569 TI - [Assessment of prognosis from the viewpoint of the biostatistician]. PMID- 3544570 TI - [Patient information--a communication problem]. PMID- 3544571 TI - New aspects of pathogenesis of type II diabetes. PMID- 3544572 TI - [Differential therapy of type II diabetes]. PMID- 3544573 TI - [Eicosanoids and peripheral occlusive disease]. PMID- 3544575 TI - [Nutrition and the rejuvenation of the chemical structures of the body]. PMID- 3544574 TI - [Food determinants of the lipid composition of biological membranes]. PMID- 3544576 TI - [Enrichment of food proteins]. PMID- 3544577 TI - [Role of food proteins in immunological and allergic reactions]. PMID- 3544578 TI - [The problems of child nutrition]. PMID- 3544579 TI - [Microecological problems of nutrition]. PMID- 3544580 TI - [Academician A. A. Pokrovskii and the propagandizing of the principles of rational nutrition]. PMID- 3544581 TI - [The study of the metabolism, pharmacokinetics and mechanism of action of xenobiotics: its importance for evaluating food safety]. PMID- 3544583 TI - [Photochemotherapy of skin diseases. Mechanism of action, results and outlook]. PMID- 3544582 TI - [Research in vitaminology: the theoretical and practical aspects]. PMID- 3544584 TI - [New methods of diagnosis and treatment in dermatology and venereology (review of patent information in the USSR)]. PMID- 3544585 TI - [Functional activity of the hypophysis, the adrenal cortex and the pancreas in patients with vesicular dermatoses during combination immunosuppressive therapy]. PMID- 3544586 TI - [Fixed prosthetic posts and aspects of surgical-prosthetic principles]. PMID- 3544587 TI - Proceedings of the Innsbruck meeting of the Society for Research into Hydrocephalus and Spina Bifida, 1986. PMID- 3544588 TI - Progressive hydrocephalus in teenage spina bifida patients. AB - Many spina bifida patients with shunts for hydrocephalus do not require shunt revisions for several years. These children are often considered to be no longer shunt dependent, only to develop rising intracranial pressure (ICP) requiring surgery in the second decade. We present three patients who, despite never having had a C.S.F. shunt, developed rising intracranial pressure in early teenage years. The diagnosis was delayed because of the lack of appreciation of this clinical entity. One child died, the second suffered permanent neurological damage, and the third recovered completely. We suggest that both shunted and non shunted patients have a common cause for the late rise in ICP. PMID- 3544589 TI - The fathers of children with spina bifida. AB - Health, employment, marital outcome and involvement with the child, of fathers with spina bifida (IF) and with "normal" controls (CF), were analysed at intervals from birth to 18 years. By 10 years IF had poorer reported health than did CF. By 18 years IF had more specific health problems, many being psychosomatic in nature, than CF or index and control mothers. This pattern was also reflected in the GHQ scores; IF had a significantly higher incidence of symptoms than CF. Practical involvement of IF and CF was generally little different but at 18 years 30% of IF were still involved in their child's "personal care". Employment and income amongst IF and CF did not differ in the early years. By 18 years, significantly more IF were claiming invalidity benefit, while they were also more likely to be the family's only wage-earner. Our evidence suggests that IF suffered surprisingly severely as a result of emotional strain. Both the psychological and practical problems could be alleviated to the benefit of all family members. PMID- 3544590 TI - The integration of spina bifida children--are their needs being met? AB - After eleven years of vigorously promoting integration, the majority of Sheffield Children's Hospital spina bifida patients are now successfully integrated. A parallel study in Greater Manchester confirmed that parents, teachers and the spina bifida children are overwhelmingly in favour of integration. A large number of children were transferred from special to ordinary schools, and very few had to be transferred back to segregated schooling. The parents found substantial social and educational advantages in integration, together with good levels of involvement with their child's education. The most important areas in need of greater funding were considered to be: non-teaching support for toiletting, visiting specialists, particularly physiotherapists, and in-service education of teachers. PMID- 3544591 TI - Learner drivers with spina bifida and hydrocephalus: the relationship between perceptual-cognitive deficit and driving performance. AB - This study investigated the relationship between perceptual-cognitive skills and driving performance in a group of eleven learner drivers disabled by spina bifida and hydrocephalus. Perceptual-cognitive skills assessed include figure-ground discrimination, visual scanning/tracking, spatial orientation, language, reasoning and memory ability. Following ten hours driving tuition in suitably adapted cars, driving performance in off-road manoeuvres and in-traffic situations was measured. Results showed that the perceptual-cognitive skills of this group were in the low average or below average range compared to a non handicapped population. Spearman Rank Order Correlations between clinical tests and driving performance indicated that although certain tests correlated with off road manoeuvres, no perceptual measures were reliable indicators of in-traffic driving. There were indications that practical measures of spatial orientation and reasoning ability may be more relevant to some aspects of driving than tested perceptual skills. Memory for road signs, landmarks and routes was also investigated. Accurate retention seemed more dependent on general reasoning ability than tested aspects of memory functioning. It is suggested that as clinically tested perceptual skills do not seem to be reliable indicators of driving performance, an individual's test results should not be used to deter him from learning to drive. PMID- 3544592 TI - The outcome of treatment of hip problems in spina bifida. PMID- 3544593 TI - [The Th. Wendler double-T clasp attachment]. PMID- 3544594 TI - [ABH and Lewis antigens in the tracheal glands. I. Lewis-positive individuals]. AB - Antigens A, B, H, Lea, and Leb were demonstrated in the tracheal glands of 15 Lewis-positive secretors and 15 nonsecretors by the indirect immunoperoxidase technique. The detection of group-specific ABH antigens in mucous epithelium and intraductal secretory fluid was dependent on the secretor character. Whereas determination of secretor character was sometimes unreliable with anti-A and anti B, the findings obtained by additional labeling with UEA1 were consistently correct. The secretors showed minimal gland labeling with anti-Lea and intensive labeling with anti-Leb; the nonsecretors, intensive Lea labeling and weaker or absent Leb labeling. Consequently, the determination of secretor character by ABH labeling could be verified by the behavior of the Lewis antigens. Since both morphologic structures and epithelial antigens are highly resistant to putrefaction, ABO and secretor character can also be diagnosed in badly decomposed tracheal wall specimens. PMID- 3544595 TI - [Value of arthrosonography in the evaluation of exudative and proliferative synovitis]. AB - The characterization of synovial tissue in rheumatoid arthritis (proliferative or exsudative synovitis), which is important in deciding between local therapies of arthritis, was examined by arthrosonography, computerized axial tomography and arthroscopy. The arthroscopic examination yields the highest significance in characterizing rheumatoid synovial tissue. Compared to arthroscopy, arthrosonographic diagnosis was correct in 70% of our cases. The arthrosonographic results were much influenced by the different concentrations of fibrin in the synovial effusions. PMID- 3544596 TI - [Behavior of delinquents in social conflict situations. A study using the Rosenzweig Picture-Frustration Test (PFT)]. AB - 35 delinquents with chronic dissocial developments and 35 neurotics (of equal sex and age) have been investigated with the Rosenzweig Picture Frustration Test (PFT). The results show a number of significant differences: The dissocial personalities are characterized by a denial of their strong latent guilt feelings. They experience frustrations generally as a blame and try to remove the unbearable conflicts as soon as possible, especially by developing great activity. A modification of the evaluation of the PFT (differentiation between ego- and super-ego-blocking items) leads to the result that only the test situations where the subjects are confronted with own fault and blame (super-ego blocking) show clear differences between neurotics and delinquents. Clusteranalysis with super-ego-reactions to super-ego-blocking items show a great homogenity of the delinquent subjects. The other clusteranalyses lead to 2 subgroups which are interpreted as 2 ways of the delinquents to handle their strong latent guilt-feelings: the subjects of one subgroup show a defiant denial of guilt-feelings with a latent passive resignation; the subjects of the other subgroup emphasize the guilt-feelings, but are unable to take full responsibility, and they show a strong tendency to become active in order to get rid of the guilt-feelings. PMID- 3544597 TI - [Preventive use of antibiotics in kidney transplantation]. AB - Antibiotic prophylaxis in kidney transplantation is controversial. In a prospective controlled study, 34 cadaveric kidney transplant recipients were investigated. Antibiotic prophylaxis was given in a random order to 16 patients whereas 18 without prophylaxis served as controlls. In 4 of 20 investigated clinical parameters statistically significant differences were found between both groups: the controlls happened to have better initial conditions; perioperative and postoperative better initial conditions; perioperative and postoperative infections were less frequent in the prophylaxis group and more antibiotics postoperatively were needed in the controlls. These findings indicate that antibiotic prophylaxis has a beneficial effect in kidney transplantation. PMID- 3544598 TI - [Prosthetic partial crown treatment]. PMID- 3544599 TI - [Fixed partial denture: preventive periodontal design]. PMID- 3544600 TI - [Problems in casting technics from the materials science viewpoint]. PMID- 3544601 TI - [How the surgeon Johannes Scultetus fought toothache in 1630]. PMID- 3544602 TI - [Surgical tooth preservation using bonding]. PMID- 3544603 TI - [New: glass ceramic for crowns]. PMID- 3544604 TI - [Fractures of the extremities with open soft tissue injury. Complications and treatment concept]. AB - In the history and also in the present time the open fractures of the extremities have a high rate of complications after the operative treatment. In our extract we will point the problems in this treatment. Also we want to show the effective ways to sink the complications. We describe the differences in the treatment of the open and closed fractures. With regard of the methods the osteosynthesis, the technique of the operative treatment and the after treatment of open fractures of the extremities we give directions for the universal and special treatment. PMID- 3544606 TI - [Arterial reconstructions spanning the knee joint]. AB - Knee-joint crossing arterial repair is an alternative solution for patients whose extremities otherwise might have to be amputated. Indications are according to Fontaine for Stages III and IV. Specialised angiographic preparatory examination and knowledge of microsurgical techniques are required. Reference is made to peculiarities of surgical access routes, vascular substitute materials, and specific surgical techniques. The use of this approach to peripheral vascular repair appears to be justified against the background of international achievements and the authors' own results. PMID- 3544605 TI - [Effectiveness and side effects of low-molecular weight heparin-dihydroergotamine in preventing thromboembolism in abdominal surgery]. AB - Low-molecular heparin-dihydroergotamine had been applied once a day to 103 patients and heparin-dihydroergotamine twice a day to 97 patients as part of a double-blind, controlled, consecutive, and randomised clinical study, with 200 abdominal surgery patients being involved. High-risk patients above 40 years of age and potentially affected by thrombotically predisposing factors were almost equally represented in both groups. Evidence to postoperative thrombosis was phlebographically produced in either group. No fatal pulmonary embolism was found to be among ten deaths. No significant differences of clinical relevance were found to exist between both groups with regard to coagulative values, intra operative and postoperative blood and drainage loss, and complications due to bleeding. No accumulated occurrence of major postoperative complications was recordable from either group. The vascular status of all patients was unchanged from beginning to end of the period of observation. The following conclusion was drawn as a result of the study: One single NMH/DHE injection daily is comparable with two HDHE applications per die for action and undesired side-effects. PMID- 3544607 TI - [Aneurysm of the extracranial internal carotid artery]. AB - Aneurysm of the extracranial internal carotid artery is a rarely observed condition. Intra-aneurysmatic thrombosis, cerebral embolism with possible neurological consequences, and rupture are the most common complications. Operations were performed on 20 patients for aneurysm of the internal carotid artery. The cases included 14 "genuine" arteriosclerotic aneurysms and seven "false" aneurysms in the wake of shell splinter injuries, tonsillectomy, thrombo arteriectomy, and blunt traumata. Pulsating tumour was the most important clinical symptom in all aneurysm cases. Arterial continuity was restored by resection of aneurysm in all cases. Sixteen patients were dehospitalised without any complaint. Two patients with preoperative cerebral infarction were left with residual paresis. One patient died of pulmonary embolism, and one patient operated on for rupture died in shock. PMID- 3544608 TI - [Findings in the postoperative angiogram]. AB - Postoperative angiography may provide clues as to vascular displacement in the wake of surgery which, in the abdominal region, may have been caused by removal of organ parenchyma or relocation of intestinal loops. Irregularities in vascular lumens may be indicative to consequences of adhesions or to infiltrative tumour growth. Interventions with the vascular system appear in the angiogram as dilatation or stenosis. Reference is made to vascular changes following kidney transplantation. PMID- 3544609 TI - [The history of anaerobic bacteria in pregnancy]. PMID- 3544610 TI - [Humoral aspects of mucous membrane immunity--perspectives for the female genital tract]. AB - Mucosal immunity of the female genital tract is a part of the "Common mucosal immunity". It is possible to induce local antibodies in the female genital tract by means of oral immunization. From these investigations new perspectives in terms of immunoprophylaxis against bacterial, viral an parasitic infections come into consideration for clinical use. In the case of bacterial infections IgA blocks the attachment of pathogens to relevant mucosal tissues and cells. Predominant among the immune mechanisms is the occurrence of secretory antibodies in the fluids that bath mucosal membranes. Secretory IgA (S-IgA) is an 11S molecule (MW 390,000) consisting of two IgA monomers covalently bonded by joining chain (J chain) and complexed to one molecule of SC.S-IgA ist the main immunoglobulin of mucosal surface. A medically important group of bacterial pathogens produce IgA1 protease cleaving only IgA1 proteins. S-IgA is resistant to protease hydrolysis. The secretory component (SC) is an epithelial cell receptor for the transport of IgA dimers, polymers and IgM polymers. Systemic suppression after oral antigen application has been demonstrated with a variety of thymic-dependent antigens, including heterologous erythrocytes, haptens, and various soluble proteins. Tolerance is mediated by antigen specific T suppressor cells (Ts). Suppressor cells first appear in the gut associated lymphoid tissue and subsequently migrate to systemic sites. At present immunoglobulin estimations in secretions are of clinical importance regarding supporting diagnostic tool of mucosal infections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544611 TI - Ultrasound surveillance of pregnancies after metroplasty for septate uterus. AB - Metroplasties were performed on twenty three septate uterus associated with recurrent reproductive wastage (19 cases) or primary infertility (4 cases). The surgical procedure and ultrasound monitoring of pregnancies conceived postoperatively are reported. Eighteen pregnancies occurred in sixteen patients; fourteen ended in live birth and four spontaneous abortions, including two blighted ova and one mole occurred. It appears from the results that uterine anomalies are rarely the sole cause of primary infertility; therefore, selection of patients is emphasized. PMID- 3544612 TI - [Obstetrics and gynecology in the medical education curriculum in the 19th century]. AB - The paper gives a survey on development of teaching in obstetrics and gynaecology at German universities in 19th century. Three aspects of these part of medical education are described: the establishment of obstetrics and gynaecology in the medical curriculum and orders of examination, institutional development of obstetrics and gynaecology as an obligatory part of medical education, the growth of specific methods of teaching in obstetrics and gynaecology. PMID- 3544613 TI - [History of neurosurgery at the turn of the 19th to the 20th century]. AB - Taking the example of the renowned German surgeon of the bile ducts Hans Kehr (1862-1916) and two cases published by him, the possibilities and limitations of neurosurgical activity within the frame of general surgery at the turn of the 19th to the 20th century at a private surgical hospital are outlined. A typical factor of the early history of specialised medical fields can be considered to be the successful autodidactic performance of almost all major interventions in all parts of the body and at the same time the turn to a topographically or pathophysiologically determined field of working. Here, peak performances in a partial field could still be well connected with a maintenance of the shole field. Kehr's actions in the practical-surgical treatment of the lesions of the skull corresponded in their basic conceptions to our present ideas. The further development, however, showed that the responsible and successful surgery in a special field-in the case of Kehr the surgery of the bile ducts-could only be performed with a far-reaching renunciation of other surgical activities. PMID- 3544614 TI - [Therapeutic and corrective work with stammering preschool children in a daytime semi-hospital]. AB - Therapeutic and corrective work with stammering preschool children conducted at a day-time semi-hospital institution presents a complex of measures aimed at improving the speech and the entire psychic activity of the child. A semi hospital form of the organization makes it possible, along with therapeutic and corrective measures, to constantly train the speech in the most diverse situations of the microsocial environment outside the hospital and thus contributes to the development of social and adaptive behaviour which the child needs for further studying in the general education school. PMID- 3544615 TI - [The anniversary of the oldest psychiatric hospital in Moscow]. PMID- 3544617 TI - [Noonan syndrome (review of the foreign literature)]. PMID- 3544616 TI - [Treatment of generalized myasthenia using therapeutic plasmapheresis (review of the literature)]. PMID- 3544618 TI - [Treatment of metabolic disorders in hereditary myodystrophies (review)]. PMID- 3544619 TI - [Etiology and pathogenesis of polyneuritis (a review of the literature)]. PMID- 3544620 TI - [Screening and identification of persons abusing alcohol (a review of the foreign literature)]. PMID- 3544621 TI - Intracellular localization of Aspergillus nidulans ornithine carbamoyltransferase in native host cells and in Saccharomyces cerevisiae cells harbouring its cloned structural gene. AB - Differential centrifugation of the Aspergillus nidulans cell lysate shows that ornithine carbamoyltransferase (EC 2.1.3.3) appears mainly in the particulate (organellar) fraction. The enzyme was located to the mitochondria by co sedimentation with cytochrome oxidase in isopycnic density gradient and by cytochemical-electron microscopic means. Arginase (EC 3.5.3.1) and ornithine delta-aminotransferase (E.C. 2.6.1.13) were found to reside in cytosol. The release of ornithine carbamoyltransferase from the organellar fraction by various agents indicates that the enzyme resides in the mitochondrial matrix. In Saccharomyces cerevisiae the plasmid pSAL43, carrying cloned Aspergillus nidulans ornithine carbamoyltransferase gene, directs the synthesis of the enzyme partially associated with yeast mitochondria even though the homologous yeast enzyme is exclusively cytosolic. The implications of these findings are discussed. PMID- 3544622 TI - Ketanserin in the treatment of essential hypertension. A double-blind study against metoprolol and a further long-term open treatment. AB - Monotherapy with Ketanserin, a serotonin receptor antagonist, reduces blood pressure in a sizeable number of patients with essential hypertension. The present study was designed to compare its antihypertensive potency with those of metoprolol in a double-blind treatment and further to study its long-term efficacy and safety in a one-year open trial, alone or combined to metoprolol, according to diastolic blood pressure (DBP) normalization. Twenty-four patients with mild to moderate hypertension were randomly assigned to two parallel treatment groups, one group (n = 11) received Ketanserin (40 mg/day) and the other one (n = 13) metoprolol (200 mg/day). After 3 months double-blind treatment, all patients received Ketanserin, on an open basis for one year alone or combined to metoprolol if Ketanserin failed to normalize DBP. A significant antihypertensive effect was demonstrated after 3 months double-blind treatment, for Ketanserin and metoprolol, in both standing and supine position (p less than 0.01). Heart rate showed a clear decrease by metoprolol (p less than 0.01). In the one-year follow-up, patients were divided in: I (n = 7) patients on Ketanserin (previously treated with the same drug); II (n = 4) patients on Ketanserin plus metoprolol (previously treated with Ketanserin, in whom it failed to normalize DBP); and III (n = 13) patients on Ketanserin (previously treated with metoprolol). In group I the blood pressure lowering effect of Ketanserin remained constant after one-year follow-up. In group II, although the number of patients was insufficient, a trend in the decrease of parameters was observed. In group III, supine and standing DBP diminished from 92.5 +/- 8 and 92.5 +/- 7 during treatment with metoprolol to 83.6 +/- 9 and 79.8 +/- 8 mmHg respectively at 12 months, after treatment with Ketanserin (p less than 0.05); accordingly, the cumulative percentage of normalized DBP increased from 4/13 after metoprolol to 12/13 at the end of the trial. Ketanserin side effects were minimal. Taking into account the wide variety of contraindications or side effects with beta blockers and diuretics, Ketanserin appears as a new and important alternative in the treatment of mild and moderate essential hypertension. PMID- 3544623 TI - Lung mechanics with relation to pulmonary haemodynamics, gas exchange and extravascular lung water in mechanically ventilated endotoxaemic pigs. AB - In a porcine model employing a continuous i.v. infusion of E. coli endotoxin the pathophysiology of early adult respiratory distress syndrome was studied with main emphasis on the early changes in lung mechanics and their relation to changes in pulmonary haemodynamics, gas exchange and extravascular lung water in intermittent positive pressure ventilated (IPPV) pigs under ketamine anaesthesia. Six animals served as controls and revealed no major physiological changes. Nine animals received endotoxin and developed significant changes in lung mechanics with increases in end-inspiratory pressure (32%), expiratory resistance (29%) and decrease in total dynamic lung compliance (27%). Changes in dynamic compliance and pulmonary haemodynamics displayed a 2-phase reaction. Venous admixture showed a rapid increase at with the increase in mean pulmonary arterial pressure (r = 0.8) and with the increase in venous admixture (r = -0.7). Extravascular lung water did not increase significantly. The decrease in dynamic compliance is most likely explained by peripheral airway constriction. A contributory factor might be pulmonary microvascular constriction with vascular stasis and mechanical compression of small airways. The increased venous admixture is best explained by a bronchiolar and microvascular constriction, i.e. a "dry" ventilation/perfusion inequality and not consequent to oedema. IPPV seems to counteract the increase in extravascular lung water. PMID- 3544624 TI - Treatment with prostaglandin E1 in a porcine model of early adult respiratory distress syndrome. AB - The effects of treatment with PGE1 were evaluated in a porcine model of early adult respiratory distress syndrome induced by endotoxaemia. Spontaneously breathing pigs under ketamine anaesthesia were infused i.v. with E. coli endotoxin (10 micrograms X kg-1 X h-1) for 6 h. Thirteen pigs were given endotoxin, and 11 pigs were treated with a continuous infusion of PGE1, 0.25 microgram X kg-1 X min-1 for 4 h, beginning 2 h after start of endotoxin and established lung injury. Four pigs served as controls and receiving only PGE1 (0.25 microgram X kg-1 X min-1) during the whole observation period of 6 h. PGE1 treatment did not influence the decline in platelet and polymorphonuclear cell counts, whereas it markedly decreased the pulmonary hypertension induced by endotoxaemia. The increased extravascular lung water returned towards baseline after institution of PGE1. The increased venous admixture was not significantly influenced by PGE1. Treatment with PGE1 induced an exacerbated hypotensive state in the endotoxaemic animals primarily due to vasodilation. The decline in cardiac output and oxygen delivery noted in endotoxaemic pigs were not influenced by PGE1 and survival was not improved. Although one should be extremely careful in extrapolating these data to the clinical situation the results from the present study suggest the need for optimum volume replacement when starting PGE1 infusion in endotoxin-induced ARDS. PMID- 3544625 TI - A low molecular weight heparin (KABI 2165) for prophylaxis of postoperative deep venous thrombosis. AB - In a prospective double-blind trial, low molecular weight (LMW) heparin (KABI 2165) 5,000 U (anti-Xa) once daily was compared with conventional heparin 5,000 IU twice daily, both given subcutaneously, as regards prevention of postoperative deep venous thrombosis (DVT) in 52 patients undergoing major abdominal surgery. Radioactive fibrinogen uptake test (FUT) was used for DVT screening. DVT, diagnosed from positive FUT, developed in two patients from each group, but could be phlebographically confirmed in only one (LMW) case. No intergroup differences were found in peroperative blood loss or requirements for blood transfusion. Complications attributable to the prophylactic regimens were few. In the LMW heparin group, the anti-Xa levels measured during operation showed considerable variation, the higher activities (greater than 0.30 U/ml) being nonsignificantly associated with increased blood loss. Studies with lower doses of LMW-heparin are recommended. PMID- 3544626 TI - Prophylaxis of deep vein thrombosis after major abdominal surgery. Comparison between dihydroergotamine-heparin and intermittent pneumatic calf compression and evaluation of added graduated static compression. AB - In a prospective, randomized study on 114 patients undergoing major abdominal surgery, the prophylactic effect of dihydroergotamine (DHE) combined with low dose heparin (LDH) against postoperative deep vein thrombosis (DVT) was compared with that of peroperative intermittent pneumatic calf compression (IPCC). The additive effect of graduated pressure stockings was also studied, by randomizing a stocking to the right or left leg in each patient. The 125I-fibrinogen test was used to diagnose DVT. The incidence of postoperative DVT was significantly lower in the DHE-LDH than in the IPCC group (4% v. 19%). In the IPCC group the incidence of postoperative DVT was equal in legs with and without stocking. The study thus indicated that DHE-LDH is more effective than peroperative IPCC in preventing DVT after major abdominal surgery, and that graduated pressure stockings do not enhance the prophylactic effect of peroperative IPCC. PMID- 3544627 TI - Immunoperoxidase confirmation of parathyroid origin of ultrasound-guided fine needle aspirates of the parathyroid glands. AB - It may be difficult to differentiate between cells of parathyroid and thyroid origin in ultrasound-guided fine needle aspirations of the neck region, even in patients with a clinical history of hyperparathyroidism. A parathyroid hormone antibody was used in an immunohistochemical system to confirm a parathyroid origin in fine needle aspirate smears from nine patients with hyperparathyroidism. Immunoperoxidase positivity for parathyroid hormone confirmed a parathyroid origin in six of nine cases and was strongly suggestive, although equivocal, in the remaining three cases. Technical problems included nonuniform staining and background staining. PMID- 3544628 TI - Immunocytodiagnosis of carcinocythemia in disseminated breast cancer. AB - A small number of large, malignant mononuclear cells were found in the blood of a patient with disseminated breast carcinoma. The detection of these scarce cells was facilitated by examining leukocyte concentrates. Cytochemical and immunochemical studies showed that these were epithelial cells, not hemopoietic cells. These findings, when correlated with the clinical features and the cytologic findings in blood and marrow, suggested that the malignant mononuclear cells in the blood were breast carcinoma cells. This study demonstrates the technical feasibility of accurately identifying cells in blood, which may stimulate interest in the study of cancer cells in the circulating blood. The method may also be applied to other cytologic specimens, such as fine needle aspirates, that contain only a few neoplastic cells. PMID- 3544629 TI - Detection of malignant melanoma of the uterine cervix from Papanicolaou smears. A case report. AB - A case of malignant amelanotic melanoma of the uterine cervix in a patient presenting with right hemiparesis and enlarged lymph nodes was diagnosed in Papanicolaou-stained cervical smears showing many melanoma cells. Melanoma cells with bizzare nuclear and cytoplasmic abnormalities, rarely seen in other tumors, helped to establish a positive diagnosis. The diagnosis was confirmed by histopathologic study of the endocervical surgical specimen, including a positive immunoperoxidase staining for S-100 protein. PMID- 3544630 TI - Human melanocytic naevi. III. Immunofluorescence and immunoelectron microscopy of the basement membrane zone. AB - Serum pemphigoid antibody (BPA) was used to demonstrate the intraepidermal location of human pigmented naevi. Immunofluorescence was predominant along the epidermal-dermal junction and around the naevus nests seemingly located in the dermis. Serial sections showed that these naevus nests were intraepidermal. The immuno-gold labelling technique for electron microscopy, was improved by using uranyl acetate with no osmium tetroxide or lead citrate. Hemidesmosomes were absent from the epidermal-dermal junction apposed to naevus nests. Gold labelling occurred in patches of particles along the lamina densa. The number of gold particles per micron length of lamina densa were quantitated. Immunofluorescence microscopy and immuno-gold electron microscopy confirmed the intraepidermal location of pigmented naevi. PMID- 3544631 TI - The effect of nadolol on heart rate in hyperthyroidism. A controlled trial. AB - Twenty hyperthyroid patients were randomly assigned in a double-blind fashion to receive either nadolol 80 mg/day or placebo for 2 weeks; all patients then took carbimazole as well from 2-6 weeks. Twenty-four hour Holter ECG recordings at 0, 2 and 6 weeks showed that nadolol reduced the mean maximum heart rate by 19.9% (P less than 0.0005) at 2 weeks and by 30.3% (P less than 0.0005) at 6 weeks compared to 5.2% (ns) and 18.3% (P less than 0.0005) in patients taking placebo. There was no alteration of the normal circadian variation of heart rate by nadolol. The minimum heart rate before therapy was significantly correlated with FT4 (r = 0.52) and with FT3 (r = 0.44). The percentage of time per hour during which the heart rate was greater than 100 was reduced by 79% at week 2 by nadolol compared to 22% in the placebo group. At the 6 week point the placebo group still had a tachycardia (mean maximum heart rate 101.6 beats/min +/- 15.2 SD) compared to the nadolol group (80.4 +/- 7.7). Nadolol did not cause excessive bradycardia. It is effective in the early management of hyperthyroidism and should be given for at least the first 4-6 weeks. PMID- 3544632 TI - Direct immunostaining of TSH receptor related autoantibodies in Graves' disease. AB - Ten thyroid specimens from patients with Graves' disease were investigated immunohistologically with respect to the localisation of thyrotropin (TSH) receptor related autoantibodies. After conventional preparation of formalin-fixed and paraffin-embedded thyroid slices for immunostaining, 3-5 micron tissue sections were incubated with a porcine thyrotropin receptor containing membrane preparation (pTSH-R). The TSH receptor containing membrane fragments bound to the thyroid tissue were revealed with a slightly modified unlabelled PAP technique according to Sternberger, using an antiserum to pTSH-R obtained from immunized rabbits. This technique resulted in a staining of a considerable portion of plasma cells within the lymphoplasmacellular infiltrates of all the Graves thyroids. No staining occurred if for negative control either pTSH-R or its antiserum from rabbit was omitted. In addition, the staining reaction was markedly reduced by pretreatment of pTSH-R with serum from patients with Graves' disease in order to occupy its binding sites for autoantibodies prior to the staining procedure. It is concluded that the staining of the intrathyroidal plasma cells is due to their synthesis of autoantibodies directed against TSH receptor related structures of thyroid epithelia. The results are in keeping with the concept that the thyroid as the target organ itself is the site of autoantibody synthesis in Graves' disease. PMID- 3544633 TI - Suppression of spermatogenesis in a nonhuman primate (Macaca fascicularis) by concomitant gonadotropin-releasing hormone antagonist and testosterone treatment. AB - The effects of concomitant testosterone (T)-supplementation on gonadotropin releasing hormone (GnRH) antagonist-induced testicular regression in cynomolgus monkeys (M. fascicularis) were investigated. Four adult monkeys were infused via osmotic minipumps with daily amounts of 2 mg of a potent GnRH antagonist (N-Ac-D Nal(2)1, D-pCl-Phe2, D-Trp3, D-hArg (Et2)6, D-Ala10)-GnRH (RS-68439) for a period of 104 days. Androgen substitution was provided via T-filled Silastic capsules implanted at initiation of GnRH antagonist treatment. Within 1-4 days of GnRH antagonist administration, serum concentrations of bioactive LH became undetectable. The implants maintained serum T at 50-80% of pre-treatment levels. Sperm production decreased in three out of four monkeys. One animal became azoospermic by the 13th week of treatment and the ejaculates of two other monkeys contained less than 5 X 10(6) sperm. In the fourth monkey, spermatogenesis was less affected. Testicular histology, judging from biopsies at termination of GnRH antagonist treatment, was typical of the hypogonadotropic status in 3 of the 4 monkeys. The most affected tubules contained only spermatogonia and Sertoli cells. Although comparison with GnRH antagonist treatment alone in a previous study indicated a delay of spermatogenic inhibition with testosterone, the present study confirms the potential of GnRH antagonist for male fertility regulation. PMID- 3544634 TI - Heterogeneity of immunoreactive gastric inhibitory polypeptide in the plasma of newly diagnosed type 1 (insulin-dependent) diabetics. AB - The aim was to compare the three molecular forms of plasma immunoreactive gastric inhibitory polypeptide (IR-GIP) i.e. void volume (Vo), 8 and 5 kDa IR-GIP, found in type 1 diabetics with those found in normal subjects. Plasma from 6 non fasting newly diagnosed ketotic type 1 diabetics obtained before and 1 h after a test meal given at start of insulin treatment, and before and 1 h after a test meal given after one and seven days of insulin treatment, respectively, was gel filtered and so was plasma from 6 normal subjects. The immunoreactivity in the effluents was measured with five different antisera. The elution positions of the three peaks were similar in controls and diabetics. With any given antiserum none of the components differed significantly as to amount of immunoreactivity between diabetics and controls, neither after the meals nor in the fasting state. The amount of Vo did not change in response to the meal, whereas the 8 and 5 kDa forms in the diabetics increased similarly to the increase in normals, also during ketosis. The Vo component did not differ significantly between diabetic and normal subjects, but it decreased significantly after start of insulin treatment. In the non-fasting, ketotic state before start of insulin treatment, no IR-GIP form was elevated significantly above normal postprandial levels. We conclude that the molecular forms of IR-GIP are similar in type 1 diabetics and normal subjects, but the molecular forms measured and their relative amounts vary according to which antiserum is used. The present study does not support that lack of insulin and ketosis markedly influence IR-GIP in plasma. PMID- 3544635 TI - [Indications for liver transplantation in 1986]. PMID- 3544636 TI - [Radiotherapy and combination radiochemotherapy in the treatment of primary cancers of the liver, pancreas and bile ducts]. PMID- 3544637 TI - [Diabetes in chronic calcifying pancreatitis]. PMID- 3544638 TI - [Insulin therapy in anesthesia and critical care and control of the diabetic in the peroperative period]. PMID- 3544639 TI - Pancytopenia associated with chronic graft-versus-host disease and possible immune-mediated regulation of hematopoiesis: report of a case. PMID- 3544640 TI - Adenosine in the inhibition of diazepam sedation by aminophylline. AB - Aminophylline in a low dose has been shown to reverse diazepam sedation. The present investigation was performed as a double-blind study to compare the effects of aminophylline and enprofylline on deep diazepam sedation after surgery. Enprofylline is a xanthine derivative with anti-asthmatic effect but, in contrast to aminophylline, enprofylline has very weak adenosine antagonistic properties. A comparison should make it possible to evaluate if adenosine is involved in the observed effects. Twenty male patients undergoing transurethral surgery in spinal anaesthesia were given diazepam during surgery to maintain a state of deep sedation. Postoperatively aminophylline or enprofylline was given from coded ampoules in equipotent anti-asthmatic doses (4.5 or 1.5 mg/kg). The degree of sedation was assessed prior to and after the injections. A difference between the groups was obvious. Patients given aminophylline showed rapid reversal of sedation, persisting throughout the 2-h observation period. Following enprofylline, a markedly slower reversal of sedation was observed. It is likely that aminophylline antagonises diazepam sedation by blocking adenosine receptors. Some clinical implications are outlined. PMID- 3544641 TI - Measurement of pulmonary capillary blood flow by a nitrous oxide rebreathing technique. AB - Measurements of pulmonary capillary blood flow by a nitrous oxide rebreathing technique (QN2O) were performed in 21 anesthetized and artificially ventilated minipigs with normal lungs and in nine minipigs with thrombin-induced (75-150 U kg-1 h-1) lung pathology. QN2O was calculated with the Hook-Meyer-formula and compared to cardiac output measurements (thermodilution, QT, or direct Fick's principle, QFick). The coefficient of variation in double QN2O measurements was 0.05. If the tidal volume to dead space ration (VD/VT) is normal, the nitrous oxide method works well, but when the efficacy of ventilation worsens, this gas uptake method fails to detect the circulation of the poorly ventilated parts of the lung. The mean ratio QN2O/QFick in pigs with normal lungs (58 measurements) was 1.00 +/- 0.10 (mean +/- s.d.). During thrombin infusion, the mean ratio QN2O/QT was 0.84 +/- 0.17 (n = 49). After corrections for shunt perfusion (Qs), the mean ration QN2O/(QT-Qs) was 0.89 +/- 0.17 (n = 49). QN2O/QT-Qs) decreased with increasing VD/VT. In measurements during thrombin infusion with VD/VT less than 0.33, the mean ratio QN2O/(QT-Qs) was 0.97 +/- 0.11 (n = 21), with a VD/VT between 0.33 and 0.44, the mean ratio QN2O (QT-QS) was 0.90 +/- 0.08 (n = 20), and with a VD/VT greater than or equal to 0.45, this ratio was 0.62 +/- 0.18 (n = 8). In the presence of only moderate functional inhomogeneities, this noninvasive rebreathing method will offer reliable data on pulmonary perfusion. PMID- 3544642 TI - Positive-pressure ventilation at moderately high frequency in newborn infants with respiratory distress syndrome (IRDS). AB - In 24 seriously ill newborn infants with respiratory distress syndrome (IRDS) and ensuing respiratory failure, high-frequency positive-pressure ventilation was administered. The mean gestational age of the infants was 32 +/- 3 weeks. In the infant ventilator employed, the compressible volume had been reduced in order to give higher flow rates but lower intratracheal pressures. The ventilation frequency was kept constant at 60-66 per min and the insufflation period at 32 35% of the ventilatory cycle. A positive end-expiratory pressure (PEEP) of 0.2 0.6 kPa was used. Arterial PCO2 was maintained at 4.0-5.3 kPa and PO2 at 8.5-10.5 kPa by adjusting the gas flow through the patient circuit, the peak tubing pressure, the PEEP and the oxygen concentration in inspired gas. High-frequency positive-pressure ventilation improved oxygenation and gave adequate alveolar ventilation in all infants, in most cases at a low peak pressure. Only one infant developed pneumothorax during intermittent positive pressure ventilation, and in no infant did bronchopulmonary dysplasia or retrolental fibroplasia occur. One infant died from intracranial hemorrhage during the ventilation period, giving a survival rate of 96%. PMID- 3544643 TI - The non-steroidal anti-inflammatory agent, indoprofen, does not protect against hydrochloric acid induced lung injury in the rat. AB - The effects of pulmonary instillation of hydrochloric acid on solute flux from the lung (measured as the clearance of 99mTcDTPA) together with an index of oedema formation (the ratio of lung wet weight to lung dry weight) was measured in rats. There was a significant increase in 99mTcDTPA clearance (P less than 0.001) and also in lung wet:dry weight ratio (P less than 0.01) 4-5 h following acid challenge. There was no difference in the effects of challenge with acid of pH1 and pH2. In addition, intravenous injection of indoprofen (20mg/kg) a non steroidal anti-inflammatory agent failed to produce any beneficial effect on the variables under study when given after acid (pH2) challenge. There was also histological evidence of an influx and sequestration of granulocytes into the lung. Despite this, the plasma concentration of thiobarbituric acid reactive material (used as an index of cell-derived, oxidant-free radical production) was significantly reduced in all acid-treated groups. These data show that hydrochloric acid will initiate a severe inflammatory response in the lung of the rat and that the non-steroidal anti-inflammatory agent indoprofen when given after the injury produced no evidence of a beneficial effect on this inflammatory response. PMID- 3544644 TI - Asystole and bradycardia in adult patients after a single dose of suxamethonium. AB - Two cases of cardiac asystole and one case of severe bradycardia were seen following a single injection of suxamethonium in a series of 46 adult patients in whom anaesthesia was induced with fentanyl and etomidate. It is suggested that the vagomimetic effects of fentanyl and, possibly also of etomidate, may contribute to the enhancement of the bradycardic effects of suxamethonium. PMID- 3544645 TI - Anaesthesiological complications in renal transplantation: a retrospective study of 500 transplantations. AB - This retrospective study consisted of 500 consecutive renal transplantations performed between September 1977 and September 1981. Preoperatively, congestive heart failure was registered in 262 cases (53.0%) and blood pressure disease in 352 cases (71.3%). The total number of patients with ischaemic heart disease was 22 (4.5%). General anaesthesia was given in 493 and regional anaesthesia in seven cases. In general anaesthesias, tubocurarine was the main relaxant and halothane the main inhalation agent used. Major complications during anaesthesia were blood pressure changes with a higher incidence of hypotension (49.6%) than hypertension (26.8%). Severe cardiac arrhythmias were rare and no intraoperative deaths occurred. One patient was successfully resuscitated in the ICU postoperatively, this being possibly related to hypoventilation caused by prolonged muscular relaxation. Other rare complications included one pneumothorax, one haemo- and hydrothorax, and two large haematomas all caused by preoperative central venous cannulation. In 69 cases (14.0%) additional neostigmine doses and in 34 cases (6.9%) naloxone was given at the end of anaesthesia. Pneumonia during the first postoperative week was recorded in 11 cases (2.2%), and occurred only in patients who received general anaesthesia. One of the three patients who died during the first week developed pneumonia postoperatively. PMID- 3544646 TI - Accidental hypothermia. Review of the literature. AB - The pathophysiology and treatment of accidental hypothermia are discussed. Special attention is paid to the pathophysiologic problems of rewarming. For severely hypothermic patients we would recommend peritoneal dialysis as the method of choice for rewarming in a hospital situation. In a "field situation" passive or slow active rewarming is recommended. PMID- 3544647 TI - Haemodynamic effects of nifedipine in patients undergoing coronary artery bypass surgery. AB - Forty patients scheduled for elective aortocoronary bypass surgery were entered in a double-blind study set up to compare the haemodynamic effects of 20 mg nifedipine (n = 20) and placebo (n = 20), both administered with the premedication. Global left ventricular function was normal in all patients. Anaesthesia was induced and maintained with standardized doses of fentanyl, flunitrazepam, and pancuronium together with 50% N2O. Cardiovascular responses to anaesthesia, intubation, skin incision, sternal retraction, and aortic manipulation were investigated. Throughout the study nifedipine produced a marked decrease in systemic vascular resistance. The reduction of left ventricular afterload was associated with an increase in cardiac index. In contrast to other reports, we observed no severe hypotension after nifedipine administration. Mean arterial pressure in patients from the nifedipine group was lower than in the placebo group only prior to anaesthesia. Since no negative drug interactions between nifedipine and the anaesthetic agents were observed, we conclude that the established cardiovascular benefit of nifedipine should be continued during anaesthesia. PMID- 3544648 TI - Diclofenac and oxycodone in treatment of postoperative pain: a double-blind trial. AB - The effects of a prostaglandin synthesis inhibitor (diclofenac, Voltaren) and an opiate (oxycodone, Oxanest) on postoperative pain were compared. Included in the study were 85 candidates for various operations. Patients requesting an analgesic were given either 75 mg of diclofenac or 10 mg of oxycodone as an intramuscular injection. The onset of analgesic effect occurred within 13 +/- 4 min with oxycodone and within 16 +/- 8 min with diclofenac. The analgesic effect of diclofenac was slightly weaker than that of oxycodone (on a pain scale of 1-4, 1.6/2.1 after 0.5 h and 1.5/1.8 after 1 h). The patients again asked for an analgesic after an average of 4.6 h in the oxycodone group and after an average of 6.1 h in the diclofenac group. The average number of injections required until the first postoperative morning was 2.5 in the oxycodone group and 1.8 in the diclofenac group. Side-effects: 21 patients in the oxycodone group reported a total of 39 side-effects and eight patients in the diclofenac group a total of 10 side-effects. Diclofenac is an alternative to opiates in the management of postoperative pain. It is especially useful in patients in whom opiates cause side-effects. PMID- 3544649 TI - Postoperative pain relief with high-dose epidural buprenorphine: a double-blind study. AB - Forty-five patients scheduled for major abdominal or intrathoracic surgery were assigned at random to two different groups. One group received 0.3 mg and the other 0.9 mg of buprenorphine epidurally to abolish postoperative pain. The first dose was given immediately upon arrival in the ICU, irrespective of pain. Subsequent medication was given on demand. The duration of action and side effects were recorded. Both doses produced excellent and long-lasting pain relief, but no statistically significant difference was found between the groups, with regard to either the duration of action or the occurrence of side-effects. PMID- 3544650 TI - Total body oxygen consumption and haemodynamics during the treatment of acute ischaemic heart failure with dopamine and high doses of insulin in dogs. AB - Acute ischaemic left ventricular failure was induced in closed-chest anaesthetized dogs by injection of 50 microns plastic microspheres into the left main coronary artery. This effected a 33% decrease in cardiac output. Dopamine and high doses of insulin restored cardiac output, and these agents in combination raised cardiac output to 34% above pre-ischaemic levels. Total body oxygen consumption was calculated at the various levels of cardiac output, and was found to remain essentially unchanged. Inotropic agents, then, may result in overperfusion with respect to oxygen demand. PMID- 3544651 TI - Combined effects of glucose and oxygen concentrations upon the ultrastructure of cultured islet cells and insulin accumulation in culture media. AB - Rat pancreatic islets cultured for 6 days at 100 or 500 mg/dl glucose and 20 or 7% O2 were examined electron-microscopically, and insulin accumulation in the culture media was assayed immunologically. In the islets cultured at 500 mg/dl glucose and 20% O2, B cells exhibited hypertrophy of granular endoplasmic reticulum and Golgi apparatus, an abundance of free ribosomes, degranulation and the margination of secretory granules. In islets cultured at 500 mg/dl glucose and 7% O2, B cells exhibited dilatation of endoplasmic reticulum cisternae and dominance of Golgi vesicles in addition to the above-mentioned changes. These changes, together with the correlated data on insulin accumulation, are discussed with special reference to the effects of glucose and oxygen upon the synthesis and release of insulin in B cells. PMID- 3544652 TI - Three-dimensional organization and topographical features of the myenteric plexus (Auerbach) in the porcine small intestine: scanning electron microscopy after enzymatic digestion and HCl-hydrolysis. AB - The present scanning electron microscopical (SEM) study was initiated to visualize the surface topography of Auerbach's plexus in the ileum of the pig. After enzymatic digestion of the connective-tissue components of the tunica muscularis and the tunica serosa followed by glutaraldehyde fixation, HCl hydrolysis and stripping off either the longitudinal or circular smooth muscle layer, the three-dimensional architecture and topographical features of the myenteric plexus can clearly be observed. In this way, ganglia, primary, secondary and tertiary strands, and single nerve fibres can be demonstrated. Individual nerve cells, which are incompletely covered by glial cells and by remnants of the basal lamina, can be recognized in the centre and periphery of the ganglia and adjacent to primary and secondary nerve strands. PMID- 3544653 TI - Comparative laboratory studies on alpha-methoxyimino furyl- and phenylacetamido cephalosporins: structure-activity relationships. AB - Eleven new cephalosporins (three phenylacetamido and eight furylacetamido) containing a methoxyimino group on the 7 beta-acyl side chain and having various substituents at their 3-positions, exhibited similar qualitative, but differing quantitative in vitro antibacterial spectra compared to that of cefuroxime, the first therapeutically used alpha-methoxyimino cephalosporin. The syn-isomers and the alpha-acyl substituted compounds are more active than either the anti-isomer or the beta-acyl substituted compounds. Compounds containing substituted tetrazole rings at the 3-position are likewise more active than those containing other types of substituents in this position. In vivo (mouse) the heterocyclic furylacetamido compounds are more efficacious (protective) than the aromatic phenylacetamido compounds. The furylacetamido alpha-methoxyimino cephalosporins containing at the 3-position the tetrazole group carrying an acidic function possess favorable pharmacokinetic properties, i.e., higher serum levels and prolonged biological half-lives in mouse and squirrel monkey and extensive binding to serum proteins. PMID- 3544654 TI - The treatment of accessory symptoms in narcolepsy: a double-blind cross-over study of a selective serotonin re-uptake inhibitor (femoxetine) versus placebo. AB - A randomized, double-blind cross-over trial was carried out in 10 patients with narcolepsy to evaluate the effect of 600 mg femoxetine versus placebo. In comparison to placebo, femoxetine treatment resulted in a significant decrease in both the number and severity score of cataplectic attacks per day. There were also significantly fewer attacks of sleep paralysis, whilst the effects on nightmare and hypnogenic hallucinations were minor. The frequency of sleep attacks decreased slightly during femoxetine treatment, but the overall estimated sleep time during the day and excessive daytime sleepiness remained un-affected. An ambulatory sleep recording for 48 h one week after the start of the femoxetine and placebo period showed that femoxetine treatment resulted in a significant decrease in the total time spent in REM sleep. The side-effects of femoxetine were restricted to transient nausea in 2 patients. It is concluded that femoxetine or other selective serotonin reuptake inhibitors may be a useful alternative for narcoleptic patients who experience troublesome side-effects with tricyclic antidepressants. PMID- 3544655 TI - Oral contraceptives and breast cancer in young women. Some notes on a current controversy. PMID- 3544656 TI - Intrauterine volume in pregnancy. AB - Intrauterine volume, a three-dimensional measure of growth, was evaluated in pregnancy. The ultrasonic method for measurement of volume was investigated for its accuracy and error potentials and then used to collect information on the growth of three volume components, - total intrauterine, intra-amniotic and placental volume, in the latter half of normal pregnancy. Against reference standards from the normal population, two other main groups, a non-selected and a pre-selected high-risk group, were studied, to test the hypothesis that a small intrauterine volume would predict the presence of a small-for-dates and possibly compromised baby. In previous times main interest in uterine volume had centered on its possible role in parturition. More recently ultrasound had been used to measure intrauterine volume in early pregnancy and a simple ultrasonic method of calculating total intrauterine volume had been used for diagnosing the small-for dates fetus. The study showed that in a phantom model situation, a method based on serial parallel planimetric area measurements was significantly more accurate than a linear measurement method that assumed the uterine shape to be like a prolate ellipsoid. With the former method 93.3% of measurements were within +/- 5% of the true volume with a mean error of -0.43%. When the method was evaluated for its accuracy in women undergoing midtrimester termination or in women delivering near term, there was good correlation between ultrasonically and directly/indirectly measured intra-amniotic volume suggesting that the same level of accuracy could be expected in pregnancy as found in the phantom models. Intra- and interobserver variation was small. The PPA method was used for all measurements in pregnancy because of its superior accuracy. Data from 115 healthy women with no pregnancy complications were evaluated longitudinally to study normal growth and derive reference standards. Median and mean values for total intrauterine volume increased from around 1,000 ml at 20 weeks to 4,500 ml at 40 weeks. The standard deviation was large at any stage of pregnancy, also for intra amniotic and placental volume. The rate of volume increase was near constant for total intrauterine and intra-amniotic volumes, except during the period 30-35 weeks, when a faster rise was observed. Placental volume growth decreased after 30 weeks. With growth of total volume following a largely linear trend, a tendency for ranking of volume levels was observed, but predictability of one measurement on the basis of earlier ones weakened with increasing separation of time points.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3544657 TI - On cantilever loading of vital and non-vital teeth. An experimental clinical study. AB - Three healthy subjects with neighboring or contralateral vital and root-filled teeth requiring crown therapy were selected as test persons. All teeth had optimal alveolar bone support. The root-filled teeth were furnished with individual cast posts and cores, and veneer crowns were made on both the vital and non-vital teeth. Buccal extension bars were then soldered to the occlusal surfaces of these crowns, and weights were applied in different positions along the bars until the test persons experienced pain. The experiments were repeated under local anesthesia. The results showed that non-vital teeth had mean pain threshold levels that, on cantilever loading, were more than twice as high as those of their neighboring or contralateral vital teeth. The positions of the centers of rotational deformations of the loaded teeth, which were assumed to be mainly rotational, were calculated and found to be located inside the peripheries of the crowns for the vital teeth but extracoronally in markedly more peripheral positions for the non-vital teeth. PMID- 3544658 TI - Is the early growth delay in the diabetic pregnancy accompanied by a delay in placental development? AB - We have previously shown that some fetuses in early diabetic pregnancy judged by the crown-rump length are smaller than expected from the menstrual history. Nine out of 26 fetuses in the present study were significantly (6 to 17 days) smaller than normal, and at birth they weighed 300 g less than the remainder. To examine whether this early somatic growth delay was accompanied by a delay in placental development, we correlated plasma levels of human placental lactogen (HPL) to menstrual age and growth delay. Multiple regression analysis showed that inclusion of the early growth delay as an explanatory variable significantly improved the correlation. The best correlation was achieved when menstrual ages were corrected by 90% of the early growth delay, suggesting that the somatic growth delay is accompanied by a similar delay in placental development. We recommend that every diabetic woman should undergo an ultrasound examination in early pregnancy, with determination of fetal size, and that management throughout pregnancy should be guided by the ultrasound age rather than that calculated from the first day of the last menstrual period. PMID- 3544659 TI - Fundal height growth in rural Africa. AB - Gestational age was assessed by ultrasound examination before the 22nd week of pregnancy in 118 Ethiopian women. Their pregnancies were monitored by taking symphysis-fundus measurements. 114 gave birth in the 37th week or later and their record were incorporated in the project. The average gestational age of this group was 39.7 weeks with an average birth weight of 3,256 g. The uterine growth pattern was the same as for Swedish women, although the mothers' average height was 156 cm (10 cm below the Swedish standard). PMID- 3544660 TI - Hemostasis in cold-knife conization. Effects and side effects of Glypressin, a long-acting analogue of lysine-vasopressin. AB - In a double-blind, randomized study, 50 patients undergoing conization were treated with either lysine-vasopressin (LVP) or its longer-acting analogue Glypressin. Bleeding during the operation and side effects were studied. The hemostatic effect appeared better with LVP than with Glypressin. One postoperative bleeding occurred in the whole series, in a patient treated with Glypressin. The effect on the general circulation, especially with respect to pallor of the skin, was less prominent with Glypressin than with LVP (with the concentrations used in this study). PMID- 3544661 TI - Urinary tract infection after vaginal surgery. Effect of prophylactic treatment with methenamine hippurate. AB - One hundred and nine consecutive patients undergoing surgery for uterovaginal prolapse followed by indwelling urinary catheter for 3 days were randomized for prophylactic treatment with methenamine hippurate (MH) or no MH prophylaxis. Significantly less bacteriuria occurred in the MH-treated patient group. In particular, the opportunistic hospital flora appeared to be suppressed by MH treatment. It is suggested that MH prophylaxis, 1 g three times daily, be used in gynecological surgery followed by short-term urinary catheterization. PMID- 3544662 TI - Normal range growth curves for fetal biparietal diameter, occipito frontal diameter, mean abdominal diameters and femur length. AB - Normal range curves for the growth of fetal biparietal diameter (BPD), occipitofrontal diameter (OFD), mean abdominal diameter (AD), and femur length (FL) were obtained in a longitudinal series of ultrasound measurements in 19 normal pregnancies. Regression analysis was used to fit the data to equations. The best equations for BPD and AD on gestational are close to similar longitudinally obtained regression curves from other Scandinavian countries. PMID- 3544663 TI - Follow up of babies delivered in a randomized controlled comparison of vacuum extraction and forceps delivery. AB - Babies delivered in a randomized controlled comparison of vacuum extraction vs. forceps delivery were reassessed at 9 months of age. There were no statistically significant differences between the two groups as regards head circumference, weight, or head circumference to weight ratio, nor in the results of hearing and vision tests. The reasons for hospital readmission, pediatric follow-up and parents' and health visitors' worries appeared to be unrelated to the mode of delivery in nearly all cases. The finding in the original trial that neonatal jaundice was more common following vacuum extraction was reinforced by an additional case of jaundice in the vacuum extractor group which had necessitated readmission to hospital. PMID- 3544664 TI - Reduced mortality in cancer patients after administration of alkoxyglycerols. AB - A regression of tumor growth is observed when alkoxyglycerols are administered prior to radiation treatment of patients suffering from cancer of the uterine cervix. This regression is remarkably higher for patients below the age of 60 years than for those over 60. The regression has been demonstrated by a change in the quotient between the incidence of early and advanced stages. PMID- 3544665 TI - Comparison between the conventional Malmstrom extractor and a new extractor with Silastic cup. AB - One hundred women for whom instrumental delivery had to be performed due to fetal asphyxia or uterine inertia were randomized to a vacuum extraction with the conventional Malmstrom instrument or the Silastic cup of Kobayashi. With the Silastic cup, extraction time was shorter and injuries to the scalp were less common. On the other hand, extraction with the Silastic cup failed more often, especially in occiput posterior position. There were no differences in Apgar scores between the two groups. PMID- 3544667 TI - Normal eyes in type 1 diabetics stay normal after one year of treatment with continuous subcutaneous insulin pump. AB - Seven patients with type 1 diabetes mellitus were restored to near normoglycaemia by treatment with continuous subcutaneous insulin infusion pumps (CSII). The patients were examined with ophthalmoscopy, fundus photography and fluorescein angiography before and one year after the start of CSII treatment. In addition, ophthalmoscopy was performed after 6 months of treatment. All 14 eyes were normal prior to the CSII treatment and none had developed any signs of retinopathy after 6 months or 1 year. It is concluded that metabolic control can be near normalized with CSII treatment without any risk for development of diabetic microangiopathy in type 1 diabetics with normal eyes. PMID- 3544666 TI - Endothelial cell density after penetrating keratoplasty using long-time banked donor material after long distance transportation (Denmark-Sweden). AB - Central corneal cell density was evaluated from photographs obtained by a clinical non-contact specular microscope (Zeiss) in 48 patients at a mean post operative time of 7 1/2 months after penetrating keratoplasty for a number of different causes, keratoconus being the most frequent indication. Cell density decrease on this occasion was compared to pre-operative data from the Eye Bank in Arhus, Denmark, which supplied corneo-scleral preparations transported by ferry and train to Linkoping, Sweden. A mean decrease in cell density of 4.4% was recorded during bank time (11-27 days). A further mean decrease from final preparation to post-operative photography of 36.5% was found. Mean total cell density decrease amounted to 39.4%, which compares well with results found in other studies. Among several factors studied, the only one associated with significantly (P less than 0.02) greater cell density decrease than other factors was long post-mortal time periods (death to bank preparation). Mean final endothelial cell density was 1899 cells/mm2, which should correspond to a good functional reserve of donor endothelium. Neither the long bank time, nor the transportation seemed to be of major importance with respect to donor material quality. Foreign material supply can be a good solution to local corneal shortage. PMID- 3544668 TI - S-100 protein in retinoblastoma revisited. An immunohistochemical study. AB - Fifty formalin-fixed and paraffin-embedded retinoblastoma specimens were studied for the presence of S-100 protein in malignant tumour cells and in reactive glial cells. Its distribution in four normal human eyeglobes enucleated because of an orbital tumour was also studied. The laboratory method was a sensitive immunohistochemical staining procedure, and sections from human brain served as controls. Three anti-S-100 protein antisera were used to determine whether previously reported discrepancies could be related to differences in antibody specificity, but all gave identical results. In morphologically normal human retina, a strong reaction for S-100 protein was seen in astrocytes, and a faint, inconsistent positivity was detected in Muller's cells. All intraocular retinoblastomata studied contained cells positive for S-100 protein, which seemed to be reactive glial cells derived from infiltrated retina. Undifferentiated malignant retinoblastoma cells, as well as differentiated tumour cells in Flexner Wintersteiner rosettes were negative for S-100 protein. Differentiated tumours appeared to contain more S-100 protein-positive glial cells than undifferentiated tumours, but this may be related to their different growth rates. The results do not support the theory that retinoblastoma cells express glial properties. PMID- 3544669 TI - Reconstructive microsurgery--a review. AB - We present some important current applications of reconstructive microsurgery. This field is expanding rapidly and the techniques are finding application in many branches of surgery. There is a pressing need for educational programs and training in microsurgery, as well as for continued research. Many of the procedures reviewed here have already been shown to substantially reduce costs, shorten hospitalization, and lessen patient disability; and as a result, several conventional procedures have been out-dated. We have stressed the concept that this is team surgery. To cover the needs of replantation and emergency free flaps around the clock, several microsurgeons must work together in established centers, and the team must possess expertise from all the involved surgical specialities. This may imply revision of many organizational aspects of patient care. Replantation centers would provide the necessary educational bases and give an impetus to the development of microsurgery. PMID- 3544670 TI - Sonography in congenital dislocation of the hip. AB - A new technique for ultrasonic examination of the hip joint was evaluated in neonatals and infants. An anterior approach was used with the sound sector centered over the femoral head and parallel to the femoral neck. The ultrasonograms corresponded to lateral radiographs of the joint with the leg in Lorenz' first position. It was possible to evaluate the size and depth of the acetabulum and the size and position of the femoral head. The projection also permitted a dynamic examination for determination of hip instability. Thus, the technique provided a method for an objective diagnosis in congenital dislocation of the hip (CDH). In 216 hips, the results of clinical evaluation for CDH were correlated with the degree of instability demonstrated by ultrasound. The comparison showed the clinical diagnosis to be highly inaccurate. PMID- 3544671 TI - Release of gentamicin from bone cement. An ex-vivo study. AB - Gentamycin-loaded cement from 16 patients undergoing revision of hip arthroplasty was studied. Samples removed at surgery were analyzed for gentamicin using an enzyme-linked immunoassay. Seventy-eight (55-98) per cent of the gentamicin was retained within the cement after 24 (1-48) months. PMID- 3544672 TI - Anders Hulth 70 years. PMID- 3544673 TI - Bizarre leiomyoblastoma of the cervix uteri. Immunohistochemical and ultrastructural study. AB - A case of bizarre leiomyoblastoma (BL) of the cervix uteri which developed in a 44-year-old premenopausal woman was reported. The tumor was found as a cervical polyp by routine pelvic examination. Histologically, it was composed of epithelioid and bizarre, often multinucleated, giant tumor cells without elevated mitotic counts and necrosis. Electronmicroscopically, abundant myofilaments in epithelioid tumor cells were observed. Immunoreactive desmin, CPK-MM (creatinine kinase mm-isozyme), and myosin could be demonstrated in most of the epithelioid tumor cells. These immunohistochemical findings seemed to reflect on the differentiation of the tumor cells to smooth muscle and provide a reliable evidence for the smooth muscle origin. The histogenesis and relationship between the histopathological findings and clinical behaviour of uterine BL were also discussed. PMID- 3544674 TI - Monoclonal antibodies to GFAP epitopes available in formaldehyde fixed tissue. AB - We have recently demonstrated that one of our monoclonal antibodies (MAB's) to glial fibrillary acidic protein (GFAP) recognizes an epitope on this molecule which is to a large degree blocked during fixation with formaldehyde or crosslinking with Dithiobis (Succinimidyl) Propionate (DTSP). This was shown to be due to the crossbinding of a single or a number of proteins to the GFAP and is not due to a change in the epitope on GFAP induced by the fixation itself. In an attempt to produce further MAB's capable of recognizing epitopes on the GFAP molecule available following formaldehyde fixation, we immunized BALB-C mice with cytoskeletal preparations of human glioma cells which contain GFAP where the blocking protein or proteins were crossbound by DTSP or formaldehyde to the GFAP. Following fusion of the spleen lymphocytes to Sp 2/0 myeloma cells we have cloned hybridomas which produce antibodies that recognize GFAP in formaldehyde fixed tissues. This method presents the antigen in its native "fixed" state for the mouse's immune system and avoids the production of MAB's which (although excellent for immunochemical studies) do not recognize any epitopes available on the molecule in question in formaldehyde fixed tissues. Antibodies so produced are of great interest in routine pathology where most tissues are still, unfortunately, undiscriminately fixed in formalin. The results also show that GFAP varies immunologically in different species (i.e. human v. rat/mouse) and confirm that the GFAP of the PNS is immunologically distinct and/or associated with different proteins from that found in the CNS. PMID- 3544675 TI - [Use of the computer and the pharmaceutical analysis in recent years in China]. PMID- 3544676 TI - [Opioid peptides and immunity]. PMID- 3544677 TI - [Recent progress in the pharmacology of learning and memory in China]. PMID- 3544678 TI - Modifications of the pancreatic beta-cell function after lowering their potassium content. AB - beta-cell-rich pancreatic islets from ob/ob-mice were kept for 3 days in a culture medium and analysed for their content of potassium. In a normal ionic milieu intracellular potassium was calculated as 190-260 mM. Whereas this concentration remained essentially unaffected after lowering extracellular K+ to 1.5 mM, further reduction to 0.15 mM depressed islet potassium to 5% or less of its original value. Irrespective of its medium concentration, potassium in the islets increased when glucose was raised from 1 to 20 mM. Depression of the islet potassium was associated with a rise of intracellular calcium. Despite profound depletion of potassium, the beta-cells maintained their insulin content and could still oxidize glucose at a substantial rate. When potassium was suppressed to 25% or less of the original content, the beta-cells responded to glucose with a paradoxical inhibition of insulin release. After 3 days of potassium depletion, exposure to a normal ionic milieu neither restored the intracellular content of potassium nor a stimulated insulin secretory response to glucose. PMID- 3544679 TI - Insulin treatment normalizes decreased glucose transport capacity in streptozotocin-diabetic rat muscle. PMID- 3544681 TI - Studies on pulmonary ventilation using digital subtraction radiography. A preliminary report. AB - Digital subtraction radiography was used in 84 patients with suspected pulmonary embolism to obtain information about localized changes in ventilation of the lungs. Preliminary experiences in patients with carcinoma of the lung, emphysema and acute inflammatory diseases have also been obtained. Digital subtraction radiography is a simple, rapid and inexpensive method to obtain information about ventilation in the lungs. It is completely non-invasive and requires only minimal cooperation of the patient. The sensitivity appears to be as good as that of 133Xe radionuclide ventilation studies. PMID- 3544680 TI - Assessment of bone mineral content and bone mass by non-invasive radiologic methods. AB - Methods for quantitative determination of bone mineral and bone mass in normal subjects and in patients with metabolic bone disorders can be measured by the Compton scattering technique, the neutron activation analysis, by measurement of metacarpal bone mass, by single and dual photon absorptiometry, and by quantitative computed tomography. Measurement on metacarpal bone (radiogrammetry) seems to be able to distinguish between resorption and/or new bone formation at the periosteal and/or endosteal surface. The intraindividual observer variation on combined cortical thickness (D-d), cortical area (D2-d2), metacarpal bone mass (D2-d2)/D2-varies from 0.7 to 2.5 per cent and the interindividual observer variation from 1.0 to 5.8 per cent. Single photon absorptiometry measures bone mineral content in the forearm with great precision. The reproducibility using repeated measurements and automatic selection of the measuring area is about one per cent and can be used to follow changes in mineral content with time in patients with metabolic bone diseases. The dual photon absorptiometry may be used for measurements of bone mineral content in lumbar spine, in the femoral neck and measurement of total body calcium with an accuracy of less than 6 per cent and a precision below 3 per cent. Quantitative computed tomography has the ability to measure trabecular and cortical bone both centrally and peripherally. Using CT scanning, scanner related changes with time (day-to-day variation +/- 4%), patient repositioning (less than 1.5%), and fat concentration (residual uncertainty of approximately 1/6 of the biologic variation) are important factors influencing the accuracy and reproducibility of the values of the measured bone mineral content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544682 TI - Vascular enhancement during incremental body computed tomography. A simple and reliable technique. AB - An initial manual bolus injection of contrast medium to an amount of 15 g iodine immediately followed by a manual infusion of 25 to 35 g iodine during 3 to 5 minutes will provide proper enhancement of vascular structures (110-150 HU) at incremental body computed tomography during that time and for some minutes after the end of the infusion. This technique applied in more than 1,000 examinations proved it to be reliable, simple and fast. A computed tomograph allowing 3 scans per minute permits an adequate and even level of vascular enhancement of the entire neck, mediastinum, abdomen or pelvis when continuous or more sparse slices of about 10 mm thickness are used. When the images are reconstructed without delay and presented on a monitor in the scanning suite, it is possible to individually optimize the rate of infusion and thereby also minimize the amount of contrast medium. A prerequisite for a proper vascular enhancement is a high rate of infusion initially. PMID- 3544683 TI - Ultrasonographic investigation of respiratory influence on diameters of portal vessels in normal subjects. AB - In order to improve the basis for ultrasonographic studies of portal hypertension the normal diameters and respiratory variations in the portal vessels were measured in sixty-seven volunteers. In healthy subjects, measurements were made on the portal vein and its major tributaries. The respiratory variations were most prominent in the splenic vein, somewhat less in the superior mesenteric vein and least in the portal vein. There were no significant correlations to weight, age or height. The hypothesis that examinations performed after food intake would give more prominent respiratory variations had to be rejected but showed that the portal vein should be examined under defined conditions regarding alimentary status. The diameters alone of the portal vessels can probably not be used reliably as an indicator of portal hypertension while a respiratory variation of less than 30 per cent in the splenic vein should be considered pathologic and lead to further investigations. PMID- 3544684 TI - Ileocolic intussusception in large cell lymphoma of the terminal ileum. Report of a case. AB - A case of an adult patient with ileocolic intussusception secondary to a lymphoma of the terminal ileum is reported. On the computed tomograms, a target mass, with the outer rim representing the annular tumour of the terminal ileum and the eccentric rim of low attenuation representing the mesentery, is described. Ultrasound patterns are those of parallel hypoechoic areas separated by hyperechoic stripes seen on longitudinal sections, and of a rounded mass of low echogenicity, exhibiting two hyperechoic concentric ring-like areas within it, on transverse scans. The appearances of the barium examinations are also described. The English literature is reviewed. PMID- 3544685 TI - Caliceal clubbing and adjacent parenchymal scarring (always reflux nephropathy?) as a cause of end-stage renal failure. AB - Various clinical and laboratory aspects in 15 kidney transplanted patients with urographic evidence of caliceal clubbing and adjacent parenchymal scarring in their native kidneys are reported. These lesions were found in 16 per cent of our series of kidney transplantations; below 35 years of age it was the second most frequent disease. In 9 of these patients severe vesicoureteral reflux had been demonstrated. In the remaining 6 patients reflux nephropathy was only a tentative diagnosis based on a striking similarity in the radiographs and in several clinical findings. Nine patients had symptoms (mainly related to urinary tract infection) from 1 to 17 years before diagnosis/urography, in 5 as early as the first year of life. Recurrent urinary tract infection and renal impairment were the most frequent disorders leading to the diagnosis. Replacement therapy was initiated at an average age of 32.7 years. Following renal transplantation urinary tract infection was documented in 37 per cent of patients whether the patient had been bilaterally nephrectomized or not. PMID- 3544686 TI - Torsion of a wandering spleen in an infant. Report of a case and a brief review of the literature. AB - A case of torsion of the wandering spleen in an infant is presented. The value and limitations of various imaging modalities in making a correct preoperative diagnosis are discussed and a brief review of the literature is given. PMID- 3544687 TI - Tumour necrosis factor--an overview. PMID- 3544688 TI - Warfarin and uric acid after myocardial infarction. AB - In order to assess the influence of warfarin on serum urate concentration, changes in serum urate were studied in 50 patients after myocardial infarction. The patients studied were part of a prospective, randomized placebo-controlled study of warfarin after myocardial infarction. Twenty-three of the patients were treated with warfarin and 27 received placebo. The mean uric acid level fell in both groups during an average of 10 months (range 6-20 months), the reduction being of the same order of magnitude in either group. This implies that warfarin, in contrast to some other oral anticoagulants, does not exert any uric acid lowering effect. PMID- 3544689 TI - Variability of blood pressure in ambulatory hypertensive patients: effects of verapamil on twice and thrice daily dose regimens. AB - The antihypertensive effects of verapamil over 24 hours were assessed on twice and thrice daily dose regimens on 12 patients (25-65 years of age; mean age 50) with essential hypertension (WHO stages I-II) in a randomised, double-blind, cross-over trial. After a dose titration period starting with either verapamil 80 mg tid or 120 mg bid the patients kept their maintenance dose (240, 360 or 480 mg daily) for 4 weeks before crossing over to the other administration schedule. Repeated ambulatory blood pressure (BP) curves were recorded in 10 patients with a non-invasive portable device (Pressurometer III, Del Mar Avionics). The BP reductions (causal BP values) obtained by 2- and 3-dose regimens were of similar magnitude (from 170 +/- 19/105 +/- 8 on placebo to 140 +/- 17/87 +/- 7 and to 146 +/- 14/88 +/- 8 by 2-and 3-dose respectively). Analyses of BP curves revealed close similarity in profiles on the two dose regimens, although DBP was significantly (p less than 0.05) lower by 3-dose as compared to 2-dose regimen during the period 0.00-2.59 a.m. Long-term (circadian rhythm) and short-term variability did not differ between the regimens. Despite the slight difference in DBP curves after midnight, the overall impression is that verapamil given both twice and thrice daily provides adequate BP control throughout 24 hours. PMID- 3544690 TI - Low-dose antihypertensive treatment with a thiazide diuretic is not diabetogenic. A 10-year controlled trial with bendroflumethiazide. AB - Blood pressure (BP) and metabolic variables were determined initially and after 1, 2, 4, 6 and 10 years' treatment in two groups of hypertensive men (n = 53 each) randomized to bendroflumethiazide 2.5-5 mg/day or propranolol 160-320 mg daily. There was no significant differences in BP or metabolic variables between the two groups at entry. BP was reduced to the same degree by both treatments. Five men in the propranolol group and one man in the thiazide group developed clinically overt diabetes during follow-up. Fasting blood sugar increased slightly but significantly though equally in both groups. Oral glucose tolerance was initially impaired to the same degree in both groups but improved significantly during treatment with both drugs. Fasting insulin increased slightly but to the same degree. While serum potassium decreased significantly in the thiazide group, the total body potassium was unchanged in this group. In the propranolol group, serum potassium rose, while total body potassium decreased significantly. Serum urate increased in both groups, though slightly more during thiazide treatment. One case of gout was found in each group. There was no difference in serum lipids between the two groups. The finding in this long-term trial indicate that in middle-aged men with mild to moderate hypertension a low dose thiazide diuretic like bendroflumethiazide is as effective and safe an antihypertensive agent as the beta-blocker propranolol is and that it does not induce diabetes. The total clinical picture favors the retention of thiazide diuretics as a first choice drug in hypertension. PMID- 3544691 TI - Glucose tolerance in patients undergoing continuous ambulatory peritoneal dialysis. AB - The effects of continuous ambulatory peritoneal dialysis (CAPD) on glucose tolerance and serum immunoreactive insulin and glucagon responses to oral glucose over the first year of therapy were studied in 13 uremic patients. Oral glucose tolerance tests were performed before treatment started, and again after 3 and 12 months on CAPD. Before CAPD, the patients showed decreased glucose tolerance. However, neither fasting blood glucose and serum insulin and glucagon levels nor the insulin and glucagon levels during the tests were significantly different from results obtained in 13 healthy controls. During CAPD, the mean intraperitoneal supply of glucose from the dialysates varied between 121 and 245 g/day and did not change during the study period. Glucose tolerance and hormone responses to glucose did not change during the study period. No patient developed manifest diabetes mellitus. We conclude that glucose intolerance in uremia persists during CAPD, but despite the continuous peritoneal absorption of 100-200 g of glucose during CAPD, the treatment had no effect on glucose tolerance and insulin secretory response. PMID- 3544692 TI - Atherosclerosis basic mechanisms. PMID- 3544693 TI - Epidemiology and primary prevention. PMID- 3544694 TI - Coronary bypass surgery. PMID- 3544695 TI - [Man and disease]. PMID- 3544696 TI - [Morphology of cervical margins in fixed prosthetics]. PMID- 3544697 TI - [Collarless ceramometal restorations: an original simplified method using 0.0005 inch (12.7 microns) platinum foil]. PMID- 3544698 TI - Sex differences in tobacco withdrawal syndrome. AB - Prospective data from an inpatient (n = 20) and outpatient (n = 50) study were examined for sex differences in tobacco withdrawal symptoms. With each subject serving as his/her own control, changes in a wide range of physiological, psychological and behavioral measures were determined from baseline to tobacco abstinence condition. For all 46 measures, no statistically significant differences between men and women were found in either the number or severity of tobacco withdrawal symptoms. PMID- 3544699 TI - Fred Shafizadeh 1924-1983. PMID- 3544700 TI - Biosynthesis of bacterial polysaccharide chains composed of repeating units. PMID- 3544701 TI - Vibrational spectra of carbohydrates. PMID- 3544702 TI - Monosaccharide isothiocyanates and thiocyanates: synthesis, chemistry, and preparative applications. PMID- 3544703 TI - Branched-chain amino and keto acid metabolism in pancreatic islets. AB - The metabolism of L-leucine in pancreatic islets is reviewed. Regulatory sites may involve the transport and intracellular distribution of L-leucine, its transamination as modulated by the availability of 2-keto acids, the activity of branched-chain 2 keto acid dehydrogenase and the further catabolism of isovaleryl coenzyme A. Emphasis is also placed on the activation of glutamate dehydrogenase by L-leucine, its interference with the utilization of endogenous nutrients and the reciprocal effects of L-leucine and either L-glutamine or L-asparagine upon their respective metabolism. The relevance of L-leucine metabolism to its insulinotropic action is underlined. PMID- 3544704 TI - Biological functions of serine proteases in the granules of rat mast cells. AB - The effects of specific low- and high-molecular weight inhibitors of chymase and tryptase and F(ab')2 of antichymase on histamine release from activated mast cells were examined. The release of histamine induced by anti-rat immunoglobulin E was markedly inhibited by F(ab')2 fragments of antichymase and the low molecular weight inhibitor of chymase chymostatin, whereas release of histamine induced by calcium ionophore A23187 was inhibited only by chymostatin. Neither the inhibitor nor the antibody affected histamine release induced by compound 48/80. These results suggest that two main chymotrypsin-type proteases are involved in process of degranulation: one is chymase, which acts at a step before calcium entry, and the other is an unidentified protease, which acts at a step after calcium entry. These results are summarized in Figure 8. After degranulation, released chymase remains associated with the cell surface while released tryptase was found in the extracellular milieu. Tryptase converted bovine prothrombin to thrombin, as shown by increase in thrombin activity with a synthetic substrate, t-butyloxy-carbonyl-Val-Pro-Arg-4-methyl-coumaryl-7-amide. The apparent Km value toward prothrombin was relatively low (2.3 microM), suggesting that tryptase contributes to blood coagulation or the process of fibrosis in tissues. The proteolytic products of IgG1 produced by chymase had chemotactic activity for neutrophil leukocytes in vitro and in vivo. These findings indicate the possible functions of these proteases after degranulation. PMID- 3544705 TI - Interaction of actin with the enzymes of carbohydrate metabolism. AB - As was shown earlier, actin is present not only in muscles, but in other animal tissues as well. Now it is firmly established that actin is built into cytoskeleton structures and is a necessary component of all kinds of eukaryotic cells. As is known, the main functions of the cytoskeleton are maintenance of the cell form and participation in the motile processes. At the same time a lot of information is available which indicates the regulatory role of actin in carbohydrate metabolism. The interaction of F-actin with most of the muscle glycolytic enzymes which are located in the region of actin filaments was shown in vitro. In particular, it was established that F-actin forms a complex with glyceraldehyde phosphate dehydrogenase and increases its activity. F-actin interacts with lactate dehydrogenase, forming a complex in which one molecule of the enzyme binds four actin monomers. The formation of the complex results in inhibition of lactate dehydrogenase activity. And, finally, F-actin has a strong activating effect on cellulase which belongs to the other enzyme system. Now the information is available on the induction of cellulase gene expression accompanied by an increase in actin synthesis. These results prove the opinion that actin is a coordinator of carbohydrate metabolism in the cell. PMID- 3544706 TI - Protein properties of the subunits of ribonucleotide reductase and the specificity of the allosteric site(s). AB - Ribonucleotide reductase catalyzes the critical reaction in which the deoxyribonucleotides required for DNA replication are synthesized de novo. This enzyme consists of two non-identical protein subunits, both of which are required for enzymatic activity. These subunits consist of a non-heme iron and an effector binding subunit. These subunits are not coordinately regulated as the cells pass from G1 to the S phase of the cell cycle. Studies carried out with the holoenzyme and the isolated subunits indicate that the effector-binding subunit is more susceptible to chymotrypsin and the sulfhydryl reagents, pCMB and NEM, than is the non-heme iron subunit. The non-heme iron subunit is more susceptible to trypsin than is the effector-binding subunit. The presence of ATP or dATP protects the effector-binding subunit from proteolysis by either trypsin or chymotrypsin. The loss of activity in the holoenzyme, as a result of proteolysis, parallels the loss of the particular subunit. These results demonstrate that the protein properties of the subunits are significantly different to account for the differential turnover. The binding of nucleotides to the effector-binding site(s), which in turn regulates ribonucleotide reductase activity, is very specific. Formycin 5'-triphosphate and etheno-ATP could not replace ATP in the CDP reductase reaction. 2',3'-DideoxyATP was 5-fold less active than dATP as a negative effector; etheno-dATP was not inhibitory. AraGTP and BuPdGTP could not replace dGTP as a positive effector of ADP reduction. BuPdGTP, but not araGTP, served as an inhibitor of CDP reduction. 2',3'-DideoxyTTP was much less active as either an activator of GDP reduction or an inhibitor of ADP reduction. These studies indicate that the binding to the allosteric sites is highly specific and suggest that the structural requirements for the binding of activators are different from the structural requirements for the binding of inhibitors. PMID- 3544707 TI - Control of phenylalanine and tyrosine metabolism by phosphorylation mechanisms. AB - A system for the parallel determination of enzyme phosphorylation and expressed activity in rat liver cells, and its application to studies of phenylalanine hydroxylase and tyrosine aminotransferase, is described. Phenylalanine hydroxylase is phosphorylated by agents which stimulate cyclic AMP- and Ca2+ dependent protein kinase activity. The phosphorylation site(s) appear to be the same for both kinases. Phosphorylation is accompanied by increased metabolic flux at low, physiologically relevant, substrate concentrations. Insulin and spermine both inhibit the phosphorylation of the enzyme, possibly by increasing dephosphorylation. Tyrosine aminotransferase is phosphorylated in liver cell incubations but the rate is slow and insensitive to additions to the medium. No parallel changes in flux could be detected. Both enzymes are subject to complex regulatory mechanisms, short- and long-term. Their activities may be coordinated in vivo by control exerted at the level of the plasma membrane where both amino acids share the same transport processes. Determination of the control coefficients for the several components indicates that membrane transport may be a major limitation on flux. PMID- 3544708 TI - Mechanisms involved in the induction of malignant cell differentiation. AB - Cancer appears to be a disease of altered maturation, with changes in genetic expression leading to a situation in which the physiological regulation of cellular proliferation and maturation are altered. Environmental factors as well as defined chemical agents have been demonstrated to have the capacity to convert neoplastic cells to end-stage forms with a finite life span through a process characteristic of cellular maturation. The correction of genetic defects by these inducers of differentiation does not appear to be required; the critical feature is that the differentiated cells assume a state in which they no longer possess the capability for continued cellular replication. The extrapolation of these advances, accomplished in experimental systems, to clinical practice should yield significant decreases in the neoplastic cell burden without the degree of morbidity produced by aggressive therapy with cytodestructive agents, especially when employed in multidrug combinations. The ultimate introduction of differentiation as a therapeutic approach to cancer treatment if attained, however, will require a variety of principles to be established, so that optimum efficacy may be obtained from each agent, the fabrication of new agents with major changes in the ratio of the concentrations required to produce cytotoxicity relative to those necessary to initiate maturation is attained, and the elucidation of non-antagonistic combinations of differentiation inducing agents with or without cytotoxic drugs is achieved to combat the problem of tumor cell heterogeneity. PMID- 3544709 TI - Regulation of carbamoyl-phosphate synthase II. AB - Evidence was provided that in rat liver synthase II activity, amount and turnover were regulated primarily by insulin. When rats were starved, synthase II activity and the immunotitratable enzyme amount markedly decreased; refeeding restored enzyme activity and amount to normal range. The changes in activity and amount were paralleled with alterations in the level of circulating insulin in the plasma. When starved rats were treated with anti-insulin serum before and during refeeding, the animals consumed the food, but the rise in synthase II activity was prevented. In diabetic rats, the activity and amount of synthase II in the liver markedly decreased and insulin treatment restored them to normal range. Actinomycin treatment prevented the refeeding and the insulin-induced rise in synthase II activity and amount. Study of the turnover of synthase II showed that in starvation the rate of synthesis decreased and refeeding restored the enzyme synthetic and degradation rates to normal range. In the diabetic rat, synthase II synthetic rate markedly decreased, and the degradation rate increased. Insulin returned the synthetic and catabolic rates to normal livers. In rapidly growing rat hepatoma 3924A, synthase II activity and amount were elevated 9- to 10-fold. Turnover studies showed that the synthetic rate in hepatoma 3924A was approximately 10-fold higher than that of normal liver. The catabolic rates of synthase II were similar in the liver and hepatoma. Thus, the increased activity and amount of synthase II in the hepatoma was due primarily to an increased rate of enzyme biosynthesis. Evidence was presented that in starvation and diabetes and on refeeding and insulin administration there is very little or no change in the enzymic activity, amount and turnover of hepatoma synthase II. The marked contrast between the turnover rate of hepatoma 3924A synthase II activity and that of the normal liver enzyme in starvation and in diabetes is under investigation. This overview of the behavior of activity, amount and turnover of synthase II in liver and hepatoma 3924A provides evidence of the important role of insulin in regulation of liver synthase II and of the apparent lack of responsiveness of the hepatoma enzyme to insulin concentrations. The precise details of the experimental procedures and the enzymic results will be published elsewhere. PMID- 3544710 TI - Enzymology of quinoproteins. PMID- 3544711 TI - NMR studies of the mechanism of enzyme action. PMID- 3544712 TI - Interaction of human low molecular weight kininogen with human mast cell tryptase. AB - The capacity of purified tryptase, the major neutral tryptic protease of human lung mast cells, to serve as a kininogenase was examined with purified human low molecular weight kininogen (LMWK) as the substrate. Incubating of 25 mug of tryptase with LMWK for 2 to 30 minutes, with or without heparin, yielded no net time-dependent kinin release as determined on the estrous rat uterus. The 0.4 mug of kinin seen represented less than 10% of that released from excess LMWK by 5 mug of human urinary kallikrein in 5 min. Incubation at pH 5.5 with or without heparin did not significantly alter this result. LMWK did not appear by SDS-PAGE to be cleaved by tryptase either in the presence or absence of heparin. In contrast to its action on HMWK, tryptase did not extensively cleave LMWK, or destroy its reactivity with kallikrein. PMID- 3544713 TI - Purification and partial characterization of cat pancreatic and urinary kallikreins--comparison with other cat tissue kallikreins and related proteases. AB - Kallikreins have been purified from cat pancreas and urine by methods similar to those described previously for cat colon and submandibular gland kallikreins. The pancreatic kallikrein (M.W. 41,200, pI 4.75) was similar to the urinary kallikrein (M.W. 34,300 pI 4.35-4.70) in pH optimum, substrate specificity and inhibition profile. Both enzymes were potent kininogenases and immunologically similar. These enzymes closely resembled the kallikreins from cat colon and submandibular glands. A trypsin (M.W. 18,800) was isolated from cat pancreas and shown to be distinct from the group of kallikreins in all parameters tested. We attempted purification of cat renal kallikrein, but were unable to isolate any such enzyme. The major acidic esterase of cat kidney cortex (M.W. 59,000, pI 4.91) was purified and was distinct from both the cat tissue kallikreins and trypsin. The origin of cat urinary kallikrein remains unclear, but in the light of our findings, it may result from renal filtration of blood-borne tissue kallikreins rather than from intrarenal synthesis. PMID- 3544714 TI - Kallikrein and kinins independently stimulate renin release from isolated rat glomeruli. AB - We studied the interaction between kallikrein, kinins, and renin release in isolated rat renal glomeruli and their attendant arterioles. Purified hog kallikrein (170 mEU/ml) significantly stimulated renin release 86% (p less than 0.025) above control. Inactivation of kallikrein by PMSF or inhibition with aprotinin blocked kallikrein stimulation of renin release. Partially purified rat submandibular gland kallikrein (160 mEU/ml) also increased renin by 87% (p less than 0.025). Superfusion of glomeruli with bradykinin (10(-5) M) significantly increased renin release by 108% (p less than 0.025), and lys-bradykinin (10(-5) M) similarly increased renin by 155% (p less than 0.025). Neither of the kinin analogues, des-arg9 bradykinin or tyr8 bradykinin (at 10(-5) M), were able to alter renin released from isolated glomeruli. The vasodilator acetylcholine (10( 5) M) had no effect upon renin release from glomeruli. No kininogen could be detected in glomeruli. Kallikrein superfusion did not result in any measurable kinin generation. We could not detect inactive renin in superfusate or glomeruli after renin activation with either kallikrein or trypsin. These results suggest that kallikrein stimulates renin release independent of kininogenase activity and that this stimulation does not appear to be due to activation of inactive renin. Further, we find that kinins can directly stimulate renin release. PMID- 3544715 TI - Effect of furosemide on the rat submandibular gland kallikrein secretion. AB - The effects of furosemide and Captopril were studied in normals and nephrectomized rats. Different doses of furosemide (5 to 50 mg/kg) increased the saliva kallikrein activity of submaxillary gland perfused with pilocarpine. Rats injected with captopril (10 mg) increased the blood flow of the gland, but did not modify the blood pressure. After furosemide (50 mg/kg) and captopril (10 mg), a decrease in arterial blood pressure was observed. The results suggest a release of glandular kallikrein which is secreted from the gland directly into the vascular compartment. On the other hand, rats sialodectomized showed no alterations in blood pressure in response to both drugs. These data suggest that submaxillary gland kallikrein play a role in regulating blood flow of the gland and blood pressure, at least in our experimental conditions. PMID- 3544716 TI - An inactive form of kallikrein in human urine. AB - An inactive form of human urinary kallikrein (inactive HUK) was highly purified from fresh urine collected from healthy men. Inactive HUK was separated from the active kallikrein (HUK) initially presents in the urine by affinity chromatography on a column of aprotinin immobilized on Sepharose 4B and further purified by gel filtration, ion-exchange chromatography and immunoaffinity chromatography on an anti-HUK antibody immobilized Sepharose 4B column. Inactive HUK was rapidly activated by a trace amount of trypsin. While, plasmin, urokinase, thrombin and chymotrypsin caused no activation of inactive HUK. The molecular weights of inactive HUK and HUK were estimated to be 4.8 X 10(4) and 4.5 X 10(4), respectively. The molecular weight of active HUK generated from inactive HUK by the action of trypsin (HUK'') was almost the same as that of HUK. The mobility of inactive HUK was slightly slower than that of HUK on both immunoelectrophoresis and polyacrylamide gel disc electrophoresis. On the other hand, the electrophoretic mobility of HUKK'' was almost the same as that of HUK. These two types of active HUK had no significant difference in the Km values for H-Pro-Phe-Arg-MCA hydrolysis and inhibition profiles by various protease inhibitors and anti-HUK antibody. Inactive HUK was unable to be measured by the direct radioimmunoassay (RIA) but HUK" generated by the action of trypsin could be measured by the RIA. PMID- 3544717 TI - Partial characterization of a liver serine-peptidase from different species which inactivates bradykinin. AB - Proteases which inactivate bradykinin were partially purified from the fresh exsanguinated liver of rat, man, dog, guinea-pig, chicken, frog and snake. The enzymes which are present in the soluble fraction of the liver homogenates, were prepared by DEAE-cellulose chromatography, in 0.025 M tris-HCl, pH 7.4. The peptidase activity was eluted with 0.09 M KCl; and further purification was achieved by gel-filtration in Sephadex G-150. The kininases are present in the same range of activity in all studied preparations, and final specific activities are also comparable. The molecular weight of the enzymes, as determined by gel filtration, are in the range of 70,000-100,000. All preparations were completely inhibited by 10 mM PMSF and 1 mM Tos-PheCh2Cl; 10 microM 2-mercaptoethanol, and 1 mM Tos-LysCH2Cl do not affect the enzymatic activity. The major site for the cleavage of bradykinin is the Phe5-Ser6 peptide bond. The serine-peptidase is found in the liver of all vertebrates so far studied. PMID- 3544718 TI - Vascular, post proline cleaving enzyme: metabolism of vasoactive peptides. AB - Vasoactive peptides contain a high proportion of proline residues which make them resistant to hydrolysis by many peptidases. However, post proline cleaving enzyme (PPCE; EC 3.4.21.26), a proline specific endopeptidase which specifically hydrolyzes internal peptide bonds on the carboxyl side of proline residues, has been shown to inactivate numerous vasoactive peptides including angiotensins, kinins, substance P, vasopressin and oxytocin. In order to determine whether PPCE could be involved in vascular metabolism of vasoactive peptides, we carried out localization and characterization studies of PPCE-like activity in hog aorta and mesenteric artery. PPCE was assayed fluorometrically at pH 7.0 using the specific PPCE substrate CBZ-Gly-Pro-4-methyl-coumarinylamide. The subcellular distribution of vascular PPCE was essentially the same as that of the cytosolic marker enzyme lactic dehydrogenase (LDH). PPCE was enriched six-fold in the cytosolic fraction (11.4 +/- 2.7 units/mg) and unlike the plasma membrane-bound proline specific exopeptidase dipeptidyl-(amino)peptidase IV (DAP IV; EC 3.4.14.5), little or no activity could be detected in the microsomal or plasma membrane fractions. Similar to PPCE characterized from other sites, vascular PPCE was stabilized and activated by dithiothreitol and EDTA, and inhibited by DFP, p-chloromercuriphenyl sulfonic acid, L-1-tosylamido-2-phenylethylchloromethyl ketone, Cu++, Ca++, and Zn++. Vascular PPCE was unaffected by inhibitors of trypsin and kallikrein (Aprotinin, ABTI), aminopeptidase M (bestatin, amastatin), neutral endopeptidase (phosphoramidon), angiotensin I converting enzyme (captopril) or carboxypeptidase N (MERGETPA). These data demonstrate that PPCE is present in vascular endothelium and/or smooth muscle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544719 TI - Initial observations of a kallikrein-like enzyme associated with the plasma membranes of rat adipocytes. AB - Homogenates of rat adipocytes and plasma membranes thereof were shown by radioimmunoassay to contain immunoreactive glandular kallikrein. On the basis of the hydrolysis of D-Val-Leu-Arg-p-nitroanilide, the kallikrein-like enzyme associated with the plasma membranes was found not to be stimulated by prior incubation with melittin or phospholipase A2. However, pre-incubation of the membrane preparation with trypsin did increase the activity of the enzyme. Furthermore, activation could also be achieved by incubating the plasma membranes with insulin at a dose that stimulated glucose uptake into intact adipocytes. On the other hand, incubation with insulin at a dose that did not increase glucose uptake into rat adipocytes was ineffective in activating the kallikrein-like enzyme. PMID- 3544720 TI - Isolation and properties of two rat plasma T-kininogens. AB - Two species of T-kininogen which release T-kinin (Ile-Ser-bradykinin) have been purified from plasma of rats treated with Freund's complete adjuvant. The molecular weight was estimated to be 69,000 for either T-kininogen I and II by SDS-polyacrylamide gel electrophoresis. Trypsin released one mole of T-kinin from one mole of either T-kininogen, but glandular kallikrein, including rat urinary and rat submandibular gland kallikreins and human urinary kallikrein, did not release any kinin from T-kininogens. Cathepsin D, which was purified from rat liver, released T-kinin from T-kininogens at pH 4.0. These results indicate that rat plasma contains two types of T-kininogen which differ from high molecular weight and low molecular weight kininogens. PMID- 3544721 TI - The intrinsic coagulation/kinin pathway--the classical complement pathway and their interactions. PMID- 3544722 TI - The effect of intracellular proteinases on transformation of human lymphocytes. AB - The effect of two intracellular proteinases, calf liver chymotrypsin-like neutral proteinase and human brain cathepsin H, and of two proteinase inhibitors, leupeptin and endogenous cysteine proteinases inhibitor, was studied on unstimulated and mitogen-stimulated peripheral human blood lymphocytes. Classification of blood samples into four types, on the basis of their potential for spontaneous and mitogen-stimulated transformation, helped in analyzing the results. Within some of these types, at least, there appears certain uniformity of response to proteinase action. Lymphocytes most susceptible to proteinase action were those that were insensitive to phytohemagglutinin mitogenic stimulus. The maximal effect of proteinases or their inhibitors was obtained most often when these agents were added to lymphocyte cultures 24 hours before mitogen. Both proteinases, although of quite different specificities, gave very often results of similar trend on the same lymphocyte culture. Moreover, this was followed also by the two inhibitors, which showed not only inhibitory, but also potentiating power of action on lymphocyte transformation. The regulatory nature of the action of proteinases within lymphocytes and other cells is underlined. PMID- 3544723 TI - Kallikrein localization in rat brain by immunohistochemistry. AB - Using an antibody-peroxidase bridge technique with either polyclonal antibodies or a specific monoclonal antibody, immunoreactive kallikrein was localized in all three lobes of the pituitary, in ependymal cells lining the third ventricle, and in cell bodies of the following hypothalamic neuronal nuclei: supraoptic, arcuate, paraventricular and ventromedial. PMID- 3544724 TI - Enkephalinase activity in both physiological and pathological conditions in man. AB - Among all the enzymes involve din enkephalin degradation "enkephalinase", cleaving the Gly3-Phe4 amide bond, is considered for its specificity with endogenous enkephalins and their receptors. This enzyme, first identified in membrane bound form, has been recently characterized in a soluble one by a new sensitive fluorimetric method substituting the radiometric technique. The possibility to evaluate "enkephalinase" activity in human plasma, amniotic fluid and cerebro spinal fluid (CSF) allows us to investigate its behavior in various physiological and pathological conditions in which alterations of the endogenous opioid system are hypothesized. Our studies were focused on pregnancy, the first period of life, idiopathic headache and opioid addiction. In these conditions "enkephalinase" activity (EKA) generally results increased. In some cases the activity is proportional to the increased amount of substrate, in other cases no correlation seems apparent. PMID- 3544725 TI - Urinary kallikrein excretion in healthy young infants. AB - Nineteen healthy hospitalized children aged between 3 weeks and 10 years and 20 others aged between one month and 16 years have been investigated for their excretion rate of active and total urinary kallikrein. Twelve hour urine samples were obtained between 7 p.m. and 7 a.m. and blood was drawn at the end of the urine collection period. Urinary kallikrein activity was measured by a synthetic substrate and a direct RIA and urinary sodium excretion, urine volume and plasma renin activity (PRA) were determined. Urinary kallikrein activity was found to be between 0 and 6 micrograms/24h and constituted approximately 10-20% of total kallikrein. When urinary kallikrein excretion rate was correlated with the sodium excretion rate the relationship was found to be positive and significant as was the correlation found between urine volume and urinary kallikrein excretion rate. No correlation could be found between PRA and urinary kallikrein excretion. Although a tendency of higher total kallikrein excretion was seen in older children, the amount excreted from all children per kilogram body weight was constant at 0.8 microgram/kg. PMID- 3544726 TI - Importance of circulating and urinary tissue kallikrein in the control of acute natriuresis and diuresis evoked by water immersion in man. AB - In ten human subjects water immersion produced a two-fold diuresis and a three fold increase in sodium secretion together with a marked fall in plasma renin activity and aldosterone. In contrast, circulating and urinary (active and total kallikrein) remained unchanged throughout the immersion period. Our results indicate that the acute diuresis and natriuresis evoked by water immersion in man is not regulated by circulating or urinary tissue kallikrein. PMID- 3544727 TI - Thiazide induced hypotension: the role of plasma volume reduction and the urinary kallikrein system. AB - The hypotensive response the thiazide diuretics was studied in 15 males with moderate essential hypertension and correlated with serial changes in plasma volume, weight, plasma renin activity, urinary aldosterone, and urinary kallikrein, both total and activity. A greater than 10 mmHg fall in mean arterial pressure after four weeks of treatment defined the responders to therapy (n = 10) while all others were considered non-responders (n = 5). In responders, the fall in mean arterial pressure was accompanied by sustained reduction in plasma volume and weight. No sustained fall in plasma volume was noted in non-responders. Plasma renin activity and urinary aldosterone excretion increased in responders but not in non-responders. Urinary kallikrein, both total and active, increased in the responders but remained unchanged in the non-responders. The results are consistent with the hypothesis that a sustained reduction in plasma volume is necessary for the maintenance of a hypotensive response to thiazides. Stimulation of the renal kallikrein-kinin system may be necessary to balance the antinatriuretic and pressor effects of the renin-angiotensin-aldosterone system. If unopposed, this system would return plasma volume and blood pressure to pretreatment levels. PMID- 3544728 TI - Renal kallikrein and renin concentrations in spontaneously hypertensive rats (SHR) during acute reduction of perfusion pressure. PMID- 3544729 TI - Hypotensive effect of bradykinin in normotensives and patients with renovascular hypertension. AB - Bradykinin is one of the most potent vasodilators and in the kidney it develops a marked diuretic and natriuretic action. The natriuretic effect of the peptide is mediated by prostaglandins. The mechanism of bradykinin induced vasodilation, however, is not yet known. Therefore, in this study the blood pressure lowering effect of bradykinin was investigated in five normotensive volunteers. Bradykinin was injected intravenously in doses between 0.001 and 7.5 micrograms/kg of body weight. Intraarterially measured blood pressure decreased in a dose related manner from 0.25 to 1.0 micrograms/kg. Changes in oral salt intake (10 to 300 nmol Na+/d) had no effect on the action of bradykinin as well as pretreatment with either indomethacin (2 X 50 mg) or propranolol (80 mg). Captopril (25 mg) potentiated the blood pressure lowering effect of bradykinin about 20-fold. In four patients with renal hypertension bradykinin provoked a more marked reduction in arterial blood pressure, while potentiation by captopril was not different in the hypertensives if compared to the normotensives. The results of our studies show that bradykinin lowers blood pressure by a direct mechanism, which acts independently of salt intake, beta-receptors and prostaglandins. Inhibition of inactivation of bradykinin by captopril enhances its activity markedly. In renal hypertension the arterial vessels are more sensitive to bradykinin than in normotension, probably indicating a lack of endogenous kinins in these patients. PMID- 3544730 TI - Reduced activation and affinity of renin during pregnancy and oral contraception: determination of kinetic parameters by a fully autologous plasma renin assay. AB - In healthy normotensive pregnancy, a complex functional network develops between the cardiovascular system, the volume and composition of the extracellular fluid and the renin-angiotensin system (RAS). Cardiac output and heart rate increase, but blood pressure is reduced. The kidneys increase in size and both the glomerular filtration rate and renal blood flow increase early. Renal tubular water and sodium reabsorption is even more enhanced, so that the total body water of mother and foetus rises in the course of pregnancy by 6-8 litres. Plasma osmolality falls by about 10 mosm/kg. yet total body sodium increases by about 1 mol. Understandably, in the face of such complex fluid and pressure adjustments, data on the changes of the RAS in normal pregnancy are often contradictory. However, there is general agreement that the angiotensinogen and inactive renin in plasma are greatly raised. Most groups have also found a considerable increase in active renin. These changes could lead to higher rates of angiotensin I (AI) formation (and hence high circulating angiotensin II levels), with adverse consequences for mother and foetus. The high proportion of inactive renin may reflect a reduction in the rate of activation of prorenin in order to avoid these consequences. This reduction may involve kallikreins which have been listed amongst the putative in vivo activators of prorenin. Excessive AI formation in pregnancy could also be avoided by the production of functionally different renins or angiotensinogens. Such changes will be difficult to detect with assays which require addition of extraneous renin or angiotensinogen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544731 TI - A monoclonal antibody to rat tissue kallikrein: use in biochemical and immunohistochemical studies. AB - A monoclonal antibody (V4G6) to rat tissue kallikrein (EC 3.4.21.35) has been developed and characterized. This clone showed no cross-reactivity with rat tonin, rat esterase A or human urinary kallikrein in either radioimmunoassay or enzyme-linked immunosorbent assay. The monoclonal antibody used in the direct radioimmunoassay detects purified rat urinary kallikrein in a range of 0.32 to 40 ng per tube. The displacement curves for rat submandibular gland, pancreatic and kidney extracts and urine were parallel with the standard curve of purified rat urinary kallikrein. Analysis of immunoprecipitates from [14C] DFP labeled submandibular gland extract with SDS-polyacrylamide gel electrophoresis, demonstrates that this antibody recognizes only one 38,000 dalton serine protease while polyclonal antiserum identifies multiple species. Using this specific monoclonal reagent, tissue kallikrein was localized immunohistochemically in the granular convoluted tubules and striated ducts of the rat submandibular gland and in the acinar cells of the rat pancreas. The results showed that the monoclonal antibody (V4G6) can specifically recognize a single kallikrein in the tissue extracts without cross-reacting with other kallikrein-related serine proteases. This monoclonal antibody can be used as a specific reagent for quantitation, identification and immunohistochemical studies of tissue kallikrein. PMID- 3544732 TI - Determination of bradykinin by enzyme immunoassay. PMID- 3544733 TI - Immunohistochemical studies on synthesis and distribution of Hageman factor and kininogen. AB - Immunohistochemical localization of Hageman factor and high molecular weight kininogen were investigated in liver, skin and kidney of guinea pig using a new conjugation method with maleimide derivative as the coupling reagent at the level of light and electron microscopes. In the liver, the positive reactions of both factors were observed in the rough and smooth endoplasmic reticulums and the Golgi apparatus in hepatocytes. In Kupffer cells and sinusoidal endothelial cells, the reaction products were visible only in the endocytotic vesicles. These findings suggested that guinea pig Hageman factor and high molecular weight kininogen were synthesized only in hepatocytes at least the liver. In the skin, positive reactions were seen in the intercellular space of epidermis, and along the basement membranes of epidermis and vessels, and among the collagen fibers in interstitial tissue particularly in papillary dermis. This interstitial presence of these molecules was also seen in liver and kidney, which suggested that Hageman factor and high molecular weight kininogen were widely distributed in the interstitial tissue space even under normal conditions. In addition, positive reactions were obtained in the reabsorption vesicles and the lysosomes of the proximal convoluted tubules of kidney and in the pinocytotic vesicles of the basal cells of epidermis. According to these findings, it was suggested that both factors were produced in hepatocytes, secreted into the blood stream, distributed in the interstitial tissue by vascular permeability even under normal condition, and reabsorbed and catabolized in the kidney and the skin. PMID- 3544734 TI - Physiological responses of Bacteroides and Clostridium strains to environmental stress factors. PMID- 3544735 TI - Regulation of carbon metabolism in Saccharomyces cerevisiae and related yeasts. PMID- 3544736 TI - The antibacterial effects of low concentrations of antibiotics. PMID- 3544737 TI - Intensive neurodiagnostic monitoring with intracranial electrodes. PMID- 3544738 TI - Alcohol-related expectancies: have they a role in the understanding and treatment of problem drinking? AB - This paper reviews the theoretical and empirical literature on the role of alcohol-related expectancies in problem drinking. It is shown that alcohol related expectancies are involved in the initiation, maintenance and treatment of problem drinking. Given that alcohol-related expectancies can influence the consumption of alcohol, it is argued that any future theoretical model and applied treatment programme for problem drinkers must include the interplay among pharmacological, environmental and cognitive, in particular alcohol-related expectancies variables. PMID- 3544739 TI - Suture materials for closing the skin and subcutaneous tissues. AB - The rationale for our current day use of absorbable and nonabsorbable suture materials is based upon the biology of wound healing and the physiologic response of tissue to implanted sutures. An understanding of the fundamental characteristics of suture materials and surgical needles is necessary if one is to obtain optimal surgical results. PMID- 3544740 TI - The role of platelet membrane glycoproteins in the adhesion of blood platelets. PMID- 3544741 TI - A critical appraisal of the clinical efficiency of anti-platelet drugs. PMID- 3544743 TI - [Clinical evaluation of kallikrein in male infertility]. AB - Kallikrein was orally administered to 44 patients with male infertility at a dose of 90 or 120 KU/day for three months. The sperm density, sperm motility and fertility index (F.I.) were improved in 51.1%, 37.2% and 38.9% of the treated patients, respectively. Statistical analysis showed that significant improvement was noted in sperm density and F.I. between before and after the treatment, but not in sperm motility, sperm volume nor sperm morphology. During the period of treatment, in these treated 44 patients, 4 patients (9.1%) succeeded in pregnancy. PMID- 3544742 TI - Eicosanoid balance at early stages of experimental atherosclerosis. Its relationship with plasma fibrinolytic activity and platelet aggregation. AB - We have studied generation of eicosanoids in blood vessels and platelets of rabbits in relation to platelet aggregation and plasma fibrinolytic activity at early stages of experimental atherosclerosis. A level of lipid peroxides in plasma augmented progressively from the 2-nd to 12-th week of atherogenic diet. In parallel, platelets generated more TXA2 and 12-HETE while in blood vessels a gradual reduction of prostacyclin formation was observed. Reduction in generation of PGI2 was accompanied by steady formation of PGE2. In the second week of the diet a slight decrease appeared of aggregatory response while later aggregability of platelets was increased. At first, plasma fibrinolytic activity was decreased, but it significantly augmented after 12 weeks of the diet. The above data indicate that changes of arachidonic acid metabolism in platelets and blood vessels appear at a very early stage of atherosclerosis and they influence platelet function and plasma fibrinolytic activity. PMID- 3544744 TI - [Prophylactic effect of etretinate on the recurrence of superficial bladder tumors--results of a randomized control study]. AB - The recurrence preventing effect of Etretinate on 174 superficial bladder tumors was examined by a randomized study using the envelope method. After transurethral resection of the bladder tumor, the tumor-free patients were divided into two groups, one administered one 10 mg capsule of Etretinate once a day, and the other group untreated (control group). As a rule, the patients were examined for recurrence every 3 months. There were 9 drop outs (9.6%) in the Etretinate group, and 8 (10%) in the control group. Therefore, 85 subjects in the Etretinate group and 72 patients in the control group were analyzed for statistics. The recurrence rate during the observation period of over 2 years was 38% in the control group and 18% in the Etretinate group, the number of relapsing cases in the latter group tending to be decreased (P less than 0.1). The cumulative recurrence inhibition rate for cases observed over one year tested by the Kaplan Meier method tended to be higher in the Etretinate group compared to the control group (P less than 0.1). Etretinate administration had a high recurrence inhibitory effect (P less than 0.05) in the cases of relapse, multiple tumors, and tumors less than 1 cm. Side effects of Etretinate administration were seen in 21 cases (22.3%). The major symptoms were dry lips, cheilitis, stomatitis, dermal desquamation, etc., and drug use was discontinued in 7 cases (7.4%). The symptoms all disappeared after drug administration was discontinued. PMID- 3544745 TI - Imaging in acute renal infection in children. AB - Infection is the most common disease of the urinary tract in children, and various imaging techniques have been used to verify its presence and location. On retrospective analysis, 50 consecutive children with documented upper urinary tract infection had abnormal findings on renal cortical scintigraphy with 99mTc glucoheptonate. The infection involved the renal poles only in 38 and the poles plus other renal cortical areas in eight. Four had abnormalities that spared the poles. Renal sonograms were abnormal in 32 of 50 children. Excretory urograms were abnormal in six of 23 children in whom they were obtained. Vesicoureteral reflux was found in 34 of 40 children in whom voiding cystourethrography was performed. These data show the high sensitivity of renal cortical scintigraphy with 99mTc-glucoheptonate in documenting upper urinary tract infection. The location of the abnormalities detected suggests that renal infections spread via an ascending mode and implies that intrarenal reflux is a major contributing factor. PMID- 3544746 TI - Posttransplant renal artery stenosis: angiographic study in 32 children. AB - Renal artery stenosis was identified in 32 children who either developed or had an exacerbation of hypertension after renal transplantation. One child developed renal artery stenosis in two sequential transplants. Renal artery stenosis occurred only in those patients who received transplants from cadavers. In 14 of the 15 patients with end-to-end renal artery anastomoses, the stenosis was at the anastomosis. In 14 of the 18 patients with end-to-side anastomoses, the stenosis was distal to the anastomosis. PMID- 3544748 TI - Sonography in patients with a possible pancreatic mass shown on CT. PMID- 3544747 TI - Pleural endometriosis: CT and sonographic findings. PMID- 3544749 TI - Daytime constancy of bile duct diameter. PMID- 3544750 TI - Aspiration biopsy of superficial lesions: ultrasonic guidance with a linear-array probe. PMID- 3544751 TI - Critical competencies for teachers of hearing-impaired students: the practitioners' view. PMID- 3544752 TI - Use of the laboratory in patient management. PMID- 3544753 TI - Reperfusion with streptokinase of an occluded right coronary artery: effects on early and late right and left ventricular ejection fraction. AB - The effect of coronary artery recanalization on early and late right and left ventricular function was studied in patients with an acute inferior wall myocardial infarction caused by an occlusion of the right coronary artery. Fifty four out of 138 patients, with chest pain lasting less than 4 hours, with ST elevations diagnostic for acute myocardial infarction not responding to medical treatment, and without contraindication for thrombolytic therapy, had an occluded right coronary artery. In 26 of these 54 patients, the occlusion was located proximal to the first right ventricular branch. Fourteen of them were treated conventionally (group A) and 12 with intracoronary streptokinase (group B). In 28 patients, the occlusion was distal to the first right ventricular branch. Fifteen were treated conventionally (group C) and 13 with intracoronary streptokinase (group D). In all patients, coronary angiograms were made 2 to 3 weeks after acute myocardial infarction. A nuclear angiogram was made the second day after admission and 3 months later to determine right and left ventricular ejection fraction. Values of radionuclide left and right ventricular ejection fraction (RVEF) between acute study (less than 48 hours after acute myocardial infarction [AMI]) and late study (3 months after AMI) showed no significant improvement in the four groups of patients studied. Group A patients (patients with total occlusion of the right coronary artery treated conventionally) had a significantly lower RVEF acutely and at late study as compared to the other three groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544754 TI - Comparative antianginal effects of nisoldipine and nifedipine in patients with chronic stable angina. AB - The acute antianginal effects of 5 mg and 20 mg nisoldipine were compared with 20 mg nifedipine and placebo. Maximal treadmill exercise testing was performed before and 3 hours after drug administration in 10 patients with chronic stable angina. Resting heart rate and systolic blood pressure were unchanged following low-dose nisoldipine, but 20 mg nisoldipine and 20 mg nifedipine increased heart rate and decreased systolic arterial pressure (p less than 0.05). Time (in seconds) to the onset of 0.1 mV ST segment depression was significantly prolonged after 5 mg nisoldipine (+60 +/- 53; p less than 0.05) and 20 mg nisoldipine (+100 +/- 78; p less than 0.01) but not after 20 mg nifedipine (+48 +/- 131; p = NS). Total exercise duration increased significantly following 5 mg and 20 mg nisoldipine (p less than 0.01 and p less than 0.001, respectively) but only slightly following nifedipine (p = NS). The maximal rate-pressure product was increased to a similar degree following doses of both nisoldipine and nifedipine (p less than 0.05). Nisoldipine is an effective antianginal agent which performs well in comparison to nifedipine. PMID- 3544755 TI - Myocardial metabolism and coronary sinus blood flow during coronary artery surgery: effects of nitroprusside and nifedipine. AB - The effects of nitroprusside and nifedipine on hemodynamics, coronary dynamics, and global myocardial metabolism were compared in two groups of patients undergoing elective coronary artery surgery, who were anesthetized with fentanyl, 100 micrograms/kg. After induction of anesthesia, either nitroprusside or nifedipine was started as follows: group S (n = 11) received nitroprusside at an initial rate of 1.3 micrograms/kg/min; group N (n = 9) received nifedipine at an initial rate of 0.7 micrograms/kg/min. Infusion rates were adjusted to maintain systolic blood pressure (SBP) between 80% and 120% of preinfusion (control) values. Control measurements were obtained 10 minutes after intubation. Then vasodilator infusion was started. Additional measurements were obtained 10 minutes after the start of infusion (before surgery) and after sternotomy. The mean (+/- SD) total dose requirements were: nitroprusside, 1.6 +/- 0.3 micrograms/kg/min; and nifedipine 1.1 +/- 0.7 micrograms/kg/min. The mean (+/- SD) total infusion time was: nitroprusside, 32 +/- 5 minutes; and nifedipine, 37 +/- 7 minutes. After 10 minutes of infusion there were decreases in SBP (p less than 0.001) and diastolic blood pressure (DBP; p less than 0.01) in group S. In group N only SBP decreased (p less than 0.01). At this time there were no significant changes in coronary sinus blood flow (CSBF) or myocardial oxygen consumption (MVO2) in either group. After stenotomy DBP remained decreased (p less than 0.05) in group S.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544756 TI - Asystole produced by the combination of amiodarone and digoxin. PMID- 3544757 TI - From irritable heart to mitral valve prolapse: systolic clicks, apical murmurs, and the auscultatory connection in the 19th century. PMID- 3544758 TI - Immunogenetic polymorphism of apolipoprotein B in humans: studies with a monoclonal anti-Ag(c) antibody. AB - In studies that use a monoclonal antibody (MB-19), apolipoprotein B exhibited one of three immunophenotypes: high, intermediate, or low affinity binding to this antibody. The distribution of these immunophenotypes (allotypes) in families was compatible with a codominant transmission of two alleles, one coding for the high and the other for the low affinity binding allotype. The high affinity binding allotype coincided with antigen Ag(c) and the low affinity binding allotype with Ag(g), two allelic antigenic determinants previously defined by human antisera. Preliminary studies did not reveal differences in plasma lipid levels in association with apolipoprotein B allotypes. Young Finnish men with low affinity binding apolipoprotein B had slightly lower plasma apolipoprotein B levels than those with the intermediate affinity binding phenotype. PMID- 3544760 TI - Alcohol-induced changes in serum lipoproteins and in their metabolism. AB - The effects of alcohol intake on serum lipids and lipoproteins depend on the dose and mode of alcohol intake, individual susceptibility, genetic variables, and dietary factors. Therefore the changes of lipoprotein pattern are different among moderate and heavy drinkers. Moderate intake of alcohol increases the concentrations of apolipoproteins (apo) AI, apo AII, and high-density lipoprotein subfraction (HDL3) in plasma without any effects on other lipoproteins. If alcohol intake exceeds 60 to 80 gm per day, the synthesis of very low-density lipoprotein (VLDL) particles is stimulated. Even short-term use of alcohol stimulates lipoprotein lipase (LPL) activity in adipose tissue, and consequently the concentration of VLDL in plasma stays normal or is even subnormal. If alcohol intake continues in excessive amounts, the increased transport rate of VLDL particles as a result of high LPL activity results in the up regulation of HDL2. This is clearly evident in chronic alcoholics. Low or subnormal low-density lipoprotein (LDL) levels are another characteristic of the lipoprotein pattern in chronic alcoholics. The increase of HDL (HDL2) and reduction of LDL levels could well explain the reduced risk of coronary heart disease in chronic alcoholics, whereas the causal factors remain open among moderate drinkers. PMID- 3544759 TI - Apolipoprotein E polymorphism in health and disease. AB - Genetic polymorphism of apolipoprotein (apo) E is controlled by three common (epsilon 2, epsilon 2, epsilon 4) and several rare alleles (e.g., epsilon 1, epsilon 4*, epsilon 4v) at the apo E structural gene locus and may be demonstrated by isoelectric focusing of delipidated sera followed by immunoblotting. Apo E allele frequencies vary significantly between different ethnic groups. The common apo E isoforms E2 (arg158----cys) and E4 (cys112--- arg) differ functionally from the parent E3 isoform, explaining their effects on the normal variance of plasma lipoprotein concentrations and their association with hyperlipidemic conditions. In all studied populations the receptor-binding defective apo E2 (arg158----cys) is associated with low cholesterol and apo B in heterozygotes and results in primary dysbetalipoproteinemia or type III hyperlipoproteinemia in homozygotes. Conversely, the epsilon 4 allele is associated with high cholesterol in Finns and Germans but less or not significantly so in Japanese or Singapore populations. In addition to their effects on the normal variance of lipoprotein concentrations, the alleles epsilon 2 and epsilon 4 are associated with hypertriglyceridemia and hypercholesterolemia, respectively. A working hypothesis explaining these observations is presented. PMID- 3544761 TI - Regulation of plasma cholesterol by hepatic low-density lipoprotein receptors. AB - The endogenous lipoprotein system (very low-density lipoprotein [VLDL], intermediate-density lipoprotein [IDL], low-density lipoprotein [LDL] cascade) holds the key to understanding the mechanisms by which hormones, diet, and drugs interact to regulate the plasma cholesterol level. Crucial components of this system are hepatic LDL receptors that mediate the uptake and degradation of plasma LDL. With experimental animals, it has been possible to demonstrate that hepatic LDL receptors are sensitive to hormonal, dietary, and pharmacologic manipulation. The decrease in number of hepatic LDL receptors in hypothyroidism or after cholesterol feeding leads to elevation of plasma LDL cholesterol levels. Conversely, the increase in number of hepatic LDL receptors results in lowering of plasma LDL cholesterol levels. This can be observed in hyperthyroidism, during administration of pharmacologic doses of 17 alpha-ethinyl estradiol, or during treatment with cholesterol-lowering drugs such as the bile acid-binding resins and cholesterol-synthesis inhibitors. Since cholesterol excretion from the body occurs via the liver, the increased efficiency of disposal of plasma cholesterol by increasing hepatic LDL receptors will ultimately lead to depletion of excessive body cholesterol. Pharmacologic regulation of hepatic LDL receptors should be a valuable tool in the prevention and therapy of atherosclerosis. PMID- 3544762 TI - Role of apolipoprotein E in lipoprotein metabolism. PMID- 3544763 TI - Mechanisms of primary hypercholesterolemia in humans. AB - Approximately 15% of middle-aged Americans have primary hypercholesterolemia, that is, plasma cholesterol levels in excess of 250 mg/dl. The risk for coronary heart disease in these patients is at least twice that of patients with a baseline level of 200 mg/dl. Only 2% of hypercholesterolemic patients have familial hypercholesterolemia. The causes of elevated cholesterol concentrations in the remaining patients have not been determined. Three major mechanisms may be responsible: overproduction of lipoproteins by the liver, reduced activity of receptors for low-density lipoproteins (LDL), and low affinity of circulating LDL for receptors. We have examined each of these mechanisms for primary hypercholesterolemia by isotope kinetic techniques. All three types have been identified, and the underlying causes of each are under investigation. PMID- 3544764 TI - High-density lipoprotein turnover. AB - High-density lipoprotein (HDL) metabolism has been reviewed from information derived from turnover studies in humans. The two major HDL apoproteins AI and AII have different removal rates, reflecting the faster catabolism of HDL2 than of HDL3. This is caused by the continual cycle of formation of HDL2 from HDL3 and its reversion to HDL3, in response to the need to transport cholesterol and other lipids from extrahepatic cells and catabolized triglyceride-rich lipoproteins. The conversion of HDL2 to HDL3 is mediated through a hepatic lipase. Because this lipase is inhibited by estrogen and stimulated by androgens, women have higher HDL2 levels than men. The synthesis of apoproteins AI and AII is also higher in women than in men. Nutrition also influences HDL turnover. Carbohydrates increase AI and HDL2 removal, whereas polyunsaturated fatty acids inhibit synthesis. Vegetarians show high HDL removal rates. Thus low-fat, low-cholesterol diets generally lead to lower HDL levels. Disorders that alter HDL composition (such as alcoholic liver disease or Tangier disease) accelerate HDL removal. Other HDL proteins such as apoproteins C and E show faster turnover rates than AI and AII, since the former exchange with triglyceride-rich lipoproteins and participate in their catabolism. Diminished exchange of apoprotein C from HDL to chylomicrons may be responsible for the diminished catabolism of these particles in type V hyperlipoproteinemia. The unusual turnover characteristics of HDL apoprotein AIV are reviewed, suggesting a dual role for this protein in both triglyceride and cholesterol transport. The striking relationship between very low-density lipoprotein (VLDL) and HDL metabolism is expressed in an inverse association between their respective removal rates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544765 TI - Coordination of very low-density lipoprotein triglyceride and apolipoprotein B metabolism in humans: effects of obesity and non-insulin-dependent diabetes mellitus. AB - To understand the relationship between very low-density lipoprotein (VLDL) triglyceride and VLDL apolipoprotein (apo) B, we studied their metabolisms simultaneously in 53 subjects with a range of obesity and glycemia. Obese subjects had increased production of both VLDL apo B and VLDL triglyceride and more VLDL of normal composition. Compared with nondiabetics, diabetic subjects had decreased clearance of both VLDL apo B and VLDL triglyceride, increased production of VLDL triglyceride but not of VLDL apo B, and more VLDL of abnormal composition. Production of both VLDL apo B and VLDL triglyceride were significantly correlated with plasma insulin concentrations, and rates of clearance of both were inversely correlated with plasma glucose. There was no direct correlation between total plasma free fatty acid concentration and production of either VLDL triglyceride or VLDL apo B, but VLDL triglyceride production was found to account for only a very small proportion of the nonoxidative component of free fatty acid turnover. We suggest that in obese subjects hyperinsulinemia induces overproduction of both VLDL apo B and VLDL triglyceride. In diabetes VLDL is increased in part because of decreased clearance; the altered composition is the result of the increase in VLDL triglyceride production independent of apo B. The increase in VLDL triglyceride production may be mediated through plasma free fatty acids or glucose, although assessment of the relationship between these precursors and VLDL triglyceride is confounded by the fact that only a small portion of free fatty acids or glucose is converted to VLDL triglyceride. PMID- 3544766 TI - Proapolipoprotein-converting enzymes and high-density lipoprotein early events in biogenesis. AB - The early events in high-density lipoprotein biogenesis involve the extracellular action of two converting enzymes affecting the cleavage of the prosegment of either proapolipoprotein A-I or proapolipoprotein A-II and the generation of mature apolipoprotein (apo) A-I and apo A-II, the main apolipoprotein of high density lipoproteins. These two converting enzymes differ from each other in mechanism of action and specificity. The observation that they can be secreted by human hepatocarcinoma G2 cells in culture provides an experimental basis for examining the possible coordination between the synthesis and secretion of these two converting enzymes and the events attending the production and cellular export of apo A-I and apo A-II. PMID- 3544768 TI - The role of lipid transfer proteins in plasma lipoprotein metabolism. AB - Human plasma contains a number of proteins that promote movement of lipids between lipoprotein fractions. One of these proteins, designated lipid transfer protein, is known to promote bidirectional transfers of cholesteryl esters, triglyceride, and phospholipids between all plasma lipoprotein fractions. This report briefly reviews the role of lipid transfer protein in plasma cholesterol transport and in the regulation of the particle size distribution of high-density lipoproteins. Studies are described that show that the small particle size of high-density lipoproteins in human subjects with hypertriglyceridemia is a result of the combined actions of lipid transfer protein and hepatic lipase. PMID- 3544767 TI - Factors affecting the rate of catalyzed transfer of cholesteryl esters in plasma. AB - The transfer of cholesteryl esters generated by lecithin-cholesterol acyltransferase to low- and very low-density lipoproteins is greatly modified under different physiologic and pathologic conditions. A major factor determining transfer rates is the level of unesterified cholesterol in the acceptor lipoproteins. Low cholesteryl ester transfer rates are characteristic of several groups at increased risk for coronary artery disease. This appears to reflect a systematic abnormality of free cholesterol metabolism and transport in these groups. PMID- 3544769 TI - Plasma high-density lipoprotein concentration and subfraction distribution in relation to triglyceride metabolism. PMID- 3544770 TI - Lipoprotein abnormalities in hypertriglyceridemia: significance in atherosclerosis. PMID- 3544771 TI - Regulation of hepatic lipase and serum lipoproteins by sex steroids. AB - The influence of sex steroids on the serum lipoprotein pattern was recognized more than 30 years ago, and it still remains among the areas of major interest. This is because of the compatible sex difference in plasma lipoprotein pattern and in coronary heart disease risk. Recent discoveries of the role of hepatic lipase in lipoprotein metabolism have elucidated mechanisms behind sex steroid induced changes in lipoproteins. These steroids regulate the activity of hepatic lipase, an enzyme bound to the endothelial cells of liver sinusoids. Hepatic lipase has a central role in the removal of phospholipids and triglycerides from subfractions of high-density lipoprotein (HDL2) particles, but it may also function in the lipolysis of triglyceride-rich particles. Some older and more recent developments in this area will be reviewed. PMID- 3544772 TI - Deficiencies of plasma lipolytic activities. PMID- 3544773 TI - The role of altered lipoproteins in the pathogenesis of atherosclerosis. PMID- 3544774 TI - Relationship of intermediate and low-density lipoprotein subspecies to risk of coronary artery disease. AB - Recent studies have shown that heterogeneity of human plasma low-density lipoproteins (LDL) is, in part, the result of production of different LDL products from two subspecies of intermediate-density lipoproteins (IDL). Cholesterol-enriched forms of both IDL species are found in plasma of patients with atherogenic dyslipidemias (familial hypercholesterolemia and type 3 hyperlipoproteinemia) and have physical properties similar to the major species in plasma of cholesterol-fed monkeys. Patients with familial combined hyperlipidemia have been shown to have increased plasma levels of IDL and of a smaller, denser LDL subclass (LDL-IIIA) that appears to be a metabolic product of the smaller IDL subspecies. Results from the NHLBI Type II Coronary Intervention study have supported a link between the small IDL-LDL pathway and coronary disease, in that 2-year changes in levels of these species were associated with disease progression. Furthermore, therapeutic reductions in IDL levels were correlated with increases in high-density lipoprotein cholesterol. Thus variation in IDL levels might influence coronary disease risk by both a direct effect and indirectly by affecting LDL particle number and possibly high-density lipoprotein metabolism. PMID- 3544775 TI - Associations of high-density lipoprotein subclasses and apolipoproteins with ischemic heart disease and coronary atherosclerosis. PMID- 3544776 TI - Analytical procedures for the detection and characterization of apolipoprotein E mutants. PMID- 3544777 TI - Intensive drug therapy of hypercholesterolemia. PMID- 3544778 TI - Review of angiographic studies on treatment of atherosclerotic vascular disease. PMID- 3544779 TI - Dietary determinants of plasma high-density lipoprotein cholesterol. PMID- 3544780 TI - Lipoproteins and atherosclerosis: some unanswered questions. PMID- 3544781 TI - Diagnosis of rupture of the ventricular septum during acute myocardial infarction by Doppler color flow mapping. PMID- 3544782 TI - Value of admission electrocardiogram in predicting outcome of thrombolytic therapy in acute myocardial infarction. A randomized trial conducted by The Netherlands Interuniversity Cardiology Institute. AB - To determine the value of the admission 12-lead electrocardiogram to predict infarct size limitation by thrombolytic therapy, data were analyzed in 488 of 533 patients with acute myocardial infarction (AMI) from a randomized multicenter study. All patients had typical electrocardiographic changes diagnostic for an AMI and were admitted within 4 hours after the onset of chest pain; 245 patients were allocated to thrombolytic treatment and 243 to conventional treatment. Cumulative 72-hour release into plasma of myocardial alpha-hydroxybutyrate dehydrogenase (HBDH) was used as a measure of infarct size. In general, the amount of infarct limitation due to thrombolytic therapy was proportional to the size of the area at risk. Patients with new Q waves, high QRS score and high ST segment elevation or depression had the largest enzymatic infarct size in both treatment groups, irrespective of location of the AMI. Compared with conventionally treated patients, patients with anterior AMI treated with streptokinase had significant infarct size limitation (480 U/liter HBDH, 37%), and limitation was most prominent in those with Q waves (820 U/liter HBDH) or high ST elevation (750 U/liter HBDH). Infarct size limitation in inferior AMI was less impressive (330 U/liter HBDH, 33%) and patients with high ST-segment elevation (460 U/liter HBDH) or marked contralateral ST-segment depression (430 U/liter HBDH) had the most notable infarct limitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544783 TI - Cardiovascular time course after digoxin administration in left ventricular dysfunction after coronary artery bypass grafting. AB - Intravenous digoxin, 1 mg, was administered over 8 hours to 10 cardiac patients with left ventricular (LV) dysfunction after coronary artery bypass grafting. The cardiovascular effects of digoxin were monitored over 20 hours by indwelling pulmonary artery and radial artery lines and were compared with those of a control group of 10 patients who had normal postoperative LV function. Digoxin administration produced an increased cardiac index and mean arterial blood pressure within 2 hours. Within 4 hours after digoxin administration pulmonary artery wedge pressure in patients receiving digoxin was significantly lower than in control patients. At 16 hours there was a significant increase in both the LV stroke work and LV stroke work index in patients receiving digoxin vs control patients. Two patients receiving digoxin and 3 control patients had changes in cardiac rhythm during the study. Thus, digoxin can be safely administered to postoperative patients with LV dysfunction and is an acceptable inotropic agent. PMID- 3544784 TI - Cations in essential hypertension. AB - Sodium intake has been linked to the development and perpetuation of hypertension for almost a century. Nevertheless, considerable controversy over this relationship remain. More recently, the other major body cations, potassium, calcium and magnesium, have also been implicated. The evidence relating dietary sodium, potassium, calcium and magnesium intake to hypertension is summarized, and the present evidence for dietary modification of cation intake in the treatment of mild essential hypertension is evaluated. PMID- 3544785 TI - Replication of arterial smooth muscle cells in hypertension and atherosclerosis. 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 the 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 will consider the current state of knowledge of the mechanisms controlling smooth muscle proliferation in these 2 diseases, put that knowledge into the context of what is known about smooth muscle biology and offer 2 hypotheses as to possible roles of smooth muscle developmental biology in manifestations of atherosclerosis and hypertension in adult humans. PMID- 3544786 TI - Short- and long-term effects of calcium entry blockers on the kidney. AB - The renal effects of the calcium entry-blocking drugs diltiazem, nifedipine, nitrendipine, nicardipine and verapamil are reviewed. Although nifedipine may acutely increase plasma renin activity, most of the calcium entry blockers have no sustained effect on any of the components of the renin-angiotensin-aldosterone system. Although all of the calcium entry blockers effectively lower blood pressure, none adversely affects renal function: Glomerular filtration rate and effective renal plasma flow are maintained. Diltiazem may increase glomerular filtration rate via attenuation of the intrarenal effects of angiotensin II or norepinephrine. Although all of the calcium entry blockers acutely increase salt and water excretion, most of the calcium entry blockers have no clinically sustained effect on salt and water excretion; serum electrolytes, urinary sodium and potassium excretion, body fluid composition and body weight are usually unchanged. Calcium entry blockers can be expected to assume a prominent role in the treatment of hypertension because of their ability to lower blood pressure while preserving renal perfusion and function. PMID- 3544787 TI - Status of risk factors and their consideration in antihypertensive therapy. AB - Risk factors for cardiovascular disease include atherogenic personal attributes, living habits that promote them, signs of preclinical disease and host susceptibility. Atherogenic traits include the blood lipids, blood pressure and glucose tolerance. An increased low density lipoprotein cholesterol level is positively related, and an increased high density lipoprotein cholesterol level is inversely related, to cardiovascular disease incidence. Hypertension, whether systolic or diastolic, labile or fixed, casual or basal, at any age in either sex contributes greatly. The impact of diabetes is greater for women than men and varies depending on the level of the foregoing risk factors. An atherogenic lifestyle is typified by a diet excessive in calories, fat and salt, sedentary habits, unrestrained weight gain and smoking. Alcohol used in moderation may be beneficial. Oral contraceptives worsen atherogenic traits and, when used for long periods beyond age 35 and in conjunction with cigarettes, predispose to thromboembolism. Type A persons with an overdeveloped sense of time urgency, drive and competitiveness develop an excess of angina pectoris. Men married to more highly educated women are at increased risk as are men married to women in white collar jobs. Preclinical signs of compromised coronary circulation include silent myocardial infarction, left ventricular hypertrophy on the electrocardiogram, blocked intraventricular conduction and repolarization abnormalities. An electrocardiogram obtained during exercise may elicit still earlier evidence. Measures of innate susceptibility include a family history, history of premature cardiovascular disease, diabetes, hypertension and gout. Optimal prediction of risk requires a quantitative combination of risk factors in multiple logistic risk formulations to identify high risk persons with multiple marginal abnormalities. PMID- 3544788 TI - Calcium antagonists for Prinzmetal's variant angina, unstable angina and silent myocardial ischemia: therapeutic tool and probe for identification of pathophysiologic mechanisms. AB - The calcium antagonists provide a unique tool to reduce myocardial oxygen demand and prevent increases in coronary vasomotor tone. For patients with Prinzmetal's variant angina, diltiazem, nifedipine and verapamil are extremely effective in preventing episodes of coronary vasospasm and symptoms of ischemia. Unstable angina pectoris is a more complex pathophysiologic syndrome with episodes of ischemia due to increases in coronary vasomotor tone, intermittent platelet aggregation or alterations in the underlying atherosclerotic plaque. Each of the calcium antagonists is effective as monotherapy in decreasing the frequency of angina at rest. Nifedipine is the only calcium antagonist that has been studied in a combination regimen with beta blockers and nitrates for patients with unstable angina, and control of angina is better with the combination regimen than with either form of therapy alone. Although symptoms of myocardial ischemia in unstable angina are reduced by calcium antagonists, these agents do not seem to decrease the incidence of adverse outcomes. Antiplatelet therapy appears to improve morbidity and mortality in patients with unstable angina, suggesting that thrombus formation may play a central role in that disorder. Episodes of silent or asymptomatic myocardial ischemia, identified by ST-segment monitoring, occur in a variety of disorders of coronary disease. Among patients with Prinzmetal's variant angina and unstable angina, episodes of silent ischemia appear to be as frequent as episodes of angina and the calcium antagonists are effective in decreasing episodes of ischemia regardless of the presence or absence of symptoms. Persisting episodes of silent ischemia among patients with unstable angina despite maximal medical therapy identify patients at high risk for an early unfavorable outcome. Among patients with stable exertional angina, episodes of silent ischemia may be up to 5 times as frequent as episodes of angina, and may be due to increases in coronary vasomotor tone, transient platelet aggregation or increases in myocardial oxygen demand. Preliminary experience suggests that calcium antagonists and beta blockers are effective in decreasing episodes of silent ischemia in patients with stable exertional angina and that a combination regimen may be more effective than either form of therapy alone. PMID- 3544789 TI - Differences in cardiovascular profile among calcium antagonists. AB - Calcium antagonists constitute a group of organic compounds with diverse chemical structures. Although their main pharmacodynamic actions are vasodilatation and myocardial depression, they are not uniform in producing these effects. Based on comparison of the potencies in producing negative inotropic, chronotropic and dromotropic effects to the coronary vasodilator potency of individual calcium antagonists determined by use of isolated, blood-perfused papillary muscle, sinoatrial node and atrioventricular node preparations of dogs, calcium antagonists are classified into 2 major groups. The dihydropyridines, nicardipine, nifedipine, nimodipine, nisoldipine, nitrendipine, PN 200-110 (isradipine) and PY 108-068, are generally far more potent in producing coronary vasodilatation than in producing negative inotropic, chronotropic and dromotropic (first-degree atrioventricular block) effects, although there are minor differences among them. The non-dihydropyridine calcium antagonists, verapamil, diltiazem, KB-944, bepridil and MCI-176, are nearly equipotent in producing coronary vasodilatation and a negative dromotropic effect, although all of them are less potent in producing negative inotropy. The non-dihydropyridine calcium antagonists can be further divided into 2 subgroups. Verapamil, diltiazem and KB 944 are nearly equipotent in producing negative dromotropic and chronotropic effects. Bepridil and MCI-176 are less potent in producing negative chronotropy than in producing negative dromotropy. PMID- 3544790 TI - Usefulness of calcium antagonists for congestive heart failure. AB - In patients with congestive heart failure (CHF) due to dilated cardiomyopathy, nifedipine, diltiazem and several of the newer calcium antagonists including nicardipine, nitrendipine, felodipine and PN 200-110 (isradipine) improve left ventricular function. Because of its relatively more pronounced negative inotropic and chronotropic actions, verapamil is generally not tolerated by patients with left ventricular failure. In addition, even relatively vascular selective agents such as nifedipine can occasionally cause significant left ventricular depression, particularly if combined with beta-adrenergic blocking agents. Comparative studies using nitroprusside to cause an equivalent decrease in arterial pressure indicate that nifedipine acts predominantly on the arterial vasculature, and that a small but significant decrease in contractility occurs, apparently due to a direct myocardial action. Although diltiazem causes a depression in myocardial contractility in dogs with volume overload heart failure, limited data show no significant negative inotropic action in patients with heart failure. The negative inotropic effects, if any, of newer and possibly more vascular-selective agents are not yet known. Calcium antagonists appear to act predominantly on the limb and coronary vasculature, with relatively less effect on renal and hepatic vessels. In patients with CHF, nifedipine causes an increase in coronary blood flow and a decrease in the aorto-coronary sinus oxygen difference indicating an improvement in myocardial energetics. Although nifedipine causes an increase in cardiac index and decreases in systemic vascular resistance and pulmonary capillary wedge pressure during exercise, the limited data available fail to show a short- or long-term increase in exercise capacity. Nifedipine causes an increase in plasma renin activity, possibly due to a direct action on the kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544791 TI - Effects of calcium antagonists on infarcting myocardium. AB - Numerous studies have been conducted over the past 10 years on the effects of calcium antagonists on regional myocardial ischemia and infarct size. Verapamil, for example, reduced the degree of adenosine triphosphate degradation during 15 minutes of coronary occlusion followed by reperfusion in an anesthetized canine preparation. It also preserved the ultrastructural appearance of mitochondria in myocardium subjected to 1 hour of ischemia. Using an 8-hour permanent coronary artery occlusion model in which risk zone was assessed with radioactive microspheres and infarct size determined by tetrazolium staining, verapamil, administered 1 hour after occlusion, resulted in a modest decrease in infarct size. In a reperfusion model in which anesthetized dogs were subjected to 3 hours of coronary artery occlusion followed by 3 hours of reperfusion, verapamil decreased infarct size when it was administered during the period of ischemia, but failed to decrease infarct size when administered only during the reperfusion phase, i.e., after 3 hours of ischemia. Although verapamil is known to have negative inotropic effects, the newer calcium antagonist agent nisoldipine is less negatively inotropic, and might therefore be preferable in the situation of compromised hemodynamics. In a 6-hour permanent coronary artery occlusion model, nisoldipine decreased infarct size without decreasing left ventricular contractility. Most published reports support the concept that calcium antagonists decrease infarct size in models of experimental infarction. Of 4 major clinical studies, only 1 has shown that calcium antagonists are capable of reducing infarct size in man. However, in most of these studies, drug therapy commenced relatively late--4 or more hours after symptoms. In order for these drugs to demonstrate beneficial effects, the risk zone may have to be small and the degree of collateral flow adequate, the drug may have to be given very early or even before coronary occlusion (in a prophylactic fashion) and administration of the drug may have to be coupled to early coronary reperfusion. PMID- 3544792 TI - Efficacy of sustained-release verapamil in chronic stable angina pectoris. AB - The effectiveness of a sustained-release preparation of verapamil (verapamil-SR) was compared with the regular formulation of verapamil and with placebo in 12 patients with chronic stable angina pectoris. All patients completed an 8-week, double-blind, double-crossover, randomized protocol with 2-week treatment periods of verapamil-SR, 240 mg twice daily; regular-formulation verapamil, 120 mg 4 times daily; and 2 placebo therapies. The frequency of weekly anginal episodes was reduced from 7.6 +/- 10.0 with placebo to 3.1 +/- 4.2 after the regular formulation of verapamil (p = 0.09) and from 6.4 +/- 7.6 with placebo to 2.8 +/- 4.8 after verapamil-SR (p = 0.06). Treadmill time increased from 384 +/- 144 seconds during the first placebo phase to 468 +/- 138 seconds after the regular formulation of verapamil (p less than 0.01) and from 354 +/- 102 seconds during the second placebo phase to 462 +/- 138 seconds after verapamil-SR (p less than 0.01). Time to the onset of angina was similarly prolonged by formulations of verapamil. There were no significant adverse effects after 1 year in any patient taking verapamil-SR, 240 mg twice daily. Thus, a twice-a-day verapamil-SR dose regimen is safe and is as effective for treatment of angina of effort as the regular formulation given 4 times a day. PMID- 3544794 TI - From irritable heart to mitral valve prolapse--World War I, the British experience and Clifford Allbutt. PMID- 3544793 TI - Electrophysiologic assessment of antiarrhythmic drug efficacy for ventricular tachyarrhythmias associated with dilated cardiomyopathy. AB - To determine the benefit of serial electrophysiologic drug testing in patients with ventricular tachyarrhythmias related to dilated cardiomyopathy, programmed ventricular stimulation was performed in 38 patients. In the baseline study, sustained ventricular tachycardia (VT) was induced in 18 patients, ventricular fibrillation in 7 and nonsustained VT in 13. The patients underwent a total of 84 trials of drug therapy (mean 2.3 +/- 1.4 trials/patient). Complete success (induction of fewer than 6 repetitive responses) was recorded in 19 trials and partial success (induction of at least 6 but no more than 15 repetitive responses) in 7. Potential proarrhythmic effects were observed in 9 trials. Overall, at least 1 successful regimen was identified for 20 patients (53%). During a mean follow-up of 21 +/- 13 months, there were no arrhythmia recurrences or episodes of sudden death among patients discharged with a drug regimen determined to be effective by serial drug testing. In comparison, among patients taking regimens that failed to prevent arrhythmia induction, there were 3 arrhythmia recurrences and 2 sudden deaths (p less than 0.05). Serial electrophysiologic drug testing provides an effective method of identifying successful medical therapy for patients with ventricular arrhythmia related to dilated cardiomyopathy. PMID- 3544795 TI - Heterogeneity of the atherosclerotic process in systemic hypertension poorly controlled by drug treatment. AB - A cross-sectional study of 85 patients with poorly controlled treated hypertension was performed to detect, by means of aortic pulse wave velocity measurement and ultrasonic examinations, subclinical alterations of arteries. Pulse wave velocity was related to the product of age and diastolic blood pressure (BP) according to a nomogram obtained from normotensive subjects, and was found inside the nomogram in 37 patients (group I) and outside in 48 (group II). Group II had higher systolic and pulse BP (p less than 0.01), lower diastolic BP (p less than 0.01), higher proportion of cigarette smokers (p less than 0.05) and higher blood glucose levels (p less than 0.02) than group I. In group II a positive correlation existed between blood glucose and pulse wave velocity (p less than 0.01). Group II had a higher frequency of carotid artery stenosis (p less than 0.05) and a trend toward increased frequency of aortic and lower limb atherosclerotic lesions. The results indicate a heterogeneous pattern of arterial alterations in which systolic BP, cigarette smoking and blood glucose level are implicated. PMID- 3544796 TI - Ultrastructure of the giant cell infiltrate of subcutaneously implanted bone particles in rats and mice. AB - The giant cells of soft tissues and those of mineralized tissues (osteoclasts) have distinctly different cell surface receptors and ultrastructural characteristics. Recently, the removal of dead bone particles in a subcutaneous environment has been described as a prototype of bone resorption, and a major issue is whether the giant cells that surround these ectopic bone implants and the processes involved in the disruption of bone surfaces are the same as those in the skeleton. We have compared the cytology and ultrastructure of giant cells recruited to subcutaneously implanted isogeneic bone particles with similar features of osteoclasts in metaphyseal bone of young normal rats and mice. Giant cells on surfaces of bone particles 2, 3, and 4 weeks after implantation were multinucleated, had a homogeneous, nonvacuolated cytoplasm, and had a bone surface interface unremarkable by light microscopy. In a few cells randomly distributed, small cytoplasmic vacuoles were present and large vacuoles were noted next to the bone surface at high magnification. By transmission electron microscopy, folded membrane configurations forming extensive interdigitations with adjacent cells were prominent features on most surfaces of giant cells. In instances where these interdigitations abutted bone surfaces, configuration resembling a ruffled border were noted, but these regions were always part of two different cells when examined at lower magnification or in serial sections. Breakdown of bone particles appeared to be by phagocytosis of small pieces and subsequent intracellular digestion in electron-dense cytoplasmic vacuoles. Osteoclasts from these same young animals were smaller with fewer nuclei, had cytoplasmic vacuoles concentrated next to bone surfaces, and had characteristic ruffled borders and clear zones. These results confirm those of others that native osteoclasts and multinucleated giant cells on dead bone particles are distinctly different with respect to both ultrastructure and mechanism of disruption of bone surfaces. PMID- 3544797 TI - Overestimate of deuterium-dilution space using respiratory water. PMID- 3544798 TI - Detection of estrogen receptors with monoclonal antibodies in routinely processed formalin-fixed paraffin sections of breast carcinoma. Use of DNase pretreatment to enhance sensitivity of the reaction. AB - This study describes an improved immunohistochemical method for the sensitive and specific identification of estrogen receptors (ERs) in paraffin sections from formalin-fixed and routinely processed breast carcinoma tissues, using DNase pretreatment to expose nuclear antigenic sites and commercially available immunoreagents (including monoclonal antibody) in kit form. Results were compared with dextran-coated charcoal cytosolic assay (DCC) and with conventional immunohistochemistry on frozen sections. Sensitivity and specificity for determinations on paraffin sections were 88% and 86%, respectively, and statistical analysis showed very good agreement between DCC and paraffin sections (kappa = 0.805). The DNase technic on paraffin sections allows excellent correlation between histologic characteristics and ER status and reduces DCC sampling error resulting from stromal dilution and tumor variability. This method offers a reliable and reproducible alternative when tissue is not suitable or unavailable for DCC or frozen tissue analysis and can be used for retrospective studies on stored tissue blocks. PMID- 3544799 TI - Aneuploidy and expression of gastric-associated mucus antigens M1 and CEA in colorectal adenomas. AB - A series of 55 flow cytometric characterized colorectal adenomas was analyzed with four different monoclonal antibodies (Mabs) for the occurrence of M1 antigens (associated with gastric fucomucins) and one Mab for carcinoembryonic antigen (CEA). The antigens were detected with an indirect immunoperoxidase technic on paraffin sections after pretreatment with pronase for M1 antigens and without pretreatment for CEA. The staining pattern revealed different correlations with the various parameters, i.e., size, histologic type, atypia, and ploidy of the adenomas. Especially the cytoplasmic staining of anti-M1, Mab (1-13 M1) correlated well with aneuploidy (R = 0.43; P less than or equal to 0.001) and with the DNA index (R = 0.34; P less than or equal to 0.01). Staining of the anti-CEA Mab only correlated with the size of the adenomas (R = 0.29; P less than or equal to 0.03). It is concluded that the immunoreactivity of Mab (1 13 M1), which significantly correlated with aneuploidy, may be associated with malignant transformation in the adenoma-carcinoma sequence. PMID- 3544800 TI - Light microscopic, S-100 immunostaining, and ultrastructural analysis of dermatopathic lymphadenopathy, with and without associated mycosis fungoides. AB - Thirty-five patients with dermatopathic lymphadenopathy, 12 with (9 patients and 3 follow-up) and 23 without associated mycosis fungoides, and 7 controls with 26 lymph nodes were studied by light microscopic examination and immunostaining for S-100 protein. Fourteen of these cases were examined ultrastructurally. The group of cases studied included lymph nodes obtained at postmortem examination from three patients with mycosis fungoides and evidence of nodal involvement by light microscopic examination. Lymph nodes from patients with dermatopathic lymphadenopathy and paracortical hyperplasia (but no effacement of architecture by recognizable mycosis fungoides cells by light microscopic examination) associated with biopsy-proven mycosis fungoides showed well-defined, diffusely distributed sheets of S-100-positive cells. Cases of dermatopathic lymphadenopathy unassociated with a skin lymphoma (23 cases), with the exception of 3 cases (12.5%), only showed scattered S-100-positive cells, a similar pattern to that noted in normal or reactive lymph nodes from the control cases and reported literature. In the three cases with diffuse sheets without associated mycosis fungoides, the intensity of S-100 staining was the same in germinal centers as in parafollicular areas, while in cases associated with mycosis fungoides, the staining was predominantly in parafollicular zones. Ultrastructural immunolabeling for S-100 protein also revealed different patterns in both subsets of patients. Interestingly, in cases in which the lymph nodes were identified by light microscopic examination to be replaced by mycosis fungoides, the sheets of S-100-positive cells disappeared. The corresponding ultrastructural evaluation showed cellular aggregates with features of T-cells. A combination of S-100 immunocytochemistry and morphologic ultrastructural assessment can be of help in evaluation of lymphadenopathy in patients with mycosis fungoides. Although this study indicates that the finding of sheets of S 100-positive cells in patients with dermatopathic lymphadenopathy is not always associated with mycosis fungoides, the identification of diffuse sheets of S-100 positive cells, especially with parafollicular distribution, in a patient without known T-cell lymphoma should probably be considered an indication to suggest a complete clinical evaluation to rule out the possibility of an undiagnosed mycosis fungoides. The finding of sheets of S-100-positive cells in patients with proven mycosis fungoides may be a morphologic indicator of impending extracutaneous dissemination. PMID- 3544801 TI - Comparison of Clostridium difficile detection by monolayer and by inhibition of nucleoside uptake. AB - Detection and identification of Clostridium difficile toxin by traditional monolayer assay were compared with results obtained by a new procedure based on toxin-dependent inhibition of target cell uptake of a radioactive nucleoside. A high degree of correlation was noted between the two determinations. Although the new procedure was quantitative and objective, its value is seen at present as a rapid screen that may support results obtained in monolayers and as a potential assay for other, currently unidentified, toxins. PMID- 3544802 TI - Comparison of an agar slide blood culture device with Bactec 6B for the detection of bacteremia. AB - Each of 1,018 blood culture specimens was inoculated into Bactec 6B (Johnston Laboratories, Towson, MD) and a biphasic blood culture system that incorporates internal removable agar dip slides (Hylab). Ninety clinically significant pathogens were recovered: 66 from both systems, 14 from Bactec only, and 10 from Hylab only. The mean incubation times to positive of the two systems did not differ when data were examined for gram-negative bacilli, gram-positive cocci, total isolates, and contaminants (P greater than 0.05). Contamination rates were also comparable: Bactec 5.4%, Hylab 7.3% (P greater than 0.05). The Hylab system may offer a practical alternative to Bactec 6B. PMID- 3544804 TI - In memoriam. James Earle Ash, M.D. (1884-1986). PMID- 3544803 TI - Recognition of hairy cell leukemia in a spleen of normal weight. The contribution of immunohistologic studies. AB - A 68-year-old man with known hairy cell leukemia (HCL) underwent splenectomy; the spleen weighed only 140 g. Microscopic examination of the spleen revealed no clear diagnostic evidence of HCL, but there was an unusual and suspicious subendothelial lymphoid infiltration of the trabecular veins. Cell suspension studies also were not diagnostic because a monoclonal B-cell population could not be defined. Alternatively, when we focused on the subendothelial infiltrate in the frozen sections prepared for immunohistochemical studies, the findings indicated that the subendothelial cells were monoclonal B-cells (IgG, kappa). Staining with monoclonal antibodies disclosed the phenotype Tac+, Leu-14+, Leu M5+, B2-, BA-1-, and BA-2-, a phenotype characteristic of HCL. In this case, an unusual but nondiagnostic morphologic finding provided guidance for the correlative immunophenotypic analysis of the same site in frozen sections and thereby allowed a definitive diagnosis. PMID- 3544805 TI - Direct smears versus rinse/filtration technics. PMID- 3544806 TI - Detection of C. difficile toxin A (enterotoxin) PMID- 3544807 TI - The nasal airway following maxillary expansion. AB - There have been suggestions that maxillary expansion may be justified on the basis of airway considerations alone. The present study assessed the effects of rapid maxillary expansion and surgical expansion on nasal airway size to determine how useful these techniques are for breathing purposes. The results demonstrate that both procedures generally improve the nasal airway. However, approximately one third of the subjects in both groups did not achieve enough improvement to eliminate the probability of obligatory mouth breathing. These findings suggest that maxillary expansion for airway purposes alone is not justified. PMID- 3544808 TI - Convulsions in childhood shigellosis. Clinical and laboratory features in 153 children. AB - We studied 153 children who experienced convulsions associated with shigellosis. The male-female ratio was 1.2:1.0. Thirty-six children had a previous history of febrile convulsions, and 31 children had a family history of convulsive disorder. Most of the children were 0.5 to 3 years of age, although 49 (32%) were older than 3 years of age and 20 (13.1%) were older than 5 years of age. All children were febrile; in 75% of the children, the temperature was over 39 degrees C. The majority of the children had generalized, self-limited convulsions, which lasted less than ten minutes. In 30 children the seizures were categorized as complex; ten of them had recurrent episodes, although none had any residual neurologic deficit. The total leukocyte count was usually within normal limits, but the differential count characteristically showed a marked increase in the number of band forms. Hypocalcemia (blood calcium level, less than 9.01 mg/dL [less than 2.25 mmol/L]) was observed in four patients; hyponatremia (blood sodium level, 130 mEq/L [130 mmol/L]), in 11 patients; and hypernatremia (blood sodium level, 157 mEq/L [157 mmol/L]), in one patient. Electroencephalographic (EEG) studies were performed in ten children, and lumbar punctures were performed in 34 children; both procedures usually yielded normal results. Shigella sonnei was isolated from 69% of the children; Shigella flexneri from 25%; Shigella boydii from 5%; and Shigella dysenteriae from 1%. Due to the benign and self-limited nature of most of the convulsions, neither diagnostic procedures, nor drug therapy, are usually necessary. These measures should, however, be considered in complicated cases characterized by focal or prolonged seizures. PMID- 3544809 TI - Is it real or is it a contaminant? A guide to the interpretation of blood culture results. PMID- 3544810 TI - Neurologic sequelae of cardiac surgery in children. AB - Major advances in surgical and cardiopulmonary bypass technology have occurred in the past 30 years. Total correction of previously inoperable congenital cardiac defects is being performed with increasing frequency and in children at progressively younger ages. While the majority of children undergoing cardiac surgery survive without incident, increasing concern is being raised about neurologic sequelae seen in some survivors. Complications such as embolization, hypoxia, inadequate cerebral perfusion, and biochemical disturbances may all lead to brain damage following cardiac surgery. Acute postoperative neurologic problems include seizures, impaired levels of consciousness, focal motor deficits, and movement disorders. Long-term sequelae include language and learning disorders, mental retardation, seizures, and cerebral palsy. Intraoperative cerebral monitoring techniques are as yet imperfect, but their use in combination with meticulous intraoperative and postoperative care currently provides the best means of reducing neurologic morbidity. Future studies should explore other methods of preserving neurologic integrity in children undergoing open heart surgery. PMID- 3544811 TI - Imipenem and cilastatin in acute osteomyelitis and suppurative arthritis. Therapy in infants and children. AB - Twenty-five infants and children with acute osteomyelitis (n = 7), suppurative arthritis (n = 11), or both (n = 7) were treated with imipenem and cilastatin sodium. Patients ranged in age from 5 months to 11.3 years. Needle aspiration of infected sites was performed in all patients, and 11 (44%) required further surgical drainage. Imipenem and cilastatin sodium in a dosage of 100 mg/kg/d was used for children 3 years of age or younger, while older ones received 60 mg/kg/d intravenously, divided in four equal doses. Bacterial pathogens were identified in 15 patients (60%): Staphylococcus aureus in five, Haemophilus influenzae b in four, Pseudomonas aeruginosa in two, Streptococcus pneumoniae in one, group A Streptococcus in one, Kingella kingae in one, and Citrobacter amalonaticus in one. All isolates were susceptible to imipenem in vitro. Imipenem and cilastatin therapy was continued for a median of six days followed by treatment with appropriate orally administered antibiotics. Median peak serum bactericidal titers after imipenem and cilastatin infusions were 1:512 for S aureus, 1:32 for H influenzae b, 1:512 for streptococci, and 1:16 for gram-negative rods. All but one patient with P aeruginosa osteomyelitis responded favorably to imipenem and cilastatin. The median duration until resolution of symptoms was six days. Imipenem and cilastatin infusions were well tolerated, and side effects included maculopapular rash in one patient, watery diarrhea in one, and mild transient elevation of alanine aminotransferase levels in three. Because of imipenem and cilastatin's unusually broad spectrum of activity and its relative safety, this drug combination can be used for the initial, empiric therapy of acute bone and joint infections in pediatric patients. PMID- 3544812 TI - Drug therapy of portal hypertension. AB - Portal hypertension is the result of increased flow and increased resistance in the portal system. Pharmacological therapy is aimed at altering these factors by the use of vasoconstrictors to reduce flow and vasodilators to decrease intrahepatic resistance. The current status of pharmacological agents to achieve these effects is reviewed. PMID- 3544813 TI - The ultrasonic demonstration of carcinoid tumor of the ileocecal valve. AB - Gastrointestinal polyps are usually not identified on ultrasonography. The first ultrasonic demonstration of a polypoid tumor of the ileocecal valve, manifesting as a hypoechoic mass, is presented. The differential diagnosis of predominantly hypoechoic lesions of the ileocecal region are discussed. PMID- 3544814 TI - Surgical alternatives for the short bowel syndrome. AB - Since the introduction of total parenteral nutrition an increasing number of patients are surviving massive intestinal resection. However, the expense, morbidity, and inconvenience of this therapy have created interest in surgical alternatives for the treatment of the short bowel syndrome. The goals of surgical therapy in the short bowel syndrome are to slow intestinal transit, increase the area of absorption, and reduce gastric hyperacidity. Antiperistaltic segments or colon interposition benefit patients with sufficient absorptive area, but rapid intestinal transit. Intestinal valves yield inconsistent results. Recirculating loops are associated with prohibitive morbidity and mortality. Experience with intestinal pacing is limited. Patients with dilated bowel segments may benefit from intestinal tapering or lengthening. Growing neomucosa holds promise but has not been evaluated clinically. Despite recent advances in immunosuppression the results of transplantation remain unsatisfactory. Gastric hyperacidity can be effectively controlled by H2 receptor antagonists. None of the operations for treatment of the short bowel syndrome is sufficiently safe and effective to recommend their routine use. Operations should be performed only on selected patients to achieve specific goals. Although investigation continues, our emphasis should continue to be prevention of intestinal resection and conservation of as much of the intestine as possible when massive resection is necessary. PMID- 3544816 TI - An epidemiologic approach to the evaluation of the effect of inbreeding on prereproductive mortality. AB - Although many studies report deleterious effects of inbreeding on prereproductive mortality (death before age 20 years), such effects are usually measured in terms of genetic load, a concept much debated in the literature. To evaluate the public health impact of inbreeding on prereproductive mortality in terms of relative and attributable risks, the authors reviewed 31 studies with 294 observations comparing various stages of infant and child mortality in offspring of unrelated parents with offspring of first cousin, first cousin once removed, and second cousin marriages, respectively. Compared with offspring of unrelated parents, offspring of first cousin marriages have a higher risk of prereproductive mortality (median relative risk (RR) = 1.41, signed-rank test, p less than 0.01). Offspring of first cousin once removed and second cousin marriages had median relative risks of 1.16 and 1.26, respectively. Countries with relatively higher rates of consanguineous marriages (greater than 5%) had lower median relative risks than did countries with lower consanguinity rates. Also, the higher the mortality rate in the population, the lower the effect of consanguinity (median relative risk). Because of the rarity (less than 5%) and declining trends of consanguineous marriages in many places of the world, and because of their modest effect on prereproductive mortality (RR less than 2.0), it can be shown that the attributable risk of prereproductive mortality due to consanguineous marriages is less than 5%. Except for a few places with very high inbreeding levels, inbreeding has a minor impact on mortality in the prereproductive period. PMID- 3544815 TI - Critical appraisal of the exposure-potential restriction rule. PMID- 3544817 TI - Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study. AB - The relation of obesity to clustering of systolic blood pressure, fasting insulin, and ratio of low and very low density lipoprotein cholesterol to high density lipoprotein cholesterol [LDL-C + VLDL-C)/HDL-C) was investigated in 3,503 subjects aged 5-24 years in Bogalusa, Louisiana, from September 1981 to September 1983. Risk ratios (RR) were calculated as the number of subjects with risk factor variables in the upper tertile divided by the expected number. The variables showed strong clustering (RR = 3.1); however, after adjusting for obesity, clustering of systolic pressure, (LDL-C + VLDL-C)/HDL-C, and insulin was reduced (RR = 1.3). Lean subjects (lower tertile of obesity) showed less clustering than expected (RR = 0.4), while more obese subjects (upper tertile of obesity) had greater clustering than expected (RR = 3.1). Furthermore, trunk fat deposition (subscapular skinfold) had a greater impact on clustering at high levels than limb fat deposition (triceps skinfold). Since obesity is related to clustering of risk factor variables in children and young adults, the prevention of the onset of obesity in early life may be important to reducing the risk of coronary heart disease in later life. PMID- 3544819 TI - Abstracts of the annual scientific meeting. National Kidney Foundation. PMID- 3544818 TI - Characteristics of human hypo- and hyperresponders to dietary cholesterol. AB - The characteristics of people whose serum cholesterol level is unusually susceptible to consumption of cholesterol were investigated. Thirty-two volunteers from the general population of Wageningen, the Netherlands, each participated in three controlled dietary trials in 1982. A low-cholesterol diet was fed during the first half and a high-cholesterol diet during the second half of each trial, and the change (response) of serum cholesterol was measured. The responses in the three trials were averaged to give each subject's mean responsiveness. Fecal excretion of cholesterol and its metabolites were measured in the second trial, and body cholesterol synthesis was calculated. Responsiveness showed a positive correlation with serum high density lipoprotein2 (HDL2) cholesterol (r = 0.41, p less than 0.05) and with serum total cholesterol level on a high-cholesterol diet (r = 0.31, p = 0.09). A negative relation was found with habitual cholesterol consumption (r = -0.62, p less than 0.01), with body mass index (r = -0.50, p less than 0.01), and with the rate of endogenous cholesterol synthesis (r = -0.40, p less than 0.05), but not with the reaction of endogenous cholesterol synthesis rate to an increased intake of cholesterol. No relation was found with age, sex, total caloric needs, or the ratio of primary to secondary fecal steroids. Upon multiple regression analysis, only habitual cholesterol intake and serum total and HDL2 cholesterol levels contributed significantly to the explanation of variance in responsiveness. Thus, a low habitual cholesterol intake, a high serum HDL2 cholesterol level, or a low body weight do not make one less susceptible to dietary cholesterol-induced hypercholesterolemia. PMID- 3544821 TI - Early and late forms of cyclosporine nephrotoxicity: studies in cardiac transplant recipients. AB - To characterize the two forms of cyclosporine nephrotoxicity, we examined renal function in the immediate and late postoperative periods after cardiac transplantation. Moderate azotemia occurred during the first postoperative week in 58% of 43 cyclosporine-treated recipients, but in only 34% of 41 azathioprine treated recipients, and 4% of 25 patients undergoing cardiopulmonary bypass for nontransplant surgery (both P less than .01 v cyclosporine). Acute renal failure developed in an additional 12% of the cyclosporine-treated group. Late postoperative renal dysfunction also occurred with a high prevalence. Life-table analysis indicated that at 6 months 55%, at 12 months 17%, at 24 months 4%, and at 36 months no cyclosporine-treated recipients retained normal renal function. Three renal biopsies performed in subjects with late nephrotoxicity demonstrated prominent interstitial fibrosis. Although one patient subsequently required chronic dialysis, reduction of cyclosporine dosage from a mean of 5.3 +/- 0.7 mg/kg/d to a mean of 2.3 +/- 0.3 mg/kg/d 9 to 21 months after transplantation with concurrent initiation of azathioprine therapy to prevent rejection led to an improvement of renal function in the five patients so treated. These data indicate that there are two distinct forms of cyclosporine nephrotoxicity. Although both occur with high prevalence, the early form does not appear to be a specific risk factor for the late form. PMID- 3544820 TI - Treatment of the hyperlipidemia of the nephrotic syndrome: a controlled trial. AB - The hyperlipidemia of the nephrotic syndrome is often associated with elevated total and low-density lipoprotein (LDL) cholesterol levels and low or normal high density lipoprotein (HDL) cholesterol levels. This pattern of hyperlipidemia has been associated with an increased risk of accelerated atherosclerosis in other populations. Despite extensive studies of diet and drug therapy in other populations, few such therapeutic studies exist in patients with the nephrotic syndrome. To investigate the effect of diet and lipid-lowering drugs on the lipoprotein-lipid profile of patients with unremitting nephrotic syndrome and marked hyperlipidemia, we conducted a controlled trial using two such drugs: colestipol and probucol. Colestipol lowered the mean total fasting plasma cholesterol of seven patients from 397 +/- 27 to 317 +/- 37 mg/dL, a 20.2% decrease, and lowered the LDL cholesterol from 398 +/- 28 to 203 +/- 18 mg/dL, a 31.9% decrease. It did not affect the HDL cholesterol level, and thus lowered the LDL-to-HDL cholesterol ratio. Probucol lowered the mean total cholesterol from 439 +/- 72 to 339 +/- 60 mg/dL, a 22.6% decrease, and the LDL cholesterol from 282 +/- 43 to 215 +/- 26 mg/dL, a 23.8% decrease. Although the HDL cholesterol was lowered from 49 +/- 9 to 43 +/- 7 mg/dL by probucol, a 12.2% decrease, the LDL-to-HDL cholesterol ratio still declined. Both drugs were well tolerated and proved safe in this short-term trial. Antihyperlipidemic therapy may well be indicated in certain patients with unremitting nephrotic syndrome. PMID- 3544822 TI - Recurrent Henoch-Schonlein purpura following renal transplantation. AB - A 20-year-old patient with Henoch-Schonlein purpura leading to end-stage renal failure received a living-related renal transplant. She was treated with conventional immunosuppressive therapy. Following a quiescent period of 18 months pretransplant, at 3 months after engraftment there was recurrence of purpuric lesions with subsequent abdominal pain and glomerulonephritis. Renal and skin biopsies confirmed the immunopathologic changes of Henoch-Schonlein purpura. This case represents the second report of an adult with multiorgan recurrence of Henoch-Schonlein purpura following transplantation. PMID- 3544823 TI - Tamm-Horsfall protein coating of free cells in urine. AB - The origin of free cells in urine is difficult to determine in the absence of cellular casts. Using fluorescein-conjugated antibody to human Tamm-Horsfall protein (THP), it was demonstrated that some free cells in urine are coated with THP. To evaluate the usefulness of this observation in the differentiation of upper from lower urinary tract disease, the presence of THP coating of cells was correlated with the clinical diagnosis in 141 subjects. The percentage of THP coated cells for each group (mean +/- SD) was Healthy volunteers (n = 10), 4% +/- 2%; hospitalized controls (n = 20), 3% +/- 3%; glomerulonephritis (n = 21), 61% +/- 6%; chronic interstitial nephritis (n = 26), 56% +/- 5%; other renal parenchymal diseases (n = 14), 50% +/- 8%; bladder disease (n = 14), 8% +/- 2%; and hypertension (n = 36), 24% +/- 33%. Based on the results from the bladder disease group, 12% coating was set as the 95% confidence limit for lower urinary tract disease. The results in this group were not different from control subjects. By analysis of variance and chi 2 analysis, subjects with renal parenchymal disease could be distinguished from those with hypertension and bladder disease (P less than .001 and P less than .0001, respectively). The presence of cellular coating by THP in renal parenchymal disease and its absence in bladder disease suggests that this simple test may be of use in determining the origin of free cells observed in the routine microscopic urinalysis. PMID- 3544824 TI - High-density lipoprotein cholesterol subfractions in chronic uremia. AB - Cholesterol content in high-density lipoprotein (HDL) subfractions has been studied in 108 patients at different evolutive stages of chronic renal failure (CRF) under conservative treatment. Results have been compared with healthy control subjects, patients receiving hemodialysis, and renal graft recipients. Significant low levels of total HDL and HDL2 cholesterol are observed in men with CRF. The more severe the CRF, the more likely that total HDL and HDL2 cholesterol will be low. Moreover, a significant inverse correlation is found between HDL2 cholesterol and serum creatinine levels. In women, although a decrease in total and HDL2 subfraction is observed, no significant differences are found across the severity of CRF. Serum HDL2 cholesterol levels are decreased in men and women receiving hemodialysis, while raised total HDL and HDL2 cholesterol levels are observed in normally functioning renal grafts. These results indicate that according to the "HDL hypothesis," despite other associated risk factors, the high cardiovascular mortality rates noted mainly in men with CRF under conservative treatment and in patients receiving hemodialysis could be explained, at least in part, by the sustained and progressive decrease in total HDL and HDL2 values. From this point of view, our study suggests the need to promote early kidney transplantation. PMID- 3544826 TI - A world of knowledge for the nation's health: the U.S. National Library of Medicine. AB - The origins, history, current collections and services, and projected future services of the U.S. National Library of Medicine are described, and the seminal figure in its development is profiled. The library, now located on the campus of the National Institutes of Health, was founded in 1836 as the Library of the Army Surgeon General's Office. The current facility holds more than 3.5 million items and offers innovative information services to health-care professionals worldwide. The leading figure in the library's development was Army physician John Shaw Billings, whose accomplishments included the international expansion and bibliographic organization of the holdings and creation of the Index Medicus and Index-Catalogue. The computerized services offered by the library include the MEDLINE database, which is based on Index Medicus, and pharmacy-related databases. Health-care practitioners can gain access to the library's resources through the Regional Medical Library Network. Among projects under development at the Lister Hill National Center for Biomedical Communications are microcomputer and optical disk technologies, the preservation of paper collections, and a unified medical language system. The U.S. National Library of Medicine has served the health-care community for 150 years; many services in the area of biomedical communications are available to pharmacists and other practitioners through the library and the Regional Medical Library Network. PMID- 3544825 TI - Acute idiopathic tubulointerstitial nephritis: report of two cases and review of the literature. AB - Two patients who presented with severe renal failure and evidence of generalized proximal tubular dysfunction were found to have severe diffuse acute tubulointerstitial nephritis on renal biopsy. No etiology could be found in either case. Both patients had dramatic improvement in renal function following steroid therapy. In the first reported case of its kind, one patient relapsed when steroids were withdrawn, but improved again with reinstitution of steroid therapy. These cases, as well as others in the literature, show that steroids are effective and may be necessary to improve renal function in some patients with acute idiopathic tubulointerstitial nephritis. Evidence of proximal tubular dysfunction is a clue to the presence of this disorder. PMID- 3544827 TI - Growth of four microorganisms in polyethylene glycol-electrolyte lavage solution. AB - The growth of Staphylococcus epidermidis, Serratia marcescens, Pseudomonas aeruginosa, and Candida albicans in reconstituted polyethylene glycol-electrolyte lavage solution (PEG-ELS) stored under refrigeration and at room temperature was studied. A standard inoculum of each organism was added to one of four 4-L containers (one organism per container). From each container 28 aliquots of 25-mL each were removed and stored under refrigeration or at room temperature. One container was not inoculated and served as a control. Duplicate aliquots of the inoculated and the control solutions were filtered and incubated for quantification of organisms on days 0, 1, 2, 4, 8, 16, and 30. Solutions stored at room temperature supported the growth of S. marcescens and Ps. aeruginosa. The counts of these organisms increased to approximately 10(6) colony-forming units (CFU)/mL over 16 days. The counts of Staph. epidermidis in solutions stored at room temperature increased slightly over the first 24 hours and declined steadily to zero after day 4. C. albicans reached a maximum colony count of 5.84 cfu/mL on day 16 and steadily declined to 0.92 cfu/mL on day 30. Solutions stored under refrigeration did not support the growth of any microorganisms. Microbial growth was not detected in any of the control solutions over the 30-day study period. The polyethylene glycol-electrolyte lavage solution studied here should be refrigerated after reconstitution to minimize microbial growth. This solution may be used for up to 30 days after reconstitution when it is stored under refrigeration. PMID- 3544828 TI - Financial threats to teaching hospitals. PMID- 3544829 TI - Hypertension in the elderly. AB - The incidence of hypertension in the geriatric population is very high and is a significant determinant of cardiovascular risk in this group. The tendency for blood pressure to increase with age in westernized societies such as the United States may depend on environmental factors such as diet, stress, and inactivity. Our population tends to become more obese; to consume relatively greater amounts of sodium and lesser amounts of potassium, calcium, and magnesium; and to decrease exercising with increasing age. Senescent changes in the cardiovascular system leading to decreased vascular compliance and decreased baroreceptor sensitivity contribute not only to rising blood pressure but also to an impairment of postural reflexes and orthostatic hypotension. The hallmark of hypertension in the elderly is increased vascular resistance. Greater vascular reactivity in the elderly hypertensive patients may reflect decreased membrane sodium pump activity and decreased beta-adrenergic receptor activity as well as age-related structural changes. Treatment of diastolic hypertension in the elderly is associated with decreased cardiovascular morbidity and mortality. Although treatment of systolic hypertension may not decrease immediate cardiovascular mortality, it appears to decrease the incidence of stroke. The initial therapeutic approach to the elderly hypertensive patient should generally consist of a reduction in salt and caloric intake and an increase in aerobic exercise, i.e., walking. Drug therapy should be initiated with lower doses of medication with a special concern about orthostatic hypotension. PMID- 3544830 TI - Uniformity and diversity of calcium metabolism in hypertension. A conceptual framework. AB - Calcium metabolism plays an important role in blood pressure homeostasis, although it remains unclear to what extent calcium contributes to or, alternatively, protects against clinical hypertension. To resolve this confusion, hypertensive subgroups were first defined by plasma renin activity, dietary salt sensitivity, sensitivity to calcium channel blockade, and calcium metabolic indices. Using these classification schemes, different patterns of calcium metabolism emerged, each predictive of divergent clinical responses. Patients with low plasma renin activity, low serum ionized calcium levels, and dietary salt sensitivity, such as black and elderly hypertensive patients, may preferentially benefit from calcium supplementation. It is postulated that calcium-regulating hormones and the renin-angiotensin-aldosterone system coordinately monitor dietary mineral intake, and transduce these environmental signals at the cellular level by altering cellular calcium uptake and disposition. Analysis of these hormonal systems is useful diagnostically in defining those patients who would most benefit from non-pharmacologic dietary forms of treatment. PMID- 3544831 TI - The calcium paradox of essential hypertension. AB - Three disparate observations--that calcium mediates vascular smooth muscle contraction, that calcium channel blockers lower blood pressure, and that increased dietary calcium intake can also ameliorate hypertension--constitute somewhat of a paradox. The complex interrelationships between calcium metabolism and essential hypertension are discussed in this review. Recent evidence suggests possible defects in intracellular calcium transport or in calcium binding in essential hypertension. This evidence, and the paradoxical therapeutic efficacy of both calcium channel blockers and supplemental dietary calcium, can be integrated into a single theoretic construct. PMID- 3544832 TI - Aging and diabetes mellitus as risk factors for vascular disease. AB - During this century, cardiovascular diseases have become the major cause of death for elderly and diabetic patients. Although risk factors for vascular diseases have been identified, the interactions of aging and diabetes on the prevalence and incidence of vascular disease have not been systematically studied. A spectrum of such interactions appears to exist. Future research efforts are likely to permit accurate weighting of the influence that diabetes and aging have on vascular disease. PMID- 3544833 TI - Cholesterol metabolism and aging. AB - Changes occur in lipid and lipoprotein concentrations with age that increase the risk of developing atherosclerotic disease. In children and young adults (less than 20 years of age), the plasma total cholesterol concentration decreases between the ages of 10 and 20 years. After age 20, the plasma total cholesterol concentration increases progressively, and in men reaches a plateau between the ages of 50 and 60 years, whereas in women, it reaches a peak between 60 and 70 years of age. The low-density lipoprotein cholesterol concentration increases progressively in men and women after age 20, but more rapidly in men, accounting for most of the overall gender difference in total cholesterol. The rate at which the low-density lipoprotein cholesterol concentration increases in women begins to accelerate between 40 and 50 years of age, and the concentration exceeds that in men by 55 to 60 years. High-density lipoprotein cholesterol concentrations decrease in males during puberty and early adulthood, and thereafter remain lower than those in women at all comparable ages. The high-density lipoprotein cholesterol concentrations remain constant in women throughout their lifetime. Beyond 30 years of age, women taking estrogen preparations have higher high density lipoprotein cholesterol concentrations than women who are not taking estrogens. The triglyceride concentration increases progressively in men, reaching peak values between 40 and 50 years of age, and then declining slightly thereafter. In women, the triglyceride concentration increases throughout their lifetime, but is always higher in those using estrogens. Whether these changes in lipoprotein concentrations merely accompany the increasing prevalence of atherosclerotic vascular disease that occurs with age, or contribute to it, is unknown at this time. PMID- 3544834 TI - Hormonal influences on osteoporosis. AB - Osteoporosis has recently received increased attention in both the medical and lay literature. It is estimated that there are more than one million osteoporosis related fractures yearly in the United States, which are responsible for between three and four billion dollars in health care expenditures. A discussion of osteoporosis requires consideration of both the physiology and pathophysiology of bone tissue. In a structural sense, bone exists in two forms, the outer compact cortex accounting for 80 percent of total bone volume, and the more porous inner trabecular bone. Bone-forming osteoblasts and bone-resorbing osteoclasts are responsible for the ongoing, life-long process of formation and resorption of bone. Sex hormone deficiency, as well as chronic illness, malnutrition, and childhood immobilization, has deleterious effects on growth and modeling, ultimately reducing peak bone mass and setting the stage for osteoporosis in later life. Estrogen is known to have a protective effect on the female skeleton. The mechanisms of this effect are unknown, although estrogen may protect against parathyroid hormone-mediated bone loss. There may be a particular subset of postmenopausal women who are particularly susceptible to estrogen deficiency. Calcitonin levels, which decrease postmenopausally, return to normal with estrogen; other hormones may also play important roles. Osteoporosis is not the result of a single hormonal deficiency or excess; it must be considered in relation to other pathogenetic and risk factors. PMID- 3544835 TI - Trabecular bone architecture in the pathogenesis and prevention of fracture. AB - Rapid loss of trabecular bone (as after menopause) occurs by complete removal of some structural elements, leaving those that remain more widely separated and less well connected. The most likely cellular mechanism is an increase in the number of resorption cavities deep enough to lead to focal perforation of trabecular plates, either as a non-specific consequence of increased remodeling activation, or as a specific consequence (direct or indirect) of estrogen deficiency. Disruption of the connections between structural elements produces a disproportionate loss of strength, for which the increased thickness of the remaining trabeculae can only partly compensate. Consequently, the most biomechanically significant component of trabecular bone loss occurs rapidly and irreversibly. This emphasizes the importance of prevention, but no treatment except estrogen replacement is of proven efficacy in preventing estrogen dependent bone loss. For adequate repair of structural damage after it has been allowed to occur, adding bone to existing surfaces may be insufficient, and it may be necessary to devise some means of forming new bone directly in the bone marrow cavity in order to re-establish normal connectivity. PMID- 3544836 TI - Role of nutrition and exercise in osteoporosis. AB - Both adequate nutrition and exercise are essential for development of peak adult bone mass and maintenance of bone during aging. The optimal dietary level of a nutrient may vary from individual to individual and may change with age, intake of other nutrients, disease, drug therapy, or sex hormone status. Effects on spinal trabecular bone may not parallel effects on axial cortical bone. Calcium nutrition is important in the prevention of osteoporosis, as calcium is a major constituent of bone. The intake of calcium among most American adults is below the levels recommended by public health agencies. There have been no adequate prospective studies to determine the optimal intake of calcium for preservation of bone mass in young or middle-aged adults, although calcium balance studies indicate that premenopausal women require approximately 1,000 mg of calcium per day. The negative calcium balance of early menopause may be ameliorated by 1,000 mg of calcium per day; however, there is no proof that greater intakes fully reverse the effects of estrogen deficiency. Calcium requirements of both elderly men and women are likely to be greater (between 1,000 and 1,500 mg per day) due to an age-related decrease in the efficiency of intestinal calcium absorption. The optimal level of weight-bearing exercise for maintenance of bone mass in old age is probably similar to that of an active young adult. Maintenance of this activity level in middle and old age improves bone mass. An exercise prescription for elderly individuals must include an appraisal of cardiovascular and muscular skeletal health and be designed to minimize the risk of trauma during exercise. PMID- 3544837 TI - Effects of age on renal sodium homeostasis and its relevance to sodium sensitivity. AB - Age-related changes in blood pressure, renal function, and sodium homeostasis suggest that sodium sensitivity of blood pressure may also be influenced by age. Blood pressure was measured in 378 normal volunteers and 198 patients with essential hypertension after an intravenous infusion of normal saline and after sodium and volume depletion. Those whose mean arterial blood pressure decreased more than 10 mm Hg after sodium and volume depletion were considered sodium sensitive, whereas those with a decrease of less than 5 mm Hg were considered sodium resistant. The normal and hypertensive subjects were divided into groups of those above and those below 40 years of age. The blood pressure responses of both older and younger groups were normally distributed, indicating that blood pressure could either decrease or increase following volume depletion. Older hypertensive and normotensive subjects are more likely to be sodium sensitive. They usually have lower renin values than do younger subjects, but substantial heterogeneity is found. Age and renin status do not reliably predict sodium sensitivity. Volume contraction and dietary sodium restriction are more likely to decrease blood pressure in older than in younger subjects, but regimens must be tailored individually. PMID- 3544838 TI - Treatment of refractory cardiac allograft rejection with OKT3 monoclonal antibody. AB - OKT3 monoclonal antibody is a murine monoclonal antibody specific for the T lymphocyte T3 cell surface receptor that mediates antigen recognition. The use of OKT3 monoclonal antibody for the treatment of cardiac allograft rejection refractory to conventional therapy with high-dose steroids and antithymocyte globulin is described. Seven patients received 5 mg of OKT3 monoclonal antibody intravenously per day for 10 to 14 days. Diagnosis of moderate or severe rejection was made in all seven from right ventricular endomyocardial biopsy. Biopsy was repeated 48 to 72 hours and seven to 10 days after OKT3 monoclonal antibody was begun. With treatment, four patients had a complete response, with improvement on both early and late biopsy. Two patients had partial responses, with improvement on early biopsy followed by worsening rejection on late biopsy. One patient died of graft failure six hours after receiving OKT3 monoclonal antibody. Adverse events were common in the first two days of therapy but were well tolerated. It is concluded that OKT3 monoclonal antibody is useful in the treatment of refractory cardiac allograft rejection. PMID- 3544839 TI - Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. AB - The effects of variations in dietary carbohydrate and fat intake on various aspects of carbohydrate and lipid metabolism were studied in patients with non insulin-dependent diabetes mellitus (NIDDM). Two test diets were utilized, and they were consumed in random order over two 15-day periods. One diet was low in fat and high in carbohydrate, and corresponded closely to recent recommendations made by the American Diabetes Association (ADA), containing (as percent of total calories) 20 percent protein, 20 percent fat, and 60 percent carbohydrate, with 10 percent of total calories as sucrose. The other diet contained 20 percent protein, 40 percent fat, and 40 percent carbohydrate, with sucrose accounting for 3 percent of total calories. Although plasma fasting glucose and insulin concentrations were similar with both diets, incremental glucose and insulin responses from 8 a.m. to 4 p.m. were higher (p less than 0.01), and mean (+/- SEM) 24-hour urine glucose excretion was significantly greater (55 +/- 16 versus 26 +/- 4 g/24 hours p less than 0.02) in response to the low-fat, high carbohydrate diet. In addition, fasting and postprandial triglyceride levels were increased (p less than 0.001 and p less than 0.05, respectively) and high-density lipoprotein (HDL) cholesterol concentrations were reduced (p less than 0.02) when patients with NIDDM ate the low-fat, high-carbohydrate diet. Finally, since low density lipoprotein (LDL) concentrations did not change with diet, the HDL/LDL cholesterol ratio fell in response to the low-fat, high-carbohydrate diet. These results document that low-fat, high-carbohydrate diets, containing moderate amounts of sucrose, similar in composition to the recommendations of the ADA, have deleterious metabolic effects when consumed by patients with NIDDM for 15 days. Until it can be shown that these untoward effects are evanescent, and that long-term ingestion of similar diets will result in beneficial metabolic changes, it seems prudent to avoid the use of low-fat, high-carbohydrate diets containing moderate amounts of sucrose in patients with NIDDM. PMID- 3544840 TI - Renal failure and death in a 60-year-old man with lung cancer. PMID- 3544841 TI - Reversal of severe diabetic hyperlipidemia by prandial insulinization. AB - Severe hyperlipidemia was nearly completely corrected in 16 diabetic patients who were treated with regular insulin at breakfast and supper. Serum cholesterol levels fell from 572 +/- 52 mg/dl to 247 +/- 10 mg/dl, and serum triglycerides fell from 6,330 +/- 820 mg/dl to 354 +/- 40 mg/dl over a 4-month period of treatment. Establishment of comparable degrees of control of the fasting blood glucose and hemoglobin A1C levels by NPH insulin did not correct the hyperlipidemia. Regular insulin timed to act for the disposal of ingested substrates appears to provide physiologic actions important in the treatment of diabetic hyperlipidemia. PMID- 3544842 TI - The management of nausea and vomiting in clinical oncology. AB - The development of cisplatin and the use of intensive combination chemotherapy have resulted in significant therapeutic advances in medical oncology, as well as the need for intensive supportive care aimed at ameliorating enhanced toxicity. From the patient's perspective, the most prominent adverse effects of chemotherapy are nausea and vomiting. Inadequate control of these symptoms leads to physiologic debilitation and psychologic distress, sequelae that result in either the patient being medically unable to continue therapy or noncompliant. Recent antiemetic research has created a voluminous data base from which the appropriate management of many aspects of chemotherapy-induced emesis can be gleaned. Despite these advances, at least 30% of patients continue to experience some degree of acute emesis with chemotherapy, and the problems of delayed and anticipatory nausea and vomiting have just begun to be addressed. Effective management of chemotherapy-induced emesis is an important aspect of the total care of oncologic patients, improving patient compliance and enhancing the therapeutic index of chemotherapy regimens resulting in a decrease in the overall morbidity and mortality of cancer therapy. PMID- 3544843 TI - Replacement of the failing heart. AB - Heart transplantation is an effective means of treating patients with severe congestive heart failure. Following heart transplantation, the 1-year survival rate is now greater than 80%, and the 5-year survival rate is more than 60% at major medical centers. More than 1,200 heart transplants were performed in more than nine countries worldwide in 1985. The failure of medicare to pay for this procedure is no longer defensible on medical grounds. The argument in favor of medicare funding for heart transplantation is at least as compelling as that for kidney dialysis, the treatment of cancer, or AIDS. The limited availability of donor organs (at most, 1300-2000/year) is likely to place a finite constraint on the number of heart transplants that can and will be performed. Although combined heart-lung transplantation is feasible therapy for certain patients with severe pulmonary hypertension, the availability of suitable donors poses an even greater restriction on this procedure. Totally implantable ventricular assist devices are on the horizon. These devices have the potential for helping 17,000 to 35,000 patients annually at an estimated cost to society of $2.5 to $5 billion per annum. The development and use of such extremely expensive technology poses major socioeconomic and ethical questions for society. PMID- 3544844 TI - Juvenile hyaline fibromatosis: two new patients and review of the literature. AB - We report on a sister and a brother (born to normal consanguineous parents) with joint contractures and osteolytic lesions of bones. The sister had also gingival hyperplasia and skin lesions consisting of multiple tumors of the face, nose, palate, ears, and neck. Histologic examination showed findings of juvenile hyaline fibromatosis. The literature is reviewed, and 15 cases already reported are summarized. PMID- 3544845 TI - Ring chromosome 6: report of a patient and literature review. AB - A patient with ring chromosome 6 had most of the manifestations previously reported in this syndrome and also had albinoid fundi and unilateral aniridia, findings not previously described. In most peripheral leukocyte metaphases analyzed, one chromosome 6 was replaced by a monocentric ring chromosome with deletion of the 6p and 6q. Fifteen other patients with a ring chromosome 6 have been reported. The most frequent findings were mental retardation, prenatal and postnatal failure, epicanthal folds, flat nasal bridge, short neck, apparently low-set and/or malformed ears, microphthalmia, and micrognathia. Studies of coagulation Factors XII and XIII and of the P blood group for possible assignment on distal 6p and 6q did not provide evidence for localization of the genes for these factors on the pter----p24 part of chromosome 6. PMID- 3544846 TI - Autosomal dominant cerebro-costo-mandibular syndrome: ultrasonographic and clinical findings. AB - We describe two patients, a father and his daughter, with the cerebro-costo mandibular syndrome. New manifestations not previously described include microstomia, long philtrum, posterior cervical skin fold, short internipple distance, and depressed sacral region. The presence of hydrocephaly in the proposita and spina bifida in the father may be other manifestations of neuraxial involvement in this syndrome. The first intrauterine ultrasonographic documentation of this syndrome showed polyhydramnios and, especially, the very unusual shape of the ribs, which were short and defective. Most characteristics of the pedigree point to autosomal dominant inheritance. The great variability of inheritance and expressivity of the very few documented familial cases described in the literature, together with the great frequency of sporadic cases, indicates genetic heterogeneity of this syndrome. PMID- 3544847 TI - A case of the Neu-Laxova syndrome: prenatal ultrasonographic monitoring in the third trimester and the histopathological findings. AB - A diagnosis of the Neu-Laxova syndrome was made by ultrasonography in the third trimester of pregnancy. Initial ultrasonographic examination, at approximately 28 wk gestation, showed intrauterine growth retardation (IUGR), hypoechoic skeletal structures, kyphosis, feeble fetal activity, and restricted limb movement. Subsequent sonograms showed microcephaly with a receding forehead and prominent eyes, generalised edema and flexion deformities of limbs. Late third trimester findings included polyhydramnios, swelling and webbing of the knee and elbow joints, and severe edema of the hands and feet, giving the impression of absent digits. The clinical features of this case are consistent with group II of Curry's classification of the Neu-Laxova syndrome [Curry, 1982]. The histopathological findings, a triad of dermatological features, poor cortex formation of the long bones, and central nervous system (CNS) dysgenesis, are discussed. In view of the 25% recurrence rate, at risk pregnancies should be carefully monitored by ultrasonography: at 6-8 wk for accurate dating, at 12-16 weeks for active fetal limb movement, and at 16-24 wk for facial and skeletal anomalies, the detection of IUGR, and polyhydramnios. PMID- 3544848 TI - Obtaining consent for eye donation. AB - We prospectively studied 100 consecutive deaths at St. Vincent's Hospital and Medical Center in New York City for possible eye donation. Fifty-two patients were unsuitable mainly because of medical contraindications and age at death. Of the 48 suitable candidates, 21 pairs (44%) of eyes were obtained. Sixteen of the 42 eyes (38%) were used for transplantation. Projection of the number of corneas obtainable for transplant in New York City were calculated. The figures indicated that the three-month waiting list of the New York Eye-Bank for Sight Restoration, Inc., could be eradicated if hospitals were able to get seven donors from every 100 deaths suitable for donation, a rate only 16% of that realized in this study. PMID- 3544849 TI - Isolation and characterization of inflammatory leukocytes from glomeruli in an in situ model of glomerulonephritis in the rat. AB - Inflammatory cell populations in glomerulonephritis (GN) are not well characterized. A method is reported for isolating leukocytes from glomeruli. GN was induced in rats by perfusing left kidneys (LKs) with cationized human IgG followed by intravenous rat anti-human IgG serum. Acute GN developed in LKs with proteinuria, deposition of human and rat IgG and C3, leukocyte infiltration, and capillary wall electron-dense deposits. Glomeruli (GL) isolated at 24 hours were digested with collagenase, trypsin, and DNase, and the resulting cells were as follows (mean +/- SEM): LK, 354 +/- 25/GL; RK, 214 +/- 32/GL. Cells were labeled with monoclonal antibody MRCOX1 (anti-rat leukocyte common [LC] antigen) followed by FITC F(ab')2 rabbit anti-mouse Ig: LK, 170 +/- 11 leukocytes/GL;RK, 8 +/- 2 leukocytes/GL (P less than 0.001). Isolated cells were sorted by flow cytometry to 98% pure LC+ cells with greater than 80% viability (Giemsa staining: 86% mononuclear cells, 14% neutrophils); the ultrastructure was that of maturing macrophages and neutrophils. This method quantitates leukocyte infiltration and provides leukocytes from nephritic glomeruli suitable for in vitro studies. PMID- 3544850 TI - Clonal composition of T cells in lymphomatoid papulosis. AB - A cDNA of the C beta 2 gene of the T-cell receptor was used as a probe to investigate the clonal composition of T cells in skin lesions of 5 patients with lymphomatoid papulosis (LyP), a chronic recurrent eruption characterized by morphologically abnormal activated T cells in the cutaneous infiltrate. Clonal T cell populations, as evidenced by rearranged DNA bands, were demonstrated in the skin lesions of four patients, one of whom has shown clinical progression toward lymphoma. Three of these patients had lesions of type A histology, a type previously shown to be associated with aneuploidy. The remaining patient with clonal lesions appeared to have the same gene rearrangement pattern in DNA obtained from separate lesions taken 11 months apart, providing evidence that the T cells in both sites were derived from the same clone. This patient had lesions of type B histology, which is not associated with aneuploidy. Absence of a rearranged band and deletion or near absence of the 10.8 kb band in Eco RI digests was interpreted as evidence of polyclonal T-cell hyperplasia, accounting for the skin infiltrate of a fifth patient who had a prolonged clinical course without progression to lymphoma. This patient had lesions of type A histology with frequent Ki-1-positive Reed-Sternberg-like cells. Our results show that gene rearrangement analysis provides information that is independent of histology in LyP and may in part explain the variable progression of LyP to lymphoma in 10-20% of patients. PMID- 3544851 TI - Actin filaments in normal dermis and during wound healing. AB - During wound healing, it has been suggested, modified fibroblasts rich in actin filaments are responsible for wound contraction. With the use of specific fluorescent probe (NBD-phallacidin), the distribution of actin filaments are compared in normal dermis and in several wound contraction models, including open and burn wounds and full and thin-thickness skin autografts. Fibroblasts of normal dermis are slightly stained with NBD-phallacidin. Fibroblasts with actin filaments are increased in autografts, particularly at Days 15 and 21 after grafting, and are prominent in open and burn wounds. The wound contraction rate is not directly related to the presence of actin-staining fibroblasts. After stabilization of the contraction of open or burn wounds, fibroblasts rich in actin filaments remain. The superficial layer of full-thickness skin graft contains a similar actin distribution without concomitant contraction. It is concluded that the distribution of actin-rich fibroblasts corresponds morphologically to previous areas of necrosis or injury. PMID- 3544853 TI - Max Brodel's contributions to otolaryngology-head and neck surgery. AB - Max Brodel arrived in the United States in 1894 to work as a medical illustrator at the Johns Hopkins Hospital. He brought with him an extensive background in medical sciences and illustration. This allowed him to develop an advanced style and technique that would greatly influence the profession of medical illustration. Much of Brodel's work concerned the head and neck region and is of particular interest to otolaryngologists. This article reviews the historical aspects of Brodel's career and highlights his contributions to Otolaryngology Head and Neck Surgery. PMID- 3544852 TI - HHF35, a muscle-actin-specific monoclonal antibody. I. Immunocytochemical and biochemical characterization. AB - A monoclonal antibody to muscle cell actin isotypes was produced and characterized. Immunocytochemical analysis of methanol-Carnoy's-fixed, paraffin embedded human tissue revealed that this antibody, termed HHF35, reacts with skeletal muscle cells, cardiac muscle cells, smooth muscle cells, pericytes, and myoepithelial cells, but is nonreactive with endothelial, epithelial, neural, or connective tissue cells. When assayed by indirect immunofluorescence, HHF35 reacts with microfilament bundles from various cultured mammalian smooth muscle cells, but does not react with cultured human dermal fibroblasts or various epithelial tumor cell lines. In one-dimensional gel electrophoresis immunoblot experiments this antibody detects a 42-kd polypeptide from tissue extracts of uterus, ileum, aorta, diaphragm, and heart and extract from smooth muscle cells. The antibody also reacts with a comigrating 42-kd band of highly purified rabbit skeletal muscle actin. HHF35 is nonreactive on immunoblots of extracts from all tested nonmuscle cell extracts. Immunoelectrophoresis followed by immunoblotting performed in the presence of urea and reducing agents reveals recognition of the alpha isoelectrophoretic variant of actin from skeletal, cardiac, and smooth muscle sources and of the gamma variant from smooth muscle sources. Because HHF35 reacts with virtually all muscle cells, it will be useful as a marker for muscle and muscle-derived cells. PMID- 3544854 TI - An update on amplification: some changing directions. AB - This report reviews some of the developments and changes that are occurring in the field of amplification. The discussion focuses on such areas as hearing aid rules and regulations, hearing aid sales and dispensing practices, hearing aid technology, and selection and evaluation procedures. PMID- 3544855 TI - Ultrasonic and skinfold caliper measures of subcutaneous adipose tissue thickness in elderly men and women. AB - Ultrasonic and skinfold caliper measures of subcutaneous adipose tissue were taken in a sample of elderly men and women, 65 to 99 years of age with an A-mode Ithaco Body Composition Meter and a Holtain skinfold caliper. For most of the measurements, standard deviations for the ultrasonic measurements were three or more times larger than corresponding caliper measurements. Also, mean absolute interobserver errors for the ultrasonic measurements were considerably larger than those for skinfold calipers. At best, the interobserver reliability for the ultrasound machine was 68% while the poorest reliability for the skinfold caliper was 88%. In the form tested, the Ithaco Body Composition Meter is not as accurate for measuring subcutaneous adipose tissue thickness in the elderly as a Holtain skinfold caliper. PMID- 3544856 TI - Ultrasonic measurements of subcutaneous adipose tissue thickness in man. AB - Subcutaneous adipose tissue thickness (SCATT) has for many years been measured using skinfold calipers, but calipers have several disadvantages, not least that they compress the skinfold. Measuring SCATT using ultrasound was validated by comparing thicknesses at 12 sites with soft-tissue radiographs in 24 adults and with depth gauge measurements on a cadaver. Correlation coefficients ranged from 0.87 to 0.99, and the regression statistics showed no significant difference between ultrasound and the other procedures. The standard errors of estimate of body density from SCATT measured by calipers and ultrasound in 63 young men was +/- 7.8 and 7.3 kg X m-3, respectively. Although problems in the identification of the adipose tissue-muscle interface can arise, ultrasound is a viable alternative to skinfold calipers and is to be preferred when measuring uncompressed SCATT. PMID- 3544857 TI - Microdifferentiation in historical Massachusetts: a comparison of migration matrix and isonymy analyses. AB - Historical studies of population structure allow assessment of the effects of demographic change on genetic variation among and within populations. This paper investigates the degree of microdifferentiation among four towns in north-central Massachusetts during the 18th and 19th centuries, a time of rapid population growth. Migration matrices were derived from 4,223 marriage records from 1785 through 1849 and then used to estimate genetic kinship using the methods of Imaizumi et al. (Genetics 66:569-582, 1970) and Harpending and Jenkins (In: Genetic Distance. New York: Plenum Press, 1974). Kinship matrices based on isonymy were also derived using the surnames of 4,039 marriages according to Morton's (In: Genetic Structure of Populations. Honolulu: University Press of Hawaii, 1973) methods. In addition, an isonymy distance matrix was constructed based on 4,659 marriage records from 1741 through 1849 to compare surname frequencies across space and time simultaneously. For both migration and isonymy matrices, the degree of micro-differentiation among the four towns, RST, was computed for each of six time cohorts. Both migration and isonymy show a reduction in among-group variation over time, reflecting population growth and stable, but high, rates of long-distance migration. Estimates of RST from migration and isonymy are very similar. The one notable exception reflects known historical events. Comparison of the kinship estimates for individual towns (rii) also shows close correspondence between migration and isonymy. The differences seem to reflect a tendency for migration matrices to overestimate kinship in earlier generations relative to isonymy. A principal coordinates analysis of the isonymy distance matrix shows the relative isolation of towns from one another in all time periods but with a reduction in differentiation over time. PMID- 3544858 TI - Relationship of fat patterning to coronary artery disease risk in obese adolescents. AB - Fatness and fat patterning of 27 male and 33 female obese adolescents were identified by principal-components analysis of five skinfolds (triceps, subscapular, iliac, abdominal, and thigh). Correlations were computed between the component scores, based on the eigen vectors, and anthropometric and physiological variables. Overall fatness, component I, was highly correlated with all anthropometric and body composition variables. Also, component I significantly correlated with fasting insulin and VO2 max for both sexes and with basal metabolism and HDL-cholesterol for females and males, respectively. Extremity fat patterning, component II, was poorly correlated with all the anthropometric and physiological variables except diastolic blood pressure for the females. Upper-lower body fat patterning, component III, was correlated with the fewest physiological variables. PMID- 3544859 TI - Dynamic state of collagen: pathways of collagen degradation in vivo and their possible role in regulation of collagen mass. AB - There is now evidence that collagen turnover in normal tissues can occur at rapid rates. In skin of adult rats, the mean rate lies between 3 and 5%/day, but rates of greater than 10%/day have been reported in some tissues, such as lung and periodontal ligament. The major sites of this degradation are still uncertain. Intracellular degradation, which occurs within minutes of synthesis, may be extensive, but its magnitude varies between tissues. This process may have evolved to allow the adaptive advantages of rapid turnover without compromising the supportive role of fibrillar collagen. There is now abundant evidence that changes in collagen degradation play an important role in the regulation of collagen mass. Increased breakdown of extracellular collagens may be required whether the mass is increased or decreased. However, preliminary evidence suggests that the degradation of newly synthesized collagen may be up- or down regulated, depending on the direction of the change in content. PMID- 3544860 TI - Pulsatile hyperglucagonemia fails to increase hepatic glucose production in normal man. AB - To study the metabolic effects of pulsatile glucagon administration, six male volunteers were submitted to a 260-min glucose-controlled glucose intravenous infusion using the Biostator. The endogenous secretion of the pancreatic hormones was inhibited by somatostatin (100 micrograms X h-1), basal insulin secretion was replaced by a continuous insulin infusion (0.2 mU X kg-1 X min-1), and glucagon was infused intravenously in two conditions at random: either continuously (125 ng X min-1) or intermittently (812.5 ng X min-1, with a switching on/off length of 2/11 min). Blood glucose levels and glucose infusion rate were monitored continuously by the Biostator, and classical methodology using a D-[3-3H]glucose infusion allowed us to study glucose turnover. While basal plasma glucagon levels were similar in both conditions (122 +/- 31 vs. 115 +/- 18 pg X ml-1), they plateaued at 189 +/- 38 pg X ml-1 during continuous infusion and varied between 95 and 501 pg X ml-1 during pulsatile infusion. When compared with continuous administration, pulsatile glucagon infusion initially induced a similar increase in endogenous (hepatic) glucose production and blood glucose, did not prevent the so-called "evanescent" effect of glucagon on blood glucose, and after 3 h tended to reduce rather than increase hepatic glucose production. In conclusion, in vivo pulsatile hyperglucagonemia in normal man fails to increase hepatic glucose production. PMID- 3544861 TI - Neurotensin releases norepinephrine differentially from perfused hypothalamus of sated and fasted rat. AB - The central injection of neurotensin (NT) has been reported to attenuate the intake of food in the fasted animal. To determine whether endogenous norepinephrine (NE) is involved in the satiating effect of NT, the in vivo activity of NE in circumscribed sites in the hypothalamus of the unanesthetized rat was examined. Bilateral guide tubes for push-pull perfusion were implanted stereotaxically to rest permanently above one of several intended sites of perfusion, which included the paraventricular nucleus (PVN), ventromedial nucleus (VMN), and the lateral hypothalamic (LH) area. After endogenous stores of NE at a specific hypothalamic locus were radiolabeled by microinjection of 0.02-0.5 mu Ci of [3H]NE, an artificial cerebrospinal fluid was perfused at the site at a rate of 20 microliter/min over successive intervals of 5.0 min. When 0.05 or 0.1 micrograms/microliter NT (0.03-0.6 mM) was added to the perfusate, the peptide served either to enhance or reduce the local release of NE at 50% of the sites of perfusion. In these experiments, the circumscribed effect of NT on the characteristics of catecholamine efflux depended entirely on the state of hunger or satiety of the rat. That is, when NT was perfused in the fully satiated rat, NE release was augmented within the PVN or VMN; conversely, NE release was inhibited in the LH. In the animal fasted for 18-22 h, NT exerted an opposite effect on the activity of NE within the same anatomical loci in that the efflux of NE was enhanced in the LH but attenuated or unaffected in the PVN or VMN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544862 TI - Fate of circulating renin in conscious rats. AB - Highly purified 125I-labeled rat renal renin (125I-renin) was given intravenously to conscious rats to study the fate of circulating renin. Specific antirat renin antiserum was used to identify the labeled renin molecules. In sham-operated rats, the disappearance of 125I-renin from the plasma showed two exponential components with a half-life of 6.7 +/- 0.4 min for the rapid component and 65.1 +/- 5.7 min for the slow component. The metabolic clearance rate was 11.4 +/- 1.0 ml X min-1 X kg-1. In bilaterally nephrectomized rats, the metabolic clearance rate of 125I-renin was reduced by 55%, but the half-life of the slow component remained unchanged. Seventy percent hepatectomy caused a 54% decrement in the metabolic clearance and prolonged the half-life of the slow component. Five minutes after injection of 125I-renin, approximately 59 and 11% of the administered 125I-renin had accumulated in the liver and the kidneys, respectively, and at later time points the 125I-renin was highly concentrated in these organs. High-performance liquid chromatographic analysis of the liver and kidney extracts demonstrated that 125I-renin was catabolized by these organs. Biliary excretion of 125I-renin was negligible. Urinary excretion of 125I-renin up to 120 min was approximately 2% of the injected dose. We conclude that both the liver and the kidney are responsible for the clearance of circulating renin, with participation of the liver being predominant. PMID- 3544863 TI - Adrenergic modulation of potassium metabolism during exercise in normal and diabetic humans. AB - The effect of acute and chronic beta- and alpha-adrenergic blockade on potassium homeostasis during moderate intensity exercise (40% VO2max) was investigated in control and insulin-dependent diabetic subjects. In protocol I, subjects were studied during exercise alone, exercise plus intravenous propranolol, and exercise plus intravenous phentolamine. In both the control and diabetic groups, exercise alone produced a modest increase in the plasma potassium concentration (0.31 +/- 0.06 meq/l), while propranolol exacerbated this hyperkalemic response. In contrast, the increment in plasma potassium during phentolamine was similar to exercise alone in normals but was 26% (P less than 0.05) lower in the diabetic group. In protocol II, the effect of chronic (5 days) beta-adrenergic blockade on potassium homeostasis was examined. Subjects participated in three studies: exercise alone, exercise plus propranolol (beta 1/beta 2-antagonist), and exercise plus metoprolol (beta 1 antagonist). In the nondiabetic group, both propranolol and metoprolol were associated with a 40% greater increase in potassium compared with exercise alone. In the diabetic group, propranolol, but not metoprolol, was associated with a deterioration in potassium tolerance. In no study could the alterations in potassium homeostasis be explained by a change in urinary potassium excretion. In summary, alpha-adrenergic blockade ameliorates exercise-induced hyperkalemia in diabetic but not in control subjects, nonspecific beta-adrenergic blockade causes a greater increment in potassium when compared with exercise alone, and specific beta 1-adrenergic blockade exacerbates exercise-induced hyperkalemia in control, but not in diabetic subjects. These results indicate that both alpha- and beta-adrenergic regulation of extrarenal potassium metabolism is altered in insulin-dependent diabetes mellitus. PMID- 3544864 TI - The relationship between gastrointestinal motility and secretion. AB - Few studies have addressed specifically or systematically the question of whether motility and secretion within the gastrointestinal tract are linked and if so by what mechanisms. The evidence for such a relationship is discussed in this review and we conclude that increased motor activity of the stomach is frequently associated with increased acid and pepsin secretion. Similarly, an increase in small intestinal motility is accompanied by elevated fluid and electrolyte secretion. Two possible mechanisms linking motility to secretion are considered. These could coexist. The first consists of parallel but separate neural pathways to smooth muscle and epithelium that might be activated synchronously and, therefore, produce simultaneous activation of motility and secretion. The existence of such parallel pathways in the stomach and small intestine are described, but their physiological significance is unresolved. The second mechanism we discuss is a sequential process in which increased motility provides a sensory stimulus for reflexly activated secretion. In the stomach the evidence for such a mechanism is largely deductive. In the intestine, however, we provide experimental evidence for an intrinsic neural mechanism activated by motor activity, which then stimulates fluid and electrolyte secretion. We conclude that such a sequential relationship exists and probably operates under physiological conditions but that further study is required. PMID- 3544865 TI - Activation of ion transport systems during cell volume regulation. AB - This review discusses the activation of transport pathways during volume regulation, including their characteristics, the possible biochemical pathways that may mediate the activation of transport pathways, and the relations between volume regulation and transepithelial transport in renal cells. Many cells regulate their volume when exposed to an anisotonic medium. The changes in cell volume are caused by activation of ion transport pathways, plus the accompanying osmotically driven water movement such that cell volume returns toward normal levels. The swelling of hypertonically shrunken cells is termed regulatory volume increase (RVI) and involves an influx of NaCl into the cell via either activation of Na-Cl, Na-K-2Cl cotransport systems, or Na+-H+ and Cl(-)-HCO3- exchangers. The reshrinking of hypotonically swollen cells is termed regulatory volume decrease (RVD) and involves an efflux of KCl and water from the cell by activation of either separate K+ and Cl-conductances, a K-Cl cotransport system, or parallel K+ H+ and Cl(-)-HCO3- exchangers. The biochemical mechanisms involved in the activation of transport systems are largely unknown, however, the phosphoinositide pathway may be implicated in RVI; phorbol esters, cGMP, and Ca2+ affect the process of volume regulation. Renal tubular cells, as well as the blood cells that traverse the medulla, are subjected to increasing osmotic gradients from the corticomedullary junction to the papillary tip, as well as changing interstitial and tubule fluid osmolarity, depending on the diuretic state of the animal. Medullary cells from the loop of Henle and the papilla can volume regulate by activating Na-K-2Cl cotransport or Na+-H+ and Cl(-)-HCO3- exchange systems. Both Na-Cl and Na-K-2Cl cotransport systems have been identified in the medullary Loop of Henle and it is postulated that the Na-K-2Cl cotransport system predominates during RVI and affects transepithelial NaCl transport while the Na-Cl cotransport system may function during RVD in these cells. PMID- 3544867 TI - Identification and regulation of renin in human cultured mesangial cells. AB - Renin activity was measured in the incubation medium, and the cellular extract of human mesangial cells, which had been cultured in the presence of renin-free human plasma (three kidneys; 4-7 passages). Active renin and total renin obtained after trypsin treatment was estimated by radioimmunoassay of angiotensin I using renin-free human plasma as a substrate. Mesangial cell renin had characteristics similar to those of standard human renin; optimum enzymatic activity at pH 5.8, marked inhibition in the presence of two (monoclonal and polyclonal) human renin specific antibodies and of SR 42128, a new potent statine-containing renin inhibitory peptide. The synthetic capability of the mesangial cells varied markedly with the original kidney (1-49 and 0.3-0.9 ng X h-1 X mg-1 for total renin in the medium and the cellular extract respectively). Renin was secreted mainly as inactive renin. Prostaglandin E2 (PGE2) and carba-prostaglandin I2 (PGI2) (a stable analogue) produced a dose-dependent (0.1-1.10 microM) increase in renin activity in both the cellular extract and the culture medium. Isoproterenol (200 microM) increased renin activity only in the medium. The effects of these agonists were more marked on inactive than on active renin. These results demonstrate that cultured human mesangial cells synthesize and release renin in a stable manner over a long period of culture, thus providing a useful tool for the in vitro study of renin secretion and its control. PMID- 3544866 TI - Glucose metabolism in muscle of sedentary and exercised rats with azotemia. AB - Insulin resistance has been demonstrated in chronic renal failure patients and may be improved by exercise training, but the mechanisms have not been identified. In this study, the response of glucose uptake, glycogen synthesis, and glucose utilization via glycolysis (glycolytic utilization) to stimulation by insulin and/or acute exercise were determined in isolated muscles from rats with moderate renal insufficiency that were exercise trained or remained sedentary. Moderate renal insufficiency had no effect on the basal rate, insulin sensitivity, or insulin responsiveness of glucose uptake, glycogen synthesis, or glycolytic utilization in muscle. The enhanced insulin responsiveness of both glycogen synthesis and glucose uptake following acute exercise, noted in control animals, was less in rats with moderate renal insufficiency, but the enhanced basal rate and insulin sensitivity after exercise were unaffected by moderate renal insufficiency. Exercise training increased the insulin sensitivity and responsiveness of muscle glucose uptake and glycolytic utilization in rats with moderate renal insufficiency and in controls. The effects of acute exercise and exercise training on insulin responsiveness of glucose uptake were additive in controls but not in animals with moderate renal insufficiency. These findings are compatible with the concept that moderate renal insufficiency is associated with a postreceptor defect in insulin's action in muscle, detectable only following maximal stimulation of glucose transport by insulin and exercise, and partially correctable by exercise training. PMID- 3544868 TI - Effect of insulin on renal potassium metabolism. AB - The effect of insulin on renal potassium excretion was examined by employing the euglycemic insulin clamp technique in combination with renal clearance measurements. While euglycemia was maintained, insulin was infused at rates of 4.8 (n = 7) and 12 (n = 5) mU X kg-1 X min-1. Steady-state plasma insulin levels of 164 +/- 8 and 370 +/- 15 microU/ml were achieved in the low- and high-dose studies, respectively. Base-line plasma potassium concentration declined progressively by a mean of 0.14 +/- 0.09 (P less than 0.05) and 0.40 +/- 0.05 meq/liter (P less than 0.01) during the low- and high-dose insulin infusion protocols. Urinary potassium excretion did not change significantly from base line with either insulin dose. Because the decline in plasma potassium concentration could have masked a stimulatory effect of insulin on UKV, six rats received a 12-mU X kg-1 X min-1 euglycemic insulin clamp in combination with an exogenous potassium infusion to maintain the plasma potassium concentration constant at the basal level (4.03 +/- 0.03 vs. 4.05 +/- 0.05 meq/l). Under these conditions of normokalemia, insulin augmented UKV 2.4-fold, from 0.20 +/- 0.05 to 0.48 +/- 0.04 meq/l (P less than 0.001). PMID- 3544869 TI - Effects of hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume. AB - The effects of long-term hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume were studied in eight conscious dogs over a 34-day period. Plasma protein concentration (PPC) was decreased by daily plasmapheresis, and the effects of decreasing and increasing sodium intake were measured. By the 12th day of plasmapheresis, during which sodium intake was 30 meq/day, PPC had decreased to 2.5 g/dl from a control value of 7.2 g/dl, mean arterial pressure had decreased to 78% of control, glomerular filtration rate (GFR) was 75.2% of control, and urinary sodium excretion was decreased. By day 18 of plasmapheresis, estimated renal plasma flow (ERPF) was decreased to 60% of control due to the decreased arterial pressure and an increase in renal vascular resistance. Also, plasma renin activity and plasma aldosterone concentration were both increased, and the relationship between mean arterial pressure and urinary sodium excretion was distinctly shifted to the left along the arterial pressure axis. In contradistinction to acute experiments, chronic hypoproteinemia results in decreases in GFR, ERPF, and urinary sodium excretion and has marked effects on both fluid volume and arterial pressure regulation. PMID- 3544870 TI - Choline and acetylcholine concentration in transplanted rat heart. AB - A liquid chromatographic assay was used to determine the choline and acetylcholine concentrations in the four chambers of rat hearts 2, 4, and 8 days after transplantation into an abdominal site. Corresponding measurements were made in the hearts of host rats. We found regional cardiac acetylcholine concentrations in controls follow the nonuniform pattern seen with choline acetyltransferase (CAT) activity, being highest in the atria (8-12 nmol/g) and lower in the ventricles (0.7-1.6 nmol/g). Following transplantation, acetylcholine levels decreased significantly only in the right ventricle after 8 days. Following a unilateral vagotomy (random, left or right), acetylcholine concentrations in the distal portion of the severed nerve decreased to half the value of the intact contralateral side by 4 days. The continued presence of acetylcholine, despite significantly reduced CAT activity in the severed nerve and transplanted heart, suggests that acetylcholine is preserved, perhaps by vesiculation in nonstimulated postganglionic terminals. The localized decrease in acetylcholine in the right ventricle after 8 days suggests that transplantation may interrupt the postganglionic fibers to this area. PMID- 3544871 TI - Abnormal blood pressure recovery during ganglion blockade in diabetic rats. AB - The aim of the present study was to determine the extent to which vasopressin or the renin-angiotensin system contributed to the recovery of blood pressure following acute hypotension induced by treatment with pentolinium and captopril, or pentolinium and the vasopressin antagonist d(CH2)5DAVP, respectively, in conscious, free-moving rats treated 21 days previously with saline or streptozotocin (STZ) (60 mg/kg ip). Half the animals given STZ were subsequently treated with insulin (about 4.5 U/day). The STZ-treated animals demonstrated a resting bradycardia and systolic hypotension. The vasopressin-mediated recovery in blood pressure seen following administration of pentolinium, in the presence of captopril, and the renin-angiotensin-mediated recovery seen following administration of pentolinium, in the presence of d(CH2)5DAVP, were both found to be significantly (P less than 0.05) attenuated in the STZ-treated animals. These abnormalities were absent in the animals injected with STZ and treated daily with insulin, but receiving their last dose 24 h before measurement. At that time the animals had elevated blood glucoses. These results indicate that the abnormalities observed were not due to toxic effects of STZ or to hyperglycemia per se. PMID- 3544872 TI - Localization of efferent function in the dorsal motor nucleus of the vagus. AB - To investigate the spatial organization of the vagal preganglionic neurons that control gastric acid, insulin and glucagon secretion, as well as bradycardia, these variables were simultaneously monitored before, during, and after monopolar stimulation (50 microA, 1 ms, 50 Hz) through semimicroelectrodes (tip 25-50 microns) in urethan-chloralose-anesthetized rats. Gastric acid, insulin, and glucagon secretion were elicited by stimulation of the dorsal motor nucleus of the vagus (DMV), whereas heart rate, mean arterial blood pressure, and plasma glucose were not affected. Post hoc analyses were used to characterize the viscerotopic patterns within the DMV. For each of the three positive responses, the "center of gravity" (centroid) of 205 stimulation sites was located within the DMV at approximately the midanterioposterior extent of the nucleus. Vectors of response effectiveness around the centroids as well as comparisons of different groups of DMV electrodes established that effective sites were found throughout the full rostrocaudal extent of the DMV. Comparisons of left vs. right DMV sites indicated that gastric acid, insulin, and glucagon secretion are influenced equally by the two sides of the brain stem. The differences in response strength observed in the DMV were best described in terms of the discrete medial and lateral longitudinal columns of the DMV. The centroid point for gastric acid was in the medial DMV, and the points for insulin and glucagon were in the lateral DMV. Further, medial placements were significantly more effective than lateral ones in eliciting gastric acid secretion; lateral placements were more effective than medial ones in eliciting insulin secretion. Although the effect was not significant in the case of glucagon, the trend paralleled the pattern for insulin. PMID- 3544873 TI - Sweat secretion by human axillary apoeccrine sweat gland in vitro. AB - Functional characteristics of isolated single human axillary apoeccrine sweat glands have been studied using in vitro sweat induction methods. Sustained copious clear fluid secretion was evoked by methacholine (MCh), epinephrine (EP), isoproterenol (ISO), and phenylephrine (PL) in decreasing order in a pharmacologically specific manner. Apoeccrine glands showed a higher cholinergic sensitivity than eccrine sweat glands, as shown by the apparent association constant for MCh of 2.7 X 10(-7) M compared with 2.1 X 10(-6) M for the axillary eccrine sweat gland. The average total sweat rate of the apoeccrine gland for a 30-min period was sevenfold higher than that of the eccrine sweat gland. In contrast, isolated apocrine glands showed intermittent pulsatile turbid sweat secretion in response to MCh or EP. The Na+ and K+ concentration of apoeccrine glands was nearly isotonic, whereas those of apocrine sweat was 120-140 mM for Na+ and 10-20 mM for K+. Apoeccrine ductal Na+ absorption was also observed in the apoeccrine glands and was no more efficient than that of the axillary eccrine sweat gland. Thus apoeccrine sweat glands are functionally and pharmacologically distinct from axillary apocrine glands and significantly contribute to overall axillary sweating in humans. PMID- 3544874 TI - CRF initiates biological actions within the brain that are observed in response to stress. AB - Corticotropin-releasing factor (CRF) is thought to be an endogenous mediator of adrenocorticotropic hormone release following stress. We examined if CRF initiates further biological actions that are observed in response to stressful events. Male beagle dogs (10-12 kg) were fitted with a chronic intracerebroventricular cannula, intra-arterial and intravenous catheters, as well as a gastric fistula. Synthetic human CRF was microinjected into the third cerebral ventricle in conscious animals. CRF (0.1-1.0 nmol/kg) significantly (P less than 0.01) increased plasma concentrations of epinephrine, norepinephrine, glucagon, and glucose and elevated mean arterial pressure and heart rate. Pretreatment of the animals with the ganglionic blocking agent chlorisondamine completely abolished the increases in plasma catecholamine and glucose concentrations as well as the elevations in blood pressure and heart rate. CRF significantly (P less than 0.01) inhibited gastric acid secretion, but not plasma gastrin concentrations stimulated by an 8% liquid peptone meal. The gastric inhibitory action of CRF was completely prevented by chlorisondamine and, in part, by naloxone and a vasopressin antagonist. In contrast, bilateral truncal vagotomy did not affect the gastric inhibitory action of CRF. The results of this study indicate that CRF acts within the central nervous system to increase plasma glucose and glucagon concentrations, mean arterial pressure, and heart rate by activation of the autonomic nervous system. CRF inhibits meal-stimulated gastric acid secretion by activation of the sympathetic nervous system and, in part, by opiate and vasopressin-dependent pathways and not by inhibition of gastrin release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544875 TI - Role of renal nerves in compensatory adaptation to chronic reductions in sodium intake. AB - The aim of this study was to investigate the importance of the renal nerves in adaptation to chronic reductions in sodium intake. Conscious dogs with unilateral (n = 7) or bilateral (n = 4) renal denervation were studied. In dogs studied before and after bilateral denervation, there were no differences in urine volume (UO), Na excretion (UNaV), or fractional reabsorption of Li (FR Li, an index of proximal tubular Na reabsorption) between innervated and denervated kidneys on either normal (80 meq/day) or low Na intake (5 meq/day, 15 days). Plasma renin activity (PRA) was attenuated following denervation on both normal (0.39 +/- 0.06 vs. 0.18 +/- 0.01 ng angiotensin I X ml-1 X h-1) and low Na intake (1.00 +/- 0.06 vs. 0.59 +/- 0.01). In unilaterally denervated dogs the left kidney was denervated and the bladder was split, allowing continuous urine collection from separate innervated and denervated kidneys in the same dog. There was no difference in UO between innervated and denervated kidneys on normal (80 meq/day) or low (7 meq/day, 9 days) Na intake. UNaV averaged 33.6 +/- 1.3 and 37.6 +/- 2.1 meq/day in innervated and denervated kidneys, respectively, on normal Na intake and 3.5 +/- 0.5 and 4.0 +/- 0.4 meq/day in innervated and denervated kidneys on low Na intake. FR Li was not different in denervated compared with innervated kidneys during normal or low sodium intake. Norepinephrine content was reduced by 99 +/- 1% in denervated kidneys.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544876 TI - Effect of vasopressors on organ blood flow during endotoxin shock in pigs. AB - A volume-resuscitated porcine endotoxin shock model was used to evaluate the effect on organ blood flow of increasing systemic arterial blood pressure with vasopressors. Administration of 0.05-0.2 mg/kg of Escherichia coli endotoxin (E) reduced mean arterial blood pressure (MAP) to 50 mmHg, decreased systemic vascular resistance to 50% of control, and did not change cardiac output or heart rate. Blood flow to brain, kidney, spleen, and skeletal muscle was reduced during endotoxin shock, but blood flow to left ventricle, small and large intestine, and stomach remained at pre-endotoxin levels throughout the study period. Four groups of animals were used to evaluate the effect of vasopressor therapy. A control group received E and no vasopressor, whereas the other three groups received either norepinephrine, dopamine, or phenylephrine. Vasopressors were administered starting 60 min after E exposure, and the dose of each was titrated to increase MAP to 75 mmHg. Despite the increase in MAP, brain blood flow did not increase in any group. Norepinephrine alone increased blood flow to the left ventricle. Kidney, splanchnic, and skeletal muscle blood flow did not change with vasopressor administration. The dose of norepinephrine required to increase MAP by 20-25 mmHg during E shock was 30 times the dose required for a similar increase in MAP in animals not receiving E. We conclude that hypotension in the fluid resuscitated porcine E shock model is primarily the result of peripheral vasodilatation, that the vascular response to vasoconstrictors in this model is markedly attenuated following E administration, that blood pressure elevation with norepinephrine, dopamine, and phenylephrine neither decreases blood flow to any organ nor increases blood flow to organs with reduced flow, and that norepinephrine, dopamine, and phenylephrine affect regional blood flow similarly in this model. PMID- 3544877 TI - Endothelial extraction of tracer water varies with extravascular water in dog lungs. AB - In multiple indicator-dilution experiments, transvascular passage of a permeating indicator is conventionally derived from the up-slope separation of the curve of the permeating indicator from that of a vascular reference and is expressed as the extraction (Ec). Extraction may be limited by the barrier (barrier-limited distribution). It may be limited by the volume of distribution accessible to it; in the time domain of an indicator-dilution experiment, the passage to and distribution in the extravascular volume are rapid relative to the velocity of blood in the exchange vessels. We examine here the relations of the extraction of tracer water as tritium oxide (THO) [Ec(THO)] and of the extraction of tracer sodium as 22Na [Ec(22Na)] to extravascular lung water, delta V wev, by adding isotonic fluid to the gas phase of the lungs. The net convective transvascular passage of water is negligible relative to the transendothelial molecular exchange. In 10 experiments in vivo and in 10 experiments in isolated perfused lungs, Ec(THO) increases as delta V wev increases. Ec(22Na) and the permeability surface area product (PS) for 22Na do not change as delta V wev increases. We conclude that the extraction of THO is determined mainly by the volume accessible to it (flow- or volume-limited distribution) and that the extraction of 22Na is determined mainly by the resistance of the endothelium (barrier-limited distribution). A diffusion limitation in the added alveolar fluid rather than a barrier limitation at the endothelium may moderate Ec(THO). PMID- 3544879 TI - Separation of captopril effects on salt and water intake by subfornical organ lesions. AB - Several experiments tested whether the subfornical organ (SFO) is necessary for water or NaCl intake arising from angiotensin-converting enzyme (CE) blockade with captopril (CAP) in the drinking fluids (0.1 mg/ml). Peripheral CAP was given to rats acutely following 24-h water deprivation or chronically over several days, either with water alone available for drinking or with 0.3 M NaCl in choice with water. Control rats drank more water, and NaCl when it was available, during CAP treatment, whereas rats with SFO damage increased NaCl intake only. CAP decreased urinary volume (UV) and increased urinary potassium excretion (UKV) during rehydration with only water available and increased urinary sodium excretion (UNaV) with NaCl present. Regardless of CAP treatment, rats with SFO damage had increased electrolyte concentrations and excretions during rehydration with only water available and increased UK with NaCl present, compared with controls. Oral CAP did not have an aversive taste at the dose used here. We conclude that the SFO is necessary for CAP-enhanced water, but not NaCl, intake and suggest that different neurological mechanisms control ingestion of each fluid during CAP. PMID- 3544878 TI - Interaction between myocardial depressant factor and vasoactive mediators with ischemia and shock. AB - A variety of endogenously formed vasoconstrictor substances circulate in the blood and act as mediators in ischemia and shock states. These humoral substances are chemically diverse and include peptides, lipids, and aromatic amines. One of the novel peptides, myocardial depressant factor (MDF) and several interesting lipids, including thromboxane A2 (TxA2), leukotriene D4 (LTD4), and platelet activating factor (PAF) are very potent substances having a broad profile of pathophysiological actions. Some of the effects of MDF include myocardial depression, constriction of splanchnic vessels, and impairment of phagocytosis. TxA2 primarily constricts blood vessels, aggregates platelets, and increases membrane permeability. LTD4 is a potent vasoconstrictor and bronchoconstrictor and promotes leakage of fluid out of blood vessels. PAF activates platelets, depresses cardiac function, constricts airways, and enhances fluid leakage from the intravascular compartment. Thus vasoconstriction is common to all these mediators. Moreover, these vasoactive substances have common mechanisms of release and interact to exacerbate ischemia and contribute to the pathogenesis of a variety of shock states. New pharmacological approaches to blocking the formation and action of these mediators have provided interesting insights into the pathophysiology of shock. PMID- 3544880 TI - Self-portrayal by a depressed poet: a contribution to the clinical biography of William Cowper. AB - The life of the eighteenth-century English poet William Cowper, who suffered from recurrent major depression, or bipolar II disorder, is described. Since no effective treatment was available, Cowper's writings give an example of the natural history of major depression. They also illustrate the fate of a mental patient of the upper classes at that time. The authors discuss the relevance of Cowper's mother's death during his childhood to his depressive illness and draw attention to the poet's sensitive description of his own psychopathology and the lifelong course of his illness. PMID- 3544882 TI - AIDS screening, confidentiality, and the duty to warn. PMID- 3544881 TI - Multiple hormonal responses to insulin-induced hypoglycemia in depressed patients and normal volunteers. AB - Studies have shown that some depressed patients may demonstrate multiple hormonal response abnormalities after a neuroendocrine challenge test; this finding has suggested the strategy of measuring several hormones after an insulin tolerance test. The authors gave insulin tolerance tests to 72 depressed patients and 51 age- and sex-matched healthy volunteer control subjects and measured glucose, cortisol, prolactin, and human growth hormone (GH) responses. Although there were no differences between patients and control subjects in the mean decrease in glucose levels after the insulin tolerance test, depressed men demonstrated significantly lower prolactin and GH levels after the test. PMID- 3544883 TI - Distribution of Trop 3 and 4 antigens as defined by monoclonal antibodies raised against a human choriocarcinoma cell line. AB - The reactivities of Trop 3 and 4 monoclonal antibodies (MAbs) were studied on human term and 7-week extraembryonic membranes, adult tissues, and cell lines. Trop 3 MAb reacted with cells of chorionic villi, decidua, amniotic epithelium, and basal plate trophoblast. Trop 4 MAb reacted only with syncytiotrophoblast. On epithelium, Trop 3 MAb bound to stratified and glandular epithelium, but Trop 4 MAb reactivity was limited to basal keratinocytes. On peripheral blood mononuclear cells, Trop 3 MAb reacted with the majority of cells and Trop 4 MAb with the totality. Most cell lines were positive with both MAbs. However, one chemically induced MHC mutant was negative and another decreased its expression of Trop 3 antigen. Our results suggest Trop 3 MAb might recognize a monomorphic determinant of TLX antigens and Trop 4 is involved in cell proliferation or in cell-to-cell interaction. PMID- 3544884 TI - Surgical repair of Achilles tendon ruptures. AB - We evaluated the surgical results of 42 consecutive patients with spontaneous rupture of the Achilles tendon treated from 1973 to 1984 to determine the causes of rupture and to evaluate our treatment methods. Patients were divided into early and late repair groups and their charts reviewed to determine common clinical features. A new method of repair with early functional range of motion exercises before casting was used and compared to other techniques in common use. Thirty-one patients were contacted for long-term followup (average, 4.7 years). Twenty-three of these patients returned for intensive reevaluation and Cybex testing. We found a high incidence of gout (14.3%) and previous steroid injections (7.1%) in our patients. Good results were obtained from the four surgical methods used. There were no reruptures and only 7% of the patients experienced minor wound problems. Patients treated with early functional range of motion exercises averaged 12.5 degrees more dorsiflexion at the time of cast removal and did not require adjunctive protective devices. Long-term results, however, revealed equilibration of range of motion and near normal function in all repair techniques with 88% of all patients returning to preinjury activity levels. PMID- 3544886 TI - Current concepts in the surgical pathology of pulmonary infections. AB - Among patients with pulmonary infections, those who are immunosuppressed and have pulmonary infiltrates continue to be the most numerous coming to biopsy and present the greatest diagnostic challenge to the surgical pathologist. These are the cases in which immunodiagnostic methods and DNA probes are immediately beneficial. Enthusiasm for application of these new methods for the recognition of infectious agents must be tempered by careful clinicopathologic correlation, since more sensitive methods are likely to pick up more bystander organisms and polymicrobial processes. Nevertheless, the development of organism-specific visualization reagents remains one of the most exciting areas in pathology. PMID- 3544885 TI - "Plasmacytoid T cells" in Castleman's disease. Immunohistologic phenotype. AB - Plasmacytoid T cells in two cases of Castleman's disease were stained with a panel of monoclonal antibodies to hematopoietic cell-associated antigens, using an immunoperoxidase technique on frozen sections. The immunohistologic phenotype of these cells was T4/Leu-3+, HLA-DR+, T1/Leu-1-, T3/Leu-4-, T8/Leu-2-, T11/Leu-5 , B1-, B2-, Leu-14-, Ig-, CALLA-, OKM1-, Leu-M1-. In contrast to plasma cells of B lineage, plasmacytoid T cells were T200+, T10-. The phenotype was similar to that of two previously reported lymphomas of plasmacytoid T cells. Plasmacytoid T cells appear to be a unique subset of lymphoid cells, whose function remains to be established. PMID- 3544887 TI - Surgical pathological considerations in inflammatory and transmissible diseases of the central nervous system. AB - Inflammatory and transmissible disorders of the central nervous system are a heterogeneous group with regard to clinical presentation, character of the histologic lesions, and nature of etiologic agent, if known. The diagnosis of many of these requires an index of suspicion, special histologic or immunohistologic procedures, or electron microscopy. Some also demand cautious handling of potentially infective tissues. The present report reviews the diagnostic considerations for selective inflammatory/transmissible disorders of the central nervous system and outlines procedures used to minimize the chance of accidental transmission of the causative agents. PMID- 3544888 TI - Carcinoid tumors and the mixed (composite) glandular-endocrine cell carcinomas. AB - Carcinoid tumors display a wider histologic spectrum than was previously thought. Some tumors may show atypical features such as glandular profiles, a spindle cell pattern, squamous or osteoid metaplasia, or pleomorphism. In rare cases they may be poorly differentiated and resemble undifferentiated carcinoma or lymphoma. As is well known, some carcinoids are associated with well-defined syndromes, such as the carcinoid or the Zollinger-Ellison syndrome, due to the secretion of amines or peptides. Immunohistochemical analysis of these tumors, however, has shown that whereas one amine or peptide may predominate, most are multihormonal. These findings are also seen with the clinically silent tumors such as the foregut and hindgut carcinoids. Furthermore, the immunohistochemically demonstrated amines and peptides in the primary tumor do not necessarily correspond to those normally found in the overlying endocrine cells. An increasing number of tumors have recently been described which contain an admixture of neoplastic endocrine and nonendocrine epithelial cells. Thus, the classification of gut mucosal tumors into carcinomas and endocrine tumors has had to be modified to include those tumors which have been designated as mixed or composite tumors. These have been further subdivided into several distinctive histologic types. Some of these tumors, such as the microglandular-goblet cell carcinomas, have a distinctive clinical behavior, whereas others, such as the adenoendocrine cell carcinomas, appear to behave in a manner similar to adenocarcinoma. Additionally, there is another tumor type, namely the amphicrine tumor, which differs from the mixed tumors in that endocrine and epithelial cell constituents are present within the same cell. PMID- 3544889 TI - Clinical and laboratory characterization of a chloroquine-resistant Plasmodium falciparum strain acquired in the Central African Republic. AB - This case of chloroquine prophylaxis failure occurred in the Central African Republic, a country heretofore unaffected by chloroquine resistance. The clinical findings and chloroquine blood levels and blood smears confirmed prophylaxis failure. In vitro susceptibility testing demonstrated the parasite to be 3- to 4 fold more resistant than a susceptible reference clone. PMID- 3544890 TI - Immunochemical analysis of a major antigen of Plasmodium falciparum (P126) among ten geographic isolates. AB - Protein P126, a parasitophorous vacuole major antigen of Plasmodium falciparum and precursor of 3 major exoantigens (50, 47, and 18 Kd in strain FCR-3) has been studied in 10 culture-adapted isolates originating from various endemic areas. Two monoclonal antibodies (specific for 50 and 47 Kd exoantigens, respectively) were used to immunoprecipitate culture supernatants and parasitized erythrocytes in each case. It was observed that all the parasite isolates reacted with both monoclonal antibodies, indicating the ubiquity of the epitopes analyzed. Further, two of the exoantigens (the 50 and 18 Kd of FCR-3) were found to have a stable molecular mass in all the isolates tested, whereas, the other one (47 Kd in FCR 3) was found to have a variable molecular mass, from 47 to 50 Kd. The molecular mass of the precursor varied from 126 Kd to 128 Kd. No correlation was found between geographic origin and antigenic size. PMID- 3544891 TI - Development of Dot-enzyme immunoassay for diagnosis of canine babesiosis. AB - A reagent conservative Dot-enzyme immunoassay (Dot-EIA) was developed primarily for canine babesiosis caused by Babesia canis. The technique is simple, specific, and sensitive. All steps were carried out at room temperature. Strong agreement was observed between Dot-EIA and the conventionally used indirect immunofluorescence test. The procedure is adaptable to other protozoal disease, e.g., bovine babesiosis and human malaria. PMID- 3544892 TI - Amodiaquine less effective than chloroquine in the treatment of falciparum malaria in the Philippines. AB - Amodiaquine was compared to chloroquine in two groups of Filipino patients with uncomplicated falciparum malaria. Every patient received 25 mg/kg of base orally given over three days. In a hospital study, all eight patients receiving chloroquine cleared their parasitemia by day 6, but six of eight patients receiving amodiaquine failed to clear parasitemia and in four patients there was no response at all (RIII resistance); this difference was significant (P less than 0.01). In a village based study, there was initial clearing of parasitemia in each patient. However, recrudescent infection occurred in all five patients receiving amodiaquine (RI resistance). Five of six falciparum infections were sensitive to chloroquine, while parasitemia reappeared in one patient. In this village, resistance to amodiaquine was significantly more common than resistance to chloroquine (P less than 0.05). To our knowledge, this is the first report of amodiaquine being substantially worse than chloroquine in the treatment of Plasmodium falciparum infection. PMID- 3544893 TI - Divergent isoenzyme profiles of sylvatic and domiciliary Trypanosoma cruzi in the eastern plains, piedmont, and highlands of Colombia. AB - Fifty-four stocks of Trypanosoma cruzi from vectors, mammalian reservoirs, and infected humans were characterized by enzyme electrophoresis in starch gels using Brazilian zymodeme reference strains (Z1, X-10; Z2, ESM; Z3, CAN-3) as standards. Colombian stocks were collected in three ecologically and epidemiologically distinct settings. Thirteen enzymes were included in the evaluation. Sixteen different phenotypic profiles or "zymodemes" were evident and generated three groups of closely related stocks: a sylvatic Z1-like group, a domiciliary Z1-like group, and a sylvatic Z3-like group. The number of zymodemes observed in foci of sylvatic transmission was greater than in foci of domiciliary transmission. Modified ecologic conditions associated with agriculture and the consequent reduction of biologic diversity may account for the observed pattern of zymodeme distribution and heterogeneity. The phenotypic similarity between the principal sylvatic group of stocks and domiciliary stocks contrasts with the extensive differences observed between the domestic Z2 zymodeme and sylvatic Z1 and Z3 zymodemes in Brazil and Chile. PMID- 3544894 TI - An ultrastructural study of the effects of mefloquine on malaria parasites. AB - The ultrastructural changes induced by the administration of a recently developed antimalarial drug, mefloquine, were studied in mice infected with Plasmodium berghei and human erythrocytes infected with P. falciparum in vitro. Pronounced changes which occurred in both experiments comprised swelling of the parasites' food vacuoles with gradual loss of pigment granules, which did not form clumps as occurs with chloroquine. These findings suggest that the malarial parasites' food vacuole is the target of this drug. PMID- 3544895 TI - Prevalence of trachoma in school children and ophthalmological outpatients in rural Egypt. AB - The prevalence of trachoma in school children and ophthalmological patients in rural villages of the Qalyub Governorate of Egypt was determined by clinical and laboratory diagnostic procedures and reported as mild, moderate, or severe according to the WHO classification scheme. Of 777 primary school students examined in 3 villages, 204 (26%) had clinically active trachoma. The overall prevalence of the disease in this population ranged from 16% to 35%. The prevalence of infection was higher in younger groups and decreased throughout primary school. Of 312 patients with ocular complaints examined at the village outpatient clinics, 100 (32%) had trachoma infections. Monoclonal FA staining showed higher sensitivity in detecting positive cases of trachoma than did Giemsa staining. This study has shown that trachoma is still prevalent in rural Egypt and that the monoclonal FA staining is a relatively sensitive and practical test for the laboratory diagnosis of trachoma in a field study, where reasonable facilities for culture diagnosis are not available. PMID- 3544896 TI - Extended applications of ultrasonography by the surgeon. A preliminary report. AB - The application of ultrasonography by surgeons in hospitalized patients and the potential benefits thereof were evaluated in 52 patients. Ultrasonography was used to diagnose emergent conditions in 30 patients, nonemergent conditions in 16 patients, and as a guide for interventional procedures in 6 patients. The procedure was carried out by a specially trained member of the surgical team, thus providing use of the technique as required. In assessing the degree of reliability of ultrasonography for surgical decision-making, it was found to be helpful in arriving at a decision in 47 patients, not helpful in 3 patients, and misleading in 2 patients in whom results were misinterpreted. The use of ultrasonography by the surgical team may help to provide early diagnosis, and thus may shorten the delay in necessary surgical intervention. It can also serve as a guide during interventional procedures and thereby can increase their safety and accuracy. We believe that the ability to carry out and interpret ultrasonographic tests is a helpful addition to the surgeon's armamentarium. PMID- 3544897 TI - New method of percutaneous gastrostomy using anchoring devices. AB - We used an anchoring device to secure the stomach to the abdominal wall when performing percutaneous endoscopic gastrostomy. This method avoids many of the disadvantages of the technique currently used. The procedure is easy to perform, allows insertion of a proper size of gastrostomy tube, ensures fixation of the stomach to the abdominal wall, and facilitates changing of the feeding tube. PMID- 3544898 TI - Agents for gallstone dissolution. AB - Numerous methods are presently available for gallstone dissolution, including oral bile salts; cholesterol solvents such as mono-octanoin and methyl tert-butyl ether; calcium or pigment solvents such as EDTA and polysorbate; mechanical extraction techniques through a T-tube tract or after endoscopic sphincterotomy; or fragmentation methods such as ultrasonography or electrohydraulic lithotripsy, lasers, and extracorporeal shock waves. Which, if any, of these methods will be appropriate for an individual patient depends on the type of stones, whether they are in the gallbladder or bile ducts, whether access to the biliary tree is available, the patient's age and general medical condition, and the availability of expert radiologists, endoscopists, and newer equipment. In the United States, the only available oral bile salt for cholesterol gallstone dissolution is chenodeoxycholate. Ursodeoxycholate, which is more rapid and less toxic, has not been approved by the Federal Drug Administration. These agents are most effective in thin women with small, floating, radiolucent cholesterol gallstones in a functioning gallbladder. Only about half of this small subset of patients, however, will experience partial or complete dissolution of stones in 6 to 12 months. Moreover, recurrence is very likely, and the potential toxicity of long term therapy is unknown. Thus, for most patients, cholecystectomy remains the most cost-effective and, perhaps, safest option. Intragallbladder instillation of methyl tert-butyl ether and extracorporeal shock wave therapy are also likely to be applicable to only small subsets of patients and to be associated with high recurrence rates. In patients with retained ductal cholesterol stones and access to the biliary tree, mono-octanoin therapy is advantageous in that it can be begun as soon as cholangiography demonstrates no extravasation. In properly selected patients, a 90 percent success rate with mono-octanoin infusion can be expected within a week. Radiologic or endoscopic extraction techniques require maturation of a relatively straight T-tube tract but are not dependent on the type of stone. In the hands of experts, these techniques are highly successful. In postcholecystectomy patients without access to the biliary tree, endoscopic sphincterotomy has become the preferred method of management and can be expected to succeed in more than 90 percent of patients. At this point, the exact role for ultrasonic or electrohydraulic lithotripsy and lasers is unknown. However, these techniques may be applicable in the future in patients with retained bile duct stones in whom extraction and infusion techniques have failed. PMID- 3544899 TI - [Various aspects of respiration in the newborn infant]. PMID- 3544900 TI - [Echographic diagnosis of iniencephaly]. PMID- 3544901 TI - Epidermal antigen preservation with freezing. AB - Antigen preservation in human foreskin was evaluated after prolonged storage. Foreskin sections previously separated and stored were examined after 24 h, 6 days, 102 days, 364 days, and 493 days, using indirect immunofluorescence techniques. Each foreskin was evaluated with high-titer human antisera against bullous pemphigoid and pemphigus antigens, rabbit antiserum against laminin, and IgG murine monoclonal antibodies against OKT6, OKIa, AF-1, and Kab-3. Each section was studied and scored by three independent observers. Except for decreased fluorescent staining of pemphigus antigens, no decrease of the immunofluorescence titers was seen over the period of observation. PMID- 3544902 TI - Acantholysis (Auspitz). PMID- 3544903 TI - The man behind the eponym. Borst and the Von Brehmer incident. PMID- 3544904 TI - The man behind the eponym. John Ferguson Smith (1888-1978). PMID- 3544906 TI - Alcohol consumption, blood pressure, lipids, and cardiovascular mortality. AB - Interest in the effects of alcohol on cardiovascular risk factors and disease has increased sharply with reports of complex and previously unsuspected associations. The present report focuses on the associations of alcohol with blood pressure, lipids, and cardiovascular disease mortality. The epidemiological evidence to date appears to support the idea that moderate alcohol consumption, defined as two drinks a day or less, may offer some protection for coronary heart disease, but that higher levels of alcohol promote hypertension and are directly toxic to the heart, leading to stroke, arrhythmias, cardiomyopathy, and perhaps even coronary heart disease. PMID- 3544905 TI - Similarities and differences in acute cardiovascular responses to alcohol among normal men of European, Japanese, and Chinese ancestry: a univariate and multivariate analysis. AB - Normal young adult males residing in Hawaii (46 of European ancestry, 30 Japanese, 27 Chinese) were tested for changes in heart rate and blood pressure following a dose of 0.59 g of ethanol/kg. The two Oriental groups did not differ in mean changes but, when pooled, differed from Europeans, having increased heart rate and decreased blood pressure. Within-race analyses showed that, contrary to the literature, all three groups have great interindividual differences in cardiovascular responses. In addition, the three races show a basically similar multivariate response: blood pressure more variable than heart rate and blood pressure changes uncorrelated with heart rate changes. PMID- 3544907 TI - Mechanisms of vitamin deficiencies in alcoholism. AB - Chronic alcoholic patients are frequently deficient in one or more vitamins. The deficiencies commonly involve folate, vitamin B6, thiamine, and vitamin A. Although inadequate dietary intake is a major cause of the vitamin deficiency, other possible mechanisms may also be involved. Alcoholism can affect the absorption, storage, metabolism, and activation of many of these vitamins. Possible factors which cause alterations in the absorption, storage, and metabolism of these vitamins are discussed. Suggestions for management of vitamin deficiencies in chronic alcoholics are also discussed. PMID- 3544908 TI - Zinc metabolism in alcoholic liver disease. AB - Alterations in zinc metabolism or zinc deficiency frequently occur in patients with alcoholic liver disease. Potential manifestations of zinc deficiency include skin lesions, hypogonadism, impaired night vision, impaired immune function, anorexia, altered protein metabolism, diarrhea, and depressed mental function. Because of the variety of ways in which zinc deficiency may present in alcoholic liver disease, clinicians must maintain a high index of suspicion for this nutrient deficiency when caring for these patients. Not only may zinc deficiency occur with alcoholic liver disease, but there also may be altered zinc metabolism. Recent data from alcoholic hepatitis patients demonstrate increased serum levels of the monokine interleukin 1, which is known to cause hypozincemia and an internal redistribution of zinc. This monokine has a host of metabolic functions other than its effect on mineral metabolism that have relevance for alcoholic liver disease such as fever production, neutrophilia, and muscle catabolism. We suggest that the patient with alcoholic liver disease frequently has problems with either zinc deficiency or altered zinc metabolism and the potential implications of this are discussed. PMID- 3544909 TI - Magnesium deficiency in alcoholism. AB - Significant magnesium deficiency occurs in chronic alcoholism. The evidence depends on a number of related lines of evidence: hypomagnesemia, a number of clinical symptoms in common with patients with nonalcoholic causes of magnesium deficiency, induction of magnesium excretion by alcohol ingestion (167-260% of control values), positive magnesium balance on alcohol withdrawal (average 1.15 meq/kg), decreased exchangeable magnesium (28Mg, mean deficit 1.12 meq/kg), a mean deficit of 11.4 meq/kg of fat-free dry weight of muscle of alcoholic patients, and hypocalcemia responsive only to magnesium therapy. When alcohol is withdrawn, free fatty acids rise sharply and plasma magnesium falls. Respiratory alkalosis occurs abruptly also on alcohol withdrawal. The alkalosis and rise of free fatty acids with concomitant fall of magnesium produces an acute instability of the internal milieu and could result in acute symptoms. There also are a number of nutritional deficiencies which need to be cared for, but magnesium, thiamine, and other B vitamins need to be administered immediately. Potassium and phosphorus should be supplied when they are low. PMID- 3544910 TI - Central cholinergic correlates of low dose ethanol-induced locomotor stimulation. AB - Brain area levels of acetycholine and choline plus the turnover rate of acetylcholine were measured in three strains of rats given low, locomotor stimulating doses of ethanol. Maudsley reactive (MR/N), Sprague-Dawley, and randomly bred MR/N (MRrb) rats were killed by microwave irradiation and cholinergic function was measured by gas chromatography/mass spectroscopy methods. The results show that the MR/N strain (2 and 5 months old), which elicits enhanced locomotor stimulation after low doses of ethanol, also demonstrates significant increases in cholinergic function at the time of behavioral stimulation. However, after locomotor stimulation, cholinergic parameters returned to normal in these animals. Strains which do not show enhanced locomotor activity after ethanol did not demonstrate significant central cholinergic changes. We conclude that central cholinergic function is related to behavioral stimulation elicited by low doses of ethanol in the MR/N rat strain but not other strains. PMID- 3544911 TI - Increased monoester lipase activity of red blood cells in alcoholism. AB - Monoester lipase activity was assayed by a radiochemical assay in the red blood cells (RBC) from 50 chronic alcoholic patients within 48 hr after discontinuation of chronic alcohol intake and from 40 nonalcoholic control subjects. The mean value of lipase activity was increased to 1213 +/- 229 milliunits/10(12) RBC in the alcoholics as compared with a value of 997 +/- 120 milliunits/10(12) RBC in the controls (p less than 0.001). The lipase increase was associated with increased values of the mean cellular volume of RBC. A subgroup (64%) of 32 alcoholic subjects with macrocytosis (mean cellular volume greater than 96 femtoliters) showed the highest mean lipase activity (1276 +/- 224 milliunits/10(12) RBC) as compared with a value of 1101 +/- 196 milliunits/10(12) RBC in the normocytic alcoholic subgroup (p less than 0.05). This latter subgroup had a mean value higher (p less than 0.05) than that in the control group. The relationship between values of mean cellular volume and lipase activity was not of predictive value in individual cases. The enzymatic increase was not related to a direct effect of alcohol on the intact RBC. It is postulated that this alteration might result from changes in the chemical and/or physical state of the plasma membrane induced by ethanol during RBC formation. In any event, the increased lipolytic activity of RBC represents a new biological characteristic of alcoholic subjects. Its determination might represent a noninvasive way of evaluating the influence of alcohol on a tissue parameter. PMID- 3544912 TI - Changes in lipid composition of rat heart mitochondria after chronic ethanol administration. AB - Triacylglycerols and phospholipids of mitochondria from heart ventricular muscle were analyzed following chronic ethanol administration (2 and 10 g/kg of body weight/day) to adult rats for 21 days via intragastric intubation. Triacylglycerols were elevated 57% in the high ethanol group as compared to controls, but cholesterol level was not altered. Most of the phospholipids, including lysophospholipids, showed a small increase in level after ethanol administration. However the greatest increase (50%) occurred in ethanolamine plasmalogens. Although small changes in the acyl group composition of phosphatidylethanolamines and phosphatidylcholines were observed, the acyl group profile of cardiolipin remained unaltered. It is concluded that myocardial membranes respond to the disordering effects of ethanol by altering the synthesis of selected lipids more than through altering the phospholipid acyl group composition. Some of these changes may be responsible for altered mitochondrial functions in the myocardium. PMID- 3544913 TI - Alcoholic ketosis. AB - We prospectively studied 23 episodes of suspected alcoholic ketosis in order to learn whether there was objective evidence of the patients having stopped drinking ethanol a few days before admission, and of being starved. Eight patients had moderate ketosis (plasma 3-hydroxybutyrate 4.1-7.8 mmol/liter); seven patients had mild ketosis (2-4 mmol/liter); and eight had little or no ketosis (less than 2 mmol/liter). The latter eight patients had mainly lactic acidosis (plasma lactate 2.0-13.3 mmol/liter). Most of the ketotic patients did not have ethanol detected in their blood. The presence of starvation was supported by the finding of subnormal plasma triiodothyronine levels (less than 90 micrograms/dl) in six of seven ketotic patients (average 60 micrograms/dl for all seven). The ketotic patients usually had low-normal plasma insulin levels (3- 16 microU/ml), as is common in starvation. Our findings support the previously undocumented belief that most patients with alcoholic ketosis did stop drinking ethanol some time before admission, and that starvation is a major pathogenetic factor in the disorder. PMID- 3544914 TI - Assessment of the development of tolerance to ethanol using multiple measures. AB - Development of tolerance to ethanol was examined using a motor coordination test, startle response, and rectal temperature in rats chronically treated with ethanol (8-11 g/kg/day), equicaloric dextrin maltose (DM) or water. A 2.0 g/kg test dose resulted in 92, 48, and 2.7% depression from baseline of motor coordination test performance, startle response, and rectal temperature, respectively, on the first test day. There was complete tolerance to the hypothermic effect of this dose of ethanol on the 9th day of treatment while 17 days of treatment were required to achieve total tolerance on dowel test but still did not produce full tolerance on the startle response. Measurement of blood ethanol concentration indicated no significant changes in the rate of ethanol disappearance. Therefore the observed decrease in sensitivity to ethanol represents functional tolerance. These results indicate tolerance to ethanol develops at different rates depending on the measures employed to evaluate it. PMID- 3544915 TI - Alcohol dehydrogenase isozymes in baboons: tissue distribution, catalytic properties, and variant phenotypes in liver, kidney, stomach, and testis. AB - Isoelectric focusing and cellulose acetate electrophoresis were used to examine the multiplicity, tissue distribution, and variability of alcohol dehydrogenase (ADH) among baboons, a primate species used as a model for research on alcohol metabolism and alcohol-induced liver pathology. Five major ADH isozymes were resolved and distinguished on the basis of their isoelectric points, tissue distributions, relative activities with alcohol substrates, and sensitivities to inhibition with 4-methyl pyrazole. ADH-1 and ADH-2 exhibited class I kinetic properties and were observed in high activity in kidney and liver extracts, respectively. ADH-3 showed class II kinetic properties, exhibiting high activity in stomach extracts, and was widely distributed in extracts of other baboon tissues, including kidney, esophagus, heart, testis, brain, and male sex accessory tissues. ADH-4 also showed class II ADH properties but was found only in liver (similar to human "pi-ADH"). ADH-5 exhibited class III ADH kinetic properties, being inactive with ethanol up to 0.5 M (similar to human "chi-ADH") and was distributed widely in baboon tissue extracts. Major activity variation was observed for liver ADH-4 between different animals. An electrophoretic variant for ADH-3 was observed for the enzyme in stomach, kidney, and testis extracts, and activity variation existed for this isozyme in kidney extracts. It is apparent that baboon ADH shares a number of features with the human ADH phenotype; however, several species-specific differences were observed, particularly for the liver and kidney class I isozymes and for stomach ADH. PMID- 3544916 TI - Suicide in male alcoholics with peptic ulcers. AB - Eighty-seven male alcoholics with peptic ulcers and 913 without peptic ulcers were first admitted to the Department of Psychiatry of Lund, Sweden during the period 1956-1969. In the initial ratings rigidity/perfectionism, strain/tenseness, sleep disturbances, the asthenic syndrome, and heredity for alcoholism/personality disturbances/suicide were more frequent in the peptic ulcer group than in the others. Patients with peptic ulcers were more often married and less often unmarried or showed antisocial/criminal indications of antisociality/criminality. A follow-up by records was performed on January 1, 1981. Seventeen percent in the peptic ulcer group and 6% in the other group had committed suicide (p less than 0.001). Mortality (suicides excluded) was similar in the two groups as was the social adjustment among the survivors. Within the peptic ulcer group strain/tenseness was significantly related to future suicide, while operation, heredity, and rigidity/perfectionism were not. PMID- 3544917 TI - Asking the right questions: problem solving in male alcoholics and male alcoholics with Korsakoff's syndrome. AB - The performance of alcoholics and alcoholics with Korsakoff's syndrome was compared with that of nonalcoholic controls on a task which required the generation of a series of questions for the solution of object and digit/letter identification problems. Each subject attempted to determine which of a set of stimuli (objects, letters, or numbers) the examiner had arbitrarily preselected as correct. The nonalcoholic control subjects asked constraint-seeking questions which reduced alternatives by inquiring about general categories (e.g., "Is it a tool?"). In contrast, the two groups of alcoholic patients assumed the far less efficient strategy of asking hypothesis-scanning and pseudo-constraint questions which provided information only about one of the possible stimuli (e.g., "Is it the saw?"). This similarity in the problem-solving strategies of alcoholics both with and without Korsakoff's syndrome is consistent with the hypothesis that the problem-solving deficits of Korsakoff patients are apparent before the acute onset of their amnesic symptoms. These deficits may be due to alcohol-induced damage to the anterior and posterior cerebral cortical association areas which mediate problem-solving and visuoperceptual functions. PMID- 3544918 TI - Alcoholism diagnoses for convicted drinking drivers referred for alcoholism evaluation. AB - The types and extent of alcohol-related problems were determined for a sample of 461 convicted drinking drivers who were referred to an alcoholism treatment facility for evaluation and possible treatment. Using responses to questionnaire and structured interview questions on alcohol-related problems, DSM III diagnoses are constructed; approximately three-quarters of the sample are diagnosed with sufficient severity for a DSM III diagnosis of abuse or dependence. Self-reported consumption levels and drinking/driving incidents increase as the level of the alcohol problem increases; persons in the Alcohol Abuse category are heavier consumers and drive more frequently after drinking than are persons who are not diagnosed by the DSM III as having an alcohol problem. Persons in the Alcohol Dependence category are heavier consumers than either the Alcohol Abuse or Undiagnosed Problem categories and report more drinking/driving incidents. The DSM III provides useful subcategories of convicted drinking drivers referred for alcoholism evaluation and distinguishes groups differing in quality, frequency, and self-reported DWI measures, independent of basic demographics. These analyses suggest that drinking/driving countermeasures should include intervention efforts to address alcohol-related problems. Serious alcohol problems exist among some drinking drivers, and drinking/driving incidents are more frequent among these individuals. PMID- 3544919 TI - Clinical and familial correlates of alcoholism in men with unipolar major depression. PMID- 3544920 TI - Monitoring drinking behavior with the alcohol dipstick during treatment. AB - The present communication is the first report on the clinical use of the alcohol dipstick to continuously monitor alcoholics' drinking during treatment. Daily urine samples from 34 alcoholics were tested for alcohol by the clinical staff using the alcohol dipstick. The patients also provided self-reports of drinking daily. Patients' compliance for submitting urine samples and for completing daily monitoring sheets (DMS) was 93 and 95%, respectively. Over 75% of the patients drank on at least one occasion; about half of these patients denied drinking detected by the urine tests. Drinking was confirmed by both methods in 39% of the patients who drank, and by the urine testing alone in 54%. The patients in treatment for less than 2 months were abstinent on 85% of the days compared to 98% for those in treatment for 6 months or longer. Seventy-two percent of all alcohol-positive urine samples were submitted by patients on days when they denied drinking. Monitoring of patients' drinking was useful in their clinical management. The alcohol dipstick was a simple, inexpensive, and rapid alcohol measuring procedure that could be used by the clinical staff in the treatment setting. PMID- 3544921 TI - Alcohol expectancies among male alcoholics, problem drinkers, and nonproblem drinkers. AB - Drinkers' expectancies regarding alcohol effects are cognitive factors hypothesized to affect decisions to drink and responses to alcohol. Recent research in this area has yielded descriptive data mostly on nonalcoholic drinkers' motives for drinking and alcohol expectancies. Much less attention has been focused on assessing the extent to which these findings generalize to a broader array of drinkers. Alcohol expectancies were assessed in this report among 260 alcoholics, 79 problem drinkers, and 81 nonproblem drinkers (all subjects were male) using a comprehensive alcohol expectancy measure. Alcoholics almost uniformly scored higher than the problem and nonproblem drinkers in their endorsements of alcohol's effects in different domains (e.g., alcohol acts as a global positive transforming agent, enhances physical and social pleasure, engenders assertiveness, reduces tension). Problem drinkers also tended to score higher than the nonproblem drinkers in these domains. A multiple discriminant analysis yielded two functions which together were moderately successful in classifying these subjects according to drinker group. Taken together, these data suggest that important individual differences exist in drinkers' expectations regarding alcohol's utility, and that alcohol expectancies vary considerably as a function of problem drinking severity. The clinical implications of these findings are discussed. PMID- 3544922 TI - Quantification of physiological and behavioral measures of alcohol withdrawal in long-sleep and short-sleep mice. AB - A quantitative, multidimensional animal model of the alcohol withdrawal syndrome is desirable for investigating individual differences in susceptibility to alcohol dependence. Following exposure to control or ethanol diets for 7 or 14 days, we measured respiration rates, body temperature, acoustic startle responses, and heart rates in Long-Sleep (LS) and Short-Sleep (SS) mice to determine how initial alcohol sensitivity influences dependence liability. SS mice consumed a greater amount of ethanol diet and exhibited a more severe withdrawal syndrome than LS mice. Withdrawal severity resulted from an interaction of genotype with duration of ethanol exposure. The abstinence syndrome was generally characterized by depressed behavioral and physiological functioning for both mouse lines. Initial alcohol sensitivity influenced the rate of alcohol increase in the blood during dependence induction which, in turn, influenced withdrawal severity. This model incorporates several discriminative measures that independently assess withdrawal reactions and provides a useful animal model of alcohol withdrawal. PMID- 3544923 TI - Vitamin K deficiency in chronic alcoholic males. AB - Twenty male alcoholic subjects were studied initially within 1 day after stopping alcohol and again after about 1 week. Vitamin and mineral measurements were made on blood and abnormal prothrombin molecules quantitated for vitamin K status. Nine of the 20 patients received menadiol after the initial blood sample. Twelve of the alcoholics had significant elevations of abnormal prothrombin. Of these 12, all five who received vitamin K reduced the abnormal prothrombin levels toward normal but no change was observed in the seven who did not receive vitamin K. All nine patients receiving vitamin K lowered the abnormal prothrombin level significantly whereas there was no change in those 11 who did not receive vitamin K. The prothrombin time by the one-stage technique was normal in all patients. These data suggest that the production of abnormal prothrombin is frequently present in alcoholics and this may represent a subclinical vitamin K deficiency. PMID- 3544924 TI - Reinterpretation of the pharmacokinetic mechanism of oral benzodiazepine ethanol interaction. AB - Previously published studies investigating the oral benzodiazepine ethanol interaction have utilized a single dose of ethanol, a single dose of oral benzodiazepine, and measured plasma benzodiazepine concentration over varying time periods. Most studies reported an increase or no change in benzodiazepine plasma concentrations following ethanol administration, which the investigators usually ascribed to an ethanol-induced increase in the benzodiazepine absorption rate constant. However, ethanol decreases the hepatic clearance of benzodiazepines that are biotransformed via the P450 enzyme system and this effect was not taken into account in evaluation of the results of these studies. Computer simulations have been used to investigate possible mechanisms of the oral benzodiazepine-ethanol interaction. The effects of a constant or transient decrease in clearance and an increase in absorption rate constant upon maximum concentration, time of maximum concentration, and area under the benzodiazepine plasma concentration curve (AUC) have been examined. A transient 75% decrease in benzodiazepine clearance resulted in a 13.6% increase in AUC (0-36 hr), a 3.4% increase in Cmax and a 5.7% increase in tmax. These changes are qualitatively consistent with, but quantitatively shy, of those observed in most studies. Consequently, an effect of ethanol upon benzodiazepine absorption must still be considered. PMID- 3544925 TI - Ethanol-induced hepatic fibrosis in the rat: role of the amount of dietary fat. AB - We have made a comparison between groups of rats fed ethanol and a diet that received intragastric infusion of ethanol continuously for prolonged periods varying only in the amount of fat in the diet (percentage of total calories as fat was 5, 25, and 35%). A fourth group of rats fed high fat (32% of calories) and a diet marginal in protein, vitamins and minerals was also studied. Control rats were pair-fed dextrose in isocaloric amounts. For rats fed diets containing 5, 25, 32, and 35% fat, the average blood alcohol levels achieved were 216, 224, 266 and 353 mg/100 ml, respectively. Average weight gains of the ethanol fed rats were: 15.4, 19.6, 14.7, and 14.9 g/week, respectively. Serum alanine aminotransferase (ALT) levels of the ethanol-fed rats averaged 123, 292, 144, and 213 units/liter, respectively. ALT levels in pair-fed controls for the rats fed 32% fat averaged 62 and those of chow-fed controls averaged 49 units/liter. Comparison of liver biopsy-semiquantified morphological findings revealed an increased 3-4+ fatty change in the ethanol-fed rats also fed the high fat rats. Moreover, fibrosis was only observed centrilobularly in rats fed diets with varying fat content (5, 25, 32, or 35% of calories): 0/16, 10/17, 4/6, and 3/7 rats, respectively, over a 5-mon period of feeding. Electron microscopy showed that ito cells predominated in the scarred areas. The mechanism for the centrilobular necrosis-fibrosis was investigated in rats given a diet of ethanol plus 32% fat diet by measuring the level of adenine nucleotide in repeated liver biopsies in five pair of rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544926 TI - Hepatic microsomal ethanol-oxidizing system (MEOS): metabolic aspects and clinical implications. PMID- 3544927 TI - Changing concepts in the pathogenesis of alcoholic liver disease. PMID- 3544928 TI - Ethanol and carcinogenesis of the alimentary tract. PMID- 3544929 TI - Effect of acute alcohol administration on erythrocyte aldehyde dehydrogenase activity in man. AB - The acute oral administration of ethanol to normal subjects resulted in an increase in erythrocyte aldehyde dehydrogenase activity. Incubation of blood with ethanol at 37 degrees C for 2 hr also increased the enzyme activity. By contrast, addition of ethanol directly to the enzyme after its partial purification had no effect on the enzyme activity. The increase in erythrocyte aldehyde dehydrogenase activity following acute ethanol administration is directly opposite to the effect of chronic ethanol consumption in decreasing the enzyme activity in alcoholics. The mechanism for this effect is unknown but may be related to alterations in the erythrocyte membrane and its interaction with the enzyme. PMID- 3544930 TI - Ethanol oxidation and toxicity: role of alcohol P-450 oxygenase. AB - The isolation and characterization of ethanol-inducible rabbit liver microsomal cytochrome P-450, termed P-450 3a or P-450ALC, has provided definitive evidence for the role of this enzyme in alcohol oxidation. From findings on the distribution, substrate specificity, and mechanism of action of P-450ALC we have suggested "alcohol P-450 oxygenase" as a more biochemically accurate name than "microsomal ethanol-oxidizing system." The present review is concerned with studies in this and other laboratories on activities and inducers associated with this versatile enzyme. Numerous xenobiotics, including alcohols and ketones, nitrosamines, aromatic compounds, and halogenated alkanes, alkenes, and ethers, are known to undergo increased microsomal metabolism after chronic exposure of various species to ethanol. Diverse compounds and treatments may induce P-450ALC, including the administration of ten or more chemically different compounds, fasting, or the diabetic state. Whether a common mechanism of induction is involved is unknown at this time. As direct evidence that P-450ALC catalyzes numerous metabolic reactions, the purified rabbit enzyme has been used in a reconstituted system to demonstrate various metabolic transformations, including the oxidation of various alcohols, acetone, acetol, p-nitrophenol, and aniline, the dealkylation of substituted nitrosamines, the reductive dechlorination of carbon tetrachloride, carbon tetrachloride-induced lipid peroxidation, and acetaminophen activation to form the glutathione conjugate. PMID- 3544931 TI - Redox effects of ethanol on steroid metabolism. PMID- 3544932 TI - The effect of ethanol on the beta-oxidation of fatty acids. AB - The application of radiolabeled fatty acids to measurements of fatty acid oxidation is discussed and a method for measuring the rate of beta-oxidation and of acetyl-CoA oxidation to CO2 is described. In hepatocytes from starved or fed rats, ethanol inhibited total beta-oxidation in the presence of 1.3 mM palmitate by 22% and 25%, respectively. If changes in the specific radioactivity of acetyl CoA were not corrected for, the effect of ethanol would have been overestimated by 15% and underestimated by 15% in hepatocytes from fed and starved rats, respectively. In perfused liver from fed rats, inhibition by ethanol of total beta-oxidation in the presence of 1 mM palmitate was 35%. The rate of beta oxidation in the absence of ethanol was underestimated by 65% if proper corrections were not applied. Inhibition of the tricarboxylic acid cycle by ethanol was 57% and 72% in hepatocytes from starved and fed rats, respectively. Pyrazole titration experiments demonstrated a correlation between changes in the mitochondrial NADH/NAD+ ratio and both inhibition of the tricarboxylic acid cycle and inhibition of the beta-oxidation pathway. The concentration of acetoacetyl CoA is suggested as an additional regulatory factor of the beta-oxidation pathway. The ethanol-induced accumulation of triacylglycerol as a consequence of the inhibition of the beta-oxidation pathway is estimated to represent a 10% increase in the cellular triacylglycerol pool/hr/g of wet weight. Hence its chemical determination requires experiments of several hours duration. Primary cultures of hepatocytes have been shown to be a useful experimental system for studies of the ethanol-induced triacylglycerol accumulation. PMID- 3544933 TI - The deuterium isotope effect on ethanol metabolism in perfused rat liver: effect of reversed perfusion on ethanol and oxygen uptake. AB - Livers from rats fasted for 24 hr were subjected to nonrecirculating perfusion with Krebs-Ringer bicarbonate solution containing 10 mM ethanol. The deuterium isotope effect was measured using (1-R)-[1-14C,1-2H]ethanol. A value of 2.57 +/- 0.09 (SD) was obtained independent of the direction of perfusion. Oxygen uptake and ethanol metabolism in contrast were significantly increased when reverse perfusion (i.e., from vena cava to vena portae) was used. The magnitude of the isotope effect indicates that contribution from microsomal ethanol-oxidizing system if this is the only supplementary system is 9.8% under the experimental conditions. At high ethanol concentrations, the contribution would approach 18%. Equal activities of microsomal ethanol-oxidizing system and catalase under the experimental conditions would mean that both contribute 7.3% of the total ethanol metabolism. At high ethanol concentrations (80 mM), however, catalase will be 6.8% and microsomal ethanol-oxidizing system is calculated to 13.3%. Preliminary experiments with rats pretreated with phenobarbital showed no change in the isotope effect or in the rate of ethanol metabolism, but a 40-50% increase in oxygen consumption. The acetaldehyde concentration in the effluent medium was below 1 microM. PMID- 3544934 TI - The effects of chronic ethanol consumption on carcinogen metabolism and on O6 methylguanine transferase-mediated repair of alkylated DNA. AB - This article presents a review and update of recent experiments conducted in collaboration with Dr. C. S. Lieber on mechanisms underlying the increased cancer risk associated with alcohol abuse. Ethanol has been found to be a potent inducer of microsomal enzymes involved in carcinogen metabolism in a variety of rat tissues including liver, esophagus, lungs, and intestines. In some of these tissues, ethanol's inductive effect on microsomal cytochrome P-450 enzyme activity may result in enhanced levels of electrophilic metabolites of procarcinogens which are not readily detoxified. In addition, chronic ethanol feeding has been found to depress the activity of O6-methylguanine transferase, an enzyme involved in the repair of carcinogen-induced DNA alkylation. The effects of ethanol on carcinogen metabolism and on DNA repair would be expected to enhance the initiation phase of chemically induced cancers. PMID- 3544935 TI - Ketotifen and methacholine-induced bronchospasm. AB - In a double-blind investigation the aspecific bronchus threshold was estimated by administration of methacholine to 16 young atopic patients with proven airways hyperreactivity (PC20 histamine less than or equal to 2 mg/ml. The influence of prolonged oral administration (12 weeks) of ketotifen (2 mg/day) on the bronchus threshold value has been studied. No significant elevation was found. It could be concluded that administration of ketotifen, even in prolonged administration, has no anticholinergic effects. PMID- 3544936 TI - Increased neutrophil chemotactic activity in exercise- and "fog"-induced asthma. AB - To investigate whether exercise- and ultrasonic "fog"-induced asthma are due to the same mechanism, i.e. mediator release induced by osmotic changes, we measured the serum neutrophil chemotactic activity before and after exercise and inhalation of "fog" in 15 asthmatic subjects. To assess changes in airway caliber we measured specific airway conductance (SGaw); to assess changes in neutrophil chemotactic activity we measured the maximum distance reached by neutrophils in a filter when challenged with the subject's serum in a Boyden chamber. In 10 subjects, SGaw decreased by more than 35% and neutrophil chemotactic activity increased significantly (P less than 0.05) both after exercise and "fog", whereas in five subjects no change occurred either after exercise or "fog". We conclude that both exercise- and "fog"-induced asthma are associated with increased serum neutrophil chemotactic activity, and that both stimuli may cause asthma by osmotically triggering mediator release from mast cells. PMID- 3544937 TI - A prospective study on the safety of immunotherapy in children with severe asthma. AB - One hundred and six of 503 (21%) consecutive children with asthma, who from 1979 to 1983 commenced hyposensitization therapy, were prospectively studied on the safety of immunotherapy. More than 80% of the patients completed therapy without side effects. Thirteen patients were withdrawn from hyposensitization due to moderate and predictable, but intolerable, side effects such as asthma/rhinitis, urticaria and subcutaneous nodules and hypersensitivity to aluminium. However, more alarming was the outcome in six children, who after an uneventful course of immunotherapy and after several months on maintenance therapy, suddenly, 5 to 20 min (mean 10 min) following an earlier tolerable allergen injection, developed severe, anaphylactic reactions, in three of them nearly fatal. Mould extracts were responsible for the most frequent and serious side effects (Alternaria iridis/alternata, 3 patients, Cladosporium herbarum, 8 patients). Furthermore, serious, but not immediately life-threatening, anaphylactic reactions occurred in two children treated with Phleum pratense. On the other hand, hyposensitization with Dermatophagoides pteronyssinus was very well tolerated. PMID- 3544938 TI - [Effects and side effects of transdermal scopolamine for premedication in general anesthesia in elderly patients]. AB - Transdermal scopolamine has already proved an effective premedication to prevent postoperative nausea and vomiting. In a double-blind study, the effects and above all the side effects of TTS-scopolamine (TTS-s) and TTS-placebo (TTS-p) were investigated in elderly patients (greater than 50 years), who are particularly susceptible to adverse drug reactions. The 59 (out of 61) male and female patients who could finally be evaluated had to undergo long (1-6.3 hrs.) surgical or gynaecological interventions in general anaesthesia after premedication with benzodiazepines in the evening and in the morning. The operations were performed under intubation anaesthesia induced by barbiturate (3-5 mg/kg bw) or etomidate (0.2-0.3 mg/kg bw), together with enflurane (0.5-2.5 vol.%) or isoflurane (0.5 1.5 vol.%), N2O/O2 (2:1) and fentanyl (0.05-0.45 mg). Alcuronium or vecuronium were given for relaxation, pyridostigmine/atropine was administered for antagonisation. The patient groups did not differ significantly with regard to age (mean = 65 years vs. 63 years), sex, height, weight, concomitant diseases, method and duration of operation, method and duration of anaesthesia, postoperative antagonisation and analgesia. In patients under TTS-s postoperative nausea was less intensive and of shorter duration. In contrast to 7 patients of the placebo group (p less than 0.05), no case of vomiting could be observed in the TTS-s group. The efficacy of TTS-s was significantly better than that of TTS p. TTS-s and TTS-p were both tolerated equally well. In both groups, the most frequent side effect was dryness of the mouth, but without any significant differences between the groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544939 TI - [Hemodynamic findings using high-frequency jet ventilation in major surgery]. AB - 13 patients with normal lung function undergoing isolated hyperthermic cytostatic perfusion were submitted to high-frequency jet ventilation (HFJV; f = 150/min, inspiratory time 30%, FIO2 0.4) and conventional ventilation (CV; f = 12/min, PEEP + 4 cm H2O) respectively. Normoventilation required a minute ventilation of 6.4 +/- 1.1 l/min (paCO2 35.4 +/- 3.3 mmHg) with CV and 15.9 +/- 2.2 1/min (paCO2 39.0 +/- 4.3 mmHg) with HFJV. Mean airway pressure was significantly lower with HFJV (4.8 +/- 1.1 cm H2O) compared to CV (7.5 +/- 1.5 cm H2O). Arterial oxygenation, heart rate, pressures and resistances of systemic and pulmonary circulation, cardiac work and stroke indices, intrapulmonary shunting, and oxygen consumption showed equal values with both modes of ventilation. HFJV does not have any striking advantage over CV and therefore cannot be recommended for routine anaesthesia in abdominal surgery. PMID- 3544940 TI - [Comparative study of the behavior of intraocular pressure in anesthesia induction by diazepam and midazolam]. AB - 20 patients scheduled for cataract extraction were randomly assigned to two groups. Before anaesthesia was induced, group A patients received 0.3 mg/kg body weight diazepam, whereas group B was given 0.15 mg/kg body weight midazolam. The ocular pressure, blood pressure, pulse and respiratory rate were determined and a capillary blood gas analysis was performed prior to the administration of the tranquilizer (time I), after the patient fell asleep (time II) as well as 5 min. after intubation (time III). Before intubation the patients received fentanyl and succinylcholin. The reduction in ocular pressure is initially somewhat less in the midazolam group, but is identical to that in the diazepam group at time III where it fell to 57% of the preinduction value. In combination with fentanyl, these two drugs are suitable for anaesthesia in intraocular surgery. PMID- 3544941 TI - [Maxillary sinusitis in intensive care patients]. AB - Fever of unknown origin is a major diagnostic problem in traumatologic postoperative intensive care medicine. Even when other causes of fever (wound infection, pneumonia, intravenous catheter contamination) have been ruled out, purulent maxillary sinusitis is rarely considered as the initial focus. The maxillary sinuses of 46 patients admitted to a postoperative intensive care unit were examined using a mobile "A-Scan" ultrasonic scanner. Follow-up examinations were performed on a regular basis. As early as on the 5th day of treatment, the initially, most often nasotracheally intubated and artificially ventilated patients exhibited a high frequency of pathological ultrasonic results, whereas only 10 of the 46 patients within the study demonstrated normal findings throughout the follow-up examinations. As a rule, bilateral involvement was observed. When findings were initially unilateral, the nasally intubated side was most often affected. Early extubation, partial mobilisation and/or administration of antibiotics from the first day of treatment onwards did not prevent the occurrence of pathologic ultrasonic results. Fever and leucocyte count were found to be elevated to a higher level in patients with purulent sinusitis. Thus, affection of the maxillary sinuses appears to be a frequent accompanying disease in intensive care patients, and should therefore always be taken into consideration as the initial focus of fever of unknown origin. PMID- 3544942 TI - Obstetric epidural test doses. A reappraisal. AB - A number of obstetric fatalities related to epidural anaesthesia have been reported recently. In each case catheter or needle misplacement had resulted in a lethal intrathecal or intravascular injection. In this review these cases and a number of other similar but nonfatal reports are examined. In many cases, essential safety checks such as the aspiration test and the test dose had not been performed before the epidural injection but in others one or both of these tests had been used and had failed to predict the complication. Safety test failures generally occurred because ineffective tests were used or because effective tests were inadequately interpreted. This is not surprising because although textbooks recommend a bewildering variety of test doses, they seldom give precise details as to how they should be conducted. A detailed test dose protocol is recommended, which will safely warn of epidural catheter and needle misplacement in the most effective manner possible. If the protocol is used, accidental subarachnoid and intravascular injections can be reduced to a minimum, but they will still occur. It is emphasised that these complications should not cause fatalities if trained personnel and adequate resuscitation facilities are available. PMID- 3544943 TI - Lack of haematological and biochemical consequences following autologous blood transfusion. PMID- 3544944 TI - [Malignant hyperthermia in Austria. I. Epidemiology and clinical aspects]. AB - Investigation of malignant hyperthermia (MH) was started in 1975; by March 1986, 79 suspected cases had been reported. In vitro contracture tests were performed in 66 probands or their parents; in 61 of these (92%), MH was confirmed and 5 (8%) proved negative. In 4 lethal crises, the parents refused biopsy, but because of well-documented clinical histories these were also included as confirmed MH reactions. We were able to analyse 65 cases of documented MH, and 9 patients are still to be investigated. About 18% of all Austrian hospitals (29 of 158) had reported 1-14 MH reactions (mean 2.7/hospital); it must therefore be assumed that a high number of crises are either not detected or not reported, and the total incidence of MH cannot be estimated. In our hospital (the University Hospital of Vienna), the incidence was 1:23,600 (including children and adults), whereas in Bludenz (Vorarlberg), the incidence was as low as 1:1,300 (in children only). This might partly be explained by genetic factors (such as inbreeding); we identified 3 families, all from Vorarlberg (which is a small, secluded mountain area), in which both parents were carriers of the MH trait. Fulminant crises (of which three times as many were rigid as were non-rigid) accounted for 58%, and masseter spasm for 26%, of all MH reactions. There was a significant influence of sex (72% males) and age (71% less than 20 years) on incidence. Neuromuscular symptoms or other signs reported to be associated with MH were found in only 5 patients (8%). During crises, cardiac symptoms (81%) and cyanosis (71%) were frequently observed; rigidity (45%) and body temperature above 39 degrees C (27%) showed remarkably low incidences. The overall mortality was 17% (11 of 65); it was significantly increased if the maximum temperature exceeded 39 degrees C, after acute surgery or anaesthesia lasting greater than 60 min, and in patients aged over 20 y. Most crises required no specific therapy; dantrolene was administered to only 10 patients. In the future, earlier detection via better monitoring, improved documentation, and mandatory reporting of suspected MH reactions should allow a more detailed description of MH and could further decrease the mortality associated with this condition. PMID- 3544945 TI - [Is organ failure in hypovolemic-traumatic shock the result of the reperfusion syndrome or of other mediators?]. AB - Decreased perfusion of vital organs is secondary to hypovolemic-traumatic shock and may lead to partial ischemia, which in turn causes nucleotide degradation and accumulation of hypoxanthine as well as the formation of xanthinoxidase. Thus, the pre-conditions for the development of detrimental oxygen radicals are set as soon as perfusion is reestablished. This could explain edema formation associated with the reperfusion syndrome, which is observed at least following total ischemia. Whether these reactions are responsible for edema formation secondary to shock, especially in endothelial cells, is being discussed with respect to the various organs. The present results indicate that damage to the organ occurs via lipid peroxidation due to the effect of oxygen radicals. The degree of involvement of the various sources of oxygen radicals--xanthinoxidase reaction, phagocytes--remains open. In all probability, the sources are involved to a different extent in the various organs. In the lung, the emphasis could be on the phagocytes (leucostasis, alveolar macrophages), in the muscle on the xanthinoxidase reaction. In addition, the numerous mediator systems should be taken into account, with particular emphasis on the unspecific proteolysis (especially through granulocyte elastase). PMID- 3544946 TI - [A new CPAP system]. AB - The "AMBU-CPAP system" is a new, simple and reliable circuit for administering positive airway pressure in spontaneous-breathing therapy. Some disadvantages of other CPAP devices are avoided, and the use of the system with low gas flow is possible. The change of airway pressure during respiration was measured and was found to be less than 5 millibars. PMID- 3544947 TI - Issue dedicated to John J. Pisano, 1929-1985. PMID- 3544948 TI - Glycosphingolipid immunostaining: detection of antibody binding with an avidin biotin enzyme system. AB - Glycosphingolipids carrying carbohydrate sequences recognized by antibodies and lectins can be detected on thin layer chromatograms using an avidin-biotin enzyme system (ABC reagents). This same method can be used to detect glycosphingolipids blot-transferred from thin layer chromatograms to nitrocellulose. This method has certain advantages over the original radioimmunoassay method, including development of positive bands in minutes after incubation with the substrate, avoidance of handling hazardous radioactive materials and stability of reagents. We have demonstrated the usefulness of this method for immunostaining glycosphingolipids with both monoclonal and polyclonal anti-carbohydrate antibodies. These reagents have previously been used to detect carbohydrate antigens in tissues and isolated cells and now it is possible to use the same reagents for the detection of glycosphingolipid antigens on chromatograms. PMID- 3544949 TI - Mapping of radiolabeled peptides derived from proteolysis of polypeptides bound to nitrocellulose after "Western" blotting. AB - Sections of nitrocellulose containing bound 32P-labeled polypeptides were excised from "Western" blots and exhaustively digested by trypsin in order to analyze the distribution of phosphorylation sites between the products of limited proteolysis of the multifunctional protein CAD. Using the criterion of analytical isoelectric focusing, the 32P-peptides obtained by this method were found to be similar, although not identical, to peptides obtained by a more conventional digestion of trichloroacetic acid precipitates. Digestion on Western blots is more straightforward than electrophoretic elution of individual gel slices, gives better recoveries than direct digestion of gel slices, and is particularly suitable for peptide mapping of small peptides which bind to nitrocellulose but would diffuse out of polyacrylamide gels during the commonly used fixing and staining procedures. PMID- 3544950 TI - Determination of thiol proteins using monobromobimane labeling and high performance liquid chromatographic analysis: application to Escherichia coli thioredoxin. AB - A highly sensitive and specific assay for Escherichia coli thioredoxin was developed using the thiol-specific reagent monobromobimane. Treatment of dithiothreitol-reduced thioredoxin with an excess of monobromobimane in Tris buffer (pH 8.0, 23 degrees C) for 30 min resulted in the formation of a stable derivative which was quantitated by reverse-phase high-performance liquid chromatography with fluorescence detection providing sensitivity in the low picomole range. This method was applied to the determination of intracellular levels of thioredoxin in E. coli. Cell extracts were heated, treated with dithiothreitol, reacted with monobromobimane, and desalted to give a solution which was analyzable for thioredoxin using the chromatographic procedure. PMID- 3544951 TI - Thiophilic adsorption of immunoglobulins--analysis of conditions optimal for selective immobilization and purification. AB - Immunoglobulins have been selected by their general affinity for adjacent sulfone thioether sulfur groups as a useful model system for the characterization of thiophilic interaction chromatography. Mercaptoethanol coupled to divinylsulfone activated agarose (thiophilic or T-gel) provided an affinity matrix for the efficient and reversible immobilization of the immunoglobulins. The adsorption/desorption process was investigated as a function of protein concentration, temperature, flow rate, and pH in different concentrations of ammonium sulfate. Immobilization of these proteins was (as a function of pH) found to be both dependent and independent of the adsorption-promoting effects of water-structure-forming salts. Buffer conditions are recommended for the selective adsorption of immunoglobulins from unfractionated human serum. These results indicate that thiophilic interaction chromatography provides a new and effective alternative for the immobilization and purification of immunoglobulins and other proteins under conditions known to preserve structure and biological activity. PMID- 3544952 TI - Enzyme-linked immunodetection of proteins on Coomassie blue-stained two dimensional cellulose acetate membranes. AB - Cellulose acetate membrane on which proteins are separated by two-dimensional electrophoresis and visualized by Coomassie staining is directly subjected to an enzyme-linked immunodetection method using a horseradish peroxidase-conjugated second antibody. The Coomassie-stained and immunochemically stained spots are distinguishable by their colors, such as blue with Coomassie blue staining and purple with horseradish peroxidase staining. Two kinds of lighting make the distinction more apparent. Coomassie-stained protein patterns are clear in the transmitted light. However, the immunochemically stained protein spots are obvious in the reflected light, in which Coomassie-stained patterns are obscure. The procedures do not require proteins to transfer onto nitrocellulose paper in contrast to proteins in polyacrylamide gel. The simple procedure excludes the nonspecific binding of the first and second antibodies to blocking proteins such as bovine serum albumin or gelatin because blocking protein is not used. With this method, matching of the Coomassie blue-stained spot with the immunochemically stained spot is done accurately and easily. PMID- 3544953 TI - Continuous-flow sample probe for fast atom bombardment mass spectrometry. PMID- 3544954 TI - Digoxin homogeneous enzyme immunoassay using high-performance liquid chromatographic column switching with amperometric detection. PMID- 3544955 TI - Automated flow injection spectrophotometric determination of zinc using zincon: applications to analysis of waters, alloys and insulin formulations. PMID- 3544956 TI - Adenosine 5'-triphosphate (ATP) concentration and acrosin activity in human spermatozoa. Their relation with the sperm penetration assay (SPA). AB - Fertility of men depends on the quality of semen. The aim of the present paper is to determine both the acrosin activity by radioimmunoassay and ATP concentration by bioluminescence in human spermatozoa, and evaluate these results in those samples with normal or low sperm penetration according to SPA test. Ejaculates obtained from 42 untreated men, were studied one hour after the obtention. These materials were divided into two groups:20 human semen samples with "in vitro" potentiality to penetrate zone-free hamster ova, between 15% to 98% and 22 human semen with SPA test between 0% to 14%. When we compare the group with normal penetration response vs that group with low or absent penetration ones, a significant decrease of ATP and acrosin concentrations was observed (P less than 0.001). Nevertheless no significant difference was observed in relation with percentage of motility, volume (ml), sperm concentration (10(6)/ml), percent of quick progressive spermatozoa and number of gametes capable of migrating into the medium layer (10(6)), between the group with low or absent penetration test against that one with normal zona-free hamster egg test. PMID- 3544958 TI - Calcium channel blocking drugs and anesthetics: is the drug interaction beneficial or detrimental? PMID- 3544957 TI - Pain relief after major abdominal surgery: a double-blind controlled comparison of sublingual buprenorphine, intramuscular buprenorphine, and intramuscular meperidine. AB - In a double-blind randomized study of three groups of 18 patients scheduled for major abdominal surgery the efficacy and side effects of sublingual buprenorphine were tested and compared to intramuscular meperidine and buprenorphine. Single doses of either 75 mg of meperidine, 0.4 mg of sublingual buprenorphine, or 0.3 mg of intramuscular buprenorphine were used. Patients given buprenorphine as sublingual tablets were significantly more conscious in the immediate postoperative period (Glasgow Coma Scale) than when given buprenorphine or meperidine intramuscularly. Median pain intensity differences (PID) showed equal pain relief, whereas the summarized pain intensity differences (SPID) were significantly higher in the intramuscular buprenorphine group compared to the meperidine group. Three cases of respiratory acidosis in the meperidine group required IPPV treatment, and one case in the intramuscular buprenorphine group required treatment. Sedation and nausea were the most common side effects in all three groups. We conclude that sublingual buprenorphine is useful for relief of postoperative pain and exhibited administrative advantages, when the patients were able to cooperate. PMID- 3544959 TI - Human T-cell lymphotropic virus type III (HTLV-III) infection: how it can affect you, your patients, and your anesthesia practice. AB - The effects of the current HTLV-III epidemic are of considerable significance to the general public and health care system. It is a new disease with diverse ramifications . . . not all of which are understood. Many drugs are being evaluated in clinical trials, but at present, they are not expected to be able to rid an infected individual of HTLV-III. There is hope for an effective vaccine, but its development is not anticipated in the near future. For now, prevention of exposure is our only means of decreasing HTLV-III transmission. We will be caring for increasing numbers of patients with HTLV-III infection. Some of these patients will have AIDS or ARC. However, a much larger pool of patients will have asymptomatic, unrecognized HTLV-III infections. Therefore, all of our patients should be treated with good hygienic practices. Appropriate guidelines can help insure our safety as well as that of our patients. The evidence is overwhelming that HTLV-III is spread sexually, by injection of contaminated blood, and from mother to fetus. Our highest personal risk for becoming infected with HTLV-III is by parenteral introduction via contaminated needles or other sharp objects. We must realize that despite the routine close contact with blood and body secretions of patients inherent to our profession, we are at little risk for becoming infected. Furthermore, with care and vigilance, we can protect our patients from risk of infection with not only HTLV-III, but a wide variety of other infectious agents as well. PMID- 3544960 TI - Naloxone therapy in spinal trauma: anesthetic effects. PMID- 3544961 TI - [O2 transport as a criterion of the efficacy of artificial pulmonary ventilation using positive end-expiratory pressure in traumatic shock patients]. PMID- 3544962 TI - [Delayed hypersensitivity to anti-tissue and bacterial antigens in the posttraumatic period]. PMID- 3544963 TI - [Effect of artificial pulmonary ventilation using intermittent positive and negative pressures in the pleural cavity on gas exchange efficiency in the isolated heart-lung preparation]. PMID- 3544964 TI - [Comparative study of 3 types of artificial pulmonary ventilation during operations for aneurysm of the thoracic aorta]. PMID- 3544965 TI - Epinephrine: systemic effects and varying concentrations in local anesthesia. AB - The range of vasoconstrictors available for use with local anesthetics in dentistry has been reviewed with emphasis on epinephrine and its physiological effects. All of the vasoconstrictors reviewed provide satisfactory results in dental anesthetic solutions when administered in appropriate concentrations and volumes. Possible drug interactions of concern to dentists include the use of vasoconstrictors with inhalational anesthetics, tricyclic antidepressants, beta blockers and, possibly, phenothiazines. Data reviewed indicates that the amounts of epinephrine used in dentistry can result in significant elevations in circulating levels of ephinephrine and concomitant physiologic changes. Evidence reviewed suggests that 1:200,000 epinephrine concentration results in optional duration and depth of local anesthesia. With the potential for adverse effects from epinephrine concentrations that are needlessly increased, it appears that in most clinical situations a 1:200,000 concentration of epinephrine can be used in an efficacious manner. PMID- 3544966 TI - New perspectives on the function of coronary artery spasm in acute myocardial infarction: the thromboischemic reentry mechanism. A review of 10 years research on the pathophysiology of AMI. AB - Research during the last ten years into the pathophysiology of acute myocardial infarction (AMI) has made it gradually clearer that this is a phasic event. A number of independent authors have made this conclusion quite obvious. The authors of this review suggest that the alternating sequence of coronary spasm and dilatation should be described as the "thromboischemic reentry mechanism," which itself leads to waves of reperfusion, producing characteristic episodic changes in some of the parameters of AMI. The spasms are brought about by substances let loose from aggregating platelets. Metabolites released during the concomitant ischemia lead the vessel from spasm to dilatation. Following thrombolytic treatment, the 'staccato' signs of myoglobinemia disappear, because of the withdrawal of the spasmogenic products of the platelets. It could also be shown that the concentration of myoglobin in the serum as a result of the dilating effect of calcium antagonists is twice the mean maximum value that the myoglobin time curve would show without such treatment. PMID- 3544967 TI - An angiographic dilemma: bronchopulmonary sequestration versus pseudosequestration: case reports. AB - Bronchopulmonary sequestration is a congenital anomaly in which part of the pulmonary tissue is detached from the normal lung and is supplied by anomalous systemic arteries. The sequestered, aberrant lung tissue does not have normal connections with the tracheobronchial tree or pulmonary arteries. In some patients with angiographic characteristics of this disorder, no sequestration is found at the time of surgery. We present three cases in which systemic arterialization of a portion of lung occurred without actual sequestration. Such cases of pseudosequestration can present a diagnostic challenge preoperatively and should be considered whenever angiographic findings compatible with bronchopulmonary sequestration are found. PMID- 3544968 TI - Titrated extract of Centella asiatica (TECA) in the treatment of venous insufficiency of the lower limbs. AB - Ninety-four patients suffering from venous insufficiency of the lower limbs participated in a multicenter, double-blind versus placebo study. After randomization, they were allotted for a treatment period of two months to one of three groups: TECA 120 mg/day, TECA 60 mg/day, or placebo. A significant difference (p less than 0.05) in favor of TECA was shown for the symptoms of heaviness in the lower limbs and edema, as well as for the overall evaluation by the patient. The venous distensibility measured by a mercury strain gauge plethysmograph at three occlusion pressures was improved for the TECA groups but aggravated for the placebo group. PMID- 3544969 TI - Salvage of ischemic myocardium by CLS 2210 in the dog: a preliminary double-blind study. AB - To assess whether a cardiac lymphagogue, CLS 2210, would reduce myocardial infarct size after coronary artery ligation, studies were performed in 14 dogs. The left anterior descending coronary artery was ligated in each dog, and the dogs were randomized to either placebo or CLS 2210 treatment, which was carried on for seven days. After seven days the animals were sacrificed and the volume of infarcted myocardium was determined macroscopically on a double-blind basis, supported by histologic examination. CLS 2210 treatment resulted in a highly significant reduction in the volume of infarcted myocardium (p less than 0.001). Since CLS 2210 is chemically and pharmacologically unrelated to hyaluronidase but shares an action with hyaluronidase as a cardiac lymphagogue, the results offer further support for a role of myocardial lymphatics in the evolution of myocardial necrosis following coronary artery occlusion and provide an explanation for the mechanism by which these agents reduce myocardial infarction size. PMID- 3544971 TI - IgG subclasses--a review. AB - Recognition that IgG consists actually of four subclasses has opened up a vast amount of knowledge regarding the biology of each subclass. Of particular interest has been the recognition that various antibodies are restricted to some subclasses. The possible role of IgG4 in immunization, desensitization, and allergy is being determined. IgG subclass deficiencies are being increasingly recognized, especially in association with infection. These patients can now be effectively treated. PMID- 3544970 TI - Refractory period to ultrasonic mist of distilled water: relationship to methacholine responsiveness, atopic status, and clinical characteristics. AB - Twenty asthmatic subjects had two successive methacholine challenges, two successive challenges with ultrasonically nebulized distilled water (UNDW) and an UNDW followed by methacholine on three separate days. Only ten subjects showed a refractory period to repeated UNDW stimulation. Prior stimulation with UNDW provoked increased methacholine responsiveness in the non-refractory group and a more rapid recovery from methacholine-induced bronchoconstriction in the refractory subset. PMID- 3544972 TI - [Methods of determination of selenium in biological matter]. AB - Main techniques used: graphite furnace atomic absorption direct or after preliminary treatment of the sample, graphite furnace atomic absorption by generation of hydrides, fluorometry, gaz chromatography, differential pulse voltammetry. The various quality criteria of these methods are compared as well as the usual values in the different biological fluids (whole blood, plasma, serum, erythrocytes, urine). PMID- 3544973 TI - [Conjugation of catecholamines: basic and physiopathological aspects]. AB - In man, the major portion of plasmatic and urinary catecholamines is found in a conjugated/sulfate form. The biological characteristics of the conjugates (formation sites, kinetics of appearance and disappearance from the plasma, genetic regulation, influence of biological factors) are different from those of the free forms. Physiopathological data show that the dosage conjugated catecholamines together with that of free amines, provides interesting informations on the integrative level of sympathetic activity and on the regulation of the catecholamines plasma concentrations by conjugation. In these two objectives, the dosage of DA sulfate proves very important. PMID- 3544974 TI - [Enzymuria]. AB - Study of enzymuria rises more and more interest in human pathology as a diagnosis parameter of renal diseases or as an index of nephrotoxicity. In this two fields, the literature demonstrated the interest of enzymes of the brush border of proximal tubuli (alanine amino peptidase, gamma glutamyl transpeptidase, alkaline phosphatase) and of lysosomal enzymes (beta glucuronidase and N acetyl beta D glucosaminidase). The authors analyse the problems limiting the present use of these methods: incomplete knowledge of enzyme of the different parts of the renal tissue and of the mechanisms of enzymuria (choice of enzymes and time periods for sampling); analytical problems referring to the study of enzymes in a complex medium (treatment and storage of samples, choice of adapted methods for activity measurement); at last the way of expression the results is still to be defined. PMID- 3544975 TI - [Contribution of Jacques Canal in the field of lipoproteins]. AB - The scientific works of J. Canal have essentially related to low density lipoproteins (L.D.L.), between 1.025 and 1.050. By using proteolytic enzymes and phospholipases, he is able to obtain informations on the accessibility of apolipoprotein B and phospholipids. So, as early as 1975, he expresses the hypothesis that only 30 p. cent of Apo B occupy a superficial position. In addition, he proposes the fact that Apo B has at least four antigenic determinants; this hypothesis formulated by J. Canal, almost 10 years ago, was recently confirmed by using monoclonal antibodies. At the same time, using phospholipases, J. Canal reaches the conclusion that phospholipids are localized on the surface of L.D.L. He demonstrates that phospholipids play a major role in the precipitation of L.D.L. by sulfate polysaccharides in the presence of L.D.L. by sulfated polysaccharides in the presence of divalent cations (Reaction of Burnstein). He proposes a mechanism for this reaction. This research on the mechanism of Burnstein's reaction will receive in clinical biochemistry an important application with the development of a completely original technique of dosage of total lipids in the serum. PMID- 3544976 TI - [Structure and metabolism of lipoproteins]. AB - Lipoproteins constitute in plasma a dynamic system allowing lipid transport. For this purpose, apolipoproteins play a very important part. They control and regulate lipid transfer between lipoproteins themselves and among cells, from their hepatic as intestinal synthesis sites to their hepatic as peripheral degradation sites. Enzymatic systems and specific receptors are involved to operate this metabolic pathway. PMID- 3544977 TI - [Catabolism of low-density lipoproteins via receptors and its regulation]. AB - Low density lipoproteins (LDL) are the main plasmatic carrier of cholesterol through the tissues. Their catabolism depends essentially on the presence of high affinity specific receptors on the surface of the cells. Every diminution, genetic (familial hypercholesterolemia) or acquired, of the LDL catabolism via the receptors, causes the acceleration of the formation of atheromatous lesions. The present review considers the main characteristics of the receptor, the mechanisms of the endocytosis of LDL, the different types of mutation affecting the catabolism of LDL in familial hypercholesterolemia, as well as certain data concerning the regulation of the catabolism of LDL via the receptors (hormonal effect, effect of AMP, of calcium and role of nutritional factors). PMID- 3544978 TI - [Methods for analyzing lipoproteins]. AB - In recent years there have been considerable advances and changes in the investigations available to study lipoprotein metabolic disorders. The methods used up to now were based on physicochemical criteria (electrophoresis, ultracentrifugation, polyanionic precipitation). But the recent demonstration of the preponderant role of apoproteins in lipoprotein metabolism makes it essential to develop a method of analysis lipoproteins at the molecular level. Immunological methods seem to be the most appropriate and should allow us to study lipoprotein metabolism more closely. PMID- 3544979 TI - [Dyslipidemias and coronary disease]. AB - Several genetic studies have established the strongly atherogenic nature of some primary hyperlipoproteinemias. Most important of these are Fredrickson's type II (essential familial hypercholesterolemia) and type III (dysbetalipoproteinemia). Several epidemiological studies have established a strong positive relationship between the cholesterol level and coronary artery disease. This correlation was seen in studies on subjects from various population groups, as well in subjects from the same population group. Of all the circulating lipoproteins, the low density lipoproteins (LDL) are the most atherogenic. Their accumulation in the plasma results from an incomplete recognition between their protein, apoprotein B100 (apo B100) and their specific cell receptor, whose job it is to remove the LDL's from the plasma. Recent studies have shown the usefulness of measuring plasma apoprotein concentrations, especially apo B100, apo Al and apo E, as predictors of coronary artery disease. It is possible that in the future, studies of their genetic polymorphism will give us a better understanding of the relationship between plasma lipids and atherosclerosis. This relationship remains for the moment only a quantitative one. Finally, from a therapeutic point of view, recent studies have proved the efficacity of treating hypocholesterolemia, in the prevention of coronary artery disease. This underlines the importance of diagnosing and treating hypercholesterolemia. PMID- 3544980 TI - [French Society of Anesthesia and Intensive Care. List of members as of 1 January 1986]. PMID- 3544981 TI - [Acute respiratory distress syndrome in adults in colchicine poisoning]. AB - Two cases of adult respiratory distress syndrome were treated in a series of 26 patients suffering from colchicine overdose. The syndrome appeared between the 24th and 72nd hours. It was characterized by the presence of interstitial as well as alveolar oedema seen on chest roentgenograms. Haemodynamic investigation showed a hyperkinetic state with moderate precapillary pulmonary arterial hypertension. In addition, multivisceral phenomena were observed in all cases. Post-mortem examination revealed interstitial and alveolar pulmonary oedema with haemorrhagic or macrophagic alveolitis often accompanied by hyaline membrane. The physiopathology of ARDS occurring in colchicine poisoning appeared to involve such different factors as infection, the presence of a state of shock and disseminated intravascular coagulopathy. The direct toxic action of colchicine on pneumocyte microtubules and the inhibition of surfactant production were a probable cause. The responsibility of colchicine in leukocyte aggregation remains to be determined. PMID- 3544982 TI - The effectiveness of nalbuphine and hydroxyzine for the emergency treatment of severe headache. AB - The present treatment for acute attacks of headache is empiric. Intramuscular nalbuphine (Nubain) and hydroxyzine (Vistaril) were assessed for pain relief in a prospective, double-blind clinical trial. Ninety-four patients were assigned randomly to treatment groups receiving nalbuphine 10 mg, nalbuphine 10 mg plus hydroxyzine 50 mg, hydroxyzine 50 mg, or placebo. The treatment groups were found to be adequately homogenous with regard to age, sex, type and duration of headaches, and history of prior narcotic use. All data were analyzed by one-way analysis of variance. Patients who had headaches diagnosed as other than classic migraine had significantly greater pain relief with nalbuphine compared to placebo (P less than .01). The combination of nalbuphine and hydroxyzine was not significantly more effective than other treatment groups. In 20 patients with classic migraine, none of the treatment regimens significantly outperformed placebo. There were no clinically significant adverse effects attributed to the study drugs. These findings are similar to others that showed a lack of efficacy of kappa receptor agonists in classic migraineurs. Nalbuphine appears to be clinically useful in other types of severe headache. This study does not support the routine addition of hydroxyzine for presumed synergistic effect. PMID- 3544984 TI - Severe impairment in lung function induced by high peak airway pressure during mechanical ventilation. An experimental study. AB - We explored the pulmonary effects of continuous mechanical ventilation (MV) at a peak inspiratory pressure of 50 cm H2O in healthy, paralyzed, and anesthetized adult sheep during a period of 48 h. The 9 control sheep (Group A) were ventilated with 40% oxygen at a tidal volume of about 10 ml/kg and a peak inspiratory pressure of 15 to 20 cm H2O. All these animals remained stable throughout the 48 h of MV with no change in lung function. The 7 sheep in Group B were ventilated with 40% oxygen using a pressure-controlled ventilator at 50 cm H2O peak inspiratory pressure, at a VT of 50 to 70 ml/kg. All sheep in Group B developed severe respiratory failure and died or were killed within 2 to 35 h, and showed parenchymal consolidation at autopsy. The 9 sheep in Group C were ventilated as in Group B, except that 3.8% CO2 was added to the inspired gases: the Group C animals deteriorated more slowly, with little change in PaO2 but with a severely reduced FRC, VT, total static lung compliance, and grossly abnormal lungs at autopsy. We conclude that in this model, mechanical ventilation at peak airway pressure of 50 cm H2O will lead to progressive impairment in pulmonary mechanics, lung function, acute respiratory failure, and alveolar cellular dysfunction, as demonstrated by highly abnormal minimal surface tension values of saline lung lavage fluid in both study groups. PMID- 3544983 TI - Effect of positive end-expiratory pressure on right and left ventricular function in patients with the adult respiratory distress syndrome. AB - The predominant mechanism of the cardiac output reduction associated with positive end-expiratory pressure (PEEP) is unclear. Reported possibilities include decreased systemic venous return, increased pulmonary vascular resistance, or change in ventricular contractility. We investigated this question by studying 9 patients with the adult respiratory distress syndrome (ARDS) during PEEP application. We used an equilibrium radionuclide angiography method modified for improved right ventricular imaging to evaluate changes in left and right ventricular volume and contractility. Thermodilution cardiac output and stroke volume progressively declined (27 and 33% mean decrease, respectively) with increasing increments of PEEP. Right and left ventricular end diastolic counts, reflecting volume, also progressively diminished as PEEP increased (38 and 27% mean decrease in RV and LV counts, respectively; p less than 0.001 for both ventricles). A slight upward trend in ejection fraction was found for both ventricles. These findings support the concept that during PEEP application the reduction in cardiac output is due to biventricular reduction in blood volume. This biventricular volume reduction is compatible with either preload reduction to both ventricles because of impeded venous return or to change in ventricular configuration caused by external compression of both ventricles. PMID- 3544985 TI - Hyporesponsiveness to aerosolized but not to infused methacholine in cigarette smoking dogs. AB - Seven beagles were exposed via a tracheostomy to smoke from 10 cigarettes/day, 5 days/wk for 10 months; 2 other dogs were exposed for 6 months only. Four dogs served as sham-exposed control animals. Mucus was collected 2 times/wk prior to and during the exposure period by resting a cytology brush on the lower trachea for 2 to 5 min. At least once prior to and as often as 3 times during exposure, transpulmonary pressure and flow were monitored under anesthesia to determine resistance RL. Two airway responses to methacholine were determined: the infusion response delta Ri, the increment in RL 4 to 6 min after infusion of 4 micrograms/kg/min, and the aerosol response delta Ra, the increment in RL 2 min after aerosolization of 2 mg/ml, the highest common dose reached. Eight of 9 smoking dogs developed persistent mucus hypersecretion. In 5 dogs, tracheal mucus flux increased 5- to 10-fold; in 3 dogs, the increase was 2 to 3 times that of control animals. One of the sham-exposed dogs developed moderate hypersecretion. After 10 months of smoke exposure, delta Ri increased to 2.24 times that of the initial value (+/- 0.47 SE) (n = 7, p less than 0.05), whereas delta Ra decreased to 0.28 times that of the control value (+/- 0.21 SE) (n = 6, p less than 0.02). The difference between aerosol and infusion response, delta Rai = delta Ra - delta Ri, is an index of relative hyporesponsiveness to methacholine aerosol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3544987 TI - Methacholine availability for bronchial challenge testing. PMID- 3544986 TI - The bronchial circulation. Small, but a vital attribute of the lung. PMID- 3544988 TI - The value of a combined study of carotid duplex ultrasound and oculopneumoplethysmography (OPG-Gee) in the diagnosis of carotid artery stenosis. AB - Two hundred consecutive carotid arteries were examined with the carotid duplex ultrasound and oculopneumoplethysmography (OPG-Gee) and compared with conventional arteriograms. The arteries were graded as normal, mildly stenotic (less than 50%), moderately stenotic (around 50%), severely stenotic (50% to 99%), or occluded. There was exact correlation between the duplex and the arteriogram as to disease severity in 70.5 per cent, good correlation in 25.5 per cent, and poor correlation in 4 per cent. When the carotid duplex was combined with an OPG-Gee, the exact correlation was 76.5 per cent, good correlation was 21 per cent, and poor correlation was 2.5 per cent. The diagnostic sensitivity of the carotid duplex alone was 95.6 per cent, diagnostic specificity was 84.3 per cent, false-positive rate was 16.2 per cent, false-negative rate was 4.2 per cent, and overall accuracy was 89.5 per cent. When the carotid duplex was combined with an OPG-Gee, the diagnostic sensitivity was 96.7 per cent, diagnostic specificity was 92.6 per cent, false-positive rate was 8.2 per cent, false-negative rate was 2.9 per cent, and overall accuracy rate was 94.5 per cent. In conclusion, when the carotid duplex was combined with an OPG-Gee, there was improvement in the exact correlation (70.5% to 76.5%), the overall accuracy (89.5% to 94.5%), and the diagnostic specificity (84.3% to 92%). The status of 15 arteries was also changed, either from moderate to mild stenosis or from possible occlusion to normal. PMID- 3544989 TI - Noninvasive differentiation of carotid artery occlusion from high-grade stenosis. AB - The differentiation of high-grade carotid artery stenosis from occlusion can be a difficult but important diagnostic dilemma. The authors used a combination of duplex scanning, pulsed spectrum analysis, audible analysis of continuous wave doppler signal, and peri-orbital doppler compressions to accurately differentiate high-grade stenosis from occlusion in a series of 24 patients. PMID- 3544990 TI - Noninvasive evaluation of peripheral vasculature following regional hyperthermic chemotherapeutic perfusion (RHCP). AB - Regional hyperthermic chemotherapeutic perfusion (RHCP) has been used to treat over 1000 patients with advanced melanoma and soft tissue sarcoma. This study analyzes the impact of RHCP on the peripheral vasculature. Forty-one patients (23 women, 18 men) with an average age of 51.3 years were treated by RHCP of an upper or lower extremity using phenyalanine mustard for 60 minutes at a mean extremity temperature of 40 C. Patients were examined preoperatively and postoperatively at 36 hours, 7 days, 1 month, and 6 months by noninvasive arterial (Doppler-resting analog velocity waveform, response to stress) and venous (Doppler, impedance plethysmography [IPG], phleborrheography [PRG]) measurements. Upper-extremity evaluation of 14 patients (9 women, 5 men) indicated no abnormal studies. Response to stress showed an increase of the brachial:distal vessel ratio of 0.1 +/- 0.05; tendency of the analog velocity waveform toward triphasic; and response to stress augmented by 0.18 +/- .03 at 36 hours. Lower-extremity evaluation of 27 patients (15 women, 12 men) indicated two with thrombophlebitis. Response to stress showed an increase of the ankle: brachial ratio of .016 +/- 0.04; change in the analog velocity waveform toward triphasic; and response to stress augmented by 0.08 +/- 0.08 at 36 hours. All measurements returned to preoperative values at 7 days. Results of this study indicate RHCP has no long-term adverse effect on the vasculature of the extremity, as monitored by the noninvasive blood flow studies. PMID- 3544991 TI - [Simple renal cysts in childhood]. AB - Simple renal cysts are infrequently diagnosed in children. Technique improvements in pediatric uroradiology lead to more frequent recognition. Authors review urographic and ultrasound studies of five simple renal cysts in children, between two days and seven years, seen during the last five years. PMID- 3544992 TI - [Triad syndrome in the neonatal period: an anatomoclinical study of 11 cases]. AB - Eleven newborn children with clinical and anatomic characteristics of Prune-Belly syndrome were studied. This establish an approximate incidence of 1:28,000 newborns. All these children died in the first-days of life, nine of them as a result of pulmonary hypoplasia secondary olygohydiamnios. All of them except one had urinary tract dilatation and in four anatomic stenosis of urethra was found as the cause of obstruction. These findings support mechanical theory more than a primary mesodermic disorder as a pathogenic mechanism. All this, together with establishment of an early prenatal diagnosis, opens the possibility of an intrauterine treatment which could free the urinary tract and prevent oligohydramnios and its, sequelae. PMID- 3544993 TI - Osteoporosis in men with idiopathic hypogonadotropic hypogonadism. AB - To assess the effect of testosterone deficiency on skeletal integrity in men, we determined bone density in 23 hypogonadal men with isolated gonadotropin releasing hormone deficiency and compared those values with ones from controls. Cortical bone density, as assessed by single-photon absorptiometry of the nondominant radius, ranged from 0.57 to 0.86 g/cm2 (mean +/- SE, 0.71 +/- 0.02) in patients with fused epiphyses and from 0.57 to 0.67 g/cm2 (mean, 0.61 +/- 0.01) in patients with open epiphyses, both of which were significantly (p less than 0.001) lower than normal. Spinal trabecular bone density, as assessed by computed tomography, was similarly decreased (p less than 0.0001) and ranged from 42 to 177 mg K2HPO4/cm3 (mean, 112 +/- 7). Cortical bone density was at least 2 SD below normal in 16 of 23 men, and 8 men had spinal bone densities below the fracture threshold of 80 to 100 mg K2HPO4/cm3. Osteopenia was equally severe in men with immature and mature bone ages, suggesting that abnormal bone development plays an important role in the osteopenia of men with idiopathic hypogonadotropic hypogonadism. PMID- 3544994 TI - Cyclosporine nephrotoxicity without major organ transplantation. PMID- 3544995 TI - Sleep disorders: sleep apnea and narcolepsy. AB - Symptoms of obstructive sleep apnea, a potentially life-threatening disorder, include excessive daytime sleepiness and sleep attacks, nocturnal breath cessation, and snorting and gasping sounds. These symptoms usually become manifest before age 40 and cluster within a few years. Most patients are obese, hypertensive men who eventually develop cardiovascular abnormalities. If sleep apnea is suspected based on clinical information, a sleep laboratory evaluation is indicated. For severe obstructive sleep apnea, tracheostomy is the most effective treatment. Narcolepsy, another sleep disorder, is a life-long and usually disabling condition. In most narcoleptic patients the first symptoms develop during childhood or adolescence, yet many years pass before the proper diagnosis is made. The presence of sleep attacks together with auxiliary symptoms, particularly cataplexy, is diagnostic. Treatment of narcolepsy includes stimulants in combination with therapeutic naps for sleep attacks and tricyclic drugs for cataplexy. PMID- 3544996 TI - The literature of American internal medicine: a historical view. AB - The literature of medicine is shaped by social and intellectual forces as well as by scientific discoveries. In America, the literature of internal medicine evolved gradually in response to changes in the structure and philosophy of medical education and the growing emphasis on research during the past century. When careers in medical education and research became possible through philanthropic and government support, Americans became more productive in research. As academic advancement came to depend primarily on publication, the literature of American internal medicine expanded dramatically. The current scope and character of the medical literature also reflect the persistent trend toward specialization and subspecialization that began more than a century ago. Although medical journals have been the most important medium for the publication of new medical knowledge for nearly 200 years, recent dramatic advances in the technology of information storage and transfer promise to undermine their primacy. PMID- 3544997 TI - Seeking the just price: constructing relative value scales and fee schedules. AB - Many conceptual issues underlie the current policy debate over how to reform the fee-for-service method of paying physicians, including the development of a relative value scale for physicians' services and the relationship between a relative value scale and a fee schedule. We consider the relationship between fees and costs and the criteria for judging whether a fee is appropriate or right and then propose a two-step process for constructing a relative value scale. A fee schedule based on a relative value scale is the most practical way to reform the current fee-for-service system and makes the most sense from both clinical and economic viewpoints. PMID- 3544998 TI - Needed: review articles with more scientific rigor. PMID- 3544999 TI - Intestinal infections with Aeromonas. PMID- 3545000 TI - [A method of venous study by real time ultrasonography associated with directional and continuous Doppler ultrasonography]. AB - The authors propose a method of investigation of the superficial and deep venous axes of the limbs, neck, abdomen and pelvis by using successively directional and continuous wave Doppler and real time high resolution echotomography. The principle is to recognise normal and pathological venous flow by the Doppler technique and to detect the intrinsic (thrombus, agenesis) or extrinsic abnormalities causing local haemodynamic disturbances or distal emboli even in the absence of flow disturbance by echotomography. If the suggested protocol is strictly observed, the method allows diagnosis of the majority of pathologies, not only their haemodynamic consequences but also the underlying causes. PMID- 3545001 TI - [Thrombocytopenia induced by heparin. Diagnosis, treatment, physiopathology: current concepts]. AB - Iatrogenic thrombocytopenia is a rare, but severe complication of treatments with heparin and heparinoids. Mean temporary thrombocytopenia failing to show any complications are usually diagnosed as quite different from acute and delayed thrombocytopenia of which severity depends mainly on thrombotic symptoms demonstrated in 65 p. 100 of cases; the initial evolution of an average thrombocytopenia is not easy to diagnose; it may as well exist a connection between the two diseases, from a physiopathogenic point of view. The diagnosis of severe thrombocytopenia depends:--clinically, on the initial data, delayed as compared with the heparin treatment beginning and existence of arterial and/or venous thrombosis;--biologically, by demonstrating an aggregating activity for platelets in presence of heparin, in the patient plasma. Such an activity requires the suppression of standard heparinotherapy as well as the choice of substitutive anticoagulant treatment in case of evolutive thrombosis. Low molecular weight heparins are prescribed only if in vitro tests of platelet aggregation with the patient's plasma are negative. Antivitamins K are to be used as soon as possible alone or combined with heparin fractions. Antiaggregants are prescribed alone, above all in case of isolated thrombocytopenia and combined with AVK. Treatment of thrombotic complications depends on surgical disobstruction if arterial thrombosis, and use of fibrinolytics if pulmonary embolisms. The acute reaction of some thrombocytopenia to heparin as well as therapeutic difficulties demonstrate the efficiency of an early diagnosis performed thanks to systematic platelet numerations during the first 15 days of a treatment with heparin, as well as to the prevention along with systematic association with aspirin, especially if replaced with AVK. PMID- 3545002 TI - [Low-molecular weight heparins. Prospects in 1985]. AB - Interaction of low molecular weight heparin (LMW-Hep) along with coagulation system is characterized through an increase of the proportion between activity anti-Xa and anticoagulation activity. In animals, their antithrombotic role can be compared with the heparin one. Longer life of the biological effect (close to 100 p. 100) enables to act subcutaneously as well as to reduce posology: only one injection is then required so as to prevent from post-operative thrombosis. There are neither method nor international standard to control preparations efficacy. At the moment, posologies are better to be expressed in mg. Trials are assessed in the treatments of thrombosis with results increasing therapeutic efficacy. Too high posologies did supply hemorrhagic syndromes in surgical patients. A biological survey is thus required. As usual tests, such as "time" of cephalin are slightly sensible to LMW-Hep, only anti-Xa activity can be used. LMW-Hep with a low anticoagulant action thus demonstrate a new concept of antithrombotic therapy. PMID- 3545003 TI - [Thrombolytic treatment in the acute phase of myocardial infarction. Evaluation in 1986]. AB - Fibrinolytic therapy is effective in reducing the extent of myocardial infarction by lysing intracoronary clots. An overview of twelve trials of prolonged intravenous infusion of SK showed a highly significant reduction in short term mortality. Intra coronary SK infusion achieved reperfusion of the coronary artery in 60 to 90 p. 100 of patients and improvement of left ventricular function was reported. Mortality was also significantly reduced at 6 months. The frequency of bleeding was relatively low and ventricular arrhythmias were not a serious problem. High dose brief duration intravenous SK therapy achieved reperfusion of the occluded coronary artery in 44 to 60 p. 100 of patients. Left ventricular function was also improved. An Italian multicentre trial has shown a significant decrease in the overall hospital mortality of a randomized population. There is no evidence that UK was more effective than SK. New fibrinolytic agents (T-PA, acylated SK-plasminogen activator), with more fibrin specific activity, were successful in inducing coronary thrombolysis in patients with acute myocardial infarction. The rate of reocclusion was about 20 p. 100 and additional stabilising procedure (percutaneous transluminal coronary angioplasty) was necessary in many patients. PMID- 3545004 TI - [Recent insulin-dependent diabetes: at least 2 daily injections with self controlled blood sugar]. PMID- 3545005 TI - [Corticoids and plasma exchange in autoimmune bullous dermatoses]. PMID- 3545006 TI - [Methylprednisolone and plasma exchange in renal allograft rejections]. PMID- 3545007 TI - [Corticotherapy and plasma exchange in systemic lupus erythematosus]. PMID- 3545008 TI - [20-year development of a case of anorexia nervosa seen through an analysis of the patient's drawings]. PMID- 3545009 TI - [Limits and uncertainties of borderline states. The example of drug addictions]. PMID- 3545010 TI - [A borderline couple. Family interactions and pictorial analysis]. PMID- 3545011 TI - Publication trends for alcohol, tobacco, and narcotics in MEDLARS. PMID- 3545012 TI - Human teratogens: how can we sort them out? PMID- 3545013 TI - Environmental agents and birth outcomes. PMID- 3545014 TI - The fragile X syndrome. PMID- 3545015 TI - Nutritional taurine and central nervous system development. PMID- 3545016 TI - Cerebral palsy: what is known regarding cause? PMID- 3545017 TI - Maternal health during childhood and later reproductive performance. PMID- 3545018 TI - Infantile lobar emphysema. AB - Infantile lobar emphysema is a symptom complex representing a spectrum of diseases characterized by overdistention of a pulmonary lobe by a check valve mechanism. The earlier in life infantile lobar emphysema presents, the more severe are the symptoms. Half of the cases appear in the first 4 weeks of life. The chest radiograph is the best diagnostic tool but can be misinterpreted. Computed tomography sometimes discloses the cause, which appears to be bronchial obstruction in 25% of cases. The bronchial obstruction may be due to intrinsic defects or to extrinsic compression. Bronchoscopy should be performed only in certain cases and then only with careful anesthetic management. PMID- 3545020 TI - Management of infants with prenatal ultrasound diagnosis of airway obstruction by teratoma. AB - We report a case of a cervical teratoma that was diagnosed prenatally. In anticipation of potential upper airway obstruction, resources were mobilized to the operating room at the time of planned cesarean section. The neonate developed respiratory distress, and her airway was secured. There was no evidence of cerebral anoxia initially, and she is currently thriving with no central or peripheral neurologic defects. As prenatal diagnosis by ultrasound becomes more refined, the otolaryngologist will play an increasing role in perinatal decision making and anticipated emergencies at the time of delivery. Airway obstruction of various causes will be the most urgent problem. PMID- 3545019 TI - Synergistic effects of sequential carbon dioxide and neodymium:yttrium aluminum garnet laser injuries. Experimental observations and measurements. AB - The carbon dioxide and neodymium:yttrium aluminum garnet lasers have well documented but characteristically different biological effects, yet little is known about their cumulative, synergistic, or paradoxical effects when used sequentially on living tissue. Using a Merrimack ML 880 laser, a series of superimposed CO2 and Nd:YAG lesions in various combinations were produced on the undersurface of dog tongues. Therapeutic time and power settings were chosen and the number of applications varied, with suitable controls. Observations and measurements were made on acute, healing, and healed lesions. All lesions were excised and submitted for routine hematoxylin and eosin histology. Acute lesions were also assessed for cell viability using rhodamine 123 as a supravital marker. The results show that, even though all the lesions eventually heal, the actual cell damage produced by the Nd:YAG laser is much more than is suggested by the size of the acute lesion. This cell damage can be reduced by the surface carbonization produced by initial application of the CO2 laser. Higher surface temperatures are reached in this combination with less fibrosis and scarring than equal energy counterparts where the Nd:YAG laser was applied first. The knowledge of these synergistic effects can be used to advantage in the clinical setting. The rhodamine 123 technique also appears to be a valid measure of acute thermal tissue injury. PMID- 3545021 TI - Variants of Mobius' syndrome and central neurologic impairment. Lindeman procedure in children. AB - Mobius' syndrome is a complex neurologic disorder; its etiology and characterization have eluded clinicians for over a century. The pure Mobius' syndrome is rare, and the involvement of the sixth and seventh nerves has been found to have a host of associated defects. These include limb and shoulder abnormalities; multiple cranial nerve defects; occasional mental retardation; external, middle, and inner ear abnormalities; laryngeal neurologic defects that cause stridor, obstruction, and aspiration; and severe dysphagia and associated aspiration with life-threatening pneumonias. The children with severe neurologic dysfunction from central nuclear deficiencies were in many respects so similar in their clinical course that they are included in this paper. All of the patients required a tracheotomy to support the airway and to permit tracheobronchial toilet. A feeding gastrostomy was necessary in all but one patient. To counter life-threatening aspiration in the patients with multiple CNS defects, the Lindeman laryngeal diversion was considered the procedure of choice and proved very effective. The details and problems of this procedure are discussed. The aural defects and laryngeal findings in this series of patients are described in detail. PMID- 3545023 TI - [Dermatoses caused by intolerance to metals of osteosynthesis materials and prostheses (nickel, chromium, cobalt)]. PMID- 3545022 TI - [Orf: recontamination 8 months after the original infection. Review of the literature apropos of a case]. AB - Frequent in France among domesticated sheep and goats, contagious pustular dermatitis of the sheep is called Orf when it occurs in man. The authors present a case of recontamination in a woman farmer of the Cher department (Central France), who had been bottle-feeding lambs affected with the zoonosis. This 71 year old woman developed papules, then papulopustules on the ulnar aspect of her hands and wrists (fig. 1). Within a few days, these lesions were 1.5 to 2 cm in diameter and surrounded with a severe inflammatory reaction. Two weeks later, the pustules became encrusted. Electron microscopy of a fragment of lesion demonstrated the virus. Cure was observed after 3 weeks. Eight months later, however, lesions identical with the previous ones appeared on the 4th finger and on the median aspect of the right wrist, corresponding to excoriations caused by nibbling from the lambs. The eruption was accompanied with fever which persisted for one month. In this patient's farm, the disease was present for the first time and affected only 2-month old lambs in the form of numerous papulo-pustules located on the lips and later covered by hard and thick scabs. These lesions were also found on the tongue and palate of some animals (fig. 5), preventing them from taking any food. Vaccination resulted in rapid and dramatic regression of the enzootie. From a more general point of view, the clinical features and epidemiology of the disease are described comparatively in animals and man. The differential diagnosis is dealt with at the end of the article. The literature on the subject is reviewed (151 references). PMID- 3545024 TI - [Retinoids: pharmacology, biological effects, mechanisms of action and future prospects]. PMID- 3545025 TI - [Contact urticaria]. PMID- 3545026 TI - [Current data on Langerhans cells]. PMID- 3545027 TI - [Dermo-epidermal junction]. PMID- 3545028 TI - [Mycosis fungoides and radiotherapy. Value of the combination: total skin electron therapy and whole-body photon therapy]. AB - Between 1975 and 1983, 46 patients with mycosis fungoides (MF) were treated with radiotherapy. The patients were classified according to the Stanford system (table II) and to the TNMB system (table III). The superficial lesions were treated with total skin electron-therapy (TSE) (7), and the visceral and lymph node lesions received additional whole-body photon therapy (WBP) (7). The results are summarized in table I. Initial complete regression was obtained in 21 of the 46 patients; 15 had partial regression. At the moment, 11 are alive without any apparent lesion. There were 9 complete remissions in each of the stage I and stage II groups. In stages III and IVa groups the course of the disease was improved by the two types of irradiation combined. In stage IVb patients the leukaemia was not improved. The survival curves (fig. 1 to 6) offer a simplified representation of the factors responsible for a favourable course. PMID- 3545029 TI - [Lymphomatoid papulosis]. PMID- 3545030 TI - [Antinuclear antibodies: from biology to clinical medicine]. PMID- 3545031 TI - [Hydatid cyst fluid (Echinococcus granulosus) biochemistry. Influence of site on cyst permeability]. AB - Eleven metabolites were determined in 19 hydatid cyst fluids of variable size and localization, and in patients plasma before surgery. Specific indirect immunofluorescent antibody titration was carried out. Sodium (132 +/- 5.2 mmol/l), chloride (92.9 +/- 6.5 mmol/l) and bicarbonate (22.1 +/- 1.5 mmol/l) were found at the same concentration than in plasma. Potassium (5.4 +/- 0.3 mmol/l) and calcium levels (4.7 +/- 0.9 mmol/l) were higher than in plasma, and phosphate (0.1 +/- 0.03 mmol/l) decreased tenfold. Glucose (3.4 +/- 0.8 mmol/l), creatinine (39.3 +/- 7.2 mumol/l) and urea nitrogen (4.6 +/- 0.8 mmol/l) showed great variations. Cholesterol levels 0.06 +/- 0.03 mmol/l) were a hundredfold lower than in plasma. Total protein levels (0.34 +/- 0.09 g/l) were found at very low concentrations. Extra-pulmonary cysts showed significantly higher antibody titers than pulmonary cysts. No correlation was observed between the size of the cysts and the level of the immune response. Significant difference about the relative cholesterol concentration (cystic concentration/plasmatic concentration) was observed between pulmonary and extra-pulmonary cysts (respectively 0.0048 +/- 0.0032 and 0.018 +/- 0.01--p less than 0.05). No correlation was observed between the size of the cyst, or the corresponding levels of the immune response, and the cholesterol levels. The hypothesis of a greater membrane permeability in extra pulmonary cyst is discussed. PMID- 3545032 TI - [A new natural intermediate host of Echinococcus multilocularis in France: the muskrat (Ondatra zibethicus L.)]. AB - The musk rat is a natural intermediate host of Echinococcus multilocularis in the Territoire de Belfort (East France). Its role in a selvatic cycle is discussed. When hunted, it can transmit the parasite to man, through dog infection. PMID- 3545033 TI - Autotransfusion, an experience of seventy six cases. AB - The use of autotransfusion with a centrifugal cell washer in a series of 76 cases is reviewed. The requirement for bank blood is reduced in patients with major operative haemorrhage, although it does not appear to be able to provide the main source of blood replacement in such cases. The major impact of autotransfusion may lie in reducing the amount of blood that needs to be crossmatched for elective operations. Nevertheless in certain cases its use can be life saving. PMID- 3545034 TI - [Treatment of unstable angina. A randomized double-blind study of propranolol, diltiazem and molsidomine]. AB - A randomized, multicentric, double blind study attempted to compare in 41 patients hospitalized for unstable angina, the efficacy of diltiazem (D) 240 mg/day, propranolol (P) 160 mg/day and molsidomine (M) 8 mg/day. The patients included in the study presented one or several spontaneous angina episodes accompanied by a transient and significant lowering of ST and/or an inverted T wave without necrosis. The evaluation criteria were the occurrence of new angina pain and electrical alterations on a continuous Holter for 5 days. 11 patients received diltiazem, 13 patients received propranolol and 15 patients received molsidomine (including an early death). Clinically, the number of painful episodes per day and per patient goes, in an average, from 1.2 to 0.23 diltiazem, from 2.2 to 0.44 for propranolol and from 2.2 to 0.45 for molsidomine. Pain disappeared on the 5th day in 54.5 per cent of patients under diltiazem, 58.8 per cent of patients under propranolol and 53.5 per cent of patients under molsidomine. Electrically, the number of ischemic accidents per day and per patient was 0.45 under diltiazem, 2.12 under propranolol (0.53 in excluding one patient with latent angina) and 0.81 under molsidomine. The number of patients without any ischemic accident was 63.6 per cent under diltiazem, 53.8 per cent under propranolol and 40 per cent under molsidomine. In conclusion, diltiazem, propranolol, and molsidomine have a comparable efficacy in unstable angina. The association of these medications could have a synergistic effect. PMID- 3545035 TI - Current topics in neurosurgery. Dedicated to Professor Stig H.M. Nystrom. PMID- 3545036 TI - Treatment of low-grade cerebral astrocytoma: new methods and evaluation of results. AB - Seventeen patients with low-grade cerebral gliomas, fourteen of them low-grade astrocytomas, were operated using CT/ultrasound-guided operative technique. The mean age of the patients was 34 years, and the mean follow-up time 13 months. The patients usually presented with symptoms of headache and/or epilepsy. Craniotomy was performed, and all lesions could be visualized as hyperechogenic masses using intraoperative ultrasound imaging. This paper describes the preliminary results of treatment with conventional resection methods, and discusses methods which could be readily adapted to the CT/ultrasound-based imaging system: CO2 and Nd YAG laser, ultrasound aspirator, intense focused ultrasound lesioning and immunotherapy with monoclonal antibodies. Finally the evaluation of treatment results with quality of life studies is suggested, especially for longitudinal follow-up of patients treated with alternative therapeutic methods. The role of quality of life studies is particularly important in assuring the longest and most useful survival of patients with small low-grade cerebral tumors. PMID- 3545037 TI - Application of ultrasound imaging to stereotactic brain tumor surgery. AB - This report describes the first application of intraoperative ultrasound to the stereotactic removal of subcortical brain tumors, here specifically applied to the Kelly system for stereotactic computer-controlled laser resection. The feasibility of ultrasound control of such procedures was demonstrated in the two cases of resection of cerebral astrocytoma presented in this paper. The chief benefits of ultrasound imaging seem to be the supplementary data it gives on the tumor itself, and the possibility of real-time imaging to follow the effects of tumor removal at successive stages of the procedure. PMID- 3545038 TI - Three-dimensional ultrasound imaging of brain for neurosurgery. AB - The ultrasound study group at the Departments of Neurosurgery and Electrical Engineering, University of Oulu, has worked since 1980 on the development of ultrasound holographic B (UHB) imaging for clinical use. It has produced images of human brain based on synthetic focusing of data obtained by wide-angle nonfocused transducers. At the same time, clinical ultrasound B-imaging has been applied to brain and spinal cord surgery. On the basis of laboratory and clinical investigations, some of the possibilities of three dimensional ultrasound imaging in neurosurgery are presented. Particularly the role of supplementary three dimensional ultrasound imaging data in computer-controlled brain surgery is stressed. PMID- 3545039 TI - Stereotactic neurosurgery: new aspects of an old method. AB - Seventy-seven patients underwent 93 stereotactic operations during a five-year period 1980-1984 at the Department of Neurosurgery, Oulu University Central Hospital, Oulu, Finland. Thirty patients were cases of general neurosurgery, consisting of 27 stereotactic biopsies of deep-seated brain tumors with a diagnostic accuracy of 89% (24/27), and three evacuation-aspiration procedures. Two-thirds of the operations (63/93) belonged to the field of functional neurosurgery, the most frequent procedure being stereotactic ventrolateral thalamotomy. In the treatment of drug resistant Parkinsonian tremor and rigidity the success rate was 70% in bilateral and over 90% in unilateral procedures. Operative mortality was 1.1% (1/93 operations) and morbidity 3.2%. Stereotactic technique is mandatory for diagnostic biopsies of deep-seated cerebral lesions. Its combination with computerized tomography ensures better resolution of the lesions and enables more radical therapeutic procedures to be undertaken. Furthermore, stereotactic operations are still indicated in selected cases of medically refractory disorders, especially in epilepsy and involuntary movement disorders. PMID- 3545040 TI - The New York Academy of Dentistry. Fellowship list 1986-87. PMID- 3545041 TI - [Infectious colitis. Endoscopy]. AB - Colon and rectum localizations of an disease or a parasitosis depend essentially on the nature of the pathogenous agent and the host resistance. Acute enterocolitis is secondary to enterotoxinogenous germs (such as cholera vibrio), invasive germs (such as shigella), penetrating germs (such as salmonella); viruses are seldom concerned. Parasitic colitis include mostly amibiasis and bilharziosis. Infectious and parasitic enterocolitis may be transmitted sexually. On the other hand, certain venereal diseases have intestinal manifestations. Finally, in AIDS, timely gastro-intestinal infections develop. The diagnosis rests on endoscopy, histological examination and biological and parasitological samplings. PMID- 3545043 TI - [Emergency colonic anastomoses]. PMID- 3545042 TI - [Colonic inertia and rectal obstruction (Arbuthnot Lane disease)]. AB - Colonic inertia and outlet obstruction are a major problem of constipation affecting almost solely women and are characterised by an extreme slowness of colonic transit time (less than 80 percent of the markers eliminated in five days) and by a lack of relaxation and a contraction of pelvic muscles, mainly of the pubo-rectalis, during defecation. This syndrome is associated with a high frequency of gynecological diseases (first described in 1908 by Arbuthnot Lane), galactorrhea, urological abnormalities, abnormal manometric oesophageal recordings, Raynaud's phenomenon, idiopathic oedema, orthostatic hypotension and neurological symptoms. A distinctive abnormality of the colonic myenteric plexus has been described. Medical treatment of the affection is without effect, with the exception, perhaps, of the prescription of naloxone. In the absence of other therapeutic means, subtotal colectomy with ileo-rectal and coeco-rectal anastomosis may give relative improvement. PMID- 3545044 TI - [Current data on fissures and their treatment]. AB - A review of the literature published during the last few years concerning the pathogenesis, clinics and treatment of anal fissures does not supply any new elements in the concept of the triggering of the fissure and its passage to chronicity. If the acute form hardly raises any diagnostic problems, the "chronic or non-cicatrized" form has to be distinguished from the anal localizations of certain general disorders such as Crohn's disease, certain cancers... Medical treatment does not cure the fissural disease. In the young, uncomplicated fissure, most cases can be cured with one or two injections of xylocaine or the double chlorhydrate of quinine and urea. However, if the fissure is old, other methods are required. Cryotherapy alone is effective. Digital or instrumental dilatation creates an uncontrolled leyomyotomia. It is rarely used and has certain disadvantages. Most proctologists resort to surgical methods: open or lateral or posterior blind sub-mucous leiomyotomia produces muscle relaxation, therefore, a reduction in pain and cicatrization of the fissure, or fissurectomy alone associated with leiomyotomia and anoplasty. The choice of technique depends more on each person's habits rather than on the more favorable results obtained with one of the methods. PMID- 3545045 TI - Non-neoplastic stenoses of the rectum. AB - Rectal stenoses, often accompanied by a simple, non-specific symptomatology, have multiple and varied causes. The clinical picture is far from specific and can go from absolute latency to the full picture of a distinct colic occlusion. The clinical examination mainly relies on the data from the proctologic examination and, in particular, the rectal touch that enables detection of the lesion. This proctologic examination is completed with a uro-genital clinical check-up. The complementary endoscopic, X-ray and biological examinations are dominated by rectoscopy, barium enema and, if necessary, scanner, ultrasonography and anatomopathology. The etiological forms comprise stenoses by extrinsic compression; inflammatory or non-inflammatory pseudo-tumoral stenoses; inflammatory cryptogenetic (RCH, Crohn) or specific (infectious, parasitic and venereal) stenoses; ischaemic stenoses; traumatic stenoses by internal or external traumatism and medical iatrogenic, post-physiotherapeutic or post surgical stenoses. The therapeutic problems depend on the type, age and size of the evolution as well as the cause (etiology) of the lesions. Depending on the case, we have to "make do with it", circumvent the problem, force or remove the obstacle. PMID- 3545046 TI - [Post-jejunoscopy bacteremia caused by Klebsiella pneumoniae]. AB - We report a case of symptomatic Klebsiella pneumoniae bacteremia following a jejunoscopy. Occurrence of bacteremia in patients undergoing gastro-intestinal endoscopy is reviewed. PMID- 3545047 TI - Carcinoembryonic antigen (CEA) expression in early embryogenesis: a study of the first trimester of gestation. AB - The immunohistological CEA positivity was studied in 711 tissue samples derived from the ecto-, meso- and entoderm of 63 embryos obtained during the first 12 weeks of gestation. It was found that CEA was expressed by derivates of all three germ layers, although the strongest reactions and the highest incidence of positivity was found in organs derived from the entoderm. In the 7th week of gestation the antigen was first seen in mesodermal and entodermal tissues; only after the 8th week the first appearance of CEA was noted, though only in 2/9 ectodermal organs examined. It therefore seems that the initially described high preponderance of CEA positivity of entodermal organs, previously observed for later stages of gestation, can be confirmed. However, not only are exceptions seen in organs of this germ layer, but CEA can also be expressed in tissues of the two other germ layers early in ontogenesis. PMID- 3545048 TI - Relationship between magnesium, cancer and carcinogenic or anticancer metals. AB - It is known that carcinogenesis induces Mg distribution disturbances which cause Mg mobilization through blood cells and Mg depletion in non-neoplastic tissues. Mg deficiency seems to be carcinogenic in cases of some particular haemolymphoreticular diseases only, more often, in cases of solid tumors, it inhibits carcinogenesis. Both carcinogenesis and Mg deficiency increase the plasma membrane permeability and fluidity. The regulation of Mg cellular and subcellular distribution is very important in cancer research. If the Mg level is normal in histones, and particularly in H1 and in nucleic acids on the N7 site of the guanine, it can protect against carcinogenesis. On the other hand, if it is abnormally high it can generate the left-handed Z DNA which is correlated with carcinogenesis. The carcinogenic action of Mg may be linked with some effects on sulfur amino-acid metabolism, growth and the immune system. Although Mg antagonizes certain carcinogenic metals, this is not one of its general properties. Our studies on human amniotic membranes show that Mg acts as a competitive antagonist on 2 or 3 weak carcinogens, Pb and Cd, but not on Co. Mg is a non-competitive antagonist of Ni and is devoid of action on As, both of which are powerful carcinogens. All carcinogenic metals (As, Ni, Cr, Cd, Co, Pb, except Be) reduce the total conductance (Gt). Reversibly all cocarcinogens increase Gt or do not modify it. However, both anticancer and carcinogenic metals reduce Gt. Thus the main target in the relationship between Mg and metals in carcinogenesis is either membrane as regards Pb and Cd, or nucleus as regards Pt, Ga, Co and Ni. The ideal treatment of Mg disturbances in carcinogenesis should control the factors which regulate cellular and subcellular Mg distribution in neoplastic tissues as well as those which avoid Mg depletion in extra malignant tissues. PMID- 3545049 TI - Acute herpetic and postherpetic neuralgia: clinical review and current management. AB - The pain of acute herpes zoster (HZ) may be severe, but it is usually transitory. A minority of patients, with the elderly at particular risk, go on to develop persistent, severe, often disabling pain called postherpetic neuralgia. Though the clinical features of these conditions are well known, the pathology of PHN is poorly described and the pathogenesis of the pain in both remains conjectural. During the past 60 years, an extraordinary number of pharmacological, anesthetic, and surgical therapies have been applied in an attempt to ameliorate the symptoms of acute herpes zoster, enhance its healing, prevent its transition to postherpetic neuralgia, and treat the pain of those with this complication. Relatively few treatments have been studied in a controlled manner, and fully reliable, safe, and effective therapeutic approaches for preventing and treating postherpetic neuralgia have not yet been found. This review summarizes current information on the epidemiology, clinical features, and pathology of herpes zoster and postherpetic neuralgia, and critically examines the accumulated experience with the various treatments. Guidelines for management are suggested. PMID- 3545050 TI - Left thalamic infarction and disturbance of verbal memory: a clinicoanatomical study with a new method of computed tomographic stereotaxic lesion localization. AB - A 41-year-old right-handed man developed disturbances of language and memory after a discrete thalamic infarction. Detailed neuropsychological assessment revealed deficits in verbal fluency, word finding, confrontation naming, and anterograde memory for verbal material. High-resolution computed tomography with stereotaxic lesion localization permitted the determination of the thalamic nuclei involved in the infarction. We suggest that the patient's problem in language and verbal memory reflected a defect in memory processing for verbal material during registration, retention, and retrieval, and that this defect probably resulted from a left anterior thalamic lesion affecting the ventrolateral nucleus, centromedian-parafascicular nuclei complex, internal medullary lamina, or mamillothalamic tract. PMID- 3545051 TI - Ophthalmological precautions in Creutzfeldt-Jakob disease. PMID- 3545052 TI - Precautions in Creutzfeldt-Jakob disease. PMID- 3545053 TI - Insects as models in neuroendocrine research. PMID- 3545054 TI - Improved detection of insecticide resistance through conventional and molecular techniques. PMID- 3545055 TI - Scorpion bionomics. PMID- 3545056 TI - Ecological genetics of insecticide and acaricide resistance. PMID- 3545057 TI - The early days of yeast genetics: a personal narrative. PMID- 3545058 TI - Fragile X syndrome: a unique mutation in man. PMID- 3545059 TI - Mutagenesis by apurinic/apyrimidinic sites. PMID- 3545061 TI - Genetic control of primary sex determination in mice. PMID- 3545060 TI - Molecular genetics of membrane phospholipid synthesis. AB - I have attempted to illustrate the genetic and biochemical complexity of membrane lipid synthesis by focusing, primarily, on E. coli. The use of molecular genetics to probe membrane lipids is relatively new. Many important questions of phospholipid biochemistry remain unanswered. In the coming years our growing knowledge of the molecular genetics of phospholipids must be applied to the solution of the following problems: How does a cell regulate its total phospholipid content in relationship to macromolecules, especially membrane proteins, cell wall components, and nucleic acids? Why do E. coli and Caulobacter behave differently in this respect? How does a cell regulate its characteristic ratios of polar headgroups and fatty acyl chains? Why does overproduction of phosphatidylserine synthase have no effect on phospholipid composition? How is lipid topography established, both in terms of intramembrane movement (flip-flop) and intermembrane movement? Are there transport systems (flippases) for short chain diacylglycerophospholipids in E. coli, as in mammalian microsomes, and can flippase mutants be isolated? What are the functions of the many individual phospholipid species? Does E. coli have a functional equivalent of the mammalian phosphatidylinositol cycle? A complete set of phospholipid mutants, together with phenotypic suppressors, should help to answer these questions by allowing selective perturbations in vivo and physiological studies of associated phenotypes. In addition, molecular cloning is already providing access to large quantities of the lipid gene products, opening the door to biophysical and chemical studies of lipid-protein interactions. A unique feature of genetics, as applied to complex biochemical or physiological systems, is the high frequency of unanticipated discoveries that accompany the characterization of new mutants. In our work, this is best illustrated by the analysis of phosphatidylglycerol deficient mutants of E. coli, which provided the clue (i.e. lipid X) that permitted the elucidation of lipid A biosynthesis. The interconnection of metabolic pathways and important control mechanisms are often revealed by the study of mutants. In the case of E. coli it is best to consider the many lipids and proteins of the envelope as a whole. Considering how few mutant alleles are available for the lipid genes of E. coli, it will be important to create many more genetic lesions in order to gain a full understanding of regulation and function. PMID- 3545062 TI - Mammalian urea cycle enzymes. PMID- 3545064 TI - Regulation of nitrogen fixation genes. PMID- 3545065 TI - [Mechanisms of chromosomal and extrachromosomal bacterial resistance to aminoglycoside antibiotics. Transport processes and resistance]. PMID- 3545066 TI - [Use of antibiotics in selecting Escherichia coli as a producer of penicillin acylase]. AB - The effect of neomycin, streptomycin, chloramphenicol and erythromycin on survival of E. coli producing penicillinacylase and its variation with respect to the property of penicillinacylase production was studied. Neomycin and chloramphenicol had the highest lethal effect on the cells of E. coli. It was shown that neomycin, erythromycin and chloramphenicol, as selective factors, promoted detection of variants with the activity levels lower than the control ones. Streptomycin promoted detection of low active and high active variants with the same frequency. PMID- 3545067 TI - [Isolation and study of the biological properties of substances stimulating levorin biosynthesis in a mixed actinomycete and yeast culture]. AB - Active components responsible for increased synthesis levels of levorin, a polyenic antibiotic in mixed cultures of an actinomycete and a yeast-like fungus C. tropicalis were isolated from the fermentation broth. Component I identified as succinic acid increased the levels of the antibiotic production by 40-50 per cent. Component II found to be lactic acid increased the antibiotic production levels by 20 per cent. Component III, a mixture of nonidentified substances of the amine nature stimulated biosynthesis of levorin by 20-25 per cent. Addition of a mixture of succinic acid and N-methyl glucosamine to the nutrient medium provided increase of the antibiotic activity of the fermentation broth up to 175 185 per cent as compared to the control. PMID- 3545063 TI - Germ-line transformation of mice. PMID- 3545068 TI - In vitro activity against aerobic and anaerobic gram-positive and gram-negative bacteria and beta-lactamase stability of RS-533, a novel carbapenem. AB - RS-533 is a novel carbapenem antibiotic. Its activity was compared with that of imipenem and the new cephalosporins, aztreonam, piperacillin, and tobramycin. RS 533 had activity comparable to that of imipenem, inhibiting the majority of the Enterobacteriaceae, streptococci, staphylococci, and Bacteroides species at concentrations of less than or equal to 2 micrograms/ml. RS-533 inhibited Enterobacter cloacae, Citrobacter freundii, and Serratia marcescens resistant to ceftazidime, aztreonam, and cefoperazone, but RS-533 did not inhibit all methicillin-resistant Staphylococcus aureus or Pseudomonas maltophilia. It inhibited tobramycin-resistant members of the Enterobacteriaceae and Pseudomonas aeruginosa. RS-533 was stable against attack by common chromosomal and plasmid mediated beta-lactamases and was an effective inhibitor of many beta-lactamases. PMID- 3545069 TI - Involvement of penicillin-binding protein 2 with other penicillin-binding proteins in lysis of Escherichia coli by some beta-lactam antibiotics alone and in synergistic lytic effect of amdinocillin (mecillinam). AB - Compared with cefotaxime, ceftazidime, moxalactam, and aztreonam, ceftriaxone produced the best lytic and bactericidal effects when each was added at about 10 times the MIC to Escherichia coli W7. When each of these antibiotics was added at its MIC, only bacteriostasis occurred, but the simultaneous addition of amdinocillin (mecillinam) was synergistic in causing rapid lysis and bactericidal effects. Induction of lysis of two E. coli mutants containing either a thermosensitive penicillin-binding protein (PBP) 2 or 3 by relatively PBP 3 specific (aztreonam) and PBP 2-specific (amdinocillin) antibiotics indicated that inhibition of only PBPs 2 and 3 can cause lysis. Examination of the interactions of cefotaxime, aztreonam, and cefsulodin, with or without amdinocillin, with their targets suggested that other combinations of PBPs could be involved in the onset of lysis. However, inhibition of both PBPs 2 and 3 may explain the better lysis-inducing activity of ceftriaxone (which binds well to both of these PBPs), as well as the synergistic effect of amdinocillin when added together with low concentrations of other beta-lactam antibiotics that interact with PBP 3. PMID- 3545070 TI - Penetration of cefixime into fibrin clots and in vivo efficacy against Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. AB - The experimental model of infected fibrin clots in rabbits was used to study the penetration and in vivo activity of cefixime against Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus. The respective MICs of cefixime against these strains were 0.25, 2, and 8 micrograms/ml. The clots were infected with 10(6) to 10(8) CFU/g. Groups of four animals for each strain received an intravenous injection of 100 mg of cefixime per kg over 30 min. High peak levels were observed in serum (146.5 micrograms/ml) and clots (15.8 micrograms/g), and the antibiotic was still detectable in the clots (0.6 micrograms/g) 24 h after administration. The respective serum and clot elimination half-lives were 0.7 and 5.0 h. The mean serum protein binding was 23.8 +/- 3.8%. Cefixime was highly bactericidal against K. pneumoniae and E. coli and reduced, over a 24-h period, their respective colony counts by 7.8 log10 and 6.2 log10 CFU/g of fibrin. It was less effective against S. aureus but still reduced the bacterial counts by 2.8 log10 CFU/g of fibrin. The present results demonstrate that cefixime, a new broad spectrum oral cephalosporin, has a long tissue half-life which ensured, at the dose given here, good in vivo bactericidal activity against both gram-positive and gram-negative bacteria up to 24 h after administration of the antibiotic. PMID- 3545071 TI - Association between colistin resistance and broad-spectrum recipient deficiency in Klebsiella pneumoniae. AB - A colistin-resistant mutant of Klebsiella pneumoniae served well as a donor but not as a recipient in conjugation. A nearly 1,000-fold difference between colistin-susceptible and colistin-resistant forms of this strain was observed by using donors of plasmids of four incompatibility groups. Recipient efficiency was not restored by filter matings. PMID- 3545072 TI - Use of mucin and hemoglobin in experimental murine gram-negative bacteremia enhances the immunoprotective action of antibodies reactive with the lipopolysaccharide core region. AB - An antiserum with a high content of antibodies, binding to the Gram-negative lipopolysaccharide core region, was prepared by immunizing rabbits with the rough Escherichia coli mutant J5. This antiserum was capable of protecting mice against lethal challenge doses of E. coli 0 111:B4 in a mouse model where the animals were compromised by means of mucin plus hemoglobin (LD 50 = 10(3) bacteria). However, no protection was observed in a non-compromised mouse model (LD 50 = 10(7) bacteria). This observation might explain why in the past so many discrepant results have been obtained in mouse protection studies with cross reactive antisera. PMID- 3545073 TI - Influence of light and natural microbiota of the Butron river on E. coli survival. AB - The survival of an E. coli strain in water samples from the Butron river has been studied. The input of E. coli cells in the aquatic system breaks down the established balance among the components of the natural microbiota: E. coli becomes the object of the active protozoal predation whereas the autochtonous heterotrophic community become alternative preys. As a result of this new situation, the natural microbiota increases but returns to the initial values once the E. coli cells have been removed from the system. The effect of the temperature of incubation on the survival is exerted through the effect of this parameter on the predatory activity of the protozoa. Light has a lethal and direct action on the E. coli cells, the effect of this parameter is even superior to that of predation. PMID- 3545074 TI - Cardiac transplantation. Organ procurement to patient discharge. AB - The care of the cardiac transplant patient is complex, yet rewarding. During the hospital stay, the patients, families, and nurses develop close-knit relationships that last after discharge. The cardiac transplant patients at Hershey Medical Center have formed a support group. To promote organ donation, they wear T-shirts, hats, and coats with the logo, "I got my heart at HMC," (Hershey Medical Center). This not only increases awareness of the need for organ donation, but also gives Hershey Medical Center recognition for its cardiac transplantation program. PMID- 3545075 TI - Lipid-polyamide-polyethyleneimine microcapsules for immobilization of free cofactors and multienzyme system. AB - Lipid-polyamide membrane microcapsules containing multienzyme system convert ammonia into glutamate. L-Glutamic dehydrogenase, alcohol dehydrogenase, NAD+, and alpha-ketoglutarate retained within the microcapsules do not leak out. This way the multienzyme system can recycle the free cofactor NAD+ and synthesize glutamate from external lipophilic ammonia diffusing into the microcapsules. By using polyethyleneimine instead of hemoglobin as microcapsule filler it is possible to obtain higher conversion rates and to increase the storage stability of the recycling activity. PMID- 3545076 TI - Microbial transformations and bioconversions. Patents and literature. PMID- 3545077 TI - Molecular relationship between two types of phospholipase B from Penicillium notatum and reconstitution of active enzyme from its peptide fragments. AB - Two types of phospholipase B of Penicillium notatum, the native type and the modified type that is thought to be generated by the introduction of some nicks into the native type of enzyme by the endogenous protease(s), were distinguished on a slab sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis under a nonreducing condition. The native form migrated with a rate corresponding to 95K Da, whereas the modified form migrated more slowly, corresponding to 106K Da, presumably because of its more extended conformation. That the "106K" protein was indeed a nicked product of the "95K" protein was confirmed by amino acid analysis, peptide mapping, N- and C-terminal sequence analyses, and immunoblotting. The peptide fragments (70K and 37K + 32K) comprising the modified protein were isolated by gel filtration in the presence of SDS and 2 mercaptoethanol (the 32K peptide was suggested to be a partial proteolytic product of the 37K peptide). When the "95K" protein was subjected to the same treatment under denaturing condition, it retained a low, but significant, enzymatic activity; in contrast, the separated peptide fragments did not show any significant activity. By a coincubation of these fragments, however, a restoration of enzymatic activity was observed through a reformation of the active complex, corresponding to the original modified protein. The enzymatic activity of this complex was further increased by a treatment with guanidine X HCl, followed by dialysis. The association of peptide fragments appears to occur through the formation of interpeptidal disulfide bonds. PMID- 3545078 TI - Action of a serine proteinase from fish skeletal muscle on myofibrils. AB - The action of a serine proteinase from fish skeletal muscle on myofibrils was studied. The enzyme was able to destroy the structural integrity of myofibrils, and to degrade both their major contractile and cytoskeletal constituent proteins. Proteolysis could be completely prevented by the addition of a trypsin inhibitor isolated from the same muscle. PMID- 3545079 TI - A 5'----3' exoribonuclease of Saccharomyces cerevisiae: size and novel substrate specificity. AB - The purification scheme for a 5'----3' exoribonuclease of Saccharomyces cerevisiae has been modified to facilitate purification of larger amounts of enzyme and further extended to yield highly purified enzyme by use of poly(A) agarose chromatography. As determined by either sodium dodecyl sulfate polyacrylamide gel electrophoresis or physical characterization, the enzyme has a molecular weight of about 160,000. Further studies of its substrate specificity show that poly(C) and poly(U) preparations require 5' phosphorylation for activity and that poly(A) with a 5'-triphosphate end group is hydrolyzed at only 12% of the rate of poly(A) with a 5'-monophosphate end group. DNA is not hydrolyzed, but synthetic polydeoxyribonucleotides are strong competitive inhibitors of the hydrolysis of noncomplementary ribopolymers. Poly(A).poly(U) and poly(A).poly(dT) are hydrolyzed at 60 and 50%, respectively, of the rate of poly(A) at 37 degrees C. The RNase H activity of the enzyme can also be demonstrated using an RNA X M13 DNA hybrid as a substrate. When poly(dT).poly(dA) with a 5'-terminal poly(A) segment on the poly(dA) is used as a substrate, the enzyme hydrolyzes the poly(A) "tail," removing the last ribonucleotide, but does not hydrolyze the poly(dA). PMID- 3545080 TI - Biochemical and immunological identity of the hepatic peroxisomal and microsomal trans-2-enoyl CoA hydratase bifunctional protein. AB - In the present study, the hepatic microsomal and peroxisomal bifunctional trans-2 enoyl CoA hydratases were isolated and purified from rats treated with 2% di-(2 ethylhexyl)phthalate for 8 days. These two enzymes (microsomal and peroxisomal) were purified with the identical purification procedures and had identical molecular masses of 76 kDa. A single band was observed on an electrophoretic gel of an equimixture of the two proteins. Both preparations had identical pI's of 8.6 and pH optima of 6.0 for the dehydrogenase (reductase) and 7.5 for the hydratase activity. Two-dimensional gel analysis of an equimixture of the two preparations showed only one band. Ouchterlony double-diffusion analysis showed that an antibody raised against the purified microsomal enzyme interacted at a point with the peroxisomal enzyme, indicating immunologic identity. Western blot analysis demonstrated that the antibody formed a single band with total microsomal and peroxisomal fractions. The antibody inhibited the enzymatic activities of both preparations in a similar manner. Interestingly, the antibody had a markedly greater inhibitory effect on the reductase activity of the two enzyme preparations, and a much less inhibitory effect on the hydratase activity, suggesting that the antigenic determinants reside at or near the catalytic site of the reductase portion of the protein. These results suggest that the microsomal and peroxisomal bifunctional proteins are identical. PMID- 3545081 TI - NADH:hydroxypyruvate reductase and NADPH:glyoxylate reductase in algae: partial purification and characterization from Chlamydomonas reinhardtii. AB - Hydroxypyruvate and glyoxylate reductase activities were measured in extracts from the unicellular green algae, Chlamydomonas reinhardtii, Chlorella vulgaris, Chlorella miniata, and Dunaliella tertiolecta. Only trace levels of these activities were detectable in the blue-green algae, Anabaena variabilis and Synechococcus leopoliensis. A NADH-dependent hydroxypyruvate reductase was purified 130-fold from Chlamydomonas to a specific activity of 18 mumol NADH oxidized X min-1 X mg protein-1. The pH optimum was 5.0 to 7.0 in the presence of phosphate and the Km(hydroxypyruvate) was 0.05 mM. Substrate inhibition by hydroxypyruvate could be partially relieved by phosphate. The molecular weight, estimated by gel filtration, was 96,000. NADH-dependent glyoxylate reductase activity copurified with the hydroxypyruvate reductase. The Km(glyoxylate) was 10 mM, and the pH optimum was 4.5 to 8.5. A specific NADPH:glyoxylate reductase was also partially purified which did not reduce hydroxypyruvate or pyruvate. The NADPH:glyoxylate reductase had a Km(glyoxylate) of 0.1 mM and a pH optimum of 5.0 to 9.5. These reductases were compared with the pyruvate reductase of Chlamydomonas which also catalyzes the reduction of both hydroxypyruvate and glyoxylate. PMID- 3545082 TI - Phenotypic differences in expression of cytochrome P-450g but not its mRNA in outbred male Sprague-Dawley rats. AB - Cytochrome P-450g was isolated from livers of adult male Sprague-Dawley (CD) rats. Antibody to P-450g cross-reacted with several proteins in Western blots of liver microsomes from male CD rats. An immunospecific antibody was prepared by adsorption over immunoaffinity columns of Sepharose-bound solubilized rat liver microsomes from female CD and male Fischer 344 rats containing little or no P 450g. The immunopurified antibody recognized a single protein on Western blots of liver microsomes from male CD rats with an electrophoretic mobility identical to that of P-450g. Using this antibody, P-450g was shown to be male specific in the CD rat and expressed at maturity. Adult male CD rats were shown to fall into two distinct populations, those expressing high levels of P-450g (+g) and those expressing low levels of P-450g (-g). The P-450g content of the two populations differed 10- to 20-fold. P-450g was low or absent in liver microsomes of both sexes of adult Fischer rats. Purified P-450g catalyzed the hydroxylation of testosterone and androstenedione principally at the 6 beta-position and progesterone at the 16 alpha- and 6 beta-positions in reconstituted systems. However, the hydroxylation of these steroids by liver microsomes from the (+g) phenotype did not differ from that of the (-g) phenotype. Translatable mRNA for P 450g could be detected in livers of adult male CD rats but not female rats. However, the level of P-450g mRNA in livers of adult male CD rats with the (+g) phenotype did not differ from that of (-g) phenotype. These data suggest that phenotypic differences in the expression of P-450g do not depend on differences in mRNA content. This study provides a clear example of a P-450 isozyme which is markedly variable in an outbred strain of rat and absent in an inbred strain. Such a marked variability in an enzyme involved in metabolism of endogenous and exogenous substrates could account for some of the strain differences in susceptibility to toxic chemicals. PMID- 3545083 TI - Purification and characterization of human colony-stimulating factor 1 from human pancreatic carcinoma (MIA PaCa-2) cells. AB - Colony-stimulating factor 1 (CSF-1) was purified from the serum-free conditioned medium of a human pancreatic carcinoma cell line (MIA PaCa-2) by a combination of conventional chromatography and high-performance liquid chromatography. The purity of human CSF-1 was demonstrated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with a diffuse single band of Mr 42,000-50,000 and by N-terminal amino acid analysis of glutamate residue. The CSF-1 was stable at 50 degrees C for 30 min. It is sensitive to treatment with trypsin, chymotrypsin, and subtilisin but less sensitive to papain digestion. Treatment of CSF-1 with different glycosidases did not affect the biological activity. Sulfhydryl reagents such as dithiothreitol (DTT), iodoacetic acid, and N-ethylmaleimide did not affect the biological activity at the concentration of 1 mM. However, CSF-1 activity was inhibited totally by the combination of 10 mM DTT and 1 mM SDS. Under denaturing and reducing conditions, CSF-1 appeared on SDS-PAGE as a single protein band of Mr 21,000-25,000 and concurrently lost its activity, indicating that human CSF-1 possibly consists of two similar subunits and that the intact quaternary structure is essential for the biological activity. When treated with neuraminidase and endo-beta-D-N-acetylglucosaminidase D, the molecular weight of CSF-1 was reduced to 36,000-40,000, and to 18,000-20,000 in the presence of mercaptoethanol. Because of the specificity of endo-beta-D-N acetylglucosaminidase D, it is suggested that the carbohydrate moieties are Asn linked "complex-type" units. PMID- 3545085 TI - Specificity and cross-reactivity of monoclonal and polyclonal antibodies against cytochrome P-450E of the marine fish scup. AB - Monoclonal antibody (MAb) 1-12-3 generated against liver cytochrome P-450E (P 450E), an aryl hydrocarbon hydroxylase of the marine fish Stenotomus chrysops (scup), reacted only with P-450E when tested in immunoblot analysis with five P 450 fractions from scup liver. This and six other MAbs against P-450E recognized purified P-450E, as well as a single band in beta-naphthoflavone (BNF)-induced scup microsomes that comigrated with authentic P-450E. Like MAb 1-12-3, polyclonal anti-P-450E reacted with P-450E but not with other scup P-450 fractions and reacted strongly with a band coincident to P-450E in BNF-treated scup microsomes. However, the polyclonal antibody (PAb) also faintly recognized additional microsomal proteins. MAb 1-12-3 recognized P-450E induced by 3,3',4,4',5,5'-hexachlorobiphenyl and by polychlorinated biphenyl mixtures in scup, and a single band induced by BNF or 3-methylcholanthrene (MC) in microsomes of other teleosts, including two trout species, killifish and winter flounder. The content of the P-450E counterpart in these fish and also in untreated scup coincided with induced ethoxyresorufin O-deethylase (EROD) activity. Induced EROD activity in scup and trout was strongly inhibited by MAb 1-12-3, further demonstrating the relationship between P-450E and induced P-450E in trout. MAb 1 12-3, two other MAbs, and anti-P-450E PAb recognized a band comigrating with P 450c in BNF-induced rat microsomes. MAb 1-12-3 also recognized purified rat P 450c. MAb 1-12-3 and anti-P-450E PAb recognized a second band of lower molecular weight than P-450c in BNF rat microsomes which may correspond to P-450d, the MC- and isosafrole-inducible rat isozyme. The results firmly establish the identity of scup P-450E, the relationship of BNF-induced P-450 in other teleosts with P 450E, and the immunochemical relationship of P-450E with rat P-450c. Furthermore, results with untreated fish suggest that effects of environmental chemicals may be detected by immunoblotting with monoclonal anti-P-450E. PMID- 3545084 TI - Characterization of cuticle-degrading proteases produced by the entomopathogen Metarhizium anisopliae. AB - Two chymoelastases and three trypsinlike proteases were separated from culture filtrates of the entomopathogen Metarhizium anisopliae. A chymoelastase (Pr1) (pI 10.3 Mr 25,000) and trypsin (Pr2) (pI 4.42, Mr 28,500) were purified to homogeneity by ammonium sulphate precipitation, isoelectric focusing, and affinity chromatography. Inhibition studies showed that both enzymes possessed essential serine and histidine residues in the active site. Pr1 shows greater activity than Pr2 or mammalian enzymes against locust cuticle and also possesses activity vs elastin. Pr1 shows a broad primary specificity toward amino acids with hydrophobic side groups in synthetic ester and amide substrates. The kinetic properties of Pr1 demonstrate a preference for extended peptide chains with the active site recognising at least five substrate residues. The S5 and S4 subsites show a preference for negatively charged succinyl and hydrophobic acetyl groups, respectively. The S3 and S2 subsites both discriminated in favor of alanine and against proline. Pr2 rapidly hydrolyzed casein and synthetic substrates containing arginine or lysine. It possessed little or no activity vs cuticle, elastin, or synthetic substrates for chymotrypsin and elastase. Specific active site inhibitors confirmed the similarities between Pr2 and trypsin. PMID- 3545086 TI - Etretinate therapy for generalized pustular psoriasis in children. AB - Two children, 19 months of age, were independently treated with a compassionate protocol of etretinate therapy for recalcitrant, debilitating pustular psoriasis. Laboratory test results, roentgenograms of the spine, and bone age were periodically monitored. Over a 31/2-year period of intermittent treatment with a maximum dosage of 1.5 mg/kg/d, both children showed remarkable improvement with no apparent drug effect on growth and development. Side effects included xerosis, skin fragility and transient, minimal elevations of aspartate aminotransferase, lactic dehydrogenase, and triglyceride levels. Etretinate therapy may prove to be a viable treatment option for the child with intractable pustular psoriasis that seriously impairs quality of life. PMID- 3545087 TI - Xeroderma pigmentosum. Cutaneous, ocular, and neurologic abnormalities in 830 published cases. AB - Quantitative frequencies of clinical abnormalities in xeroderma pigmentosum were estimated by abstracting published descriptions of 830 patients in 297 articles obtained from a survey of the medical literature from 1874 to 1982. The median patient age was 12 years with nearly equal numbers of male and female patients. Cutaneous symptoms (sun sensitivity or freckling) had a median age of onset of between 1 and 2 years. Forty-five percent of the patients described had basal cell carcinoma or squamous cell carcinoma of the skin. The median age of first nonmelanoma skin cancer among patients with xeroderma pigmentosum was 8 years, more than 50 years less than that among patients with skin cancer in the United States. Melanomas were reported in 5% of patients. Ninety-seven percent of the reported basal and squamous cell carcinomas and 65% of the melanomas in patients with xeroderma pigmentosum occurred on the face, head, or neck. Seventy percent probability of survival was attained at age 40 years, a 28-year reduction in comparison with the US general population. Ocular abnormalities were reported in 40% of the patients described and were restricted to tissues exposed to ultraviolet radiation (lid, conjunctiva, and cornea) and included ectropion, corneal opacity leading to blindness, and neoplasms. Neurologic abnormalities were found in 18% of the cases reported, consisting of progressive mental deterioration, hyporeflexia or areflexia, and progressive deafness in some patients in association with dwarfism and immature sexual development. There was scant information concerning the efficacy of any therapeutic regimen. PMID- 3545088 TI - Actinic reticuloid: an immunohistochemical study. PMID- 3545089 TI - Pyoderma gangrenosum vs malignant pyoderma. Lumpers vs splitters. PMID- 3545090 TI - Antinuclear and anti-single-stranded DNA antibodies in morphea and generalized morphea. AB - The clinical features of localized scleroderma have allowed investigators to distinguish three morphologic variants: morphea, generalized morphea, and linear scleroderma. The latter has been reported to have a higher frequency of antinuclear antibodies and has been associated with antibodies to single-stranded DNA (ssDNA). In this study we determined the frequency of antinuclear antibodies and anti-ssDNA antibodies in 22 patients with morphea or generalized morphea. None had Raynaud's phenomenon or evidence of a systemic connective-tissue disease. Antinuclear antibodies were present in 18% of patients when serum samples were tested on mouse kidney substrate but were found in 50% of HEp-2 cells. The serum samples contained anti-ssDNA antibodies in 59% of the patients, with the highest levels of ssDNA binding observed in patients with generalized morphea. The frequency of antibodies to ssDNA was higher in patients with clinical evidence of active compared with inactive disease. Discordance in immune reactivity indicates that at least three distinctive serum autoantibodies exist in morphea and generalized morphea: anti-ssDNA antibodies and antinuclear antibodies with either homogeneous or speckled immunofluorescence patterns. These findings are similar to those recently described in linear scleroderma and suggest that comparable serum autoantibody abnormalities are present in all the variants of localized scleroderma. PMID- 3545091 TI - Localized bullous pemphigoid. A mimic of acute contact dermatitis. AB - A case of localized bullous pemphigoid that mimicked an acute contact dermatitis around a stoma site is presented. The diagnosis was confirmed by direct immunofluorescence and by indirect immunofluorescence on 1.0 mol/L of sodium chloride split skin. A review of the literature demonstrates 30 previous well documented cases of localized bullous pemphigoid. As in our case, local factors such as trauma, ultraviolet light, or topical therapy seem to be frequently implicated in the production of lesions. The possibility that these patients might otherwise have subclinical bullous pemphigoid was considered. The disease has a benign course and generally responds to cessation of exacerbating factors and initiation of topical steroid therapy. PMID- 3545092 TI - Malodorous intertriginous pustules and plaques. Pemphigus vegetans, Hallopeau type. PMID- 3545093 TI - Generalized blistering eruption aggravated by heat. Pemphigus foliaceus. PMID- 3545094 TI - Asthma education by community child health nurses. AB - A randomised controlled study of an educational programme for children with asthma and their families was carried out by community child health nurses. Three hundred and sixty eight children aged 2 to 14 years were enrolled in the study after admission to hospital for asthma. The intervention group was visited monthly by a nurse for six months. The subjects were assessed six months later by a postal, self administered questionnaire. European children in the intervention group were taking significantly more drugs for the treatment of asthma six months after the index admission to hospital than those in the control group (mean (SD) intake 2.7 (1.1) v 2.1 (1.0), respectively). In particular, they were using more theophylline (56.6% v 37.0%) and inhaled steroids (34.9% v 21.0%). There was no difference between the groups for parental reports of improvement, of missed schooling, and in severe attacks of asthma of not responding to the usual treatment at home. European children in the intervention group used the hospital services for severe attacks of asthma more than controls (34.2% v 10.5%). There were more re-admissions in the European intervention group in the subsequent six months after the index admission than in the control group (mean (SD) 0.51 (0.97) v 0.29 (0.65). Re-admission continued to be higher in the 12 months after the nurse had stopped visiting (0.81 (1.65) v 0.25 (0.65]. There was no difference in the duration of hospital stay between the intervention and control groups. For Polynesian children there was no difference between the groups for any outcome measures. PMID- 3545095 TI - Periventricular leucomalacia and intraventricular haemorrhage in the preterm neonate. AB - Two hundred very low birthweight infants were prospectively scanned to ascertain the incidence of periventricular leucomalacia (PVL) and haemorrhage. Before collection of data, clear definitions of ultrasound abnormalities believed to represent PVL and intraventricular haemorrhage were described. These referred to small and moderate intraventricular haemorrhage, paenchymal haemorrhage, and PVL, including prolonged flare (echoes in the periventricular region lasting for two weeks or more and not becoming cystic). Sixty nine infants (34%) had no abnormality on ultrasound scans. Intraventricular haemorrhage occurred in 107 babies (37 grade I and 62 grade II), and only eight infants were thought to have true parenchymal haemorrhage. Ultrasound appearances of PVL were seen in 27 infants, 19 of whom developed cysts and eight died in the precystic stage. Prolonged flare occurred in another 25 babies. Unilateral parenchymal haemorrhage occurred in four infants who subsequently developed cystic PVL in the contralateral hemisphere. Twenty one infants developed ventricular dilatation, 12 of whom had associated parenchymal lesions. Haemorrhage, PVL, and flare occurred commonly in infants of 30 weeks' gestation and below and became markedly less common in more mature infants. We believe prolonged flare represents a form of PVL, and in this study a total of 52 (26%) infants had an ultrasound appearance of periventricular leucomalacia, an incidence considerably higher than previously reported. PMID- 3545097 TI - Liver transplantation. PMID- 3545096 TI - Intraventricular haemorrhage and periventricular leucomalacia: ultrasound and autopsy correlation. AB - The brains of 30 infants who died after at least one real time ultrasound scan were examined after fixation. The ultrasound diagnosis of either periventricular haemorrhage or periventricular leucomalacia was compared with the macroscopic and histological appearances. Each hemisphere was considered separately for both periventricular haemorrhage and periventricular leucomalacia. The accuracy of ultrasound diagnosis for periventricular haemorrhage was 88%, with sensitivity of 91% and specificity of 85%. The accuracy for periventricular leucomalacia was 90%, with sensitivity of 85% and specificity of 93%. Ultrasound was shown to diagnose the entire range of periventricular leucomalacia lesions. Three hemispheres showed the appearance of prolonged flare, and this correlated with extensive spongiosis and microcalcification of the periventricular white matter, although no macroscopic lesion was seen. PMID- 3545098 TI - Non-convulsive status epilepticus resistant to benzodiazepines. AB - We describe the failure of an intravenous benzodiazepine to control non convulsive status epilepticus occurring in six patients with the Lennox-Gastaut syndrome. In one patient the benzodiazepine induced a paradoxical response with clinical and electroencephalographic seizures. PMID- 3545099 TI - Screening for polycystic kidney disease: importance of clinical presentation in the newborn. AB - Fifty per cent of the offspring of adults with the adult (dominant) form of polycystic kidney disease are carriers of the abnormal gene. Clinical symptoms and signs before adolescence are rare, but renal ultrasonography may detect evidence of cyst formation. Twenty two children, all offspring of parents with known adult polycystic kidney disease, have undergone renal ultrasonography. In six cases evidence of disease was detected without clinical manifestations at the ages of 1, 2, 5, 8, 13, and 14 years. There were no renal masses, hypertension, haematuria, or evidence of renal insufficiency. In four children from three sibships, whose families had no previous history of renal disease, bilateral renal masses were noted to be present at birth. In each case one parent was subsequently found to have adult polycystic kidney disease. At the ages of 1, 4, 6, and 20 years, while renal masses were still palpable, there was no evidence of renal insufficiency or hypertension in the younger children, while the oldest had mild renal failure. An analysis of the reported cases in childhood is suggestive of a bimodal distribution of enlarged kidneys, with a number of cases diagnosed at birth or soon after, followed by an increasing incidence during later childhood. Adult polycystic kidney disease presenting at birth may be qualitatively different from the disease detected by screening programmes of children at risk. PMID- 3545100 TI - Symptoms, atopy, and bronchial response to methacholine in parents with asthma and their children. AB - We have studied 50 children with one parent with asthma at a mean age of 6.4 years by symptom questionnaire and performed allergy skin testing and measurement of bronchial responsiveness to methacholine in both parent and child in 29-32 cases. Ninety eight per cent of the parents were receiving medication for asthma. Fifty one per cent had visited their doctor and 20% had taken more than five days off work in the previous 12 months; 12% had been admitted to hospital during the preceding 10 years. In the children the prevalences of wheeze, shortness of breath, and cough were all about double that found in a general population survey of children of similar age. Atopy was present in 90% of parents, but the prevalence of atopy among the children was not significantly different from the children in the general population. Eczema and hay fever, however, had high prevalences of 40% and 24%, respectively. Responsiveness to methacholine (provocation dose achieving 20% fall in forced expiratory volume in one second less than 6.4 mumol) was found in 93% of parents and 45% of children, which is compatible with a large increase compared with the general population. All atopic but only 50% of non-atopic children with symptoms of asthma responded to methacholine. These findings indicate that children who have one parent with asthma have roughly double the chance of developing clinical features of asthma compared with the general population and suggests that, in these children, a causal interaction occurs between atopy and bronchial hyper-responsiveness. PMID- 3545101 TI - The role of bicarbonate and base precursors in treatment of acute gastroenteritis. PMID- 3545102 TI - In vitro study of the cell populations in two cases of Kaposi's sarcoma. AB - Despite numerous studies, the histogenesis of Kaposi's sarcoma remains unclear. In connection with the culture of two Kaposi's sarcomas, the morphological, ultrastructural, and immunological properties of the various cell types observed are discussed. Cloning in agar, loss of contact inhibition, and karyotyping were used to determine which cells had undergone malignant transformation. Findings for both cases revealed that endothelial cells had undergone neoplastic transformation. Fibroblastic cell lines were isolated from both sarcoma fragments; although their growth characteristics distinguished them from normal fibroblasts (increased growth and possibility of culture in soft agar), cytogenetic investigations on both lines confirmed that they were genetically normal, and occurred along with malignant cells as a accessory compartment within lesions. Endothelial cells appear to be the sole origin of Kaposi's sarcoma, and may release factors which alter fibroblastic growth. PMID- 3545103 TI - Cold-induced Raynaud's phenomenon ameliorated by intravenous administration of ketanserin: a double-blind cross-over study. AB - Fifteen patients suffering from Raynaud's phenomenon (RP) were examined. They were placed in a "climate chamber" (a small room in which the temperature and humidity could be varied). The temperature was gradually decreased, while the humidity was kept constant. After 60-90 min, distinct RP was induced and intravenous medication was administered. The whole trial was performed in a double-blind, cross-over fashion. Every patient participated in two experiments performed 2 days apart. Either ketanserin or placebo was given during the first experiment. In the second experiment, the medication (or placebo) which had not been given was administered. The effects of ketanserin were highly significant: the bluish pallor changed into bright erythema and the skin temperature rose significantly. This was interpreted as a spasmolytic effect. Intravenously administered ketanserin has a place in the clinical treatment of acutely deteriorating RP of diverse etiologies. PMID- 3545104 TI - Carpal tunnel syndrome caused by amyloid containing beta 2 microglobulin: a new amyloid and a complication of long term haemodialysis. AB - Three patients receiving long term haemodialysis treatment for chronic renal failure due to non-amyloid nephropathy developed the carpal tunnel syndrome requiring decompression surgery. The excised material contained amyloid, which by immunocytochemical techniques was shown to contain beta 2 microglobulin. This is, therefore, a new chemical form of amyloid whose deposition is likely to be the cause of osteoarticular and connective tissue disorders, which are being recognised with increasing frequency in patients receiving long term haemodialysis. Raised beta 2 microglobulin levels are known to occur in chronic renal failure, and the molecule is unable to cross conventional dialysis membranes. The importance of beta 2 microglobulin amyloidosis lies in the threat which it poses to the success of long term haemodialysis. PMID- 3545105 TI - Characterisation of nucleolar proteins as autoantigens using human autoimmune sera. AB - Sera from 271 patients with systemic rheumatic diseases were screened for antinucleolar antibodies using immunofluorescence. Antinucleolar antibodies were found in the sera of 73% of patients with progressive systemic sclerosis, 4% of patients positive for autoantibodies with rheumatoid arthritis, and 8% of patients with rheumatoid arthritis associated with sicca complex, but not in patients with systemic lupus erythematosus, Sjogren's syndrome, undifferentiated connective tissue disease, or in healthy donors. The antinucleolar sera (n = 20) were analysed by immunoblotting techniques. In four sera antibodies against nucleolar proteins with molecular weights of 35 kD, 37 kD, 69 kD, 92-93 kD, and 93 kD could be immunodetected. The nucleolar autoantigens were extractable from the nucleoli together with the preribosomal particle fraction and could be solubilised by ribonuclease (RNAse) treatment. Their presence in the nucleolus was sensitive to actinomycin D treatment of cells. The 37 kD autoantigen could be identified as nucleolar phosphoprotein B23. PMID- 3545106 TI - Surgically treated gangrenous or perforated appendicitis. A comparison of aztreonam and clindamycin versus gentamicin and clindamycin. AB - A randomized, double-blinded, controlled clinical study of 84 patients with surgically treated gangrenous or perforated appendicitis was done to compare the efficacy of the combination of aztreonam, the first monobactam antibiotic, with gentamicin when either was combined with clindamycin. Fifty-six patients who were treated with aztreonam and clindamycin (A/C) and 28 patients who were treated with gentamicin and clindamycin (G/C) fulfilled criteria for evaluation. A matched historic control group of 56 G/C patients was also included for comparison. All measures of outcome, including days of fever, hospitalization, antibiotic therapy, and the incidence of antibiotic failures, were similar. It was concluded that aztreonam was as effective as gentamicin in this study and may offer some advantages with regard to toxicity and serum drug level monitoring. PMID- 3545107 TI - Malignant lymphoma of the breast. A study of 53 patients. AB - Fifty-three patients with non-Hodgkin's lymphoma of the breast were reviewed and classified using four current classifications of lymphoma. All patients were female with a mean age of 57 years. The majority of patients had histiocytic or large-cell lesions and presented as clinical Stage I. The tumors were described clinically as primary in the breast, and mammary parenchyma was found in 79% of the diagnostic biopsy specimens. The other specimens showed lymphoma in mammary adipose tissue. Survival was not influenced by the presence or absence of breast parenchyma in the biopsy. Statistically significant survival differences were found to be related to stage at presentation as well as to tumor grade, using Kiel and Working Formulation categories. Patients with Stage I disease and those with low-grade lesions had a more favorable prognosis. No discernible factors, including stage or histologic findings, appeared to affect the recurrence rate. PMID- 3545109 TI - Effect of a stable prostacyclin analogue on canine renal allograft rejection. AB - The effect of OP-41483 (Ono Pharmaceutical Co., Osaka, Japan), a stable prostacyclin analogue, on canine renal allograft rejection was investigated. Administration for 4 days after transplantation significantly increased renal cortical blood flow and urine output when compared with untreated dogs with renal allografts. Serum creatinine levels remained relatively low during postoperative days 1-4. Mean animal survival time was prolonged. Vascular lesions and mononuclear cell infiltration were greatly diminished in biopsy specimens removed on day 4. This stable prostacyclin analogue provided a degree of protection against canine renal allograft rejection. PMID- 3545110 TI - Cancer of esophagus and esophagogastric junction: analysis of results of 1,025 resections after 5 to 20 years. AB - Resection was carried out in 1,025 of 1,654 patients with cancer of the esophagus or esophagogastric junction at the Peking Medical College Hospitals in China from 1953 through 1973. All cancers of the esophagus were squamous cell carcinomas except for five adenocarcinomas. A lesion localized within the esophageal wall was found in 55% and lymph node metastasis in 41.3% of the patients undergoing resection. All cancers of the esophagogastric junction were adenocarcinomas. The tumor had invaded beyond the boundaries of the stomach in 76.7% of these patients, and positive nodes were found in 61% of the patients. The rate of resectability was 81.2% for esophageal cancer and 74% for cancer of the esophagogastric junction. Surgical mortality after resection was 4.9% (50/1,025). The 5-year survival after resection was 20.9% (214/1,025). Better results were found following complete resection: 24% (210/875) for all patients, 28.2% (162/575) for patients with cancer of the esophagus, and 16% (48/300) for patients with cancer of the esophagogastric junction. Late survival at 10, 15, and 20 years after resection of esophageal cancer was 20%, 12%, and 7.4%, respectively. The favorable prognostic factors after resection of esophageal cancer were tumor of the lower third of the esophagus, the absence of lymph node involvement, and the presence of a localized lesion. The 5-year survival for patients with cancer of the lower third of the esophagus was 32.7%. It was 64.2% for patients with a localized lesion with negative nodes in this subgroup. PMID- 3545108 TI - The selective beta 1-blocking agent metoprolol compared with antithyroid drug and thyroxine as preoperative treatment of patients with hyperthyroidism. Results from a prospective, randomized study. AB - Despite the increasing use of beta-blocking agents alone as preoperative treatment of patients with hyperthyroidism, there are no controlled clinical studies in which this regimen has been compared with a more conventional preoperative treatment. Thirty patients with newly diagnosed and untreated hyperthyroidism were randomized to preoperative treatment with methimazole in combination with thyroxine (Group I) or the beta 1-blocking agent metoprolol (Group II). Metoprolol was used since it has been demonstrated that the beneficial effect of beta-blockade in hyperthyroidism is mainly due to beta 1 blockade. The preoperative, intraoperative, and postoperative courses in the two groups were compared, and patients were followed up for 1 year after thyroidectomy. At the time of diagnosis, serum concentration of triiodothyronine (T3) was 6.1 +/- 0.59 nmol/L in Group I and 5.7 +/- 0.66 nmol/L in Group II (reference interval 1.5-3.0 nmol/L). Clinical improvement during preoperative treatment was similar in the two groups of patients, but serum T3 was normalized only in Group I. The median length of preoperative treatment was 12 weeks in Group I and 5 weeks in Group II (p less than 0.01). There were no serious adverse effects of the drugs during preoperative preparation in either treatment group. Operating time, consistency and vascularity of the thyroid gland, and intraoperative blood loss were similar in the two groups. No anesthesiologic or cardiovascular complications occurred during operation in either group. One patient in Group I (7%) and three patients in Group II (20%) had clinical signs of hyperthyroid function during the first postoperative day. These symptoms were abolished by the administration of small doses of metoprolol, and no case of thyroid storm occurred. Postoperative hypocalcemia or recurrent laryngeal nerve paralysis did not occur in either group. During the first postoperative year, hypothyroidism developed in two patients in Group I (13%) and in six patients in Group II (40%). No patient had recurrent hyperthyroidism. The results suggest that metoprolol can be used as sole preoperative treatment of patients with hyperthyroidism without serious intra- or postoperative complications. Although the data indicate that the risk of postoperative hypothyroidism is higher after preoperative treatment with metoprolol than with an antithyroid drug, a longer follow-up period than 1 year is needed to draw conclusions regarding late results. PMID- 3545111 TI - Cardiovascular effects of positive pressure ventilation in humans. AB - Pulsus paradoxus is the pathological exaggeration of the normal transient decrease in arterial blood pressure that occurs during spontaneous inspiration. The transient increase in arterial pressure associated with positive pressure inspiration is termed reversed pulsus paradoxus (RPP). Cardiorespiratory interactions and the mechanism of these effects have been studied extensively in animals, and to a lesser extent, in humans. In this clinical investigation pulsus paradoxus and RPP were studied in 10 postoperative cardiac patients with invasive monitoring and mediastinal pressure catheters placed intraoperatively. From end expiration to end-inspiration, RPP was accompanied by decreased transmural pressures in the right atrium, left atrium, and aorta. Left ventricular end systolic volume measured by radionuclide studies diminished during a positive pressure inspiration, without a significant change in end-diastolic volume. These results are consistent with decreased left ventricular afterload as the major mechanism of RPP. During spontaneous breathing, inspiration was associated with converse effects, a fall in arterial pressure and an increase in transmural right atrial, left atrial, and aortic pressures from end-expiration to end-inspiration. End-systolic volume was significantly larger at end-expiration than end inspiration, with no change in end-diastolic volume. These findings suggest that an increase in left ventricular afterload during inspiration is responsible for the observed pulsus paradoxus. PMID- 3545112 TI - Placement of left atrial pressure monitoring catheter: use of an elastic surgical suture. AB - Placement of left atrial monitoring catheters during cardiac surgery may be complicated by hemorrhage following the removal of the catheters. The use of an elastic surgical suture made of polyurethane can prevent hemorrhage is used around inserted catheters, because the elastic suture automatically shrinks to close the catheter hole on the left atrial wall when the catheter is removed. PMID- 3545113 TI - Use of a zipper in cardiac surgical operations. AB - A simplified technique to gain repeated access to the median sternotomy incision is presented. The technique involves the use of a sterile polyester zipper attached to the skin edge. The sternum remains open. Unzipping the zipper allows for repeated relief of cardiac tamponade and viewing of cardiac action. Other advantages include prevention of cardiac compression or kinking of assist device cannulas from sternal closure, ease in changing of dressings, and quick removal of ventricular assist devices without reopening the sternum. PMID- 3545114 TI - Classics in thoracic surgery. F. Mason Sones, Jr., (1918-1985). PMID- 3545115 TI - Bacteremic hypocalcemia. A comparison between the calcium levels of bacteremic and nonbacteremic patients with infection. AB - Hypocalcemia has been documented in critically ill patients, including those with sepsis and shock. However, its incidence and significance in bacteremic patients without shock has not been established. In the present study the presence of hypocalcemia was evaluated in a group of 67 consecutive bacteremic patients, as compared with 64 infected but nonbacteremic patients. After correction of serum calcium level for serum protein, 25 of the bacteremic patients (37.3%) had "corrected" hypocalcemia (less than 8.5 mg/dL [2.12 mmol/L]), compared with only three in the nonbacteremic group (4.5%). The incidence and magnitude of hypocalcemia in gram-positive and gram-negative infections was similar. In hypocalcemic patients, the "corrected" calcium level was found to be inversely correlated with day of disease and attained a nadir on day 6 to 8 of bacteremia. This nadir was significantly lower in male than in female subjects. Hypocalcemic patients had a significantly higher maximal temperature than normocalcemic ones, but hypocalcemia was unrelated to serum levels of albumin, transaminase, and creatinine. PMID- 3545116 TI - Comparison of ketanserin and metoprolol in the treatment of essential hypertension. AB - Ketanserin, a serotonin receptor antagonist (S2), lowered blood pressure in patients with essential hypertension; at three months 72% (13/18) had a successful reduction in pressure. No marked orthostatic changes were noted. Older patients responded better when standing. Compared with metoprolol, ketanserin provided no significant difference in response at three months. With ketanserin, the heart rate was reduced only in the supine position, whereas it was reduced in the supine and standing positions with metoprolol. Response to ketanserin could not be predicted from baseline renin, aldosterone, or cortisol levels in blood, nor were there any changes in these factors or in plasma hydroxyindole levels with therapy. Ketanserin was generally well tolerated. Cholesterol values were significantly reduced with ketanserin, and there were no adverse hematologic or biochemical changes. Ketanserin should have a significant role in managing hypertension. PMID- 3545117 TI - Stage V (fibrotic) allergic bronchopulmonary aspergillosis. A review of 17 cases followed from diagnosis. AB - A review of the records of 17 patients with stage V (fibrotic stage) allergic bronchopulmonary aspergillosis observed since initial diagnosis (mean observation period, 4.9 years) demonstrated that, of the 11 surviving patients, four have very severe respiratory impairment. The other seven patients have mild or moderate functional impairment, but most of these have not shown clinical deterioration during the observation period. The occurrence of new roentgenographic infiltrates after the time of diagnosis was observed in only one patient in this series. Serum IgE and IgG levels against Aspergillus fumigatus, when compared with those of a control pool of serum samples from asthmatic patients with immediate cutaneous reactivity to Aspergillus, were the most useful immunologic studies diagnostically. Lung biopsy specimens obtained in five patients were of relatively little diagnostic value. All patients have required long-term prednisone therapy for control of asthma. Those patients whose forced expiratory volume in 1 s (FEV1) remained less than or equal to 0.8 L after initial corticosteroid treatment demonstrated a poor prognosis. When only moderate lung damage has occurred at the time of diagnosis, a stable subsequent course may be expected even in patients with stage V disease. PMID- 3545118 TI - Urinary tract infections and sexual activity in young women. AB - A group of 147 young women with symptomatic urinary tract infection (UTI) were compared with a control group of 105 symptom-free young women belonging to the same population. On logistic-regression analysis, sexual activity was the only significant and independent behavioral difference between the groups (87% of women with UTI were sexually active vs 32.7% of the control group). Of the 147 episodes of UTI, only 28.9% occurred within 24 hours of sexual intercourse; of 24 episodes that occurred during follow-up, the percentage that occurred within 24 hours of intercourse was 33.3%. This finding is in discordance with the close temporal association between UTI and sexual intercourse reported in previous studies. PMID- 3545119 TI - Health benefits of exercise in an aging society. AB - The effects of regular aerobic exercise are important to an aging society increasingly preoccupied with exercise. Traditionally, most attention has been directed to the relationship between a physically active life-style and cardiovascular mortality. In an aging society, however, active life expectancy and maintenance of independence may be as important as effects of regular exercise on longevity. Regular exercise results in increased maximum aerobic capacity due to peripheral changes in muscle (increased capacity for aerobic metabolism and improved substrate and oxygen extraction with a widened arteriovenous oxygen difference) and also due to cardiovascular changes with increased stroke volume and cardiac output in normal persons. "Therapeutic benefits" of conditioning probably occur at submaximal work loads common to everyday activity, when cardiac work and myocardial oxygen consumption are less for any given work load, muscles are more efficient, and relative oxygen requirements are less. Aging is associated with a linear decline in maximum aerobic capacity. The rate of decline is twofold greater when comparing sedentary with physically active middle-aged men. Thus, regular exercise could conceivably lower functional aerobic age by slowing this functional decline. Exercise, particularly excessive exercise, is also associated with serious hazards, including sudden death, nonfatal myocardial infarction, excessive fatigue, hyperthermia, and significant musculoskeletal problems. Accounts of the health effects of exercise should consider a wide range of risks and benefits, especially those related to improving function, minimizing disability, and prolonging independent living. PMID- 3545120 TI - Paroxysmal nocturnal hemoglobinuria preceding malignant lymphoma. AB - We diagnosed lymphoma 14 months after the patient presented with paroxysmal nocturnal hemoglobinuria. To our knowledge, this is the first presentation of both conditions in a patient. One possible explanation is that both conditions could be traced to an alteration in the most primitive hemic stem cell. Such an alteration would have resulted in abnormalities of both lymphoid and nonlymphoid cell lines. PMID- 3545121 TI - Mechanical and renohumoral factors participating in arterial pressure rising in patients with aortic coarctation. PMID- 3545123 TI - [Liver transplantation in children. Where does it stand in 1986?]. PMID- 3545122 TI - Effects of iron-limitation of Escherichia coli on growth, the respiratory chains and gallium uptake. AB - The effects of iron limitation on growth, the composition and function of the respiratory chains, and gallium uptake in Escherichia coli have been studied. Decreasing the iron concentration in a defined medium using Chelex resin gave lower growth yields in both continuous culture and prolonged batch culture. In the former, iron-limited (entering [Fe] less than or equal to 2.0 microM) cells exhibited diminished respiration rates, respiration-driven proton translocation quotients, and levels of non-haem iron and cytochromes. The cellular concentration of haemoprotein b-590 (a cytochrome alpha 1-like hydroperoxidase) decreased 20-fold on iron limitation, whilst a CO-binding pigment with an absorption maximum in the dithionite-treated form near 500 nm appeared. Gallium(III) (9 microM) added to iron-limited, but not iron-sufficient, cultures diminished growth yields further; cells grown with low entering concentrations of iron took up less gallium than iron-sufficient cells. These results are attributed to the interference by gallium(III) with siderophore-mediated metal uptake. Gallium also stimulated iron uptake and was itself accumulated by iron sufficient cells, suggesting that gallium(III) also affects the iron transport system(s) of low affinity. PMID- 3545124 TI - [Severe hypertrophic cardiomyopathy associated with an adrenocortical adenoma]. AB - A case of severe asymmetrical hypertrophic cardiomyopathy occurring in a 11 month old infant presenting with adrenocortical adenoma is reported. Cardiac involvement, as shown by echocardiography, recovered after complete excision of the tumor. Despite few published cases, the etiology of the associated cardiomyopathy is discussed. PMID- 3545125 TI - [Giant Meckel's diverticulum presenting as tumor]. AB - The authors report a case of giant Meckel's diverticulum, presenting as a subumbilical abdominal mass, associated with an infectious picture and anemia in a 16 month-old boy. Epidemiologic, pathologic and clinical features of this rare disorder are reviewed as are the diagnostic means. The differential diagnosis with other cystic masses of the umbilical area (omphalo-mesenteric duct cyst, urachal cyst, mesenteric cyst, duplication) is discussed. PMID- 3545126 TI - [Bacterial adhesiveness and recurrent urinary infections in children]. AB - Bacterial adhesivity test to epithelial cells in vitro was studied, in order to investigate whether urinary, and buccal cells, from children prone to recurrent urinary tract infections (UTI) are better adhered to by uropathogen Escherichia coli (E. coli), as compared to cells from control children, non-prone to recurrent UTI. Cells were withdrawn from 75 children, divided into 3 groups: with recurrent UTI without uropathy, with recurrent UTI and uropathy, and controls, without recurrent UTI and without uropathy. Values obtained showed that most of the children, prone or not to recurrent UTI, have cells allowing good adhesivity of the 2 uropathogen E. coli used and that there is no significant difference among these results and no relation with the 3 described groups. Bacterial adhesivity appears dependent on individual genetic variations of cell donors, presumably related to membrane receptors. Studies on in vitro bacterial adhesivity do not seem to be able to explain pathogenesis of recurrent UTI. PMID- 3545127 TI - [Iconographic rubric. Cerebral abscess caused by Proteus in a 3-week-old infant]. PMID- 3545128 TI - [Maternal-fetal and neonatal syphilis]. PMID- 3545129 TI - [What is the prognosis of preterm infants? III. Follow-up at school age]. PMID- 3545131 TI - Serial semithin sections in immunohistochemistry: techniques and applications. AB - Immunostaining of semithin sections is a valuable tool in biomedical research; however, this method is rather rarely used by histologists. To overcome the apparent reservations concerning this method, the present report describes a technique which is rather simple, largely standardized, and very useful in investigative endocrinology. The technique includes the following steps: snap freezing and freeze-drying of tissue specimens, embedding in Araldite, preparation of serial semithin sections, removal of the resin from tissue sections, immunostaining with Sternberger's peroxidase antiperoxidase (PAP) technique, and analyses of the sections by various microscopical techniques which in part optically enhance immunoreactive sites. In addition to a detailed description of the method, examples for its applications are given, including concomitant investigations of the same cells by empirical staining, immunostaining, and fluorescence histochemistry of biogenic monoamines; colocalization of multiple peptides to the same cells and corresponding specificity controls; three-dimensional reconstructions based upon immunostained serial semithin sections; quantitative (computer-assisted) determinations of immunoreactivities. Because of the advantages offered by immunostained serial semithin sections as well as the vast field of applications, the method described is recommended for routine use. Concomitantly this method covers the gap between conventional light microscopy (paraffin sections) and electron microscopy. PMID- 3545130 TI - Clinical and biochemical effects of verapamil administration to schizophrenic patients. AB - We administered verapamil hydrochloride, a calcium channel antagonist, to seven chronically ill schizophrenic patients for five weeks under double-blind, placebo controlled conditions. No therapeutic effect was noted. Worsening in hostile and uncooperative behaviors and a syndrome of heightened emotional tone was observed during verapamil treatment and during the postverapamil placebo period. Verapamil produced significant increases in cerebrospinal fluid (CSF) and plasma levels of homovanillic acid and in plasma levels of prolactin, as well as significant decreases in plasma levels of 3-methoxy-4-hydroxyphenethyleneglycol. Verapamil and its active metabolite, norverapamil, were partitioned into CSF with CSF/plasma ratios of 0.06 and 0.04, respectively. The lack of therapeutic effects of verapamil in schizophrenic patients differs from earlier reports of its usefulness in treating manic patients. The biochemical and clinical data from our study suggest the possibility that verapamil exerts behaviorally relevant central nervous system activity in schizophrenic patients. PMID- 3545132 TI - Are the islets of Langerhans neuro-paraneuronal control centers of the exocrine pancreas? AB - The authors investigate whether the islets of Langerhans can actually be regarded as "neuro-paraneuronal control centers of the exocrine pancreas" as was first suggested by Fujita and Kobayashi (1979). The question is discussed on the basis of the authors' electron microscopic findings regarding pancreatic innervation before and after truncular vagotomy. The results do not seem to support the above hypothesis which advocates that the intrainsular axons are principally engaged in the release of their transmitters into the capillaries in order to regulate, via the insuloacinar portal vessels, the exocrine function of the pancreas. On the contrary, the present data draw attention to the unambiguous assignation of intrainsular axons to endocrine cells, a point of question in line with several findings published in the literature including papers by the first supporters of this hypothesis. No change was observed in the innervation pattern of the effector cells after vagotomy. PMID- 3545133 TI - Electron microscopic observation of the primary cilium in the pancreatic islets. AB - A primary cilium often projected from the Golgi region of pancreatic A, B and D cells. The proximal portion of the cilium was found surrounded by a tubular invagination of the plasmalemma, and then the cilium extended into the intercellular canaliculus. The most proximal portion of the ciliary membrane exhibited periodical densities which might correspond to the ciliary necklace. The axoneme of the cilium was basically of the 9 + 0 pattern, i.e., nine peripheral doublets and no central singlet, though it was modified along the length of the cilium. Although a few appendages were projected from each doublet, it was difficult to identify dynein arms and nexin links. At the most proximal portion of the cilium, a "champagne-glass" structure connected each doublet with the ciliary membrane. The distal and proximal centrioles of the diplosome were connected to each other by a striated band. The proximal centriole, which served as a basal body, had accessory structures, such as alar sheets, basal feet and rootlets. Frequent projections of the primary cilium and its elaborate structure suggest that the cilium is not an aberrant structure but rather one which plays a certain role in the islet cell function. PMID- 3545134 TI - Knowledge-based systems in laboratory medicine and pathology. A review and survey of the field. AB - Knowledge-based systems are computer systems designed to handle knowledge intensive tasks, usually involving reasoning and inference. They are increasingly being applied to problems in laboratory medicine and pathology. In this article we provide a brief introduction to the basic concepts of knowledge-based systems, review some of their published applications, and report on an informal survey of specialists in laboratory medicine and pathology. The survey, sent to 102 individuals, indicated that 24% were involved in developing knowledge-based systems, with most systems at an early stage of development. Recent advances in knowledge-based systems research as well as survey responses suggest that this technology will have increasing value in laboratory medicine and pathology. PMID- 3545136 TI - Lymphocyte nuclear morphology in diffuse well-differentiated lymphocytic lymphoma. Comparative morphometry of normal lymphoid tissues, non-Hodgkin's lymphoma, and Hodgkin's disease. AB - Precise morphologic data on the relationship of diffuse well-differentiated lymphocytic lymphoma (DWDLL) to other non-Hodgkin's lymphomas (NHLs) are lacking in current classifications of lymphomas. Morphometry of plastic-embedded tissues describes details of the mean nuclear parameters and distribution of lymphocyte types in 14 cases of DWDLL in nodal and extranodal sites. The results indicate that the proportion of small (unstimulated or nontransformed) lymphocytes in DWDLL varies from 50% to 86%. The mean nuclear area of small lymphocytes in DWDLL is either within the size range or somewhat smaller, and many examples are more irregular in shape, than the small lymphocytes in germinal centers that are morphologically comparable with the majority of lymphocytes in DWDLL and mantle zones. The morphologic relationship of DWDLL to other NHLs, Hodgkin's disease, and paracortical, mantle, and germinal center lymphocytes in lymphoid-reactive hyperplasia was established by morphometric analysis of the nuclear profiles of small lymphocytes. The small (nontransformed) lymphocytes in those subtypes of NHL other than DWDLL have abnormally small and more irregular nuclear profiles than those in normal small lymphocytes, or the small-lymphocyte population of Hodgkin's disease. Such findings may be of diagnostic significance to pathologists. PMID- 3545135 TI - Main autopsy findings in bone marrow transplant patients. AB - The autopsy findings in 24 cases (representing 17 males and seven females) that underwent bone marrow transplantation during the course of disease are reported. The mean age of the patients was 20.0 years, with individual ages ranging from 7 to 40 years. In 23 cases, serious infectious disease occurred. A patient frequently exhibited more than one type of infection. In total, there were seven mycotic, eight cytomegalovirus, and 15 bacterial infections. Twenty-three cases showed striking lung pathology, the most prevalent lesions being infectious diseases and those of diffuse alveolar damage, which was found in ten cases. Gastrointestinal tract pathology of differing types was observed in 13 cases. Necrotizing enterocolitis was observed in three of these cases. Three cases also displayed cholangiolar cholestasis, probably related to their terminal infectious disease. In only two cases could graft-vs-host disease be proved histologically. PMID- 3545137 TI - Diffuse dysplasia of cerebral hemispheres in a fetus. Possible viral cause? AB - The pathologic anatomy of an infant born with an occluded ventricular system and cerebral dysplasia is described. The possible role of an intrauterine viral infection as the cause is discussed, as is the possible relationship of this lesion to cerebro-ocular dysgenesis (Warburg syndrome). PMID- 3545138 TI - Hepatic adenomata in type Ia glycogen storage disease. AB - Liver adenomata are common in young adults and adults with type Ia glycogen storage disease. Complications that may arise in these patients include acute hemorrhage and malignant transformation. With appropriate dietary therapy, they may partially or completely regress. We describe a young woman with type Ia glycogenosis who developed liver adenomata. Because of its persistence and the significant potential of malignant transformation, liver transplantation was performed. This case is discussed in light of a review of the literature on the subject. PMID- 3545139 TI - Correlation between hepatic hepatitis B core antigen and serum hepatitis B virus DNA levels in patients with chronic hepatitis B virus infections in Taiwan. AB - Paired liver biopsy specimens and serum samples from 76 patients with chronic hepatitis B virus (HBV) infection were taken for staining of hepatitis B core antigen (HBcAg) by immunoperoxidase and testing of HBV-DNA by a spot hybridization technique, respectively. Thirty-two tissue specimens showed positive staining for HBcAg in their hepatocytes. The two patients with diffuse HBcAg expression in liver tissue also had high serum concentrations of HBV-DNA (greater than 10 pg/10 microL). Among 30 patients with focal HBcAg distribution, 28 patients (93.3%) had measurable levels of serum HBV-DNA and 17 patients (60.7%) had high levels of serum HBV-DNA. Of 44 patients without hepatic HBcAg expression, only 12 patients (27.3%) had detectable serum HBV-DNA, and most patients (93.1% [11/12]) had low concentrations (less than 10 pg/10 microL). Nineteen patients had superimposed hepatitis D virus infection, and, of these, three patients (15.8%) had detectable serum HBV-DNA in low concentrations, while one of the three patients had stainable HBcAg in his hepatocytes with focal distribution. Two of the three patients with hepatitis A virus superinfection who had focal HBcAg expression in their liver tissue had serum HBV-DNA levels that were high during the acute phase of hepatitis A virus infection, and in one patient his serum HBV-DNA levels further increased from 10 pg/10 microL to 40 pg/10 microL during the recovery phase. Thus, measurement of serum HBV-DNA levels in patients with chronic HBV infection correlated well with their hepatic HBcAg expression, and both represent the precise status of HBV replication. PMID- 3545140 TI - Erythromelalgia: case report and literature review. AB - Erythromelalgia, known also as erythalgia and erythermalgia, is a rare condition causing redness and burning sensation in the extremities, usually the lower. It may be primary or idiopathic, or secondary in association with other diseases, usually myeloproliferative disorders. The present report describes a patient in whom the condition was associated with astrocytoma, after having been misdiagnosed. Because of its frequent association with posture, its differential diagnosis is important to physiatrists. PMID- 3545141 TI - Ketoconazole prevents Candida sepsis in critically ill surgical patients. AB - We conducted a prospective, randomized, double-blind, placebo-controlled study to determine whether or not ketoconazole could prevent yeast colonization or invasion in critically ill adult surgical patients. Fifty-seven patients in a surgical intensive care unit (SICU) with three or more clinical risk factors for Candida infection were randomized to receive ketoconazole, 200 mg via the gastrointestinal tract daily (27 patients), or placebo (30 patients). Patients with hepatic dysfunction were excluded. The study was continued for 21 days or until one week after discharge from the SICU, whichever was longer. Stool cultures were obtained every three days and other cultures as indicated clinically. Patients were observed for yeast colonization (sputum, urine, stool, or wound) and invasion (fungemia or deep tissue focus). The incidence of Candida colonization was significantly lower in the ketoconazole group than the placebo group. Invasive yeast sepsis developed in five (17%) of the placebo-treated patients and in no patient in the ketoconazole group, a significant difference. Length of stay in the SICU was significantly lower in the ketoconazole group, as were the basic SICU patient charges. Sixty percent of the patients with invasive fungal sepsis died. PMID- 3545142 TI - Endotoxin promotes the translocation of bacteria from the gut. AB - Experiments were performed in mice to determine whether endotoxin could cause bacteria normally colonizing the gut to spread systemically, a process termed bacterial translocation. Endotoxin given intraperitoneally promoted bacterial translocation in a dose-dependent fashion from the gut to the mesenteric lymph node (MLN). The incidence of bacterial translocation to the MLN was similar whether the endotoxin was administered intramuscularly or intraperitoneally, although the number of bacteria colonizing the MLN was greater with intraperitoneal endotoxin. The incidence and magnitude of endotoxin-induced bacterial translocation were similar between CD-1 and C3H/HeJ (endotoxin resistant) mice, indicating that bacterial translocation is not prevented by genetic resistance to endotoxin. Thus, it appears that the gut may serve as a reservoir for bacteria causing systemic infections during endotoxemia. PMID- 3545143 TI - Effect of insulin on amino acid uptake and protein turnover in skeletal muscle from septic rats. Evidence for insulin resistance of protein breakdown. AB - We investigated the effect of different concentrations of insulin (0, 10, 1 X 10(2), 1 X 10(3), 1 X 10(4), and 1 X 10(5) mU/L [0, 70, 7 X 10(2), 7 X 10(3), 7 X 10(4), and 7 X 10(5) pmol/L]) on amino acid (alpha-aminoisobutyric acid) uptake and protein synthesis and breakdown in incubated extensor digitorum longus (EDL) and soleus muscles of rats. We studied three groups: untreated, fed rats; sham operated rats; and septic rats. Sepsis was induced by cecal ligation and puncture. The alpha-aminoisobutyric acid uptake was increased by insulin in all three groups. Protein synthesis was maximally stimulated by 30% to 40% by 1 X 10(2) mU/L (7 X 10(2) pmol/L) of insulin in all three groups. Protein degradation in soleus muscle was not affected by insulin. In EDL muscles from untreated and sham-operated rats, protein breakdown was reduced by 15% to 20% by 1 X 10(2) mU/L (7 X 10(2) pmol/L) of insulin. In contrast, protein breakdown was not inhibited by insulin in septic EDL muscle until the concentration of the hormone was increased to 1 X 10(4) mU/L (7 X 10(4) pmol/L), at which concentration the hormonal effect was less than half that in nonseptic muscle. The results suggest a postreceptor insulin resistance of protein breakdown in septic muscle, while the response to the hormone of amino acid transport and protein synthesis was not altered in sepsis. PMID- 3545144 TI - Cardiotoxicity mechanisms from the point of view of preclinical or premarketing safety evaluation. AB - The most commonly occurring cardiotoxic reactions in humans are due to over exposure to chemicals that affect physiological function of the heart. These effects, which are usually receptor-mediated, are dose related and can generally be predicted from safety studies in animals. Direct chemical toxicity is initiated by an interaction of a reactive metabolite of the xenobiotic with cellular macromolecules. The incidence of such cardiotoxicity is low because few of these chemicals are metabolized in the heart. The concentration of cellular protective substances influences the development of such toxicity, and therefore species variation should be considered in safety studies. Chemically induced immune system-mediated reactions can develop in the heart, and may occur in anaphylaxis. Antibody mediated cytotoxic or immune complex reactions are rare events, and the predictability is poor. In some instances sensitivity is immunogenetically controlled. Cardiotoxic effects can also develop after prenatal exposure to chemicals, and thus consideration should be given to examining the offspring for those effects in teratology studies. PMID- 3545145 TI - Application, limitations and research requirements of in vitro test systems in toxicology. AB - There is increasing application of in vitro-test systems for toxicological evaluation of chemicals, which became possible by increasing understanding of the biological endpoints present in such systems and their capability for metabolic activation and inactivation. This communication focuses on the capacities of metabolic activation and inactivation in mutagenicity test systems, using bacteria, mammalian cells in culture and isolated hepatocytes. Bacterial test procedures with S-9-fraction are specific metabolic activation systems with low inactivation capacity. Mammalian cells are either deficient in metabolic activities or contain only limited activation capacity although special cell lines derived from hepatoma cells express certain metabolic activation as well as inactivation reactions. Isolated hepatocytes contain enzymatic activities similar to those in the intact liver, which however decrease at different rates. It is the goal of present research to construct cell lines with defined and sufficient activities of these enzymes. In isolated hepatocytes chemically induced DNA repair can be readily detected when a clear discrimination between mitochondrial, semiconservative and repair synthesis is provided. In such systems genotoxicity of reactive oxygen species is decreased by physiological concentrations of alpha keto-acids, pyruvate possessing the highest antioxidant activity. It is concluded that in vitro test systems provide a suitable tool for detecting genotoxic and toxic effects of chemicals. However, many biological parameters such as metabolic activity, degree of differentiation of the cells, cofactor requirement, and composition of the medium affect the reliability of the test system. Thus, only a detailed understanding of the biology and biochemistry of such test allow production of reliable and reproducible results. PMID- 3545146 TI - Cellular defense mechanisms against toxic substances. AB - Recent studies of cellular defense mechanisms against toxic substances are reviewed with particular emphasis on the critical functions of reduced glutathione. Studies of the metabolism of paracetamol and of the redox active quinone menadione in isolated rat hepatocytes, are summarized in order to illustrate how multiple defense mechanisms are involved in the protection of the cell against the toxicity of these agents. Cytotoxicity with both agents occurs only after the cellular defense mechanisms have become exhausted. PMID- 3545147 TI - The pharmacology of simple molecules. AB - The biological effects of simple molecules have traditionally been ascribed to their actions on the lipid portions of biological membranes. However, at the low concentrations of these molecules which induce general anaesthesia or have acute toxic effects in animals, changes in lipid bilayer properties are so small that they are unlikely to be relevant biologically. On the other hand, these molecules do inhibit the activity of a pure lipid-free protein, with ED50 concentrations which are essentially identical to the biological ED50 and LD50 concentrations. Moreover, the well-known but puzzling cutoffs in potencies in homologous series of compounds are also found with this enzyme. The accumulating evidence now suggests that the pharmacological effects of low concentrations of relatively inert agents are best explained in terms of their direct binding to amphiphilic pockets of circumscribed dimensions on proteins. PMID- 3545148 TI - Structure-activity relationship of nitroimidazo (2,1-b) thiazoles in the Salmonella mutagenicity assay. AB - The mutagenic activity of a series of nitroimidazo (2,1-b) thiazoles was determined in Salmonella typhimurium TA-100 strain by means of the Ames test. A multiple regression analysis showed a highly significant parabolic relationship between mutagenic activity and the Rm values as an expression of the lipophilic character of molecules. The lipophilic character should be important in determining an optimal cell permeation. However when the lipophilic character was expressed by means of the sigma pi values the equation was much less satisfactory. This could be due to the fact that the Rm values of nitroheterocyclic compounds actually represent a measure both of lipophilic and polar character. PMID- 3545149 TI - Review of epidemiology in relation to passive smoking. AB - Large segments of the population in many countries are exposed to environmental tobacco smoke which means that health effects resulting from this exposure are of great public health concern. Acute irritation of the eyes and airways as well as annoyance are probably the most common effects of passive smoking. Children with smoking parents run an increased risk of bronchitis and pneumonia. This seems to be related primarily to the smoking habits of the mother. Pulmonary function changes have also been reported in passive smokers but the data are not consistent. There are a few epidemiologic studies showing an increased risk of lung cancer in nonsmokers married to smokers. These studies may be affected with various types of biases and the association can not at present be regarded as causal. Particular attention should be put on the acquisition of precise and accurate exposure information in future epidemiologic investigations on health effects related to passive smoking. PMID- 3545150 TI - Aerosols of smoke, respiratory physiology and deposition. AB - Tobacco smoke is discussed as a multi-component droplet aerosol system of finite airborne life time which changes rapidly right after formation near the combustion zone of the tobacco and continues to change gradually when aging and approaching a multiphase steady state between vaporized smoke constituents mixed into the air and the dispersed particulate phase which will eventually vanish because of physical mechanisms removing the smoke particles from the airborne state. Data on chemical composition and physical characteristics of mainstream and sidestream cigarette smoke are compared and the dynamic models of aerosol particle behavior and deposition in the respiratory tract under different physiological conditions are discussed. While differences in chemical composition between mainstream and sidestream smoke aerosol systems are reported in the literature at least for the gas phase, there seems to be no reliable body of evidence confirming that mainstream and sidestream cigarette smokes have sufficiently different physical characteristics which would cause substantially different deposition patterns and different relative deposition in the respiratory tract. However, there are scanty experimental data in the literature on cigarette smoke deposition in the lung which seem to indicate that mainstream smoke deposition may exceed theoretical expectations while sidestream smoke may not. Further experimental results are needed before firm conclusions can be drawn. An ongoing experimental effort is described where deposition of sidestream cigarette smoke will be measured on mouth breathing test panels. PMID- 3545151 TI - Distribution by immunofluorescence of viral products and actin-containing cytoskeletal filaments in rubella virus-infected cells. AB - Rubella virus (RV)-host cell interactions were examined by indirect immunofluorescence staining using antibodies to viral products and cytoskeletal components as probes. The patterns of immunofluorescence observed with human convalescent sera indicated that in infected Vero cells RV-specified proteins were distributed throughout the rough endoplasmic reticulum with some possible accumulation in the region of the Golgi complex. Viral RNA synthesis, detected with anti-double stranded RNA, appeared to be confined to small, intensely stained foci irregularly distributed in the cytoplasm. When cells were infected at a higher multiplicity, these foci appeared to aggregate into linear arrays. Infection with RV had a profound effect on the organization of actin in both Vero and BHK 21 cells, as shown by anti-actin antibodies. Actin microfilaments were observed to disintegrate progressively into amorphous aggregates of apparently monomeric actin as the infection proceeded. Because of the role actin microfilaments may play in cell mitosis it is postulated that this effect may be related to the inhibition of cell division reported to be associated with the congenital rubella syndrome. PMID- 3545152 TI - Failure of intranasally administered 4', 6-dichloroflavan to protect against rhinovirus infection in man. AB - 4',6-Dichloroflavan, a potent inhibitor of rhinovirus replication in tissue culture systems was tested in a double-blind, placebo-controlled volunteer trial for its protective efficacy against experimental rhinovirus infection. Dichloroflavan was administered intranasally as a 5 per cent w/v aqueous suspension (40 mg; 5 times per day) for 5 doses before and 21 doses after intranasal challenge with rhinovirus type 9, a virus type known to be highly sensitive to the drug when tested in tissue culture. A total of 49 volunteers were included in the efficacy analysis. Dichloroflavan did not produce any consistent or significant reduction in clinical or laboratory parameters of infection. Indeed there was some indication that treatment with the drug may have been associated with increased severity of clinical signs and symptoms. Dichloroflavan administered intranasally is not, therefore, of value in the prevention of human rhinovirus infection. PMID- 3545153 TI - [Studies on a comparison between continuous changes in respiratory impedance and in regional ventilatory distribution, and on the sites of airway obstruction induced by the methacholine provocation test]. PMID- 3545154 TI - [Internal contamination with medically important radionuclides]. PMID- 3545155 TI - [Various results of a study of the pre-somite stages of human embryogenesis in vivo]. PMID- 3545156 TI - [Arterial anastomoses with the argon laser. Experimental study]. PMID- 3545157 TI - A clinical review of calcium antagonists in acute myocardial infarction. PMID- 3545158 TI - Eye-movement disorders in brain-stem and cerebellar stroke. AB - Vertebrobasilar strokes can yield varied disturbances of eye movements, by affecting specific centers and pathways contained in the brain stem and cerebellum. Unique disorders combining supranuclear, nuclear, and infranuclear syndromes may occur. Some eye-movement abnormalities are useful localizing signs (eg, gaze palsies, rotatory nystagmus, and ipsilateral saccadic bias), but many others are not. The use of techniques such as magnetic resonance imaging may provide new insights in clinicotopographic correlations in patients with good recovery, in the absence of pathologic verification. PMID- 3545159 TI - Pregnancy-related primary brain and spinal tumors. AB - We reviewed the literature concerning primary brain and spinal tumors with first manifestation or acceleration of symptoms during pregnancy or within the first postpartum week and encountered four new cases in our center. The incidence of brain tumors that become symptomatic during pregnancy appears to be decreased compared with that in age-matched women. The relative frequency of the different primary brain tumor types is not changed by pregnancy. The number of meningiomas gradually tends to increase during pregnancy, with gliomas and spinal vascular tumors accumulating in the first and third trimesters, respectively. Postpartum amelioration of symptoms has especially been described for meningiomas and spinal vascular tumors. We conclude that different types of tumors are influenced at different stages of pregnancy. Although progesterone receptors predominate compared with estrogen receptors, no definite causal relationship with progesterone has been established. PMID- 3545161 TI - Candida albicans endophthalmitis following penetrating keratoplasty. PMID- 3545160 TI - Ferrier and the study of auditory cortex. AB - David Ferrier was a British physician who studied the localization of function in the cerebral hemispheres during the latter half of the 19th century. Using stimulation and ablation techniques, Ferrier demonstrated that auditory cortex was located in the superior temporal gyrus of the monkey and that ablation of auditory cortex resulted in deafness. Although he was substantially correct, Ferrier's location of auditory cortex was not accepted by his contemporaries, and his observations of cortical deafness were, until recently, discounted by modern researchers. Just why his findings were rejected is of interest to the study of cortical function. PMID- 3545162 TI - A method for standardizing cytologic sampling for the estimation of nasal ciliary activity. AB - A method for sampling cytological brushings of human nasal mucosa using phase contrast microscopy is detailed and the modes for counting the ciliary beat frequency (CBF) are reviewed. To test the reproducibility of our method, we performed two sampling procedures on subsequent days on each of 19 volunteers and patients. The total volume of harvested cells, the number of beating ciliated cells, and the CBF were assessed. Since there are some differences present in subsequent cell samples, our findings indicate that it may be better to critically evaluate a single sampling procedure in order to establish a correct clinical diagnosis, especially if the number of harvested cells is small. The need to standardize methods for counting the CBF to achieve comparable results is stressed. PMID- 3545163 TI - Granular cell tumor of the uvula. AB - We describe the first case of granular cell tumor (GCT) of the uvula, which occurred in an 18-year-old woman. GCT is a relatively rare tumor, and is almost always benign. The most frequent locations are the skin and the oral cavity. These tumors usually present clinically as small, slowly growing tumors of characteristic histological appearance. Although its histogenesis is uncertain, our study as well as recent reports support a currently held theory of a neurogenic derivation. The recommended treatment for the granular cell tumor is local excision whenever possible. PMID- 3545164 TI - Differential distribution of von Willebrand factor in endothelial cells. Comparison between normal pigs and pigs with von Willebrand disease. AB - Endothelial cells were cultured from the thoracic aorta, inferior vena cava, and pulmonary artery of normal adult and young pigs as well as from pigs with von Willebrand disease (vWD). The von Willebrand factor (vWF) was estimated by ELISA in endothelial cell supernatants and lysates as well as by immunofluorescence of cells by use of either a polyclonal or a monoclonal antibody to vWF. In normal adult pigs, the content of vWF in supernatants and cell lysates was the highest in the pulmonary artery, lower in the inferior vena cava, and almost nil in the thoracic aorta. In the normal young pigs, vWF was higher in the inferior vena cava endothelial cell supernatants and lysates than in the pulmonary artery. Thus the synthesis of vWF by endothelial cells varies along the vascular tree and appears to be modulated by the age of the animals. In pigs with vWD, levels of vWF were slightly detectable in endothelial cells from the pulmonary artery (contrasting with levels of plasmatic vWF below 0.01 U/ml), but were undetectable in the thoracic aorta and inferior vena cava. Thus, if vWF plays a role in atherogenesis, this involves circulating, not its intracellular, form. PMID- 3545165 TI - Persistent hypoglossal artery--a case report. PMID- 3545166 TI - Pneumonia following bone marrow transplantation. PMID- 3545167 TI - Radiographic projections for coronary angiography--implications for digital subtraction angiography. PMID- 3545168 TI - Spectrum of non atretic biliary tract obstruction in children. PMID- 3545169 TI - Uterine lipoma: ultrasound and C.T. appearances. PMID- 3545170 TI - Total body irradiation and bone marrow transplantation in Adelaide--a short report on 7 years experience. PMID- 3545171 TI - Early reproductive loss. AB - Although at least 15% of clinically recognized pregnancies end in spontaneous abortion, a much higher loss varying from 8-78% probably occurs subclinically during very early gestation. This 'early reproductive loss' is largely presumptive and may be caused by factors such as chromosomal abnormalities, infections, endocrine deficiencies, uterine disease, and immunological factors. Little may be offered by way of treatment; but more recently, immunotherapy appears an attractive possibility in selected cases. PMID- 3545172 TI - Association between diaphragm use and asymptomatic bacteriuria. AB - The prevalence of asymptomatic bacteriuria was assessed in women using different contraceptive methods. Three hundred and twenty women attending a family planning centre were studied, 80 in each of the following groups: diaphragms, intrauterine contraceptive devices (IUCDs), oral contraceptives (OCs) and no contraception. The numbers with asymptomatic bacteriuria in the 4 groups were as follows: diaphragm - 12 (all E coli); IUCD - 3 (E coli; P mirabilis; S saprophyticus); OC 5 (all E coli); no contraception - 4 (3 E coli; 1 S saprophyticus). The prevalence of Gram-negative bacteriuria in women using diaphragms was significantly higher than for women in the other groups (chi 2 = 8.98; p less than 0.05). Factors such as parity, numbers of sexual partners and frequency of sexual intercourse had no apparent effect. The use of diaphragms may contribute to the risk of Gram-negative urinary tract infections in sexually active women. PMID- 3545173 TI - A prospective randomized comparative trial of the Gravigard, Latex Leaf, Dalkon Shield and Multiload Cu 250 IUDs. AB - This prospective randomized trial in 843 patients compared the effectiveness and complications of 4 intrauterine devices. At 24 months the gross accidental pregnancy rate for the Dalkon Shield was higher than for the 7Cu200 (p less than 0.05) and the ML Cu250 (p less than 0.05). The 7Cu200 had a higher expulsion rate than the Dalkon Shield (p less than 0.01), Latex Leaf (p less than 0.001) and ML Cu250 (p less than 0.001). Use-related terminations were higher for the 7Cu200 than for the ML Cu250 (p less than 0.01). Removal for pelvic inflammatory disease was necessary in 8 women (2 for the Latex Leaf and 3 each for the 7Cu200 and Dalkon Shield). There was no significant difference in termination rates between the ML Cu250 and Latex Leaf but subsequently the Leaf has given problems with removal particularly in women who have defaulted follow-up for several years. PMID- 3545174 TI - AS-204 remembered. PMID- 3545175 TI - Hormone and energy substrate changes during prolonged exercise in the heat. AB - Eleven trained men (aged 34.5 +/- 2 yrs) were studied during a 16.1 km run in the heat (Ta = 30.2 degrees C). Fasting blood samples were taken prior to the run and at 6.4, 12.9, and 16.1 km, and 3 h recovery. Serum or plasma glucose, insulin, glucagon, glycerol, and catecholamines were measured. Mean values were: exercise intensity, 80% of VO2max; final rectal temperature, 39.9 degrees C; and weight loss, 4.0%. Glucose increased 61% by 6.4 km, then decreased significantly by 16.1 km. Glycerol increased by 415% at 6.4 km, and continued to increase throughout the run. Epinephrine increased progressively during the run, but norepinephrine increased at 6.4 km, and did not change further during the exercise. Insulin increased slightly at 6.4 km, then decreased significantly from 6.4-16.1 km. Glucagon increased from 6.4-12.9 km and remained elevated at 3 h recovery. Hormone and substrate measurements obtained only before and after prolonged exercise may not reflect changes that occur during the course of the exercise. The observed insulin-glucagon relationships vary from previous findings in nontrained subjects at lower exercise intensities. PMID- 3545176 TI - Induction and prevention of acceleration atelectasis. AB - Acceleration atelectasis is the absorptional collapse of alveoli in the dependent lung due to increased accelerative forces. It is exacerbated by breathing 100% oxygen and, during +Gz exposure, by the use of an anti-G suit. Experiments were conducted on 12 subjects using simulated aerial combat maneuvers (SACM) with G profiles having peak exposures of either 4.5 G or 9 G. Decreases in vital capacity (VC) measurements were used as quantification of atelectasis, two types of reduction being identified and described. Labile reductions in VC were readily restored by a deep breath or cough. Such reduction approximated 28% following the 4.5-G SACM and 25% following the 9-G SACM. More persistent (so called) stable reductions were of lesser degree, values of -20% being seen following both 9 G and 4.5 G maneuvers. Acceleration atelectasis causes symptoms of chest pain, coughing, and shortness of breath. Subjective ratings of the severity of these symptoms were obtained from the subjects, and these were much greater following the 4.5-G SACM exposures than after the 9-G runs. Acceleration atelectasis was reduced by dilution of the inspired oxygen concentration by argon and nitrogen (evaluated at 95, 82.5, 70, 50, and 20% oxygen); the addition of unassisted positive pressure at 30 mm Hg (4 kPa) to the breathing mask; or the performance of the anti-G straining maneuver (AGSM). PMID- 3545177 TI - Left ventricular receptors: physiological controllers or pathological curiosities? AB - Mechanically and chemically sensitive receptors in the ventricle have been described histologically and electrophysiologically. Early experiments documented the hypotension and bradycardia that resulted from the intracoronary administration of one of the veratrum alkaloids (the Bezold-Jarisch reflex). Mechanical distension of the ventricles also results in a reflex decrease in heart rate and a reduction in peripheral resistance. Skeletal muscle and coronary vascular resistance appear to be most prominently affected by stimulation of ventricular receptors. Coronary ischemia has also been shown to evoke reflex effects which are attributable to stimulation of ventricular receptors. The resultant bradycardia can be especially ominous in acute myocardial infarction. Changes in myocardial inotropic state have been shown to alter ventricular receptor discharge in experimental animals. This stimulus may evoke reflex changes in peripheral hemodynamics. A variety of humoral substances can alter ventricular receptor discharge and evoke Bezold-Jarisch like responses. These include bradykinin and prostaglandins. PGI2, when given intracoronary in small doses or intravenously in larger doses will lower blood pressure while inhibiting the baroreflex induced tachycardia. It has also been shown in some experiments that PGI2 and arachidonic acid can evoke overt bradycardia and hypotension via a reflex mechanism. The role of prostaglandins in cardiovascular reflex control may be important in pathophysiologic states such as coronary ischemia and heart failure. Ventricular receptors can interact centrally with the arterial baroreceptors to attenuate the baroreflex control of both heart rate and peripheral resistance. Finally, the stimulation of ventricular receptors can alter a variety of humoral substances which are important regulators of cardiovascular and fluid volume homeostasis. These include vasopressin, renin and catecholamines. Those studies which have been done within the last 10 years or so, especially in unanesthetized animals, have demonstrated that the Bezold Jarisch reflex is more important to cardiovascular control than previously thought. Future work will be necessary to determine the precise role ventricular receptors play in various pathological situations. PMID- 3545178 TI - Myocardial performance and metabolism in non-ketotic, diabetic rat hearts: myocardial function and metabolism in vivo and in the isolated perfused heart under the influence of insulin and octanoate. AB - The influence of a non-ketonic, chronically diabetic state (60 mg/kg streptozotocin) on cardiac function and metabolism was studied under in vivo conditions by inserting a Millar-tip catheter into the left ventricle and in the model of the isolated perfused heart. In vivo heart rate and maximal left ventricular systolic pressure were reduced after a diabetes duration of 4 and 12 weeks. The maximal rise and fall in left ventricular pressure progressively declined with the duration of diabetes. The reduced myocardial function was associated with a loss in ATP and adenine nucleotides. In the perfused heart of chronically diabetic rats, heart function was also impaired and could not be restored in vitro by perfusion with glucose and insulin. In the presence of octanoate--a substrate which can be metabolized independently from insulin--heart function of diabetic rats was improved, but remained lowered as compared to controls. Since the content of myocardial creatine phosphate was reduced in diabetic hearts perfused with octanoate, these findings indicate that the suppression of cardiac performance is not only a result of an impaired glucose metabolism, but of a more general defect in energy provision and utilization. In contrast to hearts of acutely diabetic, ketotic rats most often used, the rate of lipolysis of endogenous triglycerides and the contribution of fatty acids to energy production was low in the chronically diabetic state. Inhibition of fatty acid oxidation by an inhibitor of carnitine palmitoyltransferase (CPTI) did not restore the reduced responsiveness of diabetic hearts to insulin. Analysis of intracardiac metabolites revealed that in the perfused heart of chronically diabetic rats glucose-6-phosphate and citrate do not accumulate as in hearts of ketotic, diabetic rats. Therefore, the impaired glucose metabolism presumably reflects a reduced uptake of glucose rather than in inhibition of glycolysis as in hearts of ketotic, diabetic rats. PMID- 3545180 TI - Arteriovenous glucose differences across the mammary gland of the fed, starved, and re-fed lactating rat. AB - Arteriovenous glucose difference across the mammary gland of the lactating rat was used as an 'instantaneous' monitor of mammary glucose uptake. Plasma [glucose] and arteriovenous glucose difference varied according to whether Halothane, diethyl ether or sodium pentobarbitone anaesthesia was used. In pentobarbitone-treated rats a 60% glucose extraction in the fed state decreased to 5% after 18 h starvation, and recovered to 40% and 59% after 15 min and 60 min re-feeding respectively. The increase and decrease in plasma [fatty acids] and the depletion and restoration of hepatic glycogen mostly followed similar time courses. Re-feeding was accompanied by a brief surge of plasma [insulin]. Starved lactating rats showed a markedly greater capacity than age-matched virgin rats in the oral and intraperitoneal glucose tolerance tests. Mammary glucose uptake in the starved rat was significantly restored by oral or intraperitoneal glucose or by insulin, but not by acetoacetate or by heparin-induced elevation of plasma [fatty acids]. The role of insulin and of possible changes in mammary sensitivity to insulin in the return of mammary glucose uptake on re-feeding is discussed. PMID- 3545179 TI - Multienzyme complex of aminoacyl-tRNA synthetases: an essence of being eukaryotic. PMID- 3545181 TI - The effect of bilirubin photoisomers on unbound-bilirubin concentrations estimated by the peroxidase method. AB - Unbound bilirubin is oxidized to nearly colourless substances in the presence of H2O2 or ethyl hydroperoxide and horseradish peroxidase. To predict the risk of kernicterus (degenerated yellow pigmentation of nerve cells), this principle has been widely utilized for estimating the concentration of unbound bilirubin in hyperbilirubinaemic serum. However, the serum contains polar geometric photoisomers of bilirubin. Therefore, to clarify the effect of bilirubin photoisomer concentrations on unbound-bilirubin concentration, the concentration of bilirubin and its photoisomer and of unbound bilirubin in samples obtained from experiments in vivo and in vitro were simultaneously and individually estimated by h.p.l.c. and the peroxidase method. During photoirradiation, both in vivo and in vitro, the serum polar (ZE)-bilirubin IX alpha concentration increased remarkably, but unbound-bilirubin values were not affected at all. However, during experiments in vitro, unbound bilirubin concentrations increased only when concentrations of the rather polar (EZ)- and (EE)-cyclobilirubin IX alpha increased considerably in a human serum albumin-bilirubin solution irradiated with blue light. Thus it is concluded that unbound-bilirubin concentrations, and consequently the initial rate of the peroxidase reaction, is not accelerated by the increase in either (ZE)-bilirubin or (EZ)-cyclobilirubin concentration within the clinically observed range. PMID- 3545182 TI - Mannitol-1-phosphate dehydrogenase of Escherichia coli. Chemical properties and binding of substrates. AB - Mannitol-1-phosphate dehydrogenase was purified to homogeneity, and some chemical and physical properties were examined. The isoelectric point is 4.19. Amino acid analysis and polyacrylamide-gel electrophoresis in presence of SDS indicate a subunit Mr of about 22,000, whereas gel filtration and electrophoresis of the native enzyme indicate an Mr of 45,000. Thus the enzyme is a dimer. Amino acid analysis showed cysteine, tyrosine, histidine and tryptophan to be present in low quantities, one, three, four and four residues per subunit respectively. The zinc content is not significant to activity. The enzyme is inactivated (greater than 99%) by reaction of 5,5'-dithiobis-(2-nitrobenzoate) with the single thiol group; the inactivation rate depends hyperbolically on reagent concentration, indicating non-covalent binding of the reagent before covalent modification. The pH dependence indicated a pKa greater than 10.5 for the thiol group. Coenzymes (NAD+ and NADH) at saturating concentrations protect completely against reaction with 5,5'-dithiobis-(2-nitrobenzoate), and substrates (mannitol 1-phosphate, fructose 6-phosphate) protect strongly but not completely. These results suggest that the thiol group is near the catalytic site, and indicate that substrates as well as coenzymes bind to free enzyme. Dissociation constants were determined from these protective effects: 0.6 +/- 0.1 microM for NADH, 0.2 +/- 0.03 mM for NAD+, 9 +/- 3 microM for mannitol 1-phosphate, 0.06 +/- 0.03 mM for fructose 6-phosphate. The binding order for reaction thus may be random for mannitol 1-phosphate oxidation, though ordered for fructose 6-phosphate reduction. Coenzyme and substrate binding in the E X NADH-mannitol 1-phosphate complex is weaker than in the binary complexes, though in the E X NADH+-fructose 6-phosphate complex binding is stronger. PMID- 3545183 TI - Time course of changes in plasma glucose and insulin concentrations and mammary gland lipogenesis during re-feeding of starved conscious lactating rats. AB - Temporal changes in circulating insulin concentrations were measured during re feeding of 18 h-starved lactating rats. Insulin concentrations rose rapidly over the first 20 min of re-feeding with 5 g of chow diet, and then sharply declined between 20-30 min and remained low for the rest of the 90 min experimental period. Lipogenic activity in the mammary gland also exhibited a peak during re feeding, but there was a clear time lag between the insulin response and the lipogenic response. Blood-flow measurements failed to show any major increase to the tissue during this activation of lipogenesis. Acute suppression of insulin secretion at 30 min (after the initial surge) abolished the switch-on of lipogenesis, suggesting that the insulin-sensitivity of the gland may be acutely enhanced over this period of re-feeding. PMID- 3545185 TI - The N-terminal amino acid sequences of the heavy and light chains of human cathepsin L. Relationship to a cDNA clone for a major cysteine proteinase from a mouse macrophage cell line. AB - Human liver cathepsin L consists of a heavy chain and a light chain with Mr values of 25,000 and 5000 respectively. The chains have been purified and their N terminal amino acid sequences have been determined. The 40 amino acids determined from the heavy chain and 42 amino acids sequenced in the light chain are homologous with the N-terminal and C-terminal regions respectively of the superfamily of cysteine proteinases. Therefore it is likely that the two chains of cathepsin L are derived by proteolysis of a single polypeptide precursor. Of the amino acids sequenced, 81% are identical with the homologous portions of a protein sequence for a major cysteine proteinase predicted from a cDNA clone from a mouse macrophage cell line. This is the closest relative amongst the known sequences in the superfamily and strongly indicates that the protein encoded by this mRNA is cathepsin L. The mouse protein is also probably the major excreted protein of a transformed cell line [Gal & Gottesman (1986) Biochem. Biophys. Res. Commun. 139, 156-162]. The heavy chain is identical in only 71% of its residues with the sequence of ox cathepsin S, providing further evidence that this latter enzyme is probably not a species variant of cathepsin L. The relationship with a second unidentified cathepsin cDNA clone from a bovine library is much weaker (41% identity), and so this clone remains unidentified. PMID- 3545186 TI - An investigation of arterial insufficiency in the rat hindlimb. Correlation of skeletal muscle bloodflow and glucose utilization in vivo. AB - Muscle bloodflow and the rate of glucose uptake and phosphorylation were measured in vivo in rats 7 days after unilateral femoral artery ligation and section. Bloodflow was determined by using radiolabelled microspheres. At rest, bloodflow to the gastrocnemius, plantaris and soleus muscles of the ligated limb was similar to their respective mean contralateral control values; however, bilateral sciatic nerve stimulation at 1 Hz caused a less pronounced hyperaemic response in the muscles of the ligated limb, being 59, 63 and 49% of their mean control values in the gastrocnemius, plantaris and soleus muscles respectively. The rate of glucose utilization was determined by using the 2-deoxy[3H]glucose method [Ferre, Leturque, Burnol, Penicaud & Girard (1985) Biochem. J. 228, 103-110]. At rest, the rate of glucose uptake and phosphorylation was statistically significantly increased in the gastrocnemius and soleus muscles of the ligated limb, being 126 and 140% of the mean control values respectively. Bilateral sciatic nerve stimulation at 1 Hz caused a 3-5-fold increase in the rate of glucose utilization by the ligated and contralateral control limbs; furthermore, the rate of glucose utilization was significantly increased in the muscles of the ligated limb, being 140, 129 and 207% of their mean control values respectively. For the range of bloodflow to normally perfused skeletal muscle at rest or during isometric contraction determined in the present study, a linear correlation between the rate of glucose utilization and bloodflow can be demonstrated. Applying similar methods of regression analysis to glucose utilization and bloodflow to muscles of the ligated limb reveals a similar linear correlation. However, the rate of glucose utilization at a given bloodflow is increased in muscles of the ligated limb, indicating an adaptation of skeletal muscle to hypoperfusion. PMID- 3545187 TI - Stimulation of proteoglycan biosynthesis by serum and insulin-like growth factor I in cultured bovine articular cartilage. AB - The addition of foetal calf serum to explant cultures of adult bovine articular cartilage is known to stimulate proteoglycan synthesis in a dose-dependent manner. We have now shown the activity in serum responsible for this effect to be heat- and acid-stable, to be associated with a high-Mr complex in normal serum but converted to a low-Mr form under acid conditions. The activity has an apparent Mr approximately 10,000 and isoelectric points similar to those reported for insulin-like growth factors (IGFs). Addition of a monoclonal antibody against insulin-like growth factor-I (IGF-I) prevented foetal calf serum from stimulating proteoglycan synthesis. Physiological concentrations of recombinant IGF-I or pharmacological levels of insulin when added to cartilage cultures mimicked the proteoglycan-stimulatory activity of serum. IGF-I appeared to act by increasing the rate of proteoglycan synthesis and did not change the nature of the proteoglycan synthesized nor the rate of proteoglycan catabolism by the tissue, suggesting that IGF-I may be important in the regulation of proteoglycan metabolism in adult articular cartilage. Furthermore, IGF-I can replace foetal calf serum in the culture medium, thereby allowing the use of a fully-defined medium which will maintain the synthesis and tissue levels of proteoglycan in adult articular cartilage explants for up to 5 days. PMID- 3545188 TI - Effects of insulin and prior exercise on prostaglandin release from perfused rat muscle. Evidence that prostaglandins do not mediate changes in glucose uptake. AB - Prostaglandin generation and its inter-relation to the metabolic effects of insulin and prior exercise were examined in perfused muscle of fed rats. During a 60 min perfusion of the rat hindquarter, a substantial release of the prostaglandins PGF2 alpha, PGE2 and 6-oxoPGF1 alpha was observed. Blood cells present in the perfusate released these substances in negligible amounts indicating the prostaglandins were produced by the hindquarter. Addition of insulin to the perfusate increased both glucose uptake and the generation of PGE2 and 6-oxoPGF1 alpha. At 30 min after intense treadmill exercise, glucose and alpha-aminoisobutyric acid (AIB) uptake by the hindquarter were increased in the absence of added insulin, but prostaglandin release was not increased. Insulin further increased glucose and AIB uptake; however, in contrast with its effects in non-exercised rats, insulin no longer stimulated prostaglandin generation. Indomethacin (10 microM) added to the perfusate inhibited the release of PGF2 alpha and PGE2 by 90% and the release of 6-oxoPGF1 alpha by 54%. It had no effect on the stimulation of glucose uptake by either insulin or prior exercise. The data indicate that insulin increases prostaglandin synthesis by perfused rat muscle, and that prior exercise blocks this effect. They suggest that under the conditions studied prostaglandins do not mediate the effects of insulin or prior exercise on glucose uptake. PMID- 3545190 TI - [Desynchronization of the circadian rhythm of plasma insulin levels and feeding schedules after inversion of periodicity]. AB - In experiments with laboratory mice a desynchronisation of daily rhythms in plasma insulin concentration and feeding after inversion of the light-dark periodicity is documented. Whereas the feeding rhythm follows the exogenous Zeitgeber (differences concern above all the quantity of food which decrease after inversion), the acrophase of the hormone rhythm is stable in relation to astronomic time. The daily mean, however, is reduced and the main maximum is split into three components. The results support the hypothesis that rhythms of the two investigated parameters are generated by separate oscillators. PMID- 3545184 TI - Heat shock and the heat shock proteins. PMID- 3545191 TI - The influence of experimental conditions on the morphological preservation of hippocampal slices in vitro. AB - The influence of different brain cutting techniques and various conditions of in vitro incubation on the morphological preservation of hippocampal slices was investigated comparatively. In order to obtain well-preserved slices great attention has to be paid to the immediate cooling of brain tissue to +4 degrees C and of all instruments as well. Under these conditions both the cutting technique and the incubation medium will be of subordinate importance. The incubation of 'interface slices' on a net in a slice chamber where the incubation medium flows constantly through the system and where the slices lay on the border to moistened oxygen is superior to the incubation of slices which are floating submerged in tubes--especially if the incubation time will last longer than 1.5 h. Different reliable incubation media did not show striking differences with regard to their effect on the preservation of hippocampal slices. New possibilities for incubation of slices for biochemical long-term investigations were tested and are discussed. PMID- 3545189 TI - Identification of some cleavage sites of insulin by insulin proteinase. AB - In a previous study [Muir, Offord & Davies (1986) Biochem. J. 237, 631-637] the chromatographic and electrophoretic behaviour of a major labelled fragment in the degradation of tritiated insulins by insulin proteinase were used to locate the probable sites of cleavage which had produced this fragment. In order to define these cleavage sites more precisely, authentic markers for the fragments which would be produced by cleavages at, or adjacent to, the most likely sites have now been synthesized. These markers were compared with labelled fragments of the A- and B-chains of insulin produced by insulin proteinase. The results, together with those of our previous study, show that in order to produce the observed major labelled fragment, the enzyme must have cleaved the insulin A-chain between leucine-A13 and tyrosine-A14 and the insulin B-chain between serine-B9 and histidine-B10. In addition, a minor component was observed in the labelled B chain fragment which corresponded to a cleavage either between histidine-B10 and leucine-B11 or between leucine-B11 and valine-B12. PMID- 3545192 TI - Polyacrylamide gel electrophoretic preparation of labeled and non-labeled peptides for radioimmunoassay. AB - Radioiodinated polypeptide hormones, such as insulin, glucagon, human growth hormone, and human C-peptide are employed for radioimmunoassays for investigations of hormonal alterations in states of disturbed carbohydrate metabolism. Iodination was performed using chloramine T. Iodination products of these polypeptide hormones and, for preparation of standard material, native human C-peptide from cadaver pancreases were fractionated by polyacrylamide gel electrophoresis at pH 8.9. Disc electrophoresis in 24 cm-long gel rods resulted in stable tracers with high specific activity as well as homogeneous standard material being highly suitable for radioimmunoassays. PMID- 3545193 TI - Regulation fo immunoglobulin variable region gene assembly: development of the primary antibody repertoire. PMID- 3545194 TI - 1986 index issue. Cumulative indexes for Volumes 134-141. PMID- 3545195 TI - Structure of a peptide from coho salmon endocrine pancreas with homology to neuropeptide Y. AB - The amino acid sequence of a peptide isolated from the Pacific salmon (Oncorhynchus kisutch) endocrine pancreas has been determined. This simple 36 residue peptide is a member of the pancreatic polypeptide family. It contains a C terminal tyrosinamide and is more homologous with porcine neuropeptide Y (NPY) (83%) and peptide YY (75%) than any of the previously characterized pancreatic polypeptides (PP). This peptide appears to be the major but not the only representative of this family of peptides present in the endocrine pancreas of this fish. This peptide is referred to as salmon pancreatic polypeptide (salmon PP). PMID- 3545196 TI - Molecular cloning and expression in Streptomyces lividans of a proteinous alpha amylase inhibitor (HaimII) gene from Streptomyces griseosporeus. AB - The gene encoding a proteinous alpha-amylase inhibitor (HaimII) of Streptomyces griseosporeus YM-25 has been cloned in Escherichia coli K12 using a deoxyinosine containing synthetic oligonucleotide as the probe. A 1.6 kilobases BamHI fragment was confirmed to hybridize with the probe and subcloned in an E. coli-S. lividans shuttle vector. The plasmid clone was transferred into S. lividans by transformation. An appreciable amount of alpha-amylase inhibitor activity was found in the culture medium of S. lividans harboring the plasmid. As the specificity was indistinguishable from that of HaimII produced by the original S. griseosporeus strain, we concluded that the HaimII protein was synthesized in S. lividans and excreted into the medium. PMID- 3545197 TI - Inhibition of E. coli adenylate cyclase activity by inorganic orthophosphate is dependent on IIIglc of the phosphoenolpyruvate:glycose phosphotransferase system. AB - The relationship of adenylate cyclase, inorganic orthophosphate and the proteins of the phosphoenolpyruvate:glycose phosphotransferase system (PTS) was studied. A strain deleted for the genes for Enzyme I and IIIglc of the PTS was transformed with plasmids expressing either Enzyme I and HPr, IIIglc or all three proteins. The fully reconstituted strain showed a Pi-dependent stimulation of adenylate cyclase activity; in contrast, the strain expressing only IIIglc showed a Pi dependent inhibition of adenylate cyclase activity. PMID- 3545198 TI - Effects of oral glucose administration on preproinsulin mRNA in rats in vivo. AB - An experiment was performed to examine whether the acute increase in insulin release induced by oral glucose ingestion is associated with alterations in pancreatic preproinsulin mRNA (PImRNA) levels. Rats either fed ad libitum or after overnight fast were used. Fasted rats were administered glucose orally in a conscious, unrestrained state. Pancreatic RNA was extracted and the relative level of PImRNA was determined by dot blot analysis with a cloned rat preproinsulin I cDNA probe. In fasted animals PImRNA levels decreased compared with those of fed animals and showed no significant changes after acute glucose administration, while blood glucose and plasma insulin increased rapidly to maximum values at 15 min after glucose administration. Although the transcription rate was not directly measured in this experiment, it is possible that the rapid increase in insulin release from the beta cell under physiological conditions is controlled by post-transcriptional regulations. PMID- 3545199 TI - Demethylation of bacterial chemoreceptors is inhibited by attractant stimuli in the complete absence of the regulatory domain of the demethylating enzyme. AB - The CheB methylesterase catalyzes the demethylation of membrane receptors during chemotaxis in Salmonella typhimurium. The kinetic properties of the full length product of the cheB gene are compared to those of the isolated C-terminal catalytic domain. The fragment has at least a 15-fold higher specific activity than the intact protein. In intact cells receptor demethylation is inhibited by attractants such as L-aspartate. We show here that both forms of the enzyme are similarly inhibited in vitro. Thus, the C-terminal catalytic domain of the CheB protein is sufficient for this aspect of esterase regulation. Inhibition by attractants appears to be caused by changes in receptor conformation rather than by changes in the activity of the demethylating enzyme. PMID- 3545200 TI - Identification of renin and renin messenger RNA sequence in rat ovary and uterus. AB - An increase in plasma prorenin during pregnancy suggests that prorenin might be synthesized in the ovary and the secretion of renin or prorenin may be stimulated by an ovarian steroid-mediated process. Recently, renin and angiotensinogen have been identified in human ovarian follicular fluid. However, there is considerable controversy over whether renin is synthesized in the ovary or derived from circulation. In the present study, we confirmed the presence of renin and renin mRNA in rat ovary and uterus by Northern blot analysis with rat renin cRNA as a hybridization probe. Our data show that ovarian or uterine renin is synthesized in the same cells. This suggests that the function of renin might be closely linked to the reproductive process. PMID- 3545201 TI - Evidence for the existence of an expressed minor variant tRNAPhe in yeast. AB - Two expressed brewer's yeast tRNAsPhe, a major and a minor one, have been purified and sequenced. The major tRNAPhe corresponds to the already known tRNAPhe, whereas the minor one differs from the former in the substitution of T6 A67 by C6-G67 base pair in the "acceptor stem". The minor tRNAPhe contaminates all preparations of yeast tRNAPhe except those prepared by polyacrylamide gel electrophoresis. PMID- 3545202 TI - Mass spectral analysis of complex lipids desorbed directly from lyophilized membranes and cells. AB - Three desorption ionization techniques--laser desorption, plasma desorption and fast atom bombardment mass spectrometry--have been applied to lyophilized cells, membranes, lysed cells and various extracts. It has been shown that intact polar lipids are selectively desorbed from biological membranes by these methods and that their mass spectra provide "fingerprints" which reflect the unique biochemical composition of each class of cell or membrane. PMID- 3545203 TI - Effects of metalloendoprotease inhibitors on insulin binding, internalization and processing in adipocytes. AB - The effects of metalloendoprotease inhibitors on insulin binding, internalization, and processing were studied in isolated rat adipocytes. The metalloendoprotease inhibitor phosphoramidon caused a marked (threefold) increase in intracellular insulin accumulation without affecting surface binding. The dipeptide metalloendoprotease substrate analogues benzyloxycarbonyl-Gly-Phe-NH2 and benzyloxycarbonyl-Gly-Leu-NH2 caused similar large increases in intracellular insulin but also caused a doubling of cell surface bound insulin. The effect on surface binding was due to increased insulin receptor affinity as demonstrated by Scatchard analysis and the benzyloxycarbonyl-Gly-Phe NH2 induced inhibition of the dissociation of prebound insulin from the cell surface. These results suggest a role for endogenous metalloendoprotease-like enzymes in insulin processing by rat adipocytes. PMID- 3545204 TI - Immunohistochemical detection of inhibin in the gonad. AB - Antiserum to inhibin was produced in rabbits by immunization with a synthetic [Tyr30]alpha-chain(1-30)NH2 fragment of porcine inhibin coupled to bovine serum albumin, and the elicited antiserum was used in conjunction with the avidin biotin immunoperoxidase procedure to localize inhibin-reactive cells in various rat tissue preparations. In the testes, only the Sertoli cells revealed immunoreactivity with the antiserum. Intense staining was also observed in ovarian follicular granulosa cells but not in the theca layer outside the basement membrane. In addition, the luteal cells in the corpus luteum were also stained by the antiserum. The positive staining in the gonadal tissues could be blocked completely by pre-adsorbing the serum with either the synthetic peptide or native inhibin. Immunostaining was not detected in brain, pituitary, thymus, stomach, pancreas, kidney and adrenal section, thus confirming that inhibin is a polypeptide originating only from specific cells of the gonad. PMID- 3545205 TI - Insulin-like growth factor II increases cytoplasmic free calcium in competent Balb/c 3T3 cells treated with epidermal growth factor. AB - To determine the role of calcium in the action of insulin-like growth factor II (IGF-II), we have examined the effect of multiplication stimulating activity, the rat IGF-II, on cytoplasmic-free calcium concentration, [Ca2+]c, in aequorin loaded Balb/c 3T3 cells. IGF-II does not cause any change in [Ca2+]c in quiescent cells. By contrast, IGF-II induces changes in [Ca2+]c in platelet-derived growth factor(PDGF) - pretreated competent cells: when competent cells are incubated with epidermal growth factor (EGF) for 10 min, subsequent IGF-II induces an immediate increase in [Ca2+]c. Without EGF treatment, IGF-II does not cause any increase in [Ca2+]c. The priming action of EGF is time dependent, requiring approximately 10 min for the maximum effect. The IGF-II-mediated increase in [Ca2+]c is totally dependent on extracellular calcium and is blocked by lanthanum. When DNA synthesis in PDGF-treated competent cells is assessed by measuring [3H]thymidine incorporation, IGF-II by itself has only a small effect. Likewise, a brief treatment with EGF results in only a small increase in [3H]thymidine incorporation. By contrast, in competent cells briefly treated with EGF, IGF-II causes a marked stimulation of [3H]thymidine incorporation. These results indicate that IGF-II increases [Ca2+]c in competent Balb/c 3T3 cells treated with EGF by stimulating calcium influx and that IGF-II-stimulated calcium influx may be related causally to its action on cell proliferation. PMID- 3545206 TI - Fibroblast growth factor enhances the interleukin-1-mediated chondrocytic protease release. AB - The unfractionated macrophage-conditioned medium stimulates the chondrocytes to produce high levels of proteases. Purified IL-1 preparations exhibit significantly lower activity towards chondrocytes. This IL-1 mediated effect can be enhanced in presence of fibroblast growth factor, suggesting that other factors may collaborate with IL-1, in events leading to the cartilage destruction in vivo. PMID- 3545207 TI - Some properties of human epidermal growth factor (hEGF)-like immunoreactive material originating from platelets during blood coagulation. AB - During blood coagulation, a considerable amount of human epidermal growth factor (hEGF)-like immunoreactive material (designated as platelet hEGF-LI) was liberated from platelets. The molecular nature of the platelet hEGF-LI was examined. The molecular weight of platelet hEGF-LI estimated by gel filtration was approximately 60,000-70,000. On chromatofocusing chromatography, platelet hEGF-LI was eluted mainly at pH 4.75 as a sharp peak with a minor peak at 4.30, like urine EGF. By treatment with 2-mercaptoethanol, the factor was converted into a material with molecular weight of 35,000-40,000. These results suggest that the majority of hEGF-LI in platelets may exist either in a covalently bound form with some protein(s) in platelets or as a dimer intermolecularly cross linked by an S-S linkage. Details of the biological properties and the physiological significance of the platelet hEGF-LI remain to be clarified. PMID- 3545208 TI - Gonadotropin releasing hormone (GnRH) stimulates both secretion and synthesis of human chorionic gonadotropin (hCG) by first trimester human placental minces in vitro. AB - An in vitro system using the minces of placental villi from first trimester human pregnancy (6-10 weeks) has been validated to examine the effect of addition of GnRH and its analogues on hCG secreted into the medium. Addition of low concentration of GnRH or its analogues (1 X 10(-8) M to 1 X 10(-6) M) resulted in an increase in the quantity of hCG in the medium, while addition of high concentrations of GnRH resulted in an inhibitory effect. Of the analogues tested, Buserelin was highly effective in exerting an inhibitory effect. A significant increase in 35S-methionine incorporation into immunoprecipitable hCG was noticed in the presence of GnRH. These results suggests that GnRH stimulates both synthesis and secretion of hCG by first trimester human placenta. PMID- 3545209 TI - Pyruvate decarboxylase--potentially inactive in the absence of the substrate. AB - Using two independent methods, it was shown that pyruvate decarboxylase of brewer's yeast/EC 4.1.1.1./showing a sigmoidal v/S-shape and a corresponding activation phase in the product formation is potentially inactive in the absence of its substrate-pyruvate. PMID- 3545210 TI - Effect of the diabetic environment on the lipid metabolism of Ehrlich ascites cells. AB - One strain of Ehrlich ascites cells lacking of insulin receptors, was grown into control and diabetic mice and cells harvested from diabetic mice reimplanted into control mice. The fatty acid composition of neutral and polar lipids was analyzed and several parameters calculated. Results showed that it is possible to produce similar changes in the lipid fatty acid unsaturation of Ehrlich cells to those observed in the liver of the diabetic bearing mice. These changes may be reverted by growing these cells into control mice. The diabetic environment also promoted a relative increase in the radioactivity from incorporated in vitro into neutral lipids of Ehrlich cells. This metabolic adjustment, probably due to an induction of the enzyme diglyceride acyltransferase, was completely reverted by transplanting these cells in control mice. The metabolic adaptation of Ehrlich ascites cells to the diabetic environment did not modify their biological behaviour as pointed out by their mean generation time. The evidence presented here, showing relatively normal growth of Ehrlich cells in association with changes in the lipid fatty acid pattern and in lipid metabolism, indicates the adaptation of these cells, lacking of insulin receptors, to the environment provided by the diabetic mice. PMID- 3545211 TI - Structure and function of transferrin receptors and their relationship to cell growth. AB - The transferrin receptor binds the major serum iron-transport protein, transferrin, and mediates cellular iron uptake. The receptor is a major immunodominant cell surface glycoprotein of cultured cells and its expression on the cell surface is co-ordinately regulated with cell growth. Recent structural and functional studies of the transferrin receptor are reviewed. The properties of monoclonal antibodies against the transferrin receptor that inhibit transferrin-mediated iron uptake are described. Studies with these antibodies establish that the transferrin receptor plays an important role in cell growth and suggest that monoclonal antibodies that interfere with the function of growth related receptors may be useful in regulating tumour cell growth. PMID- 3545212 TI - Cellular receptors to the anaphylatoxins C3a and C5a. AB - A single component in the plasma membrane of human polymorphonuclear leukocytes (hPMN) has been identified as the binding site for C5a. Labelled human C5a can be cross-linked to a 48,000-Mr membrane component on the hPMN surface by using the bifunctional reagent ethylene glycol bis(succinimidyl succinate). The membrane component is believed to be the C5a receptor or the binding subunit of a C5a receptor complex. Our ligand-uptake data indicate that the hPMN has high-affinity binding sites for C5a with a Kd of the order of 1-2 nM and an estimated 50,000 113,000 binding sites/cell. Preliminary binding studies of C3a and C5a to rat peritoneal mast cells indicate that non-specific uptake by these cells is so great that it obscures characterization of specific receptor interactions. Data recently reported [Gervasoni, Conrad, Hugli, Schwartz & Ruddy (1986) J. Immunol. 136, 285-292] suggest that non-specific binding of C3a to mast cells is caused by electrostatic interactions between the cationic ligand and anionic heparin proteoglycan on the cell surface, with an additional complication of the bound ligand undergoing proteolytic degradation. It is therefore proposed that synthetic analogue peptides designed to minimize non-specific interactions with the cell will be useful tools for demonstrating anaphylatoxin receptors on mast cells and may prove essential for receptor isolation. PMID- 3545213 TI - Interaction of azole antifungal agents with cytochrome P-45014DM purified from Saccharomyces cerevisiae microsomes. AB - Mechanism of action of azole antifungal agents was studied by analyzing interaction of ketoconazole, itraconazole, triadimefon and triadimenol with a purified yeast cytochrome P-450 which catalyzes lanosterol 14 alpha-demethylation (P-45014DM). These antifungal agents formed low-spin complexes with P-45014DM, indicating the interaction of their azole nitrogens with the heme iron. Affinity of these antifungal agents for the cytochrome was extremely high compared with usual nitrogenous ligands. Upon reduction with sodium dithionite, the azole complexes of ferric P-45014DM were converted to the corresponding ferrous derivatives. Spectral analysis of these complexes suggested that geometric orientation of the azole moiety of an antifungal agent to the ferrous heme iron was regulated by the interaction between the N-1 substituent and the heme environment. CO could not readily replace ketoconazole or itraconazole co ordinating to the heme iron of ferrous P-45014DM while triadimefon and triadimenol complexes of the cytochrome were promptly converted to the CO complexes. The inhibitory effects of ketoconazole and itraconazole on the P 45014DM-dependent lanosterol 14 alpha-demethylation were higher than that of triadimenfon. The substituents at N-1 of the azole moieties of ketoconazole and itraconazole are extremely large while those of triadimefon and triadimenol are relatively small. Accordingly, observations described above suggest that the N-1 substituent of an azole antifungal agent regulates the mobility of the molecule in the heme crevice of ferrous P-45014DM and determines the inhibitory effect of the compound. PMID- 3545214 TI - Formation of an amino reduction product of metronidazole in bacterial cultures: lack of bactericidal activity. AB - To investigate whether the amino reduction product of metronidazole has antibacterial activity, 5-amino-1-beta-hydroxyethyl-2-methylimidazole (AMN) was synthesized and tested against Bacteroides fragilis and Escherichia coli strain SR58, both of which are known to be sensitive to metronidazole. Neither of these strains was found to be sensitive either to AMN or to the equivalent amine derived from dimetridazole, 5-amino-1,2-dimethylimidazole. Both of these amines are relatively stable in the presence of bacteria, making it possible to examine the bacterial reduction of radiolabeled metronidazole in the presence of AMN. This experiment indicated that at least 17% of the metronidazole that disappeared under the reducing conditions of the bacterial medium was converted to AMN. We conclude, therefore, that AMN forms during the activation of metronidazole by bacterial reduction but is not a bactericidal form of metronidazole. PMID- 3545215 TI - Redistribution into plasma of tracer doses of desipramine by anti-desipramine antiserum in rats. PMID- 3545216 TI - Modulation of endothelial function by interleukin-1. A novel target for pharmacological intervention? PMID- 3545217 TI - Effects of chronic administration of vanadate to the rat on the sensitivity of glycolysis and glycogen synthesis in skeletal muscle to insulin. AB - Male Wistar rats were given sodium orthovanadate in their drinking water for at least 14 days. This treatment increased the hypoglycaemic effect of intravenously administered insulin and increased the sensitivity of isolated soleus muscle strips to insulin with respect to both glycolytic and glycogen synthetic rates. This effect of chronic vanadate administration was shown not to be a consequence of a change in the insulin binding characteristics of soleus muscle. It is suggested that these changes may be brought about by the interaction of vanadate with insulin-mediated alterations in tyrosine kinase/phosphotyrosyl phosphatase activities. PMID- 3545219 TI - [Affinity modification of E. coli RNA-polymerase in a complex with the promoter by phosphorylating derivatives of primer oligonucleotides]. AB - Oligonucleotides 2 to 7 nucleotide residues long, complementary to the codogenic strand of T7 promoter A2, have been synthesized; all of them contained a ribo unit at the 3'-end. They were converted into 5'-(N-methyl)phosphoimidazolides, and the affinity reagents obtained were allowed to bind covalently to RNA polymerase in the presence of a promoter. Some of the nucleotide residues covalently attached occupied proper positions relative to the active centre of the phosphodiester bond synthesis and on addition of [alpha-32P]UTP were elongated, so that highly selective affinity labelling occurred. With oligonucleotides of various lengths, different distribution of the label between beta, beta' and sigma subunits of RNA polymerase took place. Most efficient was labelling of beta-subunit by the residue--pCpGpCpU, and of sigma-subunit by the residue--pApApApTp-CpGpCpU (p--radioactive phosphorus atom). In both cases, the amino acid residues labelled were histidines. PMID- 3545220 TI - Fractionated total lymphoid irradiation: a promising new treatment for rheumatoid arthritis? Yes, no, maybe. PMID- 3545218 TI - ATP and phosphate-modified adenine nucleotide analogues. Effects on insulin secretion and calcium uptake. AB - Our previous experiments on isolated rat pancreas gave evidence for a P2 purinergic receptor on the insulin-secreting B cell. This work was designed to investigate whether the stimulation of insulin release by phosphorylated adenosine derivatives could also be observed in rat isolated Langerhans islets and whether this stimulation was accompanied by changes in calcium uptake. The results indicate that two structural methylene analogues of ATP and ADP (alpha,beta-methylene ATP and alpha,beta-methylene ADP) display an insulin stimulatory effect comparable to that of ATP, confirming the membrane action of the latter. It was also found that calcium uptake increased concomitantly with insulin release under the effect of alpha,beta-methylene ADP; on the other hand this agent also increased the total exchangeable calcium content of islets at isotopic equilibrium. Verapamil, a blocker of voltage-sensitive calcium channels, counteracted the stimulation of insulin release and also blocked the increase in total exchangeable calcium content. These results demonstrate the involvement of calcium in the stimulus-secretion coupling of insulin release induced by an activator of P2 purinergic receptors and suggest the implication of voltage sensitive calcium channels. PMID- 3545221 TI - T cell lymphoma in a patient with longstanding rheumatoid arthritis and Sjogren's syndrome. PMID- 3545222 TI - Basement membrane thickening of postcapillary venules and capillaries in rheumatoid synovium. Immunoelectron microscopic and electron microscopic morphometric analysis. AB - Pathologic changes in the basement membrane (BM) of postcapillary venules (PCV) and capillaries in rheumatoid arthritis (RA) synovium were studied by immunoelectron microscopy, using a monoclonal antibody against human type IV collagen, C(IV)22, and by electron microscopic morphometric analysis. The sublining region of RA synovium was classified into lymphocyte-rich areas, transitional areas, and interstitial areas, according to their pattern of cellular infiltration. In lymphocyte-rich areas, the BM of the PCV and capillaries were minimally thickened; disruption of the lamina densa was seldom seen. Transitional areas, which contained macrophages, lymphocytes, and plasma cells, had numerous PCV and capillaries. The BM was markedly thickened and partially multilamellated, and there were many disruptions in the lamina densa. The BM contained degenerated endothelial cells and cell debris. On immunostaining of this BM with monoclonal antibody C(IV)22, type IV collagen stained heavily, mainly in the disrupted lamina densa; this indicates that the thickening was, at least in part, the result of an increase in BM collagen. In uninfiltrated interstitial areas, BM were moderately thickened and multilamellated, and showed few disruptions of the lamina densa; there were similar increases in type IV collagen, but cell debris was seldom observed. Measurement of the BM width, the ratio of BM width to vessel diameter, and the fraction of vascular cross sectional area occupied by BM demonstrated that the thickness of the BM of both PCV and capillaries was greatest in transitional areas and was smallest in lymphocyte-rich areas (P less than 0.01). Since macrophages and macrophage derived factors have been found to promote synthesis of BM collagen type IV, and since transitional and interstitial areas are rich in macrophages and histiocytes, respectively, it is suggested that these mononuclear cells and the factors secreted by them play a significant role in the thickening of the BM of PCV and capillaries in RA synovitis. PMID- 3545223 TI - Cyclosporin A in rheumatoid arthritis: preliminary clinical results of an open trial. AB - Twelve patients with refractory rheumatoid arthritis were included in a 1-year open trial of cyclosporin A (CsA), 5 mg/kg/day. Clinical efficacy was observed 1 month after beginning treatment, was well established after 4 months of therapy, and remained stable for the remainder of the 1-year treatment period. Among the numerous side effects observed, renal toxicity and hypertension occurred suddenly during the trial and required constant monitoring, adequate therapy, and modulation of CsA dosage. Cyclosporin A seems to be an effective treatment for active rheumatoid arthritis, but it requires close monitoring for toxicity. PMID- 3545224 TI - Mutagenicity studies on tiopronin. AB - alpha-Mercaptopropionylglycine (tiopronin, Mucolysin), a drug endowed with an interesting mucolytic activity, was tested for mutagenicity by means of the following in vitro and in vivo tests: mutagenesis on S. typhimurium with and without metabolic activation, genetic mutation on S. pombe P1 with and without metabolic activation, gene conversion on S. cerevisiae D4 with and without metabolic activation, urinary assay in the mouse with S. cerevisiae D4, host mediated assay in the mouse with S. cerevisiae D4 and micronucleus test in the mouse. On the basis of the results obtained tiopronin proved to be free of mutagenic activity. PMID- 3545225 TI - Lack of genotoxic and cytotoxic effects of the herbicide lenacil on mouse tumor cells and on some Salmonella typhimurium strains. AB - The effects of 3-cyclohexyl-6,7-dihydro-1H-cyclopentapyrimidine-2,4(3H,5H)-dione (lenacil) on macromolecular synthesis, thymidilate synthetase activity, viability and cell cycle progression were studied using Friend leukemia (FL). P388 and Ehrlich ascites tumor cells in suspension, and its cytogenetic effects were studied in a Salmonella/mammalian microsome assay using both frameshift and base substitution tester strains. At a concentration of 0.5 mmol/l lenacil inhibited 45 to 70% thymidine incorporation into DNA fraction, while incorporations of uridine into RNA and leucine into protein were less affected. Thymidilate synthetase activity in P388 cells as assayed by the release of tritiated water from 5-3H-deoxyuridine was inhibited by the compound to about 20%. Lenacil neither showed an in vivo inhibitory action on thymidine incorporation into acid insoluble material in P388 cells, nor on thymidilate synthetase activity after a 24 or 48 h treatment. The compound did not change the melting temperature of isolated DNA. Studies of lenacil's effect on cell cycle kinetics of FL cells demonstrated that 48 h treatment increased the percentage of S-phase cells. Lenacil exerted a weak cytotoxic effect on FL cells. At concentrations above 0.1 mmol/l it inhibited cell growth the effect being nonlethal. Cytogenetic studies of lenacil revealed no indication of its mutagenicity against Salmonella typhimurium TA97, TA98, TA100 and TA102. PMID- 3545226 TI - [The effect of subinhibitory concentrations of cefaclor, erythromycin and doxycycline on phagocytosis and intracellular killing of E. coli by human neutrophil granulocytes]. AB - After determination of granulocyte basic parameters of polymorphonuclear neutrophilic leukocytes obtained from 5 unselected intensive care unit patients and 5 healthy volunteers phagocytosis of an E. coli strain isolated from clinically proven infection (urinary tract infection) was investigated with and without preincubation of the strain with subinhibitory concentrations (1/4 and 1/2 minimum inhibitory concentration; incubation time: 30 min) of cefaclor, erythromycin and doxycycline. The results show that it is very difficult to compare granulocyte functions because they differ widely in individual ranges among both groups. Nevertheless in comparison to the untreated strain a higher amount of ingestion by the granulocytes of both collectives could be obtained after preincubation with cefaclor or erythromycin; thereby cefaclor seemed to be the most effective drug. PMID- 3545227 TI - The best laid plans. PMID- 3545228 TI - Academe and the clinic. PMID- 3545229 TI - ASHA membership trends: a brief look over our shoulder. PMID- 3545231 TI - The roles of speech-language pathologists and audiologists in working with older persons. PMID- 3545230 TI - Speech-language pathologists as language-learning disabilities specialists: rites of passage. PMID- 3545232 TI - InSpeech: in business ... inspired. PMID- 3545233 TI - Bidialectalism? Mandatory or elective? PMID- 3545234 TI - Sphenoidal ridge meningioma. PMID- 3545235 TI - Congenital spinal cord tumors in children. AB - The paediatric spinal cord may host a wide variety of congenital tumors, the most common of which have been discussed. Although the majority of these lesions are benign their delayed diagnosis, serious infectious complications or associated congenital anomalies may expose the patient to life threatening morbidity or serious permanent disabilities. Prompt surgical management provides a cure in most instances, and the gratification of a neurologically intact child. PMID- 3545236 TI - Endoneurosurgery: endoscopic intracranial surgery. PMID- 3545237 TI - Evoked potential monitoring in neurosurgical practice. PMID- 3545239 TI - [Inaugural syndromes and syndromes associated with the LAV/HTLV-III virus. Clinical and biological symptomatology. Therapeutic outlook]. AB - The discovery in 1983 of the virus subsequently designated as HIV and its detection in several organs and lymphoid and others cells has led to greater knowledge of the clinical manifestations related to infection with the virus. Certain manifestations seem to be directly related to the viral infection. These are essentially acute infectious manifestations occurring with the primary infection, neurological disorders involving CNS, and more classical manifestations known from the start such as general chronic lymphadenopathy, ARC or full blown AIDS. Others clinical manifestations seem to be indirectly related to the virus, and certain appear to be an immune reaction to the virus (peripheral neuropathy like Landry Guillain Barre syndrome or thrombopenic purpura). Other manifestations such as bronchial or pancreatic carcinomas may be due to virus-induced immunodepression. Finally, some pathological states are probably related to co-infections such as lingual hairy-cell leukoplakia. One of the major current difficulties is the determination of a clinical rather than epidemiological classification of these manifestations so as to carry out a multicentric therapeutic protocol. Further therapeutic trials will be carried out on patients who maintain a subnormal immune status, and only the study of the development of several hundred patients will determine whether the treatment really succeeds by preventing the development to the next stage of the disease. PMID- 3545238 TI - Sensitivity and specificity of an HIV antibody assay. AB - We have evaluated a new enzyme immunoassay (EIA) to measure IgG antibodies (Abs) to HIV in patients with AIDS, AIDS-related complex (ARC), AIDS contacts (AC), and low risk controls. Twenty-nine (94%) of 31 AIDS, 27 (96%) of 26 ARC, 12 (54%) of 22 AC, and 1 (2%) of 60 control patients were anti-HIV Ab positive by this assay. Positive results were confirmed by Western blot analysis. The EIA for anti-HIV evaluated in this study is sensitive and specific in identifying individuals who have been infected by this retrovirus. PMID- 3545240 TI - [Histopathologic aspects of adenopathies in the persistent adenopathy syndrome and AIDS-related syndromes]. AB - The histopathological modifications of the lymph nodes are studied in patients at risk for AIDS, LAV positive, with the lymphadenopathy syndrome (LAS) or the ARC. Three different types are described: type IA, with predominantly a severe follicular hyperplasia, type IB with angiofollicular hyperplasia or Castleman disease like lesions, type II with angioimmunoblastic like lesions. In type IA, the modifications of the follicles are the most important histological modification (atrophy of the mantle zone, germinative centres lymphoid infiltrate). These lesions are non specific. But associated to modifications of the deep cortical area and the sinuses they are highly suggestive of the diagnosis of LAV infection. A correlation is shown between evolution and histopathological lesions. The lymph node biopsy in patients at risk for AIDS is useful for the diagnosis and also the prognosis. PMID- 3545241 TI - [Pulmonary manifestations of the inaugural syndromes of AIDS and their early complications]. AB - The author presents a quick review of the pulmonary lesions due to ARC, mainly the pulmonary lymphoid hyperplasias. The most frequent pulmonary complications of the disease are summarised (opportunistic infections and Kaposi sarcoma) the practical conditions of their pathological diagnosis are illustrated. PMID- 3545242 TI - [Immunohistologic marking of epithelial antigens in sarcomatoid carcinomas of the upper aerodigestive tracts]. AB - The immunoperoxidase localization of epithelial antigen (keratin, epithelial membrane antigen) was identified in 18 cases of sarcomatoid carcinomas localized in the upper aero-digestive tract. These tumors are an association of a differentiated squamous cell carcinomatous component and of spindle, or pleomorphic cells component. The anti-keratin monoclonal antibody KL1 stained the sarcomatoid component in 4 cases. A continuous staining between differentiated squamous cells and spindle cells in observed in two cases. The identification of cytokeratin is better with KL1 than with the polyclonal anti-keratin antiserum KT. The monoclonal antibody HMFG2 is not retained. These results suggest the dedifferentiation of epithelial cells in sarcomatoid component. They confirm the heterogeneity of these tumors, which has been previously found in ultrastructural studies. These immunostaining are helpful in recognizing sarcomatoid carcinoma, when they are only represented by the sarcomatoid component. PMID- 3545243 TI - [Value of immunoperoxidase with monoclonal antibodies after dismounting of previously stained sections]. AB - Immunoperoxidase using monoclonal antibodies may be applied to paraffin sections previously stained. The precise nature of cells found by routine staining may thus be investigated. It also enables, with small biopsies, immunohistochemical identification of a tissue zone lost by serial sectioning. PMID- 3545244 TI - Anaphylaxis following administration of intravenous methylprednisolone sodium succinate. AB - A 27-year-old man developed respiratory arrest following intravenous administration of methylprednisolone sodium succinate. Skin tests were positive to methylprednisolone sodium succinate but not to methylprednisolone acetate. Severe anaphylactic reactions to intravenous corticosteroid medications can occur and can require epinephrine administration or endotracheal intubation. Skin tests and drug challenge should be done to establish the safety of a particular corticosteroid drug. PMID- 3545245 TI - Hepatitis B exposure and the emergency physician: risk assessment and hepatitis vaccine update. AB - Since the hepatitis B vaccine was licensed in 1981, emergency physicians have had the opportunity to be immunized against the hepatitis B virus (HBV). The factors that affect the decision to undergo vaccination include the risk of acquiring an HBV infection in emergency practice, the prevaccination immune status of emergency physicians who have knowledge of their hepatitis serum marker profile, and the efficacy and safety of the vaccine. Emergency physicians have a significant risk of acquiring an HBV infection and are recommended by the Centers for Disease Control to receive vaccination. However, emergency physicians are often incidentally tested for HBV serum markers before immunization. Recent investigations have shown that seropositivity for hepatitis surface antibody (anti-HBs) does not necessarily preclude the need for immunization. Finally, experience with 750,000 doses has shown that it is a highly effective and extremely safe vaccine. PMID- 3545247 TI - Toxicology: an annotated bibliography of the recent literature. PMID- 3545246 TI - Transcutaneous electrical nerve stimulation versus oral analgesic: a randomized double-blind controlled study in acute traumatic pain. AB - A double-blind controlled analgesic study was undertaken in outpatients suffering acute traumatic pain. One hundred patients completed the study and were randomly assigned to four treatment groups, each receiving either functioning transcutaneous electrical nerve stimulators (TENS), placebo TENS, acetaminophen with codeine and a functioning TENS, or acetaminophen with codeine and a placebo TENS. Pain was assessed prior to treatment, at 48 hours, and at one month using a visual analog scale. A statistically significant difference in pain relief occurred between the placebo and functioning TENS groups. The TENS was approximately as effective as acetaminophen (300-600 mg) with codeine (30-60 mg) but had no side effects. Transcutaneous electrical nerve stimulators have been shown to be effective in the management of acute traumatic pain and may be indicated for patients who cannot be given medications. PMID- 3545248 TI - Is anyone listening? The lack of clinical impact of randomized controlled trials of electronic fetal monitoring. PMID- 3545249 TI - A history of accouchement force: 1550-1985. PMID- 3545250 TI - Indications for ultrasonography in obstetrics. PMID- 3545251 TI - Controlled trials of routine ultrasound in pregnancy. PMID- 3545252 TI - Possible hazards of imaging and Doppler ultrasound in obstetrics. PMID- 3545253 TI - Women's views of ultrasonography in obstetrics. PMID- 3545254 TI - Research strategies for the use of imaging ultrasound as an obstetric screening tool. PMID- 3545255 TI - The history of ultrasonography in obstetrics. PMID- 3545256 TI - [Kidney transplant in a case of multiple venous abnormalities and bilateral renal hypoplasia]. PMID- 3545257 TI - Pharmacological and anatomical analysis of fear conditioning using the fear potentiated startle paradigm. AB - Pharmacological and anatomical analysis of fear conditioning using the fear potentiated startle paradigm are reviewed. This test measures conditioned fear by an increase in the amplitude of a simple reflex (the acoustic startle reflex) in the presence of a cue previously paired with a shock. This paradigm offers a number of advantages as an alternative to most animal tests of fear or anxiety because it involves no operant and is reflected by an enhancement rather than a suppression of ongoing behavior. Fear-potentiated startle is selectively decreased by drugs such as diazepam, morphine, and buspirone that reduce fear or anxiety clinically. Electrical stimulation techniques suggest that a visual conditioned stimulus ultimately alters acoustic startle at a specific point along the acoustic startle pathway. Relevant visual structures implicated in potentiated startle include the lateral geniculate nucleus, visual cortex, and deep and intermediate layers of the superior colliculus. The central nucleus of the amygdala and the caudal branch of the ventral amygdalofugal pathway projecting to or through the substantia nigra are also necessary for potentiated startle to occur. Electrical stimulation of the central nucleus of the amygdala markedly increases acoustic startle. By combining these behavioral, anatomical, physiological, and pharmacological approaches, it should soon be possible to determine each neural pathway that is required for a stimulus signaling fear to alter startle behavior. Once the exact structures are delineated, it should be possible to determine the neurotransmitters that are released during a state of fear and how this chemical information is relayed along these pathways so as to affect behavior. PMID- 3545258 TI - Imprinting, learning, and memory. AB - If a visually naive chick is exposed to one of a wide range of conspicuous objects, the chick may learn its characteristics. A series of biochemical studies has implicated a restricted part of the forebrain in this process of imprinting; a specific region (IMHV) has been identified which may be a site of information storage. Changes in the morphology of synapses occur in this region as a consequence of training. The left and right IMHV regions play different roles in the imprinting process. Exposure to a simple artificial object, a rotating red box, has different neural consequences from those associated with exposure to a complex object, a rotating stuffed jungle fowl, which resembles a conspecific. These differences may be related to the differences in complexity of the two training objects. Another possibility is that two neural systems are implicated in imprinting: a system that underlies a predisposition to approach objects resembling conspecifics and a learning system, of which IMHV is a crucial component, that is engaged by particular objects and that in "natural" circumstances also allows the chick to learn the characteristics of its mother. PMID- 3545259 TI - Implicating causal relations between cellular function and learning behavior. AB - Learning in the nudibranch mollusc Hermissenda shows many features of vertebrate associative conditioning. Pairings of light and rotation produce conditioned suppression of phototaxis, which is retained for days, shows savings, extinction, contingency sensitivity, and, recently, temporal specificity. In addition, specific features of the behavior have been shown to undergo classical Pavlovian conditioning. Extensive analysis of the neural networks mediating the flow of visual and graviceptive information have demonstrated convergent pathways at specific cellular loci. These cells are critically implicated for a primary role in the conditioned modifications of behavior. A variety of experimental approaches consistently support the proposal that reductions of specific K+ currents in the Type B photoreceptor soma play a causal role for several different behavioral expressions of the conditioning. In this article, we review several of these behaviors to show how the demonstrated close temporal correspondence of cellular and behavioral functions further implicates certain causal relations. For example, studies of the shadow withdrawal behavior of Hermissenda suggest a causal relation between the long-lasting depolarization of the Type B photoreceptor and the animal's reduced ability to turn towards the light at light/dark boundaries. Whereas the shadow response corresponded to cellular events at the end of a light step, responses to the onset of light or rotation were largely unexplored. By using a different approach, we identified behavioral responses during the first few seconds of stimulation with light and rotation. These responses, for which Pavlovian conditioning was demonstrated, correspond closely in time to known cellular correlates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545260 TI - Mnemonic theories of hippocampal function. AB - Although mnemonic interpretations of hippocampal function in people have been readily accepted for many years, similar interpretations of hippocampal function in animals have received a number of challenges. This article reviews two of these challenges, shows how they were resolved in favor of some kind of mnemonic interpretation, and then suggests ways in which these types of interpretations must change in order to encompass new data. PMID- 3545261 TI - Aldred Scott Warthin. The man behind the tumor. AB - The personal milestones of Aldred Scott Warthin are detailed. One of the pathologic specimens that served as the basis for his original description of papillary cystadenoma lymphomatosum is reviewed. PMID- 3545263 TI - Avoiding stenosis in the tubed greater pectoral flap in pharyngeal repair. AB - Replacement of circumferential defects of the pharynx with skin-lined flaps rolled into a tube had the problem of anastomotic stricture formation. To prevent and correct stenosis at the mucocutaneous junction, an interdigitating anastomotic line produced by making vertical slits on the skin edge and the esophageal stump edge is used. It allows for maintenance of the lumen despite suture line contraction. PMID- 3545264 TI - Optic nerve hypoplasia: changing perspectives. AB - Optic nerve hypoplasia, having once been regarded as exceedingly rare, is now regarded as one of the major causes of visual loss in infancy. Recognition of subtle forms and segmental forms of optic nerve hypoplasia are important in explaining the evaluation of subnormal vision, and have an added significance in the recognised associations of central nervous system anomalies including abnormalities of the endocrine system. These changing clinical perspectives are reviewed, together with a discussion of the pathogenesis of optic nerve hypoplasia in the light of cell death and nerve fibre degeneration seen in normal development of the neural visual system. PMID- 3545262 TI - Histopathology and immunofluorescent immunoglobulins in asthmatics with aspirin idiosyncrasy. AB - Nearly 700 specimens of polyps and sinus tissues from 12 patients with asthma and aspirin idiosyncrasy were studied with histochemical and immunofluorescent immunoglobulin techniques. Hematoxylin-eosin, Giemsa, and Wright's stains were used for the histochemical analyses. Immunofluorescent antibodies for IgG, IgA, IgM, IgE, IgD, anti-C3, albumin, and fibrin were used. There was a uniform inflammatory reaction in all the tissues. A thick basement membrane and epithelial changes were also present. Immunofluorescent immunoglobulins were consistent in quantity and location in these tissues. IgG, IgA, and IgM were associated with inflammation. IgE was present in all the specimens, but this does not necessarily indicate a reagin-mediated reaction. Anti-C3 excluded the possibility of a hereditary absence of C1 esterase inhibitor. PMID- 3545265 TI - Repair of retinal detachment: personal experience of one of the earliest successful cases. PMID- 3545266 TI - [Effects of the subarachnoid hemorrhage on the release of arachidonate metabolites from canine cerebral arteries]. AB - Release of arachidonate metabolites from isolated canine cerebral arteries into perfusing medium were estimated using radioimmunoassay (RIA) in vitro. The cerebral arteries were isolated from dogs sustained experimental subarachnoid hemorrhages (SAH) and the results were compared with that of normal canine cerebral arteries. The amount of 6-Keto-PG F1 alpha (stable metabolite of PGI2) and PGE2 released from normal cerebral arteries were 455 +/- 84 (n = 7) and 177 +/- 72 (n = 8) ng/min/g dry weight (mean +/- SEM), respectively. Among other arachidonate metabolites, TXB2 (stable metabolite of TXA2), PGF2 alpha, PGD2 were also measured, but release of these arachidonate metabolites were little compared with PGI2 or PGE2. The amount of 6-Keto-PGF1 alpha and PGE2 released from the cerebral arteries subjected to subarachnoid hemorrhage were 110 +/- 34 (n = 6), 169 +/- 40 (n = 6) ng/min/g dry weight respectively. In SAH group, release of 6 Keto-PGF1 alpha had diminished remarkably, but no remarkable quantitative change were seen among other arachidonate metabolite between normal and SAH groups. The diminution of PGI2 release in the cerebral artery subjected to SAH may be involved in the pathogenesis of cerebral vasospasm. The release of PGs from canine pial arteries induced by the exposure of the pial arteries to red blood cell hemolysate was also estimated by RIA. The release of PGE2 tended to increase following to exposure to hemolysate but no other arachidonate was increased. PMID- 3545267 TI - Chlorhexidine gluconate mouthwash in the management of minor aphthous ulceration. A double-blind, placebo-controlled cross-over trial. PMID- 3545268 TI - A method for collection of submandibular saliva from dentate patients. PMID- 3545269 TI - Badges of the dental profession. The Society of University Dental Instructors. PMID- 3545270 TI - Electrocardiography then and now: where next? PMID- 3545271 TI - What proportion of patients with myocardial infarction are suitable for thrombolysis? AB - Four hundred and three patients were considered for entry into a trial of intravenous streptokinase in suspected myocardial infarction. Three hundred and sixty seven (91%) were excluded. Two hundred and sixty (65%) did not meet the inclusion criteria and 45 of the remaining 143 (35%) patients had contraindications to thrombolysis. This left 98 (24%) patients who were suitable for thrombolysis and 42 of them were over 70 years, the upper age limit. Thus according to this trial protocol 56 (14%) patients were eligible for recruitment; 36 (9%) patients were finally randomised. These data suggest that treatment with intravenous streptokinase may be applicable to only a small proportion of patients with myocardial infarction. PMID- 3545272 TI - Did Einthoven invent a string galvanometer? PMID- 3545274 TI - Human preleukaemia: do we have a model? PMID- 3545277 TI - Immunologic classification of blast cells in RAEB. PMID- 3545273 TI - The mechanism of salbutamol-induced hypokalaemia. AB - The following four intravenous treatments were administered in a balanced, randomized Latin square design to eight healthy volunteers: (-)-adrenaline (0.06 microgram kg-1 min-1 for 90 min) + vehicle control (+)-glucose infusion (60 min), salbutamol (120 ng kg-1 min-1 for 30 min) + vehicle control (+)-glucose infusion (90 min), (-)-adrenaline (0.06 microgram kg-1 min-1 for 90 min) + salbutamol (120 ng kg-1 min-1 for 30 min) and two vehicle control infusions of (+)-glucose. All active solutions were preceded by a 1 h control infusion and the control infusion was continued for 1 h following the active solutions. Both the active solutions, (-)-adrenaline and salbutamol were increased stepwise to the above doses. Heart rate and blood pressure were recorded at frequent intervals throughout and venous blood was taken for the estimation of potassium, insulin, glucose, catecholamine and salbutamol levels. Adrenaline levels similar to those seen in acute illness were achieved using this infusion protocol. Salbutamol levels rose throughout the period of the salbutamol infusions and steady-state was not achieved. Potassium levels were unchanged on the control + control study day and fell on all active treatments (0.45 mmol l-1 following (-)-adrenaline + control; 0.48 mmol l-1 following salbutamol + control; 0.93 mmol l-1 following (-)-adrenaline + salbutamol). Insulin levels rose insignificantly after salbutamol alone and fell slightly on all other treatments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545275 TI - Lymphocyte subsets in tumour of patients with undifferentiated nasopharyngeal carcinoma: presence of lymphocytes with the phenotype of activated T cells. AB - We have analyzed lymphocytes infiltrating nasopharyngeal carcinomas, using a combination of immunoperoxidase staining of frozen and paraffin-embedded sections, and immunofluorescence on lymphocyte suspensions recovered from teased tumours. A panel of monoclonal antibodies was used to define lymphocytic subsets on frozen sections of 14 different tumours. The vast majority of peri- and intra tumoral lymphocytes were stained by OKT3 antibody. In 8 sections, T4 positive cells were largely predominant, while T8 positive cells were the majority in three sections. Twenty-nine paraffin-embedded sections from other NPC patients stained with HNK-1 antibody showed a variable percentage of positive cells reaching 6 to 15% in nine patients. Most HNK-1 positive cells had the morphology of large granular lymphocytes typical of natural killer cells. Double staining experiments on lymphocytes isolated from 7 tumours revealed a constant presence of T3 positive, HLA-DR positive lymphocytes (from 6 to 29% of mononuclear cells), and of lymphocytes coexpressing the T3 and the Tac (IL-2 receptor) antigens (from 5 to 12% of mononuclear cells). Lymphocytes with a phenotype of activated T-cells are thus constantly found in NPC tumours. PMID- 3545276 TI - Roles of antibody and complement in the bactericidal activity of mouse peritoneal exudate neutrophils. AB - The contributions of complement and antibody to phagocytosis and, as a separate process, intracellular killing of Proteus mirabilis, were investigated using mouse peritoneal exudate neutrophils. Phagocytosis of P. mirabilis was promoted by both immune mouse (IMS) and normal mouse (NMS) sera. Opsonization by IMS promoted significantly greater phagocytosis than did NMS, as did NMS compared with heated IMS (HIMS). The ability of NMS to opsonize P. mirabilis for both phagocytosis and phagocytic killing was diminished by chelation with EGTA and abolished by chelation with EDTA. This suggested that fixation of complement by both alternative and classical pathways provided optimal opsonization of this organism in NMS. In order to study intracellular killing as a process separate from phagocytosis, peritoneal exudate cell suspensions were exposed to P. mirabilis, previously incubated with 1% NMS, 1% IMS, 10% HNMS (heated normal mouse serum) or 10% HIMS, followed by centrifugation of the phagocyte-bacteria mixtures on Percoll density gradients. Populations of neutrophils containing viable intracellular bacteria, and relatively free of extracellular bacteria (less than 7% of total) were recovered in washed suspensions of cells fractionated at densities greater than 1.069 g/ml. For P. mirabilis that had been opsonized with 1% NMS before phagocytosis, the continued presence of extracellular serum was necessary for intracellular killing. NMS stimulated significantly greater intracellular killing than did HNMS, which stimulated some intracellular killing compared with the absence of serum, in which no killing occurred. IMS was similar to NMS in its ability to stimulate intracellular killing. EGTA partially blocked the stimulation of intracellular killing by NMS, and EDTA abolished it. These findings suggested that (as for optimal opsonization) complement activated via both alternative and classical pathways was responsible for optimal stimulation of intracellular killing. PMID- 3545278 TI - Haemopoietic reconstitution after allogeneic bone marrow transplantation in man: recovery of haemopoietic progenitors (CFU-Mix, BFU-E and CFU-GM). AB - Haemopoietic reconstitution was evaluated in 44 patients given HLA compatible sibling bone marrow transplants. The mean peripheral blood haemoglobin, neutrophil and platelet counts were markedly reduced early post-graft but returned to normal by 26 weeks post transplant. Bone marrow multipotent (CFU Mix), erythroid (BFU-E) and myeloid (CFU-GM) progenitor cell reconstitution were also assessed at regular intervals up to 2 years post-graft. The mean value of CFU-GM increased gradually and attained a normal value by 52 weeks. The BFU-E value did not reach a normal value until after 52 weeks post-graft. However, CFU Mix growth appeared to be impaired even up to 2 years post-transplant. The occurrence of graft versus host disease at 3 months post-transplant was associated with significantly lower mean numbers of platelets, marrow CFU-GM, BFU E and CFU-Mix. Post-transplant patients who were on methotrexate therapy were also shown to have lower marrow CFU-GM and neutrophil values compared to those patients who received cyclosporin post-transplant. This study demonstrated that although peripheral blood counts were normal after 26 weeks post-graft, marrow stem cell reserve in these patients was reduced. This might in part explain the documented increase in risk of severe infections or thrombocytopenia in some of these patients, particularly during viral infection, graft-versus-host disease or immunosuppressive treatment. PMID- 3545280 TI - Detection of cells of megakaryocyte lineage in haematological malignancies by immuno-alkaline phosphatase labelling cell smears with a panel of monoclonal antibodies. AB - Immuno-alkaline phosphatase staining (by the APAAP technique) has been used to identify promegakaryoblasts in cell smears from 10 cases of leukaemia (three acute leukaemia, seven blast transformations). In all cases promegakaryoblasts were labelled by at least two anti-platelet glycoprotein (gp) antibodies, the highest percentages being obtained with anti-gp IIIa (antibody C17). HLA-DR was expressed by a variable percentage of neoplastic cells in all cases, the T11 (CD2) antigen (sheep red cell receptor) in four of seven cases tested and the p150,95 antigen in three of the six cases tested. In some cases of acute myeloid leukaemia APAAP staining of blood smears revealed circulating promegakaryoblasts and micromegakaryocytes (which superficially resemble small lymphoid cells). It is concluded that immuno-alkaline phosphatase staining of cell smears offers a convenient means of diagnosing acute megakaryoblastic leukaemia in the routine laboratory. PMID- 3545279 TI - Anti-granulocyte opsonic activity in sera from patients with systemic lupus erythematosus. AB - Neutropenia is common in patients with systemic lupus erythematosus (SLE) but mechanisms of cell depletion remain obscure. To investigate the possible autoimmune aetiology of neutropenia in SLE, sera from 31 patients with this disorder were tested for anti-granulocyte activity. Granulocyte-binding immunoglobulins were detected by indirect immunofluorescence, and the ability of patient sera to opsonize granulocytes was determined by measuring the chemiluminescent response of human monocytes to granulocytes sensitized by test sera. Sera from 22 of the 31 patients bound IgG to granulocyte cell membranes and/or to nuclei, but only membrane-binding antibodies opsonized the cells for recognition by monocytes. There was no correlation between neutrophil count and the level of granulocyte-binding IgG as measured by indirect immunofluorescence. In contrast, opsonic activity and neutrophil count were inversely correlated (r = 0.5; P less than 0.05). However, opsonic activity was present in sera from most non-neutropenic patients. In patients with SLE, impaired reticuloendothelial system function may allow sensitized granulocytes to remain in the circulation. PMID- 3545281 TI - History of occupational medicine: relevance of Imhotep and the Edwin Smith papyrus. PMID- 3545282 TI - A clinical trial using danazol for the treatment of premenstrual tension. AB - Forty women with premenstrual tension received either placebo, 100, 200 or 400 mg danazol daily for 3 months in a pilot study arranged as a double-blind trial. Thirteen patients withdrew by the third month usually because they complained of no improvement. They had significantly higher pretrial symptom scores than those who continued. In patients treated with danazol, symptom scores for breast pain during the second and third months and for irritability, anxiety and lethargy during the third month were significantly (P less than 0.05) lower than scores in those given placebo. Most symptoms improved on placebo in the first month but by the third month only three remained improved. In contrast eight symptoms were improved on 200 mg danazol by the third month. By the end of the trial more than 75% of patients who were still taking danazol were essentially free of breast pain, lethargy, anxiety and increased appetite, but results for other common symptoms were no better than with placebo. PMID- 3545283 TI - High concentrations of immunoreactive renin, prorenin and enzymatically-active renin in human ovarian follicular fluid. AB - Prorenin (enzymatically inactive) and renin (active) were measured by radioimmunoassay, using monoclonal antibodies reacting either with both prorenin and renin or with renin alone, in pre-ovulatory follicular fluid (FF) from women in an in-vitro fertilization programme who were stimulated with human menopausal/human chorionic gonadotrophin. The concentration of prorenin in FF was 40 times higher than in plasma taken at the time of FF collection; renin in FF was 10 times higher. The plasma concentration of prorenin, but not of renin, in these women was higher than in non-stimulated women in the late follicular phase of the menstrual cycle. The concentration of reninsubstrate and angiotensin converting enzyme in FF was 60% of that in plasma. Contamination of blood, which may occur at the time of FF collection, was less than 5%. Prorenin in FF was irreversibly converted into renin after adding trypsin or by endogenous serine protease, using procedures that also cause conversion of prorenin in plasma. These results support the hypothesis that the increased plasma level of prorenin in women whose ovulation is stimulated for the collection of oocytes has originated from the ovary and is under gonadotrophic control. This may also be true for the increase of plasma prorenin that has been observed in non-stimulated women during the luteal phase of the cycle and in early pregnancy. PMID- 3545284 TI - Commentary. Repair of episiotomies and perineal tears. PMID- 3545285 TI - Anterior uveal neurilemmoma--a rare neoplasm simulating malignant melanoma. AB - A 30-year-old woman presented with dilated episcleral vessels in the right eye which were found to be associated with an underlying ciliary body tumour. Contact lens examination, transpupillary transillumination, ultrasonography, computerised tomography, magnetic resonance imaging, and fine needle aspiration biopsy produced apparently conflicting and inconclusive results, and the eye was enucleated. Light and electron microscopy showed the lesion to be a neurilemmoma (schwannoma), of which very few cases have been reported. The clinical and pathological features are described and discussed. PMID- 3545286 TI - Photochemical properties of Escherichia coli DNA photolyase: a flash photolysis study. AB - Escherichia coli DNA photolyase contains a stable flavin neutral blue radical that is involved in photosensitized repair of pyrimidine dimers in DNA. We have investigated the effect of illumination on the radical using light of lambda greater than 520 nm from either a camera flash or laser. We find that both types of irradiations result in the photoreduction of the flavin radical with a quantum yield of 0.10 +/- 0.02. While photoreduction with the camera flash is minimal in the absence of an electron donor (dithiothreitol), laser flash photolysis at 532 nm reduces the flavin to the same extent in the presence or absence or an electron donor. Thus, it is concluded that the primary step in photoreduction involves an electron donor that is a constituent of the enzyme itself. Laser flash photolysis produces a transient absorption band at 420 nm that probably represents the absorption of the lowest excited doublet state (2(1)IIII*) of the radical and decays with first-order kinetics with k1 = 0.8 X 10(6) s-1. The photoreduction data combined with the results of recent studies on the activity of dithionite-reduced enzyme suggest that electron donation by excited states of E-FADH2 is the mechanism of flavin photosensitized dimer repair by E. coli DNA photolyase. PMID- 3545288 TI - Identification of the high-affinity lipid binding site in Escherichia coli pyruvate oxidase. AB - Pyruvate oxidase from Escherichia coli is a peripheral membrane associated enzyme which is activated by lipids. We have investigated the high-affinity lipid binding site associated with lipid activation of pyruvate oxidase by covalent attachment of [14C]lauric acid to the enzyme. Lauric acid is bound stoichiometrically (1 mol/mol of active sites), and the enzyme is essentially irreversibly activated. Mild tryptic digestion of the modified enzyme shows that the lauric acid is bound within the last 100 residues of the 572-residue monomer. Digestion with thermolysin releases two closely related peptides, A and B, in approximately equal amounts. Comparison of the amino acid composition of peptide A with the entire sequence of the protein shows that peptide A corresponds to the sequence from Ala-543 to Ile-554. The analysis of peptide B is very similar to that of A. Limited sequence analysis of peptide B shows that residue 1 is Ala and residue 2 is labeled. These results support the assignment of residue 1 in peptide B as Ala-543 and indicate that lauric acid is bound to Lys-544. Previous work in this laboratory has shown that pyruvate oxidase may be activated independently of lipids by mild protease digestion. Proteolytic activation is accompanied by the release of a small peptide (residues 550-572) from the carboxyl terminus of the protein. The present work locates the lipid binding site very close to this peptide. The significance of these results for the mechanism of activation of pyruvate oxidase and other lipid-activated systems is discussed. PMID- 3545287 TI - Chemical modification of Escherichia coli RNA polymerase by diethyl pyrocarbonate: evidence of histidine requirement for enzyme activity and intrinsic zinc binding. AB - RNA polymerase (RPase) from Escherichia coli contains five subunits (alpha 2 beta beta' sigma) and two intrinsic Zn ions located in the beta and beta' subunits. This enzyme was rapidly inactivated by diethyl pyrocarbonate (DEP) at pH 6.0 and 25 degrees C. The difference spectrum of the DEP-inactivated and native RPases showed a single peak at 240 nm indicating the formation of N carbethoxyhistidines. No decrease in absorbance at 278 nm, due to O carbethoxytyrosine, or modification of amino and sulfhydryl groups was observed. Inactivated RPase with six to nine histidines being modified could be fully reactivated by incubation with 0.5 M hydroxylamine at pH 6.0 and room temperature for 1 h. No structural difference was detected between the native and modified enzymes as evidenced by UV/visible and fluorescence spectra, sodium dodecyl sulfate-polyacrylamide gel electrophoretic pattern, or gel filtration properties. Substrate ATP at 0.11 and 1.14 mM concentrations provided, respectively, 25% and 90% protection against DEP inactivation, while template DNA did not. These results suggest that one or more histidine residues is/are in close proximity to the substrate binding site. The pH dependence of the DEP inactivation of RPase suggested the modification of histidine at the active site with a pK value of 6.9. The inactivation of RPase by DEP and the formation of N-carbethoxyhistidine displayed a similar second-order rate constant of approximately 0.9 mM-1 min 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545289 TI - Membrane disposition of the Escherichia coli mannitol permease: identification of membrane-bound and cytoplasmic domains. AB - Two proteolytic fragments of the Escherichia coli mannitol permease (EIImtl) have been identified on autoradiograms of sodium dodecyl sulfate-polyacrylamide gels and mapped with respect to the membrane. EIImtl was selectively radiolabeled with either [35S]methionine or a mixture of 14C-labeled amino acids in E. coli minicells harboring a plasmid containing the mannitol operon. The intact permease (Mr 65,000) in everted vesicles derived from labeled minicells was cleaved by mild trypsinolysis into two smaller fragments (Mr 34,000 and 29,000). The 34,000 dalton fragment remained in the membrane and was insensitive to further proteolysis by trypsin. This fragment was identified as the N-terminal half of the protein by comparing the amount of the original [35S]methionine label that it retained with the known differential distribution of methionine in the two halves of EIImtl. The 29,000-dalton fragment, which was released into the soluble fraction and was sensitive to further trypsinolysis, therefore corresponds to the C-terminal half of the mannitol permease. Both fragments were shown to be antigenically related to EIImtl by immunoblotting with anti-EIImtl antibody. The 34,000-dalton fragment was further shown to form an oligomer under conditions which allow the intact enzyme to dimerize, suggesting that this domain plays an important role in EIImtl subunit interactions. These results support a model in which EIImtl consists of two domains of approximately equal size: a membrane bound, N-terminal domain with a tendency to self-associate, and a cytoplasmic C terminal domain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545290 TI - Demonstration of the GC-rich common arm in yeast ribosomal 5.8S RNA via 500-MHz proton nuclear magnetic resonance and Overhauser enhancements. AB - In this paper we report the first 1H NMR study of the base-paired secondary structure of yeast 5.8S RNA. On the basis of a combination of homonuclear Overhauser enhancements and temperature dependence of the proton 500-MHz NMR spectrum, we are able to identify and assign eight of the nine base pairs in the most thermally stable helical arm: G116.C137-C117.G136-C118.G135- C119.G134 C120.G133-U121.G132- U122.A131-G123.C130. This arm contains an unusually temperature-stable (to 71 degrees C) segment of four consecutive G.C base pairs. This work constitutes the most direct evidence to date for the existence and base pair sequence of the GC-rich helix, which is common to most currently popular secondary structural models for eukaryotic 5.8S ribosomal RNA. PMID- 3545291 TI - Dissociation of the lactose repressor protein tetramer using high hydrostatic pressure. AB - Dissociation of lac repressor tetramer by high hydrostatic pressures was monitored with intrinsic tryptophan fluorescence. With the assumption of complete dissociation to monomer, tryptophan polarization data gave delta V a approximately 170 mL/mol and the concentration for 50% tetramer dissociation, C1/2, was 3.8 X 10(-8) M. Upon addition of inducer, the calculated delta V a increased to approximately 220 mL/mol and the C1/2 decreased to approximately 1 X 10(-8) M, a free energy difference of approximately 0.7 kcal. These results indicate a modest stabilization of the tetramer by the presence of inducer. Monitoring the average energy of tryptophan emission demonstrated that tetramer dissociation takes place over the same range of pressures as evidenced by the polarization data and IPTG dissociation can be more or less superimposed upon tetramer dissociation depending upon the ligand concentration used. Although the two transitions cannot be separated entirely, the delta V a for the region of the pressure dependence dominated by ligand dissociation was 69 mL/mol, an unexpectedly large value. For tetramer modified with methyl methanethiosulfonate, subunit dissociation was shifted to much higher pressures and IPTG dissociation did not occur. The delta V a for subunit association was calculated as approximately 160 mL/mol, and the C1/2 was 3.5 X 10(-9) M. Interactions at the subunit interface of the modified protein are apparently stronger than in the unmodified protein. The absence of inducer dissociation from the MMTS-modified tetramer by the application of high hydrostatic pressure suggests that the volume change for inducer binding to the modified protein is much smaller than that observed for the unmodified repressor. PMID- 3545292 TI - Aminoacyl-tRNA-elongation factor Tu-ribosome interaction leading to hydrolysis of guanosine 5'-triphosphate. AB - We investigated the elongation factor Tu (EF-Tu) dependent binding of Phe-tRNA and Phe-tRNAs with the nicks at positions 46, 37, and 17 to the Escherichia coli 70S ribosome-poly(U)-tRNAPhe complex. Binding of Phe-tRNA1-45 + 47-76, Phe-tRNA1 36 + 38-76, or Phe-tRNA1-16 + 17-76 to the 70S ribosome has been found to be poly(U) X tRNA dependent and, similar to that of intact Phe-tRNA, is inhibited by the antibiotic thiostrepton. We have further found that, contrary to a previous report [Modolell, J., Cabrer, B., Parmeggiani, A., & Vazquez, D. (1971) Proc. Natl. Acad. Sci. U.S.A. 68, 1796], the EF-Tu-ribosome GTPase mediated by Phe-tRNA is not inhibited by thiostrepton; rather, the drug stimulates the endogenous GTPase of the EF-Tu X 70S ribosome. Phe-tRNA fragments 47-76, 38-76, and 17-76 all promote the EF-Tu X GTPase reaction in the presence of 70S ribosome-poly(U) tRNAPhe yeast. Moreover, since the GTPase-promoting activities of both the short and long fragments are similar, it appears that the most important aminoacyl transfer ribonucleic acid (aa-tRNA) interaction with EF-Tu occurs alongside its 3' quarter. Thiostrepton slightly stimulates the GTPase activity of these Phe tRNA fragments. Although the Phe-tRNA1-36 + 38-76 cannot bind to poly(U) during its binding to 70S ribosomes, its binding at high Mg2+ concentration occurs at the A site. Thus, most of the bound modified Phe-tRNA functions as the acceptor in the peptidyltransferase reaction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545293 TI - Energy-dependent formation of free ATP in yeast submitochondrial particles, and its stimulation by oligomycin. AB - Yeast submitochondrial particles, in a Pi- and NADH-dependent reaction, produced low concentrations of free ATP in the absence of added ADP. This formation of free ATP, as measured by the luciferin-luciferase method, was strongly stimulated by oligomycin. For maximal stimulation, oligomycin was to be added not earlier than 5-10 min after the addition of NADH. Upon addition of antimycin or FCCP the system was completely inhibited. The amount of free ATP formed corresponded to one-third of the amount of bound ATP in submitochondrial particles. The stimulatory effect of oligomycin disappeared if the submitochondrial particles were spun down after oligomycin stimulation and then resuspended in the reaction medium, whereas submitochondrial particles with no oligomycin added initially were stimulated by oligomycin after the same procedure. A different picture emerged with addition of ADP. If the submitochondrial particles were preenergized with NADH in the presence of oligomycin before the addition of ADP the formation of free ATP upon subsequent addition of ADP was inhibited by oligomycin. In the presence of oligomycin, but lacking preenergization with NADH, a stimulation of free ATP formation was achieved with added ADP. A possible explanation for the stimulating effect of oligomycin on ATP formation in the absence of added ADP is that it enhances the release of bound ATP in an energy-requiring process. The release of only about one-third of the bound ATP could indicate that one of three nucleotide-binding subunits involved in the mechanism of ATP formation by ATP synthase is in a state suitable for such an energy-dependent release of ATP. PMID- 3545294 TI - Photolabelling of the hexose transporter at external and internal sites: fragmentation patterns and evidence for a conformational change. AB - The human erythrocyte sugar transporter has been labelled at its internal site with cytochalasin B and at its outside site by the azidosalicoyl derivative of bis(D-mannose) (ASA-BMPA). The cleavage of the transporter by various proteinases has been studied. Chymotrypsin, subtilisin and V8 proteinase give parallel fragmentation patterns for the two labels down to fragments as small as 7 kDa. Thus the binding sites for the two labels can only be separated by a small span of protein. 2-Nitro-5-thiocyanobenzoic acid (NTCB) cleaves at cysteines to give a 15 kDa fragment from the two labels. N-Bromosuccinimide (a reagent which preferentially cleaves at tryptophan residues) has revealed differences in fragmentation of the transporter labelled with either cytochalasin B or with ASA BMPA. A major cleavage site is proposed to occur at tryptophan 186 which leaves a C-terminal fragment containing both labels. A tryptophan cleavage at residue 388 divides the cytochalasin B site and the ASA-BMPA site. A further tryptophan cleavage gives a cytochalasin B labelled 3 kDa fragment probably from residues 388-412. This gives an assignment of the cytochalasin B site as the inside of the hydrophobic span H 10. Since the ASA-BMPA site is probably only 7 kDa from residue 388 and is on the same 15 kDa NTCB fragment as cytochalasin B we assign this to the outside of hydrophobic span H 9. Thermolysin only cleaves the transporter labelled with cytochalasin B and not with ASA-BMPA. A 18 kDa cytochalasin B labelled fragment is formed. This is indicative of a change in conformation of the transporter when an outside ligand is bound such that the inside of the hydrogen bonding transmembrane segments H 7 and H 8 (and containing the proposed thermolysin cleavage site) are withdrawn from the cytosolic surface. Thus it appears that the core of the transporter (including the external and internal sites plus the transmembrane channel) is located between segments H 7 and H 10. PMID- 3545295 TI - Modification of L-triiodothyronine binding sites from rat erythrocyte membrane by heating and by proteinase treatments. AB - The number of binding sites for L-triiodothyronine in rat erythrocyte membranes was increased 2-fold by incubation at 37 degrees C for 60 min. An increase of approximately 3-fold was found when the incubation was carried out at 50 degrees C. The proteinase inhibitor phenylmethylsulfonyl fluoride abolished the effect. Similar increments in the number of binding sites were obtained by treatment of the membranes with proteinases. The Kd values (0.09 X 10(-10) M and 3.6 X 10(-10) M for the high-affinity and the low-affinity binding sites, respectively) remained unchanged after the treatment, as did the free-SH group requirements, storage stability and stereospecificity. Our results suggest that endogenous proteolytic activity could be involved in the increase of the number of membrane latent sites for L-triiodothyronine. PMID- 3545296 TI - Tritium exchange kinetics of yeast ribosomal subunits. AB - Tritium exchange kinetics of 60 S and 40 S ribosomal subunits from Saccharomyces cerevisiae were studied using a rapid centrifugal, ultrafiltration procedure. This assay used commercially available disposable columns and microconcentrators. The tritium-labeled ribosome was separated from the tritiated solvent using a prepacked gel-filtration column. The labeled ribosome was applied to a microconcentrator and the exchange-out kinetics of the ribosome was measured by centrifugation of the ribosome solution and measurement of the amount of radioactivity present in the filtrate. One major advantage of this method is its simplicity and rapidity. With this method, the tritium exchange-out behavior of 60 S and 40 S ribosomal subunits and of subunits during reassociation were determined. The two subunits exhibited different exchange-out rates. Both subunits consisted of multiple classes of exchangeable protons. Considerable conformational changes in both subunits were evident during subunit reassociation, as additions of equal molar quantities of unlabeled 40 S subunits to labeled 60 S subunits caused an immediate increase in the exchange rate. Similarly, an increase in the exchange rate in the small subunits upon addition of unlabeled 60 S subunits was observed. PMID- 3545297 TI - Assembly of the mitochondrial ribosomes in a temperature-conditional mutant of Saccharomyces cerevisiae defective in the synthesis of the var1 protein. AB - An investigation of the role of the var1 protein in the assembly of the yeast mitochondrial ribosomes was carried out in a temperature conditional mutant, strain h56, which contains a mutation (tsv1) just upstream of the structural gene for the var1 protein. The mutation results in a marked decrease in the synthesis of the var1 protein at the permissive temperature of 28 degrees C and an apparently complete absence of var1 synthesis at the restrictive temperature of 36 degrees C. Long-term growth of strain h56 at the non-permissive temperature was found to result in the loss of the small (37 S) ribosomal subunit and the appearance of a novel 30 S ribonucleoparticle. Both the small (37 S) and the large (54 S) mitochondrial ribosomal subunits were found to be assembled in strain h56 for at least 3 h after transfer to the non-permissive temperature. PMID- 3545298 TI - Studies on the regulation of enolases and compartmentation of cytosolic enzymes in Saccharomyces cerevisiae. AB - Three enolase isoenzymes can be distinguished after electrophoresis of yeast crude extracts. After adding glucose to derepressed cells, there was a coordinated increase in the activity of enolase I and decrease in enolase II activity. Enolase I was found to be repressed and enolase II simultaneously induced by glucose. The third enolase activity remained unchanged and was identified as that of a hybrid enzyme. Enolase catalyses the first common step of glycolysis and gluconeogenesis. Gluconeogenic enolase I shows substrate inhibition for 2-phosphoglycerate (glycolytic substrate) and glycolytic enolase II is substrate-inhibited by phosphoenolpyruvate (gluconeogenic substrate). The gluconeogenic reaction was inhibited up to 45% by physiological concentrations of fructose 1,6-bisphosphate. To test for cytological compartmentation, a method was developed for isolating microsomes. Effective enrichment of rough and smooth endoplasmic reticulum was demonstrated by electron microscopy. No evidence was obtained for any compartmentation of either enolases or other glycolytic enzymes. PMID- 3545299 TI - Studies on the catalytic rate constant of ribosomal peptidyltransferase. AB - A detailed kinetic analysis of a model reaction for the ribosomal peptidyltransferase is described, using fMet-tRNA or Ac-Phe-tRNA as the peptidyl donor and puromycin as the acceptor. The initiation complex (fMet-tRNA X AUG X 70 S ribosome) or (Ac-Phe-tRNA X poly(U) X 70 S ribosome) (complex C) is isolated and then reacted with excess puromycin (S) to give fMet-puromycin or Ac-Phe puromycin. This reaction (puromycin reaction) is first order at all concentrations of S tested. An important asset of this kinetic analysis is the fact that the relationship between the first order rate constant kobs and [S] shows hyperbolic saturation and that the value of kobs at saturating [S] is a measure of the catalytic rate constant (k cat) of peptidyltransferase in the puromycin reaction. With fMet-tRNA as the donor, this kcat of peptidyltransferase is 8.3 min-1 when the 0.5 M NH4Cl ribosomal wash is present, compared to 3.8 min 1 in its absence. The kcat of peptidyltransferase is 2.0 min-1 when Ac-Phe-tRNA replaces fMet-tRNA in the presence of the ribosomal wash and decreases to 0.8 min 1 in its absence. This kinetic procedure is the best method available for evaluating changes in the activity of peptidyltransferase in vitro. The results suggest that peptidyltransferase is subjected to activation by the binding of fMet-tRNA to the 70 S initiation complex. PMID- 3545300 TI - Binding of renin and angiotensinogen to macromolecules in plasma studied by sedimentation equilibrium centrifugation. AB - Plasma from normal and aggressive mice was subjected to sedimentation equilibrium centrifugation in an air-driven centrifuge. The aim was to study the apparent molecular weight of renin and angiotensinogen in undiluted plasma. Both renin and angiotensinogen appeared heterogeneous with respect to molecular size, suggesting binding to plasma macromolecules. Subsequent high pressure liquid chromatography, using a size exclusion column, demonstrated molecular homogeneity and molecular weights as found in noncentrifuged plasma, indicating that the binding is easily reversible. It is concluded that renin and angiotensinogen in undiluted and unfractionated plasma are weakly bound to plasma macromolecules. This may reduce their activity and to some extent explain the previously observed apparent inhibition of the enzymatic activity. PMID- 3545301 TI - Regulation of hepatic HMG-CoA reductase in vivo by reversible phosphorylation. PMID- 3545302 TI - Phosphorylation of endogenous and exogenous peptides by rat heart sarcolemma. AB - Rat heart plasma membranes contain a calcium-dependent protein kinase which phosphorylates endogenous protein substrates as well as added histones. The major endogenous protein phosphorylated is of 17 kDa on SDS-polyacrylamide gel electrophoresis. Proteins of 85 kDa and 60 kDa were also phosphorylated. Treatment of a rat heart homogenate with the phorbol ester 12-O tetradecanoylphorbol 13-acetate increased the recovery of kinase activity in the sarcolemmal membranes by up to 10-fold. The activity in such membranes was no longer calcium dependent. Although several histones were effective substrates for the enzyme, myosin light chain and phosvitin were not phosphorylated. These membranes contain a very active ATP hydrolysing activity which necessitated very brief incubation times to avoid loss of substrate. The membranes also contain cyclic AMP dependent protein kinase activity which is not active unless cyclic AMP is added to the incubations. The calcium dependent endogenous kinase, which is not inhibited by the heat stable inhibitor protein of cyclic AMP-dependent kinase, or by trifluoperazine, has several properties in common with protein kinase C. Preincubation of the sarcolemmal membranes with a high concentration of insulin caused inhibition of the phosphorylation of the endogenous 17 kDa and 85 kDa bands. There was no effect on the phosphorylation of the 60 kDa peptide. This effect of insulin was specific for the hormone and required preincubation of the hormone with the membranes for 20 min. PMID- 3545303 TI - Failure of insulin to stimulate lipogenesis and triacylglycerol secretion in perfused livers from rats adapted to dietary fish oil. AB - Livers from male rats fed a standard commercial diet supplemented with 8% (w/w) marine fish or safflower oils were perfused for 70 min with undiluted blood in the presence and absence of insulin. Lipogenesis, as measured by the incorporation of 3H2O into liver and perfusate fatty acids, was inhibited by the feeding of fish oil. Net triacylglycerol secretion was also depressed by this dietary treatment. Infusion of insulin stimulated triacylglycerol secretion and the incorporation of newly synthesised fatty acids into liver and perfusate lipids with dietary safflower oil but not with fish oil. Hepatic cholesterol synthesis was also depressed by feeding fish oil. Net ketogenesis was raised by feeding fish oil and was depressed by insulin with both safflower and fish oil. Blood glucose was raised in the fish oil group but with both dietary oils the hormone exerted a significant hypoglycaemic effect. The data are discussed with respect to the observations that in vivo dietary fish oil (but not safflower oil) opposes the hypertriglyceridaemia arising from the hepatic overproduction of very low-density lipoproteins. PMID- 3545304 TI - [Competitive interaction of serotonin and the dye acridine orange with DNA]. AB - The interaction of serotonin and acridine orange dye with DNA isolated from bacterium Escherichia coli and the yeast Candida utilis has been analysed by spectrofluorimetric method. Using data on competitive binding to DNA of serotonin and acridine orange, known as DNA intercalator, a conclusion concerning the formation of intercalated complex between serotonin and DNA has been made. It is shown that for yeast DNA the constant of intercalated binding of serotonin is 3,5 fold smaller than for the bacterial one. PMID- 3545305 TI - [Salt ion interaction with the protein molecule: the facts and the concept]. AB - The effect of salt concentration and its nature on some properties of alpha chymotrypsin (the catalytic activity, the solution optical density, the sedimentation coefficient) has been considered. The limiting stage of enzyme-salt interaction has been shown to change with the variation of experimental conditions. As salt concentration increases the surface electrostatic interaction of salt ions with the enzyme molecule changes by ions penetration via certain channels within the protein globule and their subsequent binding to regulatory centers. The difference in ions nature and binding centers provides the variety of modifications observed. At high salt concentrations the solvent structure becomes predominant. PMID- 3545306 TI - [Method for studying the adaptation of Escherichia coli to the acidification of the medium]. AB - Apparatus permitting to regulate the growth rate of turbidostat culture of microorganisms has been worked out. The process of adaptation of culture microorganisms to the medium acidity has been investigated by the stabilization of growth rate method. The correlation coefficients between adaptation time and changes of acid concentration in medium have been determined. The effect of aeration and density of microorganisms on the parameters of adaptation process has been considered. The conclusion concerning prospects of the growth rate stabilization method application for studying the regularities of culture microorganisms adaptation to the action of the stress has been made. PMID- 3545307 TI - Immunocytochemical localization of insulin-like immunoreactivity in mouse seminal vesicle. AB - Insulin-like immunoreactivity was localized in tissue sections and cell cultures of mouse seminal vesicle using the indirect technique of immunocytochemistry. Seminal vesicles were cut into fragments, fixed in 2.5% glutaraldehyde, embedded in epoxy resin, sectioned at 1 micron, and transferred to glass slides. Epithelial cell cultures of seminal vesicle were grown on coverslips in Dulbecco's Minimal Essential Medium for 4-6 days and fixed in 2.5% glutaraldehyde. Sections (etched with sodium ethanolate) or coverslips were incubated in guinea pig antiporcine insulin antiserum, in antiserum immunoabsorbed with porcine insulin, or in normal guinea pig serum. For indirect immunocytochemistry, incubation with primary antiserum was followed by treatment with rabbit anti-guinea pig immunoglobulin (Ig) G conjugated to peroxidase, or with protein A and then rabbit peroxidase anti-peroxidase (PAP). Finally, treated samples were incubated in phenylenediamine-pyrocatechol-H2O2 substrate mixture for 6-8 min at room temperature. Specific immunoreactivity to insulin antisera was confined to the epithelium of the seminal vesicle in tissue sections. No staining occurred in subepithelial connective tissue. Specific immunoreactivity was also observed in the cytoplasm of cultured seminal vesicle epithelial cells. PMID- 3545308 TI - Failure of human chorionic gonadotropin injections to sustain gonadotropin releasing hormone-induced corpora lutea in postpartum beef cows. AB - Anestrous postpartum (PP) Hereford cows (n =20) were used to determine the effects of repeated injections of human chorionic gonadotropin (hCG) on the progesterone (P4) secretion and functional lifespan of gonadotropin-releasing hormone (GnRH)-induced corpora lutea (CL). Suckling was reduced to once a day from Day 21 to Day 25 PP, and all cows received injections of 200 micrograms GnRH at 1500 h on Day 24 PP to induce ovulation. Treated cows (HCG, n = 10) received 200 IU hCG b.i.d. from 1900 h on Day 27 PP to 1900 h on Day 33 PP; control cows (CTRL, n=10) were not injected. Blood was collected on Days 21, 23, 25, and 27 to 33, 35, 37, and 39 PP. Serum P4 concentration was measured by radioimmunoassay and used to classify luteal lifespan and the associated estrous cycle as short (SHORT) or normal (NORM) in duration. Treatment with hCG resulted in more (p less than 0.01) cows with SHORT cycles (7 of 9 vs. 4 of 9). Serum P4 concentrations were similar (p greater than 0.20) between groups from 4 days before until 6 days after GnRH injection. Cows with NORM cycles (n = 7) had greater serum P4 concentrations (p less than 0.05) on Days 7 to 11 after GnRH than cows with SHORT cycles (n = 11). By Day 39 PP, all cows with SHORT cycles appeared to have undergone a second ovulation. Charcoal-stripped serum pools from before (PRE) and during hCG injection (INJ) were assayed for total luteinizing hormone-like bioactivity (LH-BA) using a dispersed mouse-Leydig cell bioassay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545309 TI - Production of components of extracellular matrix by cultured rat Sertoli cells. AB - Sertoli cells from rats aged 15, 20, and 25 days were cultured in plastic dishes and extracted with Triton X-100 (0.1 percent w/v) or sodium deoxycholate (2 percent w/v). Residues left after extraction were found to contain three proteins characteristic of extracellular matrix (fibronectin, collagen IV, and laminin). These proteins were identified by four methods: indirect immunofluorescence, co migration with standard proteins on electrophoresis in polyacrylamide gels, immunoblotting (Western blots), and immunoprecipitation after incubating the Sertoli cells with [35S]methionine. In addition, fibronectin was identified by immunoelectron microscopy with a second antibody conjugated to colloidal gold. In the same cell residues, heparan sulfate was tentatively identified by the first of these methods. The cells used in these studies were shown, by electron microscopy, to be essentially pure cultures of Sertoli cells (greater than 95% pure). Since 100 percent of the cells examined showed positive and specific immunofluorescent staining with well-characterized antibodies to the four components of the extracellular matrix, and since studies with colloidal gold revealed the presence of fibronectin closely associated with and inside cells identified by electron microscopy as Sertoli cells, it must be concluded that Sertoli cells synthesize these four proteins and presumably heparan sulfate. Evidently, cultured Sertoli cells can synthesize and secrete some of the components of an extracellular matrix. PMID- 3545310 TI - Effect of ethanol on the thermal stability of tRNA molecules. AB - The thermal denaturation of E. coli unfractionated tRNA in ethanol/water mixtures has been studied as a function of alcohol concentration in the water-rich region (mole fraction of co-solvent chi 2 less than 0.2). The results show that with increasing alcohol concentration the melting temperature of tRNA first reaches a minimum at an intermediate composition chi *2 approximately equal to 0.055 and then increases with increasing chi 2. The value of chi *2 is close to that at which structural changes in the mixture occur as inferred from compressibility and optical absorption measurements. The present experimental data support the assumptions that the dominant mechanism by which ethanol affects the thermal stability of tRNA molecules is through its effect on the structure of water. PMID- 3545311 TI - Hepatitis delta virus infection. AB - The hepatitis delta virus (HDV) is a defective virus dependent for replication and infection on helper functions provided by the hepatitis B virus (HBV). HDV and HBV co-infection occurs mainly in acute hepatitis patients with frequent parenteral exposure such as intravenous drug addicts and transfused patients. In contrast, co-infection is very rare in patients with other sources of infection and usually is a self limited disease. HDV superinfection of HBsAg carriers may have a severe course and proceed to chronic active liver disease. Active immunoprophylaxis against HBV should be considered as the only preventive measure against HDV infection. PMID- 3545312 TI - Apheresis, exchange, adsorption and filtration of plasma: four approaches to the removal of undesirable circulating substances. AB - Plasmapheresis and plasma exchange have been widely used in the treatment of a variety of conditions, not always with a clear rationale. The most favorable results have been observed in the hyperviscosity syndrome and in a group of antibody-mediated diseases which includes post-infectious cold agglutinin disease, red cell aplasia, post-transfusion purpura, Goodpasture's syndrome, hemophilic patients with anti-factor VIII antibodies, and also in thrombotic thrombocytopenic purpura. In contrast, disappointing or conflicting results have been obtained in immune complex diseases, myasthenia gravis, cryoglobulinemia, etc. It seems likely that at least some of the difficulties may arise from the non-specific removal of a variety of substances as well as for our lack of understanding of immunological feed-back mechanisms which are disturbed by plasmapheresis and related techniques. Future developments are likely to be centered in the development of more specific approaches as based on filtration, affinity chromatography and adsorption to antibodies or other substrates. These approaches appear promising for the removal of "blocking factors" in patients with cancer, lipoproteins in patients with hypercholesterolemia, immune complexes, and toxic compounds. A cautiously optimistic approach to such new developments and their testing in animal models and in carefully controlled patient trials are essential. The principles on which these therapeutic approaches lie are valid, and the skepticism that surrounds them may be underserved, since it was largely the result of an indiscriminate use of non selective procedures. PMID- 3545313 TI - A unified theory for the development of cancer. AB - It is postulated that cancer is the result of genetic and epigenetic changes that occur mainly in stem (precursor) cells of various cell types. I propose that there are three classes of genes which are involved in the development of cancer. These are: Class I, II and III oncogenes. The classification is based on the way the oncogene acts at the cellular level to further the development of cancer. Genetic changes, that is point mutations, deletions, inversions, amplifications and chromosome translocations, gains or losses in the genes themselves or epigenetic changes in the genes (e.g. DNA hypomethylation) or in the gene products (RNA or protein) are responsible for the development of cancer. Changes of oncogene activity have a genetic or epigenetic origin or both and result in quantitative or qualitative differences in the oncogene products. These are involved in changing normal cells into the cells demonstrating a cancer phenotype (usually a form of dedifferentiated cell) in a multistep process. There are several pathways to cancer and the intermediate steps are not necessarily defined in an orderly fashion. Activation of a particular Class I or II oncogene and inactivation of a Class III oncogene could occur at any step during the development of cancer. Most benign or malignant tumors consist of a heterogeneous mixture of dedifferentiated cells arising from a single cell. PMID- 3545314 TI - Monoclonal antibodies to the two most basic papaya proteinases. AB - The proteinases from Carica papaya include papain, isoenzymes of chymopapain and two proteinases A and B distinguished by their unusually high pI. The identity of one of the most basic proteinases has been questioned. The present report describes the preparation and characterisation of two monoclonal antibodies that react specifically with papaya proteinases A and B respectively and a third that identifies a common structural feature found in papain and proteinase A. PMID- 3545315 TI - Conserved elements in the 3' untranslated regions of c-fos and actin mRNAs. AB - In this study, the nucleotide sequences of the 3' untranslated regions (UTR) of the mouse and human c-fos genes, and the rat and human beta-actin genes were examined. It is shown (i) that the 3' UTR of c-fos is highly conserved between mouse and man, (ii) that multiple copies of a 12 bp element occur, in clusters, in the 3' UTR both of c-fos and of beta-actin. This conserved 12 bp element is analogous to the putative repressor binding site previously identified (Renan, Bioscience Reports, 5 (1985), 739-753). These findings provide additional support for the proposal that regulatory signals are located in the 3' UTR's of certain genes. PMID- 3545316 TI - In vitro studies on the subcellular location of glucosidase I and glucosidase II in dog pancreas. AB - When programmed with yeast prepro-alpha-factor mRNA, the heterologous reticulocyte/dog pancreas translation system synthesizes two pheromone related polypeptides, a cytosolically located primary translation product (pp-alpha-Fcyt, 21 kDa) and a membrane-specific and multiply glycosylated alpha-factor precursor (pp-alpha-F3, 27.5 kDa). Glycosylation of the membrane specific pp-alpha-F3 species is competitively inhibited by synthetic peptides containing the consensus sequence Asn-Xaa-Thr as indicated by a shift of its molecular mass from 27.5 kDa to about 19.5 kDa (pp-alpha-F0), whereas the primary translation product pp-alpha Fcyt is not affected. Likewise, only the glycosylated pp-alpha-F3 structure is digested by Endo H yielding a polypeptide with a molecular mass between pp-alpha F0 and pp-alpha-Fcyt. These observations strongly suggest that the primary translation product is proteolytically processed during/on its translocation into the lumen of the microsomal vesicles. We believe that this proteolytic processing is due to the cleavage of a signal sequence from the pp-alpha-Fcyt species, although this interpretation contradicts previous data from other groups. The distinct effect exerted by various glycosidase inhibitors (e.g. 1 deoxynojirimycin, N-methyl-dNM, 1-deoxymannojirimycin) on the electrophoretic mobility of the pp-alpha-F3 polypeptide indicates that its oligosaccharide chains are processed to presumably Man9-GlcNAc2 structures under the in vitro conditions of translation. This oligosaccharide processing is most likely to involve the action of glucosidase I and glucosidase II as follows from the specificity of the glycosidase inhibitors applied and the differences of the molecular mass observed in their presence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545317 TI - [Participation of intestinal hormones in the development of the pancreatic B-cell reactivity of rat fetuses to the action of glucose]. AB - The involvement of intestinal hormones in the development of insulin release from rat fetal pancreas was investigated. B-cell responses were determined by changes in the concentration of immunoreactive insulin after glucose addition to the incubation medium. Coincubation of fragments of fetal pancreas and duodenum from adult and newborn rats and from 21.5-day-old fetus has shown that intestinal factors can recover the response of pancreas to glucose in fetuses with experimentally removed hypothalamus and hypophysis. Besides, the intestinal factors in the fetus were found to potentiate the effect of high glucose concentrations on B cells, but had no insulinotropic effect at physiological glucose concentration in the medium. The data obtained suggest that even in the antenatal period the intestinal, along with cephalic factors, can serve as modulators of glucose action on islet B cells. PMID- 3545318 TI - [Peripheral blood T-lymphocytes of patients with chronic B-cell lympholeukemia express Ia-like antigens]. AB - 15.7 +/- 3.5% of sheep rosette-forming cells (SRFC) were isolated from the peripheral blood of 11 patients with B-cell chronic lympholeukemia (B-CLL). SRFC did not express surface immunoglobulins, antigens of nondifferentiated blasts and antigens of early T-cell precursors, while NK-cell antigen expression was low. 6 of 11 patients revealed 44.6 +/- 19.6% of Ia-like antigens in SRFC. Ia-like antigen expression was 4.8 +/- 0.6% in SRFC isolated from the peripheral blood of 19 healthy donors. The expression of Ia-like antigens in T cells of patients with B-CLL is suggested to be related to the activation of regulatory T-lymphocyte subpopulation. PMID- 3545319 TI - Protein kinase C and the activation of the human neutrophil NADPH-oxidase. PMID- 3545321 TI - Normal synthesis and expression of endothelial IIb/IIIa in Glanzmann's thrombasthenia. AB - Glanzmann's thrombasthenia is a bleeding disorder, inherited in an autosomal recessive way and characterized by an absence or deficiency of the platelet glycoprotein (GP) IIb/IIIa complex. Recently, we and others demonstrated that cultured human umbilical vein endothelial cells synthesized a membrane protein complex similar to the platelet GP IIb/IIIa complex. In this article, we demonstrate that endothelial cells isolated from the umbilical vein of a newborn with Glanzmann's thrombasthenia, as compared with normal endothelial cells, show no difference in their ability to synthesize and express this GP IIb/IIIa complex. Our results indicate that Glanzmann's thrombasthenia is not accompanied by an "endotheliopathy." PMID- 3545320 TI - Characterization of glucocorticoid receptors and glucocorticoid receptor mRNA in human leukemia cells: stabilization of the receptor by diisopropylfluorophosphate. AB - We have shown that cytosol samples from human leukemia cells frequently contain glucocorticoid receptor fragments that have a mol wt (Mr) of approximately 52,000. In the present study we demonstrate that the Mr approximately 52,000 receptor fragments are derived from intact glucocorticoid receptors (Mr approximately 97,000) by the action of a serine protease. Mr approximately 52,000 receptor fragments were present in cytosol from 24 of 52 leukemia cell samples. Only normal size glucocorticoid receptors were present in cytosol samples if diisopropylfluorophosphate (DFP), a potent inhibitor of serine proteases, was added to the hypotonic buffer used for cytosol preparation. Receptor proteolysis was not inhibited by hydrolyzed DFP, benzamidine, phenylmethylsulfonylfluoride, aprotinin, iodoacetamide, or mercuric chloride. The leukemia cell protease digests the receptor at a different site than chymotrypsin, which digests the intact receptor to produce a Mr approximately 40,000 receptor fragment. Receptor messenger RNA (mRNA) in S49 mouse lymphoma cells and in human leukemia cells was analyzed by Northern hybridization with a cDNA for the normal glucocorticoid receptor. Mutant S49 mouse lymphoma cells that have abnormally small glucocorticoid receptors (Mr approximately 48,000) make a 5.0-kilobase receptor transcript in addition to the normal size 6.5-kilobase receptor transcript. A normal size receptor transcript of 6.5 kilobases was present in all of the human leukemia cells whether or not Mr approximately 52,000-receptor fragments were present. Therefore, abnormalities of glucocorticoid receptor mRNA, which may give rise to the synthesis of foreshortened receptors in certain mutant mouse lymphoma cells, are apparently absent from human leukemia cells. PMID- 3545322 TI - Expression of the human monocyte membrane antigen gp55 by murine fibroblasts after DNA-mediated gene transfer. AB - Human DNA sequences that contain the gene encoding gp55, a cell surface glycoprotein expressed exclusively on mature human monocytes and monocytic leukemia cells, were isolated in a mouse genetic background. DNA from mature human monocytes was cotransfected with DNA from a molecularly cloned feline sarcoma virus containing the v-fms oncogene into NIH-3T3 cells. Transformed mouse fibroblasts that expressed gp55, based on their reactivity with the MY4, B44.1, or LeuM3 monoclonal antibodies, were selected by fluorescence-activated cell sorting. Regardless of which antibody was used for selection, equivalent binding of all three antibodies was observed for positive transformants. Secondary and tertiary mouse cell transformants were obtained after additional rounds of transfection and cell sorting with the use of DNA from primary and then secondary transformants. Southern blot analysis of the cellular DNA from two independently derived tertiary subclones revealed a limited complement of human sequences, thus indicating that the gene encoding gp55 is included in fewer than 50 kilobases of human DNA. Independently derived tertiary subclones displayed concordant patterns of reactivity with 13 monocyte-specific monoclonal antibodies, thus indicating that each recognized an epitope on the product (gp55) of a single human gene. The 55-kilodalton cell surface polypeptide was specifically immunoprecipitated with a representative monoclonal antibody, 26if, from lysates of enzymatically radioiodinated peripheral blood monocytes and tertiary transformants. We conclude that gp55 is highly immunogenic and that a large number of independently derived monoclonal antibodies specific for human monocytes react with epitopes on this one molecule. PMID- 3545323 TI - Chronic myelogenous leukemia: amplification of a rearranged c-abl oncogene in both chronic phase and blast crisis. AB - The specific genetic events that distinguish the blast crisis from the chronic phase cells of chronic myelogenous leukemia (CML) are unknown. The most common karyotypic change that occurs as CML evolves from chronic phase to blast crisis is the development of multiple Philadelphia (Ph1) chromosomes, each of which is presumably harboring a translocated c-abl oncogene. We describe here a patient with CML who presented in lymphoid blast crisis with three Ph1 chromosomes/metaphase associated with an amplified, rearranged c-abl oncogene fragment and high levels of the aberrant 8-kilobase bcr-abl transcript. This rearranged c-abl fragment was amplified to a similar degree in both the patient's blast crisis cells and in his terminally differentiated granulocytes, but the level of the aberrant CML-specific bcr-abl transcript was some eight- to 16-fold higher in the blast crisis cells v the granulocytes. This analysis indicates that genomic amplification of a translocated c-abl oncogene, although perhaps important in the evolution of CML, nevertheless cannot, by itself, be the sole genetic event giving rise to blast crisis. PMID- 3545324 TI - The influence in vivo of murine colony-stimulating factor-1 on myeloid progenitor cells in mice recovering from sublethal dosages of cyclophosphamide. AB - Pure murine colony-stimulating factor-1 (CSF-1) was assessed for its effects in vivo in mice pretreated seven days earlier with a sublethal dosage of cyclophosphamide. The multipotential (CFU-GEMM), erythroid (BFU-E), and granulocyte-macrophage (CFU-GM) progenitor cells in these mice were in a slowly cycling or noncycling state. Intravenous administration of 20,000 units of CSF-1 to these mice stimulated the hematopoietic progenitors into a rapidly cycling state in the marrow and spleen within three hours. Significant increases in absolute numbers of marrow and spleen CFU-GM and spleen BFU-E and CFU-GEMM were also detected. No endotoxin was detected in the CSF-1 preparation by Limulus lysate assay, and treatment of CSF-1 at 100 degrees C for 20 to 30 minutes completely inactivated the in vitro and in vivo stimulating effects. The effects of CSF-1 were not mimicked by the in vivo administration of 0.1 to 10 ng Escherichia coli lipopolysaccharide. These results suggest that the effects of CSF-1 in vivo were not due to contaminating endotoxin or to a nonspecific protein effect. CSF-1 did not enhance colony formation by BFU-E or stimulate colony formation by CFU-GEMM in vitro, thus suggesting that at least some of the effects of CSF-1 noted in vivo are probably indirect and mediated by accessory cells. PMID- 3545325 TI - Toxic effect of isolated glycophorin A on the in vitro growth of Plasmodium falciparum. AB - We have examined the inhibitory potencies of glycophorin A, a mixture of glycophorins B and C, chymotryptic fragments of GpA, desialylated GpA, alkaliborohydride treated GpA, and the O-linked tetrasaccharide isolated from GpA on the invasion of human red blood cells by synchronous Plasmodium falciparum (strain FCB). 50% inhibition of invasion, as measured by 3H-hypoxanthine incorporation into parasites, was achieved at 14 and 155 microM for GpA and GpA CH1, respectively. We have noticed, however, that isolated GpA exhibits a toxic effect on the intraerythrocytic growth of the parasite whereas the chymotryptic fragment (amino acid residues 1-64 of GpA) does not. Thus the inhibitory potency of isolated GpA during erythrocyte invasion by the merozoite should be regarded as the result of both an inhibitory and a toxic effect. The inhibitory effect should be attributed to the carbohydrate-rich outer portion of GpA carrying clusters of neuraminic acid. The toxic effect should be attributed to the hydrophobic region of GpA which might be capable of inserting into the membrane of free merozoites and/or erythrocytes. Our data suggest that results previously obtained with glycoprotein inhibitors carrying hydrophobic portions may have to be questioned. PMID- 3545326 TI - Human granulocyte colony stimulating factor. PMID- 3545327 TI - Survival and quality of life in 23 patients with severe aplastic anemia treated with bone marrow transplantation (BMT). AB - Survival and quality of life are reported in 23 pretransfused patients with severe aplastic anemia (SAA) who underwent bone marrow transplantation (BMT). The projected survival is 76% with 18 of 23 patients being alive 332 to 1677 days post graft (median: 842). 5 patients died between day 4 and 416. 12 of 17 patients at risk developed chronic graft versus host disease (GVH-D). 4 of these patients have a diminished quality of life due GVH-D related disabling manifestations. Autologous haemopoietic recovery was excluded in all patients by the demonstration of haemopoietic chimerism. We recommand age-adapted rejection prophylaxis; such strategy may help to diminish disabling graft versus host disease in otherwise haematologically reconstituted survivors. PMID- 3545328 TI - Allogeneic bone marrow transplantation as primary therapy for chronic myelomonocytic leukemia. AB - This is the first report of a successful bone marrow transplantation for chronic myelomonocytic leukemia. A 41-year-old woman with chronic myelomonocytic leukemia received, as primary treatment, a novel preparatory regimen consisting of high dose fractionated total body irradiation and high dose VP-16 chemotherapy followed by allogeneic marrow transplantation from her histocompatible brother. The patient is now more than two years after marrow transplantation with normal blood counts and a normal bone marrow which is of donor type. For younger patients with this disease who have a histocompatible sibling donor, bone marrow transplantation may represent a valid therapeutic option with curative potential. PMID- 3545329 TI - Quinine induced Escherichia coli DNA base-pair substitution mutation. PMID- 3545330 TI - The Fielding H. Garrison lecture. Psychiatry and social activism: the politics of a specialty in postwar America. PMID- 3545331 TI - Child health in the Middle Ages as seen in the miracles of five English saints, A.D. 1150-1220. PMID- 3545332 TI - Robert Remak and the multinucleated cell: eliminating a barrier to the acceptance of cell division. PMID- 3545333 TI - "Savill's disease": a pauper epidemic in Britain and its implications. PMID- 3545334 TI - William Osler as medical hero. Essay review. PMID- 3545335 TI - Pathophysiology of haemorrhagic shock. AB - Following massive blood loss a number of compensatory mechanisms are activated which are remarkably successful for a limited period. Ultimately the functions of many organs are affected, leading to a vicious circle of impaired cardiac performance and oxygen delivery. The only therapeutic manoeuvre of proven benefit in man is early restoration of circulating volume. PMID- 3545336 TI - The intersex baby. AB - About one in 2000 newborn babies has an ambiguity of the external genitalia. The extent of the ambiguity gives no clue to the underlying aetiology. In this article the intersex disorders are discussed, with particular emphasis on the chromosomal and endocrine investigations. PMID- 3545338 TI - Peripheral venous cannulae. AB - Since Bell and Farman's (1972) review of cannulae, the British Standards Institution has published a standard for the manufacture of peripheral venous cannulae. This article outlines the contents of this standard and discusses the changes and current considerations in cannulation. PMID- 3545337 TI - The management of inflammatory complications of colonic diverticular disease. AB - Inflammatory complications of colonic diverticular disease remain a common and dangerous cause for hospital admission in our ageing society. The presentation, pathology, general and surgical management of acute diverticulitis, peritonitis and perforation of colonic diverticular disease are reviewed. PMID- 3545339 TI - Management of acute biliary disease. AB - Acute biliary disease is the commonest general surgical reason for urgent admission to hospital in the over-65 age group. With an ever-increasing elderly population to treat, cholelithiasis and its complications will continue to present both surgeons and physicians with difficult decisions regarding its proper management. PMID- 3545340 TI - Modern treatment of Parkinson's disease. AB - Both general measures and a variety of drugs serve to improve the quality of life in the Parkinsonian patient. Meticulous neurological supervision is required to monitor response and the many drug-induced side-effects. PMID- 3545341 TI - Cephalic venous flap. AB - A case is reported in which an island fasciocutaneous flap from the radial side of the forearm, with only the cephalic vein connecting it to the rest of the body (Fig. 1) was successfully transposed to cover part of a defect on the ulnar side of the elbow. An earlier case in which such a venous flap was raised but not used for cover is also detailed. A brief discussion speculating on the way this flap survived without any arterial inflow and only proximal venous drainage is included. PMID- 3545343 TI - A prefabricated hair-bearing island flap for lip reconstruction. AB - We report a case of reconstruction of the upper lip in the male using a prefabricated hair-bearing island flap. The flap was made by implantation of a superficial temporal vascular bundle with microvascular anastomoses to the facial vessels. We conclude that the technique is a useful alternative to other methods of reconstruction because of its reliable blood supply. PMID- 3545342 TI - Free vertical abdominal fasciocutaneous flap. AB - The use of a free vertical fasciocutaneous flap in total cheek reconstruction is described. The technique has been successfully used in three patients and the advantage of such a free flap in head and neck reconstruction is described. PMID- 3545344 TI - Hypospadias repair: the seagull meatoplasty. AB - An operation is described which has been used in six cases to produce a single stream of urine in patients who were spraying following hypospadias repair. It has also been used in four patients to advance the meatus terminally. PMID- 3545345 TI - Layered shaving of venous leg ulcers. AB - A method for the quick preparation of refractory venous ulcer beds for autografting is described. Irrespective of their clinical or bacteriological state, ulcer granulations and other products of frustrated healing are shaved in layers down to an even and surgically clean base using an ordinary skin grafting knife. Our experience with 32 consecutive patients (58 ulcers) is reported. The mean duration of hospital stay, the patient being completely healed on discharge, was 18.3 days. This represents a decrease of more than 3 weeks when compared to a previously used standard method. No investigation into the question of recurrence was carried out as available evidence, which is critically reviewed, indicates no significant relation between the method of grafting and the incidence of recurrence. PMID- 3545346 TI - On the occurrence of necrotising lesions in arteritis temporalis: review of the literature with a note on the potential risk of a biopsy. AB - Against the background of a steadily growing proportion of elderly individuals within the populations in the Western countries, arteritis temporalis with its wide diversity of presenting symptoms in the elderly patient, including purely psychiatric ones, has become a disease of increasing interest to the medical profession. Increasing demands may be made on the surgeon, often a plastic surgeon, responsible for carrying out the biopsy that is necessary in arteritis temporalis for both diagnostic and therapeutic reasons. Attention is called to certain elements of risk inherent in taking a biopsy of an artery under local anaesthesia, and to the fact that the administration of ergotamine tartrate may provoke serious complications in this particular disease. PMID- 3545347 TI - The free radial forearm flap--the management of the secondary defect. AB - The secondary defect of the radial forearm flap is usually reconstructed with a split skin graft. This is applied to the visceral paratenon of several tendons in addition to muscle but early movement of the hand is often followed by breakdown, infection, delayed healing and reduced function. A technique for obtaining both full primary healing and full function is described which has produced good results in 16 patients. PMID- 3545348 TI - "Is 40 years enough delay?". AB - The case of a 40-year-old tube pedicle, raised in 1939 and subsequently lost to follow-up, is presented together with a description of its appearance and eventual modified use to accomplish its original purpose. PMID- 3545349 TI - Alterations with age of the response to vasodilator agents in isolated mesenteric arteries of the beagle. AB - Responses to vasodilator agents were compared in helical strips of mesenteric beagles of different ages (30 days, 3 months, 2 years and 12 years old), precontracted with prostaglandin F2 alpha (PGF2 alpha). Relaxations induced by isoprenaline and adenosine were related inversely to age, whereas those induced by PGI2 and K+ (5 mM) did not alter with age. Acetylcholine-induced relaxations were less in the arteries from the aged (12 year old) beagles than in those from the younger beagles. Histamine-induced relaxations related directly to age between 30 days and 2 years. Acetylcholine-induced relaxation was reversed to a contraction in infant (30 day old) beagle arteries by removal of the endothelium, and significantly attenuated in the older beagle arteries. In adult (2 year old) and aged beagle arteries, removal of the endothelium attenuated the histamine induced relaxation. Treatment with indomethacin reversed the histamine-induced relaxation to a marked contraction in aged beagle arteries. It may be concluded that responses mediated by beta-adrenoceptors and P1-purinoceptors are less in aged mesenteric arteries than in those from the younger beagles, whereas responses mediated by PGI2 receptors and the electrogenic Na+ pump do not alter with age. The release of endothelium-derived relaxing factor(s) by acetylcholine appears to be inversely related to age. However, the release of PGI2 possibly caused by histamine may be less in infant beagle mesenteric arteries than in those from the older beagles. PMID- 3545350 TI - Dopamine receptor-mediated spinal antinociception in the normal and haloperidol pretreated rat: effects of sulpiride and SCH 23390. AB - Nociceptive tail flick latencies (TFL) were recorded in response to noxious thermal stimuli applied to lightly anaesthetized rats. The effects of intrathecally administered dopamine receptor agonists alone and combined with dopamine receptor antagonists were examined upon the TFL. Experiments were repeated on animals made supersensitive to dopamine following withdrawal from 28 day administration of haloperidol. In untreated animals the D2-receptor agonist LY 171555 and apomorphine produced an increase in TFL. In contrast, the Di receptor agonist SKF 38393 had no significant effect on TFL. TFL. Following haloperidol-induced dopamine-supersensitivity, SKF 38393 produced an increase in TFL. In contrast, LY171555 and apomorphine had minimal effects on TFL in this preparation. In animals not treated with haloperidol, the dopamine receptor antagonists SCH 23390 and (+/-)-sulpiride both blocked the increase in TFL produced by the D2-agonists. SCH23390 and (+/-)-sulpiride also blocked the increase in TFL produced by SKF 38393 in haloperidol-supersensitized animals. The antinociceptive action of intrathecally administered dopamine agonists appears to be mediated via D2-receptors. Whether the antinociception produced by SKF 38393 is exclusively contingent upon the activation of D1-receptors in the dopamine supersensitive animal is as yet unresolved. PMID- 3545352 TI - Parasuicide and unemployment. AB - The current economic recession in Europe and North America has led to a renewal of interest in the possible consequences of mass unemployment for the nation's health. This annotation assesses the relationship between unemployment and one indicator of morbidity: parasuicide (non-fatal deliberate self-harm). A previously published review of the literature is supplemented by more recent research, particularly from Edinburgh and Oxford. PMID- 3545351 TI - (5Z)-carbacyclin discriminates between prostacyclin-receptors coupled to adenylate cyclase in vascular smooth muscle and platelets. AB - (5E)- and (5Z)-carbacyclin are prostacyclin (PGI2) analogues endowed with antiaggregating and vasodilator properties, which stimulate adenylate cyclase activity in membranes from human platelets and cultured myocytes from rabbit mesenteric artery. In platelets they display the same efficacy as prostaglandin E1 (PGE1), and hence PGI2 both as activators of adenylate cyclase and as inhibitors of aggregation. In contrast, in vascular smooth muscle cells (5Z) carbacyclin fails to produce the same degree of stimulation of the enzyme as PGI2, (5E)-carbacyclin and PGE1, nor does it induce the maximal relaxation of the mesenteric artery as do the other prostaglandins. (5Z)-carbacyclin is also able to antagonize the activation of adenylate cyclase and the relaxation elicited by PGE1 or PGI2 in the mesenteric artery, and therefore it displays partial agonist properties in these cells. We conclude that the receptors for PGI2 coupled to adenylate cyclase in platelets and vascular smooth muscle cells are different from each other, because (5Z)-carbacyclin can discriminate between them, being a partial agonist at myocyte but not at platelet level. PMID- 3545353 TI - Genetics of fear and anxiety disorders. AB - From protozoa to mammals, organisms have been selectively bred for genetic differences in defensive behaviour which are accompanied by differences in brain and other biological functions. Studies of twins indicate some genetic control of normal human fear from infancy onwards, of anxiety as a symptom and as a syndrome, and of phobic and obsessive-compulsive phenomena. Anxiety disorders are more common among the relatives of affected probands than of controls, especially among female and first-degree relatives; alcoholism and secondary depression may also be over-represented. Familial influences have been found for panic disorder, agoraphobia, and obsessive-compulsive problems. Panic disorder in depressed probands increases the risk to their relatives of phobia as well as of panic disorder, major depression, and alcoholism. The strongest family history of all anxiety disorders is seen in blood-injury phobia; even though it can be successfully treated by exposure, its roots may lie in a genetically determined specific autonomic susceptibility. Some genetic effects can be modified by environmental means. PMID- 3545354 TI - A comparison of the antidepressant action of citalopram and amitriptyline. AB - The response of patients with major depressive illness to citalopram of amitriptyline was compared in a double-blind multi-centre trial. No differences in efficacy were observed, but citalopram had less hypnotic effect, and a remarkably lower profile of side-effects. PMID- 3545355 TI - Psychotherapy by Reciprocal Inhibition: Joseph Wolpe. PMID- 3545356 TI - Aspects of the epidemiology of schizophrenia. AB - Reasons are given why the hospital diagnosis of schizophrenia may be accurate enough for the proper study of certain aspects of its epidemiology. Studies in the seasonality of admissions and of births in schizophrenic patients have produced consistent results in different countries and at different times. The results are summarized, and causal hypotheses based on them are discussed. The idea that schizophrenia is a relatively recent disease is compatible with these hypotheses. PMID- 3545357 TI - Childhood hyperactivity. AB - Severe degrees of inattentive and restless behaviour in childhood are a risk factor for later psychological disorders. They have many causes, but a pattern of severe and pervasive hyperactivity with poor concentration in the absence of affective or psychotic disorders should be recognised as a hyperkinetic syndrome. The syndrome is often associated with developmental delays in abilities such as language and motor control. Powerful short-term treatments are available, but long-term ways of promoting normal personality development need more research. PMID- 3545358 TI - Dementia praecox oder die Gruppe der Schizophrenien: Eugen Bleuler. PMID- 3545359 TI - Cancer induction and non-stochastic effects. AB - The mechanisms of carcinogenesis are not known in detail, but there is strong evidence that cancer usually arises from a single transformed cell. Hence, although the process of carcinogenesis appears to require a multiplicity of changes in the affected cancer-forming cell, such as may be associated with successive stages of tumour initiation, tumour promotion, and tumour progression, only one such change induced by radiation in an appropriate cell may be conceived to increase the probability of neoplasia in a suitably susceptible individual. For this reason, carcinogenic effects of radiation, like mutagenic effects of radiation, are considered for purposes of radiological protection to have no threshold and to behave as stochastic phenomena. In contrast, certain other effects of radiation, such as cataract of the lens, infertility, and depression of the bone marrow, require the killing of many cells in the affected organs. Thus, they vary in severity with the extent of cell loss and have thresholds of detectability which depend on the sensitivity with which the consequences of cell loss can be measured. PMID- 3545361 TI - Radiation risks in perspective. AB - The main difficulty in presenting radiation risks in their proper perspective is that they must, in most cases, be estimated predictively. This contrasts with most other occupational and public risks, of which the magnitude and severity are known from past records and experience. The problem is greater at the low effective dose rates now observed in the majority of all forms of exposure, usually of less than 3 mSv per year from natural causes, from occupational exposure, and from exposure of "critical groups" of the general public. For most of these populations there are particular problems also in epidemiological studies at low dose, in addition to those due to the very large numbers of person years that need to be studied and the long latencies of most radiation effects. Adequate estimates can, however, now be made of the carcinogenic risk of exposure at higher dose of various organs selectively and of the whole body uniformly, and of modes of inference to the risk at lower dose. Estimates can also be made of the risks of inducing major types of inheritable and developmental abnormality. An essential step in viewing the sum of all such radiation risks in the perspective of other occupational and public risks must now be to develop an informed consensus on the relative weight that is regarded as attaching to hazards of different kind and severity. PMID- 3545360 TI - Irradiation of the embryo and fetus. AB - The human evidence on radiation damage to the individual developing in utero is confined to mental impairment and carcinogenesis. New evidence is becoming available about levels of mental impairment of direct interest to radiological protection, but as yet no framework of understanding exists to allow quantitative predictions for the purposes of radiological protection. There is general agreement that malignant disease has been increased following antenatal radiography but no unanimity yet in concluding that irradiation was the main causal factor: reasons are given for accepting that radiography was the cause. Recent increases in biological understanding suggest why maldevelopment is not to be expected after irradiation of the conceptus. A clonal hypothesis for organogenesis provides a reasonable explanation for quantitative aspects of experimental observations on teratogenesis by ionising radiation, including the commonly found highly curvilinear dose-response relationship, the occurrence of so-called critical stages of sensitivity after exposures of a few hundred roentgens, and the reduction in frequency of induced abnormality with protraction of exposure. Clonal hypotheses predict that there will be a virtual threshold for polycystic (non-stochastic) forms of radiation damage. It may be misguided to adopt a linear dose-response relationship for deriving risk estimates for the practical purposes of radiological protection unless some mechanism for production of clinically evident harm can be advanced which provides a plausible reason for expecting linearity. PMID- 3545362 TI - Growing points in radiotherapy since 1930. The 65th Mackenzie Davidson memorial lecture 1984. PMID- 3545363 TI - Ultrasonic localisation of a non-opaque intravascular catheter fragment. PMID- 3545364 TI - Ultrasound findings in children with cystic fibrosis. AB - The results of a prospective study using ultrasound to assess abdominal complications in 76 children with proven cystic fibrosis are reported. Fifty-six patients (74%) had normal liver ultrasound scans. The most striking abnormality was an irregular, inferior edge to the liver occurring in 85% of abnormal liver scans and in 70% there was corresponding clinical and biochemical evidence of abnormal liver function. This finding has been only briefly mentioned before. Increased reflectivity in abnormalities of the pancreas and gallbladder is also described. PMID- 3545365 TI - Anuria: an unusual presentation of aortic dissection (diagnosed by ultrasound). PMID- 3545366 TI - One hundred patients ten years after parietal cell vagotomy. AB - One hundred patients with duodenal or pyloric/prepyloric ulcer disease were operated with parietal cell vagotomy (PCV) and followed for a minimum of 10 years. At 6 weeks, 1,5 and 10 years postoperatively gastric secretory tests, haematological work-up and clinical examination or telephone interview were performed. There was no operative mortality and the frequency of postoperative sequelae was minimal. The cumulative ulcer recurrence rate was 18 per cent and another 14 per cent had slight to moderate symptoms of epigastric pain without any signs of ulcer. Upper gastrointestinal endoscopy was used to reveal recurrences but was performed only if the patient had symptoms of recurrence. A rise in basal acid secretion and in pentagastrin-stimulated secretion was observed the first year postoperatively, whereas insulin-stimulated peak acid output increased during the first 5 years. We conclude that PCV has a low rate of per- and postoperative complications and an acceptable recurrence rate. Therefore, it seems that PCV is the method of choice in chronic duodenal ulcer disease. PMID- 3545368 TI - Peritoneal closure after lateral paramedian incision. AB - The lateral paramedian incision has been advocated as the strongest incision for abdominal surgery. We have evaluated this incision and tested the necessity for closing the deep peritoneal layer by a prospective randomized trial. All 206 patients undergoing laparotomy in the Surgical Unit in 1984, both elective and emergency cases, were included. In patients undergoing laparotomy through unscarred tissue, a lateral paramedian incision was performed and they were randomized to have either the peritoneum closed (n = 77) or left open (n = 75). Patients in whom the laparotomy was performed through a previous incision (n = 51) and those in whom the abdomen had to be opened urgently (n = 3) were excluded from the trial but studied separately (n = 54). The rectus sheath was closed with monofilament nylon in all cases. Patients were assessed for wound integrity during the immediate postoperative period and at 1, 3, 6 and 12 months after operation. So far the patients have been followed up for between 1 and 2 years and follow-up is continuing as in some cases incisional hernia may not be detected until several years after operation. There have been no cases of burst abdomen. No incisional hernias have developed in patients in whom a lateral paramedian incision was performed and the peritoneum was closed, and one incisional hernia has occurred in the patients in whom the peritoneum was left open. Seven incisional hernias have occurred in patients excluded from the trial of the lateral paramedian incision (13 per cent). We conclude that the lateral paramedian incision successfully abolishes the burst abdomen and that incisional hernia is rare. It is not necessary to close the peritoneum with this incision. PMID- 3545367 TI - Effect of cimetidine on prognosis after simple closure of perforated duodenal ulcer. AB - A prospective controlled study in 60 patients undergoing simple closure of perforated duodenal ulcer demonstrated a significant (P less than 0.05) benefit following postoperative cimetidine treatment, in terms of avoiding subsequent dyspeptic symptoms and complications of peptic ulcer disease. Thus cimetidine is recommended in the follow-up management of perforated duodenal ulcers. PMID- 3545369 TI - Place of surgery in the management of amyloid disease. PMID- 3545370 TI - Cystic adventitial arterial disease. PMID- 3545371 TI - Endoscopic surgery in otolaryngology. PMID- 3545372 TI - Mediastinoscopy. PMID- 3545373 TI - Bronchoscopy. PMID- 3545374 TI - Therapeutic endoscopy of the upper gastrointestinal tract. PMID- 3545375 TI - Biliary tract and pancreas. PMID- 3545376 TI - Colonoscopy. PMID- 3545378 TI - Lower tract endoscopy. PMID- 3545377 TI - Endoscopic surgery of the upper urinary tract. PMID- 3545379 TI - Operative pelviscopy. PMID- 3545380 TI - Fetoscopy. PMID- 3545381 TI - Arthroscopy: the endoscopy of joints. PMID- 3545382 TI - Laser endoscopy. PMID- 3545383 TI - Advances in endoscopic diathermy. PMID- 3545385 TI - Interventional radiology. PMID- 3545384 TI - Ultrasound in association with endoscopy. PMID- 3545386 TI - Small animal endoscopy. PMID- 3545387 TI - Veterinary endoscopy in large animals. PMID- 3545388 TI - The fortification spectra of migraine. PMID- 3545390 TI - Fine structure of GABAergic neurons and synapses in the human dentate gyrus. AB - Surgical tissue samples of the human dentate gyrus were immunostained for glutamate decarboxylase (GAD), the gamma-aminobutyric acid (GABA)-synthesizing enzyme, and studied by both light and electron microscopy. Immunoreactive neurons and terminals displayed similar morphological characteristics as known from studies in laboratory animals. Thus, GAD-positive neurons prevailed in the hilar region, whereas immunoreactive terminals were most frequently observed in the granular layer forming symmetric synaptic contacts with dendrites, cell bodies and axon initial segments of granule cells. PMID- 3545389 TI - Pertussis toxin blocks depressant effects of opioid, monoaminergic and muscarinic agonists on dorsal-horn network responses in spinal cord-ganglion cultures. AB - After chronic exposure of mouse spinal cord-ganglion explants to morphine, the acute depressant effects of opioids on sensory-evoked dorsal-horn network responses are markedly attenuated, and characteristic cord discharges can then occur even in the presence of greater than 100-fold higher opioid concentrations. The present study demonstrates that a remarkably similar degree of tolerance to opioids develops in these cord-ganglion explants after exposure to pertussis toxin (PTX). The usual acute depressant effects of serotonin, norepinephrine and oxotremorine on dorsal-horn discharges are also similarly attenuated in PTX treated cultures. PTX is known to interfere with the guanine nucleotide protein Gi that is required for opioid, alpha 2-adrenergic and muscarinic receptor mediated inhibition of adenylate cyclase in various cells. We have previously found that in cord-dorsal root ganglion explants agents which elevate intracellular cAMP also attenuate opioid depressant effects. Furthermore, these explants contain an opioid-inhibited adenylate cyclase system, and chronic exposure to morphine as well as PTX increases adenylate cyclase activity. These findings together with the present results suggest that the neuromodulatory effects of opioid, monoaminergic and muscarinic agonists on primary afferent networks in the spinal cord may be mediated by binding to neuronal receptor subtypes that are negatively coupled via Gi to a common pool of adenylate cyclase. PMID- 3545391 TI - Localization of cholecystokinin in the dentate commissural-associational system of the mouse and rat. AB - Cholecystokinin immunoreactivity (CI) was demonstrated in the inner one third of the molecular layer of area dentata in the rat and 3 strains of mice. This part of the molecular layer coincides with the terminal field of the commissural associational system (C/A-system). In rats there is also CI in the middle third of this layer where the medial perforant path terminates, but there is no CI in this area in any of the 3 strains of mice. Different selective lesions except those involving the hilus, did not change this staining pattern. Electrolytic lesions of the hilus removed the CI in the terminal field of the C/A-system. Similarly, after kainic acid injections, the CI in the C/A-zone is reduced to a degree that is proportional to the amount of damage of the hilus. In the rat these lesions produced virtually no change in the CI of the medial perforant path terminal zone. The predominant type of cell within the hilus is the mossy cell and the cells of this type contain CI. The mossy cells have both commissural and ipsilateral projections that terminate in the inner one third of the molecular layer. Other cell types within the hilus contain CI, such as basket cells, oviform-like and fusiform-like cells. However, there was no evidence that any of these cells had commissural projections. Apart from the mossy cells there are other cells with commissural projections such as those in regio inferior. However, there was no evidence that any of them contained CI or also gave rise to an associational projection to the inner one third of the molecular layer. Moreover, there was a difference in the distribution of commissurally projecting cells that contained CI in the rat as compared to the mouse brain. This difference is the same as that occurring in the distribution of mossy cells where in the rat cells are found throughout the hilus, with most close to, but never inside the granule cell layer as compared to the mouse where virtually all are at a central part of the hilus. Thus these results are consistent with the hypothesis that all mossy cells contain CI and are the sole source of the C/A system. After X-ray irradiation of the neonatal rat it is known that only part of the infrapyramidal blade of the granule cell layer is formed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3545392 TI - Purification of S-100a0 protein from rat kidney. AB - In order to corroborate our previous finding that kidney may contain a considerable amount of S-100-like antigen, concentrations of S-100a0, S-100a and S-100b antigens in rat kidney were determined by an enzyme immunoassay system, which can quantify these 3 forms of S-100 protein separately. It was revealed that rat kidney was rich in S-100a0 antigen, while it was the least occurring form in brain. To confirm the above results, S-100-like antigen in rat kidney was purified, and its physicochemical properties were compared with those of S-100 proteins of bovine brain. Electrophoretic mobility, calcium binding ability, apparent molecular weight, amino acid composition as well as elution profiles from butyl-Sepharose and anion exchange columns were similar to those of S-100a0 protein of bovine brain. These results indicate that S-100a0 protein is not a protein unique to brain, as had long been believed. PMID- 3545393 TI - Musculotrophic effects of insulin receptors before and after denervation. AB - Insulin binding and metabolic effects have been used to assess properties of the insulin receptor of rodent skeletal muscles before and after denervation. It has been found that the amount of insulin-displaceable insulin binding on both type I (soleus) and type II (extensor digitorum longus) muscles rises slowly for up to 3 weeks after denervation, following a brief period of reduced binding. As estimated from weight loss and unstimulated deoxyglucose uptake, the extra binding sites are not functional. Stimulation in vitro with shocks or excess potassium can temporarily cause a relative increase in sugar uptake in both types of muscle, but an excess of insulin rapidly loses its effect in the soleus muscle. The effects of stimulation are taken to mean either conformational changes in the receptor or enhancement of some postbinding step, or both. It is suggested that the slow increase of binding sites for insulin after denervation may reflect loss of a neural substance normally effective in activating receptor degradation. PMID- 3545394 TI - Selective localization of glycine-accumulating cells in reaggregate culture of rat retina. AB - Uptake of [3H]glycine into the cells either in monolayer or reaggregate cultures of retina from two-day-old rat pups was studied. The glycine-accumulating cells (glycine cells) had short processes with several branches. Only 5% of process bearing cells were labelled in the monolayer cultures. The major cell type, previously identified as photoreceptor cells, was unlabelled. In reaggregate cultures, the glycine cells were localized mainly in the outermost layer of the reaggregate. But the proportion of positive cells among all the cells in that layer was not so large. Although the cell type of the glycine cells has not yet been unambiguously identified, these results demonstrate a possible example of selective sorting out of a group of biochemically distinct cells from a cell mixture. PMID- 3545395 TI - Phorbol ester stimulates proliferation of astrocytes in primary culture. AB - Near-confluent primary cultures of astrocytes from the neonatal rat cerebral cortex were transferred to low serum (0.1%) growth medium for 24 h before a single addition of phorbol-12-myristate-13-acetate (0.01-100 ng X ml-1), a phorbol ester which mimics diacylglycerol activation of protein kinase C. After 48 h the cultures were pulsed with [methyl-3H]thymidine. Cultures exposed to phorbol ester exhibited dose-dependent increases in thymidine incorporation which were reversed by amiloride. PMID- 3545396 TI - [Medical and social relations: the campaign against tuberculosis in the Lyons region from 1918 to 1975]. PMID- 3545398 TI - No ostriches in sight. Just an octopus. An ACFD/AFDC position paper pursuant to the manpower and prelicensure conferences. PMID- 3545397 TI - Looking inside your office micro-computer. PMID- 3545399 TI - Effectiveness of mandibular infiltration in children using the local anesthetic Ultracaine (articaine hydrochloride). PMID- 3545400 TI - Malignant hyperthermia. PMID- 3545401 TI - A comparison of Ultracaine DS (articaine HCl) and Citanest forte (prilocaine HCl) in maxillary infiltration and mandibular nerve block. PMID- 3545402 TI - Computer talk. Prospects for a new form of communication in the dental profession. PMID- 3545403 TI - Dentistry can cultivate diplomatic skills. PMID- 3545404 TI - Craniomandibular algopathia. Benign chronic pain of the craniomandibular apparatus. PMID- 3545405 TI - Management of refractory periodontitis. A case report. PMID- 3545406 TI - Gingival fibromatosis and its related syndromes. A review. PMID- 3545407 TI - Estimating future dental care requirements. The implications for dental manpower. PMID- 3545408 TI - Molecular weight determination and partial characterization of Klebsiella pneumoniae hemolysins. AB - Two thiol-activated Klebsiella pneumoniae hemolysins were purified from growth media by means of salt precipitation, gel filtration, ion-exchange chromatography, and polyacrylamide gel electrophoresis. The hemolysins peaks coincided with the protein and glycoprotein peaks as determined by chromatography and electrophoresis. The molecular weights, estimated by gel filtration, were 8400 and 19,000; by sodium dodecyl sulfate--polyacrylamide gel electrophoresis, the values were calculated as 15,500 and 27,000. The electrophoretic bands were best detected by the periodic acid--Schiff method. Reduction of the disulfide linkages did not cause the originally larger molecule to break into 8400 and 19,000 hemolysins. However, trypsin treatment cleaved the 19,000 hemolysin into an active moiety, with an electrophoretic migration similar to the 8400 hemolysin. A naturally occurring proteolytic activity was investigated using pepstatin and antipain. When the trypsin inhibitor was added to the system, the hemolytic activity was detected only in the 19,000 hemolysin and the smaller hemolysin was absent. PMID- 3545409 TI - Microbiological quality of bottled water sold in Canada. AB - The microbiological quality of bottled water sold in Canada was evaluated. A total of 114 lots of bottled water, both domestic and imported, were analyzed for aerobic colony count, coliforms, fecal coliforms, and Escherichia coli. No fecal coliforms or E. coli were found. Nineteen (46%) of the 41 lots of domestic purified water were found to exceed aerobic colony count standards and another lot exceeded coliform standards. One lot each of domestic and imported mineral water exceeded coliform standards. If mineral water were governed by the aerobic colony count standards for bottled water, then five lots each of both domestic and imported mineral water would have been found to be unsatisfactory. More surveillance of the bottled water industry in Canada is recommended. PMID- 3545410 TI - Antigenic analysis of Giardia duodenalis strains isolated in Alberta. AB - Giardia duodenalis is a common intestinal parasite in most parts of the world. In Canada it is associated with both endemic and epidemic infections that are often transmitted by the waterborne route. Although G. duodenalis strains have been isolated from several animals, the role of other mammals in human infection is unclear. We have isolated and cultured G. duodenalis trophozoites from domestic and wild animals in Alberta and compared them with a human isolate by protein gel electrophoresis and immunoblot analysis. All strains examined share a similar polypeptide profile and important protein antigens. Prominent antigens of 62, 52, 38, and 31 kilodaltons are conserved. The 52- and 31-kilodalton proteins are the major surface-exposed trophozoite components. The high degree of antigenic sharing among strains from different hosts suggests that there may be a wide range of potential reservoirs for G. duodenalis infections. PMID- 3545411 TI - Lack of protection against ascending Escherichia coli pyelonephritis in diabetic rats following immunization with purified lipopolysaccharide. AB - Purified lipopolysaccharide of Escherichia coli produced specific antibody when injected intraperitoneally or given to rats orally. Either route of immunization did not prevent ascending pyelonephritis in a diabetic rat model. The use of purified LPS excludes the potential contribution of other virulence factors of E. coli as protective antigens in the prevention of ascending pyelonephritis and confirms that anti-lipopolysaccharide antibody is not protective for ascending pyelonephritis. PMID- 3545413 TI - Disorders of neuronal migration. AB - Neuronal migration constitutes one of the major processes by which the central nervous system takes shape. Detailed knowledge about this important process now exists for different brain regions in rodent and monkey models as well as in the human. In the human, distinct genetic, chromosomal and environmental causes are known that affect neuronal migration, often in a morphologically distinct pattern, but the underlying pathological mechanisms are largely unknown. This review is intended to integrate our basic knowledge of the field with the accumulated intelligence on a large number of disorders and syndromes that represent the human part of the story. PMID- 3545412 TI - Regulation of phosphoenolpyruvate carboxykinase and pyruvate kinase in Saccharomyces cerevisiae grown in the presence of glycolytic and gluconeogenic carbon sources and the role of mitochondrial function on gluconeogenesis. AB - Phosphoenolpyruvate carboxykinase (PEPCKase) and pyruvate kinase (PKase) were measured in Saccharomyces cerevisiae grown in the presence of glycolytic and gluconeogenic carbon sources. The PEPCKase activity was highest in ethanol-grown cells. However, high PEPCKase activity was also observed in cells grown in 1% glucose, especially as compared with the activity of sucrose-, maltose-, or galactose-grown cells. Activity was first detected after 12 h when glucose was exhausted from the growth medium. The PKase activity was very high in glucose grown cells; considerable activity was also present in ethanol- and pyruvate grown cells. The absolute requirement of respiration for gluconeogenesis was demonstrated by the absence or significantly low levels of PEPCKase and fructose 1,6-bisphosphatase activities observed in respiratory deficient mutants, as well as in wild-type S. cerevisiae cells grown in the presence of glucose and antimycin A or chloramphenicol. Obligate glycolytic and gluconeogenic enzymes were present simultaneously only in stationary phase cells, but not in exponential phase cells; hence futile cycling could not occur in log phase cells regardless of the presence of carbon source in the growth medium. PMID- 3545414 TI - The relationship between timing of surgery and operative complications in aneurysmal subarachnoid hemorrhage. AB - The optimal timing of definitive aneurysm repair following subarachnoid hemorrhage remains a controversial issue. In order to examine whether the timing of surgery alters the incidence of certain technical difficulties and complications associated with intracranial aneurysm repair, data from two recent co-operative studies were examined. The cases submitted to the International Co operative Study on Timing of Aneurysm Surgery by the University of Toronto hospitals, and the cases submitted from multiple centres to the Three-Dose Multicentre Randomized Double-Blind Nimodipine Study were evaluated with regard to operative difficulties and complications, comparing early (less than or equal to 3 days) and late (greater than or equal to 4 days) surgery following subarachnoid hemorrhage. No significant differences were found in the incidence of such technical problems between the early and late surgical groups. If differences in outcome occur between comparable groups of patients operated early and late after aneurysm rupture, factors other than surgical technical complications may be responsible. PMID- 3545415 TI - Surgery in China today. AB - The fusion of traditional and modern concepts is a unique feature of medical practice in China. Since 1949, there have been considerable achievements particularly in the fields of burns, surgery of the liver, pancreas and the heart, and in microsurgery and limb reimplantation. Surgical skills are now distributed through medical units outside the large cities, and at the grass roots level, making them available to peasants. Research facilities remain limited and are responsible for the slow and uneven progress in surgery but the new China will spare no efforts to fill the gap and learn from all developed countries. PMID- 3545416 TI - Allografts in orthopedic surgery: a case report and literature review. AB - Recent advances in orthopedic surgery have reawakened interest in the use of osteochondral allografts. A case is presented of a 32-year-old man who was spared a hemipelvectomy for a huge chondrosarcoma of the pelvis by receiving a massive pelvic allograft. This is apparently the first report of such a procedure being performed in Canada. A history of allografting as well as the fate and immunologic aspects of bone grafts are presented. Bone-banking procedures and the clinical application of allografts in 1986 are discussed. PMID- 3545417 TI - John Hunter: the first surgical scientist. AB - John Hunter was a brilliant surgeon and teacher, the father of scientific surgery and surgical pathology and founder of the world-renowned Hunterian museum. This essay attempts to answer the following questions. Who was this man? How did he achieve such a remarkable station? Why was he loved by some yet detested by others? When did the poor student start to become the superb teacher? How did he manage to collect the thousands of specimens he left in his museum? What is it about Hunter that makes him so well remembered today, almost 200 years after his death? PMID- 3545418 TI - Efficacy of pneumococcal vaccine in severe chronic obstructive pulmonary disease. AB - Although pneumococcal vaccine has been recommended for patients with chronic obstructive pulmonary disease (COPD), its efficacy in this population has not been shown. A double-blind randomized controlled trial of 14-valent pneumococcal vaccine was carried out in 189 men and women aged 40 to 89 years with a clinical diagnosis of COPD and a forced expiratory volume in 1 second of less than 1.5 L. Of the 189, 92 received the vaccine and 97 received saline placebo. In a randomly chosen subsample of those who received the vaccine the mean titres of specific IgG antibody to selected pneumococcal polysaccharide serotypes increased two- to threefold by 4 weeks after vaccination. Over a 2-year period the rates of death, hospital admissions and emergency visits and the mean length of hospital stay were not significantly different in the two groups. Although a protective effect of 14-valent pneumococcal vaccine could not be shown, the small size of the sample and the relatively low follow-up rates preclude firm conclusions about efficacy from these data alone. The elevated antibody levels before vaccination in some of the patients, suggesting prior infection with Diplococcus pneumoniae, may partly explain the findings. PMID- 3545419 TI - Billing numbers fight to continue despite court setback. PMID- 3545421 TI - Geriatric assessment: an overview of its impacts. AB - Geriatric assessment programs of various types have become an increasingly important component of the geriatric health care delivery system in the United States. Such programs provide interdisciplinary assessment, treatment planning, case management, and, often, rehabilitation for frail elderly persons and are especially important for those suspected of needing long-term institutional care. A growing body of literature, summarized in this chapter, documents many proven benefits to health care outcomes. Among these benefits are better diagnostic accuracy and treatment planning, more appropriate placement decisions with less referral to nursing homes, improved patient functional and mental status, prolonged patient survival, and lower overall use of costly institutional care services. PMID- 3545420 TI - Osteoporosis, calcium and physical activity. AB - Sales of calcium supplements have increased dramatically since 1983, as middle aged women seek to prevent or treat bone loss due to osteoporosis. However, epidemiologic studies have failed to support the hypothesis that larger amounts of calcium are associated with increased bone density or a decreased incidence of fractures. The authors examine the evidence from controlled trials on the effects of calcium supplementation and physical activity on bone loss and find that weight-bearing activity, if undertaken early in life and on a regular basis, can increase the peak bone mass of early adulthood, delay the onset of bone loss and reduce the rate of loss. All of these factors will delay the onset of fractures. Carefully planned and supervised physical activity programs can also provide a safe, effective therapy for people who have osteoporosis. PMID- 3545422 TI - Assessment in the nursing home. AB - Nursing homes are an important component of the health care system for elderly people, and their importance will grow over the next several decades. Although the care provided in nursing homes is improving, it is far from optimal in many facilities. Improving the process of assessment in the nursing home is critical to improving nursing home care. This article provides a clinically oriented framework for the assessment of nursing home patients. It focuses on medical, nursing, and interdisciplinary assessment strategies for the assessment of nursing home patients and attempts to emphasize the unique and often complex issues that arise in the nursing home setting. PMID- 3545423 TI - Assessing physical function in the elderly. AB - This article emphasizes the complexity underlying the assessment of physical function. The concept of physical function is multidimensional; individuals or groups can be assessed; the assessments can be either preintervention measures or outcome measures. Six issues of measurement are discussed: verbal report versus behavior; self-reported versus proxy-reported information; capacity versus performance; assumptions in Activities of Daily Living and Instrumental Activities of Daily Living measurement; differences between items and instruments; and the search for a summary index. Specific instruments are reviewed. PMID- 3545424 TI - Assessing affect in the elderly. AB - This article describes a variety of interview and self-report measures that assess the emotions of older persons. Particular emphasis is placed on evaluation of depression, anxiety, and hostility because these are common, clinically significant negative emotions that elderly people experience. Several multidimensional scales that permit assessment of a range of emotions that include some positive feelings also are reviewed. Distinctions are drawn between instruments used primarily for diagnostic purposes versus those used for screening and/or evaluation of level of distress. Advantages and disadvantages of various instruments are presented, along with suggested future research directions. PMID- 3545425 TI - Assessing social function in the elderly. AB - Physicians and health care providers need to assess aspects of their patients' social functioning. This article discusses assessment of social relationships, social activities, social environment and resources, social support, caregivers and caregiver burden, and quality of life in the context of what a health care provider might need to know. Incorporating appropriate questions is emphasized as much as using more formal measures. This article explores ways in which such assessment of social function may be incorporated into routine practice, and suggests when more specialized assessments might be ordered from community agencies. PMID- 3545426 TI - Geriatric assessment teams. AB - In geriatric care, a form of teamwork is the recommended modality because of the complex biopsychosocial needs of the patient. The goal of geriatric assessment programs is to establish an intensive assessment of older adults which requires the competencies of several coordinated disciplines. Not only do teams have the capacity to assess patients in much greater depth but also patients share different information with different providers. The composition of the team is dictated by the needs of the patient population in accordance with resources available. Next, one must identify a method of team practice in order for interactions to take place. The method of functioning determines what kind of team it is, ranging from independent functioning with minimal formal interfacing to interdependent activity interspersed with formal and informal interactions. In initiating a geriatric assessment program, one needs to determine which tasks demand interdisciplinary collaboration, which require interdisciplinary consultation, and which can be performed using a matrix or extended team model. In this model, the core team is supplemented by other disciplines as determined by the team, predicated on patient problems. Teams can profit from training, which can help with choosing an appropriate model, establishing a manual of procedure, and managing interactive issues and problems. This can occur early in the team's formation, or when a team takes on new members. The minimal level of team development would include establishing program goals, delineating professional responsibilities and roles, and implementing a system for exchanging and documenting information about patient plans. Saving input to share only in team meeting is inefficient, so health care teams need to recognize the importance of informal interchanges. It is still a matter of conjecture about what team works best with which patients under what circumstances or conditions. Multiple randomized clinical trials with teams will give us more information in this regard. In the meantime, organizers of geriatric assessment programs will have to make decisions based on clinical practice in the team development field and extrapolations from related health care team studies. PMID- 3545427 TI - Was Queen Victoria depressed? 1. Natural history and differential diagnosis of presenting problem. AB - For some years we have speculated as to whether Queen Victoria suffered a definable psychiatric illness in her notorious and prolonged seclusion after the Prince Consort's death. We here summarize criteria for grief and depression from three authorities. Against these, we examine the natural history of the Queen's bereavement and restitution. We find that her suffering and her portrayal of the role of widow were related to her personal style and were culturally accepted. Her self-esteem, ego functions, and object relatedness were preserved. While some clinicians might favour a diagnosis of Dysthymic Disorder, we find the evidence strongly in favour of an intense, prolonged, normal human grief (Uncomplicated Bereavement of DSM III) coloured by a romantic and histrionic personal style. Intensity and duration do not, in this case, establish a diagnosis of depression. PMID- 3545428 TI - High dose cyclophosphamide, BCNU, and VP-16 (CBV) as a conditioning regimen for allogeneic bone marrow transplantation for patients with acute leukemia. AB - A high dose combination chemotherapy regimen (CBV) consisting of cyclophosphamide (1.5 gm/m2 day 1 to day 4); BCNU (300 mg/m2 day 1) and etoposide (100 mg/m2 every 12 hours for 6 doses), followed by bone marrow transplant from human leukocyte antigen (HLA) identical sibling donors, was evaluated in 29 patients in whom acute leukemia was in relapse or remission. Engraftment of donor cell type occurred in all but one of 21 patients, in whom marker differences between donor and recipient were established. Two of 11 patients transplanted during relapse of the disease, lived beyond 1 year after bone marrow transplantation. One patient died free of leukemia, 41 months after transplantation of meningitis. Two of seven patients transplanted during the second remission of the disease, are alive and free of leukemia at 42+, and 8+ months. All patients transplanted during the third or fourth remission of the disease have died from either a further relapse, or transplant related causes. The low incidence of organ toxicity with CBV allows for further dose escalation of its drug components. PMID- 3545429 TI - A morphologic study of childhood lymphoma of the diffuse "histiocytic" type. The Pediatric Oncology Group experience. AB - Of 227 cases of pediatric non-Hodgkin's lymphoma with adequate histopathologic material for review, 72 (32%) were classified as diffuse "histiocytic" lymphoma (DHL). These cases were further divided into different morphologic subtypes according to the Lukes-Collins classification, and the National Cancer Institute Working Formulation, to ascertain whether there were any significant prognostic differences among the different subtypes. The results of our study showed that 40 patients were classified as immunoblastic lymphomas, and 32 were called large follicular center cell (FCC) tumors. Of the 40 patients with immunoblastic histology, 19 had morphologic features of the clear cell type and were interpreted as consistent with T-immunoblastic lymphomas; an additional two had polymorphous features also consistent with T-cell type: 17 had plasmacytoid features, and were morphologically classified as B-immunoblastic lymphomas; two could not be subtyped. Of the 32 patients with morphologic features of FCC lymphomas, 29 were classified as large noncleaved type, and three as large cleaved type. A clinicopathologic analysis showed that 90% of the patients obtained complete remission, and there were no significant differences in complete remission rate among the different morphologic subtypes of DHL. The estimated five year disease-free survival for all patients was over 70%, with no failure after the second year; and there were no significant differences in the disease-free survival among the different subtypes. The only clinical differences that we found, were that patients with lymphomas of FCC (large noncleaved) type were younger (P = 0.01); had less nodal involvement (P = 0.03); and had more organ involvement (P less than 0.01). We conclude that the morphologic subclassification of DHL in children currently has limited clinical prognostic significance. PMID- 3545431 TI - c-myc oncogene expression in colorectal cancer. AB - The pattern of c-myc gene organization and expression has been examined in resected colonic tumors and in the adjacent normal colon from 15 patients undergoing radical surgery. DNA hybridization showed no evidence of gene amplification or rearrangement. Transcripts of the c-myc messenger ribonucleic acid (mRNA) were elevated up to 32-fold in 12 of 15 tumors. The gene product, p62c-myc, was detected by both immunoblotting and immunohistology using a monoclonal antibody raised against a synthetic peptide immunogen. There was close correlation between c-myc mRNA copy number and p62c-myc abundance. Three well differentiated tumors contained high levels of transcript and protein, whereas four poorly differentiated tumors had the lowest levels. The assay of oncogene products may provide new biologically relevant tumor markers for determining prognosis and guiding treatment. PMID- 3545430 TI - Combination chemotherapy and systemic irradiation consolidation for poor prognosis breast cancer. AB - Seventy patients with poor prognosis, metastatic breast cancer were treated with FUVAC induction chemotherapy (5-fluorouracil, vinblastine, Adriamycin [doxorubicin] and cyclophosphamide). Consolidation therapy was given to 30 of 48 responders (63%), of whom 23 received sequential hemibody irradiation (HBI) at 8 cGy, corrected in the upper half for lung transmission. Seven received high dose cyclophosphamide and total body irradiation (TBI) with subsequent infusion of stored, cryopreserved autologous bone marrow. The response rate to induction therapy was 71% (complete [CR] in 21%). The median survival for all patients entered in this study is 12 months. With consolidation, one CR patient who received cyclophosphamide and TBI is disease free at 20+ months, off all treatment, while HBI did not produce longterm remissions. Of 17 partial response (PR) patients, two of 12 improved to CR with HBI, and one of five improved with cyclophosphamide plus TBI, but all ultimately relapsed. The main toxicity of sequential HBI was myelosuppression, with prolonged thrombocytopenia in 13%; only one case of radiation pneumonitis occurred (3%). Cyclophosphamide and TBI produced temporary, reversible marrow aplasia without other major toxicity. We recommend further investigation of Cytoxan (Bristol Myers Oncology Division, Evansville, IN) and TBI for breast cancer patients in remission after chemotherapy. PMID- 3545432 TI - A T chronic lymphocytic leukemia with large granular lymphocytes. Phenotype and functions of leukemic cells under in vitro treatment by differentiation inducers. AB - We reported the morphologic, phenotypic and functional characteristics of leukemic cells with natural killer (NK) properties in a case of T chronic lymphocytic leukemia with large granular lymphocytes. These cells were cytologically and cytochemically characterized as phosphatase acid positive large granular lymphocytes (LGL), and presented parallel tubular arrays at the ultra structural level. They displayed a CD2, CD3, CD8, CD11, Leu 7, and Leu 11 positive phenotype while they lacked B cell markers including surface immunoglobulins. In addition, they expressed human leukocyte antigens (HLA) Class I, but no Class II antigens. These phenotypic studies were also performed after cells were cultured in vitro with 12-0-tetradecanoyl phorbol 13-acetate, gamma interferon, 5-azacytidine, sodium butyrate, phytohemagglutinin, and interleukin 2 (IL2). The cell surface markers underwent several significant changes. Among them we noted a higher percentage of labeled cells with anti-CD6 and CD7 monoclonal antibodies (moAbs), and a positivity with an anti-CD19 (B4) moAb. The leukemic LGL spontaneously developed a NK activity on K 562 tumor cells, which was not affected under the various T and B cells growth factors because they became more sensitive to IL2; but they were also stimulated by a 50-kilodalton (KD) B cell growth factor (BCGF) factor devoid of any T cell proliferation activity. Together these results gave a better characterization of azurophilic granules containing T chronic lymphocytic leukemia, and enabled the documentation of the differentiation of LGL with NK activity. PMID- 3545433 TI - The limitation of liver function tests in metastatic carcinoid tumors. AB - To evaluate the utility of liver function tests (LFT) as indicators of metastatic carcinoid tumors, a retrospective study was performed. The LFT results of 17 patients with carcinoid tumors metastatic to the liver were compared with 17 patients with other malignant tumors. In the noncarcinoid group, 82.4% of the patients had elevated alkaline phosphatase (AP) or gamma glutamyl transpeptidase (GGTP), whereas only 28.6% of carcinoid patients had abnormal enzymes. The medians of all LFT values were significantly higher in noncarcinoid patients than in the carcinoid group, except for glutamic pyruvic transaminase (SGPT). Our data indicate that LFT are helpful in screening for liver metastases in patients with noncarcinoid tumors, but are unreliable in carcinoid tumors. Imaging tests should be used to rule out liver metastases in carcinoid tumors, irrespective of LFT results. PMID- 3545435 TI - Carcinosarcoma of the urinary bladder. AB - The clinical and pathologic features of three new and 35 previously reported carcinosarcomas of the urinary bladder were reviewed. This type of tumor is three times more common in men than women, and has occurred in patients from 33 to 82 years of age (average, 62 years), most of whom presented with hematuria of short duration. The tumors are usually large and polypoid, and on microscopic examination contain an intimate admixture of malignant epithelial and mesenchymal elements. The former may resemble transitional cell carcinoma, squamous cell carcinoma, adenocarcinoma or undifferentiated carcinoma; and the latter, fibrosarcoma, leiomyosarcoma, or undifferentiated sarcoma: skeletal muscle, osseous, and/or cartilaginous differentiation has occurred in from 25% to 50% of the tumors. Sixteen patients died as a result of their tumors; four others had metastatic disease and three were lost to follow-up. Twelve patients were alive and free of disease from 5 months to 7 years postoperatively. Most of the 12 underwent radical cystectomy, preceded in some cases by radiation therapy, but four underwent a more conservative operation. PMID- 3545434 TI - Immunohistochemical study of intracellular estradiol in human gastric cancer. AB - Tissues from primary human gastric cancers were examined for intracellular estradiol (E2) by using the avidin-biotin-peroxidase complex (ABC) immunohistochemical method on formalin-fixed paraffin-embedded sections. Reaction products of E2 were located only in the cytoplasm of the cancer cells, and not detected in noncancerous gastric epithelium. E2-positive tissues were found in 23 (44.2%) of 52 male patients, seven (20.6%) of 34 female patients and a total of 30 (34.9%) of 86 patients. In male patients, E2-positive cases occurred without age distinction. In female patients, however, E2 was not found in patients in older age groups, especially patients in the postmenopausal state. Microscopically, E2 was found frequently in intestinal type of cancers in male patients and in cancer with scirrhous growth pattern, in female patients. This is the first report of the demonstration of E2 in gastric cancer. The findings suggest that hormonal factors are involved in gastric cancer, and that the cancers contain endocrinic characteristics. PMID- 3545436 TI - The differential reactivity of benign and malignant nevomelanocytic lesions with mouse monoclonal antibody TNKH1. AB - A mouse monoclonal antibody (TNKH1) which recognizes a marker of benign nevus cell nevus has been obtained for the first time. A375 human melanoma cells were induced to differentiate with n-butyric acid and used as immunogen. When frozen sections of nevomelanocytic lesions were tested with TNKH1 obtained by this method, 15 of 15 acquired nevus cell nevi, and two of two congenital melanocytic nevi showed strong reactivity; whereas five of five primary melanomas (three nodular, one lentigo maligna, and one subungual), as well as 10 of 10 metastatic melanomas were nonreactive. One superficial spreading melanoma showed residual TNKH1-positive nevus cells, and TNKH1-negative melanoma cells. Four of six dysplastic nevi, which would be precursors of some malignant melanomas, showed heterogeneity in staining intensity with TNKH1; indicating the initial change of malignant transformation. No reaction was found with normal melanocytes. Thus, the antigen that TNKH1 defines is present on benign nevus cells, and absent on malignant cells as well as normal melanocytes. TNKH1 could be a powerful tool not only for the diagnosis of malignant melanoma, but also for the assessment of the ontogeny of various melanomas. PMID- 3545437 TI - Clinicopathologic correlations in the oligodendroglioma. AB - To determine the prognostic significance of histologic variables in oligodendroglial neoplasms, the presence and degree of 15 such variables were correlated with postoperative survival rates in 71 patients. By univariate analysis, prognostically significant factors, in order of decreasing importance, were mitoses (log), necrosis, nuclear cytologic atypia, vascular hypertrophy, and vascular proliferation. When studied by stepwise regression, necrosis and the number of mitoses contained all of the prognostically useful information. When each of the five variables significant by univariate analysis was tested in the Cox model by adding a variable to the model containing the other four, necrosis was found to be the only independently significant variable. There were significant positive pairwise correlations between each of the five significant histologic variables except for cytologic atypia with necrosis. The only histologic variable with a significant association with older age was the number of mitoses. These results suggest that necrosis and, to a lesser extent, the mitotic count are features that, in the appropriate setting, can be used to identify the "anaplastic" oligodendroglioma. PMID- 3545438 TI - A reappraisal of Richter's syndrome. Development of two phenotypically distinctive cell lines in a case of chronic lymphocytic leukemia. AB - Richter's syndrome, the development of a malignant lymphoma in a patient with preexisting chronic lymphocytic leukemia (CLL) is an infrequent but well documented phenomenon generally thought to represent a monoclonal proliferation of B-lymphocytes arising from the CLL. A heterogeneous population of cells consisting of sheets of transformed lymphocytes in combination with clusters of bizarre, atypical histiocytes developed in a patient with a history of longstanding CLL. Immunocytochemistry using a panel of monoclonal and polyclonal antibodies by immunoperoxidase techniques identified the presence of both B lymphocytic and monocytic-histiocytic cell lines of differentiation. A mechanism of multiple differentiation is proposed to account for the dual cell population observed in this patient. Review of the literature appears to indicate that this phenomenon often may be involved in cases diagnosed as Richter's syndrome. The demonstration of cellular heterogeneity in the current case underscores the need for establishing a more precise definition for the histologic characterization of the terminal malignancy in Richter's syndrome. PMID- 3545439 TI - Phosphaturic mesenchymal tumors. A polymorphous group causing osteomalacia or rickets. AB - Reported are the pathologic features of 17 mesenchymal tumors documented as causing osteomalacia or rickets. Although these tumors were histologically polymorphous, they were classifiable into four morphological groups. In the first group there were ten unique tumors showing mixed connective tissue features and containing variably prominent vascular and/or osteoclast-like giant-cell components. Tumors of this group also displayed focal microcystic changes, osseous metaplasia, and/or poorly developed cartilaginous areas. The cartilaginous areas sometimes showed considerable dystrophic calcification. With one exception, all tumors of this group occurred in soft tissue and demonstrated benign clinical behavior. The single malignant tumor originated in bone, recurred locally, and metastasized to lung. The tumors comprising the remaining three groups (six tumors) occurred in bone, demonstrated benign clinical behavior, and were grouped according to their close resemblance to tumors known to occur in bone, that is osteoblastoma-like (four tumors), nonossifying fibroma-like (two tumors), and ossifying fibroma-like (one tumor). PMID- 3545440 TI - Clinical and pathologic features of follicular large cell (nodular histiocytic) lymphoma. AB - Clinicopathologic correlations were made in 50 patients with follicular large cell (FLC) lymphoma to better define the influence of a variety of clinical and pathologic features on survival and the potential for continuous freedom from disease. The 5- and 10-year actuarial survivals for the entire group of patients are 77% and 63%, respectively, but disease-free survival is only 46% at 5 years and 22% at 10 years. No significant survival differences were found with various treatment approaches, although a single relapse occurred after 3 years among patients treated with modern combination chemotherapy containing doxorubicin. Median survivals of approximately 10 years despite recurrent disease are characteristic of the majority of follicular lymphomas. Furthermore, the reproducibility of cytologic diagnosis among follicular lymphomas is known to be variable. At this time, it is unclear whether intensive chemotherapy will cure a significant number of FLC patients or novel approaches are necessary as for the other follicular lymphomas. PMID- 3545441 TI - Brain tumors after cranial irradiation for childhood acute lymphoblastic leukemia. A 13-year experience from the Dana-Farber Cancer Institute and the Children's Hospital. AB - Brain tumors developed in two children after they had received cranial irradiation as central nervous system therapy for acute lymphoblastic leukemia. A review of the literature demonstrated an increased incidence of brain tumors in survivors of acute lymphoblastic leukemia who received central nervous system irradiation. Most of the brain tumors occurred within a decade after radiotherapy. Further data will be required to determine whether early post radiation brain tumors in patients with acute lymphoblastic leukemia are due to the central nervous system irradiation or to a genetic predisposition. PMID- 3545442 TI - Incidence and methodologic aspects of the occurrence of liver metastases in recurrent breast cancer. AB - The occurrence of liver metastases was evaluated by ultrasonic scanning and correlated with prognostic factors, pattern of metastases, clinical examination, biochemical liver function tests from serum, and liver biopsy specimens in 394 consecutive evaluable patients with first recurrence of breast cancer. Fifty-nine patients (15%) had a positive scan, and liver metastases were the only sign of recurrent disease in 11 of these patients. The presence of liver metastases was not associated with age, menopausal status, size of the primary tumor, regional lymph node status, or the length of the recurrence-free interval; but patients with liver metastases were significantly closer to the menopause than those without (P = 0.02). The diagnostic value of clinical examinations was comparable to that of serum bilirubin and serum aspartate aminotransferase (ASAT) analyses, but was significantly better than alkaline phosphatase (AP) and lactate dehydrogenase (LDH) analyses. Analysis of serum AP was not a valuable diagnostic tool in the diagnosis of liver metastases, since it was elevated in 58% of the patients with bone metastases, and since metastases in this site were found in one third of the patients without liver metastases. If all four tests were negative, liver metastases were excluded in 99% of the patients, and if more than two of the four tests were positive, liver metastases were found in 95%. Valid (greater than 80%) diagnosis of liver metastases by serum LDH or serum ASAT alone, required an elevation of three or five times the upper normal limits, respectively. Thirty-nine patients with positive ultrasonography results underwent biopsy. The ultrasonographic diagnosis could not be confirmed histologically in three patients (8%). If ultrasonic scanning had not been performed routinely, only one of 213 patients (0.5%) with soft tissue metastases would have been offered local therapy rather than systemic treatment. These data suggest that ultrasonic scanning of the liver should not be a routine diagnostic tool in examination of patients with first recurrence of breast cancer. However, whenever indicated by clinical signs or elevated blood tests, scanning should be performed to confirm the presence of liver metastases, particularly in patients entering therapeutical trials, since liver metastases demonstrated by ultrasound examinations may serve as a measurable parameter. PMID- 3545443 TI - Urinary 6-keto-prostaglandin F1a in patients with gynaecological tumours. AB - The production of the antiaggregatory and vasodilatory prostacyclin (PGI2) in patients with gynaecological tumours was studied by assaying urinary 6-keto prostaglandin F1a (= 6-keto-PGF1a), a hydration product of PGI2), by radioimmunoassay following high performance liquid chromatography (HPLC) in 59 patients with gynaecological tumours and 12 non-tumourous control women. Urinary 6-keto-PGF1a excretion in patients with cervical cancer (28.3 +/- 3.6 pmol/mmol creatinine, mean +/- S.E., n = 12), endometrial cancer (22.8 +/- 3.7 pmol/mmol creatinine, n = 12, uterine fibroids (26.0 +/- 3.5 pmol/mmol creatinine, n = 12) benign ovarian cysts (22.4 +/- 1.8 pmol/mmol creatinine, n = 12) did not differ from that in the control women (29.9 +/- 3.6 pmol/mmol creatinine, n = 12). However, patients with ovarian cancer excreted increased amounts of 6-keto-PGF1a (55.4 +/- 10.4 pmol/mmol creatinine, n = 11, P less than 0.05), although this bore no relation to tumour histology, clinical stage or the outcome of the patients. Thus, ovarian cancer is accompanied by increased PGI2 production, perhaps in the kidneys and/or in the cancer tissue. PMID- 3545444 TI - Distribution of lung adenocarcinoma-associated antigens in human tissues and sera defined by monoclonal antibodies KM-52 and KM-93. AB - Two monoclonal antibodies to human lung adenocarcinoma, KM-52 and KM-93, were generated by the novel immunizing procedure using mice rendered tolerant to the normal human lung (N. Hanai et al., Cancer Res., 46: 4438-4443, 1986). KM-93 recognized sialylated carbohydrate epitope on the antigen different from CA19-9 and DU-PAN-2, while KM-52 recognized the protein antigen. Both antigens were different from carcinoembryonic antigen, alpha-fetoprotein, and beta 2 microglobulin. Distribution of KA-52 and KA-93, the antigens recognized by KM-52 and KM-93, respectively, in various tissues and sera was investigated. In immunoperoxidase staining, KM-93 reacted strongly and frequently with tumor cells of lung adenocarcinoma and partially with those of lung squamous cell carcinoma, large cell carcinoma, and small cell carcinoma. In normal adult and fetal tissues, KA-93 was expressed on the surface of a small number of cells of the lung, pancreas, liver, kidney, and bone marrow. KM-52 reacted selectively with tumor cells of adenocarcinoma among four different histological types of lung carcinoma. In normal adult and fetal tissues, KA-52 was distributed on a small number of cells of the lung, stomach, intestine, and pancreas. Of the two monoclonal antibodies, KM-93 could be used in detecting the antigen in sera of patients with lung cancer. The KA-93 level in sera was determined by the sandwich type enzyme-linked immunosorbent assay. Serum with a high KA-93 level was found in 34 of 70 patients with lung adenocarcinoma (48.6%), one of 67 healthy adults (1.5%), and none of 32 patients with benign diseases (0%). Combined detection by KA-93 with KA-32, a new tumor marker of lung squamous cell carcinoma (N. Hanai et al., Cancer Res., 46: 5206-5210, 1986), elevated the positive percentage in patients with lung squamous cell carcinoma (52.7%) and with lung adenocarcinoma (59.5%). These results suggested that KM-52 and KM-93 would be potential monoclonal antibodies in immunohistological diagnosis and serum diagnosis of lung adenocarcinoma, respectively. PMID- 3545446 TI - Molecules involved in proliferation of normal and cancer cells: presidential address. PMID- 3545445 TI - Tumor cell instability, diversification, and progression to the metastatic phenotype: from oncogene to oncofetal expression. AB - It is proposed that tumor cell instability and the expression of cellular diversification mechanisms ensure that malignant neoplasms contain heterogeneous, phenotypically diverse tumor cell subpopulations. In such potentially unstable cellular mixtures of tumor cell phenotypes, some malignant cells may ultimately evolve with the most favorable properties for their progression to metastatic cells. Rates of cellular phenotypic instability and phenotypic diversification as well as their underlying causes appear to vary greatly among different tumor cells, and they are probably modulated by further genetic and chromosome changes and more frequently by intra- and extracellular epigenetic events that also differ, depending on the nature of the tumor cells and their cellular and microenvironmental interactions. Diversified malignant cells are characterized by quantitative and perhaps a few qualitative differences in gene expression, which may explain their abilities to undergo rapid changes in phenotypic properties. As tumor diversification and selection proceed uniquely in vivo, highly malignant cell subpopulations may eventually become dominant and gradually and independently lose their cellular and microenvironmental responsiveness. Tumor cell diversification mechanisms may be similar or identical to normal developmentally regulated diversification mechanisms that are used during embryonic and postembryonic cell diversification and development. PMID- 3545447 TI - Rat hepatocyte-mediated bacterial mutagenicity in relation to the carcinogenic potency of benz(a)anthracene, benzo(a)pyrene, and twenty-five methylated derivatives. AB - 7,12-Dimethylbenz(a)anthracene, benz(a)anthracene, and benzo(a)pyrene as well as the 24 monomethylbenzo(a)pyrenes (MBPs) and monomethylbenz(a)anthracenes (MBAs), compounds which differ in carcinogenicity from very potent to apparently inactive, were investigated for mutagenicity (reversion to histidine prototrophy) in Salmonella typhimurium TA100 using either intact or NADPH-fortified homogenized rat hepatocytes for metabolic activation. In both systems, all 27 hydrocarbons showed positive responses. Their mutagenic potency in the homogenate mediated test varied in a narrow range and did not correlate detectably with their reported activity in carcinogenicity experiments. When the cell homogenate was replaced by intact cells, the maximal mutagenic effects were weaker by factors of 1 to 14, depending on the compound, and were seen only at higher substrate concentrations. The differences between cell- and homogenate-mediated mutagenicity were small with the strong carcinogens 7,12 dimethylbenz(a)anthracene 7-MBA, 12-MBA, benzo(a)pyrene, 1-MBP, and 11-MBP. The differences were large with the apparent noncarcinogens and those weak carcinogens that were strongly mutagenic in the homogenate-mediated test. As a result of this differential reduction in activity, the cell-mediated mutagenicity did not correlate with the homogenate-mediated mutagenicity but correlated approximately with the carcinogenic potency. The lowest effects in the cell mediated experiments were seen with 7-, 8-, 9- and 10-MBP, 2-MBA, and 3-MBA. In these compounds, the methyl group is attached to a carbon of the terminal angular benzo ring, and therefore bay-region diol-epoxides, if formed at all, additionally would carry a methyl group on one of the oxidized positions. On the other hand, among all the compounds tested 7,12-dimethylbenz(a)anthracene, 12 MBA, and 11-MBP, which have the methyl group attached in the bay-region position opposite the terminal benzo ring, showed the highest mutagenic efficacies in the cell-mediated test, as compared to those observed in the homogenate-mediated test. These structure-activity relationships and the previously reported observation that among various promutagenic benzo(a)pyrene metabolites only the 7,8-dihydrodiol was strongly mutagenic in the cell-mediated test would suggest that in the cell-mediated bacterial mutagenicity test, bay-region diol-epoxides are the ultimate mutagens which are preferentially detected. PMID- 3545448 TI - Proteases occurring in the cell membrane: a possible cell receptor for the Bowman Birk type of protease inhibitors. AB - The legume-derived Bowman-Birk trypsin and chymotrypsin protease inhibitors (BBI) are effective anticarcinogens in vivo and in vitro. The chymotrypsin-inhibitory domain has been shown to be responsible for this anticarcinogenic action. In this study we identify hydrolytic enzymes by their ability to hydrolyze the relatively specific chymotrypsin substrate succinyl-Ala-Ala-Pro-Phe-aminomethyl coumarin. Results presented in this study show: there is an approximately 2-fold increase in the activity of these enzyme(s) between normal and transformed C3H/10T1/2 cells; there are five such enzymes associated with transformed cells (separated by diethylaminoethyl-cellulose chromatography); only two of these enzymes are inhibited by BBI; the BBI-inhibitable enzymes are membrane associated; the BBI inhibitable enzymes are similar to each other but different from pancreatic chymotrypsin. BBI has thus distinguished a subpopulation of enzymes capable of hydrolyzing succinyl-Ala-Ala-Pro-Phe-aminomethyl coumarin which may mediate the transformation of C3H/10T1/2 cells. PMID- 3545449 TI - Fluorescent visualization of binding and internalization of the anticarcinogenic Bowman-Birk type protease inhibitors in transformed fibroblasts. AB - The Bowman-Birk protease inhibitors from soybeans and chick peas suppress in vitro malignant transformation. This fluorescent microscopy study is designed to visualize the cellular site of action of these protease inhibitors. Binding and internalization of active protease inhibitors occur over a time course of 2 h. The rate and character of fluorescent micrographs obtained are compared to insulin as a positive control. Internalization of both molecules is completely blocked at 4 degrees C. Interpretation of the fluorescent micrographs in conjunction with biochemical data suggests the anticarcinogenic action of Bowman Birk type protease inhibitors may involve receptor-mediated endocytosis resulting in the internalization of both the protease inhibitors and a membrane-associated protease. PMID- 3545450 TI - Enrichment of collagen and gelatin degrading activities in the plasma membranes of human cancer cells. AB - Interactions between connective tissue substrates and proteinases localized to the surface of cancer cells are implicated in cancer invasion. In this report we have compared the enrichment of collagen and gelatin degrading activities and cysteine proteinase(s) in well-characterized (enzyme markers and electron microscopy) subcellular membrane fractions isolated from human small cell lung cancer lines (NCI-H69 and NCI-H82) and the RWP-1 pancreatic cancer line. With each cell line collagenolytic, gelatinolytic, and cysteine proteinase activities were enriched 5- to 128-fold in the plasma membrane fractions with differences noted between microvilli versus smooth membrane profiles. Incubation of tumor plasma membranes with methyl-3H-labeled collagen resulted in extensive degradation of the gamma, beta, alpha 1, and alpha 2 chains, suggesting the combined action of metalloproteinases. Treatment of tumor plasma membranes with the chaotropic agent, 2 M KCl, did not diminish membrane collagen- or gelatin degrading activity, but extensively leached out the cysteine proteinase, suggesting that the latter enzyme is not an integral membrane protein. Enzyme inhibitors specific for metalloproteinases and cysteine proteinase were used to corroborate enzymatic classification. In conclusion, we have demonstrated variations in the localization of proteinases in the plasma membrane domains of different human cancer cells. PMID- 3545452 TI - Tannic acid-induced nucleolar changes in hepatocytes transplanted into syngeneic or xenogeneic host and in hepatocytes maintained in primary culture. AB - In this study we have investigated the effect of a single dose of tannic acid, administered s.c., on the nucleolar ultrastructure of hepatocytes transplanted into a syngeneic or xenogeneic host in order to evaluate the validity of our hepatocyte transplantation system as an in vivo alternative to the use of whole animals to test for species and strain differences to the effects of hepatotoxins. Within 4-6 h following tannic acid injection, rat hepatocytes transplanted into the anterior chamber of eye and inguinal fat pads of rat and athymic nude mouse, showed changes of nucleolar components, with separation of ribonucleoprotein containing granules into discrete dark zones. These dark areas were surrounded by light areas consisting of granular and fibrillar components of the nucleolus. These changes were identical to tannic acid-induced nucleolar alterations in the homotopic liver. Hamster and rat hepatocytes xenotransplanted into athymic nude mice also displayed prominent nucleolar alterations in response to tannic acid. The similarity and extent of nucleolar alterations observed in transplanted hepatocytes and the in situ homotopic liver cells attest to the usefulness of the hepatocyte transplantation system for the evaluation of species differences in biological response to toxic/carcinogenic effects of xenobiotics. PMID- 3545451 TI - Penetration and binding of radiolabeled anti-carcinoembryonic antigen monoclonal antibodies and their antigen binding fragments in human colon multicellular tumor spheroids. AB - The binding and penetration of two 125I-labeled anti-carcinoembryonic antigen (CEA) monoclonal antibodies (MAb) and their F(ab')2 and Fab fragments were measured in multicellular spheroids of poorly (HT29) and moderately well differentiated (Co112) human colon adenocarcinomas which express different amounts of CEA. Spheroids cultured in vitro model tumor microenvironments where poor vascular supply may modulate antigen expression and accessibility. The two MAb studied, 202 and 35, were shown previously to react with different CEA epitopes and to have high affinities of 1.2 and 5.8 X 10(9) M-1, respectively. MAb 202 has also been shown to cross-react with antigens present on human granulocytes and normal epithelial cells from human lung and pancreas. Specific binding of intact MAb and fragments of both antibodies was demonstrated for both types of human colon carcinoma spheroids compared to mouse colon carcinoma (CL26) and mammary tumor (EMT6/Ro) spheroids. Total binding of MAb and fragments was greater (1.5- to 2.5-fold) after 4 h compared to 1 h of exposure; the amount of binding compared to control IgG1 was 5- to 30-fold greater after 1-h incubation and 15 to 200 times greater after 4 h. This binding was stable as demonstrated by short and long wash experiments at 37 degrees and 4 degrees C. The binding of F(ab')2 and Fab fragments of the anti-CEA MAb 35 to spheroids of human colon Co112 was almost 2-fold greater than that of the intact MAb. However, for MAb 202, the binding of intact MAb and F(ab')2 was greater than that of Fab fragments. In addition the binding of both intact and F(ab')2 fragments of MAb 202 was greater than that obtained with MAb 35. Specific binding of both antibodies to HT29 spheroids, which express less CEA, was decreased for MAb and fragments of both 202 and 35. Autoradiography and immunoperoxidase experiments were performed to determine the penetration of MAb and fragments after incubation with intact spheroids. Comparisons were made with labeled MAb directly applied to frozen sections of spheroids. F(ab')2 and Fab fragments of both antibodies were bound at the surface of intact spheroids and penetrated to eight to ten cells, but the intact MAb were localized mainly at the spheroid surface and the outer one to three cell layers. There was much less binding at the surfaces of HT29 compared to Co112 spheroids. An enzyme immunoassay using MAb 35 and 202 demonstrated that Co112 spheroids produced about 8-fold more CEA/mg of cell protein than did monolayer cultures.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3545453 TI - Intravesical Bacillus Calmette-Guerin therapy for murine bladder tumors: initiation of the response by fibronectin-mediated attachment of Bacillus Calmette-Guerin. AB - Intravesical Bacillus Calmette-Guerin (BCG) is considered to be one of the most effective treatments for superficial bladder cancer. Although the mechanisms by which BCG inhibits tumor growth are not known, previous studies have shown that systemic immunization to BCG and the local expression of the immune response in the bladder are associated with a favorable response to BCG therapy. We have investigated the conditions required for the initiation of an immunological response after the intravesical instillation of BCG. Initial histological studies showed that BCG attached to the bladder wall only in areas where the urothelium was damaged by electrocautery and suggested that attachment was associated with the fibrin clot. Quantitative studies verified the histological observations. Minimal BCG attachment (mean less than 10(2) colony forming units) was observed in normal bladders in contrast with a mean of 1.42 X 10(4) colony forming units/bladder in bladders damaged by electrocautery (10 separate experiments). BCG attachment to the bladder wall was durable since organisms were observed in bladders 48 h after instillation. To investigate the proteins to which BCG attached, we tested the binding of BCG to extracellular matrix and inflammatory proteins which comprise a significant portion of the fibrin clot. BCG bound in vitro to coverslips coated in vivo with extracellular matrix proteins but did not bind to control albumin-coated coverslips. BCG also bound to coverslips coated with purified plasma fibronectin but not to coverslips coated with other purified extracellular matrix proteins including laminin, fibrinogen, and type IV collagen. BCG attachment to coverslips coated with either extracellular matrix proteins or purified fibronectin was inhibited by antibodies specific for fibronectin. Moreover, BCG attachment to cauterized bladders in vivo was inhibited by antifibronectin antibodies. These results demonstrate that fibronectin mediates the attachment of BCG to surfaces and suggest that it is the primary component mediating attachment within the bladder. Moreover, the data suggest that the BCG-fibronectin interaction may be a requisite first step for the initiation of the antitumor activity in intravesical BCG for bladder cancer. PMID- 3545455 TI - Immunological quantitation of nuclear receptors in human breast cancer: relation to cytosolic estrogen and progesterone receptors. AB - Nuclear estrogen receptors (ERn) can now be reliably analyzed using the monoclonal estrogen receptor enzyme immunoassay. In a consecutive series of 135 breast cancer biopsies, ERn as well as cytosolic estrogen receptor (ERc) and progesterone receptor (PgR) concentrations were determined to evaluate whether ERn assays provide additional valuable information for the clinical management of the disease. Furthermore, by performing analyses on this relatively large number of patients, we sought explanations for the occurrence of the receptor profiles of ERc negative PgR positive and ERc positive PgR negative, which are found in a significant proportion of tumor biopsies. Eight-four % of all tumors are classified as ERn positive (greater than or equal to 10 fmol/mg nuclear extract protein) using the monoclonal assay technique. Two trends are evident: ERc positivity was found to be associated with ERn positivity (greater than or equal to 10 fmol/mg cytosol protein) in 98% of the cases investigated; and PgR positivity (greater than or equal to 10 fmol/mg cytosol protein) was found to be associated with ERn positivity in 95% of the cases investigated. However, a major proportion (approximately 28%) of ERn positive tumors are either ERc negative or PgR negative. The pattern of ERc negative ERn positive occurs almost exclusively among younger women, most of whom also had detectable amounts of PgR in their tumor tissues, while the pattern of ERn positive PgR negative occurs primarily among older women. ERn concentration was found to be significantly correlated to the concentration of both PgR and ERc. While the correlation between ERn and PgR was found to be strongest among women younger than 50 years of age, the correlation between ERn and ERc was strongest among women older than 50 years. Young women were found to have a significantly higher proportion of total tissue estrogen receptor present as ERn than older women (27 versus 14%). The information obtained by performing ERn analyses concurrently with or in place of ERc and PgR analyses does not appear to be valuable for the clinical management of the disease. However, this new method for determination of ERn is a significant advance in receptor technology that permits reevaluation of established enigmas concerning the biology and natural history of breast cancer. PMID- 3545454 TI - Mutagenicity experiments on agroclavines, new natural antineoplastic compounds. AB - Agroclavine, an alkaloid produced by some species of fungi and dicotyledon plants, and its 1-alkylated derivatives are potentially useful as antineoplastic drugs, since they exert potent and selective cytostatic effects. In the present study, we have investigated agroclavine and its 1-propyl and 1-pentyl derivatives for mutagenicity. The genetic end point studied was the reversion of strains of Salmonella typhimurium (TA 100, TA 98, TA 1537) and Escherichia coli (WP2 uvrA), auxotrophic for histidine and tryptophan, respectively. The compounds were tested directly and in the presence of a mammalian xenobiotic-metabolizing system. In the direct test, agroclavine and the two alkylated derivatives examined exhibited substantial bacteriotoxicity but no mutagenicity. Addition of NADPH-fortified postmitochondrial supernatant fraction of rat liver homogenate led to a clear-cut decrease in bacteriotoxicity and to the formation of mutagenic products. Each compound was effective in all three strains of S. typhimurium used. In E. coli only spurious effects were seen. 1-Pentylagroclavine, the most hydrophobic compound in the series, was the strongest mutagen. Agroclavine, the least hydrophobic compound, was the weakest. The mutagenic potencies and efficacies of all these test compounds were much weaker than those of the positive controls, which were known mutagens and carcinogens. Moreover, the differential effect of metabolism by liver enzymes demonstrates that the toxicity and mutagenicity of agroclavine and its derivatives are caused by different chemical species. Hence, it may be possible to develop derivatives that are cytotoxic but not mutagenic. PMID- 3545456 TI - Immunological identification and effects of 3-methylcholanthrene and phenobarbital on rat pulmonary cytochrome P-450. AB - Rabbit antibodies to the phenobarbital (PB) inducible rat liver microsomal cytochrome P-450s b and e and to 3-methylcholanthrene (MC) inducible P-450c were used to examine the expression of these isozymes in rat lungs. Western blots of total lung microsomes demonstrated that about 40 pmol P-450b/mg protein (and no detectable P-450e) were present in lungs from control or MC treated rats and that pretreatment with PB caused a small but significant (P less than 0.05) increase in the expression of P-450b. Microsomes from control and PB treated lung contained minimal levels of P-450c, and MC induced this isozyme to 185 pmol/mg. Immunocytochemistry was used to demonstrate immunoreactivity to these isozymes in specific cell types. Neither P-450b nor P-450c was detectable in endothelial cells from control or PB treated lungs, but MC increased immunoreactivity to P 450c in pulmonary endothelial cells. Type II alveolar cells showed distinct immunoreactivity to P-450b and weak immunoreactivity to P-450c in control or PB treated rats. Individual Clara cells stained for either P-450c or P-450b in control, MC treated, and PB treated rats, and colocalization was observed in some cells. An increase in type II alveolar cell and Clara cell immunoreactivity to P 450c was observed after MC induction. Mast cells, identified by metachromatic Giemsa staining, appeared to react nonspecifically with both antisera. In conclusion, P-450c is highly inducible by MC in rat lung (detected in microsomes by Western blot), specifically in endothelial cells, Clara cells, and alveolar type II cells (as visualized by immunocytochemistry); and P-450b is present in rat lung microsomes, and immunoreactivity to this isozyme is localized in alveolar type II and Clara cells. PMID- 3545457 TI - Use of somatic cell hybrids to analyze role of specific enzymes in daunorubicin cytotoxicity. AB - Through the use of drug-adapted tissue culture cells, correlations have been observed between the level of specific enzymes and drug resistance. Drug resistance, however, may be due to multiple factors. To test whether the activity of daunorubicin reductase or NADPH diaphorase independently influences in vitro daunorubicin-induced cytotoxicity, we developed somatic cell hybrid clones to partially isolate these factors. This was accomplished by fusing daunorubicin resistant myeloblast cells obtained from a patient with monosomy 7 leukemia to a daunorubicin-sensitive Chinese hamster cell line. The in vitro cytotoxicity of daunorubicin was compared in hybrid clones having variable enzyme activities; the concentrations of daunorubicin that inhibited the growth of clones by 50% did not differ by more than 2-fold, whereas daunorubicin reductase activities and NADPH diaphorase isozyme activities differed by more than 100- and 15-fold, respectively. These large differences in enzymatic activity were obtained in part by the suppression of specific hamster genes, indicating a regulatory control mechanism for xenobiotic enzymes. Our findings suggest that in this system substantial intercellular variation in the activity of these xenobiotic enzymes does not independently influence cellular resistance to daunorubicin. PMID- 3545458 TI - Metrizamide and its neurologic complications. PMID- 3545459 TI - Should we measure free antiepileptic drug levels? PMID- 3545460 TI - The pharmacology of foot dystonia in parkinsonism. PMID- 3545461 TI - Restless legs syndrome treatment with dopaminergic drugs. AB - Sixteen patients with symptoms of restless legs syndrome and resulting insomnia are included in this study. They were nine women and seven men with a mean age of 50.8 years and with a mean duration of symptoms of 6.3 years. The purpose of the study is to determine the drugs that are useful for the treatment of restless legs syndrome. In 13 patients L-Dopa plus benserazide, in two patients bromocriptine, and in the remaining one patient piribedil were used orally at night approximately 1 h before bedtime. Compared with placebo these dopaminergic drugs decreased the times of waking up and staying awake periods at a statistically significant level (p changed between 0.025 and 0.01, t test). In this susceptibility of CNS there is dysfunction of the dopamine system triggered by sleep, and resting and dopaminergic potentiation by drugs affect the symptoms. PMID- 3545462 TI - Continuous-infusion diaziquone in acute myeloid leukemia: a Southeastern Cancer Study Group trial. AB - Diaziquone (AZQ) is a synthetic quinone with considerable activity against L1210 leukemia and potent myelosuppressive activity in man. To test the efficacy and toxicity of AZQ administered by continuous infusion, a phase II multi institutional trial was undertaken by the Southeastern Cancer Study Group. Eligible adults with acute myeloid leukemia (AML) received AZQ at a dose of 28 mg/m2 daily by continuous infusion for 5 days. Patients failing to achieve complete remission received a second course utilizing the same dose and schedule. Of 25 evaluable patients with relapsed or refractory AML, three achieved complete response (12%) and two achieved partial response (8%). All patients experienced marked myelosuppression. Severe or life-threatening infection was observed in 15 (56%) patients. Clinical or postmortem evidence of central nervous system hemorrhage was encountered in three (12%) patients with severe refractory thrombocytopenia. Minimal nonhematologic toxicity was observed, suggesting that further studies of this agent in combination regimens and possibly for marrow transplantation preparation in patients with acute leukemia are warranted. PMID- 3545463 TI - Intraperitoneal antineoplastic agents for tumors principally confined to the peritoneal cavity. PMID- 3545464 TI - The role of monoclonal antibodies in tumour diagnosis. PMID- 3545465 TI - Human carcinoma cell lines xenografted in athymic mice: biological and antigenic characteristics of an intraabdominal model. AB - In order to investigate in vivo clinical applications of murine monoclonal antibodies directed against human ovarian carcinoma a preclinical in vivo model was developed using BALB/c athymic mice. Three human carcinoma cell lines (MCF7, HT29, and SW626) were injected into the peritoneal cavity of pristane-primed animals and the biological and antigenic characteristics of the i.p. grown tumors were studied. The animals were killed when moribund or 6-8 weeks after tumor injection. At autopsy tumor take was observed in 85% of the injected animals, whereas palpable nodules were evident in only 83%. Examination of the peritoneal cavity revealed intraabdominal carcinomatosis with tumor masses varying in size between 0.2 and 0.5 cm in diameter and tumor sheets. The most frequently affected organs were the diaphragm, the liver, and the reproductive system. Ascitic fluid formation was rare and no animal developed tumors outside the peritoneal cavity. To determine whether the in vivo tumors retained the same antigenic characteristics as the in vitro cell lines, four monoclonal antibodies (MBr1, MOv2, MOv8, and MOv15) directed against ovarian carcinoma-associated antigens and two different experimental approaches (immunofluorescence and immunoblotting) were used. Variations at either a quantitative or a qualitative level were observed for some antigens, whereas no evident changes were apparent for others. In particular, the antigens detected by MBr1 and MOv15 on the MCF7 line both maintained high levels of expression and immunoblotting staining pattern, whereas the antigens detected by MOv2 on the HT29 and SW626 lines, although present at a high level, clearly changed their staining pattern. As regards the antigens recognized by MOv8 and MOv15 on the HT29 and SW626 lines, we observed a drastic decrease in the level of their expression and in many cases a drop below the threshold of detectability of the test. The intraabdominal carcinomatosis described partially mimics the growth characteristics of human ovarian cancer and maintains the expression of some antigenic markers associated with epithelial tumors of the ovary and may therefore be useful in devising immunodiagnostic and/or immunotherapeutic strategies for ovarian carcinoma. PMID- 3545467 TI - [Arterial hypertension and coronary atherosclerosis. Etiopathogenetic aspects and preventive interventions]. PMID- 3545466 TI - Adoptive immunity in mice challenged with L1210/DTIC clones. AB - New antigenic specificities, not detectable on parental cells, have been induced by many investigators in mouse lymphomas by treatment with the antitumor agent 5(3,3-dimethyl-1-triazeno)imidazole-4-carboxamide (DTIC). The antigens are transmissible, after withdrawal of the drug treatment, as an inheritable character. The mechanism of induction, the molecular nature, and the number of the new antigenic specificities have not been completely elucidated. Four clones from murine leukemia L1210 isolated and expanded in vitro were treated in vivo with DTIC and the new sublines were studied in detail. The four drug-treated sublines studied exhibited strong immunogenicity since they were rejected by syngeneic animals. Immunosuppressed animals challenged with 10(7) A/DTIC or P/DTIC cells were reciprocally protected by the adoptive transfer of spleen cells from donors that had rejected a lethal challenge of A/DTIC or P/DTIC clone. In a similar fashion, the adoptive transfer of spleen cells obtained from animals that had rejected the Q/DTIC or the R/DTIC clones protected immunosuppressed mice challenged with Q/DTIC or R/DTIC cells. No antitumor activity was observed in cross-protective schedules other than those indicated. It was been concluded that (a) the L1210 leukemia line does not have antigenic cells, (b) four DTIC-treated clone sublines were rejected by compatible hosts, and (c) two mutually exclusive sets of antigens were expressed in four antigenic clone sublines. PMID- 3545468 TI - [Treatment of dyslipidemia in the primary prevention of myocardial infarct]. PMID- 3545469 TI - [Italian study of the prevention of myocardial reinfarct with low-dose heparin]. PMID- 3545470 TI - [Eicosanoic acids and arteriopathies of the legs]. PMID- 3545471 TI - Evidence of cardiac autonomic disease in chronic alcoholics by computerized study of heart rate-respiration relationship. PMID- 3545473 TI - Dietary fat and coronary heart disease: there is much more to learn. AB - The evidence for recommending a reduction of one third or more of dietary fat as a very likely means of reducing coronary heart disease in affluent nations is far from complete. That it will do no harm is an unacceptable scientific argument, and it is still up to the proponents of this policy to prove its long-term safety. I am persuaded, because the facts are very much stronger, that such a diet should be recommended for those who have atherogenic lipoproteins in the top quintile of their distribution. But even in such people, too much should not be expected or promised. What we really need to know is how dietary saturated fat leads to the development of coronary heart disease as well as coronary atherosclerosis; why it may do so in some and not in others; and much more about the effects of specific dietary fatty acids on the mechanisms involved. PMID- 3545472 TI - Role of dietary intervention in the primary prevention of coronary heart disease. Individuals with high-normal or elevated serum cholesterol levels should be placed on cholesterol-lowering diets. AB - A large and convincing body of evidence links increased coronary risk with elevated plasma levels of low-density lipoprotein (LDL) cholesterol. Cholesterol in atherosclerotic lesions originates from that circulating in the blood bound to LDL. Even mild degrees of hypercholesterolemia (cholesterol greater than 180 mg/dl) when due to increased levels of LDL are associated with increased risk. Lowering plasma levels of LDL has been clearly shown to reduce coronary risk. We are able to modify plasma levels of LDL by restricting the dietary content of cholesterol and saturated fats. Such diets are safe and can be adhered to by large populations. Available information, reviewed here in detail, supports vigorous efforts to lower cholesterol levels by dietary means, even in the patient with so-called mild hypercholesterolemia. The evidence is overwhelming, the risk is nil, and the potential benefits are substantial. PMID- 3545474 TI - Cardiopulmonary exercise testing in clinical practice. AB - Cardiopulmonary exercise testing refers to the noninvasive measurement of respiratory gas exchange and air flow, together with heart rate, blood pressure, and the electrocardiogram. These data, obtained during an incremental exercise test, can be used to derive the aerobic capacity or VO2max, which is an objective measure of the severity of chronic cardiac and circulatory failure, as well as to predict the maximum cardiac output response to exercise. The additional monitoring of minute ventilation and arterial oxygen saturation can be used to distinguish ventilatory from cardiac or circulatory causes of exertional dyspnea. Finally, this information serves as an objective measure of functional capacity which can be monitored over time to assess the natural history of disease as well as its response to medical therapy. PMID- 3545475 TI - Management of hypertension in patients with concomitant diseases. AB - The treatment of hypertension in patients with diabetes, obstructive airway disease, impaired renal function, or congestive heart failure (CHF) is discussed. Specifically, the value of alpha 1-adrenoceptor blocking agents in such patients is reviewed. An individualized approach to therapy is required, with careful consideration of the effects of different drugs on the existing metabolic and hemodynamic situation. In diabetic individuals, commonly used step-1 agents may impair glucose tolerance; beta-adrenergic blockade may increase blood glucose levels and significantly change response to insulin-induced hypoglycemia. Diabetic patients may also be especially sensitive to side effects of some centrally acting antihypertensive agents. In patients with obstructive airway disease, beta-blockade and alpha-stimulation worsen bronchospasm; although beta stimulants produce bronchodilatation, they often are contraindicated in hypertensive patients due to their stimulatory effects on the heart. In patients with impaired renal function, therapy for hypertension may include problems such as an increased half-life of antihypertensive agents and retention of active metabolites. In patients with CHF, if blood pressure is not normalized with diuretics, more aggressive therapy may be required. According to results of several studies discussed, the alpha 1-adrenoceptor blocking-agent prazosin appears to be a safe and effective therapy, causing a minimum of side effects, for treatment of hypertension in patients with these conditions. PMID- 3545476 TI - Ceftazidime versus tobramycin plus ticarcillin in the treatment of soft-tissue infections. AB - Case report forms from a multicenter, randomized trial comparing ceftazidime (50 patients) with tobramycin plus ticarcillin (control group, 44 patients) in the treatment of skin and soft-tissue infections were reviewed. Two subsets of patients were identified. The target patient population (group I) comprised older patients with predisposing chronic disease (eg, diabetes mellitus) and an average of 1.8 bacterial pathogens per patient. Necrotizing soft-tissue and postoperative wound infections predominated. Group II comprised younger patients with acute onset of monomicrobial cellulitis or staphylococcal or streptococcal abscess. Clinical cure or improvement was achieved in 93% of ceftazidime-treated and 94% of control group I patients. Bacteriological eradication of the initial pathogens without superinfection was obtained in 85% and 82%, respectively, of the two treatment groups. In group II, each of the nine ceftazidime-treated patients was cured or improved and bacteria were eradicated; in the control group, nine of ten patients were clinically and bacteriologically cured. Among all patients, Staphylococcus aureus was eradicated in 18 of 19 treated with ceftazidime and in 14 of 15 treated with the control agents. The results of the study demonstrate the efficacy of ceftazidime as initial monotherapy for soft-tissue infections in patients with compromised vascularity. PMID- 3545477 TI - Clinical studies of a new, low-dose formulation of metolazone for the treatment of hypertension. AB - Two multicenter, double-blind, randomized studies were performed to determine the antihypertensive efficacy and effects on laboratory values of a new, shorter acting formulation of metolazone in patients with mild to moderate hypertension. After baseline placebo-control periods, 105 patients were randomly assigned to receive single daily doses of either placebo or 0.5, 1.0, or 2.0 mg of the new formulation of metolazone for six weeks in one study, and 164 patients were randomized to receive 0.5, 1.0, or 2.0 mg of the new formulation of metolazone or 2.5 mg of the older, long-acting metolazone in the other. Mean blood pressure reductions in all three metolazone groups were statistically and clinically significant. Blood pressures of 51% to 58% of patients in the 0.5-mg metolazone group were controlled (diastolic blood pressure less than 90 or a fall of greater than or equal to 10 mmHg from baseline). Reductions in mean serum potassium levels were dose-related. We conclude that 0.5 mg of metolazone is safe and effective therapy for hypertension; it will significantly reduce systolic and diastolic blood pressure and minimizes changes in laboratory test values. PMID- 3545478 TI - [The fate of students and professors of the medical faculty in Brno in relation to the events of 17 November 1939]. PMID- 3545479 TI - [Urinary infections in nephrostomies performed on transplanted kidneys]. PMID- 3545480 TI - [Abdominal ultrasonography and retrograde choledochopancreatography in the diagnosis of biliary tract diseases]. PMID- 3545482 TI - Co-localization of the immunoreactivities of corticotropin-releasing factor and arginine vasotocin in the brain and pituitary system of the teleost Catostomus commersoni. AB - The peroxidase-antiperoxidase immunocytochemical procedure was used to study the distribution of ovine corticotropin-releasing factor (CRF) and arginine vasotocin (AVT) immunoreactivities sequentially in the same sections or in adjacent sections of the brain and pituitary of Catostomus commersoni. It was found that all CRF-immunoreactive (IR) neurons in the nucleus preopticus (NPO) also contained AVT immunoreactivity. Co-localization of both immunoreactivities was also observed in fibres forming the preoptic-pituitary tract and in the neurohypophyseal digitations, the IR-CRF and IR-AVT fibres projecting mainly to the neurointermediate lobe (NIL) of the pituitary. An additional population of exclusively IR-AVT neurons and fibres in the NPO, preoptic-pituitary tract and NIL was also observed. Exclusive CRF-immunostaining was found in neurons of the nucleus lateralis tuberis (NLT), in fibres distributed in some diencephalic nuclei and in the neurohypophyseal digitations in the region of the rostral pars distalis (RPD). These results suggest that CRF- and AVT-like substances, present in NIL fibres (probably originating in the NPO), may have an integrated role in the release of the cell products from the pars intermedia, and that the control of corticotrops in the rostral pars distalis, innervated exclusively by IR-CRF fibres (probably originating in the NLT), does not require a simultaneous presence of CRF- and AVT-like substances. PMID- 3545481 TI - A double sequential immunofluorescence method demonstrating the co-localization of urotensins I and II in the caudal neurosecretory system of the teleost, Gillichthys mirabilis. AB - A double immunofluorescence method was devised to localize simultaneously urotensin-I (UI) and -II (UII) immunoreactivities in the caudal neurosecretory system of the goby, Gillichthys mirabilis. In a sequential fashion, sections of the posterior spinal cord and urophysis were treated with antiserum to corticotropin-releasing factor (CRF) that cross-reacts with UI, fluorescein conjugated sheep anti-rabbit IgG, biotinylated anti-UII and rhodamine-conjugated avidin. UI and UII immunoreactivities appeared to coexist in some neurons and in most fibers and urophysial tissue; the remainder of the fibers and urophysis and the majority of neurons were immunoreactive for CRF/UI only. No convincing evidence of immunoreactivity for UII only was found. A few nonreactive cells were seen, but these may not be neurosecretory neurons. The two immunoreactive cell types were not segregated topographically, and the intensity of perikaryal immunofluorescence for CRF/UI was variable. To explain these results a hypothesis that all caudal neurosecretory cells may synthesize both UI and UII and that immunoreactive differences may reflect different states of cellular activity, is suggested. This sequential double immunofluorescence method offers several advantages over other techniques and is especially useful for co-localization studies when primary antisera from different species are not available. PMID- 3545483 TI - Immunocytochemical localization of pyrazine-binding protein in bovine nasal mucosa. AB - Polyclonal antibodies have been raised against purified bovine pyrazine-binding protein, a protein that binds the odorant 2-isobutyl-3-methoxypyrazine. These antibodies have been utilized in immunocytochemical experiments to localize the pyrazine-binding protein in bovine nasal mucosa. Tissue fragments, macroscopically identified as olfactory and respiratory mucosa, were fixed in Bouin's fluid and embedded in paraffin. Consecutive serial sections were processed for immunofluorescence studies and restained either with haematoxylin eosin or with periodic acid Schiff-Alcian Blue. In both olfactory and respiratory mucosa, only seromucous tubulo-acinar glands were specifically labelled. These glands are located in the lamina propria underlying typical respiratory epithelium, even in those tissues that are macroscopically defined as olfactory mucosa. PMID- 3545485 TI - Caldesmon: a calmodulin-binding actin-regulatory protein. AB - The protein caldesmon, originally isolated from smooth muscle tissue where it is the most abundant calmodulin-binding protein, has since been shown to have a wide distribution in actin- and myosin- containing cells where it is localized in sub cellular structures concerned with motility, shape changes and exo- or endo cytosis. Caldesmon is believed to be an actin- regulatory protein, and binds with high affinity to actin or actin-tropomyosin. Caldesmon inhibits the activation by actin-tropomyosin of myosin MgATPase activity, and the inhibition can be reversed by Ca2+.calmodulin. The binding of caldesmon to smooth muscle proteins has been studied in detail, enabling a model to be constructed which could account for the observed Ca2+ regulation of smooth muscle thin filaments. The abundance of caldesmon, and the Ca2+-regulation of its activity via calmodulin, mean that it is potentially an important intracellular regulator of processes such as smooth muscle contraction, cell motility and secretion. PMID- 3545486 TI - Calcium-binding proteins and secretion. AB - The Ca ion plays a central role in the control of the regulated pathway of exocytotic secretion in eukaryote cells. Most secretagogues either directly or indirectly raise cytosolic free Ca levels which in turn affects granule biogenesis, contractile events, gel/sol transition in intracellular matrix and membrane fusion events occurring at exocytosis. Many of these responses are mediated by Ca-binding proteins among which calmodulin and protein kinase C have received prominent attention. Studies of the nature and inter-relationship of proteins which undergo Ca-dependent association with intracellular membranes in secretory tissue reveal that there may be further Ca-binding proteins in these cells which act as intracellular transducers of the Ca signal during secretion. PMID- 3545484 TI - Lewis Victor Heilbrunn. Pioneer of calcium as an intracellular regulator. PMID- 3545487 TI - Intracellular calcium and smooth muscle contraction. AB - Excitation-contraction coupling in smooth muscle involves many processes, some of which are outlined in this article. The total amount of Ca2+ released on excitation is considerably in excess of the free Ca2+ concentration and this implies a high capacity, high affinity Ca2+ buffer system. The two major Ca2+ binding proteins are calmodulin and myosin. Only calmodulin has the appropriate binding affinity to act as a component of the Ca2+-buffer system. The Ca2+ calmodulin complex activates myosin light chain kinase and thus is involved in the regulation of contractile activity. Phosphorylation of myosin stabilizes an active conformation and promotes cross bridge cycling and is essential for the initiation of contraction. During the initial contractile response phosphorylation correlates to tension development and velocity of shortening. However, as contraction continues the extent of myosin phosphorylation and velocity often decreases but tension is maintained. In general, the Ca2+ transient is reflected by the extent of phosphorylation that in turn correlates with shortening velocity. Maintenance of tension at low phosphorylation levels is not accounted for within our understanding of the phosphorylation theory and thus alternative regulatory mechanisms have been implicated. Some of the possibilities are discussed. PMID- 3545488 TI - Action of calcium-binding proteins in egg maturation and fertilisation. AB - There is considerable evidence that calcium acts as a primary trigger for egg maturation and fertilisation in diverse phyla. Calcium regulation has been demonstrated or suggested for numerous specific events in fertilisation, including: sperm motility, the acrosome reaction, sperm-egg binding and fusion, metabolic activation of the egg, etc. However, very little is known concerning the mechanisms whereby calcium exerts its effects. Some calcium-regulated events are mediated through calmodulin and others are likely to be as well. Additionally, protein kinase C has recently been implicated in some processes related to egg maturation and activation, although the evidence presented thus far has been indirect. Other pathways dependent upon calcium but not involving either CaM or PKC have also been identified. Much more research will be required before the multiple involvement of calcium-binding proteins in egg maturation and fertilisation are clarified. PMID- 3545489 TI - The calcium sensitive dehydrogenases of vertebrate mitochondria. AB - Three important dehydrogenases in vertebrate mitochondria are activated by Ca2+ ions with half-maximal effects at about 1 microM. These are pyruvate dehydrogenase, NAD+-isocitrate dehydrogenase and 2-oxoglutarate dehydrogenase. Activation of these enzymes can also be demonstrated within intact mitochondria when extramitochondrial Ca2+ is increased within the range of concentrations generally considered to occur in the cytoplasm of vertebrate cells. It is argued that the main role of the calcium transport system in the inner membrane of vertebrate mitochondria is to relay changes in the cytoplasmic concentration of Ca2+ into the mitochondrial matrix. In this way, hormones and other extracellular stimuli which stimulate ATP-requiring processes such as contraction and secretion through increases in the cytoplasmic concentration of Ca2+ may also increase intramitochondrial oxidative metabolism and hence the replenishment of ATP. PMID- 3545491 TI - [A preliminary study on the usefulness of the plasmid profile analysis for the epidemiological investigation of shigellosis]. PMID- 3545490 TI - Intracellular Ca2+ and cell injury: a paradoxical role of Ca2+ in complement membrane attack. AB - Disturbances in intracellular Ca2+ are known to be important in cell injury caused by a wide range of toxic factors. The complement system is a major effector of immune damage in vivo, and is known to be involved in the pathogenesis of many immune diseases. We present here evidence that the potentially lethal membrane attack complex of complement causes a rapid increase in intracellular free Ca2+ concentration before any other detectable biochemical changes in the cell. In nucleated cells the increased intracellular free Ca2+ concentration initially stimulates recovery processes, allowing the cell to escape mild complement attack and also activates the production of inflammatory mediators, which may amplify an ongoing inflammatory response. More severe complement membrane attack causes a more rapid rise in intracellular free Ca2+ concentration allowing a threshold to be breached above which recovery processes are overwhelmed, and cell death occurs. The importance of non-lytic effects and recovery processes mediated by Ca2+, and the molecular basis of these effects are discussed, and the hypothesis proposed that the cell-injuring effects of other "pore-forming" toxins are also caused by increases in intracellular free Ca2+. PMID- 3545492 TI - [Current status and trends of the control and elimination of measles]. PMID- 3545493 TI - Quantification of isoforms of plasma MM creatine kinase (CK) with an immunoblot procedure. AB - The MM isoenzyme of creatine kinase, a dimer composed of two M ("muscle type") subunits, is found in myocardium, where it constitutes 85% of tissue CK, and in skeletal muscle, where it constitutes virtually 100%, as well as in other tissues. The tissue form is designated MMA. When MMA circulates in plasma, it undergoes stepwise, post-translational modification, mediated by proteolytic enzymes in plasma and giving rise to isoforms called MMB and MMC, which lack carboxy terminal lysine on one or two subunits, respectively. We have shown previously that changes with time in plasma profiles of MM creatine kinase (CK) isoforms in dogs reflect myocardial infarction within 1 hour after the onset of coronary occlusion and permit noninvasive detection of reperfusion within 30 minutes after release of an occlusive coronary arterial ligature. However, analysis of MM CK isoforms in plasma from patients has been hampered by the lack of availability of quantitative as opposed to qualitative methods. This study was performed to develop and validate an assay with the sensitivity and specificity needed for accurate quantification of MM CK isoforms in samples of plasma from patients. A rapid assay procedure will be required ultimately for prospective, clinical use. However, as a first step and for use in development and standardization of rapid assays, a procedure is needed for accurate qualification of isoforms even if its implementation is laborious and slow. The isoform composition of normal plasma was found to comprise 32.0% MMA, 34.9% MMB, and 32.7% MMC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545494 TI - Activation of the yeast HO gene by release from multiple negative controls. AB - Transcription of the yeast HO gene requires five genes, SWI 1, 2, 3, 4, 5. We present evidence that some SWI products activate HO by antagonizing negative regulatory activities encoded by the SIN genes. sin- mutants (defining six genes) were identified because they express HO in the absence of particular SWI products. We argue that SWI5 activates HO by antagonizing SIN3 and that SWI4 activates HO by antagonizing SIN6. HO is expressed in sin3- daughter cells, hence we infer that the SIN3 product represses HO in wild-type daughter cells and that SWI5 and SIN3 are responsible for the cell-lineage-dependent expression of HO. HO is transcribed only when all types of repression are absent: in mother cells, where SWI5 antagonizes SIN3; in late G1, when SWI4 antagonizes SIN6; and in a or alpha cells, where a1-alpha 2 repression is absent. PMID- 3545495 TI - Cell diversification within the myogenic lineage: in vitro generation of two types of myoblasts from a single myogenic progenitor cell. AB - We show that a single myogenic progenitor cell in vitro generates two types of myoblasts committed to two distinct myogenic cell lineages. Using fast and slow myosin heavy chain isoform content to define myotube type, we found that myogenic cells from fetal quail (day 10 in ovo) formed two types of myotubes in vitro: fast and mixed fast/slow. Clonal analysis showed that these two types of myotubes were formed from two types of myoblasts committed to distinct fast and fast/slow lineages. Serial subcloning demonstrated that the initial myoblast progeny of an individual myogenic progenitor cell were in the fast lineage, whereas later progeny were in the fast/slow lineage. Fast and slow myosin expression within particular myotubes reflects the genetic processes underlying myoblast commitment to diverse myogenic lineages. PMID- 3545496 TI - Expression of fasciclin I and II glycoproteins on subsets of axon pathways during neuronal development in the grasshopper. AB - The "labeled pathways" hypothesis predicts that axon fascicles in the embryonic neuropil are differentially labeled by surface recognition molecules used for growth cone guidance. To identify candidates for such recognition molecules, we generated monoclonal antibodies (MAbs) that recognize surface antigens expressed on subsets of axon fascicles in the grasshopper embryo. The 3B11 and 8C6 MAbs immunoprecipitate 70- and 95-kd membrane glycoproteins called fasciclin I and II, respectively, which are expressed on different subsets of axon fascicles during development. These two glycoproteins are expressed regionally on particular portions of embryonic axons in correlation with their patterns of fasciculation, dynamically during the period of axon outgrowth in a manner consistent with a role in growth cone guidance, and at other times and places during embryogenesis, suggesting multiple developmental roles. PMID- 3545497 TI - The S. cerevisiae CDC25 gene product regulates the RAS/adenylate cyclase pathway. AB - The gene corresponding to the S. cerevisiae cell division cycle mutant cdc25 has been cloned and sequenced, revealing an open reading frame encoding a protein of 1589 amino acids that contains no significant homologies with other known proteins. Cells lacking CDC25 have low levels of cyclic AMP and decreased levels of Mg2+-dependent adenylate cyclase activity. The lethality resulting from disruption of the CDC25 gene can be suppressed by the presence of the activated RAS2val19 gene, but not by high copy plasmids expressing a normal RAS2 or RAS1 gene. These results suggest that normal RAS is dependent on CDC25 function. Furthermore, mutationally activated alleles of CDC25 are capable of inducing a set of phenotypes similar to those observed in strains containing a genetically activated RAS/adenylate cyclase pathway, suggesting that CDC25 encodes a regulatory protein. We propose that CDC25 regulates adenylate cyclase by regulating the guanine nucleotide bound to RAS proteins. PMID- 3545498 TI - A genetic analysis of dicentric minichromosomes in Saccharomyces cerevisiae. AB - We have developed an assay in S. cerevisiae in which clones of cells that contain intact dicentric minichromosomes are visually distinct from those that have rearranged to monocentric minichromosomes. We find that the instability of dicentric minichromosomes is apparently due to mitotic nondisjunction accompanied by occasional structural rearrangements. Monocentric minichromosomes arising by rearrangement of the plasmid are rapidly selected in the population since dicentric minichromosomes depress the rate of cell division. We show that the ability of one centromere to compete with another in dicentric minichromosomes requires the presence of both of the conserved structural elements, CDE II and CDE III. Dicentric minichromosomes can be stabilized if one of the centromeres on the molecule is functionally hypomorphic because of mutations in CDE II even though these mutant centromeres are highly efficient in monocentric molecules. Stable dicentric molecules can also be produced by decreasing the space between two wild-type centromeres on the same molecule. These results suggest plausible pathways for changes in chromosome number that accompany evolution. PMID- 3545499 TI - A C-terminal signal prevents secretion of luminal ER proteins. AB - Proteins that permanently reside in the lumen of the endoplasmic reticulum (ER) must somehow be distinguished from newly synthesized secretory proteins, which pass through this compartment on their way out of the cell. Three luminal ER proteins whose sequence is known, grp78 ("BiP"), grp94, and protein disulphide isomerase, share the carboxy-terminal sequence Lys-Asp-Glu-Leu (KDEL). We show that deletion (or extension) of the carboxyl terminus of grp78 results in secretion of this protein when it is expressed in COS cells. Conversely, a derivative of chicken lysozyme containing the last six amino acids of grp78 fails to be secreted and instead accumulates in the ER. We propose that the KDEL sequence marks proteins that are to be retained in the ER and discuss possible retention mechanisms. PMID- 3545500 TI - Altered cell-averaged microviscosity of murine peritoneal macrophages undergoing activation in vivo or in vitro. AB - The cell-averaged microviscosity of intact murine peritoneal mononuclear phagocytes in various stages of activation was assessed by quantifying fluorescent depolarization of 1,6-diphenyl-1,3,5-hexatriene. Macrophages activated in vivo with Mycobacterium bovis, strain BCG, were significantly more fluid than resident peritoneal macrophages, responsive macrophages elicited with thioglycollate broth, proteose peptone broth, or fetal bovine serum, or primed macrophages elicited with pyran copolymer, MVE-2. Specifically, the cell-averaged microviscosity decreased from a mean of 3.47 +/- .07 eta 25 degrees C (poise) (range of 3.32 to 3.67 p) to 2.62 eta 25 degrees C. Exposure of responsive macrophages in vitro to bacterial endotoxin plus hybridoma supernatants containing macrophage-activating factor or purified recombinant interferon gamma resulted in decreased microviscosity; the largest effect was seen after 24 hr. Macrophages primed in vivo with MVE-2 and treated in vitro with endotoxin also developed decreased microviscosity. Similar changes in microviscosity were observed in a plasma membrane-enriched fraction isolated from macrophages activated in vitro with interferon gamma and endotoxin, thus suggesting that the cell-averaged measurements reflected changes in membrane viscosity. The optimum concentration of MAF-inducing decreased overall microviscosity was identical to that for inducing tumoricidal capacity. Taken together, the data indicate activation of lytic capacity in murine macrophages is closely associated with decreased cell-averaged microviscosity and that this change reflects, at least in part, decreased microviscosity of the plasma membrane of these cells. PMID- 3545501 TI - Implication of Ia-positive bone marrow interstitial stem cells in the induction of unresponsiveness to canine renal allografts. AB - The removal from stored autologous host bone marrow of a monocytoid cell population by exposure to methylprednisolone is associated with successful introduction of unresponsiveness to renal allografts in irradiated recipients reconstituted with such treated marrow. The eliminated cells are a prominent component of the canine long bone marrow interstitium and share a number of important properties with dendritic cells (DC), including size and shape; poor or nonadherence to plastic or glass surfaces; negative staining for neutral esterase, acid phosphatase, or peroxidase; nonphagocytic; Ia positive, but negative for IgG or IgM; ability to act as accessory cells in augmenting the intensity of allogeneic mixed-lymphocyte reactions. Both cell types are of bone marrow origin and are susceptible to steroids in vitro. The results suggest that the bone marrow interstitial cells identified in the course of this study may be enriched with populations of canine dendritic cell precursors and dendritic cells at various stages of differentiation. The detection of a receptor site for Helix promatia on the surface of such cells may be of usefulness in their further characterization and in the analysis of their precise role in the modulation of allogeneic unresponsiveness. PMID- 3545502 TI - Distribution and functional analysis of a 120- to 130-kDa T-cell surface antigen. AB - A monoclonal antibody (mAb), SPV-L14, was raised that detected a human T-cell surface antigen with a molecular weight (MW) of 120 kDa on resting and phytohemagglutinin-activated peripheral blood T lymphocytes (PBL). An additional band with a MW of 130 kDa could be precipitated with variable intensities from thymocytes, neoplastic T cells, and CD4+- or CD8+ T-cell clones. Based on their reactivity with SPV-L14 and a mAb directed against CD3, four subpopulations of CD2+ lymphocytes could be detected and their existence was confirmed at the clonal level. The majority (95%) of the CD3+ cells were SPV-L14+, whereas 5% were CD3+, SPV-L14-. Among cloned cell lines CD3-,SPV-L14- and CD3-,SPV-L14+ cells were found to exist. The CD3-,SPV-L14- and CD3-,SPV-L14+ clones were shown to have NK cell activity, indicating that the 120- to 130-kDa antigen is expressed heterogeneously on CD3- NK cell clones. In addition, neoplastic T cells representing these four subpopulations were shown to exist. Although the tissue distribution and the MW of the SPV-L14 target antigen strongly suggest that SPV L14 reacts with an epitope on CD6, the SPV-L14 mAb did not react with resting or activated B cells or with malignant B cells. Blocking studies showed that SPV-L14 inhibited the proliferative response of PBL, induced by anti-CD3 mAb, but that SPV-L14 did not affect the proliferation induced by phytohemagglutinin. These results suggest that the 120- to 130-kDa MW antigen is associated with T-cell proliferation, depending on the mode of activation. PMID- 3545503 TI - Effect of microinjected calcium-calmodulin on mitosis in PtK2 cells. AB - Calcium and calmodulin are believed to play a significant role in the regulation of mitosis, because they are both localized in the mitotic spindle and because they can potentiate microtubule depolymerization in the test tube and in the living cell. It has been hypothesized, specifically, that calcium-saturated calmodulin drives the shortening of the kinetochore microtubules that must occur during prometaphase, when the chromosomes congress to the metaphase plate, and during anaphase A, when the half-spindles shorten. We have examined the role of calmodulin in mitosis by observing the consequences of calmodulin microinjection on the progress of mitosis and morphology of the mitotic spindle in PtK2 cells. We have found that the injection of excess calcium-saturated calmodulin during early prometaphase significantly prolongs the time required for the cell to go into anaphase, and that neither calcium-depleted calmodulin nor buffer alone produce a similar perturbation. Calcium ion alone produces a similar but much smaller retardation of mitosis. Immunofluorescence and fluorescent analogue cytochemical studies of spindle morphology reveal that the immediate (less than 5 min) effect of calcium-saturated calmodulin on prometaphase spindles is a significant shortening of the kinetochore fibers and "interpolar" microtubules but not the astral microtubules. After this perturbation, however, the spindle quickly recovers its normal form. An equivalent transient shortening of the spindle fibers is seen following the injection of calcium chloride solutions but not after the injection of calcium-depleted calmodulin or buffer alone. Taken together, these observations suggest that calcium-saturated calmodulin plays a significant role in the regulation of mitosis, and that this regulatory pathway involves more than spindle fiber shortening. PMID- 3545504 TI - Polymorphic assembly of subtilisin-cleaved tubulin. AB - Limited proteolysis of tubulin with subtilisin results in cleavage of both the alpha and beta subunits, releasing small peptides from the C-terminal ends. At 37 degrees C the digested tubulin assembles into polymorphic structures: microtubules with attached ribbons in the presence of GTP, rings in the presence of GDP, and protofilament spirals in the presence of vinblastine. Undigested tubulin does not assemble under these conditions. Rings and Vinca-induced spiral structures are assembled from undigested tubulin only when microtubule-associated proteins, high Mg2+ concentrations, or polycations are present. Thus, cleavage with subtilisin affects assembly in a manner similar to the addition of these agents. It appears that binding of positively charged substances may act by neutralizing the charge on the highly acidic C-terminal regions of the alpha- and beta-subunits, while cleavage with subtilisin produces the same effect by removing these peptides. Undigested and subtilisin-digested tubulin form sheets of protofilaments in the presence of Zn2+, which indicates that the binding sites for the 2-3 Zn2+ ions necessary to induce sheet formation do not reside in the C terminal regions of the monomers. PMID- 3545505 TI - [Metabolites of benflurone in vivo]. PMID- 3545507 TI - [A project for the scientific-technical development program in the health services]. PMID- 3545508 TI - [Purkinje's year]. PMID- 3545506 TI - [The Spillenberger family of physicians and pharmacists in Levoca]. PMID- 3545509 TI - Microbial mutagenicity studies with (Z)-1,3-dichloropropene. AB - This study has confirmed that the direct mutagenicity previously observed when S. typhimurium TA100 was treated with (Z)-1,3-dichloropropene (DCP) was in fact due to trace impurities. These impurities result from autoxidation of (Z)-1,3-DCP and have now been identified. Both (Z)- and (E)-2-chloro-3-(chloromethyl)oxiranes (DCP oxides) were identified as significant products during this autoxidation. The mutagenic impurities formed by autoxidation were completely removed by adsorption chromatography on silicic acid. (Z)-1,3-DCP purified in this way had no direct-acting mutagenicity towards S. typhimurium TA100. However, (Z)-1,3-DCP undergoes mono-oxygenase-catalysed conversion into bacterial mutagens in the presence of S9 fraction or washed microsomes from rat liver. The glutathione linked conjugation systems of mammalian tissues provided efficient protection against this indirect mutagenic action. However, the low concentration of glutathione in standard bacterial mutagenicity assays limits the glutathione S alkyl transferase-catalysed detoxification of (Z)-1,3-DCP and its primary bioactivation product(s). When the concentration of glutathione was adjusted to the normal physiological concentration, the mono-oxygenase-dependent mutagenic action of (Z)-1,3-DCP was virtually eliminated. These results therefore are consistent with the view that bacterial mutation assays are only qualitative indicators of potential mammalian genotoxicity. PMID- 3545510 TI - Enzyme-linked immunosorbent assay for several mannans. PMID- 3545511 TI - [Nursing of patient having undergone pancreas allotransplantation]. PMID- 3545512 TI - [Prevalence of HBsAg]. PMID- 3545513 TI - [Intestinal localizations of non-Hodgkin's lymphoma (clinical and histopathologic considerations)]. AB - The authors describe two cases of malignant lymphoma localized in the rectum and caecum respectively and, taking into account the data reported in the literature, comment on current classifications and on the latest typing methods, particularly those based on radio-immunological assay. They stress the importance of a uniform clinical classification for diagnostic and therapeutic purposes as well as the increasing amount of interest in these neoplasms, especially in relation to those carcinomas where differential diagnosis does not always prove an easy matter. PMID- 3545514 TI - [Clinico-diagnostic aspects of aggressive angiomyxoma of the pelvis and perineum]. AB - The authors report on a case of aggressive angiomyxoma of the pelvis and perineum in a 46-year-old female patient. After reviewing the cases described in the literature, they examine the clinical characteristics of this rare form of neoplasia, which tends to occur more frequently in patients of female sex and in the young to middle-aged age bracket and is characterized by slow growth, non infiltration of adjacent organs and a tendency to recur owing to incomplete excision. Metastases have never been reported. Failure to recognize the tumor at first approach may be due to the fact that it is easy to confuse it clinically with other more common diseases of the perineum. The authors conclude by advising systematic anatomicopathological identification of all perineal tumors, even when apparently benign. PMID- 3545515 TI - [Benign cysts of the ovary. Homogeneous experience in 22 cases observed in 10 years]. AB - The authors present their experience with benign ovarian cysts based upon a series of 22 cases. Occurrence age displayed 2 peaks neonatal and para-pubertal. Ultrasound and coelioscopic examination would help in the management of such functional cysts where spontaneous regression must be weighted with potential complications. PMID- 3545516 TI - [Primary peritonitis in children. Apropos of 12 case reports]. AB - Primary peritonitis is rare condition in children. Twelve cases in previously healthy children is reported. The diagnosis was made at laparotomy in the absence of intra-abdominal findings, such as intestinal perforation. Organisms was isolated from peritoneal fluid in 7 cases, Staphylococcus aureus in 3, Streptococcus pneumoniae in 2, beta-hemolytic Streptococcus and E. coli in 1. Peritoneal fluid cultures were sterile in 5 cases, Streptococcus pneumoniae was otherwise incriminated in 2 cases. Recovery was rapid with broad-spectrum antibiotic therapy in 11 cases. One death in an infant was related to late intervention. Recent reports indicate an increase of primary peritonitis caused by gram-negative organisms. The prognosis has improved since the use of antibiotics, but its incidence appears unvarying. PMID- 3545517 TI - [Primary pulmonary hemangiopericytoma in children. Apropos of a case]. AB - One case of primary pulmonary hemangiopericytoma in a 4 year child is reported; hemangiopericytoma has been found at any age and at any site, however pulmonary location has never been described before in a child under 10 years. Histology, natural history, prognosis and treatment are briefly discussed. PMID- 3545518 TI - [Radiologic examination of anorectal malformations]. AB - The aim of the radiological exploration of an infant born with an ano-rectal malformation is the definition of the level and the type of the anomaly. At first a lateral abdominal roentgenogram is performed in an head-down position. The relation of the rectal cul-de-sac to the levator ani muscles is determined by its relation to the bony landmarks of the pelvis as reported by Stephens and Cremin. A real time perineal sonography is a useful complement, and permits the recognition of the same landmarks sought for by X-Ray. The research of a perineal or urinary fistula is performed at that time. In a second time, the research of associated malformations, mainly vertebral and urinary, is done. PMID- 3545519 TI - [Functional manometric and electromyographic examination of the normal and pathologic anorectum]. AB - Manometric and electromyographic analysis of anorectal function in terminal gastrointestinal tract malformations is a technique which gives an insight into the specific pathophysiology of anorectal malformations and can be used to follow the clinical evolution and to analyse the maturation phenomena of the lowered colon. It includes the study of spontaneous sigmorecto-anal activity associated with a way of examining the anorectal response to stimuli (adaptation, reaction, relaxation reflexes of the internal anal sphincter, rectal compliance, continence reaction, measure of critical volume and lastly the anorectal profile). This study can be completed by electromyography of striated anorectal sphincter structures. Some values for normal anorectal continence and partial or complete incontinence can be calculated after review of the literature. PMID- 3545520 TI - [Anorectal malformations. Striated muscle plasty]. PMID- 3545521 TI - [Physiopathology of incontinence following treatment of anorectal malformations. Non-surgical treatments]. AB - Attainment of continence after treatment of supra-levatorian ano-rectal malformations is frequently hampered by difficult problems. Cinedefecography and particularly conventional manometry along with myography allow to analyse the different factors involved in incontinence, in connection on the one hand with the type of gut pulled-down, and on the other hand with the sphincteric system. This study allows to propose, under specific circumstances, suitable techniques aiming at modifying either the gut contents, or the properties of the pulled-down bowel, or to reinforce the spincters, particularly with biofeedback rehabilitation techniques. PMID- 3545523 TI - Aspects of cytotoxic drug penetration, with particular reference to anthracyclines. AB - Experimental data, particularly derived from tumour spheroids, indicate that drug penetration barriers may be an important determinant of cytotoxic drug efficacy, even in spheroids of only a few hundred microns in diameter. Clinically, tumour masses of this size would equate with those micrometastases which are the target of adjuvant chemotherapy in a wide range of tumour types. It is apparent, therefore, that even at this relatively early stage of the metastatic process, which ultimately proves to be fatal in many patients, measures aimed at improving drug penetration may prove to be crucial in improving the therapeutic efficacy of cytotoxic agents. PMID- 3545522 TI - Comparative activity of ifosfamide and cyclophosphamide. AB - Antitumor activity (increase in lifespan and cure) was greater for ifosfamide (IFO) in several experimental tumors, some of which were primarily resistant to cyclophosphamide (CYC). IFO has been shown to be active in anthracycline resistant and in adriamycin/cisplatin-resistant sublines of an Ehrlich ascites tumor, as well as in tumor cells primarily resistant to CYC. The few comparative controlled clinical trials available suggest superior single-agent activity of IFO compared with CYC in soft tissue sarcoma and ovarian cancer. Combination chemotherapy with IFO has been effective in second-line treatment of sarcomas, malignant lymphomas, lung cancer, and testicular cancer, most of them pretreated with or refractory to CYC. Although it is difficult to obtain clinical proof that there is no cross-resistance between IFO and CYC, IFO has been shown to be active in multirefractory malignant lymphomas, in small cell lung cancer not responding to adriamycin, vincristine, and etoposide, and in soft tissue and bone sarcomas. Testicular cancer and pancreatic cancer are some of the tumors in which IFO activity is currently being evaluated and in which CYC has so far failed to show sufficient clinical activity. More comparative controlled clinical trials are needed in ovarian cancer, breast cancer, malignant lymphomas, sarcomas and cervical cancer, in which IFO has already shown sufficient single-agent activity. Due to its lower level of cross-resistance with a variety of heterocyclic products, but also with other alkylating agents, in addition to its use in induction chemotherapy, IFO is an important second-line agent in many clinical situations. PMID- 3545525 TI - Urine mutagenicity of steel workers exposed to coke oven emissions. AB - Urine mutagenicity of 19 individuals was investigated at a steel mill. All the subjects worked on the coal processing unit. Urine samples were collected at the end of a working day. Urine samples of two exposed workers were collected at the end of two periods of rest and two periods of working. Mutagens were extracted on XAD-2 resin and tested by the Salmonella microsomal assay and the SOS spot test. Mutagenic potencies of exposed smokers and exposed non-smokers were 8.62 +/- 6.56 and 1.1 +/- 0.48 revertants/mg creatinine respectively with Salmonella typhimurium strain TA98 + S9. Both values were significantly higher than those of unexposed smokers and non-smokers (5.07 +/- 3.33 and 0.47 +/- 0.72 revertants/mg creatinine respectively). The urinary mutagenic potency of the two exposed individuals increased at the end of periods of working (15.97 +/- 2.57 revertants/mg creatinine) and decreased at the end of periods of rest (12.31 +/- 2.45 revertants/mg creatinine). Urinary mutagens were detected with S. typhimurium strain TA100 + S9 to a lesser extent. No direct-acting mutagens were detected by the SOS spot test. Atmospheric benzo[a]pyrene (BaP) were also measured by h.p.l.c. on the coke battery. BaP concentrations ranged between 0.01 and 0.6 microgram/m3 air at the different working sites. Biological monitoring with short-term tests is discussed. PMID- 3545524 TI - Flavone acetic acid (LM 975, NSC 347512). A novel antitumor agent. AB - Flavone acetic acid (FAA) is a synthetic flavonoid compound which has recently begun clinical trials as an antitumor agent based on its striking activity in solid tumor model systems. The pharmacologic behavior of FAA in animals appears to be predictive of both its cytotoxic efficacy and its toxicity to normal tissues (principally the central nervous system and gastrointestinal tract). The design and conduct of phase I studies in man are based upon these principles, with the goal of maximizing their safety and efficacy. PMID- 3545526 TI - Characterization of an inbred strain of the SENCAR mouse that is highly sensitive to phorbol esters. AB - An inbred strain of SENCAR mice was developed that is more sensitive to two-stage skin carcinogenesis protocols than the outbred parental stock. These mice, registered as SSIN/UTSP, were compared to the SENCAR in initiation-promotion protocols using the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) twice weekly for 22 weeks at dose levels of 0.5, 1.0 and 2.0 micrograms. With 0.5 microgram of TPA, the number of papillomas in the SSIN was 3-fold higher than in the SEN-CAR; the tumor incidence was 100 versus 60%, respectively. Similar, although less dramatic, results were found with 1.0 and 2.0 micrograms of TPA. In two-step promotion protocols using TPA twice weekly for 2 weeks and 2 micrograms mezerein twice weekly for 15 weeks the SSIN produced approximately 50% more tumors than the SENCAR at 0.5 microgram of TPA. At 2 micrograms of TPA the tumor response between the two mice was not significantly different. Epidermal hyperplasia was considerably greater in the SSIN at 0.5 microgram of TPA as was ornithine decarboxylase activity. These TPA-sensitive inbred mice should be useful in investigations on the biochemical and genetic factors involved in skin tumor promotion. PMID- 3545527 TI - Marked differences between mutagenicity in Salmonella and tumour-initiating activities of dibenzo[a,e]fluoranthene proximate metabolites; initiation inhibiting activity of norharman. AB - Dibenzofluoranthene-12,13-dihydrodiol (DBF-12,13-DHD) is six times more mutagenic in Salmonella TA100 than dibenzofluoranthene-3,4-dihydrodiol (DBF-3,4-DHD). However, these two major dibenzo[a,e]fluoranthene (DBF) proximate metabolites, which are immediate precursors of the corresponding diolepoxides, showed on an equimolar basis nearly identical initiation activities on mouse skin; they induced three times more papillomas than the parent hydrocarbon. On the other hand the epithelioma initiation capacities, i.e. the number of papillomas progressing to malignant tumours, of DBF or the two dibenzofluoranthene dihydrodiols were equivalent. Norharman, a putative vicinal diolepoxidation inhibitor in DBF metabolism when administered topically together with the initiation dose (100 nmol), strongly inhibited the induction of tumours by DBF 3,4-DHD and DBF. The relationship between in vitro mutagenic activity in Salmonella and the carcinogenicity of DBF metabolites in mice appears to be qualitative rather than quantitative. PMID- 3545528 TI - Effect of Escherichia coli lipopolysaccharide on the microviscosity of liver plasma membranes and hepatocyte suspensions and monolayers. AB - The fluorescence probe 1,6-diphenylhexa-1,3,5-triene (DPH) was used for monitoring structural perturbations induced by lipopolysaccharide (LPS) of Escherichia coli (0111:B4) in plasma membranes of rat liver. Changes in microviscosity were observed in plasma membrane preparations from control rats after treatment with LPS and in plasma membrane preparations from liver perfused with LPS. In both systems fluorescence polarization was measured from which microviscosity was calculated. This parameter increases with LPS treatment. From temperature dependence studies was inferred that LPS interaction with plasma membrane preparations induces an increase of both the polarization term (r0/r-1) 1 and flow activation energy (delta E). Addition of LPS to hepatocyte suspensions also induces an increase on microviscosity and a delay in the fall of microviscosity induced by a temperature rise in hepatocyte monolayers grown on microcover slides. These data suggest that LPS interaction can be attributed to its binding to membrane hydrophobic regions in a non-specific manner. PMID- 3545530 TI - Protein and energy metabolism in liver tissue following intravenous infusion of live E. coli bacteria in rats. AB - In the present study protein synthesis and energy level in liver tissue were studied in bacteremic rats following intravenous infusion of 8 +/- 4 X 10(9) live E. coli bacteria and in control animals receiving a corresponding infusion of sterile saline. For the study of protein synthesis, liver slices were incubated in a medium containing 14C-leucine and incorporation rate of amino acid into protein was determined. Hepatic concentrations of ATP, ADP, and AMP were measured and energy charge (EC) was calculated. Twenty-four hours after infusion of E. coli, hepatic protein synthesis rate was 55% higher than in control animals. Liver weight and hepatic protein content were also increased in bacteremic animals. There were no significant differences in adenine nucleotide levels or EC in liver tissue between control and bacteremic animals. Since impairment of various other liver functions has been reported during sepsis, the present results suggest that hepatic protein synthesis has high priority in this condition. PMID- 3545529 TI - Protection against disseminated intravascular coagulation and death by antithrombin-III in the Escherichia coli endotoxemic rat. AB - Gram-negative septic shock remains a major clinical problem. One frequently encountered complication of sepsis is disseminated intravascular coagulation (DIC). The present study was to determine in an Escherichia coli endotoxemia awake rat model the efficacy of antithrombin-III (AT-III) prophylaxis and to explore the role of DIC in the pathogenesis of endotoxemia. We demonstrated that DIC occurs very early, before the appearance of detectable serious abnormalities in cardiovascular, metabolic, and biochemical variables indicative of organ damage or dysfunction; AT-III prophylaxis significantly ameliorates DIC, as evidenced by completely preventing the fall in plasma fibrinogen concentration and significantly limiting the increases in prothrombin time and activated partial thromboplastin time after 4 hours of endotoxemia; and AT-III prophylaxis dramatically increases permanent survival. Results of this study suggest that AT III prophylaxis is very protective above a threshold dosage in an endotoxemic rat model and that protection is in part due to ameliorating DIC. Our data also suggest that DIC occurs very early during endotoxemia and may in part be responsible for the pathogenesis of endotoxemia in the rat. We conclude that AT III prophylaxis may be efficacious in conditions of impending DIC, such as gram negative septicemia/endotoxemia. PMID- 3545532 TI - Induction of polyploidy in cultures of neonatal rat aortic smooth muscle cells. AB - Arterial smooth muscle cells become tetraploid with age and hypertension. To further study this phenomenon, neonatal rat aortic smooth muscle cells were placed in cell culture and studied over time. Numerous cells with tetraploid and even octaploid DNA content appeared beginning in primary cultures. These increases in DNA content per cell were determined by quantitative fluorescence microscopy and flow cytometry, and true polyploidy was confirmed by chromosome counts. In contrast, cells from adult rat aortas failed to produce significant polyploid cells over time in culture. In vitro culture of neonatal aortic cells may therefore be a model system for studying the initiation of polyploidy in arterial smooth muscle. PMID- 3545533 TI - Prostaglandins contribute to cardiovascular reflexes evoked by static muscular contraction. AB - The purpose of this study was to determine the contribution of prostaglandins to the reflex cardiovascular responses induced by static contraction of the hind limb in cats, i.e., the exercise reflex. To accomplish this, the cardiovascular responses to hind limb contraction induced by electrical stimulation of spinal cord ventral roots L6-7 and S1 were compared before and after inhibition of prostaglandin synthesis (indomethacin, 2-6 mg/kg i.v., n = 5, or sodium meclofenamate, 2-6 mg/kg i.v., n = 5) or after injection of prostaglandin E2 into the hind limb arterial blood supply. Treatment with indomethacin attenuated the contraction-induced increase in mean arterial pressure and left ventricular dP/dt by 76% and 86%, respectively. Heart rate and average developed triceps surae muscle tension were unchanged. After administering sodium meclofenamate, the reflex response was attenuated to a similar degree. In the indomethacin-treated animals, injection of exogenous prostaglandin E2 (PGE2) partially restored the pressor and myocardial contractile responses. In 6 animals, treatment with exogenous PGE2 without prior inhibition of prostaglandin synthesis did not significantly augment the contraction-induced cardiovascular response. Using the radioactive microsphere technique, we measured skeletal muscle blood flow during contraction before and after treatment with indomethacin (n = 6) to determine if an indomethacin-induced alteration in blood flow could account for the attenuated contraction-induced cardiovascular response. Blood flow during static muscle contraction was not significantly altered by indomethacin. We conclude that prostaglandins contribute to the exercise reflex through an action on afferent nerve endings rather than through a regional vascular effect. PMID- 3545531 TI - Regulation of large coronary arteries. AB - The majority of studies on the control of coronary artery vasoactivity have examined changes in coronary blood flow and coronary vascular resistance, indices that primarily reflect regulation of small arterioles and precapillary vessels. With the emergence of coronary artery vasospasm as a significant cause of angina pectoris, myocardial infarction, and sudden death, the control of large coronary artery caliber has assumed more significance. It is clear that resistance coronary vessels and large coronary arteries differ in response to both pharmacologic and physiologic stimuli. Vasodilation of large coronary arteries may occur by direct action of agents on the arterial smooth muscle or by the indirect action of receptor occupation, changes in blood flow, or liberation of endothelial factors. These indirect factors appear to contribute also to responses to agents that constrict coronary smooth muscle directly or through the autonomic nervous system. Furthermore, the mechanisms responsible for control of large coronary vessels in the normal circulation are likely to be profoundly different from those in the presence of diseased vessels. For example, several factors associated with coronary artery disease--elevated plasma cholesterol levels, endothelial disruption, atherosclerosis, vascular stenosis, and aggregated platelets--all have important actions on the control of large coronary arteries. PMID- 3545534 TI - Nonsurgical closure of patent ductus arteriosus: clinical application of the Rashkind PDA Occluder System. AB - The first successful application of a transcatheter closure technique for patent ductus arteriosus (PDA) suitable for use in infants and children was performed by us in 1977. Since that time, there has been continued improvement and simplification of the equipment as well as in the implantation technique. Following a Food and Drug Administration protocol, a multicenter study was conducted to test the safety and effectiveness of this interventional method. The clinical results from three major regional test centers (Philadelphia, Houston, and New Haven) are presented. One hundred forty-six patients from a test population of 156 were treated for PDA with use of the Rashkind PDA Occluder Systems. Successful closure was accomplished in 94 (66%) of the total cases. Ten patients (7%) retained residual ductal murmurs despite correct placement of the occlusion devices; five additional patients (3%) were considered failures due to the presence of abnormal Doppler flow patterns after the procedure. Postrelease embolizations occurred in 19 (15%) instances. One patient required emergency surgical intervention after attempted retrieval of an embolized occluder. With the improvements in the manufacturing of the double-disk occluder systems as well as the perfection of the transvenous delivery technique, the incidences of closure failure and postrelease complications have decreased. Since January 1984, 78% of all transcatheter closure attempts were successful, with 10% embolization. PMID- 3545536 TI - Enzyme immunoassay method for comprehensive drug screening in micro-samples of urine. AB - We adapted the reagents from 11 different enzyme-multiplied immunoassay technique (EMIT; Syva Co., Palo Alto, CA 94304) drug-detection kits for use in a centrifugal analyzer. The antibody reagents were mixed into a single dilute solution, and the enzyme-labeled drug derivatives were combined similarly (Mixed EMIT reagents), for use in testing urine samples for the presence of multiple drugs. The assay, a rapid comprehensive drug-screening technique, requires 100 microL of sample and is capable of testing seven samples, in duplicate, simultaneously, in less than 10 min. Clinical evaluation (n = 325) by comparison with thin-layer chromatography (TLC) had the following results: 230 samples were negative by TLC and Mixed EMIT, 77 samples were positive by TLC and Mixed EMIT, 16 samples were negative by TLC and positive by Mixed EMIT, and two samples were positive by TLC and negative by Mixed EMIT. PMID- 3545535 TI - Differential structural responses of small resistance vessels to antihypertensive therapy. AB - Regression of left ventricular hypertrophy after control of blood pressure has been documented with some antihypertensive agents but not with others. To determine whether similar differences in regression of wall thickening also occur in resistance vessels during treatment, matched groups of spontaneously hypertensive rats (SHR) were treated for 12 weeks with either hydralazine (H) or captopril and hydrochlorothiazide (C-D) and they were compared with untreated SHR and Wistar-Kyoto rats (WKY). Perfusion pressure was then determined in the hindlimbs of pithed rats under conditions of constant blood flow (4.0 ml/min) and maximal vasodilation (hemodilution to 22% hematocrit combined with continuous nitroprusside and papaverine infusion). This perfusion pressure, which has been validated as an index of thickening (hypertrophy) of resistance vessels walls, averaged 26.8 +/- 0.4(SE) mm Hg in untreated WKY (n = 12) and 37.6 +/- 0.4 mm Hg in untreated SHR (n = 11) (p less than .01). Treatment with H or C-D controlled blood pressure equally in SHR, but the two drugs had significantly different effects on both left ventricular hypertrophy and resistance vessels. Perfusion pressure was reduced from 37.6 +/- 0.4 mm Hg to 34.0 +/- 0.5 mm Hg (p less than .01) with C-D but only to 36.5 +/- 0.5 mm Hg with H (NS). Left ventricular weight was significantly reduced by C-D (2.02 +/- 0.02 vs 2.63 +/- 0.05 mg/g, p less than .01) but only to 2.44 +/- 0.05 mg/g by H.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545537 TI - Endogenous digoxin-like immunoreactive factors eliminated from serum samples by hydrophobic silica-gel extraction and enzyme immunoassay. AB - Elimination of endogenous digoxin-like immunoreactive factors (DLIF) that interfere with accurate measurement of digoxin requires use of a highly specific anti-digoxin antibody, or that DLIF be separated from digoxin before immunoassay. Several commercial digoxin-assay kits include a step for separating serum proteins and other substances from digoxin before immunoassay. We tested six different immunoassay methods (some having pretreatment steps) for their ability to detect DLIF in serum from patients in renal failure, pregnant women, and neonates, all of whom were not taking digoxin. Extracting digoxin on a column of derivatized silicagel eliminated detectable DLIF from serum as measured by enzyme immunoassay (EMIT; Syva Co.), but recovery of added digoxin was quantitative. In contrast, protein precipitation with 5-sulfosalicylic acid left significant amounts of DLIF in samples, most probably because the procedure (TDx assay; Abbott Labs.) disrupted protein-DLIF binding. A glass-bead radioimmunoassay (Immophase; Corning Medical) had the most digoxin-specific antisera. By preparative silica-gel-chromatography of serum we could eliminate or significantly minimize inaccurate digoxin measurements attributable to endogenous DLIF. PMID- 3545539 TI - Removal of interference by immunoglobulins in an enzyme-amplified immunoassay for thyrotopin in serum. PMID- 3545538 TI - Dilution of plasma with Tris buffer increases measured catecholamines in plasma. AB - We investigated the effects of dilution of plasma samples on the measured concentrations of catecholamines. Diluting samples of human plasma 10-, 50-, and 100-fold with Tris buffer (100 mol/L, pH 8.6) improved analytical recovery of internal standards, suggesting that it decreases the commonly observed inhibition of methylation in radioenzymatic assays of catecholamines in plasma. However, the dilution is not associated with a proportional decrease in counted radioactivity. This extra amount of radioactivity, which is unlikely to be nonspecific in origin, accounts for a significant increase in the calculated catecholamine concentration. Tentatively, we suggest that Tris buffer releases both catecholamines and conjugated catecholamines bound to some unidentified low molecular-mass component of plasma. PMID- 3545540 TI - Simple, direct coated-tube enzyme immunoassay of cortisol in serum. PMID- 3545541 TI - Distribution of cyclosporine in blood of a renal-transplant recipient with type V hyperlipoproteinemia. AB - A patient with severe type V hyperlipoproteinemia and chronic end-stage renal disease received a renal transplant and therapy with cyclosporine. Concentrations of the drug in plasma as determined by liquid chromatography appeared extraordinarily high for the dose ingested. When we measured the drug in the plasma, plasma cleared by ultracentrifugation, leukocytes, erythrocytes, and whole blood, we found that the high concentrations of cyclosporine were associated with the chylomicrons that always were present in this patient's blood. Cyclosporine added directly to this patient's plasma was less associated with the plasma lipids. Isolated lymphocytes and kidney slices incubated with plasma from this patient bound no more drug than when incubated with nonhyperlipemic plasma containing cyclosporine at a normal therapeutic concentration. We conclude that the cyclosporine associated with the chylomicrons in this patient was not biologically available to either lymphocytes or kidney tissue. We strongly recommend the use of chylomicron-cleared plasma for therapeutic drug monitoring of cyclosporine in type V hyperlipoproteinemic patients. PMID- 3545542 TI - Vaginal preparation with povidone-iodine before abdominal hysterectomy. A comparison with antibiotic prophylaxis. AB - Two groups of women were prepared before total abdominal hysterectomy. The first by povidone-iodine tampons that remained in the vagina until the end of the operation, the second group by administration of a prophylactic antibiotic. We found statistically significant decreases both in infectious morbidity and in the percentage of positive cultures from the cervix and vagina, at the time of the operation in the povidone-iodine group as compared with the antibiotic group. Therefore, it is our impression that prophylactic antibiotic therapy for patients undergoing abdominal hysterectomy should be reserved for the patient with compromised defence mechanisms if it is used at all, and recommend local preparation of the vagina with povidone-iodine as an effective alternative. PMID- 3545544 TI - Maxillary growth following total septal resection in correction of orbital hypertelorism. AB - A rapid survey of eight cases with orbital hypertelorism did not reveal any evident change in maxillary displacement during facial growth following resection of nasal septum and medial displacement of orbital cavities. Accurate analysis of four cases according to the Ricketts long-term growth forecast showed a reduction of growth in the region of anterior nasal spine and only in the posteroanterior direction. This is not necessarily due to the absence of nasal septum. These patients have such severe deformities and the surgical procedure is so extensive that many factors can be responsible for deficient premaxillary growth. Further studies are needed, particularly in patients who, since 1975, have had the same operative method, but without septal resection, to know whether this more conservative procedure has changed the posteroanterior growth of the premaxilla. However, a nasal bone graft has a good prognosis, even when performed in children. PMID- 3545543 TI - The measurement of form: beyond biometrics. Sausages and stars, dumbbells and doughnuts: peculiar views of anatomical structures. PMID- 3545545 TI - Results of the Tessier integral procedure for correction of Treacher Collins syndrome. AB - A new procedure is proposed for correction of the malformations of severe cases of Treacher Collins syndrome in the areas of the maxilla, mandible, and orbit. The operation essentially consists of a rotation of the midfacial segment around a transverse axis at the frontonasal angle. The midface is rotated forward anteriorly and downward posteriorly. It is stabilized by cranial grafts impinged into the temporal bone and the maxilla. The mandible is lengthened either by V shape osteotomy or bone grafting of the ramus. The mandible is fixed in an overjet class III dental occlusion. A posterior bite wafer is maintained for 2 months. The construction of the orbital cavity is completed with cranial bone grafts. The Tessier integral procedure for Treacher Collins syndrome has been done in one stage in six patients and in two stages in five patients. Sufficient data were available for analysis of only four patients. PMID- 3545546 TI - Correction of hemifacial microsomia in the growing child: a follow-up study. AB - Based on longitudinal observation of more than 80 patients, we concluded that mandibular hypoplasia is the earliest skeletal manifestation of hemifacial microsomia. The clinical defect becomes worse with time as a result of continued asymmetric growth and progressive secondary deformation of the midface. We hypothesize that midface growth is restricted by the hypoplastic mandible. Therefore, early elongation of the mandible should result in a more symmetrical growth pattern by eliminating mandibular restriction and creating a space for vertical midface growth. PMID- 3545547 TI - Factors affecting long-term results in hemifacial microsomia. AB - Mandibular malformations in patients with hemifacial microsomia are described and six phases of treatment outlined. Growth of the malformed mandibular ramus in response to functional appliance treatment was studied in 15 subjects with type I mandibular malformations. It was found that length increase of the affected side during the treatment period was not significantly different from the growth of the other side. Changes in length of the affected side of the mandible following surgical repositioning and bonegrafting was assessed in 25 consecutive cases. In 10 of these subjects, the surgical procedure was done during the growth period and in 15 of them after growth had ceased. In the still growing subjects, there was additional length increase of the reconstructed mandibular ramus, but on an average, less than on the side which had normal temporomandibular joint structures. In seven cases, the length increase was similar on the two sides ( +/ 2 mm) or greater on the affected side, and the established symmetry was maintained. In three subjects, there was recurrence of asymmetry, which in two individuals was corrected by a second surgical lengthening of the mandible. There was minimal loss in length of the reconstructed mandibular ramus in the nongrowing subjects and the established mandibular position was maintained. PMID- 3545548 TI - Macrophage activation. Potential for cancer therapy. PMID- 3545551 TI - Renal transplantation. An analysis of logistical and medical factors affecting cadaver organ availability. PMID- 3545549 TI - FLow cytometry quantitation of peripheral blood T-cell subsets as a monitor of renal allograft rejection. PMID- 3545550 TI - The immunopathology of pemphigus vulgaris: recent advances. PMID- 3545552 TI - Immunotyping malignant lymphomas. A boon to diagnosis. PMID- 3545553 TI - Radiologic evaluation of the asymptomatic carotid bruit. PMID- 3545555 TI - Water and exchangeable sodium in Goldblatt two-kidney, two-clip hypertensive rats. AB - Exchangeable 22Na (ExNa), total body water (TBW) and the inulin space (InSp) were determined in two-kidney, two-clip (2K-2C) hypertensive and sham operated (normotensive) control rats 6-8 weeks after surgery. TBW (ml/kg lean body weight) was the same in hypertensive and sham rats. In contrast, ExNa (mEq/kglbw) and InSp (ml/kglbw) significantly increased (p less than 0.01) in rats whose hypertension did not exceed 170 mmHg. Consequently, sham, moderate hypertensive (less than 170 mmHg) and severe hypertensive (less than 170 mmHg) animals showed equal TBW but differed in body water distribution in that moderately hypertensive animals displayed a redistribution of water in favor of the extracellular space. PMID- 3545554 TI - Home blood pressure recording. AB - Blood pressure is an inherently variable phenomenon. In addition to this the level rises in the clinical setting; a response which is extremely variable. Problems therefore arise in the diagnosis and treatment of hypertension. Studies have shown that blood pressure can reliably be measured at home either with a stationary or ambulatory apparatus. The readings which are reproducible are generally lower than those obtained in the clinic. Ambulatory recordings are a more reliable guide to prognosis and to the response to hypotensive agents. Home recordings should therefore be more widely used in diagnosis and treatment of the disorder. PMID- 3545556 TI - Effect of renal denervation on the development of cellophane-wrap hypertension in rabbits. AB - The development of hypertension in rabbits with bilateral cellophane wrapping of the kidneys was studied in animals with and without surgical denervation of the kidneys. Mean arterial pressure was measured before and 14 and 28 days after surgery. After 14 and 28 days of wrapping, mean arterial pressure had increased 12 +/- 3 mmHg and 31 +/- 3 mmHg in rabbits with innervated kidneys and 7 +/- 2 mmHg and 26 +/- 2 mmHg in rabbits with denervated kidneys, respectively. The increases in arterial pressure were significantly less in the denervated animals. In sham wrap animals, renal denervation also resulted in significantly lower arterial pressure than in sham wrap+sham denervated rabbits. Noradrenaline concentration of denervated kidneys averaged only 4% of that measured in kidneys subjected to sham denervation. The results show that renal denervation slightly attenuated the degree of hypertension developed following renal wrapping. Since renal denervation produced a similar small decrease in arterial pressure in normotensive rabbits it is suggested that the effect is non-specific and probably due to loss of efferent renal sympathetic nerves. PMID- 3545557 TI - Psychosocial aspects of head and neck cancer--a review of the literature. AB - This study is a systematic analysis of the literature on psychosocial aspects in head and neck cancer patients. Patients with head and neck cancer experience a variety of physical as well as psychosocial problems. Physical problems include swallowing or chewing, speech and physical appearance. Psychosocial problems include anxiety, depression, loss of self-esteem and uncertainty about the future. Because of these problems, isolation from friends typically occurs, re employment is difficult, and there are social and sexual tensions within families. Information and support by professionals, partners and/or fellow patients are related to positive rehabilitation outcomes such as the acquisition of speech, increases in constructive social functioning and decreases in depression. PMID- 3545558 TI - Intestinal gas formation and the use of breath measurements to monitor the influence of diet and disease. AB - With the development of sophisticated physiological and biochemical analytical techniques and intestinal gas analysis, both direct, e.g. Argon washout and indirect, e.g. breath measurements of H2 and labelled CO2 derived from intestinal metabolism, greater understanding of the influence of diet on intestinal gas production and the development of diagnostic procedures for identifying causes of malabsorption have evolved. The use of stable isotopes and different probe molecules will see even greater developments in this field in the years ahead. PMID- 3545559 TI - Eating disorders: a review of recent research. PMID- 3545560 TI - Spontaneous hypochlorhydria in man: possible causes and consequences. AB - There have been many reports of the development of achlorhydria in individuals and in groups of subjects with previously normal levels of gastric acid secretion. The evidence that this phenomenon is due to an infective agent has been considered. Retrospective identification of CLO in gastric mucosal biopsies from some of these patients is an interesting observation, but does not conclusively prove a causal relationship. The exact significance of CLO remains speculative at present; there is more evidence to suggest that it plays a role in gastritis than in peptic ulceration. Ongoing research in this area may have major consequences for the medical treatment of gastritis, 'non-ulcer dyspepsia' and perhaps also for peptic ulcer disease. PMID- 3545561 TI - Bile acids, ornithine decarboxylase, and cell proliferation in colon cancer: a review. AB - Cell proliferation has an important role in carcinogenesis. Increased ornithine decarboxylase (ODC) activity with resulting polyamine synthesis is a phenomenon common to cells undergoing rapid proliferation and to models of tumor promotion. In colon cancer, bile acids are considered to be important tumor promoters. Inferential data suggest that bile acids can increase ODC activity and stimulate or alter cell proliferation in the large bowel. These changes may underlie tumor promotion by bile acids. Confirmation of this relationship will solidify this concept and build a framework for understanding the mechanism of bile acid promotion in colon carcinogenesis. PMID- 3545562 TI - Hormone-producing tumours of the gut. PMID- 3545563 TI - Intestinal permeability: clinical correlates. PMID- 3545564 TI - Microflora of the biliary tree and liver--clinical correlates. AB - Microbiologic aspects of hepatobiliary tracts are reviewed. The gallbladder, the common duct and the liver are discussed separately. Special attention is paid to bacteriologic sampling technique. Factors associated with bactibilia are surveyed. The relation between biliary bacteria and stone formation is evaluated. The etiology of acute calculous and acalculous cholecystitis, cholangitis and pyogenic liver abscess is discussed from a microbiological point of view. The importance of new imaging techniques, such as ultrasound, radionuclide scanning and computerized tomography, in the diagnosis and treatment of biliary obstruction or hepatic abscess is recognized. The type of bacteria and their incidence in bile was strongly associated with the underlying condition and various host factors. The flora in acute cholecystitis closely resembled that of the small intestine, while cholangitis and hepatic abscess specimens grew species often found in the colon. In addition, 'microaerophilic streptococci' were especially abundant in hepatic abscess. Nonetheless, coliforms predominated at all loci. Depending on selection criteria of the study population, bacteria of biliary origin played varying roles in the development of postoperative sepsis. Principles of perioperative antibiotic prophylaxis and treatment of manifest infection are outlined. PMID- 3545565 TI - Gustatory sequelae of alimentary disorders. AB - Disorders in different regions of the alimentary tract have been associated with alterations in gustatory function. Current understanding of mechanisms underlying the taste disturbances and their impact on the physical and emotional well-being of patients is incomplete. Indeed, in most instances, present knowledge remains at a descriptive level. Accumulating evidence that profound interactions occur between the sense of taste and alimentary function poses a challenge to apply this knowledge in the clinic setting. PMID- 3545566 TI - Food intolerance and gastrointestinal disease in infancy: personal practice. PMID- 3545568 TI - Primary biliary cirrhosis. PMID- 3545567 TI - Gastric acid and bicarbonate secretion in man. PMID- 3545569 TI - The LeVeen shunt: mechanisms of action, indications and contraindications to its use. AB - In summary, PVS has potentially a wide variety of indications. However, it is important to remember, as described in detail in this review, that this technically rather simple procedure may result in major complications. Thus, the clinician considering to employ PVS must be fully cognizant of its limitations so that it is wisely used and not abused. PMID- 3545570 TI - Combined short contact crude coal tar and dithranol therapy for psoriasis. PMID- 3545571 TI - Circulating antibodies to gliadin subfractions in dermatitis herpetiformis and linear IgA dermatosis of adults and children. PMID- 3545573 TI - Dense deposit disease: its possible pathogenesis suggested by an observation of a patient. AB - A girl, aged 8, was admitted to a hospital in a state of nephrotic syndrome of one year's duration. The renal biopsy showed mesangial and endocapillary proliferations with lobulation. Dense deposit was not demonstrated by electron microscopy, but lamellation of the lamina densa was found in most of the capillary loops. Her condition was improved by steroid treatment in a few months, but moderate proteinuria persisted. Five and half years later, follow-up biopsy showed typical pathological features of dense deposit disease. It is suggested that the lamellation of the lamina densa in the first biopsy could be related to the dense alteration of glomerular basement membrane in the second biopsy. PMID- 3545572 TI - Preparation and properties of antigen 60 from Mycobacterium bovis BCG. AB - Antigen 60 (A60) is the main thermostable immunogen of both 'old tuberculin' (OT) and 'purified protein derivative' (PPD), known reagents for cutaneous tests in tuberculosis. It is recognized by bidimensional immunoelectrophoresis with anti BCG antiserum, where it appears as the less mobile component. A60 was prepared from the cytoplasm of Mycobacterium bovis BCG, and purified by exclusion gel chromatography and lectin affinity chromatography. Labelled A60 was obtained by radioiodination and used for a radioimmunoassay. Composition of A60 was explored by use of organic solvents, chemicals and enzymes. It contained two fractions of free and bound lipids, as well as protein and polysaccharide moieties. After removal of both free and bound lipid fractions, the core still retained the ability to form immunoprecipitinogen lines with anti-BCG antiserum. The lipopolysaccharide and lipo-protein moieties of A60, as well as the free lipid fraction, were also complexed by antibodies. It is concluded that A60 is a lipopolysaccharide-protein complex of 10(6) to 10(7) daltons, which is a major immunogenic component of mycobacterial cytoplasm. The detailed structure of this antigen, its immunological properties, and its use for an ELISA type immunoassay for tuberculosis are described in two other publications. PMID- 3545574 TI - Spontaneous bilateral rupture of the quadriceps tendon in uremia and kidney transplantation. PMID- 3545576 TI - Profiles in cardiology. Irvine H. Page. PMID- 3545575 TI - QRS complex recovery during one year after acute myocardial infarction. AB - The recovery of the ECG signs of anterior myocardial infarction has been studied in 70 patients. A significant increase in R-wave amplitude and decrease in Q-wave amplitude on 24-lead precordial mapping was observed during one year after infarction. Patients with lower initial heart rate showed a greater recovery of R and Q-wave amplitudes, as did patients with smaller infarcts, as assessed by peak heat-stable lactate dehydrogenase (LDH). PMID- 3545577 TI - Diltiazem and propranolol combination for the treatment of chronic stable angina pectoris. AB - To examine the benefits and risks of combined diltiazem and propranolol therapy, 23 patients who had completed a double-blind placebo-controlled cross-over comparison between diltiazem and propranolol and who continued to develop angina despite treatment were studied. The patients received the previous dose of diltiazem (180 or 360 mg/day) combined with propranolol 120 mg daily for 4 weeks and if they still developed angina on exercise testing, they went on to propranolol 240 mg daily for a further 4 weeks. Efficacy and safety were evaluated by computer-assisted maximal treadmill tests, ambulatory heart rate monitoring, and resting systolic time intervals at the end of each 4-week treatment period. Low-dose combination therapy abolished treadmill angina in 6 patients, but 2 patients had to be withdrawn. The high-dose combination abolished treadmill angina in 5 of 15 patients. The exercise time and 1-mm ST depression time increased with each increment of combination therapy in patients on both doses of diltiazem. The resting, maximal, and ambulatory heart rates progressively decreased with each increment of combined therapy. Left ventricular function, as evaluated clinically and by the systolic time intervals, was not impaired, but severe sinus bradycardia (heart rate less than 40 beats/min) appeared in 3 patients. Two died during 6 months of follow-up. Only 11 of the 23 patients completed 6 months of combined therapy without an adverse reaction. Although combined diltiazem and propranolol therapy relieved angina and increased exercise tolerance in patients refractory to single drug therapy, it should be used with caution in such patients, since bradycardia can pose serious problems. PMID- 3545578 TI - Jean George Bachmann. PMID- 3545579 TI - Serum lipoproteins during antihypertensive therapy with beta blockers and diuretics: a controlled long-term comparative trial. AB - The influence of hydrochlorothiazide and atenolol on serum lipoproteins was investigated in a randomized, prospective study on 68 men with essential hypertension. Cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDH) cholesterol, triglycerides, and the apolipoproteins AI and B were followed up to 42 months after starting therapy. Following atenolol serum (HDL) cholesterol decreased and serum triglycerides increased significantly (p less than 0.01) from 6 to 42 months. After hydrochlorothiazide serum triglycerides, LDL cholesterol and total cholesterol all increased significantly (p less than 0.01) from 12 to 42 months. The changes were more pronounced under higher doses with beta blockade, but not with diuretics. Thus, both atenolol and hydrochlorothiazide have adverse but different effects on serum lipoproteins after long-term administration. Continuing investigation is necessary to determine whether these side effects decrease the benefit of blood pressure reduction in patients with hypertension. PMID- 3545580 TI - Measurement of quality of life in end-stage renal disease: the time trade-off approach. AB - The quality of life of patients with end-stage renal disease was estimated using the time trade-off technique. The sample included 103 transplant, 60 hospital hemodialysis, 57 home/self-care, and 52 continuous ambulatory peritoneal dialysis patients. Test-retest reliability was high: intra-class correlation coefficient 0.81 (p less than 0.001). The correlations of the time trade-off with the Spitzer Quality of Life index and a visual analogue scale completed by the nephrologists, nurses, friends/relatives, and the patient were positive and statistically significant, but still relatively low (r = 0.22-0.43; p less than 0.01). The time trade-off demonstrated evidence for discriminative construct validity by ordering treatment groups according to a priori prediction. The mean time trade-off values and standard deviations (where death is 0 and full health is 1) were 0.43 (0.26) for hospital hemodialysis 0.49 (0.23) for home/self-care hemodialysis, 0.56 (0.29) for continuous ambulatory peritoneal dialysis, and 0.84 (0.24) for transplant. Analysis of variance showed transplant to be different from all other groups (p less than 0.001) with age, sex, time with end-stage renal disease, and work status making no significant independent contribution. The partial correlation coefficients between time trade-off score and items in the physical, social, and emotional functioning sub-scales of the Rand questionnaire showed that physical functioning was far more important than social or emotional functioning. The time trade-off is reliable, demonstrates evidence for validity, and suggests that the quality of life for patients with end-stage renal disease is much poorer than that reported previously. PMID- 3545581 TI - Medicine and the two cultures: science and humanism in medicine. PMID- 3545582 TI - The microbiology of premature rupture of the membranes. AB - The foregoing discussions bring to mind several salient facts: Although numerous barriers to infection exist, this aspect is understood incompletely. Conclusions on the pathogenicity or nonpathogenicity of certain organisms are often made from studies with very small numbers of patients, or in very specific patient populations. When such entities as low birth weight, premature labor, and PROM, which are all obviously related to some extent, are studied, very complicated analyses on large numbers of patients are required. Most of the organisms discussed are considered to be sexually transmitted. Because STDs are generally recognized to travel together in the same patient populations, the statistics necessary to separate one organism from another are complex indeed. The previous discussion notwithstanding, it is extremely difficult to form a solid conclusion about relation of these organisms to PROM with confidence. Many more patients need to be studied through many more pregnancies. In addition, differences among population subgroups make extrapolation extremely difficult. Currently the Louisiana State University is participating in a large, multicenter, collaborative study under the auspices of the National Institutes of Health. This study should provide an adequate data base concerning most of the isolates discussed and potential adverse outcomes of pregnancy. Then definitive statements may be made regarding both the screening of pregnant women and initiation of selective therapy. Specific management recommendations are discussed by Nagey and Saller in this symposium. PMID- 3545583 TI - Etiology of preterm premature rupture of the membranes. PMID- 3545584 TI - Genetic aspects of premature rupture of the membranes. PMID- 3545586 TI - Diagnosis of chorioamnionitis. PMID- 3545585 TI - Fetal and neonatal outcomes associated with premature rupture of the membranes. PMID- 3545587 TI - An analysis of the decisions in the management of premature rupture of the membranes. AB - The management of preterm PROM is a complex problem best approached as a number of simple problems to be solved simultaneously. As new information surfaces, the decisions presented in this article can be reevaluated and a new protocol similar to that in Figure 1 developed. On admission of the patient a fetal monitor is placed and intravenous hydration begun. A complete history and physical examination allow accurate estimation of gestational age and diagnosis of ruptured membranes. Any contraindications to tocolysis can be uncovered at this time. If the patient is a candidate for tocolysis, if there are no signs of chorioamnionitis, if there is no fetal distress, and if no contraindications are occurring, then tocolysis may begin. Betamethasone may then be given, (though its use in PROM is not advised), and surveillance for signs of chorioamnionitis may begin. The patient is seen twice daily for abdominal examination. The white blood count is measured at least daily, and maternal vital signs and fetal heart rate are determined every 4 hours. Once signs of chorioamnionitis occur or labor begins (perhaps again) more than 48 hours after admission, then delivery is allowed. If the presentation is vertex, then vaginal delivery is allowed in the absence of fetal distress. Under any other circumstances, abdominal delivery is accomplished. If PROM occurs outside a hospital equipped with a regional intensive care nursery, and if maternal transport can be safely performed, then the mother is transported to a regional center. No digital cervical examination is to be performed until delivery is inevitable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545588 TI - Prevention of preterm labor and premature rupture of the membranes. AB - Preterm delivery is currently the leading cause of perinatal morbidity and mortality. PROM is the most common easily identifiable cause of preterm delivery, present in 20-30% of preterm births. The conflicting results of success in prematurity prevention programs obtained by different investigators probably reflect the populations that were studied. Meis and colleagues divided the etiologies of low birth weight into four categories: 1) Low birth weight in infants greater than 37 weeks' gestation, 2) PROM, 3) birth weight caused by medical complications, and 4) idiopathic premature labor (IPL). In patients seen in the county health department clinic (1,529 births), IPL accounted for 25% of birth weights less than 2,500 g. In contrast, patients seen in a large private obstetric practice (1,327 births), IPL was the etiology of low birth weight in 47% of patients. Not surprisingly, a prematurity prevention program has not reduced the rate of low birth weight for the public patients but has resulted in decreases of low birth weight for the private patients. Paramount in the prevention of preterm birth is physician education regarding known risk factors, signs and symptoms of preterm labor, and the role of close follow-up in the patients identified as high risk. Papiernik's success with limitation of physical efforts and work leave, when appropriate, in high-risk patients is laudable and, many feel, should be emulated. Prenatal care must include for each woman education concerning the signs and symptoms of preterm labor and PROM. Individual risk factors must be ascertained and followed with appropriate observation, therapy, and/or modification plans. Finally, the early detection of preterm labor will expedite prompt treatment and so increase chances of postponing delivery. PMID- 3545590 TI - Anatomic abnormalities. PMID- 3545589 TI - Recurrent miscarriages: cytogenetic causes and genetic counseling of affected families. PMID- 3545591 TI - Role of uterine adhesions in the cause of multiple pregnancy losses. PMID- 3545592 TI - Infectious causes of recurrent pregnancy loss. AB - Current knowledge supports the view that nonviral organisms may be responsible for repeated pregnancy wastage through chronic or recurrent occupancy in the maternal reproductive tract. However, two forms of evidence that would establish more clearly such a role lack for all of the organisms presented: recovery of the same organism from the products of conception in successive pregnancy losses, and demonstration of improved pregnancy outcome following specific treatment in a randomized prospective controlled trial. While acquisition of such data is scientifically justified, the necessary study designs may be viewed as unethical if the body of information derived from circumstantial cases and therapeutic trials using historical controls only continues to shape clinical opinion. Further confirmation of a specific role in pregnancy wastage for any of these organisms eventually will have to address the mysterious discrepancy between the prevalence of colonization and the incidence of sporadic and recurrent abortion purportedly due to the organism. PMID- 3545593 TI - Hormonal causes of recurrent abortion. PMID- 3545594 TI - Abortion induced by chemicals encountered in the environment. PMID- 3545595 TI - Association of autoimmune conditions with recurrent intrauterine death. PMID- 3545596 TI - Trophoblast antigens in normal and abnormal human pregnancy. AB - With all of this information about trophoblast antigens, it is necessary to have a working hypothesis of how these antigens might be dealt with by a normal woman's immunologic system. Two sets of observations have helped formulate such a working hypothesis. First is the finding that trophoblast is the only normal tissue recognized by antibodies to TA1 (and it is exceedingly difficult to demonstrate maternal anti-TA1 in normal pregnancies). Second is the serologic result that antibodies to TLX antigens within the TA2 group are lymphocytotoxic (and maternal anti-TLX can be demonstrated both in normal and abnormal pregnancies). We interpret this as meaning that TA1 is "foreign" (i.e., oncoextraembryonic) antigen and TA2 (TLX) is "self"-antigen, and that mothers have TA2 (TLX) reactive B-lymphocytes in their repertoire. Antigen-reactive B lymphocytes can be activated to produce TA1-blocking antibodies by either allotypic TA2 (TLX) in seminal plasma or allogeneic trophoblast membrane antigens during the host-versus-graft reaction subsequent to blastocyst implantation. If allotypic or allogeneic stimulation fails to produce an adequate anti-TA2 (TLX) response, the oncoextra-embryonic TA1 antigens are recognized and rapidly rejected. If allotypic or allogeneic stimulation produces an aberrant anti-TA2 (TLX) response (e.g., a cytotoxic rather than a blocking antibody), the extra embryonic membranes and placenta come under immune attack and eventually are rejected. This working hypothesis has led us to develop new immunologic approaches to the diagnosis and prevention of some types of pregnancy failures in both mice and human beings. PMID- 3545597 TI - Unexplained recurrent pregnancy loss: epilogue. PMID- 3545600 TI - Epiperineurium-fascial stitches along the stumps of a transected nerve. An additional method for closing the gap in the nerve trunk. AB - Following peripheral nerve repair, tension on the suture line is regarded as an important factor in producing scar tissue. In some cases, one or more microsurgical epiperineurium-fascial stitches (EPFS) along the proximal and distal stumps of a transected nerve permit their firm approximation, shifting tensile forces from the suture line over longer segments of the nerve stumps. This simple method was used to treat three ulnar and two cranial nerve lesions with gaps ranging from 8 to 20 mm with an end-to-end suture, avoiding any tension on the suture line. In all cases, functional recovery was satisfactory. PMID- 3545598 TI - Tuberous sclerosis: a neuropathological and immunohistochemical (PAP) study. AB - Clinical, neuropathological, and immunohistochemical (PAP) findings are reported in a 7 month-old girl with Tuberous sclerosis (TS). Polycystic kidneys and massive cardiomegaly constituted the prominent pathological features. The neuropathology of the syndrome was characterized by Megalencephaly, Subependymal giant cell astrocytoma, Very large protoplasmic astrocytes in Golgi-rapid method preparations of cortical tubers and Glial fibrillary acidic protein (GFAP) negative giant cells in the subependymal nodules as well as in the cortical tubers. The identity of these giant cells is discussed. PMID- 3545599 TI - Multistaged surgical management of posttraumatic segmental tibial bone loss. AB - Fracture nonunions associated with segmental diaphyseal bone loss challenge present methods of sustaining bone length and securing bony union. In the tibia, single-stage grafting procedures to accomplish this reconstruction requires major tissue sacrifice from adjacent areas and often results in amputation. A series of nine patients with tibial segmental diaphyseal bone loss were treated with multistaged surgical reconstruction. All nine were patients with severe trauma, with soft-tissue loss and local sepsis, who were candidates for amputation. The follow-up period averaged 5.5 years. All of the patients achieved healed, stable legs. All but one were fully ambulatory without a brace eight to 15 months after the first stage of bone grafting. There were several minor complications, which were satisfactorily treated. Multistaged bone graft operations were relatively low-risk, with a high incidence of success for treatment of major tibial segmental bone loss. PMID- 3545601 TI - Necrotizing fasciitis. Review of the literature and case report. AB - Necrotizing fasciitis (NF) of the hand was preceded by an outbreak of porphyria cutanea tarda in a 31-year-old woman. The presentation, course, differential diagnosis, and treatment of necrotizing fasciitis, including a review of the literature, illustrates the indications for hyperbaric oxygen therapy for this life-threatening infection. PMID- 3545602 TI - Foreign body reaction to polymeric debris following total hip arthroplasty. AB - Two cases of severe foreign body reaction to polymeric debris occurred following cemented total hip arthroplasty. The debris consisted of microfragments of both polyethylene and polymethylmethacrylate. Microfragments are believed to be primarily responsible for the extensive lytic reactions, which represent an extreme degree of the chronic inflammatory response that is commonly associated with loosening of cemented total hip arthroplasties. A schematic representation of the pathogenesis of component loosening, including the foreign body reaction, illustrates the relationship of this phenomenon to the general problem of aseptic loosening. Revision arthroplasty was successful in both cases, followed for a period of nine and 16 months, respectively. PMID- 3545603 TI - Osteogenesis imperfecta. The set point proposal (a possible causative mechanism). AB - The minimum effective strain (MES) constitutes a threshold that separates biomechanically acceptable from unacceptable strains on growing bone and fibrous tissues. Strains above that threshold affect modeling and remodeling activities in ways that change the size and configuration of growing bones, tendons, ligaments, and fascia to fit their new mechanical usage and return their strains to the threshold level. Were that threshold set too high from birth, the effects of normal function on remodeling and modeling should lead to thin fibrous tissue structures, to slender, osteopenic diaphyses and spongiosa, and to increased fragility. Those and other predictable set point effects fit so precisely many of the known hard and soft tissue abnormalities of osteogenesis imperfecta patients, that an elevated MES set point may be a heretofore unrecognized basic pathogenetic factor in that disease. PMID- 3545604 TI - History of the Lachman test. PMID- 3545605 TI - The lineage of sports medicine. PMID- 3545606 TI - Scintigraphic criteria for the diagnosis of renal arteriovenous fistulas. AB - Visualization of the inferior vena cava (IVC) on renal perfusion imaging occurs in cases of renal arteriovenous (AV) fistulas. A review of consecutive renal scans demonstrated IVC visualization in three of 217 patients without AV fistulas. IVC visualization occurred 3-6 seconds after peak aortic activity in normal patients. With renal AV fistulas, an intrarenal focus of increased activity is seen and IVC visualization occurs coincident with peak aortic activity. PMID- 3545608 TI - Serendipity in technetium-99m DTPA renal dynamic study. AB - A nine-year-old child was referred for a routine renal dynamic study to detect a renal and/or renovascular cause for hypertension. Tc-99m DTPA renography accidentally discovered and correctly localized a pheochromocytoma. PMID- 3545607 TI - Clinical experience with technetium-99m DTPA aerosol with perfusion scintigraphy in suspected pulmonary embolism. AB - To evaluate the clinical value of radioaerosol imaging, 156 patients with suspected pulmonary embolism (PE) were studied. In 25 patients, a preperfusion xenon-133 (Xe-133) study was compared with a postperfusion study using Tc-99m DTPA aerosol. It was found that they were of equal value most of the time (56%), but that the aerosol study was more often helpful. Because of this, and the technical ease of using six standard views with radioaerosol, the series was completed using perfusion scintigraphy followed by radioaerosol images. In 19 patients the perfusion scintigraphy with Tc-99 macroaggregated albumin (Tc-99m MAA) was normal or nearly normal and no aerosol study was required. Tc-99m DTPA aerosol images were satisfactory when the count rate was at least twice and preferably three times that of the previous perfusion study. There were 17 studies (11%) classified as intermediate. There were 26 patients classified as high probability for PE, and angiographic or autopsy correlation was available in 14. All of the 14 proved to have PE. In the 113 patients classified as low probability, there were ten with angiographic or autopsy correlation. In the ten, there was one patient with a small pulmonary embolus found at autopsy. Clinical follow-up for over two months confirmed the absence of PE in the remainder of this group. Aerosol studies have proven technically easier to perform and a satisfactory substitute for xenon imaging in suspected PE. PMID- 3545609 TI - Fungal splenic abscesses in the immunosuppressed patient. Correlation of imaging modalities. AB - A patient with fungal splenic abscesses is presented in whom multiple noninvasive diagnostic imaging modalities were available for correlation. Of the five imaging modalities, three (Gallium-67, ultrasound and computed tomography) were diagnostically useful, while two (liver-spleen scan and In-111 white blood cell scan) were not as useful. This case also stresses the use of repeated studies correlating with clinical impressions to obtain an accurate diagnosis in a potentially life-threatening condition such as splenic abscess. PMID- 3545610 TI - Vascular neck lesion from bronchogenic carcinoma. PMID- 3545611 TI - Abnormal whole-body technetium-99m MDP scintigraphy indicating cortical hyperostosis following long-term administration of prostataglandin E-1 in an infant with cyanotic congenital heart disease. PMID- 3545612 TI - Differential diagnosis of prolonged cortical retention of radiotracer in technetium-99m DTPA renal scintigraphy. AB - The mechanisms of prolonged renal cortical tracer retention in Tc-99m DTPA scintigraphy are discussed and a variety of examples are presented. PMID- 3545613 TI - Ventilation scanning with technetium labeled aerosols. PMID- 3545614 TI - Nifedipine. Relationship between pharmacokinetics and pharmacodynamics. AB - The availability of specific chemical assays and the development of appropriate biological models have made it feasible to study the relationship between the pharmacokinetics and the pharmacodynamics of nifedipine, a relationship that is presumed to be sigmoidal for most effects. In healthy volunteers the haemodynamic effects of a single dose of nifedipine are markedly influenced by the pharmaceutical preparation and the rate of drug input. When the plasma concentration of nifedipine increases rapidly, such as after an intravenous bolus injection or rapidly disintegrating capsules, there is a marked increase in heart rate and little or even no effect on blood pressure. On the other hand, when the drug is given as a slow intravenous infusion or as a sustained release tablet and when the capsules are taken together with food, the decrease in blood pressure is accompanied by few or no changes in heart rate. Furthermore, it has been shown that not only haemodynamic effects of nifedipine, but also oesophageal motor function may be used as a quantifiable pharmacological effect. For patients with angina pectoris, a plasma concentration range that is associated with optimal treatment has not been defined, since large inter-individual variations in the nifedipine plasma concentration were observed in effectively treated patients. For patients with hypertension, significant sigmoidally shaped correlations between blood pressure reduction and nifedipine plasma concentrations following single or multiple doses have been demonstrated. The concentration-effect parameters were very similar to those found for normotensive subjects. After 6 weeks of treatment the potency of the drug had decreased, which might indicate the development of some tolerance. In patients with severe renal impairment, the maximal effect of nifedipine on diastolic blood pressure was more than doubled, which cannot be explained by differences in pharmacokinetics; therefore these patients appear to be more sensitive at the pharmacodynamic level. In patients with liver cirrhosis, the pharmacokinetics of nifedipine were quite different due to reduced protein binding and reduced enzyme activity; in patients with a portacaval shunt, considerable increased bypassing of the liver during the first pass after oral administration was observed. When corrected for free drug concentrations, the concentration-effect relationship for these patients is essentially the same as that found for healthy subjects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3545617 TI - Non-Hodgkin's lymphoma in childhood presenting as thyroid enlargement. AB - The authors report a case of a 10-year-old girl with early involvement of the thyroid gland by non-Hodgkin's lymphoma, an uncommon site of presentation of childhood lymphomas. In pediatrics, thyroid enlargement is more often caused by lymphocytic thyroiditis. The good response to therapy, in spite of the advanced stage of the disease, is noted. PMID- 3545615 TI - Clinical pharmacokinetics of nicotine. AB - Nicotine intake is considered to be a major factor in sustaining tobacco addiction. For this reason, nicotine gum has recently been introduced as an adjuvant to smoking cessation. The introduction of nicotine as a 'therapeutic' entity necessitates a careful examination of its clinical pharmacokinetics. Insufficient data exist to quantitatively assess the absorption of nicotine after oral administration. Based upon physicochemical and pharmacokinetic principles, the oral bioavailability of nicotine would be expected to be less than 20%. The limited data available in the literature appear to support this conclusion. Absorption from the oral mucosa is the principal site of nicotine absorption in subjects who chew tobacco or nicotine gum. Absorption by this route is highly pH dependent. Nicotine is also readily absorbed from the nasal mucosa, and after topical administration. Nicotine distributes extensively into body tissues with a volume of distribution ranging from 1.0 to 3.0 L/kg. Nicotine has been shown to transfer across the placenta and into breast milk in humans. Plasma protein binding is negligible, ranging from 4.9 to 20%. The predominant route of nicotine elimination is hepatic metabolism. Although a number of metabolites of nicotine have been identified, it is unclear whether any of these compounds contribute to the pharmacological effect of nicotine. Nicotine is also excreted unchanged in urine in a pH-dependent fashion. With urinary pH less than 5, an average 23% of the nicotine dose is excreted unchanged. When urinary pH is maintained above 7.0, unchanged nicotine urinary excretion drops to 2%. After intravenous administration, nicotine exhibits biexponential decline in plasma. Total plasma clearance ranges from 0.92 to 2.43 L/min. During urinary acidification, renal clearance averages 0.20 L/min. Non-renal blood clearance averages 1.2 L/min, indicating that nicotine elimination is dependent on hepatic blood flow. The literature is devoid of information regarding the effect of disease on the pharmacokinetics of nicotine. Based upon the drug's pharmacokinetics in healthy smokers, it would be anticipated that disease states which alter hepatic blood flow may have the greatest impact on nicotine pharmacokinetics. In addition, drugs which alter hepatic blood flow may cause significant alterations in the systemic clearance of nicotine. Dependence on smoking appears to be related, at least in part, to the achievement of a rapid rise in plasma nicotine concentrations. If this assessment is correct, the most desirable adjuvant for smoking cessation would be one that closely mimics this pattern of plasma nicotine concentrations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3545618 TI - Hemodynamic interaction of nonselective vs. beta-1-selective beta-blockade with hydralazine in normal humans. AB - To assess the effects of nonselective vs. beta 1-selective beta-blockade on the hyperdynamic circulation induced by hydralazine, eight healthy volunteers received placebo, propranolol, 20 and 40 mg, and atenolol, 25 and 50 mg, on 5 separate days, followed by hydralazine (range 75 to 150 mg). Hydralazine decreased afterload (end-systolic wall stress) and increased venous return and left ventricular performance (by M-mode echocardiography). Both beta-blockers blunted the increases in heart rate, cardiac output, and venous return similarly, although heart rate and cardiac output were not completely normalized. Atenolol did not affect the hydralazine-induced decrease in afterload, whereas propranolol significantly opposed this change (P less than 0.03). The hyperdynamic circulation seen with hydralazine is mostly beta mediated, primarily beta 1. When given with hydralazine the two beta-blocker types differ primarily in their effects on afterload. PMID- 3545619 TI - Treatment of craniofacial microsomia. AB - The term "craniofacial microsomia" indicates that many patients with hemifacial microsomia have orbital and cranial dysplasia. Skeletal dysplasia, displacement, or absence is the prime cause of facial asymmetry, flatness, and occlusal tilt. Correction in all three-dimensional planes minimizes or eliminates the necessity for soft-tissue augmentation. Current modifications, as applied to a previously published surgical-anatomic classification, include better bone grafting and skeletal fixation techniques, as well as variations in osteotomy lines. Increasing evidence shows that earlier surgery is indicated because of previously unsuspected growth of face bone grafts. PMID- 3545616 TI - Plasma protein binding of drugs in the elderly. AB - Binding to plasma proteins can affect the pharmacokinetics and pharmacodynamics of drugs. Age is one of many factors which can affect plasma protein binding of drugs. Unfortunately, very few generalities can be drawn from the studies of the effect of age on protein binding. Whether age has an effect on protein binding is dependent not only on the drug, but also on the manner in which the study is conducted. Several studies involve patients with various disease states making assessment of the effect of age alone on protein binding difficult. Results of different studies on the same drug do not always agree--in one case finding no change in protein binding with age and in another, a significant increase or decrease in protein binding. Most drugs which exhibit increased binding (decreased free fraction) in elderly subjects are basic and tend to have a greater affinity for alpha 1-acid glycoprotein than for albumin. The list of drugs exhibiting decreased binding (increased free fraction) in the elderly is longer and includes both acidic and basic drugs. The impact of changes in protein binding with age is dependent on the magnitude of the change, on the pharmacokinetic characteristics of the drug and on its therapeutic index. Some changes, although statistically significant, are not likely to be of importance clinically. From the studies reviewed, the free fraction is changed by greater than 50% in the elderly for only a few drugs, e.g. acetazolamide, diflunisal, etomidate, naproxen, salicylate, valproate and zimeldine. PMID- 3545621 TI - Assuring successful impression making in complete dental construction. PMID- 3545620 TI - Bone grafts in craniofacial surgery. AB - Bone grafting or bone replacement is an integral part of craniofacial surgery. Most craniofacial surgeons prefer the use of autogenous bone; however, there are exceptions to this, because some plastic surgeons prefer the use of alloplastic implants for replacement of parts or missing segments in the craniomaxillofacial skeleton. Inlay bone grafts are useful in osteotomies because they show little resorption. Onlay bone grafts contour and balance the face aesthetically and enable the surgeon to obtain refinement and fine-tuning in all types of craniofacial reconstruction. These grafts demonstrate more resorption than inlay grafts. However, the use of onlay grafts coupled with soft-tissue shifts of galea and muscle enable the craniofacial surgeon to achieve superior results over those of surgeons primarily concerned with jaw- or tooth-related movements that do not utilize primary bone grafting as a method of augmentation. Superior results today are obtained with various methods and techniques of bone grafting, some of which have been described in this article. PMID- 3545623 TI - Prevalence of diabetes mellitus treated with insulin and oral hypoglycemic agents in Denmark. AB - During a period of 12 months all diabetics treated with insulin or oral hypoglycemic agents (OHA) were registered by collection of prescriptions on the island of Falster, Denmark, with 44,498 inhabitants. The overall prevalence of diabetes mellitus was 12.4 per 1,000 (553 diabetics). Insulin-treated diabetics comprised 231 persons (prevalence rate 5.2 per 1,000) and OHA-treated diabetics comprised 322 persons (prevalence rate 7.2 per 1,000). The prevalence of insulin treated diabetes especially with an age less than 30 yr was significantly higher than the prevalence in 2 other areas in Denmark. 50% of the insulin-treated diabetics with an onset age greater than or equal to 30 yr were overweight in contrast to 6% of insulin-treated diabetics with an onset age less than 30 yr (p less than 0.01). Among OHA-treated diabetics, 65% were overweight. PMID- 3545624 TI - Functioning parathyroid cyst extending from neck to anterior mediastinum. Diagnosis by sonography and computed tomography. AB - A parathyroid cyst was evaluated by sonography and computed tomography (CT) in a patient with hyperparathyroidism. Sonography demonstrated a cystic lesion near the left lower pole of the thyroid, extending into the anterior mediastinum. On CT, the parathyroid cyst had a slightly high attenuation (30 H), with a smooth wall demonstrated after intravenous administration of contrast material. Fine needle aspiration biopsy of the cyst showed elevated parathyroid hormone (PTH) level. The lesion probably represents cystic degeneration of an adenoma. PMID- 3545622 TI - Increased platelet malondialdehyde, but normal platelet sensitivity to adenosine 5-diphosphate and prostacyclin in well-controlled type 1 diabetics without vascular complications. AB - Normal platelet sensitivity to in vitro ADP-induced aggregation (median 46, range 32-62% dT) and a normal antiaggregatory effect of prostacyclin (PGI2; ID50:0.65, range 0.18-2 ng PGI2/ml PRP) were found in a carefully selected group of 30 fairly well-controlled (average HbA1c 7.0%) Type 1 diabetic patients (14m/16f; median age 27.5, range 15-45 yr; duration of disease 7, range 1-24 yr) without macroangiopathy in comparison to 19 (9m/10f; age 26, range 17-40 yr) closely matched healthy controls (42, range 34-63% dT; 0.55, range 0.35-1 ng PGI2/ml PRP). By contrast, platelet malondialdehyde (MDA) release was significantly (p less than 0.001; Mann-Whitney, two-tailed, non-parametric test) increased in diabetics (6.55, range 0.91-18.94 nmol/10(9) platelets) in comparison to controls (3.9 range 2.6-6.9 nmol/10(9) platelets). Since MDA has been used as an indicator of platelet thromboxane formation (a potent stimulator of platelet aggregation), elevated platelet MDA in diabetics has been attributed to platelet activation. In the present study, for the first time increased platelet MDA release in diabetics has been shown to occur independently from enhanced platelet aggregation, even in well-controlled patients without evidence of either macroangiopathy or microangiopathy. This could be of clinical importance, since MDA is known to act on low density lipoprotein-uptake of human macrophages. PMID- 3545625 TI - Xanthogranulomatous pyelonephritis in a child. PMID- 3545626 TI - Ultrasonographic measurement of the pancreatic body. Its significance in measuring the normal pancreas. AB - In the period January 11, 1984 till May 14, 1985 the smallest corpus diameter (SCD) of the pancreas of 172 patients without clinical suspicion of pancreatitis was measured. In 96% of the examinations the SCD proved to be less than 12 mm in diameter. It is safe to assume that a SCD greater than 16 mm is a fairly characteristic sign of general enlargement of the pancreas in the appropriate clinical setting. PMID- 3545627 TI - Measurement of liver volume using water delay ultrasonography. AB - A modification of the method of Carr et al. [1976] for the ultrasonic assessment of liver volume was devised for use with a UI Octoson water delay B mode echoscope, and 32 subjects without clinical history or signs of liver disease were examined. In 9 subjects the measurements were repeated by a separate observer. Comparison of the variance between observers and that between subjects showed that the precision of the method is within acceptable limits, the variance ratio (F) being 13.7 (p less than 0.001). The mean liver volume was 1,545.4 +/- (SD) 255 ml. This finding is in close agreement with previously published data. The liver volume was correlated with body weight, height, body surface area, and body mass index. The liver volume was found to correlate best with body weight using partial correlation analysis. This was in accordance with previously published data, with the exception of that of Koischwitz [1979]. However, variations in weight could only account for 0.43 of the variation in liver volume. PMID- 3545628 TI - Ultrasonography of the gallbladder in patients with a clinical suspicion of acute cholecystitis. AB - The prevalence of ultrasonographic (US) signs described in the literature in cases of acute cholecystitis (wall thickening, increased volume, roundness and local tenderness of the gallbladder, an anechoic layer in the gallbladder wall and cholelithiasis were studied in 136 consecutive patients referred for US examination with clinically suspected acute cholecystitis (AC). Of the patients, 56 had AC, 21 chronic cholecystitis, 2 carcinoma of the gallbladder, and 57 extrabiliary diseases. In AC, frequent findings in addition to cholelithiasis were wall thickening (79%) and an increased volume (64%). Almost one third of the patients had local tenderness (sonographic Murphy sign) (29%), and 27% of the gallbladders had a rounded form. All these features were, however, rather frequently detected also in chronic cholecystitis (5-33%) and in the 2 carcinoma patients, and also sporadically in extrabiliary diseases. A anechoic layer in the gallbladder wall was the only sign confined to AC, but was detected only in 2 cases. Roundness of the gallbladder occurred only in either acute or chronic cholecystitis. The combination of at least two diagnostic findings was noticed in 91% in AC, rather frequently in chronic cholecystitis (43%) and in both carcinoma patients, but only in 1 patient in the extrabiliary disease group. Three or more signs were seen only in gallbladder diseases (48%), but AC, chronic cholecystitis or carcinoma groups could not be completely differentiated (prevalences 63, 10 and 50%). PMID- 3545629 TI - Intravenous digital subtraction angiography with iohexol (Omnipaque) and sodium meglumin diatrizoate (Urografin). AB - A randomized, double-blind crossover trial in intravenous digital subtraction angiography (DSA) (aorto-femoral or aorto-cervical) was performed in 38 patients with Omnipaque, 350 mg I/ml versus Urografin, 370 mg I/ml. The aim of the study was to compare subjective reactions, ECG, heart rate, blood pressure, image quality and disturbing artefacts. The median volume of contrast media given per patient was 165 ml, ranging from 85 to 250 ml. No serious complications occurred. Fewer and significantly (p less than 0.05) less intense reactions as sensations of heat and taste were experienced after Omnipaque. Significantly more patients preferred Omnipaque. The heart rate changed significantly more after Urografin than after Omnipaque. Urografin also caused a significantly greater but transient decrease in systolic and diastolic blood pressure. There was a tendency to better overall quality and less artefacts when using Omnipaque, but the difference between the two media was not statistically significant. PMID- 3545630 TI - Ultrasonic real-time diagnosis of transitory fetal pleural and pericardial effusion. AB - Congenital fetal effusions are rare and often fatal. Prenatal ultrasonic diagnosis is an important factor in both diagnosis and management of this condition. We report a case with both pleural and pericardial effusion, the ultrasonic diagnosis and follow-up, and the birth of a healthy baby. A short review of the literature is given. PMID- 3545631 TI - Fibroma of the cecum. Case report. AB - The case of a young woman with pain and a tumor in the right lower abdomen is reported. Ultrasound revealed an echogenic tumor of 10 cm diameter. Fibroma of the uterus was diagnosed. During the operation in the gynecological department, the tumor turned out not to be of gynecological origin. After more extensive examinations laparotomy was performed. Histologic examination of the tumor revealed a fibroma, originating from the muscular layer of the cecum. In the literature of the last 35 years, only 5 similar cases have been reported and in 2 of them it was also misdiagnosed as fibroma of the uterus. PMID- 3545633 TI - [Geometry of eccentric vascular stenoses in various projections--significance for angiographic assessment of the degree of stenosis, especially using digital subtraction angiography]. AB - A mathematical model is used to predict the angiographic appearance of plaque like lesions and eccentric vascular stenoses. The virtual stenotic areas and the degree of stenosis are calculated for different projection angles varying between 0 degree--x-ray beam tangential to the lesion--and 90 degrees--x-ray beam incidental to the lesion. Eccentric stenoses are underestimated if the lesion is not tangential to the x-ray beam. Eccentric stenoses can be overestimated if automated programmes are based on a circular configuration of both the normal and the stenotic lumens. In this model the best estimation is obtained if the stenotic lumen is assumed to be elliptic, and if biplane rectangular projections are available. PMID- 3545632 TI - A comparison of three anti-double stranded DNA antibody assays on sera from SLE and other diseases. AB - Systemic lupus erythematosus (SLE) is a multisystem disorder accompanied by a diverse spectrum of serum autoantibodies. Antibodies to double stranded DNA (dsDNA) are considered to be the most specific marker for this disease. In this study the results obtained from three different assays for dsDNA are compared: an indirect fluorescence antibody assay (IFA), a radioimmunoassay (RIA) and, an enzyme-linked immunosorbent assay (ELISA), on 57 SLE sera and 28 Sera from other disorders. Correlation of these anti-DNA results are made with C3, C4, and antinuclear antibody (ANA) titers. Our results show the IFA assay is the most sensitive and the least specific of the three tests. The RIA was found to be the most specific and was approximately as sensitive as the ELISA. We also found significant inverse correlations between anti-dsDNA levels and circulating complement levels among SLE sera for all three assays. ANA titers were significantly correlated with all anti-dsDNA assays as well. However, these anti dsDNA assays show only modest differences explainable by numerous mechanisms. Hence, a clearly superior anti-dsDNA method does not emerge from our study. PMID- 3545634 TI - [Value of digital subtraction angiography in the imaging of a subcutaneously implanted, intra-arterial chemotherapy catheter]. AB - Intraarterial chemotherapy is already a commonly accepted treatment method in isolated liver metastases. The high risk of transcutaneous injection of chemotherapeutic substances in the implanted catheter system requires a passage examination before the beginning of therapy. 32 digital subtraction angiograms for examination and documentation of the implanted catheter have been performed in 15 patients. The DSA seems to be a good visualisation technique for the implanted chemotherapy catheter systems. PMID- 3545635 TI - Midgut malrotation diagnosed by ultrasound. AB - Ultrasound was used to demonstrate the abnormal orientation of the mesenteric vessels in six cases of midgut malrotation. Five of these patients were known to have an abnormality of rotation before the ultrasound scan. In one patient malrotation was predicted from the ultrasound scan and confirmed by a barium study and at operation. PMID- 3545636 TI - The missing balloon sign. AB - The balloon of the self-retaining Foley catheter should be readily visible during ultrasound scanning of the distended urinary bladder. Its absence should prompt a search for its location since extra-vesical inflation may result in local trauma and confusing appearances. PMID- 3545637 TI - The effect of intrathecal iohexol on visual evoked response latency: a comparison including incidence of headache with iopamidol and metrizamide in myeloradiculography. AB - Fifty consecutive unselected patients referred for myeloradiculography and examined by the same radiologist, when facilities for measuring the visual evoked response were available, are considered. The effect on the visual evoked response of the examination and the incidence of headache following the use of iohexol as the contrast medium are compared with those after the use of iopamidol and metrizamide reported in a previous study. A total of 400 cases examined with iopamidol and 200 cases examined with iohexol are reviewed with regard to the incidence of headache. Whereas iopamidol and, to a greater extent metrizamide, were found to cause significant lengthening of the visual evoked response latency 20 hours after the radiological examination, iohexol did not. Furthermore there was no significant difference in the 20 hour reading following the use of iohexol compared with the original control group of patients who underwent lumbar puncture alone. There was a lower incidence and severity of headache following the use of iohexol than with iopamidol and a markedly reduced incidence compared with metrizamide. Iohexol is considered less neurotoxic than iopamidol which had previously superceded metrizamide as the contrast medium used for myeloradiculography in the Royal Surrey County Hospital. Volumes of up to 14 ml of iohexol 300 mg I/ml have been used for lumbar radiculography and for total myelography and up to 10 ml for direct lateral cervical puncture. In 350 cases examined to date with iohexol the only serious sequel was a case of chemical meningitis following the lumbar injection of 10 ml of the 300 mg I/ml solution for a cervical examination. The patient made an uneventful recovery. PMID- 3545638 TI - Recurrent pyogenic cholangitis: ultrasound evaluation compared with endoscopic retrograde cholangiopancreatography. AB - Fifty cases of recurrent pyogenic cholangitis among Chinese in Hong Kong were studied by ultrasound and compared with endoscopic retrograde cholangiopancreatography. The sensitivity of ultrasound detection of both dilated intrahepatic biliary ducts and intrahepatic calculi is 67% as compared with endoscopic retrograde cholangiopancreatography. A negative study, therefore, does not rule out the presence of such pathological features. A dilated common duct is present in virtually every case of recurrent pyogenic cholangitis and ultrasound is very accurate in its detection. Furthermore, ultrasound is able to provide additional information which can be missed with endoscopic retrograde cholangiopancreatography. Prominent periportal echogenicity, concomitant abscesses and tumours are examples in this series. Such findings bear significance on the management of patients with recurrent pyogenic cholangitis. PMID- 3545639 TI - Duplex ultrasound in the evaluation of portacaval shunts. AB - The results of ultrasound imaging combined with Doppler studies of blood flow are presented in two patients with surgical portacaval shunts performed for portal hypertension. Duplex scanning proved a quick and noninvasive method of confirming the patency of the anastomoses. The demonstration of appropriate Doppler flow signals across the shunt is the most convincing ultrasound evidence of patency. Portacaval shunts are more amenable to study by ultrasound than more peripheral shunts because the liver can be used as an acoustic window. PMID- 3545640 TI - Report of the AFCR Public Policy Committee: current issues in public policy. PMID- 3545641 TI - The proteinase-antiproteinase theory of emphysema: time for a reappraisal? PMID- 3545642 TI - Duodenal and ileal lipid suppresses postprandial blood glucose and insulin responses in man: possible implications for the dietary management of diabetes mellitus. AB - Infusion of lipid into the ileum delays the transit of a meal through the stomach and small intestine and could therefore influence the rate and degree of nutrient absorption. Experiments were carried out on human volunteers to investigate the effect of infusion of lipid into either the duodenum or ileum on blood glucose, insulin and gastric emptying after ingestion of a mashed potato meal. Infusions of lipid into either the duodenum or the ileum significantly reduced or abolished the immediate postprandial rises in blood glucose and insulin and significantly delayed gastric emptying. Blood glucose and insulin rose shortly after the lipid infusion terminated. Addition of corn oil to a meal of mashed potato also reduced blood glucose and insulin and delayed gastric emptying. Intestinal lipid can thus modify the glycaemic and insulinaemic responses to a meal, and this modulation probably explains the reduced metabolic responses to a meal containing fat compared with a fat free meal. This principle could be of value in the dietary control of diabetes mellitus. PMID- 3545643 TI - The effect of a synthetic polypeptide on the renal handling of protein in man. AB - Haemaccel is a synthetic polymer of partially degraded gelatin and a widely used plasma volume expander. The effect of a 17.5 g infusion of Haemaccel on protein excretion was investigated in four normal subjects. The urinary excretion of two low molecular weight proteins, retinol-binding protein and beta 2-microglobulin, increased 1000- and 500-fold respectively above the values found after administration of saline as a control. The urinary excretion of albumin did not change significantly (P greater than 0.5). In the hour after Haemaccel administration the excretion of the two low molecular weight proteins approached at least 50% of a predicted filtered load. This effect of Haemaccel may be due to inhibition of proximal tubular uptake or transport of the two proteins. Absence of any effect on albumin excretion suggests alternative mechanisms for its tubular reabsorption. Haemaccel may be a valuable new agent for the study of renal tubular protein metabolism. PMID- 3545645 TI - Hypoxic pulmonary vasoconstriction persists in the human transplanted lung. AB - The preservation of hypoxic pulmonary vasoconstriction (HPV) in the denervated lung was studied in five human heart-lung transplant recipients. All five patients showed significant increases in mean pulmonary artery pressure and pulmonary vascular resistance during hypoxic exposure, returning toward normoxic values during recovery. Aside from PAO2 and Pao2, other factors known to influence pulmonary vascular resistance did not change significantly during the hypoxic period. There was no relation between the length of the post transplantation period and the intensity of HPV, suggesting that reinnervation of the pulmonary vascular bed did not account for persistent HPV and that HPV persists in the human transplanted lung despite the loss of autonomic neural innervation. PMID- 3545644 TI - Halothane hepatitis: a model of immune mediated drug hepatotoxicity. PMID- 3545646 TI - Effects of a high K+/low Na+ diet on blood pressure in young spontaneously hypertensive rats. AB - Blood pressure was measured after treatment with a high K+, a low Na+ and a combined high K+/low Na+ diet in young spontaneously hypertensive rats (SHR). A high K+ diet reduced blood pressure by approximately 10 mmHg during the development of hypertension. This decrease was accompanied by a significant increase in water intake and urine volume and a significant decrease in plasma renin activity (PRA). A low Na+ diet also decreased blood pressure significantly, but, in contrast to the high K+ diet, water intake and urine volume significantly decreased and PRA increased. When both diets were given together, the antihypertensive effects of both were eliminated. Thus while an increase in dietary K+ and a decrease in dietary Na+ are both effective antihypertensive regimens in SHR, the mechanism of action of each appears to be different and may be antagonistic in these animals. PMID- 3545647 TI - The effect of prostaglandin E1 upon the pressor and hormonal response to exogenous angiotensin II in human pregnancy. AB - The effect of prostaglandin E1 (PGE1) on the pressor and hormonal response to angiotensin (ANG) II has been studied in 22 women in second trimester pregnancy. Three-point dose-response curves were initially determined for all women. Eleven then received an infusion of PGE1 while the remainder received an infusion of normal saline as controls. The dose-response curves to ANG II were re-studied after a period of stabilization. Although assignation to treatment group was random, differences were found in age and basal blood pressure between the control group and those given PGE1. The pressor data from the PGE1 group were thus split by age for analysis. The administration of ANG II alone was associated with significant (P less than 0.001 at all doses) pressor effects without accompanying bradycardia. Plasma renin concentration (PRC) was suppressed (P less than 0.001). Plasma aldosterone concentration rose (P less than 0.001), the magnitude of the rise being directly associated with the plasma ANG II concentrations achieved (P less than 0.05). The infusion of PGE1 had no significant effect on basal blood pressure, but evoked a sustained tachycardia in both age groups (P less than 0.001). Basal hormone concentrations were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545648 TI - Effect of dietary linoleate content on the metabolic response of rats to Escherichia coli endotoxin. AB - Dietary fat influences many aspects of immune function. Escherichia coli endotoxin is a potent stimulator of interleukin 1 production from macrophages. The present study examines the effect of feeding with fat diets rich (corn oil) and poor (coconut oil) in linoleate at high and low concentrations on responses to endotoxin. Spleen phosphatidylcholine linoleate contents were higher in the corn oil than in the coconut oil group and arachidonate concentrations were highest in the group fed a high concentration of corn oil. Coconut oil completely abolished the responses to endotoxin. The inhibitory effects of coconut oil could largely be due to reduced prostaglandin and leukotriene synthesis. PMID- 3545649 TI - "Big MAAC" must be dealt with in Medicare billing. PMID- 3545650 TI - Recognition and treatment of chlamydial infections. AB - The microbiology, laboratory diagnosis, clinical features, and treatment of infectious diseases caused by Chlamydia trachomatis and Chlamydia psittaci are reviewed. Chlamydial genital infection is the most common sexually transmitted disease in the United States. C. trachomatis plays an important role in nongonococcal urethritis, postgonococcal urethritis, cervicitis, pelvic inflammatory disease, and possibly proctitis. Proper treatment of genital infections caused by C. trachomatis is important to prevent severe sequelae such as epididymitis and pelvic inflammatory disease, both of which may lead to sterility. Infected pregnant women should be treated to prevent transmission of chlamydial infections to their infants. Chlamydial conjunctivitis is the most common eye infection in the first month of life. C. trachomatis also causes pneumonia in infants. Lymphogranuloma venereum and trachoma are important diseases in developing countries. C. psittaci, transmitted by birds, causes psittacosis in humans; this disease is rare in the United States. Diagnosis is a problem because chlamydial genital infection can be asymptomatic and because the organism is difficult to isolate. Culture remains the diagnostic method of choice, but recently marketed direct-detection assays provide qualitative results within hours after specimen collection. Tetracyclines and erythromycin are the drugs of choice for treating chlamydial infections in adults. An antimicrobial with activity against both C. trachomatis and Neisseria gonorrhoeae is preferred because both organisms are often present concurrently in patients with sexually transmitted disease. Chlamydial infections in pediatric patients often respond to systemic erythromycin therapy; tetracyclines are equally effective but are contraindicated for children less than nine years of age. Adequate diagnosis and treatment of sexually transmitted chlamydial infections in patients and their contacts is important to limit the spread of disease. PMID- 3545652 TI - Glucose tolerance and lipid-lipoprotein levels in middle-aged powerlifters. AB - The purpose of this study was to obtain information regarding the effects of a form of strength training (powerlifting) on certain coronary artery disease (CAD) risk factors in middle-aged men. The risk factors studied were the plasma lipid lipoprotein profile, glucose tolerance and plasma insulin levels, all of which have been shown to be favourably influenced by endurance training in middle-aged and older men. Five elite powerlifters (52 +/- 9 years) were compared to distance runners and sedentary controls of similar age with whom they were matched in terms of body fatness as estimated from skin-fold thickness measurements. The powerlifters had a significantly (P less than 0.01) lower HDL cholesterol (HDL-C) level (34 +/- 4 mg/100 ml) than the sedentary controls (48 +/- 12 mg/100 ml) and runners (54 +/- 8 mg/100 ml). The total cholesterol to HDL-C ratio, a good indicator of CAD risk, was 41% higher in the powerlifters than in the controls, and 57% higher than in the runners (both P less than 0.01). The total area under the glucose tolerance curve during an oral glucose tolerance test (OGTT) for the powerlifters was 74% higher than for the sedentary controls (P less than 0.05) and 229% higher than for runners (P less than 0.01). Similarly, the total area under the OGTT insulin curve for the powerlifters was 68% higher than for sedentary controls and 332% higher than for the runners (P less than 0.001). These findings suggest that middle-aged powerlifters, in marked contrast to endurance athletes, have an increased risk of developing CAD. PMID- 3545651 TI - Lipoprotein lipase activity and intramuscular triglyceride stores after long-term high-fat and high-carbohydrate diets in physically trained men. AB - Men with regular physical training habits voluntarily increased their dietary fat intake from 43 to 54% of energy (E%) for four weeks. This was followed by a low fat (29 E%), high-carbohydrate diet for another four weeks. During the high-fat diet period, the muscle lipoprotein lipase activity (LPLA) increased from 59 +/- 8 to 106 +/- 12 mU/g (mean +/- SE) (P less than 0.05). After the high carbohydrate diet, LPLA was 57 +/- 16 mU/g, and unchanged relative to the pre trial value. The triglyceride content in m. vastus lateralis increased from 30 +/ 4 to 47 +/- 9 mmol/kg d.w. (P less than 0.05; mean +/- SE) following the high fat diet and to 41 +/- 8 following the high-carbohydrate diet. Neither of the diets affected the serum triglyceride and insulin concentrations, nor glucose, glycerol, beta-hydroxybutyrate, citrate and lactate levels in the blood. Nor did they alter enzyme activities in muscle used as markers for the oxidative (citrate synthase, beta-hydroxy-acyl CoA dehydrogenase) and glycolytic (glyceraldehyde phosphate dehydrogenase, lactate dehydrogenase) capacity. It is concluded that one month's adaptation to a high-fat diet results in increased muscle-LPL activity indicating a higher capacity for uptake of fatty acids from circulating serum triglycerides into the muscle cell in association with a greater capacity for triglyceride storage in the muscle. Under these conditions serum triglycerides were not decreased despite the increased muscle LPLA, and serum insulin variations could not explain the change in muscle LPLA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545653 TI - Increase of plasma renin activity at renal blood flow estimations with the xenon133 wash-out technique in patients with renal artery stenosis. AB - Eleven patients with hypertension and renal artery stenosis of fibromuscular type were investigated with renal blood flow estimations with Xenon133 wash-out technique before and after alpha-receptor blockade with infusion of phenoxybenzamine in the stenosed renal artery. During the whole investigation frequent blood samples for renal vein renin estimations were drawn from both kidneys. Immediately after the Xenon injection renal vein renin elevations on the investigated side were observed in 9/11 patients. The renin peak was reached in 10 min and the mean increase for all patients was 152%. The mean duration of the peak was 19.25 min. A neurogenic renin release mechanism triggered by renal chemoreceptors and mediated by beta-adrenergic fibres was suggested. This finding with renin release stimulation at Xenon133 infusion in the renal artery is of great importance in judging results of investigations concerning renal blood flow and renin when the Xenon wash-out technique is used. Blood samples for renin estimations should not be taken within 25 min after intrarenal Xenon133 infusions. PMID- 3545654 TI - Detection of Mycobacterium avium-Mycobacterium intracellulare in blood cultures using concentrated and unconcentrated blood in conjunction with a radiometric detection system. AB - Studies were performed in order to determine optimal methods for isolating mycobacteria from blood. The combined use of a lysis-centrifugation (Isolator) system and a radiometric-detection system (Bactec) was compared to the use of either unconcentrated blood or centrifuged blood pellet in conjunction with the Bactec mycobacterial system. Results showed that for cultures with greater than 10 colony forming units (CFU) per ml of blood, the use of unconcentrated blood and centrifuged blood pellet was as sensitive as use of the Isolator concentrate. For cultures with lower colony counts (less than 10 CFU/ml), however, Isolator concentrate was consistently better than either centrifuged or unconcentrated blood. Since over half of our positive cultures had low colony counts, the use of Isolator concentrate inoculated into either a Bactec mycobacterial culture vial or onto Middlebrook agar slants is recommended over the use of either centrifuged blood pellet or unconcentrated blood inoculated into a Bactec mycobacterial culture vial. PMID- 3545655 TI - Biochemical serogrouping of clinical isolates of Cryptococcus neoformans. AB - Three hundred twenty-three clinical isolates of Cryptococcus neoformans of diverse geographic origins were biochemically serogrouped using glycine cycloheximide-phenol red agar (GCP), the same medium less cycloheximide (GOP), and glycine-L-canavanine bromothymol blue agar (CGB). Twenty isolates gave positive reactions on all three media typical of the B and C serotypes. Three were from the Peoples' Republic of China; three each were from Michigan (two patients) and Louisiana; two each were from California, Georgia, and Virginia; and one each was from Alabama, Florida, North Carolina, Oklahoma, and Tennessee. Two hundred seventy-six isolates were identified as belonging to the A/D serogroup; 272 were of American origin and four were from China. Twenty-seven isolates were biochemically ungroupable. Evaluations of the reactions on all three media were open to subjective interpretations. Utilization of glycine was the most frequent atypical variable; 36 of 276 (13%) A/D isolates utilized glycine while being inhibited by either GCP or CGB or both. Significant differences between A/D and B/C serogroups in terms of susceptibility to 5 fluorocytosine but not to amphotericin B were observed; B/C serogroup isolates appeared to be less susceptible to 5-fluorocytosine in vitro than were the A/D serogroup isolates. These results provided new evidence on the distribution of B/C serogroup isolates of C. neoformans in America and demonstrate the difficulties of using biochemical tests for serotyping purposes. They also offer a possible explanation for the apparent more refractory therapeutic responses of infections caused by B and C serotypes to conventional antifungal chemotherapy. PMID- 3545656 TI - Evaluation of the Cellmatics and direct monoclonal fluorescence antibody staining for detection of genital chlamydial infections. AB - Three methods for Chlamydia trachomatis detection were compared: the Cellmatics (Difco Laboratories, Detroit, MI), a commercially available tissue culture system which contains a rat cell line; a direct fluorescent Chlamydia antibody (DFA) (Microtrak, Syva Corp., Palo Alto, California) stain; and a standard tissue culture isolation method employing McCoy cells. Of the 121 specimens in the study, 20 were positive by the standard cell culture. All 20 of these specimens were also positive by the Cellmatics but only 10 were positive by DFA. PMID- 3545657 TI - Evaluation of culture methods for isolation of group B streptococci. AB - Attempts were made to isolate group B streptococci (GBS) from 382 urethral and 140 rectal specimens by overnight incubation in three variants of Todd Hewitt broth, followed by subculture on human blood agar plates. All three broths prepared contained 5% sheep blood, but one contained no antibiotics (THB), while the other two contained gentamicin and nalidixic acid at concentrations of 0.8 microgram/ml and 1.5 micrograms/ml (THBL), and 8 micrograms/ml and 15 micrograms/ml (THBH), respectively. THBL gave the highest isolation frequency both for urethral and rectal specimens. While THBH was superior to THB for isolating GBS in rectal specimens, for urethral samples they were equally effective. Direct plating of 154 specimens on blood agar was less effective than was enrichment in any of the three broths followed by plating on blood agar. PMID- 3545658 TI - The role of 4-quinolones in the treatment of infections. PMID- 3545659 TI - Pulmonary infections in AIDS. AB - Based on our experience, we would like to offer a few pragmatic suggestions for the practicing clinician. These recommendations are summarized in Tables 1 and 2. The first encounter with most patients gives the impression of either a dramatic acute infection, usually in the lungs, central nervous system, or gastrointestinal tract (in this order of frequency), or that of a chronic wasting disease. The former is frequently superimposed on the latter. The exploration of AIDS risk factors and a few easily detectable physical signs are the most important clues to the correct clinical diagnosis. Once AIDS is suspected, an aggressive and rapid approach for diagnosis is justified. Selected individually for each patient, the most commonly successful tests include bronchoscopy with BAL and/or transbronchial lung biopsy; bone marrow, lymph node, or liver biopsy with both microbiologic and pathologic processing of the material; blood (and often spinal fluid) cultures for fungal organisms; cranial computerized tomographic scan; and toxoplasma serology. Other tests, while potentially useful, are less important in immediate decision-making and treatment. In all cases of respiratory compromise or symptoms related to the chest, PCP has to be ruled out by invasive methods if the suspicion of AIDS is sufficiently strong. The diagnosis of one opportunistic infection should not be interpreted as a final answer. Rather, it should stimulate more vigilant efforts to uncover additional infections and other AIDS-related diseases if any abnormalities remain unexplained or persist despite treatment. Chest radiology should not be the main tool to diagnose or monitor lung infections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545660 TI - Tropoelastin synthesis in fetal bovine tissues. AB - Tropoelastin was examined in bovine lung, aortic and ligament tissues using both organ culture and cell-free translation systems. The bovine tissues synthesized two tropoelastin polypeptides of approximately 70,000 and 68,000 daltons. Two polypeptides were also seen amongst the translation products directed by mRNAs isolated from each of the individual tissues. Both proteins were shown to be tropoelastins directly by immunoprecipitation with specific antibody and limited NH2-terminal sequence analyses and indirectly by two-dimensional gel electrophoresis. The finding of two forms of tropoelastin is similar to that previously reported in chick tissues although the apparent molecular weights of the tropoelastins differ between the two species. Another interesting observation is that the proportion of the two tropoelastins differs amongst the three fetal tissues examined. This situation is similar to the differences seen in the ratio of tropoelastin a and be between embryonic chick lung and aortic tissues. PMID- 3545662 TI - Peptidyl transferase centres of rat and yeast ribosomes. Different response to modification of protein amino groups. AB - Modification of rat liver ribosomes with dimethylmaleic anhydride, a reagent for protein amino groups, causes a large stimulation of peptidyl transferase activity assayed by the "fragment" reaction, as well as the inactivation of poly(U) directed polyphenylalanine synthesis. In contrast to rat ribosomes, the peptidyl transferase of yeast ribosomes is little affected by modification. Although other interpretations are not excluded, these results might be due to differences between the peptidyl transferase centres of mammalian and yeast ribosomes. PMID- 3545663 TI - Diagnosis of acute abdominal pain using a three-stage classifier. AB - The present paper deals with an application of a three-stage classifier based on a decision tree logic to the diagnosis of acute abdominal pain. On the basis of clinical information collected from a series of 476 patients suffering from abdominal pain of acute onset, the method of multistage classifier synthesis is presented. The results of classification accuracy using a modified version of k nearest neighbours strategy for different features used at interior nodes of a tree are given. PMID- 3545661 TI - Newly determined carboxy terminal sequences in tropoelastin: immunologic identification in insoluble elastin. AB - The carboxy terminal sequence of sheep, bovine and human tropoelastin (GFPGGACLGKA/SCGRKRK) has been inferred in earlier studies from sequencing of cloned complementary and genomic DNA. However, this putative carboxy terminal sequence was not found previously in peptides recovered from tryptic digests of tropoelastin. In order to determine whether the amino acid sequence described above is found in insoluble elastin, antibodies were raised against the chemically synthesized peptides with the appropriate sequences and the antibodies were shown to react with peptides derived from human, bovine, porcine, dog and hamster insoluble elastins. These results strongly suggest that the sequence (GFPGGACLGKA/SCGRKRK) at the carboxy terminus of tropoelastin is found in the elastins of many species. PMID- 3545664 TI - Digital signal processing in studies of animal acoustical communication, including human speech. AB - The study of animal acoustical communication and other biological signals like cardiopulmonary cycles and neurological waves has advanced rapidly in the last few years. Progress has been stimulated by dramatic improvements in transducers, recorders, computers, and digital signal processing (DSP) techniques. Nevertheless, many biologists cannot take advantage of these new techniques and technology because mainframe computer usage is expensive and DSP theory is buried in highly technical engineering and mathematical journals. Recently, new developments in microcomputer hardware and commercially available DSP software have greatly improved this picture. Nevertheless, DSP theory remains largely inaccessible to the non-specialist. In this paper, selected areas of DSP theory are surveyed in relation to a common biological signal processing problem, namely, the analysis of animal acoustical signals. Signal digitization techniques are described, including the concepts of word-width, sample rate, and data encoding. An overview of the mathematical models developed for human speech encoding and analysis is presented. Finally, selected DSP techniques used in the time and frequency domains, including digital filtering, spectral analysis, and dynamic time warping are reviewed. PMID- 3545665 TI - A microcomputer-assisted analysis of drug resistance in bacteria. AB - A software package for analysis of antimicrobial drug resistance traits has been developed. It is written in PASCAL and implemented on a microcomputer. The microbiological data to be analysed is reduced to the different patterns of drug resistance found and the associated numbers of isolates. Based upon these patterns of drug resistance, the incidence of resistance to individual drugs and combinations is calculated. Furthermore, the extent and nature of the multiple drug resistance within a group of microorganisms is examined by looking at various aspects of the statistical association of drug resistance traits. PMID- 3545666 TI - ANSIM: an anesthesia simulator for the IBM PC. AB - Simulations based on physiologic modeling have been used for over twenty years to clarify the pharmacokinetics of inhaled anesthetics. We describe ANSIM, an anesthesia simulator for the IBM PC. ANSIM uses established modeling techniques to create a life-like anesthesia simulator. ANSIM is useful as an educational tool for demonstrating classic concepts of uptake and distribution of inhaled anesthetics. PMID- 3545667 TI - Cardiac rhythms and arrhythmias: a teaching program. AB - A computer-aided instruction program for teaching cardiac rhythms and arrhythmias to second year medical students at Case Western Reserve University was created. The program seeks to integrate multiple levels of information in a visually exciting way by combining various simultaneous animations of the heart, its electrical system, and the standard representations of the electrical system (the ladder diagram and the EKG). The program features a text that covers the most important information about 22 cardiac arrhythmias in a step-by-step approach, illustrating all didactic points with high-resolution graphics. Students are instructed in the genesis and propagation of arrhythmia, as well as in the recognition of characteristic EKG features. The program is menu-driven, offering a teaching series, a quiz, and random access to each individual arrhythmia. The text describes the development of the program, its architecture, animation techniques, use, and evaluation by cardiologists and medical students. Copies of sample graphics screens are provided. PMID- 3545668 TI - Internal carotid artery hypoplasia. AB - Hypoplasia of the carotid arteries is a rare congenital anomaly which when clinically symptomatic presents as cerebral ischemia or hemorrhage. Patients with this anomaly commonly have associated variations of the circle of Willis, an increased incidence of intracranial aneurysms and extensive networks of collateral vessels to accommodate the diminished carotid flow. Carotid artery hypoplasia should not be confused with other conditions which may have a similar appearance such as arterial dissection, vasculitis, and tubular fibromuscular hyperplasia. PMID- 3545670 TI - Contact dermatitis to palladium. PMID- 3545669 TI - Contact dermatitis to antituberculosis drugs. AB - The literature has been reviewed for contact dermatitis occurring to antituberculosis agents. Of the 12 known drugs, 6 (isoniazid, rifampicin, ethambutol, para-aminosalicylic acid, streptomycin and kanamycin) have been documented by patch test to cause this type of dermatitis in certain individuals. Cross sensitization has been observed to contribute significantly to the allergic reactions noted from isoniazid, streptomycin, and kanamycin. Hyposensitization has also been discussed in this review. PMID- 3545671 TI - Cardiac transplantation: immune mechanisms and alloantigens involved in graft rejection. AB - Recent advances in surgical and chemotherapeutic approaches to cardiac transplantation have resulted in substantial improvements in patient survival. Rejection of the cardiac allograft by the recipient's immune system and complications associated with immunosuppressive therapy remain, however, important clinical problems. The rejection of the transplanted heart is a complex set of immunological reactions. Previous experimental work has indicated that a variety of mechanisms may be involved in the pathogenesis of heart rejection; these include alloantibodies, specifically sensitized cytotoxic T-lymphocytes, lymphokine-dependent T-lymphocyte delayed-type hypersensitivity reactions, and natural killer cells. The current knowledge of the role that genetic incompatibilities play in stimulating the cardiac allograft reaction and the effector mechanisms implicated in the pathogenesis of the rejection process will be discussed. PMID- 3545672 TI - Biosynthesis and processing of class II histocompatibility antigens. AB - The class II major histocompatibility antigens at the cell surface exist as heterodimers of alpha and beta subunits. During biosynthesis, these subunits are associated with a third chain, the invariant (I) or I chain. Association with the I chain occurs early in biosynthesis in the rough endoplasmic reticulum and persists during transport through the Golgi apparatus. One of the two alpha subunit N-linked oligosaccharides and the single beta subunit N-linked oligosaccharide are converted to the complex form during Golgi transit. In the human system, both I chain N-linked oligosaccharides can also be processed to the complex form, and at least two O-linked oligosaccharides can be added to the I chain. At some point during transit to the cell surface, class II antigens associate with a proteoglycan bearing chondroitin sulfate side chains. Complexes containing alpha, beta and I chain subunits and the associated proteoglycan accumulate in human B-cell lines treated with the ionophore monensin, an inhibitor of Golgi transport, suggesting that this may be a biosynthetic intermediate in class II antigen transport and assembly. Prior to cell surface expression of class II antigens, the exocytic pathway which they follow intersects the endocytic route, followed by certain ligands internalized by receptor-mediated endocytosis. The I chain appears to dissociate from mature class II alpha, beta dimers prior to their cell surface expression but following the intersection of the exocytic and endocytic pathways. PMID- 3545673 TI - Histamine modulation of lymphocyte biology: membrane receptors, signal transduction, and functions. AB - Until recently, histamine has been considered only in the context of its being the major mediator of immediate-type hypersensitivity responses. However, subsequent investigations have demonstrated an additional role for histamine as a regulator of both cellular and humoral immune responses. In this review, we will analyze critically histamine modulation of lymphocyte biology by examining the methods employed to identify cell membrane histamine receptors, the mechanisms of signal transduction following histamine-receptor interaction, and the effects of histamine on lymphocyte function. PMID- 3545674 TI - Effect of heparin concentration and infusion rate on the patency of arterial catheters. AB - In a prospective randomized controlled trial involving 470 arterial catheters in 470 children, we studied the effect of changing either the concentration or the flow rate of a heparin infusion. Although catheters tended to remain patent longer with a flow rate of 2 ml/h rather than 1 ml/h, the difference was not statistically significant. Increasing the heparin concentration from 1 to 5 U/ml significantly prolonged catheter patency. PMID- 3545675 TI - Intermittent mandatory ventilation systems. PMID- 3545676 TI - Retraction of publications. PMID- 3545677 TI - Increased pulmonary alveolar-capillary permeability in patients at risk for adult respiratory distress syndrome. AB - Two methods for predicting adult respiratory distress syndrome (ARDS) were evaluated prospectively in a group of 81 multitrauma and sepsis patients considered at clinical high risk. A popular ARDS risk-scoring method, employing discriminant analysis equations (weighted risk criteria and oxygenation characteristics), yielded a predictive accuracy of 59% and a false-negative rate of 22%. Pulmonary alveolar-capillary permeability (PACP) was determined with a radioaerosol lung-scan technique in 23 of these 81 patients, representing a statistically similar subgroup. Lung scanning achieved a predictive accuracy of 71% (after excluding patients with unilateral pulmonary contusion) and gave no false-negatives. We propose a combination of clinical risk identification and functional determination of PACP to assess a patient's risk of developing ARDS. PMID- 3545678 TI - Changes in tracheal cuff pressure during respiratory support. AB - Tracheal wall movement can affect the lateral wall pressure and seal of an endotracheal cuff. This paper studies the relationship between proximal airway pressure (Paw) and the pressure in high-volume, low-pressure, tracheal tube cuffs. Cuff pressure changes during intermittent mandatory ventilation and continuous positive airway pressure (CPAP) cannot be explained solely by the effect of tracheal pressure, as reflected by Paw, on the annulus of the cuff exposed in the trachea. Cuff pressure showed wide swings and decreased below atmospheric pressure in the presence of small Paw fluctuations during CPAP breathing. Thus, adequate gas flow in the ventilator circuit cannot assure minimal pleural pressure changes. Decreases in cuff pressure may indicate inadequate CPAP and may explain why "just seal" pressure in endotracheal cuffs may not always prevent aspiration. PMID- 3545679 TI - Calcium chloride in experimental electromechanical dissociation: a placebo controlled trial in dogs. AB - While calcium administration has been recommended in CPR, its beneficial effects have been challenged. The effectiveness of calcium chloride was evaluated and compared with epinephrine during successive episodes of electromechanical dissociation (EMD) after ventricular fibrillation in closed-chest dogs. Each of three successive episodes of CPR was randomly and blindly treated by repeated (every 2 min) injections of 5 ml H2O plus either 500 mg of calcium chloride (CaCl2), 1 mg of epinephrine (Epi), or 5% dextrose (D5W). Of 42 CPR attempts performed on 16 dogs, 16 were reversed by only chest compression and artificial ventilation. For the 26 CPR with pharmacologic intervention, recovery was obtained after one injection in 5 of 6 Epi but only in 4 of 11 CaCl2 and 4 of 9 D5W. Only four CPR attempts were ultimately unsuccessful, all in CaCl2 group. During recovery, the Epi group showed significantly higher arterial pressures and heart rates but less severe acidemia. In this model, calcium chloride alone is ineffective during EMD. PMID- 3545680 TI - Atrial fibrillation with high degree atrioventricular block masquerading as ventricular fibrillation masquerading as asystole during cardiac arrest. AB - Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block. AF with a high degree block can masquerade as VF, which simultaneously masquerades as asystole, and can be correctly diagnosed by bedside intracardiac monitoring. Patients who have a flat line rhythm which may represent asystole, fine ventricular fibrillation, or atrial fibrillation with a high degree atrioventricular block may warrant a trial of electrical countershock, high-dose atropine, or transthoracic pacing. PMID- 3545682 TI - CT of aortic dissections. AB - Dissecting aortic aneurysms are one of the few medical emergencies where prompt recognition is crucial. Contrast-enhanced computed tomography combined with dynamic scanning offers an excellent noninvasive means to evaluate patients with suspected aortic dissection. At the Medical College of Wisconsin, we retrospectively reviewed all patients who were referred to the Section of Computed Body Tomography with the diagnosis of suspected aortic dissection. Over 100 patients were studied. The sensitivity, specificity, and overall accuracy of computed tomography was greater than 95%. PMID- 3545681 TI - Immunopathologic role of complement activation in adult respiratory distress syndrome secondary to Plasmodium falciparum malaria. PMID- 3545683 TI - Information processing in magnetic resonance imaging. AB - Techniques of image processing have been developed for the extraction of information from magnetic resonance images. The response of nuclei to a sequence of magnetic stimulations has been modeled and used to predict the effects of changing magnetic resonance parameters on signal intensity. This allows the calculation of new images from a small set of acquired data without additional acquisition. These images can be used to predict the results of new imaging techniques before actual implementation and to simulate the effects of parameter variations which are unfeasible or impractical, such as variable field strength. New forms of representation, for example, a tissue type map in which each homogeneous tissue category has been identified and labeled, can be used for more direct interpretation. PMID- 3545684 TI - Improved cardiac function following hormonal therapy in brain dead pigs: relevance to organ donation. AB - Deterioration of function in brain dead baboons is associated with depletion of both myocardial energy stores and certain circulating hormones, notably thyroxine, cortisol, and insulin. We have therefore investigated the effect of the administration of these three hormones to the brain dead pig; their value has been assessed on both the freshly excised and stored donor heart. Brain death was induced by ligation of the two arteries to the upper part of the body which arise from the aortic arch. Storage of selected hearts was by continuous hypothermic perfusion for 20 to 24 hr. Hearts were biopsied for estimation of adenosine triphosphate, creatine phosphate, lactate, and glycogen, and were subsequently functionally tested. Six groups of pigs were studied. Hearts were tested from control pigs which had not undergone brain death (A1), from brain dead pigs which had received intravenous fluid and inotropic support for 4 hr (B1), and from brain dead pigs which had in addition received 2 hr of hormonal therapy (thyroxine 2 micrograms cortisol 100 mg, and insulin 5-10 IU hourly) (C1). A further 3 groups (A2-C2) underwent management identical to A1-C1, but in addition the hearts were stored for 24 hr. Brain death in pigs was followed by a consumption of myocardial energy stores, despite anaerobic glycolysis; this was associated with reduced myocardial function. The administration of hormones to the brain dead pig led to some replenishment of myocardial energy and glycogen reserves and reduction in lactate, with associated improvement in hemodynamic function. A period of hypothermic perfusion storage appeared to reverse the anaerobic metabolism occurring in the heart in the nonhormonally treated brain dead animal, though not in the hormonally treated animal, and led to replenishment of glycogen reserves in nontreated animals. The observation that both better function and an increase in myocardial energy stores occurred in hormonally treated, stored hearts, even though perfusate lactate dehydrogenase rose to significantly higher levels during hypothermic perfusion storage, and tissue lactate levels remained high, suggests that thyroxine promotes both aerobic and anaerobic metabolism in brain dead animals. PMID- 3545685 TI - A comparative study of the effects of ranitidine and cimetidine on carbohydrate tolerance, growth hormone secretion and the hypothalamic-pituitary-gonadal axis in man. AB - The effect of chronic oral administration of cimetidine (1 g per day) and ranitidine (300 mg per day) on plasma levels of prolactin (PRL), testosterone, dihydrotestosterone (DHT), luteinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG) and human growth hormone was compared in 2 groups of male patients who presented with dyspeptic symptoms. Eight were treated with ranitidine and 9 with cimetidine for 4 weeks. The glucose and insulin response to a 100 g oral glucose load was also assessed. Cimetidine treatment resulted in a significant increase in plasma testosterone levels which was not found in the ranitidine group. No significant change occurred in PRL, LH, FSH, SHBG, DHT and growth hormone. There was no evidence of a significant alteration in carbohydrate metabolism. PMID- 3545686 TI - An office-based primary care trial of pindolol ('Visken') in essential hypertension. AB - A large, open, multi-centre study was performed by physicians in general practice to evaluate the efficacy and tolerance of pindolol (10 to 20 mg per day) in the treatment of patients with essential hypertension. The records of 7324 patients who completed the 6-week protocol with pindolol alone or in combination with a diuretic were analyzed by computer. Substantial reductions in both systolic and diastolic blood pressure were obtained in the majority of patients regardless of age, sex or race. No difference in blood pressure response was found between patients taking diuretics concurrently and those on pindolol alone. Side-effects were generally not troublesome and a trend toward a reducing incidence of side effects was noted in all patients as the duration of therapy increased. Black patients tended to complain of fewer side-effects than did white patients. PMID- 3545687 TI - Antihypertensive effect of indapamide given in conjunction with captopril in severe hypertension. AB - The efficacy of captopril alone or in combination with indapamide was evaluated in 17 patients with severe hypertension (diastolic greater than 120 mmHg) previously treated with triple antihypertensive therapy, i.e. diuretic, beta blocker and a vasodilator. After a wash-out period of 1 week, captopril was given initially as 75 mg/day for 2 weeks; at the end of this period, the dosage was doubled to 150 mg/day and continued at this level for a further 2 weeks. Indapamide (2.5 mg/day) was then added to the regimen and administered for 1 month. The results showed that captopril alone lowered, but did not normalize the blood pressure. The mean diastolic pressure was reduced to 117 and 103.8 mmHg after dosages of captopril of 75 mg and 150 mg, respectively. On the addition of indapamide, the blood pressure was normalized to 93.82 mmHg mean diastolic pressure. Systolic readings were similarly reduced. Two patients developed skin rashes while on captopril alone: no other treatment-related side-effects were reported once indapamide therapy had commenced. PMID- 3545688 TI - Percutaneous drainage. PMID- 3545689 TI - Cutaneous hemangiomas, vascular stains and associated syndromes. PMID- 3545690 TI - The management of benign strictures of the bile duct. PMID- 3545691 TI - An overview of the structure and replication of baculoviruses. PMID- 3545692 TI - The 64K envelope protein of budded Autographa californica nuclear polyhedrosis virus. PMID- 3545693 TI - The primary structure of baculovirus inclusion body proteins. Evolution and structure-function aspects. PMID- 3545694 TI - Expression of the Autographa californica nuclear polyhedrosis virus genome in insect cells: homologous viral and heterologous vertebrate genes--the baculovirus vector system. PMID- 3545695 TI - The biochemistry and molecular biology of the granulosis virus that infects Plodia interpunctella. PMID- 3545696 TI - Hearing problems and the elderly. AB - Hearing problems have a profound influence on the lives of the elderly. The ability to communicate is frequently a deciding factor in determining a person's autonomy, independence, and overall well-being and happiness. In the works of Ralph Naunton, in the introduction to the report, "Society is ill-informed about the importance of speech communication and about the devastating effects of communication difficulties, and it is ill-informed about the cost effectiveness of providing communication aids to the elderly and about the cost to society and to the individual of not providing them." This report was written for health and social workers, politicians, planners, and others who care for the elderly. The purpose of the report is to provide insight into some of the most important questions concerning hearing problems of the elderly, to show what can be expected from the rehabilitative audiological services, and to make a case for more attention to the hearing problems of elderly persons. The report is organized around these 13 topics: Which criteria should be used in defining the population of elderly persons with hearing problems? How should hearing loss be described by different professions? Evaluation of present services; Do hearing thresholds differ among those having or applying for a hearing aid and those who do not have a hearing aid? Is early fitting of a hearing aid important for a positive result of hearing aid treatment? Can hearing loss provoke or promote senility? Are hearing and quality of life related factors in old age? Crises in the lives of the elderly provoked by hearing problems; Hearing problems and social class; Is audiovisual perception in the elderly a function of age? Qualitative aspects of hearing problems and influence of tinnitus on hearing; Services which should be available today for the elderly person with a hearing problem; How can we most effectively communicate the available knowledge to the elderly, to the relevant authorities, and to any other group which can be active in relieving hearing problems in the elderly? The report includes a reference list on each of the topics discussed as well as an extensive list of reading that should be useful for further study. PMID- 3545697 TI - Let's represent the interest of our patients. PMID- 3545698 TI - Thromboxane synthetase inhibition in primary pulmonary hypertension. AB - Thromboxane synthetase inhibitors have been shown to reduce thromboxane, a potent vasoconstrictor, and increase prostacyclin, a potent vasodilator, in normal subjects. We evaluated the acute and chronic (three months) effects of the thromboxane synthetase inhibitor CGS13080 administered 200 mg every six hours on the resting hemodynamics in ten patients with primary pulmonary hypertension (PPH), and on their response to 20 mg of nifedipine given sublingually before and after the thromboxane synthetase inhibitor treatment. It was concluded that one can modulate the levels of endogenous thromboxane and prostacyclin in patients with primary pulmonary hypertension using a thromboxane synthetase inhibitor. Although the thromboxane synthetase inhibitor alone produced only modest hemodynamic changes over time, the addition of nifedipine was able to produce a further lowering of pulmonary artery pressure and pulmonary vascular resistance. PMID- 3545700 TI - Differences in EPAP and CPAP. PMID- 3545699 TI - Subjective assessment vs computer analysis of wheezing in asthma. AB - To determine if wheezing is a reproducible clinical sign, we presented recorded breath sounds from asthmatic patients to four groups of health professionals: pediatric residents, nurses, pediatricians, and physiotherapists. Their subjective assessments included scores of wheezing severity and estimates of wheezing duration. All participants repeated the test at least two weeks later. Results were compared to computer aided spectral analysis of the recorded breath sounds. Interobserver and intraobserver variability fell somewhat between chance and total agreement. In contrast, the computer analysis allowed an objective and reproducible characterization of wheezing in asthma. PMID- 3545701 TI - Bronchoprovocation test in the normal and in asthmatics. AB - The bronchoprovocation test has been widely used in diagnosis of bronchial asthma. Forty-eight cases under tentative diagnosis of bronchial asthma, with complaints of cough, shortness of breath, and wheezing, were studied by using histamine and methacholine. Their baseline pulmonary functions were all normal. Among the Fourteen cases, histamine and methacholine provocation tests were both negative in 14 cases (29%) (Group 1). There were 18 cases (37%) of allergic asthmatics with positive challenge to either histamine (2 cases) or methacholine (1 case) or both (15 cases) (Group 2). There were 16 cases (34%) of nonallergic asthmatics with positive challenge to either histamine (2 cases) or methacholine (3 cases) or both (11 cases) (Group 3). In Group 2, the average PD20 FEV1 for methacholine and histamine was 25.8 +/- 8.2 BU and 22.9 +/- 7.1 BU respectively; the average PD25 FEF25-75 for methacholine and histamine was 19.4 +/- 7.0 BU and 21.1 +/- 7.1 BU respectively. The sensitivities, compared between both agents, were nearly the same. In Group 3, the average PD20 FEV1 for methacholine and histamine was 35.1 +/- 9.0 BU and 54.5 +/- 9.6 BU respectively; the average PD25 FEF25-75 for methacholine and histamine was 27.9 +/- 8.6 BU and 50.2 +/- 9.6 BU respectively. Methacholine is more sensitive in detecting airway hyperreactivity in this group. When these two groups of asthmatics were compared, Group 2 patients were more sensitive to challenges with histamine and methacholine (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545702 TI - [Effect of dexamethasone-A synthetic glucocorticoid hormone on the immune response in pigs]. AB - These experiments were designed to study the effects of a synthetic drug- dexamethasone (DEX) on the immune response of weaned pigs against viral antigen (hog cholera vaccine) and bacterial antigen (formalin inactivated Salmonella enteritis vaccine). Twenty-three five-week-old pigs were divided into eight groups, six of which were injected twice daily with DEX at 1.0 mg or 0.1 mg per Kg of body weight for either four or five days. The other two groups served as controls. During this period, the two 0.1 mg/Kg DEX-treated groups were injected with live hog cholera vaccine at 1.0 or 0.1 dosage respectively. This same treatment was applied to the two 1.0 mg/Kg DEX-treated groups. One control group was injected with a dose of hog cholera vaccine, while the other was given 1.0 ml of Sal. enteritis vaccine. The hog cholera antibody response in DEX-treated pigs was significantly suppressed (p less than 0.01). However, consistent levels of antibody titers were maintained, indicating a slight antibody production. But in pigs injected with one tenth of the normal dose of hog cholera vaccine, there was little or no immune response (p less than 0.01). A comparison of the response of pigs given different levels of DEX concentrations to those with different doses of hog cholera vaccine showed that dexamethasone significantly suppressed antibody production when antigen concentrations were lower. Significant suppression of agglutinating antibody in response to bacterial antigen was also observed at 14 days post-vaccination (p less than 0.05). PMID- 3545703 TI - Serum levels of beta-2 microglobulin in oral tumor patients. AB - Beta-2 microglobulin (beta-MG) is a low molecular weight protein of 100 amino acids. It is the light chain of HLA-A, -B or -C antigens which on the surface of nearly all nucleated cells. Clinically, the serum levels of beta-MG are increased in patients with renal failure, immune disorders, and various malignant diseases. In this study, the serum levels of beta-MG were measured clinically for a total of 114 cases. Diverse conditions were ensured by biopsy except for 10 control cases, and the following eight groups were diversified: (1) control group, 10 cases; (2) oral carcinoma, 36 cases; (3) mixed tumor, 7 cases; (4) pyogenic granuloma, 12 cases; (5) leukoplakia, 18 cases; (6) mucocele, 15 cases; (7) ameloblastoma, 7 cases; (8) fibroma, 9 cases. The serum levels of beta-MG in oral cancer and leukoplakia patients were found to be significantly higher compared with that of the control group and patients with benign oral tumors. Further study to unravel the correlations between the clinical stages, the treatment of oral cancer, and beta-MG is now in progress. PMID- 3545704 TI - Protease production with sweet potato residue by solid state fermentation. AB - The sweet potato residue being at the initial moisture content 50-58%, initial pH 3.5-4.3, supplemented with rice bran, and minerals, and incubated at 20-26 degrees C for 5 days was the optimal conditions for protease production with Aspergillus niger NTU-AM-1 by solid state fermentation. Protease could be recovered by shaking at room temperature for one hour and extracted with five times volume of 0.1% NaCl solution. The yield of protease was 814 units per gram dry weight of substrate. Partially purified protease with DEAE-Sephacel column chromatography was thermally stable and able to retain 80-100% of activity in pH 4.0-5.5 at 55 degrees C for 40 minutes. In addition, the activity of protease was stimulated by the presence of EDTA and cysteine, but was inhibited by the addition of HgCl2. PMID- 3545705 TI - [Sphincter-preserving interventions in rectal tumors. Transabdominal rectum resection]. PMID- 3545706 TI - [Sphincter-preserving interventions in rectal tumors. Transanal excision and anastomosis technic]. PMID- 3545707 TI - [Sphincter-preserving interventions in rectal tumors. The posterior approach to the rectum]. PMID- 3545708 TI - [Results of colo-anal anastomosis in deep-seated tumors of the rectum]. AB - Colo-anal anastomosis as surgical procedure for low rectal tumors was analysed in regard of complication rate, functional and oncological results. The sensibility of the method particularly in tumors near the anal sphincters, was assessed by means of a new radiological procedure (lateral distant view). From 1982 to 1985 colo-anal anastomosis was performed in 30 patients with rectal carcinoma. All tumors were within reach of the palpating finger. Tumor distance from the anal verge was measured endoscopically (6.4 +/- 1.5 cm) and radiologically (9.3 +/- 1.7 cm) (x +/- SD). The complication rate was comparable to that after anterior resection with conventional anastomosis. Inspite of problems with high frequency in the first months after surgery, all patients were satisfied with the functional result of the operation. Frequency decreased within a year to 4 stools/day. At present a reliable evaluation of the oncological results cannot yet be established. PMID- 3545709 TI - [Status of clinical pancreas transplantation]. AB - Since 1977 and especially within the latest 5 years there was a volatile development in the pancreas transplantation. If we had only 60 transplants between 1966-1977, prevalent duodeno-pancreas-transplants, the cases rose to 215 up to 1982 and to 447 transplantations between 1983 to 1985. Altogether there were 722 pancreas transplants, up to November, 15, 1985 registered. Before 1977 only 2 patients had a 1 year function rate of the transplant and of the 447 transplantations within the latest 3 years 201 transplants functioned more than 12 months. That was a 1-year function rate of 45% in contrast to 3% before 1977. The clear improvement of the results in pancreas transplantation can be attributed to operative aspects and to the employment of Cyclosporine A. The segmental pancreas transplantation with duct occlusion and intestinal or external drainage of the duct system were the most sure operative procedures. The combination of Azathioprine and Cyclosporin A brought with a 1-year function rate of 54% better results in comparison to the singular application of Azathioprine (22%) and Cyclosporin A (41%). The simultaneous pancreas-kidney transplantation had a 1-year function rate of 39%, the pancreas transplantation after kidney of 31% and the pancreas transplantation alone of 20%. PMID- 3545710 TI - [Migration of an Angelchik antireflux prosthesis in the gastrointestinal tract with ileus of the small intestine]. PMID- 3545711 TI - [Clinical observation on human chorionic gonadotrophin in maternal serum and amniotic fluid using monoclonal antibody immunoenzyme assay]. PMID- 3545712 TI - [Advances in venous transplantation]. PMID- 3545713 TI - [Anterior decompression and bone graft for the treatment of cervical injuries with spinal cord injury]. PMID- 3545714 TI - [Value of B-mode ultrasonography screening in the early diagnosis of carcinoma of the head of the pancreas and the ampulla]. PMID- 3545715 TI - [Advances in the treatment of rectal cancers in the 80's]. PMID- 3545716 TI - [Anaerobic bacterial infections and metronidazole therapy]. PMID- 3545717 TI - [Cardiospasm and cardia achalasia]. PMID- 3545718 TI - Short-term treatment of prepyloric ulcer. Comparison of sucralfate and cimetidine. AB - A double-blind, randomized, multicenter study was performed to compare the effect of sucralfate (1 g qid) and cimetidine (400 mg bid) in the treatment of prepyloric ulcer. Altogether 142 patients (68 in the sucralfate and 74 in the cimetidine group) with endoscopically confirmed ulcer within 2 cm of the pylorus completed the study. Endoscopic follow up was performed after four weeks and, if the ulcer was not healed, after eight weeks of treatment. After four weeks, 65% of the ulcers in the sucralfate group were healed, compared to 70% in the cimetidine group. There was no significant difference between sucralfate and cimetidine at either time point. The 95% confidence interval for the difference in ulcer healing with sucralfate or cimetidine ranged from +4 to -19% at eight weeks. Said another way, with an observed difference of 7% (83% vs 90%), the 95% confidence limit ranged from 4% in favor of sucralfate to 19% in favor of cimetidine. Symptomatic relief, antacid intake, and side effects did not differ significantly between the two groups. The healing rate of prepyloric ulcer in this study is similar to that reported for duodenal ulcer after four and eight weeks when treated with sucralfate or cimetidine. Sucralfate is safe and as effective as cimetidine in the short-term treatment of prepyloric ulcer. PMID- 3545719 TI - Effects of desipramine on irritable bowel syndrome compared with atropine and placebo. AB - Antidepressant treatment trials of irritable bowel syndrome (IBS) have suggested beneficial effects. Twenty-eight patients with the disorder (9 constipation predominant, 19 diarrhea-predominant) completed a double-blind crossover study using desipramine, atropine, and placebo in random sequence. A four-week observation period preceded three six-week test periods. Bowel habits, abdominal distress, and affect were reported daily and in biweekly evaluations. Psychological assessments and rectosigmoid contractile studies were done in each period. Stool frequency, diarrhea, abdominal pain, depression, and slow contractions decreased significantly more in diarrhea-predominant patients during desipramine compared with placebo and atropine treatments. Diarrhea-prone patients' depression scores fell more in all periods than constipation-prone patients. Fifteen patients (13 diarrhea-predominant) improved globally during desipramine, five during placebo and six during atropine treatments. Desipramine may be helpful in treating IBS, perhaps through antidepressant and antimuscarinic effects. PMID- 3545720 TI - Rainbow trout growth hormone: molecular cloning of cDNA and expression in Escherichia coli. AB - We have isolated several recombinant clones carrying the complementary DNA (cDNA) sequence of the rainbow trout (rt) Salmo gairdneri growth hormone (GH) mRNA by immunoblot screening using an antiserum to chum salmon (Oncorhyncus keta) GH. The nucleotide sequence of one of the rtGH cDNA clones (pAF51) was determined. The rt cDNA sequence in pAF51 encodes a hybrid polypeptide of 199 amino acid residues containing 9 amino acid residues of the bacterial beta-galactosidase, one residue from the codon at the junction of the beta-galactosidase gene, and the rtGH cDNA sequence, an additional residue from the presumptive signal peptide of the pre rtGH and the entire sequence of the mature rtGH (188 amino acid residues). Pairwise matrix comparisons of the hydropathy profiles of bovine, human, rat, and rainbow trout GH polypeptides indicate that regions of similarity exist between the rtGH and mammalian GH. In particular, there are two major regions of similarity found near the amino-terminal region and at the carboxy-terminal region. These regions correspond to hydrophilic domains of the GH molecules. The possible significance of these domains is discussed. PMID- 3545721 TI - Cloning and expression in Escherichia coli of a synthetic DNA for hirudin, the blood coagulation inhibitor in the leech. AB - A 235-bp DNA coding for the leech blood coagulation inhibitor, hirudin, was chemically synthesized. The synthesis involved preparation of seven long oligodeoxyribonucleotide pairs which were assembled and cloned using a rapid and simple procedure. More than half of the transformed Escherichia coli cells expressed a biosynthetic polypeptide having biological properties which were very similar to authentic hirudin from the leech Hirudo medicinalis. To achieve efficient expression, we fused the hirudin DNA to a truncated C1 repressor gene of bacteriophage lambda to create a hybrid protein. An additional methionine at the fusion point allowed the active hirudin to be cleaved off by cyanogen bromide. PMID- 3545722 TI - Increased amplification of plasmids pBR322 and pBR327 by low concentrations of chloramphenicol. AB - The replication and amplification of plasmids pBR322 and pBR327 is maximal during partial inhibition of protein synthesis by low concentrations (10-20 micrograms/ml) of chloramphenicol in rich medium (LB). In this manner, 5- to 10 fold greater yields of plasmid DNA at 2- to 5-fold greater initial purity (less protein and chromosomal DNA content) can be obtained than by using the standard high concentrations of chloramphenicol. These results have been obtained with an improved method of plasmid quantitation in unfractionated bacterial lysates. PMID- 3545724 TI - Tolbutamide and insulin stimulation of fructose-2,6-bisphosphate formation in hepatocytes differ. AB - The effects of tolbutamide and pancreatic hormones on liver fructose-2,6 bisphosphate (F-2,6-P2) formation were examined using isolated rat hepatocytes. Glucagon decreased the F-2,6-P2 level in a dose-dependent manner. Insulin (greater than 10(-9) M) increased the F-2,6-P2 level reduced by glucagon (less than 10(-9) M), but did not show a stimulatory effect on this activator formation in the absence of glucagon. On the other hand, tolbutamide increased the F-2,6-P2 level in hepatocytes regardless of the presence or absence of glucagon. Tolbutamide (2 mM) stimulation on liver F-2,6-P2 formation was enhanced by the concomitant addition of insulin (10(-8) M) in the presence of glucagon (3 X 10( 11) M). These observations suggest that the regulatory effect of tolbutamide on liver F-2,6-P2 level is independent of that of insulin. PMID- 3545723 TI - Immunogenicity of biosynthetic human insulin. Humoral immune response in diabetic patients beginning insulin treatment and in patients previously treated with other insulins. AB - The immunogenicity of biosynthetic human insulin (BHI) was studied in diabetic patients who had never received insulin treatment (Study A) and in diabetic patients who had already been treated with monocomponent insulin (Study B). The results of both studies were compared to matched control groups receiving other forms of insulin treatment. Blood samples obtained were tested for anti-insulin antibodies and circulating immune complexes using two different methods. After six months of treatment, the values of anti-insulin antibodies in those patients in Study A who were treated with BHI were significantly lower than those observed in control patients treated with monocomponent (P less than 0.02) or conventional insulin (P less than 0.001). At the sixth month of Study A no significant difference in the percentage of circulating immune complex positivity was seen between the three groups. In Study B no significant difference in the values of insulin antibodies or immune complexes was observed between patients who were switched to BHI and those who continued monocomponent insulin. No side effects were observed. The data show that the immunogenicity of BHI is even lower than that of monocomponent insulin. PMID- 3545725 TI - Delayed onset of action of soluble insulin after premixing with U100 lente insulin. AB - In previous studies we demonstrated that mixing lente with soluble insulin of U40 strength in the syringe delays the onset of action of soluble insulin. Lente insulin of U100 as compared to U40 strength, contains a proportionally smaller amount of excess of zinc. The purpose of our study was to investigate the effect of premixing lente and soluble insulin of U100 strength on plasma insulin levels and glucose requirements during glucose clamping for 8 h in eight healthy volunteers. Soluble (0.22 U/kg) and lente (0.33 U/kg) insulin were administered once separately and once immediately after mixing in the syringe. In both instances the insulins were injected into two depots in contralateral thighs. The initial rise of plasma insulin levels from 0 to 2 h was not significantly different for both studies: from 11 +/- 1 to 25 +/- 4 mU/l and from 10 +/- 1 to 31 +/- 5 mU/l after premixing and separate administrations, respectively. However, the areas under the curves of the glucose infusion rates were significantly greater from 0 to 2 h after the separate injections of soluble plus lente than after premixing 3.25 +/- 0.70 vs. 1.84 +/- 0.56 mmol/kg, respectively (P less than 0.05). Plasma insulin levels and glucose requirements were significantly higher after premixing, compared with separate injections of soluble plus lente, from 300 to 480 and from 405 to 480 min, respectively. We conclude that mixing soluble with lente insulin of U100 strength in the syringe delays the onset of action of soluble insulin. PMID- 3545726 TI - Insulin deficiency in non-insulin-dependent diabetics. AB - In this study, the prevalence of severe insulin deprivation amongst 104 non insulin-dependent diabetes mellitus (NIDDM) patients was determined using a mixed meal pancreatic stimulation test (2.4 MJ). Of the 104 patients, 62 were recently diagnosed and 42 had been diabetic for between 1 and 40 years, but were not adequately controlled on diet and oral hypoglycaemic agents. Twenty-one (34%) of the recently diagnosed patients and 13 (31%) of the poorly controlled patients had peak post-testmeal insulin responses less than 160 pmol/l (less than 23 mU/l) -values 3 SD below normal--and were therefore considered to have severe blunting of beta cell response to nutrient secretagogues. Amongst recently diagnosed diabetics, these patients, as a group, had higher blood glucose levels (P less than 0.05) and lower body weights (P less than 0.01) but overall these parameters correlated poorly with insulin responses. Islet cell antibodies were positive in only one patient, whereas they were present in three others with less severe insulin secretory defects. For the treated diabetics, insulin release showed very low non-significant correlations with duration of diabetes, age, weight and glycaemic control. Islet cell antibodies were present in five patients, one only showing peak insulin values less than 160 pmol/l. These data suggest that about one-third of new diabetics and one-third of treated diabetics with poor glycaemic control are insulin deficient. Clinical and biochemical parameters, including islet cell antibodies, appear to be of no value in identifying this sub-group requiring insulin therapy. Their early recognition is best facilitated by routine pancreatic function tests. PMID- 3545728 TI - The effect of continuous subcutaneous insulin infusion on insulin binding to erythrocytes in diabetes mellitus. AB - The effect of continuous subcutaneous insulin infusion (CSII) on glycaemic control and insulin binding to erythrocytes was studied in six diabetic patients. A marked improvement in blood glucose control during CSII was observed in these patients previously on conventional therapy. Specific 125I-insulin binding to erythrocytes of the diabetics before the institution of CSII was significantly lower than that of age-, weight- and sex-matched nondiabetic subjects, 6.5 +/- 0.1% vs. 9.8 +/- 0.3% (P less than 0.05). After 4-6 months of CSII, insulin binding was restored to normal levels. This normalization in insulin binding to erythrocytes of patients on CSII was due to a 35% increase in active binding sites, together with a small change in binding affinity. PMID- 3545727 TI - Observations on the metabolic basis for altered insulin dose distribution in diabetic pregnancy. AB - Insulin requirements are known to increase during pregnancy, but it has not been reported whether this relates to prandial or basal requirements, or to a change in insulin pharmacokinetics. In nine unselected pregnant patients the pattern of this increase was that of a large increase in the total morning dose and a reduction in the evening dose of intermediate acting insulin, in order to maintain good control while avoiding nocturnal hypoglycaemia. 24 h metabolic profiles were carried out in these patients in the third trimester of pregnancy. Plasma free insulin profiles reflected the dosage patterns and there was no change in insulin metabolic clearance rate in pregnancy. Pregnant diabetic patients had a broad peak of free insulin concentration around lunchtime followed by a steady fall until next morning. Blood lactate and alanine were higher than normal and 3-hydroxybutyrate lower than is usually seen in non-pregnant diabetic patients. The observations suggest that there may be differential changes in insulin sensitivity in diabetic pregnancy between the fed and fasting states, and that the therapeutic response to this causes a measurable metabolic change. PMID- 3545729 TI - [The role of epidermal growth factor and insulin in the regulation of the repair of gamma-induced single-stranded DNA breaks]. PMID- 3545730 TI - Ciprofloxacin: a comparative evaluation of its bactericidal activity in human serum against four enterobacterial species. AB - Serum bactericidal titres following a 200 mg i.v. dose of ciprofloxacin were measured in healthy volunteers and compared with those achieved with standard doses of ceftazidime, piperacillin and gentamicin, given alone or in combination. Five strains of each of four enterobacterial species were included in the study. Bactericidal titres 1 h after infusion of ciprofloxacin exceeded 1:16 for Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris and Enterobacter cloacae. While ceftazidime produced higher peak bactericidal titres against the Enterobacteriaceae, piperacillin was less effective than ciprofloxacin against three of the four enterobacterial species tested. Among the combinations, only piperacillin/gentamicin showed synergistic activity against some strains. Studies of bacterial killing kinetics again confirmed the high bactericidal activity of ciprofloxacin for the Enterobacteriaceae. The combination of ciprofloxacin with gentamicin resulted in more rapid killing of some strains of Klebsiella pneumoniae and Proteus vulgaris. PMID- 3545731 TI - Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. AB - The world-wide incidence of the fetal alcohol syndrome (FAS) is 1.9 per 1000 live births. Incidence rates vary considerably, however, depending on study site. Mental retardation is a cardinal feature of FAS and is now recognized as the leading known cause of mental retardation in the Western world. Conservatively estimated for the United States, the economic cost associated with FAS-related growth retardation, surgical repair of organic anomalies (e.g. cleft palate, Tetralogy of Fallot), treatment of sensorineural problems, and mental retardation, is +321 million per year. FAS-related mental retardation alone may account for as much as 11% of the annual cost for all mentally retarded institutionalized residents in the United States. Current treatment costs for FAS related problems are about 100 times federal funding for FAS research necessary to develop cost-effective early identification and prevention strategies. PMID- 3545732 TI - Use of intermittent dobutamine infusion in congestive heart failure. AB - Dobutamine is a cardiac inotrope useful in the acute treatment of congestive heart failure. Dobutamine improves cardiac output, decreases pulmonary wedge pressure, and decreases total systemic vascular resistance with little effect on heart rate or systemic arterial pressure. Clinical benefit has been observed to continue for weeks to months following the discontinuation of dobutamine. In addition, tolerance to dobutamine has been observed when infusions last 72 hours or longer. This has led investigators to study the effectiveness of chronic intermittent infusions of dobutamine. Studies utilizing dobutamine doses ranging from 1.5 to 15 micrograms/kg/min for 4-48 h/wk have shown sustained clinical and hemodynamic improvement in patients suffering from congestive heart failure. The mechanism by which dobutamine creates this effect is not entirely known; however, studies suggest dobutamine exerts a physical conditioning effect similar to exercise. Dobutamine infusions have also been associated with morphological and metabolic changes in myocardial tissue consistent with improved myocardial structure and function. The intermittent use of dobutamine may be beneficial in the chronic treatment of congestive heart failure in patients who fail to respond to conventional therapy. PMID- 3545733 TI - Induction of hemolytic anemia by nonsteroidal antiinflammatory drugs. AB - The incidence of immune hemolytic anemia (IHA) is increasing. The proliferation of pharmaceuticals is a contributing factor to this increase. IHA is an uncommon, though significant, adverse effect of a wide variety of drugs. Several recent case reports have implicated the nonsteroidal antiinflammatory drugs (NSAIDs). Because of the extensive use of this class of drugs, a review of case reports, clinical studies, and in vitro research was conducted on NSAID-induced IHA. Mefenamic acid, ibuprofen, sulindac, naproxen, tolmetin, feprazone, and aspirin are reported to cause IHA, with mefenamic acid most frequently implicated. Mefenamic acid appears to cause hemolytic anemia by an autoimmune mechanism similar to methyldopa and aspirin by an immune complex mechanism. However, there is insufficient information concerning ibuprofen, sulindac, naproxen, tolmetin, and feprazone to assign specific mechanisms of immune hemolysis. In individuals with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, aspirin at usual therapeutic doses is not a predisposing factor to hemolysis unless other risk factors are present. Although individuals with G-6-PD deficiency are at increased risk of developing hemolytic anemia when exposed to oxidizing stresses, the use of NSAIDs does not appear to increase this risk significantly. Because NSAID induced IHA occurs infrequently and the sensitivity of currently used tests to detect drug-dependent antibodies is limited, routine serologic testing in patients receiving NSAIDs is not justified. If hemolytic anemia occurs in a NSAID treated patient and the history is consistent with a drug-induced etiology, the NSAID should be discontinued. With discontinuation of the offending agent, the prognosis is good. There is a rapid hematologic recovery, with a slow resolution of abnormal serologic findings. PMID- 3545734 TI - Review of systemic fluoride supplementation and consideration of the pharmacist's role. AB - Interprofessional contact and consultation among dentists, physicians, and pharmacists can help to optimize patient care. Because pharmacists are readily accessible to the public, their influence is essential for the appropriate prescribing and continued use of systemic fluoride supplements. Pharmacists should be familiar with various aspects of fluoride therapy, such as mechanisms of caries inhibition, dosages associated with acute and chronic toxicity, and recommended daily dosage levels. The impact of breastfeeding, multiple sources of water intake, and changing age of the patient must be considered in determining proper systemic fluoride dosage. Pharmacists should consult with both physicians and dentists to coordinate water fluoride assay and prescribing responsibilities. They also can help to educate both prescribers and patients. Because of frequent patient contact and access to medication records, pharmacists can encourage and monitor patient compliance. Fluoride prescriptions and results of water fluoride assays should be documented on the patients' computerized or card profiles. In addition, pharmacists can counsel patients about the fluoride ion content of various home-use products and make recommendations to ensure that an optimal level of fluoride ingestion is maintained. PMID- 3545735 TI - Parkinsonism--drug treatment: Part I. AB - The purpose of this two-part review is to explain current drug treatment in part I and discuss investigational drug therapy and miscellaneous drugs in the management of parkinsonism in part II. The medical approach to this disease is still based on the imbalance between a deficiency of dopamine and a functional increase in acetylcholine. Anticholinergic agents are used to treat the tremors in the early stages of the disease. PMID- 3545736 TI - Cibenzoline-induced hypoglycemia. AB - Antiarrhythmic-induced hypoglycemia is an ill-defined phenomenon. Sporadic cases have been reported with disopyramide, a class IA antiarrhythmic agent. We report a case of cibenzoline-induced hypoglycemia in an elderly male with a history of ischemic heart disease, congestive heart failure, ventricular arrhythmias, and chronic obstructive pulmonary disease. Cibenzoline is a class I antiarrhythmic agent currently undergoing clinical investigation in the U.S. The initial hypoglycemic episode occurred after two years of successful treatment with cibenzoline. Blood glucose during the first hypoglycemic episode was 40 mg/dL. The hypoglycemia was associated with central nervous system depression, hyperkalemia, electrocardiographic abnormalities, and respiratory distress. Rechallenge with cibenzoline resulted in recurrence of symptoms and a blood glucose level of 21 mg/dL. A second rechallenge resulted in symptoms suggestive of hypoglycemia, but cibenzoline was discontinued before frank hypoglycemia and hyperkalemia recurred. Hypoglycemia occurred during periods of fasting, which most likely ruled out reactive-type hypoglycemia. Insulinoma was ruled out by the presence of normal fasting blood glucose and plasma insulin levels. It was concluded that this patient's hypoglycemia was secondary to cibenzoline. Hypoglycemia is a rare and sporadic adverse effect associated with antiarrhythmic therapy. However, the severity of these reactions warrants increased awareness of their occurrence in patients presenting with symptoms of hypoglycemia who are receiving disopyramide or cibenzoline. PMID- 3545737 TI - Atenolol vs. amiloride-hydrochlorothiazide in the treatment of mild to moderate hypertension: a double-blind, crossover, placebo-controlled study. AB - The antihypertensive effect of atenolol 100 mg was compared to that of amiloride HCl 5 mg + hydrochlorothiazide 50 mg (AHCZ) in a double-blind, crossover, placebo controlled study of 128 patients. Both drugs were given once daily. Atenolol produced a significant decline in lying, standing, and postexercise blood pressure and pulse rate values. The corresponding values on AHCZ were not significantly different from placebo. Both the beta-blocking agent and the thiazide diuretic with amiloride were relatively well tolerated. More than half of all adverse effects were nonspecific and also observed in patients on placebo. In the population studied, atenolol proved to be a superior antihypertensive agent to AHCZ. PMID- 3545738 TI - Reimbursement of clinical pharmacy services in community hospitals and nursing homes. PMID- 3545739 TI - Clinical pharmacists in drug research and development: a historical perspective. PMID- 3545740 TI - Looking after the elderly diabetic. PMID- 3545741 TI - Aspirin and myocardial infarction. PMID- 3545742 TI - [Differential diagnosis of acute inflammatory colon diseases by colonic sonography]. AB - Colon sonography enables imaging of the colon from the beginning of the rectosigmoid transition up to the cecum. Colon sonographic investigations in 29 patients (normal findings n = 15, ulcerative colitis n = 6, Crohn's disease n = 8) with a finding verified by coloscopy and biopsy show that acute ulcerative colitis and florid Crohn's disease lead to different sonographic alterations. Formation of haustra can no longer be detected in the two diseases. In Crohn's disease, the typical sonographically discernible wall layering has been abolished, and the wall is markedly thickened. In contrast to this, the wall layering is preserved in acute ulcerative colitis and the wall is only moderately thickened. The results show that differential diagnosis of acute inflammatory diseases of the large intestine is possible using colon sonography. PMID- 3545743 TI - [Insulin therapy using a new injection device. Experience with 36 type I diabetics]. AB - Thirty-six type I diabetics were switched from conventional insulin therapy to the basic bolus principle (combination of an ultralong-acting human insulin with preprandial old insulin administration) with a new injection device (NovoPen). In the observation period of four months, a better metabolic situation could be attained (HbA1c before switching 9.4%, after switching 8.41%; P less than 0.01) with approximately the same daily amount of injected insulin (before treatment 42.7 +/- 9.3 IU, after treatment 43.5 +/- 7.1 IU) in another distribution and with the injection device. All patients gave a positive appraisal of the handling and technique with the NovoPen. The new treatment principle is to be applied especially in patients with inadequate blood sugar values under conventional therapy as well as in diabetic secondary complications which require optimal compensation. Furthermore, this principle of treatment is also suitable for prevention of secondary lesions owing to diabetes. Under the precondition of more intensive attention of the patient to his metabolic disorder (self-checking of blood sugar, diabetes training), the basic bolus principle provides more freedom in daily routine and thus greater quality of life. PMID- 3545744 TI - [Nisoldipine in the treatment of essential hypertension. Efficacy and tolerance]. AB - The antihypertensive effect after a single dose of one tablet of Nisoldilpine (Bay k 5552) containing 5 mg, 10 mg or 20 mg respectively, was tested in a double blind cross-over trial with intra-individual comparison on 60 patients with stable essential hypertension. Mean age was 51.6 +/- 7.1 years, mean body-weight 78.0 +/- 11.8 kg, mean height 169.8 +/- 8.2 cm and mean duration of illness 6.1 +/- 4.3 years. 34 patients were in WHO stage I, 24 in stage II. After 5 mg nisoldipine the blood pressure fell from 150/96 to 135/92 mm Hg, after 10 mg from 153/98 to 130/88 mm Hg and after 20 mg from 149/97 to 127/84 mm Hg. Compared with placebo pre-test levels there was also a significant reduction in blood-pressure at an exercise level of 100 W. Side effects were rare and dose-dependent. PMID- 3545745 TI - [The initial electrocardiogram in cardiac infarct]. PMID- 3545746 TI - [Hypertension in children]. PMID- 3545747 TI - [Extraintestinal manifestations of Yersinia enterocolitica enteritis]. PMID- 3545748 TI - [Drug interactions in alcoholics]. PMID- 3545749 TI - [Importance of the composition of various combination regimens in the chemotherapy of metastatic breast cancer]. PMID- 3545750 TI - [Autologous bone marrow transplantation in Hodgkin's disease]. PMID- 3545751 TI - [Splenomegaly]. PMID- 3545752 TI - [Diagnosis of alcoholic hepatitis]. PMID- 3545753 TI - [Therapy of alcoholic hepatitis]. PMID- 3545755 TI - [Concentrations of electrolytes and short-chain fatty acids in the gastrointestinal tract of guinea pigs on a normal diet and on a low sodium diet]. PMID- 3545754 TI - [Prevention of the progression of chronic kidney failure]. PMID- 3545756 TI - [Mode of action of anthraquinone laxatives on the rat]. PMID- 3545757 TI - [The circadian rhythm of rabbits in light-dark alternation, in the absence of time indicators and in time-restricted feeding]. PMID- 3545758 TI - [New methods of studying small intestine motility]. PMID- 3545761 TI - Comparative aspects of digestion in the hindgut of mammals. The colonic separator mechanism (CSM) (a review). PMID- 3545760 TI - [The suitability of liver function tests in birds as a parameter for the ecotoxicological evaluation of environmental chemicals]. PMID- 3545759 TI - [A method of ecotoxicological evaluation of environmental chemicals with birds as the test organism: the determination of shell stability]. PMID- 3545762 TI - [Electrophysiological analysis of cellular regulation of sodium transport in the large intestine of the rabbit]. PMID- 3545763 TI - Volatile fatty acid absorption across rabbit colon in vivo. PMID- 3545764 TI - Haloperidol decanoate. A preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in psychosis. AB - Haloperidol decanoate is a depot preparation of haloperidol, a commonly used butyrophenone derivative with antipsychotic activity. Haloperidol decanoate has no intrinsic activity: its pharmacodynamic actions are those of haloperidol- primarily that of central antidopamine activity. The monthly administered depot formulation has several clinical and practical advantages over oral haloperidol: better compliance and more predictable absorption; more controlled plasma concentrations; fewer extrapyramidal side effects; less frequent reminders of condition; and reduced medical workload. In open and controlled studies, haloperidol decanoate has produced adequate maintenance or improvement of the condition of patients with psychoses (mainly schizophrenia) when an abrupt change from orally administered haloperidol or other antipsychotic drugs has been instituted. Limited comparative studies indicate that the depot and oral forms of haloperidol are equally effective, and that haloperidol decanoate is at least as effective as depot forms of fluphenazine, pipothiazine, flupenthixol and perphenazine in controlling the symptoms of psychosis. Extrapyramidal side effects and the need for concomitant anti-Parkinsonian drugs may be a problem, but may be less frequent than with oral haloperidol or other depot antipsychotics. Thus, haloperidol decanoate offers a useful alternative in the treatment of psychoses to orally administered haloperidol or to other depot antipsychotic drugs. PMID- 3545767 TI - [Mammography and ultrasonography of the breast]. PMID- 3545765 TI - Antimalarial drugs. An update. AB - Over the last decade, chloroquine-resistant falciparum malaria has spread to other areas from its original foci in Southeast Asia and South America. Additionally, new knowledge about the life-cycle of the malaria parasite, and about the pharmacokinetic properties of antimalarial drugs, has emerged. It is appropriate to reassess our approach to prevention and management of malaria with these factors in mind. Antimalarial drugs can be classified in two ways: biologically as tissue schizontocides, hypnozoitocides, blood schizontocides, gametocytocides or sporontocides; or by a mixed chemical/biological classification as 8-aminoquinolines, antimetabolites and (again) blood schizontocides. Chloroquine resistance in P. falciparum can now be found in most areas where malaria occurs. Malarial strains moderately resistant to the chloroquine group of drugs (chloroquine and mepacrine) are generally susceptible to the aryl amino alcohols such as quinine. Indeed, quinine is the most widely used drug for treating malaria due to chloroquine-resistant strains, followed by a 7-day course of tetracycline where some resistance to quinine is also found. Alternatively, the course of quinine may be followed by sulfadoxine/pyrimethamine or the newer quinoline derivative, mefloquine. Quinidine has also shown activity against quinine-resistant strains. Prophylaxis of chloroquine-resistant strains is best undertaken with daily proguanil (chloroguanide), and weekly chloroquine. In severe malaria, including cerebral malaria, an intravenous loading dose of quinine should be considered, and plasma concentration monitoring may be advisable to assist with dosage adjustment. In patients with severe renal insufficiency, there is evidence that the elimination of chloroquine is prolonged, and dosage adjustments may be necessary. Other recent findings on the pharmacodynamic properties, mechanisms of action and toxicity of antimalarial drugs are also discussed. PMID- 3545769 TI - [The durability of crowns in the anterior region]. PMID- 3545768 TI - Pitfalls in the clinical diagnosis of cerebral malaria. PMID- 3545766 TI - Management of infectious and immunological complications of acquired immunodeficiency syndrome (AIDS). Current and future prospects. AB - AIDS is caused by a newly recognised virus (human immunodeficiency virus; HIV) which induces a profound defect in cellular immune function associated with increased susceptibility to opportunistic infections and certain malignancies. The clinical presentation of HIV ranges from asymptomatic infection to severe immunodeficiency manifesting as severe life-threatening infectious diseases or malignancies. While major research efforts are being directed toward development of vaccine and discovery of effective antiretroviral drugs, clinicians are faced with AIDS patients with multiple and complicated medical problems including opportunistic infections and certain malignancies. Currently, efforts are directed toward early diagnosis, treatment, and prevention of recurrence of these opportunistic infections. The current approaches are reviewed in this article. Major recent developments in AIDS research include the isolation of the HIV on culture and the availability of the antibody test. Aside from vaccine and antiretroviral drugs, other measures that may be of benefit in the treatment of AIDS patients are immunological enhancement and reconstitution. Several studies are underway to evaluate antiviral agents in the treatment of HIV infection. Those undergoing clinical trial include suramin, ribavirin, antimoniotungstate, phosphonoformate and azidothymidine. Immune enhancers that have been used include alpha- and gamma-interferon and interleukin-2. HLA-matched lymphocyte transfusions and bone marrow transplantations have been used alone and in combination to replace the AIDS patient's defective immune system. PMID- 3545770 TI - [Initial results with bonded bridges and splints--a retrospective cross-sectional study. 3: Primary failures and rebonding]. PMID- 3545771 TI - [Electrochemical corrosion measurements in post and core constructions]. PMID- 3545772 TI - [The marginal fit of crowns and bridges]. PMID- 3545773 TI - [Preservation methods for the acid-etched retention surfaces of bonded bridges]. PMID- 3545775 TI - [The results of recent periodontal findings on practical periodontics]. PMID- 3545774 TI - [Periodontal aspects of fixed dentures]. PMID- 3545776 TI - [The wall-adhering properties of root canal fillings using the thermoplugger method]. PMID- 3545778 TI - [Bone transplants with microvascular pedicles as implant beds for endosseous implants]. PMID- 3545777 TI - [Microbiological studies after periodontal therapy using phase contrast microscopy]. PMID- 3545780 TI - [Effect of alloxan diabetes and exogenous insulin on the immune response of Wistar rats]. PMID- 3545779 TI - [Hormonal regulation of the immune response. IV. A discussion of the problem and its classification]. PMID- 3545782 TI - [Are lymphocytic anomalies in the schizophrenic a reflection of an immune deficit? Bibliographic review]. AB - Concerning schizophrenia, several immune abnormalities are noticed. Lymphocytes are the main known immune agents. The review of the literature suggests a reduction of T-lymphocytes and a possible increase of B-lymphocytes. These results suggest an alteration of the cells immunity processes but it is difficult to know if the reason is due to the disease or to the neuroleptic treatments. One hypothesis would assume the existence of anti-T-lymphocyte antibodies in the schizophrenic. This could also lead to a viral hypothesis. PMID- 3545781 TI - [Chromosome aberrations in monocytic leukemias]. AB - Improved cytogenetic techniques allow for the identification of subtle chromosomal rearrangements associated with particular subgroups of monocytic leukemias. A detailed assessment of both quantitative and structural chromosomal defects is presented and clinical and prognostic value of the karyotypic pattern is discussed. PMID- 3545783 TI - [Affective disorders, diabetes and carbohydrate metabolism]. AB - In a medical and biological perspective, the authors analyse the relations existing between diabetes mellitus and affective disorders on the basis of clinical, therapeutic, metabolic, neuro-endocrinal and epidemiological arguments. Besides the presentation of an original clinical case, the principal data of literature are detailed and criticized; some orientations of the future research concerning the explaining of these relations are given as well. PMID- 3545784 TI - [Potential therapeutic action of neuropeptides in depressive syndromes]. AB - Since the discovery of peptides in hypophysis and brain, several classes of these peptides have been tested on their putative antidepressive properties. The clinical research was stimulated both by the symptomatology of depressive disorders and the demonstrated neuro-endocrine disturbances which frequently occur in such syndromes, and the data obtained in investigations of CSF, blood and post-mortem material. In this concise review, attention will be focused only upon the results from clinical studies with releasing and release-inhibiting factors and hypophysial hormones respectively. PMID- 3545785 TI - [Anxiolytic efficacy and tolerance of tetrabamate in anxious patients abusing alcohol. Multicenter double-blind versus placebo study]. AB - The anxiolytic efficacy of tetrabamate was evaluated in 68 out-patients presenting an anxiety state with alcohol abuse according to DSM III criteria. The study followed a double-blind placebo-controlled design with parallel groups and lasted for 21 days. Anxiety was evaluated by the Hamilton anxiety scale, Norris visual analog scales, and the Hopkins Symptom Check List, along with the investigator's assessment. Safety was evaluated in terms of somatic symptoms (CHESS 84) and the physician's overall evaluation. The anxiolytic activity of tetrabamate (three 300 mg tablets/day) was significantly greater than that of placebo from seventh day on. There were no statistically significant differences in safety profile between tetrabamate and placebo. Moreover, in the tetrabamate group the significantly greater improvement in the scores of somatic symptoms indicates that the compound caused no notable adverse effects and its activity on somatic complaints (psychopathologic and/or toxic). PMID- 3545786 TI - [Validation of HARD (Hamilton depression rating scale) a diagram of the evaluation of depression by MADRS (Montgomery-Asberg depression rating scale) Multicentric study of mianserin]. AB - A national multicentric trial has included 402 depressed patients (DSM III Criteria) and has validated diagram HARD by MADRS. A constant and similar decrease in the total of the two rating scales has been shown at several times of assessment, Day 0, 10, 20, 60, and 90. High coefficents of correlation are found between HARD and MADRS. The sensitivity to change under treatment (mianserin 60 mg) is equal for the two rating scales. PMID- 3545787 TI - [Biochemical factors of resistance to antidepressants]. AB - This review of the literature concerning the biochemical factors of resistance to antidepressants is essentially based on the anomalies of neurotransmitters and the enzymes which regulate them. In the case of 5HIAA, because of the bimodal distribution in depressed patients, it appears to be generally accepted that when a low level of this catabolite is found in the cerebrospinal fluid, this may represent a factor of resistance to noradrenergic antidepressants, or even to all antidepressants. In contrast, a high level of this catabolite represents a factor of poor response to serotoninergic antidepressants. Low levels of urinary MHPG predict a poor response to serotoninergic antidepressants, while high levels are observed in cases of depression resistant to noradrenergic antidepressants. MAO activity, evaluated after two weeks' treatment with MAOI, is considered to be a biochemical factor of resistance when it is inhibited by less than 80%. High levels of COMT (related to the degree of anxiety and agitation) reflect a poor response to noradrenergic antidepressants. Finally, a number of strategies designed to control resistant depression (reserpine, lithium carbonate, ...) could, in certain cases, suggest the existence of a functional defect in the serotoninergic systems. PMID- 3545788 TI - [Pharmacokinetic factors and resistance to antidepressant treatment]. AB - A number of treatment failures occurring during antidepressant treatment may be related to the pharmacokinetics of the drug used. In fact, numerous factors are able to modify the fate of the antidepressant in the body. These factors may involve the absorption, distribution, biotransformation or elimination of the drug. The reality of these problems is illustrated by a number of clinical case reports. Such modifications lead to a variation in the quantity of drug available to exert its antidepressant action at the sites responsible for the pharmacodynamic effects. This raises the possible value of defining, and then using in practice, the therapeutic zone of the plasma concentrations of the antidepressant used, below and above which a poor therapeutic response is likely. Modern analytical techniques actually allow the routine analysis of plasma concentrations of a number of antidepressants, resulting in a more rational approach to drug therapy and a decrease in the number of depressions resistant to antidepressant treatments. PMID- 3545789 TI - [Good and bad therapeutic combinations in the treatment of resistant depressions]. AB - The definition of resistant depression is imprecise and variable according to the different authors. In most cases, the definition concerns depressed patients who have received well managed treatment with optimal doses of a thymoanaleptic over a sufficiently long period of time. The distinction of manic-depressive psychoses (MDP) with a rapid cycle also raises the problem of resistance to the prophylactic effect of mood regulators in MDP. The inefficacy of treatment in at least 20% of cases of depression has led a number of authors to propose original drug combinations with the aim of potentiating the action of previous treatments. Most of the studies published report isolated cases in which the therapeutic approach is often empirical and rarely explained. The most frequently reported combination is that of 2 drugs, generally including one antidepressant. Such combinations can induce pharmacodynamic or pharmacokinetic interactions resulting in either a potentiation or a reduction of the effects of one of the 2 drugs or to the induction of toxicity. These last two possibilities illustrate what the authors describe as "bad combinations". Various drug combinations are reviewed and critically analysed. The most interesting and best documented combinations involve the addition of lithium, MAOI and thyroid hormones to tricyclic treatment in non-responding patients. Other combinations with tricyclics have been reported less frequently: ECT, neuroleptics, reserpine, carbamazepine, 5 HTP, tryptophan, amphetamines, oestrogens, sleep deprivations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545790 TI - [Place of cognitive-behavioral therapies in resistant depressions]. AB - Several behavioural models have been proposed to explain the psychopathology of depression. One of these models, the cognitivo-behavioural approach developed by Beck since 1963, seems to be gaining a renewed interest in psychiatric circles, especially in North America. This model postulates the predominant role of thought content and thought processes in the psychopathology of affective disorders. In depression, there is activation of certain idiosyncratic cognitive structures (schemes) which dominate the thought processes and lead to cognitive distorsions. The therapeutic techniques proposed by Beck involve the identification and correction of these distorsions and the schemes responsible for them. This therapy is directive and structured, involving about 20 sessions over a period of three months. Three phases can be defined corresponding to the course of the depressive manifestations: The first phase involves the use of behavioural techniques such as self-recording and the prescription of tasks designed to increase the patient's activities and to test the validity of the patient's judgement of himself, on the basis of experience. The second phase involves identification and critical evaluation of the characteristic automatic thoughts in depressed patients. They reflect the combination of themes with a negative content and certain systematic errors in the thought process. In the third phase, when the patient has a sufficient behavioural and cognitive repertoire, the treatment focuses on the "silent postulates" (contents of the schemes), which are the basis for the depressive manifestations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545791 TI - [Tolerance and pharmacovigilance of trazodone]. AB - Trazodone has been approved for marketing in the United States over three years ago. During this period, over two million patients have been exposed to the compound. It is also estimated that world wide another four million individuals have been treated with the compound. This provides a fairly large clinical experience for us to draw conclusions about safety and tolerance data, both from the initial control studies and from the extensive post-marketing surveillance available as a result of this extensive clinical experience. Trazodone, "this second generation" antidepressant and its clinical efficacy and safety data, can be reviewed against the background of tricyclic antidepressants and monoamine oxidase inhibitors. These previously established therapeutic agents have been available for many years and can be used as a major reference point in making these assessments. The special areas of side effect experience with the tricyclic antidepressants have been the occurrence of significant anticholinergic side effects and the particular problems that these induce in an elderly population. In addition, the tricyclic antidepressants have been associated with a variety of cardiac effects. The other major area of concern in clinical practice is the drug interactions that may occur with the newly introduced compound. A considerable experience has been obtained with such exposure and this material will also be reviewed and presented.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545792 TI - Federal legislative impact on emergency medicine practice. AB - The specialty of emergency medicine has grown rapidly, partially as a result of federal programs providing insurance coverage for large numbers of formerly uninsured individuals. The specialty grew and flourished as a response to improving economic circumstances. Today, however, changes in federal reimbursement policies threaten the future viability of emergency medicine. PMID- 3545793 TI - Marketing and public relations in the emergency department. AB - This article outlines the elements of successful ED marketing, as well as providing definitions for terms used within the marketing process. In today's competition and rapidly changing environment, marketing and public relations are tools that every ED Medical Director may want to consider. Because the marketing process requires a great deal of time and effort, as well as a high degree of intellectual honesty, it should never be entered into without a strong commitment. However, marketing the ED can be among the most productive, stimulating, and gratifying experiences for the ED Medical Director, the emergency department physicians, and all ED service personnel. PMID- 3545794 TI - Implementation of family centered care at Harbor-UCLA Medical Center. PMID- 3545795 TI - The future isn't what it used to be. PMID- 3545796 TI - The sex difference in fetal lung surfactant production. PMID- 3545797 TI - Effects of a contingent relaxation treatment program on adults with refractory epileptic seizures. AB - A group of eighteen adults with refractory epileptic seizures were given psychological treatment in a two-phase experimental group study. In phase one, the experimental phase, the patients were divided into three groups--contingent relaxation (CR), attention control (ATC) treatment, and a no-treatment (NT) control group--with the purpose of investigating the effects of a learning-based contingent relaxation program compared with the effects of professional attention alone when superimposed on a regular medical treatment program. The design of the experimental phase was comprised of a 10-week baseline, 6-week intervention, and 10-week follow-up. Results of this phase at the end of follow-up showed a significant reduction only for those patients receiving the CR treatment. In the nonexperimental phase, the two control groups also received the CR treatment for a 6-week period, and subsequent seizure frequency measures for all three groups were analyzed after 10-week and 30-week follow-up periods. Results of this phase showed a significant reduction in seizure frequency for all three groups after receiving the CR treatment. Effects of the CR treatment were maintained at a 30 week follow-up. The results indicate that the CR treatment program may be of substantial help to adults whose seizures are resistant to conventional drug therapy. PMID- 3545798 TI - In memoriam. Alexander Hollaender 1898-1986. PMID- 3545799 TI - Disubstituted amino-, nitroso-, and nitrofluorenes: a physicochemical basis for structure-activity relationships in Salmonella typhimurium. AB - Twenty-nine derivatives of fluorene were tested for mutagenic potency in four strains of Salmonella typhimurium with and/or without S9 microsomal activation. The effects of a second functional group on the mutagenic activity of an amino-, nitroso-, and nitrofluorene were correlated with its physical and chemical properties. When the functional group is conjugated by resonance, both inductive and resonance effects are determinants of mutagenic potency. Electron-withdrawing groups such as the halogens (F, C1, Br, and I), nitro, nitroso, and cyano at C-7 increased the mutagenic potency of 2-nitrofluorene. Electron-donating substituents such as hydroxy and amino groups at C-7 decreased the mutagenic potency of 2-amino, 2-nitroso-, and 2-nitrofluorene. Acetylation of a hydroxy or an amino group at C-7 increased the mutagenic potency of 2-nitrofluorene, presumably by decreasing the electron-donating properties of these groups. In contrast, acetylation of a nonresonance-conjugated amino group decreased mutagenic activity. The physical properties of a second functional group are expected to exert their effect(s) at three points in the metabolic activation of 2,7-disubstituted fluorene derivatives: initial reduction of the nitro group (redox effect), stabilization of the hydroxylamine (inductive effect), and stabilization/destabilization of the nitrenium ion (resonance and inductive effects). The relationships between the physical properties of a second functional group and their effects on biological activities of nitro- and aminofluorenes in the Ames Salmonella assay may be of predictive value in a first approximation of both the mutagenic and carcinogenic potency of chemicals with comparable structures such as fluoranthene and biphenyl. PMID- 3545800 TI - Electronic considerations in the mutagenesis of some 4,5-bridged chrysenes. AB - The mutagenic activity of four 4,5-bridged chrysene derivatives, benz(a)aceanthrylene, and 5-methylchrysene was examined using histidine auxotrophic strains TA98 and TA100 of Salmonella typhimurium. All compounds showed a positive mutagenic response with both TA100 and TA98 in the presence of S-9. A correlation between the electronic character of the bridging group and mutagenic activity for the chrysene derivatives is proposed. PMID- 3545801 TI - Effects of metals on chromosomes of higher organisms. AB - An analysis of the available data on the clastogenic effects of metals and their compounds on higher organisms indicates some general trends. Following chronic exposure to subtoxic doses, a decrease in mitotic frequency and an increase in the number of chromosomal abnormalities are observed. These effects are usually directly proportional to the dose applied and the duration of treatment within the threshold limits. Recovery after acute treatment is inversely related to the dosage. The ultimate expression of the effects depends on certain factors, including the mode and vehicle of administration; the form administered; the test system used; the rate of detoxification, distribution, and retention in the different tissues; and interaction with foreign and endogenous substances as well as the mode of action with the biological macromolecules. In mammals, the clastogenic activity of the metals within each vertical group of the periodic table is directly proportional to the increase in atomic weight, electropositivity, and solubility of the metallic cations in water and lipids, except for Li and Ba. This pattern of inherent cytotoxicity increases with successive periods in the horizontal level. It is enhanced by the formation of covalent and coordinate covalent complexes by heavy metals with the biological macromolecules. In plants, the solubility of the metals in water is of much greater importance. The degree of dissociation of metallic salts and the rate of absorption affect significantly the frequency of chromosomal aberrations. In assessing the effects of environmental metal pollution, the presence of other metals and toxic chemicals and the level of nutrition should be taken into account, since in nature, metals occur in combination and these factors modify the cytotoxic effects to a significant extent. PMID- 3545802 TI - Reaction products of ozone: a review. AB - The reaction products of ozone that form during the oxidation of compounds found in aqueous media are reviewed. Reaction products of ozone are well documented only for a limited number of substrates, and mechanistic information is quite rare. Decomposition of ozone during its reactions, sometimes induced by matrix impurities or by the by-products of the reactions, will generate highly reactive hydroxyl radicals. Thus, even reactions occurring at pH less than 7 may have radical character. More complete destruction of organic substrates may be enhanced by using catalysts, such as ultraviolet radiation or hydrogen peroxide, to accelerate radical formation. However, complete mineralization is generally not practical economically, so partially oxidized by-products can be expected under typical treatment conditions. Ozone by-products tend to be oxygenated compounds that are usually, but not always, more biodegradable and less toxic than xenobiotic precursors. Of particular interest are hydroperoxide by-products, which may have escaped detection because of their lability, and unsaturated aldehydes. Inorganic by-products tend to be in high oxidation states, which in some cases (e.g., some metallic elements) may lead to enhanced removal by flocculation and sedimentation. In other cases oxidation may lead to formation of reactive species such as hypobromous acid from bromide ion or permanganate from manganous ion. In general, more research is required before a valid assessment of the risks of ozone by-products can be made. PMID- 3545803 TI - Effects of chlorinated drinking water on human lipid metabolism. AB - Atherosclerosis with its complications is the most important health problem affecting American adults. The levels of serum cholesterol, of high and low density lipoproteins, and of apolipoproteins A1, A2, and B are major risk factors for the development of atherosclerotic lesions. Animal studies suggest that chlorinated drinking water may elevate the serum cholesterol. Studies are too limited to confirm or refute this effect in humans. Since millions of humans have and have had daily exposure to chlorinated drinking water, it is essential to study the effects of such exposure on human lipid metabolism. We have begun a protocol to discover whether consuming chlorinated drinking water elevates serum cholesterol and the other lipid components of blood known to be associated with atherosclerosis. This protocol has been designed to improve the chance of observing an effect while preserving the ability to generalize the data. PMID- 3545804 TI - Reactions of aqueous chlorine and chlorine dioxide with model food compounds. AB - Chlorine and chlorine dioxide (ClO2), common disinfecting and bleaching chemicals used in the food industry, are potent oxidizing and chlorinating agents. Unfortunately, little is known about the nature of the reactions of chlorine with organic food constituents. This presentation reviews published information concerning the reactions of chlorine gas (Cl2[g]), aqueous chlorine, and ClO2 with model food compounds, the fate of chlorine during the chlorination of specific food products, and the potential toxicity of the reaction products. Fatty acids and their methyl esters react with chlorine with the degree of incorporation corresponding to their degree of unsaturation. Aqueous chlorine oxidizes and chlorinates lipids and amino acids much more readily than ClO2. Several amino acids are highly susceptible to oxidation and chlorination by chlorine compounds. Reactions of chlorine and ClO2 with several food products, including flour and shrimp, have also been characterized. In one model system, 99% of Cl2(g) either reacted with components of flour or was consumed by oxidation/chlorination reactions. The lipids extracted from the chlorinated flour contained significant amounts of chlorine. Exposure of shrimp to hypochlorous acid (HOCl) solution resulted in significant incorporation of chlorine into the edible portion. Although significant quantities of chlorine can be incorporated into specific model compounds and food products, the health risks associated with exposure to chlorinated organic products are unknown. Preliminary studies using the Ames Salmonella/microsome mutagenicity assay indicate that the reaction products from mixtures of aqueous chlorine and various lipids or tryptophan are nonmutagenic. Nevertheless, additional studies are warranted, so that the toxicological significance of these reaction products can be understood more fully. PMID- 3545805 TI - A review of toxicology studies on cyanurate and its chlorinated derivatives. AB - Chlorinated cyanurates are added to swimming pools as disinfectants. In the presence of water, these materials hydrolyze to yield cyanurate and hypochlorous acid. To evaluate the safety of exposure to these materials, a comprehensive testing program was undertaken. This review summarizes the results of acute and subchronic tests on chlorinated isocyanurates. Findings from acute, subchronic, reproduction, metabolism, mutagenicity, and chronic/carcinogenicity tests on cyanurate are also summarized. Results from these tests indicate that chlorinated isocyanurates are safe for use in swimming pools. PMID- 3545806 TI - Water disinfection: microbes versus molecules--an introduction of issues. AB - "Water is, apart from the air one breathes, the only nutrient which is, as a matter of necessity, consumed by every human being from the first day to the last day of his existence, and it is consumed in considerably larger quantities than any other nutritional substance."(1) PMID- 3545808 TI - [The hyper-IgE-syndrome (Buckley- or Job-syndrome)]. PMID- 3545807 TI - Occurrence of by-products of strong oxidants reacting with drinking water contaminants--scope of the problem. AB - This paper describes results of a detailed literature review of the organic and inorganic by-products that have been identified as being formed in aqueous solution with four of the strong oxidizing/disinfecting agents commonly employed in drinking water treatment. These agents are: chlorine, chlorine dioxide, chloramine, and ozone. Significant findings include the production of similar nonchlorinated organic oxidation products from chlorine, chlorine dioxide, and ozone. In addition, all three chlorinous oxidants/disinfectants can produce chlorinated by-products under certain conditions. The presence of chloronitrile compounds in drinking waters is indicated to arise from reactions of chlorine or chloramine to amine/amide functions in amino acids or proteinaceous materials, followed by dehydrohalogenation. These nitriles could hydrolyze to produce the corresponding chloroacetic acids. It is concluded that to minimize the presence of oxidation by-products in drinking waters, the concentrations of oxidizable organic/inorganic impurities should be lowered before any oxidizing agent is added. PMID- 3545809 TI - Haemochromatosis. PMID- 3545810 TI - Review of hypertrophic cardiomyopathy. PMID- 3545811 TI - The McCune-Albright syndrome. PMID- 3545812 TI - Efficient transport of Semliki Forest virus glycoproteins through a Golgi complex morphologically altered by Uukuniemi virus glycoproteins. AB - In infected BHK21 cells, the glycoproteins G1 and G2 of a temperature-sensitive mutant (ts12) of Uukuniemi virus (UUK) accumulate at 39 degrees C in the Golgi complex (GC) causing an expansion and vacuolization of this organelle. We have studied whether such an altered Golgi complex can carry out the glycosylation and transport to the plasma membrane (PM) of the Semliki Forest virus (SFV) glycoproteins in double-infected cells. Double-immunofluorescence staining showed that approximately 90% of the cells became infected with both viruses. Almost the same final yield of infectious SFV was obtained from double-infected cells as from cells infected with SFV alone. The rate of transport from the endoplasmic reticulum (ER) via the GC to the plasma membrane of the SFV glycoproteins was analysed by immunofluorescence, surface radioimmunoassay and pulse-chase labeling followed by immunoprecipitation, endoglycosidase H digestion and SDS-PAGE. The results showed that: the SFV glycoproteins were readily transported to the cell surface in double-infected cells, whereas the UUK glycoproteins were retained in the GC; the transport to the PM was retarded by approximately 20 min, due to a delay between the ER and the central Golgi; E1 of SFV appeared at the PM in a sialylated form. These results indicate that the morphologically altered GC had retained its functional integrity to glycosylate and transport plasma membrane glycoproteins. PMID- 3545813 TI - Neuronal localization of the neutral endopeptidase 'enkephalinase' in rat brain revealed by lesions and autoradiography. AB - The cellular localization of rat brain enkephalinase was studied after induction of selective unilateral lesions using in vitro quantitative autoradiography of the specific binding of the enzyme inhibitor [3H]-N-[(2RS)-3-hydroxyaminocarbonyl 2-benzyl-1-oxopropyl]glycine ([3H]HACBO-Gly). Twenty-one days following injection of kainic acid in the caudate-putamen (CP) [3H]HACBO-Gly binding was locally decreased by 52% with a concomitant reduction of 67 and 78% in the ipsilateral substantia nigra (SN) and globus pallidus (GP), respectively. Inhibition of axonal transport in the CP by unilateral stereotaxic injection of colchicine induced a large (30-60%) and progressive decrease in enkephalinase labelling within the ipsilateral GP and SN. Taken together these results strongly suggest that in the CP a large fraction of enkephalinase is localized on intrinsic striatal neurones, and that the enzyme present both in the GP and the SN is partly localized on nerve terminals originating from neurones in the CP. No change in [3H]HACBO-Gly binding was observed in the CP following injection of 6 hydroxydopamine in the nigrostriatal bundle, contrasting with the 30% depletion in opioid receptors. This would indicate that enkephalinase is present in only very low amounts, if at all, on striatal dopaminergic nerve terminals. PMID- 3545814 TI - Brain induces the expression of an early cell surface marker for blood-brain barrier-specific endothelium. AB - Capillaries derived from the perineural vascular plexus invade brain tissue early in embryonic development. Considerably later they differentiate into blood-brain barrier (BBB)-forming blood vessels. In the chick, the BBB as defined by impermeability for the protein horseradish peroxidase develops around embryonic day 13. We have previously found that brain endothelial cells start to express a number of proteins at around the same time, suggesting that these proteins play a role in BBB function. Here we describe a 74 kd protein defined by the monoclonal antibody HT7 that is expressed on the surface of chick embryonic blood cells and brain endothelial but on no other endothelial cells. This protein is not detectable on early embryonic brain endothelium, but is expressed by these cells on embryonic day 10. It is absent in choroid plexus endothelial cells which represent permeable fenestrated endothelial cells. The antigen is expressed on choroid plexus epithelium which is the site of the blood-cerebrospinal fluid barrier. Since it is also found in basolateral membranes of kidney tubules, it may be involved in specific carrier mechanisms. Embryonic mouse brain tissue transplanted on the chick chorio-allantoic membrane induces the expression of this antigen on endothelial cells derived from the chorio-allantois. Brain tissue can therefore induce in endothelial cells in vivo the expression of a molecule characteristic of brain endothelium. PMID- 3545815 TI - Complementation of sensitivity to alkylating agents in Escherichia coli and Chinese hamster ovary cells by expression of a cloned bacterial DNA repair gene. AB - Dual expression vectors derived from pSV2gpt and encoding all or part of the Escherichia coli ada+ gene have been constructed. Following transformation into an E. coli ada strain or transfection and stable integration into the genome of Chinese hamster ovary (CHO) cells, plasmid vectors containing the whole ada+ gene conferred resistance to both killing and mutagenesis by N-methyl-N'-nitro-N nitrosoguanidine (MNNG). Thus, the bacterial DNA repair gene was functionally expressed in the mammalian cells. Plasmids containing an N-terminal fragment of the ada+ gene which encoded only one of the two methyltransferase activities of the Ada protein did not significantly protect E. coli or CHO cells against MNNG. These results are consistent with the central role of the intact ada+ gene in controlling the adaptive response to alkylating agents in E. coli. However, the data further suggest that some alkylation lesions in DNA, such as O6 methylguanine, may exert partly different biological effects in E. coli and mammalian cells. PMID- 3545816 TI - Purification and characterization of a T cell specific serine proteinase (TSP-1) from cloned cytolytic T lymphocytes. AB - We describe the purification of a T cell specific serine proteinase derived from a cloned murine cytolytic T lymphocyte line. Analysis of the enzyme by sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed a mol. wt of approximately 60 kd under non-reducing conditions and of approximately 30 kd under reducing conditions. The proteinase cleaves the model peptide substrate H-D Pro-Phe-Arg-NA, at the 4 nitroanilide (NA) group with high efficiency. Much lower or no activity of the enzyme is found against synthetic peptide substrates carrying other amino acid (AA) sequences at position P2, P3 adjacent to L arginine or against substrates in which AA other than L-arginine are bound to the NA group. Optimal pH for the cleavage of H-D-Pro-Phe-Arg-NA is in the range of 8.0-8.5. The enzyme is strongly inhibited by inhibitors of serine proteinases, diisopropylfluorophosphate, phenylmethane-sulfonyl fluoride, m-aminobenzamidine, aprotinin, and leupeptin but not by inhibitors of either thiol-, metallo- or carboxyl-proteinases. We propose the designation TSP-1 (T-cell derived serine proteinase 1) for this enzyme. TSP-1 has the capacity to stimulate B lymphocytes for proliferation in the absence of antigen. PMID- 3545819 TI - R-factor-mediated multidrug resistance in Salmonella typhimurium isolates. PMID- 3545817 TI - Facilitated diffusion of a DNA binding protein on chromatin. AB - Facilitated diffusion accounts for the rapid rate of association of many bacterial DNA binding proteins with specific DNA sequences in vitro. In this mechanism the proteins bind at random to non-specific sites on the DAN and diffuse (by 'sliding' or 'hopping') along the DNA chain until they arrive at their specific functional sites. We have investigated whether such a mechanism can operate in chromatin by using a bacterial DNA binding protein, Escherichia coli RNA polymerase, that depends on linear diffusion to locate initiation sites on DNA. We have measured the competition between chromatin and its free DNA for the formation of initiation complexes. Only the short linker segments exposed by the removal of histone H1 are available for interaction with the polymerase, but the sparsely distributed promoter sites on the linker DNA of such a polynucleosome chain are located at the same rate as those on DNA. We conclude that the polymerase is free to migrate between the separate linker DNA segments of a polynucleosome chain to reach a promoter site. This chain thus permits the 'hopping' of proteins between neighboring linker segments in their search for a target site on the accessible DNA. PMID- 3545818 TI - Mapping of functional domains within the Saccharomyces cerevisiae type 1 killer preprotoxin. AB - Strains of Saccharomyces cerevisiae harboring M1-dsRNA, the determinant of type 1 killer and immunity phenotypes, secrete a dimeric 19-kd toxin that kills sensitive yeast cells by the production of cation-permeable pores in the cytoplasmic membrane. The preprotoxin, an intracellular precursor to toxin, has the domain sequence delta-alpha-gamma-beta where alpha and beta are the 9.5-and 9.0-kd subunits of secreted toxin. Plasmids containing a partial cDNA copy of M1, in which alpha, gamma, and beta are fused to the PH05 promoter and signal peptide, have previously been shown to express phosphate-repressible toxin production and immunity. Here the construction of a complete DNA copy of the preprotoxin gene and its mutagenesis are described. Analysis of the expression of these mutants from the PH05 promoter elucidates the functions of the preprotoxin domains. delta acts as a leader peptide and efficiently mediates the secretion, glycosylation and maturation of killer toxin. Mutations within the beta subunit indicate it to be essential for binding of toxin to and killing of whole cells but unnecessary for the killing of spheroplasts. Mutations within the putative active site of alpha prevent killing of both cells and spheroplasts. The probable role of beta is therefore recognition and binding to the cell wall receptor whereas alpha is the active ionophore. Mutations within alpha causing loss of toxicity also cause loss of immunity, while the mutants described within gamma and beta retain partial or complete immunity. Expression of gamma without alpha or beta confers no phenotype. The immunity determinant may minimally consist of the alpha domain and the N-terminal portion of gamma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545820 TI - A peptidase activity exhibited by human serum pseudocholinesterase. AB - The identity of a peptidase activity with human serum pseudocholinesterase (PsChE) purified to apparent homogeneity was demonstrated by co-elution of both peptidase and PsChE activities from procainamide-Sepharose and concanavalin-A- Sepharose affinity chromatographic columns; comigration on polyacrylamide gel electrophoresis; co-elution on Sephadex G-200 gel filtration and coprecipitation at different dilutions of an antibody raised against purified PsChE. The purified enzyme showed a single protein band on gel electrophoresis under non-denaturing conditions. SDS gel electrophoresis under reducing conditions, followed by silver staining, also gave a single protein band (Mr approximately equal to 90,000). Peptidase activity using different peptides showed the release of C-terminal amino acids. Blocking the carboxy terminal by an amide or ester group did not prevent the hydrolysis of peptides. There was no evidence for release of N terminal amino acids. Potent anionic or esterase site inhibitors of PsChE, such as eserine sulphate, neostigmine, procainamide, ethopropazine, imipramine, diisopropylfluorophosphate, tetra-isopropylpyrophosphoramide and phenyl boronic acid, did not inhibit the peptidase activity. An anionic site inhibitor (neostigmine or eserine) in combination with an esterase site inhibitor (diisopropylfluorophosphate) also did not inhibit the peptidase. However, the choline esters (acetylcholine, butyrylcholine, propionylcholine, benzoylcholine and succinylcholine) markedly inhibited the peptidase activity in parallel to PsChE. Choline alone or in combination with acetate, butyrate, propionate, benzoate or succinate did not significantly inhibit the peptidase activity. It appeared that inhibitor compounds which bind to both the anionic and esteratic sites simultaneously (like the substrate analogues choline esters) could inhibit the peptidase activity possibly through conformational changes affecting a peptidase domain. PMID- 3545821 TI - Large-scale purification of hnRNP proteins from HeLa cells by affinity chromatography on ssDNA-cellulose. AB - A purification procedure for proteins which bind heterogeneous nuclear RNA (hnRNP proteins) is described. The procedure, which entails standard chromatographic fractionations (single-stranded DNA cellulose, hydroxyapatite) and detection with specific antibodies, allows a large-scale preparation of these proteins and the partial separation of different polypeptides. By this method, polypeptides of higher molecular mass (53-55 kDa) can be purified, which are structurally and antigenically related to the 'canonical' hnRNP core proteins (34-43 kDa) that constitute the 40S hnRNP complexes. We also show that HeLa cells contain a protease that cleaves hnRNP core proteins to discrete smaller polypeptides of 22 28 kDa. Such protease, which has been partially purified, appears to copurify extensively with some of the hnRNP proteins. PMID- 3545822 TI - Comparison of enterobacterial common antigen from different species by serological techniques. AB - Enterobacterial common antigen (ECA) was isolated from a number of selected species (including Salmonella montevideo, Shigella sonnei and Plesiomonas shigelloides) using the extraction method described by Mannel and Mayer [Eur. J. Biochem. 86, 361-370 (1978)]. ECA of all these species behaved identically in enzyme-linked immunosorption assay (ELISA) and in its inhibition using monoclonal anti-ECA antibodies. Immunoblotting showed a ladder-like pattern of at least 20 bands for all preparations tested. ECA modified at its lipid moiety (e.g. by phospholipases A2 and D or by mild acid hydrolysis) lost its coating capacity leaving, however, the serological reactivity as detected by inhibition assays intact. In contrast, reduction of the carboxylic groups of 2-acetamido-2-deoxy-D mannopyranosyluronic acid destroyed the serological reactivity. Deacylated ECA was also not detectable in immunoblotting. Chemical reacylation restored the reactivity of deacylated ECA in ELISA and in immunoblot and thus proved the essential function of fatty acids for the physicochemical properties of the molecule. 2-Acetamido-2-deoxy-D-glucopyranose was identified as the reducing end of the ECA sugar chain after splitting off the lipid moiety by phospholipase D. PMID- 3545823 TI - Studies on the functional topography of Escherichia coli RNA polymerase. Highly selective affinity labelling by analogues of initiating substrates. AB - RNA polymerase was treated in the presence of promoter-containing templates with 16 affinity reagents, derivatives on NMPs, NDPs and NTPs with reactive substituents at the terminal phosphate. This treatment was followed by addition of a pyrimidine [alpha-32P]NTP. Due to 'catalytic competence' of some of the residues of the affinity reagents bound covalently near the active center at the first stage, active-center-catalyzed synthesis of a phosphodiester bond occurred, and radioactive residues with the general formula -pNpN (where p = radioactive phosphate) appeared covalently attached to the enzyme. Such affinity labelling was super-selective because affinity reagent residues bound outside the active center were not elongated and thus remained non-radioactive. Labelling took place only when the combination of the reagent and [alpha-32P]NTP corresponded to the sequence of nucleotides of the promoter. With reagents having short 'arms', only the beta subunit was labelled; the targets were His and/or Lys residues. With reagents having longer 'arms', the sigma subunit was also labelled. PMID- 3545824 TI - Hormonal regulation of the rate of the glycogen/glucose-1-phosphate cycle in skeletal muscle. AB - A method is presented which allows simultaneous estimation of rates of glycogen synthesis and glycogenolysis in an isolated incubated skeletal muscle, thus allowing measurement of the glycogen/glucose-1-phosphate substrate cycling rate. In the absence of hormonal additions, the measured rates of glycogen synthesis and breakdown were similar [respectively, 0.54 +/- 0.12 (8) and 0.74 +/- 0.10 (8) mumol glucosyl equiv. h-1 (g tissue)-1]. Incremental addition of insulin stimulated glycogen synthesis up to threefold and reduced glycogenolysis by about sevenfold; the half-maximally effective concentration of insulin on both processes was about 100 microU/ml (0.7 nM). Incremental addition of adrenaline (in the presence of 1 mU insulin/ml) caused a dramatic increase in the glycogenolytic rate (about 15-fold), but a much less marked inhibition of glycogen synthetic rate. In addition to hormonal manipulation of the muscle preparation in vitro, the effects of cold exposure, the hyperthyroid state, a single exercise bout and exercise-training of animals in vivo on the rates of glycogen synthesis and breakdown in the isolated incubated muscle preparation have been investigated. Significant changes in measured glycogen synthesis, breakdown and glycogen/glucose-1-phosphate cycling have been observed, both under basal conditions and in response to hormonal additions in vitro. The results are discussed with respect to the possible physiological importance of this substrate cycle. PMID- 3545825 TI - Reversible binding of Salmonella typhimurium lipopolysaccharides by immobilized protamine. AB - The ability of agarose-linked protamine to bind Salmonella typhimurium lipopolysaccharides was investigated. Radioactively labelled lipopolysaccharides were isolated both from a smooth strain (SH6749, labelled with [14C]galactose) and from a rough strain (SH5014, lipopolysaccharide chemotype Rb2, labelled with [3H]acetate). From 50-micrograms samples of the lipopolysaccharides, protamine agarose columns bound 99.5-99.9% of the input radioactivity. The binding efficacy was not affected by pH in the range from 3.7 to 10.5. Maximal binding capacity of protamine-agarose for highly soluble (triethylamine form) lipopolysaccharide of SH5014 was estimated to be 13.5 mg/ml packed adsorbent. The bound lipopolysaccharides could be totally released from the columns and recovered by elution with the anionic detergent sodium deoxycholate, or with 0.5 M NaCl in the presence of the uncharged detergent Triton X-100. By analysis in sodium dodecyl sulfate/polyacrylamide gels, the macromolecular quality of the recovered lipopolysaccharide was shown to be identical to that of the original. Protamine agarose chromatography can thus be applied to purify lipopolysaccharide preparations, and to separate as well as concentrate lipopolysaccharides from dilute solutions without altering their composition. This application was challenged with water as well as insulin solution experimentally contaminated with radiolabelled lipopolysaccharide. While the insulin protein did not bind to the protamine-agarose, the contaminating lipopolysaccharide was effectively trapped. PMID- 3545826 TI - Expression of bovine pancreatic ribonuclease A in Escherichia coli. AB - A synthetic gene for bovine pancreatic ribonuclease A (RNase A) has been expressed in Escherichia coli as a fusion protein with beta-galactosidase linked by the tetrapeptide Ile-Glu-Gly-Arg. RNase A was cleaved from the fusion using factor Xa, and the resulting product purified and reconstituted. The isolated RNase A was chromatographically, catalytically, and immunologically identical with authentic RNase A. This work argues that the method suggested by Nagai and Thogersen [Nagai, K. & Thogersen, H. C. (1984) Nature (Lond.) 309, 810-812] for releasing fusion proteins is quite general, even when applied to particularly complicated expression problem. The procedure here makes RNase A available for the first time as a model for studying structure-function relationships in proteins using site-directed mutagenesis. PMID- 3545827 TI - Nucleotide sequence of the gene for the peptidoglycan-associated lipoprotein of Escherichia coli K12. AB - During attempts to clone the gene for the Escherichia coli outer membrane protein III another gene was recovered. Its nucleotide sequence was determined and the deduced amino acid sequence showed that the gene does not encode protein III. It codes for a 173-residue polypeptide; 21 NH2-terminal residues are typical for a signal peptide. The sequence around the putative site (Ala-Cys) for removing this peptide, Ala-Ile-Ala-Ala-Cys-Ser-Ser-Asn, is highly homologous to that of the major cell envelope lipoprotein (Braun lipoprotein) surrounding its processing site; it is also homologous to the consensus pentapeptide Leu-Leu-Ala-Gly-Cys present in other lipoproteins of gram-negative bacteria. It could be shown that the gene expresses a lipoprotein with all the properties, including the amino acid composition, of the peptidoglycan-associated lipoprotein (PAL) [Mizuno, T. (1979) J. Biochem. (Tokyo) 86, 991-1000]. Therefore, the cloned gene is the pal gene. The protein does not contain hydrophobic regions which would serve as a membrane anchor. Tandemly repeated amino acid sequences exist at and near the NH2 terminus of the mature protein which are homologous to such repeats in the Braun lipoprotein, suggesting a common origin of this part of the two proteins. Attempts to place a transposon into the pal gene were unsuccessful. Hence the complete absence of the protein may be lethal and its function remains unknown. PMID- 3545828 TI - Chlorophyll-protein complexes of barley photosystem I. AB - Photosystem I (PSI) preparations with a chlorophyll a/b ratio of 6.0 were isolated from barley thylakoids using two different methods. The high-molecular mass complex (CP1a) which is resolved by non-denaturing gel electrophoresis had the same properties as a PSI preparation (PSI-200) isolated by Triton X-100 solubilisation of thylakoids followed by sucrose gradient ultracentrifugation. This material had a chlorophyll:P700 ratio of 208:1 and was composed of three different chlorophyll-protein complexes which could be separated from each other by solubilising the PSI preparation in dodecyl maltoside followed by sucrose gradient ultracentrifugation. Approximately half of the chlorophyll, including all the chlorophyll b, was located in two antenna complexes designated LHCI-680 and LHCI-730, which were identified by their characteristic low-temperature fluorescence emission spectra. The rest of the chlorophyll a was associated with the PSI reaction centre, P700 Chla-P1, which fluoresced at 720 nm. Each chlorophyll-protein complex had a unique polypeptide composition and characteristic circular dichroic and absorption spectra. The use of dodecyl maltoside instead of dodecyl sulphate resulted in a less denatured form of LHCI 680, which fluoresced at 690 nm at 77 K. One of the sucrose gradient fractions contained a complex consisting of only LHCI-730 and P700 Chla-P1 which fluoresced at 731 nm, indicating that LHCI-730 is structurally associated with P700 Chla-P1 and quenches its fluorescence. Approximately three-quarters of the light harvesting antenna chlorophyll was in LHCI-730, but only about one-quarter of the normal complement of LHCI-730 was required to quench the reaction centre. By reducing the amount of Triton relative to the chlorophyll concentration, a PSI preparation (chlorophyll a/b ratio of 3.5) with a chlorophyll:P700 ratio of 300:1 was isolated. It contained no photosystem II, but a significant amount of LHCII which was functionally connected to the PSI reaction centre. Reconstitution studies demonstrated that excitation energy transfer from LHCII to PSI requires the presence of LHCI-680, and we propose that, in PSI, the following linear excitation energy transfer sequence occurs: LHCII----LHCI-680----LHCI-730----P700 Chla-P1. PMID- 3545829 TI - The A and B fragments of normal type I procollagen have a similar thermal stability to proteinase digestion but are selectively destabilized by structural mutations. AB - Previous studies demonstrated that the thermal stability of the procollagen triple helix can be assayed by digesting the protein for short periods with high concentrations of trypsin and chymotrypsin. Here we cleaved human type I procollagen or collagen with vertebrate collagenase to generate A fragments from the three-quarter amino termini and B fragments from the one-quarter carboxy termini of the molecules. The thermal stabilities of the fragments were then assayed by rapid trypsin/chymotrypsin digestion. Both fragments were resistant up to 36 degrees C and completely degraded between 37 degrees C and 39 degrees C. In subsequent experiments the same assay was carried out with type I procollagens synthesized by fibroblasts from two patients with lethal variants of osteogenesis imperfecta. With one, the A fragments were selectively destabilized, an observation consistent with previous data indicating that the mutation in the patient produced a deletion of 84 amino acids from the middle of the alpha 1(I) chain. With procollagen synthesized by fibroblasts from the second patient the B fragments were selectively destabilized, an observation consistent with preliminary data indicating a mutation that alters the primary structure of the carboxy-terminal region of the alpha 1(I) chain. Therefore, the procedures described here present a simple and direct method for locating mutations that destabilize the collagen triple helix. PMID- 3545830 TI - Purification and characterization of a novel metalloendopeptidase from Streptococcus cremoris H61. A metalloendopeptidase that recognizes the size of its substrate. AB - An endopeptidase (LEP-II), which has a unique substrate specificity, was purified to homogeneity by conventional chromatographic techniques from Streptococcus cremoris H61. The enzyme was a metalloendopeptidase since it was inhibited by EDTA and 1,10-phenanthroline; the metal-depleted enzyme could be fully reactivated by micromolar levels of Zn2+ and was not inhibited by specific inhibitors for serine or thiol protease. The molecular mass of the enzyme was estimated to be 80 kDa by Sephacryl S-300 gel filtration and high-performance liquid chromatography with a TSK-G3000SW column. The enzyme consisted of two identical subunits and the N-terminal sequence of LEP-II was determined up to the 19th residue. Although the enzyme had a broad substrate specificity it specifically hydrolyzed the peptide bonds involving the amino groups of hydrophobic amino acid residues. Various small polypeptides, such as alpha s1 CN(f1-23), alpha s1-CN(f91-100), oxidized insulin B chain, glucagon and some biologically active peptides were hydrolyzed. However, a variety of larger polypeptides or proteins, such as alpha s1-CN(f1-54), alpha s1-CN(f61-123), alpha s1-CN(f136-196), alpha s1-casein, beta-casein, and kappa-casein were not hydrolyzed. LEP-II recognized the size of its substrates, which were limited below a molecular mass of about 3.5 kDa. PMID- 3545831 TI - Recombinant-DNA-derived bovine growth hormone from Escherichia coli. 1. Demonstration that the hormone is expressed in reduced form, and isolation of the hormone in oxidized, native form. AB - The isolation of bacterially synthesized, recombinant-DNA-derived, bovine growth hormone (r-bGH) with native structure is described. The r-bGH is found in insoluble form, in a pellet fraction, after cell breakage and centrifugation. Cell envelope components (protein, lipid, endotoxin) and nucleic acids are selectively removed from the pellet fraction by an EDTA/lysozyme/deoxycholate extraction. We demonstrate that the r-bGH is largely reduced until solubilized using 6 M guanidine/HCl. Air oxidation is then carried out, in the presence of the guanidine/HCl. The oxidation results in a mixture of about one-third disulfide-linked oligomers and two-thirds oxidized monomer. The latter may include some incorrectly oxidized material, but appears to be mostly correctly oxidized. The oxidized monomer is isolated by gel filtration in the presence of guanidine/HCl. Subsequent guanidine/HCl removal leads to refolded, oxidized r bGH. All steps in the procedure, in particular the oxidation and refolding steps, can be carried out at relatively high protein concentrations. PMID- 3545832 TI - Conformations of yeast alpha-mating factor and analog peptides as bound to phospholipid bilayer. Correlation of membrane-bound conformation with physiological activity. AB - The transferred nuclear Overhauser effects of yeast alpha-mating factor [(1 13)peptide] in the presence of various spin-labeled phosphatidylcholines in small unilamellar vesicles of perdeuterated phosphatidylcholine have been analyzed. From the analysis of the quenching effect by spin-labels, the depth of amino acid side chains of the mating factor in phospholipid bilayer has been elucidated. The Leu4 and Leu6 residues are buried deeply in the apolar region of the phospholipid bilayer while the hydrophilic residues such as Gln5 and Lys7 are in the shallow region of the bilayer. The interaction of the side chains of Trp1 and Trp3 residues of alpha-mating factor with the hydrophobic interior of the bilayer contributes to the binding of this peptide with the phosphatidylcholine bilayer. The conformation of des-Trp1-alpha-mating-factor [(2-13)peptide] in the membrane bound state has been found to be similar to that of (1-13)peptide from the analysis of transferred nuclear Overhauser effects in the presence of mixed vesicles of perdeuterated phosphatidylcholine and perdeuterated phosphatidylserine. The incorporation of this acidic phospholipid in the vesicle remarkably enhances the binding of (1-13)peptide and analog peptides. However, such modifications that weaken the interaction with phospholipid bilayer (deletion of Trp1 and substitution of Trp3 by Gly or Ala) appreciably lower the physiological activity. Transferred nuclear Overhauser effect analyses have also been made of [DHis2]peptide, [DLeu6]peptide and [DLys7]peptide in the presence of the vesicles of perdeuterated phosphatidylcholine. The main-chain conformations of these three analogs in the membrane-bound state have been found to be similar to that of (1-13)peptide, although the side-chain conformations of the D-amino acid residues are naturally different from those of the L-amino acid ones. Thus, the physiological activities of the (1-13)peptide and a variety of analog peptides are found to correlate with the affinities to the phosphatidylcholine/phosphatidylserine membrane and with the molecular conformations in the membrane-bound state. PMID- 3545833 TI - Proteinase yscD mutants of yeast. Isolation and characterization. AB - Mutants of the yeast Saccharomyces cerevisiae, devoid of proteinase yscD activity, were isolated by screening for the inability of mutagenized cells to hydrolyze Ac-Ala-Ala-Pro-Ala-beta-naphthylamide in situ. One of the selected mutants bears a thermolabile activity pointing to the gene called PRD1 as being the structural gene for proteinase yscD. All mutants isolated fell into one complementation group. The defect segregates 2:2 in meiotic tetrads indicating a single gene mutation, which was shown to be recessive. Diploids heterozygous for PRD1 display gene dosage. The absence of proteinase yscD did not affect mitotic growth under rich or poor growth conditions, neither mating nor ascopore formation. Also growth of mutant cells after a nutritional shift-down was not altered. Inactivation of enzymes tested which are subject to carbon-catabolite inactivation, a process proposed to be of proteolytic nature, is not affected by the absence of proteinase yscD. Protein degradation rates in growing cells, in cells under conditions of differentiation or heat shock, showed no obvious alteration in the absence of proteinase yscD activity. Also inactivation of alpha factor pheromone was not affected by proteinase yscD absence. Normal growth of mutant cells on glycerol indicates that the enzyme is not involved in any vital event in mitochondrial biogenesis. PMID- 3545834 TI - Murein biosynthesis in synchronized cells of Proteus mirabilis. Quantitative analysis of O-acetylated murein subunits and of chain terminators incorporated into the sacculus during the cell cycle. AB - Cells of Proteus mirabilis, synchronized by sucrose density gradient centrifugation, were grown in complex medium containing radioactive N acetylglucosamine. At various times, labelled murein sacculi were isolated and digested with endo-N,O-acetylmuramidase from Chalaropsis. The murein fragments thus obtained were separated into disaccharide peptides as the monomeric subunits and into peptide-cross-linked subunits by gel filtration. The subunits were further differentiated into O-acetylated and non-O-acetylated species, and into subunits containing anhydro-N-acetylmuramic acid which were glycan chain terminators in the native sacculi. Quantification of the subunit species gave the following results. At specific times during the cell cycle, murein subunits were lost from the polymer and a transient decrease in cross-linkage was observed. The overall degree of cross-linkage in mature murein, i.e. the ratio of peptide-cross linked subunits versus uncross-linked subunits, was 1.15 as determined by regression analysis. Anhydro-N-acetylmuramic-acid-containing murein subunits representing glycan chain terminators were found either peptide-cross-linked or uncross-linked as monomers. Since these two subunit species were recovered in a defined ratio of 1.6, mature murein consisted of at least two different types of glycan chains. On average, each chain contained 15.4 murein subunits. About 60% of the murein subunits in mature murein were O-acetylated and showed a higher degree of cross-linkage than the non-O-acetylated portion. Finally, following the composition of the sacculus during the cell cycle revealed a complex precursor product relationship between non-O-acetylated and O-acetylated subunits during murein maturation. The data allowed us to deduce several features of the assembly process of murein sacculi. PMID- 3545835 TI - A constitutive transmembrane glycoprotein of Mr 165,000 (desmoglein) in epidermal and non-epidermal desmosomes. I. Biochemical identification of the polypeptide. AB - Two murine monoclonal antibodies (DG 3.4 and DG 3.10) raised against a major glycoprotein ("band 3 component") from desmosomes of bovine muzzle epidermis were used in immunoblot experiments following SDS-polyacrylamide gel electrophoresis or two-dimensional gel electrophoresis to identify this or immunologically related proteins in other bovine tissues and cultured cell lines. In all desmosome-bearing cells, i.e. cells also expressing desmoplakins, including representative of stratified, transitional and simple epithelia as well as myocardium, only a single distinct polypeptide of identical Mr value (165,000) and electrical charge was detected. These findings, together with the immunolocalization results reported in the companion paper indicate that this glycoprotein (desmoglein) is a general constituent protein of desmosomes, providing a case of an integral membrane protein co-expressed with non-membranous desmosomal proteins such as the plaque component, desmoplakin I. Our results further suggest that, contrary to previous suggestions, desmoglein is very similar, if not identical in different cells of the same species and does not display significant cell type diversity. PMID- 3545836 TI - Identification of distinct accumulation sites of 4-aminoquinoline in chloroquine sensitive and resistant Plasmodium berghei strains. AB - We report the synthesis of an analogue of chloroquine (CQA) which can be used as a probe to visualize accumulation of 4-aminoquinoline by electron microscopy. A mouse monoclonal antibody against CQA was raised and used for immunodetection by the protein-A gold method on ultrathin cryosections, of CQA treated parasites. We demonstrate that in a P. berghei chloroquine(CQ)-sensitive strain (N strain) the chloroquine analogue used accumulates in the endocytic vacuoles where hemoglobin (Hb) degradation is occurring. In contrast, in a P. berghei CQ-resistant strain (RC strain) the probe was found scattered all over the cytoplasm of the parasite. This result suggests that endocytic vacuoles of the parasite could constitute the site of antimalarial action of CQ. PMID- 3545837 TI - Microtubule arrays in differentiated cells contain elevated levels of a post translationally modified form of tubulin. AB - Tyrosinated (Tyr) and detyrosinated (Glu) alpha-tubulins are post-translationally modified species that differ by a single amino acid at their respective C termini. We have examined the distribution of these two species by immunofluorescence in proliferating and differentiated cells using antisera specifically reactive with each of the forms. In proliferating PtK1 cells, Tyr tubulin was the predominant form in almost every cytoplasmic microtubule (MT); only a few MTs contained detectable Glu tubulin. In contrast, staining of centrioles and primary cilia of PtK1 cells suggested that Glu tubulin was the predominant form in these stable assemblies of MTs. An examination of the distribution (by immunofluorescence) and relative amount (by immunoblot analysis) of the two forms of tubulin in the stable assemblies of MTs present in cultured neuronal cells (neurites), sperm and tracheal cells (axonemes and basal bodies), and platelets and erythrocytes (marginal bands) revealed that, in general, the MTs in these arrays contained substantially elevated levels of Glu tubulin in comparison with the levels in MTs of cultured cells. The one exception, the marginal band of toad erythrocytes, which contained only Tyr tubulin, demonstrates that an elevated level of Glu tubulin is not an obligate feature of a stable array of MTs. Nonetheless, an elevated level of Glu tubulin may be a useful indicator of stable MTs in differentiated cells. It is important to note that commonly used sources of tubulin (e.g., brain or flagella) necessarily yield tubulin that differs strikingly from tubulin of proliferating cells in its content of Glu tubulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545838 TI - Immunostaining of spindle components in tipulid spermatocytes using a serum against pericentriolar material. AB - First meiotic division of tipulid (Pales ferruginea) spermatocytes was investigated by double immunostaining with anti-tubulin IgG and scleroderma 5051 serum against pericentriolar material (PCM). PCM-like material became visible in late diakinesis in centrosomal areas as well as in kinetochores. Anti-PCM fluorescence was most pronounced in metaphase and diminished again in anaphase. Displacement of one of the centrosomes from the nucleus at diakinesis in Pales spermatocytes leads to the formation of a bipolar, normally functioning spindle possessing one aster and centriole-free spindle pole (AFP). In about 80% of the AFPs observed there were no traces of anti-PCM staining detectable. This finding supports the assumption based on previous studies that polar PCM is not obligatory for spindle pole formation. The chromosomes seem to be able to induce the organization of a half-spindle. The strong anti-PCM fluorescence of the kinetochores observed here may be taken as further indication of tipulid chromosome autonomy regarding spindle formation. PMID- 3545839 TI - Identification of actin in boar spermatids and spermatozoa by immunoelectron microscopy. AB - Actin was localized in testicular spermatids and in ionophore-treated ejaculated sperm of boar by use of a monoclonal anti-actin antibody labeled with colloidal gold. With the on-grid postembedding immunostaining of Lowicryl K4M sections, actin was identified in the subacrosomal region of differentiating spermatids, in the microfilaments of the surrounding Sertoli cells, and in the myoid cells of the tubular wall. Ejaculated sperm, labeled with the preembedding method, showed actin between the plasma membrane and the outer acrosomal membrane of the equatorial segment. Indirect immunofluorescence was positive in the equatorial segment and in the acrosomal cap of intact sperm, whereas reacted sperm at the anterior head region retained fluorescence only in the inner acrosomal membrane. Rhodamine-phalloidin failed to stain intact and reacted sperm. The distribution of actin in sperm head membranes (inner acrosomal membrane, membranes of the equatorial segment), which are retained after the acrosome reaction, is discussed. PMID- 3545840 TI - Cytoskeletal proteins of the rat kidney proximal tubule brush border. AB - Cytoskeletal components backing the brush border of the rat kidney proximal tubule cell were identified and compared with those of the well characterized intestinal brush border by immuneoverlay and immunocytochemistry. Antibodies reactive against the intestinal microvillus core components, villin and fimbrin, as well as against the terminal web components, spectrin (fodrin) and myosin, were used. Proteins of similar molecular weight to these intestinal brush border cytoskeletal components were identified in isolated kidney brush borders by immuneoverlay. Spectrin, a major component of the terminal web region of both cell types, was more concentrated in the kidney brush border relative to both actin and myosin. By immunofluorescence, villin and fimbrin were localized in the microvilli, and spectrin and myosin were localized to the terminal web region of the brush border. In addition, spectrin was found along the basolateral membranes of the proximal tubule cell, and myosin was detected in a punctate staining pattern throughout its cytoplasm. By immunoelectron microscopy using immunogold labeling procedures, fimbrin and villin were localized in the terminal web as well as in microvilli, and spectrin and myosin were localized to fibrils in the terminal web. A key difference between the epithelia of the two organs is the extensive network of clathrin coated pits found in the terminal web region of the kidney but not the intestinal brush border. The clathrin-rich terminal web region of the kidney, like the intestinal brush border, proved to be quite stable and resistant to disruption by non-ionic detergents and harsh mechanical treatment. PMID- 3545841 TI - Role of anticoagulation and anti-aggregation. PMID- 3545842 TI - The UKEP study: multicentre clinical trial on two local regimens of urokinase in massive pulmonary embolism. The UKEP Study Research Group. AB - A multicentre trial (10 centres) of urokinase (UK) was performed in patients with acute severe pulmonary embolism (PE). The aim of this trial was, to compare the efficacy of two doses of UK administered via a catheter in the pulmonary artery: 2000 IU kg-1 h-1 for 24 hours (UK 2000) in conjunction with heparin versus 4400 IU kg-1 h-1 UK alone for 12 hours (UK 4400) followed by heparin. PE was less than 5 days old and the clinical diagnosis was confirmed by pulmonary angiograms demonstrating a vascular obstruction of more than 30% (Miller's index greater than 11). The efficacy of treatment was evaluated by the degree of early revascularization (pulmonary angiograms were performed 30 to 48 hours after initiation of thrombolytic treatment and analysed blindly by four independent vascular radiologists). 133 patients were included in this trial: two patients died before treatment and two were excluded retrospectively, leaving 129 patients for final analysis (67: UK 2000 + heparin; 62: UK 4400). The two groups had similar pretreatment clinical, haemodynamic and angiographic characteristics: the Miller angiographic index of severity averaged 22.6 +/- 3.7 for patients in the UK 2000 group, and 22.6 +/- 3.4 for patients in the UK 4400 group (average filling defect of 66% on pulmonary angiograms). There was a similar and significant degree of resolution in the two groups: 26% and 20%, respectively. Minor and major bleeding problems were observed with equal frequency in the two groups (24% and 29%, respectively). These bleeding complications were severe in only 4.5% and 3%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545843 TI - Primary (genetic) cardiomyopathies in infancy. A survey of possible disorders and guidelines for diagnosis. AB - This is a survey of genetic metabolic diseases in which cardiomyopathy is typical or can be the leading symptom in infancy. Apart from the well-known Pompe disease, several other storage disorders, mitochondrial disorders, and miscellaneous conditions (particularly the carnitine deficiency syndromes) may be seen in this way. Since prompt diagnosis may be mandatory for genetic counselling, and sometimes for specific treatment, guidelines for clinical, cardiological, and laboratory work-up are given. PMID- 3545845 TI - Neurosyphilis: a changing diagnostic problem? AB - In the recent literature about neurosyphilis, several publications have mentioned more atypical presentations of neurosyphilis. Inadequate penicillin therapy and improved serological methods are supposed to be responsible for these findings. In contrast with this proposition the present retrospective study of two groups of neurosyphilitic patients (518 patients during the period 1930-1940 and 121 during 1970-1984) reveals no marked differences in clinical data of these groups. Besides the fall in incidence of syphilis and neurosyphilis and the shift in the male/female ratio, conforming to modern literature, there is an increase in the cases of asymptomatic neurosyphilis, due to development of the immunological techniques to detect the diagnosis 'neurosyphilis' earlier. PMID- 3545844 TI - Amoxicillin twice daily in the treatment of acute otitis media in infants and children. AB - A total of 110 children with acute otitis media were assigned randomly to treatment with 60 mg/kg per day amoxicillin in a twice-daily (group A) or a thrice-daily (group B) regimen for 10 days. Patients were scheduled for follow-up examinations at mid-treatment, 5 days after the end of therapy and 30, 60, 90 days after starting therapy. At 15 days 6 out of 55 patients (10.9%) treated with amoxicillin twice daily were considered treatment failures compared to 4 children (7.2%) in the thrice daily group. Rates of cure, recurrent otitis media and persistent middle ear effusion were comparable in the two groups of patients at later time intervals. By 90 days the total cure rate was 42.3% (22/52) in children treated twice daily and 41.5% (22/53) in those who had received amoxicillin thrice daily. At the same time persistence of bilateral and unilateral effusion was noted in 12/52 (23.1%) and 8/52 (15.3%) children in group A and in 16/53 (30.1%) and in 10/53 (18.9%) in group B respectively. No significant difference was noted in the two treatment regimens with regard to adverse side effects. Because reduction in division of the amoxicillin dose caused no significant difference in the efficacy of antibiotic treatment of acute otitis media in infants and children, we think that this simplified scheme of therapy can routinely be used in clinical practice and thus improve compliance to antibiotic administration. PMID- 3545846 TI - Profiles of endogenous prostaglandin F2 alpha, thromboxane A2 and prostacyclin with regard to cardiovascular and organ functions in early septic shock in man. AB - 15 out of 68 patients with severe sepsis were examined in an early stage of shock and analyzed for objective hemodynamic and functional shock criteria. These data were correlated to endogenous plasma concentrations of the vasoactive arachidonate derivatives: prostaglandin F2 alpha (PGF2 alpha), thromboxane A2 (TXA2) and prostacyclin (PGI2). Marked differences in invasively measured data of cardiac, pulmonary and renal functions divided clinically otherwise comparable patients into group I and II. Group I was characterized by a hypodynamic response as compared to group II which was hyperdynamic. In spite of similar levels of PGF2 alpha (570 +/- 80 vs. 560 +/- 103 pg/ml) in both groups indicating a comparable state of arachidonate turnover, opposing profiles with regard to the TXA2/PGI2 ratio as measured from their stable degradation products were found (TXB2 [I]: a 740 +/- 184; TXB2 [II]: 280 +/- 75; 6-k-PGF1 alpha [I]: 260 +/- 117; 6-k-PGF1 alpha [II]: 940 +/- 190 pg/ml). It is concluded that early sepsis in man leads to variable profiles of endogenously released prostaglandins and thromboxane in which the predominance of PGI2 over TXA2 is associated with better cardiovascular performance and organ functions, and vice versa. PMID- 3545848 TI - Efficacy of in situ extracorporeal shock wave lithotripsy for upper ureteral calculi. AB - In contrast to the majority of renal calculi, in situ extracorporeal shock wave lithotripsy (ESWL) for upper ureteral stones is still controversial. Some centers recommend retrograde mobilization of the calculus into the renal pelvis prior to ESWL as a routine procedure (UC + ESWL). To evaluate the efficiency of in situ ESWL for upper ureteric stones, we initiated a prospective clinical trial. From July 1985 to January 1986, 122 patients presented with upper ureteral calculi, necessitating a total of 146 different procedures: 88 in situ ESWL; 31 UC + ESWL; 15 antegrade ureteroscopies (URS); 6 retrograde URS; 2 open surgery (ureterolithotomy, nephrectomy), and 4 patients were managed conservatively. Of all 99 patients treated at the lithotripter, 80 patients received in situ ESWL (no emergency case, no location problems): in 60 patients (75%) the stone could be disintegrated in one session; 8 patients (10%) required a second ESWL session due to partial fragmentation. Retrograde mobilization using a ureteral catheter or URS was necessary in 9 patients due to failure of in situ ESWL (11%) and, in only 3 patients, we had to remove the stone by antegrade URS (4%). In conclusion, 96% of all upper ureteric stones suitable for primary ESWL could be treated by a noninvasive (in situ ESWL) or minimally invasive (UC + ESWL) procedure. Therefore we recommend in situ ESWL for these calculi. Primary retrograde mobilization is only indicated in case of location problems (stone close to the spine, obesity, skeleton deformation) or emergency cases (colic, hydronephrosis). Antegrade URS should be performed if retrograde mobilization fails or in emergency cases (acute pyelonephritis, following percutaneous nephrostomy, after clinical stabilization). The rate of open surgery is below 2%. PMID- 3545849 TI - Escherichia coli adherence to human transitional cell tumors: a simple research model of bacterial attachment to the lower urinary tract. AB - A simple model for assaying bacterial adherence to the urinary tract is presented. Cell suspensions of freshly excised transitional cell tumors were used as substrata for attachment of 3H-adenine-labeled Escherichia coli urine isolates. Quantitative radioactive counts were confirmed by microscopic observations in replicate assays of each condition tested. This model provided for species and organ specificity in studies of the bacterial adherence role in urinary tract infections. PMID- 3545847 TI - Protection by aminated glucan in experimental endogenous peritonitis. AB - The effect of prophylactic intraperitoneal aminated glucan on the survival rate and formation of adhesions and abscesses was investigated in rats with acute and subacute peritonitis, respectively induced by cecal perforation and ileal ligation. A significantly reduced mortality was found in both forms of peritonitis. Pretreatment by aminated glucan also significantly reduced the number of abscesses and peritoneal adhesions. An about threefold increase in peritoneal macrophages in aminated glucan-treated rats compared to controls was noted. In vitro studies, using 32P-labelled Escherichia coli, demonstrated that peritoneal macrophages from aminated glucan-treated rats had an enhanced ability to engulf and degrade bacteria. Scanning electron microscopy showed that macrophages from aminated glucan-treated animals were highly spread with prominent ruffling and bacteria located intracellularly, as opposed to macrophages from controls which were rounded with bacteria on the cell surface. PMID- 3545850 TI - Limitations associated with the use of labelled antibodies against CEA for potential tumour localisation and therapy. A review. PMID- 3545851 TI - High doses of metoclopramide or droperidol in the prevention of cisplatin-induced emesis. AB - The antiemetic effects of the benzamide metoclopramide (MCL, Paspertin) and of the butyrophenone droperidol (DRO, Dehydrobenzperidol) were compared by two sequential analytical trials in cisplatin treated patients. In the first trial (cisplatin 60-90 mg/m2) the drugs were given as loading infusions (MCL 0.5 mg/kg, and DRO 0.05 mg/kg, each per b.w./h over 2 hr), beginning 2 hr before cisplatin administration; this was followed by the maintenance infusion at half the dose, over 24 hr (total dose of MCL 7 mg/kg, and DRO 0.7 mg/kg b.w. per cycle, resp.). During the second trial (cisplatin 90-120 mg/m2) the antiemetic dosages were doubled (total dose of 14 or 1.4 mg/kg per cycle. After 12 and 14 treatment pairs, resp., MCL was significantly (P less than 0.05) more effective than DRO. Clinically antiemetic protection (i.e. less than three vomiting episodes) were seen in 9 of 12 and 13 of 14 patients, resp., compared with only 5 of 12 and 5 of 14 patients on DRO. The incidence of major extrapyramidal side-effects was more than 2-fold higher at DRO. The benefit/risk relationships (i.e. the relation between the prevented emetic episodes and the number of extrapyramidal reactions seen) of MCL were 2.7-3.0-fold better than those of DRO. The relatively higher antiemetic efficacy of MCL may be due to its additional gastrointestinal mechanisms. PMID- 3545853 TI - Human large granular lymphocytes induce immunoglobulin synthesis after bone marrow transplantation. AB - Following T cell-depleted bone marrow transplantation, helper T cell numbers remain depressed for some months. Nonetheless, functional B cells can be adoptively transferred to the recipients of such grafts, where they continue to secrete antibody. We now show that immunoglobulin production by these transferred B cells is induced by activated large granular lymphocytes (LGL) which circulate in the recipients in substantial numbers during the immediate post-transplant period. The LGL are CD3 negative and therefore provide help in an antigen unlinked manner. Helper effects for autologous (donor) B cells are augmented by the addition of anti-LFA-2 (anti-CD2) which appears to act by blocking recruitment of LGL inhibitory to developing B cells. In contrast antibody to the beta chain of LFA-1, which effectively reduces natural killer activity of LGL, does not influence their helper function. The peripheral blood LGL fraction thus contains both helper and cytotoxic activity, which can be distinguished by appropriate monoclonal antibodies. PMID- 3545852 TI - Interleukin 1 and poly(rI).poly(rC) induce production of a hybridoma growth factor by human fibroblasts. AB - Cultures of normal diploid fibroblasts and of a human osteosarcoma cell line (MG 63) are shown to be able to produce a factor which promotes the growth of B cell hybridomas (hybridoma growth factor, HGF). The induction is stimulated by treatment of the cells with interleukin 1 (IL 1) (alpha or beta) or polyriboinosinic-polyribocytidylic acid [poly(rI).poly(rC)]. Combined treatment with cycloheximide and actinomycin D also stimulates production and enhances production induced by IL 1 or poly(rI).poly(rC). Extremely small doses of IL 1 (0.1 units/ml) are active as inducer of HGF. Also, under optimal conditions the yield of HGF can attain as much as 10(4) units/ml. Tumor necrosis factor (TNF alpha), which otherwise shares various properties with IL 1, is a weak inducer of HGF. Although there is a superficial resemblance between induction of HGF and that of interferon-beta, the two activities are serologically distinct and conditions for their induction are quite different. In fact, conditions for induction of HGF are indistinguishable from those described for the induction of the mRNA of the so-called 26-kDa protein (also known as interferon-beta 2). Finally, the HGF derived from IL 1- or poly(rI).poly(rC)-treated fibroblasts is serologically not distinguishable from that produced by mitogen-stimulated peripheral blood leukocytes. PMID- 3545854 TI - Glucose homeostasis in rats treated acutely and chronically with quinine. AB - Glucose homeostasis in normal rats was studied after chronic or acute administration of quinine. Male rats received a daily dose of 10-30 mg/kg of quinine in the drinking water for 20 weeks. The high dose caused a slight decrease in food intake and weight gain. Though basal plasma insulin levels were increased in treated rats, their plasma glucose levels were only slightly and not consistently decreased. After oral or intravenous administration of glucose, the plasma insulin levels were higher and the disappearance rate of glucose was greater in rats receiving quinine than in the controls. The insulin content of the pancreas was not affected by quinine treatment. Intraperitoneal injection of a high dose of quinine (30 mg/kg) transiently increased plasma glucose and insulin levels. The insulin response was increased during a subsequent administration of glucose but the glucose levels were not modified. This study shows that chronic administration of quinine increases plasma insulin levels, accelerates disposal of oral or intravenous glucose but does not cause hypoglycaemia in normal rats. PMID- 3545856 TI - [Biological and hematochemical characteristics of herbivorous common voles (Microtus arvalis Pallas)]. AB - In 1979, some pairs of voles (Microtus arvalis Pallas) were introduced to our laboratory from Hungary. Thereafter, they were successfully bred and increased in number, as experimental small animals for herbivorous domestic animals. They have been raised in a room and fed with pelleted feed for herbivores and chopped hay cubes. We can change the high-fiber-containing rations from the chopped hay-cube to the alfalfa pellet that is widely available in laboratories. Regarding the breeding characteristics of the voles, the average litter size was 5.44 +/- 1.64, and the age at the first birth was 55.4 +/- 10.7 days. Some voles with white coats were found during the breeding process in our laboratory. Hematochemical characteristics of the voles were determined and the following characteristics were noted. Red blood cell counts of the voles were higher than those of other experimental animals (rat, mouse). White blood cell counts of the voles were lower than those of the other animals. The electrophoretic patterns of serum protein differed markedly from those of other experimental animals. The gamma globulin concentrations of the voles were very low, and A/G ratios were high. Blood glucose concentrations of the voles were lower than those of the other mono gastric experimental animals. Activities of serum enzymes (GOT, GPT, ALP) were higher than those of other experimental animals (rat, mouse, cow). PMID- 3545855 TI - Characterisation of two probes for the localisation of enkephalinase in rat brain: [3H]thiorphan and a 125I-labeled monoclonal antibody. AB - We studied the binding of two radioactive probes, i.e. [3H]thiorphan and a 125I labeled monoclonal antibody raised against the rabbit kidney enzyme, to enkephalinase (EC 3.4.24.11, membrane metalloendopeptidase) from rat cerebral membranes. [3H]Thiorphan binding at equilibrium to striatal membranes was monophasic with a KD (0.7 nM) and a pharmacology consistent with a selective labeling of the enzyme. The ratio of Vmax/Bmax was in the same range as the Kcat of the enzyme purified from peripheral tissues. The monoclonal antibody immunoprecipitated to a similar extent the solubilised enkephalinase activity and [3H]thiorphan binding sites from striatum. The regional distributions of binding sites for the two probes established either on isolated membranes or autoradiographic sections were highly heterogeneous and similar to that of enkephalinase activity. Hence the two probes appear to label membrane-bound enkephalinase in rat brain but, from a technical point of a view, the 125I monoclonal antibody is a more sensitive and flexible tool. PMID- 3545857 TI - Epizootiological studies of Salmonella typhimurium infection in guinea pigs. AB - In two natural outbreaks of S. typhimurium infection in guinea pigs, frequent isolations of the organism from the conjunctiva and cervical lymph nodes and high incidences of the conjunctivitis and abscess formation in the cervical lymph nodes were shown, suggesting more importance of the conjunctiva as infection route than oral route. These features in salmonellosis of guinea pigs were tried to reproduce in experimental infections by conjunctival and oral inoculations of 10(2) and 10(6) cells of 4 different strains of S. typhimurium and also by contact infection simulating natural conditions. As the results, it was demonstrated that guinea pigs were more susceptible to the conjunctival infection than the oral infection, because higher infection rates and more frequent incidence of abscess formation in the cervical lymph nodes as well as conjunctivitis were produced by the conjunctival inoculation than the oral inoculation of the organism. Main localization sites of the organism were the cervical lymph nodes, conjunctiva and upper respiratory tract in conjunctivally inoculated guinea pigs but more widely distributed in orally infected ones. These findings were common in animals infected with 4 different strains of S. typhimurium and also in contact infection. Thus the conjunctiva was regarded as an important route of S. typhimurium in guinea pigs. PMID- 3545859 TI - Dependence of insulin degradation by intact erythrocytes on receptor binding in diabetic patients. AB - Degradation of insulin during incubation of erythrocytes at 37 degrees C was studied in relation to insulin binding to membrane receptors. A method was developed for measuring separately the degradation caused by insulinase released from leaky cells into the incubation medium, and the degradation generated by intact cells. In the 23 samples studied, intact erythrocytes generated 16-41%, and cell-free insulinase the rest, 59-84%, of the amount of insulin degradation products formed during 40 min of incubation. The number and affinities of insulin receptors, and the degradation of insulin by intact erythrocytes, were measured in samples from 23 patients with glucose intolerance. Degradation rate correlated well with the receptor number and to a lesser degree with the affinities. The results suggest that insulin binding is a regulatory step for the formation of insulin degradation products. PMID- 3545858 TI - Age-dependent relationship of fasting C-peptide concentration and insulin secretion in non-obese subjects with normal glucose tolerance. AB - The age-dependent relationship of fasting immunomeasurable C-peptide to fasting immunomeasurable insulin (IRI) and IRI response to glucose was studied in 113 non obese healthy subjects with normal glucose tolerance (oGTT according to the new WHO recommendations), ranging in age from 6 to 44 years. Fasting C-peptide concentration increased significantly in adolescents and adults when compared with children. The higher fasting C-peptide concentration in the adult group might be explained by the concomitant higher fasting blood glucose concentration whereas such relationship was lacking in adolescents. In contrast to this we failed to demonstrate such relationship with regard to fasting IRI levels. There was, however, a relationship between advancing age and early (IRI area 0-30 min), late (IRI area 30-120 min) and total (IRI area 0-120 min) insulin response to glucose. There was a significant correlation between fasting C-peptide concentration and estimates of IRI response in children and adolescents, whereas such relationship was lacking in adults. Based on these results, the present study demonstrates an age-related increase of the pancreatic beta-cell function which might be partly explained by the concomitant higher blood glucose concentration. PMID- 3545860 TI - Insulin binding to erythrocyte receptors in acromegalic patients in relation to the activity of acromegaly and to concomitant diabetes mellitus. AB - Insulin binding to receptors on erythrocytes was studied in patients with acromegaly (n = 27) and in control subjects without any endocrine pathology, diabetes or obesity (n = 13). According to fasting serum concentration of growth hormone (GH), acromegalics were divided into two groups: A) GH less than 10 ng/ml (n = 16) and B) GH above 20 ng/ml (n = 11), in which patients were further divided into subgroups with regard to the presence or absence of diabetes. Insulin binding was decreased both in active and inactive acromegalics when compared with controls. A greater decrease was seen in active acromegaly coupled with diabetes. This was not the case of inactive hyperglycaemic acromegalics, where a compensatory increase in the affinity of "empty" receptors might account for a lack of a greater decrease in insulin binding. PMID- 3545861 TI - Pituitary prolactin cells in diabetic rats induced by the injection of streptozotocin. AB - Ultrastructural changes of prolactin (PRL) cells in streptozotocin (STZ)-induced diabetic rats treated with or without insulin were observed by means of conventional and immunocytochemical electron microscopic studies. With progress of diabetic state, the number, cellular outline and secretory granules of PRL cells were decreased, and the organella were changed into atrophic. Granule extrusion was frequently observed in PRL cells of diabetic rats but was not seen after the injection of insulin to the diabetic rats in spite of recovering the ultrastructural features of organella in PRL cells. The above results may suggest that the injection of insulin to diabetic rats stimulates the activity of PRL cells but suppresses the PRL release from PRL cells. PMID- 3545862 TI - Myosin switching during amoebo-plasmodial differentiation of slime mold, Physarum polycephalum. AB - We reported previously that myosins from amoebal and plasmodial stages in the life cycle of Physarum polycephalum differ in the primary structure of heavy chains and phosphorylatable 18,000 Mr light chains, while Ca-binding 14,000 Mr light chains are common to both myosins (Kohama & Takano-Ohmuro, Proc Jpn acad 60B (1984) 431; Kohama et al., J biol chem 260 (1986) 8022). We have carried out immunofluorescence microscopical studies upon differentiating cultures of amoebic colonies, which show apogamic amoebo-plasmodial differentiation as follows: Typical amoebae differentiate into mono-nucleate intermediate cells with swollen nuclei and then into two or multi-nucleate young plasmodia (Anderson et al., Protoplasma 89 (1976) 29. Antibodies against plasmodial myosin heavy chain (PMHC) and 18,000 Mr plasmodial myosin light chain (PMLC18) stained intermediate cells and young plasmodia, but not typical amoebae. On the other hand, antibody against amoebal myosin heavy chain (AMHC) stained typical amoebae and intermediate cells- but not young plasmodia. Thus staining was detected using antibodies against both PMHC and AMHC in intermediate cells. Intermediate cells were also stained by antibody against another plasmodium-specific cytoskeletal protein, viz., high molecular weight actin-binding protein (HMWP). We propose that synthesis of myosin subunits switches immediately from amoebal to plasmodial type in mono nucleate cells with swollen nuclei. This myosin switching is associated with the initiation of HMWP synthesis. PMID- 3545863 TI - The expression of specific surface antigen of smooth muscle cells is related to proliferation. AB - Monoclonal antibody L1 has been obtained after immunization of BALB/c mice with long-term cultured smooth muscle cells (SMC) originally isolated from rat aortic media. Antibody L1 recognizes only the surface antigen of cultured SMC and does not react with other cultured rat cell types. It has been shown that in primary culture of SMC the L1-positive cells appear on the 2nd to 3rd day and their proportion increases up to the 7th day up to 40% in DMEM supplemented with 10% of fetal calf serum (FCS), up to 25% in DMEM with 5% of rat whole-blood serum, but up to only 5% in DMEM with 5% rat plasma-derived serum. These results are in agreement with data on [14C]thymidine incorporation and on flow cytometry. Using FACS II, the SMC were sorted into subpopulations on the 4th and 8th days of primary culture according to the intensity of their specific immunofluorescence. It has been found that the DNA profile in intensively labelled cells corresponds to that in an intensively proliferating population of cells. These findings suggest that antigen L1 appears to be the specific marker of modulated SMC entering the cell cycle. PMID- 3545864 TI - Serum-induced G0/G1 transition in chemically transformed 3T3 cells. Independence of protein synthesis, stable "memory", and enhancement by cycloheximide pretreatment. AB - Quiescent, chemically transformed (benzo-alpha-pyrene) BALB/c 3T3 cells (BP A31) enter the cell division cycle when exposed to complete medium containing 10% fetal calf serum (FCS); the number of cells recruited is a function of the duration of serum exposure. The recruitment of cells by short (less than 4 h) serum pulses is not inhibited by simultaneous exposure to cycloheximide (CH), and therefore the initial commitment does not require protein synthesis. The cells enter S phase with a constant delay following the removal of CH, even if CH exposure has been continued for as long as 20 h after the end of the serum pulse. The cell recruitment by serum pulses was inhibited by 5,6-dichloro-1-beta-D ribofuranosyl-benzimidazole (DRB), an inhibitor of cytoplasmic mRNA accumulation. These data suggest that serum exposure produces a stable 'memory' that is necessary and sufficient for the eventual progression through G1 to S phase that occurs when protein synthesis is resumed after the removal of CH; this 'memory' probably consists of mRNA species that are induced by serum and that are stable in the absence of protein synthesis. Unexpectedly, pretreatment of quiescent BP A31 cells with CH (8-24 h) dramatically increased the fraction of the total cell population that is recruited by a serum pulse of fixed duration. PMID- 3545866 TI - Immunocytochemical discrimination of visual pigments in the retinal photoreceptors of the nocturnal gecko Teratoscincus scincus. AB - Using a monoclonal antibody (COS-1) against a chicken cone visual pigment and an anti-rhodopsin serum, two visual pigments were distinguished in the gecko retina. One pigment, recognized by the monoclonal antibody COS-1, was found in the outer segments of all photoreceptor cells except the thinner members of type C double cells and the middle members of the triplet cells. These COS-1-negative photoreceptors contained another pigment which could be demonstrated by the anti rhodopsin serum. Based on an earlier microspectrophotometric study, the visual pigment recognized by COS-1 is a green-sensitive pigment, while the one demonstrated by anti-rhodopsin is a blue-sensitive photopigment. PMID- 3545865 TI - Histochemistry of adenylate cyclase activity in the anterior segment of the eye: a methodological evaluation with biochemical background. AB - A histochemical technique for adenylate cyclase activity suitable for both light and electron microscopy is described. This technique is based on the Sr2+ capture reaction using adenylylimidodiphosphate as the substrate. The precipitated strontium phosphate is converted to lead phosphate, which is electron-dense for electron microscopy and can also be made visible by light microscopy. Different fixatives and fixation times were tested; paraformaldehyde at a concentration of 1% for 5 min demonstrated the enzyme activity best. The enzyme was protected and or stimulated during all stages with isoproterenol, 5-guanylylimidodiphosphate, and dimethyl sulfoxide (DMSO). Numerous capturing agents (Pb2+, Co2+, Ce2+, Ba2+, Cd2+, and Sr2+) were tested. Strontium chloride (10 mM) produced the best result, inhibiting the enzyme less than 50%. The others gave inconsistent results. By this technique, adenylate cyclase activity was localized on the cell membranes of the deep layers of the rabbit corneal epithelium, on the endothelium, and on the cell membranes of the non-pigmented epithelium in the ciliary processes. These sites correspond well with earlier autoradiographic localization of beta adrenergic receptors in the rabbit eye. PMID- 3545867 TI - In celebration of the 80th birthday of Nathan W. Shock, Ph.D. 25 December 1986. PMID- 3545868 TI - Gerontology comes of age--Dr. Shock's 40-year legacy. PMID- 3545869 TI - Bits of fossils (W.W. Peter). PMID- 3545871 TI - Age-related polyploidization of hepatocytes: the cause and possible role. A mini review. PMID- 3545870 TI - Biogerontological precepts of Nathan Shock which influenced our aging research. PMID- 3545872 TI - Genetic instability as the primary cause of human aging. AB - The origins of aging of higher forms of life, particularly humans, is presented as the consequence of an evolved balance between 4 specific kinds of dysfunction producing events and 4 kinds of evolved counteracting effects in long-lived forms. Among the deleterious events, particular importance is assigned to damage to DNA, but damage of a different kind than classical mutations. The evolution in man's ancestors of means to counteract the kinds of events that limit the life spans of short lived mammals is postulated to be the indirect consequence of the prior evolution of superior mental capacities. Further, it is shown that the human species rapidly evolved its life-extending mutations because of the special circumstances afforded by the subdivision of the species into small semi-isolated (genetically) tribes of 10-100 individuals in which polygamy was the key factor in rapid incorporation of life- and well-being-extending new features. These conditions permit at least one or two orders of magnitude more of such beneficial genes to have been incorporated into our genomes during the 100,000 years or so of extremely rapid human evolution that evidently occurred about 100,000 to 200,000 years age than has been posited by other workers. The sources of damage to DNA are then considered, with special emphasis on free-radical derivatives of molecular oxygen and evidence is presented that longer lived forms of mammals have peroxide lysing enzymes that produce a lower steady state of damaging radicals derived from this compound. Evidence that so-called "classical" mutations cannot be the source of aging is then reviewed. A different kind of mutation, one that is not increased in proportion to point mutations by mutagens, namely deletion of tandemly duplicated copies of genes, is discussed and the evidence that such damage (gene loss) occurs in an amount sufficient to account for the major losses in function during aging is presented. The most likely mechanisms of such loss plus the prospects for evolving and bio-engineering means to counteract these losses together with some implications regarding the documented loss of NORs with age (as regards rDNA loss) together with key areas for intensive present and future research on aging are presented. PMID- 3545873 TI - Anatomic and physiologic age changes in the kidney. AB - Cross-sectional studies of renal function in man indicate there is a progressive decline with age after the age of 40 years. The blood vessels, glomeruli, tubules and interstitium are all potential sites of primary involvement in the aging process as well as for renal disease. Regardless of the anatomic structure initially affected, most chronic renal conditions evolve with destruction of the entire nephron. Whether the observed decrease in renal function associated with aging is the result of intervening pathologic processes, e.g. ischemia (vascular obliteration) or infection, or is the result of a more insidious involutional process, it has generated much discussion but few answers. The purpose of this report is to review the descriptive studies documenting the changes in renal morphology and physiology with age and to focus on what is known about the mechanisms involved in these losses of renal substances and function. PMID- 3545874 TI - Splanchnic factors enhance the norepinephrine response to oral glucose in aged man. AB - Oral glucose has been shown to increase sympathetic nervous system (SNS) activity more in old than in young subjects. In contrast intravenous glucose during euglycemic hyperinsulinemia increases SNS activity in young but not in old subjects. To evaluate the role of splanchnic factors in this discrepancy, we employed a modification of the glucose clamp technique in 6 young (24-39 years) and 8 old (65-83 years) normal males. Each subject underwent two studies in which insulin was infused at 120 mU/m2 X min for 3 h and either oral glucose (50 gms) or water was given 60 min after initiating insulin. Euglycemia was maintained in all studies. When compared to control drink, oral glucose elevated norepinephrine in old (p less than 0.01), but not in young subjects. The difference between old and young was significant (p less than 0.02). When compared to control drink, oral glucose increased pulse rate and double product in the young, and pulse rate in the old. These results indicate that oral glucose activates the SNS in the elderly via splanchnic mechanisms independent of changes in circulating levels of glucose or insulin. PMID- 3545875 TI - Forty years of experimental psychology in relation to age: retrospect and prospect. AB - Experimental psychological research on performance in relation to age is outlined to show how aims, methods and interests have developed between the pioneering days of the 1940s and the present time. More detailed consideration is then given to the actual and potential applications to studies of aging of the quantitative methods of Information and Signal Detection Theories, and to the importance of taking account not only of correct performance but of the frequency and nature of errors if age changes are to be fully understood. Research in relation to age on continued performance is discussed, including short-term serial effects and the longer terms effects of fatigue, learning and practice, and the need for further research in these areas is emphasised. Guiding principles for future psychological research on aging are briefly urged. PMID- 3545876 TI - Stem cell kinetics: correlation of in vivo and in vitro data. AB - Comparisons have been made along three parameters between the observations of a number of workers regarding in vivo the transitional cell compartment, and in vitro observations of colony-forming units. The parameters used were size changes when the stem cell requirements are increased, the existence of three size groups in both the transitional cell compartment and in the colony-forming units examined, and the relation between cell size and the percentage of cells in DNA synthesis. On all these parameters there appears to be close correlation between the in vitro properties of stem cells and progenitor cells and the in vivo properties of the transitional cell compartment. Transitional cells appear to be the only cells in the marrow that can match the kinetic properties of a number of colony-forming units. PMID- 3545877 TI - Quantity and nature of residual bone marrow T cells after treatment of the marrow with Campath-1. AB - Precise characterization of T-cell depletion in marrows used for transplantation is necessary for the evaluation of their potential contribution to engraftment and to graft-versus-host disease. A limiting dilution culture method that allows the determination of small numbers of bone marrow T cells is described. It can detect less than one T cell in 10(4) cells. Bone marrow T-cell depletion with the rat monoclonal antibody Campath-1 and fresh human complement results in a median decrease of 1.7 log (range, 1.6-2.1 log) of marrow T cells. A 2.7 to 3.3-log reduction is obtained when peripheral blood T cells are treated. A second incubation with fresh complement removes additional T cells from peripheral blood and from marrow samples, indicating the importance of bystander marrow cells to complement activity. The assay system described also allows the phenotypic study of responding cells growing in culture. These studies demonstrate that, after treatment with Campath-1 plus complement, no T-subset imbalance occurs. Furthermore, the T cells in these cultures are derived from mature T cells contained in the samples. PMID- 3545878 TI - Protection of mice from whole body gamma irradiation by deuteration of drinking water: hematologic findings. AB - Partial deuteration of mice by ingestion of 29% heavy water for 12 days prior to irradiation lessened their susceptibility to lethal doses of whole body gamma irradiation from a 60Co source. Deuteration alone slightly reduced the number of nucleated bone marrow cells, blood leukocytes, and platelets. After exposure to 8.5 Gy, all mice drank tap water. Radiation-induced destruction of hemopoietic and lymphoid tissues was of equal degree in deuterated and control animals. Conversely, nucleated bone marrow cells, blood leukocytes and platelets, endogenous spleen colonies, and thymus of deuterated mice displayed signs of an accelerated and/or enhanced regeneration. The cytokinetic changes observed in deuterated animals were consistent with a protective effect for pluripotent stem cells at the time of irradiation. PMID- 3545879 TI - Human megakaryocytes. IV. Growth and characterization of clonable megakaryocyte progenitors in agar. AB - Human megakaryocyte progenitors were cloned in semisolid agar from unfractionated bone marrow cells and recognized by their capability of producing discrete megakaryocyte colonies. Megakaryocyte colonies were identified in situ by immunofluorescence, using antibodies against platelet glycoproteins Ib, IIb, and IIIa, as well as von Willebrand factor (vWf), which are regarded as distinct protein markers for the megakaryocyte-platelet lineage. Megakaryocyte colonies typically contained 20-50 cells arranged in compact configurations, with high nuclear-cytoplasmic ratios, diameters between 10 and 14 micron, and round, oval, or indented nuclei. Colony numbers peaked at days 6 and 7, with a mean of 17.9 megakaryocyte colonies (range, 8-33) per 2 X 10(5) unseparated marrow cells. The in vitro growth characteristics and kinetics of megakaryocytes grown in agar are different from those described for the plasma clot and methylcellulose systems, which suggests selection of distinct progenitor subsets. Consequently, this assay may be a useful complement to other approaches in characterizing the megakaryocyte progenitor population. PMID- 3545880 TI - Ectopic implantation studies using Sl/Sld marrow and recipients. AB - Marrow from Sl/Sld mice (in which the hemopoietic stromal microenvironment is defective), when implanted beneath the renal capsule of a normal littermate, produces an ectopic marrow site containing the same number of stem cells (CFU-S) and nearly as many GM-CFC as that obtained by implanting marrow from a normal littermate. On the other hand, a marrow plug from an Sl/Sld donor implanted beneath the renal capsule of an Sl/Sld littermate produces less than half the number of CFU-S and about 10% of the number of GM-CFC. This suggests that the recipient of the ectopic implant can contribute in some way to the stromal environment of the grafted marrow. PMID- 3545881 TI - In vitro chemoseparation of leukemic cells from murine bone marrow using VP16 213: importance of stem cell assays. AB - The use of chemopurified autologous bone marrow (BM) is being explored as a transplant source for patients with leukemia who do not have a HLA-matched donor. Because stem cell assays have not previously been found to predict engraftment after transplantation, the optimal drug(s) and drug concentrations have not been determined. To determine the effectiveness of the podophyllotoxin derivative, VP16, and the value of stem cell assays in chemopurification studies, a murine model using the C57B1/6 mouse and its syngeneic leukemia EL-4 was developed. Kill of committed (CFU-C) and pluripotent (CFU-S) hematopoietic stem cells and tumor (tCFU) stem cells after a 1-h exposure to VP16 was first determined. A marked kill differential of tCFU compared to that of the CFU-C/S populations was found, with no tCFU surviving at VP16 concentrations greater than 30 micrograms/ml. No kill differential of CFU-C versus CFU-S was seen at VP16 doses greater than 10 micrograms/ml. All mice transplanted with a mixture of 25 X 10(6) BM cells and 1 X 10(7) EL-4 cells treated in vitro with 40 micrograms/ml of VP16 died of their tumors. However by reducing the tumor burden to 1 X 10(6) EL-4 and 5 X 10(6) EL 4, nine of ten and four of six of the mice, respectively, survived 90+ days tumor free. On the basis of survival data, it was found that engraftment of VP16 treated BM was directly proportional to the product of the degree of CFU-S inhibition and BM cell inoculum, i.e., the number of viable CFU-S transplanted. The maximum VP16 concentration that led to predictable engraftment at BM doses less than 25 X 10(6) cells was 55 micrograms/ml. Thus, 15 mice were transplanted with 1 X 10(7) BM cells and 1 X 10(7) EL-4 cells, incubated with 55 micrograms/ml of VP16; 13 out of 15 survived tumor free for 90+ days. When VP16 was used as a BM chemopurification agent, up to 50% of contaminating tumor cells were eliminated from BM suspensions without affecting engraftment after transplantation. Because stem cell inhibition predicted engraftment, drug concentrations that maximized tumor cell kill could be chosen. PMID- 3545882 TI - The effect of RU 41.740, an immune modulating compound, in the prevention of acute exacerbations in patients with chronic bronchitis. AB - The effect of Biostim (RU 41.740), a new non-specific immune modulator, in reducing the number of acute exacerbations in patients with chronic bronchitis, was examined. One hundred and ninety-eight patients with chronic bronchitis stages 2 and 3 entered the study, which was conducted as a multicenter, double blind, parallel three-group, placebo-controlled trial. The patients were randomised to placebo, Biostim 2 or 8 mg per day, and received treatment for 1 week every other week for 3 successive months during the winter 1983. A significant (p = 0.005) reduction in the number of acute exacerbations was observed in the patients treated with Biostim 2 mg/day, whereas no effect was observed in the placebo or 8 mg/day group. No serious side-effects were encountered. PMID- 3545884 TI - Quantification and chemical markers of tobacco-exposure. AB - Quantitation of exposure to tobacco products is useful for any individual smoker, and necessary for epidemiological studies which relate smoking to pathology, or which are concerned with the efficacy of smoking cessation methods. The medical history, trying to quantitate the current mean daily cigarette consumption (consumption rate), the cumulative risk (pack years) and the various types of smoking, including inhalation habits, should also be attempted. However, due to the quasi-systematic underrating of tobacco consumption which smokers have revealed on many occasions, together with difficulty in correctly observing cigarette smoking, objective validation of recent historical data by quantitative measurement of tobacco products in tissue fluids is mandatory. Measurements of nicotine and cotinine levels in serum and urine require elaborate and expensive methods, and are not adequate for validation of smoking cessation in smokers who are using nicotine chewing gum. Carbon monoxide is a good marker of smoke inhalation. Normal carboxyhaemoglobin levels allow us to confirm that a subject has recently stopped smoking, as its half-life is only a few hours in blood. Salivary (or plasma) measurements of thiocyanate discriminate between smokers and ex-smokers, with a high probability, particularly in those who have stopped smoking for at least 14 days, separating these clearly from current smokers. However, several potential causes of error must be considered to allow correct interpretation of measurements of thiocyanate. PMID- 3545883 TI - Ambroxol therapy in simple chronic bronchitis: effects on subjective symptoms and ventilatory function. AB - Ambroxol, a metabolite of bromhexine, was investigated in a double-blind, controlled trial using parallel groups. We studied the effects of 60 mg and 120 mg daily versus placebo in subjects with simple chronic bronchitis. Possible therapeutic effects were evaluated by means of interviews on subjective drug effects and current respiratory symptomatology, patient diary cards, and lung function tests. Ninety-seven subjects entered the study and 92 completed satisfactorily. Comparison with the placebo group at the end of the study showed that significantly more subjects in the 120 mg ambroxol group reported improvement in respiratory symptoms, principally improved expectoration. Subjects in the 120 mg group tended to prefer the treatment period when compared to placebo but the diary cards did not indicate significant changes. Lung function values were mainly normal and did not change during treatment. We conclude that the drug had a symptomatic effect and that further studies in more severely affected patients would be worthwhile. PMID- 3545885 TI - Specific antibody in the subclasses of immunoglobulin G in patients with smear positive pulmonary tuberculosis. AB - Discrimination between patients with smear-positive pulmonary tuberculosis and healthy adults achieved by the assay of serum anti-mycobacterial antibodies in the major immunoglobulin class (IgG) was greatly improved by assay of antibodies in its four subclasses. By the former method, only 55 of 107 (51%) patients had antibody levels above the upper limit of 31 control sera, but 96 (90%) patients had levels above the upper control level in one or more of the IgG subclasses. Antibody levels in the IgA and IgM classes were less discriminative, but four patients with no elevated levels in the IgG subclasses had elevated IgA antibody levels, bringing the total of patients with significant serological changes compatible with tuberculosis to 100 (93.5%). PMID- 3545886 TI - Immunocomplexes in rat and rabbit spinal cord after injury. AB - The possibility that, following a major lesion of the central nervous system, a humoral immune response could be evoked with formation of immune complexes "in situ" was investigated. For this purpose, an immunohistochemical study on rabbit and rat spinal cord at different times after surgical transection was carried out. The peroxidase-antiperoxidase method showed IgG decoration of the myelin sheaths starting a short time after surgery. The sera of intact and injured animals were then tested both by immunohistochemical methods on intact spinal cord sections and by immunoelectrophoresis on a protein extract of homologous spinal cord. The results showed in the rabbit the absence of antibodies to neural antigens before surgical injury and its appearance within a few days after surgery. On the other hand, in the rat, even before the injury, we found antibodies to neural tissue which decreased in the first few hours after injury, and returned to control values during successive days. The same experiments were conducted after a peripheral nerve lesion (sciatic nerve crush), but no immune response could be detected. The possible role of this immune response in the failure of axonal regeneration in mammalian spinal cord is briefly discussed. PMID- 3545887 TI - The host serotonin projection to tectal grafts in young rats: an immunohistochemical study. AB - It has been shown previously that embryonic tectal tissue grafted to the midbrain of newborn rats is innervated by fibers from a variety of host regions, including the raphe nuclei. The present study examined the distribution within tectal transplants of axons arising from these serotonin-containing neurons in the host brain stem. Fetal tectal tissue was transplanted to the midbrain of young host rats aged 0 to 21 days. After 7 or more weeks, the host serotonin projection to the grafts was examined immunohistochemically using a monoclonal antibody to serotonin. In most cases, visualization of serotonin axons was enhanced by treating the animals with 5, 7-dihydroxytryptamine. Tectal transplants were found lying on or embedded within the host midbrain. In the newborn hosts, serotonin innervation was densest and most frequently encountered in the nonembedded grafts. Fibers with serotonin-like immunoreactivity were also seen in the tectal tissue grafted into older hosts. The pattern of innervation of serotonin fibers varied from one graft to another and did not correlate with any obvious morphologic or histochemical features within the grafts. This is in contrast to the distribution of host retinal and cortical axons, which have been shown to consistently project to specific and recognizable regions within the graft neuropil. PMID- 3545888 TI - A small-gauge cannula device for continuous infusion of exogenous agents into the brain. AB - A method is described for the construction of an intraventricular or intraparenchymal cannula device, which when connected to an Alzet osmotic pump, can be used for the continuous infusion of experimental solutions into the brain. A 33-gauge, stainless-steel cannula is encased within a dental acrylic stabilization platform prior to stereotaxic implantation, and after implantation, the platform is glued to the animal's skull using cyanoacrylate adhesive. This procedure provides for the long-term stability (at least 4 weeks) of the small gauge cannula without the need for additional stabilization skull screws, thus minimizing damage to surrounding tissues by the cannula and postsurgical trauma to the animal. Using the stock model 2002 Alzet pump to infuse artificial cerebral spinal fluid at a flow rate equal to 0.5 microliter/h, an inflammatory tissue reaction around the cannula tip was consistently found after 2 weeks of continuous intraparenchymal infusion. However, the inflammatory reaction could be significantly reduced or eliminated by decreasing the flow rate to approximately 0.25 microliter/h, using a modified Alzet pump. Alternatively, the stock 0.5 microliter/h pump could be used without causing parenchymal damage if the cannula tip was implanted into the lateral ventricle. PMID- 3545889 TI - Transection of the canine anterior cruciate ligament: a concise review of experience with this model of degenerative joint disease. AB - Transection of the anterior cruciate ligament in dogs is probably the most widely used model for degenerative articular disease. Two techniques, the percutaneous stab and arthrotomy, are currently employed. Reported results of the degree of cartilage damage and the time of onset of lesions vary considerably in the literature. Several papers described overt fibrillation as early as 6 weeks post operatively while others found only mild changes up to nearly 4 years. Critical analysis of the model revealed that parameters such as the breed of dog, its age, weight, amount of exercise and technique of surgery may influence the onset and severity of lesions. Further research is essential to define the relative importance of each. PMID- 3545891 TI - Ornithine decarboxylase, S-adenosyl-L-methionine decarboxylase and arginine decarboxylase from Mycobacterium bovis (BCG). AB - Ornithine decarboxylase (ODC), S-adenosyl-L-methionine decarboxylase (AMDC) and arginine decarboxylase (ADC) activities were detected for the first time in extracts of Mycobacterium bovis (BCG). All the decarboxylases differed from corresponding known bacterial decarboxylases in that: a) ODC did not require GTP for activity; b) ODC was not inhibited by any known inhibitor of bacterial ODCs; c) AMDC and ADC did not require Mg2+-ion for activity and were not markedly inhibited by any known inhibitor of the decarboxylases of other bacteria. PMID- 3545892 TI - A practicable variant of the ion exchange method for the radiometric estimation of ornithine decarboxylase activity. AB - A known ornithine decarboxylase assay working with ion exchange separation of [3H]ornithine and [3H]putrescine has been revised. The assay can be performed in disposable 1.5 ml vessels with a total of four pipetting steps. The separation of enzyme substrate and product, respectively, requires 3 h per 50 samples. The detection limit is about 50 pmoles [3H]putrescine formed. PMID- 3545893 TI - Central neural control of pineal melatonin synthesis in the rat. AB - To investigate a possible central neural influence on nocturnal pineal metabolic activity in rats, frontal transsections of the stria medullaris thalami were conducted. Enzymes involved in melatonin synthesis, i.e. N-acetyltransferase and hydroxyindole-O-methyl-transferase, exhibited reduced activities in operated animals when compared to controls. These results indicate a modulatory role of central structures on nocturnal pineal indole metabolism. PMID- 3545894 TI - Immunoreactive luteinizing hormone-containing neurons in the brain of the white footed mouse, Peromyscus leucopus. AB - The distribution of immunoreactive LH in the brain of the white-footed mouse (Peromyscus leucopus) was determined using immunocytochemical procedures. Immunoreactive fibers are located in the hypothalamus, preoptic area, septum and amygdala. Stained cell bodies are seen in the arcuate nucleus and preoptic area. Gonadectomy enhances staining for LH in the brain. PMID- 3545895 TI - An enzyme immunoassay for mouse epidermal growth factor utilizing a liquid phase double-antibody system. AB - An enzyme immunoassay for mouse epidermal growth factor (EGF) involving a liquid phase double-antibody system was developed. The EGF-beta-galactosidase conjugate prepared was stable for at least 8 months. By this method, EGF was detectable at a concentration as low as 20 pg per tube. The concentrations of EGF in various tissues of mice are also presented. PMID- 3545890 TI - Cardiac cellular electrophysiology: past and present. AB - The time-course of the cardiac action potential can be accounted for in terms of ionic currents crossing the cell membranes. Depolarizing current is carried by Na+ or Ca2+ entering the cells, repolarizing current by K+ leaving the cells. Membrane permeability for the passive movement of these ions is thought to be voltage-dependent as well as time-dependent. Net transfer of charge may also result from active transport, 2 Na+ out against 1 K+ in; or coupled exchange, 3 or 4 Na+ in against 1 Ca2+ out. This review follows the path by which present-day knowledge has been reached. It also gives a few examples to illustrate that electrophysiology has provided concepts useful to clinical cardiology. PMID- 3545897 TI - Characteristics of interneurons in the ocellar system of the honeybee. AB - Intracellular recording and staining has revealed new aspects of the anatomy and physiology of ocellar interneurons in the honeybee (Apis mellifera). Homologous large first-order interneurons (L-neurons) from different individuals vary in structure as well as in their response to light. Even the response patterns of one type of L-neuron may present a continuum from graded responses to spiking responses. The response depends on the state of the L-neuron and cannot be correlated with particular morphological types. Graded responses are unimodal and can be elicited exclusively by stationary illumination of the ocelli, whereas spiking L-neurons can also respond to stimuli of other sensory modalities. Recordings from the same type of multimodal spiking L-neuron in different individuals demonstrate considerable variation in responses to different modalities. The existence of two response patterns in the same cell that can encode different information may be of general importance with respect to the processing of information in the brain. There appears to be a variety of different pathways enabling interaction of ocellar and compound eye signals either by direct contact between ocellar and optic lobe neurons or by convergence of the two pathways to a common descending or local interneuron. Two examples are discussed: an ocellar small first-order interneuron (S-neuron) that project directly to the optic lobes and a local interneuron that is situated in the posterior midbrain close to situated in the posterior midbrain close to ocellar terminals and optic lobe outputs and that responds to stimulation of both visual systems.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545896 TI - Effect of phosphorylation of myosin light chains on interaction of heavy meromyosin with regulated F-actin in ghost fibers. AB - The binding of phosphorylated heavy meromyosin to regulated F-actin in ghost fibers at high Ca2+ concentration increases, and at low Ca2+ concentration decreases, the anisotropy of intrinsic tryptophan fluorescence of F-actin. The effect is opposite to the effect of the binding of dephosphorylated heavy meromyosin. PMID- 3545898 TI - [Luliberin analogs--a new class of contraceptive agents]. PMID- 3545900 TI - [Dynamics of the joint pains at night in rheumatoid arthritis and arthroses treated with Rengasil and piroxicam]. AB - The effect of a novel nonsteroidal antiinflammatory drug Rengasil on pain at rest in rheumatoid arthritis and arthroses was studied in comparison with piroxicam and placebo. Intensity of nocturnal pains was estimated according to the "visual analogous scale". The relationship between the time of occurrence of a complete analgesic effect and severity of the pain syndrome before the beginning of monotherapy was established. PMID- 3545899 TI - [Adrenomimetics and adrenoreceptor function in bronchial asthma]. PMID- 3545901 TI - [Historical stages in the experimental and clinical study of cardiac glycosides]. PMID- 3545902 TI - Crosslinking of trypsin digested acto-heavy meromyosin as a probe of the affinity of the two myosin heads to actin. AB - The interaction of the two heads of the myosin molecule with actin was studied by tryptic digestion of HMM in the presence of actin, followed by crosslinking the two nicked heavy chains with Nbs2 at the S2 region. In view of the protection by actin of the 50/60 kDa junction against proteolysis, the percentage of the heads interacting with actin was estimated from the proportion of the 110 kDa to the 60 kDa digestion product. Under conditions such that about 50% of HMM heads were protected by actin (at an actin to HMM head molar ratio of 1:1 in the absence of nucleotide, or 3:1 in the presence of 5 mM ADP), the crosslinking of the digestion products yielded a 230 kDa (110 + 110 kDa), 125 kDa (60 + 60 kDa) and 175 kDa (60 + 110 kDa) species. Since the latter should be the only crosslinking product when only one head of HMM molecule is protected by actin, it is concluded that there is no preferential binding of one of the two HMM heads to actin in the presence of ADP or at equimolar actin to myosin heads ratio. PMID- 3545903 TI - Simplified in vitro synthesis of mutated RNA molecules. An oligonucleotide promoter determines the initiation site of T7RNA polymerase on ss M13 phage DNA. AB - We describe a simplified method for the in vitro synthesis of mutated RNA molecules. The method makes use of an oligodeoxyribonucleotide (T7-oligo) which contains the T7RNA polymerase promoter sequence. In combination with a second oligonucleotide, a series of transcripts initiating and terminating at any chosen position on a cloned ss DNA (e.g. M13 phage DNA) can be generated. The phage DNA represents the non-coding DNA strand for the desired transcript; the T7-oligo determines the transcription start site, whereas the second oligonucleotide permits the choice of the transcription termination site. The synthesis of the required template DNA is achieved by hybridizing the two oligonucleotides to the phage DNA and subsequently synthesizing the coding DNA strand by a fill-in reaction with Klenow enzyme. The reaction product is used directly as a template for T7RNA polymerase; cloning of mutants is not required. PMID- 3545904 TI - Secretion of human insulin by a transformed yeast cell. AB - A yeast expression plasmid encoding a mini-proinsulin molecule was constructed and transformed into Saccharomyces cerevisiae. The plasmid encoded the sequence: B-Arg-Arg-Leu-Gln-Lys-Arg-A in which B represents the B-chain (30 amino acid residues) and A represents the A-chain (21 amino acid residues) of human insulin. The secreted peptides were shown to be a mixture of human insulin and des(B 30)human insulin. Thus, correct disulphide bridges can be established in proinsulin-like molecules devoid of a normal C-peptide region. Furthermore, the specificity of the yeast processing enzymes is so similar to the proinsulin converting enzymes in the human pancreatic beta-cell that it allows the processing of the mini-proinsulin to insulin. PMID- 3545905 TI - Rectal carcinoma: a new technique to allow safer postoperative irradiation of the pelvis. AB - Local recurrence after abdomino-perineal excision of the rectum for Dukes C carcinoma is common. The influence of postoperative radiotherapy in reducing this is currently under investigation, and one of the potential complications is radiation damage to the small bowel. This paper describes a simple and quick method of excluding the small bowel from the pelvis which, combined with more sophisticated radiation field planning, could dramatically reduce the incidence of enteric effects. PMID- 3545906 TI - Chemotherapy of gastric carcinoma. PMID- 3545907 TI - Reconstruction of full-thickness cheek defects after cancer surgery. AB - The value of various surgical techniques used to reconstruct full-thickness cheek defects is discussed. Small defects can be repaired with the use of local cervical skin flaps with a random vascular pattern. Axial pattern temporal flap is another choice, either alone or combined with a cervical flap. Whenever local tissues are not suitable (i.e. after irradiation or neck dissection) a transfer of distant myocutaneous island flap based on a pedicle of axial muscle vessels is a valuable alternative. Split skin graft may form a good intra-oral lining of such island flap. PMID- 3545908 TI - Eponyms in oncology. Cuthbert Esquire Dukes (1890-1977). PMID- 3545909 TI - A double-blind, placebo-controlled study of the use of methylprednisolone in infertile men with sperm-associated immunoglobulins. AB - Forty-three men with antibody-mediated infertility identified by measuring sperm associated immunoglobulin with a direct radiolabeled antiglobulin assay were enrolled in a double-blind, placebo-controlled protocol to judge the efficacy of corticosteroids in this condition. In the active drug group, men were given 96 mg methylprednisolone in three divided doses for 7 days followed by a 2-day tapering of the drug. The control group was given placebo in the same manner. Both regimens were repeated three times approximately 1 month apart on the basis of their female partner's menstrual cycle. There was not a favorable effect of corticosteroids over placebo on the men's semen parameters, the results of assays for sperm-associated IgA and plasma IgG antisperm antibodies, or the men's subsequent fertility. There was a statistically significant effect on sperm associated IgG in men given methylprednisolone compared with men given placebo. PMID- 3545910 TI - Abnormal distribution of epididymal antigens on spermatozoa from infertile men. AB - An antiserum raised against human epididymal proteins associated with ejaculated sperm was used to test the hypothesis that the amount and/or localization of these antigens may be altered in men with infertility. With the use of immunofluorescence we found that in sperm from fertile donors 88.4% of the cells had the antigens localized over the acrosomal cap only and 1.3% had most of the antigens at extraacrosomal sites. Fifteen of the 26 infertile men (P1) studied had a similar relative distribution of antigens, but the remaining 11 patients (P2) had a 38-fold increase in cells with extraacrosomal localization of the antigens (40%, P less than 0.005). Using flow cytometry to quantitate immunofluorescence, content of antigen on sperm from patients from population P1 (680 +/- 60 V X 10(-4)) was not different from that of control (835 +/- 53 V X 10(-4], whereas it was significantly lower in sperm from patients from population P2 (554 +/- 64 V X 10(-4), P less than 0.005). Differences could not be correlated with parameters measured by routine semen analysis. Our results suggest a possible relationship between the decreased amount of epididymal antigens or their altered localization on sperm and the infertility of patients from population P2. PMID- 3545911 TI - Lack of a head in human spermatozoa from sterile patients: a syndrome associated with impaired fertilization. AB - Three patients with primary sterility in whom the majority of spermatozoa lacked a normally implanted head are presented. A small cephalic knob was evident in most of them by routine colorimetric techniques, and the Feulgen reaction failed to show any deoxyribose nucleic acid. The morphologic features of the tails was normal. Few loose sperm heads were observed in the ejaculates. Even though motility was decreased, there were numerous acephalic sperms with different degrees of forward motility. Electron microscopy showed a well-organized structure of the centrioles and connecting piece, which were located in the neck region within a small cytoplasmic mass, but no chromatin was detected in any case. Studies on immature spermatids present in semen evidenced an independent anomalous development of heads and tails and suggested that they became separated at the end of spermatid maturation. This anomaly, of probable genetic origin, is interpreted to be due either to an alteration in the mechanism of migration and positioning of the tail on the caudal pole of the nucleus or to an interference with the formation of the implantation fossa of the head, which normally accommodates the connecting piece. PMID- 3545913 TI - A new transvaginal probe and biopsy guide for oocyte retrieval. PMID- 3545912 TI - A comparison between argon laser and microsuture anastomosis of the rat uterine horn. AB - For assessment of the use of the argon laser for tubal anastomosis, the uterine horns of 12 Sprague-Dawley rats were surgically divided and then anastomosed, 6 by argon laser photocoagulation and 6 by the conventional technique of microsurgery. After a 4- to 6-week postsurgical period subjects were reexamined. All microsutured anastomoses were fully patent and continuous, with no apparent fibrosis. Four of six laser subjects had complete occlusion; the other two exhibited patencies between 10% and 20% of normal luminal area. Although initially producing satisfactory union, argon laser photocoagulation proved highly tissue traumatic, resulting in poor regeneration of the anastomotic site. PMID- 3545914 TI - [The cellular excitability problem in the research of physiologists in the Ukrainian SSR]. PMID- 3545915 TI - [Retrograde horseradish peroxidase- and fluorochrome-labelled thalamic sources of afferent projections into the parietal associative cerebral cortex of the cat]. PMID- 3545916 TI - [Clinical study of Elmex toothpaste. Effect of amino-fluoride on periodontitis, oral hygiene and salivary microflora]. PMID- 3545918 TI - Relaxation techniques in acute myocardial infarction: the theoretic rationale. PMID- 3545917 TI - Brain death in children--is there a difference? PMID- 3545919 TI - [Functional significance and physiologic mechanisms of the variability of the baroreceptor reflex]. PMID- 3545920 TI - Seasonal variations of testicular activity in juvenile and mature bank voles (Clethrionomys glareolus). PMID- 3545922 TI - Cerebral vascular disease: update. PMID- 3545921 TI - [Problems in the determination of steroid hormones]. PMID- 3545923 TI - Pectoris Dolor, by William Heberden, Sr. PMID- 3545924 TI - Alginate impression procedures. PMID- 3545925 TI - [The lupus band test. IV. Findings in persistent ANA negative SLE]. PMID- 3545927 TI - Demonstration of the mucous hemagglutinin in the club cells of eel skin. AB - Eel epidermis was subjected to immunocytochemical study in order to clarify the origin of mucus hemagglutinin. Skin mucus extract was applied on a Sephacryl S 400 column. The active fractions of the hemagglutinin, which agglutinated rabbit red blood cells, were collected. These fractions were contaminated with a hemolysin. Therefore, after inactivation of the hemolysin by heating at 45 degrees C for 30 min, they were reacted with rabbit red blood cells. The agglutinated cells were hemolyzed to make a hemagglutinin-cell membrane complex. Rabbits were immunized with the complex, and antisera against the hemagglutinin were obtained. Skin sections of eel were stained immunocytochemically by a peroxidase-antiperoxidase (PAP) method using the rabbit anti-hemagglutinin serum. Positive reaction for the hemagglutinin was seen in club cells, especially in secretory vacuoles. This fact indicates the mucous hemagglutinin is derived from the club cells in eel. PMID- 3545926 TI - [Conversion of the ultraviolet lamp SL 500 to a halogen metal vapor lamp of the NS 400 type]. PMID- 3545928 TI - Plasma calcitonin variations in normal women and in women with family history of diabetes during pregnancy. AB - In eight normal pregnant women and in eighteen women with a family history of diabetes, plasma calcitonin (CT), parathyroid hormone (PTH), insulin and glucagon variations and total plasma calcium levels were investigated. Calcitonin, parathyroid hormone and glucagon were all increased during the 2nd and 3rd trimester of pregnancy in normal women (N.W.) and in women with a family history of diabetes (W.F.H.D.). Plasma calcitonin levels were statistically significantly different between the two groups only in the 3rd trimester (118 +/- 4.9 vs 139 +/ 3.6 pg/ml p less than 0.01 in N.W. and W.F.H.D. respectively). Total plasma calcium levels were decreased significantly in the 3rd trimester in both groups: 3rd vs 1st trimester p less than 0.005 and p less than 0.001 in N.W. and W.F.H.D. respectively. Statistically significant difference between the two groups in total insulinemic area (p less than 0.001), in the rapid phase area (p less than 0.01) and insulinogenic index (p less than 0.05) were observed in the 3rd trimester. PMID- 3545929 TI - Glucose tolerance tests and "in vivo" response to intravenous insulin in the unanaesthesized late pregnant rat and their consequences to the fetus. AB - In the late pregnant rat, blood glucose levels were lower and plasma RIA-insulin levels were slightly higher than in virgin animals. Oral and intravenous glucose tolerance tests produced parallel changes in blood glucose in both groups whereas plasma RIA-insulin increased more in the pregnant animals. Blood glucose levels after either low (0.1-1 IU/kg) or high (10 IU/Kg) doses of intravenous insulin decreased more slowly and less in pregnant than in virgin rats. Fetal blood glucose levels were not affected by maternal insulin treatment. Results show that in the unanaesthesized late pregnant rat both insulin sensitivity and responsiveness decreased and it is proposed that this insulin resistance may represent a mechanism to delay disposal of ingested nutrients by maternal tissues, ensuring their availability to the fetus. PMID- 3545930 TI - Cultured fibroblasts as a suitable model for studying insulin action on glucose uptake. AB - The action of insulin on glucose uptake in human or animal cultured fibroblasts has been subject of several studies. The results obtained vary greatly from one study to the next with regard to the response to the hormone but this should be related to the various and somewhat questionable experimental protocols. In general, it would appear that fibroblasts are less sensitive to insulin than adipocytes in the stimulation of sugar transport. This might be due to a smaller number of insulin receptors in fibroblasts or to a poor affinity for the hormone. In addition, as the response to insulin depends greatly on culture conditions (confluency, serum or glucose starvation ...) this cellular model must be used carefully in studies concerning insulin action on glucose uptake. PMID- 3545931 TI - Combined insulin and sulfonylurea therapy in non-insulin-dependent diabetics with secondary failure to oral drugs: a one year follow-up. AB - We studied the influence of chronic sulfonylurea treatment on glucose metabolism and beta-cell secretory activity in diabetic patients requiring insulin after secondary failure to oral drugs. Thirty diabetics were allocated at random into two groups, each consisting of 15 subjects: group A continued insulin treatment, while group B received combined insulin plus sulfonylurea. Daily doses of the sulfonylurea gliclazide ranged from 40 to 240 mg, and dose adjustment was made on the basis of periodic monthly control. This treatment (12 months) caused a significant improvement of both diurnal glucose profile and HbA1 levels; the beta cell secretory response to 1 mg glucagon was significantly increased at the end of the study. There was on average a 40% reduction of the daily insulin dose in the diabetics receiving combined treatment. None of these improvements were seen in the control group receiving only insulin for the same period of time. We suggest that combining a sulfonylurea with insulin can be useful in insulin requiring type-2 diabetics who still secrete some endogenous insulin. PMID- 3545932 TI - Control of non-insulin dependent diabetes is not correlated with endogenous insulin secretion. AB - C-peptide was determined in seventy-one patients with non-insulin dependent diabetes mellitus (NIDDM) before and after a standard 500-calorie breakfast. Whereas in the normal-weight and obese controls the fasting C-peptide was 1.7-2.2 and postprandial maximum 6.0-6.6 ng/ml, in NIDDM the fasting level was only 2.4 +/- 1.5 ng/ml in spite of hyperglycemia of 234 mg/dl, and increased after breakfast to only 3.9 +/- 1.9 ng/ml. Fasting and postprandial levels of C-peptide correlated among themselves but did not correlate with age, duration of diabetes, body mass index, fasting or postprandial glycemia or--in the insulin-treated group--with the dose or duration of the treatment. There was no difference in glycemia between the subgroups of patients with the fasting C-peptide 5.9 +/- 1.7 and 1.0 +/- 0.2 ng/ml. No differences in any parameter were found between patients treated with insulin and with sulphonylureas. PMID- 3545933 TI - Gastric inhibitory polypeptide and the entero-insular axis in streptozotocin diabetic mice. AB - The function of the entero-insular axis and abnormalities of circulating gastric inhibitory polypeptide (GIP) were examined in mice for 40 days after induction of streptozotocin diabetes. Compared with untreated controls, streptozotocin diabetic mice exhibited marked hyperglycaemia and hypoinsulinaemia, with impaired body weight gain, lipoatrophy, hyperphagia, intestinal hypertrophy, polydipsia and renal hypertrophy. Plasma GIP concentrations were elevated in fed but not fasted streptozotocin diabetic mice, and oral fat evoked a greater GIP response than control mice. In spite of marked hyperglycaemia, fat-stimulated GIP release did not raise plasma insulin in streptozotocin diabetic mice. Neither oral nor intraperitoneal glucose produced a significant insulin response in streptozotocin diabetic mice, although oral glucose resulted in a smaller change in glycaemia. The results indicate that streptozotocin diabetes in mice is associated with ineffectiveness of the entero-insular axis, despite elevated GIP concentrations, which are probably mediated through hyperphagia and defective feedback inhibition by insulin on intestinal K cells. PMID- 3545935 TI - [Insulin hypersensitivity]. PMID- 3545934 TI - Physiopathological mechanisms in lipoatrophic diabetes. PMID- 3545937 TI - Cardiovascular dynamics in relation to presentation and postural changes in normal fetuses. AB - The role of fetal cardiovascular function in the reduced intrauterine growth rate of breech pregnancy was studied in fetuses with different presentations. Hemodynamic responses to postural changes were also investigated in fetuses in horizontal and vertical positions. Thirty-one normal pregnancies, with 15 fetuses presenting by the breech and 16 fetuses by the vertex, were included in the study. Diameter pulse waves from the fetal descending aorta were measured using equipment combining real-time ultrasound imaging with phase-locked echo-tracking. No differences in basal pulse wave parameters were demonstrated between breech and vertex fetuses nor did any differences appear when maternal posture was changed from horizontal to upright or vice versa. The present observations suggest that fetal circulatory factors are less likely to be a primary cause of the reduced intrauterine growth in breech presentation. Tilting of the fetus in late gestation seems to produce neither a redistribution of its blood volume nor secondary adaptations to an orthostatic challenge. The hydrostatic effect of amniotic fluid presumably precludes the requirement of fetal circulatory adaptation to postural changes. PMID- 3545936 TI - Estimation of fetal weight in the third trimester by ultrasound. AB - A method to estimate the intrauterine fetal weight by use of ultrasound measurements of the fetal biparietal diameter (BPD) and the abdominal diameter (AD) is presented. From a consecutive series of single pregnancies the 238 pregnancies (3% of the hospital population) with ultrasound measurements obtained within 4 days before delivery were used in the estimation of birth weight. In addition, the estimated formula was applied on a test material consisting of 100 similarly selected pregnancies from the same hospital. To evaluate the expected selection effects, the birth weight for gestational age in the study group was compared with birth weight for gestational age in the total population. The weight could be estimated as 0.0351 X AD1.65 X BPD0.69 X exp(0.00196 X gestational age). Thus, the actual birth weight was within 83-120% of the estimated weight (95% prediction limits), with a residual coefficient of variation of about 9%. The gestational age could be omitted without major influence on the weight prediction. When applying the formula on the test material, 70% of the actual weights deviated less than 10% from the estimated fetal weight, but a tendency towards a slight overestimation of the weight for light for gestational age infants was found. PMID- 3545939 TI - Changes in exopeptidase activities in skeletal muscles during disuse. AB - Some aminopeptidase activities, dipeptidase-, tripeptidase-, and carboxypeptidase activities were measured in two different types of skeletal muscle in rabbit soleus muscle as a slow oxidative, and gastrocnemius muscle as a fast glycolytic type after immobilization in full extension with a plaster cast for 1, 2, 4, 7, 14 or 28 days. In correlation to the higher protein turnover in red muscles, the activities except of leucine and alanine aminopeptidase were higher in the normal soleus muscle than in the gastrocnemius muscle. Much higher activities of the tested enzymes were obtained in the immobilized soleus muscle than in the normal one after 2 weeks of immobilization. In the gastrocnemius muscle the tested enzyme activities generally did not change or decrease. The results demonstrate that the peptidases play a role in the process of protein breakdown in normal and disused skeletal muscles. PMID- 3545938 TI - Male fetus with epignathus originating from the ethmoidal sinus. AB - Epignathus or teratoma arising from the hard palate nasal cavity is an extremely rare abnormality. This tumour usually causes death in neonatal life because of its location and because surgical removal is often impossible. We are presenting a case of epignathus originating from the ethmoidal sinus delivered at gestational week 29 by caesarean section due to increasing hydramniosis. The child died within a few minutes. Prenatal diagnosis is important for genetic counselling, obstetric management and, in some cases, neonatal surgery. PMID- 3545940 TI - Radio--spreading the word on family planning. PMID- 3545941 TI - The clinical efficacy and safety of bacampicillin twice daily in comparative studies. AB - In 16 controlled, randomized, comparative studies a total of 953 patients were treated for urinary tract infection, sinusitis, otitis media or chronic bronchitis. The aim was to evaluate the efficacy and safety of bacampicillin in a twice daily dosage, compared with three times daily dosages of bacampicillin, ampicillin, amoxycillin and a twice daily dosage of co-trimoxazole. Bacampicillin was given in amounts of either 400 or 800 mg to 422 of the patients in these studies. The twice daily dosage of bacampicillin eradicated 89% of the causative bacteria of urinary tract infections compared to 86% with the other regimens. In acute sinusitis 92% and 96% of the patients were either cured or improved when treated with 400 and 800 mg bacampicillin twice daily respectively. Similar percentages occurred in the groups given the three times daily dosages. In exacerbation of chronic bronchitis, 800 mg bacampicillin twice daily was the minimum effective dosage and 84% of the patients were either cured or improved with this regimen. Adverse drug reactions due to bacampicillin at all dose levels were less frequent than those of other anti-microbials. The lowest frequency of diarrhoea, 2.4%, was seen in the group given 400 mg bacampicillin twice daily. Dosages of 400 or 800 mg bacampicillin twice daily had a reliable efficacy combined with a low frequency of adverse reactions in respiratory and urinary tract infections. PMID- 3545942 TI - Intramuscular treatment of migraine attacks using diclofenac sodium: a crossover clinical trial. AB - This was a double-blind clinical trial, with a crossover design, to compare the efficacy of a non-steroidal anti-inflammatory drug, diclofenac sodium, intramuscularly administered, and placebo in the treatment of migraine attacks. The drug was administered to 40 patients once a day in three consecutive migraine attacks. If pain still remained after 6 h following administration the patient was given a 100 mg diclofenac sodium suppository, in open condition. Evaluation was by a complete medical examination performed by the physician and by the patient completing a specially designed self-assessment card. A total of eight patients dropped out of the trial (all during placebo administration): three due to poor compliance, four for refusal to continue and one because no further migraine attacks developed. Results were analysed after having checked the absence of both period and carry-over effects. In all cases diclofenac sodium was more effective than placebo (P less than 0.01). This was also confirmed by data obtained from the patient self-assessment cards (P less than 0.001) and by preferences expressed by patients at the end of the trial (P less than 0.001). Tolerance to the drug was similar to that of placebo. PMID- 3545943 TI - A locus regulating N-acetylglucosaminidase synthesis during development in dictyostelium. AB - The cellular specific activity of N-acetylglucosaminidase increases during development in Dictyostelium discoideum. A monoclonal antibody which specifically recognizes Mr 68,000 and 67,000 forms of N-acetylglucosaminidase was used to show that changes in the relative rate of enzyme synthesis during development parallel the pattern of enzyme accumulation. Developmental and regulatory mutants were isolated to study the relationship between development and enzyme accumulation. No evidence was obtained for any dependence of enzyme accumulation on those genes that are required for aggregation. However, a separate regulatory locus was identified which is involved in enzyme accumulation. Mutations in this gene, nagC, prevent enzyme accumulation during development by preventing an increase in the relative synthetic rate of N-acetylglucosaminidase. The accumulation of other enzymes is unaffected and the mutation causes no developmental defects other than those caused by the loss of N-acetylglucosaminidase activity. The nagC mutation, which is recessive, maps to linkage group VI and is therefore unlinked to the structural gene for N-acetylglucosaminidase. PMID- 3545944 TI - Glucose tolerance, insulin release, and insulin sensitivity in normal-weight women with previous gestational diabetes mellitus. AB - Out of 57 women with previous histories of gestational diabetes (GD), 23 were of normal weight postpartum and willing to participate in three studies characterizing oral glucose tolerance (OGTT), insulin responsiveness to intravenous glucose (glucose infusion test, GIT), and insulin sensitivity (somatostatin, insulin, and glucose infusion test, SIGIT). The experiments were performed 6-36 mo after cessation of breast-feeding. The control group comprised 10 healthy women with normal OGTT matched for age and weight. Among subjects with previous histories of GD, 9 had normal, 8 borderline, and 6 decreased OGTT. As a group, women with previous histories of GD have significantly decreased insulin response and insulin sensitivity. Furthermore, all 14 with borderline and decreased OGTT demonstrated a low early insulin response during GIT (5-min value below the upper border of the lower quartile of normals), whereas insulin sensitivity was normal in 6 and low in 8 (glucose values attained during SIGIT were lower or higher, respectively, than the lower border of the upper quartile of controls). The women with previous histories of GD and normal OGTT exhibited normal (n = 4) and low (n = 5) insulin responses. Three of the former subjects had low and the remaining 6 had normal insulin sensitivity. In conclusion, as many as 60% of normal-weight women with previous histories of GD had borderline or decreased OGTT 6-36 mo postpartum. This derangement could be due to impaired early insulin response, which in some subjects was combined with low insulin sensitivity. Follow-up of women with previous histories of GD might enlighten the pathogenesis of non-insulin-dependent diabetes mellitus. PMID- 3545945 TI - Urine C-peptide as index of integrated insulin secretion in hypocaloric states in obese human subjects. AB - To determine the effects of different hypocaloric diets on insulin secretion, 24 h urine C-peptide was measured in 11 obese subjects on a weight-maintaining baseline diet, and the results were compared with values obtained during 14-day periods of diets containing 400 kcal/day of only protein (n = 6) or glucose (n = 5), followed by 14 days of fasting and 14 days of refeeding on 800-1000 kcal/day. A significant positive correlation between total caloric intake and urine C peptide excretion was found once the C-peptide excretion reached steady state after several days on each diet. Multiple regression analysis showed no contribution of body weight to urine C-peptide during the different diets. In contrast, a significant correlation was found between body weight and urine C peptide in the fasting state. A marked and identical decrease of approximately 75% in urine C-peptide occurred over the first 5-7 days of the two 400-kcal diets, followed by a further decrease during fasting to 5% of baseline values. Refeeding was associated with a progressive increase. Plasma insulin and C peptide followed the same trends as found for urine C-peptide, although the magnitude of change was much smaller. C-peptide clearance was not assessed because of the variation in plasma levels on eating meals. However, the same responses were found when C-peptide excretion was factored for creatinine excretion. Thus, the major determinant of urine C-peptide excretion appears to be food intake, and adaptations take 5-7 days to reach steady state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545946 TI - Impaired insulin secretion associated with near normoglycemia. Study in normal rats with 96-h in vivo glucose infusions. AB - We have previously demonstrated impaired glucose influence on insulin secretion in normal rats made overtly hyperglycemic with glucose infusions for 48 h. We examined the effects of a 96-h infusion period. Rats received 30, 35, or 50% glucose or 0.45% NaCl at 2 ml/h. The plasma glucose in the 30 and 35% rats peaked at 24 h but then returned to normal by 72 h. A peak followed by a gradual fall also occurred in the 50% rats, but significant hyperglycemia was maintained throughout. beta-Cell responsiveness to glucose was assessed with the perfused pancreas by examining the effect of altering the perfusate glucose concentration on insulin release. Insulin secretion remained intact in the 30% rats, but the response to a glucose increase was blunted in the 35% group and totally absent in the 50% rats. In a second protocol, glucose influence on arginine-stimulated insulin release was tested by adding 10 mM arginine to the perfusate and administering it with 2.8 and 16.7 mM glucose. The ability of the different glucose backgrounds to influence the insulin response decreased as the level of infused glucose rose. On the other hand, when phloridzin was added to 50% glucose during the second 48 h of infusion, glucose modulation of insulin release was completely restored. These data indicate that during a period of overt hyperglycemia, beta-cell defects can fully evolve within 48 h in the rat. Thereafter, they are maintained by the glucose infusion even though the plasma glucose level returns to near normal. Continued minor stimulation of the beta cell may be the responsible factor. PMID- 3545947 TI - Somatomedin-C in human fetal pancreas. Cellular localization and release during organ culture. AB - The presence of somatomedin-C/insulin-like growth factor I (SM-C/IGF-I) was investigated in human fetal pancreatic glands obtained after prostaglandin induced abortion at 14-17 wk of gestation. Pancreatic explants were cultured in medium containing 11.1 or 22.2 mM glucose and 20% fetal calf serum for 8-10 days. During this period they were exposed, on two separate occasions, to serum-free culture medium for 24 h. SM-C/IGF-I and insulin were measured radioimmunologically in the serum-free media and in acid-ethanol-extracted homogenates of the cultured explants. SM-C/IGF-I was measurable in the conditioned media only after extraction by reverse-phase chromatography to remove somatomedin-binding proteins. On gel filtration at neutral pH of extracted medium samples, the immunoreactive SM-C/IGF-I was recovered in the region of the homogeneous peptide with an apparent molecular weight of 7000-8000. Explants cultured in 22.2 mM glucose contained more SM-C/IGF-I and had a tendency to release more of the peptide into the culture medium than explants cultured in 11.1 mM. There was no difference in insulin content or release between the two groups. By immunocytochemistry, SM-C/IGF-I was localized to the beta-cells of the endocrine pancreas in both freshly fixed tissue and cultured explants. We conclude that the human fetal pancreas contains SM-C/IGF-I and secretes the peptide during tissue culture. The presence of SM-C/IGF-I in the islets of Langerhans may contribute to the growth and development of the insulin-producing beta-cell. PMID- 3545949 TI - Evidence for presence of proinsulin-immunoreactive glycoprotein(s) in fetal bovine pancreatic extracts. AB - A large-molecular-weight proinsulin-immunoreactive protein fraction was obtained from an extract of fetal bovine pancreases by gel filtration in 6 M guanidine-1 M acetic acid. Concanavalin A-Sepharose-affinity column chromatography of the large molecular-weight fraction yielded a discrete alpha-methyl-mannoside-displaceable immunoreactive peak that also displayed N-acetylglucosamine-specific binding to wheat germ lectin-Sepharose. Chemically tritiated and radioiodinated lectin reactive proteins interacted specifically with antibodies to insulin and bovine proinsulin. Immunochemically purified (reaction with antibodies followed by separation of antigen-antibody complexes on protein A-Sepharose) radiolabeled lectin-reactive proteins were analyzed by gel filtration in guanidine-acetic acid and by sodium dodecyl sulfate polyacrylamide gel electrophoresis after disulfide bond-cleavage treatments. Results from these studies suggest the existence of an approximately 67,000-Mr glycoprotein that contains antigenic domains common to proinsulin and insulin. PMID- 3545948 TI - Fuel-stimulated insulin secretion by clonal hamster beta-cell line HIT T-15. AB - Insulin secretion by monolayer cultures of HIT T-15 cells was measured in response to various fuel molecules (glucose, dihydroxyacetone, lactate, glutamine, alpha-ketoisocaproic acid, alpha-ketoisovaleric acid) and a nonmetabolized glucose analogue (3-O-methylglucose). HIT cells secreted insulin in response to fuel molecules, but 3-O-methylglucose was ineffective. Stimulation of insulin release by fuels was increased by isobutylmethylxanthine and blocked by antimycin A. Iodoacetate selectively inhibited glucose-stimulated insulin release but had little effect on alpha-ketoisocaproic acid-stimulated insulin secretion. These results indicate that HIT cells retain the capacity of normal beta-cells to act as fuel sensors. Thus, HIT cells may provide a well-defined and relatively abundant tissue source in studies of stimulus-secretion coupling in beta-cells stimulated by fuels. PMID- 3545950 TI - Time course of islet cell antibodies and beta-cell function in non-insulin dependent stage of type I diabetes. AB - The time course of islet cell antibodies (ICA) and serum C-peptides responses (CPRs) to oral glucose tolerance tests (OGTTs) were studied prospectively up to 60 (mean 35) mo in 32 ICA-positive subjects [28 with non-insulin-dependent diabetes (NIDDM) and 4 subjects with impaired glucose tolerance (IGT); mean age 45 yr], 96 matched subjects [56 with NIDDM, 8 with IGT, and 32 normal first degree relatives of patients with insulin-dependent diabetes (IDDM); mean age 45 yr] who were negative for ICA at the beginning of the study. In addition, the effects of human leukocyte antigens (HLA) on the time course of ICA and beta-cell function were evaluated. In 10 subjects (8 with NIDDM and 2 with IGT) who were ICA positive, ICA became undetectable, even by sensitive ICA assay, 15 +/- 2 mo (mean +/- SE) after initiation of this study. In these subjects, integrated serum CPR values (sigma CPR) and 2-h blood glucose values in response to OGTTs improved significantly (P less than .05-.01). In contrast, the remaining 22 subjects who were ICA positive were persistently positive for ICA. CPR and blood glucose responses deteriorated progressively in these 22 subjects, and 7 subjects in this group progressed to the insulin-dependent state. Serum CPR and blood glucose responses to OGTTs showed no remarkable changes in 64 patients (56 with NIDDM and 8 with IGT) and 32 normal first-degree relatives of patients with IDDM who remained negative for ICA throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545951 TI - Insulin-stimulated glucose transport and insulin internalization share a common postbinding step in adipocytes. AB - We recently demonstrated that chymotrypsin substrate analogues inhibit receptor mediated insulin internalization in isolated rat adipocytes. In this study, the effect on glucose transport of inhibiting insulin internalization with these agents was examined. Glucose transport was assayed by measuring [3H]-2 deoxyglucose uptake, and internalized insulin was measured after rapidly dissociating surface-bound insulin with an acidic buffer. The chymotrypsin substrate analogue N-acetyl-Tyr ethyl ester inhibited insulin internalization by 85% while increasing surface-bound insulin by 80-110%. Under these conditions, ATP levels were minimally altered, and basal glucose transport was unchanged; however, insulin-stimulated glucose transport was decreased by 86%. The inhibition of insulin-stimulated glucose transport was not overcome by supramaximal concentrations (400 ng/ml) of insulin. When insulin internalization and insulin-stimulated glucose transport were measured in the presence of increasing concentrations of N-acetyl-Tyr ethyl ester (0.1-1 mM), a strong and highly significant correlation (r = .97, P less than .001) was found between inhibition of insulin internalization and inhibition of insulin-stimulated glucose uptake. Fragments of N-acetyl-Tyr ethyl ester that do not inhibit insulin internalization were also without effect on insulin-stimulated glucose transport. In addition to N-acetyl-Tyr ethyl ester, four other chymotrypsin substrate analogues that are effective inhibitors of insulin internalization also markedly inhibited insulin-stimulated glucose transport. These results indicate that insulin internalization and insulin-stimulated glucose transport share a common postbinding step in adipocytes and that this step is inhibitable by chymotrypsin substrate analogues. PMID- 3545952 TI - Narrow heads of preterm infants--do they matter? AB - The biparietal diameters (BPD) and occipitofrontal diameters (OFD) were measured in a group of 203 newborn infants weighing 501 to 2000g, and at intervals until the age of three years. The heads of 96 normal-birthweight children were also measured. 11 per cent of the low-birthweight group had marked early narrowing, i.e. OFD/BPD (a/b) ratios of greater than 1.55. These babies were lighter and less mature, but by three years of age there was no significant difference in head shape or developmental quotient between these babies and the rest of the group. Intracranial pathology did not appear to affect head shape. At all ages the low-birthweight children showed greater head narrowing than those of normal birthweight. PMID- 3545953 TI - Circulating gastrointestinal hormones in patients with flatulent dyspepsia, with and without gallbladder disease. AB - Fasting and post-prandial circulating levels of insulin, gastrin, gastric inhibitory polypeptide, pancreatic polypeptide and neurotensin were measured in patients with flatulent dyspepsia, with and without gallbladder disease and post cholecystectomy. Levels were also measured in non-dyspeptic patients with gallbladder disease and normal controls. There were no consistent significant differences from controls for fasting and post-prandial responses in patients with a history of dyspepsia or those who experienced dyspepsia at the time of the test. In patients with gallbladder disease, with and without dyspepsia, there was a reduced neurotensin response compared to normal controls. It is concluded that circulating levels of these hormones are not related to symptoms of flatulent dyspepsia. PMID- 3545954 TI - Relationship between B-cell function and HLA antigens in patients with type 2 (non-insulin-dependent) diabetes. AB - In order to study the heterogeneity of Type 2 (noninsulin-dependent) diabetes, we determined HLA antigens and measured B-cell function as C-peptide response to intravenous glucagon in 217 patients with onset of non-ketotic diabetes after the age of 40 years. Their HLA frequencies were compared with those of Type 1 (insulin-dependent) diabetic patients and of healthy blood donors. The Type 1 diabetic patients showed a typical HLA pattern, with increased frequencies of B15, DR3, DR4, B8/B15 and DR3/DR4 and decreased frequencies of B7 and DR2. The Type 2 diabetic patients could be distinguished from blood donors by increased frequencies of Cw4, DR4, DR5 and DR3/DR4, and from Type 1 diabetic patients by increased frequencies of B7, DR2, DR5 and decreased frequency of A9, Bw22 and DR4. Age at onset and body mass index were unrelated to HLA antigens, but the Type 2 diabetic patients with HLA-Cw4, DR5 and DR6 showed a strong family history for Type 2 diabetes. Type 2 diabetic patients with HLA-B8, DR4, B8/B15 and DR3/DR4 showed significantly lower C-peptide concentrations (p less than 0.05) than patients without these HLA antigens. In contrast, patients with DR5 and DRw8 presented with high C-peptide levels. Twelve patients who were positive for both DR3 and DR4 and 23 patients who were DR3/DR4 negative were followed with repeated C-peptide determinations during a period of three years. The C-peptide concentrations of the DR3/DR4 positive patients decreased during this period, whereas there was no change in C-peptide levels in the DR3/DR4 negative patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3545955 TI - The serum insulin and plasma glucose responses to milk and fruit products in type 2 (non-insulin-dependent) diabetic patients. AB - The plasma glucose and serum insulin responses were determined in untreated Type 2 (non-insulin-dependent) diabetic patients following the ingestion of foods containing sucrose, glucose, fructose or lactose in portions that contained 50 g of carbohydrate. The results were compared to those obtained following the ingestion of pure fructose, sucrose, glucose + fructose and lactose. The objectives were to determine 1) if the glucose response to naturally occurring foods could be explained by the known carbohydrate content, and 2) whether the insulin response could be explained by the glucose response. The glucose response was essentially the same whether the carbohydrate was given as a pure substance, or in the form of a naturally occurring food. The glucose response to each type of carbohydrate was that expected from the known metabolism of the constituent monosaccharides. The glucose areas following the ingestion of the foods were: Study 1: glucose 11.7, orange juice 7.3, sucrose 5.2, glucose + fructose 6.3, and fructose 0.7 mmol X h/l; Study 2: glucose 14.6, orange juice 7.3, apples 5.5, and apple juice 4.7 mmol X h/l; Study 3: glucose 12.6, ice cream 8.1, milk 3.7, and lactose 4.1 mmol X h/l. The insulin response was greater than could be explained by the glucose response for all meals except apples. Milk was a particularly potent insulin secretagogue; the observed insulin response was approximately 5 fold greater than would be anticipated from the glucose response. In summary, the plasma glucose response to ingestion of fruits and milk products can be predicted from the constituent carbohydrate present. The serum insulin response cannot. PMID- 3545956 TI - Longitudinal study of first phase insulin release in the BB rat. AB - First phase insulin release was measured in response to intravenous glucose given weekly from approximately day 40 in 6 BB rats which subsequently developed diabetes and in age-matched non-diabetic (n = 15) and normal Wistar rats (n = 8) until day 180. The mean sequential insulin responses in BB rats with and without diabetes were significantly lower (p = 0.008 and less than 0.0001, respectively) than in normal rats from an early age. Five diabetic BB rats showed a progressive decline in first phase insulin release immediately prior to glycosuria, with the impaired phases ranging from 25-50 days. However, protracted periods of low first phase responses were also seen in several aglycosuric BB rats, which showed histological evidence of insulitis and B-cell loss. Our findings demonstrate that, although most BB rats with diabetes show a progressive impairment of B-cell function preceding the disease, this aberrant phase can also be present in BB rats which remain aglycosuric. Impaired first phase insulin release in response to serial intravenous glucose tolerance tests may not be a reliable predictor of Type 1 (insulin-dependent) diabetes in this animal model. PMID- 3545957 TI - Increased capacity of urea synthesis in streptozotocin diabetes in rats. AB - Diabetes was induced in Wistar rats by intravenous streptozotocin, 75 mg/kg. Four and 14 days after streptozotocin, fasting insulin decreased to about one-third, and fasting glucagon increased three-fold. The urea-N synthesis rate, stimulated by infusion of alanine, was measured at different amino acid concentrations 14 days after streptozotocin in 24 rats. The relationship was compatible with a barrier limited substrate inhibition kinetics. Data were examined accordingly by non-linear regression analysis. Among the estimated kinetic constants, only the 70% increase in Vmax was different from control values. In control rats the capacity of urea nitrogen synthesis, as measured within the amino acid concentration interval 7.3-11.6 mmol/l, was 10.2 +/- 1.1 mumol . (min 100 g BW)-1 (mean +/- SEM). The capacity was not different in 4 day diabetic rats, whereas it doubled in 14 day diabetic rats, 20.9 +/- 1.7 mumol (min 100 g BW)-1. The alanine elimination rate was 35% higher in the 14 day diabetic rats compared both to 4 day diabetic and control rats. The increase of urea synthesis is suggested to be due to enzyme induction by glucagon. The net nitrogen balance was negative at amino acid concentrations up to 25 mmol/l, indicating that the urea synthesis was increased at the expense of amino nitrogen. PMID- 3545958 TI - Subcutaneous implantation of a ferrocene-mediated glucose sensor in pigs. AB - Miniature, amperometric glucose sensors were constructed using entrapped 1,1' dimethylferrocene to mediate electron transfer between immobilised glucose oxidase and a carbon base electrode. Electrodes were calibrated in buffered glucose solutions and then implanted in the subcutaneous tissue of anaesthetised, non-diabetic pigs. Subcutaneous tissue glucose concentrations, as measured by the sensor, were about 20% of blood glucose values, measured by a conventional glucose oxidase assay. After an intravenous 0.07 mol bolus glucose injection, electrode responses increased with almost no time lag, but the subsequent rates of rise and fall of electrode-measured tissue glucose concentrations were slower than that of the blood values. After an intravenous 0.2 U/Kg bolus short-acting insulin injection the electrode response was also rapid, but decreased at a slower rate than the blood glucose concentrations. We conclude that this is a feasible technology for future development as an implantable glucose sensor for use in diabetic man. PMID- 3545959 TI - [Certain general physiological principles of human brain functioning]. PMID- 3545960 TI - [Theoretical basis and was of implementing the psychophysiological approach to optimization of verbal memory]. PMID- 3545961 TI - [Neurophysiologic mechanisms of visual and auditory deprivation]. PMID- 3545962 TI - [Color-coded Doppler: further progress in the non-invasive evaluation of valvular insufficiency]. PMID- 3545963 TI - [Trials and prospectives in the treatment of AIDS]. PMID- 3545964 TI - Subcellular localization of pepsinogen II in stomach and duodenum by the immunogold technique. AB - We have determined the ultrastructural localization of pepsinogen II (PG II) in aldehyde-osmium fixed, resin-embedded ultrathin sections of human gastric fundic and pyloric gland mucosa and duodenum using the protein A immunogold technique and antiserum specific for PG II. Chief cells contained homogeneous, finely granular secretory granules that were uniformly PG II-positive. In contrast, mucous neck, pyloric gland, and Brunner's gland cells contained secretory granules consisting of an eccentrically placed dense core surrounded by a clear matrix; PG II immunoreactivity was concentrated over the dense core of these biphasic granules. Pyloric gland cells also contained monophasic secretory granules having the same electron density, texture, and PG II immunoreactivity as the nucleoids of biphasic granules and clear vesicular granules that were PG II negative. Vesicular granules also were found in Brunner's gland cells. The Golgi region of pyloric gland cells contained small PG II-positive monophasic granules adjacent to small PG II-negative vesicular granules. This observation suggests that biphasic granules may form in the Golgi region of pyloric gland cells by fusion of PG II-containing monophasic granules and PG II-unreactive vesicular granules. PMID- 3545965 TI - Failure of a cytoprotective dose of arbaprostil to heal acute duodenal ulcers. Results of a multiclinic trial. AB - Previous therapeutic trials with prostaglandins have shown them to be effective in healing duodenal ulcers when used at doses that are highly effective suppressors of gastric acid secretion. We undertook this trial to determine if a cytoprotective dose of arbaprostil (10 micrograms q.i.d. for 4 wk) would also be efficacious in this disease state. Eighty-two patients between the ages of 19 and 72 yr with endoscopically documented duodenal ulcers were entered into this randomized double-blind placebo-controlled trial. The patients were monitored with biweekly endoscopies and laboratory examinations, weekly interviews during the period when drug was administered, and a follow-up interview plus laboratory examinations 1 wk after drug administration was completed. No statistically significant differences between the arbaprostil and placebo treatment groups were found for ulcer healing rates, pain relief, antacid consumption, side effects, or laboratory examinations. It is presumed that this prostaglandin may not have sufficient duodenal cytoprotective capacity to effectively heal duodenal ulcers, or that some suppression of gastric acid secretion may be required to achieve significant clinical efficacy. PMID- 3545966 TI - [Variations of the Holman method for reducing prolapsed fetal membranes]. AB - Reducing the prolapsed membranes with the bulb of a catheter (Holman's method) prior to cerclage is advantageous. Utilisation of a special forceps provides on additional advantage in handling. The method is simple and practically atraumatic to the membranes. PMID- 3545967 TI - [Breast cancer: age and tumor diameter. Partial results of a long-term study since 1966]. AB - From 1963 to 1985 approximately 2,800 patients underwent primary treatment for breast cancer at Erlangen University Gynecological Clinic. In the same period just under 60,000 women underwent thorough clinical, mammographic, and in some cases sonographic examination. In the last 20 years the age of patients with breast cancer has shifted toward the younger age groups. Peak incidence is found among 40 to 49-year-old and 60 to 64-year-old women. The data indicate that women should undergo screening for breast cancer from the age of 35 on, and in high risk cases from age 25. The majority of the carcinomas are 1-2 cm in diameter. This has not changed in the last 10 years. Only in every tenth patient is the tumor less than 1 cm in diameter. PMID- 3545968 TI - [Desmoid tumor in a cesarean section scar as a labor complication in subsequent pregnancy]. AB - A fist-sized tumour was seen in a Caesarean section scar of a 28-year old pregnant Turkish woman who had been operated on three years previously. The tumour was excised during Caesarean section and diagnosed as desmoid tumour. Etiology and pathogenesis of these rare soft tissue tumours are discussed and the literature reviewed. PMID- 3545969 TI - [Hydatidiform mole in an elderly female; a differential diagnostic problem--a case report]. AB - A case of a 54-year-old woman with hydatidiform mole is presented. Preoperatively the enlarged uterus was mistaken for a fibroid. Diagnostic considerations and therapy of trophoblastic disease in perimenopausal women are discussed, as well as pitfalls in diagnosis. PMID- 3545971 TI - [The role of factors influencing the hemagglutination reaction in the preparation of highly active typing anti-erythrocyte sera and detection of alloantibodies]. PMID- 3545970 TI - [Effect of low molecular weight bifunctional reagents on erythrocyte properties]. PMID- 3545972 TI - [Immunological properties of antibodies reacting with thrombocytes]. PMID- 3545973 TI - [Current aspects of the treatment of Rendu-Osler disease (hereditary hemorrhagic telangiectasia)]. PMID- 3545974 TI - [Immunodeficiency in lymphoproliferative processes and possibilities of correcting it]. PMID- 3545975 TI - [Presence of cross-reacting HLA-antigens in a donor-recipient pair and viability of the renal allograft]. PMID- 3545976 TI - Pharmacologic intervention to prevent decompression sickness (DCS). PMID- 3545977 TI - Mast cell: its mediators and effects on arterial wall metabolism. AB - Some general aspects of mast cells and their functional mediators, mainly histamine and heparin are reviewed. The actions of mast cells, histamine and heparin are analyzed in the context of their possible role in the physiology and pathophysiology of vascular tissue metabolism. PMID- 3545978 TI - Pituitary thyrotropin and gonadotropin of coho salmon (Oncorhynchus kisutch): separation by chromatofocusing. AB - Thyrotropin (TSH) and gonadotropin (GTH) were isolated from adult female coho salmon pituitary glands. After final extraction in acidic alcohol and precipitation in 85% ethanol, proteins were fractionated using gel filtration chromatography and chromatofocusing. Homologous bioassay systems were used to monitor bioactivity during the purification procedures. TSH activity was measured in vivo in coho salmon parr. GTH (steroidogenic) activity was determined in vitro using cultures of adult coho salmon ovarian follicles. Using these procedures, TSH and GTH activities were separated. TSH activity eluted as one major peak at pH 6.3 whereas GTH activity eluted as five major peaks at pH's 5.4, 5.0, 4.7, 4.3, and after 1.0 M NaCl on chromatofocusing. Molecular weights of the TSH and GTHs were estimated by gel filtration chromatography as 35 and 40 kDa, respectively. Like other vertebrate TSHs and gonadotropins, the coho salmon TSH and GTHs appeared to consist of two subunits. Coho salmon TSH and bovine TSH (bTSH) were equipotent in the TSH bioassay. The five coho salmon GTHs exhibited similar potencies in stimulating ovarian estradiol synthesis in vitro. Further biochemical analysis and tests for other gonadotropic activities are warranted to determine if these five GTHs are isoforms of one GTH or if they can be distinguished functionally in other GTH bioassays. Sufficient quantities of coho salmon TSH were isolated in this study for future studies of the hypothalamic pituitary-thyroid axis in fish. PMID- 3545980 TI - Effect of multiple copies of rpoBC on the rate of RNA synthesis in Escherichia coli. PMID- 3545979 TI - [Genetic analysis of mitochondrial rho-mutability in Saccharomyces. IV. Relation between spontaneous rho-mutability and mitotic stability in disomic Saccharomyces cerevisiae]. AB - In the yeast Saccharomyces cerevisiae the disomy for chromosome XIV resembles the previously described disomy for chromosome IV in that it leads to a significant decrease in spontaneous rho- mutability. The nuclear srm1 mutation, reducing spontaneous rho- mutability, diminishes significantly the mitotic disome stability. So, the mechanisms of spontaneous rho- mutagenesis and mitotic disome stability seem to compete for the function affected by the srm1 mutation. PMID- 3545981 TI - [Cellular pathology--a change in paradigm in Parisian and Vienne medical thought after Berlin?]. PMID- 3545982 TI - [The American period in medical history]. PMID- 3545983 TI - [Wilhelm Griesinger--from internal medicine to psychiatry]. PMID- 3545984 TI - [Scientific and moral justification of toxicologic animal trials in the 17th century. Johann Jakob Wepfer and Johann Jakob Harder]. PMID- 3545985 TI - [The dwarf in fable and story--the origin or image of deformities in humans?]. PMID- 3545986 TI - [What we learn about Jan Swammerdam (1637-1685) from his correspondence with Niels Stensen]. PMID- 3545987 TI - A pathology textbook of 1838: G. Freckleton, Outlines of General Pathology. PMID- 3545988 TI - ["L'Homme Machine" by La Mettrie in the light of modern neurobiology]. PMID- 3545989 TI - [From the mentally ill poor to the poor mentally ill. A study of mental illness and insanity in baroque Rome]. PMID- 3545990 TI - [Relations between the Lavater family of pharmacists in Zurich and Johann Bartholomaus Trommsdorff, Erfurt. A contribution to the German-Swiss history of pharmacy on the occasion of the 205th birthday of Diethelm Lavater II]. PMID- 3545991 TI - [Vlas Zakharovich Martyniuk (on the 90th anniversary of his birth)]. PMID- 3545992 TI - [Biological significance of the body's autoimmune response to exposure to environmental factors]. PMID- 3545993 TI - [Alkanes and other aliphatic compounds--metabolism and toxicity]. PMID- 3545994 TI - [Current concepts of the biological action of metals]. PMID- 3545995 TI - [Problems of social medicine care in the strike demands of workers at Ural plants during the 1905-1907 Revolution]. PMID- 3545996 TI - [Health education and problems of the sanitary improvement of working and living conditions of the population of Bashkiria in the '20s and '30s]. PMID- 3545997 TI - [Nature of the changes in indicator, opportunistic and pathogenic microflora as affected by anthropogenic activities and its meaning in assessing the conditions of water consumption by the population]. PMID- 3545999 TI - [Arsenic in food products and the human body (its biological role and toxicity)]. PMID- 3545998 TI - [New trends in water decontamination using ultraviolet rays]. PMID- 3546000 TI - [Data for establishing the maximum permissible concentrations in the migration of the vulcanization accelerator N',N'-dithiodimorpholine from rubber goods]. PMID- 3546001 TI - [Usefulness of ultrasound in fetal transfusion. Presentation of a case]. PMID- 3546002 TI - [Contribution of G.Kh. Shakhbazian to the development of occupational medicine (on the 90th anniversary of his birth)]. PMID- 3546003 TI - [A 40-year history of the academic obstetrico-gynecologic center in Lublin (1945 1985)]. PMID- 3546005 TI - [The bond strength of commercial visible light-cured composites]. PMID- 3546006 TI - Hypercalcaemia in "non-secretory" myeloma. AB - A patient is described with hypercalcaemia due to myelomatosis without paraproteinaemia or Bence-Jones proteinuria. Immunological investigations yielded some evidence of intra-cellular immunoglobulin production. Histological features suggested the secretion of osteoclast activating factor. Relevant experimental work in support of this interpretation is reviewed. PMID- 3546004 TI - Relationship between gastric secretion and infection. PMID- 3546007 TI - [Reverse cholesterol transport]. PMID- 3546008 TI - [Autoantibodies: part of the normal preimmune repertoire]. PMID- 3546009 TI - [Inherited disorders of thyroid hormone action]. PMID- 3546010 TI - [Changes in food supplies in Israel during the past 25 years, 1960-1984, and their implication to health]. PMID- 3546011 TI - [Uremic osteodystrophy--update]. PMID- 3546012 TI - [Does insulin resistance present a significant problem in type 2 diabetes?]. PMID- 3546013 TI - [Hemochromatosis and iron chelating therapy]. PMID- 3546014 TI - [Drugs in diabetes mellitus]. PMID- 3546015 TI - [Eosinophilic spongiosis in various vesicobullous diseases]. PMID- 3546016 TI - [Color vision defects in diabetic patients]. PMID- 3546017 TI - [Acanthosis nigricans]. PMID- 3546018 TI - [Tuftsin]. PMID- 3546019 TI - [Dipyridamole]. PMID- 3546020 TI - [Water and salt imbalance in the elderly]. PMID- 3546021 TI - [Sport related sudden death]. PMID- 3546022 TI - [Angio-immunoblastic lymphadenopathy]. PMID- 3546023 TI - [The pathophysiological basis of the pharmacological treatment of portal hypertension]. PMID- 3546024 TI - [Unexpected sudden death in children and the approach to their parents]. PMID- 3546025 TI - [Pharmacology of a new sleep-inducer, 1H-1,2,4-triazolyl benzophenone derivative, 450191-S (VI). Determination of metabolites in monkey plasma by combined high performance liquid chromatography and enzyme immunoassay]. AB - A new sleep-inducer, 450191-S, was orally administered to two old rhesus monkeys and three young ones at a pharmacologically active dose (1 mg/kg). The area under the plasma concentration versus time curve (AUC) of M-1 was the smallest among the measured metabolites. The AUC of M-2 in the old monkeys was 10 times higher than that of the young ones. M-A was one of the major metabolites, and its AUC in the old monkeys was also four times higher than that in the young ones. The AUC of M-3 was the largest among the measured metabolites. The time of maximum concentration was 12-16 hr after dosing; and thereafter, the concentration decreased gradually with a 12-hr half-life. The M-4 level was constantly low during 24 hr after dosing and then decreased gradually. The active metabolite M-1 was also administered to the two young monkeys at a dose of 0.73 mg/kg, and the time course of the plasma concentration of metabolites was compared with that after 450191-S administration to the young monkeys, because 450191-S may be changed to M-1 in the process of intestinal absorption. The concentration of M-1 was extremely low in spite of the dosing of M-1 itself, and the AUC of M-1 was one-sixth of that after 450191-S administration. The concentration of M-2 was also low, and its AUC was one-third of that after 450191-S administration. The AUC's of M-A, M-3 and M-4 were not very different from those after 450191-S administration. These results indicated that there is an age-related difference in the plasma concentration of M-2 and M-A when 450191-S is administered orally and that the plasma concentrations of M-1 and M-2 differ greatly between 450191-S and M-1 administrations. PMID- 3546026 TI - Kinetics of delta 5,7-sterol accumulation during growth of Saccharomyces cerevisiae. AB - Saccharomyces cerevisiae accumulates delta 5,7-sterols up to 4 mg per g biomass. The differential rate of sterol synthesis continually increases during growth, its value only being decreased at sterol levels higher than 30 mg per g biomass. The specific rate of sterol synthesis reaches a broad maximum during the growth phase. The gradual sterol accumulation pattern is dominant in cultures growing both on fermentable and nonfermentable carbon sources and is modulated by glucose repression. Limited feeding with sucrose has a significantly greater negative impact on sterol accumulation than feeding with ethanol as a carbon source. PMID- 3546028 TI - Experimental production of colicin type V of Shigella sonnei unusual in nature. AB - Col V factor of Fredericq's strain Escherichia coli 1.7a was mobilized for a transfer by the R (Sm, Cm, Tc, Su) factor of Shigella sonnei strain in three component test. The strain E. coli K13 HfrR (a universal indicator for evidence of colicinogeny) and S. sonnei strain became the recipient of both plasmids. S. sonnei, a producer of colicin V has not been found in natural conditions as yet. PMID- 3546027 TI - Two types of antimutagenic effects of gallic and tannic acids towards N-nitroso compounds-induced mutagenicity in the Ames Salmonella assay. AB - The frequency of his+ revertants induced by N-methyl-N-nitrosourea (MNU) and N methyl-N'-nitro-N-nitrosoguanidine (MNNG) in the strain TA100 of Salmonella typhimurium was decreased by gallic and tannic acid. In weak buffer solutions, the inhibition effects of gallic acid towards MNU and MNNG mutagenicity was caused primarily by a decrease of pH in the incubation mixtures. At adjusted pH (pH 5.0 and 6.5), the antimutagenic effects are largely the result of an interaction between MNU or MNNG with phenolic acids outside the cells. PMID- 3546029 TI - New trends in microbial technology. AB - Microbial technology includes not only the production of materials in bioreactors, or the production of new catalysts by genetic engineering but extends to aspects of both human and animal health care, waste and pollution management, enhanced oil recovery, mineral leaching, advanced plant breeding, diagnostics and analytical equipment, biosensors, bioelectronics and renewable energy system based on biomass feedstocks. National strategies of industrialized countries are being developed which identify microbial technology as a substantial factor in the attainment of industrial and economic goals. Although extremely promising microbial technology is not a quick fix and its application will only arise as a result of systematic programme of research and development. Such programme requires a broad base of disciplinary underpinning in molecular biology, genetics and bioengineering. The development of expertise of this kind in the tertiary educational institutions is the essential starting point. It should be developed by appropriate programmes and networking systems. PMID- 3546030 TI - Effect of cultivation conditions on proteinase production by Lactobacillus murinus. AB - Proteinase production by Lactobacillus murinus was influenced by temperature, glucose concentration, initial pH and nitrogen sources. Maximum proteinase production occurred at 45 degrees C, pH 6.6 and with 0.5% (W/V) glucose. Tryptone, peptone and gelatin inhibited it. PMID- 3546031 TI - Placental transfer of ochratoxin A and its cytotoxic effect on the mouse embryonic brain. AB - Pregnant ICR mice were given a single ip injection of 5 mg ochratoxin A/kg on day 11 or 13 of pregnancy. Concentrations of ochratoxin A in the maternal serum and tissues reached maximum levels within 2 hr of the injection and then decreased rapidly. The half-life of the toxin in serum was 28.7 hr on day 11 and 23.6 hr on day 13. On the other hand, the concentrations of ochratoxin A in the embryos were very low 2 hr after injection and then gradually increased up to 48 and 30 hr after injection on day 11 and 13, respectively. Pharmacokinetically, the embryo was found to be a 'deep' compartment. In mice treated with ochratoxin A on day 10 of pregnancy, the incidence of pyknotic cells in the telencephalon of the embryos began to increase 12 hr after injection to a peak between 36 and 48 hr, coinciding with the time of peak concentration of the toxin in the embryo. PMID- 3546032 TI - [Ultrasonic measurements of the movements of the back of the tongue in speech production: clinical aspects]. PMID- 3546033 TI - [Structural principles of hemostatic processes]. AB - The formation of the hemostatic plug on areas of skin injury is characterized as a sequence of structure-forming processes ending in the formation of an impenetrable barrier. The morphology of this barrier is further elucidated by means of scanning- and transmission electron microscopy. Especially the fibrin coating of the injury shows a completely different formation than is deducible from the solely hemostaseologically orientated view of the formation of the hemostatic plug. These structure-forming processes are: activation of the intrinsic clotting system by means of explosion-like destruction of thrombocytes with an immediate formation of a fibrin clot within seconds after the injury. Later during the process the fibrin clot is then condensed and as a function of thrombocyte dependent retraction receives its final fibrin stabilisation and modellation towards an occluding plug. The very narrow net formation of fibrin fibers is interpreted as dependent on the destruction of thrombocyte pseudopodia using their round shape as a rail for fibrin fiber formation. Disturbances of clot formation of postmortal clots compared to vital clots are interpreted as functional thrombocytic distortions, especially of the thrombocytic energy metabolism. Extracorporal clotting of blood drops after extreme ischemia resemble fibrin structures and fibrin structure formation distortions of postmortal origin. PMID- 3546034 TI - Cyclosporine and analogues--isolation and synthesis--mechanism of action and structural requirements for pharmacological activity. PMID- 3546035 TI - The antibiotics of the pluramycin group (4H-anthra[1,2-b]pyran antibiotics). PMID- 3546036 TI - [Vitamin A therapy of pemphigoid of the conjunctiva]. PMID- 3546037 TI - [Clinicopathologic correlations in keratoplasty eyes (autopsy eyes)]. PMID- 3546038 TI - [Immunohistochemical characterization of lymphocytes in the cornea]. PMID- 3546039 TI - [Echographic evaluation of malignant melanoma of the uvea following ruthenium therapy]. PMID- 3546040 TI - [Wound management using a silicone foam dressing. Results of a multicenter study]. PMID- 3546041 TI - [Hyperthermia for carcinoma of the esophagus]. PMID- 3546042 TI - Survey of Campylobacter jejuni and enterotoxigenic Escherichia coli in Kenya. PMID- 3546043 TI - A new approach to capital payment in a competitive era. PMID- 3546044 TI - [Clinical pathology of lung cancer]. PMID- 3546045 TI - [Experimental therapy in Chinese hamsters and rats infected with larval Echinococcus multilocularis by using mebendazole, albendazole and ivermectin with brief review of chemotherapy of human multilocular echinococcosis]. AB - The effects of the mebendazole, albendazole and ivermectin on secondary multilocular echinococcosis in Chinese hamsters infected with intraperitoneal inoculation of protoscolices and in rats infected with transportal inoculation of protoscolices were investigated. A reduction in weight of the hydatids greater than 95% was recorded in Chinese hamsters intraperitoneally injected with mebendazole suspension. Oral administration of mebendazole moderately inhibited the development of the hydatids. Albendazole was less effective than mebendazole. Ivermectin was ineffective. The treatment with mebendazole of larval E. multilocularis inhibited the growth of the hydatids but it could not completely kill the parasite tissues. The present status of chemotherapy of the human multilocular echinococcosis was briefly discussed. PMID- 3546047 TI - Effects of cholinergic stimulation and antagonism on plasma insulin concentration in lean and obese human subjects. AB - The effect of cholinomimetic stimulation by infusion of edrophonium chloride or muscarinic blockade by infusion of atropine sulfate on insulin and GIP secretion was studied in normal lean subjects during eu- and hyperglycemia. Cholinomimetic stimulation led to a slight non-significant increase and muscarinic blockade to a slight, non-significant suppression of both GIP and insulin. No modification of the insulin secretion pattern was observed under either condition during hyperglycemia. The effect of atropine infusion on fasting plasma insulin and GIP was subsequently studied in 11 obese patients and 10 lean subjects. Muscarinic antagonism by atropine led to a transient non-significant suppression of GIP and insulin in lean subjects, but to a significant, sustained suppression of these hormones in obese patients. Insulin and GIP levels were however, not suppressed to control values after atropine administration in obese patients. A positive correlation was found between fasting plasma insulin and maximal suppression of insulin attained during the 30 min following administration of atropine. It is concluded that part of the hyperinsulinemia observed in human obesity is under the control of the parasympathetic nervous system. An abnormal balance between sympathetic inhibitory and parasympathetic stimulatory tones on insulin secretion, as observed in the VMH lesioned rat, might be present in human obesity. PMID- 3546046 TI - Measurement of glycosylated haemoglobins and glycosylated plasma proteins in animal models with diabetes or inappropriate hypoglycaemia. AB - Stable glycosylated haemoglobins and glycosylated plasma proteins were determined by affinity chromatography using Glycogel B in animal models with diabetes or inappropriate hypoglycaemia. Adult Aston ob/ob mice and C57BL/KsJ db/db mice exhibited 1.5-1.9 fold increases of body weight, 2.5-3.4 fold elevations of plasma glucose and 20.9-29.3 fold elevations of plasma insulin. Glycosylated haemoglobins and glycosylated plasma proteins were raised 7.2-8.2 fold and 6.6 6.7 fold respectively. In adult NEDH rats, administration of streptozotocin or implantation of transplantable insulinoma fragments produced reciprocal changes in insulin and glucose concentrations either resulting in the onset of insulin deficiency (5.9 fold decrease) and hyperglycaemia (3.2 fold increase) by 2 days, or hyperinsulinaemia (2.1 fold increase) and hypoglycaemia (1.4 fold decrease) by 6 and 8 days, respectively. Glycosylated plasma proteins were increased (1.2 fold) rapidly after streptozotocin treatment followed by glycosylated haemoglobins (1.6 fold increase) after 8 days. In contrast, the decreases in glycosylated plasma proteins and glycosylated haemoglobins (4.4 fold and 1.4 fold, respectively) in insulinoma-bearing rats preceded the demonstration of hypoglycaemia by 5 and 2 days, respectively. Glycosylated plasma proteins in insulinoma-bearing rats returned to pretransplantation values at 10-16 days. Good correlations were observed in mice and rats between glucose and both glycosylated haemoglobins (r = 0.92 and r = 0.90, respectively) and glycosylated plasma proteins (r = 0.85 and r = 0.93), and between the glycosylated blood proteins themselves (r = 0.95 and r = 0.91). The results show that the measurement of glycosylated blood proteins by affinity chromatography using Glycogel B provides a sensitive and reliable indicator of the recent glycaemic environment. PMID- 3546048 TI - Identification of insulin in the human pancreatic juice. AB - In this study, we purified insulin-like substance (ILS) in the human pancreatic juice by the combined use of affinity chromatography and radioimmunoassay (RIA). The amino acid sequence of ILS in the N-terminal region is the same as that of human insulin. The influence of the enzymes present in the pancreatic juice on the RIA procedure, was examined. Trypsin, chymotrypsin and amylase showed steep influences on radioactivity. The addition of enzyme inhibitors could not reduce pseudo-activity, but the elimination of enzymes in the pancreatic juice by ultrafiltration with the Mole-Cut (Millipore, Japan) resulted in a lowering of the pseudo-insulin activity. Affinity chromatography on Sepharose 4B coupled with anti-porcine insulin was used to capture ILS. ILS was eluted by 1 M acetic acid from the affinity column monitoring pH and the insulin activity by RIA. The amino acid sequences of two components of ILS in amino terminal region were Phe-Val and Gly-Ile-Val. This indicates that ILS obtained from human pancreatic juice was the insulin derived from endocrine secretion of pancreas. PMID- 3546049 TI - Insulin stimulates glucose transport in isolated human adipose cells through a translocation of intracellular glucose transporters to the plasma membrane: a preliminary report. AB - Insulin's effect on glucose transport activity and the subcellular distribution of glucose transporters have been examined in isolated human abdominal adipose cells, by measuring 3-O-methylglucose transport and specific D-glucose inhibitable cytochalasin B binding to plasma membranes and low-density microsomes, respectively. Insulin appears to stimulate glucose transport in isolated human adipose cell through the translocation of glucose transporters from a large intracellular pool to the plasma membrane as initially postulated for rat adipose and muscle cells. PMID- 3546050 TI - Epidermal growth factor stimulates (pro-)insulin biosynthesis and 3H-thymidine incorporation in isolated pancreatic rat islets. PMID- 3546051 TI - Insulin binding to circulating erythrocytes in nonobese diabetic mice. AB - Insulin binding to circulating erythrocytes was studied in nonobese diabetic (NOD) mice which develop insulinopenic diabetes mellitus spontaneously. NOD mice with a short duration of diabetes mellitus and mild insulinopenia did not show any change in insulin binding, while those with a long duration of diabetes mellitus and severe insulinopenia showed an increase in insulin binding compared with nondiabetic NOD mice (6.85 +/- 0.38% bound vs. 4.19 +/- 0.24% bound, p less than 0.01). This increase in insulin binding was due to an increase in the number of receptors. Insulin treatment of diabetic NOD mice significantly reduced the insulin binding by 64%, which resulted from a decrease in the number of the receptors. These results indicate that insulin binding to erythrocytes in NOD mice is controlled mostly by up-and-down regulation. PMID- 3546052 TI - An immunocytochemical study of T-cell lymphomas using monoclonal and polyclonal antibodies effective in routinely fixed wax embedded tissues. AB - Formalin fixed and paraffin wax embedded tissue from 24 cases of T-cell lymphoma diagnosed using immunocytochemistry on cryostat sections was examined using a panel of eight monoclonal and three polyclonal antisera. The monoclonal antibodies UCHL1 and MT1 proved to be comparable and reliable markers of neoplastic cells in T-cell lymphomas. The B-cell specific marker, MB1, strongly stained all cells in two cases of pleomorphic large cell T-cell lymphoma, large cells in two cases of pleomorphic mixed medium and large cell lymphoma, and isolated clusters of blast cells in four cases of T-zone and angioimmunoblastic lymphadenopathy-like T-cell lymphoma. The cells stained by MB1 expressed T suppressor/cytotoxic surface markers on frozen section. Epithelial membrane antigen, as detected by a polyclonal anti-EMA and the monoclonal antibody HMFG2, was expressed in 36% of tumours especially those of monomorphic large cell and pleomorphic large cell phenotype. Single granules or finely dispersed cytoplasmic granularity was seen in four tumours using the anti-granulocyte reagent Leu M1. Tumour cells in one case stained in a pattern identical to Reed-Sternberg cells in Hodgkin's disease. Granular alpha-1-antitrypsin staining was found in 10 cases of pleomorphic large cell and monomorphic large cell lymphoma. No staining was observed using anti-lysozyme or the monoclonal macrophage specific marker Mac411. Monomorphic and pleomorphic large cell lymphomas tended to show a common immunophenotype with the majority of cells co-expressing alpha-1-antitrypsin HLA DR and epithelial membrane antigen. Scattered large transformed blast cells in cases of angioimmunoblastic lymphadenopathy-like T-cell lymphomas and T-zone lymphomas shared a similar immunophenotype with the large cell lymphomas. Using a panel of monoclonal antibodies effective in paraffin embedded tissue, diagnostically useful staining profiles which correlate with the morphological phenotype can be established in T-cell lymphomas. PMID- 3546053 TI - Strategies for success: an examination of the organizational development of early hospice programs. PMID- 3546055 TI - Hospitals doubt "promptness" of prompt payment. PMID- 3546054 TI - Congress rallies around catastrophic coverage. PMID- 3546056 TI - Will HCFA limit coverage beyond transplants? PMID- 3546058 TI - Waiving Medicare deductibles: illegal tactic? PMID- 3546057 TI - Evangelical acts to hike cash flow without PIP. PMID- 3546059 TI - No fanfare for HCFA's Medicare capitation plan. PMID- 3546060 TI - PRO scrutiny means more hospital involvement. Interview by Myk Cherskov. PMID- 3546061 TI - Preparing for capitation: don't bypass purchasing. PMID- 3546062 TI - States create 2,972 programs to ratchet costs. PMID- 3546063 TI - CBO report on Medicare cuts sparks concern. PMID- 3546064 TI - Unreliable AAPCC rates minimize provider interest. PMID- 3546065 TI - Secondary payer laws confuse hospitals: HCFA. PMID- 3546066 TI - Industry opposes HCFA's recent capital proposal. PMID- 3546067 TI - Capitation: are you ready? PMID- 3546068 TI - Capitation: will one price fit all? PMID- 3546069 TI - Multis to pursue high-tech future. PMID- 3546070 TI - New frontiers in neonatal neuropathology. PMID- 3546071 TI - Associations between morphology, karyotype, and clinical features in myeloid leukemias. PMID- 3546072 TI - Cell biology of endothelial cells. AB - Endothelial cells are a source of physiologically important molecules synthesized therein and secreted to the blood and/or to the subendothelial extracellular matrix. These molecules participate in formation of platelet and fibrin thrombi (e.g., von Willebrand factor and tissue factor) and contribute to antithrombotic properties of the endothelium (e.g., prostacyclin, thrombomodulin, and heparan sulfate). Endothelial cells synthesize and secrete plasminogen activator and inhibitors. They are the source of molecules regulating the growth of other cells; they synthesize angiotensin-converting enzyme, and bind lipoproteins and hormones. Finally, they are the target for, and participant in, immune reactions. Thus, endothelial cells constitute not only the first barrier between the blood and the extravascular space but also serve as a source of molecules influencing the structural and functional integrity of the circulation. PMID- 3546073 TI - Common mechanisms of proliferation of smooth muscle in atherosclerosis and hypertension. AB - At least two exogenous sources of agents able to control vascular smooth muscle proliferation can be identified. Platelets contain and release mitogens as well as a factor, TGF-beta, that inhibits cell growth on plastic surfaces while stimulating it when cells are grown in suspension in soft agar. Macrophages release mitogens, including PGDF, and macrophage invasion is characteristic of early experimental lesions in fat-fed animals. Finally, it is at least possible that endothelial cell production of mitogens may represent a response to some as yet undefined external injury. The vessel wall also offers sources of growth control endogenous to the smooth muscle cell layers. The vessel wall contains heparan sulfate able to inhibit cell growth of smooth muscle cells, which by themselves can synthesize PDGF. This provides possible positive and negative control of replication intrinsic to the smooth muscle cells themselves. The role of these intrinsic or extrinsic factors in the smooth muscle proliferation of hypertension and atherosclerosis remains hypothetical. It is intriguing to implicate platelets and/or macrophages in the denuding injuries seen in small hypertensive vessels and in advancing atherosclerotic plaques. At least for the latter case, however, there seem to be other critical factors. Simple denudation and thrombosis, for example, are not sufficient to stimulate smooth muscle growth, and the kinetics of proliferation after balloon denudation imply the presence of some other event required to initiate smooth muscle proliferation. Similarly, smooth muscle replication in large vessels of hypertensive animals occurs without loss of endothelial continuity. This implies that replication in response to hypertension depends on factors intrinsic to the vessel wall. Benditt's observation of monoclonality also implies some intrinsic mechanism allowing cells to grow in a focal manner. It is intriguing to consider the possibility that this commitment process could require the release of cells from the intrinsic inhibitory effects of heparan sulfate located around the cells or the synthesis of growth factors secreted by the smooth muscle cells themselves. If we add the hypothesis that only some cells are capable of such a response, we would expect the sort of oligodense phenomenon demonstrated by Benditt. Proof of such a hypothesis, however, will have to await development of methods to explore these mechanisms directly in the vessel wall responding to injury. PMID- 3546074 TI - Eicosanoid biosynthesis in human cardiovascular disease. AB - Thromboxane A2, the predominant cyclooxygenase product in platelets, is a potent platelet agonist and vasoconstrictor in vitro. Prostacyclin, the major product of vascular endothelium, has opposite effects on platelet function and vascular tone. These properties prompted the hypothesis that a "balance" between these compounds regulated interactions between platelets and the vessel wall in vivo. Although this possibility has been addressed extensively through experiments in vitro, clinical investigations commonly have been confounded by problems with analytic methodology, by selection of inappropriate metabolic targets for analysis, and by artifacts of trial design. The most reliable forms of assessing biosynthesis that are currently available still do not provide definitive information as to the tissue of origin of the compound studied and are directed toward stable but biologically inactive metabolites rather than the evanescent primary compounds themselves. Despite these limitations, both biochemical evidence and clinical trials clearly implicate thromboxane A2 as an important mediator of vascular occlusive disease in humans. The role of prostacyclin is much more conjectural. It does not circulate in concentrations sufficient to exert a systemic effect, but it may play a local homeostatic role in the regulation of platelet-vascular interactions. Whether preservation of the capacity to form prostacyclin coincident with inhibition of thromboxane A2 is of functional importance can be addressed only by clinical trials comparing inhibitors of thromboxane synthesis inhibition that are selective with cyclooxygenase inhibitors that also block the biosynthesis of prostacyclin. The recognition that multiple factors have the potential to regulate both platelet and vascular function at their interface renders the concept of a thromboxane A2 prostacyclin "balance" somewhat unlikely. However, both eicosanoids may interact with other factors to determine the development or persistence of vascular occlusion. Inhibition of the synthesis or function of thromboxane A2 remains the predominant mechanism for achieving interference with platelet function in vivo. Accumulating evidence for the efficacy of aspirin in human syndromes of vascular occlusion suggests that the biologic role of these compounds in humans should be pursued. PMID- 3546075 TI - Physiologic regulation and pathologic disorders of fibrinolysis. AB - Physiologic fibrinolysis is a reparative process that occurs in response to hemostatic plug or thrombus formation. The final enzymatic step, fibrin proteolysis, results from a coordinated interaction of enzymes and inhibitors, which produces effective action at the site of the disease and spares the proteins of the blood or uninvolved parts of the vascular system. The agent of fibrinolysis, the enzyme plasmin, is derived from its zymogen (plasminogen) through limited proteolysis effected by plasminogen activators. They can be grouped according to functional and immunologic properties into the tissue type and urokinase-like plasminogen activators. The ability of alpha 2 antiplasmin to neutralize efficiently free (nonfibrin-bound) plasmin prevents inappropriate systemic activation of fibrinolysis. This control is superseded in certain conditions, such as with the therapeutic administration of plasminogen activators to lyse pathologic thrombi, when plasmin degrades plasma fibrinogen into degradation fragments (X, Y, D, and E). Degradation of cross-linked fibrin results in distinctive products that are characterized by cross-linked (factor XIIIa-induced) derivatives such as D dimer. Disease states resulting from abnormalities in the fibrinolytic system include both hemorrhagic disorders, resulting from excessive fibrinolysis, and thrombosis, as the result of deficient fibrinolysis. Hyperfibrinolysis can result from pharmacologic administration of activators or from defective inhibition produced by alpha 2 antiplasmin deficiency. Hypofibrinolytic thrombosis can result from hereditary defects, for instance of plasminogen or fibrinogen, or from pharmacologic inhibition of fibrinolysis such as with epsilon aminocaproic acid. Laboratory evaluation of fibrinolysis is useful for monitoring fibrinolytic therapy and assessing thrombotic disorders and bleeding; it also includes the specific measurements of plasminogen activator, plasminogen, plasmin, inhibitors and circulating fibrinogen, and cross-linked fibrin degradation products. PMID- 3546076 TI - Thrombosis and cancer. AB - Abnormal hemostasis is a fundamental property of malignant disease, not merely an epiphenomenon attributable to therapy or to chronic illness. Many types of tumor cells express clotting initiators such as tissue factor and act again late in the coagulation pathway by providing a surface for prothrombinase generation. Thus, entry of tumor cells into the plasma, as during metastasis, may be expected to trigger intravascular clotting. However, and perhaps of greater importance, solid tumors growing outside of the blood vasculature regularly deposit fibrin locally in the tissues. They do so by rendering the microvasculature hyperpermeable, allowing fibrinogen and other plasma-clotting proteins to leak into the extravascular space where procoagulants associated with tumor cells or with benign stromal cells initiate clotting. Both fibrin deposition and turnover in solid tumors proceed at rapid rates. Thus, whether attributable to events in the intra- or extra-vascular space, the result is the same: abnormal clotting and fibrinolysis whose consequences may include protection from host inflammatory cells, modulation of the immune response, and induction of angiogenesis. PMID- 3546077 TI - The macrophagic origin of multinucleated giant cells in myeloma kidney: an immunohistologic study. AB - The cast-engulfing giant cells in a case of kappa light chain nephropathy/Bence Jones cast nephropathy were characterized with monoclonal antibodies Uro-5 (renal epithelium: Henle's loop, distal tubule, collecting duct) and Leu-M5 (macrophage/monocyte/dendritic cell specific). The giant cells were Leu-M5 positive and Uro-5 negative. There was an increased concentration of Leu-M5 positive cells surrounding cast-containing tubules, and occasional Leu-M5 positive cells were found within the tubular epithelial layer. Although there were no Uro-5-positive giant cells, an occasional Uro-5-positive cell was found within casts. The majority of casts were found within Uro-5-positive tubules. These results confirm earlier electron microscopic reports that the cell of origin of the cast-engulfing multinucleated giant cell is the macrophage (Leu-M5 positive, Uro-5 negative). These giant cells may originate from macrophages that have migrated from the interstitium through the tubular epithelium. PMID- 3546078 TI - Homozygous paracentric inversion 12 in a mentally retarded boy: a case report and review of the literature. AB - A mentally retarded male was found to be homozygous for a paracentric inversion of the long arm of chromosome 12(inv(12)(q21.1q23.2]. His parents, who are first cousins, and his phenotypically normal younger brother are inversion heterozygotes. Homozygous structural rearrangements are discussed and cases of paracentric inversions, including a further nine previously unpublished, are reviewed. PMID- 3546079 TI - Enzyme linked immunosorbent assays with Treponema pallidum or axial filament of T phagedenis biotype Reiter as antigen: evaluation as screening tests for syphilis. AB - Enzyme linked immunosorbent assays with an ultrasonicate of Treponema pallidum (TP-ELISA) or axial filament of Treponema phagedenis biotype Reiter (AF-ELISA) were developed to detect treponemal antibody. TP-ELISA and AF-ELISA were compared with the T pallidum haemagglutination assay (TPHA), the fluorescent treponemal antibody-absorbed (FTA-ABS) test, and the Venereal Disease Research Laboratory (VDRL) test for sensitivity and specificity of serodiagnosis of syphilis. A total of 1423 serum samples, 253 from patients with various stages of syphilis, 500 from patients attending a sexually transmitted disease (STD) clinic, and 670 from people without syphilis, were investigated. At all stages of syphilis the sensitivity of the TP-ELISA, the AF-ELISA, the TPHA, and the FTA-ABS test did not differ significantly, except that the AF-ELISA was less sensitive than the TPHA (p less than 0.05) for treated syphilis. In primary syphilis, neurosyphilis, and treated syphilis the TP-ELISA and AF-ELISA were significantly more sensitive than the VDRL test (p less than 0.05). The specificity of all tests was comparable (p greater than 0.05). The TP-ELISA and AF-ELISA appear to be good alternatives to the TPHA as screening tests for syphilis. Because of the easy availability of a well defined antigen the AF-ELISA seems to be better suited for large scale testing. PMID- 3546080 TI - Specificity and sensitivity of chlamydial direct specimen test: a comparative and quantitative study in patients attending a sexually transmitted disease clinic and a high risk group. PMID- 3546081 TI - Treatment of gonorrhoea with ceftriaxone. PMID- 3546082 TI - Paraquat--a review of safety in agricultural and horticultural use. AB - Over the past 20 years plus that paraquat has been used throughout the world, it has enjoyed an excellent safety record when used normally and for its intended purpose. Its safety record is explained by the following reasons: inhalational exposure during normal use is not significant toxicologically; dermal exposure predominates during normal use; intact human skin provides a very good barrier against penetration by paraquat. Its safety record has been confirmed by several field studies, which have assessed exposure and health of workers, who have used paraquat for short and longer periods of time. The unanimous conclusions of the studies is that exposure to paraquat does not result in any acute or chronic adverse health effects. Minor and reversible injuries to the skin, eyes, nose and nails do occur and probably result from overexposure to the extremely irritant concentrated formulations. Most of these effects can be avoided using ordinary personal hygiene. There have been a few anecdotal cases reported in the literature when dermal absorption of paraquat has genuinely occurred and led to serious health effects. In all cases prolonged exposure to concentrated paraquat solutions has been involved resulting in severe and extensive skin damage, with removal of the barrier and absorption of lethal amounts of the chemical. Those cases involving exposure to concentrated paraquat solutions emphasise the need to handle such formulations, for example 'Gramoxone', with case and ensure that the spray solution is correctly made up--at a dilution of at least 1 part 'Gramoxone' to 40 parts water. PMID- 3546083 TI - The epidemiology and prevention of paraquat poisoning. AB - In the UK there was an increase in the annual number of deaths associated with paraquat poisoning between 1966 and 1975. Since that time there has been little change in numbers. High mortality is associated commonly with suicidal intent. Serious accidental poisoning from paraquat has never been frequent in the UK and there have been no deaths reported in children since 1977. The National Poisons Information Service has monitored in detail all reports of paraquat poisoning since 1980. Of the 1074 cases recorded there were 209 deaths. In recent years serious poisoning has been more commonly associated with ingestion of concentrated products by males. Local exposure to paraquat has not resulted in systemic poisoning. International data for paraquat poisoning is incomplete and difficult to compare. There is a scarcity of morbidity data at both international and national levels. Information obtained from Poison Control Centres indicates that paraquat poisoning occurs in many countries but detailed comparisons are hindered by lack of standardised methods of recording. Various measures to prevent paraquat poisoning have been introduced. Their effectiveness has not been studied in detail. Some support is provided by the low incidence of serious accidental paraquat poisoning in the UK, but because of the suicidal nature of paraquat poisoning it is unlikely that current preventative measures will influence the number of deaths occurring each year. Preventative measures against paraquat poisoning should be tailored to national needs, based on and assessed by epidemiological studies. PMID- 3546084 TI - Mechanism of paraquat toxicity in lung and its relevance to treatment. AB - The symptoms of paraquat poisoning depend largely on the amount of compound consumed, although in many cases the most characteristic feature of poisoning is lung damage, causing severe anoxia which leads to death. Studies in experimental animals have demonstrated that paraquat produces an acute damaging phase in the lung, followed by a reparative phase dominated by an extensive fibrosis. The latter is a major contributor to the lung lesion that causes anoxia. The specific toxicity in the lung can be explained in part by the selective accumulation of paraquat into this organ in comparison with other tissues. The accumulation is energy-dependent and probably specific to certain lung cells. It is now known that paraquat is accumulated into the lung by a recently described diamine transport process located in the alveolar epithelial cells and the Clara cells of the airways. When accumulated, paraquat undergoes a NADPH-dependent one-electron reduction to for its free radical which almost instantly reacts with molecular oxygen to reform the cation and concomitantly produce superoxide anion. This species of oxygen radical can contribute to the formation of more toxic species of radical which may directly damage vital cellular constituents. Paraquat has been shown to stimulate rapidly the pentose phosphate pathway and inhibit the synthesis of fatty acids in the lung in a dose-dependent manner. In addition there is a rapid increase in the pulmonary levels of mixed disulphides and the eventual reduction of NADPH levels in the lung. These results are consistent with the suggestion that paraquat causes a rapid and pronounced oxidation of NADPH which initiates compensatory biochemical responses in the lung.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546085 TI - Paraquat poisoning: clinical features and immediate general management. AB - In contrast to 10-15 years ago most cases of paraquat poisoning are now due to deliberate self-poisoning with parasuicidal or suicidal intent rather than to accidental ingestion. Less commonly, poisoning may follow careless handling of paraquat during occupational use. Although paraquat can be absorbed through the skin if improperly handled, poisoning usually follows ingestion and has rarely been reported after subcutaneous, intravenous or intraperitoneal injection. Clinically, three degrees of intoxication may be distinguished. Mild poisoning occurs after the ingestion or injection of less than 20 mg of paraquat ion/kg body weight. In these cases patients are either asymptomatic or symptoms are confined to the gastrointestinal system. All patients recover fully. Moderate to severe poisoning usually follows the ingestion (rarely injection) of 20-40 mg of paraquat ion/kg body weight. Non-specific symptoms of ill health together with local gastrointestinal symptoms precede the development of renal failure (which may recover spontaneously) and pulmonary fibrosis which may not be manifest for days or weeks. Death occurs in the majority of cases but is usually delayed for 2 3 weeks. Acute fulminant poisoning follows the ingestion of substantial quantities of paraquat (greater than 40 mg of paraquat ion/kg body weight). In addition to local symptoms, multiple organ (cardiac, respiratory, hepatic, renal, adrenal, pancreatic, neurological) failure occurs. Death may supervene within hours and is never delayed for more than a few days. Initial general management has four priorities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546087 TI - Pharmacological treatments of paraquat poisoning. AB - A large number of pharmacological techniques aimed at modifying paraquat toxicity have been investigated. There is no convincing controlled evidence that any are unequivocally useful. Studies with an ascorbic acid and riboflavin combination appear effective in rats, and there is a suggestion that cyclophosphamide and dexamethasone may in some way alter paraquat toxicity in man and by pretreatment, but not concurrent treatment, also in the rat. Further controlled studies are required of these treatments in patients who are potentially salvageable. There is a need for a rapid paraquat assay for clinical use in order that patients in this category can be identified quickly and included in appropriate controlled studies. PMID- 3546086 TI - Treatment of paraquat poisoning in man: methods to prevent absorption. AB - Theoretically, absorption of an ingested dose of paraquat may be reduced by gastric lavage, induced emesis, whole-gut lavage or by the oral administration of absorbent substances. Animal experiments suggest that paraquat is absorbed poorly from the stomach and absorbed incompletely (less than 5%) from the small intestine over a 1-6 h period. Although gastric lavage would therefore seem a logical way to ameliorate the toxicity of an ingested dose of paraquat, peak plasma concentrations are attained rapidly and evidence for the efficacy of gastric lavage in man is poor. In 1977, a potent emetic (PP796) was added to liquid and solid formulations of paraquat because experiments in primates had demonstrated a fivefold reduction in toxicity. In man, ingestion of formulations containing an emetic is more likely to cause spontaneous vomiting within 30 min than non-emetic preparations. However, definite evidence of benefit, as judged by improved patient prognosis, has yet to be established. Gut lavage has been shown to remove only a small proportion of an ingested dose of paraquat. At the flow rates employed in man (75 ml/min), approximately 0.5-1.0 litres of lavage fluid/h may be absorbed across the intestinal wall. Since there is a theoretical risk of increasing paraquat absorption, the use of whole-gut lavage cannot be recommended. Bipyridilium herbicides are absorbed by soil and clay minerals, and montmorillonite in particular has been shown to be a strong binding agent in vitro. Accordingly, the use of Fuller's Earth (calcium montmorillonite) and Bentonite (sodium montmorillonite) for the treatment of poisoning has been investigated in animal models.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546088 TI - Elimination of paraquat. AB - There is a striking discrepancy between the efficacy of the kidneys, haemodialysis and haemoperfusion in removing paraquat from the body and the poor prognosis of paraquat poisoning even when the blood and urine concentrations (which are good indices of concentrations in lung and other tissues) are very low. Extracorporeal elimination techniques have been used world-wide in paraquat poisoning. Do they remove paraquat effectively? Certainly. Do they increase the survival rate? Probably not. The reason being that when these techniques of elimination are initiated, potentially lethal concentrations of paraquat have already been attained in the highly vascular tissues of vital organs and in pneumocytes. The data presented here suggest that the successful treatment of paraquat poisoning will not be achieved by modification of toxicokinetics. PMID- 3546089 TI - Uses and usefulness of paraquat. AB - Paraquat was discovered in 1955 and introduced to the market place in 1962. During the 23 years between introduction and the present day numerous successful practical uses of the herbicide have been developed. In addition the characteristics of the chemical have allowed significant changes to be made in the ways that some crops are grown. Paraquat is a relatively non-selective foliage-applied contact herbicide. It is inactivated on contact with almost all naturally occurring soils and it was this property, perhaps above all others, that provided the greatest breakthrough in chemical weed control at the time of its discovery. Inactivation on contact with soil means that no biologically active residues remain in the soil, thus allowing planting or sowing to be carried out almost immediately after spraying. Although the non-systemic (contact) property of paraquat makes it less than ideal for the long-term control of perennial weeds, the same property is of real advantage when parts of crop plants are sprayed accidentally, for usually only the part receiving the spray is affected. Total annual usage of all herbicides in agriculture and horticulture in England and Wales, UK, over the period of 1980-1983 has been estimated at 26,360 tonnes used on 12402 X 10(3) ha (1 hectare = 1 X 10(4) m2). For paraquat (not including its mixtures with diquat and monolinuron) 270 tonnes were sprayed over 392,218 ha/year. It is estimated from sales records that in Europe 5 X 10(6) ha are sprayed annually with paraquat.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546090 TI - Emergency analysis of paraquat in biological fluids. AB - A variety of spectrophotometric, gas and liquid chromatographic and radioimmunoassay techniques have been applied to the measurement of paraquat in biological fluids. A brief review of these techniques is presented. The majority of described methods are far from suitable in the provision of an accurate and reliable quantitative result in an emergency situation and the further development of suitable 'rapid' techniques is desirable. The preparation and characterisation of internal accuracy control materials and the introduction of an external quality assessment scheme would be valuable in the improvement of laboratory investigations of paraquat poisoning. PMID- 3546091 TI - Classifier-directed signal processing in brain research. PMID- 3546092 TI - A microprocessor-based signal processing system for measurement of vascular and urethral parameters. PMID- 3546093 TI - Military nursing: 211 years of commitment to the American soldier. PMID- 3546094 TI - The U.S. Cadet Nurse Corps: nursing's answer to World War II demands. PMID- 3546095 TI - Implications of remineralization in the treatment of dental caries. PMID- 3546096 TI - Does adjuvant cyclophosphamide augment immune status of breast cancer patients? PMID- 3546098 TI - Dental management of the irradiated patient. PMID- 3546097 TI - Ultrasonic diagnosis of primary carcinoma of gall bladder--a report of 48 cases. PMID- 3546099 TI - Phenotypic analysis of mast cell granule proteinases in normal rat bone marrow cultures. AB - Mast cells with morphological and some biochemical properties of mucosal mast cells (MMC) proliferate and mature in rat bone marrow cultures stimulated with factors from antigen- or mitogen-activated T lymphocytes. There has been much controversy over the criteria used to distinguish the different mast cell subsets, and because histochemistry of granule glycosaminoglycans does not adequately define mast cell subsets morphologically, the proteinase phenotypes of cultured mast cells were analysed. Affinity-purified cross-absorbed monospecific F(ab')2 antibodies raised against rat mast cell protease I (RMCPI) from connective tissue mast cells (CTMC) and against rat mast cell protease II (RMCPII) isolated from mucosal mast cells were used to stain granule proteinase by an immunohistochemical technique. Mast cells grown in culture from normal rat bone marrow stained exclusively with anti-RMCPII antibodies, thus providing further confirmation of their similarity to, and identity with, MMC. PMID- 3546100 TI - Functional and histological studies of adoptive immunity in neonatally transplanted rabbits. AB - The adoptive transfer of immunity by means of spleen and lymph node cells has been analysed in rabbits of defined major histocompatibility (RLA) types and immunoglobulin (Ig) allotypes. Previous results had shown that chimaeras formed by transplanting adult cells into RLA-matched newborn hosts become stable B lymphocyte chimaeras, as determined by their continuous production of donor type Ig. However, specific antibodies made by adult chimaeras were demonstrably only of recipient origin, unless the donor had been primed. The present report describes early events after the transfer of cells from donors primed with trinitrophenylated keyhole limpet haemocyanin (TNP-KLH). Double-staining with enzyme-labelled antigen or antibody conjugates was applied to identify lymphocytes of donor or recipient origin in spleen sections of transplanted rabbits and also to identify cells producing anti-TNP. Lymphocytes with membrane bound Ig (mIg+ cells) of donor allotype were readily identified scattered singly or in small clusters throughout the recipients' B-lymphocyte areas within 5 days after transfer. Groups of donor-derived cells producing anti-TNP were demonstrable only in animals that had been specifically stimulated. Serological analysis and lymphocyte marker and function studies correlated well with results obtained by the histocytochemical approach. These results show that a systematic study of the role and importance of mature B lymphocytes in transplantation is now feasible. PMID- 3546101 TI - Cloned cytolytic T-effector cells and their malignant variants produce an extracellular matrix degrading trypsin-like serine proteinase. AB - This report describes the distribution of a trypsin-like proteinase in defined homogeneous cytolytic T-cell lines (CTLL) and their in vitro and in vivo derived malignant T-lymphoma variants. By means of chromogenic peptide substrates, we found the enzyme to attack preferentially at the carboxy terminus of arginine, in particular when non-polar amino acids were present in the amino terminal neighbouring position. The enzyme was identified by means of various inhibitors as a serine type proteinase having a pH optimum around 8 X 5. Affinity chromatography in connection with molecular sieving resulted in a 200-fold purification and indicated a molecular weight (MW) of about 50,000 for the proteinase. The enzyme was found to be highly expressed in antigen-specific CTLL as well as in their tumorigenic variants. Both intact lymphocytes of all CTLL tested and Triton X-100 lysates or enriched proteinase preparations thereof were able to degrade a high molecular weight protein (casein) and to release high molecular weight split products from the sulphated proteoglycans in subendothelial extracellular matrix. The results are discussed with respect to the invasiveness of normal and malignant T lymphocytes and the proteinase is suggested to be crucially involved in the process of cellular migration in vivo. PMID- 3546102 TI - An immunohistochemical study of endopeptidase-24.11 and aminopeptidase N in lymphoid tissues. AB - Two cell surface peptidases, endopeptidase-24.11 and aminopeptidase N, thought to be involved in metabolizing regulatory peptides, have been immunohistochemically mapped in pig lymphoid organs using specific monoclonal and polyclonal antibodies. In tonsil, spleen, thymus and Peyer's patches, the endopeptidase 24.11 immunoreactivity exhibited a reticular pattern similar to that previously observed in lymph nodes, where this enzyme is much more abundant. Apart from this location in reticular cells, the only structures seen to express endopeptidase 24.11 were Hassall's corpuscles in the thymus, confirming their reticular cell origin. Aminopeptidase N exhibited a cellular distribution quite distinct from that of the endopeptidase. It was associated with cells scattered throughout the lymphoid organs studied, consistent with its localization in macrophages. In lymph nodes, some fibroblasts buried in trabeculae also stained for aminopeptidase, but this was not observed in spleen and thymus. PMID- 3546103 TI - Natural antibodies to treponemal antigens in four strains of guinea-pigs. AB - A total of 185 serum samples obtained from healthy male and female guinea-pigs of inbred strains 2 and 13 and outbred strains C4D and Hartley A were examined for natural antibodies to treponemal antigens by ELISA using Treponema pallidum (TP), T. phagedenis biotype Reiter (TR) and T. vincentii (TV) antigens and by the FTA test. The prevalence and titres of natural antibodies depended on the age and strain of guinea-pig and the treponemal antigen used. One- and 7-day-old guinea pigs contained significantly (P less than 0.001) higher levels of natural antibodies than did animals 1 or 3-6 months old. The similar high levels of natural antibodies in newborn guinea-pigs and their mothers (12-30 months old) and the sharp drop observed at the age of 1 month suggested maternal transfer as the mechanism of acquisition. In young adults 3-6 months old, the age group most susceptible to TP infection, antibodies to TP and TR were at their lowest levels, but antibodies reacting to TV had already begun to rise. Natural antibodies were of the IgG1 and IgG2 but not of the IgM class. The highest levels of natural antibodies were in the C4D guinea-pigs; the lowest were in the Hartley A strain. Natural antibody activity was inhibited or adsorbed by TR antigens. PMID- 3546104 TI - Disc/stick ELISA for diagnosis of bancroftian filariasis. PMID- 3546105 TI - Enzyme-mechanism based reaction of 1,1'-diacetyl-1,1',4,4'-tetrahydro-4,4' bipyridine (DTB) with para nitrosophenetole: mutagenicity of the reaction products. PMID- 3546106 TI - A clinical trial of ketotifen in Indian extrinsic asthmatic adults. PMID- 3546107 TI - Use of plastic kits for rapid recovery of streptococci in epidemiological studies. PMID- 3546108 TI - Comparison of two methods for the detection of Hert labile enterotoxin of enterotoxigenic E. coli from infantile diarrhoea. PMID- 3546109 TI - Renal allograft rejection. A light microscopic study of 12 cases. PMID- 3546110 TI - Isolation and evaluation of antigens from microfilaraemia plasma and immune complexes for diagnosis of bancroftian filariasis. PMID- 3546111 TI - Cardiotoxicity of streptolysin O of group A and group C haemolytic streptococci. PMID- 3546112 TI - Antibody response of guinea pigs to fluid and adsorbed tetanus toxoids. PMID- 3546113 TI - Plasmids coding for enterotoxins, hemolysins and hemagglutinins and their role in virulence and pathogenicity of Escherichia coli. PMID- 3546114 TI - Isolation of bacteria of public health significance from some pork products. PMID- 3546115 TI - Biotyping, klebocin typing and antibiogram pattern of clinical isolates of Klebsiella pneumoniae. PMID- 3546116 TI - Prevention of post-asphyxial hypoxic-ischemic encephalopathy. PMID- 3546117 TI - Invasive bacterial diarrhea in Bangalore. PMID- 3546118 TI - Alcohol consumption and hypertension. AB - An increased prevalence of hypertension in groups with high alcohol consumption has been recognized for a number of years. More recently, several studies have suggested an independent association between alcohol consumption and blood pressure levels in samples from general populations. Of 30 cross-sectional population studies reviewed, the majority reported small but significant elevations in blood pressure in those consuming three drinks or more per day in comparison with nondrinkers. In 25% of studies, elevations in blood pressure were also reported at lower levels of consumption; in about 40%, the blood pressure of nondrinkers was greater than that of those consuming one to two drinks per day. In two studies, one from the United States and one from Australia, the maximum contribution to the prevalence of hypertension of alcohol consumption greater than two drinks per day was estimated to be 5 to 7%; the contribution in men (11%) was greater than that in women because of their greater alcohol consumption. A prospective association of alcohol consumption with change in blood pressure was observed in five studies. In a small number of experimental studies, short-term falls in blood pressure accompanied alcohol restriction in both normotensive and hypertensive subjects. Uncontrolled observations in heavy drinking populations suggest that the effect on blood pressure of alcohol withdrawal may be lasting. However, firm conclusions about the long-term effects of alcohol restriction, particularly in moderate consumers who represent a large proportion in many populations, must await long-term controlled trials. PMID- 3546119 TI - Influence of blood pressure on development of aortic medial smooth muscle hypertrophy in spontaneously hypertensive rats. AB - The hypothesis that a primary stimulus for aortic medial hypertrophy in spontaneously hypertensive rats (SHR) is increased blood pressure was tested by determining whether development of smooth muscle cell hypertrophy and hyperploidy in SHR could be dissociated from blood pressure levels in rats treated with various antihypertensive drugs with different mechanisms of action. Wistar-Kyoto rats (WKY) and SHR were treated between 2 and 5 months of age with captopril (375 mg/L), hydralazine (40 mg/L), or propranolol (1.5 mg/L) administered in their drinking water. Smooth muscle hypertrophy and hyperploidy were analyzed by morphometric evaluation of medial smooth muscle content, flow cytometric analysis of the frequency of polyploid smooth muscle cells, and biochemical estimates of smooth muscle cell number. All drugs significantly lowered blood pressure in SHR compared with untreated controls (order of efficacy: captopril greater than hydralazine greater than propranolol). Captopril also was most effective at changing blood pressure in WKY, while propranolol and hydralazine had similar blood pressure-lowering effects. The efficacy of drugs in preventing the development of smooth muscle cell polyploidism and medial hypertrophy in SHR was the same as their efficacy in lowering blood pressure, although propranolol had no effect on medial smooth muscle hypertrophy despite lowering blood pressure by 26 mm Hg. Regression analyses showed a high degree of correlation between blood pressure and the frequency of polyploid smooth muscle cells and medial smooth muscle content. These results are consistent with the hypothesis that aortic medial hypertrophy may be, in part, a response to increased blood pressure or wall stress. However, analysis of covariance and two-stage multiple regression analyses indicated that captopril had an effect over and above that predicted by its blood pressure-lowering effect. Furthermore, propranolol lowered blood pressure but did not affect medial hypertrophy. These results suggest that smooth muscle hypertrophy is not simply a response to increased blood pressure, but that other factors, such as angiotensin II, may be important in modulating aortic medial hypertrophy in SHR. PMID- 3546121 TI - Effects of mesencephalic lesion on the histomorphology of testis and spermatogenesis. AB - Mesencephalic reticular formation lesions were produced bilaterally by using two epoxy-coated stainless steel electrodes. Electrolytic lesions resulted in atrophy of testes, and decreased spermatogenesis. Seminiferous tubules of lesioned rats were characterised by a general decrease in the number of cells from different generation of germinal epithelium, empty spaces, degeneration of spermatogonia, degeneration of spermatocytes I and of young spermatids. There were significant reductions in weights of the testes (P less than 0.01). Similarly the areas of cross-sections of seminiferous tubules were significantly reduced (P less than 0.05). Another note-worthy feature was a gross reduction in the complete cross section count of interstitial cells. The study strongly suggests that the mesencephalic reticular formation influences the testes and spermatogenesis. PMID- 3546120 TI - Antihypertensive and volume-depleting effects of mild exercise on essential hypertension. AB - After a general clinical observation period of over 4 weeks, 20 essential hypertensive subjects (Japanese) were randomly divided into two groups. One group (n = 10; 4 men and 6 women; 51.4 +/- 2.8 years of age) agreed to physical training using bicycle ergometer exercise with the intensity at blood lactate threshold for 60 minutes three times a week for 10 weeks, while the other group (n = 10; 4 men and 6 women; 51.0 +/- 2.9 years of age) did no particular physical training and was followed once a week as the control. Changes in blood pressure, hemodynamics, and humoral factors of the exercised group were compared with values in the controls. The following significant changes were found only in the exercised group. Blood pressure was significantly (p less than 0.01) reduced. Whole blood and plasma volume indices were significantly reduced (p less than 0.05, p less than 0.01, respectively). The change in ratio of serum sodium to potassium positively correlated with the change in systolic blood pressure (r = 0.76, p less than 0.02). Plasma norepinephrine concentrations both at rest and at the workload of blood lactate threshold during graded exercise tests were significantly reduced (p less than 0.05, p less than 0.02 respectively) after 10 weeks of exercise training. The change in the resting level of plasma norepinephrine positively correlated with that in the mean blood pressure. No such changes were observed in the control group. In both groups, body weight and urinary sodium excretion showed no statistically significant changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546122 TI - Serum phenytoin levels with different brands. AB - Four brands of phenytoin were studied in 60 newly diagnosed epileptic patients randomly and equally placed in 4 groups. Serum phenytoin levels were estimated by EMIT and spectrophotometric methods both of which gave close values with good correlation (r = 0.985). Average serum levels and the incidence of remission achieved with the 4 brands varied within statistical scatter; thus these 4 brands manifested equivalent therapeutic efficacy. In 22 patients serum level was less than 5 micrograms/ml, in 9 of whom attacks remained uncontrolled. In 38 patients serum level exceeded 5 micrograms/ml in 2 of whom attacks were uncontrolled. In 44 out of 60 patients the 2 weeks serum levels were significantly higher (P less than 0.001 by paired t-test) than those after 3 months. In the remaining 16 patients the serum levels at 3 months were significantly higher than at 2 weeks levels (P less than 0.01). PMID- 3546123 TI - What is an accident? PMID- 3546124 TI - The use of an oral prostaglandin inhibitor following splintage in fractures of the distal radius--a prospective trial. AB - A prospective, double-blind, controlled trial is reported in which oral diclofenac, a prostaglandin inhibitor, was given for 1 week immediately following the removal of splintage for fracture of the distal end of the radius. The patients who received the prostaglandin inhibitor had less pain, a more rapid recovery of range of movement and a stronger grip than those who received a placebo. PMID- 3546126 TI - Medical antishock trousers (MAST): a review. AB - A review of the literature on medical antishock trousers (MAST) is presented together with a report on their use at Hope Hospital, Salford. Their relevance in British emergency management and future uses are considered. PMID- 3546125 TI - Use of sterile gloves in the management of sutured hand wounds in the A&E department. AB - In a single-blind, controlled, prospective trial of 242 sutured wounds of the hand in the A&E department there was increased late purulent infection in those treated without gloves. This difference is statistically significant. We recommend wearing of sterile gloves to suture all wounds in A&E departments. PMID- 3546127 TI - Ultrasound in abdominal injury in children. AB - Ultrasonography has been used as an investigation in children with abdominal signs after blunt injury. Sixteen children were examined, of whom nine had abnormal findings. Free intraperitoneal fluid was demonstrated in four cases. The injuries found are detailed and subsequent management of the patients is described. The children with normal scans settled with no sequelae. It is suggested that ultrasonography offers a valuable, non-invasive method of investigating blunt abdominal injury. PMID- 3546128 TI - Post-traumatic meningitis in children. AB - A retrospective survey over a 66-month period of children admitted with head injury who subsequently developed meningitis within the same period yielded six cases (five boys, one girl), giving an incidence of 0.38 per cent. Two of the six died, and four survived with no sequelae. Four cases occurred within the first week. One patient, who had received prophylactic antibiotics, developed Escherichia coli meningitis after 14 days and one had meningitis 2 years after the head injury. The most common organism was pneumococcus (four cases). Three patients had periorbital haematomas and none had cerebrospinal fluid leakage. Increasing drowsiness and fever were the most consistent features. Radiography of the skull was of little use in demonstrating fracture of the base of the skull. Two of the four surviving patients had craniotomy with successful dural repair. PMID- 3546129 TI - Biological and immunochemical identity of M protein on group G streptococci with M protein on group A streptococci. AB - Previous evidence for the presence of an M or M-like protein on group G streptococci has been based on the ability of these strains to survive in human blood. In addition, cross-reactions between group A and group G streptococci have been demonstrated, but they have relied either on whole bacterial cell vaccine induced polyclonal sera or crude protein extracts of these cells. In this study two monoclonal antibodies prepared against the purified, native group A streptococcal M6 protein demonstrated a high degree of cross-reactivity with group G streptococcal clinical isolates (9 and 19 of 22 strains examined, respectively). Ten of these strains exhibited resistance to phagocytosis when rotated in human blood. In addition, immunoblot analysis of crude mutanolysin extracts of group G streptococci with one of the M6 monoclonal antibodies illustrated a remarkable similarity in the protein pattern of these extracts as compared with those of group A streptococcal M protein. The immunoblots further demonstrated a variation in the relative molecular weights of the extracted proteins from strain to strain over a range of 57,000 to 77,000. In addition, a purified, pepsin-derived fragment (Mr, 43,000) from a group G strain was capable of eliciting rabbit antibodies that were opsonic for group G cells in a bactericidal assay. These functional and immunochemical data, in concert with DNA hybridization between group G streptococcal DNA and a group A M6 gene probe (J. R. Scott, W. M. Pulliam, S. K. Hollingshead, and V. A. Fischetti, Proc. Natl. Acad. Sci. USA 82:1822-1826, 1985), provide strong evidence for the presence of an M protein on these organisms and indicate its probable role as a virulence molecule on the surface of group G streptococci. PMID- 3546130 TI - Plasmid-mediated early killing of eucaryotic cells by Shigella flexneri as studied by infection of J774 macrophages. AB - In Shigella flexneri a 220-kilobase plasmid encodes the ability to invade nonprofessional phagocytes by a mechanism similar to phagocytosis. In this report, the continuous macrophage cell line J774 was used to study the intracellular fate of both invasive and noninvasive strains. pWR100, the virulence plasmid of S. flexneri serotype 5, mediated very efficient and rapid killing of J774 macrophages, as measured by cellular detachment and uptake of trypan blue. For this to occur, the bacteria had to be within the cells, since the macrophages were protected by cytochalasin D. A battery of strains differing in their levels of Shiga toxin production showed that inhibition of protein synthesis by Shiga toxin, as measured by [35S]methionine incorporation into infected macrophages, was not required for early killing of cells. Damage to J774 macrophages rather correlated with the ability of invasive bacteria to rapidly and efficiently lyse the membrane of the phagocytic vacuole. The role of the release of bacteria within the cytosol for subsequent expression of cytotoxic activity is discussed, and mitochondria are proposed as a potential target for this activity. PMID- 3546131 TI - Impairment of the oxidative metabolism of mouse peritoneal macrophages by intracellular Leishmania spp. AB - When stimulated in vitro with macrophage-activating factor or lipopolysaccharide, mouse peritoneal macrophages acquire the capacity to develop a strong respiratory burst when they are triggered by membrane-active agents. The presence of intracellular parasites of the genus Leishmania (L. enriettii, L. major) significantly inhibited such activity, as measured by chemiluminescence, reduction of cytochrome c and Nitro Blue Tetrazolium, and hexose monophosphate shunt levels. On the contrary, inert intracellular particles such as latex beads strongly increased the macrophage respiratory burst, suggesting that the Leishmania-linked inhibition resulted from a specific parasite effect. Impairment of macrophage oxidative metabolism by intracellular Leishmania spp. was a function of the number of infecting microorganisms and was more pronounced in macrophages infected with living than with dead parasites. Moreover, the metabolic inhibition was less apparent in L. enriettii-infected macrophages that were exposed to both macrophage-activating factor and lipopolysaccharide, i.e., conditions leading to complete parasite destruction. The mechanisms of respiratory burst inhibition by intracellular Leishmania spp. are unclear, but these observations suggest that such effects may contribute significantly to intracellular survival of the microorganisms. PMID- 3546132 TI - Antigenic differences between mannoproteins of germ tubes and blastospores of Candida albicans. AB - To determine the nature of germ tube-specific antigens of Candida albicans, procedures for intrinsically labeling cell wall antigens metabolically were developed. Blastospores or germ tubes labeled either in their proteins with L [35S]methionine or in mannose-containing carbohydrates with D[2-3H]mannose contained surface components similar to those found previously with 125I-labeled organisms. Germ tube-specific determinants, were found on a 200-kilodalton protein in digests from germ tubes, whereas a component of similar molecular size in blastospore extracts reacted weakly or not at all with germ tube-specific antibody. In addition, a glycan fraction prepared from germ tubes reacted with the unadsorbed anti-C. albicans polyvalent antibody but not with the germ tube specific antibody, suggesting that the germ tube-specific determinants are not carbohydrates. PMID- 3546134 TI - Prophylactic administration of interleukin-2 protects mice from lethal challenge with gram-negative bacteria. AB - Prophylactic administration of recombinant human interleukin-2 (IL-2) in mice enhanced survival and produced complete recovery from an otherwise lethal acute bacterial infection. IL-2 was administered as a single intraperitoneal or intravenous bolus dose to CDI mice 18 h before challenge with a lethal dose of a clinical isolate of Escherichia coli type O2 (minimal 100% lethal dose, 6 X 10(7) CFU per mouse). At IL-2 dosages of 7 X 10(6) U/kg, 90% of treated CDI mice survived as compared to 0% for the excipient buffer control animals (P less than 0.001). This protective effect was also demonstrable in immune-deficient beige mice. The IL-2 effect was dose dependent; protection was consistently observed in mice pretreated with IL-2 at doses ranging from 1.8 X 10(6) to 7 X 10(6) U/kg. However, at 3.5 X 10(5) U/kg the protective effect was more variable. The route of administration of IL-2 was shown to play an important role; when IL-2 and challenge bacteria were given by the same route (either intravenously or intraperitoneally), protection was readily observable, but when IL-2 and challenge bacteria were given by different routes, little or no protective effect was observed. The protective effect was fully inducible as early as 1 h after IL 2 administration and was effective against various strains of gram-negative bacteria, indicating that the probable mode of action represents control of the establishment of infection by increased activity of the nonspecific host defense mechanisms. The IL-2 effect was abrogated by the administration of carrageenan, suggesting a possible role of macrophages. These data demonstrate that IL-2 may be a potentially useful adjunct for the prophylaxis of bacterial infections in both clinical and veterinary medicine. PMID- 3546133 TI - Enzymatic and antigenic characterization of immunoglobulin A1 proteases from Bacteroides and Capnocytophaga spp. AB - Bacteroides and Capnocytophaga species have been implicated as periodontal pathogens. Some of these species possess immunoglobulin A1 (IgA1) proteases that are capable of cleaving the human IgA1 molecule in the hinge region, leaving intact Fc alpha and Fab alpha fragments. The purpose of this study was to characterize this activity. In addition to IgA1 protease activity in already known species, IgA1 protease activity was a feature of Bacteroides buccalis, Bacteroides oralis, Bacteroides veroralis, Bacteroides capillus, and Bacteroides pentosaceus. Results of immunoelectrophoretic and sodium dodecyl sulfate polyacrylamide gel electrophoretic analyses suggested that all species cleave the alpha-chain at the same peptide bond, i.e., the prolyl-seryl bond between residues 223 and 224 in the hinge region. The Bacteroides proteases could be classified as thiol proteases, which were at the same time dependent on metal ions, while the Capnocytophaga proteases were metallo enzymes. None of the proteases were inhibited by the physiologic proteases inhibitors alpha 2 macroglobulin and alpha 1-proteinase inhibitor. Investigations with enzyme neutralizing antibodies raised in rabbits against protease preparations from the respective type strains revealed that, despite otherwise identical characteristics, the IgA1 protease of each Bacteroides species was antigenically distinct. Bacteroides buccae and the two later synonymous species B. capillus and B. pentosaceus produced identical proteases. In contrast, IgA1 proteases from Capnocytophaga ochracea and Capnocytophaga sputigena strains were apparently identical, while Capnocytophaga gingivalis had a protease that differed from those of the other Capnocytophaga species. PMID- 3546135 TI - Variable severity and Ia antigen expression in streptococcal-cell-wall-induced hepatic granulomas in rats. AB - We have previously reported that a single intraperitoneal injection of an aqueous suspension of group A streptococcal cell wall (SCW) fragments induces extensive hepatic granulomas in LEW/N female rats, but not in F344/N female rats. To further understand the mechanisms underlying these differences, we compared granuloma development and class II major histocompatibility complex antigen (Ia) expression in histocompatible LEW/N, F344/N, and CAR/N female rats in response to SCW fragments of four different average molecular sizes. In LEW/N female rats, the smallest fragments (less than 5 megadaltons) induced the most severe hepatic inflammatory disease, with development of widespread granulomas composed of macrophages, lymphocytes, and a peripheral rim of fibroblasts. The largest fragments (greater than 500 megadaltons) induced equivocal disease. Fragments of intermediate size induced granulomas of intermediate severity. The extent of granuloma development, the intensity of Ia antigen expression, and the amount of SCW antigen deposited in the liver qualitatively paralleled each other. In contrast, injection of the most granulomagenic SCW fragments into F344/N and CAR/N rats did not induce granulomas. Although these rat strains are histocompatible with the LEW/N (i.e., RTL.1) strain, hepatic Ia antigen expression in these strains was not increased significantly above basal levels. The amount of SCW antigen in the livers of the resistant rat strains appeared similar to the amount in the susceptible LEW/N strain. These data indicate that granuloma development is dependent on the size of the SCW fragment and host genetic background and that Ia expression directly parallels the severity of the hepatic disease. In addition, the data suggest that non-major histocompatibility complex genetic loci play a major role in regulating the development of the hepatic disease. PMID- 3546136 TI - Intracellular fate of Mycobacterium leprae in normal and activated mouse macrophages. AB - Mycobacterium leprae replicates within mononuclear phagocytes, reaching enormous numbers in the macrophage-rich granulomas of lepromatous leprosy. To examine the capability of macrophages to digest M. leprae, we studied the intracellular fate of M. leprae organisms in normal and activated mouse macrophages by using the electron-dense secondary lysosome tracer Thoria Sol. Intracellular M. leprae organisms, surrounded by a characteristic electron-transparent zone, were contained within phagosomal vacuoles of macrophages cultured in vitro for 1 to 6 days. In normal macrophages, a majority of phagosomes containing freshly isolated live M. leprae cells resisted fusion with Thoria Sol-labeled lysosomes. The extent of fusion was not significantly affected by pretreatment of M. leprae with human patient serum high in specific immunoglobulin G and M antibodies. In contrast, a majority of phagosomes containing gamma-irradiated M. leprae cells underwent lysosome fusion in normal macrophages. In addition, increased phagolysosome fusion was observed with live M. leprae-containing phagosomes in macrophages activated with gamma interferon. Increased fusion was associated with an increase in the number of fragmented and damaged bacilli, suggesting that increased digestion followed fusion. This study indicates that activated macrophages may have an increased capacity for clearance of normally resistant M. leprae. PMID- 3546137 TI - Isolation and characterization of a protease from Bacteroides gingivalis. AB - A protease was purified from Bacteroides gingivalis ATCC 33277 culture fluid by sequential procedures including ammonium sulfate precipitation, ion-exchange chromatography, and isoelectric focusing. The enzyme was active against benzoyl-L arginine-p-nitroanilide, carbobenzoxy-L-phenylalanyl-L-valyl-L-arginine-p nitroanilide azoalbumin, azocasein, azocoll, and p-tosyl-L-arginine methyl ester. The molecular weight of the enzyme was about 300,000 as determined by gel filtration. Its isoelectric point was 5.0. The maximum activity was found at pH 7.5, and the optimum temperature for activity was between 40 and 45 degrees C. The apparent Km value for benzoyl-L-arginine-p-nitroanilide was 2 mM. The enzyme was inhibited by sulfhydryl group-blocking reagents, tosyl-L-lysine chloromethyl ketone, and EDTA. Soybean trypsin inhibitor and diisopropylfluorophosphate were not inhibitory. PMID- 3546138 TI - Histoenzymological study of selected dehydrogenase enzymes in Pneumocystis carinii. AB - The metabolic activity of Pneumocystis carinii cysts was studied histochemically by a tetrazolium dye technique to assess substrate-specific dehydrogenase activity. Lactate dehydrogenase, succinate dehydrogenase, and glutamate dehydrogenase produced moderate-to-strong reactions in the cysts, whereas glucose 6-phosphate dehydrogenase had little if any reactivity. These results suggest that pneumocystis cysts have some of the enzymes necessary for glycolysis, Krebs cycle activity, and intermediary protein metabolism. These studies provide a method of directly assessing metabolic pathways in P. carinii which circumvents the uncertainties of specificity inherent in previous investigations with partially purified suspensions. PMID- 3546139 TI - Production, characterization, and antibody specificity of a mouse monoclonal antibody reactive with Cryptococcus neoformans capsular polysaccharide. AB - Two monoclonal immunoglobulin G1 antibodies reacting with Cryptococcus neoformans capsular polysaccharide (CNPS) were produced in mice by using a carefully defined procedure for immunization with unmodified CNPS purified from C. neoformans serotype A. Since the antibodies were found to have the same pattern of specificity, only one of them (E1) is described. This anti-CNPS monoclonal antibody reacted with the glucuronoxylomannan component of CNPS but not with the constituent monosaccharides or with the mannose alpha(1----3)-linked oligosaccharide structures present on CNPS. E1 appeared to be specific for C. neoformans serotype A by agglutination of whole cells; it was specific for soluble CNPS A by gel immunoprecipitation. However, indirect immunofluorescence and competitive-binding enzyme-linked immunosorbent assay experiments showed low levels of cross-reactivity with serotypes B and D but not with serotype C. Concentrations 10,000 times higher for serotypes B and D cells than for serotype A cells were required for a 50% inhibition of E1 anti-CNPS A activity as measured by enzyme-linked immunosorbent assay. Among the other yeasts tested, a cross reaction was only detected with Trichosporon beigelii. The four serotypes of C. neoformans could be distinguished based on intensities and patterns of fluorescence in an indirect immunofluorescence assay using the monoclonal anti CNPS A antibody. Monoclonal anti-CNPS A antibodies could be useful for fundamental studies on the glucuronoxylomannan structure, as well as for clinical applications such as serotyping and possibly the serological diagnosis of cryptococcosis. PMID- 3546140 TI - Protection of mice against experimental cryptococcosis by anti-Cryptococcus neoformans monoclonal antibody. AB - Humoral immunity does not play a prominent role during experimental cryptococcosis. However, previous studies have shown that immunoglobulin G (IgG) anti-Cryptococcus neoformans antibodies can mediate cell-dependent yeast killing in vitro. Therefore, the protective effect of a previously described monoclonal IgG1 anti-C. neoformans antibody (E1) administered intraperitoneally 24 h before intravenous infection with a C. neoformans serotype A strain was evaluated in mice. Heavily infected (3 X 10(6) cells) untreated mice died in 2.9 +/- 0.5 (standard deviation) days. Survival time was 17.9 +/- 1.6 days for mice treated with 100 micrograms of E1 and 3.0 +/- 0.7 days for mice treated with 100 micrograms of a monoclonal IgG1 anti-thyroglobulin antibody used as a control. Protection was dose dependent and required at least 10 micrograms of E1 (mean antibody concentration in serum +/- standard deviation, 6.6 +/- 2.3 micrograms/ml). Insufficient concentrations of IgG anti-C. neoformans antibody could explain previous negative results obtained with polyclonal immune serum. After infection with a smaller inoculum (5 X 10(3) to 5 X 10(4)), the protective effect of E1 was confirmed by the presence of fewer CFUs in the spleens and brains of treated mice than in those of controls. CFU were still detected in the brains of protected mice 5 days after infection, although soluble antigen was negative in sera. These results suggest that passive serotherapy with monoclonal IgG antibodies could participate in the prevention or treatment of experimental cryptococcosis. PMID- 3546141 TI - Purification and partial characterization of the multicomponent dextranase complex of Streptococcus sobrinus and cloning of the dextranase gene. AB - The presence of proteases in culture supernatant fluids and on the cell surface of Streptococcus sobrinus and the aggregation of multicomponent enzyme complexes make the isolation and characterization of cell surface proteins difficult. We report a simple purification procedure for dextranase and the cloning of the dextranase structural gene. S. sobrinus culture supernatant fluids were precipitated with 70% ammonium sulfate, and the precipitate was dialyzed against sodium acetate buffer and loaded onto a hemoglobin-Sepharose 4B column connected to a blue dextran-agarose column at 4 degrees C. After being washed with low concentrations of salt, the dextranase and the dextran-binding proteins were eluted with 5 M KI and further purified by gel filtration. Two dextranases (molecular weights, 175,000 and 160,000) were purified and partially characterized. The structural gene for the dextranase of S. sobrinus 6715 strain UAB66, serotype g, was cloned into the cosmid vector, pHC79. Clones were selected for expression of dextranase activity by detection of zones of enzyme-mediated hydrolysis of a blue dextran substrate incorporated into minimal medium agar plates. Release of dextranase was achieved by induction of thermoinducible, excision-defective Escherichia coli K-12 lysogens containing recombinant cosmid molecules of S. sobrinus DNA. Recombinant cosmid molecules were repackaged simultaneously into infectious lambdoid particles. Recombinant clones expressing dextranase activity which varied in size from the high-molecular-weight protein produced by S. sobrinus (i.e., 175,000) to lower-molecular-weight forms expressed by S. sobrinus have been identified and partially characterized. PMID- 3546142 TI - Protective immunity induced by outer membrane proteins of Salmonella typhimurium in mice. AB - Outer membrane proteins (OMP) extracted from both smooth (C5) and rough (Rb2) strains of Salmonella typhimurium were able to induce protective immunity to salmonellosis. The OMP-induced protection lasted for at least 6 months. The antibody level was estimated by passive hemagglutination. In the C5 OMP-immunized mice, antibodies to both proteins and lipopolysaccharide were detected. On the other hand, in the Rb2 OMP-immunized mice, antiprotein but not antilipopolysaccharide antibodies were detected. Delayed-type hypersensitivity appeared as early as the second week after immunization with OMP and persisted through the fourth week. PMID- 3546143 TI - Immunologic cross-reactivity of type A streptococcal exotoxin (erythrogenic toxin) and staphylococcal enterotoxins B and C1. AB - Immunologic cross-reactivity between Streptococcus pyogenes type A exotoxin (erythrogenic toxin) and Staphylococcus aureus enterotoxins B and C1 was demonstrated by Ouchterlony double diffusion, Western immunoblot, and immunodot analyses. Specific antiserum to type A streptococcal exotoxin reacted more strongly with staphylococcal enterotoxin B than with enterotoxin C1. The reactivity of type A streptococcal exotoxin with antiserum to staphylococcal enterotoxin B was greater than that of antiserum to enterotoxin C1. These results suggest that a conserved domain is present in the three exotoxins, which most likely originated from a common evolutionary ancestor. PMID- 3546144 TI - Empiric antimicrobial therapy in febrile granulocytopenic patients. Randomized prospective comparison of amikacin plus piperacillin with or without parenteral trimethoprim/sulphamethoxazole. AB - In a prospective randomized trial parenteral trimethoprim/sulphamethoxazole was added to amikacin plus piperacillin in order to compare triple-drug antibiotic combination with a standard regimen as empiric therapy of fever in patients with granulocytopenia. One hundred and sixty-one episodes were evaluated; 74 episodes with amikacin plus piperacillin and 87 episodes with amikacin plus piperacillin plus trimethoprim/sulphamethoxazole. The overall response to therapy (63% vs. 84%) as well as the response of microbiologically documented infections (60% vs. 82%) was significantly better in patients treated with the triple-drug combination (p less than 0.05). However, no statistically significant differences in response to antibiotics at different infection sites or with regard to any single pathogen was found between the two groups. Trimethoprim/sulphamethoxazole seemed to be responsible for additional toxicity (nausea and vomiting) when added to amikacin plus piperacillin, but these side-effects were clearly related to the rate of infusion of trimethoprim/sulphamethoxazole. The findings of this study support the use of a three-drug versus a two-drug combination as empiric antibiotic regimen in febrile granulocytopenic patients. PMID- 3546146 TI - Efficacy of ofloxacin (HOE 280) in a model of subcutaneous abscess: penetration and prevention of abscess formation. AB - A mouse model of subcutaneous abscess was used to determine the penetration into the abscess and the preventive value of ofloxacin (Hoe 280). Sterile cecal contents were injected subcutaneously combined with three different types of inoculum: Bacteroides fragilis, Escherichia coli and E. coli plus B. fragilis. For penetration studies three doses of 20 mg/kg of ofloxacin were administered intraperitoneally 8 hourly after abscesses had formed. Serum levels at 10, 20, 30, 60 and 90 min after the last dose showed mean values of: 6.9, 4.7, 3.8, 2.35 and 1.08 mg/l respectively. Simultaneously assessed ofloxacin abscess levels were 3.6, 4.1, 2.4, 1.91 and 1.98 mg/kg. In order to evaluate its preventive value, ofloxacin was given intraperitoneally at doses of 20 mg/kg in four regimens. Regimen A: one dose immediately before injection of the inoculum; regimen B: one dose 4 h after the injection of the inoculum; regimen C: one dose immediately before and two doses 8 h and 16 h after injection of the inoculum and regimen D: one dose 4 h, 12 h and 20 h after injection of the inoculum. The results are expressed as the percentage of the reduction in the number of abscesses formed in the survivors versus the control groups: regimens A) 30 to 70%; B) 0 to 40%; C) 50 to 60%, and D) 10 to 60%. The viable bacterial counts in the abscess contents were also assessed. PMID- 3546147 TI - A double-blind randomized study comparing ofloxacin and amoxicillin in treating infective episodes in bronchiectasis. AB - 32 hospitalized adult patients with infective episodes of bronchiectasis were enrolled in an ongoing double-blind, placebo-controlled study comparing ofloxacin with amoxicillin. They were randomized to receive either 200 mg ofloxacin or 1 g amoxicillin, both t.i.d. orally for ten days. In the ofloxacin group (15 patients), clinical response was excellent (clinical cure) in 11 and fair (clinical improvement or early reinfection) in three patients with one failure. In the amoxicillin group (17 patients), clinical response was excellent in six, fair in five, and poor (treatment failure) in six patients. Ofloxacin levels at 2 h (day 5) were 2.3 to 8.2 mg/l (mean 3.9 mg/l) for serum and 1.3 to 15 mg/l (mean 4.5 mg/l) for sputum. Sputum: serum ratio was 1.2:1. Amoxicillin levels at 2 h were 10 to 40 mg/l (mean 19.9 mg/l) for serum and 0 to 1.5 mg/l (mean 0.3 mg/l) for sputum, with no amoxicillin detected in sputum in 10 of 17 patients. Sputum: serum ratio was 0.02:1. One patient in the ofloxacin group had nausea. In the amoxicillin group, four patients had nausea and stomach pain, one had vertigo and one had transient peripheral eosinophilia. Ofloxacin thus yielded higher sputum concentration and appeared to be more effective and better tolerated than amoxicillin in infective episodes of bronchiectasis. PMID- 3546145 TI - The comparative activity of pefloxacin, enoxacin, ciprofloxacin and 13 other antimicrobial agents against enteropathogenic microorganisms. AB - In this study, we compared the activity of pefloxacin, enoxacin and ciprofloxacin against 269 enteropathogenic strains (Campylobacter jejuni, enteropathogenic Escherichia coli, Salmonella typhi, Shigella spp., Vibrio cholerae and Yersinia enterocolitica) with that of rosoxacin, flumequin, nifuroxazide, erythromycin, chloramphenicol, ampicillin, cefotaxime, tetracycline, amikacin, netilmicin, sulfamethoxazole, trimethoprim and co-trimoxazole. Pefloxacin, enoxacin and ciprofloxacin were always among the most active compounds. Furthermore, resistant strains or strains with elevated MIC values were not found. The MIC90 value for these three compounds was less than or equal to 0.25 mg/l, except for C. jejuni where it was 0.3 mg/l and 1.4 mg/l for pefloxacin and enoxacin, respectively. PMID- 3546149 TI - A multicenter study on clinical efficacy of ofloxacin in respiratory and urinary tract infections. AB - A multicenter trial on the efficacy and tolerability of ofloxacin in upper and lower respiratory tract infections and urinary tract infections was carried out on 1,436 patients (926 males and 510 females; mean age 55.9 +/- 18.4 years). Three dosage regimens were randomly applied: 200 mg, 300 mg and 400 mg ofloxacin b.i.d. by the oral route. The overall clinical outcome expressed as the ratio of the number of patients cured and improved to the number of patients treated was 279/324 (86%) in upper respiratory tract infections; 612/667 (91.8%) in lower respiratory tract infections and 418/445 (93.9%) in urinary tract infections. Out of 872 bacterial strains isolated in 802 patients, 742 (85.1%) were eradicated. Side effects not requiring interruption of therapy were observed in 65 patients (4.5%), while interruption was necessary in 23 patients (1.6%). The most frequent side effects were gastrointestinal disturbances. In conclusion ofloxacin showed a good clinical efficacy and tolerability in the treatment of respiratory and urinary tract infections. PMID- 3546148 TI - Treatment of surgical infections with a modern quinolone: therapy of soft tissue infections and pneumonia with ofloxacin. AB - A randomized, open, prospective study including 45 patients with either soft tissue infections (29 cases) or pneumonia (15 cases) after surgical intervention and one case having both indications was carried out with ofloxacin. The standard dose was 200 mg ofloxacin b. i. d. In most cases, clinical symptoms, such as fever, rubor, swelling and pain in soft tissue infections, as well as fever, dyspnoea, physical and radiological signs for pneumonia, subsided within two to seven days. Laboratory data (blood analyses, liver enzymes) remained in the normal range. The overall tolerability was good. Bacteriological controls have proven that ofloxacin is able to eradicate a broad range of pathogens, including persister pathogens and also certain bacteria like Clostridium perfringens and Erysipelothrix rhusiopathiae. In our study, Streptococcus faecalis was of intermediate sensitivity in one case and resistant in another. Ofloxacin has proven to be effective in soft tissue infections and pneumonia after surgical intervention. PMID- 3546150 TI - Clinical experience with ofloxacin in urinary tract infection. AB - Preliminary data from the U.S. regarding the safety and efficacy of ofloxacin in the treatment of urinary tract infections are presented. Treatment of uncomplicated urinary tract infections with either 200 mg or 300 mg ofloxacin b.i.d. was as effective as treatment with a standard therapy, co-trimoxazole. In another series of patients with underlying abnormalities of the urinary tract, ofloxacin therapy resulted in fewer failures and relapses than co-trimoxazole treatment. Ofloxacin was well tolerated in these studies. PMID- 3546151 TI - Clinical evaluation of ofloxacin versus ciprofloxacin in complicated urinary tract infections. AB - Ofloxacin was administered to 18 patients and ciprofloxacin to 17 patients suffering from acute or chronic complicated urinary tract infections. Patients received doses of 100 mg ofloxacin, b.i.d., or 250 mg ciprofloxacin, b.i.d., for seven days. The clinical and bacteriological response were evaluated after 17 days. Resolution of symptoms were found in approximately 60% of cases for both treatments and bacteriological eradication was 66% for ofloxacin and 50% for ciprofloxacin. Side-effects such as itching and rash were reported in three cases. The results indicate that ofloxacin and ciprofloxacin are safe and effective agents in the treatment of complicated urinary tract infections. PMID- 3546152 TI - Clinical experience with ofloxacin (DL 8280) in the therapy of various infections: preliminary report. AB - Thirteen hospitalized patients with various infections, five with typhoid fever, two with gastroenteritis, four with respiratory tract infection and two with biliary tract infection, were treated with ofloxacin at a daily dosage ranging between 600 and 900 mg orally. 12 patients completely recovered from the infection, and the pathogens were eradicated. Treatment failed in one patient suffering from respiratory tract infection. No side effects were recorded. In these cases ofloxacin can be considered as a safe and effective antimicrobial agent. PMID- 3546153 TI - Clinical experience with ofloxacin in sexually transmitted disease. AB - Experience with ofloxacin in the United States in the treatment of sexually transmitted diseases is reviewed. In one study, a single oral dose of either 400 mg or 600 mg eradicated Neisseria gonorrhoeae in all 43 evaluable patients. In another multicenter study a seven-day course of ofloxacin 300 mg b.i.d. was as effective as a seven-day course of doxycycline 100 mg b.i.d. in eradicating N. gonorrhoeae, Chlamydia trachomatis and, in men, Ureaplasma urealyticum. Because of increasing problems with antimicrobial resistance, particularly among strains of N. gonorrhoeae, ofloxacin, with its unique mechanism of action, and its broad spectrum activity against pathogens, may prove useful in the treatment of sexually transmitted diseases. PMID- 3546155 TI - Single dose ofloxacin in treatment of uncomplicated gonorrhoea. AB - 78 patients (66 male and 12 female) suffering from uncomplicated gonorrhoea were randomly selected to receive a single oral dose of either 400 mg or 600 mg ofloxacin. Of the 59 patients completely followed up penicillinase-producing Neisseria gonorrhoeae strains were cultured in 15 (25.4%) and the overall cure rate was 100%. Both groups showed excellent clinical effectiveness in over 80% and adverse reactions were uncommon and transient. We conclude that a single oral dose of ofloxacin in the studied dosage regimens was highly effective and safe in the treatment of uncomplicated gonorrhoea. PMID- 3546154 TI - Efficacy of ofloxacin in uncomplicated gonorrhoea. AB - A randomised double blind trial comparing single oral dose therapy with 200 mg and 400 mg of ofloxacin, respectively was conducted at the Bangrak Hospital, Bangkok during the period December 6, 1985 to January 24, 1986. We treated 234 male patients diagnosed as having uncomplicated gonococcal urethritis with ofloxacin. Ofloxacin, at a single dose of 200 mg or 400 mg, was given to each of them. Fourteen patients were excluded for efficacy assessment. There were 223 patients left for safety assessment. The cure rates were 100% in both groups. Among 233 isolates tested, 48.5% were penicillinase producing Neisseria gonorrhoeae. The range of minimum inhibitory concentrations of ofloxacin was 0.008 to 0.063 mg/l. No adverse drug experiences were reported. PMID- 3546156 TI - Ofloxacin: therapeutic results in Chlamydia trachomatis urethritis. AB - Sexually transmitted Chlamydia trachomatis infection of the genito-urinary tract is becoming recognized as a disease which has reached a higher incidence than gonococcal infections, and caused severe and complicated infections in males and females even without major complaints. The MicroTrak test is used to demonstrate C. trachomatis by direct identification under the fluorescence microscope using fluorescein-labelled monoclonal antibodies. 20 patients (15 males, five females) with proven C. trachomatis urethritis were treated for five days with 2 X 200 mg ofloxacin. The initial cure rate was 90% (18 of 20 patients) with an additional 10% being cured after extended therapy over ten days. No side-effects occurred during ofloxacin therapy. Thus ofloxacin can be regarded as an effective and safe drug for the treatment of the genito-urinary infections caused by C. trachomatis. PMID- 3546157 TI - Clinical efficacy of ofloxacin in the treatment of otorhinolaryngological infections. AB - A multi-centered clinical study was carried out to evaluate the efficacy of ofloxacin in otorhinolaryngological infections in Japan. Ofloxacin was used at a dosage of 300 mg to 800 mg daily for three to 20 days in 206 cases of various infectious diseases in the otorhinolaryngological field such as otitis media, external otitis, paranasal sinusitis, tonsillitis and pharyngolaryngitis. Its efficacy rate was 79.9%. Minor side effects were seen in three cases (1.5%), gastro-intestinal disorders in two and headache in one. The antibacterial activity of ofloxacin was compared with the activity of pipemidic acid, nalidixic acid and norfloxacin against clinically isolated microorganisms. Ofloxacin was highly superior to pipemidic acid and nalidixic acid, and slightly more active than or equivalent to norfloxacin. PMID- 3546158 TI - Behavior therapy and the elderly: a conceptual and ethical analysis. AB - This article examines several dimensions of the conceptual framework of the behavioral approach to the treatment of the elderly's problems in living that require emphasis. These dimensions are: 1) Within the behavioral approach behavior is viewed as not being a function of discontinuous, developmental stages each with a unique set of psychological processes; chronological age therefore is considered not to be a causal variable in psychological development, but rather a pure index of only certain physical events; 2) The level of analysis of the behavioral approach to the problems of the elderly is that of molar behavior, and therefore explanations which appeal to other levels of observation, described in different terms and measured in different dimensions, are not considered to be part of this approach; 3) The molar behavior of the elderly is viewed as a function of the contingencies of reinforcement, and behavior that is labeled abnormal is viewed as not quantitatively nor qualitatively different in its development and maintenance from other learned behavior; and 4) Behavior therapy, like all therapies, is a value-laden enterprise in which ends as well as means can be explicated and critically examined. Behavior therapy, in which the involvement of the elderly in the determination of treatment goals is maximized and in which the ability of the elderly to influence and design their environments is enhanced, is advocated. PMID- 3546160 TI - Contextual age as a life-position index. AB - A contextual age construct was developed and examined as a transactional, life position index of aging. The eighteen-item contextual age index included six interrelated dimensions: physical health, interpersonal interaction, mobility, life satisfaction, social activity, and economic security. In addition to the development of the index, associations among contextual age and sociodemographic characteristics were examined for a sample of 640 persons. Chronological age was correlated negatively with mobility and physical health, and positively with economic security, life satisfaction, and interpersonal interaction. Mobility, economic security, life satisfaction, physical health, and interpersonal interaction discriminated between chronological age groups. Interpersonal interaction, economic security, physical health, and social activity were predictors of life satisfaction. The contextual age construct raises questions concerning several negative myths about aging. The findings reflect the weak validity of chronological age as a unidimensional indicator of life-position and well-being. PMID- 3546159 TI - Communication and informed consent in clinical geriatrics. AB - Obtaining a valid informed consent from an elderly person, especially with possible senile dementia of the Alzheimer's type (SDAT), first may involve solving the practical problems of effective communication. Perceptual constraints that frequently occur in the elderly and that may interfere with communication, i.e., the sharing of information, are auditory and/or visual. The most common auditory obstacle, presbycusis (the hearing loss for pure tones due to normal aging) and other hearing impairments, may make the communication of any information about a proposed research project difficult, if not impossible, when not suspected and successfully overcome. Speech and language impediments, whether as a result of stroke or SDAT, are also common and need to be addressed if the person is to communicate his or her concerns and questions effectively with the researcher. Included in such constraints are the misunderstandings that arise from the use of confusing vocabulary, especially "medicalese." Presbyopia, cataract, and glaucoma are some of the visual constraints that may play an important role in making it difficult for the person to read the informed consent form. This article discusses these and other impediments to effective communication with SDAT elderly and makes suggestions how to obviate them. PMID- 3546161 TI - Marketing to older American consumers. AB - Older adults are examined as a potential market for American businesses. Data indicate that in terms of size and income, senior citizens comprise a substantial buying group. Their buying styles, product and service needs, and shopping behavior are shown to vary from those of younger adults and, in fact, vary substantially within the older adult population. Differences are speculated to be the result not only of age influence, but also of cohort and period influences. Strategies for successful marketing are suggested. These strategies relate directly to the identified characteristics of older adults. PMID- 3546162 TI - Plasma exchange with prostaglandin I2 and ACD solution: comparative effects. AB - Discontinuous plasma exchange with prostaglandin I2 (5 ng/kg/min) and low dosage heparin (5-6 IU/kg/min) (treatment I), and ACD solution alone (treatment II) was studied. During both treatments the activated partial thromboplastin time remained within the normal range. After treatment I platelet count was not decreased but in vitro platelet aggregation was reduced (p less than 0.001). After treatment II platelet count was reduced and in vitro platelet aggregation unchanged. Prostaglandin I2 at this dosage caused no cardiovascular complications. The physiopathological implications of these differences are discussed. PMID- 3546163 TI - EBV-transformed lymphoblastoid cell lines down-regulate EBNA in parallel with secretory differentiation. AB - Four monoclonal and one polyclonal lymphoblastoid cell line (LCL) were studied with regard to cytoplasmic immunoglobulin (cIg) expression, presence of the Epstein-Barr virus (EBV)-determined nuclear antigen (EBNA) and DNA synthesis. Each line was found to consist of two subpopulations, with only minimal overlap. Proliferating, EBNA-positive, cIg-negative cells formed the majority. The minority were EBNA-negative, contained abundant cIg and were largely non proliferating. This suggests the continuous occurrence of a maturation process within each LCL. The concomitant down-regulation of EBNA raises the interesting question whether continued synthesis of the nuclear antigen is incompatible with differentiation for epigenetic reasons, or, alternatively, whether differentiation takes place when the viral genomes are suppressed or lost. PMID- 3546164 TI - Dirk Durrer. Thirty-five years of cardiology in Amsterdam. PMID- 3546165 TI - Dr. Helen Brooke Taussig May 24, 1898--May 21, 1986. International cardiologist. PMID- 3546166 TI - Evaluation of anti-inflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. AB - A new model for evaluating nonsteroidal anti-inflammatory drugs (NSAIDs) is described. In this model of postoperative inflammation, the anti-inflammatory activity of curcumin (diferuloyl methane) was investigated in comparison with phenylbutazone and placebo. Phenylbutazone and curcumin produced a better anti inflammatory response than placebo. PMID- 3546167 TI - A comparison of regular insulin and vesicle encapsulated insulin on glucose metabolism in diabetic subjects. AB - In an attempt to preferentially enhance insulin action on the liver, insulin has been encapsulated within lipid vesicles (VEI) bearing a galactosyl unit for which there are high affinity hepatic receptors. To determine whether such a formulation of insulin would have a selective hepatic effect, glucose production and utilization (3(3)H glucose) were measured in IDDM volunteers during infusions of VEI and unencapsulated regular insulin (UI) at rates of 1, 2, 4 and 8 nmol/kg/min (n = 6). Euglycemia was maintained using the glucose clamp technique. Dose-response analysis indicated that VEI insulin was one-third as potent as UI, both on stimulation of glucose utilization and suppression of hepatic glucose production. These results differ from effects of VEI in the dog and do not support the view that in man, insulin incorporation within this preparation of lipid vesicles results in selective hepatic insulinization. PMID- 3546168 TI - Diuretic-induced hypokalemia and altered renal function. AB - The effect of a maximal dose of a commonly used diuretic, chlorthalidone, on renal function was assessed in 6 patients with untreated essential hypertension. 100 mg daily of chlorthalidone for a 4-week period produced a significant fall in the plasma potassium concentration and total body potassium content by 16 and 4.2%, respectively. Associated with this change in body potassium status was a 10% decrease in the maximum urine concentrating capacity (p less than 0.01). Renal plasma flow, but not glomerular filtration rate, was also depressed (9.2%) by diuretic therapy. These results suggest that small diuretic induced deficits in the plasma potassium concentration as well as the total body potassium status interfere with renal tubular function. PMID- 3546169 TI - Use of ceftazidime in the treatment of osteomyelitis and osteoarthritis. AB - The authors report the results obtained with the use of ceftazidime, administered by various methods, in 18 cases of orthopedic infections (osteomyelitis, arthritis). The results, which are regarded as good, are stable over time. The antibiotic therapy proves particularly efficacious in those cases subjected to appropriate surgical treatment. PMID- 3546170 TI - Controlled field trials of a vaccine against New World cutaneous leishmaniasis. AB - Two controlled, double blind field trials of a non-living promastigote vaccine against New World Cutaneous Leishmaniasis (NWCL) were conducted in 1981 and 1983 in Brazil. Brazilian Army conscripts were randomly assigned to the vaccine or placebo groups and tested during their training in the Amazon jungle, a high risk area for NWCL. The results obtained showed: no significant differences between the vaccine and the placebo groups with respect to a number of characteristics (age, race, previous contact with the jungle, etc.); no significant differences between the participants who got and who did not get NWCL during the trial, with respect to length of exposure, contact with the jungle, etc. and a reduction of 67.3 and 85.7% in the annual incidence rate of NWCL, in 1981 and 1983 respectively (although the difference between incidence rates of the disease in vaccinated and control groups in the 1983 trial was not statistically significant), among those vaccinated who had converted to a positive leishmanin skin test as compared with the placebo groups. PMID- 3546172 TI - Solution synthesis of antigenic and inhibiting peptides of the human renin prosegment-2. [Tyr40] preprorenin-(40-50) peptide methyl ester. AB - The [Tyr40] preprorenin (40-50) peptide methyl ester, an undecapeptide related to the human renin prosegment, has been synthesized using a stepwise strategy with hydrogenolisable protections on the side chains. The final deprotection was very difficult as observed by 1H NMR and reversed phase HPLC. 2D 1H NMR spectroscopy of the purified peptide allowed the assignment of all protons. PMID- 3546171 TI - Solution synthesis of antigenic and inhibiting peptides of the human renin prosegment-1. [Tyr47, Nle53] preprorenin-(47-60) peptide methyl ester. AB - The [Tyr47, Nle53] preprorenin (47-60) peptide methyl ester, a tetradecapeptide related to the human renin prosegment, has been synthesized using a three-segment coupling strategy. Selective deprotection of the segments before coupling allowed an easy removal of the final tetradecapeptide side chain-protecting groups by acidolysis and an easy purification. Antibodies raised against this peptide bound the plasmatic inactive renin. PMID- 3546173 TI - The kidney in hematologic disease. A review. AB - The kidney is involved in a variety of systemic diseases and conditions including collagen, endocrine, liver, infectious, neoplastic, and cardiac diseases, as well as pregnancy. Renal involvement in hematologic diseases has not been stressed. In this review we will summarize the role of coagulation in the pathophysiology of renal disease and present renal involvement in sickle cell anemia, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, leukemia, and other less common hematologic diseases. PMID- 3546174 TI - Idiopathic hypertension in a child. PMID- 3546175 TI - Significance of immediate diuresis in relation to transplant kidney survival rate. AB - Transplant kidney survival of recipients with immediate diuresis (n = 19) is compared with recipients who did not have a significant post-operative diuresis (n = 53). There is statistically no significant difference between patients without significant early diuresis (survival rate 71%) and patients with immediate diuresis (survival rate 68%, p greater than 0.1). The renal function was not different in the survivors of the two groups at 12 months post-transplant as measured by creatinine clearance (p greater than 0.35). PMID- 3546177 TI - [Abuse of and dependence on stimulants and appetite depressants]. PMID- 3546176 TI - Urinary excretion of vitamin C in chronic renal failure and after renal transplantation. AB - Urinary excretion of vitamin C was investigated in 44 patients with chronic renal diseases and in 25 patients after renal transplantation with various mean glomerular filtration rates. In both groups a hyperbolic relationship was observed between FE vitamin C and CCr. In addition, direct relationships were found between FE vitamin C and FE Na, FEK and FE H2O in both groups. Various chronic renal diseases and treatments had no influence on the investigated relationships. In 16 healthy subjects urinary excretion of sodium during maximal water diuresis did not increase but urinary excretion of vitamin C significantly increased. In 10 patients in the polyuric stage of chronic renal failure without dialysis treatment during Giordano-Giovanetti-Maggiora diet with addition of sodium chloride the urinary excretion of sodium increased but that of vitamin C was not influenced. The results obtained for the biochemical parameters tested suggest that the urinary excretion of vitamin C depends on the urinary excretion of water. PMID- 3546178 TI - [Inhalation of substances. Household and industrial chemicals as intoxicants]. PMID- 3546179 TI - [Abuse of analgesics with special reference to analgesic nephropathy]. PMID- 3546180 TI - [Abuse of laxatives]. PMID- 3546181 TI - [Recurring macrohematuria in a 39-year-old patient]. PMID- 3546182 TI - [Combined asthmatic and alveolitic reaction following exposure to hay dust]. PMID- 3546183 TI - Activity of flavone acetic acid (NSC-347512) against solid tumors of mice. AB - Flavone acetic acid (FAA) is a new antitumor agent that has recently entered Phase I clinical trials. In preclinical studies, we have found that FAA was broadly active against a variety of transplantable solid tumors of mice (colon #51, #07, #10, #26; pancreatic ductal adenocarcinomas #02 and #03; mammary adenocarcinoma #16/C/Adr; M5076 reticulum cell sarcoma and Glasgow's osteosarcoma). FAA was curative for colon adenocarcinoma #10 and pancreatic ductal adenocarcinoma #03. Thus, for the first time an agent has been identified with very broad, perhaps nearly universal solid tumor activity. FAA was also found to be orally active and stable in solution at 37 degrees C for 48 h. FAA was selectively cytotoxic in vitro for solid tumors over leukemias L1210 and P388 (in a soft-agar colony formation assay), thus correlating cellular selectivity in vitro with in vivo antitumor activity. The finding that FAA was active in vitro, established that the agent did not need metabolism (activation) outside the tumor cell. The main drawback of FAA was an unusual 'threshold' behavior in which only a narrow range of doses were active and splitting the dose markedly decreased activity. PMID- 3546184 TI - Didemnin B. The first marine compound entering clinical trials as an antineoplastic agent. AB - A new class of marine compounds, the didemnins, with potent antitumor activity has been identified. They share the novel structure of a cyclic depsipeptide. Among three structurally related compounds, didemnin B is by far the most potent in its in vitro cytotoxicity and in vivo antitumor activity (0.001 microgram/ml inhibits the growth of L1210 leukemia cells by 50%). It also demonstrates good antitumor activity against B16 melanoma and moderate activity against M5076 sarcoma and P388 leukemia. The compound also has good antiviral and potent immunosuppressive properties. Although the precise mechanism of action for the cytotoxicity remains unknown, the agent inhibits protein synthesis more than DNA synthesis and the inhibition of protein synthesis is closely correlated with inhibition of L1210 cell growth. Toxicology studies in CD2F1 mice, Fischer 344 rats and beagle dogs reveal that major target organs are the lymphatics, gastrointestinal tract, liver and kidney. Phase I trials are currently in progress under the auspices of the National Cancer Institute. PMID- 3546185 TI - Safety and efficacy of sodium and meglumine ioxaglate (Hexabrix) and Hypaque M60% in contrast-enhanced computed cranial tomographic scanning. A double-blind clinical study. AB - The safety and efficacy of sodium and meglumine ioxaglate (Hexabrix, Mallinckrodt, Inc., St. Louis, MO), a new low-osmolality contrast agent, and Hypaque Meglumine 60% (Wintrop-Breon, Inc., New York, NY) were compared for contrast-enhanced computed cranial tomographic scanning. Fifty-two patients with possible enhancing lesions of the brain received a total of 59 injections of either Hexabrix or Hypaque M60 in a double-blind, randomized fashion. Hexabrix was superior to Hypaque M60 in both subjective and objective patient tolerance. A lower incidence of heat and pain in patients receiving Hexabrix was believed to be related to its lower osmolality. Lesion enhancement with both Hexabrix and Hypaque M60 was excellent. There was a statistically significant increase in the degree of enhancement immediately after injection with Hexabrix. Hexabrix had less effect on the cardiovascular system than Hypaque M60. No neurologic complications or adverse reactions requiring treatment occurred in either group. Hexabrix is a suitable agent for intravenous contrast-enhancement for cranial CT. PMID- 3546186 TI - The structure, function, and regulation of transferrin receptors. PMID- 3546187 TI - The ADS revolution: what's ahead for Iowa physicians? PMID- 3546188 TI - Can a computer assisted electrocardiograph replace a cardiologist for ECG measurements? PMID- 3546189 TI - Can a computer diagnosis of "normal ECG" be trusted? PMID- 3546190 TI - One hundred eleventh critical bibliography of the history of science and its cultural influences. PMID- 3546191 TI - Eugenol modulation of the immune response in mice. AB - The effect of eugenol on selected parameters of the immune response of C57BL/6 mice was studied. In a dose-response study, eugenol at high doses completely inhibited the plaque-forming cell responses of splenocytes to the T-dependent antigen (sheep erythrocytes) both in vitro and in vivo. In vitro, at concentrations higher than 1.0 mM, eugenol was found to be cytotoxic. In vivo, however, at very low doses there appeared to be a suppression of the plaque forming cell response to sheep erythrocytes, reaching maximal suppression at 0.1 mumol eugenol/kg mouse body weight. This was followed by enhancement of the response, peaking at 0.25 mumol eugenol/kg mouse body weight. These changes correlated fairly well with body weight changes. Thymic weights appeared to remain unchanged for all doses except the 1.0 mumol eugenol/kg body weight, which was significantly (p less than 0.05) higher than the rest of the groups. Natural killer activity at all effector:target ratios (100:1, 50:1, 25:1) was significantly (p less than 0.05) enhanced at both 0.25 and 2.5 mumol eugenol/kg body weight. Overall, eugenol seems to have dose-dependent suppressive and enhancing effects on the immune response. These effects represent an atypical multiphasic response in which an inversed dose-response relationship is observed. PMID- 3546192 TI - Immunomodulation by RS-2131, a new non-steroidal antiinflammatory drug. AB - The immunomodulatory properties of RS-2131, 2-[4-(2 oxocyclohexylidenemethyl)phenyl]propionic acid, were studied using normal and autoimmune mice. RS-2131 suppressed the Arthus-type footpad reaction in BALB/c mice when administered orally at the time of immunization with sheep red blood cells, in contrast to indomethacin. This drug also suppressed the direct plaque forming cell response against sheep erythrocytes in BALB/c mice. Under the same experimental conditions, the percentage ratio of Lyt 2+ cells to Thy 1.2+ cells were increased in the spleen cells. When used in non-immunized normal BALB/c mice, however, RS-2131 produced no effect on the ratio of Lyt 2+ cells to Thy 1.2+ cells in the spleen cells and on the percent distribution of T lymphocyte subsets. In MRL/Mp-lpr/lpr (MRL/lpr) mice, which have been known as a model of autoimmune disease, Lyt 2 cells in the thymus and the lymph node increased on oral treatment with RS-2131. These findings suggest that this drug may induce suppressor T cells only when the immune response in host animals is increased and then results in inhibition of immune responses in mice. PMID- 3546193 TI - Role of reactive oxygen intermediates in the hepatotoxicity of endotoxin. AB - Administration of endotoxin (2.5 micrograms/mouse, iv) to Corynebacterium parvum pretreated (14 days earlier, 1 mg/mouse, i.v.) mice caused a rapid (90 min) decrease in liver cytochrome P450-dependent drug metabolism and an elevation of serum transaminase. The time course of the priming effect of C. parvum suggested that macrophages might be responsible for this sensitization to endotoxin. The antioxidant N-acetylcysteine (500 mg/kg) effectively protected against this depression of liver drug metabolism, thus supporting the hypothesis that liver macrophage-generated free radicals might mediate this hepatotoxic effect of endotoxin. PMID- 3546194 TI - Nadolol and propranolol in migraine management. PMID- 3546195 TI - Molecular genetics: what is it and what is its impact on current and future medical practice? PMID- 3546196 TI - Changing patterns in the management of end stage renal failure in Aberdeen. PMID- 3546197 TI - [Treatment of symptomatic mucinosis follicularis in mycosis fungoides using fast electrons]. AB - Mucinosis follicularis is a chronic type of dermatosis involving the sebaceous glands and outer root sheaths, which can be differentiated into primary and secondary types. The latter - also called symptomatic mucinosis follicularis - causes therapeutic problems because of the underlying malignant lymphoma. Successful treatment using electron beams supported by etretinate is described in detail in a 40-year-old man with symptomatic mucinosis follicularis based on plaque-type mycosis fungoides. After 6 months free of skin symptoms, the mycosis fungoides lesions recurred in the overlapping borders of the irradiation fields. These lesions were treated again with electron beams. A relapse after 32 months was controlled by PUVA. Electron beam therapy is recomended in the plaque type of mycosis fungoides, especially if PUVA has no effect for some reason. PMID- 3546198 TI - Transfer coefficient of 226Ra from food to young weaned meadow voles, Microtus pennsylvanicus, in the laboratory. PMID- 3546199 TI - 1986 Distinguished Scientific Achievement Award presented to Victor P. Bond. PMID- 3546200 TI - 1986 Founders Award presented to Allen Brodsky. PMID- 3546201 TI - 1986 Elda E. Anderson Award presented to Darrell Reed Fisher. PMID- 3546202 TI - Ongoing patient randomization: an innovation in medical care research. AB - Hospitals often have rotational assignment of patients to one of several similar provider care teams. The research potential of these arrangements has gone unnoticed. By changing to random assignment of patients and physicians to provider care teams (firms) this kind of organization can be used for sequential, randomized clinical trials which are ethical and efficient. The paper describes such arrangements at three different hospitals: Cleveland Metropolitan General Hospital, Brooke Army Medical Center, and University Hospitals of Cleveland. Associated methodologic issues are discussed. This is a new, more widely applicable method for medical care research. PMID- 3546203 TI - Children with spina bifida: the role of the health visitor in tertiary prevention. PMID- 3546204 TI - An ABC of alternative medicine: Hellerwork. PMID- 3546206 TI - A very useful little book. PMID- 3546205 TI - Hypnotherapy and relaxation. PMID- 3546207 TI - Impact of symptom frequency and symptom distress on self-reported quality of life in heart transplant recipients. PMID- 3546208 TI - A review of infection control practices related to intravascular pressure monitoring devices (1975-1985). PMID- 3546209 TI - A correctable complication of advanced congestive heart failure. AB - Hyponatremia is a common complication of chronic advanced CHF unresponsive to the usual therapeutic measures. Thus low levels of serum sodium are a significant marker for severe CHF refractory to the more conventional measures. The combined use of ACE inhibitors and diuretics is generally very effective in correcting the hyponatremic state and often helpful in reversing CHF. PMID- 3546210 TI - Synthesis and murine tissue uptake of sodium [18F]fluoroacetate. AB - Fluoroacetate (FAc) is well known as the rodenticide "1080" and for its potent biochemical properties, but much less is known about its behavior in vivo. In order to study this behavior, the compound was labeled with 18F. The synthesis was accomplished in good yields (30%) from carrier-added radiofluorine gas by its conversion to [18F]tetrabutylammonium fluoride, followed by a heat-assisted halogen exchange with ethylbromoacetate. The isolated ester was rapidly and quantitatively hydrolysed with base to form [18F]FAc. preliminary studies in mice revealed relatively little soft tissue retention over the 4 h study period. However, substantial bone accumulation, indicative of defluorination, occurred to a significant degree. PMID- 3546211 TI - Mild radioiodination of insulin with dichloramine-T. AB - Iodination of insulin using N-dichloro-p-toluene sulphonamide(dichloramine-T) has been standardised. Dichloramine-T, a water insoluble derivative of chloramine-T showed excellent properties as an iodination reagent, for the preparation of radiolabeled insulin for use in radioimmunoassay. Iodination using dichloramine-T could be done at as low as 0.5-2 micrograms of the reagent, and at this concentration the molar ratio worked out to 1:3 to 1:12 (protein:dichloramine-T). Iodination yields of greater than 90% were obtained at pH 5-7. Evaluation of the iodinated tracer for suitability in radioimmunoassay was carried out by estimating radiochemical purity, immunological purity, non specific binding and stability on storage. PMID- 3546212 TI - Neonatal periventricular leukomalacia: diagnosis and evolution evaluated by real time ultrasound. AB - Recent advances in imaging techniques have provided the opportunity to obtain prompt diagnosis and to study the natural evolution of periventricular leukomalacia (PVL). Three premature neonates were followed up by brain sonograms from birth to six, four and three months of age, respectively. Sequential ultrasound examinations confirmed previous observations which identified four stages of PVL; 1. increased echogenicity in the periventricular white matter, 2. apparent normalization, 3. cystic cavitation, 4. resolution of cysts and development of ventriculomegaly. Decreased perfusion of the periventricular end arterial zone is responsible for the development of PVL; this selective hypoperfusion has been documented in infants with a significant history of cardiorespiratory disturbances and group-B streptococcal sepsis. Two of our patients and other cases described in the literature, however, did not exhibit these clinical features. The present study suggests the involvement of chronic hypoxia and toxic insults in the pathogenesis of this condition and confirms the value and accuracy of sequential sonography in the diagnosis of PVL. PMID- 3546213 TI - Centric fission in Microtus oeconomus. A new locality in south east Norway. PMID- 3546214 TI - A history of hip surgery before 1900. PMID- 3546215 TI - Fractures of the femoral head. AB - Fractures of the femoral head infrequently accompany hip dislocations, but create complex therapeutic dilemmas for the orthopaedist when they do occur. The difficulties are compounded by existing incomplete classification schemes, which do not satisfactorily predict the final clinical results of a given injury or treatment. This chapter encompasses an extensive literature review of 238 published cases and analyzes the areas of confusion concerning this group of injuries. Our experience with 27 cases of femoral head fracture is presented. These examples emphasize the need for prompt, concentric reduction of the hip joint followed by individualized treatment of each type of femoral head fracture. An improved classification system to eliminate the ambiguities of previous systems and to provide the clinician with treatment guidelines for each type of femoral head fracture is proposed. These guidelines should improve the final results in these difficult and rare injuries. PMID- 3546217 TI - Bone grafting for acetabular deficiency in association with total hip replacement. PMID- 3546216 TI - Noncemented hip implants. Factors augmenting or inhibiting biological fixation. PMID- 3546218 TI - The use of allograft bone in revision hip arthroplasty. PMID- 3546219 TI - Simultaneous and successive localization of two antigens in the same tissue section using 3,3'-diaminobenzidine and 1-naphthol basic dye. AB - We describe two procedures for the simultaneous and successive localization of two antigens in the same tissue section. In the simultaneous staining procedure, the first antigen was localized using 3,3'-diaminobenzidine (DAB), while the second antigen was stained using the 1-naphthol basic dye (1-NBD) method. The colour of the second antigen depended on the basic dye used, and no mixing of colours was observed when the two antigens were localized in different cells or structures. However, sequential double staining proved to be more convenient for the demonstration of two antigens in the same cell. In this procedure, the first antigen was stained using 1-NBD, and the interesting microscopic fields were photographed. The basic dye was then completely removed, and the second antigen was stained using DAB. PMID- 3546221 TI - [Dilatation of the glottis in bilateral vocal cord paralysis. Review of various surgical procedures and a report of personal experience using a functional lateral fixation surgical technic]. AB - For the treatment of bilateral vocal cord paralysis, the author's technique consists of preservation of the posterior crico-arytenoid ligament as a hinge as well as turning and tilting of the arytenoid cartilage laterally. It is held in this position with three permanent retention sutures, two of them armed with heavy knots. These knots will reinforce the lateral rotation of the arytenoid cartilage. These sutures run in the submucosa horizontally along the anterior surface of the arytenoid cartilage and are fixed through burr holes on the posterior margin of the thyroid cartilage. This method developed from the original "King Procedure" leaves the laryngeal mucosa maximally undisturbed so that in 80% of the cases preliminary tracheotomy became unnecessary. During a period of 27 years, 110 patients were operated; 27 of them had a previously created tracheostoma. Out of the remaining 83, 16 had tracheotomy directly before surgery. Of the remaining 67 patients, four required postoperative tracheotomy for a few days only, while 63 did not require this additional treatment. The average hospital stay was 11 days. In the majority of cases the operation could be performed under local anaesthesia which helped to establish proper voice function. PMID- 3546220 TI - Neuropeptide Y (NPY) immunoreactive neurons in the retina of different species. AB - Neurons displaying Neuropeptide Y (NPY) immunoreactivity were found among amacrine cells in the retina of baboon, pig, cat, pigeon, chicken, frog, trout, carp and goldfish. The immunoreactive cell bodies were located in the middle and the innermost cell rows of the inner nuclear layer with processes forming one, two or three more or less well-defined sublayers in the inner plexiform layer. The location and the density of the sublayers varied with the species investigated. In the frog retina, bipolar-like cell bodies were found in the middle of the inner nuclear layer as well as sparsely occurring ovoid cell bodies in the ganglion cell layer. Like the amacrine cells, these cells emitted processes ramifying in three sublayers in the inner plexiform layer. PMID- 3546222 TI - [Nuclear magnetic resonance tomography in the diagnosis of parotid tumors. A comparison of methods]. AB - The diagnostic value and the limitations of magnetic resonance imaging (MRI) in the management of large parotid masses were evaluated in a prospective clinical study. The results were compared with computed tomography (CT) and B-mode ultrasonography (US). MRI was performed using a Siemens 1.5 Tesla Magnetom with a RF head coil and surface RF coils. The images were evaluated by the following parameters of clinical importance: tumour detectability and marginal appearance, internal architecture, regional extension, and artifact degradation. MR imaging of parotid masses was superior to CT and US for the following reasons. The marginal appearance of the tumour was sharp and further enhanced in T2 weighted pictures. The extension of the tumour can be well seen by use of transaxial and frontal projections. This is an advantage especially when the mass extends to the retromandibular fossa or even to the pterygopalatine fossa. The position of the jaw, external ear canal, mastoid, skull base, and vessels of the neck are clearly shown without artifact degradation. Benign neoplasms can be well differentiated from malignant tumours which show local infiltration into the adjacent anatomical structures as well as irregularities of their internal structure. However, their appearance in MRI can be identical to that of an acute inflammation of the parotid gland. In summary MRI is the imaging technique of choice for extensive parotid masses, whereas US is effective for small tumours not situated in the retromandibular fossa. PMID- 3546223 TI - Correlation of pre-treatment transurethral resection and prognosis in patients with stage C carcinoma of the prostate treated with definitive radiotherapy--RTOG experience. AB - Four hundred and ninety-four patients with clinical Stage C carcinoma of the prostate, who were entered onto a phase III RTOG study, have been analyzed as to the potential effect of the pre-treatment transurethral resection (TUR) of the tumor. Treatment consisted of definitive irradiation to the prostate (6500-7000 cGy) and regional lymphatics (4500-5000 cGy). A total of 202 patients underwent pre-treatment TUR. This population was compared with the remaining 292 patients as to the rate of locoregional failure, incidence of distant metastases, disease free survival, and survival. The TUR population fared significantly worse for all four end-points. To account for uneven distribution of recognized prognostic factors the results were then adjusted using stratified Mantel-Haenszel tests. The stratification process resulted in a reduced level of significance in the differences between the two populations. However, a trend toward a higher incidence of distant metastases could be observed within most strata. The trend was most pronounced in subpopulations characterized by Gleason score 6-7 and normal serum acid phosphatase (SAP). For the population characterized by Gleason score 6-10 and normal SAP, the differences in the incidence of distant metastases retained statistical significance. Whether these findings are secondary to tumor dissemination during TUR or are due to incompletely identified selection biases remains to be demonstrated in future (prospective) studies. PMID- 3546224 TI - Oral contraceptives and dysmenorrhea. PMID- 3546225 TI - Treatment of common genital infections in adolescents. PMID- 3546226 TI - Adolescents' compliance with therapeutic regimens. Psychological and social aspects and intervention. PMID- 3546227 TI - The adolescent athlete and ergogenic aids. AB - Amphetamines and anabolic/androgenic steroids are the ergogenic aids with the most serious side effects that adolescents are likely to misuse, although adolescents are more frequently lured into taking expensive and worthless vitamin and protein supplements. Physicians performing preparticipation physical examinations should address the issue of ergogenic aids when they offer anticipatory guidance to adolescent athletes. PMID- 3546228 TI - The use of therapeutics in adolescence. PMID- 3546229 TI - Corticosteroid therapy in adolescent patients. AB - Since their introduction in the 1950s, corticosteroids have become an important adjunct in the therapy for a wide variety of diseases. Improved guidelines for clinical applications and for reduction in undesirable effects have been achieved through a better understanding of corticosteroid mechanisms of action and pharmacokinetic properties. This discussion will review the indications and adverse effects associated with corticosteroid therapy. Emphasis will be placed on the important aspects of corticosteroid therapy in adolescent patients including recent advances essential to the development of guidelines for dosing and therapeutic monitoring. PMID- 3546230 TI - Issues in the pharmacologic management of primary hypertension in adolescence. AB - Hypertension may occur in as many as 12% of adolescents and is usually of primary origin. There is an age-related increase of the blood pressure, making it difficult to define the limits of normal. True hypertension can be defined as blood pressure exceeding 140/90 mmHg regardless of age. Borderline blood pressure is said to exist when the blood pressure is above the 90th percentile for age. Blood pressure can be lowered with a wide variety of drugs, and adolescents are most often prescribed adult doses. There are specific concerns about the drugs' side effects in adolescents, particularly effects on growth and development, cognitive function, and metabolism. Diuretics are not the best first choice for therapy because of their metabolic effects. Cardiac hypertrophy and the morbidity of sustained hypertension are reduced by sympathetic inhibitors. Beta-blockers are the best currently available choice, although newer alpha-blocking agents may have some advantages. Even borderline pressure has been associated with evidence of cardiac hypertrophy, and there is substantial evidence that the adolescents with the highest blood pressures, even if still within normal limits, have the highest likelihood of developing sustained hypertension as adults. Yet there is no data establishing a beneficial effect on long-term risk of early treatment with drugs. For these reasons, nonpharmacologic intervention and close follow up are preferred as treatment for borderline blood pressure. PMID- 3546231 TI - Teenage pregnancy and parenthood in Illinois. Estimated 1979-1983 costs. AB - This study presents an estimation of the 1979-1983 public and private costs of teenage pregnancy and teenage parenthood in the State of Illinois. Data from public records, national and local surveys, and knowledgeable professionals were obtained to delineate 68 key events associated with teenage sexuality, teenage births, newborn care, children's medical care, support to families headed by teenagers, and the cost of these events. Estimates of the total cost of services consumed were apportioned according to corporate, state, federal, municipal, and private individuals as sources of revenue. As of 1983, Illinois businesses and citizens paid $848 million for services rendered to the five-year cohort of 94,000 teenage mothers and their 137,483 children. This sum divides between $152 million annually for business and $696 annually for individuals. Each Illinois household paid an average of $84 out of pocket, $81 dollars in higher state and federal taxes, and $37 dollars in higher prices due to business pass-through, for a total of $202 per year per household. PMID- 3546232 TI - Adolescent risk-taking behavior. PMID- 3546233 TI - Group B streptococcal infection in two cats. PMID- 3546235 TI - Staphylococcosis. PMID- 3546234 TI - Clinicopathologic, renal immunofluorescent, and light microscopic features of glomerulonephritis in the dog: 41 cases (1975-1985). AB - In a 10-year retrospective study, we evaluated the clinicopathologic features and renal immunofluorescence patterns of glomerulonephritis in 41 dogs. On the basis of results of histologic examinations, the dogs were segregated into 3 groups, including membranous (n = 12), mesangioproliferative (n = 15), or membranoproliferative glomerulonephritis (n = 14). No significant differences existed among groups in regard to age or duration of illness. Most dogs had been ill for one month or longer. The proportion of dogs with azotemia, anemia, and hyperphosphatemia were not different among the disease groups. Proportion of dogs with hypoalbuminemia and the severity of hypoalbuminemia were not different among groups. Highest urine protein losses and 24-hour urine protein/creatinine ratios developed in dogs with membranous glomerulonephritis. Although hypoalbuminemia and hypercholesterolemia were common (49%), the formation of edema or ascites was not (15%) and, therefore, few dogs had all of the classic features of the nephrotic syndrome. Few dogs suffered thromboembolic complications. Antinuclear antibody titers developed in 11 dogs, the highest titers developing in dogs with polyarthritis and systemic lupus erythematosis. Cellulose acetate electrophoresis detected alpha 2 and beta 1 globulin spikes in most dogs (87%). Results of renal immunofluorescence testing were positive in 36 dogs, using polyvalent antisera for immunoglobulins (Ig)G, IgA, IgM, and/or antisera for complement factor C3. When monovalent antisera for IgG, IgA, and IgM, and fibrinogen were used, immunofluorescence was not observed as often. The major fluorescent pattern was discrete multifocal segmental granular glomerular fluorescence, consistent with immune-complex deposition. Two dogs had linear glomerular staining patterns; however, antibodies directed against normal glomerular basement membrane were not found via elution studies. A high prevalence of glucocorticoid excess (treatment with glucocorticoids and spontaneous hyperadrenocorticism) (34%), chronic inflammatory skin disease (27%), neoplasia (17%), polyarthritis (12%), and systemic lupus erythematosis (7%) were observed as clinical problems concurrent with glomerulonephritis. In 5 dogs, treatment of glomerulonephritis with prednisolone (0.5 to 1.1 mg/kg) did not result in beneficial effects and in fact appeared to be detrimental, leading to azotemia and worsening proteinuria and physical condition in some of the dogs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3546236 TI - Microvascular distant transfer of a cervical axial-pattern skin flap in a dog. PMID- 3546238 TI - Influence of exogenous growth hormone and gestational diet on sow blood and milk characteristics and on baby pig blood, body composition and performance. AB - Sows (14) and gilts (6) were used in a 2 X 2 factorial experiment to evaluate the effect of diet and highly purified porcine growth hormone (pGH) on sow metabolic status and baby pig survival parameters. Injections were 10 mg/d pGH (GH) or sham control (SH). Diets consisted of a glucose-fat energy source (GF) or control (C). Treatments were administered the last 21 d before parturition (P). Serum GH concentrations were significantly elevated on d -19 P and d -4 P in sows receiving GH injections. Significantly elevated serum glucose and insulin concentrations were concomitantly observed in GH-treated sows, suggesting that the animals had developed a state of insulin resistance. Serum free fatty acids (FFA) were greater (P less than .01) on d -19 P for sows fed the GF diet. Fasted pigs from GH-C dams had greater (P less than .06) mean serum glucose concentrations than pigs from SH-C, SH-GF or GH-GF dams. Pigs from GH-injected sows had more (P less than .01) total body lipids at birth and tended to have increased mean FFA concentrations when compared to SH pigs. However, birth weight, number born live, number born dead, number that died and survival to 21 d were not affected by dam's injection or dietary treatment. Growth hormone injections resulted in a diabetogenic state in gestating sows and led to improved traits related to baby pig blood glucose homeostasis, including increased blood glucose, increased body lipids and a tendency toward increased liver glycogen concentrations. Injection X diet interactions indicate that dietary energy source should be regarded in future growth hormone experiments. PMID- 3546237 TI - Induction of antitumor resistance to mouse leukemia L1210 by spergualins. AB - Spergualin and its analog, 15-deoxyspergualin showed a marked antitumor effect against L1210 by intraperitoneal and oral administrations. After treatment with these substances 40- or 60-day survivors (cured mice of L1210) were resistant to reinoculation of L1210 cells. They were resistant only to L1210. The antitumor effector cells in these mice were determined to be T cells. NK activity of spleen cells was also enhanced by spergualins. The antitumor activity of 15 deoxyspergualin was markedly reduced in immuno-deficient mice. IL (interleukin)-2 production, but not IL-1, was enhanced in supernatant of mixed lymphocyte cultures by treatment with 15-deoxyspergualin. The mechanism of action of 15 deoxyspergualin on the immune system was discussed. PMID- 3546240 TI - Evaluation of urea dilution as a technique for estimating body composition of beef steers in vivo: validation of published equations and comparison with chemical composition. AB - Urea dilution equations for prediction of empty body water in live cattle, developed by three separate groups of investigators, were evaluated by comparing empty body water calculated by these equations with that measured chemically in 6 , 12- and 18-mo-old crossbred beef steers (n = 10, 9 and 9, respectively). Of four equations for prediction of percent empty body water, one derived from mixed breeds of steers overestimated empty body water in the 6-mo-old steers by 7.59% (P less than .05). For the 12- and 18-mo-old steers, calculated and measured percent empty body water did not differ (P greater than .05). Of seven equations for calculation of empty body water volume, two derived from Angus steers with an without live weight in the equation, and one derived from a combination of Angus and mixed-breeds of steers overestimated empty body water (P less than .05) in the 6-mo-old steers. No differences (P greater than .05) between calculated and measured empty body water volume were observed for either the 12- or 18-mo-old steers. When calculated empty body water values were regressed against that measured directly, all regression slopes were not different from 1 (P greater than .05). Intercepts from regressions involving percent empty body water (four equations) were not different from 0. Three of the seven equations for calculation of empty body water volume, one derived from bulls and the others from Angus steers had intercept estimates not different (P greater than .05) from 0. Validity required that these regressions have slopes not different from 1 and intercepts not different from 0. Empty body water calculated from equations that combined live weight and urea space were more highly correlated with directly measured empty body water than that calculated from equations derived only from urea space. Urea space correlations with body composition of our steers also were improved when live weight was included with urea space in multiple regression models. Results of this study suggest that before using any prediction equation for calculating body composition of cattle in vivo, equations should be tested with a sub-sample of cattle from the population for which its use is intended. PMID- 3546239 TI - Effect of restriction of energy during lactation on body condition, energy metabolism, endocrine changes and reproductive performance in primiparous sows. AB - Seventeen Landrace X Large White primiparous sows that farrowed in August 1982 were fed ad libitum (AL, n = 8) or their intakes were restricted (R, n = 9) during lactation. Litter sizes were equalized after farrowing and pigs were not allowed creep feed. Pigs were weaned 23.8 +/- .4 d postpartum. On d 6, 12 and 20 postpartum, all sows were fasted for 16 h and blood samples were collected prior to feeding for analysis of plasma glucose (GLU), urea nitrogen (UN), free fatty acids (FFA), prolactin (PRL) and serum insulin (INS). On d -2, 2 and 4 from weaning, sows were fasted for 16 h and then blood samples were collected hourly from 0 to 6 postprandial for analysis of GLU, UN, FFA, PRL and INS. Serum for analysis of luteinizing hormone (LH), progesterone and estradiol was collected every 6 h from 1 d before until 12 d after weaning. Samples for LH were also collected at 15-min intervals for 3 h at -18, -6, 6, 18, 78, 102, 126, 150, 240 and 480 h from weaning. After weaning all sows were fed 1.8 kg X d-1, and were checked for estrus twice daily. Daily intakes of metabolizable energy (ME) during lactation were greater in AL (12,194 +/- 465 kcal) than in R sows (8,144 +/- 90 kcal). Compared with AL sows, R sows lost more weight and backfat during lactation and had higher postprandial UN levels 2 d before and 4 d after weaning. Reproductive performance and reproductive hormones were not affected by restriction of energy, but frequency of episodic release of LH prior to weaning was greater in sows that exhibited estrus after weaning (n = 12) than in anestrous sows (n = 5). After weaning, LH and estradiol concentrations were similar between estrous and anestrous sows until onset of the preovulatory increase in estradiol in the sows that exhibited estrus. Energy intake, body condition and productivity were similar between anestrous sows and sows that exhibited estrus. On d 12 and 20 of lactation, preprandial levels of GLU were greater and FFA were lower in anestrous than estrous sows. We conclude that restriction of feed intake during lactation affected body condition and metabolism of primiparous sows, but reproductive performance and productivity were not affected. Aberrations in partitioning of energy during lactation may predispose primiparous sows to postweaning anestrus, but the mechanisms by which this occurs have yet to be defined. PMID- 3546241 TI - Monoclonal antibody technology in the development of vaccines for livestock parasites. AB - Vaccination against animal parasites offers an alternative to chemotherapy for the control of losses due to morbidity and mortality. However, only a few vaccines are currently available, and these are based on controlled infections with living parasites. Further advancement in the development of defined vaccines against parasite infections has been hindered by incomplete knowledge of the immunological relationship between the host and the parasite. The advent of monoclonal antibody technology has provided a powerful new tool for the identification and isolation of parasite antigens. Exploitation of this technique in veterinary parasitology has greatly facilitated progress toward the development of vaccines against several animal parasites. PMID- 3546242 TI - Transport of tetracyclines into Escherichia coli requires a carboxamide group at the C2 position of the molecule. AB - Structural features of the tetracycline molecule required for transport into Escherichia coli were investigated by examining the uptake of various tetracycline analogues. Uptake was assessed by determining the ability of analogues to induce Tn10 encoded resistance to tetracycline and by direct transport assays using tetracycline susceptible bacteria. Seven tetracyclines (including tetracycline itself) were studied. Two of these compounds, chlorotetracyclinonitrile and tetracyclinonitrile were not accumulated by E. coli, which suggests that the carboxamide group at the C2 position of the tetracycline molecule is required for transport into bacteria. PMID- 3546243 TI - Evaluation of aztreonam, cefoperazone, latamoxef and ceftazidime in the hamster colitis model. AB - Aztreonam, ceftazidime, cefoperazone and latamoxef (moxalactam) were evaluated in a hamster model for antibiotic-associated colitis. Aztreonam, a novel monocyclic beta-lactam antibiotic specifically directed against aerobic Gram-negative bacteria with limited activity against Gram-positive and anaerobic bacteria did not cause haemorrhagic caecitis and death in hamsters when administered intraperitioneally or orally. Quantitative caecal cultures showed no changes in the anaerobic caecal microflora of hamsters treated intraperitoneally with aztreonam and only a temporary decrease in anaerobic Gram-negative bacilli in hamsters treated orally. Clostridium difficile and its cytotoxin were not present in these animals. Parenteral administration of ceftazidime also did not affect the anaerobic caecal microflora or cause caecitis. However, when given orally, ceftazidime suppressed the anaerobic caecal microflora and a lethal C. difficile induced caecitis developed. Latamoxef or cefoperazone given parenterally resulted in caecitis and death in five days with marked changes in the anaerobic caecal microflora and C. difficile present in the caecal contents of these animals. The lethal haemorrhagic caecitis observed in this study was indistinguishable from that seen in the clindamycin-induced colitis model in the hamster. The possible correlation of these findings to gastrointestinal disturbances as a complication of antibiotic therapy in humans is discussed. PMID- 3546244 TI - High performance liquid chromatographic determination of ketoconazole in human serum. AB - A reversed-phase high-performance liquid chromatographic (HPLC) method with terconazole as internal standard is described for the rapid analysis of ketoconazole in human serum. Except for diazepam no other drug interfered with the analysis. The lowest reproducible limit of the method was 0.05 mg/l. The coefficient of variation of the procedure was less than or equal to 7.5% over a range of ketoconazole concentrations from 1.0 to 10.0 mg/l and less than or equal to 16.75% over a range from 0.05 to 0.5 mg/l. Comparison with a microbiological method showed good correlation. PMID- 3546245 TI - Release of endotoxin from Escherichia coli by quinolones. PMID- 3546246 TI - Comparative activity of imipenem, ceftazidime and cefotaxime against Acinetobacter calcoaceticus. AB - Imipenem was the most active drug against Acinetobacter, even against strains possessing beta-lactamases. MICs of imipenem for 50% and 90% of the A. calcoaceticus (var. anitratum) were 0.28 and 0.61 mg/l respectively whereas for ceftazidime they were 4.4 and 10.0, and for cefotaxime, 7.9 and 22.2 mg/l. No change occurred in the in-vitro activity of imipenem against Acinetobacter, during the period 1980-1985. Geometric mean MICs in 1985 were 0.33 mg/l for A. calcoaceticus var. anitratum; the values were lower for A. calcoaceticus var. lwoffi. Ceftazidime and cefotaxime MICs were also stable from 1981 to 1985, but the values were higher, geometric mean MICs being 5.3 and 10.1 mg/l respectively. MBCs of imipenem for A. calcoaceticus var. anitratum ranged from 0.194 to 0.35 mg/l; the ratio MBC/MIC was 1.17. PMID- 3546247 TI - Postantibiotic effect of imipenem on gram-positive and gram-negative micro organisms. AB - The bactericidal effect (BE) of an antibiotic reduces the infective population, and its postantibiotic effect (PAE) assures a persistent inhibition of bacterial cells after a short exposure to the antimicrobial agent. Both effects prevent the early regrowth of the infecting organisms when the antibiotic tissue levels decrease to below the MIC value. The BE and the PAE of imipenem, cefotaxime, ceftazidime, piperacillin, gentamicin and ampicillin on Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Acinetobacter calcoaceticus, Staphylococcus aureus and Streptococcus faecalis were investigated with viable counts and continuous impedance monitoring of broth cultures. Imipenem and gentamicin gave similar high BE and PAE values at low concentrations and with short drug exposures in most strains tested. PAE is low or non-existent for Gram-negative strains with other beta-lactam antibiotics. These results suggest the possibility of future clinical studies with new experimental dosage schedules for imipenem. PMID- 3546248 TI - Effect on growth curves and killing curves of brief exposure of Escherichia coli to imipenem and piperacillin. AB - Escherichia coli was exposed to various concentrations of imipenem and piperacillin. As with the majority of beta-lactam antibiotics, the kinetic turbidometric growth curves showed, during the first few hours, an increase in optical density (OD) before lysis. This increase in OD depended on the concentration of imipenem and was independent of the concentration of piperacillin. A good correlation was found between the pre-lytic increase in OD and the killing curve. The bactericidal activity rate of imipenem was concentration-dependent. Imipenem was rapidly bactericidal, in contrast to piperacillin. PMID- 3546249 TI - An overview of the pharmacology of imipenem/cilastatin. AB - Imipenem is the first clinically available carbapenem antibiotic. Since it is hydrolysed by dehydropeptidase-I, a zinc metallo-enzyme resident in the brush border of the renal tubule, it is co-administered with cilastatin, a reversible inhibitor of this enzyme. This provides clinically relevant concentrations of imipenem in the urine for 8-10 h after a 500 mg dose. The half-life of both drugs is 1 h in normal volunteers. Plasma clearances are reproducible between volunteers and studies and average 220 ml/min for imipenem. Renal clearance of unchanged imipenem accounts for 60-70% of plasma clearance when the imipenem is given with cilastatin. Administration of radiolabelled drugs results in recovery of over 99% of the radiolabel in the urine for both imipenem and cilastatin. With increasing renal dysfunction, the half-life of imipenem is controlled by a metabolic clearance pathway which is unaffected by cilastatin. Renal clearance is by glomerular filtration and active tubular secretion for both imipenem and cilastatin. Renal dysfunction results in terminal half-lives of slightly greater than 4 h for imipenem and 16 h for cilastatin in the functionally anephric. Both drugs are well cleared by haemodialysis and supplemental 500 mg doses are recommended after a dialysis. In the case of severe renal failure, dose and schedule alterations serve to prevent accumulation of cilastatin and circulating metabolites of imipenem, while still providing therapeutic concentrations of imipenem. PMID- 3546250 TI - Cell of the mucous membrane of the female genital tract in culture: a comparative study with regard to the histogenesis of endometriosis. AB - Cellular elements from the mucous membrane of the uterus and oviducts and from peritoneal washings were cultured. The in vitro behavior of these cells was compared to elucidate the histogenesis of endometriosis and the role of various diagnostic procedures. In 65% of the cultured material obtained by uterine-tubal flushing, proliferating cells of the uterine-tubal mucous membrane were present. Their morphology and behavior corresponded to those of cultured cells obtained by separate washing of the uterine cavity and the tubes, respectively, curetted material, and biopsies of endometriosis lesions. Epithelial and stromal cells were identified using phase contrast microscopy, electron microscopy, and immunohistochemical methods. These cell types did not occur in peritoneal washings before the flushing of uterus and tubes. It was therefore assumed that they were detached and transported to the pelvic cavity during the above mentioned procedures. In view of their intensive proliferation they may form the basis in the development of nodules of endometriosis. This would support the implantation theory concerning the pathogenesis of endometriosis. Interactions between epithelial and mesothelial cells point to the possible role of the latter in encapsulating the endometrial elements. PMID- 3546251 TI - Different hormonal requirements for androgen-independent growth of normal and tumor epithelial cells from rat prostate. AB - The proliferation of isolated normal prostate epithelial cells from rat and man is androgen-independent and requires cholera toxin, insulin, dexamethasone, epidermal growth factor (EGF) and one or more polypeptide factors that are concentrated in bovine neural tissue. The active agents in the neural tissue extract are heparin-binding polypeptides (prostatropins), the predominant form of which has a molecular weight of 17400 and an acetylalanine at the aminoterminus. Prostatropins supported a half-maximal increase in normal prostate epithelial cell number at 50 picomolar. The proliferation of primary and serially-cultured epithelial cells from androgen-responsive Dunning R3327 rat prostate tumors was also androgen-independent, but exhibited dramatic alterations in response to hormones that stimulated normal cell proliferation. At low cell density, androgen independent growth of isolated tumor-derived epithelial cells was independent on cholera toxin, was stimulated by dexamethasone, required insulin and either EGF or prostatropin. The presence of either EGF or prostatropin masked the response to the other factor. In the absence of EGF, purified prostatropins supported a half-maximal increase in tumor cell number at 7 picomolar. Endogenous production of EGF-like and prostatropin-like factors or both was suggested by the reduced requirement for EGF and prostatropin at high prostate tumor cell density. These results suggest that anti-hormonal therapies against prostate tumor growth should be based on intervention with the activity of insulin (or insulin-like factors) or simultaneous intervention with both EGF and prostatropin (or their homologues). PMID- 3546253 TI - A horizontal rail system for high resolution photomacrography. PMID- 3546252 TI - Preparation and characterization of rabbit myometrial cells in primary culture: influence of estradiol and progesterone treatment. AB - Myometrial cells were obtained following a three-step enzymatic digestion of uterine horns from Day 1 pseudopregnant rabbits. Isolated cells were cultured in RPMI 1640 supplemented with 10% fetal bovine serum (FBS), whole or steroid depleted (FBS-DC) at a plating density of 0.5 X 10(6) cells/ml. The cells reached confluency on Day 6 to 7 with whole serum and on Day 7 to 8 with DC serum. The process yielded myometrial cells at a purity level of at least 80% as assessed by indirect immunofluorescence using desmin antibody on confluent cultures. The addition of increasing doses of 17 beta-estradiol (E2) (0.1 nM to 1 microM) to the culture medium resulted in an increase in total protein and DNA content (1.5 fold at 1 nM). Similar treatment with progesterone (P) resulted in a 25% inhibition of protein and DNA content at 10 nM. Pretreatment of cells with E2 (1 nM) for 3 d followed by P (10 nM) for 3 d resulted in a 1.8-fold stimulation of protein with a higher protein: DNA ratio indicating that the increase was due to cellular hypertrophy. Analysis of desmin by polyacrylamide gel electrophoresis showed that this cytoskeleton protein was not affected by steroid treatment. Our results indicate that PR can generate two different responses depending on cell pretreatment. In as much as myometrial cells grown in primary culture respond differentially to E2 and P they should provide a useful model to study the regulation of myometrial contractility. PMID- 3546254 TI - Methacholine inhalational challenge in the evaluation of chronic cough in children. AB - The medical records of 58 children (age range, 7 to 16 years) who presented with chronic cough were retrospectively analyzed to determine the value of methacholine (MCH) bronchial challenge in reaching a specific diagnosis. Baseline lung function tests were normal in all subjects, apart from an elevated residual volume/total lung capacity ratio (RV/TLC) in 11 patients, and a reduced midexpiratory flow rate (FEF25-75) in five of these patients. Thirty-one patients had a positive response to MCH, but these patients could not be identified on the basis of clinical criteria or spirometric parameters. MCH-positive patients did have a significantly higher RV/TLC than did MCH-negative patients. Twenty-seven of the 31 MCH-positive patients responded to a trial of bronchodilator therapy (albuterol/theophylline), confirming the diagnosis of cough variant asthma in these patients. We conclude that children with chronic cough should be considered for methacholine challenge in order to identify patients who are likely to benefit from specific bronchodilator therapy. PMID- 3546255 TI - Serum 13-14-diOH-15-keto-prostaglandin F2 alpha and airway response to meclofenamate and metaproterenol in relation to the menstrual cycle. AB - In order to evaluate whether adverse reactions to a nonsteroidal antiinflammatory agent (NSAIA) were related to variations in prostaglandin levels during the menstrual cycle, we measured 13-14-diOH-15-keto-prostaglandin F2 alpha in serum and the effect on airways of a single dose of 100 mg oral meclofenamate and 1.5 mg inhaled metaproterenol during the early (follicular phase) and late (luteal phase) menstrual cycle. Among 24 women with premenstrual asthma (PMA), four women with regular asthma (REA), and four healthy women, the 13-14-diOH-15-keto-PGF2 alpha averaged 140.9 +/- 68.4 pg/0.1 ml during the follicular phase but only 14.4 +/- 2.2 pg/0.1 ml during the luteal phase (p less than 0.0001). Acute asthma reactions to the meclofenamate occurred during the follicular phase in six women with PMA but were never observed during the luteal phase (p = 0.016). These reactions occurred preferentially in patients on corticosteroids (p = 0.004). Conversely, one patient with PMA had 18% improvement in FEV1 with meclofenamate during the luteal phase. A placebo-controlled, double-blind evaluation of the healthy women and the women with REA revealed a trend toward improvement in FEV1 during the luteal phase (0.15 less than p less than 0.10) but no change during the follicular phase. The effect of metaproterenol did not vary with the menstrual cycle, and there was no interaction between the effects of meclofenamate and those of metaproterenol. It appears that meclofenamate causes adverse effects on pulmonary function in asthmatic women primarily during the follicular phase of the menstrual cycle. This effect is associated with corticosteroid treatment and may be related to monthly variation in serum 13-14 diOH-15-keto-PGF2 alpha. PMID- 3546256 TI - Chronobiology and asthma. I. Day-night differences in bronchial patency and dyspnea and circadian rhythm dependencies. AB - The symptoms of allergic asthmatic patients typically worsen during the night, especially during the early morning hours. Although 24-hour variations in the environment contribute to the intensification of the asthmatic condition nocturnally, environmental changes themselves do not fully explain the temporal aspects of this disease. Circadian (about 24-hour) rhythms in critical bioprocesses constitute significant contributory factors. The exacerbation of asthma during the night represents the changing status of biological functioning due to circadian rhythms in bronchial patency; airways hyperreactivity to acetylcholine, histamine, and house dust; and plasma cortisol, epinephrine, histamine, and cyclic AMP, among others. PMID- 3546258 TI - Endoscopic sclerotherapy of oesophageal varices. PMID- 3546257 TI - Amiodarone in ventricular arrhythmias. PMID- 3546259 TI - [Clinical trial of a new barium suspension in double-contrast examination of the colon. Randomized study of useful parameters]. PMID- 3546260 TI - Lysogenic conversion of Salmonella typhimurium bacteriophages A3 and A4 consists of O-acetylation of rhamnose of the repeating unit of the O-antigenic polysaccharide chain. AB - Lysogenization of Salmonella typhimurium with either of the bacteriophages A3 and A4 results in O-acetylation of the L-rhamnose residues of the O-polysaccharide chain of the lipopolysaccharide of the bacterial cell envelope. The O-acetyl group is found on both O-2 and O-3 of the L-rhamnosyl residues. This lysogenic conversion prevents the adsorption of the A3 and A4 phages and also greatly reduces the rate of adsorption of phage P22 to the O-polysaccharide chain as measured by binding studies with whole bacteria. Isolated lipopolysaccharide from A3- and A4-lysogenized bacteria was also inefficient in inactivating these phages: the concentration required for 50% inactivation was 10,000-fold higher than that for lipopolysaccharide from S. typhimurium not lysogenized by any A phage. Binding of phages A3 and A4 is accompanied by hydrolysis of the alpha-1,3 linkage between rhamnose and galactose in the tetrasaccharide repeating unit of the O-polysaccharide. Phage hydrolysis generates saccharides of various lengths, the majority being dodecasaccharides, i.e., equivalent to three repeating units. It is surmised that O-acetylation of the rhamnosyl residue interferes with phage A3, A4, and P22 infection by preventing binding to and hydrolysis of the O polysaccharide chain, the initial step in the phage infection cycle. The new O acetyl-rhamnose entities did not elicit specific antibodies in rabbits in accordance with earlier experiences. The O-acetylation of O-2 and O-3 of rhamnose is a new, hitherto unknown, modification of the O-polysaccharide chain of S. typhimurium. PMID- 3546261 TI - Purification and use of Methanobacterium wolfei pseudomurein endopeptidase for lysis of Methanobacterium thermoautotrophicum. AB - The pseudomurein-degrading enzyme from autolysates of Methanobacterium wolfei was purified approximately 500-fold to electrophoretic homogeneity by ion-exchange chromatography under anaerobic conditions. Analysis of the soluble cell wall fragments produced by the pure enzyme from a cell wall preparation of M. thermoautotrophicum indicated that it is a peptidase hydrolyzing the epsilon-Ala Lys bond of pseudomurein. A partially purified preparation of pseudomurein endopeptidase was free of nuclease activity and thus proved useful for the preparation in high yields of undegraded chromosomal and plasmid DNA from M. thermoautotrophicum. The partially purified enzyme was also used for the preparation of protoplasts, which were stabilized by 0.8 M sucrose. Under growth conditions the protoplasts produced methane and increased up to 100-fold in size, but failed to regenerate a cell wall. PMID- 3546262 TI - Expression in Escherichia coli of a cloned crystal protein gene of Bacillus thuringiensis subsp. israelensis. AB - A ca. 10-kilobase (kb) HindIII fragment of plasmid DNA from Bacillus thuringiensis subsp. israelensis was cloned into plasmid pUC9 and transformed into Escherichia coli. Extracts of the recombinant strain contained a 27 kilodalton (kDa) peptide that reacted with antibodies to a 27-kDa peptide isolated from crystals produced by B. thuringiensis subsp. israelensis. Extracts of the recombinant strain were hemolytic and toxic to Aedes aegypti larvae. Full expression of the 27-kDa peptide required the presence of a ca. 0.8-kb region of DNA located 4 kb upstream from the structural gene; the 0.8-kb region could be present in cis or trans relative to the gene and apparently acted post transcriptionally. Analysis of maxicells showed that the 10-kb insert also coded for peptides of 67, 20, and 16 kDa; data obtained with different subclones suggest that the 20-kDa peptide is encoded in the 0.8-kb DNA region. PMID- 3546263 TI - Pyruvate decarboxylase of Zymomonas mobilis: isolation, properties, and genetic expression in Escherichia coli. AB - Pyruvate decarboxylase (EC 4.1.1.1) from Zymomonas mobilis purified to homogeneity by using dye-ligand and ion-exchange chromatography. Antibodies produced against the enzyme and the amino-terminal sequence obtained for the pure enzyme were used to select and confirm the identity of a genomic clone encoding the enzyme selected from a genomic library of Z. mobilis DNA cloned into pUC9. The genomic fragment encoding the enzyme expressed high levels of pyruvate decarboxylase in Escherichia coli. Possible RNA polymerase and ribosome-binding sites have been identified in the 5'-untranslated region of the pyruvate decarboxylase gene. PMID- 3546264 TI - Genetic suppression of a temperature-sensitive groES mutation by an altered subunit of RNA polymerase of Escherichia coli K-12. AB - Temperature-resistant suppressor mutants were isolated from Escherichia coli mutant strain groES131(Ts). Phage P1-mediated transduction and a two-dimensional gel electrophoretic analysis of cellular proteins indicated that these suppressor mutants carry an additional mutation in either the groEL gene or the rpoA gene. PMID- 3546266 TI - Localization and stoichiometry of hook-associated proteins within Salmonella typhimurium flagella. AB - The localization of hook-associated proteins (HAP1, HAP2, and HAP3) in Salmonella typhimurium flagella was studied by using specific antibodies together with a second antibody conjugated with colloidal gold. HAP1 and HAP3 were localized at the hook-filament junction, as has been suggested previously. HAP2, however, was localized at the filament tip. This finding supports the idea that HAP2 acts to induce polymerization of endogenous flagellin at the filament tip, and HAP1 and HAP3 are junction proteins to connect hook with filament. Analysis of the protein composition of short flagella from a mutant indicated that a single flagellum contains about 10 to 20 HAP1, 10 to 20 HAP2, and 10 to 40 HAP3 molecules. PMID- 3546265 TI - Essential DNA sequence for the replication of Rts1. AB - The promoter sequence of the mini-Rts1 repA gene encoding the 33,000-dalton RepA protein that is essential for replication was defined by RNA polymerase protection experiments and by analyzing RepA protein synthesized in maxicells harboring mini-Rts1 derivatives deleted upstream of or within the presumptive promoter region. The -10 region of the promoter which shows homology to the incII repeat sequences overlaps two inverted repeats. One of the repeats forms a pair with a sequence in the -35 region, and the other forms a pair with the translation initiation region. The replication origin region, ori(Rts1), which was determined by supplying RepA protein in trans, was localized within 188 base pairs in a region containing three incII repeats and four GATC sequences. Dyad dnaA boxes that exist upstream from the GATC sequences appeared to be dispensable for the origin function, but deletion of both dnaA boxes from ori(Rts1) resulted in reduced replication frequency, suggesting that host-encoded DnaA protein is involved in the replication of Rts1 as a stimulatory element. Combination of the minimal repA and ori(Rts1) segments, even in the reverse orientation compared with the natural sequence, resulted in reconstitution of an autonomously replicating molecule. PMID- 3546267 TI - Cloning and characterization of the Escherichia coli lit gene, which blocks bacteriophage T4 late gene expression. AB - Escherichia coli lit mutations inhibit gene expression late in infection by bacteriophage T4. We cloned the lit gene from wild-type E. coli and three independent lit mutants. We present evidence that lit mutations [renamed lit(Con) mutations] cause overproduction of the lit gene product and that overproduction of this product causes the inhibition of gene expression. We also present evidence that the lit gene product is nonessential for E. coli growth, although the gene is common to most E. coli K-12 strains. PMID- 3546268 TI - Isolation and genetic analysis of mutations allowing the degradation of furans and thiophenes by Escherichia coli. AB - Successive mutations of Escherichia coli yielded a strain that was able to degrade a variety of heterocyclic oxygen- and sulfur-containing ring compounds. In particular, this strain could use both furan-2-carboxylic acid and thiophene-2 carboxylic acid as sole carbon and energy sources. Nitrogen-containing heterocyclic compounds were not degraded. This mutant was isolated by selecting first for oxidation of furan derivatives and then for thiophene degradation. Genetic analysis revealed that mutations in three novel genes, thdA (12 min), thdC (92 min), and thdD (98 min), were required for thiophene degradation. In addition, constitutively at both of the previously characterized fadR and atoC loci was required for efficient thiophene breakdown. The pathway of furan and thiophene degradation remains obscure, but the inability of our mutants to degrade 5-nitro- or 5-bromo-substituted furan derivatives suggests that hydroxylation at position 5 may be involved. Thiophene derivatives were toxic when they were present at concentrations of 0.1% or greater; however, addition of trace amounts of phenylalanine plus tyrosine greatly reduced this effect. PMID- 3546269 TI - Roles of cheY and cheZ gene products in controlling flagellar rotation in bacterial chemotaxis of Escherichia coli. AB - To understand output control in bacterial chemotaxis, we varied the levels of expression of cellular cheY and cheZ genes and found that the overproduction of the corresponding proteins affected Escherichia coli swimming behavior. In the absence of other signal-transducing gene products, CheY overproduction made free swimming cells tumble more frequently. A plot of the fraction of the population that are tumbling versus the CheY concentration was hyperbolic, with half of the population tumbling at 30 microM (25,000 copies per cell) CheY monomers in the cytosol. Overproduction of aspartate receptor (Tar) by 30-fold had a negligible effect on CheY-induced tumbling, so Tar does not sequester CheY. CheZ overproduction decreased tumbling in all tumbling mutants except certain flaAII(cheC) mutants. In the absence of other chemotaxis gene products, CheZ overproduction inhibited CheY-induced tumbling. Models for CheY as a tumbling signal and CheZ as a smooth-swimming signal to control flagellar rotation are discussed. PMID- 3546270 TI - Control of the kilA gene of the broad-host-range plasmid RK2: involvement of korA, korB, and a new gene, korE. AB - Broad-host-range plasmid RK2 encodes several different kil genes which are potentially lethal to an Escherichia coli host. The kil genes and the essential RK2 replication gene trfA are regulated by the products of kor genes. We have shown previously that kilA can be controlled by a constitutively expressed korA gene. In this study, we have found that the wild-type, autoregulated korA gene is insufficient for control of kilA cloned on high-copy-number plasmids. One of two other genes must also be present with korA. One gene is korB, originally discovered by its ability to control the determinants in the kilB region and later found to affect expression of both trfA and korA. The other is a new gene, korE, which has been cloned from the 2.2' to 4.1' region located between korC and kilA. Studies with a kilA-cat fusion suggest that korA, korB, and korE all participate in the control of kilA gene expression. PMID- 3546271 TI - Roles of the Pribnow box in positive regulation of the ompC and ompF genes in Escherichia coli. AB - The roles of the first base of the Pribnow box in positive regulation of the ompC and ompF genes were studied. G- and A-to-T substitutions of the first base of the ompC and ompF Pribnow boxes, respectively, resulted in a high-level functioning of the promoters in the ompR background. The level was further enhanced significantly in the ompR+ background. The effects of other substitutions were also studied. Based on these observations, the roles of the Pribnow box in the positive regulation are discussed. PMID- 3546272 TI - Cloning of Rhizobium leguminosarum genes for competitive nodulation blocking on peas. AB - One type of competitive interaction among rhizobia is that between nonnodulating and nodulating strains of Rhizobium leguminosarum on primitive pea genotypes. Pisum sativum cv. Afghanistan nodulates effectively with R. leguminosarum TOM, and this can be blocked in mixed inoculations by R. leguminosarum PF2, which does not nodulate this cultivar. We termed this PF2 phenotype Cnb+, for competitive nodulation blocking. Strain PF2 contains three large plasmids including a 250 kilobase-pair symbiotic (Sym) plasmid. Transfer of this plasmid, pSymPF2, to nonblocking rhizobia conferred the Cnb+ phenotype on recipients in mixed inoculations on cultivar Afghanistan with TOM. A library of the PF2 genome constructed in the vector pMMB33 was used to isolate two cosmid clones which hybridize to pSymPF2. These cosmids, pDD50 and pDD58, overlapped to the extent of 23 kilobase pairs and conferred a Cnb+ phenotype on recipient Cnb- rhizobia, as did pSD1, a subclone from the common region. PMID- 3546274 TI - Carbamazepine versus lithium in mania: a double-blind study. AB - Thirty-four manic patients were randomly assigned to treatment with carbamazepine or lithium. Clinical response was rated over 4 weeks. Twenty-eight patients, 14 in each group, completed the full protocol. Serum levels for both drugs were within the accepted therapeutic range. The overall response to treatment was not significantly different between the two groups. Comparison of individual Clinical Global Impressions, Brief Psychiatric Rating Scale, and Beigel-Murphy Manic State Rating Scale change scores showed a more consistent level of improvement across patients in the lithium-treated group compared to a minority of good responders in the carbamazepine-treated group. The findings suggest that carbamazepine has antimanic potential in specific bipolar patients whose clinical characteristics remain to be clearly defined. PMID- 3546273 TI - Evolutionary origin of pathogenic determinants in enterotoxigenic Escherichia coli and Vibrio cholerae O1. AB - Three families of the evolutionarily related pathogenic determinants in enterotoxigenic Escherichia coli and Vibrio cholerae O1, a family of cholera enterotoxin (CT) and heat-labile enterotoxin (LT) including CT, LTh, and LTp, a family of heat-stable enterotoxin I (STI) including STIa and STIb, and a family of K88 enteroadhesion fimbriae including K88ab, K88ac, and K88ad were analyzed for synonymous (silent) nucleotide substitutions by using the gene nucleotide sequences of earlier reports and the LTp gene nucleotide sequence presented in this paper. The data suggested that the divergences between LT and CT and between STIa and STIb occurred in the remote past, whereas those between LTh and LTp and between members of the K88 family occurred very recently. We concluded that the LT gene is a foreign gene that has been acquired by E. coli to form an enteropathogen. This provides evolutionary evidence of species-to-species transfer of pathogenic determinants in procaryotes. PMID- 3546275 TI - A cell-binding, immunoglobulin-like protein from human plasma. II. Cell-binding activity. AB - Cell adhesion to plastic surfaces coated with a new high-molecular-mass immunoglobulin-like protein from normal human plasma was studied. Mouse subdermal fibroblasts, hamster kidney cells, human umbilical vein endothelial cells, and human skin fibroblasts were found to become attached to the surface, but cancer cells derived from human stomach cancer and human breast cancer did not. The appearance of the attached cells differed from that of cells attached to surfaces coated with fibronectin or concanavalin A. The cell adhesion to the surfaces coated with the protein was inhibited by goat anti-human IgM. Furthermore, the binding of the protein to the cell surfaces was demonstrated by the indirect immunofluorescence method. It is concluded that this protein is a new cell binding protein. PMID- 3546276 TI - Intermolecular relations of the photosystem II complex in spinach chloroplasts as detected by immunochemical assay. AB - Polyclonal antibodies were prepared to the subunits of the spinach photosystem II fraction (PS II): p47, p43, p27, p33, p24, and p17. (The protein nomenclature refers to Mr). p47 and p43 are the subunits of reaction center complex, and p27 is light-harvesting chlorophyll protein. p33, p24, and p17 are extractable from PS II with 1 M Tris, and p24 and p17 with 1 M NaCl. With untreated PS II fractions, the antibody to p24 inhibited the photosynthetic oxygen-evolving activity, but not the DCPI-photoreduction activity in the presence of DPC, indicating that p24 played an important role in the former activity. Bindings of the respective antibodies to the PS II treated with sodium dodecyl sulfate were regarded as 100%. To untreated PS II, the bindings were 20-30% for p47, p43, and p27, about 50% for p33, and 70-80% for p24 and p17. To NaCl-washed PS II, the binding to p33 increased by 9%, indicating that p33 was adjacent or bound with p24 or/and p17. To Tris-washed PS II, the binding to p43 increased by 7%, indicating that p43 was adjacent or bound with p33. To PS II treated with 3% of Brij 58, only the binding to p27 increased appreciably. To PS II treated with 1% of octyl glucoside, the binding to p47 was still lower than 50%, whereas those to the other subunits were 74-91%. These values could be a measure of the extents to which the subunits were exposed to the aqueous phase, because of the nature of polyclonal antibodies. These results suggest that in intact PS II, p47, p43, and p27 were in most part buried in the inside, p47 being located at the most central and p27 at the outermost part, whereas p33, p24, and p17 were exposed to the outside by 50-75%. PMID- 3546277 TI - Interactions of alpha-chymotrypsin and Carlsberg subtilisin with methyl N alpha acetyl-2-(alkylthio)-L-tryptophanoates. AB - Methyl N alpha-acetyl-2-(alkylthio)-L-tryptophanoates bearing different alkylthio groups were synthesized and employed as substrates for alpha-chymotrypsin and Carlsberg subtilisin in an attempt to investigate the properties of the hydrophobic pocket or cleft (S1 subsite) of the enzymes which accommodates the side-chain of the P1 amino acid residue of the substrates. The derivatives with ethylthio, 2-hydroxyethylthio, 2,3-dihydroxypropylthio, 2-aminoethylthio, carboxymethylthio, 2-carboxyethylthio, 1,2-dicarboxyethylthio, and 2-amino-2 carboxyethylthio (cysteinyl-S) groups were hydrolyzed by alpha-chymotrypsin but with kcat/Km values 4.6 to 15 times smaller than that of methyl N alpha-acetyl-L tryptophanoate, due mainly to larger Km values. The glutathionyl derivative was only weakly bound to the enzyme. Analyses of the kinetic parameters suggested that the S1 pocket of alpha-chymotrypsin is rather more spacious than has been supposed and is able to interact flexibly with substrates so as to orient the scissile bond to the catalytic residues. On the other hand, none of the derivatives were hydrolyzed by Carlsberg subtilisin but they all inhibited the enzyme with Ki values which are generally smaller than the Km values for N alpha acetyl-L-aromatic (modified aromatic) amino acid methyl esters. The S1 cleft of Carlsberg subtilisin interacts rather strongly with the derivatives but lacks the flexibility necessary for catalysis. PMID- 3546278 TI - A highly sensitive enzyme immunoassay of anti-insulin antibodies in guinea pig serum. AB - A highly sensitive enzyme immunoassay of anti-insulin antibodies in guinea pig serum is described. Guinea pig anti-insulin serum was diluted to various extents with nonspecific guinea pig serum and incubated with insulin. After incubation, free insulin was separated from insulin-anti-insulin antibody complex by treatment with dextran-charcoal. Anti-insulin antibodies in the complex were dissociated from insulin by incubation with 0.23 M HCl and inactivated. The amount of dissociated insulin was measured by sandwich enzyme immunoassay using anti-insulin IgG-coated polystyrene balls and affinity-purified anti-insulin Fab' horseradish peroxidase conjugate. The detection limit of anti-insulin antibodies in guinea pig serum was 6.7 pg/assay or 150 ng/liter of serum. The present enzyme immunoassay was 10,000-fold more sensitive than the previously described enzyme immunoassay, in which insulin-coated polystyrene balls were incubated with diluted guinea pig anti-insulin serum and subsequently with rabbit (anti-guinea pig IgG) Fab'-horseradish peroxidase conjugate. PMID- 3546279 TI - Isolation, and catalytic and immunochemical properties of cathepsin D-like acid proteinase from rat erythrocytes. AB - An erythrocyte membrane-associated cathepsin D-like acid proteinase, termed "EMAP," was purified to homogeneity from freshly collected rat blood in a yield of 60-65%. The molecular weight of the enzyme was determined to be 80,000-82,000 by Sephadex G-100 gel filtration. The enzyme was inhibited strongly by pepstatin and partially by HgCl2, Pb(NO3)2, and iodoacetic acid. The preferred substrate for the enzyme was hemoglobin. The enzyme also hydrolyzed serum albumin and casein, but to lesser extents, with an optimum pH of 3.5-4.0. However, it could not hydrolyze leucyl-2-naphthylamide, benzyloxycarbonyl-Phe-Arg-4-methyl-7 coumarylamide or other synthetic substrates at pH values ranging from 3.5 to 9.5. The enzyme was very similar to human EMAP in a number of enzymatic properties, whereas it differed from rat cathepsin D in several respects, such as pH stability, molecular weight, isoelectric point, and chromatographic properties. Immunologically, the enzyme cross-reacted with the rabbit antibody prepared against human EMAP. The patterns of immunoelectrophoresis, immunoblotting, and immunoprecipitation of the enzyme were remarkably similar, if not identical, to those of human EMAP. In contrast, rat EMAP showed no reaction with the rabbit antibody raised to rat spleen cathepsin D. These results indicate that EMAP is a unique cathepsin D-like acid proteinase different from ordinary cathepsin D. PMID- 3546280 TI - Differential rate assay of human pancreatic and salivary alpha-amylases in serum using two coupled enzymes. AB - p-Nitrophenyl O-6-deoxy-6-[(2-pyridyl)amino]-alpha-D-glucopyranosyl-(1----4)-O alpha- D-glucopyranosyl-(1----4)-O-alpha-D-glucopyranosyl-(1----4)-O-alpha-D- glucopyranosyl-(1----4)-alpha-D-glucopyranoside (FG5P) is hydrolyzed by human pancreatic a-amylase (HPA) or salivary alpha-amylase (HSA) to O-6-deoxy-6-[(2 pyridyl)amino]-alpha-D- glucopyranosyl-(1----4)-O-alpha-D-glucopyranosyl-(1----4) D-glucose (FG3) and p-nitrophenyl alpha-maltoside or to O-6-deoxy-6-[(2 pyridyl)amino]-alpha-D-glucopyranosyl-(1----4)-O-alpha- D-glucopyranosyl-(1----4) O-alpha-D-glucopyranosyl-(1----4)-D-glucose (FG4) and p-nitrophenyl alpha glucoside. The use of alpha-D-glucosidase (maltase) [EC 3.2.1.20] of Saccharomyces carlsbergensis and oligo-1,6-glucosidase (isomaltase) [EC 3.2.1.10] of bakers' yeast as coupled enzymes differentiates between the two reactions, because alpha-D-glucosidase liberates p-nitrophenol from both p-nitrophenyl alpha glucoside and p-nitrophenyl alpha-maltoside, but oligo-1,6-glucosidase liberates it only from p-nitrophenyl alpha-glucoside. HPA produces more FG4 and p nitrophenyl alpha-glucoside than HSA. Taking advantage of the differences in the action of the two amylases and in the substrate specificity of the coupled enzymes, we have developed a new colorimetric differential rate assay of alpha amylases in human serum. PMID- 3546281 TI - Lipoprotein lipase in mouse peritoneal macrophages: the effects of insulin and dexamethasone. AB - The effects of insulin and dexamethasone on the secretion of lipoprotein lipase (LPL) by mouse peritoneal macrophages were examined in vitro. Macrophages from either normal or thioglycollate-primed mice continuously secreted LPL into the culture medium. The time courses and the amounts of enzyme secretion and the responses to the hormones were essentially the same in resident or thioglycollate primed macrophages. Insulin did not enhance the secretion of this enzyme by macrophages, even though a marked effect of this hormone on the enzyme in adipose tissue has been well established. Dexamethasone, which has been reported to stimulate the secretion of LPL in the heart, suppressed the secretion of LPL by macrophages. The present study is the first report to deal with the effect of hormones on the secretion of LPL by macrophages, and clearly demonstrates that insulin does not play an important role in the regulation of LPL activity in macrophages. Dexamethasone also showed a different effect on macrophage LPL compared to that on the enzyme in other tissues. This difference in the regulation of LPL may be relevant to the possibly different role of this enzyme in macrophages as compared to other tissues such as adipose tissue, muscle, or heart. PMID- 3546282 TI - Tumor necrosis factor increases the number of epidermal growth factor receptors on human fibroblasts. AB - Tumor necrosis factor (TNF) was shown previously to stimulate the growth of human FS-4 fibroblasts. Here we show that human recombinant TNF can increase the binding of epidermal growth factor (EGF) to these cells. Incubation with TNF resulted in a 40-80% increase in the number of EGF-binding sites with no apparent change in receptor binding affinity. The increase in EGF binding was apparent 8 12 h after the addition of TNF. TNF also increased the amount of EGF receptor protein immunoprecipitated from cells labeled with [35S]methionine. Stimulation of EGF receptor protein synthesis was demonstrable 2-4 h following TNF treatment. TNF increased EGF binding with a dose-response relationship similar to that reported earlier for the mitogenic action. Increased expression of EGF receptors, due to enhanced synthesis of the EGF receptor protein, may be functionally related to the mitogenic action of TNF in human fibroblasts. PMID- 3546283 TI - 19F nuclear magnetic resonance as a probe of structural transitions and cooperative interactions in heavy meromyosin. AB - An 19F NMR probe has been attached to the reactive sulfhydryl SH1 of the globular heads of rabbit skeletal heavy meromyosin. It serves as a sensitive monitor of the conformational state of the heads of heavy meromyosin in a manner similar to that seen for subfragment-1 (Shriver, J.W., and Sykes, B.D. (1982) Biochemistry 21, 3022-3028; Tollemar, U., Cunningham, K., and Shriver, J.W. (1986) Biochim. Biophys. Acta 873, 243-251). The NMR spectra indicate that there are at least two states for the heads in the SH1 region. The energetics of the interconversion of the two states of heavy meromyosin (HMM) differs significantly from that of S-1. In HMM in the absence of divalent cations, there are two reversible paths between the low temperature and high temperature states with a hysteresis-like behavior. One path is consistent with the head groups behaving independently and similar to S-1 alone. The second path indicates a coupling of the globular head region observed in S-1 with a second region forming a distinctly different cooperative unit. Upon addition of Ca(II) the hysteresis effect is lost and only the second cooperative unit is observed. Two explanations are offered for these results: the globular heads in HMM may couple with the S-2 segment, or the two globular heads of HMM may couple to form a larger cooperative unit. The ability to stabilize the larger cooperative unit with a divalent metal ion implicates a role for the LC2 light chain in coupling regions of the myosin molecule. PMID- 3546284 TI - Branch specificity of bovine colostrum CMP-sialic acid: Gal beta 1----4GlcNAc-R alpha 2----6-sialyltransferase. Sialylation of bi-, tri-, and tetraantennary oligosaccharides and glycopeptides of the N-acetyllactosamine type. AB - Using 500-MHz 1H NMR spectroscopy we have investigated the branch specificity that bovine colostrum CMP-NeuAc:Gal beta 1----4GlcNAc-R alpha 2----6 sialyltransferase shows in its sialylation of bi-, tri-, and tetraantennary glycopeptides and oligosaccharides of the N-acetyllactosamine type. The enzyme appears to highly prefer the galactose residue at the Gal beta 1----4GlcNAc beta 1----2Man alpha 1----3 branch for attachment of the 1st mol of sialic acid in all the acceptors tested. The 2nd mol of sialic acid becomes linked mainly to the Gal beta 1----4GlcNAc beta 1----2Man alpha 1----6 branch in bi- and triantennary substrates, but this reaction invariably proceeds at a much lower rate. Under the conditions employed, the Gal beta 1----4GlcNAc beta 1----6Man alpha 1----6 branch is extremely resistant to alpha 2----6-sialylation. A higher degree of branching of the acceptors leads to a decrease in the rate of sialylation. In particular, the presence of the Gal beta 1----4GlcNAc beta 1----6Man alpha 1----6 branch strongly inhibits the rate of transfer of both the 1st and the 2nd mol of sialic acid. In addition, it directs the incorporation of the 2nd mol into tetraantennary structures toward the Gal beta 1----4GlcNAc beta 1----4Man alpha 1 ---3 branch. In contrast, the presence of the Gal beta 1----4GlcNAc beta 1--- 4Man alpha 1----3 branch has only minor effects on the rates of sialylation and, consequently, on the branch preference of sialic acid attachment. Results obtained with partial structures of tetraantennary acceptors indicate that the Man beta 1----4GlcNAc part of the core is essential for the expression of branch specificity of the sialyltransferase. The sialylation patterns observed in vivo in glycoproteins of different origin are consistent with the in vitro preference of alpha 2----6-sialyltransferase for the Gal beta 1----4GlcNAc beta 1----2Man alpha 1----3 branch. Our findings suggest that the terminal structures of branched glycans of the N-acetyllactosamine type are the result of the complementary branch specificity of the various glycosyltransferases that are specific for the acceptor sequence Gal beta 1----4GlcNAc-R. PMID- 3546285 TI - Properties of initiation complexes formed between Escherichia coli DNA polymerase III holoenzyme and primed DNA in the absence of ATP. AB - In the presence of ATP, the beta subunit of the Escherichia coli DNA polymerase III holoenzyme can induce a stable initiation complex with the other holoenzyme subunits and primed DNA that is capable of highly processive synthesis. We have recently demonstrated that the ATP requirement for processive synthesis can be bypassed by an excess of the beta subunit (Crute, J., LaDuca, R., Johanson, K., McHenry, C., and Bambara, R. (1983) J. Biol. Chem. 258, 11344-11349). To examine the complex formed with excess beta subunit, and the lengths of the products of processive synthesis, we have designed a uniquely primed DNA template. Poly(dA)4000 was tailed with dCTP by terminal deoxynucleotidyl transferase and the resulting template annealed to oligo(dG)12-18. In the presence of excess beta, the lengths of processively extended primers nearly equaled the full-length of the DNA template. Similar length synthesis occurred in the presence or absence of spermidine or single-stranded DNA-binding protein. When the beta subunit was present at normal holoenzyme stoichiometry it could induce highly processive synthesis without ATP, although inefficiently. Both ATP and excess beta increased the amount of initiation complex formation, but complexes produced with excess beta did so without the time delay observed with ATP, suggesting different mechanisms for formation. Almost 50% of initiation complexes formed without ATP survived a 30-min incubation with anti-beta IgG, reflecting a stability similar to those formed with ATP. The ability to form initiation complexes in the absence of ATP permitted the demonstration that cycling of the holoenzyme to a new primer, after chain termination with a dideoxynucleotide, is not affected by the presence of ATP. PMID- 3546286 TI - Identification of a novel insulin-sensitive glycophospholipid from H35 hepatoma cells. AB - This study identifies and partially characterizes an insulin-sensitive glycophospholipid in H35 hepatoma cells. The incorporation of [3H]glucosamine into cell lipids was investigated. A major labeled lipid was purified by sequential thin layer chromatography using first an acid followed by a basic solvent system. After hydrochloric acid hydrolysis and sugar analysis by thin layer chromatography, 80% of the radioactivity in the purified lipid was found to comigrate with glucosamine. H35 cells were prelabeled with [3H]glucosamine for either 4 or 24 h and treated with insulin causing a dose-dependent stimulation of turnover of the glycophospholipid which was detected within 1 min. The purified glycolipid was cleaved by nitrous acid deamination indicating that the glucosamine C-1 was linked to the lipid moiety through a glycosidic bond. [14C]Ethanolamine, [3H]inositol, and [3H]sorbitol were not incorporated into the purified glycolipid. The incorporation of various fatty acids into this glycolipid was also studied. [3H]Palmitate was found to be preferentially incorporated while myristic acid, stearic acid, oleic acid, linoleic acid, linolenic acid, and arachidonic acid were either not incorporated or incorporated less than 10% of palmitate. The purified glycolipid labeled with [3H]palmitate was cleaved by treatment with phospholipase A2 but was resistant to mild alkali hydrolysis suggesting the presence of a 1-hexadecyl,2-palmitoyl-glyceryl moiety in the purified lipid. Treatment of labeled glycophospholipid with phosphatidylinositol-specific phospholipase C from Staphylococcus aureus generated a compound migrating as 1-alkyl,2-acyl-glycerol and a polar head group with a size in the range from 800 to 3500. These findings coupled with the nitrous acid deamination demonstrate that glucosamine was covalently linked through a phosphodiester bond to the glyceryl moiety of the purified glycolipid. These findings suggest that insulin acts on this glycophospholipid by stimulating an insulin-sensitive phospholipase C. This unique glycophospholipid may play an important role in insulin action by serving as precursor of insulin-generated mediators. PMID- 3546287 TI - Biochemical characterization of recombinant human phenylalanine hydroxylase produced in Escherichia coli. AB - A full-length human phenylalanine hydroxylase cDNA has been recombined with a prokaryotic expression vector and introduced into Escherichia coli. Transformed bacteria express phenylalanine hydroxylase immunoreactive protein and pterin dependent conversion of phenylalanine to tyrosine. Recombinant human phenylalanine hydroxylase produced in E. coli has been partially purified, and biochemical studies have been performed comparing the activity and kinetics of the recombinant enzyme with native phenylalanine hydroxylase from human liver. The optimal reaction conditions, kinetic constants, and sensitivity to inhibition by aromatic amino acids are the same for recombinant phenylalanine hydroxylase and native phenylalanine hydroxylase. These data indicate that the recombinant human phenylalanine hydroxylase is an authentic and complete phenylalanine hydroxylase enzyme and that the characteristic aspects of phenylalanine hydroxylase enzymatic activity are determined by a single gene product and can be constituted in the absence of any specific accessory functions of the eukaryotic cell. The availability of recombinant human phenylalanine hydroxylase produced in E. coli will expedite physical and chemical characterization of human phenylalanine hydroxylase which has been hindered in the past by inavailability of the native enzyme for study. PMID- 3546288 TI - Transport of beta-very low density lipoproteins and chylomicron remnants by macrophages is mediated by the low density lipoprotein receptor pathway. AB - The receptor-mediated uptake of rat hypercholesterolemic very low density lipoproteins (beta VLDL) and rat chylomicron remnants was studied in monolayer cultures of the J774 and P388D1 macrophage cell lines and in primary cultures of mouse peritoneal macrophages. Uptake of 125I-beta VLDL and 125I-chylomicron remnants was reduced 80-90% in the presence of high concentrations of unlabeled human low density lipoproteins (LDL). Human acetyl-LDL did not significantly compete at any concentration tested. Uptake of 125I-beta VLDL and 125I chylomicron remnants was also competitively inhibited by specific polyclonal antibodies directed against the estrogen-induced LDL receptor of rat liver. Incubation in the presence of anti-LDL receptor IgG, but not nonimmune IgG, reduced specific uptake greater than 80%. Anti-LDL receptor IgG, 125I-beta VLDL, and 125I-chylomicron remnants bound to two protein components of apparent molecular weights 125,000 and 111,000 on nitrocellulose blots of detergent solubilized macrophage membranes. Between 70-90% of 125I-lipoprotein binding was confined to the 125,000-Da peptide. Binding of 125I-beta VLDL and 125I chylomicron remnants to these proteins was competitively inhibited by anti-LDL receptor antibodies. Comparison of anti-LDL receptor IgG immunoblot profiles of detergent-solubilized membranes from mouse macrophages, fibroblasts, and liver, and normal and estrogen-induced rat liver demonstrated that the immunoreactive LDL receptor of mouse cells is of a lower molecular weight than that of rat liver. Incubation of J774 cells with 1.0 micrograms of 25-hydroxycholesterol/ml plus 20 micrograms of cholesterol/ml for 48 h decreased 125I-beta VLDL uptake and immuno- and ligand blotting to the 125,000- and 111,000-Da peptides by only 25%. Taken together, these data demonstrate that uptake of beta VLDL and chylomicron remnants by macrophages is mediated by an LDL receptor that is immunologically related to the LDL receptor of rat liver. PMID- 3546289 TI - An affinity labeling of ras p21 protein and its use in the identification of ras p21 in cellular and tissue extracts. AB - We have carried out photoaffinity labeling of the ras p21 protein, a ras oncogene product, with [alpha-32P]GTP. Based on our studies, a sensitive, rapid, and specific assay for the detection of multiple forms of ras p21 has been developed. The specificity of this protocol is shown by (a) sensitivity of affinity labeling of ras p21 to known inhibitors of GTP binding and (b) immunoprecipitation of affinity labeled protein with anti-ras p21 serum. Detection and semiquantitation of ras p21 by this method is accomplished in less than 24 h and requires as little as 100,000 cells or about 5 mg of tissue sample from skin tumor, liver, and mammary tumor tissues. Furthermore, using this approach, we were able to detect the selective loss of one species of ras p21 in transplanted Morris hepatoma cells. PMID- 3546290 TI - Two-step prorenin-renin conversion. Isolation of an intermediary form of activated prorenin. AB - Prorenin is an inactive form of the aspartic protease renin. Like pepsinogen, it is activated at low pH. The kinetics of acid activation of prorenin were studied in human amniotic fluid and plasma and in preparations of purified prorenin isolated from amniotic fluid and plasma. Conversion of prorenin (pR) into active renin (R) appeared to be a two-step process involving the generation of an intermediary form of activated prorenin (pRa). The pR----pRa step is an acid induced reversible change in the conformation of the molecule, and the pRa----R step is proteolytic. pRa----R conversion occurred in amniotic fluid at low pH by the action of an endogenous aspartic protease. In plasma pRa----R conversion occurs after restoration of pH to neutral and is caused by the serine protease plasma kallikrein. pRa----R conversion did not occur in purified preparations of prorenin. Thus, in contrast to pepsinogen, the acid-induced reversible conformational change is not followed by autocatalysis. pRa of amniotic fluid and plasma could be separated from R by affinity chromatography on Cibacron blue F3GA agarose, and R but not pRa was detected by an immunoassay using monoclonal antibodies reacting with R and not with pR. The first-order rate constant for pR- --pRa conversion depends on the protonation of a polar group (or groups) with pK approximately 3.4, the rate constant being proportional to the fraction of pR molecules that have this group protonated. This is analogous to the reversible acid-induced conformational change of pepsinogen that occurs before its proteolytic conversion into pepsin. kcat/Km for pRa----R conversion by plasmin and plasma kallikrein at pH 7.4 and 37 degrees C was 7.8 X 10(6) and 5.2 X 10(6) M-1 min-1, respectively, which was about 50-70 times greater than for pR----R conversion. The susceptibility of pRa to proteolytic attack is high enough for the intrinsic factor XII-kallikrein pathway to cause rapid pRa----R conversion at 37 degrees C even in whole blood with its abundance of serine protease inhibitors. Formation of pRa may occur in vivo in an acidic cellular compartment, such as exo- or endocytotic vesicles. PMID- 3546291 TI - Physical characteristics of ribosomal protein S4 from Escherichia coli. AB - A hydrodynamic study of protein S4 from Escherichia coli 30 S ribosomal subunits indicates that this protein is moderately asymmetric. A sedimentation coefficient of 1.69 S and a diffusion coefficient of 7.58 X 10(-7) cm2/s suggest that S4 has an axial ratio of about 5:1 using a prolate ellipsoidal model. This structure should give a radius of gyration of about 29-30 A from small-angle neutron or small-angle x-ray scattering studies. This study has utilized quasi-elastic light scattering as an analytical tool to obtain a diffusion coefficient as well as a method to monitor sample quality. Using quasi-elastic light scattering in this manner allows an assessment of problems associated with protein purity which may be responsible for the many disparate results reported for ribosomal proteins and especially protein S4. PMID- 3546292 TI - Isolation and nucleotide sequence of a Saccharomyces cerevisiae protein kinase gene suppressing the cell cycle start mutation cdc25. AB - We have isolated two unlinked yeast genes complementing the cell division cycle mutant cdc25-1, one containing the wild type allele CDC25 and the other acting as an extragenic suppressor of the cdc25-1 lesion if present on a multicopy plasmid. Nucleotide sequence analysis of the suppressor gene has revealed an open reading frame that encodes a 45,000-dalton protein belonging to the protein kinase family. The cdc25-suppressing protein kinase (PK-25) shows 48% sequence similarity to the catalytic subunit (CA) of mammalian cAMP-dependent protein kinase and 27-31% similarity to cyclic nucleotide-independent enzymes, including the yeast CDC28 gene product. The PK-25 gene was targeted by integrative transformation into a chromosomal region unlinked to the CYR2 site, the structural gene of CA. The cdc25-suppressing protein kinase is also functionally different from CA, since cyr2 strains deficient in the free catalytic subunit remain temperature sensitive if transformed with a multicopy plasmid containing the PK-25 gene. Furthermore, a deficiency of the cAMP-binding regulatory subunit (RA) caused by the bcy1 mutation fails to suppress the cdc25 mutation, indicating that PK-25 does not interact with the cAMP receptor protein. Our data suggest that the cdc25 suppressor gene encodes a cAMP-independent protein kinase involved in the control of the cell cycle start. PMID- 3546293 TI - Phorbol ester- and protein kinase C-mediated phosphorylation of the cellular Kirsten ras gene product. AB - The effect of phorbol 12-myristate 13-acetate on the phosphorylation of the ras p21 protein was studied by metabolically labeling cultured cells with [32P]orthophosphate and using a monoclonal antibody to immunoprecipitate the protein. Phorbol 12-myristate 13-acetate (100 nM) induced phosphorylation of cKi ras p21 in a mouse adrenocortical cell line (Yl) expressing high levels of cKi ras with exon 4B. Phosphorylation was detected at 10 min and was maximal at 2 h. The ras protein was not phosphorylated in response to phorbol 12-myristate 13 acetate in NIH 3T3 cells expressing activated cHa-ras or vHa-ras. In vitro, protein kinase C phosphorylated cKi-ras in a phosphatidylserine and diolein dependent manner. Both in intact cells and in vitro the amino acid phosphorylated was serine. Analysis of p21 from NIH 3T3 cells expressing a variety of ras proteins indicated that phosphorylation occurs within a domain encoded by exon 4B of cKi-ras. Phosphorylation affected neither the binding nor the GTPase activity of the ras protein. We conclude that cKi-ras is a substrate for protein kinase C and that the site of phosphorylation is likely to be serine 181 encoded by exon 4B. PMID- 3546294 TI - Reassessment of insulin effects on the Vmax and Km values of hexose transport in isolated rat epididymal adipocytes. AB - Effects of insulin on the kinetic parameters of hexose transport in rat epididymal adipocytes were re-examined. The transport activity was assessed by measuring the rate of uptake of 3-O-[3H]methyl-D-glucose (MeGlc) under equilibrium exchange and zero-trans conditions. The incubation was carried out at 37 degrees C in an infant incubator. During the incubation, the cell suspension (25%, v/v, in a total volume of 48 microliter) was mechanically swirled at a rate of 600 rpm (r = 2 mm). The swirling facilitated the rapid uptake of MeGlc without stimulating the basal transport activity by "mechanical agitation". The basal and insulin-treated cells were incubated under identical conditions, except for the length of the incubation period. The incubation was terminated by the addition of 350 microliters of 1 mM phloretin, which inhibited transport in approximately 0.06 s. The time course of MeGlc uptake was consistent with the view that the process was a multiple-phase reaction. The initial phase of the reaction was completed when the intracellular distribution space of MeGlc was approximately 1% of the total cell volume. Insulin (10 nM) increased the Vmax value of MeGlc uptake 16-fold in equilibrium exchange experiments and 18-fold in zero-trans experiments. At the same time, the hormone decreased the Km value of MeGlc uptake from 11.7 to 5.4 mM in equilibrium exchange experiments and from 9.7 to 4.8 mM in zero-trans experiments. It is concluded that the major effect of insulin on MeGlc uptake is to increase the Vmax value, but the hormone has the additional effect of lowering the apparent Km value. PMID- 3546295 TI - Bovine high molecular weight kininogen. The amino acid sequence, positions of carbohydrate chains and disulfide bridges in the heavy chain portion. AB - The existence of two types of circulating bovine plasma high molecular weight kininogen (HMWK) was predicted from analyses of complementary DNAs coding for this protein (Kitamura, N., Takagaki, Y., Furuto, S., Tanaka, T., Nawa, H., and Nakanishi, S. (1983) Nature 305, 545-549). The present protein-based study provided evidence in support of the proposed amino acid sequence derived from analysis of the cDNA clone, and the results confirm the existence of two types of circulating HMWK. Type I HMWK contains a heavy chain composed of 361 residues, while the heavy chain of type II HMWK contains 359 residues. The amino acid sequences of type I and type II HMWK determined in this study were identical to that inferred from the cDNA sequence with the exception of microheterogeneity observed in the cDNA at position 87 (Glu/Gln) and 168 (Lys/Arg). The heavy chain of type I HMWK contains 4 asparagine-linked carbohydrate chains at Asn-69, -150 (or -151), -179, and -186, while the heavy chain of type II HMWK contains these and an additional carbohydrate chain at Asn-264. In addition, a carbohydrate chain was found to be O-glycosidically linked to Thr-118 in both chains. Among nine disulfide linkages found in HMWK, eight intrachain disulfide pairs were established in the heavy chain. One interchain disulfide bridge occurs between the heavy chain and the light chain. This disulfide pairing, as well as repeating amino acid sequences observed in the heavy chain, provides strong evidence for the existence of three homologous domains in the heavy chain of bovine HMWK. PMID- 3546296 TI - Escherichia coli S-adenosylmethionine decarboxylase. Subunit structure, reductive amination, and NH2-terminal sequences. AB - S-Adenosylmethionine decarboxylase is one of a small group of enzymes that use a pyruvoyl residue as a cofactor. Histidine decarboxylase from Lactobacillus 30a, the best studied pyruvoyl-containing enzyme, has an (alpha beta)6 subunit structure with the pyruvoyl moiety linked through an amide bond to the NH2 terminal of the larger alpha subunit (Recsei, P. A., Huynh, Q. K., and Snell, E. E. (1983) Proc. Natl. Acad. Sci. U. S. A. 80, 973-977). To examine potential structural analogies between the two enzymes, we have isolated and partially characterized S-adenosylmethionine decarboxylase. The purified enzyme comprises equimolar amounts of two subunits of Mr = 14,000 and 19,000 (by sodium dodecyl sulfate-polyacrylamide gel electrophoresis) and has a native molecular weight of 136,000 (by gel filtration). Approximately 4 mol of [methyl-3H] adenosylmethionine are incorporated per mol of enzyme (Mr = 136,000) when the enzyme is inactivated with this substrate and NaCNBH3. These data suggest an (alpha beta)4 structure with 1 pyruvoyl residue for each alpha beta pair. The two subunits have been separated by reversed-phase high performance liquid chromatography after reduction and carboxymethylation. The smaller subunit (beta) has a free amino terminus. The amino terminus of the larger subunit (alpha) appears to be blocked by a pyruvoyl group; this subunit can be sequenced only after this group is converted to an alanyl residue by reduction with sodium cyanoborohydride in the presence of ammonium acetate. This work suggests that S adenosylmethionine decarboxylase is structurally much more similar to histidine decarboxylase than previously thought. PMID- 3546297 TI - Single crystals of hydrogenase from Desulfovibrio vulgaris Miyazaki F. AB - The hydrogenase solubilized from the particulate fraction from Desulfovibrio vulgaris Miyazaki F (IAM 12604) has been crystallized. Although the solubilized hydrogenase purified by the previous method (Yagi, T., Kimura, K., Daidoji, H., Sakai, F., Tamura, S., and Inokuchi, H. (1976) J. Biochem. (Tokyo) 79,661-671) revealed a single band upon disc electrophoresis, it could not be crystallized. The apparently homogeneous hydrogenase has been separated into three components of similar molecular weights by high performance liquid chromatography on DEAE Toyopearl. Each hydrogenase component was successfully crystallized by means of the vapor diffusion method with polyethylene glycol or 2-methyl-2,4-pentanediol as a precipitating agent. Seeding procedure is necessary to grow an x-ray grade crystal. Preliminary x-ray experiments reveal that crystals grown from one component are in space group of P2(1)2(1)2(1) with a = 102.1(1), b = 126.8 (3), and c = 66.9(1) A. The unit cell volume of 8.66 X 10(5) A3 suggests that it contains one molecule/asymmetric unit (Vm = 2.43). The crystals grown from another component are in the same space group with a = 99.6(1), b = 126.8(3), c = 66.9(1) A, and the unit cell volume is 8.45 X 10(5) A3 (Vm = 2.37). The crystals diffract more than 2.5 A and are suitable for complete crystal analysis. Up to 4 A resolution native data have been collected on a diffractometer. PMID- 3546298 TI - Crystallization and preliminary X-ray investigation of uridine phosphorylase from Escherichia coli. AB - Crystals of uridine phosphorylase from Escherichia coli K12 have been grown from solutions of polyethylene glycol 4000. The crystals are trigonal, space group R3; the hexagonal axes are a = 154.4 A and c = 49.4 A. The crystals are quite stable to x-rays and diffract beyond 2.6 A resolution. It appears that the molecule is a hexamer with a subunit molecular weight of 27,500 and utilizes the 3-fold symmetry of the space group, resulting in two subunits/asymmetric unit. PMID- 3546299 TI - Insulin stimulation of the insulin receptor kinase can occur in the complete absence of beta subunit autophosphorylation. AB - The glutamic acid:tyrosine (Glu:Tyr) synthetic polymer was observed to inhibit the insulin receptor beta subunit autophosphorylation with an IC50 of 0.20 mg/ml in the absence and 0.15 mg/ml in the presence of insulin. Even though complete blockade of beta subunit autophosphorylation was observed at 4.0 mg/ml Glu:Tyr, insulin was still capable of stimulating the exogenous protein kinase activity of the insulin receptor toward Glu:Tyr. Histone H2B (1.3 mg/ml) was also observed to inhibit the beta subunit autophosphorylation by approximately 80% with an IC50 of 0.31 and 0.35 mg/ml in the absence and presence of insulin, respectively. Similar to the results with Glu:Tyr, insulin was found to stimulate histone H2B phosphorylation under these conditions. Comparisons between the time courses of beta subunit autophosphorylation with those of Glu:Tyr phosphorylation both in the presence and absence of insulin confirmed that insulin can stimulate the exogenous protein kinase activity of the insulin receptor in the complete absence of beta subunit autophosphorylation. Prephosphorylation of the insulin receptor (from 0 to 1.3 mol of phosphate/mol of insulin receptor) in the absence of insulin was found to have no significant effect on the exogenous protein kinase activity when assayed both in the presence and absence of insulin. Insulin was observed to stimulate the phosphorylation of Glu:Tyr approximately 3-fold independent of the extent of beta subunit autophosphorylation. In contrast, prephosphorylation of the insulin receptors in the presence of insulin was observed to enhance the exogenous protein kinase activity dependent on the extent of autophosphorylation, such that by 1.4 mol of phosphate incorporated per mol of insulin receptor, insulin was found to maximally stimulate the initial rate of Glu:Tyr phosphorylation (approximately 9-fold). These results demonstrate that the insulin-dependent autophosphorylation of the insulin receptor results in an amplification of the insulin stimulation of the exogenous protein kinase activity, whereas the insulin-independent autophosphorylation does not. PMID- 3546300 TI - Thermal destruction processes in proteins involving cystine residues. AB - To ascertain the upper limit of protein thermostability and to evaluate the introduction of additional -S-S- bridges for the enhancement of protein thermostability by site-directed mutagenesis, the stability of cystine residues at 100 degrees C has been investigated in a number of unrelated proteins. All proteins studied (more than a dozen) undergo heat-induced beta-elimination of cystine residues in the pH range from 4 to 8. The time courses of this process closely follow first-order kinetics indicating that the stability of a cystine residue is not significantly affected by its position in the polypeptide chain. Furthermore, the first-order rate constants of beta-elimination of disulfide bonds at 100 degrees C are remarkably similar for different proteins--0.8 +/- 0.3 h-1 and 0.06 +/- 0.02 h-1 at pH 8.0 and 6.0, respectively. Thus, this process is relatively independent of both the primary structure and the elements of higher structures remaining in proteins in 100 degrees C. beta-Elimination of disulfides produces free thiols that cause yet another deleterious reaction in proteins- heat-induced disulfide interchange. This reshuffling of -S-S-bonds, which is much faster than beta-elimination, has also been quantitatively characterized. PMID- 3546301 TI - Amino acid sequence of the monomer subunit of the extracellular hemoglobin of Lumbricus terrestris. AB - The giant extracellular hemoglobin (3,800 kDa) of the oligochaete Lumbricus terrestris consists of four subunits: a monomer (chain I), two subunits each of about 35 kDa (chains V and VI), and a disulfide-bonded trimer (50 kDa) of chains II, III, and IV. The complete amino acid sequence of chain I was determined: it consists of 142 amino acid residues and has a molecular weight of 16,750 including a heme group. Fifty-nine residues (42%) were found to be identical with those in the corresponding positions in Lumbricus chain II (Garlick, R. L., and Riggs, A. F. (1982) J. Biol. Chem. 257, 9005-9015); 45 (32%), 56 (40%), 44 (31%), and 45 (32%) residues were found to be in identical positions in the sequences of chains I, IIA, IIB, and IIC, respectively, of Tylorrhynchus heterochaetus hemoglobin (Suzuki, T., and Gotoh, T. (1986) J. Biol. Chem. 261, 9257-9267). When the sequences of all six annelid chains are compared, 18 invariant residues are found in the first 104 residues of the molecule; very little homology exists among the annelid chains in the carboxyl-terminal 38-residue region. Nine of the 18 invariant residues are also found in the human beta-globin chain. PMID- 3546302 TI - Molecular cloning and sequence analysis of cDNA for batroxobin, a thrombin-like snake venom enzyme. AB - Determination of the nucleotide sequence of a cDNA for batroxobin, a thrombin like enzyme from Bothrops atrox, moojeni venom, allowed elucidation of the complete amino acid sequence of batroxobin for the first time for a thrombin-like snake venom enzyme. The molecular weight of batroxobin is 25,503 (231 amino acids). The amino acid sequence of batroxobin exhibits significant homology with those of mammalian serine proteases (trypsin, pancreatic kallikrein, and thrombin), indicating that batroxobin is a member of the serine protease family. Based on this homology and enzymatic and chemical studies, the catalytic residues and disulfide bridges of batroxobin were deduced to be as follows: catalytic residues, His41, Asp86, and Ser178; and disulfide bridges, Cys7-Cys139, Cys26 Cys42, Cys74-Cys230, Cys118-Cys184, Cys150-Cys163, and Cys174-Cys199. The amino terminal amino acid residue of batroxobin, valine, is preceded by 24 amino acids. This may indicate that the amino-terminal hydrophobic peptide (18 amino acids) is a prepeptide and that the hydrophilic peptide (6 amino acids), preceded by the putative prepeptide, is a propeptide. PMID- 3546303 TI - ATP-Mn2+ stimulates the generation of a putative mediator of insulin action. AB - Substantial evidence suggests that insulin receptor-associated protein kinase may play a pivotal role in the expression of the intracellular effects of insulin. This study was undertaken to determine whether insulin receptor kinase contributes to the generation of putative insulin mediators. The effect of ATP and divalent cation addition on the production of insulin mediators from liver plasma membranes was investigated. ATP (1 mM) added to liver plasma membranes in the absence of divalent cations enhanced insulin-stimulated release/generation of mediator slightly (approximately 3-fold). ATP in the presence of Mn2+ further increased release/generation of mediator markedly (approximately 100-fold). In contrast, ATP in the presence of Mg2+ had no stimulatory effect. Mn2+ and Mg2+ alone were ineffective. Addition of EDTA completely diminished the stimulatory effects of insulin, ATP, and Mn2+. The stimulation was ATP-specific since other nucleotides and nonhydrolyzable analogues of ATP had no or very weak activity. ATP-Mn2+ stimulated insulin-dependent mediator release/generation in a dose dependent manner. These results suggest that insulin mediator release/generation is markedly stimulated by an ATP-Mn2+-dependent phosphorylation reaction, similar to insulin-stimulated receptor tyrosine kinase phosphorylation. PMID- 3546304 TI - In vitro stimulation of megakaryocyte maturation by megakaryocyte stimulatory factor. AB - Counterflow centrifugal elutriation and Percoll density gradient centrifugation were employed to prepare cell populations from rat bone marrow that were selectively enriched in the cytoplasmically immature megakaryocytes and depleted of the most mature megakaryocytes. The incorporation of [14C]leucine into the platelet-specific alpha-granule protein, platelet factor 4, as well as the incorporation of [35S]sulfate into platelet proteoglycans synthesized by the maturing megakaryocytes were monitored as markers of cytoplasmic maturation. Rat platelet factor 4 was specifically isolated and characterized by its high affinity for heparin-Sepharose and its amino-terminal sequence homology to human and rabbit platelet factor 4. The [35S]sulfate-labeled proteoglycans were primarily composed of chondroitin 4-sulfate glycosaminoglycans and were identified as platelet granule components by their ability to be secreted by megakaryocytes in response to thrombin or A23187. The production of both components was increased as much as 3-fold in a dose-dependent manner by the addition of picomolar concentrations of purified megakaryocyte stimulatory factor, without a concomitant increase in general protein synthesis. The above results suggest that the megakaryocyte stimulatory factor may regulate the synthesis of platelet granule components by megakaryocytes and hence control the rate and/or extent of cytoplasmic maturation during megakaryocyte development. PMID- 3546305 TI - The VLA protein family. Characterization of five distinct cell surface heterodimers each with a common 130,000 molecular weight beta subunit. AB - The family of human cell surface heterodimers which includes VLA-1 and VLA-2 is now shown to include three additional heterodimers, here called VLA-3, VLA-4, and VLA-5. Each of these separate VLA structures is composed of a distinct alpha subunit (Mr 110,000-200,000 nonreduced) noncovalently associated with a common beta subunit (Mr 110,000 nonreduced). Chemical cross-linking experiments provided evidence that each VLA complex exists predominantly as a 1:1 alpha beta heterodimer. The VLA proteins are widely distributed, with one or more of the heterodimers present on nearly all cell types tested. Evidence for five distinct VLA alpha subunits was obtained from differences observed in antibody recognition, cell distribution patterns, two-dimensional gel analyses, and V8 protease cleavage patterns. On the other hand, the beta subunit present in each heterodimer was immunochemically and electrophoretically indistinguishable, and yielded identical V8 cleavage fragments. Immunoblotting experiments revealed that besides the Mr 110,000 beta normally seen, another beta protein was present that is smaller in size (Mr 90,000 nonreduced), altered or deficient in glycosylation, and not available for cell surface radiolabeling. PMID- 3546306 TI - Nuclear translocation of the insulin receptor. A possible mediator of insulin's long term effects. AB - The translocation of occupied surface insulin receptors to the nuclei of isolated hepatocytes was studied using the biologically active photosensitive insulin derivative, B2(2-nitro-4-azidophenylacetyl)-des-PheB1-insulin (NAPA-DP-insulin). When hepatocytes were photolabeled at 4 degrees C, extensively washed, and then further incubated at 37 degrees C for 1 h, photolabeled insulin receptors, which were initially localized to the cell surface, accumulated in the subsequently isolated nuclei. When the isolated nuclei were solubilized and subjected to polyacrylamide gel electrophoresis and radioautography, labeled proteins with Mr identical to the cell surface insulin receptor were detected. Light microscopic radioautography of nuclei isolated from cells incubated for 1 ha at 37 degrees C demonstrated that 28% of these nuclei were specifically labeled with one or more grains. Electron microscopic radioautography of intact cultured hepatocytes, incubated 60 min at 37 degrees C, revealed that 26% of the thin-sectioned nuclei contained at least a single grain and 8.3% of the total cell-associated associated grains were located over the nuclei. Only 1.6% of grains were localized to lysosomes. In contrast, if photolabeled hepatocytes were incubated at 4 degrees C for up to 2 h, negligible accumulation of nuclear radioactivity was observed by polyacrylamide gel electrophoresis on light or electron microscopic radioautography. Conclusions are as follows. Occupied cell surface insulin receptors can internalize and translocate to the nucleus of intact hepatocytes by a time- and temperature-dependent mechanism. Accumulation and possible degradation of insulin receptors in lysosomes involves only a small percentage of the receptors internalized. Nuclear translocation of occupied cell surface insulin receptors may be a mechanism which mediates insulin's long term effects. PMID- 3546308 TI - Chemical characterization of recombinant human leukocyte interferon A using fast atom bombardment mass spectrometry. AB - Proteolytic digests of biologically active fractions of recombinant human leukocyte interferon A expressed in large quantities in Escherichia coli were analyzed by fast atom bombardment mass spectrometry and high-performance liquid chromatography. The values observed in the mass spectra of digests of the major fraction of recombinant human leukocyte interferon A with trypsin and Staphylococcus aureus protease V8 accounted for 93% of the amino acid sequences of human leukocyte interferon A predicted from the nucleotide sequence of the gene encoding the protein, indicating that the major fraction of recombinant human leukocyte interferon A was expressed with the same amino acid sequence as that translated from the nucleotide sequence of the gene encoding the protein. Mass spectrometry of proteolytic digests of two minor fractions of recombinant human leukocyte interferon A and mass and amino acid analyses of their high performance liquid chromatography fractions showed that the amino group of the N terminal amino acid residue of interferon was in part acetylated, and the Cys-1 and Cys-98 residues were oxidized to cysteic acid or linked to glutathione. These findings suggest that amino acid residues in recombinant proteins prepared in large quantities in E. coli are modified post-translationally. PMID- 3546307 TI - Human complement proteins D, C2, and B. Active site mapping with peptide thioester substrates. AB - The specificity and reactivity of complement serine proteases D, B, Bb, C2, and C2a were determined using a series of peptide thioester substrates. The rates of thioester hydrolysis were measured using assay mixtures containing the thiol reagent 4,4'-dithiodipyridine at pH 7.5. Each substrate contained a P1 arginine residue, and the effect of various groups and amino acids in the P2, P3, P4, and P5 positions was determined using kcat/Km values to compare reactivities. Among peptide thioesters corresponding to the activation site sequence in B, dipeptide thioesters containing a P2 lysine residue were the best substrates for D. Extending the chain to include a P3 or P4 amino acid resulted in loss of activity, and neither the tripeptide nor the tetrapeptide containing the cleavage sequence of B was hydrolyzed. Overall, D cleaved fewer substrates and was 2-3 orders of magnitude less reactive than C1s against some thioester substrates. C2 and fragment C2a had comparable reactivities and hydrolyzed peptides containing Leu-Ala-Arg and Leu-Gly-Arg, which have the same sequence as the cleavage sites of C3 and C5, respectively. The best substrates for C2 and C2a were Z-Gly-Leu-Ala Arg-SBzl and Z-Leu-Gly-Leu-Ala-Arg-SBzl, respectively, where Bzl is benzyl. B was the least reactive among these complement enzymes. The best substrate for B was Z Lys-Arg-SBzl with a kcat/Km value of 1370 M-1 s-1. The catalytic fragment of B, Bb, had higher activity toward these peptide thioester substrates. The best substrate for Bb was Z-Gly-Leu-Ala-Arg-SBzl with a kcat/Km similar to C2a and 10 times higher than the value for B. Both C2a and Bb were considerably more reactive against C3-like than C5-like substrates. Bovine trypsin hydrolyzed thioester substrates with kcat/Km approximately 10(3) higher than the complement enzymes. These thioester substrates for D, B, and C2 should be quite useful in kinetic and active site studies of the purified enzymes. PMID- 3546309 TI - Purification and properties of a bacteriophage-induced endo-N-acetylneuraminidase specific for poly-alpha-2,8-sialosyl carbohydrate units. AB - The soluble form of a bacteriophage-induced endo-N-acetylneuraminidase (Endo-N) specific for hydrolyzing oligo- or poly-alpha-2,8-linked sialosyl units in sources as disparate as bacterial and neural membrane glycoconjugates was purified approximately 10,000-fold and characterized. The enzyme appears homogenous by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and has a subunit Mr 105,000. This corresponds to one of the higher Mr phage proteins which comprises 7.5% (by weight) of the total phage protein. The holoenzyme is active at neutral pH and has a Mr by gel filtration of 328,000, suggesting that the active enzyme is a trimer. Endo-N requires a minimum of 5 sialyl residues (DP5, where DP represents degree of polymerization) for activity. The limit digest products from the alpha-2,8-linked polysialic acid capsule of Escherichia coli K1 are DP4 with some DP3 and DP1,2. DP2-4 do not appear to inhibit depolymerization of polysialic acid. Endo-N digestion of the polysialosyl moiety on neural cell adhesion molecules yields sialyl oligomers with DP3 and DP4. The presence of a terminal sialitol changes both the distribution of limit digestion products and the apparent minimum substrate size. Higher Mr alpha-2,8-linked sialyl polymers (approximately DP200) are better substrates (Km 50-70 microM) than sialyl oligomers of approximately DP10-20 (Km 1.2 mM). Endo-N activity is inhibited by DNA and several other poly-anions tested. An examination of the distribution of intermediate products shows that Endo-N binds and cleaves at random sites on the polysialosyl chains, in contrast to initiating cleavage at one end and depolymerizing processively. Endo-N can serve as a specific molecular probe to detect and selectively modify poly-alpha-2,8-sialosyl carbohydrate units which have been implicated in bacterial meningitis and neural cell adhesion. PMID- 3546310 TI - Kunitz-type inhibitors in human serum. Identification and characterization. AB - Human serum contains small amounts (approximately 0.1 mg/liter) of two protein protease inhibitors of low molecular weight (approximately 6500) and basic isoelectric point (Kunitz-type). They were purified by affinity chromatography on immobilized trypsin and ion-exchange chromatography in the fast protein liquid chromatography system. Their chemical, immunochemical, and functional properties indicate that the purified inhibitors are highly homologous with the basic pancreatic trypsin inhibitor which is widely distributed in bovids and caprids. Their inhibitory activity toward serine proteases such as plasmin and kallikrein suggests a possible regulatory role in blood clotting and fibrinolysis. PMID- 3546311 TI - Roles of the TGACT repeat sequence in the yeast TRP5 promoter. AB - Yeast genes under general amino acid control contain multiple copies of a sequence known as the TGACT repeat in the 5'-flanking DNA. The yeast TRP5 gene contains two copies of the TGACT repeat sequence in its 5'-flanking region. The upstream TGACT repeat of TRP5 is required for normal basal expression as well as derepression by general control. Synthetic oligonucleotides containing a TGACT sequence were inserted into previously constructed TRP5 control region deletion mutants. A synthetic 17-base pairs (bp) oligonucleotide containing a TGACT copy along with flanking nucleotides from HIS3 was able to restore derepression in all deletion mutants tested. The 17-bp oligonucleotide also functioned bidirectionally. Replacements in the upstream control region by synthetic oligonucleotides indicated that sequences other than the TGACT repeat are required for high basal expression. Replacements of the downstream repeat sequence by the 17-bp oligonucleotide suggest its main role in this position is for derepressed expression. High level derepressed expression was found to correlate with the presence of two repeats. PMID- 3546312 TI - Glucosidase II, a protein of the endoplasmic reticulum with high mannose oligosaccharide chains and a rapid turnover. AB - Glucosidase II is regarded as a resident protein of the endoplasmatic reticulum. The enzyme removes alpha-1-3-linked glucose from high mannose oligosaccharides N linked to asparagine residues of glycoproteins. Monospecific antibodies raised against the pig kidney enzyme are used to study the metabolism of the enzyme in a rat hepatoma cell line. These antiglucosidase II antibodies specifically immune precipitate glucosidase II as a 100,000-Da species from [35S]methionine-labeled cells. In addition, protein blotting and immune staining of cell extracts from both rat liver and human and rat hepatoma cell lines show identity in apparent Mr (100,000). Glucosidase II synthesized in the presence of tunicamycin is approximately 94,000 Da, indicating the presence of one or more N-linked oligosaccharide chains. Cell-free protein synthesis of rat hepatoma total RNA demonstrates that glucosidase II is synthesized as a slightly higher molecular weight species as compared to the polypeptide synthesized in whole cells in the presence of tunicamycin, indicating that the enzyme has a cleavable signal sequence. Using a pulse-chase protocol, the apparent molecular weight does not change upon longer chase periods. In addition, the 100,000-Da protein remains sensitive to endo-beta-N-acetylglucosaminidase H regardless of prolonged chase periods. The cells incorporate [3H]mannose into the enzyme; after release with endo-beta-N-acetylglucosaminidase H, most of the radioactivity comigrates with Glc1-Man9-GlcNAc on a gel filtration column. Phase separation in Triton X-114 shows a partition between the aqueous and the Triton phase, the major portion being separated in the aqueous phase. In rat hepatoma cells glucosidase II has a half-life of 50 min. This value is not altered if the cells are grown in the presence of monensin nor of methyl-deoxynoijirimycin. However, tunicamycin and low concentrations or primaquine (raising the pH of acidic compartments) causes a 100% increase in half-life of glucosidase II. We conclude that glucosidase II is a hydrophilic, probably not a transmembrane membrane, protein with a short half life. It is the first example of an oligosaccharide-processing enzyme not being an integral membrane protein. PMID- 3546314 TI - Superoxide dismutase-rich bacteria. Paradoxical increase in oxidant toxicity. AB - Superoxide dismutase is considered important in protection of aerobes against oxidant damage, and increased tolerance to oxidant stress is associated with induction of this enzyme. However, the importance of superoxide dismutase in this tolerance is not clear because conditions which promote the synthesis of superoxide dismutase likewise affect other antioxidant enzymes and substances. To clarify the role of superoxide dismutase per se in organismal defense against oxidant-generating drugs, we employed Escherichia coli transformed with multiple copies of the gene for bacterial iron superoxide dismutase. These bacteria have greater than ten times the superoxide dismutase activity of wild-type E. coli but, importantly, are normal in other oxidant defense parameters including catalase, peroxidases, glutathione, and glutathione reductase. High superoxide dismutase and control bacteria were exposed to the O2- -generating drug paraquat and to elevated pO2. We find; high superoxide dismutase E. coli are more readily killed by paraquat under aerobic, but not anaerobic, conditions. During exposure to paraquat, high superoxide dismutase E. coli accumulate more H2O2. Coincidentally, the reduced glutathione content of high superoxide dismutase E. coli declines more than in control E. coli. E. coli with high superoxide dismutase activity are also more readily killed by hyperoxia. Interestingly, the susceptibility of the parental and high superoxide dismutase E. coli to killing by exogenous H2O2 is not significantly different. Thus, under these experimental conditions, greatly enhanced superoxide dismutase activity accelerates H2O2 formation. The increased H2O2 probably accounts for the exaggerated sensitivity of high superoxide dismutase bacteria to oxidant-generating drugs. These results support the concept that the product of superoxide dismutase, H2O2, is at least as hazardous as the substrate, O2-. We conclude that effective organismal defense against reactive oxygen species may require balanced increments in antioxidant enzymes and cannot necessarily be improved by increases in the activity of single enzymes. PMID- 3546313 TI - Insulin increases membrane and cytosolic protein kinase C activity in BC3H-1 myocytes. AB - Insulin treatment stimulated the activity of the Ca2+- and phospholipid-dependent protein kinase (protein kinase C) in both cytosolic and membrane fractions of BC3H-1 myocytes. Within 60 s of insulin treatment, membrane protein kinase C activity increased 2-fold, diminished toward control levels transiently, and then increased 2-fold again after 15 min. Cytosolic protein kinase C activity increased more gradually and steadily up to 80% over a 20-min period. Increases in protein kinase C activity were dose-dependent and were not simply a result of translocation of cytosolic enzyme (although this may have occurred), as total activity was also increased. The increase in protein kinase C activity was not inhibited by cycloheximide (which also increased protein kinase C activity and 2 deoxyglucose transport) and was still evident following anion exchange chromatography. The insulin effect was decidedly different from those of 12-O tetradecanoylphorbol-13-acetate and phenylephrine using histone III-S as substrate. Phenylephrine decreased cytosolic protein kinase C activity while increasing membrane activity; 12-O-tetradecanoylphorbol-13-acetate only decreased cytosolic protein kinase C activity. The early insulin-induced increases in membrane protein kinase C activity may be related to increased diacylglycerol generation from de novo phosphatidic acid synthesis, as there were rapid increases in [3H]glycerol incorporation into diacylglycerol, and transient increases in phospholipid hydrolysis, as there were transient rapid increases in [3H]diacylglycerol in cells prelabeled with [3H]arachidonate. Later, sustained increases in membrane and cytosolic protein kinase C activity may reflect the continuous activation of de novo phospholipid synthesis, as there were associated increases in [3H]glycerol incorporation into diacylglycerol at later, as well as very early time points. PMID- 3546315 TI - Interferon-alpha down-regulates insulin receptors in lymphoblastoid (Daudi) cells. Relationship to inhibition of cell proliferation. AB - The Daudi line of human lymphoblastoid cells requires insulin and transferrin for growth in serum-free medium and is highly sensitive to the inhibitory effect of human leukocyte interferon (IFN-alpha) on cell proliferation. A variant subline of Daudi cells, which is resistant to the antiproliferative action of IFN-alpha, also has been grown in serum-free medium containing insulin and transferrin. The proliferation of IFN-sensitive and -resistant Daudi cells is dependent on the occupancy of insulin receptors, with optimal cell proliferation observed at high receptor occupancy (nearly 100%). No evidence was found for receptors for insulin like growth factor I on Daudi cells. IFN treatment of IFN-sensitive cells decreased the capacity of the cells to bind 125I-insulin. The altered binding capacity was due to diminished specific, lower affinity insulin binding, as detected at high 125I-insulin concentrations. Higher affinity insulin binding was not altered by IFN. Insulin binding was also reduced in detergent-solubilized extracts from IFN-treated sensitive Daudi cells and the magnitude of the effect was comparable to that observed in intact cells. This indicates that the total number of insulin binding sites (surface + internal) is decreased in IFN-treated sensitive cells. Insulin binding to IFN-sensitive cells decreased linearly with time between 6 and 48 h from the addition of IFN. The effect on lower affinity insulin binding developed more rapidly than the inhibitory effect of IFN on cell proliferation. The insulin-binding capacity of Daudi cells resistant to the antiproliferative effect of IFN was unaffected by IFN, despite the fact that these cells contain as many cell surface IFN receptors as sensitive cells. These observations raise the possibility that lower affinity insulin binding is important in the growth-promoting actions of insulin. PMID- 3546316 TI - Purification and NMR characterization of acyl carrier protein. AB - The acyl carrier protein preparation obtained using the 2-propanol method of Rock and Cronan (Rock, C. O., and Cronan, J. E., Jr. (1981) Methods Enzymol. 71, 341 351) can be further purified with reversed-phase high-performance liquid chromatography. A homogeneous sample of acyl carrier protein is obtained as determined by NMR and reversed-phase high-performance liquid chromatography. PMID- 3546317 TI - Kinetic characterization of yeast alcohol dehydrogenases. Amino acid residue 294 and substrate specificity. AB - A three-dimensional model of yeast alcohol dehydrogenase, based on the homologous horse liver enzyme, was used to compare the substrate binding pockets of the three isozymes (I, II, and III) from Saccharomyces cerevisiae and the enzyme from Schizosaccharomyces pombe. Isozyme I and the S. pombe enzyme have methionine at position 294 (numbered as in the liver enzyme, corresponding to 270 in yeast), whereas isozymes II and III have leucine. Otherwise the active sites of the S. cerevisiae enzymes are the same. All four wild-type enzymes were produced from the cloned genes. In addition, oligonucleotide-directed mutagenesis was used to change Met-294 in alcohol dehydrogenase I to leucine. The mechanisms for all five enzymes were predominantly ordered with ethanol (but partially random with butanol) at pH 7.3 and 30 degrees C. The wild-type alcohol dehydrogenases and the leucine mutant had similar kinetic constants, except that isozyme II had 10-20 fold smaller Michaelis and inhibition constants for ethanol. Thus, residue 294 is not responsible for this difference. Apparently, substitutions outside of the substrate binding pocket indirectly affect the interactions of the alcohol dehydrogenases with ethanol. Nevertheless, the substitution of methionine with leucine in the substrate binding site of alcohol dehydrogenase I produced a 7-10 fold increase in reactivity (V/Km) with butanol, pentanol, and hexanol. The higher activity is due to tighter binding of the longer chain alcohols and to more rapid hydrogen transfer. PMID- 3546318 TI - Crystallization and preliminary x-ray investigation of thymidine phosphorylase from Escherichia coli. AB - Crystals of thymidine phosphorylase from Escherichia coli have been grown from solutions of ammonium sulfate. The crystals are tetragonal, space group P4(1)2(1)2 or P4(3)2(1)2; the axes are a = 132.0 (1) and c = 67.2 (1) A. The crystals are quite stable to x-rays and diffract beyond 2.6-A resolution. The molecule is a dimer and utilizes the 2-fold symmetry of the space group, resulting in one subunit per asymmetric unit. PMID- 3546319 TI - Enzymatic properties of a proteolytically nicked RNA polymerase of bacteriophage T7. AB - The RNA polymerase of bacteriophage T7 is sensitive to cleavage by a protease associated with the membrane fraction of many strains of Escherichia coli. A major degradation product is a T7 RNA polymerase that is proteolytically cleaved between amino acids 172 (lysine) and 173 (arginine) (Tabor, S., and Richardson, C.C. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 1074-1078). The cleavage splits the enzyme into a large fragment (Mr approximately 75,000) and a small fragment (Mr approximately 23,000) which remain tightly associated during the purification of nicked RNA polymerase. The protein retains RNA polymerase activity, but specific activity is reduced 3.5-fold. The proteolytic cleavage also reduces the Mg2+ requirements, increases the apparent Michaelis-Menten constants for the utilization of the ribonucleoside 5'-triphosphates, increases the temperature sensitivity, increases the sensitivity to inhibition by heparin, and increases the probability that a transcript will not be removed from the template. The reduced activity of nicked T7 RNA polymerase is apparently a consequence of inefficient initiation and premature termination. Nicked T7 RNA polymerase successfully initiates at the phi 10 promoter at half the efficiency of native T7 RNA polymerase. Transcripts synthesized by the nicked enzyme are also significantly shorter than transcripts synthesized by the native enzyme. In contrast, nicked T7 RNA polymerase and T7 RNA polymerase exhibit equivalent poly(dI).poly(dC)-dependent activity and equivalent polymerization velocities (60 bases/s at 25 degrees C). PMID- 3546320 TI - Interactions of a proteolytically nicked RNA polymerase of bacteriophage T7 with its promoter. AB - The association of nicked RNA polymerase of bacteriophage T7 (Ikeda, R. A., and Richardson, C. C. (1987) J. Biol. Chem. 262, 3790-3799) with the T7 phi 10 promoter has been examined by DNA cleavage protection. The phi 10 promoter consists of a 23-base pair consensus sequence that extends from -17 to +6 with respect to the site of the initiation of transcription (+1). Nicked T7 RNA polymerase alone protects 20 bases from -21 to -2 (+/- 1) base at each border. Initiation and synthesis of the trinucleotide r(GGG) expands and shifts the sequence protected by nicked T7 RNA polymerase. Twenty-five bases are protected from -17 to +8 (+/- 1). The polymerization of three additional ribonucleotides, synthesis of the hexamer r(GGGAGA), further expands the protected sequence. Twenty-seven bases are protected from -17-+10 (+/- 1). Finally, the synthesis of a pentadecaribonucleotide transcript, r(GGGAGACCACGG), leads to the formation of a transcription complex that protects 22 bases from -2-+20 (+/- 1). In comparison to the sequences protected by T7 RNA polymerase the sequences protected by the nicked enzyme are shortened at the 5' end and are translocated downstream much earlier during the initiation of transcription. It appears that a portion of the DNA contacts made at the amino terminus of T7 RNA polymerase are disrupted in the small fragment of nicked T7 RNA polymerase. The changes that are observed in the sequences protected by nicked T7 RNA polymerase are reflected in the physical characteristics of the DNA X enzyme complexes. The number of ion pairs formed by the r(GGG)-initiated complex of the nicked enzyme is reduced, and the association constant for the formation of the r(GGG)-initiated complex is decreased as compared to the intact T7 RNA polymerase. PMID- 3546321 TI - Muscarinic receptor subtypes: a critique of the current classification and a proposal for a working nomenclature. PMID- 3546322 TI - Open intramedullary nailing and bone-grafting for non-union of tibial diaphyseal fracture. AB - Twenty consecutive patients who had non-union of twenty-two fractures (two of the patients had a segmental fracture) of the tibia underwent open reduction, debridement, and intramedullary nailing that was supplemented by bone-grafting with either autogenous cancellous iliac bone or cortical reamings of bone from the intramedullary canal. Eighteen patients had significant deformity associated with the tibial fracture. All but three patients had postoperative splinting for two to four weeks, followed by walking without a brace; the three patients who did not have postoperative splinting were more than sixty-five years old. All of the fractures went on to union. Two patients had a minor complication that did not affect the final result. Incorporation of callus across the site of non-union occurred at a rapid rate. Anatomical alignment of the tibial shaft was obtained in nineteen of the twenty patients. PMID- 3546323 TI - Fibrous dysplasia. An analysis of options for treatment. AB - The results of treatment of sixty-five symptomatic lesions in forty-three patients who had fibrous dysplasia were reviewed. For fourteen (93 per cent) of the fifteen times that a lesion in the upper extremity was treated non operatively, the result was satisfactory. These results were independent of the patient's age when first seen. In contrast, in the lower extremity, the results were highly dependent on the age of the patients at the time of the initial presentation of symptoms. In patients who were eighteen years old or older, eight (88 per cent) of the nine times that a lesion involving the lower extremity had closed treatment and both times that a lesion was treated with curettage and bone grafting, the result was satisfactory. The results of these modalities of treatment in patients who were less than eighteen years old were discouraging. Twenty-eight (88 per cent) of the thirty-two times that closed treatment was used and twenty-five (81 per cent) of the thirty-one times that curettage and bone grafting was used, the result was unsatisfactory. However, after eighteen (86 per cent) of the twenty-one times that a lesion in the lower extremity was treated by internal fixation in a patient who was less than eighteen years old, there was a satisfactory outcome. We concluded that closed treatment of a symptomatic lesion in the upper extremity generally provides satisfactory results. In patients who are less than eighteen years old, neither closed treatment nor curettage and bone grafting is adequate treatment for a symptomatic lesion in the lower extremity. Internal fixation should be strongly considered in these young patients. PMID- 3546324 TI - Diagnostic ultrasound in haemophilia. AB - Ultrasound examination has been recommended for the evaluation of acute haemorrhages into soft tissues or joints in haemophilic patients. We have reviewed the notes of all such patients admitted during one calendar year and find that in 47 separate admissions the ultrasound examination assisted management decisions on 27 occasions. The technique is described with an analysis of the ways in which ultrasound observations may influence the clinician. PMID- 3546325 TI - Repair of triceps tendon avulsions or ruptures. PMID- 3546326 TI - Diastematomyelia--the "double-barrelled" spine. PMID- 3546327 TI - Neglected posterior dislocation of the elbow. A reconstruction operation. AB - A new technique for repair of neglected posterior dislocation of the elbow is described, consisting of open reduction with tendon graft stabilisation to create a medial collateral and an intra-articular "cruciate" ligament. This allows flexion-extension exercises to start six days after operation. Eleven cases are reported in which the average range of movement improved from 38 degrees before operation to 105 degrees after a minimum follow-up of two years, with a mean valgus-varus instability of only 13 degrees. One patient had a postoperative infection but all the others were satisfied with the functional result. PMID- 3546328 TI - Bone grafting for protrusio acetabuli during total hip replacement. A review of the Wrightington method in 61 hips. AB - Total hip replacement has been very successful in patients with painful, stiff hips associated with protrusio acetabuli, but the heat of polymerisation of methylmethacrylate cement may cause necrosis of the thin medial wall with consequent danger of migration of the cup. Since 1968 at Wrightington, thin slices of the head of the femur have been used as bone grafts to reinforce the acetabulum. We have reviewed 61 hips in 51 patients at an average of 4 years 3 months after operation. Grading for severity is discussed and the degree of physiological remodelling of the medial wall of the acetabulum after grafting assessed. There was an average of about 4 mm of remodelling, but this varied considerably; most took place within the first year. In no case was there relapse of the protrusio. PMID- 3546329 TI - Sonography and joint pressure in synovitis of the adult hip. AB - Sonography was successfully used to diagnose an effusion in the hips of three adults with septic arthritis and four with aseptic synovitis. The effusions were confirmed by aspiration. All the patients had markedly increased intracapsular pressure which, in the extended position, exceeded the systolic blood pressure and could well compromise the blood supply to the head of femur. Aspiration reduced pain and intracapsular pressure, as did flexion of the hip to 45 degrees. PMID- 3546330 TI - Ultrasound assessment of femoral anteversion. A comparison with computerised tomography. AB - The calculation of femoral anteversion using a static ultrasound scanner has been compared with results obtained by computer tomographic (CT) scanning. Assuming the CT results to be accurate, the ultrasound method was frequently found to be unreliable. PMID- 3546331 TI - Distribution of the Burkitt's lymphoma-associated antigen (BLA) in normal human tissue and malignant lymphoma as defined by immunohistological staining with monoclonal antibody 38.13. AB - The distribution of the Burkitt's lymphoma-associated antigen (BLA) or globotriaosylceramide (Pk antigen) in normal human tissues and in 194 haematopoietic neoplasms was demonstrated by immunoperoxidase labelling of frozen tissue sections with monoclonal antibody 38.13. Staining was seen in most tissues of the body and was most pronounced in the epithelial compartments. In normal lymphoid tissue only dendritic reticulum cells, sinus-lining cells, macrophages and endothelial cells stained whereas lymphocytes were unlabelled. Among neoplasms, BLA was expressed strongly in 4/5 Burkitt's lymphomas. Rather weak expression was seen in 8/120 of the other B-cell lymphomas which included cases of pre-B-stage, mid-stage and secretory-stage B-cell maturation. Expression of BLA was also found in 3/54 T-cell lymphomas (all 3 of activated T-cell phenotype), 1 case of Hodgkin's disease and in 1 case of monocytic sarcoma. We found no correlation between the expression of BLA and any particular surface Ig type in the B-cell lymphomas. We conclude that BLA is neither a tumour-specific antigen, nor a typical B-cell differentiation antigen. The results concerned with the antigen distribution in human tissues and haematopoietic neoplasms preclude the use of 38.13 as a reagent for diagnosis or specific in vivo immunotherapy of Burkitt's lymphoma. PMID- 3546332 TI - The multitubulin hypothesis revisited: what have we learned? PMID- 3546333 TI - Microtubule dynamics in vivo: a test of mechanisms of turnover. AB - Clarification of the mechanism of microtubule dynamics requires an analysis of the microtubule pattern at two time points in the same cell with single fiber resolution. Single microtubule resolution was obtained by microinjection of haptenized tubulin (fluorescein-tubulin) and subsequent indirect immunofluorescence with an antifluorescein antibody. The two time points in a single cell were, first, the time of photobleaching fluorescein-tubulin, and second, the time of fixation. The pattern of fluorescence replacement in the bleached zone during this time interval revealed the relevant mechanisms. In fibroblasts, microtubule domains in the bleached zone are replaced microtubule by microtubule and not by mechanisms that affect all microtubules simultaneously. Of the models we consider, treadmilling and subunit exchange along the length do not account for this observation, but dynamic instability can since it suggests that growing and shrinking microtubules coexist. In addition, we show that the half time for microtubule replacement is shortest at the leading edge. Dynamic instability accounts for this observation if in general microtubules do not catastrophically disassemble from the plus end, but instead have a significant probability of undergoing a transition to the growing phase before they depolymerize completely. This type of instability we call tempered rather than catastrophic because, through limited disassembly followed by regrowth, it will preferentially replace polymer domains at the ends of microtubules, thus accounting for the observation that the half-time of microtubule domain replacement is shorter with proximity to the leading edge. PMID- 3546334 TI - Distinct localization and cell cycle dependence of COOH terminally tyrosinolated alpha-tubulin in the microtubules of Trypanosoma brucei brucei. AB - alpha-Tubulin can be posttranslationally modified in that its COOH-terminal amino acid residue, tyrosine, can be selectively removed and replaced again. This reaction cycle involves two enzymes, tubulin carboxypeptidase and tubulin tyrosine ligase. The functional significance of this unusual modification is unclear. The present study demonstrates that posttranslational tyrosinolation of alpha-tubulin does occur in the parasitic hemoflagellate Trypanosoma brucei brucei and that posttranslational tyrosinolation can be detected in both alpha tubulin isoforms found in this organism. Trypanosomes contain a number of microtubular structures: the flagellar axoneme; the subpellicular layer of singlet microtubules which are closely associated with the cell membrane; the basal bodies; and a cytoplasmic pool of soluble tubulin. Tyrosinolated alpha tubulin is present in all these populations. However, immunofluorescence studies demonstrate a distinct localization of tyrosinolated alpha-tubulin within individual microtubules and organelles. This localization is subject to a temporal modulation that correlates strongly with progress of a cell through the cell cycle. Our results indicate that the presence of tyrosinolated alpha-tubulin is a marker for newly formed microtubules. PMID- 3546335 TI - Slow myosin in developing rat skeletal muscle. AB - Through S1 nuclease mapping using a specific cDNA probe, we demonstrate that the slow myosin heavy-chain (MHC) gene, characteristic of adult soleus, is expressed in bulk hind limb muscle obtained from the 18-d rat fetus. We support these results by use of a monoclonal antibody (mAb) which is highly specific to the adult slow MHC. Immunoblots of MHC peptide maps show the same peptides, uniquely recognized by this antibody in adult soleus, are also identified in 18-d fetal limb muscle. Thus synthesis of slow myosin is an early event in skeletal myogenesis and is expressed concurrently with embryonic myosin. By immunofluorescence we demonstrate that in the 16-d fetus all primary myotubes in future fast and future slow muscles homogeneously express slow as well as embryonic myosin. Fiber heterogeneity arises owing to a developmentally regulated inhibition of slow MHC accumulation as muscles are progressively assembled from successive orders of cells. Assembly involves addition of new, superficial areas of the anterior tibial muscle (AT) and extensor digitorum longus muscle (EDL) in which primary cells initially stain weakly or are unstained with the slow mAb. In the developing AT and EDL, expression of slow myosin is unstable and is progressively restricted as these muscles specialize more and more towards the fast phenotype. Slow fibers persisting in deep portions of the adult EDL and AT are interpreted as vestiges of the original muscle primordium. A comparable inhibition of slow MHC accumulation occurs in the developing soleus but involves secondary, not primary, cells. Our results show that the fate of secondary cells is flexible and is spatially determined. By RIA we show that the relative proportions of slow MHC are fivefold greater in the soleus than in the EDL or AT at birth. After neonatal denervation, concentrations of slow MHC in the soleus rapidly decline, and we hypothesize that, in this muscle, the nerve protects and amplifies initial programs of slow MHC synthesis. Conversely, the content of slow MHC rises in the neonatally denervated EDL. This suggests that as the nerve amplifies fast MHC accumulation in the developing EDL, accumulation of slow MHC is inhibited in an antithetic fashion. Studies with phenylthiouracil-induced hypothyroidism indicate that inhibition of slow MHC accumulation in the EDL and AT is not initially under thyroid regulation. At later stages, the development of thyroid function plays a role in inhibiting slow MHC accumulation in the differentiating EDL and AT.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3546336 TI - The relationship of the postsynaptic 43K protein to acetylcholine receptors in receptor clusters isolated from cultured rat myotubes. AB - We have examined the relationship of acetylcholine receptors (AChR) to the Mr 43,000 receptor-associated protein (43K) in the AChR clusters of cultured rat myotubes. Indirect immunofluorescence revealed that the 43K protein was concentrated at the AChR domains of the receptor clusters in intact rat myotubes, in myotube fragments, and in clusters that had been purified approximately 100 fold by extraction with saponin. The association of the 43K protein with clustered AChR was not affected by buffers of high or low ionic strength, by alkaline pHs up to 10, or by chymotrypsin at 10 micrograms/ml. However, the 43K protein was removed from clusters with lithium diiodosalicylate or at alkaline pH (greater than 10). Upon extraction of 43K, several changes were observed in the AChR population. Receptors redistributed in the plane of the muscle membrane in alkali-extracted samples. The number of binding sites accessible to an anti-AChR monoclonal antibody directed against cytoplasmic epitopes (88B) doubled. Receptors became more susceptible to digestion by chymotrypsin, which destroyed the binding sites for the 88B antibody only after 43K was extracted. These results suggest that in isolated AChR clusters the 43K protein covers part of the cytoplasmic domain of AChR and may contribute to the unique distribution of this membrane protein. PMID- 3546338 TI - E.B. Wilson medalists, 1983. PMID- 3546339 TI - The effects of sulfhydryl modifying reagents on nonhormonal and hormonally regulated hexose transport in cultured human skin fibroblasts. AB - The effects of various sulfhydryl modifying reagents on hexose transport in cultured human skin fibroblasts were studied. H2O2 was observed to have no effect on 2-deoxy-D-glucose transport in serum-starved glucose-fed cells. The elevation of hexose transport rates in cells by glucose deprivation, insulin, or serum stimulation rendered them sensitive to H2O2. Hexose transport in glucose-deprived cells was inhibited 51-55% by 1-2 mM H2O2, while hexose transport in insulin or serum-stimulated glucose-fed cells was inhibited 45% and 46%, respectively. H2O2 inhibition was blocked or reversed by 8 mM dithiothreitol. N-ethyl-maleimide (NEM), a permeant, sulfhydryl reagent, elicited effects on hexose transport similar to those effected by H2O2 (i.e., in glucose-deprived and insulin stimulated cells, inhibition of hexose transport was 44% and 23%, respectively). Impermeant sulfhydryl reagents such as dithio(bis)nitrobenzoic acid (DTNB) and N iodoacetyl-N'-(5-sulfo-1-naphthly-ethylenediame (1,5,-I-AEDANS) had no inhibitory effect on hexose transport under any conditions (i.e., glucose-fed, glucose deprived, and insulin-stimulated cells). DTNB and 1,5-I-AEDANS afforded no protection from the action of H2O2 on hexose transport. The data suggest that the sensitive sites are thiol in nature and are located at an intramembrane or intracellular site and probably not exofacial. PMID- 3546340 TI - Internalisation and recycling of the granulocyte-macrophage colony-stimulating factor (GM-CSF) receptor on a murine myelomonocytic leukemia. AB - Radioiodinated granulocyte-macrophage colony-stimulating factor (125I-GM-CSF) binds to specific receptors (molecular weight approximately 50,000 daltons) on the murine myelomonocytic leukemia, WEHI-3BD+. At 4 degrees C 125I-GM-CSF remains on the surface of the cells and can be eluted by washing the cells with acidified isotonic buffer. When the cells are warmed to 37 degrees C, the 125I-GM-CSF is internalized rapidly (t 1/2: 7 min). The internalisation appears to be entirely receptor mediated and is independent of energy sources inhibited by sodium azide. This GM-CSF-mediated internalisation is not due to a general increase in the turnover of cell surface molecules as the specific binding of 125I-transferrin is not affected by incubation of WEHI-3BD+ cells with GM-CSF. The initial 125I released when the cells are warmed to 37 degrees C appears to be intact 125I-GM CSF; however, after 2 h 80% of the 125I released was not precipitable with trichloroacetic acid and presumably represented degraded 125I-GM-CSF. Ammonium chloride or monensin reduced the release of 125I-GM-CSF from the cells, suggesting that the receptor-bound ligand was processed through the lysosomes. A considerable proportion of the internalised GM-CSF receptors were recycled to the surface and were available for ligand binding. Synthesis of new GM-CSF receptors contributed to the re-expression of GM-CSF receptors after down-regulation and it is possible that the GM-CSF enhances the synthesis of its own receptors. PMID- 3546337 TI - The large external domain is sufficient for the correct sorting of secreted or chimeric influenza virus hemagglutinins in polarized monkey kidney cells. AB - MA104.11 rhesus kidney cells express several characteristics of polarized epithelial cells, including the formation of "domes" on impermeable substrates, the establishment of a transmonolayer electrical resistance when grown on collagen gels, the polarized maturation of influenza and vesicular stomatitis viruses, and the expression of the glycoproteins of those viruses at a single surface domain. The polarized expression of the influenza virus hemagglutinin (HA) is maintained in MA104.11 cells infected with SV40-derived vectors carrying a cDNA gene for either the wild-type influenza virus HA, a truncated HA gene encoding a secreted form of HA (HAsec), or a chimeric gene encoding a hybrid protein with the external domain of the HA and the transmembrane and cytoplasmic domains of the vesicular stomatitis virus G protein (HAG). Thus, the recognition event separating glycoproteins, such as HA, destined for the apical surface from proteins, such as G, destined for the basolateral membranes involves features of the external domains of the proteins. The transmembrane and cytoplasmic domains of HA have no role in this process. PMID- 3546341 TI - Enucleation of normal and transformed cells. AB - A quantitative analysis based on centrifugal force requirements for enucleation was developed to examine the response of a number of untransformed and transformed cell lines to cytochalasin mediated enucleation. Examination of the extent of cell enucleation as a function of centrifugal force resulted in a series of response curves demonstrating that enucleation g force requirements varied between Balb/c 3T3, Swiss 3T3, and Kirsten sarcoma virus transformed Balb/c 3T3 (3T3-K). A four times greater centrifugal force was required to reach 50% enucleation for transformed Balb/c 3T3-K when compared to Swiss 3T3. A qualitative correlation could be observed between ease of enucleation and the existence of a well-formed stress fiber network. A comparison of cytochalasin B and D suggested that cytochalasin D was far more effective in the enucleation of transformed cells. Experiments with 2-deoxyglucose and monensin provided evidence that decreasing cellular ATP levels, either directly or potentially by uncoupling ion transport from ATP generation, can decrease the efficiency of enucleation. It is suggested that the organization of the cytoskeleton is affected by the altered cellular ATP levels which can affect the centrifugal requirements of enucleation. PMID- 3546342 TI - Instabilities of the wrist. AB - Carpal instability is the result of ligamentous injury to the wrist. Although any ligament may be injured, certain recurring patterns are frequently seen. Common to the treatment of all instability patterns is the need to transfer load from the capitate to the radius: reliably, without stressing normal joints, and while preserving functional motion. Limited wrist arthrodesis fulfills these needs. The radius and carpal bones are shaped so that in their "normal" position, they are preloaded. Were it not for complex ligamentous systems, the bones would immediately assume unloaded "neutral anatomic" positions. Because the shape of the wrist bones tends to displace them with significant forces, current ligamentous reconstructions are inadequate. Common radial side instabilities invariably lead to degenerative arthritis. PMID- 3546343 TI - A rational approach for the recognition and treatment of Colles' fracture. AB - The approach to Colles' fracture, as recommended in this article, is derived from understanding the mechanism of injury. Fractures that are inherently unstable can be recognized by observing the depth of comminution presented on the lateral postreduction radiography. These unstable fractures demand a more vigorous approach to achieve the result our patients have come to demand. External fixators, percutaneous pinning, and bone grafting have all been successfully used to achieve a satisfactory result. Fortunately, the majority of Colles' fractures are stable and can be treated by accurate closed reduction and immobilization in plaster. If the fracture results in loss of containment of the carpus, a chronically weak and sometimes painful wrist will result. This event can be remedied surgically. The final emphasis I would like to impart is the prevention of sympathetic reflex dystrophy. Early involvement by the patients in their rehabilitation process is essential in minimizing this condition. Understanding and application of the principles I have presented will result in patients pleased with the result of their care and, consequently, with their physician. PMID- 3546344 TI - Kienbock's disease. AB - Kienbock's disease is a progressive disruption of the lunate secondary to avascular necrosis, which may be due to the lunate's precarious blood supply, external compression forces, and fractures of its surfaces. The treatment options for Kienbock's disease are based on the stage of the disease, defined by Stahl, and include immobilization, radial shortening or ulnar lengthening, intracarpal fusion, and prosthetic replacement. The prognosis for functional recovery is better in stage I and II disease, which emphasizes the need for early diagnosis. PMID- 3546345 TI - Ulnar lengthening and shortening. AB - Alteration in length of the distal ulna may provide an attractive alternative to more destructive procedures commonly used for the treatment of mechanical and degenerative problems at the distal radioulnar joint. Ulnar recession has shown effectiveness in ulnolunate impingement, triangular fibrocartilage tears, and symptomatic ulnar plus variance. It has also been effective in chondromalacia of the ulnar head in the sigmoid notch and in unstable distal radioulnar joints where recession alters the bearing surface and tightens the ulnocarpal ligamentous complex. Ulnar lengthening has been efficacious in relieving the symptoms of Kienbock's disease by decompressing the involved portion of the lunate and distributing joint compressive force on the triquetrum and medial lunate articular surfaces. It may also be of value in some instances of NDCI associated with an ulnar minus variant. PMID- 3546346 TI - Evolution in the structure and function of aspartic proteases. AB - Aspartic proteases (EC3.4.23) are a group of proteolytic enzymes of the pepsin family that share the same catalytic apparatus and usually function in acid solutions. This latter aspect limits the function of aspartic proteases to some specific locations in different organisms; thus the occurrence of aspartic proteases is less abundant than other groups of proteases, such as serine proteases. The best known sources of aspartic proteases are stomach (for pepsin, gastricsin, and chymosin), lysosomes (for cathepsins D and E), kidney (for renin), yeast granules, and fungi (for secreted proteases such as rhizopuspepsin, penicillopepsin, and endothiapepsin). These aspartic proteases have been extensively studied for their structure and function relationships and have been the topics of several reviews or monographs (Tang: Acid Proteases, Structure, Function and Biology. New York: Plenum Press, 1977; Tang: J Mol Cell Biochem 26:93-109, 1979; Kostka: Aspartic Proteinases and Their Inhibitors. Berlin: Walter de Gruyter, 1985). All mammalian aspartic proteases are synthesized as zymogens and are subsequently activated to active proteases. Although a zymogen for a fungal aspartic protease has not been found, the cDNA structure of rhizopuspepsin suggests the presence of a "pro" enzyme (Wong et al: Fed Proc 44:2725, 1985). It is probable that other fungal aspartic proteases are also synthesized as zymogens. It is the aim of this article to summarize the major models of structure-function relationships of aspartic proteases and their zymogens with emphasis on more recent findings. Attempts will also be made to relate these models to other aspartic proteases. PMID- 3546347 TI - The effect of biosynthetic human proinsulin on the hepatic response to glucagon in insulin-deficient diabetes. AB - The relative tissue specificities of biosynthetic human proinsulin and porcine insulin were compared in eight insulin-deficient diabetic patients. Variable proinsulin and insulin infusions were administered iv for at least 18 h on separate occasions to achieve euglycemia. Once equivalence with respect to this end point was established, the paired infusions were made constant and compared with respect to their effect on plasma glucose, hepatic glucose output (Ra), glucose utilization, glucose clearance, and blood beta-hydroxybutyrate, alanine, and glycerol in response to a glucagon infusion (3 ng/kg X min). Basal Ra did not differ between euglycemia established using proinsulin vs. insulin [1.92 +/- 0.12 vs. 1.65 +/- 0.07 mg/kg X min] when data were analyzed by multivariate analysis of variance; likewise, the increment in Ra in response to glucagon infusion did not differ between the two treatments (1.26 +/- 0.22 vs. 1.17 +/- 0.24 mg/kg X min). Blood beta OHB, alanine, and glycerol also did not differ between the insulin and proinsulin treatments. Under these conditions of prolonged infusion in which the differences in clearance properties between proinsulin and insulin do not play a role and which maintain basal euglycemia, the two compounds equally limit the response to a stimulus to hepatic glucose production. Under nonsteady state conditions, when the differences in clearance rates are operative, proinsulin may have relatively greater effects on Ra than do doses of insulin that are biologically equivalent after prolonged infusions. PMID- 3546348 TI - Dihydrotestosterone heptanoate: synthesis, pharmacokinetics, and effects on hypothalamic-pituitary-testicular function. AB - Dihydrotestosterone heptanoate (DHT-hp), a seven-carbon fatty acid ester of DHT, was synthesized, and its pharmacokinetics and effects on hypothalamic-pituitary testicular function were determined in men and pubertal boys. Plasma DHT levels markedly increased 24 h after im injection of DHT-hp, reached their peak during the first week, and fell to baseline levels after 4-6 weeks. An estimated 43-55% of DHT-hp was converted to DHT 4-6 weeks after injection. Plasma testosterone, estradiol, LH, and FSH levels decreased by 4 days after DHT-hp injection, were lowest during the second week, and returned to baseline values after 4-6 weeks. The LH and FSH responses to GnRH were diminished by chronic administration of DHT hp to pubertal boys at 3-week intervals for 15 weeks. The affinity of DHT-hp was 100 times less than the affinity of DHT for the human androgen receptor, and no affinity for the estrogen receptor in breast tissue could be demonstrated. Since DHT is a nonaromatizable androgen, and neither DHT nor DHT-hp binds readily to the estrogen receptor, suppression of LH and FSH secretion by this drug probably occurs via an androgen-dependent mechanism. Receptor binding and pharmacokinetic data indicate that unesterified DHT is the active principle. DHT-hp is a useful derivative of DHT, since prompt, predictable, and sustained rises in DHT occur after its administration. PMID- 3546349 TI - Chronic sex steroid exposure increases mean plasma growth hormone concentration and pulse amplitude in men with isolated hypogonadotropic hypogonadism. AB - Sex steroid administration can increase the GH response to provocative stimuli, but the relationship of sex steroids to spontaneous GH secretion is still controversial. We sought to characterize the effect of sex steroids on the plasma GH concentration by examining the 24-h pattern of episodic GH secretion in nine previously untreated adult men with isolated hypogonadotropic hypogonadism before and during long term testosterone, gonadotropin, or pulsatile GnRH treatment. After chronic sex steroid exposure, the mean 24-h plasma GH level, mean GH pulse amplitude, and mean area under the curve of pulses were significantly increased compared to pretreatment values [3.2 +/- 1.8 ( +/- SD) vs. 1.8 +/- 1.2 ng/mL (P less than 0.01); 11.4 +/- 7.2 vs. 5.5 +/- 4.4 ng/mL (P less than 0.05); and 720 +/- 547 vs. 316 +/- 371 ng/mL X 20 min (P less than 0.05), respectively], while mean 24-h pre- and posttreatment GH pulse frequencies were indistinguishable (5.7 +/- 2.1 posttreatment vs. 5.0 +/- 3.2 pretreatment; P = NS). The mean posttreatment plasma somatomedin-C level also rose significantly during treatment (1.89 +/- 0.65 vs. 1.28 +/- 0.48 U/mL; P less than 0.01). We conclude that the increase in the mean plasma GH level during chronic sex steroid exposure is due mainly to augmentation of GH pulse amplitude, and that sex steroids probably increase spontaneous GH secretion. PMID- 3546350 TI - Effects of weight loss in massive obesity on insulin and C-peptide dynamics: sequential changes in insulin production, clearance, and sensitivity. AB - In massively obese patients hyperinsulinemia and insulin insensitivity usually improve with weight loss. To clarify the mechanism of these reversible abnormalities eight nondiabetic massively obese patients were studied before and at intervals (3 months and 1 yr) after weight loss following gastroplasty. Insulin dynamics were studied during the hyperglycemic clamp (change in glucose, 7 mmol L-1 for 2 h) by measuring the area under the insulin and C-peptide response curves, representing, respectively, systemic insulin response and insulin production. Compared to lean age-matched normal subjects the massively obese patients had the expected fasting hyperinsulinemia and an exaggerated insulin response (P less than 0.05). Within 3 months and after an approximately 20% weight loss, they had a marked reduction in the systemic insulin response but no change in the C-peptide response. Therefore, the reduction in insulin response was due to enhanced hepatic insulin clearance rather than reduced insulin production. Thus, the liver serves a gate-keeping role in regulating the systemic insulin response to a glucose challenge. With additional weight loss of 14% and then weight maintenance, insulin clearance was further increased, and a reduction in insulin production became evident, since the C-peptide response was reduced. Exogenous insulin clearance was measured using the euglycemic clamp technique before and after weight loss. Insulin clearance was initially lower in the massively obese patients compared to that in the normal subjects (P less than 0.05) and increased toward normal with weight loss (P less than 0.05). Similarly, insulin sensitivity, as measured by the ratio of glucose metabolised per U endogenous insulin, normalized with weight loss and weight maintenance. Thus, after significant weight loss followed by weight maintenance at a reduced, but not ideal, level, insulin clearance, production, and sensitivity all reverted to normal. These findings suggest that adipose mass per se may not be exclusively responsible for altered insulin and glucose dynamics in obesity and that additional factors associated with obesity, such as nutrient load, adipose distribution, fat cell size, or fatty acid flux, play a contributing role. PMID- 3546351 TI - Increased plasma gonadotropin levels in spontaneous hyperthyroidism reproduced by thyroxine but not by triiodothyronine administration to normal subjects. AB - In nine hyperthyroid women studied in the follicular phase of the menstrual cycle basal plasma LH concentrations and LH and FSH responses to GnRH were increased compared to those in nine normal women. The increased gonadotropin levels could not be related to changes in body weight or plasma estradiol or serum sex hormone binding globulin levels, and they approached normal levels during or after treatment of hyperthyroidism. When normal women were treated with T4 (0.5 mg daily for 6-10 days), their mean serum free T4 level increased to about 60% of that in the hyperthyroid patients, while their serum T3 levels increased to a lesser degree. During T4 administration these women had gonadotropin changes similar to those of the hyperthyroid patients. When the normal women took T3 (60 120 micrograms for 6-8 days), their serum T3 level rose almost to the level in the hyperthyroid patients, but basal and GnRH-stimulated LH and FSH remained close to control levels. Dopaminergic blockade with metoclopramide did not alter the gonadotropin response to GnRH in any subject group. We conclude that serum T4 is of greater importance than serum T3 for at least short term gonadotropin regulation. PMID- 3546352 TI - Correlation of hormones with lipid and lipoprotein levels during normal pregnancy and postpartum. AB - In a comprehensive study the concentrations of plasma lipids and lipo- and apolipoproteins were measured in 24 nonpregnant women (control) and longitudinally in 42 women throughout gestation and postpartum. The results were correlated with hCG, 17 beta-estradiol (E2), progesterone (PG), human placental lactogen (hPL), and insulin levels by time series analysis. Insulin concentrations were constant until week 25 and increased thereafter. Plasma E2, PG, and hPL as well as plasma lipid levels rose continuously during gestation. Apolipoproteins AI, AII, and B concentrations increased until weeks 25, 28, and 32, respectively, and remained constant until term. Low density lipoprotein cholesterol reached maximum levels at week 36. High density lipoprotein cholesterol exhibited a triphasic behavior, with maximum levels at week 25, a fall until week 32, and maintenance of the level until term. Time series analysis revealed positive correlations with E2, PG, and hPL. These results provide evidence that apoprotein concentrations undergo pronounced serial changes during gestation, which in part might be due to the effect of E2. Furthermore, the importance of hPL as a determinant of the plasma levels of total and free cholesterol, triglycerides, and phospholipids is now documented. PMID- 3546353 TI - Serum levels of human chorionic gonadotropin in nonpregnant women and men are modulated by gonadotropin-releasing hormone and sex steroids. AB - Serum hCG levels were measured in apparently healthy nonpregnant women and men using a highly sensitive and specific time-resolved immunofluorometric assay. The sensitivity of the assay was 0.03 IU/L. The levels were low in women of fertile age (median, 0.05 IU/L) and in men less than 60 yr of age (median, 0.04 IU/L). In women the median level increased to 1.1 IU/L after the menopause (range, 0.17-4.8 IU/L), and a similar but smaller increase occurred in men after 60 yr of age (median, 0.20 IU/L; range, less than 0.03-2.3). Stimulation with GnRH caused a 2- to 3-fold increase in the hCG level in both men and women. Chronic treatment of postmenopausal women with a combination of estrogen and progestagen lowered their serum hCG levels to about 50% of the pretreatment values. The hCG in serum could be separated from LH by gel chromatography, and the hCG immunoreactivity measured by direct assay of serum corresponded to the immunoreactivity eluted in the hCG fractions after gel chromatography. Thus, the results were not due to cross reaction with LH. We conclude that serum of nonpregnant women and men contains hCG-like material, whose production is modulated by GnRH and sex steroids. PMID- 3546354 TI - Can insulin resistance exist as a primary defect in noninsulin-dependent diabetes mellitus? AB - In this study we have attempted to quantify the plasma insulin response to glucose and insulin action in 22 nonobese subjects: 11 with normal glucose tolerance and 11 with mild [mean fasting plasma glucose concentration, 128 +/- (+/- SEM) 5 mg/dL] noninsulin-dependent diabetes mellitus (NIDDM). Estimates of the plasma insulin response were made by determining the plasma insulin concentration at hourly intervals from 0800-1600 h, before and after mixed meals consumed at 0800 h (breakfast) and 1200 h (lunch). Insulin action was assessed by measuring glucose uptake during insulin clamp studies performed at steady state plasma insulin levels of approximately 10 and 60 microU/mL, with the difference between the 2 values defined as insulin-stimulated glucose uptake. Plasma glucose (P less than 0.001) and insulin (P less than 0.001) concentrations were significantly higher in patients with NIDDM throughout the 8-h period (by two-way analysis of variance). However, mean (+/- SEM) insulin-stimulated glucose uptake was markedly reduced (P less than 0.001) in patients with type 2 diabetes mellitus (112 +/- 72 vs. 336 +/- 44 mg/m2 min-1). Thus, patients with NIDDM and mild fasting hyperglycemia were both insulin resistant and hyperinsulinemic compared to normal individuals. These data indicate that a defect in insulin stimulated glucose uptake can occur in NIDDM in the absence of significant hyperglycemia and/or hypoinsulinemia. PMID- 3546355 TI - Altered insulin distribution and metabolism in type I diabetics assessed by [123I]insulin scanning. AB - Scintigraphic scanning with [123I]insulin provides a direct and quantitative assessment of insulin uptake and disappearance at specific organ sites. Using this technique, the biodistribution and metabolism of insulin were studied in type 1 diabetic patients and normal subjects. The major organ of [123I]insulin uptake in both diabetic and normal subjects was the liver. After iv injection in normal subjects, the uptake of [123I]insulin by the liver was rapid, with peak activity at 7 min. Activity declined rapidly thereafter, consistent with rapid insulin degradation and clearance. Rapid uptake of [123I]insulin also occurred in the kidneys, although the uptake of insulin by the kidneys was about 80% of that by liver. In type 1 diabetic patients, uptake of [123I]insulin in these organ sites was lower than that in normal subjects; peak insulin uptakes in liver and kidneys were 21% and 40% lower than those in normal subjects, respectively. The kinetics of insulin clearance from the liver was comparable in diabetic and normal subjects, whereas clearance from the kidneys was decreased in diabetics. The plasma clearance of [123I]insulin was decreased in diabetic patients, as was insulin degradation, assessed by trichloroacetic acid precipitability. Thirty minutes after injection, 70.9 +/- 3.8% (+/- SEM) of [123I]insulin in the plasma of diabetics was trichloroacetic acid precipitable vs. only 53.9 +/- 4.0% in normal subjects. A positive correlation was present between the organ uptake of [123I]insulin in the liver or kidneys and insulin degradation (r = 0.74; P less than 0.001). Both decreased insulin uptake in the liver and kidneys and decreased insulin degradation were inversely correlated to the binding capacity of antiinsulin antibodies in plasma of diabetics (r = -0.87 to -0.92; P less than 0.001). In summary, type 1 diabetic patients have altered patterns of insulin biodistribution and metabolism, with decreased organ uptake and slow degradation of [123I]insulin, which correlated with the insulin antibody-binding capacity of their serum. Thus, antiinsulin antibodies, even at subclinical concentrations, may modulate the metabolic effects of insulin in the diabetic by prolonging the biological half-life of the hormone as well as by altering its distribution and uptake at specific organ sites. PMID- 3546356 TI - Glucocorticoids and insulin promote the differentiation of human adipocyte precursor cells into fat cells. AB - To study the in vitro differentiation of human adipocyte precursor cells and its regulation by hormones, primary cultures of stromal vascular cells of human adipose tissue were established. A 30- to 70-fold increase in the number of developing fat cells was achieved by the addition of cortisol or related corticosteroids in the presence of insulin. Either of the two hormones alone was ineffective. The stimulatory action of cortisol was dose dependent and occurred at physiological concentrations. The results suggest that glucocorticoids may play a role in the development of human hyperplastic obesity by stimulating the formation of adipocytes from precursor cells. PMID- 3546357 TI - Distribution of uteroglobin in the rabbit endometrium after treatment with an anti-progesterone (ZK 98.734): an immunocytochemical study. AB - The effect of the synthetic steroid ZK 98.734, an anti-progesterone with high affinity for the progesterone receptor, on uteroglobin distribution in the rabbit endometrium has been studied by means of immunocytochemistry. Rabbits were treated with ZK 98.734 during the second, third and fourth day of pseudopregnancy. From the fifth up to the eighth day of pseudopregnancy the uteri were processed for immunocytochemistry using the peroxidase--antiperoxidase (PAP) and protein A--gold techniques. Uteroglobin synthesis and release could be inhibited by the anti-progesterone treatment. On day 5 and 6 there was no labelling of the uterine secretions and only a few diffusely labelled non ciliated cells could be seen in the surface and glandular epithelium. The inhibition was reversible in so far as on day 7 and day 8 the rabbit endometrium exhibits a clear labelling of the uterine secretion as well as an increase in positive reaction in the epithelial cells lining the glands. In all treated animals the intracellular uteroglobin labelling was confined to the Golgi complex and secretory vesicles with a significant increase from the fifth to the eighth day of pseudopregnancy. Together with the described morphological changes these results indicate that ZK 98.734 is capable of inducing a delayed secretion in the rabbit endometrium, which is comparable to the delay in secretion caused by post coital oestradiol treatment. However, the antigestagen effect is probably due to a different mechanism of endocrine interference with pre-implantation. The most exciting consequence, so far, is the prolongation of progesterone action after the anti-progesterone treatment had ended. PMID- 3546358 TI - Medical treatment of hyperprolactinaemic disorders. AB - The current status of treatments designed to treat prolactinoma and other hyperprolactinaemic disorders is reviewed. The use of ergoline derivatives is described to correct prolactin levels, restore reproductive dysfunctions and reduce the size of prolactinomas. Side effects are minimal but withdrawal is almost always followed by a recurrence of the original condition. Radiation therapy is less effective and surgical resection of prolactinomas is effective, but the condition may recur. The authors recommend that dopaminergic drugs should be the primary therapies for prolactin-secreting adenomas and idiopathic hyperprolactinaemia, and surgery should be reserved for dopamine-resistant conditions. PMID- 3546359 TI - Indirect immunofluorescence assay for antibodies to human immunodeficiency virus. AB - We compared an indirect immunofluorescence assay (IFA) with a commercial enzyme linked immunosorbent assay (ELISA) screening procedure for the detection of antibodies to the human immunodeficiency virus (HIV). The IFA assay was as sensitive and specific as the ELISA. No false results were observed with IFA on single testing of 181 sera, while the ELISA produced five false-positive results which required retesting for resolution. In addition, the IFA was suitable for quantitation of anti-HIV responses. The IFA was superior to the ELISA for its reliability, simplicity, and rapidity in the diagnostic laboratory. PMID- 3546360 TI - Diaper area skin microflora of normal children and children with atopic dermatitis. AB - In vitro studies established that neither cloth nor disposable diapers demonstrably contributed to the growth of Escherichia coli, Proteus vulgaris, Staphylococcus aureus, or Candida albicans when urine was present as a growth medium. In a clinical study of 166 children, the microbial skin flora of children with atopic dermatitis was compared with the flora of children with normal skin to determine the influence of diaper type. No biologically significant differences were detected between groups wearing disposable or cloth diapers in terms of frequency of isolation or log mean recovery of selected skin flora. Repeated isolation of S. aureus correlated with atopic dermatitis. The log mean recovery of S. aureus was higher in the atopic groups. The effects of each diaper type on skin microflora were equivalent in the normal and atopic populations. PMID- 3546361 TI - Isolation of immunodominant antigens from sera of patients with systemic candidiasis and characterization of serological response to Candida albicans. AB - Candidal antigens were isolated by affinity chromatography from the sera of patients with disseminated Candida albicans infections. The immunodominant 47 kilodalton (kDa) antigen appeared to be a heat-stable breakdown product of several larger heat-labile components (84 to 92, 74 to 79, and 66 to 72 kDa). It was undetectable in normal sera and sera from four patients with systemic C. parapsilosis, C. tropicalis, and C. krusei infections. Serum samples from 92 patients with proven systemic C. albicans infections were examined by the immunoblot technique. Seventy-four patients had detectable antibody, and 92% of these produced antibody to the 47-kDa antigen. All survivors had major serological responses to this antigen, whereas patients who died had no, minor, or fading responses. Fifty-five of the patients were neutropenic following cytotoxic chemotherapy for malignancies, usually lymphoproliferative disorders (hematological patients). The remainder were surgical or medical patients (nonhematological). Hematological patients differed from nonhematological patients in the range of antigens that were commonly recognized by their immune systems, although antibodies to the 47- and 60-kDa antigens were frequently present in both groups. They also differed in that they produced mainly an immunoglobulin M (IgM) response, failing to seroconvent to IgG. This did not reduce survival rates, which were similar in both groups. It may be responsible, however, for the lower antigen titers that were observed in hematological patients when measured by reverse passive latex agglutination. PMID- 3546362 TI - Rapid presumptive identification of streptococci directly from blood cultures by serologic tests and the L-pyrrolidonyl-beta-naphthylamide reaction. AB - The value of the Strepslide kit for the rapid presumptive identification of streptococci directly from blood cultures without prior determination of hemolysis patterns was assessed and compared with that of the Streptex and Phadebact streptococcus kits. Studies involved 94 simulated and 60 clinical isolates of 83 streptococci. The Streptex and Strepslide kits had excellent sensitivity and specificity for group A, B, F, and G organisms, and the Phadebact kit had excellent sensitivity and specificity for groups B and G. Group C reactions usually occurred with all of the streptococcus kits with pneumococci and occasionally with alpha-hemolytic streptococci. Although these kits were unacceptable for group C and D organisms, enterococci which were common clinical isolates could be directly identified in blood cultures by a supplementary rapid L-pyrrolidonyl-beta-naphthylamide biochemical test. Direct application of the Phadebact pneumococcus kit to blood cultures was also assessed with 29 isolates of 20 organisms. The specificity was good, but the sensitivity was only 65.5%. PMID- 3546363 TI - Rapid detection of group B streptococcal antigen in human amniotic fluid. AB - Infants exposed in utero to group B streptococcus (GBS)-infected human amniotic fluid (HAF) are at high risk for serious infection. Latex particle agglutination (LPA) tests are not approved for detection of GBS in HAF. Two LPA systems, Patho Dx Strep B and Wellcogen Strep B, were used to test unfiltered sterile HAF and filtered HAF containing concentrations of GBS carbohydrate from 0.2 to 100 micrograms/ml. Four different processing techniques were used to prevent nonspecific LPA: EDTA, nitrous acid, enzyme, and nitrous acid-heat. GBS (10(2) CFU/ml) was inoculated into filtered HAF, incubated, sampled serially, processed with enzyme, and tested by LPA. Unprocessed, unfiltered HAF showed 33% nonspecific agglutination when tested by LPA. Processing of HAF removed nonspecific agglutination and improved GBS antigen detection. Without processing, LPA could not detect less than 100 micrograms of GBS carbohydrate per ml. With nitrous acid or enzyme processing, as little as 0.2 microgram/ml could be detected. Results were easier to read after enzyme processing than after nitrous acid processing. Although both LPA systems were equally efficient, testing was easier with the Patho-Dx system. After enzyme processing, LPA could detect as few as 10(4) CFU/ml when agglutination was read with a 4 X hand lens. Substances in HAF induce false-positive reactions during LPA testing. Processing removes the interference and improves the detection of GBS. LPA testing of HAF may allow earlier identification and treatment of infants at risk for serious GBS infection. PMID- 3546364 TI - Comparison of TestPack Strep A test kit with culture technique for detection of group A streptococci. AB - Results obtained with Abbott Laboratories TestPack Strep A (TPSA), a 7-min enzyme immunoassay method, were compared with culture results to measure the ability of this assay to detect group A streptococci directly from 365 throat swabs. Our study demonstrated a sensitivity of 90.0% and a specificity of 97.4% for TPSA compared with cultures incubated for 48 h. The positive and negative predictive values of this assay versus the culture method were 92.8 and 96.3%, respectively. If specimens that provided fewer than 10 colonies per plate of group A streptococci are eliminated from the data, the sensitivity is increased to 95.6%. Additionally, 10 group A and 40 non-group A streptococcal isolates were tested directly with TPSA for the ability to distinguish group A from non-group A streptococci. All 50 isolates were correctly identified (100% accuracy). TPSA is a rapid, accurate, and easy-to-interpret method for detection and confirmation of group A streptococcal antigen directly from throat swabs and pure culture isolates. PMID- 3546365 TI - Effect of agitation and frequent subculturing on recovery of aerobic and facultative pathogens by Roche Septi-Chek and BACTEC blood culture systems. AB - The positivity rate and time to recovery of pathogens were compared in Roche Septi-Chek (RSC-TSB) and BACTEC radiometric systems on 3,539 paired blood cultures. Both systems were steadily agitated, with frequent subculturing or processing of the RSC-TSB agar slides and BACTEC bottles, respectively, during the first 24 h of incubation. The RSC-TSB system recovered 249 pathogens (7.0% positivity rate), compared with 234 (6.6% positivity rate) isolates recovered from BACTEC. For the most common isolates, Staphylococcus aureus and the Enterobacteriaceae, the median time to detection was 15.8 h for BACTEC and 18.6 h for the RSC-TSB system. No statistically significant difference was observed in recovery of organisms from the two systems, except for S. aureus (P less than 0.05). In the RSC-TSB system, 42% of S. aureus, 58% of the Enterobacteriaceae, and 45% of Pseudomonas aeruginosa isolates had sufficient growth on the agar slant to allow performance of rapid standardized identification and susceptibility studies. In comparison with other studies using static incubation, it appears that agitation and frequent subculturing of the RSC-TSB system during the first 24 h of incubation decreased the time to detection for the majority of significant blood culture isolates. PMID- 3546367 TI - Electrophoretic and immunoblot analyses of Rhizopus arrhizus antigens. AB - Four antigen preparations from Rhizopus arrhizus were made and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and column chromatography. Electrophoretic analyses of these antigens indicated that there are 18 to 28 component bands with a molecular mass range of approximately 10,500 to 83,000 daltons. Seven of these bands appear to be components common to three antigen preparations. Several of the bands identified by SDS-PAGE were composed of glycoproteins or carbohydrates as determined by their affinity for concanavalin A. Western blots, using sera from five patients with mucormycosis, consistently identified five different determinants in the R. arrhizus antigens separated by SDS-PAGE. This suggests that several of the Rhizopus antigens are present during mucormycosis. Four of the antigenic determinants recognized by patient sera reacted with the concanavalin A-peroxidase stain, indicating that they are composed of glycoproteins or carbohydrate. Enzyme-linked immunosorbent assays of sera from five patients with mucormycosis and with rabbit antisera resulted in antibody titers ranging from 1:64 to 1:32,000 for the R. arrhizus antigens. PMID- 3546366 TI - Detection of enterotoxigenic Escherichia coli by dot blot hybridization with biotinylated DNA probes. AB - A dot blot hybridization test was developed for the detection of enterotoxigenic E. coli without the use of radioisotopes. Three biotin-labeled DNA (Bio-DNA) probes corresponding to structural genes specifying heat-labile and heat-stable enterotoxins of porcine and human origin were prepared by random priming; label incorporation was significantly higher than that obtained from the use of nick translation. Bio-DNA probes were highly specific when reacted with protein- and RNA-free DNA preparations in a dot blot hybridization assay. The Bio-DNA probe, in which 40% of available thymidines were replaced by a biotin-labeled deoxyuridine, readily detected 160 pg of target DNA mixed with 6 micrograms of carrier DNA. The minimum amount of total DNA required for reliable identification of a single-copy enterotoxin gene of porcine origin within a 5,000-kilobase chromosome was found to be approximately 5 micrograms. Complete agreement among the results of Bio-DNA probe hybridization, [32P]DNA hybridization, and biological assay was demonstrated for 15 (100%) of the clinical isolates. This procedure provides a more suitable approach for the diagnosis of enterotoxigenic E. coli infections in clinical settings than the hybridization assay based on 32P labeled DNA probes. PMID- 3546368 TI - Improved method for recovery of peritonitis-causing microorganisms from peritoneal dialysate. AB - The efficacy of recovery of peritonitis-causing microorganisms from peritoneal dialysate fluid by using the Septi-Chek blood culture system (Roche Diagnostics, Div. Hoffmann-La Roche Inc., Nutley, N.J.) was compared with those of other conventional techniques, such as the 20-ml culture and the filtration methods. The recovery of microorganisms by using the Septi-Chek system was found to be as effective as the filtration of 250 ml of dialysate that used a modified Millipore filtration technique (Millipore Corp., Bedford, Mass.). Both methods were found to be superior to the 20-ml culture method. We suggest using the Septi-Chek method as the standard protocol for the culture of dialysate as a relatively inexpensive and labor-saving recovery technique. PMID- 3546369 TI - Significance of quantitative enzyme-linked immunosorbent assay (ELISA) results in evaluation of three ELISAs and Western blot tests for detection of antibodies to human immunodeficiency virus in a high-risk population. AB - The characteristics of primary (first) tests with three enzyme-linked immunosorbent assay (ELISA) kits for human immunodeficiency virus (HIV) antibody were determined. The three ELISAs were performed on 3,229, 3,130, and 685 specimens from high-risk individuals using the Litton (LT; Litton Bionetics Laboratory Products, Charleston, S.C.), Dupont (DP; E. I. du Pont de Nemours & Co., Inc., Wilmington, Del.), and Genetic Systems (GS; Genetic Systems, Seattle, Wash.) kits, respectively. Evaluation was based on the distribution of quantitative test results (such as optical densities), a comparison with Western blot (WB) results, reproducibility of the tests, and identification of seroconverters. The performances of the GS and the DP kits were good by all four criteria and exceeded that of the LT kit. Primary ELISA-negative results were not always confirmed with repeat ELISA and by WB testing. The largest percentage of these unconfirmed negative test results came from samples with quantitative results in the fifth percentile nearest the cutoff. Thus, supplementary testing was indicated for samples with test results in this borderline negative range. Similarly, borderline positive primary ELISA results that were quantitatively nearest (fifth percentile) the cutoff value were more likely to be antibody negative on supplementary testing than samples with high antibody values. In this study, results of repeated tests by GS ELISA showed the least change from first test results. DP ELISA showed more unconfirmed primary positive test results, and LT ELISA showed more unconfirmed primary negative test results. Designation of a specimen with a single ELISA quantitative level near the cutoff value as positive or negative should be viewed with skepticism. A higher than normal proportion of specimens with high negative optical densities by GS ELISA (fifth percentile nearest the cutoff) and also negative by WB were found to be from individuals in the process of seroconversion. PMID- 3546370 TI - Cryptococcus neoformans var. gattii in Australia. AB - An examination of 45 clinical isolates of Cryptococcus neoformans revealed an unusually high incidence of C. neoformans var. gattii in South Australia (65%) and in the Northern Territory (95%). In assessing all the available data from Australian isolates of C. neoformans, there appeared to be an endemic focus for the incidence of C. neoformans var. gattii in the rural aboriginal population of the Northern Territory. PMID- 3546371 TI - Comparison of HEp-2 cell culture and Abbott respiratory syncytial virus enzyme immunoassay. AB - Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection in children. Rapid identification of RSV infections would allow for specific chemotherapy. We evaluated a means of rapid diagnosis, the Abbott enzyme immunoassay (EIA), by using 314 stored nasopharyngeal aspirates. RSV antigens were identified in 62 of 66 RSV culture-positive specimens. An additional 37 specimens from which RSV was not isolated were positive in the EIA. Of these, 29 were confirmed as truly positive by a blocking assay, for a total of 95 (66 + 29) positive specimens. The sensitivity of the EIA for total positive samples was 96% (91/95) versus 69% (66/95) for cell culture. The specificity of the EIA was 96% (211/219). In these stored specimens, Abbott EIA was superior to cell culture for the detection of RSV. PMID- 3546372 TI - Lim group B Strep Broth and coagglutination for rapid identification of group B streptococci in preterm pregnant women. AB - A total of 147 preterm pregnant women at Orlando Regional Medical Center were screened for group B streptococci by using Lim Group B Strep Broth (GIBCO Laboratories, Madison, Wis.) and the Phadebact Strep B Test (Pharmacia Diagnostics, Piscataway, N.J.). Test results were available within 20 h of culture and, in the case of heavily colonized women, within 5 h. This procedure is useful in rapid diagnosis of preterm pregnant women for group B streptococcal colonization. PMID- 3546373 TI - Inhibition of the interaction of mycobacteria with Schwann cells by antimycobacterial antibodies. AB - The effect of antimycobacterial serum on the uptake of Mycobacterium w by 33B rat Schwannoma cell line and rat peritoneal macrophages was studied. Incubation of Mycobacterium w with antimycobacterial serum caused a marked inhibition of its uptake by 33B cells but did not diminish its uptake by macrophages. These results suggest that the mechanism of the interaction of mycobacteria with Schwann cells differs from that with macrophages. PMID- 3546375 TI - Demonstration of defective C3-receptor-mediated clearance by the reticuloendothelial system in patients with acquired immunodeficiency syndrome. AB - The function of macrophage C3 receptors was assessed in vivo by measuring the clearance of C3-sensitized autologous erythrocytes in seven acquired immunodeficiency syndrome (AIDS) patients, eight healthy homosexual men, eight healthy heterosexual men, and four infected controls. Healthy heterosexual men had an initial clearance of 50.1 +/- 2.0% of the inoculum, with a release of a small portion of these cells (10.9 +/- 1.3%) into the circulation. Healthy homosexual men had a greater initial clearance of 66.0 +/- 4.2% (P less than 0.01) followed by a similar release (14.0 +/- 3.3%). AIDS patients had an initial clearance of 60.6 +/- 7.5% but had a relatively large release of cells (25.6 +/- 3.2%) (P less than 0.005 vs. heterosexuals; P less than 0.05 vs. homosexuals), suggesting a failure of macrophage phagocytosis. Infected controls had an initial clearance of 59.4 +/- 4.9%, with a release of 19.6 +/- 3.8% (P = NS vs. AIDS). These data, in addition to Fc-receptor dysfunction, demonstrate a global reticuloendothelial system dysfunction in AIDS patients. This may contribute to their frequent infections with opportunistic pathogens and inappropriate immune responses against these microorganisms. PMID- 3546374 TI - Tissue injury in inflammation. Oxidants, proteinases, and cationic proteins. PMID- 3546377 TI - Isolation of glycine betaine and proline betaine from human urine. Assessment of their role as osmoprotective agents for bacteria and the kidney. AB - Human urine is osmoprotective for enteric bacteria, permitting E. coli to grow with high concentrations of NaCl and other salts and even higher concentrations of sucrose and mannitol but not urea. The active material in urine is soluble in methanol and is precipitated by ammonium reineckate at acid pH. Using gel filtration and high-pressure liquid chromatography, we have identified two major osmoprotective compounds in urine. One is glycine betaine; the other is proline betaine as demonstrated by nuclear magnetic resonance, mass spectrum scanning, and chemical synthesis. Proline betaine has not been described previously to our knowledge in vertebrate tissues. It is known to be a cell volume-regulating agent for marine red algae and the euryhaline mollusk Elysia chloritica. We suggest that the presence of glycine and proline betaines in human urine may reflect an osmoprotective role for the kidney and that they protect bacteria in the urine only fortuitously. PMID- 3546376 TI - Comparative effects in vivo of recombinant murine interleukin 3, natural murine colony-stimulating factor-1, and recombinant murine granulocyte-macrophage colony stimulating factor on myelopoiesis in mice. AB - Purified murine colony-stimulating factors (CSF) recombinant interleukin 3 (IL 3), natural CSF-1, and recombinant granulocyte-macrophage (GM) CSF were assessed in vivo for their effects on BDF1 mouse bone marrow and spleen granulocyte macrophage (CFU-GM), erythroid (BFU-E), and multipotential (CFU-GEMM) progenitor cells in untreated mice and in mice pretreated with purified iron-saturated human lactoferrin (LF). The CSF and LF preparations did not contain detectable endotoxin (less than 0.1 ng). Mice pretreated with LF were more sensitive to the effects of CSF. In mice pretreated with LF, 2,000 U IL-3 or 20,000 U CSF-1 significantly enhanced the cycling status and absolute numbers of all progenitors, whereas 20,000 U GM-CSF significantly increased the cycling status of CFU-GM and CFU-GEMM, but had no effect on cycling of BFU-E or on numbers of any of the progenitors. The effects of CSF in mice pretreated with LF were not mimicked by 0.1-100 ng E. coli lipopolysaccharide. PMID- 3546378 TI - Glycemic thresholds for activation of glucose counterregulatory systems are higher than the threshold for symptoms. AB - To define glycemic thresholds for activation of glucose counterregulatory systems and for symptoms of hypoglycemia, we measured these during stepped reductions in the plasma glucose concentration (in six 10-mg/dl hourly steps) from 90 to 40 mg/dl under hyperinsulinemic clamp conditions, and compared these with the same measurements during euglycemia (90 mg/dl) under the same conditions over 6 h in 10 normal humans. Arterialized venous plasma glucose concentrations were used to calculate glycemic thresholds of 69 +/- 2 mg/dl for epinephrine secretion, 68 +/- 2 mg/dl for glucagon secretion, 66 +/- 2 mg/dl for growth hormone secretion, and 58 +/- 3 mg/dl for cortisol secretion. In contrast, the glycemic threshold for symptoms was 53 +/- 2 mg/dl, significantly lower than the thresholds for epinephrine (P less than 0.001), glucagon (P less than 0.001), and growth hormone (P less than 0.01) secretion. Thus, the glycemic thresholds for activation of glucose counterregulatory systems during decrements in plasma glucose lie within or just below the physiologic plasma glucose concentration range, and are substantially higher than the threshold for hypoglycemic symptoms in normal humans. These findings provide further support for the concept that glucose counterregulatory systems are involved in the prevention, as well as the correction, of hypoglycemia. PMID- 3546379 TI - Equivalence of the insulin sensitivity index in man derived by the minimal model method and the euglycemic glucose clamp. AB - Studies were done to determine whether the minimal model approach and the glucose clamp measure equivalent indices of insulin action. Euglycemic glucose clamps (glucose, G: 85 mg/dl) were performed at two rates of insulin (I) infusion (15 and 40 mU/min per m2) in 10 subjects (body mass index, BMI, from 21 to 41 kg/m2). Insulin sensitivity index (SI) from clamps varied from 0.15 to 3.15 (mean: 1.87 +/- 0.36 X 10(-2) dl/[min per m2] per microU/ml), and declined linearly with increasing adiposity (versus BMI: r = -0.97; P less than 0.001). SI from modeling the modified frequently sampled intravenous tolerance test varied from 0.66 to 7.34 X 10(-4) min-1 per microU/ml, and was strongly correlated with SIP(clamp) (r = 0.89; P less than 0.001). SI and SIP(clamp) were similar (0.046 +/- 0.008 vs. 0.037 +/- 0.007 dl/min per microU/ml, P greater than 0.35); the relation had a slope not different from unity (1.05 P greater than 0.70) and passed through the origin (P greater than 0.40). However, on a period basis, SI exceeded SIP(clamp) slightly, due to inhibition of hepatic glucose output during the FSIGT, not included in SIP(clamp). These methods are equivalent for assessment of overall insulin sensitivity in normal and insulin-resistant nondiabetic subjects. PMID- 3546380 TI - Support of cultured hepatocytes by a laminin-rich gel. Evidence for a functionally significant subendothelial matrix in normal rat liver. AB - The subendothelial space of normal rat liver contains the constituent proteins of a basal lamina, as judged by immunohistochemical study of tissue sections. However, it is unknown whether these proteins constitute a complex with effects on hepatocellular function. We have examined this question, using normal rat hepatocytes cultured on substrata of matrix proteins as a model of the interaction between cells and basal lamina in vivo. In cultures on a type I collagen substratum, albumin secretion decreased progressively after 2 d. By contrast, when cells were cultured on a laminin-rich gel matrix, albumin secretion was stable for at least 3 wk; other functions and ultrastructural morphology were similarly maintained. None of the individual matrix proteins effectively substituted for the gel matrix, suggesting that full support of hepatocellular function requires a complex of matrix proteins. We speculate that a cause of hepatocellular dysfunction in acute inflammation is disruption of this matrix and alteration of its interaction with the hepatocyte plasma membrane. PMID- 3546383 TI - Advances in neonatal and infant behavioral assessment: toward a comprehensive evaluation of early patterns of development. AB - Recognizing the impressive range of behavioral capacities of newborn infants, clinicians and researchers have long searched for valid assessment instruments to help evaluate infant behavior. Behavioral assessments with high predictive validity would aid the goals of developmental diagnostic, prognostic, and treatment programs for infants born at risk from biological or environmental circumstances. The failure of current assessments to predict developmental outcome based on infant behavior may be due to the limited information about higher central nervous system (CNS) functioning obtained from available measures, or to the very dynamic nature of CNS organization in young infants. We begin our review by discussing some major functional characteristics of neonates and then proceed to describe critically the commonly used methods of neurological and behavioral assessment. Noting the need for measures that are more predictive, we turn next to a discussion of a number of experimental techniques that seem to hold great promise for developmental prediction and clinical application. PMID- 3546382 TI - Antibodies to a 64,000 Mr human islet cell antigen precede the clinical onset of insulin-dependent diabetes. AB - Antibodies in sera from newly diagnosed insulin-dependent diabetes mellitus (IDDM) patients are directed to a human islet cell protein of relative molecular mass (Mr) 64,000. Since IDDM seems to develop after a prodromal period of beta cell autoimmunity, this study has examined whether 64,000 Mr antibodies could be detected in 14 individuals who subsequently developed IDDM and five first degree relatives who have indications of altered beta-cell function. Sera were screened by immunoprecipitation on total detergent lysates of human islets and positive sera retested on membrane protein preparations. Antibodies to the 64,000 Mr membrane protein were consistently detected in 11/14 IDDM patients, and in all 5 first degree relatives. 10 IDDM patients were already positive in the first samples, obtained 4-91 mo before the clinical onset of IDDM, whereas 1 patient progressed to a high 64,000 Mr immunoreactivity, at a time where a commencement of a decline in beta-cell function was detected. 64,000 Mr antibodies were detected before islet cell cytoplasmic antibodies (ICCA) in two patients. In the control groups of 21 healthy individuals, 36 patients with diseases of the thyroid and 5 SLE patients, the 64,000 Mr antibodies were detected in only one individual, who was a healthy sibling to an IDDM patient. These results suggest that antibodies against the Mr 64,000 human islet protein are an early marker of beta-cell autoimmunity and may be useful to predict a later development of IDDM. PMID- 3546385 TI - Therapeutic progress--review XXIII. Are we making progress in the treatment of acute stroke? AB - The principal purpose of the treatment of acute stroke is to ensure that the quality of life of those affected is returned to as near normal as possible. Early nursing and physiotherapy are important components of effective management of acute stroke. It is not the intention of this review to examine these aspects which are so well described elsewhere (1). Instead, the theoretical and clinical bases for the various specific treatments advocated in recent years to reduce brain damage after ischaemic insult will be considered to serve as a guide for clinicians. Areas in this field where further research may prove rewarding are highlighted. PMID- 3546381 TI - Implications of anti-Ro/Sjogren's syndrome A antigen autoantibody in normal sera for autoimmunity. AB - We have applied a sensitive assay to analyze lupus and Sjogren's syndrome autoantibodies in 40 normal sera. Seven of these bound Ro/Sjogren's syndrome A antigen (SSA). Although this binding was 1,000-fold lower than the highest anti Ro/SSA level measured from patients, it was inhibited by human Ro/SSA. Positive normal serum-bound Ro/SSA in Western immunoblots and binding activity was demonstrated in the F(ab')2 fragment of IgG. Affinity purification of normal anti Ro/SSA IgG increased the specific anti-Ro/SSA binding by greater than 17-fold. This purified antibody formed a Ro/SSA precipitin and had a relative affinity for Ro/SSA identical to that of Ro/SSA precipitin-positive patients. These data demonstrate that the anti-Ro/SSA present in healthy normal donors is true autoantibody. Anti-La/Sjogren's syndrome B antigen (SSB) autoantibodies were found in 3 of the 40 normal sera, while none bound nuclear ribonucleoprotein (Sm). Finding low levels of anti-Ro/SSA and anti-La/SSB among normals may indicate that anti-Ro/SSA and anti-La/SSB occur in disease by enhancement of a preexisting immune response. PMID- 3546386 TI - New instrument for longitudinal hemisectioning of undecalcified marrow cores, for simultaneous processing and examination with useful and complimentary techniques. PMID- 3546384 TI - Therapeutic progress--review XXIII. Morphine analgesia in terminal care. AB - Pain as a problem in terminal care is considered in this review with particular emphasis on the use of opiates. The choice of routes of administration is discussed in detail and the role of combination of opiates with anti-emetics and steroids is considered. PMID- 3546387 TI - Some preliminary studies on low incidence of infant botulism in the United Kingdom. PMID- 3546388 TI - Major histocompatibility complex class II antigen expression in B and T cell non Hodgkin's lymphoma. AB - An immunohistochemical study of 46 B and T cell non-Hodgkin's lymphomas, using monoclonal antibodies to the products of the major histocompatibility complex (MHC) class II antigen subregions, DP, DQ, and DR, showed that most B and T cell lymphomas express these antigens. Both coordinate and non-coordinate expression of MHC class II antigens was observed, but this did not correlate with immunological phenotype, morphological grade, or proliferation index as determined by flow cytometry. PMID- 3546389 TI - Use of histological samples for assessing skeletal calcium. AB - Bone samples were decalcified using 5% formic acid. Their calcium content was then quantified by analysing the calcium extracted in the decalcification solution. This was correlated with matched samples digested in hydrochloric acid. No significant differences were found. This indicates that bone biopsy specimens taken for histological analysis can be used for the direct assessment of skeletal calcium. The method can therefore simplify investigations into metabolic bone diseases and provide a direct correlation between skeletal calcium and bone histology. PMID- 3546390 TI - Evaluation of sensitivity of two serological tests for diagnosing pneumonia caused by Legionella pneumophila serogroup 1. AB - The sensitivity of an indirect immunofluorescence antibody test (IFAT) and a rapid microagglutination test (RMAT) for the diagnosis of Legionnaires' disease caused by Legionella pneumophila serogroup 1 was evaluated using serum specimens from 119 patients with bacteriologically confirmed infections. The sensitivity of both assays was found to be about 80%. In addition, antibody titres suggestive of L pneumophila infection were found in 40% of patients in the first week after admission to hospital. These data show that both assays can be used with confidence in the early diagnosis of Legionnaires' disease. PMID- 3546392 TI - Immunohistological detection of Legionella pneumophila in lung sections. AB - Immunohistology was used for the detection of Legionella pneumophila serogroup I in necropsy tissue. Study of pneumonic lung from the recent Stafford outbreak has shown that this technique has a high sensitivity. A retrospective postmortem examination showed that L pneumophila serogroup 1 was an unusual cause of pneumonia in Oxfordshire during the study period. L pneumophila serogroup 1 can be successfully subgrouped, using a panel of monoclonal antibodies on formalin fixed paraffin embedded sections. Immunohistological methods have a potentially useful role in the diagnosis of Legionellosis at postmortem examination and in the epidemiological investigation of individual cases and outbreaks. PMID- 3546391 TI - Expression of intermediate filament proteins in normal and diseased thyroid glands. AB - A total of 67 samples from normal and pathological thyroid glands were stained (as formalin fixed paraffin sections) with a panel of monoclonal antibodies directed against intermediate filament proteins. The study confirmed previous reports of cytokeratin and vimentin coexpression in primary thyroid carcinomas, but coexpression was also detected in normal thyroid and in a range of benign conditions including follicular adenomas, Hashimoto's thyroiditis, and diffuse hyperplasia (thyrotoxicosis). Prekeratin expression was found (using antibodies recognising higher molecular weight cytokeratins) predominantly in areas of squamous change, independent of the underlying thyroid pathology. This study does not therefore support previous findings that prekeratin expression provides a reliable means of distinguishing follicular pattern papillary carcinoma from follicular carcinoma with its poorer prognosis or that it helps distinguish benign from malignant papillary lesions. No evidence of desmin or neurofilament expression was seen, and in particular, neurofilaments could not be detected in any of the cases of medullary carcinoma studied. PMID- 3546393 TI - New marker of B lymphocytes, MB2: comparison with other lymphocyte subset markers active in conventionally processed tissue sections. AB - The use of the murine monoclonal antibody MB2 for identifying B lymphocytes in routinely processed tissue was evaluated and contrasted with the use of the monoclonal antibody UCHL1 for identifying T cells. One hundred and sixty eight surgical biopsy specimens were immunostained with these antibodies, including a wide range of normal and neoplastic non-lymphoid tissues, as well as normal lymphoreticular tissues and lymphomas. Sixty four non-Hodgkin's lymphomas were also examined, of which 51 had been previously phenotypically defined. In selected cases the results were compared with those obtained using two other monoclonal antibodies MB1 and MT1, used for identifying B and T cells, respectively, in paraffin sections. MB1 stained a smaller proportion of B cell tumours than MB2 and staining was, in general, weaker, except in one case of centroblastic lymphoma. MT1 immunoreactivity was comparable with that of UCHL1, except in one case of T lymphoblastic lymphoma (MT1 positive, UCHL1 negative). None of the antibodies is ideal, but, if used as a panel, they permit the separation of B cells and T cells in paraffin sections. PMID- 3546394 TI - Immunohistochemical staining of colorectal tissues with monoclonal antibodies to ras oncogene p21 product and carbohydrate determinant antigen 19-9. AB - Two monoclonal antibodies were applied to benign, dysplastic, and malignant human colorectal tissues using immunohistochemical techniques on formalin fixed paraffin embedded material. RAP-5 antibody is directed against a synthetic peptide, reflecting an amino acid sequence of the ras oncogene p21 protein product. Despite using several different techniques and antibody dilutions differential staining between the various epithelial populations was not obtained. RAP-5 also showed other tissue components such as plasma cells, histiocytes, fibroblasts, smooth muscle and vascular endothelium. CA19-9 antibody recognizes an epithelial surface carbohydrate antigen originally derived from a human colorectal carcinoma cell line: it did not stain normal colorectal mucosa or adenomatous polyps, but showed focal expression of variable strength in regenerative, dysplastic, and cancerous mucosa in ulcerative colitis, and in non colitic colorectal carcinoma. Neither antibody was found to be a reliable marker of the evolution of malignant mucosal changes, although CA19-9 may be of limited use in confirming adenocarcinoma of gastrointestinal origin. PMID- 3546395 TI - Monoclonal antibody that detects human type I muscle fibres in routinely fixed wax embedded sections. AB - A murine monoclonal antibody, F7, which selectively shows type I fibres in human skeletal muscle is reported. The antibody reacts with frozen sections and with formalin fixed wax embedded material. It should prove useful in the retrospective and prospective study of muscle pathology. PMID- 3546396 TI - Sweet's syndrome: histological and immunohistochemical study of 15 cases. AB - Conventional histology and immunoperoxidase staining for fibrin, immunoglobulins, and complement components were used to look for evidence of cutaneous vasculitis and immune complex deposition in Sweet's syndrome. These features were not identified in any of the 15 cases studied. The lack of any vasculitis emphasises the distinctive character of Sweet's syndrome when compared with certain spontaneous and experimentally induced inflammatory skin lesions, and may imply a similarly distinctive pathogenesis. PMID- 3546397 TI - Evaluation of enzyme immunoassay (Chlamydiazyme) for detecting Chlamydia trachomatis in genital tract specimens. AB - An enzyme immunoassay (Chlamydiazyme) for detecting Chlamydia trachomatis was evaluated on genital specimens from 96 men and 272 women attending a clinic for sexually transmitted diseases (STD clinic). Compared with a direct immunofluorescence test for chlamydial elementary bodies, the enzyme immunoassay had a sensitivity of 58% on specimens from men, a specificity of 90%, a positive predictive value of 93%, and a negative predictive value of 88%; the assay had a sensitivity of 67% on specimens from women, a specificity of 89%, a positive predictive value of 63% and a negative predictive value of 90%. Immunofluorescence provided the most stringent test for the performance of the enzyme immunoassay as values were improved a little when a cell culture procedure was used for comparison. Further evidence for the lack of sensitivity was the detection of elementary bodies, sometimes in large numbers, in the enzyme immunoassay buffer of 13 of 19 specimens that had given a negative enzyme immunoassay result and the finding in comparative titrations of four laboratory strains that the enzyme immunoassay was at least 100-fold less able to detect chlamydiae than either immunofluorescence or the cell culture procedure. Lack of specificity may be associated with the finding that the enzyme immunoassay antibody reacted with strains of Acinetobacter calcoaceticus, Escherichia coli, Gardnerella vaginalis, Neisseria gonorrhoeae and group B streptococci. The enzyme immunoassay was not considered to be sufficiently sensitive, specific, or reproducible for routine use. PMID- 3546398 TI - Diversity of autoantibodies in patients with antimitochondrial antibody and their diagnostic value. AB - A retrospective analysis of clinical and laboratory features of 102 patients, whose sera contained antibody to mitochondria, showed that primary biliary cirrhosis was diagnosed in 50% of them. Immunofluorescence showed that the sera of the patients with primary biliary cirrhosis all had the M2 antimitochondrial antibody staining pattern. A new staining pattern, designated M2(1), which could be mistaken for the M2 pattern, was not found in any patients with either primary biliary cirrhosis or chronic active hepatitis. Other serological variables such as antibody to mitochondria in IgM class, to multiple nuclear dots, and to the XR antigen, were associated with primary biliary cirrhosis, and taken in association with antimitochondrial antibody of M2 type, contribute to the diagnosis of the disease. PMID- 3546399 TI - Bacterial identification using nitrocellulose blotting technique that incorporates ELISA to bacterial surface antigen. PMID- 3546400 TI - Comparison of radiometric and gas capture systems for blood cultures. PMID- 3546401 TI - Examiner agreement in estimating changes in periodontal bone from conventional and subtraction radiographs. AB - It has previously been shown that computer-assisted subtraction of serially obtained radiographs yields a higher degree of accuracy in the detection of small changes in the marginal periodontal bone than conventional radiographs. This study concerns another important aspect of such diagnostic methods, namely the intra- and inter-examiner agreement rates. On 10 patients with moderate to severe periodontal bone loss involved in a clinical trial to evaluate the effectiveness of subgingival antimicrobial irrigation, conventional radiographs were taken at baseline and after 32 and 52 weeks. The changes in terms of gain or loss of bone occurring between the examination at baseline and that after 32 weeks, as well as those occurring between the examination performed after 32 weeks and that made after 52 weeks, were evaluated by means of conventional radiographs and by subtraction images. Both types of image were interpreted by each of 4 observers. The images were read a 2nd time after a period of at least 2 weeks. The inter observer as well as the intra-observer agreement were assessed by calculating 3 different measures of agreement: the overall agreement, the specific agreement and the kappa value. Regardless of measure, higher inter-observer agreement rates were found for all observers when the subtraction technique was employed. A similar pattern was found with respect to the intra-observer agreement rates. PMID- 3546402 TI - The pathophysiologies of substance abuse and affective disorders: an integrative model? AB - Substance abuse and affective disorders involve overlapping symptom complexes. The author suggests that the neurobiologies of these conditions could be related and presents a model useful in studying the pharmacologies of some of the drugs of abuse and the pathophysiology of affective disorders. This model may bridge two disciplines and render them mutually useful. PMID- 3546403 TI - Review of haloperidol blood level and clinical response: looking through the window. AB - The studies of relationship between haloperidol plasma levels and clinical response in schizophrenia have yielded variable results. A therapeutic window for haloperidol may exist, but the evidence for it is inconsistent. Future studies of this problem using larger patient samples would permit the investigation of interactions between the clinical predictors and the haloperidol plasma levels in the determination of clinical outcome. Although the reduced haloperidol in plasma as well as the red blood cell levels of haloperidol and reduced haloperidol or ratios of the metabolite to parent compound may also be related to clinical outcome, the evidence for this relationship is very tentative. More research is needed before routine clinical monitoring of haloperidol blood levels can be recommended. PMID- 3546404 TI - A comparison of GABA- and GAD-like immunoreactivity within the area postrema of the rat and cat. AB - The immunohistochemical localization of gamma-aminobutyric acid (GABA) was compared to that of glutamate decarboxylase (GAD) in the rat and cat area postrema with the aid of a polyclonal antibody produced in rabbits directed against GABA. In both the rat and cat, dense and very dense accumulations of GABA like immunoreactive (GABA-LI) varicosities were present throughout the area postrema. GABA-LI cell bodies were present in both species and were evenly distributed throughout the area postrema's extent. However, the rat area postrema contained more GABA-LI cell bodies and varicosities than the cat area postrema. In the cat area postrema, a range of cell sizes were immunostained with the GABA antibody. The GAD antibody, however, failed to reveal cell bodies in the area postrema of the cat, thus indicating that the GABA polyclonal antibody may be a better indicator of GABA-containing somata. Although the mechanism of action of GABA in the area postrema is not understood, it is possible that GABA may play a role in the different functions of the area postrema in emetic and nonemetic species. PMID- 3546405 TI - Transient expression of adenosine deaminase in facial and hypoglossal motoneurons of the rat during development. AB - Immunohistochemical and retrograde tracing techniques were employed to demonstrate a changing pattern of adenosine deaminase (ADA) immunoreactivity in cranial motoneurons during their ontogenesis in the rat. Immunostaining for ADA was observed only in motoneurons of hypoglossal and facial motor nuclei and only at certain stages during development. Moreover, ADA immunoreactivity was restricted to subpopulations of motoneurons within each nucleus. In the hypoglossal nucleus ADA-immunostained neurons were seen only in the dorsal subnucleus, where they appeared at about 15 days of gestation, reached maximal staining intensity early after birth, and disappeared by the 25th postnatal day. In the facial motor nucleus, immunoreactive neurons were detected only in the intermediate subnucleus, where ADA immunostaining was first detected at 18 days of gestation and was maximal during the first few postnatal days, and in the lateral subnucleus, where immunostaining appeared perinatally. In both facial motor subnuclei, ADA immunoreactivity was no longer detectable by the 15th postnatal day. Retrograde tracing with WGA-HRP or fluorescent dye injected into various muscles of the face or tongue in young animals indicated that ADA immunoreactive motoneurons in the hypoglossal and facial motor nuclei innervate retractor muscles of the tongue and perioral or nasal muscles, respectively. In view of the critical role of these muscles in suckling and sniffing behavior, it is suggested that metabolic pathways associated with ADA may be involved in the early maturation of the motoneurons projecting to these muscles. Alternatively, the transient presence of ADA in these neurons may reflect a developmental period during which purine nucleosides and/or nucleotides may serve as neuromodulators at their peripheral terminations. PMID- 3546406 TI - Distribution of luteinizing hormone-releasing hormone in the nervus terminalis and brain of the mouse detected by immunocytochemistry. AB - Immunoreactive luteinizing hormone-releasing hormone (LHRH) was localized in a relatively large number of ganglion cells and fibers of the nervus terminalis of neonatal and adult mice, indicating that this nerve is a substantial source of LHRH in the mouse brain. Whole-head specimens of neonatal mice, prior to calcification of the cranium, revealed an extensive distribution of LHRH neurons and fine fibers throughout the peripheral, intracranial, and central parts of the nervus terminalis. The most striking difference between the neonatal and adult animals, in the nervus terminalis, was the increase in immunoreactive axons that made up the fiber bundles of this nerve. In the adult mouse, the intracranial and central projections were composed of thick fascicles of immunoreactive axons, ensheathed by glial cells and accompanied by ganglia that contained both LHRH reactive and nonimmunoreactive neurons. LHRH-immunoreactive cells and axons were seen in a branch of the nervus terminalis that coursed along the medial, posterodorsal aspect of the olfactory bulb and in branches of this nerve that accompany the vomeronasal nerves to the accessory olfactory bulb. A few LHRH neurons and many immunoreactive processes were seen in the accessory and main olfactory bulbs. LHRH-reactive neurons were seen in the hypothalamus and extrahypothalamic structures. Examination of adult mouse brains revealed a pattern of distribution and number of immunoreactive neurons similar to that seen in the neonate. However, many more LHRH-reactive axons were seen in all areas of the brain of the mature animal. PMID- 3546407 TI - Mapping of neuropeptide Y-like immunoreactivity in the feline hypothalamus and hypophysis. AB - The distribution of neuropeptide Y (NPY) in the cat hypothalamus and hypophysis was studied with the indirect immunofluorescence technique of Coons and co workers (Coons, Leduc, and Connolly: J. Exp. Med. 102:49-60, 1955), which provided a detailed map of NPY-like immunoreactive neurons. The immunolabelling was detected in cell bodies, fibers, and terminallike structures widely distributed throughout the whole hypothalamus. A large population of medium-sized NPY-like immunoreactive cell bodies was localized in the area of arcuate nucleus. The number of immunoreactive cell bodies visualized was dramatically increased after intracerebroventricular injections of colchicine. Numerous immunolabelled cell bodies were also visible in the median eminence and scattered in the lateral hypothalamic area. Dense plexuses of NPY-immunoreactive fibers were observed in the arcuate nucleus, internal layer of median eminence, periventricular zone, and paraventricular nucleus. Other regions of hypothalamus displaying numerous NPY like immunoreactive fibers included dorsal and ventrolateral hypothalamic areas. In contrast, certain hypothalamic areas were almost devoid of NPY-like immunoreactive fibers-namely, the mammillary bodies and suprachiasmatic nucleus. Finally, in neurohypophysis, bright immunofluorescent fibers were observed along the pituitary stalk and penetrating the neural lobe. These results suggest the widespread distribution of the NPY-containing neuronal systems in the cat hypothalamus and hypophysis. PMID- 3546408 TI - Immunocytochemical and autoradiographic localization of GABAergic neurons in the goldfish retina. AB - The putative neurotransmitter gamma-aminobutyric acid (GABA) was localized in goldfish retina by using an antiserum directed against GABA itself. The same types of cells were stained with this antibody as were labelled with an antiserum directed against the synthesizing enzyme for GABA, glutamic acid decarboxylase. Stained neurites of these cells were located throughout the inner plexiform layer (IPL) but staining was more intense in the proximal IPL. The GABA-immunoreactive staining could be reduced or completely abolished by preabsorbing the primary antibody with GABA. Uptake of [3H]-GABA or the GABA agonist [3H]-muscimol was localized in GABA-stained retinas using light microscope autoradiography. These experiments demonstrated that all types of GABA-immunoreactive amacrine cells had high-affinity uptake mechanisms for both [3H]-GABA and -muscimol. Thirty percent of proximal inner nuclear layer (INL) and some cells in the ganglion cell layer (GCL) were labelled by all three GABAergic markers. Most GABA-immunoreactive amacrine cells were lightly labelled due to [3H]-GABA uptake but a few amacrines (Ab) were heavily labelled. These findings demonstrate that the autoradiographic localization of [3H]-GABA or [3H]-muscimol uptake and the immunocytochemical localization of GAD or GABA are appropriate methods for localizing GABAergic neurons in the retina. Few GABA-immunoreactive amacrine cells accumulated the putative amino acid transmitter [3H]-glycine, verifying that the goldfish retina contains distinct subpopulations of glycinergic and GABAergic amacrine cells. PMID- 3546409 TI - Postembryonic differentiation of serotonin-immunoreactive neurons in fleshfly optic lobes developing in situ or cultured in vivo without eye discs. AB - The differentiation of serotonin-immunoreactive (5-HTi) neurons in the optic lobes of fleshflies was studied during in situ development and in in vivo cultures. All 5-HTi neurons with cell bodies in the imaginal optic lobes differentiate during postembryonic (pupal) development. These are local anaxonal neurons. In addition there are two large 5-HTi bilateral neurons that connect all optic lobe neuropil regions on both sides of the brain and have their cell bodies in the midbrain proper. Deafferentation of optic lobes cultured in vivo leads to drastic reduction in optic lobe volume and increased cell death. All the 5-HTi neurons differentiate after deafferentation but their morphology changes. The neuropil receiving the photoreceptor inputs, the lamina, degenerates but a disorganized "pseudolamina" is formed by the processes of the two large 5-HTi neurons. The layering of the optic lobe neuropils cannot be distinguished and 5 HTi processes form novel projectional patterns. Hence, the 5-HTi neurons do not require afferent inputs from the retina for their differentiation and survival, but the effect on other optic lobe interneurons is reflected in the morphological plasticity of the 5-HTi neurons. PMID- 3546411 TI - Pathogenesis of haemagglutinating encephalomyelitis virus (HEV) in mice experimentally infected by different routes. AB - Three-day-old suckling mice inoculated intracerebrally (i.c.) with the 67N strain of haemagglutinating encephalomyelitis virus (HEV) showed nervous signs and died. The virus was passaged 10 times in suckling mice and was designated the MB-67N strain. The pathogenesis of MB-67N was studied with various ages of mice and inoculation routes. All mice inoculated i.c. with a large dose of virus died regardless of age, although a smaller dose caused fatal infection only in suckling mice. By intranasal, intraperitoneal and subcutaneous inoculation, the virus also killed suckling mice under 16 days old, but not older mice, even with a large dose. The susceptibility of mice for the MB-67N strain was influenced by age and inoculation routes. High titres of virus were re-isolated from the brain of diseased mice after inoculation by any route, but not from other organs. Histologically, numerous areas of severe focal necrosis were produced in the cerebral cortex. Specific immuno-fluorescence and numerous viral particles were found in the cytoplasm of nerve cells by immuno-fluorescence staining and electron microscopy. These findings indicate that the MB-67N propagates mainly in the central nervous system and nerve cells serve as a main target of virus replication. PMID- 3546410 TI - Antigenic map of the rat cerebellar cortex: the distribution of parasagittal bands as revealed by monoclonal anti-Purkinje cell antibody mabQ113. AB - Both anatomical and physiological mapping methods have revealed that the mammalian cerebellar cortex consists of a family of parasagittal bands of cells, each band with its own pattern of afferent and efferent axons. Monoclonal antibody mabQ113 recognizes an unknown polypeptide antigen that is confined to a subset of rat cerebellar Purkinje cells. Immunoreactive cells are arranged into parasagittal bands extending throughout the vermis and hemispheres. Expression of the Q113 epitope by individual Purkinje cells may not be all-or-nothing, since the bands tend to be more strongly stained in the vermis than the hemispheres. The band display is symmetrical about the midline and reproducible from individual to individual. Whole-mount immunocytochemistry and serial reconstruction reveal a median band of mabQ113+ Purkinje cells adjacent to the midline (P1+) and six other positive bands disposed symmetrically at either side (P2+ to P7+). Bands are distinct throughout most of the cortex but tend to fuse ventrally and caudally. There are two sources of interindividual differences. Firstly, most animals express supernumerary "satellite" bands in the vermis. Satellite bands are usually only one cell wide, are not bilaterally symmetrical, and differ in position and number from individual to individual. Secondly, the precise position of an individual band can differ, perhaps according to the variable cortical lobulation, for example, the position of P4+ in lobules VIII/IX and P6+ in lobule VII. While a scheme of parasagittal bands is a good description of the vermian organization, the distribution of mabQ113+ and mabQ113- Purkinje cells in the hemispheres may be better described as a checkerboard of antigenic patches. PMID- 3546412 TI - Ageing changes in the bovine kidney. AB - A study of macroscopically normal bovine kidneys from three age groups (neonatal calves, 2.5- to 3-year-old bullocks and cull cows), with no abnormalities on urine analysis, was carried out by light microscopy, immunofluorescence and electron microscopy. There was a slight increase in the proportion of involuted nephrons with increasing age but the proportion of nephrons affected was not greater than 10 per cent in any age group. In contrast to the findings of earlier workers, no evidence of diffuse proliferative glomerulonephritis was found in the material examined. It was concluded that the above techniques should be applied to the investigation of renal disease in cattle, as has already been done in man and small domestic animals. PMID- 3546413 TI - Localized cutaneous cryptococcosis successfully treated with ketoconazole. AB - A 27-year-old female recipient of a renal allograft, treated with systemic steroids and azathioprine, developed progressive cutaneous lesions (an ulcer, a nodule, and an abscess). Histopathologic and tissue-culture examination of the skin lesions led to the diagnosis of cutaneous cryptococcosis. A description of the light and electron microscopic features of the cutaneous lesions is reported. A thorough visceral investigation failed to detect systemic involvement. The patient was treated with oral ketoconazole (400 mg daily) for 6 months. A gradual healing of the lesions was obtained, and cultures performed 3 months after the onset of treatment failed to show Cryptococcus neoformans. No relapse or dissemination has so far been observed. PMID- 3546414 TI - Etretinate therapy. AB - Etretinate is a retinoid given orally for the treatment of psoriasis and many other dermatoses. Side effects are similar to the hypervitaminosis A condition. Etretinate represents a substantial advance in dermatologic therapy. PMID- 3546415 TI - Bullous pemphigoid controlled by tetracycline. AB - Two men with nonscarring, persistent, localized bullous pemphigoid, whose eruption is completely controlled with daily doses of oral tetracycline, are described. A review of the literature on persistent, localized bullous pemphigoid is presented. The effects of tetracycline on leukocytes that may play a role in the response of these patients are discussed. PMID- 3546416 TI - Toxic epidermal necrolysis: an approach to management using cryopreserved allograft skin. AB - Toxic epidermal necrolysis is an acute exfoliation of skin simulating a scald injury. Drug-induced toxic epidermal necrolysis has a mortality of greater than 50%. We report an 8-year-old girl with drug-induced toxic epidermal necrolysis who was treated with cryopreserved cadaver skin, with good outcome. The allograft was clinically and histologically viable. Graft keratinocytes demonstrated epiboly as reepithelialization by the host occurred along the host/graft interface. Host epidermis regenerated rapidly, presumably from adnexae, and displaced the viable allograft along the plane of the host/graft interface. The new epidermis appeared normal in all respects. PMID- 3546417 TI - Two types of linear IgA bullous dermatosis. PMID- 3546418 TI - Extracellular deposition of eosinophil granule major basic protein in pressure urticaria. AB - Utilizing affinity chromatography-purified antibody to the eosinophil granule major basic protein and formalin-fixed paraffin embedded tissue, we investigated the localization of major basic protein by immunofluorescence in twenty-four skin biopsy specimens from ten patients with pressure urticaria. Fourteen of twenty four biopsy specimens were obtained from spontaneously occurring urticarial lesions of 4 to 48 hours' duration, and ten of the twenty-four specimens were from dermographometer-induced lesions that had been present from 40 minutes to 24 hours. Twenty-one of twenty-four biopsy specimens showed extracellular fluorescence of eosinophil granule major basic protein within the dermis. The extent and intensity of extracellular staining were not related to the presence or degree of tissue eosinophilia. Serial section controls from each block were stained with protein A purified rabbit IgG and were negative. Previous immunofluorescence studies have demonstrated deposition of major basic protein in lesions of chronic idiopathic urticaria, episodic angioedema, and facial edema. Major basic protein causes release of histamine from human basophils and induces wheal-and-flare reactions on intradermal injection. The present observations add further evidence to support a role for eosinophil mediators, particularly major basic protein, in the pathogenesis of cutaneous disease characterized by edema. PMID- 3546420 TI - Topical treatment for moccasin-type tinea pedis. AB - Sixty patients were treated for tinea pedis with 2% topical ketoconazole cream either once or twice daily. All diagnoses were confirmed mycologically. They were randomly assigned in a double-blind study into three groups on the basis of their clinical lesions, that is, vesicular pedis, interdigital pedis, and hyperkeratotic "moccasin" pedis. Patients were treated for a period of 1 month and were evaluated weekly. A 4-week posttreatment evaluation permitted an assessment of recurrence or improvement. The follow-up visits showed 93% of the vesicular patients, 86% of the interdigital patients, and 83% of the moccasin patients had responded to topical ketoconazole therapy. The high percent of clinical efficacy seen in the first two groups corroborates treatment experiences held by most practicing dermatologists. Of practical interest, however, was the high number of responders among the moccasin-type of tinea pedis. Dermatologists rarely consider topical treatment useful for this clinical entity. PMID- 3546419 TI - Primary cutaneous large cell lymphomas of follicular center cell origin. A clinical follow-up study of nineteen patients. AB - In this study the clinical characteristics and follow-up data of nineteen patients with a diffuse large cell lymphoma of follicular center cell (B cell) origin, with only skin lesions at presentation, are reported. Sixteen of nineteen patients came to us with localized nodules or tumors, preferentially on the trunk, scalp, and lower legs. Remarkably, eight of eleven patients with disease confined to a limited area on the trunk had a history of slowly progressive papular lesions that had been present for 1 to 20 years prior to the development of rapidly growing skin tumors. Initial treatment, generally radiotherapy and/or polychemotherapy, resulted in complete remissions in seventeen of nineteen patients. Only three patients developed extracutaneous disease, whereas two other patients had recurrent disease in the skin at sites distant from the original skin lesions. Excluding three patients who had just finished initial treatment at the time of writing, twelve of sixteen patients were currently alive and in complete remission with a median survival of 44 months. Four patients died, three of whom were elderly women who had skin tumors on the lower legs when first seen. These results suggest that patients with a primary cutaneous large cell lymphoma of follicular center cell origin with disease confined to the trunk of scalp have a very favorable prognosis. PMID- 3546421 TI - Cutaneous malignant melanoma. PMID- 3546422 TI - Leprosy and psoriasis. PMID- 3546423 TI - Physicians who care. PMID- 3546424 TI - CT demonstration of a bizarre intrahepatic portal branch. PMID- 3546425 TI - Examination of the failure of a Wiptam-post-restored tooth. PMID- 3546427 TI - Surface roughness of dental stone casts from alginate impressions. PMID- 3546426 TI - Acoustic absorption within human teeth during ultrasonic descaling. PMID- 3546428 TI - Investigation into the wettability of poly(methylmethacrylate) in vivo. PMID- 3546429 TI - The Maryland bridge: a useful modification. PMID- 3546430 TI - Empirical and functional posterior palatal sealing of full upper dentures: a comparative study. PMID- 3546431 TI - [Computer-assisted design and construction of dental prosthetics. A general description of the project]. PMID- 3546432 TI - "Pinch modification" of the linear advancement flap. AB - Pinch modification of linear advancement flap is a hybrid of advancement and bilateral rotation flaps. This modification, which shortens and widens the flap, shows an increase in flap survival rate over the traditional advancement technique. PMID- 3546433 TI - Painful papule of the ear: a follicular disorder. AB - The etiology of painful papule of the external ear, chondrodermatitis nodularis chronica helicis, has been an enigma for over half a century. I reviewed 84 skin biopsy specimens from 82 patients with this histopathologic diagnosis and found evidence that the infundibular portion of the hair follicle is probably the primary cutaneous structure involved in this condition. This lesion appears to evolve from an acute, suppurative, granulomatous dermatitis into a later fibrosing dermatitis having the clinical and histologic features of perforating folliculitis and prurigo nodularis. PMID- 3546434 TI - The role of MCA in dermatology: monoclonal antibodies in cutaneous immunohistochemistry. PMID- 3546435 TI - The proteoglycans in hypertrophic scar. PMID- 3546436 TI - Eczema herpeticum in three siblings: clinical features and acyclovir treatment. PMID- 3546437 TI - Fine structural deformation of the dermal capillary following immersion fixation procedure. PMID- 3546438 TI - Distribution pattern of DNA polymerases in epidermis. PMID- 3546439 TI - Analyses of delta-aminolevulinic acid dehydratase activity and protoporphyrin levels in erythrocytes among three different species. PMID- 3546440 TI - Radiodermatitis--an analysis of 43 cases. PMID- 3546441 TI - Staphylococcal scalded skin syndrome in an adult. PMID- 3546442 TI - A case of acantholytic squamous cell carcinoma derived from the acantholytic type of solar keratosis. PMID- 3546444 TI - Amikacin treatment for Mycobacterium marinum infection. PMID- 3546443 TI - Febrile ulceronecrotic Mucha-Habermann's disease and its successful therapy with DDS. PMID- 3546445 TI - Chromate allergy: chromate content of Asian cement. PMID- 3546447 TI - Lichen nitidus with hyperpigmentation. PMID- 3546446 TI - Low glucose-6-phosphate dehydrogenase activity in cultured skin fibroblasts from Werner's syndrome. PMID- 3546449 TI - Ultrasonic backscatter from bovine tissues: variation with pathology. AB - This is the second in a series of two papers reporting results collected on ultrasonic propagation properties, namely, velocity, attenuation, and backscatter of various mammalian tissues. In the first paper [J. Acoust. Soc. Am 78, 871 (1985)], the experimental results of five different types of normal bovine tissues were given. In this paper, results obtained for the most common bovine disease in the liver, liver abscess, and in the heart, lymphosarcoma, will be presented. These data show that the ultrasonic properties of tissues with these two types of pathologies are significantly deviated from those of normal tissues, thus providing further evidence that ultrasonic properties may be used as quantitative indicators of a certain disease for diagnostic purposes. PMID- 3546448 TI - [Depressing effect of IgE anaphylaxis on allograft rejection in mice]. PMID- 3546450 TI - Microtrak fluorescent monoclonal antibody screening for Chlamydia trachomatis cervicitis in symptomatic and asymptomatic college students. PMID- 3546451 TI - Modern management of the type I or insulin-dependent diabetic college student. PMID- 3546452 TI - The presidents. Charles Heston Patton 1960-1961. PMID- 3546453 TI - Aided retention of mandibular dentures by magnets. PMID- 3546454 TI - Liquid versus gel etchants on glass ionomers: their effects on surface morphology and shear bond strengths to composite resins. PMID- 3546455 TI - Tensile bond strength between glass ionomer cements and composite resins. AB - Etching or roughening the surface of glass ionomer cement before use of composite resins and bond agents produces bond strengths comparable to the bond strength between glass ionomers and dentin. Bond failure at such surfaces occurs within the glass ionomer. Adequate washing with water after acid etching the glass ionomer is essential to obtain optimal bond strength. Apparently, some combinations of ionomer cements and resins are more effective than are others in providing a good bond in the "sandwich technique". PMID- 3546456 TI - Combining resin-bonded prostheses and removable partial dentures: report of case. AB - The resin-bonded prosthesis provides an alternative for tooth replacement in that the prosthesis can be combined with other dentures. The prosthesis was used conservatively in this case, with modified abutment teeth to improve the function of the removable partial denture. Decreased expense, shorter chair time, and the noninvasive nature of the procedure make the prosthesis an option for patients with special problems. PMID- 3546457 TI - The mandibular staple bone plate: a 5 1/2-year follow-up. AB - Clinical observations for 5 1/2 years and a postmortem examination, including radiographic and microscopic evaluation, showed a mandibular staple bone plate functioned well for a 78-year-old patient in compromised health. PMID- 3546458 TI - Clinical factors affecting the strength of composite resin to enamel bonds. AB - When adhesive bonding anchors composite resin to tooth enamel, a good restoration can be made. This study analyzes clinical factors affecting bond strength with emphasis on sources of air used while restoring teeth. PMID- 3546459 TI - Dentistry on stamps (J.W. Elliot). PMID- 3546460 TI - Comparison of three Doppler ultrasound methods in the prediction of pulmonary artery pressure. AB - Pulmonary artery pressure was noninvasively estimated by three Doppler echocardiographic methods in 50 consecutive patients undergoing cardiac catheterization. First, a systolic transtricuspid gradient was calculated from Doppler-detected tricuspid regurgitation; clinical jugular venous pressure or a fixed value of 14 mm Hg was added to yield systolic pulmonary artery pressure. Second, acceleration time from pulmonary flow analysis was used in a regression equation to derive mean pulmonary artery pressure. Third, right ventricular isovolumic relaxation time was calculated from Doppler-determined pulmonary valve closure and tricuspid valve opening; systolic pulmonary artery pressure was then derived from a nomogram. In 48 patients (96%) at least one of the methods could be employed. A tricuspid pressure gradient, obtained in 36 patients (72%), provided reliable prediction of systolic pulmonary artery pressure. The prediction was superior when 14 mm Hg rather than estimated jugular venous pressure was used to account for right atrial pressure. In 44 patients (88%), pulmonary flow was analyzed. Prediction of mean pulmonary artery pressure was unsatisfactory (r = 0.65) but improved (r = 0.85) when only patients with a heart rate between 60 and 100 beats/min were considered. The effect of correcting pulmonary flow indexes for heart rate was examined by correlating different flow indexes before and after correction for heart rate. There was a good correlation between corrected acceleration time and either systolic (r = -0.85) or mean (r = 0.83) pulmonary artery pressure. Because of a high incidence of arrhythmia, right ventricular relaxation time could be determined in only 11 patients (22%). Noninvasive prediction of pulmonary artery pressure is feasible in most patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546462 TI - Computer-aided learning: experiences, perspectives and promises. AB - Despite the recent strong interest in computer-aided learning, very few high quality programs are available. This article describes an authoring system that was designed to help faculty at medical schools develop a library of effective computer-based lessons. Features of the system include ease of authoring and the ability to incorporate natural language input by the learner, model complex situations, keep track of 100 performance variables and employ interactive laser video disk technology. The authors describe the experience that has been gained in the development and implementation of computer-aided learning at a medical school, and reflect on its future applications and value. PMID- 3546461 TI - Imaging of cardiac allograft rejection in dogs using indium-111 monoclonal antimyosin Fab. AB - The acute rejection of cardiac allografts is currently diagnosed by the presence of myocyte necrosis on endomyocardial biopsy. We evaluated the efficacy of noninvasive scintigraphic imaging with indium-111-labeled anticardiac myosin Fab fragments (indium-111 antimyosin) to detect and quantify cardiac allograft rejection. Six dogs that had intrathoracic heterotopic cardiac allograft transplantation were injected with indium-111 antimyosin and planar and single photon emission computed tomographic (SPECT) images were obtained in various stages of acute and subacute rejection. Four dogs had an allograft older than 8 months and had been on long-term immunosuppressive therapy; two dogs had an allograft less than 2 weeks old and were not on immunosuppressive therapy. Count ratios comparing heterotopic with native hearts were calculated from both SPECT images and in vitro scans of excised and sectioned hearts and were compared with the degree of rejection scored by an independent histopathologic review. Indium 111 antimyosin uptake was not visible in planar or SPECT images of native hearts. Faint diffuse uptake was apparent in cardiac allografts during long-term immunosuppression and intense radioactivity was present in hearts with electrocardiographic evidence of rejection. The heterotopic to native heart count ratios in SPECT images correlated significantly with the count ratios in the excised hearts (r = 0.93) and with the histopathologic rejection score (r = 0.97). The distribution of indium-111 antimyosin activity in right and left ventricles corresponded to areas of histopathologic abnormalities. Immunoperoxidase studies showed deposition of indium-111 antimyosin only in areas of myocyte necrosis. The results demonstrate that indium-111 antimyosin imaging can noninvasively detect the presence, location and severity of canine cardiac allograft rejection. PMID- 3546463 TI - Neuropeptides in the lung: localization, function, and pathophysiologic implications. PMID- 3546464 TI - The role of the methacholine challenge in children with chronic cough. AB - Thirty-nine male and 35 female subjects, aged 6 to 20 years, with chronic cough were studied with spirometry and standard methacholine (MCH) challenge. The duration of their cough before the MCH challenge ranged from 2 months to 13 years. Their FEV1 ranged 62% to 132% predicted. Thirty-six (49%) patients had a positive MCH challenge. The MCH concentration inhaled to decrease the FEV1 by 20% ranged from 0.55 to 25 mg/ml. Follow-up data (mean 14 months) were available on all 74 patients. Fifty-four patients received asthma medications, and 93% improved in mean 3.6 weeks. At the end of the follow-up, 22 (30%) were asymptomatic, 39 (53%) were improved, and 13 patients (17%) were symptomatic. We were unable to predict bronchial hyperreactivity in this population on the basis of duration of the cough, personal or family history of allergies, or baseline spirometry. Thus, MCH challenge is helpful in evaluating children with chronic cough and in guiding therapy. Follow-up of children with chronic cough is important. Eleven percent of this study population progressed to develop bronchial asthma. Forty percent of these patients, initially doing well, were asymptomatic at the end of the follow-up period. PMID- 3546465 TI - Long-term, placebo-controlled trial of ketotifen in the management of preschool children with asthma. AB - Forty-seven children with chronic asthma, aged 2 to 6 years, completed a double blind, placebo-controlled, crossover trial of ketotifen, 1 mg twice daily, in the prophylaxis of asthma. The study period covered two 24-week periods preceded by a 4-week run-in and separated by a 4-week washout. When symptoms, concomitant medication, frequency of acute exacerbations, and parental and physician preferences were analyzed, there were no significant differences between active and placebo treatments. The results suggest that ketotifen has no place in the management of young children with frequent asthma. PMID- 3546466 TI - Double-blind, dose-response study of metaproterenol inhalant solution in children with acute asthma. AB - One hundred children, aged 6 to 12 years, with acute asthma received nebulized therapy with saline, 5, 10, or 15 mg of metaproterenol aerosol solution according to a prerandomized, double-blind protocol. Pulmonary function and cardiac function were assessed for 60 minutes. All patients then received 5 mg of metaproterenol aerosol solution, and observation continued for another 30 minutes. The best response to therapy in terms of rise in FEV1, forced expiratory flow rate between 25% and 75% of FVC, and area under the curve (change in lung function with time) occurred with 5 and 10 mg of metaproterenol. The highest dose, 15 mg, produced significantly less bronchodilation. Although there were no electrocardiographic abnormalities, pulse rate was significantly higher with 10 and 15 mg of metaproterenol than with 5 mg. Five milligrams of metaproterenol aerosol solution is the optimal bronchodilating dose for treating acute asthma in children. Repeating this dose provides some additional bronchodilation and is well tolerated. PMID- 3546467 TI - Distribution of methacholine inhalation challenge responses in a selected adult population. AB - To determine bronchial reactivity patterns in adults, 211 subjects, 22 to 86 years of age, underwent a methacholine challenge in a Natural History of Asthma study. The diagnosis of asthma or nonasthmatic allergic diseases was based on a standardized respiratory questionnaire. Subjects were nonsmokers and had not had an infection for 1 month. Intradermal skin tests were done to a battery of common antigens. The methacholine challenge response was expressed as the area under the dose-response curve integrated to a 35% fall in the FEV1 or 800 breath units. Thirty-three subjects with asthma, 47 normal subjects from normal families (NF), 59 normal subjects from families with asthma (AF), 31 allergic subjects without asthma, 23 subjects with questionable asthma, and 18 subjects with prior asthma were studied. Overall, 50% of the subjects without asthma had a negative response to methacholine. There was a difference (p less than 0.02) in the distribution of log10 methacholine area under the dose-response curve integrated to a 35% fall in the FEV1 or 800 breath units responses in normal subjects from NFs compared to normal subjects from AFs. The allergic subjects from AF had a greater degree of bronchial reactivity compared to normal individuals from NF. The age of the normal subjects had an influence on the degree of bronchial reactivity. Methacholine challenge studies in adult patients need to be interpreted with age and family history in mind. PMID- 3546468 TI - Age-related changes in postprandial plasma glucose, insulin, and free fatty acid concentrations in nondiabetic individuals. AB - Plasma glucose, insulin, and free fatty acid (FFA) concentrations were measured from 0800 to 1600 hours in 40 nondiabetic individuals, separated into younger (38 +/- 1.4 years) and older (64 +/- 1.5 years) age groups. Meals were served at 0800 (20% total daily calories) and 1200 h (40% of total daily calories), and blood drawn just before the 0800 hours meal and at hourly intervals thereafter until 1600 hours. Statistical evaluation of the results of these measurements indicated that day-long plasma glucose and insulin levels were higher in the older individuals. In contrast, the day-long FFA response was reduced in this age group. These data suggest that the ability of insulin to maintain normal plasma glucose levels deteriorates with age, whereas regulation of FFA levels does not. PMID- 3546469 TI - The centennial of the National Institutes of Health. PMID- 3546470 TI - [Tears of the retinal pigment epithelium]. PMID- 3546471 TI - [Toward a rational strategy in the treatment of postoperative bacterial endophthalmia]. AB - 18 cases of bacterial endophthalmitis are reported. From bacteriological, epidemiological, pharmacokinetic data, we can propose a management of infectious endophthalmitis based on the two following rules: systematic intraocular fluid aspiration, on emergency, for stained smears (as real bacteriological extemporaneous investigations) and cultures; initial wide spectrum antibiotherapy with a quick adaptation to gram stain and culture identification. The antibiotics are selected according to their intraocular penetration, safety and spectrum. The intraocular bactericidal concentration requires the association of systemic, peri ocular, and intraocular antibiotherapy, before the settlement of irreversible retinal lesions. By vitrectomy, the infected vitreous may be cleared, and intraocular drugs diffuse more easily. PMID- 3546472 TI - [Prevention of retinopathy of prematurity]. PMID- 3546473 TI - Insulin action in aging man: evidence for tissue-specific differences at low physiologic insulin levels. AB - This study examined the effect of age on insulin action in several tissues. Euglycemic insulin clamp studies were performed on healthy young (n = 7, 20 to 35 years, 10 and 20 mU/m2 X min insulin infusions) and old (n = 7, 66 to 80 years, 8 and 16 mU/m2 X min insulin infusions) adults. Insulin values were similar during both the lower (young, 24 +/- 1.6, old, 24 +/- 2.1 microU/ml) and higher (young, 40 +/- 3.3; old, 39 +/- 3.8 microU/ml) insulin infusion rates. Although suppression of hepatic glucose output (HGO) was more rapid (p less than .05) in the elderly group at each dose, HGO was eventually suppressed to similar levels in both age groups (low dose: young, 34.4 +/- 10.8, old, 25.3 +/- 1.8 mg/m2 X min; higher dose: young, 22.8 +/- 10.2, old, 6.2 +/- 2.1 mg/m2 X min). Glucose disposal was less (p less than .01) in the aged group at both insulin infusion rates. Suppression of C-peptide was slower in the elderly participants (p less than .05) in the low dose study. Suppression of free fatty acid and glucagon levels was the same in each age group. We concluded that the insulin resistance of aging is not generalized to all tissues. PMID- 3546475 TI - [Monitoring of high-risk pregnancies. Complementary aspects of the nonstress test, the oxytocin test and the biophysical score]. AB - The authors have studied the recent literature as well as the conclusions reached at the FIGO Congress in Berlin in 1985 to define rigorous criteria for interpreting the three principal methods that are carried out for antepartum monitoring. These are the non-stress test (NST), the oxytocin test (OCT) and the biophysical score (BPS). The point out the usefulness and the reliability of the NST as a screening technique for hypoxia in utero and also how necessary it is to use more sensitive tests like OCT ou BPS to work out the degree to which the fetus is affected. The way the cases should be handled clinically according to the results of these tests is described. PMID- 3546474 TI - [Secondary cancers arising in mature benign cystic teratomas of the ovary (dermoid cysts). Review of the literature apropos of a new case]. AB - No new general review has appeared concerning the malignant changes that can occur in dermoid cysts of the ovary since the works of Peterson in 1957 and Climie and Heath in 1968. A personal case of epidermoid carcinoma--Stage II B- which occurred in a dermoid cyst gave us the opportunity of reviewing the 132 cases published between 1968 and 1985, which bring the total cases published to more than 400. The cancer arises in 1.78% of mature cystic teratomas. The mean age at diagnosis is 53 years and this pathological change is found five times more frequently after than before the menopause. Before laparotomy is carried out there is no clinical sign nor paraclinical evidence of the diagnosis over and above that of a benign cyst. There are all kinds of histological changes but the epidermoid carcinomas occur in 75% of cases. The survival rate for this kind of ovarian tumour is very poor, with 27% survival after 3 years, taking into account all states and all histological types. Epidermoid carcinomas seem to have a better prognosis than other histological types, and an important prognostic feature is the spread and the ability to remove the tumour surgically when it has extended beyond the capsule of the ovary. Although it is not easy to lay down the best therapy for this condition, by and large extended surgery followed by polychemotherapy or radiotherapy are apparently the only ways of improving the poor prognosis for these tumours. PMID- 3546476 TI - A nursing approach to the use of high frequency jet ventilation. PMID- 3546477 TI - Medical museum notes (Dr. John Stough Bobbs). PMID- 3546478 TI - Malthus's Essay on Population: the facts of "super-growth" and the rhetoric of scientific persuasion. AB - For the Malthusian theory of population to be accepted as "scientific," it was essential that the theory be established on wide empirical evidence. A close examination of the "facts" provided by Malthus, however, shows that many of his crucial facts are based on distortions of the available evidence. Malthus was probably aware of much of this weakness, but for rhetorical reasons he persisted with the sandy empirical foundations from which he began. PMID- 3546479 TI - Margaret Mead and behavioral scientists in World War II: problems in responsibility, truth, and effectiveness. AB - In World War II, Margaret Mead and her behavioral science colleagues actively applied their science to the American war effort on issues such as morale, food habits, psychological warfare, and the evacuation of Japanese-Americans from the West Coast. Mead's participation or lack of participation in these activities, and her varying enthusiasms and misgivings about them, raise fundamental issues about the responsibility of behavioral scientists to warn the public against dangerous policies, as well as the ethics of behavioral scientists participating in deceitful psychological warfare and the extent of their effectiveness in contributing to public policymaking. PMID- 3546480 TI - Thomas Brown on the philosophy and psychology of perception. AB - Thomas Brown's theory of perception is set in its philosophical context, and the influence of George Berkeley, David Hume, and Thomas Reid on Brown is discussed. Destutt de Tracy, who appears to have been an unacknowledged source for Brown's ideas, is also discussed. Brown's theory of perception is elaborated, and he is categorized both as a sense-datum theorist and as a phenomenalist. PMID- 3546481 TI - Direct visualization of IgM antibodies bound to tissue antigens using a monoclonal anti-type III collagen IgM as a model system. AB - A mouse monoclonal IgM antibody directed against human Type III collagen was utilized to immunolocalize Type III collagen by transmission and scanning electron microscopy without the use of an electron-dense conjugate. Because bound IgM can be directly visualized, primary or secondary antibody conjugates, such as ferritin, HRP, colloidal gold, etc., are unnecessary in this method. Immunolocalization to Type III collagen in the matrix of human skin and to fibrils formed in vitro using only IgM antibody reveals uninterrupted IgM binding which exactly matches the banding period of the collagen fibrils. In contrast, colloidal gold-conjugated secondary antibody complexes directed against primary IgM binding sites reveal less precise labeling. The data suggest that direct visualization of primary monoclonal IgM antibodies may be useful in a wide variety of highly specific ultrastructural immunolocalization studies without requiring the use of electron-dense conjugates. PMID- 3546482 TI - Immunolocalization of glyceraldehyde-3-phosphate dehydrogenase, hexokinase, and carboxypeptidase Y in yeast cells at the ultrastructural level. AB - We have developed a simple and effective method to embed whole yeast cells in Lowicryl resins with excellent ultrastructural and antigenic preservation. Using affinity-purified antibodies eluted from electrophoretically separated proteins transferred to nitrocellulose, we have shown by immunoelectron microscopy that two glycolytic enzymes, glyceraldehyde-3-phosphate dehydrogenase and hexokinase, are present in the cytoplasm and the nucleus. Carboxypeptidase Y is localized in the yeast vacuole. These results agree with earlier localization studies based on subcellular fractionation. PMID- 3546483 TI - Transition from mitosis to interphase in sea urchin first division: immunofluorescence studies of tubulin distribution in methacrylate sections. AB - Previous immunofluorescence studies of microtubule distribution in fertilized sea urchin eggs have suffered from poor resolution caused by cell thickness, unavoidable artifacts resulting from excessive flattening, or extraction by detergents of membranes and other lipid-containing structures that may be of interest in relation to the microtubules. To avoid these difficulties, we have developed a fixation and embedding protocol based on buffered paraformaldehyde fixation and butyl-methyl methacrylate embedment, which allows immunofluorescence staining of 0.5-1 micron sections. Polymerization artifacts are reduced by polymerizing the methacrylate at a relatively low temperature (40-45 degrees C) and by flat embedding for more uniform polymerization. Using this method, we have examined mitotic stages in the first cleavage cycle of the sea urchin Strongylocentrotus purpuratus. We provide evidence that the interphase microtubules that appear after first division are not derived from the mitotic asters but are new structures growing from organizing centers within the degenerating mitotic asters. During the transition from mitosis to interphase, there is a temporary overlap of old and new microtubules to form a very large composite aster at telophase before the old structure finally disappears. PMID- 3546484 TI - Studies with anti-bromodeoxyuridine antibodies: II. Simultaneous immunocytochemical detection of antigen expression and DNA synthesis by in vivo labeling of mouse intestinal mucosa. AB - We developed a rapid and convenient immunocytochemical method for simultaneous detection of antigen expression and S-phase cells by means of anti bromodeoxyuridine (BrdUrd) antibodies. Immunocytochemical detection of BrdUrd after in vivo administration in mice was compared with autoradiography using [3H] BrdUrd. Both the sensitivity and specificity of the technique were high. For the dual peroxidase staining technique, DAB color modification by cobalt ions was used. We showed that antigen localization was not affected by the BrdUrd staining protocol. The technique we describe here can be performed on frozen or paraffin embedded tissue and on cytocentrifuge preparations for analysis of the cytokinetics of phenotypically defined cells in heterogeneous populations. PMID- 3546485 TI - Ultrastructural localization of a breast tumor-associated antigen. AB - We used a monoclonal antibody to a high molecular weight glycoprotein of the milk fat globule membrane to study at the ultrastructural level the sites of accumulation of immunoreactive material in breast tumors. By light microscopy, the antigen was found only on the luminal membrane of normal resting or lactating breast cells. In tumors, antigen could be found in the cytoplasm. We used the avidin-biotin-peroxidase complex immunoperoxidase technique to localize the site of cytoplasmic accumulation of immunoreactive material in breast tumors. This technique showed that antigen is found on the membrane of cytoplasmic vesicles. Some of these vesicles were collapsed and gave rise to what appeared to be clumps of free cytoplasmic immunoreactive material. We have also documented that in some tumors the entire cytoplasmic membrane bears antigen, whereas in other tumors only areas of cytoplasmic membrane that form microscopic lumina express antigen. PMID- 3546486 TI - Immunohistochemical studies on hemoglobin-haptoglobin and hemoglobin catabolism sites. AB - In order to clarify the catabolism sites of Hb-Hp and free Hb, the organ distributions of [125I]-Hb-Hp and [125I]-Hb were studied, and the cell types in each organ incorporating them were determined by immunohistochemical methods. After administration of [125I]-Hb-Hp in very small amounts to rats, 84.5% was incorporated into the liver, but the renal uptake was only 0.6%. [125I]-Hb was incorporated into the kidneys rather than into the liver when a fivefold greater amount of [125I]-Hb than the binding capacity of plasma Hp was administered. Parenchymal cells, but not Kupffer cells, in the liver were stained with anti-Hb or anti-Hp IgG after administration of Hb in an amount corresponding to the Hb binding capacity of Hp. The proximal tubule cells, but not the distal tubule cells, in the kidney were stained with anti-Hb IgG after administration of a fivefold greater amount of Hb than the binding capacity of Hp. On the basis of these results, we suggest that Hb-Hp was incorporated mainly into liver parenchymal cells and did not traverse glomeruli in the kidney. In contrast to Hb Hp, free Hb could pass through the glomeruli easily and was incorporated into the proximal tubule cells. PMID- 3546487 TI - Immunoelectron microscopic localization of fibronectin in the smooth muscle layer of mouse small intestine. AB - We studied the ultrastructural distribution of fibronectin in the smooth muscle layer of mouse small intestine with affinity-purified antibodies using the immunogold technique. Fibronectin was present over the pericellular area extending from the cell membrane to the extracellular matrix beyond the basal lamina. Distribution of the glycoprotein over the pericellular area was heterogeneous, i.e., it was localized more abundantly in the narrow space between smooth muscle cells, the gaps having a width of 60-80 nm where the two dense bands in adjacent cells matched each other. Such localization suggests that fibronectin contributes to cell adhesion. Within the basement membrane, gold label was localized both in lamina lucida and lamina densa, more densely in the latter than in the former. Fibronectin was also co-distributed with collagen fibers in the extracellular matrix. Within smooth muscle cells, gold particles were observed on rough endoplasmic reticulum and secretory vesicle-like structures. These results suggest that smooth muscle cells synthesize fibronectin and secrete it as a component of the basal lamina and extracellular matrix. PMID- 3546488 TI - Correlative light and electron microscopic immunocytochemistry on the same section with colloidal gold. AB - Ultrastructural localization of growth hormone in rat anterior pituitary and of muscle-specific actin in rabbit arterial smooth muscle cells was accomplished with a post-embedment procedure using colloidal gold. Plastic sections (2 microns) were mounted on slides, deplasticized, immunostained with immunoglobulin colloidal gold particles, re-embedded in Epon, and sectioned for electron microscopy. This procedure enabled light and electron microscopic localization of these intracellular antigens on the same section. Positive immunostaining was demonstrated with this procedure with a muscle-specific actin antibody which previously failed to localize antigenic sites by EM. The procedure described yielded staining of high specificity, with minimal background and well-preserved ultrastructure. This re-embedding technique is useful in situations where problems with post-embedding EM immunostaining exist and where correlative LM and EM immunostaining is essential. PMID- 3546489 TI - Localization of adenosine deaminase and adenosine deaminase complexing protein in rabbit brain. AB - Adenosine deaminase and adenosine deaminase complexing protein have been localized in rabbit brain. Brains fixed in paraformaldehyde or in Clarke's solution were blocked coronally. Blocks from brains fixed in paraformaldehyde were either frozen in liquid nitrogen or embedded in paraffin. Tissue fixed in Clarke's solution was embedded in paraffin. Sections from each block were stained by the peroxidase-antiperoxidase method for adenosine deaminase or complexing protein using affinity-purified goat antibodies. Adenosine deaminase and complexing protein did not co-localize. Adenosine deaminase was detected in oligodendroglia and in endothelial cells lining blood vessels, whereas complexing protein was concentrated in neurons. The subcellular location and appearance of the peroxidase reaction product associated with individual cells was also quite distinctive. The cell bodies of adenosine deaminase-positive oligodendroglia were filled with intense deposits of peroxidase reaction product. In contrast to oligodendroglia, the reaction product associated with most neurons stained for complexing protein was concentrated in granular-appearing cytoplasmic deposits. In some instances, these deposits were clustered about the nuclear membrane. Staining of neurons in the granular layer of cerebellum was an exception. Granule cells were lightly outlined by peroxidase reaction product. Cerebellar islands, also referred to as glomeruli, were stained an intense uniform brown. These results raise the possibility that oligodendroglia and blood vessel endothelia, through the action of adenosine deaminase, might play a role in controlling the concentration of extracellular adenosine in brain. They do not, however, support the suggestion that complexing protein aids in adenosine metabolism by positioning adenosine deaminase on the plasma membrane. PMID- 3546490 TI - Detection of albumin mRNAs in rat liver by in situ hybridization: usefulness of paraffin embedding and comparison of various fixation procedures. AB - Our aim was to define optimal conditions for efficient and reproducible albumin mRNA detection in rat liver by in situ hybridization. We used an albumin-specific [3H]-labeled cDNA probe with a specific activity of 6-8.10(6) cpm/microgram DNA. In situ hybridization is as efficient on paraffin sections as on cryostat sections for detecting albumin mRNAs. Perfusion fixation with a 4% paraformaldehyde solution results in homogeneous RNA retention within tissue blocks, in contrast with immersion fixation, which yields heterogeneous RNA preservation. Comparison of immersion fixation with three different fixatives (paraformaldehyde, ethanol-acetic acid, and Bouin's fixative) shows that the highest level of hybridization signal is obtained with paraformaldehyde. Ethanol acetic acid and Bouin's fixative appear less efficient for albumin mRNA detection. Loss of mRNAs within liver tissue blocks over time is largely although not completely prevented by paraffin embedding. PMID- 3546491 TI - Epithelial membrane polarity: a stable, differentiated feature of an established human breast carcinoma cell line MCF-7. AB - Carcinoma cells typically show little or no polarity as compared to normal, differentiated epithelial cells. We have studied polarity in two established human breast carcinoma cell lines, T47D and MCF-7, by various techniques (electron microscopic enzyme- and immunocytochemistry, freeze-fracture) and show that one of them (MCF-7) is characterized by a high degree of polarity. Thus, in contrast to T47D cells, MCF-7 cells in monolayer culture form apical tight junctions, do not allow a ricin-horseradish peroxidase conjugate, which binds to terminal galactose residues on the apical surface, to stain the basolateral membrane domain, and express a surface antigen (MFGM-A) only in the apical surface membrane domain, as do normal mammary epithelial cells in vivo. This polarization is independent of a basement membrane, since it is maintained when MCF-7 cells, which do not deposit type IV collagen themselves, are grown directly on plastic. Moreover, even though MCF-7 cells express estrogen receptors rather homogeneously, estrogen has no effect on this polarity, neither in vitro nor after transplantation to nude mice. We conclude that polarity is a stable, differentiated feature of MCF-7 cells. PMID- 3546492 TI - Prostaglandins and experimental hypertension: a review with special emphasis on the effect of dietary lipids. PMID- 3546493 TI - Psychosocial hypertension and the defence and defeat reactions. PMID- 3546494 TI - Active and inactive renin in anephric man: a comparison of molecular weight studies with normal human plasma and the effect of a specific monoclonal anti renin antibody. AB - Measurements of active and inactive renin have been made in a group of six anephric patients and in 30 normal healthy volunteers. Plasma renin activity (PRA) was detected in all of the anephric patients but values were below the normal range. A trypsin-activatable totally inactive renin was present in the plasma of all six patients. In three patients, levels of inactive renin were greater than that found for the mean value of the control group. Gel filtration studies of anephric plasma revealed a degree of heterogeneity of molecular forms of active high molecular weight (HMW) renin. However, an active form of approximately 65,000 daltons was usually present. Inactive renin, partially purified from anephric plasma had an apparent molecular weight (MW) of 59,000 daltons. Affinity chromatography with H.77 Sepharose was used to purify active renin from anephric and normal plasma following treatment with trypsin. The increased PRA in plasma from both groups following trypsin was associated with a 56,000 daltons form indicating little, if any, change in MW upon activation. The active HMW forms and the activated inactive renin were all totally inhibited by a renin-specific monoclonal antibody raised against human kidney renin. PMID- 3546495 TI - Can total prorenin in human plasma be determined by current activation methods? AB - A proper evaluation of the physiological significance of plasma prorenin depends on its accurate determination. However, current activation methods do not necessarily measure total prorenin, or a known proportion of it, even when carried out to apparent completion. Thus, extending cold activation of human plasma at -4 degrees C generally revealed progressive increments of prorenin, mainly during the first 15 days, but the total and the time required to achieve it varied considerably among individuals. Similarly, the titration curves of individual plasmas varied with increments of added trypsin and achieved totals that were not necessarily greater than those obtained by cold activation. This indicates the inappropriateness of attributing greater effectiveness to one method over the other. When the two methods were paired in sequence, a synergism was apparent in that prorenin estimates increased consistently; in one case more than 10-fold. Thus, total prorenin by any single method generally fell short of the total achieved by double methods. However, this too may still not represent the unknown true total prorenin. The sequence of activation steps was important, providing clues as to the mechanism of the observed synergism. Trypsin-before cold activation proved to be more effective than trypsin-after-cold activation, with no further advantage being gained from triple treatments involving cold before and after trypsin, or trypsin before and after cold. The inferiority of trypsin-after-cold activation was apparently due to sensitization of the plasma to the destructive effects of trypsin, shifting its titration curve to the left.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546496 TI - Circulatory adaptation to pregnancy--serial studies of haemodynamics, blood volume, renin and aldosterone in the baboon (Papio hamadryas). AB - To test the hypothesis that haemodynamic changes in pregnancy precede any significant increase in circulating blood volume, serial haemodynamic studies were performed in eight baboon pregnancies using Swan-Ganz catheterization and arterial cannulation. Simultaneous measurements were made of red cell and plasma volumes, and of plasma renin activity and aldosterone concentration. Haemodynamic changes identified by 4 weeks gestation included significant (P less than 0.01) reductions in right atrial pressure, systemic and pulmonary arterial pressures, and systemic and pulmonary vascular resistance. Stroke volume increased in early pregnancy (P less than 0.01), with a consequent increase in cardiac output. Plasma renin activity and aldosterone concentration were elevated by 4 weeks (P less than 0.01), but plasma volume did not expand until 12 weeks. At no stage in middle or late pregnancy was cardiac filling pressure increased. These results provide the first haemodynamic evidence that pregnancy is a state of reduced effective blood volume associated with vasodilatation from the early weeks. PMID- 3546497 TI - Preparation and characterization of polyclonal and monoclonal antibodies against human interleukin 1 alpha (IL 1 alpha). AB - Polyclonal and monoclonal anti-human IL 1 alpha antibodies (Ab) have been established. These Ab neutralized human recombinant IL 1 alpha (rIL 1 alpha) activity effectively, but did not interfere with human rIL 1 beta, murine rIL 1 alpha, or human rIL 2 activity. Fifty percent of rIL 1 alpha activity (25 U/ml, or 2.5 ng/ml) was neutralized by less than 0.06 microgram/ml of rabbit anti-IL 1 alpha Ab (R-38.3G) and by less than 0.13 microgram/ml of monoclonal Ab (clone 28(3B1], respectively. In other experiments, 10 micrograms/ml of rabbit anti-IL 1 alpha Ab could effectively neutralize 50% of 2000 U of rIL 1 alpha activity, and the same amount of monoclonal Ab neutralized 50% of 500 U/ml of rIL 1 alpha activity. Not only IL 1 alpha activity in the thymocyte costimulator assay, but also IL 1-dependent IL 2 production by a human leukemic cell line, HSB.2 subclone, were blocked by these polyclonal or monoclonal Ab. In addition, pI 4.9 IL 1 activity produced by the myelomonocytic cell line THP-1 and by the Epstein Barr virus-transformed B cell lines, were neutralized by these Ab, suggesting that these cell lines also produce IL 1 alpha. The specificity of these polyclonal and monoclonal Ab was further confirmed by immunochemical method (Western blotting), in which anti-IL 1 alpha Ab reacted with rIL 1 alpha in a specific manner. Furthermore, an enzyme-linked immunosorbent assay system has been developed that can detect low levels of IL 1 alpha activity (less than 0.3 ng/ml or less than 3 U/ml), which is still less sensitive than thymocyte comitogenic assay and considerably less sensitive than the D10 assay. Finally, anti-IL 1 alpha Ab-conjugated affinity columns were prepared, by which IL 1 alpha activity, but not IL 1 beta activity, was specifically adsorbed and eluted effectively. PMID- 3546498 TI - Revision of femoral component loosening with titanium ingrowth prosthesis and bone grafting. AB - Preliminary results of 24 cementless revision hips are very encouraging and show no evidence of loosening at 12 to 45 months follow-up. With the problem inherent in femoral component loosening and the high incidence of failure from cemented revision total hip arthroplasty, the use of a porous ingrowth long stem prosthesis fitted to the canal with bone grafting proximally offers a logical solution to a very difficult problem. PMID- 3546499 TI - Salvage of acetabular insufficiency with cementless components. AB - In conclusion, it appears that large outside-diameter bipolar devices or threaded, cement-free acetabular components (with or without porous surfaces) provide excellent hip stability when used to salvage hips with acetabular insufficiency. The bipolar or threaded devices can maintain or restore normal or nearly normal hip mechanics, minimize pain by preventing motion between the cup and the bone, and permit fill-in of bony defects and healing of nonunited fractures. Both grafting should be used whenever possible, since it may prevent medial migration and allow for replacement with a cemented or cementless porous surfaced cup in the future should pain occur. A cane or crutch should be used to minimize stress across the joint and thereby prolong the life of the reconstruction. All patients must realize that these are salvage procedures. PMID- 3546501 TI - Corrosion and ion transfer from porous metallic alloys to tissues. AB - Investigations on porous and nonporous alloys currently available for surgical implant device stabilization through tissue ingrowth have shown microstructures that are characteristic of the thermal processing history of the device and alloy with differences between the nonporous and porous devices of the same nominal chemical analysis, in vitro corrosion potentials that are similar for porous and nonporous alloys and corrosion rates that are approximately proportional to the increases in relative surface areas (X 2 to X 10); local tissue interactions at the cellular level that are specific to the type and amount of elemental constituents present at the interface; and no direct correlations between the local cellular responses (fibroblasts) and the potential for hypersensitivity and other systemically mediated responses. Evaluations of the available published literature and available information on device retrievals and analyses support the opinion that no quantitative, statistically based epidemiologic studies have yet established significant correlations between selected metallic ions and major types of tissue lesions. However, with the changes in surface area and basic surface chemistry for existing alloy systems, research on the long-term tissue responses should be emphasized. In our opinion, biomaterial surface modifications are possible, whereby the relative quantities of released ions available to the environment could be significantly reduced. PMID- 3546502 TI - Total knee arthroplasty: technical planning and surgical aspects. AB - This chapter has outlined the considerations that must be made preoperatively- assessing the difficulty of the procedure at hand, intelligently selecting the prosthesis to be used, planning the patient's alignment, and understanding the instrumentation to be used. Intraoperatively the surgeon must work with an adequate, yet careful, surgical exposure, and a safe and effective saw technique. In addition, the surgeon must understand and manage any major, fixed deformity and ensure proper patellar tracking. PMID- 3546500 TI - Treatment concepts and lessons learned in the treatment of infected implants. AB - In summary, if the pathophysiology of surgical infection is understood and the principles of treatment are followed, dealing with the complex problems of infected transplants should be less formidable. PMID- 3546503 TI - Knee arthrodesis. AB - Thorough excision of all scarred and infected tissues with careful contouring of the bone ends to ensure adequate bone apposition should be performed. Cancellous bone grafts placed about the periphery of the arthrodesis should be considered in the case of loss of bone stock to improve the surfaces for bone apposition. Rigid biplanar external fixation should be used to obtain a compression arthrodesis combined with prolonged immobilization. Unfortunately, some patients will require permanent bracing. PMID- 3546504 TI - Skin blister immunocytology. A new method to quantify cellular kinetics in vivo. AB - A method is described using tuberculin purified protein derivative (PPD) as a model to follow the in vivo cellular immune response. This combines induction of a local response, formation of skin blisters, and staining of the cells appearing in the sterile exudate over time, using standard cytopreparatory and immunoperoxidase techniques. Skin blisters were induced over sites previously injected intradermally with PPD or control saline using suction over a template on the forearm. The cells which appeared in the exudate at 24, 36, 48 and 72 h were collected on small cellulose filters which were divided into several parts. The cells on the filter segments were then stained using a biotin-avidin immunoperoxidase method with a panel of monoclonal antibodies, and with enzyme histochemical techniques. This allowed quantitative estimation over an extended period of total numbers of each cell type responding as a local expression of cellular immunity. The kinetics of an early, non-specific inflammatory response could be distinguished from the later immune response using total cell counts. Maximal cell counts correlated well with PPD induced induration at 48 h, showing an overwhelming predominance of mononuclear cells. Over 72 h, the number of non specific esterase (NSE) positive cells (macrophage) declined while Leu4 positive cells (T cells) increased. OKT4 positive cells (T helper) outnumbered OKT8 positive cells (T suppressor) as the response developed. This method enables the direct quantitative assessment of cell populations arriving at the site of an immune response using a simple inexpensive technique which is painless, non invasive and non-scarring. PMID- 3546506 TI - Relative and absolute numbers of human lymphocyte subpopulations. A comparison of immunofluorescence microscopy and flow cytometric methodologies with special reference to precision and reference values. AB - Lymphocyte subpopulations were determined in blood samples from blood donors (40 women and 45 men) using immunofluorescence microscopy and flow cytometric methodologies. The study demonstrates the value of both methods for the enumeration of lymphocyte subpopulations. The advantages of employing an automated flow cytometer system are better precision and speed. The automated systems require a large initial technical and financial burden and are therefore probably destined to be reserved for the larger laboratory. There is a need for an adequate lymphocyte standard which shows little variation between aliquots and can be used for interlaboratory comparisons. PMID- 3546505 TI - A sensitive method for testing the effect of immunoglobulin binding factor on Ig secretion by hybridoma B cells. AB - A microtiter plate assay to detect the effect of immunoglobulin binding factor (IBF) on Ig secretion by hybridoma B cells is described. This technique permits the analysis of Ig secretion by only 200-400 hybridoma B cells using a PFC assay and an ELISA, and therefore increases the IBF/cell number ratio. This increase allows the detection of a strong IBF-mediated inhibitory effect on Ig secretion by hybridoma B cells, which is otherwise difficult to obtain reproducibly. The technique is simple, does not require any transferring step and is convenient, since it permits large numbers of samples to be tested. It can be extended to test IBF for all isotypes or other lymphokines that affect Ig secretion. PMID- 3546507 TI - Murine embryonal carcinoma cells express class I MHC-like antigens. AB - Previous work has concluded that murine embryonal carcinoma (EC) cells, the oncogenic stem cells of teratocarcinomas, do not express class-I, H-2K or D/L gene encoded products. Experiments using cell-mediated lysis, serological and molecular biological approaches show that EC cells do express some major histocompatibility complex (MHC) class I or class I-like molecules. PMID- 3546508 TI - Histocompatibility and the genetics of tumour resistance. PMID- 3546509 TI - Germ cell tumours of the testicle. A model for MHC influence on human malignancy. PMID- 3546510 TI - Herpes zoster and the immunocompromised. PMID- 3546511 TI - Creutzfeldt-Jakob disease with reference to the safety of pituitary growth hormone. PMID- 3546512 TI - Use of dot immunobinding assay (DIB) for the rapid diagnosis of human brucellosis. PMID- 3546513 TI - [Use of the intestinal graft in renal transplantation in children and adults]. AB - Intestinal grafts as a means to external shunting of urine during renal transplant operation were described by W.D. Kelly as early as 1966. Since then 80 cases have been reported in the Anglo-Saxon literature. A total of 68 well documented cases showed functional kidneys in 52%, complications in 42% and a 13% mortality rate. Between 1973 and 1985, of 400 renal transplant operations in children, an intestinal graft was used in 8 cases (2%) to provide 4 definitive external diversions and 4 enlargements or replacements of bladder. Indications for use were neurological bladder and posterior urethra valves. In all cases the graft was prepared before transplant operation. Enlargement of bladder requires good cervico-urethral function determined by previous study of a generally nonfunctioning bladder distal to an cutaneous ureterostomy. To avoid post transplant urological effects the graft for enlargement or replacement is opened temporarily on to skin and closed several months after grafting. Follow up for 2 to 8 years showed 6 kidneys functioning normally, and 3 enlarged or replaced bladders out of 4 currently closed functioning satisfactorily. The 2 lost kidneys were rejected 2 weeks and 2 years respectively after the graft operation. There was no mortality or urological complication. The only surgical complications related to the intestinal graft were 3 early-onset occlusions treated successfully. Calculi formed in 2 cases, one being eliminated spontaneously at an early stage and the other, of late onset, requiring two operations. Metabolic or infectious complications were benign.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546514 TI - Festschrift in honor of Albert Montgomery Kligman. PMID- 3546515 TI - Aged skin: a study by light, transmission electron, and scanning electron microscopy. AB - The fine structural organization of the epidermis, dermal/epidermal junction, and dermis from an unexposed site (upper inner arm) of elderly people was compared with the organization of a similar region of young people. Despite an overall thinning of the epidermis and focal areas of cytologic atypia, the characteristic morphological markers associated with the keratinization process are not markedly altered in appearance or amount. A well-formed stratum corneum consisting of flattened, enucleated horny cells enveloped by a thickened membrane, and intracellular spaces filled with electron-dense material provide structural evidence that barrier ability is not compromised in senile skin. The dermal/epidermal changes in aged skin are marked and have significant physiologic implications. The major change is a relatively flat dermal/epidermal junction resulting from the retraction of the epidermal papillae as well as the microprojections of basal cells into the dermis. This flattening results in a more fragile epidermal/dermal interface and, consequently, the epidermis is less resistant to shearing forces. Retraction of the epidermal downgrowths (preferential sites of the putative epidermal stem cell) may also explain the loss in proliferative capacity associated with the aged epidermis. The three dimensional arrangements of collagen and elastic fibers showed marked alterations with age. Both fibrous components appear more compact because of a decrease in spaces between the fibers. Collagen bundles appear to unravel, and the individual elastic fibers show signs of elastosis. These changes may contribute to the loss of resilience that is one of the salient features of senile skin. PMID- 3546516 TI - Patterns of antibody response in individuals infected with the human immunodeficiency virus. AB - Immunofluorescence and immunoblot assays were conducted on 488 sera from patients with AIDS and clinically healthy individuals at risk for infection by the human immunodeficiency virus. Of these, 360 contained antiviral antibodies, and nearly all reacted with the envelope precursor glycoprotein gp160. Sera from 103 individuals for whom a complete clinical history was available were evaluated in detail. Most sera recognized both the gp160 and the p55 gag precursor protein. Because these two antigens are found primarily in infected cells, the results suggest that this association makes them more immunogenic. A high prevalence of antibodies to the polymerase gene products (p65 and p31) and to a viral protein p48, which is not yet fully defined, was also noted. Many sera, particularly those from patients with Kaposi's sarcoma or Pneumocystis carinii pneumonia, lacked antibodies to both p25 and gp41. These antibody patterns could help predict the prognosis for virus-infected individuals. PMID- 3546517 TI - Role of respiratory tract proteases in infectivity of influenza A virus. AB - Proteolytic cleavage of influenza virus hemagglutinin (HA) glycoprotein into subunits designated HA1 and HA2 is required for penetration of virus into the cell. It is generally assumed that this cleavage is an intracellular function of the host cell. Human adenoid fibroblast (HAF) lines, which support the growth of influenza A virus but release virus with an uncleaved HA, provide a model system that has allowed exploration of mechanisms of cleavage in vivo. Exposure of HAF grown influenza virus to nasal secretions from children with respiratory tract symptoms induced HA cleavage and rendered virus fully infectious. Characterization of this proteolytic enzyme, present in the extracellular environment of the respiratory tract, suggests that it is a serine endopeptidase. PMID- 3546518 TI - Influence of focal growth conditions on the pathogenesis of toxic shock syndrome. AB - Patients with toxic shock syndrome (TSS) had sequestered focal sites colonized or infected with Staphylococcus aureus significantly more frequently than did patients with scalded skin syndrome. Growth conditions within the infected foci of four patients with TSS included nearly physiological levels of pH, pO2, pCO2, protein, calcium, and magnesium. Two strains of S. aureus had typical TSS phenotypes (production of TSS toxin-1 [TSST-1] and protease), which were optimally expressed in vitro under conditions similar to those documented in vivo (6% CO2, pH 7.0, aerobic, high levels of protein). Altering any one of these growth factors significantly decreased production of TSST-1. In protein containing media, depletion of divalent cations had a less-profound effect on organism growth and TSST-1 production. The unique in vivo environment in patients with non-menstrual TSS is similar to conditions associated with tampon use during menstruation. Growth conditions may play an important role in the expression of S. aureus phenotype and the pathogenesis of TSS. PMID- 3546519 TI - Phage-associated cytotoxin production by and enteroadhesiveness of enteropathogenic Escherichia coli isolated from infants with diarrhea in West Germany. AB - We assessed the frequency of isolating enteropathogenic Escherichia coli (EPEC) from the stools of infants with diarrhea, the enteroadhesiveness of the EPEC, their production of cytotoxin, and the association of cytotoxin synthesis with lysogenic phages. One hundred twenty-five isolates of EPEC obtained from 1,674 children with diarrhea; three were isolated from 868 controls. Thirty EPEC made elevated levels (greater than or equal to 10(4) 50% cytotoxic doses/mg of cell lysate protein) of a cytotoxin for HeLa cells, and cell-associated cytotoxicity for 27 of these isolates was neutralized by antibody to Shiga toxin. Cell lysates of these isolates were paralytic and lethal for mice. Phages from cytotoxin producing strains were tested for toxin-converting capacity. Fifteen of 30 such strains harbored toxin-converting phages, and the cytotoxicity of 12 isolates of E. coli K12 transduced with these phages was neutralized by antibody to Shiga toxin. Fifty-seven EPEC exhibited either localized or diffuse adherence to HEp-2 cells, but only nine producers of elevated levels of cytotoxin were adherent. PMID- 3546520 TI - Treponema pallidum attachment to surface and matrix proteins of cultured rabbit epithelial cells. AB - Treponema pallidum strain Nichols adheres readily to rabbit epithelial cells (SF1Ep) in tissue culture. We examined a variety of sugars for their ability to inhibit attachment. Mannose, galactose, and N-acetylgalactosamine showed minor but reproducible inhibition of attachment at high concentrations, whereas sialic acid was highly inhibitory even at low concentrations. Whole-cell lysates of SF1Ep cells contained a large number of glycoproteins, which might be related to the sialic acid-inhibitable attachment. When the cells and extracellular matrix were fractionated, only a few proteins were found in the matrix fraction. They included a 220-kilodalton (kDa) protein, shown by immunoblotting to be fibronectin, and an approximately 90-kDa protein (both were isolated on SDS-PAGE gels). When nitrocellulose replicas of these SDS-PAGE gels were exposed to 125I labeled T. pallidum, adherence was mainly to the 90-kDa protein. PMID- 3546521 TI - Postabortal Chlamydia trachomatis salpingitis: correlating risk with antigen specific serological responses and with neutralization. AB - Serum antibodies to Chlamydia trachomatis were studied by microimmunofluorescence (micro-IF) testing and by immunoblotting among 52 women with C. trachomatis cervical infection. All women underwent therapeutic abortion, and 10 (19.2%) subsequently developed laparoscopically confirmed salpingitis. Women who developed salpingitis had lower geometric mean titers of micro-IF antibody before abortion (14.9 x/divided by 2.3) than did women who did not develop salpingitis (41.6 x/divided by 4.9, P less than .01). Women who developed salpingitis significantly less often had serum IgA antibodies to a 60-kilodalton (kDa) chlamydial antigen (P = .02) and IgG antibodies to antigens of 75-kDa (P = .008), 60-kDa (P = .03), and 57-kDa (P = .0003). Serum antibodies to 100-kDa, 32-kDa, and 29-kDa antigens occurred only in women who did not develop salpingitis. Differences in antibody prevalence to specific chlamydial antigens were not due to differences in serum antibody titers between the two groups. No correlation between neutralizing sera and the risk of postabortal salpingitis was detected. PMID- 3546523 TI - Phage-typing scheme for Escherichia coli O157:H7. PMID- 3546522 TI - Four-year prospective study of homosexual men: correlation of immunologic abnormalities, clinical status, and serology to human immunodeficiency virus. PMID- 3546525 TI - [Killer phenomenon in yeast: biosynthesis and mode of action of the killer toxin]. PMID- 3546524 TI - Utility of oligodeoxyribonucleotide probes for detecting enterotoxigenic Escherichia coli. PMID- 3546526 TI - [Biochemistry of Sarcophaga peregrina (flesh fly)]. PMID- 3546528 TI - [Multiple functions of interleukin 1]. PMID- 3546527 TI - [Molecular mechanism of induced synthesis of colicin E1]. PMID- 3546529 TI - [Inositol 1,2-cyclic phosphates in the signal transduction system]. PMID- 3546530 TI - [Oxygen toxicity in the lung]. PMID- 3546531 TI - [Some current topics on platelet membrane glycoproteins]. PMID- 3546532 TI - [Ultrasonic findings in polycystic ovary]. AB - Nineteen patients with polycystic ovarian disease (PCO) underwent ultrasound examinations. Criteria of PCO were determined by clinical findings [(1) sterility (2) irregular menses], and hormonal analysis [(1) basal LH level greater than or equal to 20 mIU/ml, (2) LH/FSH greater than or equal to 2.5, (3) maximum LH level after LH-RH test greater than or equal to 150 mIU/ml]. Seven cases out of nineteen patients were confirmed by histologic examinations. Fourteen normal women were compared with PCO patients. We have obtained the following results. No significant differences between PCO groups and normal women were observed in uterine longest diameter (ULD) and uterine volume (UV). On the other hand, correlation tests of ovarian longest diameter (OLD), ovarian volume (OV), OLD/ULD and OV/UV were highly significant (p less than 0.01), as compared with each for normal women. The sonographic spectra of ovarian morphology in PCO were classified into three types. In type I, the ovary was filled with a light homogeneous echo. And type II was divided into two small types, IIa and IIb. In type IIa, small cysts (3-5 mm) were sporadic in the ovary and indistinct. In type IIb, the cyst was rather larger (5-7 mm) and more distinct than that of type IIa. In type III, the capsule echo of the ovary was thick and cysts under the capsule were 3-7 mm-sized and arranged regularly. We investigated the induced ovulation rates with clomiphene in each type. Two of 4 cases of type I and 6 of 8 cases of type IIa were induced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546533 TI - [Flow cytometric DNA analysis of gynecologic malignant tumors using paraffin embedded tissue]. AB - We have studied flow cytometric DNA analysis of gynecologic malignant tumors using paraffin-embedded tissue for histopathology. A close correlation was observed between the DNA indices obtained from fresh unfixed tissue and from paraffin-embedded tissue (r = 0.993). The coefficient of variation (CV) for the diploid G0G1 peak of the paraffin-embedded tissue was one and half greater than that obtained from fresh tissue on the average. In the DNA analysis of 64 endometrial carcinomas, DNA aneuploidy was detected in 3% of nuclear grade 1, in 25% of nuclear grade 2 and in 63% of nuclear grade 3. That is, the more abnormal the nuclear findings, the higher the percentage of DNA aneuploidy. In the analysis of 48 ovarian tumors, DNA aneuploidy was detected in 79% of serous adenocarcinoma, in no of mucinous adenocarcinoma, in 17% of endometrioid carcinoma, in all of clear cell carcinoma and dysgerminoma, that is, its incidence was different among histological subtypes. PMID- 3546534 TI - [Preeclampsia and tubular dysfunction]. AB - Renal involvement associated with preeclampsia is well investigated, especially from the aspect of glomerular lesion and coagulation. On the other hand, only a few studies on tubular dysfunction during normal pregnancy and preeclampsia have been reported. The first study was carried out to clarify and estimate the chronological changes in tubular function. Pregnant women without obvious tubular dysfunction and toxemia (group A) were investigated using serum Cl, Na minus Cl (Na-Cl index), uric acid and urinary beta 2-microglobulin (u-beta-MG) at the 10th, 20th, 30th and 36th weeks of gestation. The second study was carried out to determine the significance of tubular dysfunction accompanied by preeclampsia. Patients with severe preeclampsia (group B) and normal pregnancy (group C) were examined by the same index of tubular dysfunction. The diagnosis of severe preeclampsia was confirmed with hypertension (over 170/110 mmHg), proteinuria (beyond 3 g/day) and severe edema. The following results were obtained: Urinary beta-MG and serum Cl increased during the third trimester in group A, but the Na Cl index decreased. The serum uric acid concentration increased during the third trimester in group A. Tubular dysfunction was evident during the third trimester in normal pregnancy. Every index of tubular dysfunction including u-beta-MG, serum Cl, Na-Cl index and uric acid in group B was significantly higher than in group C. In group B, 4 fetuses died and 7 out of 15 cases required Cesarean sections. The critical line of tubular dysfunction for fetal prognosis was Cl 110 mEq/l, Na-Cl index 28 mEq/l, uric acid 6.0 mg/dl and u-beta-MG 1,000 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546535 TI - [Placental implantation as the cause of breech presentation]. AB - The ultrasonographic study of 5294 singleton pregnancies between the 16 and 41 gestational weeks and 47 breech presentations at term revealed the following: The placenta was found in the mid-anterior or mid-posterior region of the uterus in 60.9 to 74.0%. In 12.8 to 18.7% of cases, the placenta was implanted in the fundal region before gestational week 28, but thereafter it was found in the cornual region in 13.8 to 19.1%. Of 47 cases with breech presentation at term, the placenta was implanted in the cornual region in 28, in the fundus in 7, in the lateral in 6, and in the mid-anterior or mid-posterior in another 6. In gestational weeks from 16 to 19, the breech presentation was found in 38% when the placenta was implanted in the cornual region, in 50% when it was implanted in the lateral region, 52.8% in the fundus, and 47.2% in the middle, with no significant difference in the incidence of occurrence. However in gestational weeks from 36 to 41, the incidence was 20.2, 6.4, 9.0 and 1.1% respectively and the spontaneous version rate was significantly higher when the placenta was implanted in the middle region than in others (p less than 0.01). The author has concluded that the breech presentation in single pregnancy is caused by the placental position; when it markedly indents and changes the inverted pear shape of the amniotic cavity, the spontaneous fetal cephalic version is inhibited.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546536 TI - [Antimicrobial effect of human endometrial peroxidase on Escherichia coli and Staphylococcus aureus]. AB - Human endometrium had potent peroxidase activity and an antimicrobial effect. Relationships which existed between the human endometrial peroxidase and antimicrobial effect were studied. Human endometrial peroxidase activity was measured by the modified method of Himmelhoch. In the normal menstrual cycle, the peroxidase activity in the secretory phase was higher than in the proliferative phase. The peroxidase activity in endometrial carcinoma was remarkably higher than in the normal menstrual cycle. The organisms (E.coli, S.aureus) and peroxidase extract were incubated for 60 min at 37 degrees C. Bacterial viability was determined by the plate culture method. The viable cell count was decreased. Endometrial peroxidase had an antimicrobial effect on E.coli and S.aureus. But the antimicrobial effect on clinically isolated S.aureus exerted by the peroxidase was not effective. Although the peroxidase activity in the endometrial carcinoma was higher than in the normal endometrium, there was no detectable antimicrobial effect. Peroxidase of endometrial carcinoma was suspected of having some different characteristics from normal endometrium. PMID- 3546537 TI - [Detection of type-specific group B streptococcal antibody by indirect immunofluorescence and prevention of vertical transmission by antibiotic therapy]. AB - Seventy-six (13.6%) of 558 third trimester pregnant women had positive vaginal Group B Streptococcal (GBS) colonization. Among these colonizing GBS, 17 (22.4%) of 76 reacted positively to type Ia serum, 6 (7.9%) to type Ib serum, 2 (2.6%) to type II serum, and 23 (30.3%) to type III serum respectively, whereas 22 (28.9%) lacked these heat stable antigens when examined by the agglutination method. Persistence of the colonization of GBS was observed only in 4 (9.9%) out of 44 ampicillin-treated women whereas 65 (86.7%) out of 75 cases in the non-treated group. The colonization rates of GBS in infants born to carrier mothers were 37.5% in the non-treated group and 7.4% in the ampicillin treated group. The levels of ampicillin concentration in cord sera and amniotic fluids were maintained over the MIC of GBS for 7 hours after the drug administration. Type specific antibodies were assayed by indirect immunofluorescence in both maternal and cord sera. In 58(87%) of 67 cases antibodies to type Ia, in 15(27%) of 55 cases to type II, and in 28(42%) of 67 cases to type III were detected in the maternal sera. No antibody to type Ia was detected in a mother who had an affected infant with the same type of GBS. In cord sera, antibody titres of a premature infant and a low-birth-weight infant were lower than those of their mothers. PMID- 3546538 TI - [The development of enzyme immunoassay for prostaglandin F2 alpha]. AB - It has recently been demonstrated that prostaglandins (PGs) play an important role in the ovulation, the onset of menstruation and labor pain and other reproductive phenomena. The purpose of this study is to develop the enzyme immunoassay (EIA) for PGF2 alpha to estimate the PGF2 alpha level in body fluids. beta-Galactosidase-PGF2 alpha conjugate and bovine serum albumin-PGF2 alpha conjugate were prepared by a mixed anhydride method. PGF2 alpha was extracted with ethylacetate from an acidified sample. EIA was carried out using a double antibody method. As for the conjugation ratio of PGF2 alpha and beta Galactosidase, 5, 10, 20, 40 and 80 were examined. Recovered enzyme activity and sensitivity of the method were better in the enzyme of conjugation ratio 10 than in the other conjugation ratios, 5, 20, 40, 80. Values measured by RIA and EIA were well correlated. The correlation rate was 0.84. The recovery rate was 102.3%. The sensitivity of the standard curve was 5-100 pg/tube. PGF2 alpha in the menstrual blood of the 18 women was determined with the EIA method. The mean value for PGF2 alpha in menstrual blood is 20.9 ng/ml (S.D. = 11.4). PMID- 3546539 TI - [Hydronephrosis in pregnancy and its etiology]. AB - Using ultrasonography, the cause and incidence of hydronephrosis were investigated in humans and rabbits and the following results were obtained. The degree of hydronephrosis was classified into grade I (calyceal diameter; up to 5 mm) to grade V (calyceal diameter; 21 mm or more). In normal non-pregnant women, the calyceal diameter was within grade I. The hydronephrosis was found in 45.5 87.0% of pregnant women in the right kidney and in 29.1-51.0% in the left. Throughout pregnancy, the incidence was significantly higher in the right than in the left. On the 6th puerperal day, the incidence of hydronephrosis was lowered, but the diameter did not return to the non-pregnant level. Comparison of women who practised swimming during pregnancy and those who did not reveal the incidence of hydronephrosis was lower in the swimming group than in the non swimming. In rabbits, calyceal dilatation increased as gestation advanced and hydronephrosis was found in progesterone-treated ovariectomized rabbits. It was concluded that the hydronephrosis in the 1st trimester was due to increased steroid hormones, but also that, in the 2nd trimester, the combined effect of hormones and mechanical obstruction was responsible for its occurrence. PMID- 3546540 TI - [The 1MHz C-W Doppler device with an adaptive equalizer for fetal heat rate monitoring during labor]. AB - A new 1MHz continuous wave Doppler device with adaptive digital data processing was introduced to fetal heart rate monitoring during labor. Frequency characteristics of three different continuous wave Doppler devices (2MHz, 1MHz, and 455kHz) were evaluated by FFT analysis, after triggering at the QRS peaks of simultaneously recorded fetal scalp ECG. By three dimensional FFT display, the 1MHz carrier frequency was found to be optimal because of its improved penetration and coverage of a wider area, than with 2MHz and 455kHz. It was obvious that the 1MHz signal provided simplified wave form patterns, and this was much more convenient in detecting the individual valve or flow signal originating in the fetal heart. However, the study revealed that at 455kHz, which was theoretically a compatible figure considering the size and the stroke of the fetal heart, the nature of Doppler signal was different from those at a higher frequency, suggesting that it is inconvenient for exact determination of the fetal heart rate. Another point to emphasize is the application of an adaptive equalizer. This equalizer gave a constant configuration of the Doppler signal, by calculating the average output level in the amplitude and frequency range during a given time interval. By this newly-devised specific filtering, the individual valve or flow component could be easily discerned. This analysis showed that the combination of a 1MHz Doppler device and an adaptive equalizer to be the best device for fetal heart rate monitoring during labor. PMID- 3546541 TI - [A simplified method for differentiating microorganisms in obstetric infections]. PMID- 3546542 TI - [A triplet pregnancy after LHRH pulsatile infusion therapy in a postoperative case of growth hormone-producing pituitary macroadenoma]. PMID- 3546543 TI - ELISA detection of IgM antibodies against phenolic glycolipid-I in the management of leprosy: a comparison between laboratories. AB - IgM antibodies to the phenolic glycolipid-I (PGL-I) antigen of Mycobacterium leprae were detected by different ELISA techniques in three laboratories (in New York, Colorado, Seattle, U.S.A.). The agreement on seropositivity and overall correlation between techniques was excellent. A positive linear correlation between the bacterial index (BI) and anti-PGL-I IgM, previously reported by the New York laboratory, was detected by all techniques. The role of erythema nodosum leprosum in decreasing the relationship of BI versus anti-PGL-I IgM was seen by the New York laboratory with sera diluted 1:20 and ABTS substrate solution and by the Colorado laboratory but not by New York with sera at 1:300 and OPD substrate or by the Seattle laboratory. PMID- 3546544 TI - Selection of sites for slit skin smears in untreated and treated leprosy patients. AB - A total of 1000 slit-skin smears were taken from multiple sites (both ear lobules, right elbow, dorsal aspect of middle phalanx of the left finger, and dorsum of middle phalanx of the right foot) from 558 leprosy patients. There were 319 sets (1595 smears) from untreated patients and 681 sets (3405 smears) from the treated group. The duration of treatment varied from 6 months (multidrug therapy) to 7 years (dapsone monotherapy). The ear lobules gave significantly higher values for the bacterial index (BI) compared to toes and fingers in the untreated group. The morphological index (MI) was also significantly higher from the ear lobules compared to toes, elbows, and fingers. In five patients from the untreated group, bacilli were found in some other sites when the earlobes did not reveal any. In the treated group, all sites yielded similar BI and MI values, the figures being lowest from elbows and toes but not different statistically. In 20 long-treated patients, bacilli were detected at sites other than the ear lobules. In 28 patients, sites other than the ear lobules gave a higher MI and in 20 patients, solid bacilli were seen at sites other than the ear lobules. PMID- 3546546 TI - In vitro and in vivo activities of ofloxacin against Mycobacterium leprae infection induced in mice. AB - Ofloxacin, a new quinolone, exhibits bactericidal activity against Mycobacterium leprae in mice, both in vivo and in vitro. PMID- 3546545 TI - Evaluation of monitoring antibodies to PGL-I in armadillos experimentally infected with M. leprae. AB - An enzyme-linked immunosorbent assay (ELISA) for IgM antibodies to the phenolic glycolipid-I antigen of Mycobacterium leprae was evaluated for efficacy in monitoring armadillos experimentally infected with the bacillus. IgM antibodies were detected in armadillos from 186 days after experimental infection until the animals were sacrificed. The ELISA demonstrated the establishment of infection earlier and more reliably than the histologic methods previously applied. Satisfactory yields of M. leprae from individual armadillos could be predicted 97% of the time, and the technique may be useful in identifying appropriate harvest times or resistance among armadillos. The ELISA seems to be a valuable adjunct for managing experimental infections of M. leprae in armadillos. PMID- 3546547 TI - Antimycobacterial activities of two newer ansamycins, R-76-1 and DL 473. AB - The antimycobacterial activities of two newer ansamycins, isobutylpiperazinylrifamycin SV (R-76-1) and cyclopentylrifamycin SV (DL 473), were compared with those of rifampin (RMP) both in vitro and in vivo. In terms of minimal inhibitory concentrations against a number of cultivable mycobacteria, R 76-1 was about eight times more active in vitro than RMP; whereas DL 473 was only slightly more active than RMP. Therapeutic activities of R-76-1 versus RMP and DL 473 versus RMP were compared, respectively, in the experimental infection of mice with Mycobacterium lepraemurium by different treatment schedules (immediate and delayed) and dosage regimens. R-76-1 appeared to have been three times more effective than RMP; DL 473 was also more effective than RMP in that an equivalent therapeutic effect could be obtained by fewer doses of DL 473 than of RMP, and in that DL 473 exerted a more prolonged activity than RMP. With the kinetic method and a dosage of 0.001% in the diet, R-76-1 demonstrated a bactericidal-type effect against M. leprae whereas RMP did not; with the proportional bactericidal method, R-76-1 possessed about three times the bactericidal activity of RMP against M. leprae. When drugs were administered once in 4 weeks, the RMP dose required to prevent multiplication of M. leprae in the foot pads of half of the mice was in the range of 1.25 to 2.5 mg/kg; whereas that of DL 473 was less than 0.625 mg/kg. With the proportional bactericidal method, even a single dose of 1.25 mg DL 473 per kg was active against M. leprae; whereas the smallest single active dose of RMP was 10 mg/kg. DL 473 in single doses of 5 mg/kg and 10 mg/kg was significantly more effective than RMP in equal doses and, among the intermittent regimens administered four times, once every 4 weeks, no significant differences of bactericidal activity were observed between RMP at 20 mg/kg and DL 473 at 0.625 mg/kg. A preliminary clinical trial of R-76-1 in 20 patients with lepromatous leprosy showed that the compound, administered in a dosage of 150 mg daily, was very effective. PMID- 3546548 TI - Identification of cat leprosy bacillus grown in mice. AB - Cat leprosy bacilli passaged in mice could be isolated on 1% Ogawa yolk medium. The isolated cat leprosy bacilli which were cultivated successively four times on 1% Ogawa yolk medium produced a leproma in mice. All characteristics of the isolated cat leprosy bacillus were the same as isolated murine leprosy bacillus, as follows: slow grower, light yellowish-white rough colony, production of much coproporphyrin on the medium, heat-resistant catalase negative, heat-resistant phosphatase negative, arylsulfatase negative, niacin negative, hydrolysis of Tween 80 negative, urease negative, nicotinamidase positive, pyrazinamidase positive, cytochrome b1 at 560 nm positive, cytochrome a2 at 630 nm positive, and cytochrome c at 550 nm negative. Cats are susceptible to both cat and murine leprosy bacilli; the bacilli produced a leproma in a newborn cat at 3 to 4 months and in an adult cat at 2 months after inoculation. Many globi of acid-fast bacilli (AFB) were observed in the histopathological sections and the smear preparations of the newborn cat's lepromas, especially in the necrotic areas of the lepromas. Many AFB and polymorphonuclear leukocytes were seen in the histopathological sections and the smear preparations of the adult cat's lepromas. These lepromas formed ulcers by autolysis and healed or absorbed without ulcer formation over the course of months. Large lepromas remained for a long time without ulcer formation and caseation in some cats. Secondary infections with cat and murine leprosy bacilli were done respectively to the right and left femoral subcutaneous regions of newborn cats carrying primary lepromas. After one month, granulomas in which many AFB were observed were produced in both infection sites. Cats are susceptible to infection with cat and murine leprosy bacilli; however, the bacilli did not invade progressively to internal organs or other subcutaneous areas. Cat leprosy bacilli which were passaged in the mouse are identical to murine leprosy bacilli. PMID- 3546549 TI - Classification of nerves is modified by the delayed recognition of Mycobacterium leprae. AB - Biopsies of 42 concurrent nerve and skin lesions across the spectrum of leprosy were classified and compared histologically and bacteriologically. Observations were made as follows: a) The bacterial load was higher in nerve than in skin lesions of the same histological classification, and it was higher in nerve than in concurrent skin lesions irrespective of classification, although not at the lepromatous pole. b) There was some discrepancy between the histological classification of nerve and skin lesions in half the cases. Skin classification appeared to represent the general tissue response and, insofar as discrepancies existed, the skin classification was thought to give the better evaluation. Nerve classification was subject to minor variations of a random nature which were thought to be the outcome of local reactions due to the build up of antigen as a result of delayed recognition in an immunologically protected situation. Upgrading or downgrading ensued locally, depending on the level of antigen at the time of its detection. In such cases, the corresponding skin classification was usually BT, which occupied a critical point in the spectrum. A certain autonomy of the response between lesions of skin and nerve suggests an explanation for downgrading reactions. Although Mycobacterium leprae, alone among mycobacteria, has some sort of affinity for Schwann cells, it is the role of the nerves as protected sites which is fundamental to the course of the disease. PMID- 3546550 TI - Host-parasite interrelationship between M. leprae and Schwann cells in vitro. PMID- 3546551 TI - Leprosy and social class in the Middle Ages. PMID- 3546552 TI - Shakespeare's "Hoar leprosy". PMID- 3546553 TI - The "Ex Libris" of Dr. N.A.Torshujev. PMID- 3546554 TI - Osler on leprosy. PMID- 3546555 TI - [The permeability of tooth root structures to 35S--a fundamental study on root planing with various kinds of root treatment]. PMID- 3546556 TI - [Air scalers]. PMID- 3546557 TI - [Scaling and root planing--effect of strokes and applied lateral pressure on the sharpness of scalers]. PMID- 3546558 TI - [Asymptomatic renal cancers incidentally recognized by abdominal ultrasonography]. PMID- 3546559 TI - [Clinical features of virus hepatitis: infection, immunology, strategy]. PMID- 3546560 TI - [Chronic renal failure: present and future. Pathophysiology and metabolic abnormalities--uremic toxin, middle and large molecular substances]. PMID- 3546561 TI - Inhibition of aromatase as treatment of breast carcinoma in postmenopausal women. AB - Recent treatment strategies have been directed toward blockade of estrogen action or inhibition of estrogen biosynthesis as a means of inducing regression of hormone-dependent breast cancer. The major source of estrogen in postmenopausal women is the peripheral conversion of androstenedione to estrone through the enzyme aromatase. It is known that aromatase activity increases proportionately with degree of obesity in women. To test the importance of this modulatory factor, we correlated body weight with estrogen excretion in our population of patients with breast cancer and found significant relationships. In situ production of estradiol from plasma precursors within breast cancer tissue may provide another source of estrogen. Major enzymes mediating estrogen biosynthesis were found to be present in tumor biopsy specimens. Aromatase activity was found to be present in 48/61 human tumors, sulfatase in 35/35, and 17 beta hydroxysteroid dehydrogenase in 41/41. One inhibitor of aromatase, aminoglutethimide, has been extensively studied in patients with breast cancer. The additional effects of this drug on cholesterol side-chain cleavage and on 11 hydroxylase activity require coadministration of replacement glucocorticoid in treatment regimens. In pilot trials, 37% of patients experienced objective tumor regression with a combination of 1000 mg aminoglutethimide and 40 mg hydrocortisone daily. In randomized clinical trials with this regimen, aromatase inhibition with aminoglutethimide produced tumor regression with similar frequency as did surgical hypophysectomy, surgical adrenalectomy, or tamoxifen administration. The side effects of aminoglutethimide, including lethargy, skin rash, and ataxia complicate its use even though these problems are generally transient. Regimens of low-dose aminoglutethimide are being developed to reduce these side effects. Low-dose aminoglutethimide appears to block aromatase effectively and to have limited side effects, and is undergoing extensive clinical trial. A more specific aromatase inhibitor, 4-hydroxyandrostenedione, is now also being tested clinically, whereas MDL 18962, another new selective inhibitor, is undergoing study in animals. PMID- 3546562 TI - Advances in neuroradiologic imaging of the pituitary gland: changing concepts. AB - A review of pituitary imaging is presented based on the history of neuroradiologic definition of the sellar contents as well as modern diagnostic techniques. The importance of normal pituitary and seller anatomy is stressed in an attempt to determine the limitations of defining abnormal sellar contents with the imaging techniques of computed tomography and magnetic resonance imaging. The sensitivity and specificity of these techniques are illustrated with histopathologic correlation. PMID- 3546563 TI - Sir George Thomas Beatson, M.D. (1848-1933). PMID- 3546564 TI - Anti-endothelial cell antibodies: detection and characterization using a cellular enzyme-linked immunosorbent assay. AB - Anti-endothelial cell antibodies (AECA) have been detected in autoimmune diseases such as systemic lupus erythematosus (SLE) and scleroderma (PSS) but their role in pathogenesis is unknown. Immunofluorescence, immunohistochemistry, complement dependent antibody lysis, and radioimmunoassay have been used in the past to detect AECA. We have developed a rapid, sensitive, and quantitative cellular enzyme-linked immunosorbent assay (ELISA) to detect and characterize AECA. Sera were obtained from 28 normal volunteers, 28 patients with SLE, and 14 patients with PSS. We also performed studies in 47 patients with various monoclonal gammopathies. Endothelial cells (EC) were obtained from human umbilical veins by standard methods and subcultured on 96-well tissue culture plates without fixation. EC were then sequentially incubated with sera, peroxidase-conjugated goat anti-human Ig (IgG, IgM, or IgA), and substrate. Optical density readings were converted to arbitrary units by developing a standard curve. Heavy-chain specific antibodies were used to determine the class of AECA binding to EC. IgG was purified by using protein A columns and digested with pepsin to obtain F(ab')2 fragments. The mean units of AECA from normals were 19.3 for IgG and 12.5 for IgM. SLE sera showed significant levels of IgM AECA (37 units, P less than 0.001) but not IgG (29 units, P less than 0.1). PSS sera showed significant levels of both IgM AECA (38 units, P = 0.001) and IgG AECA (42.7 units, P less than 0.005). IgA AECA were not detected in normal, SLE, or PSS sera. Blocking Fc receptors with rabbit IgG did not affect the titer of IgG or IgM AECA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546565 TI - Effect of Sar1-Ileu8-angiotensin on renal prostaglandin E2 biosynthesis and excretion. AB - To test the hypothesis that renal prostaglandin (PG) biosynthesis is regulated by angiotensin (AII), rabbits were given prolonged treatment with the AII analogue, Sar1-Ileu8AII (200 micrograms/kg/4 hr, subcutaneously), for 2 days during a low, normal, and high sodium intake. Sodium restriction augmented plasma renin activity (PRA), which was associated with a rise in basal renal PGE2 synthesis and urinary excretion, whereas sodium supplementation attenuated PRA with a decrease in renal PGE2 synthesis and urinary excretion. Sar1-Ileu8AII administration, with either a low, normal, or high salt intake, suppressed PRA. Sar1-Ileu8AII injection with a low sodium intake also suppressed renal PGE2 synthesis and excretion that was associated with a fall in blood pressure, suggesting an antagonistic action of this agent on vascular beds and renal PGE2 synthesis. On the other hand, with a high sodium intake Sar1-Ileu8-AII increased renal PGE2 synthesis and excretion as well as blood pressure, revealing an agonistic action of this compound under these conditions. The results suggest that exogenous AII analogue may act as an antagonist or agonist depending on sodium intake and endogenous AII levels, renal PGE2 synthesis is dependent on AII levels, either endogenously produced or exogenously administered (as an AII agonist), and the action of AII analogue on vascular beds and renal PGE2 synthesis does not appear to parallel its action on renin-AII feedback regulation at the juxtaglomerular cell especially under conditions of high sodium intake. PMID- 3546566 TI - Management of diabetes mellitus in pregnancy. PMID- 3546567 TI - Cardiac transplantation in Georgia. PMID- 3546568 TI - Ganglioglioma of brain: study of two cases with computed tomographic scanning and immunohistochemistry. PMID- 3546569 TI - Hypoglycaemia and acute stress-induced hyperinsulinaemia in mice infected with Bordetella pertussis or treated with pertussis toxin. AB - Intranasal infection of mice with a sublethal dose of Bordetella pertussis produced hypoglycaemia and hyperinsulinaemia. Exposure to ether vapour did not modify serum insulin concentrations in control mice, but produced a marked transient hyperinsulinaemia in mice infected with B. pertussis. A similar hyperinsulinaemia in infected, but not control, mice was also seen after a brief (10-15 s) period of anoxia (produced by exposure to an atmosphere of 100% N2 or 100% CO2), or following the injection of histamine or 2-deoxyglucose. Exposure to cold (2-4 degrees C) or hypoxia (8% O2 in 92% N2), however, did not alter serum concentrations of insulin in control or infected mice. The hyperinsulinaemic response to ether stress observed in mice infected with B. pertussis was abolished by pretreatment with alloxan. The hyperglycaemic effects of histamine and 2-deoxyglucose were attenuated or abolished in mice infected with B. pertussis. However, none of the stimuli which produced hyperinsulinaemia in the infected mice resulted in any further lowering of the blood glucose concentration. Pretreatment of mice with pertussis toxin (150 ng/mouse, i.v.) produced hypoglycaemia similar in magnitude to that found in animals infected with B. pertussis. Moreover, exposure of mice treated with pertussis toxin to ether vapour produced marked hyperinsulinaemia. It is suggested that the metabolic alterations seen in animals infected with B. pertussis may be mediated by pertussis toxin. PMID- 3546570 TI - Effect of pulsatile infusion of gonadotropin-releasing hormone on plasma oestradiol-17 beta concentrations and follicular development during naturally and artificially maintained high levels of plasma progesterone in heifers. AB - To stimulate a follicular-phase pattern of pulsatile LH release, gonadotrophin releasing hormone (GnRH; 5 micrograms) was infused (i.v.) hourly into heifers for periods of 5-11 days during the luteal phase of the oestrous cycle, and also when plasma progesterone levels were increased artificially by means of a progesterone releasing intravaginal device. Plasma oestradiol-17 beta concentrations increased from basal (less than or equal to 2.5 pmol/l) to preovulatory peak levels (20-30 pmol/l) during the first 3 days of GnRH treatment. They were maintained at these values before returning to basal levels within 24 h of cessation of infusion. This response occurred regardless of the source of progesterone (endogenous or administered). Follicular development was observed by ovarian palpation (per rectum) in some heifers at the time of maximum secretion of oestradiol-17 beta. There was no detectable cervical mucus secretion or oestrous behaviour during these periods of high oestradiol-17 beta levels and ovulation did not occur. Treatment with GnRH did not affect plasma progesterone concentrations or oestrous cycle length. The study shows that oestradiol-17 beta secretion and follicular development (and the accompanying oestrus and ovulation) are suppressed during the luteal phase of the cycle by high concentrations of plasma progesterone, and provides strong indirect evidence that such inhibition is associated with a reduction in the pulse frequency of LH release. PMID- 3546571 TI - Changes in protein metabolism of ovine primary muscle cultures on treatment with growth hormone, insulin, insulin-like growth factor I or epidermal growth factor. AB - Methods for the primary culture of muscle cells from fetal sheep were developed which gave high yields of cells. Myoblasts were grown in vitro, and allowed to fuse to form contractile multinucleate myotubes; these could be maintained in a good condition for at least 2 weeks. Protein turnover in these differentiated cultures was examined for sensitivity to each of four potentially anabolic peptide hormones and growth factors: insulin, insulin-like growth factor I (somatomedin C), epidermal growth factor and growth hormone. Insulin was found to have no effect except at high concentrations (1 mumol/l), compatible with its role as a somatomedin analogue. Insulin-like growth factor I was active at lower levels (1 nmol/l) but the cultures were not as responsive to it as were primary rat muscle cultures or differentiated L6 cells, which were tested in similar experiments. The maximum stimulation of protein synthesis observed with the ruminant system was only 16%. Epidermal growth factor was highly anabolic for primary cultures from sheep muscle, and the cells were very sensitive to it, half maximal stimulation of protein synthesis being seen with concentrations as low as 20 pmol/l. No effects of bovine growth hormone were seen in the ovine system. However, an inhibition of protein breakdown was found with high concentrations (0.1 mumol/l) in the L6 rat myoblast cell line. It was found that the culture conditions used could affect the observed responses of protein synthesis and degradation, despite withdrawal of serum from the incubation media 22 h before testing. PMID- 3546572 TI - The involvement of ovarian factors in maintaining the pituitary glands of female rats in a state of low LH responsiveness to LHRH. AB - The effects of discontinuation and restoration of ovarian influences on the pituitary LH response to LHRH in vitro were investigated. When female rat pituitary glands taken on day 2 of dioestrus were incubated with LHRH the release of LH was low during the first hour (lag phase response) and afterwards a progressive, protein synthesis-dependent increase took place (second phase response), this being the self-priming action of LHRH. Short-term discontinuation (less than 1 day) of ovarian influences on the rat pituitary gland in vivo (ovariectomy) or in vitro (incubation in medium only) resulted in an increased LHRH-induced LH response during the lag phase. The biphasic LH response or the self-priming action of LHRH disappeared completely after long-term discontinuation of ovarian influences on the pituitary gland, LH release being at its maximum from the start of the incubation. The biphasic response was reinstated when ovaries were implanted under the kidney capsules of ovariectomized rats. Auto-implantation of an ovary into the spleen immediately after bilateral ovariectomy did not, however, prevent the disappearance of the LHRH self-priming action. Ovarian activity responsible for the presence of the low LH response during the lag phase was thus effectively removed by the liver, but inhibin-like activity suppressing serum FSH levels remained present. Silicone elastomer implants (s.c.) containing oestradiol-17 beta, implanted for 4 weeks, did not reverse the loss of the biphasic LH response to LHRH. It is concluded that liver-labile factors released by the ovaries keep the pituitary gland in a state of low responsiveness to LHRH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546573 TI - Effects of modifiers of cytoskeletal structures on the dynamics of release of LH from sheep anterior pituitary cells stimulated with gonadotrophin-releasing hormone, K+ or phorbol ester. AB - This study investigated the importance of reorganization of cell components by cytoskeletal structures to the short-term dynamic changes in LH release from dispersed sheep pituitary cells in perifusion, when stimulated with different dynamic patterns of gonadotrophin-releasing hormone (GnRH). The changes in rate of LH release investigated were the initial response to GnRH, desensitization, change of dose-response during desensitization, and recovery of sensitivity between pulses of stimulation. Cytochalasin D and colchicine were used to modify microfilament and microtubule action respectively. To determine whether receptor movement after binding of agonist was involved in the altered responses, K+ and phorbol 12-myristate 13-acetate (PMA) were used as stimulants because they cause LH release independently of agonist-receptor interaction. After 3 and 48 h culture on dextran beads and 2-3 h incubation in the presence and absence of 2-48 mumol cytochalasin D/1, or 8 or 250 mumol colchicine/l, aliquots of collagenase dispersed sheep pituitary cells were stimulated at 37 degrees C in tubes or in a multicolumn perifusion system with 850 pmol GnRH/1, 109 mmol K+/1 or 10 nmol PMA/1. Fractions of supernatant or effluent were collected at intervals and LH concentrations measured by radioimmunoassay. Control samples were treated in the same way but without stimulation. Maximal, reversible enhancement of LH release over the first 20 min following stimulation with all secretagogues was observed after incubation of cells in 6 mumol cytochalasin/l. Desensitization behaviour, the supramaximal response, and the ability of cells to recover sensitivity to repeated pulses of GnRH were not altered by this modifier of microfilament polymerization at 6 or 24 mumol/ml. Colchicine at 8 mumol/l caused no changes in LH release. At 250 mumol/l, colchicine reduced the initial response of cells to GnRH stimulation but its action at this relatively high level may not be specific; there was no other major change in desensitization patterns, nor recovery of sensitivity to pulsed GnRH stimulation. Each treatment affected cellular responses similarly before and after culture. From studying the details of the dynamics of the short-term responses of gonadotrophs, we conclude that transport of cell components involving microfilaments and microtubules is unlikely to be a major limitation on the rate of LH release during desensitization, the supramaximal response, or the recovery of sensitivity between pulses of GnRH. This suggests that biochemical reactions rather than physical translocation may be rate-limiting in these processes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3546574 TI - Vaccination-induced variation in the 140 kD merozoite surface antigen of Plasmodium knowlesi malaria. AB - Immunity to 143/140 kD schizont antigens of a monkey malaria, Plasmodium knowlesi, provides partial protection to lethal malaria infection in rhesus monkeys challenged with uncloned parasites. To determine the capacity of a cloned parasite to generate variants of the 143/140 kD antigens, immunized monkeys were challenged with a clone of P. knowlesi. Parasites recovered 8 d after inoculation with a cloned parasite retained the 143/140 kD antigens. Parasites recovered 30 d after challenge had undergone changes in the 143/140 kD antigens. Antibodies that block erythrocyte invasion in vitro of the inoculum parasites did not inhibit invasion of erythrocytes by two isolates recovered from the immunized monkeys. An isolate from one monkey recovered on day 30 contained clones expressing new 76/72 kD antigens reactive with rabbit antiserum against the 143/140 kD proteins, and other clones expressing no antigens crossreactive with antisera against the 143/140 kD proteins. An isolate from another monkey obtained 59 d after challenge expressed new antigens of 160/155, 115/113, and 87/85 kD. Using monoclonal antibodies, we found that epitopes were lost from the variant proteins, but we were unable to determine whether new epitopes had appeared. We conclude that clones of P. knowlesi can rapidly vary antigenic determinants on the 143/140 kD proteins in animals immunized with these antigens. PMID- 3546575 TI - Use of insertional inactivation to facilitate studies of biological properties of pneumococcal surface protein A (PspA). AB - PspA is a cell surface protein of Streptococcus pneumoniae that is present on a number of clinical isolates as well as the nonencapsulated laboratory strain Rx1. In a previous report we have shown that mAbs directed against PspA can protect mice from at least some of the pneumococcal strains bearing this protein. In our present report we have produced insertional inactivation mutants that lack PspA and have used these mutants to demonstrate that PspA can play a role in pneumococcal virulence and that anti-PspA immunity can lead to protection against pneumococcal infection. PspA- mutants were obtained using derivatives of plasmid pVA891 carrying chromosomal fragments from Rx1. From one of the mutants, we cloned a 550 bp fragment of the pneumococcal gene into pVA891 and transferred this chimeric plasmid, designated pKSD300, into Escherichia coli. After transformation of pKSD300 into Rx1, PspA production is not detected. In colony hybridization experiments, the 550 bp fragment hybridizes specifically to pneumococcal isolates in a pattern consistent with the hypothesis that the fragment is a portion of the pspA structural gene that is different from the portions coding for the antigenic determinants detected by mAbs Xi64 or Xi126. When X-linked immunodeficient (xid) CBA/N mice were immunized with wild-type Rx1, they were resistant to challenge with type 3 strain WU2. However, when these mice were immunized with a PspA- mutant of Rx1, they failed to survive the subsequent challenge, indicating that immunity to PspA can contribute to the resistance to pneumococcal infection. Using pKSD300 we insertionally inactivated pspA in D39, a virulent strain of S. pneumoniae. When injected intravenously there was a 10-fold greater reduction of the mutant pneumococci in the blood, as compared to the wild type D39. PMID- 3546577 TI - Maternally transmitted antigens are codominantly expressed by mouse cells containing two kinds of mitochondrial DNA. AB - Mtf, a cytoplasmic, probably mitochondrial factor, controls Mta polymorphism. We tested for dominance between two forms of Mtf to determine whether Mta is controlled by positive or negative genetic mechanisms. We fused Mtf-disparate cells containing distinct mtDNA markers and selected for hybrids containing both. Such mtDNA heteroplasmons codominantly and stably express alternative Mta antigens. Stable codominance excludes negative genetic mechanisms as well as a model of induced nuclear compensation, and implies Mtf controls Mta expression through a positive genetic mechanism. PMID- 3546576 TI - Cutaneous leishmaniasis. The defect in T cell influx in BALB/c mice. AB - Local cellular responses to cutaneous infection with Leishmania mexicana amazonensis were examined in susceptible (BALB/c) and resistant (C57BL/6) mouse strains by immunocytochemical and electron microscopic studies. Infection during the first 8 wk in both animal strains was characterized by progressively enlarging lesions, epidermal thickening and ulceration, and accumulation of eosinophils and Ia+ infected macrophages. Healing of C57BL/6 mouse lesions began after 12 wk of infection and was associated with local influx of both Th (L3T4+) and T cytotoxic/suppressor (Lyt-2+) cells into the dermis, and Ia antigen expression on epidermal keratinocytes. T lymphocyte infiltration was marked and intracellular parasites were scarce by 21 wk of C57BL/6 infection. Similarly, granulomas in C57BL/6 livers contained L3T4+ and Lyt-2+ T lymphocytes and no visible intracellular parasites by 21 wk of infection. In contrast, BALB/c mouse lesions continued to enlarge and never healed. Throughout the entire course of infection, T lymphocyte influx into the heavily infected dermis was minimal. Keratinocyte Ia expression was absent in BALB/c lesions. BALB/c livers were heavily infected by 18 wk of cutaneous infection, with few demonstrable T lymphocytes. A systemic absence of T cells could not be demonstrated in BALB/c mice. Both L3T4+ and Lyt-2+ T cells were found in the peripheral blood in normal numbers in both mouse strains. Our results support the role of T cells as important local effector cells in the healing response of murine cutaneous leishmaniasis. We suggest that local T lymphocyte infiltration may provide lymphokines, particularly IFN-gamma, that can activate infected macrophages to destroy the intracellular parasites. Alternatively, T cells may play a cytotoxic role, killing infected macrophages and allowing local humoral factors to destroy released extracellular parasites. PMID- 3546578 TI - Specific cytotoxic T cells are found in the nonrejected kidneys of blood transfused rats. AB - Preoperative, donor-specific blood transfusion leads to indefinite survival of rat renal allografts in the strain combinations used. 51Cr-release assays have shown that the level of specific cytotoxic effector activity in the grafts of transfused (nonrejected kidney) animals is very high and may equal or exceed that seen in the grafts of untreated (rejected kidney) recipients. Such cytotoxicity demonstrates specificity for the alloantigens of the kidney, is T cell-mediated, and may persist within the transplant. PMID- 3546579 TI - Antiviral antibody-producing cells in parenchymatous organs during persistent virus infection. AB - In mice persistently infected with lymphocytic choriomeningitis virus (LCMV), the parenchymatous organs contain infiltrates of mononuclear cells, the sizes and numbers of which vary between strains and become more numerous and extensive when the animals grow older. Histologically, these were found to possess a tissue-like structure, and by use of immunohistologic procedures they were shown to contain plasma cells secreting IgM and IgG. Cells of kidneys, livers, brains, and spleens of LCMV carrier mice were dispersed by digestion with trypsin, leukocytes were separated by density gradient centrifugation, and numbers of cells producing antibodies against LCMV were determined by use of a solid-phase immunoenzymatic technique. In all these organs, cells producing LCMV-specific IgM and IgG antibodies were demonstrated, the latter more numerous than the former. Their numbers correlated with numbers and extent of the lymphoid cell infiltrates. The blood of the same mice was essentially free of antiviral antibody-forming cell. The proportion of cells producing LCMV-specific antibodies to all cells producing Ig of any specificity varied between organs, being lowest in spleen, intermediate in liver and kidney, and highest in the brain, where in individual mice up to 90% of all active cells produced virus-specific antibodies. The LCMV carrier mouse should prove to be a useful animal model to investigate antibody production in parenchymatous organs during persistent virus infections. PMID- 3546580 TI - Unspecific binding of group B streptococcal cocytolysin (CAMP factor) to immunoglobulins and its possible role in pathogenicity. AB - The protein B of group B streptococci can bind in a nonimmune reaction to Ig of the IgG and IgM classes of various mammalian species (i.e., human, mouse, rabbit, and bovine). Protein B binding involves the Fc parts of both IgG and IgM molecules. Monoclonal or polyclonal IgG or IgM and the IgM-FC5 mu fragment of human myeloma protein combined with the protein B thereby inhibiting protein B induced hemolysis in the CAMP reaction. The protein B/Ig complex can be dissociated with 1% Triton or guanidine-HCl (6 M). Mice infected intraperitoneally with sublethal doses of group B streptococci (GBS) and that received seven repeated intravenous injections of highly purified protein B during the first 9 h of infection developed fatal septicemia within 24 h with colony counts of up to 10(8) CFU/ml in the blood. Animals treated in the same way with either PBS or trypsinized protein B recovered. The protein B itself was not pathogenic when injected into healthy mice. Tissue sections of liver or spleen from mice infected with a lethal dose of GBS revealed the presence of protein B together with large numbers of cocci when stained by the peroxidase method using specific antibodies raised against purified protein B in the rabbit. PMID- 3546581 TI - Lamin B autoantibodies in sera of certain patients with systemic lupus erythematosus. AB - Sera from four patients with systemic lupus erythematosus containing antibodies that yield nuclear rim staining of HEp-2 cells by indirect immunofluorescence were identified and characterized. Each serum contained autoantibodies reacting strongly with lamin B on western blots. One of the four sera displayed weaker reactivity with lamins A and C, while the other three displayed only minimal reactivity with lamins A and C. Titers of antilamin antibodies ranged from 1:1,250 to 1:36,250. Two of the sera also reacted at a dilution of 1:20 with cytoplasmic filaments of PTK-2 cells, suggesting that a small fraction of the autoantibodies in these sera may bind to alpha-helical domains of the lamins that are homologous to those of intermediate filaments. The majority of the antilamin antibodies in these patients' sera are specific for portions of the lamin B molecule that are not homologous to lamins A and C, however. The findings suggest that autoantibodies to the nuclear lamina may, in some instances, be responsible for a rim pattern in the fluorescent antinuclear antibody assay. In addition, autoantibodies to the nuclear lamina in sera of certain patients with systemic lupus erythematosus may be useful for defining the molecular structure and biological functions of lamin B, as well as for studying mechanisms of autoimmunity. PMID- 3546582 TI - Distribution and turnover of Langerhans cells during delayed immune responses in human skin. AB - The changes in distribution and turnover of T6+ Langerhans cells (LC) in the skin during delayed immune responses to tuberculin, and in the lesions of tuberculoid leprosy and cutaneous Leishmaniasis were investigated. In each situation, there was a dermal accumulation of monocytes and T cells and epidermal thickening with keratinocyte Ia expression. In the tuberculin response a dramatic change in the distribution of LC was observed. By 41 h, T6+ LC were displaced to the upper zone of the thickening epidermis followed by an almost complete loss of LC from the epidermis by approximately 72 h. After 7 d, T6+ cells started to reappear in the epidermis, which regained almost normal numbers of T6+ LC by 14 d. After antigen administration and initiation of the delayed immune response, enhanced numbers of T6+ cells appeared in association with the mononuclear cell infiltrate of the upper dermal lesions. Their numbers peaked by 72 h, were reduced at 7 d, and again enhanced by 14 d, when the epidermis was being repopulated. Similar numbers of T6+ cells were found in the chronic lesions of tuberculoid leprosy and cutaneous Leishmaniasis but not lepromatous leprosy. The cells of the dermis were identified as typical LC by the presence of Birbeck granules and surface T6 antigen at the electron microscope level. These cells were closely associated with lymphocytes. We have quantified the number of LC, evaluated their directional flux into the epidermis and dermis, determined nearest neighbors, and made predictions as to their fate. PMID- 3546584 TI - Evaluation of radioimmunoassays: comparison of dose interpolation calculations by four parameter logistic and spline functions. AB - Two computerized methods for dose interpolation calculation were compared. Generated data sets with a known coefficient of variation as well as laboratory RIA data were analysed. The four parameter logistic method, which is based on an approximation of the mass action law, performed better than the Spline method, a procedure which makes no a priori assumptions about the data. Correct weighting of the data was important for obtaining satisfactory fits. The determination of the response error relationship proved to be the most satisfactory approach in obtaining suitable weighting factors. PMID- 3546585 TI - Serum inorganic sulphate: quantitation by a new radiochemical method. AB - A new procedure for serum inorganic sulphate determination is described. The method is simple, accurate and highly reproducible. It is based on radioisotopic dilution of 35S-sulphate by protein-free, phosphate-free serum. The decrease in initial 35S-sulphate specific activity (corresponding to added serum sulphate) is determined in the supernatant after partial precipitation of sulphate by barium ion. Serum sulphate is computed thereafter from a standard curve. Recovery of added sulphate from dialysed or undialysed serum was 100%. The intra- and interassay coefficients of variation were 3.5% and 4.1%, respectively. The serum sulphate concentration measured by this method in 93 normal subjects was 400 +/- 90 mumol/l (mean +/- SD), which agreed with the values reported in the literature. Serum sulphate did not correlate with sex (p greater than 0.40, n = 93), but a significant correlation with age was observed (r = 0.25, p less than 0.02, n = 93). PMID- 3546583 TI - Prolonged survival of actively enhanced rat renal allografts despite accelerated cellular infiltration and rapid induction of both class I and class II MHC antigens. AB - Administration of 1 ml of donor whole blood 7 d before renal transplantation produces long-term (greater than 100 d) graft survival in the DA (RT1a) into PVG (RT1c) rat strain combination. Using this model, the pattern and phenotype of infiltrating leukocytes were examined in rejecting and enhanced renal allografts, at days 1, 3, 5, and 7 after transplantation, by immunohistologic techniques. Paradoxically, enhanced grafts showed a more rapid and substantial leukocyte infiltrate, the phenotype of which was similar to that in rejecting grafts except for a reduced number of MRC OX-8+ cells and MRC OX-39+ cells. Graft infiltrating cells and splenocytes from transfused animals showed similar, although modest, levels of both nonspecific cytotoxicity and alloantigen-specific cytotoxicity. Immunohistologic analysis of MHC antigen distribution within the allograft revealed, unexpectedly, that enhanced grafts underwent an accelerated and extensive induction of both donor class I and class II MHC antigens. These findings were confirmed by allospecific quantitative absorption analysis, which showed severalfold increases in class I and class II MHC antigens by day 3 in enhanced grafts but not until day 5 in rejecting grafts. An additional observation was the more rapid disappearance of donor interstitial cells from enhanced grafts. These findings emphasize the overwhelming suppressive effect induced by an organ allograft after preoperative blood transfusion despite the associated induction of large numbers of potential effector cells and increased target antigen density within the graft. PMID- 3546586 TI - Catalytic activities of alkaline phosphatase and N-acetyl-beta-D-glucosaminidase in human cortical nephron segments: heterogeneous changes in acute renal failure and acute rejection following kidney allotransplantation. AB - The catalytic activities of alkaline phosphatase and N-acetyl-beta-D glucosaminidase, constituents of luminal brush-border membranes and lysosomes of kidney tubular cells, were measured in human kidney allografts in the maintenance and recovery phases of acute renal failure and in acute rejection crisis. The enzyme activities were fluorometrically determined in single microdissected cortical nephron segments of biopsies from 4 kidney allografts taken intraoperatively and postoperatively at different periods, which exhibited either good function or dysfunction. For comparison, the unaffected part of a human kidney nephrectomized due to hypernephroma as well as a biopsy of a morphologically normal human kidney were examined. Both enzymes displayed highest activities in the proximal part of the human nephron. In some intraoperative and postoperative biopsies with acute renal failure, alkaline phosphatase activity was reduced in proximal tubules, predominantly in the straight portion. This reduction could not be correlated with function. In acute rejection, very low alkaline phosphatase activities were uniformly found in proximal convoluted and straight tubules. Furthermore, intraoperative biopsies and biopsies of the functioning allograft have only approximately 50% of normal N-acetyl-beta-D glucosaminidase activity in proximal convoluted tubules, but generally normal values in the straight portion. However, in acute renal failure, this enzyme activity was several-fold enhanced along the whole nephron, when compared with intraoperative values. In acute rejection, N-acetyl-beta-D-glucosaminidase activity was slightly reduced in proximal convoluted tubules, when compared with biopsies showing good function. It is suggested that the decrease of proximal tubular enzyme activities is the consequence of increased enzymuria and inadequate enzyme regeneration. On the other hand, the overshoot of N-acetyl-beta D-glucosaminidase activity in the maintenance phase of acute renal failure appears to indicate increased degradative capacity, associated with cellular regeneration along the whole nephron. PMID- 3546587 TI - A two-center review of bacteremia in the community hospital. AB - There are fewer studies on bacteremia coming from the community hospital, where the practicing family physician is likely to see this problem, than from the university hospital. The hypothesis of this study was that patterns of bacteremia would be different between the two types of hospitals. Two hundred four patient episodes of culture-proven bacteremia from two analogous community hospitals were reviewed. Bacteremia was discovered in 2.6 of 1,000 patients, which is lower than reports from university hospitals. Of the 213 organisms isolated, slightly more were gram-negative than gram-positive, whereas many tertiary care centers report a preponderance of gram-negative organisms. About 20 percent of the episodes of bacteremia ended in death, a rate lower than in many tertiary care centers, and slightly more patients died of gram-negative than gram-positive bacteremia. The most common organisms in descending order were the streptococci and Escherichia coli followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus species, and Streptococcus pneumoniae. The most common sources of bacteremia were, in decreasing order, urinary tract, source unknown, heart valve, and lung. The most common underlying disorders were, in decreasing order, malignancy, diabetes mellitus, complicated urinary tract infection, valvular heart disease, and postoperative infection. Correctness of treatment of bacteremia appeared to increase survival. PMID- 3546588 TI - Infective endocarditis. AB - Despite major changes in the epidemiology, microbiology, and prognosis over the last 50 years, the diagnosis of infective endocarditis is still difficult, and serious complications including death are not uncommon. Prosthetic and right sided valvular infections are more common and require longer periods of vigorous antimicrobial therapy than in the past. An effective short-course antibiotic regimen has been designed for sensitive microorganisms, and protocols have been established for culture-negative cases (15 percent) and empiric situations. Finally, cardiac surgery should be considered as an important modality, especially in cases of congestive heart failure. PMID- 3546590 TI - Lessons from history--a change in positions. PMID- 3546589 TI - Homicide by insulin administration. AB - This report describes a case of homicide by insulin administration and a study of the effects of storage conditions on insulin in serum. The study revealed insulin to be remarkably stable at refrigerator temperatures. Therefore, for forensic science purposes, insulin immunoassay data are interpretable even when serum is not stored by the standard laboratory method of freezing. PMID- 3546591 TI - Intra- and retroperitoneal varices simulating lymphomatous nodes--differentiation by duplex ultrasound. PMID- 3546592 TI - Abortive infection by bacteriophage Me1 of Escherichia coli K12 strains bearing the plasmid ColV, I-K94. AB - Bacteriophage Me1 is unable to grow on Escherichia coli strains harbouring the ColV,I-K94 plasmid. The nature of this inhibition was investigated, and it was found not to be due to restriction, superinfection exclusion or receptor-mediated resistance, but to be a new example of plasmid-mediated abortive infection. Investigation of events occurring during abortive Me1 infection revealed some differences from previously described cases, especially with regard to late protein synthesis, which did occur, albeit showing abnormal amounts of some proteins. No major differences were observed in membrane permeability of productively and abortively infected cells. Phage-directed DNA synthesis was reduced in abortively infected cells. Comparative studies of Me1 and T4 revealed a striking similarity despite some minor differences. PMID- 3546593 TI - Parvovirus gene regulation. PMID- 3546594 TI - Incubation periods and survival times for mice injected stereotaxically with three scrapie strains in different brain regions. AB - Incubation period and survival time were determined in C57BL mice which had been injected stereotaxically with either the 139A, ME7 or 22L strain of scrapie in one of five different brain regions (cerebral cortex, caudate nucleus, thalamus, substantia nigra, cerebellum). The injection of 139A in the caudate nucleus, thalamus, substantia nigra or cerebellum resulted in significantly shorter incubation periods than following cerebral cortex injection. For ME7, mice injected in the thalamus and cerebellum had incubation periods approximately 2 weeks shorter than the cerebral cortex group. For 22L, the incubation periods after substantia nigra or cerebellum injection were significantly shorter than after cortex injection. The cerebellum injection group had a significantly shorter incubation period than the substantia nigra injection group. The survival times for mice injected with a particular scrapie strain were directly related to the incubation periods. The groups with the shortest incubation also had the shortest survival time (e.g. 22L in the cerebellum). On histological examination, 139A and ME7 produced brain lesions in all brain areas regardless of injection site. For the 22L strain, after cerebellum injection vacuolation was limited to the cerebellum, while injection into the cerebral cortex and other forebrain regions resulted in vacuolation in all brain regions examined. Despite the difference in the distribution of vacuolation seen in cerebellum- compared to cortex-injected (22L) mice, infectivity titres were similar in the cortex, cerebellum, cerebellar cortex and medulla plus pons. PMID- 3546595 TI - Activation of hypoxanthine/guanine phosphoribosyltransferase from yeast by divalent zinc and nickel ions. AB - We have observed previously that the reactions catalyzed by hypoxanthine/guanine phosphoribosyltransferase (HGPRTase) are activated by Mg(II), Mn(II), and Co(II), and we have defined the mechanism by which these activations proceed [Biochemistry 22, 3419-3424 (1983)]. A more extensive survey of the kinds of metal ions that will activate the HGPRTase catalysis now has been completed through the use of an HPLC assay procedure. Although Fe(II) and Ca(II) are unable to activate this reaction, a significant activation was achieved with the addition of spectroscopically pure Zn(II) to the assay solution. In addition some IMP synthesis resulted from the addition of Ni(II) to the assay mixture. Both the Zn(II) and Ni(II) kinetic effects on HGPRTase over a limited metal ion concentration range have been analyzed through the use of curve-fitting exercises. These results, in addition to the similar pH profiles for the activations by Mg(II), Mn(II), Co(II), and Zn(II), suggest that all of these metal ions activate the HGPRTase-catalyzed synthesis of IMP by way of the same mechanism [model II as defined by London and Steck, Biochemistry 8, 1767-1779 (1969)], during which two divalent ions bind to the HGPRTase active site per molecule of PRibPP. PMID- 3546596 TI - Synthesis of [3,5-14C]trachelanthamidine and [5-3H]isoretronecanol and their incorporation into the retronecine moiety of riddelliine in Senecio riddellii. AB - (+/-)-[3,5-14C]Trachelanthamidine and (+/-)-[5-3H]isoretronecanol, which are diastereomers, were prepared from potassium [14C]cyanide and [5-3H]proline, respectively. These compounds and [1,4-14C]putrescine were administered to Senecio riddellii plants resulting in the formation of labeled riddelliine, in which almost all the radioactivity was located in its retronecine moiety. The activity of the beta-alanine obtained by degradation of the retronecine was consistent with specific labeling of this pyrrolizidine base at the expected positions. The extremely high absolute incorporation (15.1, 22.1%) of trachelanthamidine into riddelliine strongly favors this 1 hydroxymethylpyrrolizidine as the one on the main biosynthetic pathway to retronecine. The lower incorporation (0.75%) of isoretronecanol may represent a minor or aberrant pathway to retronecine. PMID- 3546597 TI - Mutagenic perylenequinone metabolites of Alternaria alternata: altertoxins I, II, and III. AB - The mold genus Alternaria is a widely distributed plant pathogen. Some of these species, e.g., A. alternata, are common decay organisms of fruits and vegetables. Two novel perylene oxide metabolites, altertoxins II and III, have been identified in extracts of A. alternata isolates that exhibit mutagenic responses in the Ames Salmonella typhimurium assay. These identifications were based on mass, optical rotational, and 1H- and 13C-nmr spectral studies. Previous reports of related perylene dione mycotoxins have been clarified. PMID- 3546598 TI - Measurement of tissue impedence in conjunction with computed tomography-guided stereotaxic biopsies. AB - Twenty-two patients undergoing CT-guided stereotaxic biopsies had intraoperative monopolar and bipolar impedance monitoring along the trajectory of the biopsy. Patterns of tissue impedance were retrospectively correlated with CT scans demonstrating decreased impedance generally corresponding to low density regions and increased impedance to the enhancing lesions. PMID- 3546599 TI - Biopterin in Parkinson's disease. AB - Tetrahydrobiopterin is an essential co-factor in the natural synthesis of dopamine. Oral tetrahydrobiopterin was given in small doses to four patients with early Parkinson's disease but had no discernible effect. PMID- 3546600 TI - Neurofilaments: structure, metabolism and implications in disease. PMID- 3546601 TI - Human cerebral malaria: a pathological study. AB - The following report using light and electron microscopic and immunological techniques is based on a series of 19 Burmese patients who died of cerebral malaria. The principal change was blockage of cerebral capillaries by Plasmodium falciparum-infected erythrocytes. Ring hemorrhages and segmental necrosis of cerebral capillaries were common. Cerebral edema was variable in these cases. Electron-dense knobs, 40 X 80 nm in size, which protruded from the membrane of infected erythrocytes, formed focal junctions between endothelial cells and erythrocytes. These junctions resulted in the entrapment of erythrocytes and caused blockage in the capillary lumen. Immunoperoxidase study revealed that P. falciparum antigens and IgG deposits in the capillary basement membrane. This implies that damage to the cerebral capillary could be related to immune mechanisms. PMID- 3546602 TI - Localization of alpha-spectrin in chicken and monkey ventral horns by immunoelectron microscopy. AB - Localization of alpha-spectrin in chicken and monkey ventral horns has been studied by immunoperoxidase techniques at the electron microscopic level. For this purpose, an antiserum specific for chicken alpha-spectrin (240 kD subunit of spectrin) was prepared. The characteristics of the staining patterns of both chicken and monkey ventral horns were essentially identical. The reaction product for peroxidase was contained in the somata of large cells (presumably motor neurons), dendrites and axons. No specific staining was seen with either preimmune or blocked sera. The staining within the cell somata was primarily localized in cortical cytoplasm. Within dendrites and axons the immunocytochemical label was associated predominantly with the cortical cytoplasm and with microtubules. Staining was heavy over postsynaptic densities. Although presynaptic terminals showed weak staining as a whole, heavy staining was sometimes observed in areas adjacent to the presynaptic plasma membrane facing the postsynaptic density. These results indicate that spectrin distributes widely and functions in many biological activities in the nervous system. PMID- 3546603 TI - Vesicle-containing dendrites in the nucleus raphe dorsalis of the cat. A serial section electron microscopic analysis. AB - The nucleus raphe dorsalis of the cat was examined by serial section electron microscopy and the presence of vesicle-containing dendrites is reported. Such dendrites were divided into two classes according to their synaptic contact. Dendrites containing round and/or pleomorphic vesicles associated with a clear synaptic specialization which was generally intermediate between a Gray's type I or II were classified as presynaptic dendrites. These presynaptic dendrites were presynaptic to conventional dendrites and dendritic spines. In addition, some profiles containing a sparse population of vesicles which may be dendritic in nature were observed involved in serial synaptic arrangements. A second class of dendrites were characterized by the presence of vesicles which were never found associated with any synaptic membrane specialization. Commonly, the vesicles were densely packed and associated with unusual densities. Serial section analysis of these densities showed that they were not presynaptic dense projections. We suggest that the existence of vesicle-containing dendrites in the nucleus raphe dorsalis of the cat constitute the morphological support for the dendritic release of neurotransmitters. PMID- 3546606 TI - Unusual EEG findings in a case of Creutzfeldt-Jakob disease. AB - A case is reported of histopathologically verified Creutzfeldt-Jakob disease of long duration (more than 3 years) with some clinical peculiarities. The prominent peculiarity was a nearly normal EEG during repeated examinations, even in the terminal stage. PMID- 3546605 TI - A controlled trial of isoniazid therapy for action tremor in multiple sclerosis. AB - Ten patients with clinically definite multiple sclerosis (MS) and action tremor were treated with isoniazid (INH) in a double-blind single crossover trial. The daily dose of INH administered during the 4-week treatment phase of the trial was determined by acetylator phenotype with slow acetylators receiving 12 mg/kg per day and rapid acetylators 20 mg/kg per day. Six of eight patients who completed the trial showed clinical improvement in the postural (alternating) tremor while on INH but the degree was minimal in all cases. Results of tremograms indicated that improvement also occurred in the intentional (synchronous) component of three patients while on INH, but this did not achieve statistical significance. Cerebrospinal fluid (CSF) levels of gamma-aminobutyric acid (GABA) homocarnosine and ornithine were markedly elevated with INH therapy (providing evidence for substantial inhibition of GABA aminotransferase activity and increase in GABA in the CNS), but no correlation was found between the degree of GABA elevation in the CSF and the clinical response. Side effects were minimal and well tolerated. Although INH appears to have a limited therapeutic role, a trial is warranted in MS patients with postural tremor. PMID- 3546604 TI - Antifibrinolytic agents in subarachnoid haemorrhage. AB - For many years clinicians have used antifibrinolytic agents to try to reduce rebleeding after subarachnoid haemorrhage. Early studies of their effectiveness produced conflicting results. This paper re-evaluates the available trials and considers benefits in the light of potential complications. Present evidence conclusively demonstrates that epsilon-aminocaproic acid and tranexamic acid administered in standard dosage, reduce the risk of rebleeding but, as a result of an increased incidence of ischaemic complications, do not benefit patients' outcome. PMID- 3546607 TI - An assessment of the knowledge base of the insulin-dependent diabetic adult. PMID- 3546608 TI - Automated measurement of functional residual capacity by sulfur hexafluoride washout. AB - We have constructed a computerized, totally automated system for measuring functional residual capacity (FRC) during mechanical ventilation, at any positive end-expiratory pressure (PEEP) and fraction of inspired oxygen. This system uses washout of a small amount (0.5 to 1.0%) of an insoluble, nontoxic tracer gas, sulfur hexafluoride, to measure FRC. It requires no modification of the ventilator and only minimal changes in the breathing circuit; it can be programmed to make measurements routinely without manual intervention. The system was evaluated with three tests. The prototype sulfur hexafluoride analyzer characteristic curve was determined, and the analyzer was evaluated to determine carbon dioxide interference. A comparison with nitrogen washout FRC measurements was made in an extensive bench test with a Plexiglas lung model. The bench test was designed to determine the effects of changing gas composition and minute volume. A study was done in six healthy dogs to determine reproducibility of the FRC measurements at four PEEP levels (0, 5, 10, and 15 cm H2O: two repetitions in each animal). The sulfur hexafluoride analyzer was well characterized by an exponential equation with a multiple r2 = 0.996. The analyzer was not affected by the presence of carbon dioxide (paired t test, t19 = 1.23, P greater than 0.10). The bench test indicated that FRC (measured) = 0.969 X FRC (true) - 5.3 ml. (Multiple r2 = 0.979.) This was significantly better than the nitrogen washout system, whose regression equation was also a function of minute volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546610 TI - Hormone stimulation and chemotherapy for breast cancer. PMID- 3546609 TI - Monitoring of sensory evoked potentials is highly reliable and helpful in the operating room. AB - Because short-latency evoked potentials are relatively resistant to anesthetic agents, they can be used to monitor neural pathways during surgical procedures. The use of median nerve somatosensory evoked potentials to localize the central sulcus is an established aid of indisputable value in neurosurgical procedures involving cortical incisions for resection of certain epileptic foci, vascular malformations, or neoplasms near the central area of the brain. Likewise, recording of intraoperative nerve action potentials is currently regarded as indispensable in management of the neuroma-incontinuity after peripheral nerve trauma, as this evoked potential monitoring technique provides the only reliable method of distinguishing between axonotmetic and neurotmetic lesions. Evoked potential monitoring has been of value during many other types of surgical procedures, including cerebral aneurysm clipping, carotid endarterectomy, aortic procedures, microvascular decompression for trigeminal neuralgia and hemifacial spasm, acoustic neuroma resection, and a variety of spinal procedures. A detailed review of the literature is presented on the use of evoked potential monitoring for one of the more common indications: scoliosis surgery. Many orthopedic surgeons use the "wake-up test" only if the somatosensory evoked potentials change during surgery. A detailed review of the few reported cases of "false negative" evoked potentials is presented. The dearth of convincing reports of such phenomena in the face of so many positive experiences should persuade even the skeptical that monitoring of evoked potentials is a highly reliable and helpful intraoperative tool. PMID- 3546612 TI - Correlation of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer. AB - Natural killer (NK) cell activity and psychological status were measured at baseline and at 3 months into treatment, as part of the National Cancer Institute (NCI) Protocol 79-C-111, randomizing breast cancer patients to lumpectomy/radiation v mastectomy. Patients who were found to have positive axillary lymph nodes also received combination chemotherapy (Adriamycin [Adria Laboratories, Columbus, OH], plus Cytoxan [Mead Johnson Pharmaceuticals, Evansville, IN] or methotrexate, plus 5-fluorouracil [5-FU]). Seventy-five patients were entered onto this behavioral immunology protocol at the time of data analysis. We reported in an earlier publication that NK activity was an important predictor of patient baseline prognosis relevant to nodal status. In that study, by using multiple regression analyses, 51% of the baseline NK activity variance could be accounted for by entering three distress indicators into the equation (patient "adjustment," lack of social support, and fatigue/depression symptoms). On reassessment of NK activity after 3 months, it was found that NK activity was not affected by the interim administration of chemotherapy and/or radiotherapy. However, consistent with our earlier findings, NK activity levels remained markedly lower in patients with positive nodes than in patients with negative nodes (at 60 to 1 effector to target cell [E:T] ratio, mean of 18% lytic activity v mean of 31% lytic activity [t = 1.87, P less than .05]). Even though average levels of NK activity were lower for patients with more tumor burden, there was still a substantial range of NK activity levels within the node positive patient group, as well as within the patient group as a whole. We hypothesized that differences in levels of NK activity could be predicted on the basis of baseline distress factors found to be significant in our earlier report. In fact, we found that we could account for 30% of NK activity level variance at 3 months follow-up on the basis of baseline NK activity, fatigue/depression, and lack of social support. Therefore, although neither radiation nor chemotherapy appeared to affect NK activity, tumor burden was again clearly associated with NK activity levels, and a significant amount of baseline and 3-month NK activity could be predicted on the basis of CNS-mediated effects. At the least, such factors provide a psychological marker of host biological status. PMID- 3546611 TI - Conventional versus cytokinetic polychemotherapy with estrogenic recruitment in metastatic breast cancer: results of a randomized cooperative trial. AB - Diethylstilbestrol (DES) can induce a recruitment into the proliferative pool of previously resting breast cancer cells in vivo. In order to verify if estrogenic recruitment could result in a larger tumor cell killing by chemotherapy, 117 patients with metastatic breast cancer were randomized to receive CEF (cyclophosphamide, 600 mg/m2; epidoxorubicin, 60 mg/m2; and 5-fluorouracil, 600 mg/m2 on day 1); DES-CEF (cyclophosphamide, 600 mg/m2 on day 1; DES, 1 mg orally on days 5, 6, and 7; and epidoxorubicin, 60 mg/m2, and 5-fluorouracil, 600 mg/m2, on day 8) every 21 days. No significant difference in objective response rates, survival, or progression-free survival was seen between the two regimens. Patients in the DES-CEF arm experienced a higher complete response (CR) rate (24.1% v 16.1%), which reached statistical significance in the case of soft tissue metastasis (48% v 27.3%; P less than .05) and estrogen receptor-negative tumors (35.7% v 11.1%; P less than .025). Survival and progression-free survival of patients refractory to treatment were not worsened by estrogenic recruitment. In the subset of patients failing after adjuvant polychemotherapy, DES-CEF unexpectedly induced a significantly longer survival (greater than 802 days v 375 days; P = .029) and progression-free survival (239 days v 192 days; P = .041) than CEF. The DES-CEF regimen was more myelotoxic, and 43.3% of the DES-CEF cycles had to be delayed because of leukopenia in comparison with 11.8% of the CEF cycles (P less than .0001). In conclusion, chemotherapy with estrogenic recruitment was able to induce more CRs in certain subsets of patients and a significant prolongation in survival and progression-free survival of patients failing after adjuvant polychemotherapy. These results have been achieved despite a significantly lower dose intensity of chemotherapy. PMID- 3546613 TI - A new regimen of amsacrine with high-dose cytarabine is safe and effective therapy for acute leukemia. AB - Amsacrine and high-dose cytarabine (HiDAc), when administered as single agents, are effective treatment of acute leukemia. When used in combination, a high remission rate is also possible. We treated 47 patients with acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), and blastic phase of chronic myelogenous leukemia (CML) with a combination of amsacrine and HiDAc. The patients received amsacrine 200 mg/m2 daily for three days and, concurrently, HiDAc 3 g/m2 over three hours once daily for five days. Of 20 evaluable patients with AML in relapse, there were 12 remissions; of seven additional patients with primary refractory AML, there were two remissions, and of 12 patients with ALL in relapse, there were eight remissions. The three patients with blastic phase CML and the three patients with biphenotypic leukemia did not respond. Nausea, vomiting, stomatitis, hepatic dysfunction, and diarrhea were common, but cutaneous, conjunctival, and significant cerebellar and cerebral side effects were absent. We conclude that this regimen is highly effective therapy for AML and ALL and is also safe, eliminating the major toxicities encountered with HiDAc. PMID- 3546614 TI - Successful reinduction of patients with acute lymphoblastic leukemia who relapse following bone marrow transplantation. AB - At the present time, there is limited information on the outcome of patients with acute lymphoblastic leukemia (ALL) who relapse after bone marrow transplantation (BMT). Intuitively, it might be expected that leukemia recurring after BMT would be refractory to further treatment. In an attempt to improve survival in patients with ALL who relapse after BMT, we used standard chemotherapy for reinduction and maintenance. Of 65 patients who relapsed following allogeneic, autologous, or syngeneic BMT, 12 elected to receive no further chemotherapy, and their median survival from relapse was 36 days (range 13 to 167 days). The 53 patients who received therapy had a significantly longer median survival of 168 days (range 18 days to 4.7 years). With multidrug induction regimens there were 29 of 52 (56%) complete remissions. Six patients are currently alive, with two off therapy. In the patients who received therapy, the following factors were independent predictors of prolonged survival: longer time from BMT to relapse; younger age at diagnosis; and the use of a preparative regimen containing fractionated total body irradiation. In conclusion, leukemia recurring after BMT remains sensitive to standard therapy in many patients. We recommend that patients with ALL who relapse after BMT receive reinduction and maintenance therapy as additional good quality survival time is achieved in patients who attain a remission. PMID- 3546615 TI - Acute lymphoblastic leukemia with chromosomal 5;14 translocation and hypereosinophilia: case report and literature review. AB - A 19-year-old man with acute lymphoblastic leukemia (ALL) presented with 82,000 WBC/microL, 57% eosinophils, and cardiorespiratory symptoms. Lymphoblast infiltration of the meninges and testes developed without eosinophil infiltration at these sites and peripheral blood and marrow lymphoblast counts progressively increased, while blood eosinophilia disappeared. The patient's bone marrow cells had a clonal cytogenetic abnormality--t(5;14), (q?,q32)--which disappeared during remission and reappeared during disease relapse. Including this case, three patients with ALL and hypereosinophilia have had cytogenetic studies with G banding. All three had 14q + chromosomal abnormalities and two had a similar translocation t(5,14), (q?,q32). Survival of the 26 ALL patients with hypereosinophilia reported since 1973 was similar to that of 52 age- and sex matched historical-control patients without hypereosinophilia treated during the same time interval. PMID- 3546616 TI - A clinical and pharmacokinetic study of mitoxantrone in acute nonlymphocytic leukemia. AB - Twenty-two patients with relapsed or refractory acute leukemia received 31 treatment courses of mitoxantrone (10 to 12 mg/m2/d) as a one-hour infusion for five days. Seven of the 13 patients who had greater than or equal to 95% reduction in the leukemia cell mass, calculated using the bone marrow examination on day 6, achieved a complete remission (CR). These remissions lasted up to 14 months without additional therapy. There were no CRs among the 18 patients who had less than 95% cytoreduction by day 6. The sequential addition of 5 azacytidine (200 mg/m2/d) for three days in those patients with residual disease on day 6 provided little additional benefit. Nonhematological toxicity from mitoxantrone was mild, although fever and infection were common. A new high performance liquid chromatography (HPLC) assay was used to describe the clinical pharmacokinetics of mitoxantrone. Neither clinical response nor toxicity was strongly correlated with the peak plasma mitoxantrone concentration on the first day (mean +/- SD, 510 +/- 206 ng/mL), nor the area under the concentration-time curve (484 +/- 229 ng X h/mL), nor the systemic clearance (405 +/- 124 mL/min/m2). Mitoxantrone causes rapid cytoreduction in acute nonlymphocytic leukemia (ANLL), but the optimal dose and schedule remain to be determined. PMID- 3546617 TI - Prevention of graft-versus-host disease in HLA-matched bone marrow transplantation for malignant diseases: a multicentric study of 62 patients using 3-pan-T monoclonal antibodies and rabbit complement. AB - In order to evaluate the effectiveness and reproducibility of T cell depletion in human leukocyte antigen (HLA)-matched bone marrow graft to prevent graft-v-host disease (GVHD), our multicentric study (nine different centers) investigated 62 consecutive patients with poor prognosis leukemia or hematosarcoma from June 1984 to November 1985. The data were updated October 1, 1986, and the mean follow-up was 18 +/- 4.3 months. T cells were depleted with a combination of 3-pan-T cell monoclonal antibodies (CD2 "D66"; CD5 "A50"; CD7 "I21") with a single incubation of rabbit complement (C'). The average number of T cells infused was 0.66 X 10(6) +/- 0.56/kg body weight. Twenty-six patients received chemoprophylaxis for GVHD, 16 received methotrexate, and ten received cyclosporin A. Only a single case of severe (greater than grade II) GVHD was observed, yet the incidence of graft failure was 19%. Factors that might have influenced the occurrence of graft failure appear to be the lack of radiotherapy in the conditioning regimen; the conditioning regimen itself (fractionated total body irradiation [TBI], 12 Gy, v single dose is better than TBI, 10 Gy, but still not statistically significant); and the age of the patients (high-risk after 30 years of age). In contrast, neither the number of nucleated cells reinfused nor the level of T cell depletion (provided the T cells were below critical numbers) seemed to have an influence, nor did chemoprophylaxis for GVHD or splenectomy in chronic granulocytic leukemia (CGL) patients. The survival of graft failure patients was very poor (one of 11; survival at 15 months of the initial graft). Thus, our study demonstrates the reproducibility and high effectiveness in preventing GVHD by immunodepletion of T cells in a large-scale multicentric assay, in which compliance with the protocol of immunodepletion was reasonably good. This study thus provides interesting clues to overcoming graft rejection. PMID- 3546618 TI - A prospective randomized trial of maintenance versus nonmaintenance intravesical bacillus Calmette-Guerin therapy of superficial bladder cancer. AB - Between August 1981 and July 1984, 93 patients with polychronotopic superficial papillary carcinoma (Ta and/or T1), flat carcinoma in situ (Tis), or concomitant superficial papillary and in situ bladder carcinoma were entered into a prospective randomized trial of maintenance v nonmaintenance intravesical bacillus Calmette-Guerin (BCG) therapy. Forty-six patients who received BCG weekly for 6 weeks were compared with 47 patients receiving the six-weekly doses of BCG plus monthly BCG for 2 years. Both groups were evaluated every 3 months by cytology, cystoscopy, and biopsy. A significant reduction in the number of recurrent tumors per patient-month was demonstrated for both groups (P less than .0001); however, the difference in reduction of tumors between the two groups was not significant. Additionally, patients receiving maintenance and nonmaintenance therapy had similar tumor recurrence and progression rates. These results indicate that monthly maintenance BCG does not prevent, delay, or reduce tumor recurrence or progression observed with the 6-week regimen. Maintenance BCG was associated with increased local toxicity, primarily dysuria, frequency, and urgency. Dosage reduction was required in 22 of 47 patients (46.8%). When the data were subjected to multivariate analysis, the presence or absence of tumor following induction BCG and PPD skin test results were found to be significant variables. Controlling for either the presence or absence of tumor following induction BCG, tumor recurrence and progression rates were not significantly different for the two treatment groups. However, the absence of tumor after induction BCG was associated with a longer disease-free duration (P = .00001) and time to progression (P = .095). Patients with a reactive tuberculin skin test before and after induction BCG had significantly less tumor recurrences than patients with different PPD skin tests results (P = .02). Tumor progression was not related to tuberculin skin testing. PMID- 3546619 TI - Adjuvant chemotherapy for high-risk squamous-cell carcinoma of the head and neck. AB - A prospective clinical trial was developed to evaluate efficacy, toxicity, and patient compliance to adjuvant chemotherapy following surgery and postoperative radiation therapy in patients with squamous-cell carcinoma of the head and neck with extracapsular spread of tumor in cervical metastases. Following postoperative radiation therapy, 18 courses of methotrexate (MTX) and 5 fluorouracil (5-FU) were administered over 6 months. Fifty patients were registered. A total of 771 doses were administered. Dose reduction was required 72 times. Therapy was stopped in one patient (2%) because of toxicity. Three patients (6%) refused to complete the adjuvant therapy. Adjusted 2-year no evidence of disease (NED) survival is 66%. This study demonstrates that patients with advanced squamous-cell carcinoma of the head and neck can undertake an aggressive program of adjuvant MTX/5-FU with acceptable compliance and toxicities. Preliminary data generated in this nonrandomized study support the call for a prospective randomized multiinstitutional trial of this program. PMID- 3546620 TI - Carboplatin and recurrent childhood brain tumors. AB - Carboplatin, a cisplatin analogue, was administered as an intravenous (IV) one hour infusion in a 4-consecutive weekly dose schedule to 44 patients with recurrent childhood brain tumors. Twenty-four patients were registered on our phase I, and 20 on our phase II studies. The maximum tolerable dose derived from our phase I study was 210 mg/m2/wk in patients with solid tumors, and the recommended dose for subsequent pediatric phase II studies was 175 mg/m2/wk. This dose was administered to 14 patients in the phase I and all 20 patients in the phase II study. Nine of 36 (25%) evaluable patients in the combined studies experienced objective responses for a median duration of 10+ months. Seven of nine responders had received prior cisplatin. Disease-specific response rates were as follows: medulloblastoma, six of 14 (43%) with three complete (CR) and three partial responses (PR); pineoblastoma, one of one (PR); germinoma, one of two (CR); and brainstem glioma, one of eight (13%) (PR). Carboplatin had mild emetic effects but no significant auditory or renal toxicity. Thrombocytopenia (less than 49,000) was encountered in nine of 28 (32%) evaluable trials at a dose of 175 mg/m2/wk. Because of its low potential for auditory, renal, and emetic toxicity, ease of administration, and high disease-specific activity, carboplatin deserves further study in multiagent phase II and III trials, especially in chemotherapy-sensitive diseases such as medulloblastoma. PMID- 3546621 TI - Evidence for serotonin synthesis, uptake, and release in dissociated rat sympathetic neurons in culture. AB - In the previous paper (Matsumoto et al., 1987), pharmacological evidence for secretion of serotonin (5-HT) by cultured sympathetic principal neurons was reported. Here, we present further evidence that 5-HT is a transmitter of some of these neurons under certain culture conditions, and can also be a "false" transmitter. Sympathetic principal neurons, dissociated from superior cervical ganglia (SCG) of newborn rats, were grown in cell culture. The presence of serotonin was demonstrated with high-performance liquid chromatography (HPLC), immunocytochemistry, and electrophysiological recording. Homogenates of cultures contained a substance that comigrated with authentic 5-HT in HPLC. A voltammogram for this substance was superimposed upon that for authentic 5-HT. When the cultures were examined with immunocytochemical staining, using the peroxidase antiperoxidase technique, many neuronal processes contained 5-HT-like immunoreactive material. Many somata also contained 5-HT-like immunoreactivity when the neurons were grown in the presence of medium conditioned by heart cells (CM), but few somata stained above background in the absence of CM. Medium that contained a raised concentration of K+ (54 mM) or veratridine evoked Ca2+ dependent release of 5-HT, consistent with a neurotransmitter role for 5-HT in the cultures. In preliminary electrophysiological experiments on microcultures containing single sympathetic principal neurons and cardiac myocytes, a nonadrenergic excitatory (NAE) interaction was sometimes obtained after exposing the neurons to 100 microM 5-hydroxytryptophan. This interaction was sensitive to the serotonin blockers reserpine, methysergide, and gramine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546622 TI - Immunological probes reveal spatial and developmental diversity in insect neuroglia. AB - A set of monoclonal antibodies (MAbs) has been generated that recognizes distinct classes of neuroglia in the adult nervous system of the cricket Acheta domesticus corresponding to glial types distinguished by morphological criteria. These include antibodies that bind to the neuroglia of the ganglionic cortex, perineurium, neuropil, and glia associated with the glial lacunar system (interface) and fiber tracts. Another MAb specifically labels components of the neural lamella, a complex extracellular matrix secreted by underlying perineurial cells. Selected adult glial-specific MAbs recognize particular glial antigens expressed during embryonic development of Acheta. Immunohistochemical staining of frozen sections of late- (90-95%) and intermediate- (50-55%) stage whole embryos reveals that the spatial distribution, degree of tissue restriction, or level of expression of some glial determinants changes as development proceeds. Labeling of certain neuroblasts in the embryonic CNS at 50-55% development by an antibody (MAb 3G6) that binds to neuropil glia in the adult CNS implies that at least 1 class of insect glia may be generated by these cells. PMID- 3546624 TI - Dimensional stability of alginate impression materials measured by a non-pressure direct method. PMID- 3546623 TI - Physiological identification, morphological analysis, and development of identified serotonin-proctolin containing neurons in the lobster ventral nerve cord. AB - Amines and peptides exert a wide range of physiological actions on both central neurons and peripheral tissues. Among these actions, serotonin and octopamine are known to trigger contrasting postures when injected into freely moving lobsters. Immunocytochemical studies of lobster ganglia have identified presumptive serotonergic neurons, their central and peripheral projections, and their terminal fields of arborization. More than 100 neurons that show serotonin-like immunoreactivity have been found in the lobster nervous system (Beltz and Kravitz, 1983). From immunocytochemical studies it appears that varicosities within peripheral neurosecretory structures and endings in certain central neuropil regions arise from the same 2 pairs of large cells located in the fifth thoracic (T5) and first abdominal (A1) ganglia. Because we believed that such cells could account for the central and peripheral actions of serotonin on the postural system, we chose to study these 2 pairs of neurons in greater detail. In the previous paper, Siwicki et al. (1987) report that these neurons contain the pentapeptide proctolin in addition to serotonin. In this communication, we report that these cells can be identified reliably in living preparations; they have large fields of innervation projecting anteriorly into at least 4 segmental ganglia; these neurons are the origin of the fibers that form the thoracic second root neurosecretory regions; they are generally spontaneously active neurons that have overshooting action potentials in their cell bodies; and the serotonin and proctolin immunoreactivities are first expressed in these cells at widely different times in development. PMID- 3546625 TI - Basic studies on visible light-curing resin as a denture base--Part 4: Its strength in the repair of fractured parts of heat-curing denture base resin. PMID- 3546626 TI - Measurement of glomerular filtration rate with technetium-99m DTPA: comparison of plasma clearance techniques. AB - We have compared several techniques for measuring [99mTc]DTPA plasma clearance following single injection to estimate glomerular filtration rate (GFR). Half hourly measurements of disappearance of plasma activity were used to calculate a reference GFR corrected for one-pool assumption and body surface area. Alternative methods involving (i) single blood sample, (ii) two blood samples, (iii) external detector clearance rate, and (iv) a combination of (i) and (iii) were then compared. Closest correlations were obtained with (i) two blood samples at 2 hr and 4 hr (s.e.e. 2.8 ml/min) and (i.v.) external rate constant from 2-5 hr with a blood sample at 3 hr (s.e.e. 3.0 ml/min). Correlations with single blood sample were closest at 3 hr and 4 hr postinjection (s.e.e. 5.4 and 4.5 ml/min, respectively). External detector disappearance rate constant alone was least accurate (s.e.e. greater than 10 ml. min). PMID- 3546627 TI - Chemical breakdown of technetium-99m DTPA during nebulization. AB - Aerosols of 99mTc diethylenetriaminepentaacetic acid ([99mTc]DTPA) used for measuring lung permeability and lung ventilation require a radioaerosol delivery system to produce an aerosol with reproducible size and radiochemical purity. To test how well nebulizers meet this requirement, radiochemical purity of aerosols produced with a jet and an ultrasonic nebulizer was evaluated. The activity median aerodynamic diameter (AMAD) and geometric standard deviation (sigma g) of radioaerosols were 0.46 micron (sigma g = 1.6) for the jet nebulizer and 0.70 micron (sigma g = 1.7) for the ultrasonic nebulizer. Paper and liquid chromatographic assays were obtained on the [99mTc]DTPA aerosol solute produced with each nebulizer. The results of these tests showed major differences in radiochemical purity. Aerosols produced in the jet nebulizer consistently showed greater than 90% of the radioactivity bound to the DTPA ligand whereas aerosols produced in the ultrasonic nebulizer showed less than 10% of the radioactivity bound to DTPA. The results support the need to test radiochemical purity of aerosols before using an aerosol nebulizer for pulmonary imaging and clearance studies. PMID- 3546629 TI - Methods for the study of the metabolism of radiolabeled monoclonal antibodies by liver and tumor. AB - Methods for elucidating the mechanisms by which radiolabeled antibodies are taken up and accumulated in tumor and liver are reviewed. These include the use of isolated perfused rat livers, RES blockade using dextran sulfate, single and double labeled antibodies, micropore chambers for the accumulation of the interstitial fluid, and in vitro tissue culture studies of antibody metabolism. Each method has its utility, examples of which will be discussed along with the methods' limitations. All of the methods have value in furthering our understanding of the metabolism of monoclonal antibodies both in vivo and in vitro. Use of these procedures to create a greater understanding of radiolabeled antibody metabolism, hopefully, will result in improved clinically useful agents for diagnosis and therapy. PMID- 3546628 TI - Aluminemic disturbance of technetium-99m DTPA renal function measurement. AB - During follow-up study of a patient with surgically corrected unilateral renal ischemia, using computer image generated [99mTc]diethylenethiaminepentaacetic acid (DTPA) glomerular filtration rate (GFR) and [131I]orthoiodohippurate estimated renal plasma flow (ERPF), we observed prominent gastric and intestinal uptake of 99mTc. Profound alteration in the GFR results, but not the ERPF results, was also observed. Radiopharmaceutical breakdown was suspected and shown to be endogenous and due to hyperaluminemia at 28 ng/ml. These case findings add DTPA to the list of 99mTc radiopharmaceuticals that have previously been reported to have altered biodistribution when hyperaluminemia is present. The case findings also reaffirm the benefits of obtaining images to corroborate the validity of quantitative data and demonstrate that quantitative radionuclide renal function data are not independent of renal chemical handling. PMID- 3546630 TI - Measurement of single kidney glomerular filtration rate by technetium-DTPA renography. PMID- 3546631 TI - JONA's Semiannual Directory of Consultants to Nursing Administration. PMID- 3546632 TI - Cooperative care. The time has come. AB - What happens when patients decide when to take their medications, when to eat, what to wear, and what family member will stay with them? These authors state the result of these patient self-care activities are reduced cost, and more satisfied patients and staff. PMID- 3546633 TI - Involvement of metallothionein in the hepatic metabolism of copper. AB - Metallothionein (MT) is often a major copper-binding protein in the liver, particularly of copper-loaded animals. This review describes the isolation of hepatic copper-MT, its physicochemical properties, biosynthesis and intracellular distribution, and possible routes for its degradation and secretion. There is increasing evidence that MT plays an important role in the cellular detoxification of copper, although an involvement in the uptake, storage and transfer of copper has also been proposed. These roles are discussed. PMID- 3546634 TI - Relative amount and ester composition of vitamin A in rat hepatocytes as a function of the method of cell preparation and of total liver stores. AB - The aim of this study was to determine the cellular distribution of vitamin A in the liver of adult, well-nourished Sprague-Dawley rats with different stores of this vitamin. Three groups of three rats each were fed AIN-76 diet. Each group received an oral supplement of either 0, 2, or 12 mg of retinol. Retinol and retinyl esters were measured in the whole liver, in hepatocytes isolated either by gravity sedimentation or by centrifugal elutriation, and in the supernatant solution recovered after hepatocyte sedimentation. Dietary supplementation with vitamin A increased the liver stores from 138 to 390 micrograms/g. A mean of 5% of the liver vitamin A was found in hepatocytes isolated by centrifugal elutriation. This percentage tended to decrease as liver vitamin A increased. In contrast, a mean of 38% of total liver vitamin A was found in hepatocytes isolated by gravity sedimentation over a threefold range of liver reserves. Whereas the retinol concentration in hepatocytes remained constant, the percentage of total vitamin A as retinyl esters, which accounted for more than 96% of the total vitamin A, increased as liver stores increased. The retinyl ester composition was similar in all three groups, major esters being palmitate (76-82%), stearate (9-12%), oleate (5-7%), and linoleate (3-4%). Over a threefold range of liver vitamin A concentrations in well-nourished rats, therefore, we estimate that only 10-20% of the total vitamin A in liver is present in the parenchymal cells. PMID- 3546635 TI - Leukemia and occupational exposure to electromagnetic fields: review of epidemiologic surveys. AB - Several recent surveys have presented data suggesting an increased risk of leukemia among men with occupational exposure to electromagnetic fields. Eleven pertinent data sets were compiled in order to assess the consistency of this pattern and to identify those occupations most deserving closer examination. Results for total leukemia show a modest excess risk for men in exposed occupations, with an enhanced risk elevation for acute leukemia and especially acute myelogenous leukemia. These studies are inherently limited regarding the effect of electromagnetic fields due to the absence of exposure characterization. Nonetheless, telegraph, radio, and radar operators, power and telephone linemen, and electrical and electronic engineers showed the most consistent results and warrant further study to ascertain potential occupational health hazards. PMID- 3546636 TI - Environmental tobacco smoke and indoor air quality in modern office work environments. AB - Recent attempts to clean the air in modern sealed office buildings appear to have focused on one component of indoor air quality, environmental tobacco smoke (ETS). Prohibiting smoking entirely or designating specific smoking areas has been suggested to improve comfort of office workers and reduce acute symptoms of so-called "building illness." The effectiveness of such methods, as well as the overall relation of ETS to indoor air quality, are here evaluated, based on reviews of a large number of studies of indoor air quality in modern office buildings under normal use and occupancy. Under these conditions, ETS does not appear to contribute significantly to a build-up of contaminants in offices. Also, in two large series of studies of buildings with health and comfort complaints in the US and Canada, ETS does not appear to be associated with cases of building illness. PMID- 3546637 TI - Obstetric ultrasound: application in a clinic setting. AB - A brief review of the medical literature indicates areas of concern related to the safety of obstetric ultrasound usage. Questions raised in the medical literature dictate the need for conservative and appropriate use of ultrasound until long-term follow-up studies have been completed. The current use of diagnostic ultrasound in a prenatal clinic setting is explored. In the meantime, health-care providers should follow guidelines for obstetric ultrasound use to prevent indiscriminate patient exposure. PMID- 3546638 TI - Intraoral quadrangular Le Fort II osteotomy. AB - The technical aspects of the intraoral quadrangular Le Fort II osteotomy are described, and the anesthetic technique, blood loss, operating time, intraoperative and postoperative complications, length of hospitalization, and length of fixation in seven cases are reported. This procedure was predictable and reproducible with few complications, had low surgical and postsurgical morbidity, exhibited excellent initial skeletal stability, provided esthetics superior to those achieved with lower osteotomy and onlay bone grafting techniques, and demonstrated versatility within limits. PMID- 3546639 TI - Spindle cell carcinoma of oral mucosa: case report with immunoperoxidase and electron microscopic studies. PMID- 3546640 TI - The metal post and composite core combination. AB - Restoring broken down non-vital teeth implies in general the provision of a post and core foundation. Many materials and techniques have been introduced for this purpose in recent years. In this article the advantages and disadvantages of the cast and the non-cast post and core are discussed. The problems involved with the application of the post and core are reviewed. An efficient procedure for restoring a broken down tooth with a prefabricated post in combination with a composite core is presented. PMID- 3546641 TI - Helkimo's indices before and after prosthetic treatment in selected series. AB - The series consisted of sixty subjects selected from the patients who attended the prosthetic or restorative departments of the Institute of Dentistry at the University of Kuopio in 1978-82. All the patients had had a mutilated or reduced dental arch in the upper or lower jaw for at least 1 year. They had received no prosthetic treatment and little restorative treatment. Helkimo's indices were registered in the first examination. After the first examination the pre prosthetic treatment was performed on all the patients. The second examination was after 18 months. Then Helkimo's indices were registered again. The prosthetic treatment had then been performed on thirty-nine patients (group A). The control group consisted of nineteen patients without prosthetic treatment (group B). The changes in Helkimo's indices were analysed statistically (Mann-Whitney U-test). The changes in the anamnestic index were not significant in either group while the changes in the dysfunction and occlusal index were highly significant in both groups (P less than 0.001). PMID- 3546642 TI - The coefficient of swallowable composition of masticated hard-baked soya beans. AB - In addition to the graphical representation of swallowable composition (SC) of masticated food, an index--the coefficient of swallowable composition (CSC)--has been proposed in this study. This index was tested using hard-baked soya beans on various types of dentitions. The value of CSC ranged from +24 to -14 in full dentition and full denture wearers respectively. PMID- 3546643 TI - Role of internal fixation in infection of open fractures: studies with Staphylococcus aureus and Proteus mirabilis. AB - Studies of infections in open fractures are described. The hamster was chosen as the experimental model. Osteotomies of the femur were created with an osteotomy saw. Some osteotomies were left to heal and others were fixed with an 0.9 mm K wire. The infection rates in fixed and unfixed fractures were compared. The first group of hamsters with fixed and unfixed osteotomies was returned to cages with open wounds. There was no difference in the infection rate at 2 weeks. The second group was deliberately contaminated with Staphylococcus aureus and then returned to cages with open wounds. In this group, the infection rate at 2 weeks was lower in the internally-fixed fractures than in the unfixed fractures. The third group was deliberately contaminated with the gram negative organism Proteus mirabilis. In these animals, the infection rate was increased in the presence of the internal fixation device. The fourth group was deliberately contaminated with both Staphylococcus aureus and Proteus mirabilis. The infection rate in these animals was very high; Proteus was recovered from those animals with internal fixation and Staphylococcus was recovered from those animals without internal fixation. These studies in the hamster document the usefulness of this animal as an inexpensive and reproducible model for studying infection of open fractures. The hamsters tolerated the procedure well, and wound and fracture healing progressed satisfactorily. PMID- 3546644 TI - [Finite element analysis on removable prosthetic appliances and their supporting tissues. 1. Effect of loading conditions and materials of maxillary bilateral external extension dentures on stress distribution]. PMID- 3546645 TI - [Finite element analysis on removable prosthetic appliances and their supporting tissues. 2. Effect of bone resorption and denture rebasing]. PMID- 3546646 TI - Pediatric Doppler echocardiography 1987: major advances in technology. AB - The major advances in the capabilities of pediatric cardiologists to evaluate the heart by ultrasound that have occurred in the last 5 years have been reviewed. In addition to the new Doppler methods, the evolution of higher resolution echo techniques have provided a comprehensive means of evaluating the heart noninvasively. This information has relegated catheterization to a more therapeutic arena, leaving ultrasound as the major diagnostic technique for evaluation of congenital heart disease, both before and after birth. PMID- 3546647 TI - Growth and development in infants after renal transplantation. AB - Between January 1, 1978, and August 31, 1985, 13 infants aged 6 to 11 months received primary renal transplants (12, living related donor; one cadaver) at the University of Minnesota. Twelve infants are alive with functioning grafts (10 primary and two second transplants) after 4 months to 7.5 years. To assess the long-term outcome, we analyzed growth and development in the first nine infants 2 to 7.5 years after receiving their first transplant. Before transplantation, head circumference and height standard deviation scores in six of nine infants were less than -2. Five had seizures; four had delayed mental development, and six delayed motor development. The mean increment in height standard deviation scores for six boys after transplantation was +1.4 (P less than 0.05), and one achieved complete catch-up growth. The mean difference in height standard deviation scores for three infant girls with primary hyperoxaluria was -2.1; nevertheless, two infants with oxalosis are currently alive 2.7 to 3.3 years later. All eight surviving children achieved normal head circumference (mean improvement +2.2 SDS, P less than 0.001), and no child had further seizures. Of seven infants reassessed with the Bayley Scales after transplantation, mental development was normal in all and motor development was normal in five. Our findings suggest that early living related renal transplantation is an important option in the management of end-stage renal disease in infants. PMID- 3546648 TI - Growth and sexual maturation in children after kidney transplantation. AB - Linear growth and sexual maturation were assessed in 68 long-term pediatric renal allograft recipients (43 boys) receiving daily or alternate-day prednisone therapy. Growth was analyzed both during the prepubertal period and during puberty. Height at transplantation was greater than 2 SD below the mean in 34.2% of prepubertal children. After the first posttransplant year, 59.2% of the prepubertal children had a normal height increment (greater than 4.8 cm/yr). Onset of puberty was recorded at a chronologic age of 14.6 +/- 1.9 years in boys and 13.3 +/- 1.9 years in girls. Height at onset of puberty related to chronologic age was -2.4 +/- 1.3 SD. Height velocity during puberty was within normal limits in 62.5% of the children. No significant difference in pubertal growth was detected in patients who had received transplants before and after the onset of puberty. Duration of pubertal development was within normal limits. In girls, menarche was achieved at a mean chronologic age of 15.9 years and bone age 12.9 years. Adult height was attained at an average age of 20.3 years in boys and 18.7 years in girls. Overall, one third of the children attained an adult height greater than 2 SD below the mean. Our data indicate that although poor growth before kidney transplantation has a great influence on adult height, the loss of growth potential during pubertal development seems even more important. PMID- 3546649 TI - Short-term treatment of short stature and subnormal growth rate with human growth hormone. AB - Forty-eight children with short stature, growth rate less than 4 cm/yr, and normal growth hormone response to secretagogues were given exogenous human growth hormone (hGH) for 6 months to determine its effect on the short-term growth rate in these children. All except three had an increase in growth rate with hGH therapy. The mean +/- SD pretreatment growth rate (3.4 +/- 0.8 cm/yr) was significantly less than either the growth rate during 6 months of hGH therapy (6.9 +/- 2.6 cm/yr) or after therapy (4.1 +/- 1.8 cm/yr). Several patterns of response were observed after treatment was stopped: the mean growth rate in 22 children decreased after treatment but remained above basal rates, the mean growth rate in seven children was similar to the rates during treatment, and the mean growth rate in 16 children was less than basal rates. Twenty children received therapy for an additional 6 months and had a mean increase in growth rate from 3.6 +/- 1.3 to 6.7 +/- 2.4 cm/yr. The decreased growth rate after discontinuation of treatment and increased rate with resumption of therapy indicates that maintenance of the increased growth rate might be dependent on continuation of hGH therapy. PMID- 3546650 TI - Contribution of extrahepatic tissues to biochemical abnormalities in hereditary tyrosinemia type I: study of three patients after liver transplantation. AB - Three patients with hereditary tyrosinemia type I were examined before and after liver transplantation to assess the role of extrahepatic tissues in the biochemical disorders of this disease. Before transplantation the three patients excreted excessive amounts of succinylacetoacetate (SAA), succinylacetone (SA), tyrosyl acidic compounds, and 5-aminolevulinate (ALA). The activity of 5 aminolevulinate dehydratase (ALA-D) in red blood cells was markedly inhibited (1% to 5% of control) in the three patients. Successful liver transplantation resulted in decreased excretion of urinary SAA plus SA, tyrosyl acidic compounds, and ALA. Two of the patients continued to excrete significant amounts of SAA plus SA, whereas those compounds were undetectable in the urine of the third patient. Tyrosine loading resulted in increased excretion of SAA plus SA in two patients, but those compounds remained undetectable in the third. All three patients continued to excrete higher than normal amounts of ALA, but the activity of ALA-D in red blood cells returned to normal after transplantation, indicating marked clearance of SA from the blood. Liver transplantation may not totally correct the biochemical abnormalities of hereditary tyrosinemia. It is likely that the kidney is the source of persistent biochemical aberrations in the urine without significant effects on the blood. Our results suggest the existence of heterogeneity for renal involvement in hereditary tyrosinemia. PMID- 3546651 TI - Growth after renal transplantation in children. PMID- 3546653 TI - Crigler-Najjar syndrome type I: treatment by home phototherapy followed by orthotopic hepatic transplantation. PMID- 3546652 TI - Renewed catch-up growth with increased replacement doses of human growth hormone. PMID- 3546654 TI - Large-scale laboratory maintenance of Schistosoma mansoni, with observations on three schistosome/snail host combinations. AB - This review discusses the large-scale laboratory maintenance of Schistosoma mansoni. Emphasized are features which increase efficiency in such facilities, and problems most frequently encountered. Profiles are given of the long-term, high-level production of 3 strains of S. mansoni. Two of the strains, NMRI and PR 1, were of Puerto Rican origin and the other, LE, was from Brazil. Three to 8 million cercariae of each strain were usually obtained per week. The most obvious differences between the 3 strains were cercarial output per snail and snail mortality rates. Maintenance problems encountered were usually related to water quality, temperature, genetics of the parasite or snail host, predators or contaminants, feeding, or crowding of snails. Examination of the production data from these 3 life cycles led to identification of features that could be of benefit for increasing the productivity and efficiency of other S. mansoni life cycles used in research activities. PMID- 3546655 TI - Stage-dependent inhibition of chloroquine on Plasmodium falciparum in vitro. AB - Morphological observation of the life cycle of the malaria parasite, Plasmodium falciparum, in highly synchronous cultures after an exposure to therapeutic concentrations of chloroquine in ring, trophozoite and schizont stages, respectively, were carried out in order to determine the influence of chloroquine on the growth of the different stages of the malarial parasites. It was found that chloroquine could not affect merozoite invasion of the erythrocytes; the ring stage was more sensitive to chloroquine than the trophozoite and schizont stages; and chloroquine in therapeutic concentrations prevented only the transformation of rings to trophozoites and could not affect the transformations of trophozoites to schizonts and schizonts to new rings. The determination of the IC50 of chloroquine showed that the IC50 of trophozoites was about 6 times as high as that of rings. PMID- 3546656 TI - Cysteinyl proteinases of Schistosoma mansoni eggs: purification and partial characterization. AB - The egg stage of Schistosoma mansoni, a trematode blood fluke, is known to be responsible for an immunologically mediated granuloma formation. Proteolytic enzymes of S. mansoni eggs may be involved in the penetration of host tissue by eggs and/or may act as antigens to cause a humoral as well as a cell-mediated response leading to granuloma formation. Three acidic, thiol-dependent proteinases from the eggs of S. mansoni were isolated, and 2 major proteinases (I and II) were purified to homogeneity using chromatofocusing, AcA54 ultrogel chromatography, and thiopropyl-Sepharose 6B affinity chromatography. Proteinases I and II have molecular weights of 25,400 and 30,500, and isoelectric points of 6.0 and 5.6, respectively. These enzymes were found to be cathespin B-like cysteinyl proteinases based on similarities in molecular weight, isoelectric point, optimal assay pH, instability to neutral pH, substrate specificity, and inhibitor sensitivity. A monoclonal antibody, specific to S. mansoni egg proteinases was used in immunoblotting studies. Under native, but not under denaturing, conditions for gel electrophoresis, this monoclonal antibody reacted with egg proteinases. This antibody had previously been shown to recognize an antigen in the miracidial penetration glands of schistosome eggs. PMID- 3546658 TI - Elicitation of the reproduction-inhibiting antibody ablastin by serum exoantigens of Trypanosoma lewisi. AB - Serum exoantigens of Trypanosoma lewisi were collected 5 days after infection from immunocompetent (untreated) rats and rats immunosuppressed by treatment with either hydrocortisone acetate or dexamethasone. Normal rats were then immunized with pooled, whole exoantigen-containing serum from 1 of these 3 sources plus alum as an adjuvant, and the immune sera produced were tested individually. All contained agglutinating (trypanocidal) antibodies to both antigenic variants of T. lewisi, but only about two-thirds showed precipitating activity with exoantigens in gels. More importantly, however, when these antisera were thoroughly adsorbed with living trypanosomes (from immunocompetent hosts) to remove agglutinating antibody only and then tested for ablastic activity in vitro, all showed significant (P less than 0.01) reproduction-inhibiting activity, comparable to that shown by ablastic serum collected from rats that experienced a natural infection. Antisera from control rats similarly immunized with normal rat serum were negative in all antibody tests. The exoantigens of T. lewisi are, therefore, a complex mixture of immunogens that are related to the known immune responses to the parasite and can elicit the formation of ablastic antibody with the same biological properties as that produced during a natural infection. PMID- 3546657 TI - Immunocytolocalization of two protection-inducing antigens of Trichinella spiralis during its enteral phase in immune and non-immune mice. AB - Monoclonal antibodies (mAb) recognizing epitopes on the 48K (beta stichocyte specific) and the 50/55K antigen (alpha stichocyte specific) were used as first ligands for immunocytolocalization on de-paraffinized sections of infected gut tissue of non-immune and immune CFW strain mice. The enteral phase was studied at 6, 14, 23, 30 hr and 7 days after initiation of infection via the oral route, times corresponding in worm development to the first (L1), second (L2), and third (L3) stage larva and adult. No change in the intensity of the immune reaction with either mAb was noted in parasites developing within immune or non-immune mice for any of the time-points studied. The 48K and the 50/55K antigens were present within the stichocytes at 6 hr. Enterocytes adjacent to some worms also stained positive for both epitopes at this time. Throughout worm development, the amount of each antigen within the worm diminished, until almost none was left at 30 hr. At day 7, the 48K antigen was present within a few stichocyte cells, the canalicular tree, and within the lumen of the midgut. The 50/55K antigen at this time point was localized within only a few stichocyte granules and on the lining of the worm's gut. Embryo stages did not possess either the 48K or 50/55K epitopes. A marked increase in cells bearing IgG in the lamina propria was noted in immune mice when compared with their non-immune counterparts. PMID- 3546659 TI - Esophageal atresia and ante-thoracic skin tube esophageal conduits: squamous cell carcinoma in the conduit 44 years following surgery. AB - Prior to 1941, a small group of patients born with esophageal atresia had esophageal continuity reestablished by creation of an ante-thoracic skin tube conduit. This conduit was constructed in stages using tubed bipedicle grafts of thoracic skin. William E. Ladd reported on seven such patients. M.H., a 45-year old married female, was the first patient to undergo this procedure and had maintained a normal existence until 6 months prior to admission to this hospital in 1985. She was a nonsmoker and nondrinker who had married and borne 2 children and had maintained adequate nutrition. Six months prior to admission, the patient noticed increasing dysphagia and the presence of a firm area in the upper third of the subcutaneous esophagus. Esophagoscopy demonstrated two polypoid lesions within the conduit. Multiple biopsies did not show any evidence of malignancy. Despite this, it was felt that the subcutaneous skin tube should be removed. A substernal colonic esophageal conduit was established and the subcutaneous skin tube removed. Histologic examination revealed extensive areas of benign pseudoepitheliomatous hyperplasia with foci of well-differentiated microinvasive squamous cell carcinoma within the wall of the tube. Ultimately, excision of overlying skin, subcutaneous tissue, and muscle under the skin tube site was done. This area was covered with a skin graft. The therapeutic approach as well as the implications concerning the long-term use of skin in heterotopic locations was discussed. PMID- 3546660 TI - Esophageal atresia: a simple technical detail aiding the mobilization and circular myotomy of the proximal segment. AB - A simple technical detail in placing the upper pouch holding suture to facilitate proximal segment mobilization in esophageal atresia is described. The suture is passed through both walls of the upper segment and the tip of the Foley catheter. If circular myotomy is needed, the Foley catheter balloon is inflated to fill the lumen of the upper pouch to facilitate dissection. This technique has been successfully used in 32 patients, eight with myotomy. PMID- 3546661 TI - Aberrant thymus: a misleading mediastinal mass. AB - We report two cases in which aberrant thymic tissue caused a misleading superior mediastinal mass. The diagnosis can be made by awareness of it and by use of appropriate investigations. Should surgery be performed we recommend frozen section biopsy if ectopic thymus is suspected, and if confirmed, the mass should not be excised unless it is causing serious mechanical problems. PMID- 3546662 TI - Skeletal Class II treatment with the Chateau appliance. PMID- 3546663 TI - Primary anterior strip crowns: a new approach. PMID- 3546664 TI - Acute polyhydramnios complicating monozygous twin pregnancies--case report. AB - Two cases of acute polyhydramnios complicating twin pregnancies were treated with repeated amniocentesis for the relief of extreme abdominal discomfort and to prevent imminent premature labor. The procedure was found to be safe and resulted in prolonging the pregnancies by 14 to 11 days respectively. This management, with the addition of tocolysis and close fetal surveillance (which resulted in 2/4 living children) can offer some hope in an otherwise hopeless situation. PMID- 3546665 TI - Fetal ventriculomegaly, agenesis of the corpus callosum and chromosomal translocation--case report. AB - Real-time ultrasound was used to evaluate intracranial anatomy and ventricular size in a child with fetal ventriculomegaly. It was associated with agenesis of the corpus callosum and chromosomal translocation. Serial measurements of cerebral ventricular dilatation at various gestational age may improve perinatal management of the newborn with fetal ventricular enlargement. PMID- 3546666 TI - Alterations in the fetal electrocardiogram as a sign of fetal asphyxia- experimental data with a clinical implementation. AB - Although considerable progress occurred with the introduction of electronic fetal monitoring it is now clear that the fetal heart rate alone does not provide optimal information about the fetus. Thus, a question arises whether additional information could be gained by further analyzing the fetal ECG as this is likely to be the parameter presently most easily accessible during labor. For the past 10 years work by our group in Goteborg has been focused on the evaluation of ST waveform changes in the fetal ECG as a method for fetal surveillance. Fetal hypoxemia results in a reproducible pattern of changes with the progressive increase in T wave amplitude as the main response. The ratio between the amplitude of the T wave and QRS complex, the so called T/QRS ratio, quantifies this T wave alteration. Considerable information has been gained, using this parameter, by conducting experiments on the fetal lamb and guinea-pig. The closest relationship was found between the rate of breakdown of myocardial glycogen and the increase in T wave amplitude. This utilization of myocardial glycogen during hypoxia is stimulated by beta-adrenoreceptors. The data also indicate a close link between the adrenaline surge and the appearance of high T waves in the fetal ECG. Relating T wave changes to other biochemical parameters shows a relationship during marked asphyxia with the appearance of a metabolic acidosis which is a result of an increase in blood lactate concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546667 TI - Technical progress in fetal electrocardiography--a review. AB - The fetal electrocardiogram (FECG) was first demonstrated 80 years ago, but initial progress in research into the subject was slow and limited by the technical equipment available. As improved amplifiers became available, the detection of the waveform became easier, but observation of waveform morphology was still difficult because of background noise. The signal-to-noise ratio of the original FECG waveform was improved considerably with the use of directly applied fetal electrodes, and the development of digital computer techniques has allowed signal enhancement. It is now possible to monitor the FECG waveform continuously in labor and reliably produce waveforms with all of the components clearly defined. PMID- 3546668 TI - The clinical relevance of the abdominal fetal electrocardiogram. AB - We investigated the duration of fetal electrocardiographic events during normal pregnancies and during pregnancies with fetal abnormalities. The fetal abdominal signal was processed and enhanced by means of the averaging technique after removing the maternal complex. In normal pregnancies P wave and QRS complex duration increases progressively from the 17th week up to the term: this increase parallels the gain in weight of the fetal heart and particularly of the ventricular mass. These results indicated that the duration of fetal complexes could be used as an index of the size, development and maturity of the fetal heart. When fetal growth retardation (FGR) is present, the weight of the fetal heart is significantly reduced, and is reflected in a decrease in QRS duration. In a series of 107 cases the sensitivity of this parameter in detecting FGR was 81% and the specificity 93%. Moreover no perinatal death nor Apgar values below 7 occurred in growth retarded fetuses with normal QRS duration, while in the group with shortened QRS neonatal deaths were 11% and Apgar scores below 7 26%. Abdominal FECG do provide important auxiliary information for prenatal diagnosis of congenital heart defects (CHD). Anomalies with abnormal atrioventricular connection were reflected in longer PR interval. Ventricular hypertrophia and hypoplasia were associated with increased or decreased QRS duration, respectively. Furthermore, the three fetuses which developed congestive heart failure showed prolonged QRS duration. In severe RH disease, chronic fetal anemia can lead to myocardial hypertrophy and cardiac enlargement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546669 TI - Fetal electrocardiographic monitoring: past, present and future--a historical perspective. AB - The first recording of the fetal electrocardiogram was described 80 years ago. Since that time only the peak of the QRS complex has been used in fetal monitoring for the measurement of fetal heart rate. Attempts to quantify changes in the configuration and time constants have been attempted over the last 30 years but despite the data obtained from animal experiments suggesting configurational changes in relation to hypoxia, the problems of electrical noise and signal distortion have restricted the application of these observations in the detection of fetal hypoxia in the human. Recent technical developments have now enabled continuous real time monitoring of the PR interval, heart rate and ST segment, and their findings and the interrelationships between different variables suggest a new approach to precise monitoring of the fetal state. PMID- 3546670 TI - Advances in electronic fetal monitors--real or imaginary. AB - Changes in the technologies used in the latest generation of electronic fetal monitors has resulted generally in an improvement in the quality of the FHR data produced. However, in a number of instruments the use of inappropriate printers and signal processing has led to a degradation in the FHR trace. This may result in difficulties in interpretation of the data thereby putting the compromised fetus at risk. This paper discusses the factors which affect the interpretation of the data, such as signal detection and rejection of noise, errors due to the signal processing and rate determination, and the effect of the chart recorder on the presentation of the data. Finally information is given about the UK Departments of Health evaluation programme for electronic fetal monitors (cardiotocographs). PMID- 3546671 TI - Mucoperiosteal flaps with and without removal of the pocket epithelium. AB - The purpose of this study was to clinically evaluate the need for elimination of the pocket epithelium during mucoperiosteal flap surgery aimed at reattachment or readaptation. A split mouth design was used in 13 patients with two bicuspids and two molars included in each quadrant. Two surgical techniques were compared. One of the quadrants received a modified Widman flap with removal of the pocket epithelium, while the contralateral side received a crevicular flap without removing the pocket epithelium. One month after the hygienic phase was completed, the following measurements were taken: Gingival Index, Plaque Index, gingival crevicular fluid flow, mobility, furcation involvement, level of attachment, pocket depth and gingival recession. In addition to these measurements, which were taken immediately prior to the surgery (baseline), 1- and 3-month postsurgical measurements were also taken. Gingival recession was recorded immediately after the flaps were replaced and sutured. All data were analyzed statistically using paired t test and sign test. The biometric results showed that without the removal of the pocket epithelium, good clinical results relative to gain in clinical attachment levels and reduction in probing depth were achieved. Greater gingival recession occurred on the crevicular flap side postsurgically when compared to the modified Widman flap. The other clinical parameters remained the same at the three time intervals. This was true within each technique and when both techniques were compared. PMID- 3546672 TI - A comparison of the effectiveness of hand scaling and ultrasonic debridement in furcations as evaluated by differential dark-field microscopy. AB - There have been no previous reports in the literature comparing the effects of hand scaling with ultrasonic debridement in furcations, or which have used dark field microscopy for this comparison. The purpose of this study was to compare the efficacy of these two modes of debridement in various classes of furcations, using gingival crevicular fluid flow and dark-field microscopy as parameters. A total of 33 furcated molars were evaluated. Results indicated that both hand scaling and ultrasonic debridement were equally effective in Class I furcations in changing the gingival fluid flow and bacterial proportions to those of a healthy state. In contrast, ultrasonic debridement was significantly more effective than hand scaling in Class II and Class III furcations in altering these parameters. PMID- 3546673 TI - The subpedicle connective tissue graft. A bilaminar reconstructive procedure for the coverage of denuded root surfaces. AB - A mucogingival grafting procedure has been developed to cover denuded root surfaces. This procedure, the subpedicle connective tissue graft, is a bilaminar graft that is composed of a free connective tissue graft and an overlying pedicle graft. By overlaying grafted free connective tissue with a pedicle, the otherwise compromised section of free graft which covers a denuded root surface is supplied by plasmatic circulation from capillaries in the vascular portion of the pedicle allowing it to survive. In this report 29 teeth were treated and monitored for as long as 42 months. In the group with advanced recession of 7 to 10 mm, there was an average of 88% coverage. The subpedicle graft created a healthy, functional, and esthetic result that appeared resistant to further breakdown. The subpedicle graft is indicated when a single surgical procedure is desired that will predictably cover denuded root surfaces when there is inadequate keratinized gingiva available for a pedicle graft and where the prognosis is poor for root coverage with a free gingival graft. PMID- 3546674 TI - [Enzymatic activity and drug binding activity of human serum albumin]. PMID- 3546675 TI - Peroneal spastic flatfoot and tarsal coalitions. PMID- 3546676 TI - The Evans procedure for treatment of severe pes planovalgus. PMID- 3546677 TI - [The Hoffmann reflex]. PMID- 3546678 TI - Sir John Forbes (1787-1861). A bicentenary review. PMID- 3546679 TI - Introduction of Walter J. Pelton. Recipient of the John W. Knutson award in dental public health. PMID- 3546680 TI - An international collaborative study on the First International Standard of bovine luteinizing hormone for immunoassay. AB - An ampouled freeze-dried preparation of bovine pituitary luteinizing hormone (bLH), coded EHC-bLH-1, has been evaluated in an international collaborative study and shown to be suitable and sufficiently stable to serve as a standard for bLH. Eight laboratories provided immunoassay data, one laboratory provided receptor assay data, and bioassay data were obtained from 4 laboratories. The geometric mean potency estimate obtained by immunoassays, expressed as milliunits of the USDA bLH-B-5 preparation per ampoule, was 25.6, which is consistent with the result obtained by in-vivo bioassays. The geometric mean estimate obtained by receptor assays or by in-vitro bioassays was lower, i.e. 13.2 milliunits per ampoule. The reason for this discrepancy is currently under investigation. With the authorization of the Expert Committee on Biological Standardization of the World Health Organization this preparation was established in 1985 as the International Standard for Luteinizing Hormone, Bovine, for Immunoassay with a unitage of 25 mi.u. per ampoule. PMID- 3546681 TI - Rouleaux formation by spermatozoa in the naked-tail armadillo, Cabassous unicinctus. AB - Spermatozoa from the ductus deferens of a naked-tail armadillo, Cabassous unicinctus, were arranged in rouleaux. The sperm heads were wafer-thin, with the acrosome and nucleus flattened together. Dense subacrosomal material in the equatorial segment of the acrosomal region was present on one surface but not on the other. PMID- 3546682 TI - Pulsatile GnRH administration stimulates the number of pituitary GnRH receptors in seasonally anoestrous ewes. AB - Twenty seasonally anoestrous ewes were pretreated with progesterone for 4 days and divided into four equal groups. Ewes in Group 1 received no GnRH treatment and were slaughtered immediately after progesterone removal. Ewes in Groups 2, 3 and 4 received i.v. injections of 250 ng GnRH every 2 h for 36 h starting at the time of progesterone removal. Ewes in Group 2 were slaughtered immediately after the 36 h GnRH pulsing, while ewes in Groups 3 and 4 were given a bolus injection of 125 micrograms GnRH at this time and were slaughtered 2 and 10 h after the bolus injection, respectively. Blood samples were collected every 30 min from ewes in Group 4 only, from 4 h before the start of GnRH treatment until 10 h after the bolus injection. Pulsing with GnRH resulted in episodic release of LH, and the bolus injection of GnRH was immediately followed by a preovulatory type LH surge in those ewes in which an endogenous surge had no already begun. The pituitary GnRH receptor numbers were significantly higher for the ewes in Group 2 than for any of the other treatment groups, while there was no significant difference in the receptor numbers between Groups 1, 3 and 4. The results suggest an up-regulation of GnRH receptors resulting from pulsatile GnRH therapy. PMID- 3546683 TI - Comparison of the gonadal response of wild and laboratory field voles (Microtus agrestis) to different photoperiods. AB - Weanling male and female field voles from laboratory stock and from the F1 generation of wild-caught animals were placed in a long (16L:8D) or short (6L:18D) photoperiod for 28 or 56 days. Both types of field vole showed the well established effect of photoperiod upon sexual maturation, with animals in the long photoperiod having larger and more active gonads than animals in the short photoperiod. After 28 and 56 days laboratory stock females were more mature, sexually, and had a higher growth rate than did Wild F1 females. There was no difference between the two types of males at 28 days, but by 56 days laboratory stock males were more sexually mature and had a higher growth rate than did Wild F1 males. These differences between the two types occurred in the long and short photoperiods. There was no interaction between photoperiod and type of vole. The use of laboratory stock animals in experiments could lead to an incorrect assessment of the effect of photoperiod in the control of seasonal breeding in wild populations. PMID- 3546684 TI - Developmental studies of sperm surface antigens using sperm-specific monoclonal antibodies. AB - Sperm-specific monoclonal antibodies generated against mouse sperm isoantigens were used to analyze the developmental expressions of sperm surface antigens during different stages of spermatogenesis. Indirect immunofluorescent assays using the freshly isolated testicular cells from mature and immature mice revealed that a number of monoclonal antibodies did not stain the surface of spermatogenic cells in testis. Instead these antibodies reacted with the sperm surface antigens in testis and/or epididymis. Further analysis was performed using frozen testicular sections from mice of day 14 to day 30 after birth. It was generally observed that a significant number of these antibodies reacted with the cytoplasmic components of spermatogenic cells in testis at the postmeiotic stages (e.g. day 22 after birth). After meiosis, the percentage of seminiferous tubules that were stained by immunofluorescence was found to increase with the ages of the mice. The results of this study suggest that some cytoplasmic components (especially acrosomal) of spermatogenic cells are expressed postmeiotically in testis, but later translocated to the sperm surface during very late stages of spermatogenesis. PMID- 3546685 TI - Uptake of immunoglobulins and other proteins from serum into epithelial cells of the mouse uterus and oviduct. AB - The transport of immunoglobulins into the lumen of the female reproductive tract is not well understood, especially in the case of IgG. In mice, there are conflicting reports concerning the presence of immunoglobulins in uterine luminal and glandular epithelial cells, and immunoglobulins have not been detected in the luminal epithelial cells of the oviduct. In the present study we detected both IgA and IgG in uterine luminal and glandular epithelial cells on day 1 of pregnancy by immunolabeling. Also, we observed that fluorescein-conjugated mouse and bovine IgG and other proteins were taken up into vesicles in uterine luminal and glandular epithelial cells after intravenous administration. These observations indicate that both kinds of epithelial cells take up immunoglobulins from the interstitial fluid on day 1 of pregnancy, and that the cells may therefore be involved in the transport of immunoglobulins and other proteins to the uterine lumen at that time. In the oviduct, we detected IgA and IgG in vesicles in the luminal epithelial cells of the preampulla by immunolabeling, and we observed fluorescein-conjugated IgA and IgG in similar vesicles after intravenous administration. The presence of IgA and IgG in vesicles in the epithelial cells of the preampulla, together with the previous demonstration of plasma cells of both isotypes and large amounts of interstitial immunoglobulins in the lamina propria of this segment, suggests that the preampulla of the oviduct may be an important site for the local immune system in the mouse female genital tract. PMID- 3546686 TI - Different antibody patterns and different prognoses in patients with scleroderma with various extent of skin sclerosis. AB - Ninety patients who fulfilled the ARA criteria for systemic sclerosis were divided into 6 groups on the basis of cutaneous areas of sclerosis. Anticentromere antibody (ACA) was found in 14 of 28 patients of the first 2 groups, the first group being pure sclerodactyly, and the second sclerodactyly plus minimal sclerotic lesions (eyelids, neck, armpits). In the other 4 groups (62 patients) in whom skin sclerosis was more diffuse, ACA was found in one case. Fluorescent antinuclear antibodies (FANA) with a diffusely grainy pattern, those with a nucleolar pattern and the anti-Scl-70 antibody were present in all 6 groups, but were significantly more frequent in the last 4 groups than in Groups 1 and 2. The cumulative survival rate as well as disease duration were found to be significantly longer in the first 2 groups designated "limited cutaneous systemic sclerosis," than in the 5th and 6th groups, i.e., patients in whom the trunk also was involved: "diffuse cutaneous systemic sclerosis." The cumulative survival rate and disease duration of patients with skin sclerosis of the face and limbs, but not of trunk, were not significantly different either from those of patients with limited cutaneous systemic sclerosis or from those of patients with diffuse cutaneous systemic sclerosis. Thus these patients show the same antibody pattern as diffuse cutaneous systemic sclerosis, but the prognosis not significantly different from the other 2 subsets. We suggest they constitute a distinct subset of systemic sclerosis for which we propose the name "intermediate cutaneous systemic sclerosis." PMID- 3546687 TI - Lung function in patients with ankylosing spondylitis. A study of the influence of disease activity and treatment with nonsteroidal antiinflammatory drugs. AB - Progressive ankylosis of the thoracic skeleton in ankylosing spondylitis (AS) causes restrictive pulmonary function impairment characterized by a reduction in vital capacity (VC). After a wash-out period of 2 weeks, 33 men with active AS were treated with either diflunisal or phenylbutazone according to a double blind randomized design for 12 weeks, followed by an open extension period of 36 weeks. A spirometric study was performed at baseline, Week 12, and Week 48. In the active phase of the disease a correlation was found between VC and chest expansion, whereas neither of these variables was related to the thoracic pain and over-all disease activity. We also found that the VC correlated with the lumbar flexion index, but not with the erythrocyte sedimentation rate or IgA. Although all clinical efficacy variables showed an improvement during treatment with both drugs, no change in VC was found, even in patients with the most restricted ventilatory impairment. We conclude that the VC is not an appropriate variable for the evaluation of short term therapy in AS. PMID- 3546688 TI - Quantitative structure-activity analysis in dihydropteroate synthase inhibition by sulfones. Comparison with sulfanilamides. AB - A set of 25 4'-, eight 2',4'-, and five 2',4',6'-substituted 4-aminodiphenyl sulfones were tested for their inhibitory activity on dihydropteroate synthase of Escherichia coli. Linear regression analysis shows that enzymic inhibition indices correlate well with both quantum chemical and spectroscopic descriptors of the electronic structure of the common moiety 4-NH2-C6H4-SO2 of the sulfones (the above descriptors being expressed in relation to the electronic structure of the enzyme substrate, p-aminobenzoate). Therefore, the biological activity of the sulfones can be related to the electronic structural resemblance between these inhibitors and the substrate of the target enzyme. Since a similar result was previously obtained for a wide series of sulfanilamides in their different (amidic, imidic, and anionic) forms, it appears possible to consider the antibacterial sulfones and sulfanilamides as a congeneric chemical series. On the basis of the present results, the classical theory of antimetabolites would appear to take on a quantitative and sound rationale. PMID- 3546689 TI - Synthesis and 3'-substituent effects of some 7 alpha-methoxy-1-oxacephems on antibacterial activity and alkaline hydrolysis rates. AB - Relationships between intrinsic antibacterial activity and beta-lactam chemical reactivity of 7 beta-(phenylacetamido)-7 alpha-methoxy-1-oxacephems with various 3'-substituents were studied in order to clarify the effect of the 3'-substituent on the antibacterial activity. The chemical reactivity of the beta-lactam ring estimated by pseudo-first-order rate constants log kobsdNMR of alkaline hydrolysis at pD 10.4 and 35.0 degrees C correlates well linearly with 13C NMR chemical shift differences (delta delta(4-3], infrared stretching frequencies of the beta-lactam carbonyl (vC = O), and sigma I values. Values of log (1/CN), averaged for the MIC values for Escherichia coli, E. coli NIH JC-2, E. coli EC 14, and Klebsiella pneumoniae SRC-1, were taken as an estimation of the intrinsic antibacterial activity. The log (1/CN) values of the compounds without good leaving groups correlated fairly well with log kobsdNMR values. The comparatively high antibacterial activity of compounds with good leaving groups may be attributable to the different course of decomposition of these compounds. PMID- 3546690 TI - alpha-Methylproline-containing renin inhibitory peptides: in vivo evaluation in an anesthetized, ganglion-blocked, hog renin infused rat model. AB - A structure-activity analysis of peptides containing backbone C alpha-methyl modification at the P4 site of the angiotensinogen sequence led to the discovery of potent renin inhibitors with apparent in vitro metabolic stability. Boc-alpha MePro-Phe-His-Leu psi[CHOHCH2]Val-Ile-Amp dicitrate (Va) is a potent inhibitor of human plasma renin with an IC50 value of 1.8 nM. This peptide was shown not to be degraded in vitro by chymotrypsin, elastase, pepsin, and a rat liver homogenate preparation. It is also a potent inhibitor of hog renin with an IC50 value of 1.6 nM and was shown to elicit in vivo activity and cause dose-dependent hypotensive responses when given intravenously to anesthetized ganglion-blocked, hog renin infused rats. PMID- 3546692 TI - Predation on Rhodnius prolixus (Hemiptera: Reduviidae) by the spider Theridion rufipes (Araneida: Theridiidae). PMID- 3546691 TI - Synthesis and quantitative structure-activity relationship analysis of N triiodoallyl- and N-iodopropargylazoles. New antifungal agents. AB - New series of N-(2,3,3-triiodoallyl) and N-(3-iodopropargyl) azole derivatives (100 compounds) involving pyrrole, pyrazole, imidazole, triazole, and tetrazole nuclei were synthesized successively with the aid of quantitative structure activity relationship (QSAR) analysis to obtain potent antifungal agents. Starting from the derivatives of nitropyrrole-containing antibiotics, the QSAR analysis of the pyrrole derivatives against Candida albicans and Trichophyton mentagrophytes strains indicated the positive contribution of the nitro group and negative effect of the size of molecule. Further application of the QSAR analysis on the multi-azole derivatives revealed the importance of hydrophobicity and electronegativity as well as steric effect to the activities and led to the synthesis of one of the most potent iodo compounds, 2-(2,3,3 triiodoallyl)tetrazole (67, ME1401). PMID- 3546693 TI - Isozyme evidence of lack of speciation between wild and domestic Triatoma infestans (Heteroptera: Reduviidae) in Bolivia. PMID- 3546694 TI - [Mammography and mammary ultrasonic diagnosis. Coupled examination; clarification]. PMID- 3546695 TI - The VA-medical school partnership: the medical school perspective. PMID- 3546696 TI - The VA-medical school partnership: the VA perspective. PMID- 3546697 TI - Intracranial pressure: a review of clinical problems, measurement techniques and monitoring methods. AB - Intracranial hypertension is a dangerous condition and is common in patients suffering from a severe head injury or from a variety of pathological problems. Measurement of intracranial pressure (ICP) is considered by many to be a valuable aid in the management of such patients. Despite the invasive nature of the more widely-used measurement techniques, and hence their associated risks, results from many centres have convincingly shown that ICP measurement enables management of intracranial hypertension to be rationally approached, and a direct measure of the progress and outcome of treatment to be obtained. This paper begins with a description of normal cerebrospinal fluid (c.s.f.) pressure. This is followed by an account of the pressure-volume relationship of the intracranial system, and the control mechanisms that regulate the ICP during limited increases in mass volume within the cranium. The consequences of these for patient management are discussed. Reasons why ICP is monitored, and the benefits arising, are described. The paper then concentrates upon the methods of measuring ICP and discusses their relative merits and limitations. A selection of typical pressure sensors is described. Finally, methods that have been devised to monitor ICP and to anticipate intracranial hypertension are reviewed, and the direction of work in this area is assessed. PMID- 3546698 TI - Microbial adherence to vulvar epithelial cells. AB - Under uniform experimental conditions, different degrees of selective attachment of Staphylococcus aureus and Candida albicans to epithelial cells of the labium majus, the labium minus, and the vagina were compared and contrasted with those found in studies with cells of the buccal and nasal mucosa and forearm skin by a novel analysis of adherence density. For both micro-organisms, the larger, rougher cells of the labium majus gave the highest adherence scores matched only by the interaction of S. aureus with fully keratinised nasal epithelial cells. Increasing acidity to pH 3.5 enhanced microbial adherence to vaginal cells. Menstruation also influenced attachment; highest densities were reached between the third and fourth weeks of the cycle. Autogenous ribitol teichoic acid was found to block the attachment of S. aureus to labium majus and labium minus cells by 76% and 81% respectively, and to vaginal cells by 66%. Adherence is considered to be an important attribute of vulvar ecology and may be a determinant of infectious disease. PMID- 3546699 TI - The response of Escherichia coli to ciprofloxacin and norfloxacin. AB - The action of ciprofloxacin and norfloxacin on two strains of Escherichia coli was studied by diverse methods including electronmicroscopy, viable counting and continuous turbidimetric monitoring. During the first few hours of exposure to inhibitory concentrations of the drugs, the opacity of bacterial cultures continued to increase for a period that was inversely proportional to the drug concentration. This change corresponded to the appearance of filamentous bacteria, swollen forms and some lysis. There was subsequently a gradual drop in opacity during which extensive lysis occurred. As judged by viable counts of bacteria washed free of drug, cell death occurred within 30 min of first exposure to the drugs and continued over a 3-h period. Ultrastructure studies demonstrated that lysis was preceded by the formation of vacuoles, predominantly at the poles of the cells. At these sites, breaks in the cell walls eventually occurred, resulting in extrusion of the cytoplasmic contents. PMID- 3546700 TI - Temperature control in Lowicryl K4M and glycol methacrylate during polymerization: is there a low-temperature embedding method? AB - An apparatus for embedding tissues at resin temperatures down to 228 K is described. By placing thermocouples in the resin the temperature has been monitored during embedding at low temperature with glycol methacrylate (GMA) and Lowicryl K4M. Even in this apparatus with a liquid cooling bath the heat of polymerization is not dissipated and the resin temperature rises. This rise is directly proportional to the resin temperature at the onset of polymerization and is higher in Lowicryl K4M than GMA. The initial resin temperature also affects the time taken for polymerization. The time to the onset of the peak and its duration are both increased as the temperature is lowered. This effect is more pronounced with GMA than Lowicryl K4M and polymerization of GMA is inhibited at the lowest temperature used. When Lowicryl K4M, polymerized at low temperature, is warmed up to ambient a further exothermic reaction occurs, which causes the resin temperature to rise well above ambient. Both this temperature peak and that during polymerization are reduced, but not totally eliminated, by reducing the resin volume. Air-cooled systems are inefficient compared with the low temperature apparatus used here and the resin temperature rise is consequently greater and, even with small resin volumes, it can be very high. It is therefore unlikely for published methods that the temperature specified has been maintained in the resin during polymerization. The implications of these findings are discussed in relation to enzyme and antigen survival. Recommendations include use of very small volumes of resin, refrigerated liquid-bath rather than air-cooled systems and contact with a heat sink when specimens are warmed up to ambient temperature. Examples of enzyme reaction, antigen survival and structural preservation obtained with the method are presented. PMID- 3546701 TI - The application of a microwave technique for the preparation of cell blocks from sputum. AB - Microwaves stimulate diffusion in tissue and affect the proteins and membrane of the cell. These actions can be used to shorten the time required to fix and prepare cell blocks from sputum. The fixative containing ethyl alcohol and polyethylene glycol is particularly suitable for microwave enhanced fixation. Applying a commercially available domestic microwave oven, in which the temperature and power level can be set, cell blocks can be prepared from fresh sputum in 35 min. The microscopical results are of a superior quality because of the microwave-induced homogeneous distribution of the effects of the applied immersion fluids on the cells. The method is very successful for all specimens containing a large amount of mucous. Health hazards for laboratory personnel are nil in this cell blocking method; in contrast to when fresh sputum containing infectious agents is used for smear preparation. PMID- 3546702 TI - Cryo-transfer revised. AB - Vapour deposition of water is a major problem in cryo-transfer and cryo observation of frozen specimens. The use of (sliding) shields to protect the specimen during transfer has been evaluated and was found to be a fail-safe procedure. Shielding the specimen with solidified coolant is proposed as an alternative or additional protection. The protective layer (ethane, Freon 22) can be evaporated in the high vacuum of the microscope. The evaporating coolant will carry away water films deposited on top. The temperature of coolant evaporation is low enough to prevent possible devitrification of water in the specimen itself. PMID- 3546703 TI - Regulated yeast promoters produced by DNA rearrangements selected in vivo. AB - DNA rearrangements that activated a promoterless his3 gene were selected in vivo. DNA segments that promote the expression of his3 were identified in Ty1 DNA sequences and a variety of sites in the vector DNA. These elements appear to function when placed in either orientation relative to his3 but not when placed at the 3' end of the his3 gene. Promoter elements regulated by carbon source, nitrogen source, pyrimidines or galactose were characterized. The assembly of more complex regulatory elements and transposons from these units is discussed. PMID- 3546705 TI - Contraction properties and motor nucleus morphology of the two heads of the cat flexor carpi ulnaris muscle. AB - Previous studies have examined the isometric contraction properties of the two heads of the cat flexor carpi ulnaris acting as a single unit. In this study, the contraction properties and fiber architecture of each head of the flexor carpi ulnaris were determined separately and related to previous reports on the histochemical characteristics of this muscle. The morphology of retrograde labeled motor nuclei for the two heads of the muscle was also examined. The humeral head had a significantly longer contraction time (48 msec) than the ulnar head (36 msec) as well as a significantly lower tetanic fusion frequency (28 Hz vs. 35 Hz). The maximum tetanic tension per gram of muscle tissue was 71% greater in the ulnar head. Motoneurons of the flexor carpi ulnaris formed a column 12 mm long and 0.5 mm wide in the center of the ventral grey in spinal segments C8 and T1. The ulnar head had alpha-motoneurons with greater soma diameters than those in the humeral head. The smaller soma diameter, slower contraction time, and weaker contraction in the humeral head correlate with the preponderance of oxidative-metabolic muscle fiber types found in the humeral head by other workers. These correlations suggest that the humeral head plays a major role in maintaining a sustained antigravity tension that prevents the wrist from buckling during standing. PMID- 3546704 TI - Splicing of a yeast proline tRNA containing a novel suppressor mutation in the anticodon stem. AB - The intron-containing proline tRNAUGG genes in Saccharomyces cerevisiae can mutate to suppress +1 frameshift mutations in proline codons via a G to U base substitution mutation at position 39. The mutation alters the 3' splice junction and disrupts the bottom base-pair of the anticodon stem which presumably allows the tRNA to read a four-base codon. In order to understand the mechanism of suppression and to study the splicing of suppressor pre-tRNA, we determined the sequences of the mature wild-type and mutant suppressor gene products in vivo and analyzed splicing of the corresponding pre-tRNAs in vitro. We show that a novel tRNA isolated from suppressor strains is the product of frameshift suppressor genes. Sequence analysis indicated that suppressor pre-tRNA is spliced at the same sites as wild-type pre-tRNA. The tRNA therefore contains a four-base anticodon stem and nine-base anticodon loop. Analysis of suppressor pre-tRNA in vitro revealed that endonuclease cleavage at the 3' splice junction occurred with reduced efficiency compared to wild-type. In addition, reduced accumulation of mature suppressor tRNA was observed in a combined cleavage and ligation reaction. These results suggest that cleavage at the 3' splice junction is inefficient but not abolished. The novel tRNA from suppressor strains was shown to be the functional agent of suppression by deleting the intron from a suppressor gene. The tRNA produced in vivo from this gene is identical to that of the product of an intron+ gene, indicating that the intron is not required for proper base modification. The product of the intron- gene is a more efficient suppressor than the product of an intron+ gene. One interpretation of this result is that inefficient splicing in vivo may be limiting the steady-state level of mature suppressor tRNA. PMID- 3546706 TI - John de Carle: profile of a pioneer. PMID- 3546707 TI - Effects of recreational drugs on physical activity. AB - The literature relating to the effects of recreational drugs on physical work and endurance is reviewed. Interactions between muscular coordination and cognitive function make it difficult to formulate overall conclusions about the effect of these drugs on physical performance. PMID- 3546708 TI - Coma and the etiology of violence, Part 2. AB - Coma and the etiology of violence are explored by the author through a review of the literature. Animal studies, post-traumatic psychic disorder studies, post traumatic anger and violence studies, tumor and lesion of the limbic system studies, temporal lobe epilepsy studies, episodic dyscontrol syndrome studies, and minimal brain dysfunction studies were reviewed in Part 1, which was published in the December 1986 issue of the Journal. Part 2 concludes the review with clinical surveys on violent individuals and studies on clinical treatment of violence.These studies reveal the etiologic significance of central nervous system dysfunction in the production of violent behavior. Because central nervous system factors are involved in some instances of violent behavior, physicians clearly have a role in the early identification of potentially violent subjects and in the intervention or treatment of individuals who have been violent toward others. Studies have consistently found that lower socioeconomic groups are more predisposed to brain injury from trauma, and several studies have indicated that this is true for segments of the black community. Therefore, investigations in the relationship between central nervous system injury and violence should be a major goal of the black community. Black physicians should assume a lead role in these inquiries and in the prevention and treatment of violence, specifically black-on-black number. PMID- 3546709 TI - The effect of rapid resuscitation upon cardiac index following thermal trauma in a porcine model. AB - Minipigs were divided into four experimental groups: nonburned control (C); burn, minimal resuscitation (MR); burn, standard resuscitation (SR); and burn, rapid resuscitation (RR). Resuscitation was begun 30 minutes postburn and hemodynamics were measured through 24 hours postburn. At 30 minutes postburn, the three burn groups demonstrated a significant decrease in cardiac index % (CI%). At 1 1/2 hours postburn, the RR group CI% was significantly greater than for the SR group and not significantly different from that of controls. At 2 hours postburn, fluid was abruptly decreased in the RR group and the salutary effect on CI promptly dissipated. In this model, the early decrement in CI following thermal injury is responsive to rapid resuscitation, concluding that the etiology of decreased CI following thermal trauma is at least partially due to inadequate volumes of fluid administration in the early postburn period. PMID- 3546710 TI - Hypertrophic skin grafts in burned patients: a prospective analysis of variables. AB - A prospective study of 70 consecutive burned patients, 26 pediatric patients and 44 adults, who had 173 separate anatomic sites grafted, was carried out to determine the incidence of hypertrophic skin grafts after thermal injury. The age, race, postburn day grafted, anatomic site grafted, and nature of the recipient graft bed was recorded. The patients were followed for a minimum of 1 year, at which time the skin grafts were classified as Excellent (E)--skin graft flat and not thickened; Good (G)--less than 5% of skin graft thickened or elevated; Fair (F)--greater than 5% of skin graft thickened or elevated; and Poor (P)--skin graft elevated greater than 2 mm or contracture present. Overall, 55% of the grafted sites were excellent, 18% were good, 13% were fair, and 14% were poor. Pediatric patients had a higher incidence of fair or poor results (50%) than adults (17%) (p less than 0.001), and blacks had poorer (39% F or P) results than whites (12% F or P) (p less than 0.001). The presence of dermal elements in the recipient graft bed was associated with less long-term skin graft scarring than when the grafts were placed on recipient beds without dermal elements (p less than 0.01). Skin grafts that were performed within 14 days of the injury had a lower incidence of F or P results (24%), than grafts performed after 14 days postburn (37%) (p less than 0.03). Based on the results of this prospective study, it is possible to identify and quantitate the relative risk of a burned patient developing a hypertrophic skin graft. PMID- 3546711 TI - Biosynthetic skin substitute versus frozen human cadaver allograft for temporary coverage of excised burn wounds. AB - During the past 2 years a multicenter study was performed comparing Biobrane (Woodroof) and frozen cadaver allograft as temporary dressings on freshly excised full-thickness burns before the application of autograft. Each biologic dressing was evaluated with respect to the other on the same patient. Seventy-one patients were evaluated. The mean burn size was 35 +/- 20% with a mean full-thickness burn of 28 +/- 20%. Mean patient age was 34 +/- 21 years. Overall survival was 82%. The mean time of wound coverage was 10.2 +/- 6.7 days. There was no significant difference in the number of dressing changes, area changed, purulence, autograft take, and final results between allograft- and Biobrane-covered sites. There were no complications following use of either Biobrane or allograft. We conclude that Biobrane is as effective as frozen human cadaver allograft for the temporary coverage of freshly excised full-thickness burn wounds before autografting. PMID- 3546712 TI - Evaluation of a caloric requirement formula in burned children treated with early excision. AB - This study was undertaken to evaluate the effectiveness of a standard caloric requirement formula, as determined by retrospective analysis of weight gain of patients treated by serial debridement, for patients treated by early excision. The caloric intakes of 61 patients with more than 40% third-degree burn, 27 treated with serial debridement of the burn wound and 34 treated with early massive excision, were reviewed and compared to their calculated requirements. Nutritional support in both groups was similar. Of the 48 survivors there was no difference in their age, % TBSA burn, and per cent meeting caloric requirement. The early excision survivors had a greater percentage third-degree burn and weight change but a decreased length of stay. It was concluded that even though the formula, previously developed at our institution, may lead to a slight overestimation in determination of the caloric needs of early excision patients, it is an acceptable means of determining their requirements. PMID- 3546713 TI - Serial debridement and allografting of facial burns: a method of controlling spontaneous healing. AB - Management of severe partial-thickness facial burns is difficult and not ideal. Over the past 4 years, 18 patients have undergone serial debridements and allografting at regular intervals until re-epithelialization occurred. Twelve patients required one procedure and two patients required two procedures. Four patients also required autografts on portions of the facial burns. Fourteen patients have been followed for greater than 6 months. Only four patients required scar revision procedures. Three desired cosmetic improvement, and one required functional improvement. The use of serial debridements and allografting controls facial burn healing, as well as producing good cosmetic and functional results. PMID- 3546714 TI - Determinants of mortality in pediatric patients with greater than 70% full thickness total body surface area thermal injury treated by early total excision and grafting. AB - Recent advancements in burn care have improved the survival rates of victims with severe burn injuries. The total mortality rate in a series of 1,057 pediatric patients admitted to Shriners Burns Institute Galveston Unit between 1982 and 1986 was 2.7%. The burn size resulting in a 50% death rate was 95% of the total body surface area (TBSA). In this study 19 survivors and 13 nonsurvivors with greater than 70% full-thickness TBSA burn injuries were compared. All survivors were adequately resuscitated upon arrival 11% sustained an inhalation injury. Forty-six per cent of the nonsurvivors sustained an inhalation injury; 31% were not initially adequately resuscitated. The presence of preadmission shock and inhalation injury were early determinants of mortality with secondary renal, pulmonary, or cardiovascular collapse being the later predictors of mortality in these massively burned pediatric patients. PMID- 3546715 TI - The effect of artemisinin combined with standard antimalarials against chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum in vitro. AB - The activity of artemisinin (qinghaosu) in combination with some commonly-used antimalarial drugs was tested in vitro against a chloroquine-sensitive (NF54) and a chloroquine-resistant (K1) strain of Plasmodium falciparum. Both mefloquine and tetracycline showed marked potentiative synergism with artemisinin against both strains, whilst primaquine showed potentiation against K1. Combinations of artemisinin with pyrimethamine and with chloroquine were antagonistic. The results confirm observations on rodent malaria in vivo and indicate that the drug interactions seen were direct, through actions on the parasite, and not merely effects on drug distribution and metabolism in the mouse host. PMID- 3546716 TI - Treatment of intestinal E. histolytica and G. lamblia with metronidazole, tinidazole and ornidazole: a comparative study. AB - Metronidazole, tinidazole and ornidazole were compared in patients treated for Entamoeba histolytica or Giardia lamblia intestinal infections. Only patients with three positive stool specimens for trophozoites and/or cysts of E. histolytica or G. lamblia by the merthiolate iodine formaldehyde (MIFC) technique were included. Criteria for cure were at least 10 negative stool specimens over 3 weeks after completing therapy. Fifty-three male patients (aged 9-65 years) had E. histolytica infection. Seventeen received metronidazole (1.5 g daily for 10 days), 18 tinidazole (1.5 g daily for 10 days) and 18 ornidazole (1 g daily for 10 days). Metronidazole yielded 88%, tinidazole 67% and ornidazole 94% cure rates. Side reactions were minor. Eighty patients had G. lamblia infection, of whom 20 received metronidazole (0.5 g daily for 10 days), 30 tinidazole (single 2 g dose) and 30 ornidazole (single 1 g dose). Cure rates were 95% for metronidazole, 90% for tinidazole and 97% for ornidazole with no side reactions. PMID- 3546717 TI - Sonographic detection of smoking-related decreased fetal growth. AB - The influence of the effect of maternal smoking on various parameters of fetal growth was tested on two different groups of patients. One was studied with a cross-sectional design and the other one with a longitudinal approach. The fetal parameters measured, reflected head growth (biparietal and occipito-frontal diameters), somatic growth (femur, humerus, tibia, ulna, arm perimeter, thigh perimeter), and visceral growth (abdominal perimeter, cardiac diameters and volume, kidney diameters and volume). The results derived from the longitudinal study demonstrated that head, somatic, and visceral parameters were all affected, when compared with normal curve, while with the cross-sectional study it was not possible to demonstrate impairment of growth. It is concluded that although there is an effect on fetal growth, the detection of such an effect requires sophisticated statistical techniques and study design. This corroborates various studies that had dealt only with the biparietal diameter (BPD) growth. PMID- 3546718 TI - The hypoechoic normal tendon. A pitfall. AB - Varying results have been reported concerning the echogenicity of normal superficial tendons. Our recent results using high-resolution real-time linear array equipment indicate that the normal tendons display a specific echogenic longitudinally oriented fibrillar pattern. However, the visualization of this normal texture requires a perfect technique of examination. The obliquity of the ultrasound beams in relation to the tendon in longitudinal scans as well as the nonrespect of the strict perpendicularity of the scanning plane in transverse sections result in an artifactual hypoechogenicity of the normal tendon. Since hypoechogenicity has been shown a diagnostic criterion for inflammatory changes in tendons, the awareness of this pitfall is instrumental in preventing a false positive diagnosis of tendinitis. PMID- 3546719 TI - Distinguishing normal from abnormal gestational sac growth in early pregnancy. AB - In order to evaluate normal and abnormal gestational sac development, serial sonograms were performed in 83 women whose initial sonogram demonstrated a gestational sac lacking a detectable embryo. Of 53 normal gestations, the mean sac growth was 1.13 mm/day (range, 0.71-1.75). In comparison, of 30 abnormal gestations, 24 demonstrated sac growth, and of these, the mean growth was 0.70 mm/day (range, 0.14-1.71). Based on these observations, we suggest that gestational sac growth of less than or equal to 0.6 mm/day is evidence for abnormal development. Analysis of the initial and follow-up scans for the 53 normal gestations showed that a living embryo was always detected when the mean gestational sac was greater than 25 mm in average diameter, and a yolk sac was always seen when the mean sac diameter was greater than 20 mm. In comparison, of 30 abnormal gestations, six were greater than 25 mm without a detectable embryo, and four were greater than 20 mm without a yolk sac. Recommendations for the optimal time of a follow-up sonogram are presented based on the initial sac size. PMID- 3546720 TI - Sonography of wall thickening of the renal collecting system. A nonspecific finding. AB - Eleven cases of sonographically visualized thickening of the wall of the renal collecting system were reviewed and the clinical diagnoses compiled. In only three of these patients was acute rejection after renal transplantation considered responsible for the finding. The remaining eight had acute tubular necrosis, urinary tract infection complicating hydronephrosis, congenital hydronephrosis after pyeloplasty, congenital hydronephrosis due to reflux, and one was on total parenteral nutrition. It was seen to resolve after therapy in five patients, including all three renal transplants, one patient with hydronephrosis and infection, and one patient with hydronephrosis after surgery. Sonographically visible thickening of the wall of the renal collecting system is a nonspecific finding and can be seen in a variety of renal diseases. PMID- 3546721 TI - Fetal bowel. Normal sonographic findings. AB - The normal sonographic appearance of fetal colon and small bowel is reported in a prospective study of 130 fetuses. The colon, which appeared as a continuous tubular structure located around the perimeter of the abdominal cavity, was seen in some fetuses as early as 22 menstrual weeks and in all fetuses examined after 28 weeks. Colon diameter demonstrated a linear relation (r = 0.82) with menstrual age, reaching a maximum of 18 mm at term. In comparison, small bowel was located centrally and individual segments never exceeded 7 mm in diameter or 15 mm in length. Small bowel loops were seen in only 30% of fetuses examined after 34 weeks. Peristalsis was routinely demonstrated of the small bowel, but was not observed in the colon. PMID- 3546722 TI - Ultrasound in the evaluation of the knee and patellar regions. AB - Studies were carried out in 25 patients (mean age, 34.2 years) with knee or patellar problems, using a real-time scanner. The contralateral leg, which was asymptomatic, was used as a control. Identification of the patellar bone and the area of insertion of the infrapatellar tendon was not difficult. The area of insertion was less echogenic than other parts of the tendon. Patchy, partial, or total ruptures could be identified using ultrasound. Sonolucent structures in cases of Baker's cyst were easily identified. The study revealed three partial suprapatellar tendon ruptures, three partial infrapatellar tendon ruptures, six old injuries of the infrapatellar tendon with fibrosis and scar tissue, one case of prepatellar bursitis, one parapatellar (cartilaginous) loose body, two intraarticular loose bodies (bony), and four cases of Baker's cyst, of which one was found to be ruptured. The differences in echogenicity of the tendons and surrounding soft tissues were more conspicuous using interposed Kiteko than with direct skin contact. PMID- 3546723 TI - Spontaneous resolution of fetal ventriculomegaly in a diabetic patient. PMID- 3546724 TI - Early prenatal diagnosis of asphyxiating thoracic dysplasia (Jeune's syndrome). Value of fetal thoracic measurement. PMID- 3546726 TI - Meconium peritonitis masquerading as fetal hydrops. PMID- 3546725 TI - Giant fetal abdominal cyst. Ultrasonic diagnosis and management. PMID- 3546727 TI - Leiomyosarcoma of the inferior vena cava. Ultrasonographic appearance. AB - Ultrasonographic features of six leiomyosarcomas of the inferior vena cava are described. In most cases, the presentation is typical enough to strongly suggest the histologic diagnosis. The tumor is usually greater than 10 cm long, hypoechoic, heterogeneous. Cystic components can be found. It is sharply demarcated from neighboring organs which are displaced. The mass is located at the very place of the inferior vena cava, the lumen of which is no longer seen. It is fusiform shaped, surprisingly sparing the aorta. Differential diagnosis along with other radiologic examinations, pathologic findings, and prognosis are discussed. PMID- 3546728 TI - In vivo phosphorylation and protein analysis of hepatitis B virus core antigen. AB - The C open reading frame of the hepatitis B virus contains two in-frame ATG codons that are separated by the precore region and encodes two major polypeptides that are antigenically distinct and that are probably synthesized from individual mRNAs. The precore region directs the secretion of the e antigen, whereas the core antigen can be expressed in the absence of these sequences. In this report a transient expression system was used to study the hepatitis B virus core antigen. By using a chimeric complex of adenovirus major late promoter simian virus 40 enhancer sequences, we were able to achieve high levels of core antigen expression in transfected cells, permitting characterization of this protein and analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The core polypeptide is a 20.9-kilodalton protein, and we show in this study that it is phosphorylated in vivo. Cell fractionation studies, the results of which are supported by indirect immunofluorescence, localized the phosphocore in the cytosol and the nucleus and indicated that it is associated with the membrane of transfected cells. Results of Triton X-114 solubilization studies indicated that the phosphocore is peripherally associated with cytoplasmic membranes. Expression of the membrane-associated phosphocore occurred in the absence of the precore sequences. The phosphocore also assembled into particles in the absence of other viral gene products or intact DNA. PMID- 3546730 TI - Considerations in the choice of sutures for wound closure of the genitourinary tract. AB - The ideal suture for use within the urinary tract should maintain its tensile strength until wound repair is satisfactory and then it should undergo rapid total absorption without promoting stone formation. The bladder has a great potential for repair, attaining 100 per cent of the strength of the unwounded tissue in 14 to 21 days. Braided synthetic absorbable sutures appear to be suited ideally for closure of incised wounds of a urinary conduit. They maintain their tensile strength for approximately 21 days, during which time the healing tissues regain strength rapidly. Because sutures are foreign bodies and have access to urine, they may serve as a nidus for stone formation. Several factors that have been identified as important determinants of foreign body urolithiasis include the presence of urine, urine volume and pH, infection, physical and chemical configuration of the foreign body, and animal species. The incidence of suture urolithiasis is related directly to the duration in which the sutures are present in the urinary tract. Consequently, absorbable sutures are preferred over nonabsorbable sutures for closure of wounds of the urinary conduit. In the absence of infection braided synthetic absorbable sutures have distinct advantages over gut sutures for closure of urinary tract wounds. They are absorbed by nonenzymatic hydrolysis in a predictable manner with limited inflammatory response. In contrast, gut sutures have an unpredictable absorption rate by enzymatic degradation and elicit an exaggerated inflammatory response. Because infected urine, especially Proteus species, accelerates the degradation of absorbable synthetic sutures to a greater degree than gut sutures, wound closure in the presence of infection should be accomplished with the absorbable natural fiber suture. Nonabsorbable sutures or staples should not be used in the urinary tract because they predictably promote urolithiasis. PMID- 3546729 TI - Site-specific antibodies define a cleavage site conserved among arenavirus GP-C glycoproteins. AB - Arenaviruses share a common strategy for glycoprotein synthesis and processing in which a mannose-rich precursor glycoprotein, termed GP-C in lymphocytic choriomeningitis virus (LCMV), is posttranslationally processed by oligosaccharide trimming and proteolytic cleavage to yield two structural glycoproteins, GP-1 and GP-2. Mapping the orientation and proteolytic cleavage site(s) in such polyproteins has traditionally required direct protein sequencing of one or more of the cleaved products. This technique requires rigorous purification of the products for sequencing and may be complicated by amino terminal modifications which interfere with sequence analysis. We used an alternative approach in which synthetic peptides corresponding to sequences bracketing a potential protease cleavage site were used to raise antisera which define the boundaries of the cleaved products. We found that cleavage of LCMV GP C to yield GP-1 and GP-2 occurs within a 9-amino-acid stretch of GP-C which contains a paired basic amino acid group -Arg-Arg-, corresponding to amino acids 262 to 263 in the LCMV GP-C sequence. By comparison with the predicted amino acid sequences of a second LCMV strain, LCMV-WE, as well as with the deduced amino acid sequences of the New World arenavirus Pichinde and the Old World virus Lassa, we observed similar conservation of paired basic and flanking amino acid sequences among these viruses. PMID- 3546731 TI - A comparison of endoscopic suspension of the vesical neck with suprapubic vesicourethropexy for treatment of stress urinary incontinence. AB - To compare the efficacy of the Stamey endoscopic vesical neck suspension with the Marshall-Marchetti-Krantz vesicourethropexy in the correction of stress urinary incontinence, we studied retrospectively 127 consecutive patients who underwent either procedure during a defined interval at our institution. Of 95 women for whom adequate data were available 41 (group 1) underwent the Stamey and 54 (group 2) underwent the Marshall-Marchetti-Krantz procedures. Characteristics of the 2 groups were similar. A cure was obtained 21 to 118 months postoperatively in 61 per cent of the patients in group 1 and in 57 per cent in group 2. Cured and improved rates for the 2 groups were 78 and 80 per cent, respectively. Cure rates decreased with time in both groups. Complications occurred in 37.5 per cent of the patients in group 1 and in 18.5 per cent in group 2. Risk factors implicated in the pathogenesis of primary or recurrent stress urinary incontinence did not predispose to failure in either group. Adequate interpretation of our lower cure rates vis-a-vis those reported previously is hampered by the variability between series in the definition of cure and length of postoperative followup. PMID- 3546732 TI - Computerized tomography and transrectal ultrasound in the assessment of local extension of prostatic cancer before radical retropubic prostatectomy. AB - The value of computerized tomography and transrectal ultrasound in the demonstration of local extension of prostatic cancer was evaluated in 38 patients undergoing radical retropubic prostatectomy. Transrectal ultrasound proved to be reliable for the demonstration of local extension of cancer beyond the prostatic capsule (sensitivity 86 per cent, specificity 94 per cent and accuracy 90 per cent). Invasion of the seminal vesicles was demonstrated by ultrasound, with a sensitivity of 29 per cent, specificity 100 per cent and accuracy 77 per cent. The addition of transrectal ultrasound scanning to clinical evaluation increased sensitivity in relation to detection of extraprostatic involvement from 15 to 92 per cent. When computerized tomography scanning was added to clinical examination, the sensitivity increased from 15 to only 46 per cent. Transrectal ultrasound is valuable for the preoperative evaluation of patients in whom radical prostatectomy is being considered as treatment for clinically localized prostatic cancer. PMID- 3546733 TI - Posterior lumbotomy in pediatric pyeloplasty. AB - Between 1981 and 1985 we performed 32 ureteropyeloplasties on 29 infants and children with ureteropelvic junction obstruction. The posterior lumbotomy incision was used in 14 cases and proved to offer distinct advantages when compared to the anterior and flank incisions. The surgical technique is described in detail and the advantages are discussed. PMID- 3546734 TI - Experience with free grafts in urethral reconstruction. AB - A total of 33 patients underwent hypospadias or epispadias repair by patch or tubular grafts of skin or bladder epithelium from July 1980 to January 1985. Indications included previous circumcision, proximal primary hypospadias, severe chordee alone, inadequate local skin during extended urethroplasty at 2-stage hypospadias repair, multiple previous reconstructions and failed epispadias repair. Genital skin grafts were used in 25 patients, extragenital skin grafts in 4 and bladder epithelial grafts in 4. Complications occurred in 13 patients (39.4 per cent): 8 required reoperation for a fistula, stricture or diverticulum, and 5 underwent internal urethrotomy or urethral dilation. Of the 8 patients 3 needed more than 1 revision. These revisions were short and generally uncomplicated. Final results uniformly were good functionally and cosmetically. Based on our experience and that of others we believe that despite a high incidence of minor complications a free graft serves as an excellent substitute urethra for treatment of a variety of urethral problems in children. PMID- 3546735 TI - Psoas abscess in chronic dialysis patients. AB - We report 4 cases of nontuberculous psoas abscess occurring in patients with end stage renal disease. Fever and pain were the presenting symptoms but diagnosis was delayed. A computerized tomography scan of the abdomen was the critical test that led to the correct diagnosis. Therapy involved drainage and antibiotics, and was successful in 3 of the 4 patients. PMID- 3546736 TI - Urinary bladder prostanoids--their synthesis, function and possible role in the pathogenesis and treatment of disease. AB - The present review surveys the factors governing the synthesis of prostanoids by the urinary bladder, their role in the maintenance of normal bladder function, the pattern of their secretion in bladder disease and, finally, their possible use in the treatment of bladder pathology. It should be emphasized that this area of investigation is in its infancy, and therefore the pathophysiological and clinical relevance of these observations is, to some extent, speculative. However, a certain degree of awareness is necessary to stimulate further studies in this promising field of research. PMID- 3546737 TI - Prostacyclin production by the heart: effect of nicotine and carbon monoxide. AB - Smoking has been linked to the development and progression of atherosclerosis but the mechanism by which smoking exerts its deleterious effects remains unknown. This study was designed to examine in a systematic way the effects of nicotine and carbon monoxide on platelets, arterial walls, and the heart. Results of experiments designed to assess the effect of nicotine and carbon monoxide on the production of prostacyclin (PGI2) by the rabbit heart are reported. Animals exposed to carbon monoxide had the carboxyhemoglobin raised to at least 12% by breathing an atmosphere enriched with carbon monoxide. Nicotine was infused at 50 micrograms/kg/hr for 1 week. Nicotine was measured by gas/liquid chromatography. PGI2 was measured by radioimmunoassay of 6-keto-PGF1 alpha, and its biologic activity was assessed by inhibition of platelet aggregation. Nicotine is concentrated in the heart and blood vessel wall and causes a statistically significant reduction in PGI2 production. Carbon monoxide raised PGI2 production significantly in all chambers, and the combination of nicotine and carbon monoxide further raised PGI2 production. The difference between the effects of nitrogen and carbon monoxide alone and nitrogen and a combination of nitrogen and carbon monoxide was significant in all chambers. It is hypothesized that nicotine exerts a direct metabolic effect in lowering PGI2 production. Carbon monoxide may make the endothelial cell relatively hypoxic, a powerful stimulus of PGI2 production, or less likely exert a direct toxic effect on the endothelial cell. PMID- 3546738 TI - Spontaneous arterial perforation: the Ehlers-Danlos specter. AB - The Ehlers-Danlos syndrome (EDs) is one of the most frequently inherited disorders of connective tissue. Type IV EDs, the arterial-ecchymotic type, is of concern to vascular surgeons because it is frequently associated with spontaneous catastrophic bleeding. This article summarizes our experience with five members of a family and reviews the 31 patients with type IV EDs described in the literature. The 22 male and 14 female patients had a mean age of 26 years. The 36 patients included 23 with easy "bruisability," 22 with hypermobility of their joints (especially the fingers), 13 with transparent skin, and 11 with excessive elasticity of the skin. The patients had 41 episodes of hemorrhage and 29 vascular surgical procedures. Twenty-nine of the patients had an aneurysm or a dissection, whereas eight patients had arteriovenous fistulas. Arteriography was associated with a complication rate of 67%. The prognosis for a patient with type IV EDs is poor; 44% die before surgery and 19% die during the operative period. Bleeding should be managed nonoperatively when possible. Fifty-one percent die before reaching 40 years of age. Arteriography should be avoided. The standard repair of aneurysms and perforations is unlikely to be successful because of marked vessel friability. Bleeding vessels should be repaired with buttressed sutures and no tension or should be ligated. Genetic counseling with assay of collagen production is recommended for family members. PMID- 3546739 TI - Durability of the in situ saphenous vein arterial bypass: a comparison of primary and secondary patency. AB - The use of the saphenous vein in situ is associated with unique problems that decrease primary graft patency (patency uninterrupted by revision). During the past 5 years, we have performed 192 in situ saphenous vein bypasses in 182 patients, including 61 to the popliteal artery, 128 to infrapopliteal arteries, and three to isolated popliteal artery segments. The operative indications were critical limb ischemia in 178 cases (93%), popliteal aneurysm in eight cases (4%), and disabling claudication in six cases (3%). A progressive decline in primary patency occurred after operation. The primary patency rate at 36 months was only 48% for femoropopliteal bypasses and was 58% for femorotibial bypasses. In contrast, the secondary patency rate (patency maintained by thrombectomy, thrombolysis, or revision) at 36 months was 89% and 80% for femoropopliteal and femorotibial bypasses, respectively. The improved secondary patency was due to postoperative surveillance of graft hemodynamics and the success of graft revision. Problems unique to the in situ technique (incomplete valve incision, residual arteriovenous fistula, graft torsion and entrapment) accounted for 58% of early (less than 30 days) graft revisions and 52% of late revisions. The use of Doppler spectral analysis at operation and duplex scanning after operation can locate unsuspected technical errors and identify grafts with low flow at increased risk for failure. The primary patency of the in situ bypass mandates objective assessment of valve incision sites at operation and a protocol of postoperative surveillance to identify grafts that require revision. Early surgical intervention of hemodynamically abnormal but patent in situ bypasses is rewarded by excellent secondary patency. PMID- 3546741 TI - Kyphosis in the marsh rice rat (Oryzomys palustris). PMID- 3546740 TI - Pathologic characteristics of recurrent carotid artery stenosis. AB - Recurrent carotid stenosis occurs randomly in approximately 10% of patients undergoing endarterectomy. Previous studies have described several histologic features but have failed to clearly elucidate the pathogenesis of this disorder. To improve our understanding of this disease, we reviewed pathologic lesions from 20 patients with recurrent stenosis. All specimens had been fixed in formalin and were embedded in paraffin and had undergone routine microscopic studies. In addition, immunoperoxidase staining with anti-factor VIII for endothelial cells and anti-desmin and anti-actin for smooth muscle cells was performed. Recurrent stenosis had developed in 16 of the 20 specimens within 2 years of endarterectomy (early), whereas the remaining four cases occurred from 2 to 7 years after the original carotid endarterectomy (late). Endothelial cells were found lining the luminal surface of both early and late recurrent lesions. Six of sixteen early and three of four late specimens had areas of luminal surface covered with cells exhibiting immunoreactivity for anti-factor VIII. Cells showing immunoreactivity for actin or desmin and demonstrating the morphology of smooth muscle cells were found in 9 of 16 early restenotic lesions but in no late ones. Areas of endothelial cell lining of the recurrent carotid lesions in a substantial number of patients in this study represent a finding not previously described. The presence of these cells implies that a phase of the arterial healing after endarterectomy involves re-endothelialization. Contrary to previous reports, no significant role of thrombosis and/or intraplaque hemorrhage could be found to contribute to development of recurrent stenosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546742 TI - Occurrence of toxigenic Clostridium botulinum type C in the soil of wetlands in Saskatchewan. AB - Mouse-lethal toxin identified as that of Clostridium botulinum type C by antitoxin neutralization was present in cultures of 38.0% of 326 soil samples collected from 28 wetlands in Saskatchewan. There was no difference in prevalence of toxicity between samples collected in spring and summer, and no relationship was evident between the occurrence of toxicity and water salinity, marsh type or water depth. There was a strong association between the prior occurrence of avian botulism in a marsh and the presence of toxin in cultures from soil; 59.2% of soil samples from marshes with a known history of botulism produced toxin, whereas only 6.2% of soil samples from marshes with no history of the disease produced toxin. Eight of the 10 soil samples collected from a marsh that had been dry for several years, and from another marsh that had not had a recognized outbreak of botulism for 11 yr produced toxin, indicating a long residual effect after a botulism outbreak. The results suggest that any wetland with a history of botulism is likely to suffer repeated occurrences because of heavy contamination of the soil with spores, and should be managed to control the disease. PMID- 3546743 TI - Long-term study evidence accumulating, but radial keratotomy controversy continues. PMID- 3546744 TI - The prevention of acquired immunodeficiency syndrome in the United States. An objective strategy for medicine, public health, business, and the community. AB - Human immunodeficiency virus (HIV) is one of the most virulent infectious agents ever encountered. This virus, estimated to kill up to a half of those infected, has spread to more than 1 million Americans. There is no safe and effective treatment. Nor is there a vaccine. From our understanding of HIV transmission, further spread of the virus can be stopped by the use of various techniques. The combined use of education-motivation-skill building, serologic screening, and contact tracing/notification could eliminate or substantially reduce transmission. To accomplish this reduction an immense concerted effort by physicians, public health practitioners, business, and community organizations is required to get across the simple prevention messages. Those messages are: Any sexual intercourse (outside of mutually monogamous or HIV antibody-negative relationships) must be protected with a condom. Do not share unsterile needles or syringes. All women who may have been exposed should seek HIV-antibody testing before becoming pregnant and, if positive, avoid pregnancy. Only through a concerted, vigorous, and sustained prevention program that deals frankly with this problem will those individuals at risk be reached and motivated to take personal responsibility to protect themselves. Without such an effort, acquired immunodeficiency syndrome will continue to kill ever-increasing numbers of Americans. PMID- 3546745 TI - Treatment of patients with acquired immunodeficiency syndrome and associated manifestations. AB - Treatment of AIDS is multidisciplinary and often involves input from a number of medical subspecialties. Treatment of opportunistic infections and malignancies in AIDS is largely palliative in that these treatments do not reverse the underlying immunodeficiency. Investigational approaches to the treatment of this syndrome with immunomodulators and antiviral agents are currently being investigated with the hope that these agents, either alone or in combination, will be active against this devastating disease. PMID- 3546746 TI - Public hospitals: doing what everyone wants done but few others wish to do. PMID- 3546747 TI - Nutritional therapy for high blood pressure. Final report of a four-year randomized controlled trial--the Hypertension Control Program. AB - A four-year trial assessed whether less severe hypertensives could discontinue antihypertensive drug therapy, using nutritional means to control blood pressure. Randomization was to three groups: group 1--discontinue drug therapy and reduce overweight, excess salt, and alcohol; group 2--discontinue drug therapy, with no nutritional program; or group 3--continue drug therapy, with no nutritional program. In groups 1 and 2 patients resumed drug therapy if pressure rose to hypertensive levels. Loss of at least 4.5 kg (10 + lb) was maintained by 30% of group 1, with a group mean loss of 1.8 kg (4 lb); sodium intake fell 36% and modest alcohol intake reduction was reported. At four years, 39% in group 1 remained normotensive without drug therapy, compared with 5% in group 2. Study findings demonstrated that nutritional therapy may substitute for drugs in a sizable proportion of hypertensives or, if drugs are still needed, can lessen some unwanted biochemical effects of drug treatment. PMID- 3546748 TI - Health effects of video display terminals. Council on Scientific Affairs. AB - About 15 million video display terminals are in use in the United States, and their numbers will continue to swell. Much concern has been raised by their users about possible adverse health effects. The extensive collection of research papers and state-of-the-art reports on this subject are reviewed in this article. PMID- 3546749 TI - Demise of Philadelphia General an instructive case; other cities treat public hospital ills differently. PMID- 3546750 TI - Leads from the MMWR. Acute rheumatic fever--Utah. PMID- 3546751 TI - Automatic external defibrillators used by emergency medical technicians. A controlled clinical trial. AB - In a randomized controlled clinical trial, the effectiveness of emergency medical technician (EMT) use of automatic external defibrillators (AEDs) was compared with EMT use of standard defibrillators for patients in cardiac arrest. A total of 321 cardiac arrest patients were treated during the study: 116 were treated by EMTs using the AED (AUTO group), 158 were treated by EMTs using the standard defibrillators (standard group), and 47 were treated by EMTs using the standard defibrillator when they were assigned to use the AED. There was no significant differences in hospital admission or discharge rates between the AUTO group (54% admitted, 28% discharged) and the standard group (52% admitted, 23% discharged) for patients in ventricular fibrillation (VF), for patients in non-VF rhythms, or for all patients combined. The only significant difference observed was in the time from power ON to first shock: 1.1 minutes average AUTO group and 2.0 minutes average standard group. The treatment groups did not differ significantly in sensitivity for VF (78% AED, 76% standard), specificity for non-VF rhythms (100% AED, 95% standard), or rates of defibrillation to a non-VF rhythm (62% AED, 57% standard). We conclude that in clinical outcomes and device performance, AEDs are comparable with standard defibrillators and should be considered an acceptable alternative. Automatic external defibrillators appear to have advantages over standard defibrillators in training, skill retention, and faster operation. Such devices can make early defibrillation available for a much larger portion of the population. They are a major innovation for the prehospital care of cardiac arrest patients. PMID- 3546752 TI - Liberation of the patient from mechanical ventilation. AB - Discontinuation of mechanical ventilation is too frequently difficult and frustrating for the patient and the clinician alike. With the view that expeditious withdrawal of mechanical support is often a mirror-image exercise requiring reversal of the factors that led to respiratory failure, we begin with a discussion of the various pathophysiologies of respiratory failure. We then describe an approach emphasizing assessment of respiratory load and neuromuscular function at the bedside, with strategies outlined for diminishing mechanical load while conditioning and strengthening respiratory muscles to the point that spontaneous ventilation can be sustained. PMID- 3546753 TI - Traditions of folk medicine in America. PMID- 3546754 TI - Sectarian medicine. PMID- 3546755 TI - Medicine 100 years ago. I. JAMA and the competition: 1887. PMID- 3546756 TI - Public hospitals often face unmet capital needs, underfunding, uncompensated patient-care costs. PMID- 3546757 TI - The impact of Medicare's prospective payment system on Wisconsin nursing homes. AB - To assess the impact of Medicare's prospective payment system (PPS) on nursing homes, we reviewed hospitalization and mortality data for Wisconsin's Medicaid and general elderly populations. During the 12 months following implementation of the PPS, Wisconsin's institutionalized elderly Medicaid population experienced a 72% increase in the rate of hospitalization and a 26% decline in hospital length of stay. Two explanations for the increased hospitalization include physician manipulation of the PPS and increased rehospitalization of nursing home residents who may have been discharged prematurely from hospitals. Between 1982 and 1985, analysis of mortality data revealed a 26.2% increase in the rate of deaths occurring in nursing homes. The increase in nursing home deaths began in 1983 and was associated with a 10.3% decline in hospital deaths during the same period. Using a series of logistic analyses, the shift in location of death from hospitals to nursing homes was found to be more pronounced after implementation of the PPS. This change in location of death may reflect both a less aggressive use of hospital resources by physicians caring for terminally ill patients and a transfer of seriously ill patients to nursing homes for terminal care. PMID- 3546758 TI - Introduction to the management of immunosuppression. Council on Scientific Affairs. AB - Advances in solid-organ allograft have depended in great measure on the development of improved means of suppressing the immune system of the recipient. This article presents an overview of the major forms of immunosuppression used in organ transplantation, specifically corticosteroids, azathioprine, antilymphocyte and antithymocyte globulin and cyclosporine, monoclonal antibody to the T3 receptor on lymphocytes, and blood transfusions. PMID- 3546759 TI - Assessing Medicare's prospective payment system. PMID- 3546760 TI - Bone marrow transplantation, ulcerative colitis, and acquired immunodeficiency syndrome (AIDS) PMID- 3546761 TI - Asymptomatic ischemia in patients with coronary artery disease. PMID- 3546762 TI - Fat kinetics and recommended dietary intake in burns. AB - In recent years, there has been an increased interest in the nutritional consequences of injury. This review paper attempts to collate available knowledge concerning the impact of burn injury on fat metabolism, and the effect of manipulated dietary fat intake on burn outcome. Although the interaction is only partially understood at present, several conclusions are evident. Burn patients exhibit alterations in triglyceride, cholesterol, carnitine, fatty acid, lipoprotein and prostaglandin metabolism. Glucose appears to be more effective than fat as an energy source in the nutritional support of seriously burned patients. Conservative administration of fat, particularly linoleic acid, is recommended in view of its immunosuppressive and hyperlipidemic tendencies. Dietary enrichment with eicosapentaenoic acid may likewise prove to be of merit in the diet therapy of burns. PMID- 3546764 TI - Early change of myocardial water during acute cardiac allograft rejection. AB - To determine the changes in myocardial water during acute cardiac rejection and the effects of Ciclosporin (CYA) on the myocardial water, 90 heterotopic cardiac transplants were performed in rats which were divided into 3 groups, namely those receiving 1) Lewis X Lewis isografts, 2) Lewis X Brown Norway allografts and 3) CYA treated allografts (15 mg/kg/day). The water content was measured in both recipient and donor hearts at 2, 4, 6 and 8 days after transplant. Pathological specimens were examined by light and electron microscopy, and scored on a 0 to 4+ scale of increasing evidence of rejection. The water content of the isografts showed no significant change throughout the post operative period. In contrast, the allografts had significant increase of water content as early as 2 days after transplant, compared to the isografts and recipients hearts. A significant difference in cellular infiltration was noted between isograft and allograft 4 days after transplant. CYA suppressed significantly the increase of myocardial water and cellular infiltration in the allografts. These data suggest that myocardial edema may precede cellular infiltration during the rejection process and it may be suppressed with CYA treatment. The measurement of myocardial water may be useful in early detection of acute cardiac allograft rejection and for examining the therapeutic effects of CYA. PMID- 3546763 TI - Acute effects of oral captopril on hemodynamics in patients with cor pulmonale. AB - The cause of pulmonary hypertension in chronic obstructive pulmonary disease (COPD) is considered to be hypoxic pulmonary vasoconstriction, which may be mediated in part by angiotensin II. We administered captopril (25 mg, orally) to seven patients with COPD and complicating cor pulmonale in stable state. Hemodynamic responses were recorded before and one hour after the administration of the drug. Captopril increased cardiac output by 23% (p less than 0.025) and reduced mean systemic pressure by 12% (p less than 0.004), but did not alter mean pulmonary arterial pressure. Pulmonary and systemic vascular resistance fell, respectively, by 14% (p less than 0.035) and 31% (p less than 0.03). There was an increase in pulmonary/systemic vascular resistance ratio (p less than 0.007). Heart rate, mean right atrial, pulmonary capillary wedge pressure, arterial oxygen tension and dioxide tension, and alveolar- arterial oxygen tension difference remained unchanged. These results suggest that captopril is successful in reducing pulmonary vascular resistance without affecting arterial blood gases, but does not change mean pulmonary arterial pressure probably because of the concurrent increase in pulmonary blood flow. In addition, results indicate that captopril has more effects on the systemic vasculature than on the pulmonary circulation. PMID- 3546765 TI - Sympathetic nerve activity, plasma renin activity and water-sodium balance in obese patients with essential hypertension. AB - Studies were conducted to evaluate the role of water-sodium metabolism on the hypertensive mechanisms in obese patients with essential hypertension (EHT). The obesity index correlated positively with the mean arterial pressure, plasma volume, extracellular fluid volume or total exchangeable sodium, and negatively with plasma noradrenaline concentration or plasma renin activity in EHT. Hypotensive effects of sodium restriction (Na 35 mEq, K 75 mEq) or the natriuretic response to infused dopamine (3 micrograms/kg/min) was remarkable in obese EHT. Fractional excretion of sodium (FENa), which reflects the renal tubular reabsorption of sodium, was significantly lower in obese EHT than that in non-obese or mildly obese EHT. Urinary excretion of free dopamine (UDA) had a positive relationship with simultaneously measured urinary excretion of sodium or FENa. In addition, UDA correlated positively with the obesity index in patients whose weight was under 115% of the ideal weight. On the contrary, the relation between the two parameters was significantly negative in patients whose weight was over 115% of the ideal weight. These findings suggest that the expansion of body fluid volume and sodium, which might result from the blunted natriuretic ability, at least in part, due to an attenuation of the renal dopaminergic activity, play an important role of the hypertensive mechanisms in obese EHT. PMID- 3546766 TI - Is renin secreted by exocytotic mechanism through mature renin granules from juxtaglomerular cells? AB - Mature renin granules were isolated by the combination of discontinuous and continuous Percoll density gradient centrifugation. Stored renin in the renin granules was found to consist of isoelectrically seven different forms. The seven different isoelectric points (pIs) were 5.6, 5.35, 5.2, 5.0, 4.8, 4.6 and 4.4. Approximately 70% of the stored renin as the total enzymatic activities from all isoelectric peaks was found in a peak which pI corresponded to be 5.35. Renin secreted from isolated glomeruli was also focused into seven peaks possessing identical values. However, the distribution pattern of renin peaks was quite different from that of stored renin. In the secreted renin, peaks of 5.35 (pI) and 5.2 (pI) showed high renin activity and each had approximately 30% of released renin as the total recovered. These results indicate multiple forms of renin are stored and secreted by rat kidney. As the distribution pattern of enzymatic activities in renin peaks between stored renin and secreted renin are different, it is probable that renin may not secreted through mature renin granules by exocytotic mechanism. PMID- 3546768 TI - Effect of ketanserin on pressor response to vasoactive substances in early phase of one-kidney, one clip renal artery stenosis in rats and rabbits. AB - The effect of ketanserin (KET), a specific 5-hydroxytryptamine2 (5-HT2) receptor blockade, on pressor response to vasoactive substances was examined in rats with one-kidney, one clip renal artery stenosis of 2 days' duration (2-day clipped rat) and in rabbits with renal artery stenosis of 3 days' duration (3-day clipped rabbits). The 2-day clipped rats showed hyperresponsiveness to norepinephrine (NE), arginine vasopressin (AVP) and 5-HT. All hyperresponsiveness were attenuated by a subdepressor dose of KET. The infusion of KET, 10 micrograms/kg/min for 30 minutes, decreased mean arterial pressure of the 3-day clipped rabbits; the dose did not alter blood pressure of the normal controls. Exaggerated pressor response to NE was observed in the 3-day clipped rabbits and was abolished by a subdepressor dose of KET, 2.5 micrograms/kg/min. These results suggest that 5-HT may be involved in the enhanced pressor response to vasoconstrictor substances in the 2-day clipped rats and 3-day clipped rabbits, and that it may also play an important role in maintaining blood pressure in the 3-day clipped rabbits. PMID- 3546767 TI - Blood pressure and sympathetic nervous function in spontaneously hypertensive rats derived from breeders on low sodium diet. AB - We investigated the effect of dietary salt restriction in spontaneously hypertensive rat (SHR) breeders to determine if the development of hypertension of offspring would be blunted. Weaning SHRs (F-0) were divided into 3 groups and were given a diets containing sodium of 0.4% (G 1), 0.05% (G 2), or 0.4% plus mefruside 0.001% (G 3) with distilled water. Potassium content was 0.75% and the other ingredients except chloride were identical in all the diets. Offsprings (F 1) were derived from selective inbreeding within each group. Systolic blood pressure rose over 160 mmHg by 8 weeks of age in all the male rats of all the groups in both F-0 and F-1. There was no difference in blood pressure between G 1 and G 2 at any age, while in G 3 blood pressure was significantly lower than in G 1 at 12 and 20 weeks of age in F-1. The findings in pressure were ascertained by heart-body weight ratio determined at autopsy, which was similar between G 1 and G 2, and was smaller in G 3 than the others at 20 weeks of age. Aldostrone excretion rate was markedly higher in G 2 than G 1 and G 3 at all study points, whereas plasma renin content was similar between G 1 and G 2, and higher in G 3. Plasma concentrations of noradrenaline and adrenaline did not differ among the 3 groups at any age in both F-0 and F-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546769 TI - The rapid diagnosis of group A streptococcal infection. PMID- 3546770 TI - A new latex agglutination test for rapid diagnosis of group A streptococci. AB - A rapid diagnostic test for group A streptococci from throat swabs (Culturette Brand 10-Min Strep ID test of Marion Inc.) was performed in 210 patients with acute pharyngitis. This agglutination test is based on the extraction of streptococcal polysaccharide by nitrous acid and observe agglutination with anti polysaccharide-coated latex suspension. There was a 95.2% total agreement with a standard culture method and agglutination test and specificity of 93.4%, sensitivity of 96.0% positive predictive value of 90.5% and negative predictive value of 97.3%. From the results of our study, the agglutination test for group A streptococci is of diagnostic value. This new kit would be most useful in out patient clinics, especially in a small private medical office without culture facilities. PMID- 3546771 TI - Evaluation of direct and rapid identification of group A streptococci from throat swabs by Culturette 10-Minute Group A Strep ID test kit. AB - The Culturette Brand 10-Minute Group A Strep ID test kit (Marion Scientific, Division of Marion Laboratories, Inc., Kansas City, Mo.) was evaluated for its sensitivity and specificity in identifying the group A streptococci directly from 96 throat swabs, against the conventional culture method and serological grouping test. Our results indicated that the rapid test kit and conventional method are 93.8% accurate; percent sensitivity and specificity of the rapid test was 80.6% and 100%, respectively. None of the false-positive observed in rapid test kits occurred with the heterogeneous microorganisms. More than 8 X 10(4) colony forming unit per swab was required for the positive latex agglutination of the test kit. Since the Culturette method is simple to perform and correctly identifies group A streptococcal antigen, and also required no special instruments, it appears to be applicable in hospital laboratories and outpatients clinics. PMID- 3546773 TI - [Significance of amikacin administered orally prior to operation for prevention of postoperative infections in colonic cancer surgery]. AB - Since December of 1983, clinical trial was undertaken on the prophylactic use of amikacin sulfate (AMK) and metronidazole (MET) in colonic cancer surgery. Daily dose of AMK 1,600 mg and MET 1,000 mg was administered orally in 4 divided doses to 17 patients with colonic cancer for 3 days prior to operation. As a result, wound infection was recognized in only one of 17 cases treated (5.9%). An examination was also performed on bacterial flora in the feces. After the administration of AMK and MET, E. coli and Klebsiella were remarkably decreased, however, E. faecalis and Candida remained unchanged. P. aeruginosa and Bacteroides detected in a few cases were also reduced. These bacteria were restored to the pretreatment level in 1 or 2 weeks after operation. PMID- 3546772 TI - Effects of sensitization of hemolytic streptococcal M-protein fraction on embryonic heart in the rat. AB - After sensitization by M-protein fraction (MP) of hemolytic streptococci for two generations, Wistar rats were injected with 9 ml/kg of MP on day 9 of gestation (plug day = day 0). The incidence of malformations was about 12% whether anti-MP antibody was positive or not in the maternal sera. The primary malformations were ventricular septal defect, anophthalmia, and microphthalmia. Light microscopic study revealed no myocarditis nor endocarditis in either the maternal or fetal heart. No antinuclear antibody was detected in the maternal sera by the fluorescent antibody technique. No complete heart block was found in the fetus by electrocardiogram. These results were similar to previous findings using a single injection of MP, and therefore further demonstration that the principal factor in the teratogenesis induced by MP administration in the rat is not an inflammation in the fetal organs caused by an autoimmune mechanism but rather yolk sac dysfunction. PMID- 3546774 TI - [Clinical evaluation of astromicin administered by intravenous drip infusion. Report II. Bacterial infections in the field of surgery]. AB - A clinical evaluation of astromicin (ASTM) administered by intravenous drip infusion against infections in the surgical field was made, and the results were summarized as follows. Excellent effect was observed in 19 out of a total of 44 cases, good effect in 19, fair in 1 and poor in 5. The efficacy rate calculated from the 38 cases of "excellent" and "good" was 86%. In stratification by disease, the efficacy rate was 91% in localized peritonitis (31/34 cases) and 63% in diffuse peritonitis (5/8 cases); the overall efficacy rate in peritonitis was 86%. The efficacy rate in 2 cases infected by Gram-positive bacteria was 50%, and that in 16 cases by Gram-negative bacteria was 94%. The disappearance rate of Gram-negative bacteria was 93%, and this drug was especially effective against E. coli. There were no subjective or objective side effects and no abnormal laboratory test values that were related to the administration of ASTM. PMID- 3546775 TI - [Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1984). II. Background of patients]. AB - Groups of bacteria were isolated from patients with infections of urinary tracts, and backgrounds of these isolates and patients have been studied in terms of the sexual distribution, and distributions of sexes versus age of the patients relationships between bacterial types and sexual and age distribution of the patients from whom the isolates were obtained correlation ages of patients and types of infections, the association of certain types of bacteria with certain infections and the effect of antibacterial treatments on these types of bacteria, approximately 20% of simple infections of urinary tracts occurred in males and approximately 80% in females on average from 1981 to 1984. This ratio showed hardly any changes during this period. Likewise, male patients comprised approximately 60-70% of all the cases with complicated infections of urinary tracts regardless of indwelling or without indwelling of catheters. In terms of age, the ratio of urinary tract infections was almost universally observed, e.g., for patients in 40's: 10.0% in 1981, 11.0% in 1984, while in those in 70's: 25.5% and 21.2%, respectively. Consequently, background factors of the cases with infections of urinary tracts, such as sexes, age, or simple or complicated, remained almost stable, whereas bacteria involved showed considerable variations. In 1982 and 1983, the frequency of isolations of Enterococcus spp. was approximately 8% in both males and females. However, in 1984, the frequency of isolation of Enterococcus spp. was 22.5% in the males 17.9% in the females. The frequency of isolation of Enterococcus spp. increased in all age groups, but the frequency was not particularly high among the aged. A study on variations and isolation frequencies of bacteria before the administration of antibiotic agents revealed that isolation frequencies of Enterococcus spp. sharply increased in 1983, and this high frequency remained in 1984. The frequency of isolation of E. coli tended to decrease year after year. This finding represents that the frequency of isolations of E. coli from materials of cases with simple infections of urinary tracts has decreased, showing that pathogenic bacteria from simple infections of urinary tracts were becoming similar to that of the complicated infections of urinary tracts. These findings seem to be worth mentioning here. In cases receiving administrations of antibacterial and antibiotic agents for more than 8 days. Frequencies of isolation from cases without catheter retention and from those with catheter retention were similar.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3546777 TI - [Phagocytes in the host defense mechanism]. PMID- 3546776 TI - [A nationwide study of the antimicrobial susceptibility of clinical isolates of Escherichia coli in Japan]. AB - We studied the antimicrobial susceptibility of E. coli isolated in 1983 and 1984 and also the yearly changes of the susceptibility of E. coli from 1980 to 1984 isolated in 103 hospitals in Japan. Antibiotics used for MIC determination were ampicillin (ABPC) as a penicillin, cefazolin (CEZ) as a cephalosporin, cefmetazole (CMZ) as a cephamycin and gentamicin (GM) as an aminoglycoside. Numbers of isolates tested were 2,321 strains in 1983 and 1,965 strains in 1984. CMZ was the most effective agent among the 4 antibiotics tested, followed by GM and CEZ in this order. A large number of the isolates were inhibited by 1.56 micrograms/ml on CMZ and GM and by 6.25 micrograms/ml of CEZ. About two-thirds of the isolates were inhibited at a concentration of 12.5 micrograms/ml or less of ABPC. The susceptibility of E. coli against the 4 antibiotics changed little year by year and the tendency of the appearance of resistant strains did not increase in the last 5 years. PMID- 3546778 TI - A new method for the histological study of aging changes in the sinoatrial node. AB - In the autopsied heart, histological observation of specialized conducting cells, especially in the sinoatrial node, is very difficult. Conducting cells were investigated and classified in electron microscopic studies which were not adapted to the examination of the autopsied heart. In this study, we aimed to obtain a clear understanding of the microenvironment in the sinoatrial node of autopsied hearts. For this purpose, we prepared 1 mu thick sections using epon embedding methods for electron microscopy. Thus, we were able to isolate human SA nodal cells from the background collagen fiber, and morphological classification of conducting cells was enhanced. We examined histologically SA nodal cells from various age groups (20-86 years of age), and calculated the mean diameter and number of nodal cells in 4 age groups. SA nodal cells increased in diameter and decreased in number with aging. PMID- 3546779 TI - Comparable effects of oral diltiazem and verapamil in the treatment of hypertrophic cardiomyopathy. Double-blind crossover study. AB - The effects of oral diltiazem, 180 mg/day, were compared with those of oral verapamil, 240 mg/day, in 32 patients with hypertrophic cardiomyopathy (HCM), using a double-blind crossover study design. In the first treatment period, diltiazem and verapamil improved subjective complaints in 83% and 71% of those who were symptomatic in the baseline period. Maximal oxygen consumption on exercise stress test increased with verapamil by 2.9 +/- 4.2 ml/Kg/min (p less than 0.05), and tended to increase with diltiazem. Verapamil also reduced the amplitude of negative T wave. In the statistical analysis based on the crossover design, diltiazem and verapamil did not differ in global improvement, overall safety and global utility ratings. In addition, both drugs showed comparable effects on electrocardiographic and echocardiographic variables and exercise tolerance except for minor differences in diastolic blood pressure, T wave amplitude and peak exercise heart rate. On the other hand, verapamil tended to induce more serious side effects, forcing the discontinuation of medication in 3 patients. Therefore, the present study indicates that diltiazem is essentially equally as effective as verapamil and is preferable in the treatment of patients with HCM since it may exhibit fewer serious side effects. PMID- 3546780 TI - The ventricular gradient and repolarization. AB - The ventricular gradient concept of Wilson was an important insight into the physiology of ventricular repolarization and its electrocardiographic expression. For many years the validity of the concept was questioned because QRST deflection area was not independent of ventricular activation sequence but it is now evident that electrotonic effects on repolarization account for that behavior. There is solid theoretic and experimental evidence that QRST deflection area depends on disparity of repolarization. The established relation of disparate repolarization to arrhythmia vulnerability provides an important clinical objective for measurement of the QRST area and promising evidence for the prediction of arrhythmias has been obtained. Finally, there is evidence that the sufficiently sampled map of QRST deflection areas provides useful information concerning the distribution of repolarization properties as well as their disparity. PMID- 3546781 TI - [Enzyme- and immuno-histochemical study of childhood non-Hodgkin's lymphomas]. AB - Enzyme-and immuno-histochemical methods were applied to 19 childhood non Hodgkin's lymphomas. According to the LSG classification, all lymphomas were of the diffuse type and comprised of 4 cases of the medium-sized cell type, 1 the mixed cell type, 3 the large cell type, 3 the Burkitt type and 8 the lymphoblastic type. Immunoperoxidase stains for the leukocyte common antigen on paraffin sections were positive in all 19 lymphomas while they were negative in all 6 childhood solid tumors. Surface and/or cytoplasmic immunoglobulin restricted to one light chain was demonstrated in 1 medium cell type and 3 Burkitt type lymphomas. Prolonged incubation of paraffin sections produced positive paranuclear ACP and ANAE reactions in 1 medium-sized cell type, 2 large cell and 4 lymphoblastic type lymphomas. Immunoperoxidase stains using monoclonal antibodies on fresh tissue imprints and frozen sections revealed appropriate surface markers for phenotyping individual lymphomas studied. In conclusion, the application of enzyme-and immuno-histochemical techniques helped to establish the diagnosis with a biologically meaningful subclassification of non-Hodgkin's lymphomas in children. PMID- 3546782 TI - [Protein engineering and bioelectronics]. PMID- 3546783 TI - [Hairy cell leukemia]. PMID- 3546784 TI - [Health care workers and AIDS]. PMID- 3546785 TI - [Metabolic bone disease: osteogenic cells]. PMID- 3546786 TI - [Metabolic bone disease: calcification and matrix vesicle]. PMID- 3546787 TI - [Metabolic bone diseases: various factors influencing bone resorption and osteogenesis--with special reference to the mechanism of action--bone metabolism and growth factors]. PMID- 3546788 TI - [Metabolic bone diseases: various factors influencing bone resorption and osteogenesis--with special reference to the mechanism of action--bone resorption and immunologic-cell-derived factors]. PMID- 3546789 TI - [Metabolic bone diseases: various factors influencing bone resorption and osteogenesis--with special reference to the mechanism of action--prostaglandins and related substances]. PMID- 3546790 TI - [Metabolic bone diseases: various factors influencing bone resorption and osteogenesis--with special reference to the mechanism of action--steroid hormone]. PMID- 3546791 TI - [Metabolic bone diseases: various factors influencing bone resorption and osteogenesis--with special reference to the mechanism of action--thyroid hormones]. PMID- 3546792 TI - [Metabolic bone diseases]. PMID- 3546793 TI - [Etiology and pathology of metabolic bone diseases: osteoporosis]. PMID- 3546794 TI - [Etiology and pathology of metabolic bone diseases: rickets and osteomalacia]. PMID- 3546795 TI - [Etiology and pathology of metabolic bone diseases: osteitis fibrosa]. PMID- 3546796 TI - [Etiology and pathology of metabolic bone diseases: renal osteodystrophy]. PMID- 3546797 TI - [Etiology and pathology of metabolic bone diseases: Paget's disease of bone and osteosclerosis]. PMID- 3546799 TI - [Diagnosis of metabolic bone diseases: photon densitometry]. PMID- 3546798 TI - [Diagnosis of metabolic bone diseases: radiographic diagnosis]. PMID- 3546800 TI - [Diagnosis of metabolic bone diseases: bone scintigraphy]. PMID- 3546801 TI - [Diagnosis of metabolic bone diseases: bone biopsy and bone histomorphometry]. PMID- 3546802 TI - [Metabolic bone diseases: malignancy-associated hypercalcemia]. PMID- 3546803 TI - [Metabolic bone diseases: tumor-induced hypophosphatemic osteomalacia]. PMID- 3546804 TI - [Metabolic bone diseases: osteomalacia due to Fe or Al poisoning]. PMID- 3546805 TI - [Metabolic bone diseases: renal tubular acidosis]. PMID- 3546806 TI - [Metabolic bone diseases: glucocorticoid-induced osteopenia]. PMID- 3546807 TI - [Metabolic bone diseases: idiopathic juvenile osteoporosis]. PMID- 3546808 TI - [Metabolic bone diseases: drug therapy of osteoporosis]. PMID- 3546809 TI - [Development of vascular adhesives--special reference to urethane polymers]. PMID- 3546810 TI - [Urinary tract infections as a clinical disease entity]. PMID- 3546812 TI - [Drug resistance and bacterial replacement of pathogens of urinary tract infections]. PMID- 3546811 TI - [Comparison of the susceptibility of isolated bacteria from urinary tract infections to antibiotics]. PMID- 3546813 TI - [Problems of complicated urinary tract infections and infections with multiple pathogens]. PMID- 3546815 TI - [Selection and administration of antibiotics in the therapy of complicated urinary tract infections]. PMID- 3546817 TI - [Maintenance chemotherapy in complicated urinary tract infections]. PMID- 3546814 TI - [Therapeutic schedule in complicated urinary tract infections and infections with multiple pathogens]. PMID- 3546816 TI - [Selection and administration of antibiotics in the therapy of urinary tract infections with multiple pathogens]. PMID- 3546818 TI - [Selection of antibiotics when confirmation of pathogens of urinary tract infections is not available]. PMID- 3546819 TI - [Susceptibility of urine bacteria and kidney excretion to antibiotics]. PMID- 3546820 TI - [Chemotherapy of urinary tract infections in patients with kidney diseases]. PMID- 3546821 TI - [Chemotherapy of urinary tract infections caused by Pseudomonas]. PMID- 3546822 TI - [Urinary tract infections caused by coagulase-negative Staphylococcus]. PMID- 3546823 TI - [Clinical study of fungal urinary tract infections]. PMID- 3546824 TI - [Urinary tract infections and urodynamics]. PMID- 3546825 TI - [Characteristics of urinary tract infections in the aged]. PMID- 3546826 TI - [Urinary tract infections following cerebrovascular disorders]. PMID- 3546827 TI - [Vesico-ureteral reflux and upper urinary tract infections]. PMID- 3546828 TI - [neurogenic bladder and urinary tract infections]. PMID- 3546829 TI - [Prevention of recurrence of repetitious urinary tract infections in women]. PMID- 3546830 TI - [Locational diagnosis of urinary tract infections in children]. PMID- 3546831 TI - [Progress in systems for the identification of urinary bacteria]. PMID- 3546832 TI - [The First International Conference on the Clinical Applications of Photosensitization in Diagnosis and Treatment]. PMID- 3546833 TI - [New technics in the therapy of urinary calculi]. PMID- 3546834 TI - [Present aspects and future prospects in the development of remote medical treatment support systems]. PMID- 3546835 TI - [Topics of interest related to diabetes mellitus]. PMID- 3546836 TI - [Diabetic therapy--insulin]. PMID- 3546837 TI - [MRI equipment, recent advances and improvements in image quality]. PMID- 3546838 TI - [Lipoprotein metabolism and the molecular structure of the LDL receptor]. PMID- 3546839 TI - [The multi-isotope in vivo NMR and study of tissue metabolism]. PMID- 3546840 TI - [Development and clinical application of enzyme immunoassay]. PMID- 3546841 TI - [Rapid diagnosis of viral infections]. PMID- 3546842 TI - [Serological diagnosis of chlamydial infections]. PMID- 3546843 TI - [Current status of automation in infectious bacterial diseases]. PMID- 3546844 TI - [Thoracic CT: scanning technic and image depiction]. PMID- 3546845 TI - [Thoracic CT: the normal mediastinal CT image and its variations]. PMID- 3546847 TI - [Thoracic CT: mediastinal lesions]. PMID- 3546846 TI - [Thoracic CT: anatomy of lung]. PMID- 3546848 TI - [Thoracic CT: diagnosis of heart lesions]. PMID- 3546849 TI - [Thoracic CT: diagnosis of lesions of the great vessels]. PMID- 3546850 TI - [Thoracic CT: diagnosis of atelectasis and local infiltration]. PMID- 3546851 TI - [Thoracic CT: diagnosis of lung tumors]. PMID- 3546852 TI - [Thoracic CT: resectability of lung neoplasms and CT]. PMID- 3546853 TI - [Thoracic CT: diagnosis of the cavity and cyst lesions]. PMID- 3546854 TI - [Thoracic CT: diagnosis of diffuse lung lesions]. PMID- 3546855 TI - [Thoracic CT: comparative study of CT imaging of peripheral lung lesions with fixed lung specimens]. PMID- 3546856 TI - [Thoracic CT: diagnosis of the pleura and thoracic wall lesions]. PMID- 3546858 TI - [Ultrasonic diagnosis. Fatty liver]. PMID- 3546857 TI - [Thoracic CT: application of ultrasonic diagnosis to thoracic lesions]. PMID- 3546859 TI - [Ultrasonic diagnosis of intrahepatic cholelithiasis]. PMID- 3546860 TI - [A case of transient bullous epidermolysis of the newborn]. PMID- 3546861 TI - [Epidemiology of fatty liver--ultrasound mass survey in a rural region]. PMID- 3546862 TI - [Immunohistochemical study of CEA and CA 19-9 in biliary tract epithelium--using biopsied specimens taken by percutaneous transhepatic cholangioscopy]. PMID- 3546863 TI - [Ultrasonically guided percutaneous pancreatograms compared with pathological findings--special reference to pancreatic head cancers]. PMID- 3546864 TI - [Analysis of antigens defined by anti-anisakis larvae IG-G and IG-E antibodies in sera of patients with acute gastric anisakiasis]. PMID- 3546865 TI - The road to diploid androgenesis (the Japan Society of Human Genetics award lecture). PMID- 3546866 TI - [Detection of SOS function induced by chemical mutagens using the umu-test kit]. PMID- 3546867 TI - [Instrumentation physics in medicine: quantitative diagnosis using X-ray CT and digital radiography]. PMID- 3546868 TI - [Construction of ultrasonograms by spiral scan and three-dimensional display of tissue]. PMID- 3546869 TI - [Recent progress with the artificial heart]. PMID- 3546870 TI - [Changes in midwifery practice. 20. Health education programs developed by Ms. Mathison of the General Headquarters]. PMID- 3546871 TI - [Mizoribine-induced hyperuricemia]. PMID- 3546873 TI - [Renal interstitial involvement in Sjogren's syndrome. The relationship between renal functions and renal interstitial lesions]. PMID- 3546872 TI - [Role of the adrenal medulla in elevation of blood pressure induced by sodium loading]. PMID- 3546874 TI - [Biological and immunological activities of erythrocyte superoxide dismutase (SOD) in hemodialysis patients]. PMID- 3546875 TI - [Effects of diltiazem on plasma arginine vasopressin, aldosterone levels and plasma renin activity in man]. PMID- 3546876 TI - Hypertension and intrarenal small vessel lesions in patients with IgA nephritis. A subset of cases mimicking essential hypertension. PMID- 3546877 TI - The renin-angiotensin-aldosterone system in patients with chronic primary glomerular diseases. PMID- 3546878 TI - Effects of commercial and partially purified bovine serum albumin on dog renin activity. PMID- 3546879 TI - Correlation with clinical types and lymphocyte subsets in chronic renal allograft rejection. PMID- 3546880 TI - [Dynamic renal scintigraphy in aortic disorders--evaluation of renal arterial involvement]. PMID- 3546881 TI - [Clinical evaluation of factor analysis in renal dynamic studies using 99mTc-DTPA -normal kidneys and transplanted kidneys]. PMID- 3546882 TI - [Evaluation of split renal function in experimentally induced urinary obstruction]. PMID- 3546884 TI - Cryopreservation of fetal rat liver tissue--a morphological investigation. AB - The present study was undertaken to define optimal conditions for cryopreservation of fetal rat liver tissue fragments. First, various cooling rates (1, 4, 10, 20 and 30 degrees C/min) and preserving temperatures (-20, -80 and -196 degrees C) were examined. Next, various concentrations of Me2SO (5, 10, 20 and 30 per cent vol/vol) were examined by freezing at a rate of 4 degrees C/min to -80 degrees C before transfer to -196 degrees C. All samples were preserved for at least one week. After recovery from cryopreservation, the fragments were transplanted into the spleens of syngeneic rats. Histological assessment of the grafts was made one month after transplantation. Consequently, the optimal cryopreserving conditions for fetal rat liver fragments were defined as follows: cooling rate was 1 to 10 degrees C/min, preserving temperature was at -196 degrees C, concentration of Me2SO was 20 per cent (final concentration: 10 per cent). In the long term observation, the stored liver fragments could be differentiated into adult hepatocytes and the surviving hepatocytes showed little difference from the nonfrozen controls, either histochemically or ultrastructurally. The surviving hepatocytes in the stored transplants were less numerous than in the nonfrozen ones and hepatic cell plates and sinusoids were nil. PMID- 3546885 TI - [Evaluation of phasic coronary blood flow in aortic regurgitation during cardiac surgery]. PMID- 3546886 TI - [Successful surgical repair of trachea-innominate artery fistula]. PMID- 3546883 TI - Problems of pancreatitis. AB - Pancreatitis is not one disease but several and perhaps many. Diagnosis is imperfect in all forms and the usual lack of histologic material has hampered attempts to understand the pathogenesis and possible interrelationships of the different forms of pancreatic inflammation. Acute pancreatitis does not as a rule evolve into chronic pancreatitis, even after multiple recurrences. Recurrent acute attacks can be ended by identifying and treating the factor causing the disease, including recently recognized entities such as accessory papilla stenosis associated with pancreas divisum. Attempts to improve the treatment of severe acute pancreatitis are focussing upon preventing injury to pancreatic cell structures, enhancing endogenous mechanisms for capture and disposal of activated enzymes, and upon early detection and debridement of damaged pancreatic and peripancreatic tissues. Pancreatic duct stricture or obstruction as a consequence of scarring from necrotizing pancreatitis may produce recurrent symptoms, now designated as obstructive pancreatitis. Obstructive pancreatitis has its own unique histologic characteristics and is appropriately treated by resection of the blocked segment of pancreas when the point of obstruction is distal to the papilla. Chronic pancreatitis differs from acute or obstructive pancreatitis in that it is difficult or impossible to halt its progression. The role of intraductal protein precipitates, whether of enzymes or perhaps of other unique pancreatic secretory proteins, in the pathogenesis of the disease is being evaluated. The goal of surgical treatment is not to cure, but to reduce pain, overcome associated obstruction of the bile duct or duodenum, and to treat pancreatic duct disruptions including pseudocysts and internal pancreatic fistulas. Because continuing deterioration of pancreatic function is to be expected in chronic pancreatitis, maximum conservation of pancreatic tissue by avoiding resectional procedures is advisable. PMID- 3546887 TI - [Quantitative renal function study using the RI clearance method by external counting]. PMID- 3546888 TI - [Pathological staging of bladder cancer by percutaneous needle biopsy of all layers of the bladder wall]. PMID- 3546889 TI - Studies on the parasite fauna of Thailand. 6. Three new heligmonellid nematodes from Pere David's vole, Eothenomys melanogaster (Milne-Edwards). PMID- 3546890 TI - Purification and characterization of hemagglutinin of Clostridium botulinum type C strain Stockholm. PMID- 3546891 TI - Histological and immunohistochemical studies on the architecture of lymph nodes in pig. PMID- 3546892 TI - Secretory responses of plasma insulin, glucagon, cortisol and glucose to heat exposure in calves. PMID- 3546893 TI - Challenges and goals. PMID- 3546894 TI - Nurses in prehospital care: preparation and regulation information sought. PMID- 3546895 TI - General treatments of household poisonings. PMID- 3546896 TI - Emergency nursing in Nepal. PMID- 3546897 TI - Specific treatments of poisoning by household products and medications. PMID- 3546898 TI - Common pathologic conditions in elderly persons: nursing assessment and intervention. PMID- 3546899 TI - Personality types of emergency nurses. PMID- 3546900 TI - Megatrends and health care in the late 1980s. PMID- 3546901 TI - To profess--to be a professional. PMID- 3546902 TI - Trichinosis: recent case reports and current intervention. PMID- 3546903 TI - A quick overview of the new standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care. PMID- 3546904 TI - Hospital liability to nonpatients: a case report. PMID- 3546905 TI - Standard of care for the adult patient with thermal injury. PMID- 3546906 TI - Triage of a patient exhibiting Hamman's crunch after a fall. PMID- 3546907 TI - Night shift. PMID- 3546908 TI - Elevation of infiltrating mononuclear phagocytes in human colorectal tumors. AB - The distribution of infiltrating monocytes-macrophages and T-lymphocytes in 45 primary colorectal tumors and 8 metastatic lymph nodes has been investigated by immunoperoxidase labeling with monoclonal antibodies (MoAbs). The number of lymphoreticular cells observed in tumor tissue, staged according to Dukes classification, was compared with paired normal tissue and between staged groups by statistical analysis. T-lymphocytes were not significantly elevated above the normal in either Dukes B or C stage tumors, although the IL-2 receptor (MoAb Tac) was expressed by varying numbers of T-cells in both groups. Mononuclear phagocytes increased numerically in both Dukes B (1.5-fold, P-value less than .01) and Dukes C tumors (2.5-fold, P-value less than .001) as compared to those in the uninvolved gut. In addition, the number of both total (MoAbs 3.9, 24) and stimulated mononuclear phagocytes expressing the C3b receptor (MoAb E11) was greater in metastasizing than in nonmetastasizing tumors (P-value less than .01). Thus the T-cell-to-monocyte ratio was altered from 2:1 in normal tissue to 1:1 in advanced tumors. The stromal environment around tumor cells in lymph nodes was similar to that of the primary tumor, but there was a reduction in the proportion of cells expressing the C3b receptor; unlike the primary tumor, there was virtually no infiltration of the tumor epithelium. Although there is a significant alteration in the mononuclear phagocyte population within colorectal tumors, there is no histologic evidence for a cytotoxic role for these cells. PMID- 3546909 TI - Characterization of a transplantable adenocarcinoma of the mouse colon producing cachexia in recipient animals. AB - MAC16 is a chemically induced, transplantable adenocarcinoma of the colon passaged in inbred NMRI mice. At small tumor burdens (less than 1% of the host weight), weight loss was observed without a reduction in food intake. As the tumor mass increased, weight loss also increased and reached 33% of host body weight in females and 20% in males when compared with the weight of age-matched controls. The reduction in host body weight was directly proportional to the tumor size and was reversible when the tumor was excised. There was a preferential loss of body fat in tumor-bearing animals with an increase in the plasma level of free fatty acids, although there was a minimal elevation of ketone bodies. Tumor growth was accompanied by progressive hypoglycemia and a reduction in the plasma insulin levels. The decrease in plasma insulin may have contributed to the catabolic effects of progressive tumor growth. PMID- 3546910 TI - Regarding mutagenic mucus in the cervix of smokers. PMID- 3546911 TI - Men of their time. PMID- 3546912 TI - Kentucky Dental Journal dedicates this issue ot the honor of Edward B. Gernert. PMID- 3546913 TI - Loss of glomerular responses to vasoconstrictor agents in rabbits recovering from ARF. AB - Glomerular responses to angiotensin II (AII), arginine vasopressin (AVP), and norepinephrine (NE) were estimated in rabbits recovering from uranium-mediated nephropathy or ischemic acute renal failure (ARF) to examine roles of intraglomerular events in resistance to ARF. Uranyl acetate (UA, 0.8 mg/kg) produced ARF in some animals but did not in others. Rabbits recovering from UA induced ARF were highly resistant to a rechallenge with a larger dose of the agent (2 mg/kg). Their glomeruli did not respond to AII, AVP and NE in vitro. In animals having not experienced ARF following the initial insult, however, resistance to the rechallenge was lower than in animals recovering from ARF, and the glomerular response to contractile stimuli was well sustained. A two hour clamping of the renal artery induced ARF in uninephrectomized rabbits. These animals were not resistant to an additional ischemia in the recovery phase, despite inhibited glomerular contractile responses to AII. These data indicate a nonspecific inhibition of glomerular responses to contractile stimuli in the recovery phase of ARF. It is unlikely, however, that resistance to ARF can be attributed to the loss of the glomerular contractile response. PMID- 3546914 TI - Augmented aldosterone and insulin responses to potassium infusion in dogs with renal failure. AB - The present study examines acute potassium-induced insulin and aldosterone responses in renal failure, and the role of chronic dietary potassium intake in modifying these acute responses. Plasma aldosterone (PA) and insulin (IRI) responses to acute KCl infusion were examined in control and remnant kidney dogs on two potassium intakes. Dogs (N = 8) received the KCl infusions after 10 days of a 60, and then 10 days of a 200, mEq daily potassium intake during control and after surgical-induced renal failure (CRF). A one hour intravenous infusion of KCl (2 mEq KCl/kg/hr) in dextrose and water was performed with blood samples for PA, IRI, creatinine and electrolytes, and urine for electrolytes and creatinine at 20 minute intervals one hour preceding, during, and after the infusion. Preinfusion PA was higher (P less than 0.05) in controls and CRF dogs on 200 mEq potassium intake compared to 60 mEq potassium intake. The peak incremental responses of PA to KCl infusion were increased (P less than 0.01) in CRF compared to controls on 60 mEq (PA 36 +/- 4.2 vs. 26 +/- 3.0 ng/dl) and 200 mEq (delta PA 49 +/- 5.6 vs. 37 +/- 2.8 ng/dl) potassium intakes. Differences in incremental PA responses in CRF were not due to altered aldosterone metabolic clearance rates, changes in renin, or ACTH activity. Pre-infusion IRI was higher (P less than 0.05) in CRF than control dogs on both potassium diets.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546916 TI - Cyclosporine nephrotoxicity. PMID- 3546917 TI - [Marie-Elise Kayser. Recollections on the occasion of her 100th birthday 28 November 1985]. PMID- 3546915 TI - Detection of both isotypes of complement C4, C4A and C4B, in normal human glomeruli. AB - Monoclonal antibodies reactive against the complement C4A and C4B isotypic components were used in an immunoperoxidase technique for the histological study of normal human renal tissue. Prominent staining with both antibodies was seen in the mesangial areas of all normal kidney sections investigated. Occasional staining of arteriolar walls of the same tissues, however, was also observed. In contrast, no mesangial staining was seen using monoclonal antibodies reactive against other 'early' complement components, such as C1q and C3. Specificity of the glomerular staining with the anti-C4 reagents was demonstrated in two patients possessing only the C4A serum component but lacking genetically the C4B locus products. As would be predicted, glomerular staining with the anti-C4A reagent, but not anti-C4B, was clearly demonstrable. It is concluded that both isotypes of complement C4 are present in normal human glomeruli and thus might be operative for normal mesangial function. PMID- 3546918 TI - [Peritoneal dialysis in the treatment of chronic renal failure]. PMID- 3546919 TI - [Ultrasonic indication of the great saphenous vein before the Troianov Trendelenburg operation]. PMID- 3546920 TI - [Suturing a lateral injury of the abdominal aorta]. PMID- 3546921 TI - [Surgical treatment of complications of median sternotomies (review of the literature)]. PMID- 3546922 TI - [Block transplantation of the abdominal organs (review of the literature)]. PMID- 3546923 TI - [Surgical treatment of cardiospasm]. PMID- 3546924 TI - [A calendar of anniversary dates in the history of surgery 1987]. PMID- 3546925 TI - [Surgical treatment of twists and loops of the brachiocephalic arteries]. PMID- 3546926 TI - [Echographic diagnosis and follow-up of traumatic hematomas of the spleen]. PMID- 3546927 TI - [Surgical methods of treating acute endo- and exotoxicoses]. PMID- 3546928 TI - [Subclavian steal syndrome demonstrated by ultrasonic Doppler sonography in a case of thromboembolism of the axillary and internal carotid arteries]. PMID- 3546929 TI - [Decembrists and the establishment of scientific-medical schools]. PMID- 3546930 TI - [A. P. Chekhov on S. P. Botkin]. PMID- 3546931 TI - [Status of the liver in different forms of pseudotuberculosis]. PMID- 3546932 TI - A comparison of blood plasma parameters in wild and laboratory meadow voles (Microtus pennsylvanicus). PMID- 3546934 TI - Development and evaluation of a microtiter plate enzyme immunoassay for antibodies to 3,3'-dichlorobenzidine. AB - The authors obtained and evaluated antisera from rabbits injected with a derivative of a potent bladder carcinogen, dichlorobenzidine (DCB), conjugated to bovine serum albumin (BSA). A 14C-radioimmunoassay (RIA) was able to detect the presence of DCB antibodies, but its relative insensitivity led to the development of a more sensitive enzyme immunoassay (EIA). The EIA test was a "sandwich" method in which a second antibody, labeled with an enzyme (horseradish peroxidase), was used to measure antibody binding to transferrin (Tf)-conjugated DCB immobilized on a microtiter plate. Antibody titers measured by RIA were approximately 1:40; when measured by EIA, they were approximately 1:40,000. Antibody specificity was assessed by comparing the antibody binding activities of DCB, BSA, Tf, BSA-conjugated to DCB, and a number of N-substituted aromatic compounds that included benzidine (Bz). Among the compounds tested, the rabbit antiserum reacted only with DCB and the carrier protein, BSA. Moreover, antibody binding activity to Tf-conjugated DCB was significantly inhibited by unconjugated DCB concentrations between 30 and 500 ng/mL. The precision of antibody binding activities as a function of DCB concentration (expressed by the CV) ranged from 9% for low (30 ng/mL) DCB levels to 12% for higher (500 ng/mL) levels. This evaluation suggests that the antiserum obtained would be appropriate for detecting DCB levels at the ng/mL level. PMID- 3546933 TI - Establishment and characterization of a neuroendocrine skin carcinoma cell line. AB - A neuroendocrine skin carcinoma cell line MKL-1 has been established from a nodal metastasis in a 26-year-old patient. The line grows as irregularly outlined, loosely packed floating aggregates lacking central necrosis. MKL-1 is hyperdiploid and has a mean doubling time of 120 hours. Xenografts of 2 X 10(7) MKL-1 cells produce tumors in nude mice at 4 to 6 weeks after subcutaneous inoculation. The xenografts were morphologically indistinguishable from the original skin primary and the nodal metastasis. Electron microscopy revealed sparse membrane-bound neurosecretory granules, and conspicuous, paranuclear aggregates of intermediate filaments. Immunohistochemical study showed diffuse and consistent staining with neuron-specific enolase, while bombesin, adrenocorticotrophic hormone, Leu-enkephalin, substance P, and vasoactive intestinal polypeptide displayed heterogeneous and variable expression. Uniform staining of all cells appearing as cytoplasmic fibrils and paranuclear aggregates was noted with antibodies to cytokeratin. Appreciable amounts of cytokeratin polypeptides 8, 18, and 19 and IT protein were seen on two-dimensional gel electrophoresis of cytoskeletal preparations from MKL-1 cells and from tumor-rich frozen sections. Immunostaining also showed coexpression of neurofilaments arranged in paranuclear aggregates; gel electrophoresis and immunoblotting demonstrated the presence in MKL-1 cells of prominent amounts of the small neurofilament polypeptide. Focal expression of desmoplakin was noted in the xenografts. The cells reacted with monoclonal antibodies anti-Leu-7 and anti-Leu M1 but did not react with antibodies to human lymphocyte antigens (HLA)-A, HLA-B, and HLA-C. Cytogenetic analysis revealed the presence of 3 chromosomally abnormal cell lines with the majority of metaphase cells demonstrating a gain of an isochromosome of the short arm of chromosome 5. Thus, MKL-1 cell line shares several characteristics with small cell neuroendocrine bronchopulmonary carcinoma cell lines but shows distinct cytogenetic abnormalities. PMID- 3546935 TI - Preliminary report: a new technique of enterotomy closure using Nd:YAG laser welding compared to suture repair. AB - This study compared the histology and tensile strength of Nd:YAG laser welded and sutured small bowel enterotomies in Sprague-Dawley rats. Enterotomies (0.5 cm long) were either welded with the Nd:YAG laser (1 W and 10.6 sec pulses) or repaired with interrupted, simple 6-O silk sutures. Group I consisted of seven animals; five with enterotomies repaired by laser welding and two repaired by suturing. Group II consisted of eight animals with each having both laser and suture repairs. Animals were killed and specimens were removed and examined at 1 day, and at 1, 2, and 3 weeks postoperatively to compare the progression of healing. On macroscopic examination the laser welded enterotomies were closed 84% of the time and only 23% had adhesion formation while 90% of sutured repairs were closed and 100% had adhesion formation. Histologic examination of both suture and laser welded enterotomies demonstrated active healing at 1 week with minimal collagen bridging the enterotomies. At 2 and 3 weeks the sutured enterotomies had granulomatous reaction around the sutures while the laser welded enterotomies had minimal inflammatory response and near normal small bowel histology. The tensile strength of the 3-week specimens from both the suture and laser welded enterotomies were 50% of normal bowel. These findings suggest that the laser welding of small bowel enterotomies is comparable in closure and tensile strength to suture repair. The time required to repair the enterotomy is significantly decreased, the procedure is easily performed, and there is a marked decrease in adhesion formation following laser repair. PMID- 3546936 TI - Pulsed Doppler frequency and carotid stenosis. AB - Two hundred and forty-two internal carotid arteries (ICA) were evaluated by independently interpreted arteriography and pulsed Doppler spectrum analysis using ultrasonic arteriography to evaluate the ability of peak systolic frequency (PSF) to predict the degree of internal carotid stenosis. Mean PSF in the 129 (53.3%) high grade ICA stenoses of greater than 50% diameter reduction was 6.55 +/- 0.14 (SEM) khz, while mean PSF in the 113 (46.7%) low grade (less than 50% diameter reduction) stenoses was 3.38 +/- 0.12 (SEM) kHz (P less than 0.0001). Receiver-operator characteristic (ROC) analysis revealed that PSFs of 4.5 kHz (sensitivity 87%, specificity 88%) and 5.0 kHz (sensitivity 83%, specificity 93%) were best for identifying a 50% diameter stenosis. Positive predictive value of 5.0 kHz was 93% (107/115) and negative predictive value was 82.7% (105/127). Linear regression analysis of PSF in kHz versus percentage diameter reduction yielded the equation: % stenosis = 10.7 (PSF) - 4.1 (r = 0.76). A nonlinear equation was also derived: % stenosis = 61.9 - 33.5 (PSF) + 8.7 (PSF)2 - 0.5 (PSF)3 (r = 0.77). Based on this analysis peak systolic frequency criteria measured by pulsed Doppler spectrum analysis appear to be useful for distinguishing high grade from low grade stenoses. Both the linear and nonlinear equations further suggest that PSF can more precisely quantitate the degree of ICA luminal narrowing. PMID- 3546937 TI - Growth factors and determinants of wound repair. AB - The application of contemporary biochemical, analytical, and production technology have, in part, clarified the physiologic processes and identified many new factors active in wound repair. A restructuring of the sequence of the reparative events for the wound environment followed the identification of an array of hormonal polypeptides and growth factors. Deterrents of the early phases of repair include neoplasms and therapeutic doses of steroidal and cytotoxic agents. The physiological effects of these agents are rapidly reversed following their removal with a resultant enhancement of wound tear strength and wound energy. The use of synthetic growth hormone and recombinant DNA-produced polypeptide may reverse the deleterious wound healing events initiated in the injured and tumor-bearing host. PMID- 3546938 TI - Prostacyclin and thromboxane in acute hemorrhagic pancreatitis in dogs. AB - To study the role of the vasodilatory, antiaggregatory prostacyclin (PGI2) and its endogenous antagonist thromboxane A2 (TxA2) in acute pancreatitis, we measured serum thromboxane B2 (TxB2, which indicates platelet TxA2 production) and plasma 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha, which indicates systemic PGI2 production) from sequential blood samples in trypsin and taurocholate induced acute canine hemorrhagic pancreatitis (AHP). In addition the effect of a prostaglandin synthesis inhibitor, ibuprofen, was studied and systemic (MAP) and pulmonary artery pressure (MPAP) were recorded for 4.5 hr. The animals were divided into a sham-operated group, an AHP group, an ibuprofen prophylaxis group, and an ibuprofen therapy group. In the sham group the parameters remained stable throughout the experiment. In the AHP group MAP decreased steadily and 6-keto-PGF1 alpha rose significantly from 80.0 +/- 7.8 to 956.0 +/- 287.0 pg/ml (P less than 0.001), whereas serum TxB2 and MPAP remained unchanged. Ibuprofen prophylaxis eliminated the initial fall in MAP and the rise of 6-keto-PGF1 alpha. Ibuprofen therapy normalized the initially decreased MAP and depressed the level of 6-keto-PGF1 alpha. We conclude that PGI2 may at least partly mediate the initial hypotension in canine AHP, whereas platelet TxA2 production obviously has a negligible role in the development of hemodynamic changes in AHP. PMID- 3546939 TI - PTFE graft treated with silver norfloxacin (AgNF): drug retention and resistance to bacterial challenge. AB - Norfloxacin (NF) and silver norfloxacin (AgNF) were used to coat polytetrafluoroethylene (PTFE) vascular prostheses by using triododecylmethylammonium chloride as a cationic surfactant. The relative retention of the drug on the graft after subjecting it to the biological environment for 3 weeks and antibacterial activity against coagulase-positive Staphylococcus aureus and Escherichia coli were determined. In addition, the ability of AgNF-coated PTFE grafts to sterilize perigraft tissue after mixed bacterial contamination was studied and compared with control PTFE grafts in 10 dogs. At the end of 21 days, 15 and 18% of AgNF were retained on the grafts tested in in vitro and in vivo experiments, respectively. During the same time AgNF-coated grafts from in vitro experiments exhibited significant antibacterial activity (25 mm zone of inhibition (z.i.)), but antibacterial activity was negligible (10 mm z.i.) in the grafts from in vivo experiments. NF retention on the grafts could not be determined because of spectral interference by blood. The antibacterial activity of NF-coated grafts significantly declined after 24 hr in in vivo experiments, hence further evaluation of NF-coated grafts was not done. Seven perigraft sites surrounding AgNF-coated grafts were sterile, but only one perigraft site surrounding control grafts was sterile (P less than 0.05). Cultures from six of nine perigraft infections surrounding control grafts yielded heavy bacterial growth. There was only one wound infection at the site of AgNF graft while there were seven severe wound infections at control graft sites. AgNF coated grafts exhibited prolonged antibacterial activity compared to NF-coated grafts and offered significant protection against infection from local bacterial contamination. PMID- 3546940 TI - Measurement of coronary blood flow: a critical review. PMID- 3546941 TI - A history of cancer in U.S. presidents. PMID- 3546942 TI - Management of diabetes mellitus in the home, office and hospital. PMID- 3546943 TI - Ovarian steroid production in rats treated with gonadotropin-releasing hormone during early pregnancy. AB - In the pregnant rat, luteinizing hormone (LH) stimulates the ovarian production of testosterone (T) which is aromatized to estradiol (E2). E2 promotes progesterone (P) synthesis by the ovary. To determine if the administration of gonadotropin-releasing hormone (GnRH) disrupts pregnancy by suppressing ovarian steroid production, rats were treated on days 7-12 of pregnancy with 25, 50 or 100 micrograms/day of GnRH or 0.2, 1 or 5 micrograms/day of a GnRH agonist (GnRH Ag). The higher two doses of GnRH or GnRH-Ag within 24 h suppressed peripheral levels of plasma P and terminated pregnancy within 48 h. By day 12, P levels in the ovarian vein in rats treated with GnRH or GnRH-Ag in respective doses were 2098 +/- 261, 732 +/- 437, 110 +/- 15, and 2575 +/- 463, 49 +/- 9, 43 +/- 8 compared to 1833 +/- 433 ng/ml in controls. Daily treatment of P (4 mg) and E2 (0.5 microgram) simultaneously with GnRH-Ag at its maximum dose reversed the abortifacient effect of GnRH-Ag and maintained pregnancy. Peripheral levels of Plasma LH in all groups were higher than controls on days 10 and 12. Ovarian vein levels of T on days 10 or 12 of pregnancy were either not significantly different from controls (at 2703 +/- 607 or 3249 +/- 690 pg/ml, respectively) or increased dramatically to 9547 +/- 1769 on day 10 and to 5985 +/- 1426 pg/ml on day 12 in rats treated with 0.2 microgram of GnRH-Ag. Similarly, ovarian vein levels of E2 on days 10 or 12 were either not significantly different from controls (at 2022 +/- 227 or 2793 +/- 184 pg/ml, respectively) or increased dramatically to 2980 +/ 58 pg/ml on day 10 in rats treated with 25 micrograms of GnRH or to 3296 +/- 241 on day 10 and to 3420 +/- 325 pg/ml on day 12 in rats treated with 0.2 microgram of GnRH-Ag. These results indicate that the abortifacient effect of GnRH administration in rats is not due to its effect on the uterus, but to its suppressive effects on ovarian P secretion. There was no evidence to show that a GnRH-induced fall in ovarian secretion of either T or E2 were involved in this process. PMID- 3546944 TI - The measurement of 11 beta-hydroxy-4-pregnene-3,20-dione (21-deoxycorticosterone) by radioimmunoassay in human plasma. AB - A specific radioimmunoassay (RIA) method is described for the determination of 21 deoxycorticosterone (21 DB) in human plasma. 21-Deoxycorticosterone-3-(O carboxymethyl) oxime-bovine serum albumin conjugate was used to generate antisera in rabbits. Steroids which reacted significantly with the antisera were found to be progesterone, pregnenolone, corticosterone and 11-oxo progesterone. However, after extraction of plasma and column chromatography on Celite, all these steroids were separated from 21-deoxycorticosterone and consequently did not interfere with the radioimmunoassay. The intra- and interassays coefficients of variation were 8% and 11% respectively. Mean plasma 21-deoxycorticosterone level for healthy subjects was very low: 17.8 +/- 14.8 pmol/l (mean +/- SD) with no statistical difference between males and females. During the ACTH stimulation test, the 21-deoxycorticosterone levels of healthy subjects increased to 84.7 +/- 26.3 pmol/l (mean +/- SD) for males and 79.3 +/- 31.6 pmol/l (mean +/- SD) for females. Consequently high levels of plasma 21-deoxycorticosterone were found in treated patients suffering from congenital adrenal hyperplasia (CAH) with 21 hydroxylase deficiency, particularly in CAH salt-losers with high plasma renin activity (PRA), where the plasma level reached 40,545 pmol/l. Thus, 21 deoxycorticosterone may be a new marker for adrenal 21-hydroxylase deficiency. PMID- 3546945 TI - A simple procedure for enzyme labelling of progesterone derivatives: application of active esters formed using N,N'-disuccinimidyl carbonate. AB - N,N'-Disuccinimidyl carbonate was used to synthesize N-hydroxysuccinimide esters of 11 alpha-hydroxyprogesterone 11-[1,4-14C]hemisuccinate (P11-HS) and 11 alpha hydroxyprogesterone 11-glucuronide (P11-Glu) in a one-step procedure at room temperature. Enzyme-labelled progesterone was subsequently formed by reaction of the ester, without purification, with alkaline phosphatase. Labels produced by this simple procedure compared favourably with those formed using an established method of ester synthesis when assessed in enzyme immunoassay (EIA). PMID- 3546946 TI - Immunoelectron microscopic localization of progesterone receptor in the chick oviduct. AB - A peroxidase-anti-peroxidase (PAP) method using polyclonal anti-PR antibodies was used to localize progesterone receptor (PR) electron microscopically in the chick oviduct. The immunoreaction precipitate indicating PR was localized inside the nuclei of epithelial, glandular and stromal cells. In the estrogen withdrawn oviduct cytoplasmic immunoreaction precipitate was not seen. Inside the nucleus unoccupied PR was localized mainly like the heterochromatin. As visualized by the PAP technique, the localization of PR was not systematically changed after progesterone administration. In conclusion, we suggest that progesterone receptor in the chick oviduct is an intranuclear protein. PMID- 3546947 TI - Endotoxin-induced changes in sex steroid hormone levels in male rats. AB - Intravenous administration of Escherichia coli endotoxin (ENDO) was found to induce profound time and dose dependent changes in the serum steroid hormones, oestrone (E1), oestradiol (E2), corticosterone (B), progesterone (P4), 17 alpha OH progesterone (17 alpha OHP4), and testosterone (T) of intact male rats. These changes were rapid, with a maximal response at 2 h and a return to close to normal values by 4 h. Non-lethal doses (0.01-2 mg/kg) of ENDO induced large increases in oestrogens (3-9-fold), P4 (4-fold) and B (2-3-fold) and decreased serum T (2-fold). The greatest increase in E2 level was seen with an ENDO dose of 2 mg/kg. Serum E1, E2 and T did not change in response to lethal ENDO doses (4-8 mg/kg); B, P4 and 17 alpha OHP4 levels alone were moderately elevated. Systemic mean arterial pressure was unchanged, except at the highest ENDO dose used. Thus, the hormonal responses are unlikely to be the result of hemodynamic changes. Low doses of ENDO did not produce an increase in serum E1 and E2 in adrenalectomized or orchidectomized rats. These results indicate that oestrogens are largely produced in the testis. The aromatization of the testicular and adrenal androgens can be stimulated by glucocorticoid. PMID- 3546948 TI - Intracaval extension of pheochromocytoma simulating pulmonary embolism. AB - Pheochromocytoma, a chromaffin tumor of the sympathoadrenal nervous system, rarely exhibits direct extension into the inferior vena cava. We report a patient with a right adrenal pheochromocytoma that caused symptoms of recurrent pulmonary emboli. Intracaval extension of the tumor was detected during investigations for the source of the emboli by abdominal CT scan, ultrasonography, and venacavography. The biochemical diagnosis of pheochromocytoma was confirmed by sharply elevated catecholamine, metanephrine, and VMA urinary levels, which returned to normal upon resection of the tumor. The patient had no evidence of metastatic disease. PMID- 3546949 TI - Randomized trial of the addition of cis-platin (DDP) and/or BCG to cyclophosphamide (CTX) chemotherapy for ovarian carcinoma. AB - A prospective randomized trial has compared cyclophosphamide (CTX) with CTX plus cis-diamminodichloroplatinum (DDP) as the initial chemotherapy for advanced ovarian carcinoma. A secondary randomization compared the addition of BCG treatment to either chemotherapy. The addition of DDP had no measurable impact on survival, but a small survival trend favoring BCG-treated patients was noted (P less than 0.08). Toxicity from BCG treatment was insignificant, but the addition of DDP increased both early nausea and vomiting and later hematologic toxicity. There were three long-term complete remission patients, and these all came from the group of six patients with pretreatment residual disease less than 2 cm. A univariate analysis of pretreatment prognostic factors indicated significantly better prognosis (P less than 0.02) for patients with no palpable tumor, platelet count less than 400,000/mm3, residual tumor less than 2 cm, resting pulse less than 91/min. and LDH less than 250 U/L. The authors conclude that for patients with large (greater than 2 cm) residual disease, there is no compelling evidence that initial combination therapy is superior to aggressive single alkylating agent treatment. PMID- 3546950 TI - Leiomyosarcoma of the scrotum. AB - A case of leiomyosarcoma arising from the dartos muscle of the scrotum is described. Review of the literature reveals only eight other cases, and aspects of management of these and our case are discussed. PMID- 3546951 TI - Liposarcoma of the spermatic cord: case report and review of the literature. AB - This report describes a patient with liposarcoma of the spermatic cord. The clinical presentation, pathogenesis, and prognosis of this unusual sarcoma are reviewed. The low-grade malignant potential and irregular growth characteristics of this liposarcoma render preoperative diagnosis difficult. The role of radical orchiectomy, retroperitoneal lymph node dissection, radiation therapy, and chemotherapy in the treatment of spermatic cord sarcomas is discussed. PMID- 3546952 TI - Metastatic colon carcinoma to the jaw: a case report and review of the literature. AB - Presented is a case of adenocarcinoma of the cecum metastatic to the anterior mandible. The patient had a Duke's C2 cecal adenocarcinoma resected twenty months prior to her development of loose teeth, jaw pain, and jaw mass. A biopsy of the mass revealed metastatic adenocarcinoma, identical to her primary neoplasm. Metastatic carcinoma to the mandible is a rare event. A review of the literature reveals only nineteen cases of colon carcinoma metastatic to the jaw. When further subdivided, there is only one other case of cecal adenocarcinoma metastasizing to the jaw. Almost half of the other cases have been rectal carcinomas. Treatment of these patients has been uniformly unsuccessful, with life expectancy reported between one and seven months. The literature has shown that 5-FU and radiotherapy may produce palliation of symptoms. The patient presented here responded well to 5-FU and radiotherapy. PMID- 3546953 TI - [Neuropeptidases responsible for the inactivation of enkephalins and the pharmacology of their inhibitors]. PMID- 3546954 TI - Ethnobotanical review of medicinal plants from Thai traditional books, Part I: Plants with anti-inflammatory, anti-asthmatic and antihypertensive properties. AB - A survey of medicinal plants used in Thailand has been made from Thai books on traditional herbal medicine. In this part of the survey, plants with anti inflammatory, anti-asthmatic and antihypertensive properties including plant part used and methods of preparation and administration are described. PMID- 3546955 TI - Bronchial anastomosis with a tissue adhesive. AB - Air leakage and necrotic degeneration may occur after bronchial anastomosis and can lead to death from secondary pneumothorax and pneumonia. We studied the ability of a new tissue adhesive (N-butyl-cyanoacrylate monomer) to enforce the bronchial suture line. The left main bronchus in each of five pigs in Group A was completely transected and closed by four stitches and tissue adhesive. The transected left main bronchus in each of the other five pigs in Group B was connected with 11 to 14 interrupted polyglycolic acid 3-0 sutures. The time required for reconstruction was 10 +/- 3.6 minutes in Group A and 25.0 +/- 6.5 minutes in Group B. No symptoms of a constricted airway were apparent in Group A. All pigs were examined at an interval of from 5 to 8 weeks after operation. Evidence of infection at the bronchus appeared in three animals: two in Group A and one in Group B. One instance of air leakage at the anastomosis occurred in Group B. We measured the maximum tensile strength of the bronchial suture line by means of an electromechanical testing machine comparing the tensile strength of the treated left bronchus with that of the control right bronchus. The maximum tension of the treated bronchus in Group A was 10.3 +/- 1.52 (pounds) and that of control was 8.0 +/- 1.56 (pounds) (p less than 0.05). The maximum tension of Group B was 7.93 +/- 0.29 (pounds) on the treated side and 6.78 +/- 0.32 (pounds) on the control side (p less than 0.05). The suture line with tissue adhesive was enforced sufficiently to act as a stable connective tissue. Histologic studies in Group A revealed that the suture line was completely healed without tissue damage and was strengthened by the tissue adhesive. PMID- 3546956 TI - Donor marrow progenitors (CFU-Mix, BFU-E and CFU-GM) and haemopoietic engraftment following HLA matched sibling bone marrow transplantation. AB - Bone marrow multipotent (CFU-Mix) and unipotent (CFU-GM and BFU-E) progenitor cells in the donor marrow inoculums were measured in 24 histocompatible sibling bone marrow transplants. The number of donor marrow nucleated cells, CFU-Mix, CFU GM and BFU-E given per kilogram (kg) of recipient's body weight were 2.4 +/- 0.6 X 10(8), 3.6 +/- 4.2 X 10(3), 4.9 +/- 3.3 X 10(-4) and 4.3 +/- 4.1 X 10(4) respectively (mean +/- S.D.). Fast engraftment patients, as assessed by rise in peripheral blood neutrophils (greater than or equal to 0.5 and greater than or equal to 1.0 X 10(9)/l) and platelets (greater than 20 and greater than 50 X 10(9)/l), received a significantly greater amount of CFU-Mix/kg (greater than 3 X 10(3)/kg, p less than 0.025) and CFU-GM/kg (greater than 3 X 10(4)/kg, p less than 0.05 except for plat greater than or equal to 20 X 10(9)/l) than the slow recovery patients. Significant correlations were found between the donor CFU Mix/kg infused and neutrophil recovery to 1 X 10(9)/l and platelet to 50 X 10(9)/l (Spearman's rank correlation coefficient r = 0.38, p = 0.04 and r = 0.58, p = 0.003, respectively). The amount of donor CFU-GM/kg given also correlated significantly to neutrophil (1 X 10(9)/l) and platelet (50 X 10(9)/l) recovery, (r = 0.33 and r = 0.37, respectively, p less than or equal to 0.05). There was no association between BFU-E, and marrow nucleated cells infused per kg and haemopoietic recovery. A number of clinical parameters were also examined to determine other factors that may influence the rate of engraftment. Acute graft vs host disease (greater than or equal to grade II) and methotrexate therapy post transplant delayed the platelet regeneration. The results of the present report indicate that in vitro measurement of donor CFU-Mix and CFU-GM progenitors infused, correlate with the speed of granulocyte and platelet recovery in clinical allogeneic bone marrow transplants. PMID- 3546957 TI - Localization of the main noradrenergic neuron groups in the pons and medulla of the rabbit and the importance of cathodal lesions for prolonged survival. AB - Methods for stereotaxically localizing the major noradrenergic (NA) cell groups (i.e. A1, A2, A5 and A6 + A7) in the rabbit are described. Using a modified Kopf head holder we used surface landmarks including the obex for making lesions of the A1 and A2 cells in the medulla. Localization of the pontine cell groups was done by mapping intracerebral structures including the facial nerve for A5 and the motor nucleus of the trigeminal nerve for A6 + A7. In the initial experiments we made A1 lesions by passing anodal currents through stainless steel electrodes, which was associated with pulmonary oedema, neurological complications and a high mortality. This syndrome was probably related to toxic effects of ferric ion deposition, and disappeared when cathodal currents were employed. We have now made 106 bilateral cathodal lesions in the different groups, with a 20% intraoperative mortality. But virtually all survivors remained indefinitely in clinically good condition for the 2-4 weeks duration of our experiments. In 65 of these rabbits we achieved greater than 75% of NA cell destruction (average 84%). From the cardiovascular viewpoint 'non-specific' damage by the lesions was relatively small, except after A2 lesions where there was some impairment in the baroreceptor-heart rate reflex, though a considerable amount of residual function remained. PMID- 3546958 TI - A novel spinal cord slice preparation from the rat. AB - A spinal cord slice preparation is described. The lumbar enlargement of weanling rats is exposed by laminectomy, the dorsal and ventral roots cut and a portion of cord consisting of about 4 segments removed and chilled to 3 degrees C. A modified tissue chopper is used to produce 400 micron dorsoventral longitudinal slices. The slices are maintained in a low-volume, continuously perfused tissue chamber at the interface between warm moist 95% O2/5% CO2 and oxygenated artificial cerebrospinal fluid, and remain viable for over 8 h. An extracellular recording of excitatory amino acid-induced activity of a dorsal horn lamina IV cell is shown. Excitatory amino acid antagonists applied iontophoretically and in the perfusate have actions similar to those in the adult spinal cord in vivo. This in vitro preparation of the cord has permitted stable extracellular recordings from single cells of 2 h or more, and has the potential for intracellular investigation of spinal cord neurones. PMID- 3546959 TI - Purification of adrenal chromaffin cells on Renografin gradients. AB - Bovine adrenal medullary cells purified on discontinuous gradients of the radiopaque contrast agent Renografin contained about 20% more catecholamine than those prepared by centrifugation on Percoll gradients, a standard method for chromaffin cell purification. Catecholamine recoveries by the two methods were similar, suggesting increased purity in the Renografin preparation. Neutral red staining indicated that the cells prepared on Renografin gradients were approximately 90% chromaffin cells, compared to an average of 75% chromaffin cell purity obtained following centrifugation on self-generated gradients of Percoll. Cells purified on Renografin gradients were equivalent to Percoll-prepared cells by the criteria of maintenance in culture and secretory activity. Thus, density gradient centrifugation in Renografin is a rapid technique for producing adrenal medullary chromaffin cells of high purity and is superior to Percoll gradient centrifugation for this purpose. PMID- 3546960 TI - [History of nursing in Okinawa. An interview with Ms. Nobu Madamubashi. 12]. PMID- 3546961 TI - Localization of interleukin-1 in normal or reactive lymphoid tissues and skin: abundance of IL-1 in interdigitating reticulum cells. AB - The distribution of interleukin 1 producing cells was determined in the human lymphoid tissues and skin using immunohistochemical staining and a rabbit anti interleukin-1 antibody. Interleukin-1 was detected mainly in the interdigitating reticulum cells localized in the T cell zone. Approximately, 10-30% of the histiocytes were also positively stained by anti-interleukin-1. The results suggests that interdigitating reticulum cells may play an important role in the initiation and amplification of T-cell immunity. PMID- 3546962 TI - Monokine mediated release of intracellular iron in tumor target cells in vitro. AB - Activated macrophages cocultured with tumor cells mediate intracellular iron release in both lytically-sensitive and lytically-resistant targets. The early inhibition of aconitase and loss of intracellular iron in tumor targets upon coincubation with activated macrophages have been proposed to be causally linked. In this report we demonstrate that release of iron may be monokine mediated. The monokine is rapidly released from murine BCG-activated peritoneal macrophages after endotoxin triggering, reaching peak levels in the supernatant within 2-4 hr. The response of the target depends on both the dose of the monokine administered and the duration of its exposure. The monokine is heat-labile and is retained by ultrafiltration on a YM-10 membrane. Iron-release is not mediated by a cytolytic factor secreted by activated macrophages, nor by a factor which causes reversible lesions in the electron transport chain. The molecular weight of the iron-releasing monokine is approximately 50 kD as determined by HPLC gel filtration on Superose 12. PMID- 3546964 TI - Therapeutic use of propranolol for intermittent explosive disorder. AB - Intermittent explosive disorder is a syndrome characterized by episodic sudden outbursts of verbal abuse and physical violence in response to minor provocations. Propranolol has been proposed as a promising treatment for this cause of violent behavior. Of eight Mayo Clinic patients with intermittent explosive disorder who had been treated with propranolol between 1983 and 1985, five had substantial diminution or complete remission of symptoms. This response confirms the previously published reports of the effectiveness of propranolol in the treatment of intermittent explosive disorder. PMID- 3546963 TI - Recent advances in the understanding of the biochemistry and clinical pharmacology of interleukin-2. AB - This review covers significant developments in the understanding of the biochemistry and clinical pharmacology of Interleukin-2 (IL-2) that were achieved from 1984 through September 1986. These include developments in the molecular biology of IL-2 and its receptors. Human IL-2 was cloned and sequenced by Taniguchi et al. in 1983. The gene for human IL-2 is located on the long arm of chromosome 4. The secondary structure of the gene is predominantly alpha helix. The mature gene product is a 133 amino acid glycoprotein with a molecular weight of 15,420 Daltons. The IL-2 receptor was revealed to be a glycoprotein of 272 amino acids. The mature receptor has a molecular weight of 55,000 Daltons. A more precise understanding of the mechanism of action IL-2, in particular its role in the induction of the IL-2 receptor, and aspects of the control of IL-2 production was also achieved. Metabolic and morphologic studies have revealed that activation of the T-cell antigen receptor renders the cells responsive to IL-2, but does not move them through the cell cycle. Rather, it appears that IL-2 stimulates G1 progression to S phase ie. blastic transformation. During this progression the cellular proto-oncogene c-myb is induced transiently to 6 to 7 times basal levels. The role of IL-2 as a growth factor for several subsets of T cells has been confirmed, and a new role as a growth factor for B cells was defined. Most importantly, IL-2 was shown to be directly mitogenic for and to expand subpopulations of peripheral blood cells, termed lymphokine-activated killer (LAK) cells and tumor-infiltrating lymphocytes (TIL). A number of pathologies of IL-2 production or activity have been defined, including Hodgkin's disease, graft versus host disease, systemic lupus erythematosus, lepromatous leprosy, acquired immune deficiency syndrome, and adult T cell leukemia. Murine and human in vivo studies reviewed here have revealed significant parameters of the therapeutic potential as well as the toxicity of this growth factor. Finally, the modulation of IL-2 receptors on human PBL's by thymosin fraction 5 and thymosin alpha 1 suggests that it might be possible to up-regulate IL-2 receptor expression in certain disease states and thus increase the efficacy of IL-2. PMID- 3546965 TI - Ernst von Bergmann: pioneer of aseptic methods. PMID- 3546966 TI - Nucleic acid hybridization: from research tool to routine diagnostic method. AB - The nucleic acid hybridization reaction is extremely specific and thus a valuable tool for the identification of genes or organism of interest. The increasing use of nucleic acid hybridization in applied fields like diagnostic medicine has led to the development of more convenient hybridization assays than those originally used in basic research. In conventional nucleic acid hybridization methods immobilized nucleic acids are detected on a filter by a radiolabelled probe. Sandwich hybridization is a simple test format for the analysis of unpurified biological material, but has the disadvantage of a slow reaction rate. Solution hybridization methods are fast and easy to perform provided that a method to separate the formed hybrids from the reaction mixture is available. In non isotopic detection the nucleic acid probe is modified with a chemical group, which is identified with a labelled detector molecule after hybridization. The low sensitivity of detection is the main problem in nucleic acid hybridization methods. Procedures to amplify the detectable signal or the amount of detectable nucleic acid sequences are potential solutions to this problem. The new hybridization methods have successfully been used for some applications, but still need to be combined into well performing tests to be applicable to any desired purpose. PMID- 3546967 TI - A possible biological function of carbohydrate structures which are typical of erythrocytes. AB - Carbohydrates of erythrocyte glycoconjugates seem to be specifically designed so that they do not appreciably interact with other types of cells or ligands. This applies to glycosphingolipids (GSLs) and glycoproteins (GPs). An important distinction between the two types of glycoconjugates seems to be that GPs, apart from carrying carbohydrates, have some biological function which is most likely associated with their protein moieties. GSLs of erythrocytes, including the ABH, PP1 and Pk blood group substances, are viewed as energetically cheap membrane packing substances filling in the membrane areas not covered by functional GPs. Their sole function should be the formation of inert carbohydrate protective layer at the membrane. The role of the inert carbohydrate structures in the development, tumorigenesis and evolution of blood group polymorphism is discussed. PMID- 3546968 TI - Including a measure of health status in Medicare's health maintenance organization capitation formula: reliability issues. AB - Medicare's formula for determining capitation levels for risk-based HMOs, the Adjusted Average Per Capita Cost (AAPCC), has been criticized as a poor basis for establishing payments. Among new adjusting factors suggested for the formula is a measure of beneficiaries' functional health status. The ability of such a measure to improve predictions of Medicare costs has been demonstrated in several studies. In addition to possessing predictive validity, a measure considered for inclusion in the AAPCC must also be reliable. In this paper, the authors examine a measure of functional health status for intrarater reliability or, equivalently, stability over time. A sample of 1,616 Medicare beneficiaries was surveyed twice--in late 1982 and in January 1984. Using a five-point scale, functional health status scores were calculated for each of the beneficiaries at two points in time. For 68.4% of the sample, functional health scores were unchanged over the year, and second-year scores were within one point of first year scores for 94.3% of the sample. Based on the intraclass correlation coefficient, the scores on this functional health scale demonstrated substantial to "almost perfect" agreement over the 1-year period. PMID- 3546969 TI - Use of health care before and during Citicare. AB - The Citicare program was implemented in Jefferson County, Kentucky, between July 1982 and June 1983. Approximately 40,000 AFDC-related Medicaid recipients were enrolled. Granted federal waivers, the program established a primary care network with capitation payment and physician sharing of savings. Interviews were conducted with 300 recipients just prior to the program and with 348 recipients 1 year later. No changes occurred in the rate of hospital inpatient stays, ambulatory care, or prescribed drugs. There was, however, a 40% reduction in hospital emergency room use and a shift in the locus of care from doctors' offices to health centers and clinics. Recipients' perceptions of the quality of care received in health centers and clinics increased, but declined for care in physicians' offices. Although the program met most of its objectives, it did not gain physician support and was terminated by a new governor. PMID- 3546970 TI - The future of kidney transplantation. The effect of improvements in survival rate on the shortage of donated kidneys. AB - New drugs and other medical advances in organ transplantation are expected to increase the rate of retention of transplanted kidneys, or grafts, and therefore also raise patient survival rates. In particular, the immunosuppressive drug cyclosporine has been found to reduce the likelihood of rejection of a transplanted kidney by the immune system of the transplant recipient. A critical issue is the effect changes in the graft and patient survival rates will have on the current shortage of donated kidneys. On one hand, higher survival rates may decrease the demand for transplants, as fewer people require a second or third transplant following the failure of a previous one. On the other hand, however, demand for first-time transplants may increase as more end-stage renal disease (ESRD) patients perceive transplantation as a more successful, and therefore more desirable, procedure. We used a simulation model to estimate the net effect of these changes. The results show that, all else being held constant, the increase in the survival rate resulting from medical advances could alleviate the current kidney shortage. However, if higher survival rates lead to an increased demand for transplants, the net effect would be a substantial aggravation of the current shortage of donated kidneys. That would force regional organ procurement agencies and other concerned organizations to attempt unprecedented increases in kidney donations ranging from 50% to 300% over the current rate. PMID- 3546971 TI - [Possibility of maintaining optimal metabolic control in pregnant patients with insulin-dependent diabetes]. PMID- 3546972 TI - [Airport malaria in Spain]. PMID- 3546973 TI - [Enteritis caused by serotype 028ac:H- enteroinvader Escherichia coli]. PMID- 3546974 TI - [Group A beta-hemolytic Streptococcus bacteremia]. PMID- 3546975 TI - [Acute megakaryoblastic leukemia (M7). Immunocytochemical and ultrastructural study of 2 cases]. PMID- 3546976 TI - [Renin-secreting juxtaglomerular cell tumor]. PMID- 3546977 TI - [Vasopressinergic system. I]. PMID- 3546978 TI - Anatomy, physiology, and neuropharmacology of cancer pain. AB - The anatomy, physiology, and pharmacology of nociception and its modification by analgesic drugs have been studied extensively in the past decade. Although the neural mechanisms of nociceptors and the stimuli that activate them are much better understood, it must be emphasized that the perception of pain, as well as the meaning of pain to the individual, is a complex behavioral phenomenon and involves psychologic and emotional processes in addition to activation of nociceptive pathways. Pain related to malignant disease can be classified as somatic, visceral, and deafferentation in type. Somatic pain and visceral pain involve direct activation of nociceptors and are often a complication of tumor infiltration of tissues or injury of tissues as a consequence of cancer therapy. The management of this type of pain is typically accomplished by treating the tumor (with surgery, chemotherapy, and/or radiation therapy) and by using the appropriate non-narcotic, narcotic, and adjuvant analgesic agents. Neuroablative therapies may be helpful in specific circumstances. For example, cordotomy may be helpful for unilateral pain below the waist in patients with somatic and visceral pain. This procedure may also be helpful for early deafferentiation pain (i.e., lumbosacral plexopathy) in which peripheral nerves are compressed but not infiltrated or destroyed by metastatic tumor growth. Deafferentiation pain may be a complication of tumor infiltration of peripheral nerve or of cancer therapy that injures neural tissue. This type of pain is often poorly tolerated and difficult to control, particularly if not treated early and aggressively. Although incompletely understood, the pathophysiology of deafferentation pain appears to be different from that of somatic or visceral pain, and the treatment approaches may be different. Management approaches to deafferentation pain usually emphasize treatment of the pain, because injury to the nervous system may be difficult to reverse, even if one can successfully treat the underlying malignancy, and many deafferentation pain syndromes occur as a complication of cancer therapy. The role of narcotic analgesics in the management of deafferentation pain is not clear, although the published experience suggests that they are less useful than in somatic or visceral pain. PMID- 3546979 TI - Pain syndromes in patients with cancer. AB - A series of common pain syndromes in patients with pain and cancer includes pain associated with direct tumor infiltration, pain resulting from cancer therapy, and pain unrelated to the cancer or cancer therapy. Appropriate management is dependent on their careful evaluation. PMID- 3546980 TI - The cancer patient with pain: psychiatric complications and their management. AB - The psychiatric complications most often seen in cancer are depression, anxiety, and delirium. All are more likely to occur in the cancer patient who has pain. It is important for patient comfort and quality of life to evaluate and intervene to manage the psychologic distress in the patient with cancer, especially if pain is a complication. PMID- 3546981 TI - The management of chemotherapy-induced nausea and vomiting. AB - This paper reviews one of the major side-effects of chemotherapy, emesis. Included are patient and treatment factors that can affect the control of nausea and vomiting as well as a summary of the management of chemotherapy-induced emesis. PMID- 3546982 TI - [The man behind the syndrome: Charles Bell. The surgeon at Waterloo who became a pioneer in neurology]. PMID- 3546983 TI - [Is cerebral angiography of organ donors dangerous in kidney transplantation?]. PMID- 3546984 TI - [Neutropenia--causes, mechanism and therapy]. PMID- 3546985 TI - [Microsurgical bile duct anastomosis: animal experiment and clinical study]. AB - In 10 Gottingen-minipigs an end-to-end anastomosis of the normal common bile duct was accomplished under the microscope with 11/0 Polygalactin-sutures. Biliary flow was controlled by serum concentration of alkaline phosphatase, by cholangiography and by dynamic hepato-biliary scintigraphy 2 weeks, and 3 and 6 months after the operation. Anastomoses were judged by macroscopic, microscopic and scanning electronmicroscopic examination 6 or 12 months postoperatively. The anastomoses presented no stenosis at all, only a light periductal fibrosis with intact luminal epithelium. Alkaline phosphatases and cholangiography showed a normal pattern, the scintigraphy presented dyskinesia after 2 weeks and normal flow at the later controls. After a microsurgical operation one patient showed a normal anastomosis after 6 months. A biliary anastomosis should be made by microscope in all patients with a long life span and unchanged bile duct wall in spite of the more difficult operation. PMID- 3546986 TI - Alveolar rhabdomyosarcoma of the larynx: case report and literature review. AB - We report the 11th well-documented case of laryngeal rhabdomyosarcoma and only the second of laryngeal alveolar rhabdomyosarcoma. The optimum treatment of head and neck rhabdomyosarcoma has not yet been defined, but it appears that the ideal should consist of an aggressive multimodality approach. This includes surgical extirpation if it can be done without major morbidity, postoperative radiotherapy with a margin around known and suspected disease, and multiagent chemotherapy. Unlike most sarcomas, rhabdomyosarcoma (especially alveolar rhabdomyosarcoma) spreads by way of the lymphatic system as well as the blood stream. Inclusion of the draining lymphatics in the radiation field must be given strong consideration. PMID- 3546987 TI - Myofacial pain dysfunction: analysis of 476 patients. PMID- 3546988 TI - Effects of calcium and parathyroid hormone on prostacyclin synthesis by vascular tissue. AB - Prostacyclin generation by rat aortic rings was studied at different calcium concentrations. Extracellular calcium influenced prostacyclin synthesis, as reflected by the release of 6-keto-PGF1 alpha into the medium, in a concentration dependent fashion. Calcium levels beyond the physiological range (1.12-1.25 mM unbound calcium) markedly stimulated 6-keto-PGF1 alpha production when compared with calcium-free solutions. On the other hand, addition of purified parathyroid hormone did not change 6-keto-PGF1 alpha production at any calcium concentration tested. These data suggest that parathyroid hormone has no direct effect on prostacyclin synthesis by vascular tissue, although it might influence prostacyclin generation through changes in extracellular calcium levels. PMID- 3546989 TI - Alterations in amphetamine stereotypy following acute lesions of substantia nigra. AB - Stereotypy induced by high doses of amphetamine has been related to the ability of this drug to increase the release of dopamine in the caudate nucleus and to block its reuptake. Since amphetamine-stimulated dopamine release in the caudate is blocked by acute lesions of the nigrostriatal pathway, the mechanism by which amphetamine acts to produce stereotypy may be dependent upon intact nigrostriatal impulse flow. The present study examined the involvement of nigrostriatal impulse flow in amphetamine stereotypy by determining the effect of acute, bilateral lesions of substantia nigra pars compacta on measures of stimulant-induced stereotypy and motility. Acute nigral lesions did not significantly alter the stereotypy or motility induced by 3.0 or 6.0 mg/kg amphetamine. These results suggest that the observed behavioral effects of amphetamine do not require an intact nigrostriatal pathway, and thus may involve changes in spontaneous release or reuptake of dopamine rather than in changes in impulse-coupled dopamine release. PMID- 3546990 TI - Computerized anatomy instruction. PMID- 3546991 TI - Clinical research system. PMID- 3546992 TI - The future of medical education: beyond CAI. PMID- 3546993 TI - Computer-aided education. PMID- 3546994 TI - An introduction to PILOT. PMID- 3546995 TI - CPR training by computer. PMID- 3546996 TI - GasMan. PMID- 3546997 TI - Computers in medical education: observations from 15 years' experience. PMID- 3546998 TI - Comparative pharmacology of 'non-opioid' analgesics. AB - Pain is the most prominent symptom of disease in man and analgesics are the most widely used drugs. More than 90% of the analgesics used belong to the so-called peripherally acting, non-opioid (non-narcotic) or mild analgesics. They all derive from 3 types of compounds: aspirin and other acidic non-steroidal anti inflammatory drugs (NSAIDs), aniline derivatives such as paracetamol (acetaminophen) and non-acidic pyrazole drugs like propyphenazone and dipyrone (metamizole). These compounds and all of their derivatives differ in their analgesic activity and their typical profile of side effects. While NSAIDs are particularly useful in the treatment of pain related to inflammation these compounds are well known to cause gastrointestinal, haematological and kidney side effects. Aniline derivatives such as paracetamol are not very effective analgesics, but reasonably good antipyretics. These compounds, unlike aspirin like drugs, do not interfere with inflammatory pain. Their main side effects are allergic but, particularly at overdose, they cause liver and kidney damage. Rarely, they have also been associated with kidney damage and malignomas of the urinary system after long term administration. Non-acidic pyrazole drugs are supposedly particularly active in pain originating from spasms of smooth muscles. They are not very effective anti-inflammatory drugs but are good antipyretics. Their major side effects consist of mild allergic reactions. They have also rarely been associated with agranulocytosis and shock. In addition to these differences in therapeutic application and side effect profile the major representatives of the groups of analgesics mentioned differ in their pharmacokinetic behaviour in the human body. Aspirin shows non-linear pharmacokinetics not seen with ibuprofen, a more modern NSAID.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3546999 TI - Renal toxicity of non-narcotic analgesics. At-risk patients and prescribing applications. AB - Acute and chronic renal damage may occur with many analgesics. Acute effects on the kidney occur mainly with aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). One of the most obvious effects in healthy individuals is fluid retention which is thought to be mediated through inhibition of the renal effects of prostaglandins. Aspirin and NSAIDs also cause a decrease in glomerular filtration rate and renal blood flow and although these changes may occur in healthy individuals they are more pronounced in high renin states and in patients with pre-existing renal disease. Clinical syndromes associated with the renal effects of NSAIDs include oedema, acute renal failure and the nephrotic syndrome. Advanced age, dehydration, concurrent diuretic use and pre-existing renal disease are risk factors for these syndromes. Chronic effects of non-narcotic analgesics on the kidney were suspected before their acute effects became apparent. The key chronic renal lesion in the kidney attributed to prolonged ingestion of non narcotic analgesics is renal papillary necrosis. The incidence of analgesic associated renal papillary necrosis in different countries has generally paralleled the national regular use of analgesics. Although phenacetin was widely implicated as the cause of renal papillary necrosis, there is now increasing evidence that aspirin and other NSAIDs may cause renal papillary necrosis in patients who have not taken phenacetin. There is some evidence that this problem is reduced by legislative control of over-the-counter sales. Uroepithelial tumours have also been attributed to chronic abuse of analgesic mixtures. Such tumours are characterised by a reversal of the usual sex ratio, being more common in females. PMID- 3547000 TI - Gastrointestinal toxicity. Role of prostaglandins and leukotrienes. AB - Gastrointestinal tissues have a high synthesising capacity for prostaglandins. As exogenous prostaglandins protect the gastrointestinal mucosa against potentially noxious agents, it has been suggested that the generation of prostaglandins plays a crucial role in the maintenance of mucosal integrity. Analgesic and anti inflammatory drugs with a potent inhibitory action on gastrointestinal cyclo oxygenase, such as indomethacin, induce gastric and intestinal ulcerations in experimental animals and frequently lead to gastrointestinal side effects in man. However, drugs that do not reduce gastrointestinal prostaglandin formation, such as paracetamol (acetaminophen), are devoid of gastrointestinal toxicity. Various factors, e.g. tissue-specific differences in the sensitivity of cyclo-oxygenase against inhibition and pharmacokinetic properties, modify the inhibitory activity of analgesic and anti-inflammatory drugs on gastrointestinal prostaglandin formation. As leukotriene C4 is a potent gastric vasoconstrictor, increased metabolism of arachidonic acid via the 5-lipoxygenase pathway in the presence of inhibition of cyclo-oxygenase could possibly contribute to drug-induced gastrointestinal damage. PMID- 3547001 TI - Liver damage with non-narcotic analgesics. AB - Non-narcotic analgesics can produce a variety of hepatic lesions but clinically significant liver damage is uncommon with normal therapeutic use. The pattern of hepatotoxicity caused by the salicylates, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen) and the pyrazolones differs but many of these drugs can cause generalised reactions which involve the liver. Depending on the drugs in question, the risks of liver injury may be conditioned by factors such as age, sex, dose and duration of treatment. Hepatotoxicity associated with the use of salicylates and most NSAIDs has been reported most often in females with collagen diseases but this may simply reflect the greater use of these drugs in such patients. Paracetamol-induced liver damage occurs almost exclusively as a result of overdosage. Except for the microvesicular fatty changes in hepatocytes in patients with Reye's syndrome attributed to salicylate, the acute centrilobular necrosis caused by paracetamol in overdosage and the marked cholestasis produced by benoxaprofen, the pathological changes in hepatic reactions to non-narcotic analgesics are rather variable and nonspecific. About 50% of patients given salicylate in full anti-inflammatory dosage develop minor abnormalities of liver function. There is usually a mild to moderate increase in plasma aminotransferase activity with patchy necrosis and degeneration of hepatocytes. These changes are related to plasma salicylate concentration and are usually rapidly reversible. In a small minority of patients, particularly the young, liver damage is more severe and may be associated with liver failure, acidosis, hypoglycaemia and encephalopathy. This picture closely resembles Reye's syndrome. In overdosage, paracetamol can cause acute hepatic necrosis. Without specific treatment, some 8% of adults suffer severe liver damage with plasma aminotransferase activity greater than 1000 U/L and about 1% die with hepatic failure and encephalopathy. The administration of sulfhydryl compounds such as N acetylcysteine within 8 to 10 hours effectively prevents liver damage and death. Liver damage has been attributed to the therapeutic use of paracetamol. However, in most reports the dose was excessive and many patients were chronic alcoholics (who seem to be at increased risk). In these cases the features were typical of acute overdosage. A consistent and characteristic pattern of hepatotoxicity is evident with relatively few non-steroidal anti-inflammatory and pyrazolone analgesics. A rank order of relative risk cannot be established and the incidence in relation to use is not known.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3547002 TI - Blood dyscrasias secondary to non-steroidal anti-inflammatory drugs. AB - Drug reactions may be classified into 2 categories. The first category comprises reactions to the pharmacological properties of the drug which is given either in excessive amounts or to a subject who is highly susceptible to a given pharmacological action (e.g. G6PD-deficient subjects with regard to oxidants and patients with von Willebrand's disease with regard to drugs which inhibit platelet aggregability). The second category concerns reactions caused by a drug dependent immune mechanism. By far the largest proportion of NSAID-induced side effects belong to the second category. The sensitising potential of a drug is probably connected to its protein-binding capacity. The clinical aspect depends on the type of immune reaction as well as its localisation within the organism. Cellular immunity usually leads to erythematous skin rashes. However, it is possible that some of the haematological side effects may be caused by T lymphocytes reacting specifically with haematopoietic cells to which a drug adheres. Antibody-mediated immune reactions are more common. Today, we can distinguish 5 different mechanisms: IgE-mediated drug reactions usually lead to eosinophilia, sometimes with eosinophilic infiltrates in the lung. In such cases, patients frequently develop urticarial rashes. In a number of drug-induced cytopenias the underlying mechanism resides in the action of soluble immune complexes on red cells, leucocytes or platelets as in the case of agranulocytosis secondary to medication with pyrazoles. IgG and/or IgM may be implicated in the formation of the immune complexes. In this system, blood cells are affected when incubated with the serum of an allergic subject previously incubated with the offending drug or one of its metabolites. Some drugs or drug metabolites have a strong affinity for certain blood cells to which they become attached. If a patient develops antibodies to these drugs, an antibody interaction with the drug coated cells can lead to the destruction of the cells. This mechanism may be operative not only in the periphery but also within the bone marrow. In the serological testing, preincubation of the serum with the offending drug will inhibit the reaction of the antibody to drug-coated cells. This mechanism may coexist with the immune complex type of blood cell damage. Today it appears established that patients may develop antibodies the specificity of which depends on a drug as well as on a membrane component of blood cells. The haematological specificity of the immune reaction would then be explained by the autoantigenic constituent of the drug-autoantigen complex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3547003 TI - Treatment of human amatoxin mushroom poisoning. Myths and advances in therapy. PMID- 3547004 TI - Adverse effects of hypolipidaemic drugs. AB - Cholestyramine, colestipol, clofibrate, gemfibrozil, nicotinic acid (niacin), probucol, neomycin, and dextrothyroxine are the most commonly used drugs in the treatment of hyperlipoproteinaemic disorders. While adverse reaction data are available for all of them, definitive data regarding the frequency and severity of potential adverse effects from well-controlled trials using large numbers of patients (greater than 1000) are available only for cholestyramine, clofibrate, nicotinic acid and dextrothyroxine. In adult patients treated with cholestyramine, gastrointestinal complaints, especially constipation, abdominal pain and unpalatability are most frequently observed. Continued administration along with dietary manipulation (e.g. addition of dietary fibre) and/or stool softeners results in diminished complaints during long term therapy. Large doses of cholestyramine (greater than 32 g/day) may be associated with malabsorption of fat-soluble vitamins. Most significantly, osteomalacia and, on rare occasions, haemorrhagic diathesis are reported with cholestyramine impairment of vitamin D and vitamin K absorption, respectively. Paediatric patients have been reported to experience hyperchloraemic metabolic acidosis or gastrointestinal obstruction. Concurrent administration of acidic drugs may result in their reduced bioavailability. Serious adverse reactions to clofibrate will probably limit its role in the future. Of particular concern are ventricular arrhythmias, induction of cholelithiasis and cholecystitis, and the potential for promoting gastrointestinal malignancy which far outweigh the reported benefits in preventing new or recurrent myocardial infarction, cardiovascular death and overall death. Patients with renal disease are particularly prone to myositis, secondary to alterations in protein binding and impaired renal excretion of clofibrate. Drug interactions with coumarin anticoagulants and sulphonylurea compounds may produce bleeding episodes and hypoglycaemia, respectively. Nicotinic acid produces frequent adverse effects, but they are usually not serious, tend to decrease with time, and can be managed easily. Dermal and gastrointestinal reactions are most common. Truncal and facial flushing are reported in 90 to 100% of treated patients in large clinical trials. Significant elevations of liver enzymes, serum glucose, and serum uric acid are occasionally seen with nicotinic acid therapy. Liver enzyme elevations are more common in patients given large dosage increases over short periods of time, and in patients treated with sustained release formulations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3547005 TI - Neurological manifestations and toxicities of the antituberculosis drugs. A review. AB - The neurological manifestations and toxicities of 12 antituberculosis drugs [isoniazid, rifampicin (rifampin), ethambutol, p-aminosalicylic acid, pyrazinamide, streptomycin, kanamycin, ethionamide, cycloserine, capreomycin, viomycin and thiacetazone] are reviewed. Their effects upon the central nervous system, cranial nerves, peripheral nerves and the neuromuscular junction are examined, and drug interactions of neurological concern are briefly discussed. Isoniazid is well known to increase the concentrations of gamma-aminobutyric acid in neural tissues. Although conflicting data have been published, isoniazid may play a limited future role in reducing the degree of adventitious movements noted in certain neurological diseases such as multiple sclerosis, spasmodic torticollis, and other segmental dystonic syndromes. With rifampicin neurological complications have been observed infrequently. Rifampicin penetrates into the CSF and has been shown to have useful activity against various micro-organisms in the CSF, including certain viruses; however, contrary to earlier suggestions, it appears to have no role in the treatment of subacute sclerosing panencephalitis. A number of studies have indicated that isoniazid is associated with a large number of accidental and intentional poisonings. The highest incidence has been observed with Southwestern American Indians in which this agent was involved in 7% of all suicide attempts and 19% of the suicide deaths. Degeneration of the optic chiasma and nerve is a well-known adverse effect of ethambutol; toxicity is manifested by impairment of visual acuity, marked loss of colour discrimination, constricted visual fields, and central and peripheral scotoma. Ototoxicity is a well known problem caused by streptomycin, kanamycin, capreomycin and viomycin. The use of streptomycin in pregnant mothers is associated with congenital deafness in newborns in certain cases. The aminoglycoside antibiotics are also associated with flaccid paralysis following neuromuscular blockade. Adverse reactions to cycloserine are mainly dose-related with neurological and psychiatric syndromes noted in up to 50% of patients. Recent data indicate that isoniazid, rifampicin, ethambutol, pyrazinamide, streptomycin, kanamycin, ethionamide, and cycloserine appear in measurable quantities in the cerebrospinal fluid. Five of these compounds (isoniazid, rifampicin, ethambutol, kanamycin, cycloserine) pass to some degree through non-inflamed meninges. Other than discontinuation of the therapeutic regimen and general supportive measures, very few methods are described in the literature for treatment of acute intoxications with antituberculosis drugs. PMID- 3547007 TI - Forensic medicine in China: its history to the present day. PMID- 3547006 TI - Physical assessment and differential diagnosis of the poisoned patient. AB - The rapid diagnosis and immediate intervention required in patients with serious drug overdose or poisoning makes toxicological screening of limited value to the emergency department physician. Instead, a careful clinical evaluation using the history, physical examination, and the more readily available laboratory tests may allow a tentative diagnosis and the initiation of life-saving treatment. Laboratory tests should include serum osmolality, electrolytes, glucose, BUN and an estimation of the anion and osmolar gaps. The ECG can also provide useful information. Clinical findings of important include altered blood pressure, pulse, respiration and body temperature, the presence of coma, agitation, delirium or psychosis, and muscular weakness. An ophthalmological examination is also of importance in the acutely poisoned patient. Oral burns or dysphagia may occur following ingestion of any strongly reactive substance, but the absence of oral burns does not preclude the possibility of oesophageal or stomach injury. Odours and skin colour may also contribute to the diagnosis. Comprehensive toxicology screening may not be immediately available, or may be inaccurate, thus adding little to the information obtained during the initial evaluation of the poisoned patient. PMID- 3547008 TI - Exercise training-induced hypervolemia in the horse. AB - The purpose of this study was to determine if a chronic hypervolemia would accompany endurance exercise training in the horse. Six mature previously inactive horses were utilized for this study. During the 5-wk experiment, five of the horses were trained for 14 d on a treadmill ergometer at a constant treadmill speed of 5.6 km X hr-1 and a constant grade of 12.5% for graduated lengths of time. One horse was trained by lunging at a trotting pace in a round pen. Following training, plasma volume increased by 4.7 1 (29.1%, P less than 0.05). Although the rate of daily water intake did not change during the training period, 24-h urine output decreased by an average of 3.5 1 X d-1 (-24.5%, P less than 0.05). Resting glomerular filtration rate and the rate of sodium clearance were not altered by training. However, urea, potassium, and osmotic clearance were decreased by training (P less than 0.05) while free water clearance was increased (P less than 0.05). Resting plasma aldosterone and arginine vasopressin concentrations were not altered by training. Plasma potassium concentration was significantly decreased (P less than 0.05) following the 2 wk of training. These data would appear to suggest that renal control mechanisms affecting water reabsorption via the re-absorption of urea and osmotically active substances other than sodium provide the primary route for the training-induced hypervolemia seen in horses. PMID- 3547009 TI - Effect of pre-exercise carbohydrate feedings on endurance cycling performance. AB - Six men were studied to compare the effects of pre-exercise carbohydrate feedings on endurance performance and muscle glycogen utilization during prolonged exercise. Trials consisted of a cycling ride to exhaustion at 75% maximal oxygen uptake preceded by the ingestion of either 75 g of glucose in 350 ml of water (GLU), 75 g of fructose in 350 ml of water (FRU), or 350 ml of an artificially sweetened and flavored placebo (CON). No differences were observed between trials for oxygen uptake, respiratory exchange ratio, heart rate, or exercise time to exhaustion (CON = 92.7 +/- 5.2 min, FRU = 90.6 +/- 12.4, and GLU = 92.8 +/- 11.3, mean +/- SE). Blood glucose was elevated as a result of the GLU feeding, but fell rapidly with the onset of exercise, reaching a low of 4.02 +/- 0.34 mmol X l-1 at 15 min of exercise. Serum insulin also increased following the GLU feeding but had returned to pre-drink levels by 30 min of exercise. No differences in blood glucose and insulin were observed between FRU and CON. Muscle glycogen utilization during the first 30 min of exercise (CON = 46.3 +/- 8.2 mmol X kg-1 wet weight, FRU = 56.3 +/- 3.0 mmol X kg-1 wet weight, GLU = 50.0 +/- 4.9 mmol X kg-1 wet weight) and total glycogen use (CON = 93.4 +/- 11.1, FRU = 118.8 +/- 10.9, and GLU = 99.5 +/- 4.3) were similar in the three trials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547010 TI - Cardiac myxoma. A review. AB - Cardiac myxoma is a true intracardiac neoplasm, which is histologically benign but which on occasion may exhibit behavior suggestive of a true malignancy. It is the most common form of primary cardiac tumor, accounting for 50% of such neoplasms. Seventy-five percent of myxomas are found in the left atrium, typically arising from a stalk attached to the area of the foramen ovale. Cardiac myxomas typically present as a triad of obstructive, embolic, and constitutional symptoms and thus mimic many more common systemic illnesses. This report summarizes 9 cases of cardiac myxoma seen at this institution since a previous report in 1972. Four cases with unusual manifestations are high-lighted in the text to illustrate the protean manifestations of this potentially curable illness. Non-invasive cardiac imaging is essential to establish the diagnosis and differentiate myxoma from the other more common illnesses it imitates. Echocardiography is highly accurate for its diagnosis, has proved invaluable for the management of these patients, and is the imaging technique of choice for initial evaluation of patients in whom the diagnosis of cardiac myxoma is suspected. PMID- 3547011 TI - Nevoid basal-cell carcinoma syndrome. AB - The nevoid basal-cell carcinoma syndrome is characterized by major manifestations, such as multiple basal-cell carcinomata, cysts of the jaws, and skeletal--specifically, rib--abnormalities. Findings in 53 patients and a review of the literature document both major and lesser-known manifestations of the disorder. The odontogenic keratocyst, which usually appears during adolescence, has a marked tendency to recur. In addition to the skin tumors, milia, epidermoid cysts, chalazia, comedones, and palmar and plantar pits are frequent. The skin tumors, originally thought to be independent of sun exposure, are more common in sun-exposed areas and are far less frequent and occur at a much later age in blacks than in whites. There is some evidence that radiation of the skin promotes the appearance of skin cancers in this disorder. Unilateral linear nevoid basal cell carcinomas with comedones may represent postzygotic somatic mutation. A proclivity to other forms of neoplasia exists. Patients with this syndrome have had medulloblastoma, meningioma, ovarian fibroma, ovarian fibrosarcoma, fibrosarcoma of the jaws, cardiac fibroma, fetal rhabdomyoma, and lymphatic or chylous cysts of the mesentery. In addition to the usual modalities of treatment, topical immunotherapy and topical 5-fluorouracil have been used with success. Oral synthetic retinoids, such as 13-cis-retinoic acid, have been used to prevent new lesions from appearing and to arrest the growth of older lesions by inducing differentiation. The independent observations of increased prostaglandin levels associated both with odontogenic keratocyst expansion and aggression of basal cell cancers merit further investigation both as a fundamental cellular mechanism and as a possible basis for treatment (e.g., with antiprostaglandins). The key to pre- and early postnatal diagnosis of the disorder--as well as to an understanding of the basic abnormality--lies in molecular genetics. Prime attention should be given to finding the site of the gene through the use of DNA and other markers. PMID- 3547012 TI - Inverse relationship of metabolic clearance rate of insulin to body mass index. AB - Twenty-five human subjects, whose body mass indices (BMI) ranged from 18.0 to 34.1 kg/m2, underwent euglycemic clamps at both low (1.5 mU/kg/min) and high (10 mU/kg/min) insulin infusion rates. Mean C-peptide concentrations were less than or equal to 0.5 ng/mL at the end of each two-hour period. The metabolic clearance rates (MCR) of insulin (mL/kg/min) were significantly (P less than .001) inversely correlated with BMI at both the low (r = -.65) and high (r = -.71) insulin infusion rates. The negative inverse correlations with BMI remained significant at both the low (r = -.42, P less than .05) and high (r = -.61, P less than .005) insulin infusion rates if the MCR were expressed as mL/m2/min. There were no significantly correlations (r less than .21) between the MCR at either rates of insulin infusion and age or tracer insulin binding to monocytes. Decreased MCR of insulin may contribute to the hyperinsulinemia seen in obese subjects. PMID- 3547013 TI - Effect of short-term consumption of a high-fat, low-carbohydrate diet on metabolic control in insulin-deficient diabetic rats. AB - This study examined the effect of changing the proportion of dietary fat on metabolic control in rats rendered mildly diabetic with streptozotocin (STZ). The high-fat (HF) diet contained 66% energy as fat and 12% as carbohydrate while the low-fat (LF) diet contained 12% energy as fat and 66% as carbohydrate. Both diets had a P/S ratio of 1:3. Young male rats weighing 100 g were treated with STZ (60 mg/kg IV) and randomly allocated to either the LF of HF diet. After 2 weeks, the fasting plasma glucose concentrations were significantly higher in the HF-STZ rats than in the LF-STZ rats (13.2 +/- 1.2 mmol/L v 7.1 +/- 0.8 mmol/L, respectively, P less than 0.001). The increase in plasma glucose above the basal level following the intravenous glucose load (0.5 g/kg body wt) was similar in both groups of STZ-treated rats and glucose clearance was similarly impaired. The fall in glucose concentrations in the 30 minutes following the IV insulin (0.5 U Actrapid insulin/kg body wt) was greater in the LF-STZ rats (delta AUC = -1.60 +/ 0.20 mmol/L 0.5h) than in the HF-STZ group (delta AUC = -0.97 +/- 0.20 mmol/L 0.5 h, P less than 0.05) and either of the control groups (delta AUC = -0.94 +/- 0.37, -0.83 +/- 0.09 mmol/L 0.5 h for LF and HF rats, respectively, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547014 TI - Metabolic factors in the insulin resistance in human obesity. AB - Insulin resistance is frequently observed in obese subjects. The present work was initiated to study its relationship with the increased lipid metabolism generally observed in obesity. A first group of five obese subjects (146 +/- 10% of their ideal body weight [IBW] with normal glucose tolerance was submitted to a 75-g oral glucose tolerance test (OGTT) as a control and during an intralipid infusion (20% fat emulsion, 1 mL/min, started 90 minutes prior to the glucose load). Lipid and glucose oxidation were measured by continuous indirect calorimetry. The significant rise over control conditions in both plasma FFA and lipid oxidation rate during the lipid infusion was accompanied by a marked decrease in glucose tolerance (two hours venous plasma glucose: 151 +/- 12 during intralipid infusion v 110 +/- 3 mg/dL, P less than .01) together with a rise of the plasma insulin curve. Glucose oxidation was significantly decreased. A second group of five obese subjects (146 +/- 7% of their IBW) with impaired glucose tolerance was submitted to a similar OGTT, as a control, and during an infusion of beta-pyridyl carbinol, a nicotinic acid derivative, to lower FFA. Both plasma FFA and lipid oxidation rates were decreased already prior to the OGTT. The previously impaired glucose tolerance was normalized (two hours venous plasma glucose: 129 +/- 13 during the beta-pyridyl-carbinol infusion v 172 +/- 7 mg/dL, P less than .01), and the insulin curve lowered. Glucose oxidation was increased during the early phase of the OGTT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547015 TI - Inhibitory effect of enkephalin on insulin secretion in healthy subjects and in non insulin-dependent diabetic subjects. AB - The administration of the long-acting met-enkephalin analogue (FK 33-824, Sandoz; Basel Switzerland) inhibits insulin secretion induced by glucose (oral and intravenous) and nonglucose (arginine and breakfast) secretagogues in both normal subjects and in patients with noninsulin-dependent diabetes mellitus. The plasma glucose rise triggered by oral glucose and breakfast is reduced by FK in both groups of subjects, suggesting for the opioid peptide an effect in delaying glucose absorption. The data suggest a negative role for enkephalin in the regulation of insulin secretion in both normal and noninsulin-dependent diabetic subjects. PMID- 3547017 TI - Immunochemical techniques. Part J. Phagocytosis and cell-mediated cytotoxicity. PMID- 3547016 TI - HPLC analysis of nucleotide profiles in glucose-stimulated perifused rat islets. AB - Nucleotide concentrations were measured in isolated pancreatic islets from rats using HPLC. This method was used to study the role of nucleotides in islets, which were perifused for several hours with different substrates and exhibited signs of exhaustion. Using islet tissue extracts, it was possible to determine 11 nucleotides. It was hoped that alterations in islet nucleotide concentrations would provide clues for the biochemical basis for the exhaustion phenomenon; however, changes in nucleotide concentrations that were observed in exhausted islet tissue did not correlate with corresponding changes in insulin release. Therefore, they are unlikely to be directly related to islet exhaustion. PMID- 3547018 TI - Measurement of surface properties of phagocytes, bacteria, and other particles. PMID- 3547020 TI - Assay of phagosome-lysosome fusion. PMID- 3547019 TI - Oil-droplet method for measuring phagocytosis. PMID- 3547021 TI - Measurement of hydrogen peroxide production by phagocytes using homovanillic acid and horseradish peroxidase. PMID- 3547022 TI - Cytotoxicity by macrophages and monocytes. PMID- 3547024 TI - Induction of specific macrophage cytotoxicity. PMID- 3547023 TI - Intracellular killing of bacteria and fungi. PMID- 3547025 TI - Assay of a cytocidal protein excreted by activated macrophages. PMID- 3547026 TI - Assays detecting the antibody-dependent and independent binding and cytolysis of tumor cells by murine macrophages. PMID- 3547027 TI - Cytotoxicity of chloramines. PMID- 3547028 TI - Liposome encapsulation of muramyl peptides for activation of macrophage cytotoxic properties. PMID- 3547029 TI - Parasiticidal activity of macrophages against Toxoplasma. PMID- 3547030 TI - Active center-based immunoassay approach using bacterial luciferase. PMID- 3547031 TI - Cloning firefly luciferase. PMID- 3547032 TI - Luminescent bioassays based on macrophage cell lines. PMID- 3547034 TI - Proteolytic modification of tubulin. PMID- 3547033 TI - Synthesis of chemiluminogenic protein conjugates with dimethyl adipimidate for sensitive immunoassays. PMID- 3547035 TI - Isolation of mitotic spindles and spindle pole bodies from yeast. PMID- 3547036 TI - Isolation of a kinetochore-centromere fraction from HeLa metaphase chromosomes. PMID- 3547038 TI - Analysis of cytoskeletal structures using blot-purified monospecific antibodies. PMID- 3547037 TI - Isolation of the calcium-modulated contractile protein of striated flagellar roots. PMID- 3547039 TI - Agar overlay method: high-resolution immunofluorescence for the study of the contractile apparatus. PMID- 3547040 TI - Polyethylene glycol embedding protocol for immunofluorescence microscopy. PMID- 3547041 TI - Preembedding for localization by electron microscopy of cytoskeletal antigens in cultured cell monolayers using gold-labeled antibodies. PMID- 3547043 TI - [Degradation of ribonucleic acids in yeast cells during desiccation]. AB - From 26 to 43% of RNA undergoes degradation in yeast cells when they pass into the state of anabiosis. Most of the degradation was found to occur at the first stage of cell dehydration when free water was removed from the cells. The mechanism of RNA degradation is supposed to involve enzyme-catalysed processes which are realised in the cell at the early stages of its dehydration. PMID- 3547042 TI - [Formation of secreted acid phosphatase during the growth of Saccharomyces cerevisiae yeasts on different sources of carbon and nitrogen nutrition]. AB - The effect of certain components in the growth medium on the secretion of acid phosphatase was studied with Saccharomyces cerevisiae. The presence of phosphate at a concentration of 10 mM in the medium inhibited the formation of repressible forms of this enzyme. The synthesis of the secreted enzyme depended on the sources of carbon and nitrogen nutrition. The enzyme yield was highest in a medium with sucrose as a carbon source and ammonium chloride as a nitrogen source. The secretion of acid phosphatase is stimulated by an increase in the sugar content and a deficiency of the nitrogen source in the medium. PMID- 3547044 TI - [Immobilization of microorganisms on latex for producing artificial flocs]. AB - Microorganisms belonging to the genera Pseudomonas, Micrococcus, Bacillus and Rhodotorula are flocculated with divinyl styrene latex. The process of flocculation depends on a number of physico-chemical factors but, all in all, is universal for microorganisms with different taxonomy, morphology and physiology. The structure of artificial bioflocs has been studied using optical and scanning electron microscopy. PMID- 3547045 TI - [Intracellular development of Escherichia coli bacteriophages after culturing the infected bacteria under conditions of anabiosis and hypothermia]. AB - The intracellular growth of bacteriophages T3, T4 and phi X174 was studied in Escherichia coli cells frozen to -196 degrees C and cooled to 0 degree C at various intervals from the instant of phage infection. The processes of biosynthesis were delayed and the latent period was longer in the growth of cells frozen to -196 degrees C. The levels of RNA and protein biosynthesis as well as the yield of phages decreased when cells were frozen at a later stage of the phage growth. No changes were found in the intracellular growth processes of the phages during the subsequent cultivation of the bacterium when it was infected and then cooled to 0 degree C. PMID- 3547046 TI - [Relation between the transport of glutamic acid and Escherichia coli resistance to tetracyclines]. AB - The rate of glutamate uptake was shown to decrease while the rate of glutamate export from preloaded cells increased after the resistance to tetracyclines had been induced in the cells of plasmid-bearing Escherichia coli strains. Similar results were obtained with membrane vesicles prepared from the cells induced by the antibiotic and from the non-induced cells. These data imply that the transport channel formed after the induction in the membranes of resistant cells can also function as a mechanism which mediates the active export of glutamate from the cells. PMID- 3547047 TI - [Survival of bacteria and the fate of Escherichia coli DNA in amino acid deficiency]. AB - The survival rate of an E. coli polyauxotrophous strain AB1157 and the behaviour of its DNA were studied when the strain was incubated for a long time at 43 degrees C in a medium deficient in glucose, phosphates and amino acids. Under these conditions, the survival rate fell down to 10%, but no cell lysis occurred. DNA synthesis stopped within the first two hours of starvation. Neither DNA degradation, despiralization nor decrease of its molecular weight could be detected during the entire starvation. Therefore, the death of E. coli cells under these conditions was not associated with DNA damages. PMID- 3547049 TI - Twenty-first anniversary. PMID- 3547048 TI - [Reduction of chromium (VI) by reference bacterial strains]. AB - Collection bacterial strains were found to be capable of chromium (VI) reduction although they had not been in contact with chromium compounds before. Strains capable of nitrate respiration could use bichromate ions as a terminal electron acceptor in the absence of competing acceptors. Cr(VI) was reduced to Cr(III) when bichromate was added to the cultural broth whose redox potential reached 140 mV. PMID- 3547051 TI - Ischaemic gangrene of leg due to ring constriction: a case report. PMID- 3547050 TI - Self-instruction through patient simulation by computer. PMID- 3547053 TI - The effect of zinc supplements on plasma zinc and copper levels and the reported symptoms in healthy volunteers. AB - Information from animal studies has demonstrated the harmful effects of zinc supplementation on copper transport. Although some studies have been carried out in humans, the effect on humans has not been as well documented as the effect on animals. Forty-seven healthy volunteers (26 women and 21 men) took part in a double-blind cross-over trial which lasted for 12 weeks. The subjects were asked to take 50 mg of elemental zinc (as 220 mg zinc sulphate) or placebo, three times a day for six weeks. Venous blood was collected for the analysis of plasma levels of copper and zinc. Symptoms, which included headaches, abdominal cramps, nausea, loss of appetite and vomiting, were registered from 84% of women and 18% of men. Six female volunteers discontinued the trial; five owing to gastric irritation and one owing to consistent headaches. Plasma zinc levels rose significantly in both men and women, the increase being 36% and 57%, respectively. Plasma copper levels did not change significantly. Our study suggests that the gastric discomfort that is associated with zinc supplementation may be related to body weight as symptoms were reported from the lower-weight volunteers. Our study also shows no detrimental effect of 150 mg of zinc a day on plasma copper levels in healthy volunteers over a period of six weeks. PMID- 3547052 TI - Insulin therapy in patients with poorly controlled non-insulin dependent diabetes mellitus. AB - In spite of maximal doses of sulphonylurea agents, patients with poorly controlled non-insulin dependent diabetes (NIDDM) often do not have improved metabolic control after the introduction of insulin therapy. We have assessed 22 patients with NIDDM who commenced insulin therapy in order to identify those characteristics which were associated with an improvement in glycaemic control. Twelve months after the commencement of insulin therapy, 14 (64%) patients showed a decrease in glycosylated haemoglobin (HbA1) levels; 12 of the 14 (55%) patients had achieved HbA1 levels that were considered to reflect acceptable glycaemic control (HbA1 less than or equal to 11%; reference range, 6%-9%). The HbA1 levels in the other patients either remained unchanged or had increased (one subject). When the subjects who had achieved good glycaemic control with insulin therapy were compared with the remainder of the group, a failure to improve with insulin therapy was associated with a longer duration of diabetes, greater obesity and higher levels of cholesterol and triglycerides before the commencement of insulin therapy. Greater obesity and high levels of circulating lipids were found by means of multiple linear regression analysis to correlate independently with a poor response to insulin therapy. We conclude that standard insulin therapy can improve the majority of patients with poorly controlled NIDDM. However, there is a substantial number of patients, who tend to be obese and have high levels of circulating lipids, whose condition does not improve with insulin therapy, or who require more aggressive dosage increases than are used as a routine. PMID- 3547054 TI - Malarial outbreak in Queensland. PMID- 3547055 TI - Norfloxacin (Noroxin). PMID- 3547056 TI - Subtype-specific identification of influenza virus in cell cultures with FITC labelled egg yolk antibodies. AB - We report on results obtained with a direct immunofluorescence test for subtype specific identification of influenza virus in detached cells of MDCK cultures after inoculation of 281 clinical specimens from patients with influenza-like disease. Influenza virus antibodies were produced in eggs from immunized hens and labelled with FITC. In 157 cases CPE was found in MDCK cells. A total of 57 cases of influenza A (H3N2), 86 cases of influenza A (H1N1), and 14 cases of influenza B were identified. In 33 cases of influenza A (H1N1) infection with massive CPE guinea pig but not chicken erythrocytes were agglutinated by the cell culture supernatants. The single step immunofluorescence test described proved easy to perform and results were obtained within 1 h after CPE was observed in contrast to the conventional HIT which is very time-consuming. PMID- 3547058 TI - [Effect of low-frequency ultrasound on the viability of embryonal elements of the larvocysts of Echinococcus granulosus and Alveococcus multilocularis in vitro]. PMID- 3547057 TI - A new ELISA test for HIV antibodies using a bacterially produced viral env gene product. AB - Screening tests for antibodies to the human immunodeficiency virus (HIV), based on the indirect ELISA principle using viral preparations as antigen, yield a substantial number of false-positive and false-negative results. These failures are due to the lack of certain viral polypeptides or contaminating cellular polypeptides in viral preparations. Therefore, the accuracy of the screening tests should be improved by using highly purified, synthetic viral antigens. With establishment of such an ELISA antigen in mind, we examined a bacterially synthesized polypeptide [ENV(80)] that corresponds to 80 conserved amino acids of the HIV gp41 transmembrane glycoprotein. ENV(80) was expressed as a DHFR fusion protein in Escherichia coli. Results obtained by HIV ELISA and immunoprecipitation with 497 serum samples from various groups at risk of AIDS were compared with those obtained with the ENV(80) ELISA. The ENV(80) ELISA was found to be superior to the H9/HTLV-III ELISA with respect to sensitivity and specificity and is almost equivalent in accuracy to immunoprecipitation. PMID- 3547059 TI - [In vivo and in vitro study of the sensitivity of imported strains of Plasmodium falciparum to antimalarial preparations]. PMID- 3547060 TI - [Production of an attenuated strain of P. berghei by secondary passages through mice receiving vitamin E]. PMID- 3547061 TI - [Variability of tick-borne encephalitis virus during passage through Ixodes ticks and small mammals]. PMID- 3547062 TI - [Toxoplasmosis: facts and conjectures. 3. Congenital toxoplasmosis]. PMID- 3547063 TI - [Internal medicine: the past and present]. PMID- 3547064 TI - [Immune response in active-passive immunization against tetanus]. PMID- 3547066 TI - [Syndrome of hyperreninemic hypoaldosteronism in critically ill patients]. PMID- 3547065 TI - [A case of combustio spontanea totalis in a novel by Emile Zola]. PMID- 3547067 TI - Hepatic microvascular regulatory mechanisms. VII. Effects of endoportally-infused endotoxin on microcirculation and mast cells in rats. AB - Changes in hepatic microvasculature and systemic arterial blood pressure were measured for 1 hr in anesthetized male Sprague-Dawley rats receiving an endoportal injection of 15 mg/kg b.w. Boivin-extracted E. coli endotoxin (026:B6) or sterile saline solution as a control. Image shearing and videodensimetric methods were used to quantify internal diameters (D) and cellular velocities (V) and to calculate relative rates of volumetric blood flow (Q) at the inlet of periportal and the outlet of centrilobular sinusoids. Determination of the number of Falck-Hillarp-positive mast cells was made in 8 microns sections of liver at the light microscopic level. Endotoxin produced a mild hypotensive response by 20 min after which time rats remained normotensive. In vivo microscopy of transilluminated livers revealed adherence of platelets and mononuclear leukocytes to the microvascular wall between 15 to 30 min post-endotoxin infusion and constriction at 50 and 60 min of centrilobular sinusoids but not that of the other microvascular segments. A significant increase in cellular velocity was observed within 5 min at the inlet of periportal sinusoids. This response was accompanied by constriction at both the inlet and outlet of periportal and centrilobular sinusoids, respectively. After 1 hr, endotoxin- treated livers demonstrated a 26% decrease in the number of fluorescent serotonin-containing mast cells. However, no change in hepatic lobular perfusion or in volumetric flow rate was observed during this period. Given these results, it is postulated that volumetric flow rate within hepatic lobules is maintained during the first hr after endotoxin infusion by modulation of microvascular internal diameters in response to changes in cellular blood flow velocity, and mast cell mediators such as serotonin trigger hepatic microvascular autoregulation following the administration of endotoxin. PMID- 3547068 TI - Paying for HMO care: issues and options in setting capitation rates. AB - As the public and private sectors continue to promote use of capitated health care systems, the problem of how to establish payment rates for individuals becomes increasingly important. Inattention to pricing policies can lead to increased total costs, windfall profits for some providers, and the loss of comprehensive coverage for high-risk individuals. Capitation systems used by government and corporations are measured against social and economic ideals; the shortfall can be addressed by proposed new alternatives. PMID- 3547069 TI - Averting a crisis in rural health care. A summary report by the MMA Task Force on Rural Health. PMID- 3547070 TI - Preserving access and quality in rural areas. PMID- 3547071 TI - [Iontophoresis in dental practice. I. General features]. PMID- 3547072 TI - [Clinical evaluation of peroral fosfomycin in dental interventions]. PMID- 3547073 TI - [Postactinic dental complications: radiotherapy involvement in Gougerot-Sjogren syndrome]. PMID- 3547074 TI - [Biocompatible materials]. PMID- 3547075 TI - [Pre-operative staging in advanced gastric cancer by ultrasound; with special reference to para-aortic lymph node metastases]. AB - Extraluminal cancer spreadings such as peritoneal dissemination, liver metastases, lymph node metastases and infiltration to surrounding organs were examined in 236 patients with gastric cancer by ultrasound (US). Peritoneal dissemination was found in 36 of 236 cases. Ascites, nodules in the cul-de-sac and thickened wall of the transverse colon could be detected by US in 24 of 36 cases (sensitivity of 67%). Liver metastases were detected in 18 out of 23 cases (78%). Infiltration to the surrounding organs, mainly to the pancreas, was impossible to demonstrate by US. Sensitivity was 44% (17/39). Lymph node metastases in the region around the celiac axis were indicated in 30 of 40 cases (75%) by US. Para-aortic nodal metastases were also detected in 27 of 34 cases (79%). Ultrasonic images of para-aortic lymph node metastases were classified into four figures: plate type, sandwich type, unilateral multiple type, unilateral solitary type. These types were not necessarily the same in indication of laparotomy, selection of combined or adjuvant therapy, significance of nodal dissection and also prognosis. Solitary involved para-aortic node near the left renal vein should be removed in a case free from peritoneal dissemination or liver metastases. Ultrasound could be very useful in screening patients with gastric cancer for peritoneal dissemination, liver metastases and lymph node metastases. PMID- 3547076 TI - Sequence and nuclear localization of the Saccharomyces cerevisiae HAP2 protein, a transcriptional activator. AB - Activation of the CYC1 upstream activation site (UAS2) and other Saccharomyces cerevisiae genes encoding respiratory functions requires the products of the regulatory loci HAP2 and HAP3. We present here the DNA sequence of the yeast HAP2 gene and an initial investigation into the function of its product. The DNA sequence indicated that HAP2 encoded a 265-amino-acid protein whose carboxyl third was highly basic. Also found in the sequence was a polyglutamine tract spanning residues 120 to 133. Several experiments described herein suggest that HAP2 encodes a direct activator of transcription. First, a bifunctional HAP2-beta galactosidase fusion gene was localized to the yeast nucleus. Second, a lexA-HAP2 fusion gene was capable of activating transcription when bound to a lexA operator site. The additional requirement for the HAP3 product in activation is discussed. PMID- 3547077 TI - Role of transcriptional and posttranscriptional regulation in expression of histone genes in Saccharomyces cerevisiae. AB - We analyzed the role of posttranscriptional mechanisms in the regulation of histone gene expression in Saccharomyces cerevisiae. The rapid drop in histone RNA levels associated with the inhibition of ongoing DNA replication was postulated to be due to posttranscriptional degradation of histone transcripts. However, in analyzing the sequences required for this response, we showed that the coupling of histone RNA levels to DNA replication was due mostly, if not entirely, to transcriptional regulatory mechanisms. Furthermore, deletions which removed the negative, cell cycle control sequences from the histone promoter also uncoupled histone transcription from DNA replication. We propose that the arrest of DNA synthesis prematurely activates the regulatory pathway used in the normal cell cycle to repress transcription. Although posttranscriptional regulation did not appear to play a significant role in coupling histone RNA levels to DNA replication, it did affect the levels of histone RNA in the cell cycle. Posttranscriptional regulation could apparently restore much of the periodicity of histone RNA accumulation in cells which constitutively transcribed the histone genes. Unlike transcriptional regulation, periodic posttranscriptional regulation appears to operate on a clock which is independent of events in the mitotic DNA cycle. Posttranscriptional recognition of histone RNA must require either sequences in the 3' end of the RNA or an intact three-dimensional structure since H2A- and H2B-lacZ fusion transcripts, containing only 5' histone sequences, were insensitive to posttranscriptional controls. PMID- 3547078 TI - Antisense RNA of proto-oncogene c-fos blocks renewed growth of quiescent 3T3 cells. AB - Mouse 3T3 cells were transformed with an antisense c-fos gene fused to a mouse mammary tumor virus promoter. In transformants that integrated a large number of antisense c-fos sequences, the usual large increase in c-fos mRNA and protein following stimulation of quiescent cells by platelet-derived growth factor was blocked in the presence of dexamethasone. These cells subsequently also failed to show the stimulation of DNA synthesis normally induced by platelet-derived growth factor. Appropriate expression of c-fos appears to be a prerequisite for reentry of quiescent cells into the cell cycle. PMID- 3547079 TI - Induction of clonal monocyte-macrophage tumors in vivo by a mouse c-myc retrovirus: rearrangement of the CSF-1 gene as a secondary transforming event. AB - A mouse retrovirus containing the c-myc oncogene was found to induce tumors of mononuclear phagocytic cells in vivo. All tumors expressed the c-myc retroviral gene but not the endogenous c-myc gene (with one exception), and virtually all tumors were clonal with a unique proviral integration. This observation, coupled with a lag time in tumor formation, suggests that a second event, in addition to c-myc proviral integration, is necessary for the generation of neoplastic cells in vivo. All of the tumor cells expressed high levels of mRNA for both the putative colony-stimulating factor 1 (CSF-1) receptor (c-fms proto-oncogene product), as well as the c-fos proto-oncogene. Although all of the tumor cells proliferated in culture without the addition of exogenous CSF-1, which is required for the proliferation of primary macrophages partially transformed by the same c-myc retrovirus, several phenotypes were observed with respect to the expression of CSF-1 and granulocyte-macrophage CSF and to their growth factor responsiveness. The proliferation of one tumor, which secreted high levels of CSF 1, was blocked by specific anti-CSF-1 serum. This tumor was found to express altered CSF-1 mRNA and to have a DNA rearrangement at the CSF-1 locus. In this particular case, the data indicate that a CSF-1 gene rearrangement was the secondary event in development of the tumor. The pleiotropy of phenotypes among the other tumors indicated that there are a variety of other mechanisms for such secondary events which can be investigated with this system. PMID- 3547080 TI - SSN20 is an essential gene with mutant alleles that suppress defects in SUC2 transcription in Saccharomyces cerevisiae. AB - Dominant and recessive mutations at the SSN20 locus were previously isolated as extragenic suppressors of mutations in three genes (SNF2, SNF5, and SNF6) that are required in trans to derepress invertase expression. All ssn20 alleles cause recessive, temperature-sensitive lethality. In this study we cloned the SSN20 gene, identified a 4.6-kilobase poly(A)-containing RNA, and showed that disruption of the gene is lethal in a haploid cell. Genetic mapping of SSN20 to a locus on chromosome VII 10 centimorgans distal to cly8 led to the finding that SSN20 is the same gene as SPT6, which affects expression of delta insertions in the 5' noncoding region of HIS4 (F. Winston, D. T. Chaleff, B. Valent, and G. R. Fink, Genetics 107:179-197, 1984). We also showed that an ssn20 mutation restored expression of secreted invertase from deletions of the SUC2 upstream regulatory region; ssn20 restored derepression of SUC2 mRNA in strains with a SUC2 upstream region deletion or a snf2 mutation. Increased or decreased gene dosage of SSN20 also suppressed defects that are suppressed by ssn20 missense mutations. These findings suggest that SSN20 plays a role in general transcriptional processes. PMID- 3547081 TI - The yeast repeated element sigma contains a hormone-inducible promoter. AB - A genomic clone (lambda ScG7) from Saccharomyces cerevisiae encoded a 650 nucleotide poly(A)-containing [poly(A)+] RNA that was about 50 times more abundant in MATa cells that had been exposed to the peptide pheromone alpha factor than in untreated cells. This RNA was transcribed from a cluster of repetitive sequences: both intact and truncated delta and sigma elements adjacent to a tRNATrp gene. Strand-specific probes indicated that this RNA initiated within an intact sigma element and contained sigma sequences at its 5' end. MATa cells produced two other prominent poly(A)+ RNAs (500 and 5,300 bases) in response to alpha-factor that were homologous to the same strand of sigma but transcribed from other locations in the genome. Induction of the sigma-related transcripts was rapid, was not blocked by inhibition of protein synthesis, required a functional receptor (STE2 gene product), and hence appeared to be a primary response to pheromone. Pulse-labeling confirmed that accumulation of sigma RNA following alpha-factor administration was accounted for by an increase in its rate of transcription. The sigma RNAs also were induced in MAT alpha cells that had been treated with a-factor, but were not present at significant levels in MATa/MAT alpha diploids. In MATa cells transformed with a plasmid in which the lambda ScG7 sigma element was inserted just upstream of a gene coding for the intracellular form of invertase (SUC2) lacking its own promoter, a new poly(A)+ RNA (2.2 kilobases) appeared in response to alpha-factor that hybridized to both sigma and SUC2 probes, and intracellular invertase activity was elevated about 10 fold within 30 min. Primer extension showed that transcription from the hybrid gene initiated exclusively within the sigma sequence (117 nucleotides from the 3' end of the element). PMID- 3547082 TI - Dissociation of c-fos induction from macrophage differentiation in human myeloid leukemic cell lines. AB - Treatment of five human myeloid leukemic cell lines (KG1, ML3, HL-60, U-937, and HEL) with TPA was followed by macrophage differentiation and was accompanied by an early and transient increase in the mRNA level of c-fos proto-oncogene. The induction of c-fos was also observed in human cell lines K562 and K-Gla that did not respond to TPA with terminal macrophage differentiation. The treatment of HL 60 and U-937 cell lines with 1-oleoyl-2-acetylglycerol, a synthetic analog of diacylglycerol that, like TPA, stimulates protein kinase C activity, was followed by early and transient induction of c-fos mRNA in the absence of terminal macrophage differentiation. Finally, treatment of HL-60 with TPA in the presence of retinal, an inhibitor of protein kinase C, drastically reduced the induction of c-fos mRNA but had no effect on the terminal macrophage differentiation that is induced in this cell line by TPA. These results indicate that the induction of c-fos and terminal macrophage differentiation in response to TPA treatment can be dissociated in the in vitro models provided by human myeloid leukemic cell lines. Moreover, these findings suggest that the induction of c-fos is not only insufficient but may also be unnecessary for the differentiation along the monocyte-macrophage pathway. PMID- 3547083 TI - The GCR1 gene encodes a positive transcriptional regulator of the enolase and glyceraldehyde-3-phosphate dehydrogenase gene families in Saccharomyces cerevisiae. AB - The intracellular concentrations of the polypeptides encoded by the two enolase (ENO1 and ENO2) and three glyceraldehyde-3-phosphate dehydrogenase (TDH1, TDH2, and TDH3) genes were coordinately reduced more than 20-fold in a Saccharomyces cerevisiae strain carrying the gcr1-1 mutation. The steady-state concentration of glyceraldehyde-3-phosphate dehydrogenase mRNA was shown to be approximately 50 fold reduced in the mutant strain. Overexpression of enolase and glyceraldehyde-3 phosphate dehydrogenase in strains carrying multiple copies of either ENO1 or TDH3 was reduced more than 50-fold in strains carrying the gcr1-1 mutation. These results demonstrated that the GCR1 gene encodes a trans-acting factor which is required for efficient and coordinate expression of these glycolytic gene families. The GCR1 gene and the gcr1-1 mutant allele were cloned and sequenced. GCR1 encodes a predicted 844-amino-acid polypeptide; the gcr1-1 allele contains a 1-base-pair insertion mutation at codon 304. A null mutant carrying a deletion of 90% of the GCR1 coding sequence and a URA3 gene insertion was constructed by gene replacement. The phenotype of a strain carrying this null mutation was identical to that of the gcr1-1 mutant strain. PMID- 3547084 TI - Deletion of 5'-coding sequences of the cellular p53 gene in mouse erythroleukemia: a novel mechanism of oncogene regulation. AB - The p53 gene is rearranged in an erythroleukemic cell line (DP15-2) transformed by Friend retrovirus. Here, we characterize the mutation and identify a deletion of approximately equal to 3.0 kilobases that removes exon 2 coding sequences. The gene is expressed in DP15-2 cells and results in synthesis of a 44,000-dalton protein that is missing the N-terminal amino acid residues of p53. The truncated protein is unusually stable and accumulates to high levels intracellularly. Moreover, it appears to have undergone a change in conformation as revealed by epitope mapping studies. This study represents the first description of an altered p53 gene product arising by mutation during neoplastic progression and identifies a region in the p53 protein molecule that plays a role in determining p53 stability in vivo. PMID- 3547085 TI - Biogenesis and transmembrane orientation of the cellular isoform of the scrapie prion protein [published errratum appears in Mol Cell Biol 1987 May;7(5):2035]. AB - Considerable evidence suggests that the scrapie prion protein (PrP) is a component of the infectious particle. We studied the biogenesis and transmembrane orientation of an integral-membrane form of PrP in a cell-free transcription linked translation-coupled translocation system programmed with a full-length PrP cDNA cloned behind the SP6 promoter. Translation of SP6 transcripts of the cDNA or of native mRNA from either normal or infected hamster brain in the absence of dog pancreas membranes resulted in the synthesis of a single PrP immunoreactive polypeptide (each polypeptide was the same size; Mr, 28,000), as predicted from the known sequence of the coding region. In the cotranslational presence of membranes, two additional forms were observed. Using peptide antisera specific to sequences from the amino- or the carboxy-terminal domain of PrP together with proteinase K or endoglycosidase H digestion or both, we showed that one of these forms included an integrated and glycosylated form of PrP (Mr = 33,000) which spans the bilayer twice, with domains of both the amino and carboxy termini in the extracytoplasmic space. By these criteria, the other form appeared to be an unglycosylated intermediate of similar transmembrane orientation. The PrP cell free translation products did not display resistance to proteinase K digestion in the presence of nondenaturing detergents. These results suggest that the PrP cell free translation products most closely resemble the normal cellular isoform of the protein, since its homolog from infected brain was proteinase K resistant. The implications of these findings for PrP structure and function are discussed. PMID- 3547086 TI - Activation of c-myc and c-K-ras oncogenes in primary rat tumors induced by ionizing radiation. AB - An activated K-ras oncogene was detected by transfection in NIH 3T3 cells and by Southern blot analysis in 6 of 12 rat skin tumors induced by ionizing radiation. The DNA from 10 of the 12 tumors also showed c-myc gene amplification and restriction polymorphisms. Evidence for tissue specificity was observed in patterns of oncogene activation, with each of three clear cell carcinomas exhibiting activation of both c-myc and K-ras oncogenes. PMID- 3547087 TI - Presence of a c-myc transcript initiated in intron 1 in Friend erythroleukemia cells and in other murine cell types with no evidence of c-myc gene rearrangement. AB - In Friend murine erythroleukemia cells, although no detectable c-myc gene rearrangement was found, we observed, in addition to the normal 2.3-kilobase c myc transcript, the presence of a 2.3-kilobase c-myc mRNA initiated in intron 1 at a promoter site called P3. The intron 1-initiated transcript has a longer half life than the normal c-myc mRNA. This c-myc transcript initiated in intron 1 was also found in other murine cell types where no rearrangement of the c-myc locus has been reported. PMID- 3547088 TI - Primary structure polymorphism at amino acid residue 72 of human p53. AB - We analyzed p53 cDNA and genomic clones from a variety of normal and transformed cells. Sequence analysis of these clones revealed that amino acid residue 72 can be an arginine, proline, or cysteine. This single codon difference results in electrophoretically distinct forms of human p53 seen in normal and transformed cells. PMID- 3547089 TI - Bases for an isotypic network. PMID- 3547090 TI - Isolation and characterization of chicken and turkey beta 2-microglobulin. AB - Chicken and turkey beta 2-m were isolated from citrated plasma in sequential use of three chromatographic steps: affinity chromatography, gel filtration chromatography and anion-exchange chromatography. The purified protein was identified as beta 2-m by reaction with a beta 2-m specific monoclonal antibody and by the ability to recombine with the chicken MHC class I heavy chain. The purity was estimated by SDS-PAGE and IEF. The pI was between 5.1 and 5.3 for chicken beta 2-m and 4.7 and 4.8 for turkey beta 2-m, which fact is reflected in their different electrophoretic mobilities in agarose gel (turkey migrates in the alpha and chicken migrates in the beta region). The mol. wt of both chicken and turkey beta 2-m was 14,500 estimated by SDS-PAGE whereas calculations based on the amino acid compositions gave mol. wts of 11,000. EM280 was 15.9 for chicken beta 2-m and 16.4 for turkey beta 2-m. The amino acid compositions and sequences of the two avian beta 2-m molecules have been compared with earlier data from the literature. The sequence of the 23 N-terminal amino acids was found to be identical in our preparations from both chicken and turkey, namely DLTPKVQVYSRFPASAGTKNVLN, and is incompatible with a previously published sequence also thought to be from turkey beta 2-m. Reasons for our opinion that the molecules isolated and sequenced in this paper are the correct ones are given. PMID- 3547091 TI - [Significance of C-reactive protein in pediatric diagnosis]. AB - The present review summarizes the results of C-reactive protein determinations in the serum of 9100 infants and children and gives a survey on data presented in the literature. Quantitative estimations of CRP are a useful screening method for the evaluation of infections and the activity of inflammatory processes in chronic diseases. In a variety of diseases CRP correlates well with erythrocyte sedimentation rate. CRP is, however, superior to ESR in showing faster dynamics and being uninfluenced by anemia, nephrotic syndrome or renal insufficiency. Marked elevations of CRP concentration may help to differentiate between viral and bacterial infections. It can be concluded that the determination of CRP in the serum must be added to the list of standard investigations in acutely and chronically ill infants and children. PMID- 3547093 TI - [Intralobar lung sequestration. Diagnosis using the duplex-scan technic]. AB - A 3 7/12 year old boy, suffered from a intralobar sequestration of the lung and recurrent pneumonia. In the area of the right lower lobe, a plain film showed a limited density. The ultrasonographic evaluation demonstrated a homogenous tumor above the diaphragm. We found pulsatile flow patterns by pulsed doppler sonography within the arteries feeding the sequestration. Aortography finally clearly showed the anomalous arteries leading from the descending aorta to the sequestrum. Bronchoscopy and bronchography demonstrated, that the sequestered area of the lung had no open connexion to the rest of the bronchial tree. Surgical treatment is the only possible method to remove the cause of the recurrent infections. PMID- 3547092 TI - [Spinal sonography in childhood. Indications and value in abnormalities and space occupying lesions]. AB - Conditions, examination technique, and sonographic anatomy of the spinal canal are presented. The sonographical appearance of various kinds of dysraphism and their differentiation, of malformations at the cranio-cervical junction and of mass lesions is demonstrated and illustrated. Based on our preliminary experience spinal sonography appears to be useful as first imaging device for the differentiation of complex malformations, and as screening method for occult dysraphism. In case of mass lesions spinal sonography is suitable to diagnose and follow up disease although additional imaging procedures are currently needed for the confirmation of the diagnosis. PMID- 3547094 TI - [Pulmonary embolism in early adulthood. Detection using intravenous subtraction angiography]. AB - In female adolescents with pulmonary embolism such as in the presented 19 year old patient oral contraceptives have to be considered as an etiologic factor. It is important to consider this diagnosis even in that age group. The diagnosis can be verified by intravenous digital subtraction angiography. PMID- 3547095 TI - [Experimental studies of the effect of metal cores (silver alloy) on the gingival tissue. 2. Extensive studies of gingival discoloration]. PMID- 3547096 TI - [Stress analysis of inclined teeth--a case of prosthodontic therapy for inclined upper anterior teeth (a finite element method)]. PMID- 3547097 TI - [3-dimensional analysis of the forces exerted on a denture by the cheeks and tongue]. PMID- 3547098 TI - [The correlation of various planes in dental prosthetics]. PMID- 3547099 TI - [Non-invasive measurement of the thickness of oral soft tissues]. PMID- 3547100 TI - [Detecting tooth contacts by tooth vibration. 1: Method of sensor attachment]. PMID- 3547101 TI - Structure-activity relationships of the azide metabolite, azidoalanine, in S. typhimurium. AB - Azide is metabolized to the proximate mutagen, L-azidoalanine in bacterial systems. While this novel mutagenic metabolite plays a key role in azide mutagenesis, the biochemistry of this role is unknown. The chemical synthesis of authentic racemic azidoalanine and several derivatives thereof allowed the exploration of structure-activity relationships with this unique mutagen. We found that whereas azide, azidoalanine and azidoalanine tert.-butyl ester were of comparable mutagenic potency, derivatives which lack the free amino group, such as azidopropionic acid and amino-blocked azidoalanine, were orders of magnitude less active. These findings demonstrate that the free amino group is essential for significant activity, while the carboxyl group may be less important. This conclusion together with the finding that DL-azidoalanine is a less potent mutagen than azide itself, suggests that the metabolite, while necessary for azide mutagenicity, may not be the ultimate mutagenic species. Instead, the data are consistent with the hypothesis that azidoalanine requires further bioactivation. PMID- 3547102 TI - Desmutagenic effect of alpha-dicarbonyl and alpha-hydroxycarbonyl compounds against mutagenic heterocyclic amines. AB - The desmutagenic effects of alpha-hydroxycarbonyl compounds, such as glyceraldehyde, glycolaldehyde, dihydroxyacetone, furfural, 5 hydroxymethylfurfural, maltol, acetol and acetoin and alpha-dicarbonyl compounds, such as diacetyl, glyoxal, methyl glyoxal and 2,3-pentanedione were investigated against the mutagenic heterocyclic amines, such as Trp-P-1, Trp-P-2, Glu-P-1, Glu P-2 and IQ. Most of the carbonyl compounds suppressed the mutagenicity of heterocyclic amines for S. typhimurium TA98, alpha-dicarbonyl compounds showing a higher desmutagenic effect than alpha-hydroxycarbonyl compounds. Among the alpha hydroxycarbonyl compounds, glyceraldehyde, glycolaldehyde and dihydroxyacetone showed more effective desmutagenicity, and diacetyl among the alpha-dicarbonyl compounds had the highest desmutagenic effect. These carbonyl compounds alone also showed mutagenicity to S. typhimurium TA100 without S9 mix. The reaction of carbonyl compounds with mutagenic heterocyclic amines also eliminated the mutagenicity of the former for S. typhimurium TA100. PMID- 3547103 TI - T4 endonuclease V promotes the formation of multimeric DNA structures. AB - Electron microscopy of UV-irradiated circular DNA molecules which had been treated with T4 endonuclease V revealed the formation of multimeric DNA structures in addition to the expected conversion of the superhelical DNA molecules into nicked circular and linear forms. The multimeric DNA molecules could be distinguished in electron micrographs from catenated molecules which were present in the original DNA preparation by a combination of rotary and single angle heavy metal shadowing. The complexity and frequency of these structures increased with time of reaction with endonuclease V. Their formation, as well as the endonuclease activity of enzyme, was dependent on UV irradiation of the DNA, and the complexes could be disrupted by prior phenol extraction and ethanol precipitation. Preparations of endonuclease V estimated to be 98% pure by mass promoted the same complex formation between DNA molecules as did preparations estimated to be only 5-10% pure. In addition to these intermolecular structures, the formation of complexes between regions on the same DNA molecules was manifest as discrete double-stranded 'loops' 200-300 base pairs in length. DNA 'bubble structures' were also observed and may represent folding of the 'loops' onto adjacent segments of DNA. These results suggest that at least one active form of T4 endonuclease V may be a multimeric complex of enzyme molecules in association with DNA. PMID- 3547104 TI - Purification of the T4 endonuclease V. AB - A new purification protocol has been developed for the rapid isolation to physical homogeneity of T4 endonuclease V. The enzyme was purified from an Escherichia coli strain which harbors a plasmid containing the T4 denV structural gene downstream of the lambda rightward promoter. The purification of the enzyme was monitored by pyrimidine dimer-specific nicking activity, Western blot analysis and silver or Coomassie Blue staining of SDS-polyacrylamide gels. Milligram quantities of the enzyme have been purified by the following procedure. After sonication of cells and removal of major cell debris, total protein and nucleic acids were passed over a single-stranded DNA agarose column. Endonuclease V was eluted at 650 mM KCl with a linear salt gradient yielding enzyme of approximately 20% purity and following dialysis, was applied to a chromatofocusing column. The enzyme elutes at pH 9.4 and is greater than 90% homogeneous at this step. The final purification step is CM-Sephadex chromatography which attains greater than 98% homogeneity. PMID- 3547105 TI - Proteolytic processing of the Ada protein that repairs DNA O6-methylguanine residues in E. coli. AB - In extracts of E. coli treated with an adapting regime of MNNG, the induced 39kd Ada protein having O6-MeG-DNA methyltransferase activity is processed to a 19kd active domain corresponding to the C-terminal half of the intact protein. This proteolytic processing has been followed on Western immunoblots using antisera raised against the 19kd fragment. Initial processing at 25 degrees C or 37 degrees C mainly generates a fragment of mol. wt. 24kd which then undergoes a slower second cleavage to generate the 19kd active domain. Preceding this second cleavage site is a sequence of amino acids Thr- -Gly-Met-Thr- -Lys that also occurs at another site in the N-terminal half of the 39kd methyltransferase. It is proposed that this sequence is a recognition site for proteolytic activity. On the basis of cleavage of the Ada protein at either one or both of these sites, fragments may be generated of mol. wt. 24kd and 19kd containing the active site for O6-methylguanine and O4-methylthymine repair, and 15kd and 20kd, containing the active site for methylphosphotriester repair. These observations explain previous reports by others on the existence in cell extracts of multiple methyltransferase activities of different sizes recognizing O-methyl lesions in DNA. The cellular protease involved is resistant to a wide range of protease inhibitors. PMID- 3547106 TI - Repair of plasmid DNA damaged in vitro with cis- or trans diamminedichloroplatinum(II) in Escherichia coli. AB - Plasmid pBR322 was modified in vitro with the antitumor compound cis diamminedichloroplatinum(II) (cis-DDP) or the isomeric trans-DDP. The numbers of platinum adducts were determined by atomic absorption spectrophotometry. DNA repair-proficient and various DNA-repair-deficient (uvrB, uvrD, recB and recA) strains of Escherichia coli were transformed by the damaged plasmids and the ratios of the transformation frequencies of cells by damaged plasmids relative to those by untreated plasmids were determined. Results of transformation assays indicated that the uvrB gene function was essential for repair of plasmid DNA damaged with cis-DDP. A functional recA gene product seemed to be of minor importance for repair of plasmids damaged with cis-DDP. trans-DDP had a different effect on plasmid DNA. trans-DDP-modified DNA was better able to transform cells than cis-DDP-modified DNA, and the DNAs appeared to be repaired differently. Prior induction of SOS functions increased the survival of plasmids treated with cis-DDP in wild-type and uvrD mutants, but did not increase the survival of plasmids damaged with trans-DDP in these strains. In in vitro repair experiments, plasmid DNA modified with cis-DDP was more readily incised by the UVRABC excinuclease than that modified with trans-DDP. PMID- 3547107 TI - Inducible DNA-repair systems in yeast: competition for lesions. AB - DNA lesions may be recognized and repaired by more than one DNA-repair process. If two repair systems with different error frequencies have overlapping lesion specificity and one or both is inducible, the resulting variable competition for the lesions can change the biological consequences of these lesions. This concept was demonstrated by observing mutation in yeast cells (Saccharomyces cerevisiae) exposed to combinations of mutagens under conditions which influenced the induction of error-free recombinational repair or error-prone repair. Total mutation frequency was reduced in a manner proportional to the dose of 60Co-gamma or 254 nm UV radiation delivered prior to or subsequent to an MNNG exposure. Suppression was greater per unit radiation dose in cells gamma-irradiated in O2 as compared to N2. A rad3 (excision-repair) mutant gave results similar to wild type but mutation in a rad52 (rec-) mutant exposed to MNNG was not suppressed by radiation. Protein-synthesis inhibition with heat shock or cycloheximide indicated that it was the mutation due to MNNG and not that due to radiation which had changed. These results indicate that MNNG lesions are recognized by both the recombinational repair system and the inducible error-prone system, but that gamma-radiation induction of error-free recombinational repair resulted in increased competition for the lesions, thereby reducing mutation. Similarly, gamma-radiation exposure resulted in a radiation dose-dependent reduction in mutation due to MNU, EMS, ENU and 8-MOP + UVA, but no reduction in mutation due to MMS. These results suggest that the number of mutational MMS lesions recognizable by the recombinational repair system must be very small relative to those produced by the other agents. MNNG induction of the inducible error-prone systems however, did not alter mutation frequencies due to ENU or MMS exposure but, in contrast to radiation, increased the mutagenic effectiveness of EMS. These experiments demonstrate that in this lower eukaryote, mutagen exposure does not necessarily result in a fixed risk of mutation, but that the risk can be markedly influenced by a variety of external stimuli including heat shock or exposure to other mutagens. PMID- 3547108 TI - Repair of UV-irradiated plasmid DNA in Saccharomyces cerevisiae. Inability to complement mutational defects in excision repair by in vitro treatment with Micrococcus luteus UV endonuclease. AB - Excision repair defects of Saccharomyces cerevisiae rad1-1, rad4-4, rad7-1 and rad14 mutants were examined. As previously found, transformation of such cells with UV-irradiated plasmid DNA is poor compared to wild-type yeast. Treatment of UV-irradiated YRp12 plasmid DNA with crude preparations of Micrococcus luteus UV endonuclease before introducing it into rad1-1 cells increased transformation efficiency to wild-type levels. This is consistent with earlier reports of rad1-1 mutants being defective in the incision step of excision repair. However, with purified UV endonuclease little or no rescue occurred when the UV-irradiated plasmid was incised before transformation into rad1-1 or rad4-4 cells. Furthermore, the purified UV endonuclease reduced transformation of rad7-1 and rad14 mutants to levels seen in rad1-1 and rad4-4 cells. In contrast such treatment caused only a small decrease in the transforming ability of UV irradiated DNA in wild-type cells. These results show that yeast can normally process pre-incised, UV-irradiated DNA and that this activity is absent in rad1 1, rad4-4, rad7-1 and rad14 mutants. Thus, in addition to their previously reported roles in incision, the RAD1, 4, 7 and 14 gene products are also required for repair to continue after the incision of DNA lesions. PMID- 3547109 TI - Mechanisms of butylated hydroxytoluene-mediated modulation of 2 acetylaminofluorene mutagenicity in rat and human hepatocyte/Salmonella assays. AB - Salmonella typhimurium (TA98) mutagenesis assays were used to study the influence of the antioxidant butylated hydroxytoluene (BHT) on 2-acetylaminofluorene (2 AAF) mutagenesis, in search of the mechanism of the anticarcinogenic effects of BHT. Rats pre-treated with BHT in the diet (0.5% w/w for 10 days) provided hepatocytes and hepatocyte S9 which were more efficient in the activation of 2 AAF than were similar preparations from control rats. The increased release of mutagens from hepatocytes might explain the reported increase in the incidence of bladder tumours in BHT-treated rats. In contrast, the mutagenic activity of 2-AAF was inhibited by the in vitro addition of BHT into incubations where human or rat liver S9 and intact hepatocytes were used for metabolic activation. Both competitive and un-competitive inhibition by BHT of 7-ethoxycoumarin O deethylation was observed in hepatocytes which suggested that the antimutagenic activity may be mediated by one or more mechanisms of cytochrome P-450 inhibition. BHT inhibition of the mutagenicity of N-OH 2-AAF and of rat urinary metabolites of 2-AAF indicated that effects other than those mediated by cytochrome P-450 also occur e.g. scavenging of reactive metabolites. It was concluded that BHT-modulation of 2-AAF metabolic activation and mutagenesis (which may relate to BHT-protection against hepatocarcinogenicity) involves multiple mechanisms. PMID- 3547110 TI - Mutagenic substances in red and white wine in Chile, a high risk area for gastric cancer. AB - Chilean home-made and commercial wines were analyzed for the presence of mutagenic substances using the Salmonella mutagenicity test with preincubation. Strains TA98 and TA100 were used in the absence and in the presence of S9 mix. 90% of red wines from a total of 30 samples and 54% of white wines from a total of 22 were found to be mutagenic. In all cases, S9 mix did not affect the mutagenicity of the samples. At least in one case, more than one mutagen was present, since the mutagenicity with TA98 could be selectively inactivated without affecting that with TA100. This study supports the hypothesis that wine consumption may be an important risk factor for upper gastrointestinal cancer, particularly for adenocarcinoma of the stomach, which is highly prevalent in Chile. PMID- 3547112 TI - Retinol (vitamin A) inhibition of dimethylnitrosamine (DMN) and diethylnitrosamine (DEN) induced sister-chromatid exchanges in V79 cells and mutations in Salmonella/microsome assays. AB - When the Chinese hamster cell line V79 and the tester strain of Salmonella typhimurium TA100 were treated with the precarcinogens dimethylnitrosamine (DMN) or diethylnitrosamine (DEN) in the presence of S9 mix, a dose-dependent increase of sister-chromatid exchanges (SCE) in V79 cells and His+ revertants in TA100 resulted. DMN was a far more efficient SCE inducer than DEN, while DEN was a more efficient inducer of His+ revertants than DMN. Retinol (Rol) effectively inhibited DMN and DEN induced SCE in V79 cells and His+ revertants in TA100. Concurrent treatment of V79 cells with Rol at various doses and one dose of DMN or DEN in the presence of S9 mix caused a significant reduction of SCE as compared to SCE induced by DMN or DEN without Rol. Rol inhibition of DMN-induced SCE was dose-dependent. Rol was less efficient in inhibiting DEN-induced SCE, and no consistent dose-dependent inhibition was observed. At all doses, Rol significantly inhibited DMN and DEN induced mutation frequencies in TA100. At the highest dose of Rol (40 micrograms/plate), the inhibition of DMN and DEN induced His+ revertants reached about 90% and 60%, respectively. The possibility that Rol exerts its antimutagenic activities by inhibiting certain forms of the cytochrome P-450 isoenzymes required for activation of precarcinogens such as DMN and DEN is discussed. PMID- 3547113 TI - Selenium inhibition of benzo[a]pyrene, 3-methylcholanthrene, and 3 methylcholanthrylene mutagenicity in Salmonella typhimurium strains TA98 and TA100. AB - Selenium (Se) decreased the mutagenicity of benzo[a]pyrene (BP), 3 methylcholanthrene (3MC), and 3-methylcholanthrylene (3MCE) in Salmonella typhimurium strains TA98 and TA100. Metabolism of BP, 3MC and 3MCE to mutagens was accomplished with the liver S9 fraction from Aroclor 1254-treated male Sprague-Dawley rats. Exposure of the bacteria to 4 nmoles BP, 10 nmoles 3MC, or 10 nmoles 3MCE in the presence of S9, and up to 200 nmoles Se as Na2SeO3 resulted in decreased mutagenicities up to 39, 66 and 60% of their respective control activities without Se in TA98 and up to 46, 52 and 64% of their respective control activities without Se in TA100. Se (200 nmoles) alone was not mutagenic in strains TA98 or TA100 with or without S9. BP, 3MC and 3MCE were not mutagenic in either strain without S9. None of the tested concentrations of BP, 3MC, 3MCE and Se were cytotoxic. Assays of the aryl hydrocarbon hydroxylase (AHH) activity in the S9 preparation revealed decreased AHH activity with increase in Se concentration. The decreased mutagenicity and AHH activity were Se (as Na2SeO3) dependent and could not be duplicated by sulfur (S as Na2SO3). Inhibition of AHH activity by Se provides an explanation of the mechanism of Se inhibition of BP, 3MC and 3MCE mutagenicities in S. typhimurium TA98 and TA100. PMID- 3547111 TI - Fluoranthene, a volatile mutagenic compound, present in creosote and coal tar. AB - Creosote, a coal-tar distillation product, contains mutagens which are volatile at 37 degrees C. After distillation of creosote we found that these volatile mutagens were present in the distillation fraction with the highest boiling range (greater than 360 degrees C). The "volatile mutagenic activity" was connected with the presence of fluoranthene, a polycyclic aromatic hydrocarbon. Commercially available fluoranthene was positive in the so-called "taped-plate assay" (the test system used for the detection of volatile mutagens) towards the strains TA98 and TA100 in the presence of S9 mix. The tested creosote and coal tar contained fluoranthene in concentrations of 5.2 and 2.2%, respectively. PMID- 3547115 TI - 2,7-Diamino-3,8-dimethylphenazine as the major mutagenic product from the reaction of 2,4-diaminotoluene with hydrogen peroxide. AB - The mutagenicity of 2,4-diaminotoluene (DAT) in Ames's Salmonella/microsome test was remarkably enhanced by treatment with hydrogen peroxide. Therefore, identification of the major mutagenic reaction product of 2,4-DAT with hydrogen peroxide at room temperature has been performed. Red precipitates were produced in a 2-day reaction mixture and were column chromatographed on silica gel. 5 fractions having mutagenic potency were obtained. The red crystalline needles, obtained as the major reaction product, were separated from fraction 2 and were subjected to high resolution mass spectrometry, 1H- and 13C-NMR spectrometry. The structure of the compound was determined to be 2,7-diamino-3,8-dimethylphenazine from physicochemical and chemical evidence. The compound induced 212 revertants/nmole in Salmonella typhimurium TA98 with 25 microliters S9 per plate. PMID- 3547114 TI - Enhancement of the mutagenicity of 2-acetylaminofluorene by flavonoids and the structural requirements. AB - The enhancing effects of 12 kinds of flavonoids on the mutagenicity of 2 acetylaminofluorene (AAF) in Salmonella typhimurium TA98 were investigated. In the mixed applications of AAF (22.4 nmoles/plate) with flavonoids (31.4-45.0 nmoles/plate) in the presence of a mammalian metabolic activation system (S9 mix), morin, galangin, flavonol, kaempferol, quercetin and myricetin enhanced the mutagenicity of AAF by 3.3-10.2-fold. The potency of the mutagenicity enhancing effects increased in the described order. For the mutagenicity-enhancing effects of the flavonoids on AAF, the flavonol structure, including the free 3-hydroxyl group and the 2,3-double bond, were essential. In the quercetin analogues, the 5 hydroxyl group was also essential. Further, the numbers of the hydroxyl groups substituted at the 3', 4' and 5'-positions in the B-ring contributed to an increase of the enhancing effect, whereas the substitution of a hydroxyl group at the 2'-position depressed the potency of the effect. PMID- 3547116 TI - 5-Amino-4-imidazolecarboxamide is a mutagen in E. coli. AB - 5-Amino-4-imidazolecarboxamide (5A4IC), the base moiety of a common intermediate in de novo purine biosynthesis, was found to be mutagenic in E. coli. Using a series of mutants in the tryptophan synthetase A gene, 5A4IC was observed to cause transition and transversion mutations at similar levels. At 400 micrograms/ml in the growth medium, it stimulates the base substitution GC----AT 4.8-fold; AT----GC 20-fold; AT----CG (2 sites) an average of 6.0-fold; AT----TA 7.8-fold; and GC----CG 6.1-fold. The transversion GC----TA was not tested. In contrast to the base, 5-amino-4-imidazolecarboxamide riboside is not mutagenic at a similar molar concentration. PMID- 3547117 TI - Mutagenicity of some substituted 1-phenyl-3,3-dimethyltriazenes. I. The salmonella/mammalian microsome assay and repair test. AB - The mutagenic activity and related biological properties of Br-, Cl-, NO2- and CH3-derivatives of 1-(phenyl)-3,3-dimethyltriazene were investigated in Salmonella/microsome assays with standard and preincubation metabolic activation and in the repair test using Salmonella and E. coli B/r. In the repair test, the CH3-derivative was slightly positive in the E. coli recA and uvrA repair system, the NO2-derivative had a killing effect on Salmonella typhimurium uvrB-deficient strains. In Salmonella mutagenicity assays, all tested triazene derivatives reverted frameshift tester strains, especially TA1537. The highest number of frameshift mutations was induced by the CH3-derivative in the presence of a standard metabolic activation system; direct mutagenicity of this derivative was weak, reaching about the same level of activity as seen after preincubation. The only test compound that induced mutations of the base-substitution type was the NO2-derivative; this derivative showed the highest mutagenicity when activated by preincubation. PMID- 3547118 TI - Lack of mutagenic activity of bile acids in bacterial fluctuation tests. AB - 3 bile acids (cholic acid, chenodeoxycholic acid and deoxycholic acid) were assayed for mutagenicity in Salmonella typhimurium TA98 and TA100 in fluctuation tests in the absence of an external source of metabolic activation. At the doses tested, there were no dose-related statistically significant increases in mutagenicity compared with appropriate controls. These results do not support the claim (Watabe, J., and H. Bernstein (1985) Mutation Res., 158, 45-51) that these bile acids are mutagenic. PMID- 3547119 TI - Localization of myoglobin in human muscle cells by immunoelectron microscopy. AB - The localization of myoglobin in human skeletal muscle cell was studied by immunoelectron microscopy. The Fab'-horseradish peroxidase (HRP) conjugate was prepared by the maleimide method recently developed by Ishikawa et al. This method gave better recovery and less polymerization of HRP than the periodate method. By the direct immunoperoxidase method using this conjugate, myoglobin was shown to be localized in the I-band region of skeletal muscle cells. The outer membrane of mitochondria and triads stained intensely, but A-bands were not stained. Myonuclei and intermyofibrillar spaces were also not stained. The localization of myoglobin in the I-band implies its function in energy generation. PMID- 3547120 TI - Management of end stage respiratory failure in Duchenne muscular dystrophy. AB - There were 31 Duchenne patients placed on overnight mouth intermittent positive pressure ventilation for severe respiratory insufficiency at the average age of 19.9 years. Most patients had vital capacities less than 200 cc at their last evaluations. Of these, 23 patients are alive at the average age of 27 years and live in the community, although they are dependent on assisted ventilation 24 hours a day. There were 8 patients who died at the average age of 30 years. Although normocapnic during the day, the presence of symptomatic nocturnal hypoventilation or pCO2 over 55 mmHg documented by continuous overnight capnograph study indicates the need for introducing overnight respiratory assistance. Mouth intermittent positive pressure ventilation alone or in combination with other techniques of ventilatory assistance can prolong life while allowing optimal function, attainment of higher levels of education, and home management of patients with Duchenne muscular dystrophy. PMID- 3547121 TI - Detection of Cryptococcus neoformans in biopsy specimens from the spleen and the liver of AIDS patients: critical comments. PMID- 3547122 TI - [Formation of mucoid capsules in vitro by Cryptococcus neoformans]. PMID- 3547123 TI - Experimental cryptococcosis: dissemination of Cryptococcus neoformans and dermotropism in guinea-pigs. PMID- 3547124 TI - [An unusual strain of Trichophyton rubrum from Schleswig-Holstein]. PMID- 3547126 TI - Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis. AB - We randomly assigned 20 patients with progressively worsening generalized myasthenia gravis of recent onset whose illness was not controlled by anticholinesterase therapy to treatment with either cyclosporine (6 mg per kilogram of body weight per day) or placebo. Patients who had been treated with thymectomy, steroids, or other immunosuppressive agents were excluded. The duration of treatment was 12 months. Disease activity was assessed by quantified strength testing and by measurements of antihuman acetylcholine-receptor antibody. Patients were assessed at 6 months and 12 months, or at the following early end points: drug failure (doubling of creatinine), treatment failure (respiratory or swallowing difficulty), or protocol violation (stopping medication for more than five days). At six months, patients in the cyclosporine group had had significantly more objective improvement in strength; one early end point had been reached (drug failure; no treatment failures). In the placebo group, three early end points had been reached (all treatment failures). The decline in titers of acetylcholine-receptor antibody was larger in the treated group, although the difference was not statistically significant. At the end of the study (after 12 months of treatment or arrival at an earlier end point), improvement in strength and reduction in titers of anti-receptor antibody continued to be greater in the cyclosporine group. Nephrotoxicity occurred in three patients receiving cyclosporine but was nonprogressive with a reduction in dosage and reversible with discontinuation of the drug. These results are preliminary and need confirmation, but we conclude that cyclosporine is probably an effective therapy in some patients with myasthenia gravis. PMID- 3547125 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 11-1987. A 54-year-old woman with a contracted urinary bladder and hematuria. PMID- 3547127 TI - Current trends in cigarette advertising and marketing. AB - Because the nation's health is so greatly influenced by cigarette smoking, this report examines current trends in cigarette advertising and marketing. According to the Federal Trade Commission, total cigarette advertising and promotional expenditures reached $2.1 billion in 1984. From 1974 through 1984, total expenditures increased approximately sevenfold, or threefold after adjustment according to the consumer price index. In 1985, cigarette advertising expenditures accounted for 22.3 percent, 7.1 percent, and 0.8 percent of total advertising expenditures in outdoor media, magazines, and newspapers, respectively. When all products and services were ranked according to national advertising expenditures, cigarettes were first in the outdoor media, second in magazines, and third in newspapers. The proportion of total cigarette advertising and promotional expenditures devoted to promotional activities has increased steadily, from 25.5 percent in 1975 to 47.6 percent in 1984. The proportion of expenditures for cigarettes yielding 15 mg or less of "tar" has increased substantially and has consistently exceeded the domestic market share of these cigarettes. The fastest growing markets are discounted cigarettes and brands containing 25 cigarettes per pack. Several advertising campaigns have targeted women, minorities, and blue-collar workers. The study of these marketing trends should assist health officials in identifying and predicting patterns of cigarette use and in developing health promotion programs that counteract the influence of advertising by incorporating similar, effective techniques. PMID- 3547128 TI - Allogeneic bone marrow transplantation in a patient with chemotherapy-resistant progressive histiocytosis X. PMID- 3547129 TI - Langerhans cell histiocytosis. PMID- 3547130 TI - Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology, and therapy (1). PMID- 3547132 TI - Was the international randomized trial of extracranial-intracranial arterial bypass representative of the population at risk? PMID- 3547131 TI - The extracranial-intracranial arterial bypass study: what have we learned? PMID- 3547133 TI - The Extracranial-Intracranial Bypass Study. A report of the committee appointed by the American Association of Neurological Surgeons to examine the study. PMID- 3547134 TI - Neurologic uncertainty in newborn intensive care. PMID- 3547135 TI - Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology, and therapy (2). PMID- 3547137 TI - Cardiac allotransplantation in newborns. PMID- 3547136 TI - Medicare-designated centers for cardiac transplantation. PMID- 3547138 TI - Alzheimer's disease. Progress in molecular pathology. PMID- 3547139 TI - Close linkage of c-Harvey-ras-1 and the insulin gene to affective disorder is ruled out in three North American pedigrees. AB - Affective disorder (AD) is one of the major forms of functional psychoses. Although the mode of transmission is uncertain, family, twin and adoption studies strongly suggest a genetic involvement. Because a basic biochemical abnormality is not known, direct analysis of the disease using a probe for the defective gene is not possible. However, a specific locus can be tested for its relevance to the aetiology of AD by genetic linkage, using restriction fragment length polymorphisms (RFLPs). Using probes for the c-Ha-ras-1 oncogene and the insulin gene, Gerhard et al. and Egeland et al. found convincing evidence for close linkage between these markers and a locus for AD in a large Old Order Amish pedigree. In an attempt to confirm this finding, we examined three bipolar pedigrees outside the Amish population. Our results indicate the absence of linkage from 0 to 15% recombination frequency between AD and the insulin gene HRAS1 region in these pedigrees. PMID- 3547140 TI - Long-range cooperativity between gene regulatory sequences in a prokaryote. AB - Regulation of transcription initiation by proteins binding at DNA sequences some distance from the promoter region itself seems to be a general phenomenon in both eukaryotes and prokaryotes. Proteins bound to an enhancer site in eukaryotes can turn on a distant gene, whereas efficient repression of some prokaryotic genes such as the gal, ara and deo operons of Escherichia coli, requires the presence of two operator sites, separated by 110, 200 and 600 base pairs (bp) respectively. In the deo operon, which encodes nucleoside catabolizing enzymes, we have shown that efficient and cooperative repression can be obtained when the distance between the two sites ranges from 224 to 997 bp. Here, we report that transcription initiation can be regulated from an operator site placed 1 to 5 kilobases (kb) downstream of the deoP2 promoter (and downstream of the transcribed gene), and present the first experimental data for prokaryotic regulation at distances greater than 1 kb. Our results support the model of DNA loop formation as a common regulatory mechanism explaining both some prokaryotic regulation and the action of eukaryotic enhancers. PMID- 3547141 TI - Mapping using gene encyclopaedias. PMID- 3547142 TI - [100 years of Escherichia coli]. PMID- 3547143 TI - [100 years of Diplococcus pneumoniae]. PMID- 3547144 TI - Efficacy and specificity of vindesine monoclonal anti-carcinoembryonic antigen conjugate with nine human cancer cell lines. AB - To establish a model for evaluation of the efficacy and specificity of monoclonal anti-CEA-vindesine (VDS) conjugates, we have characterized 10 human tumor cell lines (7 colorectal cancer and 3 lung cancer) with 3 monoclonal antibodies that recognize different epitopes of the CEA molecule. Immunocytochemistry indicated high, medium, low, or no capacity of the cell lines to bind antibody and express CEA. We used 125I-labeled antibodies to quantitate the number of antibody molecules binding per cell. The most thoroughly evaluated monoclonal antibody, 11 285-14, which is nonreactive with nonspecific cross-reacting antigen and is known to localize in xenografts and in cancer patients, was selected for assessment of VDS-conjugate efficacy. This was evaluated by 24- and 72-hour exposure in tritiated uridine microcytostasis assays with nine of the cell lines. Conjugates were shown to retain anti-CEA activity after conjugation, and the efficacy of VDS 11-285-14 in vitro was found to be correlated with target antigen expression, except with two lines that were resistant to free drug. Absorption of VDS-11-285 14 with purified CEA resulted in loss of efficacy in positive cell lines, thereby giving a further indication of the selectivity of conjugate efficacy. PMID- 3547145 TI - Use of iodine-131-labeled anti-immune response-associated monoclonal antibody as preparative regimen prior to bone marrow transplantation: initial dosimetry. AB - Despite the use of near maximal doses of external beam total-body irradiation, many patients who received transplants for relapsed hematologic cancers will fail because of tumor recurrence following therapy. With the use of radioisotope labeled monoclonal antibodies, a more directed delivery of systemic radiotherapy may be achieved; tumor cell kill is increased without increased toxicity. On the basis of this hypothesis, we have begun dosimetry studies in normal dogs using an anti-immune response-associated antibody (7.2) labeled with 131I. Compared with an irrelevant isotype-matched antibody, the blood concentration of 131I-labeled 7.2 fell rapidly over the first 3 hours and then cleared more slowly. During this time, there was specific localization of 131I-7.2 in lymph nodes, spleen, and marrow. On the basis of the concentration curves generated over 48 hours, administration of enough 131I-7.2 to deliver 10 Grays to the blood would result in radiation doses of 9.8, 16.3, and 32.3 Grays to liver, marrow, and spleen, respectively. The liver uptake of labeled 7.2 appeared to be the result of its direct antigen-specific binding to hepatic Kupffer cells rather than to the clearance by the liver of either antigen-antibody complexes or antibody-coated cells. Gastric or intestinal radiation toxicity may be a problem due to gastric excretion of free I following binding of 131I-7.2 and subsequent deiodination. PMID- 3547146 TI - [A discussion from the previous century: multiple sclerosis or tabes dorsalis; or Friedreich's disease?]. PMID- 3547147 TI - [The Public Health Service in the Dutch East Indies; a look back]. PMID- 3547148 TI - [The childbirth of Constanze Mozart; a musical happening?]. PMID- 3547149 TI - [Casting off names (Gerrit Achterberg)]. PMID- 3547150 TI - [Allogeneic bone marrow transplantation in beta thalassemia]. PMID- 3547151 TI - [Initial results with prospective echographic studies of hip joints in newborn infants]. PMID- 3547152 TI - [Clinical study of an 'insulin pen' for frequent daily usage by the patient]. PMID- 3547153 TI - [Consensus on the 'diabetic foot']. PMID- 3547154 TI - [Amputate or leave it to nature? A surgical case from the 18th century]. PMID- 3547155 TI - [The woman-(un)friendly vaginal speculum]. PMID- 3547156 TI - [The recessive inheritance of affective paraphrenia of King Ludwig and King Otto of Bavaria]. PMID- 3547157 TI - [Historical recall of surgery of intracranial aneurysms]. PMID- 3547159 TI - [Formation of images in echotomography]. AB - The authors describe shortly how ultrasounds are produced and which phenomena are observed when they pass through alive tissues: waves propagation, reflexion, refraction and attenuation. The reception of reflective waves (echo) is then shown with the different modes of visualisation of the obtained informations (echotomography A, B or T.M.). It is necessary to know the limits of this technique to obtain the best results. PMID- 3547158 TI - [Experimental arterial microsutures. Evaluation of the risks of thrombosis using technetium 99-labeled heparin]. AB - Following demonstration of a method of assay of circulation heparin by measurement of radioactivity after labelling with 99 m technetium, the technique was used to study effects of arterial microsuture on metabolism of heparin injected postoperatively. Results of a study involving rat aorta showed that local binding was maximum during the first half-hour and that abnormal consumption of heparin continued during the 6 hours following operation. These finding suggest that a risk of thrombosis probably persists throughout this postoperative period. PMID- 3547160 TI - [Peroperative spinal cord echography]. AB - Real time intraoperative ultrasonography is used since 1982 in spinal surgery. It gives numerous information, so that the neurosurgeon may adapt his technique to the obtained views. The authors describe this technique and give their experience based on 25 preliminary cases and on the literature. The normal echoanatomy of the spinal cord and the spinal canal is described as well as the echostructure of the different components observed in all cases. They give afterwards the different aspects of intramedullary tumours, extramedullary lesions (intra or extradurally), spinal traumas and syringomyelia. PMID- 3547161 TI - [Postoperative echographic surveillance]. AB - Real time ultrasonography can be used in the post operative period through a bone defect such as a craniectomy or laminectomy when their surface excess 6 cm2. It permits without moving the patient the study of the normal post-operative evolution of certain lesions such as abscess or ventricule enlargement, and the diagnosis of early post-operative complications. Tardive unfavourable anatomic evolution and/or recurrence can also be studied. In the future, the miniaturization of the probe will allow to extend this technique to smaller bone window. PMID- 3547162 TI - [Macrophage infiltration in human glomerulonephritis: histochemical study by the non-specific esterase method]. AB - Detection of glomerular macrophages in glomerulonephritis (GN) was attempted in 77 renal biopsies by measuring non-specific esterase (NSE) activity. Macrophage infiltration was at its highest in two cases of cryoglobulinemia (NSE index greater than 10) both associated with a diffuse proliferative GN. In 15 cases of lupus, macrophage infiltration was low or absent (NSE index 0.44). In diffuse proliferative GN (24 cases) only GN with extracapillary proliferation had an NSE index greater than 1. In GN with predominant IgA (23 cases), apart 2 cases of extracapillary forms, there was no notable macrophage infiltration. There is a relation between monocytes and the localization and the quantity of glomerular deposits. The NSE index is higher in the case of large sub-endothelial deposits of immunoglobulins, C3 and/or fibrin. PMID- 3547164 TI - [Levels of plasma beta 2-microglobulin and deposits of amyloid substance in patients under chronic hemodialysis]. PMID- 3547165 TI - Investigation of the influence of a cyclic luliberin analog on ovulation. PMID- 3547166 TI - Interrelationship of monoamines and luliberin in the synaptosomes of the medial basal hypothalamus and its individual structures. PMID- 3547163 TI - [Rapidly progressing glomerulonephritis with mesangial IgA deposits in sarcoidosis]. AB - This report concerns a patient with sarcoidosis who developed acute renal failure due to rapidly progressive glomerulonephritis. Renal biopsy revealed severe endo and extracapillary proliferation with diffuse mesangial deposits of IgA, C3 and beta 1-H on immunofluorescence. The possibility of a common immunopathogenic pathway between sarcoidosis and IgA nephritis is briefly discussed. PMID- 3547168 TI - Normal development of the spinal cord in neonates and infants seen on ultrasonography. AB - The normal development of the spinal cord from the fetal period to infancy was studied by ultrasonography (US) with a 7.5 MHz transducer. Longitudinal and transverse sections of the spinal cord were clearly observed. The sagittal and transverse diameters of the spinal cord increased with age. In order to evaluate disorders of the spinal cord precisely, it is necessary to clarify the normal features as well as the normal development of the spinal canal and cord, and the surrounding structures. US with such a high frequency transducer will be the most suitable for this purpose. PMID- 3547167 TI - The missing pericallosal artery on sonography: a sign of agenesis of the corpus callosum in the neonatal brain? AB - The sonographic findings in five newborn infants with agenesis of the corpus callosum are reported. Besides abnormal shape and position of the lateral and third ventricles of the brain, it was noted that echoreflections from the pericallosal artery were missing in all infants. Normally the pericallosal artery, which follows the surface of the corpus callosum, can be easily detected in the midline sagittal scanplane on sonography through the anterior fontanelle. It is suggested that a missing pericallosal artery is an easily detectable sign of agenesis of the corpus callosum in newborn infants. PMID- 3547169 TI - Molecular anatomy of viral disease. The George Cotzias memorial lecture 1986. PMID- 3547170 TI - [Warren's distal splenorenal anastomosis. Current status]. PMID- 3547172 TI - [Leiomyosarcoma of the stomach]. PMID- 3547171 TI - [Our experience in the treatment of diffuse acute peritonitis with ceftazidime]. PMID- 3547173 TI - [Pancreatic cysts]. PMID- 3547174 TI - [Pathology of the supra-aortic blood vessels. Diagnostic aspects]. PMID- 3547175 TI - [Instrumental follow-up of anterior mechanical resection]. PMID- 3547176 TI - [Splenic abscess: apropos of a clinical case. Review of the literature]. PMID- 3547177 TI - [Cysts of the mesenterium. Clinical, differential diagnostic aspects and contribution of the various radiologic and instrumental methods]. PMID- 3547178 TI - [Primary intrahepatic calculosis. Echographic diagnosis of a case]. PMID- 3547179 TI - [Diacereine: an original approach in the treatment of degenerative and/or extra articular rheumatism]. AB - 71 patients with variously located osteoarthrosis or primary fibromyalgic syndrome were treated with oral diacereine (DAR). The case series was accumulated in successive periods and may be divided into three groups. An "open" test on DAR (100 mg/die for 4 weeks) was conducted on the first group of 31 arthrosis patients. On the second group of 20 other arthrosis patients a "double-blind, cross-over" test was carried out using DAR (100 mg/die) and naproxene (500 mg/die) both for 2 weeks. The third group of 20 patients with fibromyalgia was treated with DAR alone: 100 mg/die 5 days a week for 12 weeks. The efficacy of the treatment was judged on the basis of the following parameters: rest pain, pressure pain, pain on active and passive movement, and functional limitation. In the first group a positive therapeutic effect was noted in 20 cases (68.9%). There were side effects (moderate diarrhea) in 3 patients 2 of whom suspended treatment. In the second group, DAR and naproxene had an almost identical effect. However 7 patients (36.8%) expressed a preference for DAR, 9 (47.4%) expressed no preference and only 3 (15.8%) preferred naproxene. Side effects were encountered in 3 patients treated with naproxene (2 cases of epigastralgia and pyrosis and 1 case of dyspnea so marked as to require suspension of treatment) and in 3 treated with DAR (modest diarrhea). In the third group, a positive therapeutic effect was noted in 68.4% of the patients with fibromyalgia with a 15% incidence of side effects consisting of slight abdominal pain (diarrhea caused suspension of treatment in 1 case only). Blood chemical parameters were studied in all three groups and no alterations attributable to the treatment were found. The obtained result suggests that the new drug is effective and well tolerated in the envisaged indications. PMID- 3547180 TI - Hippocampal seizures and striatal regulation: a possible functional pathway. AB - Experimental findings have suggested the possibility of a functional relationship between the basal ganglia and the hippocampus. Previous research has revealed a predominantly inhibitory action of the caudate nucleus (CN) and an excitatory effect of the globus pallidus (GP) on electrically induced hippocampal afterdischarges (HAD). The effects of electrolytic destruction of the CN on the threshold and duration of HAD has been studied in the 'encephale isole' cat. The threshold and duration of HAD was also studied following conditioning stimulation of the CN in animals in which the inner segment of the globus pallidus (GPi) and medial septal nucleus (MSN) had been destroyed. Following CN lesions, the hippocampal excitability threshold underwent a significant reduction, while the duration of HAD appeared to be increased. Following destruction of the GPi and MSN, the threshold and duration of HAD exhibited no change following conditioning stimulation of the CN. The results reveal a tonic inhibitory effect of the CN on the hippocampus and suggest that a strio-pallido-septal pathway is the anatomical substrate for the effect. PMID- 3547181 TI - An amperometric enzyme electrode for monitoring brain glucose in the freely moving rat. AB - Brain glucose concentration was measured with an amperometric enzyme electrode using glucose oxidase (EC 1.1.3.4) irreversibly adsorbed onto an organic conducting salt. The responses of the electrode and its stability both in vitro and in vivo are described. Parellel changes in brain glucose and blood glucose (measured in samples from an implanted intra-atrial cannula) following injections of insulin are reported. PMID- 3547183 TI - Pyrrolizidine alkaloids. PMID- 3547182 TI - Evidence that neurons of the paraventricular nucleus of the hypothalamus with projections to the spinal cord are sensitive to the toxic effects of N-methyl aspartic acid. AB - Controversy exists concerning the sensitivity of neurons of the paraventricular nucleus (PVN) of the hypothalamus to the toxic effects of N-methyl aspartic acid (NMA). To further investigate this problem, male golden hamsters (Mesocricetus auratus) received unilateral intrahypothalamic injections of NMA, coupled with injections of horseradish peroxidase into the area of the spinal cord which receives projections from the PVN. Histological evaluation of the brains showed that the NMA injections destroyed PVN neurons that project to the spinal cord. These results are discussed in reference to previous reports on the effects of NMA injections on photoperiod-dependent seasonal cycles in hamsters. PMID- 3547184 TI - Diterpenoids. PMID- 3547185 TI - Recent advances in chemical ecology. PMID- 3547186 TI - Aporphinoid alkaloids. PMID- 3547187 TI - Recent progress in the chemistry of indole alkaloids and mould metabolites. PMID- 3547188 TI - The biosynthesis of the vitamins thiamin, riboflavin, and folic acid. PMID- 3547189 TI - Diterpenoid alkaloids. PMID- 3547190 TI - Recent advances in the use of enzyme-catalysed reactions in organic research: the synthesis of biologically active natural products and analogues. PMID- 3547191 TI - Dietary fat, calorie restriction, ad libitum feeding, and cancer risk. PMID- 3547192 TI - Bulimia among college students. PMID- 3547193 TI - Energy intake and lactation performance in women. PMID- 3547194 TI - Nutrition classics. The American Journal of Cancer, Volume XXXVIII, March, 1940: The initiation and growth of tumors. Introduction. I. Effects of underfeeding. By Albert Tannenbaum. PMID- 3547195 TI - Dietary protein and vitamin B6 requirements. PMID- 3547196 TI - Dietary choline and synaptic morphology in mice. PMID- 3547197 TI - The effect of vitamin E on immune responses. PMID- 3547198 TI - Moderate alcohol consumption increases plasma high-density lipoprotein cholesterol. PMID- 3547199 TI - The Jasmine Beckford inquiry. PMID- 3547200 TI - The controversial A.Z.T. study: a nurse's perspective. PMID- 3547201 TI - Janet Frame: contributions to psychiatry. PMID- 3547202 TI - A community-based trial of transdermal antihypertensive therapy with clonidine (Catapres-TTS). AB - The effectiveness of transdermally administered clonidine using Catapres-TTS patches applied once a week was assessed in the control of mild to moderate hypertension by 16 general practitioners in 135 subjects. Following two weeks on placebo patches, subjects with mean seated diastolic pressures 90 to 104 mmHg were titrated to one, two or three patches and blood pressure responses measured at monthly intervals for three months. Satisfactory response of blood pressure to 90 mmHg or lower was obtained in 85% of patients who completed the maintenance phase; in 20 patients whose blood pressure responses did not reach 90 mmHg, a significantly higher blood pressure (mean 158/103 mmHg) occurred at entry into the trial (145/96 mmHg). Withdrawal from the trial was mainly for reasons of inadequate blood pressure control (15%) or localised skin reactions (15%). Dryness of the mouth was the only systemic side effect encountered with significant frequency and resulted in the withdrawal of three patients. Localised skin reactions were encountered in 51% of subjects, in the majority these were mild and subjects elected to continue with transdermal clonidine because of the convenience of once a week administration. Severe or generalised skin reactions were not encountered. Serum biochemical measurements, including serum lipid levels, remained unaltered. Transdermal clonidine therapy provided satisfactory blood pressure control in the majority of subjects and apart from the localised skin reactions which were largely of nuisance value, proved safe and acceptable to patients. PMID- 3547203 TI - Acoustic trauma with sensory nerve hearing loss. PMID- 3547204 TI - Immunological thrombocytopenia in pregnancy. PMID- 3547205 TI - Severe pneumococcal peritonitis complicating IUD: case report and review of the literature. AB - A case of pneumococcal peritonitis associated with an IUD is presented and four previously reported cases of pneumococcal peritonitis with IUD are reviewed. The infection may occur in previously healthy women who were fitted with an IUD, possibly by ascending infection from the genital tract via the fallopian tubes. The condition is usually accompanied by bilateral salpingitis and may be severe, with fatal outcome. We suggest that any woman over 30 using an IUD, who presents with peritonitis without obvious cause, should be given antibiotics with activity against Streptococcus pneumoniae, following removal of the IUD. PMID- 3547206 TI - Peripartum cardiomyopathy: two case reports and a review. AB - Peripartum cardiomyopathy is a myocardial disease of a dilatative (congestive) nature which typically presents in the last month of pregnancy or within the first 5 postpartum months. In the first case described, heart failure was noted prior to delivery, and complete recovery was achieved with early and aggressive management. Cardiomyopathy developed postpartum in the second case, with a fatal outcome. Early diagnosis and prompt treatment are of paramount importance. Mortality is still high. Recent pathologic findings, methods of diagnosis and theories on etiology are discussed. PMID- 3547207 TI - Alcohol and reproductive function: a review. PMID- 3547209 TI - An ultrasonic view of the umbilical cord. PMID- 3547208 TI - Fetal pulmonary maturity and antenatal diagnosis of respiratory distress syndrome. AB - The clinical entity of hyaline membrane disease affords one the opportunity to study a disease from the cellular, biochemical, anatomical, and clinical standpoint, and to be able to formulate a theory on its pathogenesis. Recent refinements in methodology give the clinician a valuable tool in diagnosing and hopefully preventing hyaline membrane disease. In the setting where early delivery is unavoidable, the potential for pharmacologic intervention exists, and hopefully, long-term studies will prove the benefit of steroid therapy. PMID- 3547210 TI - Detection of Chlamydia trachomatis infection by direct immunofluorescence staining of genital secretion. AB - A monoclonal antibody specific for Chlamydia trachomatis (Syva Microtrak) was used to stain directly 249, 127, and 67 specimens obtained from the cervix, and the female and the male urethra, respectively. The Microtrak system identified 100% or 23 culture-positive cases from the cervix (prevalence 9.2), 100% or seven culture-positive cases from the female urethra (prevalence 5.5%), and 93% or 14 culture-positive cases from the male urethra (prevalence 22.4%). Because the Microtrak system is readily available, relatively inexpensive, and easy to read with a fluorescent microscope, it should become a valuable tool to assess objectively both men and women suspect for this common sexually transmitted disease. PMID- 3547211 TI - Clinical interpretation of ultrasound measurements in preterm pregnancies with premature rupture of the membranes. AB - Interpreting ultrasound measurements in preterm pregnancies complicated by premature rupture of the membranes is problematic; the effects of physical compression and diminished fetal growth are unclear. To delineate these factors, we analyzed ultrasound scans from 397 preterm pregnancies, including 26 with premature rupture of the membranes. Mean biparietal diameter (BPD), abdominal circumference, femur length, and estimated fetal weight were all significantly smaller with premature rupture of the membranes than without. However, this reflected younger gestational age and diminished fetal growth, rather than physical compression. The reduction in abdominal circumference was greater than that in other indices, which further suggests compromised intrauterine growth. Clinical interpretation of ultrasound measurements should consider the increased likelihood of growth retardation with preterm premature rupture of the membranes to avoid underestimating gestational age and/or missing the diagnosis of intrauterine growth retardation. PMID- 3547212 TI - Ultrasonic diagnosis of discordant fetal growth in twin gestations. AB - Forty-three consecutive twin pregnancies were evaluated by ultrasound to establish criteria for antenatal detection of discordant fetal growth. For each fetus an attempt was made to measure the biparietal diameter (BPD), abdominal circumference, and femur length; the estimated fetal weight was also calculated based on published formulas. The intrapair differences in BPD, abdominal circumference, femur length, and estimated fetal weight were evaluated as predictors of discordant fetal growth. Although the intrapair difference in BPD measurement was not a statistically significant predictor, an intrapair difference in abdominal circumference of 20 mm or more was found to have sensitivity 80%, specificity 85%, positive predictive value 62%, and negative predictive value 93%. Intrapair difference in the estimated fetal weight was found to be the best predictor of discordant fetal growth (sensitivity 80%, specificity 93%, positive predictive value 80%, and negative predictive value 93%). These data suggest that the intrapair difference in abdominal circumference measurement could be effectively used as a screening test for the diagnosis of discordant fetal growth. If the intrapair difference in abdominal circumference is 20 mm or greater, further evaluation, by determining the intrapair difference in estimated fetal weight, is indicated. PMID- 3547213 TI - Clinical aspects of fetal heart auscultation. AB - The widespread belief that fetal heart tones are first detected with an unamplified fetoscope at about 20 weeks' gestation has been studied prospectively only twice. Using data collection prospectively from 352 visits of 77 patients between 15 and 23 weeks' pregnancy, we studied various clinical aspects of fetal heart tone detection. We determined the gestational age at the time of initial auscultation of fetal heart tones with an ordinary fetoscope, and its relationship to quickening, parity, and placenta location. Fetal heart tones were first identified by auscultation at a mean gestational age of 19.4 weeks (range 17-22 weeks). Detection was possible in 81% of patients examined at 20 weeks and in virtually all patients examined at 21 weeks or later. Once heard, fetal heart tones were identified in every subsequent visit for all patients. Parity and placenta location were significant factors influencing initial fetal heart tone detection. Auscultation preceded quickening in only 12% of patients. Recommendations for using initial fetal heart tone detection in clinical practice are given. PMID- 3547214 TI - Effects of maternal oral salbutamol therapy on neonatal endocrine status at birth. AB - Cord blood concentrations of insulin, growth hormone (GH), triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) from 20 patients treated with oral salbutamol were compared with those of 18 matched patients who had not received any betamimetic agents. No significant difference was found in circulating insulin, T3, T4, and TSH between both groups. However, GH levels were significantly higher in the treated group (36.5 +/- 17.4 ng/mL) than in the control group (17.4 +/- 6.6 ng/mL; P less than .001). The unexpected increase in GH levels in the treated group could reflect either fluctuating fetal blood glucose in response to episodic betamimetic administration or direct fetal pituitary production through adrenergic stimulation. PMID- 3547215 TI - Ultrasonic recognition of the small-for-gestational-age fetus. AB - Sonar biparietal diameter, femur length, abdominal circumference, femur length/abdominal circumference ratio, ponderal index, and estimated fetal weight were obtained within ten days of delivery of small-for-gestational-age (SGA) (N = 102) and non-SGA (N = 204) newborns. The effectiveness of each ultrasound variable in the antenatal recognition of the SGA fetus was assessed. An abnormal abdominal circumference was the best predictor, confirming SGA in 98% of cases. Other variables (biparietal diameter, femur length, femur length/abdominal circumference ratio, ponderal index, or estimated fetal weight) were less accurate for predicting SGA. When we determined expected results based on a 10% prevalence of SGA, negative predictive value was greater than 92% for all variables studied; however, with the exception of estimated fetal weight and femur length, positive predictive values were disappointing, including abdominal circumference (21%). This report establishes the limits of ultrasound-derived growth variables in the antenatal identification of the SGA fetus. PMID- 3547216 TI - Estimated fetal weight in the evaluation of growth in twin gestations: a prospective longitudinal study. AB - A prospective longitudinal study was conducted in order to determine by sonographically estimated fetal weight the patterns of fetal growth in twins. Thirty-five healthy women with normal twin pregnancies were examined every three weeks from the 15th week of gestation to delivery. Among the measurements obtained were the biparietal diameter (BPD), the abdominal circumference, and the calculated fetal weight. From 15-28 weeks, the growth velocity of the BPD and abdominal circumference remained fairly constant, with a steady increase in incremental growth. Beyond this age, we observed a slowing in growth of the BPD, while the abdominal circumference continued at a constant rate. The growth velocity of the weight steadily increased throughout pregnancy. Although greater biologic variability in weight between twin A and B was observed as gestational age progressed, the overall mean weights of twin A and B were not statistically different. We have generated a nomogram of fetal weight gain throughout pregnancy. PMID- 3547217 TI - Antenatal evaluation and management of ultrasonically detected fetal anomalies. AB - With the advent of improved ultrasound imaging, it is now possible to make an intrauterine diagnosis of many fetal anomalies. The key to an accurate antenatal diagnosis is careful scanning of the fetus and knowledge of the abnormalities that may be associated with a particular anomaly. In the presence of fetal anomalies known to be associated with increased frequency of chromosome abnormalities, fetal karyotyping is indicated, using either amniocentesis or fetal blood sampling, depending upon the urgency of the diagnosis. Fetal echocardiography is mandatory when the ultrasonically detected fetal anomaly is one that is known to be associated frequently with cardiac disease. Based on the antenatal findings, the parents should receive appropriate genetic and perinatal counseling. The management plan should always take into consideration the parents' wishes. Management plans for the most common ultrasonically detected fetal anomalies are presented, based upon review of the literature and authors' experience. PMID- 3547218 TI - A simplified method for estimating fetal weight using ultrasound measurements. AB - A simplified method of estimating fetal weight was developed and tested on 366 ultrasound examinations performed close to delivery. Constructed by linear regression on the sum of the biparietal diameter (BPD), mean abdominal diameter, and femur length against the logarithm of birth weight, the model was compared to the Shepard-Warsof model, which uses BPD and abdominal circumference to estimate fetal weight. Models using the same simplified approach to estimate fetal weight using BPD with mean abdominal diameter, and femur length with mean abdominal diameter, were also developed. Fetal weight estimate tables for these models involve only one variable, making them easier to use. PMID- 3547219 TI - [Peptidases of oral Streptococci--I. Hydrolysis mechanisms and comparison of arylamidase activities in oral Streptococcus species using the API ZYM system]. PMID- 3547220 TI - [A prominent ophthalmologist and tireless researcher (on the 120th anniversary of the birth of S. S. Golovin)]. PMID- 3547221 TI - [The final year of S. S. Golovin's work in Odessa]. PMID- 3547222 TI - [Successful chemotherapy in a primary cerebral centroblastic non-Hodgkin's lymphoma in childhood]. AB - Primary lymphomas of the central nervous system (CNS) are rare diseases. Often these tumors are surrounded by glia cells and may, therefore, be misdiagnosed as 'astrocytomas' with accompanying reactive lymphocytosis. A 15-year old patient was irradiated to the posterior cranial fossa and the brain stem because of a supposed astrocytoma. Five months after completion of radiotherapy he presented two lesions each in the right and left cerebral hemisphere. Repeated biopsy led to a revision of the primary diagnosis in favor of a B-cell Non-Hodgkin lymphoma (centroblastic type). After cyclic polychemotherapy including high-dose methotrexate and cytosine-arabinoside he entered a complete remission. No further radiotherapy was given. So far, 18 months after discontinuating therapy, the patient has been in complete remission and is in an excellent physical condition. PMID- 3547223 TI - Chemotherapy of advanced gastric carcinoma. AB - The results of current chemotherapeutic treatment for advanced gastric carcinoma are reviewed. Recent results of phase-II trials suggest that besides 5 fluorouracil, the nitrosoureas, adriamycin and mitomycin C, cis-platinum is also an effective drug in advanced gastric carcinoma. The favorable results obtained with the FAM-regimen in the late seventies, which were believed to be a significant step towards an improved treatment of gastric carcinoma, could not be confirmed, and several tested FAM-modifications were not able to improve treatment results. However, some recent investigations of cis-platinum within combination chemotherapy, i.e. with 5-fluorouracil and adriamycin (FAP), showed response rates beyond 30% and possibly a prolongation of median survival. These favorable data, which suggest an encouraging progress within the treatment of advanced gastric carcinoma, have to be confirmed in further controlled clinical trials. PMID- 3547224 TI - [Significance of TNM classification in evaluating the prognosis of resected lung cancer]. PMID- 3547225 TI - [Simulation modelling of cell systems in definitive and developing tissues]. AB - A review of simulation models of cells is provided, with a description of the basic methods of simulation. The deterministic and stochastic models of cell kinetics are considered on a few examples. A tendency has been revealed to applying the method computer reflection of the structure of heterogeneous cell systems. The utilization of specialized programmed languages of simulation is considered as promising. PMID- 3547226 TI - [Mechanism of action of vitamin A on cell differentiation and function]. AB - The vitamin A effects on cell proliferation, differentiation and functioning might be due to its influence on genome expression at the level of regulation of the transcription of certain genes, posttranscriptional modification of mRNA levels, or changes in the membrane structural-functional organization. Vitamin A can affect the biosynthesis of various proteins, including those involved in regulation of development and cell functioning or determining cell sensitivity to hormones and hormone-like factors. Vitamin A can also influence the formation of secretory proteins which play the role of hormones. It is proposed to use the differential sensitivity of various cells in cell populations to vitamin A or its forms for studying intercellular relations. In particular, the capacity of retinol and retinoic acid to maintain the development and functioning of various vitamin A-dependent cells of the testis can be used for studying local regulation of spermatogenesis in mammals. PMID- 3547227 TI - [Immunofluorescent research on the species specificity of the antigens of hematopoietic cells in rodents]. AB - The bone marrow cells of mice, rats, guinea pigs, Syrian and dwarf hamsters exhibit a positive immunofluorescence reaction with antisera against insoluble antigens of the bone marrow cells of mice, Syrian and dwarf hamsters and, hence, contain common "cross-reacting" antigens. The use of different methods of antiserum absorption made it possible to reveal, in addition, antigens of "narrow" specificity in (1) mice, Syrian and dwarf hamsters, (2) Syrian and dwarf hamsters, as well as species specific antigens of the bone marrow cells of mice, Syrian and dwarf hamsters. PMID- 3547229 TI - Inflamed eye in Marfan's syndrome with posteriorly luxated lens. AB - A 34-year-old man with Marfan's syndrome complained of redness and pain in the left eye. The right eye had been blind because of untractable retinal detachment. The left eye had had three surgical procedures for retinal detachment, and the lens had been luxated in the vitreous for more than 14 years. Ultrasonography demonstrated the spontaneously luxated lens as the possible cause of the inflammatory reaction. The diagnosis of lens-induced endophthalmitis was confirmed by histopathologic examination of the excised lens. PMID- 3547228 TI - Preliminary research on the resistance of IOLs to a Q-switched Nd-YAG laser. AB - Using a multimode and a fundamental mode Q-switched Nd-YAG laser, the authors study the possible damages to glass and PMMA IOLs in vitro. The fundamental parameters in this evaluation seem to be the distance between the focus and the IOL and the power delivered. PMID- 3547231 TI - Fibro-osseous integrated and osseous integrated dental implants. A comparative study. Part one. PMID- 3547230 TI - Topical retinoic acid treatment of drug-induced pseudopemphigoid. AB - A case of drug-induced ocular cicatricial pemphigoid with pronounced keratinizing squamous epithelium metaplasia was treated for 5 months with all-trans retinoic acid ointment. Keratinization reversed completely and the cicatricial process was stabilized in one eye and slowed down in the other eye. The treatment was well tolerated. PMID- 3547232 TI - Lichen planus pemphigoides: report of a case with oral lesions. AB - Lichen planus pemphigoides is a rare condition characterized by the coexistence of lichen planus and bullous pemphigoid. Oral lesions have been reported but have not been studied immunopathologically. We describe a 59-year-old white man with cutaneous and oral lesions of lichen planus pemphigoides. Biopsies were done on these lesions, and the specimens were examined by routine light microscopy and immunofluorescent techniques. Fine keratotic striae on the anterior buccal mucosa were clinically consistent with oral lichen planus. Perilesional tissue associated with ulceration of the posterior buccal mucosa showed histologic and immunopathologic changes consistent with bullous pemphigoid. PMID- 3547233 TI - Extraradicular cemental fragments in the alveolar bone of prehistoric American Indians: report of three cases. AB - Heretofore unreported, grossly observable structures composed of cementum were found in the superficial alveolar bone--but not attached to the tooth root--in three prehistoric American Indian skeletons from South Dakota. The macroscopic, radiographic, and histologic morphology of these fragments is described and compared with other cemental structures that occur in the alveolar process. PMID- 3547235 TI - [Surgical treatment of "settled" tibial condyli]. PMID- 3547234 TI - [Control of the condition of bone autotransplants on the vascular pedicle]. PMID- 3547236 TI - [On the centenary of the birth of Prof. A.E. Frumina]. PMID- 3547237 TI - [Current aspects of treating closed diaphyseal fractures of the forearm bones]. PMID- 3547238 TI - [Cases of adult acute non-lymphoblastic leukemia in patients disease-free for more than 2 years]. PMID- 3547239 TI - [Ultrasonic diagnosis of hypoxic-ischemic encephalopathy in mature neonates]. PMID- 3547240 TI - [Nicolas Appert and food preservation]. PMID- 3547241 TI - [Treatment of hypothalamic amenorrhea by pulsatile infusion of gonadotropin releasing hormone]. PMID- 3547242 TI - [Xanthogranulomatous pyelonephritis]. PMID- 3547243 TI - [Results of extended screening aimed at risk groups for cardiopulmonary diseases in the 10th District of Budapest]. PMID- 3547244 TI - [In memory of Albert Szent-Gyorgyi]. PMID- 3547245 TI - [In memory of Sandor Belak]. PMID- 3547246 TI - [A physician-writer from the Vojvoda District (Kornel Szenteleky)]. PMID- 3547247 TI - [The laudable enterprise of Slovak medical historians]. PMID- 3547248 TI - [Anticoagulant and platelet-inhibition therapy of patients with artificial heart valves]. PMID- 3547249 TI - [Serum and urine beta-2-microglobulin levels in various kidney diseases]. PMID- 3547250 TI - [Is the consumption of coffee and methylxanthine derivatives a health hazard?]. PMID- 3547252 TI - [The city of Nagybanya--from the viewpoint of medical history]. PMID- 3547251 TI - [Thoughts of Istvan Weszpremi on the Holy Crown of Hungary...]. PMID- 3547253 TI - Roman ophthalmic science (743 B.C.--A.D. 476). AB - Literary and archeological evidence for the achievements and progress of Roman ophthalmic science is reviewed. It appears that, by the end of the period under consideration, significant advances had been made in the diagnosis and treatment of a variety of ocular disorders, and in knowledge of ocular anatomy. However, in spite of their possession of skills of a high order in some aspects of glass technology and their familiarity with various aspects of geometrical optics, the Romans never developed optical aids to overcome refractive defects. PMID- 3547255 TI - Evidence that adjuvant arthritis in the rat is associated with chronic pain. AB - The paper reviews evidence that adjuvant arthritis in the rat is associated with chronic pain and discusses the time course and measurement of this putative pain. The available evidence is consistent with the view that arthritic rats suffer pain, but it appears difficult to formally establish the occurrence of chronic pain in animals. The data suggest the pain to be severe during weeks 2 and 3 and to persist during weeks 4 and 5 after inoculation. The continuing inflammation of joints likely results in movement-induced acutely elicited pains that may persist till about the 8th week. The severe pain during weeks 2 and 3 may be associated with a depression of some drives, and the entire week 2-8 period is likely associated with varying levels of chronic stress. Neurochemical and neurophysiological studies indicate that adjuvant arthritis profoundly influences several of the neurotransmission and neuroendocrine functions of brain and spinal cord; among the affected systems are substance P-ergic, serotonergic and endorphinergic systems. Adjuvant arthritis in the rat constitutes the only laboratory animal model of chronic pain that has been validated to a significant extent. It is suggested that the model be examined further and that additional animal models of chronic pain be developed. PMID- 3547254 TI - Comparison of the anti-inflammatory activity and effect on intraocular pressure of fluoromethalone, clobetasone butyrate and betamethasone phosphate eye drops. AB - The effect of fluoromethalone 0.1% suspension (FML), clobetasone butyrate 0.1% (Eumovate) and betamethasone phosphate 0.1% (Betnesol) in post-operative inflammation was studied in 60 eyes (50 patients) in a randomized trial. No significant differences were noted, although two patients required higher penetration steroids than FML or Eumovate. Betnesol seemed to have a greater tendency to cause raised intraocular pressure than FML. In this series, however, the authors are unable to comment on differences between Eumovate and Betnesol. PMID- 3547256 TI - Thermally potentiated responses to algesic substances of visceral nociceptors. AB - Using spermatic nerve preparations from testis superior, the effects of temperature rise on chemical responses were studied in vitro, within both subthreshold and suprathreshold ranges for testicular polymodal receptors, one type of visceral nociceptor. In the range of temperature subthreshold for polymodal receptors, the responses to algesic substances tested were greater at higher temperatures. The mean discharge rates induced by various concentrations of bradykinin (BK, 9 X 10(-9)-9 X 10(-6) M), were significantly greater at 36 degrees C than at 30 degrees C. Responses to hypertonic saline, tested in the temperature range, 34-43 degrees C, showed similar temperature-dependent increases, and Q10 values between 2.3 and 4.2. In the units exhibiting 'heat sensitization' with repeated testing of suprathreshold temperature rises, the response to hypertonic saline (616 mM) at 34 degrees C also increased. Although calor in the inflamed tissues is in itself not high enough to cause excitation of 'pain receptors,' temperature-dependent augmentation of chemical responses of the polymodal receptor might partly explain peripheral hyperalgesic behaviour observable in inflamed tissue on the basis of sensory receptor activity. PMID- 3547257 TI - Trichinella spiralis: immunocytochemical localization of surface and intracellular antigens using monoclonal antibody probes. AB - A panel of immunologically and biochemically defined monoclonal antibody probes has been used in conjunction with immunocytochemical techniques to localize target antigens in sections of different life-cycle stages of Trichinella spiralis. Monoclonals that immunoprecipitate surface components from adult worms, show reactivity with the surface but not with internal tissues of sectioned parasites. Reagents that immunoprecipitate radio-isotope labelled stage-specific surface components of muscle-stage larvae, however, react with the stichosome and gut lining of sectioned larvae, as well as with the surface. Monoclonal antibody probes that do not stain the surfaces of live, intact muscle larvae in immunofluorescence assays, but which immunoprecipitate solubilized surface glycoproteins, also show reactivity with cuticular and stichosomal antigens of sectioned larvae. The more powerful resolution provided by electron microscopy has localized the surface antigens to the epicuticle and the intestinal antigens to the brush-border microvilli. Of particular interest was the finding that antigens of muscle-stage larvae, known to confer protection upon recipient mice, also exist in the stichosome of adult parasites. This observation may shed some light on the fact that mice immunized with antigens from muscle-stage larvae show, in addition to reduced muscle larva burden, accelerated expulsion of adult worms. The implications of these data for stage specificity of immune responses to trichinosis are discussed. PMID- 3547258 TI - Isoenzyme characterization of trypanosomes of the subgenus Herpetosoma. AB - Isoenzyme analysis was used to characterize 6 species of trypanosomes of the subgenus Herpetosoma using 13 different enzyme systems. The species studied were Trypanosoma lewisi, T. musculi, T. grosi, T. microti, T. evotomys and T. nabiasi which cannot be distinguished on morphological grounds. Extracts for thin-layer starch-gel electrophoresis were prepared from cultures of insect forms in either Schneider's Drosophila or Grace's insect tissue culture media with foetal calf serum or a nutrient agar medium. Extracts of T. lewisi and T. musculi bloodstream forms were also run for comparison. All parasites gave distinct patterns which enabled them to be differentiated on one or more enzyme systems. Two types of computer analysis were used to group the parasites; using these techniques the murine parasites T. lewisi, T. musculi and T. grosi fell into one broad group, and T. microti and T. evotomys of microtine rodents formed another. These findings are in accord with earlier observations on the behavioural characteristics of these parasites in their mammalian host and their vector (fleas). The clear differences observed provide the basis for the application of other biochemical and immunological techniques for differentiation within this subgenus of trypanosomes. PMID- 3547259 TI - The response of ventral horn neurons to ricin. An experimental abiotrophy model. AB - The morphological alterations of anterior horn neurons of the spinal cord of rabbits produced by the administration of ricin conveyed via retrograde axonal flow are described. The differences with the primary response after axonal transection and the similarity with degenerative abiotrophic systemic lesions are discussed. PMID- 3547260 TI - [In vitro study of the effects of an imipenem-fosfomycin combination against clinical strains of Staphylococcus]. AB - In vitro antibacterial activity of imipenem-fosfomycin (IMP-FOS) combinations were studied against 31 clinical isolates of Staphylococcus strains: methicillin susceptible S. aureus (MSSA, 11 strains), methicillin resistant S. aureus (MRSA, 11 strains), methicillin resistant S. epidermidis (MRSE, 9 strains). The study was carried out by means of a microtiter checkerboard method (FICs and FBCs index) and killing-curves (3 strains). Imipenem antibacterial activity was good against MSSA (mean MICs of 0.12 micrograms/ml) but reduced against MRSA (16 micrograms/ml). Fosfomycin was regularly effective (CMI less than or equal to 64 micrograms/ml) against most strains. IMP-FOS combination was strongly synergistic (FIC less than 0.125) against MSSA and still synergistic with achievable therapeutic concentrations against heterogeneous MRSA and MRSE strains (mean FIC of 0.125, MIC in the combination of 1 microgram/ml). The bactericidal activity (FBCs and killing-curves) was limited against homogeneous MRSA and MRSE needing higher concentrations (8 micrograms/ml in the combination). In the 3 cases fosfomycin concentrations in combination remained low (1 to 2 micrograms/ml). PMID- 3547261 TI - [Antibiotic sensitivity of Pasteurella multocida and related bacteria (bacterial groups M5 and EF4). Studies of minimal inhibitory concentrations by agar dilution]. AB - We have been isolating Pasteurella multocida and similar germs increasingly during the last few years: due to the rabies coming back in Eastern France, more consultations have been held following animal bites; samples are then taken for a bacteriologic research. We have studied their sensitivity towards 30 antibiotics. The determination of the MIC was achieved through the agar dilution method on 34 Pasteurella multocida of human origin issued after bites and expectorations, 4 EF4 and 4 M5. The Pasteurella are very sensitive to: beta-lactam antibiotics (the lowest MIC were observed for ureido-penicillins, amino-benzylpenicillins and third generation cephalosporins), chloramphenicol, cyclines and quinolones. Fosfomycin colistin and aminoglycosides are also active but with higher MIC. The macrolides have got a slow or no activity at all. The M5 are susceptible to the same antibiotics as Pasteurella but with slightly higher concentrations. Regarding EF4, minor sensitivity or resistance to penicillin G, cephalothin and cefamandole can be pointed out. PMID- 3547263 TI - [Interstitial pneumopathies during amiodarone treatment. Determination of serum amiodarone, typing of lymphocytes from bronchiolo-alveolar lavage]. AB - We report 6 cases of diffuse interstitial pneumonia complicating therapy. The patients' study included the determination of amiodarone plasma level by high performance liquid chromatography (HPLC) and a study of lymphocyte subpopulations in alveolar lavage (wash cut). The mean cumulative dosage of amiodarone was 229 g; clinical symptoms were mainly weight loss, asthenia, dyspnea and dry cough. Bronchiolo-alveolar lavage fluids contained numerous lymphocytes, of which were T cells with a predominance of T8 lymphocytes. This is compatible with an immunoallergic mechanism as suggested in allergic alveolitis and in other drug induced pulmonary diseases. The determination of plasma amiodarone level performed after amiodarone withdrawal consistently showed a level inferior to the toxic one. These data confirm the lack of correlation between the pneumonitis outbreak and the amiodarone plasma level. Study of the red cell concentration of amiodarone and its major metabolites seems to be of greater interest. PMID- 3547262 TI - [Methylation of membrane phospholipids of alveolar macrophages in pulmonary sarcoidosis and diffuse interstitial pulmonary fibrosis]. AB - Alveolar macrophage plays an important role in alveolitis pathogenesis and lung fibrosis process. Macrophages exhibit plasmic membrane biochemical modifications during cell activation. Phospholipid methylation is involved during plasmic membrane stimulation. Phosphatidylethanolamine methyltransferase I was measured in alveolar macrophage membrane from normal subjects and patients presenting with pulmonary sarcoidosis or interstitial lung fibrosis. We observed increased enzyme activity among sarcoidosis subjects with high intensity lung alveolitis and normal subjects receiving immunostimulating treatment (RU 41740). The role of membrane phospholipidic modifications in granulomatous process is discussed. PMID- 3547264 TI - [Pharmacokinetics of cefmenoxime in the aged subject (60 to 90 years of age) after an intravenous injection of 1 g]. AB - A pharmacokinetic study of Cefmenoxime (CMX) has been carried out in 17 patients, 60 to 90 years old, following IV injection of 1 gram. Plasma concentrations of CMX were determined in 15 blood samples drawn between 0.25-12th hour by a specific high pressure liquid chromatography. The apparent terminal half lives calculated by regression analysis ranged from 0.94 to 3.8 h. We observed an increase of apparent elimination half life and a decrease of total clearance with aging as compared to that of healthy young subjects. Apparent volume of distribution seemed not to differ from those observed in young adults. There is a correlation between renal function and elimination kinetics of Cefmenoxime. In spite of kinetics modifications, it seems that it is not necessary to modify the dosage regimen in elderly. PMID- 3547265 TI - [Methodological problems in the determination of microalbuminuria]. AB - We have performed 7 different urinary collections to assess albumin excretion rate in insulin-dependent diabetics. The night and the 24 hours urine collections were more accepted than the others. For albumin excretion rate there was no correlation among the different collections. So, the albumin excretion rate must be done always on the same sample for one patient and be repeated to confirm pathological values. PMID- 3547266 TI - [Evaluation of the activity of antibiotics against Listeria. Therapeutic perspectives]. AB - The activity of different antibiotics was considered by studying the results reported in literature and during the IXth International Symposium on the Problems of Listeriosis. Listeria susceptibility to antibiotics did not change. Ampicillin was always one of the most effective and used antibiotics against Listeria. The association with an aminoglycoside produced a synergistic effect, which made the bactericidal activity quicker, in vitro as in vivo on animal. More recent molecules like third generation cephalosporins or fluoro-piperazinyl quinolones had poor activity against Listeria. PMID- 3547267 TI - Complement and host defence against microorganisms. PMID- 3547269 TI - Lymphocytes, polymorphonuclear leukocytes, macrophages and platelets in synovium involved by rheumatoid arthritis. A study with monoclonal antibodies. AB - The inflammatory cell infiltrate involving synovial tissues from joints affected by rheumatoid arthritis (RA)++ has been contrasted with that present in synovium removed from joints involved by previous trauma (T) or osteoarthritis (OA). Cell deployment has been mapped by immunohistochemistry using monoclonal antibodies which recognise epitopes characterising T and B cells, polymorphonuclear leukocytes, mononuclear phagocytes and platelets. Mononuclear phagocytes were the most consistent feature of the rheumatoid inflammatory cell exudate and were present, particularly in the synovial layer, in all OA/T samples. The synovial cells lacked the C3b complement receptor, CR1, but expressed CR3, the receptor for C3bi. In rheumatoid synovium, interdigitating cells were difficult to identify but cells of dendritic morphology bore at least one macrophage epitope. T cells far out-numbered B cells and generally lacked the IL-2 receptor which is an indicator of T cell activation. Care is required in the estimation of the T helper/inducer (TH) T suppressor/cytotoxic (Ts) ratio. Polymorphonuclear leukocytes were demonstrated around vessels and near the synovial intimal cell layer suggesting rapid tissue transit. Extravascular platelets were sparse. Follicular dendritic cells were defined by their central location in lymphoid follicles and strong expression of CR1 receptors. HLA-DR expression was widespread except on endothelial cells. PMID- 3547268 TI - Retrospective confirmation of Mycoplasma infection by the immunoperoxidase technique. AB - Rat tissues embedded in paraffin blocks stored for 8-10 yr were sectioned for immunoperoxidase staining. Sections of lung, trachea and endometrium of 22 of 32 rats that had exhibited clinical symptoms of mycoplasmal pneumonia prior to euthanasia, and whose organs had shown gross lesions suggesting mycoplasmal infection on necropsy, demonstrated the presence of Mycoplasma pulmonis organisms by the immunoperoxidase technique in one or more of these tissues. PMID- 3547270 TI - Seroimmunology of AIDS retrovirus infection. I. Use of immunofluorescence assay to confirm sera with ELISA reactivity. AB - One thousand sera shown to be reactive by one of two commercial enzyme linked immunosorbent assays (ELISA) for antibodies to the AIDS virus were referred to the NSW State Reference Laboratory for confirmatory assays. Each serum was retested by two commercial ELISA systems (Abbott and ENI), the ENI exclusionary H9 ELISA and an immunofluorescence assay. Three hundred and twenty four sera were reactive by all 3 tests whereas 244 demonstrated concordant non-reactivity. Three hundred and seventy seven sera were reactive by Abbott EIA only and could not be confirmed positive by the ENI ELISA incorporating exclusionary testing, immunofluorescence or Western immunoblot of representative sera. Sera obtained from teaching hospital laboratories were more likely to be positive and less likely to be negative by all 3 tests, and were also less likely to be Abbott EIA reactive only compared with sera obtained from the blood transfusion service. Of the remaining 55 sera, 52 demonstrated a negative immunofluorescent reaction or a pattern of equal fluorescence on AIDS virus infected and control cells. Representative sera were shown to be negative on Western immunoblot analysis. Of the 3 sera which demonstrated immunofluorescence reactivity, one was positive and one was negative by Western immunoblot, and one could not be determined. We conclude that a combination of two ELISAs, one with an exclusionary ELISA test and an immunofluorescence assay is a reliable and simple means of confirming reactive sera for AIDS virus antibodies. PMID- 3547271 TI - HLA-DR expression on renal tubular cells in various renal disorders. PMID- 3547272 TI - Aerosols from the catalase test. PMID- 3547273 TI - [Embalming practices in Europe (including the Middle Ages)]. PMID- 3547274 TI - Metastatic histiocytoid carcinoma of the breast. Immunocytochemical report of a case. PMID- 3547275 TI - Diabetic glomerulosclerosis: computer-aided quantitative microscopy. PMID- 3547277 TI - Radiological imaging of urogenital tuberculosis in children with emphasis on ultrasound. AB - Radiological recognition of tuberculosis in children ist uncommon as the initial lesions are occult. The appearances of our last 12 cases of renal TB have been tabulated. When the condition becomes radiologically evident the bladder is usually involved and the lesions can be detected ultrasonically. Ultrasonography as a primary method of diagnosis is described. PMID- 3547276 TI - Pneumatosis intestinalis in children after allogeneic bone marrow transplantation. AB - Four children, ages 3 to 8 years, developed pneumatosis intestinalis (PI) after allogeneic bone marrow transplantation (BMT) for acute leukemia or severe aplastic anemia. PI was detected at a median of 48 days (range, 10-63 days) after BMT and was associated with abdominal symptoms and clinical signs. All patients had severe systemic and/or high-grade cutaneous acute graft-versus-host disease (AGVHD) at some time after BMT and were receiving corticosteroids at the time of development of PI; however, PI was associated with concomitant severe AGVHD in only one patient. One patient with PI had Hafnia alvei bacteremia and another patient had gastroenteritis due to rotavirus and adenovirus. All patients were treated with supportive care and systemic broad-spectrum antibiotics, and PI resolved 2-16 days after onset. Two patients died with BMT-associated complications unrelated to PI. Multiple factors contribute to the development of PI after BMT, and the prognosis for recovery from PI is good with medical management alone. Overall survival in these patients is dependent on the frequency and severity of other conditions, such as AGVHD and opportunistic infections, after BMT. PMID- 3547278 TI - CT demonstration of asymptomatic pulmonary emboli after bone marrow transplantation: case report. AB - Asymptomatic pulmonary emboli producing microcalcifications were observed 200 days after bone marrow transplantation on a routine surveillance CT in a child. The findings consisted of peripheral hazy, nodular infiltrates in the lower lung fields. To our knowledge this has not been recorded in the radiologic literature. PMID- 3547280 TI - Pyelocalyceal diverticula in the Beckwith-Wiedemann syndrome. AB - A case of pyelocalyceal diverticula in a patient with the Beckwith-Wiedemann syndrome is presented. The abnormalities were first identified on screening ultrasound and confirmed at excretory urography. The diverticula in this syndrome are likely secondary to hereditary embryopathy of the kidneys. PMID- 3547279 TI - Transitional cell papillary carcinoma of the bladder in a child. AB - We report a rare case of transitional cell papillary carcinoma of the bladder in a 10-year-old girl who had hematuria. The tumor was diagnosed and assessed through VCUG and ultrasound. The tumor protruded into the urethra during micturition and its mobility was observed by both diagnostic procedures. PMID- 3547281 TI - Bilobed testicle. PMID- 3547282 TI - High frequency chest wall compression in cats with normal lungs. AB - Ten anesthetized, paralyzed adult cats were ventilated by high frequency chest wall compression (HFCWC) at 3, 5, 7, and 9 Hz by means of a single chamber cuff enclosing the thorax from the axillae to the xyphisternum. The effects of HFCWC in terms of gas exchange, end-expiratory lung volume, and respiratory system compliance were compared to conventional intermittent positive pressure ventilation (IPPV) (30 breaths/mn). HFCWC and IPPV were compared at three levels of matched end-expiratory airway pressure [continuous positive airway pressure (CPAP)/positive end-expiratory pressure/(PEEP) of 0, 2, and 5 cm H2O]. In the absence of CPAP, HFCWC resulted in a marked decrease (up to 50%) in end expiratory lung volume with significantly lower PaO2, lower compliance, and higher alveolar-arterial oxygen gradient than during IPPV. No differences in PaO2 and a-ADO2 were observed when HFCWC was combined to CPAP greater than or equal to 2 cm H2O. At frequencies below 9 Hz, PaCO2 became significantly lower during HFCWC + CPAP than during IPPV. During HFCWC + 2 cm H2O CPAP, lung volume was lower than during IPPV + 2 cm H2O and similar to the volumes observed during IPPV + 0 positive end-expiratory pressure. Additional studies in six cats at HFCWC + 3 cm H2O confirmed that CPAP greater than 2 cm H2O more than adequately compensated the decrease in lung volume associated with HFCWC alone. Peak cuff pressures between 14 and 17 cm H2O generated oscillary tidal volumes between 4.5 and 2.1 ml/kg. The size of the oscillatory volume was significantly affected by increasing frequencies (decrease in tidal volume) and increasing levels of positive airway pressure (increase in tidal volume). We conclude that in cats with normal lungs, HFCWC can provide for normal gas exchange, provided that it is combined with low level CPAP in order to prevent the occurrence of airway closure associated with HFCWC alone. PMID- 3547283 TI - [2 cases of cortical hyperostosis in infants]. PMID- 3547284 TI - Otitis media and sinusitis: management and when to refer to the otolaryngologist. PMID- 3547285 TI - Diagnosis and management of acute urinary tract infections in infants and children. PMID- 3547286 TI - Human immunodeficiency virus infections in children: public health and public policy issues. PMID- 3547287 TI - Changing therapy for skin and soft tissue infections in children: have we come full circle? PMID- 3547288 TI - Pathogenicity and therapy of anaerobic bacteria in upper respiratory tract infections. PMID- 3547289 TI - Bronchitis and pneumonia in ambulatory patients. PMID- 3547290 TI - Streptozyme test for antibodies to group A streptococcal antigens. AB - The ability of the Streptozyme test to identify significant antibody rises in 46 patients with streptococcal pharyngitis was comparable to, but no greater than, that of the antistreptolysin O or antideoxyribonuclease B test and inferior to that of the combined use of both the antistreptolysin O and antideoxyribonuclease B tests. Serum specimens were also simultaneously analyzed with three different lots of Streptozyme reagent. Lot-to-lot variation in the reagent resulted in a significant difference in antibody titer for 18 (19%) of the 92 sera tested. Differences among the three lots also produced variation in determining whether a significant rise in titer had occurred from the acute phase to the convalescent phase serum for a given patient. These observations raise concerns about the standardization of the Streptozyme reagent and document the need for precise identification and quantitation of the streptococcal antigens used in this product. PMID- 3547291 TI - Perspectives on the current Haemophilus vaccine. PMID- 3547292 TI - Shigella keratitis: a report of two cases and a review of the literature. PMID- 3547293 TI - Care of mammalian bites. PMID- 3547295 TI - The increasing importance of Branhamella catarrhalis in respiratory infections. PMID- 3547294 TI - Detection of Toxoplasma gondii in the spinal fluid of a bone marrow transplant recipient. PMID- 3547296 TI - Diagnosis and management of acute sinusitis in children. PMID- 3547297 TI - Inborn errors of metabolism: the clinical diagnosis in early infancy. AB - Major advances occurring in recent years in the recognition and treatment of inborn errors of metabolism have made it more essential than ever that the physician be familiar with the clinical presentation of these disorders. Although infants with inborn errors of metabolism will continue to be best cared for in centers with expertise in the treatment of inherited metabolic disease, the initial recognition of these disorders remains the responsibility of the practicing physician. A clinical approach to the diagnosis of inborn errors of metabolism in the young infant is presented as well as suggestions for the use of readily available laboratory studies that can serve to identify these infants who will benefit from further evaluation and treatment. PMID- 3547298 TI - Buffy coat transfusions in neonates with sepsis and neutrophil storage pool depletion. AB - A randomized study was initiated in neonates with neutropenia (absolute peripheral neutrophil count less than 1,500/microL) and suspected bacterial infection. Twenty infants with proven infection were enrolled, nine of whom had depletion of bone marrow stores of maturing neutrophils (less than or equal to 7% metamyelocyte, band and mature forms per 100 nucleated cells). These nine were randomized to receive 15 mL/kg of either buffy coat transfusions (group 2) or plasma and blood products (group 3). The remaining 11 (group 1) were observed. Peripheral neutrophil counts were monitored to determine the neutrophil response to transfusions. There were ten of 11 patients in group 1, two of four in group 2, and two of five in group 3 who lived at least seven days. No complications of transfusion were noted. No difference in the rate of peripheral neutrophil increase was found among the three groups. The study was stopped when it became clear that sufficient numbers of patients could not be entered into the study, in a reasonable period of time, to prove or disprove a clinically significant improvement in outcome. Although in vitro testing of the buffy coat preparations showed normal function in three of four cases, the clinical quality of the buffy coats may have been inadequate because of poor availability of whole fresh blood less than 24 hours old. The role of neutrophil transfusions in these patients remains unclear. PMID- 3547299 TI - Hypertrichosis and congenital anomalies associated with maternal use of minoxidil. PMID- 3547301 TI - Intratracheal suctioning in sick preterm infants: prevention of intracranial hypertension and cerebral hypoperfusion by muscle paralysis. AB - In a prospective nonrandomized study, using each baby as his or her own control, we compared intracranial pressure (anterior fontanel pressure as measured with the Digilab pneumotonometer), cerebral perfusion pressure, BP, heart rate, transcutaneous Po2, and transcutaneous Pco2 before, during, and after endotracheal suctioning, with and without muscle paralysis, in 28 critically ill preterm infants with respiratory distress syndrome. With suctioning, there was a small but significant increase in intracranial pressure in paralyzed patients (from 13.7 [mean] +/- 4.4 mm Hg [SD] to 15.8 +/- 5.2 mm Hg) but a significantly larger (P less than .001) increase when they were not paralyzed (from 12.5 +/- 3.6 to 28.5 +/- 8.3 mm Hg). Suctioning led to a slight increase in BP with (from 45.3 +/- 9.1 to 48.0 +/- 8.7 mm Hg) and without muscle paralysis (from 45.1 +/- 9.4 to 50.0 +/- 11.7 mm Hg); but there was no significant difference between the two groups. The cerebral perfusion pressure in paralyzed infants did not show any significant change before, during, and after suctioning (31.5 +/- 9.1 mm Hg before v 32.0 +/- 8.7 mm Hg during suctioning), but without muscle paralysis cerebral perfusion pressure decreased (P less than .001) from 32.8 +/- 9.7 to 21.3 +/- 13.1 mm Hg. Suctioning induced a slight decrease in mean heart rate and transcutaneous Po2, but pancuronium did not alter these changes. There was no statistical difference in transcutaneous Pco2 before, during, and after suctioning with and without muscle paralysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547300 TI - Tocopherol efficacy and safety for preventing retinopathy of prematurity: a randomized, controlled, double-masked trial. AB - To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P less than .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P less than .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg. PMID- 3547302 TI - Cutaneous necrosis following a spider bite: a case report and review. AB - Several species of spiders indigenous to the United States can cause a painful and necrotic wound. Recognition of the characteristic clinical course is important to avoid potential complications. A case report and review are presented. PMID- 3547303 TI - Von Hippel-Lindau disease in an adolescent. AB - Von Hippel-Lindau disease is a hereditary neoplastic syndrome that generally manifests in early adulthood but does present occasionally in adolescence. In the past, diagnosis and management of this disorder fell within the domain of internists and surgeons. Because pediatricians are now seeing older patients, they must learn to recognize the various components of this disorder. Additionally, they must be able to assure appropriate medical evaluation and follow-up and also arrange for genetic counseling. Pediatricians already attuned to the benefits of preventive medicine should find themselves uniquely qualified to provide the level of care that this disease requires. PMID- 3547304 TI - [Efficacy of antioxidants in the complex treatment of interstitial nephritis in children]. PMID- 3547305 TI - [Hemolytic-uremic syndrome and Escherichia coli enterocolitis. Apropos of 2 cases]. AB - The authors report two cases of HUS that presented as colitis due to E. Coli. They emphasize the interest--from an epidemiological point of view--of looking for E. Coli in stools of children with HUS and serotyping them. PMID- 3547306 TI - [Neonatal diabetes. Apropos of 2 cases]. AB - Diabetes mellitus uncommon in the newborn infant. There are two entities: a transient form and a permanent one. Differenciation is difficult. Transient diabetes, apparently the more common of the two, results in complete recovery. Permanent diabetes requires continued insulin therapy. The clinical presentations of these patients in the first days to weeks of life are similar in that the infants are small for gestational age, hyperglycemic, dehydrated and only rarely have ketonemia or ketonuria. However, the aetiology of the syndrome is unknown. The authors report two cases of permanent diabetes mellitus identified in the first two months of life, and still treated at thirty months of life. PMID- 3547307 TI - [Physiopathology of the hemolytic-uremic syndrome]. PMID- 3547308 TI - Founders of Pediatric Pathology: Ronald Melville Norman, MD, FRCP, DPM 1904-1968. PMID- 3547309 TI - Pathology of childhood osteosarcoma. PMID- 3547310 TI - Pathology of histiocytosis X. PMID- 3547311 TI - The leukemias of childhood. PMID- 3547312 TI - Effect of methacholine on ionic permeability of basal membrane of the eccrine secretory cell. AB - In an attempt to clarify the possible change in ionic permeability of the basal membrane of secretory cells during methacholine (MCH) stimulation, the effect of ionic substitution on membrane potential (PD) was studied in the isolated monkey palm eccrine secretory tubule. The mean PD (Vcb) was -73 mV. Stimulation with local iontophoresis of MCH caused a biphasic change in Vcb, an initial transient depolarization of 5 to 10 mV, followed by repolarization near the resting PD. MCH induced PD transient reversed its polarity at -43 mV (MCH-null potential). Vcb markedly depolarized by an increase in [K+]b or a decrease in [Cl-]b. Ion dependent partial potential ratio (Ti) using the estimated change in electromotive force delta Eb yielded values of 0.72 for K+ and 0.26 for Cl-, indicating that the basal membrane is conductive predominantly to K+ and Cl-. However, delta Vcb due to K+ or Cl- replacement did not change before or during MCH stimulation. Although replacement of Na+ with Tris+ or Li+ transiently depolarized Vcb, the delta Vcb reversed to hyperpolarization during MCH stimulation, suggesting that MCH causes a small increase in Na+ conductance across the basal membrane. The implication of these data have been discussed within the conceptual framework of ionic movements in Cl- transporting epithelia. PMID- 3547313 TI - Differential regional changes of prostacyclin and thromboxane A2 synthesis in the intestinal tract of the fasted and semistarved rat. AB - The synthesis of prostacyclin (PGI2) and thromboxane A2 (TXA2) by the mucosal and muscular portions of the duodenum, jejunum, ileum and ascending colon, as well as that by mesenteric vessels, was investigated in starved and semistarved rats. The jejunal mucosa and muscularis showed a marked increase in PGI2 synthesis after fasting for 48 h and 72 h or semistarvation for 9 days when compared with controls. Jejunal TXA2 synthesis did not alter. In contrast, PGI2 and TXA2 synthesis in ileal mucosa and muscularis was significantly reduced after fasting for 48 h, 72 h and semistarvation for 9 days. PGI2 and TXA2 synthesis by duodenal and colonic muscularis was unaffected by fasting or semistarvation. PGI2 synthesis in mesenteric vessels was significantly increased by fasting and semistarvation. No changes in PGI2 or TXA2 were detected at 24 h in fasted rats in any of the tissues studied when compared with controls. These selective changes in PGI2/TXA2 secretion may be important mediators of adaptive changes in the small intestine in response to starvation. PMID- 3547314 TI - [Fine-needle aspiration biopsy under sonographic guidance in renal and retroperitoneal masses]. PMID- 3547315 TI - [Determination of characteristic curves in a digital subtraction angiography system]. PMID- 3547316 TI - [Protective action of OK-432 (Picibanil) on radiation-induced myelosuppression- examination of its action in whole body irradiated mice]. PMID- 3547317 TI - [Intra-arterial digital subtraction angiography. Analysis of cerebral circulation by intra-arterial digital subtraction angiography]. PMID- 3547318 TI - [Radiosensitization effects of nucleoside analogs]. PMID- 3547320 TI - [Non-pharmacological treatment of arterial hypertension]. PMID- 3547319 TI - [Hypertension after the age of 70--a therapeutic dilemma?]. PMID- 3547321 TI - [Streptococcal diagnosis in ambulatory care--a questionnaire study]. PMID- 3547322 TI - A tribute to Dr. Irwin Epstein. PMID- 3547323 TI - Evolutionary changes in the higher order structure of the ribosomal 5S RNA. AB - Comparative studies have been undertaken on the higher order structure of ribosomal 5S RNAs from diverse origins. Competitive reassociation studies show that 5S RNA from either a eukaryote or archaebacterium will form a stable ribonucleoprotein complex with the yeast ribosomal 5S RNA binding protein (YL3); in contrast, eubacterial RNAs will not compete in a similar fashion. Partial S1 ribonuclease digestion and ethylnitrosourea reactivity were used to probe the structural differences suggested by the reconstitution experiments. The results indicate a more compact higher order structure in eukaryotic 5S RNAs as compared to eubacteria and suggest that the archaebacterial 5S RNA contains features which are common to either group. The potential significance of these results with respect to a generalized model for the tertiary structure of the ribosomal 5S RNA and to the heterogeneity in the protein components of 5S RNA-protein complexes are discussed. PMID- 3547324 TI - Structure of the Saccharomyces cerevisiae gene encoding tRNAIle (IAU). PMID- 3547325 TI - Complete nucleotide sequence of the gene encoding the regulatory subunit of 3',5' cyclic AMP-dependent protein kinase from the yeast Saccharomyces cerevisiae. PMID- 3547326 TI - Structure of secondary cleavage sites of E. coli RNAaseIII in A3t RNA from bacteriophage T7. AB - Five 'secondary' cleavage sites of E. coli RNAaseIII within the initiator RNA A3t (141 nucleotides) from bacteriophage T7 are described. Cleavage takes place apparEntly within or at the bottom of a short double-stranded stretch of RNA. Three secondary sites are efficiently cleaved in the presence of magnesium 2+ ions, two additional sites are cleaved in the presence of manganese 2+ ions at low monovalent salt concentrations (less than 0.05 M). PMID- 3547327 TI - Dynamic and structural characterisation of multiple steps during complex formation between E. coli RNA polymerase and the tetR promoter from pSC101. AB - Kinetic, functional and structural studies of the recognition of the tetR promoter from pSC101 by E. coli RNA polymerase allowed the characterization of several steps in the specific complex formation and transcription initiation process. First, enzyme and DNA enter in a short life-time complex. An isomerization will convert this unstable complex into a closed stable one where RNA polymerase is tightly attached without establishing stable chemical contacts with the bases. In the next step, stable close contacts appear between both macromolecules involving mainly the downstream part of the promoter. A further isomerization will lead to an open complex where DNA is locally melted and the system is able to initiate transcription. This latter process is accompanied by changes in the upstream part of the promoter. Finally, in vitro transcription assays showed that the position of the major transcription start sites depends on temperature. From the reported results, it appears that the recognition event is a sequential process where different structural elements of the promoter, that can be located apart in the sequence, are involved in a concerted manner in each stage. PMID- 3547328 TI - Nucleotide sequence and analysis of the coliphage T3 S-adenosylmethionine hydrolase gene and its surrounding ribonuclease III processing sites. AB - To understand better the characteristics of the coliphage T3 S-adenosyl-L methionine (AdoMet) hydrolase (AdoMetase, E.C. 3.3.1.2) and its expression in phage-infected Escherichia coli, we determined the DNA sequence of the cloned gene and its surrounding ribonuclease (RNase) III mRNA transcript processing sites. The AdoMetase gene contains two in-frame protein translation initiation sites specifying peptides 17105 and 13978 daltons in size. Both proteins terminate at the same ochre codon making the shorter peptide identical to the carboxy terminal 82% of the 17 kd protein. Our data explain the existence of two AdoMetase-related peptides in preparations of the purified enzyme as well as identify sequences that might serve to regulate the enzyme's expression. Comparisons between this T3 sequence and the homologous 0.3 gene region of the closely related coliphage T7 show both the nucleotide and amino acid sequences to be unrelated. The RNase III mRNA processing sites that bracket these genes in T3 and T7 are highly conserved in both their primary and secondary structures. PMID- 3547329 TI - Sequence distributions associated with DNA curvature are found upstream of strong E. coli promoters. AB - The regions upstream from forty-three procaryotic promoters were examined for nucleotide distributions which have been associated with DNA curvature. The analysis procedure assigned a DNA curvature score based on the phasing of the 5' and 3' ends of An and Tn tracts, n greater than or equal to 3. The weighting scheme for the curvature score was based on recent studies which showed that tracts of An and Tn periodically phased with the helix repeat cause DNA curvature. Results show that promoters which have high transcription initiation rates in vivo tend to have high curvature scores in their upstream regions. Regions downstream from the transcription start-point do not have sequences correlated with DNA curvature. Four promoters which have been shown to have upstream activation regions have curvature scores above 1.5 in their -40 to -150 regions. The correlations observed lend support to the hypothesis that DNA curvature is associated with upstream activation of transcription. PMID- 3547331 TI - The nucleotide sequence of 3-isopropylmalate dehydrogenase gene from Bacillus caldotenax. PMID- 3547330 TI - Characterization of the virE operon of the Agrobacterium Ti plasmid pTiA6. AB - The Agrobacterium tumefaciens Ti plasmid contains at least six transcriptional units (designated vir loci) which are essential for efficient crown gall tumorigenesis. Mutations in one of these loci, virE, result in a sharply attenuated virulence phenotype. In the present communication, we have analyzed the virE operon at the molecular level. This locus contains open reading frames coding for two hydrophilic proteins having molecular weights of approximately 7,000 daltons and 60,500 daltons. Using a maxicell strain of E. coli, we have visualized two proteins encoded by virE which correspond in size to these open reading frames. Analysis of codon usage of virE and seven other vir loci indicates that, in contrast to E. coli, all possible codons for a given amino acid are utilized at approximately the same frequency. PMID- 3547332 TI - Binding of E. coli DNA photolyase to a defined substrate containing a single T mean value of T dimer. AB - The E. coli DNA photolyase is a flavoprotein that catalyzes the photoreversal of pyrimidine dimers. The enzyme binds to DNA containing pyrimidine dimers in a light-independent step and repairs the dimer upon absorbing a photon in the 300 600 nm range. The rate and equilibrium constants for the light-independent reaction were determined before, using randomly modified substrates that contained T mean value of T, T mean value of C and C mean value of C dimers in random sequence surrounding. In this paper we have determined these constants for a defined substrate (a 43 bp oligomer containing a T mean value of T dimer) using the gel retardation assay. We find that: the equilibrium constant and the off rate obtained with this substrate by this technique are similar to those obtained with randomly modified DNA using filter binding and flash photolysis techniques. the off rate with the defined substrate is heterogeneous indicating heterogeneity in the enzyme population or in the enzyme-substrate complexes, and the enzyme has 7.5 X 10(4)-fold higher affinity for pyrimidine dimer compared to non-dimer DNA nucleotides. PMID- 3547333 TI - Sequences coding for part of oncogene-induced transin are highly conserved in a related rat gene. AB - The transin gene is induced by oncogenes and epidermal growth factor (EGF). We report here the isolation of a related gene (transin-2 gene). The structures of these genes are very similar. Indeed, a stretch of 428 nucleotides of the transin gene containing both exon and intron sequences is 98% conserved in the transin-2 gene. However, the putative promoter regions of the genes show little sequence homology, apart from a short element related to a sequence involved in control of transcription by cyclic AMP or a tumour promoter. Expression of the transin-2 gene, unlike that of the transin gene, is not induced by EGF, dibutyryl cyclic AMP or cytochalasin D. Nevertheless, transin-2 RNA is expressed in several transformed rat embryo fibroblast cell lines, and can be induced by a tumour promoter. The proteins transin and transin-2 are approximately 71% homologous in sequence. Both proteins show significant sequence homology with two connective tissue degrading metalloproteases. These homologies raise the possibility that expression of transin and transin-2 in transformed cells might play a role in tumour invasion. PMID- 3547334 TI - Utilization of DNA photolyase, pyrimidine dimer endonucleases, and alkali hydrolysis in the analysis of aberrant ABC excinuclease incisions adjacent to UV induced DNA photoproducts. AB - ABC excinuclease of Escherichia coli removes 6-4 photoproducts and pyrimidine dimers from DNA by making two single strand incisions, one 8 phosphodiester bonds 5' and another 4 or 5 phosphodiester bonds 3' to the lesion. We describe in this communication a method, which utilizes DNA photolyase from E. coli, pyrimidine dimer endonucleases from M. luteus and bacteriophage T4, and alkali hydrolysis, for analyzing the ABC excinuclease incision pattern corresponding to each of these photoproducts in a DNA fragment. On occasion, ABC excinuclease does not incise DNA exclusively 8 phosphodiester bonds 5' or 4 or 5 phosphodiester bonds 3' to the photoproduct. Both the nature of the adduct (6-4 photoproduct or pyrimidine dimer) and the sequence of neighboring nucleotides influence the incision pattern of ABC excinuclease. We show directly that photolyase stimulates the removal of pyrimidine dimers (but not 6-4 photoproducts) by the excinuclease. Also, photolyase does not repair CC pyrimidine dimers efficiently while it does repair TT or TC pyrimidine dimers. PMID- 3547335 TI - The codon Adaptation Index--a measure of directional synonymous codon usage bias, and its potential applications. AB - A simple, effective measure of synonymous codon usage bias, the Codon Adaptation Index, is detailed. The index uses a reference set of highly expressed genes from a species to assess the relative merits of each codon, and a score for a gene is calculated from the frequency of use of all codons in that gene. The index assesses the extent to which selection has been effective in moulding the pattern of codon usage. In that respect it is useful for predicting the level of expression of a gene, for assessing the adaptation of viral genes to their hosts, and for making comparisons of codon usage in different organisms. The index may also give an approximate indication of the likely success of heterologous gene expression. PMID- 3547338 TI - Insights from the past. PMID- 3547336 TI - Novobiocin inhibits interactions required for yeast TFIIIB sequestration during stable transcription complex formation in vitro. AB - Novobiocin concentrations normally used to inhibit a putative eukaryotic DNA gyrase have been found to inhibit transcription of a yeast 5S rRNA gene using an in vitro yeast transcription system. Purified RNA polymerase III and three yeast transcription factors (chromatographically separated, partially purified and free of any detectable gyrase activity) were used. Novobiocin prevents specific transcription if added to the in vitro system immediately prior to the addition of transcription factors and RNA polymerase. If a stable transcription factor complex is allowed to form prior to the addition of novobiocin, concentrations of novobiocin as high as 1000 micrograms/ml have no effect on in vitro transcription. Transcription factors TFIIIA and TFIIIC are able to be stably sequestered onto 5SrDNA-cellulose, but factor TFIIIB is not able to associate with the 5SrDNA-TFIIIA-TFIIIC complex in the presence of novobiocin. Although novobiocin is able to precipitate other basic proteins, it does not appear to precipitate any of these class III gene transcription factors, but instead appears to act by disrupting specific factor-factor interactions. PMID- 3547337 TI - Effect of the deletion of upstream DNA sequences on expression from the ilvGp2 promoter of the ilvGMEDA operon of Escherichia coli K-12. AB - Transcription in vitro of the regulatory region of the ilvGMEDA operon yields two attenuated RNAs initiated from the tandem promoters ilvGp1 and ilvGp2. Both S1 nuclease analysis and the fusion of ilvGp1 to galK indicate that transcription is not initiated in vivo from ilvGp1. However deletion of DNA sequences 150 to 100 bp upstream of ilvGp2 drastically reduces expression in vivo from ilvGp2. Both the distance separating ilvGp2 from the upstream DNA sequences and their relative orientation to each other on the DNA helix affect expression from ilvGp2. Deletion of DNA sequences approximately 400 bp upstream of ilvGp2 increases expression in vivo from this promoter. Analysis of products of transcription in vitro indicates that the effects observed in vivo are probably not due to DNA conformation or interactions of RNA polymerase. PMID- 3547339 TI - Bone marrow transplant--recovery. PMID- 3547340 TI - Ineffective airway clearance related to airway infection. AB - Clearance of secretions is a common problem in patients who experience acute respiratory tract infections. Although the offending agent is a major factor, the degree of severity of ineffective airway clearance depends on many other factors: pulmonary host defenses, presence of underlying pulmonary disease, age, lifestyle habits, environments, airway clearance self-management skills, and time of specific treatment. PMID- 3547341 TI - Ineffective airway clearance related to artificial airway. AB - Ineffective airway clearance occurs when an artificial airway is used because normal mucociliary transport mechanisms are bypassed and impaired. Nursing assessment and intervention are the keys to maintaining airway patency in the patient with an artificial airway in place. The assessment of breath sounds is critical to making a valid clinical judgment about airway patency. Nursing interventions such as tracheobronchial suctioning, postural drainage, and providing exogenous humidity to the inspired air are indicated to maintain airway patency, which is the goal of treatment. Suggested areas for future research related to this diagnosis include validation of the signs and symptoms which are proposed as being specific to the causes of ineffective airway clearance and the continuation of experimental studies to demonstrate the efficacy of various interventions for this nursing diagnosis. PMID- 3547342 TI - Ineffective breathing pattern related to airflow limitation. AB - Patients with chronic airflow limitation tend to breathe with rapid shallow respirations, but the precise relationship between airflow limitation and these changes in breathing pattern is not clear. Furthermore, as airflow limitation increases, patients experience increasing dyspnea and deterioration of breathing patterns. This ultimately leads to a decline in activity tolerance. Hence, the majority of nursing interventions are directed toward reducing dyspnea and improving breathing patterns. As was pointed out, there is a limited body of knowledge on which to base clinical decisions and interventions; hence further research is needed in this area. PMID- 3547343 TI - Ineffective breathing pattern related to respiratory muscle fatigue. AB - In brief, preliminary research suggests that respiratory muscle fatigue contributes to the clinical manifestations of CAL and is associated with changes in breathing patterns. The specific mechanisms for changes in breathing patterns have not been clearly elucidated. Moreover, the mechanisms of respiratory muscle fatigue remain unclear, and clinical methods for diagnosing respiratory muscle fatigue are inconclusive. Until we improve our understanding of respiratory muscle fatigue, interventions are mostly directed toward preventing respiratory muscle fatigue by improving respiratory muscle function. One way to achieve this goal is by inspiratory muscle training. However, further research is needed to elucidate the physiologic mechanisms, clinical implications, and therapeutic interventions for respiratory muscle fatigue so that we can improve the associated ineffective breathing patterns. PMID- 3547345 TI - Patient education. Bone marrow harvest. PMID- 3547344 TI - A Delphi survey of oncology clinical nurse specialist competencies. PMID- 3547346 TI - Retentive properties of dowel post systems. PMID- 3547348 TI - Distinguished Member Award (Jose E. Medina). PMID- 3547347 TI - Clinical evaluation of cervical composite resin restorations placed without retention. PMID- 3547349 TI - Benefit-risk assessment of investigational drugs: current methodology, limitations, and alternative approaches. AB - Development of investigational drugs is a process integrated traditionally into four overlapping phases. The goal is to introduce new therapies to clinical medicine by assessing benefits and risks associated with administering the new drug. Benefit assessment is performed with respect to the disease for which the drug may comprise an effective treatment. In contrast, safety assessment is relatively standardized across many pharmacologic classes of agents. For purposes of benefit-risk assessment, investigational drugs are developed to provide benefit in three major disease categories: acute, episodic, and chronic. Benefit assessment is the major focus of conventional methodologies. Inherent limitations of risk assessment produced by conventional approaches are illustrated by the historical inability to detect toxicities of various drugs until large patient populations have been treated, typically after the drug is marketed. Alternative approaches to overcome these limitations include assessment of safety in studies specifically designed to optimize such evaluation and more extensive safety testing of investigational drugs in patient subgroups at higher risk. Such approaches serve the interest of patients, physicians, and developers by facilitating the development of new therapies by providing a more complete benefit-risk assessment prior to initial marketing of the drug. PMID- 3547350 TI - Pharmacology and therapeutic use of low-dose dopamine. AB - The renal pharmacologic effects of intravenous dopamine in doses of 0.5-3.0 micrograms/kg/min include increases in renal blood flow, glomerular filtration rate, solute excretion, and urine flow. Clinical studies revealed that low-dose dopamine can reverse oliguria, but these studies were poorly controlled, were confounded by the use of other diuretics, had small patient populations, and often did not evaluate mortality or long-term renal function. When used in low doses, side effects are rarely seen. Because of dopamine's effect on hepatic and renal function, changes in drug clearance may occur. Low-dose dopamine may be considered in the early course of oliguric patients; however, specific advantages over other diuretic therapy have not been established. PMID- 3547351 TI - Analgesic efficacy of low-dose ibuprofen in dental extraction pain. AB - A single-dose, double-blind, randomized, parallel trial was conducted to compare the analgesic efficacy of oral ibuprofen (I) 100, 200, or 400 mg, aspirin (ASA) 650 mg, and placebo in moderate to severe pain after extraction of impacted teeth. Subjective, self-evaluated pain intensity and pain relief reports, hourly for 6 hours, were used as indexes of analgesic response. Data on 227 evaluable patients showed significant differences among the 4 active treatments and placebo (p less than 0.001) by most measurements of analgesia. Although no consistent, significant differences were observed among the active drugs, I 400 mg performed the best, followed by I 200 mg, ASA 650 mg, and I 100 mg. Remedication was required by 59% patients receiving I 400 mg, 67% taking I 200 mg, 73% taking ASA 650 mg, 74% taking I 100 mg, and 96% receiving placebo. Differences between I 400 mg and I 100 mg were significant for remedication data (p less than 0.05). Side effects were minor, infrequent, and not dose related. In this study, I 100 mg was distinctly superior to placebo and probably as effective as ASA 650 mg in relieving pain. Only a shallow dose response of ibuprofen was observed. PMID- 3547352 TI - [Pathogenic effect of strains of specific serogroups of Escherichia coli on the development of bovine mastitis. III. Blood changes]. AB - Colimastitis was evoked in 14 cows which were injected into the udder E. coli strains (pathogenic) from the field, belonging to serological groups: 093, 086, 010, non pathological (museum) strains from groups: 0132, 0120, 093 and E. coli endotoxin (serogroup 093). Two cows were used for the studies of each strain and endotoxin. From the animals blood was taken three times before and after 2, 4, 6, 9, 12, 18, 24, 36, 48 hours and 3, 4, 5, 6, 7, 10, 14 days of the infusion of the strains or endotoxin into the udder. In the serum all cows the presense of endotoxin was found between the 4th and 9th hour since the infection. The level of free histamine was also found to increase (in the 2, 4 and 6th hr), and to decrease (in the first 12 hrs), and then an increase of the titre of specific antibodies. In the first 18 hrs after the infection strongly expressed leucopenia was observed. It was shown that general symptoms accompanying colimastitis were associated with the presense of endotoxin at an elevated level of free histamine in blood circulation. PMID- 3547353 TI - Photobiological activity of certain pyranocoumarin derivatives: potential agents for the photochemotherapy of psoriasis. AB - The photobiological properties of a series of pyranocoumarin derivatives having linear (xanthyletines) and angular structure (seselins) have been studied; while the linear derivative carrying the methyl geminal group, typical of the parent natural compound, appeared to be entirely inactive in all tests performed, very probably because of the steric hindrance in the dark interaction with DNA, 4 substances lacking in this group showed a marked capacity for inhibiting DNA synthesis in Ehrlich cells. In particular, 4,6-dimethyl-8-desmethylseselin proved to be about 7 times more active than 8-MOP. Practically all compounds were capable of inducing cross-links in DNA, but this feature, marked in the linear compounds, is very much reduced in the angular ones; this property appears to be clearly related to the mutagenicity in the light and with the skin phototoxicity, which are both marked in the former and low or absent in the latter. In the dark, while all compounds are non-mutagenic in the absence of metabolic activation, in the presence of microsomial enzymes pyranocoumarins become mutagens; only the xanthyletine derivative carrying a geminal methyl group at the 8 position was not activated, suggesting that the enzymes metabolize the pyranic ring. PMID- 3547354 TI - Current aspects of polymorphous light eruptions in Sweden. AB - The prevalence of polymorphous light eruptions (PMLE) in a Swedish pharmaceutical company employing 412 individuals was estimated by the use of a detailed questionnaire, and 397 (96.4%) answered the survey. Their ages ranged from 18 to 65 yr (mean 40.2), and 66% were females. Eighty-three individuals (21%), mainly women (89%), had symptoms consistent with the diagnosis PMLE. Duration of their disease ranged from 1 to 53 yr, mean 14 yr. A positive family history of PMLE was surprisingly common (46%). Their threshold for sun tolerance was fairly high. They required rather high doses of sunlight to trigger their eruptions, 42% from 30 min to 2 h, and 45% greater than 2 h of solar irradiation. Only 3% had consulted a physician for their PMLE. A hardening phenomenon occurred in 84%. The PMLE group included habitual sunbathers (70%). A fair complexion was common in the PMLE group, 40% having skin types I and II, but as many as 59% had skin type III. Individuals with no light sensitivity had skin type I and II in 22%, and had skin type III in 69% of cases. In conclusion, PMLE is a common disorder and milder forms seem to be more prevalent than earlier described in northern countries such as Sweden. PMID- 3547355 TI - [Food allergy in children]. PMID- 3547356 TI - [The heritage of 19th century surgery in Warsaw]. PMID- 3547358 TI - [Calculi in the transplanted kidney]. PMID- 3547357 TI - [Clinical evaluation of ceftazidime and the combined administration of cefotaxime and tobramycin in the treatment of urinary tract infections. Prospective and randomized studies]. PMID- 3547360 TI - [Appendicitis in Salmonella enteritidis food poisoning]. PMID- 3547359 TI - [Pathogenesis and clinical aspects of struvite urinary calculi]. PMID- 3547361 TI - [Primary cancer of the gallbladder: a difficult problem in biliary tract surgery]. PMID- 3547362 TI - [100 years of prevention of surgical infection]. PMID- 3547363 TI - [Auxiliary diagnostic methods in the differentiation and detection of infantile cerebral palsy]. PMID- 3547364 TI - [Alternating noncross-resistant polychemotherapy to improve the results of the treatment of Hodgkin's disease]. PMID- 3547365 TI - Echogenic structure of prostatic cancer imaged on radical prostatectomy specimens. AB - Twenty radical prostatectomy specimens were scanned ultrasonically in vitro using a transrectal ultrasonic probe to evaluate the ultrasonic pattern of prostatic cancer. Histological and ultrasonic findings of the same areas were compared. No ultrasonic pattern specific for intracapsular prostatic cancer was found. Most often (in 40% of cases) the areas of prostatic cancer appeared hypoechoic on the ultrasonograms. In 30% of cases the carcinoma had a hyperechoic or mixed ultrasonic pattern, and in 30% the echo structure of the prostate was fairly uniform; intracapsular cancer could not be detected ultrasonically in these latter cases. The lack of a specific ultrasonic pattern for intracapsular prostatic carcinoma reduces the value of transrectal ultrasonography in detecting early intracapsular cancers. The main value of ultrasonography in patients with prostatic cancer is in the preoperative staging of the disease and in the follow up of patients. PMID- 3547366 TI - Vascular morphology of the periodontium of the beagle dog. PMID- 3547367 TI - Relative errors associated with two methods for measuring gingival cervicular fluid. PMID- 3547368 TI - Relationship between overhanging amalgam restorations and periodontal disease. PMID- 3547369 TI - Comparison of ceforanide and cephalothin prophylaxis in patients undergoing total joint arthroplasty. AB - One hundred one patients undergoing total hip and knee arthroplasty were randomly assigned to receive either two 1 gm doses of ceforanide or five doses of cephalothin perioperatively. Simultaneous plasma and cancellous bone specimens were obtained intraoperatively and assayed for antibiotic concentration. Ceforanide plasma and bone levels remained sustained over six hours. Cephalothin plasma and bone levels obtained three to four hours post administration were 91% lower than levels obtained one hour post-dose. Patients were examined for infection for up to 18 months following surgery. None of the patients developed an infected implant. The sustained plasma and bone levels achieved with ceforanide obviate the need for intraoperative dosing necessary with other agents. PMID- 3547370 TI - Postoperative laminectomy pain control using bupivacaine and epidural morphine. AB - In a prospective double blind study, 26 patients were evaluated for postoperative pain relief with use of epidural morphine. The variable in this study was the addition of paravertebral bupivacaine used in 14 patients. The addition of the bupivacaine did not have a statistically significant effect on lowering the analgesic requirement during the first 36 hours after surgery, the total dose of medication required during hospitalization, nor the time to the onset of supplemental pain medicine requirement. There were no problems with late respiratory depression. We conclude that the addition of paravertebral bupivacaine is not effective in decreasing the amount of pain medication that is required in lumbar laminectomy patients and adds very little to patients already receiving epidural narcotics. PMID- 3547371 TI - Giant pancreatic retention cyst in cystic fibrosis: a case report. AB - This is the fourth reported large pancreatic retention cyst in a patient with cystic fibrosis. The cyst recurred 7 months after partial cystectomy and produced extrinsic obstructive jaundice. It is presumed that the retention cyst developed in the ventral pancreas as a consequence of ductal obstruction by inspissated mucus with secondary fibrosis. PMID- 3547372 TI - Fetal rhabdomyoma of the parotid gland in an infant: histological, immunohistochemical, and ultrastructural features. AB - A case of fetal rhabdomyoma of the parotid gland in a 3-year-old infant is presented. The histological, ultrastructural, and immunohistochemical findings in this very uncommon benign tumor are described together with a review of the literature. PMID- 3547373 TI - Autopsy findings of Serratia meningoencephalitis in infants. AB - Serratia meningoencephalitis is often a fatal disease that causes widespread destruction of brain tissue despite aggressive antibiotic treatment. The autopsy findings of 2 cases are described. In a case caused by S. liquefaciens, previously not reported as the causative organism of meningoencephalitis, suppurative meningitis, ventriculitis, vasculitis, and extensive necrotic process of the brain matter were found. In the other case, caused by S. marcescens, the findings were those of acute and subacute abscesses with hemorrhagic necrosis. PMID- 3547374 TI - Adolescence and its discontents: attentional disorders among teenagers and young adults. AB - Attention deficit disorder (ADD) is the most commonly diagnosed childhood behavioral condition in the United States. This condition has important implications for and influences on adolescent development and adult functioning including emotional and conduct disorders, poor socialization, and school underachievement. In addition it has only been appreciated recently that some symptoms of ADD persist and can be identified among adolescents and young adults. In some situations, ADD may be newly identified during adolescence. Similar to younger children with ADD, a multi-modality approach to the management of adolescents with ADD is recommended. PMID- 3547375 TI - Early failure of the famous. AB - This is a historical review of school failure, underachievement and underestimation of the ability of children destined for world fame. Many were refused admission to a college of higher education, many failed to secure a university degree, more than 30 were expelled from school or university and several were sent to prison. Some reasons are discussed for the failure of parents and teachers to recognize outstanding ability in children. PMID- 3547376 TI - [Staphylococcal coagulase]. PMID- 3547377 TI - [Pyruvate kinase]. PMID- 3547378 TI - Pelvic inflammatory disease. Its pathogenesis, diagnosis, and treatment. PMID- 3547379 TI - Toxic shock syndrome. What have we learned? PMID- 3547380 TI - Otolaryngology 1947-1987. A PGM retrospective. PMID- 3547381 TI - Prostaglandins in peptic ulcer disease. Their postulated role in the pathogenesis and treatment. AB - Prostaglandins are important in the pathophysiology of peptic ulcer disease and possibly in its prevention and treatment as well. Prostaglandins have been shown to inhibit gastric secretion, stimulate bicarbonate secretion, and increase gastric blood volume. Pretreatment with prostaglandins has recently been found to promote rapid restitution of the superficial epithelium of the gastric mucosa and preservation of the deeper layers. These effects and their degree of importance to an individual patient may depend on the insulting agent. Orally administered prostaglandin analogues have been helpful in some patients who failed to heal with standard ulcer treatment and in smokers, who usually do not heal as well as nonsmokers. They have also been effective in persons at high risk for gastric lesions, such as chronic consumers of nonsteroidal antiinflammatory drugs or alcohol. Recent reports show that persons with peptic ulcer disease may produce fewer prostanoids than others, so replacement therapy may be useful in preventing damage of the gastroduodenal mucosa. PMID- 3547382 TI - Management of the post-myocardial infarction patient. Essential considerations. AB - Management of patients who survive acute myocardial infarction (MI) demands the physician's awareness of certain essential considerations. Risk stratification, a useful prognostic indicator of mortality, should be done early in convalescence. If present, postinfarction angina or postinfarction syndrome warrants appropriate therapy. Low-level exercise testing should be under-taken within three weeks of acute MI, and left ventricular function should be assessed and arrhythmias delineated before the patient's discharge from the hospital. Findings may indicate the need for coronary bypass surgery or angioplasty, antiarrhythmic drug therapy, or permanent pacing. Digitalis should be used for treating congestive heart failure only if deemed absolutely necessary. If there are no contraindications, all postinfarction patients should receive beta blockers for at least two years after MI. Control of coronary risk factors is essential. Aspirin can be used prophylactically in patients at risk for recurrent MI; routine use of anticoagulants is not indicated. PMID- 3547383 TI - Human immunodeficiency virus infection. Diagnostic and treatment issues in an expanding spectrum. AB - Like many other viruses, human immunodeficiency virus (HIV) causes a broad array of host responses. Some persons mount an appropriate immune response after infection and remain asymptomatic, while others become progressively debilitated by the effects of the infection. Paradoxically, autoimmune disease can coexist with the immunodeficiency state. In addition, HIV has proven to be more versatile in its organ system involvement than a simple lymphotropic virus. The clinical manifestations in seropositive persons are complex and may mimic those of other diseases. Because of this complexity, HIV infection should be an important consideration in all persons from defined risk groups who have an unexplained illness. Although the optimal strategy for curtailing these devastating clinical problems is one of prevention, education and behavior modification have not entirely stopped the spread of any sexually transmitted virus. Vaccine development is being intensively studied but still has many scientific and practical problems to overcome. Failing prevention, the next conceivable level of intervention would be effective antiviral therapy. A multitude of agents have shown promise in vitro, but in vivo data are disappointing. One notable exception is the favorable outcome observed in preliminary trials of azidothymidine. Therapy aimed at reconstituting the immune response also has not lived up to its in vitro promise. A more productive approach in the future may be to combine this type of treatment with antiviral agents. Until more definitive methods become available, however, treating the multiple end-organ complications of HIV infection remains a difficult task. PMID- 3547384 TI - The family as the unit of care in nursing: a historical review. PMID- 3547385 TI - Prenatal diagnosis of osteogenesis imperfecta type III. AB - Ultrasonographic and radiographic evaluation of a fetus at risk for osteogenesis imperfecta (O.I) type III was performed. Real-time ultrasound measurements at 15 weeks gestation were interpreted as normal, but at 20 and 22 weeks of gestation revealed marked shortening of the long bones and deformity of the femurs. The findings were confirmed by fetal radiography at 22 weeks gestation. Radiographic and histologic changes characteristic of O.I. were observed in the aborted fetus. Thus the antenatal manifestations of O.I. type III maybe severe enough to make prenatal diagnosis possible in the second trimester for families at risk for recurrence of this disorder. PMID- 3547386 TI - Learner characteristics associated with responses to film and interactive video lessons on smokeless tobacco. AB - To determine college students' cognitive and affective responses to alternative technologies for presenting a lesson on smokeless tobacco, and to learn if responses to experimental conditions were associated with gender, ethnicity, tobacco-use practices, and the practices of significant others, 162 undergraduate students were randomly assigned to either a control group (questionnaire only) or one of two experimental groups. Experimental subjects viewed a videotape or an interactive video version of the lesson and then completed a questionnaire to ascertain knowledge and attitude. Each main effect was significant for knowledge about smokeless tobacco [experimental condition (P less than 0.001); gender (P less than 0.024); and ethnicity (P less than 0.003)]. The interactive video group demonstrated the most accurate and comprehensive recall. Neither gender nor ethnicity interacted significantly with experimental condition, indicating that the effect of experimental condition is constant across gender and ethnicity. Attitudes to instructional formats did not vary significantly as a function of experimental condition or gender, but were associated with ethnicity (P less than 0.034). Again, neither gender nor ethnicity interacted significantly with experimental condition, suggesting that attitudes reflect a generalized view toward content irrespective of presentation mode. Responses to both experimental conditions were quite favorable. Items about present and past experiences with tobacco, with the exception of the "Do you smoke?" item, were not associated with total cognitive score or attitude. PMID- 3547387 TI - Participation in fecal occult blood screening: a critical review. AB - The factors that influence participation in fecal occult blood screening for colorectal cancer are poorly understood. A better understanding of these factors could lead to better screening products or to educational approaches to increase participation with currently available products. In this article, we review findings from studies that have examined the determinants of participation in fecal occult blood screening. Two components of participation are identified: initial agreement to participate and subsequent compliance with the testing procedures. We conclude that the factors that lead to agreement often differ from those that lead to compliance. Following the literature review, we discuss ways in which recent advances in attitude and behavior research might be used to improve future investigations of the determinants of participation in fecal occult blood screening. Specifically, this research suggests that investigators should focus on beliefs and attitudes associated with the perceived consequences of screening participation rather than on other types of beliefs and attitudes; measure beliefs and attitudes at the same level of specificity as behavior; and distinguish between individuals' initial agreement to participate in screening and their actual participation. PMID- 3547388 TI - [Optimization of the use of horseradish peroxidase and its antibodies in immunoenzyme analysis]. AB - The steady-state kinetics of peroxidation of 8 aromatic amines was studied. p Phenylenediamine, o-dianisidine (o-DA) and 3,5,3',5'-tetramethylbenzidine were found to be optimal substrates of horse-radish peroxidase. The kinetics of oxidation of these substrates by horseradish peroxidase modified with three molecules of Strophanthin K was studied as well. Within the temperature range from 37 to 53 degrees C the inactivation rate constants were determined for peroxidase and its conjugate with Strophanthin K. The effect of sugars and polyols on thermal stability of the conjugate peroxidase-Strophanthin K was investigated. A comparative kinetic study was performed of oxidation of o-DA and its conjugate with dextran. The results obtained made a basis for an enzyme immunoassay of cardiac glycosides during their isolation from plant raw material. PMID- 3547389 TI - [The role of free radical oxidation in the regulation of growth and lipid formation in eukaryotic and prokaryotic organisms]. AB - The review considers the effect of free-radical oxidation on the growth of microorganisms, intensity of their metabolism, and composition of the membrane lipids. Using both own research evidence and this presented in the literature, the authors put forward a hypothesis about a certain correlation between physico chemical properties of the membrane lipids and the intensity of the growth of eucaryotic and procaryotic microorganisms. PMID- 3547390 TI - [Preparation of films and fibers containing proteolytic enzymes]. AB - Immobilization of the proteolytic enzymes trypsin and terrylitin in fluorplastic 42 films and fibers as well as in water-soluble polymeric (polyvinyl alcohol and carboxymethyl cellulose) films was being studied during preparation of the films. The properties of the proteolytic enzymes immobilized in the polymers are dependent on the conditions of preparation of fibers and films. PMID- 3547391 TI - [Characteristics of the endocrine function of the pancreas in diffuse toxic goiter in children]. AB - The examination of 28 children with diffuse toxic goiter showed disturbance of glucose tolerance with a significant decrease in the level of C-peptide in the blood serum and its response to glucose. The concentration of immunoreactive insulin (IRI) and its increment under the influence of a glucose tolerance test in children was much above the normal. At the same time the molar C-peptide/IRI ratio in the patients' sera both on an empty stomach and during the glucose tolerance test showed a dramatic decrease indicating the reduction of insulin extraction by the liver as a cause of peripheral hyperinsulinemia. Distortion of the plasma immunoreactive glucagon reaction to a glucose tolerance test was observed in children with diffuse toxic goiter. PMID- 3547392 TI - [Diabetic hepatopathy and cholecystopathy]. PMID- 3547393 TI - Selective amine oxidase inhibitors: basic to clinical studies and back. PMID- 3547395 TI - Accidental antidepressants: search for specific action. PMID- 3547394 TI - Therapeutic effect of selective 5HT reuptake inhibitors in comparison with tricyclic antidepressants. PMID- 3547397 TI - Diagnostic criteria in epidemiological caries studies. PMID- 3547398 TI - Carbohydrate sweeteners and dental caries. PMID- 3547396 TI - Effect of selective D1 and D2 dopamine receptor antagonists and agonists in Cebus monkeys: implications for acute and tardive dyskinesias. A preliminary report. PMID- 3547399 TI - Response of pulpo-dentinal complex to caries attack. PMID- 3547400 TI - Superinduction of the Dictyostelium discoideum cell surface cAMP receptor by pulses of cAMP. AB - Extracellular cAMP plays a crucial role in regulating the developmental program of Dictyostelium discoideum, functioning as a chemotactic agent, as well as a signal that regulates expression of developmentally expressed genes. These activities appear to be mediated by a cell-surface receptor for cAMP. We have studied the regulation of this receptor in cells developed in starved suspension cultures exposed to 50 nM pulses of cAMP every 6 min. cAMP-pulsed cells display roughly 10-fold higher cAMP receptor levels than cells that developed on filters or that were starved in suspension without cAMP pulses. Based on saturation binding analysis, the superinduced binding activity represents an increase in receptor number, while receptor affinity for cAMP is unaffected. Photoaffinity labeling of superinduced cells results in specific labeling of the same molecules that are labeled in starved cells. This increased cAMP binding activity was also detected in membrane preparations from cAMP-pulsed cells. These results provide evidence for an unusual mode of receptor regulation: autogenous induction of the receptor by its ligand. PMID- 3547402 TI - Polypeptide-dependent protein kinase from bakers' yeast. AB - The purification and properties of a protein serine kinase (PK-P) extracted with Triton X-100 from membranes of bakers' yeast are described. The enzyme is virtually inactive unless either a histone or a heat-stable polypeptide from yeast membranes and Mg2+ are added. Other divalent cations substitute for Mg2+ poorly or not at all; most of them, including Mn2+, inhibit when added in the presence of 5 mM Mg2+. The enzyme is unstable but can be stabilized by addition of 0.1% Triton X-100 and 20% glycerol. The final preparation shows, on silver stained electrophoresis gels, two major bands (Mr 41,000 and 35,000). According to gel filtration the molecular weight of the active protein is about 75,000. Of the two subunits, only the smaller one appears to be autophosphorylated. In addition to casein, the enzyme phosphorylates several proteins including the H+ ATPase (Mr 100,000) in the yeast plasma membrane. In order to demonstrate the phosphorylation of the ATPase (up to 0.9 equivalents), exposure of the latter to an acid phosphatase was required. Other phosphorylated proteins include mRNA cap binding protein from mammalian erythrocytes and yeast, a glucocorticoid receptor protein, and a preparation of the guanine nucleotide-binding proteins Gi and Go from brain. A partial purification of a natural activator from yeast plasma membranes is described. PMID- 3547401 TI - Complete correction of the enzymatic defect of type I Gaucher disease fibroblasts by retroviral-mediated gene transfer. AB - Glucocerebrosidase cDNA and the neomycin-resistance gene (neo) were cloned into a retrovirus vector. Mouse fibroblasts infected with this vector expressed human glucocerebrosidase, which was readily distinguished from the mouse enzyme using mouse monoclonal anti-glucocerebrosidase antibodies. Cultured fibroblasts and transformed lymphoblasts from patients with type I Gaucher disease were infected with the retrovirus rescued from the mouse fibroblasts by a helper virus. Transformed cells were selected with the antibiotic G418. The enzyme activity of cells infected with virus containing glucocerebrosidase cDNA was restored to normal, while uninfected cells or cells infected with virus containing only the neo gene did not produce glucocerebrosidase. PMID- 3547404 TI - Gonadotropin-releasing peptide from human follicular fluid: isolation, characterization, and chemical synthesis. AB - A gonadotropin-releasing peptide has been isolated from human follicular fluid. Its amino acid composition and sequence are completely different from the hypothalamic lutropin-releasing hormone. It is designated human follicular gonadotropin-releasing peptide and abbreviated as hF-GRP. The primary structure of this peptide (H-Thr-Asp-Thr-Ser-His-His-Asp-Gln-Asp-His-Pro-Thr-Phe-Asn-OH) has been confirmed by chemical synthesis. In the mouse pituitary incubation assay, the ED50 value for follitropin or lutropin release is estimated to be 1.2 1.6 nM. PMID- 3547403 TI - Partial characterization of a low molecular weight human collagen that undergoes alternative splicing. AB - A cDNA library prepared from RNA isolated from a cultured human tumor cell line, HT-1080, was screened with a mouse cDNA clone coding for part of the -Gly-Xaa-Yaa domain of the alpha 2(IV) collagen chain. Four overlapping cDNA clones were characterized that coded for a low molecular weight human collagen. The cDNA clones did not, however, code for the short-chain collagens, types IX and X. The amino acid sequences derived from the clones resembled type IV collagen in that there were short interruptions in the repeating -Gly-Xaa-Yaa- sequence. The noncollagenous, carboxyl-terminal domain was, however, much shorter and contained only 18 amino acid residues. Interestingly, one of the cDNA clones contained an additional 36 nucleotides not found in an overlapping clone. The 36 nucleotides encoded four -Gly-Xaa-Yaa- repeats without changing the reading frame. Nuclease S1 mapping demonstrated that the difference between the clones was due to existence of two different mRNAs. A synthetic 24-residue peptide corresponding to the last two -Gly-Xaa-Yaa- triplets and the entire carboxyl-terminal domain was used to generate polyclonal antibodies. Electrophoretic transfer blot analysis of HT-1080 cells and normal human skin fibroblasts identified two polypeptides, Mr 67,000 and Mr 62,000, that were sensitive to bacterial collagenase. PMID- 3547405 TI - Cloning, sequence, and expression of the lysostaphin gene from Staphylococcus simulans. AB - A 1.5-kilobase-pair fragment of DNA that contains the lysostaphin gene from Staphylococcus simulans and its flanking sequences has been cloned and completely sequenced. The gene encodes a preproenzyme of Mr 42,000. The NH2-terminal sequence of the preproenzyme is composed of a signal peptide followed by seven tandem repeats of a 13-amino acid sequence. Conversion of prolysostaphin to the mature enzyme occurs extracellularly in cultures of S. simulans and involves removal of the NH2-terminal portion of the proenzyme that contains the tandem repeats. The high degree of homology of the repeats suggests that they have arisen by duplication of a 39-base-pair sequence of DNA. In S. simulans, the lysostaphin gene is present on a large beta-lactamase plasmid. PMID- 3547406 TI - Prokaryotic and eukaryotic RNA polymerases have homologous core subunits. AB - Eukaryotic RNA polymerases are complex aggregates whose component subunits are functionally ill-defined. The gene that encodes the 140,000-dalton subunit of Saccharomyces cerevisiae RNA polymerase II was isolated and studied in detail to obtain clues to the protein's function. This gene, RPB2, exists in a single copy in the haploid genome. Disruption of the gene is lethal to the yeast cell. RPB2 encodes a protein of 138,750 daltons, which contains sequences implicated in binding purine nucleotides and zinc ions and exhibits striking sequence homology with the beta subunit of Escherichia coli RNA polymerase. These observations suggest that the yeast and the E. coli subunit have similar roles in RNA synthesis, as the beta subunit contains binding sites for nucleotide substrates and a portion of the catalytic site for RNA synthesis. The subunit homologies reported here, and those observed previously with the largest RNA polymerase subunit, indicate that components of the prokaryotic RNA polymerase "core" enzyme have counterparts in eukaryotic RNA polymerases. PMID- 3547407 TI - Designing substrate specificity by protein engineering of electrostatic interactions. AB - Protein engineering of electrostatic interactions between charged substrates and complementary charged amino acids, at two different sites in the substrate binding cleft of the protease subtilisin BPN', increases kcat/Km toward complementary charged substrates (up to 1900 times) and decreases kcat/Km toward similarly charged substrates. From kinetic analysis of 16 mutants of subtilisin and the wild type, the average free energies for enzyme-substrate ion-pair interactions at the two different sites are calculated to be -1.8 +/- 0.5 and 2.3 +/- 0.6 kcal/mol (1 cal = 4.18 J) [at 25 degrees C in 0.1 M Tris X HCl (pH 8.6)]. The combined electrostatic effects are roughly additive. These studies demonstrate the feasibility for rational design of charged ligand binding sites in proteins by tailoring of electrostatic interactions. PMID- 3547408 TI - DNA rearrangements in human follicular lymphoma can involve the 5' or the 3' region of the bcl-2 gene. AB - In most human follicular lymphomas, the chromosome translocation t(14;18) occurs within two breakpoint clustering regions on chromosome 18, the major one at the 3' untranslated region of the bcl-2 gene and the minor one at 3' of the gene. Analysis of a panel of follicular lymphoma DNAs using probes for the first exon of the bcl-2 gene indicates that DNA rearrangements may also occur 5' to the involved bcl-2 gene. In this case the IgH locus and the bcl-2 gene are found in the order 3' C gamma S gamma/mu JH 5'::5' bcl-2 3' (where C = constant, S = switch, and JH = joining segment of the heavy chain locus), suggesting that an inversion also occurred during the translocation process. The coding regions of the bcl-2 gene, however, are left intact in all cases of follicular lymphoma studied to date. PMID- 3547409 TI - Insulin binding to human B lymphoblasts is a function of HLA haplotype. AB - A variety of genetic and biochemical evidence points to an association between major histocompatibility complex (MHC) haplotype and several types of cell surface receptors including epidermal growth factor and insulin receptors. We report evidence for such associations between human class I MHC antigens, HLA antigens, and specific insulin binding sites on human B lymphoblasts. We have measured insulin binding to cells of an HLA-heterozygous, Epstein-Barr virus transformed B-cell line, LCL 721, and to derivative mutants from which all or part of the HLA complex had been deleted. The affinity, Ka, of insulin binding sites is approximately 10(8) M-1 in mutants expressing antigen HLA-B5 together with other HLA antigens and in mutants expressing only HLA-C. HLA-A1; HLA-A1,B8; HLA-A2,C; and HLA null mutants (not expressing any HLA antigens) bind insulin to sites with an affinity of approximately 10(9) M-1. PMID- 3547410 TI - The offspring of the female diabetic "nonobese diabetic" (NOD) mouse are large for gestational age and have elevated pancreatic insulin content: a new animal model of human diabetic pregnancy. AB - Pregnancy in diabetic mothers is associated with intrauterine death, perinatal mortality, and birth weight greater than that of infants born of normal mothers. The use of rodents made diabetic by alloxan or streptozotocin as an animal model for human diabetic pregnancy has been controversial because of the severity of the diabetes as well as the direct effect of diabetogenic drugs on the developing organism. Among our female NOD (nonobese diabetic) mice, insulin-dependent diabetes occurs spontaneously in 9% by 12 weeks and in 80% by 29 weeks of age. Offspring born within 21 days of conception to mildly hyperglycemic NOD pregnant mice between 26 and 52 weeks of age, and prior to the onset of maternal ketonuria are macrosomic with an average of 31% increase in body weight and 44% increase in kidney weight, in comparison to controls. Besides organomegaly, the macrosomic offspring have significantly higher pancreatic insulin content which was elevated 80% when compared with that of controls, and litter sizes are significantly 50% smaller. These results suggest that the mildly hyperglycemic pregnant NOD mouse represents a promising model for the study of pregnancy complicated by diabetes. PMID- 3547412 TI - Self-help in preventing stress build-up. PMID- 3547411 TI - Yohimbine increases plasma insulin concentrations of dogs. AB - Recent evidence suggests that catecholamines inhibit insulin release by stimulating alpha 2-adrenoreceptors in beta-cells of the pancreatic islets. In the present study, iv injections of 0.1 and 0.3 mg/kg of yohimbine, an alpha 2 adrenoreceptor antagonist, resulted in increased plasma insulin and decreased plasma glucose concentrations in the dog. The use of alpha 2-adrenoreceptor antagonists may be of value in non-insulin-dependent diabetic patients by counteracting the inhibitory influence of endogenous catecholamines. PMID- 3547413 TI - Insulin delivery systems. PMID- 3547414 TI - Selective suppression of platelet thromboxane formation with sparing of vascular prostacyclin synthesis by aqueous extract of garlic in rabbits. AB - It has been suggested that a drug which selectively inhibits platelet thromboxane synthesis, sparing vascular synthesis of prostacyclin, would be more effective as an anti-thrombotic agent. We studied the effect of an aqueous extract of garlic on the production of thromboxane and prostacyclin by rabbit whole blood and aorta in vitro and ex vivo. A dose-dependent inhibition of thromboxane production was observed during blood clotting. Synthesis of prostacyclin was not affected by any concentration of garlic extract used in the experiment. A slight but insignificant reduction in the vascular synthesis of prostacyclin was observed at the highest concentration of garlic used in in vitro experiments. The synthesis of thromboxane by aorta was completely suppressed at all the concentrations of garlic tested. A similar pattern of results was observed after intraperitoneal administration of garlic (1 ml/kg) for one week on the enzymatic synthesis of thromboxane and prostacyclin of these tissues ex-vivo. Aortic synthesis of prostacyclin was significantly increased in the garlic treated rabbits compared to the controls. The data obtained from these rabbit experiments suggested that it may be possible to achieve a selective suppression of thromboxane formation by platelets with sparing of vascular synthesis of prostacyclin by garlic treatment. PMID- 3547415 TI - Production of prostaglandins I2, E2 and F2 alpha by blood vessels of normotensive and hypertensive, male and female rats. AB - Prostaglandin (PG) I2 (measured as 6-keto-PGF1 alpha) was the major PG synthesized by aortic homogenates from normotensive and hypertensive male rats, with lesser quantities of PGF2 alpha and PGE2. Homogenates of vena cava from the same rats synthesized PGI2 and PGE2 in similar quantities. PGF2 alpha synthesis by aortic homogenates was significantly higher in hypertensive than in normotensive male rats. A similar trend was seen in PGF2 alpha synthesis by homogenates of the vena cava. Separation of the aorta of normotensive and hypertensive, male rats showed that PGI2 was the major PG synthesized by endothelial cells and smooth muscle, and that PGF2 alpha was the major PG synthesized by adventitia. PGI2 synthesis by smooth muscle and PGE2 synthesis by endothelial cells were lower, and PGF2 alpha synthesis by endothelial cells and smooth muscle were higher in hypertensive than in normotensive, male rats. PGI2 was the major PG released from the aorta of normotensive and hypertensive male rats, together with lesser quantities of PGE2 and PGF2 alpha. Aortic PGF2 alpha output, but not PGI2 and PGE2 outputs, was significantly higher in hypertensive compared to normotensive, male rats. PMID- 3547416 TI - Circadian rhythm of eicosanoid formation as affected by dietary linoleate. AB - Circadian rhythms of eicosanoid formation were investigated in linoleic acid (LA) rich (sunflower seed oil, 13.3 cal% LA) and LA deficient (hydrogenated palm kernel fat, 0.5 cal% LA) diet fed male Wistar rats adapted to an artificial lighting regimen of 12 hours light and 12 hours darkness. Over a period of 24 hours we examined at 4 hour intervals eicosanoid formation in the aorta (PGI2, PGE, PGF2 alpha), in the heart (6-keto-PGF1 alpha, PGE, PGF2 alpha, TXB2), in the kidney (PGE, PGF2 alpha) and in the brain (PGE, PGF2 alpha). Two types of circadian variation curves were observed: Low eicosanoid formation in the light period and increase in the dark cycle (PGE in aorta and heart, TXB2 in heart). The increase in eicosanoid formation in the dark cycle was diminished after an LA deficient diet. Continuous decrease (PGI2 in aorta) and increase (PGE in the brain), respectively, in the course of the day, without differences between the two dietary groups. We assume that the circadian oscillations of eicosanoid formation might be of importance for the development of the circadian time structure of the organism. PMID- 3547417 TI - [The history of pharmaceutical science. 18. The development of pharmacy at the University of Greifswald between 1903 and 1968. 3. The development of technical standards]. PMID- 3547418 TI - [The history of acetylsalicylic acid synthesis]. PMID- 3547419 TI - Interpersonal psychotherapy (IPT) and drugs in the treatment of depression. AB - IPT is a brief form of psychotherapy, developed specifically for treatment of depression. It is based on the theoretical writings of Meyer and Sullivan and empirical research from epidemiology and clinical investigations. The efficacy of IPT for ambulatory depressive has been established in three controlled studies, two conducted by the investigators and one conducted by the National Institute of Mental Health. PMID- 3547420 TI - Effects of electroconvulsive shock on noradrenergic and serotonergic receptors in rat brain. AB - It is likely that both noradrenalin and serotonin neurotransmission are important in the pathophysiology of depression and to its treatment. In particular, certain receptors for these neurotransmitters are altered by repeated treatment with both antidepressant drugs and electroconvulsive shock. This paper reviews the effects of electroconvulsive shock on alpha-1-adrenergic, beta-adrenergic, and serotonin 2 receptors in rat brain, and compares these effects to those produced by anti depressant drugs. The similarities and differences in the effects of antidepressant drugs and electroconvulsive shock in rat brain may provide clues for the development of more effective treatments for depression and could single out targets for future investigation of the pathophysiology of depression in patients when safe methods are developed. PMID- 3547421 TI - Neuroendocrinological studies on depression with special reference to research at the Max-Planck-Institute of Psychiatry. AB - Hypercortisolism due to Cushing's syndrome or glucocorticoid therapy induces disturbances in several other endocrine systems and may also cause mental changes, predominantly depression of various degrees. On the other hand, it has repeatedly been shown that endogenous depression is often accompanied by hypercortisolemia, usually of a modest degree, and/or by changes in other hormonal systems similar to those observed in Cushing's syndrome and during treatment with glucocorticoids. Research performed at the MPIP on 327 psychiatric patients and 103 healthy subjects has demonstrated that, in contrast to Cushing's syndrome, the circadian rhythm in depression is usually well preserved, and that diurnal variation in mood is correlated with that rhythm. Furthermore, it was found that a modest hyperactivity of the HPA system, as indicated by enhanced UFC excretion and nonsuppression in the DST, is not specific for depression in general or its endogenous subtype. It can also be observed in many other psychiatric disorders and seems to mirror stress and the influence of other factors, such as weight loss due to anorexia, rather than a particular nosology. TSH blunting in the TRH test appears as a consequence of hypercortisolemia in psychiatric disorders as is the case in Cushing's syndrome and in the course of glucocorticoid therapy. Differences in the patterns of neuroendocrine abnormalities in depressives and other psychiatric patients probably reflect differences in the individual responsiveness of the various hormonal axes to stress rather than nosological subtypes of the disorder. A comparison of these results with the past and current literature reveals remarkable changes in the concepts of neuroendocrine dysfunctions in depression and leads to suggestions of new strategies for research on this subject. PMID- 3547422 TI - Spinal nerve root compression--some clinical implications. A review of the literature. AB - Spinal nerve root compression (SNRC) lesions resulting from various etiological conditions are a problem affecting many patients seen by physical therapists. The purposes of this article are to describe the factors that determine the strength deficits (SDs) accompanying these lesions and to discuss evaluation procedures and therapeutic considerations for patients with these SDs. Because of biological compensatory mechanisms and the shortcomings of techniques for measuring SDs, physical therapists may be unaware of the motor involvement of patients with SNRC lesions. The application of appropriate evaluation procedures should enable physical therapists to identify the SDs and monitor their response to therapeutic interventions. These interventions should be applied with appreciation of the potential for causing further damage from overworking the weakened muscles. PMID- 3547423 TI - Characteristics of spontaneous obesity in male rhesus monkeys. AB - Adult male rhesus monkeys representing a wide range of adiposity were characterized according to body dimensions, eating behaviors, and endocrinologic/metabolic indices. Body fat, located most prominently on the abdomen, ranged from 30 to 61% of body weight. Three groups were formed on the basis of body composition data: Very Obese (VO), Moderately Obese (MO) and Nonobese (N). These groups did not differ in food intake, preferences for sweet solutions, or compensatory changes in food intake following consumption of sugar solutions. Glucose tolerance was normal, but fasting insulin levels and insulin response to glucose loading increased with increasing adiposity. Fasting triglyceride levels were highly correlated with insulin values and body fat. It is concluded that some adult male rhesus monkeys develop obesity without obvious differences in eating behavior and that obese monkeys, like obese humans, are at risk for diabetes mellitus and its complications. PMID- 3547424 TI - Stimulation of insulin release and suppression of feeding by hepatic portal glucagon infusion in rats. AB - Plasma insulin and glucose concentrations were measured in rats by remote blood sampling techniques 5 and 25 min after the start of a continuous intraportal glucagon infusion (0.33, 1.0, 3.3, 10 and 33 micrograms/kg/min). Plasma insulin levels were elevated in a dose-related fashion by glucagon, with the highest dose producing a 23-fold increase above control levels. In contrast, the glycemic effect of glucagon was not dose-related. Glucagon-induced hyperglycemia was similar for all glucagon doses, despite the fact that a glucagon dose range spanning two orders of magnitude was used. In a second experiment, plasma glucose and insulin were measured as described above at two glucagon infusion rates (1 and 10 micrograms/kg/min), but the animals were allowed to eat during the infusion. Results showed that the effects of glucagon infusions on plasma insulin and glucose were additive with the normal prandial changes in these substances. Finally, food intake was inversely related to insulin level and dissociated from the hyperglycemia during glucagon infusion. These results show that exogenous glucagon provides a potent stimulus for insulin release in the rat both in the presence and in the absence of food. Furthermore, these results in combination with other data suggest that glucagon-induced hyperinsulinemia merits further investigation as one possible determinant of glucagon satiety in the rat. PMID- 3547425 TI - A microcomputer-based system for stereotaxic coordinates in the rat brain. AB - In this report, the computer hardware and software used in the generation of a stereotaxic rat brain atlas are described. The atlas consists of sagittal and frontal sections drawn to the high-resolution page of the Apple II series computer. Brain architectural and macroscopic areas are represented by lines. Microscopic areas are represented by dots. The system employs a large data base to make available hundreds of brain areas on stereotaxic sections containing precise positional information of thousands of specific locations. For each display, the brain area is identified by name and by cross-hairs with digital display of stereotaxic coordinates. These coordinates may be referenced by earbar zero or bregma. Other program options allow the printing of brain sections and a listing of available brain areas. Although designed for research in the neurosciences, the software may also be used for educational purposes. PMID- 3547426 TI - An inexpensive and reliable rat stereotaxic adaptor for small bird neurosurgery. AB - The present note describes the construction of a nose bar adaptor for small bird neurosurgery. The adaptor is simple, inexpensive and reliable, and has been used extensively in our laboratory investigating the neural mechanisms of food-caching in birds. PMID- 3547427 TI - Blockade of ovulation by prostaglandins synthesis inhibitor in medial preoptic area. AB - Indomethacin, a known inhibitor of prostaglandins synthesis, injected into the medial preoptic area on the day of proestrus blocked ovulation in regularly cycling female rats. This finding provides evidence for a facilitatory role of endogenous prostaglandin synthesis, in the medial preoptic area, in the process of ovulation. PMID- 3547428 TI - Photoperiodic regulation of body mass and fat reserves in the meadow vole. AB - Short photoperiods reduce both body mass and food intake of male meadow voles. To help determine whether the primary effect of short day lengths is on regulation of some component of body mass or on the control of food consumption, voles housed in a long photoperiod were provided rations equivalent to those consumed by animals in short day lengths. Animals were transferred to a short photoperiod and after either 3 or 6 weeks of food restriction were fed ad lib. Both groups of voles overate after termination of food restriction and achieved seasonally appropriate body masses that were influenced by the duration of short photoperiod treatment. We conclude that short photoperiods gradually alter the regulated level of one or more components of body mass. We tested and failed to support the hypothesis that the subcutaneous fat depot is selectively spared during seasonal weight loss and thereby increases surface insulation. Thus, the proportion of adipose tissue reduction did not differ significantly among the epididymal, retroperitoneal, and inguinal-subcutaneous fat depots of voles housed in short day lengths. PMID- 3547430 TI - [Use of narcotic agents among children and youth]. PMID- 3547429 TI - Hypophagia induced by endogenous or liposome-encapsulated 3,4-dihydroxybutanoic acid. AB - Hypophagia induced by 3,4-dihydroxybutanoic acid (2-deoxytetronic acid, 2-DTA), an endogenous short-chain polyhydroxymonocarboxylic acid, was investigated in rats. Intraperitoneal injection of 2500 mumol 2-DTA did not suppress feeding, but 2.5 mumol 2-DTA injected into the third cerebroventricle did. To efficiently transport exogenous 2-DTA into the brain, its encapsulation and delivery in specially made sulfatide liposomes was attempted. Feeding was suppressed dose dependently by intraperitoneally injected 2-DTA in liposomes. Injection of 2500 mumol 2-DTA into the common carotid artery also suppressed feeding. Administration by either route prolonged postprandial intermeal interval with no change in meal size, as was observed after central administration of 2-DTA. Injection of 2.5 mumol 2-DTA into the third cerebroventricle elevated plasma glucose level, leaving insulin and free fatty acids unaffected. These findings, together with previous results, indicate that at least one site for the physiological action of 2-DTA is in the hypothalamic centers for food intake. PMID- 3547431 TI - [25th anniversary of the H. Chrzanowska Medical School]. PMID- 3547432 TI - Hynes pharyngoplasty revisited. AB - The treatment of velopharyngeal incompetence remains unsatisfactory because the causes are many, as are the variations in anatomic and physiologic defects. Therefore, full assessment and investigation are essential in tailoring the surgery to the defect. A modified Hynes pharyngoplasty has been used in 40 patients, aged 4 to 52, over a 4-year period for velopharyngeal incompetence of varying etiologic causes. Speech was assessed before and at least 6 months after pharyngoplasty. At the same time, radiologic and, when possible, nasendoscopic investigations were undertaken. Thirty-eight patients had no or variable nasal escape (variable defined as achieving intermittent closure), whereas 33 had normal or slight hyponasal resonance. There was only one complication, an asymptomatic dehiscence of the "bucket handle" flap from the posterior wall. Thirteen patients had an assortment of side effects, none requiring surgical treatment. We believe that patients who are suitable for the described sphincter pharyngoplasty are those with slight or moderate nasal escape having a mobile palate with an anteroposterior gap of 5 mm or less. PMID- 3547433 TI - Sensibility and cutaneous reinnervation in free flaps. AB - Sensibility and sensory reinnervation were investigated in 19 free flaps, predominantly located on the lower extremities, between 2 months and 3 years after flap transfer. All patients showed deep pressure sensibility. In 10 of the patients, primarily those examined late after surgery, a heat pain threshold was obtained at about 50 degrees C. None of the patients had superficial sensibility of any other modality. No neurofilament-positive sensory nerve fibers were observed in the dermis or epidermis. In one patient nerve fibers were detected in the subcutaneous tissue. It is concluded that patients will have deep pressure sensibility of the flap area even early after the operation and that most patients will develop a heat pain sensitivity, probably due to subcutaneous reinnervation. PMID- 3547434 TI - A combined regimen of controlled motion following flexor tendon repair in "no man's land". AB - A program of controlled motion following repair of flexor tendons in the hand is presented. This regimen incorporates the features of active extension against rubber band passive flexion, as well as those of controlled passive extension and passive flexion. In this prospective study, 44 digits with complete lacerations of the flexor digitorum profundus and flexor digitorum superficialis in zone 2 were treated. Using the Strickland formula of total active motion of the interphalangeal joints, 36 fingers (82 percent) were rated "excellent"; 7 fingers (16 percent) were rated "good"; 1 finger (2 percent) was rated "fair"; none was rated "poor". There was no statistical difference between the results of delayed primary repair and immediate primary repair. PMID- 3547435 TI - Skin graft from a scalp flap. AB - We present a case of scalp avulsion treated with a transposition scalp flap utilizing a split-thickness skin graft from the flap. Using the flap as a donor site confined the operation to a single anatomic region and saved the patient an additional donor-site scar. The flap healed uneventfully with normal regrowth of hair, the donor site was well concealed, and there was complete take of the split thickness skin graft. PMID- 3547437 TI - On some decisive influences in the development of Latin American psychiatry. PMID- 3547436 TI - History of the Committee of Psychiatry and Foreign Affairs. PMID- 3547438 TI - Speculations on the measurement of recovery from severe psychiatric disorder and the human condition. PMID- 3547440 TI - The matter of time in psychiatry: a preliminary report. PMID- 3547439 TI - Attachment and separation: the implications for gender identity and for the structuralization of the self: a theoretical model for transsexualism, and homosexuality. PMID- 3547441 TI - The teaching of psychotherapy to foreign medical graduate residents in psychiatry. PMID- 3547442 TI - A comparative study of adolescents and adults who wilfully set fires. PMID- 3547443 TI - Self-inflicted eye injury: clinical and psychodynamic aspects. PMID- 3547444 TI - Child analysis, 1947-1984. A retrospective. PMID- 3547445 TI - Twinship themes and fantasies in the work of Thornton Wilder. PMID- 3547446 TI - The structure of amyloid filaments in Alzheimer's disease and the unconventional virus infections of the nervous system. PMID- 3547447 TI - The adolescence of a thirteenth-century visionary nun. AB - Among the most notable features of the religious revival in western Europe in the early thirteenth century was the development of mysticism among the nuns and religious women of the lowlands. As scholarly attention becomes increasingly focused on this group of remarkable women, the question arises whether a psychiatric viewpoint has something of value to offer to the understanding of such individuals and the culture in which they struggled. The methodological and intellectual problems inherent in examining the life of a thirteenth-century mystic with a twentieth-century empirical frame of reference are illustrated in this study of the adolescence of Beatrice of Nazareth. Beatrice's stormy asceticism, ecstatic states and mood swings lend themselves to potentially competing hypotheses regarding the spiritual and psychopathological significance of her adolescent development and eventual life-course. Common grounds for reconciling these alternative models are discussed. PMID- 3547449 TI - Computerized clinical practice: promises and shortcomings. PMID- 3547448 TI - Experiments on clinical observation and judgement in the assessment of depression: profiled videotapes and Judgement Analysis. AB - Variations within and between observer-judges reduce the accuracy of clinical research. Judgement Analysis allows strategies to be developed and applied which reduce variation in judgement. The prediction that the removal of important sources of error variance by this means would reduce the likelihood of committing a Type 2 Error was supported by the application of Judgement Analysis to assessments by 15 psychiatrists of 92 patients in a clinical trial of 2 antidepressive treatments. The statistical significance of differences between the effect of the treatments on the severity of depression was increased, and significant differences appeared earlier. Ten stimulated patient profiles were also converted into narrative case histories, enacted by experienced psychiatrists or psychologists and videotaped. The participants' judgements of the overall severity of the depression were in good agreement with those they had made on the original cases. Videotapes so prepared help training to reduce variation in observation, just as Judgement Analysis can lead to reductions in the variation of judgement. PMID- 3547450 TI - Impact of relaxation-training and cognitive-therapy on coronary patients post surgery. PMID- 3547451 TI - An oriental point of view in psychosomatic medicine. AB - In many cases of 'alexithymia' there also seems to be a difficulty in the awareness and expression of bodily feelings (tentatively called 'alexisomia'). Furthermore, this insensitivity to the body obstructs one's awareness towards the laws of nature with which the body is implicitly in touch. Holistic awareness, which includes not only the intellect but also emotional, bodily and ecological (existential) aspects of man, can be the basic principle for holistic self control. Oriental body-oriented approaches which facilitate such a holistic awareness must be reevaluated as an essential part of psychosomatic treatment. PMID- 3547452 TI - A syndrome of familial intrathyroidal primary parathyroid hyperplasia: case reports and critical review of literature. AB - Intrathyroidal hyperplastic parathyroid glands were responsible for primary hyperparathyroidism (PHPT) in two of three members in a family. The third had an extrathyroidal parathyroid "adenoma". Both intrathyroidal parathyroid (IThP) hyperplastic glands were the largest ones removed at the time of surgical cure. A review of the literature confirmed our postulate of a higher incidence of familial cases among patients with hyperparathyroidism and IThP with an incidence of 10.34% of IThP in familial cases versus a 4.2% in non-familial cases with PHPT. This contrasts with an incidence of 0.1% of IThP in normal patients. We hypothesize that stimulation of IThP tissue by surrounding calcitonin-producing C cells might play a role in the seemingly preferential IThP hyperplasia. Recognition of this syndrome of Familial IThP Hyperplasia is important in order to avoid unnecessarily aggressive surgery for hyperparathyroidism. PMID- 3547453 TI - Rare earth magnetic attachments: the state of the art in removable prosthodontics. PMID- 3547454 TI - [Identification of Enterobacteriaceae using the ABAC-ABACTOR II semiautomatic system]. AB - The validity of the semi-automatic ABAC-ABACTOR II system in diagnostic use has been confirmed with identification and control assays of 238 strains of Enterobacteriaceae. PMID- 3547455 TI - [False positive reactions to the fluorescence test (FTA-ABS) in skin disease patients]. AB - False positive reactions to the fluorescence test (FTA-ABS) were found in a group of dermatological patients compared to another group, made up of healthy subjects and blood-donors. Reactivity to FTA-ABS test was particularly evident in patients suffering from Herpes simplex genitalis, allergic diseases and collagenoses. Practical and theoretical aspects of this finding are discussed. PMID- 3547456 TI - [Isolation of thymidine-dependent strains. Microbiologic considerations and personal observations]. AB - We describe the emergence of three thymidine-dependent strains (Thy-): two Escherichia coli obtained in successive occasions from urine of a woman treated with co-trimoxazole before the organisms were isolated and one Proteus mirabilis obtained from urine of a man who had a treatment with norfloxacin. Cultural characteristics and methods for the detection of these Thy- strains are given. PMID- 3547459 TI - [Methods of enhancing the radioprotective efficacy of serum immunoglobulin]. AB - In this work the authors propose three ways of increasing the radioprotective efficiency of immunoglobulin: in vitro irradiation with gamma-quanta (60Co, 20,000 Gy), increasing the time of storage of whole blood (raw material for immunoglobulin production) up to 5-7 days at +4 degrees C, and the application of immunoglobulin with antibiotics. In experiments in vitro it was first shown that a combination of immunoglobulin with gentamicin exerted a pronounced bactericidal effect on E. coli. The effect was absent with immunoglobulin and markedly less pronounced with gentamicin used separately. PMID- 3547458 TI - [Changes in the content of carbohydrate-containing proteins in the liver of rats chronically exposed to pesticides combined with total gamma irradiation]. AB - A study was made of the chronic effect of pesticides, within a wide range of doses, combined with whole-body gamma-irradiation, on the content of carbohydrate containing proteins of rat liver. The extent to which disturbances in the carbohydrate-containing protein metabolism were manifest was shown to depend upon dose and time of action of the damaging factors. As determined by certain parameters, the combined effect of pesticides and gamma-radiation at the biochemical level was additive, and it was more than additive as estimated by a number of other tests. PMID- 3547457 TI - Current aspects on the radiation induced base damage in DNA. AB - In this short review, some current aspects of our knowledge about base damage in DNA induced by ionizing radiation will be summarized. It is not intended, to describe all the literature in this field; a very extensive review has been given in the book of Huttermann et al. (1978) and also in later by Cadet and Berger (1985), Hutchinson (1985) and v. Sonntag and Schuchmann (1986). However, in this review, current ideas and unsolved problems concerning DNA base damage will be discussed, which may outline possible future research in this field. The understanding of DNA base damage requires the analysis of radicals formed in irradiated single DNA moieties as well as in whole DNA. Chemical studies about can be used for the molecular alterations of bases and biochemical methods for DNA-sequencing. In addition enzymes recognizing DNA damage and immunological methods with specific antibodies can be employed. However special emphasis should be given to the analysis of DNA base damage in irradiated cells and it will be shown, that a distinct gap in knowledge exists in this field in contrast to the radiation chemistry in aqueous solutions of DNA. PMID- 3547460 TI - [Longevity of animals in combined exposure to total gamma irradiation and incorporated plutonium-239]. AB - The paper presents the functions and nomograms permitting to estimate the expected consequences of the combined effect of alpha-radiation from incorporated plutonium 239 and external gamma-rays at random doses on the lifetime of animals. PMID- 3547463 TI - [Quantitative description of a change in radiosensitivity]. AB - Modification of cell radiosensitivity was expressed mathematically in terms of known experimental values of oxygen enhancement ratios for different yeast cell strains. It was shown that the parameters used permit to quantitate the dependence of the efficiency of radioprotectors and radiosensitizers upon yeast cell genotype. PMID- 3547462 TI - [Dynamic analysis of the induction of chromosome aberrations in the bone marrow cells of laboratory mice]. AB - A study was made of the incidence of such damages as breaks, gaps, and exchanges occurring in bone marrow cells of CBA mice after irradiation with a dose of 12.9 mC/kg. Males and females exhibited a similar spontaneous chromosome aberration level. Nevertheless, the experimental results obtained indicate that males are more radiosensitive than females. PMID- 3547461 TI - [Embryonic mortality of the root vole as an index of the effect of small doses of natural radioactivity on genetic processes in populations]. AB - A study was made of the pre- and post-implantation death of (F2--F4) Microtus oeconomus progeny whose parents lived in territories where natural radiation background was increased (an exposition dose-rate of 3.6-144.0 pC/kg X s). The spontaneous rate of pre- and post-implantation death of progeny of irradiated (experimental) animals was higher than that of intact ones (control). The animals kept in conditions of chronic irradiation (46.2 pC/kg X s) exhibited a more pronounced discrepancy in embryonal death rate. It is suggested that genetic differences in the populations were responsible for different rate of embryonal death of the control and experimental animals. PMID- 3547464 TI - [Karyometric characteristics of the rat sensorimotor cortex in non-uniform gamma irradiation]. AB - Neurocyte nuclei increase in volume without structural changes in karyoplasm at early times after gamma-irradiation of rat head with doses of 50 to 100 Gy. Irradiation of 200 Gy causes a diminution of the nuclei volume while at a dose of 400 Gy the nuclei do not change their volume. A dose as high as 1000 Gy causes severe changes in the karyoplasm leading to nucleus swelling. At later times (24 72 h), the increase in the nuclei volume is associated with the changes in the karyoplasm structure. At one and the same dose, radiation causes either a decrease (irradiation of the head) or increase (exposure of the body) in the neurocyte nuclei volume. At early times after wholebody uniform irradiation no karyometric changes are detected. The nucleus swelling is more pronounced at lower dose-rates. PMID- 3547465 TI - Cross-sectional imaging of inflammatory bowel disease. AB - The cross-sectional imaging modalities provide an important diagnostic perspective in patients with inflammatory bowel disease that often has a profound influence on the therapeutic decision-making process. They can directly and noninvasively image infectious and inflammatory complications involving the bowel wall, serosa, and mesentery that can only be assessed indirectly by colonoscopy and barium studies. At the present time, CT is superior to ultrasound and MR in diagnosing these extramucosal complications. PMID- 3547466 TI - Nuclear medicine imaging of inflammatory bowel disease. AB - With the availability of indium-labeled white blood cells, radionuclide imaging studies have a definite role in the diagnosis and staging of patients with inflammatory bowel disease. The In-111 white blood cell study is particularly helpful in evaluating recurrent disease in patients with severe intercurrent diseases and in screening patients without the need for barium examinations. PMID- 3547467 TI - Malignancy complicating inflammatory bowel disease. AB - There is now general agreement that both ulcerative colitis and Crohn's disease predispose patients to the development of malignancy. Many controversies still remain concerning the incidence of this complication as well as the diagnostic approach to be taken with these patients. This article reviews the topic and examines the contribution the radiologist can make in evaluating the patient with chronic inflammatory bowel disease. PMID- 3547468 TI - Hepatobiliary complications of inflammatory bowel disease. AB - A variety of biliary and hepatocellular diseases occur with increased incidence in patients with inflammatory bowel disease. These include fatty infiltration of the liver, cholelithiasis, pericholangitis-primary sclerosing cholangitis, cirrhosis, chronic active hepatitis, liver abscess, amyloidosis, granulomatous hepatitis, and bile duct carcinoma. Radiography is essential in accurate diagnosis. PMID- 3547469 TI - Crohn's disease of the small intestine. AB - The small bowel remains the most frequent site of inflammation in Crohn's disease, involving 75 to 85 per cent of all patients. In spite of the advent of newer imaging modalities and the increasing sophistication of endoscopy, barium studies remain the primary method of diagnosis and evaluation of small bowel Crohn's disease. It is important not only to detect the presence of disease, but also to give a correct anatomic distribution as well as identify possible complications. PMID- 3547470 TI - Colitis: radiographic features and differentiation of idiopathic inflammatory bowel disease. AB - It is important clinically to be able to differentiate ulcerative colitis from Crohn's colitis because they differ considerably in the nature of complications and prognoses. Radiographically, it is possible to render a specific diagnosis in the vast majority of cases using criteria described in this article. The problem of the underlying process in inflammatory bowel disease in elderly patients and indeterminate colitis is also discussed. PMID- 3547471 TI - Organ transplantation. PMID- 3547472 TI - Renal transplantation: clinical considerations. AB - Renal transplantation is the treatment of choice for adults and children with end stage renal disease. More than 7500 kidney transplants are performed in the United States each year with an average 2-year graft survival rate of 95, 85, and 75 per cent for HLA-identical, living related, and cadaver donor recipients, respectively. New immunosuppressive modalities including donor specific transfusions and cyclosporine have resulted in improved results with fewer infectious complications. Careful attention to hemostasis, minimization of tissue injury, and aseptic technique is necessary in uremic and immunosuppressed patients. The most common complications requiring radiologic evaluation and treatment after renal transplantation include acute tubular necrosis, renal artery or renal vein thrombosis, lymphocele, ureteral necrosis, bladder disruption, bleeding, ureteral obstruction or stricture, and renal artery stenosis. The most useful radiologic studies are renograms, echograms, computed axial tomograms, cystograms, arteriograms, percutaneous nephrostograms, and intravenous or retrograde pyelograms. PMID- 3547473 TI - Angiographic assessment of potential renal transplant donors. AB - Preoperative evaluation of the donor kidney is performed using excretory urography and angiography. Indications for this evaluation include assessment of possible renal anomalies, determination of the status of the arterial supply, and most importantly, the need to ensure that the donor's remaining kidney is normal. A technique for renal donor angiography using semiselective aortography is described. PMID- 3547475 TI - MRI in organ transplantation. AB - Experience with MRI in transplant patients is limited. The normal transplant kidney is characterized by a sharply defined corticomedullary border on T1 weighted images. Loss of CMC is seen in transplant rejection and in some patients with ATN. Presence of CMC does not rule out rejection, however. The spectrum of changes in cyclosporine toxicity is unclear, as only a few patients have been reported. For heart, liver, and pancreas transplantation magnetic resonance spectroscopy and imaging may prove useful in the evaluation of organ viability preoperatively and in early detection of rejection. Carefully designed prospective studies are needed to better define the role of MRI in organ transplantation. PMID- 3547474 TI - Ultrasound and computed tomographic evaluation of renal transplantation. AB - Ultrasound and computed tomography are very useful in the diagnosis of parenchymal and urologic abnormalities after renal transplantation. The increased use of Doppler duplex sonography will further enhance the role of ultrasound in the evaluation of patients with kidney transplants. Computed tomography is of particular value in the setting of suspected posttransplant malignancy. Both imaging techniques can be used to guide diagnostic and therapeutic interventional radiologic procedures. PMID- 3547477 TI - Preoperative angiographic evaluation of prospective liver recipients. AB - The radiologic evaluation for liver transplantation involves physiologic studies of function and anatomic studies of the intrahepatic and extrahepatic structures. CT and US are successful for examining and measuring the PV and IVC in 75 per cent of cases, whereas the remaining patients will require more invasive angiographic or venographic studies. These studies require careful planning and sequencing and should be performed in the order of least invasive first, with progression to more invasive studies if necessary. PMID- 3547476 TI - Clinical considerations in orthotopic liver transplantation. AB - Progress in immunosuppression, surgical techniques, and perioperative care has promoted orthotopic liver transplantation from an experimental procedure to an accepted clinical treatment. Orthotopic liver transplantation, in turn, has changed the treatment of terminal liver disease from care that is largely treatment of symptoms and support to cure, but at the price of major surgery and life-long immunosuppression. This article reviews the current status of liver transplantation as practiced at the University of Pittsburgh. PMID- 3547478 TI - Postoperative angiographic and interventional radiologic evaluation of liver recipients. AB - Since the first liver transplant in 1968 at the University of Minnesota, over 125 liver transplants have been performed. Postoperatively, these patients require intensive care, and many ultimately require angiographic or interventional radiologic procedures, or both, to diagnose postoperative vascular anastomotic problems, thrombotic complications, biliary anastomotic problems, and infrequently, hemorrhagic problems. PMID- 3547479 TI - Ultrasound and computed tomographic evaluation in hepatic transplantation. AB - Ultrasound and CT are valuable in the non-invasive evaluation of complications of hepatic transplantation. Ultrasound is particularly helpful in detecting biliary obstruction and in documenting vascular patency. As with renal transplantation, the value of US in the assessment of rejection will likely increase with time. Computed tomography is most valuable in identifying large parenchymal abnormalities and abdominal fluid. Both US and CT can be used to guide diagnostic and therapeutic percutaneous procedures in hepatic transplant recipients. PMID- 3547480 TI - Pancreas transplantation: clinical considerations. AB - The number of pancreas transplants performed and the success rate have increased significantly since the first segmental pancreas transplant was performed in 1966. Since 1977, 716 pancreas transplants have been performed in 670 patients at 69 institutions. Currently 230 grafts (32 per cent) are listed as functioning (insulin independent). The present 1-year actuarial graft and survival rates at the University of Minnesota are 43 and 88 per cent, respectively. The indications for pancreas transplantation and the selection of recipients have undergone modification, and more nonuremic nonkidney transplant patients are now receiving pancreas allografts. A variety of techniques have been used for pancreas transplantation. Whole or segmental pancreas grafts have been used. Most centers drain the graft exocrine secretions into the gastrointestinal tract as a Roux-en Y pancreaticojejunostomy or into the bladder as a pancreaticocystostomy. The most common complications requiring radiologic evaluation and treatment include vascular thromboses utilizing technetium flow studies and arteriography and intra abdominal fluid collections and infections requiring ultrasonography and CT scans. Percutaneous aspiration of intra-abdominal fluid collections is important for diagnosis but has not been successful therapeutically. Intra-abdominal infections are most common in patients with enteric drainage of the pancreas graft, which carries a high risk of contamination at the site of anastomosis. Most intra-abdominal infections require surgical drainage and removal of the graft. PMID- 3547481 TI - Ultrasound and computed tomography in the evaluation of pancreatic transplantation. AB - Both ultrasound and computed tomography are useful imaging modalities in the evaluation of pancreatic transplants and their complications. Ultrasound and computed tomography are most valuable in the detection of peripancreatic fluid collections, although some parenchymal abnormalities can occasionally be detected. Directed diagnostic aspiration is useful in determining the etiology of peripancreatic and other peritoneal fluid collections. The role of percutaneous catheter drainage in the management of these complex patients is not yet clearly defined. PMID- 3547483 TI - Diagnostic challenges following cardiac transplantation. AB - It is now almost two decades since the first human cardiac transplantation was performed. Recipients will require close follow-up by their referring physicians outside of the main referral centers. This article is intended to assist the referring physician in choosing the most appropriate diagnostic studies throughout the posttransplant period. PMID- 3547482 TI - Clinical considerations of cardiac transplantation in organ transplantation: preoperative and postoperative evaluation. AB - Cardiac transplantation is being performed with increasing frequency worldwide; over 840 transplants were performed in 1985. All facets of cardiac transplantation are reviewed, including preoperative evaluation of both recipients and donors, technical aspects of the surgical procedure, and postoperative care of the recipient. Immunosuppression, complications, and long term statistics are also reviewed. Particular care is taken to discuss pertinent radiographic studies as they apply to cardiac transplantation. PMID- 3547484 TI - [Comparative evaluation of radiodiagnostic imaging procedures]. PMID- 3547485 TI - [X-ray morphological findings in 34 patients with acute myeloid leukemia, cytoreductive therapy and bone marrow transplantation in relation to the clinical data and irradiation regimen]. PMID- 3547486 TI - [Place of ultrasound-B imaging, computed tomography and arteriography in renal tuberculosis]. PMID- 3547487 TI - Radiography in the United States Army during World War II: Part II. AB - This is the second of two articles highlighting Army radiography during World War II. Topics center around the certification of Army radiographers, rank structure, scope of service, adverse working conditions, improvisations, and contributions by Arthur W. Fuchs. The contributions of Army radiographers during World War II were significant in helping to meet the challenges of the military medical threat and assisted in saving thousands of lives around the world. PMID- 3547488 TI - Caring for the major trauma victim: the role for radiology. AB - Two innovations have improved the care of the major trauma victim in the past 20 years. Both depend on active radiologist participation. The first has been the progressive nationwide development of the Emergency Medical Service System, which identifies trauma centers by a process of categorization, regionalization, and verification. The hospital must be staffed and equipped to perform computed tomography, angiography, and sonography. Trauma centers effectively reduce morbidity and mortality of the accident patient. The second innovation has been the intensive use of computed tomography (CT) for immediate patient evaluation. CT surpasses other imaging methods in examination for craniocerebral, abdominal, spinal, pelvic, and facial trauma. In craniocerebral trauma, the precise diagnosis afforded by CT reduces the fatality rate by permitting early surgical intervention. In abdominal trauma, CT examination supports nonoperative management of hemodynamically stable patients with solid organ injury. In spinal, pelvic, and facial injuries, CT provides diagnostic information not available with conventional radiography. PMID- 3547489 TI - Stop-type and shunt-type varicoceles: venographic findings. AB - Forty-four patients with a left-sided idiopathic varicocele were examined with bidirectional Doppler ultrasound (US), physical examination, and percutaneous retrograde venography. On the basis of the Doppler findings, the varicoceles were classified as either stop type or shunt type. On venography, the stop-type varicoceles showed only retrograde blood flow (reflux) in the testicular (internal spermatic) vein, whereas each shunt-type varicocele showed both retrograde and orthograde (i.e., physiologic) venous blood flow: First, reflux appeared in the testicular vein, then orthograde flow occurred in the deferential vein, cremasteric vein, or both. The shunt-type varicocele therefore represented a kind of venous bypass. Thus, the existence of two hemodynamically different types of varicocele as suggested initially by Doppler US is confirmed by percutaneous retrograde venography. The shunting of venous blood appears to be a precondition for medium and large varicoceles and might have some prognostic significance for subfertility associated with varicoceles. PMID- 3547490 TI - Acute appendicitis: high-resolution real-time US findings. AB - High-resolution, real-time ultrasonography (US) with graded compression was used to evaluate 90 patients with clinically suspected acute appendicitis. US visualization of a noncompressible appendix was the primary criterion for a diagnosis of acute appendicitis. The overall sensitivity was 89%, the specificity was 95%, and the accuracy was 93%. When the results in women were analyzed separately (n = 49), the overall accuracy was 96%. Several important limitations of US scanning were encountered. There were three false-positive examinations in patients with a sonographically visible appendix whose symptoms spontaneously resolved. Another patient had a normal compressible appendix with a thin (2-mm), symmetric wall surrounded by ascites. There were three nondiagnostic studies (3%) due to inability to compress the cecum and right lower quadrant adequately because of exquisite tenderness (two patients) or massive ascites (one patient). When interpreted in light of the clinical examination, sonography should significantly reduce the rate of false-negative appendectomies, particularly in women. PMID- 3547491 TI - Polycystic ovarian disease: US features in 104 patients. AB - Ultrasonographic (US) study was performed in 25 healthy women and 104 patients with polycystic ovarian disease (PCOD). Although the average size of ovaries in the PCOD patients was much larger than that of the healthy women, 29.7% of ovaries in the PCOD patients were normal in size. The shapes of the ovaries (roundness index) in PCOD patients were not different from those of the healthy women. There was no significant correlation between the size and shape of the ovaries. Bilaterally enlarged, globular-shaped ovaries were rare and usually asymmetric in size. The most important feature of PCOD on US scans is the bilaterally increased numbers of developing follicles (0.5-0.8 cm in size), usually more than five in each ovary. Although maturing follicles (1.5-2.9 cm) are much rarer in PCOD patients (13.5%) than in healthy women (36%), the incidences of follicular cysts (greater than 3 cm) was about the same in both. PMID- 3547492 TI - Cranial duplex sonography of the infant. AB - Duplex sonography was used to evaluate the cranial contents of 75 infants. The first 35 were scanned to establish technique and evaluate basic flow patterns. All cranial vessels scanned in healthy term infants produced diphasic (low resistance) waveforms, although certain cerebral vessels had characteristic Doppler signatures. The pericallosal, callosomarginal, anterior cerebral, basilar, middle cerebral, and internal carotid arteries and the vein of Galen were isolated and evaluated in almost every subject. In the second part of the study duplex characteristics of healthy term infants, healthy preterm infants, preterm infants with intracranial hemorrhages, and hydrocephalic infants were evaluated. Relative flow velocity at peak systole and end diastole and pulsatility index were investigated. The most significant variable was gestational age. Preterm infants frequently had no forward flow during diastole. Duplex sonography does not appear to add significant diagnostic information to routine real-time cranial studies. It does, however, permit more exact evaluation of cerebral blood flow than does non-pulse-gated, nondirected Doppler scanning. PMID- 3547493 TI - Fetal hydrocephalus: sonographic detection and clinical significance of associated anomalies. AB - Sixty-one cases of fetal hydrocephalus were reviewed to determine the accuracy and clinical significance of prenatal ultrasound (US) for detecting concurrent anomalies. Of 61 fetuses studied, 51 (84%) had one or more major central nervous system (CNS) malformations (38 fetuses with 39 anomalies) and/or extra-CNS anomalies (34 fetuses). Only ten (16%) fetuses had no concurrent anomaly. Anomalies of the CNS were correctly identified with US in 35 of 39 (90%) cases. Of 34 fetuses (56%) with extra-CNS anomalies, 27 had multiple anomalies. One or more extra-CNS abnormality was identified with US in 22 of the 27 (81%) fetuses with multiple anomalies but no anomalies were identified with US in the seven patients with an isolated anomaly. Fetal mortality was directly related to the presence of extra-CNS anomalies (P less than .01). Many important anomalies coexisting with fetal hydrocephalus can be identified with US. Furthermore, sonographic detection of extra-CNS malformations carries a poor prognosis and was associated with a uniformly fatal outcome in this series. PMID- 3547494 TI - Unusual renal mass in a newborn infant. AB - A newborn male infant had a right flank mass and hematuria. A solid renal mass was demonstrated on ultrasound and computed tomography studies, while Doppler studies suggested the diagnosis of renal vascular injury. Laparotomy disclosed avulsion of the right renal pedicle, and a right nephrectomy was performed. Traumatic renal hemorrhage should be considered in the differential diagnosis of a solid renal mass in the neonate, especially if the history or physical findings suggest trauma or if there is evidence of abdominal hemorrhage. PMID- 3547495 TI - US-guided percutaneous biopsy: use of a screw biopsy stylet to aid needle detection. AB - Insertion of a screw biopsy stylet into a thin-walled biopsy needle greatly enhances detection of the needle during ultrasound-guided percutaneous biopsy. This technique is helpful when precise needle-tip localization is needed for biopsies of small lesions. PMID- 3547496 TI - Cerebrovascular disease: evaluation with transbrachial intraarterial digital subtraction angiography using a 4-F catheter. PMID- 3547497 TI - MR imaging of the scrotum with a high-resolution surface coil. AB - Magnetic resonance (MR) imaging of the scrotum with a high-resolution surface coil was performed in ten healthy volunteers and 20 patients with scrotal abnormalities demonstrated by high-resolution real-time ultrasound (US). Four patients had an abnormal testis (two tumors, one cyst, one testicular atrophy), and 16 patients had extratesticular abnormalities (four hydroceles, five epididymal cysts, one hernia, and six cases of epididymitis). The normal structures of the scrotum were depicted clearly on MR images. In all cases, the tunica albuginea was easily differentiated from the testis and epididymis. MR imaging enabled one to distinguish intratesticular from extratesticular lesions and to determine whether a lesion was solid or cystic. Complicated and simple fluid collections could also be differentiated. In general, MR imaging and US scanning provided similar information. A potential advantage of MR imaging is in the evaluation of patients with painful scrotal lesions that may limit US evaluation. PMID- 3547498 TI - [Go forth and can you make the genes follow?]. PMID- 3547499 TI - Platelet-inhibitor drugs' role in coronary artery disease. PMID- 3547500 TI - Management of the vascular patient with multisystem atherosclerosis. PMID- 3547501 TI - Metabolic control of coronary blood flow. PMID- 3547502 TI - Approaches to a three-dimensional model of E. coli ribosome. PMID- 3547503 TI - The hypothalamus, intrinsic connections and outflow pathways to the endocrine system in relation to the control of feeding and metabolism. PMID- 3547504 TI - [Structure and evolution of the gene coding for carbamyl phosphate synthetase]. PMID- 3547505 TI - [Phospholipase A from the pancreas and E. coli]. PMID- 3547506 TI - The synthesis of benzindene prostacyclin analogs as potential antiulcer agents. AB - Two new diastereomeric benzindene prostacyclin analogs (U-72,382 and U-72,383) related to the potent antiulcer agent U-68,215 have been synthesized. These cyclohexyl ring modified analogs of U-68,215 were prepared to determine how the gastrointestinal and hypotensive endpoints observed for U-68,215 would be affected. PMID- 3547507 TI - [Sic gloria ingenii. The inscription on the Freud monument in Vienna]. PMID- 3547508 TI - Surveyed crowns: a key for integrating fixed and removable prosthodontics. PMID- 3547509 TI - [Radioreceptor assay--application and perspectives]. PMID- 3547510 TI - Acute renal failure--a continuing enigma. PMID- 3547511 TI - The causal role of salt depletion in acute renal failure due to captopril in hypertensive patients with a single functioning kidney and renal artery stenosis. AB - Captopril (C) causes ARF in hypertensive patients with renal artery stenosis (RAS) with a single functioning kidney (SK). Retrospective studies in two patients showed that episodes of C-induced ARF were preceded by a rise in urinary Na+ excretion and a rapid decrease in body weight. These observations prompted us to investigate whether extracellular fluid volume depletion secondary to C induced natriuresis can be responsible for ARF. Prospective studies were performed in four patients with RAS-SK treated with C. These studies have shown that: ARF is associated with negative Na+ balance and is corrected by salt replacement, even without interrupting C; ARF is preceded by a rise in urinary prostaglandin (PG) E2 and 6-keto-F1 alpha; ARF is prevented by either saline infusion or aspirin administration; ARF does not occur when the dose of C is not sufficient to raise PGs and urinary N + excretion. We conclude therefore that C induced ARF in patients with RAS-SK can be secondary to salt depletion dependent on a raised secretion of PGs. PMID- 3547512 TI - [Pulp tests as a means of diagnosis: review of the literature and clinical applications]. PMID- 3547513 TI - [Dento-muco-supported removable partial prosthesis: physical and mathematical treatment of various problems]. PMID- 3547514 TI - [Govert Bidloo (1649-1713), man of letters and professor of anatomy]. PMID- 3547515 TI - [Molecular arrangement of synthetic resins on the surfaces of alloys]. PMID- 3547516 TI - [Retrospective evaluation of occupational exposure in epidemiologic studies. Use of the Delphi method]. AB - A method, based on the Delphi technique, for evaluating occupational risks in a quantifiable manner was devised in the course of a case-control study on respiratory cancers in the nickel mining and refining industry in New Caledonia. There were four stages in the evaluation process: identification of eleven potential carcinogenic factors in the company during the 1930-1977 period; grouping of a limited number of work-stations; evaluation of exposure levels for the different factors for each workstation; computation of the cumulative value of exposure for each subject under study. A partial validation study shows that this kind of approach may prove useful for future occupational epidemiological studies. PMID- 3547517 TI - [Anesthesia in renal transplantation]. PMID- 3547519 TI - [Doppler technics in cardiology]. PMID- 3547518 TI - [Non-aggressive monitoring of the saturation of hemoglobin using pulse oximetry]. PMID- 3547520 TI - [Study of valvular function after heart transplant]. PMID- 3547521 TI - [Hemokinetic study using ultrasonic Doppler analysis: a new view of blood flow mechanics]. PMID- 3547522 TI - [Occurrence of HTLV-III infection and related clinical forms in a homogeneous group of drug addicts. Significance of immunologic changes and evaluation of risk factors]. PMID- 3547523 TI - [Senile and presenile, preclinical and subclinical hypothyroidism]. PMID- 3547524 TI - Endocrine regulation of postpartum ovarian activity in cattle: a review. AB - The problem of postpartum anoestrus is a real one because it results in prolongation of the time between calvings. The interval between the calving and resumption of cyclic ovarian activity depends on several factors, i.e., amount of feeding before and after parturition, level of milk yield, age of the animal, calving difficulty, presence of a bull in the herd, season and its photoperiodism and particularly the suckling or lactating status of the cow. The anoestrus period is longer in suckled cows (30 to 110 days) than in milked cattle (20 to 70 days). The physiology of the hypothalamic-pituitary-ovarian axis is still far from clear. Nevertheless, some events are very well demonstrated. The pulsatile release of LH and GnRH and the pituitary sensitivity to GnRH increase gradually after calving. They are inhibited by suckling, which acts more on LH and GnRH release than on their synthesis. Suckling or the presence of a calf can exercise its action via oestrogens. Suckling inhibits oestrogen synthesis by follicular cells and diminishes their feed-back positive effect on the hypothalamic pituitary axis. The suckling effect depends on oestrogen concentrations and on time after calving. The progressive LH release induces the synthesis of progesterone. After calving, the first luteal phase is shorter and the progesterone plasma concentrations are lower than what is observed during a normal cycle. Amongst some hypotheses proposed, premature luteolysis induced by uterine prostaglandins offers a new and very interesting field of research related to the utero-ovarian relationship after calving. The effects of FSH, prolactin and glucocorticoids hormones are much less understood. PMID- 3547526 TI - Skin graft and kidney transplantation in rats. Relation between circulatory condition of the transplanted organ and histocompatibility. AB - To determine the relationship between histocompatibility and circulation in the transplanted graft, which are the major factors influencing graft survival, the survival of the skin grafts and kidney transplants were compared between strong (ACI to Lewis) and weak (Fisher to Lewis) histocompatible strains, because rats given skin graft receive poor blood supply from a recipient, and the rats given kidney transplants receive immediate blood supply after transplant. In the group with a weak histocompatibility barrier circulation of the engrafted organ was better and the survival period longer. In the group with a strong histocompatibility barrier graft survival was little influenced by the circulatory disorder, and the degree of histocompatibility overwhelmed the circulatory condition. PMID- 3547527 TI - Serodiagnosis of fascioliasis in buffaloes by immunoprecipitation using adult Fasciola gigantica antigens. AB - Partial purification of a saline extract of adult Fasciola gigantica by chromatography on Sephadex G200 gave four peaks, of which only the first two contained material which gave a precipitation reaction with sera from infected buffaloes. None of these gave false reactions with sera from uninfected animals but even the first and most sensitive fraction only reacted with 57.5 per cent of sera from animals known to be infected with moderate numbers of F gigantica. PMID- 3547525 TI - The role of adrenal medulla in endogenous dopaminergic inhibition of aldosterone secretion. AB - Evidence has accumulated that aldosterone secretion is under endogenous dopaminergic inhibition. To examine potential sources of the dopamine thus inhibitorily acting in the adrenal zona glomerulosa, the responsiveness of aldosterone, plasma renin activity, prolactin, and plasma catecholamines to haloperidol, a dopaminergic antagonist, was studied in rats 6 weeks after unilateral adrenalectomy (Group B), 6 weeks after unilateral adrenal demedullation followed by contralateral adrenalectomy 5 days later (Group C), and in controls without any pretreatment (Group A). In Group C, there were increases in basal levels of norepinephrine (P less than 0.01), prolactin (P less than 0.02), and aldosterone (P less than 0.01). Basal plasma renin activity was also increased (P less than 0.05), epinephrine concentrations were decreased. Two hours after haloperidol 1 mg/kg b.wt. i.p., aldosterone levels were increased in Groups A + B (P less than 0.01) but unresponsive in Group C. Haloperidol-induced stimulation of prolactin and norepinephrine was not impaired by the surgical procedures. Epinephrine levels were increased by haloperidol only in groups A + B (P less than 0.002). In none of the groups were plasma renin activity or dopamine levels influenced by haloperidol. It is concluded that dopaminergic inhibition of aldosterone production is brought about neither by circulating dopamine nor by potential dopaminergic nerves accompanying arterial blood supply of the adrenal cortex but by dopamine originating directly in adrenal medulla. PMID- 3547528 TI - Antigenic diversity in Babesia divergens: preliminary results with three monoclonal antibodies to the rat-adapted strain. AB - Three murine monoclonal antibodies were raised against the rat-adapted strain of Babesia divergens. In the indirect fluorescent antibody test (IFAT) the monoclonals did not react with B microti or B bovis. The monoclonals in IFAT gave high titres with the rat-adapted strain of B divergens, but showed variable reactivity with field isolates of the parasite indicating antigenic diversity in this parasite. Two of the monoclonals, as ascitic fluid, were protective against the rat-adapted strain in splenectomised rats. PMID- 3547529 TI - [Smoking and lung diseases]. PMID- 3547530 TI - [Cardiopulmonary function in symptomatic asthma]. PMID- 3547531 TI - [Treatment of the sleep apnea syndrome]. PMID- 3547532 TI - [Utility and problems of Holter ECG for cardiac arrhythmia diagnosis]. PMID- 3547534 TI - [Enzyme immunoassay of secretory IgA in human saliva. Studies on S-IgA concentration, S-IgA/total protein ratio in children and adults]. PMID- 3547533 TI - Deposition and phagocytosis of inhaled particles in the gas exchange region of the duck, Anas platyrhynchos. AB - Little is known about the fate of inhaled aerosol particles in birds; even the anatomical location of phagocytic cells within the lungs has yet to be clearly demonstrated. We exposed 2 anesthetized, spontaneously breathing ducks to a non toxic iron oxide aerosol (aerodynamic mass mean diameter = 0.18 micron; 460 mg/m3) for 1.75 h and 2 awake, resting ducks to less concentrated aerosol (38 mg/m3) for 6 h on two consecutive days. All 4 ducks were sacrificed 24 h after the end of the last exposure. Their lungs, as well as the lungs from a control duck not exposed to the aerosol, were fixed in situ by insufflation of osmium tetroxide vapor or by intravascular perfusion. Then samples of the gas exchange region were examined with a transmission electron microscope. We found iron oxide particles: trapped within the trilaminar substance that is unique to avian lungs and coats the atria and infundibula; within epithelial cells of the atria and initial portions of the infundibula; and within interstitial macrophages. Only occasionally, small amounts of particles were found in the air capillaries. We conclude that both epithelial cells and interstitial macrophages can phagocytize particles in avian lungs, and that there is some convective transport of aerosol to the atria and the initial portions of the infundibula. PMID- 3547535 TI - [Bond strength of resin cements in Class II cavities (1). The retention force of cements and the effect of re-cementation on 12% Au-Ag-Pd inlays in standardized cavities]. PMID- 3547536 TI - Science and medicine of canoeing and kayaking. AB - Canoeing and kayaking are upper-body sports that make varying demands on the body, depending on the type of contest and the distance covered. The shorter events (500 m) are primarily anaerobic (2 minutes of exercise), calling for powerful shoulder muscles with a high proportion of fast-twitch fibres. In contrast, 10,000 m events call for aerobic work to be performed by the arms. Such contestants need a high proportion of slow-twitch fibres, and an ability to develop close to 100% of their leg maximum oxygen intake when paddling. In slalom and whitewater contests, the value of physiological testing is somewhat limited, since performance is strongly influenced by experience and the ability to make precisely judged rapid paddling efforts under considerable emotional stress. Paddlers face dangers from their hostile cold water environment; causes of fatalities (drowning, cardiac arrest, ventricular fibrillation and hypothermia) are briefly reviewed. Medical problems include provision of adequate nutrition and a clean water supply, effects of repeated immersion (softening of the skin, blistering, paronychial infections, sinusitis, otitis), varicose veins (secondary to thoracic fixation) and hazards of exposure to fibreglass and polystyrene in the home workshop. Surgical problems include muscle sprains and mechanical injuries (haemotomas, lacerations, contusions, concussion, and fractures). PMID- 3547537 TI - Body composition and menstrual function in athletes. AB - The problem of menstrual dysfunction in athletes was recognised at about the same time as a theory was developed that a critical fat level was necessary for the onset and maintenance of menstrual function (17% and 22% of bodyweight, respectively). This theory was acceptable because of the frequency of leanness in athletes experiencing menstrual dysfunction and because of the role of adipose tissue in the intraconversion of hormones which could affect hypothalamic and pituitary regulatory centres. Research on this topic has been hampered by the extensive use of surveys, confining sampling to specific sports, use of inaccurate methods of body composition assessment, and lack of data on hormonal changes. Studies using appropriate body composition measures do not support the critical fat theory, but they do not exclude a role for body composition changes in the regulation of menstrual function. The probability of finding menstrual dysfunction in very lean athletes is high, but not absolute, and there is no assurance that dysfunction will improve merely by increasing bodyweight. Perhaps of more concern, however, is recent research on very lean, long term amenorrhoeic athletes who train intensely and show a loss of bone mineral, apparently related to low oestrogen levels. This mineral deficiency is apparently a factor in stress fractures. The bone mineral content of these athletes is similar to that of post menopausal women susceptible to osteoporosis. Although the loss of bone due to short term amenorrhoea may be reversible, the prognosis for a long term deficiency is not presently known. PMID- 3547538 TI - Exercise-induced hypoxaemia in highly trained athletes. AB - Traditionally, the pulmonary system has not been considered the limiting factor in determining maximal oxygen uptake (VO2max) in healthy individuals since arterial oxygen-haemoglobin saturation is thought to remain high during intense exercise. However, there appears to be a major exception to this rule. Recent evidence suggests that arterial hypoxaemia results during heavy exercise in well trained individuals with a high VO2max. Further, the degree of arterial desaturation is inversely related to VO2max. This exercise-induced hypoxaemia does not appear to be due to hypoventilation although athletes who have limited hyperventilation seem to exhibit the lowest arterial oxygen-haemoglobin saturation. A significant venoarterial shunt has been ruled out as a primary cause of the hypoxaemia based on both experimental and theoretical considerations. Therefore, it appears that the exercise-induced hypoxaemia seen in highly trained athletes during heavy exercise is primarily due to diffusion limitations and ventillation-perfusion inequality. It is postulated that incomplete diffusion in the healthy lung may be due to a rapid red blood cell transit time through the pulmonary capillary. In summary, recent findings suggest that the limits of the human pulmonary system may be reached or even exceeded during intense exercise in some individuals. In light of these findings the role of the pulmonary system as a limiting factor during maximal exercise in the highly trained endurance athlete warrants further investigation. PMID- 3547539 TI - Exercise and arthritis. AB - Recreational exercise has achieved great popularity. Possible benefits to participants are increased longevity, decreased risk of cardiovascular disease, improved psychological well-being, and greater fitness. A very important but as yet unanswered concern is whether regular exercise will lead to degenerative joint disease or osteoarthritis. Many factors (e.g. physical characteristics of participants, biomechanical and physical features, nature of the playing surface and sport, manner of participation, preventive measures, and certain medical considerations) might influence the risk of developing osteoarthritis from sports participation. However, none of these have been evaluated. Although studies with animals have identified situations in which articular cartilage degeneration may be accelerated, experimental observations have not found normal joint motion in exercising animals to be harmful to joints. Anecdotal observations in man have suggested relationships between recreational activities and degenerative joint disease. However, those few controlled studies reported indicate that exercise need not be deleterious to joints. We interpret available data as suggesting that reasonable recreational exercise, carried out within limits of comfort, putting joints through normal motions, without underlying joint abnormality, even over many years, need not inevitably lead to joint injury. PMID- 3547540 TI - Scintigraphic uptake of 99mTc at non-painful sites in athletes with stress fractures. The concept of bone strain. AB - Stress fractures are commonly found in athletes attending sports medicine clinics for diagnosis of lower limb pain. Plain radiographs are less reliable than the 99mTc bone scan for diagnosing stress fractures because of their low sensitivity. While the heightened sensitivity of the bone scan is advantageous as a diagnostic aid, the uptake of 99mTc at non-painful sites occurs frequently in the athlete. Although the clinical significance has not been determined, asymptomatic uptake may indicate bone remodelling as part of a continuum of adaptation to physical stress. It is not known whether athletes who have uptake of 99mTc in asymptomatic areas represent a separate population from those who do not. This study retrospectively reviewed the medical charts and bone scan reports of 320 athletes diagnosed as having stress fractures, to determine the frequency of asymptomatic focal uptake at sites other than the site of pain. This group was compared with the group who had no asymptomatic uptake on a number of demographic variables and physical findings. Asymptomatic focal uptake was found in 37.5% of athletes with the average number of sites being 1.8 per person. No significant differences between groups with focal asymptomatic uptake and groups with no asymptomatic uptake were found when compared for age, height, weight, mileage in runners, times to diagnosis and recovery, frequency of tenderness, swelling, trauma history, varus alignment, and x-ray abnormalities. It is concluded that asymptomatic uptake of 99mTc occurs frequently in athletes with stress fractures and there are no significant clinical differences between the group with asymptomatic uptake and the group without. It is suggested that symptomatic uptake of 99mTc represents the remodelling response of bone to physical stress. PMID- 3547542 TI - [Pancreatic sonography--study technic]. PMID- 3547541 TI - Effects of aerobic exercise and training on the trace minerals chromium, zinc and copper. AB - Aerobic exercise and training lead to numerous changes and/or adaptations in the normal physiological functioning of the body. The trace minerals chromium, zinc, and copper are directly involved in maintaining and regulating many of these physiological processes, especially those involved in normal carbohydrate, fat and protein metabolism and the ultimate formation of usable energy. Therefore, it is important to establish whether exercise and training alter the functions of these trace elements, and to determine the overall effects of exercise on nutritional status and physical performance. Exercise results in a marked mobilisation of chromium into circulation, while zinc and copper levels have been shown to either remain stable or increase. Exercise also results in large increases in excretion of chromium, zinc and copper. Urinary chromium excretion has been shown to increase on an exercise day compared with a rest day, while increased zinc losses occur in urine and sweat and increased copper losses occur in urine, and faeces. When exercise-enhanced trace mineral losses are coupled with dietary intakes below the recommended levels, which are commonplace for both sedentary and exercising individuals, the nutritional status and overall health of exercising individuals may be suboptimal. Individuals who train intensively may be at special risk due to repeated increased losses. Trained athletes have lower resting urinary chromium losses, larger increases in urinary chromium losses due to exercise, lower resting serum zinc levels, and possible alterations in copper nutriture compared with sedentary controls. These changes suggest an altered metabolism and/or nutritional status of the trace minerals chromium, zinc, and copper in trained individuals and those who exercise strenuously. PMID- 3547543 TI - [Endoscopic sonography of the upper digestive tract--possibilities and limitations]. PMID- 3547544 TI - [Echography of the breast]. PMID- 3547545 TI - [The concept of tic in the history of abnormal movements]. AB - History of abnormal movements started during the 14th century. At that time the St Vitus' Dance was described, but the nosology of dyskinesias remained confusing during the next five centuries. The concept of tic was elaborated in France during the 18th century. It remained too large a concept however. Definitive semiologies appeared at the end of the 19th century, thus allowing tics to emerge from the "chaos of choreas". The etymology of the word "tic" still remains mysterious. In 1905, Meige thought that the word tic was used for the first time by reference to horses. He referred to the tic of the bear in the horse described by Rudler and Chomel at The Societe de Neurologie de Paris in 1903. Veterinarians were thus probably the first to describe the word. If so, however, the horse must leave anteriority to the goat. The word Ticq was used in 1611 as mentioned by the French dictionary Robert. The word is said to be an onomatopea and is compared to the italian word ticchio which means caprice. Another dictionary (Littre) suggest the german word "ticken", which means "to touch slightly", the galic word tacaid (sudden pain) and the german ziki (young goat), a word which could have lead to ticchio as capra, goat in italian, gave capricio. PMID- 3547547 TI - [Tics: from Itard to the neuroleptics]. AB - When the six DSM-III (1980) diagnostic criteria are applied to the nine cases reported by Gilles de la Tourette in 1885, six of them are found to be in accordance with the diagnosis of Gilles de la Tourette's syndrome (cases nos 4, 5 and 7 do not involve vocal tics). Gilles de la Tourette deserves credit, not only for having regrouped fragmented observations into one remarkably well described clinical entity which held over time (such as Itard's observations nos 9 and 10 in 1825; the latter is the famous Marquise of D ... seen several times by Charcot and the only one which, along with no 1, appears in Gilles de la Tourette's paper), but also for having described the course of this chronic and fluctuating disease. Why Gilles de la Tourette did not use the term "tic", a term which had been in use for a long time in both veterinary and human medicine, to describe "the motor incoordination" of these patients? Did Charcot take some distance from his student's paper as early as 1885? He viewed tics as the basis of "the disease described by Gilles de la Tourette". In addition to coprolalia and echolalia, he alsa reported the existence of "mental tics". How have French neurologists and psychiatrists been able to perpetuate Brissaud's error who, contrary to Gilles de la Tourette, mentioned that the illness "can be associated with severe mental disorders which often lead to dementia"?(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547546 TI - Georges Gilles de la Tourette. The man and his times. AB - Georges Albert Edouard Brutus Gilles de la Tourette (1857-1904), one of Charcot's favourite pupils and his self-appointed amanuensis made several valuable contributions to medicine and literature. His most substantial achievements were in the study of hysteria and the medico-legal ramifications of hypnotism, but he was also a competent neuropsychiatrist with a particular interest in therapeutics. He was a dynamic, passionately outspoken man whose prodigious literary output reflected his own restless compulsions as well as the interests of his beloved chiefs Brouardel and Charcot. His love of Loudun, his ancestral home strongly influenced his subject matter which included a biography of Theophraste Renaudot and with his colleague Gabriel Legue a perceptive analysis of Soeur Jeanne des Anges' account of her hysterical illness induced by her unrequited love for the Loudun priest Urbain Grandier. In 1893 shortly after the tragic death of his young son and of his mentor Charcot, Gilles de la Tourette was shot by a deluded woman who had been a patient at the Salpetriere. Her claims that she had been hypnotised by Gilles de la Tourette against her will causing her to lose her sanity bore a macabre resemblance to the accusation of Soeur Jeanne des Anges against Grandier. The bizarre episode became a "proces celebre" seeming superficially to vindicate the Nancy School's views that criminal suggestion was possible under hypnotism, a view Gilles de la Tourette had vehemently rejected. Despite his colourful life and varied achievements only an incomplete biographical account by his friend Paul le Gendre, a few informative orbituaries and some caustic sketches by Leon Daudet exist. PMID- 3547548 TI - Gilles de la Tourette syndrome: etiologic considerations. AB - The prevalence of Gilles de la Tourette syndrome is 28/100,000 in subjects of among the school age population. Familial cases have been described, although it is not an hereditary disease. This indicates that non genetic factors are critical. The fact that Gilles de la Tourette syndrome is frequently associated with migraine, sleep disturbances, attentional or compulsive deficits, does not orient towards a specific cause. An environmental factor has never been demonstrated. Epidemiological studies should be developed in the future, and more systematic anatomical and biochemical researches should be undertaken. PMID- 3547549 TI - [Clinical forms and variants of the course of primary osteoarthrosis deformans]. PMID- 3547550 TI - [Heart lesions in Bekhterev's disease (according to clinical and echocardiographic findings)]. PMID- 3547551 TI - [Intermittent hydrarthrosis]. PMID- 3547552 TI - [Monitored anti-aggregation therapy in hemorrhagic vasculitis in children]. PMID- 3547553 TI - [Use of androgens in the complex treatment of men with systemic lupus erythematosus]. PMID- 3547555 TI - [Course and outcome of rheumatic carditis (clinico-echocardiographic study)]. PMID- 3547554 TI - [Clinical features of different forms of yersinia infections]. PMID- 3547556 TI - [Arthroscopy and precision biopsy of the knee joint in the diagnosis and differential diagnosis of rheumatoid arthritis]. PMID- 3547558 TI - [Functional status of the lungs in systemic scleroderma]. PMID- 3547557 TI - [Various personality traits of children with rheumatoid arthritis]. PMID- 3547559 TI - [Relation between the water content of joint cartilage and the degree of its destruction]. PMID- 3547560 TI - [Leukocyte migration inhibition response in patients with osteoarthrosis deformans]. PMID- 3547561 TI - [Quantitative and qualitative changes in the T- and B-lymphocytes of patients with osteoarthrosis deformans]. PMID- 3547562 TI - [Reactive arthritis--etiology and possible pathogenetic mechanisms]. PMID- 3547564 TI - [Classification and nomenclature of rheumatic diseases]. PMID- 3547563 TI - [Experimental study of osteoarthrosis deformans]. PMID- 3547565 TI - [Incidence and features of the course of urinary tract infections in rheumatoid arthritis patients]. PMID- 3547567 TI - Nontypable Haemophilus influenzae: a review of clinical aspects, surface antigens, and the human immune response to infection. AB - Nontypable Haemophilus influenzae has now become well established as an important pathogen in both adults and children. Recent work has identified clear distinctions between nontypable and type b strains of H. influenzae. These organisms affect different patient populations, cause different infections, present different surface antigens to the host, and are genetically different. The commonest clinical manifestation of infection due to nontypable H. influenzae in adults is lower respiratory tract infection, particularly in the elderly and in those with chronic bronchitis. The bacterium is a frequent cause of acute otitis media in children. The surface of nontypable H. influenzae is composed of outer-membrane proteins and lipooligosaccharide, and both of these demonstrate substantial antigenic heterogeneity, which can be used to serotype isolates. Some respiratory tract isolates are fimbriated, but the role of fimbriae in pathogenesis is unclear. Antibodies to outer-membrane proteins and lipooligosaccharide are present in human serum. Investigation of human immunity to infection is focusing on identification of those antigens to which protective antibody is directed. PMID- 3547568 TI - Noncardiogenic pulmonary edema and pulmonary fibrosis in falciparum malaria. AB - Noncardiogenic pulmonary edema is an uncommon but serious complication of falciparum malaria. A case of fatal noncardiogenic pulmonary edema complicating falciparum malaria is presented in which the unfavorable outcome resulted from rapidly developing pulmonary fibrosis, documented through open-lung biopsy. Possible mechanisms of lung injury in falciparum malaria include: impaired perfusion and tissue hypoxia in the pulmonary microcirculation caused by reduced effective circulating volume; abnormal autonomic effects on the lung resulting from reduced blood flow in the central nervous system; immunologic injury to alveolar-capillary structures; and morphologic changes in the surface membranes of infected erythrocytes leading to sequestration of parasitized erythrocytes in vascular beds and pulmonary capillary damage. That pulmonary involvement in falciparum malaria is usually associated with high-grade parasitemia, concurrent cerebral involvement, and delay in institution of antimalarial therapy emphasizes the importance of early diagnosis and treatment. PMID- 3547566 TI - [Osteoporosis and spontaneous fractures during corticosteroid therapy]. PMID- 3547569 TI - Yellow fever: a medically neglected disease. Report on a seminar. AB - In 1984 the Pan American Health Organization (PAHO) sponsored an international seminar on the treatment and laboratory diagnosis of yellow fever. The meeting, held April 2-6 in Brasilia, was attended by 37 participants representing Bolivia, Brazil, Colombia, Peru, Venezuela, the United States, PAHO, and the World Health Organization. The objectives of the seminar were to review the current status of the disease, with emphasis on diagnosis and on the care and management of patients, and to formulate recommendations for improvements in diagnosis and management and for future research. A unique aspect of the seminar and one that distinguished it from previous, epidemiologically oriented meetings on yellow fever was the emphasis on clinical medicine and the participation of individuals representing academic medicine in relevant specialties such as hepatology, hematology, cardiology, and nephrology. PMID- 3547570 TI - Vaccines against encapsulated bacteria: a global agenda. AB - The World Health Organization (WHO) asked the authors to create a comprehensive program for the development of vaccines against encapsulated bacteria as a guide for the WHO Programme on Vaccine Development. The goal is a new generation of safe, inexpensive, and easily administered vaccines that are immunogenic in infancy and provide prolonged immunity in the vaccinate, secondary immunization to community members not reached in the initial application, and/or herd immunity. The approach is to capitalize on advances in molecular biology, biochemistry, and immunology, and the agenda developed addresses the five genera that cause most morbidity in less-developed areas of the world: Neisseria, Streptococcus, Staphylococcus, Haemophilus, and Pseudomonas. Three strategic areas for study are emphasized: existing polysaccharide vaccines, natural immunity and pathogenesis, and evaluation of new or speculative alternative approaches. It is hoped that this agenda will stimulate the widest possible participation in this global initiative. PMID- 3547571 TI - The white cells: use of granulocyte transfusions. AB - Since serious infections are major complications in patients with fewer than 200 phagocytic cells per microliter or in patients with dysfunctional phagocytes, granulocyte transfusions have been used in an attempt to improve clinical outcome. After two decades of trial and clinical use, the role of granulocyte transfusions for therapy of serious infections has not been clearly established. The methods of harvest, storage, and transfusion of granulocytes are acceptable; however, the quantities that are obtained from donors restrict numbers of cells that may be transfused. Limited clinical response has diminished enthusiasm for the use of granulocyte transfusions as therapy, and their use as prophylaxis has been ineffective. Reported clinical data suggest that patients with persisting granulocytopenia with sepsis due to gram-negative bacteria and patients with chronic granulomatous disease with life-threatening infections unresponsive to aggressive antimicrobial therapy may benefit from granulocyte transfusions. PMID- 3547572 TI - Controversies in the use of passive immunotherapy for bacterial infections in the critically ill patient. AB - Several preparations of standard immunoglobulins for intravenous use have been tested as adjunctive therapy for bacterial infections in premature neonates and in critically ill adults after major surgery, trauma, and burn. The use of intravenous immunoglobulins in these settings is controversial because the efficacy and cost-effectiveness of this treatment are still not definitively established. Specific preparations of immunoglobulins against Pseudomonas aeruginosa for intramuscular administration have shown promising efficacy, and preparations for intravenous administration are now under investigation. Cross protection against a wide range of gram-negative infections has been attempted by the administration of antiserum to the core glycolipid of lipopolysaccharide prepared from volunteers immunized with the J5 mutant of Escherichia coli 0111. Treatment with this preparation improved the survival rate of patients with gram negative bacteremia and, when administered prophylactically to high-risk surgical patients, prevented shock and death related to gram-negative infections. The mechanism of protection of the J5 antiserum is not clearly understood because of our inability to measure the actual protective antibody in polyclonal J5 antiserum. Thus, the preparation of readily available cross-protective hyperimmune immunoglobulins is hampered because there is presently no method of selecting appropriate donors or high-titered plasma pools. PMID- 3547573 TI - Hospital hotel services as risk factors for infection among immunocompromised patients. AB - Much is known about the association of urinary catheters, respiratory-assist devices, intravenous catheters and infusions, and other clinically related equipment with a risk of infection. The compromised host tends to develop infection with organisms that are frequently encountered in the normal flora. However, the results of surveillance cultures suggest that these organisms have indeed been acquired during hospitalization. This report suggests that many of these pathogens are acquired not as a result of clinically related activities but, rather, in conjunction with the "hotel services" of the hospital, such as the supply of food, water, and air. Tentative recommendations to hospitals for reducing the risk of infection from these services include proper design and maintenance of air-ventilating systems, regular monitoring of the water system, and preparation of foods low in microbial content for granulocytopenic patients. PMID- 3547574 TI - After empiric therapy: what to do until the granulocyte comes back. AB - The prompt initiation of empiric broad-spectrum antibiotic therapy when a granulocytopenic patient becomes febrile has become standard practice and has resulted in a significant reduction in the early morbidity and mortality associated with infection. Granulocytopenic patients, however, are at risk for multiple infectious episodes, particularly when the duration of neutropenia is prolonged. Accordingly, the addition of one or more antimicrobial agents to the initial empiric antibiotic regimen is often necessary to deal effectively with these second infections and to help maximize the patient's chance for survival. An organized plan that incorporates modifications of the primary antibiotic regimen (e.g., the addition of another antibiotic or an antifungal agent) into the overall management of the febrile neutropenic patient is important, especially when neutropenia lasts for more than a week. PMID- 3547575 TI - A. Conan Doyle, Sherlock Holmes, and murder by tropical infection. AB - The scientific insights with which A. Conan Doyle endowed his creation, the master detective Sherlock Holmes, continue to attract scholarly interest. Indeed, the clinical and/or scientific aspects of Doyle's fiction hold appeal for those interested in the epidemiology of tropical infectious diseases. The origins and routes of transmission of tropical infections were subjects of fruitful investigation in the latter half of the nineteenth century. In "The Adventure of the Dying Detective," Sherlock Holmes investigates a murder that he suspects to have resulted from a fatal Asiatic disease associated with a short incubation period: the indications point to primary septicemic plague as the murder weapon. PMID- 3547576 TI - Nocardia asteroides meningitis without brain abscess. PMID- 3547577 TI - Traditional enteropathogenic Escherichia coli of infantile diarrhea. AB - First described in 1885, Escherichia coli gradually emerged as a cause of infantile diarrhea. Currently, four pathogenic categories of diarrheagenic E. coli are recognized: enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroinvasive (EIEC), and enterohemorrhagic (EHEC). Of these, ETEC and EPEC are important causes of pediatric diarrhea, especially in developing countries. ETEC strains are characterized by their production of well-defined heat-labile or heat stable enterotoxins. In the absence of other identifying characteristics, EPEC strains have been identified by serotyping only; recent laboratory and clinical investigations have shown that these strains constitute a distinctive group of pathogenic microorganisms displaying characteristic adherence to cultured epithelial cells and producing pathognomonic histopathologic changes in experimentally infected animals and naturally infected children. The pathogenicity of most strains of EPEC is associated with the carriage of a 55- to 70-megadalton plasmid that specifies the production of an adherence factor. EPEC strains may also owe their pathogenicity to the production of at least one enterotoxin, possibly a Shiga-like cytotoxin. PMID- 3547578 TI - Nonenteric infections acquired through contact with water. AB - In recent years water has been recognized as an important vehicle for extraintestinal infection. A variety of pathogens are acquired through occupational, recreational, and even therapeutic contact with water. The nature of nonenteric waterborne disease is often determined by the ecology of aquatic pathogens. Such infections are of basically two types: superficial, involving damaged or previously intact mucosae and skin; and systemic, often serious infections that may occur in the setting of depressed immunity. A broad spectrum of aquatic organisms, including viruses, bacteria, fungi, algae, and parasites, may invade the host through such extraintestinal routes as the conjunctivae, respiratory mucosae, skin, and genitalia. PMID- 3547579 TI - Yersinia enterocolitica, a primary model for bacterial invasiveness. AB - Yersinia enterocolitica is now the species of Yersinia most frequently isolated from human and animal infections. The species includes pathogens and ubiquitous strains. Among the human pathogens, those isolated in America are more virulent than those isolated elsewhere, especially in Europe and Japan, and these isolates differ biochemically and serologically. The relation between Y. enterocolitica and Y. pestis only became obvious in 1980 with the discovery that at 37 degrees C Y. enterocolitica requires Ca++, a phenotype described in the 1960s for Y. pestis. This requirement as well as virulence is dependent on a 70-kilobase plasmid found later in Y. pseudotuberculosis and Y. pestis. Thus, many bacteriologists elected Y. enterocolitica as a model for bacterial invasiveness. However, studies with non-American strains were impeded by the lack of an inexpensive, simple animal test, a difficulty now circumvented by supplying an appropriate siderophore to the bacteria. Ca++ dependence can be viewed as a transition between free growth and protection against the immune system. In the latter phase, Y. enterocolitica synthesizes and releases large amounts of six plasmid-encoded outer membrane proteins. Most of these are under the control of the plasmid region governing Ca++ dependence. Mutants in this region either lose the Ca++ requirement at 37 degrees C or become unable to grow at 37 degrees C irrespective of the Ca++ concentration. The complex events leading to Ca++ dependence is still not understood. Virulence in Y. enterocolitica also depends on chromosomal genes: the endocytosis in intestinal epithelial cells seems not to be encoded by the pYV plasmid. Studies of Y. pseudotuberculosis suggest that this property depends on a single chromosomal locus, the study of which might be particularly important in the understanding of the first step in infection. PMID- 3547581 TI - [Non-visible appliances]. PMID- 3547580 TI - Biochemistry of C3 and related thiolester proteins in infection and inflammation. AB - The characterization of the reactive thiolester bond in the third component of human complement has led to the identification of homologous sites in a number of proteins. In addition to the participation of the C3 thiolester in the opsonic acylation of surface components of microorganisms, new evidence is emerging to implicate thiolester disruption by physiologic nucleophiles, such as ammonia, as a potent mediator of local inflammation in the lung, the kidney, and at endothelial surfaces. Manipulation of the thiolester bonds in these related proteins should permit us to understand, and ultimately to direct, the molecular mechanisms of inflammation. PMID- 3547583 TI - [Ergonomics and the lingual bracket technic]. PMID- 3547584 TI - [Precision in the lingual bracket technic]. PMID- 3547582 TI - [Treatment with lingual brackets: another approach in orthodontics]. PMID- 3547585 TI - [Debonding of bonded brackets]. PMID- 3547586 TI - [ Hypoxia of the fetus and neonate of a diabetic mother. Importance of hemorheologic anomalies]. AB - Death in utero (or immediately following birth) of children of diabetic mothers remains rather mysterious. Next to abnormalities of carbohydrates metabolism, hypoxia appears to be a determining factor of the frailty of children of diabetic mothers. Now, the so called "hemorheologic" alterations, which means the difficulties derived from the blood discharge by increased viscosity, represent a cause of hypoxia as well as an aggravating factor of hypoxia. This study demonstrates the abnormalities of blood viscosity in diabetic patients, which, in association with hypercoagulability, aggravate fetal anoxia. PMID- 3547587 TI - [Twin pregnancy with acardiac fetus. Contribution of echography to the diagnosis. Review of the literature apropos of a case]. AB - An acardiac fetus is an extremely rare anomaly occurring only in twin pregnancies and its etiology is still controverted. Sonography must permit an early diagnosis, in order to anticipate the risks of the pregnancy and the delivery, as well as the future of the second twin. PMID- 3547588 TI - [Loss of renal function caused by urinary infection after renal transplantation]. PMID- 3547590 TI - [Ureterovesical implantation with invagination in the repair of the urinary tract in homologous renal transplants. Experience with 250 cases]. PMID- 3547589 TI - [Urinary infection after transplantation: prevalence, predisposing factors and morbidity]. PMID- 3547592 TI - [Comparative study of penile arterial pressure and sexual potency in patients subjected to single or multiple renal transplantation]. PMID- 3547591 TI - [Behavior of ABH surface antigens in superficial and invasive bladder neoplasma: inferences for the mechanism of tumor progression]. PMID- 3547593 TI - [Vasectomy: controversies]. PMID- 3547594 TI - [Cyclosporin]. PMID- 3547595 TI - [Chemoluminescence of human neutrophil granulocytes. IV. Non-phagocytic inducers; various inhibitors]. PMID- 3547596 TI - [Introducing the computer as a tool during the process of nursing education]. PMID- 3547597 TI - [And to you, what is a bibliography?]. PMID- 3547598 TI - [The ways and abuses of alcohol]. PMID- 3547599 TI - An immunohistochemic assay to localize leptospires in tissue specimens. PMID- 3547600 TI - Providing quality prosthetic devices: how the dentist and the dental laboratory work together. PMID- 3547601 TI - The bacterial flora of the nasal cavity in healthy young men. AB - The nasal cavity of 97 young healthy men (applicants for the pilot education in the Finnish Air Force) was examined. Bacterial culture demonstrated one or more species of aerobic bacteria in all 194 nasal cavities examined and anaerobic bacteria in 76.5%. In ten per cent of the cultures bacteria were detected after enrichment only. The most common aerobic bacteria were Staphylococcus epidermidis (79%), diphtheroids (41%) and Staphylococcus aureus (34%). Haemophilus influenzae was found in 5% and Streptococcus pneumoniae in 0.5%. Anaerobic culture yielded Propionibacterium acnes in 74.5% and Peptococcus magnus in 3.5%. PMID- 3547604 TI - When the lack of privacy gets to your patient. PMID- 3547603 TI - [Celebration of the 100th issue of ROL gives credit to our nursing performance]. PMID- 3547602 TI - Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis. AB - Nasal secretions, maxillary sinus aspirates and specimens of the maxillary sinus mucosa were collected in 44 patients aged between 25 and 60 affected by mono- or bilateral chronic maxillary sinusitis, in order to establish the best sampling technique for microbiological purposes, the most frequently involved bacteria and the physiopathological mechanism underlying chronic maxillary disease. The sinusal mucosa resulted to be the most reliable sample as it reduces contamination and microbial variability. Anaerobic bacteria were isolated in nasal swab (15.6%), in maxillary sinus aspirates (30.4%) and in maxillary sinus mucosa (36.4%) of maxillary sinusitis patients. In controls anaerobic bacteria were isolated only in one nasal swab (2.3%), while they could not be isolated in maxillary sinus aspirates and in maxillary sinus mucosa. The presence of anaerobic bacteria in chronic maxillary sinusitis patients and their absence in controls seem to confirm that anaerobic microorganisms represent the main pathogenetic agents of chronic maxillary sinusitis. The possible physiopathological mechanisms underlying chronic maxillary sinus disease are finally discussed. PMID- 3547605 TI - An introspective look at the history of RNABC. PMID- 3547606 TI - [Pharmacokinetics and tolerance of roentgen contrast media]. AB - The improved tolerance of nonionic contrast media compared with conventional contrast media is mainly due to their lower osmolality and reduced allergoid potential. Tolerance advantages that have been definitely proven are, for example, low-pain contrast medium injection and superior systemic tolerance; side effects of an allergic pattern occur less often. Animals experiments have established that nonionic contrast media exercise a comparatively lower influence on the cardiovascular system. The haemodynamics of pulmonary circulation are less adversely affected on intravenous bolus injection. Reduced potential risk is to be expected especially in cardiac and bronchopulmonary high-risk patients. The reduced nephrotoxicity of nonionic contrast media was definitely established by clinical studies. Further systematic studies will however be required to provide an answer to the question whether this also entails a reduction in the incidence of renal failures induced by contrast media. PMID- 3547607 TI - [Recent technical (diagnostic and therapeutic) advances in bladder pathology]. PMID- 3547608 TI - [Mononuclear phagocytic cells in human rheumatoid synovial membrane. Histochemical and immunohistological study]. AB - Non specific immunity in human rheumatoid synovium: histochemical and immunohistological analysis. Enzymatic activities and monocyte-specific membrane antigens were looked for on frozen sections from 25 synovial membrane samples from patients with rheumatoid arthritis. Classical histochemical reactions were used to identify non specific esterases, alkaline and acid phosphatases, ATPase and peroxidase. Indirect immunofluorescence was performed with a series of monoclonal antibodies to monocyte membrane antigens and HLA class II molecules. Technical pitfalls were successfully overcome, and specific labelings demonstrated the variety and heterogeneity of these markers among synovial cells and vascular endothelia. Reported data indicated that such a panel of investigations is useful to better define the non-specific immunological phenomenons which take place in this active pathological tissue. They suggest that numerous metabolic activities concur to sustain chronic inflammation. PMID- 3547610 TI - [Articular and periarticular manifestations of chronic hemodialysis in the adult]. PMID- 3547609 TI - [Purulent polyarthritis in Streptococcus B septicemia]. PMID- 3547611 TI - Cephalic phase of gastroduodenal alkaline secretion. AB - This study was designed to determine gastric alkaline secretion (GAS) and duodenal alkaline secretion (DAS) and their relation to the duodenal motility pattern in conscious dogs under basal conditions and after vagal stimulation by sham-feeding and insulin hypoglycaemia. GAS was measured in the gastric perfusate and DAS was determined in the perfusate of the upper duodenum (7 cm in length between occluding balloons). Resting GAS and DAS showed typical periodicity in phase with myoelectric and motor activity, reaching peaks during phases II and III, respectively, and nadir during phase I of the migrating motor cycle (MMC). Vagal excitation by sham-feeding or insulin hypoglycaemia resulted in an immediate rise in GAS and DAS, accompanied by a suppression of MMC. Atropine (25 micrograms/kg) reduced basal GAS and DAS by about 50% and abolished GAS but not DAS in response to vagal stimulation, being accompanied by complete suppression of MMC for several hours. Following injection of indomethacin (2.5 mg/kg) to suppress the generation of endogenous prostaglandins, a prolonged reduction in basal GAS and DAS and an increase in the myoelectric activity and the disruption of the MMC occurred. Neither GAS nor DAS responses to vagal stimulation were affected by indomethacin. We conclude that resting GAS and DAS fluctuate cyclically in phase with gastroduodenal motor activity, and that vagal excitation results in a potent stimulation of alkaline secretion and myoelectric activity which are, in part, cholinergic and do not depend upon the generation of endogenous prostaglandins. PMID- 3547613 TI - Prostaglandins and clinical experience in peptic ulcer disease. AB - Synthetic prostaglandin analogues of the E series offer a new approach to the medical treatment of peptic ulcer disease by combining antisecretory with cytoprotective properties, such as protection of the gastric mucosa against damage induced by aspirin. Controlled trials of prostaglandin analogues in peptic ulcer healing have failed to demonstrate any superiority to conventional treatment. Any beneficial effect is explicable by acid inhibition, and diarrhoea is a major and dose-limiting side effect. Non-antisecretory doses that are still said to be cytoprotective do not accelerate ulcer healing. Also, the prostaglandin analogues seem ineffective in the treatment of peptic ulcer haemorrhage. Thus the clinical relevance of cytoprotection by synthetic prostaglandins has not been established. Although antisecretory doses of some analogues may prove to be yet another approach to drug treatment, the present results do not forecast a new breakthrough in the management of peptic ulcer disease. PMID- 3547612 TI - Protective drugs in the treatment of gastroduodenal ulcer disease. AB - Reduction of gastric acidity by the inhibition of secretion or neutralization is the therapeutic principle most widely used in peptic ulcer disease. From a pathophysiological standpoint, this does not appear logical, because in a majority of patients gastric acid secretion is not increased. In addition, there is some concern about the consequences of a reduction in gastric acidity, especially in the long term. And finally, all available inhibitors of gastric acid secretion have a systemic action and may thus cause systemic side effects. Carbenoxolone, sucralfate, and tri-potassium dicitrato bismuthate have been shown to accelerate healing of ulcers without appreciable acid inhibition. Despite an apparently different mode of action, the healing rates are similar to those of commonly used acid inhibitors. Several possible mechanisms of action have been claimed for each of these agents, but none has been convincingly demonstrated to be essential in ulcer healing. This may reflect ignorance of the relevant events rather than an action by a combined principle. PMID- 3547615 TI - Mobile blood-derived components in rat renal allograft contain significant immunogenic potential. AB - Using a modified 'primed rejection assay' (PRA), we have investigated the immunogenic potential of different rat renal allograft components. Temporary transplantation of an extensively perfused DA kidney to a WF recipient can sensitize the WF recipient in less than 10 min; consequently, the survival of a subsequent DA heart allograft is significantly reduced. Irradiation of the renal allograft donor significantly reduces the immunogenic potential of the first allograft, but does not deplete it entirely. When the first allograft was made chimeric with regard to the (capillary) blood compartment, it was found that in vivo perfusion of an irradiated DA kidney with WF blood did not alter the immunogenic potential in WF recipients, whereas perfusion of irradiated DA kidneys with DA blood increased the immunogenicity. On the other hand, short in vivo perfusion of irradiated WF kidneys with DA blood make the first WF kidney allograft strongly immunogenic in the WF recipient, whereas perfusion of the kidney with WF blood has no effect. The rapid rate of sensitization observed, coupled with the induction and alteration of the allograft immunogenic potential by manipulation of blood-derived capillary compartment, suggests that mobile blood-derived components, which are outside the reach of extensive perfusion, contain significant immunogenic potential. PMID- 3547614 TI - Antacids for peptic ulcer: do we have anything better? AB - During recent years several reports have appeared documenting that antacids containing aluminium hydroxide accelerate the healing process of duodenal ulcer. In gastric ulcer, however, only one study has demonstrated an effect clearly superior to that of placebo. Several studies, in both gastric and duodenal ulcer patients, have not been able to demonstrate any significant difference between antacids and H2 blockers with respect to ulcer healing and symptom relief. An important acknowledgement is the fact that the doses of antacids required for ulcer healing are much smaller than first assumed, and that tablet formulations of antacids are at least as effective as liquid antacid suspensions. The excellent effect of the more convenient low-dose tablet regimens has strengthened the position of antacids in the competition with other anti-ulcer drugs. Usually, side effects of low-dose antacid regimens are few and mild. In patients with impaired renal function, accumulation of absorbed aluminium may have serious consequences. However, in patients with healthy kidneys, aluminium is quickly excreted after absorption, and unhealthy effects are not documented. Antacids should therefore still constitute a cornerstone in the treatment of peptic ulcers. PMID- 3547616 TI - Analysis of monoclonal antibodies to Mycobacterium leprae by crossed immunoelectrophoresis. AB - Monoclonal antibodies to Mycobacterium leprae were characterized in crossed immunoelectrophoresis and showed markedly different patterns of reactivity with M. leprae lines 2, 7 and 11 respectively. Line 7 corresponds to a cell wall associated macromolecular complex containing lipid, polysaccharide, and two distinct 36 K and 65 K proteins. PMID- 3547617 TI - Changes in microbial ecology by therapeutic use of aminoglycosides. AB - Alterations in microbial ecology caused by the usage of aminoglycosides for therapy of human infections are due to their selective pressure favouring insensitive or resistant species or strains. There is a positive correlation between aminoglycoside consumption and the incidence of resistance to aminoglycosides. This correlation is, however, modified by measures of infection control. At the present time, the overall incidence of resistance to aminoglycosides does not show major changes. The ecological impacts of aminoglycoside consumption appear to be less significant as compared to other antibiotics due to factors specific for the aminoglycoside group. PMID- 3547619 TI - Consequences on emergence of resistant bacteria from the use of antibacterials in animal husbandry. AB - Concern over the appearance of resistant bacteria in domestic animals and birds led in Great Britain to the establishment of a Government Committee of Enquiry on the use of antibiotics in Animal Husbandry and Veterinary Medicine known as the Swan Committee. This Committee made a number of recommendations about surveillance and control of diseases of animals communicable to man which included the establishment of a system of data collection. These recommendations were incorporated in a legal statute, the Zoonoses Order of 1975. Data on the incidence of salmonellosis and of antibiotic resistance in Great Britain are presented in this paper together with a consideration of the epidemiology of salmonellosis and its control. PMID- 3547618 TI - Frequency and expression of mutational resistance to the 4-quinolone antibacterials. AB - The frequency with which Escherichia coli mutated to resist a series of ten 4 quinolone antibacterials was studied. It was found that the mutation frequency could not be predicted from the potency of the drugs against sensitive bacteria. The mutation rates were lowest with ofloxacin, norfloxacin and ciprofloxacin. No mutants were observed with ofloxacin while less mutants were observed with norfloxacin than with ciprofloxacin, despite the latter possessing greatest activity against susceptible bacteria. The mutation frequencies observed with nalidixic acid, cinoxacin, pipemidic acid, flumequine, rosoxacin, oxolinic acid, and enoxacin were much higher than those observed with the three 4-quinolones mentioned earlier. When the sensitivities of the mutants to 4-quinolones were investigated, it was again found that the potency of each 4-quinolone against sensitive bacteria did not correlate with the levels of resistance of mutants to that drug. However, when the relative activities of the 4-quinolones against the mutants were investigated, it was found that no mutant isolated resisted a concentration exceeding the peak serum levels of ciprofloxacin, norfloxacin or ofloxacin. Although some mutants exhibited more resistance than the maximum attainable serum levels of the other 4-quinolones, the sensitivity of all the mutants fell well within the urine levels of pipemidic acid, flumequine, rosoxacin, oxolinic acid, enoxacin, norfloxacin, ofloxacin, and ciprofloxacin. PMID- 3547620 TI - Consequences of treatment of gastrointestinal infections. AB - Diarrhoeal disease is a common problem in developing countries. As a result of recent advances in diagnostic methodology, the causative agents can now be identified in most cases of acute diarrhoeal diseases. Enteric bacterial pathogens are the common cause of gastroenteritis in developing countries. Appropriate uses of antibiotics in selected cases of diarrhoea will decrease symptoms or reduce faecal shedding of the organism and prevent spread of infection. Antimicrobial agents improve the diarrhoea associated with cholera, shigellosis, enteric fever, enterotoxigenic Escherichia coli, giardiasis, amoebiasis, and probably Vibrio parahaemolyticus, and enteropathogenic E. coli. Antibiotics have no role in the treatment of viral diarrhoea or uncomplicated salmonella gastroenteritis. Most of the diarrhoeal diseases are self-limited and the wrong choice of antimicrobial agents will worsen the symptoms. Treatment of gastrointestinal infections with antimicrobials will change intestinal microflora, promote the emergence of resistant strains and overgrowth of potential pathogenic bacteria and fungi. Risks and benefits should be considered before prescribing antimicrobial agents. PMID- 3547621 TI - Anaerobic infections and Clostridium difficile colitis emerging during antibacterial therapy. AB - Almost all cases of Clostridium difficile-related pseudomembranous colitis are related to antimicrobial therapy. Virtually all antibacterial agents have been implicated, notable exceptions being vancomycin and parenterally administered aminoglycosides. The most prominent causes of colitis are ampicillin, clindamycin and various cephalosporins. In general, this complication is related to suppression of indigenous flora and overgrowth of C. difficile. In the case of ampicillin, however, C. difficile is always susceptible. Beta-lactamase production by elements of the bowel flora leads to destruction of ampicillin and subsequently to increased counts of C. difficile and colitis. Much less well appreciated, and much less studied, is overgrowth and subsequent infection by other types of anaerobic bacteria. Superinfection by anaerobes may follow the use of "intestinal antiseptics" such as oral neomycin; indeed, that is the rationale for the current practice in the U.S. of combining erythromycin or tetracycline with the oral aminoglycoside. Superinfection with anaerobes may also follow systemic administration of various antimicrobial compounds. Such superinfections may involve any site in the body, although sepsis and intraabdominal infection have been noted most commonly; all major types of anaerobes have been involved. A wide variety of antimicrobial compounds has been implicated in predisposing to anaerobic infection. PMID- 3547622 TI - Emergence of resistance as a consequence of antimicrobial prophylaxis in immunocompromised patients. AB - Many authors in the literature have investigated the use of antibiotics in prophylaxis against infections in granulocytopenic patients. Two general methods have been used: one consists in trying to decontaminate the digestive tract in the hope of reducing the amount of microorganisms responsible for systemic infections. Another method is to use well-absorbed oral antibiotics, like trimethoprim-sulphamethoxazole, throughout the neutropenic period. It is considered critical to preserve as much as possible of the anaerobic flora, which is believed to provide protection against colonization by aerobic microorganisms or by fungi. Experimental and clinical evidence for this is critically reviewed. The efficacy of such methods has been variable, but there is also widespread fears that they could enhance selection of resistant organisms. We have reviewed the literature, specifically looking for data on the emergence of such resistant organisms, as well as data on changes in bacterial and fungal faecal flora. PMID- 3547623 TI - Ecological consequences of broad spectrum versus narrow spectrum antibacterial therapy. AB - It is commonly assumed that antibiotics with a broad antibacterial spectrum affect the normal flora more than those with narrow spectrum. As exemplified in this overview, this in many cases is a misconception. Comparing two well-absorbed oral antibiotics like amoxycillin and cephradine, the former has more negative ecological consequences on the faecal flora. That is probably due to the effect of amoxicillin on enterococci, allowing resistant Escherichia coli to establish themselves in the ecological niche left vacant when the susceptible E. coli are eradicated. Absorption following oral administration may be of importance for the ecological pressure. However, norfloxacin which is absorbed incompletely, does not negatively affect the faecal flora. Other antibiotics may cause serious disturbances of the intestinal flora if excreted via the bile. Profound effects on the intestinal flora together with high incidences of diarrhoea have been demonstrated for ceftriaxone and cefoperazone while imipenem which has a broader spectrum but is not excreted via the bile, does not affect the faecal flora. It is concluded that factors other than the width of the antibacterial spectrum may be of importance for the ecological consequences of antibiotic treatment. PMID- 3547624 TI - Chromosomal beta-lactam resistance in enterobacteria. AB - Most enterobacterial species carry a chromosomal ampC beta-lactamase gene. In Escherichia coli and Shigella, expression from ampC is non-inducible and the beta lactamase is synthesized at low levels. Mutations leading to increased beta lactamase synthesis occur rather infrequently, making resistance to modern cephalosporins a rare event in these species. In other enterobacteria and Pseudomonas, ampC beta-lactamase synthesis is induced by beta-lactams. In Enterobacter cloacae, Citrobacter freundii and probably also in other species with inducible beta-lactamase expression, ampC is regulated by at least two genes, ampR and ampD. Mutations affecting ampR abolish beta-lactamase inducibility, and mutants devoid of ampR, produce ampC beta-lactamase at low constitutive levels. Mutations in ampD lead to constitutive overproduction of inducible beta-lactamase if an intact ampR protein is present in the cell. The latter type of mutations occur at a high frequency and result in clinical resistance to several third-generation cephalosporins. PMID- 3547626 TI - Antimicrobial induced alterations of the human oropharyngeal and intestinal microflora. AB - Although the role of the normal oropharyngeal and intestinal microflora is not fully understood, there are evidences that alterations in the flora may have serious consequences. The most common and significant cause of disturbances in the normal microflora is the administration of antimicrobial agents. The microflora can be influenced by antimicrobial agents because of incomplete absorption of any orally administered antimicrobial agent, secretion of an antimicrobial agent by the salivary glands or in the bile, or secretion from the intestinal mucosa. In most cases the influence is not beneficial to the patient because suppression of the indigenous microorganisms often permits potential pathogens to overgrow and cause septic conditions, stomatitis, diarrhoea, or colitis. Antimicrobial agents that influence the normal microflora also promote the emergence of antimicrobial-resistant strains. During the recent years, the impact of different antimicrobial agents on the human microflora has been investigated by our research group. Thus the effects on the oropharyngeal and intestinal microflora by peroral administration of penicillin, bacampicillin, erythromycin, clindamycin, doxycycline, nitroimidazole, norfloxacin and ciprofloxacin have been studied. The impact on the microflora by parenteral administration of ampicillin + sulbactam, azlocillin, aztreonam, piperacillin, cefoperazone, cefoxitin, ceftriaxone, moxalactam, imipenem, nitroimidazole and clindamycin has also been investigated. Pronounced changes were observed in the microflora in patients receiving clindamycin, erythromycin, cefoperazone, ceftriaxone and moxalactam, whereas moderate changes were seen in those patients receiving doxycycline, cefoxitin, aztreonam, ampicillin + sulbactam, azlocillin and piperacillin. Penicillin, bacampicillin, imipenem, nitroimidazole, ciprofloxacin and norfloxacin produced only minor changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547627 TI - Effect of beta-lactam prodrugs on human intestinal microflora. AB - The ampicillin prodrugs bacampicillin, pivampicillin, and talampicillin, the mecillinam prodrug pivmecillinam and the sulbactam prodrug sulbactam pivoxil all have a greatly improved oral availability compared to the parent drug. They show no antibacterial activity themselves until transformed into active drugs after absorption. This double advantage makes them less likely to influence the intestinal microbial ecosystem. Ampicillin has been reported to cause marked changes in the colon microflora, particularly as regards Enterobacter species, Klebsiella species, enterococci, lactobacilli, bacteroides, and clostridia, in contrast to pivampicillin, which did not exert much influence. Similarly, talampicillin has been reported to have less influence than ampicillin on the colon flora. Diarrhoea was more common after ampicillin and was accompanied by an overgrowth of Candida. Pivmecillinam has been reported to reduce the number of Escherichia coli and lactobacilli. No changes were seen in the colon flora of subjects receiving bacampicillin tablets. This was verified in a parallel group study, in which one group was given the combination of bacampicillin and sulbactam pivoxil, the other bacampicillin, for seven days. Of the subjects given the combination, five had a moderate and ten a considerable change in their colon microflora. The subjects were often heavily colonized by new aerobic strains such as enterococci, E. coli, Bacillus, Enterobacter, Aeromonas, and yeasts. Among the anaerobes, Veillonella, the bifidobacteria-lactobacillus group, and bacteroides decreased. Some strains of clostridia decreased but there was also a colonization with new strains. One subject was colonized with Clostridium difficile. Diarrhoea was seen only during the week of active drug administration in the group given the combination. The symptoms generally appeared on the second or third day of treatment and had, in most cases, subsided at the end of treatment. The results illustrate the correlation between disturbances in the intestinal microbial ecosystem and intestinal adverse reactions. PMID- 3547625 TI - R-factors in gram-positive and gram-negative aerobic bacteria selected by antimicrobial therapy. AB - Populations of resistant bacteria emerge by the operation of selective pressure on resistant bacteria. The acquisition of resistance by sensitive bacteria is dependent upon the genetic determinant of the resistance, and its ability to move between different bacterial cells and within cells between different replicons. In contrast to chromosomal mediated resistance, plasmids and transposable elements coding for resistance to antibiotics have been the major factors in the spread of resistance and the prevalence of resistant bacteria in humans, farm animals and poultry. Different types of R-factors can be described. Resistance to ampicillin, tetracycline, chloramphenicol, gentamicin, trimethoprim, erythromycin may exemplify epidemiological aspects of resistance genes in Gram-negative and Gram-positive bacteria. The ecological destiny of resistant bacterial populations suggests the role of other factors than antibiotic resistance: characters of a particular host, host-plasmid relationship and properties which may lead to survival and adaptation in a given niche. PMID- 3547628 TI - Effects of antimicrobial agents upon the functional part of the intestinal flora. AB - For functional studies of the complex intestinal ecosystem, two recently introduced terms have been shown to be of value. A Microflora-Associated Characteristic--MAC--is defined as the recording of any anatomical structure, physiological or biochemical function in a macroorganism which has been influenced by the microflora. When functionally active microbes are absent, as in germfree animals, the recording of a MAC can be defined as a Germfree Animal Characteristic--GAC. In our ongoing, long-term ecological studies we have investigated the influence of a long list of antimicrobial agents upon various biochemical MACs in man and rats. Parameters such as conversion of cholesterol to coprostanol, 7-dehydroxylation of bile acids, transformation of bilirubin, degradation of mucin, production of short chain fatty acids and inactivation of tryptic activity have been the MACs most often studied. Each antibiotic may create its own MAC/GAC profile, partly reflecting its antibacterial spectrum and concentration in the intestinal tract and partly the characteristics of the microbial species actually involved in the reaction. MACs influenced mainly by species dominated by a K-selection are generally more disturbed than MACs influenced by species dominated by a r-selection. PMID- 3547629 TI - Pharmacokinetic differentiation and consequences for normal microflora. AB - The pharmacokinetic properties of a drug are decisive for effective antibacterial therapy, the ability of the drug to reach a site of infection, but they also contribute to whether concentrations become undesirably high in places where the antibiotics are not wanted but where they may interfere with the normal microflora. The microflora in the intestines is particularly important because of the sheer numbers of bacteria present there and the consequences of imbalance such as diarrhoea and selection of bacteria resistant against antibiotics. For these reasons, high intestinal absorption, as can be achieved by the ampicillin prodrugs, is important. This leads to high utilization of the dose and decisively reduces the frequency of loose stools and diarrhoea. Improvement of biopharmaceutical properties of oral dosage forms need combined pharmaceutical and pharmacokinetic assessment. High elimination in the bile can have a considerable impact on the intestinal microflora as, for instance, agents with broad spectrum, like beta-lactamase stable cephalosporins that are not absorbed but remain within the gastrointestinal tract. Cephalosporins have been implicated in the selection of beta-lactamase producing enterobacteria. Narrow spectrum has been a sales argument, but if these agents produce high intestinal concentrations, as is the case with formulations of erythromycin that have poor formulations and are incompletely absorbed, the result may be disturbed faecal flora. In addition to low absorption, erythromycin elimination by bile is high. Clostridium difficile may in particular be selected by high concentrations of antibacterial drugs in the intestines.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547630 TI - Serological tests in the assessment of disease activity in systemic lupus erythematosus. PMID- 3547631 TI - Prolonged remission in Raynaud's phenomenon after prostacyclin infusion. AB - We infused prostacyclin (PGI2) (7.5 ng/kg/min) during 5 h, three times at weekly intervals in 8 patients with Raynaud's phenomenon (RP). In 4 patients, improvement was long-term, more than 90 days after the last infusion (good responders); in 3 patients, improvement was mild, less than 15 days, and in one patient no improvement was observed (poor responders). Clinical response was always accompanied by improvement, although less prolonged, of capillary appearance and/or function, as judged by microscopy and/or hemodynamic tests (pulse volume index; radial artery blood flow). Lastly, increased catabolism of PGI2 seemed to be excluded in poor responders, since no statistical difference in PGI2 metabolism could be observed between the two groups. PMID- 3547633 TI - [Intravenous digital subtraction angiography]. AB - Thanks to its high contrast resolution, intravenous digital subtraction angiography (IV-DSA) makes it possible to examine the arteries after injection of contrast media into a peripheral arm vein. IV-DSA is indicated in patients with clinical suspicion of arterial stenosis, occlusion, aneurysm or anomaly (ascending and descending aorta, aortic arch and its great vessels, and the renal, iliac, femoral and popliteal arteries). In many such patients, IV-DSA successfully replaces intraarterial catheter angiography. The advantages of IV DSA (with a peripheral injection technique) as compared to conventional angiography, include its non-invasive character, a lower complication rate and less discomfort for the patient. The disadvantages of IV-DSA include poorer image quality due to lower concentration of contrast media in the vessels, reduced spatial resolution and the need for larger volumes of contrast media. The indication for conventional angiography is an inconclusive intravenous study due to motion artifacts and/or poor resolution. PMID- 3547632 TI - Airborne cadmium and carcinogenesis of the respiratory tract. AB - Exposure to airborne cadmium occurs mainly at the workplace. Significant exposure also occurs through smoking. Results of a recent epidemiologic study suggest that occupational inhalation of cadmium is connected with an increased lung cancer risk. This finding corroborates the high lung cancer incidence found among rats after chronic low-level exposure to cadmium chloride aerosols. Differences in the tumor sites, exposure conditions, and the pulmonary metabolism of cadmium between rodents and man make it difficult to extrapolate quantitatively from rats to humans. In contrast to the workplace, concentrations of cadmium in ambient air are very low, and the risk of lung cancer is probably very low, even for people living close to cadmium-emitting industries. The chemical form of inhaled cadmium appears to be important. While cadmium oxide and cadmium chloride seem to be equally toxic, cadmium sulfide exhibits a lower acute pulmonary toxicity. However, whether this is also true for carcinogenic effects is not known. Additional long-term inhalation studies with animals and further evaluation of epidemiologic studies are necessary to answer questions about the carcinogenic potency of cadmium compounds of different chemical form. As long as such results are not available, it is prudent to regard all cadmium compounds as having a carcinogenic potential. PMID- 3547634 TI - Corporate medicine for profit. PMID- 3547635 TI - [Ultrasound diagnosis of the stomach wall--experimental studies]. AB - The gastrointestinal wall can be separated into 5 layers by means of ultrasonic endoscopy and also by external ultrasound when using a probe of 5 Mhz. We studied the relationship between these echographic layers and the real anatomical structures by means of in-vitro examination of surgical specimens. The anatomical layers were separated in these specimens step by step. We found that the first and the fifth hyperechoic layers are border echos. The 2. (inner echopoor layer), the 3. (middle echogenic layer) and the 4. (outer echopoor layer) correspond to the mucosa, the submucosa and the muscularis propria, respectively. In so far, the differentiation between early cancer and advanced cancer of the stomach should be possible by endoscopic ultrasonography. PMID- 3547636 TI - [Study of the correlation of sonographic and scintigraphic results in measuring stomach emptying]. AB - "Stomach cockade" can be readily imaged sonographically, so that it has also been possible to carry out studies of gastric motility or measurements of gastric emptying times of fluids. However, the results of measurements should be verified by reference methods using new investigation techniques. For this reason, we measured synchronously by sonography and scintigraphy the emptying of test fluids from the stomach in patients with diabetes mellitus and suspected gastroparesis. We found a correlation of the two methods of measurement, so that sonographic measurement can be regarded as confirmed by scintigraphy as a reference method. PMID- 3547637 TI - [Sonographic diagnosis of complicated peptic ulcer]. AB - The sensitivity of sonography was assessed in an unselected series of 56 patients suffering from complicated gastric (20) or duodenal (36) ulcers. Evidence of ingested material and/or free gas in the peritoneal cavity associated with a pathologic gastroduodenal cockade proves perforation. Ulcer penetration is visible as eccentric "tumour" extension into hepatoduodenal ligament, liver or pancreas, whereas callous ulcer is recognisable as pathologic noninfiltrating cockade, and duodenal obstruction from stomach distention in spite of fasting. Based on these criteria, immediate diagnosis was feasible in 42/56 patients (approximately 75%). Ulcer perforation was confirmed in 20/26 (approximately 77%), including plain x-ray negative cases, which comprised approximately 31% of the perforations in this series. Ulcer penetration and - obstruction and chronic callous ulcers were diagnosed in 22/30 (approximately 73%) patients. Thus, sonography was proven to be highly contributive to immediate diagnostic fact finding and therapy. PMID- 3547638 TI - [Sonography of chronic inflammatory bowel diseases--a prospective study]. AB - In a prospective study, 118 patients with Crohn's disease, 51 patients with ulcerative colitis, and 72 patients with no disease of the intestine proximal to the rectum, were investigated by ultrasound. In Crohn's disease, thickening of the bowel wall and inflammatory conglomerates were detected in 72.0% of the patients. Using a transducer with optimal imaging properties these findings were detected in 87.2% of a group of 47 patients. Additionally an abscess was found in 5 patients. In ulcerative colitis, bowel wall thickening was detected in 52.9% of all patients. In both conditions, the extent of the mural changes was recognized completely in individual cases only. In Crohn's disease, the wall thickening was, on the whole, more marked, and an accumulation of pathological findings was found in the right lower abdomen. In the case of ulcerative colitis, on the other hand, the wall thickening was less pronounced, and located particularly in the left lateral abdomen. In the comparative group, low-grade thickening of the wall was observed in 3 cases only. The ultrasonographic image permits no conclusions to be drawn as to the degree of activity of the disease, although, in ulcerative colitis, the number of positive findings increases with increasing activity. No correlation of the findings with the duration of the disease was established. Considerably increased wall thickness if localized in the right lower quadrant and found in combination with an inflammatory conglomerate or an abscess, suggests Crohn's disease. It is not possible to exclude either disease by means of ultrasound. PMID- 3547639 TI - [Sonographic detection of fistulas in Crohn disease]. AB - The sonographic detection of fistulas in Crohn's disease has been almost impossible up to now and had therefore not been attempted. Two findings of an enterocutaneous and a blind-ending colohepatic fistula are demonstrated. Probably sonographic diagnosis of fistulas is better than has been believed so far, due to the high contrast of tiny gas bubbles; the "compression technique" to bypass meteoristic intestinal loops, which is been increasingly employed, and the improved physical resolution that allows to distinguish between different layers of the intestinal wall, are further contributing factors to the increasing use of sonography in this category of diagnostics. PMID- 3547640 TI - [Sonographic assessment of tumor spread in rectal cancer]. AB - The authors present the combined method of sonographic assessment of rectal carcinomas in respect of spread of tumour as well as metastasising, using linear rectal sounds (Aloka-Hellige) and rotating rectal sounds (Bruel-Kjear). This method involves further diagnostic progress compared with the methods employed to date. The article comprises application in 24 patients with histologically confirmed carcinoma of the rectum. PMID- 3547641 TI - [Ultrasound-controlled drainage of amebic abscess of the liver in Mexico]. AB - Drainage of a hepatic amoebic abscess by puncture guided by ultrasonography is described by means of an example. The treatment by puncture has the advantage of shortening clinical treatment. It should be combined with pharmacotherapy. PMID- 3547642 TI - [Ultrasound-controlled puncture procedures: free-hand puncture versus transducer biopsy puncture. 5 years' experience]. AB - To compare the accuracy of both ultrasound-guided puncture methods 417 patients were examined over a period of 5 years (retrospectively). Our results show no significant difference in accuracy between free-hand puncture and biopsy transducer puncture. It may be that puncture of very small (less than 2 cm) und very deep (greater than 8 cm) targets by biopsy transducer is a little more advantageous. In our opinion free-hand puncture is time-saving. Free-hand puncture allows a better visibility of the biopsy-needle artefact and is better practicable in case of anomalies of body structure. We did not observe complications worth mentioning with any of these two methods. We prefer free-hand puncture. PMID- 3547643 TI - [Reliability of sonography in diagnosing liver metastases in breast and bronchial cancer. A retrospective comparison of physical examination, laboratory tests and liver scintigraphy]. AB - To determine the accuracy of liver sonography in the diagnosis of liver metastases, the results of 99 patients with breast or lung cancer were compared with liver scintigraphy, physical examination, laboratory tests, histological examination and clinical follow-up. Liver sonography proved to be an accurate method to demonstrate or exclude liver metastases, with a sensitivity of 78.6% and a specificity of 90.0%. The highest accuracy was achieved if the sonographic examination of the liver was performed while there was a clinical suspicion of liver metastases and if compoundscan sonography was supplemented by real-time sonography. PMID- 3547644 TI - [Volumetry of the testis using real-time sonography]. AB - 99 testes of corpses (death had occurred between 26 and 86 years) were examined via real time sonography in a water-bath, measuring their length, breadth and height. They were then exposed surgically and their volume (by litres) determined according to Archimedes' principle. The volume determined via testes sonography was set in relationship to the "real" volume according to Archimedes. A correction factor was found (corresponding to an ellipsoid) of f (sono) = 0.65 +/ 0.1 (for the rotation ellipsoid this is pi/6 = 0.524). On multiplication with the optimised factor f (sono) = 0.65 the best possible calculated testes volume was obtained. A direct comparison of both measurement methods showed a random mean error of 7% for the principle of Archimedes, whereas with sonographic determination of the volume a mean error of 15% must be taken into account. Whereas the accuracy of measurement increases with increasing volumes, both methods should be used with caution if the volumes are below 4 ml, since the possibilities of error are rather great. PMID- 3547645 TI - Mutagenicity assay of emission extracts from wood stoves: comparison with other emission parameters. AB - The emission from wood stoves of several types of air pollutants has been measured under standardized burning conditions with emphasis on the amount of organic compounds and determination of the mutagenic activity with the Salmonella/microsome assay. The study corroborates earlier findings that conventional wood stoves can be a significant source of hydrocarbon and tar compounds in the ambient air. The emission of mutagenic compounds comprise both compounds requiring mammalian activation and compounds which are active in the test without exogenous activation. The mutagenicity tests show that nitroaromatic compounds are present in wood stove emissions, although the emission of nitrogen oxides is low. A wood stove constructed using the downdraft principle emitted much less hydrocarbons and tar, less mutagenic components and slightly less carbon monoxide than conventional wood stoves. PMID- 3547646 TI - Encystation and expression of cyst antigens by Giardia lamblia in vitro. AB - The cyst form of Giardia lamblia is responsible for transmission of giardiasis, a common waterborne intestinal disease. In these studies, encystation of Giardia lamblia in vitro was demonstrated by morphologic, immunologic, and biochemical criteria. In the suckling mouse model, the jejunum was shown to be a major site of encystation of the parasite. Small intestinal factors were therefore tested as stimuli of encystation. An antiserum that reacted with cysts, but not with cultured trophozoites was raised in rabbits and used as a sensitive probe for differentiation in vitro. Cultured trophozoites that were exposed to bile salts showed a more than 20-fold increase in the number of oval, refractile cells that reacted strongly with anticyst antibodies, and in the expression of major cyst antigens. Exposure to primary bile salts resulted in higher levels of encystation than exposure to secondary bile salts. These studies will aid in understanding the differentiation of an important protozoan pathogen. PMID- 3547647 TI - Clinical trials planned for new AIDS drug. PMID- 3547648 TI - CDC25: a component of the RAS-adenylate cyclase pathway in Saccharomyces cerevisiae. AB - The yeast Saccharomyces cerevisiae contains two functional homologues of the ras oncogene family, RAS1 and RAS2. These genes are required for growth, and all evidence indicates that this essential function is the activation of adenylate cyclase. In contrast, ras in mammalian cells does not appear to influence adenylate cyclase activity. To clarify the relation between ras function in yeast and in higher eukaryotes, and the role played by yeast RAS in growth control, it is necessary to identify functions acting upstream of RAS in the adenylate cyclase pathway. The evidence presented here indicates that CDC25, identified by conditional cell cycle arrest mutations, encodes such an upstream function. PMID- 3547649 TI - Retraction of research findings. PMID- 3547650 TI - Human trials begin for malaria vaccine. PMID- 3547651 TI - Molecular cloning and expression of a human B-cell growth factor gene in Escherichia coli. AB - A human B-cell growth factor (BCGF) (12 kilodaltons) supports the clonal proliferation of B lymphocytes. A clone was isolated that contained the proper structural sequence to encode biologically active, 12-kilodalton BCGF in Escherichia coli and to hybridize to a specific messenger RNA, identified by in vitro translation in Xenopus laevis oocytes. A relatively hydrophobic region of 18 amino acids was found at the amino terminal of the 124-amino acid-long polypeptide. The carboxyl terminal is composed of at least 32 amino acids that are derived from nucleotide sequences bearing significant homology to the Alu repeat family. PMID- 3547653 TI - Optical trapping and manipulation of viruses and bacteria. AB - Optical trapping and manipulation of viruses and bacteria by laser radiation pressure were demonstrated with single-beam gradient traps. Individual tobacco mosaic viruses and dense oriented arrays of viruses were trapped in aqueous solution with no apparent damage using approximately 120 milliwatts of argon laser power. Trapping and manipulation of single live motile bacteria and Escherichia coli bacteria were also demonstrated in a high-resolution microscope at powers of a few milliwatts. PMID- 3547652 TI - Two mammalian genes transcribed from opposite strands of the same DNA locus. AB - This report describes the characterization of a genomic locus in the rat that encodes overlapping genes occupying both strands of the same piece of DNA. One gene (strand) encodes gonadotropin-releasing hormone (GnRH). A second gene, SH, is transcribed from the other DNA strand to produce RNA of undefined function. The RNAs transcribed from each DNA strand are spliced and polyadenylated, and share significant exon domains. GnRH is expressed in the central nervous system while SH transcripts are present in the heart. Thus, the genome of a mammalian organism encodes two distinct genes by using both strands of the same DNA. PMID- 3547654 TI - The role of stress and trauma in rheumatoid arthritis and systemic lupus erythematosus. AB - Only one study, albeit inconclusive, has specifically addressed the etiologic role of physical trauma in RA. The weight of evidence from a variety of studies strongly suggests a role for psychologic stress in inducing, exacerbating, and effecting the ultimate outcome in RA. Well designed controlled trials aimed specifically at deciding these issues are urgently needed. This also applies to SLE, where the role of physical trauma has never been investigated, and disease exacerbation induced by emotional stress has been strongly suggested, but not yet verified in a scientifically acceptable fashion. Stress can depress immune responsiveness, but the end result of this (eg, increased susceptibility to infection, increased disease activity) is not known. It is uncertain how much or what kind of stress is required to depress responsiveness, or even how differing degrees of stress can be quantitated or reproduced. Even though eight million Americans have RA and SLE, we still know very little about the influences of stress and trauma on these disorders. PMID- 3547655 TI - Uveitis associated with juvenile rheumatoid arthritis. AB - Chronic nongranulomatous uveitis associated with JRA, a distinctive clinical entity occurring almost exclusively in the pediatric age group, represents an important cause of visual impairment in children. Despite continuing clarification of the clinical manifestations of this disorder, the etiology of uveitis associated with JRA remains unknown and the pathophysiology is still poorly understood. Further study of uveitis-associated JRA, by the application of improved immunologic theories and techniques, should aid in developing more effective therapeutic and preventive strategies. PMID- 3547656 TI - Pulmonary fibrosis in rheumatoid arthritis: a review of clinical features and therapy. AB - During the past four decades there has been a growing appreciation of the frequency of pulmonary abnormalities associated with RA. Approximately 30% to 40% of patients with RA demonstrate either radiographic or pulmonary function abnormalities indicative of interstitial fibrosis or restrictive lung disease. The severity of pulmonary fibrosis is not associated with rheumatologic symptoms or the duration of the associated RA, nor is there any clear relation to the extraarticular features of RA or serologic findings. Survival rates in patients with coexisting RA and pulmonary fibrosis are similar to those of patients with idiopathic pulmonary fibrosis. However, the spectrum of disease activity is quite variable. The majority of patients with progressive pulmonary symptomatology, when treated with corticosteroids, will have equivocal results. Some patients appear to respond to immunosuppressive or cytotoxic medications. The role of macrophages may be central to the injury to lung. Recent studies suggest a potential treatment role for cyclosporine, which may be able to interrupt lymphocyte-stimulated macrophage activation, and thus, fibroblast-mediated fibrosis in patients with pulmonary interstitial fibrosis. Bronchoalveolar lavage studies may delineate subgroups of patients who are more likely to respond to immunosuppressive agents, especially when treatment is started early. PMID- 3547657 TI - Gold lung: recent developments in pathogenesis, diagnosis, and therapy. AB - Gold lung is a hypersensitivity pneumonitis to gold-containing compounds. It can be distinguished from rheumatoid lung by its subacute or acute onset, diffuse interstitial and/or alveolar filling pattern on chest roentgenogram, presence of lymphocytes on BAL with an inverse helper/suppressor ratio, and response to withdrawal of gold and/or corticosteroid therapy. Other in vitro assays of gold hypersensitivity using peripheral blood lymphocytes are only sporadically positive and, therefore, of limited value in making the diagnosis. Physicians prescribing organic gold compounds should elicit pulmonary complaints throughout the duration of therapy. When patients receiving gold therapy present with signs and symptoms consistent with an acute or subacute hypersensitivity pneumonitis, the gold therapy should be withheld and a diagnostic workup initiated. PMID- 3547659 TI - Synovial fluid lipid abnormalities in various disease states: review and classification. AB - Although lipids are not usually present in large quantities in normal synovial fluids or in the usual synovial fluid seen in most rheumatologic conditions, their presence in synovial fluid may have diagnostic importance. As summarized in Table 2, analysis of synovial fluids for lipid constituents is relatively simple. On standing or after centrifugation, significant amounts of lipids may layer out and be visible as a supernatant. On microscopic examination, lipid droplets are usually easily seen and should be stainable with appropriate dyes (oil red O or Sudan III or IV), or may occasionally be visualized as intracellular or extracellular inclusions by polarized microscopy. Small (0.5 to 2.0 microns) intracellular inclusions containing triglycerides may be seen in neutrophils from most synovial fluids, and are of no diagnostic importance. Cholesterol crystals may be readily recognized microscopically by their characteristic flat, plate like appearance and notched corners Synovial fluid may also be analyzed for cholesterol and triglycerides in routine clinical laboratories, and free fatty acids and lipolytic enzymes in special lipid laboratories. The presence of massive increases in cholesterol associated with microscopically visible cholesterol crystals is usually associated with chronic RA, occasionally in the setting of super-imposed bacterial infection. The presence of gross or microscopic lipid droplets is usually associated with trauma and hemorrhagic effusions. When present in this setting, the clinician should entertain a high suspicion for a significant intraarticular injury, such as fracture, meniscal tear, or severe ligamentous injury. In addition, however, several instances of non-traumatic inflammatory effusions associated with intracellular and extracellular lipid droplets have been reported.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3547658 TI - Antimalarials in rheumatology: efficacy and safety. PMID- 3547660 TI - Mycobacterium kansasii septic arthritis complicating rheumatic disease: case report and review of the literature. PMID- 3547661 TI - Functional imaging of the heart. AB - The generation of functional images from the time-activity curves of individual pixels in the gated blood-pool study has become a routine part of most nuclear medicine computer systems. These images have the advantage of extracting useful functional information from the entire study and presenting it in an easily interpretable format. One can rapidly examine them, especially the phase and amplitude images, to seek out potential abnormalities of contraction and conduction. These are not designed to be "stand alone" images and correlation with the remainder of the study, including the cine display, is required. In addition to their use in assessing abnormalities of either ventricular chamber, they also have been shown to be useful in delineating atrioventricular borders in both the left and right sides of the heart. This facilitates definition of regions of interest for the calculation of ejection fractions. These images are produced at no increased expense or inconvenience to the patient and therefore should always be evaluated. PMID- 3547662 TI - A general comparison of functional imaging in nuclear medicine with other modalities. AB - New (noninvasive) diagnostic procedures in medicine (ultrasound [US], digital subtraction angiography [DSA], computed tomography [CT], nuclear magnetic resonance [NMR]) create a need for a review of the clinical utility of functional imaging in nuclear medicine. A general approach that is valid for all imaging procedures is not possible. For this reason, an individual assessment for each class of functional imaging is necessary, taking into account the complexity and sophistication of the various imaging procedures. This leads to a hierarchical order: first order functional imaging: imaging of organ motion (heart, lungs, blood); second order functional imaging: imaging of excretory function (kidneys, liver); and third and fourth order functional imaging: imaging of metabolism (except excretory function). First order functional imaging is possible fundamentally, although with limitations in detail, by all modalities. Second order functional imaging is not possible with US. Third and fourth order functional imaging is a privilege of nuclear medicine alone. Up to now, NMR has not proven clinically useful to produce metabolic images in its true sense. This is due to the fact that the signals used are too weak to provide metabolic information with satisfactory local resolution, even after administration of nonradioactive isotopes. First and second order functional imaging of nonradioactive procedures face severe disadvantages, including difficulties in performing stress investigations, which are essential for coronary heart disease, limited capability for true quantitative information (eg, kidney clearance in mL/min), side effects of contrast media and paramagnetic substances, and high costs. Therefore, nuclear medicine functional imaging turns out to be in a favorable clinical position, even in the presence of the competitive diagnostic modalities that have been developed in recent years. PMID- 3547663 TI - Time-based multiple organ functional images. AB - Computer generation of functional images has gained recognition as a valuable method of analyzing physiologic data. However, most mathematical models used to produce these images are frequency-based, which requires that the entire function be examined. Because frequency-based characteristics are only indirectly related to physiologic characteristics, this technique has inherent deficiencies that may be minimized through various manipulations. Our technique is to base such images on time-related features, rather than frequency-based. This technique deals directly with regional count rate behavior, which in turn reflects function. Benefits from such an approach include the ability to generate images from isolated portions of an event and the removal of sinusoidal models that may or may not accurately represent function. Our experience with such an approach to the generation of functional images of the heart, lungs, and liver has been highly successful. PMID- 3547664 TI - Functional image data acquisition and processing. AB - In the production of functional images certain hardware and software considerations are necessary for the rapid and accurate determination of kinetic parameters. The advent of the digital scintillation camera has made available increased accuracy of quantitation and ease of image handling, although its integrated computer system may not be optimal for program development presently. To reduce the deleterious effects of Poisson noise on parameter estimation, the single or multiple application of easily implemented smoothing operators in space and time is recommended as a first step in image processing. The properties of these operators are conveniently expressed in terms of their variance. Following smoothing, count or variance thresholding is performed to reduce computer processing time and eliminate extraneous background from functional images. Time activity curves can be fit by a variety of mathematical functions, the most useful of which is probably the finite Fourier series. In a simulated gated blood pool study of the left ventricle, with and without an aneurysm, it is found that increased smoothing of the original image data results in more accurate parameter determinations, to the extent that small regions of dissimilar temporal behavior are not obliterated. PMID- 3547666 TI - Current status of adjuvant endocrine therapy for resectable breast cancer. PMID- 3547665 TI - Quantitative gallium 67 lung scan to assess the inflammatory activity in the pneumoconioses. AB - Gallium 67 lung scan has recently become increasingly used to evaluate the biological activity of alveolitis of interstitial lung diseases and to stage the disease process. In order to have a more precise and objective indicator of the inflammatory activity in the lung, we and others have developed computer-based quantitative techniques to process the 67Ga scan. In this report, we compare the results of three such computer-based methods of analysis of the scans of 38 normal humans and 60 patients suspected to have pneumoconiosis. Results of previous investigations on the mechanisms of 67Ga uptake in interstitial lung disease are reviewed. These data strengthen the view that quantitative 67Ga lung scan has become a standard technique to assess inflammatory activity in the interstitial lung diseases and that computer-based method of analysis of the scan provides an index of inflammatory activity of the lung disease that correlates with lung lavage and biopsy indices of inflammation in the lung tissue. PMID- 3547667 TI - New agents and new medical treatments for advanced breast cancer. PMID- 3547668 TI - Current status of adjuvant chemotherapy for breast cancer. PMID- 3547670 TI - Chemical leukemogenesis: benzene as a model. PMID- 3547671 TI - Acute lymphoblastic leukemia in adults: recent progress, future directions. AB - The data reviewed indicate substantial recent progress in the treatment of ALL in adults. Most patients, greater than 70% to 80%, will achieve a remission following induction chemotherapy with vincristine, prednisone, and an anthracycline. Additional drugs do not convincingly increase the remission rate; their effect on remission duration is unknown. Although continuation therapy has not been critically evaluated in randomized trials, the longest remissions have been reported in individuals receiving consolidation/intensification, particularly in the immediate postremission period. Presently, a disease-free survival is 35% to 45% at greater than 5 years when this type of consolidation/intensification therapy is used. The precise value of conventional maintenance chemotherapy in adult ALL is unknown. CNS prophylaxis is necessary; the standard of treatment remains cranial radiation and intrathecal methotrexate. Alternative approaches are currently being studied such as systemic treatment with high doses of methotrexate or cytarabine. Recently, prognostic factors have been better defined. In recent studies with intensive treatment, time to response, age, WBC, immunologic subtype and cytogenetic data can be used to divide patients into a low-risk group with a projected disease-free survival of 60% or more and a high-risk group with a disease-free survival of 20% to 25%. The definition of risk groups in adult ALL may be useful in determining future further optimal therapeutic approaches. PMID- 3547669 TI - Controversies in the management of childhood acute lymphoblastic leukemia: treatment intensification, CNS leukemia, and prognostic factors. PMID- 3547672 TI - Therapy of acute myelogenous leukemia. AB - Over the past 10 years, there have been substantial advances in the treatment of AML. Intensive induction chemotherapy using 7-day courses of cytarabine and daunorubicin or amsacrine produce remission in 60% to 85% of patients. Median remission duration is 9 to 16 months. In some series, 20% to 40% of patients are in continuous remission for 2 years or more; many of these patients remain in remission for 5 years or longer and some may be cured. Bone marrow transplantation has evolved as a useful therapeutic modality capable of achieving long-term survival in some circumstances in which chemotherapy is relatively ineffective. Its precise role in the initial therapy of AML remains to be defined, but it is likely to be beneficial in selected patients. These data indicate substantial recent progress in the treatment of this disease, which was almost uniformly fatal 30 years ago. The fact that most patients relapse within 1 to 2 years reflects a lack of progress in developing effective postremission therapy. Maintenance chemotherapy, immunotherapy, and CNS prophylaxis have little role in AML. It is unclear whether consolidation or intensification extend remissions or increase the proportion of long-term survivors; controlled randomized trials should answer this question within the next few years. Future progress in the treatment of AML awaits the development of more sensitive methods for detecting residual leukemia, more effective use of current therapeutic modalities and the introduction of new effective drugs. Most data suggest that early intensive treatment is of key importance for achieving cures. However, we cannot presently distinguish between patients cured by initial treatment and those who required further chemotherapy. PMID- 3547673 TI - Bone marrow transplantation for acute leukemia: recent advances and comparison with alternative therapies. AB - Bone marrow transplantation is an effective therapy in patients with acute leukemia. High-dose chemotherapy with or without total body irradiation and allogeneic bone marrow transplantation is a more effective antileukemic treatment than chemotherapy. This approach is limited, however, by a relatively high risk of transplant-related complications, particularly graft rejection, GVHD, and interstitial pneumonitis. Autologous bone marrow transplantation avoids the problems of graft rejection and GVHD. It does, however, introduce a risk of reinfusing residual leukemia cells with the autologous bone marrow and absence of a possible graft-versus-leukemia effect associated with allogeneic transplants. Bone marrow transplantation is useful in AML. Syngeneic or allogeneic HLA identical bone marrow transplantation is the preferred treatment for patients under age 45 to 50 who fail chemotherapy. Transplantation is also likely to be superior or comparable to chemotherapy for patients less than 20 to 30 years of age in first remission. Transplantation in older individuals in first remission is controversial; results are comparable to those achieved with postremission chemotherapy. Transplants from donors other than HLA-identical siblings must be considered investigational but may be a reasonable alternative in young individuals in first relapse or second remission. Autotransplants are difficult to evaluate critically but may be considered as investigational therapy for individuals in second or later remission for whom a suitable allogeneic donor is unavailable. Autotransplants in first remission should be restricted to controlled clinical trials because it is otherwise impossible to determine their efficacy. It is uncertain whether ex vivo treatment of the bone marrow to remove leukemia cells is necessary in the context of autotransplantation; again, controlled trials are required. Bone marrow transplantation from an HLA-identical sibling is effective in individuals with ALL who relapse despite chemotherapy. Patients undergoing transplantation while in second or later remission or in relapse have a survival rate superior to those treated with chemotherapy. One important and unresolved issue is whether patients with high-risk ALL should receive bone marrow transplants or intensive postremission chemotherapy while in first remission; controlled clinical trials are needed. Bone marrow transplants from donors other than HLA-identical siblings and autologous bone marrow transplants are investigational approaches that should be considered in selected young patients who fail despite chemotherapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3547674 TI - Collaborative epidemiological research in perinatology. PMID- 3547675 TI - Update on retinopathy of prematurity. PMID- 3547676 TI - Reducing iatrogenic lung disease in the premature newborn. PMID- 3547677 TI - Preventing complications from lines and tubes. AB - Rather than providing an exhaustive list of known complications of all tubes and lines used in the NICU, we have highlighted the potentially traumatic nature of their use and outlined general principles of prevention. Most complications of care are more easily avoided if we know about them in advance. Attention to simple details, while recognizing that use of indwelling tubes and lines has both benefits and hazards, should lessen some of these morbidities. PMID- 3547679 TI - AIDS-related Kaposi sarcoma and lymphomas. PMID- 3547678 TI - The neuroradiology of AIDS. PMID- 3547680 TI - Pediatric AIDS. PMID- 3547682 TI - Rings of madness: service areas of 19th century asylums in North America. AB - The mid-19th century saw the emergence of a major medical innovation, namely, the rise of the state lunatic asylum. Beginning in the northeast, the phenomenon spread rapidly westwards. By 1875 no fewer than 71 mental hospitals were opened in 32 existing states. Although premised upon belief in the efficacy of 'moral and humane' treatment, the asylums soon became custodial rather than therapeutic institutions. Average size continually increased; some accommodated well over 2000 patients. The provision of more asylums, and broadened definitions of insanity, generated increasing patient numbers which, in turn, caused public consternation and fear of increasing 'madness' in the population. Geographic analysis of admissions in 18 U.S. states and two Canadian provinces reveals the universality of distance decay around the asylums, and demonstrates that hospital service-area cones were predominantly local in effect. Thus the 'state' asylum was in reality a local institution. The deinstitutionalization movement of recent decades is apparently bringing to a closure a 100-year cycle of incarceration decarceration of the mentally ill. Nevertheless, whether patients are geographically concentrated or dispersed, the influence of distance decay remains a relevant consideration. PMID- 3547681 TI - [Effects of splanchnicotomy on plasma catecholamines, glucose and lactic acid during insulin hypoglycemia in sheep]. PMID- 3547683 TI - Separating doctors' homes and doctors' offices: San Francisco, 1881-1941. AB - The urban medical delivery system includes not only the technological and scientific skills and apparatus used by health care practitioners but also those economic and social arrangements made by doctors that affect their ability to provide medical care. Among the most important of these is the location of health care facilities, especially doctors' offices. This paper traces the changing locations of doctors' offices in San Francisco between 1881 and 1941. Most specifically, it focuses on the separation of office from residence and the location of offices in the city. Changes in location began to occur during the urban transformation that occurred late in the nineteenth century. At that time, changes in the division of labor, the role of the family, and transportation and communications technology interacted with changes in science, medical technology and professional organization to alter the nature and location of the settings used to provide medical care. The health care delivery system is thus interpreted as the product of the overall dynamics of urbanization rather than the outcome simply of scientific discovery, medical technology and the influence of key medical practitioners and professional organizations. PMID- 3547684 TI - Reforming Medicare: the limited framework of political discourse on equity and economy. AB - Medicare, the major program that organizes the delivery and financing of health care for the elderly in the United States, is being rapidly and significantly changed in order to bring Federal expenditures for health care under control. Questions of 'equity', 'justice' and 'access to health care' (that have long been associated with liberal ideology) have lost discursive currency within the realm of acceptable political debate that now focuses on 'economy' and the restoration of 'competitive market forces' to the health care industry (a point of view associated with conservative ideology). Pluralistic analyses of American health care policy most often focus on the differences between liberals and conservatives and could only explain the current bipartisan effort to reorganize Medicare as a defeat for liberals and as a vindication for the conservative perspective during a period of economic crisis. This essay develops the alternative point of view that American political debate on health care, among and between liberals and conservatives, has always taken place within a space bracketed by well defined limits established by widespread support for the market model of health care. The strength and dominance of this model that organizes and supports the private production of health care for profit is far more important in explaining the continuity in American health care policy over time and the recent policy adjustments than any examination of ideological differences between political conservatives and liberals. After analyzing the limited framework of debate structured by the market model of health care, this paper critically examines the recent changes in Medicare and challenges the market model on empirical grounds. Finally, the author returns to a discussion of the implications of these changes for equity and justice. PMID- 3547685 TI - State, society and old-age policy in France: from 1945 to the current crisis. AB - The aim herein is to understand the public interventions that, over a period of nearly 40 years (1945-1982), have shaped the relations between old age and society in France. Most of the State's interventions have turned around three axes: retirement, way-of-life issues and employment (in fact, early withdrawal schemes). Three periods, each of which corresponds to different combinations of these three dimensions can be distinguished. The interplay of the antagonism as well as complementarity of social forces that has led to government interventions during each period is used to show both the ways that old age has been managed and the linkage, subject to strain and change, between the State and various social forces. By shedding light upon the action systems underlying the development of old-age policies, processes can be discerned that have resulted in the present day crisis of the Welfare State, and the State's actions in social policy can be conceptualized. PMID- 3547686 TI - The development of health and social services for the elderly in Iceland: an overview. AB - In the present paper, we provide a general overview of the changing position of the aged population in Iceland. After a long history of subsistence, Icelandic society has evolved only recently from pre-industrial conditions compared with other Western developed nations. The 1000-year preindustrial record is in large part one of a struggle for survival in which formal and informal measures to support the frail and disabled were often overwhelmed by disease and famine; this history is outlined to provide a baseline for recent changes. Both the speed and propinquity of Iceland's transition from these conditions have left a unique stamp on the present-day society: development has driven a quick elaboration of occupational roles and other social status shifts, vast health status improvements, and great population and urban growth. Public and personal health services have grown in scope and adequacy in comparatively recent decades, contributing to the now unsurpassed health status of the general population. The effect of these trends on the condition of elderly is described. As the birth rate in Iceland has dropped in recent decades, the proportion and number of Icelanders in the older and especially the oldest age-strata has been steadily rising. The current and planned organization of health and social services is reviewed, as Iceland faces new tasks of caring for elderly. PMID- 3547687 TI - Defective modernization and health in Mexico. AB - This paper uses data gathered in a semi-arid, mountain region of the border state of Sonora, Mexico to illustrate that modernization and the importation of urban ideas and values can influence health status in unexpected ways. It traces the historic process of modernization in a rural municipio, relating this to social promises and economic cycles in Mexico. Modernization is seen to encompass life standard improvements and access to medical care; extension of road and transportation systems; and the widespread availability of information and education, as well as lifestyle changes required to incorporate these 'urban' influences. Reviewing the link between climate and health in arid lands, the paper notes that such modernization can be a well-meaning intrusion upon a set of cultural and social practices which had proved adaptive in dealing with climatic extremes. Initial modernization produces impressive declines in mortality and morbidity, as illustrated in an analysis of mortality figures and causes in relation to age cohorts and decades for the years 1955-1984. However, reductions in epidermic-related infant mortality are shown to be offset by increases in deaths due to trauma, chronic conditions and endemic disease. An analysis of morbidity for the year 1983-84 indicates that continuing high rates of infectious disease are related to conditions which result from increasingly defective modernization. To maintain technology, including water, electrical, and sewage systems, continual capital expenditure on both the public and private level is required. The economic crisis in Mexico is reducing available funds at a time when the community has adjusted its traditional lifestyle to incorporate technological improvements. In light of this, it is likely that inroads against infectious disease will not just continue to be stalemated, but could actually be reversed. This finding has implications for towns and villages on both sides of the Mexican-American border. PMID- 3547688 TI - Public health in pre-colonial east-central Africa. AB - This study is the first of its kind to suggest that a rich public health tradition existed in east-central Africa before the twentieth century, and that the tradition can be reconstructed historically. It breaks with earlier studies of public health history for the region in that it does not define public health on the basis of western institutions and activities. The definition of public health that is used in this study makes a simple equation between politics and medicine. It includes all activities that ruling authorities undertake to promote the well-being of the societies over which they have charge. Thus rainmaking and sorcery control, the principal services in traditional African societies, are the focus of this study. Evidence is presented here of the control exercised by kings, chiefs, priests over these services in various societies located in southeastern Zaire, southern Tanzania, Zambia, Malawi, northern Mozambique, and Zimbabwe. The cases are all set in the pre-colonial period, before the twentieth century and the beginning of most written records. The evidence is derived primarily, though not exclusively, from non-written sources, such as archaeology, linguistic, and ethnographic records. The best data are those that come from cultural exchanges between people, for historical records are created in this way. Therefore, the cases discussed here all involve contacts between immigrant and autochthonous groups. The political histories of these contacts are already known. What this study does is link up those traditions with independently acquired evidence of change in medical traditions. Political change often, but not always, led to change in public health institutions. The control of ruling elites over health services is thus made apparent by the manner in which new medical institutions were implanted when new political authorities arose. PMID- 3547689 TI - Canine heartworm disease: a review and pilot study. AB - Canine heartworm disease is a mosquito vectored illness resulting from parasitization by the filariid worm Dirofilaria immitis. While presenting some danger to humans, the filariid has its greatest impact on the canine population. In recent years the disease has become established throughout much of the United States, perhaps as the result of diffusion from a suspected hearth in the southeastern coastal plain. While its distribution is known in general terms, much research remains to be done to assess the pattern of distribution as well as the impact of D. immitis on canine populations and their human owners for many locales. The present study provides a review of the literature on the parasite; on its distribution, particularly in the United States; and on the ecology of canine heartworm disease. A pilot study is presented which emphasizes the problems encountered in establishing a data base for observations on the disease at the local level. PMID- 3547690 TI - [Artificial intelligence. Expert systems]. PMID- 3547691 TI - Hepatic transplantation. AB - In this article hepatic transplantation is discussed with respect to selection of patients, indications and contraindications, the donor and recipient operation, complications, and results. PMID- 3547692 TI - [The public health of the Tiumen' region during World War II]. PMID- 3547693 TI - [Participation of physicians of the Sumi Region in the revolution of 1905]. PMID- 3547694 TI - [A week of Soviet medicine in Berlin]. PMID- 3547695 TI - [Biography of D. M. Vellanskii]. PMID- 3547696 TI - Spontaneous perforation of the renal pelvis after transplantation. A report of 2 cases and a review of 8 cases previously reported. PMID- 3547697 TI - Wound infection after major lower-limb amputation--the role of antibiotic prophylaxis. PMID- 3547698 TI - The role of pancreatic function testing in the 1980s. AB - The recent advent of non-invasive imaging techniques and tubeless pancreatic function tests has revolutionised the investigation of patients with suspected chronic pancreatic disease. The current diagnostic role of the conventional pancreatic function test is evaluated and the practical usefulness of alternative modalities is reviewed. PMID- 3547699 TI - Marine pollution and health in South Africa. AB - Although the RSA does not have a serious marine pollution problem, rapid population growth and increasing industrialization make it imperative to assess the pollution status of coastal waters and to plan for future developments. All pollution on earth ends up in the sea, which consequently contains a mixture of substances, the effects of which on the biota and on human health are poorly understood. Many of these substances are accumulated by marine organisms and become ever more concentrated along the food chain; where man is at the top of the chain, he thus runs the greatest risk of all. Too much raw sewage is allowed to pollute the sea, the provision of sewage treatment plants being largely inadequate for the growing population. Notwithstanding the excellent work done by a number of South African organisations and individuals, and the sound basis of the country's anti-marine pollution legislation, a plea is made for greater co operation between those whose expertise and/or official position would enable them to contribute to combating the problem. PMID- 3547700 TI - Chloroquine-resistant malaria. PMID- 3547701 TI - Annual Statistical Supplement, 1986. PMID- 3547702 TI - Constitutional background to the Social Security Act of 1935. AB - In June 1937, the Senate Judiciary Committee reported unfavorably on Roosevelt's Court-packing plan and the bill was effectively killed. In the same month, Justice Van Devanter retired and gave Roosevelt his first opportunity to make an appointment to the Supreme Court. Over the following 6 years, Roosevelt made seven more appointments to the Court, and in the years that followed the Court continued in the direction boldly advanced in the spring of 1937. A residual effect of the taxing-spending construction of the old-age insurance provisions of the Social Security Act of 1935 has been the Court's continued adherence to the view that social security programs consist of separate taxing and spending provisions and are not, constitutionally speaking, social insurance programs. The issue has arisen in both a due process context and an equal protection context. But it is unlikely that the decisions reached in these contexts would have been different had the old-age insurance program been drafted as an earned-benefits program pursuant to the commerce power. Of course, the Court's decisions in the social security cases represented a significant constitutional development in establishing the breadth of Congress' powers to tax and spend for the general welfare. The decisions not only cleared the way for other general welfare programs, but more fundamentally provided the Federal Government with the substantive power and institutional flexibility to respond to the changing needs of the Nation. PMID- 3547703 TI - Prophylaxis of postoperative venous thromboembolism. PMID- 3547704 TI - Extracorporeal membrane oxygenation for neonatal respiratory failure. AB - Extracorporeal membrane oxygenation will continue to be an appropriate modality of treatment in properly selected infants. In the future, respiratory management and selection criteria for these patients should become standardized and universally accepted. It is conceivable that as we become more comfortable with this treatment we can complete prospective, randomized trials on infants who have less than a 90 percent mortality likelihood and thereby avoid the ethical implications of a study in which the control population has death as an endpoint. It is also conceivable that ECMO will be more benign and induce less morbidity than the barotrauma seen in many of the infants supported by aggressive ventilator management. PMID- 3547705 TI - The options in surgical treatment of diverticular disease. PMID- 3547706 TI - The uses and consequences of the Roux-en-Y operation. PMID- 3547707 TI - The role of prostaglandins in acute pancreatitis. PMID- 3547708 TI - Postcholecystectomy syndromes. AB - The postcholecystectomy syndrome in its chronic form is characterized by severe episodes of upper abdominal pain that may or may not be accompanied by hepatic or pancreatic dysfunction or ductal dilation. Endoscopic retrograde cholangiopancreatography is the most definitive way to identify anatomic defects. Transendoscopic papillary manometry is a promising new diagnostic technique. A surgical approach should be used only after persistence of symptoms without apparent cause and a prolonged trial of medical therapy. The operation should include exploration of the contents of the peritoneal cavity and transduodenal examination of the papilla of Vater. An extended papilloplasty should be performed to include a 1- to 2-cm anterior sphincteroplasty and an excision of the transampullary septum. Approximately 75 percent of patients with chronic pain after cholecystectomy will gain long-term relief of their symptoms. PMID- 3547709 TI - The role of lasers in the management of carcinoma of the lung and the esophagus. PMID- 3547710 TI - Duplex scanning in vascular surgery. PMID- 3547711 TI - The treatment of complicated reflux esophagitis. PMID- 3547712 TI - The surgical treatment of achalasia. PMID- 3547713 TI - Hepatic artery chemotherapy for colorectal cancer metastatic to the liver. PMID- 3547714 TI - The conservative management of breast cancer. PMID- 3547715 TI - Oropharyngeal dysphagia and operations on the upper esophageal sphincter. PMID- 3547716 TI - Hemodynamics of aortic cross-clamping: experimental observations and clinical applications. PMID- 3547717 TI - The surgical treatment of parathyroid disease. PMID- 3547718 TI - Selective shunting procedures in portal hypertension: current perspectives. PMID- 3547719 TI - The importance of early diagnosis of acute acalculus cholecystitis. AB - Most observations of acute acalculus cholecystitis have been reported in patients after trauma, after unrelated surgical treatment and in critically ill patients, patient populations in whom the diagnosis of this condition is difficult. The importance of making an early diagnosis is demonstrated by the rapid development of complicated forms of cholecystitis. The results of collective reports have indicated that 40 to 100 per cent of the patients with acute acalculus cholecystitis will have advanced disease with gangrene, empyema or perforation of the gallbladder at operation. To demonstrate the importance of early suspicion and the use of sonography in making the diagnosis of this condition, a retrospective study of 40 patients with a surgical and pathologic proved diagnosis of acute acalculus cholecystitis was conducted. The fulminant nature of this disease was underscored by the fact that 70 per cent of these patients had advanced disease. Patients were divided into two groups, those who underwent operation within 48 hours of the onset of symptoms and those whose surgical treatment was delayed. Forty per cent of the patients who underwent operation more than 48 hours after the onset of symptoms had gallbladder perforation, while only 8 per cent of the patients without a delay in surgical treatment of more than 48 hours had perforations. Since advanced disease, especially perforation, carries a much higher morbidity and mortality than uncomplicated cholecystitis, making an early diagnosis is of paramount importance. Therefore, heightened awareness on the part of physicians is a key in making an early diagnosis. In 25 per cent of the patients in this study, unexplained fever was the first sign of the disease. Although most patients later presented with more classic symptoms of cholecystitis, many of these patients still presented with confusing clinical signs and symptoms leading to a delay in diagnosis due to the coexistence of the post-trauma, postsurgical or critically ill state. Ultrasound proved to be an important adjunct to the often confusing clinical clues in making an early diagnosis. Three ultrasonographic signs in the absence of stones--1, a thickened gallbladder wall; 2, an enlarged tender gallbladder, and 3, a pericholecystic collection--were suggestive of acute acalculus cholecystitis. One of these findings was present in almost 90 per cent of the patients in this study with acute acalculus cholecystitis who underwent biliary ultrasound. PMID- 3547720 TI - Unique performance characteristics of Novafil. AB - Polybutester is a unique copolymer that can be extruded as a flexible monofilament nonabsorbable suture. The mechanical performance of this new suture material was compared with that of polypropylene and nylon. The results indicate that polybutester sutures are as strong, have the same degree of total elongation at break and knot as the other monofilament sutures. In contrast with polypropylene and nylon sutures, the polybutester sutures have a perceptible stretch, are more elastic and flexible, and exhibit less creep. Polybutester sutures appear to be an acceptable alternative to polypropylene and nylon sutures and their unique mechanical properties may even prove to be superior in vivo. PMID- 3547721 TI - Intestinal anastomosis after preoperative radiation therapy for carcinoma of the rectum. AB - A retrospective review was conducted on 133 patients who underwent anterior resection and primary intestinal anastomosis for adenocarcinoma of the rectum from 1973 to 1983 at the Baystate Medical Center. Forty patients received a moderate dose, 4,500 rads, of radiation therapy preoperatively. Twenty-six of these patients (65 per cent) underwent protective colostomy at operation. An additional 93 patients underwent an operation without radiation and 38 of these (42 per cent) had a colostomy. We found no significant difference between patients who did or did not undergo radiation therapy in the over-all rate of complications (25 per cent for those who underwent radiation and 29 per cent for those who did not). Furthermore, there was no significant difference in anastomotic leak rates between the two groups (10 and 7 per cent respectively), even after controlling for the presence of a protective colostomy. We did find that leak rates for both groups were markedly higher for patients with a colostomy (14 per cent) than for patients without (1 per cent) (p less than 0.005). We conclude that a moderate dose of radiation therapy preoperatively does not increase the risk of anastomotic leakage or other operative complications with anterior resection. Colorectal intestinal anastomosis may be safely performed without routine colostomy after planned preoperative adjuvant radiation therapy if the anastomosis is technically satisfactory. PMID- 3547723 TI - Lobular carcinoma in situ of the breast. AB - Lobular carcinoma in situ of the breast is a well defined pathologic entity which is found in about 2.5 per cent of all specimens of the breast taken for biopsy and most commonly occurs in premenopausal females. Its diagnosis is virtually always incidental due to the absence of any clinical indication of its presence. This lesion carries a significant risk for development of subsequent invasive carcinoma which applies equally to both breasts and which appears to increase with time. The appropriate treatment of this disease remains a controversial issue. Various aspects of its epidemiology, pathology and natural history which have an important bearing on the therapeutic decision as well as the many treatment options available are analyzed herein. There is certainly a perception that lobular carcinoma in situ represent the early form of a malignant process which can be cured or prevented if appropriately treated at this stage. At the very least, an understanding of this lesion holds the potential for broadening our understanding of the physiologic basis of carcinoma of the breast as a whole. PMID- 3547722 TI - A simplified technique for the treatment of simple pleural effusions. AB - This technique for the drainage of simple pleural effusions is simple, safe and effective. It requires little more skill than the ability to perform a thoracentesis or central venous line placement. It appears ideal for both the bedridden patient who cannot sit for repetitive thoracentesis and for the ambulatory patient who need not be tied down with a chest tube and underwater seal system. We stress that the system is functional only for simple transudates and will provide unsatisfactory drainage of thick or bloody effusions. PMID- 3547725 TI - EORTC prospective trials of altered fractionation using multiple fractions per day (MFD). PMID- 3547724 TI - Multidisciplinary treatment of carcinoma of oropharynx and hypopharynx: principles and EORTC studies. PMID- 3547727 TI - [Value of the immunofluorescent antibody technic in the follow-up of patients with tonsillar cancer]. PMID- 3547726 TI - [Advanced hypopharyngeal cancer: functional surgery, chemotherapy and monoclonal antibodies]. PMID- 3547728 TI - [Classification of oropharyngeal and hypopharyngeal cancer]. PMID- 3547729 TI - [Radiation management of the lymph drainage passages]. PMID- 3547731 TI - [Role of systemic chemotherapy in the treatment of squamous cell carcinoma of the head and neck]. PMID- 3547730 TI - [New imaging technics in the oro- and hypopharyngeal regions]. PMID- 3547732 TI - [Results of the Gottingen chemotherapy studies]. PMID- 3547734 TI - Photochemotherapy applied stereotactically to brain tumors. PMID- 3547733 TI - Computed tomography demonstration of multiple parenchymal central nervous system nodules due to histiocytosis X. AB - The computed tomography demonstration of multiple parenchymal brain lesions due to histiocytosis X is described. A comparison of follow-up computed tomography and magnetic resonance imaging studies is made. PMID- 3547735 TI - Current concepts and controversies concerning the etiology, pathogenesis, diagnosis, and treatment of malignant tumors of the anus. AB - Malignant disease of the anus is uncommon. Possible predisposing causes include chronic inflammation and a transmissible agent. Epidemiologic studies suggest an increased incidence in homosexuals. With the exception of mucoepidermoid and small-cell carcinoma, the morphology of anal carcinoma has little influence on treatment and prognosis. Site, size of the primary lesion, and the presence of groin metastases are the crucial factors in prognosis. There is no satisfactory method for staging anal carcinoma--the symptoms are nonspecific. Diagnosis is based on histologic examination of biopsy material or tissue obtained from anal operations. The treatment of infiltrating, recurrent, or residual malignant anal lesions is a radical abdominoperineal resection. The addition of a limited obturator and hypogastric lymphadenectomy may be worthwhile. Inguinal lymphadenectomy provides palliation in the treatment of synchronous groin metastases, whereas in cases of metachronous metastases, groin dissection may result in an occasional cure. Small, noninfiltrating, low-grade anal lesions are best treated by either adequate local excision or supervoltage radiotherapy. If borne out, the promising results obtained with the combined chemoradiotherapy for anal cancer followed by local excision of the residuum will radically alter the future management of carcinoma of the anus. PMID- 3547736 TI - Gallstone obstruction of the intestine: an analysis of ten patients and a review of the literature. AB - Ten patients with gallstone ileus were studied to evaluate diagnostic and therapeutic procedures. The preoperative diagnosis was correct in four patients. All patients underwent laparotomy. In five patients, stones were removed by enterotomy and in three patients the obstruction was relieved by manual propulsion of the stones. One-stage small-bowel resection, cholecystectomy, and biliary enteric fistula repair were performed in two patients. Four patients had uneventful recovery. One episode of recurrent gallstone ileus was encountered. Three patients died of septic complications. It is concluded from the study and from a review of the literature that treatment should be aimed at relieving the obstruction, without performing additional surgical procedures, such as cholecystectomy and fistula repair. Secondary biliary surgery is to be performed only in patients with recurrent biliary disease. PMID- 3547737 TI - Freshly harvested cadaveric venous homografts as arterial conduits in infected fields. AB - Six patients with patent multilevel prosthetic grafts (three axillofemoral femoral grafts, an aortobifemoral graft, an axillofemoral and femoral-anterior tibial graft, and an axillofemoral and femoral-popliteal graft) that demonstrated overt infection involving both the proximal inflow (one infrarenal aorta, five axillary arteries) and groin anastomoses required complete graft excision. Cadaveric inferior vena cava, common and external iliac, common and superficial femoral, and greater saphenous veins were harvested in conjunction with multiple organ donor procedures. Identical anatomic reconstruction within the infected fields was accomplished, with patency and distal perfusion maintained for intervals sufficient to achieve complete resolution of infection in all cases. This interval of revascularization with a venous homograft has served as a temporizing maneuver, which permitted eradication of infection and allowed subsequent reimplantation of prosthetic graft material without associated reinfection in the two instances in which it was required. Use of freshly harvested large-caliber caval, iliac, and femoral homograft veins as arterial substitutes in infected fields has not been previously reported. Case histories and a review of the venous homografting literature are included. PMID- 3547739 TI - [Danish Nursing Council. One talked about decentralization 53 years ago]. PMID- 3547738 TI - Determination of optimal positive end-expiratory pressure by means of conjunctival oximetry. AB - A method for determining the optimal level of positive end-expiratory pressure (PEEP) by means of noninvasive conjunctival oxygen (PcjO2) monitoring and arterial blood gas analysis was developed from the pattern of changes in PcjO2 tension, invasive hemodynamic parameters, and oxygen transport variables during PEEP titration in a series of patients with adult respiratory distress syndrome. All patients had radial and pulmonary artery (PA) catheters inserted and blood volume was measured with 125I serum albumin before each study. During progressive increases in the level of PEEP, PcjO2 tensions reflected changes in both PaO2 and cardiac index (CI), depending on whether PEEP produced a significant decrease in CI. In patients with a stable CI, PcjO2 tensions tracked PaO2 values (rw = 0.92); in patients with a greater than a 15% decrease in CI, the conjunctival index, CjI (defined as the PcjO2/PaO2 ratio), tracked CI (rw = 0.87), excluding one patient with high cardiac output-septic shock and severe hypoxemia. PcjO2 correlated with PaO2 in the latter patient (r = 0.99) probably because conjunctival oxygen transport was limited by arterial oxygen content (PaO2 = 34 torr) rather than blood flow (CI greater than 6 L/min X m2). In patients with a greater than a 10% decrease in CI as a result of PEEP, the greater the decrease in CI, the better CjI values correlated with CI. We conclude that PcjO2 monitoring combined with repeated arterial blood gas analysis may be used to titrate PEEP therapy in patients with adult respiratory distress syndrome. In patients whose CjI significantly decreases because of PEEP, PA catheterization and measurement of cardiac output are indicated because of the likelihood of a significant (greater than 15%) decrease in CI. In the absence of a significant decrease in the CjI, optimum PEEP occurs at the level producing maximum PcjO2. It is hoped that by following the described algorithm, many patients will be spared the cost and morbidity of unnecessary PA catheterization. PMID- 3547740 TI - [Not a great but an important anniversary]. PMID- 3547741 TI - [Nurses make plans for their own continuing education]. PMID- 3547742 TI - [The principle program is a compass for finding new ways]. PMID- 3547743 TI - [Health policy. A new distribution of the Copenhagen health visitors]. PMID- 3547744 TI - [Cellular and subcellular mechanisms of action of cardiac glycosides]. PMID- 3547745 TI - [Digitalis poisoning and its treatment]. PMID- 3547746 TI - [Diabetes mellitus--immunologic aspects]. PMID- 3547747 TI - [Efficacy of captopril in the treatment of patients with severe forms of chronic heart failure]. AB - A study was made of the efficacy of captopril used alone and in combination with cardiac glycosides in 20 patients with stage IIB congestive heart failure. The patients' clinical status and changes in some indices of hemodynamics and external respiratory function were taken into account. A single use of the drug improved the clinical status and indices of hemodynamics and external respiratory function in the patients. The most noticeable clinical effect was achieved with the combined use of cardiac glycosides, diuretics and captopril. PMID- 3547748 TI - [Changes in peripheral hemodynamics and platelet aggregation during captopril treatment of patients with chronic circulatory failure]. AB - A total of 18 patients with chronic congestive heart failure were examined using an acute pharmacological test (25-50 mg of captopril) and during 2-week course treatment. A marked positive effect of the drug was noted in 15 (83.3%) patients. Captopril significantly decreased venous tone by 19.0 +/- 2.4% and by 40.4 +/- 4.1% and regional vascular resistance by 25.7 +/- 1.9% and by 39.4 +/- 2.9% in the acute test and in course treatment, respectively. Microcirculatory indices also improved: there was an increase in tissue oxygenation (PO2 by 38.8 +/- 2.7%), oxygen supply rate and small arteriolar function (more pronounced in course treatment). Platelet aggregation in the captopril acute test was slightly decreased but in course treatment it did not significantly differ from the initial one. A conclusion was made that captopril, mostly in course treatment, decreased venular and arteriolar tone and improved microcirculatory processes making an insignificant effect on platelet aggregation permitting its recommendation for prolonged treatment of patients with chronic congestive heart failure with minimum risk of complications. PMID- 3547749 TI - [Plasma renin activity and aldosterone concentration of patients with congestive cardiomyopathy]. AB - Blood plasma aldosterone concentration and renin plasma activity were studied in 30 patients with congestive cardiomyopathy and in 41 patients with congestive heart failure resulting from CHD or valvular heart disease using a radio immunoassay. In congestive cardiomyopathy as well as in congestive heart failure of another etiology an increase in plasma renin activity was noted in single cases in stages IIA and IIB and in most patients with stage III congestive heart failure. Changes in plasma aldosterone concentration with relation to stages of congestive heart failure were unidirectional in both groups of examinees. There was no correlation between plasma renin activity and aldosterone concentration. The study has shown that in congestive cardiomyopathy shifts in the renin angiotensin-aldosterone system are of the same nature as in patients with congestive heart failure of another etiology. PMID- 3547750 TI - [The new basic agent prospidin in the therapy of rheumatoid arthritis. An evaluation of the clinical effectiveness and the mechanism of action of prospidin]. AB - A therapeutic effect of prospidine, a Soviet antitumor drug, was studied on the basis of clinicoimmunological correlations in 74 patients with proved rheumatoid arthritis (RA) who were resistant to well known basic drugs. It was administered parenterally and intraarticularly according to the methods developed by the authors, and its effect on the indices of T- and B-immune response was studied. Prospidine was shown to possess a true and high (91.8%) antirheumatic activity producing an analgesic, antiexudative and antiproliferative effect; it was capable of lessening hormone dependence and causing remission bringing about no serious side-effects which could require discontinuation of therapy. At the same time the use of the drug resulted in an elevation of the level of T-suppressors, a decrease in the amount of B-cells, T-helpers, titers of the rheumatoid factor, antisynovial antibodies, cytopathic and lymphokine synthesizing activity. Its mechanism of action and indications for use were discussed. Prospidine was considered as a drug of choice in drug therapy of rheumatoid arthritis. PMID- 3547751 TI - [Mitral valve insufficiency of nonrheumatic etiology]. PMID- 3547752 TI - [Rheumatoid lesion of the heart]. PMID- 3547753 TI - [Acute radiation sickness]. PMID- 3547754 TI - [Insulin, cortisol and somatotropic hormone content of the blood in ischemic heart disease patients with varying tolerance for physical loading and varying myocardial contractile capacity]. PMID- 3547755 TI - [Evaluation of the use of ultrasonic cardiac scanning for the diagnosis of myocardial infarct and unstable stenocardia]. AB - Basing on an analysis of left ventricular myocardial segmental contractility (according to the results of ultrasonic scanning) diagnostic criteria have been defined for patients with myocardial infarction and unstable angina to detect these diseases on the 1st day of a patient's stay in the in-patient department and to diagnose myocardial infarction when findings of electrocardiography and enzymatic diagnostics provide little information. PMID- 3547756 TI - Nasal response of rhinitic and non-rhinitic subjects to histamine and methacholine: a comparative study. AB - The nasal responses to provocation with histamine and methacholine were compared in 20 subjects with and 20 without rhinitis. Two variables were measured: nasal airways resistance and the development of rhinorrhoea. Histamine had a greater effect than methacholine in increasing nasal airways resistance while the converse was true for rhinorrhoea. Rhinitic subjects had a significantly greater response to histamine induced changes in nasal airways resistance (p less than 0.05), rhinorrhoea (p less than 0.05) and methacholine induced rhinorrhoea (p less than 0.01) than those without rhinitis. No significant differences were found between the two groups in methacholine induced changes in nasal airways resistance. The findings show that, like the lower airways of patients with asthma, the nasal mucosa of rhinitic subjects shows a greater responsiveness to non-specific agonists than that of non-rhinitic subjects. PMID- 3547757 TI - Comparison of two high dose corticosteroid aerosol treatments, beclomethasone dipropionate (1500 micrograms/day) and budesonide (1600 micrograms/day), for chronic asthma. AB - Twenty eight patients with chronic asthma took part in a double blind single crossover controlled trial of inhaled budesonide and inhaled beclomethasone dipropionate, using high doses of 1600 micrograms and 1500 micrograms daily respectively. Both drugs were administered by pressurised aerosol inhaler; the inhaler containing budesonide and its matching placebo were fitted with a collapsible spacer device. There was no significant difference in the control of asthma during the two six week treatment periods. There was no significant difference in FEV1 and forced vital capacity after four and six weeks of treatment or in mean morning and evening peak expiratory flow rates for the last 21 days of treatment. There was a small but statistically significant reduction in the daytime wheeze score while they were taking high dose budesonide but there was no difference for daytime activity, cough, and night symptoms. The mean basal cortisol concentrations were significantly lower after six weeks of high dose treatment than before treatment (budesonide p less than 0.01, beclomethasone p less than 0.05). There was no difference between mean basal cortisol values after six weeks of high dose treatment, and there was no effect on the rise of cortisol obtained after a short tetracosactrin test. High dose inhaled corticosteroids produced few side effects and were well tolerated. PMID- 3547758 TI - [Drug prevention in duodenal ulcer. A placebo-controlled trial with ranitidine]. PMID- 3547760 TI - [Classical article. Current viewpoint of the theory of natural immunity. By H.J. Hamburger, 1898]. PMID- 3547759 TI - [Survey in heart transplant patients]. PMID- 3547762 TI - [Classical article. An observation on neurotomy in horses. By J.B.H. Moubis. 1876]. PMID- 3547761 TI - [The use of 'enriched' colostrum in the prevention of neonatal calf diarrhea caused by E. coli K99]. PMID- 3547764 TI - [Classical article. Canine distemper (canine epizootic catarrhal fever). By J.C. van der Slooten. 1894]. PMID- 3547763 TI - [Classical article. Various observations on neurotomy. By J.B.H. Moubis. 1878]. PMID- 3547765 TI - [Puberty induction using pulsatile LHRH administration]. AB - Puberty is a maturational process of the hypothalamo-pituitary-gonadal axis resulting in growth and development of the genital organs and concomitantly physical changes. All these changes are the result of an increasing activity of the pituitary and consequently of the gonads caused by increased stimulation by the luteinizing hormone-releasing hormone (LHRH). Delayed puberty is a common problem in contrast to true hypogonadotropic hypogonadism. Since a few years pulsatile LHRH administration is applied to induce pubertal development in hypogonadotropic boys. Except for virilisation, development of the testes including spermatogenesis can be achieved. In contrast to boys, substitution with sex steroids brings about a satisfactory physiologic development of the sex characteristics in girls. The physiology and disorders of pubertal development as well as this new LHRH treatment to induce puberty will be discussed in this paper. PMID- 3547766 TI - [Ambulatory treatment and monitoring of children with insulin-dependent diabetes mellitus (IDDM)]. AB - In recent years diabetes research has made substantial progress. Insight in epidemiology, aetiology, patho-physiology of diabetes and pharmacokinetics of insulin is increased. Furthermore the development of self-monitoring has changed the management of diabetes. In this paper the consequences of this progress for modern ambulatory treatment of diabetes in childhood are discussed. PMID- 3547767 TI - ["Cancer eye" in German spotted cattle. Occurrence, treatment methods and results]. AB - Incidence, therapy and outcome of bovine ocular squamous cell carcinoma are reported on the basis of 128 cases seen in Fleckvieh cows over a period of 15 years. Of the cases observed, 112 were treated surgically. Of 70 patients checked between 6 and 31 months post op. 56 (80%) remained tumor free. Prerequisites of successful treatment of periocular neoplasms include early recognition, preferably in early stages, and immediate removal. PMID- 3547768 TI - [Hypoglycemia in puppies and young dogs, especially in toy breeds]. AB - This article deals with diseases producing hypoglycemia in juvenile dogs, especially in toy breeds. This leads to a life-threatening condition, which has to be recognized and treated as quickly as possible to prevent irreversible brain damage. Pathophysiological mechanisms of transient juvenile hypoglycemia and persistent forms of hypoglycemia in young dogs are discussed. PMID- 3547769 TI - [Veterinary aspects of raising chimpanzees]. AB - The problems involved in chimpanzee husbandry are mainly baised on their behaviour, intelligence and psychical sensitivity. The most suitable species specific conditions of keeping, feeding and veterinary welfare are fundamental demands for physical and mental health as well as for successful reproduction of chimpanzees living in captivity. In spite of different possibilities and motives of chimpanzee husbandry in each particular case, the general statements given in this article may be useful concerning these requirements. PMID- 3547770 TI - [Changes in laboratories in small animal practice]. AB - Economical considerations have led to a reduction of laboratory analysis. In particular, photometric examinations are rarely carried out in private practice because of its high level of personal labour intensive quality controls and the rapid decay of reagents. Nowadays, analyses are more and more carried out in commercial laboratories which can operate at considerably lower costs. Especially the loss of time until results can be obtained is an intolerable disadvantage which is particularly serious in emergency cases. Often too much time passes before an equivalent therapy can be started. Instead of the diagnosis in presence, i.e. direct sequence of anamnese, clinical investigation and laboratory diagnostic should be aimed at. The most common types of laboratory tests are instant semiquantitative methods with dry reagent strips for measuring blood sugar and urea. Very recently on the market are reflectance photometers which allow to determine blood parameters with dry chemical carriers. The systems Ektachem DT60, Reflotron and Seralyzer are presented. The use of this dry chemistry could reestablish the laboratory in the private small animal practice again. PMID- 3547771 TI - Establishment of six human pancreatic cancer cell lines and their sensitivities to anti-tumor drugs. AB - Six human pancreatic cancer cell lines PK-1, -8, -9, -12, -14 and -16, were established. They originated from either primary pancreatic cancer biopsy or liver metastasis biopsy, or xenografts of these biopsy specimens in athymic nude mice. The primary tumors were all well differentiated adenocarcinomas of pancreatic duct origin. The six established PK cell lines were all CEA positive and had tumorigenicity in athymic nude mice. Morphology of the xenografted tumors was closely similar to that of the original tumor. PK cells grew slowly with the doubling time of 41.3 to 82 hr and showed aneuploid chromosome pattern. High levels of glucose-6-phosphate dehydrogenase (G6PDH) and lactic dehydrogenase (LDH) were found in each cell extract. Trypsin was not detected in cell extracts except PK-8 and PK-9. In chemosensitivity test, all of PK cell lines were sensitive to aclacinomycin A (ACM), and PK-1 and PK-8 were sensitive to 5 Fluorouracil (5-Fu) at concentrations of 0.02 microgram/ml, ACM and 1 microgram/ml, 5-Fu, when the drugs were used for over 48 hr. At higher concentrations, they showed time independent sensitivity to mitomycin C (MMC). PK 9 was resistant to 5-Fu and MMC. PMID- 3547772 TI - Stability of endotoxin detected in human plasma against endotoxin-inactivating factor (EIF): quantitative analysis of EIF using chromogenic endotoxin assay. AB - Using a quantitative blood endotoxin assay utilizing chromogenic substrate coupled with perchloric acid pretreatment (PCA-LCT), we showed the presence of endotoxin-inactivating factor (EIF) in human plasma in vitro. EIF activity inactivated added endotoxin to about 10(-4) of the initial level within 20 min, followed by a stable phase where the residual endotoxin became resistant to EIF and was not further inactivated. The residual endotoxin may represent the endotoxin in patient plasma which is also EIF resistant. We postulate that endotoxin, upon entering the blood, is rapidly inactivated by chemical modification of its active site, lipid A, through EIF. Subsequently, inactivated endotoxin, mainly consisting of polysaccharide, is gradually removed from circulation by endocytosis in the reticuloendothelial system. PMID- 3547774 TI - Absence of antibodies to human immunodeficiency (AIDS) virus in dental health care workers in Johannesburg. PMID- 3547773 TI - Alkylformamides as inducers of tumour cell differentiation--a mini-review. AB - The induction of terminal differentiation in tumour cells represents a possible therapeutic strategy for treating cancer. The alkylformamides are 1 group of experimental compounds which have been shown to induce terminal differentiation in human HL-60 leukemia and murine Friend erythroleukemia cells in vitro. Their mechanism of action is unknown. Dimethylformamide has been used as a model inducer in carcinoma and fibroblastic models. Analysis of the relationship between structure and inducing activity of the alkylformamides in vitro reveals that no specificity of structure exists and that their properties as inducers of terminal differentiation extend to related compounds, e.g. the alkylacetamides and alkylureas. This is in contrast to the marked specificity of N methylformamide (NMF) as an in vivo antitumour agent. The potency of these compounds as inducers of differentiation is predictable and correlated with their molecular weight. High concentrations of NMF are required to induce differentiation in vitro and these concentrations are not achievable in vivo. However, while NMF is unlikely to be a useful inducer in vivo many of its higher MW analogues are very much more potent as inducers in vitro and yet no more toxic (to the host) in vivo. Some of these (e.g. tetramethylurea or 1,3-dimethylurea) may be capable of achieving inducing concentrations in vivo. PMID- 3547775 TI - A resin bonded natural autogenous-toothed immediate fixed bridge. PMID- 3547776 TI - The influence of desipramine on the blood pressure elevation and heart rate stimulation by levonordefrin and felypressin alone and in the presence of local anaesthetics. PMID- 3547777 TI - [Experimental studies on metal-plastic combinations]. PMID- 3547778 TI - [Noise exposure and time expenditure during various grinding and rotary instrument use in cast crown preparations]. PMID- 3547779 TI - [An uncommon finding and its prosthetic rehabilitation]. PMID- 3547780 TI - [History of dental history education in universities in the 19th and 20th century]. PMID- 3547781 TI - [Prosthetic treatment in children and adolescents]. PMID- 3547782 TI - Simple, rapid 125I-labeled cyclosporine double antibody/polyethylene glycol radioimmunoassay used in a pediatric cardiac transplant program. AB - We modified the Sandoz cyclosporine radioimmunoassay because of our need for frequent clinical monitoring of cyclosporine drug levels in allo- and xenograft pediatric cardiac transplant patients. With application of a commercially available [125I]cyclosporine label in place of [3H]cyclosporine and a second antibody/polyethylene glycol (PEG) method of separation in place of charcoal separation, we simplified and enhanced the speed and precision of assay performance. Studies of 140 whole blood samples comparing this new method to the [3H]cyclosporine radioimmunoassay (RIA) method of Berk and colleagues yielded a coefficient of correlation of 0.96 (p less than 0.00001) with means of 626 and 667 ng/ml for [3H]RIA and [125I]RIA, respectively, and a regression equation of y = 28 + 1.02x. The major advantages are that total assay time is reduced to approximately 1 h; [125I]cyclosporine label is used, avoiding the problems associated with liquid scintillation counting; and precision is enhanced by separating bound and free fractions with second antibody/PEG. These modifications should provide for greater ease of assay performance and improved clinical utility of cyclosporine monitoring not only in the pediatric but also in the adult transplant patient. PMID- 3547783 TI - Discovery of phenytoin. AB - Numerous letters and reports located in the Parke, Davis and Smithsonian files add to the story of Merritt's and Putnam's discovery of the anticonvulsant (AC) properties of phenytoin. The major events preceding this work were the fortuitous discovery of phenobarbital as an AC agent, structure/hypnotic activity studies with barbiturates and hydantoins in the early 1920s by A. W. Dox in the Parke, Davis laboratories, and the development of AC assay techniques in animals, by a number of laboratories. Phenytoin was the first item on the list of compounds sent to Putnam by Dox and W. G. Bywater in April 1936. It was found to have AC properties in animals late in 1936, but no public reports were issued until the following year. Clinical efficacy was established in 1937, but no public reports were issued until 1938. Dilantin sodium capsules were prepared by Parke, Davis & Co. and were ready for marketing the same year. PMID- 3547784 TI - Aphakic and pseudophakic cystoid macular edema: perifoveal hemorrhages. PMID- 3547785 TI - Red cell alloantibodies produced after bone marrow transplantation. AB - This article describes the production of red cell alloantibodies in 13 of 150 patients after bone marrow transplantation. New alloantibodies appeared 12 days to 11 months after the transplantation. The specificities of these antibodies were anti-N, -Jka, -E-like, -Kell-like, -M, -Leb, -Hl, -H and -A1. The posttransplantation production of antibody could be due to either the transfusion of mature lymphocytes along with the marrow, the ability of the grafted immune system to produce alloantibodies, or the viable immunocompetent cells remaining despite high-dose chemotherapy and irradation. PMID- 3547786 TI - Mechanism of action of cyclosporine in preventing cardiac allograft rejection. I. Rate of entry of lymphocytes from the blood, fibrin deposition, and expression of Ia antigens on infiltrating cells. AB - The rate of entry of 3H-leucine-labeled lymphocytes was monitored in cyclosporine (CsA) treated or untreated rats that had received a cardiac allograft 5 days previously. In the untreated recipients there was a preferential localization of labeled cells in the graft heart compared with the native heart, which was evident within the first hour as well as at 3 and 24 hr after injection. In CsA treated recipients, the rate and extent of entry of lymphocytes in the graft heart was not substantially different from the native heart. Fibrin deposition within allografts, thought to be a consequence of T cell activation, was substantially reduced by CsA treatment of the recipients. A double immunoenzyme staining technique was used to identify Ia-positive macrophages and Ia-positive T cells in cryostat sections of grafts: although the number of macrophages and T cells was reduced in CsA treated recipients, there was no difference in the extent to which these cells were Ia-positive. PMID- 3547787 TI - Mechanism of action of cyclosporine in preventing cardiac allograft rejection. II. Graft tissue levels of prostacyclin and thromboxane. AB - Four cyclo-oxygenase products (COP) of arachidonate were measured in tissue homogenates of rat cardiac allografts at intervals after transplantation. In rejecting graft tissue, there was a progressive decrease in the levels of prostaglandin E2 (PGE2) and PGF2 alpha from the time of grafting, which was accompanied by a rise in the levels of prostacyclin (PGI2, measured as its stable hydrolysis product 6-oxo-PGF1 alpha) and thromboxane A2 (TxA2, measured as its stable hydrolysis product TxB2). When the level of each individual COP in rejecting graft tissue was expressed as a percentage of the total COP measured, PGI2 and TxA2 increased from 9% to 36% and from 7% to 25%, respectively, from day three after grafting until the time of graft rejection. In contrast to these changes in COP levels in rejecting grafts, the levels of all four COP in nonrejecting allografts maintained by treatment of the graft recipients with cyclosporine remained normal--i.e., comparable to the levels in the recipients' own hearts. PMID- 3547788 TI - Urinary thromboxane excretion in cardiac allograft rejection in immunosuppressed rats. AB - Increased urinary excretion of immunoreactive thromboxane B2 (iTxB2) was found to have a high predictive value, with high sensitivity as an indicator of cardiac allograft rejection in both the immunosuppressed and nonimmunosuppressed rat. In the animals receiving an allograft, urinary iTxB2 excretion significantly increased prior to the onset of rejection, remained elevated, and returned to basal values following completion of the episode. Urinary iTxB2 remained at baseline values in the control animals. The association between rejection and iTxB2 excretion was preserved regardless of the presence or nature of immunosuppression. Urinary iTxB2 excretion increased significantly prior to the reduction of graft beat or histological evidence of rejection. Evaluation of urinary iTxB2 monitoring as a noninvasive indicator for surveillance of clinical cardiac allograft rejection appears to be warranted. PMID- 3547789 TI - Short-term changes in blood ketone body ratio in the phase immediately after liver transplantation. AB - Arterial blood ketone body ratio was measured after orthotopic liver transplantation in piglets. Ketone body ratio immediately decreased at the beginning of the anhepatic phase and was rapidly restored to the normal levels within 30 min after the revascularization of the allograft. Serum lactate and pyruvate levels increased in anhepatic phase and gradually decreased after revascularization. Changes in the lactate and pyruvate levels were always preceded by changes in ketone body ratio. In the case of transplantation after 12 hr-preservation of the allograft, ketone body ratio failed to maintain normal levels after transplantation, resulting in a high mortality. It is suggested that the elevation of decreased ketone body ratio is prerequisite for the normalization of the deranged metabolic state after liver transplantation, and that ketone body ratio provides an accurate means to assess the initial metabolic function of the allograft. PMID- 3547790 TI - Prednisolone and posttransplantation hypertension in rat renal allograft recipients. AB - Rat recipients of renal allografts and unilaterally nephrectomized control rats were studied to evaluate the response in blood pressure to prednisolone in diverse doses, and to determine the dosage required to achieve adequate immunosuppression without undue complication of hypertension. While a continuous infusion of 2 mg/kg/day or more of prednisolone proved effective in prolonging allograft survival time, this dosage increased the blood pressure of recipients as well as unilaterally nephrectomized control rats. In contrast to control rats, the recipients remained hypertensive after the cessation of prednisolone administration. This suggests that the high blood pressure observed during prednisolone administration was due to its hypertensive action. On the other hand, the high blood pressure remaining after cessation of the prednisolone administration is likely to be caused by an incomplete prevention of rejection. If recipients had received a transfusion of donor-strain blood prior to transplantation in combination with the infusion of 2 mg/kg/day or more of prednisolone, they became normotensive when the prednisolone infusion was ceased. By reducing the prednisolone dosage to 1 mg/kg/day in combination with donor strain blood pretreatment, hypertension could also be eliminated during the first two weeks. In conclusion, effective immuno suppression can be achieved with prednisolone in rats, without inducing hypertension, provided prednisolone is administered at a low dosage in combination with adjuvant immunosuppression- i.e., donor-strain blood pretreatment. PMID- 3547791 TI - Hypothermic preservation of the rat liver assessed by orthotopic transplantation. II. Evaluation of citrate solutions. AB - Rat livers were flushed with isotonic citrate solution (IC), hypertonic citrate solution (HC), or Collins' solution (C2), and were stored at 0 degree C for 8-16 hr. Following 8-hr preservation, the number of animals surviving for one month was greatest with IC grafts (6/8) and least with C2 grafts (2/7). There was no significant difference between the two citrate groups. Following 12-hr preservation, the IC group was superior to the HC group (3/6 vs. 1/6). Following 16-hr preservation, all four animals in each citrate group died within 24 hr. The ability of livers to produce bile was greater in the citrate groups, compared with the C2 group. A bile flow rate less than 0.3 microliter/min/g liver, 15 min after implantation, appeared to predict subsequent poor survival. There were no significant histological differences between biopsies taken from each group at the end of the transplant operation. Biochemical measures of liver function were best in animals that had received IC grafts, and functional damage after preservation was consistently greater in the C2 group than the citrate groups. The best results were obtained with grafts preserved with IC solution. PMID- 3547792 TI - Orthotopic transplantation of partially hepatectomized liver in the pig. AB - One of the major technical obstacles to liver transplantation in children is to find a liver of appropriate size because of the rarity of child donors. To overcome this difficulty an experimental study was carried out using only a portion of the donor liver (right liver) transplanted orthotopically in pigs. A group of 15 allotransplants were performed. A left hepatectomy of the liver graft was performed ex situ and the right liver amounted to 55% of the whole liver. A total of 13 animals survived for more than 5 days (5 to 30 days, with an average of 16). Upon killing, the liver weight was considerably more than that of the part transplanted. The absence of technical complications suggests that this procedure is safe and feasible. PMID- 3547793 TI - Immunological and clinical observations in diabetic kidney graft recipients pretreated with total-lymphoid irradiation. AB - In a feasibility study, twenty patients with end-stage diabetic nephropathy were treated with fractionated total-lymphoid irradiation (TLI, mean dose 25 Gy), before transplantation of a first cadaveric kidney. During radiotherapy, only one patient had a serious side effect (bone marrow depression). After transplantation four patients died (one of a myocardial infarction, one of ketoacidosis, and two of infections occurring during treatment of rejection crises). One graft was lost because of chronic rejection. The other 15 patients have a functioning graft (mean follow-up 24 months) and receive low-dose prednisone alone (less than 10 mg/day, n = 11) or in conjunction with cyclosporine (n = 4) as maintenance immunosuppressive therapy. A favorable clinical outcome after TLI (no, or only one, steroid-sensitive rejection crisis) was significantly correlated with a high pre-TLI helper/suppressor lymphocyte ratio, a short interval between TLI and the time of transplantation, and the occurrence of functional suppressor cells early after TLI. The most striking immunological changes provoked by TLI consisted of a long-term depression of the mixed lymphocyte reaction and of the phytohemagglutinin, and Concanavalin A or pokeweed-mitogen-induced blastogenesis. A rapid and complete recovery of the natural killer cell activity was observed after TLI. A permanent inversion of the OKT4+ (T helper/inducer) over OKT8+ (T suppressor/cytotoxic) lymphocyte ratio was provoked by a decrease of the OTK4+ subpopulation, together with a supranormal recovery of the OKT8+ lymphocytes. A majority of the latter lymphocytes did also express the Leu 7 and the Leu 15 phenotype. PMID- 3547794 TI - The impact of high lymphocyte sensitivity to glucocorticoids on kidney graft survival in patients treated with azathioprine and cyclosporine. AB - Lymphocyte sensitivity to methylprednisolone (MP) was examined in 70 consecutive cadaver kidney recipients: 36 recipients were given prednisolone and azathioprine (Aza), while 34 patients received prednisolone and cyclosporine (CsA). Peripheral blood lymphocytes (PBL) isolated just before transplantation, and again 6-12 hr after transplantation and i.v. administration of 120 mg of MP were stimulated with phytohemagglutinin (PHA). The observation period for all recipients was six months. In vivo, administration of MP was followed by a significant (P less than 0.02) decrease in the mitogen response of lymphocyte cultures from Aza-treated patients with graft function (n = 23) at six months. In contrast, the mitogen response of lymphocyte cultures from patients with graft failure (n = 13) did not decrease. Lymphocyte cultures from CsA-treated patients with graft function (n = 26) were not more responsive to i.v. MP than cultures from recipients who lost their grafts (n = 8). In vitro, the dose-response curves to MP were examined in pretransplant PHA cultures. The lymphocyte cultures from Aza-treated patients with graft function were 20 times more sensitive to MP than those of patients with graft failure at six months. The difference was highly significant (P = 0.005). Lymphocyte cultures from CsA-treated patients who maintained graft function were 12 times more sensitive to MP than cultures from recipients who lost their grafts (P = 0.02). Thus, in vivo and in vitro lymphocyte sensitivity to MP, which can be examined before transplantation, is suggested to have an important influence on the graft survival of azathioprine-treated patients. Furthermore, this effect is partly modified by treatment with cyclosporine. PMID- 3547795 TI - Selective reduction of donor-specific cytotoxic T lymphocyte precursors in patients with a well-functioning kidney allograft. AB - We have recently developed a sensitive limiting dilution (LD) culture system to measure human alloreactive cytotoxic T lymphocyte precursors (CTL-p) in a given lymphoid cell population. We have now used this system to determine frequencies of donor HLA antigen-inducible CTL-p in the peripheral blood of human allograft recipients at various stages after transplantation. All patients (1 pancreas recipient and 9 kidney recipients) were on continuous cyclosporine treatment throughout the study. We report that, in patients with a well-functioning kidney graft (6/9), the number of donor-reactive CTL-p among peripheral blood lymphocytes decreased within 3-8 months after transplantation--in some cases (2/6) more than 10-fold. In contrast, frequencies of CTL-p with specificity for third-part HLA antigens remained largely unaltered in these patients. Furthermore, no decrease of donor-reactive CTL-p frequencies was seen in 3 of 4 patients showing clinical symptoms of graft rejection. These results indicate that functional clonal deletion of antigraft-reactive CTL-p may contribute to the state of graft tolerance in certain patients with a well-functioning kidney allograft. PMID- 3547796 TI - Allogeneic bone marrow transplantation for acute lymphoblastic leukemia during first complete remission. AB - Patients with acute lymphoblastic leukemia who have poor prognostic features at diagnosis usually have a short disease-free survival in spite of successful remission induction. Those poor risk features are: age over 30 years, a white blood cell count over 25,000/microliter, certain translocations of chromosomes, and requirement for more than six weeks of induction chemotherapy to attain a complete remission. We have used high-dose radiochemotherapy to prepare 39 patients with acute lymphoblastic leukemia in first complete remission (1 infant and 38 adults; median age 23 years) for bone marrow transplantation from histocompatible sibling donors. Thirty-one of the 39 patients in this study had one (n = 23) or more (n = 8) poor risk features: age (n = 7); high white blood cell count (n = 19); translocations (n = 4), or resistance to initial induction therapy (n = 11). Currently, 26 patients are surviving for 4-72 months (median 18 months) following marrow grafting and are in complete remission. One of the surviving patients had two marrow transplant procedures because of recurrent leukemia. Actuarial survival in complete remission is 63% for the entire group of 39 patients and is 60% if the eight patients who had no poor risk features are excluded from analysis. The following causes for failure were observed: leukemic relapse was encountered in four patients between 3 and 17 months after BMT for an actuarial relapse rate of 16%; bacterial sepsis was the cause of death in two patients; graft-versus-host disease and/or interstitial pneumonia led to the demise of seven patients, and one patient died with leukoencephalopathy. It appears that high-dose radiochemotherapy followed by bone marrow transplantation from a histocompatible sibling donor during first complete remission can result in a high disease-free survival rate for younger adults with poor-risk acute lymphoblastic leukemia. This concept needs to be tested in prospective trials comparing bone marrow transplantation with chemotherapy. PMID- 3547797 TI - Different specificities of cloned T cells assessed by in vitro proliferation assays and by the ability to mediate skin graft rejection in vivo. AB - The experiments presented here have compared the specificities of T cell clones as determined by in vitro proliferative responses and their specificities as reflected by their ability to mediate skin graft rejection in vivo. Two proliferative T cell clones with distinct in vitro specificities were evaluated for their ability to mediate rejection of skin grafts from C57BL/10 Scn nu/nu mice. Clone 14.11 (L3T4+, Lyt2-) was specifically stimulated to proliferate in vitro by I-Ad determinants, while clone 3.3.10 (also L3T4+, Lyt2-) recognized M1sa products in the context of MHC-encoded cell surface determinants. The results demonstrate that both clone 14.11 and clone 3.3.10 T cells are capable of mediating rejection of DBA/2 (H-2d, M1sa) skin grafts from B10 nu/nu mice. Surprisingly, neither clone 3.3.10 T cells nor clone 14.11 T cells were found to be effective at rejecting skin grafts from the D1.C congenic donor strain of mice (also H-2d, M1sa) from B10 nu/nu mice. Further, clone 14.11 T cells were also found to be ineffective at rejecting B10.D2 (H-2d, M1sb) skin grafts from B10 nu/nu mice. These data indicate the existence of a striking dichotomy between the specificity of alloreactive T cell clones as determined by in vitro proliferation studies and their functional capabilities in vivo. PMID- 3547798 TI - Interferon alpha/beta synthesis during acute graft-versus-host disease. AB - Graft-versus-host disease (GVHD) is a major obstacle to successful bone marrow transplantation. The role of interferon (IFN) in GVHD is currently unclear. We have previously shown that interferon (IFN) is produced in vitro by alloantigen stimulated murine bone marrow cells. This study was initiated to examine whether IFN production occurs in vivo during GVHD. Lethally irradiated mice were given bone marrow (10(7)) and/or spleen cells (2 X 10(7)) from either allogeneic or syngeneic mice. Mice given allogeneic spleen cells or bone marrow and spleen cells showed signs of GVHD within 10 days and usually died within 20 days of transplantation. Mice undergoing GVHD were found to have significant levels of IFN activity in their sera. Serum IFN was detected early (day 3) after transplantation with optimal IFN activity (greater than or equal to 80 units) occurring at 5-6 days. The IFN activity present in the sera obtained from mice with GVHD was identified as IFN alpha/beta by using specific antisera against IFN alpha/beta and IFN gamma. In contrast, irradiated mice given T-cell-depleted allogeneic bone marrow and spleen cells failed to develop GVHD and had no detectable serum IFN activity. Irradiated mice given syngeneic bone marrow and spleen cells or only allogeneic bone marrow cells did not develop GVHD and did not produce detectable IFN activity in their sera. These results show that serum IFN activity correlates well with GVHD and opens for speculation the possibility that IFN may be involved in the pathogenesis associated with GVHD. PMID- 3547799 TI - Enhancement of heterotopic cardiac allograft survival by experimental biliary ligation. PMID- 3547800 TI - Rapid separation of whole human bone marrow aspirates by counterflow centrifugation elutriation. PMID- 3547801 TI - The effect of T subset depletion on the incidence of lethal graft-versus-host disease in a murine major-histocompatibility-complex-mismatched transplantation system. PMID- 3547802 TI - The influence of pretransplant blood transfusions and uremia on cardiac allograft survival in histoincompatible rats. PMID- 3547803 TI - Long-term normalization of resistant renal hypertension after embolization of host kidneys in a transplanted patient--a case report. PMID- 3547804 TI - Reduced monocyte-associated fibronectin in patients after allogeneic marrow transplantation. PMID- 3547805 TI - Alternate-day cyclosporine. Allograft and antibody immunosuppression. PMID- 3547806 TI - Lipid inclusions in hepatocyte grafts. PMID- 3547807 TI - Liver transplantation. PMID- 3547808 TI - Optimal use of cyclosporine in clinical organ transplantation. PMID- 3547809 TI - Prospective HLA typing is helpful in cadaveric renal transplantation. PMID- 3547810 TI - Prospective HLA typing is helpful in cadaveric renal transplantation--maybe? PMID- 3547811 TI - Improved kidney graft survival in nontransfused recipients. PMID- 3547812 TI - Problems facing the society today. PMID- 3547813 TI - Donor-specific blood transfusions versus cyclosporine--the DST story. AB - DST provides excellent graft survival in one- and zero-haplotype-matched donor recipient pairs as well as a trend towards improving graft survival in HLA identical matches; serum creatinine levels are good in functioning grafts; Imuran coverage does appear to decrease DST sensitization to the blood donor in nonsensitized patients undergoing a first transplant, which encourages early DST and transplantation in this group; flow cytometry has been extremely helpful in excluding subliminal anti-class 1 antigen activity in patients with positive B warm crossmatches alone; DST, in itself, does not appear to preclude subsequent cadaveric transplantation in patients sensitized to their blood donor; and the family history of the blood donor is known, with essentially no risk to the recipients of hepatitis, AIDS, etc. In regards to the issue of whether DST or Cs is better, both have merits, and one must be aware of the circumstances that relate to the optimum application of each therapy. Only a prospective study of DST- and Cs-treated patients with a long-term follow-up will probably resolve the issue of the optimum regimen for one-haplotype-matched living related donor recipient pairs. The ultimate strategy may involve the selective use of each regimen for the most appropriate circumstances. PMID- 3547814 TI - Living donor kidney transplantation. PMID- 3547815 TI - Genetically determined variation of constitutive major histocompatibility complex class II antigen expression in various rat strains and cell types. PMID- 3547816 TI - Evidence for dendritic cell-lymphocyte clustering in vivo. PMID- 3547818 TI - Blood group ABO-incompatible kidney transplantation biochemical and immunochemical studies of blood group A glycolipid antigens in human kidney and characterization of the antibody response (antigen specificity and antibody class) in O recipients receiving A2 grafts. PMID- 3547817 TI - Early disappearance of donor-specific immunofluorescence in spontaneously tolerated liver allografts in inbred rats. PMID- 3547819 TI - Purification of canine sinusoidal lining cells by centrifugal elutriation and their possible role in liver allograft rejection. PMID- 3547820 TI - Strategies used to alter the immunogenicity of vascularized organ allografts. PMID- 3547821 TI - Effect of Langerhans' cells on cytotoxic T lymphocyte responses to major and minor alloantigens expressed on heterotopic corneal allografts. PMID- 3547822 TI - Phenotypic analysis of graft infiltrating cells and major histocompatibility complex expression in actively enhanced rat renal allografts. AB - In this study donor specific blood transfusion of PVG recipients prevented rejection of DA strain kidneys but, paradoxically, failed to prevent the rapid and progressive accumulation of large numbers of mononuclear cells within enhanced grafts. Morphometric analysis showed that the percentage cellular infiltrate at day 3 was significantly greater in enhanced than in rejecting grafts but a notable feature in the phenotypic analysis of day 5 infiltrates was a markedly reduced number of MRC OX8 positive cells (Tc/s and NK cells) in enhanced grafts. Both rejecting and enhanced allografts showed a marked induction not only of class I but also of class II MHC antigens, and quantitative absorption analysis of donor class I MHC antigens indicated that induction occurred more rapidly in enhanced grafts. Taken together, these findings suggest that blood transfusion sensitizes the recipient, resulting in a more rapid allograft response, but that even in the presence of massive MHC/antigen induction and large numbers of infiltrating cells, immunoregulatory mechanisms are able to suppress the rejection response. PMID- 3547823 TI - Phenotype and patterns of inflammatory cell infiltration associated with rejection or acceptance of rat liver allografts. PMID- 3547824 TI - Enzyme histochemical study of cardiac allografts in rats. PMID- 3547825 TI - Leukocyte subsets infiltrating fully allogeneic, long-surviving rat liver allografts. PMID- 3547826 TI - Attenuation of immunologic memory in canine recipients hyperimmunized with DLA specific alloantigens. PMID- 3547827 TI - Effect of azathioprine on kidney allograft tolerance induced by rabbit ATG and donor bone marrow in primates. PMID- 3547828 TI - The role of the thymus in regulating tolerance to self and nonself. PMID- 3547829 TI - Effect of Lyt-2 mAb on murine skin graft survivals. PMID- 3547830 TI - Effect of monoclonal anti-IL-2 antibodies on the survival of rat cardiac allografts. PMID- 3547831 TI - Effect of ex vivo perfusion with anti-Ia monoclonal antibodies on rat cardiac allograft survival. PMID- 3547832 TI - Ex vivo perfusion of the intact rat pancreas with anti-class II monoclonal antibody: labeling of dendritic cells. PMID- 3547833 TI - Widening indications of kidney transplantation--are there limits? PMID- 3547835 TI - Genomic typing for HLA class II antigens: application to matching of renal allografts. PMID- 3547834 TI - Effect of HLA matching in 10,000 cyclosporine-treated cadaver kidney transplants. PMID- 3547836 TI - Influence of donor and recipient DRw6 status on outcome of cadaver kidney transplantation. PMID- 3547837 TI - Effect of class I HLA matching on graft survival in sensitized patients. AB - First, the proportion of highly sensitized transplant candidates grows in the absence of organ sharing. The unsensitized patient is transplanted readily; the sensitized patient has restricted access because of the need for a well-matched kidney to permit a negative cross-match. Second, well-matched grafts are equally successful in sensitized and unsensitized recipients. Finally, emphasis on organ sharing would reverse the trend of accumulation of sensitized candidates without decreasing graft survival. PMID- 3547838 TI - Evaluation of the effects of cyclosporine and HLA-typed source leukocyte transfusions (apheresis by-products) on the immune systems of highly sensitized prospective renal allograft recipients. PMID- 3547839 TI - Search for anti-idiotypic antibodies in sera of renal transplant recipients. PMID- 3547840 TI - Positive B cell crossmatches in highly sensitized patients--influence of antibody specificity on renal transplant outcome. PMID- 3547841 TI - Positive B lymphocyte crossmatch and glomerular rejection in renal transplant recipients. PMID- 3547842 TI - What can be done about the insufficient supply of grafts? AB - Due to significant improvements in surgical techniques and immunosuppression, more and more kidneys but also nonrenal organs are transplanted. In order to meet this still increasing demand for organs in the future, optimal utilization of already existing resources by reduction of the wastage rate, multiple-organ procurement, and even dividing grafts is suggested. A real increase in graft supply may be achieved by creating a proper legal basis, recognition of brain death, and adoption of adequate forms of organization. In the light of the latest medical information, the justification of live donation has to be reconsidered. However, until enough organs from cadaveric donors are retrieved, kidneys may be taken from related living donors and in special situations from emotionally related persons. The concept of buying and selling organs has to be deplored for ethical reasons. The possibilities of xenografting will have to be evaluated in animal models by using modern immunosuppressive strategies. PMID- 3547843 TI - Useful antiglobulin crossmatch test for DST-sensitized patients. AB - The AG-CDC tests were performed in parallel with C-CDC tests for studying sensitization of DST patients. Fourteen of 56 DST patients were positive by the AG-CDC tests after DST. Ten of 14 were also positive by both tests after DST. In 8 of 14 patients AG-CDC antibodies continued to be detectable even after C-CDC antibodies became undetectable as time passed and with plasmapheresis. Thus, AG CDC tests are more sensitive compared to C-CDC tests and can extend the detection rate of DST-sensitized patients. Except for two DST patients (highly sensitized), 12 of 14 DST-sensitized patients were given transplants from specific blood donors at the time when their C-CDC tests became negative. One graft failed, another one had impaired function, and ten of them functioned. It should be noted that DST patients were transplanted successfully with or without plasmapheresis across a positive AG-CDC test if the titer was less than 1:4 at the time of transplant. All four DST recipients who developed antibodies detected only by AG CDC tests after DST experienced severe accelerated rejections. In contrast, two of eight patients who were positive by both tests had "severe" accelerated rejections. The incidence of severe accelerated rejections was shown to be highly associated with the presence of AG-CDC antibodies. These facts suggest that AG CDC antibodies may damage kidney grafts and result in severe accelerated rejections; and that AG-CDC tests are useful for predicting occurrence of severe accelerated rejections in DST recipients. PMID- 3547844 TI - Omission of donor-recipient crossmatching to minimize cold ischemia time in cadaveric renal transplantation. PMID- 3547845 TI - Genetic control of permanently accepted allografts. PMID- 3547847 TI - Pancreatic transplantation with double arterial and venous bridge anastomosis: a technique to avoid vascular thrombosis. PMID- 3547846 TI - Current developments in marrow transplantation. PMID- 3547848 TI - Isograft and allograft control studies for murine cardiac transplantation. PMID- 3547849 TI - Humoral rejection of rat hepatic transplants by passive transfer of serum. PMID- 3547850 TI - Effects of liver transplantation in congenitally albumin-deficient rats. PMID- 3547851 TI - Significance of graft tissue oxygen saturation as a prognostic assessment for orthotopic liver transplantation in the rat. PMID- 3547852 TI - Preclinical evaluation of immunosuppression selective for T cells recognizing class I histocompatibility antigens. PMID- 3547854 TI - Cardiac xenograft survival in baboons treated with cyclosporine in combination with conventional immunosuppression. PMID- 3547853 TI - Effects of cyclosporine, aspirin, and cobra venom factor on discordant cardiac xenograft survival in rats. PMID- 3547855 TI - Influence of in vivo cyclosporine on interleukin production in kidney transplant recipients. PMID- 3547856 TI - Graft-versus-host and host-versus-graft reactions after small intestine allografts in hyperimmunized rats: effect of cyclosporine treatment. PMID- 3547857 TI - Immunopathology of rat thymus after cyclosporine A. PMID- 3547858 TI - Cyclosporine A toxicity for vascularized pancreatic transplantation in the rat. PMID- 3547859 TI - Daily and alternate-day cyclosporine immunosuppressive regimens and synergism with azathioprine. PMID- 3547860 TI - Conversion from cyclosporine to bredinin in canine orthotopic liver transplantation. PMID- 3547861 TI - Improved rat cardiac allograft survival with nonsteroidal pharmacologic agents related to eicosanoids. PMID- 3547862 TI - Suppression of macrophage function and prolongation of graft survival by the new guanidinic-like structure, 15-deoxyspergualin. PMID- 3547863 TI - Effect of prostaglandin E1 on the prolongation of rat cardiac allograft survival. PMID- 3547864 TI - The pathophysiology of the no-reflow phenomenon in cold-stored kidneys. PMID- 3547865 TI - Influence of the calcium antagonist diltiazem on delayed graft function in cadaveric kidney transplantation: results of a 6-month follow-up. PMID- 3547867 TI - Results in live-donor renal transplantation: the SEOPF Multicenter Study. South Eastern Organ Procurement Foundation. PMID- 3547866 TI - Does cyclosporine improve the results of HLA-identical renal transplantation? PMID- 3547869 TI - Spontaneous blastogenesis as a monitor of renal allograft rejection. PMID- 3547868 TI - Preoperative immunomodulation of renal allograft recipients by concomitant immunosuppression and donor-specific transfusions. AB - The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 113 patients by the pretransplant administration of donor specific whole blood or buffy coat in conjunction with continuous Aza immunosuppression. All donor/recipient combinations were at least 1-haplotype disparate and 17 were 2-haplotype disparate. Presensitization, defined as a positive Amos or antiglobulin T cell CM or a positive high-titer (greater than or equal to 1:8) B cell CM was present in 10 patients and not present in 103 patients. Attempts at desensitization of the already sensitized group were uniformly unsuccessful. Treatment of the 103 nonpresensitized patients resulted in transient sensitization in 3 patients, permanent sensitization in 8, and no evidence of sensitization in 92. Ninety-one nonsensitized patients underwent renal transplantation from the specific blood donor, and only 5 have experienced renal allograft rejection loss during a mean follow-up period of 26 months (6 to 70 months). Fifty-four percent have never experienced a rejection episode. The allograft survival rate at 2 years (91%) and 5 years (89%) is significantly better (P less than .01) than our historical experience with 1-haplotype living related transplants at 2 years (66%) and 5 years (64%). The low rate of sensitization (8%) has permitted almost all patients to undergo eventual renal transplantation from the specific blood donor. This and the low rate of rejection (5%) argues for a modification of the immunologic response rather than a selecting out process as the mechanism for improved allograft survival. PMID- 3547870 TI - Differential effects of cyclosporine and azathioprine on host cell populations in renal allograft recipients. PMID- 3547871 TI - The prognostic significance of the presence of monocytes in glomeruli of renal transplant allografts. PMID- 3547872 TI - Identification of mononuclear cell populations infiltrating human renal allografts. PMID- 3547873 TI - Infiltrate analysis by monoclonal antibodies does not contribute to the usefulness of fine needle aspiration biopsy. PMID- 3547874 TI - Nuclear spin tomography of the transplanted kidney. PMID- 3547877 TI - A new and sensitive method to detect acute rejection in renal transplantation. PMID- 3547875 TI - Magnetic resonance imaging of the transplanted kidney and measurement of T2 relaxation time. PMID- 3547876 TI - Detection of acute allograft rejection by indium-111 labeled platelet scintigraphy in renal transplant patients. PMID- 3547878 TI - Comparison of cyclosporine A dosage and metabolism in liver and heart transplant recipients. PMID- 3547879 TI - The effect of oral metoclopramide on the absorption of cyclosporine. AB - This study was performed to determine the effect of coadministered oral metoclopramide on the absorption of oral cyclosporine in 14 kidney transplant patients with stable renal function. The study was conducted on two consecutive days. Ten patients were studied twice and four patients once, giving 24 studies. The total dosage of metoclopramide was 20 mg. The day on which metoclopramide was administered was chosen randomly. Whole blood cyclosporine levels were analyzed by high performance liquid chromatography. Coadministration of cyclosporine with metoclopramide resulted in a significant increase in mean maximum blood concentration (567 ng/mL nu 388 ng/mL) and mean area under the blood concentration nu time curve (4120 ng X h/mL nu 3370 ng X h/mL), and a significant decrease in mean time to reach maximum concentration: The mean increase in area under the blood concentration versus time curve was 29%. No significant changes were observed in the elimination of cyclosporine when it was coadministered with metoclopramide. These observations suggest that coadministered metoclopramide increased the total absorption of cyclosporine. Metoclopramide has been shown to hasten gastric emptying; since cyclosporine is absorbed predominantly in the small intestine, coadministration of metoclopramide resulted in increased bioavailability of cyclosporine. PMID- 3547881 TI - Correlation between whole blood and plasma cyclosporine blood levels. PMID- 3547880 TI - Nephrotoxic effect of cyclosporine A can be reversed by dopamine. PMID- 3547882 TI - The effect of low-dose cyclosporine A on histopathologic findings in transplant biopsy specimens and function rates after cadaver renal transplantation. PMID- 3547883 TI - Evaluation of cyclosporine-induced nephrotoxicity by immunoperoxidase analysis of renal allograft biopsies. PMID- 3547884 TI - The clinical significance of urinary fibrinopeptide A and fibrinopeptide B-beta 15-42 in chronic rejection and nephrotoxicity of renal allograft recipients immunosuppressed with cyclosporine. PMID- 3547886 TI - Assessment of the risks of malignancy and lymphomas developing in patients using Sandimmune. PMID- 3547885 TI - Spleen-liver scintiscan: a new technique for distinguishing allograft rejection from cyclosporine nephrotoxicity. PMID- 3547887 TI - Proceedings of the Eleventh International Congress of the Transplantation Society. August 3-8, 1986, Helsinki, Finland. PMID- 3547888 TI - Beneficial effects of transplantation of liver tissue fragments on acute ischemic liver injury in dogs. PMID- 3547889 TI - Survival of adult hepatocytes and fetal hepatic tissue transplanted into the spleens of allogeneic rats. PMID- 3547890 TI - Risk factors for cadaveric donor allograft survival in cyclosporine-prednisone treated recipients. PMID- 3547891 TI - Cyclosporine-steroids versus conventional therapy in cadaver kidney transplantation: analysis of a randomized trial at two years. PMID- 3547893 TI - Use of cyclosporine and Minnesota antilymphoblast globulin in the early postoperative treatment of primary cadaveric renal transplant recipients. PMID- 3547892 TI - Superior renal allograft survival and decreased rejection with early high-dose and sequential multi-species antilymphocyte globulin therapy. PMID- 3547894 TI - Treatment of acute rejection crisis by antilymphocyte globulins: a randomized prospective study in pediatric kidney transplantation. PMID- 3547895 TI - Triple combination of low-dose cyclosporine, azathioprine, and steroids in first cadaver donor renal allografts. PMID- 3547896 TI - Triple and quadruple therapy after renal transplantation in patients from developing countries. PMID- 3547897 TI - Quadruple drug therapy prevents graft loss from acute rejection without increasing mortality. PMID- 3547898 TI - Reduction of nephrotoxicity and improvement of immunosuppression by combination of cyclosporine A and azathioprine. PMID- 3547899 TI - Management of immunosuppressive problems in renal allograft recipients. PMID- 3547901 TI - A randomized study of buffy coat transfusions in cadaveric renal transplantation. PMID- 3547900 TI - Immunosuppression with low-dose cyclosporine combined with bredinin and prednisolone. PMID- 3547903 TI - Adverse effects of low-dose azathioprine on Australian primary graft survival (1978-1984). PMID- 3547902 TI - Wide field low-dose total lymphoid irradiation in clinical kidney transplantation. PMID- 3547904 TI - Improvement of renal function after conversion from cyclosporine only to prednisolone-azathioprine followed by late-onset graft failure in renal transplant patients. PMID- 3547905 TI - The fate of living related donor kidney recipients after conversion from cyclosporine to azathioprine. PMID- 3547906 TI - Conversion of cyclosporine to azathioprine in renal transplant patients. PMID- 3547907 TI - Preservation of the cortical renal microcirculation: a prerequisite for immediate renal allograft function. PMID- 3547908 TI - Preservation effect on oligo-anuria in the cyclosporine era: a prospective trial with 26 paired cadaveric renal allografts. PMID- 3547909 TI - Limiting factors in successful preservation of cadaveric kidneys with ischemia time exceeding 50 hours. AB - The results of 61 cadaveric allografts preserved for 30 to 76 hours were analyzed to determine the effect of cold ischemia time, the method of preservation, and the type of immunosuppression on early graft viability and long-term graft survival. Preservation in cold storage up to 50 hours gave a low incidence of nonfunction (4%) and of posttransplant dialysis (20%) and a high rate of function both at 1 month (96%) and at 2 years (60%). Cold ischemia time greater than 50 hours caused a significantly increased need for dialysis (58%) but without appreciable difference in graft function at 1 month or at 2 years. Preservation by machine had no advantage over preservation by simple cold storage when the cold ischemia time was less than 50 hours. When cold ischemia time exceeded 50 hours, machine preservation was associated with a significantly reduced incidence of posttransplant dialysis but without significant differences in long-term function at 2 years. With up to 50 hours of cold ischemia and providing there was no ATN, CsA had little nephrotoxicity and gave excellent graft function at 1 month and at 2 years. However, the nephrotoxicity of CsA was markedly increased when the preservation interval exceeded 50 hours, resulting in a significantly increased rate of primary nonfunction and the need for dialysis with a significant decrease in graft function at 1 month and at 2 years. The nephrotoxicity of CsA was considerably decreased or eliminated without affecting its powerful immunosuppressive property when initial immunosuppression was begun with azathioprine with sequential conversion to CsA when graft function was fully established. It is recommended that when cold ischemia is long or when there is ATN, CsA should be used as a sequential therapy to azathioprine after graft diuresis or, alternatively, in much smaller doses as part of a combination therapy with azathioprine. PMID- 3547910 TI - Improved early course after cadaveric renal transplantation by reducing the cyclosporine dose and adding azathioprine. PMID- 3547911 TI - The effect of cyclosporine on the early postoperative function of allografted kidneys with warm ischemic damage. PMID- 3547912 TI - Significance of delayed function in cyclosporine-treated cadaver kidney transplants. PMID- 3547914 TI - Impact of immunosuppressive regimen on early posttransplant renal function. PMID- 3547913 TI - Cyclosporine immunosuppression and delayed graft function in 455 cadaveric renal transplants. PMID- 3547915 TI - New approach to management of chronic vascular rejection with prostacyclin analogue after kidney transplantation. PMID- 3547916 TI - The influence of hepatitis B infection on the outcome of renal allotransplantation. AB - Renal allograft and patient survival and liver function abnormalities were studied in a group of HBsAg-negative and -positive recipients. Thirty-five patients were positive, and 20 patients became antigenemic prior to transplantation. Two hundred twenty-four patients were HBsAg-negative. No difference in patient or graft survival was found between patients with hepatitis B antigenemia and antigen-negative cadaver allograft recipients. The incidence of significant hepatic disease was low in comparison with several recently published reports. It is concluded that hepatitis B antigenemia is not an absolute contraindication to transplantation. PMID- 3547917 TI - Observations relating to the incidence of the acquired immune deficiency syndrome and other possibly associated conditions in a large population of renal transplant recipients. PMID- 3547918 TI - Investigation of human T-lymphotropic virus III serology in a renal transplant population. PMID- 3547919 TI - Effectiveness of oral acyclovir prophylaxis in renal transplant recipients. PMID- 3547920 TI - Prospective study and long-term follow-up of liver damage in renal transplant recipients. PMID- 3547921 TI - Type II hyperlipoproteinemia, hyperapobetalipoproteinemia, and hyperalphalipoproteinemia following renal transplantation: prevalence and precipitating factors. PMID- 3547922 TI - Peptic ulcer disease following renal transplantation. PMID- 3547923 TI - Interleukin 2 response inhibition following donor specific transfusions given with azathioprine. PMID- 3547924 TI - Recurrent diabetic nephropathy in renal allografts placed in diabetic patients and protective effect of simultaneous pancreatic transplantation. PMID- 3547925 TI - Use of recipient mesenteric vessels for revascularization of segmental pancreas grafts: technical and metabolic considerations. PMID- 3547926 TI - Evolution of metabolic and endocrine function in ten neoprene-injected segmental pancreas allografts at three to 54 months after transplantation, versus preliminary results in nine whole pancrease allografts with enteric diversion. PMID- 3547927 TI - A new variant for whole pancreas grafting. AB - A new variant for whole pancreas grafting is described in which a segment of the duodenum and the spleen is included in the graft. The graft is placed extraperitoneally as in kidney transplantation. The exocrine drainage is with side-to-side anastomosis between duodenum and bladder. The spleen is irradiated to prevent the occurrence of GVHD, as is reported in splenic transplantation. PMID- 3547928 TI - Complications of pancreas transplantation-effect of technique. PMID- 3547929 TI - Monitoring of the pancreatic allograft by analysis of exocrine secretion. PMID- 3547930 TI - Late mortality and morbidity after liver transplantation. PMID- 3547931 TI - Hepatic artery in liver transplantation. PMID- 3547932 TI - Selective bowel decontamination to prevent gram-negative bacterial and fungal infection following orthotopic liver transplantation. PMID- 3547933 TI - Modified patterns of major histocompatibility complex-antigen expression in human liver grafts during rejection. PMID- 3547935 TI - Endocrine response to exercise in cardiac transplant patients. PMID- 3547934 TI - Analysis of T lymphocytes infiltrating human hepatic allografts. PMID- 3547936 TI - Prevention of toxic side effects of cyclosporine in heart transplantation. PMID- 3547937 TI - Doppler echocardiographic indices of diastolic function as markers of acute cardiac rejection. PMID- 3547939 TI - Myocyte injury in acute cardiac transplant rejection and in lymphocytic myocarditis is similar and reversible. PMID- 3547938 TI - Sequential infiltration of class I and class II specific alloreactive T cells in human cardiac allografts. PMID- 3547940 TI - Current status of bone marrow transplantation for severe aplastic anemia: a preliminary report from the International Bone Marrow Transplant Registry. PMID- 3547941 TI - European experience of bone marrow transplantation for leukemia. PMID- 3547942 TI - Marrow transplantation for leukemia and aplastic anemia: two controlled trials of a combination of methotrexate and cyclosporine v cyclosporine alone or methotrexate alone for prophylaxis of acute graft-v-host disease. PMID- 3547943 TI - Graft failure and leukemia relapse following T lymphocyte-depleted bone marrow transplants: effect of intensification of immunosuppressive conditioning. PMID- 3547944 TI - Thalidomide induction of bone marrow transplantation tolerance. PMID- 3547945 TI - Graft-versus-leukemia in the rat--the antileukemic efficacy of syngeneic and allogeneic graft-versus-host disease. PMID- 3547946 TI - Detection of anti-non-MHC-directed T cell reactivity following in vivo priming after HLA-identical marrow transplantation and following in vitro priming in limiting dilution cultures. PMID- 3547947 TI - Cyclosporine-induced syngeneic graft-versus-host disease: assessment of T cell differentiation. PMID- 3547948 TI - T cell depletion of HLA and haploidentical marrow reduces graft-versus-host disease but it may impair a graft-versus-leukemia effect. PMID- 3547949 TI - Selective multiplication of hematopoietic stem cells for bone marrow transplantation in mice and rhesus monkeys. PMID- 3547950 TI - Lysosomal enzyme replacement in neural tissue by allogeneic bone marrow transplantation following total lymphoid irradiation in canine fucosidosis. PMID- 3547951 TI - Cytogenetic evidence of partial chimerism after T cell-depleted allogeneic bone marrow transplantation in leukemic HLA-matched patients. PMID- 3547952 TI - Specific inhibition of hybrid resistance in B6D2F1 mice pretreated with parental strain B6 cells: role of a nylon-adherent cell induced in the spleen of the B6 pretreated B6D2F1 hybrid. PMID- 3547953 TI - Effector cells of graft-versus-host disease, host resistance, and the graft versus-leukemia effect: summary of a workshop on bone marrow transplantation. PMID- 3547954 TI - Immunosuppression. PMID- 3547955 TI - Critical issues in bone marrow transplantation. PMID- 3547956 TI - Clinical organ transplantation. PMID- 3547957 TI - How to prevent malaria. PMID- 3547958 TI - [Changes in the surface topography of 3T3 cells as affected by epidermal growth factor and insulin]. AB - Using scanning electron microscopy, a study was made of the surface topography of the Swiss 3T3 cells whose proliferation was arrested in the serum-less (0.5%) medium due to the application of the epidermal growth factor and insulin for, respectively, 10 and 30 minutes. The early cell response on the growth factors was diminishing the number of microvilli and appearance of plasma membrane invaginations. The degree of quiescent cell spreading under the action of the two above factors was different, since the epidermal growth factor, unlike insulin, induced cell reaction. PMID- 3547959 TI - [Why does a cell monolayer replicate the metal tray pattern of the thermostat?]. AB - Cells freshly seeded into the closed culture flasks or dishes and placed on the metal tray with holes of the thermostat or incubator are seen to form the layer with uneven density: with high density corresponding to the flask bottom regions above the metal and low density corresponding to the flask bottom region above the holes in the tray. The effect was shown using several cell lines with different degrees of transformation and saturation density, including Swiss 3T3. The main cause of this effect is the difference between the temperature inside the thermostat and the lower temperature of the flasks with culture medium (rather than between the metal framework and the air), together with a high heat conduction of the metal. The reverse difference in the temperatures (higher temperature of the culture flasks) leads to the formation of the reverse pattern of the cell layer, with higher density corresponding to the holes. The temperature differences exert their influence presumably during the first 10-15 minutes after the cells seeding, when the process of cell sedimentation is involved possibly by creating the microcurrents in the medium. PMID- 3547960 TI - [Pulmonary parasitosis]. PMID- 3547961 TI - [Prolonged pregnancy and perinatal distress]. PMID- 3547962 TI - [Multisegmental malignant lymphoma of the digestive tract (apropos of a case report and review of the literature)]. PMID- 3547963 TI - [42 cases of streptococcal infections confirmed by bacteriological studies]. PMID- 3547965 TI - [Myxoma of the left atrium. Apropos of 3 cases]. PMID- 3547964 TI - [Substitute treatment of end-stage renal insufficiency in Tunisia]. PMID- 3547966 TI - Adrenal schwannoma with apparent uptake of immunoglobulins. AB - Schwannoma, a rare tumor of the adrenal gland, was an incidental finding in a 63 year-old woman who had no endocrine symptoms. In addition to the usual light and electron microscopic and immunohistochemical features of a schwannoma, the tumor contained large granular cells and a stroma rich in lymphocytes and plasma cells. The tumor cells appeared on ultrastructural examination to incorporate proteinaceous material by endocytosis into large lysosomal bodies and on immunocytologic studies; the presence of immunoglobulins was noted within the cytoplasm. The apparent massive uptake of immunoglobulins by tumor cells suggests a direct interaction between host and the tumor. PMID- 3547967 TI - Immunonegative stain techniques for electron microscopic detection of viruses in human faeces. AB - Immune electron microscopy techniques have for some years been applied to detection of viruses in clinical specimens, especially faecal samples, as both sensitivity and specificity are improved by use of specific antibody. The following review describes in detail different preparation methods and illustrates some of the results that may be obtained. PMID- 3547968 TI - Left temporal lobe cerebral cortex mass in a 19-year-old male. PMID- 3547969 TI - [Patients' experience in epidural anesthesia and general anesthesia]. PMID- 3547970 TI - [Moistening of inspired air during respirator treatment. Comparison between the water-bath evaporator and hygroscopic moisture heat exchanger]. PMID- 3547971 TI - [Preoperative ultrasound scanning of the liver in colorectal cancer. A comparative study]. PMID- 3547972 TI - [Comparison between depot terbutaline tablets and ordinary terbutaline tablets]. PMID- 3547973 TI - [Chronic dialysis in children. Results from the Danish National Hospital 1970 1984]. PMID- 3547974 TI - [Computer-based expert systems. Artificial intelligence in medicine]. PMID- 3547975 TI - [Routine microscopic examination and culture. Benefits and clinical consequences]. PMID- 3547976 TI - [Peroral irrigation compared with rectal intestinal irrigation. A prospective study on patients before surgery]. PMID- 3547977 TI - [The respiratory depressant effects of morphine and nicomorphine. A comparative clinical study]. PMID- 3547978 TI - [Observer variations in weighing patients]. PMID- 3547979 TI - [Does diazepam prevent fasciculation and myalgias caused by suxamethonium? A double-blind study]. PMID- 3547980 TI - [Postoperative analgesia with intrathecal morphine in connection with spinal analgesia]. PMID- 3547981 TI - Festschrift in honor of Professor Ernst Ruska on the occasion of his 80th birthday. PMID- 3547982 TI - Real-time analysis of Doppler waveforms. AB - The usefulness of objective analysis of Doppler waveforms is now well established but to date such measures have generally not been available in real-time. This Paper describes a real-time data analysis and collection system in use with a duplex scanner which is capable of producing objective measures of waveform shape during the investigation. It is shown as an example that this information can be used to identify, with high accuracy, babies likely to be classified at birth as distressed as early as the 34th week of pregnancy. PMID- 3547983 TI - Normal US anatomy of the prostate. AB - Recent concepts on prostate anatomy are first emphasized. The sonographic approaches to the prostate and the seminal vesicles are then described. They are the external suprapubic and transperineal and the transrectal and transurethral approaches. The most detailed images were obtained with transrectal sonography by using a radial then a linear-array probe. The various views of the prostate and seminal vesicles are shown according to the approach and scan orientation. Their advantages and drawbacks are discussed. Our routine protocol includes suprapubic, transperineal and transrectal scanning with a radial and a linear-array probe. Linear-array probes also allow the voiding study of the bladder neck and prostatic urethra. PMID- 3547984 TI - Intraoperative monitoring in vascular surgery. AB - Doppler ultrasound and real-time B-mode ultrasonic imaging are useful techniques to monitor the technical success of reconstructive vascular operations. Gas sterilized CW or pulsed Doppler probes permit audible or spectral detection of normal and abnormal blood velocity patterns associated with intimal flaps, thrombotic or platelet aggregates, retained venous valve cusps or arteriovenous fistulas. Real-time ultrasonic B-mode imaging allows detection of technical defects or thrombotic debris which is of particular importance in minimizing stroke or recurrent lesions following carotid endarterectomy. These ultrasonic techniques should become routine adjuncts for surgeons interested in defining localized pathology and hemodynamics, assuring technical integrity, detecting intraoperative defects, and predicting favorable outcome of vascular reconstruction procedures. PMID- 3547986 TI - Fetal hydrocephaly: diagnosis, prognosis and management. AB - Ventricle/hemisphere (V/H) ratio and head circumference (HC) measurements were obtained in 230 normal pregnancies between 16 and 28 weeks of gestation. The mean V/H ratio demonstrated a gradual decrease from 0.50 at 16 weeks to 0.26 at 26-28 weeks. HC showed a linear increase from 133 mm at 16 weeks to 268 mm at 28 weeks. In 9 other pregnancies, fetal hydrocephaly was established by routine ultrasound before 26 weeks of gestation. Whereas all V/H ratio values were situated above the upper normal limit, most of the corresponding HC values (6/9) were within the normal range. Severe hydrocephaly (V/H ratio greater than 3X upper confidence interval) was established in 7 out of 9 fetuses; associated intra or extra cranial structural anomalies were observed in 6 out of 9 fetuses. The implications of these findings for obstetric management of hydrocephaly are discussed. PMID- 3547985 TI - Ultrasonic study of in vivo kinetic characteristics of human tissues. AB - A method is described for quantifying tissue movement in vivo from the computation of correlation coefficient between pairs of A-scans with appropriate time separation. The method yields quantifiable and repeatable secondary patterns of soft tissue movement in response to primary cardiac movement in a given subject, shows consistently different results as between normal livers and a variety of abdominal tumours, and is sensitive to either progress or therapeutically-induced regression of malignant disease. While the results reported here have been obtained using somewhat simple and crude equipment, the method is well suited to implementation on a commercial real-time scanner. PMID- 3547987 TI - An endoscopic micromanipulator for multiplanar transesophageal imaging. AB - We have developed an esophageal probe with a precision micromanipulator and a transversely oriented 32 element ultrasonic array which operates at 3.5 MHz. The probe allows us to obtain multiple two-dimensional images of the heart with known angular relationships between them over a series of cardiac cycles. Our ultimate purpose is to acquire images for left ventricular volume estimation with a three dimensional reconstruction method. Technical details of the probe design are given. In vitro tests have shown that the imaging plane can be angulated within 1.5 degree root mean square error. In vivo results with dogs have demonstrated its ability to obtain multiplanar short axis images of the heart. PMID- 3547988 TI - Ultrasound and CT of peritoneal recesses and ligaments: a pictorial essay. AB - US and CT permit one to visualize peritoneal recesses and ligaments. Ultrasonic analysis relies mostly on the liquid contrast of peritoneal effusions. CT demonstrates more readily the fatty and vascular contents of ligaments. Thus ultrasound displays essentially the thin part of ligaments, which CT is unable to show due to kinetic blur, whereas CT demonstrates readily the thick fatty parts of those peritoneal elements. PMID- 3547989 TI - The sonographic appearance of the normal gastric wall: an in vitro study. AB - In order to evaluate the real number and anatomical correspondence of the ultrasonographically recognizable layers within the gastric wall, we used a high frequency (7.5 MHz) rotating transducer to examine five surgical specimens of the stomach suspended in a water bath. Five layers were always clearly distinguishable within the gastric wall, whose thickness was 3-6 mm. Fine needles and lancets were localized at the level of the 3rd hyperechoic layer when inserted in the submucosa and in the 4th hypoechoic layer when inserted in the muscolaris propria. Thin echogenic bands were always displayed on both sides of other homogeneous tissues (spleen, myometrium) suspended in water. On the basis of these findings and also taking in account the physical laws of ultrasound interactions with tissues, we conclude that the 1st and the 5th hyperechoic layers are partially generated by ultrasound reflection at the interface liquid/wall. The 2nd hypoechoic layer corresponds to the deepest part of the mucosa; the 3rd hyperechoic to the submucosa and the submucosa/muscularis propria interface and the 4th hypoechoic layer to the muscularis propria. PMID- 3547990 TI - Ultrasound of the normal kidney: a sonographic, anatomic and histologic correlation. AB - Technical progress in sonographic equipment providing routinely high resolution images makes it appropriate that some criteria of normality have to be reviewed. In this paper normal sonographic images of the kidney are correlated with anatomy and histology. The effect of aging upon normal anatomical relations and histologic findings is analysed. Special attention is focussed on particular anatomical details as far as they can explain the particular topography or sonographic appearance of some pathologies. PMID- 3547991 TI - [Bacteriologic studies of the use of incision drapes in orthopedic operations]. AB - The usefulness of plastic adhesive drapes for the prophylaxis of wound infections following to orthopedic operations was investigated in a prospectively randomized study including 123 patients. The drape was used in 68 cases, 55 patients were operated without drape. In order to carry out qualitative bacteriological examinations, smears were taken prior to, one and two hours after the beginning and after the end of the operations. Bacterial infestation in the operation area was found in 30 patients (54.5%) operated without drape and in 30 patients (44.1%) in whose operations the drape was employed. Most of the bacteria found were coagulase-negative staphylococci, in some cases corynebacteria and aerobic spore-forming organisms. There were no postoperative wound infections. No evidence of a significant difference was shown by a statistical evaluation of the results using the chi 2 test. The use of incision drapes for the prophylaxis of postoperative wound infections is therefore not necessary in orthopedic surgery. PMID- 3547992 TI - Investigation of blood group antigens and carcinoembryonic antigen in urinary bladder carcinoma. AB - Blood group antigens and carcinoembryonic antigen (CEA) were sought in the tissues of 37 bladder tumor cases using enzyme antibody method. A correlation (p less than 0.01) was found between the extinction of ABO (H) and progressive malignant states of the tumor or invasion stage. Significant correlation (p less than 0.05) was observed between the presence of CEA and the invasion stage. The state of the T antigen, however, did not reflect the malignancy grade or invasion stage. The states of ABO (H) and CEA significantly reflected (p less than 0.05) the prognosis, as did the malignancy grade and invasion stage, while the state of the T antigen did not correlate with the prognosis. Although there was a correlation (p less than 0.01) between the extinction of ABO (H) blood group antigens and the presence of CEA, the state of T antigen did not significantly correlate with ABO (H) antigen or CEA. From what has been mentioned, the search for intratissue ABO (H) antigens and CEA is important and will provide a useful auxiliary means in diagnosing biopsy specimens. PMID- 3547993 TI - Treatment of recurrent urinary tract infections: efficacy of an orally administered biological response modifier. AB - 64 out-patients suffering from recurrent UTI were treated under double-blind conditions with one capsule daily of either the biological response modifier OM 8930 or the placebo for 3 months, followed by a 3-month observation period. Dysuria, bacteriuria, leucocyturia and antibiotic or chemotherapeutic consumption showed a significant reduction under OM-8930 in comparison with the placebo. As to the tolerance, a single case of allergic exanthema on the neck was observed in the OM-8930 group. Both the curative efficacy in the acute crisis and the consolidative efficacy in preventing further recurrences showed a highly significant superior effect of OM-8930 with respect to the placebo. PMID- 3547994 TI - Image contrast and pulse sequences in urinary tract magnetic resonance imaging. AB - Since image contrast in urinary tract proton magnetic resonance imaging (MRI) depends on both intrinsic properties of the imaged tissue and the imaging technique, it is important to understand the principles underlying image production, both while performing urinary tract MRI and when interpreting the images. This paper reviews briefly the major characteristics of tissue that can produce image contrast: mobile proton density, tissue motion, and relaxation times. It also describes the principles by which these factors, together with the choice of pulse sequence, affect image appearance. The specific pulse sequences described include the spin-echo and inversion recovery sequences; the influence of repetition time, echo delay, and inversion time are also described. Although empiric data regarding the best pulse sequences to use for all types and sites of pathology in the urinary tract are not complete, knowledge of the characteristics of normal tissue and the major sorts of pathologic change permit one to make general conclusions about the appropriate choice of pulse sequences. PMID- 3547995 TI - Magnetic resonance imaging of the adrenal glands. AB - Applications of nuclear magnetic resonance (NMR) to the adrenal gland have received considerable attention in recent years. Using high field strength magnets and surface coil technology, images of normal and abnormal adrenal glands have been obtained that compare favorably, and in some instances excel, computed tomography (CT) with respect to both image quality and, to a greater degree, differentiation of pathology. This article reviews the current state of magnetic resonance (MR) imaging of normal and abnormal adrenal glands, compares MR with CT imaging, and indicates where NMR spectroscopy has been of greatest value to date in the study of adrenal gland disease. PMID- 3547996 TI - Magnetic resonance imaging of the kidney. AB - After a few years of the use of clinically oriented imaging, magnetic resonance (MR) can now be measured against the other cross-sectional radiologic imaging techniques. Its superior sensitivity in demonstrating diseases of the central nervous system and heart has yet to be matched by similar success in the detection of abdominal disease. However, MR is evolving further and improvements in hardware, software, and pulse sequence selection are expected to continue. We present here the experience accumulated to date in the MR evaluation of the kidney in its normal and diseased states. PMID- 3547997 TI - Magnetic resonance imaging in the evaluation of the retroperitoneum. AB - Magnetic resonance imaging techniques have made it possible to delineate a variety of pathologic processes in the retroperitoneum, including lymphadenopathy, atherosclerotic and aneurysmal disease of the aorta, congenital venous anomalies, and primary and secondary retroperitoneal neoplasms. The availability of multiplanar image display, the excellent soft tissue contrast resolution, and the fact that exogenous contrast materials are not needed are valuable assets of this imaging modality. PMID- 3547998 TI - Magnetic resonance imaging of the pelvis: prostate and urinary bladder. AB - Magnetic resonance imaging has opened up a new horizon in the evaluation of the male pelvis. Its direct multiplanar imaging and display of the unique tissue contrast allows for the demonstration of prostate anatomy. Prostatic disease, even when confined to the gland, is easily depicted. However, one cannot distinguish benign from malignant processes. In a patient with a known prostatic neoplasm, magnetic resonance is useful as a staging modality. Accuracy in the staging of prostatic malignancies by MRI surpasses that of ultrasound or CT. In the evaluation of the urinary bladder, the greatest advantage of magnetic resonance is its ability to differentiate between a normal bladder, and other pathologic conditions affecting the bladder, including inflammatory, congestive and neoplastic processes. In the evaluation of bladder carcinoma, magnetic resonance is useful as a staging modality. Clinical application of magnetic resonance is just beginning and therefore, the full potential of the modality has yet to be explored. PMID- 3547999 TI - Magnetic resonance imaging of the female pelvis. AB - Magnetic resonance (MR) imaging is particularly well suited for the evaluation of the female pelvis because of the lack of respiratory motion and the multiplanar imaging ability of MR. The MR appearance of normal anatomy is dependent on the pulse sequence used. This is also true for pelvic pathology. Primary cervical carcinoma is best seen on T2-weighted images; parametrial extension and lymph node metastases are best evaluated on T1-weighted images. Endometrial carcinoma is also best seen on T2-weighted images. Absence of the junctional low intensity band of the uterus may indicate myometrial invasion by endometrial tumor, although more data are needed to make a final diagnosis. Uterine leiomyomata have a variable MR appearance which may be related to the degree of cellularity of the tumor. Our experience in the MR appearance of adnexal masses is limited. MR imaging should assume a more important role in imaging the female pelvis in the future. PMID- 3548001 TI - Pattern recognition methods for optimizing multivariate tissue signatures in diagnostic ultrasound. AB - Described is a supervised parametric approach to the detection and classification of disease from acoustic data. Statistical pattern recognition techniques are implemented to design the best ultrasonic tissue signature from a set of measurements and for a given task, and to rate its performance in a way that can be compared with other diagnostic tools. In this paper, we considered combinations of four ultrasonic tissue parameters to discriminate, in vivo, between normal liver and chronic active hepatitis. The separation between normal and diseased samples was made by application of the Bayes decision rule for minimum risk which includes the prior probability for the presence of disease and the cost of misclassification. Large differences in classification performance of various tissue parameter combinations were demonstrated using the Hotelling trace criterion (HTC) and receiver operating characteristic (ROC) analysis. The ability of additional measurements to increase or decrease discriminability, even measurements from other diagnostic modalities, can be evaluated directly in this manner. PMID- 3548000 TI - A quantitative approach to speckle reduction via frequency compounding. AB - Coherent speckle is a source of image noise in ultrasonic B-mode imaging. The use of multiple imaging frequencies has been suggested as a technique for speckle contrast reduction. This technique involves the averaging of images whose speckle patterns have been modified by a change in the spectrum of the transmitted or received acoustical pulse. We have measured the rate of this speckle pattern change in ultrasonic images as a function of the change in center frequency of the transmitted acoustical pulse. This data is used to quantitatively describe the trade-off of resolution loss versus speckle reduction encountered when frequency compounding is employed and to derive the optimal method of frequency compounding. These results are then used as a basis for describing the overall advisability of frequency compounding in ultrasonic imaging systems. Our analysis indicates that simple frequency compounding is counterproductive in improving image quality. PMID- 3548002 TI - Presence of cepstral peak in random reflected ultrasound signals. AB - A peak in the power cepstrum, or the squared magnitude of the Fourier transform of the data log-power spectrum, is commonly observed when processing reflections from plate-like structures, such as membranes. In this case, the cepstral peak at the smallest nonzero time lag, or quefrency, value can be used to determine the thickness of the plate. For reflections from a medium composed of randomly distributed scatterers, such as liver tissue, a cepstral peak is also commonly observed, but cannot be so intuitively explained as in the deterministic case above. In this paper, it is demonstrated that the presence of a cepstral peak depends on the form of the probability density function (pdf) of the separation between reflectors. In the case where the pdf is uniform from O to SM, the cepstral peak is found to occur at the quefrency corresponding to SM. For simple unimodal pdfs, a cepstral peak will occur at the location of the maximum probability. These observations are shown analytically and verified through simulations. The diagnostic value of these results lies in the interpretation of the relation of the cepstral peak location to the spacing of the scattering elements in the tissue. PMID- 3548003 TI - Use of a narrowband estimator for acoustic attenuation in liver. PMID- 3548005 TI - Percutaneous placement of radioactive gold seeds in localized prostatic carcinoma. PMID- 3548004 TI - Nephrogenic adenoma. AB - Nephrogenic adenoma is a peculiar reactive process of urothelium which may occur anywhere along the urinary collecting system but rarely if ever arises in the absence of a preexisting urogenital abnormality. Although its histogenesis and biological potential have not been entirely defined, the evidence strongly suggests a metaplastic lesion comprising immature cells which lack the capacity to invade or metastasize. Clinical signs and symptoms are nonspecific and may relate more to the coexisting abnormality than to the nephrogenic adenoma itself. Although nephrogenic adenomas may resemble certain types of urologic malignancies, their histology is distinctive and varies little from lesion to lesion so that once the entity is considered, an accurate pathologic diagnosis is rarely a problem. PMID- 3548006 TI - Intraoperative endoscopic evaluation of suprapubic urethropexy. AB - In a preliminary study of 32 women with stress urinary incontinence, a modification was added to the standard suprapubic urethropexy to decrease the incidence of postoperative urinary retention. Immediately before the elevating sutures are tied, a urethroscope is inserted into the midurethra and the bladder neck is visualized while the sutures are being tied with just enough tension to close the bladder neck. This resulted in a 100 per cent continence rate at twenty four months and an average catheter time of 6.2 days, with 69 per cent of the patients voiding easily on the fourth postoperative day. This has resulted in a significant improvement over the length of catheter time when the urethroscope is not used, and additionally provides good experience and immediate feedback in a teaching situation for accuracy of suture placement and adequacy of bladder neck closure. PMID- 3548007 TI - Ejaculatory stimulation in spinal-cord injured men. AB - Anejaculation is a common problem among spinal-cord injured (SCI) men. Only 1-20 per cent of SCI men can ejaculate. Methods of ejaculatory stimulation are needed to obtain sperm for artificial insemination purposes. The methods of stimulation heretofore used include intrathecal neostigmine, rectal probe electro ejaculation, vibratory stimulation of the penis, and subcutaneous physostigmine. Ejaculatory ability increased to as much as 58 per cent using these techniques, but complications such as nausea and vomiting, elevated blood pressure, and headaches have been reported. The mechanisms of action of these techniques are poorly understood; they are believed to stimulate either reflex spinal ejaculatory centers or efferent peripheral nerves from these centers. The studies with these techniques often fail to use scientific methods of evaluation and are deficient in characterizing the subject population, description of stimulator and technique utilized, definition and presentation of "success" and/or complications observed. The criteria by which future studies of ejaculatory stimulation should be measured are suggested. PMID- 3548009 TI - Comparison of butorphanol tartrate and meperidine in moderate to severe renal colic. AB - The analgesic efficacy and safety of parenteral butorphanol and meperidine were compared. The double-blind, randomized study involved 120 patients presenting with moderate to severe renal colic. Pain intensity and pain relief were evaluated by trained observers at fixed time intervals for four hours after study drug was administered. Eighty-three patients with documented upper urinary tract calculi were evaluated for efficacy. Butorphanol 4 mg was significantly more effective than butorphanol 2 mg and was equivalent to meperidine 80 mg. Overall efficacy assessments were "good" or "excellent" for 87 per cent, 72 per cent, and 85 per cent, respectively. There were no significant differences in side effects among treatment groups in the 83 evaluable and 27 inevaluable patients receiving study drugs. Butorphanol was effective and well-tolerated in this patient population, with important advantages over opiate analgesics. PMID- 3548008 TI - Case profile: absent seminal vesicle diagnosed by transrectal ultrasound. PMID- 3548010 TI - Who shall treat acute gonorrhea in the U.S. Army? Spicy correspondence of 1944. PMID- 3548011 TI - [Role of ultrasonic scanning in the surgical treatment of hemophthalmos]. PMID- 3548012 TI - [Oral contraceptives and the organ of vision]. PMID- 3548013 TI - [Correction of rheologic properties of the blood in transfusiology]. PMID- 3548014 TI - [Effect of extracorporeal circulation on antibacterial properties of the blood]. PMID- 3548015 TI - [Combined autoallodermatoplasty in the treatment of severely burned patients]. PMID- 3548016 TI - [Surgical treatment of chronic ischemia of the digestive organs]. PMID- 3548017 TI - [Use of oil preparations for hemostasis in gastroduodenal hemorrhage]. AB - The authors report on using oil preparations in endoscopic surgery for arrest of bleedings from vessels of the stomach and duodenum. Persistent hemostasis was obtained in 60 out of 64 patients. PMID- 3548018 TI - [Various approaches to the suturing of laparotomy wounds]. AB - The differential approach to suturing laparotomy wounds is described with special reference to the kind of operation, disease, state of the tissues in the field of the operation wound. The muscle-aponeurotic layer was sutured with the help of an autodermal strip, a modified method of putting removable stitches on the aponeurosis was used, in critical patients with peritonitis aponeurosis was not sutured. The methods were used in the complex treatment of 80 surgical patients, among them 38 patients had acute purulent peritonitis. The incidence of suppurative postoperative wounds was 3.8%, in patients with peritonitis it was 7.9%. There were no eventrations. PMID- 3548019 TI - [Intravascular rheoplethysmography in the diagnosis of aortic coarctation and aortic valve insufficiency]. AB - Methods of intravascular impedance plethysmography when used in the clinic during catheterization of heart cavities can reliably diagnose coarctation of the aorta and incompetence of its valves. The intravascular impedance plethysmography is a substantial supplement to the arsenal of methods of examination in the angiographic unit. PMID- 3548021 TI - [Possibilities of improving the results of surgical treatment of patients with perforated stomach and duodenal ulcers]. PMID- 3548020 TI - [Treatment of suppurative wounds of soft tissues with colocyl and its combination with proteolytic enzymes]. AB - The effect of a collagenous preparation Colocyl and its combination with proteolytic enzymes on the healing of soft tissue purulent wounds were studied in 239 patients. Colocyl and its combination with proteolytic enzymes were shown to facilitate the rejection of devitalized tissues, control of the inflammation and activation of reparative processes. PMID- 3548022 TI - [Surgical treatment of benign bone tumors in children]. AB - Based upon the data obtained in analyzing results of the surgical treatment of 248 children with different benign tumors of the skeleton the authors consider that the operation volume depends on the kind, localization and spread of the pathological process in the bone. The method of autoplasty gives the best results in substitution of bone defects after removal of the tumor in the children age. PMID- 3548023 TI - [Erythrocyte deformability in its clinical aspect]. PMID- 3548024 TI - Effects of Escherichia coli heat-stable enterotoxin b on small intestinal villi in pigs, rabbits, and lambs. AB - Culture supernates from two strains of E. coli were placed into different ligated intestinal sections (loops) of each animal. The two bacterial strains were identical except that one contained a plasmid carrying the heat-stable toxin b (STb) gene, while the other did not. Morphometric techniques were used to assess villous epithelial surface areas and mucosal volumes in both intestinal segments exposed to STb-positive (test) and to STb-negative (control) supernates. In pigs whose intestines were exposed to STb-positive supernatants for 2 hours, both villous epithelial surface area and mucosal volume were significantly smaller in test loops than in control loops (P less than 0.02). In test loops of pigs incubated for 1 hour, and in test loops of lambs incubated for 2 hours, there was a decrease in villous epithelial surface area which approached the test for significance but did not meet it (0.05 less than P less than 0.10). Rabbit test loops did not differ from rabbit control loops in either villous epithelial surface area or mucosal volume. Histological examination of the tissues from all three species revealed epithelial changes in porcine and ovine tissues only. In porcine and ovine tissues, epithelium at villous tips was seen to be cuboidal or squamous, or even to be absent. Villi with similarly altered epithelium were seen in control loops, but were seen much more frequently in test loops. These epithelial changes were seen as early as 30 minutes of incubation in pigs. Intestinal tissues from these pigs were examined by transmission electron microscopy, but no difference between test and control tissues was seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548025 TI - American Board of Toxicology, Inc. 1987 directory of diplomates. PMID- 3548026 TI - [Analysis of the results of ultrasonic tomography and endoscopic retrograde cholangiopancreatography in the diagnosis of cancer of the pancreas]. PMID- 3548027 TI - Absence of lymphokine-enhanced macrophage migration in vitro in the Australian brush-tailed opossum, Trichosurus vulpecula. AB - The supernatants from cultures of either opossum or guinea pig splenic lymphocytes, stimulated with phytohaemagglutinin, significantly enhanced the in vitro migration of guinea pig peritoneal macrophages (P greater than 0.001) but not that of opossum peritoneal macrophages. Failure of opossum macrophages to respond to a putative macrophage chemotactic factor might account for the observed paucity of immune granulomas in these animals and help explain the species' susceptibility to tuberculosis. PMID- 3548028 TI - Localization of immunoglobulins and complement by the peroxidase antiperoxidase method in autoimmune and non-autoimmune canine dermatopathies. AB - Formalin-fixed, paraffin embedded skin biopsy specimens from 44 dogs with various dermatopathies were examined for the presence of immunoglobulins (IgG, IgM, IgA) and complement (C3) by the peroxidase antiperoxidase method (PAP). Final diagnoses of the skin diseases were determined by clinical findings, fungal and bacterial cultures, skin scrapings, serum endocrinologic tests, and histologic features of cutaneous biopsies. The dermatopathies included examples of pyoderma (folliculitis/furunculosis), demodecosis, sarcoptic mange, dermatophytosis, endocrine dermatopathy, and autoimmune skin disease (AISD). In the latter category, 7 cases of pemphigus foliaceus, 1 pemphigus vulgaris, 4 discoid lupus erythematosus (DLE) and 4 examples of indeterminate AISD were examined. Immunoglobulins, C3, or both, were localized in tissue sections from AISD (15/16), pyoderma (7/11), demodecosis (4/8) sarcoptic mange (3/3), and dermatomycosis (2/3). Endocrine dermatopathy biopsies were consistently negative for Ig and C3 (0/3). The pattern of localization was most often intercellular (31/44 positive biopsies) with basement membrane immunoreactivity in 4 cases of DLE, and 1 case of indeterminate AISD. There was no consistent correlation between histologic features of hematoxylin and eosin-stained biopsies and the presence of Ig and C3. Clinical outcome was similar in both Ig and C3 positive and negative cases of non-AISD dermatitis. The high percentage (95%) of positive results in AISD biopsies indicates the usefulness and sensitivity of the PAP method for the localization of Ig and C3. Because of the high percentage of Ig localization in pyoderma (73%), biopsy specimens with extensive inflammatory skin disease are not suitable for diagnosis of AISD. The PAP method is useful in the diagnosis of AISD in biopsy specimens with minimal inflammation. Caution is warranted in the interpretation of immunoreactivity independent of clinical and histologic information. PMID- 3548029 TI - Neutrophil mediated and IgA dependent antibacterial immunity against enteropathogenic Escherichia coli in the porcine intestinal mucosa. AB - The role of polymorphonuclear neutrophils (PMN) in the antibacterial immunity against enteropathogenic Escherichia coli (EEC) 0:149 in the porcine intestine was studied using intestinal Thiry-Vella loop (T-V loop) as a model. Intraluminal immunizations of T-V loops resulted in elevated levels of immunoglobulin A (IgA) anti-EEC 0:149 antibody in the loop secretions, an infiltration of PMN in the lumen of the loops and an increase in the concentrations of lactoferrin (LF), lysozyme (LY), cationic proteins (CP), and a specific bactericidal response in the immunized loops. PMN were observed by electron microscopy (EM) to be actively phagocytic in the lumen of the immune loops. EM observations of loop fluids as well as the abrogating effect of iron on the in vivo bactericidal response strongly suggest that the pMN played an important role in the bactericidal response in the loops against EEC. In addition to phagocytosis by PMN and subsequent intracellular killing, disintegration of PMN in the lumen of the loops and extracellular killing of EEC by the antibacterial products of PMN such as LF, LY and CP, with and/or without synergistic effect of IgA antibodies, also contribute to the bactericidal response of the immunized loops. PMID- 3548030 TI - Separation and identification of bovine lymphocyte populations. AB - Various methods for separation of lymphocyte populations have been modified and adapted for use in isolating and identifying bovine lymphocytes. Ficoll diatrizoate (F-D) with a specific density of 1.084 was found to be superior to those with densities of 1.080 and 1.077 which were developed originally for the mouse and human mononuclear cells, respectively. F-D with a density of 1.084 attained a lymphocyte (absolute number) recovery rate of 92% whereas those with densities of 1.080 and 1.077 yielded 81% and 71% recovery rate of lymphocytes, respectively. Subsequent separation of T lymphocytes was achieved best by nylon wool column whereas separation of B lymphocytes was attained best by complement mediated depletion of T lymphocytes with the T lymphocyte specific monoclonal antibody (MAb), BLT-1. The former yielded 95 +/- 3% T lymphocytes with 47 +/- 9% recovery rate, and the latter gave 96 +/- 3% B lymphocytes with 71 +/- 9% recovery rate. In comparison, direct panning of F-D gradient separated mononuclear cells with goat anti-bovine IgG coated plates yielded 80% B lymphocytes with 31% recovery rate and indirect panning of MAb BLT-1 treated F-D gradient-separated mononuclear cells with goat anti-mouse IgG coated plates yielded 89% T lymphocytes with 35% recovery rate. PMID- 3548031 TI - [Pharyngeal viral population in 3- to 6-year-old children before and after influenza immunization using the NIVGRIP vaccine administered orally]. AB - Immunofluorescence techniques were used to investigate the incidence of viral antigens in exfoliated pharyngeal cells collected from 94 3-6-year-old children living in a collectivity, vaccinated by oral route with NIVGRIP inactivated influenza vaccine. The vaccination resulted in a significant decrease of IF positive subjects from 80% before to 39% after immunization, indicating a fall in the virus carriage level. The percentage of children in which two or more viral antigens were found also decreased from 72% to 33%. As regards the incidence of different viruses, the complete disappearance of influenza antigens and a marked decrease of the other investigated viral agents were recorded. PMID- 3548032 TI - [Sensitivity to influenza infection of X-ray-irradiated animals and the protective effect of a thymus extract]. AB - The A 2/Romania 1/73 (H3N2) strain of influenza virus at the 15th passage on chick embryos was compared to the mouse adapted A0/PR8/34 (H0N1) strain, as regards pathogenicity for X-ray irradiated mice. Irradiated mice showed a greater sensitivity to influenza infection than nonirradiated controls, irrespective of the strain used: hemagglutinating (HA) titers were constantly higher in the first group of animals. Administration of a polypeptidic thymus extract to irradiated mice inoculated with the A0/PR8 strain had a protective effect and was followed by a decrease in mean HA titer from 1/3077 to 1/164. The authors discuss the possible mechanisms of the viral multiplication rate increase in irradiated animals and of the higher resistance against influenza infection noted in thymus extract treated animals. PMID- 3548033 TI - The spleen necrosis virus int gene product expressed in Escherichia coli has DNA binding activity and mediates att and U5-specific DNA multimer formation in vitro. AB - To facilitate the in vitro study of the spleen necrosis virus (SNV) int gene product, we expressed the viral int locus in an Escherichia coli expression vector. Antiserum made against the protein produced in bacteria precipitated a 44 kDa polypeptide from virus-infected chicken embryo fibroblasts. This result is consistent with the expected size of the SNV int polypeptide. In a protein blotting assay, the expressed protein binds strongly to DNA and was able to complex nonspecifically with both single- and double-stranded DNAs containing or lacking viral sequences. However, under solution conditions favoring transient DNA unwinding, DNA binding was confined to supercoiled molecules containing either the SNV att sequence (the viral cis-acting region required for integration) or the U5 region of the long terminal repeat alone. Under these conditions of specific binding, multimeric DNA species were formed by apparent intermolecular interaction between protein-DNA complexes. These data indicate that retroviral integration may require local DNA unwinding at the att site for complex formation between the int gene product and DNA. This complex may be an intermediate in the viral DNA insertion process. PMID- 3548034 TI - Characterization of morphogenetic intermediates and progeny of normal and alkylated bacteriophage T7. AB - Analysis of thin sections of Escherichia coli B cells infected by normal (nonalkylated) or alkylated bacteriophage T7 showed that alkylation altered phage morphogenesis. To understand these morphogenetic alterations, we have isolated phage-related particles from infected-cell lysates by differential and sucrose gradient centrifugation. Cells infected by normal and by alkylated phage produced mature phage particles, empty heads, and proheads; however, production of proheads and mature phage particles was less in the case of alkylated phage. These lysates also contained sedimentable material which migrated more slowly than empty heads on sucrose gradients. In the case of alkylated phage, this peak contained radioactive material in amounts nearly equal to that in either proheads or empty heads; for normal phage, this peak represented a smaller fraction of the total radioactivity. Examination of the gradient fractions by electron microscopy revealed appreciable quantities of phage tails and tail-related particles. The same gradient fractions contained phage tail proteins: gene products (gps) 11, 12, and 17 as well as smaller amounts of gp 8, the head-tail connector. In addition, these fractions contained two other proteins which we believe to be of bacterial origin. These proteins may be related to tail formation or function as part of the phage receptor. On the basis of our data, we propose an alternative morphogenetic pathway for T7 tail formation, a pathway which would involve formation of a complex of tail proteins prior to association with the phage head. PMID- 3548035 TI - [Rapid control of acute hypertensive conditions by administration of sublingual nifedipine]. PMID- 3548036 TI - [35th anniversary of the Czechoslovak Hematology Society]. PMID- 3548037 TI - [The importance of determining beta-2-microglobulin levels in urine in the differential diagnosis of kidney diseases]. PMID- 3548039 TI - [A simple manually-operated injector for insulin therapy]. PMID- 3548038 TI - [Significance of the determination of C-peptide in type 2 diabetes]. PMID- 3548040 TI - [Present findings on the pathogenesis of type 2 diabetes]. PMID- 3548041 TI - [Various questions concerning medical provisions for the forces at the Western Front in the Battle of Moscow]. PMID- 3548042 TI - [Use of large-frame fluorography in examinations of the wounded in a triage evacuation hospital]. PMID- 3548043 TI - [Use of an automated system in the diagnosis of ischemic heart disease at the pre hospital stage]. PMID- 3548044 TI - [Method of rapid prediction of the complications of myocardial infarction]. PMID- 3548045 TI - [Blocks in the system of the combined treatment of injuries to the lower extremities (2)]. PMID- 3548046 TI - [Portable ligature cassette]. PMID- 3548047 TI - [Zinovii Petrovich Solov'ev (on the 110th anniversary of his birth)]. PMID- 3548048 TI - [Nikolai Fedorovich Arendt (on the 200th anniversary of his birth)]. PMID- 3548049 TI - [Functional biofeedback in exercise therapy]. PMID- 3548050 TI - [Mechanisms of the physiological and therapeutic action of mechanical vibrations]. PMID- 3548051 TI - [Metastasis of stomach cancer to the extraligamentous regional lymph nodes]. PMID- 3548052 TI - [Current status and outlook for the use of lasers in oncology]. PMID- 3548053 TI - [Ultrasonic tomography in the diagnosis of pancreatic cancer]. AB - The results of an ultrasonic tomographic study of 77 patients are presented. Cancer of the pancreas was identified in 50 patients. The diagnosis was verified by a complex examination and surgical evidence. The histological pattern of tumor was identified in 28 cases. The diagnosis of pancreatic carcinoma was confirmed by ultrasonic tomography in 42 cases, the sensitivity of the procedure being 88%, specificity-81%. In cases of chronic pancreatitis, the sensitivity proved 70%, thus requiring a complex approach to differential diagnosis between the two pathologies. PMID- 3548054 TI - [Surgical prophylaxis of peritonitis and other suppurative-inflammatory complications following intra-abdominal resections in cancer of the large intestine]. AB - The report discusses a surgical procedure for prevention of pyo-inflammatory complications and peritonitis tested experimentally in 21 rabbits and clinically in 44 patients with colorectal cancers. The frequency of pyo-inflammatory complications was reduced following a reinforcement of anastomosis sutures with autoplastic materials in a procedure employing extraperitonization. PMID- 3548055 TI - [Hygienic aspects of the possibility of using tobacco as a source of dietary protein]. PMID- 3548056 TI - [Vitamins and immunity. I. Ascorbic acid]. PMID- 3548057 TI - [Interrelation of various microelements in the process of their metabolism in the body]. PMID- 3548058 TI - [Museum of the N. I. Pirogov Vinnitsa Province Clinical Hospital]. PMID- 3548059 TI - [Focal segmental glomerulosclerosis and hyalinosis (a review of the literature)]. PMID- 3548060 TI - [Use of antioxidants in chronic nonspecific lung diseases (a review of the literature)]. PMID- 3548061 TI - [Cerebral hemodynamic function in arteriosclerosis patients based on the data from Doppler ultrasonography and zonal rheoencephalography]. PMID- 3548062 TI - [Importance of ultrasonic study in the diagnosis of the postcholecystectomy syndrome]. PMID- 3548063 TI - [90th anniversary of the founding of the Kiev L. V. Gromashevskii Research Institute of Epidemiology and Infectious Diseases]. PMID- 3548064 TI - [Leukocyte migration and the NBT test indices in acute and protracted forms of pneumonia]. PMID- 3548065 TI - [Role of the blood kinin system in the course of the reparation processes in tuberculosis]. PMID- 3548066 TI - [Monoclonal antibodies to NP protein and their use in studying influenza A viruses]. AB - Monoclonal antibodies to NP-proteins of influenza A/sea gull/Kazakhstan/470/79 (H1N1) virus have been prepared. Each clone interacted with spatially non overlapping antigenic sites of NP-protein. The clones differed in their capacity to inhibit the polymerase activity of different influenza A virus strains. F-81 clone was shown to interact actively with NP of human influenza A viruses, clone H12 reacted with both human and animal influenza viruses. PMID- 3548067 TI - [Expert diagnosis of infectivity with the AIDS virus using immune blotting: the development of a system and assessment of its parameters]. AB - A system for serodiagnosis of infection with AIDS viruses by means of immune ("western") blotting has been developed. The system has been found to be highly sensitive and suitable for expert serodiagnosis of AIDS disease and infection with human AIDS viruses. PMID- 3548068 TI - [Use of rhodamine-based fluorochromes in the immunofluorescent method in arbovirus research]. PMID- 3548069 TI - [Comparative study of immunoenzyme test systems for the rapid detection of measles virus antibodies]. PMID- 3548071 TI - Cough due to captopril. PMID- 3548073 TI - [Non-neoplastic stenosis and obstruction of the extrahepatic bile ducts and current methods of their treatment]. PMID- 3548070 TI - Physical activity and health maintenance--exactly what is known? AB - Broad claims have been made regarding the health benefits of physical activity. In analyzing the data on which these claims are based, including those on the risks of exercise, 5 of 13 proposed health benefits were found to have strong support in the literature. For the remainder the evidence is less conclusive or equivocal. Data regarding the risks of exercise are similarly varied. Proponents of physical activity should evaluate the documentation of its benefits and risks so as not to dilute the power of their remedy with unsubstantiated claims. PMID- 3548072 TI - [Results using Cavinton in various diseases of the central nervous system in children]. PMID- 3548074 TI - [Disorders of copper metabolism]. PMID- 3548075 TI - [A rare complication of bacterial endocarditis]. PMID- 3548076 TI - [Control of tuberculosis among university students in Lwow in the 22 Republic]. PMID- 3548077 TI - [Carcinogenic effect of ultraviolet rays]. PMID- 3548078 TI - [Pathophysiologic basis and clinical use of hemodilution in the treatment of cerebrovascular circulation disorders]. PMID- 3548079 TI - [Gynecologic operations in the scientific works of Ludwik Rydygier]. PMID- 3548080 TI - [Measuring cyclosporin in immunosuppressive treatment following liver and heart transplantation]. AB - Selective suppression of the immune system in graft recipients is now achieved in most cases by treatment with cyclosporine A. Due to large individual differences in absorption, utilization and metabolisation of this drug, therapeutic blood levels (immunosuppression/toxicity) can be maintained only by frequent measurements of the cyclosporine concentrations in blood samples and dosage readjustments. In the present study, we measured cyclosporine in whole blood samples from 37 patients (23 liver and 14 heart transplant recipients) using an high pressure liquid chromatographic method for native cyclosporine A which has been developed in our laboratory and a radioimmunoassay method (cyclosporine A + metabolites). By comparison of the results of HPLC and RIA-measurements (n = 520) we found a relatively stable metabolization rate (RIA/HPLC-ratio) of 4.23 +/- 1.30 for heart transplant recipients. In contrast RIA/HPLC ratios were highly variable in liver graft recipients ranging from 1.3-9 for the same patient in the posttransplant period. The liver recipients could be classified into two groups according to their mean RIA/HPLC-ratios: for 11 patients we observed a mean ratio of 2.65 +/- 0.35, for another 12 patients one of 4.35 +/- 0.75. Lower metabolisation rates seem to be associated with low donor age. No direct correlation was found between changes in RIA/HPLC-ratios and liver function, rejection and infection periods. Rejection treatment with high doses of methylprednisolone had no systematic influence on cyclosporine metabolisation in our patients. Since cyclosporine metabolites, at least those ones which are most abundant, have less immunosuppressive and toxic effects we recommend measurements of cyclosporine blood concentrations with any HPLC-method specific for the unchanged drug.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548081 TI - [Liver transplantation--indications and postoperative course]. AB - 54 liver transplantations on 53 patients are analysed. Tumor disease was found in 57%, cirrhotic liver disease in 43%. 9 patients had metastatic liver tumors after distal colon surgery. The fatal technical failure rate was 3%, the postoperative mortality for the first 3 month and for 1 year 40% and 52% respectively. Very often jaundice and rejection in the graft were found, independent from the crossmatch (pos. in 16%). There is only one child with 3 years. The main reason for postoperative death are lung and heart diseases, which were not diagnosed preoperatively in 10 patients. We conclude that the postoperative complication rate is to be lowered by applying rigorous selection criteria, raising the replantation rate and improving the donor organisation. PMID- 3548082 TI - [Sonographic comparative studies of the portal vascular system before and following endoscopic sclerosing of esophageal varices]. AB - On the occasion of 35 episodes of oesophageal injection therapy in which partly the intravascular and partly the perivascular injection technique were used, real time sonographic measurements were performed on the veins of the portal system immediately before and after sclerotherapy. In the case of intravascular injection, both the portal and the splenic vein and the confluens of the splenic and the superior mesenteric vein showed an increase in diameter, whereas in the cases of perivascular injection such changes were minimal or absent. The practical applicability of such sonographic calibrations could possibly lie in certain conclusions that could be drawn concerning the degree of vascular compression or obliteration during each session of sclerotherapy. PMID- 3548083 TI - [Optical immunofluorescence detection of alloantibodies as a supplement to classical crossmatching within the scope of organ transplantation]. AB - The importance of the indirect immunofluorescence test in evaluating an alloantigen-sensitization in organ transplantation is examined. In some antigen antibody combinations, which are non reactive in standard complement dependent microlymphocytotoxicity assay there is seen a highly positive reaction in the indirect immunofluorescence test. Therefore this test is an important supplementation in the compatibility-definition in organ transplantation. PMID- 3548084 TI - [Cyclosporin A as a diabetogenic cofactor]. AB - Two kidney transplanted patients are reported, who developed an insulin dependent diabetes mellitus after crossing therapeutic Cyclosporine A levels. After stabilisation of the Cyclosporine A levels the insulin dependent diabetes mellitus was completely reversible. The results are indicating Cyclosporine A as the insulin dependent diabetes mellitus initiator. PMID- 3548085 TI - [The 1st Medical Department of the Vienna General Polyclinic]. PMID- 3548086 TI - [Reduced deformability of erythrocytes as a common denominator of hemolytic anemias]. AB - Impairment of red cell deformability (and decrease of survival time) is the common trait of congenital haemolytic anemias with the exception of the enzyme defect glucose-6-phosphate-dehydrogenase (GPDH) deficiency. Causes for increased red cell rigidity may be: spherocytosis (familial hemolytic anemia), instable less fluid Hb (instable hemoglobinopathy), abnormal HbS-formation (sickle cell disease), genetic synthesis defect of Hb chains (homozygous beta-thalassemia), enzyme defects (autosomal recessive pyruvate-kinase deficiency). With GPDH red cell deformability remains unchanged. Splenectomy may be beneficial in anemias with erythrocyte rigidification if clinical condition so requires (repeated transfusions, aplastic and hemolytic crises). Assessment of red cell deformability in vitro saves laborous and exposure to radiation involving testing of cell survival time (e.g. radiochrome test). PMID- 3548087 TI - [Present status of hemorheology in neurology]. AB - Abnormalities of hemorheologic parameters are of pathophysiological importance in cases with evidence of vessel wall lesions and can thus be detected already in asymptomatic controls. Close relationships have been established to the severity of vessel wall lesions, to cerebral blood flow and to the severity of clinical symptoms. PMID- 3548088 TI - [Hemorheologic applications in vascular surgery]. AB - Possible vascular surgery interventions are reviewed in respect of the supraaortic segment (carotis obstruction), in aortic aneurysm, and in the lower extremities region (aorto-iliac/femoro-popliteal segment). The conservative therapeutic measures in terms of pre-, per-, and postoperative reocclusion prevention are discussed--also with a view to "surgically exhausted" cases--with special focus on platelet antiaggregants (acetylsalicylic acid [ASA]), hemorheological principles (hemodilution, pentoxifylline) and anticoagulation. In an one year comparative reocclusion prevention study of ASA and pentoxifylline (Trental 400) in patients with prosthetic bypass surgery in the femoro-popliteal segment no difference was found in respect of the patency rate between the two treatments, the hemorheological medication, however, proved significantly better tolerable. It can be concluded that such conservative treatments can clearly support the outcome of vascular surgery on the long run, with, indeed, control of risk factors and activation of patients to physical therapy (walking exercise). PMID- 3548089 TI - [Blood rheology in peripheral occlusive disease. Effects of hemodilution and pentoxifylline]. AB - The understanding of rheological relations in peripheral chronic arterial occlusive disease gained in the past two decades allows the conclusion that an efficient conservative therapy may be realized by rheological measures even in advanced states of this vascular disease. The points of therapeutic approach are the flow properties or the fluidity of the blood. The therapeutic objective consists in the improvement of the microcirculation by restoring perfusion reserves for the formation of collaterals. Employment of hemodilution and administration of the rheologically active drug pentoxifylline are quoted as exemplary possibilities for a promising treatment. The therapeutic procedures must also include consequent elimination of risk factors and should bear in mind correction of hypercoagulation in order to counteract the progression of the disease. PMID- 3548090 TI - [Hemodilution]. AB - The induced hemodilution is the most simple and efficient therapeutic measure of improving hemorheological parameters. Decrease of hematocrit, lowering of fibrinogen concentration and reduction of plasma viscosity are the mainly involved factors. They are to improve microcirculatory perfusion via amelioration of blood fluidity. The hematocrit value of 45% represents the critical borderline for the selection of the relevant procedure. Indications and limitations for the hypovolaemic (phlebotomy), iso- or normovolaemic and hypervolaemic dilution are reviewed with regard to the changes of the various hemorheological factors. Preference is given to the use of hydroxyethyl starch solutions. PMID- 3548091 TI - The clinical relevance of the flow properties of blood cells. AB - In the recent years hemorheology has gained increasing interest in medicine and contributed to new understanding of the role of blood fluidity with regard to microcirculation especially in chronic occlusive vascular disease. Various hemorheologic factors have been uncovered as being of significance in physiologic and pathologic flow conditions. Primarily the deformability of red cells was in the center of interest and various devices mostly based on filtration systems, were introduced for the measuring of red cell's ability to deform. In the last few years the role of white cells came into play especially in conditions of low perfusion pressure in ischaemic areas. Since it is plausible that in capillaries white cells can hold up a very much larger number of red cells it is most likely that the rheological properties of white cells play a governing role in areas of ischaemia and infarction in respect of blood fluidity, flow and prognostic aspects. A new filtration device is now available which can distinguish between the resistance to flow of the rheologically predominant cell type of a suspension (initial filtration rate) and the number of rigid cells blocking the filter pores (clogging rate). Intensive studies will be necessary to clarify the rheological behaviour of the different types of white cells. PMID- 3548092 TI - Epoxide hydrolase expression in human and rodent established cell lines. AB - Four human, four hamster and three mouse established cell lines have been analysed for epoxide hydrolase activity, and these have been compared with activities of human and mouse tissue preparations. Activities expressed by the cell lines, using styrene oxide as substrate, varied between less than 0.005 and 0.44 nmol/min per mg total cellular protein. Human liver and human kidney expressed 12.2 nmol and 2.7 nmol/min per mg total protein respectively. Antibodies prepared against purified human- and mouse-liver epoxide hydrolase enzymes were used to characterize the enzyme in the cell lines. Antihuman antibody was able to inactivate and precipitate enzyme in human cell lines and partially inactivate and precipitate hamster enzymes. It was much less effective against mouse cell lines. Antimouse antibody was able to precipitate mouse enzymes and partially precipitate hamster enzymes but did not precipitate human enzymes. These data may reflect evolutionary divergence of the three species. PMID- 3548093 TI - [A stepwise method of evaluating sugar substitutes--a preliminary study using enzymes. 1. Alpha-glucosidase from yeast]. AB - alpha-Glucosidase from yeast was checked for its catalytic potency under a variety of experimental conditions. Michaelis constants and maximal velocities are reported for 7 disaccharides of the glucosyl-fructosyl or glucosyl-glucosyl type, 4 disaccharide alcohols, and 2 mixtures of each 2 disaccharide alcohols. Reduction of a carbonyl group is of less importance for the substrate properties than the type of the glycoside bond; consequences for the suitability of potential sugar substitutes are derived. PMID- 3548094 TI - [A stepwise method of evaluating sugar substitutes--a preliminary study using enzymes. 2. Beta-fructosidase from yeast]. AB - No D-glucosylfructoses except sucrose, neither the alpha(1----1)- nor the alpha(1 ---3)- or the alpha(1----5)- or the alpha(1----6)-disaccharide possess substrate properties for beta-fructosidase from yeast. The two latter ones, leucrose and isomaltulose, however, are non-competitive (leucrose) or uncompetitive (isomaltulose, Palatinose) inhibitors of beta-fructosidase from yeast. Due to the high substrate specificity of invertase, assays of its activity have predictive power for cariological aspects of sugar substitutes carrying glycoside bonds between glucose and fructose. PMID- 3548095 TI - [Significance of commemorative meetings on great physicians of the past]. AB - Commemoration-days are particularly significant, when thinking approaches from former times can be related to new hypotheses and working methods and thus can lead to better results. This is generally taken into consideration and here especially applies to great physicians. For the characterization of a great physician 6 points are mentioned: 1. a high measure of creativity, 2. unflinching industry, 3. teachers of their subject, 4. formation of schools, 5. action as an example, 6. setting up a standard for his subject. From the history of medicine 30 great physicians are mentioned with name and lifetime and with short words is thought of their important achievements, continuing effective historically. PMID- 3548096 TI - [Max Burger--achievements in conflict-laden times--on his 100th birthday]. AB - Max Burger (1885-1966) is one of the most outstanding German internists in our century. His special merit is the application of modern scientific methods to his special field and the founding of gerontology as a new field of research. During the time of fascism in Germany Max Burger has retained his fidelity to an humanistic engagement of the medical profession and, in contrast to many other distinguished representatives of medicine, he didn't succumb the various corruptions for participation in misuse of authority. In spite of the hard conditions in 1945 Max Burger decided to carry on his activities in Leipzig. Here he achieved in the following years significant results for the reconstruction of Public Health and medical university education. The underlie of these commendable decisions was a humanistic professional ethos, to whom the engagement for suffering individuals was more important than the personal prosperity. PMID- 3548097 TI - [Bioergography of Max Burger]. AB - For the inquiry into changes during ageing apart from the usual methods of the cross-sectional and longitudinal research the biographical analysis is at our disposal. The establishment of statistics of works is called bioergography. This method is particularly suitable for the recognition of changes of creativity of productive persons, as it is shown at the instance of Ludwig van Beethoven. The bioergography of Max Burger reveals how form and essence of his work have changed in the course of his life without speaking about a decline of his vigour. PMID- 3548098 TI - [Diabetes mellitus as a primary and secondary metabolic disease]. AB - Already in the preface of his book "Alimentary and Metabolic Diseases" Max Burger writes: "I see a difficulty in the definition in the field of metabolic diseases. Since all life processes are finally based on a change of the substances, the accentuation of individual diseases as metabolic diseases is more or less arbitrary." The diabetes mellitus belongs to the classical metabolic diseases. But here only the symptoms are taken into consideration which phenotypically are standing in the foreground. The further clarification of the etiopathogenesis shows that the diabetes mellitus has heterogeneous causes and an existing insulin deficiency is etiologically to be classified as a primary immunological or endocrinological disease and thus one should speak of a secondary metabolic disease, while in normal insulin secretion it should be regarded as a primary metabolic disease. PMID- 3548099 TI - [Glucagon, its discovery and description and the work of Max Burger]. AB - After intravenous injection of technical insulin (lower degree of purity) already in 1923 Murlin observed transient initial increases of blood sugar. He suggested that this would be caused by another hormone and he gave him the name of glucagon. Nearly from 1928 Burger dealt with the synergistic effect of muscle work and intravenous application of insulin on the blood sugar. Here he also established the blood sugar increasing principle glucagon. Subsequently by animal experimental and clinical examinations he essentially contributed to the characterization of the substance itself and its mode of action. He always acknowledged the priority of Murlin. The statement of the A-cells of the pancreas as the place of the synthesis of glucagon, the clarification of its structure and its pure preparation caused the fact that nowadays comprehensive knowledge about the second pancreatic hormone is available. PMID- 3548100 TI - [Physiosclerosis--arteriosclerosis. Progression and regression then and now]. AB - The clinical recognition of the physiosclerosis is still problematic even nowadays. This question seems not to be actual, since the disease arteriosclerosis with all its sequels is the superior epidemiological problem of mankind. Therefore, the inhibition of the progression and the regression of arteriosclerosis is of great interest. Now as ever, however, the coming forth of an atheromatous focus into the blood stream and the later change of the ulcer developed in such a way into fibrous connective tissue is the only regression of the arteriosclerosis in man up to now certainly made evident. A new course is adopted. Three approaches of intervention are represented with own results: favourable effects of multiply unsaturated fatty acid, importance of the trace element balance, particularly of selenium, the use of the classical risk factor concept at all ages. PMID- 3548101 TI - [Burger's efforts for a productive relationship between physiology research and internal medicine]. AB - On the occasion of the 100th anniversary of Max Burger's birthday his performances in the field of physiology are summarizingly valued and deduced from Burger's philosophical conception. For his whole life Burger felt obliged to the developmental biological ideas of the first half of the last century. So the observation and description of the age-depending change of physiological accomplishments and functions became his essential subject of research. Particular attention deserve his investigations of the intrathoracic pressure as well as his studies on the sex-dependence of courses of the disease. As clinician Max Burger particularly identified himself successfully with the development of the pathological physiology as subject of instruction and education. PMID- 3548102 TI - [Contributions of Max Burger to the development of sports medicine]. AB - The paper describes and appreciates the merits of Max Burger who--as a clinician- realized very early the preventive and health-promoting role of regular physical training which can be principally carried out, from his point of view, up to the older age. He proved this opinion over more than 3 decades by numerous results of examinations especially in the field of the cardiopulmonary system and metabolism. Max Burger became in several ways one of the forerunners of modern sports medicine by his important publications (among others "Normale und pathologische Physiologie des Blutkreislaufes bei sportlichen Anstrengungen", "Die Methodik der korperlichen Leistungsprufungen mit Einschluss der Eignungsprufungen fur Beruf und Sport") by influencing the development of new research apparatuses and the installation of a larger performance diagnostic unit within his hospital as well as by the understanding between his aging research and sports medicine promoted by him and by his inititative to invite interested sports physicians to the foundation session of a "working group for sports medicine" the 13th and 14th November 1954. PMID- 3548103 TI - [Diabetic angiopathy--retrospect and prospect]. AB - Max Burger intensively dealt with the problems of angiopathia diabetica which determines the prognosis of the diabetic. His successful action in diabetogenic gangrene must from the modern point of view possibly supplemented by methods opening the vascular lumenor by haemorheological therapy. In contrast to this many questions of the prophylaxis and early therapy of arteriosclerosis in diabetes mellitus still await their only interdisciplinary possible clarification. In practice hopes are connected with the new possibilities of the management of metabolism in diabetes type I and the improvement of the patient's compliance. PMID- 3548104 TI - [Ars medica Anhaltina (IV): Friedrich Samuel Kretschmar (1730-1793) and public healer organization in the philanthropic principality of Anhalt-Dessau]. AB - In the history of the organisation of public health of the 18th century the territory of Anhalt-Dessau takes a remarkable place. There the ideas of enlightenment and philanthropism induced a model, the details of which were determined above all by the activities of the physician Friedrich Samuel Kretschmar. A carefully worked out system of social welfare was particularly for the benefit of the poor population and included prophylactic measures, which also oriented to the variolisation. PMID- 3548106 TI - [Endoscopic intragastric detection of hydrogen]. AB - The sensitivity of hydrogen (H2) breath-tests for testing small-intestinal bacterial overgrowth is limited by many factors. In this study H2 was tested directly with a selective electrochemical cell in a sample of stomach gas obtained during gastroscopy. This was possible in 100 of 109 cases. In patients with dyspeptic disorders (complaints of excess gas) H2 concentrations were significantly higher than in the group of patients without these complaints (p less than 0.001). In dyspepsia the stomach-test was significantly more often pathological than H2-breath-test with glucose (p = 0.01). There was no correlation between the results of both tests in 66 cases. Intragastral H2 may result from H2-reflux from the small bowel, because there was no difference in bacterial growth in gastric and duodenal juice and in gastric mucosa of patients with high and normal H2 concentrations in the stomach and because a motility disturbance of upper GI-tract (prolonged gastric emptying time) correlated well with H2-concentrations (p less than 0.05). PH of gastric contents, various ingested dietary substrates, smoking, endoscopic and histological diagnosis did not influence ig H2. Measurement of H2 during gastroscopy may give immediate evidence of small bowel motility-disorders. PMID- 3548107 TI - [Acute fatty liver of pregnancy. A case report of the differential diagnosis of pregnancy-associated liver diseases]. AB - Acute fatty liver of pregnancy (AFLP) is a rare, but often fatal disorder in the third trimester of pregnancy. We report on a patient with AFLP complicated by acute hemorrhagic diathesis, who survived after early diagnosis and adequate treatment. On electronmicroscopy, the characteristic microvesicular fatty deposits in the centrolobular hepatocytes could be demonstrated. PMID- 3548105 TI - [Mycoplasma etiology of acute pancreatitis]. AB - In a 10 year-old girl the clinical and laboratory findings led to the diagnosis of pancreatitis. At the same time an infection by mycoplasma pneumoniae was serologically stated. Since there could not be found another cause for pancreatitis, a relation between pancreatitis and infection by mycoplasms is very probable. PMID- 3548108 TI - [Differential diagnosis of jaundice by combined noninvasive diagnostic means using a logistic discriminant analysis]. AB - Using a logistic discriminant function we retrospectively evaluated the diagnostic value of laboratory features and abdominal sonography in 70 patients with jaundice. 18 patients had an extrahepatic obstruction of the common bile duct (EHO), 22 patients had metastatic liver disease (MLD) and 30 patients had an infectious or toxic hepatocellular disease (HCD). The sensitivity resp. specificity of the 5 laboratory values AP, GGT, GPT, GOT and bilirubin was 22% resp. 90% for diagnosing EHO, 82% resp. 79% for diagnosing MLD and 67% resp. 68% for diagnosing HCD. The diagnostic value determined by their Chi2-value was AP greater than GPT greater than bilirubin greater than GOT greater than GGT. An undoubtedly dilated common bile duct was seen in 56% of the patients with EHO and in none of the other patients. Metastatic lesions were seen exclusively in 81% of the patients with MLD. No distinct sonographic sign could be found for the patients with HCD. The combination of AP, GPT and bilirubin with the result of abdominal sonography in a logistic discriminant function led to a correct a posteriori classification of all patients. Using a mathematical classification model jaundiced patients can be diagnosed on the basis of noninvasive methods alone and invasive procedures should be restricted to therapeutic interventions. PMID- 3548109 TI - Therapy of pancreatogenic steatorrhoea: does acid protection of pancreatic enzymes offer any advantage? AB - Pancreatic enzyme replacement may fail to achieve a beneficial effect because of enzyme inactivation by gastric acid. In this controlled randomized study, 8 hospitalized patients with severe exocrine pancreatic insufficiency and considerable steatorrhoea (greater than 15 g faecal fat/day) were treated with a conventional pancreatic enzyme preparation (Pankreon 700; 3 X 3 dragees daily), with (300 mg) and without cimetidine before meals, and with a new pH-sensitive enzyme preparation (Kreon; 3 X 6 capsules daily) comprising acid-protected granules. Both conventional enzyme replacement plus cimetidine, and acid protected pancreatin were significantly (p less than 0.05) more effective than conventional enzyme therapy alone. Since both regimens are equally potent in overcoming gastric acid-induced enzyme inactivation, it is concluded that therapy with acid-protected pancreatin may simplify and improve treatment of exocrine pancreatic insufficiency in the presence of gastric hyper- or normo-acidity. PMID- 3548110 TI - Monitoring of renal allografts under immunosuppression. PMID- 3548111 TI - [New possibilities for reducing transplant immunogenicity by influencing the antigen-presenting cells--results of basic immunologic research]. PMID- 3548112 TI - [Phagocyte chemiluminescence during kidney graft rejection in a dog model]. PMID- 3548113 TI - [State and problems of the HLA serologic DRS with respect to kidney transplantation in East Germany]. PMID- 3548114 TI - [Correlation of new DNCB cutaneous tests with the survival rate of transplanted kidneys under cyclosporin A treatment]. PMID- 3548115 TI - [Experiences in the immunologic supervision of patients after kidney transplantation]. PMID- 3548116 TI - [The transplanted heart. Morphologic findings in endomyocardial biopsies (EMCB)]. PMID- 3548117 TI - [Immunologic-cytologic monitoring of heart transplant patients]. PMID- 3548118 TI - [Artificial heart in heart transplantation--a review]. PMID- 3548119 TI - [Orthotopic heart transplantation: on the problem of indications in coronary heart disease]. PMID- 3548120 TI - [Pathology in Heidelberg]. PMID- 3548121 TI - [Phenotypic and genotypic marker in malignant lymphomas: cellular origin of Hodgkin's disease and malignant histiocytosis as well as implications for classifying T-cell and B-cell lymphomas]. PMID- 3548122 TI - [Morphological methods: methodological spectrum (principles, mechanisms, evaluation)]. PMID- 3548123 TI - [Immunocytochemical cytodiagnostic of tumors]. PMID- 3548124 TI - [Prognostic relevance of tissue marker staining in stomach carcinomas and their lymph node metastases]. PMID- 3548125 TI - [Detection of carcinoembryonic antigens (CEA) in frozen and paraffin sections of stomach carcinomas]. PMID- 3548126 TI - [Correlation of immunohistological results of stomach carcinomas with the Lauren classification and tumor stage]. PMID- 3548127 TI - [Comparison of immunohistochemical and biochemical analysis of estrogen receptors in breast carcinoma and correlations with the histological tumor classification]. PMID- 3548128 TI - [Immunohistochemistry of alpha-lactalbumin, lactoferrin and trans- ferrin receptor in invasive breast carcinomas with regard to tumor grading, estrogen receptor status and tumor staging]. PMID- 3548129 TI - [Tumor-associated macrophage subpopulation and the prolific activity of malignant tumors--an immunohistochemical study of 109 breast carcinomas]. PMID- 3548130 TI - [Immunohistochemical studies of cell differentiation in non-puerperal chronic granulomatous mastitis]. PMID- 3548131 TI - [Immunohistochemical estimation of the proliferative action of breast and large intestine carcinomas]. PMID- 3548132 TI - [Immunohistochemical findings in thyroid gland tumors]. PMID- 3548133 TI - [Differential diagnosis of true paragangliomas and paraganglioma- like tumors of the thyroid by means of immunohistochemical tumor markers]. PMID- 3548134 TI - [The significance of determining intermediate filament and epithelial membrane antigens in the differential diagnosis and histogenetic differentiation of ovarian tumors]. PMID- 3548135 TI - [Immunohistologically confirmed pulmonary carcinosarcoma]. PMID- 3548137 TI - [Immunohistology of pituitary adenomas--significance for classification and clinical correlation]. PMID- 3548138 TI - Small blood vessels or lymphatic channels with neoplastic microemboli: a comparative immunohistochemical study. PMID- 3548136 TI - [Immunohistochemical studies of Ewing's sarcomas and their differential diagnosis with other "small round blue cell" sarcomas of childhood and adolescence]. PMID- 3548139 TI - [Differentiation of macrophages and smooth muscle cells with monoclonal antibodies in arteriosclerotic plaques of the human aorta]. PMID- 3548140 TI - [Esthesioneurogenic tumors--observations on cellular differentiation]. PMID- 3548141 TI - Clinical and immunohistological findings in subependymomas of the spinal cord. PMID- 3548142 TI - [Application of the immunoperoxidase slide method in immunohistochemistry]. PMID- 3548143 TI - [Rational screening of cell fusion supernatants for the histochemical evidence of monoclonal antibodies against tumor-associated and other antigens]. PMID- 3548144 TI - [Hormonal tumor markers]. PMID- 3548145 TI - [Morphologic aspects of adaptation of the fetus-placenta system during different conditions of intrauterine development]. PMID- 3548146 TI - [The pathogenesis of fetal growth retardation]. PMID- 3548147 TI - [Second generation of antitumor complex platinum compounds in experimental and clinical chemotherapy]. PMID- 3548148 TI - [Immunoenzyme method of diagnosis in gonococcal infections]. PMID- 3548149 TI - Pneumococcal polysaccharide vaccine prevents death from pneumonia in Papua New Guinean children. PMID- 3548150 TI - Congenital malaria due to Plasmodium vivax: a case study in Papua New Guinea. PMID- 3548151 TI - Early surgical exploration and epineural repair in birth brachial palsy. AB - The management of birth brachial palsy (Erb-Duchenne, Klumpke) has been traditionally conservative, and that is why the condition leaves some patients with impaired upper limb function for life. Development of anaesthesiology and microsurgical techniques have made safe early surgical repair of selected palsies possible. A 12 years' experience of early exploration of 11 patients aged from 2 weeks to 7 months is evaluated. The technique of direct epineural repair of ruptured roots has been successful in the early treatment of birth palsy. In the follow-up of 1 to 13 years after operation 7/11 patients regained good to excellent hand function. PMID- 3548153 TI - [Implantation technic of a peritoneal dialysis catheter in infancy and childhood]. AB - Since 1979 the continuous ambulatory peritoneal dialysis (CAPD) is used even in childhood. Practical management and tolerance of this method over a longer period are dependent on the compatibility of the chosen catheter material, the implantation technique and the exact introduction in catheter care with sac changing. The used variant of the classical Tenckhoff-catheter with spiral end and individually fitted cuffs has proved to be reliable. The left-sided paramedian incision is the preferred operative access. The transrectal position of the catheter guarantees its cranio-caudal course and placement of the spiral in the minor pelvis. The standardisation of surgical procedure in all details is an essential assumption for the improvement of long-term catheter function. PMID- 3548152 TI - [Effect of testicular torsion on the contralateral testis following experimental testicular torsion in rats]. AB - Experimental torsions of the testicle were carried out in 100 adult and 80 premature Wistar rats. Histology revealed in 27.7% severe morphological changes in the contralateral testicles. Their possible influence on temporal or irreversible disturbances of fertility is discussed. CB-RIA investigations detected the presence of antisperm antibodies in the serum of 67 between 90 rats of the experimental group. PMID- 3548155 TI - [Practical use of the Kurer anchor system. Introduction and progress report]. PMID- 3548154 TI - [Treatment with low-dose methotrexate in chronic polyarthritis. Review of the literature]. AB - The therapeutic effect of low-dose MTX-treatment (10-25 mg/week) in active rheumatoid arthritis can be demonstrated by an improvement in clinical and laboratory parameters of disease activity already after 4-6 weeks. The mode of action is not fully understood. Direct anti-inflammatory effects seem to be more important than the weak immunosuppressive properties. Methotrexate treatment is indicated in all very active cases of rheumatoid arthritis, which do not respond to, or do not tolerate, conventional slow-acting antirheumatic drugs. In severe, rapidly progressing diseases MTX can be given without waiting for the effect of other disease modifying drugs. MTX is administered once a week i.v., i.m. or in one oral dose before breakfast. Absorption is reduced by food. The initial weekly dose is 15-25 mg and can be reduced to a minimum of 10 mg (7.5 mg) according to the clinical effect. A combination with antimalarials or gold salts is possible. The prescription of MTX is contraindicated in cases of renal function disturbances, active liver disease, bone marrow disturbances, active infectious diseases, pregnancy and excessive alcohol consumption. The most common side effects are nausea and vomiting, stomatitis, transient elevations of transaminases. Rare conditions are leucopenia, thrombocytopenia and lung infiltrations. The side-effects are dose-related and disappear with dose reduction. They can be avoided by administering leucovorin 12 hours after giving MTX. Before starting the treatment total blood count with differential count and platelet count, serum creatinine and liver enzymes should be done. These laboratory studies have to be repeated every week for the first month, every two weeks up to the third month and every 1-2 months thereafter. When contraindications are considered and regular controls are made methotrexate is better tolerated than other cytotoxic agents. The rate of withdrawals is lower than with gold-treatment. In low-dose MTX-treatment drug interactions do not play a major role with normal renal function. Concomitant application of nonsteroidal antirheumatic drugs can delay MTX elimination and increase toxicity. We therefore avoid giving these drugs on the day of MTX-administration as far as possible. PMID- 3548157 TI - [Theoretical and technological principles of extra- and intra-coronal attachments made in East Germany of precious and non-precious metals]. PMID- 3548156 TI - [Corrosion resistance of post anchors and post crowns. Problem-free silanization]. PMID- 3548158 TI - [The marginal periodontium and crown margins]. PMID- 3548159 TI - [A device for plasticizing wax in dental technology]. PMID- 3548160 TI - [100 years of the Berlin Surgical Society]. PMID- 3548161 TI - [Notes on the 100th anniversary of the Berlin Surgical Society]. PMID- 3548162 TI - [The development of surgery by Ernst von Bergmann]. PMID- 3548163 TI - [The painting "Prof. Ernst v. Bergmann at the Royal University Clinic of Berlin" painted by Franz Skarbina]. PMID- 3548164 TI - [August Bier and the history of medicine]. PMID- 3548165 TI - [The work of Ferdinand Sauerbruch (1875-1951) in Greifswald]. PMID- 3548166 TI - [Indications and choice of surgical procedure in bleeding gastroduodenal ulcer]. AB - Lethality of bleeding peptic ulcer has been reduced to about 15 per cent in recent years by therapeutic endoscopy in combination with differentiated surgical tactics. Intensity and activity of bleeding as well as additional criteria, such as localisation, recurrence of bleeding, and age of the patient, are some of the parameters for surgical indication which are used in decision-making, with due consideration of the spontaneous course. Endoscopic haemostasis should be intensively used to avoid emergency operations and action of early recurrence. Selective early surgery should be performed whenever possible. Surgical techniques should be chosen with two objectives in mind, localised haemostasis and definitive ulcer treatment. Extraluminal and intraluminal ligation and additional vagotomy should be the optional approach to bleeding peptic ulcer. Billroth's I operation should be applied to ventricular ulcer. PMID- 3548167 TI - [Effect of the choice of recipient, surgical technic and logistics on the Zurich results of pancreas transplantation]. AB - Simultaneous pancreas and kidney transplantation was applied to 22 type-I diabetics with diabetic nephropathy and other secondary complications, between July 1st, 1980 and November 30th, 1985. Four pancreas transplants, at present, are functional 56, 25, 15, and twelve months from transplantation. Six transplants lost their function within one and a half to 61 months from transplantation. The transplanted kidneys were immunologically rejected in four of these six cases. Four patients died with functioning transplants between 36 hours and eight months from transplantation. Three of them died of cardiac secondary sequels of their primary disease. In nine cases, pancreas transplants lost function within one month from transplantation without affecting functions of simultaneously transplanted kidneys. Most of the functional failures of transplants had been caused by ischaemic damage and postoperative vascular thrombosis. Complications from the exocrine pancreas were eliminated or avoided by postponement of percutaneous duct occlusion, using prolamine. The results reported in this paper show that for juvenile diabetics with nephropathy and ophthalmopathy simultaneous pancreas and kidney transplantation is the method of choice, whereas the course of the disease in patients with advanced secondary complications, such as severe angiopathy and gastropathy, could not be decisively improved by pancreas transplantation. PMID- 3548168 TI - [Ultrasonic measurements of the uterus in adolescents]. AB - Length of uterus, anterior-posterior and cross diameter in 105 healthy and 101 diabetic girls at the age from 9 to 20 years determined by ultrasound. Length of uterus and its calculated volume are correlated to age and Tanner classification, in order to conceive in a reproducable way the development of uterus in puberty. In both groups a clear push of growth occurs about the time of menarche. The diabetic girls showed a slight delay of uterus development, which is adjusted, however, at the end of puberty (Tanner IV and V). PMID- 3548169 TI - [Detection of microbial variants of Salmonella typhi in the bone marrow of typhoid patients and carriers]. AB - The immunofluorescence test with the use of antisera to S. typhi and its L-forms permits the detection of the infective agent in bone marrow smears. This diagnostic method is particularly important in cases of carrier state in the latent phase and in differential diagnosis. As revealed in this study, the microbial variants of S. typhi, reacting with antiserum to its L-forms, are present in the bone marrow of carriers. They are localized, as a rule, on the membranes of lymphoid and erythroid cells, which probably leads to the formation of rosettes. PMID- 3548170 TI - [Delayed-type hypersensitivity in mice immunized with ribosomal vaccines against Shigella sonnei]. AB - The capacity of S. sonnei ribosomal vaccine (SRV) for inducing delayed hypersensitivity (DH) was studied in the foot pad test on mice. The test injection of SRV in a dose of 10 micrograms, inducing only transient changes in intact mice, led to a highly pronounced reaction in mice immunized with ribosomes in Freund's complete adjuvant. The mean difference in thickness between the test and control (injected with physiological saline) feet amounted to 0.54 mm on day 16 after immunization in two injections. Immunization in a single injection produced a less pronounced reaction. After the injection of SRV without the adjuvant no DH developed in the animals. Histologically, the reaction was typical for DH in mice: in 24 hours, at the time of maximal swelling, the cell infiltration of the tissues with the prevalence of mononuclear cells and a significant proportion of neutrophils was observed. The specificity of this reaction was confirmed by cross tests in mice immunized with SRV and bovine serum albumin: positive reactions were observed in homologous systems only. The independence of the foot pad reaction to SRV from antibody formation was corroborated by the fact that the peak of humoral response occurred two weeks before the development of cutaneous hyperreactivity. It was also shown that, in contrast to antibody formation, the foot pad reaction was completely resistant to the treatment of mice with cyclophosphamide in a dose of 200 mg/kg. PMID- 3548171 TI - [Evaluation of vaccinal immunogenesis by the peroxidase method]. AB - The possibility of evaluating functional immunomorphogenesis in the course of the vaccinal process after the injection of conjugated and live brucellosis vaccines, as well as conjugated plague antigen and Yersinia pestis strain EV, to guinea pigs has been shown by means of the direct and two-layer variants of the immunoperoxidase assay. The dynamics of the accumulation of globulin-producing cells in the immunocompetent organs and the time course of immunoglobulin titers in the peripheral blood after the injection of live and conjugated vaccines have been followed up. These data may be used for the morphological evaluation of approved preparations. PMID- 3548172 TI - [Immunofluorescence method of detecting cholera enterotoxin]. AB - The quantitative immunofluorescent assay for the determination of cholera enterotoxin is proposed. The assay is based on the selective sorption of cholera enterotoxin by gangliosides incorporated into polyacrylamide granules. The preliminary treatment of gangliosides with neuraminidase enhances the sensitivity of this assay. The assay permits the detection of cholerigen in an amount of 20 ng. PMID- 3548173 TI - [Properties of the human anti-IgG-IgG system in various modifications of immunoenzyme analysis]. AB - The physico-chemical characteristics of EIA, and in particular sensitivity, accuracy, reproducibility, can undergo essential changes with variations occurring in the course of the experiment, which makes it necessary to optimize conditions at each stage of the assay. For this purpose the human anti-IgG-IgG system has been studied in two modifications of EIA: the sandwich and competitive methods. PMID- 3548174 TI - [The use of direct immunoenzyme analysis with genus-specific peroxidase conjugate in leptospirosis]. AB - For the first time anti-Patoc I peroxidase conjugate was obtained from the serum of a hyperimmunized guinea pig by the method of Nakane and Kawaoi (1974) in the modification of Mathiesen et al. (1978). In the experimental study of 37 Leptospira strains belonging to 19 serological groups, carried out with the use of direct EIA techniques, anti-Patoc I peroxidase conjugate was found to be genus specific and highly active. The possibility of detecting Leptospira antigens of 7 serological groups in the blood and in suspensions of the liver and kidneys of golden hamsters by direct EIA with the use of the above-mentioned conjugate was established. The use of direct EIA with anti-Patoc I peroxidase conjugate for the diagnosis of leptospirosis is recommended. PMID- 3548175 TI - [Comparative evaluation of Yersinia interaction with HEp-2 cells]. AB - In experiments on HEp-2 cells, the comparative characterization of the mechanism of invasion and the cytotoxic action of a number of Y. pseudotuberculosis strains, serovar 1, and Y. enterocolitica strains 03 and 09 (24 strains newly isolated from human patients and rodents and 5 laboratory strains at different degrees of attenuation) has been made on the basis of data obtained by optical and electron microscopy, as well as by cytoenzymological analysis. As revealed in these experiments, the invasion of Yersinia into epithelial cells and their capacity for intracellular multiplication depend on the cytotoxicity of the bacteria, most pronounced in Y. pseudotuberculosis, serotype 1, considerably less pronounced in Y. enterocolitica 09, and poorly pronounced (or absent) in Y. enterocolitica 03. Cytopathic changes are manifested by vacuolization, the exocytosis (clasmatosis) of the peripheral cytoplasm, impoverishment in organellae, the formation of autophagosomes, the shriveling of the nuclei and the perinuclear cytoplasm, the rounding of the cells and their separation from the glass surface. The development of these changes is accompanied by the increased activity of phosphatases diffusing into the cytoplasm and by the inhibition of cell respiration and dehydrogenase activity. PMID- 3548176 TI - [Determination of antibodies against ribosomes and various cell wall components and detection of circulating antigens of group A Streptococcus in patients with erysipelas]. AB - The level of antibodies to the ribosomes, polysaccharide A and peptidoglycan of group A streptococcus in the blood of patients with primary, secondary, and often relapsing erysipelas was studied by means of the enzyme immunoassay with the use of the sandwich techniques. For control, the sera of healthy donors were used. In the sera obtained from all groups of erysipelas patients a significant rise in the levels of antibodies to ribosomes and peptidoglycan in comparison with the controls was revealed. An increase in the level of antibodies to polysaccharide A was revealed only in patients with frequently relapsing and secondary erysipelas. Depending on the clinical form and the duration of the disease, polysaccharide A was detected in 32-51.9% of erysipelas patients and protein-ribosomal antigen was detected in 28.6-51.9% of such patients. PMID- 3548177 TI - [Heterogeneity of the host population in the epidemic process and immuno prophylaxis of diphtheria]. PMID- 3548178 TI - [Crisis of contemporary psychoanalysis in the USA and in France (review of the literature)]. PMID- 3548179 TI - [Effect of meteo- and heliofactors on the state of the autonomic nervous system and the adaptive capacity of man (review)]. PMID- 3548180 TI - [Semeiotics of incipient forms of vascular diseases of the brain and their diagnosis during preventive examinations of the population]. AB - Using formalized documentation and computerized techniques, the authors analyzed clinical, electrophysiological, and biochemical semiotics in 2180 individuals- healthy subjects, patients with subclinical and initial manifestations of cerebral circulation insufficiency, initial dyscirculatory encephalopathy developing in the presence of neurocirculatory dystonias, atherosclerosis, and arterial hypertension. The author has established characteristics of the semiotics which depend on the nature of the underlying vascular disease, the stage of the process and the patient's age. Tabulated methods and a computerized system of the diagnosis of cerebrovascular disease have been developed. They are based on the employment of a bank of clinical and physiological information used for prophylactic examinations and population screening. The social, medical and economic effectiveness of the proposed methods of the diagnosis and prevention of cerebrovascular diseases allows their recommendation for wide introduction into health care practice. PMID- 3548181 TI - [The beginnings of science-oriented dentistry in Austria]. PMID- 3548182 TI - [Origins and pioneering epoch of operative dentistry]. PMID- 3548183 TI - [Periodontology as times are changing--an historical retrospective and a view toward the future]. PMID- 3548184 TI - [The development of dental prosthetics in Austria]. PMID- 3548185 TI - [125 years of dental surgery, oral-maxillofacial surgery]. PMID- 3548186 TI - [The historical development of orthodontics]. PMID- 3548187 TI - Clinical lung transplantation: state of the art after 23 years of rational progress. PMID- 3548188 TI - [The postoperative course and kidney rejection]. PMID- 3548189 TI - [Total lymphoid irradiation, autoimmune diseases and organ transplantation]. PMID- 3548190 TI - Carcinoembryonic antigen in effusions. A diagnostic adjunct to cytology. AB - A total of 189 effusion specimens (100 benign and 89 malignant) submitted for cytologic examination were assayed for carcinoembryonic antigen (CEA) by an enzyme immunoassay to determine whether the addition of CEA evaluation to cytologic study would improve the diagnostic accuracy for the detection of malignancy. The sensitivity and specificity were 78% and 90%, respectively, for a cytologic diagnosis of malignancy and 68% and 99%, respectively, for a positive CEA (greater than 5 ng/mL). CEA assay was negative in the most common epithelial malignancies of the female genital tract (15 of 17 cases), mesotheliomas (5), lymphomas (7) and alveolar-cell carcinoma of lung (1). CEA assay was positive in 55 of 89 cases of malignancy, including 14 cases with cytologically negative malignant effusions. The CEA assay sensitivity for lung carcinoma (95% for adenocarcinoma, 100% for oat-cell carcinoma and 100% for carcinosarcoma), breast carcinoma (95%), and gastrointestinal carcinoma (100%) were all over 90%. No significant difference in the levels of CEA was noted between gastrointestinal and lung adenocarcinomas. Oat-cell carcinomas and squamous-cell carcinomas had lower values. In cases of an effusion with an unknown primary, an elevated CEA in the fluid is diagnostic of metastatic carcinoma arising from the breast, lung or gastrointestinal tract. PMID- 3548191 TI - Pleural effusions in non-Hodgkin's lymphoma. A cytomorphologic, cytochemical and immunologic study. AB - Review of the records of 243 cases of cytologically diagnosed non-Hodgkin's lymphomas (NHL) revealed pleural effusions in 21 (8.6%). Cytologic examination of pleural fluid was done in 17 cases, of which 16 were reported as positive. Cytologic examination was supplemented with cytochemical staining (acid phosphatase, alpha naphthyl acetate esterase and periodic-acid-Schiff reactions) and E-rosetting studies in 12 cases. Of the 16 positive cases, 11 were malignant lymphomas consisting of convoluted lymphocytes. Acute lymphatic leukemia of the prothymocytic type (T-ALL) and chronic lymphocytic leukemia of the T-cell type (T CLL) comprised one case each, and there were three cases of follicular center cell lymphomas, two of the cleaved-cell type and one of the Burkitt-type. Comparison of the cytomorphology of the tumor cells in the pleural effusion with those in fine needle aspiration smears from the solid tumors in 14 cases showed an identical appearance in 13 cases; in one, the Burkitt-type lymphoma, the cells were larger and more pleomorphic in the pleural effusion. This study indicates that the cytologic diagnosis and categorization of NHL of the convoluted-cell type is greatly enhanced by the study of neoplastic lymphocytes in a pleural effusion. PMID- 3548192 TI - A simple method for processing cytologic samples obtained from body cavity fluids and by fine needle aspiration biopsy for ultrastructural studies. AB - A simple method for processing routine cytologic samples for electron microscopy is described. The method has been successfully applied to body cavity fluids and fine needle aspiration biopsies. The technique neither requires additional time and personnel nor interferes with the normal activity of the laboratory. PMID- 3548193 TI - Phenobarbital enhances pituitary LH release induced by LRH pulses in the ovariectomized rat. AB - In the ovariectomized (OVX) rat, the plasma LH response was measured to a pulse of LRH (1.25 or 5 ng/100 g body weight, ia) given before and 1 h after ip administration of phenobarbital (80 mg/kg body weight). The LH response to the LRH pulses was increased 1 h after phenobarbital. In a second experiment, the pituitary LH content of OVX rats was measured 1 h after administration of phenobarbital or saline. No difference in pituitary LH content was found. It is concluded that in the OVX rat, phenobarbital increases the response to a pulse of LRH, presumably by suppressing endogenous pulsatile LRH. This, together with results of earlier experiments, further supports the hypothesis that under conditions where endogenous pulsatile LRH is present, there is always a certain degree of pituitary desensitization or refractoriness and that the removal of this endogenous LRH leads to recovery of pituitary sensitivity to LRH. PMID- 3548194 TI - Effects of extreme hyperinsulinaemia on serum levels of trace metals, trace metal binding proteins, and electrolytes in normal females. AB - In order to assess the possible effects of insulin on serum concentrations of trace metals (iron, copper, zinc) and trace metal binding proteins (ferritin, transferrin, coeruloplasmin), five normal females were studied with the hyperinsulinaemic-euglycaemic clamp technique. A 0.1 U/kg insulin bolus was administered, followed by an insulin infusion at a rate of 10 mU/kg/min for 12-16 h. Insulin levels of 1500-2000 microU/ml (9.21-12.28 nmol/l) were attained. When iron levels in serum were assayed colorimetrically, there appeared to be a progressive rise in the mean concentration during the course of the insulin infusion. Direct analysis of serum samples by atomic absorption spectrophotometry also showed that the level of non-haeme iron increased 3-fold in the serum of the subject with the lowest concentration of this metal at the start of the study. In contrast with the results for serum iron, the levels of ferritin, total iron binding capacity (transferrin), zinc, copper and coeruloplasmin were not altered in any subject during the insulin infusion or at 24 h following discontinuation of the infusion. Within 4 h of institution of the hyperinsulinaemic clamp significant reductions in serum levels of potassium, phosphorus, cholesterol, total protein and albumin were noted. As the insulin infusion progressed, the urea nitrogen, uric acid and bicarbonate levels fell as well. These observations suggest that supraphysiologic hyperinsulinaemia of 12-16 h duration may alter serum levels of iron, but not serum levels of zinc, copper or trace metal binding proteins in some individuals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548195 TI - [Drainage of a pancreatic pseudocyst using endoscopic cystogastrostomy]. PMID- 3548196 TI - [3H-TdR labeling index measurement of immunoglobulin-containing cells by combination of autoradiography with peroxidase-antiperoxidase method]. PMID- 3548197 TI - Pressure characteristics of the Ambu CPAP system and the Servo ventilator 900C in CPAP mode. AB - Spontaneous breathing was stimulated in the Ambu continuous positive airway pressure (CPAP) system and the Servo Ventilator 900C by means of a lung model programmed to mimic the respiratory flow patterns of a healthy volunteer and a patient in severe respiratory distress. Changes in airway pressure, flow and volume were recorded during "breathing" with CPAP at 0.5, 1.0 and 1.5 kPa. In the Ambu system, the airway pressure decreased during inspiration and increased during expiration, while the mean airway pressure was close to the pre-set CPAP value. The pressure changes were minimal when the fresh gas flow was increased from 15 to 25 1 X min-1. The higher fresh gas flow is recommendable during deep or rapid breathing. In the Servo ventilator 900C, there was a short initial inspiratory pressure drop, succeeded by a pressure rise above the CPAP value. The expiratory airway pressure was somewhat higher than CPAP. Both systems were found to be recommendable for clinical use. PMID- 3548199 TI - Spontaneous versus controlled ventilation in anaesthetized children with congenital cardiac malformations. AB - The effects of intermittent positive pressure ventilation on gas exchange were studied in 12 children with congenital cardiac malformation. Six children (b.w. 3.7-16 kg) had a left-to-right shunt (Group LR) resulting in overperfused lungs, while six others (b.w. 3.4-12 kg) had a right-to-left shunt (Group RL) with oligaemic lungs. Measurements, prior to surgery, were done during spontaneous breathing (SB) and controlled mechanical ventilation (CMV) with a short (25%) and a long (55%) duration of inspiration. In children with oligaemic lungs P(a-E')CO2 differences and VD/VT ratios were greater and PaO2 was lower than in those with overperfused lungs, indicating a less efficient ventilation. In Group RL, ventilation and gas exchange during SB were similar at the two settings of CMV. In Group LR, however, VD/VT was reduced during CMV, with the lowest VD/VT ratio at the longer inspiration time. It is concluded that in children with an oligaemic lung perfusion, either of the two ventilator settings could be used. When controlled ventilation is to be used in children with overperfused lungs, the longer duration of inspiration seems to be preferable. PMID- 3548198 TI - Intermittent and continuous positive-pressure ventilation in the prophylaxis of endotoxin-induced lung insufficiency. A study in pigs. AB - The effects of intermittent and continuous positive-pressure ventilation (IPPV and CPPV) instituted prophylactically were evaluated in a porcine model of endotoxin-induced pulmonary and cardiovascular failure. Pigs under ketamine anaesthesia were infused i.v. with E. coli endotoxin over 6 h. Twenty animals, breathing air spontaneously, received endotoxin without treatment. Fifteen animals were treated prophylactically with IPPV (normoventilation with air). Nine animals received prophylactic treatment with CPPV (positive end-expiratory pressure 0.8 kPa (8 cmH2O). Endotoxin infusion in spontaneously breathing animals caused profound deterioration of pulmonary gas exchange, a marked rise in pulmonary vascular resistance (PVR) and a moderate increase in extravascular lung water (EVLW). Cardiac output (Qt) and O2 delivery decreased considerably. Metabolic acidosis indicated oxygen deficit. Eleven of 20 animals died during the observation period. IPPV improved arterial oxygenation during endotoxin infusion, and the increase in EVLW tended to be lower. The alterations in pulmonary haemodynamics, Qt and O2 delivery, were of the same magnitude as in spontaneously breathing animals. Survival was improved. CPPV fully prevented the deterioration in pulmonary gas exchange and the development of pulmonary oedema. There was an accentuated increase in PVR. Qt and O2 delivery decreased markedly and a severe metabolic acidosis developed. All animals treated with CPPV died during the observation period. These results indicate that prophylactic IPPV and CPPV may counteract the development of sepsis-induced lung insufficiency in man. However, it must be emphasized that adequate cardiovascular support is essential in optimizing the treatment. PMID- 3548200 TI - Ultrastructural analysis of chick embryo blastoderms explanted in vitro in absence of endoderm. Differentiation capacity of mesoderm. AB - A study of the structural characteristics of stage 5 chick embryo blastoderms, cultured in vitro, was carried out after previous elimination of endoderm to analyse the differentiation capacity of mesoderm. Our results show that only the precardiac mesoderm is determined at this early stage and that it is able to differentiate cardiac tissue in the absence of the endoderm. The ultrastructural characteristics of this tissue are described. However, the degree of differentiation of cardiomyoblasts does not reach the expected level of organization and myofibrillar complexity. PMID- 3548201 TI - The effect of nicotine and alcohol on the fertility and life span of rats. A cytological analysis. AB - Inbred Fisher and Buffalo rats were exposed to nicotine and alcohol. Fertility was greatly reduced in both strains with nicotine treatments being much more deleterious than alcohol use. Fisher rats tolerated both toxins better than Buffalo rats. Both strains became 'extinct' after one generation of fetal and postnatal exposure to nicotine, but alcohol-ingesting Fisher rats had 3 or more generations of offspring. The total reproductive period was significantly shortened in both strains under the effect of both toxins, as was the total life span. The causes of the teratological effects of both toxins are inflammatory processes as evidenced by the presence of numerous lymphocytes and/or polymorphonuclear leukocytes. Their presence occurs earlier in nicotine than in alcohol use and earlier in Buffalo than in Fisher rats, but the damage done during nicotine treatment is reversible when the procedure is terminated. Inflammation is not transmitted to the newborn offspring of nicotine- or alcohol treated mothers, but occurs in neonates during the nursing period or later. There is considerable individual variation in the tolerance to both toxins. Experimental results and clinical observations show a sufficient number of similarities to justify the use of experimental data as a model for further studies on human subjects. PMID- 3548202 TI - Brown adipose tissue: a scanning electron microscopic study of tissue and cultured adipocytes. AB - The ultrastructure of rat brown adipose tissue (BAT) and of adipocytes cultured from BAT were studied by scanning electron microscopy (SEM). Brown adipocytes in the intact tissue were arranged in lobules with bundles of collagen among them; within each lobule 20- to 40-microns-large adipocytes were packed together. Fibers of reticular collagen enveloped each adipocyte and also connected each cell to vessels and nerves. At the adipocyte surface rounded protrusions were present, which corresponded to the BAT-typical multivacuolar lipid depot. Gradual digestion of the stroma with collagenase disclosed a more delicate, felt-like cover surrounding each adipocyte, probably representing the external lamina of the cell. Complete digestion of the stroma showed a smooth plasmalemma with occasional roundish blebs which varied in size. Cultured (24 h) brown adipocytes from the stromal-vascular fraction of BAT were elongated or polygonal in shape, with a flattened, central nucleus and a number of spherical cytoplasmatic inclusions which have the same dimension and location as lipid droplets. These inclusions were arranged either at cellular poles or around the nucleus; this suggests that brown adipocytes with mature features were present in the culture. Pictures suggesting the detachment of lipid droplets from the cell body were also visible. Lipid droplet extrusion could be a complementary mechanism which might explain the rapid delipidation of brown adipocytes in culture. PMID- 3548204 TI - Computer editing of morphometric data on nerve fibers. An improved computer program. AB - A short guide is given for the planning of nerve fiber morphometry using computer assisted methods. A new computer program is introduced which allows, among other factors, correction for myelin sheath shrinkage. If myelin shrinkage is not corrected for, there will be false high values for axon caliber and false low values for sheath thickness. The magnitude of the skew produced by this factor is shown on hand from computer editing. PMID- 3548203 TI - Non-glial specificities of immunocytochemistry for the glial fibrillary acidic protein (GFAP). Triple expression of GFAP, vimentin and cytokeratins in papillary meningioma and metastasizing renal carcinoma. AB - In an extensive immunocytochemistry study for glial fibrillary acidic protein (GFAP) of human neuropathological biopsy or autopsy tissue specimens examined for diagnostic or research purposes, rare non-glial specificities of the GFAP immunostain were observed: Schwann cells of some small nerves in salivary gland, renal capsule, and in epidural fat adjacent to a metastatic carcinoma, Schwann and satellite cells in a spinal ganglion invaded by tumor, chondrocytes of epiglottic cartilage, few cells of a malignant pleomorphic adenoma of salivary gland, most cells of a recurrent papillary meningioma with areas similar to the hemangiopericytic variant, and many cells of a renal carcinoma metastatic to brain; the primary renal tumor had been operated 4 years earlier and focally contained some GFAP-positive cells. To ascertain the specificity of such unexpected immunoreactivities for GFAP and to exclude possible crossreactivities with other intermediate filament (IF) proteins, a panel of different antibodies was used for immunocytochemistry with the peroxidase-antiperoxidase (polyclonal antisera) or labeled biotin-avidin (monoclonal antibodies) techniques: two monoclonal and four polyclonal anti-GFAP, three monoclonal and one polyclonal anti-cytokeratins (CK), and two monoclonal anti-vimentin (VIM) antibodies. Triple expression of GFAP, VIM and CK was found in the papillary meningioma (in patterns suggesting frequent co-localization), in the metastatic carcinoma (in patterns suggesting little co-localization), and in the pleomorphic adenoma (only few GFAP positive cells). Co-expression of GFAP and VIM was seen in epiglottic chondrocytes and reactive astroglia; another metastatic carcinoma was labeled only for CKs. In the light of previous reports on non-glial specificities of the GFAP immunostain, and of the consistency of our immunostaining results obtained by all monospecific anti-GFAP antibodies as well as the lack of immunocytochemically evident crossreactivity with other IF proteins, authentic GFAP production by some rare non-glial tissues and tumors is suggested. PMID- 3548205 TI - The clinical pharmacology of piroxicam. AB - Piroxicam, a potent inhibitor of prostaglandins, is effective and well-tolerated in the treatment of primary dysmenorrhea. A single 40 mg dose has been shown to rapidly reduce the uterine hypercontractility of primary dysmenorrhea. In clinical trials vs placebo, piroxicam in a dose of 40 mg once daily for two days followed by 20 mg once daily thereafter demonstrated superior efficacy. In more than 1,400 piroxicam-treated menstrual cycles and more than 200 placebo controlled cycles, a similar incidence of side effects-7% and 8.4% respectively was observed. PMID- 3548206 TI - Worldwide studies comparing piroxicam and naproxen. AB - In double-blind, crossover studies, piroxicam was compared with naproxen. Piroxicam 40 mg was given once daily for two days, followed by 20 mg once daily and is compared with naproxen 750 mg daily for two days, followed by 500 mg daily (N = 85) and with naproxen 1,000 mg daily (N = 83) in the treatment of primary dysmenorrhea. The different parameters studied included pain intensity, treatment preference and side effects. Piroxicam 40 mg/day was effective and well tolerated and produced a significantly greater reduction in menstrual pain on the first day of the cycle than naproxen 750 mg/day. When compared to naproxen 1,000 mg/day, piroxicam 40 mg/day was equally effective. It is concluded that both drugs were well tolerated, but in both studies patients preferred piroxicam. PMID- 3548207 TI - A comparative crossover study of piroxicam vs. mefenamic acid and diclofenac in France. AB - A multicenter open crossover study compared piroxicam and mefenamic acid and piroxicam and diclofenac in the treatment of primary dysmenorrhea in 91 patients. Piroxicam 40 mg/day for two days followed by 20 mg/day was compared with mefenamic acid 500 mg t.i.d. and diclofenac 50 mg b.i.d. for two menstrual cycles on each drug. Assessment of efficacy found that piroxicam was more effective than either comparative drug. All three agents were well tolerated. It is concluded that piroxicam is a safe and effective drug for the treatment of primary dysmenorrhea. PMID- 3548208 TI - Current concepts in the etiology and treatment of primary dysmenorrhea. AB - Primary dysmenorrhea may affect as many as 40 percent of all adult women, temporarily disabling one-tenth of them. The etiology of this condition may be related to excess production of prostaglandins by the endometrium following decline in progesterone levels consequent to corpus luteum regression. It is proposed that increased prostaglandin levels produce increased myometrial contractility and uterine ischemia and sensitization of pain fibers, resulting in pelvic pain. Administration of nonsteroidal anti-inflammatory agents which block the cyclooxygenase enzyme of the arachidonic acid cascade is an effective treatment for primary dysmenorrhea, as is oral contraceptive therapy. Criteria for an ideal prostaglandin synthetase inhibitor are described. PMID- 3548209 TI - Induction of labor with intravenous oxytocin or vaginal PGE2 suppositories. A randomized study. AB - Thirty-eight term pregnant women with a moderately unfavorable cervix (cervical score 4-5 p.) were randomly given intravenous oxytocin (Group A) or 3 mg PGE2 as a vaginal suppository (Group B) for labor induction. Eight out of 19 in Group A and 17 out of 19 in Group B gave birth vaginally within 24 h. The remaining 11 women in Group A had still an unfavorable cervix after 24 h. They were then given 3 mg PGE2 as a vaginal suppository and all but one had given birth vaginally without complications within 24 h. In Group B only 2 were still undelivered after 24 h. Both had a favorable cervix and were delivered vaginally within 12 h after intravenous infusion of oxytocin. The number of instrumental deliveries in Group A was one cesarean section and two vacuum extractions and in Group B three vacuum extractions. One woman in Group B reported nausea and vomiting and in one had strong uterine contractions in the second stage of labor. Otherwise no side effects were registered. All babies were born in good condition with Apgar scores greater than or equal to 7. In conclusion, vaginal application of 3 mg PGE2 as a suppository seems to be more effective than intravenous infusion of oxytocin for labor induction in women with half-ripened cervices, i.e. cervical scores of 4-5 p. PMID- 3548210 TI - Fetal hemothorax complicating amniocentesis--antenatal sonographic diagnosis. PMID- 3548211 TI - Antenatal sonographic diagnoses of giant cystic hygroma of the neck. A problem for the clinician. PMID- 3548212 TI - Intrahepatic bile duct injury following bone marrow transplantation. Analysis of pathological features based on three-dimensional and histochemical observation. AB - A specific bile duct injury is frequently observed in the liver following bone marrow transplantation. The materials used for study consisted of liver specimens obtained from 7 autopsy cases and 2 biopsies. The pathological lesions were analyzed by reconstruction of serial sections and by immunohistochemical examination. Injury following bone marrow transplantation occurred most frequently in bile ducts right after the canalicular-ductular junction to ducts having an outer diameter of 50-60 mu, being especially prominent in those less than 30 mu in diameter. They preserved their continuity and there was neither complete destruction nor loss of bile ducts as seen in primary biliary cirrhosis. Immunohistochemical examination showed predominancy of suppressor T lymphocytes around ducts and they were frequently found adjacent to epithelial cells of bile ducts. C3 components and HLA-DR antigens were confirmed to be localized in ductular epithelia in the area where injury took place. Although their localization and site of injury did not necessarily coincide, the participation of an immunologic mechanism against injury cannot be denied. Evidence of a relation between ductular injury and cytomegalovirus infection could not be obtained. PMID- 3548213 TI - Effect of immunoglobulin deposition on the amount of glomerular sialic acids in patients with membranous nephropathy. AB - A study of double immunofluorescence staining of immunoglobulins and sialic acids in the glomeruli from patients with membranous nephropathy was described. Renal biopsy specimens from patients with membranous nephropathy were stained with rhodamine-labeled limulus polyphemus (LPA) and tricum vulgaris (WGA). The binding of LPA or WGA was hardly observed in the glomerular capillary walls from patients with membranous nephropathy although the deposition of immunoglobulin was marked. Both binding of LPA and deposition of IgG in the glomerular capillary walls were observed in only one out of nine patients with membranous nephropathy (11%). In that case, binding of LPA was observed in the inside of glomerular capillary walls although the deposition of IgG was observed on the outside of the walls. It was suggested that decrease of sialic acids in the glomerular capillary walls might be due to deposition of IgG in some patients with membranous nephropathy. PMID- 3548214 TI - Foamy cell syndrome associated with repeated platelet transfusions. AB - Variable numbers of foamy cells (macrophages with foamy cytoplasm) were noted in generalized organs from four patients who received repeated were noted in generalized organs from four patients who received repeated platelet transfusions. The underlying disease in three cases was aplastic anemia, and the remaining case was chronic myelocytic leukemia. In two patients (aplastic anemia and chronic myelocytic leukemia) bone marrow transplantation (BMT) was done. Opportunistic infection was noted in three out of four cases. The foamy cells were stained black with Sudan black B. Variable amounts of materials immunoreactive with antihuman platelet antibody were demonstrated in most of the foamy cells. Ultrastructurally, the foamy cells contained myelin-like materials. The foamy cells described here resembled those demonstrable in the spleen from patients with idiopathic thrombocytopenic purpura. We suggest that the foamy appearance of the macrophage results from incomplete intracellular degradation of phagocytosed platelets. PMID- 3548215 TI - Solid and cystic acinar cell tumors of the pancreas. A report of two cases with immunohistochemical and ultrastructural studies. AB - Two pancreatic tumors were found in young women without detectable functional symptoms. These tumors were identical in gross, histological and electron microscopic features. Each of them formed a large abdominal mass. One of them was found because of this abdominal mass, while the other was found incidentally. Grossly, the tumors were well circumscribed by a firm, white, fibrous capsule, and their cut-surfaces showed mainly cystic degenerative changes with necrotic and hemorrhagic material, with only some solid portions. The solid portions were composed of uniform cells forming solid and papillary structures with numerous PAS-positive diastase-resistant granules. Immunohistochemical staining for alpha 1-antitrypsin showed a granular distribution. Electron microscopic examination showed that the tumor cells had numerous mitochondria, zymogen-like granules, and annulate lamellae. These findings strongly suggested acinar cell differentiation, although ductal and endocrine differentiation have also been observed by others. Therefore, this type of tumor can best be termed an acinar cell tumor. There was no recurrence in either patient after the operation. Long survival can be expected, but reports indicate that this neoplasm should be recognized as a lesion of low malignancy. PMID- 3548216 TI - Neurothekeoma. Report of a case with immunohistochemical and ultrastructural studies. AB - A case of neurothekeoma in a 52-year-old woman is reported. The tumor developed on the medial aspect of the right nostril as a well-demarcated, dome-shaped, erythematous nodule of rubbery consistency. Microscopically, it consisted of numerous nests and cords of spindle-shaped cells in the dermis. Some of the tumor cell nests appeared epithelial-like, while the other areas showed a myxomatous appearence with various amount of mucinous matrix in the intercellular space. Neurothekeoma is a benign cutaneous tumor, and is considered to be of schwann cell origin. In the present case, the tumor cells did not stain positively for S 100 protein, despite the light microscopic suggestion of peripheral nerve origin. Ultrastructurally, most tumor cells contained a large number of myelinoid figures. This ultrastructural finding appears to be a useful diagnostic characteristics of neurothekeomas. PMID- 3548217 TI - [Progress of UV-VIS spectroscopy in pharmaceutical analysis]. PMID- 3548219 TI - 100 years of animal welfare regulation and of experiments with animals in Germany, effects and reasons. AB - The first regulations (1883) have been renewed twice (1933, 1972) and will soon be renewed once again (1986). They have always been influenced by two motivations: men's feeling of responsibility for animals on one hand and antiscientism or public suspicion against scientists on the other hand. The general rules concerning animal welfare (anaesthesia, reduction of number and harm, species selection etc.) have been constant for 100 years, but governmental control increases by the establishment of special licences (for each project, for the responsible scientist, for the location) by regular controls of the laboratories, by installing a permanent animal welfare officer in the institutions, by protocols, special taxes and increasing penalties. Out of different public ethical concepts about the use of animals, the law for the present agrees with those permitting to use animals for "reasonable purposes". But now the public opinion wants to change to "only for necessary" purposes; this especially concerns animal experiments causing severe pain. Philosophers and public have difficulties to find consentaneous reasons for the "necessity" of basic research. Each basic research in biology must be accepted as necessary because life is multifactorially organized and can be analyzed sufficiently only by random-like strategies to test not monocausally evidenthypotheses alone, but all reasonable possibilities. PMID- 3548218 TI - Mechanism of the post-haemorrhagic vasopressin release from the posterior pituitary lobe. AB - The mechanism of post-haemorrhagic vasopressin release from the neurohypophysis was studied in rats anaesthetized with urethane. Neurohypophysial vasopressin content was determined according to Dekanski and plasma renin activity by radioimmunoassay. In animals bled (1.5% body weight) 60 min after induction of anaesthesia and 30 min after bilateral nephrectomy vasopressin content of the posterior pituitary was significantly higher than in sham-nephrectomized rats. However, when haemorrhage was produced 240 min after induction of anaesthesia and 210 min after nephrectomy, the neurohypophysial vasopressin content was low and similar as that in non-nephrectomized animals. It is concluded that in the phase directly following haemorrhage vasopressin release depends on acute activation of the renin-angiotensin system. Other mechanisms, possibly circulatory reflexes, are involved in the late phase, during prolonged anaesthesia. PMID- 3548220 TI - Regulation of animal experimentation: Canada's program of voluntary control. AB - The Canadian Council on Animal Care (CCAC), is an autonomous advisory and supervisory body responsible for surveillance of experimental animal care and use in Canada's universities, government laboratories and pharmaceutical houses. Its 20-organization membership includes representatives of government, industry, academia and the humane movement. CCAC's voluntary peer review program depends heavily on institutional animal care committees who evaluate the ethical aspects of animal study protocols, and provide day-to-day surveillance of animal care. Its scientific teams, each of which also includes an appointee of the Canadian Federation of Humane Societies (CFHS), conduct assessments based on CCAC's "Guide to the Care and Use of Experimental Animals" (Volume 1, 1980; Volume 2, 1984). Canada's two major funding agencies, the Medical Research Council (MRC) and the Natural Sciences and Engineering Research Council (NSERC), have recently stated that, in the event of an institution's continued non-compliance with CCAC requirements, sanctions may include the "freezing or withdrawal of any or all research programs funded by either or both Research Councils in an institution". This presentation describes the CCAC program of voluntary peer review and examines historic aspects of animal issues in Canada, from that country's early reliance on the fur trade, to today's almost defunct harp seal fishery, from Banting and Best's discovery of insulin, to development of the pacemaker. PMID- 3548221 TI - Survival analysis (or time to an event analysis), and the Cox regression model- methods for longitudinal psychiatric research. AB - A multivariate statistical instrument is presented, which combines the life table with regression analysis: the Cox proportional hazards regression model. It is suitable for analyzing longitudinal clinical data, and to find predictors of different outcomes in psychiatric research such as death, relapse or cure. All patient information can be used, since the time to the outcome event is included in the model. Treatments can be compared, and prognostic indices created. PMID- 3548222 TI - Comparative study of proliferation of suckling and adult rat hepatocytes in primary culture in response to growth-stimulating factors. AB - The replicative responses of suckling and adult rat hepatocytes in primary culture to growth-stimulating factors were compared. By addition of L-proline alone, the [3H]-thymidine labeling of suckling rat hepatocytes was dramatically enhanced, but that of adult ones was not. Epidermal growth factor (EGF), insulin, triiodothyronine (T3) and glucagon also enhanced the labeling of suckling rat hepatocytes regardless of the presence or the absence of L-proline. On the other hand, in the absence of L-proline, only EGF enhanced the labeling of adult rat hepatocytes, and, in the presence of L-proline, insulin as well as EGF enhanced the labeling. In the presence of growth factors and L-proline, the number of suckling rat hepatocytes increased up to about 143%, whereas that of adult rat hepatocytes hardly increased. Thus, a remarkable difference in replicative responses to growth factors and L-proline was observed between suckling and adult rat hepatocytes in primary culture. PMID- 3548223 TI - Renin, aldosterone, urinary sodium and weight change in cirrhotic patients with ascites and sodium restriction. PMID- 3548224 TI - Delayed epidural hematoma. A review. AB - Since the CT has become the main diagnostic tool in head trauma, more cases of DEDH have become confirmed and published although some have been classified among other entities and under different criteria. This review tries to describe the characteristics of DEDH based on the cases previously published, as well as on three of our own cases. The entity is mainly radiological i.e. appearance of an epidural hematoma in a CT scan following up a previous one which has not shown this pathology. Although not specific, we have found some common features among the cases published. The patients are usually young people. The cause of many injuries is either a fall injury or involvement of a pedestrian in a road accident. Skull fracture under which the DEDH develops is the rule. DEDH is not found in the usual location of the classic epidural hematoma (the temporal fossa). Some of the patients developed DEDH after an earlier neurosurgical operation for evacuation of another traumatic mass lesion for urgent decompression. Others developed DEDH after medical treatment aimed at restoring normal blood pressure or reducing increased ICP. This main group of patients had other associated lesions, mainly intracranial. The others (including our case no. 1) were considered to have a skull fracture associated only with concussion of the brain, as the clinical picture changed or persistent headache developed, another CT scan was indicated and DEDH was then found. This group constitutes those patients in whom the prognosis is expected to be good or excellent. Keeping in mind the necessity for repeated CT scans in this group (we think the number will increase in the future), other patients will benefit from the awareness of the clinician of the importance of this diagnostic tool. CT scan is efficient, accurate and can be repeated at short intervals. It enables a correct diagnosis to be made in nearly 100% of cases of head trauma. Although this liberal use of CT may increase the number of negative scans, it will also increase the number of DEDH's diagnosable at an earlier stage. PMID- 3548226 TI - High resolution real-time B-mode echotomography in the diagnosis of extracranial carotid lesions. Comparison with traditional angiography. AB - Sixty-three patients (115 carotid arteries) have been examined first by Dopplersonography, then by echotomography and finally by angiography using the Seldinger technique. The comparison between echotomography and angiography showed a sensitivity of 0.9, a specificity of 0.7 and a accuracy of 0.8. There have been 15 false positive results; in 14 of them the lesions were lower than 10% of lumen reduction and in one case there was a 10-45% stenosis. It seems that echotomography can better estimate lower degree lesions. It was difficult for echotomography to detect correctly the presence of an occlusion and to evaluate the surface aspect mainly in the presence of ulcerations. PMID- 3548228 TI - [Theoretical and empirical analysis of the value of minor neurological signs in psychiatry]. PMID- 3548227 TI - Hemodynamic aspects of cerebral angiomas. PMID- 3548225 TI - Morbidity and mortality of carotid endarterectomy. A literature review of the results reported in the last 10 years. AB - A review of the mortality and morbidity of carotid endarterectomy reported during the last 10 years was made and compared to the risk of carotid stenosis managed by the best medical treatment. For comparison, the patients were classified in asymptomatic patients (grade I), patients with transient ischaemic attacks (grade II), patients with ischaemic neurological deficits operated on acutely (grade III) and into patients with no or incomplete recovery 4-6 weeks after the stroke (grade IV). Based on the results of this literature review, only patients in grade II seem to benefit from carotid endarterectomy. PMID- 3548229 TI - [Vascular complications in renal transplant]. PMID- 3548230 TI - [Urologic complications in 60 renal transplants]. PMID- 3548231 TI - [New approaches in the diagnosis and treatment of retroperitoneal abscess]. PMID- 3548232 TI - [Transurethral echography of the bladder. I. Normal morphology and non-tumor changes in the wall]. PMID- 3548233 TI - [Transurethral echography of the bladder. 2: Diagnosis and tumor staging]. PMID- 3548234 TI - [Transurethral echography of the bladder. 3: Control of tumor resection]. PMID- 3548235 TI - [Renal leiomyosarcoma]. PMID- 3548236 TI - [Nonpenetrating testicular injuries: usefulness of echography]. PMID- 3548237 TI - The action of acrosin on the zona pellucida. AB - The presence of hydrolytic enzymes in and associated with the sperm head has long argued for their functioning in fertilization. Several observations led investigators to propose that the acrosomal trypsin-like enzyme, acrosin in mammals, functioned in fertilization in aiding the sperm to penetrate the zona pellucida. While many have raised significant objections to this role, the action of acrosin on its presumed physiological substrate has not been characterized in a biochemical fashion. The intent of this study was to examine the effect of sperm proteases on the innermost egg envelopes in a parallel study, with the pig, Sous scrofa and the South African clawed frog, Xenopus laevis. With the pig, a great deal of information exists concerning the boar enzyme, acrosin, but little is known about the chemical structure of the zona pellucida. The opposite situation exists in X. laevis where the vitelline envelope is well characterized chemically, but little is known about the putative sperm lysins. PMID- 3548238 TI - Biochemical studies of the envelope transformations in Xenopus laevis eggs. AB - The envelopes that enclose the eggs of the amphibian Xenopus laevis were isolated and examined for biochemical correlates of the ultrastructural and sperm penetrability differences among the coelomic egg envelope (CE), the vitelline envelope (VE), and the fertilization envelope (FE). By sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), the 43,000 molecular weight glycoproteins of CEs were found to be converted to components with molecular weights of 41,000 in VEs; also, a protein with a molecular weight of 57,000 was added to the envelope during the CE-to-VE conversion. The molecular weights of two components decreased during the VE-to-FE conversion, from 69,000 and 64,000 in the VE to 66,000 and 61,000 in the FE. Components from the cortical granules and the innermost jelly coat were also added to the newly-formed FE. As detected by iodination with lactoperoxidase or IODOGEN, both the CE-to-VE and the VE-to-FE conversions caused conformational changes in envelope glycoproteins. Peptide mapping demonstrated that the 43,000 molecular weight components of CE were precursors to the 41,000 molecular weight components of VE and the 69,000 and 64,000 molecular weight components of VE were precursors to the 66,000 and 61,000 molecular weight components of FE. The CE-to-VE conversion presumably occurs in the first portion of the oviduct. Experiments probing the VE-to-FE conversion demonstrated the need for an intact jelly coat for the molecular weight changes to occur. Sperm were not required for the envelope alteration; the SDS-PAGE pattern of envelopes from jellied eggs activated with the Ca++-ionophore A23187 were indistinguishable from the FE. These studies show that there are molecular correlates of the morphological and biological differences among the envelopes. The CE-to-VE and the VE-to-FE conversions follow a similar pattern: in both cases, material is added to the envelope and there are changes in the molecular weights of some of the components. PMID- 3548239 TI - Sperm-egg interactions preparatory to fertilization. AB - In 1902, Boveri introduced the important concept that for the success of fertilization the gametes must activate one another. Based primarily on studies on the sea urchin and ascidian fertilization the suggestion is presented here that "activation" of the spermatozoon actually involves a switching off of its metabolic machinery as a result of its interaction with the sperm receptors of the egg envelopes and prior to its fusion with the egg. Concerning the activation of the egg, there is a fairly large body of old and new experimental evidence that activation per se does not require sperm incorporation. Indeed, the chain of reactions culminating in the activation of the egg is initiated upon attachment of the spermatozoon to the egg plasma membrane. PMID- 3548240 TI - Structure, assembly and function of the surface envelope (fertilization envelope) from eggs of the sea urchin, Strongylocentrotus purpuratus. AB - The sea urchin fertilization envelope (FE) is formed following initial sperm-egg interaction from the egg surface vitelline envelope (VE) and the paracrystalline protein fraction (PCF), derived from cortical granules. Although mature FEs are physicochemically hardened postinsemination, a major protein fraction consisting of seven major polypeptides was extracted from Strongylocentrotus purpuratus FEs and the major, separated components were immunologically cross-reactive with the principal polypeptides in PCF and isolated cortical granules. Antibodies prepared against extracted, core FEs were immunologically crossreactive with isolated VEs, but not with PCF, suggesting that only VE components are covalently crosslinked. Based on protease inhibitor experiments, our model of FE development is that a benzamidine-sensitive, cortical granule protease cleaves a 200 kD VE polypeptide during initial envelope elevation to set up the morphological change in FE papillae which occurs later. Divalent cations precipitate the PCF and form metal proteinate bridges between the VE and PCF. Based on peroxidase inhibitor experiments, we suggest that the cortical granule peroxidase crosslinks VE polypeptides, beginning at 2-3 min postinsemination, to restrict the permeability of the VE so that normal envelope thickening occurs. A 305 kD VE polypeptide was isolated and appears to be important in sperm-egg interaction based on inhibition of sperm binding and fertilization by antibodies against the purified polypeptide. PMID- 3548241 TI - Fertilization and immunity--revisited. PMID- 3548242 TI - Steps in the fertilization process: understanding and control. PMID- 3548243 TI - Control of fertilization by immunization with peptide fragments of sperm specific LDH-C4. AB - The use of a well-defined, synthetic antigen is essential to progress in developing a vaccine for fertility control and to establish with certainty the utility of such technology. The studies with LDH-C4 are consistent with the feasibility of using a synthetic antigen in a vaccine to control fertility. LDH C4 remains the best-developed candidate for future studies. Immunization with LDH C4 does suppress fertility, and the complete biochemical characterization of this isozyme is well underway. These studies will provide a wealth of synthetic antigens to substitute for the natural product in experiments to determine whether immunologic contraception is appropriate and desirable for wide-scale application in human beings. PMID- 3548244 TI - Research frontiers in human in vitro fertilization. AB - The acceptance of IVF-ET as a treatment modality for certain types of infertility in the human has triggered a flurry of activity in providing a patient service, in applied research endeavors designed primarily to improve clinical pregnancy rates and in basic research in reproductive endocrinology and physiology. This paper outlines the state of the art in technologic and research frontiers associated with these endeavors. PMID- 3548245 TI - Nature of the mouse egg's receptor for sperm. AB - The zona pellucida is an extracellular coat that surrounds all mammalian eggs. Sperm must penetrate the zona pellucida in order to reach and fuse with the plasma membrane of unfertilized eggs. Penetration is accomplished by a sequence of events involving both egg and sperm. First, sperm must bind to the outer margin of the zona pellucida. Such binding is mediated in a relatively species specific manner by "sperm receptors" in the zona pellucida. Second, sperm must undergo the "acrosome reaction", a membrane fusion event, in order to traverse the zona pellucida. Here we review results from our own laboratory which demonstrate that, during the course of sperm-egg interaction in mice, zona pellucida glycoprotein ZP3 serves as both receptor for sperm and inducer of the acrosome reaction. Furthermore, we review evidence from our laboratory indicating that the sperm receptor activity of ZP3 is dependent only on its 0-linked carbohydrate components, whereas acrosome reaction-inducing activity is dependent on the polypeptide portion of ZP3 as well. PMID- 3548246 TI - Intravenous therapy with gamma globulin. AB - The availability of intravenous gamma globulin preparations that are safe and effective has revolutionized replacement therapy in those patients suffering primary or secondary hypogammaglobulinemia. The potential for controlling numerous autoimmune reactions with high-dose gamma globulin infusion is exciting and challenging. Unraveling the immunoregulatory mechanisms that interact with large doses of human IgG may teach us much about immunoregulation in general and the immunopathogenic mechanisms that lead to chronic disease for so many. PMID- 3548247 TI - Calcium-channel blockers in thrombotic diseases. PMID- 3548248 TI - Refractory anemia in the elderly. AB - Anatomical observations have indicated a decrease of marrow cellularity with age, but these changes are not associated with anemia in the healthy geriatric patient. Aged patients with refractory anemia should be studied by utilizing red cell volume (MCV) and red cell heterogeneity (RDW). A classification with these indices initially can separate the anemias for a more fruitful investigation. By old age the anemias of hereditary red cell membrane or hemoglobin disorders should be known to the patient. In the absence of tumor, elderly patients have an increasing frequency of refractory anemias that can be called preleukemia or myelodysplastic syndrome. Morphological observations have emphasized the importance of abnormal megakaryocytes and platelets in all phases of preleukemia, and these cytologic changes should be used to guide the physician in the early diagnosis of the syndrome complex. This group of refractory anemias have a limited survival, but nonspecific marrow stimulation can be effective and should be tried. With a more complete classification of the chromosomal abnormalities in the myelodysplastic syndrome, a more accurate prognosis can be anticipated. The anemias of marrow aplasia and ineffective iron utilization (anemia of chronic disease) are found frequently in the elderly, and the physician may offer more effective therapy by an early diagnosis. PMID- 3548249 TI - The confusing and tenacious coagulase-negative staphylococci. PMID- 3548250 TI - Praziquantel for the treatment of helminthic infections. PMID- 3548251 TI - Diagnosis and management of male infertility. PMID- 3548252 TI - Angina pectoris: expanded concepts. PMID- 3548253 TI - Genetic influences in alcoholism. PMID- 3548254 TI - Hyponatremia associated with permanent brain damage. PMID- 3548255 TI - Hepatitis delta virus infection. PMID- 3548256 TI - Primary biliary cirrhosis. PMID- 3548257 TI - Drug metabolism in patients with liver disease. PMID- 3548258 TI - Laser therapy in gastrointestinal diseases. PMID- 3548259 TI - An internist's view of coronary artery surgery. PMID- 3548260 TI - The long Q-T interval and syndromes. AB - The clinical syndromes characterized by an abnormally long Q-T interval in the ECG are classified at present as acquired (rate-dependent), congenital (adrenergic-dependent), and miscellaneous. The therapy of each differs depending on the cause, the principal of which are drugs (for the acquired form), excessive sympathetic activity (for the congenital form), and a variety of causes for the miscellaneous group. The long Q-T interval, ascribable in some cases to pathologic disparity of durations of the excited state, aggravated under certain conditions by increased sympathetic activity transmitted through the stellate ganglia and sympathetic cardiac nerves, are at present the most probable electrical sources of arrhythmogenesis in the LQTS. However, there are other possibilities for the development of threshold potentials during the Q-T and Q-U intervals (regarding the U wave as part of the myocardial recovery process). These include minor deviations in the time or site of ventricular activation, the onset of recovery before excitation is completed, physiologic and pathologic displacements of the S-T segment (large ventricular gradient), desynchronized depolarization and repolarization, principally endocardial (in ischemic heart disease), early afterdepolarization with arrested repolarization, and late afterdepolarization following a slow diastolic wave that may be related to the U wave. Although the basis for some of these possibilities has been observations made at the membrane level principally on the canine Purkinje fiber, evidence for the clinical validity of some has accumulated in isolated examples. It is likely that additional clinical proof will be forthcoming, and with it additional means of managing the malignant ventricular arrhythmias encountered in the long Q-T syndromes. A number of drugs with the desired selective actions are under active investigation. PMID- 3548261 TI - Blood pressure effects of apomorphine and domperidone in parkinsonism. PMID- 3548262 TI - Single-dose study of slow release preparation of levodopa and benserazide (Madopar HBS) in Parkinson's disease. PMID- 3548263 TI - Bromocriptine in the treatment of Parkinson's disease: a double-blind study against L-dopa/carbidopa. PMID- 3548264 TI - Treatment of early morning akinesia with low-dose bromocriptine. PMID- 3548265 TI - Parallel double-blind study of pergolide in Parkinson's disease. PMID- 3548266 TI - Double-blind controlled study of pergolide mesylate as an adjunct to Sinemet in the treatment of Parkinson's disease. PMID- 3548267 TI - Evaluation of terguride in patients with Parkinson's disease. PMID- 3548269 TI - Arrhythmogenic effects of antiarrhythmic drugs. PMID- 3548268 TI - Effect of ciladopa on Parkinson's disease: a preliminary report. PMID- 3548270 TI - Quinine toxicity. PMID- 3548271 TI - Genetic toxicology: a review. PMID- 3548272 TI - The effect of cigarette smoke on gastroduodenal mucosal endogenous prostacyclin level (experimental and clinical observations). AB - In our opinion the endogenous prostacyclin (PGI2) is one of the most important natural protective substances in the gastric mucosa. We have, therefore checked in experimental circumstances in rats, as well as in clinical observations in humans, the possible effect of smoking on endogenous gastroduodenal mucosal PGI2 level. The animal experiments seem to verify that cigarette smoke really has an unwanted effect on the gastric mucosa. The target of this action is the endogenous PGI2 content of the mucosa. According to our observations in humans there is a definite tendency toward decreased endogenous PGI2 production in the gastroduodenal mucosa of smokers too. PMID- 3548273 TI - Stress influences phagocytic cell function in calves. PMID- 3548274 TI - [Suppression of corneal graft rejection in rabbits by mizoribine]. PMID- 3548275 TI - [Fibronectin of the trabeculum in glaucomatous eyes]. PMID- 3548276 TI - [Clinical utility of trapidil (MDR-1865) in treating diabetic retinopathy--a multicenter, placebo-controlled, double-blind study]. PMID- 3548277 TI - [Interaction of Candida albicans and pathogenic bacteria in the etiology of denture stomatitis]. PMID- 3548278 TI - [The treatment of anterior hypospadias using a pediculated lateral skin flap]. PMID- 3548279 TI - Leydig cell tumor of the testis. Four new cases. PMID- 3548280 TI - An evaluation of the bladder wash-out test and the anti-body-coated bacteria test for the localization of a urinary tract infection in patients with and without a neurogenic bladder. PMID- 3548281 TI - Morphological studies of Escherichia coli in the urine of patients with acute simple cystitis treated with aztreonam. AB - The effects of aztreonam (AZT) on the morphology of Escherichia coli in the urine of 5 patients with acute simple cystitis were studied by differential interference contrast microscopy. The urine specimens were collected via catheter before, 5, 15 and 30 minutes after intravenous administration of 1.0 gm AZT. The minimum inhibitory concentration of E. coli against AZT was 0.05 microgram/ml. The mean urinary concentrations at 5, 15 and 30 minutes after administration of AZT were 481.6 micrograms/ml, 1168.2 micrograms/ml and 993.4 micrograms/ml, respectively. In 4 patients, the urinalysis became normal within 30 minutes after the administration. Filamentous cells were observed at low and high urinary concentrations of AZT. They had vacuole-like formations. These findings were characteristic morphological changes caused by AZT. In the other patient, spheroplasts and ovoid cells were observed. AZT in the urine of patients with acute simple cystitis is suggested to have a high affinity for penicillin-binding protein (PBP) 3 and moderate affinity for PBP 1a. PMID- 3548282 TI - Tension pneumopericardium: an unusual manifestation of invasive pulmonary aspergillosis. PMID- 3548284 TI - The mistaken or indeterminate CT diagnosis of hepatic metastases: the value of sonography. AB - Small liver cysts may be mistakenly diagnosed as metastatic disease on screening CT of the abdomen in patients with known carcinoma. These cysts can appear solid as a result of volume averaging. On retrospective review of 122 patients with known extrahepatic malignancies and liver lesions on CT, 77 had metastases, three had large cysts, and two had cavernous hemangiomas. The other 40 were found to have single or multiple, small (less than 2-cm), low-density lesions. In 33 patients these were proven to be benign hepatic cysts by sonography, follow-up CT, or clinical course. The initial CT interpretations in these patients had been metastatic disease in seven (21%), benign cysts in five (15%), and indeterminate in 21 (64%). Since the distinction between cysts and metastases has important clinical implications, sonography should be used whenever the true nature of these lesions cannot be determined by CT. PMID- 3548283 TI - Nodular regenerative hyperplasia of the liver: clinical and radiologic observations. AB - This report describes 21 cases of nodular regenerative hyperplasia (NRH) and its clinical and radiologic features. NRH of the liver is an established pathologic entity that should not be confused with focal nodular hyperplasia, hepatocellular adenoma, or the regenerative nodules associated with cirrhosis. Correct diagnosis will prevent an unnecessary hepatic lobectomy should NRH be mistaken for hepatocellular adenoma. Unlike focal nodular hyperplasia, NRH may bleed, may be associated with portal hypertension in one-half of cases, and is often associated with a systemic disease such as a myelo- or lymphoproliferative disorder. Correct diagnosis is important because the prognosis in patients with NRH and portal hypertension is better than that in patients with portal hypertension due to cirrhosis. Radiologically, multiple nodules, large masses, or an apparently normal liver (containing nodules less than 0.5 cm in diameter) were visible. The nodules may take up technetium sulfur colloid and have variable echogenicity on sonography. They are often hypodense on CT without significant enhancement. The nodules may fill from the periphery on angiography, are vascular, and sometimes contain small hypovascular areas due to hemorrhage. A large nodule may rupture and cause hemoperitoneum. These findings may resemble some features of focal nodular hyperplasia, hepatocellular adenoma, or metastases. NRH is probably underdiagnosed owing to a lack of recognition of the entity and limited sampling of liver tissue by needle biopsy. Scintigraphy, sonography, and CT of the liver should be performed in cases of idiopathic portal hypertension to detect NRH. In cases with compatible findings, multiple needle biopsies or a laparoscopically guided needle biopsy or wedge liver biopsy should be recommended for definitive diagnosis. PMID- 3548285 TI - Radiologic findings in xanthogranulomatous cholecystitis. AB - Xanthogranulomatous cholecystitis is rare, and information on its radiologic diagnosis is limited. Radiologic findings of seven patients with histologically proven xanthogranulomatous cholecystitis were reviewed retrospectively. Sonography showed a calculus or calculi of the gallbladder with moderate thickening of the wall in all. IV cholangiography was performed in six cases. Findings were nonspecific. Four had nonopacified gallbladder, and one had stenosis of the proximal part of the common bile duct. Marked thickening of the gallbladder wall was seen in six of seven cases on CT. In one case the thickened wall was lobulated and irregular. The border between the gallbladder and the adjacent liver was unclear in two and relatively clear in five. Four patients underwent angiography to evaluate the possibility of tumor. Two of them had irregularity and stenosis of the cystic artery highly suggestive of carcinoma. The other two showed only dilatation of the cystic artery. On the basis of all radiologic studies, carcinoma was diagnosed preoperatively in two of the seven cases. Radiologically, xanthogranulomatous cholecystitis may best be regarded as a tumor-like condition and should be included in the differential diagnosis of gallbladder cancer. PMID- 3548286 TI - Evaluation of renal transplant rejection by duplex Doppler examination: value of the resistive index. AB - The increasing use and availability of renal transplantation has resulted in a demand for noninvasive methods to study possible complications. One of the most serious adverse reactions is acute rejection, a possibly reversible cause of transplant failure if treated promptly. Differentiation from other causes of acute renal failure frequently is difficult, and the lack of specificity in many imaging studies has been troublesome. Eighty-one patients with renal transplants, including 41 with acute rejection, were examined. Duplex Doppler examination of the intrarenal arteries and a simplified formula, the resistive index ([peak systolic frequency shift--lowest diastolic frequency shift]/[peak systolic frequency shift]), were used to diagnose rejection. With a resistive index greater than 0.90, a 100% positive predictive value was obtained for the diagnosis of acute rejection. A value less than 0.70 was unlikely to be rejection (negative predictive value, 94%). This approach uses a simple analysis of the waveform. Use of a duplex Doppler examination and the formula described here appears to be an accurate method for the detection of acute rejection and for the differentiation of acute rejection from the various other causes of acute renal failure. PMID- 3548288 TI - Stereoscopic digital subtraction angiography of hepatic artery and vein. PMID- 3548287 TI - Sonographic findings in adenomyosis of the uterus. AB - In an attempt to define better the sonographic findings of adenomyosis of the uterus, we reviewed sonograms in seven cases of pathologically proven extensive adenomyosis without associated uterine diseases. In all cases, the uterus was enlarged. In five cases, the posterior wall of the uterus was thickened, and echoes in the endometrial cavity were eccentric. Six cases showed a slight decrease in uterine echogenicity. One case had sonographic findings suggestive of a calcified leiomyoma. The diagnosis of adenomyosis cannot be made conclusively by sonography. However, it can be suggested if the uterus is slightly enlarged and if the posterior portion of the myometrium is anechoic and thickened. PMID- 3548289 TI - Sonographic appearance of Klatskin tumors. PMID- 3548290 TI - Youth fitness, exercise and health behavior: a brief review. PMID- 3548291 TI - Restorative dentistry for the geriatric patient. PMID- 3548292 TI - Cancer chemotherapy in the elderly. AB - Although age may reduce the physiologic reserve of many systems, elderly patients with good performance status may receive chemotherapy without undue toxicity. Both survival and quality of life may be improved by treatment of responsive neoplasms, such as acute leukemia, multiple myeloma, small cell cancer of the lung, lymphomas and breast cancer. Age-related decrements in glomerular filtration rate and cardiac reserve suggest that doses of renally excreted drugs and cardiotoxic anthracyclines should be reduced in the elderly. PMID- 3548293 TI - Antihypertensive therapy and quality of life. AB - Treatment of mild hypertension is becoming increasingly accepted, and many more patients are receiving antihypertensive drugs. A number of new agents offer potential benefits over traditional therapy. These benefits are due to differences in side effect profiles, which have the potential for improved compliance. Quality of life is an important consideration in the selection of antihypertensive therapy. PMID- 3548294 TI - Prophylactic anticoagulation for left ventricular thrombi after acute myocardial infarction: a prospective randomized trial. AB - Thirty patients with a first episode of an anterior acute myocardial infarction (AMI) without a history of cardiac disease were prospectively randomized into a prophylactic heparin-treated group (group I) and a control nonanticoagulated group (group II) within 12 hours of the onset of chest pain to determine the effectiveness of anticoagulation for preventing left ventricular (LV) thrombi. Serial two-dimensional echocardiograms were performed during the hospital stay and patients were followed clinically for systemic emboli for 1 month after discharge from the hospital. Thirty-one percent of patients in group I (4/13) and 35% of patients in group II (6/17) developed LV thrombi on two-dimensional echocardiograms. There was no statistical difference in the incidence of LV thrombi between the two groups (p greater than 0.05). Infarct size as determined by creatine phosphokinase isoenzymes (2,386 +/- 1,568 vs 2,083 +/- 1,462 IU for groups I and II, respectively; p greater than 0.05), wall motion score (12.7 +/- 5 vs 10.7 +/- 5 for groups I and II, respectively; p greater than 0.05) and wall motion index (1.8 +/- 0.6 vs 1.8 +/- 0.56 for groups I and II, respectively; p greater than 0.05) were not statistically different between the two groups of patients. One patient in both groups had an embolic event. In conclusion, prophylactic anticoagulation in high-risk AMI patients for LV thrombus development does not prevent LV thrombus formation during the acute and subacute stages of an AMI. The results also suggest that anticoagulation may not prevent systemic embolization. PMID- 3548296 TI - Nonbacterial thrombotic endocarditis: a review. AB - The entity of NBTE is reviewed in this article. Historic aspects, epidemiology, and pathogenesis are discussed. The clinicopathologic findings are emphasized as well as the potential for antemortem diagnosis and therapy. NBTE is diagnosed infrequently before death. Clinical suspicion is aroused in patients with an underlying process such as malignancy, DIC, or a spectrum of other diseases and evidence of pulmonary and/or systemic embolization. Systemic infection must be excluded. Two-dimensional echocardiography can be utilized to confirm the diagnosis. Anticoagulation therapy with heparin may prevent embolization. PMID- 3548295 TI - Improved left ventricular performance during exercise with verapamil or nifedipine in patients with chronic stable angina. AB - To examine the effects of chronic oral therapy with verapamil, 120 mg three times a day, and nifedipine, 20 mg four times daily, on left ventricular ejection fraction and regional wall motion at rest and exercise, 10 patients with chronic stable angina pectoris underwent serial rest and exercise radionuclide angiography. Pre drug control study revealed a resting left ventricular ejection fraction (LVEF) of 0.62 +/- 0.08, falling to 0.54 +/- 0.12 at peak exercise (p less than 0.05). Wall motion score deteriorated from a resting value of 13.8 +/- 2.3 to 10.6 +/- 1.8 (p less than 0.01) with exercise. Patients were subsequently randomized to verapamil or nifedipine for 4 weeks each in an open-labeled crossover design. Rest and exercise radionuclide angiography were repeated at the end of each 4-week period. Neither verapamil nor nifedipine had a significant effect on resting LVEF (verapamil LVEF = 0.61 +/- 0.10, nifedipine LVEF = 0.64 +/ 0.02). Likewise, they had no significant effect on resting wall motion score (verapamil = 14.2 +/- 2.2, nifedipine = 14.4 +/- 1.6). Both verapamil and nifedipine significantly increased LVEF at peak exercise (verapamil = 0.63 +/- 0.09, nifedipine = 0.65 +/- 0.08, p less than 0.05 vs pre drug control) and improved peak exercise wall motion score (verapamil = 13 +/- 1.9, nifedipine = 13.8 +/- 1.6, p less than 0.05 vs pre drug control). Both drugs significantly reduced maximal ST depression at peak exercise and prolonged exercise duration. Episodes of angina and nitroglycerin use were also significantly reduced. In summary, verapamil and nifedipine improved left ventricular performance at exercise in patients with angina pectoris. PMID- 3548297 TI - Malignant pericardial diseases: diagnosis and treatment. AB - Pericardial involvement in malignant disease is fairly common. Usually the various clinical presentations--effusion, tamponade, constriction--occur in patients with known malignancy. Primary malignancy of the pericardium is rare, whereas secondary tumor involvement of the pericardium is more frequently observed. The common secondary solid tumors involving the pericardium are from lung and breast carcinomas; of the nonhematologic malignancies, lymphomas and leukemias are most frequent. A high index of suspicion in patients with malignancy, along with a history, physical examination, x-ray films, ECG, and echocardiography, will often make the diagnosis in a hemodynamically compromised patient. Occasionally, cardiac catheterization and pericardial biopsy are necessary to differentiate malignant pericardial disease from radiation pericarditis and restrictive heart disease. Therapy is dependent on the underlying condition and includes pericardiectomy, chemotherapy to obliterate the pericardial space, and external beam radiotherapy. These therapies are all palliative, but provide months of hemodynamic relief. The underlying prognosis of malignant pericardial disease remains grave. PMID- 3548298 TI - Analysis of reported randomized trials of streptokinase therapy for acute myocardial infarction in the 1980s. AB - Trials of intracoronary (IC) and intravenous (IV) streptokinase (SK) therapy for myocardial infarction have shown variable effects on mortality and left ventricular (LV) function. A pooled analysis of 10 randomized trials involving a total of 14,355 patients was performed to look for overall trends in the change in mortality within 6 weeks (group A) and after 6 weeks (group B) of follow-up, and the change in LV function. All 10 trials, 7 with IC and 3 with IV SK, were randomized after 1980. There was a significant reduction in mortality risk in patients in group A treated with IV SK (pooled odds ratio = 0.81, 95% confidence interval = 0.73 to 0.90, p less than 0.001). In contrast, no significant differences in mortality were detected in patients in group B treated with IV SK or in patients in either group treated with IC SK. Two IV SK trials that prospectively stratified patient population according to duration of symptoms showed a greater reduction in mortality with administration of SK therapy within 3 hours of onset of symptoms. Analysis of LV function was performed before, within 96 hours after and 1 to 4 weeks after SK therapy. Only 2 of 7 IC SK trials showed significantly greater improvement in global LV ejection fraction in SK group compared with a control group, both showing improvement in LV function between early and late after treatment. Thus, IV SK therapy significantly reduces short-term risk of death after acute myocardial infarction; 2 trials show a greater reduction in mortality risk with earlier institution of IV SK therapy. PMID- 3548300 TI - Localization of significant coronary arterial narrowings using body surface potential mapping during exercise stress testing. AB - The ability of body surface potential mapping to localize coronary arterial narrowings during exercise stress testing was investigated. An array of 48 chest wall electrodes, simultaneously recorded, was used. Digital filtering and signal processing, data reduction techniques and discriminant analysis were applied to process the information. Forty patients whose coronary angiograms showed a single significant narrowing of either the left anterior descending or right coronary artery were selected for further study. On the basis of body surface potential mapping, the site of coronary arterial narrowing was correctly classified in 88% of the patients. PMID- 3548299 TI - Factors affecting outcome of coronary reperfusion with intracoronary streptokinase in acute myocardial infarction. AB - Aggressive interventional therapy in acute myocardial infarction (AMI) is expensive, time-consuming and not without significant risk. To determine which patients are most likely to benefit from such therapy, the effects of patient age, reperfusion success, admission left ventricular (LV) function, infarct location, admission clinical class, time from onset of pain to reperfusion and admission electrocardiographic findings on the outcome of coronary reperfusion in AMI were assessed in 292 prospectively studied, sequential patients from August 1980 to January 1984. Two hundred ten patients received intracoronary streptokinase (SK) therapy on admission and 82 patients, who either refused the protocol or met exclusion criteria, served as control subjects. Patients older than 65 years showed little improvement in 1-year mortality risk and no significant improvement in LV function during hospitalization after treatment with intracoronary SK. The remaining patients, 178 treated with SK and 48 control, were well matched and served as the basis for further comparisons. In this subgroup of patients, reperfusion success was associated with improved survival and LV function (mortality rate 3%, vs 17% in control subjects; increase in ejection fraction [EF] 18% vs 4%). Patients with an EF of less than 45% on admission showed a 21 +/- 30% increase in EF, compared with an increase in control subjects of 8 +/- 19%, and a lower 1-year mortality rate than controls (6% vs 21%, p = 0.01). Patients with anterior AMI had a significant increase in EF in the SK group (22 +/- 31%) and lower mortality compared with control subjects (5% vs 25%, p = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548301 TI - Comparison of hydrochlorothiazide and sustained-release diltiazem for mild-to moderate systemic hypertension. AB - The safety and efficacy of sustained-release diltiazem, 120 to 180 mg twice daily, was compared with those of hydrochlorothiazide, 25 to 50 mg twice daily, in 207 patients with mild-to-moderate hypertension (supine diastolic blood pressure [BP] 95 to 114 mm Hg) using a baseline, placebo, parallel-design study protocol. All patients received placebo for 2 to 4 weeks, followed by either study drug during the double-blind phase, titrated over 8 weeks to achieve a goal of supine diastolic BP reduction of at least 10 mm Hg and/or a diastolic BP of less than 90 mm Hg. Patients not achieving the treatment goal with either drug alone received the other drug in combination. Both drugs produced significant decreases in supine and upright BP throughout the 26-week study. The magnitude of decrease in mean supine diastolic BP was similar for both drugs as monotherapy at week 14 (-11.4 and -12.1 mm Hg, respectively). Hydrochlorothiazide produced significantly greater reductions at week 14 in mean supine systolic BP than sustained-release diltiazem (-19.5 and -12.7 mm Hg, respectively). The difference in mean supine diastolic BP reduction with the 2 drugs diminished when hydrochlorothiazide (50 mg/day) was compared with sustained-release diltiazem. The BP effects were sustained for 6 months with both drugs. The 2 drugs appeared to lower BP more in patients older than 60 years and more in black than in white patients. The combination of the 2 drugs decreased supine diastolic BP to goal levels in about 56% of the patients not achieving goal with either drug alone. Adverse effects were minimal with either drug alone and in combination, except for hypokalemia, which increased with thiazide alone and in combination. PMID- 3548302 TI - Determination of left ventricular ejection fraction by computer densitometric analysis of digital subtraction angiography: experimental validation and correlation with area-length methods. AB - Conventional methods for calculating left ventricular (LV) ejection fraction (EF) require accurate edge definition and geometric assumptions, which may be compromised in the presence of dyssynergy. Computer densitometric analysis (CDA) of digital subtraction angiography offers the potential for calculation of EF, independent of LV shape, by comparing summated brightness for regions of interest at end diastole and end systole. Therefore, the accuracy of CDA was validated for 2 mechanical heart models of differing geometry, spherical and rectangular. Both models confirmed the close correlation between calculated and measured EF (r = 0.98 and r = 0.99, respectively). Subsequently, the CDA was compared with single and biplane area-length EF calculations in 72 patients, half with a previous myocardial infarction. In patients without previous myocardial infarction, CDA correlated closely with both single-plane and biplane EF (r = 0.91 and 0.93, respectively). The close correlation was maintained regardless of whether CDA was applied to direct LV injection or intravenous digital subtraction angiography. However, in 36 patients with previous myocardial infarction, CDA correlated less closely with single-plane (r = 0.74) than with biplane (r = 0.86) area-length EF. Thus, CDA permits calculation of EF without geometric assumptions, and may be superior to the area-length method in patients with LV dyssynergy after myocardial infarction. PMID- 3548303 TI - Liver transplantation for treatment of cardiovascular disease: comparison with medication and plasma exchange in homozygous familial hypercholesterolemia. PMID- 3548304 TI - Diagnosis of functional pulmonary atresia using hyperventilation and Doppler ultrasound. PMID- 3548305 TI - Role of cardiopulmonary mechanoreceptors in the postural regulation of renin. AB - To change the stretch on cardiopulmonary mechanoreceptors, large shifts of blood in the capacity space were elicited by tilting and by exerting positive lower body pressure in the tilted position. Twelve volunteers underwent invasive hemodynamic studies and in 10 other subjects cardiac size was determined by radionuclide cardiography. In all 22 subjects tilting caused the expected increase of renin, which was abolished by lower body compression. Decompression caused renin to increase again. Right atrial pressure in invasive studies and end systolic and end-diastolic counts in noninvasive studies showed a significant and strong negative correlation with renin and norepinephrine levels. Thus, the degree of stretch of the cardiopulmonary mechanoreceptors is a major determinant of reflex regulation of renin release in humans. PMID- 3548306 TI - Predictability of mitral regurgitation detected by Doppler echocardiography in patients referred for cardiac transplantation. AB - Mitral regurgitation (MR) is common in patients with congestive heart failure (CHF), but the frequency in relation to the origin of ventricular dilatation has not been established. In 50 patients referred for cardiac transplantation, MR was assessed by Doppler echocardiography and the findings were compared with clinical information. Dilatation of the left ventricle, left atrium and mitral anulus was analyzed in 25 patients with respect to cause of CHF. All 50 patients had MR of at least moderate severity, regardless of cause (idiopathic dilated cardiomyopathy in 36, coronary artery disease in 14), length of symptoms (20 +/- 19 months, less than 6 months in 13 patients) or presence of murmurs (absent in 13 patients). Comparison of patients with nonischemic cardiomyopathy to those with ischemic heart disease revealed larger left ventricular volumes (215 +/- 81 vs 131 +/- 60 ml in systole, p less than 0.05) and left atrial volumes (124 +/- 70 vs 70 +/- 35 ml, p less than 0.05). Mitral anular dilatation was present only in patients with idiopathic cardiomyopathy (diameters 3.6 +/- 0.4 vs 3.1 +/- 0.2 cm, p less than 0.05). The frequency of significant MR in these patients with CHF suggests that it may have a major role in decompensation and in the therapeutic response. PMID- 3548307 TI - Contribution of the renin-angiotensin-aldosterone system to development of tolerance and fluid retention in chronic congestive heart failure during prazosin treatment. AB - To determine the effects of the renin-angiotensin-aldosterone system on development of tolerance and fluid retention in patients with chronic congestive heart failure during long-term prazosin treatment, plasma renin concentration, aldosterone, norepinephrine and maximal exercise tolerance were measured during chronic therapy with digitalis and diuretics, to which prazosin, captopril or a combination of both drugs was added. Plasma renin concentration and aldosterone level decreased slightly during prazosin therapy and norepinephrine level increased significantly. When captopril was given, plasma renin concentration increased as expected, aldosterone level normalized and norepinephrine level decreased significantly. When prazosin was added to captopril therapy, norepinephrine level increased and plasma renin concentration and aldosterone level did not change. Exercise capacity did not increase during prazosin treatment, but was increased with captopril treatment. Prazosin treatment was associated with an increase in body weight even though the dose of furosemide was increased. Inhibition of the renin-angiotensin system did not prevent fluid retention induced by prazosin during combination therapy. These findings suggest that the renin-angiotensin-aldosterone system is not substantially involved in development of tolerance and fluid retention during prazosin therapy; stimulation of plasma norepinephrine may be of decisive importance. PMID- 3548308 TI - Reviews of classic books and ineptness of reviewers: lessons for judges of medical manuscripts. PMID- 3548309 TI - Rathke's pouch grafts in adult brain sites. AB - Donor tissue containing Rathke's pouch (RP) with its associated mesenchyme and neural lobe was isolated from 15-day fetal rats and stereotaxically transplanted either to hypothalamic hypophysiotropic sites or to cerebral cortex of adult females for 30 days. Hosts either were intact or had been hypophysectomized 2-4 weeks prior to transplantation of Rathke's pouch. Grafts in the hypothalamus of either intact or hypophysectomized hosts were pleomorphic and large, often as wide as 1-2 mm, and occasionally larger. Grafts in the cortex of either intact or hypophysectomized hosts were nodular and occasionally projected upward in association with the meninges (cortex/meninges grafts). Certain features were characteristic of the grafts in all experimental groups, i.e., development of histotypic pars distalis with cell cords and fenestrated capillaries. In all experimental groups gonadotrophs and somatotrophs, when present, were localized at the graft margin adjacent to the connective-tissue interface; mammotrophs, when present, were distributed throughout the graft. Features specific to each experimental group also were apparent. Grafts in the hypothalamus of both intact and hypophysectomized hosts typically were encapsulated by a labyrinthine meshwork of cell processes, whereas cortex/meninges grafts directly abutted dense connective tissue or neural tissue. In hypothalamic grafts in intact hosts, moderately differentiated mammotrophs, gonadotrophs, and somatotrophs could be identified by their cytological features and immunopositivity for prolactin, luteinizing hormone, and growth hormone, respectively. In hypothalamic grafts in hypophysectomized hosts, mammotrophs were absent, and gonadotrophs and somatotrophs were poorly granulated and not abundant. Grafts in the cortex of intact hosts contained numerous, well-differentiated mammotrophs, gonadotrophs, and somatotrophs. Many of the mammotrophs in these grafts were hypertrophied, and profiles of exocytosis were common. In grafts in the cortex of hypophysectomized hosts, mammotrophs were either absent or very few, whereas gonadotrophs and somatotrophs were numerous. Gonadotrophs in these grafts were dramatically hypertrophied, although exocytosis was rare. The results indicate that development of histotypic pars distalis may occur in hypophysiotropic and non hypophysiotropic brain sites and that the hormonal state of the host as well as implantation site modulate cytodifferentiation of specific pars distalis cell types. PMID- 3548310 TI - A hypnotic relaxation technique for the treatment of premature labor. PMID- 3548311 TI - An insulinogenic effect of oral fructose in humans during postprandial hyperglycemia. AB - This study proposed to determine whether the stimulation of insulin secretion observed in humans infused with fructose when glucose levels were elevated could be observed when fructose was consumed during postprandial hyperglycemia. At 2-wk intervals, healthy volunteers consumed drinks containing glucose, starch, glucose followed 20 min later by fructose, starch followed 20 min later by fructose, and water followed 20 min later by fructose. Fructose consumption following glucose or starch drinks produced significantly higher levels of plasma insulin, but not plasma glucose, as compared to corresponding drinks consumed without fructose. Ten subjects whose blood glucose response levels were above 155 mg% after a glucose-containing drink appeared to be particularly responsive to the effects of fructose with increases in insulin levels of 60-288%. Results indicate that oral fructose can be insulinogenic in humans when blood glucose levels are elevated. PMID- 3548312 TI - Insulinemic and glycemic indexes of six starch-rich foods taken alone and in a mixed meal by type 2 diabetics. AB - The glycemic index concept neglects the insulin secretion factor and has not been systematically studied during mixed meals. Six starch-rich foods were tested alone and in an isoglucido-lipido-protidic meal in 18 NIDDs and compared with a glucose challenge. These test meals were randomly assigned using a three factor experiment design. All three tests contained 50 g carbohydrate; mixed meals were adjusted to bring the same amount of fat (20 g), protein (24 g), water (300 mL), and calories (475 kcal) but not the same amount of fiber. Whatever the tested meals, foods elicited a growing glycemic index hierarchy from beans to lentils, rice, spaghetti, potato, and bread (mean range: 0.21 +/- 0.12-92 +/- 0.12, p less than 0.001). Mixing the meals significantly increased the insulinemic indexes (p less than 0.05) and introduced a positive correlation between glycemic and insulinemic indexes (n = 6, r = 0.903; p less than 0.05). The glycemic index concept remains discriminating, even in the context of an iso-glucido-lipido protidic meal. Insulinemic indexes do not improve discrimination between foods taken alone in type 2 diabetics: they only discriminate between foods during mixed meals, similarly to glycemic indexes. PMID- 3548313 TI - Empiric weather report and prospectives for the future. PMID- 3548314 TI - A randomized trial of aminoglutethimide +/- estrogen before chemotherapy in advanced breast cancer. AB - Recent reports have suggested that the sensitivity to chemotherapy of endocrine dependent breast cancer may be enhanced by transient exposure to hormonal stimulation. To test this concept, 39 postmenopausal women with proven metastatic breast carcinoma and measurable disease were entered into this prospective, double-blind trial; 35 are currently evaluable. All patients were continuously treated with aminoglutethimide and hydrocortisone to lower estrogen production, plus cyclic chemotherapy. Patients in the "stimulation" arm received in addition, Estrace 2 mg b.i.d. sublingually for 3 days before and on the day of chemotherapy. Estrace administration appeared to accelerate tumor growth as demonstrated by increased bone pain, hypercalcemia, and growth of skin lesions. Response rates, response duration, and survival were similar in the stimulation and control groups. PMID- 3548315 TI - Lack of value for cisplatin added to mitomycin-doxorubicin combination chemotherapy for carcinoma of unknown primary site. A randomized trial. AB - Fifty-five patients with metastatic carcinomas of unknown primary site (50 adenocarcinomas) were randomized, after stratification, to treatment with either mitomycin and doxorubicin (MA) or mitomycin, doxorubicin, and cisplatin (MAP). There was a moderate but nonsignificant improvement in regression frequency (14 vs. 27%) and a slight but also nonsignificant worsening of survival (median 5.5 months vs. median 4.6 months) by the addition of cisplatin at 60 mg/m2 to the MA regimen. PMID- 3548316 TI - Epithelioid sarcoma. An immunohistochemical study. AB - The immunohistochemical findings in 14 epithelioid sarcomas, neoplasms of uncertain histogenesis, indicate that they react with antibodies against cytokeratin, epithelial membrane antigen, and vimentin. All cases were nonreactive for leukocyte common antigen, myoglobin, and Factor VIII-related antigen. These results point to the fact that epithelioid sarcoma expresses phenotypic characteristics more often associated with epithelioid neoplasms, rather than the mesenchymal profile of most soft tissue sarcomas. One explanation for this observation is that epithelioid sarcoma is in fact a carcinoma originating in the deep soft tissues. On the other hand, the pluripotential mesoderm has a known embryonic capacity to differentiate into epithelium and, therefore, it is plausible that epithelioid sarcoma is a mesenchymally derived neoplasm. Aside from histogenetic considerations, epithelioid sarcoma may be confused with a number of other neoplastic and granulomatous processes. Differential immunohistochemical stains are useful in selected instances wherein light and electron microscopic findings are diagnostically equivocal. PMID- 3548317 TI - Immunohistologic localization of corticotrophin-releasing hormone in human tumors. AB - The authors investigated formalin-fixed, paraffin-embedded human tissues for the presence of corticotrophin-releasing hormone (CRH) using the avidin-biotin peroxidase technic. Immunopositivity was demonstrated in nontumorous hypothalami, 1 of 8 hypothalamic gangliocytomas, 3 of 9 bronchial endocrine tumors, 1 of 30 small cell lung carcinomas, 1 of 8 ileal endocrine neoplasms, 2 of 20 pancreatic endocrine tumors, 2 of 10 medullary thyroid carcinomas, and 1 of 3 small cell prostate carcinomas. Of the tumors containing immunoreactivity, most were associated with Cushing's syndrome; the ileal and thyroid tumors were not. Adrenocorticotrophic hormone was immunohistochemically localized in two bronchial and one pancreatic tumor, which contained CRH-like immunoreactivity. No CRH was detected in nontumorous extrahypothalamic tissues from which the CRH-containing tumors derived, two mediastinal endocrine carcinomas, six endocrine tumors of the stomach/duodenum/appendix, eight pheochromocytomas, one Merkel cell tumor, and 32 squamous and adenocarcinomas of the lung/gut. CRH-like immunoreactivity may be found in tumors composed of peptide-hormone-producing endocrine cells; hypersecretion of CRH by those neoplasms may be significant in the development of Cushing's syndrome. PMID- 3548318 TI - Clinical comparison of the Roche Septi-Chek and Dupont Isolator blood culture systems. AB - A study was conducted to compare the recovery of clinical isolates by the DuPont Isolator and Roche Septi-Chek blood culture systems. A total of 5,262 blood culture specimens were processed by the two systems. Of these, 358 cultures contained significant isolates: 219 were positive in both systems, 68 were recovered only by Isolator, 71 were recovered by Septi-Chek only (not statistically significant). Of the isolates recovered in both systems, 159 were positive the same day, 55 were recovered first by Isolator, and 5 were recovered first by Septi-Chek. In cases where Isolator recovered organisms first, the average difference in time was one to two days. Regarding particular groups of organisms, there was no difference between the systems in recovery of Enterobacteriaceae, anaerobes, yeast, and gram-positive bacteria, except for Streptococcus pneumoniae. Septi-Chek recovered S. pneumoniae significantly more often. These results suggest that these two systems are essentially comparable, except with S. pneumoniae, although the Isolator frequently provided results more rapidly. PMID- 3548319 TI - Comparison of commercial kits for the detection of anti-nDNA antibodies using Crithidia luciliae. AB - The reactions of sera from 15 selected patients with connective tissue diseases and 4 selected control people were compared with the use of five commercial kits detecting anti-nDNA antibodies by indirect immunofluorescence on Crithidia luciliae. The cases with systemic lupus erythematosus (SLE) and a related condition reacted with the kinetoplasts of the C. luciliae in each kit tested with one exception, notably a case of drug-induced LE. The four control cases selected for a trace of staining of the nuclei of C. luciliae gave negative reactions with the kinetoplasts. The titer for each individual positive serum varied from 1.36 to 2.67 (mean SG 2.04) geometric standard deviation units. The staining pattern of sera positive for anti-nDNA antibodies on C. luciliae included reactivity of the kinetoplast with or without nuclear staining. The drug induced LE serum produced only nuclear staining with no significant kinetoplast staining, i.e., a negative test for anti-nDNA antibodies. Patient control sera stained only the nucleus when any reactivity on C. luciliae was present. Generally, there were no major differences in titers and patterns of sera when comparisons were made between manufacturers. The sera were also tested by the Farr radioimmunoassay and the latex nucleoprotein test. The results of both of these assays correlated in most cases with the C. luciliae reactions. PMID- 3548320 TI - A double-blind comparative immunotypic study between two institutions phenotyping non-Hodgkin's lymphomas. AB - To establish the feasibility of immunotyping specimens transported over great distance, the University of Arizona and the Cleveland Clinic exchanged 39 lymphoma cases (26 B-cell, 13 T-cell cases) via air express for phenotyping. They were exchanged with the use of glass slides with adherent snap-frozen sections. The method involved immunohistochemistry using a common battery of 20 antibodies directed at B- and T-cell antigens. Using similar, but not identical, methods and reagents, cases were assayed before and after transport. Results were generated as paired determinations in a double-blind fashion (1,338 total determinations, 669 paired determinations/669 antigens). Using "pretransport" values as the baseline, there was subsequent agreement with baseline in 624 of 669 antigenic determinations (93.3%) and disagreement in 45 (6.7%). Interinstitutional agreement was 94% for T-antigens (Leu-1-7,9) and 93% for B-antigens (K, lambda; IgM, G, A, D; B1, B2, B4, L14; J5, common acute lymphocyte leukemia antigen [CALLA]; Ia). In spite of 6.7% disagreement, there was agreement of overall phenotypic profile (e.g., B vs. T and subset stage) in all 39 cases. This is because discrepancies were isolated and the battery offset undue reliance on a single antigen. The disagreements relate mainly to certain B-antigens: CALLA/J5 (eight disagreements) and B1 and B2 (six and five disagreements, respectively). T antigen disagreements were more sporadic (e.g., Leu-5 [three disagreements]). These discrepancies may relate to antigen loss with transport, variable antigen density or antibody avidity, methodologic differences, quality of reagents, or differences of phenotype interpretation. A further exchange of the 45 disagreement slides indicated that difference of observer interpretation was a minor factor (3 of 45). In conclusion, the authors' study demonstrates a high degree of immunotype reproducibility (approximately 93%), suggesting promise for institutions doing collaborative lymphoma studies. PMID- 3548321 TI - Clinical interpretation of beta-lactamase-producing strains of Branhamella catarrhalis in sputum Gram's stain and culture. AB - Branhamella catarrhalis has been implicated previously as a cause of bronchopulmonary infections. Sputum Gram's stain and culture results suggesting significant infection with beta-lactamase-producing strains of B. catarrhalis were correlated with a retrospective chart review of eight pediatric and ten adult patients. Preexisting pulmonary disease was observed in 12 patients; 5 had a history of aspiration; and 13 were intubated. Clinically, ten patients had pneumonia, five had bronchitis, and three manifested no disease. Only three sputum specimens grew a pure culture of B. catarrhalis, and six specimens yielded B. catarrhalis in the presence of normal upper respiratory flora. Analysis of broth microdilution susceptibility test results showed that 90% of the strains were inhibited at the following minimum inhibitory concentrations (MICs90): ampicillin, 8 micrograms/mL; cefotaxime, 0.5 microgram/mL; cefoxitin, 0.5 microgram/mL; cephalexin, 4 micrograms/mL; cephalothin, 8 micrograms/mL; chloramphenicol, 1 microgram/mL; clindamycin, 4 micrograms/mL; erythromycin, 0.25 microgram/mL; methicillin, 16 micrograms/mL; mezlocillin, 16 micrograms/mL; moxalactam less than or equal to 0.6 microgram/mL; penicillin, 16 micrograms/mL; piperacillin, 8 micrograms/mL; tetracycline, less than or equal to 0.3 microgram/mL; and trimethoprim/sulfamethoxazole, 1.6/30 micrograms/mL. Therapy may have been adequate in only eight (44%) of the cases. However, all but four of the patients, who died of unrelated causes, exhibited resolution of disease. The data indicate that Gram's stain and culture results of sputum specimens suggesting B. catarrhalis bronchopulmonary infection should be interpreted with caution by clinicians. PMID- 3548322 TI - Outpatient evaluation of a rapid, direct test for detection of group A streptococci in throat swabs. AB - A latex agglutination test (Marion Laboratories) was compared with standard culture methods for the detection of Group A streptococci in two studies of 500 throat swabs each. Swabs were first inoculated to sheep blood agar and then tested for Group A streptococcal antigen. The direct test performed with nearly identical sensitivity and specificity in the two phases of the study. Overall, Group A streptococci were isolated from 91 specimens, and 81 (89%) of these were detected by the direct latex test. The predictive value positive for the latex test was 90%, and the accuracy was 98%. The sensitivity of the latex test for detection of specimens having ten or more colonies of Group A streptococci was 95%. Non-Group A beta-hemolytic streptococci were isolated from 65 specimens, and all of these specimens had negative latex tests. The authors' findings suggest that this direct latex agglutination test is a reliable screening method for rapid detection of Group A streptococci in outpatient throat specimens. PMID- 3548323 TI - 1986 Ward Burdick Award lecture. Pathology as an investigative discipline. PMID- 3548324 TI - Esophageal motility disorders: a clinical overview. PMID- 3548325 TI - Omeprazole. PMID- 3548326 TI - Rapid urease test in the management of Campylobacter pyloridis-associated gastritis. AB - Campylobacter pyloridis colonization of the stomach may be an etiological factor in gastritis and peptic ulceration. Campylobacter pyloridis produces large amounts of urease, and the presence of this enzyme in gastric mucosa usually indicates infection with the organism. In this paper we describe the use of a rapid urease test (CLOtest) to detect C. pyloridis infection in gastric mucosal biopsies. In 141 consecutive endoscopy cases, antral biopsies were taken for culture and histology, and an extra biopsy was inserted into the CLOtest gel. There were 79 patients infected with C. pyloridis, 78 of whom were detected by CLOtest: 75% were positive at 20 min, 92% at 3 h, and 98% at 24 h. There were no false positive results. Eighteen infected patients were rebiopsied after a course of amoxycillin and bismuth subcitrate. Active chronic gastritis resolved in eight of nine who were cleared of the organism, but histological gastritis was unchanged in nine patients who were still infected. CLOtest is a simple, sensitive, and highly specific test that enables the endoscopist to diagnose C. pyloridis infection in the endoscopy room. A negative test after antibiotic therapy correlates with clearance of the bacteria and healing of active gastritis. PMID- 3548328 TI - Courvoisier's "law"--an eponym in evolution. PMID- 3548327 TI - Effect of modifying the rate of digestion of a food on the blood glucose, amino acid, and endocrine responses in patients with cirrhosis. AB - To see whether foods with slower rates of digestion may benefit the metabolic abnormalities seen in cirrhosis, the same food, processed in two different ways, was fed to seven patients with cirrhosis. The breakfast of lentils processed by prolonged heating, to produce more rapid in vitro digestion, resulted in a significantly higher incremental rise in large neutral amino acid levels at 60 min (p less than 0.02) and a tendency for a more rapid rise in total amino acid concentrations by comparison with conventionally cooked lentils with slower in vitro digestion rates. After more rapidly digested lentils, incremental levels of branched-chain amino acids were also higher at 60 min (67 +/- 9, p less than 0.001) despite a greater overall insulin response. Comparable incremental amino acid areas after both meals suggested that the total amount of amino acids absorbed was not influenced by processing. Greater blood glucose, insulin, and gastric inhibitory polypeptide responses were seen after the more processed meal with no significant differences in pancreatic glucagon, entroglucagon, or neurotensin levels. Processing a food to alter the rate of digestion may therefore be used to manipulate amino acid, glucose, and endocrine responses in cirrhosis. PMID- 3548329 TI - Endoscopic retrograde cholangiopancreatography findings of a gallbladder filling defect caused by sludge. AB - Ultrasound of the abdomen has described intraluminal gallbladder masses or stones without acoustic shadowing which have been termed "sludge balls." This finding has not been previously reported via its x-ray appearance at endoscopic retrograde cholangiopancreatography. This case reports this finding at endoscopic retrograde cholangiopancreatography and emphasizes that it is in the spectrum between suprasaturated bile and choledocholithiasis. PMID- 3548330 TI - Bile peritonitis after liver biopsy: nonsurgical management of a patient with an acute abdomen: a case report with review of the literature. AB - A 67-yr-old anicteric man with esophageal varices underwent a percutaneous liver biopsy. The procedure was complicated by bile peritonitis resulting in an acute abdomen that was successfully managed conservatively with intravenous fluids, antibiotic therapy, and intensive care unit monitoring. The published literature on this complication after liver biopsy is reviewed. PMID- 3548331 TI - Subclinical epidemiology. The first Harry A. Feldman memorial lecture. PMID- 3548332 TI - Electric power use and breast cancer: a hypothesis. PMID- 3548333 TI - Plasma insulin and serum lipids and lipoproteins in middle-aged non-insulin dependent diabetic and non-diabetic subjects. AB - The relationship between fasting plasma insulin and serum lipid and lipoprotein levels was studied in 1982-1983 in Kuopio, East Finland in 225 patients with non insulin-dependent diabetes mellitus (119 men and 106 women) and 124 non-diabetic controls (65 men and 59 women). Compared to the non-diabetic controls, diabetic subjects showed significantly lower levels of high density lipoprotein (HDL) cholesterol and high density lipoprotein2 (HDL2) cholesterol and higher levels of total triglycerides and very low density lipoprotein (VLDL) triglycerides. Fasting plasma insulin correlated significantly with total triglycerides and VLDL triglycerides and negatively with HDL cholesterol and HDL2 cholesterol in both male and female diabetic subjects and non-diabetic control subjects. The correlation between fasting plasma insulin and HDL cholesterol remained statistically significant in non-insulin-dependent diabetic subjects and in female non-diabetic control subjects after adjustment for body mass index, alcohol intake, physical activity, smoking, and fasting plasma glucose. The correlation between fasting plasma insulin and total triglycerides remained significant after adjustment for these variables only in females. By multiple stepwise linear regression analysis, fasting plasma insulin had an independent association with HDL cholesterol in female non-diabetic control subjects and in male diabetic subjects and with triglycerides in female non-diabetic control subjects and in female diabetic subjects. The results show that hyperinsulinemia is related to low HDL cholesterol and HDL2 cholesterol and high total triglycerides and VLDL triglycerides in both non-insulin-dependent diabetic subjects and non-diabetic control subjects. This effect of hyperinsulinemia on lipid and lipoprotein patterns may be one explanation why high plasma insulin can promote accelerated atherosclerosis, particularly in patients with non-insulin dependent diabetes mellitus. PMID- 3548334 TI - Sex differences in the coronary heart disease risk profile: a possible role for insulin. The Beaver County Study. AB - The mortality rate from coronary heart disease is much higher among men than women except in diabetes mellitus, which appears to reduce this sex difference. It is hypothesized that the female advantage is due, at least partly, to the more efficient insulin mediated glucose homeostasis in females, an advantage lost in the diabetic state. The authors studied 170 young adult men and women aged 20-24 years from a population-based survey in Beaver County, Pennsylvania, in 1981 1982, in an attempt to further elucidate the sex-specific relationships between fasting serum insulin concentrations and several risk factors. Women who used oral contraceptives and subjects whose fasting serum glucose exceeded 110 mg/dl were excluded. Insulin was related to body mass index in both sexes (r = 0.31; p less than 0.01 for men; r = 0.26, p less than 0.01 for women) and to systolic blood pressure (r = 0.27, p less than 0.01 for men; r = 0.36, p less than 0.001 for women). Insulin was related to diastolic blood pressure in men only (r = 0.31, p less than 0.05). Multivariate analysis revealed fasting serum insulin to be an independent predictor of systolic blood pressure in both sexes and of diastolic blood pressure in men only. Insulin was inversely related to high density lipoprotein cholesterol only among men and this relationship appeared to be largely independent of body mass index and triglycerides. Results indicate that insulin concentration is associated with an adverse coronary heart disease risk factor profile especially among men, consistent with their excess risk of cardiovascular disease. PMID- 3548335 TI - Ultrastructural localization of the membrane attack complex of complement in human renal tissues. AB - Utilizing a monoclonal antibody (Poly C9-MA) to a neoantigen of the C9 portion of the membrane attack complex of complement (MAC), immunoelectron (IEM) and immunofluorescent (IF) microscopy were performed on kidney tissue from normal humans and patients with insulin-dependent diabetes mellitus (IDDM) and type II membrano-proliferative glomerulonephritis (MPGN II). Comparative studies were conducted using polyclonal antibodies to human C3, C5, IgG, IgA, and IgM. In normal human tissue, there was a close correlation between increasing chronologic age and the quantity of MAC deposited in the mesangial stalk, along the interstitial aspect of and within tubular basement membranes (TBMs) and in arteriolar walls. IF of kidney tissues from 12 patients with IDDM with varying degrees of mesangial expansion and glomerulosclerosis demonstrated a direct relationship between the degree of tissue damage and the amount of MAC deposited in the mesangium. IEM of three normal and four diabetic specimens revealed reaction product of Poly C9-MA on linear and circular membranous structures within the mesangium, TBMs, and vessel walls, and within the glomerular basement membranes (GBMs) in diabetic subjects. Evidence is presented that these structures, which have been previously described by routine electron microscopy, represent cellular debris in these loci on which Poly C9-MA has been deposited. In MPGN II, Poly C9-MA and C3 were distributed within subepithelial deposits, along either side of the dense deposits (DDs) within the GBMs and TBMs, and around circular masses of DDs within the mesangium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548336 TI - Reducing the hemorrhagic complications of hemodialysis: a controlled comparison of low-dose heparin and citrate anticoagulation. AB - We report a randomized prospective study comparing the results of anticoagulation using hypertonic trisodium citrate and low-dose controlled heparin during 45 hemodialysis treatments performed on patients determined to be at high or very high risk for bleeding. Dialysis-associated bleeding was more frequent following low-dose controlled heparin anticoagulation than during hypertonic citrate therapy (P less than .05). Dialysis effectiveness measured by postdialysis chemistries and weight loss was equivalent in the two groups. PMID- 3548337 TI - Trends in the US end-stage renal disease population: 1973-1983. PMID- 3548338 TI - Cirrhotic glomerulonephritis: incidence, morphology, clinical features, and pathogenesis. AB - Glomerulonephritis is a little known manifestation of liver cirrhosis. Since the introduction of sophisticated immunologic staining methods, glomerular morphologic abnormalities have been noted in more than 50% of patients with cirrhosis at both necropsy and biopsy. The distinctive pathologic findings consist of glomerular mesangial IgA deposits usually accompanied by complement deposition. Increased serum IgA levels are found in over 90% of cirrhotic patients with glomerular IgA deposition. Cirrhotic glomerulonephritis is usually a clinically silent disease, however, the diagnosis can be suspected by finding proteinuria or abnormalities of the urine sediment. The pathogenesis may relate to defective hepatic processing and/or portacaval shunting of circulating immune complexes. PMID- 3548339 TI - Influence of race of cadaveric kidney donor and recipient on graft survival: a multifactorial analysis. AB - Actuarial survival analysis of 889 cadaver transplant patients between 1972 and 1981 in Michigan reveals functional graft (P = .0003) and patient (P = .004) survivals are improved when donors and recipients are of the same race (black or white). The Cox regression model for multifactorial analysis confirms the significantly lower graft survival for the mixed racial combination group with a relative risk of 1.27 (P less than .05). By this analysis, other significant factors adversely affecting the graft survival rates include diabetes as a cause of end-stage renal disease, earlier date of transplantation, shorter duration of prior dialysis, and a significant center effect. Patient survival has a significantly greater relative risk for the black to white racial combination, diabetes, earlier calendar year of transplantation, and age of patient. While the mixed racial group was slightly older (delta = 2 years), had more hypertension, less glomerulonephritis, and more HLA mismatches, our analysis by the Cox regression model suggests that these factors played only minor roles (P greater than .05) regarding graft survival rates. Therefore, our data suggest that independent of several other factors, cadaver kidneys have a better functional outcome when they are transplanted into recipients of the same race. PMID- 3548340 TI - Experimental and clinical studies on the reproductive toxicology of 2,3,7,8 tetrachlorodibenzo-p-dioxin. AB - The reproductive toxicology of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has been studied in animal models and in human populations. In animals, TCDD has a range of toxic effects on organs of the reproductive system in males and females, on hormone biochemistry, and on embryo-fetal development. These effects may involve in part an identified intracellular TCDD receptor and its association with the induction of microsomal cytochrome P-450-dependent monooxygenases in many organs. TCDD treatment increases activity of monooxygenase enzyme in liver and gonads of treated animals, but unlike other polycyclic aromatic hydrocarbons that are monooxygenase inducers, TCDD is not cytotoxic to any population of oocytes in the mature female mouse. Epidemiological studies of TCDD reproductive toxicity have been limited in design. There are some reports of adverse effects in the Seveso population and in children born to American veterans presumed to have been exposed to TCDD in Agent Orange during the Vietnam war. Occupational cohorts have not been found to show such paternally mediated effects of TCDD exposure. PMID- 3548341 TI - Stability of cisplatin, iproplatin, carboplatin, and tetraplatin in commonly used intravenous solutions. AB - The stability of cisplatin, iproplatin, carboplatin, and tetraplatin in common intravenous solutions was studied. Admixtures of each drug in each of the following vehicles were prepared in glass containers: 0.9% sodium chloride injection, 5% dextrose injection, 5% dextrose and 0.9% sodium chloride injection, 5% dextrose and 0.45% sodium chloride injection (admixtures were prepared in plastic bags also), and 5% dextrose and 0.225% sodium chloride injection. Drug concentrations were monitored for 24 hours using stability-indicating high performance liquid chromatographic methods. The stability of cisplatin and tetraplatin was related to the chloride ion content of the infusion fluid; when the infusion fluid contained 0.9% sodium chloride, each of these drugs was present at greater than 90% of the original concentration after six hours. The stability of iproplatin was not related to chloride concentration. A slight increase in the decomposition rate of carboplatin was observed in the presence of chloride ion. Carboplatin and iproplatin are stable for 24 hours in all the infusion fluids studied, but carboplatin should not be diluted with solutions containing chloride ions because of possible conversion to cisplatin. Cisplatin is stable for 24 hours in admixtures containing sodium chloride concentrations of 0.3% or greater. Tetraplatin is stable for six hours in admixtures containing sodium chloride concentrations of at least 0.018%. PMID- 3548342 TI - Impact of PROs on hospitals and pharmacy practice. PMID- 3548343 TI - Bone metastases: pathogenesis, treatment, and rationale for use of resorption inhibitors. AB - Tumors in bone are usually metastatic, with breast, prostate, and lung tumors accounting for more than 80 percent of clinically manifest lesions. Untreated, such metastases can produce the symptoms that most concern cancer patients--pain, pathologic fractures, and paralysis through epidural cord compression. Recent advances in the understanding of the metastatic cascade and the regulation of bone formation and resorption provide unique therapeutic approaches for prevention and treatment of these lesions. This article reviews the prevalence, distribution, diagnosis, and treatment of metastatic cancer in the skeleton, as well as the processes involved in the development of such metastases, the local mediators responsible for some of the destructive changes in bone, and their pathologic results. In addition to considering some of the conventional therapeutic approaches, a rationale for the use of bone resorption inhibitors, such as the diphosphonates (bisphosphonates), is presented for the prevention and amelioration of the pathologic consequences of skeletal metastases. PMID- 3548344 TI - Activation of the renin system in acute pancreatitis. AB - Activity of the renin-angiotensin system was assessed in patients with acute pancreatitis. Measurements of active plasma renin and inactive plasma renin were made in normal subjects, patients with acute pancreatitis, and patients with acute abdominal pain syndromes exclusive of pancreatitis. Active plasma renin values were significantly increased in acute pancreatitis, nearly 500 percent higher than in the other two groups. Inactive plasma renin values were similar in the three groups. In a subgroup of patients with acute pancreatitis, measurements were made on presentation and after recovery. The elevated active plasma renin values on admission fell significantly with recovery, in parallel with changes in serum amylase values. Inactive plasma renin values changed variably; there was a significant inverse regression relationship between the changes in active and inactive plasma renin values with recovery. The results indicate that the renin angiotensin system is activated in acute pancreatitis to a significantly greater extent than in other syndromes with acute abdominal pain. The increased active plasma renin in acute pancreatitis is most likely due to renal release secondary to the reduced circulating volume and hypotensive effect of this disease. However, changes in the relationship between active and inactive plasma renin in some patients suggest that activation of inactive renin by proteolytic enzymes released in acute pancreatitis might play an additional role. PMID- 3548345 TI - Rapid insulin initiation in non-insulin-dependent diabetes mellitus. AB - Three insulin-initiation regimens were compared in 43 severely hyperglycemic non insulin-dependent diabetic patients: a "standard" regimen (Lente insulin once daily), a "rapid" regimen (a mixture of regular and Lente insulins twice daily), and a "rapid/intravenous" regimen (the "rapid" regimen preceded by overnight intravenous infusion of regular insulin). The mean serum glucose level fell more rapidly in both groups receiving "rapid" regimens, reaching less than 200 mg/dl in 3.0 days with the "rapid" regimen compared with 5.9 days with the "standard" regimen (p less than 0.005). Duration of hospitalization was similarly reduced (6.4 versus 9.9 days, p less than 0.0001) as was the cost of hospitalization. In contrast to the "rapid" regimens, symptomatic hypoglycemia was common and adequate glycemic control was rare with the "standard" regimen. Thus, rapid initiation of insulin therapy with 0.5 to 0.6 units/kg per day of a mixture of regular and intermediate-acting insulins given twice daily is effective, safe, and reduces the cost of hospitalization in patients with non-insulin-dependent diabetes mellitus who require insulin treatment. PMID- 3548346 TI - Hepatorenal syndrome. Studies of the effect of vascular volume and intraperitoneal pressure on renal and hepatic function. AB - Eleven patients with well-documented hepatorenal syndrome were studied by measurement of blood volume, glomerular filtration rate, renal plasma flow, plasma aldosterone concentration, renin substrate concentration, and plasma renin activity. They were then given 750 ml of stored plasma, 750 ml of fresh frozen plasma, and then an infusion of angiotensin II, in random order on successive days. Infusion of fresh frozen plasma improved function more than did stored plasma and in addition returned a very low filtration fraction toward normal. Angiotensin II infusion increased filtration fraction, but decreased glomerular filtration rate, renal plasma flow, and urine flow sharply. Patients were then given a daily infusion of 1,000 ml of fresh frozen plasma for seven to 18 days to expand the blood volume to supranormal levels as assayed by serial measurement of blood volume. Plasma aldosterone levels decreased to a normal range, glomerular filtration rate and renal plasma flow both increased, and urinary excretion of sodium and potassium both returned toward normal. The effect of intraperitoneal pressure was then studied by measuring glomerular filtration rate, renal plasma flow, pressure in the vena cava, hepatic vein free flow, and hepatic vein wedged pressure before, during, and after paracentesis to reduce the intraperitoneal pressure from 30 to 40 cm H2O to 12 to 17 cm H2O. Venous pressures moved parallel to ascitic fluid pressures, and glomerular filtration rate, renal plasma flow, and urine flow all improved sharply; then, as ascitic fluid continued to form, reducing vascular volume, urine flow, glomerular filtration rate, and renal plasma flow all decreased slowly. Six patients then underwent placement of a LeVeen shunt. Improvement in glomerular filtration rate and renal plasma flow and clinical condition was dramatic. During postoperative observation of up to two years, progressive improvement in hepatic function has occurred. PMID- 3548348 TI - Cardiovascular disease of connective tissue origin. AB - Inherited abnormalities of connective tissue elements often cause changes in the structure and function of the cardiovascular system. Well-known heritable disorders of connective tissue in which cardiovascular abnormalities are prominent include the Marfan syndrome and the Ehlers-Danlos syndrome. Connective tissue abnormalities also occur without the associated features of a recognized syndrome. These include isolated valvular prolapse and anuloaortic ectasia. In this review, the cardiovascular features of connective tissue abnormalities--both the recognized syndromes and the isolated abnormalities--are described, important concepts in the diagnosis and treatment of these disorders are reviewed, and the classification of inherited connective tissue abnormalities of the cardiovascular system is discussed. PMID- 3548347 TI - Comparison of pseudoachalasia and achalasia. AB - Malignancies involving the gastric cardia or distal esophagus can result in a clinical syndrome termed pseudoachalasisa that mimics idiopathic achalasia. If not promptly recognized, pseudoachalasia can result in inappropriate pneumatic dilatation of the lower esophageal sphincter segment and delay appropriate treatment of the underlying malignancy. During the past 14 years, six patients with pseudoachalasia and 161 patients with primary idiopathic achalasia were encountered. Pseudoachalasia occurred mainly in the elderly and represented about 9 percent of these patients over 60 years of age with suspected achalasia. Five of the six pseudoachalasia cases were secondary to adenocarcinoma that originated in the gastric fundus, and one was caused by a squamous cell carcinoma of the distal esophagus. Conventional esophageal manometry did not discriminate achalasia from pseudoachalasia. On the other hand, esophagogastroscopy with biopsy resulted in a diagnosis of pseudoachalasia in five of these cases and in 24 of 32 cases reported previously. Ominous endoscopic findings are mucosal ulceration or nodularity, reduced compliance of the esophagogastric junction, or an inability to pass the endoscope into the stomach. Radiographic evaluation, particularly in conjunction with amyl nitrite inhalation, was also useful in discriminating pseudoachalasia from primary achalasia. It is concluded that pseudoachalasia generally mimics idiopathic achalasia imperfectly and can usually be diagnosed prior to surgery by fastidious endoscopic and radiographic examination. PMID- 3548349 TI - Complexity and contradiction in clinical trial research. AB - Randomized clinical trials have become the accepted scientific standard for evaluating therapeutic efficacy. Contradictory results from multiple randomized clinical trials on the same topic have been attributed either to methodologic deficiencies in the design of one of the trials or to small sample sizes that did not provide assurance that a meaningful therapeutic difference would be detected. When 36 topics with conflicting results that included over 200 randomized clinical trials in cardiology and gastroenterology were reviewed, it was discovered that results of randomized clinical trials often disagree because the complexity of the randomized clinical trial design and the clinical setting creates inconsistencies and variation in the therapeutic evaluation. Nine methodologic sources of this variation were identified, including six items concerned with the design of the trials, and three items concerned with interpretation. The design issues include eligibility criteria and the selection of study groups, baseline differences in the available population, variability in indications for the principal and concomitant therapies, protocol requirements of the randomized clinical trial, and management of intermediate outcomes. The issues in interpreting the trials include the regulatory effects of treatments, the frailty of double-blinding, and the occurrence of unexpected trial outcomes. The results of this review suggest that pooled analyses of conflicting results of randomized clinical trials (meta-analyses) may be misleading by obscuring important distinctions among trials, and that enhanced flexibility in strategies for data analysis will be needed to ensure the clinical applicability of randomized clinical trial results. PMID- 3548350 TI - Lack of response to suramin in patients with AIDS and AIDS-related complex. AB - Forty-one homosexual men with the acquired immune deficiency syndrome (AIDS) or AIDS-related complex were treated with 0.5, 1.0, or 1.5 g of suramin weekly for up to six months. In no patient was evidence of symptomatic improvement or regression of Kaposi's sarcoma shown. Opportunistic infections developed in 16 patients during therapy. Only six patients (15 percent) became human immunodeficiency virus (HIV) culture-negative during treatment, despite documentation of adequate serum suramin levels. All but one of these six have had disease progression. Decreases in the numbers of total T4 cells with time were observed in both AIDS and AIDS-related complex subgroups. Toxicity was significant and consisted of fatigue, fever, and hepatic and renal dysfunction, all of which were observed most frequently with the 1.0 or 1.5 g dosages. Fatal hepatic failure developed in two patients, and adrenal insufficiency was documented in eight patients. Suramin is a toxic agent that shows no virologic, immunologic, or clinical benefit in patients with HIV-related disease. PMID- 3548351 TI - Cryptococcal peritonitis. Report of a case and review of the literature. AB - Cryptococcus neoformans is a rare cause of peritonitis; only four cases have been reported in the literature. A 63-year-old man in whom isolation of C. neoformans from ascitic fluid provided the initial clue to disseminated cryptococcosis is described. Review of this case and those previously reported reveals striking association between cryptococcal peritonitis and hepatic disease. PMID- 3548352 TI - Treatment compliance in end-stage renal disease patients on dialysis. AB - This paper reviews the current knowledge concerning treatment compliance in patients with end-stage renal disease (ESRD). Adult hemodialysis patient noncompliance with the treatment regimen is very common. Objective and subjective measures of compliance, however, are often weakly correlated. In addition, the patients may be compliant with some aspects of the treatment regimen, but noncompliant with others. Unfortunately, no current model of predicting the degree of hemodialysis patient compliance is very accurate. In spite of this, behavioral approaches to increase regimen compliance do have at least short-term efficacy. There is a paucity of published data on compliance in adult peritoneal dialysis patients and an almost complete absence of systematic studies of compliance in children and adolescent dialysis patients. A multidimensional nosology of compliance behavior in ESRD patients is, therefore, proposed, as well as an approach to the diagnosis of noncompliance in ESRD patients and to possible interventions. PMID- 3548354 TI - End-stage renal disease treatment modality and patients' quality of life. Longitudinal assessment. AB - Quality of life assessments were obtained at two 18-month follow-up intervals from 97 end-stage renal disease patients. Data were compared for three stable treatment groups (transplant, home hemodialysis, in-center hemodialysis) and for two transfer treatment groups (hemodialysis to transplant, hemodialysis to continuous ambulatory peritoneal dialysis). Home hemodialysis patients demonstrated the highest quality of life and lowest hospitalization rates over time. Transplant patients had higher employment and perceived health status but not necessarily higher subjective quality of life as compared to in-center hemodialysis patients, and transplant patients experienced more hospitalization. At follow-up, hemodialysis patients who obtained transplants assessed their quality of life as higher than did hemodialysis patients who went on continuous ambulatory peritoneal dialysis. PMID- 3548353 TI - De novo diabetic nephropathy with functional impairment in a renal allograft. AB - Recurrence of diabetic nephropathy in the allograft of diabetics with end-stage renal disease who undergo renal transplantation has been reported. We report a case of a patient who underwent cadaveric renal transplantation for end-stage renal disease secondary to chronic glomerulonephritis 13 years ago. He developed steroid-induced, insulin-dependent diabetes mellitus 9 months after transplantation and florid nephrotic syndrome with progressive functional impairment due to biopsy-proven diabetic nephropathy 11 years later. This is, to our knowledge, the first report of de novo diabetic nephropathy in a renal allograft of a patient who was not a diabetic at the time of transplantation. It is suggested that histopathologic changes of diabetes mellitus cannot only recur in a renal allograft, but also can develop de novo and lead to functional impairment and ultimately affect graft survival. In view of increasing patient and graft survival in transplanted diabetic and non-diabetic patients, it is reasonable to anticipate an increased incidence of this complication. PMID- 3548355 TI - Short-term efficacy of nifedipine in essential and renovascular hypertension. PMID- 3548356 TI - Combined nifedipine and captopril treatment in moderately severe primary hypertension. PMID- 3548357 TI - Calcium antagonists in the treatment of arterial hypertension in the elderly. PMID- 3548358 TI - Calcium metabolism in essential hypertensive patients treated by verapamil. PMID- 3548359 TI - Calcium, cell function and cell death. PMID- 3548361 TI - Calcium, parathyroid hormone, and sympathoadrenal system. PMID- 3548360 TI - Serum calcium, parathyroid hormone, and blood pressure. PMID- 3548362 TI - Renin-angiotensin system in acute hypercalcemic hypertension in man. PMID- 3548363 TI - Altered cellular calcium control in blood cells in primary hypertension. PMID- 3548364 TI - Side effects of calcium antagonists. PMID- 3548365 TI - Calcium antagonists: interactions in hypertension. PMID- 3548366 TI - Home care is more than Medicare regs. PMID- 3548367 TI - The road not taken. PMID- 3548368 TI - Cervical ripening and labor induction with prostaglandin E2 gel: a placebo controlled study. AB - A randomized double-blind, placebo-controlled study was undertaken to evaluate the effect of a single intracervical application of prostaglandin E2 gel on the ripening of the cervix and on the subsequent induction of labor with oxytocin in patients with low Bishop scores (less than or equal to 4). Compared to controls receiving gel only, the group receiving prostaglandin E2 gel had significant increases in their cervical Bishop scores, shorter induction-to-delivery intervals, shorter time requiring use of oxytocin, and more successful labor induction without oxytocin. Systemic side effects were minimal and fetal outcomes were comparable, as were the routes of delivery. PMID- 3548369 TI - Fetal foot length as a predictor of gestational age. AB - Ultrasonographic measurement of fetal foot length is useful in the assessment of gestational age. Two hundred twenty-three postpartum and 224 ultrasonographic measurements were performed between 11 and 43 weeks' gestation; 207 postpartum and 160 ultrasonographic measurements met our requirements of secure dates and no physical anomaly or maternal disease. Mean foot length at each week of gestation compared favorably with Streeter's data, based on pathologic specimens, described in 1920. Comparison of curvilinear regression of foot length versus gestational age demonstrated a strong correlation with an R2 value of 0.981; 95% confidence intervals at each week compared favorably with both biparietal diameter and femur length data. Fetal foot length is a reliable parameter for use in the assessment of gestational age and is particularly useful when other parameters do not accurately predict gestational age, for example, hydrocephalus, anencephaly, short limb dysplasia. PMID- 3548370 TI - Sacrococcygeal teratoma: prenatal diagnosis and management. AB - Although sacrococcygeal teratoma is a rare and potentially malignant tumor, 10 cases were documented during a 5-year period at the University of Toronto Perinatal Complex. Diagnosis was made in the six cases in which prenatal ultrasound examination was performed. One patient with twins elected to terminate the pregnancy at 19 weeks. In three of the cases diagnosed prenatally, serial ultrasound was performed. There was a 75% cesarean section rate. In all cases diagnosed prenatally, the large tumor size affected the mode of delivery. In the four cases without prenatal diagnosis, two infants were delivered vaginally, and two were delivered abdominally for obstetric reasons. There was one case of neonatal morbidity where tumor vascularity and rupture resulted in hypovolemic shock. All tumors were resected and found to be benign. A plan of management is recommended and, with appropriate obstetric and pediatric care, a good outcome can be anticipated in most cases. PMID- 3548371 TI - Doppler ultrasound prediction of fetal outcome in twin pregnancies. AB - The usefulness of pulsed Doppler ultrasound in predicting twin pregnancies destined for unsatisfactory outcomes was examined in 30 twin pregnancies. Fetal flow velocity waveform analysis (systolic/diastolic ratio and pulsatility index) and quantitative analysis in the descending aorta and umbilical artery demonstrated good sensitivity and specificity when compared with biparietal diameter and abdominal circumference measurements. This technique shows some promise as a useful adjunct in the management of twin pregnancies. PMID- 3548372 TI - Congenital and nosocomial sepsis in infants born in a regional perinatal unit: cause, outcome, and white blood cell response. AB - The incidence, cause, and outcome of sepsis and the white blood cell response were studied in 6315 infants born in a regional perinatal unit. The incidence of neonatal sepsis was 6.5 per 1000 live births. Congenital sepsis (12 cases) was overwhelming, with associated maternal infection (92%), neutropenia (75%), and high rate of mortality (50%). The most common organism was Escherichia coli (58%). Gestational age and birth weight were similar in survivors and nonsurvivors. There was a strong correlation between total white blood cell count and both mature and immature neutrophil counts in survivors but this correlation decreased substantially in neonates that died. Analysis of variance indicated that the means for polymorphonuclear leukocyte and immature neutrophil counts were significantly higher in survivors. Nosocomial sepsis (38 cases) occurred in premature low birth weight infants receiving invasive, intensive care. The most common organism was Staphylococcus epidermidis (76%). Total white blood cell, polymorphonuclear leukocyte, and immature neutrophil counts rose significantly in response to sepsis. None died. Prevention of congenital sepsis requires methods to detect early maternal-fetal infection. Providing granulocytes to neutropenic neonates with congenital sepsis might improve outcome. PMID- 3548373 TI - Sonographic determination of fetal weights in diabetic pregnancies. AB - Accurate antenatal diagnosis of the macrosomic infant of a diabetic mother should lead to a decrease in perinatal morbidity. Several formulas for weight estimation based on sonographic measurements are in common use, but none of them has been devised specifically for the infant of a diabetic mother. We assessed the accuracy of conventional formulas at estimating fetal weight in 160 of these infants and found their relative errors (error as a percentage of birth weight) had standard deviations of 12.2% to 13.1% (greater than has been reported in the general population) with no statistically significant difference among formulas. We also devised customized formulas generated from a "training set" of 80 patients and tested on a second set of 80 patients. The best formula yielded a standard deviation of 11.0%. The difference between customized and conventional formulas was not statistically significant. With use of one conventional formula, the likelihood of macrosomia was found to be 77% when the estimated weight was greater than 4000 gm and 86% when the estimated weight was greater than 4500 gm. We conclude that fetal weight prediction is even less accurate in the infant of a diabetic mother than in the general population and that "customized" formulas fare no better than conventional formulas in diabetics. Despite this, estimated weights can offer guidance in predicting fetal macrosomia and therefore aid in obstetric management. PMID- 3548374 TI - Three-contrasts method: an ultrasound technique for monitoring transcervical operations. AB - The "three-contrasts method" of ultrasonography is designed to monitor transcervical operations for submucous uterine myomas and uterine septa when a pediatric urologic resectoscope is used. This monitoring method has proved more effective than concomitant laparoscopy. The pediatric resectoscope can also be used efficiently for diagnostic and therapeutic purposes without dilating the cervical canal. PMID- 3548376 TI - Microbiology of the female genital tract. AB - Patients who contract genital tract infections are predominantly young, are otherwise healthy, and generally respond well to treatment for bacterial infections. These infections are most commonly polymicrobial in etiology, with several noteworthy exceptions. Often there is an inciting event such as childbirth, surgical intervention, pregnancy termination or intrauterine contraceptive device insertion. With treatment, prognosis for cure is excellent; however, sequelae such as recurrent infections, infertility, or ectopic pregnancy can be serious. Bacteria encountered in the female genital tract can be divided into aerobic and anaerobic organisms. Among the aerobic gram-positive organisms, several varieties of streptococci such as Group B streptococci and enterococci occur frequently. Staphylococcus aureus is an infrequent but important pathogen. Among the aerobic gram-negative organisms, the most common is Escherichia coli. Klebsiella sp. and Proteus sp. occur in about 5% of genital tract infections. Species that are more resistant to antibiotics, such as Pseudomonas aeruginosa and Enterobacter sp., occur in approximately 1% or 2% of these cases and are more likely to appear in patients who have previously received antibiotic therapy or who have been hospitalized for some time. Among the anaerobic organisms, the most common gram-positive isolates are Peptostreptococci and Peptococci. Clostridia sp. occurs less frequently. Among the anaerobic gram-negative organisms, the Bacteroides sp. most frequently encountered are Bacteroides bivius and Bacteroides disiens. Bacteroides fragilis is still a common problem but appears to be less predominant. Other organisms encountered are Chlamydia trachomatis, the genital mycoplasmas, yeasts, protozoa, and viruses. PMID- 3548375 TI - Prenatal ultrasonic diagnosis of multiple bowel atresias. AB - This case illustrates the course of an obstructive process through spontaneous perforation resulting in decompression of dilated bowel loops. The resulting meconium peritonitis appeared as fetal ascites. Postnatal investigations and laparotomy confirmed the diagnosis of a rare form of multiple congenital atresias of the bowel. PMID- 3548377 TI - A review of the role of beta-lactamase-producing bacteria in obstetric gynecologic infections. AB - beta-Lactam antibiotics are the most commonly used antibiotics in obstetrics and gynecology. However, they are susceptible to inactivation when attacked by beta lactamase, an enzyme produced by many bacterial species. During the past three decades, numerous penicillins and cephalosporins have been made with a stable beta-lactam ring that resists enzyme attack. More recently enzyme inhibitors have been discovered that inactivate beta-lactamase. The combination of an enzyme inhibitor with a beta-lactam antibiotic, such as ampicillin, restores the antimicrobial activity of the beta-lactam against formerly resistant strains of staphylococci, Haemophilus influenzae, Enterobacteriaceae, and Bacteroides fragilis. PMID- 3548378 TI - Induction of beta-lactamase enzymes: clinical applications for the obstetric gynecologic patient. AB - The emergence of bacteria resistant to antibiotics has resulted in intensive research for new and improved beta-lactam antibiotics. Many improvements in antimicrobial agents are based on a knowledge of the mechanism responsible for resistance. This has led to the development of new extended-spectrum antibiotic compounds. However, several features have been noted since the development of extended-spectrum antibiotics, such as the rapid development of bacterial resistance, the induction of beta-lactamase enzyme activity by these stable antibiotics, failure to detect induced enzyme activity and resistance in the laboratory, and beta-lactam antagonism. The resistance of bacteria to antimicrobial agents has obvious impact on the selection of appropriate therapy against infections caused by these pathogens. Gram-negative anaerobic bacteria, such as Bacteroides fragilis and Bacteroides bivius, are organisms frequently recovered from women whose initial therapy for pelvic infection failed. The transfer of antimicrobial resistance in bacteria indicates that these organisms have a system for the spread of such resistance. Therefore determination of antimicrobial susceptibilities and prompt eradication of isolates from infected patients are necessary to delay the emergence of resistant organisms. PMID- 3548379 TI - The use and misuse of the fetal biophysical profile. AB - The value of the fetal biophysical profile in determining fetal well-being has been well documented. The increasing clinical use of the fetal biophysical profile, however, has led to the recognition of frequent errors in the interpretation and application of this modality. These errors may result in unnecessary interventions or adverse perinatal outcome. The most frequent errors in the interpretation and application of the fetal biophysical profile are described; in an attempt to minimize the misuse of the fetal biophysical profile, an alternative protocol of antepartum fetal evaluation is suggested based upon the information obtained from the biophysical monitoring of the fetus. PMID- 3548380 TI - Can ultrasonography replace amniocentesis in fetal gender determination during the early second trimester? AB - Fetal gender was prospectively determined by ultrasonography in 115 patients with singleton pregnancies between 16 and 20 weeks of gestation. Gender determination was performed as a part of the sonographic examination preceding genetic amniocentesis, and the results were compared to the amniotic fluid fetal karyotype results. Our rate of visualization of the fetal external genitalia was 83.5%. The accuracy rate for gender determination was 90% in male infants and 100% in female infants, with an overall rate of prediction of 92.7%. PMID- 3548381 TI - Exaggerated gonadotropin response to luteinizing hormone-releasing hormone in amenorrheic runners. AB - Most studies of exercise-induced amenorrhea have compared amenorrheic athletes (usually runners) with sedentary control subjects. Such comparisons will identify hormonal changes that develop as a result of exercise training but cannot determine which of these changes play a role in causing amenorrhea. To obviate this problem, we assessed reproductive hormone status in a group of five amenorrheic runners and compared them to a group of six eumenorrheic runners matched for body fatness, training intensity, and exercise performance. Compared to the eumenorrheic runners, the amenorrheic runners had lower serum estradiol concentrations, similar basal serum luteinizing hormone and follicle-stimulating hormone concentrations, and exaggerated responses of serum gonadotropins after administration of luteinizing hormone-releasing hormone (100 micrograms intravenous bolus). Serum prolactin levels, both basally and after thyrotropin releasing hormone administration (500 micrograms intravenous bolus) or treadmill exercise, was similar in the two groups, as were serum thyroid function tests (including thyrotropin response to thyrotropin-releasing hormone). Changes in serum cortisol levels after short-term treadmill exercise were similar in both groups, and serum testosterone levels increased after exercise only in the eumenorrheic group. In neither group did such exercise change serum luteinizing hormone, follicle-stimulating hormone, or thyrotropin levels. We concluded that exercise-induced amenorrhea is not solely related to the development of increased prolactin output after exercise training. The exaggerated gonadotropin response to luteinizing hormone-releasing hormone seen in amenorrheic runners in comparison with matched eumenorrheic runners is consistent with a hypothalamic etiology for the menstrual dysfunction, analogous to that previously described in "stress-induced" or "psychogenic" amenorrhea. PMID- 3548382 TI - Magnesium sulfate and ritodrine hydrochloride: a randomized comparison. AB - The efficacy of magnesium sulfate was analyzed in relation to ritodrine hydrochloride. Patients presenting in preterm labor between 20 and 35 weeks' gestation were prospectively randomized. Tocolysis was achieved for more than 72 hours in 35 of 40 cases (88%) where magnesium sulfate was administered and 31 of 39 cases (79%) in which ritodrine hydrochloride was infused. Delay of greater than or equal to 7 days was achieved in 75% and 72% of cases, respectively. The mean dosage to achieve tocolysis was 4.5 gm/hr, in the magnesium sulfate group and 210.0 micrograms/hr in ritodrine hydrochloride-treated patients. The mean magnesium level to achieve tocolysis was 6.60 mg/dl. Side effects in the two groups were similar in number but less alarming in the magnesium sulfate group. Magnesium sulfate was found to be easy to administer and clinically efficacious. Its tocolytic action was found to be dose dependent and drug concentrations are easily determined. On the basis of this work and data from other investigators, magnesium sulfate should be used as the first line of tocolytic therapy with ritodrine hydrochloride as its pharmacologic backup. PMID- 3548383 TI - Umbilical artery Doppler blood flow studies in the preterm, small for gestational age fetus. AB - Umbilical artery Doppler studies were performed on the day of delivery in 15 singleton preterm pregnancies. In each case the fetus was significantly growth retarded on ultrasound examination and the attending obstetrician had made a decision to deliver the patient of the infant. Eight women had severe preeclampsia, three had mild chronic hypertension, and in four there was no recognized maternal disorder. Doppler studies were analyzed by use of the pulsatility index and the A/B ratio. In 14 of the 15 cases both were markedly abnormal. Three early neonatal deaths occurred. A positive correlation was found between the degree of abnormality of the pulsatility index and A/B ratio and a poor neonatal outcome (p less than 0.001 and p less than 0.02). Umbilical artery Doppler studies were not helpful in differentiating between intrinsic and extrinsic causes of growth retardation but seemed to identify the pregnancy at increased risk of a poor neonatal outcome. PMID- 3548385 TI - Reliable criteria for the prenatal sonographic diagnosis of alobar holoprosencephaly. AB - A series of 10 consecutive cases of alobar holoprosencephaly is described. The disorder was diagnosed prenatally by ultrasound according to two criteria: a large central fluid collection in the fetal head, with no visible midline structures but with the presence of a mantle around the fluid collection and fusion of the thalami and corpus striatum, and sonographic abnormalities of the face, including hypotelorism, central clefts, facial asymmetry, and abnormal orbits. PMID- 3548384 TI - Type-specific streptococcal antibodies in amniotic fluid. AB - Type-specific antibodies against group B streptococcal and pneumococcal capsular antigens were measured in 68 amniotic fluid samples from healthy women between 16 and 20 weeks of pregnancy. Mean antibody levels ranged from 0.13 to 0.61 microgram/ml, with few samples having greater than 1 microgram/ml against any antigen. The role of antibodies in protection against intrauterine infection is discussed. PMID- 3548386 TI - Fetal biophysical profile scoring: selective use of the nonstress test. AB - The fetal biophysical profile score was modified by selective use of the nonstress test. In 2712 study patients (7851 tests) the incidence of nonstress test was reduced to 2.7% with no measurable effect or test accuracy. The nonstress test was most useful in evaluation of abnormal ultrasound monitored variables. PMID- 3548387 TI - Embryonic trunk circumference: a new biometric parameter for estimation of gestational age. AB - One hundred thirty-one uncomplicated, singleton pregnancies between 7 and 12 weeks of gestation were ultrasonically examined. Evaluation included confirmation of cardiac activity and measurements of fetal crown-rump length and trunk circumference. Both crown-rump length and trunk circumference were curvilinearly correlated with gestational age. A second- and third-degree polynomial equation best described this curvilinear relationship between trunk circumference and gestational age and between crown-rump length and gestational age. The crown-rump length and trunk circumference were similar in their prediction of gestational age, but the combination of the two parameters did not improve the prediction of gestational age. A nomogram of gestational age as predicted by trunk circumference was generated. These data provide an additional measurement for the estimation of gestational age in the first trimester of pregnancy. PMID- 3548388 TI - Immunohistochemical localization of epidermal growth factor receptor and myc oncogene product in human placenta: implication for trophoblast proliferation and differentiation. AB - Cytologic localization of epidermal growth factor receptor and myc oncogene protein product in developing human placenta was analyzed by avidin/biotin immunoperoxidase techniques with a monoclonal antibody to epidermal growth factor receptor and an affinity purified polyclonal antibody to myc protein product. Epidermal growth factor receptor was found to be almost exclusively localized to syncytiotrophoblast, paralleling the immunohistochemical localization of human chorionic gonadotropin. Since epidermal growth factor has been shown to stimulate human chorionic gonadotropin and human placental lactogen production by cultured early placental tissue, the present finding that epidermal growth factor receptor was localized to mitotically inactive syncytiotrophoblast suggests a role for epidermal growth factor receptor in the induction of differentiated function of trophoblast rather than trophoblast proliferation. By contrast, myc protein product was found to be predominantly localized to cytotrophoblastic cells, paralleling the autoradiographic distribution of replicating cytotrophoblast identified by tritiated thymidine labeling of placental explant. A close similarity between the cytologic localization of myc protein product and tritiated thymidine labeling of placental explant suggests that myc protein expression is linked to trophoblast proliferation. Furthermore, immunohistochemical cellular levels of both epidermal growth factor receptor and myc protein product were most pronounced in early placenta and declined in term placenta. Thus myc protein product and epidermal growth factor receptor seem to play a crucial role in the induction of trophoblast proliferation and differentiation, respectively, during the development of human placenta. PMID- 3548389 TI - Infusion of gonadotropin-releasing hormone agonist during pregnancy: maternal and fetal responses in primates. AB - To determine whether a gonadotropin-releasing hormone agonist could cross the placenta to the fetus, each pregnant rhesus monkey (110 to 155 days' gestation, n = 10) and her in utero fetus had indwelling cannulas placed in the femoral veins. Gonadotropin-releasing hormone agonist (1000 micrograms intravenously) was injected into the mother (n = 8) or fetus (n = 2); serial blood samples were collected from mother and fetus for luteinizing hormone and follicle-stimulating hormone determination. None of the mothers responded to the gonadotropin releasing hormone agonist bolus. In contrast, some of the fetal monkeys receiving gonadotropin-releasing hormone agonist via placental transfer and all fetal monkeys injected directly with the agonist responded as indicated by increased luteinizing hormone (2.8- to 12.3-fold) and follicle-stimulating hormone (1.5- to 8.9-fold) concentrations. In evaluating maternal and fetal effects, we found that continuous maternal infusion with either gonadotropin-releasing hormone agonist (n = 14) or saline solution (n = 11) throughout pregnancy did not alter maternal hormonal profiles. Histologically, gonads from their infants, removed within 3 days post partum, were normal. Although neonatal ovarian weights were unaffected by the in utero treatment, the testes weighed less (p less than 0.05) in male infants born of mothers treated with gonadotropin-releasing hormone agonist compared to controls. Thus gonadotropin-releasing hormone agonist can cross from maternal to fetal circulation, and the fetus can respond (at least during the third trimester). PMID- 3548390 TI - Echographic localization of corticosteroids after periocular injection. AB - The location of repository corticosteroid after subtenon injection was determined in 24 patients with macular edema associated with uveitis or anterior segment surgery. Standardized A-scan and B-scan echography were performed immediately before and after each injection. Localization was compared after subtenon injection in either the superior or inferior temporal quadrants. Echography showed that corticosteroid was deposited within the subtenon space over the macula in 11 of 24 cases. The therapeutic response manifested by improvement in macular function may be related to the proximity of the corticosteroid to the macular area. Lack of therapeutic response to repository corticosteroids may be because of placement at a site relatively far from the target zone. PMID- 3548391 TI - The advantages of partial patching or tarsorrhaphy over complete eyelid closure. PMID- 3548392 TI - Specular microscopy of corneal epithelium after epikeratophakia. AB - We studied the characteristics of the corneal epithelium by specular microscopy in 12 eyes of 11 patients, at three, six, and 16 months after epikeratophakia surgery. We found attenuation of cells; irregular shape; decreased density; loss of differentiation into dark and light cells and into small, medium, and large cells; and poor interdigitation between adjacent cells. Corneal hypesthesia noted in these grafts may contribute to the aberrant epithelial characteristics. PMID- 3548393 TI - Nonfreeze epikeratophakia for the correction of myopia. AB - We developed a procedure for preparing epikeratophakia tissue lenses for the correction of myopia from unfrozen tissue using a newly developed artificial anterior chamber and the BKS-1000 (Barraquer-Krumeich-Swinger) refractive set. The results of 23 clinical cases involving tissue that was not frozen or lyophilized demonstrate a correlation coefficient of 0.90 in terms of accuracy of correction and good visual acuity results. PMID- 3548394 TI - Corneal topography in myopic patients undergoing epikeratophakia. AB - We analyzed the corneal topography of eight eyes in seven patients who had undergone myopic epikeratophakia, using a 1.5-mm graft/host disparity. Topographic maps of corneal power generated by computer analysis of keratoscope photographs disclosed a central spherical optical zone smaller in diameter than was predicted by the preoperative lathing measurements. Outside this optical zone, the dioptric power of the graft surface increased steadily, indicating a progressive steepening of the corneal slope as the graft/host interface is approached. This pattern occurred in patients with accurate and inaccurate refractive results. The center of the graft was noted in some cases to be decentered from the patient's visual axis. The corneal topography analysis system has made clear the need to maximize the diameter of the effective optical zone. PMID- 3548395 TI - Relaxing incisions with augmentation sutures for the correction of postkeratoplasty astigmatism. AB - We performed a prospective study of relaxing incisions with augmentation sutures in 21 patients who were unable to wear spectacles or contact lenses after penetrating keratoplasty because of high astigmatism. The mean preoperative astigmatism was 9.37 diopters (range, 4.50 to 14.50 diopters), and the mean postoperative astigmatism was 3.73 diopters (range, 0.00 to 7.00 diopters). The net decrease in astigmatism was 6.56 diopters (range, 1.00 to 11.00 diopters), which represents a 67% decrease in astigmatism. The mean vector corrected change in astigmatism was 8.40 diopters (86%). These results were compared with those of our previous study of relaxing incisions without sutures. Overall, there was a significantly greater decrease in astigmatism (67% vs 47%, P = .009) when augmentation sutures were placed 90 degrees away from the relaxing incisions. Furthermore, in patients with more than 8.50 diopters of astigmatism, relaxing incisions with sutures yielded a much greater reduction in astigmatism compared with relaxing incisions without sutures (70% with sutures vs 39% without sutures, P = .002). We recommend relaxing incisions with augmentation sutures as the initial surgical procedure in eyes with more than 8.50 diopters of astigmatism. PMID- 3548396 TI - A preliminary comparative study of epikeratophakia or penetrating keratoplasty for keratoconus. PMID- 3548397 TI - Excimer laser cut lenticules for epikeratophakia. PMID- 3548398 TI - Reduction of astigmatism after keratoplasty. PMID- 3548399 TI - Chemical and physical properties of the normal and aging lens: spectroscopic (UV, fluorescence, phosphorescence, and NMR) analyses. AB - In vitro [UV absorption, fluorescence, phosphorescence, and nuclear magnetic resonance (NMR)] spectroscopic studies on the normal human lens demonstrate age related changes which can be correlated with biochemical and photobiologic mechanisms occurring during our lifetime. Chronic cumulative UV exposure results in an age-related increase of photochemically induced chromophores and in color of the lens nucleus. This enables the lens to filter the incident UV radiation, thereby protecting the underlying aging retina from UV photodamage. We have measured the age-related increase in lens fluorescence in vivo on more than 300 normal subjects (1st to 9th decade) by UV slitlamp densitography. These data show a good correlation with the in vitro lens fluorescence studies reported previously and demonstrate that molecular photodamage can be monitored in the lens. In vitro NMR (human and animal lenses) and in vivo experiments currently in progress are rapidly elucidating the physicochemical basis for transparency and the development of light scattering areas. Surface scanning NMR can monitor organophosphate metabolism in the ocular lens in vivo as well as in vitro. These studies demonstrate the feasibility of using biophysical methods (optical spectroscopy and NMR analyses) to delineate age-related parameters in the lens, in vivo as well as in vitro. PMID- 3548401 TI - Immunoanatomic distribution of cytostructural and tissue-associated antigens in the human urinary tract. AB - The main objective of the present study is to define the expression and/or modulation of antigenic phenotypes in cells of the normal human kidney and urothelium according to cell type. Fourteen antibodies detecting differentiation and structural antigens expressed in the human urinary tract have been used to define the immunoanatomic distribution of these antigenic systems. They include urinary tract antigens (Tamm-Horsfall glycoprotein and prostate-specific antigen), tissue-associated antigens (epithelial membrane antigen, Factor VIII antigen, and Protein S-100), and cytoskeletal antigens of the intermediate filament classes (cytokeratins, vimentin, desmin, glial fibrillary acidic protein, and neurofilaments. Immunofluorescence and immunoperoxidase analyses performed on normal human fetal and adult tissue sections have demonstrated that these antigens are expressed by different cell types and domains of the nephron. Studies correlating normal fetal and adult tissues reveal that some of the antigens appear at distinct stages of maturation, representing early and late antigenic expression events. These antibodies offer a wide range of potential applications that include studies of embryogenesis of the human urinary tract and immunopathologic analyses of neoplastic and nonneoplastic diseases of the human kidney and urothelium. PMID- 3548400 TI - Tumor markers in the human ovary and its neoplasms. A comparative immunohistochemical study. AB - The incidence and histologic characteristics of the expression of placental alkaline phosphatase (PLAP) in ovarian tumors was compared with that of five other tumor antigens. Three monoclonal antibodies were used for the specific localization of PLAP. PLAP was present in some sex cord cells of the 13-16-week fetal ovary, probably germ cells. In normal ovaries, all antigens except carcinoembryonic antigen (CEA) were frequently found in inclusion cysts; the germinal epithelium was positive only for cancer antigen 125 (CA 125). The frequency and extent of PLAP expression in nonmucinous carcinomas was higher than observed for CA 19-9 and CEA, but was lower than for CA 125 and human milk fat globule antigen. Serous tumors had the highest PLAP expression, followed by endometrioid and poorly differentiated adenocarcinomas, and some other tumors. PLAP was predominantly membranous; its histologic distribution was in general heterogeneous. Different antibodies to PLAP gave different staining intensities in some tumors, but the staining patterns were always qualitatively identical. PMID- 3548402 TI - Murine autoimmune oophoritis, epididymoorchitis, and gastritis induced by day 3 thymectomy. Immunopathology. AB - (C57BL/6 X A/J) F1, (SWR/J X A/J) F1 and BALB/cBy mice, thymectomized on Day 3 (D3TX) or Day 7 (D7TX) or sham thymectomized (STX), were studied for immunopathologic changes in the ovary, testis, and gastric wall. In 95% of B6AF1, 100% of SWRAF1, and 35% of BALB/cBy mice ovarian disease developed, with onset at 5-6 weeks of age. Ovarian disease was not found in D7TX or STX mice. In D3TX mice, it was associated with mononuclear infiltration and ovarian follicle destruction, leading to atrophy. Epididymovasitis was detected in 70-90% of SWRAF1, 50% of B6AF1, and 64% of BALB/cBy mice after D3TX; whereas orchitis occurred in about 20% of SWRAF1 and B6AF1 mice. In some mice epididymovasitis also developed after D7TX, but not after STX. In contrast to the negative immunohistochemical findings in diseased ovaries, typical immune complex-like deposits of mouse IgG were detected by immunofluorescence along the basement membrane of epididymal ducts and seminiferous tubules. However, maximum incidence of epididymitis preceded immune complex detection. Gastritis developed in both female (57%) and male (50%) BALB/cBy mice after D3TX, occasionally after D7TX, but not after STX. Gastric mucosa was hypertrophic with dilated glands and heavy lymphocytic infiltrations throughout all gastric layers. BALB/cBy mice with gastritis usually did not have disease in the gonads, and vice versa. This study, therefore, confirms and extends the findings of Nishizuka and colleagues. PMID- 3548403 TI - Diffuse large cell lymphomas of follicular center cell origin presenting in the skin. A clinicopathologic and immunologic study of 16 patients. AB - This report describes the clinical, histologic, and immunologic characteristics of 16 diffuse large cell lymphomas of follicular center cell origin with only skin lesions at presentation. These patients presented with nodular and tumorous skin lesions, which in 10 of 16 cases were confined to a circumscribed area on the trunk. Four patients, all elderly women, presented with skin tumors on the lower legs. Histologically, these 16 lymphomas showed nonepidermotropic diffuse dermal infiltrates, mainly consisting of large follicular center cells, with a variable admixture of small cleaved cells, immunoblasts, T-lymphocytes, and macrophages. The relative numbers of large cleaved and large noncleaved cells, respectively, varied considerably in these lymphomas. Immunophenotypically, almost all lymphomas expressed monotypic surface immunoglobulins and HLA-DR antigens, whereas all lymphomas were reactive with B-cell-associated monoclonal antisera B1, Leu-14, and/or To15. Three of four elderly female patients presenting with disease on the lower legs died. Of the 12 other patients, 11 are currently alive and in complete remission, which suggests a favorable prognosis for this type of cutaneous large cell lymphoma. PMID- 3548404 TI - Adult respiratory distress syndrome. A live E coli septic primate model. PMID- 3548405 TI - AIDS subacute encephalitis. Identification of HIV-infected cells. AB - Human immunodeficiency virus (HIV) RNA and proteins were detected in the brains of several AIDS patients with subacute encephalitis, by in situ hybridization and immunohistology. The majority of infected cells were mononucleated and bore processes. Using single and double immunohistologic procedures, the authors identified these cells as macrophages. The majority of them had the phenotype of microglial cells (Leu-M3-, CD4-), others were labeled with markers of circulating macrophages (Leu-M3+, CD4+/-). The presence of HIV RNA and proteins in CD4- cells could be explained by depressed CD4 antigen expression, as a result of infection or macrophage tissue differentiation. PMID- 3548406 TI - Expression of Ha-ras oncogene p21 protein in relation to the cell cycle of cultured human tumor cells. AB - It has been postulated that the expression of the product (p21) encoded by the ras genes may have a role in cell cycle events. Simultaneous multiparameter flow cytometry was used to measure the p21 content in relation to the cell cycle of several cancer cell lines of human origin. These studies revealed that p21 levels rise during the G1 phase of the cycle and remain approximately constant as cells traverse the S and G2 + M phases. The threshold level of p21 expression of S phase cells was used to divide the G1 cell population into cells with low (G1A) and high (G1B) p21 content. The p21 levels of G1B cells were approximately ten times higher than those of G1A cells. The validity of this subdivision was confirmed by synchronous measurements of RNA content and p21. Cells with low RNA content, hence in early part of G1 phase of the cell cycle, expressed low levels of p21, and cells with higher RNA content expressed higher levels of p21. These observations suggest that the levels of p21 are much lower at the onset of the cell cycle than at its end; hence a drop in p21 expression is likely to occur during or immediately after mitotic division. PMID- 3548407 TI - Microvascular function in skin windows. AB - The dermal microvasculature is an integral component of skin windows. However, in spite of the obvious dependence of the skin window model on vascular function, its almost exclusive application has been the study of leukocyte function and recovery of the cellular components of inflammatory exudates. In the studies reported here, skin window chambers were employed for assessment of function of the underlying microvasculature in rats given intravenous infusions of Evans blue dye or colloidal carbon. Increased vascular permeability was documented by photometric measurement of Evans blue dye, and vascular labeling of dermal vessels with colloidal carbon was assessed histologically. Zymosan-activated serum elicited accumulation of both leukocytes and Evans blue dye in chamber fluid overlying skin windows, confirming the responsiveness of the preparations. With serotonin as a model vasoactive substance, both increased vascular permeability and vascular labeling were directly related to serotonin concentration in the chamber fluid. It is estimated that plasma exudates were distributed as approximately 10% in the fluid and 90% in the dermis. Finally, serotonin-induced exudates recovered from the 0.3-ml chambers were estimated to be up to 3 microliter of plasma based on Evans blue dye measurement or up to 70 micrograms of protein based on Lowry assay. Thus, soluble components of skin window exudates were recovered for examination, and the dermal microvasculature was shown to be an important functional component of the skin window model that was directly accessible for study. PMID- 3548408 TI - Desmosomal plaque-associated vimentin filaments in human ovarian granulosa cell tumors of various histologic patterns. AB - Proteins of intermediate-sized filaments and desmosomal plaques (desmoplakins) of four human ovarian granulosa cell tumors were studied by immunofluorescence and immunoelectron microscopy and by two-dimensional gel electrophoresis of microdissected tissue samples. All tumor cells, irrespective of their specific histologic patterns, contained both vimentin and desmoplakins. Cytokeratin positive structures were absent or very scant in most tumor regions, but more common in trabecular, insular, macro- and microfollicular structures. Biochemical analysis revealed the presence of Cytokeratin Polypeptides 8 and 18. Desmin filaments, neurofilaments, and glial filaments were not detected. Immunoelectron microscopy showed vimentin filaments attached to desmoplakin-positive plaques of desmosomes. These results indicate that granulosa cell tumors contain true desmosomes, which are associated primarily with vimentin filaments. This phenomenon has so far only been described in meningiomas and in blastema cells of nephroblastomas. Our observations suggest that in most neoplastic granulosa cells one epithelial feature, ie, cytokeratin expression, is greatly reduced, whereas desmosomes are still formed in appreciable frequencies. This unusual constellation of cytoskeletal elements in granulosa cell tumors may be useful in the differential diagnosis from other ovarian neoplasms, especially undifferentiated carcinomas. The importance of the use of antibodies specific for exclusively desmosomal proteins in classifying morphologically ill-defined junctional structures (eg, "rudimentary junctions," "primitive junctions," "desmosome-like junctions") is emphasized. PMID- 3548409 TI - Binding of anti-basement membrane antibody to alveolar basement membrane after intratracheal gasoline instillation in rabbits. AB - A possible causal relationship has been suggested between hydrocarbon (gasoline, solvents, etc.) exposure and development of anti-basement membrane antibody associated Goodpasture's syndrome in man. The authors evaluated the effect of hydrocarbons on pulmonary capillary permeability and binding of heterologous anti basement membrane antibodies in the lungs after intratracheal instillation of minute amounts of unleaded gasoline into rabbits. The anti-glomerular basement membrane (GBM) antibodies used reacted with the alveolar basement membrane (ABM) in vitro by indirect immunofluorescence. The gasoline treatment altered pulmonary capillary permeability, judging from the increased accumulation of systemically administered radioiodinated bovine serum albumin in the alveolar and extravascular spaces of lungs; it also induced focal macroscopic and microscopic pulmonary histologic lesions. The gasoline caused focal in vivo binding of the anti-GBM antibodies to the ABM detectable by immunofluorescence microscopy. No binding was observed in lungs from control rabbits given saline instillations when assayed by immunofluorescence. The paired label radioisotope technique confirmed the increased antibody binding to lungs injured with gasoline (1.08 +/- 0.03 micrograms) versus 0.37 +/- 0.07 microgram after saline (P less than 0.001). These results indicate that gasoline exposure damages a pulmonary barrier that normally prevents binding of anti-GBM/ABM antibody to ABM and suggest that hydrocarbon exposure may be one of perhaps several pneumotoxic events that contribute to the episodic pulmonary hemorrhage in Goodpasture's syndrome by temporarily allowing ABM binding of anti-basement membrane antibodies. PMID- 3548410 TI - Renal ultrastructural markers in AIDS-associated nephropathy. AB - Renal tissues from two groups of patients with acquired immune deficiency syndrome (AIDS) were examined: Group A had severe proteinuria and varying degrees of renal insufficiency, designated AIDS-associated nephropathy (AAN), and Group B had no renal involvement. Control Group C consisted of patients with heroin associated nephropathy (HAN) with proteinuria comparable to patients in Group A but without AIDS or its related complex (ARC). The most frequent finding, common to both AAN and HAN, was focal glomerular sclerosis. In contrast to HAN, AAN tissue showed mesangial hypocellularity, sparse interstitial infiltrates, severe tubular degenerative changes, tubular microcystic ectasia, Bowman's space dilatation, and presence of multiple complex inclusions both in the nuclei and cytoplasm in a variety of cells. Abundant tubuloreticular inclusions were found in the endothelial and occasionally in the interstitial cell cytoplasm. Nuclear bodies (NBs) were seen in greater frequency, complexity, size, and heterogeneity, and of budding configuration in Group A as compared with Groups B and C; NBs in Group C were mostly of simple types (I and II). In addition, a peculiar granulofibrillary transformation in many tubular and interstitial cell nuclei was observed in Group A. This transformation was rarely present in Group B and was never seen in Group C. Because complex NBs (Types III to V) and various intracytoplasmic and intranuclear inclusions present in Group A are often associated with viral invasion, their presence in kidneys of AIDS patients with proteinuria suggests a viral etiology for AAN. PMID- 3548411 TI - Morphologic and immunohistochemical observations in granulomatous glomerulonephritis. AB - Eight renal biopsies of Wegener's granulomatosis and other vasculitic syndromes with periglomerular granulomatous reactions (granulomatous glomerulonephritis) are studied. Controls consist of 57 biopsies of crescentic and focal necrotizing glomerulonephritis (of various diseases, excluding systemic lupus erythematosus). Both groups have in common the morphologic alterations of inflammatory tuft necrosis, fibrin exudation into the urinary space, crescent formation, and breaks of Bowman's capsule. In the study group, the unique feature of glomeruli with surrounding granulomatous reactions was the presence, within the urinary space, of an exudate of fibrin mixed with immune reactants (immunoglobulins and usually complement) in association with gaps of Bowman's capsule. This contrasts with an exudate of fibrin alone in glomeruli of the control group and other glomeruli of the study group. The study group also had a significantly greater incidence of immune deposits in Bowman's capsule (P less than 0.001). Giant cells may result from the interaction of macrophages of the granuloma with Bowman's capsule that is permeated with immune reactants. PMID- 3548412 TI - Ricinus communis agglutinin I blocks the binding of human anti-renal basement membrane antibodies to the kidney. AB - Whether or not glycosyl moieties of glycoproteins present in human renal basement membranes are related to the sites where anti-basement membrane antibodies bind was examined by blocking experiments using several kinds of lectin. Ricinus communis agglutinin I (RCA I), specific for galactose, blocked the binding of human anti-glomerular basement membrane (GBM) and anti-tubular basement membrane (TBM) antibodies to renal basement membranes. This lectin also diminished the binding of rabbit anti-laminin antibody, but did not inhibit the binding of mouse anti-fibronectin or rabbit anti-human TBM antibodies. These findings suggest that the binding sites of human anti-GBM and anti-TBM antibodies and heteroantibodies to laminin are closely related to the galactose moieties in glycoproteins of human renal basement membranes. Whether the galactose-containing branches are associated with the nephritogenicity of human anti-GBM and anti-TBM antibodies or simply exist adjacently to the antibody binding sites remains to be discerned. PMID- 3548413 TI - Tissue identification and histologic study of six lung specimens from Egyptian mummies. AB - Twenty-eight specimens obtained either from organ bundles in the body cavities of intact mummies, from damaged mummies, or from isolated canopic jars were examined for tissue identification and histopathologic study. The methods of rehydration and fixation were optimized by application to 40 dehydrated modern samples before studies of mummified tissue were undertaken. The tissue of origin could be definitely identified in 24 of the 28 specimens. Even small fragments obtained from isolated canopic jars proved suitable for histologic study. Six lung specimens were selected for more detailed study. All six showed focal deposition of anthracotic pigment. Electron diffraction and electron microprobe analysis of one of the small, polarizable crystals associated with the anthracosis indicated a mineral content of silica, aluminum, and iron. Two specimens showed focal areas of calcification consistent with old mycobacterial disease. Other histopathologic findings included evidence of pulmonary edema, emphysema, and pneumonia. PMID- 3548414 TI - Stimulation of albumin gene transcription by insulin in primary cultures of rat hepatocytes. AB - The first goal of the work reported here was to prepare single-stranded DNA sequences for use in studies on the regulation of albumin gene expression. A double-stranded rat albumin cDNA clone was subcloned into the bacteriophage vector M13mp7. Single-stranded recombinant clones were screened for albumin sequences containing either the mRNA strand or the complementary strand. Two clones were selected that contained the 1,200 nucleotide long 3' end of the albumin sequence. DNA from the clone containing the mRNA strand was used as a template for DNA polymerase I to prepare a radiolabeled, single-stranded cDNA to albumin mRNA. This radiolabeled cDNA probe was used to quantitate the relative abundance of albumin mRNA in samples of total cellular RNA. DNA from the clone containing the complementary strand was used to measure relative rates of albumin gene transcription in isolated nuclei. The second goal was to use the single stranded DNA probes to investigate the mechanism of the insulin-mediated stimulation of albumin synthesis in primary cultures of rat hepatocytes. Addition of insulin to hepatocytes maintained in hepatocytes. Addition of insulin to hepatocytes maintained in a chemically defined, serum-free medium for 40 h in the absence of any hormones resulted in a specific 1.5- to 2.5-fold stimulation of albumin gene transcription that was maximal at 3 h and was maintained above control values for at least 24 h. The relative abundance of albumin mRNA and albumin secretion increased correspondingly within 24 to 30 h. These parameters remained above control levels for at least 60 h after addition of insulin. Maximal responses were attained at an insulin concentration of 100 nM and there was a close correspondence between albumin gene transcription and albumin secretion at each concentration tested. The rate of albumin gene transcription in nuclei isolated from livers of diabetic rats was reduced to 50% of the value recorded in control nuclei. Taken together, these findings demonstrate that insulin regulates synthesis of albumin at the level of gene transcription. PMID- 3548415 TI - Plasma protein-mediated transport of steroid and thyroid hormones. AB - The free hormone or free drug hypotheses have traditionally assumed that the concentration of cellular exchangeable hormone (i.e., the pool that drives cellular hormone or drug receptor occupancy) can be reliably estimated by in vitro measurements of unbound hormone concentrations. The corollary of this view is that the large reservoir of bound hormone in blood is passively transported by plasma proteins and is physiologically inactive. However, when these assumptions are subjected to direct empiric testing with either in vivo or perfused organ techniques, it is found that the large pool of bound hormone in blood is operationally available for transport across microcirculatory barriers without the plasma protein, per se, significantly exiting the plasma compartment. This process is believed to involve a mechanism of enhanced dissociation of hormone or drug from the plasma protein caused by transient conformational changes about the ligand binding site within the microcirculation: The biochemical mechanism of the interaction of the plasma protein with the surface of the microcirculation may involve receptor, charged selectivity, or local inhibitor mechanisms. PMID- 3548416 TI - Pregnancy-induced insulin resistance in liver and skeletal muscles of the conscious rabbit. AB - Insulin sensitivity of maternal nonuterine tissues (liver and skeletal muscles) has been investigated in the conscious rabbit during late gestation (24 and 30 days). The specific effect of insulin on glucose production and utilization was evaluated with the hyperinsulinemic euglycemic clamp technique. The net balance of glucose across the hindlimb muscles was studied by means of the Fick principle in basal and insulin stimulated conditions (clamp study). Our results show that an insulin-resistant state develops between days 24 and 30 of gestation in the rabbit and involves both glucose producing (liver) and utilizing (muscles) tissues. On day 30 of gestation, muscle glucose uptake was not significantly stimulated at a plasma insulin concentration of 700 microU/ml, whereas it was stimulated by 30-40% in nonpregnant and 24 day pregnant rabbits. At similar plasma insulin concentration, endogenous glucose production was suppressed by 85% in both nonpregnant and 24 day pregnant rabbits, whereas it was decreased by only 30% in 30 day pregnant rabbits. The present data suggest that hindlimb muscles of late pregnant rabbits are able to reduce their insulin-induced glucose utilization. This could contribute to meet the glucose requirements of pregnant uterus in late gestation. PMID- 3548417 TI - Insulin receptor binding and protein kinase activity in muscles of trained rats. AB - Exercise has been shown to increase insulin sensitivity, and muscle is quantitatively the most important tissue of insulin action. Since the first step in insulin action is the binding to a membrane receptor, we postulated that exercise training would change insulin receptors in muscle and in this study we have investigated this hypothesis. Female rats initially weighing approximately 100 g were trained by treadmill running for 2 h/day, 6 days/wk for 4 wk at 25 m/min (0 grade). Insulin receptors from vastus intermedius muscles were solubilized by homogenizing in a buffer containing 1% Triton X-100 and then partially purified by passing the soluble extract over a wheat germ agglutinin column. The 4 wk training regimen resulted in a 65% increase in citrate synthase activity in red vastus lateralis muscle, indicating an adaptation to exercise. Insulin binding by the partially purified receptor preparation s was approximately doubled in muscle of trained rats at all insulin concentrations, suggesting an increase in the number of receptors. Training did not alter insulin receptor structure as evidenced by electrophoretic mobility under reducing and nonreducing conditions. Basal insulin receptor protein kinase activity was higher in trained than untrained animals and this was likely due to the greater number of receptors. However, insulin stimulation of the protein kinase activity was depressed by training. These results demonstrate that endurance training does alter receptor number and function in muscle and these changes may be important in increasing insulin sensitivity after exercise training. PMID- 3548418 TI - Effect of insulin on in vivo glucose utilization in individual tissues of anesthetized lactating rats. AB - Glucose utilization rate has been measured in skeletal muscles, white adipose tissue, and mammary gland of anesthetized nonlactating and lactating rats. During lactation, basal glucose utilization is decreased by 40% in periovarian white adipose tissue and by 65% in epitrochlearis and extensor digitorum longus but not in soleus muscle. This may be related to the lower blood glucose and plasma insulin concentrations observed during lactation. Basal glucose utilization rate in the mammary gland was, respectively, 18 +/- 2 and 350 +/- 50 micrograms/min in nonlactating and lactating rats. During the euglycemic hyperinsulinemic clamp, a physiological increment in plasma insulin concentration (231 +/- 18 in lactating vs. 306 +/- 24 microU/ml in nonlactating rats) induces a similar increase in glucose utilization rate in skeletal muscles (except soleus) and white adipose tissue in the two groups of rats. Furthermore this low increase in plasma insulin concentration does not alter mammary glucose utilization rate in nonlactating rats but induces the same increase (sevenfold over basal) as a maximal insulin concentration in lactating rats. These data show that the active mammary gland is the most insulin-sensitive tissue of the lactating rat that has been tested. The overall increase in insulin sensitivity and responsiveness that has been described in lactating rats can then mainly be attributed to the presence of the active mammary gland. PMID- 3548420 TI - Increased sensitivity of the genetically obese mouse to corticosterone. AB - Adrenalectomy normalizes many abnormalities of the obese (ob/ob) mouse. The high corticosterone concentration in blood may account in part for development of obesity and other abnormalities in the ob/ob mouse. Our objective was to determine dose-response relationships for the effect of corticosterone on the obesity. Lean and ob/ob mice were adrenalectomized or sham-operated at 4.5 wk of age. Adrenalectomized mice received 100 mg implants of cholesterol containing corticosterone (0, 2, 5, 20, or 50 mg) at 8.5 wk of age and were killed at 10.5 wk of age. In ob/ob mice, but not in lean mice, low physiological levels of serum corticosterone (up to 10 micrograms/dl) markedly increased body weight gain, food intake, and serum insulin. They also increased white and brown adipose tissue weights and decreased brown adipose tissue mitochondrial GDP binding. Higher levels of corticosterone (12-22 micrograms/dl) increased body weight gain, white and brown adipose tissue weights, and serum insulin and suppressed brown adipose tissue mitochondrial GDP binding in lean mice also, although in most cases to a lesser extent than in ob/ob mice, but were still without effect on food intake. Only very high levels of corticosterone (approximately 30 micrograms/dl) increased food intake in lean mice. Hyperglycemia was induced in ob/ob, but not lean, mice only at concentrations of corticosterone greater than 17 micrograms/dl. Thermoregulation was unaffected by serum corticosterone at levels from 0 to 30 micrograms/dl in both ob/ob and lean mice. Thus the ob/ob mouse is excessively sensitive and responsive to an effect of physiological levels of corticosterone that results in hyperphagia, hyperinsulinemia, and increased weight gain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548419 TI - Effect of short-term fasting on lipolytic responsiveness in normal and obese human subjects. AB - In this study the rate of lipolysis (fatty acid and glycerol release into blood) has been quantified in both normal weight and obese volunteers after both 15 and 87 h of fasting. In each study, the basal rate and subsequent response to epinephrine infusion (0.015 microgram X kg-1 X min-1) were determined. The rate of appearance (Ra) of free fatty acids (FFA) and glycerol were quantified by infusion of [1-13C]palmitate and D-5-glycerol, respectively. Substrate flux rates per unit of body fat mass and lean body mass were calculated from total body water measurements using H2(18)O dilution. In normal volunteers, the basal Ra FFA and Ra glycerol rose markedly with 87 h of fasting, whereas the increases were more modest in the obese subjects. However, the rate of mobilization of fat, in relation to the lean body mass, was higher in the obese subjects than in the normal subjects after 15 h of fasting, and the values were similar in both groups after 87 h of fasting. There was an increased lipolytic response to epinephrine after fasting in both groups. This increased sensitivity may have resulted from the enhancement of fatty acid-triglyceride substrate cycling that occurred after fasting. PMID- 3548421 TI - First-pass hepatic extraction and metabolic effects of insulin and insulin analogues. AB - First-pass hepatic extraction of insulin and hepatic and peripheral contributions to hypoglycemia were compared in conscious dogs during portal infusion of insulin A1, B29 diacetyl insulin, or A1-B29 dodecoyl insulin at 7 and 14 pmol X kg-1 X min-1. The liver removed 43 +/- 2% of insulin, 12 +/- 1% of dodecoyl, and 8 +/- 1% of diacetyl insulin, in a single transhepatic circulation. The hypoglycemia induced by insulin and diacetyl insulin and the ensuing glucagon response were greater than that produced by the dodecoyl analogue. Diacetyl insulin primarily increased glucose utilization, dodecoyl insulin solely inhibited hepatic production, and insulin affected both. The lack of hepatic effect of diacetyl insulin during hypoglycemia can be ascribed to greater counterregulation, because under euglycemic clamp conditions, this analogue caused suppression of glucose production. The different patterns of hypoglycemia exhibited can be explained by the combined effects of altered distribution between the liver and peripheral tissues caused by differences in hepatic extraction, the effect of this phenomenon on the counterregulatory response, and the intrinsic biological potency of the analogues. PMID- 3548422 TI - Insulin receptor kinase is hyperresponsive in adipocytes of young obese Zucker rats. AB - Thirty-day-old obese Zucker rats have hyperresponsive adipose tissue, whereas their skeletal muscle normally responds to insulin in vitro. To further substantiate the role of insulin receptor tyrosine kinase in insulin action, we have studied the kinase activity of receptors obtained from adipocytes and skeletal muscle of these young obese Zucker rats. Insulin receptors, partially purified by wheat germ agglutinin agarose chromatography from plasma membranes of isolated adipocytes or from skeletal muscles, were studied in a cell-free system for auto-phosphorylation and for their ability to phosphorylate a synthetic glutamate-tyrosine copolymer. For an identical amount of receptors, the insulin stimulatory action on its beta-subunit receptor phosphorylation was markedly augmented in preparations from hyperresponsive adipocytes of obese animals compared with lean rats. Basal phosphorylation of adipocyte insulin receptors was nearly identical in lean and obese animals. Similarly the capacity of adipocyte insulin receptors to catalyze the phosphorylation of the synthetic substrate in response to insulin was increased. By contrast, the kinase activity of insulin receptors prepared from normally insulin-responsive skeletal muscle was similar in preparations of lean and obese rats. These results show that a state of hyperresponsiveness to insulin is correlated with a parallel increase of insulin receptor kinase activity suggesting an important role for this activity in insulin action. PMID- 3548423 TI - VIP and PHI in the pig pancreas: coexistence, corelease, and cooperative effects. AB - The human vasoactive intestinal polypeptide (VIP) precursor contains a sequence, a peptide with an N-terminal histidine and C-terminal methionine (PHM), which is 93% homologous to the porcine intestinal peptide, (PHI) a peptide having N terminal histidine and C-terminal isoleucine amide, suggesting that PHI could be a product of the porcine VIP precursor. If so, VIP-producing nerves would be expected to produce and release PHI in addition to VIP. We studied this in the pig pancreas. By immunohistochemistry, we identified nerve cell bodies in local ganglia and nerve fibers that were both PHI and VIP immunoreactive, innervating exocrine as well as endocrine structures. During electrical stimulation of the vagus nerve supply to the isolated perfused pig pancreas, a synchronous and approximately equimolar release of immunoreactive PHI and VIP was observed. Both responses were abolished by hexamethonium and could be copied by cholinergic agonists. Infusions of PHI and VIP at 10(-9) M stimulated the exocrine secretion of fluid and bicarbonate, and the effect of a combination of the two peptides was additive. In addition, both peptides stimulated insulin as well as glucagon secretion. By gel chromatography the VIP immunoreactivity in the venous effluent corresponded precisely to synthetic VIP, but only 24% of the PHI immunoreactivity corresponded to synthetic PHI; a larger peptide (mol wt 5,000-7,000) was responsible for the majority. The biological activity of this component is unknown. The results suggest that both VIP and PHI, released from intrapancreatic nerve fibers, participate in the parasympathetic control of pancreatic secretion. PMID- 3548424 TI - Faster ribosome synthesis induced by elevated aortic pressure in rat heart. AB - An increase in aortic pressure from 60 to 120 mmHg accelerated ribosomal protein synthesis in rat hearts during 1 or 2 h of labeling with 0.4 mM [3H]phenylalanine. When hearts were perfused with buffer that contained 20 mM glucose and normal plasma concentrations of 19 other amino acids without added insulin, ribosomal protein synthesis relative to the rate of total protein synthesis increased from approximately 0.22 to 0.36 and 0.30 as aortic pressure was raised from 60 to 120 mmHg during 1 or 2 h of labeling, respectively. With the addition of insulin, the relative rate of ribosomal protein synthesis averaged 0.33 at an aortic pressure of 60 mmHg and increased to 0.42 when aortic pressure was raised to 120 mmHg. These results indicate that elevation of aortic pressure has a preferential effect on synthesis of new ribosomes. This response appears to be an early and physiologically significant event in cardiac hypertrophy. PMID- 3548425 TI - Cortisol-induced inhibition of ovine renin and aldosterone responses to hypotension. AB - Previous studies from this laboratory have demonstrated that in preterm fetal sheep increases in plasma cortisol (F) concentration equal in amplitude to fetal F stress responses suppress plasma renin activity (PRA). The purpose of this study was to investigate the possibility that this negative interaction exists in adult sheep. Five conscious ewes with chronically prepared carotid arterial loops were infused intravenously with F (6 micrograms X kg-1 X min-1) or vehicle (5% ethanol in 0.9% saline) for 5 h. One hour after the end of F or vehicle infusion, renin secretion was stimulated by hypotension produced by infusion of sodium nitroprusside (20 micrograms X kg-1 X min-1, iv). F infusion increased plasma F from 26 +/- 3 to 46 +/- 8 ng/ml; during vehicle infusion plasma F did not change from 20 +/- 4 ng/ml. F infusion decreased hematocrit from 29 +/- 2 to 26 +/- 1%. Basal PRA in vehicle- and F-infused groups were 0.4 +/- 0 and 0.2 +/- 0.1 ng angiotensin I X ml-1 X h-1 and did not change. In vehicle-infused ewes, PRA increased from 0.4 +/- 0 and 0.2 +/- 0.1 ng angiotensin I X ml-1 X h-1 and did not change. In vehicle-infused ewes, PRA increased from 0.4 +/- 0 to 4.6 +/- 0.4 and plasma aldosterone from 26.0 +/- 1.0 to 173.1 +/- 21.8 pg/ml, while, in F infused ewes, PRA increased from 0.2 +/- 1 to 3.3 +/- 0.4 ng angiotensin I X ml-1 X h-1 and aldosterone from 25.0 +/- 0 to 48.2 +/- 23.2 pg/ml, significantly smaller responses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548427 TI - Effects of insulin on hexose transport across blood-brain barrier in normoglycemia. AB - The effects of insulin on 3-O-[14C]methylglucose transport across the blood-brain barrier (BBB) were studied in conscious rats under steady-state normoglycemic conditions. The [14C]methylglucose was infused intravenously at a constant rate, and animals were killed at various times between 5 and 30 min after the initiation of the infusion. The time course of the arterial plasma concentration of [14C]methylglucose was determined in timed arterial blood samples taken during the infusion. Local cerebral tissue concentrations of [14C]methylglucose at the time of killing were determined by quantitative autoradiography of brain sections. The rate constants for inward and outward transport of [14C]methylglucose across the BBB, K1, and k2, respectively, were estimated by a least-squares, best-fit of a kinetic equation to the measured time courses of plasma and tissue concentrations. K1 and k2 were reduced by an average of 24 and 31%, respectively, in gray matter and 7 and 16% in white matter from values estimated similarly in normal insulinemic control rats. The equilibrium distribution ratio, K1/k2, for [14C]methylglucose in brain increased by approximately 10-11% in the hyperinsulinemic animals. Because 3-O [14C]methylglucose shares the same carrier that transports glucose and other hexoses across the BBB, these results suggest that hyperinsulinemia decreases the rate constants for transport but increases the distribution space for hexoses in brain. These effects are, however, quite small and are probably minor or negligible when compared with the major effects of insulin in other tissues. PMID- 3548426 TI - Regulation of albumin synthesis by hormones and amino acids in primary cultures of rat hepatocytes. AB - Culture conditions necessary for optimizing albumin secretion were studied in rat hepatocytes maintained in a chemically defined, serum-free medium. Amino acid analysis of the culture medium, which was based on a 1:1 mixture of Ham's F12:Dulbecco's modified Eagle's medium (unsupplemented medium), revealed that certain essential amino acids were depleted from this medium over a 24-h incubation. Rates of albumin secretion were significantly higher and better maintained when the medium was supplemented with additional amino acids (supplemented medium). Moreover, selective removal of an essential amino acid resulted in an immediate decrease in total protein and albumin synthesis and after 48 h a further selective decrease in albumin synthesis. Linear rates of albumin secretion were observed over a wide variety of experimental conditions, but secretion was not strictly proportional to cell number. Maximal rates of secretion were obtained at plating densities of 2-3 X 10(6) cells/60 mm culture dish. Albumin secretion also increased with time in culture reaching a maximum on days 3 and 4. When added singly, either insulin or dexamethasone increased rates of albumin secretion in a dose-dependent manner, but both hormones and an adequate supply of amino acids were necessary for maximal rates of secretion as well as long-term maintenance of the hepatocytes (greater than 3-4 days). In the presence of dexamethasone the dose-response curve for insulin was shifted toward physiological insulin concentrations. Changes in rates of albumin secretion in response to added hormones in supplemented media were found to parallel changes in albumin synthesis and relative amounts of albumin mRNA. Changes in gene transcription were probably involved. PMID- 3548428 TI - Role of acidosis in regulating hepatic nitrogen metabolism during fasting in conscious dog. AB - This study was designed to investigate the role that acidosis plays in the metabolic responses to fasting. Eighteen conscious dogs with surgically implanted catheters in the femoral artery and in the hepatic, portal, and renal veins were studied. Six were fasted for 24 h and 12 were fasted for 4 days (96 h). On the day of the study, six 4-day fasted dogs were infused intravenously with NaHCO3 (10 mumol X kg-1 X min-1) for 3 h, while the rest received saline and acted as controls. Splanchnic balances of glutamine, alanine, blood urea nitrogen, ammonia, lactate, beta-hydroxybutyrate, and acetoacetate were estimated using the Fick principle. Blood flow to the splanchnic and renal beds were estimated using indocyanine green and p-aminohippurate extraction methods, respectively. The infusion of NaHCO3 nearly abolished the base deficit associated with fasting and normalized arterial bicarbonate levels but did not alter blood pH. It suppressed but did not abolish hepatic glutamine output by 60%. This was associated with a shift in cytoplasmic and mitochondrial redox potentials of the hepatocyte as evident by a decrease in hepatic production of beta-hydroxybutyrate and an increase in hepatic production of acetoacetate and a decrease in hepatic lactate utilization. Concomitantly, renal glutamine uptake decreased. Glutamine release of skeletal muscle was unchanged. The data suggest that hepatic glutamine synthesis and release seen with 4-day fasting has two components: a bicarbonate dependent component that is influenced by the redox potential of the hepatocyte and a bicarbonate-independent component, the nature of which is not yet clear.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548429 TI - Effects of D-amino acid substituents on degradation of LHRH analogues by proximal tubule. AB - Less than Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2, the luteinizing hormone releasing hormone, LHRH, is degraded in renal proximal tubules (PT) in vivo (rat) and in vitro (rabbit) to less than Glu-His (2), less than Glu-His-Trp (3), and less than Glu-His-Trp-Ser (4). LHRH may be cleaved by endopeptidases simultaneously at multiple bonds, or initially at Ser4-Tyr5 followed by carboxypeptidase hydrolysis of 4 to 3 and then 2. To distinguish between these mechanisms, [3H]LHRH analogues were incubated with rabbit renal brush-border membranes (BBM), microinfused into PT in vivo or in vitro, and products were analyzed by HPLC. [D-Ser4]LHRH was not cleaved at D Ser4-Tyr5 but yielded less than Glu-His-Trp-D-Ser-Tyr-Gly as the major metabolite plus 2 and 3. [D-Trp6]LHRH was cleaved by BBM and PT to 2 and 3, but not to 4. [D-Ser4, D-Trp6]LHRH was not cleaved by BBM, but was degraded to 2 by PT in vivo. Thus, D-amino acid substituents altered the expected cleavage pattern of these analogues. [3H]LHRH was cleaved by BBM or by endopeptidase-24.11 from porcine PT to metabolites 2, 4, small amounts of 3, and less than Glu-His-Trp-Ser-Tyr-Gly, but cleavage was strongly inhibited by the specific inhibitor phosphoramidon. Thus, normally LHRH may be cleaved in PT by endopeptidase-24.11 to 2 and 4, and by angiotensin I converting enzyme to 3, its known cleavage site. PMID- 3548430 TI - Membrane currents of identified isolated rat corticotropes and gonadotropes. AB - Membrane currents of identified, isolated corticotropes and gonadotropes from mammalian anterior pituitary gland have been evaluated. Pituitary gonadotropes and corticotropes were isolated enzymatically and stained in the living state using biotinylated gonadotropin-releasing hormone (Bio-GnRH) or biotinylated corticotropin-releasing hormone (Bio-CRF) followed by avidin fluorescein. Electrophysiological recordings were made with patch-clamp electrodes in the whole-cell clamp configuration. Tetrodotoxin (TTX)-sensitive sodium currents were larger in corticotropes than in gonadotropes. Corticotropes showed two components of calcium currents, a transient low-threshold component and a longer lasting high-threshold component. Small TTX-resistant inward currents were present also in gonadotropes, and both cell types had transient and steady potassium currents. PMID- 3548431 TI - Effect of anesthesia on glucose production and utilization in rats. AB - This study was undertaken to determine the effects of pentobarbital anesthesia (50 mg/kg ip) on glucose kinetics and individual tissue glucose utilization in vivo, in chronically catheterized rats. Glucose turnover studies were carried out using [3-3H]glucose as tracer. A transient hyperglycemia and an increased glucose production were observed 3 min after induction of anesthesia. However, 40 min after induction of anesthesia, glycemia returned to the level observed in awake animals, whereas glucose turnover was decreased by 30% as compared with unanesthetized rats. These results are discussed with regard to the variations observed in plasma insulin, glucagon, and catecholamine levels. Glucose utilization by individual tissues was studied by the 2-[1-3H]deoxyglucose technique. A four- to fivefold decrease in glucose utilization was observed in postural muscles (soleus and adductor longus), while in other nonpostural muscles (epitrochlearis, tibialis anterior, extensor digitorum longus, and diaphragm) and other tissues (white and brown adipose tissues) anesthesia did not modify the rate of glucose utilization. A decrease in glucose utilization was also observed in the brain. PMID- 3548432 TI - Asperlicin antagonizes stimulatory effects of cholecystokinin on isolated islets. AB - Asperlicin, a product derived from the fungus Aspergillus alliaceus, antagonized the multiple stimulatory effects of cholecystokinin (CCK-8S) on isolated islets. At a level of 10 microM, asperlicin completely inhibited insulin release in response to 25 nM CCK-8S. Increasing the level of CCK-8S to 100 nM partially restored a secretory response, while an even greater insulin stimulatory effect was noted with 500 nM CCK-8S. The inhibitory effect of asperlicin on CCK-8S induced release was reversible. Asperlicin exposure had no effect on glucose or glyceraldehyde-induced secretion. Asperlicin reduced, in parallel with secretion, the increase in 3H efflux from [3H]inositol prelabeled islets usually noted with CCK-8S addition. Asperlicin did not influence the small glucose-stimulated increase in 3H efflux. The results support the notion that asperlicin is a specific and potent antagonist of the multiple stimulatory effects of CCK-8S on islet tissue. PMID- 3548433 TI - Effect of diet on insulin binding and glucose transport in rat sarcolemmal vesicles. AB - The purpose of this study was to compare the effects of a high-fat, high-sucrose diet (HFS) and a low-fat, high-complex carbohydrate diet (LFC) on glucose tolerance, insulin binding, and glucose transport in rat skeletal muscle. During the intravenous glucose tolerance test, peak glucose values at 5 min were significantly higher in the HFS group; 0-, 20-, and 60-min values were similar. Insulin values were significantly higher in the HFS group at all time points (except 60 min), indicating whole-body insulin resistance. Skeletal muscle was responsible, in part, for this insulin resistance, because specific D-glucose transport in isolated sarcolemmal (SL) vesicles under basal conditions was similar between LFC and HFS rats (35 +/- 5 vs. 32 +/- 4 pmol/mg protein), despite the higher plasma insulin levels. Scatchard analyses of insulin binding curves to sarcolemmal vesicles revealed that the Ka of the high-affinity binding sites was significantly reduced by the HFS diet (0.63 +/- 0.09 vs. 0.35 +/- 0.05 X 10(9) M 1); no other binding changes were noted. Specific D-glucose transport in SL vesicles after maximum insulin stimulation (1 U/kg) was significantly depressed in the HFS group (87 +/- 7 vs. 58 +/- 7 pmol/mg protein), indicating that HFS feeding also caused a postbinding defect. These results indicate that the insulin resistance in skeletal muscle associated with a HFS diet is due to both a decrease in the Ka of the high-affinity insulin receptors and a postbinding defect. PMID- 3548434 TI - Metabolic derivatives of aldosterone. AB - Metabolism of aldosterone during the latent period prior to the action of the hormone may be of physiological importance. In the rat, liver metabolizes aldosterone in a sex-dependent manner; larger quantities of neutral polar and reduced aldosterone derivatives are found in male rat kidney; correlating with the larger physiological responses of male rats to aldosterone. The target tissues, mammalian kidney and toad urinary bladder, are also capable of metabolizing aldosterone in situ to neutral polar, 5 alpha- and 5 beta-reduced, and monosulfate derivatives. The 5 alpha-reduced metabolites possess significant antinatriuretic activity and are preferentially synthesized by rat kidney nuclei. The metabolic pathways leading to the synthesis of 5 alpha-reduced metabolites and their subsequent neutral polar derivatives appear to be regulated by dietary sodium and can be inhibited by antimineralocorticoids. At concentrations somewhat higher than aldosterone, these 5 alpha-reduced metabolites also can recreate the development of hypertension and suppress plasma renin activity in young adrenalectomized spontaneously hypertensive rats. Thus, several of the metabolically transformed aldosterone derivatives can be correlated with physiological regulation and/or expression of the actions of the hormone. PMID- 3548435 TI - Renal hemodynamic, fluid volume, and arterial pressure changes during hyperproteinemia. AB - The chronic effects of hyperproteinemia on renal hemodynamics, fluid volume, and arterial pressure were determined in six conscious dogs over a 32-day period. Plasma protein concentration was increased by intravenous infusion of approximately 300 ml/day of previously collected autologous plasma, and the responses to changes in sodium intake were studied. By the end of a 9-day period of hyperproteinemia and normal sodium intake, plasma protein concentration had increased 2.2 g/dl, plasma colloid osmotic pressure had increased 7-8 mmHg, mean arterial pressure had increased 12 mmHg, glomerular filtration rate (GFR) had increased 15%, estimated renal plasma flow (ERPF) had increased 51% primarily due to renal vasodilatation, and filtration fraction had decreased 23%. Also, sodium balance was negative, water balance was positive, sodium iothalamate space had increased, plasma sodium concentration had decreased, and the relationship between mean arterial pressure and urinary sodium excretion was shifted to the right along the arterial pressure axis. In conclusion, long-term increases of plasma protein concentration result in a marked increase in ERPF as well as significant increases in GFR, extracellular fluid volume, and arterial pressure. PMID- 3548436 TI - Immunological segmentation of the rabbit distal, connecting, and collecting tubules. AB - To obtain monoclonal antibodies (MAB) specific for the different cell types of distal and collecting tubules, BALB/c mice were immunized with cell suspensions highly enriched in cells from the distal segments of the rabbit nephron. Nine MAB were selected and cloned. Four groups could be identified on the basis of double labeling immunofluorescence (IF) on frozen kidney sections and on microdissected tubules. In addition, binding specificity at the cellular level was studied by immunoelectronmicroscopy (IEM) for selected MAB. A single MAB (group 1) was specific for distal bright cells and a subpopulation of cortical ascending limb cells. Six MAB (group 2) reacted with connecting and collecting tubules. Five of these (group 2A) had similar binding patterns and reacted identically with the two tubular segments. The MAB studied by IEM was specific for connecting and principal cells. One antibody (group 2B) reacted with only a fraction of the cells associated with the connecting tubule (CNT), but with all cells of the cortical collecting tubule (CCT). By IEM, this antibody was found to be specific for intercalated cells in CNT and bound both principal and intercalated cells of the CCT. Two MAB (group 3) reacted with antigen(s) expressed by the various terminal segments of renal tubule. MAB of groups 1 and 2A, which define distal bright cells and connecting-principal cells from the CNT-CCT, respectively, were used for cell fractionation experiments. Heterogeneous rabbit cortical cells were first incubated with the selected MAB. MAB-bearing renal cells were separated on plastic dishes previously coated with an affinity-purified goat anti-mouse immunoglobulin. Using these procedures it was possible to obtain highly purified subpopulations of distal, bright, or connecting-principal cells. PMID- 3548437 TI - Neuropeptide Y inhibits renin release by a pertussis toxin-sensitive mechanism. AB - The effects of neuropeptide Y (NPY) were studied in the isolated rat kidney, which was perfused at constant perfusion pressure with a synthetic medium. In this preparation NPY produced concentration (1-100 nM)-dependent inhibition of renin release and vasoconstriction. In kidneys perfused at constant flow, inhibition of renin release by NPY was even more pronounced, excluding a flow dependent washout effect. The simultaneous infusion of the calcium channel antagonist methoxyverapamil (2 microM) or of the calmodulin inhibitor calmidazolium (1 microM) did not prevent these effects of NPY, suggesting that calcium-dependent reactions are not primarily involved. Inhibition of renin release by NPY was also observed in tissue pieces prepared from the hydronephrotic rat kidney, in which tubular elements are lacking. This indicates that inhibition of renin release by NPY is not dependent on the presence of macula densa cells or on changes of intrarenal hemodynamics. In isolated kidneys from rats pretreated with pertussis toxin (2 micrograms/100 g ip) both effects of NPY, renal vasoconstriction and inhibition of renin release, were almost completely abolished. The pertussis toxin-sensitive factor mediating the effects of NPY is most likely the Ni-coupling protein of the adenylate cyclase complex. Accordingly, our data suggest that NPY induces renal vasoconstriction and inhibits renin release by inhibition of adenylate cyclase activity in vascular smooth muscle and renin-producing cells. PMID- 3548438 TI - Microvessel hematocrit: measurement and implications for capillary oxygen transport. AB - Microvascular preparations of the hamster cheek pouch and cremaster muscle were used to establish the relationship among three measures of red cell distribution: 1) the systemic hematocrit defined as the volume percentage of red cells sampled from a toe clip; 2) the tube hematocrit defined as the instantaneous volume fraction of red cells in a microvessel segment of measured length and diameter; and 3) the discharge hematocrit defined as the volume percentage of red cells that flowed into micropipettes inserted into microvessels. The results show the tube hematocrit is low and highly variable in the presence of a nearly constant systemic hematocrit. The discharge hematocrit, in contrast, consistently approximated systemic values in blood taken from arterioles or venules with diameters of 6-98 micron. Indeed, the mean ratio of the discharge to the systemic hematocrit did not differ from unity (P greater than 0.25). The observed similarity between the discharge and systemic hematocrit indicates that red cells are distributed uniformly across capillary networks. Differences between the absolute value and variance of the tube hematocrit compared with the discharge hematocrit imply that the anatomical volume of a microvessel can differ from the volume available to cells and plasma within a microvessel. Thus moment-to-moment variation in the tube hematocrit or capillary red cell spacing may be indicative of a change in the effective capillary flow cross section and not solely on the inflow hematocrit. PMID- 3548439 TI - Cholinergic vasodilator mechanism in human fingers. AB - The effect of a cholinergic agonist and antagonist on finger blood flow (FBF) was studied in 10 normal subjects. Total finger blood flow was measured by venous occlusion, air plethysmography, and capillary blood flow (FCF) by the disappearance rate of a radioisotope from a fingertip injection. Methacholine in doses of 10-80 micrograms/min was given by constant infusion via a brachial artery catheter. Average FBF (7.4 +/- 2.5 to 10.9 +/- 4.3 ml X min-1 X 100 ml tissue-1) and vascular resistance (22.4 +/- 4.7 to 21.3 +/- 7.0 mmHg X ml-1 X min X 100 ml tissue) were not significantly affected. However, the half time (t1/2) of the disappearance rate decreased from 50.8 +/- 13.4 to 11.1 +/- 1.5 min (P less than 0.01); a decrease occurred in all subjects. In seven subjects, atropine (0.2 mg) had no affect alone but inhibited the effect of methacholine on FCF (t1/2 47.6 +/- 6.2 to 50.2 +/- 6.7 min) and prevented the redness and sweating of the forearm and hand that occurs with this agent. This study demonstrates a muscarinic cholinergic vasodilator mechanism in the fingertip that uniquely increases capillary blood flow. PMID- 3548440 TI - Vascular effects of infused adenosine are not mediated by prostacyclin release in humans. AB - Adenosine may contribute to the regulation of tissue blood flow directly and via release of vasoactive substances. For example, in the isolated, perfused heart, the nucleoside has been reported to release prostacyclin, a potent vasodilator. In humans, minor variations in prostacyclin release into the circulation result in readily detectable changes in the urinary excretion of its metabolite, 2,3 dinor-6-ketoprostaglandin (PG) F1 alpha, as measured by negative ion-chemical ionization gas chromatography-mass spectrometry. To test the hypothesis that prostacyclin participates in or mediates the vascular effects of adenosine, we administered adenosine (5.1 mg/min) or vehicle to healthy volunteers in random order as a 2-h infusion into the femoral artery under double-blind conditions. The plasma levels of adenosine, inosine, and hypoxanthine increased significantly during infusion of active drug, but the urinary excretion of adenosine and uric acid were unchanged, implying efficient tissue uptake of the infused nucleoside. Adenosine, but not vehicle, significantly (P less than 0.01) increased leg blood flow (from 2.7 +/- 0.3 to 8.7 +/- 2.5 ml X 100 ml tissue-1 X min-1), heart rate (from 66 +/- 3 to 80 +/- 4 beats/min), and urinary epinephrine excretion (from 2.8 +/- 0.4 to 5.4 +/- 0.8 ng/mg creatinine). In contrast, the excretion of 2,3 dinor-6-keto-PGF1 alpha was unaltered by infusion of adenosine. We confirmed that biologically significant alterations in prostacyclin release in the lower limb vascular bed would be reflected by the urinary metabolite in experiments involving local infusion of prostacyclin at a rate below the threshold necessary to alter limb blood flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548441 TI - Resistance to diet-induced obesity: food intake, pancreatic sympathetic tone, and insulin. AB - After 15 wk on a moderately high-calorie high-fat (CM) diet, 43% of 40 3-mo-old male Sprague-Dawley rats developed diet-induced obesity (DIO) (29% more weight gain), whereas 57% of diet-resistant (DR) rats gained no more weight than 20 chow fed controls. When switched to chow for another 7 wk, DR rats ate 13% less, gained 55% less weight, and had 49% lower food efficiency, whereas DIO rats ate 4% less but had comparable weight gain and efficiency to controls. DIO rats had 29% more carcass lipid (percent of carcass weight). DIO rat retroperitoneal white adipose pads had 65% more cells that were the same size as those in chow-fed pads; DR rat cells were similar to controls. Both DR and DIO rats increased norepinephrine turnover in their interscapular brown adipose pads by greater than 90%. DIO rats also had 40% lower pancreatic turnover; their plasma insulin levels were 327% of controls after 15 wk on the CM diet and 188% after 7 wk on chow. DR levels were the same as controls at both times. Therefore, regulation of caloric intake, pancreatic sympathetic tone, and plasma insulin levels were three important differences between rats that resisted and those that developed DIO on high-energy diets. PMID- 3548442 TI - Intensive psychodynamic therapy with borderline patients: an overview. AB - The author reviews major controversies in the literature regarding techniques of intensive psychodynamic therapy with borderline patients. These include debates about the importance of content versus process in the therapist's early interventions, the origins of transference, the primacy of positive versus negative transference in therapeutic work, the usefulness of early interpretation of negative transference, and the therapist's role in providing "corrective" experiences. He suggests that different conceptions of borderline psychopathology, different patient populations studied, variations in therapists' personality styles, and emphasis on different phases of treatment may account for the diversity of treatment techniques advocated in the literature. PMID- 3548443 TI - Failure of nalmefene and estrogen to improve memory in Alzheimer's disease. PMID- 3548444 TI - "Lord of the Mirrors" and demon lover. AB - Repeated object loss drove Sylvia Plath to create, and what she created were her greatest, and best-known poems, collected in the book Ariel. Yet the compulsion to create alternated with the compulsion to destroy. Her suicidal impulses were as intense as her poetic impulses (see Bach, 1985, on the "Marquis de Sade"). How these two contrasting impulses counter-balanced each other, until self destruction took the lead, is the story of Sylvia Plath. What remains with us is the puzzle of her despair. This puzzle can only be pieced together by looking at the internal object relations of the father-daughter bond, which germinated like a ghost and spector within Sylvia Plath's soul. PMID- 3548445 TI - Expenditure effects of changes in Medicaid benefit coverage: an alcohol and substance abuse example. AB - An evaluation of the effect on total health care costs of a Medicaid demonstration project to provide coverage for alcoholism and substance abuse was conducted in Illinois in 1985. A pre/post-treatment analysis of expenditures for a subgroup of demonstration clients suggests that the addition of the alcohol and drug benefit did not result in higher total expenditures. [An important policy implication is that, when medical services substitute for one another, costs savings (increases) will not necessarily be realized when benefit packages are cut (expanded).] PMID- 3548446 TI - Corticotroph cell pituitary adenoma within an ovarian teratoma. A new cause of Cushing's syndrome. AB - A 24-year-old woman with severe Cushing's syndrome was found to have corticotroph cell pituitary adenoma arising within a benign cystic ovarian teratoma. The patient manifested sustained hypercortisolemia and lack of suppression of either adrenocorticotropin (ACTH) or cortisol production. There was no evidence of a pituitary mass or secretion of other hormones. After careful clinical evaluation, no other tumor masses were found. Resection of the ovarian tumor led to normalization of ACTH and cortisol levels. Densely granulated corticotroph tumor cells with prominent Type I microfilaments and intracytoplasmic ACTH immunoreactivity characterized the neoplasm as a pituitary corticotroph cell adenoma. This is, to our knowledge, the first case reported of a functioning pituitary adenoma arising within a benign cystic teratoma. PMID- 3548447 TI - Lymphocyte-associated apoptosis in AIDS, in bone-marrow transplantation, and other conditions. PMID- 3548448 TI - In vitro and in vivo adaptation of the Geneve/SGE-1 strain of Plasmodium falciparum to growth in a squirrel monkey (Saimiri sciureus) model. AB - Human erythrocytic culture-adapted parasites of the Geneve/SGE-1 strain of Plasmodium falciparum were successfully adapted to grow in an in vitro culture system containing squirrel monkey erythrocytes and serum. These monkey culture adapted organisms were then used to produce a patent infection in a splenectomized squirrel monkey. Fresh infected blood from this animal was introduced into another splenectomized monkey and was subsequently serially passed through seven intact squirrel monkeys. High level parasitemias (greater than 10%) were obtained in the animals from the last two passes following inoculation of moderate numbers of parasites. It is anticipated that this squirrel monkey-adapted Geneve/SGE-1 strain of P. falciparum will continue to produce high level parasitemias in intact Bolivian Saimiri, and consequently will be suitable for challenge of these monkeys. PMID- 3548449 TI - Thrombospondin binding by parasitized erythrocyte isolates in falciparum malaria. AB - Toward understanding the pathogenesis of vascular sequestration in falciparum malaria, we investigated binding of Plasmodium falciparum parasitized erythrocyte isolates to thrombospondin and other adhesive proteins. Blood samples with rings from 12 patients with falciparum malaria were cultured 30 hr until parasites were mature trophozoites and schizonts. All parasitized erythrocyte isolates bound to thrombospondin, but not to fibronectin, laminin, vitronectin, or factor VIII/von Willebrand factor. Parasitized erythrocyte binding varied among isolates, ranging from 192 to 6,725 per mm2, average 2,953. There was good correlation between trophozoite plus schizont % parasitemia and thrombospondin binding (r = 0.884, P less than 0.001). In two patients with stupor, 3,642 and 2,864 parasitized erythrocytes bound per mm2, in proportion to parasitemia, suggesting cerebral malaria is not due to increased binding affinity. These results indicate there is a conserved function among isolates from this geographic region, known to be antigenically diverse at the parasitized erythrocyte membrane surface. These results support the hypothesis that specific binding to an endothelial receptor, possibly involving thrombospondin, plays a role in vascular sequestration in falciparum malaria. PMID- 3548450 TI - Human and primate malarial sera inhibit Fc receptor-mediated phagocytosis. AB - Sera obtained from humans in P. falciparum-endemic regions and from P. vivax infected Saimiri sciureus were assayed for their ability to inhibit Fc receptor mediated phagocytosis. Some sera of humans exposed to P. falciparum from The Gambia, Sudan, and Thailand inhibited ingestion via the Fc receptor by normal human monocytes. In addition, sera from infected monkeys and a high molecular weight fraction of infected monkey serum inhibited ingestion of EIgG by normal monkey spleen macrophages. Generally, inhibition was correlated with higher parasitemia and higher IFA titers. PMID- 3548451 TI - The feasibility of a Dot enzyme-linked immunosorbent assay (Dot-ELISA) for the diagnosis of Plasmodium falciparum antigens and antibodies. AB - An enzyme-linked immunosorbent assay for rapid detection of malarial antibodies and antigens was developed. Plasmodium falciparum antigen preparation, obtained from sonicated cultures of the parasite at a parasitemia of 10%-15%, was applied to cellulose filter discs in volumes of 0.1 microliter in 96-well microtiter plates. Antibodies were detected by successive incubations with: bovine serum albumin for blocking, tested serum at different dilutions, peroxidase-conjugated antihuman IgG, and the precipitable substrate 4-chloro-1-naphtol. Positive reactions appeared as blue dots on a white background which are easily read by eye. Pools of sera from patients with recent disease or from individuals with a history of malaria, contained antibodies detectable up to a dilution of 1:64,000. Negative results were obtained when normal RBC were used for dotting the filters. Normal sera showed no reaction at any antigen concentration. P. falciparum antigens were detected by their ability to inhibit the binding of antibody to the filters. RBC infected with P. falciparum in vitro can be detected at a level of 0.001% parasitemia. This report presents the feasibility of an assay for detecting malarial antibodies and antigens in blood samples which is easily applicable to field conditions. PMID- 3548452 TI - Simultaneous use of Plasmodium falciparum crude antigen and red blood cell control antigen in the enzyme-linked immunosorbent assay for malaria. AB - An enzyme-linked immunosorbent assay for malaria, based upon duplicate testing of serum samples on both a crude Plasmodium falciparum antigen and a red blood cell control antigen, is evaluated. Results were analyzed using the Student's t-test for identification of positive serum samples (t greater than or equal to 2.92, P less than or equal to 0.05) and for calculation of the mean difference in absorbance values (delta ABS) obtained between the P. falciparum wells and the control wells. Cross-evaluation with the IFA test for P. falciparum antibodies gave 89.6% concording positive or negative results. Among discrepant sera 8.35% were ELISA+/IFA- and 2.05% ELISA-/IFA+. In addition, delta ABS values in ELISA were highly correlated to titers obtained in immunofluorescence (r = 0.80, P less than 0.001). The results confirm the high degree of species-specificity of the ELISA using P. falciparum crude antigen. The necessity of the simultaneous use of red blood cell control antigen with a crude plasmodial antigen is demonstrated by comparing the presented results with those obtained on the P. falciparum antigen only. PMID- 3548453 TI - Comparison of two antigenically distinct Giardia lamblia isolates in gerbils. AB - Previous studies established that some isolates of Giardia differ antigenically. In order to determine if antigenic differences resulted in altered biological behavior of host immune responses, two antigenically distinct isolates, WB and GS E, were used to infect gerbils, and the course of infection, resistance to reinfection, and host humoral responses were measured. Maximum numbers of trophozoites were recovered on day 14 from the intestine of gerbils infected with both isolates, but by day 28, 75% of WB-infected gerbils were free of infection, while GS-E-infected animals continued to be infected until day 42. After curative metronidazole therapy, animals were challenged with the homologous or heterologous isolates. Gerbils previously infected with WB were resistant to challenge with WB and GS-E, while previously GS-E-infected gerbils were more resistant to challenge with the homologous isolate. Antibody responses were measured by ELISA to both surface and cytosol antigens and by IFA to the surface of Giardia. By IFA there was a greater reactivity using the homologous isolate, but with ELISA this was not as apparent. Complement independent cytotoxicity of sera was additionally tested against both isolates. Sera from WB-infected gerbils were cytotoxic to both WB and GS-E whereas sera from GS-E-infected gerbils were cytotoxic to GS-E only. These studies demonstrate that Giardia possessing different surface antigens have different patterns of infection and induce qualitatively and quantitatively different immune responses. Cytotoxicity of sera, most likely antibodies, correlated best with the development of resistance. PMID- 3548454 TI - Viability of intramedullary canal bone reamings for continued calcification. AB - The viability of intramedullary canal bone reamings as a potential bone graft material was examined. Intramedullary bone reamings were obtained from the tibia or femur of three patients during intramedullary nailing procedures. Histologic examination showed bone marrow elements with complete disruption of the marrow compartmental organization. Bone trabeculas were present in a randomly scattered fashion with no structural organization. To assess the viability after reaming of the material for continued calcification, implants of the reaming material were placed in a pocket made in the gluteus maximus muscle of 12 rats. After 7 days, the implanted bone spicules showed evidence of tetracycline label uptake, indicating the material obtained after reaming the intramedullary canal was still viable and capable of continued calcification. That the intramedullary canal bone reamings may be a source of bone graft material is interesting. The reamings appear to continue an osteoproductive capacity when used as a graft. PMID- 3548455 TI - Safe jugular and subclavian venipuncture under ultrasonographic guidance. AB - Although jugular and subclavian venipuncture is a valuable technique and frequently utilized, blind venipuncture is at times associated with complications such as arterial puncture, pneumothorax, and malpositioning of catheters. We performed venipuncture under the guidance of high-resolution real-time ultrasonography, and these catheter-related complications were prevented. Jugular, subclavian and innominate veins and arteries, the pleura, and the lung are all delineated by supraclavicular and subclavicular scanning, and the needle and catheter can also be visualized. Ultrasonographically-assisted jugular and subclavian venipuncture is a simple and helpful procedure to carry out safe venipuncture. This method is particularly recommended for less experienced physicians and for more accurate puncture in patients with distorted cervical or subclavicular anatomic characteristics. PMID- 3548456 TI - The centenary of Bassini's contribution to inguinal herniorrhaphy. AB - One hundred years ago, Edoardo Bassini, a professor of surgery in northern Italy, pioneered the modern approach to inguinal repair. Today, the most common operation performed for hernia is one of the many modifications of the procedure he introduced. Since he reported his series from 1887 to 1894 in the Italian and German literature, and other surgeons soon claimed priority, most surgeons today are unfamiliar with the details and importance of Bassini's contribution. Therefore, his illustrious career is outlined and his papers regarding herniorrhaphy, along with previous biographies, are discussed. Pernicious and benign modifications of his operation are described, and the present status of his procedure is discussed in light of its revival as the Shouldice operation and amid the continuing criticism of its many modifications. PMID- 3548457 TI - Influence of mitosis on the in vitro intra-nuclear penetration of anti-RNP antibodies in several cell and tissue cultures. PMID- 3548458 TI - [Heart transplantation in 1987]. PMID- 3548459 TI - [Present status of kidney transplantation]. PMID- 3548460 TI - [Immunologic factors and renal graft survival]. PMID- 3548461 TI - [Present status of liver transplantation]. PMID- 3548463 TI - [Analytic study of the organ procurement activity over the past 6 years at the University Hospital Center, Bordeaux]. PMID- 3548462 TI - [Liver transplantation in children: problems related to the recruitment of potential donors]. PMID- 3548464 TI - [Regulation of ovarian function (review of the literature)]. PMID- 3548465 TI - Oral contraceptives. A review of risks, benefits, and indications for use. PMID- 3548466 TI - The affiliation partnership between U.S. medical schools and the Veterans Administration. PMID- 3548467 TI - Hippocrates, the Father of Medicine. PMID- 3548468 TI - The developmental changes of the extracerebral space seen on ultrasonography in neonates and infants. AB - Ultrasonographic examination was performed in 70 healthy neonates and infants using a real-time sector scanner array machine with a 7.5-MHz transducer and a 4 cm waterbag. The skin, subcutaneous tissue, dura mater, interhemispheric fissure, gyri, sulci and sagittal sinus could be clearly visualized on ultrasonography (US), and the distance from the dura mater to the brain surface was determined. The extracerebral space under the anterior fontanel increased until 3 months after birth, and decreased gradually from 3 months to 12 months. The width and structure of the extracerebral space seen on US can be useful as parameters for assessing the process of brain growth and for detecting extra- and intracerebral pathologies in neonates and infants. PMID- 3548469 TI - [Health aspects of chemical warfare]. PMID- 3548470 TI - [Acoustic trauma]. PMID- 3548471 TI - [Depression among geniuses (Schwermut)]. PMID- 3548472 TI - [Jose Celestino Mutis: physician, humanist]. PMID- 3548473 TI - The prevention of renal impairment in patients undergoing orthotopic liver grafting by infusion of low dose dopamine. AB - Administration of low dose dopamine (2.0 micrograms/kg/minute) begun before surgery in patients undergoing liver transplantation decreases the incidence of postoperative renal impairment. Thirty-four consecutive patients in the Cambridge/King's College Hospital liver transplantation series were studied. Nineteen patients (21 transplant operations) received prophylactic low dose dopamine throughout the operative and early postoperative period, while 15 patients (15 transplant operations) received dopamine only when clinically indicated for incipient renal failure or as an inotropic agent. In the prophylactic dopamine group, only two transplant operations (9.5%) were complicated by renal impairment, whereas in the other group, 10 patients (67%) developed renal impairment (p = 0.001); of these, four developed acute renal failure (27%). Comparison of seven pairs of patients, matched for age, sex, diagnosis, operative blood loss and operative hypotension (one group receiving dopamine, the other not), revealed a significantly higher urine output in the first 24 hours and creatinine clearance 24-48 hours after surgery (p less than 0.05) in those treated prophylactically. In view of these findings, we would recommend that consideration be given to the prophylactic use of dopamine in patients undergoing orthotopic liver transplantation. PMID- 3548474 TI - Severe acute anaemia in a Jehovah's Witness. Survival without blood transfusion. AB - A case is described in which a Jehovah's Witness underwent emergency surgery following which her haemoglobin fell to 1.8 g/d litre. She was successfully treated in an intensive care unit with intermittent positive pressure ventilation of the lungs, high inspired oxygen concentrations and transfusions of large volumes of gelatin solution. PMID- 3548475 TI - Myocardial ischaemia during non-cardiac surgery. A comparison of different lead systems using computerised ST segment analysis. AB - Computerised ST segment analysis was used to compare the frequency of ischaemia occurring in electrocardiographic leads II, V5, CS5 and CB5. Three out of 15 patients with ischaemic heart disease developed ischaemic changes, which were evident in all four leads in each patient. A single bipolar lead may be substituted for a true V5 lead when monitoring patients at increased risk of developing myocardial ischaemia. ST segment analysis facilitates the early diagnosis of peri-operative myocardial ischaemia, which may otherwise be missed on the standard electrocardiogram. PMID- 3548476 TI - Bowel sounds during intermittent positive pressure ventilation. PMID- 3548477 TI - [Patient monitoring during anesthesia]. AB - Three functional levels are monitored during anaesthesia: vital functions such as cardiovascular and respiratory systems; metabolic functions; and organs such as brain and muscle. These three levels interact with each other and with the anaesthesia system. Basic monitoring systems include the ECG, noninvasive blood pressure measurement, inspired O2 concentration, tidal volume, airway pressure, and alarm systems for stenosis and disconnection. Other monitors are added to this list, including pulse oximetry, capnography, temperature, and neuromuscular transmission. The type of surgery and anaesthetic risk will determine the extent of the monitoring used during surgery. New and expensive noninvasive monitoring techniques such as transesophageal Doppler echocardiography and somatosensory evoked potentials will increasingly be added. The high costs and the rising number of monitoring systems necessitate a better definition of what is essential and what is optional for each individual case. PMID- 3548478 TI - [Intracranial pressure and circulatory parameters with positive end-expiratory pressure (PEEP). The possibility of drug modification]. AB - In patients who have head injuries as well as injuries involving other organ systems, especially those of the thorax and upper abdomen, conflict can arise between the need to ensure adequate ventilation and the simultaneous need to protect the brain against further increases in intracranial pressure. Positive end-expiratory pressure (PEEP) ventilation, in particular, is suspected of causing the intracranial pressure to rise. Our study of the effects of a combination of anaesthetics on animals, was designed to investigate whether, the negative effects of PEEP ventilation on both intracranial pressure and on various circulatory parameters could be prevented. In animals with normal intracranial pressure at the outset of the experiment, during PEEP ventilation at pressures of up to 12 cmH2O, neither clinically significant rises in intracranial pressure, nor notable changes in circulatory parameters occurred. In comparison, those animals with artificially raised intracranial pressure showed marked differences with respect to their tolerance of PEEP ventilation. Whereas ventilation with an oxygen/nitrous oxide mixture caused a distinct elevation of the intracranial pressure and the deterioration of circulatory parameters, a combined regimen of etomidate and alfentanil under ventilation with an oxygen/air mixture minimized the negative effects of PEEP. Gradual increases in PEEP were tolerated better than a rapid rise in PEEP. With appropriate drug therapy, it is therefore possible to maintain PEEP ventilation in the presence of raised intracranial pressure without causing deterioration of the circulatory situation, or exacerbating the problems of intracranial pressure or cerebral perfusion pressure. PMID- 3548479 TI - [Determination of cardiac output under PEEP-respiration with the "NCCOM 3" non invasive bioimpedence monitor in comparison with the thermodilution method. A study in anesthetized dogs]. AB - A new noninvasive cardiac output (CO) computer ("NCCOM 3") based on the bioimpedance principle was compared to a CO computer based on standard thermodilution measurements. Simultaneous measurements were made on dogs who were ventilated with or without positive end expiratory pressure (PEEP). There was no correlation of cardiac output measurements with the two methods (r = 0.10, n = 60). Comparing only measurements without PEEP yielded r = 0.41. Thermodilution measurements showed the well-known decline in cardiac output during PEEP, whereas the bioimpedance device recorded an increase in cardiac output. These differences were statistically significant. We conclude that the NCCOM 3 cannot at present replace the invasive standard methods of CO measurement in ventilated patients. A lack of differentiation of circulatory effects, thoracic gas volume, and intrathoracic fluid content is the most likely cause of the discrepancies seen. PMID- 3548480 TI - Assay of 25-hydroxy vitamin D3-1 alpha-hydroxylase in pig kidney mitochondria using isotope dilution-mass spectrometry. AB - An assay of 1 alpha-hydroxylation of 25-hydroxy vitamin D3 in pig kidney mitochondria, based on selected ion monitoring, has been developed. Trideuterium labeled 1,25-dihydroxy vitamin D3 was synthesized and used as internal standard. This standard was added immediately after incubation of 25-hydroxy vitamin D3 with the mitochondrial fraction. The incubation extracts were purified by high performance liquid chromatography. After formation of the trimethylsilyl derivative, the product was quantitated by mass fragmentography using the ion at m/z 452 and m/z 455. With the use of this assay it was found that formation of 1,25-dihydroxy vitamin D3 was linear with the amount of mitochondrial protein and time of incubation. Substrate saturation was obtained at about 20 microM of 25 hydroxy vitamin D3. The maximal rate of conversion obtained under the conditions employed was about 0.1 pmol/mg protein X minute. PMID- 3548481 TI - [Nathanael Highmore (1613-1685) and the maxillary sinus]. AB - The paper presents some details of the life and work of Nathanael Highmore (1613 1685) whose name is connected with the discovery of the maxillary sinus (1651) though the first descriptions and drawings are known from Leonardo Da Vinci (1489). PMID- 3548482 TI - Distribution of calcitonin gene-related peptide-like immunoreactivity in the guinea pig heart. AB - The distribution of calcitonin gene-related peptide like-immunoreactivity (CGRP IR) within the heart and adjacent blood vessels of the guinea pig was investigated immunohistochemically by use of the peroxidase-antiperoxidase (PAP) technique. Numerous paravascular and perivascular immunoreactive nerve fibers were localized around the aorta, coronary arteries and their branches down to the terminal vasculature. Arterioles in the atria showed greatest density of immunoreactive varicosities of all blood vessels. The epicardium, endocardium and the conductive system also contained numerous CGRP-IR nerve fibers. In the myocardium the number of immunoreactive varicosities was variable. Many were present in both atria, moderate amounts were seen in the right ventricle and parts of the intraventricular septum, and only a few occurred in the left ventricle. CGRP-IR was infrequently found within intracardial ganglionic cells but was abundantly distributed in the surrounding nerve fibers. PMID- 3548483 TI - Structural differences between bone formed intramuscularly following the transplantation of isolated calvarial bone cells or chondrocytes. AB - Bone formed in intramuscular transplants of isolated syngeneic calvarial bone cells in mice, was compared with endochondral bone induced by cartilage produced by analogous transplants of isolated epiphyseal chondrocytes, as well as with parietal bones forming the bulk of the calvaria. Transplanted calvarial cells produced islands of bone, some of which contained intraosseous cavities. Osteoclasts inside these cavities were observed only in 14-day-old transplants and bone marrow cells in 28-day and older transplants. On the contrary, bone marrow appeared soon after formation of bone trabeculae in endochondral bone. The percentage area occupied by bone marrow in these specimens was about twentyfold larger than in the bone formed by transplanted bone cells. On the other hand, the bone marrow area in the latter type of bone was somewhat smaller but of similar order as in parietal bones. Moreover, both in parietal bones and in bone formed by isolated bone cells, the bone marrow was devoid of fat cells which were numerous in bone arising by endochondral ossification. It appears, therefore, that the ratio of bone marrow to the bone tissue area in parietal bones depends more on the intrinsic properties of osteoblasts than on the local factors in the environment of the developing bone. In the case of bone induced by cartilage, the bone marrow/bone tissue area could be determined both by the extent of cartilage resorption by vascularized tissue and by the properties of osteoblasts. PMID- 3548484 TI - Development of the pulmonary acinus in fetal rat lung: a study based on an antiserum recognizing surfactant-associated proteins. AB - In this study on the development of the pulmonary acinus in fetal rat lung use was made of an antiserum, rabbit anti-mouse, that recognizes the type II alveolar epithelial cell or its precursor (a cuboidal cell lacking multilamellar bodies) by the presence of a cell-specific antigen. This serum had already been used in studies on mouse-lung development in our laboratory. Immunoblotting experiments showed that this serum reacts with surfactant-associated proteins in the pellet fraction of rat-lung lavage fluid having molecular weights of about 26,000, 32,000, and 38,000 daltons. In adult and fetal rat-lung homogenates the antiserum reacts with proteins with apparent molecular weights of about 40,000 and 42,000 daltons, probably also surfactant-associated proteins. No reaction with serum proteins was seen. Use of this antiserum in immuno-incubations of frozen sections of lungs of 15- to 21-day-old rat embryos showed that the type II epithelial cell or its precursor first appears on day 16 in embryos weighing 349-398 mg. Our results indicate that in the rat - as in the mouse - the bronchial and respiratory portions develop from morphologically and immunologically different parts of the tubular system in the fetal lung. The basic structure in the genesis of the pulmonary acinus is a tubule, called the acinar tubule, which is lined by the type II epithelial cell or its precursor. PMID- 3548485 TI - Meperidine as a spinal anesthetic agent: a comparison with lidocaine-glucose. AB - The anesthetic effect of 2 ml of 5% lidocaine in 7.5% glucose (LG) or 5% meperidine in water were evaluated and compared in 40 ASA class 1 or 2 patients. Patients were randomly assigned to one of the two groups (20 patients in each) according to the anesthetic agent, which was injected into the lumbar subarachnoid space in the sitting position. The patients remained sitting for 5 min before being placed in the supine position. Times of onset of sensory and complete motor blockade were significantly more rapid with LG. The extent of maximum cephalad spread of analgesia and the time to maximum height of analgesia in the two groups were not different. Duration of analgesia at the T-7 (48.96 +/- 6.64 min with LG, 44.74 +/- 6.14 min with meperidine; means +/- SEM) and L-1 (94.37 +/- 7.42 min with LG, 76.19 +/- 5.64 min with meperidine) dermatomes was not different in the two groups but was statistically longer at the T-10 dermatome with LG (66.83 +/- 6.72 min) than with meperidine (46.66 +/- 6.26 min). The duration of complete motor blockade was also significantly longer with LG (66.44 +/- 7.05 min) than with meperidine (42.67 +/- 4.47 min). Complications in both groups included decrease in blood pressure and nausea and vomiting intraoperatively, and urinary retention, nausea and vomiting, and mild headache postoperatively. Complications that occurred only in the meperidine group were intraoperative drowsiness, respiratory depression, bronchospasm, and itching. The frequency of complications was greater wit meperidine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548486 TI - Perioperative evaluation of regional wall motion by transesophageal two dimensional echocardiography. PMID- 3548487 TI - Advances in noninvasive cardiovascular imaging: implications for the anesthesiologist. AB - We have presented a review of recent advances in medical imaging which are relevant to the practice of anesthesia and associated research. The appropriate interpretation and use of the information derived from these noninvasive technologies can prevent unnecessary morbidity and mortality. Echocardiography remains the most advanced tool for noninvasive cardiac imaging because of its applicability for most cardiac disorders and its exquisite spatial resolution. Two-dimensional systems produce real time, dynamic, qualitative assessments of cardiac chamber morphology, size, thickness, and performance. The development of transesophageal echocardiography has brought this imaging power into the operating room for use by anesthesiologists. Recently developed quantitative and color-coded Doppler techniques will reveal intracardiac flow patterns and their alterations by anesthetics and surgery. These advantages are partially offset by inherent difficulties in quantifying echocardiographic data, and the need for highly trained operators for image reproduction. Nuclear cardiology and echocardiology are highly complementary. The scintigraphic methods identify myocardium at risk for infarction, confirm infarction when present, and produce quantitative, highly reproducible estimates of ventricular filling and performance. Time required to obtain data can be very brief for first-pass techniques, and these data are ideally suited for computer processing. Equilibrium studies require a larger dose of radioactive material, but provide excellent assessment of segmental wall motion. Preoperative studies with dipyridamole and Tl can indicate the patients truly at high risk for perioperative myocardial infarction. Monitoring and intensive care efforts may be better allocated with this information. No new technology in the past decade has stirred as much interest among clinicians as magnetic resonance imaging. Like echocardiography, it uses no ionizing radiation and is entirely noninvasive. But, unlike other imaging techniques, it utilizes multiple tissue characteristics to provide quick, highly resolved, tomographic images. Since bone is invisible to the magnetic resonance scanner, tissues inside bony structures are often best revealed with MRI. Nonimaging studies, i.e., spectroscopic data not spatially encoded, may prove to be the most important research currently underway in this field. In vivo estimates of intracellular functions, enzyme kinetics, and drug kinetics and metabolism are already in progress. The effects of anesthetic in the central nervous system and other organs may be explored in ways previously not possible.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3548488 TI - [Resuscitation of a child after severe etmozin poisoning]. PMID- 3548489 TI - [Problem of hypertension in the postperfusion and early postoperative periods]. PMID- 3548490 TI - [Use of sodium nitroprusside in anesthesiology and resuscitation]. PMID- 3548491 TI - Acquired amputation and prostheses before the sixteenth century. AB - Amputation has been practiced at least since 43,000 B.C.E. for ritualistic, punitive, curative, or vocational reasons. Fitting with prostheses has been done since at least 1,500 B.C.E. Anesthetics were used, but which ones is not known. Analgesics such as salicylates in plants, narcotics such as cocaine and opium, and soporifics such as alcohol and peyote were common. Amputation was done with knives, axes, and saws. Control of bleeding was by ligature, cautery, bandaging pressure, and plant and animal products. Suture was with cotton or human hair, acacia and other thorns, ant jaws, and sinew, with or without a drain. Prostheses were made of fiber, wood, bone, and metals, often lined with rags. PMID- 3548492 TI - Thermography as a predictor of the more involved side in bilateral carotid disease: case history. AB - Contact thermography using liquid crystals provides a simple, inexpensive method of evaluating carotid disease. It does not duplicate information provided by other noninvasive methods, because, whereas Dopplers give an indication of flow and degree of stenosis in the artery, thermography measures the actual hypoperfusion as demonstrated by diminished temperature in areas of the forehead supplied by branches of the ophthalmic artery. A 74-year-old man presented with bilateral carotid distribution TIAs. Carotid Dopplers and angiography revealed 99% occlusion of both internal carotid arteries. Contact thermography showed diminished temperature in the right supraorbital artery territory. The patient subsequently underwent carotid endarterectomy. Following induction of anesthesia but prior to carotid clamping, the patient became transiently hypotensive. Intraoperative EEG monitoring showed marked attenuation of the background rhythm on the right with preservation of background on the left. Normal rhythm was quickly restored with pharmacologic restoration of the blood pressure. This case illustrates the usefulness of thermography, which predicted the hemisphere in jeopardy when Dopplers and angiography showed equal bilateral disease. PMID- 3548493 TI - Influence of pentoxifylline on muscle tissue oxygen tension (pO2) of patients with intermittent claudication before and after pedal ergometer exercise. AB - Ten patients with Stage II chronic arterial occlusive disease (intermittent claudication) took part in a randomized, intraindividual crossover study involving acute intravenous administration of 200 mg pentoxifylline or physiological saline solution (placebo). The tissue oxygen tension (pO2) response (pO2 kinetics) following treatment with placebo revealed a nominal but statistically nonsignificant increase in arithmetic mean and median pO2 immediately after the end of exercise. Values thereafter reverted approximately to the initial values recorded at rest. Comparison of the pooled pO2 histograms during the individual periods before and after the end of exercise, however, revealed a broadening of the histogram base, reflecting both higher pO2 values and, more particularly, increased numbers of hypoxic and anoxic pO2 values. This is interpreted as an expression of nonhomogeneous capillary perfusion (maldistribution). Following administration of pentoxifylline to the same patients, there was a statistically significant increase in mean and median pO2 at ten and twenty minutes after the end of exercise. Even after thirty and sixty minutes, these values were in some cases still clearly higher than the initial preexercise values. Study of the pooled pO2 histograms discloses a right shift compared with the initial preexercise histograms. This suggests that pentoxifylline exerts a positive effect on maldistribution by making capillary perfusion more homogeneous. The results support the conclusion that, in the context of reactive hyperemia after muscular exercise, tissue oxygen supply is markedly improved by pentoxifylline in comparison with saline solution. The measurement of tissue pO2 before and at intervals after pedal ergometer exercise is a new objective technique for assessing the efficacy of blood flow-promoting therapy, permitting close simulation of the pathophysiological situation in the muscles of the lower leg in intermittent claudication. PMID- 3548494 TI - Topical fluoride in orthodontic bonding. AB - Neutral and acidified sodium fluoride solutions were topically applied to enamel etched in a manner typical for orthodontic bonding procedures. Enamel fluoride levels were greater with the acidified solutions. PMID- 3548495 TI - New material on craniology of the Bashkirs. PMID- 3548496 TI - Ultrasonic measurements of the thickness of soft facial tissue among the Bashkirs. PMID- 3548497 TI - Occupational immunologic lung disease. AB - Occupational immunologic lung diseases either asthma or hypersensitivity pneumonitis, can occur in a wide variety of occupations from numerous antigens. New OILD syndromes and antigens are being reported constantly. In the case of some occupational agents that have been reported like isocyanates, formaldehyde, and Western red cedar, there is current investigation into the incidence of disease, mechanisms, and appropriate diagnostic criteria. A key principle in OILD is that prevention or at least early treatment by environmental control should be the goal. Determination of threshold limits for sensitization and adherence to these limits would be useful, for instance. In manufacturing processes in which this is not possible, workers and management in high risk industries should be educated so that affected workers are recognized early and avoidance can be instituted. Currently, there are no pre-employment screening criteria that have been shown to be very useful in predicting OILD. Prospective studies of animal handlers are underway and may provide useful information. In the case of TMA exposed workers, prospective studies have demonstrated that serial immunologic studies are useful in predicting workers at risk for OILD and that reduction of airborne exposure will reduce prevalence. This sort of approach will probably be useful in studying other occupational agents. Such studies are complex and, to succeed, generally require cooperation and collaboration of physicians, industry, labor, industrial hygiene, and governmental agencies. PMID- 3548498 TI - [Determination of plasma catecholamines in clinical biology]. AB - The use of sensitive detectors has enabled the development of high performance liquid chromatography (HPLC) for the dosage of plasma catecholamines (adrenalin, A; noradrenalin, NA and dopamine, DA). Separation of the catecholamines may be done with a pair of ions chromatography on grafted silica or with an exchange of ions chromatography. The quantification is carried out, either by electro chemical detection (HPLC-ECD), or by fluorometry after catecholamines shunting into trihydroxyindoles compounds (THI). The THI method, more sensitive, does not permit the detection of DA. Plasma levels of A or NA of 30 pg/ml (or 150 fmol/ml) may be measured by HPLC-ECD). The validation of this method as compared with a radioenzymatic method (RA-COMT) permits to imagine that the HPLC-ECD method, which has the advantage of being more economical, less complex and faster than the RA-COMT method, represent a useful tool for the exploration of the adrenergic system clinically as well as in research. PMID- 3548499 TI - [Estrogen receptors in cancer of the breast. Comparison of 2 methods]. AB - The dosage of estrogenic receptors (ER) was performed on 80 cytosols of human breast carcinomas "immediately operable", by using a methode consisting of a single saturating dose (5 nM) with carbon-dextran and a new immuno-enzymatic method commercialized by ABBOTT laboratories using anti-ER monoclonal antibodies. The concordance is excellent between the two methods in terms of positivity. The results are significantly higher with the ER-IEA method than with the biochemical method (p. less than 1.10(-5]. The regression of the ER-IEA method as compared to the biochemical method is linear with a regression line: Y (ER-IEA) = 0.82 X (ER Biochem) + 0.76 (logo10 conc. fmoles/g tissue). The correlation is good between the two methods (r = 0.90). A significant relationship (p less than 0.01) has also been observed with the histological grade of the carcinoma. Finally, the immuno-enzymatic technique seems particularly well adapted to small biopsies and slightly positive tumors. PMID- 3548500 TI - [Reliability of tests for determining morphine derivatives in urine]. PMID- 3548501 TI - A multicenter validation of the prehospital index. AB - The prehospital index (PHI) is a triage-oriented trauma severity scoring system. This prospective multicenter validation of the PHI was undertaken in response to a favorable pilot study. We applied the PHI to 3,581 patients from 14 different institutions during the period from January 1985 to February 1986. The PHI was accurate in predicting the need for emergency life-saving surgery within four hours (P less than .0001) and mortality within 72 hours (P less than .0001) following traumatic injury. The curves were generated for PHI versus emergency surgery, mortality, surgery and mortality, injury severity score, and ICU admission rate. These data compare favorably with those from previously published, prospectively tested, triage-oriented trauma severity scoring systems. PMID- 3548502 TI - Escherichia coli-induced lung and liver dysfunction in dogs: effects of flunixin meglumine treatment. AB - Twelve dogs were infused with 10(10) Escherichia coli/kg of body weight through a portal vein catheter over a 1-hour period; 6 dogs were treated with flunixin meglumine (1 mg/kg) 15 minutes after the infusion had begun. Six dogs (controls) were infused with a comparable volume of sterile saline solution over the same period. Over a 4-hour monitoring period, nontreated septicemic dogs developed systemic hypotension, decreased cardiac output, increased portal pressure, increased serum alanine transaminase values, increased extravascular liver water, increased liver glycogen depletion, and decreased arterial oxygen tension compared with control dogs. Accumulations of polymorphonuclear leukocytes and E coli were found in the livers and lungs of septicemic dogs. Flunixin meglumine treatment prevented systemic hypotension and hypoxemia, reversed the early but not the late stages of portal hypertension, and decreased E coli concentrations in the lungs. Other effects of treatment were not noticed. PMID- 3548503 TI - Nocturnal ventilation--a new method. PMID- 3548504 TI - Increased in vitro histamine responses in human small airways smooth muscle from patients with chronic obstructive pulmonary disease. AB - We tested the hypothesis that abnormal responses of airway smooth muscle contribute to the pathogenesis of airway obstruction in chronic obstructive pulmonary disease (COPD). For this purpose, lung tissue from 10 patients with and 10 patients without COPD was obtained during thoracotomies. Lung function was measured preoperatively. The in vitro responses of isolated bronchioles were measured using histamine, leukotriene (LT)C4, and methacholine as contracting agents, and the results of the in vitro measurements were compared between patients with and without COPD. Histamine efficacy (maximal isometric force, Tmax) in vitro of bronchioles from patients with COPD was significantly greater than the histamine Tmax of the bronchioles from patients without COPD (p less than 0.01). This difference was probably not due to histamine tachyphylaxis or the production of relaxing prostaglandins by airways without COPD, as neither mechanism could be detected in separate experiments on airways without COPD. No differences were found between in vitro bronchiolar responses to LTC4 and methacholine in patients with and patients without COPD. Increased histamine responses of small airways may be one of the determinants of airway obstruction in COPD. PMID- 3548505 TI - Bronchoalveolar lavage does not alter airway responsiveness in asthmatic subjects. AB - Bronchoalveolar lavage (BAL) during fiberoptic bronchoscopy is being used increasingly for the investigation of asthma. Airway responsiveness to methacholine is a sensitive indicator of the presence and severity of asthma. Therefore, we studied the effect of BAL on methacholine airway responsiveness in stable asthmatics. Geometric mean methacholine PC20 was 1.34 mg/ml before and 1.80 mg/ml after BAL (p = 0.26) in asthmatics. Immediate symptoms of airway narrowing after BAL occurred only in the 3 asthmatics with moderate to severe hyperresponsiveness. These symptoms were rapidly relieved by inhaled bronchodilator. There was no relationship between the occurrence of symptoms and the amount of topical lidocaine used for local anaesthesia or the volume of lavage fluid returned. The absence of an effect of BAL on airway responsiveness supports the safety of this procedure in the controlled asthmatic patient with near normal FEV1, irrespective of the level of baseline airway responsiveness. PMID- 3548506 TI - Insulin stimulates amino acid transport by alveolar type II epithelial cells in primary culture. AB - The present experiments were designed to investigate the effect of insulin on amino acid transport by alveolar type II epithelial cells isolated from adult rats. The initial rates of amino acid transport were determined by measuring the uptake of the nonmetabolizable amino acid, alpha-aminoisobutyric acid (AIB). Alveolar type II epithelial cells transported AIB by a sodium-dependent process that displayed saturable kinetics. Insulin stimulated transport of 0.1 mM AIB (82.3 +/- 15.0%, mean +/- SE, n = 4) with a half-maximally effective insulin concentration of 2.2 +/- 1.0 ng/ml (mean +/- SE), which is within the physiologic range of rat serum insulin concentration. Kinetic analysis of AIB transport showed that insulin increased the Vmax from 6.7 +/- 1.2 nmol/10(6) cells/min to 9.3 +/- 1.8 nmol/10(6) cells/min and had no effect on the Km value (5.2 +/- 0.8 mM). Alpha-(methylamino) isobutyric acid, a specific substrate for amino acid transport system A, inhibited both the sodium-dependent and insulin-modulated transport of AIB. Thus, alveolar type II epithelial cells transport amino acids in a sodium-dependent process and insulin stimulates this transport. The present study indicates that insulin may play a physiologic role in regulating amino acid transport in alveolar type II epithelial cells. PMID- 3548507 TI - Prediction of pulmonary function abnormalities after adult respiratory distress syndrome (ARDS). AB - To determine if measures of ARDS severity during the acute illness correlate with lung function after recovery from ARDS, we regressed lowest total thoracic compliance (CTH), initial intrapulmonary shunt fraction (Qsp/Qt), initial mean pulmonary artery pressure (PAP), maximal level of positive end-expiratory pressure (PEEP), time ventilated (Tvent), and time with FlO2 greater than 0.6 (TO2) against the percent of predicted FVC, TLC, and DLCO of 16 previously healthy, nonsmoking ARDS survivors. Pulmonary function tests were performed more than 1 yr after ARDS. Percent of predicted FVC correlated with CTH (r = 0.66, p less than 0.01) and PAP (r = 0.53, p less than 0.05), and percent of predicted TLC correlated with CTH (r = 0.71, p less than 0.01), PEEP (r = -0.55, p less than 0.05), and Qsp/Qt (r = -0.53, p less than 0.05). Only TO2 correlated with percent of predicted DLCO (r = -0.53, p less than 0.05). Five of 7 ARDS survivors with an abnormal DLCO were supported at FlO2 greater than 0.6 for more than 24 h, whereas all of 9 survivors with a normal DLCO received FlO2 greater than 0.6 for less than 24 h. We conclude that physiologic markers of ARDS severity during the acute illness correlate with residual pulmonary dysfunction after recovery from ARDS. Support with FlO2 greater than 0.6 for more than 24 h appears to be a sensitive and specific predictor of an abnormally reduced DLCO more than 1 yr after ARDS. PMID- 3548508 TI - Proteolytic activity in sheep lung lymph as marker of lung capillary injury. AB - Intravenous infusions of Escherichia coli endotoxin into sheep caused the appearance in lung lymph of high levels of an enzyme with trypsinlike activity. The time course of appearance of the enzyme and the extent of its increase corresponded to the known events of endotoxin-induced capillary injury. Accordingly, activity was low in the first phase of endotoxin-induced increased lung lymph flow caused by increased pressure filtration but was high in the second phase of increased lung lymph flow caused by increased permeability filtration. Recovery was associated with a decrease of activity to preinfusion levels. Capillary damage and increased permeability filtration induced by air emboli or oleic acid led to a similar increase in lung lymph proteolytic activity. By contrast lung lymph proteolytic activity remained virtually unchanged during increased pressure filtration induced by inflation of a balloon in the left atrium. Activity also remained unchanged in thoracic duct lymph, indicating that the increased activity in lung lymph is not an expression of a generalized response to endotoxin. The enzyme, a serine protease with a molecular weight of about 70,000 to 75,000 and a pH optimum between 7.3 and 7.6, was not related to lymph clotting and was not capable of correcting the clotting defects of plasmas deficient in enzymes of the clotting cascade. These results together with specificity studies indicate that the enzyme represents a new, hitherto unidentified, protease. Measurements of its activity in lung lymph represent a sensitive marker of lung capillary injury. PMID- 3548510 TI - Immunoelectron microscopic study on the histogenesis of epidermoid metaplasia in respiratory epithelium. AB - To elucidate the histogenesis of epidermoid metaplasia with an immunoelectron microscopic method, we studied the localization of secretory component (SC), a differentiation marker of the epithelial cell, in human bronchial epithelium. In the area of normal epithelium, SC was synthesized by mucous cells, particularly by small mucous granule cells. It was also found with small mucous granules in both superficial columnar or cuboidal cells in the area of stratification and superficial, less flattened cells in the area of epidermoid metaplasia, but SC was not identified in polygonal cells under the superficial SC-positive cells in both of the above areas. These superficial cells containing SC and small mucous granules possessed increasing number of tonofilaments parallel with the degree of flattening of the surface cells. On the other hand, in the advanced epidermoid metaplasia, in which surface cells were composed of very flattened cells, SC and small mucous granules were not found in the bronchial epithelium. Tonofilaments increased in number in the cytoplasm parallel to morphologic changes from basal cells to outermost flattened cells, via polygonal cells. These findings suggest that small mucous granule cells containing SC could gradually change to flattened cells through a quantitative change of a cytoplasmic component, such as SC or tonofilaments, and constitute the superficial cells of initial epidermoid metaplasia, in which surface cells are composed of less flattened cells. Moreover, these findings suggested that basal cells play an important role in epidermoid differentiation. PMID- 3548509 TI - The effect of human antiendotoxin monoclonal antibodies on endotoxin-induced lung injury in the rat. AB - A model of endotoxin-induced lung injury was developed in the rat. We found that 24 h after intravenously administered endotoxin (3 mg/kg) there was increased clearance of the isotope 99mTcDTPA from the lung to blood, increased neutrophils in the lung in bronchoalveolar lavage, and increased levels of products of peroxidation of lipids and nucleic acid in the serum. Using this model, we evaluated the effect of pretreatment of rats with a human monoclonal antibody specific to the core glycolipid that is common to all endotoxins. We found that pretreatment prevented the increased clearance of 99mTcDTPA from the lung, as well as the increase in lipid peroxidation products in the serum. The antibody did not prevent increased neutrophil accumulation in the lung. The findings suggest that the administration of human antiendotoxin monoclonal antibodies prior to endotoxemia may prevent some of the changes in the lung associated with endotoxin. PMID- 3548511 TI - Nocturnal positive pressure ventilation via nasal mask. AB - Five patients with chronic respiratory failure from neuromuscular disease and symptomatic worsening nocturnal hypoventilation were treated with nocturnal ventilation. Home ventilation at night was provided by a volume-cycled positive pressure ventilator attached to a nasal mask originally designed to administer nasal continuous positive airway pressure (CPAP) for obstructive sleep apnea. The device was well tolerated. Symptoms of headache, insomnia/somnolence, and impaired intellectual capacity rapidly disappeared with nocturnal ventilatory support. Daytime arterial PO2 and PCO2 improved after therapy. There are several advantages over commonly used, negative pressure devices for nocturnal ventilation. These include patient synchronization of tidal volume, ease of application, less cumbersome apparatus, more nocturnal patient mobility, and absence of production of upper airway obstruction. PMID- 3548512 TI - Shortened endotoxin-activated clotting times in patients with carcinoma. AB - Isolated human monocytes generate tissue factor when stimulated with endotoxins. This tissue factor generation provides a convenient marker of monocyte activation. Furthermore, the only circulating blood cell capable of generating large quantities of tissue factor is the monocyte. Therefore, the addition of endotoxin to citrated blood, and the determination of the recalcification times after incubation, yields a measure of monocyte activation. In order to determine whether monocyte activation as measured by this technique varies between patients with carcinoma and healthy volunteers, recalcification times were evaluated. The recalcification time and range for 19 healthy volunteers (controls) was 6.55 min (5.3-8.5) for the saline incubated sample and 5.69 min (4.6-7.2) for the endotoxin-activated sample. The results for 13 patients with carcinoma are 4.81 min (3.3-6.3) for the former and 3.17 min (2.0-4.3) for the latter. These results show that the longest recalcification time with endotoxin incubation for patients with carcinoma was lower than the lowest recalcification time in the control group. Whether this simple test can be of use in the diagnosis and monitoring of patients with carcinomas is currently being investigated. PMID- 3548513 TI - [Isolated congenital aplasia of the anterior hypophysis and neonatal hypoglycemia. Report of a case with review of the literature]. AB - We describe a female newborn infant who became severely hypoglycaemic (0.73 mg %), cyanosed and collapsed at five hours of age. After this episode she developed new hypoglycaemia and convulsions and did not tolerate short fasting periods. Physical examination revealed macrocephalia (PC 36 cm), prominent frontal bone and flat face. Hormonal tests showed normal insulines, a relative secondary hypothyroidism and GH, ACTH and cortisol deficiencies (GH, 0.15 and 11 ng/ml; cortisol, 3.5 and 2 mg %). The baby died at the age of 3 months after pulmonary aspiration. The findings at necropsy showed a normally developed brain and flat sella turcica with fragments of neurohypophysis without evidence of adenohypophysis and adrenals and thyroid markedly hypoplastic. Diagnosis of this entity as well as cases reported in pediatric literature are reviewed. PMID- 3548514 TI - [First infantile liver transplants in Spain]. AB - For the first time in Spain, authors report the experience, started by the Hospital Infantil "Valle de Hebron" of Barcelona on pediatric liver transplant in terminal liver disease in childhood which means a new opportunity for these patients otherwise facing a fatal out come in a short time. We show the 4 first pediatric liver transplants performed in our country and we point out some of the most important factors of a pediatric liver transplant program in a consolidation phase. PMID- 3548515 TI - [Parasitosis caused by Plasmodium vivax]. PMID- 3548516 TI - [Hypospadias, new technics and review of cases]. AB - We presented the review of 360 cases of hypospadias treated in our service between 1974 and 1983. Until 1982 the correction was performed in two or more stages at ages ranging from 2 to 7 years. Since 1982 we prefer only one stage operations and at an early age using hormonal stimulation (local or general) microsurgery and new suture materials. A comparative study of the two periods is presented. PMID- 3548517 TI - [Familial childhood cortical hyperostosis]. AB - We present three cases of Caffey's disease, which have been observed in a family and a previous one former generation of the same family. A review of the literature upon family cases is carried out (35 families with 143 patients) prevailing the hypothesis of the type of autosomal dominant trait with incomplete penetrance and variable expressivity. HLA system is studied in such a family without common haplotypes being found and therefore the trait does not seem to be linked to genes of this system. PMID- 3548518 TI - [Diabetes insipidus in a newborn infant with Streptococcus group B sepsis and meningitis]. PMID- 3548519 TI - [Wandering spleen. Discussion apropos of a case]. PMID- 3548520 TI - Developmental effects of irradiation on the brain of the embryo and fetus. PMID- 3548521 TI - Digoxin for converting recent-onset atrial fibrillation to sinus rhythm. A randomized, double-blinded trial. AB - STUDY OBJECTIVE: to determine whether digoxin is effective in converting atrial fibrillation of recent onset to normal sinus rhythm. DESIGN: randomized, double blinded, placebo-controlled trial with a maximum 18-hour treatment period. SETTING: emergency room and medical floors of a non-referral city hospital. PATIENTS: consecutive sample of 36 patients with atrial fibrillation of 7 days' duration or less, not on digitalis glycoside or anti-arrhythmic agents, with ventricular rate between 85 to 175 beats/min, without evidence of heart failure, acute myocardial infarction, unstable angina, preexcitation syndrome, thyrotoxicosis, hypokalemia, renal impairment, or severe metabolic disturbances. INTERVENTIONS: digoxin solution in capsules or identical placebo, given in doses of 0.6, 0.4, 0.2, and 0.2 mg, at 0, 4, 8, and 14 hours, respectively, or until conversion to sinus rhythm, whichever occurred first. Continuous electrocardiographic recording by Holter monitor. MEASUREMENTS AND MAIN RESULTS: nine of eighteen patients receiving digoxin and 8 of 18 receiving placebo had a return to sinus rhythm within 18 hours of study entry (95% confidence interval for the difference in proportions, -11% to 22%). Mean time to conversion was 5.1 hours in the digoxin group and 3.3 in the placebo group (95% Cl, -3.6 to 7.0 hours). CONCLUSIONS: spontaneous reversion to sinus rhythm is common in patients with atrial fibrillation of recent onset. Digitalization was not shown to affect the likelihood of reversion to sinus rhythm, and thus cannot be recommended for this purpose in patients with atrial fibrillation. PMID- 3548522 TI - Pneumonia associated with the TWAR strain of Chlamydia. AB - From November 1981 to August 1984, 301 adult patients with community-acquired pneumonia were admitted to the major referral hospital of Nova Scotia. Serologic tests done on these patients included microimmunofluorescence using the TWAR strain of Chlamydia and all Chlamydia trachomatis serovars as antigens. The TWAR strain has been shown to cause mild pneumonia in teenagers and young adults. Of the 301 patients, 18 (6%) had serologic evidence of recent infection with the TWAR organism. Their mean age was 64 years. Pneumonia associated with the presence of acute TWAR antibody had no characteristic clinical or radiographic features when compared with pneumonia without acute chlamydia antibody. Six patients, who all had preexisting serious chronic disease, had severe illness, and 2 died. Both patients who died had complicated hospital courses and other concomitant infections. We conclude that the TWAR organism may cause pneumonia in older adults and persons with chronic diseases that require hospitalization. PMID- 3548523 TI - Papillary stenosis and sclerosing cholangitis in the acquired immunodeficiency syndrome. AB - Eight homosexual men with the acquired immunodeficiency syndrome (AIDS) presented with clinical, biochemical, and radiologic features of stenosis of the papilla of Vater and sclerosing cholangitis. This newly recognized complication of AIDS produces abdominal pain, nausea, and vomiting and may predispose patients to superimposed bacterial cholangitis. Marked elevation of serum alkaline phosphatase levels and lesser changes in hepatic aminotransferase levels are common. Although abdominal ultrasonography and computed tomography detect ductal abnormalities, endoscopic retrograde cholangiography best shows precise ductal irregularities and provides therapeutic intervention. Prompt relief of symptoms follows endoscopic sphincterotomy, often with resolution of biochemical evidence of cholestasis. Biliary tract infection with cytomegalovirus or cryptosporidia and resultant viral or coccidial cholangitis are the proposed pathophysiologic mechanisms. PMID- 3548524 TI - Prophylactic therapy for stress ulcer bleeding: a reappraisal. AB - The combined data from 16 prospective trials (2133 patients) appear to suggest that antacids prevent stress ulcer bleeding more effectively than does cimetidine. However, the use of occult blood detection methods to diagnose stress ulcer bleeding may have led to the recognition of clinically insignificant bleeding. When the data from these trials are categorized according to the criteria used for the diagnoses of bleeding (either occult blood detection or clinically overt bleeding), there was no significant difference between antacids and cimetidine in the prevention of overt bleeding (3.3% of 458 compared with 2.7% of 402 patients who bled, respectively; p = 0.69). In addition, both agents were more effective (p less than 0.001) than placebo (15% of 720 patients who bled) in the prevention of overt bleeding. Cimetidine and antacids are equal in preventing significant stress ulcer bleeding. PMID- 3548525 TI - Sleep disorders: insomnia, sleepwalking, night terrors, nightmares, and enuresis. AB - All five sleep disorders reviewed in this article can be adequately evaluated in the physician's office by taking a sleep history and conducting a careful general medical and psychiatric assessment. Insomnia, the commonest sleep disorder, is more prevalent among women and elderly and psychosocially disadvantaged persons. Personality factors such as a tendency toward the internalization of emotions and the occurrence of stressful life events also play a major role in the development of chronic insomnia. A multidimensional approach is indicated for the treatment of chronic insomnia; hypnotic drugs should be used only as an adjunct to this treatment. In children, sleepwalking and night terrors (two manifestations of the same pathophysiologic substrate), nightmares, and enuresis are commonly related to developmental factors; counseling and reassurance of the parents is indicated. Psychopathologic disorders are usually present in secondary enuresis, as well as in sleepwalking, night terrors, and nightmares that occur in adulthood. Psychotherapy and the occasional use of psychotropic drugs may be necessary in the treatment given adults with these disorders. PMID- 3548527 TI - BACTEC 460 blood culture system. PMID- 3548526 TI - Nutritional therapy for rheumatic diseases. PMID- 3548528 TI - Microvascular complications of diabetes mellitus and glycemic control. PMID- 3548529 TI - The complete blood count and physician payment. PMID- 3548530 TI - [Application of a miniaturized system to the study of the intestinal microflora]. PMID- 3548531 TI - [Bacterial flora in jejunal aspirates: study using culture examination, gas chromatography and H2 breath-test]. PMID- 3548532 TI - [The cytotoxic necrotizing factor (CNF) of Escherichia coli]. PMID- 3548533 TI - New intestinal pathogens. PMID- 3548534 TI - [50 years of the Library of the Istituto Superiore di Sanita]. PMID- 3548535 TI - [The National Medical Library]. PMID- 3548536 TI - [Management of bibliographic information in the scientific libraries of Rizzoli Orthopedic Institutes of Bologna]. PMID- 3548537 TI - [The Documentation Service of the Istituto Superiore di Sanita: the prerequisite for research activities]. PMID- 3548538 TI - DIMDI's role in biomedical information. Deutsches Institut fur Medizinische Dokumentation und Information. PMID- 3548539 TI - Choroidal osteoma: two case reports in elderly patients. AB - A 71-year-old woman and a 66-year-old man, both asymptomatic and with normal visual acuity, were found to have bilateral choroidal osteomas. To our knowledge, these represent the oldest reported cases of choroidal osteoma. The lack of symptoms, stability of the lesions, and minimal funduscopic findings may lead to an underdiagnosis in the elderly population. PMID- 3548540 TI - [Current status of the treatment of nasal septal perforations]. AB - If the most part of the patients with septal perforation have an history of previous surgery, only few of them present symptoms and require surgical repair in spite of the various techniques described in the literature. Bilateral naso septal mucosal flaps with temporalis fascia interposition graft give the best results. That's why the use of more complicated process remain the exception. Owing to the dubiousness of these reconstructions, it seems advisable to point out the value of preventive actions in order to preserve the nasal physiology. PMID- 3548541 TI - [Collodion baby: 32 new case reports]. AB - A critical study of 69 cases of collodion baby observed between 1976 and 1984 is compared with the study conducted in 1976. These 69 cases are divided into 32 examined by the authors personally and 37 published in the literature. The total number of collodion babies is 267. A collodion baby is a high risk newborn who must be nursed in a specialized intensive care unit during the neonatal period. The vital prognosis has been improved by the prevention of metabolic disorders (dehydration with hypernatraemia) and of percutaneous intoxication with topical products, and by the early treatment of infections. The mortality rate, which was 33 p. 100 in 1976, had fallen to 11 p. 100 in 1984. Skin infection with systemic spread remains the major complication (the present situation is summarized in table II). The collodion baby is the neonatal expression of different disorders of keratinization and as such, constitutes a syndrome. Several conclusions can be drawn from a comparison of the keratinization disorders observed in our two series (table VI). Congenital ichthyosiform erythroderma and lamellar ichthyosis are responsible for 60 p. 100 of collodion babies. These two lesions may be the first signs of an ichthyosis transmitted as an autosomal dominant trait in 9.7 p. 100 of the cases. Trichothiodystrophy may be heralded by a collodion baby syndrome. In 9.7 p. 100 of the cases this syndrome disappears without sequelae. Sex-linked ichthyosis never begins with a collodion baby syndrome. PMID- 3548542 TI - [Direct identification of Chlamydia trachomatis using fluorescent monoclonal antibodies in infections of the lower urogenital tract]. AB - Direct identification of Chlamydia trachomatis with fluorescent monoclonal antibodies in smears was recently introduced for a rapid diagnosis of lower urogenital tract infections. In the present study the performance of this method was compared with that of the classical cell culture procedure with McCoy cells and iodine staining on 880 clinical specimens (table I). One hundred and twenty specimens in which one of the two methods failed for technical reasons are therefore not available for comparison. Among the remaining 760 specimens there was agreement between the two methods in 724 (95 p. 100). The sensitivity of direct identification was 85 p. 100, its specificity 97 p. 100 (table II). Our results are comparable to those reported in the literature and confirm that direct identification of Chlamydia trachomatis with fluorescent monoclonal antibodies is a useful, reasonably sensitive method for rapid diagnosis of this infection. Failures, which are relatively frequent (8 p. 100 in our series), are mostly due to inadequate specimen collection, the smears containing no epithelial cell. PMID- 3548543 TI - [Antiphospholipid antibodies: new data in the pathogenesis of collagenosis]. AB - Antiphospholipid antibodies (APAB) were first detected as a result of the disturbances they cause in routine biological tests. These effects include lupus anticoagulant (LA) in APTT test and false serological reactions for syphilis in VDRL test. With more sensitive techniques using purified phospholipid antibodies (ELISA, RIA) antibodies directed specifically against cardiolipidin or other phospholipids can be assayed. Beside being responsible for positivity of the VDRL test in the context of syphilis, APAB (false serological reactions for syphilis, LA, anticardiolipin antibodies) have also been detected in systemic lupus erythematosus (SLE) and lupus-like syndromes, after intake of certain drugs, and, more rarely, in a number of diseases (table I). The specificity of APAB detected in syphilis (antiphosphatidylcholine) is different from that of APAB detected in SLE (antiphosphatidylserine and anticardiolipin). A given APAB can react with several phospholipids, but such crossreactions do not occur haphazardly with all phospholipids. Crossreactions are observed between APAB and polynucleotides on the one hand, and between antinuclear antibodies and phospholipids on the other. This pattern has led to speculate that APAB are directly involved in the pathogenesis of SLE; however since these crossreactions are not extensive, such speculation is controversial. The presence of APAB in the form of LA, false serological reactions for syphilis or anticardiolipin antibodies is associated with a number of problems including recurrent thrombosis, repeated abortions, thrombocytopenia and positive Coombs' tests or, more rarely, pulmonary hypertension, migraine, epilepsy, chorea, and transverse myelitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548544 TI - [Staphylococcal scalded skin syndrome (SSSS) in adults]. PMID- 3548545 TI - [Herpes gestationis]. PMID- 3548546 TI - [Dietetics in insulin-dependent diabetes in children and adolescents]. PMID- 3548547 TI - [Value of self-monitoring of blood sugar combined with the monitoring of urinary glucose in the young diabetic]. PMID- 3548548 TI - [Blood and urinary glucose for optimal control of diabetes in children]. PMID- 3548549 TI - [Echographic aspect of abnormalities of the vulva and vagina in children]. PMID- 3548550 TI - [In utero diagnosis of cysts of the ovary]. PMID- 3548551 TI - Secondary bone grafting and orthodontic treatment in patients with bilateral complete clefts of the lip and palate. AB - The results of secondary bone grafting and orthodontic treatment in 41 patients with bilateral complete clefts of the lip and palate are reported. Good bone formation was found in 98% of the cleft sites grafted before the eruption of the canines, and in 80% of the clefts grafted later. Closure of both cleft spaces by orthodontic means was achieved in 20 of the 21 patients in the first group, and in 14 of the 20 patients in the second group. The bone grafts failed in one cleft site in 4 patients, all of which were regrafted with satisfactory results. In 2 patients one of the canines was later affected by external root resorption, necessitating endodontic treatment. Both the failures and the root resorptions occurred in patients bone grafted at an older age than was considered optimal for bilateral clefts: 10 to 11 years. Seven patients needed a bridge prosthesis, 3 of these over one cleft space only. Even these patients benefited greatly from bone grafting. PMID- 3548552 TI - Grafting of burns with widely meshed autograft split skin and Langerhans cell depressed allograft split skin overlay. AB - Extensively burned patients suffer from lack of sufficient autologous donor skin. Meshing and wide expansion of the obtained split skin has met the requirement to a large degree. However, the wider the expansion, the less chance of a proper take. By covering widely expanded autografts with viable cadaver split skin, the take has been improved. If the epidermal Langerhans cells in the cadaver split skin are depressed by ultraviolet B light and glucocorticosteroids before grafting, a prolonged allograft take can be achieved and the healing of the underlying autografts is ensured for an extended period. Grafting results in 6 patients with extensive burns are reported. PMID- 3548553 TI - Experience with electrothrombosis in the treatment of angiomas. AB - We report unsatisfactory results of electrothrombosis for the treatment of venous angiomas. After we reviewed a report of successful use of electrothrombosis for treating cirsoid angiomas of the face and scalp and varices of the leg, a clinical trial was begun with 6 patients in whom previous conventional surgery was relatively unsuccessful and in whom further surgery had not been recommended owing to the high risk or probability of unsatisfactory results. Two patients had objective clinical improvement, resulting in no further treatment in 1 patient and allowing secondary surgical correction in the other. Four patients had no significant improvement. We now recommend and will continue further laboratory research with electrothrombosis for the treatment of angiomas before treating additional clinical cases. PMID- 3548554 TI - Update on cranial bone grafts in craniofacial surgery. AB - A large series of cranial bone grafts performed during a 6-year period is presented. The types of grafts are discussed and the techniques of taking the grafts are described. The complications have been few. Full-thickness skull penetration occasionally occurs but should not be a cause for concern. The skull has gradually become our main bone graft donor site. PMID- 3548555 TI - [Comparison of ultrasonography and scintigraphy in parathyroid hyperplasia. Preliminary results of a prospective study of 9 cases]. PMID- 3548557 TI - [X-ray computed tomographic aspects of pancreatic diseases]. PMID- 3548556 TI - [Peritoneal tuberculosis. Apropos of a case]. PMID- 3548558 TI - [Ultrasonic study of the left adrenal gland by anterior transgastric approach]. PMID- 3548559 TI - [Tyzzer's disease]. AB - Tyzzer's disease occurs as an epizootic disease in a number of mammals including rabbits and is characterized by sever diarrhoea and high mortality. Lesions consist of necrotic and hemorrhagic enteritis and are observed mainly in the distal digestive tract (ileum-caecum-colon). Congestion and vivid reddening of the caecum and marked serosal and submucosal oedema are present. Typical hepatic lesions, i.e. necrotic and miliary foci of the liver are generally absent in acute phase of the disease in rabbits. The diagnosis of Tyzzer's disease is difficult to establish and is based on the histologic demonstration of the causative agent Bacillus piliformis within the cytoplasm and nucleus of viable cells around necrotic area of the liver or intestine. Cultivation of this pleomorphic organism in cell-free media has been unsuccessful. Hence, taxonomic position of B. piliformis remains questionable. It is possible that Tyzzer's agent is an anaerobic, Extremely Oxygen Sensitive (EOS) bacteria closely similar to Fusobacterium. Failure to cultivate B. piliformis in vitro makes its study difficult and the role of this organism in the outbreaks of diarrhoea remains unclear. We believe that like in "swine dysentery", strong modifications of the intestinal flora facilitated by disorders of some factors particular to the animal--such the impairment of the mechanisms of immunity--or the perturbations of the environmental conditions are important even in the genesis of Tyzzer's disease and that the difficulty of diagnosis probably minimize the incidence of this organism in breeding. PMID- 3548560 TI - [Experimental infection with Salmonella abortus ovis in rams]. AB - The susceptibility of rams to experimental challenge with Salmonella abortus ovis was investigated by subcutaneous, conjunctival or preputial administration of 1 X 10(10) viable salmonella to 3 groups of 6 adult Prealpes rams. Slaughter and autopsy of 15 rams were made 83 days after challenge. Each of the 3 remaining rams was introduced in 3 groups of 6 salmonellosis-free ewes. The subcutaneous injection caused a significant hyperthermia, a rapid increase in antibody titers without detectable genital excretion of salmonella. The conjunctival or preputial challenge caused a significant serological response without fever; S. abortus ovis was isolated from samples taken 1 to 13 days after challenge only in rams challenged by the preputial route. No salmonella was isolated from organs of the 15 slaughtered rams. Ewes made pregnant by the 3 remaining rams showed no signs of infection. In our experimental conditions, a genital colonization was not observed; a passive genital carriage of S. abortus ovis was shown to be possible; its hypothetical epidemiological role was discussed. PMID- 3548561 TI - Prostaglandin F2 alpha and prostacyclin imbalance in cows with placental retention: new findings. AB - The aim of this work was to investigate possible differences in peripheral blood concentrations of 13, 14 dihydro 15 keto PGF alpha (PGFM) and 6 keto PGF1 alpha (PGIM), between dairy cows retaining (RP) and not retaining (NRP) their placenta. Blood samples were collected 5, 30, and 60 minutes postpartum from 8 RP and 17 NRP cows. PGFM concentrations were significantly lower in RP cows than in NRP cows 60 minutes after birth (8156 pg/ml vs 12016 pg/ml; P less than or equal to 0.05). There was a significant rise of PGFM levels between 30 and 60 minutes in NRP cows (6225 pg/ml vs 12016 pg/ml; P less than or equal to 0.01), while in RP cows PGFM levels remained fairly constant along the period studied. No significant differences were found between RP and NRP cows regarding PGIM levels during this period although absolute values were slightly higher in RP cows. The PGFM/PGIM ratio was significantly higher 60 minutes postpartum in NRP cows than in RP cows (15.5 vs 8.8; P less than or equal to 0.01). This ratio increased significantly in NRP cows between 30 and 60 minutes (7.2 vs 15.5; P less than or equal to 0.01), a pattern not observed in RP cows. There was no correlation between PGIM and PGFM levels during the first 60 minutes postpartum in the NRP cows. However, the same correlation was significantly positive in the RP cows (r = 0.75; P less than or equal to 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548562 TI - [Experimental study of diarrhea induced by a strain of Escherichia coli (serogroup O-103) in growing rabbits]. AB - The experimental infection by mouth of weaned, 6 week old rabbits was performed with Escherichia coli strain O-103/10 without any adjuvant. The quantities of E. coli for the 3 experimental treatments were - none (control) - 10(4) or 10(7) per animal. The 142 rabbits were divided into 2 groups, each including the 3 treatments: A - observation of weight and eventual diarrhea during 25 days after infection; B - killing during the same period of some healthy and diarrheic animals every 2 or 3 days, for physiological, bacteriological, and histological observations. In the A group, mortality after 25 days was 0/24 in the control, 12 and 15/24 for 10(4) and 10(7) treatments respectively, but it was observed earlier for the 10(7) one. Diarrhea has been observed for 90% of infected and 20% of control rabbits, at first on day 7, 12 and 20 post-infection for the 10(7), 10(4) and control treatments respectively. The mean duration of diarrhea was 4 days in infected and only 2 in control rabbits. Always, diarrhea and weight lost were observed before death. Although the slowing down of growth rate during the experimental period, at the end, mean live weight was quite the same for animals surviving in the 3 treatments. Necropsy of killed rabbits of the B group, revealed hemorrhagic damages mainly on cecal and colonic wall, associated with high counts for E. coli (10(7) to 8 X 10(9] in the cecal content. In rabbits with highest counts (9/15), E. coli was also observed in blood. In diarrheic rabbits cecal pH was higher (6.61 vs 5.82) and cecal VFA concentration lower (53 vs 98 mM/l) than in healthy ones; but the proportions of acetic, propionic and butyric acids were not significantly affected. At constant VFA concentration in the cecum, pH and E. coli counts were correlated (r = + 0.35). Histology revealed first, attachment of bacteria to the apex of villi cells, and furthermore destruction of the epithelium with hemorrhages and necrosis. Thus the strain O 103/10 of E. coli is confirmed to be pathogenic and will provide a good experimental model for studies of diarrhea due to E. coli. PMID- 3548563 TI - [Atrial fibrillation: some current practical problems]. AB - We emphasize: the great frequency of atrial fibrillation, present in approximately 10% of men and more than 20 p. cent of women hospitalized in a cardiology department; the advantage of a comprehensive etiological survey, reducing to less than 10 p. cent the percentage of idiopathic permanent atrial fibrillations, in this department; the need to take into account all factors determining the prognosis of atrial fibrillation: ventricular contractility and hemodynamic consequences of the rhythm disorder, volume of the left atrium, condition of the valvular orifices, risk of thrombo-emboly, etc., as well as the difficulty of therapeutic indications, linked on the one hand to the multiplicity of etiologies and prognosis factors, and on the other hand to the diversity of the therapeutic approaches, of which we are here reminded. PMID- 3548565 TI - [Thrombolysis in acute myocardial infarction. Re-evaluation]. AB - The responsibility of a thrombus and the feasibility of saving an ischemic myocardium by early revascularization explain the development of thrombolysis. Streptokinase administered intravenously rather than intracoronary restores coronary patency in 45 p. cent of the cases, improves the total and segmental left ventricular function if an early and complete revascularization is performed before the 3rd hour, helped eventually by a sequential angioplasty. At the cost of an acceptable hemorrhagic risk, thrombolysis reduces in-hospital mortality in patients under 65 years, with anterior primary infarctions. New thrombolytic agents, standardized protocols, decreased length of hospitalization and optimization of infrastructures should improve these first results. PMID- 3548564 TI - [Anti-aggregating agents: for which patients?]. AB - Platelets are at the center of the phenomenon leading to thrombus formation; they also occupy an important place in the process leading to the development of the atheromatous plaque: these two actions justify the interest taken in anti platelets medications in cardiac pathology. In spite of the uncertainties remaining about this very controverted subject, it seems that the prescription of an anti-platelets medication is legitimate in all situations where there is a danger of formation or extension of a thrombus. Within the scope of coronary pathology, the most recent trials show a favorable action of anti-platelets medications in unstable angina, aorto-coronary by-pass or the secondary prevention of myocardial infarction. In addition, it is recommended to start the treatment as quickly as possible before surgery, as far as cardiac surgery is concerned. Finally, concerning the dispute about the optimal dose of aspirin, the current tendency is to advocate a moderate dosage. PMID- 3548566 TI - [Tricuspid endocarditis with right-left auricular shunt through a patent foramen ovale]. AB - The authors report the case of a tricuspid endocarditis secondary to Streptococcus bovis with important regurgitation and severe hypoxemia secondary to a right-left atrial shunt through a patent foramen ovale, requiring a surgical treatment which included the replacement of the tricuspid valve and closure of the dehiscence in the inter-atrial septum. The presence of a patent foramen ovale in the course of a tricuspid endocarditis has been exceptionally reported. This diagnosis deserves to be evoked in case of an unexplained hypoxic condition or a systemic embolism complicating a tricuspid endocarditis. The report emphasizes the advantage of ultrasonic examinations (contrast sonocardiography, pulsated Doppler) in order to demonstrate this right-left atrial shunt in addition to the data collected about the tricuspid valve. PMID- 3548567 TI - [Arterial hypertension in black patients]. AB - Arterial hypertension in blacks seems to present a few peculiarities in comparison to that of caucasians, whether it is from the epidemiological point of view: greater frequency of the disease, more severe prognosis; from the physiopathological point of view with especially a definite prevalence of HBP with low renin and inflation of the plasma volume and increased tendency to sodium retention, or finally from the therapeutic point of view, since randomized studies have demonstrated that black patients respond better to diuretics than to beta-blockers. Currently, it is impossible to explain these differences in a simple fashion: is it a genetic factor or, on the contrary, environmental factors? Perhaps the response lies between those two extremes. PMID- 3548568 TI - [Agranulocytosis caused by captopril]. AB - Captopril, an inhibitor of the conversion enzyme, is a medication with a known efficacy in the treatment of arterial hypertension and congestive cardiac insufficiency. Its side-effects are few. Among them, agranulocytosis is a severe complication, all the more severe and frequent as it occurs in patients with chronic renal insufficiency, collagen disease, or patient treated with medication having a leucopenic potential. Our case reports an agranulocytosis secondary to captopril in a patient with cardiac insufficiency presenting none of these aggravating factors. The mechanism of agranulocytosis secondary to captopril remains currently debatable, but does not seem, in the present case, to be dose related. Thus, a captopril prescription must comply with certain rules; decrease of the dosage in case of renal insufficiency, usual precautions in patients with collagene diseases. The association to a medication with leucopenic potential is to be avoided. Hematologic monitoring will be adapted to each particular case. PMID- 3548569 TI - Screening for congenital hypothyroidism. PMID- 3548570 TI - Interpretation of insulin radioreceptor assays. PMID- 3548571 TI - [hGH and molecular biology]. AB - This review summarizes the progress recently made through the approaches provided by DNA recombinant technology in the knowledge of the human growth hormone (hGH) gene and of the molecular basis of hGH deficiencies. The growth hormone gene is part of a family of five structural genes located on the long arm of human chromosome 17, over a distance of 55 kilobases (kb), and oriented in the same transcriptional 5' to 3' direction in the order 5' hGH-N, hCS-L, hCS-A, hGH-V, and hCS-B 3'. The five genes contain five exons interrupted by four introns, and they display a high sequence homology. GH and CS genes show class differences on their 3' side, approximately 100 base pairs beyond the polyadenylation sites. Analysis of homology regions has permitted to define duplication units useful to trace the evolution process of the cluster. The hGH-N gene codes for the normal, pituitary, 22K human growth hormone. The hGH-V genes codes for a variant peptide that can be expressed in vitro in transgenomic systems, but that is not known to be expressed in vivo. The hCS-A and -B genes each code for human chorionic somatomammotropin. They specify the same mature hormone and are expressed at different levels in term placenta. The hCS-L gene appears to be an unexpressed pseudogene and has a single base substitution, located in a splicing site, that would preclude normal mRNA maturation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548572 TI - Perceiving a stable environment when one moves. PMID- 3548573 TI - The organization of neocortex in mammals: implications for theories of brain function. PMID- 3548574 TI - Adult development and aging. PMID- 3548575 TI - Auditory psychophysics: spectrotemporal representation of signals. AB - The study of audition has widened: Having been concentrated in the 1960s on a few topics like pitch perception, binaural hearing, and fatigue, it now spans many more subjects. In the present paper we have emphasized the following topics: frequency analysis--this topic includes spectral integration and resolution, auditory excitation patterns, and processing of spectral information; temporal analysis--this topic refers mainly to studies in which abstract and stylized temporal variations in stimuli are used; binaural hearing--a subfield that still attracts a great deal of attention because of its unique character; pitch perception--of particular interest is this field for the perception of prosodic features of speech, but it also addresses fundamental questions of how the auditory system works; and pathology of hearing--in particular the effects of impaired hearing on speech perception and the relations among various hearing test results. (This section was written in collaboration with W. A. Dreschler.) Many of the topics discussed have a direct relation to the capabilities of the auditory system in analyzing sounds--in particular, speech sounds. Experimentally, the problem can be approached from two sides: in one the stimuli are generated in a stylized form, and in the other they are taken as distorted versions of actual speech elements. In this paper we have described mainly the first category of experiments. Whereas we know for certain that the auditory system operates in the frequency-temporal domain, it is remarkable that the distinction between fields 1 and 2 (above) can still be made. Temporal effects in frequency analysis are often considered as perturbations, and the same is true for spectral effects in the study of temporal resolution. A true integration of time and frequency is often sought but seldom achieved as the focus of study. Of the many subjects that would ideally have received more coverage we mention two: the use of additional stimulation pathways to help patients with large hearing loss or deaf-blind people, and the use of a cochlear prosthesis ("cochlear implant"). Because we lacked space to cover these topics adequately, we omitted them completely. This indicates no undervaluation of these subjects of study or of the benefits they can provide to hearing-impaired people. PMID- 3548576 TI - Social cognition and social perception. PMID- 3548577 TI - Social and community interventions. PMID- 3548578 TI - Psychopathology of childhood: from description to validation. PMID- 3548579 TI - Perception and information. PMID- 3548580 TI - Human learning and memory. AB - There have been several notable recent trends in the area of learning and memory. Problems with the episodic/semantic distinction have become more apparent, and new efforts have been made (exemplar models, distributed-memory models) to represent general knowledge without assuming a separate semantic system. Less emphasis is being placed on stable, prestored prototypes and more emphasis on a flexible memory system that provides the basis for a multitude of categories or frames of reference, derived on the spot as tasks demand. There is increasing acceptance of the idea that mental models are constructed and stored in memory in addition to, rather than instead of, memorial representations that are more closely tied to perceptions. This gives rise to questions concerning the conditions that permit inferences to be drawn and mental models to be constructed, and to questions concerning the similarities and differences in the nature of the representations in memory of perceived and generated information and in their functions. There has also been a swing from interest in deliberate strategies to interest in automatic, unconscious (even mechanistic!) processes, reflecting an appreciation that certain situations (e.g. recognition, frequency judgements, savings in indirect tasks, aspects of skill acquisition, etc) seem not to depend much on the products of strategic, effortful or reflective processes. There is a lively interest in relations among memory measures and attempts to characterize memory representations and/or processes that could give rise to dissociations among measures. Whether the pattern of results reflects the operation of functional subsystems of memory and, if so, what the "modules" are is far from clear. This issue has been fueled by work with amnesics and has contributed to a revival of interaction between researchers studying learning and memory in humans and those studying learning and memory in animals. Thus, neuroscience rivals computer science as a source of interdisciplinary stimulation. Research on topics such as memory for spatial location, the relation between memory and affect, and autobiographical memory reminds us that general theories of memory based on studies of verbal materials alone are limited. Investigating how people remember complex natural events should provide us with a larger set of memory phenomena to explain and consequently insight into a wider range of memory principles or a deeper understanding of the ones we already accept (e.g. the role of repetition, encoding specificity), including their functional significance for human behavior.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3548581 TI - Developmental psychobiology: prenatal, perinatal, and early postnatal aspects of behavioral development. PMID- 3548582 TI - [History of anthropology]. AB - The author describes the history of biological anthropology with special reference to the period from 17th to 19th century. The most important anthropological theories and methodological developments of that time as well as their representatives are discussed in detail. PMID- 3548583 TI - [Historical development of anthropology in Basel]. AB - The author reports on the history of physical anthropology in Basel (Switzerland). The anthropological research activities of Carl Gustav Jung (1794 1864), Wilhelm His-Vischer (1831-1904), Ludwig Rutimeyer (1825-1895), Julius Kollmann (1834-1918), Paul and Fritz Sarasin (P.: 1856-1924; F.: 1859-1942), Felix Speiser (1880-1949) and the author himself (b. 1909) are described in detail. PMID- 3548584 TI - [Anthropology in the French-speaking Switzerland: a historical sketch]. AB - The author reports on the history of anthropology in the French speaking part of Switzerland from its beginning in the 16th century until the foundation of the Swiss Society of Anthropology in 1920. PMID- 3548585 TI - Cases from the past; a look back. PMID- 3548586 TI - Deep breathing relaxation. A pain management technique. PMID- 3548587 TI - Influence of stimulus frequency and probe size on vibration-induced alleviation of acute orofacial pain. AB - The pain-relieving effect of vibratory stimulation, using different stimulus parameters, and placebo stimulation in acute orofacial pain is reported. The influence of 10-, 100-, and 200-Hz vibrations on pain reduction was studied in 96 patients; two different probe sizes were used. 54 out of 76 patients, receiving vibrations at any of the above frequencies, reported relief of pain to some extent, while only 6 out of 20 patients receiving placebo treatment experienced pain alleviation. No significant differences were found between the different frequencies and probe sizes used regarding the pain-relieving effect. However, placebo stimulation was significantly less effective than any kind of vibratory stimulation. Induction time for pain relief was significantly shorter using the larger probe as compared to using the smaller probe, regardless of frequency. The results indicate that the vibratory frequency (10-200 Hz) for activation of pain inhibitory mechanisms is not critical in acute orofacial pain. Also, spatial summation from vibration-sensitive afferents seems to be of importance for a fast activation of the inhibitory systems. PMID- 3548588 TI - Measuring genetic stability in bacteria of potential use in genetic engineering. AB - Four commonly used conjugation techniques, colony cross streak (CCS), broth mating (BM), combined spread plate (CSP), and membrane filtration (MF), were compared with each other regarding reliability, sensitivity, and complexity in evaluating the transfer of conjugative plasmids. Five plasmids representing several incompatibility groups plus a variety of laboratory and environmental isolates were used as mating pairs. The suitability of each method was evaluated for use in a routine assessment of the genetic stability of genetically engineered microorganisms. By the CSP and MF techniques with laboratory strains such as Escherichia coli and Pseudomonas species as recipients, transconjugants were usually produced in 100% of the mating trials. However, when environmental strains isolated from plants and soil were used as recipients, transconjugants were detected in 100% of some crosses and in as little as 30% in other crosses depending on the plasmid and recipient used. In general, differences in the percentage of successful matings between the CSP and MF techniques compared with the BM and CCS techniques were not statistically significant at the P less than or equal to 0.05 level. Occasionally, certain mating pairs consistently produced transconjugants by CCS or BM but not by CSP or MF. Since any single conjugation mating technique is not completely reliable in detecting transconjugants, we have developed a combined mating technique which integrates the CCS, CSP, BM, and MF methods as a single procedure to assess the mobility of plasmid DNA of genetically engineered microorganisms. PMID- 3548589 TI - Inhibition of Clostridium botulinum 62A by fumarates and maleates and relationship of activity to some physicochemical constants. AB - A series of n-monoalkyl maleates and n-mono-, di-, and methyl n-alkyl fumarates were prepared, 18 esters of each, with R = CH3 to C18H37. Their activity against Clostridium botulinum was determined in culture medium. The n-monoalkyl maleates and fumarates possessed significant activity, particularly those esterified with higher C13 to C18 alcohols. Somewhat lower activity was exhibited by methyl n alkyl fumarates, while symmetrical esters, di-n-alkyl fumarates, were almost inactive. An attempt was made to correlate the activity of n-monoalkyl maleates and fumarates with chain length, solubility in water, apparent dissociation constant (pKa'), and infrared and UV absorption frequencies. The active esters may have potential as preservatives in foods. PMID- 3548590 TI - Effects of irradiation on growth and toxigenicity of Clostridium botulinum types A and B inoculated onto chicken skins. AB - This study was conducted to examine the effects of 0.3-Mrad irradiation on growth and toxigenicity of Clostridium botulinum types A and B on chicken skins. Irradiation followed by aerobic or anaerobic incubation at 30 degrees C extended the shelf life of skin samples and delayed growth and toxin production by C. botulinum. During 2 weeks of incubation at 10 degrees C, the irradiated and nonirradiated C. botulinum spores failed to grow or produce toxin. PMID- 3548591 TI - Autoconditioning factor relieves ethanol-induced growth inhibition of Saccharomyces cerevisiae. AB - Viable Saccharomyces cerevisiae suspended in medium containing growth-inhibiting concentrations of ethanol produce a metabolite that relieves growth inhibition. This autoconditioning of the medium by yeasts is due to the formation of small amounts (0.01%, vol/vol) of acetaldehyde. The effect is duplicated precisely in fresh medium by the addition of acetaldehyde. Acetaldehyde does not increase the yield of or accelerate ethanol production by the organism. Ethanol-induced modifications of membrane order in the plasma membranes, as measured by steady state fluorescence anisotropy of 1,6-diphenyl-1,3,5-hexatriene, were not resolved by exogenously added acetaldehyde. PMID- 3548592 TI - Characteristics of the endoglucanase encoded by a cel gene from Bacteroides succinogenes expressed in Escherichia coli. AB - A cel gene from Bacteroides succinogenes inserted into the vector pUC8 coded for an enzyme which exhibited high hydrolytic activity on carboxymethylcellulose, p nitrophenylcellobioside, and lichenan and low activity on laminarin and xylan. The enzyme was not synthesized by the Escherichia coli host when cells were cultured in complex medium containing added glucose. In the absence of added glucose, the endoglucanase and cellobiosidase activities synthesized were partitioned into the periplasmic space during growth, and practically all enzyme was located in the periplasm when the stationary phase of growth was reached. The enzyme exhibited 17- and sixfold higher Km values for the hydrolysis of carboxymethylcellulose and lichenan, respectively, than did the extracellular endoglucanase complex from B. succinogenes. The Cel endoglucanase had a pH optimum similar to that of the B. succinogenes enzyme except that the range was narrower, and the Cel endoglucanase was more readily inactivated on exposure to high temperature, detergents, and certain metals. Its activity was stimulated by calcium and magnesium. Nondenaturing polyacrylamide gel electrophoresis at different acrylamide concentrations revealed the presence of three endoglucanase components, two with molecular weights of 43,000 and one with a molecular weight of 55,000. PMID- 3548593 TI - Comparison of two biological aerosol sampling methods. AB - Two biological aerosol samplers, the Andersen two-stage microbial impactor and the May three-stage glass impinger, were examined to determine the benefits and effectiveness of the May sampler compared with the Andersen sampler, one of the most widely accepted samplers. Side-by-side samples were collected during simulated wastewater spray irrigation dispersion studies. Escherichia coli colony counts and air concentrations were statistically treated to determine the dependability of the May results with respect to the Andersen results. After data pairs containing potentially overloaded Andersen counts were eliminated, a linear regression of the remaining data was performed. It indicates that although the May sampler reports 82% of the Andersen sampler value, the correlation between the two samplers is good with an r2 value of 0.84. This comparison indicates that although there are differences between the two samplers, they do give comparable results and that when both are used in a sampling program, they tend to complement each other. PMID- 3548594 TI - Epithelial-mesenchymal interactions: effects of a dental biomatrix on odontoblasts. AB - The functional differentiation of odontoblasts requires specific interactions between these cells and the extracellular matrix. To further analyze these phenomena we studied the effects of a "dental papillae biomatrix" on isolated dental papillae cultured in vitro. The dental papillae biomatrix was extracted from EDTA-dissociated day-18 mouse dental papillae by homogenization, NaCl and enzymatic treatments, and deposited on Millipore filters. This biomatrix was studied by means of transmission electron microscopy and indirect immunofluorescence: it contained collagen fibrils, type IV collagen, fibronectin and laminin; cellular residues were also observed. The dental papillae were isolated by trypsin treatment of homologous tooth germs and cultured on uncoated (control) and coated filters. As shown by histological and cytological data, odontoblast-like cells never differentiated in control cultures. In presence of biomatrix and serum, polarized functional cells were observed. The functional state of these cells was enhanced by the addition of ascorbic acid to the culture media. Study of the incorporation of 3H-proline in cultured dental papillae and in macromolecules secreted into the culture media corroborated the morphological findings. PMID- 3548595 TI - Characteristics of cellular structures derived by tissue culture of pre implantation blastocysts of the pig. AB - Tissue mechanically dissociated from blastocysts of the pig around the time of implantation were found to produce, in culture, free-floating multicellular spheroids (trophospheres) and adherent monolayer cells. Ultrastructurally the two cellular layers of the trophospheres were very similar to those of the blastocyst but the trophosphere outer layer characteristically contained very large mitochondria with a vastly expanded matrix and few cristae. Similar mitochondria were also found in the monolayer cells. Using a monoclonal antibody specific for pig trophectoderm, it was found that about 20% of the monolayer cells, and some of the spheroids expressed this trophectodermal antigen. In the latter case the antigen was present only on the surface facing the medium. The spheroids were fluid-filled and occasionally grew inside each other. The monolayer cells were predominantly uninuclear but did form a number of binucleate cells and in older cultures the occasional cell with many nuclei could be seen. The spheroids and the monolayer cells had similar glycoprotein profiles indicating that they were composed of similar cell populations. A glycoprotein of apparent molecular weight 68,000 observed in both spheres and monolayers may represent pig placental alkaline phosphatase. Both trophospheres and monolayer cells were observed to interconvert steroid precursors. It is apparent that the trophospheres share many features of the blastocyst and may thus represent a valuable model system similar to those described in other species for the investigation of their biochemical physiological and immunological properties. PMID- 3548596 TI - [Antitumor activity of platinum analogs against human ovarian tumors heterotransplanted into nude mice]. AB - The chemotherapeutic effects of CDDP, CBDCA and CHIP on human ovarian cancers heterotransplanted into nude mice (mucinous cystadenocarcinoma OVA-1, poorly differentiated adenocarcinoma OVA-2, endometrioid adenocarcinoma OVA-3, serous cystadenocarcinoma OVA-4, and three yolk sac tumors YST-1, YST-2, YST-3) were examined. OVA-1 did not respond to CDDP, although it responded well to CBDCA and CHIP. OVA-2 responded well to all these platinum analogs. OVA-3 responded well to CDDP, but did not respond to CBDCA or CHIP. OVA-4 responded well to CDDP and CBDCA, but did not respond to CHIP. Tumors YST-2 and YST-3 exhibited broadly comparable sensitivity to CDDP and the two other analogs, and YST-1 was substantially more sensitive to CDDP than to CBDCA or CHIP. The results indicated the necessity of selection of platinum analogs according to the histological types of tumor for the effective treatment of ovarian cancer. PMID- 3548597 TI - [Antimetastatic effect of batroxobin]. PMID- 3548598 TI - [Primary cultures of various differentiated human cells and their transfer (3). Apparatus and instrument for primary culture]. AB - Clean bench, water distilled, low speed centrifuge, CO2-incubator and invert microscope were described and discussed as those necessary for the primary culture of differentiated human cells. Also the instruments including knives, filter sterilization equipment, the reagents including culture media were described and discussed as ones necessary for those primary cultures. PMID- 3548599 TI - Glucose and insulin responses are improved in patients with psoriasis during therapy with etretinate. AB - Since lipemia is commonly induced by retinoid therapy, we investigated the effects of etretinate administration on glucose metabolism by obtaining five-hour oral glucose tolerance tests in 23 patients before and after 20 weeks of etretinate therapy for psoriasis. Compared with pretreatment values, peak and aggregate levels for serum glucose and aggregate levels for serum insulin were significantly lower during therapy. The changes were not associated with obesity, weight loss during treatment, or pretherapy glucose tolerance or insulin secretion level. Of 11 patients with impaired or diabetic glucose tolerance prior to therapy, eight patients had improved glucose tolerance after 20 weeks of etretinate treatment. Despite inducing hypertriglyceridemia in most patients, etretinate therapy is associated with a reduction in glucose levels in response to a glucose load. PMID- 3548600 TI - Early onset anorexia nervosa. AB - This paper describes 48 children, aged 14 years or less, who met diagnostic criteria for anorexia nervosa modified from Morgan and Russell. The characteristics of the sample (13 boys and 35 girls) are described along with features of the illness, associated family characteristics, treatment in hospital, and a brief description of treatment. Difficulties in diagnosis are addressed, with reference in particular to the high incidence of depression in this group. Finally, the importance and difficulty of close paediatric/psychiatric liaison in diagnosis and treatment is emphasised. PMID- 3548601 TI - Reactions to dietary tartrazine. AB - Double blind challenges with tartrazine and benzoic acid were performed in hospital in 24 children whose parents gave a definite history of a purely behavioural immediate adverse reaction to one of these substances. The patients, whose ages ranged from 1.6 to 12.4 years, were on a diet that avoided these items, and in all there was a clear history that any lapse of the diet caused an obvious adverse behavioural reaction within two hours. In no patient was any change in behaviour noted either by the parents or the nursing staff after the administration of placebo or active substances. Twenty two patients returned to a normal diet without problems, but the parents of two children insisted on continuing the diet. While popular belief has it that additives may have harmful behavioural effects, objective verification is required to prevent overdiagnosis. PMID- 3548602 TI - Remission induced by an elemental diet in small bowel Crohn's disease. AB - Seventeen children with active Crohn's disease of the small intestine were entered into a randomised control trial comparing the efficacy of an elemental diet with that of a high dose steroid regimen. Eight children received an elemental diet (Flexical) through a nasogastric tube for six weeks, followed by reintroduction of food over six weeks during which the Flexical was stopped. Seven children were given intramuscular adrenocorticotrophic hormone followed by oral prednisolone with sulphasalazine. Two children were withdrawn from the trial. The elemental diet was equally effective in inducing an improvement in Lloyd-Still disease activity index, erythrocyte sedimentation rate, C reactive protein and albumin concentrations, and body weight as the high dose steroid regimen. Linear growth, assessed from height velocity over six months, was significantly greater in the children receiving an elemental diet. PMID- 3548603 TI - Successful management of daytime enuresis using alarm procedures: a randomly controlled trial. AB - Forty four children with daytime wetting were included in a randomly controlled trial of two alarm devices, a contingent one that sounded when wetting occurred and a non-contingent one that went off from time to time unrelated to wetting events. A quota allocation system ensured comparability between treatment groups. Two thirds responded to an alarm by becoming dry. The non-contingent alarm produced as good a response as the contingent one and is recommended for routine use in children with diurnal enuresis. Twenty three per cent of those who responded to treatment relapsed up to two years after completion of the trial. PMID- 3548604 TI - Urinary nitrite in symptomatic and asymptomatic urinary infection. AB - The dipstrip test for urinary nitrite is fairly unreliable in symptomatic urinary infections and only 104 (52%) of 200 symptomatic children with urinary infection attending an emergency department had a positive result. The test yielded positive results, however, in 83 of 100 outpatients with largely asymptomatic urinary infection attending a follow up clinic because of known predisposition to urinary infection. This difference was highly significant. The finding of urinary nitrite is highly specific for urinary infection and only 1% of 300 uninfected urine specimens gave a positive result. After addition of a broth culture of Escherichia coli to sterile urine incubation at 37 degrees C for four to six hours was required before the nitrite test yielded positive results. This suggests that frequency of micturition in urinary infection reduces the reliability of the nitrite test. On the other hand, the use of overnight, first morning urine specimens may further improve the sensitivity. If nitrite testing is used for screening for urinary infection at home, however, patients should be warned not to rely on a negative result in the presence of symptoms of urinary infection. PMID- 3548605 TI - The immunocytochemical localization of new soluble placental tissue proteins (PP14, 16, 17, 19, 20 and PP21) in human and cynomolgus monkey placentae. AB - Apparently Placenta-specific placental tissue proteins (PP14 and PP17) and solitary tissue proteins (PP16, 19, 20 and PP21) were investigated by avidin biotin immunoperoxidase technique in the human and cynomolgus monkey placentae, membranes, decidua and umbilical cords. In human early placentae, PP14, 16, 17, 19 and PP21 were localized mainly in the cytoplasm of villous syncytiotrophoblast. PP20 was localized in the cytoplasm of basal chorionic trophoblasts. In human term placentae, positive stainings for PP16, 19 and PP21 were observed mainly in all kinds of trophoblastic cells, while positive stainings for PP14, 17 and PP20 were weakened in the trophoblastic cells. PP20 was clearly localized in the cytoplasm of Hofbauer-like cells in the villous stroma. The membrane of villous syncytiotrophoblast showed strongly positive stainings for PP21. PP21 was also localized in the membrane of amniotic and umbilical epithelium. The umbilical epithelium was cytoplasmically positive for PP14, 16 and PP20. Clear positive stainings for PP14 and PP21 were found in the cytoplasm of fetal polymorphonuclear neutrophils. All of the placental proteins were immunocytochemically positive in the decidual large cells. In the cynomolgus monkey placentae, similar immunostaining results were obtained. The monkey could, thus, serve as a model for the investigation of the placental proteins. PMID- 3548606 TI - [Relative influence of the variables associated with kidney transplants from cadavers]. PMID- 3548607 TI - [Analysis of the incidence of seminal and prostatic lithiasis by transrectal echography]. PMID- 3548608 TI - Adherent cells from rheumatoid synovia: identity of HLA-DR positive stellate cells. AB - Rheumatoid synovia were enzymatically digested and the in vitro morphology of different types of plastic adherent cells was observed. Four main types of cells were found after 24 hours in culture: stellate cells which had nuclei resembling those of classical cultured fibroblasts, but which stained positively with I2 antibody (anti-HLA-DR antibody); fibroblastic cells; cells which resembled morphologically in vitro macrophages and which were I2 and OKM-1 positive; round monocytes. The stellate cells did not stain with anti-S-100 or OKT-6 antibodies, which are used to detect classical antigen presenting dendritic cells. Furthermore, in the presence of indomethacin the stellate shaped cells were replaced by new I2 positive cells with a typical fibroblast shape. These results support the view that the stellate cells in synovial cell cultures represent HLA DR positive fibroblasts, probably B cells of synovial lining. PMID- 3548609 TI - [History of 80 years of observations and studies on theileriasis in Zaire, Rwanda and Burundi]. PMID- 3548611 TI - Imipenem (N-F-thienamycin) versus netilmicin plus clindamycin. A controlled and randomized comparison in intra-abdominal infections. AB - In a randomized study the clinical and bacteriologic effectiveness of imipenem was compared with the classical combination of netilmicin with clindamycin in patients who had surgery for an intraperitoneal infection, localized or generalized, with positive bacteriologic findings of the specimen taken at surgery. Excluded were all patients who received other antibiotics before surgery, or who died within 3 days after antibiotic therapy was started. Imipenem was given at a dose of 500 mg t.i.d., clindamycin 600 mg t.i.d., and netilmicin according to serum levels. The diagnoses ranged from postoperative peritonitis, gallbladder empyema, perforated gastroduodenal ulcer, small bowel perforation with and without obstruction, and perforated appendicitis to perforation of the colon. The bacteriologic work-up included examination of the primary specimen (aerobic and anaerobic), the urine, feces, and serologic testing for Candida albicans once or twice a week and after the course of antibiotic therapy. In addition, pH measurements of abscesses and drainage fluids were performed. Ninety three patients entered the study. Forty-seven patients were treated with imipenem (test group), and 46 patients were treated with the combination therapy (control group). The two groups did not show significant differences in age, sex, diagnostic groups, risk factors, primary bacteriology, and duration of therapy (mean: 6.7 days). Thirty-eight patients (80.9%) treated with imipenem were cured, six patients (12.8%) were improved, and there were three (6.4%) failures. The respective numbers for the control group were 31 (67.4%), 10 (21.7%), and 5 (10.9%). The mean duration of hospitalization was 19 days for the test group and 24.5 days for the control group. There were four wound infections in the test group and 11 wound infections in the control group. Imipenem is at least as effective in the adjuvant therapy of intra-abdominal infections as the combination of netilmicin with clindamycin. PMID- 3548610 TI - Usefulness of selective arterial secretin injection test for localization of gastrinoma in the Zollinger-Ellison syndrome. AB - Secretin was injected into a feeding or nonfeeding artery of a gastrinoma and blood samples were taken from the hepatic vein (HV) or a peripheral artery (PA) to measure the changes of serum immunoreactive gastrin concentration (IRG). The IRG in the HV rose within 40 seconds and in the PA rose within 60 seconds after the injection of secretin into a feeding artery, but not after secretin was injected into a nonfeeder. These results indicated that secretin directly stimulates a gastrinoma to release gastrin in vivo. The selective arterial secretin injection test (SASI test) was applied in three patients in whom gastrinomas could not be located by computed tomography, ultrasonography, or arteriography, and functioning gastrinomas were located in all three patients. In one patient, malignant gastrinomas in the head of the pancreas and in the duodenum could be resected radically with the help of this test. PMID- 3548613 TI - Laryngotracheal trauma. AB - Laryngotracheal trauma can be an immediately life-threatening injury. Failure to recognize such injuries and promptly secure an airway may have fatal consequences. Failure to recognize acute injuries or to observe the principles of management can lead to laryngotracheal stenosis. We have seen 10 patients with acute injuries. Blunt trauma was responsible in 5, penetrating trauma in 4, and iatrogenic injury in 1. Esophageal transection was present in 1 patient. Thoracotomy was required in 2 patients with injury of the carina, and cervical exposure was adequate in 8. All patients underwent successful repair of the injuries. Seventeen patients have been treated for delayed traumatic laryngotracheal stenosis. Vocal cord paralysis was apparent in 14. Concomitant esophageal injury was repaired in 4 patients. Eight patients required intralaryngeal procedures prior to repair of the laryngotracheal stenosis. All patients except 1 have a good airway, and 16 of the 17 have a good voice. PMID- 3548612 TI - The effect of stress level, amino acid formula, and nitrogen dose on nitrogen retention in traumatic and septic stress. AB - Eighty-seven patients were entered into a randomized, prospective, double-blind, six-center study to evaluate the effect of amino acid loading and a formula that was branched chain enriched (50%) on nitrogen retention in metabolic stress. The patients had varying levels of metabolic stress (0-3) after major surgery, polytrauma, or surgical sepsis. The study was isocaloric and isonitrogenous and lasted for 7 days. The patients received either a standard amino acid formula (SAA) (Travasol) or a 50% branched chain enriched formula that was equimolar, leucine, isoleucine, and valine (MAA) (Travasol + Branchamin concentrate) at a dose of 1.0-2.0 g/kg/day in a fixed ratio with 114 glucose calories per gram of nitrogen administered. The nitrogen retention was proportionate to the nitrogen (and, therefore, caloric) load in both groups. The MAA group, however, had better nitrogen retention, reached nitrogen equilibrium at a lower dose of amino acids, and had less urinary nitrogen excretion per gram of nitrogen administered. Since the groups were isonitrogenous and the calorie to nitrogen ratios were fixed, it appears that nitrogen equilibrium in surgical stress is proportionate to the amino acid load over a range of 0.05-0.4 g/kg/day of nitrogen; and that MAA are more efficient at inducing nitrogen retention and a reduction in urea excretion. These effects on nitrogen retention were more significant at level 2 stress or greater. At these higher stress levels, a dose of 2 +/- 0.2 g/kg/day of MAA seemed most efficient in promoting nitrogen retention. PMID- 3548614 TI - Esophageal mucocele: a complication of blind loop esophagus. AB - Mucocele of the bypassed esophagus is an unusual complication of esophageal replacement and has been described only in isolated references. This report is based on our experience with 6 patients in whom a mucocele developed following esophageal replacement. Esophageal replacement was performed on 37 patients over a 10-year period at the Medical College of Georgia Hospital. A symptomatic mucocele requiring excision developed in 3 patients with achalasia, 1 with congenital tracheoesophageal fistula, 1 with esophageal atresia, and 1 with inflammatory stricture. Conduits used included stomach (4), reversed gastric tube (1), and colon (1). Our experience indicates that conversion of a closed-loop esophagus into a symptomatic mucocele is more likely in the presence of functioning, chronically irritated mucosa. The clinical features were referable to the mucocele itself or respiratory embarrassment therefrom. Thoracic roentgenograms and computed tomographic scans were diagnostic in verifying the presence of the esophageal mucocele. All five mucoceles arose from squamous epithelium. One of 3 patients with achalasia in whom a mucocele developed following esophageal replacement had premalignant changes in the mucosa. Based on this experience, our treatment of choice is early, complete excision of the mucocele. PMID- 3548615 TI - Experimental aerobic-anaerobic thoracic empyema in the guinea pig. AB - The clinical and pathological features of experimental aerobic-anaerobic thoracic empyema in the Duncan-Harley guinea pig are described. Thoracic empyema development and early death (less than 14 days after bacterial inoculation) were noted after various concentrations and species were inoculated into the pleural space with a piece of umbilical tape, which was used as a cofactor. The effect of concomitant hemothorax was also tested. Gram-negative infection was found to have a more virulent course than Gram-positive infection in the thoracic cavity. Moreover, these findings support the thesis that intrathoracic inoculation of anaerobic bacteria, even in combination with other anaerobic species, fails to produce clinical empyemas. However, anaerobic bacteria appear to enhance synergistically the virulence of sublethal and subempyema-forming concentrations of aerobic bacteria such as Staphylococcus aureus and Escherichia coli. PMID- 3548616 TI - Effect of preoperative antiplatelet drugs on vascular prostacyclin synthesis. AB - Patients undergoing aortocoronary bypass using autogenous saphenous veins were randomly divided into three comparable groups. Group 1 (n = 10) acted as a control, Group 2 (n = 14) received 80 mg of aspirin at midnight before the operation, and Group 3 (n = 12) received 80 mg of aspirin and 75 mg of dipyridamole at midnight and an additional 75-mg dose of dipyridamole at 6 AM. The purpose was to determine which regimen would maximally inhibit platelet function without depressing vascular prostacyclin synthesis. Serum thromboxane A2, saphenous vein wall and aortic wall prostacyclin, platelet aggregation, and bleeding time were measured in all patients. None was restarted on a regimen of aspirin or dipyridamole postoperatively. Aspirin alone and in combination with dipyridamole significantly inhibited thromboxane A2 and platelet aggregation in all treated patients but spared venous prostacyclin synthesis. Aortic prostacyclin synthesis was partially inhibited in both treated groups. Chest tube drainage was comparable in all three groups. These results indicate that the combination of aspirin and dipyridamole offers no measurable advantage over aspirin alone in the perioperative period. PMID- 3548617 TI - Legionnaires' disease: an emerging surgical problem. AB - Legionnaires' disease is an important, although often overlooked, complication in the patient postoperatively. Up to 50% of all nosocomial legionellosis in the hospitals reviewed was found in surgical patients. Patients undergoing a transplant procedure are at highest risk, but occurrence is common in the surgical patient undergoing general anesthesia, endotracheal intubation, or both. Aerosolization, aspiration, and direct instillation of contaminated water during manipulation of the respiratory tract are likely mechanisms of transmission. The usual clinical presentation is that of a nonspecific pneumonia. Specialized laboratory techniques including selective culture media, direct fluorescent antibody stains, and serological detection of antibodies are necessary for accurate diagnosis. If these tests are not routinely available, Legionnaires' disease may remain undiagnosed. Environmental surveillance of the hospital water distribution system is advisable for hospitals with a large surgical case load. If transplantation is performed, such surveillance is mandatory. PMID- 3548618 TI - Alfred Blalock and thymectomy for myasthenia gravis. AB - In 1936, Alfred Blalock performed the successful removal of a thymic tumor in a patient with myasthenia gravis. The patient experienced marked and sustained improvement for several years. Blalock prophesized then that exploration of the thymic region would be indicated in all patients with severe myasthenia gravis. A few years later, in 1941, he applied this theory by introducing thymectomy for nonthymomatous myasthenia and achieved similar improvement. Despite modern sophisticated knowledge about the disease and advances in thoracic surgical techniques, Blalock's original observations remain valid, and thymectomy has become a standard treatment for myasthenia gravis the world over. PMID- 3548619 TI - Surgery for carcinoma of the esophagus. PMID- 3548620 TI - Invertebrate spermatozoa--structure and spermatogenesis. PMID- 3548621 TI - Memorial lecture: Verzar's ideas on the age-dependent protein cross-linking in the light of the present knowledge. AB - This lecture was aimed to commemorate the centenary of the birthday (18 September 1886) of Fritz Verzar, one of the most important European founders of experimental gerontology. He was an exceptionally creative scientist who contributed considerably to the development of physiology in this century: he achieved important results in the fields of intestinal absorption, in the adrenal gland's function, and finally, from 1952 until his death (1979), he was creator, promotor and one of the best leaders of experimental gerontology. His idea about the age-dependent cross-linking of protein molecules as a general cause of cell aging--studied by him mainly using the collagen as a model, however, extended also to the nucleoproteins--was a pioneer's work. Yet, its significance was not immediately recognized, the contemporary scientists could not interpret his thoughts in the terms of test-tube biochemistry. However, about a decade later, in the sixties and afterwards, an increasing body of evidence has been accumulated indicating that Verzar was right: the most general age-dependent alteration of the proteins in the living systems known so far is a posttranslational modification of their structure and conformation due to the aggressive effects of the oxygen free radicals. Consequences of these thoughts are being realized nowadays in theory and practice. The present generation of scientists expresses its respect and recognition to Fritz Verzar whose life and activity have been teaching us that aging can be understood, if we find the proper theoretical approach to it. PMID- 3548622 TI - Cellular aging of the reticuloendothelial system. AB - The reticuloendothelial system (RES) consists of macrophages and other endocytic cells which contribute to natural resistance to disease agents. The RES has been implicated as being partly responsible for the observed age-related decrease in resistance to pathogenic microorganisms in man and experimental animals. It is largely unknown to what extent age-related deficiencies in specific functions of reticuloendothelial cells contribute to the decrease of RES functions. This study describes experiments focussed on Kupffer and endothelial cells of the liver which represent a major part of the RES and are primarily responsible for clearance of potentially harmful substances from the circulation. The age-related changes in the clearance of a RES test colloid (heat-aggregated colloidal albumin (CA)) and of E. coli endotoxin were investigated using female BN/BiRij rats of various age groups. With CA, studies were performed on the plasma clearance and on the endocytic capacity of whole liver and of Kupffer and endothelial cells in vivo, as well as on the kinetics of endocytosis by Kupffer cells in culture. The results showed that the plasma disappearance of endotoxin was significantly prolonged in rats of 24 and 36 months resulting in an increase in half-life of about 50% as compared to young rats. The plasma clearance of CA, the uptake by the liver and the endocytosis by endothelial cells were unchanged with age. In contrast, an age-related decrease in endocytic capacity was observed in Kupffer cells in vivo and in Kupffer cells which were isolated from rats of various ages and maintained in culture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548623 TI - Influence of environmental stress on lipofuscin production. AB - The Corollospora maritima, a marine ascomycete, has been used as an experimental model to investigate the possibility that age pigments can be considered indicators also of environmental stress. Synthetic sea water enriched with iron or copper has been inoculated in a broth culture of the fungus. After 5 days of incubation the mycetes were assayed for lipofuscin fluorescent pigment and malondialdehyde content. The presence in the culture medium of the heavy metal ions results in an increase of the lipofuscin and malondialdehyde production. The same evidence has been obtained with sea water samples collected at seven sites along the coast of the Gulf of Naples (Italy): the lipofuscin and malondialdehyde production increases proportionally with the copper and iron pollution in the sea water. PMID- 3548624 TI - Systemic salmonellosis in patients with disseminated histoplasmosis. Case for 'macrophage blockade' caused by Histoplasma capsulatum. AB - Five patients are described with disseminated histoplasmosis and systemic salmonellosis. Four of these patients were also immunocompromised because of the acquired immunodeficiency syndrome in two patients and renal transplantation in another two patients. Histologic studies in two patients showed histiocytes that were heavily laden with Histoplasma capsulatum yeast-phase organisms. We postulate that diffuse parasitization of the reticuloendothelial system (RES) by Histoplasma organisms may cause "RES blockade," which then predisposes to systemic salmonellosis, as reported in certain other infections and in sickle cell anemia. PMID- 3548625 TI - The deadly hookworm. Why did the Puerto Ricans die? PMID- 3548626 TI - Ketoconazole in the prevention of candidiasis in patients with cancer. A prospective, randomized, controlled, double-blind study. AB - A prospective, randomized, controlled, double-blind study was performed between 1982 and 1985 to assess the ability of ketoconazole to prevent fungal infections in selected patients with cancer. Fifty-six patients receiving induction chemotherapy for acute leukemia, autologous bone marrow transplant for refractory nonhematopoietic malignant neoplasms, multidrug chemotherapy for malignant lymphoma, or corticosteroids for brain metastases were randomized to receive either oral ketoconazole, 400 mg/d, or placebo and observed until leukopenia resolved or corticosteroid therapy was stopped. Oral candidiasis developed in eight (28%) of 29 patients receiving placebo compared with none of 27 receiving ketoconazole. However, ketoconazole failed to prevent Candida esophagitis and vulvovaginitis in two patients and one patient, respectively. Furthermore, prophylactic use of ketoconazole did not significantly alter the total number of hospital days, febrile days, or antibiotic days or the requirement for amphotericin B in patients with acute leukemia and autologous bone marrow transplant. Since oral candidiasis can be successfully managed by several different treatment modalities when it does occur, we do not think that the routine prophylactic use of ketoconazole is justified. PMID- 3548627 TI - Magnesium in the prevention of lethal arrhythmias in acute myocardial infarction. AB - Seven of 48 patients (14.6%) with acute myocardial infarction who were given 2.4 g of magnesium sulfate as a single intravenous dose had potentially lethal arrhythmias during the first 24 hours after admission, whereas 16 (34.8%) of 46 patients receiving placebo had similar arrhythmias. In addition, 14 of these 16 patients in the placebo group had their first arrhythmia (in the intensive coronary-care unit) within two hours after the start of the study, whereas in the magnesium-treated group, there were no such arrhythmias until some four hours later. The higher the lymphocyte potassium concentration, the greater the reduction in the incidence of arrhythmias. Serum magnesium levels increased by 16.5% and lymphocyte magnesium concentrations by 72% in the magnesium treated group. Intravenous magnesium reduces the incidence of serious arrhythmias after acute myocardial infarction. PMID- 3548628 TI - Incorporation of mannoproteins into the walls of aculeacin A-treated yeast cells. AB - Inhibition of the synthesis of alkali-insoluble glucan by aculeacin A in Saccharomyces cerevisiae cells caused a decrease in the incorporation of a high molecular weight heterogeneous mannoprotein material and of a 33,000 mannoprotein into the wall network. This was concomitant with the excretion of the latter molecule into the growth medium. Regenerating yeast protoplasts liberated considerable amounts of the heterogeneous material to the medium independently of the presence of aculeacin. The protoplast walls did lack this component and contained only minor amounts of the 33,000 molecule, which was also completely absent from walls of aculeacin-treated protoplasts. Considerable levels of the 33,000 species were immunodetected in the supernatants from treated and untreated protoplasts. These results point to the existence of specific interactions between the glucan network of the yeast cell surface and some of the wall mannoproteins. On the other hand, the presence of a population of SDS solubilizable mannoproteins in the wall was independent of glucan levels. PMID- 3548629 TI - Evaluation of halothane anaesthesia with intermittant positive pressure ventilation in buffalo calves (Bubalus bubalis). PMID- 3548630 TI - [The postnatal behavior of immunoglobulin levels and T-lymphocyte count in piglets of the mini-Lewe breed]. PMID- 3548631 TI - [Seriousness of severe acquired aplastic anemia in children. Apropos of 32 cases]. AB - Thirty-two cases of severe aplastic anemia in children less than 16 years of age, observed between 1967 and 1985 in the Rhone-Alpes area were studied retrospectively. A toxic cause was suspected in 7 cases, an hepatitis in 5 cases. Patients presented with 2 of the 3 following cytopenias during the 3 weeks following diagnosis: hemoglobin level below 100 g/l, reticulocyte count lower than 20 G/l, neutrophil polymorphonuclear leukocyte count below 0.5 G/l, platelet count lower than 20 G/l. Whatever the treatment, prognosis was poor: 6 surviving patients (18.7%). Nineteen patients did not undergo bone marrow transplantation: only 2 are surviving after 4 years, one after low dose corticosteroid therapy, the other after antilymphocyte globulins and androgen therapy; 10 of 17 deaths occurred in the first 4 months. Thirteen bone marrow transplantations from sibling donors, of which 10 HLA A, B DR identical and 3 haploidentical allowed for 8 prolonged takes but only 4 survivors of whom 2 lasted for more than 2 years. PMID- 3548632 TI - [Allogeneic bone marrow transplantation in acute lymphoblastic leukemia of children. Analysis of prognostic factors. GEGMO (Bone Marrow Study Group) study]. AB - Sixty-five children with acute lymphoblastic leukemia (ALL) underwent allogenic bone marrow transplantation (BMT) from an HLA identical donor, following cytoreduction with cyclophosphamide and total body irradiation (TBI): 15 were transplanted in 1st remission, 43 in 2nd and 7 in 3rd or in 4th. The Kaplan Meier estimate of surviving disease free at 4 years post BMT was 49.9% and the probability of continued remission at 4 years was 63.3%. Fourteen patients relapsed between 90 and 690 days (mean: 240 +/- 88) post BMT. The other causes of BMP failure included: graft versus host disease, veno-occlusive disease and sepsis. No interstitial pneumonitis has been reported. Patients who had a relapse while on chemotherapy had a higher probability of relapse than those who had a relapse while off therapy (p less than 0.01). We conclude that allogeneic BMT is the treatment of choice for children with ALL in second hematologic remission, the interval between diagnosis and first relapse being the most significant prognostic factor. Patients with poor prognosis might benefit from a more intensive chemotherapy/total body irradiation schedule or a BMT earlier in the course of their disease. PMID- 3548633 TI - [Allogeneic bone marrow transplantation in the treatment of acute leukemias of children. Study of 26 patients]. AB - Twenty-six children with acute leukemia were treated with allogeneic marrow transplantation from HLA identical siblings after a conditioning regimen with Cyclophosphamide-total body irradiation (19 patients), Melphalan-total body irradiation (6 patients) or Busulfan-cyclophosphamide (1 patient). Eighteen were transplanted in complete remission (4 with acute non lymphoblastic leukemia in first remission, 14 with acute lymphoblastic leukemia: 6 in first, 6 in second and 2 in subsequent remission): 2 died of cytomegalovirus pneumoniae, 1 relapsed and 15 survive in continuous complete remission from 5 to 42 months after transplantation (median = 22 months). Eight were transplanted in relapse, 7 achieve complete remission, 5 of them relapsed, 1 died of G.V.H. and 1 survives in continuous complete remission 46 months after transplantation. Actuarial analysis shows a disease free survival rate at 3 years of 82% for patients transplanted in remission and 12% for patients transplanted in relapse (p less than 0.01). PMID- 3548634 TI - [Generalized BCG infection, with a favorable outcome, in a 3-month-old immunocompetent infant]. AB - A 3 month-old infant vaccinated with BCG at birth presented with granulomatous hepatitis with BCG isolated in the liver. Splenomegaly, infiltrates in both pulmonary apices and hilar adenopathies were simultaneously present. No immune deficiency could be found. Complete recovery followed specific polychemotherapy. Parenchymal calcifications appeared in the liver, spleen, lungs and mesenteric ganglia. PMID- 3548635 TI - [Infantile diarrhea in Libreville (Gabon). Ecological studies]. AB - The identification of different infectious agents found in infantile diarrheas was undertaken in 237 children hospitalized in pediatric institutions in Libreville. In neonates between 0 and 18 months of age, the most common pathogen was Rotavirus (20.6%), followed by Shigella (10.8%), E. coli (9.24%), Salmonella (3.46%), E. histolytica (0.8%) and Y. enterocolitica (0.4%). The highest percentage of diarrheas caused by rotaviruses was found among children between 6 and 11 months of age. The frequency of Salmonella among children 2 to 4 years of age is almost the same at that in children under 2 years of age (3.44%). Isolation of Shigella in this group reaches 12.06%. The protective effect of breast milk and the carriage state among adults are discussed. PMID- 3548636 TI - [Taurine in human nutrition]. PMID- 3548637 TI - Biochemical changes during clomipramine treatment of childhood obsessive compulsive disorder. AB - Peripheral measures of serotonergic and noradrenergic function were obtained in 29 obsessive-compulsive adolescents and 31 age- and sex-matched controls, as well as in a subsample of 22 patients after five weeks of treatment with clomipramine hydrochloride (134 +/- 33 mg/d) (mean +/- SD) given in a double-blind placebo controlled trial. Drug-free obsessive-compulsive subjects did not differ from controls on measures of platelet serotonin and monoamine oxidase (MAO) activity, nor on plasma epinephrine or norepinephrine concentrations at rest and after a standard orthostatic challenge procedure. Compared with placebo, treatment with clomipramine was clinically effective and produced a marked decrease in platelet serotonin concentration, a trend toward a reduction in platelet MAO activity, and a rise in standing plasma norepinephrine. Clinical improvement during drug therapy was closely correlated with pretreatment platelet serotonin concentration and MAO activity, as well as with the decrease in both measures during clomipramine administration. This suggests that the effects of clomipramine on serotonin uptake may be essential to the antiobsessional action observed. PMID- 3548638 TI - Use of pattern analysis to identify true drug response. A replication. AB - In any antidepressant study, placebo response in patients assigned active drug is a troubling source of variance. There have been few attempts to identify the patients whose conditions improve as a result of true drug effect, in contrast with improvement that is a result of nonspecific effects. In a previous report we demonstrated that true drug effect seemed to be characterized by a two-week delay in onset and persistence. We described a method of pattern analysis to identify such patients. In this report, we describe the use of pattern analysis to replicate our initial findings. Data from a new sample of 150 nonmelancholic patients support the hypothesis that true drug effect is characterized by a two week delay in onset and persistence of improvement, once achieved. There was little evidence of the onset of antidepressant effect before two weeks. The theoretical and clinical implications of this work are discussed. PMID- 3548639 TI - [Chemotherapy alternatives, problems and outlook in testicular tumors]. AB - The treatment of testicular tumors is among the most impressive examples of progress in tumor chemotherapy. At present, a complete remission can be achieved with the world-wide adopted standard therapy Cisplatinum/Vinblastine/Bleomycin in 50-80% of the cases. Whether these remissions are equivalent to healing remains to be established in long-term studies; at any rate, they are long-term palliations. Main problems of further research are the high-risk patients. Approaches to reach complete remissions and thus long-term palliations or healing, consist in increase of combination, dose escalation with Cisplatinum, introduction of novel substances (Etoposide, Ifosfamide etc.). The latter field is scientifically underdeveloped, as is the field of second- and third-order therapy. After all, chemotherapy of testicular tumors--similarly as treatment of leukemia--is an oncological intensive therapy that should be restricted to specialized centers. PMID- 3548640 TI - [Adjuvant chemotherapy of breast cancer: an international review and the Swiss experience]. AB - Initially somewhat exaggerated expectations about increased cure rates from adjuvant chemotherapy in operable breast cancer have been fulfilled only partially up to this date. However, most of the randomized, prospective and all of the historically controlled trials have revealed significantly decreased relapse and (less impressive) also death rates (expected mortality ratio) 5 and more years after mastectomy. Not all patient subgroups seem to benefit equally from adjuvant chemotherapy: its effectiveness seems to be more pronounced in pre- than in post-menopausal women and in those with only 1-3 instead of 4 and more tumor-positive homolateral axillary lymph nodes. Adjuvant combination chemotherapy seems to be more effective than monochemotherapy. Shortening of adjuvant CMF from 12 to 6 cycles gives the same result with definitely less toxicity. Adjuvant Tamoxifen probably is yielding similar results as adjuvant CMF (or other combinations) in post-menopausal, hormone-receptor positive women, but neither its long-term impact on survival nor the necessary treatment duration with antiestrogens are clearly known today. The value of adjuvant chemo- and hormone-therapy in node-negative women is still controversial, although at least hormone-receptor negative, node-negative patients exhibit the same risk of relapse and ultimate prognosis as do node-positive women. After 8-15 years of median follow-up in controlled studies, there seems to be no increased, but rather a decreased risk of second malignancies and also late leukemias in women treated with temporary adjuvant chemotherapy. Optimizing effectiveness and practicability of adjuvant chemo- (and also hormono-) therapy requires additional carefully controlled clinical studies, especially in high risk patients with more than 3 tumor-positive axillary nodes. PMID- 3548641 TI - [Chemoembolization of the hepatic artery combined with intraportal cytostatic infusion--a new concept in the regional chemotherapy of liver metastases]. AB - At present international the regional cytostatic chemotherapy for hepatic metastases is used by the intraarterial way. Newest methods are the technically very pretentious intraarterial perfusion with venous hemofiltration and the chemo embolization of the hepatic artery requiring meanwhile an adjuvant systemic chemotherapy because the chemo-embolization influences only the arterially supplied part of the metastases. By the combination of the transumbilical intraportal chemotherapy formerly developed in the Central Institute for Cancer Research Berlin-Buch with the intraarterial chemo-embolization it is possible to reduce considerably the technical expenditure and to increase the regional concentration of cytostatics simultaneous avoiding the load of the whole organism. The bases of this new method and the technical procedure are discussed. PMID- 3548642 TI - [The early history of biliary tumor surgery in Germany]. AB - By means of the famous German gall-system surgeon Hans Kehr (1862-1916) the level of the cancer surgery concerning the biliary organs in the late 19th and the early 20th century is represented. The violent progress in gall-stone surgery led to an intensive employment of the carcinomas too. The knowledge carried through, that the malignant tumors of the biliary tract are curable only by the surgical treatment. Like today the diagnosis of the gall-bladder carcinoma was the greatest problem. Within the bounds of his scientific work Hans Kehr plead for the surgical intervention instead of the medication and invented many new operative methods. PMID- 3548643 TI - [Hypotheses: The adaptation of cancer strategy to progress in tumor immunology. General cancer prevention, metastasis prevention and the combination of classical cancer therapies with O2 multistep immunostimulation]. AB - The numerical development of cancer cells during tumor growth and under current forms of therapy is quantitatively described as a fundament of a scientifically founded anticancer strategy. As to general cancer prevention, suppression of metastasis and reduction of recurrencies, figures for orientation are derived, which allow to assess the minimal number of malignant cells to be killed. The killing potency of current tumor immunological measures has been not so far sufficient enough to have a good chance for achieving these pretentious goals. The mean reyason for this to be supposed the neglection of the oxygen status of the body and its dynamics. This is a surprising fact, since all immunological mechanisms are known to be energy-, i.e., oxygen-dependent. The experimentally confirmed correlation between the effectiveness of body defense and the quality of the oxygen status was the origin of several variants of the oxygen multistep immunostimulation concept (application of immunostimulators combined with the oxygen multistep therapy). Clinical results reflect the remarkable increase of the cell-killing potency achievable by these measures and give reasons for the adaptation of anticancer strategies to progress in tumor immunology. Furthermore, real methodological proposals are made for general cancer prevention, suppression of metastasis, and reduction of recurrencies, and the concept of a combined therapy is developed. This therapy comprises the currently accepted measures, such as surgery, irradiation and drugs, and the adjuvant O2 multistep immunostimulation, which is applied three-fold according to a specific schedule. The advantage of this combination is that the patient comes first into the enjoyment of all the beneficial effects that established regimens can offer for the particular case. Then and moreover, the patient gains better quality of life, because the adverse side-effects of radiation and drugs are attenuated and, finally, the individual gets a fair chance of stopping the progression of the disease. PMID- 3548644 TI - Coronary vasculitis. A review in the current scheme of classification of vasculitis. AB - Coronary artery disease is overwhelmingly atherosclerotic in nature, but inflammatory disease of the coronary arteries can be just as life-threatening a cause of ischemic heart disease in all age groups. Coronary vasculitis is not short in variety; as a clinicopathologic entity it spans the entire spectrum of systemic vasculitides. Coronary vasculitis is most closely associated with the polyarteritis group of necrotizing angiitis, vasculitis of collagen-vascular disease, and granulomatous giant cell arteritis. This article provides an overview of coronary vasculitis as an independent entity as well as a manifestation of systemic vasculitis, both the common and the uncommon varieties. PMID- 3548646 TI - Medicare's three-hour rule. PMID- 3548645 TI - CAP Comprehensive Blood Bank Survey--1984. AB - An average of 2750 laboratories participated in the 1984 Comprehensive Blood Bank Survey of the College of American Pathologists. Results from 16 laboratories were utilized to validate results and assure maintenance of specimen character during shipment. Results of ABO grouping, D typing, special antigen typing, antibody detection, and antibody identification by participants remained good and are discussed. Special ungraded samples were provided as additional challenges. The results of these studies and the responses to supplementary questions are discussed. PMID- 3548647 TI - Simultaneous cadaver renal and pancreas transplantation in type I diabetes. AB - Between February 1985 and April 1986, we performed 11 simultaneous cadaver kidney and segmental pancreatic transplants in patients with type I diabetes. There were nine men and two women ranging in age from 25 to 47 years (mean, 38.5 years). All pancreatic grafts were extraperitoneal, and the pancreatic duct was managed by pancreaticocystostomy utilizing an internal stent. Three patients died from two to six weeks postoperatively of septic complications. Four pancreatic grafts were functioning at 2, 5, 11, and 14 months after operation, and eight patients had had functioning renal allografts from two to 14 months (mean, 6.8 months) with a mean serum creatinine level of 2.4 mg/dL (210 mumol/L). Graft failure occurred in the other four patients from vascular thrombosis (three patients) or hemorrhagic pancreatitis (one patient). Significant morbidity included an infected arterial anastomosis (two patients), pancreatic fistulas (four patients), and bladder leak (four patients). In conclusion, this procedure is an effective option for selective diabetics with end-stage renal disease. Although technical complications were frequent, no adverse effect on renal allograft function was evident. With technical refinements, this procedure should be applicable to most type I diabetics with renal failure. PMID- 3548648 TI - Preclinical safety testing of species-specific proteins produced with recombinant DNA-techniques. An attempt to transfer current experience into future testing strategies. AB - Preclinical toxicity studies in animals with species-specific recombinant DNA products have now been performed for several years. An interim statement on the significance of these animal tests and their ability to predict adverse effects in humans therefore appears indicated, with the aim of deducing future testing strategies. The experience accumulated so far shows that the animal models have failed to predict adverse effects subsequently observed in man. Immunogenicity of these proteins further restricted the usefulness of standard toxicity tests. There is also increasing evidence that animal tests on the toxic potential of impurities contained in the products are markedly inferior in sensitivity to analytical and quality control methods. Thus, modified testing programs are proposed to demonstrate safety rather than target organ toxicity using rodents and small non-rodent species and restricted dosing; furthermore the study duration should be limited by the detection of immunogenic responses. PMID- 3548649 TI - cis- and trans-1,2-diphenylaziridines: induction of xenobiotic-metabolizing enzymes in rat liver and mutagenicity in Salmonella typhimurium. AB - trans-Stilbene imine (trans-1,2-diphenylaziridine) is the nitrogen analog of trans-stilbene oxide, a potent inducer of several microsomal and cytosolic xenobiotic-metabolizing enzymes. Although the acute toxicity of cis- and trans stilbene imines prevents their application at the usual dose for trans-stilbene oxide (400 mg/kg/day), it is apparent that the imines nevertheless potently induce several xenobiotic-metabolizing enzymes in rat liver. The IP administration of trans-stilbene imine resulted in statistically significant increases in the activities of aminopyrine N-demethylase, microsomal epoxide hydrolase, glutathione transferase (toward 1-chloro-2,4-dinitrobenzene, 1,2 dichloro-4-nitrobenzene and delta 5-androstene-3,17-dione) and UDP glucuronosyltransferase (toward testosterone). cis-Stilbene imine was less potent in inducing these activities. Although trans-stilbene imine (total dose = 400 mg/kg) was more potent than trans-stilbene oxide (total dose = 1200 mg/kg) in inducing the activities of glutathione transferase (toward 1-chloro-2,4 dinitrobenzene) and UDP-glucuronosyltransferase (toward testosterone), both compounds belong to the class of substances which are more potent inducers of conjugating (phase II) enzymes. Because of their structural similarity with K region arene imines which are potent mutagens, cis-stilbene imine and trans stilbene imine were investigated for mutagenicity (reversion of his- strains of Salmonella typhimurium). cis-Stilbene imine and trans-stilbene imine were direct mutagens in the strain TA100. This result, and the finding that acenaphthene 1,2 imine efficiently reverts various strains of Salmonella typhimurium, demonstrates that not only K-region arene imines, but also other aziridines substituted at the two carbons with aromatic moieties, are mutagenic. PMID- 3548650 TI - Urinary trehalase as an early indicator of cadmium-induced renal tubular damage in rabbit. AB - The significance of urinary trehalase as a possible early indicator of renal disorder was examined using Cd-treated rabbits, which received 1 mg/kg Cd thrice weekly for 3 months subcutaneously. The results showed that urinary trehalase increased significantly from 1 week after treatment, earlier than LAP, ALP, proteinuria and glucosuria, with no changes in plasma trehalase level. A marked decrease in trehalase activity in renal brush border membranes prepared from Cd treated rabbits was observed. It was also confirmed by immunohistological techniques that Cd treatment resulted in a marked decrease in specific fluorescence compared with controls. Ouchterlony double diffusion analysis demonstrated that urine and renal brush border extracts formed precipitation lines against anti-renal trehalase IgG, indicating that urinary trehalase and renal trehalase had the same antigenicity. Therefore, the facts presented here would suggest that urinary trehalase originated from the renal brush border, indicating its superiority as a diagnostic tool over other indicative indicating its superiority as a diagnostic tool over other indicative enzymes like LAP and ALP in detecting injury to renal proximal tubular cells in the early stage. PMID- 3548652 TI - [The immune complex]. PMID- 3548651 TI - Serological evidence of recent influenza virus A (H 3 N 2) infections in forensic cases of the sudden infant death syndrome (SIDS). AB - 40 forensic SIDS cases were found to have a significantly higher rate of serologic evidence of recent influenza A (H 3 N 2) infection than did matched controls. In contrast, the SIDS cases had serologically no significantly increased infection rate with influenza H 1 N 1 and B virus, parainfluenza virus, RS virus, adenovirus, and cytomegalovirus. SIDS cases with recent influenza infection had a significantly higher rate of histological findings as described for primary viral pneumonia than did SIDS cases without influenza infection. SIDS cases with recent influenza infection occurred much more frequently during epidemic than during interepidemic influenza A (H 3 N 2) periods. Our results confirm previous reports that SIDS cases have an increased rate of respiratory virus infections. However, they cannot prove a causal relationship between influenza infection and death. Since our SIDS cases comprised 75 per cent of cases aged more than three months, our results pertain essentially to cases of this age group. PMID- 3548653 TI - [Ultrastructural changes in cells of the white pulp of the spleen during experimental salmonella infection]. AB - The electron microscopic investigation of the immuno-competent cells in various zones of the spleen has revealed certain subcellular bases of the organ's reaction to the experimental salmonellosis. Alterations at early stage of the experiment (3-24 h after infection with Salmonella) are predominantly of destructive character: pyknosis of nuclei, dilated cisterns of the karyotheca, lysis of crests in mitochondria of some cells. On the 3d-14th day hyperplasia and hypertrophy of organelles in the immune-competent cells are revealed; it is connected with increasing processes of immunogenesis. At late stages of the investigation, normalization of the spleen cells ultrastructure and increased functional fibroblastic activity are noted. PMID- 3548654 TI - [Features of the development of the pituitary-thyroid system of the Wrangel Island hoofed lemming Dicrostonyx torquatus at stages of growth and peak population]. AB - By means of morphometric techniques, peculiarities in formation of the hypophyseal-thyroid system during prenatal and early postnatal periods have been studied in lemmings (Dicrostonyx torquatus) from the Wrangel island at growth stages and at the peak of the population quantity. Folliculoformation rate, time when the organ reaches the definitive structure, periods for establishing connection with the regulating center--the anterior hypophyseal lobe, correlation of differentiation rates of histo- and ultrastructures of the organ distinctly react to changes in the density population of the animals. Periods of initiation of folliculoformation are early and comparable at both stages of the population cycles. However, further at the peak of the population quantity, an essential retardation in the development of both histo- and ultrastructures of the thyroid cells is observed; formation of the histostructure significantly overtakes differentiation of the ultrastructures composing its cellular elements. The follicular structure begins to form only in newborn animals, the folliculogenesis completes on the 1st-6th days of the postnatal period. At the stage of growth of the population quantity, the folliculogenesis lasts 2 days (the 15th-17th days of the prenatal development), the organ's structure becomes definitive on the 17th day, at the same period connections are established with the anterior hypophyseal lobe. The role of the thyroid hormones in formation of reprodactive and adaptive potencies of the organism at various stages of the population cycle is discussed. PMID- 3548655 TI - [Various structural aspects of the functional transformation of the kidneys during adaptation to fasting]. AB - Electron microscopic and morphometric investigations of the rat kidneys in 3-6 days after a complete fasting have revealed certain ultrastructural signs of an increased proteolysis in the proximal parts of the nephron canaliculi and structural manifestation in the glomerular blood stream changes, that represents an important condition for passing proteins the glomerular membrane. In this connection, it is supposed that at adaptation to fasting the kidney ensures proteolysis of endogenic-proteins--the first stage of their reconstruction. This function is ensured by structural-functional reconstruction of the juxtaglomerular complex, vessels of the filtrative apparatus and by the proteolytic system in the proximal part of the nephron canaliculus. PMID- 3548656 TI - [Method of embedding the breast in acetylcellulose]. AB - A new method of preparation and embedding the mamma from mature and elderly women has been suggested for the total histologic study. Acetylcellulose obtained from safety film (used for x-ray, cinema and photography) was used as an embedding material instead of celloidine that is not readily available. The method suggested can be widely applied both for research, and practical activities of pathoanatomists in total histotopographic study of the organ. PMID- 3548657 TI - [Study of pathologic conditions of the body by the technic of nuclear gamma resonance (Mossbauer) spectroscopy]. AB - The analytical review of the literature dealing with the use of Mossbauer spectroscopy for studying the pathologic states of the body has shown the directions of the multimodal hemoglobin studies by means of nuclear gamma resonance spectroscopy related to the tasks of molecular pathology. PMID- 3548658 TI - [Morphologic features of the endothelial lining of the blood vessels and endocardium]. AB - The endothelial lining (EL) of ventricular endocardium and coronary arteries of a dog, minipig and humans, as well as that of the abdominal aorta of a rat and superior vena cava (minipig) was studied using luminescent microscope in the reflected light after staining of the non-fixed tissue with thioflavine-T and argentation. Marked heterogeneity of the endotheliocytes was shown to be both specific and depending on the localization of the cells in the cardiovascular system. Comparative analysis of EL in different animal species and in man, as well as in different parts of the CVS, indicated the relationship between the cellular morphologic features and local hemodynamics. PMID- 3548659 TI - [Value of morphometry in the endocrine system of the kidneys]. AB - Basing on the comparison of literature and own data on the morphofunctional analysis of the endocrine renal system (juxtaglomerular apparatus and interstitial medullary cells taken as an example) the necessity was shown to characterize first of all the changes occurring in the structures studied and to determine the stages of the pathologic process involved. Such an approach enables one to select the adequate method of quantitative analysis and to obtain reliable results. The significance of quantification is emphasized as an integral part of any morphologic study providing the performance of correction analysis with the identification of morphofunctional parallels. PMID- 3548660 TI - [Somatic cell hybridization as 1 of the mechanisms explaining the inadequacy of immunologic surveillance]. AB - The literature analysis has shown that somatic cell hybridization is one of the mechanisms of tumour progression in vivo. This mechanism is suggested to underlie the establishment and development of human tumours, in particular of human breast cancer. Somatic hybridization of cells in human breast cancer is supposed to be one of the mechanisms responsible for the inadequacy of immunologic surveillance. The latter appears to occur in those cases when antigenic determinants of unchanged original cells predominate on the surface of hybrid formations. PMID- 3548661 TI - [Clinico-ergometric evaluation of timolol maleate in stable angina: double-blind, randomized and crossed study]. PMID- 3548662 TI - [Amiodarone in the treatment of cardiac arrhythmias]. PMID- 3548663 TI - [Sexual activity after myocardial infarction]. PMID- 3548664 TI - Beneficial effects of timolol in digitalized patients with atrial fibrillation and a rapid ventricular response. PMID- 3548665 TI - [Mild or moderate arterial hypertension. Clinical, phonomechanocardiographic and echocardiographic evaluation of pindolol and propranolol]. PMID- 3548666 TI - [Effects of pantethine on blood lipids]. PMID- 3548667 TI - Akinetic mutism in a bone marrow transplant recipient following total-body irradiation and amphotericin B chemoprophylaxis. A positron emission tomographic and neuropathologic study. AB - We describe a case of akinetic mutism associated with diffuse cerebral leukoencephalopathy, which developed in a bone marrow transplant recipient following total-body irradiation and amphotericin B chemoprophylaxis. A trial of high-dose bromocriptine did not stimulate purposeful verbal or motor activity. Fluorine 18-fluorodeoxyglucose/positron emission tomographic studies, performed before and during bromocriptine therapy, demonstrated cerebral hypometabolism and treatment-related decreases in regional cerebral blood volume. We conclude that whole-brain or total-body irradiation may increase blood-brain barrier permeability to polyene antibiotics, and that high-dose therapy with dopamine agonists is unlikely to benefit patients with akinetic mutism due to diffuse white-matter lesions. PMID- 3548668 TI - Cerebral congestion. A vanished disease. AB - The concept of "cerebral congestion" as a cause of apoplexy was first proposed by Morgagni in 1761, and had a profound influence in the treatment of stroke during the next 150 years. It accounted not only for cerebral hemorrhage, but also for lacunae (Dechambre, 1838), etat crible (Durand-Fardel, 1842), depression, maniac outbursts, headaches, coma, and seizures. According to Hammond (1871, 1878), cerebral congestion was "more common...than any other affection of the nervous system." This notion fell into oblivion when an accurate method for bedside determination of blood pressure became available (Riva-Rocci, 1896; Korotkov, 1905) allowing for better understanding of the neurologic complications of arterial hypertension. PMID- 3548669 TI - Is applanation tonometry a risk factor for transmission of Creutzfeldt-Jakob disease? PMID- 3548670 TI - Expanding access to knowledge and information. PMID- 3548672 TI - [Current clinical aspects of lymph node diseases of the head and neck]. PMID- 3548671 TI - Titanium retinal tacks with pneumatic insertion. Histologic evaluation in rabbits. AB - Titanium retinal tacks were implanted through the formed vitreous into the posterior retinas of rabbits and evaluated by electroretinographic testing and by light microscopy at intervals after implantation. Tritiated thymidine autoradiography was used to evaluate the proliferation of ocular tissues in response to tack insertion. Within one month after implantation, the retinal tacks were surrounded by scar tissue produced by the proliferation of retinal glial cells and choroidal and scleral connective tissue cells. The tissue response was focal and there was no excessive fibrous tissue or vascular proliferation or any indication of iris neovascularization for six months. The observations of firm retinal adherence and low tissue reactivity suggest that titanium tacks can be used to secure the retina during retinal attachment surgery and can remain permanently in the eye. PMID- 3548673 TI - [Experimental otolaryngology]. PMID- 3548674 TI - [Oncology]. PMID- 3548675 TI - Differential diagnosis of intraperitoneal fluid by ultrasound. PMID- 3548676 TI - Cytology of fetal ascites and antenatal diagnosis of meconium peritonitis. PMID- 3548677 TI - A history of the Institute of Dental Research, Sydney. PMID- 3548678 TI - Infective endocarditis and the dentist. PMID- 3548679 TI - Isolation of a new rhabdovirus in Australia related to Tibrogargan virus. AB - A virus isolated from the blood of a healthy steer and designated DPP53 was shown to have rhabdovirus morphology. Although DPP53 virus was antigenically related to Tibrogargan virus by reciprocal immunofluorescence and neutralization tests, the viruses were distinguishable by neutralization tests. DPP53 virus contained RNA and was sensitive to both ether and chloroform. The geographical distribution of neutralizing antibody to DPP53 virus in Australian cattle corresponded to the distribution of Culicoides brevitarsis indicating that this virus may be arthropod-borne with this midge as a possible vector. Antibody to DPP53 virus was detected in serum from cattle, buffalo, dogs and one horse, but not in serum from deer, pigs, humans or wallabies. Highest virus titres were obtained by growth in Vero and BHK21 cell cultures, but the virus could also be grown in Aedes albopictus cell cultures. Higher virus titres were obtained when the multiplicity of infection was low. The name advanced for DPP53 virus is 'Coastal Plains' virus. PMID- 3548680 TI - Development of a sheep hind-limb muscle preparation for metabolic studies. AB - A sheep hind-limb preparation used for the study of muscle metabolism by arteriovenous (AV) difference procedures was validated by identifying the muscles which contribute to venous drainage at different positions along the lateral saphenous vein. Dissection of the hind limbs of six mature sheep (three wethers and three ewes) showed that venous blood from the plantar group (M. gastrocnemius, M. soleus, M. plantaris, M. flexo digitorum profundus), and from M. semitendinosus, M. biceps femoris, M. gracilis, M. pectineus and M. adductor muscles entered the lateral saphenous vein but the position of the tip of the blood sampling catheter was found to be critical. In order to sample venous blood from all of the muscles listed above, and to minimize the contribution of blood from non-muscular tissues, blood samples must be taken 25-26 cm from the junction of the cranial and caudal branches of the lateral saphenous vein (for average size sheep of body length about 108 cm and height at withers about 73 cm). The estimation of sheep hind-limb muscle mass is a necessary concomitant of AV difference studies, and a combined tritiated water and dye-dilution procedure has been used to measure both muscle mass and blood flow. The muscle mass estimated in vivo by this technique was closely similar to the true muscle mass obtained by dissection, the range of values of the difference between true and calculated muscle mass expressed as percentage of the true mass being 0.5-16%. It is concluded that these techniques are sufficiently accurate for use in the quantitation of exchange of metabolites across the hind-limb muscle preparation. Patterns of amino acid uptake and release by muscle need to be related to the amino acid profile of the tissue, and the amino acid content of a representative muscle, M. biceps femoris, was determined, and the results compared with published data. PMID- 3548681 TI - Intravenous digital subtraction angiography for patients with positional nystagmus. AB - Thirty cases of intractable positional vertigo were studied by means of digital subtraction angiography (DSA). Benign paroxysmal positional vertigo was not included. DSA allows real time digital subtraction of X-ray transmission data using an image intensifier and television system. Intravenous DSA (IV DSA) was used to compare blood vessel flow in the right and left vertebral arteries. Abnormal findings were noted in 27 patients, with 10 being affected on the left side, 7 on the right, and 10 bilaterally. Twenty-three patients had slight stenosis, and bending and kinking were observed in 17. DSA results were related to the 6 established types of positional nystagmus. DSA is, therefore, considered to be an important tool in the diagnosis and treatment of positional vertigo. PMID- 3548682 TI - Designing computer programs: two student projects. PMID- 3548683 TI - Quality assurance protocol for digital subtraction angiographic units. PMID- 3548684 TI - The catecholamine response to acute myocardial infarction: effect of early administration of sotalol. AB - Thirty-five patients with suspected acute myocardial infarction were studied in a randomised controlled trial to determine whether the catecholamine response to myocardial infarction was altered by administration of the beta blocker, sotalol, given within six hours of the onset of chest pain. Myocardial infarction evolved in 30 patients (15 placebo-treated, 15 sotalol-treated) and was associated with markedly increased plasma and urine noradrenaline and adrenaline levels. Intravenously administered sotalol was well tolerated and produced significant acute falls in blood pressure and heart rate. The reduction in heart rate was maintained in the sotalol group with once-daily therapy. Plasma levels of both catecholamines showed slow but very similar falls in the two groups, the decline being evident earlier for adrenaline than for noradrenaline. This was also reflected in the pattern of catecholamine excretion: significant falls in adrenaline but not noradrenaline excretion were seen on day 2 in both groups. Although mean plasma and urinary catecholamine levels tended to be higher in the sotalol group throughout the study, the differences between the sotalol and placebo groups for the changes in plasma or urinary catecholamines with time were not statistically significant. Episodes of ventricular tachycardia occurred in 68% of the patients on day 1 and 27% of patients on day 2. More patients in the sotalol group experienced episodes of ventricular tachycardia (sotalol 89% placebo 54%) but this difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548685 TI - Protein loading test before and after kidney donation. AB - Renal response to a 60 g protein load was investigated in 33 normal subjects in terms of creatinine clearance and urinary protein excretion. The test was repeated in 10 of these subjects six months after donor nephrectomy. Creatinine clearance and urinary protein excretion increased significantly one and two hours after ingestion of the protein load (in the form of casein mixture); the change in urinary protein excretion correlated significantly with the change in creatinine clearance (p less than 0.0001). Plasma urea, calcium, and phosphate concentrations increased after protein ingestion, while plasma creatinine and uric acid decreased. Six months after donor nephrectomy the creatinine clearance had decreased but baseline protein excretion had increased. The pre-nephrectomy renal response to protein ingestion (i.e. increase in creatinine clearance and urinary protein excretion) did not predict creatinine clearance of the kidney after donor nephrectomy. After donor nephrectomy, the single kidney was able to increase creatinine clearance after a protein load, although qualitatively the response was different from that obtained with two kidneys in situ. PMID- 3548686 TI - Current concepts in the etiopathogenesis and treatment of systemic lupus erythematosus (SLE). AB - Systemic lupus erythematosus is an autoimmune disorder that occurs spontaneously in humans and mice. Genetic factors play an important role in the predisposition to and expression of disease. Environmental factors augment the expression of illness and in the absence of normal control mechanisms may provide the stimulus to autoimmunity. Sex hormones modulate the immune response and tend to modify disease expression. Disordered immune regulation may be due to a primary or secondary abnormality in cellular, cytokine, and/or humoral function. Therapy for SLE is directed towards suppression of exaggerated immunological and inflammatory activity. This review will re-evaluate current therapy and describe newer approaches including the use of pharmacological, hormonal, immunological, dietary, and physical modalities. PMID- 3548687 TI - The first 75 years of the International Society of Surgery 1905-1980. PMID- 3548688 TI - Serology of experimental toxoplasmosis in pregnant ewes and their foetuses. AB - Ewes were inoculated orally with 1500 Toxoplasma gondii oocysts at 6 to 14 weeks of pregnancy. Abortions occurred at 26 to 55 days after inoculation, and maternal serum T. gondii antibody titres did not peak/plateau until 20 to 103 days after inoculation, usually after abortion occurred. Serums or body fluids from unautolysed foetuses aborted at 35 days or more after maternal inoculation, contained significant levels of Toxoplasma antibodies as determined by the indirect fluorescent-antibody test. It was considered that foetal serology was a quick and efficient method of diagnosing congenital toxoplasmosis in sheep on a flock basis. PMID- 3548689 TI - Some problems with the physiological concept of "stress". AB - Stress has become a central concept in discussion of animal welfare, partly because it has been seen to have a precise physiological definition. However, stress is a term in ordinary language with a variety of connotations, not all of which can be related to activity of the pituitary adrenal axis. There is good evidence against the idea that the rise in plasma corticosteroids that occurs in response to some treatment can be used to assess the degree of suffering or distress experienced by an animal. The rise may simply reflect demands on the learning abilities of the animals. Veterinarians should be careful in their use of the term, and in their interpretation of such physiological data, in the context of animal welfare. PMID- 3548690 TI - Objective measures of welfare in farming environments. AB - Welfare in farm animals is both difficult to define and measure. Definitions of welfare and the indicators of welfare which can be scientifically measured are discussed. These indicators are health, productivity, physiological and biochemical changes, and behavioural patterns; they can often be correlated from a husbandry system to give a good indication of the welfare status of the animals in the system. Most of the research work in this area has been done in the intensive pig and poultry industries, although the correlation of biochemical measures with husbandry procedures used in sheep and cattle has begun. It is difficult at this stage to develop a simple stress test that would take all the variables into account, but a change of any of the indicators will suggest further investigation is required. The most obvious to monitor is behaviour, as even a slight change can indicate a change in welfare status. PMID- 3548691 TI - Two types of Newcastle disease viruses isolated from feral birds in western Australia detected by monoclonal antibodies. AB - Thirteen viruses isolated from feral birds and one isolated from a domestic duck, obtained in 1979-1980 during a survey of birds in Western Australia, were shown to be Newcastle disease viruses of low virulence for chickens. The binding of mouse monoclonal antibodies, raised against NDV-Ulster 2C to MDBK cells infected with the isolates was assessed using an indirect immunoperoxidase test. Five viruses caused binding of all 9 monoclonal antibodies tested, whereas the other 9 isolates induced binding of only 4 monoclonal antibodies. PMID- 3548692 TI - Oxytocin induced second trimester uterine rupture. AB - A case of oxytocin induced rupture of an unscarred uterus during the second trimester is presented. While rupture of the uterus by oxytocic agents in the second trimester has previously been documented, this case is unusual in that fetal parts were palpable through the cervical os, delaying diagnosis and definitive management. Digital palpation of fetal parts through the cervix does not preclude the diagnosis of fetal extrusion secondary to uterine rupture. PMID- 3548693 TI - Smokeless tobacco country: from nicotine dependency to oral problems and cancer. PMID- 3548694 TI - Production of a monoclonal antibody reacting with vimentin, a structural protein of intermediate filaments. AB - This paper reports on the production of a monoclonal antibody (i-18) reacting with vimentin, the major structural component of intermediate filaments in cells of mesenchymal origin. The antibody was obtained following immunization with hamster fibroblasts and was selected for its ability to bind to the cytoskeleton fraction of the aforementioned cells. It decorated a perinuclear filamentous network characteristic of vimentin filaments in cells of mesenchymal origin of avian through human species. The specificity of the reagent was further ascertained on the basis of the sensitivity of the decorated filaments to colcemide. The strict antibody specificity for cells of mesenchymal versus epithelial origin was confirmed also in vivo on histological specimens from solid tissue. The i-18 monoclonal antibody precipitated a molecule of about 57 Kd from metabolically labelled cellular extracts. The broad cross-reactivity of this monoclonal antibody among different animal species, as well as its strict in vivo mesenchymal tissue specificity makes this antibody a useful reagent for both experimental and diagnostic purposes. PMID- 3548695 TI - Distribution of glial fibrillary acidic protein in normal and gliotic human retina. AB - The distribution of glial fibrillary acidic protein (GFAP) in normal human retina and in retinae with gliosis due to different diseases was studied by immunohistochemical methods. In normal retina, an evident GFAP-positivity is encountered only in the nerve fiber and ganglion cell layers; Muller cells do not stain. In retinal gliosis, together with an enhanced positivity of the perivascular and accessory glia, a strong staining for GFAP is observed in Muller cells, which extends from the inner to the outer limiting layers. A correlation between the intensity of immunohistochemical glial staining, its anatomical localization and the degree of retinal changes is suggested. PMID- 3548696 TI - In vitro immunohistochemical localization of S-phase cells by a monoclonal antibody to bromodeoxyuridine. AB - Thin viable slices of normal or pathological human tissues were incubated in vitro with bromodeoxyuridine (BrdU). Later, cryostatic sections and histological sections from the same samples embedded in paraffin were examined by an immunohistochemical method using a monoclonal antibody anti-bromodeoxyuridine (anti-BrdU-MAb): on both cryostatic and histological sections, the nuclei of the S-phase cells proved positive. The optimization of the technique depends on the concentration of bromodeoxyuridine in the culture medium (160 microM), the duration of incubation (not less than two h), the method of DNA denaturation (2N or 4N HCl) and the dilution of the anti-BrdU-MAb (1:50). In vitro, immunohistochemical application of the BrdU/anti-BrdU-MAb method permits a quantitative assessment of the proliferative activity of a tissue as well as the direct location of the actively replicating cells in histological sections. PMID- 3548697 TI - [Bacteriologic studies of the incidence of Haemophilus somnus in the genital tract of cattle]. PMID- 3548698 TI - [Detection of coliphages in the dust of a fattening pig stall]. PMID- 3548699 TI - Influence of Ca2+ on the structure of reptilase-derived and thrombin-derived fibrin gels. AB - The effects of Ca2+ ion on the structure of thrombin-derived and reptilase derived fibrin gels formed at various ionic strengths were studied turbidimetrically. For both enzymes clotting times were shorter, final gel turbidities were higher and fibre mass/length ratios were increased as the ionic strength was lowered. The addition of 5 mM-Ca2+ augmented each of these effects for any given ionic strength. In the thrombin system, Ca2+ increased the final gel turbidity from 0.04 to 0.26 A632.8 at ionic strength 0.15. Under identical conditions in the reptilase system, the final gel turbidity increased from 0.03 A632.8 in the absence of Ca2+ to 0.345 A632.8 in the presence of 5 mM-Ca2+. In the thrombin system, fibre mass/length ratios increased from 0.4 X 10(12) to 6.9 X 10(12) Da/cm in the absence of Ca2+, and from 4.4 X 10(12) to 7.9 X 10(12) Da/cm in the presence of Ca2+, as the ionic strengths were decreased from 0.15 to 0.08 and to 0.11 respectively. In the reptilase system, the mass/length ratios increased from 0.9 X 10(12) to 5.8 X 10(12) Da/cm in the absence of Ca2+, and from 4.8 X 10(12) to 8.7 X 10(12) Da/cm in the presence of Ca2+, as the ionic strengths were decreased from 0.15 to 0.08 and to 0.10 respectively. At ionic strengths below 0.10, the presence of 5 mM-Ca2+ caused precipitation and macroscopic aggregation of fibrinogen upon the addition of either enzyme. In the presence of 5 mM-Ca2+, the fibres composing thrombin-induced and reptilase induced gels were virtually identical. PMID- 3548700 TI - Properties of a class C beta-lactamase from Serratia marcescens. AB - A beta-lactamase produced by a penicillin-resistant strain of Serratia marcescens was isolated and purified. The kcat. value for benzylpenicillin was about 5% of that observed for the best cephalosporin substrates. However, the low Km of the penam resulted in a high catalytic efficiency (kcat./Km) and the classification of the enzyme as a cephalosporinase might not be completely justified. It also exhibited a low but measurable activity against cefotaxime, cefuroxime, cefoxitin and moxalactam. Substrate-induced inactivation was observed both with a very good (cephalothin) or a very bad (moxalactam) substrate. The active site was labelled by beta-iodopenicillanate. Trypsin digestion produced a 19-residue active-site peptide whose sequence clearly allowed the classification of the enzyme as a class C beta-lactamase. PMID- 3548701 TI - Cell-surface insulin receptor cycling and its implication in the glycogenic response in cultured foetal hepatocytes. AB - The insulin-receptor cycle was investigated in cultured foetal rat hepatocytes by determining the variations in insulin-binding sites at the cell surface after short exposure to the hormone. Binding of 125I-insulin was measured at 4 degrees C after dissociation of prebound native insulin. Two protocols were used: exchange binding assay and binding after acid treatment; both gave the same results. Cell-surface 125I-insulin-receptor binding decreased sharply (by 40%) during the first 5 min of 10 nM-insulin exposure (t1/2 = 2 min) and remained practically constant thereafter; subsequent removal of the hormone restored the initial binding within 10 min. This fall-rise sequence corresponded to variations in the number of insulin receptors at the cell surface, with no detectable change in receptor affinity. The reversible translocation of insulin receptors from the cell surface to a compartment not accessible to insulin at 4 degrees C was hormone-concentration- and temperature-dependent. SDS/polyacrylamide-gel electrophoresis after cross-linking of bound 125I-insulin to cell-surface proteins with disuccinimidyl suberate showed that these variations were not associated with changes in Mr of binding components, in particular for the major labelled band of Mr 130,000. The insulin-receptor cycle could be repeated after intermittent exposure to insulin. Continuous or intermittent exposure to the hormone gave a similar glycogenic response, contrary to the partial effect of a unique short (5-20 min) exposure. A relationship could be established between the repetitive character of the rapid insulin-receptor cycle and the maximal expression of the biological effect in cultured foetal hepatocytes. PMID- 3548702 TI - Diurnal variations in the effects of an unsaturated-fat-containing diet on fatty acid and cholesterol synthesis in rat hepatocytes. AB - Rats were fed ad libitum on either a standard high-carbohydrate diet, or a standard diet supplemented with 15% corn oil. Hepatocytes were prepared either during the light phase (L2-hepatocytes) or during the dark phase (D6-hepatocytes) of the diurnal cycle. In hepatocytes from rats fed on the fat-containing diet, fatty acid synthesis (lipogenesis) was suppressed to a much greater extent at D6 than at L2. The magnitude of the increase in plasma-free fatty acid concentration was similar at the two times of day. The rate of cholesterol synthesis was also significantly suppressed in the D6- but not in the L2-hepatocytes. This differential inhibition resulted in the abolition of the normal diurnal rhythm of cholesterogenesis. The initial activity of 3-hydroxy-3-methylglutaryl-CoA reductase in hepatocytes was also suppressed by corn-oil feeding at D6 but not at L2. In D6-hepatocytes, the inhibitory effect of the high-fat diet on the conversion of lactate into cholesterol and fatty acids was greater than that on total carbon flux into these substances for all endogenous sources. Despite this, under these conditions a high concentration of lactate and pyruvate resulted in a several-fold stimulation of total carbon flux into fatty acids. In hepatocytes prepared at L2, fat-feeding had little effect on the degree of stimulation of lipogenesis by insulin or inhibition by glucagon. However, at D6, fat-feeding blunted the response of lipogenesis to both these hormones. PMID- 3548703 TI - Purification and characterization of a novel NADPH(NADH)-dependent glyoxylate reductase from spinach leaves. Comparison of immunological properties of leaf glyoxylate reductase and hydroxypyruvate reductase. AB - A novel reductase displaying high specificity for glyoxylate and NADPH was purified 3343-fold from spinach leaves. The enzyme was found to be an oligomer of about 125 kDa, composed of four equal subunits of 33 kDa each. A Km for glyoxylate was about 14-fold lower with NADPH than with NADH (0.085 and 1.10 mM respectively), but the maximal activity, 210 mumol/min per mg of protein, was similar with either cofactor. Km values for NADPH and NADH were 3 and 150 microM respectively. Optimal rates with either NADPH or NADH were found in the pH range 6.5-7.4. The enzyme also showed some reactivity towards hydroxypyruvate with rates less than 2% of those observed for glyoxylate. Results of immunological studies, using antibodies prepared against either glyoxylate reductase or spinach peroxisomal hydroxypyruvate reductase, suggested substantial differences in molecular structure of the two proteins. The high rates of NADPH(NADH)-glyoxylate reductase in crude leaf extracts of spinach, wheat and soya bean (30-45 mumol/h per mg of chlorophyll) and its strong affinity for glyoxylate suggest that the enzyme may be an important side component of photorespiration in vivo. In leaves of nitrogen-fixing legumes, this reductase may also be involved in ureide breakdown, utilizing the glyoxylate produced during allantoate metabolism. PMID- 3548704 TI - Amiloride added together with bumetanide completely blocks mouse 3T3-cell exit from G0/G1-phase and entry into S-phase. AB - In this study we tested the hypothesis that stimulation of univalent-cation fluxes which follow the addition of growth factors are required for cell transition through the G1-phase of the cell cycle. The effect of two drugs, amiloride and bumetanide, were tested on exit of BALB/c 3T3 cells from G0/G1 phase and entry into S-phase (DNA synthesis). Amiloride, an inhibitor of the Na+/H+ antiport, only partially inhibited DNA synthesis induced by serum. Bumetanide, an inhibitor of the Na+/K+ co-transport, only slightly suppressed DNA synthesis by itself, but when added together with amiloride completely blocked cell transition through G1 and entry into S-phase. Similar inhibitory effects of the two drugs were found on the induction of ornithine decarboxylase (ODC) (a marker of mid-G1-phase) in synchronized cells stimulated by either partially purified fibroblast growth factor (FGF) or serum. To test this hypothesis further, cells arrested in G0/G1 were stimulated by serum, insulin or FGF. All induced similar elevations of cellular K+ content during the early G1-phase of the cell cycle. However, serum and FGF, but not insulin, released the cells from the G0/G1 arrest, as measured by ODC enzyme induction. This result implies that the increase in cellular K+ content may be necessary but not sufficient for induction of early events during the G1-phase. The synergistic inhibitory effects of amiloride and bumetanide on the two activities stimulated by serum growth factors, namely ODC induction (mid-G1) and thymidine incorporation into DNA (S phase), suggested that the amiloride-sensitive Na+/H+ antiport system together with the bumetanide-sensitive Na+/K+ transporter play a role in the mitogenic signal. PMID- 3548705 TI - The purification of eukaryotic polypeptides synthesized in Escherichia coli. PMID- 3548707 TI - Purification, N-terminal amino acid sequence and properties of hydroxymethylbilane synthase (porphobilinogen deaminase) from Escherichia coli. AB - Hydroxymethylbilane synthase (porphobilinogen deaminase) was purified to apparent homogeneity from Escherichia coli. The enzyme is a monomer of Mr approx. 40,000. The Km for porphobilinogen and relative Vmax. values have been obtained at various pH values over the range 6.2-8.8, enabling pK values for ionizable groups important for activity to be determined. The N-terminal amino acid sequence is presented. PMID- 3548708 TI - The N-terminal amino acid sequence of pig kidney endopeptidase-24.11 shows homology with pro-sucrase-isomaltase. AB - Endopeptidase-24.11 (EC 3.4.24.11), a widely distributed ectoenzyme, was isolated from pig kidneys by detergent solubilization of membranes and immuno-affinity chromatography. In all, 12 preparations of the enzyme were submitted to solid phase sequencing, yielding a consensus sequence of 25 amino acid residues of the N-terminal segment. Some samples were treated with either trypsin or Staphylococcus aureus V8 proteinase before sequencing. There were four lysine and one arginine residues in the first nine positions. This segment was susceptible to hydrolysis by trypsin and, in some samples, to endogenous proteinases. From residue 19 onwards, the sequence became intensely hydrophobic. There was a striking homology with the N-terminal sequence of pro-sucrase-isomaltase. From Lys7 to Leu20 there were seven identical amino acid residues and four conservative substitutions. We suggest that endopeptidase-24.11 is topologically similar to this glycosidase, the N-terminus at the cytoplasmic face and hydrophobic segment serving the roles of both signal peptide and hydrophobic anchor. PMID- 3548706 TI - Biochemical and functional characterization of the rat liver glucose-transport system. Comparisons with the adipocyte glucose-transport system. AB - The properties of the glucose-transport systems in rat adipocytes and hepatocytes were compared in cells prepared from the same animals. Hormones and other agents which cause a large stimulation of 3-O-methylglucose transport in adipocytes were without acute effect in hepatocytes. Hepatocytes displayed a lower affinity for 3 O-methylglucose (20 mM) and alternative substrates than adipocytes (6 mM), whereas inhibitor affinities were similar in both cell types. The concentration and distribution of glucose transporters were determined by Scatchard analysis of D-glucose-inhibitable [3H]cytochalasin B binding to subcellular fractions. In liver, most of the transporters were located in the plasma membrane (42 +/- 5 pmol/mg of protein) with a small amount (4 +/- 3 pmol/mg) in the low-density microsomal fraction ('microsomes'), the reverse of the situation in adipocytes. Glucose transporters were covalently labelled with [3H]cytochalasin B by using the photochemical cross-linking agent hydroxysuccinimidyl-4-azidobenzoate and analysed by SDS/polyacrylamide-gel electrophoresis. A single D-glucose inhibitable peak with a molecular mass of 40-50 kDa was seen in both plasma membrane and low-density microsomes. This peak was further characterized by isoelectric focusing and revealed a single peak of specific [3H]cytochalasin B binding at pI 6.05 in both low-density microsomes and plasma membrane, compared with peaks at pI 6.4 and 5.6 in adipocyte membranes. In summary: the glucose transport system in hepatocytes has a lower affinity and higher capacity than that in adipocytes, and is also not accurately modulated by insulin; the subcellular distribution of glucose transporters in the liver suggests that few intracellular transporters would be available for translocation; the liver transporter has a molecular mass similar to that of the adipocyte transporter; the liver glucose transporter exists as a single charged form (pI 6.05), compared with the multiple forms in adipocytes. This difference in charge could reflect a functionally important difference in molecular structure between the two cell types. PMID- 3548709 TI - Decreased rate of ketone-body oxidation and decreased activity of D-3 hydroxybutyrate dehydrogenase and succinyl-CoA:3-oxo-acid CoA-transferase in heart mitochondria of diabetic rats. AB - Heart mitochondria from chronically diabetic rats ('diabetic mitochondria'), in metabolic State 3, oxidized 3-hydroxybutyrate and acetoacetate at a relatively slow rate, as compared with mitochondria from normal rats ('normal mitochondria'). No significant differences were observed, however, with pyruvate or L-glutamate plus L-malate as substrates. Diabetic mitochondria also showed decreased 3-hydroxybutyrate dehydrogenase and succinyl-CoA: 3-oxoacid CoA transferase activities, but cytochrome content and NADH-dehydrogenase, succinate dehydrogenase, cytochrome oxidase and acetoacetyl-CoA thiolase activities proved normal. The decrease of 3-hydroxybutyrate dehydrogenase activity was observed in diabetic mitochondria subjected to different disruption procedures, namely freeze thawing, sonication or hypoosmotic treatment, between pH 7.5 and 8.5, at temperatures in the range 6-36 degrees C, and in the presence of L-cysteine. Determination of the kinetic parameters of the enzyme reaction in diabetic mitochondria revealed diminution of maximal velocity (Vmax) as its outstanding feature. The decrease in 3-hydroxybutyrate dehydrogenase in diabetic mitochondria was a slow-developing effect, which reached full expression 2-3 months after the onset of diabetes; 1 week after onset, no significant difference between enzyme activity in diabetic and normal mitochondria could be established. Insulin administration to chronically diabetic rats for 2 weeks resulted in limited recovery of enzyme activity. G.l.c. analysis of fatty acid composition and measurement of diphenylhexatriene fluorescence anisotropy failed to reveal significant differences between diabetic and normal mitochondria. The Arrhenius plot characteristics for 3-hydroxybutyrate dehydrogenase in membranes of diabetic and normal mitochondria were similar. It is assumed that the variation of the assayed enzymes in diabetic mitochondria results from a slow adaptation to the metabolic conditions resulting from diabetes, rather than to insulin deficiency itself. PMID- 3548710 TI - Response of muscle protein turnover to insulin after acute exercise and training. AB - To determine whether the enhanced insulin-sensitivity of glucose metabolism in muscle after acute exercise also extends to protein metabolism, untrained and exercise-trained rats were subjected to an acute bout of exercise, and the responses of protein synthesis and degradation to insulin were measured in epitrochlearis muscles in vitro. Acute exercise of both untrained and trained rats decreased protein synthesis in muscle in the absence or presence of insulin, but protein degradation was not altered. Exercise training alone had no effect on protein synthesis or degradation in muscle in the absence or presence of insulin. Acute exercise or training alone enhanced the sensitivities of both protein synthesis and degradation to insulin, but the enhanced insulin-sensitivities from training alone were not additive to those after acute exercise. These results indicate that: a decrease in protein synthesis is the primary change in muscle protein turnover after acute exercise and is not altered by prior exercise training, and the enhanced insulin-sensitivities of metabolism of both glucose and protein after either acute exercise or training suggest post-binding receptor events. PMID- 3548711 TI - Selection by genetic complementation and characterization of the gene coding for the yeast porphobilinogen deaminase. AB - The porphobilinogen deaminase (PBG-D) gene of Saccharomyces cerevisiae has been isolated by genetic complementation of a mutant GL7 (alpha hem 3) strain, previously shown to be defective in this haembiosynthetic enzyme [Gollub, Liu, Dayan, Adlersberg & Sprinson (1977) J. Biol. Chem. 252, 2846-2854]. The gene was selected from a yeast wild-type genomic DNA library ligated into the shuttle vector YEp13. The complementing gene restored growth of the hem 3 (PBG-D) mutant strain on media in the absence of exogeneous haem or fatty acid and sterol supplements. The recombinant plasmid was retained in the Hem+ transformant provided that selective pressure for plasmid-dependent growth was maintained. Transformation of the mutant strain (hem 3) restored the PBG-D activity to levels up to 10-fold those of the parental strain. The mutant strain GL7 does not show any measurable enzymic activity. Analysis of the plasmid designated YEpPBG-D (containing the PBG-D gene) by hybrid-selected translation revealed that it contained the coding information for a single protein of apparent Mr 43,000. The coding region was localized on an 1.5 kb endonuclease-EcoRI fragment (E4), within the 5.5 kb genomic insert in YEpPBG-D. PMID- 3548712 TI - Structural analysis of a yeast centromere. PMID- 3548713 TI - Evidence for the involvement of a single major species of replicative complex in DNA synthesis from two diverse nuclear replicons in yeast. AB - The activity that replicates the 2-micron yeast DNA plasmid in vitro can be isolated as a high-molecular weight (approximately 2 X 10(6)) fraction, which possesses many of the features of a multiprotein replicative complex. This fraction also initiates DNA synthesis at the yeast chromosomal replicator ARS1 raising the question whether the preparations discriminate between origins. It was determined that the binding of replicative complex to plasmids containing either 2-microns or ARS1 origins of replication was indistinguishable. The preparations also showed no preference among them for replication. In addition, the DNAs competed with each other to the same extent for binding of replicative complex. These results suggest that these two origins share one major species of replicative complex. PMID- 3548714 TI - Synthesis and application of 13C enriched phenylisothiocyanate as a 13C NMR protein probe. AB - Phenylisothiocyanate, enriched with 13C at the isothiocyanate carbon, has been synthesized and utilized as a 13C NMR probe of proteins for the first time. The reagent has been used to label the amino groups of oxidized glutathione, and the resulting 13C NMR spectrum shows a prominent thiocarbonyl peak after a single NMR scan. The reagent is also capable of differentiating amino groups on the insulin molecule with distinct peaks corresponding to the amino groups on the A and B chains of insulin. This study illustrates the potential of using a new 13C label to functionalize amino groups of proteins and to study the labeled proteins with 13C NMR. PMID- 3548715 TI - Decrease in the levels of a constitutive cytochrome P-450 (RLM5) in hepatic microsomes of diabetic rats. AB - Cytochrome P-450 dependent hydroxylation of testosterone has been measured in hepatic microsomes of control, diabetic and insulin-treated diabetic rats. The observed decrease in testosterone 16 alpha-hydroxylase activity in diabetes, an activity previously shown to be largely due to RLM5, was accompanied by a dramatic decrease in immunodetectable RLM5. Diabetic rats which received insulin had elevated testosterone 16 alpha-hydroxylase activity relative to the diabetic animals, which was accompanied by a corresponding increase in the levels of RLM5. These results provide evidence that specific constitutive cytochrome P-450 enzymes are altered in the diabetic state and that these changes are not permanent since they can be overcome, at least partially, by insulin replacement therapy. PMID- 3548716 TI - 2,3-Bisphosphoglycerate protects mitochondrial and cytosolic proteins from proteolytic inactivation. AB - 2,3-bisphosphoglycerate at physiological concentration similar to that found in many tissues protects effectively ornithine transcarbamoylase (OTC) from proteolytic inactivation by broken lysosomes. 2,3-bisphosphoglycerate protects also many other mitochondrial and cytosolic proteins, such as glutamate dehydrogenase (GDH) an glyceraldehyde-3-phosphate dehydrogenase (GAPDH), from proteolysis by broken lysosomes and other proteases. It is, thus, suggested that 2,3-bisphosphoglycerate may play an important role in the control of the degradative rates of some proteins, which may explain its high concentration in certain cells. PMID- 3548717 TI - Analysis of DNA extracted from formalin-fixed, paraffin-embedded tissues by enzymatic amplification and hybridization with sequence-specific oligonucleotides. AB - The "polymerase chain reaction" (PCR) procedure for amplifying specific gene sequences has recently been combined with sequence-specific oligonucleotide (SSO) probe hybridization to develop a highly sensitive, rapid, and simple method for analyzing allelic variations in genomic DNA. In the present study we have used PCR/SSO to analyze partially purified DNA extracted from formalin-fixed, paraffin embedded tissue specimens. We report that this DNA, including samples that were partially degraded, proved to be suitable for analysis by the PCR/SSO procedure. PMID- 3548718 TI - Effects of growth factors on an intestinal epithelial cell line: transforming growth factor beta inhibits proliferation and stimulates differentiation. AB - The effects of epidermal growth factor transforming growth factor beta (TGF beta) and other growth factors on the proliferation and differentiation of a cell line derived from rat intestinal crypt epithelium (IEC-6) were defined. Incorporation of [3H]-thymidine was stimulated 1.4-2.4 fold by insulin, insulin like growth factor (IGF), platelet derived growth factor (PDGF), epidermal growth factor (EGF) and 2% fetal calf serum (FCS) respectively. Additive stimulation was observed when FCS was supplemented by insulin,IGF-I or PDGF but not EGF. Incorporation of [3H]-thymidine by IEC-6 was strongly inhibited by TGF beta with greater than 80% inhibition of incorporation at concentration approximately equal to 2.0 pM. IEC-6 cells bound 4.1 +/- 0.15 X 10(4) molecules TGF beta/cell and appeared to have only a single class of high affinity receptors (Kd approximately equal to 0.5 pM). TGF beta inhibition was unaffected by the presence of insulin or IGF-I suggesting it inhibits proliferation at a step subsequent to that at which these growth factors stimulate [3H]-thymidine incorporation. TGF beta also reduced the stimulation induced by FCS by 65%. In contrast EGF reduced TGF beta inhibition by 60%. IEC-6 cells demonstrated the appearance of sucrase activity after greater than 18 hours treatment with TGF beta. These findings suggest that TGF beta may inhibit proliferative activity and promote the development of differentiated function in intestinal epithelial cells. PMID- 3548720 TI - The catalytic mechanism of Escherichia coli aspartate carbamoyltransferase: a molecular modelling study. AB - Based on molecular modelling study, we propose that the reaction between L aspartate an carbamoylphosphate, catalyzed by E. coli aspartate carbamoyltransferase, may proceed via a tetrahedral intermediate and that the breakdown of the intermediate is facilitated by an intramolecular proton transfer between the amino group of L-aspartate and a terminal phosphate oxygen of carbamoylphosphate. PMID- 3548719 TI - Relation of streptococcal M protein with human and rabbit tropomyosin: the complete amino acid sequence of human cardiac alpha tropomyosin, a highly conserved contractile protein. AB - Partial sequences of group A streptococcal M proteins exhibit up to 50% sequence identity with segments of rabbit skeletal tropomyosin. It is well recognized that rheumatic fever and rheumatic heart disease in humans are sequelae of group A streptococcal infection. To examine whether the human cardiac tropomyosin would exhibit greater homology with the streptococcal M proteins, we have now determined its complete amino acid sequence. The amino acid sequence of human cardiac tropomyosin was established from sequence analyses of its peptides derived by enzymic and chemical cleavages, and comparison of these sequences to the reported sequence of rabbit skeletal tropomyosin. These studies have revealed that the amino acid sequence of human cardiac alpha tropomyosin is identical to that of the rabbit skeletal alpha tropomyosin, but for a single conservative substitution of Arg/Lys at position 220. This observation increases the significance of the previously observed sequence homology between streptococcal M protein and rabbit skeletal tropomyosin and may have relevance to the pathogenesis of rheumatic fever. Furthermore, these results rank tropomyosin as one of the most highly conserved contractile proteins between vertebrate species reported thus far. PMID- 3548721 TI - Characterization of the guanosine-3'-diphosphate-5'-diphosphate binding site on E. coli RNA polymerase using a photoprobe, 8-azidoguanosine-3'-5'-bisphosphate. AB - Nucleotide binding sites on DNA-dependent RNA polymerase from E. coli have been studied by photoaffinity labeling with a GTP analog [gamma-32P]-8-AzidoGTP and a guanosine-3'-diphosphate-5'-diphosphate analog, 8-Azidoguanosine-3'-phosphate-5' 85'-32P]phosphate. The guanosine diphosphate photoprobe labeled the beta, beta', and sigma subunits with the sigma subunit being most heavily labeled. The GTP photoprobe also labeled the beta, beta', sigma subunits but the beta' subunit was most heavily labeled. In competition experiments guanosine-3'-diphosphate-5' diphosphate decreased photolabeling by 8-Azidoguanosine-3'-phosphate-5'-[5' 32P]phosphate better than GTP, while the opposite was true for photolabeling with [gamma-32P]8- AzidoGTP. The guanosine diphosphate photoprobe inhibited transcription on E. coli DNA with Ki of ca. 150 microM. Present studies suggest a unique ppGpp binding site distinct from substrate binding site(s) and this photoprobe may be used to localize this binding site(s). PMID- 3548722 TI - Proofreading of a mutagenic nucleotide, N4-aminodeoxycytidylic acid, by Escherichia coli DNA polymerase I. AB - N4-Aminodeoxycytidine triphosphate, a putative metabolite of N4-aminocytidine which is a potent mutagen, is incorporated, in vitro, into polynucleotides in place of dCTP and at a much lesser extent, but significantly, in place of dTTP by E. coli DNA polymerase I large fragment. The activity of the polymerase to proofread this unnatural nucleotide has now been investigated. The results indicate that the 3'-5' exonuclease in the polymerase recognizes N4-aminocytosine as an incorrect base when N4-aminocytosine is incorporated opposite adenine but the enzyme cannot distinguish N4-aminocytosine from cytosine when it is incorporated opposite guanine. PMID- 3548723 TI - C-13 NMR spectral studies of the thyroid hormone transport protein, transthyretin and the pancreatic insulin storage moiety, the zinc-insulin hexamer. AB - The DEPT spectral editing technique was used to separate the CH, CH2 and CH3 resonances in the C-13 NMR spectra of transthyretin and the porcine zinc insulin hexamer. The advantages of this technique in terms of spectral simplification and sensitivity enhancement for 13C NMR of proteins is discussed. Spin-lattice relaxation time and nuclear Overhauser effect measurements of the backbone C alpha and aliphatic sidechain carbons provided information about the dynamics of the proteins in solution and the relative mobility of some sidechain groups. PMID- 3548724 TI - Identification of polypeptides of photosystem I reaction center as the products of chloroplast genes PS1A1 and PS1A2. AB - The Photosystem I Reaction Center of spinach was found to contain two polypeptides of approximate apparent Mr of 56,000 and 64,000. the 56 kDa polypeptide was identified as the product of chloroplast gene PS1A1 using an antibody specific for the PS1A1 gene product of corn. Presumably the 64 kDa polypeptide is the product of gene PS1A2. PMID- 3548725 TI - A sensitive colorimetric detection of virus DNA and oncogene. AB - Advantage of cloning probe DNA fragment in phage M13 DNA was taken to provide a larger single stranded DNA as a hybridization probe. High level of direct enzyme labels was introduced via the M13 DNA moiety as well as probe DNA. A highly sensitive colorimetric detection of virus DNA and oncogene was developed. PMID- 3548726 TI - Modified peptides which display potent and specific inhibition of human renin. AB - A new class of angiotensinogen analogues which contain heteroatom-methylene and retro-inverso amide bond replacements was synthesized and evaluated for renin inhibition. Selected compounds in the series were specific for renin over other aspartic proteinases, and the most potent inhibitor demonstrated hypotensive activity in a salt depleted monkey. PMID- 3548727 TI - New substrates for enkephalinase (neutral endopeptidase) based on fluorescence energy transfer. AB - Novel fluorescent substrates for enkephalinase (neutral endopeptidase; EC 3.4.24.11) have been developed. These new assays are based on the disappearance of energy transfer between a tryptophan or a tyrosine residue and the 5 dimethylaminonaphthalene-1-sulfonyl group (dansyl) in the substrates dansyl-Gly Trp-Gly or dansyl-Gly-Tyr-Gly upon hydrolysis of their Gly-Trp or Gly-Tyr amide bond by enkephalinase. No significant difference in Km or kcat values were found for dansyl-Gly-Trp-Gly and dansyl-Gly-Tyr-Gly, indicating that, in contrast to thermolysin, the active site of enkephalinase easily accommodates tryptophan residues. Both tryptophan and tyrosine-containing substrates can be used for continuous recording of enkephalinase activity and should prove useful for detailed study of the substrate specificity of this enzyme. PMID- 3548728 TI - Insulin stimulation of iodothyronine 5'-deiodinase in rat brown adipocytes. AB - Insulin (100-3333 microU/ml) stimulates iodothyronine 5'-deiodinase 3 to 4 fold in dispersed rat brown adipocytes. Deiodinase activity increased steadily from 1 to 4 hours. Insulin increased enzyme activity via an increase in the Vmax while the Km remained unchanged. Omission of glucose from the medium did not affect the insulin response. Studies with alpha-amanitin suggested that the increase in deiodinase activity was not due to an increase in the rate of transcription. The insulin effect was not additive to that of alpha 1-catecholamines, suggesting the two stimulators might have one or more common elements. PMID- 3548729 TI - Effect of hypoglycin A on insulin release. AB - Thirty experimental and fifteen control Wistar rats were studied to determine whether hypoglycin A influences insulin levels in the body to contribute to the state of hypoglycemia usually observed in Jamaican vomiting sickness, a condition arising after ingestion of unripe ackees. This fruit also grows in other Caribbean islands, as well as North and Central America. Hypoglycin A is one of the toxic compounds found in unripe ackees and is capable of inducing hypoglycemia. A fall in blood glucose occurred after administration of hypoglycin A. The lowest level of 42.60 +/- 4.84 mg/dl was attained 3 hr after administration of the drug. This alteration of blood glucose from the fasting level of 80.31 +/- 5.20 mg/dl was significant (P less than 0.01). The blood glucose level in the control rats showed no significant change from the fasting level. The insulin level in portal and peripheral blood showed no significant change. Results showed that, although hypoglycin A induced severe hypoglycemia after intravenous application, there was no significant change in insulin levels. This observation suggests that hypoglycin A has a mechanism of action other than an alteration in insulin levels to induce hypoglycemia. PMID- 3548730 TI - Toxicity of certain products of lipid peroxidation to the human malaria parasite Plasmodium falciparum. AB - Aldehydes generated during radical-induced lipid peroxidation, in particular 4 hydroxynonenal, are known to inhibit growth of certain cells. To extend our arguments that free radicals might be involved in the host response against malaria parasites we tested 26 carbonyls (n-alkanals, C6-C11; 2-alkenals, C3-C9; 2,4-alkadienals, C7, C9, C10; 4-OH-2-alkenals, C6, C8, C9; 2-alkanones, C3-C9; and malonyldialdehyde) against Plasmodium falciparum in vitro. We had previously detected many of these substances in oxidant-stressed, malaria-infected erythrocytes. Three 2,4-alkadienals (C7, C9 and C10) and three 4-OH-2-alkenals (C6, C8 and C9), at 20-100 microM concentrations, markedly inhibited incorporation of [3H]-hypoxanthine by P. falciparum. Acrolein had low effect, and none of the other compounds (12 aldehydes and 7 ketones) were active at concentrations up to 100 microM. Malonyldialdehyde was without effect at concentrations up to 450 microM. The aldehydes found to be inhibitory against P. falciparum could contribute to both the non-antibody host responses against this parasite and the antimalarial effects of radical-generating compounds such as t butyl hydroperoxide, hydrogen peroxide, alloxan, isouramil, divicine and primaquine. PMID- 3548731 TI - Mast cell numbers in rheumatoid synovial tissues. Correlations with quantitative measures of lymphocytic infiltration and modulation by antiinflammatory therapy. AB - Synovial biopsy specimens from 20 patients with rheumatoid arthritis were subjected to quantitative analysis for several parameters of inflammation and for enumeration of synovial tissue mast cells. Strong positive correlations were found between numbers of mast cells per cubic millimeter of synovial tissue and the following synovial tissue parameters: inflammatory index (a quantification of lymphocytic infiltration), Leu-3a grade (T helper/inducer lymphocytes), Leu-1 grade (T lymphocyte), and plasma cell grade. A strong negative correlation was found between the synovial mast cell count and the extent of sublining layer fibrin deposition. Correlations between synovial mast cell count and Leu-2a grade, ratio of Leu-3a grade:Leu-2a grade, OKM1 grade, HLA-DR grade, and lining layer thickness grade did not reach statistical significance. In addition, we obtained synovial specimens from 6 of the patients both before and after long term therapy with oral methotrexate and from 3 of the patients before, and 1 week after, an intraarticular injection of steroid. The 3 patients who had an intraarticular steroid injection showed a 67-96% decrease in the number of synovial tissue mast cells; there was no significant change in the number of synovial mast cells in the tissues of the 6 patients who received oral methotrexate. These observations are the first documentation of a quantitative relationship between the number of mast cells and the number and phenotypic profile of infiltrating lymphocytes in an inflamed tissue, which in this case, is human synovium. Our findings suggest that mast cells are involved in the pathologic interactions in rheumatoid arthritis and might play a role in the early phases of exacerbations of disease activity. PMID- 3548732 TI - A controlled study of concurrent therapy with a nonacetylated salicylate and naproxen in rheumatoid arthritis. AB - Previous studies of combinations of nonsteroidal drugs used in the treatment of rheumatoid arthritis (RA) have yielded conflicting results. We used standard methods to measure disease activity and high pressure liquid chromatography to measure plasma drug concentrations. We used doses of choline magnesium trisalicylate, adjusted to achieve therapeutic serum salicylate concentrations, and naproxen in a randomized, double-blind, placebo-controlled cross-over study of full dose trisalicylate (CMT), full dose naproxen (N), full dose of both (CMT N), and half dose of both (cmt-n) to examine their relative efficacy and toxicity in treating RA. CMT-N was statistically superior to all other treatments in only 1 of 12 efficacy variables, but was equal to N and better than CMT or cmt-n for 7 variables. There were minimal differences among treatments for the other 4 efficacy variables. The mean percentage difference for the efficacy variables between CMT-N and N was 3%, between CMT-N and CMT was 10.6%, and between CMT-N and cmt-n was 10.5%. Thirteen percent of patients manifested toxic reactions during the initial open dose-adjustment salicylate run-in phase. During the double-blind phases of the study, CMT-N was more toxic than N, CMT, or cmt-n (7.5% versus 3.4%, 1.8%, and 3.7%, respectively). Tinnitus was more common when full-dose CMT was used; N (N or CMT-N) was associated with increased skin toxicity. Gastrointestinal complaints were equally common with all regimens. CMT N, although sometimes statistically superior to CMT, N, or cmt-n, showed no clinically important additive or synergistic effect versus N or CMT alone. PMID- 3548733 TI - Lack of association between HLA-DR2 and clinical response to methotrexate in patients with rheumatoid arthritis. AB - Recent studies have indicated an association between the HLA-DR2 phenotype and substantial response to methrotrexate in patients with rheumatoid arthritis (RA). To further resolve this issue, we analyzed this relationship. Our data, obtained from a multicenter, double-blind study of rigorously assessed patients with RA, demonstrated that neither HLA-DR2 nor any other HLA-DR specificity is significantly associated with a substantial clinical response to methotrexate in patients with RA. PMID- 3548734 TI - Effects of fenofibrate on lipids, lipoproteins, and apolipoproteins in 33 subjects with primary hypercholesterolemia. AB - The effects of fenofibrate on lipids, lipoproteins, and apolipoproteins in 33 subjects with primary hypercholesterolemia were assessed in a 6-month parallel group study, placebo (n = 15) versus fenofibrate 300 mg/day (n = 18), followed by an open label 6-month treatment period. After stabilization on an isocaloric low fat (less than 35% total calories) diet with less than 250 mg cholesterol/day and a P/S ratio of 1, and maintenance of LDL-cholesterol (LDL-C) levels greater than or equal to 175 mg/dl, subjects received placebo for 6 weeks and were then randomized into placebo or fenofibrate groups for 6 months, followed by open label treatment for 6 months. During the 6-month double-blind period, compared to the placebo group, the treatment group had significant reductions in total cholesterol, LDL-C, total apo B, and triglyceride, and increments in HDL cholesterol, apolipoprotein A-I and apolipoprotein A-II (P less than 0.01 for all comparisons). Compared to placebo baseline, therapy with fenofibrate resulted in a reduction of LDL-C, apo B, and the LDL-C/HDL-C ratio of 15%, 13%, and 18% respectively; HDL-C, apo A-I, and apo A-II increased respectively 12%, 13% and 30% (P less than 0.01 for all comparisons). Mean adherence during the double blind phase of the trial was 95% in the drug group and 96% in the placebo group. An additional 6 months of open label fenofibrate therapy maintained the reduced total and LDL-C as well as the elevated HDL-C, apo A-I and apo A-II in the drug drug group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548735 TI - Effects of a fish oil supplement on serum lipids, blood pressure, bleeding time, haemostatic and rheological variables. A double blind randomised controlled trial in healthy volunteers. AB - Sixty male volunteers were randomised to take 10-16 ml of a fish oil supplement (MaxEPA) or 10-16 ml of olive oil for a period of 3-6 weeks. A fall in serum triglyceride of 54% (P less than 0.01) and a fall in diastolic blood pressure of 7% (P less than 0.05) was attributable to taking fish oil supplements. The bleeding time was prolonged by 12%, but this did not reach conventional levels of statistical significance. A global test of heparin-neutralising activity, the heparin thrombin clotting time, increased by 14% (P = 0.05) but there was no demonstrable effect on thrombin time, fibrinogen or (intraplatelet) platelet factor 4. A fall in red cell pore transit time of 23% was attributable to fish oil, but was not statistically significant. There was no convincing evidence of an effect of fish oil supplementation on total serum cholesterol, HDL cholesterol, blood counts or platelet aggregation. A beneficial effect of fish oil on the cardiovascular risk profile was confirmed in this study. However, with this regime changes in total cholesterol, HDL-cholesterol and platelet aggregation are of unlikely clinical importance. PMID- 3548736 TI - Influence of clofibrate on the plasma lipoprotein pattern and on the lipid content and protein and collagen synthesis in atherosclerotic coronary arteries and abdominal aorta from hypercholesterolemic mini-pigs. AB - The influence of clofibrate on the plasma lipoprotein pattern in hyperlipidemic mini-pigs was studied and an attempt was made to characterize the type of atherosclerosis produced in this animal model. Thirty-two female mini-pigs of the Gottingen strain were used. Experimental hypercholesterolemia and atherosclerosis were produced in 16 of the animals by adding 11.2% egg yolk and 0.5% cholesterol to the diet for 14 months. In groups of 8 normolipidemic and 8 hyperlipidemic animals clofibrate was added in a dose of 2 g per animal and day. The remaining 8 animals of each category served as controls. Two months of clofibrate treatment normalized the plasma cholesterol in the hyperlipidemic group mainly by reducing the elevated LDL-cholesterol fraction. In normolipidemic animals clofibrate significantly reduced the HDL-cholesterol. At the end of the treatment period the animals were slaughtered and autopsied. The right coronary artery and normal and atherosclerotic pieces of the abdominal aorta were taken for biochemical analysis. There was a marked accumulation of free and esterified cholesterol in the right coronary artery from hyperlipidemic animals. Clofibrate treatment significantly reduced the content of esterified cholesterol in this vessel. Atherosclerotic pieces from the abdominal aorta were also rich in free and esterified cholesterol and showed a higher rate of proline and hydroxyproline incorporation than the adjacent normal tissue. The contents of proline and hydroxyproline were relatively unchanged, however, suggesting that there may be an increased turnover of protein and collagen synthesis rather than an increased total protein and collagen production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548737 TI - A review of the proliferative behaviour, morphology and phenotypes of vascular smooth muscle. AB - This article reviews the proliferative, structural and synthetic behaviour of vascular smooth muscle cells under a variety of conditions. It shows how some experimental procedures produce dramatic increases in smooth muscle cell proliferation and, in many cases, subsequent cell migration to the intimal layer. Possible control mechanisms influencing changes in such activity are discussed. The morphology, histogenesis and differentiation of vascular smooth muscle is reviewed, with particular emphasis on the differentiation of such cells into contractile or synthetic phenotypes. The significance of the synthetic phenotype is discussed in relation to the synthesis of intra- and extracellular components. PMID- 3548739 TI - The global epidemic of AIDS. AB - Recent changes in sexual habits have likely contributed to the emergence of a new sexually transmissible agent, acquired immune deficiency syndrome (AIDS) virus. This virus may have been present in central Africa as early as 1959; however, frequent infection did not produce an epidemic until the late 1970's. Migration of Africans from rural to urban areas may have contributed to the transmission of AIDS virus. An estimated 1.7 million Americans and 5,000,000 Africans are infected. An incubation period of five years +/- 36 months to onset of disease is estimated. Development of AIDS during a three-year period after detection of AIDS virus antibodies has occurred in 30% of homosexual males in Manhattan and 10% of infected men in Denmark. Conservatively, in excess of 20% of seropositive will likely develop AIDS. Although modification of sexual behavior is recommended, those who will develop AIDS in the near future are already infected. Public health workers ought to be preparing for additional pandemics of infectious diseases which may arise from changing cultural habits. PMID- 3548738 TI - Hepatotoxicity of maternal ethanol consumption in rat offspring: an assessment with a study of the ontogenetic development of ethanol-oxidizing systems. AB - The effect of chronic maternal ethanol ingestion on the ontogenetic development of rat hepatic ethanol-oxidizing systems was investigated. Alcohol dehydrogenase (ADH) activity was first detected at day 19 of gestation. It then increased rapidly to reach adult levels by day 14 postnatally. The ontogenetic pattern, the specific activity and the affinity of the enzyme for its substrate or cofactor were not affected by chronic maternal ethanol consumption. Hepatic microsomal cytochrome P-450 content was first detected in trace amounts just prior to birth. It then increased rapidly in the first 10 days postnatally. Chronic maternal ethanol ingestion did not affect the developmental pattern but induced an increase in the total amount of P-450 detected throughout the postnatal period studied. Fat accumulation was found in fetal and postnatal livers and appeared to correlate with the emerging ability to oxidize ethanol by fetal ADH. The late appearance of the ADH and microsomal ethanol-oxidizing systems indicates that the fetal liver would be entirely dependent on maternal mechanisms to oxidize in utero ethanol. PMID- 3548741 TI - [Location of pulp and periodontal neurons. Experimental study using horseradish peroxidase and fluorochromes]. PMID- 3548740 TI - Intravenous prochlorperazine for the rapid control of nausea and vomiting in acute myocardial infarction: a clinical observation. AB - Sixteen patients with acute myocardial infarctions who were either vomiting or nauseated were given an intravenous injection of prochlorperazine. All patients obtained relief with exception of one patient who was in acute renal failure. No patient developed symptomatic hypotension. Intravenous prochlorperazine in the dose of 2.5 mg is a rapid, effective, and safe method to relieve vomiting and nausea in patients who have sustained an acute myocardial infarction. PMID- 3548742 TI - [Dental stresses in the consideration of the biomechanical design of removable partial dentures]. PMID- 3548743 TI - [Complication of a ventriculo-atrial shunt for the treatment of hydrocephalus. Report of an unusual case]. PMID- 3548744 TI - [Streptococcal pharyngo-tonsillitis: diagnostic and therapeutic approach]. PMID- 3548745 TI - [Streptococcus pyogenes: contributions to its study]. PMID- 3548746 TI - [Pathology of intestinal infections caused by enteropathogenic Escherichia coli]. PMID- 3548748 TI - Electron microscopical structure analysis of yeast fatty-acid synthase at low resolution. AB - From an electron microscopical tilt series of the multi-enzyme complex yeast fatty-acid synthase eight three-dimensional molecular structures were obtained by three-dimensional reconstruction of single molecules. The structures confirm present concepts showing a well defined central wall and a sequential arrangement of protein domains in the form of "arches". Additional structural details as ring shaped parts in the central walls are recognizable. Because of the flattening and the irregular structural deterioration of the single molecules three-dimensional averaging was only partially successful; however, a satisfactory average from five molecules could be obtained. Attempts to find the symmetry of the subunit arrangement by applying correlation methods and by establishing a novel type of correlation analysis ("correlation tables") did not yield a clear proof. However, several strong indications of D3 symmetry were found. PMID- 3548747 TI - Effect of infrared and visible light on 2-azidoanthraquinone in the QA binding site of photosynthetic reaction centres. An unusual mode of activation of a photoaffinity label. AB - Quinone-depleted reaction centres of Rhodobacter sphaeroides were reconstituted with 2-azidoanthraquinone and irradiated with short (50 ms) pulses of intense infrared (lambda = 850 +/- 50 nm) or visible light (460 less than lambda less than 630 nm). The irradiations brought about the rapid degradation of the protein bound photoaffinity label even though it does not absorb light in either spectral region. The decomposition of the label was accompanied by a covalent modification of subunit M and by a loss of photochemical activity of the reaction centre protein (as measured by the light-induced electron transfer onto the primary acceptor, QA). In the case of the photolysis with IR light, these effects were triggered by the reduction of the protein-bound quinone (QA) to the semiquinone (Q-A) in the process of primary charge separation. The resulting reactive species showed properties of both a semiquinone and a triplet nitrene. Efficiency and specificity of the covalent incorporation were markedly improved when visible rather than IR light was used for the photolysis, presumably, because the triplet nitrene resulting from the primary charge separation was further activated in a second light-dependent reaction. The results suggest that, in conventional photoaffinity labeling experiments, the efficiency and specificity of the covalent incorporation of an aryl azide photolabel into a target protein may be improved when the photolysis is carried out with a combination of UV and intense visible light, rather than with UV light alone. PMID- 3548749 TI - Interaction of chloride with yeast aminopeptidase I. Equilibrium binding studies. AB - The effect of chloride on metal binding by yeast aminopeptidase I, as well as the binding of chloride to various enzyme forms were studied by means of a micro centrifugation technique using radioactive 36Cl- as a ligand. Chloride did not significantly alter the binding of activating Zn2+, or binding of Co2+ to the essential metal sites. Both the native Zn2+ enzyme and Co2+-substituted aminopeptidase I bind stoichiometric amounts of C1- (1 Cl-/subunit) with apparent dissociation constants of 0.1-0.2 mM. Additional Cl- was bound at higher concentrations. In contrast to the metal-containing enzyme forms the apoenzyme did not express the high-affinity chloride binding site. PMID- 3548750 TI - Modification of the isoinhibitors of human serum alpha 1-proteinase inhibitor (alpha 1-antitrypsin) by pancreatic proteases. AB - Due to the action of a serum protease, the two most cathodal isoinhibitors of the alpha 1-proteinase inhibitor (alpha 1-PI) are cleaved at the Gly5-Asp6 bond and lack two negative charges. In spite of this, these can bind trypsin and chymotrypsin, showing that the N-terminal pentapeptide is not indispensable for inhibition function. Pancreatic proteases also cleave a bond near the N-terminus in alpha 1-PI, resulting in a loss of two negative charges and a corresponding cathodal shift in the electrofocusing behavior of the isoinhibitors. Trypsin cleaves isoinhibitors near the N-terminus at a large inhibitor excess and unless an additional cleavage takes place, at least two of the new isoinhibitors remain active. An additional cleavage(s), most likely at a distance of 30-40 residues from the C-terminus results in a corresponding decrease of the molecular mass and a loss of inhibition function. Although the C-terminal cleavage peptide does separate from the protein by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, it remains associated with it under conditions of polyacrylamide gel isoelectric focusing. Chymotrypsin also cleaved alpha 1-PI near the N terminus but this could be observed only at protease excess and the modified isoinhibitors did not form complexes with chymotrypsin. The molecular polymorphism of alpha 1-PI is partly explained by the absence of the N-terminal pentapeptide from some of the isoinhibitors. PMID- 3548751 TI - The dissociation between the plasma levels of aminopeptidases A and B in spontaneously hypertensive rats. AB - We performed a longitudinal study for 20 weeks on spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKR) to determine the relationship between peptide metabolism and the age-dependent increase in blood pressure. In both SHR and WKR, the plasma level of aminopeptidase A (AP-A) clearly showed an age-dependent decrease. The plasma level of aminopeptidase B paralleled that of AP-A in WKR, but such an age-dependency was not observed in SHR, thus showing a dissociation between the two aminopeptidases. With age in both strains, the level of angiotensin-converting enzyme tended to decrease, while that of kallikrein activity tended to increase. In addition to these findings, a multivariate study testing the relationship of blood pressure to these enzyme activities, as well as to plasma levels of angiotensin I and renin activity, suggested abnormalities in the networks of proteolytic enzymes and in the peptide metabolism surrounding the renin-angiotensin system in SHR. These abnormalities may play some important roles in pathophysiological mechanisms of hypertension in SHR. PMID- 3548752 TI - Endotoxin detection and elimination in biotechnology. AB - Endotoxins liberated by gram-negative bacteria are frequent contaminants of aqueous and physiological solutions. Because of their potent biological effects in vivo and in vitro, their detection and removal are essential for the safe parenteral administration of products produced from natural sources, as well as those produced by recombinant DNA technology. Traditional methods of endotoxin detection include the U.S. Pharmacopeia rabbit test and the Limulus amebocyte lysate test. Elimination of endotoxins, however, continues to be a problem. Standard methods of sterilization, such as autoclaving or sterile filtration, have little effect on endotoxin levels. Various techniques for the prevention of endotoxin contamination and endotoxin removal have been discussed. The overall role of endotoxin prevention, detection, and elimination in biotechnology is emphasized. PMID- 3548753 TI - Comparison between adherence of C. albicans and Candida spp. to human epithelial cells. AB - A comparison was made of the adherence of different Candida species to human epithelial cells. Three strains each of C. albicans serotype A, serotype B, C. stellatoidea, C. tropicalis, C. krusei and C. glabrata recently clinical isolated were studied. The adherence assay, run in triplicate, was carried out using pooled buccal epithelial cells from healthy donors. The results indicate that both serotypes of C. albicans adhere to buccal epithelial cells in a significantly greater degree than the other species tested and there is no differences between C. albicans serotypes A and B. The rate of adherence of C. stellatoidea and C. tropicalis was similar to that of C. albicans serotypes A and B respectively. Among different strains of C. stellatoidea, C. tropicalis and C. glabrata, the adherence varied significantly and it is possible that there exist a relationship with different degree of pathogenicity of these particular strains. PMID- 3548754 TI - Approaches used to examine the mechanism and regulation of hexose transport in rat myoblasts. AB - This review discusses some of the approaches and general criteria that we have used to examine the properties of the hexose transport system in undifferentiated L6 rat myoblasts. These approaches include studying the kinetics of hexose transport in whole cells and plasma membrane vesicles, the effects of various inhibitors on hexose transport, the isolation and characterization of hexose transport mutants, and the use of cytochalasin B (CB) to identify the transport component(s). Transport kinetics indicated that two transport systems are present in these cells. 2-Deoxy-D-glucose is transported primarily by the high affinity system, whereas 3-O-methyl-D-glucose is transported by the low affinity system. Furthermore, these two transport systems are inactivated to different extents by CB. CB has a higher binding affinity for the low affinity hexose transport system. The inhibitory effect of various hexose analogues also revealed the presence of two hexose transport systems. The effects of various ionophores and energy uncouplers on hexose transport suggest that the high affinity system is an active transport process, whereas the low affinity system is of the facilitated diffusion type. The high affinity system is also sensitive to sulfhydryl reagents, whereas the low affinity system is not. Further evidence for the presence of two transport systems comes from the characterization of hexose transport mutants. Two of the mutants isolated are shown to be defective in the high affinity transport system, but not in the low affinity transport system. These mutants are also defective in the CB low affinity binding site. Based on our results a tentative working model for hexose transport in L6 rat myoblasts is presented. PMID- 3548755 TI - Experimental approaches to the study of the biogenesis of mammalian mitochondrial proteins. AB - Mitochondrial proteins are synthesized in mitochondria and on cytosolic ribosomes. Several approaches used to establish the site of synthesis and the identity of mitochondrially synthesized proteins are described. These include the specific inhibition of mitochondrial translation by inhibitors or mutation and the specific elimination of cytosolic translation either by using isolated mitochondria or specific inhibitors. Experimental approaches to study the import of proteins into mitochondria are also discussed. PMID- 3548756 TI - Origins of the phospholipids in animal mitochondria. AB - As is the case for the assembly of protein components of the membranes in animal mitochondria, the bilayer phospholipids arise from a complicated interplay of intra- and extra-mitochondrial reactions. Our early studies indicated that the bulk of mitochondrial phospholipids (typified by phosphatidylcholine) had their origin in the endoplasmic reticulum and were transported to the mitochondria as complexes with phospholipid-exchange proteins. The polyglycerophosphatides (typified by diphosphatidylglycerol) were apparently synthesized in situ by intramitochondrial membrane-bound enzymes using CDP-diglycerides as intermediates. The case for the precursors in the latter pathway is less clear, although evidence has been presented for dual localization of enzymes for glycerophosphate acylation and CTP:phosphatidate cytidylyl transfer in both mitochondria and microsomes. Phosphatidylethanolamine also shows evidence for two sites of origin: by translocation from its site of synthesis in the endoplasmic reticulum and by translocation of phosphatidylserine followed by decarboxylation within the mitochondria. In the latter case mitochondrial phosphatidylserine decarboxylase may play an important role in the regulation of phospholipid metabolism throughout the cell. PMID- 3548757 TI - Secretion of triglyceride lipase from rat hepatocytes in culture: modulation by insulin and phenobarbital. AB - Hepatic triglyceride lipase (HTGL) was measured in primary rat hepatocytes maintained for 3 days under three different culture conditions: basal medium, basal medium plus insulin, and basal medium plus insulin and phenobarbital. The activity of HTGL secreted by these cells was measured by treating intact cells with heparin; intracellular enzyme was subsequently measured in cell homogenates. Insulin stimulated intracellular triglyceride lipase activity by 48% and extracellular lipase by 30%. Phenobarbital, an enzyme-inducing drug, caused a further 15% increase in extracellular hepatic triglyceride lipase; whereas, the intracellular activity was reduced. The presence of insulin greatly stimulated the rate of enzyme secretion, and this rate was not notably affected by the presence of phenobarbital. After 3 days in culture, the short term (2-8 h) synthesis and secretion of enzyme from cultures treated with insulin or insulin plus phenobarbital were equally inhibited by cycloheximide. Monensin also inhibited enzyme secretion in both cultures and caused a similar increase in intracellular lipase activities. Insulin did not significantly affect the proportion of intracellular enzyme (17.7% basal vs. 15.8% insulin). On the other hand phenobarbital produced a 20-30% reduction in the proportion of intracellular enzyme (12.5 vs. 17.7% basal or 15.8% insulin). These findings suggest a drug induced redistribution of triglyceride lipase. PMID- 3548758 TI - [Identification of lymphocyte subpopulations using the immunogold method. Scanning and transmission electron microscopy studies]. PMID- 3548759 TI - [Fatty acid analysis of tissue in liporegulation]. PMID- 3548760 TI - [Structure and function of the mitochondrion]. PMID- 3548761 TI - [Clinical and biochemical approach to mitochondrial cytopathy--carnitine palmitoyltransferase deficiency]. PMID- 3548762 TI - [Pathology of leukodystrophies in childhood]. PMID- 3548763 TI - Activation of sea urchin gametes. PMID- 3548764 TI - Core particle, fiber, and transcriptionally active chromatin structure. PMID- 3548766 TI - Region-specific cell activities in amphibian gastrulation. PMID- 3548765 TI - The role of protein kinase C in transmembrane signalling. PMID- 3548767 TI - T-cell activation. PMID- 3548768 TI - Anchoring and biosynthesis of stalked brush border membrane proteins: glycosidases and peptidases of enterocytes and renal tubuli. PMID- 3548769 TI - Cell-matrix interactions and cell adhesion during development. PMID- 3548770 TI - Cotranslational and posttranslational protein translocation in prokaryotic systems. PMID- 3548771 TI - The directed migration of eukaryotic cells. PMID- 3548772 TI - Protein import into the cell nucleus. PMID- 3548773 TI - Microtubule-associated proteins. PMID- 3548774 TI - Structure and function of nuclear and cytoplasmic ribonucleoprotein particles. PMID- 3548775 TI - Regulation of the synthesis and assembly of ciliary and flagellar proteins during regeneration. PMID- 3548776 TI - Cell adhesion molecules in the regulation of animal form and tissue pattern. PMID- 3548777 TI - [Cerebral circulation and metabolism in elderly patients with dementia]. PMID- 3548778 TI - Moments in history. Introduction of left ventricular assistance. PMID- 3548779 TI - Temporary ventricular support. Current indications and results. AB - Current data indicate that temporary ventricular support in patients who cannot be weaned from cardiopulmonary bypass is a reasonable and therapeutic treatment to extend life. Ventricular recovery and quality of life are satisfactory in long term hospital survivors, and noncardiac disability is rare. Although the role of temporary ventricular support for acute myocardial infarction and cardiogenic shock is undefined, the expansion of indications to include these patients is reasonable and future clinical trials are warranted. Additionally, there is sufficient evidence to indicate that temporary mechanical support is useful as a bridge to heart transplantation. The superiority of one support system over another in any given clinical instance can only be settled after the results of continued and carefully controlled clinical experiences have been reported. PMID- 3548781 TI - 'The burning mouth sensation related to the wearing of acrylic dentures'. PMID- 3548782 TI - Investigation into patients' hearing following ultrasonic scaling. PMID- 3548780 TI - Biomaterial-associated infection, neoplasia, and calcification. Clinicopathologic features and pathophysiologic concepts. PMID- 3548783 TI - Badges of the dental profession. The Middlesex and Hertfordshire Branch. PMID- 3548784 TI - Investigation of allergic and hypersensitivity reactions to anaesthetic agents. PMID- 3548785 TI - Drug interactions in anaesthesia. PMID- 3548787 TI - Toxicity of i.v. anaesthetics. PMID- 3548786 TI - Adverse effects of volatile anaesthetics. AB - The volatile inhalation anaesthetics have been implicated in a variety of adverse viscerotoxic reactions. In general, they have been proven to produce very few non predicted toxicities. Hepatitis caused by halothane now seems to be the only major problem in this regard with these drugs in current practice. The evidence is convincing that this reaction is based initially on biotransformation. Thus decreases in the amount of biotransformation and lessened production of reactive metabolic products would theoretically produce a safer anaesthetic. While not perfect in all circumstances, enflurane and isoflurane come close to achieving the goal of decreased adverse viscerotoxic events. PMID- 3548788 TI - Clinical aspects of the interaction between nitrous oxide and vitamin B12. PMID- 3548789 TI - Adverse effects of local anaesthetics. AB - Complications of local anaesthesia in general have been considered in so far as they may be confused with adverse effects of local anaesthetic drugs. Local anaesthetics may give rise to adverse reactions by a number of mechanisms. They affect nerve conduction and vasculature at the site of injection: a local effect; but is it unlikely that they ever produce an irreversible noxious effect on nerve fibres. They produce regional effects resulting from nerve conduction blockade; hypotension and respiratory depression by this mechanism are frequently mistaken for pharmacological effects of the agent concerned. They produce focal effects, usually when carried in high concentration via the arterial supply to the brain. They produce systemic effects following absorption or intravenous administration, which are manifested principally in the central nervous system. Ignorance or carelessness are frequently causative factors in serious reactions. Adequate oxygenation is vital in prophylaxis and immediate treatment of systemic toxicity, while resuscitative skill and equipment must always be to hand. Idiosyncrasy or allergy can only rarely be an excuse for adverse reactions to local anaesthesia. PMID- 3548790 TI - Environmental pollution by inhalation anaesthetics. PMID- 3548791 TI - Haematological changes caused by nitrous oxide. Cause for concern? PMID- 3548792 TI - Clinical experience and plasma laudanosine concentrations during the infusion of atracurium in the intensive therapy unit. AB - Twenty patients in the intensive care unit received an infusion of atracurium to permit mechanical ventilation. The duration of infusion ranged from 38 to 219 h and the average rate of infusion during the study was 0.76 mg kg-1 h-1. In 14 patients an increase in atracurium requirement occurred within the first 72 h of the infusion. Recovery from neuromuscular blockade after a prolonged infusion was sufficiently rapid to avoid pharmacologically induced reversal. In six patients maximum plasma concentrations of laudanosine were 1.9-5 micrograms ml-1, and there was no evidence of cerebral excitation. PMID- 3548793 TI - Subarachnoid analgesia for caesarean section. A double-blind comparison of plain and hyperbaric 0.5% bupivacaine. AB - Equal volumes (2.5 ml, 12.5 mg) of plain 0.5% bupivacaine (glucose-free) and hyperbaric 0.5% bupivacaine (in 8% glucose) were compared in a randomized double blind study of 40 patients undergoing Caesarean section under subarachnoid anaesthesia. There were no differences in the rate of onset, maximum spread, number of patients with high cervical levels, duration of anaesthesia or incidence of post-spinal headaches between the two solutions. The median maximum cephalad levels of analgesia were (hyperbaric) T1 (range C1-T4), and (plain) T2 (range C1-T4). Thirteen patients in the hyperbaric group and 10 in the isobaric group required i.v. ephedrine to treat hypotension. Nine patients (23%) developed a post-spinal headache, and three were treated with an extradural blood patch. PMID- 3548795 TI - The reliability of immunofluorescence and histopathology in the diagnosis of discoid lupus erythematosus and lichen planus. AB - We have investigated the diagnostic reliability of the immunofluorescence (IF) technique and histopathology in discoid lupus erythematosus (DLE) and lichen planus (LP) and in diseases clinically resembling these (DLE-like and LP-like). In all cases of DLE and LP it was possible to establish the clinical diagnosis with one or both methods, when in initially negative cases the investigations were repeated on fresh biopsies. In DLE the diagnostic specificity of IF was greater than that of histopathology, and the diagnostic sensitivity of the results of both methods together was greater than that of the two methods separately. In LP the diagnostic specificity of both methods was maximal, but IF showed greater diagnostic sensitivity. These differences were not statistically significant. The most important immunohistochemical feature for diagnosis by IF was the incidence and the morphological pattern of IgG along the epidermal basement membrane. This held true for differentiation between LP and DLE and also between DLE and DLE-like diseases. Combination of the results of IF and histopathology gave the most reliable results in DLE. In LP, IF was more reliable than histopathology. PMID- 3548794 TI - Metabolism of azathioprine to 6-thioguanine nucleotides in patients with pemphigus vulgaris. AB - Azathioprine metabolism, to red cell 6-thioguanine nucleotides (6TGN), was studied in four patients with pemphigus vulgaris. Throughout treatment blood samples were taken for red cell 6TGN assay and differential white cell counts. Metabolite steady-state occurred in three patients in 2, 2 and 4 months respectively. In the fourth patient red cell 6TGN concentrations increased slowly over 3 years. There was a significant negative correlation between 6TGN concentrations and the white blood cell count (rs = -0.92, P less than 0.0005) in this patient. PMID- 3548797 TI - Different repopulation kinetics of erythroid (BFU-E), myeloid (CFU-GM) and T lymphocyte (TL-CFU) progenitor cells after autologous and allogeneic bone marrow transplantation. AB - Marrow recovery of erythroid (BFU-E), myeloid (CFU-GM) and T-lymphocyte (TL-CFU) progenitor cells was studied at various time intervals after autologous bone marrow transplantation in 10 patients with acute myeloid leukaemia in remission. These data were compared with those in 14 recipients of T-cell depleted allogeneic marrow grafts. The results indicate markedly different repopulation kinetics of BFU-E, CFU-GM and TL-CFU after autologous and allogeneic bone marrow transplantation. Following autografting reduced numbers of BFU-E and CFU-GM were always present at 2 months after transplantation. Between 2-6 and 6-24 months a gradual increase occurred, although reduced BFU-E and CFU-GM values were still noted in 50% of the cases in spite of normal bone marrow cellularity and restoration of peripheral blood counts. In contrast, in the allograft recipients normal BFU-E numbers appeared within 2 months after transplantation. In addition, CFU-GM values had become normal in 35% of the tests performed at 1-2 months and respectively in 66% and 100% at 2-6 and 6-24 months. The recovery pattern of TL CFU differed from that of the other haemopoietic progenitor cells. TL-CFU showed a fast recovery, i.e. within 1 month after autologous bone marrow transplantation which was much more rapid than that of BFU-E and CFU-GM. After allografting, however, TL-CFU regenerated at a slower rate and reached normal levels between 2 and 6 months after transplantation. We suggest that the delayed restoration of myeloid and erythroid progenitor cells after autologous transplantation is related to a proliferative defect of the graft as a result of the preceding cytotoxic chemotherapy, the underlying malignant disease and/or cryopreservation. The slower recovery of the T lymphocyte precursors after allografting might be due to the immunological interactions between graft and host, the immuno suppressive therapy and/or the in vitro T cell depletion of the graft. PMID- 3548796 TI - Pemphigus in an Indian mother and daughter. AB - An Indian mother and daughter who developed pemphigus within a few months of one another are reported. This is the first fully documented case of familial pemphigus in Indian patients, and the first occasion on which HLA typing has been performed. It is also the first fully documented example of familial pemphigus in the British literature. PMID- 3548798 TI - Cytogenetic follow-up studies of recipients of T-cell depleted allogeneic bone marrow. AB - Serial cytogenetic studies of bone marrow and blood cells were made in leukaemic patients who had received an allogeneic bone marrow graft from a donor of unlike sex. The donor marrow was treated with the monoclonal antibody Campath-1 before infusion. The persistence of a significant proportion of dividing recipient cells in marrow and blood was observed after grafting. These recipient cells showed evidence of radiation damage of both the stable and unstable types. More than one transient clone of chromosomally abnormal recipient cells was observed in three cases. The differences between the cytogenetic findings in patients receiving donor marrow from which T cells have been removed and those cases previously studied in our Leukaemia Unit who had received untreated donor marrow are discussed. PMID- 3548800 TI - Effects of iron and desferrioxamine on the growth of Plasmodium falciparum in vitro. PMID- 3548799 TI - Graft rejection following T lymphocyte depleted bone marrow transplantation with two different TBI regimens. PMID- 3548802 TI - A comparison of symphysis-fundal height and ultrasound as screening tests for light-for-gestational age infants. AB - The clinical efficiency of serial measurement of symphysis-fundal height (SFH) for the prediction of light-for-gestational age (LGA) infants was compared with that of a single measurement of fetal abdominal circumference (AC) by ultrasound in the third trimester. To make the tests comparable the lower cut-off point of AC was altered until the specificity matched that of SFH. The sensitivity of the AC measurement (83%) was slightly better than that of the SFH measurement (76%) but this difference was not statistically significant. Each test had a false positive rate of about 60% which is comparable with clinical assessment. Screening with both tests and predicting LGA with abnormal results from either test improved the sensitivity to 93% but, as expected, decreased the specificity to 67% and the positive predictive value to 32%. If ultrasound facilities permit both tests should be used otherwise SFH measurements only could screen for LGA with ultrasound back-up for those with low SFH results. PMID- 3548801 TI - Update on lung disease in coalminers. PMID- 3548803 TI - A randomized study of fetal abdominal diameter and fetal weight estimation for detection of light-for-gestation infants in low-risk pregnancies. AB - A total of 2771 pregnant women with gestational age estimated by ultrasound measurement of the fetal biparietal diameter (BPD) before the 22nd week of gestation were re-examined by ultrasound in the 32nd and 37th week of pregnancy at which time the fetal BPD and abdominal diameter (AD) were measured. An additional examination was performed at 34 weeks if the fetal weight in the 32nd week was estimated to be less than 95% of the expected mean weight. Light-for gestational age (LGA) was suspected if the estimated birth-weight was less than 85% of the expected mean birthweight. This applied to 186 uncomplicated pregnancies in which there was no clinical suspicion of poor intrauterine growth. These pregnancies were randomly allocated to a treatment group (AD and estimated weight reported) or to a control group (AD and estimated weight withheld). Induction of labour was significantly more common in the treatment group (41%) than in the control group (15%). No statistically significant difference was found in the use of instrumental vaginal delivery or caesarean section. There was a suggestion of marginal benefit in terms of neonatal morbidity but this was not statistically significant. PMID- 3548804 TI - A new method for fetal weight estimation using real-time ultrasound. AB - A method for estimating fetal weight by calculating an approximate fetal volume from abdominal area, head area and femur length has been developed. Birthweights were calculated within 48 h before delivery for 434 patients, using this method and two other methods already in widespread use. Statistical analysis of the three sets of predictions gave standard deviations of 297 g for the new method, compared with 323 g and 342 g for the other methods. Further analysis of the data showed that estimates closest to the true birthweight were obtained in 41% of cases by using the new method, and in 33% and 26% of cases using the other methods. PMID- 3548805 TI - Growth retardation in preterm infants. AB - This paper combines earlier results on the relation between birthweight and gestational age, and the relation between fetal weight and ultrasound measurements of the fetal biparietal diameter (BPD) and mean abdominal diameter (AD) to investigate whether preterm infants (viewed as a group) are smaller than unborn fetuses of the same gestational age. The birthweight distribution for each sex at 223 and 258 days gestation was derived from the birthweight-for gestational age charts based on 3888 newborn infants. The sex-specific intrauterine weight distribution was estimated from ultrasound measurement of the fetal BPD and AD performed on randomly selected fetuses of gestational age 223 and 258 days. The birthweights were lower than the intrauterine weights, especially early in pregnancy and for female infants. Thus, the 10th birthweight centile for girls at day 223 corresponds to the 4th centile of the 'true' intrauterine weight, and the 'true' intrauterine 10th centile corresponds to the 25th centile birthweight at day 223. PMID- 3548806 TI - Rational acyclovir therapy in herpetic eye disease. AB - Acyclovir has been widely used against the various manifestations of eye disease due to herpes simplex since it first became generally available in the UK nearly five years ago. This paper discusses the rational indications for its use, through considerations of its pharmacology and pharmacokinetics, and through results of the many clinical trials that have been carried out to investigate its effects since its clinical efficacy was first demonstrated in 1979. PMID- 3548810 TI - Editorial: In honour of Professor Barrie Jones. PMID- 3548808 TI - Congenital hereditary corneal oedema of Maumenee: its clinical features, management, and pathology. AB - The clinical and histological features of congenital hereditary corneal oedema in 23 patients are presented. The series includes cases of both recessive and dominant inheritance. Although the condition is present at birth or in early childhood, visual development appears to be little impaired, if at all. Penetrating keratoplasty carries a relatively good surgical prognosis and can produce a substantial visual gain even when carried out late in life. PMID- 3548809 TI - Effect of osmolarity of artificial tear drops on relief of dry eye symptoms: BJ6 and beyond. AB - Patients with clinically well defined keratoconjunctivitis sicca (KCS) participated in two trials of hypo-osmolar tear substitutes. The trials were double masked, single crossover studies with computer generated random order allocation and were conducted by postal questionnaire. In the first trial a hypo osmolar formulation using polyvinylpyrrolidone and hydroxyethyl cellulose was compared with the patients' usual treatment (BJ6 or hypromellose) and found to be inferior, especially in respect of blurring and stickiness caused by higher viscosity. In the second trial hypo-osmolar preparations of BJ6 and hypromellose were compared with their iso-osmolar equivalents and found not to be significantly different in their effects. Hypo-osmolarity alone does not seem to guarantee relief of symptoms in KCS. Other factors including viscosity and colloid osmotic pressure may be more significant. PMID- 3548807 TI - The enigma of herpes stromal disease. AB - Herpes stromal disease is due to direct damage as a result of viral replication, virally induced immune mechanisms, or a combination of the two. Viral replication may have a major initiating role in the production of herpes simplex and herpes zoster induced stromal disease, and steroids may initially be harmful in their treatment. On topical antiviral drugs alone, in patients who never previously had had topical steroids, 14 of 15 cases of herpes simplex induced disciform keratitis responded favourably in an average of 44 days of treatment. This compared with one out of 14 responding if steroids had previously been used, 13 of 14 requiring topical steroids and an average 112 days' treatment. In herpes zoster stromal disease cases 78% had epithelial involvement, 54 of 57 responded to topical antivirals alone without the use of steroids, 2% recurred, and treatment averaged a total of 62 days. If steroids were used alone or in combination with antivirals, there was a 50% recurrence rate and 200 day total treatment duration. PMID- 3548811 TI - Ocular findings in a double-blind study of ivermectin versus diethylcarbamazine versus placebo in the treatment of onchocerciasis. AB - The effect of ivermectin, a new microfilaricide, was assessed in a double blind trial against diethylcarbamazine citrate (DEC) and placebo. Fifty-nine adult males with moderate to heavy infection with Onchocerca volvulus and with eye involvement were recruited from an area under Onchocerciasis Control Programme (OCP) vector control in Northern Ghana. They were randomly assigned to an eight day treatment with ivermectin as a single dose of 12 mg on day 1 followed by placebo for the remaining seven days, or DEC, total dose 1.3 g, or placebo, and ophthalmological review was undertaken over a period of one year. DEC acted quickly to eliminate microfilariae from the eye and was associated with reactive ocular changes and in a few cases functional deficit. Ivermectin eliminated microfilariae slowly from the anterior chamber of the eye over a period of six months. The ocular inflammatory reaction was minimal and no functional deficit occurred. It is postulated that the observed slow action of ivermectin on the eye may be attributed in part to its instability to cross the blood-aqueous humour barrier because of its molecular size as a macrocyclic lactone causing microfilariae to leave the eye gradually along a newly created gradient. Ivermectin is an effective microfilaricide with minimal ocular adverse effect and could therefore be suitable for widespread application without strict supervision. PMID- 3548812 TI - Topical steroid, cyclosporin A, and the outcome of rat corneal allografts. AB - The effects of a combination of topical corticosteroid and cyclosporin A on corneal graft survival were tested in a model of penetrating keratoplasty in the inbred rat. Topical medications were applied four times daily to the graft for 28 days postgraft. Neither topical steroid (1% prednisolone acetate) nor topical cyclosporin (1% in chremophor EL/ethanol) was able to modify the overall incidence of rejection, though all steroid-containing medications delayed the onset of rejection significantly. The combined formulation of steroid plus cyclosporin A caused a reduction in the incidence of rejection which did not reach statistical significance and which did not eliminate the response in all animals. The chremophor/ethanol vehicle was reasonably well tolerated but did cause some periocular dermatitis. PMID- 3548813 TI - Structural and functional properties of a phospholipase A2 purified from an inflammatory exudate. AB - The cell-free supernatant of sterile inflammatory peritoneal exudates contains a phospholipase A2 that participates in the digestion of Escherichia coli killed by polymorphonuclear leukocytes or by the purified bactericidal/permeability increasing protein (BPI) of these cells. This phospholipase A2 has been purified, and the sequence of the NH2-terminal 39 amino acids has been determined and compared with sequences of both BPI-responsive and BPI-nonresponsive phospholipases A2 from snake venoms and mammalian pancreas. The high concentration and location of basic residues in the NH2-terminal region is a common feature of BPI-responsive phospholipases A2 and may characterize those phospholipases A2 participating in inflammatory events. PMID- 3548814 TI - Kinetics and mechanism of human leukocyte elastase inactivation by ynenol lactones. AB - Human leukocyte elastase (HLE), a serine protease involved in inflammation and tissue degradation, can be irreversibly inactivated in a time- and concentration dependent manner by ynenol lactones. Ynenol lactones that are alpha-unsubstituted do not inactivate but are alternate substrate inhibitors that are hydrolyzed by the enzyme. Ynenol lactones that are both substituted alpha to to the lactone carbonyl and unsubstituted at the acetylene terminus are rapid inactivators of HLE and inactivate pancreatic elastase and trypsin more slowly. 3-Benzyl-5(E) (prop-2-ynylidene)tetrahydro-2-furanone inactivates HLE with biphasic kinetics and an apparent second-order rate of up to 22,000 M-1 s-1 (pH 7.8, 25 degrees C). The rate of inactivation is pH-dependent and is slowed by a competitive inhibitor. The partition ratio is 1.6 +/- 0.1. Rapid removal of ynenol lactone during the course of inactivation yields a mixture of acyl and inactivated enzyme species, which then shows a partial recovery of activity that is time- and pH dependent. Inactivation is not reversible with hydroxylamine. The enzyme is not inactivated if the untethered allenone is added exogenously. All of these results are consistent with a mechanism involving enzyme acylation at serine-195 by the ynenol lactone, isomerization of the acyl enzyme to give a tethered allenone, and capture of a nucleophile (probably histidine-57) to inactivate the enzyme. Substitution at the acetylene terminus of ynenol lactones severely reduces their ability to inactivate HLE, because allenone formation is slowed and/or nucleophile capture is hindered. Chemical competence of each of these steps has been demonstrated [Spencer, R.W., Tam, T.F., Thomas, E.M., Robinson, V.J.,& Krantz, A. (1986) J. Am. Chem. Soc. 108, 5589-5597]. PMID- 3548815 TI - Thermodynamic study of yeast phosphoglycerate kinase. AB - Enthalpies of binding of MgADP, MgATP, and 3-phosphoglycerate to yeast phosphoglycerate kinase have been determined by flow calorimetry at 9.95-32.00 degrees C. Combination of these data with published dissociation constants [Scopes, R.K. (1978) Eur. J. Biochem. 91, 119-129] yielded the following thermodynamic parameters for the binding of 3-phosphoglycerate at 25 degrees C: delta Go = -6.76 +/- 0.11 kcal mol-1, delta H = 3.74 +/- 0.08 kcal mol-1, delta So = 35.2 +/- 0.6 cal K-1 mol-1, and delta Cp = 0.12 +/- 0.32 kcal K-1 mol-1. The thermal unfolding of phosphoglycerate kinase in the absence and presence of the ligands listed above was studied by differential scanning calorimetry. The temperature of half-completion, t 1/2, of the denaturation and the denaturational enthalpy are increased by the binding of the ligands, the increase in t 1/2 being a manifestation of Le Chatelier's principle and that in enthalpy reflecting the enthalpy of dissociation of the ligand. Only one denaturational peak was observed under all conditions, and in contrast with the case of yeast hexokinase [Takahashi, K., Casey, J.L., & Sturtevant, J.M. (1981) Biochemistry 20, 4693 4697], no definitive evidence for the unfolding of more than one domain was obtained. PMID- 3548816 TI - Chicken ovomucoid: determination of its amino acid sequence, determination of the trypsin reactive site, and preparation of all three of its domains. AB - The complete amino acid sequence of chicken ovomucoid (OMCHI) is presented. OMCHI consists of three tandem domains, each homologous to pancreatic secretory trypsin inhibitor (Kazal) and each with an actual or putative reactive site for inhibition of serine proteinases. The major reactive site for bovine beta-trypsin is the Arg89-Ala peptide bond in the second domain. The equilibrium constant for hydrolysis of this peptide bond, K0hyd, is 1.85. The first and third domains of OMCHI are relatively ineffective inhibitors of several serine proteinases against which they were tested. OMCHI is a mixture of two forms: the major form with all of the amino acid residues and a minor form with Val134-Ser135 deleted. This polymorphism is present in all chicken eggs and is the result of ambiguous excision at the 5' end of the F intron. Procedures are given for preparation of modified chicken ovomucoid, OMCHI (in which the Arg89-Ala bond is hydrolyzed), of the first domain, OMCHI1 (residues 1-68), of the second domain, OMCHI2 (residues 65-130), and of the third domain, OMCHI3 (residues 131-186). In the case of the third domain, both the Asn175 glycosylated form, OMCHI3(+), and the carbohydrate free form, OMCHI3(-), were obtained. These isolated native domains are useful in many studies of ovomucoid behavior. PMID- 3548817 TI - Amino acid sequence of a unique protease from the crayfish Astacus fluviatilis. AB - The amino acid sequence of a protease from the crayfish Astacus fluviatilis has been determined from overlapping sets of peptides derived largely by cleavage at Met, Lys, or Arg residues. The protein comprises 200 amino acid residues in a single polypeptide chain, corresponding to a molecular mass of 22,614 daltons. Two disulfide bonds link Cys-42 to Cys-198 and Cys-64 to Cys-84. The sequence of this invertebrate protease appears to be unique since it has no homologous relationship to any of the known protein sequences. PMID- 3548818 TI - Synthesis and biological properties of 5-azido-2'-deoxyuridine 5'-triphosphate, a photoactive nucleotide suitable for making light-sensitive DNA. AB - A photoactive nucleotide analogue of dUTP, 5-azido-2'-deoxyuridine 5' triphosphate (5-N3dUTP), was synthesized from dUMP in five steps. The key reaction in the synthesis of 5-N3dUTP is the nitration of dUMP in 98% yield in 5 min at 25 degrees C using an excess of nitrosonium tetrafluoroborate in anhydrous dimethylformamide. Reduction of the resulting 5-nitro compound with zinc and 20 mM HCl gave 5-aminodeoxyuridine monophosphate (5-NH2dUMP). Diazotization of 5 NH2dUMP with HNO2 followed by the addition of NaN3 to the acidic diazonium salt solution gave a photoactive nucleotide derivative in 80-90% yield. The monophosphate product was identified as 5-N3dUMP by proton NMR, UV, IR, and chromatographic analysis as well as by the mode of synthesis and its photosensitivity. After formation of 5-N3dUTP through a chemical coupling of pyrophosphate to 5-N3dUMP, the triphosphate form of the nucleotide was found to support DNA synthesis by Escherichia coli DNA polymerase I at a rate indistinguishable from that supported by dTTP. When UMP was used as the starting compound, 5-N3UTP was formed in an analogous fashion with similar yields and produced a photoactive nucleotide which is a substrate for E. coli RNA polymerase. To prepare [gamma-32P]-5-N3dUTP for use as an active-site-directed photoaffinity labeling reagent, a simple method of preparing gamma-32P-labeled pyrimidine nucleotides was developed. [gamma-32P]-5-N3dUTP is an effective photoaffinity labeling reagent for DNA polymerase I and was found to bind to the active site with a 2-fold higher affinity than dTTP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3548819 TI - Competitive labeling as an approach to defining the binding surfaces of proteins: binding of monomeric insulin to lipid bilayers. AB - The free monomeric form of insulin is known to adsorb strongly to many different surfaces. A question of physiological relevance for which no previous studies have been reported is whether the monomeric form of insulin binds to lipid bilayers. In order to answer this question, it is necessary to carry out studies at the very dilute concentrations (less than 10(-6) M) necessary to obtain this species. We have approached this problem by applying the method of competitive labeling [Hefford, M.A., Evans, R.M., Oda, G., & Kaplan, H. (1985) Biochemistry 24, 867-874] to study insulin at concentrations as low as 3 X 10(-8) M, in the presence and absence of large unilamellar liposomes. With 1-fluoro-2,4 dinitrobenzene as the labeling reagent, the relative chemical reactivities of the functional groups of insulin were found to decrease markedly when insulin was incubated with liposomes consisting of egg lecithin and cholesterol (2:1 mol/mol) in 1.0 M KCl, pH 7.5 at 37 degrees C. The decrease for each functional group was found to directly correlate with its proximity to the dimer-forming surface of the monomer. It is concluded that insulin binds to lipid bilayers in a specific orientation, with the dimer-forming surface interacting with the bilayer. These results demonstrate the feasibility of applying competitive labeling to obtain structure-function relationships of membrane-interactive proteins in general and monomeric insulin in particular. PMID- 3548820 TI - Structure of the complex group-specific polysaccharide of group B Streptococcus. AB - The group-specific antigen was isolated from a type Ia group B streptococcal strain and is a complex polysaccharide composed of alpha-L-rhamnopyranosyl, alpha D-galactopyranosyl, 2-acetamido-2-deoxy-beta-D-glucopyranosyl, D-glucitol, and phosphate residues. The complexity of the group B polysaccharide antigen is evident from the fact that when depolymerized by basic hydrolysis it yielded three structurally related, but nevertheless significantly different, oligosaccharides. These oligosaccharides were obtained in different molar quantities as their monophosphate esters. This evidence strongly suggests that they are linked by phosphodiester bonds in the original group B antigen. If these oligosaccharides are in fact randomly situated throughout the linear polysaccharide, then this type of heterogeneous repeating unit is unusual for a polysaccharide of bacterial origin. However, this structural arrangement of the oligosaccharides has yet to be unambiguously established because the alternate explanation of there being three different polysaccharides in the group B antigen cannot be discounted in the evidence presented here. The oligosaccharides were enzymatically dephosphorylated, and the structures of two of the three oligosaccharides are (formula: see text) Despite their structural differences, the two oligosaccharides are related by the smaller being an integral part of the larger. In the structural analysis of the group B antigen, methylation analysis, periodate oxidation, nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry, fast atom bombardment mass spectrometry, and various specific chemical and enzymatic degradations were the principal methods used. Of particular interest was the use of an alpha-rhamnosidase to selectively degrade the larger oligosaccharide. This facilitated the assignment of signals in its 1H and 13C NMR spectra. PMID- 3548821 TI - Nuclear magnetic resonance and molecular genetic studies of the membrane-bound D lactate dehydrogenase of Escherichia coli. AB - In this study we demonstrate the potential of combining fluorine-19 nuclear magnetic resonance (NMR) spectroscopy with molecular genetics. We are using the membrane-bound enzyme D-lactate dehydrogenase of Escherichia coli as a model system to characterize interactions between proteins and lipids. We have labeled D-lactate dehydrogenase with 4-, 5-, and 6-fluorotryptophans and obtained high resolution fluorine-19 NMR spectra showing five resonances, in agreement with the five tryptophan residues expected from the DNA sequence. The five 19F resonances in the spectra have been assigned to the specific tryptophan residues in the primary sequence of D-lactate dehydrogenase by site-directed oligonucleotide mutagenesis of the cloned gene. We observe large differences in the relative fluorine-19 chemical shifts of each tryptophan residue when labeled by different isomers of fluorotryptophan. We have determined by NMR methods that two tryptophans are exposed to the solvent and that none of the tryptophan residues are within 10 A of the lipid phase. On the basis of 19F NMR spectroscopy of the labeled tryptophan residues, the conformation of D-lactate dehydrogenase is similar in aqueous solution and in the presence of a variety of lipids and detergents. This result indicates that the presence of lipids or detergents is not required to maintain the tertiary structure of this membrane-bound enzyme. In contrast, Triton X-100 induces a change to an abnormal conformation of the enzyme as judged from both NMR spectroscopy and the effect of temperature on the maximal velocity of the enzyme in the presence of this detergent. PMID- 3548822 TI - Stereochemistry and mechanism of a new single-turnover, half-transamination reaction catalyzed by the tryptophan synthase alpha 2 beta 2 complex. AB - Tryptophan synthase is a versatile enzyme that catalyzes a wide variety of pyridoxal phosphate dependent reactions that are also catalyzed in model systems. These include beta-replacement, beta-elimination, racemization, and transamination reactions. We now show that the apo-alpha 2 beta 2 complex of tryptophan synthase will bind two unnatural substrates, pyridoxamine phosphate and indole-3-pyruvic acid, and will convert them by a single-turnover, half transamination reaction to pyridoxal phosphate and L-tryptophan, the natural coenzyme and a natural product, respectively. This enzyme-catalyzed reaction is more rapid and more stereospecific than an analogous model reaction. The pro-S 4' methylene proton of pyridoxamine phosphate is removed during the reaction, and the product is primarily L-tryptophan. We conclude that pyridoxal phosphate enzymes may be able to catalyze some unnatural reactions involving bound reactants and bound coenzyme since the coenzyme itself has the intrinsic ability to promote a variety of reactions. PMID- 3548823 TI - Kinetic analysis of guanosine 5'-O-(3-thiotriphosphate) effects on phosphatidylinositol turnover in NRK cell homogenates. AB - Addition of the guanine nucleotide analogue guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) to [3H]inositol-labeled NRK cell homogenates resulted in rapid breakdown of cellular polyphosphoinositides. GTP gamma S stimulated phospholipase C, resulting in a more than 4-fold increase in the hydrolysis rates of phosphatidylinositol 4-phosphate (PIP) and phosphatidylinositol 4,5 bis(phosphate) (PIP2). No significant effect of GTP gamma S on direct phosphatidylinositol (PI) hydrolysis was detected. There was an increase in water soluble inositols, with inositol tris(phosphate) (IP3) levels increasing at least 10 times over the decrease seen in PIP2, indicating that PIP kinase activity was also accelerated following GTP gamma S addition. Inositol 1,4,5-tris(phosphate) peaked rapidly after GTP gamma S addition (less than 2 min) while inositol 1,3,4 tris-(phosphate) was produced more slowly and leveled off after approximately 10 min. The differential equations describing conversion between intermediates in the PI turnover pathway were solved and fitted to data obtained from both [3H]inositol and [32P]phosphate fluxes by nonlinear least-squares analysis. GTP gamma S effects on the pseudo-first-order rate constants for the lipase, kinase, and phosphatase steps were determined from the analysis. From these measurements it can be estimated that, in the presence of GTP gamma S and calcium buffered to 130 nM, hydrolysis of PIP2 accounts for at least 10 times as much diacylglycerol as direct PI breakdown despite the 100-fold excess of PI over PIP2. From the kinetic model it is predicted that small changes in the activities of PI and PIP kinases can have large but different effects on the level of IP3 and diacylglycerol following GTP gamma S addition. These results argue that regulation of PI and PIP kinases may be important for determining both cellular IP3 and diacylglycerol levels. PMID- 3548824 TI - Molecular aspects of inorganic phosphate transport in mitochondria. PMID- 3548825 TI - Mitochondrial respiratory control in the myocardium. AB - The heart muscle has proved to be a practical model for studying respiratory control in intact tissues. It also demonstrates that control at the level of the respiratory chain is augmented by metabolic control at the substrate level as exemplified by the very narrow range of changes in the redox state of the mitochondrial NADH/NAD couple even during extensive changes in ATP and oxygen consumption. The behaviour of mitochondria when isolated can largely be duplicated in the intact myocardium. Moreover, the high intracellular concentrations of enzymes, coenzymes and adenine nucleotides create conditions of high reaction rates, enabling the formation of a near equilibrium network of certain main pathways. This equilibrium network in connection with metabolic regulation of the hydrogen pressure upon the matrix NADH/NAD pool is a prerequisite for the regulation of cellular respiration at a high efficiency of energy transfer. Experimentation on the intact myocardium also seems to be capable of resolving some of the uncertainties about prevailing mechanisms for the regulation of cellular respiration. PMID- 3548826 TI - Purification and properties of two multiple forms of dihydrodiol dehydrogenase from guinea-pig testis. AB - NADP+-dependent dihydrodiol dehydrogenase (trans-1,2-dihydrobenzene-1,2-diol: NADP+ oxidoreductase, EC 1.3.1.20) activity in the cytosol of guinea-pig testis was separated into two major and two minor peaks by Q-Sepharose chromatography; one minor form was immunologically cross-reacted with hepatic aldehyde reductase. The two major enzyme forms were purified to homogeneity. One form, which had the highest amount in the tissue, was a monomeric protein with a molecular weight of 32,000 and isoelectric point of 4.2, showed strict specificity for benzene dihydrodiol and NADP+, and reduced pyridine aldehydes, glyceraldehyde and diacetyl at low rates. Another form, with a molecular weight of 36,000 and isoelectric point of 5.0, oxidized n-butanol, glycerol and sorbitol as well as benzene dihydrodiol in the presence of NADP+ or NAD+, and exhibited much higher reductase activity towards various aldehydes, aldoses and diacetyl. The pI 5.0 form was more sensitive to inhibition by sorbinil and p-chloromercuriphenyl sulfonate than the pI 4.2 form and was activated by sulfate ion. The two enzymes did not catalyze the oxidation of hydroxysteroids and xenobiotic alicyclic alcohols and were immunologically different from hepatic 17 beta-hydroxysteroid dihydrodiol dehydrogenase. The results indicate that guinea-pig testis contains at least two dihydrodiol dehydrogenases distinct from the hepatic enzymes, one of which, the pI 5.0 enzyme form, may be identical to aldose reductase. PMID- 3548827 TI - Purification and properties of a pepstatin-insensitive carboxyl proteinase from a gram-negative bacterium. AB - A carboxyl proteinase was found in the culture filtrate of a Gram-negative bacterium. The optimum for the action of the purified enzyme was approx. pH 3 and its caseinolytic activity was not inhibited by carboxyl proteinase inhibitors, such as pepstatin, Streptomyces pepsin inhibitor and diazoacetyl-DL-norleucine methyl ester. 1,2-epoxy-3-(p-nitrophenoxy)propane modified the enzyme with concomitant loss of its enzyme activity. The enzymatic and physicochemical properties of the enzyme were compared with those of known pepstatin- and diazoacetyl-DL-norleucine methyl ester-insensitive carboxyl proteinases previously reported. To our knowledge, this is the first carboxyl proteinase isolated from bacteria. PMID- 3548828 TI - Neutral proteinases of the human intervertebral disc. AB - Disc tissue consisting of pooled annuli fibrosus and nuclei pulposus from the cadaver of an adolescent aged 19 years was extracted with 4.0 M Gu-HCl. Proteins of low buoyant density (p less than or equal to 1.38 g/ml) containing the disc enzymes and inhibitors were separated from proteoglycans of high buoyant density (p greater than or equal to 1.50 g/ml) by density gradient ultracentrifugation. Sephadex G-75F gel chromatography followed by trypsin affinity chromatography was then used to resolve disc proteolytic and trypsin inhibitory activities. The results obtained were strongly suggestive of the presence of a high molecular weight zymogen which upon activation generated a population of smaller molecular weight proteinases. The disc proteinases obtained by this process showed similar properties in terms of: their pH optima (7.4-7.6); their inhibition patterns by class-specific proteinase inhibitors; their variation of activity as a function of NaCl and lysine concentrations; and the hydrodynamic size of their proteoglycan degradation products. The activated disc neutral proteinase demonstrated many characteristics in common with plasmin; however, unlike the latter, the disc proteinases also showed some calcium dependence. PMID- 3548829 TI - Catabolism of neurotensin in the epithelial layer of porcine small intestine. AB - The mammalian small intestine is both a source and a site of degradation of neurotensin. Metabolites produced by incubation of the peptide with dispersed enterocytes from porcine small intestine were isolated by high-performance liquid chromatography and identified by amino-acid analysis. The principal sites of cleavage were at the Tyr-11-Ile-12 bond, generating neurotensin-(1-11), and at the Pro-10-Tyr-11 bond, generating neurotensin-(1-10). The corresponding COOH terminal fragments, neurotensin-(11-13) and -(12-13) were metabolized further. Formation of neurotensin-(1-11) and -(1-10) was completely inhibited by phosphoramidon (Ki = 6 nM), an inhibitor of endopeptidase 24.11, but not by captopril, an inhibitor of peptidyl dipeptidase A. Incubation of neurotensin with purified endopeptidase 24.11 from pig stomach also resulted in cleavage of the Tyr-11-Ile-12 and Pro-10-Tyr-11 bonds. A minor pathway of cell-surface-mediated degradation was the phosphoramidon-insensitive cleavage of the Tyr-3-Glu-4 bond, generating neurotensin-(1-3) and neurotensin-(4-13). No evidence for specific binding sites (putative receptors) for neurotensin was found either on the intact enterocyte or on vesicles prepared from the basolateral membranes of the cells. Neurotensin-(1-8), the major circulating metabolite, was not formed when neurotensin(1-13) was incubated with cells, but represented a major metabolite (together with neurotensin-(1-10] when neurotensin-(1-11) was used as substrate. The study has shown that degradation of neurotensin in the epithelial layer of the small intestine is mediated principally through the action of endopeptidase 24.11, but this enzyme is probably not responsible for the production of the neurotensin fragments detected in the circulation. PMID- 3548830 TI - Substrate specificity in the stimulation of intestinal ornithine decarboxylase activity by refeeding after starvation. AB - Jejunal loops in 3-day-fasted rats were perfused with hexoses and amino acids to test for their ability to stimulate intestinal ornithine decarboxylase activity. Intraluminal L- and D-glucose, galactose and 3-O-methylglucose were potent stimulants, while D-fructose and L-leucine were not. Intravenously infused D glucose was also without effect. Induction of ornithine decarboxylase therefore appears to involve a receptor-mediated event which is probably located at the luminal cell surface. PMID- 3548831 TI - Inhibition by insulin of glucagon-dependent phospholipid methyltransferase phosphorylation in rat hepatocytes. AB - Addition of insulin to isolated rat hepatocytes prelabeled with [32P]phosphate inhibited glucagon-dependent phospholipid methyltransferase phosphorylation and activation. Insulin alone had no effect on either the phosphorylation of the enzyme or on its activity. The effect of insulin on glucagon-dependent phospholipid methyltransferase phosphorylation was dose-dependent and occurred at physiological doses of the hormone (10(-11)-10(-10) M). Analysis of 32P-labeled peptides after digestion with trypsin revealed only one site of phosphorylation regulated by glucagon (10(-8) M) in isolated rat hepatocytes. This site, as analyzed by HPLC and thin-layer chromatography, coincided with that phosphorylated by the cAMP-dependent protein kinase using purified rat liver phospholipid methyltransferase. PMID- 3548832 TI - Effect of insulin on glucose/oxygen and lactate/oxygen quotients across the hindlimb of fetal lambs. AB - In order to determine whether insulin stimulates glucose uptake by the hindlimb tissue of the fetal lamb, we performed 7 paired, euglycemic glucose 'clamp' experiments in 7 chronically prepared fetal sheep. Four sample sets for oxygen content, glucose and lactate concentration were drawn from the external iliac artery and vein during a control period and repeated during a euglycemic, hyperinsulinemic 'clamp' period. Insulin was infused at constant rate (4 mU/min/kg) and the fetal arterial glucose concentration was maintained by variable glucose infusion. The glucose/oxygen quotient increased significantly: 1.05 +/- 0.07 (control) versus 2.02 +/- 0.16 (hyperinsulinemia). There was no change in lactate/oxygen quotient. The data demonstrate that with maximal insulin stimulation, fetal hindlimb tissues increase glucose uptake by 92% with no large change in lactate production, indicating a net accumulation of glucose carbon under these experimental conditions. PMID- 3548833 TI - Effects of social environment on sexual maturation in female cotton rats (Sigmodon hispidus). AB - Age at sexual maturation among female cotton rats was measured in a variety of intraspecific social environments. Two experiments were conducted. In Experiment I, female cotton rats attained vaginal perforation and first estrus at younger ages and lighter body masses when paired from weaning with a conspecific juvenile male than when caged alone. In Experiment II, these findings were replicated and extended. Females housed with juvenile males matured at the youngest ages, while those housed alone matured at the oldest ages. Females housed with adult males matured at intermediate ages. Presence of a second juvenile female during maturation was significantly associated with early vaginal opening but not with early first estrus. The results of this study are discussed in context of similar social environmental effects on female sexual maturation that have been identified in other rodent species. PMID- 3548834 TI - Pulsatile administration of gonadotropin-releasing hormone advances ovulation in cycling mares. AB - Cycling standardbred mares were infused with saline or 20 micrograms gonadotropin releasing hormone (GnRH) in a pulsatile pattern (one 5-sec pulse/h, 2 h or 4 h) beginning on Day 16 of the estrous cycle. Although serum concentrations of luteinizing hormone (LH) increased significantly earlier in all three GnRH treated groups (within one day of the initiation of infusion) compared to saline infused controls, there were no differences in peak periovulatory LH concentrations among treatments (overall mean +/- SEM, 8.98 +/- 0.55 ng/ml). The number of days from the start of treatment to ovulation was significantly less in mares infused with 20 micrograms GnRH/h (mean +/- SEM, 2.9 +/- 0.6 days after the initiation of treatment, or 18.9 days from the previous ovulation; N = 7) compared to mares treated with saline (5.9 +/- 0.3 days, or 21.9 days from previous ovulation; N = 7) or 20 micrograms GnRH per 4 h (5.4 +/- 0.9 days or 21.4 days from previous ovulation; N = 5). Although mares infused with 20 micrograms GnRH/2 h ovulated after 4.3 +/- 0.7 days of treatment (Day 20.3; N = 7), this was not significantly different from either the control or 20 micrograms GnRH/h treatment groups. Neither the duration of the resulting luteal phase nor the length of the estrous cycle was different between any of the treatment groups (combined means, 14.7 +/- 0.2 days and 21.3 +/- 0.4 days, respectively). We conclude that pulsatile infusion of GnRH is effective in advancing the time of ovulation in cycling mares, but that the frequency of pulse infusion is a critical variable. PMID- 3548835 TI - Monoclonal antibodies against rat Leydig cell surface antigens. AB - Monoclonal antibodies (MAbs) directed against the Leydig cell surface may be used to identify this cell in testicular preparations. Collagenase-dispersed adult rat interstitial cells were fractionated on Percoll density gradients, and Leydig cell-enriched fractions were used to prepare MAbs. Hybridomas were screened by enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence assay (IIF) on isolated testicular cells and immunocytochemical localization on paraffin sections of adult testes. In density gradient fractions, immunoglobulin (Ig) M MAbs (LC-1C6 and LC-6H6) labeled the surface of cells possessing the morphological characteristics of Leydig cells. The density gradient profiles of MAb-binding activity observed by IIF and ELISA were parallel with the Leydig cell distribution as determined by [125I]-human chorionic gonadotropin (hCG) binding, testosterone response to hCG in vitro, 3 beta-hydroxysteroid dehydrogenase histochemistry and electron microscopy. The MAbs prominently labeled most interstitial cells in sections, but there was little or no labeling of connective tissue, endothelial or seminiferous tubule cells. Both MAbs recognized components of Mr 58,000 in Western blots of Leydig cell-enriched extracts. The results indicate that LC-1C6 and LC-6H6 recognize antigens on the Leydig cell surface that are not present on other isolated testicular cells from the adult rat. These MAbs are specific markers of the Leydig cell in situ and in vitro. PMID- 3548836 TI - Experience with bone marrow transplantation for severe aplastic anemia and leukemia. Two years experience with 31 patients in Zagreb (Yugoslavia). AB - Since 1983, twelve patients with severe aplastic anemia and nineteen patients with leukemia were treated with bone marrow transplantation. Six patients with severe aplastic anemia are still alive at 300 to 1,210 days after transplantation, and twelve patients with leukemia are alive at 199 to 671 days. The incidence of GvHD was relatively high (60%). Bacterial infections were the main causes of death. PMID- 3548837 TI - [Effect of stretching on the action potentials of the human and rabbit ventricular myocardium]. AB - The effect of stretching from L0 to Lmax on the electrical activity was studied on human myocardial preparations from patients with heart disease and on strips of rabbit ventricular myocardium. Muscular deformation was shown to decrease the amplitude and velocity of depolarization in slow action potentials. The action potentials (AP) possessing a fast depolarization phase were not sensitive to physiological stretching. Antiarrhythmic drugs--ethmozin (2 X 10(-5) M) and ethacizin (2 X 10(-6) M)--caused a decrease in the rate of AP depolarization, thus increasing AP sensitivity to deformation. It is suggested that stretching under the action of ethmozin and ethacizin reduced cardiomyocyte excitability due to suppression of slow Ca-current. PMID- 3548838 TI - [Changes in the nonspecific factors of body protection in experimental Salmonella infection]. AB - Cytochemical studies of the components of intracellular microbicidal system of leukocytes were performed on rabbits. Two experimental models of Salmonella infection were used. With the oral infection by S. typhimurium the mild form of experimental salmonellosis was noticed. The decrease in myeloperoxidase activity and cation protein and lipid content, as well as an increase in glycogen content and NBT-test activity were observed. Intravenous injection of S. typhimurium endotoxin produced the clinical pattern of endotoxin shock. The activity of all the variables tested was decreased. It returned to standard values 120-240 hours after endotoxin injection. PMID- 3548839 TI - [Detection of immunomodulating polypeptides in human thymus cells by an immunofluorescent method]. PMID- 3548840 TI - [Induced differentiation of subpopulations of leukemic blood cells in patients with chronic B-cell lympholeukemia]. AB - M+-cell subpopulation forming M-rosettes and M(-)-cell subpopulation not forming M-rosettes were revealed in the peripheral blood of patients with B-cell chronic lympholeukemia (B-CLL) by means of mouse red blood rosette formation test. M+ subpopulation contained a larger percentage of cells expressing Ia-like antigens, as compared to M- subpopulation. On the other hand, the latter contained a significantly higher amount of cytoplasmatic immunoglobulin-containing cells. M+ appeared to be less mature than M- cells. Cells of B-CLL patients had a heterogeneous response to 12-0-tetradecanoylphorbol-13-acetate (TPA). Less mature cells with surface immunoglobulin expression did differentiate, while more mature cells containing cytoplasmatic immunoglobulins did not. Differentiation was accompanied by the acquisition of characteristics peculiar to more mature cells, i. e. cytoplasmatic immunoglobulin accumulation. Subpopulations of M+ and M- cells from each patient also had a different pattern of response to TPA: less mature M+ cells did differentiate, while more mature M- cells did not. Maturation of less mature leukemia cells, as the disease progresses, is suggested to result in a heterogeneous pattern of immunological B-CLL phenotype. PMID- 3548841 TI - Total body irradiation and high-dose etoposide: a new preparatory regimen for bone marrow transplantation in patients with advanced hematologic malignancies. AB - In a phase I/II study, 47 patients (median age, 24 years) with hematologic malignancies (33 patients with acute leukemia not in first remission and 14 patients with other advanced malignant hematologic disorders) were treated with total body irradiation and high doses of etoposide (VP16-213) followed by bone marrow transplantation. At the time of analysis, 21 patients were alive, and 19 of them were in continued complete remission for 101 days to greater than 40 months (median, 12 months). The actuarial disease-free survival rate of the 33 acute leukemia patients is 43% (2 SEM, 18%) and the actuarial relapse rate is 32% (2 SEM, 20%). Five of the 14 patients with the other hematologic malignancies are alive, and four of them continue to be free of disease for 8 to 27 months. Pharmacokinetic studies established a strong correlation between the administered drug doses and their plasma levels and also demonstrated complete drug clearance prior to marrow grafting. An etoposide dose of 60 mg/kg body weight was found to be the maximum tolerated dose. This new preparatory regimen was well tolerated and was not associated with specific acute or long-term regimen-related toxicities. Our data suggest that total body irradiation with high-dose etoposide presents a viable alternative to other preparatory regimens. The role of this novel combination remains to be defined by future prospective randomized trials. PMID- 3548842 TI - The in vitro synthesis of polypeptides for the platelet membrane glycoproteins IIb and IIIa. AB - The platelet membrane glycoproteins IIb (GpIIb) and GpIIIa form calcium-dependent heterodimers containing binding sites for fibrinogen, von Willebrand factor, and fibronectin. Although GpIIb and GpIIIa are distinct proteins, both GpIIb and GpIIIa are deficient in platelets from individuals with the recessive disorder Glanzmann's thrombasthenia. To gain a better understanding of the genetic basis for GpIIb and GpIIIa synthesis, we studied their synthesis by two human leukemia cell lines, HEL and K562. HEL cells contained complexes of GpIIb and GpIIIa, and K562 cells expressed GpIIIa, but not GpIIb, when stimulated with phorbol-12 myristate-13-acetate (PMA). RNA from HEL cells directed the in vitro synthesis of a 110,000-Mr precursor for GpIIb and a 92,000-Mr precursor for GpIIIa, which indicates that the synthesis of GpIIb and GpIIIa by HEL cells is directed by separate mRNAs. In contrast, RNA from PMA-stimulated K562 cells only directed the synthesis of a 92,000-Mr precursor for GpIIIa. The dissociation of GpIIb and GpIIIa synthesis in K562 cells suggests that GpIIb and GpIIIa may be the products of separate genes. PMID- 3548843 TI - Studies on the ultrastructure of fibrin lacking fibrinopeptide B (beta-fibrin). AB - Release of fibrinopeptide B from fibrinogen by copperhead venom procoagulant enzyme results in a form of fibrin (beta-fibrin) with weaker self-aggregation characteristics than the normal product (alpha beta-fibrin) produced by release of fibrinopeptides A (FPA) and B (FPB) by thrombin. We investigated the ultrastructure of these two types of fibrin as well as that of beta-fibrin prepared from fibrinogen Metz (A alpha 16 Arg----Cys), a homozygous dysfibrinogenemic mutant that does not release FPA. At 14 degrees C and physiologic solvent conditions (0.15 mol/L of NaCl, 0.015 mol/L of Tris buffer pH 7.4), the turbidity (350 nm) of rapidly polymerizing alpha beta-fibrin (thrombin 1 to 2 U/mL) plateaued in less than 6 min and formed a "coarse" matrix consisting of anastomosing fiber bundles (mean diameter 92 nm). More slowly polymerizing alpha beta-fibrin (thrombin 0.01 and 0.001 U/mL) surpassed this turbidity after greater than or equal to 60 minutes and concomitantly developed a network of thicker fiber bundles (mean diameters 118 and 186 nm, respectively). Such matrices also contained networks of highly branched, twisting, "fine" fibrils (fiber diameters 7 to 30 nm) that are usually characteristic of matrices formed at high ionic strength and pH. Slowly polymerizing beta-fibrin, like slowly polymerizing alpha beta-fibrin, displayed considerable quantities of fine matrix in addition to an underlying thick cable network (mean fiber diameter 135 nm), whereas rapidly polymerizing beta-fibrin monomer was comprised almost exclusively of wide, poorly anastomosed, striated cables (mean diameter 212 nm). Metz beta fibrin clots were more fragile than those of normal beta-fibrin and were comprised almost entirely of a fine network. Metz fibrin could be induced, however, to form thick fiber bundles (mean diameter 76 nm) in the presence of albumin at a concentration (500 mumol/L) in the physiologic range and resembled a Metz plasma fibrin clot in that regard. The diminished capacity of Metz beta fibrin to form thick fiber bundles may be due to impaired use or occupancy of a polymerization site exposed by FPB release. Our results indicate that twisting fibrils are an inherent structural feature of all forms of assembling fibrin, and suggest that mature beta-fibrin or alpha beta-fibrin clots develop from networks of thin fibrils that have the ability to coalesce to form thicker fiber bundles. PMID- 3548844 TI - Stromal growth factor production in irradiated lectin exposed long-term murine bone marrow cultures. AB - Hematopoietic regulatory factors produced by adherent (stromal) cells in long term murine bone marrow cultures have been investigated. Using an in situ double layer agar overlay system, we demonstrated that exposure of the stromal cells to 1,100-rad irradiation increased their activities in stimulating colony formation of FDC-P1, an interleukin 3 (IL 3)-responsive cell line. The colony-stimulating activities (CSAs) of the irradiated stroma also stimulated normal marrow cells to form granulocyte-macrophage, megakaryocyte, and mixed lineage colonies. Addition of the lectin pokeweed mitogen to the irradiated stroma increased the level of CSAs. The FDC-P1 CSA of the irradiated stroma was inhibited by antibodies directed against murine granulocyte-macrophage colony stimulating factor (GM-CSF) but not by those against murine IL 3. Stromal-derived CSA for marrow cells was also partially blocked by anti-GM-CSF antibodies, probably reflecting the presence of other CSAs such as CSF-1. This latter growth factor has been found to be present in conditioned media from Dexter stroma, but levels are not increased after irradiation or lectin exposure. Partially purified GM-CSF, like IL 3, stimulated FDC-P1 proliferation and granulocyte, macrophage, and megakaryocyte colony formation. These results indicate that the major terminal differentiating hormone elicited by irradiation or lectin exposure of murine marrow stromal cells is GM-CSF. This growth factor, along with CSF-1, can account for the differentiated progeny produced in this system: macrophages, granulocytes, and megakaryocytes. PMID- 3548845 TI - The isolation of human platelet factor V. AB - Human platelet factor V has been isolated using either a monoclonal or polyclonal antibody directed against human plasma factor V. The largest peptide observed upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis of purified human platelet factor V comigrates with purified human plasma factor V. However, a significant portion of the isolated protein is represented by peptides of lower apparent molecular weight (Mr). These lower Mr species that copurify with platelet factor V have been shown to be platelet factor V components by their immunological cross-reactivity with monoclonal and polyclonal antibodies to purified human plasma factor V. Platelets isolated from whole blood drawn directly into inhibitors to prevent proteolysis and platelet activation demonstrate the pattern of fragmented platelet factor V. The components of purified platelet factor V demonstrate apparent Mr ranging between 115 K and 330 K and are detectably different from the intermediates and end products observed during the thrombin cleavage of single-chain plasma factor V. Upon treatment with thrombin the platelet factor V components are cleaved and the end products are indistinguishable from those obtained upon thrombin activation of plasma factor V to plasma factor Va. Examination of the components by immunoblotting demonstrates that some of the cleavages which have occurred in the platelet factor V molecule are within the 150-K activation peptide. Bioassay indicates that platelet factor V exists as a procofactor and cleavage by thrombin yields the active cofactor, platelet factor Va. These data suggest that human platelet factor V is stored in the platelet as a partially fragmented procofactor that can be activated by thrombin to yield human platelet factor Va, the active cofactor in the human prothrombinase complex. PMID- 3548846 TI - Bone marrow transplantation in multiple myeloma: report from the European Cooperative Group for Bone Marrow Transplantation. AB - Of 14 patients who received an allogeneic bone marrow graft from HLA-compatible sibling donors, 10 have survived for 6 to 34 months posttransplantation (median, 12 months). Four patients have died, two of relapse at extramedullary sites, one of severe acute GVHD, and one from GI bleeding and pericardial effusion. One patient is alive in relapse and four patients have signs of minimal persistent disease. Five patients are well without signs of active disease. Minor improvement in osteolytic lesions on X-ray were seen in three patients, but the X ray bone structure was mainly unchanged in most patients. Bone marrow transplantation appears promising for treatment of certain patients with multiple myeloma. PMID- 3548847 TI - Immune lymphocyte survival after chemotherapy and radiation. PMID- 3548849 TI - Scarlet fever and confinement: the Edwardian debate over isolation hospitals. PMID- 3548848 TI - [An evaluation using transparency of various root canal filling methods]. PMID- 3548850 TI - Madness and medicine: trends in American medical therapeutics for insanity, 1820 1860. PMID- 3548851 TI - The diagnostic dream in ancient medical theory and practice. PMID- 3548852 TI - The Society of Chemical Physicians, the new philosophy, and the Restoration court. PMID- 3548853 TI - The Henry Phipps Institute, 1903-1937: pioneering tuberculosis work with an urban minority. PMID- 3548854 TI - Study on dye penetration after root canal filling with gutta-percha point and various sealers. PMID- 3548855 TI - [Clinical evaluation of new toothache drug "LTA"]. PMID- 3548856 TI - Evaluation of humoral and cellular immunity in patients with urinary tract infections. AB - The cellular and humoral immunity of 15 patients with recurrent urinary tract infections was assessed during infection. We determined the reactivity of peripheral blood lymphocytes to microbial antigens (PPD, streptolysin O, tetanus toxoid, Salmonella typhi and Escherichia coli), to allogenic cells, and to mitogens (phytohemagglutinin, concanavalin A, pokeweed mitogen and jacalin). T and B cells were counted by the rosette technique. We also evaluated serum immunoglobulins and C3 and C4 levels by radial immunoprecipitation and specific antibodies for the etiological agent by direct agglutination, hemagglutination and indirect immunofluorescence. Urinary antibodies were assessed by the antibody coated bacteria test (ACB). Some patients were retested for cellular immune function after cure. No significant alteration of immunoglobulin levels was detected, except for two patients who showed elevated IgM levels. C3 and C4 were elevated in one and in five cases, respectively. Specific serum antibodies for the etiological agent were present in all patients but their levels did not differ from those of normal controls. In only five patients were urinary antibodies detected by the ACB test. Patients' peripheral blood lymphocyte reactivity was depressed during infection for most of the microbial antigens and mitogens tested and returned to normal levels after cure. T and B cell numbers were within the normal range. PMID- 3548857 TI - Complement-mediated-lysis detection of antibodies in paracoccidioidomycosis: a preliminary study. AB - The objective of this study was to detect the presence of antibodies by the complement-mediated lysis test in patients with paracoccidioidomycosis, before and after treatment, and to correlate them with the clinical form of the disease and with the levels of precipitin and fluorescent anti-P. brasiliensis antibodies. Eighty percent of sera from 15 untreated paracoccidioidomycosis patients showed positive lytic activity indices (greater than or equal to 15%), as opposed to 50% of sera from 24 treated patients. Sera from 29 of 30 control group blood donors showed 0 to 14% lysis. No correlation was observed between lytic antibody levels and precipitin titers or anti-P. brasiliensis total Ig and IgM antibody titers, either in the untreated or treated patient group. Anti-P. brasiliensis lytic antibodies were detected in various clinical forms of paracoccidioidomycosis. This is the first study using living forms of the fungus to detect anti-P. brasiliensis antibodies and opens the possibility of using the lytic antibodies as indicators of active disease. PMID- 3548858 TI - Effect of Trypanosoma cruzi membrane components on the formation of the classical pathway C3 convertase. AB - When T. cruzi trypomastigote forms are held at 45 degrees C for 10 min in saline they become susceptible to lysis by the alternative complement pathway. As the result of heating trypomastigotes, but not epimastigotes, substances are released into the fluid phase which inhibit EAC1,4,2,3 by inducing decay. The inhibition was most pronounced at the level of the decay of the C14b2a complex. C3 convertase of the classical pathway was also inhibited by live trypomastigote forms. These data suggest that the trypomastigote but not epimastigote forms of T. cruzi have cell surface modulators of C3 convertase that permit them to evade the lytic action of complement. PMID- 3548859 TI - Release of lactate dehydrogenase activity by rabbit renal cortex slices during storage in solutions used for kidney transplantation. AB - Lactate dehydrogenase (LDH) activity was evaluated after incubation of rabbit renal cortical slices in several preservation solutions. Experimental solutions commonly used for kidney transplantation decreased LDH activity up to 72 h of storage at 4 degrees C compared to a control plasma-like solution. Low temperature (4 degrees C) storage led to a smaller release of LDH than slices preserved at 25 degrees C in control solutions. The addition of organic substrates to the control solution diminished enzyme release only of those slices incubated at 25 degrees C. After 72 h of incubation, the rate of LDH release was constant for all solutions except Collins glucose 330 mOsm solution for which the rate increased still further up to 96 h. The lower rate of LDH release exhibited by experimental solutions for up to 72 h indicates the maintenance of cellular integrity and hence of tissue viability. On the other hand, the continued increase of the rate of LDH release shown by Collins glucose 300 mOsm solution up to 96 h may suggest an even higher survival of viable cells and the stabilization of the rate of LDH release observed in the latter period of storage may indicate the onset of necrosis. PMID- 3548860 TI - The health care payment environment: past, present and future. AB - Between 1965 and 1982, hospital costs per admission rose by some 690%. Factors that contributed to this inflationary trend and that caused payers to take drastic action are analyzed. The actions taken in the past and current proposals to control the rate of increase are reviewed. It is predicted that payment systems for other providers such as physicians and nursing homes will change in similar ways. PMID- 3548861 TI - The MLA Medical Librarianship Oral History Program. PMID- 3548862 TI - [Register of the Academy and program of conferences]. PMID- 3548863 TI - Economic incentives and utilization. PMID- 3548864 TI - What drives the system? PMID- 3548866 TI - Searching the literature: Index Medicus or MEDLINE? AB - Index Medicus and MEDLINE are of great importance for searching the periodical literature in biomedicine, and many medical libraries now offer both services. Here the contents and potential of each service are described in order to help doctors in choosing when to search the literature by hand and when to go "on line". PMID- 3548865 TI - Assuring access in a changing health care system. PMID- 3548867 TI - Conservative treatment of early breast cancer. PMID- 3548868 TI - Surgery for stroke. AB - The failure of medical management to make dramatic progress in the prevention and treatment of ischaemic stroke led to the development of surgical approaches. This article discusses the rationale and the track record of the two major procedures currently in use. PMID- 3548869 TI - The current management of testicular cancer. PMID- 3548870 TI - Eicosanoid synthesis by human urinary bladder mucosa: pathological implications. AB - Biopsies of human urinary bladder mucosa obtained during cystoscopy were shown to release eicosanoids in the following order: prostacyclin (PGI2), prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF2 alpha) and thromboxane A2 (TXA2). The total and the relative amounts of eicosanoids released were similar to those reported for the rat urinary bladder. These eicosanoids may play a role in modulating the tone and contractility of the bladder as well as affecting cytoprotection of the mucosa. In view of the abundant release of eicosanoids by the bladder, caution must be exercised when considering urinary eicosanoid excretion as reflecting production by the systemic vasculature and/or the kidneys. PMID- 3548871 TI - Experience with intracorporeal injection of papaverine and duplex ultrasound scanning for assessment of arteriogenic impotence. AB - We present our experience with the intracorporeal injection of papaverine and duplex sonography in the assessment of 47 patients with suspected vasculogenic impotence. Sonography and Doppler analysis were performed before and after the papaverine injection. The anatomy of the penis was easily seen. Flow in the deep arteries was obtained in most patients in both the flaccid and erect state. Patients with a good erectile response to papaverine injection had a larger increase in the inner diameter of the deep cavernosal artery than did those with a poor response. However, the percentage change in the diameter did not correlate with the degree of clinical response. Following injection, the systolic peak flow rates and diastolic minimum flow rates were higher in patients with some clinical response but only the increase in diastolic flow rates correlated in a stepwise fashion with the degree of clinical response. This technique provides a method for the objective assessment of response to intracorporeal papaverine injection. Its potential as a diagnostic test will only be determined after normal values are established. At present it appears most useful in patients responding poorly to papaverine injection by indicating the possible area of vascular impairment and the direction for further evaluation. PMID- 3548872 TI - Renal abscess with gas formation secondary to acute appendicitis. PMID- 3548873 TI - Unusual foreign body in the bladder. PMID- 3548874 TI - Obstructive nephropathy: comparison between parenchymal transit time index and frusemide diuresis. AB - Sixty-three patients presenting with the clinical problem of renal outflow disorder were studied using 99mTc DTPA. The techniques of frusemide diuresis and parenchymal transit time index analysis were compared and both shown to be successful in aiding the decision as to the presence or absence of significant outflow obstruction. PMID- 3548875 TI - Colorectal cancer: the case for endoscopic screening. PMID- 3548876 TI - Intraduct enterokinase is lethal in rats with experimental bile-salt pancreatitis. AB - Controlled intraduct infusion and peri-acinar dispersal of 100 microliter buffer containing sodium glycodeoxycholate (GDOC) at concentrations of 8.5, 17 and 34 mmol/l in rats caused a progressively severe acute pancreatitis from which none of the animals died over the experimental period. Infusion of affinity-purified active human enterokinase in buffer did not cause pancreatitis, presumably because of the inability of the macromolecule to gain access to its specific intracellular substrate trypsinogens. The addition of enterokinase 200 ng to GDOC 34 mmol/l in the infusate resulted in a severe systemic disturbance and a form of acute necrotizing pancreatitis which was uniformly and rapidly lethal. This effect was not seen when equimolar trypsin was substituted for enterokinase. These findings show that enterokinase specifically increases the lethality of experimental bile salt pancreatitis and suggest that this bile-borne enzyme may in some cases pose a significant clinical threat. PMID- 3548877 TI - New silicone rubber mat: a simple aid for laparotomy wound closure. PMID- 3548878 TI - A study of the efficacy of intramammary antibiotics in the treatment of clinical mastitis. PMID- 3548879 TI - Anterior thalamic mediation of generalized pentylenetetrazol seizures. AB - The effects of microinjection of various neuroactive compounds into the anterior thalamic nucleus (AN) and other selected subcortical regions of guinea pig brain on the expression of pentylenetetrazol (PTZ)-induced behavioral and electrical seizure activity were examined. Excitatory agents, kainic acid (KA), bicuculline (BIC) or PTZ, injected into the AN or other thalamic nuclei, striatum, but not the mammillary bodies (MB), facilitated the EEG convulsant action of systemically administered PTZ. Injection of muscimol into the AN protected against the expression of PTZ-induced repetitive high-voltage EEG seizure discharges and inhibited the facilitatory effects of subcortically applied KA or BIC. Injection of muscimol into the AN was also able to terminate established ongoing seizure discharges. Unilateral application of muscimol to the AN did not prevent the repetitive hypersynchronous EEG discharges following systemic PTZ but did result in the delay in the onset of cortical hypersynchrony in the ipsilateral hemisphere. Muscimol injections into other thalamic nuclei, MB, cortex, striatum or directly into the CSF space had no anticonvulsant effect, however. Microinjection of gamma-vinyl-gamma-aminobutyric acid, a selective GABA transaminase inhibitor, resulted in protection from the behavioral convulsant action and lethal effects of PTZ when administered into the thalamus, especially the AN, but not when injected into the striatum or CSF. These data demonstrate that the AN is an important subcortical nucleus for the mediation of both cortical EEG synchrony and behavioral seizure expression induced by PTZ. In light of previous results establishing a role for the brainstem and diencephalon in PTZ seizure expression, the AN may serve, in part, as a gating mechanism for the propagation of paroxysmal activity between subcortical areas and the cerebral cortex. PMID- 3548880 TI - Lateral hypothalamic lesions in ground squirrels: rapid recovery and residual deficits. AB - The effects of lateral hypothalamic (LH) lesions were studied in golden-mantled ground squirrels, Spermophilus lateralis, a species of mammalian hibernator that displays endogenous circannual body weight cycles when kept in constant conditions. The lesions were made during the weight-gain phase. Evidence that the lesions were well placed included interruption of weight gain, transient aphagia, disrupted nest building, increased spillage of food crumbs and in some cases abnormal postures or movement. Despite these deficits most animals survived. Their body weights at the first postoperative peak of the cycle recovered either to within the control range (Experiment 1) or close to preoperative peak levels (Experiment 2). There was no evidence that the lesions lowered set points. The rapid recovery of weight and eating by ground squirrels given only dry rodent chow, after large lesions (1.5-2.5 mA, DC anodal, 15-25 s), contrasts with what is seen in rats following LH lesions. PMID- 3548881 TI - Laminar asymmetry in the distribution of choline acetyltransferase-immunoreactive neurons in the retina of the tree shrew (Tupaia belangeri). AB - Cholinergic neurons in the retina of the tree shrew were identified immunocytochemically using a monoclonal antibody directed against choline acetyltransferase (ChAT). The chief result is that roughly 4 times as many ChAT immunoreactive neurons are found in the inner nuclear layer (INL) as in the ganglion cell layer (GCL). In the INL, two classes of cholinergic neuron can be distinguished on the basis of soma size, one large and one small. The large neurons correspond closely in size and number to the displaced cholinergic neurons in the GCL, suggesting that these are the matching populations of cholinergic amacrine cells reported in other species. The small ChAT immunoreactive neurons, on the other hand, which make up 60% of the total number of ChAT-positive neurons in the retina, appear to have no counterpart in the GCL. Whether these small neurons are a separate class of amacrine cell or some other cell type (e.g. bipolar, interplexiform, etc.) remains to be determined. PMID- 3548882 TI - Immunocytochemical localization of estrogen-binding neurons in the songbird brain. AB - This study used monoclonal antibodies against estrogen receptor for the identification and localization of estrogen-binding cells in the avian brain. The distribution of estrogen-binding neurons in the songbird brain conformed to the general vertebrate pattern with highest labelling in hypothalamus and preoptic area. For the first time, estrogen-binding neurons were found in the song control system: these neurons might provide a substrate for the direct action of estrogen on the song system. PMID- 3548883 TI - Immunohistochemical localization of calcineurin, calmodulin-stimulated phosphatase, in the rat hippocampus using a monoclonal antibody. AB - Immunohistochemical localization of calcineurin, a calmodulin-stimulated phosphatase, was examined in the rat hippocampus by using a monoclonal antibody VD3 which is specific for the A subunit (61 kDa) of calcineurin. The stratum lucidum, where the mossy fiber terminal forms giant synaptic boutons, showed strong immunoreactivity. PMID- 3548884 TI - An immunocytochemical study of choline acetyltransferase-containing neurons and axon terminals in normal and partially deafferented hippocampal formation. AB - Monoclonal antibodies to the acetylcholine synthesizing enzyme, choline acetyltransferase (ChAT), have been used to study putative cholinergic structures in immunocytochemical preparations of normal rat hippocampal formation and of hippocampal formation deprived of its septal innervation. Small numbers of ChAT positive (ChAT+) neuronal somata were observed scattered throughout the septotemporal extent of the normal hippocampal formation. They were most common in stratum lacunosum-moleculare of regio superior, but were also found in various layers of the dentate gyrus and occasionally in the remaining hippocampal laminae. In addition, light microscopy demonstrated that ChAT+ terminal fields in normal hippocampal formation were organized in discrete bands and laminae. Pronounced dense bands were observed: immediately superficial to stratum granulosum; deep to stratum pyramidale; and at the border between stratum radiatum and stratum lacunosum-moleculare. In the dentate gyrus, ChAT+ staining was pronounced in the hilus at temporal levels, but only moderate staining occurred in the anterior hilus and throughout the molecular layer. A close correspondence was observed in the density and distribution of ChAT+ immunoreactivity and acetylcholinesterase staining. Electrolytic lesions of the medial septal nucleus/diagonal band complex had no effect on the occurrence of ChAT+ somata, but virtually abolished the ChAT+ laminar staining pattern and eliminated all but occasional small patches of ChAT+ terminals. These results confirm that the vast majority of hippocampal cholinergic terminals originate either from neurons of the medial septum/diagonal band complex or from fibers of passage. The newly observed intrinsic hippocampal neurons can account for at least some of the ChAT activity remaining after septal lesions, and they apparently contribute to the cholinergic innervation of the hippocampal formation. PMID- 3548885 TI - Localization of a peptide sequence contained in the precursor to gonadotropin releasing hormone (GnRH). AB - The precursor protein that contains the sequence for the neurohormone gonadotropin releasing hormone (GnRH) also contains an additional fragment (amino acids 14-26, designated pHGnRH14-26) that can release luteinizing hormone (LH) and follicle stimulating hormone (FSH) in vitro. An immunocytochemical study was carried out to determine if this sequence could be found in its processed form in hypothalamic nerve terminals. In rats, ewes and rhesus monkeys pHGnRH14-26 was demonstrated in both neuronal cell bodies and in axon terminals. In mice, immunoreactivity was present in terminals only. No reaction was found in the hamster hypothalamus. Double label immunocytochemical studies for GnRH and pHGnRH14-26 showed that both sequences could be found in the rat septal-preoptic hypothalamic continuum in some but not all neuronal cell bodies. Control experiments strongly suggest that the 14-26 immunoreactivity represents the fragment after it has been cleaved from the precursor protein and that this peptide could be available for release into the hypophysial portal system. PMID- 3548886 TI - Suppression of the jaw-opening reflex by periaqueductal gray stimulation is decreased by paramedian brainstem lesions. AB - Electrical stimulation of the midbrain periaqueductal gray region (PAG) suppresses the tooth pulp-evoked jaw-opening reflex (TP-JOR). In the present study the pathways that mediate this suppression were investigated by placing brainstem lesions in lightly anesthetized cats. Parasagittal lesions that interrupted the afferent and efferent connections of the medullary and pontine raphe nuclei attenuated (but did not abolish) suppression of the TP-JOR evoked by PAG stimulation. This result provides further evidence that medial brainstem structures partially mediate the effects of PAG stimulation in the trigeminal system. PMID- 3548887 TI - N-acetyl-aspartylglutamate: binding sites and excitatory action in the dorsolateral septum of rats. AB - In this study we examined the distribution of binding sites for [3H]N-acetyl aspartylglutamate (NAAG) in the rat lateral septal nucleus (LSN) and the effect of iontophoretically applied NAAG on neuronal firing in this area. A high density of [3H]NAAG binding sites was found in the dorsolateral part of the LSN. Binding in the intermediate/ventral part of the LSN and medial septum was less dense. NAAG excited 75% of the dorsal neurons in the LSN, but only 36% of the cells in the intermediate/ventral part. Glutamic diethylester, an amino acid antagonist, depressed responses to NAAG to a similar extent as responses to quisqualate. The antagonist amino phosphonovaleric acid, which suppressed responses to N-methyl-D aspartate almost completely, reduced NAAG-evoked responses only by 40%. A possible role of NAAG as excitatory transmitter in the LSN is discussed. PMID- 3548888 TI - Neurotensin immunoreactive neurons in the human infant diencephalon. AB - Neurotensin-like immunoreactive (NT-IR) neurons are present in discrete subregions of the anterior, medial and lateral thalamic nuclear groups of the human infant brain. The pulvinar is notably rich in such cells. Smaller numbers of cells are present in the ventral group, centromedian nucleus, reticular nuclei and intralaminar nuclei. Neurotensin immunoreactive axons accumulate dorsally in the thalamus and cross the deep white matter. The cerebral cortex contains a rich network of NT-IR axons. The subthalamic nucleus is rich in NT-IR neurons. Within the hypothalamus NT-IR perikarya are present in parts of the lateral and tuberal regions and in the lateral mammillary area. NT-IR axons are widespread being particularly prominent in parts of the tuberal region and the mammillary body. PMID- 3548889 TI - A cholinergic antagonist, mecamylamine, blocks the phase-shifting effects of light on the circadian rhythm of locomotor activity in the golden hamster. AB - Despite the well known role of the light-dark cycle in the entrainment of circadian rhythms, very little is known about the neurochemical events that mediate the effects of light on the mammalian circadian clock. Recent anatomical and pharmacological data support the hypothesis that acetylcholine may be involved in relaying light-dark information from the retina to, or within, the circadian clock of rodents. If acetylcholine is required for this response, it should be possible to block the phase-shifting effects of a light pulse by blocking cholinergic neurotransmission. To test this possibility, hamsters free running in constant darkness received an intraventricular injection of the anticholinergic drug, mecamylamine (450 micrograms), 10 min before being exposed to a 5-min pulse of light known to induce sub-maximal phase shifts in the circadian rhythm of wheel-running behavior. Compared to vehicle-injected control animals, mecamylamine treatment blocked or reduced both the phase-advancing and phase-delaying effects of light. These results support the hypothesis that acetylcholine is involved in mediating the phase-shifting effects of light on the mammalian circadian clock. PMID- 3548891 TI - [Use of microplates in immunohematology]. PMID- 3548890 TI - Co-localization of enkephalin and cholecystokinin in discrete areas of rat brain. AB - A double-label immunofluorescence technique was used to demonstrate that immunoreactivities for the functionally antagonistic neuropeptides enkephalin and cholecystokinin octapeptide (CCK) are co-localized within individual neurons and processes in discrete areas of rat midbrain and forebrain. Coexistence was most prominent within varicose pericellular axons extending from the periaqueductal gray matter to a field overlying the medial lemniscus, axons and terminal-like puncta in the central medial, paracentral, interanterodorsal and ventral anterior thalamic nuclei, and perikarya and proximal axonal fragments in layers II and III of neo- and allocortex, and in the anterior olfactory nucleus. The former two systems of axons lie in areas of spinothalamic tract termination. These data suggest that some of the antagonism of opioid analgesia by CCK occurs at the synaptic level in nociceptive areas of brain-stem and thalamus where CCK and enkephalin are co-localized and presumably co-released. PMID- 3548892 TI - [Effect of beta-aescin on the incidence of sister chromatid exchanges in V79 cells]. PMID- 3548893 TI - [The "apoplexies" of Monsieur Voltaire]. PMID- 3548894 TI - [Emile Zola, the placebo effect and parallel medicines]. PMID- 3548895 TI - [Liver transplantation: new indications, new results]. PMID- 3548896 TI - [Evolution of vital and functional prognosis in osteogenic sarcomas]. PMID- 3548897 TI - [Conservative surgery in the treatment of breast cancer]. PMID- 3548899 TI - [Animal tuberculosis]. PMID- 3548898 TI - [From romantic phthisis to tuberculosis, a common disease]. PMID- 3548900 TI - [Current epidemiology of tuberculosis in France]. PMID- 3548901 TI - [Current modalities for the treatment of tuberculosis]. PMID- 3548902 TI - [On a decree establishing the list of instruments that may be used by midwives]. PMID- 3548903 TI - [Eulogy for Robert Courrier (1895-1986)]. PMID- 3548904 TI - [The inferior vena cava in hepatic pathology: anatomy, behavior, therapy]. PMID- 3548905 TI - [Articular chondrocytes in culture: a study model for use in physiopathology and pharmacology]. PMID- 3548906 TI - [Remarks on the practice of medicine in its specialties]. PMID- 3548907 TI - Face burn reconstruction--does early excision and autografting improve aesthetic appearance? AB - Despite improvements in functional rehabilitation secondary to better control of scar and contractures, aesthetic rehabilitation of the extensively burned face has remained a difficult problem. This study was undertaken to evaluate both technique and aesthetic results of early excision and split thickness autografting (STAG) of full skin thickness face burns. Twenty-five patients with full skin thickness face burns were operated on between days 4 and 14 post-burn. Thirteen patients had excision and STAG in one stage. Twelve patients had a two stage procedure-excision and coverage with a biological dressing followed 24-72 h later by STAG. Seven of these patients had a pressure dressing in the form of a silicone face mask applied at the second stage. Early cosmetic results were encouraging in all patients. Twenty-five per cent of patients later required either contracture release or skin resurfacing. Preliminary results are encouraging and warrant evaluation by surgeons at other centres. When early excision of full skin thickness face burns is undertaken, cautious optimism as to the ultimate aesthetic result, both by the surgeon and the patient, is advisable. PMID- 3548909 TI - Mesh grafts--an 18 month follow-up. AB - Thirty-four patients, who had received either sheet or mesh grafts during surgery at the McIndoe Burns Unit, were reviewed, with a minimum follow-up period of 18 months. Expert observers were able to identify 1:1.5 mesh after close examination, but no group found the cosmetic result inferior to that of sheet graft. 1:4 mesh was uniformly identified, and cosmesis was judged unsatisfactory by all observers. PMID- 3548908 TI - Treatment of the burned hand: early surgical treatment (1975-85) vs. conservative treatment (1964-74). A comparative study. AB - Our experience with early tangential excision and grafting for burns of the hands is presented. The advantages of the early surgical approach are proven by comparing this technique with the 'old' conservative treatment in two different populations. It is clearly concluded that early excision and grafting, combined with adequate physiotherapy and pressure garments, offer favourable results for the burned hand. Early excision of the burn eschar, before the appearance of contamination, may prevent infection, long and unfavourable delay in healing, scar formation with its incapacitating sequellae and a non-aesthetic appearance. Such a delay was characteristic of the 'conservative period', which was dominated by 'fibroblast', 'good granulation tissue', and hypertrophic scarring. Early surgery, as described and advocated here, shortens the healing time, lessens the hospital stay, minimizes reconstructive surgery and leads to a good functioning hand with a reasonable aesthetic appearance, enabling the affected patient to return quickly to work and normal routine life. PMID- 3548910 TI - Deep electrical burns to the scalp. AB - Full skin thickness burns to the scalp involving bone damage are not uncommon. These are mainly caused by electricity, but there are some flame injuries. Investigation of the extent of bone damage by technetium bone scan and the use of CT head scan are recommended. Early closure of the defect using a flap is also recommended, even if wound contamination is present. The results can be very gratifying. PMID- 3548911 TI - Management of wounds treated by thrombin coagulation. AB - Thrombin solution was applied to skin-graft donor sites following skin removal with a Reese dermatome. Immediately after the blood was clotted by the thrombin solution, sheets of silicone gauze were applied to the clotting site. Forty-eight hours after the operation, the coagulated blood had disappeared spontaneously. In a total of 21 operations, the wounds treated by the above method healed completely without infection. PMID- 3548912 TI - A century after Gamgee. PMID- 3548913 TI - The cellular ets genes: molecular biology and clinical implications in human leukemias. PMID- 3548915 TI - Unorthodox cancer medicine. PMID- 3548914 TI - Predictors of response of acute nonlymphocytic leukemia. AB - Given the time and effort expended by investigators and given the large numbers of patients studied, there are disappointingly few "predictors" of response. From the clinical perspective, aside from performance status, age, prior history of toxic exposure, and grossly abnormal organ function, there are essentially no reliable indicators of the likelihood of a patient surviving remission induction therapy. The absence of such indicators might reflect the fact that without grossly abnormal organ function, all patients generally begin with an equal possibility of survival and that events which occur during therapy determine survival. One thing is certain, death directly attributable to leukemic cell overgrowth despite chemotherapy is an extremely rare event. Hence, therapeutic inadequacy in this sense, at the time of initial diagnosis, is not a common cause of treatment failure. Studies aimed at the prediction of leukemic cell responsiveness to therapy have been plagued by two general problems. The first is that the drug sensitivity assays have been quite primitive. For example, the ability of a cell to take up a drug is not synonymous with sensitivity to that drug. Additionally, tests which are dependent upon assays capable of making measurements in only a small subpopulation of cells, such as in vitro clonogenic assays, are likely to have only limited applicability. On the other hand, assays which measure the properties of the leukemic cell population as a whole are incapable of recognizing arabinoside therapy have provided data which suggest that in addition to patient survival three conditions must be satisfied if a complete remission is to occur: the pretherapy leukemic cell mass must be moderate or low, an adequate number of cells must be synthesizing DNA, and cytosine arabinoside must produce significant inhibition of DNA synthesis in vitro. Each factor is consistent with what is known about cytosine arabinoside: it is an S-phase-specific agent which must be incorporated into DNA in order to kill leukemic cells. When the relationship between these same factors and response to combination chemotherapy were studied, not unexpectedly, no relationship was discerned. Finally, in this setting pharmacokinetic studies have demonstrated that the amount of araCTP formed in leukemic cells in vivo when doses of 2 g and 3 g/m2 are administered are indistinguishable, thereby explaining the clinical equivalence of these two dosage levels.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3548916 TI - Developmental effects of child abuse: recent findings. AB - This paper summarizes the pre-1982 research findings on the developmental effects of child abuse and reviews recent contributions to this area. While some of the recent research continues to demonstrate deleterious developmental consequences of child maltreatment, others are pointing to a complex relationship between child maltreatment and development. Mediating variables such as the child's individual characteristics, environmental resources, and the quality of personal interactions the child is exposed to may interact with negative experiences like maltreatment and may be just as important in predicting outcome than maltreatment alone. Recent research has also been concerned with specifying the possible differential effects of different patterns of maltreatment. This has led to a clearer separation between the effects of abuse and neglect, particularly in language development. Despite the methodological improvements in recent research, there is still the need for longitudinal prospective studies on the developmental effects of child abuse, taking into account possible mediating variables. PMID- 3548917 TI - Social support and child maltreatment: a review of the evidence. AB - Parents who maltreat their children have long been thought to lack support from informal and social networks. Recent writers have taken the position that this relationship is a proven, causal one, with social isolation seen as a necessary antecedent condition for the occurrence of child abuse. Concurrently, initial enthusiasm for social support as a powerful explanatory variable in other areas of psychological and health research is giving way to cautious reevaluation of the evidence. The present review was undertaken to bring into sharper focus what is now known regarding the relationship between child maltreatment and parental isolation from informal helping networks. Existing research is fraught with both conceptual and methodological problems. There is, at present, little research evidence that lack of social support plays a significant role in the etiology of physical abuse. Stronger evidence exists that neglectful parents are socially isolated, but the data are consistent with the hypothesis that this is one manifestation of the character problems of these parents. Future research must give closer attention to clearly defining social support and using reliable and valid instruments to measure it, while exploring multivariate models of child maltreatment. PMID- 3548919 TI - [Hypotension induced by a combination of enflurane and captopril in middle ear surgery]. PMID- 3548920 TI - [Blood sodium disorders]. PMID- 3548921 TI - [Principles of antibiotic therapy in primary prevention of postoperative pulmonary infections]. PMID- 3548922 TI - [Oral premedication and controlled surgery]. PMID- 3548923 TI - Preparing dental hygiene students for community dental health--an interagency approach. PMID- 3548924 TI - Staff management. The point of view of a practitioner. PMID- 3548925 TI - Recovery of dental waxes. PMID- 3548926 TI - The oral health status of Cree children living in Chisasibi, Quebec. PMID- 3548927 TI - Pain measurement. Its application in craniomandibular therapy. PMID- 3548928 TI - [Immunofluorescence as a diagnostic aid in oral medicine (1)]. PMID- 3548929 TI - Grant application strategies for computers in nursing education. PMID- 3548931 TI - William Harvey, 1. That incomparable invention of Dr. Harvey's. AB - Harvey's discovery of the circulation had its roots far back in his early studies in medicine at the University of Padua where he was a pupil of the famed anatomist Fabricius, who was very interested in the valves of the veins. The difference between his teacher and Harvey was Harvey's dedication to the modern concept "scientific method". Other influences on his findings included the earlier work of Erasistratus and Galen. Harvey, after a long period of experimentation, published his findings on the circulation of the blood in his famous treatise De Motu Cordis in 1628. It is noteworthy that Harvey as a clinical practitioner failed thereafter to apply his discoveries to his work as a physician. The first of two articles on Harvey, this is concerned with his work as a scientist and discoverer. The second article is devoted to his work as a medical doctor. PMID- 3548930 TI - Ticarcillin/clavulanic acid (Timentin) compared to metronidazole/netilmicin in preventing postoperative infection after elective colorectal surgery. AB - A randomized controlled trial was performed to compare the effectiveness of ticarcillin/clavulanic acid to metronidazole/netilmicin in preventing postoperative infections after elective colorectal surgery. Ninety-two patients were randomly allocated to receive three doses of ticarcillin, 3 g, with clavulanic acid, 100 mg every 8 hours, or three doses of metronidazole, 500 mg, and netilmicin, 80 mg intravenously every 8 hours. All patients received a mechanical bowel preparation with 3 L of Go-lytely solution. There were no operative deaths. Eight patients had wound infections--three in the ticarcillin/clavulanic acid group and five in the metronidazole/netilmicin group. One patient in the ticarcillin/clavulanic acid group had an intra-abdominal abscess. There were two anastomotic leaks, one in each group. Ticarcillin/clavulanic acid and metronidazole/netilmicin appear to be equally effective in preventing postoperative infections after elective colorectal surgery. PMID- 3548932 TI - Medicare: ethics versus economics. PMID- 3548933 TI - The role of oral acyclovir in the management of genital herpes simplex. AB - Oral acyclovir is an antiviral nucleoside analogue that has recently been released in Canada for use in selected patients with genital infections by the herpes simplex virus. First episodes of genital herpes should be treated with oral acyclovir as soon as the diagnosis is considered. Most people with recurrent genital herpes do not require systemic drug therapy. Selected patients with severe or long-lasting recurrences, recurrences associated with long prodromal periods (greater than 12 to 24 hours) or systemic complications such as erythema multiforme and eczema herpeticum may receive measurable benefit from treatment at the onset of symptoms. In most patients frequently recurrent disease can be suppressed with long-term therapy. Since long-term safety beyond 1 year has not been established, suppressive therapy should be stopped at least once per year to reassess the recurrence pattern. Acyclovir has not been adequately tested for safety in pregnancy and should not be prescribed for pregnant women unless the potential benefits outweigh the risks. Careful attention to disease severity, accurate diagnosis and exclusion of other causes of genital lesions will ensure that the drug is used only when beneficial. PMID- 3548934 TI - Effect of a geriatric consultation service on management of patients in an acute care hospital. AB - Elderly patients present particular management challenges. We conducted a randomized clinical trial of the effect of a geriatric consultation service on the management of elderly patients in an acute care hospital. A total of 113 patients aged 75 years or more who met certain criteria were assigned to either receive (57 patients) or not receive (56) care by the service. At the end of their hospital stay the patients were assessed with regard to predetermined outcomes. The patients were followed up for 1 year after discharge to determine death rates and direct health care expenditures. The intervention group showed significantly greater improvement in mental status (p less than 0.01), were receiving fewer medications at discharge (p less than 0.05) and had lower short term death rates (p less than 0.05) than the control group. A geriatric consultation service can improve the hospital care and health of the elderly. PMID- 3548935 TI - Visual display terminals and operator morbidity. PMID- 3548936 TI - Standardized extracts, foods. AB - While progress has been made in the areas of food allergen characterization, both the complexity of the biochemical constituents of food and the body's normal physiologic (digestion) and immunologic responses to food ingestion provide challenging obstacles to efforts aimed at developing standardized food extracts. As indicated above, while currently available food extracts can be useful in the evaluation of food hypersensitivity, the results obtained using these reagents are far from optimal. Indeed, in some cases, skin testing after rubbing a small amount of the food on the skin may be more inciteful than using commercially prepared extracts. While this approach may provide physicians with help in terms of diagnosis, purified food components will be necessary to comprehensively study the complex issues of food allergen digestion and absorption; immune response and tolerance to food allergens; and hopefully, treatment and prevention of food hypersensitivity. PMID- 3548937 TI - Standardization of fungal allergens. AB - The ability of various fungi to induce human IgE-mediated disease, especially allergic asthma, has been well established. The relative clinical importance of fungal aeroallergens varies considerably in different geographic areas. The magnitude of exposure to fungal aeroallergens can be quantitated more precisely by newer immunochemical assays than by more traditional fungal cultures or quantitation of fungal spores by microscopy. Although the wide variations in biologic potency among commercial mold allergenic extracts have been appreciated for decades, only recently have laboratory technologic advances and the production of international reference extracts permitted the development of standardized fungal extracts of defined potency. Future efforts should be directed toward documenting the expected diagnostic and therapeutic advantages of such standardized fungal extracts. PMID- 3548938 TI - Standardized allergenic extracts derived from mammals. PMID- 3548939 TI - Standardized extracts. Stinging and biting insects. PMID- 3548940 TI - Standardized extracts modified allergens--allergoids. PMID- 3548941 TI - Biology, oncology, and RNA splicing. PMID- 3548942 TI - Assessment of tumor cell kinetics by immunohistochemistry in carcinoma of breast. AB - Cell proliferation was assessed in 33 invasive breast carcinomas by an immunoperoxidase procedure using the monoclonal antibody, Ki-67, which reacts with a nuclear antigen in proliferating cells. The antibody labeled a variable proportion of tumor cells ranging from 3% to 60%. High numbers of Ki-67-positive cells were found in tumors with high mitotic rates, high nuclear grade, high histologic grade, and in premenopausal women. Tumors with low and intermediate Ki 67 labeling rates often had high estrogen receptor content, whereas tumors with high Ki-67 labeling rates were usually estrogen receptor negative. These correlations are similar to those previously reported for other measurements of cell cycle kinetics such as thymidine labeling index and suggest that immunohistochemical staining of invasive breast carcinoma for the Ki-67 epitope may provide cell cycle information not otherwise readily available to the clinician and may be useful in assessing prognosis in carcinoma of the breast. PMID- 3548943 TI - Human chorionic gonadotropin in colorectal carcinoma. An immunohistochemical study. AB - To assess the biological significance of human chorionic gonadotropin (HCG) detection in large bowel carcinomas, we have studied immunohistochemically 50 colorectal carcinomas, 20 adenomas, 8 ulcerative colitis, and 10 normal colonic mucosae. The HCG-immunoreactive cells were found in 26 carcinomas (52%). Positivity was not detected in any normal mucosa or benign lesions. Cells containing HCG predominated in mucinous (80%) and poorly differentiated carcinomas (92%). No trophoblastic differentiation could be demonstrated in any tumor. Human chorionic gonadotropin was detected more frequently in carcinomas invading the entire bowel wall (67%) than in those confined to the submucosa or muscularis propria (30%). Fifteen of 19 cases (79%) with lymph node and/or hepatic metastases had HCG in the primary tumor, whereas only 9 of 23 cases (32%) without metastases showed HCG immunoreactivity. The eight patients with hepatic metastases had HCG in the primary tumor. Thus, the immunohistochemical detection of HCG in colorectal carcinomas may be a biological marker of prognostic significance. PMID- 3548944 TI - Abnormal sexual differentiation and neoplasia. AB - The prevalence of neoplasia is increased in individuals with certain disorders of sexual differentiation. Etiology and frequency of neoplasia vary with the particular disorder. In uncomplicated cryptorchidism, the testis is at least 10 times more likely to undergo neoplastic transformation than a normal scrotal testis. Neoplasia probably is a function of both testicular location (intraabdominal) and underlying dysgenetic structure. If cryptorchidism is unilateral, and if orchiopexy has not been performed prior to age 6-10 years, orchiectomy should be encouraged. In those forms of gonadal dysgenesis not associated with a Y chromosome (e.g., 45,X; 45,X/46,XX; 46,XX) there is no definite increase in neoplasia, suggesting that elevated gonadotropin levels per se are not carcinogenic. Gonadal tumors are found in at least 30% of individuals with XY gonadal dysgenesis and are particularly frequent (55%) in H-Y antigen positive patients. These tumors are almost always gonadoblastomas or dysgerminomas. Similar tumors are found in 15%-20% of 45,X/46,XY individuals. In either situation the neoplastic transformation could be a) secondary to the existence of XY gonadal tissue in an inhospitable environment, or b) integrally related to that process--genetic or cytogenetic--producing the dysgenetic gonads. The risk of neoplasia is sufficiently high that most of these patients should be offered early gonadal extirpation. The prevalence of gonadal tumors is not increased in Klinefelter's syndrome, further indicating that gonadotropins are not carcinogenic per se. However, Klinefelter patients are 20 times more likely to develop a carcinoma of the breast than are 46,XY males. Extragonadal germ cell tumors also are more common. In female pseudohermaphrodites there is probably no increased risk of neoplasia, whereas, in true hermaphrodites neoplasia is unusual but does occur. Neoplasia occurs in patients with complete testicular feminization (complete androgen insensitivity) but rarely in those with incomplete testicular feminization/Reifenstein's syndrome, 5 alpha-reductase deficiency, anorchia, agonadia, or testosterone biosynthetic defects. In complete testicular feminization the risk of malignant tumors is small prior to age 25. After age 25, it is about 2%-5%. Orchiectomy is recommended after pubertal feminization. PMID- 3548945 TI - Chromosome studies in patients with Philadelphia chromosome-positive chronic myeloid leukemia submitted to bone marrow transplantation--results of a European Cooperative Study. AB - The karyotypes of 74 patients with Ph-positive chronic myeloid leukemia submitted to bone marrow transplantation collected from nine institutions were studied serially before and after transplantation. In 13 cases sporadic Ph-positive metaphases were detected without signs of relapsing disease at various intervals after transplantation. These data indicate that the leukemic clone may not be completely suppressed by the conditioning treatment and that other biological mechanisms may be involved in destroying this clone or controlling its expansion. PMID- 3548946 TI - Chromosome studies in patients with acute nonlymphocytic or acute lymphocytic leukemia submitted to bone marrow transplantation--results of a European cooperative study. AB - The chromosomal data of 58 acute nonlymphocytic leukemia (ANLL) patients and of 32 acute lymphocytic leukemia (ALL) patients submitted to bone marrow transplantation and collected from nine institutions are reported. Chromosomal studies were available at diagnosis in 19 cases with ANLL: seven had a partially or completely abnormal pattern. Forty-one patients had a chromosome study before bone marrow transplantation and all had a normal pattern. Thirteen patients with ALL were studied at diagnosis: five had a partially or completely abnormal karyotype. Of 20 cases analyzed before bone marrow transplantation, only one has maintained the abnormal pattern of diagnosis in part of the cells. Karyotypes were available in nine ANLL patients relapsed after bone marrow transplantations. Two showed the same clonal abnormalities seen at diagnosis; in three other cases the leukemic clone of relapse carried an additional chromosome abnormality with respect to the pattern at diagnosis and four more cases presented at relapse complex abnormalities; two of them had a cytogenetically normal pattern at diagnosis. In four of ten relapsed ALL cases chromosomes analyses were available. A relapse in donor cells and a hyperdiploid pattern were observed in two cases, respectively, while a normal, recipient pattern was documented in the other two cases. Serial chromosome studies performed in acute leukemia patients after bone marrow transplantation may allow the detection of different chromosomal patterns of relapse. In those cases who relapsed with a cell clone cytogenetically different from the pattern at diagnosis, a direct role played by the conditioning treatment in the pathogenesis of the relapsing disease may be hypothesized. PMID- 3548947 TI - Modulation of secreted plasminogen activator activity of human renal carcinoma cells by dimethylsulfoxide, butyrate and retinoate. AB - Dimethylsulfoxide, butyrate and retinoic acid, agents which induce differentiation of certain malignant cells, were examined for their effect on the activity of plasminogen activator (PA) of serumless conditioned medium (CM) of two human renal carcinoma cell lines. All three agents produced a decrease in PA activity. More than 90% of the PA was secreted in latent form, and this was not altered by the agents. Active PA components of Mr 52,000 and 93,000 were identified in cell secretions by zymography. In the presence of DMSO or butyrate the Mr 52,000 component was markedly reduced. Reversibility of the effect on PA was demonstrated for both DMSO and retinoic acid with activity of CM returning to control level after removal of the agent. That the effect was temporary agrees with most observations of the effects of these and similar agents on cells from solid tumors. PMID- 3548949 TI - Cell differentiation and bypassing of genetic defects in the suppression of malignancy. PMID- 3548948 TI - Protection of L5178Y cells by vitamin E against acute hydroxyurea toxicity does not change the efficiency of ribonucleotide reductase-mediated hydroxyurea induced cytotoxic events. AB - Exposure of L5178Y cells in culture to 0.2 mM hydroxyurea (HU) for up to 48 h induces inhibition of DNA synthesis, killing of about 20% of cells during the first 24 h exposure, gradual progress of cells into the state of unbalanced growth (measured as progressive increase in cell size, DNA protein ratio and acid phosphatase activity) with final death of the majority of cells. These effects were used to compare effectiveness of rapid and late HU cytotoxicity in cells treated with HU in the presence or absence of vitamin E, employed as a protective agent against non-specific toxicity of HU. It has been found that while the presence of vitamin E prevents cell killing induced by HU treatment during first 24 h, its presence does not change the progress of cells into the state of unbalanced growth and final cell killing. It is suggested that the protection exerted by vitamin E against HU-induced side toxicity does not change the effectiveness of ribonucleotide reductase-mediated DNA synthesis inhibition, leading to cell death through the state of unbalanced growth. PMID- 3548951 TI - The role of L-dopa holiday in the long-term management of Parkinson's disease. PMID- 3548950 TI - Relationship of radioantibody localization and cell viability in a xenografted human cancer model as measured by whole-body autoradiography. AB - The simultaneous distribution of monoclonal 131I-labeled anti-carcinoembryonic antigen (CEA) immunoglobulin (IgG) (NP-2) or 131I-labeled irrelevant myeloma IgG (Ag8) and [3H]thymidine was studied in hamsters bearing transplants of the GW-39 human colon carcinoma by qualitative double-tracer whole-body autoradiography. Autoradiography showed that large solid GW-39 tumors are characterized by heterogeneity of radioantibody retention and uneven [3H]thymidine accumulation, reflecting zonal variations in antibody reactivity and tumor cell proliferation, respectively. The autoradiographic images showed that both 131I-labeled monoclonal antibody and control 131I-labeled IgG targeted nonproliferating tumor zones, suggesting a mechanism of nonspecific tumor uptake of radioantibodies in these areas. Absence of tumor center labeling with [3H]thymidine, associated with cellular necrosis, was confirmed by histology and microautoradiography in separate animal studies. In confirmation of earlier reports, 131I-labeled anti CEA monoclonal antibody gave higher tumor-to-non-tumor labeling patterns than did control 131I-labeled IgG, at both 3 and 7 days following treatment. Immunohistochemical localization of CEA in GW-39 tumors with necrotic centers showed the presence of CEA in nonviable cells, but CEA antigen concentrations were diminished as compared to cells located in the tumor's periphery. The results indicate that double-tracer whole-body autoradiography is well suited for studying the kinetics of radioantibody localization in relation to regional tumor cell viability. PMID- 3548952 TI - The bulimic disorders. PMID- 3548953 TI - Does magnesium sulfate treat eclamptic convulsions? PMID- 3548954 TI - Noradrenergic and cholinergic agents in Korsakoff's syndrome. AB - Subjects suffering from memory disorders associated with Korsakoff's syndrome were treated with noradrenergic and cholinergic drugs in two phases. In the acute phase, tests of short- and long-term memory were conducted shortly after the administration of methylphenidate, physostigmine, an oral placebo, and an intramuscular placebo. In the chronic phase, the memory tests were given after the subjects had been administered each of the following for 1-week periods: methylphenidate, choline chloride, methylphenidate plus choline chloride, and an oral placebo. Significant improvements were seen in long-term memory scores of patients receiving chronic methylphenidate treatment. Significant improvement was not found in short-term memory measures with any of the drug treatments. PMID- 3548955 TI - The opioids, dopamine, cholecystokinin, and eating disorders. PMID- 3548956 TI - Phase I trial of caracemide using bolus and infusion schedules. AB - We conducted a phase I trial of caracemide, a new chemotherapeutic agent, which is active in the MX1 (mammary) and CX1 (colon) human tumor xenografts. Using a 5 day bolus schedule, dose-limiting toxicity consisting of burning perioral pain associated with flushing, nasal stuffiness, and excess lacrimation was seen at 650 mg/m2/day. Using a 5-day continuous-infusion schedule, dose-limiting toxicity in the form of changes in affect, lethargy, disorientation, and cognitive dysfunction with electroencephalogram abnormalities was noted at 800 mg/m2/day. The recommended phase II dose levels are 525 mg/m2/day using the 5-day bolus schedule and 650 mg/m2/day using the continuous-infusion schedule. Because of venous pain at the site of infusion, the drug must be delivered via central venous access. The pathophysiology of both the peripheral and central side effects of caracemide may be related to increased cholinergic activity. PMID- 3548957 TI - Retinoids as preventive and therapeutic anticancer agents (Part I). AB - Retinoids, the synthetic and natural analogs of vitamin A, frequently block the phenotypic expression of cancer in vitro; they also inhibit growth and induce differentiation in many animal and human malignant cell types. Only recently has it become possible to propose a unifying mechanism of retinoid action, which involves the protein kinase-C cascade system. This system may mediate retinoids' many diverse actions, including their effects on enzyme synthesis, membrane properties, growth factors, binding proteins, genomic and postgenomic expression, the extracellular matrix, and immunologic responses. Ongoing in vitro studies of retinoid structure-activity relationships, effects on oncogene expression, reversal of drug-resistance, and, especially, the protein kinase-C cascade system should help clarify the precise mechanism of their anticancer action. Many in vitro and in vivo assay systems are available for testing the 2000 + synthetic retinoids. These assays indicate specific drug sensitivities, which may help focus future clinical trials. In human cancer prevention, retinoids have been most effective for skin diseases, including actinic keratosis, keratoacanthoma, and basal cell carcinoma; however, nondermatologic premalignancies, such as oral leukoplakia, bronchial metaplasia, laryngeal papillomatosis, cervical dysplasia, myelodysplastic syndromes, and the urinary bladder, also respond to retinoid therapy. Significant therapeutic advances are also occurring with this class of drugs in refractory malignancies, including advanced cutaneous squamous and basal cell cancer, mycosis fungoides, and acute promyelocytic leukemia. Newer third generation retinoids, such as the highly potent retinoidal benzoic acid derivatives, are demonstrating therapeutic indexes far higher than earlier generation retinoids. Current in vitro testing is also demonstrating that retinoids have synergistic activity in combination with other agents (eg, biologic modifiers, hormones, and DNA synthesis inhibitors) and treatment modalities (eg, irradiation). Notwithstanding the progress already made with retinoids in human cancer, many in vitro questions remain, and clinical work is just beginning. PMID- 3548958 TI - Clinical trial of plasma perfusion over immobilized staphylococcal protein A in metastatic breast cancer. AB - Nineteen patients with metastatic breast cancer refractory to conventional therapy were treated with plasma perfusion over 200 mg of staphylococcal Protein A immobilized on a silica matrix. Fever and chills (33%), pain at the site of tumor (18%), and dyspnea (16%) were the most frequent toxic effects encountered. Four patients (21%) developed a disseminated rash which necessitated cessation of treatment. Of 16 patients evaluable for response, one achieved a minor response of chest wall disease and two had no change in hepatic metastases for 4 and 5 months' duration. Potential mechanisms of antitumor effect are discussed. PMID- 3548960 TI - Phase II trial of tiazofurin in recurrent squamous cell carcinoma of the head and neck. PMID- 3548959 TI - FAM (5-fluorouracil, doxorubicin, and mitomycin) plus triazinate (FAM-T) in gastric carcinoma: a combined phase II trial of the Mid-Atlantic Oncology Program and the Pan American Health Organization. PMID- 3548961 TI - Esorubicin in refractory metastatic carcinoma of the breast: a Northern California Oncology Group Study. PMID- 3548962 TI - Phase II study of the combination of carmustine and 6-thioguanine in advanced malignant melanoma. PMID- 3548963 TI - Are the metabolic characteristics of congenital intraspinal lipoma cells identical to, or different from normal adipocytes? AB - Congenital intraspinal lipomas are frequently responsible for progressive neurological deficits caused by distortion or compression of the nervous system. Since fat metabolism in these lesions has not been previously studied, the aim of this study was to determine whether intraspinal lipoma cells behave like lipomas or like normal adipocytes. In 11 patients, intraspinal lipoma cells were compared with normal adipocytes isolated from adjacent subcutaneous adipose tissue for the following parameters: lipoprotein lipase (LPL), lipogenesis from U14C glucose, beta-receptor number, adenylate cyclase activity, cyclic AMP production, and lipolysis in response to beta- and alpha 2-adrenergic agonists. No significant difference between these two cell populations was found, suggesting that intraspinal lipomas are not lipomatous tumors, but hamartomatous lesions capable of growth and regression along with the changes in the rest of the fatty pool. This emphasizes the danger of an abnormal weight gain, as well as the possible usefulness of an hypocaloric diet in patients who worsen in spite of previous surgery. PMID- 3548964 TI - Synthesis of "dihydroacarbose", a potent alpha-D-glucosidase inhibitor. PMID- 3548965 TI - [Indications for heart transplant]. PMID- 3548966 TI - [Treatment of patients awaiting heart transplant]. PMID- 3548967 TI - [The heart transplant: surgical aspects]. PMID- 3548968 TI - [International activity of heart transplantation (1967-1985). The heart transplant in Italy: personal experience]. PMID- 3548969 TI - [Alternatives to heart transplantation]. PMID- 3548970 TI - [Therapy of arterial hypertension in the elderly]. PMID- 3548971 TI - [Echocardiographic evaluation of the effects of thrombolysis with systemic urokinase]. PMID- 3548972 TI - Lysis of venous, pulmonary, prosthetic valvular, arterial, and ventricular clots. AB - Thrombolysis has been used for the treatment of diverse thrombotic conditions for almost 50 years. Treatment of deep venous thrombosis and pulmonary embolism have been extensively studied, and benefit has been demonstrated in some subgroups. More recently thrombolysis has been investigated for the treatment of prosthetic valvular, arterial, and ventricular mural thrombi. PMID- 3548973 TI - Coronary atherosclerosis and thrombosis underlying acute myocardial infarction. AB - Autopsy and clinical studies indicate that coronary thrombosis plays a key role in the development of acute transmural myocardial infarction and possibly in unstable angina and sudden cardiac death. The pathogenesis of coronary thrombosis is complex. It involves the dynamic interplay among the atherosclerotic arterial wall, vasomotor influences, cellular and humoral mediators, and the blood coagulation pathways. PMID- 3548974 TI - Pathophysiology of myocardial reperfusion. AB - The feasibility of myocardial reperfusion is established. However, restoring patency to epicardial coronary arteries does not necessarily signify restoration of tissue perfusion or restoration of biochemical or mechanical function to the heart muscle previously supplied by the occluded vessel. This review examines the biochemical, functional, and histopathologic changes associated with myocardial reperfusion in an attempt to define the constraints within which reperfusion may lead to optimal recovery of myocardium, and to explore future possibilities for maximizing benefits of reperfusion while minimizing potential reperfusion injury. PMID- 3548975 TI - Assessment of coronary thrombolysis. AB - The efficacy of coronary thrombolysis may be assessed by several invasive and noninvasive means, including coronary angiography, contrast and radionuclide angiography, thallium 201 or 99mTc-pyrophosphate scintigraphy, positron emission tomography, cardiac ultrasonography, electrocardiography, and analysis of plasma creatine kinase activity. Each technique has its own strengths and limitations, but when used in concert these methods may provide insight into the physiology of coronary reperfusion and the efficacy of reperfusion in individual patients and populations. PMID- 3548976 TI - Coronary thrombolysis with intracoronary streptokinase. AB - Because there are several means by which a clinician may pharmacologically activate the fibrinolytic system for thrombolysis, the clinician must understand the clinical ramifications of the use of each pharmacologic agent. Intracoronary streptokinase is one such agent whose therapeutic use, although effective in many cases, must not be taken lightly. This article, therefore, reviews the pharmacology, therapeutic uses, and possible complications that could arise as a result of intracoronary streptokinase. PMID- 3548977 TI - Coronary thrombolysis with intravenous streptokinase. AB - Coronary thrombolysis can be achieved with several lytic agents administered via the intravenous or intracoronary routes. Streptokinase, when administered intravenously, produces coronary thrombolysis in from 34 to 75 per cent of patients. Intravenous administration has the advantage of rapid administration without the risks or delays inherent in the performance of cardiac catheterization, although lysis rates are lower than those achieved with intracoronary administration. Administration early after infarction (in the first 4 hours) is associated with improved ventricular function and reduced mortality. PMID- 3548978 TI - Dr. C. Edmund Kells, Jr., genius of dentistry (part II). PMID- 3548979 TI - Use of the crown-and-sleeve coping design in the treatment of rapidly advancing periodontitis. PMID- 3548980 TI - New methods for the detection of Chlamydia trachomatis. AB - The increasing worldwide recognition of the deleterious sequelae of Chlamydia trachomatis urogenital tract infections makes rapid, inexpensive diagnostic tests a high priority. Cell culture, still the standard for all other methods, is only 90% sensitive. Direct fluorescent antibody (FA) tests use highly specific monoclonal fluorescing antibodies directed against the elementary body, permitting direct examination of urethral and endo-cervical smears. These tests are highly sensitive (92% to 95%) and specific (95% to 96%). Major drawbacks are cost, need for a fluorescence microscope, the care required to collect and prepare adequate smears (up to 10% of smears are unacceptable), and the expertise required to interpret slides. By means of enzyme-linked immunoassay (EIA) tests large batches of specimens can be tested in a few hours; they require little technician time and no subjective interpretation, but their sensitivity appears to be less than that of the direct FA tests. Analysis of Gram-stained urethral and endocervical specimens, combined with gonococcal cultures in women, is still the cheapest, most rapid method of establishing a presumptive diagnosis of chlamydial urethritis and endocervicitis. In sexually transmitted disease clinics it is still the method of choice. An EIA test can be used for high-volume screening of women but should be used only in high-risk populations because its predictive value falls sharply as the prevalence of infection decreases. PMID- 3548981 TI - Evaluation of doxycycline in the treatment of urethritis and cervicitis caused by Chlamydia trachomatis. AB - The efficacy of treatment with doxycycline hyclate was studied in 50 patients (25 men and 25 women) with urethritis or cervicitis, or both, caused by Chlamydia trachomatis. Microbiological diagnosis was carried out by means of a micro immunofluorescent technique. The pathogen was eradicated in the specimens from the urethra and endo-cervix from 86% of the patients after treatment with 200 mg/day doxycycline for up to 24 days. Clinical symptoms disappeared in 76% of the patients, and the remaining patients showed improvement. A possible adverse effect (mild gastric discomfort) was reported by one patient, but it did not prevent his completing the treatment course. The results of the study support previously published findings and indicate that doxycycline may be a treatment of choice for patients with lower genital tract infections caused by C trachomatis. PMID- 3548982 TI - Efficacy of diflunisal versus naproxen in osteoarthritis of the knee: an open study. AB - Thirty-one patients with osteoarthritis of the knee were treated with either diflunisal (n = 17) or naproxen (n = 14) in a 12-week open-label study. Treatment was begun with 500 mg BID of diflunisal or 375 mg BID of naproxen. Patients not showing an adequate response to these dosages were given increases to 750 mg BID of diflunisal (n = 7) or 500 mg BID of naproxen (n = 8). Both drugs achieved statistically significant improvements in pain indices, tenderness, swelling, morning stiffness, functional capacity, knee flexion, and 50-foot walking time, and no significant difference was found between the two drugs. At the end of the study, all patients taking diflunisal and 11/14 patients taking naproxen felt that they had improved with treatment. Drug safety and tolerability were assessed in 21 patients given diflunisal and 16 given naproxen (including patients not part of the efficacy evaluation). Six (29%) patients in the diflunisal group and four (25%) in the naproxen group experienced side effects; three were withdrawn from the diflunisal group and one from the naproxen group because of adverse effects. In general, both drugs were well tolerated. PMID- 3548983 TI - Comparison of diflunisal and piroxicam in the management of patients with osteoarthritis. AB - An open-label comparison of diflunisal, a nonacetylated salicylate nonsteroidal anti-inflammatory drug (NSAID), and piroxicam, an NSAID belonging to the oxicam family, was conducted in patients with osteoarthritis. Efficacy assessments were made biweekly by the physician and patients during a 12-week treatment and observation period. The physician's evaluations showed that both drugs resulted in significant reductions in knee pain, tenderness, swelling, stiffness, and difficulty walking. A greater number of statistically significant differences were noted with diflunisal than with piroxicam, but there were no statistically significant differences between the two treatment groups. Patients' efficacy ratings tended to favor diflunisal, and diflunisal was significantly more effective than piroxicam in relieving night pain. Seventy-five percent of patients receiving diflunisal and 40% of those receiving piroxicam considered their condition improved after treatment; however, the proportion of good to excellent drug ratings was similar for the two drugs. Both drugs were generally well tolerated. Adverse effects were encountered in five (28%) of 18 patients given diflunisal and in four (33%) of 12 patients given piroxicam. Six patients were withdrawn from the study because of side effects, four from the piroxicam group and two from the diflunisal group. In this study, diflunisal was found to be an effective and well tolerated drug for use in the management of osteoarthritis. PMID- 3548984 TI - A 12-week, double-blind, multicenter study comparing diflunisal twice daily and ibuprofen four times daily in the treatment of rheumatoid arthritis. AB - Diflunisal, a nonacetylated salicylate preparation with a prolonged duration of action, was compared with ibuprofen for the treatment of rheumatoid arthritis in a multicenter trial comprising 210 patients. Diflunisal was administered twice a day (500 to 750 mg/day) and ibuprofen was administered four times a day (1,600 to 2,400 mg/day). To maintain double-blind conditions, all patients ostensibly followed the same regimen, ingesting their assigned drug and a matching placebo of their nonassigned drug. Disease activity assessments and laboratory tests were done periodically throughout the 12 weeks of the study, and results were compared with pretreatment findings. Efficacy evaluations in 187 patients showed that both treatments were similarly efficacious. Safety and tolerability also were similar in the two groups. Diflunisal, however, offers a more acceptable BID treatment schedule. PMID- 3548985 TI - Comparison of diflunisal and aspirin in long-term treatment of patients with rheumatoid arthritis. AB - A multicenter, open-label clinical trial evaluated the efficacy and tolerability of diflunisal given twice daily and aspirin given four times daily in the long term treatment of patients with rheumatoid arthritis. Patients who successfully completed a 12-week, double-blind, parallel study comparing diflunisal (500 to 750 mg daily) with aspirin (2.6 to 3.9 gm daily) continued on the same medication in a 40-week, open-label segment of the study. The dosage of diflunisal could be increased to a maximum of 1 gm daily during the open-label phase. Both regimens were effective during the 40-week study. Diflunisal was better tolerated than aspirin as judged by the overall incidence of clinical adverse experiences. Patients treated with diflunisal had significantly fewer adverse experiences involving the digestive system and organs of special sense than did those treated with aspirin. PMID- 3548986 TI - Comparison of diflunisal and naproxen for relief of anterior knee pain. AB - Two nonsteroidal anti-inflammatory drugs, diflunisal and naproxen, were compared for efficacy in relieving anterior knee pain of mild to moderate severity. Of 36 patients completing the study, 20 received diflunisal and 16 received naproxen. Eleven (55%) patients given diflunisal and ten (63%) given naproxen had significant relief of pain, but there were no statistically significant differences between the two treatments. Although adverse reactions were frequent in both groups, they were not severe and they abated upon discontinuation of medication. PMID- 3548987 TI - Comparison of diflunisal and naproxen in the treatment of tennis elbow. AB - The authors favor conservative treatment of tennis elbow, starting with cessation of the offending activity and prescription of a nonsteroidal anti-inflammatory drug (NSAID) and followed by isometric and isotonic exercises when pain and inflammation have subsided. Two NSAIDs, diflunisal and naproxen, were evaluated in 38 patients with mild-to-moderate pain associated with tennis elbow. The physicians' assessments found no statistically significant differences between the two drugs; both provided effective reduction of pain and swelling. Patients' assessments of pain relief achieved with their respective drugs significantly (P = 0.019) favored diflunisal. Prompt and effective relief of pain and swelling hastens the patient's progression to physical therapy and return to normal activities. PMID- 3548988 TI - Special honour issue for Professor Raymond Wegmann on the 30th anniversary of the founding of Cellular and Molecular Biology, formerly Annales d'Histochimie 1956 1986. PMID- 3548989 TI - Cellular and subcellular distribution of alpha-1-antitrypsin in the normal rat liver and during acute inflammatory reaction. A light and electron microscopic study with peroxidase labelled antibodies. PMID- 3548990 TI - Effects of growth factors on the ultrastructure of cardiac muscle cells in culture. PMID- 3548991 TI - Effects of pineal factors on the action potentials of sympathetic neurons. AB - Neurons from rat superior cervical ganglia were grown in coculture with pineal cells. Action potentials of neurons in cocultures were 25% longer and were 25% greater in amplitude than those recorded from neurons grown in the presence of ganglionic nonneuronal cells alone. Neurons showed an increase in action potential duration with increasing time in culture. This may have been related to the recovery of nonneuronal cell populations after an initial exposure to the antimitotic agent Ara-C. In cultures not initially exposed to Ara-C, a subsequent exposure after 7 days in culture resulted in a shortening of the action-potential duration. Neuronal cultures were exposed to gel slabs containing the pineal indolamines, serotonin, N-acetylserotonin, and melatonin. Serotonin and N acetylserotonin showed no effect on the neuronal action potentials at the concentrations tested. Melatonin caused an increase in action-potential duration that was associated not with an increase in action-potential amplitude, but with a decrease in action-potential rise rates. The effects of long-term exposure in melatonin appeared to be reversible in some cells but not in all. Short-term effects of melatonin were observed in older cultures and in younger cultures after the cells were stimulated repeatedly. Older cultures also had higher levels of spontaneous activity. The dependence of the short-term effects of melatonin on electrical activity may suggest a role for melatonin as a neuromodulator. PMID- 3548992 TI - Cytoskeletal polarity in mammalian lymphocytes in situ. AB - The distribution of vimentin and spectrin in lymphocytes within murine lymphoid tissues was studied by means of immunofluorescence. A polarized submembranous aggregate of intermediate filaments was observed to be characteristic of lymphocytes within the medulla of the thymus as well as in lymphocytes within specific areas of spleen and lymph-node. This aggregate was determined to be in close association with a similarly polarized aggregate of spectrin. Lymphocytes of both B and T surface phenotype comprise the population of cells that are naturally polarized in terms of these cytoskeletal proteins. Lymphocytes with such a naturally polarized cytoskeleton are not observed in the spleen until approximately 5 days after birth, but are observed in the thymus by day 19 of gestation. Incubating lymphocytes with cytochalasin D, but not colchicine, caused a rapid dispersal of the spectrin aggregate without altering the polar accumulation of intermediate filaments. When splenic B-cells were allowed to form uropods as a result of ligand binding, the uropod (as well as surface receptor "cap") was positioned above the region containing the polar aggregate of spectrin and vimentin. The possible physiological significance of naturally occurring cytoskeletal polarity in lymphocytes is discussed. PMID- 3548994 TI - Localization of ornithine decarboxylase in the chick embryo during organogenesis. AB - The localization of ornithine decarboxylase (ODC), a key enzyme in polyamine biosynthesis and thus in cell growth, was determined in the 4.5-day-old chick embryo, using two independent methods of analysis. ODC protein was identified by indirect immunofluorescence with a monospecific ODC antibody, and catalytically active ODC was identified by autoradiography with alpha-(5-3H) difluoromethylornithine. Both methods revealed a basically similar distribution of ODC within the embryo. Among the organs, the brain exhibited the highest ODC levels. ODC levels were also high in spinal cord, mesonephric tubules and heart. Similar levels, but confined to limited areas, were found in liver tissue, head mesenchyme, and the oral and pharyngeal regions. Organs that exhibited high ODC levels are all engaged in rapid growth, as well as in extensive tissue remodeling and differentiation. PMID- 3548993 TI - Serotonin-storing cells of the chicken duodenum: light, fluorescence and electron microscopy, and immunohistochemistry. AB - In an attempt to identify duodenal endocrine cells emitting formaldehyde-induced fluorescence (FIF), chicken duodena were studied by combined fluorescence, ultrastructural, silver impregnation and immunohistochemical methods in the same or consecutive sections. Our results show that: (1) Almost all the cells emitting yellow fluorescence by both the Falck-Hillarp and the Furness methods exhibit an immunohistochemical reaction with serotonin (5-HT) antiserum. (2) Almost all cells radiating yellow fluorescence by the Furness method stain with toluidine blue in Epon-embedded sections, but, by high-voltage electron microscopy, can be subdivided into two types of cell containing either small round or polymorphous types of granules. (3) In the sections from which resin had been removed, all the cells emitting yellow FIF show argentaffinity by the Singh method, but not all cells display argyrophilia with the Grimelius method. (4) Cells exhibiting both argyrophil and argentaffin reactions in deresined serial sections are also separated into two types of cell, containing either small spherical or polymorphous types of granules by conventional electron microscopy in thin sections. Therefore, chicken enterochromaffin cells emit yellow FIF, store 5-HT, show both argentaffinity and argyrophilia, but are ultrastructurally classified into two types of granule-containing cells which may be related to polypeptides coexisting with 5-HT. PMID- 3548995 TI - Expression of parvalbumin and other Ca2+-binding proteins in normal and tumor cells: a topical review. PMID- 3548996 TI - Recombination-stimulating sequences in yeast ribosomal DNA correspond to sequences regulating transcription by RNA polymerase I. AB - A DNA sequence (HOT1) from the repeated ribosomal RNA gene cluster of Saccharomyces cerevisiae can stimulate genetic exchange when inserted at novel locations in the yeast genome. Localization of the sequences required for HOT1 activity demonstrates that two noncontiguous fragments of DNA are required for the stimulation of recombination. One of these fragments contains the transcription initiation site for the major 35S ribosomal RNA precursor. The other contains an enhancer of RNA polymerase I transcription. We suggest that transcription by RNA polymerase I initiating in the inserted rDNA and proceeding through the adjacent sequences is responsible for the stimulation of exchange. Consistent with this interpretation, insertion of the putative termination site for RNA polymerase I transcription between HOT1 and the adjacent recombining DNA abolishes the recombination stimulation. Transcription through both copies of the homologous recombining sequences appears to be necessary for enhanced exchange. PMID- 3548997 TI - Movement of myosin fragments in vitro: domains involved in force production. AB - We have used the Nitella-based movement assay to localize the site of force production in myosin. Methods were developed to use nonfilamentous myosin or proteolytic fragments of myosin in place of the thick filaments used in the original assay. In the experiments described here, the tail of myosin or its subfragments is anchored via antibodies to the surface of small particles. Nonfilamentous myosin or its subfragments move along Nitella actin cables at speeds similar to those obtained with filamentous myosin. We generated short HMM, a myosin fragment containing the heads and only 400 A of the tail. Although short HMM lacks the "hinge" region proposed by Harrington to be the site of force generation, and is incapable of forming thick filaments, it moves along actin at speeds above 1 micron/sec. Therefore, neither a thick filament nor the carboxy terminal 1100 A of the tail is required for movement along actin. The results indicate that force production occurs in or near the myosin heads. PMID- 3548998 TI - Characterization and cloning of fasciclin III: a glycoprotein expressed on a subset of neurons and axon pathways in Drosophila. AB - To identify candidates for neuronal recognition molecules in Drosophila, we used monoclonal antibodies to search for surface glycoproteins expressed on subsets of axon bundles (or fascicles) during development. Here we report on the characterization and cloning of fasciclin III, which is expressed on a subset of neurons and axon pathways in the Drosophila embryo. Fasciclin III is also expressed at other times and places including transient segmentally repeated patches in the neuroepithelium and segmentally repeated stripes in the body epidermis. Antisera generated against each of four highly related forms of the protein were used for cDNA expression cloning to identify a single gene, which was confirmed to encode fasciclin III by tissue in situ hybridization and genetic deficiency analysis. PMID- 3548999 TI - Rearrangement of the vimentin cytoskeleton during adipose conversion: formation of an intermediate filament cage around lipid globules. AB - During adipose conversion of murine 3T3-L1 cells, the arrangement of vimentin intermediate filaments (IFs) changes from an extended fibrillar state to a complex cage formation tightly associated with the forming lipid globules. The fully developed cage complex surrounding the lipid globule consists of a monolayer of groups of regularly spaced vimentin IFs that in turn is closely ensheathed by a special endoplasmic reticulum cisterna. The same IF cage is also seen in other adipocytes in culture and in tissues. The specificity of the association of lipid globules with vimentin IFs during adipose conversion is discussed as a special form of compartmentalization supporting adipogenesis and is taken as an example of a possible IF function in relation to a cell differentiation process. PMID- 3549000 TI - Pseudogenes in yeast? PMID- 3549001 TI - Effects of preparative technique on the rate of adoption of crawling-like movements by polymorphonuclear leukocytes. AB - Various component steps of several "standard" techniques for separating polymorphonuclear leukocytes (PMN) from whole blood were tested for their effects on the rate at which these cells exhibit crawling-like movements when suspended in 100% plasma. The rate was depressed by excessive centrifugation, excessive agitation, erythrocyte lysis techniques, prolonged preparation time and one type of separation medium used. More than 95% of PMN in all preparations excluded the dye Trypan blue. The rate at which PMN exhibit crawling-like movements in plasma could be a sensitive index of the viability of these cells. PMID- 3549002 TI - Effects of insulin and retinoic acid on the anchorage-independent growth of transformed BHK21/C13 cells cultured with different lots of fetal bovine serum. AB - Several lots of fetal bovine serum (FBS) were divided into 2 groups; in one group, retinoic acid (RA) suppressed the anchorage-independent growth (AIG) of spontaneously transformed BHK21/C13 cells (clone Ag8-1) dose-dependently, but in the other group, little suppression occurred. In neither group of FBS was the anchorage-dependent growth (ADG) of the cells suppressed by RA. The addition of insulin enhanced the AIG of the cells in both groups even in the presence of RA. The 2 types of AIG systems in Ag8-1 cells, one susceptible and the other resistant to RA, are discussed. PMID- 3549003 TI - Dimethyl sulfoxide induces microtubule formation in cultured arterial smooth muscle cells. AB - Prolonged exposure of cultured arterial smooth muscle cells to 1% dimethyl sulfoxide (DMSO) resulted in a remarkable increase in cytoplasmic microtubules and an appearance of bundle-like aggregates of microtubules associated with ribosomes (microtubule-ribosome-complex). In this complex, fine filaments of 8 to 16 nm diameter were interspersed, some of which displayed continuity with the microtubules and were studded with a single array of ribosomes. The microtubule ribosome-complex may represent an unusual aggregate of microtubules containing incompletely polymerized forms of newly synthesized tubulin induced by prolonged effect of DMSO. PMID- 3549004 TI - Human bone marrow cells synthesize collagen, in diffusion chambers, implanted into the normal rat. AB - Endosteal bone marrow cell populations were harvested, from freshly removed human femoral trabecular bone fragments, by enzymatic digestion. Diffusion chambers inoculated with fractions of this cell population were then implanted in the peritoneal cavities of three Albino Wistar rats for six weeks. The human cells were found both to survive within the chambers and to produce a collagen containing extracellular matrix. PMID- 3549005 TI - Immunotoxins: current use and future prospects in bone marrow transplantation and cancer treatment. AB - Immunotoxins are protein toxins which have been conjugated in whole or in part to antibodies in the hope of producing cell-type-specific toxic reagents with useful properties. Such reagents hold the promise for eliminating unwanted cells both in vivo and in vitro. In practice, to date, only in vitro usage has proven clinically and experimentally useful. The design of effective immunotoxins is based on utilizing cellular entry mechanisms or entry mechanisms inherent in the parent toxins to cross the plasma membrane barrier to the cytosol compartment where the toxins exert their effects. Knowledge in the area of receptor-mediated protein transport is expanding rapidly and new immunotoxins with increased efficiencies are anticipated. PMID- 3549006 TI - Nonparenteral administration of peptide and protein drugs. AB - Peptides/proteins are an important class of drugs which are usually administered by parenteral route. In recent years, pharmaceutical research has been directed towards developing a nonparenteral route of delivery of peptide/protein drugs. These studies report that it may be possible to administer the peptides/proteins especially insulin, by nasal, buccal, rectal, or even transdermal route. Therefore, there is a great potential for future development of a nonparenteral route of delivery of peptide/protein drugs. The primary objective of this review is to report the present status of research involving nonparenteral administration of macromolecular peptides/proteins, with special emphasis on insulin. PMID- 3549007 TI - Poly(hydroxy acids) in drug delivery. AB - Poly(hydroxy acids) so far have been examined for use in drug delivery in limited number, while the advantageous use of the polymers has been recognized due to their biodegradability and biocompatibility. Homo- and copolymers of lactic acid and glycolic acid have been studied in drug delivery by many workers, while homo- and copolymers of epsilon-caprolactone have been studied by only one group of workers. Although poly-hydroxybutyric acid had been found to be a naturally occurring polymer, examination as to the use of the polymer in drug delivery is rather recent and reports are still limited. In the present article, the use of poly(hydroxy acids) including homo- and copolymers of lactic acid and glycolic acid, polycaprolactone, and poly-beta-hydroxybutyric acid in drug delivery is reviewed. Physicochemical properties, biodegradability, and biocompatibility of the polymers, and evaluations in vitro and in vivo of specific dosage forms using the polymers, are included. The most recent work in our laboratories on the use of polyactic acid and poly-beta-hydroxybutyric acid is also included. PMID- 3549008 TI - Nanoparticles in drug delivery. AB - Alkylcyanoacrylates can be polymerized in acidified aqueous media by a process of anionic polymerization. The small particles produced tend to be monodisperse and have sizes in the range of 20 to 3000 nm depending upon the polymerization conditions and the presence of additives in the form of surfactants and other stabilizers. The polyalkylcyanoacrylate nanoparticles so produced have been studied in recent years as a possible means of targeting drugs to specific sites in the body, with particular emphasis in cancer chemotherapy. The small colloidal carriers are biodegradable and drug substances can be incorporated normally by a process of surface adsorption. The review by Davis and others considers the formulation of nanoparticles, the important physicochemical variables such as pH, monomer concentration, added stabilizers, ionic strengths, etc., as well as the characteristics of the particle so created in terms of surface charge, particle size, and molecular weight. Monodisperse particles in the range of 20 to 3000 nm can be obtained. In addition, by the use of stabilizers such as dextran and its derivatives, which can be incorporated into the nanoparticle surface by a process of polymer grafting, it is possible to make nanoparticles with interesting surface characteristics and different surface charges (sign). The stability of nanoparticles in vitro and their biodegradation in vivo are examined, and the possible formation of toxic products such as formaldehyde is highlighted. Alternative biodegradable acrylates are mentioned. Drugs can be incorporated into nanoparticles by either direct incorporation during the polymerization process or adsorption to preformed nanoparticles. The efficiency of the incorporation and the release characteristics of model compounds as well as anticancer drugs are discussed. Methods for examining these processes, including the determination of adsorption and desorption, kinetics, and isotherms, are mentioned. Selectivity in drug targeting can, in theory, be achieved by the attachment of some form of homing device, normally a monoclonal antibody or a lectin. Work in vitro and in vivo, where nanoparticles have been coated with monoclonal antibodies, is described. Finally, methods for the labeling of nanoparticles with gamma-emitting radionuclides are presented, and results obtained in animal species are given. PMID- 3549009 TI - Treatment of urinary infections: clinical perspectives. AB - The present study was carried out with the aim of comparing the microbiological and clinical efficacy of norfloxacin, cinoxacin and aztreonam in urinary tract infections. Patients were tested who had infections of the higher and/or lower urinary tracts associated with complicating factors. The microorganism most frequently isolated in these individuals was Escherichia coli. The assays carried out with the aim of testing the in vitro antibacterial activity (agar diffusion method and minimum inhibitory concentration) on the microorganisms responsible for the infections, as well as the evaluation of clinical efficacy, showed that norfloxacin has a wider antibacterial spectrum of action and inhibitory activity greater than the other two drugs tested. PMID- 3549010 TI - Oral ciprofloxacin in the treatment of uncomplicated gonococcal urethritis in men. AB - Two hundred and seventy-one male patients suffering from uncomplicated gonococcal urethritis were treated in an open randomized study with either 250 mg (121 patients) or 500 mg (150 patients) single oral doses of ciprofloxacin. The efficacy of treatment was verified on the third day by direct examination of urethral swabs in 91 patients and by culture and direct microscopic examination in 180 subjects. Cure rates were 100% in the 500 mg group and 96.6% in the 250 mg treated patients. No side effects were seen. Ciprofloxacin appears to be a very effective and safe drug in the treatment of uncomplicated gonococcal urethritis in men. PMID- 3549011 TI - 5-Fluorocytosine and Candida yeasts. AB - The authors report 5-fluorocytosine's activity against 101 Candida albicans and 42 Candida non-albicans strains. They point out the drug's lower inhibitory and lethal activity against Candida non-albicans. A 1.56 microgram/ml concentration inhibits 83% of Candida albicans while only 40% of Candida non-albicans is inhibited. PMID- 3549012 TI - Competitive enzyme immunoassay for anti-ulcer agent, (-)-cis-2,3-dihydro-3-(4 methylpiperazinylmethyl)-2-phenyl-1,5- benzothiazepin-4(5H)-one hydrochloride (BTM-1086). PMID- 3549013 TI - Synthesis of a highly potent analogue of prostacyclin, (-)-5 methyleneisocarbacyclin. PMID- 3549014 TI - Deoxyribonucleic acids and related compounds. XXII. Synthesis of genes for human nerve growth factor and its fused protein. PMID- 3549015 TI - Regulation of GM2 ganglioside metabolism in cultured cells. AB - GM2-ganglioside (II3NeuAcGgOse3Cer) is a minor component of adult nervous tissue, but is probably an oncofetal antigen. Its biological role is unknown, but several lines of evidence indicate its potential role in cell adhesion both in the retina and in oligodendrocytes. The biosynthesis of GM2-ganglioside appears to be tightly regulated, since it is a key intermediate in complex ganglioside synthesis. The specific GM3: hexosaminyl-transferase is activated under conditions which activate cyclic AMP-dependent protein kinase, and cell transformation with retroviruses inactivates it. Catabolism of GM2 requires the concerted action of three gene products (alpha-chain, beta-chain and activator protein in a thermolabile alpha beta 2 AP complex referred to as HexA). Defects in either three components results in the neuronal storage of GM2 ganglioside and the manifestations of Tay-Sachs Disease in children or motor neuron disease in adults. PMID- 3549016 TI - Phylogenetic development of myelin glycosphingolipids. AB - Myelin is a highly specialized membrane, which enwraps axons and facilitates saltatory nerve conduction in vertebrates. Galactocerebroside and its sulfate ester, sulfatide, are highly localized in myelin. To understand the role played by these galactosphingolipids we investigated the changes of these myelin specific compounds during the course of the evolution of myelin. We found that urodele nerve myelin lacks alpha-hydroxy fatty acid-containing galactosphingolipids. Our morphological and physiological studies of urodele nerves indicated that these hydroxy fatty acid-containing galactosphingolipids probably contribute to fast nerve conduction. Also it is suspected that they are involved in the regulation of the thickness of myelin in relation to the size of the axon. In another study, we discovered that glucocerebroside, which has glucose instead of galactose as its carbohydrate component, is abundantly present in the myelin-like sheath membrane of crustacean nerves. Subsequently, the phylogenetic study indicated that galactocerebrosides were limited to the nervous system of deuterostomes, while all protostome nerves contain glucocerebrosides. The role of glucocerebrosides in multilayered membranes and in the conduction velocity of the protostome nervous system is discussed. PMID- 3549017 TI - Sulfatide-binding proteins. AB - Sulfatides (galactosyl ceramide-I3-sulfate) and other sulfated glycolipids are found in many tissues. The cell adhesion proteins laminin, thrombospondin, and von Willebrand factor bind specifically to sulfated glycolipids. Methods for characterizing the specificity of these interactions using surface-adsorbed glycolipids are reviewed. The three proteins do not bind to other anionic lipids, including gangliosides, phospholipids, or cholesterol 3-sulfate. Binding to sulfatides is saturable and of relatively high affinity. Relative binding avidity depends on the oligosaccharide structure of the glycolipids. Binding to sulfatides in erythrocyte membranes can account for the hemagglutinating activities of the three proteins and may play a role in the interactions of these proteins with other cell types. PMID- 3549018 TI - Elucidation of glycolipid structure by proton nuclear magnetic resonance spectroscopy. AB - The primary structure of the oligosaccharide moiety of a glycosphingolipid can be elucidated by employing high-field proton nuclear magnetic resonance (NMR) spectroscopy. Information with respect to the composition and configuration of its sugar residues, and the sequence and linkage sites of the oligosaccharide chain can be obtained by employing a variety of one- and two-dimensional techniques. The latter include both scalar and dipolar correlated two-dimensional NMR spectroscopy. These techniques are also useful in establishing the solution conformation (secondary structure) of the oligosaccharide moiety. Examples in utilizing these techniques in elucidating the primary and secondary structures of glycolipids are presented. PMID- 3549019 TI - New chemical trends in ganglioside research. AB - A report is given of recent progress in the methodology for isolation of gangliosides from natural sources, for the preparation of molecular species of gangliosides homogeneous in both the oligosaccharide and ceramide portions of the molecule, for chemical manipulation and derivatization of gangliosides, and for the preparation of gangliosides radiolabelled in different parts of the molecule. Particular emphasis has been given to: high performance liquid chromatographic procedures capable to separate gangliosides on the basis of their oligosaccharide or ceramide moieties and yielding completely homogeneous compounds, that is gangliosides with a single oligosaccharide, a single long chain base and a single fatty acid; two-dimensional thin-layer chromatographic procedures, provided with a fully computerized quantification system, particularly suitable to identifying gangliosides containing alkali-labile linkages, including ganglioside lactones; chemical procedures of high yield for reducing gangliosides at the double bond of long chain base, for selective removal of the fatty acyl moiety and replacement with a novel fatty acid, and for the synthesis of ganglioside lactones; chemical procedures for inserting fluorescent, paramagnetic or photoreactive probes at the fatty acyl part of the ganglioside molecule; procedures for chemical isotopic radiolabelling of gangliosides at the level of sialic acid acetyl group and at the fatty acid moiety. Examples are provided evidencing the significance and potential use of a variety of ganglioside derivatives in the study of ganglioside metabolism and functional implications. PMID- 3549020 TI - Molecular interactions and thermotropic behavior of glycosphingolipids in model membrane systems. AB - The oligosaccharide chain of glycosphingolipids (GSLs) has a marked influence on their thermotropic behavior, intermolecular packing and surface electrical potential. The transition temperature and enthalpy of GSLs decrease proportionally to the complexity of the polar head group and show a linear dependence with the intermolecular spacings. Interactions occurring among GSLs and phospholipids induce changes of the molecular area and surface potential that depend on the type of GSLs. Increasing proportions of phospholipids perturb the thermodynamic properties of the GSLs up to a point where phase separated phospholipid domains separate out but no phase separation of pure GSLs occurs. Heterogeneous equilibria among different structures occur for some systems. Large changes of the molecular free energy, eccentricity, asymmetry ratio and phase state of the GSLs-containing structure can be triggered by small changes of the molecular parameters, lipid composition and lateral surface pressure. The thermotropic behavior of GSLs is considerably perturbed by myelin basic protein. Phase separation occurs depending on the amount of protein and type of GSLs. The protein induces a decrease of the lipid molecular area, the more so the more complex the oligosaccharide chain in the GSLs. These membrane systems can not be described only on the basis of the individual properties of the molecules involved in a simple causal manner. Still scarcely explored long range thermodynamic, geometric and field effects that belong simultaneously to the intervening molecules, to the morphological properties of the structure involved and to the aqueous environment, are important determinants of their behavior. PMID- 3549021 TI - Gene transfer as a novel approach to the gene-controlled mechanism of the cellular expression of glycosphingolipids. AB - Gene transfer is a useful technique to analyse the gene-controlled mechanism of cellular expression of glycosphingolipids. Using various oncogenes (DNA tumor virus oncogenes: adenovirus 12 E1 and its transcriptional subunits, myc and SV40 T antigens; RNA tumor retrovirus oncogens: fos, src and H-ras) for the transfer, it was demonstrated that these genes invariably caused remarkable and characteristic changes of the cellular expression of gangliosides in the same recipient rat embryonic cell line, 3Y1. As a consequence of the transfer, various ganglioside species appeared or disappeared, the extent of the changes varying according to the type of oncogenes used. Analysis of the enzymatic background of such changes was also carried out. Based on these results, the effects of oncogene transfer on glycosphingolipids were classified and discussed according to the mode of subcellular distribution of gene products. PMID- 3549022 TI - Perfluorocarbon blood substitutes. AB - The salient physicochemical properties of the fluorocarbons are briefly reviewed, including their solubility for the physiologically important gases and their properties relevant to formulation (nonmiscibility with water). The preparations used to date are described, including their properties and compositions, with some comment about the available knowledge of the properties of the constituents. A critical review of the biological aspects and the possible uses of fluorocarbon emulsions constitutes the main body of the manuscript. Gas-transporting capabilities are considered quantitatively. The biological effects of these preparations are reviewed in in vivo, whole body systems, with some in vitro evidence where appropriate. The usefulness of these preparations investigated to date are reviewed under the broad headings of cardiovascular system, radiology, intoxications, and organ preservation. Finally, the shortcomings and potential usefulness are discussed, with recommendations for potential modifications. PMID- 3549023 TI - [Toxoplasma gondii in Haiti. Results of a sero-epidemiologic survey in a rural area]. AB - In Haiti, positive immunofluorescent tests are observed in 5.9% of the inhabitants of a rural area in the South of the country. The index of positive reactions is increasing with age. No difference between males and females is noticed. Seropositive cases are clustered within defined families for 60% of them. The antibodies titers are low: 8 I. U. for 88% of cases. The prevalence of toxoplasmosis varies from 0 to 15%, according to the village, without any clear relationship with rainfall, altitude, or prevalence of intestinal worm infections. Subjects harboring nematodes transmitted by skin penetration are more often serologically positive than others. Oocysts voided by cats seem to be mainly responsible for transmission to humans in this part of the world. PMID- 3549024 TI - [Lymphatic filariasis in Haiti: historical sequel or future public health problem in this geographic region?]. AB - Wuchereria bancrofti persists in Haiti in localized foci, discontinuously distributed. The parasite, transmitted by Culex quinquefasciatus, develops in mesoendemic or hyperendemic fashion in urban and suburban areas, on the coastal plains sheltered from the prevailing winds, predominantly in the Nord department and around the gulf of La Gonave. Lymphatic filariasis is a major public health problem. Its impact is more evident in males on account of the genital repercussion of the disease. The acute lesions appear from early infancy and are related to microfilarial density. The chronic lesions begin with adolescence, and occur with high frequency in adults. Lymphatic filariasis has retreated in the countries where socioeconomic or sanitary conditions have improved: Puerto Rico, French West Indies, Cuba. In countries confronted by underdevelopment, overpopulation and uncontrolled urbanization, the disease is prevalent: Haiti, Dominican Republic, Trinidad. It is essential to carry out epidemiological investigations in order to identify the extend of the lymphatic filariasis problem in the Caribbean, particularly as population migration in both directions is becoming intensified: the native people looking for work in the industrialized countries, and tourists seeking the attractions of the tropics. PMID- 3549025 TI - [Epidemiology of filariasis (onchocerciasis and bancroftosis) in the Tala-Mokolo region (Mandara Mountains of North Cameroon)]. AB - The effect of the bancroftian filariasis on the health of the inhabitants are minimal in the study area, where the prevalence of the disease (nocturnal microfilaremia) is 0.4% only. But skin snips harboring Onchocerca microfilariae are seen in 12.1% of the sample studied. Onchocerciasis skin lesions, low visual acuity and blindness are often seen in the villages where the prevalence is high, among inhabitants more than 40 years of age. Simulium damnosum is seldom seen in the area, except in the large streams and rivers like the mayo Tsanaga and the mayo Djingliya. Larvae and nymphae of this species hardly succeed in developing on the overspelling of the small dams, this being due more to a discontinuous run of the water in the overspilling than to a to high speed of the water. PMID- 3549026 TI - [Treatment of keratoconus by keratoplasty. Report on 39 operations]. PMID- 3549027 TI - [Spontaneous improvement of diabetic macular edema: apropos of a clinical case]. PMID- 3549028 TI - Precurarisation in infants and children less than three years of age. AB - Sixty patients less than three years of age about to undergo adenoidectomy or endoscopy were divided into three groups of 20 each according to age (0-11 months, 12-23 months, 24-35 months). Before the induction of anaesthesia with thiopentone, either tubocurarine 0.05 mg X kg-1 or normal saline was given at random in a double-blind fashion. Three minutes later, the children received succinylcholine 1.5 or 1.0 mg X kg-1, respectively. Muscle movements were graded according to a four-point scale. Blood was sampled for creatine kinase (CK) activity before anaesthesia and on the following morning. When all age groups were combined, there was a significant reduction of muscle movements in patients who had received tubocurarine pretreatment. Serum CK activity rose significantly when saline pretreatment was used in children over the age of one year but not in the infants, despite the presence of muscle movements following succinylcholine administration. PMID- 3549029 TI - Double-blind comparison of lidocaine, tubocurarine and diazepam pretreatment in modifying intraocular pressure increases. AB - One hundred and sixty patients, divided randomly into four groups received normal saline (5 ml), d-tubocurarine (0.05 mg X kg-1), diazepam (0.1 mg X kg-1) or lidocaine (1 mg X kg-1) as pretreatment, in a double blind manner, five minutes before anaesthetic induction with thiopentone and succinylcholine (1 mg X kg-1). Succinylcholine caused a significant increase in IOP in all groups. However, in the lidocaine group, this increase was significantly less than that observed in the control group. The post-succinylcholine increase in IOP was further aggravated by tracheal intubation in all except the lidocaine group. A further clinical trial with higher doses of lidocaine is suggested to assess its ability to obtund the succinylcholine-induced increase in IOP. Lidocaine in a dose of 1 mg X kg-1 IV prevents the rise in IOP which follows intubation. PMID- 3549030 TI - A century of progress in combating yellow fever. AB - Yellow fever was responsible for several epidemics among the settlers in tropical areas of the Americas and Africa during the 17th to the 19th centuries. Scientific research into its cause and epidemiology was started at the beginning of the present century and progressed well ahead of other viral disease research. However, epidemics still occur and the worst one ever recorded was in Ethiopia in 1960-62. Epidemiological research has recently provided new findings on the ecology of the virus and the risk of epidemics. Recent breakthroughs in the molecular study of the virus should provide new tools for further progress in treatment and control of the disease. Meanwhile, the risk of urbanization of the disease, deficiencies in treatment, limitations in vector control, and erratic policies in preventive immunization present real problems. PMID- 3549031 TI - Defined Plasmodium falciparum antigens in malaria serology. AB - The study evaluates three enzyme-linked immunosorbent assays (ELISA) of malaria antigens suitable for use in large-scale epidemiological studies. Results obtained using sera from 567 persons from the Gambia indicated that the micro ELISA method using parasitized red blood cell extract did not reliably quantitate antimalarial antibodies, especially in young children. In contrast, two micro ELISA methods that employed purified, defined antigens (a polypeptide of M(r) = 41 000 present in rhoptries, and a 31-1 fusion polypeptide corresponding to a merozoite surface antigen) permitted the precise determination of antimalarial antibodies in both adults and children. Problems and advantages associated with the use of the M(r) = 41 000 and 31-1 antigens for the determination of antimalarial antibodies are discussed. PMID- 3549032 TI - Diagnosis and management of prolactinomas. AB - Prolactin secreting tumors account for ten to twenty percent of all intracranial lesions. The patients harboring these tumors present with amenorrhea, galactorrhea, other ovulatory disorders, infertility, delays in puberty and mixed polyendocrinopathy. These tumors are diagnosed by the measurement of serum prolactin levels, Goldmann-Bowl perimetry, and either computed axial tomography or magnetic resonance imaging. Protein secreting tumors are usually benign lesions and historically have been treated by partial or total hypophysectomy or radiation therapy. Surgical resection of the lesion often is followed by recurrence and administration of proton beam radiation therapy results in the development of a panhypopituitary state. Growth of pituitary tumors is controlled with the administration of dopamine agonists such as bromocriptine and prospective studies have suggested that these drugs are now the preferred method of treatment for primary lesions and recurrences. PMID- 3549034 TI - Biological and clinical studies relevant to metastasis of breast cancer. AB - The progression of neoplastic epithelial proliferation in the breast does not inevitably lead to an infiltrating carcinoma. The carcinoma-in-situ which do metastasize apparently produce cells whose first moves through tissue are facilitated by lysing inert intercellular material (types I and IV collagen). Metastasis, defined as the capability of tumor cells to disseminate to distant sites in the body and set up secondary neoplasms, is a property separate and additional to tumorigenicity or local invasiveness. The driving engine of the metastatic process is identified as regulatory genomic disturbances in the population of cells within the tumor. Success or failure of secondary tumor growth in distant sites depends upon the outcome of interaction with local microenvironmental factors and systemic endocrine and immunological conditions. PMID- 3549033 TI - Analysis of the lodgement and extravasation of tumor cells in experimental models of hematogenous metastasis. AB - This review summarizes our experiments on the metastatic distribution patterns of Yoshida sarcoma and several strains of rat ascites hepatomas. These dissemination patterns cannot be explained entirely by either anatomical-mechanical considerations or by the seed-and-soil hypotheses for metastatic localization. In some experimental situations, anatomical-mechanical factors seem more important, but in others the seed-and-soil hypothesis offers a more compelling interpretation. Lodgement of tumor cells in the microcirculation of different organ vascular beds can occur by three non-exclusive mechanisms: direct attachment to vascular endothelial cells; direct adhesion to exposed vascular basement membrane components or by entrapment in thrombi. Similarly, extravasation can also occur via several mechanisms. The first, involves infiltration of tumor cells into perivascular tissues via their own movement. A second mechanism involves sequestration of tumor cells beneath vascular endothelial cells where they are separated from the blood stream. The third option for extravasation involves 'explosive' displacement in which the blood vessel wall swells as a result of intracapillary growth of tumor emboli causing the vessel to rupture. PMID- 3549035 TI - Tumor cell surface carbohydrate and the metastatic phenotype. AB - The synthesis and expression of cell surface carbohydrates is a developmentally regulated process that appears to affect a number of cell-cell interactions. To determine whether specific oligosaccharide structures present on highly malignant cells are required for expression of the metastatic phenotype, we have isolated lectin resistant tumor cell mutants with defects in the biosynthesis of oligosaccharides. The mutants selected from the highly aggressive lymphoreticular like tumor line MDAY-D2 were grouped into genetic complementation classes, compared for metastatic ability and for changes in cell surface glycoconjugates. The Asn-linked oligosaccharides and glycolipids of class 1 mutants were deficient in both sialic acid and galactose and the cells showed a greatly attenuated metastatic phenotype compared to the parental cells. A revertant of the class 1 mutation selected in vitro regained the wild type glycoconjugate profile and the highly metastatic phenotype indicating a direct association between the mutation and the loss of metastatic potential. Class 2 mutants remained highly metastatic and had Asn-linked oligosaccharide structures very similar to those found in the wild type cells with N-glycolylneuraminic acid rather than the N-acetylneuraminic acid. Swainsonine, an inhibitor of golgi alpha-mannosidase II, blocks the synthesis of complex-type Asn-linked oligosaccharides resulting in the expression of hybrid-type oligosaccharides at the cell surface and the cells display a lectin resistant phenotype. Although swainsonine inhibited neither tumor cell growth in vitro nor solid tumor growth in situ, the drug dramatically reduced the incidence of lung colonies after i.v. inoculation of both MDAY-D2 and B16F10 melanoma cells. These results, taken together, indicate that certain sialylated Asn-linked oligosaccharides found on metastatic tumor cells are required for expression of the metastatic phenotype. PMID- 3549036 TI - Biological and biochemical properties of new anticancer folate antagonists. AB - We review the biology and biochemical pharmacology of four antifolates that were recently introduced into clinical trial as anticancer agents, and one compound in preclinical development. Toxicology and clinical data are not discussed. 10-Ethyl 10-deazaaminopterin (10-EdAM) is a classical antifolate, structurally related to methotrexate (MTX) but with greater activity against murine tumors. 10-EdAM has more efficient membrane transport, and relatively greater polyglutamylation in murine tumors than in normal mouse tissues, and these differential effects are greater for 10-EdAM than for other 10-deaza antifolates or for MTX. Trimetrexate and piritrexim are nonclassical antifolates, lacking a glutamate substitution. They are lipophilic, cross cell membranes more rapidly than does MTX, and retain activity against tumors resistant to MTX because of impaired drug transport. These nonclassical antifolates are active against several MTX-insensitive murine tumors, and both have demonstrated clinical anticancer activity. 10-EdAM, trimetrexate and piritrexim all inhibit dihydrofolate reductase (DHFR) as their primary site of action. As such, they deplete cellular thymidylate and purine pools, and inhibit DNA replication. N10-Propargyl-5,8-dideazafolic acid (CB3717) differs from the first three compounds in acting primarily on thymidylate synthase. Like DHFR inhibitors, it blocks DNA replication through depletion of dTTP, but it does not exert an antipurine effect. CB3717 retains activity against transport-defective MTX-resistant cells, and also against cells that overproduce DHFR. 5,10-Dideazatetrahydrofolic acid (DDATHF) is a selective inhibitor of glycinamide ribotide transformylase, and its biochemical pharmacology may differ appreciably from that of the other antifolates under study. DDATHF has strong antitumor activity in several murine systems. PMID- 3549038 TI - The 32P-post-labeling method in quantitative DNA adduct dosimetry of 2 acetylaminofluorene-induced mutagenicity in Chinese hamster ovary cells and Salmonella typhimurium TA1538. AB - The usefulness of the 32P-post-labeling/t.l.c. method for quantitative DNA adduct dosimetry was evaluated. 2-Acetylaminofluorene (2-AAF)-DNA adducts from three systems were characterized qualitatively and quantitatively by the 3H radiolabeled technique with subsequent analysis by h.p.l.c. (pre-labeling method) and by the 32P-post-labeling method. Both methods showed N acetoxyacetylaminofluorene (N-OAc-AAF) reaction products with calf thymus DNA were predominantly N-(deoxyguanosin-8-yl)-2-acetylaminofluorene (dG-C8-AAF) with some N-(deoxyguanosin-8-yl)-2-aminofluorene (dG-C8-AF) and N-(deoxyguanosin-N2 yl)-2-acetylaminofluorene (dG-N2-AAF). In contrast, Chinese hamster ovary (CHO) cells treated with [3H]N-OAc-AAF gave 80 or 90% dG-C8-AF adducts and 20 or 10% dG C8-AAF adducts with the post- or pre-labeling method, respectively. Likewise in CHO cells treated with 2-AAF in the presence of rat liver homogenate, approximately 90% dG-C8-AF and 10% dG-C8-AAF adducts were detected using the 32P post-labeling method. In Salmonella typhimurium strain TA1538 treated with 2-AAF or [3H]2-AAF in the presence of a rat liver homogenate, one adduct, dG-C8-AF, was identified. Similar quantitative results were also obtained with the two methods. However, the 32P-post-labeling method was more sensitive and also eliminated the use of radiolabeled-mutagen treatments. Quantitative DNA adduct dosimetry was applied to AAF-induced mutagenesis in the S. typhimurium and CHO/HPRT mutation assays. A linear and reproducible relationship existed between dG-C8-AF levels and AAF-induced mutants in both systems. PMID- 3549039 TI - Time course of changes of plasma renin activity and catecholamines during hemorrhage in conscious sheep. AB - The time courses of humoral changes in the renin-angiotensin system and the sympathetic nervous system were studied in conscious sheep in response to slow and fast hemorrhages. In two separate groups of chronically instrumented animals, 18 hemorrhages. In two separate groups of chronically instrumented animals, 18 ml/kg of blood was withdrawn over 10 or 30 minutes. The activation of the renin angiotensin system was assessed by measurement of plasma renin activity and the sympathetic nervous system was assessed by measurement of circulating epinephrine and norepinephrine concentrations. The activation of both the renin-angiotensin system and the sympathetic nervous system occurred more rapidly in the fast hemorrhage group than the slow hemorrhage group. The peak mean plasma renin activity was 20.83 +/- 5.75 ng angiotensin I/ml/hr during the rapid hemorrhage and 8.8 +/- 1.43 ng angiotensin I/ml/hr during the slow hemorrhage (p less than 0.05). In contrast, the levels of maximal activation of the sympathetic nervous system during the slow and rapid hemorrhages were not significantly different. However, despite the threefold difference in rate of blood removal between the two groups, when the activities of the renin-angiotensin system and the sympathetic nervous system were plotted against the volume of blood removed, the time courses of change of these two humoral defense mechanisms were similar in the slow and fast hemorrhage groups. In both groups, an increase in plasma renin activity began earlier than the increase in circulating concentrations of epinephrine and norepinephrine; the maximal increase in all three humoral agents occurred near the end of the blood withdrawal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549037 TI - Antibacterial therapy in patients with malignancies. AB - Patients with malignant disease may be predisposed to bacterial infections because of neoplastic disruption of normal tissue barriers, exogenous immunosuppressive therapy (drugs with or without radiation), and intrinsic host immune deficits secondary to these diseases. Diminished polymorphonuclear leukocyte numbers or function and impaired humoral immunity are highly correlated with the development of serious bacterial infections. The usual signs and symptoms of infection may be absent or altered in a compromised host. Therapy must be instituted promptly upon clinical suspicion of bacterial infection, and empirical choices should usually include combinations that are synergistic for likely pathogens based on knowledge of the local predominant flora and susceptibility data. Synergism has most often been demonstrated in combinations that utilize a beta-lactam (semisynthetic penicillin or cephalosporin) and an aminoglycoside. Triple drug therapy has not been shown to be advantageous. Monotherapy with third generation cephalosporins, carbapenems, monobactams, or ureidopenicillins has not been proven to offer advantages over 2-drug regimens for these patients. Patients with blood deficient in granulocytes (granulocytopenic) who respond to 2-drug therapy but remain deficient in neutrophils (neutropenic) may need continued treatment until the neutropenia subsides. Those who do not respond and remain febrile with an unclear focus of infection may need to be started on antifungal therapy in addition to the antibacterial agent. The use of oral agents for the prophylaxis of neutropenic patients against bacteremia remains controversial. If drugs are used, co trimoxazole and nystatin suspension may be preferable. PMID- 3549041 TI - The quest for the mechanisms of the sudden infant death syndrome: doubts and progress. PMID- 3549040 TI - Leukotriene antagonist FPL 57231 prevents the acute pulmonary effects of Escherichia coli endotoxin in cats. AB - We studied the effects of a selective leukotriene (LT) antagonist (FPL 57231, 2 mg kg-1 min-1) on the acute cardiopulmonary changes observed in feline endotoxin shock. LTC4 and LTD4 (0.1-3.0 micrograms kg-1) given intravenously had little or no activity on pulmonary arterial pressure (PAP), dynamic lung compliance (Cdyn), and airways resistance (Raw). They did, however, produce a systemic hypertension, which was significantly attenuated during the FPL 57231 infusion. E. coli endotoxin (2 mg kg-1) administration resulted in decreases in systemic arterial blood pressure and Cdyn, together with increases in both PAP and Raw. During infusion of FPL 57231, all these endotoxin-induced cardiopulmonary changes were attenuated. Radioimmunoassay of blood samples taken from cats given FPL 57231 showed that levels of 6-keto prosta-glandin F1 alpha and thromboxane B2 were not significantly increased by endotoxin, as would normally be expected in cats administered endotoxin. FPL 57231 was also found to antagonise the pulmonary effects of the thromboxanemimetic U46619 and of prostaglandin F2 alpha. These results indicate that it is unlikely that the leukotrienes are involved as important mediators of the acute phase of endotoxin shock in cats. PMID- 3549042 TI - Current status of body surface electrocardiographic mapping. PMID- 3549043 TI - Prophylactic antiarrhythmic therapy of high-risk survivors of myocardial infarction: lower mortality at 1 month but not at 1 year. AB - To determine whether prophylactic antiarrhythmic therapy influences mortality in high-risk patients after acute myocardial infarction, 143 such patients were randomized in a double-blind individually dose-adjusted, placebo-controlled trial an average of 14 +/- 7 days after myocardial infarction and followed for 1 year. Patients were judged to be at high risk on the basis of (1) ejection fraction less than 40% (n = 60), (2) arrhythmias of Lown class 3 or higher (n = 26), or (3) both (n = 57). Aprindine was chosen because of its long half-life, few side effects, and antiarrhythmic efficacy. Baseline characteristics in the treatment arms did not differ. Holter-detected arrhythmias were reduced in aprindine treated patients at 3 months (p less than .001) and at 1 year (p less than .001). One patient was lost to follow-up; in the remaining patients 1 year mortality was 20% (28/142; 12 aprindine and 16 placebo). There was no significant difference between the two study arms in overall mortality and sudden death. However, among those who died, median duration of survival was longer in aprindine-treated patients (86 vs 21.5 days) (p = .04). Although antiarrhythmic treatment with aprindine of high-risk patients after myocardial infarction does not affect 1 year survival, mortality appears to be delayed; thus there may be a role for short-term treatment before more definitive therapy such as surgery. PMID- 3549044 TI - Antiarrhythmic efficacy and hemodynamic effects of cibenzoline in patients with nonsustained ventricular tachycardia and left ventricular dysfunction. AB - This was a prospective single-blind, placebo-controlled study of cibenzoline in 21 patients with five or more runs of nonsustained ventricular tachycardia (VT) and left ventricular dysfunction (mean left ventricular ejection fraction 36 +/- 24%). Ambulatory electrocardiographic monitoring revealed a baseline of 616 +/- 431 runs of VT/day on placebo. Of the 18 patients tolerating the drug, 14 (77%) patients initially had a 75% or greater reduction in VT (177 +/- 164 runs of VT/day, p less than .05). A repeat ambulatory electrocardiogram documented long term suppression of VT in 13 of 14 patients at 1 month (2.1 +/- 1.3 runs VT/day, p less than .01), in 10 of 14 patients at 3 months (2.5 +/- 1.9 runs VT/day, p less than .01), and in nine of 14 patients at 6 months (1.5 +/- 0.8 runs VT/day, p less than .01). Aggravation of arrhythmia or drug failure was seen in four of 18 (22%) patients (new onset of sudden cardiac death, two patients; sustained VT, two patients). Hemodynamic measurements were obtained with the use of right heart catheterization in patients at rest and exercising during the placebo phase and after 60 hr of oral cibenzoline. Group hemodynamic variables, both measured and derived, showed no detrimental effect of cibenzoline. However, in three of 21 patients (mean ejection fraction 21%), cibenzoline was discontinued due to severe depression of left ventricular function. Caution is recommended in the use of cibenzoline in patients with left ventricular ejection fractions of less than 25%. PMID- 3549045 TI - Potentiation of cardiac electrophysiologic effects of verapamil after autonomic blockade or cardiac transplantation. AB - Cardiac electrophysiologic effects of verapamil in vivo are the result of both direct and indirect actions on the heart (the latter due to augmentation of sympathetic neural tone, diminution of parasympathetic neural tone, and increased circulating catecholamines). In this study we assessed the interaction of verapamil's direct and indirect actions on electrophysiologic properties of the heart in awake, previously instrumented, unsedated dogs. After administration of intravenous verapamil (0.2 mg/kg), electrophysiologic effects were assessed serially over a 1 hr period in 10 awake dogs before (group 1 studies) and during pharmacologic autonomic blockade (group 2 studies), and in a subset of these dogs (n = 5) after orthotopic cardiac transplantation (group 3 studies). In group 1 dogs, sinus cycle length (SCL) initially shortened after verapamil (postverapamil 379 +/- 50 msec vs baseline of 494 +/- 72 msec, p less than .001) and subsequently gradually prolonged. In groups 2 and 3, transient SCL shortening was absent. SCL prolonged promptly after verapamil, and sinus arrest developed in two of 10 group 2 and two of five group 3 animals. Verapamil exerted a negative dromotropic effect on atrioventricular node conduction in all three experimental groups, as assessed by drug-induced changes in minimum cycle length with sustained 1:1 atrioventricular conduction and measurements of atrioventricular node effective and functional refractory period. However, compared with findings in group 1, this negative dromotropic effect occurred more rapidly and was markedly potentiated in groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549046 TI - Electrophysiologic mechanisms: sinus node dysfunction. PMID- 3549047 TI - Techniques and criteria in electrophysiologic study of ventricular tachycardia. PMID- 3549048 TI - Electrophysiologic testing in survivors of cardiac arrest. PMID- 3549049 TI - The prognostic significance of programmed ventricular stimulation after myocardial infarction: a review. PMID- 3549050 TI - Nonsurgical electrical ablation (fulguration) of tachycardias. PMID- 3549051 TI - Accessory pathway tachycardia: techniques of electrophysiologic study and mechanisms. PMID- 3549052 TI - Long-term electrocardiographic and event recorders for the diagnosis and treatment of cardiac arrhythmias. PMID- 3549053 TI - Signal averaging. PMID- 3549054 TI - Indications for electrophysiologic testing in the diagnosis and assessment of sinus node dysfunction. PMID- 3549055 TI - Quinine directly determined in serum or urine by separation fluoroimmunoassay. AB - We developed and validated a magnetizable solid-phase fluoroimmunoassay for directly determining quinine in serum or urine. We prepared the immunogen by coupling quinine hemisuccinate to keyhole-limpet hemocyanine, using this to immunize three sheep, and coupling the antisera to magnetizable solid-phase particles to facilitate separation of bound antigen from interfering components of serum or urine. We tested the stability of two fluorescein-labeled derivatives of quinine--one prepared by direct conjugation of quinine to dichlorotriazenyl aminofluorescein, the other by conjugating quinine hemisuccinate to fluorescein thiocarbamyl ethylenediamine. The latter was unstable. Using the former label and an 30-min incubation, we saw no interference by quinidine (an enantiomer of quinine) or other antimalarial drugs at their therapeutic concentrations. PMID- 3549056 TI - Temperature-dependent binding of cyclosporine to an erythrocyte protein. AB - In this competitive binding assay to measure endogenous binding capacity for cyclosporine (CsA) in erythrocyte lysates, a fixed amount of [3H]CsA plus various concentrations of unlabeled CsA is incubated with aliquots of a test hemolysate. Free CsA is then adsorbed onto charcoal and removed by centrifugation; CsA complexed with a cyclosporine-binding protein (CsBP) remains in the supernate. We confirmed the validity of this charcoal-separation mode of binding analysis by comparison with equilibrium dialysis. Scatchard plot analysis of the results at 4 degrees C yielded a straight line with slope corresponding to a binding constant of 1.9 X 10(7) L/mol and a saturation capacity of approximately 4 mumol per liter of packed erythrocytes. Similar analysis of binding data at 24 degrees C and 37 degrees C showed that the binding constant decreased with increasing temperature, but the saturation capacity did not change. CsBP was not membrane bound but appeared to be freely distributed within erythrocytes. 125I-labeled CsA did not complex with the erythrocyte CsBP. Several antibiotics and other drugs did not inhibit binding between CsA and CsBP. These findings may explain the temperature dependent uptake of CsA by erythrocytes in whole blood and suggest that measurement of CsBP in erythrocytes or lymphocytes may help predict therapeutic response or toxicity after administration of CsA. PMID- 3549057 TI - Enzymic ethanol assay: a new colorimetric method based on measurement of hydrogen peroxide. AB - We describe a new colorimetric method for measuring ethanol in plasma by use of a peroxidase-coupled assay system and alcohol oxidase (EC 1.1.3.13) from Pichia species. Absorptivity is low enough to give useful results without sample dilution. The procedure is also applicable to saliva samples and utilizes only one working reagent. The absorbance of the blue dye that is formed is measured at 600 nm. The standard curve for the method is linear for ethanol concentrations up to 4 g/L. Average analytical recovery of ethanol in human plasma exceeded 99%. Within-run and between-run CVs were less than 2.45% and less than 1.92%, respectively. Results correlate very well with those by gas chromatography (r = 0.9977). The method is adaptable to automation. PMID- 3549058 TI - An accelerated enzyme immunoassay for human choriogonadotropin in urine, involving reflow of specimen through capillary tubes. AB - A very rapid and sensitive assay for human choriogonadotropin (hCG) has been developed involving two beta-subunit-specific monoclonal antibodies. In the assay the test specimen is passed backward and forward (reflow) through a monoclonal antibody-coated capillary tube for 1 min, then incubated for 1 min with a second monoclonal antibody conjugated to urease (EC 3.5.1.5). After addition of a urease substrate solution, 10 int. units of hCG per liter can be detected visually within 5 min, which compares very favorably with other currently available hCG assay procedures. Advantages of the reflow/capillary tube assay system and optimization of the test procedure are discussed. PMID- 3549059 TI - Discrepancies in carcinoembryonic antigen measurements: survey and control values vs values for patients. AB - We analyzed the carcinoembryonic antigen (CEA) test results reported in the College of American Pathologists' (CAP) surveys to determine the relationship between the source of CEA used to manufacture the survey specimens and the discrepancies among analytical methods. With the 1983 survey specimens, which were prepared from metastatic colon carcinoma, laboratories using Roche RIA with Clinetics columns reported results that were only one-half the values reported by laboratories using the Abbott polyclonal enzyme immunoassay. With the 1984 specimens, prepared from a different metastatic colon carcinoma, and the 1985 specimens, prepared from a tissue-culture source of CEA, the Roche results were about one-sixth as large as the Abbott results. These differences are larger than the reported assay differences for patients' specimens. In addition, twofold proportional differences were found when survey and control specimens were tested with different lots of Abbott polyclonal reagent, whereas only random differences were found with 102 patients' specimens. Evidently, assay systems perform differently with proficiency-testing and control specimens than with patients' specimens. PMID- 3549060 TI - Lactate dehydrogenase isoenzyme 1 as determined by inhibition with 1,6-hexanediol and by two other methods in patients with myocardial infarction or cardiac-bypass surgery. AB - In this assay for lactate dehydrogenase (EC 1.1.1.27) isoenzyme 1 (LD-1), 1,6 hexanediol is added to serum after total LD has been measured. After incubation for 5 min the total LD remaining is determined. Samples from patients who had a myocardial infarction or who had undergone bypass surgery were assayed simultaneously by the 1,6-hexanediol method, the Roche "Isomune LD," and by electrophoresis on agarose gel. For 101 analyses of sera from bypass patients, correlations were high for results by the inhibitor method and electrophoresis (r = 0.96), by Roche Isomune and the inhibitor method (r = 0.96), and by the Roche method and electrophoresis (r = 0.97). In general, values for total LD were quite comparable by the three methods, but results by the inhibitor method seemed slightly higher and showed greater variability (CV) than those by the electrophoretic method. The assay is simple--requiring one reagent addition and a short incubation--and inexpensive: LD-1 can currently be determined for less than 1 over the cost of determining total LD. PMID- 3549061 TI - Digoxin-like immunoreactivity eliminated from serum by centrifugal ultrafiltration before fluorescence polarization immunoassay of digoxin. AB - Digoxin determined in the Abbott "TDx" by fluorescence polarization immunoassay by the manufacturer's recommended method involving precipitation of protein with 5-sulfosalicylic acid (SSA) is subject to interference from endogenous compounds having digoxin-like immunoreactivity. Guided by the work of Graves et al. (Clin Chem 1986;32:1506-9), we eliminated interference caused by digoxin-like immunoreactivity by substituting ultrafiltration for precipitation with SSA to remove protein. Using the manufacturer's method, we quantified digoxin in serum from 53 patients in three clinically defined groups who were receiving no digoxin, finding apparent digoxin in excess of the 200 ng/L detection limit in 24% of the 17 pregnant women, 59% of the 17 renal-dialysis patients, and all of 19 neonatal cord-blood samples examined. No measurable digoxin immunoreactivity was observed by fluorescence polarization immunoassay for any of the 53 clinically defined patients after removal of protein by ultrafiltration. For 22 men for whom digoxin was prescribed, digoxin measurement after protein removal by SSA and by ultrafiltration correlated well (r = 0.98), with good proportionality (slope = 1.04). Analytical recovery of added digoxin from adulterated serum was 115% after SSA, but 100% after ultrafiltration. Thus, before this assay procedure, we recommend ultrafiltration, to remove digoxin-like interference. PMID- 3549062 TI - Characterization of small monoclonal protein bands with Beckman's "Paragon" immunofixation system. PMID- 3549063 TI - Interference by goat-derived anti-lymphocyte globulin in a double-antibody radioimmunoassay of digoxin. AB - Therapy with anti-lymphocyte and anti-thymocyte globulins, two animal-derived preparations used as immunosuppressive agents, results in high concentrations of foreign immunoglobulin circulating in plasma. We describe a case that illustrates how the presence of these immunoglobulins can interfere with double-antibody radioimmunoassay procedures. PMID- 3549064 TI - Performance criteria for appropriate characterization of "(highly) sensitive" thyrotropin assays. PMID- 3549065 TI - Biosensor for lactate determination in biological fluids. I. Construction and properties of the biosensor. AB - The preparation of a biosensor for lactate determination is described. The biosensor is based on an immobilized suspension of the aerobic yeast Hansenula anomala, containing flavocytochrome b2 in high activity. The conditions for yeast cultivation were optimized to gain a sufficiently high activity of this enzyme converting lactate in the cells. The properties of the biosensor are compared with those of a sensor based on immobilized enzyme flavocytochrome b2. The yeast lactate biosensor has a sufficient sensitivity and linearity and short time of response. The precision and accuracy of lactate determination as well as the results of comparisons using an enzyme electrode and the spectrophotometric UV test, enables this biosensor to be used in routine work. Analysis can be performed in blood plasma or whole blood. The stability of the biosensor makes it possible to work for 4 weeks with one yeast cell pellet. PMID- 3549066 TI - Human growth hormone (hGH) in urine and its correlation to serum hGH examined by a highly sensitive sandwich enzyme immunoassay. PMID- 3549067 TI - Robinow syndrome: report of two patients and review of literature. AB - We report two patients with Robinow or fetal face syndrome. We present a thirteen year follow-up on three previously published cases and a review of 32 cases in the literature. The cardinal features of this condition include mesomelic shortening of the forearms, frontal bossing, hypertelorism, wide palpebral fissures, short upturned broad nose with anteverted nares, long philtrum, small chin, brachydactyly, hypoplastic genitalia and a normal karyotype. Development delay and mental retardation was noted in 18% of the reported cases. Early death was identified in about 10% of the cases. Genetic heterogeneity is suggested with autosomal dominant inheritance reported in 8 individuals from 3 families and autosomal recessive inheritance in 8 siblings from 4 families although no clinical differences were identified among those individuals with different inheritance patterns. Male to male transmission was reported in one family. Parental age does not appear to be a factor in the cause of this syndrome. PMID- 3549068 TI - The effect of high frequency oscillatory ventilation on extravascular lung water in the rabbit. AB - High frequency ventilation (HFV) systems have the theoretical advantage of producing less barotrauma and lung damage because of the associated smaller oscillations in alveolar pressure compared to conventional ventilators. An index of lung damage is an increase in extravascular lung water but previous studies using HFV have produced conflicting results. Lung wet-to-dry ratio, extravascular lung water and blood mass were measured in 30 rabbits divided into three groups (n = 10); spontaneously breathing (SV), conventional positive pressure ventilation (CV) and high frequency oscillatory ventilation (HFV). HFV maintained normal blood gases and produced a significant reduction in the wet-to-dry weight ratio compared to SV and CV (P less than 0.05). Extravascular lung water and blood mass were significantly reduced in HFV compared to SV (P less than 0.05). It is concluded that the system of HFV used in this study has clinical potential in the treatment of lung injury. PMID- 3549070 TI - In vivo binding of immunoglobulin and complement to elastic structures in urinary bladder vascular walls in interstitial cystitis: demonstration by immunoelectron microscopy. AB - An ultrastructural immunoperoxidase staining technique was used to identify and localize immune deposits in the urinary bladder vessel walls of patients with interstitial cystitis. Deposition of immunoglobulin together with the C3 component of complement was found in the subendothelial space and in endothelial basement membranes. More peripherally, deposits were often found associated with elastic fibers between smooth muscle cells. In these fibers the staining was confined to the microfibrillar coat. The findings suggest that elastic microfibrils act as target sites for the immunologic reaction occurring in vivo. Following binding of autoantibodies to antigens in bladder mucosa, activation of complement could be involved in the production of tissue injury and in the chronic self-perpetuating inflammation typical of this disease. PMID- 3549069 TI - The presence of IgE on macrophages and dendritic cells infiltrating into the skin lesion of atopic dermatitis. AB - Monoclonal antibodies reactive with human IgE were used to investigate the presence of surface IgE in situ on mononuclear cells infiltrating into the skin lesion of atopic dermatitis (A.D.) by application of the immunoperoxidase technique to tissue sections for light and electron microscopic examination. A substantial proportion of infiltrating macrophages but not of lymphocytes were found to bear IgE on their cell surfaces. These observations raise the possibility that IgE may contribute to the skin inflammation associated with A.D. via non-mast-cell-mediated immune mechanisms. We hypothesize that allergens introduced into the skin lesion of A.D. are potentially capable of interacting not only with IgE-bearing mast cells but also with IgE-bearing macrophages and dendritic cells to cause the release of inflammatory mediators. PMID- 3549071 TI - Genetic principles. AB - The author discusses the basic principles of genetics, including the classification of genetic disorders and a consideration of the rules and mechanisms of inheritance. The most common pitfalls in clinical genetic diagnosis are described, with emphasis on the problem of the negative or misleading family history. PMID- 3549072 TI - Syndromes of premature aging. AB - The classic premature aging syndromes are rare disorders, all of which clinically differ a great deal from the normal aging process. None is well understood at the biochemical level, and no specific treatment exists for any of these syndromes. Genetic counseling, preventive measures in some instances, and symptomatic treatment are available. The interest of gerontologists and geriatricians in these disorders derives in part from the expectation that such presumed single gene mutations might contribute to our understanding of the molecular basis for normal aging. Unfortunately, to date, this expectation has not been realized. PMID- 3549073 TI - The mechanobullous diseases. AB - The mechanobullous diseases exhibit extensive skin fragility such that minimal trauma results in blistering. Clinical manifestations range from mild to severe generalized involvement with significant morbidity and mortality. Ultrastructural and biochemical abnormalities have been described and provide insight into these disease processes. PMID- 3549074 TI - Heritable disorders of hair. AB - Changes in the quality and quantity of hair occur in a large number of hereditary syndromes. Because of their rarity and our lack of knowledge about their pathophysiology, no entirely satisfactory classification of these hair disorders exists. This review arbitrarily groups the heritable disorders of the hair into five classes: primary hair shaft disorders, alopecia without associated defects, ectodermal dysplasias, changes in hair color, and ectopic hair. PMID- 3549075 TI - Genetically transmitted, generalized disorders of cornification. The ichthyoses. AB - In this review, we have attempted to classify the genetically transmitted, generalized disorders of cornification according to available genetic, clinical, and biochemical data (Table 1). Admittedly, the list is long and sure to be lengthened, but this manner of delineation is required to uncover the underlying biochemical causes of the DOC. Grouping diseases according to artificial and outmoded standards clearly impedes this effort, as well as undermines a scholarly approach to patients, because important information about disease expression, differences in inheritance patterns, and subtle, but important, differences in responsiveness to therapy may be obscured by classification of an entity on the basis of overly simplified diagnostic criteria. Thus, clinicians should be wary of classification schemes based solely upon phenotypic similarities, because they may not be based upon valid genetic or biochemical criteria. Clearly, the classification offered in this article must be considered provisional, and it should be modified as new information is acquired. Despite our desire to recognize and codify distinct genetic disorders, this has not been possible in all cases, such as in DOC 17 (chondrodysplasia punctata syndromes), which almost certainly includes more than one genetic entity. PMID- 3549076 TI - Dominant disorders with multiple organ involvement. AB - Diagnosis of the preceding disorders may be difficult because of their wide range of clinical expression. The genetic patterns of incontinentia pigmenti, incontinentia pigmenti achromians, and focal dermal hypoplasia are still unclear, and literature regarding this subject may be confusing. Therefore, it is necessary to observe strict clinical criteria for diagnosis of these syndromes, and genetic counseling of affected individuals and families should be undertaken with care. PMID- 3549077 TI - Genodermatoses with malignant potential. AB - Cowden's disease, which is characterized by multiple facial papules, gingival papillomas, acral papules, and other hamartomatous lesions, represents a genodermatosis with a high incidence of breast and thyroid carcinoma. PMID- 3549078 TI - Genetic disorders and medical malpractice. AB - Physicians who encounter a patient with a genetic disorder are under the same legal obligation to that patient as they are to each patient whom they treat. They are required to possess sufficient knowledge, training, and skill with respect to the particular subject to provide proper medical services in a competent manner. Physicians are required to act reasonably in accordance with the information that they acquire. The courts have held that reasonable conduct includes properly evaluating and diagnosing the medical condition, adequately informing the patient of the consequences of the diagnosis, and alerting other potentially inflicted individuals. The best advice to the practicing dermatologist who encounters a patient with a genetic disorder is that he or she maintain a high standard of medical care, combined with personal respect for each individual patient, which calls for both a sensitive awareness of the profound psychologic implications of the disorder and a thorough, meaningful dialogue encompassing informed consent. PMID- 3549079 TI - The porphyrias. AB - The porphyrias are a group of disorders of heme metabolism that result from partial defects in the several enzymes that control heme biosynthesis. Accumulation of porphyrins or porphyrin precursors in several different patterns results from these defects and biochemically characterizes each specific syndrome. Patterns of cutaneous photosensitivity and associated systemic symptoms among the several porphyrias result from the types of porphyrins or precursors accumulated in each. PMID- 3549080 TI - Heritable skin diseases with molecular defects in collagen or elastin. AB - The recent progress made in understanding the normal biology and biochemistry of the extracellular matrix of human skin has allowed us to identify several different levels at which errors could be introduced into the structure and metabolism of collagen or elastin, the two major fibrillar components of the dermis. Currently, several heritable cutaneous diseases are known to display distinct collagen or elastin abnormalities. This article reviews some of the heritable cutaneous diseases and highlights those entities in which definite information on molecular alterations in collagen or elastin is available. PMID- 3549081 TI - Genetic diseases associated with DNA and chromosomal instability. AB - Diseases associated with DNA and chromosomal instability, along with their underlying etiopathologic mechanisms, are among the most complex and poorly understood of any group of disorders known. Their pathogenesis is almost certainly intimately related to the most fundamental processes of life itself: the maintenance, replication, and expression of the genome. Include is a discussion of xeroderma pigmentosum, ataxia-telangiectasia. Cockayne's syndrome, Fanconi's anemia, retinoblastoma, and neurodegenerative diseases. PMID- 3549082 TI - Parameters for indication of plasmapheresis and the interpretation of results. AB - Plasmapheresis has been employed in the treatment of various immunological disorders, and its efficacy has mainly been attributed to the removal of humoral factors. Besides these effects, plasmapheresis may induce some modifications to the cellular immunological status, contributing to the restoration of altered immunological function. In immunological renal diseases various parameters may be followed to decide the use of plasmapheresis, and to judge the effect of treatment. They include clinical, functional, and morphological investigations. In patients with lupus nephritis the main indications for plasmapheresis are the presence of impaired renal function and histological signs of activity in renal biopsy. In these patients plasmapheresis is able to modify humoral and cellular immunological abnormalities. Renal function and clinical course may improve in most cases. In patients with arteritis and acute renal failure the response to plasmapheresis combined with immunosuppressive drugs is better than the response to drug therapy alone. In acute renal transplant rejection plasmapheresis may be of value in improving the graft prognosis, when humoral factors are demonstrable in the pathogenesis of graft damage and vascular lesions are present in the kidney. PMID- 3549083 TI - Effects of triple therapy on the progression of mesangial proliferative glomerulonephritis. AB - Fifty-two pairs of patients with idiopathic diffuse mesangial proliferative glomerulonephritis entered a controlled 3-year prospective trial of a combination regimen of cyclophosphamide, dipyridamole and warfarin. In the treatment group proteinuria decreased significantly (p less than 0.01) and renal function remained stable, but in the control group there was no change in proteinuria and creatinine clearance (Ccr) decreased significantly (p less than 0.01). The time patients with renal impairment in the control group and those in the treatment group took to reach end stage renal failure was significantly different (6.1 years versus 8.9 years, p less than 0.02). Among the patients with IgA nephritis, those in the treatment group (n = 27) had stable renal function and a significant decrease in proteinuria (p less than 0.01) but in the control group (n = 21) there was a significant fall in Ccr (p less than 0.01) and rise in serum creatinine (p less than 0.02) with no change in proteinuria. Among 23 pairs of patients in the study who were matched for renal function and degree of glomerulosclerosis, those in the treatment group had stable renal function and decrease in proteinuria (p less than 0.01) whereas those in the control group had decreased Ccr (p less than 0.01) but no change in proteinuria. PMID- 3549084 TI - Determination of urinary albumin excretion by radioimmunoassay in patients with subclinical lupus nephritis. AB - In an attempt to evaluate subclinical lupus nephropathy, we determined the level of urinary albumin by radioimmunoassay in 27 patients with systemic lupus erythematosus (SLE) who had no evidence of clinical renal involvement. The ratio of urinary albumin to urinary creatinine (Ualb/Ucreat X 100) was significantly higher in patients with SLE (2.56 +/- 2.71) than in normal controls (0.83 +/- 0.72). A significant decrease of urinary albumin level in response to steroid therapy was demonstrated in 5 patients examined repeatedly before and during steroid treatment. In one patient who had two episodes of exacerbations of the disease the urinary albumin level increased parallel with a worsening of the serological data and the appearance of clinical proteinuria followed. It is concluded that many SLE patients even without clinical renal involvement have pathologic albuminuria and the determination of the urinary albumin level by radioimmunoassay in these patients is useful for the management of the disease. PMID- 3549085 TI - A case of recurrent lupus nephritis after renal transplantation. AB - A case of recurrent lupus nephritis in an 18-year-old girl with a renal transplant is described. Serological titer of ANA and Anti-DNA were low prior to renal transplantation following pulse therapy with methylpredonisolone and high dose oral predonisolone. A living related transplantation was performed after 6 months of hemodialysis. Maintenance immunosuppressive therapy consisted of predonisolone, mizoribine and cyclophosphamide. Graft function remained stable for one and half years after transplantation. Clinical recurrence was heralded by the development of proteinuria. If the serologic activities had been analyzed, the increase in ANA and Anti-DNA titers a few months before the onset of proteinuria might have predicted a possible histopathological recurrence. Fortunately, however, despite the histological and clinical recurrence of systemic lupus erythematosus, her renal allograft has continued to function fairly well. PMID- 3549086 TI - Current review of exercise testing: application and interpretation. AB - Exercise testing has changed dramatically in scope over the past 50 years. While initially used to assess functional capacity, it is now also utilized to detect the presence and severity of coronary artery disease (CAD), to evaluate postmyocardial infarction patients at risk for future cardiac events, to screen certain asymptomatic populations for CAD, and to evaluate dysrhythmias, peripheral vascular disease, and lung disease. Dynamic exercise in continuous multistage protocols is most popularly employed because of the more easily measured workload. The safety of exercise testing, its contraindications and termination end points are summarized. The sensitivity of exercise testing ranges between 60 and 70% while specificity has been reported between 85 and 90%. Both sensitivity and specificity are enhanced through use of radionuclide exercise thallium imaging and ventricular angiography. PMID- 3549087 TI - William Heberden and Some Account of a Disorder of the Breast. PMID- 3549088 TI - Critical evaluation of viral antigen data in Paget's disease of bone. AB - This study evaluates previous viral antigen data obtained from fixed tissue sections and cells grown in culture from bone affected by Paget's disease. Finding antigens to both respiratory syncytial virus (RSV) and measles virus (MV) in the same osteoclasts of ten patients could not be explained on the basis of any previously known cross-reactivity. Therefore, possible causes for these observations were sought. Monoclonal antibodies to viral proteins of RSV and MV were used to label proteins. Polyclonal antibodies that were monospecific and were produced exclusively in nonhuman species were used to rule out nonspecific reaction with human proteins. Antivimentin antibody was used to test the possibility of cross-reactivity with a cytoskeletal protein, as a second antibody F(ab')2 conjugated to fluorescein was used to rule out nonspecific reactivity with Fc receptors. Electron microscopy was used to evaluate bone cell cultures derived from Paget's bone in comparison with Paget's osteoclasts. Results showed that the pattern of monoclonal viral antibody labeling followed different patterns in different patients. Nonspecific reactivity was ruled out by significant negative and positive controls. Cross-reactivity with vimentin could not account for the positive immunofluorescent results because of an entirely different pattern of fluorescence in the same samples of live and fixed cells after colchemid treatment. It was concluded that specific viral antigens are present in osteoclasts and in cells grown from Paget's bone and that the present data are compatible with the possibility that Paget's disease of bone is a slow virus infection. PMID- 3549089 TI - Pathogenesis of Paget's disease based on viral etiology. AB - It has been slightly over 100 years since Sir James Paget's classic descriptions of "osteitis deformans" first appeared. He had described the mid- to late stages of patients with the chronic, debilitating, rare, and polyostotic forms of the disease. It is now known that the milder forms of the disease are quite common particularly in those of Anglo-Saxon ancestry. He believed the condition to be a chronic inflammation of unknown etiology because of its asymmetrical skeletal distribution, chronicity, and the gross appearance of the bones. With regard to the possible etiology of Paget's disease of bone, nothing worthy of note had been discovered until 1974 when viral-like inclusions were reported within the osteoclasts of all Paget's disease patients. In the ensuing decade, a great deal more circumstantial evidence from electron microscopic and immunologic studies supports the view that Paget's disease represents a slow virus infection. This article deals with the possible to probable viral etiology of Paget's disease with respect to its pathogenesis and its potential for eventual eradication. For many years Paget's disease was considered a disease almost exclusively confined to adulthood. Evidence now suggests that "familial chronic hyperphosphatasemia" represents the childhood form of Paget's disease. PMID- 3549090 TI - Diagnosis by ultrasound of congenital dislocation of the hip joint. AB - Two hundred thirty-four hips of 117 babies from one day to 18 months of age were examined ultrasonographically for congenital dislocation of the hip joint. Ten hips in eight babies were dislocated or subluxated and there were 11 hip dysplasias in seven babies. In the normal hip, the adaptation between the acetabulum and the femoral head is well demonstrated, and there is no apparent interposition of the limbus between the acetabular roof and the cartilaginous head. In the dislocated hip, the protrusion of the acetabular rim is not so clear as that of the normal hip, and the limbus is seen to be interpositioned between the acetabular roof and the cartilaginous head. In severe cases, the acetabular rim is hidden under the shade of the femoral head. Ultrasonography is an effective method of determining the incidence of dislocation and of diagnosing hip subluxation as well as dysplasia and does not have the hazards of x-ray examination. PMID- 3549091 TI - Triradiate cartilage injury. Report of two cases and review of the literature. AB - Acetabular fractures in children are not uncommon, but traumatic disruption of the acetabular triradiate cartilage occurs infrequently and may be associated with acetabular dysplasia and subluxation of the hip. The triradiate cartilage is at risk from birth to closure. The earlier the age at the time of injury, the greater the chance of acetabular dysplasia. In two cases of triradiate cartilage injury, one had premature closure of the triradiate cartilage with subsequent acetabular dysplasia requiring acetabular reconstruction. A review of the literature reveals ten other cases of acetabular dysplasia after injury to the triradiate cartilage. A review of all 11 cases reveals age to be the most significant factor in the development of acetabular dysplasia, with the greatest degree of growth disturbance occurring in young patients. PMID- 3549092 TI - Total joint arthroplasty for steroid-induced osteonecrosis in cardiac transplant patients. AB - Ten cardiac transplant patients have had bilateral total hip or knee surgery for treatment of osteonecrosis secondary to corticosteroid immunosuppression. Nine had bilateral total hip arthroplasty and one had bilateral total knee arthroplasty for osteonecrosis of the tibial plateaus. The only immediate postoperative complication was in a single hip patient who had a nonfatal pulmonary embolism. Two patients died from cardiovascular causes; the remaining eight had excellent results from arthroplasty, with an average Harris hip rating of 95 at a mean follow-up period of 34 months. No patient had required revision surgery and radiographic follow-up examination has revealed no evidence of loosening of any of these cemented arthroplasties. One patient developed a late hematogeneous sepsis of one hip seven years after replacement from atypical mycobacterium three months following renal transplantation, which was done 11 years after cardiac transplantation. Total joint arthroplasty has resulted in excellent clinical and radiologic results in this patient population. Despite the increased risks of major surgery in these immunocompromised transplant recipients, total joint arthroplasty appears to be a safe and effective method of treatment of osteonecrosis of the hip. PMID- 3549093 TI - Metabolic consequences of bone turnover in Paget's disease of bone. AB - High rates of bone resorption, bone formation, and marrow fibrosis are characteristic of Paget's disease of bone. This excessive bone turnover is reflected by increased fluxes of calcium ions out of and into the skeleton. The rates of these fluxes are highly geared to each other such that calcium balances are close to zero in the absence of fracture or significant immobilization. An increased turnover of bone matrix is also evident by increased urinary excretion of collagen breakdown products (oligopeptides of hydroxyproline, hydroxylysine, and hydroxylysine glycosides) as well as products (peptides of higher molecular weight) related to collagen synthesis. Increased circulatory levels of procollagen extension fragments reflect increased synthesis of Type I collagen (bone matrix) and Type III collagen (marrow fibrosis). Increased levels of bone gamma-carboxyglutamic acid-protein presumably reflect primarily bone matrix synthesis but bone resorption as well. When bone resorption is suppressed pharmacologically, the abnormal levels of these markers of matrix turnover and osteoblastic activity (alkaline phosphatase) also decrease, presumably as a result of coupling of resorption and formation. PMID- 3549094 TI - The classic. Osteoclast ultrastructure in Paget's disease. By A. Rebel, K. Malkani, M. Basle, and Ch. Bregeon. 1976. PMID- 3549095 TI - Calcitonin and the peptides from the calcitonin gene. AB - The alpha-calcitonin gene encodes a small family of peptides: calcitonin, katacalcin, and calcitonin gene-related peptide (CGRP). Calcitonin and katacalcin are produced from one precursor and CGRP from another. Calcitonin and katacalcin come mainly from the thyroid, while CGRP is present in both the thyroid and the central nervous system. Calcitonin is concerned with skeletal integrity, while the function of katacalcin, if any, is unknown. The secretion of calcitonin is, in part, estrogen dependent, and it appears likely that a postmenopausal decline in calcitonin secretion is a factor in the development of postmenopausal osteoporosis. It is possible that calcitonin may prove useful in the prevention and perhaps the treatment of this condition. CGRP, conversely, is one of the most potent vasodilators known and probably plays an important physiologic role in the control of vessel tone and blood flow. CGRP may also have a role as neurotransmitter or neuromodulator. PMID- 3549097 TI - Experimental basis for the use of bisphosphonates in Paget's disease of bone. AB - Geminal bisphosphonates are a new class of drugs recently developed. They are characterized by a phosphorus-carbon-phosphorus (PCP) bond and are thus analogs of pyrophosphate. The bind strongly to hydroxyapatite crystals and inhibit in vitro both their formation and dissolution. In vivo they inhibit soft tissue calcification and in some instances normal calcification. Bone resorption is also inhibited. The mechanism of action for the inhibition of calcification is probably the inhibition of calcium phosphate crystal growth. However, the mode of action on bone resorption is not yet known but is more likely to be cellular. These properties have been used in man to prevent heterotopic calcification, to retard dental calculus, and to slow down bone resorption in conditions such as Paget's disease, tumoral bone disease, and osteoporotic immobilization. PMID- 3549096 TI - New modes of administration of salmon calcitonin in Paget's disease. Nasal spray and suppository. AB - In volunteers the activity of various doses of a nasal spray and of a suppository of salmon calcitonin was compared to a placebo and to the parenteral route of administration. Both new modes of administration were found to be active on the kidney (and the suppository was found to affect bone turnover as well). The parenteral route proved more effective, but the nasal and/or rectal routes were devoid of systemic side effects and had minimal local intolerance. The nasal spray was used at 200 units daily in 15 patients with Paget's disease, and at 400 units daily in another nine patients, both trials lasting one year. The two regimens proved active on the parameters of bone turnover and the higher dose was more effective than the lower one. Similarly, a 300 unit suppository was given to another 12 patients. This trial is still being completed at this time. At the third month of therapy, the parameters of bone turnover were significantly depressed. Both new modes of therapy were able to improve the focal bone balance of the osteolytic lesions monitored on sequential roentgenograms. Systemic side effects were absent and local side effects were minimal. Only one patient interrupted the nasal spray therapy, and no one interrupted the suppository therapy. PMID- 3549098 TI - On the trail of paramyxoviruses in Paget's disease of bone. AB - The ultrastructural discovery of microcylindric inclusions in the nuclei and cytoplasm of osteoclasts in tissue affected by Paget's disease of bone has created a new approach. The morphologic similarity of the inclusions to viral structures has stimulated further studies involving immunocytologic techniques and in situ hybridization. Polyclonal antibodies reveal the presence of paramyxovirus antigens and measles virus and respiratory syncytial virus in pagetic osteoclasts. Monoclonal and monospecific polyclonal antibodies demonstrate paramyxovirus antigens of measles virus, simian virus (SV5), and human parainfluenza virus (PF3). In situ hybridization carried out with a 3H labeled DNA probe, specific for the measles nucleocapsid protein, detects measles virus nucleotide sequences in the nuclei and cytoplasm of pagetic osteoclasts, confirming ultrastructural and immunocytologic findings. Surprisingly, the tritiated probe also hybridizes with a large proportion of mononucleated cells: osteoblasts, osteocytes, fibroblasts, and lymphocytes. This suggests a very wide host cell range for measles virus genomic information which, however, would appear to undergo translation only in osteoclasts. The cause-effect relation between the viral information contained by diseased bone cells and Paget's disease of bone remains to be established. PMID- 3549099 TI - [Effect of a cysteine protease inhibitor EST on urinary 3-methylhistidine in dystrophic hamsters (BIO 14.6)]. PMID- 3549100 TI - [Familial amyloidotic polyneuropathy: review of the 20 year's study and prospective view]. PMID- 3549101 TI - Emphysematous pyelonephritis as seen on technetium-99m DTPA renal imaging. PMID- 3549102 TI - Bladder defect due to use of vaginal tampon. PMID- 3549103 TI - Comparative imaging. Pheochromocytoma. PMID- 3549104 TI - The pharmacokinetics of non-steroidal anti-inflammatory drugs in the elderly. AB - The elderly often suffer from chronic musculoskeletal disease, and non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to control symptoms. The aged have been shown to be particularly at risk of adverse effects from these drugs, of which gastrointestinal irritation and bleeding are both common and potentially serious. Because of this, a comparison of NSAID pharmacokinetics in young and elderly subjects is of particular importance. In general, protein binding tends to decrease with age; volumes of distribution may undergo a small increase; and clearance, especially of renally eliminated drugs, may fall. However, these changes are relatively minor, and the increased propensity of the elderly to suffer adverse reactions to NSAIDs cannot readily be explained on a pharmacokinetic basis. PMID- 3549106 TI - Sporadic congenital Caffey's disease. AB - Caffey's disease is an inflammatory skeletal disorder of infancy manifested clinically by fever, soft-tissue swelling, and constitutional signs with radiographic evidence of periosteal new bone formation. Although prevalent between 1940 and 1960, nonfamilial cases have become extraordinarily rare. The authors report the sporadic occurrence of congenital Caffey's disease in a premature infant and note an interesting association with maternal herpes zoster early during gestation. The etiology of this mysterious disease is likely to remain elusive as new cases become scarce. PMID- 3549107 TI - Umbilical artery catheterization: a potential cause of refractory hypoglycemia. AB - Two infants with persistent, symptomatic hypoglycemia are reported. Both were thought to have iatrogenic hyperinsulinism due to a malpositioned umbilical artery catheter. Repositioning of the catheter to avoid direct infusion into the arterial blood supply to the pancreas resulted in prompt cessation of hypoglycemia. PMID- 3549108 TI - Neonatal retropharyngeal cellulitis due to group B streptococcus. AB - Two neonates who presented with histories of poor feeding, irritability and noisy breathing had group B streptococcal (GBS) bacteremia and retropharyngeal cellulitis. One infant also had submandibular cellulitis. Retropharyngeal cellulitis has not been recognized as a manifestation of GBS disease. Evaluation of the upper airway should be part of the workup of any sick infant with noisy breathing and/or grunting. Retropharyngeal tissue enlargement may be an early indicator of GBS disease. PMID- 3549109 TI - Acute renal failure in the neonate. Two fatal cases due to group B streptococci with rhabdomyolysis. AB - Two cases of fatal group B streptococcal disease complicated by rhabdomyolysis in the neonate are described. They were identified by blood and cerebrospinal fluid cultures positive for group B streptococcus and by a combination of hyperkalemia, urine dipstick positive for blood without microscopic hematuria, and elevated serum muscle enzymes. PMID- 3549110 TI - Sucking disorders in neurologically impaired infants: assessment and facilitation of breastfeeding. AB - Neurologically impaired infants have immature, damaged, or abnormally developed nervous systems that may cause abnormalities of sucking and swallowing, among other problems. Sucking abnormalities usually present as absence of the sucking response, weakness or incoordination of sucking and swallowing, or some combination of these problems. More investigation of the responses of these infants to various stimuli and training techniques is greatly needed. Although training neurologically impaired infants to breastfeed may present a challenge to even the most experienced neonatal nurse, physician, or therapist, most infants improve and can learn to suckle at the breast. If a mother has intended to nurse her infant, she should be encouraged to do so, even when the infant has abnormalities of sucking, except in the rare and most severely affected infants who remain dependent on gavage or gastrostomy feedings. Various techniques of stimulating, positioning, and progressive weaning to the breast can be helpful in teaching mother and infant to breastfeed. Encouraging support should be provided by all professionals involved with the mother and infant, as well as by a team experienced in helping with such problems. Most importantly, mother and staff must be patient, because the rewards for both the infant and mother are worth the effort. PMID- 3549105 TI - Intravenous anaesthetic agents. Pharmacokinetic-pharmacodynamic relationships. AB - The number and variety of intravenous anaesthetics available has increased dramatically in recent years. In order to administer these agents safely and rationally in the operating theatre, the anaesthesiologist needs to have a detailed understanding of their dose-response behaviour. The pharmacokinetic and pharmacodynamic profiles of these anaesthetics underlie this behaviour. In understanding and applying this information, an integrated approach involving combined pharmacokinetic and pharmacodynamic modelling has proved tremendously helpful. This approach has provided significant insight into the pharmacology of these drugs under conditions of normal and abnormal physiology. Intravenous anaesthetics may be classified as hypnotics, narcotics, or muscle relaxants. Through quantitative measures or drug effect, as provided by the electroencephalogram (EEG) in the former two classes or electromyography in the latter class, precise measures of end-organ (brain or neuromuscular junction) sensitivity have been generated using integrated modelling techniques. These values not only allow for dose potency comparisons within an anaesthetic class but, furthermore, may explain changes in drug response with ageing and disease. Incorporation within these models of an effect compartment, characterised by a rate constant for equilibration with plasma (keo), has proved to be essential in accurately describing the temporal lag between drug administration and effect. Quantitating the size of this lag has direct implications for the design of anaesthetic bolus and infusion regimens. Combined pharmacokinetic and pharmacodynamic modelling of intravenous anaesthetics provides a precise, rational basis for the clinical use of these classes of drugs. PMID- 3549111 TI - Special properties of human milk. AB - Human milk is a highly complex fluid with a nutrient balance and an array of functional properties that may promote a level of metabolic efficiency that is not attainable when a cow milk-based formula is fed. This is not a novel idea. Mitchell in 1933 proposed that the level of efficiency of energy use is determined by the nutrient "balance" in the diet. Nonetheless, difficulties remain in the attempt to reconcile the low levels of intake with established estimates of energy needs. If the amount of energy that appears necessary for growth and maintenance of a 4-month-old infant is compared with that from his or her intake of an exclusive human milk diet, the infant should have little or no energy left for activity. Do metabolic economies contribute to more efficient uses of energy for growth and maintenance in breastfed infants? Are there differences in body composition? Does more efficient use of energy occur as a result of a decrease in clinical and subclinical infections? Is efficient energy utilization accomplished by significant curtailment in activity? If an excess level of energy is consumed by bottlefed infants, what are the positive or negative short-term or long-term consequences? These questions are the focus of research in numerous laboratories. Field and clinical studies of breastfed infants and in vitro studies of human milk offer unique opportunities to understand basic mechanisms of human adaptations to nutrient intake and environmental challenges. PMID- 3549113 TI - Hypothermia and acid-base regulation in infants. AB - During progressive hypothermia for cardiac surgery, the need for advanced and comprehensive physiological monitoring systems is even more apparent and vital. A review of the literature on the physiological effects of hypothermia in animals reveals that the "physiological neutrality" intracellularly is achieved at progressively higher pH values as temperature falls, and that this more alkaline acid-base balance is apparently achieved while the total carbon dioxide content of the tissues remains at normothermic (normal body temperature) levels. Based on this, an anesthetic technique was studied, whereby the ventilation was maintained throughout the cooling/surgery/rewarming cycle at normothermic levels. This allowed a progressively more alkaline acid-base environment to be achieved. This technique is discussed in detail, together with information relating to the circulatory changes and complications seen and the degree of acid-base control obtained. The conclusion is drawn that the addition of carbon dioxide to the ventilation gases, of alternatively, a decrease in ventilation as temperature falls, is not only unnecessary, but perhaps also harmful. PMID- 3549112 TI - Breastfeeding the low birth weight preterm infant. AB - The recent increase in the use of human milk in feeding low birth weight (LBW) preterm infants has stimulated new research questions in infant nutrition, especially in regards to the nutritional adequacy and nutrient composition of milk from mothers of mature and preterm infants. The current state of knowledge on the effect of feeding human milk with or without nutritional supplements on growth of the low birth weight infant is summarized. Recommendations and guidelines for feeding human milk and/or supplementing human milk in LBW infants are discussed and appropriate handling of human milk and feeding schedules are outlined. PMID- 3549115 TI - The significance of drugs in breast milk. Pharmacokinetic considerations. AB - This article discusses the importance of the pharmacokinetic properties of various drugs in adults and in infants in the interpretation of the significance of the excretion of drugs in breast milk to the neonates. PMID- 3549114 TI - The effect of lactation on ovulation and fertility. AB - It has long been recognized that women who breastfeed their children have a longer period of amenorrhea and infertility following delivery than do those women who do not breastfeed. The length of postpartum amenorrhea is quite variable, and depends on several factors, including maternal age and parity, and the duration and frequency of breastfeeding. In general, it would appear that the more frequent and the longer the episodes of breastfeeding, the longer will be the period of anovulation, and the longer the period of infertility. PMID- 3549116 TI - Maternal disease as a consideration in lactation management. AB - Breastfeeding for mothers with chronic medical conditions presents important medical decisions for the primary physician. The issues need to be considered in light of the chronic disease, the physiological process of lactation, and the individual Mother for whom breastfeeding is very important. Management plans need to be based on adequate information and coordinated by the mother's physician and the pediatrician. PMID- 3549117 TI - Breastfeeding and human milk: their association with jaundice in the neonate. AB - As demonstrated by this discussion, jaundice in breastfeeding infants appears to be related both to feeding-related issues and to an as-yet unidentified factor in the human milk of a small minority of women. In the case of feeding-related factors, how a mother breastfeeds; that is, how often she offers the breast and how well the baby suckles, as well as how often and how much the baby is offered complementary or supplementary feedings of water, glucose solutions, or a nonhuman mammal milk, influence serum bilirubin concentrations in the first week of postnatal life. We call this breastfeeding-related jaundice, recognizing that the feeding process is a key element in the condition. We urge that management recommendations focus on the feeding process to reduce the level of serum bilirubin concentration in the first week of life. It is appropriate to note at this juncture that hyperbilirubinemia also occurs in bottlefed infants; the frequency of feeding of these infants also may play a role in the severity of jaundice. If research findings bear out such a relationship, we may see a corollary label of "feeding-related" jaundice also applied to bottlefed babies. In a very small percentage of breastfeeding infants, a second form of jaundice occurs. Its onset appears somewhat later in the postnatal period, and it is characterized by a higher peak and a slower decline in the level of serum bilirubin concentration. We call this breast milk jaundice, recognizing that it appears to stem from the milk the baby receives rather than the manner in which he or she is fed. Eliminating other causes of jaundice prior to considering even a brief interruption of breastfeeding is appropriate when caring for the infant with this syndrome. In the breastfeeding infant, both early- and late-onset jaundice appear to be related. We suggest this because the baby with breast feeding jaundice may be more responsive to the factor in abnormal milk, which produces breast milk jaundice. The infant with breast-feeding jaundice has a larger bilirubin load at the time the abnormal milk is being ingested. The recycling of this increased load, because of exaggerated enterohepatic circulation, results in a further late rise in serum bilirubin. If the initial bilirubin pool is smaller, the effect of the abnormal milk might well be insignificant or at least markedly diminished.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549119 TI - Stability of theophylline elimination rate. AB - The elimination rate for theophylline varies greatly among patients, but recommendations for maintenance dosing schedules have assumed relatively little intrapatient variability even over extended time periods. Reports of large intrapatient variability of theophylline elimination rate and consequent clearance raise concerns regarding this assumption and also challenge the practice of assuming relative constancy of elimination rate in the performance of bioavailability studies of slow-release formulations. We therefore systematically studied under controlled conditions the elimination rate of theophylline in 10 patients over an extended time interval. The initial elimination rate constants ranged from 0.062 to 0.136 hours-1. The changes ranged from -5.9% to 9.4% of the initial value during intervals of 2 to 11 months. Correlation of the first and second values was 0.96. Thus the elimination rate of theophylline generally appears to vary little within individuals over time when studied under controlled conditions. PMID- 3549118 TI - Effects of sulindac on renal and extrarenal eicosanoid synthesis. AB - We measured the renal and extrarenal synthesis of prostacyclin and thromboxane A2, as reflected by the urinary excretion of the stable hydration products 6-keto prostaglandin F 1 alpha and thromboxane B2 and the corresponding 2,3-dinor derivatives, during chronic administration of sulindac (200, 400, 600, and 800 mg/day, each dose given for 7 days in successive weeks) in seven healthy subjects. Urinary eicosanoids were measured by negative ion, chemical ionization GC/MS-validated RIA techniques. Both 2,3-dinor-thromboxane B2 and 2,3-dinor-6 keto-prostaglandin F 1 alpha showed a dose-dependent reduction, ranging between 45% and 85%. In contrast, the urinary excretion of 6-keto-prostaglandin F1 alpha and thromboxane B2 did not change significantly throughout the study. These results extend previous observations of a selective sparing of renal cyclooxygenase activity by sulindac in humans and demonstrate that this selectivity is not related to an overall weaker enzyme inhibition. PMID- 3549121 TI - Sequential infusions of glucose and insulin at prefixed rates: a simple method for assessing insulin sensitivity and insulin responsiveness. AB - In a previous study a close correlation was demonstrated between metabolic clearance rates of glucose (MCR) at an insulin infusion rate of 50 mU X kg-1 hr-1 when assessed with the isoglycaemic clamp technique and the simple, concomitant infusion of insulin and glucose at a fixed rate. To determine insulin sensitivity and insulin responsiveness it is necessary to construct insulin dose response curves by measuring insulin stimulated glucose disposal at various insulin levels. The aim of the present study was to validate a simple method for constructing insulin dose response curves in 8 healthy volunteers and 12 patients with varying degrees of glucose tolerance. Insulin mediated glucose disposal, expressed as MCR, was assessed during the steady states of sequential, concomitant infusions of insulin at 50, 150 and 500 mU X kg-1 hr-1 and glucose at 33, 44 and 55 mumol X kg-1 min-1 for 150, 120 and 120 min, respectively. The results were compared with the isoglycaemic clamp technique at the same sequential insulin infusion rates for 2 hr each. A close correlation was found between the assessments of the metabolic clearance rates of glucose with either test: tau = 0.80, tau = 0.80 and tau = 0.81 at 50, 150 and 500 mU X kg-1 hr-1, respectively. The mean (+/- SEM) MCR's of glucose, assessed with sequential glucose-insulin infusions and isoglycaemic clamp technique at insulin infusion rates of 50, 150 and 500 mU X kg-1 hr-1 were in the normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549120 TI - Plasma and cerebrospinal fluid pharmacokinetics of 3'-azido-3'-deoxythymidine: a novel pyrimidine analog with potential application for the treatment of patients with AIDS and related diseases. AB - We investigated the clinical pharmacokinetics of azidothymidine (N3TdR) as part of a phase I/II trial in the treatment of acquired immunodeficiency syndrome and related diseases. During the 6-week course of therapy, drug levels in plasma, cerebrospinal fluid, and urine were determined by HLPC. The plasma half-life of N3TdR was 1.1 hour. The total body clearance was 1.3 L/kg/hr. At intravenous doses of 5 mg/kg or oral doses of 10 mg/kg, plasma levels were continuously maintained above the target level of 1 mumol/L. Oral bioavailability was 63% +/- 13%. Substantial penetration of N3TdR into cerebrospinal fluid was demonstrated. At doses of 5 mg/kg intravenously or 10 mg/kg orally, cerebrospinal fluid drug levels exceeded and were maintained close to 1 mumol/L. Nineteen percent of the administered dose was excreted unchanged into the urine. Renal clearance was 0.23 L/kg/hr. N3TdR possesses pharmacokinetic properties that would facilitate the long-term treatment of patients with acquired immunodeficiency syndrome: it can be given orally and it penetrates the central nervous system. PMID- 3549122 TI - The effect of cigarette smoke and diabetes mellitus on muscarinic stimulation of prostacyclin synthesis by the rat penis. AB - The effect of cigarette smoke extracts and experimental diabetes on rat penile prostacyclin (PGI2) synthesis was investigated. Cigarette smoke extracts induced a dose-related inhibition of methacholine-stimulated PGI2 secretion. Induction of diabetes by streptozotocin resulted in diminished PGI2 secretion, which was further inhibited by cigarette smoke extracts in an additive fashion. Treatment with insulin prevented the inhibition of PGI2 in diabetic animals. Since PGI2 is a potent vasodilator, it may mediate the increased blood flow to the penis responsible for erection following parasympathetic stimulation. The inhibition of PGI2 secretion by cigarette smoke extracts or diabetes, or both, may therefore provide a mechanism to account for the epidemiological observation that smoking and diabetes are major risk factors for male impotence. PMID- 3549124 TI - Arterial haemodynamics of hypertension. PMID- 3549126 TI - Diagnostic electron microscopy of tumors. PMID- 3549123 TI - C-peptide in diabetes mellitus treated with insulin. A 3-year epidemiological study on the island of Falster, Denmark. AB - In a 3 yr prospective epidemiological study of 227 insulin-treated diabetics the clinical value of fasting C-peptide measurements for discriminating between insulin dependence and non-insulin dependence was assessed. A significant difference (p less than 0.01) in fasting C-peptide secretion was found between diabetics with an early onset age (less than 30 yr) and a late onset age (greater than or equal to 30 yr). Among diabetics with a late onset age (n = 124) 45% were classified as non-insulin dependent according to fasting C-peptide levels (greater than 0.40 pmol/ml) and characterized by overweight. Diabetics with C peptide concentrations less than 20 pmol/ml were characterized by an early onset of diabetes mellitus (less than 30 yr), the duration of diabetes mellitus (greater than 5 yr), slight deviation from ideal weight, development of insulin antibodies and high daily insulin dosage. Among the 57 diabetics with a C-peptide level greater than 0.40 pmol/ml 31 accepted and could maintain good metabolic control in a period of 3 yr after change from treatment with insulin to treatment with oral hypoglycaemic agent and diet or diet regime alone. It is concluded that measurement of fasting C-peptide is of additional clinical importance for the choice of treatment of diabetics. PMID- 3549125 TI - The special proteins of bone tissue. PMID- 3549127 TI - Tumors of Schwann's cells and pigmented skin cells. AB - Both melanocytes and peripheral nerve sheath cells have an established origin from the neural crest. Benign and malignant neoplasms of these cells have distinctive ultrastructural features, but there is a group of tumors that has some characteristics of both cell types. The distinguishing feature of melanocytic neoplasms is the presence of cytoplasmic premelanosomes, which indicates cellular synthesis of melanin. Nerve-sheath neoplasms may show ultrastructural variation, but are generally found to have long cell processes associated with basal lamina-like material. Immunocytochemistry can be used to help distinguish tumors of melanocytic and Schwann's cells from unrelated neoplasms. PMID- 3549128 TI - Soft-tissue tumors. AB - A variable number of soft-tissue tumors, depending largely on the experience of the pathologist, cannot be precisely classified by light microscopy, and electron microscopy and/or immunocytochemistry may be required. The applications and limitations of these techniques in the diagnosis of selected soft-tissue tumors are briefly reviewed. PMID- 3549129 TI - Tumors of serosal tissue origin. AB - Primary serosal neoplasms demonstrate a wide spectrum of growth patterns and biologic aggressiveness. The adenomatoid tumor is uniformly benign, whereas the diffuse malignant mesothelioma pursues a downhill clinical course, rapidly leading to fatality. The cystic peritoneal mesothelioma occupies an intermediate position characterized by persistent and/or recurrent disease but without progression to death. The distinction of an epithelial mesothelioma from metastatic adenocarcinoma remains a challenging problem. In the vast majority of cases, this can be accomplished by combining routine histochemistry, immunocytochemistry, and electron microscopy. The absence of epithelial mucins and nonreactivity with antibodies to CEA strongly favor mesothelioma. Ultrastructurally observed long, thin, sinuous surface microvilli without a glycocalix, well-developed desmosomes, and abundant tonofilaments add further support for a primary serosal neoplasm. The sarcomatoid mesothelioma can easily be confused with a chest-wall sarcoma. Despite lacking ultrastructural evidence of "epithelial" differentiation, immunocytochemical studies demonstrate cytokeratin. This distinguishes the sarcomatoid mesothelioma from most soft tissue sarcomas. There remains a small number of cases, particularly those in the "poorly differentiated" or "transitional" category, in which the distinction between mesothelioma and metastatic carcinoma remains difficult. In this situation, it is imperative that all the clinical information be closely reviewed and a diligent search for a primary site be carried out. There are many parallels between reactive and neoplastic serosal tissue. The desmoplastic/sarcomatoid mesothelioma morphologically and immunocytochemically resembles the reactive multipotential subserosal cell (MSC) of injured serosal tissue, whereas the adenomatoid tumor, cystic peritoneal mesothelioma, and epithelial mesothelioma resemble surface mesothelium. The poorly differentiated mesothelioma resembles a stage of maturation between the two extremes, and thus the term "transitional" mesothelioma is suggested. The localized fibrous tumor of the pleura is unique among all other serosal neoplasms in its failure to express cytokeratin. It more closely resembles the unspecialized connective tissue fibroblast of normal serosal tissue, and thus may be more analogous to a soft-tissue tumor than to the remaining mesothelial-derived neoplasms. PMID- 3549130 TI - Tumors of the alimentary tract. AB - Electron microscopy offers substantial aid in the diagnosis of gastrointestinal tract tumors, especially small-cell carcinoma and enterochromaffin-cell tumors. Tumors that are most difficult to classify by light microscopy--that is, poorly differentiated ones--may also have ultrastructural features by which the cell of origin can be determined. As always, the well-preserved tissue is more likely to retain diagnostic features than is the inadequately preserved. PMID- 3549131 TI - The carboxylesterases of Trypanosoma cruzi epimastigotes. AB - Carboxylesterase activity in Trypanosoma cruzi was found mainly in the microsomal (40%) and the cytosolic fraction (26%). The Vmax for p-nitrophenyl acetate was 28.50 and 17.60 nmol per min and mg of protein for the microsomal and the cytosolic fractions, respectively. The Km was 0.78 mM for the microsomal activity and 0.55 mM for the cytosolic activity. The inhibition rate constant with N ethylmaleimide were 38.10 M-1 min-1 and 2.56 M-1 min-1 for the cytosolic and the microsomal enzymes, respectively. The rate constants with Paraoxon were 8,360 M-1 X min-1 and 32,600 M-1 X min-1. Polyacrylamide gel electrophoresis under nondenaturing conditions showed three bands of microsomal activity with M.W. of 63, 136 and 153 kDA. Similarly, three bands of cytosolic activity with M.W. of 126, 294 and 479 kDA were identified. PMID- 3549132 TI - High molecular weight heat-stable alkaline proteinase from white croaker and chum salmon muscle: comparison of the activating effects by heating and urea. AB - Effects of heating and urea on the heat-stable alkaline proteinase from white croaker and chum salmon muscle were compared in order to know the regulating mechanism of the proteinase. Chum salmon proteinase required a higher temperature for activity and was more heat-stable than white croaker proteinase. In the presence of 5M urea, the activity was observed to some degree at 37 degrees C only in white croaker proteinase, while both proteinases lost their activities at usual assay temperature around 60 degrees C. These results suggest that the stability of the regulatory and catalytic subunits of the proteinases is somewhat different among fish species. PMID- 3549133 TI - Computer diagnosis of primary headaches in children. AB - In the area of primary headaches in children several diagnostic classes (migraine, psychogenic) and other nondefined headaches are recognized. Their clinical diagnosis is complex and still not standardized. We present a Personal Computer program for diagnosing types of primary headaches in children. The program calls for the input of each patient's score on five clinical variables chosen by means of discriminant analysis, and the output gives a clinical diagnosis along with its posterior probability. The program was used on an initial group of 223 pediatric patients and was cross-validated at a first level on a second group of 90 patients and at a second level on a third group of 70 patients. The total correct classification figures were 85.2, 90, and 87.1%, respectively. PMID- 3549134 TI - A flight simulator for general anesthesia training. AB - A simulator of general anesthesia is described. It consists of an integrated set of physiologic computer models and a graphics display. The model predicts many of the physiologic and pharmacodynamic changes associated with general anesthesia. It is a multiple model consisting of circulatory, respiratory, pharmacokinetic, and pharmacodynamic models and their interactions. The model can account for many pathologic states of the cardiorespiratory system plus poor renal and hepatic function. Both intravenous and inhalation agents are included. Examples of its capabilities are presented, including pharmacokinetic changes associated with thiopental administration to a hypovolemic subject, administration of oxygen in several pulmonary pathologic conditions, and a simulation of an induction using fentanyl or thiopental. The model, combined with the graphics interface, becomes a real-time simulator useful for training students and residents. PMID- 3549135 TI - Aging America. The time bomb keeps ticking. PMID- 3549136 TI - The ninety-nine day Kaiser. PMID- 3549137 TI - Ribavirin. PMID- 3549138 TI - In praise of being amateur. PMID- 3549139 TI - Procaine versus magnesium in cardioplegia solution. A prospective study. PMID- 3549140 TI - The postcoital IUD as an effective continuing contraceptive method. AB - A two-year controlled clinical study of the effectiveness of postcoital IUD as a continuing contraceptive method in 98 women requesting a postcoital contraception is presented. The control group was selected from women requesting an IUD as contraceptive choice. The rates of accidental pregnancy, expulsion and removal for medical reasons did not differ between the two groups. Removal for personal reasons was the only termination event that showed a significant difference at one year. Moreover, the removal for personal reasons of interceptive IUD users mainly occurred in the early months after insertion. Postcoital IUD has proved to be an effective continuing contraceptive method. Special attention and sympathetic counseling should be given to postcoital IUD users before insertion and during the three months following insertion. PMID- 3549141 TI - ICMR (Indian Council of Medical Research) Task Force on Hormonal Contraception. Return of fertility following discontinuation of an injectable contraceptive- norethisterone oenanthate (NET EN) 200mg dose. Council of Medical Research. AB - The return of fertility following discontinuation of norethisterone oenanthate (NET EN) 200 mg injectable contraceptive after use for a minimum period of six months or more was studied in 69 women who discontinued the method for planning pregnancy. Former users of copper intra-uterine device (CuT 200) were enrolled as a control group. Another 161 women who had discontinued NET EN due to other reasons (e.g. amenorrohea, excessive bleeding or personal reasons) were also studied for return of fertility after ensuring that they were not using any other method of contraception and were exposed to the risk of pregnancy. The subjects from both groups were followed for a period of one year. The cumulative conception rates at one year were 72.5 and 83.6 per 100 subjects for ex-NET EN and ex-CuT 200 users who had discontinued the method for planning pregnancy and this difference was not statistically significant (P greater than 0.05). The median time for conception for ex-NET EN users was 7.8 months as compared to 3.7 months in ex-CuT 200 users but the cumulative conception rates at the end of one year show that future return of fertility in NET EN users does not appear to be adversely affected. In 51 subjects who had discontinued NET EN due to amenorrhoea, the return of fertility was predictably slower and less. The return of fertility in subjects who discontinued NET EN for other reasons (e.g. excessive bleeding and other personal reasons) was similar to ex-NET EN and ex CuT 200 users. PMID- 3549142 TI - Abnormalities in amino acid metabolism in patients with chronic renal failure. A pathophysiological approach to the nutritional treatment. I. Studies in the postabsorptive state. PMID- 3549143 TI - Morphologic patterns of renal allograft rejection. PMID- 3549144 TI - Abnormalities in amino acid metabolism in patients with chronic renal failure. A pathophysiological approach to the nutritional treatment. II. Studies after amino acid ingestion. PMID- 3549145 TI - Recurrent glomerulonephritis in transplanted children. PMID- 3549146 TI - Brief review of the morphology of ciclosporin nephropathy. PMID- 3549147 TI - Pathophysiology and clinical aspects of drug-induced tubular necrosis in man. PMID- 3549148 TI - Renal toxicity of nonsteroidal anti-inflammatory drugs. PMID- 3549149 TI - Radiocontrast media nephrotoxicity. Clinical aspects. PMID- 3549150 TI - Lead Nephropathy. PMID- 3549151 TI - Aluminum toxicity in dialysis patients. PMID- 3549152 TI - Biomaterials and biocompatibility in hemodialysis. PMID- 3549153 TI - Treatment of progressive chronic renal failure. Implications for changing the composition of amino acid and ketoacid supplements. PMID- 3549154 TI - Proteinuria and glomerulosclerosis. New clues from experimental models. PMID- 3549155 TI - Pathophysiological aspects of stone disease. PMID- 3549156 TI - Medical treatment of renal calculi. PMID- 3549157 TI - Echocardiographic assessment of the haemodynamic effect of ethmozine and its diethylamine analogue etacizine in patients with heart failure. AB - The purpose of the study was to compare the haemodynamic effect of new antiarrhythmic preparations - ethmozine and its diethylamine analogue etacizine in 22 patients with heart failure (HF), stage IIa, of different etiology. The patients were given for one week ethmozine and then again for one week etacizine, during which periods they were followed echocardiographically, with pressure measurement in the pulmonary artery (PAP) and in the right atrium (RAP). Ethmozine in a daily dosis of 600-800 mg did not induce changes in left ventricular dimensions, percentual shortening of the anteroposterior left ventricular dimension (% delta S), in PAP, RAP, arterial pressure and heart rate. With application of etacizine in a dose of 150-200 mg/day, a clinically insignificant decrease was observed in % delta S (by 19.7%; p less than 0.05), which was not accompanied by a more marked augmentation of left ventricular dimensions, PAP, RAP or an intensification of clinical signs of heart failure. In spite of this, on administration of etacizine to patients with HF it is necessary to control haemodynamics, the most suitable method for this being echocardiography. PMID- 3549158 TI - Buoyant density variation during the cell cycle in microorganisms. AB - The behavior of cell buoyant density during the cell cycle has been determined for a number of different cell types, including bacteria, yeast, and mammalian cells. Mean buoyant density was extremely constant and independent of cell age during the cell cycle of the bacterium Escherichia coli, the fission yeast Schizosaccharomyces cerevisiae, the protozoan Amoebae proteus, cells from suspension cell cultures of mouse lymphoma and myeloma, and Chinese hamster ovary cells. In all of these cases, the buoyant densities of these cells were very narrowly distributed, with coefficients of variation of 0.1 to 0.3%. In contrast, buoyant density was variable in cells with thick cell walls and high buoyant densities. Density varied markedly during the cell cycle of the budding yeast Schizosaccharomyces cerevisiae and of the bacterium Streptococcus faecium. The average buoyant densities of cells in exponentially growing cultures of E. coli or Schizosaccharomyces pombe were also independent of growth rate of the cultures. Experiments with E. coli have established that cell buoyant density is controlled by the osmoregulatory system. Although the regulatory mechanisms for this control are unknown, the results suggest that the same or similar mechanisms regulate buoyant density in all of the cells that do not have unduly heavy cell walls and, therefore, these regulatory mechanisms were either conserved during evolution or reflect the convergent evolution found for organic osmolytes. PMID- 3549160 TI - Biochemistry and technology of chickpea (Cicer arietinum L.) seeds. AB - Chickpea is an important source of proteins, carbohydrates, B-group vitamins, and certain minerals, particularly to the populations of developing nations. India contributes over 75% of the chickpea production in the world where it is mostly consumed as dhal, whole seeds, and several types of traditional, fermented, deep fried, sweetened, and puffed products. In this review, the world production and distribution, genetic background, biochemical and nutritional quality, and developments in storage and processing technology of chickpea are discussed. Future research needs, to improve the utilization of chickpea as human food, are addressed. PMID- 3549159 TI - The genetics of medically important fungi. AB - The present review is concerned with recent progress in basic genetic investigations with a variety of fungi which are pathogenic for man and animals. The principles and strategies involved in undertaking genetic investigations of sexual species and of asexual species are discussed. Progress in genetic analysis of Cryptococcus neoformans made possible by the discovery of its sexual phase is described in detail, as is progress in development of parasexual methods of analysis in Candida albicans. The genetic bases of virulence and drug resistance are discussed for those few species in which these phenotypes have been investigated. Suggestions for future research, including the application of recent advances in molecular biology to the study of pathogenic fungi, are presented. PMID- 3549161 TI - Critical review of water activities and microbiology of drying of meats. AB - The drying of meat is one of the least expensive and most effective ways to preserve meat. This article reviews the influence of intrinsic and extrinsic parameters of foods in relation to the drying of meat and the role of microbial activities in the drying and storage of meat. The critical role of water activity and its relationship with other physical and chemical parameters and microbial survival in the drying of meat is also reviewed in detail. This article ends with a description of the various methods to measure water activity in foods. The conclusion is that the drying of meat is a highly complex phenomenon which is influenced by the composition of meat, its water holding capacity, the processing of meat, and various microorganisms found on meat before and after the drying process. There is no doubt that the drying of meat is an effective preservation process, but attention should be placed on the possible survival of microorganisms in the process in order to prevent spoilage and food-borne diseases. PMID- 3549162 TI - A double-blind comparative trial of acyclovir and adenine arabinoside in combination with dilute betamethasone in the management of herpetic disciform keratitis. AB - A double-blind comparative trial of acyclovir (ACV) and adenine arabinoside (ARA A) in combination with dilute betamethasone was carried out in 30 patients with herpetic disciform keratitis. Of those receiving ACV and betamethasone, 86.7% healed in a mean time of 22.5 days, while 76.9% of those receiving the Ara-A combination healed in a mean time of 26.7 days. There was no statistical difference between the two treatment groups for efficacy parameters. However, the proportion of patients developing superficial punctate keratopathy (SPK) was significantly greater in the Ara-A treatment group. PMID- 3549163 TI - Acyclovir (Zovirax) ophthalmic ointment: a review of clinical tolerance. AB - Twenty nine published clinical trials with acyclovir (ACV) ophthalmic ointment in the treatment of herpes simplex virus (HSV) corneal disease have been reviewed in which ACV has been demonstrated to be effective in the treatment of simple dendritic ulcers, geographic ulcers, deep corneal HSV infections and ocular disease associated with herpes zoster (VZV) infection affecting the ophthalmic division of the trigeminal nerve. 998 patients were studied. The most commonly occurring adverse reactions were superficial punctate keratopathy (in 9.8% of patients) and burning or stinging on application of the ointment (4%). ACV ophthalmic ointment was first licensed for the treatment of HSV infections of the eye in September 1981. Spontaneous reports of adverse reactions to ACV ophthalmic ointment to both the UK Committee on Safety of Medicines and the Wellcome Group Adverse Reactions Reporting Centre total 43 cases. These include conjunctivitis, inflammation and pain in the treated eye. In this time it is estimated that there have been approximately one million exposures to the ointment. Thus in general use, tolerance to ACV treatment has been extremely good, and clinical trial data demonstrate that it compares favourably with alternative therapies for HSV corneal disease. PMID- 3549164 TI - Heart disease in the elderly. AB - As the number of individuals over age 65 years continues to increase, the elderly will comprise an ever-growing portion of each physician's practice. While heart disease in the elderly may be similar in many respects to that in younger patients, major age-related differences do exist with regard to etiology, pathogenesis, natural history, clinical presentation, and management. Optimal management of the older cardiac patient requires that these differences be taken into account. In prescribing a medical regimen, it is important to keep in mind that age-related decreases in renal function, hepatic perfusion, and drug metabolism may result in higher drug levels and that the elderly are also often more prone to adverse drug effects, especially central nervous system changes. One should remember that chronology is not necessarily synonymous with physiology, and much depends on the individual patient in terms of the lifestyle he/she led and that which he/she wishes to have. Advanced age may be associated with greater interventional morbidity and mortality, but age alone should not be a contraindication to aggressive medical or surgical therapy. PMID- 3549165 TI - Peripherally delivered renin supports reflex adrenal catecholamine secretion in anephric dogs. PMID- 3549166 TI - Pretransplant blood transfusion in a primate cardiac xenograft model. PMID- 3549167 TI - Cyclosporine increases rat heart weight in heterotopic transplants. PMID- 3549168 TI - Protein structure and expression among arenaviruses. PMID- 3549169 TI - Regulation of the concentration of 3H-ouabain binding sites in mammalian skeletal muscle--effects of age, K-depletion, thyroid status and hypertension. PMID- 3549170 TI - The sensitivity and specificity of Hippuran renography as a diagnostic investigation of renal transplant rejection. AB - Renography is a valuable investigation of a graft, as it can alert suspicions of rejection before it is clinically discernible. Renographic signs of rejection are delayed excretory phase and decreased Hippuran uptake in phase 1 and 2. A prospective trial was performed including 319 necrokidney transplanted patients. In 139 patients, acute rejection was diagnosed on clinical parameters. The material was divided into two groups: 1. Transplant patients suffering from acute tubulointerstitial nephropathy and having unmeasurably low creatinine clearance and an initial renogram showing an accumulation curve. 2. Patients with functioning grafts exposing a renogram with an excretion phase. The prevalence of rejection was 0.19 and 0.33, respectively, in the two groups. The sensitivity and specificity of renography as a parameter for diagnosing rejection was for group 1: Sensitivity 0.77 and specificity 0.95. Group 2: Sensitivity 0.68 and specificity 0.84. Efficiency of renography as a predictive test for the whole material was 74 percent. In group 1: 92 percent and in group 2: 79 percent. Acute rejection was diagnosed with renography in group 1 in 30/39 episodes before it was clinically evident. In group 2, with functioning grafts, rejection was diagnosed in 67 percent of the cases one to two days before it was clinically manifest. On the day of clinically manifest rejection, 92 percent of the renograms showed positive signs of rejection. False positive renographic signs of rejection were mainly caused by urinary tract obstruction, infection, and medication. PMID- 3549171 TI - The influence of ischemia on 131I-Hippuran renograms performed after kidney transplantation and its prognostic value. AB - Within 72 hours after 289 uncomplicated cadaver kidney transplantations, 131I ortho-iodo-hippurate renography was performed. The renographic changes caused by ischemic damage were correlated to the length of warm and cold ischemia times and followed during the recovery of graft function. Normal or slightly decreased phase 1 and 2 were seen in approximately 65 percent of the renograms if warm ischemia time was shorter than 15 min and the cold ischemic period less than 10 hours. For cold ischemia longer than 10 hours, the proportion was 30-60 percent. Warm ischemia time between 15 and 30 min caused a decrease of phase 1 and 2. Approximately 40 percent were normal or reduced if the cold ischemia time was less than 10 hours; for longer than 10 hours, the proportion was approximately 30 percent. Renograms with an excretion phase were mainly seen in the group with warm ischemia time less than 15 min combined with cold preservation for less than 20 hours. The phases of the post transplant renograms were closely correlated to the creatinine clearance. A normal or slightly decreased phase 1 or 2 was seen in patients with a clearance of 20-35 ml/min, moderately decreased phase was seen in the group with clearance of 10 ml/min, severely changed phase in the group with clearance of 0-5 ml/min. Correlating the onset of renal function to the initial posttransplant renogram showed immediate onset of function of 65 percent of the grafts with a normal or slightly decreased phase 1 or 2, as opposed to 15 percent of the grafts with moderately to severely decreased phases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549172 TI - Diagnostic approaches to pulmonary complications of marrow transplantation. PMID- 3549173 TI - Dose-response study of nebulized bitolterol mesylate solution in asthmatic patients. AB - Bitolterol mesylate, a new beta 2 adrenergic bronchodilator, is a "pro-drug" which is activated by esterases in the lung. In order to determine the optimal bronchodilator dose of bitolterol, six doses, (0.5 mg, 1.0 mg, 1.5 mg, 2.0 mg, 2.5 mg and 3.0 mg), were administered by closed-port, intermittent-flow nebulization (CPIF) to asthmatic patients on different days. For most patients, the onset of bronchodilator activity (FEV1 increase of at least 15 percent above baseline) occurred within 5 minutes and lasted at least 8 hours. Maximum mean increases in FEV1 were 46-50 percent at the 1.0 mg to 3.0 mg doses. Beyond the 1.0 mg dose, there was no significant improvement in bronchodilator effect, but adverse effects, particularly tremor, increased at higher doses. The optimal dose of bitolterol administered by CPIF was determined to be 1.0 mg which is similar to the dose of bitolterol recommended for use by metered-dose inhaler (MDI) which is 0.7 mg to 1.1 mg. If continuous-flow nebulization is used, two-three times more drug may be needed for a comparable effect. Bitolterol appears to be a safe, effective and long-lasting bronchodilator when administered by jet nebulization. PMID- 3549174 TI - Decreasing hydrostatic pressure does not uniformly decrease high-pressure pulmonary edema. AB - Pulmonary artery wedge pressure (PAWP) of 30 mm Hg with left atrial balloon inflation for 1 1/2 hours produced pulmonary edema in eight dogs. PAWP was then decreased to 10 mm Hg for two hours, and shunt, lung water (extravascular thermal volume, or ETV, by thermal dye), and perfusion distribution (radiomicrosphere technique) were measured and compared with four other dogs (group 1) whose PAWP was maintained at 10 mm Hg. The eight dogs with PAWP of 30 mm Hg for 1 1/2 hours were retrospectively subdivided into two groups of four based on ETV (group 2, double baseline ETV; group 3, triple baseline ETV). Baseline ETV and shunt were similar for all groups and remained unchanged for group 1. At 1 1/2 hours, 2 hours (1/2 hour after decreasing PAWP), 2 1/2 hours, and 3 1/2 hours, respectively, ETV were: 13.9 +/- 1.9, 12.8 +/- 2.0, 9.3 +/- 1.5, and 8.5 +/- 1.0 ml/kg in group 2; and 21.9 +/- 2.1, 22.7 +/- 2.2, 22.5 +/- 2.0, and 22.2 +/- 2.0 ml/kg in group 3. A more variable rate of edema formation was detected in eight additional dogs, but failure to resolve higher levels of edema after decreasing PAWP was also demonstrated in this group. Edema was greatest in lower lobes and decreased lobar perfusion. Shunt was higher in group 3 than in group 2 at 1 1/2 hours and decreased in group 2 but not in group 3 at 3 1/2 hours. Changes in colloid osmotic pressure may account for the differences in edema formation and resolution, but our data suggest that, independent of the rate of edema formation, a decrease in vascular exchange surface area at higher levels of edema may inhibit edema resolution when PAWP is decreased. PMID- 3549176 TI - Barotrauma. Pathophysiology, risk factors, and prevention. PMID- 3549175 TI - The impact of substance abuse on the respiratory system. PMID- 3549177 TI - Adult respiratory distress syndrome related to antilymphocyte globulin therapy. AB - A 21-year-old man developed the adult respiratory distress syndrome (ARDS) within five hours of receiving antilymphocyte globulin. No other identifiable cause of ARDS was present. The mechanism for development of acute lung injury is unknown, but may be related either to direct lung cytotoxicity or to complement-mediated leukocyte and platelet destruction with secondary lung injury from inflammatory mediators. PMID- 3549178 TI - Obstructive sleep apnea initiated by a lax epiglottis. A contraindication for continuous positive airway pressure. AB - Treatment with nasal continuous positive airway pressure (CPAP) was attempted in a patient with severe obstructive sleep apnea. However, application of nasal CPAP gave the patient a feeling of being suffocated. This was later documented by cine fluoroscopic examinations of the upper airways with and without nasal CPAP. The epiglottis was large and lax, and upon positive pressure inspiration, it was literally blown down so it occluded the hypopharyngeal airway. PMID- 3549179 TI - In vitro activity of two new aryl-fluoroquinolone antimicrobial agents, difloxacin (A-56619) and A-56620 compared to that of other antimicrobial agents. AB - The in vitro activity of difloxacin (A-56619) and A-56620, two new aryl difluoroquinolones, was compared to that of other new quinolones and several parenteral and oral antimicrobial agents. A-56620 inhibited 90% of Enterobacteriaceae at less than or equal to 1 microgram/ml, Staphylococcus aureus 0.25 micrograms/ml, hemolytic streptococci 2 micrograms/ml, Pseudomonas aeruginosa 2 micrograms/ml, Bacteroides sp. and Clostridium at 8 micrograms/ml. A 56620 was equal or 2-fold more active than norfloxacin and ofloxacin, and 2-8 fold less active than ciprofloxacin. Difloxacin had similar in vitro activity with many isolates but usually was 2-8-fold less active than A-56620. Both agents inhibited beta-lactamase positive Haemophilus influenzae (MIC 0.015 micrograms/ml) and Neisseria gonorrhoeae (MK less than or equal to 0.008 micrograms/ml). Both agents were more active against streptococci and Streptococcus pneumoniae than norfloxacin, ofloxacin and enoxacin, but not more active than ciprofloxacin. They inhibited Enterobacter cloacae, Citrobacter freundii and Serratia marcescens resistant to cephalosporins and methicillin resistant S. aureus and Staphylococcus epidermidis. Spontaneously resistant mutants were seen with Enterobacteriaceae, P. aeruginosa and S. aureus at a frequency similar to that found for other new quinolones. These agents show overall in vitro activity comparable to other quinolones in clinical trial or recently approved for clinical use. PMID- 3549180 TI - Influence of dosage interval on the therapeutic response to gentamicin in mice infected with Klebsiella pneumoniae. AB - Without treatment all mice died after receiving 10(3) Klebsiella pneumoniae by intraperitoneal injection. Nevertheless, it was possible to delay treatment for 12 h and still observe a therapeutic response from im gentamicin (5 mg/kg). This gave initial serum concentrations comparable to clinical levels, which fell rapidly (t 1/2 = 15 min) to reach the limit of detection by 90 min. Courses were given of 3 or 6 doses spaced at different intervals. Irrespective of dosage interval there was a marked fall in bacteraemia with each of the first two doses. Between doses separated by 8 or even 12 h there was no evidence of bacterial multiplication but this was obvious by 24 h. Both the bacteraemic responses and the lengths of survival were best with the 12-hour dosage interval. These results are consistent with other reports of the persistence of antibiotic effects despite undetectable serum concentrations and the compatibility of a substantial dosage interval with a successful therapeutic outcome. PMID- 3549181 TI - Infantile autism and parental socioeconomic status: a case of bimodal distribution. PMID- 3549182 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3549183 TI - [Complications of the deciduous dentition in the writings of 18th century French dentists]. PMID- 3549184 TI - [Management of osteopetrosis using allogenic grafts with cyclosporin A. Use in the "op" rat. Observation of dental results]. PMID- 3549185 TI - [Augusta Dejerine-Klumpke (1859-1927)]. PMID- 3549186 TI - [Proposed definitions of entries on the foot for the Polish Medical Dictionary]. PMID- 3549187 TI - [Chronic pancreatitis: definition, severity and therapeutic consequences]. PMID- 3549188 TI - [Chronic pancreatitis--drainage and resection procedures: status determination]. PMID- 3549189 TI - [Esophagojejunostomy--how safe is manual suture today?]. AB - Between 1982 and 1986 a total of 137 patients were gastrectomized for cancer of the stomach. The esophago-jejunal anastomosis was always carried out as an end-to side anastomosis applying the conventional two layer technique. Only in 1 patient (0.7%) an insufficiency of this anastomosis was observed; 9 reoperations (6.6%) were necessary and 3 patients (2.2%) died in the postoperative course. These results confirm that with a precise, standardised conventional suture technique the esophageal anastomosis can be safely performed today. PMID- 3549190 TI - [Duodenum-preserving pancreas head resection]. PMID- 3549191 TI - [Inter-tibiofibular graft. Results and choice of indications. Apropos of 62 cases]. PMID- 3549192 TI - [Biological characteristics of oxytocin]. PMID- 3549193 TI - Alterations to the microtubular cytoskeleton and increased disorder of chromosome alignment in spontaneously ovulated mouse oocytes aged in vivo: an immunofluorescence study. AB - Alterations in the organization of the microtubular cytoskeleton and chromosome alignment were examined by tubulin immunofluorescence and DAPI staining during in vivo ageing of naturally ovulated, metaphase-arrested oocytes of CBA/Ca mice in the fallopian tubes. In oocytes isolated from young mice on the day of oestrus, a few hours after ovulation, when they are still tightly surrounded by cumulus, the anti-tubulin fluorescence is almost exclusively restricted to the metaphase spindle. Only some faintly staining foci are observed in the cytoplasm, which presumably represent cytoplasmic MTOC not involved in spindle formation. The spindle is usually barrel-shaped or slightly pointed at its poles and does not possess astral fibres. In oocytes aged for more than 12 h in the fallopian tubes cytoplasmic asters develop, while microtubules seem to become gradually lost from the spindle, preferentially in its central area near the chromosomes. Astral fibres are observed radiating out from the polar centrosomes into the cytoplasm. In oocytes free of cumulus, and consequently more than 24 h post-ovulation, a pronounced shrinking of the spindle is observed. The mean pole-to-pole distance becomes significantly reduced in postovulatory aged cells. At the same time astral microtubules in the cytoplasm appear to become gradually depolymerized. Age-dependent alterations in the microtubular cytoskeleton do not seem to result from a changed pattern of the post-translational detyrosylation of alpha-tubulin in certain sets of microtubules. In freshly ovulated oocytes chromosomes in most spindles are well ordered and precisely arranged at the equatorial plane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549194 TI - Preservation of chromosome integrity during micronucleation induced by colchicine in PtK1 cells. AB - Colchicine induces the formation of small nuclei called micronuclei which contain limited parts of the genome. Some of them exhibit a DNA content equivalent to that of a single chromosome. Our purpose was to study the preservation of chromosome integrity during this micronucleation in PtK1 cells. Observation of karyotypes obtained after 3 days of cell cycle restoration revealed that micronucleation did not affect chromosome integrity or the presence of each chromosome pair in the surviving cells. In 'early restoration' cells, all the chromosomes included a centromere and were represented in the karyotype, but at variable rates. Furthermore, flow cytometry analysis of micronucleated cells, intermediate in DNA rate between control PtK1 cells in G1 and those in G2/M phases, led us to consider the possibility of selective replication of some chromosomes during micronucleation. Using antibodies against the kinetochore proteins, we derived the presence of one centromeric region (1-2 spots) in the smallest micronuclei. Therefore, these data (karyotypes, number of chromosomes, DNA content and kinetochore proteins) seem to indicate that micronucleation does not induce chromosome damages or translocations. Micronuclei are a convenient tool for investigation of the role of the different chromosomes in the organization of the interphase nuclei. PMID- 3549195 TI - The role of uvomorulin in the formation of epithelial occluding junctions. AB - We have used an assay for the recovery of transepithelial resistance to identify proteins involved in the formation of the epithelial occluding barrier. The occluding junctions of high resistance monolayers of strain I MDCK cells (greater than 2500 ohm X cm2) were opened briefly and reversibly by removal of Ca2+ from the bathing medium. We screened for monoclonal antibodies which could inhibit the recovery of resistance upon Ca2+ readdition. One such monoclonal antibody, rrl, was obtained which recognizes a uvomorulin-like (or L-CAM-like) polypeptide in MDCK cells. Uvomorulin may be primarily, if not entirely, responsible for the Ca2+ dependence of occluding junction integrity. The maintenance of transmonolayer resistance had the same divalent cation selectivity as the conformational change shown by the uvomorulin molecule. In contrast to its exclusive localization to the zonula adherens of small intestinal cells, we found uvomorulin to be distributed over much of the lateral plasma membrane of MDCK cells and dog hepatocytes. The role of extrajunctional uvomorulin in these cells is not understood. Treatment of intact, high resistance monolayers of MDCK cells with antibody rr1 failed to induce a loss of resistance even though the antibody had access to uvomorulin at the lateral surfaces. Thus, cell junctions must be partially disrupted to perturb the function of uvomorulin. We present a working model for the function of uvomorulin in the establishment of the epithelial occluding barrier. PMID- 3549196 TI - [Zinc metabolism in surgical patients]. PMID- 3549197 TI - Traumatic anal incontinence. Results of surgical repair. AB - The results after surgical repair of traumatic anal incontinence in 23 patients, 12 with simple lesions and 11 with complicated lesions, were analyzed. Overlapping suture was the standard technique in simple lesions, whereas additional procedures were necessary in complicated lesions. Fifteen patients (65 percent; 95 percent confidence limits: 43-83) had excellent results and seven (30 percent; 13-53) had acceptable results. In patients with simple lesions, the result was excellent in nine (75 percent; 43-94), and was excellent also in six patients with complicated lesions (55 percent; 23-83). PMID- 3549198 TI - Classic articles in colonic and rectal surgery. Charles Boyd Kelsey 1850-1917. On division of the sphincter ani muscle as a therapeutic measure. PMID- 3549199 TI - Transplantable colonic adenocarcinomas in rats. AB - The induction of colonic adenocarcinoma using two different regimens of dimethylhydrazine (DMH) in Fischer F344 rats is described. Rats receiving 20 mg/kg of DMH per week for 20 weeks developed primary tumors with metastases, whereas rats receiving the same weekly dose for 15 weeks developed primary tumors only. The most common route of metastases was transcelomic which often was associated with ascites. The epithelial origin of malignant ascites cells was confirmed by immunofluorescent staining with antidesmosomal antibodies and demonstration of desmosomes by electron microscopy. When transplanted into syngeneic rats, the cells of the malignant ascites resulted in the development of adenocarcinomatous metastases. PMID- 3549200 TI - Experience with local rectal cancer excision in light of two recent preoperative diagnostic methods. AB - This study analyzes the usefulness of two diagnostic methods: endorectal echotomography and adenolymphoscintigraphy. Echotomography is an important means for determining the extent of a tumor beyond the rectal wall, whereas lymphoscintigraphy is useful in demonstrating the metastatic locations in lymph nodes. These two modes of evaluation may permit an evaluation of the extent of the tumor and the possible involvement of regional lymph nodes before a surgical operation. Although the case material is limited, the statistical data can lead one to believe that, in the near future, a reasoned choice will be possible between local excision and abdominoperineal resection. The study includes 60 endorectal echotomographies and 26 lymphoscintigraphies (20 with 99mTc colloid and six with 201-Tl colloid). PMID- 3549201 TI - Classic articles in colonic and rectal surgery. John Hilton 1805-1878. On the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain. PMID- 3549202 TI - Transrectal repair of rectocele. PMID- 3549203 TI - Radiologic appearance of gallstones and its relationship with biliary symptoms and awareness of having gallstones. Observations during epidemiological studies. Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO). AB - In the course of two cross-sectional epidemiological surveys carried out by the Rome Group for Epidemiology and Prevention of Cholelithiasis (GREPCO), cholecystography was performed in 82 of 126 subjects identified by means of ultrasonography as having gallstones. In four subjects gallstones were not detected by cholecystography. The x-ray characteristics of the gallbladder and gallstones of the remaining 78 subjects were related to age, sex, presence of biliary symptoms in the five years prior to the study, and awareness of having gallstones. Twenty-three of the 78 gallstone subjects (29.5%) showed a nonvisualized gallbladder. Among the 55 subjects with visualized gallbladder, 16 (29.1%) and 28 (50.9%) showed radiopaque and solitary stones, respectively. The mean diameter of the largest stone was 19.7 mm +/- 11.2 (SD). Age was related inversely to the number of stones. X-ray characteristics of gallstones did not differ between men and women. Presence of biliary symptoms in the five years prior to the study or awareness of having gallstones were not related to any radiologic feature, either in univariate or multivariate statistical analysis which included age, sex, weight, and height as possible confounding variables. Nineteen (24.3%) of the 78 subjects showed gallstones which would have been suitable for medical therapy with bile acids (ie, radiolucent, with a diameter of less than 20 mm, and in a visualized gallbladder). PMID- 3549204 TI - Characterization of the syndrome of small and large intestinal variceal bleeding. AB - Massive bleeding from jejunal varices in a young alcoholic with cirrhosis and portal hypertension ceased following a portocaval shunt. Although rare, bleeding from small or large bowel varices has a high mortality. In 62 cases, small or large bowel varices are almost always associated with a predisposing condition including previous abdominal surgery and portal hypertension from cirrhosis or other causes. Hematochezia without hematemesis and nonbleeding esophageal varices generally occur. Angiography is the best diagnostic test. PMID- 3549205 TI - Mucoepidermoid (adenosquamous) carcinoma arising in Barrett's esophagus. AB - A case of mucoepidermoid or adenosquamous carcinoma arising from the mucous epithelium of a Barrett's esophagus is presented. Immunohistologic examination demonstrated carcinoembryonic antigen (CEA) in both the glandular and squamous components, but keratin only in the latter. Although mucoepidermoid carcinoma of the esophagus is believed to arise from submucosal glands, heterotopic gastric surface epithelium may also give rise to this uncommon neoplasm. PMID- 3549206 TI - Preparing for the CCRN examination. Part 2: Selecting published resources. PMID- 3549207 TI - Preparing for the CCRN examination. Part 3: Test-taking strategies. PMID- 3549208 TI - Expression in Saccharomyces cerevisiae of chimeric cytochrome P450 cDNAs constructed from cDNAs for rat cytochrome P450c and P450d. AB - Three chimeric cytochrome P450 cDNAs were constructed by replacing the central region, carboxy-terminal region, or both central and carboxy-terminal regions of cytochrome P450c cDNA with the corresponding regions of cytochrome P450d cDNA. These were inserted between the alcohol dehydrogenase I promoter and terminator of yeast expression vector pAAH5 to form expression plasmids pACDC2, pACCD1, and pACDD2. On introduction of each of these plasmids into Saccharomyces cerevisiae AH22 cells, chimeric cytochrome P450 proteins were expressed in AH22/pACDC2, AH22/pACCD1, and AH22/pACDD2 cells at the level of at least 10(5), 4 X 10(5) molecules per cell, respectively. The reduced CO-difference spectra showed that AH22/pACCD1 and AH22/pACDD2 cells contained 4 X 10(5) and 10(5) molecules per cell of the corresponding chimeric cytochrome P450 hemoproteins, designated as cytochrome P450ccd and cytochrome P450cdd, respectively. Cytochrome P450ccd exhibited higher monooxygenase activities toward 7-ethoxycoumarin, acetanilide, and benzo[alpha]pyrene than cytochrome P450c, although the substrate specificity of cytochrome P450ccd seemed to be the same as that of cytochrome P450c. Cytochrome P450cdd exhibited lower activities toward 7-ethoxycoumarin and benzo[alpha]pyrene, and a higher activity toward acetanilide as compared with those of cytochrome P450c and cytochrome P450ccd. Therefore, the substrate specificity of cytochrome P450cdd seemed to be the same as that of cytochrome P450d. These results suggest that the central one-third region of cytochrome P450c and cytochrome P450d is responsible for substrate-binding, and that the carboxy-terminal third of both cytochromes P450 plays an important role in electron transport. PMID- 3549209 TI - Expression of an interferon-alpha gene variant in E. coli using tandemly repeated synthetic ribosomal binding sites. AB - A human interferon-alpha 2 gene variant was expressed in Escherichia coli under the control of the tryptophan operon promoter and of a series of synthetic partially overlapping ribosomal binding sites, which control initiation of translation. Variation in the distance between the start codon and such a set of ribosomal binding sites affected the level of interferon expression much less than previously described for single ribosomal binding sites. PMID- 3549210 TI - [Inheritance of artificial mini-chromosomes in Saccharomyces yeasts with instability of native chromosomes]. PMID- 3549212 TI - Factors influencing the clinical efficacy of activated charcoal. AB - The use of activated charcoal as part of the treatment of intoxicated patients has increased dramatically over the last ten years. Activated charcoal is currently suggested as therapy to prevent the absorption of orally ingested compounds, and is gaining popularity as a method of increasing systemic drug clearance. This review presents variables that should be considered when activated charcoal is used in the treatment of intoxicated patients. Variables that may alter the efficacy of charcoal therapy include the preparation and dose of charcoal used, the intoxicants involved, stomach contents, the gastrointestinal pH, concurrently administered materials, and time from toxin ingestion to charcoal administration. As a general guideline, a single, large dose should be administered with a cathartic as soon as possible after oral ingestion to prevent drug absorption. When charcoal is used to enhance systemic drug clearance, the dosage regimen should be individualized, based on the drugs involved and the patient's gastrointestinal tract function, fluid and electrolyte status, and the severity of intoxication. PMID- 3549211 TI - Acute iron intoxication: treatment controversies. AB - Accidental ingestion of iron-containing preparations is a common, serious pediatric problem. Despite the frequency of this type of ingestion, the treatment remains under dispute. Controversies surrounding the use of sodium bicarbonate and phosphate solutions for complexation, oral deferoxamine lavage, and the deferoxamine provocation test are discussed. Therapeutic recommendations are made based on a review of the literature. PMID- 3549213 TI - Parkinsonism--drug treatment: Part II. AB - This article, second in a two-part review, discusses investigational drug therapy and miscellaneous drug management of parkinsonism. Drug therapy should be individualized according to signs and changed as the disease progresses or if the patient develops intolerable side effects. Investigational drugs being examined include sustained-release and injectable dopaminergic formulations. Drug-induced parkinsonism is also examined. PMID- 3549214 TI - Postgraduate pharmacy fellowships (1986-87) AB - During September and October 1986, the Brigham and Women's Hospital Pharmacy Services Department conducted its sixth annual nationwide survey of postgraduate pharmacy fellowships. There are 170 fellowships offered with 146 fellows at 44 sites. PMID- 3549215 TI - [Indications for the therapy of chronic lymphatic leukemia]. PMID- 3549216 TI - [Diagnosis of gastrointestinal non-Hodgkin's lymphomas]. PMID- 3549217 TI - [Therapy of gastrointestinal non-Hodgkin's lymphomas]. PMID- 3549219 TI - [Sonographic follow-up of acute colonic diverticulitis]. PMID- 3549218 TI - [The retained bladder catheter. Technics for its removal]. PMID- 3549220 TI - [Percutaneous pancreatico-gastric drainage of a pseudocyst]. AB - Pancreatico-gastric drainage, guided by ultrasound and endoscopy, of pancreatic pseudocysts was performed in two patients. The cysts emptied into the stomach within 12 and 24 hours, respectively. After the drainage both patients developed leucocytosis and fever, which quickly subsided after antibiotic treatment. There were no further complications or recurrences. PMID- 3549221 TI - [Meniscus sonography--alternative to invasive meniscus diagnosis?]. AB - Sonographic visualization of the meniscus as well as the detection and evaluation of its lesions presupposes use of the 7.5 MHz transducer of a sector scan. All lesions applied by means of a scalpel to cadaver knees could be pictured and evaluated in this way. In a clinical study, there was agreement between sonographic and surgical findings in 86 out of 91 patients (94%). The arthrography carried out in addition in 50 of these patients had a lower precision (88%) than sonography (98%). Agreement between the results of sonography and arthrography was found in 87 out of 98 patients (89%). The complete freedom from risk and high precision support the application of sonography in diagnosis of meniscus lesions. It can thus replace arthrography in this indication. PMID- 3549222 TI - Toxicodietetics: dietary alterations of toxic action. PMID- 3549223 TI - Skin as a target organ of immunotoxicity reactions. PMID- 3549224 TI - Skin absorption of chemical contaminants from drinking water while bathing or swimming. PMID- 3549225 TI - Reproductive and developmental toxicology--identifying hazards and estimating risks. PMID- 3549226 TI - The bioavailability and toxicity of topical drugs related to diseased skin. PMID- 3549227 TI - Occupational toxicology of trichloroethylene with special reference to neurotoxicity. PMID- 3549228 TI - Metabolic conversion of tri- and tetrachloroethylene: formation and deactivation of genotoxic intermediates. PMID- 3549229 TI - Environmental pollution by trichloroethylene and tetrachloroethylene: a nationwide survey. PMID- 3549230 TI - In vitro model as a primary short-term screening test for teratogens. PMID- 3549231 TI - Challenges and pitfalls in experimental studies with trichothecene mycotoxins. PMID- 3549232 TI - Cytochalasins-actin filament modifiers as a group of mycotoxins. PMID- 3549233 TI - Toxicokinetics versus pharmacokinetics. PMID- 3549234 TI - Antidotal therapy: pharmacokinetic aspects. PMID- 3549235 TI - Pharmacokinetic evaluation of forced diuresis, dialysis, and hemoperfusion. PMID- 3549236 TI - Elimination of paraquat. AB - There is a striking discrepancy between: the efficacy of the kidneys, haemodialysis (HD) and Haemoperfusion (HP) in removing paraquat from the body and the poor prognosis of paraquat poisoning even when the blood and urine levels (which are good indices of concentrations in lung and other tissues) are very low. Extra-corporeal elimination techniques have been used worldwide in paraquat poisoning. Do they remove paraquat effectively? Certainly. Do they increase the survival rate? Probably not. The reason being that when these techniques of elimination are initiated, potentially lethal concentrations of paraquat have already been attained in the highly vascular tissues of vital organs and in pneumocytes. The data presented suggest that the successful treatment of paraquat poisoning does not depend on modification of toxicokinetics. PMID- 3549238 TI - Cellular effects of chemical carcinogens. PMID- 3549237 TI - Organ-specific modifying effects of phenobarbital, saccharin and antioxidants on 2-stage chemical carcinogenesis. PMID- 3549239 TI - Strategy of long-term animal testing for quantitative evaluation of chemical carcinogenicity. PMID- 3549240 TI - Overview of recent problems in chemical carcinogenesis. PMID- 3549241 TI - The influence of diet on activation and inactivation of chemicals--evidence from animals and man. PMID- 3549242 TI - Diet in relation to cancer. PMID- 3549243 TI - Structural basis of the activity of nitrated polycyclic aromatic hydrocarbons. PMID- 3549244 TI - Cyclosporine nephrotoxicity: clinical and experimental aspects. PMID- 3549245 TI - Evaluation of N-acetyl-beta-glucosaminidase in two groups of renal transplant recipients undergoing conventional and cyclosporin A therapy: 48 months follow up. PMID- 3549246 TI - Cyclosporine related hypertension and nephrotoxicity in rat heart transplantation. PMID- 3549247 TI - Studies on nephrotoxicity of cyclosporine in human renal allograft and rat. PMID- 3549248 TI - Calcium-phosphorus metabolism after successful kidney transplantation: comparison between patients treated with conventional immunosuppressive therapy and cyclosporin A. PMID- 3549249 TI - Cyclosporine nephrotoxicity can be minimized by careful monitoring of whole blood trough levels. PMID- 3549250 TI - The use of cultured kidney cells to study renal toxicology. PMID- 3549251 TI - Interorgan metabolism of glutathione as the defence mechanism against oxidative stress. PMID- 3549252 TI - Drug-induced hypersensitivity nephritis in humans and animals. PMID- 3549253 TI - Open-loop technique. PMID- 3549254 TI - Direct effects of glucose on proinsulin synthesis and processing during desensitization. AB - Prolonged exposure of isolated islets to glucose (11 mM) results in desensitization of insulin secretion. In this study, both glucose-regulated proinsulin biosynthesis and its processing during glucose-induced desensitization were examined at critical periods during 24 h. Although insulin secretion declined at 24 h to one third the 3 h maximum rate, the total rate of proinsulin biosynthesis, assessed by [3H]leucine incorporation, was unchanged at 0, 3, and 24 h of glucose (11 mM) exposure. Total insulin recovery measured by immunoreactive insulin in islets and media after 24 h was approximately 172% of the initial islet content. After correction for insulin degradation, and since proinsulin biosynthesis was unchanged, the synthesis rate was calculated to be a constant 3.5 +/- 1.1%/h of the initial islet content. Results suggest that desensitization may occur at the release mechanism rather than at a step in glucose metabolism common for the stimulation of synthesis and secretion. In contrast, the conversion rate of proinsulin to insulin progressively increased with prolonged prior glucose exposure, the major increase occurring by 3 h of glucose preincubation. Low glucose (2 mM), when used during the 3-h prelabeling period, did not affect the conversion rate. Furthermore, cycloheximide added during the 3-h preexposure to glucose (11 mM) completely prevented glucose induced activation of the conversion process. These results indicate that the conversion rate of proinsulin to insulin is a glucose-regulated process requiring synthesis of a pool of either converting enzyme(s) or other regulating protein before initiation of proinsulin synthesis. PMID- 3549255 TI - Intracellular localization of the glucocorticoid receptor: evidence for cytoplasmic and nuclear localization. AB - Using a monospecific, monoclonal antibody against the glucocorticoid receptor (GR), an immunocytochemical study was performed to investigate the intracellular localization of GR both in the presence or absence of ligand. With all fixation methods tested (paraformaldehyde, acetic acid in ethanol, Bouin's fixative, and bensochinone in PBS), it was possible to obtain specific GR staining. Fixation with paraformaldehyde was chosen for further studies on the effect of permeabilization, using several concentrations of Triton X-100 or saponin. A rat Rueber hepatoma (H-4-II-E) and a human uterus carcinoma (NHIK 3025) cell line were used as well as cultured hepatocytes from normal rat. The accessibility of the different cell compartments after fixation and permeabilization was tested for by using antibodies against cellular constituents with known locations (i.e. core-nucleosome proteins and tubulin), in combination with the anti-GR antibody in double immunofluorescence staining experiments. The specific GR stain obtained with the indirect peroxidase antiperoxidase technique or with fluorescein isothiocyanate-labeled second antibodies was shown to be present both in the cytoplasm and in the nucleus. Staining of all cellular compartments was abolished (peroxidase antiperoxidase) or diminished (fluorescein isothiocyanate) if the monoclonal antibody was preincubated with a 90% pure GR preparation. These findings are in contrast to recently reported immunocytochemical studies, where a strict nuclear existence of the estrogen and progestin receptors has been reported. Consequently, generalizations with regard to steroid receptor localization cannot be made. Furthermore, an in vitro model is described, where the effect of dexamethasone administration upon the localization of receptor staining in H-4-II-E cells can be studied. PMID- 3549256 TI - Insulin inhibits the accumulation of the major lung surfactant apoprotein in human fetal lung explants maintained in vitro. AB - In the present study, we characterized the proteins associated with a purified lamellar body fraction isolated from human fetal lung explants. We then raised antibodies directed against the major human surfactant apoprotein, a 35-K glycoprotein, and used the technique of immunoblot analysis to evaluate the content of the surfactant apoprotein in human fetal lung explants maintained in serum-free medium in vitro. We found that the 35K surfactant apoprotein was undetectable in homogenates of fetal lung tissue before culture; the surfactant apoprotein was induced in the cultured explants coincident with the appearance of differentiated type II cells. Insulin, at concentrations as low as 2.5 ng/ml, caused marked inhibition of the accumulation of the 35K protein in the cultured fetal lung tissue. The inhibitory effect of insulin was dose dependent and was apparent as early as day 2 of incubation. When explants were cultured in medium containing insulin plus cortisol, the amount of immunoreactive surfactant apoprotein was reduced compared to that of explants cultured in control medium or explants cultured with cortisol alone. On the other hand, as reported previously, insulin and cortisol, in combination, stimulated phosphatidylcholine synthesis. These findings are indicative that the phospholipid and apoprotein components of surfactant are regulated independently. The results of our studies suggest that fetal hyperinsulinemia may cause the production of a surfactant deficient in the 35K apoprotein, and this may provide an explanation for the increased incidence of respiratory distress syndrome in infants of diabetic mothers. PMID- 3549257 TI - Renal sensitivity to angiotensin II in the conscious dog. AB - Local formation of angiotensin II (AII) within the kidney has been demonstrated. Changes in renal function induced by inhibitors of the renin-angiotensin system have been the basis for the postulate that AII may act as a paracrine substance in the kidney. We studied the renal action of chronic intrarenal infusions of AII at doses between 2 and 2000 fmol/kg X min in uninephrectomized conscious dogs monitored on 80 meq daily sodium intake. Exogenous AII was confined to the kidney, as demonstrated by the absence of systemic pressor and adrenal cortical responses during the intrarenal infusion. After 2 control days, each dose of AII was infused intrarenally for a period of 3 days. The smallest intrarenal dose of AII that caused significant antinatriuresis and antidiuresis was 20 fmol/kg X min. A significant reduction in urinary volume and sodium excretion occurred during the first 24 h of the infusion period and was proportionate to the amount of peptide infused. Renal escape from the antinatriuretic and antidiuretic effects of the peptide ensued on the second and third days of infusion. There were no significant changes in urinary potassium excretion, plasma renin activity (PRA), plasma aldosterone concentration, or blood pressure throughout the period of intrarenal AII administration. These data demonstrate dose-dependent direct antinatriuretic and antidiuretic actions of low AII concentrations. Escape from the sodium-retaining action of intrarenal AII occurred by 48 h and was independent of suppression of endogenous renin-angiotensin. These results indicate that AII alters renal function by direct intrarenal mechanisms. PMID- 3549258 TI - Reduced glomerular angiotensin II receptor density in diabetes mellitus in the rat: time course and mechanism. AB - Glomerular angiotensin II receptors are reduced in number in early diabetes mellitus, which may contribute to hyperfiltration and glomerular injury. The time course and role of the renin-angiotensin-aldosterone system in the pathogenesis of the receptor abnormality were studied in male Sprague-Dawley rats made diabetic with streptozotocin (65 mg, iv). Glomerular angiotensin II receptors were measured by Scatchard analysis; insulin, renin activity, angiotensin II, and aldosterone were measured by RIA. Diabetes mellitus was documented at 24 h by a rise in plasma glucose (vehicle-injected control, 133 +/- 4; diabetic, 482 +/- 22 mg/dl; P less than 0.001) and a fall in plasma insulin (control, 53.1 +/- 5.7; diabetic, 35.6 +/- 4.0 microIU/ml; P less than 0.05). At 24 h glomerular angiotensin II receptor density was decreased by 26.5% in diabetic rats (control, 75.5 +/- 9.6 X 10(6); diabetic, 55.5 +/- 8.3 X 10(6) receptors/glomerulus; P less than 0.01). Receptor occupancy could not explain the defect, because there was reduced binding in diabetic glomeruli after pretreatment with 3 M MgCl2, a maneuver that caused dissociation of previously bound hormone. There was a progressive return of the receptor density toward normal over the 60 days following induction of diabetes, with diabetic glomeruli measuring 22.7%, 14.8%, and 3.7% fewer receptors than age-matched controls at 11 days, 1 month, and 2 months, respectively (r = 0.99; n = 4; P less than 0.01). Three lines of evidence suggested that reduced angiotensin II receptor density at 24 h was not due to down-regulation by angiotensin II: PRA and angiotensin II were identical in control and diabetic rats; angiotensin II infusion (50 ng/min) caused down regulation in both control and diabetic rats, but the change in receptor density persisted (control, 33.6 +/- 6.9 X 10(6); diabetic, 18.5 +/- 1.3 X 10(6) receptors/glomerulus; P less than 0.05); and angiotensin-converting enzyme inhibition with enalapril caused receptor up-regulation, but the differences persisted (control, 105.5 +/- 21.2 X 10(6); diabetic, 67.1 +/- 3.0 X 10(6) receptors/glomerulus; P less than 0.05). Rats with chronic diabetes (7-60 days) had normal PRA and angiotensin II, but plasma aldosterone was elevated (control, 29.8 +/- 3.3; diabetic, 68.6 +/- 12.4 ng/dl; P less than 0.005). The return of angiotensin II receptor density to normal levels in chronic diabetes may be the result of receptor up-regulation by increased plasma aldosterone rather than recovery of the underlying defect. PMID- 3549259 TI - Hepatic metabolism of neurotensin. AB - Neurotensin is released from the intestinal mucosa into the portal circulation and, to exert a systemic effect, it must traverse the liver intact. We examined the potential role of the liver in neurotensin clearance using the isolated perfused rat liver model. With N-terminal and C-terminal directed RIAs and HPLC, we demonstrated rapid metabolism of intact neurotensin to inactive N-terminal fragments in the isolated rat liver system. The disappearance half-lives of C terminal and N-terminal immunoreactivity were 20.4 +/- 6.0 min and 82.7 +/- 7.7 min, respectively, (P less than 0.002). To assess whether this neurotensin disappearance might be due to metabolism within the perfusate itself by a peptidase released from liver, we further incubated neurotensin in perfusate previously circulated through liver. A rapid and progressive breakdown of intact neurotensin to N-terminal fragments was again shown. These data demonstrate that a substantial proportion of the hepatic clearance of neurotensin is attributable to release of a peptidase by the liver into the circulation. PMID- 3549260 TI - Comparison of the roles of insulin and insulin-like growth factor I in casein gene expression and in the development of alpha-lactalbumin and glucose transport activities in the mouse mammary epithelial cell. AB - The concentration-activity profiles for insulin and insulin-like growth factor I (IGF-I; in the presence of and insulin-like growth factor I (IGF-I; in the presence of hydrocortisone and PRL) have been compared in terms of the accumulation of beta-casein mRNA, total casein synthesis, and alpha-lactalbumin and basal carrier-mediated glucose transport activities in mammary epithelial cells from midpregnant mice. For the accumulation of the casein mRNA and the induction of casein synthesis and alpha-lactalbumin activity, the insulin ED50 is 1-2 ng/ml, while that for IGF-I is 10- to 20-fold greater. The effects of insulin and IGF-I are not additive in these instances. For the induction of basal carrier mediated glucose transport, the insulin ED50 is 8 ng/ml, and that for IGF-I is 16 ng/ml. Either factor can induce transport activity up to the level present in the cells from 2-day lactating mice. In this instance the effects are additive; insulin and IGF-I together can induce the transport up to the 10-day lactating level. PMID- 3549262 TI - Rapid normalization/stimulation by 1,25-dihydroxyvitamin D3 of insulin secretion and glucose tolerance in the vitamin D-deficient rat. AB - It has been previously demonstrated in this laboratory that vitamin D3 is essential for normal insulin secretion from the perfused rat pancreas. More recently we have shown, consistent with a physiological role for the vitamin in this process, that vitamin D-deficient rats exhibit impaired glucose clearance and insulin secretion, as monitored during iv glucose tolerance tests. Both of these parameters are significantly improved after vitamin D repletion independently of nutritional factors and the prevailing plasma calcium and phosphorus concentrations. In this present study the dose response and time course of effect of a single sc injection of the active metabolite 1,25 dihydroxyvitamin D3 [1,25-(OH)2D3] on glucose tolerance and insulin secretion were investigated. The impaired glucose clearance of vitamin D-deficient rats (KG = 912 +/- 37, where KG is a function of glucose tolerance) was markedly improved as early as 3 h after acute 1,25(OH)2D3 (1.3 nmol; 20 U) administration (KG = 676 +/- 13), and this clearance was maintained for up to 20 h (KG = 688 +/- 24). This improvement corresponded to enhanced glucose-induced insulin secretion. By 3 h after 1,25-(OH)2D3 substitution, the peak of insulin secretion was elevated by 170% of control values, independently of a significant increase in plasma phosphorus or plasma calcium concentrations. The hypoglycemic propensity of 1,25 (OH)2D3 was also dose dependent. Glucose tolerance was significantly improved (KG = 573 +/- 33), and insulin secretion was maximal (250% of control) after administration of only 0.26 nmol (4 U) 1,25-(OH)2D3. Higher concentrations of seco-steroid, although stimulatory, proved less effective. This study demonstrates a rapid response (within 3 h) to the potentiating action of 1,25 (OH)2D3 on in vivo insulin secretion and glucose clearance in the vitamin D deficient rat. A dose dependence of this hypoglycemic action is also established. PMID- 3549261 TI - Binding and degradation of insulin-like growth factors I and II by rat kidney membrane. AB - We have investigated the binding and degradation of insulin-like growth factors (IGF)/somatomedin by rat kidney membrane using 125I-labeled IGF-I and IGF-II. The binding of IGF-I and IGF-II were specific to their respective kidney membrane receptors with indicated Mr of 130,000 and 250,000, respectively. The IGF-I and IGF-II degrading activities of the kidney membrane were also found to be specific for the respective hormones. Comparison of the binding and degrading kinetics suggested the two systems to be separate. The characterization of the degrading activities revealed the activities to be neutral sulfhydryl proteases which are different from insulin neutral protease. Identity of these proteases as separate from the insulin protease was revealed from the specificity of the degrading enzymes for IGF and the differential inhibitory effect of N-ethylmaleimide on the enzymes compared to insulin protease. In summary, the IGF binding and degrading activities of kidney membrane are two independent systems with specificity for IGF-I or IGF-II, respectively. Additionally, the characterized IGF-degrading systems revealed the enzymes to be different from the previously described insulin protease. PMID- 3549264 TI - Effects of a low calcium environment on luteinizing hormone biosynthesis in cultured rat anterior pituitary cells. AB - The purpose of this study was to investigate the effects of lowering the extracellular calcium concentration on GnRH-stimulated LH glycosylation and LH translation, as measured by the incorporation of [3H]glucosamine (3H-Gln) and [35S]methionine (35S-Met) into immunoprecipitable LH. Cultured anterior pituitary cells, previously exposed to estradiol (5 X 10(-10) M) to maximize precursor incorporation were incubated for 4 h in normal calcium (2.5 mM) or low calcium medium (less than 15 microM) containing radiolabeled precursors with or without 1 nM GnRH. In the presence of normal calcium, GnRH significantly increased 3H-Gln labeled LH in the medium (278%) and cells (290%), as well as total (cells plus medium) 3H- Gln LH (280%) compared to the control value (no GnRH). GnRH also significantly increased the 35S-Met LH released into the medium (164%) and total 35S-Met LH (186%) over control values. Depletion of extracellular calcium completely inhibited GnRH-stimulated 3H-Gln LH and 35S-Met LH production. Total immunoreactive LH (iLH), as measured by RIA, was also increased significantly by GnRH treatment in the presence of calcium, but this response was prevented by removal of calcium from the medium. Lowering extracellular calcium had no effect on cellular uptake or incorporation of 3H-Gln or 35S-Met into total trichloroacetic acid-precipitable protein. Approximately 80% of newly synthesized LH was released into the medium in all treatment groups independent of whether calcium or GnRH was present. The specific activity (disintegrations per min/microgram iLH) of radiolabeled LH released into the medium was significantly reduced by treatment with GnRH due to the large amount of unlabeled iLH released into the medium. However, when the cells were incubated in low calcium, the SA of 3H-Gln LH and 35S-Met LH in the medium was unaltered by GnRH, whereas GnRH stimulated iLH release was inhibited. We conclude that GnRH stimulation of LH glycosylation and LH apoprotein synthesis involves extracellular calcium dependent events, and the release of newly synthesized LH is closely coupled to LH biosynthesis and is less dependent on extracellular calcium, whereas the GnRH stimulated release of previously synthesized, stored LH is dependent on extracellular calcium. PMID- 3549263 TI - The effects of gonadotropin-releasing hormone and estradiol on luteinizing hormone biosynthesis in cultured rat anterior pituitary cells. AB - This study investigated the effects of physiological concentrations of GnRH and estradiol (E2) on LH biosynthesis and release using cultured anterior pituitary cells. Pituitaries from female rats were enzymatically dispersed and cultured for 48 h in steroid-free alpha-Modified Eagle's Medium, followed by a 24-h culture in medium with or without E2. The cells were then incubated for a 4-h (Exp 1 and 2) or 8-h (Exp 3) period in medium containing radiolabeled precursors with or without GnRH. Radioactive precursor incorporation into LH was determined by immunoprecipitation, while immunoreactive LH (iLH) content was quantified by RIA. In the first experiment, all concentrations of E2 (10(-11)-10(-8) M) enhanced iLH release in response to 1 nM GnRH, confirming previous reports. GnRH increased [3H]glucosamine (3H-Gln) incorporation into LH, but had no effect on [35S]methionine (35S-Met) incorporation. The higher concentrations of E2 enhanced GnRH-stimulated 3H-Gln LH production. In the second experiment, the effects of GnRH (10(-9) M) and E2 (5 X 10(-10) M) on the incorporation of [3H]galactose, [3H]mannose, [3H]fucose, or [35S]sulfate into LH were investigated. Although all precursors were incorporated into LH, no specific effect of GnRH and/or E2 on incorporation of any of the precursors into LH was noted. In Exp 3, pituitary cells were cultured with or without 0.5 nM E2 followed by an 8-h incubation with varying physiological concentrations of GnRH (10(-11)-10(-9) M) and radiolabeled precursors (3H-Gln and 35S-Met). GnRH stimulated iLH release in a dose-dependent manner, and this response was enhanced by E2. GnRH also increased the incorporation of both 3H-Gln and 35S-Met into LH, but the dose of GnRH required for this response was dependent upon the estrogen environment. In the absence of E2, only 10(-9) M GnRH increased 3H-Gln LH and 35S-Met LH production, whereas in cells exposed to E2, all concentrations of GnRH (10(-11)-10(-9) M) increased 3H Gln LH and 35S-Met LH production. In all experiments, the specific activity of radiolabeled LH released under basal conditions was greatly reduced by stimulation with GnRH. These results suggest that GnRH regulates both LH glycosylation and LH polypeptide synthesis and that E2 lowers the physiological concentration of GnRH necessary to stimulate this biosynthetic response. Moreover, estrogen's enhancement of GnRH-stimulated LH release appears to be due to its action on mechanisms regulating the release of previously synthesized stored hormone as well as the release of newly synthesized LH. PMID- 3549265 TI - Metabolic basis for the diabetogenic action of growth hormone in the obese (ob/ob) mouse. AB - The ob/ob mouse responds predictably to chronic treatment with large doses of pituitary GH with marked hyperglycemia and decreased glucose tolerance. The purpose of the present study was to characterize the metabolic alterations produced by GH that lead to this diabetogenic response in the ob/ob mouse in order to determine whether this animal might serve as a useful model for the study of the cellular mechanisms involved in the diabetogenic action of GH. Female ob/ob mice were treated sc for 3 days with either saline or 200 micrograms/day S-carboxymethylated human GH (RCM-hGH), a diabetogenic GH derivative lacking significant growth-promoting or insulin-like activities. Six hours before the start of the experiment, the animals were given a sc injection of 2 micrograms dexamethasone and deprived of food. RCM-hGH treatment produced marked increases in fasting blood glucose and plasma insulin concentrations, but had no effect on plasma glucagon or serum insulin-like growth factor I levels. It had no effect on liver glycogen level or in vitro hepatic glucose production in the absence or presence of pyruvate and lactate added to the incubation medium. By contrast, the in vitro stimulatory effects of insulin on [14C] glucose oxidation by isolated soleus muscle or segments of parametrial fat were greatly attenuated by RCM-hGH treatment, without changes in rates of basal glucose oxidation. This change in peripheral tissue responsiveness to insulin does not appear to involve glucose transport, since the in vitro stimulation by insulin of 3-O-[14C]methylglucose transport into isolated diaphragm muscle was not altered by RCM-hGH treatment. Moreover, the RCM-hGH-induced reduction in adipose tissue responsiveness to insulin does not appear to be mediated by a reduction in insulin binding, since [125I]iodoinsulin binding to adipocytes isolated from RCM hGH-treated mice was similar to that to cells from saline-treated animals. Interestingly, the reduction in responsiveness to insulin seen with segments of adipose tissue from RCM-hGH-treated animals was not found with isolated adipocytes prepared from such tissue by collagenase digestion. These results suggest that the hyperglycemia and glucose intolerance produced in ob/ob mice by chronic GH treatment result primarily from increased peripheral tissue insulin resistance. Therefore, the ob/ob mouse provides a useful model to elucidate the cellular mechanism(s) of this aspect of the diabetogenic action of GH. PMID- 3549266 TI - Effects of luteinizing hormone (LH)-releasing hormone pulse amplitude and frequency on LH secretion by perifused rat anterior pituitary cells. AB - Recent studies have shown that LH secretion in vivo is pulsatile. In the present study, a cell perifusion system was employed to characterize the pituitary response to changes in LHRH pulse amplitude and frequency. Increases in pulse amplitude consistently elevated both mean LH levels and the amount of LH released in response to individual LHRH pulses. The EC50 for LHRH was approximately 3 nM. Increases in pulse frequency also increased mean LH levels, but frequencies of three or more pulses per h were associated with a decrease in the amount of LH released per pulse. Alterations in LHRH pulse characteristics changed qualitative as well as quantitative aspects of LH secretion, with high frequency, high amplitude pulses producing a biphasic response to LHRH. Initially a self-priming response was seen during the second and third hours of stimulation; this was followed by increasing desensitization of the cultures to LHRH. These results, by defining the pituitary response to specific conditions of stimulation, will help to clarify the relationship of LHRH stimulation to LH secretion in vivo. PMID- 3549267 TI - Gonadal steroids modulate pulsatile luteinizing hormone secretion by perifused rat anterior pituitary cells. AB - Recent studies have shown that LH secretion is pulsatile and that LH pulse characteristics are affected by the prevailing steroid environment in both male and female rats. In the present study, a cell perifusion system was used to examine the effects of testosterone (T) and 17 beta-estradiol (E) on LHRH stimulated pulsatile LH secretion. T inhibited LH secretion, increasing the EC50 for LHRH, while E stimulated secretion, lowering the EC50. Steroid effects were independent of both LHRH pulse amplitude and frequency. E also affected the pattern of LH secretion by facilitating both LHRH self-priming and desensitization to LHRH. These results show that steroids can affect pulsatile LH secretion by actions exerted at the pituitary level and that steroids can induce both quantitative and qualitative changes in LH secretion in the presence of an invariant LHRH stimulus. These results help to elucidate the mechanisms underlying steroid feedback in vivo, since reduction in pituitary responsiveness to LHRH may play an important role in T feedback, while facilitation by E of both self-priming and desensitization may serve to increase the magnitude and shorten the duration of the proestrous LH surge. PMID- 3549269 TI - [The risk in using growth hormone obtained from human pituitary glands]. PMID- 3549268 TI - Liver tissue produces a potent lactogen that partially mimics the actions of prolactin. AB - An in vitro bioassay (based on the detection of casein release from isolated mammary cells by reverse hemolytic plaque assay) was used to detect a lactogenic factor secreted by liver tissue from suckled rats. This material stimulates casein release in the absence of added PRL and is actually more potent than PRL in this regard. The substance(s) possesses the following additional characteristics: it is released from liver tissue of lactating but not virgin female or male rats; when tested together with PRL, its effects are additive rather than synergistic; and unlike PRL, it does not increase the proportion of mammary cells committed to casein release. These findings are consistent with the possibility that a Liver Lactogenic Factor may mediate, at least in part, the lactogenic component of PRL's action. This functional relationship may be similar to that which exists between GH and the somatomedins. PMID- 3549270 TI - [Determining autoantibodies in thyroid diseases using an immunoenzyme method]. PMID- 3549271 TI - Colonic haemorrhage from solitary submucosal vessels diagnosed by lower gastrointestinal Doppler-endoscopy. AB - The case of a 21-year-old woman presenting with acute gastrointestinal haemorrhage is reported. By means of Doppler-endoscopy, a solitary minute polyp located in the proximal ascending colon, which revealed arterial pulsation, was detected, and removed with the aid of forceps. The histological work-up revealed thick-walled, in part dilated, vessels located in the lamina propria and in the submucosa. Following endoscopic sclerotherapy, the patient has now been haemorrhage-free for the past 6 months. The lesion is very probably a Dieulafoy like erosion, an entity which was previously known only in the stomach and jejunum, but which in more recent times has also been observed in the colon. PMID- 3549273 TI - Cytochrome P-450scc a review of the specificity and properties of the cholesterol binding site. AB - Cytochrome P-450scc is unusual among members of this class of enzymes in showing a high degree of substrate specificity. Features of the cholesterol structure which are particularly important for binding include the 3 beta-hydroxyl, the delta 5-ring configuration, and the side-chain organization in the 20-22 region. Regarding the ring system, binding appears to require planarity and limited size at the 4-5-6 carbons (the A-B ring juncture). In the region of the 3 beta hydroxyl, a "cleft" in the binding site extends about 4 A beyond the hydroxyl and can accommodate two additional ether-linked carbons. Evidence indicates that an enzyme residue hydrogen-bonds to the oxygen of the 3 beta hydroxyl, providing much of the energy for the initial enzyme-substrate interaction. The cytochrome shows less specificity for the side-chain structure, except in the region of carbons 20-22 where hydroxylation/side-chain cleavage takes place. The binding cleft for the side-chain is limited to approximately the length of the isocaproic group but can accommodate structural variations beyond the 22-position. Evidence indicates that the region near the 20-22 bond is more limited in size, and that an amino acid residue near the heme iron binds strongly and stereospecifically to the 22R-hydroxyl of the cleavage intermediates, 22R-hydroxycholesterol and 20 alpha, 22R-dihydroxycholesterol. The 22R-hydrogen of cholesterol is very close to the heme iron (approximately 3 A), while the 22S-hydrogen is slightly further (about 4 A). The size and bonding properties of the steroid binding/active site suggest a mechanism which accounts for the stereospecificity and sequence of reactions catalyzed by cytochrome P-450scc. PMID- 3549272 TI - Lac repressor-Lac operator complexes. Solution X-ray scattering and electrophoretic studies. AB - Complexes between the Lac repressor and a small DNA operator fragment (29 base pairs) were investigated using polyacrylamide gel electrophoresis and solution X ray scattering. Titration of the DNA fragment with the repressor, followed by gel electrophoresis showed that only two types of complexes are formed with repressor/operator ratios of 0.5 and 2. Radii of gyration and forward scattered intensities were obtained from Guinier plots for repressor/operator ratios ranging from 0.3 to 2. They demonstrated that the first complex contains one repressor and two operators, whereas the second one contains four repressors and two operators. Mixing operator and repressor in equimolar concentrations leads to a mixture of both complexes. A possible model for the four repressor/two operator complex is proposed. PMID- 3549274 TI - Cytochrome P-450/pseudosubstrate interactions and the role of antioxidants in the adrenal cortex. AB - The adrenal cortex is the site of the synthesis of the steroid hormones such as the glucocorticoid cortisol and the mineralocorticoid aldosterone. The pathway of biosynthesis of these steroids from cholesterol involves a sequence of transformations using cytochrome P-450 enzymes. The hypothesis presented here is that damage to cytochrome P-450 enzymes on interaction with certain steroids, synthesized by the adrenal cortex itself, may be of pathological and perhaps physiological importance. The interaction between cytochrome P-450 enzymes and these steroids, which act as pseudosubstrates, may form part of the pathogenesis of some steroidogenic enzyme deficiencies, with consequent overproduction of precursor steroids, leading to mineralocorticoid or androgen excess. This interaction is dependent on achieving high concentrations of the pseudosubstrate steroids in the adrenal cortex, which probably occurs as a result of the arrangement of the vasculature in the adrenal gland. High concentrations of steroids may be expected to accumulate in steroidogenic cells, both in culture and in vivo, and may have autoregulating effects. The high content of antioxidant compounds in the adrenal cortex, principally ascorbate, may serve to protect cytochrome P-450 enzymes from the damaging effects of oxygen radical species formed as a result of cytochrome P-450/pseudosubstrate interactions. PMID- 3549275 TI - Biological actions of androgens. AB - Though unnecessary for life itself, androgens are essential for the propagation of the species and for establishment and maintenance of the quality of life of males through their support of sexual behavior and function, muscle strength, and sense of well-being. In carrying out its many functions, T acts both as hormone and prohormone. It is an outstanding example of the diverse evolutionary utilization of a primitive informational molecule both among and within species. Not only does T act through the androgen receptor both unchanged and via 5 alpha reduction, but it acts in tissues with a high aromatase level as an estrogen via the estrogen receptor. Furthermore, DHT, binding to the estrogen receptor, can act as an inhibitor of estrogen action. The products of androgen metabolism may also play active regulatory roles in hematopoiesis and in the regulation of certain hepatic enzymes. Table 3 summarizes the actions of secreted T in males indicating the probable effector hormone. While gross hypogonadism is uncommon, mild androgen insufficiency may be much more frequent, especially in older men, and in those receiving treatment for chronic medical conditions. It is quite possible that such individuals would benefit from appropriate androgen therapy were it available, but the current forms of replacement therapy are not very satisfactory. Better approaches are required. With the exception of a small number of secreted proteins, the products of transcription induced by androgens are not, as yet, known. When the androgen receptor gene is cloned it will be possible to identify androgen-regulated genes and their products. It will then be possible to design agents selectively producing specific desired androgenic effects. PMID- 3549276 TI - Estrogenic regulation of growth and polypeptide growth factor secretion in human breast carcinoma. PMID- 3549277 TI - Cell proliferation of estrogen-sensitive cells: the case for negative control. PMID- 3549279 TI - Molecular characterization of a karyophilic, histone-binding protein: cDNA cloning, amino acid sequence and expression of nuclear protein N1/N2 of Xenopus laevis. AB - In the amphibian oocyte, most of the non-chromatin-bound histones are not free but form complexes with specific karyophilic proteins, the most prominent being nucleoplasmin and 'protein N1/N2'. Using antibodies against polypeptide N1 and N2 (Mr approximately 105,000 and approximately 110,000) we have isolated, from a Xenopus laevis ovary lambda gt11 expression library, several full length cDNA clones encoding one of the two closely related polypeptides N1 and N2 (these could not be distinguished by hybridization techniques). The amino acid sequence deduced from one of these clones (N1/N2, lambda 106.2) defines a polypeptide of mol. wt 64,774. The remarkably high difference between the value of Mr approximately 110,000 estimated from SDS-PAGE mobility and the true mol. wt has been found for (i) the cell protein, (ii) the polypeptide synthesized in vitro by transcription and translation and (iii) the fusion protein with beta galactosidase expressed in Escherichia coli, indicating that the protein runs anomalously on SDS-PAGE. The amino and carboxy termini of the purified protein N1/N2 have been confirmed by direct amino acid sequencing of CNBr fragments. The amino acid sequence displays two glutamic acid-rich domains, which are probably involved in the interaction with the histones, and a putative nuclear targeting signal with high homology to that of the SV40 large T-antigen which is located near the carboxy terminus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549280 TI - Xenopus myc proto-oncogene during development: expression as a stable maternal mRNA uncoupled from cell division. AB - A Xenopus cDNA clone highly homologous to the proto-oncogene c-myc has been isolated and used to derive a homologous probe to study myc expression during embryonic development. Myc RNA is identified as a member of the class of maternal mRNAs expressed before fertilisation. It is highly accumulated from early oogenesis and an unfertilised egg contains 8 pg, about 10(5)-fold the myc content of proliferative somatic cells. After fertilisation a post-transcriptional regulation of the gene is induced and the accumulated myc RNA is degraded (t1/2 = 4 h 20 min) to reach a level at gastrula of 10 transcripts per cell; a value maintained during subsequent embryonic development. The Xenopus myc protein has also been identified by both myc-specific antibodies and hybrid selection experiments. Translation in vitro of Xenopus myc RNA shows that it encodes a 62 kd protein which is also recognised by myc antibodies in oocyte extracts. This protein is accumulated in late oogenesis. The results indicate an unusual uncoupling of myc expression and cell proliferation linked to a stabilisation of the RNA product. PMID- 3549281 TI - C-myc expression is dissociated from DNA synthesis and cell division in Xenopus oocyte and early embryonic development. AB - The combined use of a human c-myc probe and of an antibody raised against the human c-myc gene product demonstrated that the Xenopus cells contained a 2.5-kb c myc transcript and synthesized a c-myc immunoreactive 65-kd polypeptide. In full grown oocytes, p65c-myc was predominantly located in the nucleus. In non-dividing Xenopus oocytes c-myc mRNA was present at a steady-state level 10(4) times higher than that of growing somatic A6 cells. This very high level of c-myc transcript was reached early in oogenesis and remained constant thereafter. The rate of p65c myc synthesis also reached high levels, but only in vitellogenic oocytes, suggesting a post-transcriptional control. Although the cell cycle is resumed at a very fast pace in developing embryos, no further increase in total embryonic content of c-myc RNA could be demonstrated up to the swimming tadpole stage. Furthermore, in embryos the rate of synthesis of p65c-myc decreased to a level markedly lower than that of cell cycle-arrested vitellogenic oocytes. This observation suggests that the function of the c-myc gene in the cell cycle may not be implicated directly in sustaining DNA synthesis or mitosis. PMID- 3549278 TI - Radiation effects in the lung. AB - This article outlines the principles of radiobiology that can explain the time of onset, duration, and severity of the complex reactions of the lung to ionizing radiation. These reactions have been assayed biochemically, cell kinetically, physiologically, and pathologically. Clinical and experimental data are used to describe the acute and late reactions of the lung to both external and internal radiation including pneumonitis, fibrosis and carcinogenesis. Acute radiation pneumonitis, which can be fatal, develops in both humans and animals within 6 months of exposure to doses greater than or equal to 8 Gy of low LET radiation. It is divisible into a latent period lasting up to 4 weeks; an exudative phase (3 8 weeks) and with an acute pneumonitic phase between 2 and 6 months. The latter is an inflammatory reaction with intra-alveolar and septal edema accompanied by epithelial and endothelial desquamation. The critical role of type II pneumonocytes is discussed. One favored hypothesis suggests that the primary response of the lung is an increase in microvascular permeability. The plasma proteins overwhelm the lymphatic and other drainage mechanisms and this elicits the secondary response of type II cell hyperplasia. This, in its turn, produces an excess of surfactant that ultimately causes the fall in compliance, abnormal gas exchange values, and even respiratory failure. The inflammatory early reaction may progress to chronic fibrosis. There is much evidence to suggest that pneumonitis is an epithelial reaction and some evidence to suggest that this early damage may not be predictive of late fibrosis. However, despite detailed work on collagen metabolism, the pathogenesis of radiation fibrosis remains unknown. The data on radiation-induced pulmonary cancer, both in man and experimental animals from both external and internal irradiation following the inhalation of both soluble and insoluble alpha and beta emitting radionuclides are reviewed. Emphasis is placed on the data showing that alpha emitters are at least an order of magnitude more hazardous than beta/gamma radiation and on recent data showing that the more homogeneous the irradiation of the lung, the greater is the carcinogenic hazard which contradicts the so-called "hot particle" theory. PMID- 3549283 TI - Suppression of defective RAS1 and RAS2 functions in yeast by an adenylate cyclase activated by a single amino acid change. AB - We have constructed the yeast strain TS1, with the RAS2 gene replaced by mutant allele encoding a partially defective gene product, and with an inactive RAS1 gene. TS1 cells accumulate as unbudded cells upon temperature shift from 30 to 37 degrees C, thus showing that the RAS1 and RAS2 gene functions are important for progression through the G1 phase of the cell cycle. After the isolation of revertants able to grow at the nonpermissive temperature, we have found that a chromosomal point mutation can bypass the G1 arrest of TS1 and cdc25 cells, and the lethality of ras1 ras2 mutants. The mutation predicts the replacement of threonine by isoleucine at position 1651 of yeast adenylate cyclase. The RAS independent, as well as the RAS-dependent adenylate cyclase activity, is increased by the mutation. Like the wild-type enzyme, the RAS-dependent activity of the mutant adenylate cyclase is turned on by the GTP-bound form of the RAS2 protein. The amino acid sequence surrounding the threonine 1651 shows similarity with protein kinase substrates. Possible implications for the function of adenylate cyclase are discussed. PMID- 3549282 TI - Targeting efficiency of a mitochondrial pre-sequence is dependent on the passenger protein. AB - The mitochondrial matrix enzyme manganese superoxide dismutase (SOD) of Saccharomyces cerevisiae is encoded in the nucleus. It is synthesized as a precursor with an NH2-terminal extension of 26 amino acids which is cleaved off during import into the mitochondrion. Fusions between the NH2-terminal 34 amino acids of SOD and the cytosolic proteins invertase of yeast and mouse dihydrofolate reductase (DHFR) were tested for in vitro binding and import into mitochondria. Efficient translocation over the mitochondrial membranes takes place in the case of the SOD-DHFR fusion. The SOD-invertase fusion protein does not get translocated and binds to the organelle with only low efficiency. Yeast transformants harbouring the SOD-invertase fusion gene accumulate approximately 95% of the hybrid protein in the cytosol. The remaining material is found in the interior of the mitochondrion, loosely attached to the inner membrane. We conclude that the pre-sequence of SOD is able to deliver a passenger protein to the mitochondrion. The efficiency of protein delivery and translocation across the membrane is, however, influenced by the passenger protein. PMID- 3549284 TI - Both hydrophobic domains of M13 procoat are required to initiate membrane insertion. AB - M13 procoat protein has two hydrophobic domains, one in the leader peptide and one which anchors the mature coat protein in the membrane. Disruption of the membrane anchor region by insertion of arginyl residues does not yield periplasmic coat protein. Instead, the rate of membrane assembly is slowed greater than 100-fold (t1/2 less than 5 s for wild-type, t1/2 greater than 10 min for mutant). The hydrophobic region of mature coat protein not only functions as a membrane anchor, but has an important role in the membrane assembly process per se. PMID- 3549285 TI - Fluorescence analysis of protein dynamics. PMID- 3549286 TI - Activation and control of the complement system. PMID- 3549287 TI - Effects of dietary manipulations on blood glucose and hormonal responses following supramaximal exercise. AB - The effects of supramaximal exercise on blood glucose, insulin, and catecholamine responses were examined in 7 healthy male physical education students (mean +/- SD: age = 21 +/- 1.2 years; VO2max = 54 +/- 6 ml X kg-1 X min-1) in response to the following three dietary conditions: a normal mixed diet (N); a 24-h low carbohydrate (CHO) diet intended to reduce liver glycogen content (D1); and a 24 h low CHO diet preceded by a leg muscle CHO overloading protocol intended to reduce hepatic glycogen content with increased muscle glycogen store (D2). Exercise was performed on a bicycle ergometer at an exercise intensity of 130% VO2max for 90 s. Irrespective of the dietary manipulation, supramaximal exercise was associated with a similar significant (p less than 0.01) increase in the exercise and recovery plasma glucose values. The increase in blood glucose levels was accompanied by a similar increase in insulin concentrations in all three groups despite lower resting insulin levels in conditions D1 and D2. Lactate concentrations were higher during the early phase of the recovery period in the D2 as compared to the N condition. At cessation of exercise, epinephrine and norepinephrine were greatly elevated in all three conditions. These results indicate that the increase in plasma glucose and insulin associated with very high intensity exercise, persists in spite of dietary manipulations intended to reduce liver glycogen content or increase muscle glycogen store.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549289 TI - Massive overproduction of dihydrofolate reductase in bacteria as a response to the use of trimethoprim. AB - Among several observations of greatly increased levels of chromosomal dihydrofolate reductase as a cause of resistance to high concentrations of the antifolate drug trimethoprim, in clinically isolated bacteria, one is described here of a strain of Escherichia coli overproducing dihydrofolate reductase several hundredfold. The chromosomally located resistance gene of this strain was isolated, inserted into a plasmid vector, and analyzed for its nucleotide sequence. The structural gene for the overproduced dihydrofolate reductase was found to be identical to that of E. coli K12, with nine exceptions, of which seven resulted in synonymous codon usage. Two transversions resulted in a substitution of Gly or Trp at amino acid position 30, and of Gln for Glu at position 154. Six of the nine base changes resulted in codons more frequently used. The Gly substitution which leads to a less commonly used codon, was thought to relate to the observed threefold increase in Ki for trimethoprim. Furthermore, a C----T transition was found in the -35 region of the promoter, increasing its homology with the E. coli consensus promoter sequence. In the ribosome-binding area of the resistant strain, finally, seven base changes were observed, two of which resulted in a five-base sequence of complementarity with the 3'-end of ribosomal 16S RNA. The distance between the -10 site of the promoter and the start codon for translation was finally increased one base pair by the insertion of an A at position +9 in the resistant strain. These genetic changes towards more efficient transcriptional and translational start sequences and towards increased mRNA expressivity are interpreted to reflect an evolutionary adaptation to the presence of antifolates. PMID- 3549288 TI - Identification of the C-terminally alpha-amidated amino acid in peptides by high performance liquid chromatography. AB - A sensitive method for the rapid identification of the C-terminally amidated amino acid in peptides is described. Peptides containing the alpha-amide group at the C-terminus were cleaved with endopeptidases. The fragments released (oligopeptides, amino acids and the C-terminally amidated residue) are coupled to phenylisothiocyanate. The phenylthiocarbamoyl derivative of the amino acid alpha amide is selectively extracted from the mixture by alkaline butyl acetate and identified by a high-performance liquid chromatography system that enables rapid and complete separation of the derivatives of 17 amino acid amides at a detection limit of 20-50 pmol. The C-terminal alpha-amides of neurokinin-A (Met-NH2), mammalian secretin (Val-NH2), pancreatic polypeptide (Tyr-NH2) and peptide HI (Ile-NH2) are unequivocally determined at a level of 0.5-2 nmol per peptide. This method was used to characterize a crude peptide fraction prepared from porcine brain. Cholecystokinin-58 was identified in this fraction by detection of phenylthiocarbamoyl-phenylalaninamide. The method is suitable for the identification of the C-terminal alpha-amidated residue of purified peptides, but can also be used as a screening strategy to isolate from complex biological extracts novel peptides containing an alpha-amidated amino acid at the C terminus. PMID- 3549290 TI - Fatty-acid-induced activation of NADPH oxidase in plasma membranes of human neutrophils depends on neutrophil cytosol and is potentiated by stable guanine nucleotides. AB - Both cis and trans unsaturated fatty acids and sodium dodecyl sulfate activated NADPH oxidase in plasma membranes of human neutrophils in the presence of neutrophil cytosol. In contrast, 5,8,11,14-icosatetraynoic acid, saturated fatty acids, esters, peroxides and 4 beta-phorbol 12-myristate 13-acetate, a potent activator of protein kinase C, were inactive. 5,8,11,14-icosatetraynoic acid inhibited superoxide formation elicited by fatty acids. Guanosine 5'[gamma thio]triphosphate (GTP[gamma S]), a potent activator of guanine-nucleotide binding proteins (N-proteins) enhanced superoxide formation elicited by fatty acids up to fourfold, supporting our previous suggestion that NADPH oxidase is regulated by an N-protein [Seifert, R. et al. (1986) FEBS Lett. 205, 161-165]. Cytosols from various tissues, soybean lipoxygenase and protein kinase C, purified from chicken stomach, did not substitute neutrophil cytosol. The activity of neutrophil cytosol was destroyed by heating at 95 degrees C. Superoxide formation was not affected by the inhibitor of protein kinase C 1-(5 isoquinolinesulfonyl)-2-methylpiperazine (H-7). Removal of cytosolic ATP by preincubation with hexokinase and glucose, dialysis of neutrophil cytosol or chelation of calcium with EGTA did not abolish the stimulatory effect of arachidonic acid and GTP[gamma S]. Thus, the cytosolic cofactor appears to be a neutrophil-specific and heat-labile protein, which is neither a lipoxygenase nor protein kinase C. PMID- 3549291 TI - Subcellular location of enzymes involved in the N-glycosylation and processing of asparagine-linked oligosaccharides in Saccharomyces cerevisiae. AB - A particulate translation system isolated from the yeast Saccharomyces cerevisiae was shown to translate faithfully in-vitro-transcribed mRNA coding for a mating hormone precursor (prepro-alpha-factor mRNA) and to N-glycosylate the primary translation product after its translocation into the lumen of the microsomal vesicles. Glycosylation of its three potential sugar attachment sites was found to be competitively inhibited by acceptor peptides containing the consensus sequence Asn-Xaa-Thr, supporting the view that the glycan chains are N glycosidically attached to the prepro-alpha-factor polypeptide. The accumulation in the presence of acceptor peptides of a membrane-specific, unglycosylated translation product (pp-alpha-F0) differing in molecular mass from a cytosolically located, protease-K-sensitive alpha-factor polypeptide (pp-alpha Fcyt) by about 1.3 kDa, suggests that, in contrast to previous reports, a signal sequence is cleaved from the mating hormone precursor on/after translocation. This conclusion is supported by the observation that the multiply glycosylated alpha-factor precursor is cleaved by endoglucosaminidase H to a product with a molecular mass smaller than the primary translation product pp-alpha-Fcyt but larger than the membrane-specific pp-alpha-F0. Translation and glycosylation experiments carried out in the presence of various glycosidase inhibitors (e.g. 1 deoxynojirimycin, N-methyl-1-deoxynojirimyin and 1-deoxymannojirimycin) indicate that the N-linked oligosaccharide chains of the glycosylated prepro-alpha-factor species are extensively processed under the in vitro conditions of translation. From the specificity of the glycosidase inhibitors applied and the differences in the molecular mass of the glycosylated translation products generated in their presence, we conclude that the glycosylation-competent microsomes contain trimming enzymes, most likely glucosidase I, glucosidase II and a trimming mannosidase, which process the prepro-alpha-factor glycans down to the (Man)8(GlcNAc)2 stage. Furthermore, several arguments strongly suggest that these three enzymes, which apparently represent the full array of trimming activities in yeast, are exclusively located in the lumen of microsomal vesicles derived from endoplasmic reticulum membranes. PMID- 3549293 TI - Molecular characterisation of the DNA ligase gene, CDC17, from the fission yeast Schizosaccharomyces pombe. AB - We have sequenced a 4200-base-pair fragment of Schizosaccharomyces pombe DNA which encompasses the entire DNA ligase gene, CDC17. S1 mapping has enabled us to identify two small introns (40 and 62 nucleotides) at the 5' end of the coding region of the gene and their 3' internal conserved sequences match the CTRAY consensus found in other S. pombe introns. The major transcription initiation and 3' polyadenylation sites have been mapped and are preceded by higher eukaryotic like TATA and AATAAA sequences respectively. Furthermore, the CDC17 mRNA carries a poly(A) tail whose length (approximately 250 nucleotides) is typical of that found in higher eukaryotic mRNAs, and is in contrast to the much shorter polyadenylated sequences found for the mRNAs of the budding yeast, Saccharomyces cerevisiae. The deduced amino acid sequence of the S. pombe DNA ligase predicts a protein of 86182 daltons, and an overall 53% homology with the same enzyme from S. cerevisiae. In particular, a stretch of 24 amino acids with 100% sequence homology spans the putative ATP-binding region which is also conserved in T4 and T7 bacteriophage DNA ligases. PMID- 3549292 TI - Interaction of mitogenic bacterial lipoprotein and a synthetic analogue with mouse lymphocytes. Isolation and characterization of binding proteins. AB - Lipoprotein from the outer membrane of Escherichia coli constitutes a potent mitogen and polyclonal activator for B lymphocytes of different species. The binding of lipoprotein to murine spleen cells was investigated using water soluble 125I-labelled citraconylated lipoprotein from E. coli B/r. Our results indicate that the binding of this B-cell mitogen to splenocytes is a saturable, time- and dose-dependent, reversible process; about 9.7 X 10(8) lipoprotein molecules were bound to each cell. The mechanism of the binding of lipoprotein to lymphocytes was investigated by using the synthetic analogue of its N-terminal part, S-[2,3-bis(palmitoyloxy)-(2RS)-propyl]-N-palmitoyl-(R)-cysteinyl-( S)-seryl (S)-seryl-(S)-asparaginyl-(S)-alanine (tripalmitoyl pentapeptide). This compound had been shown by us previously to be the molecular part of lipoprotein responsible for mitogenicity and exhibited, in all experiments performed, a stimulatory activity towards B lymphocytes comparable, or even superior, to native lipoprotein. Binding proteins for the synthetic N-terminus were enriched by affinity chromatography, using an affinity column prepared by coupling the mitogenic compound to CPG-aminopropyl controlled-pore glass beads by the carbodiimide method. [3H]Leucine-labelled murine spleen cells were solubilized by the nonionic detergent NP40 and applied to the affinity adsorbent. Proteins bound to the column were selectively eluted by a solution of tripalmitoyl pentapeptide, and the fractions were analyzed by sodium dodecyl sulphate/polyacrylamide gel electrophoresis and autoradiography. Our results indicate the presence of a major binding protein of Mr 35000 on mouse primary lymphocytes for the biologically active N-terminal structure of lipoprotein, which might play a role as membrane receptor in mitogenic B lymphocyte activation. PMID- 3549294 TI - Reconstruction of peptidyltransferase activity on 50S and 70S ribosomal particles by peptide fragments of protein L16. AB - Ribosomal protein L16 was digested with Staphylococcus aureus protease V8 and the resulting peptides were separated by reversed-phase high-performance liquid chromatography. One of the fragments, identified by sequence analysis as the N terminal peptide of L16, was shown to exhibit partial peptide-bond-formation and transesterification activities of peptidyltransferase upon reconstitution with L16-depleted 50S core particles. However, several proteins enhanced these activities. L15 increased both reactions when added to the reconstitution mixture, suggesting a limited capacity of the L16 peptide to incorporate into 50S core particles. In contrast, the interaction of L11 with the N-terminal peptide stimulated the transesterification reaction but not the peptide-bond-forming activity of ribosomes, indicating a different topological domain for these reactions. Also, EF-P, a soluble protein which reconstructs the peptide-bond formation and transesterification reactions on 70S ribosomes, stimulated both peptidyltransferase activities exhibited by the L16 N-terminal peptide. PMID- 3549295 TI - Dissociation of the ribulosebisphosphate-carboxylase large-subunit binding protein into dissimilar subunits. AB - The ribulosebisphosphate-carboxylase large-subunit binding protein from Pisum sativum chloroplasts is an oligomer of two types of subunit with the composition alpha 6 beta 6. These two subunits are immunologically distinct, show different partial protease digestion patterns and have different amino-terminal sequences. Leaves of Hordeum vulgare also contain an oligomeric binding protein composed of equal amounts of two types of subunit. Treatment of either P. sativum stromal extracts or purified binding protein with ATP and Mg2+ ions causes the dissociation of the oligomeric form of the binding protein to the monomeric subunits. This effect is highly specific for ATP since CTP, UTP, GTP, ADP, AMP, cyclic AMP, NADPH and pyrophosphate do not cause dissociation. PMID- 3549296 TI - Antibodies to the photosystem I chlorophyll a + b antenna cross-react with polypeptides of CP29 and LHCII. AB - A chlorophyll (a + b)--protein complex associated with photosystem I (PSI) was isolated from a larger PSI complex (CPIa) produced by electrophoresis of barley thylakoids solubilized with 300 mM octyl glucoside. It had an apparent Mr of 35,000-43,000 on 7.5% and 10% acrylamide gels respectively, and a chlorophyll a/b ratio of 2.5 +/- 1.5. Denaturation released four polypeptides migrating between 21-24 kDa. They were well separated from the polypeptides of the two photosystem II chlorophyll a + b antenna complexes: LHCII (25-27 kDa) and CP29 (28-29 kDa). In order to study the PSI antenna complex, antibodies were raised against highly purified CPIa. The antigen appeared to be pure when electrophoresed, blotted and reacted with its antiserum, i.e. anti-CPIa detected only the 64-66-kDa CPI apoprotein and the four 21-24 kDa antenna polypeptides. However, when blotted against the whole spectrum of thylakoid proteins, it cross-reacted with both LHCII and CP29 apoproteins. Removal of anti-CPI activity from the anti-CPIa did not affect these cross-reactions, showing that they were not due to antibodies directed against CPI. To show that the same antibody population was reacting with both the photosystem I and photosystem II antenna polypeptides, anti-CPIa was adsorbed onto highly purified CPIa on nitrocellulose. The bound antibody was eluted and used again in a Western blot against whole thylakoid proteins. This selected antibody population showed the same relative strength of reaction with photosystem I and photosystem II antenna polypeptides as the original antibody population had. Similar observations have been made with antibodies to the two photosystem II antenna complexes. We therefore conclude that there are antigenic determinants in common among the chlorophyll a + b binding polypeptides, and predict that there could be amino acid sequence similarities. PMID- 3549297 TI - The N-terminal region of Escherichia coli lactose permease mediates membrane contact of the nascent polypeptide chain. AB - Plasmids encoding N-terminal segments of the Escherichia coli lactose permease (also referred to as lactose carrier) have been used to analyze the biosynthesis and membrane insertion of this complex integral protein of the cytoplasmic membrane. Such truncated polypeptides were found to be stably associated with the membrane and to resemble the full-length protein with respect to their solubilization characteristics. Membrane-bound and free cytoplasmic polysomes were prepared from plasmid-bearing cells and incubated in the presence of [35S]methionine to permit completion of polypeptides initiated in vivo. Under these conditions, lactose permease was found to be radiolabeled in the fraction of membrane-bound polysomes; beta-galactosidase, used as a control, was translated almost exclusively by free polysomes. From similar experiments with N terminal segments of lactose permease, we estimate that at most a polypeptide of 120 amino acid residues emerging from the ribosome is needed to target the nascent chain to the lipid bilayer and to mediate attachment of the ribosome to the membrane during elongation. Additional data support the idea that even shorter N-terminal sequences of 50 and 71 amino acid residues contain sufficient 'information' to provide contact with the membrane. PMID- 3549298 TI - Primary structures of three fragments of proglucagon from the pancreatic islets of the daddy Sculpin (Cottus scorpius). AB - Three peptides isolated from the Brockmann bodies of the daddy sculpin, a teleostean fish, have been identified as fragments of one or more proglucagons. The peptide L Q D A E D S S R F D A D D T L A G E A R E L S T P K represents the NH2 terminus of proglucagon (residues 1-27), H S E G T F S N D Y S K Y L E T R R A Q D F V Q W L K N S represents glucagon and H A D G T F T S D V S S Y L N D Q A I K D F V A K L K S G K V represents the glucagon-like peptide at the COOH terminus of the precursor. The fast-atom bombardment mass spectra of the three peptides were consistent with the proposed structures and demonstrated that further posttranslational modifications of the peptides had not taken place. Sculpin glucagon is identical to anglerfish glucagon II but sculpin proglucagon(1 27) and glucagon-like peptide show stronger homology to the corresponding regions of anglerfish proglucagon I than to proglucagon II. The structures of the peptides are suggestive of the action of trypsin-like and carboxypeptidase-B-like enzymes at the site of pairs of basic amino acid residues in proglucagon. The presence of a COOH-terminal lysyl group in proglucagon(1-27) may indicate, however, that the penultimate prolyl residue partially inhibits the action of the carboxypeptidase-B-like activity. PMID- 3549299 TI - Trypanothione reductase from Trypanosoma cruzi. Purification and characterization of the crystalline enzyme. AB - The structural differences between trypanothione reductase of Trypanosoma cruzi and human glutathione reductase, an enzyme of known three-dimensional structure, offer an opportunity for rational drug design against Chagas' disease. As a first step in the analysis of the parasite enzyme we report its purification and characterization. 2.2 mg trypanothione reductase was extracted from 33 g wet weight of cultured epimastigotes or from 4 g lyophilized cells. The flavoenzyme was purified 2400-fold to homogeneity in three steps with an overall yield of 45%. The enzyme is a dimer with a subunit Mr of 50,000. Using NADPH (Km = 5 microM) and trypanothione disulfide (Km = 45 microM) as substrates, a turnover number of 14,200 min-1 was estimated. Trypanothione reductase, the parasite enzyme, and glutathione reductase, the host enzyme, exhibit mutually exclusive specificities for their respective disulfide substrates. When screening cell cultures or column eluates for the presence of trypanothione reductase, a microassay based on Ellman's reagent as indicator was used. A mixture of regioisomeric glutathionylspermidine disulfides isolated from Escherichia coli served as substrate in this microassay. Experimentally, the catalytic cycle of the enzyme can be subdivided into the half-reactions Eox + NADPH + H+----EH2 + NADP+, and EH2 + trypanothione disulfide----Eox + dihydrotrypanothione. This is also true for the crystallized enzyme in the presence of 2 M (NH4)2SO4. The spectral properties of trypanothione reductase both in the oxidized form (Eox) and in the two-electron-reduced form (EH2) closely resemble those of human glutathione reductase. Both proteins contain a flavin and a redox-active disulfide at the catalytic site. After reduction of Eox to EH2, trypanothione reductase can be inactivated by specifically alkylating one of the nascent active site thiols. PMID- 3549300 TI - Investigations into the polymorphism of lipid A from lipopolysaccharides of Escherichia coli and Salmonella minnesota by Fourier-transform infrared spectroscopy. AB - The polymorphism of lipid A, the endotoxic principle of the lipopolysaccharides of gram-negative bacteria, has been investigated in the fully hydrated state at temperatures between 5 degrees and 58 degrees C via Fourier-transform infrared spectroscopy. These measurements were supplemented by X-ray diffraction, fluorescence intensity techniques and differential thermal analysis. Up to three distinct phase transitions could be detected, with the main transition temperatures lying at approximately 41 degrees, 46 degrees, 44 degrees and 47 degrees C for Escherichia coli lipid A, Salmonella minnesota lipid A, and the synthetic lipid A compounds 506 and 516, respectively. 4'-Monophosphoryl-lipid A samples exhibited their main transition temperatures at considerably higher temperatures (about 52 degrees C for E. coli lipid A). The analysis of greater than CH2 stretching absorption bands as well as the wide-angle scattering behaviour of the lipid A samples showed that the main transition apparently involved the completion of hydrocarbon chain melting of lipid A, as typically observed for phospholipids. However, the phase transition behaviour was found to be much more complex than that usually observed for model phospholipid systems. Even below the main transition temperature, considerable amounts of the methylene segments of the acyl chains of lipid A were found to assume gauche conformations. These conformational changes might be related to the occurrence of up to two further transitions located at about 22 degrees, 30 degrees, 27 degrees and 25.5 degrees C (first transition) and at about 34 degrees, 42 degrees, 38.5 degrees and 40.5 degrees C (second transition) for E. coli lipid A, S. minnesota lipid A and the synthetic lipid A compounds 506 and 516, respectively. Furthermore, by the analysis of some characteristic infrared absorption bands related to the hydrophilic backbone, it could be demonstrated that the temperature-induced conformational changes occurring within the hydrocarbon chains were constantly and simultaneously accompanied by detectable rearrangements within the interfacial region and the polar head group of lipid A. The following conclusions were drawn: Up to about 30 degrees C the lipid A assemblies were supposed to adopt virtually bilayered, true lamellar arrangements, as revealed by the analysis of greater than CH2 scissoring vibrations and X-ray diffraction pattern. However, as indicated by fluorometric techniques, no stable closed vesicles seemed to be formed even under these conditions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549301 TI - Biosynthesis and maturation of glucocerebrosidase in Gaucher fibroblasts. AB - The biosynthesis and maturation of glucocerebrosidase were studied in fibroblasts from patients with the neurological and non-neurological forms of Gaucher disease and in control cells. In control fibroblasts the precursor of glucocerebrosidase (62-63 kDa), observed after a short pulse with [35S]methionine, was converted during the chase period to a 66-kDa intermediate form and, finally, to the 59-kDa mature protein. In fibroblasts from patients with the non-neurological phenotype of Gaucher disease (type 1) the same biosynthetic forms were seen as in control fibroblasts. These biosynthetic forms correspond to the three-banded pattern seen in control and Gaucher type 1 fibroblast extracts analysed by the immunoblotting procedure, or after electrophoresis and fluorography of extracts of such fibroblasts cultured for 5 days with [14C]leucine. The 59-kDa protein seen in type 1 fibroblasts was unstable and disappeared after a prolonged chase; this disappearance was not observed when the cells were grown in the presence of leupeptin. In fibroblasts from patients with the neurological forms of Gaucher disease (types 2 and 3) the 62.5-kDa precursor of glucocerebrosidase was present in near-normal amounts after a short pulse, but the 59-kDa form was not detected even when cells were cultured with leupeptin. These results are in accordance with the absence of the 59-kDa band in immunoblots of types 2 and 3 fibroblast extracts. Culturing of type 1, type 2 and type 3 Gaucher fibroblasts in the presence of leupeptin led to an increase in the activity of glucocerebrosidase. PMID- 3549302 TI - Early increases in the frequency of DNA initiations and of phospholipid synthesis discontinuities after nutritional shift-up in Escherichia coli. AB - Cultures of Escherichia coli (strains ML30 and K12 AB1157), synchronized by repeated phosphate starvation, were submitted to nutritional shifts-up at various cell ages. The progression of the replication forks was assessed by DNA-DNA hybridization of pulse-labelled chromosomal DNA with plasmid DNA probes containing specific chromosomal sequences. The rate of phospholipid synthesis and its cyclic discontinuities were measured by continuous and pulse labelling with palmitate. The DNA-DNA hybridization experiments showed that a shift-up induces a burst of initiation from the oriC region. These hybridization results, taken together with older data from the literature, suggest that most DNA initiations belonging to this burst are not followed by complete replication. Following a shift-up, the rate of phospholipid synthesis is maintained for 13-20 min, depending on cell age at shift-up, then doubles. The new steady-state rate of phospholipid synthesis is reached through a series of three doublings, while the cell mass doubles approximately twice. This discrepancy brings the rate of phospholipid synthesis per mass unit to its steady-state postshift value. PMID- 3549303 TI - Mature bovine adrenodoxin contains a 14-amino-acid COOH-terminal extension originally detected by cDNA sequencing. AB - Since the nucleotide sequence of bovine adrenodoxin cDNA is at variance with protein sequencing data in that it encodes an additional 14 amino acids at the COOH terminus, we used a specific antibody raised against this 14-amino-acid segment to examine its presence in: nascent precursor polypeptide chains, the processed mature adrenodoxin and mitochondria of both steroidogenic and nonsteroidogenic tissues. These studies reveal the presence of the extra peptide in the precursor form derived from in vitro translation and in the newly synthesized mature form as shown by [35S]methionine labeling of proteins in adrenocortical cells. Both the purified COOH-terminal synthetic peptide and purified mature adrenodoxin competed with radiolabeled adrenodoxin for immunoprecipitation by the anti-peptide antibody. Immunoblots revealed the presence of the extra peptide in purified adrenodoxin and in bovine adrenocortical, corpus luteal, kidney and liver mitochondria while it was not detectable in heart mitochondria. Thus, we conclude that mature adrenodoxin and its homologs in non-steroidogenic tissues contain the C-terminal extension following uptake into mitochondria. These results indicate structural homology between adrenodoxin and the iron-sulfur proteins of the kidney and liver and also suggest the presence of a second iron-sulfur protein in kidney and liver. PMID- 3549304 TI - The macrophage-attachment glycoprotein gp63 is the predominant C3-acceptor site on Leishmania mexicana promastigotes. AB - The interaction between Leishmania promastigotes and their vertebrate host's complement system results not only in parasite lysis but also, due to surface bound complement components, in increased macrophage binding potential. In this study we demonstrate, with the use of isolated complement components, that activation is via the alternative complement pathway, initiated by direct deposition of C3 onto the parasite surface. The predominant C3 acceptor site on the promastigotes was initially identified as the glycoprotein gp63 by anti-C3 antibody immunoprecipitation of radioiodinated promastigotes following incubation in the alternative pathway initiators C3, and factors B and D. The C3-binding properties of gp63 were confirmed and quantified, in relation to other surface antigens, by incubating parasites in iodinated C3 and immunoprecipitating bound C3 with antibodies directed against different promastigote surface antigens. The other abundant surface antigen, the glycolipid 'excreted factor', did not show any C3-binding activity. Further demonstration was provided by incubating liposomes containing either gp63 or excreted factor in iodinated C3 and factors B and D. Only gp63-containing liposomes bound C3. Considering that both gp63 and the excreted factor have recently been implicated in attachment and uptake by macrophage, these findings may have considerable bearing in the determination of which of the macrophage surface receptors identify which parasite ligand. PMID- 3549305 TI - Characterization of insulin degradation by rat-liver low-density vesicles. AB - When incubated in vitro, isolated rat liver low-density vesicles degrade endocytosed insulin intraluminally. The rate of intravesicular degradation suggests that this pathway contributes significantly to insulin degradation in vivo. The vesicles can be selectively disrupted with digitonin at concentrations that abolish the latency of NADH pyrophosphatase, with minimal effect on the cisternal Golgi marker, galactosyl transferase. The results suggest that latent NADH pyrophosphatase may act as a marker enzyme for the vesicles within which insulin is degraded. The possible role of insulin-glucagon protease, a candidate enzyme for insulin degradation by the liver, was investigated. The activity of latent insulin-glucagon protease associated with low-density vesicles is sufficient to account for the rate of intravesicular proteolysis. However, the rate of intravesicular proteolysis is insensitive to membrane-permeant thiol reagents under conditions which strongly inhibit insulin-glucagon protease. This shows that insulin-glucagon protease is not rate-limiting for insulin degradation by these vesicles, and is unlikely to be involved in the regulation of degradation. After disruption with Brij, internalized insulin remains associated with the membrane. Degradation is not inhibited by addition of excess unlabelled insulin to the medium, and occurs more rapidly than the degradation of an equal activity of iodo-insulin added to the disrupted membranes. This implies that degradation of endocytosed insulin occurs while it is still bound to the inner surface of the vesicles. When bacitracin is coinjected with iodo-insulin, it inhibits degradation of internalized insulin both by intact and Brij-disrupted vesicles, but not the degradation of added exogenous insulin, confirming that degradation is membrane-associated, and that it does not require the release of insulin into free solution. PMID- 3549306 TI - Evidence that the N-terminal region of A1-light chain of myosin interacts directly with the C-terminal region of actin. A proton magnetic resonance study. AB - Earlier 1H-NMR experiments on the myosin subfragment-1 (S1) light chain isoenzymes from rabbit fast muscle, containing either the A1 or the A2 alkali light chains [S1(A1) or S1(A2)], have shown that the 41-residue N-terminal extension of A1, rich in proline, alanine and lysine residues, is freely mobile in solution but that this mobility is constrained in the acto-S1(A1) complex [Prince et al. (1981) Eur. J. Biochem. 121, 213-219]. It is now established that this N-terminal region of the A1-light chain interacts directly with the C terminal region of actin in the acto-S1(A1) complex. This was shown by covalently labelling the Cys-374 residue of actin with a spin-label and observing the enhanced relaxation this paramagnetic centre induced in the 1H-NMR spectrum of S1(A1). In particular, the signal arising from the -N+(CH3)3 protons of alpha-N trimethylalanine (Me3Ala) were monitored as this residue is uniquely sited at the N-terminus of the A1 light chain [Henry et al. (1982) FEBS Lett. 144, 11-15]. Experiments using complexes of actin with either the N-terminal 37-residue peptide of A1, S1(A1) or heavy meromyosin indicate that the N-terminal region of A1 is binding in a similar manner to actin in each case, with the N-terminal Me3Ala residue within 1.5 nm of the spin label introduced to Cys-374 of actin. A similar strategy was adopted to show that the Me3Ala residue can also be found close (less than 1.5 nm) to the fast-reacting SH1 thiol group on the S1 heavy chain. These data, together with published work, have been used to suggest a possible organisation for the polypeptide chains in the myosin head. PMID- 3549307 TI - Inhibition of ribosomal peptidyltransferase by chloramphenicol. Kinetic studies. AB - The mechanism of action of chloramphenicol in inhibiting peptide bond formation has been examined with the aim of discovering whether chloramphenicol brings about conformational changes in the peptidyltransferase domain, its target locus on the ribosome. These conformational changes have been sought as changes in the catalytic rate constant of peptidyltransferase. A detailed kinetic analysis of the inhibition of the puromycin reaction in a system derived from Escherichia coli [Kalpaxis et al. (1986) Eur. J. Biochem. 154, 267-271] has been carried out. There is an initial phase of competitive inhibition (Ki = 0.7 microM) in which the double-reciprocal plots are linear. This phase is observed at concentrations of chloramphenicol up to about 3.0 microM (4.3 Ki). By increasing the concentration of the inhibitor the kinetics change and the inhibition becomes no longer of the competitive type. These results are obtained when the inhibitor is added simultaneously with the substrate (puromycin). Preincubation with the inhibitor before the addition of puromycin gives hyperbolic double-reciprocal plots at inhibitor concentrations around the Ki. After preincubation with the inhibitor at concentrations above the Ki (3-100 Ki) the double-reciprocal plots are linear again and indicate complete, mixed non-competitive inhibition. Analogous behaviour is observed with thiamphenicol (Ki = 0.45 microM) and tevenel (Ki = 1.7 microM). It is proposed that initially chloramphenicol and its two analogs interact with puromycin at a ribosomal locus (peptidyltransferase domain) in a mutually exclusive binding mode (competitive kinetics). Soon after this initial interaction, the antibiotic induces conformational changes to the peptidyltransferase domain so that puromycin is accepted and peptide bonds are still formed but with a lower catalytic rate constant. At this latter state, the ribosome can accept both the inhibitor and the substrate (puromycin) but then, if the concentration of the inhibitor is sufficiently high, peptide bonds are not formed (complete, linear mixed non-competitive inhibition). PMID- 3549308 TI - Unequal crossing-over between two alu-repetitive DNA sequences in the low-density lipoprotein-receptor gene. A possible mechanism for the defect in a patient with familial hypercholesterolaemia. AB - We have previously identified a patient with familial hypercholesterolaemia (FH), where the defect appears to be caused by a deletion in the 3' region of the low density lipoprotein (LDL)-receptor gene. We have now isolated the LDL-receptor gene from the patient and have studied the defect at the DNA level. Restriction mapping and sequence analysis demonstrate that a 4-kb DNA deletion has occurred between two alu-repetitive sequences that are in the same orientation, one in intron 12 and the other in intron 14. This deletion eliminates exons 13 and 14, and changes the reading frame of the resulting spliced mRNA such that a stop codon is created in the following exon. Immuno- and ligand-blot analysis using cultured fibroblasts from this patient revealed the normal gene product, but failed to detect any smaller receptor protein. This implies that the truncated receptor protein that is synthesised is rapidly degraded. We suggest that in this patient the deletion is caused by an unequal crossing-over event that occurred between two homologous chromosomes at meiosis. PMID- 3549309 TI - A suprasternal approach to the mediastinum using real-time ultrasonography. Echoanatomical correlations. AB - This work was undertaken in order to define the potential capabilities of real time echography for the exploration of the mediastinum by a suprasternal approach. We present the results of a comparative study between anatomical frontal oblique sections of the mediastinum and echographic slices performed along the same planes from the suprasternal fossa. From these data, it seems possible to enlarge the applications of echography in the study of mediastinal pathology. PMID- 3549310 TI - Clinical significance of sonography of the ureter. AB - The relevance of sonography compared with conventional methods is demonstrated by means of 103 patients investigated with obstruction of the ureter. The knowledge of the exact topographic anatomy of the ureter in all sections enables the experienced investigator to demonstrate cause and position of ureteral obstruction by sonography in up to 75% of cases. Ultrasound is not sufficiently accurate to be used as the primary modality, but could be the initial modality in specific circumstances such as pregnancy, children or patients with a history of reaction to contrast media. PMID- 3549311 TI - Comparison of performance characteristics of different DSA-installations. AB - Standardized measurements of spatial resolution, contrast detectability, II entrance exposure and dynamic range were performed using simple and quick procedures for the assessment of performance characteristics. DSA-systems of different users and manufacturers can be compared with these performance criteria. Periodical measurements of performance are necessary to maintain a constant high image quality. The results of 10 DSA-systems demonstrate, that top of the line DSA-systems had a spatial resolution up to 1.2 lp/mm. and a contrast detectability up to 1 mm (10 mgI/ml) for an II-diameter of 22-26 cm. PMID- 3549313 TI - Serological diagnosis of Q fever endocarditis. AB - The diagnosis of Q fever endocarditis cannot be made by bacterial cultures and necessitates serological identification of specific antibodies to Coxiella burnetii which stimulates mainly the production of anti-phase II antibodies during the acute disease, but primarily anti-phase I antibodies in endocarditis. Indirect microimmunofluorescence allows rapid detection of specific IgA, IgG and IgM. The results of serological analyses of 191 acute cases of Q fever were compared with those of 8 cases of Coxiella burnetii endocarditis. All sera were evaluated by complement fixation and microimmunofluorescence tests. The highest titre differences between primary Q fever and Q fever endocarditis were observed with anti-phase I IgA and IgG antibodies measured by microimmunofluorescence followed by anti-phase I antibodies measured by complement fixation tests. Antiphase I IgG and IgM titres were consistently higher than anti-phase II titres in endocarditis. The reverse is true in acute Q fever. In addition, anti-phase I IgA appeared to be diagnostic for Coxiella burnetii endocarditis. Accordingly we recommend the testing of these specific IgA, IgG, and IgM by microimmunofluorescence in cases of culture-negative endocarditis. These tests could also prove useful for following the development of Coxiella burnetii endocarditis in patients under treatment. PMID- 3549312 TI - Left ventricular function following withdrawal of chronic metoprolol treatment in patients with ischaemic heart disease. A double blind study. AB - The effect on left ventricular function of a gradual withdrawal of chronic metoprolol treatment in postinfarction patients was studied. All patients were in a randomized double-blind postinfarction study with metoprolol (M 100-200 mg daily; N = 14) or placebo (P; N = 18). After three years treatment the study medication was gradually withdrawn during one week. M-mode echocardiography, guided by concomitant cross-sectional recordings, were performed before, one and 12 weeks after the withdrawal. Treatment (i.e. M or P) had to be reinstituted in eight patients (5 M; 3P) because of the development of disabling symptoms during the follow-up. Heart rate was lower in patients treated with M (57 +/- 4) than with P (69 +/- 10) (p less than 0.01). One week after withdrawal of M, heart rate had increased to 77 +/- 13 (p less than 0.001), while patients on P showed no significant change. In order to minimize the influence of heart rate on the evaluation of time intervals in the cardiac cycle, heart rate dependent correction factors were used. One week after M withdrawal there was a prolongation of the pre-ejection period (PEP) from 120 +/- 15 ms to 133 +/- 16 ms (p less than 0.01), mainly due to a prolongation of the interval for early isovolumetric contraction (Q Mc) from 87 +/- 10 ms to 101 +/- 11 ms (N = 11; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549314 TI - Infection of cardiac mural thrombus associated with left ventricular aneurysm. AB - Infection is a rare complication of cardiac mural thrombus and may prove difficult to diagnose and treat. We describe a patient with infected thrombus associated with a left ventricular aneurysm, involving Salmonella typhimurium. Cross-sectional echocardiography proved helpful in establishing the diagnosis. PMID- 3549315 TI - Leukocyte protease activities in myotonic dystrophy: studies on effects of protease inhibitors. AB - Neutral and acid protease activities inhibited by chymostatin, leupeptin, pepstatin and HgCl2 in mononuclear cells and granulocytes showed no significant differences between myotonic dystrophy patients and controls. These results suggest that chymotrypsin and cathepsin B and D activities are probably normal in leukocytes in myotonic dystrophy. PMID- 3549317 TI - European studies with cisplatin and cisplatin analogs in advanced ovarian cancer. PMID- 3549316 TI - Trigeminal neuralgia: its treatment with two new carbamazepine analogues. AB - The dihydroketo and dihydromonohydroxy analogues of carbamazepine (GP 47680 and GP 47779) were tested against carbamazepine for efficacy and tolerability in 13 patients (6 male and 7 female, mean age 69 years) and 11 patients (5 male and 6 female, mean age 64 years), respectively, all of whom were suffering from trigeminal neuralgia. Both derivatives brought about freedom from symptoms or a marked reduction in the pain in all patients. Onset of effect was observed within 48 h in most cases. For both analogues the effective dose was between 10 and 20 mg/kg body weight in most patients. There was a linear relationship, with a correlation coefficient of 0.83 (n = 36; p less than 0.001), between the doses and the serum level. Doses almost twice as high as those of carbamazepine are needed in order to achieve freedom from symptoms with the carbamazepine analogues. Since unwanted effects, in the form of dizziness and ataxia, occur much less frequently than with carbamazepine, the analogues can be administered in higher doses. PMID- 3549318 TI - Significance testing in the comparison of survival curves from clinical trials of cancer treatment. PMID- 3549319 TI - Effect of cyclosporin on serum creatinine in patients with rheumatoid arthritis. AB - Serum creatinine levels were measured before, during and after the administration of cyclosporin (Cy) in a double-blind placebo-controlled study in patients with rheumatoid arthritis (RA). The level rose significantly during and after Cy therapy, whereas the initial serum creatinine value did not change in the placebo group. The increase in the Cy group was not correlated with the mean Cy blood level. The rise in serum creatinine during Cy therapy was gradual and was not significantly correlated with the initial creatinine level; relative to the pretreatment value, the post-treatment increase was significantly correlated with the increase during Cy therapy. It is concluded that Cy administration for not more than 6 months, and at a maximum dosage of 10 mg/kg for 2 months, leads to an irreversible loss of more than 10% of renal function in RA patients. The damage may be ascribed to the combination of Cy with other factors compromising the kidneys, e.g., the use of non-steroidal anti-inflammatory drugs in the potentially systemic disorder of RA. PMID- 3549320 TI - The influence of ibuprofen, diclofenac and sulindac on the blood pressure lowering effect of hydrochlorothiazide. AB - In an open triple crossover study in 8 patients with essential hypertension, the possibility has been investigated of whether the blood pressure lowering effect of hydrochlorothiazide 50 mg once daily was attenuated by co-administration for 4 weeks of ibuprofen 400 mg t.i.d., diclofenac 25 mg t.i.d. or sulindac 200 mg b.i.d. Only a slight, statistically nonsignificant change was found, with the exception of a significant increase in systolic blood pressure after 4 weeks treatment with ibuprofen. There was considerable variation in the blood pressure response during treatment with all three NSAIDs, with slight rises in blood pressure in 13 out of 24 periods. Body weight increased significantly on treatment both with ibuprofen and diclofenac, whereas the increase on sulindac was less and was transient. No significant change was found in various biochemical parameters, including plasma electrolytes, plasma renin activity (PRA), aldosterone, albumin and creatinine, in haematocrit or in the 24-h urinary excretion of sodium and potassium. The sole exception was a decrease in PRA during ibuprofen treatment. From these observations it is concluded that ibuprofen and diclofenac differ from sulindac in their interaction with the diuretic action of hydrochlorothiazide. It appears that all three NSAIDs can safely be combined with hydrochlorothiazide in hypertensive patients, but blood pressure should be monitored carefully when an NSAID are added. PMID- 3549321 TI - Pharmacokinetics of budesonide in children with asthma. AB - The pharmacokinetics of the glucocorticoid budesonide was studied in 6 children with asthma after i.v. injection of 0.5 mg and oral inhalation of 1 mg as an aerosol. Budesonide is a 1:1 mixture of the epimers 22 S and 22 R, which were assayed separately by HPLC combined with RIA. All pharmacokinetic parameters of the epimers differed except the half-life of about 1.5 h. It was significantly shorter than that reported in adults. Plasma clearance averaged 103 l X h-1 for epimer 22 R and 74 l X h-1 for epimer 22 S; calculated per kg body weight these values were about 50% higher than in adults. The difference was about 40% when calculated per m2 of body surface area. Since budesonide is a high-clearance drug, the data indicate higher liver blood flow X kg-1 body weight and m2 of body surface area in children. The systemic availability of the aerosol was approximately 30% of nominal dose, i.e. the same as in adults. The high clearance and short half-life of budesonide in children are advantageous in reducing the risk of possible systemic side-effects of prophylactic treatment of asthma in childhood. PMID- 3549322 TI - The effect of propranolol on urinary prostaglandin E2 after frusemide administration in healthy subjects. AB - We have evaluated the effect of propranolol on urinary prostaglandin E2 (PGE2) excretion after frusemide administration in 8 healthy subjects. Urine was collected for 60 min after frusemide administration (20 mg intravenously) with or without propranolol pretreatment, and urinary excretion of PGE2, frusemide, and sodium were determined. Plasma renin activity (PRA) was also measured before and 60 min after frusemide administration. Urinary PGE2 excretion after frusemide administration and frusemide-stimulated PRA were reduced after propranolol pretreatment. However, urine volume and the urinary excretion of frusemide and sodium were not influenced by propranolol pretreatment. These results suggest that urinary PGE2 excretion after frusemide administration may be reduced by propranolol and that the mechanism responsible for the effect of propranolol on the frusemide-induced renal PGE2 production may be, at least in part, secondary to inhibition of the renin-angiotensin system. PMID- 3549323 TI - Comparison of the clinical hypnotic effects of zopiclone and triazolam. AB - In a double blind crossover therapeutic trial the hypnotic effect of Zopiclone 7.5 mg and Triazolam 0.5 mg given orally at bedtime for 7 consecutive days have been compared. 5 of the items in Spiegel's questionnaire and 12 of the 18 items in Norris' visual analogue scale were significantly more improved by Zopiclone than by Triazolam. Both drugs caused few side-effects. PMID- 3549324 TI - Genetic variation in the human hepatic cytochrome P-450 system. AB - Studies in rodents indicate that the cytochrome P-450 system consists of a superfamily of heme proteins, produced by clusters of structural genes on different chromosomes. Equivalent P-450s of different species show more homologies than members of different P-450 families within a species. The Ah receptor serves the induction of members of one of the cytochrome families. The human structural gene for the methylcholanthrene-inducible P1-450 is located on Chromosome 15. This gene has been completely sequenced. The human Ah receptor is also measurable. New methods to measure inducibility in man involve new lymphocyte bioassays and mRNA determinations, while in vivo biotransformation studies of caffeine allow estimates of the state of induction. Structural genes for phenobarbital-inducible cytochromes have been localized to Chromosome 19. The deficiency of biotransformation of debrisoquine and sparteine continues to be explored intensely. Linkage studies indicate the gene for the variable cytochrome P-450 to be located on Chromosome 22. The deficiency is more likely due to structural variation than absence of the cytochrome. Inhibiting drugs can mimic the genetic defect. Many pharmacological and toxicological consequences of the deficiency have been defined. The main characteristics of the genetic deficiencies affecting the metabolisms of mephenytoin, phenytoin, tolbutamide, nifedipine and of methyl cysteine were outlined briefly. PMID- 3549326 TI - Plasmodium falciparum-specific human T cell clones: recognition of different parasite antigens. AB - T lymphocyte clones specific for malarial (Plasmodium falciparum) blood stage antigens were obtained from acutely infected patients or from donors living in a malaria-endemic area of West Africa. Thirty-four clones carrying the CD4 antigen, and one CD8+ clone, were tested in a proliferation assay for their capacity to recognize P. falciparum isolates of different geographical origins. Only one clone distinguished between different parasite isolates (it failed to react with a parasite isolate originating from East Africa, but did recognize West African and Asian isolates). All of the clones responded well to intact erythrocytes containing viable parasites, but some responded poorly to extracts of parasitized cells. Eight of 19 clones studied (all CD4+) recognized parasite antigens which had characteristic mobilities in sodium dodecyl sulfate-containing polyacrylamide gels. The antigens had apparent molecular weights of about 20,000, 35,000, 40,000, 120,000, 150,000-200,000 and 200,000. These results (together with a previous report of two clones recognizing an antigen of molecular weight about 50,000, Sinigaglia and Pink, EMBO J. 1985. 4:3819) show that T cells in infected individuals react with at least 6 different parasite proteins. PMID- 3549325 TI - Miglitol may have a blood glucose lowering effect unrelated to inhibition of alpha-glucosidase. AB - Miglitol is an alpha-glucosidase inhibitor which lowers blood glucose and insulin concentrations in healthy volunteers after a starch meal. It also lowers blood glucose concentrations after a starch meal in patients with non-insulin-dependent diabetes mellitus, but under these circumstances insulin is unaffected. We have studied the effect of miglitol after a glucose load in six healthy male volunteers. Although one would expect an alpha-glucosidase inhibitor to have no effect on blood glucose concentrations after a glucose load, miglitol produced a significant decrease in blood glucose concentrations after the absorption peak. This could be due to enhancement of insulin effects or to depression of anti insulin factors. PMID- 3549327 TI - Sialylation patterns of lymphocyte function-associated antigen 1 (LFA-1) differ between T and B lymphocytes. AB - Lymphocyte function-associated antigen 1 (LFA-1) was immunoprecipitated from various types of surface-radioiodinated murine lymphocytes, and analyzed by two dimensional polyacrylamide gel electrophoresis. LFA-1 alpha and beta chains from splenic B lymphocytes had the same apparent molecular weights as, but distinct isoelectrofocusing patterns from, their counterparts from thymocytes or splenic T lymphocytes. The splenic B lymphocytes lacked a basically charged population of alpha chain, while the thymocytes and the splenic T lymphocytes showed both the acidic and the basic portions. Furthermore, the beta chain of the former migrated more towards the acidic end than that of the latter. No difference was found between LFA-1 molecules of the same lineage of cells from several strains of mice whose H-2 haplotypes were different from one another. When murine lymphocyte lines were examined, LFA-1 with various isoelectrofocusing patterns were recognized. The charge difference again reflected the difference in lymphocyte lineage, but in a more exaggerated manner than that seen with cells from mice. The average acidity of both chains of LFA-1 decreased in the order of B cell lines, pre-B cell lines and T cell lines. The lineage-dependent charge difference of either chain disappeared after neuraminidase treatment of LFA-1, indicating that lymphocyte differentiation was accompanied by changes in LFA-1 sialylation. PMID- 3549329 TI - CNS-endocrine pancreas system. V. The paraventriculo-vagal concept on regulation of the endocrine pancreas. PMID- 3549328 TI - Cyclosporin A does not affect the in vitro induction of antigen-specific delayed type hypersensitivity-mediating T cells. AB - The effect of cyclosporin A (CsA) on the in vitro induction of sheep red blood cell (SRBC)-specific T cells mediating the delayed-type hypersensitivity (DTH) reaction was studied. CsA (1 microgram/ml) addition to the culture medium totally inhibits the in vitro anti-SRBC humoral response but does not interfere with the generation of anti-SRBC DTH-mediating T (TDTH) cells. The induction of TDTH requires the presence of antigen and their expression is mediated selectively by the antigen used in the culture. The TDTH cells generated are Lyt-1+,2- and their induction occurs with a similar efficiency in CsA-treated and untreated cultures: the frequency of the TDTH cells increases by a factor of 10 to 20 during the 6 day incubation period. Lyt-2+ suppressor cells are also generated in CsA-treated or untreated cultures. Our results suggest that a small fraction of T cells can be driven into the proliferative pathway by antigen even in presence of CsA. PMID- 3549330 TI - The nonenzymatic glycation of proteins and nucleic acids, their importance for the development of diabetic complications, possible molecular basis of aging and autoimmunological processes. AB - The formation of nonenzymatic glycation products of proteins and nucleic acids appears to be a link between chronic hyperglycaemia and long-term diabetic complications and special forms of aging during normoglycaemia. The major effects of extended glycation include cross-linking of glycated proteins, attachment of soluble proteins to extracellular glycated matrices, conformational changes of proteins followed by altered functions and immunogenicity, and abnormalities in nucleic acid functions. PMID- 3549331 TI - Some characteristics of soluble thyroid proteins in human fetus during morphogenesis of follicular structure. AB - Soluble thyroid proteins of the human fetus were studied in parallel with the formation of the follicular structure of the gland using polyacrylamide disc electrophoresis and a radioimmunological method for measuring thyroglobulin (Tg). The study covered 24 fetuses obtained after sectio parvae performed at 12-28 weeks of gestation for socio-medical reasons. Before the first trimester of gestation the human fetal thyroid, which did not have an organized follicular structure contained a significant amount of the 12S protein fraction, but only trace amounts of Tg. In the cells of a gland of afollicular structure immunofluorescent material was confirmed by reaction with anti-Tg antibodies. Later, with the formation of follicles and the appearance of follicular colloid, the absolute and relative amounts of Tg in the fetal gland increased, while the 12S subunit decreased. The Tg content in the fetal thyroid was positively correlated with the total weight of the gland, i.e. gestational age. The T4 and T3 contents in Tg of human fetal thyroids (20-24 weeks) amounted to 0.54 +/- 0.39 and 0.12 +/- 0.09 mole/Tg mole, respectively. The 27 S iodoprotein was not found in any of the extracts of fetal thyroids with formed follicles and considerable amounts of follicular colloid. The finding of the 12 S protein in the human thyroid during early fetal life, i.e. in the prefollicular phase, implies a low rate of aggregation of Tg subunits (12 S). The absence of the 27 S iodoprotein from the fetal thyroid with organized follicular structure suggests the yet incomplete morphological and biochemical maturation of the fetal gland. PMID- 3549332 TI - The effects of epidermal growth factor on neural crest cells in tissue culture. AB - Epidermal growth factor (EGF) stimulates the release of hyaluronic acid (HA) and chondroitin sulfate proteoglycan (CSPG) from quail trunk neural crest cultures in a dose-dependent fashion. It also promotes the expression of cell-associated heparan sulfate proteoglycan (HSPG) as detected by immunofluorescence and immunoprecipitation of the 3H-labeled proteoglycan. Furthermore, EGF stimulates [3H]thymidine incorporation into total cell DNA. These results raise the possibility that EGF or an analogous growth factor is involved in regulation of neural crest cell morphogenesis. PMID- 3549334 TI - Mercurated nucleic acid probes, a new principle for non-radioactive in situ hybridization. AB - This report describes the localization of specific nucleic acid sequences in interphase nuclei and metaphase chromosomes by a new hybridocytochemical method based on the use of mercurated nucleic acid probes. After the hybridization a sulfhydryl-hapten compound is reacted with the hybrids formed. A number of such ligands were synthesized and tested. A fluorescyl ligand could be used for the direct visualization of highly repetitive sequences. For indirect immunocytochemical visualization trinitrophenyl ligands were found to be more sensitive than biotinyl analogues. These ligands were applied for the detection of target sequences in metaphase chromosomes and interphase nuclei of somatic cell hybrids, human lymphoid cell lines and blood cell cultures. The sequences were in the range of high to low copy numbers. The lower limit of sensitivity is indicated by the visualization of two human unique DNA fragments (40 and 15.6 kb) in human metaphases. The method is rapid, gives consistent results and can be used for both RNA and DNA probes. Other potentials of the new principle are discussed. PMID- 3549333 TI - Evidence of the presence of a specific vascular endothelial growth factor in fetal bovine retina. AB - The presence of a vascular endothelial cell growth factor (VEGF) in the retina was reported in a previous study. The present experiments show that VEGF exhibits a pronounced synergism with the serum-derived factor and the vascular endothelium (VE) effectors in stimulating the proliferation of vascular VE cells. VEGF shows a chromatographic multiplicity with the 25,000-D component as the smallest subunit. Mg2+ is the specific divalent cation that retains the VEGF molecule in the aggregated form and enhances the activity, both total and specific. In addition, VEGF is highly specific for endothelial cells and is distinctly different from FGF, EGF, and insulin in terms of molecular weight (MW) and cell specificity. Under our assay conditions, VEGF has no stimulatory effect on other cell lines examined, including lens epithelial cells, corneal epithelial cells, corneal keratocytes, Walker 256 carcinoma, and fibroblasts. These findings indicate that VEGF possesses characteristic properties not reported for other growth factors, and that VEGF is distinctly different from the growth factors isolated from the retina in other laboratories. The present study suggests that VEGF in the retina represents a new type of growth factor. The need to employ a highly defined assay condition could have eluded the detection of this factor in other laboratories. PMID- 3549335 TI - Actin in B16 melanoma cells of differing metastatic potential. Effects of trypsin and serum. AB - Actin is present in cells in monomeric and polymeric (filamentous) forms. Filamentous actin is distributed in Triton-soluble (cytosolic) and Triton insoluble (cytoskeletal core) fractions. We have used the DNase 1 inhibition assay and immunofluorescence to investigate the distribution of actin in monomeric and polymeric forms in cloned B16 murine melanoma cell lines of low and high metastatic capacity. The protease trypsin caused rounding up and detachment of both cell lines within 5 min. This was associated with almost complete depolymerization of cytosolic actin filaments but the Triton-insoluble cytoskeleton was not quantitatively affected by trypsin treatment. There were quantitative differences between the clones in their response to incubation in the presence or absence of 10% serum. The highly metastatic cell line contained 35% more actin when incubated in the presence of 10% serum, almost completely distributed to the Triton-insoluble cytoskeleton, an effect not seen in the low metastatic cells. PMID- 3549336 TI - Induction of meiotic maturation in Xenopus oocytes by 12-O-tetradecanoylphorbol 13-acetate. AB - Fully grown Xenopus oocytes are physiologically arrested at the G2/prophase border of the first meiotic division. Addition in vitro of progesterone or insulin causes release of the G2/prophase block and stimulates meiotic cell division of the oocyte, leading to maturation of the oocyte into an unfertilized egg. The possibility that the products of polyphosphoinositide breakdown, diacylglycerol and inositol-1,4,5-trisphosphate (IP3-, are involved in oocyte maturation was investigated. Microinjection of IP3 into oocytes just prior to addition of progesterone or insulin accelerated the rate of germinal vesicle breakdown (GVBD) by up to 25%. Half-maximal acceleration occurred at an intracellular IP3 concentration of 1 microM. Treatment of oocytes with the diacylglycerol analog and tumor promoter, 12-O-tetradecanoylphorbol 13-acetate (TPA) induced GVBD in the absence of hormone. Half-maximal induction of GVBD occurred with 150 nM TPA and was blocked by pretreatment of oocytes with 10 nM cholera toxin. Microinjection of highly purified protein kinase C from rat brain into oocytes did not induce maturation but markedly accelerated the rate of insulin-induced oocyte maturation. However, injection of the enzyme had no effect on progesterone action. In oocytes with a basal intracellular pH below 7.6, TPA increased intracellular pH, but GVBD occurred with TPA in Na-substituted medium. Neomycin, a putative inhibitor of polyphosphoinositide breakdown, reversibly inhibited insulin- but not progesterone-induced maturation. Half-maximal inhibition occurred at 1.6 mM neomycin. These results indicate that protein kinase C is capable of regulating oocyte maturation in Xenopus. PMID- 3549337 TI - Bacterial populations on dressed pig carcasses. AB - Samples were collected at two abattoirs from four sites on pig carcasses as they were being placed in a chiller. Bacteriological examination showed that no single sampling site could be used to assess the microbiological status of pig carcass surfaces. Sampling from multiple sites on a carcass may be required to assess the degree of contamination by different bacteria. It is suggested that the hygiene of slaughtering and dressing of pig carcasses at an abattoir cannot be assessed on a single visit and that a number of visits are necessary to establish a hygiene pattern. PMID- 3549338 TI - The prevalence of human isolates of Salmonella subspecies II in southern Africa. AB - The Salmonella Reference Centre in Johannesburg received 14059 strains of human origin between 1979 and 1984. A significant proportion (6.3%) proved to belong to subspecies II. The majority were cultured from faecal material, usually associated with symptoms related to the gastrointestinal tract. They comprised 884 isolates, represented by 203 serotypes, of which 45 were new serotypes. The poor hygienic conditions found in many rural areas, together with possible contamination of food and water by wild animals, may contribute to the greater frequency of human S.II infections and the widespread occurrence of unusual serotypes in man in this geographic region. PMID- 3549339 TI - Poultry waste associated type C botulism in cattle. AB - Botulism in UK cattle has been confirmed by demonstrating type C botulinum toxin in sera from affected animals. Evidence is presented indicating the source of intoxication to be poultry carcasses containing type C Clostridium botulinum and its toxin. The organism was also found in poultry litter and in alimentary tract samples from slaughtered animals. The implications of these findings are discussed. PMID- 3549340 TI - Experimental infection of badgers (Meles meles) with Mycobacterium bovis. AB - The intradermal inoculation of four badgers with small numbers of Mycobacterium bovis resulted in localized lesions with ulceration which slowly healed by 5 months after inoculation. Lesions of generalized tuberculosis were seen in three badgers, one of which died at 17 months post-inoculation and in the remaining two killed 22 months post-inoculation. In the fourth badger lesions were confined to the draining lymph node of the inoculation site but M. bovis was isolated from the liver. Monthly clinical sampling of faeces, urine, tracheal aspirate and inoculation site exudates detected only the excretion of M. bovis from the inoculation site of one badger. There were marked seasonal variations in body weight but significant weight loss was observed during the second year in all four badgers, particularly prior to death. Four badgers inoculated intratracheally with a similar inoculum of M. bovis and another two control badgers showed no evidence of infection with M. bovis. PMID- 3549341 TI - The immunological consequences of challenge with bovine tubercle bacilli in badgers (Meles meles). AB - Optimal conditions were determined for performing antibody measurements (ELISA), lymphocyte transformation tests and, to some extent, skin tests in badgers. These parameters, together with the bacteriological and pathological studies reported previously (Pritchard et al. 1987), were used to follow the course of intradermal and intratracheal challenge of badgers with bovine tubercle bacilli. Two challenge doses were used for each route of infection and two animals received each dose. None of the four animals challenged by the intratracheal method showed any evidence of infection, suggesting that adult badgers may have some resistance to challenge by this method. All four animals challenged intradermally developed lesion of tuberculosis. Immunologically the disease passed through three phases. There was an early phase in which lymphocyte transformation to whole BCG steadily and significantly increased, and skin tests to tuberculin became positive but there was little change in antibody levels. This was followed by an intermediate phase of variable skin responses, fluctuating lymphocyte transformation and significant increase in antibody levels. The final phase, which was only seen in two animals with extensive disease, was associated with changing skin reactions and falling lymphocyte responses, together with a sudden increase in antibody levels. This paper presents the first formal evidence of cell-mediated immunity to tuberculosis in the badger, which may delay onset and prolong the survival of challenged animals. PMID- 3549342 TI - Experimental infection of monkeys with Leptospira interrogans serovar hardjo. AB - Grivet monkeys experimentally infected with two different strains of Leptospira interrogans serovar hardjo showed no signs of severe clinical disease. There were no significant macroscopic lesions in any of the tissues examined, but the organisms were demonstrated in various tissues by immunofluorescent technique and were isolated from the blood and urine of two monkeys and the kidney of one. Abraded skin was shown to be a viable route of infection in non-human primates. PMID- 3549343 TI - Q fever in the Netherlands: a sero-epidemiological survey among human population groups from 1968 to 1983. AB - A sero-epidemiological survey, using an indirect immunofluorescence test for IgG against Coxiella burnetii (phase II), was carried out in the Netherlands. Serum samples taken in 1968, 1975, 1979 and 1983 were tested. Occupational groups with a supposedly high risk of infection (veterinarians, residents of dairy farms and taxidermists) showed a significantly higher percentage of seropositives than defined controls. The percentage of seropositive amateur wool spinners was significantly higher than that of the controls from the same region. Since 1968 there has been no increase in the percentage of infected persons, indicating that, contrary to earlier assumptions, Q fever has been endemic in The Netherlands for a long time already. The increase in numbers of notified cases of overt Q fever is considered to be the result of the recent introduction of a sensitive indirect immunofluorescence test for IgM antibodies against C. burnetii. Antibody percentages in all age classes between 1 and 64 years were much alike, suggesting that most infections occur in early childhood. This is in accordance with the finding that 35% of our patients are younger than 3 years. The possibility of infection related to childbirth and lactation is discussed. PMID- 3549344 TI - Escherichia coli flagellar serotyping is as reliable as it has always been! PMID- 3549345 TI - Glial fibrillary acidic protein increases in Muller cells after retinal detachment. AB - Retinal detachment, separation of the neural retina from the retinal pigment epithelium (RPE), initiates a series of changes in the eye which result in loss of vision if the retina is not rapidly reattached to the RPE. Many of the complex effects of this separation on the cell biology of the retina have yet to be determined. We report here a change in the amount and location of a specific cytoskeletal protein, glial fibrillary acidic protein (GFAP), within Muller cells after retinal detachment. Cat neural retina and RPE were separated by injecting fluid into the extracellular space between the retina and RPE. Normal retinas and retinas detached for 30 days were fixed and embedded for conventional electron microscopy or immunocytochemistry, or homogenized and processed by SDS-PAGE for immunoblot analysis with anti-GFAP. In normal retinas and in attached retinal regions of eyes with retinal detachment, GFAP was detected only in the end feet of the Muller cells as 10 nm diameter filaments and as a diffuse component over the cytoplasm. By contrast, in regions where the retina was detached from the RPE, GFAP was localized throughout the Muller cells in both of these forms. Immunoblots revealed a significant increase in anti-GFAP labeling of a 51,000 MW band from the detached retina. PMID- 3549346 TI - Cancer and aging. AB - It is widely accepted that the incidence of cancer increases with aging and many hypotheses have been put forward to explain this association. A review of the literature, however, shows that the relationship between cancer and aging has to be reappraised. Although the incidence of most cancers increases during the second half of the animal life span, only with a few does it increase progressively with senescence in humans as well as in animals. As a matter of fact in many cases the incidence does not vary, levels off or even decreases in old individuals. Late developing tumors also seem in many instances to progress more slowly. Thus it seems that the incidence of cancer is related to age rather than to aging and that some conditions may be created during senescence which oppose the development of some cancers. PMID- 3549347 TI - Choline acetyltransferase (ChAT) immunoelectron microscopy distinguishes at least three types of efferent synapses in the organ of Corti. AB - Using anatomical criteria, the olivo-cochlear fibers ending in the organ of Corti (efferent fibers) have recently been separated into two systems: a lateral system innervating principally the inner hair cell (IHC) area and a medial system innervating mainly the outer hair cells (OHCs). Electrophysiological and biochemical experiments suggest that acetylcholine may be a neurotransmitter of these efferent fibers. However, efferent synapses that use acetylcholine as neurotransmitter have not yet been identified at the electron microscopic level. Using a pre-embedding immunoelectron microscopic technique with a monoclonal antibody against choline acetyltransferase (ChAT), we localized ChAT immunostained fibers below both the IHCs and OHCs. In the inner spiral bundle, one type of ChAT-immunostained fibers was vesiculated and formed axo-dendritic synapses with the afferent auditory dendrites contacting the inner hair cells. A second type of ChAT-immunostained fibers seen in the inner spiral bundle was unvesiculated. Unstained vesiculated varicosities synapsing with the auditory dendrites were also seen in the inner spiral bundle. At the OHC level, ChAT immunostaining was found in nearly all the terminals synapsing with the OHCs. The finding of two types of ChAT-immunostained efferent synapses in the organ of Corti, i.e. axo-dendritic synapses in the inner spiral bundle and axo-somatic synapses with the OHCs, supports the hypothesis that both the lateral and the medial olivo-cochlear systems use acetylcholine as a neurotransmitter. The finding of numerous unstained synapses in the inner spiral bundle, and some below OHCs, together with previous data about putative cochlear neurotransmitters, suggests the possibility of additional non-cholinergic olivo-cochlear systems. It might soon appear useful to reclassify efferents according to the nature of the different neurotransmitters/co-transmitters found in the various efferent synapses of the organ of Corti. PMID- 3549348 TI - Origin of leucine-enkephalin fibers and their two main afferent pathways in the bed nucleus of the stria terminalis in the rat. AB - The destruction of the central amygdaloid nucleus (Ce), which contains a large group of neurons with leucine-enkephalin (L-ENK)-like immunoreactivity (L-ENKI), resulted in a marked ipsilateral reduction of these fibers in the bed nucleus of the stria terminalis (BST) suggesting that L-ENKI neurons in the Ce project ipsilaterally to the BST. This was supported by the finding that injection of biotin-wheat germ agglutinin into the BST labeled many neurons in the Ce. Simultaneous staining with antiserum showed that some of these neurons are L ENKI. The L-ENKI fibers from the Ce reach the BST via two pathways; one from the venral amygdalofugal pathway (VA), which terminate in the ventral subdivision of the BST pars lateralis (BSTL), and the other from the stria terminalis (ST), which terminates in the lateral subdivision of the BSTL, because accumulation of L-ENKI structures appeared in the axons of these two systems on the amygdaloid side, transection or destruction of the ST alone caused only a slight reduction of ENKI fibers in the lateral subdivision of the BSTL ipsilaterally and transection or destruction of VA alone markedly reduced the number of L-ENKI fibers in the ventral subdivision of the ipsilateral BSTL. Thus, the VA L-ENKI fiber system is the major source of L-ENKI fibers in the ventral subdivision, while the ST L-ENKI fiber system is a minor source of the L-ENKI fibers in the lateral subdivision. The presence of an intrinsic L-ENKI system in the BST which may innervate the lateral subdivision was also suggested. PMID- 3549349 TI - Carnosine-like immunoreactivity in the primary olfactory neuron of the rat. AB - Using the peroxidase-antiperoxidase immunohistochemical technique, carnosine-like immunoreactivity was demonstrated to localize specifically within the primary olfactory neuron. PMID- 3549350 TI - Insulin-like effect of dichloroacetic acid on hexose transport in Swiss 3T3 cells. AB - Hexose transport in Swiss 3T3 cells was increased by treatment with dichloroacetic acid as well as by treatment with insulin. Neither extra- nor intracellular Ca2+ was found to be involved in their stimulatory action. On the other hand, the removal of intracellular Mg2+ resulted in a loss of the stimulation. These results suggest that dichloroacetic acid stimulates the hexose transport in Mg2+-dependent manner, similar to that of insulin. PMID- 3549351 TI - Effect of acute ozone exposure on the proteinase-antiproteinase balance in the rat lung. AB - Lung disease may result from a persisting proteinase excess or a depletion of antiproteinase in pulmonary parenchyma. We investigated the in vivo effect of a 48-hr exposure to ozone at 0.5, 1.0, or 1.5 ppm on proteinase and antiproteinase activity of rat lungs. Elastase inhibitory capacities of serum, lung tissue, and airway washings were measured as indicators of antielastase activity. Trypsin inhibitory capacity was measured using an esterolytic procedure. Proteinase was measured as radioactive release from a 14C-globin substrate. The 48-hr exposures to O3 at levels up to 1 ppm produced concentration-dependent decreases of 35-80% of antiproteinase activities in serum and in lung tissue. However, exposure to 1.5 ppm O3 resulted in no decrease in antiproteinase activities. Acid proteinase activities (pH 4.2) were increased 65-120% by exposure to 1 or 1.5 ppm O3, which correlated with inflammatory cells noted histologically. At 1.5 ppm O3, pulmonary edema and hemorrhage were noted in histologic sections. These changes led to a flooding of the alveoli with up to 40 times normal protein levels and a greater than fivefold increase in airway antiproteinase. These data suggest that serum and soluble lung tissue antiproteinase activity decreased upon exposure to low levels of ozone. However, if O3 exposure is high enough to produce pulmonary hemorrhage, antiproteinase may increase following serum exudation. These changes may be important in the development of ozone-induced lung diseases, especially emphysema. PMID- 3549352 TI - Manuals of food quality control. 8. Food analysis: quality, adulteration, and tests of identity. PMID- 3549353 TI - [The pharmacology of purine receptors]. PMID- 3549354 TI - [Effect of armin on nonspecific resistance factors of the body and on the primary humoral immune response]. AB - A dose-dependent increase of parameters of non-specific defence of the organism and depression of primary humoral immune response following a single subcutaneous administration of armin in doses of 0.04-0.16 mg/kg were found during experiments on mice and rats. PMID- 3549355 TI - Index of biochemical reviews 1985. PMID- 3549356 TI - Susceptibility of human glial cells to infection with human immunodeficiency virus (HIV). AB - Three human brain-derived cell lines (including two of astrocytic origin) were exposed in vitro to the human immunodeficiency virus (HIV), the etiologic agent of immunodeficiency in AIDS. In all three lines, HIV transcripts were detected by in situ hybridisation in 20-30% of cells 48 h after infection. Synthesis of virus gag gene products p24 and p55 was demonstrated by immunoblotting. No cytopathic effects typical of HIV-infected human T lymphocytes were observed. Our data indicate that HIV is neurotropic, and support the hypothesis that this virus may infect astrocytes in the brain. PMID- 3549357 TI - Spacer alterations which increase the expression of porcine growth hormone in E. coli. AB - Full-length porcine growth hormone (PGH) cDNA clones were isolated from a porcine pituitary cDNA library. When the coding portion of the PGH gene was cloned into an E. coli expression vector downstream from the powerful trc promoter, high levels of mRNA, but no protein were detected. Mutation directed by an oligodeoxynucleotide primer altered 5'-non-coding sequences and raised the level of PGH produced from undetectable to 15% of the total cellular protein. Alteration of four codons infrequently used by E. coli in the 5'-end of the gene produced no further increases. PMID- 3549358 TI - Demonstration of an epidermal growth factor-dependent 58 kDa phosphoprotein secreted by rat kidney fibroblasts. AB - Epidermal growth factor and 12-O-tetradecanoylphorbol-13-acetate increased the amount of 32Pi found as phosphoserine in a major, hitherto not described 58 kDa phosphoprotein (pp58) secreted by normal rat kidney fibroblasts. Platelet-derived growth factor, insulin, nerve growth factor and fibroblast growth factor did not affect pp58 while transforming growth factor beta decreased the accumulation of radioactivity into pp58. Cycloheximide, actinomycin D and ammonium chloride suppressed the labelling of pp58. PMID- 3549359 TI - dam methylase from E. coli. Circular dichroism investigations of the secondary structure and influence of S-adenosylmethionine. AB - The enzyme dam methylase which recognizes and methylates the adenine in the palindromic sequence GATC in DNA was isolated and the secondary structure was determined by CD spectroscopy and various predicting methods from the amino acid sequence. The interaction of dam methylase with S-adenosylmethionine was studied by CD spectroscopy indicating a decrease of the percentage of alpha-helix as the amount of S-adenosylmethionine bound to the enzyme was increased. PMID- 3549360 TI - Eponyms in oncology: Denis Burkitt (contemporary). PMID- 3549361 TI - The first E.S.S.O. senior award lecture. PMID- 3549362 TI - Dietary fat, hormones and breast cancer: the cell membrane as a possible site of interaction of these two risk factors. PMID- 3549363 TI - Ontogeny of in vitro-differentiated mouse mast cells. AB - Rat and mouse heparin-containing connective tissue mast cells (CTMC) are stained by both alcian blue and safranin, whereas the chondroitin sulfate-containing mucosal mast cells (MMC) are stained by alcian blue but not by safranin. Mouse bone marrow-derived mast cells (BMMC) (the presumptive in vitro counterpart of the in vivo-differentiated MMC) were derived by culture of progenitors in the presence of 50% WEHI-3-conditioned medium and 10% fetal calf serum and were then cultured for up to 14 days with confluent skin-derived mouse 3T3 fibroblasts in the same culture medium. Although the BMMC adhered to the fibroblast monolayer, they continued to divide, probably because of the presence of interleukin 3 in the conditioned medium. After 14 days of coculture, their cellular histamine content increased approximately 15-fold, and greater than 50% of the BMMC changed histochemically from safranin negative to safranin positive. At this time 30-50% of the glycosaminoglycans of the proteoglycans synthesized by these cocultured mast cells were heparin, whereas the initial BMMC synthesized proteoglycans containing chondroitin sulfate E. When activated immunologically, the cocultured mast cells generated approximately fivefold more prostaglandin D2 than did the activated starting BMMC. Thus, interleukin 3-dependent mouse BMMC can be induced to undergo phenotypic changes in staining characteristics, histamine content, glycosaminoglycan structure, and metabolism of arachidonic acid to resemble heparin-containing CTMC. These findings suggest that the tissue microenvironment determines the phenotypic characteristics of mast cells. This demonstration of the functional diversity of different populations of mast cells adds an important dimension to the understanding of the role of mast cells in biological processes. PMID- 3549364 TI - Conditioning exercise decreases premenstrual symptoms: a prospective, controlled 6-month trial. AB - Six months of exercise training was associated with decreased premenstrual symptoms in two groups of women. There was no change in symptoms in nontraining women. Eight sedentary (ST) women increased running from 0 to 76 +/- 26 km/cycle (mean +/- standard deviation) over 6 months and seven runners (MT) trained for a marathon (42.2 km). Six normally active, nontraining (C-NT) women kept their activity constant. Each subject completed monthly intensity-graded questionnaires or kept daily symptoms diaries concerning premenstrual symptoms. All monitored basal body temperature, weight, and exercise. Gonadal steroids were measured in ST women. For ST subjects, breast (P = 0.005), fluid (P = 0.01), and personal stress (P = 0.025) decreased. MT women experienced decreased fluid (P = 0.034) and depression (P = 0.014). Anxiety tended to decrease (P = 0.087). ST and MT subjects experienced decreases in premenstrual symptoms without documented hormonal, menstrual cycle, or weight changes. These symptom changes appear to be the earliest evidence of the effects of conditioning exercise on the reproductive system. PMID- 3549365 TI - Linear regression analysis of ultrasound follicular growth series: statistical relationship of growth rate and calculated date of growth onset to total growth period. AB - Linear regression analysis was used to assess the serial growth of carefully measured individual mean follicular diameters as a function of menstrual age in a group of normal volunteers in natural, unstimulated cycles (n = 18). Follicle diameter (FD) growth, as measured with serial pelvic ultrasonography, can be shown to be essentially linear (mean R2, 0.92) with respect to time up to the point of ovulation. Growth rate (k) and the calculated date of growth onset (Do) are obtainable from the individual regression equations. Because an approximation of the date of ovulation (Dov, measured by menstrual age at the date of peak mean follicular size) is an available parameter, total growth period (TGP) is calculated with the equation (TGP = Dov - Do). Do, k, and TGP are highly correlated with one another. The mean parameters (+/- standard deviation) are Do = 4.29 +/- 2.77 day, k = 0.24 +/- 0.07 cm/day, TGP = 10.32 +/- 2.35 day, peak FD = 2.34 +/- 0.28 cm, and Dov = 14.61 +/- 2.00 day. The internal correlation of these parameters predicts that information from the first several scans in an individual series may be used to forecast date of ovulation. This may represent an improvement over the use of follicle size or menstrual age alone in planning for human chorionic gonadotropin administration, insemination timing, follicular aspiration and other interventions. PMID- 3549366 TI - In vitro immune absorption of antisperm antibodies with immunobead-rise, immunomagnetic, and immunocolumn separation techniques. AB - Fourteen men with a mean duration of infertility greater than 3 years who had significant sperm immobilizing or sperm-agglutinating antibodies were studied. All patients had greater than 20% IgG or IgA immunobinding to sperm in their seminal plasma and 7 had immunobinding levels of greater than 50%. Sperm from these men were less able to penetrate an overlaying buffer layer than sperm from a fertile control. Addition of immunobeads to the specimen was of little use, because few motile sperm could swim into the overlaying buffer; retained immunobeads were noted in the buffer layer of 18-hour capacitated specimens. Magnetic isolation of antibody-coated sperm from antibody-free sperm avoids potential damage to fragile sperm through centrifugation. Viable spermatozoa were isolated from magnetite-complexed spermatozoa, but the motility of the isolated spermatozoa deteriorated rapidly during the subsequent capacitation period. Passage of diluted ejaculate through a column of dextran beads for antisperm antibody processing (ASAP) was associated with superior sperm quality and fertilizing potential. The use of ASAP resulted in good sperm velocity and linearity and improved sperm function, as measured with the hamster egg penetration test. Sperm from men with immunologically mediated infertility can be processed through the ASAP and used for artificial insemination of their partners or in an in vitro fertilization program. PMID- 3549367 TI - Treatment of idiopathic hypogonadotropic hypogonadism in men with luteinizing hormone-releasing hormone: a comparison of treatment with daily injections and with the pulsatile infusion pump. AB - Thirty husbands in childless couples, aged 24 to 35 years, were treated with luteinizing hormone-releasing hormone (LH-RH) for idiopathic hypogonadotropic hypogonadism (IHH) of peripubertal (incomplete) type. They were azoospermic or oligospermic, with less than 1.5 X 10(6)/ml nonmotile spermatozoa. The diagnosis of IHH was based on clinical and laboratory features and testicular biopsy specimen study and was further supported by results of stimulation tests and gonadotropin-releasing hormone (GnRH) test. Two treatment modalities were used: subcutaneous injections of 500 micrograms LH-RH twice daily; and perpetual subcutaneous injection, via portable infusion pump, of 25 ng/kg LH-RH, at 90 minute intervals. Two patients required a short second period of pulsatile treatment to cause a second pregnancy of their spouses. The pump proved to yield better results, compared with intermittent injections, in respect to endocrine responses, spermatogenesis, and fertility capacity. Normal levels of luteinizing hormone and follicle-stimulating hormone were reached in 2 to 3 weeks and normal testosterone levels in 8 to 10 weeks from the start of treatment. Sperm counts rose to greater than 60 X 10(6)/ml viable spermatozoa with less than 15% of abnormal forms in 3 to 5 months, and the wives conceived. Of a total of 18 deliveries of healthy infants, 12 offspring were identified genetically with their fathers. Four women were still pregnant at the conclusion of the study. The pump was well tolerated, without special operational problems to the patients. Pulsatile treatment is therefore recommended in the treatment of well-diagnosed and carefully selected cases of incomplete IHH. PMID- 3549368 TI - The basement membrane in endometriosis. AB - Disruption of the BM can be found in metastasizing neoplasms. It has been suggested that also in some patients with endometriosis the BM is lacking, depending on the severity of disease. Thus studying the aspect of the BM would enable characterization of the disease and possibly have a prognostic value with respect to (medical) treatment. We studied the aspect of the BM in 16 patients with endometriosis, 4 in each of the stages of the rAFS classification, and demonstrated all endometriosis lesions in all patients to be surrounded by a continuous and intact BM. We conclude that studying the BM in endometriosis offers no advantage in determining the prognosis of the disease and its possible response to therapy. PMID- 3549369 TI - The sonographic picture of endometrium in spontaneous and induced cycles. AB - Ultrasonic volume evaluation of the endometrium was performed on 19 spontaneously ovulating and 48 ovulation-induced women and correlated to E2 and P values in peripheral blood. No statistical correlations were obtained between either hormone level and any of the sonographically obtained parameters except for E2 levels in reference to the anteroposterior diameter of the endometrium in stimulated cycles (R = 0.29; P less than 0.05). It is concluded that the sonographic evaluation of the endometrium does not contribute to the evaluation of either spontaneous or induced cycles. PMID- 3549370 TI - [Effect of various biologically active substances on the secretory function of the stomach and its blood supply]. PMID- 3549371 TI - [Clinical experience with a 5-year use of Evicrol fillings]. PMID- 3549373 TI - Chamber retained restorations with glass ionomer cements. PMID- 3549372 TI - [3-year results of the WHO xylitol caries-prevention program in Hungarian homes for children. IV. Microbiological studies: changes in salivary Lactobacillus and Candida albicans counts]. PMID- 3549374 TI - The surgical management of uveal effusion syndrome. AB - Vortex vein decompression and/or partial thickness sclerectomies were performed on 6 eyes of 4 patients with uveal effusion syndrome. Vortex vein decompression was undertaken in 3 eyes and was followed by retinal re-attachment in two. Multiple sclerectomies were undertaken in 4 eyes of 3 patients; an initial reduction of sub-retinal fluid occurred in all eyes and retinal re-attachment followed in two. There were no complications following the procedure. The response to surgery in these eyes suggests that the approach is justified and provides further evidence that a scleral abnormality is the underlying cause of uveal effusion syndrome. PMID- 3549375 TI - Assessment of the glaucomatous patient. PMID- 3549376 TI - [Fish and the evolution of pituitary hormones]. PMID- 3549377 TI - The dietary effects of xanthan gum in man. AB - Following a 7-day control period, 5 male volunteers consumed, on each of 23 consecutive days, a weight of xanthan gum equal to 15 times the current acceptable daily intake (10 mg/kg b.w.) approved by the EEC and by the Joint FAO/WHO Expert Committee on Food Additives; thus, the lightest and heaviest of the volunteers consumed 10.4 g and 12.9 g respectively of xanthan daily. Measurements before and at the end of the test period showed that the ingestion of xanthan, as a pre-hydrated gel, acted as a bulking agent in terms of its effects on faecal wet and dry weight and intestinal transit time but had no significant effect on plasma biochemistry, haematological indices, urinalysis parameters, glucose tolerance and insulin tests, serum immunoglobulins, triglycerides, phospholipids and HDL cholesterol, breath hydrogen and breath methane concentrations. There was a moderate (10%) reduction in serum cholesterol and a significant increase in faecal bile acid concentrations. The data indicate that the ingestion of xanthan caused no adverse dietary nor physiological effects in any of the subjects. In particular, all of the enzymatic and other parameters that act as sensitive indicators of adverse toxicological effects remained unchanged. PMID- 3549379 TI - The construction of models and casts. PMID- 3549378 TI - The formation and occurrence of amino acid pyrolysates and related mutagens in cooked foods. AB - The classes of cooked foods that contain detectable levels of mutagenic activity are discussed together with the effects of different cooking procedures on the extent of mutagen formation. Analytical procedures that have so far been devised to quantify the concentrations of specific mutagenic compounds are described and the levels of these species that have been detected in cooked foods are detailed. PMID- 3549380 TI - Computer-assisted instruction for intraoral radiography. Part III. Evaluation of time-consumption. PMID- 3549381 TI - Fibronectin in pemphigus. AB - In the skin organ culture model of pemphigus, fibronectin concentrations of 300 and 500 micrograms/ml inhibited pemphigus plasma-induced acantholysis and intraepidermal binding of the pemphigus antibodies examined by direct immunofluorescence. A direct interaction of fibronectin with pemphigus antibodies could not be demonstrated by chromatography of pemphigus plasma on immobilized fibronectin or by incubation with fibronectin and subsequent precipitation with antifibronectin. We then measured fibronectin concentrations in the plasma of 15 patients suffering from various types of pemphigus and presenting different activities of their disease. Immunoreactive fibronectin levels in untreated patients with active disease were generally in the low normal or even clearly in the subnormal range. They had the tendency to decrease when the disease subsided during therapy with high doses of glucocorticoids, sometimes in combination with azathioprine. The fibronectin concentration in the blister fluid of a patient with acute, untreated pemphigus vulgaris was similar to that in a plasma sample taken at the same time. Skin biopsies of pemphigus patients exhibited an essentially normal fibronectin pattern in direct immunofluorescence. We discuss a possible protective role of fibronectin in pemphigus e.g., by reducing the permeability for pemphigus antibodies in the dermal-epidermal junction zone. PMID- 3549382 TI - Immunohistochemical study of Langerhans cells in skin tumors. AB - The behavior of Langerhans cells in skin tumors was investigated by immunohistochemical techniques using OKT6. OKT6-positive cells were numerous in squamous cell carcinomas, seborrheic keratoses and keratoacanthomas. They were rare in basal cell carcinomas, Bowen's disease, eccrine poromas, extramammary Paget's disease and warts. In solar keratosis, the number of OKT6-positive cells was almost equal or slightly larger compared to the normal epidermis. These results indicate that the density of Langerhans cells may not correlate with the degree of malignancy but, to a certain extent, with the nature of the membrane of tumor cells occurring e.g. during keratinization. PMID- 3549383 TI - Proquazone: a treatment for lymphocytic infiltration of the skin. Comparative study with 2 other nonsteroid anti-inflammatory drugs. AB - 15 patients with lymphocytic infiltration of the skin (LIS) were treated with the nonsteroid anti-inflammatory (NSAI) drug proquazone [1-isopropyl-4-phenyl-7 methyl-2(IH)]. In contrast to other NSAI drugs proquazone is a nonacidic compound which is known to be a potent prostaglandin synthesis inhibitor. Of the 15 patients 8 were healed completely with proquazone; in half of these patients lesions recurred but healed with reintroduction of the drug. Two patients remained symptom-free with a small maintenance dose. Two patients showed a partial remission. The treatment was discontinued in 3 patients, in 2 of them because of side effects and in 1 because of lack of response. Two other NSAI drugs, both known to be potent prostaglandin synthesis inhibitors, namely indomethacin and ibuprofen, were tried, however without effect. The present study indicates that proquazone should be considered in the treatment of LIS. PMID- 3549384 TI - Therapeutic concentrations of griseofulvin do not affect yeast cell phagocytosis by monocytes. AB - The effect of griseofulvin on monocyte phagocytosis was assessed by studying the uptake of fluorescent yeast cells by glass-adherent monocytes (a fluorescence quenching technique). In contrast to other microtubule antagonists, griseofulvin did not inhibit monocyte phagocytosis. It is suggested that the lack of griseofulvin interference with essential leukocyte functions is a possible explanation for the fact that the microtubule antagonist griseofulvin serves as a comparatively safe and harmless drug. PMID- 3549385 TI - The use of the Escherichia coli beta-glucuronidase as a gene fusion marker for studies of gene expression in higher plants. PMID- 3549386 TI - The role of N-ras p21 in the coupling of growth factor receptors to inositol phospholipid turnover. PMID- 3549387 TI - Monoclonal antibodies as probes of the structure and function of insulin receptors. PMID- 3549388 TI - Identification of insulin receptors on rat Sertoli cells. AB - The binding of insulin to rat Sertoli cells was investigated to establish if effects of insulin on Sertoli cells can be mediated via insulin receptors. Sertoli cells were isolated from the testes of 3-week-old rats, and preincubated for 3 days in the absence of hormones. Binding of 125I-porcine insulin to the Sertoli cells was 75-80% specific and this binding was time- and pH-dependent and reversible. Scatchard analysis of the binding data resulted in curvilinear plots with a high affinity binding of Kd = 1.8 X 10(-9) M. Porcine and bovine insulin competed equally well for 125I-porcine insulin binding. Porcine proinsulin was 10 50 times less potent, corresponding to its lower biological activity. Insulin like growth factor-I (IGF-I) was 30-40 times less potent, indicating low affinity binding of IGF-I to the insulin receptor. Lutropin which was used as a control gave no competition with the 125I-insulin binding. Affinity labelling of Sertoli cell membrane proteins with 125I-insulin using the cross-linking agent disuccinimidylsuberate revealed binding of insulin to (a) protein(s) of Mr greater than 300,000 or Mr = 130,000 after electrophoresis under non-reducing or reducing conditions, respectively. Affinity labelling with 125I-insulin was largely prevented by unlabelled insulin. It is concluded that the protein of Mr 130,000 may represent the alpha-subunit of the insulin receptor. The presence of insulin receptors as well as IGF-I receptors on cultured rat Sertoli cells may suggest that insulin and IGF-I have specific functions in regulating the maturation and activities of Sertoli cells during the initiation and maintenance of spermatogenesis. PMID- 3549389 TI - Cellular events associated with lung branching morphogenesis including the deposition of collagen type IV. AB - In this study mouse lung development was examined using an in vitro model system. The culture system permitted examination of a morphogenic process that eventually led to the formation of presumptive alveoli (terminal sacs). The observations included changes in epithelial cell morphology (transition from a columnar to a spindle shape), and evidence for motile activity on the part of primitive airway epithelial cells. The importance of Type IV collagen to the cellular events associated with branching morphogenesis was investigated by immunolocalization. In addition, we assessed the similarity of normal lung development to in vitro development by comparing cultured lungs with equivalent stages of embryonic and fetal mouse lungs. The results show that cultured embryonic lung explants proceed along a morphogenic pathway that parallels normal lung development; that primitive pulmonary epithelial cells engage in motile activity and transiently acquire an extended cell shape both in vitro and in vivo; that, as suggested by others, the pattern of late branching morphogenesis is not dichotomous, but irregular; and that short wisplike fibers of Type IV collagen are present in developing embryonic and fetal lung mesenchyme. Taken together, the results show that early and late lung branching patterns differ significantly, and suggest that later stages of lung branching involve distinct epithelial cell shape transitions. The immunofluorescence data suggest that fibrous Type IV collagen may be the extracellular matrix scaffold within which early epithelial cells accomplish lung branching morphogenesis. PMID- 3549390 TI - Formation of the dorsal root ganglia in the avian embryo: segmental origin and migratory behavior of neural crest progenitor cells. AB - The segmental origin and migratory pattern of neural crest cells at the trunk level of avian embryos was studied, with special emphasis on the formation of the dorsal root ganglia (DRG) which organize in the anterior half of each somite. Neural crest cells were visualized using the quail-chick marker and HNK-1 immunofluorescence. The migratory process turned out to be closely correlated with somitic development: when the somites are epithelial in structure few labeled cells were found in a dorsolateral position on the neural tube, uniformly distributed along the craniocaudal axis. Following somitic dissociation into dermomyotome and sclerotome labeled cells follow defined migratory pathways restricted to each anterior somitic half. In contrast, opposite the posterior half of the somites, cells remain grouped in a dorsolateral position on the neural tube. The fate of crest cells originating at the level of the posterior somitic half was investigated by grafting into chick hosts short segments of quail neural primordium, which ended at mid-somitic or at intersomitic levels. It was found that neural crest cells arising opposite the posterior somitic half participate in the formation of the DRG and Schwann cells lining the dorsal and ventral root fibers of the same somitic level as well as of the subsequent one, whereas those cells originating from levels facing the anterior half of a somite participate in the formation of the corresponding DRG. Moreover, crest cells from both segmental halves segregate within each ganglion in a distinct topographical arrangement which reflects their segmental origin on the neural primordium. Labeled cells which relocate from posterior into anterior somitic regions migrate longitudinally along the neural tube. Longitudinal migration of neural crest cells was first observed when the somites are epithelial in structure and is completed after the disappearance of the last cells from the posterior somitic region at a stage corresponding to the organogenesis of the DRG. PMID- 3549391 TI - A provisional epithelium in leech embryo: cellular origins and influence on a developmental equivalence group. AB - Segmental tissues of glossiphoniid leeches arise from rostrocaudally arrayed columns (bandlets) of segmental founder cells (primary m, n, o, p, and q blast cells) which undergo stereotyped sublineages to generate identifiable subsets of definitive progeny. The bandlets lie at the surface of the embryo beneath the squamous epithelium of a transient embryonic covering called the provisional integument. This "provisional epithelium" derives from microsomes produced during the early cleavage divisions. Previous experiments have shown that the primary o and p blast cells constitute an equivalence group, i.e., are initially developmentally equipotent and undergo hierarchical interactions which cause them to assume distinct O and P fates. Here, we examine the role of the provisional epithelium in determining the fates of the underlying o and p blast cells. Experiments entailing the microinjection of individual micromeres with cell lineage tracers show that, at stages 7-8 of normal development, the epithelium comprises coherent and relatively stereotyped domains derived from particular micromeres. Upon photoablating domains of epithelium labeled with photosensitizing lineage tracer, the normal assignment of O fates is disturbed; o blast cells divide symmetrically (as p blast cells do) and some supernumerary definitive progeny expressing P fates arise within the O lineage. We therefore conclude that the epithelium is essential for generation and/or reception of signal(s) by which the o and p blast cells' normally determine their fates. Finally, a new tracer substance, biotinylated fixable dextran (BFD), is described which was essential for this study by virtue of its superior resistance to photobleaching and which offers several other advantages as well. PMID- 3549393 TI - Studies on the combined administration of Haemophilus influenzae type B- diphtheria toxoid conjugate vaccine (PRP-D) and DTP. AB - The safety and immunogenicity of an Haemophilus influenzae type b capsular polysaccharide-diphtheria toxoid vaccine (PRP-D) has been evaluated when administered alone or simultaneously with other vaccines in over 1,400 2-24 month old subjects. In the first infant study, groups of subjects received either the PRP-D, PRP or placebo vaccine at 3, 5 and 7 months, one month after DPT immunization at 2, 4 and 6 months of age. In a subsequent study infants received either the PRP-D or PRP vaccine simultaneously with DPT. Safety of the PRP-D vaccine was indistinguishable from that of the PRP and placebo vaccines. In both studies, greater than 90% of the PRP-D recipients developed protective levels of antibody (greater than 0.15 microgram/ml) and the majority developed greater than 1.0 microgram/ml of anti-PRP. Following a booster dose of PRP-D at 14-18 months, simultaneously with either MMR, DPT or polio vaccine, all children in these studies developed greater than 1.0 micrograms/ml of antibody. Several other administration schedules have been evaluated in separate clinical studies. Acceptability of a combined DPT/PRP-D vaccine is currently being evaluated in experimental studies. PMID- 3549392 TI - Changes in the types of collagen synthesized during chondrogenesis of the mouse otic capsule. AB - We have investigated the temporal relationship between the morphological differentiation of the mouse otic capsule and the pattern of collagen synthesis by mouse otocyst-mesenchyme complexes labeled in vitro. In 10.5- to 12-day embryos the mesenchyme surrounding the otocyst was loosely organized except for a few lateroventral condensations; explants from these embryos synthesized only small amounts of collagen. Collagen synthesis by whole explants increased by more than 50% between 12 and 13 days concomitant with metachromatic staining of the lateral periotic mesenchyme. Cartilage specific type II collagen was the predominant collagen synthesized by these explants as confirmed by SDS-PAGE, densitometry, CNBr cleavage, and V8 protease digestion. This biochemical expression of the cartilage phenotype preceded morphologic recognition of otic capsular cartilage by almost 2 days. Type II collagen synthesis continued to increase and predominate through Day 16 of gestation by which time the otic labyrinth was surrounded by mature cartilage. The minor cartilage collagen chains, 1 alpha, 2 alpha, and 3 alpha, first appeared on different days of gestation. The 1 alpha, and 3 alpha chains were synthesized by explants from 11 day embryos while the 2 alpha chain appeared during Day 13, just before overt differentiation of mature cartilage. These results suggested that the 1 alpha, 2 alpha, and 3 alpha chains may not form heterotrimers containing all three chains and that synthesis of the 2 alpha chain may be associated with stabilization of the cartilaginous matrix. Comparison of these data with the patterns of collagen production by mutant, diseased, or experimentally manipulated inner ear tissues may provide insights into the molecular basis of chondrogenic tissue interactions. PMID- 3549394 TI - Injections and poliomyelitis: what are the risks of vaccine associated paralysis? AB - Provocation by injections can increase the risk of paralytic poliomyelitis by up to 25 fold. In England and Wales the risk of provocation paralysis from DPT given with oral poliovirus is 1 to 2 cases per million children immunized. Cases in India following immunization with oral poliovaccine and DPT are likely to be caused by wild rather than vaccine virus. Most cases of poliomyelitis in the Third World probably follow provocation by unsterile and unnecessary injections. There should normally be very few cases due to immunization. Injections should be sterile and only given when necessary. PMID- 3549395 TI - Appropriate age for measles vaccination in the United States. AB - The appropriate age for measles vaccination is determined by weighing the risk of measles disease and complications at a given age with vaccine efficacy at that age. In the United States, measles vaccine was initially used in children as young as 9 months of age because the disease was common and complications were greatest in persons less than 1 year of age. In 1965, when it became apparent that vaccine failure was unacceptably high in children less than 1 year and when epidemiologic analysis indicated that children greater than or equal to 1 year, particularly schoolchildren, were the primary focus of measles transmission, the vaccination age was raised to 12 months. In 1976, further studies showed efficacy was slightly higher at 15 months of age versus 12 months or 12-14 months of age. Because the risk of acquiring measles in children less than 15 months was low, the age for routine vaccination was increased to 15 months. This age recommendation may be appropriate for developed countries where the epidemiology of measles may be similar to the epidemiology in the United States. However, this age is inappropriate for many countries in the developing world where the risks of measles and complications from measles are high in young preschool children. In those countries, the recommended age for routine vaccination against measles is generally 9 months. PMID- 3549396 TI - Preparation and use of calcium phosphate adsorbed vaccines. AB - Simple or combined D,T,P and inactivated polio vaccines adsorbed onto calcium phosphate are prepared according to two procedures. Antigens can be dialysed in a sodium phosphate solution and quickly mixed with an equal volume of an equimolar solution of calcium chloride, the pH is adjusted to 6.8-7. Toxoids added to the phosphate solution are in this way entrapped within the 3-dimensional network during the formation of the precipitate. Antigens can also be added to a calcium phosphate gel suspension prepared in advance. Results of animal experiments and of field trials using either combined vaccines or simultaneous immunization with diphtheria, tetanus, pertussis, meningococcal and several viral vaccines: polio, rabies, hepatitis-B, etc., will be presented. Several programs have been studied in developing countries, mainly with the aim at simplifying vaccination campaigns. The efficiency of a two-dose regimen with DT vaccine has been ascertained, this has also been applied to pregnant women. Adsorbed tetanus toxoid was successfully used as a diluent for freeze-dried measles, meningococcal polysaccharide and rabies vaccines. Levels of circulating antibodies and potency of vaccines have been measured by new in vivo and in vitro methods. The choice of detoxified purified toxins is desirable for the preparation of vaccines in order to prevent the occurrence of adverse reactions. Local and generalized reactions have been studied. Adverse Arthus-type reactions have been encountered and related with the presence of high levels of circulating tetanus antibodies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549397 TI - Preliminary data from a clinical trial (phase 2) of an acellular pertussis vaccine, J-NIH-6. AB - In the search for a new and better pertussis vaccine for general vaccination in Sweden, a clinical trial of an adsorbed acellular vaccine from Japan has been performed. The vaccine used was produced by Biken and contained only F-HA and the toxoid of pertussis toxin (LPF). The aims were: To demonstrate the serological response to primary vaccination of this adsorbed acellular vaccine in comparison to a plain whole cell vaccine. To compare the incidence of side reactions between the two types of vaccines and the adjuvant (aluminium phosphate) of the acellular vaccine used as placebo. PMID- 3549398 TI - The use and standardization of multicomponent veterinary vaccines. AB - Farming practices necessitate the use of combined vaccines for the protection of sheep, cattle and pigs. Multi-component Clostridial vaccines have been available in veterinary medicine since the late 1950s and are standardized on the basis of antibody responses in small animals and/or challenge tests. The development of new vaccines against respiratory and enteric diseases has posed a number of standardization problems as small animal models are not readily available and antibody responses do not necessarily correlate with protection. Approaches to the standardization and use of these components will be discussed. PMID- 3549399 TI - Evaluation of a combined vaccine against measles-mumps-rubella produced on human diploid cells. AB - The combined Measles-Mumps-Rubella vaccines commercially available for use are safe, highly immunogenic, and protective. But the acceptance rate of these vaccines by the public and also by the general practitioners in most part of Europe is not a very high one. One of the reasons for this low acceptance-rate is the fear of side-reactions. In spite of that only exceptional cases of dangerous allergic reactions induced by such vaccines, especially the lay population can be scared by the contraindications mentioned in the "physician circular-patent product information". Therefore it was worthwhile to test a new trivalent vaccine produced exclusively on human tissue without using any avian protein or animal protein extracts or antibiotics. Under double-blind conditions 120 children aged between 15 and 24 months received either the new vaccine or the commercially available M-M-R-II vaccine produced by MSD. Measles and Rubella antibodies were tested by hemagglutination-inhibition tests, Mumps by the immuno-fluorescence technique. No reports of major side-effects were received from the 12 physicians participating in the trial. The seroconversion rates recorded 6 to 8 weeks after vaccination were high (95-100%) and there was no statistically significant difference between the two vaccines with regard to immunogenic potency. PMID- 3549400 TI - A tribute to Clarence Luther Herrick (1858-1904): founder of developmental psychobiology. PMID- 3549401 TI - Ultrasonic study of sucking and swallowing by newborn infants. PMID- 3549402 TI - Infant hearing screening: program implementation and validation. AB - Congenital and early-onset hearing losses were discovered in 6.1% of 975 Intensive Care Nursery (ICN) graduates. The methods used were neonatal screening by Crib-O-Gram (COG) and high risk register, in combination with repeated behavioral hearing tests at 1 to 3 years. This 7-year longitudinal study had follow-up hearing evaluations for a remarkably high 84% of all subjects. Significant losses that interfered with speech and language development (1000 to 8000 Hz average loss greater than 45 dB HL bilaterally) were found in 4.3% of infants. COG in combination with subsequent behavioral hearing screening was a sensitive strategy for detecting significant hearing loss: only one child was missed with this combination. Alone, COG sensitivity to significant hearing losses was 79.3%, but would have been higher had a stricter passing criterion been adopted. Behavioral hearing screenings detected bilateral hearing losses of even mild (greater than 20 dB HL) degree. Sensitivity to significant hearing losses was 82.6% and would have been improved if test frequencies greater than 3000 Hz were included in the screen. Even if screening failure occurred at 1 year of age, the age of actual confirmation of hearing loss depended on severity of the loss and ear involvement. Significant hearing losses were confirmed earlier than less severe or unilateral losses. Although behavioral screenings could be done during the first year of life, continued follow-up was required to detect progressive hearing losses. PMID- 3549403 TI - The effect of body hydration state on oral fluids. PMID- 3549404 TI - Training residents for the future: final draft report. The STFM Task Force on Training Residents for the Future. PMID- 3549405 TI - Interactive video in family medicine. AB - Interactive video is a new technology linking microcomputers to video players. It is gaining wide use in nonmedical education settings. Teachers of family medicine should be aware of this development and may wish to produce or use interactive video programs. The present paper describes the system, discusses uses developed for medical education, and provides recommendations about its use to improve family medicine education and practice. PMID- 3549407 TI - [Francisco Ortega del Villar (1822-1886)]. PMID- 3549406 TI - Ciencia y Caridad. PMID- 3549408 TI - [Metabolic relation between lipolysis and oxygen consumption in epididymal adipose tissue of the rat. Changes caused by fasting, adrenaline, triiodothyronine, glucose and insulin]. PMID- 3549409 TI - [A panoramic view of medicine in Mexico]. PMID- 3549410 TI - [Standardization of the size of the diencephalon in the stereotaxic localization of the subcortical structures in man]. PMID- 3549411 TI - [Fine needle cytopuncture of the pancreas. Apropos of 45 cases]. AB - In this report, we examined the sensitivity and specificity of pancreatic fine needle aspiration cytology in the diagnosis of pancreatic cancer. Aspiration cytodiagnosis was performed in 45 patients (36 cancers and 9 benign pancreatic lesions) using a 22 Gauge fine needle either percutaneously in 25 patients with real-time ultrasonic guidance or during surgery in 20 patients. Cytologic examination included a precise description and the classification in one of the 4 Papanicolaou classes, the fourth only being considered as positive in terms of cancer. No complication occurred with either technic. Overall sensitivity was 75 p. 100, 74 p. 100 percutaneously and 77 p. 100 intraoperatively, but specificity was 78 p. 100 due to two false-positive results recorded among the 9 benign lesions. Retrospective analysis of cytologic examinations of the 29 class IV lesions led us to differentiate cases with "sure malignancy" (20 cases) from those with "strong suspicion of malignancy" (9 cases including the 2 false positives). Only class IV lesions with "sure malignancy" call for aggressive treatment, whereas a "strong suspicion of malignancy", which may result from carcinoma or severe cellular abnormalities occasionally found in inflammatory pancreatic lesions, should lead to a second pancreatic aspiration. PMID- 3549412 TI - [Pancreatic polypeptide, peptide YY and neuropeptide Y. A new family of regulatory peptides]. PMID- 3549413 TI - [Controlled study of propranolol in the prevention of recurrent hemorrhage in cirrhotic patients]. AB - The aim of this study was to assess, by a pragmatic controlled trial, the value of propranolol in the prevention of recurrent bleeding in patients with cirrhosis. From January 1982 to December 1984, 368 cirrhotic patients were admitted for bleeding episode due to portal hypertension. Ninety-nine patients were included in the trial 24 h after cessation of bleeding (5 days on the average after hospital admission) and were randomly assigned to 2 groups: 51 patients receiving propranolol at doses that reduced the resting heart rate by 25 p. 100 and 48 receiving neither treatment nor placebo. Ninety-one per cent presented a rupture of varices, and 9 p. 100 acute gastric erosions: 94 p. 100 had an alcoholic cirrhosis. The distribution according to Child Turcotte's classification was grade A: 45.5 p. 100, B: 45.5 p. 100, C: 100 p. 100. The two groups were not significantly different excepted for previous bleeding episodes. The cumulative percentages of recurrent bleeding were not significantly different: between the treated and untreated groups (60 p. 100 vs. 68 p. 100 at 18 months); between the compliant patients (n = 39) and untreated and not compliant patients altogether; between the treated and untreated patients of Child's grade A on the one hand, and patients grades B and C on the other hand. The curves of cumulative survival were not significantly different between treated and untreated patients (66 p. 100 vs. 78 p. 100 at 18 months).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549414 TI - [Diverticular abscess: demonstration of a colonic fistula in ultrasonography and success of percutaneous drainage]. PMID- 3549415 TI - Sonographic demonstration of portal venous system thromboses secondary to inflammatory diseases of the pancreas. AB - Sonographic demonstration of abdominal venous thromboses subsequent to pancreatic benign inflammatory diseases has been seldom reported up to now. Seven cases of thromboses of the portal venous system associated with acute or chronic pancreatitis are reported. All cases were detected by sonography in patients without clinical manifestations of portal hypertension. Echogenic thrombus within the lumen of the vein was observed only in the short-term follow-up of acute pancreatitis. Cavernomatous transformation was observed in 6 patients with long term calcifying pancreatitis. Extrinsic compression by pseudocyst of the pancreas was observed in only 1 case. In all the other cases, thromboses seems to be secondary to local inflammatory phenomena during previous episodes of acute pancreatitis. PMID- 3549416 TI - Transection of the pancreas demonstrated by ultrasound and computed tomography. AB - The early occurrence of peritoneal signs and hyperamylasemia in a 14-year-old boy, who had fallen off his horse, urged us to perform a sonographic and computed tomographic study of the upper abdomen. Both examinations showed a complete pancreatic rupture. Distal pancreatectomy led to a rapid and uneventful recovery. PMID- 3549417 TI - Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: a five-year experience. AB - Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis. Over a 5-year period 625 liver transplants in 477 patients were performed at the University Health Center of Pittsburgh. Fifty-three patients (56 transplants) underwent 70 PTCs. Complications diagnosed by PTC included biliary strictures, bile leaks, bilomas, liver abscesses, stones, and problems associated with internal biliary stents. Thirty-two percutaneous transhepatic biliary drainage procedures were performed. Ten transplantation patients underwent balloon dilatation of postoperative biliary strictures. Interventional radiologic techniques were important in treating other complications and avoiding additional surgery in many of these patients. PMID- 3549418 TI - Sonography of appendiceal intussusception. AB - A case in which appendiceal intussusception was diagnosed preoperatively by sonography is described. The sonographic finding of multiple concentric hypoechoic and hyperechoic rings was confirmed at laparotomy to be due to appendiceal intussusception. Demonstration of the sonographic coiled spring sign in the right lower quadrant should raise the possibility of appendiceal intussusception. The differential diagnosis is discussed. PMID- 3549419 TI - Applied potential tomography. A new noninvasive technique for measuring gastric emptying. AB - Applied potential tomography is a new, noninvasive technique that yields sequential images of the resistivity of gastric contents after subjects have ingested a liquid or semisolid meal. This study validates the technique as a means of measuring gastric emptying. Experiments in vitro showed an excellent correlation between measurements of resistivity and either the square of the radius of a glass rod or the volume of water in a spherical balloon when both were placed in an oval tank containing saline. Altering the lateral position of the rod in the tank did not alter the values obtained. Images of abdominal resistivity were also directly correlated with the volume of air in a gastric balloon. Profiles of gastric emptying of liquid meals obtained using applied potential tomography were very similar to those obtained using scintigraphy or dye dilution techniques, provided that acid secretion was inhibited by cimetidine. Profiles of emptying of a mashed potato meal using applied potential tomography were also very similar to those obtained by scintigraphy. Measurements of the emptying of a liquid meal from the stomach were reproducible if acid secretion was inhibited by cimetidine. Thus, applied potential tomography is an accurate and reproducible method of measuring gastric emptying of liquids and particulate food. It is inexpensive, well tolerated, easy to use, and ideally suited for multiple studies in patients, even those who are pregnant. PMID- 3549421 TI - Successful treatment of hepatic venocclusive disease in a bone marrow transplant patient with side-to-side portacaval shunt. AB - Hepatic venocclusive disease developed in a 14-yr-old white girl after allogenic bone marrow transplantation from an HLA-identical sibling donor. Clinical diagnosis of venocclusive disease was based on the development of ascites, hepatomegaly, and jaundice 3 wk after transplantation. Current treatment of hepatic venocclusive disease is ineffective. The pathophysiology of the hepatic lesion suggests that construction of a side-to-side portacaval shunt should be beneficial in relieving the ascites and preventing further hepatic damage. Because the ascites was refractory to medical therapy and she was clinically deteriorating, a side-to-side portacaval shunt was performed. Histologic examination of a liver biopsy specimen obtained at surgery documented the presence of venocclusive disease. Postoperatively, the patient diuresed and returned to her baseline weight. One year after surgery the patient was doing well, her weight was stable, and she was being maintained on salt restriction alone. While the resolution of ascites and improvement of hepatic function in our patient after side-to-side portacaval shunt does not guarantee that such an approach will be uniformly successful, it should serve to encourage others to consider such therapy for this frequently devastating complication of chemoradiation therapy. PMID- 3549420 TI - Low-dose trazodone for symptomatic patients with esophageal contraction abnormalities. A double-blind, placebo-controlled trial. AB - Twenty-nine patients with esophageal symptoms and contraction abnormalities of the esophageal body completed a 6-wk, double-blind, placebo-controlled trial of trazodone (100-150 mg/day). Measures of esophageal and psychologic symptoms were completed at entry and at each follow-up visit. Esophageal manometry was repeated at the termination of the trial. Upon completion of the treatment, patients receiving trazodone (n = 15) reported a significantly greater global improvement than those receiving placebo (n = 14; p = 0.02). Although a variable clinical response was observed, the trazodone group had less residual distress over esophageal symptoms compared with the placebo group (59% +/- 9% vs. 108% +/- 19%, p = 0.03). Manometric changes observed during the course of the trial were not influenced by treatment nor by clinical response. Remarkable reductions in ratings of chest pain were reported by both treatment groups, emphasizing the importance of controlled trials when studying this patient population. We conclude that low-dose trazodone therapy can be of benefit in the management of symptomatic patients with esophageal contraction abnormalities. In addition, our findings support recent observations that manometric abnormalities characterizing this patient group may not be solely responsible for symptoms. PMID- 3549422 TI - Biomarkers of increased susceptibility to gastrointestinal cancer. Their development and application to studies of cancer prevention. PMID- 3549423 TI - Effects of insulin, transferrin, cholera toxin, and epidermal growth factor on growth and morphology of human fetal normal colon epithelial cells. AB - Primary and serially passaged human fetal normal colon epithelial cells have been propagated and characterized with regard to their nature and origin. The cells exhibited many characteristics of colonic epithelial cells including the presence of mucopolysaccharides and carcinoembryonic antigen. Serial passaging of the cultures required supplementing the medium with insulin, transferrin, epidermal growth factor, and cholera toxin. This study also shows that these factors have specific roles in the regulation of growth and morphologic differentiation of the cell cultures. Insulin apparently is mainly associated with cell multiplication, whereas transferrin, epidermal growth factor, and cholera toxin are associated with the maintenance of morphologic differentiation status of the cell cultures. PMID- 3549425 TI - Gastrin-releasing peptide in the porcine pancreas. AB - The presence of gastrin-releasing peptide (GRP) was studied in extracts of porcine pancreata. Gel filtration and high-pressure liquid chromatographic profiles of these extracts as monitored with both C-terminally and N-terminally directed radioimmunoassays against GRP showed pancreatic GRP to consist of one main form, namely the 27-amino acid peptide originally extracted from porcine stomach, and small amounts of a C-terminal fragment identical with the C-terminal 10-amino acid peptide. Gastrin-releasing peptide-like immunoreactivity released from the isolated perfused porcine pancreas during electrical vagal stimulation was shown by gel filtration to consist of the same two forms. By use of immunocytochemical techniques employing an antiserum directed against its N terminus, GRP was localized to varicose nerve fibers in close association with the exocrine tissue of the porcine pancreas in particular. Some fibers were found penetrating into pancreatic islets also. Immunoreactive nerve cell bodies as well as fibers were found within intrapancreatic ganglia. The potency of GRP in stimulating exocrine as well as endocrine secretion from the porcine pancreas, its presence in close contact with both acini and islets, and its release during vagal stimulation indicate that GRP may have a role in the parasympathetic regulation of endocrine and exocrine secretion from the pig pancreas. PMID- 3549424 TI - Biosynthesis of gastrin. Localization of the precursor and peptide products using electron microscopic-immunogold methods. AB - Antibodies to different peptides produced from the gastrin precursor have been used in light microscopic- and electron microscopic-immunogold studies of gastrinoma tissue and normal antral mucosa. Antibodies to the C terminus of progastrin, which are known to react with the intact precursor, revealed immunoreactive material in the rough endoplasmic reticulum, Golgi region, and electron-dense granules in gastrinoma cells. In normal antrum these antibodies again revealed the Golgi region and a population of electron-dense granules. Other antibodies that react with the products of progastrin processing, but not the precursor, e.g., C-terminal and N-terminal gastrin 17 specific antibodies, revealed only granules. In addition to electron-dense granules already mentioned, the latter antibodies also revealed electron-lucent and intermediate granule populations, which in antrum were the major granule types. It is proposed that the intact precursor occurs in rough endoplasmic reticulum and Golgi; thereafter, in the immature electron-dense granules, and subsequently in electron-lucent granules, biosynthetic processing liberates gastrin 17 and gastrin 34, which are the major active products of gastrin gene expression. PMID- 3549426 TI - [Importance of echography in the diagnosis of extramedullary foci of hematopoiesis in acute lymphoid leukemia in children]. PMID- 3549427 TI - [Mechanism of action and clinical manifestations of overload of the body with iron in hereditary hemochromatosis]. PMID- 3549428 TI - Inhibition of enkephalinase activity attenuates naloxone-precipitated withdrawal symptoms. AB - In this study we examined the effects of the enkephalinase inhibitor, thiorphan, on the naloxone-precipitated withdrawal syndrome in chronic morphine dependent rats. Intracerebroventricular administration of thiorphan (40 micrograms/2 microliter) in morphine dependent rats, inhibited the severity of the naloxone precipitated abstinential syndrome. Administration of thiorphan (20 micrograms/0.5 microliter) in the periaqueductal grey matter of morphine dependent rats, in addition to explosive motor behaviour and ipsilateral rotation, also significantly suppressed most of the naloxone-precipitated withdrawal symptoms. It is suggested that a decreased biotransformation of endogenous opioid peptides might replace the relative shortage of morphine during withdrawal in opiate addicted subjects and attenuate the abstinence symptoms. PMID- 3549429 TI - Effect of chronic administration of haloperidol on secretory response mediated by cholinergic receptors in rat submandibular glands. AB - Administration of haloperidol influences peripheral non-dopaminergic receptors. The sialagogue response of the submandibular glands of the rats to methacholine was enhanced by chronic administration of haloperidol. The binding of [3H]QNB to muscarinic receptors in the submandibular glands was not changed by chronic haloperidol. The supersensitivity of postsynaptic cholinergic receptors to drugs in haloperidol treated rats is not related to changes in the number or affinity of such receptors. This paper confirmed the sialagogue supersensitivity to adrenergic drugs related to an increase in alpha 1-adrenoceptors in the submandibular glands of haloperidol injected rats. PMID- 3549430 TI - Plasma glucagon levels in different species of fish. AB - Plasma glucagon levels in 11 different teleosts and in dogfish were evaluated using an adapted classical mammalian radioimmunoassay (RIA). The values obtained are considered relative; sensitivity was inferior to the original method, but the validation experiment results are acceptable. The mean value of the coefficient of the variation for interassay was 6% and for intraassay 4%, recovery was 98%, and a good linearity in the dilution test was found. Some species (Sparus aurata and cyprinids) presented high plasma glucagon concentrations (0.50-1.60 ng/ml) versus the lower levels (0.08-0.40 ng/ml) found in salmonids and others, and the lowest in dogfish (0.02-0.20 ng/ml). A positive correlation (P less than 0.02) between insulin and glucagon plasma levels was found in different species. The low levels obtained in all parameters analyzed in the selachian were remarkable. This adapted RIA could serve as a useful tool in amplifying knowledge on the endocrine pancreatic response in fish in different biological situations. PMID- 3549431 TI - An immunocytochemical and ultrastructural study of the endocrine pancreas of Sparus auratus L. (Teleostei). AB - The pancreatic endocrine cells of Sparus auratus (gilthead sea bream) are concentrated in two or three principal islets, or Brockmann bodies, and numerous smaller islets embedded in the exocrine tissue. Insulin-, glucagon-, somatostatin , and pancreatic polypeptide (PP)-immunoreactive cells were identified in all pancreatic islets of S. auratus using an indirect immunocytochemical (PAP) method. Insulin-immunoreactive cells were found in the central region of the islets. Glucagon-immunoreactive cells could be seen at the periphery of the islets and isolated in the exocrine tissue surrounding the large principal islet. Somatostatin-immunoreactive cells were distributed throughout the islets. PP immunoreactive cells were clustered, in a limited shallow section, being found in no other part of the large principal islet whereas, in the smaller islets, these cells were more numerous and found in the whole peripheral area. Four cell types were identified in the pancreatic islets of S. auratus by electron microscopy. A,B,D and PP cells were characterized by the shape, size, and electron density of their respective secretory granules. PMID- 3549432 TI - Gonadotropic hormone-releasing hormone (GnRH) bioactivity in the brain of the immature rainbow trout, Salmo gairdneri: the effect of testosterone. AB - The effect of exogenous testosterone on the synthesis and release of a bioactive gonadotropic hormone-releasing hormone (GnRH)-like substance has been studied in juvenile male rainbow trout. Long-term testosterone treatment caused an increased gonadotropic hormone (GTH) release and precocious sexual maturity. Tel- and diencephalon extracts from long-term testosterone-treated juvenile rainbow trout showed significantly higher GTH-releasing activity than extracts from control animals when injected in short-term testosterone-pretreated juvenile rainbow trout. It was concluded that long-term testosterone treatment caused an increased synthesis and release of GnRH-like material. PMID- 3549433 TI - Primary structure of insulin and a truncated C-peptide from an elasmobranchian fish, Torpedo marmorata. AB - Insulin has been isolated from the pancreas of Torpedo marmorata, an elasmobranchian fish, and shown to contain 21 amino acid residues in the A-chain and 30 residues in the B-chain. The sequence of insulin has been strongly conserved within the class Elasmobranchii with only one substitution and one deletion in the A chain and one substitution in the B-chain compared with insulin from the spiny dogfish, Squalus acanthias. A second peptide, present in the pancreatic extracts in approximately equimolar concentration with insulin, was identified as a heptadecapeptide. The sequence of this peptide shows homology to the N-terminal region of anglerfish (Lophius americanus) C-peptide at six of 17 sites. The isolation of a truncated C-peptide suggests either that the sequence encoding the COOH-terminal region of T. marmorata C-peptide has been deleted from the preproinsulin gene or that a larger C-peptide has undergone a proteolytic cleavage in the central portion of the molecule during packaging in the secretory granules of the B cell. PMID- 3549434 TI - Relationship between brain gonadotrophin-releasing hormone (GnRH) and seasonal reproductive cycle of "caribe colorado," Pygocentrus notatus. AB - Immunoreactive gonadotrophic hormone-releasing hormone (ir-GnRH) was detected in hypothalamic and telencephalic extracts of the Venezuelan freshwater fish "caribe colorado," Pygocentrus notatus. Hypothalamic ir-GnRH from female fish demonstrated displacement curves parallel to those of synthetic mammalian luteinizing hormone-releasing hormone (LHRH). The content of hypothalamic and telencephalic ir-GnRH from female fish was more than four-fold greater than that of male animals. Also, fluctuations that depended on the reproductive state and environmental conditions (rainfall) occurred in females but not in males. Thus, ir-GnRH levels were higher in hypothalamic and telencephalic extracts from sexually mature females than in those from fish sampled outside the climatically determined breeding season. PMID- 3549435 TI - The cellular location of 1 alpha-hydroxycorticosterone binding protein in skate. AB - Antiserum to 1 alpha-hydroxycorticosterone binding protein was used to investigate its location in selected tissues of the skate Raja ocellata. Immunofluorescence, using an indirect technique, showed 1 alpha hydroxycorticosterone binding sites in potential target tissue: gill. chloride cells, rectal gland parenchyma, and a portion of the kidney tubule. The binding protein was not detectable in the ventricle or the intestinal spiral valve but was associated with liver parenchyma and interrenal cells. The intracellular location of the binding protein is apparently tissue specific. PMID- 3549436 TI - Blood pressure homeostasis in the snake, Ptyas korros. AB - Three putative pressor systems, the alpha-adrenergic system (AS), the renin angiotensin system (RAS), and the arginine vasotocin system (AVT-S), were studied for their roles in blood pressure regulation and their possible interactions in the rat snake. Ptyas korros. Norepinephrine (NE), angiotensin I (ANG I), and arginine vasotocin (AVT) increased the mean arterial pressure (MAP) of the snake while administration of phentolamine, an alpha-adrenergic antagonist, and captopril, an ANG-converting enzyme inhibitor, but not KBIV24, an AVT antagonist, decreased the MAP. Treatment with any combination of two of these antagonists/inhibitor invariably decreased the MAP. Treatment with the agonist of the remaining third system invariably returned the MAP to normal or above. Phentolamine and KBIV24 attenuated the vasopressor effect of ANG I. Phentolamine and captopril enhanced the vasopressor effect of AVT. The pressor effect of NE was not altered by KBIV24 and captopril. It was concluded that there were at least two pressor systems (AS and RAS) regulating the basal MAP in the snake. There was also interaction among the three systems which could affect the MAP. PMID- 3549437 TI - Immunochemical and biochemical characterization of gastrin/cholecystokinin-like peptides in Palaemon serratus (Crustacea Decapoda): intermolt variations. AB - Gastrin/cholecystokinin (G/CCK)-like peptides cross-reacting with an antiserum specific for the carboxyamide terminal pentapeptide of gastrin and CCK have been detected in the eyestalks and in the stomach of the prawn Palaemon serratus using immunocytochemical methods. In the eyestalks, immunoreactivity is present in the neuroendocrine cells, the X organ-sinus gland tractus and the neurohemal organ itself. This suggests, for the first time, the existence of a neuroendocrine secretion of G/CCK-like peptides. Hemolymph G/CCK level is about 18 pM. In the stomach, G/CCK-like material has been observed in epithelial cells in the cuticle and in the lumen. Molecular sieving of crude extracts of the medulla terminalis from the eyestalks, the stomach, and the hemolymph samples on a Sephadex G-50 filtration column exhibited a molecular heterogeneity of the G/CCK immunoreactive material. Large components were observed principally in the medulla terminalis and in the hemolymph, and smaller forms in the stomach. A fraction common for the three tissues had an apparent molecular weight of 2500 Da. That fraction was characterized further by HPLC and shown to be more hydrophobic than human G17 I. By radioimmunoassay relatively low levels were detected in all the aforementioned organs. Although the concentration of the G/CCK-like components varies during the intermolt cycle, this was the case mainly in the hemolymph and in the stomach. These observations suggest a possible role of G/CCK-like peptides in molting processes. PMID- 3549438 TI - Activity of position-8-substituted analogs of mammalian gonadotropin-releasing hormone (mGnRH) and chicken and lamprey gonadotropin-releasing hormones in goldfish. AB - Several vertebrate gonadotropin-releasing hormones (GnRH) and analogs were tested for activity in vivo in goldfish. Each peptide was administered intraperitoneally to goldfish, pretreated with pimozide or vehicle for pimozide, and changes in serum levels of gonadotropin were determined. Pimozide potentiates the activity of GnRH in vivo in goldfish by blocking the endogenous gonadotropin release inhibitory activity of dopamine; relative potencies of GnRH peptides become evident in vivo in goldfish pretreated with pimozide (R. Peter et al. (1985), Gen. Comp. Endocrinol. 58, 231-242). Mammalian GnRH (mGnRH) was used as reference standard. [Try3, Leu5, Glu6, Trp7, Lys8]-GnRH (lamprey GnRH), [Gln8]-GnRH (chicken GnRH-I), and [His5, Trp7, Try8]-GnRH (chicken GnRH-II) caused increases in serum gonadotropin level similar in magnitude to mGnRH. [His5, D-Arg6, Trp7, Tyr8]-GnRH is superactive in the goldfish. [Asn8]-, [Met8]-, [Phe8]-, and [Ser8] GnRH had activity similar to mGnRH in goldfish; [His8]-, [Ile8]-, and [Leu8]-GnRH had a lower level of activity; [Glu8]-GnRH had no apparent activity. The results indicate that there is no particular requirement for a hydrophobic or hydrophilic amino acid, or for a positively charged amino acid in position 8 of mGnRH for activity in vivo in the goldfish; a negatively charged amino acid in position 8 is detrimental for activity. PMID- 3549439 TI - Calbindin in vertebrate classes: immunohistochemical localization and Western blot analysis. AB - Calbindin immunoreactivity was investigated in various vertebrates. Positive labeling was observed in the absorptive cells of the duodenum of all birds and reptiles but not in mammals, amphibia, or fish. Staining was present in the kidney distal convoluted tubule from amphibia and higher vertebrates. Fish kidney was negative. In the central nervous system of all species investigated, cellular bodies and fibers were Calbindin positive. Their distribution was quite broad and correlates well with the previously reported mapping for chick and rat. Western blot analysis revealed two Calbindins in brain from mammals, birds, reptiles, and amphibia (27,000 and 29,000 Da). Only one band was detected in fish. We conclude that Calbindin from the evolutionary point of view is primarily a neuronal protein, with a highly conservative character. PMID- 3549440 TI - Localization of a salmon calcitonin-like molecule in one type of ultimobranchial cells in the freshwater turtle Pseudemys scripta. AB - Immunohistochemical methods using affinity adsorbed antibodies raised against the three families of calcitonins (CT) were applied to ultimobranchial (UB) cells in situ to investigate the nature of the Chelonian calcitonin molecule and its distribution in the ultimobranchial bodies of the freshwater turtle, Pseudemys scripta. In this species, the UB glands were present on both sides and consisted of scattered cell clumps between epithelial vesicular structures. The neighboring parathyroid tissue also contained two components, the majority being composed of similar vesicles, with occasional solid cell cords evenly distributed. Calcitonin immunoreactivity was found in the cell clumps of the UB gland and in the cell cords of the associated parathyroid, but not in the epithelial component lining the vesicles or in the amorphous material which sometimes filled the lumen. Turtle calcitonin was exclusively of the salmon type, as determined by the negative results obtained in situ after the use of antibodies raised against human and porcine molecules. The salmon-like calcitonin content of the ultimobranchial area was estimated as 15.2 ng; however, the molecule was undetectable in the circulation. In this work we localize the quantitate a salmon like CT molecule in one type of ultimobranchial and parathyroid cell of a reptile for the first time. PMID- 3549441 TI - Isolation of two forms of growth hormone secreted from eel pituitaries in vitro. AB - Two forms of growth hormone (GH) were purified by chromatofocusing of medium from cultured Japanese eel (Anguilla japonica) pituitaries. The pituitaries were organ cultured in Eagle's minimum essential medium with Earle's salts. Following polyacrylamide gel electrophoresis of the medium at pH 9.5, two prominent bands were seen with Rf 0.36 and 0.29; they were designated as eGHI and eGHII, respectively. Seven-hundred fifty milliliters of medium, in which 260 pituitaries were cultured for 6-10 weeks, was concentrated by DIAFLO membrane (YM-5) and subjected to gel filtration on a Sephadex G-75 column and to chromatofocusing on a PBE-94 column. eGHI and II were finally purified by gel filtration on a Sephadex G-75 column, yielding 2.0 mg of eGHI and 1.3 mg of eGHII. Both eGHI and eGHII were equipotent to ovine GH in promoting growth of juvenile rainbow trout. The putative GH-producing cells in the proximal pars distalis of the eel pituitary were stained specifically with antisera raised against eGHI or eGHII; no cross-reactivity was seen in the follicular prolactin cells in the rostral pars distalis. As determined by gel isoelectric focusing, eGHI and eGHII have isoelectric points of 6.3 and 6.7, respectively. Identical molecular masses of 23,000 Da were determined by sodium dodecyl sulfate gel electrophoresis. Their amino acid compositions strongly resembled each other; comparison of the partial N-terminal amino acids indicates that sequence 1 to 36 of GHII is exactly the same as 4 to 39 of GHI. PMID- 3549442 TI - Sewall Wright and physiological genetics. PMID- 3549443 TI - Functional alcohol dehydrogenase mutants of Saccharomyces cerevisiae conferring temperature-conditional allyl alcohol resistance. AB - Selection for allyl alcohol resistance in respiratory incompetent yeast is a highly specific method for isolating functional mutations at ADH1, the gene coding for the cytoplasmic alcohol dehydrogenase, ADHI. Because of the nature of this selection scheme, the ADHI activity of such mutants is retained, but the kinetic characteristics of the enzymes are altered. The high specificity for targeting functional mutations at this locus suggested that selection for enzyme variants with more subtle phenotypic effects might be possible. Here, we describe functional ADHI mutants that are temperature-conditional in their allyl alcohol resistance. Haploid cells of one of these mutants grow well on plates at 10 mM allyl alcohol at 19 degrees, but not at 37 degrees, the restrictive temperature. A second mutant grows well at 10 mM at 37 degrees, but its growth is restricted at 19 degrees. What distinguishes these mutants from other temperature-sensitive mutants is that the temperature-conditional growth phenotypes described here must be due to interactions between allyl alcohol levels and ADHI functional properties and cannot be due to lability of the enzyme at the restrictive temperature. This system shows promise for the investigation of functional enzyme variants that differ by only one or two amino acid residues but have significant temperature- and substrate-conditional effects on growth phenotypes in both the haploids and the diploids. PMID- 3549444 TI - Fine structure recombinational analysis of cloned genes using yeast transformation. AB - We describe a general method for analyzing the genetic fine structure of plasmid borne genes in yeast. Previously we had reported that a linearized plasmid is efficiently rescued by recombination with a homologous restriction fragment when these are co-introduced by DNA-mediated transformation of yeast. Here, we show that a mutation can be localized to a small DNA interval when members of a deletion series of wild-type restriction fragments are used in the rescue of a linearized mutant plasmid. The resolution of this method is to at least 30 base pairs and is limited by the loss of a wild-type marker with proximity to a free DNA end. As a means for establishing the nonidentity of two mutations, we determined the resolution of two-point crosses with a mutant linearized plasmid and a mutant homologous restriction fragment. Recombination between mutations separated by as little as 100 base pairs was detected. Moreover, the results indicate that exchange within a marked interval results primarily from one of two single crossovers that repair the linearized plasmid. These approaches to mapping the genetic fine structure of plasmids should join existing methods in a robust approach to the mutational analysis of gene structure in yeast. PMID- 3549445 TI - The RAD24 (= Rs1) gene product of Saccharomyces cerevisiae participates in two different pathways of DNA repair. AB - The moderately UV- and X-ray-sensitive mutant of Saccharomyces cerevisiae originally designated rs1 complements all rad and mms mutants available. Therefore, the new nomination rad24-1 according to the RAD nomenclature is suggested. RAD24 maps on chromosome V, close to RAD3 (1.3 cM). In order to associate the RAD24 gene with one of the three repair pathways, double mutants of rad24 and various representative genes of each pathway were constructed. The UV and X-ray sensitivities of the double mutants compared to the single mutants indicate that RAD24 is involved in excision repair of UV damage (RAD3 epistasis group), as well as in recombination repair of UV and X-ray damage (RAD52 epistasis group). Properties of the mutant are discussed which hint at the control of late steps in the pathways. PMID- 3549447 TI - Paradox found. PMID- 3549446 TI - Cloning, disruption and chromosomal mapping of yeast LEU3, a putative regulatory gene. AB - The LEU3 gene of the yeast Saccharomyces cerevisiae, which is involved in the regulation of at least two LEU structural genes (LEU1 and LEU2), has been cloned by complementation of leu3 mutations and shown to reside within a 5.6-kb fragment. Transformation of leu3 mutants with LEU3-carrying multicopy plasmids restored normal, leucine-independent growth behavior in the recipients. It also restored approximately wild-type levels of isopropylmalate isomerase (LEU1) and beta-isopropylmalate dehydrogenase (LEU2), which were strongly reduced when exogenous leucine was supplied. Strains containing a disrupted leu3 allele were constructed by deleting 0.7-kb of LEU3 DNA and inserting the yeast HIS3 gene in its place. Like other leu3 mutants, these strains were leaky leucine auxotrophs, owing to a basal level of expression of LEU1 and LEU2. Southern transfer and genetic analyses of strains carrying a disrupted leu3 allele demonstrated that the cloned gene was LEU3, as opposed to a suppressor. Disruption of LEU3 was performed also with a diploid and shown to be nonlethal by tetrad analysis. Northern transfer experiments showed that the LEU3 gene produces mRNA approximately 2.9 kilonucleotides in length. The leu3 marker was mapped to chromosome XII by the spo11 method. Linkage to ura4 by about 44 centiMorgans places leu3 on the right arm of this chromosome. PMID- 3549448 TI - Studies on the recombination genes of bacteriophage T4: suppression of uvsX and uvsY mutations by uvsW mutations. AB - Genes uvsW, uvsX and uvsY are dispensable for T4 growth but are implicated in recombination and in the repair of damaged DNA. We found that large-plaque mutants arose efficiently from small-plaque uvsX and uvsY mutants at 42 degrees and were pseudorevertants containing a new mutation in uvsW. Using reconstructed double mutants, we confirmed that a mutation in uvsW partially increases the burst size and UV resistance of uvsX and uvsY mutants. At 41 degrees the uvsW mutation completely restores the arrest in DNA synthesis caused by mutations in genes uvsX, uvsY and 46, but at 30 degrees it only partially restores DNA synthesis in a gene 46 mutant and does not restore DNA synthesis in uvsX and uvsY mutants. Restored DNA synthesis at 41 degrees was paralleled by the overproduction of single-stranded DNA and gene 32 protein. Based on these findings, we propose that the uvsW gene regulates the production of single stranded DNA and we discuss the phenotype of uvsW mutants and their suppression of some uvsX and uvsY phenotypes. Infection of restrictive cells with am uvsW mutants revealed a defect in the synthesis of a protein of molecular weight 53,000 daltons, suggesting that this protein is the uvsW gene product. PMID- 3549449 TI - Meiotic gene conversion and crossing over between dispersed homologous sequences occurs frequently in Saccharomyces cerevisiae. AB - We have examined meiotic recombination between two defined leu2 heteroalleles present at the normal LEU2 locus and in leu2-containing plasmids inserted at four other genomic locations. In diploids where the two leu2 markers were present at allelic locations on parental homologs, the frequency of Leu2+ spores varied 38 fold, in a location-dependent manner. These results indicate that recombination in a genetic interval can be modulated by sequences at least 2.7 kb outside that interval. Leu2+ meiotic segregants were also recovered from diploids where LEU2 was marked with one heteroallele, and the other leu2 heteroallele was inserted at another genomic location. These products of ectopic interactions, between dispersed copies of leu2 sharing only 2.2 kb of homology, were recovered at a frequency comparable to that observed in corresponding allelic crosses. This high frequency of ectopic meiotic recombination was observed in crosses where both recombining partners could potentially pair with sequences at an allelic position. In addition, a significant fraction (22-50%) of these ectopic recombinants were associated with crossing over of flanking sequences. PMID- 3549450 TI - Mutations causing constitutive invertase synthesis in yeast: genetic interactions with snf mutations. AB - We have selected 210 mutants able to grow on sucrose in the presence of 2 deoxyglucose. We identified recessive mutations in three major complementation groups that cause constitutive (glucose-insensitive) secreted invertase synthesis. Two groups comprise alleles of the previously identified HXK2 and REG1 genes, and the third group was designated cid1 (constitutive invertase derepression). The effect of cid1 on SUC2 expression is mediated by the SUC2 upstream regulatory region, as judged by the constitutive expression of a SUC2 LEU2-lacZ fusion in which the LEU2 promoter is under control of SUC2 upstream sequences. A cid1 mutation also causes glucose-insensitive expression of maltase. The previously isolated constitutive mutation ssn6 is epistatic to cid1, reg1 and hxk2 for very high level constitutive invertase expression. Mutations in SNF genes that prevent derepression of invertase are epistatic to cid1, reg1 and hxk2; we have previously shown that ssn6 has different epistasis relationships with snf mutations. The constitutive mutation tup1 was found to resemble ssn6 in its genetic interactions with snf mutations. These findings suggest that CID1, REG1 and HXK2 are functionally distinct from SSN6 and TUP1. PMID- 3549452 TI - The primary structure of the mitochondrial genome of Saccharomyces cerevisiae--a review. AB - We have collated and compiled all the available primary structure data on the mitochondrial genome of Saccharomyces cerevisiae. Data concern 78,500 bp, namely 92% of the 'long' genomes; they are derived from several laboratory strains. Interstrain differences belong to three classes: a small number of large deletions/additions, mainly concerning introns; a large number of small (10-150 bp) deletions/additions located in the intergenic sequences; 1-3 bp deletions/additions and point mutations; the interstrain sequence divergence due to the latter, is of the order of 2% for the strains compared; this low value is, however, an overestimate because of sequence mistakes. PMID- 3549451 TI - Protease B of Saccharomyces cerevisiae: isolation and regulation of the PRB1 structural gene. AB - We have isolated the structural gene, PRB1, for the vacuolar protease B of Saccharomyces cerevisiae from a genomic library by complementation of the prb1 1122 mutation. Deletion analysis localized the complementing activity to a 3.2 kilobase pair XhoI-HindIII restriction enzyme fragment. The fragment was used to identify a 2.3-kilobase mRNA. S1 endonuclease mapping indicated that the mRNA and the gene were colinear. No introns were detected. The mRNA is of sufficient size to encode a protein of about 69,000 molecular weight, a number much larger than either the mature enzyme (congruent to 30,000 protein molecular weight) or the sole reported precursor (congruent to 39,000 protein molecular weight). These results suggest that proteolytic processing steps beyond that thought to be catalyzed by protease A may be required to convert the initial glycosylated translation product into mature protease B. The PRB1 mRNA is made in substantial amounts only when the cells have exhausted the glucose supply and enter the diauxic plateau. There is an extended time lag between PRB1 transcription and expression of protease B activity. A deletion that removes about 83% of the coding region was constructed as a diploid heterozygote. Spores bearing the deletion germinate, grow at normal rates into colonies, and have no obvious phenotype beyond protease B deficiency. PMID- 3549453 TI - Expression of synthetic suppressor tRNA genes under the control of a synthetic promoter. AB - A synthetic promoter derived from the Escherichia coli lipoprotein promoter sequence was used to express synthetic suppressor tRNA genes in E. coli. These constructs, cloned into a plasmid of the pEMBL family, gave very high yields of suppressor tRNA in vivo. PMID- 3549455 TI - Synthesis of mutant parathyroid hormone genes via site-specific recombination directed by crossover linkers. AB - A synthetic 'crossover linker' technique has been designed for gene modification. The linker has a restriction end for an initial 'cohesive end' ligation with one terminus of a linearized plasmid, a middle section carrying modified sequence information, and an 'homology-searching' sequence of 20 bp at its other end, that is homologous to a specific region in the opposite terminus of the plasmid. Inside the Escherichia coli transformation host, intramolecular recombination between the homologous ends of the resultant plasmid intermediate completes the integration of the linker. Using different crossover linkers, a human parathyroid hormone gene which had previously been cloned into plasmid pUC8 was converted to mutant coding sequences via specific base substitution, sequence deletion and sequence insertion. PMID- 3549454 TI - The organization of the araBAD operon of Escherichia coli. AB - The nucleotide (nt) sequence of the araBAD operon of Escherichia coli B/r has been determined. The nt sequence predicts a transcript of about 4250 nt. The coding regions of araB, araA and araD genes were identified by partial amino acid (aa) sequences of the purified proteins and their cleavage products. We have deduced that the polypeptides encoded by the araBAD operon consist of 566 (araB), 500 (araA) and 231 (araD) aa residues. The operon contains a leader sequence of 27 nt. The intergenic region between araB and araA is 10 bp in length, while the araA and araD genes are separated by 283 bp consisting primarily of six REP sequences. Comparison of the E. coli sequence with that of Salmonella typhimurium [Lin et al., Gene 34 (1985) 111-122; 123-128; 129-134] shows that, while considerable divergence in nt sequence has occurred, the aa sequences are largely conserved. The most pronounced difference, found in the araD gene, is the deletion of a single nt in the S. typhimurium sequence. PMID- 3549456 TI - A shuttle vector system for Brevibacterium lactofermentum. AB - We have constructed a shuttle vector that replicates in Escherichia coli, Corynebacterium glutamicum and Brevibacterium lactofermentum, by fusion of a 4.4 kb cryptic plasmid isolated from B. lactofermentum and a derivative of pBR322. Resistance to erythromycin which is expressed in all three bacteria has been a useful selective marker. The frequency of homospecific transformation was 1.5 X 10(5) transformants/micrograms of hybrid plasmid DNA. PMID- 3549457 TI - Molecular cloning of the plasmid RP4 primase region in a multi-host-range tacP expression vector. AB - Plasmid RP4 primase was overproduced by utilizing autoregulated high-level expression vector systems in Escherichia coli and in four other Gram-negative bacterial species. Analysis of the products in E. coli revealed that in addition to the two primase polypeptides of 118 and 80 kDa the pri region of RP4 encodes two smaller proteins of 16.5 and 8.6 kDa. The transcript for the four RP4 specified products is polycistronic. The vector system used in E. coli is based on the plasmid pKK223-3 (Brosius and Holy, 1984), a ColE1-type replicon which contains a polylinker sequence flanked on one side by the controllable tac promoter and on the other side by two strong transcriptional terminators. The gene for the lac repressor (lacIQ) was inserted to render the use of the plasmid independent from repressor-overproducing strains. The gene cartridge essential for high-level expression and selection was combined with the RSF1010 replicon to generate a vector plasmid functioning in a wide variety of Gram-negative hosts. The versatility of the vector family was extended by constructing derivatives that contain the polylinker in inverted orientation relative to the tac promoter. Therefore, the orientation of the cloned fragment can be chosen by 'forced cloning' into the appropriately selected vector. PMID- 3549458 TI - Regulation of the yeast metallothionein gene. AB - To study regulation of the yeast CUP1 gene, we have employed plasmids containing the CUP1 regulatory sequences fused to the Escherichia coli galK gene. A comparison of galK expression from low- and high-copy-number CUP1/galK fusion plasmids demonstrated that both basal and induced levels of galactokinase (GalK) increase proportionately with plasmid copy number. Host strains with an amplified, single or deleted CUP1 locus were compared to look for effects of chromosomal CUP1 gene dosage on expression from the episomal CUP1 promoter. Basal GalK levels are similar in CUP1R and cupls hosts, but can be induced to higher levels in the cup1s than the CUP1R host. In contrast, in a strain deleted for the chromosomal copy of CUP1, synthesis of GalK is constitutive but can be induced to yet higher levels by copper. A hybrid vector, placing the CUP1 coding sequence under the control of a constitutive promoter, was constructed. Introduction of this hybrid CUP1 gene into the deletion host containing the CUP1/galK plasmid restores regulation. Thus, metallothionein, in trans, can effect repression of the CUP1 promoter. The possible roles of metallothionein and free copper in CUP1 regulation are discussed. PMID- 3549459 TI - The nucleotide sequence of the pepN gene and its over-expression in Escherichia coli. AB - The complete nucleotide sequence has been determined for the pepN gene of Escherichia coli K-12. The product of this gene, peptidase N, is apparently 870 amino acids in length. The coding sequence is followed by a tandem pair of stop codons and then a sequence capable of forming a stem-and-loop structure in the pepN mRNA. In the process of subcloning the pepN gene we constructed a plasmid which causes peptidase N to be produced at a level of 50% of total protein. The peptidase is fully active and completely soluble and these overproducing cells appear otherwise normal. PMID- 3549460 TI - Expression of the hepatitis B virus large envelope protein in Saccharomyces cerevisiae. AB - The yeast vector pPV2 has been constructed for inducible expression of non-fused proteins from the PHO5 promoter. Signals of the URA3 gene are used for transcription termination. The 226-amino-acid 'major' and the 389-amino-acid 'large' envelope protein of hepatitis B virus (HBV) have been produced in Saccharomyces cerevisiae following insertion of the S gene or of the entire pre-S region and the S gene, respectively, of HBV into pPV2. Although normally only a minor constituent of the viral envelope, the 'large' protein forms particles with cellular lipids similar to those composed of the 'major' envelope protein. Such particles carry pre-S1, pre-S2, and S-encoded epitopes and, in addition, a receptor for polymerized human serum albumin. PMID- 3549461 TI - The cloning and sequence of the gene encoding the omega subunit of Escherichia coli RNA polymerase. AB - Omega is a small protein found associated with Escherichia coli RNA polymerase. The role of omega, if any, in transcription is not known. We have cloned the omega-encoding gene (rpoZ) so that we can produce large amounts of omega by over production and to introduce mutations in its gene. We determined the N-terminal amino acid (aa) sequence of omega by aa microsequencing. Using the sequence we synthesized an eight-fold ambiguous 14-mer oligodeoxynucleotide probe and screened an E. coli genomic library using the base composition independent method of hybridization reported by Wood et al. [Proc. Natl. Acad. Sci. USA 82 (1985) 1585-1588]. With this method we isolated a clone that contained part of rpoZ which we used as a probe to isolate the complete gene. The sequence of the region containing the rpoZ gene predicts a highly charged protein of 91 aa with an Mr of 10 105. In addition, upstream from the gene is a good promoter-like sequence. We have verified by S1 mapping that in vivo transcripts originate from this promoter and possibly from a second promoter farther upstream. PMID- 3549462 TI - Primary structure of Mucor miehei aspartyl protease: evidence for a zymogen intermediate. AB - The gene encoding the aspartyl protease of the filamentous fungus Mucor miehei has been cloned in Escherichia coli and the DNA sequenced. The deduced primary translation product contains an N-terminal region of 69 amino acid (aa) residues not present in the mature protein. By analogy to the evolutionarily related mammalian gastric aspartyl proteases it is inferred that the primary secreted product is a zymogen containing a 47-aa propeptide. This propeptide is presumably removed in the later steps of the secretion process or upon secretion into the medium. To study the effects of modifications of the protease structure on its maturation by enzyme-engineering methods, an efficient expression system was sought. In E. coli, transcription of the preproenzyme coding sequence from a bacterial promoter results primarily in the accumulation of unsecreted, enzymatically inactive polypeptides, immunologically related to the authentic protease. In Aspergillus nidulans expression of the cloned gene, probably from its own promoter, results in the secretion into the culture medium of polypeptides which, compared to the authentic protease, are similar in specific activity, but differ in the character of their asparagine-linked oligosaccharides. PMID- 3549463 TI - A system for the analysis of expression signals in Aspergillus. AB - To analyse gene expression signals in Aspergillus we have constructed a set of integration vectors each of which contains in front of the Escherichia coli 'lacZ gene a unique BamHI site in one of the three possible translational reading frames and the A. nidulans argB gene as a selection marker. The vectors allow in phase translational fusion of any gene to 'lacZ. After transformation of an A. nidulans argB strain, the vectors integrate with a high percentage at the argB locus of the genome, as a single copy. The insertion of the fusion genes at the argB locus assures the constancy of influences of the chromosomal environment on gene expression. PMID- 3549464 TI - Screening recombinant clones containing sequences homologous to Escherichia coli genes using single-stranded bacteriophage vector. AB - Detection and isolation of Escherichia coli clones carrying vectors with foreign DNA sequences partially homologous to specific E. coli genes is difficult because denatured DNA in the host genome can hybridize with the probe. In this paper we present a procedure which simplifies this task by using bacteriophage M13 as the cloning vector. The procedure takes advantage of the secretory properties of the phage, as well as the property of nitrocellulose membrane to bind protein and single-stranded DNA but not double-stranded DNA. This procedure is shown to be effective in identifying E. coli clones containing sequences of Chlamydomonas reinhardtii chloroplast DNA that are homologous to the rpoC gene of E. coli. We suggest that this procedure can be used generally for rapid isolation of DNA sequences that are homologous to E. coli genes. PMID- 3549465 TI - Synthesis and processing of Semliki forest virus polyprotein in Saccharomyces cerevisiae: a yeast type glycosylation of E1 envelope protein. AB - A cDNA coding for the structural proteins of Semliki Forest virus (SFV) was ligated between the ADC1 promoter and terminator in a yeast expression vector, pAAH5. Synthesis of the SFV-specific proteins in Saccharomyces cerevisiae transformed with this vector was shown by immunoblotting and immunoprecipitation. Detection of the N-terminal and the C-terminal components of the viral polyprotein, capsid protein and E1 envelope protein, respectively, suggested that the entire polyprotein was translated in yeast. The capsid protein was effectively released from the polyprotein as a normal size polypeptide, but the following protein, p62 (E3, E2 precursor) was not detected, suggesting that it was rapidly degraded. Electrophoretic analyses indicated that the final protein, E1, entered the secretory pathway, the signal sequence was cleaved off and the protein became extensively and heterogeneously glycosylated. These data suggest that E1 was transported to the Golgi complex and that yeast-characteristic outer chain glycans were added to the protein. PMID- 3549467 TI - Medicare slowdown: Physicians and patients are victimized. PMID- 3549468 TI - Aging, glucose metabolism, and diabetes: current concepts. AB - Glucose metabolism slows with the aging process, leading to diabetes mellitus and impaired glucose tolerance in approximately 25% of persons 65 years and older. A reduction in the biologic action of insulin, at a point beyond the insulin receptor (postbinding site), is primarily responsible for the reduced rate of glucose utilization. The contributions made by the "molecular" events of aging and environmental factors such as changes in diet, activity level, and body composition to the alterations in glucose metabolism are not well defined. Whether impaired glucose tolerance or diabetes mellitus contributes to morbidity or mortality in the aging population is not known. PMID- 3549466 TI - Structure and activity of the translocated c-myc in mouse plasmacytoma XRPC-24. AB - In the mouse plasmacytoma XRPC-24 both c-mos and c-myc are rearranged. We cloned the rearranged c-myc and found that it was translocated to the immunoglobulin C alpha locus. The breakpoint is at the end of exon 1 in c-myc and approximately 0.5 kb upstream from exon 1 of C alpha. The cloned translocated c-myc linked to a strong transcriptional promoter can efficiently transform rat embryo fibroblasts when co-transfected with the activated Ha-ras. The transformed cells are tumorigenic in syngeneic rats. PMID- 3549469 TI - [Evolution of views on the surgical treatment of ovarian infertility]. PMID- 3549470 TI - [Results of treating Trichomonas vaginitis with Solco-Trichovac vaccine]. PMID- 3549471 TI - Immunotherapy for cancer: the use of lymphokine activated killer (LAK) cells. PMID- 3549474 TI - Breast carcinoma: an overview. AB - Breast cancer incidence in the United States is increasing, and the role of the gynecologist is becoming increasingly important in early detection of this common tumor of women. This article presents basic information on the anatomy and physiology of the female breast and their relationship to benign and malignant conditions commonly seen in clinical practice. An overview of detection screening, diagnosis, and treatment of breast carcinoma is also provided. PMID- 3549472 TI - Colonic bacterial proteases to IgA1 and sIgA in patients with ulcerative colitis. AB - The colonic faecal and mucosal associated bacterial populations of five patients with ulcerative colitis and four control patients were studied in detail to assess their ability to produce IgA1-proteases. A total of 330 bacterial strains were isolated from the patients with ulcerative colitis and IgA1-protease activity was unable to be reliably shown in any. It is therefore unlikely that such enzyme production by colonic bacteria plays a significant role in the pathogenesis of ulcerative colitis. PMID- 3549473 TI - Randomised study of the influence of non-steroidal anti-inflammatory drugs on the treatment of peptic ulcer in patients with rheumatic disease. AB - Sixty-seven patients with rheumatic disease, treated with non-steroidal anti inflammatory drugs (NSAIDs), entered a controlled trial with a diagnosis of duodenal (n = 51), gastric (n = 14), or gastric and duodenal (n = 2) ulcers. The main objectives of the study were a comparison of ranitidine and sucralfate in ulcer treatment, and to observe the influence of continued NSAID administration during peptic ulcer therapy. Ulcers healed within nine weeks in 52 patients. The mean healing time was similar in 27 patients given ranitidine 150 mg bd (4.9 weeks) and 25 patients given sucralfate 1 g qid (4.6 weeks). In patients with unhealed ulcers after nine weeks of treatment, healing was obtained in seven after further therapy for 3-9 weeks. Of the 30 patients who continued NSAIDs during treatment with either ranitidine or sucralfate, 23 ulcers healed (mean healing time: 5.0 weeks). Of 32 patients in whom NSAIDs were stopped, ulcer healing was documented in 29 (mean healing time: 4.6 weeks). The difference in healing rates was not statistically significant (p greater than 0.10). The outcome of ulcer treatment did not differ in patients with rheumatoid arthritis and patients suffering from osteoarthritis. During a 12 month follow up 14 symptomatic ulcer recurrences were recorded. PMID- 3549475 TI - Immunocytochemical localization of prolactin in carcinoma of the cervix. AB - Immunocytochemical methods were used to demonstrate prolactin in both normal and malignant human cervices. Four of five cervices with epidermoid carcinoma and three of four cervices with adenocarcinoma demonstrated prolactin. One of four normal cervices stained positive for prolactin in the endocervical glands. Four cervices from pregnant patients were positive for prolactin. The results of this study show prolactin in human cervical carcinomas. The role and source of cervical prolactin is unknown. PMID- 3549476 TI - Phase III study on the treatment of women with cervical cancer, stage IIB, IIIB, and IVA (confined to the pelvis and/or periaortic nodes), with radiotherapy alone versus radiotherapy plus immunotherapy with intravenous Corynebacterium parvum: a Gynecologic Oncology Group Study. AB - A report on a study conducted under the auspices of the Gynecologic Oncology Group on the treatment of women with advanced carcinoma of the uterine cervix (stages IIB, IIIB, IVA) with radiotherapy alone versus radiotherapy plus immunotherapy (intravenous Corynebacterium parvum) is presented. There were 283 patients considered evaluable for analysis. Of these, 135 patients were randomized to radiotherapy plus C. parvum (120 patients received at least one course) and 148 were randomized to radiotherapy only. The two treatment regimens were similar for those adverse effects commonly associated with radiation therapy but for hematologic toxicity and fever and/or chills were significantly more frequent among those patients who received C. parvum. There was no statistical difference in the treatment regimens with regard to survival or progression-free interval. Of the 42 patients with positive periaortic nodes, 19% were alive at 3 years. No therapeutic value was demonstrated by combining C. parvum therapy with traditional radiation therapy in advanced cervical cancer. Because of the greater frequency of adverse effects in those patients receiving C. parvum, the further use of C. parvum at this dose and schedule does not appear to be indicated for treating cervical cancer patients. PMID- 3549477 TI - [Stable soft tissue reconstruction using an autochthonous muscle flap transposition and simultaneous bone reconstruction in post-traumatic and osteitis defects of the lower extremity]. AB - Posttraumatic soft tissue and bone defects can pose problems for the surgeon. Autogenous bone from the iliac crest may be used to fill bone defects. To achieve bone healing, a well vascularized recipient site for the graft is important. Local muscle flaps or distant microvascular flaps improve vascularity by introducing a fresh blood supply. Cellular and humoral antibodies are more effective and allow quicker revascularisation of the transplanted graft. 49 soft tissue defects were treated by local muscle flaps. In 14 cases the soleus, in 28 the gastrocnemius, in three the tibialis anterior, in two the abductor hallucis, and in two the gracilis muscle was transposed. 38 cases had posttraumatic osteitis, in eight the defect was merely a soft tissue defect and in three due to tumour excision. In 24 patients a combination of soft tissue repair and cancellous bone grafting was performed. Four flaps failed because of total or partial necrosis. In all cases full weight bearing on the leg with good soft tissue cover was achieved. PMID- 3549478 TI - History of nasal reconstruction. A brief survey. AB - Nasal reconstruction goes back to very early times; it was practised in ancient India about 1000 B.C. The first reports in the Western World come from the Branca family in Sicily (mid XV century) and from the Vianeo family in Calabria (mid XVI century): this art was later taken up by Tagliacozzi and published by him in 1597. A review of the literature reveals that the numerous procedures now available to repair the nose had already been devised by the middle of the nineteenth century in Germany and France as well as in England. Outstanding contributions were also made in Italy and the United States. PMID- 3549479 TI - [Systemic lupus erythematosus in pregnancy]. PMID- 3549480 TI - [Interleukins: the hormones of the immune system]. PMID- 3549481 TI - [Physiology of vitamin D]. PMID- 3549482 TI - [New therapeutic approach in treatment in early latent and asymptomatic neurosyphilis]. PMID- 3549483 TI - [Natural killer (NK) cells: a defence mechanism in viral infections]. PMID- 3549484 TI - [Ischemic myocardial metabolism and antianginal drugs]. AB - The effect of several kinds of antianginal drugs: nitrates, coronary vasodilators, beta-adrenergic blocking agents and calcium entry blocking agents on the myocardial metabolism and myocardial acidosis during ischemia was studied in the dog heart in vivo. Ischemia was induced by ligating the left anterior descending coronary artery. Ischemia accelerated anaerobic metabolism in the myocardium, in which glycogen breakdown, accumulation of glycolytic intermediates, loss of high energy phosphate and tissue acidosis occurred. Nitroglycerin, beta-adrenergic blocking agents such as propranolol, and some calcium entry blocking agents such as diltiazem and flunarizine prevented the myocardial metabolism from shifting to an anaerobic metabolism in spite of ischemia. However, coronary vasodilators and the dihydropyridine type of calcium entry blocking agents were not capable of reducing changes in the myocardial metabolism and myocardial acidosis during ischemia. The author makes a point in the present review that all the drugs which dilate coronary artery are not always effective on the ischemic myocardium. PMID- 3549486 TI - ABO-grouping of human hair by immunoenzyme technique. PMID- 3549485 TI - Vinyl chloride: an assessment of the risk of occupational exposure. AB - There is little doubt that exposure to high levels of VCM as a consequence of occupation can result in an increased incidence of ASL. A review of 20 epidemiological studies involving about 45,000 workers occupationally exposed to VCM showed that neoplasms of the liver showed an increase in incidence in the majority of studies. For brain cancer the association between exposure to VCM and an increased incidence was less clear because of the lower relative risk. Neoplasms of the respiratory tract, digestive system, lymphatic and haemopoietic system, buccal cavity, and pharynx, cardiovascular system and colon/stomach were reported to show an increased incidence in one or more studies, but to show no increase, or in some cases a decrease, in incidence in other studies. In view of the increased incidence of breast neoplasms in rodents exposed to VCM, the studies of Chaizze et al. (1980), who did not confirm these findings in humans, are of importance. The register of ASL cases now contains records of 99 persons with confirmed ASL and occupational exposure to VCM. The average latent period between first exposure to VCM and death from ASL is 21.9 years. The majority of cases occurred in autoclave workers, who are recognized as having been exposed to extremely high levels. Although precise estimates of exposure are not available for the periods of most interest, the pattern of cases roughly suggests that extremely high exposures were necessary for the induction of ASL. For example, ASL cases tended to occur in larger numbers in some plants than in others, a finding that can be explained most easily by differences in exposure patterns. There is an extensive series of animal studies on the carcinogenicity of VCM. Some of these precede the epidemiological studies confirming the association between VCM exposure and ASL in man. ASL and neoplasms of a number of other organs have been induced in laboratory rodents by VCM. Estimation of the exposure levels likely to cause a lifetime risk of ASL of 10(-6) on the basis of these data give extremely low levels (down to 3.9 X 10(-7) ppb) which appear to be unrealistic estimates for man. Part of the reason for this is that laboratory studies have shown that VCM is metabolized in the liver (and elsewhere in the body) to the reactive metabolites chloroethylene oxide and chloroacetaldehyde. The rate of conversion is limited at high levels of exposure giving inaccurate estimates of the slope of the dose-response relationship.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549487 TI - [Significance of secondary osteoplasty in orthodontic treatment of facial cleft patients]. PMID- 3549488 TI - [Corrective operations following primary surgical management of facial cleft patients]. PMID- 3549489 TI - [Prosthetic management of patients with lip, jaw and palate clefts]. PMID- 3549490 TI - [The tolerance of frustration in adolescent and adult patients with lip, jaw and palate clefts]. PMID- 3549491 TI - [The gunner with the silver mask. An ingenious design for facial reconstruction in the 19th century]. PMID- 3549492 TI - [Physical performance in antihypertensive therapy. Results of a calcium antagonist-beta blocker combination]. PMID- 3549493 TI - [Acute therapy of duodenal ulcer. Comparison of famotidine and ranitidine in a single evening dose]. PMID- 3549494 TI - [Meniscus sonography. Value and accuracy compared to arthrography and arthroscopy or surgery]. PMID- 3549495 TI - [Assuring esophageal anastomosis using vicryl mesh. Experimental study]. PMID- 3549496 TI - A life of service. Miss Helen E. Browne, C.B.E. 1911-1987. PMID- 3549497 TI - [Radiobiological rationale of neutron radiotherapy]. PMID- 3549498 TI - [Postnatal development of the neuronal cell bodies using the HRP technic and analyzing by the computer system--I. Oculomotor nucleus of the rat]. PMID- 3549499 TI - Nuclear magnetic resonance imaging of the cardiovascular system. AB - Nuclear magnetic resonance (NMR) imaging provides a noninvasive method of detecting and characterizing several clinically important cardiac diseases. These include hypertrophic cardiomyopathy, several congenital disorders, especially those with abnormalities of the surrounding great vessels and those with surgical shunts in place, intra and extra cardiac masses and constrictive pericarditis. NMR imaging is becoming useful in the visualization of aortic disease, particular for the serial management of coarctation, and for the diagnosis of thoracic and abdominal aneurysms and dissections. Other peripheral vascular lesions such as portal shunts and arterial-venous malformations are detected. With further experience and improved technology, NMR imaging will become a valuable tool for the detection and characterization of recent infarction, monitoring of cardiac transplantation patients for the presence of rejection, detection of myocardial iron overload and the visualization of peripheral vascular disease. For NMR imaging to become firmly entrenched as a cardiovascular imaging tool, however, it will be necessary to carefully document its advantage over already well established and less expensive methods, such as radionuclide imaging techniques and 2-D echocardiography. Moreover, NMR imaging will need to be compared to developing technology like cine computerized X-ray tomography before the best noninvasive imaging technique is finally established for a particular cardiovascular disease. PMID- 3549500 TI - Immunoreactive C-peptide in spontaneous syndromes of obesity and diabetes in mice. AB - Immunoreactive C-peptide was evaluated in the plasma and pancreas of Aston ob/ob and C57BL/KsJ db/db mice in relation to disturbances in pancreatic B-cell function. At 18-24 weeks of age, ob/ob and db/db mice displayed hyperglycaemia (1.6 and 3.8 fold increases respectively) and hyperinsulinaemia (10.8 and 5.1 fold increases respectively) despite a similar pancreatic insulin content to their respective non-diabetic lean control mice. Immunoreactive C-peptide concentrations in the plasma and pancreas of the mutants corresponded with the degree of hyperinsulinaemia and pancreatic insulin content, and the insulin: C peptide molar ratios in both mutants were similar to lean controls. In ob/ob mice parenteral glucose administration decreased plasma insulin and C-peptide concentrations, despite markedly raised glucose concentrations. However, administration of a low dose of insulin (5 U/kg) to lean mice and much higher doses of insulin (50 and 120 U/kg) to ob/ob mice markedly decreased plasma glucose and C-peptide concentrations. When the rate and extent of insulin-induced glucose suppression observed in ob/ob mice was mimicked in lean mice, an almost complete (95%) inhibition of C-peptide was achieved compared with a 57% decrease in the ob/ob mutant. Injection of ob/ob mice with glucose to counter the insulin induced hypoglycaemia failed to affect the fall of C-peptide concentrations. The data suggest that the metabolic processing of insulin and C-peptide are undisturbed in obese-diabetic mice, and that the impaired suppression of circulating C-peptide by insulin-hypoglycaemia in ob/ob mice predominantly reflects impaired feedback inhibition by insulin. PMID- 3549501 TI - Influence of the thymus extract on the immunological function of animals with experimental diabetes. AB - After immunization with SRBC, the number of plaque-forming cells (PFC) in the spleen of alloxan-diabetic mice, in nondiabetic TIR mice and in alloxan-diabetic TIR mice was significantly decreased as compared with control non-diabetic donors. The ability of lymphocytes from alloxan-diabetic mice to adoptively restore the suppressed immune response of TIR mice, was reduced in comparison with the effect of lymphocytes from normal, nondiabetic donors. Local GVH reaction in nondiabetic rat recipients provoked by lymphocytes from control healthy mice was 5.6 +/- 0.7 mm. Significantly lower rate of local GVH reaction after injection of lymphocytes from diabetic donors was found in diabetic as in nondiabetic recipients as well. Treatment of alloxan-diabetic mice with thymus extract or with insulin, partly restored depressed function of the humoral and cellular system. Treatment of diabetic mice with both thymus extract and insulin, was even more effective in restoring of their immune reactivity. Diabetic condition strongly influenced the function of the immune system. This could be attributed to depletion of T-lymphocytes, changed relations between the lymphocyte subpopulations in diabetic donors, and disturbance of lymphocyte metabolism. PMID- 3549502 TI - Effect of insulin on the response of gut glucagon-like immunoreactivity (GLI) to oral glucose and food ingestion in the goose. AB - Gut GLI levels were measured in the plasma of normal, totally and subtotally depancreatized geese, using an antiserum specific for avian pancreatic glucagon and another one which crossreacts with intestinal extracts. Gut GLI was determined by difference between "total" GLI and immunoreactive pancreatic glucagon (IRG). Glucose given orally or a meal rich in carbohydrates elicited an elevation in plasma gut GLI. The increment of gut GLI was greater when the pancreas was removed. The over-stimulation of gut GLI was corrected by the administration of insulin. This is the first study which reports a correlation between insulin and gut GLI secretion in birds. PMID- 3549503 TI - Is the response of plasma glucose and insulin to short-term exercise-training genetically determined? AB - Six male monozygotic (MZ) twin pairs participated in the present study which was undertaken to assess the contribution of heredity to changes in plasma glucose and insulin in response to exercise-training. This group was submitted to a vigorous ergocycle exercise program inducing a surplus in energy expenditure of 1000 kcal/day over habitual energy expenditure during 22 consecutive days. An oral glucose tolerance test (OGTT, 75 g glucose) was performed before and about 16 hours after the experimental period. Fasting plasma glucose as well as its increase over basal level (delta area) during OGTT were not modified by exercise training (p greater than 0.05), although a marked reduction in insulin was observed, both in the fasting state and during the OGTT (p less than 0.01). To assess the extent to which heredity influenced the response to the treatment, i.e. the genotype-training interaction, within and between MZ twin pairs means of squares were calculated. A significant intrapair resemblance in the response to exercise-training was observed for fasting insulin and delta insulin area/delta glucose area ratio during OGTT, but not for delta insulin area. These results provide some indications about a possible role of the genotype on the sensitivity to reduce plasma insulin in response to exercise-training. However, this hypothesis needs to be substantiated by other experimental data with control over the genotype of subjects. PMID- 3549504 TI - Acute changes in plasma renin activity, plasma aldosterone concentration and plasma electrolyte concentrations following furosemide administration in patients with congestive heart failure--interrelationships and diuretic response. AB - We studied the effects of furosemide on plasma renin and plasma aldosterone in 8 patients with mild to moderate congestive heart failure. In particular, we tried to correlate these effects with changes in plasma electrolyte concentrations and with the diuretic response on furosemide. We concluded that the diuretic response in patients with congestive heart failure is not dependent on the initial serum renin nor on the initial serum aldosterone concentration. The diuretic response did not correlate either with the changes in serum renin and/or serum aldosterone concentration. Serum renin and serum aldosterone correlated mutually before and after intravenous furosemide. We confirmed the inverse correlation between serum sodium and serum renin. SeNa and SeK correlated at all times with serum aldosterone; SeCl correlated with serum aldosterone only before intravenous furosemide administration. Indirect evidence could be provided that in patients with congestive heart failure a decreased renal blood flow is present, using the urinary beta 2-microglobulin concentration. Aldosterone has again, indirectly, proved to be integrated in the renal magnesium handling. PMID- 3549505 TI - Insulin resistance in patients of Asian Indian and European origin with non insulin dependent diabetes. PMID- 3549506 TI - Assessing depression in prepubertal children. AB - Although symptoms of major depression are the same in adults and prepubertal children, diagnosing depression in children presents special problems not encountered with adults. In addition to the standard clinical interview, methods of assessing childhood depression include diagnostic interviews, self-report inventories, projective tests, peer ratings, and biological markers. Unfortunately many of these methods currently lack detailed reliability and validity studies. Despite their limitations these techniques can be helpful in making a diagnosis. However, accurate diagnosis still requires careful evaluation and individualized clinical judgement. PMID- 3549507 TI - Prevention of recurrent bleeding in cirrhotics with recent variceal hemorrhage: prospective, randomized comparison of propranolol and sclerotherapy. AB - To compare the efficacy of endoscopic paravariceal sclerotherapy and oral propranolol in the prevention of recurrent upper gastrointestinal bleeding, 78 cirrhotic patients were randomly assigned to either treatment after an endoscopically proven bleed from esophageal varices. After randomization, but before treatment had been started, a total of eight patients had to be withdrawn from the study due to early rebleeding (requiring emergency sclerotherapy) or violations of the protocol. Among the 70 patients analyzed (36 sclerotherapy, 34 propranolol), both treatment groups were comparable with respect to demographic, clinical and laboratory data. The groups also did not differ with respect to continued alcohol intake. Sclerotherapy was performed twice weekly using 1% polidocanol as the sclerosing agent until the varices were eradicated or well covered by fibrous tissue. Propranolol was given twice daily at a dose reducing the resting heart rate by 25% (60 to 320 mg per day; mean +/- SD = 161 +/- 80 mg per day). Patients were followed for up to 2 years with visits at 3 monthly intervals (mean follow-up = sclerotherapy, 14 months; propranolol, 9.2 months). Life table analysis of patients without rebleeding from nonvariceal sites revealed a tendency in favor of propranolol; however, the difference did not reach statistical significance. No significant difference was observed between sclerotherapy and propranolol in the proportion of patients rebleeding from esophageal varices or from all sources of upper gastrointestinal bleeding. Furthermore, survival was similar in both treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549509 TI - Recent advances in hepatic vitamin K metabolism and function. PMID- 3549508 TI - Evidence that host size determines liver size: studies in dogs receiving orthotopic liver transplants. AB - Orthotopic liver transplantation was performed in two groups of dogs; Group I animals consisted of large dogs that served as recipients of livers obtained from smaller dogs while Group II animals consisted of dogs that received liver from donor dogs of nearly the same size. The small-for-size livers transplanted into the Group I dogs rapidly increased in size over the course of 2 weeks until they achieved a size equal to that originally present in the larger recipient dogs. In contrast, the livers transplanted into dogs of the same size as the donors underwent some degree of atrophy. In both groups of animals, plasma levels of insulin and glucagon and hepatic (graft) activities of thymidine kinase and ornithine decarboxylase were followed serially. The only difference between the two groups of animals for these measures was that the ornithine decarboxylase activity rose to a greater degree in the liver that underwent graft enlargement. These data suggest that recipient size determines, at least in part, liver graft size once it is transplanted. These data also suggest that of the parameters followed, only ornithine decarboxylase activity parallels the finding of growth of the transplanted liver. PMID- 3549510 TI - The pathophysiological significance of lipid peroxidation in oxidative cell injury. PMID- 3549511 TI - Non-secretory multiple myeloma: a report of 13 cases with a review of the literature. AB - The clinical features of 13 patients with non-secretory myeloma from a series of 172 consecutive multiple myelomas are presented. The non-secretors survived significantly longer that the secretors, median 46 months versus 21 months (p less than 0.01). Non-secretory myeloma was associated with a higher incidence of neurological presentation, minimal lytic bone disease, a lower median percentage of plasma cells in the marrow and a lower incidence of hypogammaglobulinaemia. The median survival of the non-secretors with minimal lytic bone lesions was 74 months compared to 21 months for those with extensive bone disease. The superior survival of non-secretors is thus thought to be due to earlier presentation possibly as a result of a tendency to form symptomatic local tumours. Retrospective immunoperoxidase staining of stored tissue was performed in nine cases. In only one of these was a monoclonal immunoglobulin not detected indicating that true 'non-production' is rare. In four patients who produced a biochemically detectable paraprotein during the course of their disease and in whom immunoperoxidase data was available the immunoglobulin was of the same type. Immunoperoxidase staining may help in the initial diagnosis of non-secretory myeloma but did not contribute any prognostic information. PMID- 3549513 TI - Is it necessary to embed bone marrow biopsies in plastic for haematological diagnosis? AB - With the increase in the use of bone marrow trephines for diagnosis have come numerous reports that traditional methods of preparation (by decalcification and embedding in paraffin wax) should be replaced by plastic embedding to avoid decalcification. It has been argued that only by this means can the high quality preparations needed for accurate haematopathological diagnosis be achieved. The present study challenges this viewpoint and argues that with a little extra care and attention conventional paraffin embedding techniques can give equally high quality preparations. Sections prepared in this way meet the diagnostic needs of the haematologist, without requiring a separate technique to be established in the pathology laboratory solely for bone marrow trephines. PMID- 3549512 TI - An investigation of Ki-1 positive large cell lymphoma with antibodies reactive with tissue macrophages. AB - The diagnosis of true histiocytic lymphoma (THL) represents one of the most difficult and controversial areas of lymph node pathology. Recently, Stein et al. (1985) have demonstrated that a series of tumours presenting with morphological and immunocytochemical features, previously considered as being indicative of THL, share antigenic markers with Reed-Sternberg and mononuclear Hodgkin's cells and, therefore, may be derived from lymphocytes, rather than histiocytes. In this study we have re-investigated some of these cases with a panel of monoclonal antibodies variously reactive with macrophages. Although all cases contain a heavy infiltrate of reactive histiocytes the tumour populations are negative for histiocyte antigens. PMID- 3549514 TI - Ductal adenoma of the breast--a lesion exhibiting a myoepithelial/epithelial phenotype. AB - A detailed immunocytochemical study has been carried out on a case of ductal adenoma of the breast. The lesion was oestrogen receptor positive and contained focal areas of apocrine metaplasia and marked nuclear atypia. The tumour had a pseudo-infiltrative growth pattern and showed good evidence of both epithelial and myoepithelial differentiation. Islands of tumour cells were surrounded by a clearly defined basement membrane as demonstrated with an anti-type IV collagen antibody. The heterogeneous staining pattern produced by monoclonal antibody BA17, which recognizes keratin 19, was similar to that seen in normal lobules and raises questions concerning the site of origin of this lesion in the breast. PMID- 3549515 TI - The expression of cell surface MHC class I heavy and light chain molecules in pre malignant and malignant lesions of the oral mucosa. AB - Major histocompatibility complex (MHC) class I antigenic expression was examined on epithelial cell surfaces in normal oral mucosa, non-specific oral keratoses, dysplastic epithelium adjacent to carcinomas and in invasive tumour islands of squamous cell carcinomas, using antibodies to HLA-A,B,C shared determinant antigen and beta 2 microglobulin (beta 2m). HLA-A,B,C antigens were present in the basal and lower spinous cells in normal and dysplastic epithelium and in the non-specific keratoses, but in a minority of carcinomas staining was disorganized and absent at the periphery of tumour islands. beta 2m staining was present in the basal and lower spinous epithelial cells in all tissues; staining was lost progressively with increasing dilution of the primary antibody until it was completely lost in the invasive carcinoma tissue at 1:400, in dysplastic epithelium at 1:800 and in non-specific keratoses at 1:3200; in contrast, staining persisted in normal tissues at greater than 1:3200 anti-beta 2m dilution. Loss of beta 2m staining in the dysplastic epithelial tissues correlated broadly with the degree of cellular atypia. The results suggest that there are decreased concentrations of cell surface beta 2m in potentially malignant and malignant epithelial tissues, with normal concentrations of MHC class I heavy chains. PMID- 3549516 TI - Estrogen and the induction of lordosis in female and male prairie voles (Microtus ochrogaster). AB - Estrogen elicited lordosis in ovariectomized female prairie voles (Microtus ochrogaster). Treatment with estradiol benzoate (EB) was particularly effective if administered as multiple injections. Very high dose levels were not, in general, any more effective than lower doses. Individual animals typically showed lordosis within 24 to 48 hr following the onset of EB treatment and prolonged treatments did not increase the percentage of females responding to EB. Castrated male prairie voles did not respond with lordosis to repeated daily injections of 10 micrograms EB given for a period of 15 consecutive days. PMID- 3549517 TI - Male stimuli are necessary for female sexual behavior and uterine growth in prairie voles (Microtus ochrogaster). AB - In reproductively naive female prairie voles (Microtus ochrogaster) direct contact with male urine or housing in a male-soiled cage, in the absence of physical contact, resulted in increased uterine weights, but did not reliably elicit behavioral estrus (defined by lordosis). Physical contact with an unfamiliar male, for 1 hr or more, followed by 30 or 48 hr of continuous access to a male-soiled cage, induced lordosis in approximately two-thirds of the females tested. When females were physically exposed to a male for 18 hr and tested 6 hr later, 70% showed lordosis. However, when females receiving either 1 or 18 hr of male contact were removed from the presence of the male and placed in a clean cage for 24 hr, only 29-37% of the females subsequently showed lordosis. These results suggest that direct physical contact with the male or chemical stimuli from the male may be necessary to induce and maintain behavioral estrus in female prairie voles. PMID- 3549518 TI - Will profit data drive Medicare policy? PMID- 3549519 TI - Steep Medicaid cutbacks may spell disaster. PMID- 3549520 TI - Are IG's profit figures for real? Maybe not. PMID- 3549521 TI - In Philadelphia, HMO-PA, Blues battle for top spot. PMID- 3549524 TI - Hospitals charge PROs with unfair crackdowns. PMID- 3549522 TI - HMO industry voices concern about PRO review. Interview by Cathy Tokarski. PMID- 3549523 TI - Tying Medicare benefits to income gains support. PMID- 3549525 TI - Providers bear cost of poor payer information. PMID- 3549526 TI - HCFA plans delays, considers dumping bad debts. PMID- 3549527 TI - A rare event: hospital receives credit upgrading ... but CFO is concerned about the loss of PIP. PMID- 3549528 TI - HMO review plan panned by prospective bidders. PMID- 3549529 TI - Hospitals track Medicare HMO enrollees. PMID- 3549530 TI - Progress in the analysis of serial data during the century since Bowditch and future expectations. Fourth Raymond Pearl memorial lecture, 1986. PMID- 3549531 TI - [Determination of insulin, porcine proinsulin and pancreatic polypeptide antibodies in human serum by radioimmunoassay]. PMID- 3549532 TI - Computerized interactive morphometry in pathology: current instrumentation and methods. AB - This review is concerned with the current applications of interactive computerized morphometry for diagnostic applications. "Interactive" differs from fully automatic procedures in that the essential function of cell recognition is performed by a trained observer, assisted by a computerized instrument that performs all desirable measurement and processing tasks. This article describes the instrumental needs (video systems, computer, and specialized hardware) and interactive peripherals, in particular, high-resolution touch screens for most common and currently useful video analysis tasks. The authors describe a number of general instrumental procedures with widespread applications (point counting, tracing of contours, graphic standards of size and length, shape analysis, automatic edge detection). Diagnostic procedures are based on the generation of multiple data followed by either multivariate statistical analysis that allows diagnosis of individual cases or hierarchical algorithms. The best current application is the objective study of controversial or difficult cases; there is a possibility that in the future interactive computerized morphometry may become useful for the mass screening of cytologic specimens. PMID- 3549533 TI - Immunoelectron microscopy for growth hormone and prolactin in pituitary adenomas. AB - Growth hormone (GH)- and prolactin (Prl)-producing pituitary adenomas were studied with immunoelectron microscopy using protein A-gold complex, and were compared with the normal pituitary gland. GH-producing cells were readily identifiable by numerous, uniformly dense, round secretory granules in both adenomas and normal pituitary gland. In contrast, Prl secretory granules in normal pituitary gland were much larger in size than the scarce, smaller, secretory granules of Prl-producing adenomas. Thus immunoelectron microscopic identification of Prl is more valuable for prolactinoma. With more specific antigens available as tumor markers, immunoelectron microscopy appears to be a powerful tool for tumor diagnosis. PMID- 3549534 TI - An immunohistochemical analysis of human aortic fatty streaks. AB - Recent studies have shown both macrophages and lymphocytes in very early intimal lesions of experimental aortic atherosclerosis. The authors obtained fresh samples of human aortic wall, which had been removed in the course of aortocoronary bypass graft surgery. Intimal fatty streaks were identified macroscopically and six were studied immunohistochemically. The fatty streaks contained foam cells that were virtually all labeled by antibodies directed against members of the mononuclear phagocyte series (RFD-2 and RFD-7). Macrophages demonstrated acid phosphatase activity and marked expression of HLA DR, suggesting activation. Other monoclonal antibodies (UCHT-1, OKT-4, and RFT-8) identified T lymphocytes, of both helper and suppressor phenotypes, within the fatty streaks. T lymphocytes of suppressor phenotype appeared to predominate over helper cells. B lymphocytes were not detected. The presence of activated macrophages and T lymphocytes in the fatty streaks indicates that components of a cell-mediated immune response are present. Such an immune process may be important in the pathogenesis of human atherosclerosis. PMID- 3549537 TI - Demineralization and remineralization of root surface caries. PMID- 3549538 TI - Prevention of root caries. PMID- 3549536 TI - Microbial etiology of root surface caries. PMID- 3549540 TI - A method for quantitative ultrasonic backscatter estimates in the presence of phase distortion. PMID- 3549539 TI - Opportunity for selection in the parish of Tuna, Sweden. AB - This article is part of a series of studies on the opportunity for selection in Swedish populations. The study concerns women who, with some exceptions, were born during the first half of the 19th century. A modified form of Crow's index has been used to estimate the upper limit of natural selection. The average index for the period 1805-1850 was I = 1.136, which value falls within the limits of what has been found for the other Swedish populations that have been studied. PMID- 3549541 TI - Data processing of exercise ECG's. PMID- 3549535 TI - Ataxia-telangiectasia: an inherited disorder of ionizing-radiation sensitivity in man. Progress in the elucidation of the underlying biochemical defect. AB - This review summarizes the current research on the biochemical defect leading to ataxia-telangiectasia (AT). A DNA repair defect has been linked to AT, although the precise defect has not been found. A critical examination of the evidence for and against a DNA repair defect in AT is presented. Consideration of other recent data on AT raises the possibility that AT may not primarily be the result of a DNA repair defect. Therefore, in this review AT is approached as a syndrome which is defective in the ability to respond to ionizing-radiation-type damage, rather than defective in the ability to repair this damage. However, this does not necessarily exclude the potential involvement of a DNA repair defect in some of the genetically distinct subsets present in AT. Other recent anomalies found in AT, including an altered cell cycle and DNA synthesis profile following ionizing radiation damage, are also assessed. A suggestion to account for the underlying defect in AT, based on the various research reports, is presented. PMID- 3549542 TI - Literature searches by computer. PMID- 3549543 TI - NSNA: how it grew. PMID- 3549544 TI - Clinical experience with captopril in treatment of moderate and severe hypertension. PMID- 3549545 TI - [Use of ceftazidime in the treatment of skin infections]. PMID- 3549546 TI - [Use of 0.3% diflucortolone valerate in the topical treatment of steroid sensitive dermatitis]. PMID- 3549547 TI - [Lymphocyte subpopulations in psoriasis vulgaris. A histochemical study of 21 cases]. PMID- 3549548 TI - [Immunohistological findings in Brocq's pseudopelade: analogy with lichen planus?]. PMID- 3549549 TI - [Immunoenzyme test (ELISA) in the serological diagnosis of syphilis. II. Evaluation of the IgM-specific antitreponemal reactivity]. PMID- 3549550 TI - [Alternaria mycosis in a kidney transplant patient]. PMID- 3549551 TI - [Immunoenzyme test (ELISA) in the serologic diagnosis of syphilis]. PMID- 3549552 TI - [Evaluation of anti-Treponema pallidum activity in the sera of treated and non treated syphilitics]. PMID- 3549553 TI - Enterotoxin production & colonization factor among somatic antigen groups of Escherichia coli strains. PMID- 3549554 TI - Group B streptococcus colonization & neonatal outcome in north India. PMID- 3549557 TI - The Institute of Pediatrics, Niloufer Hospital, Hyderabad. PMID- 3549556 TI - Festschrift in honour of Professor Harish Chandra. PMID- 3549555 TI - Use of nucleic acid probes in the diagnosis of diarrheal disorders. PMID- 3549558 TI - Water loading and restriction in essential hypertension. AB - Blood pressure, plasma arginine vasopressin (AVP), and renal excretory responses to short-term water loading (oral load of 20 ml/kg body weight over 30-45 minutes) were compared in 10 normotensive and 13 mild to moderately essential hypertensive subjects. In addition, we examined the renal concentrating ability of an additional group of 10 normotensive subjects and 12 hypertensive subjects in response to a 24-hour water restriction and intranasal administration of 10 micrograms of [1-deamino,8-D-arginine]vasopression. The hypertensive subjects exhibited both an exaggerated diuresis and natriuresis to the water load. At 20- and 60-minutes after water loading, hypertensive subjects had excreted 34 and 55% of the load, respectively, compared with 15 and 35% in normotensive subjects. Mean blood pressure rose significantly in both groups and hypertensive subjects exhibited a greater rise of systolic blood pressure (16 mm Hg) than normotensive subjects (8 mm Hg) 20 minutes after water loading. The maximum diuresis and natriuresis corresponded to the period in which the rise of blood pressure was greatest. The hypertensive subjects diluted and concentrated their urine as well as normotensive subjects did, indicating normal renal responsiveness to AVP. Plasma Na, osmolality, and AVP decreased similarly in both groups after water loading and rose similarly in the two groups after water restriction. This finding suggests that osmotic responsiveness of AVP is not altered in hypertensive subjects. In conclusion, the data suggest that the exaggerated renal response to water loading could be explained by the greater rise of blood pressure in hypertensive subjects rather than by altered AVP responses. PMID- 3549559 TI - Role of medial preoptic area (MPOA) in the reproductive function and feeding behavior in rats. AB - Adult female rats were given ad lib access to two pairs of specially prepared diets containing the three macro-nutrients, protein, fat and carbohydrate, in such proportion that both pairs were isocaloric but one pair varied in protein content (45% and 5%) and the other pair in carbohydrate content (70% and 25%). Body weights, food intake and selectivity were noted daily. Following lesions of Medial Preoptic Area (MPOA), there was an increase in the total food and protein intake and disruption of the regular estrus cycles. In the second series, the total food intake increased after ovariectomy and decreased following intracranial estrogen instillation in the MPOA. A change in the selectivity of the diets was also noted. The observations are suggestive of the role of MPOA in the food intake and selectivity and this is probably effected through the estrogen receptors situated therein. PMID- 3549560 TI - Comparative translocation of enteropathogenic Campylobacter spp. and Escherichia coli from the intestinal tract of gnotobiotic mice. AB - In C3H gnotobiotic mice, no significant difference was observed between the translocation of nine clinical isolates of enteropathogenic Campylobacter spp. and that of seven nonisogeneic Escherichia coli strains with or without various determinants of pathogenicity. In addition, there was no correlation found between the intensity of translocation of Campylobacter strains and the signs of invasiveness in the patients from whom the strains had been isolated. PMID- 3549561 TI - Analysis by gel electrophoresis, Western blot, and peptide mapping of protein A heterogeneity in Staphylococcus aureus strains. AB - To evaluate potential differences in protein A among Staphylococcus aureus strains, lysostaphin-solubilized cell wall proteins from 12 serologically distinct strains were analyzed by 7.5% sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE). Seven presumptive protein A variant identified in the 45- to 57-kilodalton range were then studied for qualitative binding affinities to nonimmune mouse and rabbit immunoglobulin G (IgG) by enzyme linked immunoelectrotransfer blot. Essentially, all presumptive protein A variants demonstrated binding to both nonimmune rabbit and mouse IgG and had differential binding to mouse monoclonal IgG1 at pH 8.2 than at 5.5. Because of Fc-binding properties and molecular weight similarity to the well-characterized Cowan I protein A, these proteins appeared to represent protein A variants. Amino sugar analysis (less than 1%) by reverse-phase high-pressure liquid chromatography suggested that the apparent molecular weight differences in protein A were not due to associated mucopeptides. Further differences in protein A variants were studied by peptide mapping. Each of the seven protein A variants, distinguishable on SDS-PAGE, also produced distinct peptide cleavage patterns. In addition, two protein A variants indistinguishable on SDS-PAGE could be further subdivided by peptide mapping. These results suggest that SDS-PAGE analysis of protein A, particularly in conjunction with peptide mapping, may be useful in distinguishing distinct strains of S. aureus. Different protein A variants may also have unique functional or immunologic capabilities. PMID- 3549562 TI - Killing of Plasmodium falciparum by eosinophil secretory products. AB - The multiplication of two strains of Plasmodium falciparum in culture, as measured by [3H]hypoxanthine incorporation, was inhibited in a dose-dependent manner by granule proteins secreted by purified eosinophils obtained from patients with the hypereosinophilic syndrome. Morphological examination revealed the presence of abnormal parasites inside erythrocytes, indicating that they were killed in situ, and the later stages of the developmental cycle were found to be most susceptible to these toxic effects. A monoclonal antibody against eosinophil cationic protein partially blocked the inhibitory effect, suggesting that it was caused by more than one of the eosinophil granule proteins. Thus some of the antimalarial effects of molecules such as the tumor necrosis factor, which activates eosinophils, may be mediated through the enhanced production of eosinophil secretion products. PMID- 3549564 TI - Epidemiological correlation between levels of antibodies promoting merozoite phagocytosis of Plasmodium falciparum and malaria-immune status. AB - A phagocytosis assay was used to measure the prevalence of cytophilic antibodies directed against Plasmodium falciparum merozoites in three groups of subjects from Africa: preimmune (individuals aged 2 to 15 years), immune (adults), and postimmune (African adults residing out of the endemic area). Results show that levels of antibodies promoting merozoite phagocytosis (APMP) increase slowly and gradually with age. The production of high levels of APMP requires about 15 years of continuous exposure to malaria and concurs with the ability of exposed individuals to control a high parasitemia and its pathological consequences, such as spleen enlargement. In the absence of antigenic restimulation for more than 1 year (postimmune subjects), APMP titers decrease abruptly. No correlation was found between APMP levels and levels of antimalarial antibodies detected by fluorescence and precipitation assays. Low levels of APMP in subjects susceptible to clinical manifestations of the disease and high levels in subjects in a state of premunition suggest that the results of the merozoite phagocytosis assay more closely reflect clinical immunity than do other markers of antimalarial humoral immunity. PMID- 3549563 TI - Antigenic diversity of lipooligosaccharides of nontypable Haemophilus influenzae. AB - The lipooligosaccharides (LOS) of nontypable Haemophilus influenzae are an antigenically heterogeneous group of macromolecules. Immunodiffusion and enzyme linked immunosorbent assay inhibition studies with phenol-water-extracted LOS and absorbed antisera specific for the oligosaccharide portion of the LOS identified six LOS strain-specific antigens. To facilitate screening large numbers of strains to search for LOS antigenic heterogeneity, a system utilizing proteinase K whole cell digests in Western blots was developed. Seventy-two nontypable H. influenzae LOS extracts were analyzed in this Western blot assay. Thirty-seven of these extracts could be segregated into 10 antigenically distinct LOS groups based on immunologic recognition by one or more of the rabbit antisera. Thirty five of the strains did not contain these LOS antigens. These results demonstrate that antigenic differences exist among the LOS of nontypable H. influenzae strains, and this heterogeneity has the potential to be used to establish an LOS based serogrouping system. PMID- 3549565 TI - Isolation and characterization of murine monoclonal antibodies specific for gram negative bacterial lipopolysaccharide: association of cross-genus reactivity with lipid A specificity. AB - Somatic cell hybrids secreting monoclonal antibodies against the core-glycolipid portion of enterobacterial endotoxin were derived from mice immunized with Escherichia coli J5 or Salmonella minnesota R595 heat-killed organisms or lipopolysaccharide (LPS). Eight antibodies were selected for their ability to cross-react with several members of a panel of gram-negative bacterial antigens in a radioimmunoassay. This panel represented five genera and two families of organisms: E. coli O111:B4, E. coli O55:B5, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella minnesota, and Serratia marcescens. The binding sites for six of the antibodies were unequivocally localized within the lipid A moiety of the endotoxin molecule by using the radioimmunoassay on LPS and free lipid A. The anti-lipid A antibodies were further characterized for their ability to interact with LPS variants by using a sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunostaining procedure. The monoclonal antibodies bound almost exclusively to the low-molecular-weight species of LPS on the polyacrylamide gel. These components corresponded to LPS isolated from rough strains of organisms (strains which lack O-specific carbohydrate). These results suggested that the cross-reactive component of antisera raised against rough mutants of gram-negative bacteria contain antibodies of lipid A specificity. Moreover, the determinant within the lipid A moiety of LPS may have been accessible to the monoclonal antibodies only in those endotoxin molecules on the outer membrane surface which lack the O-specific carbohydrate. PMID- 3549567 TI - Expression and immunological properties of the five subunits of pertussis toxin. AB - Pertussis toxin, a protein composed of five different subunits, is responsible for the pathogenicity of Bordetella pertussis and is the main component of a new vaccine against whooping cough. The genes coding for the five subunits, recently cloned and sequenced, are organized as an operon. We approached the problem of expression of the five genes in Escherichia coli and, although we obtained high levels of transcription of the native pertussis toxin genes, the amount of proteins produced was very low or undetectable. To obtain suitable expression of each of the five subunits, we fused their genes to the gene coding for the DNA polymerase of MS2 in the expression vector pEx31. A total of 5 to 30 mg of purified fusion proteins could be obtained from 1 liter of culture. The purified fusion proteins were used to immunize rabbits to obtain sera against each of the five subunits. These sera, although able to recognize the toxin in an enzyme linked immunosorbent assay and the corresponding subunits in Western blots, were not able to protect CHO cells from the action of pertussis toxin. Mice immunized with the five subunits were not protected from an intracerebral challenge with B. pertussis. Subunits S2 and S3, which are 67% homologous, were shown to cross react immunologically. The fused subunit S1 was able to ADP-ribosylate transducin as efficiently as the native pertussis toxin. PMID- 3549566 TI - Spontaneous production of thymocyte-activating factor by human gingival fibroblasts and its autoregulatory effect on their proliferation. AB - The purpose of this study was to examine whether human gingival fibroblasts produce a cytokine which modulates in immune and inflammatory responses including alterations in connective tissue metabolism in periodontal tissue. We found that a cultured human gingival fibroblast cell line (Gin-1) and freshly isolated human gingival fibroblasts produced thymocyte-activating factor(s), so we called the factor(s) fibroblast-derived thymocyte-activating factor (FTAF). Growth of the producing cell was itself modulated by the factor(s). Gin-1 cells spontaneously produced a significant amount of FTAF in a cell growth-dependent manner. Maximum activity was observed in conditioned medium from stationary-phase cells. The activity in conditioned medium of cultures lacking serum was significantly higher than that in those containing serum. Treatment of Gin-1 cell cultures with cycloheximide, an inhibitor of protein synthesis, markedly inhibited FTAF production. When Gin-1 cells were stimulated by triggering with muramyl dipeptide or sonicated extracts of Bacteroides gingivalis, FTAF production was significantly stimulated. Freshly isolated human gingival fibroblasts from gingival biopsies of healthy donors also produced FTAF which enhanced thymocyte proliferation. Peaks of thymocyte proliferation activity in conditioned medium from Gin-1 cells were observed in fractions having molecular weights of 25,000, 35,000, and 45,000, as determined by Sephadex G-75 column chromatography. The peak fractions (partially purified FTAF) significantly suppressed the proliferation of Gin-1 cells themselves as evaluated by [3H]thymidine uptake. The suppressive effect of partially purified FTAF was, at least partially, mediated by endogenous prostaglandin for the following reasons: addition of indomethacin, and inhibitor of prostaglandin synthesis, abrogated the suppressive effect; partially purified FTAF stimulated the production of prostaglandin E2 by the cells; and the suppression of cell proliferation was reinforced by addition of exogenous prostaglandins. These observations suggest that gingival fibroblasts play a significant role in regulation of cell growth of lymphocytes and in their own growth under physiological conditions and in pathological states in periodontal connective tissue. PMID- 3549568 TI - Cecectomy causes long-term reduction of colonization resistance in the mouse gastrointestinal tract. AB - Removal of the cecum from normal mice caused a major perturbation of the microbial ecology of the gastrointestinal tract. There was a permanent reduction in colonization resistance resulting in a 1,000-fold increase in the concentration of facultatively anaerobic coliform bacteria. The animals were significantly more susceptible to peroral challenge by the intestinal pathogen Salmonella enteritidis. Coincident with this increase in coliform counts and susceptibility to salmonellae was a decrease in the numbers of strictly anaerobic fusiform bacteria that dominate the rodent intestinal tract, resulting in reduced levels of acetic, propionic, and butyric acids. Cecectomized mice are likely to be a useful model for study of the interaction between intestinal pathogens and the normal microbiota and for studies of translocation of bacteria into host tissues after loss of colonization resistance. PMID- 3549569 TI - Non-auditory effects of noise in industry. VII. Evaluation, conclusions and recommendations. AB - The results of epidemiological studies on non-auditory effects of noise in industry are commented upon. The present state of the art does not permit any definite conclusion to be drawn about the risk of hypertension. Annoyance by noise is widespread; it has many different aspects and it has been studied in detail in this project. Combinations of working conditions should be studied that produce interaction effects overloading psychological or physiological systems. Some examples are given. Standards and guidelines for industrial exposure to noise should also prevent wellknown, non-auditory effects, such as communication problems, which result in social isolation. PMID- 3549570 TI - Minority status, aging, and mental health. AB - Research findings on mental health and life satisfaction among aged blacks, Mexican-Americans and native Americans are reviewed. Although the literature has generally followed a social stress perspective that predicts greater mental health problems among minority group aged, the evidence shows that mental health and life satisfaction of these groups is not any lower than might be anticipated based on their relative socioeconomic standing. It is concluded that, despite increased research, little is known about how ethnicity and minority group status influence psychopathology and life satisfaction in late life. PMID- 3549571 TI - The pilgrimage of Joel Andrews: aging in the autobiography of a Yankee farmer. AB - Autobiographical writing offers a vast and virtually untapped resource for the historical phenomenology of aging. This essay interprets the autobiography of Joel Andrews-an aging Yankee farmer whose life spanned the period from the American Revolution to the end of the Civil War. We attempt to recreate the poignance and integrity of this ordinary man's struggle with aging and death within the context of his own historical circumstances and religious beliefs. In particular, the essay argues that Andrews' autobiography both reflects and helps accomplish his central task in old age: the religiously sanctioned transition from physical to spiritual man. Andrews' experience provides an interesting contrast to contemporary ideas about health and vitality in old age. PMID- 3549572 TI - Polycentric 384-month study of biofiltration (BF) with AN69s. AB - Polycentric 384-month study of biofiltration (BF) with AN69s. Since January 1984, 39 uremic dialyzed patients have been included in a randomized prospective study, to evaluate the clinical utility of BF. The trial lasted 9.85 months/pt (384.15 months of total observations) and patients admitted had some not well controlled clinical signs: major acidosis, intradialytic cardiovascular instability, intolerance to acetate dialysis, hypercatabolism, neuropathy, etc. We obtained some positive effects: the incidence of intradialytic hypotension decreased 26.6%; interdialytic body weight gain fell from 3.1 to 2.7 kg (p less than 0.05) and the dialytic time per week was reduced from 12.3 to 10.0 hours (p less than 0.01). At the same time dry body weight increased from 62.4 to 64.6 kg with worthwhile improvement of the acid-base status (ABS) in all patients. This controlled trial showed that BF is particularly useful for patients suffering from severe acidosis and/or cardiovascular instability. PMID- 3549574 TI - Reference master: a microcomputer-based storage and retrieval system for bibliographic references. AB - A complete system for housekeeping and retrieval of bibliographic references managing individual reprint collections is described. By the use of special hardware and individual data base software even large reprint collections in the range up to 65,000 papers are handled economically. A fast 8-bit microprocessor (HD 64180) in combination with a Winchester hard disk drive serves as the basis for rapid access to the desired information. An efficient string search algorithm written in assembly language guarantees a fast operation with a search speed of more than 6,000 entries/minute. The system cannot only prepare reference lists and reference files, but also incorporates an editor and maintains the control whether reprints are already on file or requested. The implementation of back-up schemes assure against data losses. Using a state of the art design single board computer and the most recent mass storage device technology, the system is as well small and cost effective, and thus suitable for personal use. In addition, some general questions and pitfalls concerning the management of scientific literature collections are touched upon. PMID- 3549573 TI - Effects of chronic biofiltration with PAN membranes on acid-base status: polycentric study. AB - Effects of chronic biofiltration (BF) with PAN membranes on acid-base status (ABS): polycentric study. From the 39 cases in a polycentric study we selected 13 patients with metabolic acidosis (pH 7.23 +/- 0.03), marked reduction of plasma bicarbonate (15.4 +/- 2.2 mEq/l) and hyperkalemia (6.2 +/- 0.6 mEq/l). BF was performed with a continuous post-dilutional supply of HCO3 (85 mmol/h), and attained rapid normalisation of blood bicarbonates and serum potassium during the treatment. After 6 months of BF treatment the pre-dialytic ABS showed remarkable improvement, and values were normal after one year. The remaining 26 patients in the polycentric study, treated by chronic BF without severe acidosis, showed good dialytic tolerance. In 15 of them the supply of bicarbonate was too high (because of moderate post-BF alkalosis) and we had to reduce the buffer inflow to about 50 mmol/h. PMID- 3549575 TI - Medical diagnosis: are expert systems needed? AB - An evaluation of the pitfalls of computer-aided diagnosis during the last ten years seems to show that increased emphasis on real clinical problems as well as increased use of medical knowledge are required. Since such an approach could fit into the 'expert system' framework, one should expect new developments in that research field to occur soon. However, expert systems can also be designed along the same concepts as previous models of diagnostic reasoning presumably with the same shortcomings. PMID- 3549576 TI - Human versus machine: a comparison of a computer 'expert system' with human experts in the diagnosis of vaginal discharge. AB - A model system has been designed which generates 'cases' of vaginal discharge. Each such case is presented to a human for diagnosis, and this is then compared with a computer diagnosis using two forms of Bayes' theorem. Six subjects (2 medical; 4 non-medical) participated in the trial and each examined 100 successive 'cases'. When the humans had forewarning of the trial and full access to the knowledge-base their performance was superior to that of Bayes' theorem using positive features only and equivalent to that using both positive and negative features. When the trial was repeated without forewarning the human performance was markedly inferior to that of the machine. It is concluded: that human and computer-aided diagnosis can be of approximately equal efficiency for complex and non-definitive data; that the imperfections of human memory give an obvious potential advantage to the machine in this type of situation. PMID- 3549577 TI - Cultured mammary carcinoma cells contain gonadotropin-releasing hormone-like immunoreactivity, GnRH binding sites and chorionic gonadotropin. AB - Immunoperoxidase staining and radioimmunoassay were used to identify gonadotropin releasing hormone (GnRH) and chorionic gonadotropin (hCG) in 4 mammary carcinoma cell lines. GnRH-like immunoreactivity was found in all cell lines; 2 lines also contained hCG. Binding of a GnRH agonist was demonstrated by radioreceptor assay in cultured mammary carcinoma cells. In cell column perfusion of the same cells, exogenous GnRH did not stimulate release of hCG. PMID- 3549578 TI - The ST segment/heart rate relationship as an index of myocardial ischaemia. PMID- 3549579 TI - Acquired abnormalities of the tricuspid valve--an ultrasonographic study. AB - In a retrospective ultrasonographic study, 32 cases of acquired disease of the tricuspid valve were detected amongst 7000 consecutive patients. Patients with congenital heart disease (except when the seat of an acquired disease) and with prosthetic heart valves, were excluded. There were twenty-one cases of rheumatic disease, all having additional involvement of the mitral valve. Prolapse (5 patients), bacterial endocarditis (2 patients), rupture of papillary muscle (1 patient), cardiac tumours (2 patients) and carcinoid heart disease (1 patient) were also identified. Acquired disease of the tricuspid valve is infrequently encountered during routine cross-sectional echocardiography but its recognition is clinically important. PMID- 3549580 TI - Acute effect of furosemide on renal kallikrein and prostaglandin systems in mild to moderate essential hypertension. AB - The activity of basal 24-hour urinary kallikrein activity (UKA), prostaglandin E2 (U. PGE2) and thromboxane B2 (U. TxB2) and their relationship to natriuresis (U. Sodium), urinary aldosterone (U. Aldosterone) and plasma renin activity (in supine position: PRA1; in standing position: PRA2) were evaluated in 20 patients with early-moderate hemodynamically defined (first pass and gate blood pool radionuclide angiocardiography) essential hypertension (H) and in 13 age-matched normotensive patients (N). In basal conditions, UKA and PRA2 were significantly reduced (p less than 0.005 and p less than 0.05, respectively) in H compared with N. However, no differences between N and H were found for U. TxB2, U. PGE2, U. Aldosterone, U. Sodium, and PRA1. All parameters were also evaluated both in H and N before and after the administration of furosemide (40 mg i.v.). In H, but not in N, furosemide induced an increase of UKA (p less than 0.05), U. TxB2 (p less than 0.05) and U. Sodium (p less than 0.001). In both H and N furosemide caused a significant rise of PRA1 (p less than 0.001 in H and p less than 0.01 in N) and PRA2 (p less than 0.001 in H and p less than 0.05 in N). In H a significant correlation was found between percent increases of U. Sodium and U. Kallikrein (r = 0.54, p less than 0.01) and between percent differences of PGE2 and TxB2 (r = 0.59, p less than 0.01). It is proposed that reduction of basal UKA may be an early evidence of the first stages of hypertension, i.e., in absence of renal and cardiovascular alteration. The finding is not accompanied by significant changes in urinary excretion of arachidonic acid metabolites and aldosterone. Finally, any relation between UKA values and systemic hemodynamics is lacking. PMID- 3549581 TI - Combination of amikacin and ceftazidime as empiric treatment of febrile leukopenic patients affected by solid tumors. AB - A combination of amikacin and ceftazidime was used as initial empiric therapy for the treatment of 25 evaluable febrile episodes (temperature greater than or equal to 38.5 degrees C) in leukopenic adult patients (wbc less than or equal to 1,000/mm3) with solid tumors, characterized by poor prognosis because of low performance status (median Karnofsky score: 50) and progressive disease (76% of cases). Nineteen (76%) of the 25 episodes responded to the initial empiric antibiotic combination. In the microbiologically documented infections, there was no significant difference in the response rate between bacteremia (67%) and localized infections (81%). The response in localized infections caused by gram negative organisms (81%) was similar to that obtained in gram-positive organisms (82%), whereas gram-positive bacteremia responded better than gram-negative (100 vs 50%). No serious side effects were observed. Reversible nephrotoxicity occurred in 12% and hypokalemia in 20% of the patients treated. This antibiotic combination is a safe and efficacious empiric therapy for infections in leukopenic patients with solid neoplasia. PMID- 3549582 TI - The metabolic effects of acute and chronic administration of gastrozepin. AB - The structure of gastrozepin (G) resembles that of tricyclic antidepressants and antihistaminic and antiserotonic cyproheptadine which are compounds with known metabolic effects. The object of this study was to test the potential action of G on the metabolism of basic nutrients, insulin and selected hormonal parameters after parenteral administration (10 and 20 mg G) and after chronic oral administration (50 mg G) during antiulcer therapy. Investigations carried out in two groups of 7 and 9 healthy volunteers, respectively, and on one group of seven patients with ulcer disease, revealed no changes in any of the blood parameters studied, nor in the excretion of catecholamines or 17-OH steroids in the urine. Our observations practically rule out any metabotropic activity of G, thereby differentiating it from tricyclic antidepressants and cyproheptadine. Isolated significant differences from the basal value seen after G and saline, can be attributed to other than pharmacological or specific mechanisms such as stress associated with the first examination, effect of fasting, individual response of the subjects, and so on. PMID- 3549584 TI - Clinical aspects of phencyclidine (PCP). AB - The authors provide a comprehensive review of the current phencylidine literature in exploring the history, clinical effects, diagnostic criteria, and treatment of PCP abuse. Seventy-one references are cited. PMID- 3549583 TI - Double-blind, randomized, cross-over clinical trial of metoprolol and propranolol in mild to moderate essential hypertension. AB - Thirty-two patients with mild to moderate essential hypertension completed this double-blind cross-over clinical trial of propranolol and metoprolol. Metoprolol was found to be as effective and safe as propranolol in lowering the systolic and diastolic blood pressure in both supine and standing positions. The mean fall in blood pressure was greater in the group which received metoprolol as the first treatment, as compared to the group which received propranolol as the first treatment. The side-effects produced by both drugs were mild and did not require discontinuation of therapy except for 2 patients who were on metoprolol. One patient who was controlled diabetic developed severe weakness and the other patient developed bronchospasm. Metoprolol did not produce any central nervous system related side-effects. PMID- 3549585 TI - Drug abuse social policy in the United States and Israel: a comparative sociological perspective. AB - The United States and Israel have implemented the same social policy toward drug abuse: a supply/demand reduction model aimed at minimizing illicit drug use. The paper examines the results of this social policy in both countries, concluding that this social policy achieved a relative success in Israel, while relatively failing to achieve its explicit goal in the United States. The sociological nature of the drug abuse problem is analyzed, indicating that this problem is most efficaciously viewed as a moral-ideological one, and not as it has been: a technical-medical problem. Once the sociological nature of drug abuse is made clear, an explanation for the differential success of the supply/demand reduction model is offered. The explanation focuses on the different cultural matrices of the two societies, as well as on more technical differences such as borders and the army draft. PMID- 3549586 TI - A prospective study of the treatment of severe tears of the lateral ligament of the ankle. AB - A prospective randomized clinical study was undertaken to compare bandaging, plaster cast immobilisation and operative treatment for recent tears of the lateral ligament of the ankle. The follow-up period was two years. Subjectively, only the fear of giving-way showed a clear difference in favour of operative repair. Objective evaluation, including stress radiographs, demonstrated no statistical differences between the three methods of treatment. Although bandaging appeared somewhat less satisfactory with respect to the resulting stability of the ankle, the differences were not statistically significant. The lateral ligament in patients over 40 years of age showed a statistically significant tendency to heal less well than that of younger patients. Severe ankle sprains in patients under 40 years of age should preferably be treated by operation, especially in younger patients and if the person is physically active. Lateral ligament tears in patients over 40 years of age should be treated conservatively and a secondary reconstruction carried out later, if necessary. PMID- 3549588 TI - Repair of osteochondral defects in articular weightbearing areas in the rabbit's knee. The use of autologous osteochondral and meniscal grafts. AB - Repair of osteochondral defects in articular weightbearing areas presents its own particular problems because of the low potential of hyaline cartilage for regeneration. Our first group of experiments on the knee of the rabbit confirms that the new regenerated cartilage comes from bone marrow which degenerates before developing into true hyaline cartilage. The second group of experiments shows that autologous grafts from the non-weightbearing articular area suitable for the repair of defects in weightbearing areas. In an third group, autologous meniscal fibrocartilage was used as a graft for the repair of osteochondral defects. PMID- 3549587 TI - Hemijoint allografts in the treatment of low grade malignant and aggressive bone tumours about the knee. AB - Nine consecutive patients undergoing osteoarticular allogenic transplantation for low grade malignant or aggressively benign tumours have been followed up for between 8 to 15 years. Eight patients had functioning knees whilst 1 ended in arthrodesis. Of the functioning knees all had full extension but only 3 could flex more than 90 degrees. Seven patients had returned to work. Radiologically all the knees showed progressive deterioration. In spite of this only three knees were painful with exercise and none at rest. We conclude that hemijoint allografts represent a useful alternative to make good a bony defect after tumour resection about the knee, but that the ultimate result of such a reconstruction depends on survival of the joint surfaces. PMID- 3549589 TI - The deprofessionalization of Soviet physicians: a reconsideration. AB - Traditional explanations for the relatively low status of the Soviet medical profession credit the Bolshevik government in the 1920s with deprofessionalizing or "leveling" a once autonomous and powerful occupational group. This article presents new data which challenge that interpretation. The Russian medical profession was never autonomous and powerful. Many physicians cooperated with the Bolsheviks because of shared beliefs regarding the organization of medical care. By the late imperial period, many physicians advocated the inclusion of all medical workers in policy-making administrative organs. Focusing upon Russian psychiatrists, the author analyzes the events that prompted the profession to adopt this position. The finding of greater continuity between prerevolutionary Russian and Soviet physicians suggests that this presumably anomalous case has greater significance for theoretical models of professionalization and occupational prestige than previously supposed. PMID- 3549590 TI - Health services and the legitimation of the colonial state: British Malaya 1786 1941. AB - This article is concerned with the establishment and extension of health care and medical services in British colonial Malaya. Initially, medical care was provided for the colonial elite and those in their direct employment. With the expansion of colonial control beyond trade centers into the hinterland and with the growth of agriculture and mining. Western medicine was extended both to labor involved in these export industries and to others whose ill health might jeopardize the welfare of the colonists. Public health programs in the twentieth century continued to focus on medical problems that had direct impact on the colonial economy, but programs were extended to ensure the reproduction as well as the maintenance of the labor force. This article develops the notion of a legitimation vacuum, and the role of the state provision of social services, including medical services, in legitimizing colonial presence and control. PMID- 3549591 TI - Venous leg ulcers. The post-phlebitic syndrome. PMID- 3549592 TI - Nasal carriage of staphylococci and streptococci. PMID- 3549593 TI - Corynebacterium pyogenes. Its pathogenic mechanism in epidemic leg ulcers in Thailand. AB - There is a yearly outbreak of endemic leg ulcers in Thailand. Corynebacterium pyogenes, a pathogen to animals, is frequently isolated from the fresh lesions in addition to common pyogenic bacteria such as beta-hemolytic streptococci, mostly group A, and Staphylococcus aureus and Staphylococcus epidermidis. Although circulating titers of IgG and IgM anti-C. pyogenes antibodies were found to be very low in studied cases, intradermal skin test with C. pyogenes vaccine containing nonviable 10(5) microorganisms induced an erythematous reaction with maximum intensity at 6 hours; direct immunofluorescence showed granular deposition of C3 along the dermoepidermal junction at this time. Unexpectedly, the sites of such a skin test that subsequently underwent biopsy presented tender erythematosus induration 1 week later and developed granulomatous ulcerative lesions after 10 days in 11 of 15 patients. Radioimmunoassay for C5a and C5a of arginine demonstrated that C. pyogenes activated complement even in the absence of specific antibodies. These findings suggest that importance of skin injury followed by infection with C. pyogenes in the development of endemic leg ulcers, supporting our hypothesis that the infection of accidentally traumatized skin by C. pyogenes, which is carried by Oriental-eye flies, induces the granulomatous lesions of endemic leg ulcers. PMID- 3549594 TI - Perspectives of analysis of carcinogenic and mutagenic metals in biological samples. AB - There is a continuing need to assess the status of exposure to humans of the carcinogenic and/or mutagenic metals in both biological and environmental samples to better ensure that current or past exposures do not entail unacceptable health risks or to detect potentially excessive exposure before the appearance of adverse health effects. In order to more readily evaluate both the extent of exposure and trends of human exposure as well as the bioavailability, bioaccumulation and transport of these elements and their compounds, sensitive analytical procedures are required for their determination of the various oxidative states (as well as their organic derivatives) in complex matrices such as those found in both environmental and biological samples. The major objective of this overview is to highlight the more recent trends and state-of-the-art methodologies for the determination and speciation of arsenic, selenium, cadmium, chromium and nickel in human and animal tissues while concomitantly noting germane aspects of their bioavailability and interactions. Aspects of biological monitoring of the above elements will be stressed due to their potential utility in augmenting diverse epidemiologic and occupational health studies. PMID- 3549596 TI - List of addresses of the Jules Gonin Club's members. PMID- 3549595 TI - Effect of cyclospasmol on early diabetic retinopathy. AB - A randomized, double-blind, placebo controlled study to investigate the long-term effect of Cyclospasmol (cyclandelate) on the abnormal permeability of the blood retinal barrier was performed in 26 patients with insulin-dependent diabetes mellitus for at least 1 year and minimal retinopathy. Cyclospasmol 400 mg or placebo capsules were taken 4 times daily for 12 months by equal numbers in both groups. Each patient underwent a routine ophthalmoscopic examination, retinal fluorescein angiography and quantitative vitreous fluorophotometry to assess the permeability of the blood-retinal barrier just before the trial and following 6 and 12 months of therapy. Laboratory tests for determining blood and urine glucose levels and blood HbA1-levels were also carried out at these assessments. Statistically significant changes in diabetic control, in HbA1-levels or in the frequency of retinal microaneurysms could not be shown in either treatment group during the trial, nor were there any significant differences in these parameters between the two groups. Analysis of fluorophotometric data on fluorescein penetration into the left posterior vitreous demonstrated significant reductions in this parameter during the trial compared to the pretreatment level in Cyclospasmol treated diabetics. These changes in the pretreatment level after 6 and 12 months also differed significantly between the two groups. However, this statistically significant beneficial reduction in fluorescein penetration into the left posterior vitreous did not occur in the right eye in the Cyclospasmol group. In placebo treated patients a consistently deleterious trend for this parameter was observed for both eyes during the one year study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549597 TI - A study of the drop-outs in psychopharmacological research with bulimics. AB - Given the high drop-out rates frequently noted in drug trials with bulimic subjects, we have attempted to correlate drop-out status with a greater level of psychopathology as measured by a thorough standardized psychological assessment battery (NIMH-DIS, EDI, POMS and SCL-90). Despite a trend toward higher scores on the Paranoid Ideation Subscale of the SCL-90 among drop-outs compared to completers, there were no significant differences found between the two groups participating in a fifteen week double blind crossover study on the effectiveness of desipramine in bulimia. PMID- 3549598 TI - Stress, relaxation and asthma. PMID- 3549599 TI - Bacterial drug resistance in meat animals: a review. AB - Prolonged oral or parenteral administration of antibiotics has led to the development of resistant strains of microorganisms. Bacteria acquire drug resistance by mutation, conjugation and transduction. Oral antibiotics by a process of selection pressure facilitate the proliferation of resistant population of bacteria. Drug resistant bacteria are capable of transferring their resistance to drugs to other bacteria by the process of transferable drug resistance (TDR). This can lead to multiple resistance to a vast number of therapeutically useful antibiotics which will, therefore, become ineffective for treatment. TDR can occur between pathogenic organism, between organism of different species, such as E. coli, Salmonella and Shigella; and also between pathogenic and non-pathogenic organisms. Faecal contamination of meat during slaughter may result in the transfer of antibiotic resistant E. coli to the meat. In the human gut this E. coli could transfer resistance to other gut flora, namely E. coli or Salmonella. Antibiotic-resistant coliforms have been isolated from carcases, fresh and cooked meat, raw meat handlers and livestock handlers. Handling of raw market meat by buyers in Nigeria could also lead to contamination of meat with resistant microorganisms. Veterinary drugs are sold and used without much control in Nigeria. This practice may have created a population of resistant bacteria in the meat animals. The presence of antibiotic residues in meat, milk and their products pose potential health hazards for man. Allergic skin conditions, nausea, vomiting, anaphylactic shock and even death have resulted from the ingestion of residues. Cooking and freezing have minimal effect on residues. Resistance to antibiotics have been detected in food poisoning bacteria, namely Salmonella typhimurium, Staphylococcus aureus and Clostridium perfringens. Some epidemiological link has been established between S. typhimurium of calves and food poisoning in man. Judicious use of antibiotics, public education on the health risks of the promiscuous use of drugs in livestock production; and hygienic slaughter at the slaughter houses, will help to reduce bacterial drug resistance in man and animals. PMID- 3549600 TI - Current status of rabies. PMID- 3549601 TI - Thrombosis prevention with ticlopidine after femoropopliteal thromboendarterectomy. AB - Fifty patients submitted to thromboendarterectomy in the femoropopliteal district for obstructive arterial disease of the lower limbs, documented angiographically, were randomly allocated to treatment with ticlopidine (500 mg/day) (T) or a placebo (P) in double-blind conditions. The treatment was started as soon as possible after the surgical intervention and was continued for six months or until a clinically evident reocclusion occurred. There were 46 patients available for assessment, 23 in each treatment group both of which were comparable in preoperative characteristics and type of surgery. Doppler ultrasonography at the end of treatment showed three cases of reocclusion of the operated segment in the T group versus six occlusions and seven significant stenoses in the P group (p = 0.003). Clinically, the active treatment significantly reduced the incidence of both acute ischemia during the treatment (four cases, all in the P group) and residual claudication at the end of treatment: in the T group five patients presented persistent or recurrent symptoms versus 16 in the P group (p = 0.001). Hemostatic function tests showed a marked inhibition of platelet activation in the T group. The treatment was well tolerated. PMID- 3549602 TI - One hundred volumes of the International Review of Cytology. PMID- 3549603 TI - The early days of electron microscopy of nerve tissue and membranes. PMID- 3549604 TI - Development of centrifuges and their use in the study of living cells. PMID- 3549605 TI - Ionized groups on the cell surface: their cytochemical detection and related cell function. PMID- 3549606 TI - Nucleocytoplasmic interactions in morphogenesis. PMID- 3549607 TI - Protistan phylogeny and eukaryogenesis. PMID- 3549608 TI - Protozoological approaches to the cellular basis of mammalian stress repair. PMID- 3549609 TI - The chromosome cycle and the centrosome cycle in the mitotic cycle. PMID- 3549610 TI - Cell reproduction. PMID- 3549611 TI - Immunofluorescent studies of fibronectin and laminin in the human eye. AB - The topographic distribution of fibronectin and laminin in young and old human eyes was determined by indirect immunofluorescent techniques. These two glycoproteins may play a role in the attachment of the vitreous to the internal limiting membrane (ILM) and the internal limiting membrane to the Mueller cell processes. A double-laminated pattern of fluorescence for both glycoproteins was frequently found at the ILM of the posterior retina of aged eyes. This pattern of fluorescence, which was rarely seen in young eyes, may represent senescent changes in the ILM which could predispose the eye to posterior vitreous detachment. PMID- 3549612 TI - Fate of lyophilized xenogeneic corneal lenticules in intrastromal implantation and epikeratophakia. AB - The antigenicity of intrastromal and epikeratophakia xenografts of lyophilized corneal tissue was evaluated in nonimmune and immune recipients. Lyophilized feline lenticules were implanted into intrastromal pockets in unsensitized rabbits and rabbits sensitized to the donor cat. In both cases, the grafts remained clear. Sensitized rabbits with clear intrastromal grafts received fresh tissue penetrating keratoplasty grafts from the same donor cat, placed adjacent to the intrastromal grafts. The fresh tissue penetrating keratoplasty grafts were rapidly rejected, while the lyophilized intrastromal grafts remained clear. Cats sensitized to rabbits received lyophilized and rehydrated epikeratophakia grafts shaped from rabbit cornea; these lyophilized grafts also remained clear for the 3 month period of the study. The results indicate that lyophilized and rehydrated corneal stroma, which is devoid of living cells, is not antigenic and is not subjected to immunologic attack, even in cases where the donor and host are of different species and the host has been previously immunized to the donor. PMID- 3549613 TI - Correlation of in vitro and in vivo susceptibility of Candida albicans to amphotericin B and natamycin. AB - The efficacy of topical 0.15% amphotericin B and 5% natamycin was examined in a model of Candida keratitis in rabbits and correlated with three tests of in vitro susceptibility: tube dilution minimal inhibitory concentration (MIC), minimal fungicidal concentration (MFC) and agar diffusion zones of inhibition. For a panel of 17 strains, the MIC classified precisely the same strains as resistant or susceptible to amphotericin B as did the in vivo response. Several strains were misclassified using the MFC and the zone of inhibition. For natamycin the MIC misclassified two strains but it was still superior to the other two tests. For all strains, amphotericin B was equal or superior in efficacy to natamycin in vivo. The tube dilution MIC for amphotericin B was a reliable indicator for natamycin efficacy in vivo. PMID- 3549614 TI - Immunoaffinity purification of S-antigen using monoclonal antibodies to different antigenic sites. AB - Retinal S-antigen (S-ag) was purified by monoclonal antibody (MoAb) immunoaffinity chromatography from soluble protein extracts of bovine and human retina. Purification of S-ag was readily achieved by affinity chromatography using four different MoAb-Sepharose 4B columns. The four antibody columns gave different recoveries with material of comparable enrichment with greater than 95% purity as judged by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The use of two different MoAbs covalently bound to Sepharose 4B and known to be directed to disparate, spacially distant epitopes on S-ag led to at least a twofold increase in recovery, with the aforementioned purity. Immunoaffinity purified S-ag retained its serological and uveitogenic properties. The high recovery of S-ag associated with this one-step procedure is preferable to conventional preparatory techniques, and enables high antigen recovery when tissue availability is limited (eg human retina). PMID- 3549615 TI - Origin of notches in CSF: optical or neural? AB - Grating contrast sensitivity was measured across a range of 1 to 32 cycles per degree (c/deg) in normal observers with a computer-automated method of ascending limits. Monocular contrast sensitivity functions (CSF) were obtained for vertical, oblique and horizontal orientations, with or without full refractive correction. Small amounts of astigmatic error resulted in loss of sensitivity at selective spatial frequencies. Coincident with these CSF "notches" was the presence of monocular diplopia induced, in this study, by the condition of astigmatic error. Experimental manipulation of the selective spatial frequency losses was possible by the introduction of slight cylindrical defocus and by changes in grating orientation. Determination of the angular displacement and orientation of the monocular double images allowed prediction of the spatial frequencies which would show reduced sensitivity due to partial cancellation of contrast. The close fit between the predicted and measured sensitivity loss supports the suggestion that refractive error can affect narrowly-tuned notches. These results indicate that before the presence of a notch in the CSF can be attributed to neural abnormality, an optical cause must be eliminated. PMID- 3549616 TI - Calcium binding protein immunoreactivity in pigeon retina. AB - Pigeon retina has been mapped immunocytochemically for vitamin D-dependent calcium-binding protein (D-CaBP). Immunoreactivity was found in the cones of the yellow field, but not in photoreceptors of the red field. The D-CaBP-containing cones were a subpopulation of those in the yellow field having straight fibres leading to their synaptic terminals. D-CaBP immunoreactivity was also found in horizontal cells, the amount present varying according to position along the retina, and in some amacrine cells. Immunoblots of pigeon retinal proteins separated by SDS-polyacrylamide gel electrophoresis indicated two D-CaBP forms, having apparent molecular weights of 27000 and 29000. Both these forms of D-CaBP have been found previously in rat and pigeon brain. PMID- 3549617 TI - Electron microscopy and HLA expression of a new cell line of retinoblastoma. AB - A new continuous retinoblastoma cell line (Rb 355-7) derived from a nonfamilial unilaterally-affected child was studied morphologically and with regard to HLA expression. The tumor was compared with two older and widely studied cell lines, the Y-79 and WERI-Rb1 strains. The Rb 355-7 line grew in tissue culture in clusters and chains. Its doubling time was calculated to be 4.4 days. In contrast to the Y-79 and WERI-Rb1 cell lines, the Rb 355-7 showed a paucity of HLA expression. PMID- 3549619 TI - Cross-sectional imaging method. A system to compare ultrasound, computed tomography, and magnetic resonance with histologic findings. AB - Studies comparing imaging modalities require a precise knowledge of the type and location of tissue structures. When comparing cross-sectional techniques such as ultrasound, computed tomography, and magnetic resonance imaging, the images must be obtained through the same tissue section that is examined histologically. An experimental system that permits comparison of these modalities with histologic sections of precisely corresponding tissue is described. Application in 30 gastrointestinal tissue specimens shows a high degree of correspondence between cross-sectional images and histologic sections. This method should be useful in tissue imaging research for anatomic correlation and for comparisons between imaging modalities. PMID- 3549618 TI - Computed tomographic staging of gastrointestinal malignancies. Part II. The small bowel, colon, and rectum. PMID- 3549620 TI - Two patron saints of medicine: Cosmas and Damian. PMID- 3549621 TI - Medicine and painting in Ireland. PMID- 3549622 TI - Artists and critics: the national medical journals. PMID- 3549623 TI - The Irish Medical Journal 1937-1987. PMID- 3549624 TI - Bartholomew Mosse (1712-1759). PMID- 3549625 TI - MacWilliam. PMID- 3549626 TI - Early detection of necrotizing pancreatitis by computer. AB - In 59 patients admitted with a clinical picture compatible with acute pancreatitis, 88 features, recorded within the first day, were retrospectively collected and stored in a database programmed on a NCR DM V personal computer. On the basis of the final diagnosis, the patients were divided into two groups, according to Becker's grading of acute pancreatitis. A third group comprised the false-positives. Using 14 significant differences (p less than 0.025) between the three groups, a Bayesian analysis was programmed for early prediction, in terms of percentage probability, of each of the three final diagnoses. A retrospective assessment of computer performance was carried out in the patients entered the initial database, and further 38 underwent a prospective test. In the detection of necrotizing pancreatitis the procedure gave 95.8% accuracy, 91.9% sensitivity and 98.3% specificity. Previous diagnosis of pancreatitis, estimate of the degree of necrosis, data to be used for the processing, are discussed. Performances, similar in retrospective and prospective series, proved higher as compared to diagnostic peritoneal lavage. Comparison with Ranson's multiple criteria or computed tomography is inappropriate. The system seems to be reliable feasible and adaptable. The choice of treatment is difficult in acute pancreatitis. A computer-aided analysis may provide a better approach, than an unaided clinical estimate, to several decisional problems in acute pancreatitis. PMID- 3549627 TI - Gastric stricture following migration of the Angelchik prosthesis. A case report. AB - An unusual case of migration of an Angelchik esophageal antireflux prosthesis is reported. It was displaced at the middle third of gastric body, in a 49-year old female patient, who had undergone a surgical correction of hiatal hernia 6 months before and it had induced a severe narrowing of gastric lumen. Surgeons using this device should be aware of its various complications and employ it only in particular cases. PMID- 3549628 TI - Impairment of consciousness and memory in migraine: a review. PMID- 3549629 TI - The effect of intravenous verapamil on acute migraine headache. PMID- 3549630 TI - Health care marketing: lots of talk, any action? AB - Although health care managers pay a great deal of attention to marketing, there appears to be limited substantive action. As more organizations successfully implement the marketing concept, other organizations will follow suit and marketing will become more prevalent throughout the health care industry. PMID- 3549631 TI - Marketing physician services in an academic medical center. AB - As a result of recent environmental changes in the health care industry, marketing has become a vital necessity for the survival of most hospitals. Kotler's conceptual framework is used to study and evaluate an innovative program for marketing physician services in a large urban medical center. This program was quite successful in increasing admissions and referrals and won a national award in 1984. PMID- 3549632 TI - Planning evolution in hospital management. AB - In today's competitive health care market, hospitals are adopting more sophisticated and aggressive planning systems. The development of hospital planning can be visualized as an evolutionary progression from financially based systems to advanced systems of strategic analysis. This article offers a prescriptive model that hospital administrators can use to assess their organization's planning capabilities and move along the path to more effective planning. PMID- 3549633 TI - [Fistulous pyoderma caused by Serratia liquefaciens]. AB - Human infections with Serratia liquefaciens are rare. We therefore present a patient with fistulous pyoderma due to this pathogen. The success of the therapy of Serratia infections depends on determination of the resistance and sensitivity to antibiotics. Following the tentative diagnosis of dermal tuberculosis, histological, microbiological and X-ray examinations were performed. Serratia liquefaciens was identified by culture as the only cause of the skin lesions. After therapy with sulfamethoxazole trimethoprim, the lesions disappeared. PMID- 3549634 TI - The W.A. Schroeder Symposium on the Application of HPLC in Hemoglobin Analysis. July 28, 1986, Atlanta, GA. Proceedings. PMID- 3549636 TI - [Progressive inner ear diseases--sequelae of a secondary autoimmune process? Significance of antibodies to endoplasmic reticulum]. AB - In sera from patients with different forms of inner ear diseases antibodies against endoplasmic reticulum (anti-ER) could be detected by ELISA in association with antisarcolemmal (ASA) and antiendothelial antibodies (AEA). 36% of 296 patients with sensorineural hearing loss (SNHL), 30% of 20 patients with tinnitus, 21% of 48 patients with sudden deafness and 20% of 49 patients with Meniere's disease had ASA. 94% of these ASA positive patients were also positive for anti-ER. The overall frequency of anti-ER was 57% of patients with SNHL, 60% of patients with tinnitus, 46% of patients with sudden deafness and 22% of patients with Meniere's disease. Analysing the clinical course in 5 anti-ER positive and 11 anti-ER negative patients with SNHL it was shown that all 5 patients either had a progressive course and/or a systemic manifestation in contrast to only 4 of the anti-ER negative patients. Anti-ER antibodies were also detected in 38-53% of patients with different chronic inflammatory disorders of unknown aetiology (polymyalgia rheumatica, vasculitis, sarcoidosis, ankylosing spondylitis etc.) while only 6% of patients with typical autoimmune disorders (collagen diseases, lupoid hepatitis, primary biliary cirrhosis) and 8% of blood donors had this antibody. Therefore it can be concluded that anti-ER antibodies have no apparent relevance for the diagnosis of SNHL. They may be, however, indicative of a secondary autoimmune process triggered by a persistent infectious agent. PMID- 3549635 TI - Subcellular distribution of acid alpha-glucosidase in fibroblasts and of antigenically cross-reactive material in Pompe's disease fibroblasts. AB - From fibroblasts of two cases of Pompe's disease (acid alpha-glucosidase deficiency), one of the childhood type (RH-SF-1) and one of the adult type (RH-SF 2), and normal fibroblasts, antigenically cross-reactive material and acid alpha glucosidase were immunoprecipitated and analysed by immunoelectrotransfer blotting. The acid alpha-glucosidase and antigenically cross-reactive material (which reacts with antibody raised against normal acid alpha-glucosidase) revealed a precursor form of molecular weight 97,000 and two major components of 79,000 and 76,000. When monensin was added to the fibroblast culture, the two major components of normal acid alpha-glucosidase were decreased, whereas the large molecular weight precursor was increased. On the other hand, the 97,000 molecular weight component of cross-reactive material in the Pompe's fibroblasts (RH-SF-1 and RH-SF-2) was only slightly increased on monensin treatment. The fibroblasts were pulse-chase labelled with [2-H3] mannose and 32Pi. The cross reactive material and acid alpha-glucosidase were precipitated with anti acid alpha-glucosidase antibody, and after sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), fluorography was performed. The radiolabel of 3H in the cross-reactive material of RH-SF-1 and -2 was weak, and 32P in the cross reactive material of both fibroblasts was very weak when compared with those of the acid alpha-glucosidase. The radiolabel of 32P in the cross-reactive material of RH-SF-1 was extremely weak. Immunofluorescence histochemistry revealed a granular localization of acid alpha-glucosidase in the normal fibroblast cytoplasm, and a diffuse distribution of cross-reactive material in the cytoplasm of RH-SF-1 and -2. Immuno-electron microscopic examinations showed a normal acid alpha-glucosidase localization on the inner side of the lysosomal membrane and also diffusely in the lysosome; when treated with monensin, it was present on the trans part of the Golgi apparatus. Antigenically cross-reactive material, however, was found in the cytoplasm and endoplasmic reticulum. Some lysosomal localization was observed sporadically. Even after monensin treatment, it was not demonstrated on the Golgi apparatus. PMID- 3549637 TI - [Immunologic findings and therapeutic results in chronic progressive inner ear hearing loss]. AB - In a retrospective study of 147 patients with progressive sensorineural hearing loss we analysed the therapeutic results in relationship to the serum tissue antibody. Serum antibodies against heterologous tissue were detected in about 50% of the patients studied. These antibodies were mainly against sarcolemma, endothelium and smooth muscle. One group of patients was treated with corticosteroids. In this group, one third of the antibody-positive patients and 10% of the antibody-negative patients had hearing improvement. The second group of patients was treated with rheological substances (Dextrane 40 with Procaine or Naftidrofuryl). In this group, there was hearing improvement in 17% of the antibody-positive and 20% of the antibody-negative patients. The results of our study suggest that routine immunological tests may not be sufficient to predict the usefulness of corticosteroid treatment. It may be necessary to develope new immunological techniques which are more specific to the inner ear. PMID- 3549638 TI - The eruptions of pregnancy: review and new classification. PMID- 3549639 TI - Traumatic atlanto-occipital dislocations: value of the Powers ratio in diagnosis. PMID- 3549640 TI - Coexistence of hairy-cell leukemia and histiocytic lymphoma. PMID- 3549641 TI - Hypertension in the 1980s. PMID- 3549642 TI - Specific patient challenge: the elderly hypertensive patient. PMID- 3549643 TI - Captopril therapy in heart failure. PMID- 3549644 TI - Ninth annual del Regato lecture: optimal multidisciplinary management of head and neck cancer. PMID- 3549645 TI - Combined treatment of radiation and cisdiamminedichloroplatinum (II): a review of experimental and clinical data. AB - Cis-diamminedichloroplatinum (II) (c-DDP), a highly effective cytostatic drug, is increasingly used in combination with irradiation both in the laboratory and in patients. This review aims at a critical reassessment of the potential role of this drug as a "radiosensitizer." The opinion about c-DDP being an effective hypoxic cell radiosensitizer in bacteria was substantiated in some studies on mammalian cells in culture but not in others. More powerful mechanisms of radiation enhancement, which are not yet fully explored, may be depletion of endogenous thiols, inhibition of cellular repair processes, and proliferation inhibition. The effects of c-DDP in combination with irradiation in experimental tumors seem to vary between different investigators and between different tumor systems. Occasionally, supra-additive effects have been observed in some animal tumors. This stresses the need for testing this combination treatment in various tumor types, preferentially of human origin. In normal tissues, the effects are, to a large extent, explained by independent cell killing by each agent. A substantial number of clinical pilot studies have shown that the combination treatment is feasible, but the results of ongoing phase III trials will be needed to assess the potential therapeutic benefit of this combined treatment modality. PMID- 3549646 TI - Advances in hypoxyradiotherapy. AB - Observations in animal experiments and in Phase I clinical trials on the effect of breathing 8-10% oxygen are summarized. The animal tests indicated that the hypoxia induced in this way for periods varying between 10-45 minutes had a radioprotective effect on normal tissues. Patients tolerated the hypoxic treatment given for 15 minutes without any acute or late complications. Phase II trials have been started to test the effect of hypoxic radiotherapy in administering a larger total tumor dose than in conventional radiotherapy. PMID- 3549647 TI - Henri Coutard. PMID- 3549648 TI - Effect of cisplatin resistance on cellular radiation response. AB - Cisplatin-resistant tumors of the head and neck are generally resistant to irradiation. To determine whether the association between cisplatin (DDP) resistance and radiation resistance is a cellular phenomenon, we developed DDP resistant Chinese hamster fibroblasts and studied their response to radiation. DDP resistance did not confer cross resistance to radiation. DDP-resistant cells did not demonstrate altered ability to repair sublethal or potentially lethal radiation damage. However, an isodose concentration of DDP did not inhibit repair of radiation damage in drug-resistant cells as readily as it did in drug sensitive cells. The results suggest that cross resistance of tumors between DDP and radiation may be a result of the tumor microenvironment, rather than being a cellular phenomenon. Additionally, DDP may not inhibit the repair of radiation damage in DDP-resistant tumors. PMID- 3549649 TI - An algorithm for planning stereotactic brain implants. AB - A computer software package was developed for the planning and execution of brain biopsy and radioactive implant procedures with the BRW Stereotaxic System. With the application of computer graphics and a zero-one integer variable programming algorithm, an implant plan with accompanying isodose distributions and stereotactic coordinates can be easily accomplished at the time of the operation when the computer imaging terminal and a printer/plotter is placed in the operating room. PMID- 3549650 TI - Use of ultrasonography for the detection of aortic-iliac thrombosis in horses. AB - Two dimensional ultrasonographic evaluation of the iliac arteries and terminal portion of the aorta was utilized in 18 horses with histories of exercise intolerance or hindlimb lameness. A plaque or thrombus was imaged in one or more of these vessels in 5 horses. In 2 horses, the initial rectal examination findings were normal and the thrombus may have been missed without the use of diagnostic ultrasonography. PMID- 3549651 TI - Upbeat view on blind-stitch abomasopexy. PMID- 3549652 TI - Symposium on the development of a drug: LHRH agonists. Boston, Massachusetts, April 27 to May 2, 1985. PMID- 3549653 TI - Costs of research and patent considerations. PMID- 3549654 TI - Animal pharmacology and safety studies with an LHRH agonist. PMID- 3549655 TI - Biochemical studies of metalloendoprotease activity in the spermatozoa of three mammalian species. AB - Ejaculated porcine and human spermatozoa, hamster spermatozoa from the cauda epididymidis, isolated hamster sperm heads and hamster cytoplasmic droplets contained activity that hydrolyzed the metalloendoprotease substrate ABZ-Ala-Gly Leu-Ala-NBA (AAGLAN). Hamster sperm heads were isolated by treating spermatozoa with proteinase K and removing sperm tails with Dowex-50W beads. Hamster sperm activity was characterized using spermatozoa from which cytoplasmic droplets were removed by sonication and centrifugation. Porcine sperm preparations were essentially free of cytoplasmic droplets, while human sperm preparations retained somewhat more droplet material. Activity from all of these sources was inhibited by the metalloendoprotease inhibitors phosphoramidon, 1,10-phenanthroline, CBZ-D Phe and CBZ-L-Phe but was not competitively inhibited by the metalloendoprotease substrate CBZ-Ser-Leu-amide. The AAGLAN hydrolyzing activity found in intact spermatozoa of all three species had a pH optimum of 6.2, while the optimum of the hamster sperm cytoplasmic droplet activity was 7.0. In addition, hamster sperm preparations were inhibited by ZnCl2 and dithiothreitol, but were not affected by toluene, benzamidine or chymostatin. The AAGLAN hydrolyzing activity of hamster sperm preparations was reduced, but not eliminated, by dialysis. It is concluded that spermatozoa from all three species, hamster sperm heads and hamster cytoplasmic droplets contain metalloendoprotease activity. Furthermore, metalloendoprotease activity found in hamster cytoplasmic droplets is different from that found in spermatozoa. PMID- 3549656 TI - Semisynthetic beta-lactam antibiotics. III. Effect on antibacterial activity and comt-susceptibility of chlorine-introduction into the catechol nucleus of 6-[(R) 2-[3-(3,4-dihydroxybenzoyl)-3-(3-hydroxypropyl)-1-ureido]-2- phenylacetamido]penicillanic acid. AB - The resistance of 6-[(R)-2-[3-(3,4-dihydroxybenzoyl)-3-(3-hydroxypropyl)-1 ureido]-2- phenylacetamido]penicillanic acid (1a) to metabolism by catechol-O methyl-transferase (COMT) was increased by introduction of the chlorine atom into the catechol moiety. Penicillins (1b-1d) having one or two chlorine atoms at the positions adjacent to the hydroxyl group were found to have greater stability to COMT. This resulted in greater efficiency in vivo in experimental Pseudomonas aeruginosa and Escherichia coli infections. In vitro activities were essentially unchanged. PMID- 3549657 TI - Morphological and electrophysiological study of the inner ear and the central auditory pathways following whole body fetal irradiation. AB - Pregnant CBA/CBA mice were whole body irradiated with 2 Gy on the 13th or 16th day of gestation, respectively. The exposed fetuses were raised to an age of 21 postnatal days. Auditory brainstem recordings of threshold levels showed a considerable elevation independent of if irradiation had been performed on either the 13th gestational day or the 16th gestational day. In exposed animals a latency difference occurs in the peaks that increases from peak 1 to peak 5, measuring in peak 5 up to 1.16 ms. Also the peak-to-peak length of waves 1-5 increases in irradiated animals. Scanning electron microscopy of the cochleae showed varying degrees of stereociliary derangement of both outer and inner hair cells, particularly in cochleae where irradiation had been performed on the 13th gestational day, but not loss of hair cells. Light microscopic analysis of auditory brainstem nuclei revealed normal conditions except that in inner ears exposed on the 16th gestational day the flocculus was fused to the lateral surface of the anterior ventral cochlear nucleus. It is concluded that the elevated threshold levels in irradiated animals are most likely due to pathological changes in the peripheral receptor organ whereas the increased latencies and the increased peak-to-peak length likewise reflect functional changes in the brainstem auditory nuclei. PMID- 3549658 TI - Genetic control of immune responsiveness: a review of its use as a tool for selection for disease resistance. AB - Disease resistance and immune responsiveness have been traits generally ignored by animal breeders. Recent advances in immunology and molecular biology have opened new avenues towards our understanding of genetic control of these traits. The major histocompatibility gene complex (MHC) appears to play a central role in all immune functions and disease resistance. The need to understand the relationship between immune responsiveness, disease resistance and production traits is discussed in this review. Antagonistic relationships might prevent simultaneous improvement of all of these traits by conventional breeding methods. It is suggested that genetic engineering methods may allow the simultaneous improvement of disease resistance and production traits in domestic animals. Genes of the MHC will be especially good candidates for genetic engineering experiments to improve domestic species. PMID- 3549659 TI - Concentrations of hormones in plasma from cattle with different growth potentials. AB - Blood samples were taken from four large- and four small-frame steers each month for 12 mo to study the effect of size on plasma hormone concentrations in cattle from 5 to 17 mo of age. The rate of gain and daily feed intake were 45% (P less than .05) and 51% (P less than .001) greater for the large steers. The large frame steers had higher mean concentrations of growth hormone (P less than .001), insulin (P less than .06), thyroxine (P less than .06) and cortisol (P less than .002). The concentration of growth hormone was highest in the young cattle (P less than .01) and gradually declined with increasing age. Insulin concentrations were lowest in the young cattle (P less than .01) and gradually increased with age. The results of this study suggested that there are differences in hormone concentrations that are related to size rather than being the result of differences in physiological maturity of different breeds of cattle. PMID- 3549660 TI - Response of postpartum beef cows to exogenous progestogens and gonadotropin releasing hormone. AB - Plasma progesterone (P4) profile and estrous detection were used during three experiments to evaluate the effects of exogenous progestogens on the life span of gonadotropin releasing hormone (GnRH)-induced corpora lutea (CL) in postpartum (pp) beef cows. Experiment 1 utilized primiparous fall-calving cows (n = 28, trial 1); and spring-calving cows (n = 29, trial 2). On d 18 to 27 pp (d 0) all cows received intravaginal devices containing either P4 or no P4 (NP) for 5 d. On d 5 the devices were removed and calves were either removed (CR) or were present (CP) with half of the cows within steroid group. At 50 h after device removal, 500 micrograms of GnRH was given (iv) to all cows, and weaned calves were reunited with their dams. The induced CL had a normal life span (greater than 16 d) in 17 and 86% (trial 1) and 8 and 79% (trial 2) of NP and P4 cows, respectively. Calf removal did not affect (P greater than .10) the life span of the CL. In Exp. 2, spring-calving multiparous cows (d 18 to 24 pp; d 0) received either no P4 (NP; n = 19), P4 for 6 d via intravaginal devices (P4H; n = 19) or a single im injection of 300 mg P4 (P4 IM; n = 18). At 48 h after device removal or at 8 d after the injection of P4, half of the cows within steroid group received either 500 micrograms GnRH or saline. Corpora lutea had a normal life span in 0, 11, and 80% of NP, P4 IM and P4H cows, respectively, that received GnRH and in 22% of P4-saline cows. In Exp. 3, fall-calving multiparous and primiparous cows (d 25 to 31 pp) received either no progestogen (NP; n = 20), P4 via intravaginal devices for 5 d (P4H; n = 21) or melengestrol acetate (MGA; .5 mg.head-1.d-1 for 5 d orally, n = 15). At 48 d after device removal or at 72 h after the last MGA feeding, all cows received 500 micrograms GnRH. Progesterone post-GnRH injection was increased (greater than 1 ng/ml) at d 7 in 64, 100 and 100%, and remained elevated at d 14 in 11, 46 and 100% of NP, MGA and P4H cows, respectively. For all experiments plasma P4 was increased (range 2 to 5 ng/ml) when the devices containing P4 were in place, then decreased (less than 1 ng/ml) by 48 to 50 h after device removal.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549661 TI - Function of ovine corpora lutea after administration of luteinizing hormone releasing hormone. AB - Ewes were treated with an agonistic analog of luteinizing hormone-releasing hormone (LH-RH) during the luteal phase (d 10) of the estrous cycle. Function of natural and hormonally-induced corpora lutea (CL) was evaluated by measurements of progesterone in sera or luteal tissue. Synthesis and secretion of progesterone by natural CL were not chronically altered by LH-RH. Likewise, there was no in vitro effect of LH-RH on luteal function. When natural CL were surgically removed, newly formed CL functioned at a defective level. Hysterectomy shortly after ovulation did not significantly influence such luteal activity. Induction of ovulation by LH-RH during the follicular phase (d 16) in uterus-intact ewes was followed by normal profiles of luteal secretion of progesterone; serum concentrations of progesterone in animals that were hysterectomized increased in association with development of the CL, but then plateaued at a subnormal level. There were no differences in patterns of secretion of luteinizing hormone in response to LH-RH due to stage of the estrous cycle. Follicles stimulated to ovulate during the luteal phase contained low numbers of steroidogenically deficient granulosal-lutein cells. These results indicate that: ovine CL are not sensitive to exogenous LH-RH; luteal dysfunction is a consequence of ovulation during the luteal phase, and the etiology of this abnormality appears to be linked with the developmental status of the ovulatory follicle; and CL that are formed from ovulation of a matured follicle begin to develop normally, but then function at a defective rate in the absence of the uterus. PMID- 3549662 TI - Distinguished Service Award Citation presented to Kanemi Kanazawa, DDS. PMID- 3549663 TI - O-demethylation, dehydroxylation, ring-reduction and cleavage of aromatic substrates by Enterobacteriaceae under anaerobic conditions. AB - Four fermentative facultative anaerobes, members of the genera Enterobacter and Escherichia, were tested for their ability to transform an aromatic lignin derivative, 3-methoxy-4-hydroxy-cinnamic acid (ferulic acid), under anaerobic (fermentative) conditions. The pure cultures studied were shown to O-demethylate, dehydroxylate, reduce the double bond in the side-chain, decarboxylate the aromatic ring to the stage of benzoate and to reduce the ring to an alicyclic acid. Aromatic hydrocarbons (toluene, ethylbenzene and propylbenzene), as well as phenols (phenol, o-cresol, p-cresol, 2-ethylphenol and 3-hydroxy-4-ethylphenol) were also produced. In addition, during 3 months incubation, the cleavage of the aromatic ring occurred, whereby a small fraction of the substrate was converted to straight-chain and branched (methylated, ethylated) five- to eight-carbon aliphatic acids. The results indicate that pure cultures of fermentative facultative anaerobes might be capable of degrading substituted aromatic acids to aliphatic products under strictly anaerobic (fermentative) conditions. These abilities, which have so far been found only in denitrifying pseudomonads among facultative anaerobes, might be common in Enterobacteriaceae. It is conceivable that these bacteria are important as degraders of aromatic compounds in anaerobic ecosystems. PMID- 3549664 TI - A tentative national reference procedure for isolation and enumeration of Escherichia coli from bivalve molluscan shellfish by most probable number method. AB - In the UK several quantitative methods exist for the examination of bivalve molluscan shellfish for sewage contamination. These methods include roll tubes, pour plates and most probable number (MPN) techniques, but there is no national standard method. A comparative study was made of the most commonly used methods for detection of Escherichia coli in bivalve shellfish. Schemes employing solid media, such as the roll tube and pour plate methods, underestimated faecal contamination in shellfish tissue compared with a liquid MPN multiple test-tube method using minerals-modified-glutamate broth (MMGB) as primary enrichment medium. The composition of MMGB apparently permits repair of sublethally injured cells of E. coli. Incorporation of resuscitation stages into the pour plate technique did not yield higher counts. A standardized MPN technique for examination of bivalve molluscan shellfish for E. coli content is proposed as a possible national reference procedure pending further collaborative assessment. PMID- 3549665 TI - Evaluation of a commercial beta-glucuronidase test for the rapid and economical identification of Escherichia coli. AB - A commercial beta-glucuronidase (beta-GUR) test for the rapid and economical identification of Escherichia coli was evaluated. A total of 762 clinical strains and 228 environmental isolates were studied. More than 95% of the E. coli strains were found to be beta-GUR positive. Thirty-one clinical isolates of Shigella sonnei, 10 of Enterobacter cloacae, eight of Enterobacter aerogenes, nine of Citrobacter freundii and one of Salmonella enteritidis also gave positive results. The enzyme beta-GUR was also detected in two environmental strains of E. cloacae and one C. freundii. A comparative study between the beta-GUR test and the conventional identification system was carried out in 233 consecutive isolates of lactose positive enterobacteria. Agreement was observed in 223 cases and 190 E. coli strains were correctly identified using this test. Discrepancies were found in 10 cases: nine E. coli were beta-GUR negative and one C. freundii was beta-GUR positive. Escherichia coli was the only species positive for both beta-GUR and indole tests. This procedure permits a rapid, easy, precise and inexpensive identification of E. coli. beta-GUR positive Enterobacter strains have not previously been described. PMID- 3549666 TI - [Analysis of mycolic acids and various carbon-chain-length fatty acids in Mycobacterium lepraemurium originating from rough and smooth colonies grown on Ogawa's yolk media]. PMID- 3549667 TI - Comparative evaluation of the Abbott TDX, the Abbott ABA200, and the Syva LAB5000 for assay of serum gentamicin. AB - Three automated chemical assays for serum gentamicin were compared for accuracy, reproducibility and cost. One method utilized fluorescence polarization (Abbott TDX), and the other two enzyme-multiplied immunoassay (Abbott ABA200, and the Syva Lab5000). All three systems produced a high degree of accuracy and reproducibility with spiked samples when the concentrations of gentamicin were within the range of 3.0-8.0 mg/l. However, with concentrations below 2.0 mg/l or above 8.0 mg/l, only the TDX system gave acceptable coefficients of variation and accurate recoveries. Similarly, excellent correlations were obtained between all three systems for assays of clinical specimens containing 2.0-8.0 mg/l gentamicin, but above and below this range, the correlations were poor except between TDX and Lab5000 within the range of 0.0-2.0 mg/l. The Abbott TDX was thus the most accurate and reproducible of the three systems for the assay of serum gentamicin in the critical concentrations below 2.0 mg/l and above 8.0 mg/l. The cost per assay by the Abbott TDX was US$4.57 compared with US$5.40 for the Abbott ABA200, and US$3.20 for the Syva Lab5000. PMID- 3549668 TI - Inducible expression of an aminoglycoside-acetylating enzyme in Providencia stuartii. AB - Strains of Providencia stuartii were collected from a chronic-care geriatric ward of a large Veteran's Administration hospital. Two strains of P. stuartii, and one of Escherichia coli isolated from the same ward, were transferred five times in the presence of gentamicin or netilmicin. At the fifth transfer the MICs of both gentamicin and netilmicin for the two P. stuartii strains had increased at least ten-fold. The MICs for the E. coli remained essentially unchanged. Enzyme assay demonstrated increased activity of an aminoglycoside-2'-acetylating enzyme in P. stuartii during the period of the transfers. Five subsequent transfers in the absence of aminoglycosides resulted in return of enzyme activity to the initial level. Neither of the P. stuartii strains tested contained any detectable plasmid DNA. The 2'-acetylating enzyme in some strains of P. stuartii can be induced to high levels of activity by exposure to gentamicin or netilmicin. PMID- 3549669 TI - Neutrophil depletion does not prevent lung edema after endotoxin infusion in goats. AB - Neutropenia was produced in goats by injection of either nitrogen mustard, (1.5 mg/kg) or hydroxyurea (200 mg X kg-1 X day-1). A nitrogen mustard (M + E) group (n = 6), a hydroxyurea (H + E) group (n = 5), and a control (E) group (n = 7) were given 1-h infusions of endotoxin (5 micrograms/kg total dose), then monitored for up to 5 h. Postmortem extravascular lung water (EVLW) was significantly higher in the M + E group (14.2 +/- 4.4 ml/kg) and the E group (11.9 +/- 3.9 ml/kg) when compared with a normal control (6.6 +/- 1.3 ml/kg) group that did not receive endotoxin. EVLW in a group made neutropenic with nitrogen mustard (6.7 +/- 1.3 ml/kg) and the H + E (7.9 +/- 1.5 ml/kg) groups were not statistically different from each other or from normal controls. Circulating neutrophil counts averaged 32 +/- 42 cells/microliter in the M + E group and 180 +/- 210 cells/microliter in the H + E group. Only minimal histological changes were seen in the H + E group, but the E and M + E lungs had severe pulmonary edema. We conclude that neutrophils are not required for increased EVLW and decreased arterial O2 partial pressure after endotoxin infusion, and hydroxyurea prevents at least part of the pulmonary edema after endotoxin by a mechanism that is not neutrophil dependent. PMID- 3549671 TI - Isovolumetric and isobaric rabbit tracheal contraction in vitro. AB - Isovolumetric and isobaric tracheal smooth muscle (TSM) contraction were studied in vitro in a preparation of the whole rabbit trachea. Eight tracheae from New Zealand White rabbits were excised and mounted at a fixed length in an organ bath. Electrical field stimulation (EFS) was performed in isovolumetric and isobaric conditions at varying transmural pressures (TMP). Supramaximal stimulation with methacholine was done at 0 TMP. Active change in pressure (delta P) with EFS showed a peak at 3.1 +/- 1.06 cmH2O TMP during inflation and at 4.1 +/- 1.18 cmH2O TMP during deflation (mean +/- SE). Active delta P decreased at higher or lower TMP. Active change in volume with EFS showed a peak at 3.2 +/- 1.26 cmH2O TMP during inflation and at 1.8 +/- 0.98 cmH2O TMP during deflation. A decrease in response was also observed at higher and lower TMP. From these data, we concluded that TSM is at optimal length (Lmax) at TMP of 2-3 cmH2O. Maximal TSM shortening with supramaximal stimulation with methacholine was 32% Lmax. This figure is considerably smaller than the 80% shortening found in unloaded strips of TSM. We conclude that rabbit TSM length is close to Lmax at TMP similar to those found at functional residual capacity and that the loads that the muscle has to overcome probably contribute to the limited shortening observed in situ. PMID- 3549670 TI - Hemodynamic, gas exchange, and hormonal consequences of LBPP during PEEP ventilation. AB - Hemodynamic, gas exchange, and hormonal response induced by application of a 25- to 40-mmHg lower body positive pressure (LBPP), during positive end-expiratory pressure (PEEP; 14 +/- 2.5 cmH2O) were studied in nine patients with acute respiratory failure. Compared with PEEP alone, LBPP increased cardiac index (CI) from 3.57 to 4.76 l X min-1 X m-2 (P less than 0.001) in relation to changes in right atrial pressure (RAP) (11 to 16 mmHg; P less than 0.01). Cardiopulmonary blood volume (CPBV) measured in five patients increased during LBPP from 546 +/- 126 to 664 +/- 150 ml (P less than 0.01), with a positive linear relationship between changes in RAP and CPBV (r = 0.88; P less than 0.001). Venous admixture (Qva/QT) decreased with PEEP from 24 to 16% (P less than 0.001) but did not change with LBPP despite the large increase in CI, leading to a marked O2 availability increase (P less than 0.001). Although PEEP induced a significant rise in plasma norepinephrine level (NE) (from 838 +/- 97 to 1008 +/- 139 pg/ml; P less than 0.05), NE was significantly decreased by LBPP to control level (from 1,008 +/- 139 to 794 +/- 124 pg/ml; P less than 0.003). Plasma epinephrine levels were not influenced by PEEP or LBPP. Changes of plasma renin activity (PRA) paralleled those of NE. No change in plasma arginine vasopressin (AVP) was recorded. We concluded that LBPP increases venous return and CPBV and counteracts hemodynamic effects of PEEP ventilation, without significant change in Qva/QT. Mechanical ventilation with PEEP stimulates sympathetic activity and PRA apparently by a reflex neuronal mechanism, at least partially inhibited by the loading of cardiopulmonary low-pressure reflex and high-pressure baroreflex. Finally, AVP does not appear to be involved in the acute cardiovascular adaptation to PEEP. PMID- 3549672 TI - Adipocyte insulin resistance: effects of aging, obesity, exercise, and food restriction. AB - This study examined the effects of aging, exercise training, and food restriction on epididymal fat cell size and resistance to insulin in rats. The exercise group was given access to voluntary running wheels at age 6 mo. The rats were studied at ages 12 and 28 mo. Sedentary free-eating (SFE) rats were obese and their fat cells were extremely insulin resistant, showing minimal increases in glucose oxidation and 2-deoxy-D-glucose (2-DOG) uptake in response to high insulin concentrations. The runners' adipocytes were smaller and had a greater responsiveness to insulin (approximately 9-fold for 2-DOG uptake and approximately 30-fold for glucose oxidation) than those of the SFE rats. Sedentary rats that were food restricted to keep their body weights the same as those of the runners had fat cells that were intermediate both in size and insulin responsiveness relative to those of the SFE rats and runners. There was a close correlation between fat cell size and responsiveness to insulin of 2-DOG uptake and glucose oxidation independent of age. There were no significant differences in fat cell size, insulin sensitivity, or insulin responsiveness between the adult (12 mo) and old (28 mo) rats in the same treatment groups. We conclude that aging alone has little or no effect on the responsiveness to insulin of glucose metabolism in fat cells and that the insulin resistance of adipocytes from obese older rats is due to fat cell hypertrophy, not aging. Exercise is effective in protecting against development of fat cell hypertrophy and insulin resistance. PMID- 3549673 TI - Central chemoreceptors. AB - When all peripheral chemoreceptors are denervated, animals continue to show increased ventilation when made to breathe CO2, indicating that receptors within the brain ("central chemoreceptors") are excited by acidity or changes in CO2. No cells have been identified within the brain that are indisputedly chemoreceptors for CO2 or H+, but there is abundant evidence that respiration can be affected by chemical, electrical, and thermal stimuli applied locally to the ventral surface of the medulla. Furthermore, the actions of traditional central chemical respiratory stimuli can be blunted or abolished after inhibition of neural function within this ventrolateral medullary shell (VMS). The VMS is an integrative region for cardiovascular and respiratory function and may be involved in nociception. The distinction between the former two is not always clear, but recent studies using microinjection techniques seem promising for identifying the respiratory substrates. The many recent advances elucidating anatomic connections between the VMS and other brain regions are important but do not directly address the question of the site of central respiratory chemosensitivity. Knowledge of such connections, however, should provide more definitive opportunities for addressing this question. PMID- 3549674 TI - Influence of inspiratory assistance on ventilatory control during moderate exercise. AB - In five healthy subjects, we studied the effects of controlled mechanical unloading of the respiratory system on ventilatory control during moderate exercise, utilizing a modified positive-pressure ventilator (IEEE Trans. Biomed. Eng. BME-33: 361-365, 1986). We were especially interested in whether isocapnia was maintained when a portion of the normal ventilatory response to constant-load cycling was subserved by the ventilator. The mechanical unloading was achieved by "assisting" airflow throughout inspiration in a constant proportion to instantaneous flow. Two modest degrees of assistance (A1 = 1.5 and A2 = 3.0 cmH2O X l-1 X s) were imposed. The assistance caused minute ventilation (VE) to increase immediately (inspiratory time shortening and tidal volume rising) and end-tidal PCO2 (PETCO2) to fall. Some 10-15 s later, inspiratory occlusion pressure (P100) decreased, and in the new steady-state VE and PETCO2 were virtually restored to their control exercise levels. The modest residual hyperventilation [delta PETCO2 = -0.9 Torr (A1) and -1.6 Torr (A2)], which was not significant statistically, contrasted markedly with the much larger increase predicted for VE had there been no compensatory reduction in ventilatory drive (as evidenced by the fall in P100). Consistent with earlier studies utilizing resistive loading (J. Appl. Physiol. 35: 361-366, 1973 and Acta Physiol. Scand. 120: 557-565, 1984), these observations suggest that ventilatory drive during moderate exercise is controlled to compensate for modest changes in respiratory mechanical load, so that VE is preserved at a level appropriate to metabolic rate or nearly so. PMID- 3549675 TI - Effects of airway pressure on bronchial blood flow. AB - We studied the effects of increased airway pressure caused by increasing levels of positive end-expiratory pressure (PEEP) on bronchial arterial pressure-flow relationships. In eight alpha-chloralose-anesthetized mechanically ventilated sheep (23-27 kg), the common bronchial artery, the bronchial branch of the bronchoesophageal artery, was cannulated and perfused with a pump. The control bronchial blood flow (avg 12 +/- 1 ml/min or 0.48 ml X min-1 X kg-1) was set to maintain mean bronchial arterial pressure equal to systemic blood pressure. Pressure-flow curves of the bronchial circulation were measured by making step changes in bronchial blood flow, and changes in these curves were analyzed with measurements of the pressure at zero flow and the slope of the linearized curve. The zero-flow pressure represents the effective downstream pressure, and the slope represents the resistance through the bronchial vasculature. At a constant bronchial arterial pressure of 100 mmHg, an 8 mmHg increase in mean airway pressure caused a 40% reduction in bronchial blood flow. Under constant flow conditions, increases in mean airway pressure with the application of PEEP caused substantial increases in bronchial arterial pressure, averaging 4.6 mmHg for every millimeters of mercury increase in mean airway pressure. However, bronchial arterial pressure at zero flow increased approximately one-for-one with increases in mean airway pressure. Thus the acute sensitivity of the bronchial artery to changes in mean airway pressure results primarily from changes in bronchovascular resistance and not downstream pressure. PMID- 3549676 TI - Effect of endotoxin on diaphragm lymph contamination in unanesthetized sheep. AB - The preparation for collecting lung lymph from sheep caudal mediastinal lymph node (CMN) efferent vessels is widely used to study the effects of endotoxin on lung microvascular permeability. However, there are nonpulmonary lymph vessels that drain into the CMN along with the afferent lymph vessels from the lung. Thus CMN lymph is a mixture of lymph from the lung and diaphragm lymph vessels as well as from other nonpulmonary lymph vessels. We studied the effect of 0.5-1.0 microgram/kg Escherichia coli endotoxin on the flow rates in diaphragm and CMN efferent lymph vessels (Qdi and QCMN, respectively) in unanesthetized sheep. For the time period between 2 and 5.5 h after endotoxin QCMN was increased from its base line of 7.2 +/- 4.4 (SD) to 17.3 +/- 10.6 ml/h and the lymph-to-plasma protein concentration ratio (L/PCMN) had increased from 0.68 +/- 0.11 to 0.81 +/- 0.06. During the same time period, Qdi was 4.5 +/- 3.1 ml/h compared with 1.0 +/- 0.8 ml/h at base line and the diaphragm lymph-to-plasma protein concentration ratio (L/Pdi) was 0.92 +/- 0.07 (base line = 0.74 +/- 0.15). The increases in flow rate and protein concentration were significant for each type of vessel (P less than 0.05). We conclude that the period of increased QCMN and L/PCMN after endotoxin is associated with an increase in Qdi and L/Pdi. Thus, it is difficult to determine how much of the CMN lymph response comes from the lungs and how much comes from diaphragm lymph vessels. PMID- 3549677 TI - Lung lymph flow after bone marrow injection into goats was reduced by indomethacin. AB - We examined the pulmonary response to bone marrow embolism in untreated and indomethacin-treated goats. Pulmonary arterial pressure increased by 15 cmH2O after bone marrow infusion, reaching a peak of 37.2 then stabilizing at greater than 30 cmH2O in the control group. In the treated group it increased by 4.3 cmH2O from a base line of 18.5 cmH2O but had returned to base line by 6 h. Lymph flow increased in the control group from a base line of 7.3 ml/h to a peak of 22.4 ml/h and remained near that level. It increased from a base line of 6.4 ml/h to a peak of 9.8 ml/h in the treated group and remained close to that value. The lymph-to-plasma protein ratio was little changed throughout the experiment. Cardiac output decreased by 1.2 l/min in the control group but was unchanged from base line in the treated group. Systemic arterial pressure was similar in both groups of animals. We conclude that indomethacin prevents the pulmonary hypertension seen after bone marrow infusion and protects against some of the increased permeability. PMID- 3549678 TI - Transferrin is a major mouse milk protein and is synthesized by mammary epithelial cells. AB - We have identified a major mouse milk protein as transferrin (Tf) using immunoprecipitation, 2-dimensional electrophoresis, Ouchterlony diffusion and V-8 protease digests. We show that Tf is synthesized by mammary epithelial cells themselves and that its synthesis and secretion is regulated distinctly from that of other milk proteins. In culture, the kinetics of Tf synthesis and secretion are distinct from that of beta-casein; furthermore, Tf is relatively insensitive to lactogenic hormones whereas beta-casein is hormone-dependent. In vivo, however, Tf is regulated by pregnancy. While the virgin gland produces small amounts of Tf, its production is greatly increased during pregnancy and lactation. Thus, Tf synthesis in the mammary gland is modulated by as yet unknown factors in vivo. These observations are discussed in terms of Tf's possible role in mammary gland growth, differentiation and function. PMID- 3549679 TI - Analytical methods for measuring uric acid in biological samples and food products. AB - During the last 7 decades, uric acid methodology has kept pace with the introduction of state-of-the-art technology (e.g., spectroscopy, electrochemistry, chromatography) or the discovery of unique chemical processes (e.g., redox, enzymatic). We envision this practice will continue in the future. There never will be a single analytical method applicable for biofluids or foodstuffs. Therefore, it is imperative that the analyst not only understand the advantages and disadvantages of a procedure, but also thoroughly understand its underlying chemical and technological principles. Since many procedures available for analysis of biofluids and foodstuffs rely on identical chemical or technological principles, this report shall review both sample types and the available spectroscopic, electroanalytical, and chromatographic methods. PMID- 3549680 TI - Glucuronidase assay in a rapid MPN determination for recovery of Escherichia coli from selected foods. AB - Glucuronidase is present in most strains of Escherichia coli but absent in most other enteric microorganisms; therefore, an assay for this enzyme is useful for determining the presence of the organism. The substrate 4-methylumbelliferyl beta D-glucuronide (MUG) is incorporated into either lauryl tryptose (LT) broth or EC medium; the inoculated tubes are then incubated under specified conditions and examined under longwave UV light for the presence of a fluorogenic glucuronidase end product. When compared with the 10-day most probable number (MPN) procedure of AOAC, the LT-MUG and the EC-MUG tests required 24 and 96 h, respectively, and gave comparable mean log MPN values for samples of crabmeat, sunflower kernels, and walnut pieces. However, false-positive and false-negative reactions were observed with foods tested by both of these rapid methods. Overall, method sensitivity was not compromised by using the LT-MUG rather than the EC-MUG method. Incorporation of 25 micrograms MUG/mL into LT broth resulted in diminished fluorescence of positive reactions, whereas MUG concentrations of 50 and 100 micrograms/mL provided decisive fluorogenic reactions. PMID- 3549681 TI - Preliminary study of imipramine in profoundly retarded residents. AB - This was a double-blind, placebo-controlled crossover trial of imipramine (3 mg/kg/day) in 10 profoundly retarded residents. Two groups were formulated: one with depressivelike (or affective) symptoms and one with acting-out behaviors. Measures of drug response included ratings of ward behavior using the Aberrant Behavior Checklist, interval samples of behavior in the living units, and observations of behavior in a playroom situation. Results indicated that the drug caused behavioral deterioration in the Irritability, Lethargy/social withdrawal, and Hyperactivity dimensions of the rating scale, irrespective of subgroup. In addition, gross motor activity was significantly increased on the wards due to imipramine, and it was found that the affective group became less active and the acting-out group more active during free play. Physical side effects were uncommon. These unexpected adverse behavioral effects were discussed with respect to dosage and diagnostic considerations. PMID- 3549682 TI - Captopril in congestive cardiac failure. PMID- 3549683 TI - Role of disulfide bonds in the oligomeric structure and protease resistance of recombinant and native Treponema pallidum surface antigen 4D. AB - Recombinant Treponema pallidum surface antigen 4D isolated from Escherichia coli formed a protease-resistant ordered ring structure composed of 19,000-dalton subunits. On gradient sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the higher oligomers of recombinant 4D migrated with molecular masses that were nearly multiples of the 190,000-dalton basic ordered ring. Reduction at room temperature with 2-mercaptoethanol converted the 190,000-dalton ordered ring and the higher oligomers to a 160,000-dalton form and the dissociated monomer. A 190,000-dalton form of 4D was identified in sodium dodecyl sulfate-solubilized T. pallidum after reduction at room temperature. Disulfide bonds stabilized both native and recombinant 4D oligomers against dissociation by heating in detergent without a reducing agent. Electron microscopy of recombinant 4D revealed that the characteristic ordered ring structure was maintained after reduction. Reduction of 4D under conditions that preserved the ordered ring structure did not affect the resistance of the molecule to digestion with proteinase K. The properties of 4D suggest that it may fulfill an important structural role in the T. pallidum outer membrane. PMID- 3549684 TI - Conditions leading to secretion of a normally periplasmic protein in Escherichia coli. AB - The phosphate-binding protein (PhoS) is a periplasmic protein which is part of the high-affinity phosphate transport system of Escherichia coli. Hyperproduction of PhoS in strains carrying a multicopy plasmid containing phoS led to partial secretion of the protein. By 6 h after transfer to phosphate-limiting medium, about 13% of the total newly synthesized PhoS was secreted to the medium. Kinetic studies demonstrated that this secretion consists of newly synthesized PhoS. This secretion occurs in PhoS-hyperproducer strains but not in a PhoS-overproducer strain. Another type of secretion concerning periplasmic PhoS was observed in both PhoS-hyperproducer and PhoS-overproducer strains. This mode of secretion depended upon the addition of phosphate to cells previously grown in phosphate limiting medium. PMID- 3549685 TI - A new methionine locus, metR, that encodes a trans-acting protein required for activation of metE and metH in Escherichia coli and Salmonella typhimurium. AB - We isolated an Escherichia coli methionine auxotroph that displays a growth phenotype similar to that of known metF mutants but has elevated levels of 5,10 methylenetetrahydrofolate reductase, the metF gene product. Transduction analysis indicates that the mutant carries normal metE, metH, and metF genes; the phenotype is due to a single mutation, eliminating the possibility that the strain is a metE metH double mutant; and the new mutation is linked to the metE gene by P1 transduction. Plasmids carrying the Salmonella typhimurium metE gene and flanking regions complement the mutation, even when the plasmid-borne metE gene is inactivated. Enzyme assays show that the mutation results in a dramatic decrease in metE gene expression, a moderate decrease in metH gene expression, and a disruption of the metH-mediated vitamin B12 repression of the metE and metF genes. Our evidence suggests that the methionine auxotrophy caused by the new mutation is a result of insufficient production of both the vitamin B12 independent (metE) and vitamin B12-dependent (metH) transmethylase enzymes that are necessary for the synthesis of methionine from homocysteine. We propose that this mutation defines a positive regulatory gene, designated metR, whose product acts in trans to activate the metE and metH genes. PMID- 3549686 TI - Processing and secretion of the Yarrowia lipolytica RNase. AB - Secretion of the extracellular RNase from the yeast Yarrowia lipolytica was studied in pulse-chase and immunoprecipitation experiments. A polypeptide of 45,000 daltons was immunoprecipitated from [35S]methionine-labeled cell extracts and supernatant medium by rabbit anti-RNase antiserum. The RNase was secreted rapidly; the time between synthesis and appearance in the extracellular medium was about 5 min. In pulse-chase experiments, about 50% of the RNase was still cell associated 30 min after labeling. A polypeptide of 73,000 daltons whose immunoprecipitation was blocked by an excess of purified RNase was also detected. It broke down to a polypeptide with the same mobility and same peptide map as the mature RNase. Peptide maps of the undegraded 73-kilodalton polypeptide and the intracellular mature RNase contained several peptides of identical mobility. Immunoprecipitates from cells labeled in the presence of tunicamycin contained 66 and 45-kilodalton polypeptides. Endoglycosidase H treatment of the 73-kilodalton polypeptide converted it to a 66-kilodalton form, but did not change the apparent molecular weight of the mature form of the RNase. Labeling kinetics from pulse chase experiments did not clearly support a precursor-product relationship between the 73-kilodalton polypeptide and the intracellular 45-kilodalton form of the RNase, and other relationships between the two polypeptides are possible. PMID- 3549687 TI - Altered molecular form of acyl carrier protein associated with beta-ketoacyl-acyl carrier protein synthase II (fabF) mutants. AB - Acyl carrier protein (ACP) is a required cofactor for fatty acid synthesis in Escherichia coli. Mutants lacking beta-ketoacyl-ACP synthase II activity (fabF1 or fabF3) possessed a different molecular species of ACP (F-ACP) that was separated from the normal form of the protein by conformationally sensitive gel electrophoresis. Synthase I mutants contained the normal protein. Complementation of fabF1 mutants with an F' factor harboring the wild-type synthase II allele resulted in the appearance of normal ACP, whereas complementation with an F' possessing the fabF2 allele (a mutation that produces a synthase II enzyme with altered catalytic activity) resulted in the production of both forms of ACP. The structural difference between F-ACP and ACP persisted after the removal of the 4' phosphopantetheine prosthetic group, and both forms of the protein had identical properties in an in vitro fatty acid synthase assay. Both ACP and F-ACP were purified to homogeneity, and their primary amino acid sequences were determined. The two ACP species were identical but differed from the sequence reported for E. coli E-15 ACP in that an Asn instead of an Asp was at position 24 and an Ile instead of a Val was at position 43. Therefore, F-ACP appears to be a modification of ACP that is detected when beta-ketoacyl-ACP synthase II activity is impaired. PMID- 3549689 TI - Formation of flagella lacking outer rings by flaM, flaU, and flaY mutants of Escherichia coli. AB - Among flagellar mutants of Escherichia coli, flaM or flaU mutants form basal bodies lacking the outer P and L rings, whereas flaY mutants predominantly form basal bodies lacking the L ring. In these mutants, hooks and filaments are occasionally assembled onto these incomplete basal bodies. When the hook protein gene, flaFV, of Salmonella typhimurium was cloned on the multicopy plasmid pBR322 and introduced into these mutants, the efficiency with which cells assembled hooks and filaments onto the incomplete basal bodies increased significantly. Such cells formed characteristic dotted swarms on semisolid plates, indicating that cells carrying flagella without the outer rings are weakly motile because of poor function of their flagella, a low flagellar number per cell, or both of these defects. FlaV mutants also produced incomplete basal bodies lacking the outer rings, but assembly of hooks and filaments did not occur in these mutants even after introduction of the plasmid carrying flaFV of S. typhimurium. The failure in the case of flaV mutants was attributed to their inability to modify the rod tip to the structure competent for assembly of hook protein. PMID- 3549688 TI - Characterization of a membrane-associated serine protease in Escherichia coli. AB - Three membrane-associated proteolytic activities in Escherichia coli were resolved by DEAE-cellulose chromatography from detergent extracts of the total envelope fraction. On the basis of substrate specificity for the hydrolysis of chromogenic amino acid ester substrates, the first two eluting activities were determined previously to be protease V and protease IV, respectively (M. Pacaud, J. Bacteriol. 149:6-14, 1982). The third proteolytic activity eluting from the DEAE-cellulose column was further purified by affinity chromatography on benzamidine-Sepharose 6B. We termed this enzyme protease VI. Protease VI did not hydrolyze any of the chromogenic substrates used in the detection of protease IV and protease V. However, all three enzymes generated acid-soluble fragments from a mixture of E. coli membrane proteins which were biosynthetically labeled with radioactive amino acids. The activity of protease VI was sensitive to serine protease inhibitors. Using [3H]diisopropylfluorophosphate as an active-site labeling reagent, we determined that protease VI has an apparent molecular weight of 43,000 in polyacrylamide gels. All three membrane-associated serine proteases were insensitive to inhibition by Ecotin, and endogenous, periplasmic inhibitor of trypsin. PMID- 3549690 TI - Identification of proteins of the outer (L and P) rings of the flagellar basal body of Escherichia coli. AB - Synthesis of the Salmonella typhimurium hook protein from the gene cloned on a multicopy plasmid results in partial suppression of the flagellar assembly defects of certain classes of Escherichia coli mutants (K. Ohnishi, M. Homma, K. Kutsukake, and T. Iino, J. Bacteriol, 169:1485-1488, 1987). This phenomenon allowed hook-basal body complexes from such mutants to be purified and analyzed by electron microscopy and gel electrophoresis. The absence of the P and L rings in such structures was found to correlate with the absence of proteins of apparent molecular weight 39,000 and 26,000, respectively. Gene-polypeptide correlations from other studies enabled us to complete gene-polypeptide-structure correspondences for these two proteins as flaM----39-kilodalton protein----P ring and flaY----26-kilodalton protein----L ring. PMID- 3549691 TI - The flaFIX gene product of Salmonella typhimurium is a flagellar basal body component with a signal peptide for export. AB - flaFIX, the structural gene for the periplasmic P ring of the flagellar basal body of Salmonella typhimurium, was cloned. Two gene products with apparent molecular weights of 38,000 and 40,000 were identified by minicell analysis. Data from pulse-chase and membrane fractionation experiments and data on the inhibitory effect of the proton ionophore carbonyl cyanide m chlorophenylhydrazone all indicated that the 40-kilodalton protein was a precursor form which, after export across the cytoplasmic membrane accompanied by cleavage of a signal peptide, gave rise to the mature protein in the periplasm. The N-terminal amino acid sequence of the FlaFIX protein, predicted from the DNA sequence, conformed well to known signal peptide sequences. The results indicate that the P-ring protein of the basal body (unlike flagellin and possible some other external flagellar components) crosses the cytoplasmic membrane in a conventional signal peptide-dependent manner. PMID- 3549693 TI - Molecular cloning of bile acid 7-dehydroxylase from Eubacterium sp. strain VPI 12708. AB - Eubacterium sp. strain VPI 12708 is a human intestinal bacterium which contains an inducible bile acid 7-dehydroxylase. Two-dimensional polyacrylamide gel electrophoresis showed that at least four new polypeptides were synthesized after exposure of growing cells to sodium cholate. One of these, of molecular weight 27,000 (PP-27), was implicated in 7-dehydroxylase catalysis. PP-27 was purified to greater than 95% homogeneity by DEAE-cellulose chromatography, high-pressure liquid chromatographic gel filtration, high-pressure liquid chromatography-DEAE chromatography, and preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The first 33 amino acid residues of the N terminus of PP-27 were determined with a gas-phase sequencer, and a corresponding mixed oligonucleotide (17-mer) was synthesized. Southern blot analysis of EcoRI total digests of chromosomal DNA showed a 2.2-kilobase fragment which hybridized to the 32P labeled 17-mer. This fragment was enriched for by size fractionation of an EcoRI total digest of genomic DNA, ligated into the bacterial plasmid pUC8, and used to transform Escherichia coli HB101. Transformants containing the putative 7 dehydroxylase gene were detected with the 32P-labeled 17-mer by colony hybridization techniques. The insert was 2.2 kilobases in length and contained the first 290 bases of the PP-27 gene. Preliminary nucleic acid sequence data correlate with the amino acid sequence. The entire gene was cloned on a 1,150 base-pair TaqI fragment. Western blot analysis of E. coli strains containing these plasmids indicated that PP-27 is expressed in E. coli but is not regulated by bile acids under the conditions used. PMID- 3549692 TI - The secreted hemolysins of Proteus mirabilis, Proteus vulgaris, and Morganella morganii are genetically related to each other and to the alpha-hemolysin of Escherichia coli. AB - Secreted hemolysins were extremely common among clinical isolates of Proteus mirabilis, Proteus vulgaris, and Morganella morganii, and hemolytic activity was either cell associated or cell free. Southern hybridization of total DNA from hemolytic isolates to cloned regions of the Escherichia coli alpha-hemolysin (hly) determinant showed clear but incomplete homology between genes encoding production of hemolysins in the four species. One of the two E. coli secretion genes, hlyD, hybridized only with DNA from P. vulgaris and M. morganii, which produced cell-free hemolysis, but not with that from P. mirabilis, which showed only cell-associated activity. Molecular cloning of the genetic determinants of cell-free hemolytic activity from P. vulgaris and M. morganii chromosomal DNA allowed their functional analysis via inactivation with the transposons Tn1000 and Tn5. Both hemolysin determinants were about 7.5 kilobase pairs and comprised contiguous regions directing regulation, synthesis, and specific secretion out of the cell. Transposon mutations which eliminated secretion of the Proteus and Morganella hemolysins could be complemented specifically by the E. coli hemolysin secretion genes hlyB or hlyD. Alignment of the physically and functionally defined hly determinants from P. vulgaris and M. morganii with that of the E. coli alpha-hemolysin confirmed a close genetic relationship but also indicated extensive evolutionary divergence. PMID- 3549694 TI - Characterization of the virE locus of Agrobacterium tumefaciens plasmid pTiC58. AB - The virE locus that is responsible for the efficiency of infection by Agrobacterium tumefaciens (T. Hirooka and C. Kado, J. Bacteriol. 168:237-243, 1986) is located next to the right boundary of the virulence (Vir) region of the nopaline plasmid pTiC58. This locus is very similar to the virE locus of octopine type Ti plasmids on the basis of nucleotide and amino acid sequence comparisons as well as genetic complementation analyses. The nucleotide sequence of virE revealed three open reading frames, arranged as an operon, with a potential coding capacity for proteins of 9, 7.1, and 63.5 kilodaltons. The promoter region of virE was analyzed by using gene fusions to promoterless cat and lux genes. Two different promoters were detected, one which operates in A. tumefaciens and one which operates in Escherichia coli. virE is transcribed from left to right toward the T region. In A. tumefaciens, the expression of virE was induced by acetosyringone and required the presence of pTiC58. PMID- 3549695 TI - Cloning and expression in Escherichia coli of three fragments of diphtheria toxin truncated within fragment B. AB - We have constructed three different truncated versions of diphtheria toxin (a 535 amino-acid polypeptide) which correspond to the N-terminal 290, 377, and 485 amino acids of the toxin. These lengths include one, three, and all four of the putative membrane-spanning sequences of the toxin which are thought to play a role in the translocation of fragment A into cells. Each of these three genes has been modified at its 3' end to code for a C-terminal cysteine (to allow for disulfide linkage of a targeting ligand) or a gene fusion with alpha-melanocyte stimulating hormone. We have also substituted the native diphtheria tox promoter (ptox) with the lambda pR promoter in an effort to overexpress these proteins. The truncated genes are expressed in Escherichia coli from both the tox promoter in a constitutive fashion and from the pR promoter by using the heat-inducible cI857 repressor. The clones produce proteins which react with anti-diphtheria toxin serum, which migrate at the anticipated Mr on Western blots, and which have ADP-ribosyltransferase activity. Constitutive synthesis from ptox leads to severe proteolytic degradation even in a protease-deficient strain. High-level expression from the pR promoter in the same lon htpR strain allows the full length polypeptides to accumulate but also stops the growth of the cells. It appears that removal of as few as 50 amino acids from the C-terminus of diphtheria toxin alters its conformation, making it a target for proteases and causing overexpression lethality in the host cells. PMID- 3549696 TI - RRP1, a Saccharomyces cerevisiae gene affecting rRNA processing and production of mature ribosomal subunits. AB - The Saccharomyces cerevisiae mutant ts351 had been shown to affect processing of 27S pre-rRNA to mature 25S and 5.8S rRNAs (C. Andrew, A. K. Hopper, and B. D. Hall, Mol. Gen. Genet. 144:29-37, 1976). We showed that this strain contains two mutations leading to temperature-sensitive lethality. The rRNA-processing defect, however, is a result of only one of the two mutations. We designated the lesion responsible for the rRNA-processing defect rrp1 and showed that it is located on the right arm of chromosome IV either allelic to or tightly linked to mak21. This rrp1 lesion also results in hypersensitivity to aminoglycoside antibiotics and a reduced 25S/18S rRNA ratio at semipermissive temperatures. We cloned the RRP1 gene and provide evidence that it encodes a moderately abundant mRNA which is in lower abundance and larger than most mRNAs encoding ribosomal proteins. PMID- 3549698 TI - Purification and characterization of a Ca2+-dependent membrane peptidase involved in the signaling of mating pheromone in Rhodosporidium toruloides. AB - A mating-type-specific, membrane thiol peptidase (referred to as trigger peptidase) that seems to play a key role in the transmembrane signaling of the lipopeptidyl mating pheromone rhodotorucine A at the cell surface of mating type a cells of Rhodosporidium toruloides (T. Miyakawa, M. Kaji, T. Yasutake, Y.K. Jeong, E. Tsuchiya, and S. Fukui, J. Bacteriol. 162:294-299, 1985) was purified to homogeneity and characterized. The following lines of evidence support the contention that the enzyme we purified was the trigger peptidase: the identical specificity of hydrolysis at the Arg-Asn sequence of rhodotorucine A and the sensitivity of the reaction to sulfhydryl-blocking reagents; the identical specificity for the substrate, with a strict requirement for the presence of the lipid moiety; and the absence of the corresponding activity in the pheromone producing strain (mating type A) and in a sterile mutant strain, M-39 (type a), that lacks trigger peptidase activity in vivo. The apparent molecular weight of trigger peptidase was estimated to be 68,000 by Sepharose 6B gel filtration in the presence of octylglucoside and 63,000 by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Trigger peptidase alone was inactive but exhibited enzymatic activity with the simultaneous addition of Ca2+, membrane phospholipids, and a nonionic detergent such as octylglucoside. The concentration of Ca2+ required for maximum activation was approximately 1 mM. Only Mn2+ could replace Ca2+ at comparable concentrations. Among the phospholipids tested, only phosphatidylserine and phosphatidylethanolamine supported trigger peptidase activation. Solubilized trigger peptidase was strongly inhibited by antipain and phosphoramidon. PMID- 3549697 TI - Molecular cloning of genes encoding branched-chain keto acid dehydrogenase of Pseudomonas putida. AB - We cloned the structural genes for the individual subunits of the branched-chain keto acid dehydrogenase multienzyme complex on a 7.8-kilobase EcoRI-SstI restriction fragment of Pseudomonas putida chromosomal DNA by cloning into the broad-host-range vector pKT230. A direct selection system for growth on valine isoleucine agar was achieved by complementation of P. putida branched-chain keto acid dehydrogenase mutants. The recombinant plasmid, pSS1-1, increased expression of branched-chain keto acid dehydrogenase up to five times in wild-type P. putida. The complex was expressed constitutively in P. putida(pSS1-1) but was inducible in Escherichia coli HB101(pSS1-1) by high valine. E. coli minicells transformed with pSS1-1 produced three polypeptides which did not match the four polypeptides of the purified complex. To resolve this problem, we inserted P. putida DNA from pSS1-1 into pUC18 and pUC19. The pUC-derived plasmids were used as DNA templates in an E. coli transcription-translation system. Four polypeptides were produced from the pUC18-derived plasmid which had the correct molecular weights, showing that the structural genes had been cloned. Since only weak bands were produced with the pUC19-derived plasmid, the direction of transcription was established. The locations and order of all the structural genes of branched-chain keto acid dehydrogenase were located by restriction enzyme mapping. PMID- 3549699 TI - The SNF3 gene is required for high-affinity glucose transport in Saccharomyces cerevisiae. AB - Glucose uptake mutants have not been previously obtained in Saccharomyces cerevisiae, possibly because there seem to be at least two transport systems, of low and high affinities. We showed that snf3 (sucrose nonfermenting) mutants did not express high-affinity glucose uptake. Furthermore, their growth was completely impaired on low concentrations of glucose in the presence of antimycin A (which blocks respiration). Several genes which complemented the original snf3 gene were obtained on multicopy plasmids. Some of them, as well as plasmid carried SNF3 itself, conferred a substantial increase in high-affinity glucose uptake in both snf3 and wild-type hosts. The effects of glucose on the expression of such a plasmid-determined high-affinity uptake resembled those in the wild type. Other genes complementing snf3 seemed to cause an increase in low-affinity glucose uptake. We suggest that SNF3 may function specifically in high-affinity glucose uptake, which is needed under some conditions of growth on low glucose concentrations. SNF3 itself or the other complementing genes may specify components of the glucose uptake system. PMID- 3549701 TI - Determination of the promoter strength of the gene encoding Escherichia coli heat stable enterotoxin II. AB - We studied the promoter strength of the gene encoding the Escherichia coli heat stable enterotoxin II (STII). The promoter region and a portion of the 5' coding sequence of the STII gene were fused to the lacZ gene so that the production of beta-galactosidase was under the control of the STII gene promoter. The strength of the STII gene promoter was compared with that of the ompF and lac operons, which were similarly fused to the lacZ gene. The beta-galactosidase produced by the hybrid genes was assayed in vitro by using cell extracts. The mRNA transcribed by each promoter was assayed by Northern blot analysis and by in vitro transcription. The results suggest that the STII gene is regulated by a relatively weak promoter. PMID- 3549702 TI - Involvement of the phosphate regulon and the psiD locus in carbon-phosphorus lyase activity of Escherichia coli K-12. AB - Escherichia coli K-12 can readily mutate to use methylphosphonic acid as the sole phosphorus source by a direct carbon-to-phosphorus (C-P) bond cleavage activity that releases methane and Pi. The in vivo C-P lyase activity is both physiologically and genetically regulated as a member of the phosphate regulon. Since psiD::lacZ(Mu d1) mutants cannot metabolize methylphosphonic acid, psiD may be the structural gene(s) for C-P lyase. PMID- 3549700 TI - Regulation of allantoate transport in wild-type and mutant strains of Saccharomyces cerevisiae. AB - Accumulation of intracellular allantoin and allantoate is mediated by two distinct active transport systems in Saccharomyces cerevisiae. Allantoin transport (DAL4 gene) is inducible, while allantoate uptake is constitutive (it occurs at full levels in the absence of any allantoate-related compounds from the culture medium). Both systems appear to be sensitive to nitrogen catabolite repression, feedback inhibition, and trans-inhibition. Mutants (dal5) that lack allantoate transport have been isolated. These strains also exhibit a 60% loss of allantoin transport capability. Conversely, dal4 mutants previously described are unable to transport allantoin and exhibit a 50% loss of allantoate transport. We interpret the pleiotropic behavior of the dal4 and dal5 mutations as deriving from a functional interaction between elements of the two transport systems. PMID- 3549703 TI - Cloning and expression in Escherichia coli of a cellulase gene from Ruminococcus flavefaciens. AB - An endoglucanase gene of Ruminococcus flavefaciens FD1 was cloned on the vector pEcoR251 to form the recombinant plasmid pMEB200. The cloned endoglucanase gene showed carboxymethylcellulase enzyme activity but no degradation of Avicel (FMC Corp., Philadelphia, Pa.) or filter paper. Carboxymethylcellulase activity was found during the late-exponential-growth phase and accumulated in the periplasmic fraction. Enzyme production was not subject to catabolite repression by glucose. PMID- 3549704 TI - Conditional transduction of Salmonella typhimurium envB mutations. AB - Joint transduction of the argR and envB genes was observed, at a frequency of 24.5%, when four envB strains were transduced to tetracycline resistance (Tetr) with bacteriophage P22 grown on an argR372::Tn10 envB+ donor. When round-cell argR372::Tn10 derivatives of those envB strains were used as donors, two of them did not produce envB transductants in wild-type LT2 and other envB+ recipients, even though large numbers of Tetr transductants were obtained. This apparent exclusion of envB mutations did not occur when mecillinam-resistant derivatives of those envB+ strains were used as recipients. Mutations conferring partial resistance to mecillinam were found, unlinked to the argR-envB region, in three of the four envB strains studied; envB+ derivatives of the four strains were competent to accept envB mutations excluded by wild-type recipients. It is suggested that some envB mutations are lethal in the absence of suppressor mutations, some of which increase resistance to mecillinam. PMID- 3549705 TI - An outpatient evaluation of phenelzine and imipramine. AB - Phenelzine and imipramine were evaluated in a 5-week double-blind study of outpatients with major depression. Median daily doses of phenelzine 75 mg and imipramine 150 mg were employed. Of 27 patients 26 completed the 5-week study. Both drugs produced an equal overall effect, as measured by the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory (BDI). When patients were grouped on the basis of panic attack symptoms, phenelzine was found to be more effective than imipramine (p less than .05 for all patients on the BDI; p less than .05 for women on both rating scales). PMID- 3549706 TI - Use of arteriovenous shunts and right atrial catheters for daily granulocyte collection. AB - Between June 1982 and April 1984, 67 adult granulocyte donors were randomized to receive external arteriovenous shunts or modified right atrial catheters as vascular access for daily granulocyte collections using blood cell separators. Six of 32 donors with shunts and 2 of 35 donors with right atrial catheters experienced failure of the access method. Local infection occurred in one donor with a shunt and one donor with a right atrial catheter. Bacteremia occurred in one donor with a right atrial catheter. Specified whole blood flow rates of 50-65 ml/minute were achieved with 28 of 32 shunts and 29 of 35 right atrial catheters (P = NS). The majority of the donors in each group tolerated the vascular access without significant problems. This study demonstrates that modified right atrial catheters can be successfully used as method of vascular access for single donor granulocyte collection with blood cell separators. PMID- 3549707 TI - Plasma exchange and plasma modification for the removal of anti-red cell antibodies prior to ABO-incompatible marrow transplant. AB - Plasma exchange (PE) is performed only rarely to remove a specific, well defined antibody. ABO incompatibility in marrow transplantation has allowed us a unique opportunity to compare the effectiveness of three apheresis procedures for removing anti-red cell antibodies. We performed 140 marrow transplants in which a major ABO incompatibility between donor and recipient existed. To avoid a hemolytic transfusion reaction at the time of marrow infusion PE, plasma immunoadsorption (PIA) or whole-blood immunoadsorption (WBIA) was performed a total of 243 times. PE removed a mean of 87% of intravascular IgM and 86% of intravascular IgG directed against red cell antigens. PIA removed 75% and 73% of IgM and IgG, respectively (P less than .001 when compared to PE). Results for WBIA were 66% and 65%, respectively. Thus, PIA and WBIA were less efficient at removing antibody than PE. Furthermore, there were a few specific instances in which PIA or WBIA removed little or no antibody owing to differences in antibody specificity. PIA and WBIA resulted in less platelet consumption than PE. Although somewhat less effective that PE, PIA and WBIA have other advantages that can make them more desirable. PMID- 3549708 TI - A multiple-component, ATP-dependent protease from Escherichia coli. AB - A new ATP-dependent, casein-degrading proteolytic complex has been identified and partially purified from Escherichia coli. The proteolytic complex can be isolated from wild-type cells as well as from mutants in which the gene for the ATP dependent Lon protease is deleted. The complex consists of at least two components (components I and II) that can be separated from each other (and from wild-type Lon protease) by phosphocellulose chromatography. Neither component has casein-degrading activity when added separately to assay solutions with or without ATP. Both components must be present simultaneously for casein degradation to occur. Of the nucleotides tested, only ATP activates the proteolytic complex, and the ATP must be present continuously for degradation to occur. Component II copurifies with an ATPase activity and binds to a Type 4 ATP affinity column. ATP protects component II from heat inactivation, suggesting that component II interacts with ATP. Proteolysis was not inhibited by any serine protease inhibitors but was inhibited by reagents such as the organomercurial Neohydrin and N-ethylmaleimide, which react with sulfhydryl groups. Our data provide convincing evidence that E. coli possesses a previously undescribed proteolytic system composed of at least two complementary components and absolutely dependent on ATP. PMID- 3549709 TI - An increased content of protease La, the lon gene product, increases protein degradation and blocks growth in Escherichia coli. AB - The lon gene product in Escherichia coli is an ATP-dependent protease (La) that plays an important role in the breakdown of abnormal proteins and certain normal polypeptides. Since transcription of the lon gene rises as part of the heat-shock response, we studied the physiological effects of increased levels of protease La. In cells carrying additional copies of the lon gene under the control of the lac or tac promoter, induction of the protease resulted in a rapid cessation of cell growth and in a loss of viability at stationary phase. Similarly, cells carrying a multicopy plasmid encoding the lon gene contained 2-5-fold more protease La and grew much more slowly than did control cells. In such cells, insertion sequences appeared spontaneously in the lon gene on the plasmid and prevented the excess protease production and allowed more rapid growth. The cells with increased content of protease La (due to the lon plasmid or induction of the lon gene) exhibited severalfold higher rates of degradation of abnormal proteins containing amino acid analogs and of incomplete polypeptides containing puromycin. Also, a beta-galactosidase fusion protein with enzymatic activity was relatively stable in control cells but unstable in the cells with high protease La content. In these cells, the overall degradation of normal proteins increased 2-fold, and certain cellular polypeptides appeared particularly sensitive to proteolysis. Thus, rates of protein degradation in vivo are limited in part by the cellular content of the ATP-dependent protease, and increases in transcription of the lon gene enhance proteolysis and can be deleterious to the cell. PMID- 3549710 TI - Cloning, sequencing, in vivo promoter mapping, and expression in Escherichia coli of the gene for the HhaI methyltransferase. AB - A 1476-base pair DNA fragment from Haemophilus haemolyticus containing the HhaI methyltransferase gene was isolated from a cell library and cloned into pBR322. The nucleotide sequence of this fragment was determined. The structural gene is 981 nucleotides in length coding for a protein of 327 amino acids (Mr 37,000). The translational start signal (ATG) is preceded by the putative ribosome-binding site (TAAG). Recombinant plasmids containing the 1476-basepair fragment are completely methylated when isolated from Escherichia coli, as judged by their insusceptibility to the HhaI restriction endonuclease. However, the presence of an active HhaI methylase gene in certain E. coli strains results in a very poor yield of transformants and/or in vivo-originated deletions due to the Rg1 functions of these hosts. The in vivo transcription initiation sites have been identified by S1 protection and primer-extension experiments using specific probes with total RNA prepared from E. coli cells (HB101 or RR1) which tolerate the expression of MHhaI. PMID- 3549711 TI - Crystals of the trp repressor-operator complex suitable for X-ray diffraction analysis. AB - Crystals of a simulated trp repressor-operator complex have been grown that are large enough and are sufficiently well ordered and durable to provide a high quality molecular image of this regulatory protein X DNA complex to better than 3 A resolution. The "operator" consists of a 2-fold rotationally symmetric 18-base pair duplex that is extended by a dT residue at both 5'-termini. This system exhibits extensive crystal polymorphism. The crystal form and diffraction properties are very sensitive to the length and terminal structure of the operator fragment, as well as the type and concentration of multivalent ions. When combined with the experience reported by others, our results do not support a consistent strategy for crystallization of protein X DNA complexes. PMID- 3549712 TI - The structural basis for the interaction between L-tryptophan and the Escherichia coli trp aporepressor. AB - We have employed equilibrium dialysis to help study the mechanism by which the unliganded Escherichia coli trp aporepressor is activated by L-tryptophan to the liganded trp repressor. By measuring the relative affinity of L-tryptophan and various tryptophan analogues for the co-repressor's binding site, we have estimated the extent to which each of the functional groups of L-tryptophan contributes to the liganding process and discuss their role in the context of the crystal structures of the trp repressor and aporepressor. We have found that the indole ring and alpha carboxyl group of L-tryptophan are mainly responsible for its affinity to the aporepressor. The alpha amino group, however, has a small negative contribution to the affinity of L-tryptophan for the aporepressor which may be associated with its essential role in operator-specific binding. PMID- 3549713 TI - Supercoiling facilitates lac operator-repressor-pseudooperator interactions. AB - The binding affinity of the Escherichia coli lactose repressor to operator containing plasmids was increased by negative supercoiling of the DNA. The increased affinities observed were dependent on the sequence context of the DNA as well as the degree of supercoiling. Dissociation rate constants for plasmids containing a single operator site decreased as a function of the negative supercoil density. However, the presence of pseudooperators in the plasmid DNA in addition to the primary operator sequence resulted in a significant decrease in the operator-plasmid dissociation rate at higher negative supercoil densities. Approximately eight ionic interactions were determined for both the supercoiled plasmids and the linear DNAs examined. These results suggest that the stabilization provided by the topology of supercoiled DNA affects the nonionic component of the protein-DNA interaction. The ability to form a ternary complex of protein with two DNA segments is increased by the presence of multiple operator-like sites on the DNA. Furthermore, supercoiling DNA with multiple operator-like sequences profoundly diminishes the dissociation rate and results in a remarkably stable ternary, presumably looped complex (t1/2 approximately 28 h). These data suggest a critical role in vivo for DNA topology and pseudooperator(s) in transcriptional regulation of the lac operon. PMID- 3549714 TI - Neutron scattering analysis of bacterial lipopolysaccharide phase structure. Changes at high pH. AB - The aggregate structure of lipopolysaccharide isolated from an Re strain of Escherichia coli was examined at different pH values using small angle neutron scattering. At pH values of 6 and 7.4, angle-averaged scattering of the sodium salt of this isolate was consistent with randomly coiled tubular micelles approximately 100 A in diameter. At pH 9.1, however, Kratky analysis of the scattering data was distinctly different and consistent with pairing of uniform tubular micelle sections of length 1440 and 110 A in diameter. Contrast variation measurements of the micelles yielded an average micellar weight of the sample at pH 9.1 of approximately 1.11 X 10(7) daltons and suggested that the aggregates were tubular micelles of size and length similar to that derived from the scattering intensity data. Anisotropic scattering patterns of samples under shear indicated a rigidification of the micelles as the pH was increased to 9.1 and the temperature decreased from 25 to 10 degrees C. The rotational diffusion constants deduced from the observed shear anisotropy indicate that the structure at pH 9.1 must have smallest and largest dimensions which differ by at least an order of magnitude, ruling out spherical or moderately ellipsoidal structures. Analysis of the shear rate needed to induce anisotropic scattering indicated that the stiffness length of the micelles at pH 9.1 was approximately 1000 A and decreased at higher and lower pH values. PMID- 3549715 TI - Mechanism for markedly hyperresponsive insulin-stimulated glucose transport activity in adipose cells from insulin-treated streptozotocin diabetic rats. Evidence for increased glucose transporter intrinsic activity. AB - The effects of insulin therapy in streptozotocin diabetic rats on the glucose transport response to insulin in adipose cells have been examined. At sequential intervals during subcutaneous insulin infusion, isolated cells were prepared and incubated with or without insulin, and 3-O-methylglucose transport was measured. Insulin treatment not only reversed the insulin-resistant glucose transport associated with diabetes, but resulted in a progressive hyperresponsiveness, peaking with a 3-fold overshoot at 7-8 days (12.1 +/- 0.3 versus 3.4 +/- 0.1 fmol/cell/min, mean +/- S.E.) and remaining elevated for more than 3 weeks. During the peak overshoot, glucose transporters in subcellular membrane fractions were assessed by cytochalasin B binding. Insulin therapy restored glucose transporter concentration in the plasma membranes of insulin-stimulated cells from a 40% depleted level previously reported in the diabetic state to approximately 35% greater than control (38 +/- 4 versus 28 +/- 2 pmol/mg of membrane protein). Glucose transporter concentration in the low-density microsomes from basal cells was also restored from an approximately 45% depleted level back to normal (50 +/- 4 versus 50 +/- 6 pmol/mg of membrane protein), whereas total intracellular glucose transporters were further increased due to an approximately 2-fold increase in low-density microsomal membrane protein. However, these increases remained markedly less than the enhancement of insulin stimulated glucose transport activity in the intact cell. Thus, insulin treatment of diabetic rats produces a marked and sustained hyperresponsive insulin stimulated glucose transport activity in the adipose cell with little more than a restoration to the non-diabetic control level of glucose transporter translocation. Because this enhanced glucose transport activity occurs through an increase in Vmax, insulin therapy appears to be associated with a marked increase in glucose transporter intrinsic activity. PMID- 3549716 TI - Biosynthesis of lipid A precursors in Escherichia coli. A cytoplasmic acyltransferase that converts UDP-N-acetylglucosamine to UDP-3-O-(R-3 hydroxymyristoyl)-N-acetylglucosamine. AB - Preliminary studies from our laboratory have suggested the existence of a novel set of fatty acyltransferases in extracts of Escherichia coli that attach two R-3 hydroxymyristoyl moieties to UDP-GlcNAc (Anderson, M.S., Bulawa, C.E., and Raetz, C.R.H. (1985) J. Biol. Chem. 260, 15536-15541). The resulting "glucosamine derived" phospholipids appear to be crucial precursors for the biosynthesis of the lipid A component of lipopolysaccharide. We now describe an assay and a 1000 fold purification of the first enzyme in this pathway, which catalyzes the reaction: UDP-GlcNAc + R-3-hydroxymyristoyl-acyl carrier protein----UDP-3-O-(R-3 hydroxymyristoyl)-GlcNAc + acyl carrier protein. The covalent structure of the monoacylated UDP-GlcNAc product was established by fast atom bombardment mass spectrometry and 1H-NMR spectroscopy. The UDP-GlcNAc acyltransferase has a strict requirement for R-3-hydroxymyristoyl-acyl carrier protein, since R-3 hydroxymyristoyl coenzyme A and myristoyl-acyl carrier protein are not substrates. Of various NDP-GlcNAc preparations examined, only the uridine and thymidine derivatives were utilized to a significant extent. When the product of the reaction (UDP-3-O-(R-3-hydroxymyristoyl)-GlcNAc) was isolated and reincubated with crude E. coli extracts, it was rapidly converted to more hydrophobic products in the presence of R-3-hydroxymyristoyl-acyl carrier protein. We propose that the addition of an R-3-hydroxymyristoyl residue to the 3 position of the GlcNAc moiety of UDP-GlcNAc is the first committed step in lipid A biosynthesis and that UDP-GlcNAc is situated at a biosynthetic branchpoint in E. coli leading either to lipid A or to peptidoglycan. PMID- 3549718 TI - Gene 1.2 protein of bacteriophage T7. Effect on deoxyribonucleotide pools. AB - The gene 1.2 protein of bacteriophage T7, a protein required for phage T7 growth on Escherichia coli optA1 strains, has been purified to apparent homogeneity and shown to restore DNA packaging activity of extracts prepared from E. coli optA1 cells infected with T7 gene 1.2 mutants (Myers, J. A., Beauchamp, B. B., White, J. H., and Richardson, C. C. (1987) J. Biol. Chem. 262, 5280-5287). After infection of E. coli optA1 by T7 gene 1.2 mutant phage, under conditions where phage DNA synthesis is blocked, the intracellular pools of dATP, dTTP, and dCTP increase 10-40-fold, similar to the increase observed in an infection with wild type T7. However, the pool of dGTP remains unchanged in the mutant-infected cells as opposed to a 200-fold increase in the wild-type phage-infected cells. Uninfected E. coli optA+ strains contain severalfold higher levels of dGTP compared to E. coli optA1 cells. In agreement with this observation, dGTP can fully substitute for purified gene 1.2 protein in restoring DNA packaging activity to extracts prepared from E. coli optA1 cells infected with T7 gene 1.2 mutants. dGMP or polymers containing deoxyguanosine can also restore packaging activity while dGDP is considerably less effective. dATP, dTTP, dCTP, and ribonucleotides have no significant effect. The addition of dGTP or dGMP to packaging extracts restores DNA synthesis. Gene 1.2 protein elevates the level of dGTP in these packaging extracts and restores DNA synthesis, thus suggesting that depletion of a guanine deoxynucleotide pool in E. coli optA1 cells infected with T7 gene 1.2 mutants may account for the observed defects. PMID- 3549717 TI - Biosynthesis of lipid A precursors in Escherichia coli. A membrane-bound enzyme that transfers a palmitoyl residue from a glycerophospholipid to lipid X. AB - Certain phosphatidylglycerol-deficient mutants of Escherichia coli accumulate two fatty acylated monosaccharides related to lipid A biosynthesis that have been identified as 2,3-diacylglucosamine 1-phosphate (lipid X) and triacylglucosamine 1-phosphate (lipid Y) (Raetz, C. R. H. (1984) Rev. Infect. Dis. 6, 463-472). Lipid Y has the same structure as lipid X, except that it bears an additional palmitoyl moiety, esterified to the 3-OH of the N-linked R-3-hydroxymyristoyl residue. We now describe a membrane-associated system for the enzymatic conversion of lipid X to lipid Y. Removal of glycerophospholipids form such membranes by washing with cold ethanol abolishes the activity. The system can be reactivated by the addition of exogenous phospholipids dispersed as mixed micelles with Triton X-100. When reconstituted in this manner, the formation of lipid Y is strictly dependent upon a glycerophospholipid donor bearing a palmitoyl residue in the sn-1 position. The enzyme system does not utilize palmitoyl coenzyme A or palmitoyl acyl carrier protein. It does not catalyze efficient transfer of fatty acids differing from palmitate by only one carbon atom. In contrast, the enzyme has relatively little specificity for the polar headgroup of the phospholipid donor, and it also appears to utilize a disaccharide precursor of lipid A as an alternative palmitoyl acceptor. Since the in vitro synthesis of lipid Y proceeds with a high yield, we have isolated the product and verified its structure by 1H NMR spectroscopy and mass spectrometry. The transesterification reaction that converts lipid X to lipid Y may be a model for the enzymatic synthesis of other acyloxyacyl structures, known to occur in mature lipid A. PMID- 3549719 TI - Cloning of the mast cell protease, RMCP II. Evidence for cell-specific expression and a multi-gene family. AB - We have isolated, cloned, and characterized cDNA and genomic DNA corresponding to the mRNA and gene for the rat mast cell protease, RMCP II. The amino acid sequence deduced from the cDNA provides evidence that this protease is synthesized as a precursor, with a signal peptide and additional residues at the N and C termini. RNA homologous to the cDNA is expressed only in mast cells. Analysis of RNA from the two subclasses of mast cell, mucosal and serosal, indicates subclass specific expression of the different proteases found in each of these two subclasses. S1 protection analysis and the sequence of the genomic clone indicate that the serosal mast cell protease, RMCP I, is likely to be coded for by a separate, highly homologous gene. A comparison of the exon/intron structure of the RMCP II gene with genes of related serine proteases further indicates that RMCP II is a member of a family of proteases distinct from those found in the pancreas. We have also isolated a third gene, highly homologous to RMCP II but different from it and from the gene for RMCP I. Analysis of the 5' transcriptional control region of both genes showed striking homology to the TATA box and enhancer regions of the pancreatic proteases. PMID- 3549720 TI - Crystallization of rat intestinal fatty acid binding protein. Preliminary X-ray data obtained from protein expressed in Escherichia coli. AB - Rat intestinal fatty acid binding protein has been expressed in Escherichia coli, purified with bound long chain fatty acids and crystals grown from solutions of polyethylene glycol 4000. The crystals are monoclinic, space group P2(1), a = 3638 A, b = 57.2 A, c = 31.9 A, and beta = 113.9 degrees. Each unit cell contains two monomers of this 132-residue, 15.1-kDa polypeptide. The crystals are remarkably resistant to x-ray damage. X-ray diffraction data have been observed to 2.0 A resolution. Platinum chloride was used to generate a potential isomorphous heavy atom derivative. PMID- 3549721 TI - The consequences of stepwise deletions from the signal-processing site of beta lactamase. AB - Amino acids have been deleted from the processing site of pre-beta-lactamase, either into the signal sequence or into the mature protein. Whereas the loss of more than 2 amino acid residues from the C-terminal end of the signal sequence prevents the translocation of the protein into the periplasm, the removal of two or more amino acids from the beginning of the mature protein has no effect on the translocation of the truncated protein. The insertion of an additional one to three amino acids at the processing site has no detectable phenotypic consequence either. It appears that many sequences for the first few residues of the mature protein allow successful translocation and processing. In sharp contrast, the removal of one (but not both) of the amino acids that flank the processing site results in a severe growth defect in the host cell and very low expression of the protein. Yet removal of two amino acids from either side of the processing site, or removal of both the flanking residues of the processing site, results in normal secretion and signal cleavage. These results illustrate the limits on the amino acid sequence around the processing junction and suggest that interference with the signal cleavage step can lead not only to aborted secretion but also to pleiotropic consequences for the growth of the host organism. PMID- 3549722 TI - Heterogeneity of amelogenin mRNA in the bovine tooth germ. AB - The amelogenins are a complex mixture of hydrophobic proteins that are the major organic component of developing enamel. To study the molecular mechanisms underlying the heterogeneity of the amelogenins we isolated cDNA clones encoding these proteins. The clones were definitively identified by hybrid-selected translation experiments and by comparison of the DNA sequence with the protein derived amino acid sequence. Southern hybridization of bovine genomic DNA indicated that amelogenin is a single copy gene. However, Northern hybridization experiments distinctly showed two major species of mRNA, each of which were sufficiently large enough to encode the highest known molecular weight species of amelogenin proteins. Furthermore, immunoprecipitation of hybrid-selected translation products using isolated amelogenin cDNA showed multiple, translated protein products. These data are supportive of a differential mRNA processing mechanism involved in generating a heterogeneous family of amelogenin matrix proteins from a single gene. PMID- 3549723 TI - Thyroglobulin gene expression is regulated by insulin and insulin-like growth factor I, as well as thyrotropin, in FRTL-5 thyroid cells. AB - In FRTL-5 thyroid cells depleted of thyrotropin, insulin, and serum for 3 days, growth and synthesis of thyroglobulin are inhibited. Readdition of insulin or IGF I in the absence of thyrotropin stimulates thyroglobulin synthesis or thyroglobulin mRNA level by 2-4-fold but has no effect on cell growth. The half maximal effects of insulin and IGF-I are at 100 and 10 ng/ml, respectively. In both cases, the increased mRNA levels are accompanied by an increase in transcription rate. Maximally effective concentrations of insulin or IGF-I are additive with thyrotropin in increasing thyroglobulin mRNA levels and in increasing transcription; in contrast, the effect of insulin is not additive with IGF-I. PMID- 3549724 TI - Purification and properties of an endothelial cell growth factor from human platelets. AB - An endothelial cell growth factor has been purified about 1,000,000-fold to homogeneity from human platelets by a seven-step procedure. The purified product has an apparent Mr on sodium dodecyl sulfate-polyacrylamide gels of 45,000. The mobility in sodium dodecyl sulfate gel electrophoresis was similar in the presence or absence of reducing agents, indicating that the factor consists of a single polypeptide chain. Maximal stimulation by the purified protein was achieved at a concentration of about 20 ng/ml (440 pM). Heparin did not potentiate the activity, nor did the factor bind to heparin immobilized on Sepharose. The purified factor was heat- and acid-labile; it was active on porcine and human endothelial cells, but not on human foreskin fibroblasts. Chromatofocusing revealed that the pI of the factor was 4.6. The structural and functional characteristics of the platelet-derived endothelial cell growth factor are distinct from previously characterized endothelial cell mitogens with affinities for heparin. PMID- 3549725 TI - The binding of myosin heads on heavy meromyosin and assembled myosin to actin in the presence of nucleotides. Measurements by the proteolytic rates method. AB - The initial rates of tryptic digestion at the 50/20-kDa junction in myosin and myosin subfragment 1 were determined for the free proteins and their complexes with actin in the presence and absence of MgATP. The proteolytic reactions were carried out at 24 degrees C and under ionic strength conditions (mu) adjusted to 35, 60, and 130 mM. The percentages of myosin heads and myosin subfragment 1 bound to actin in the presence of MgATP were calculated from the rates of proteolysis for each set of digestion experiments. In all cases, the myosin heads in the synthetic filaments showed greater binding to actin than myosin subfragment 1. This binding difference was most prominent (3-fold) at mu = 130 mM. The binding of heavy meromyosin (HMM) to actin in the presence of MgADP was measured at 4 degrees C by ultracentrifugation and the proteolytic rates methods. Ultracentrifugation experiments determined the fraction of HMM molecules bound to actin in the presence of MgADP, whereas the proteolytic measurements yielded the information on the fraction of HMM heads bound to actin. Taken together, these measurements show that a significant fraction of HMM is bound to actin with only one head in the presence of MgADP under ionic conditions of 180 and 280 mM. PMID- 3549726 TI - Characterization of 2'(3')-trinitrophenyl-ATP as an inhibitor of ATP-dependent initiation complex formation between the DNA polymerase III holoenzyme and primed DNA. AB - We have identified 2'(3')-trinitrophenyl-ATP to be an inhibitor of the ATP dependent initiation complex formation reaction between the Escherichia coli DNA polymerase III holoenzyme and primed DNA. The inhibitor is specific for the initiation stage; once initiation complexes are formed the subsequent elongation reaction is unaffected. Three ATP-dependent DNA polymerase III holoenzyme reactions can be independently assayed: the ATP-dependent formation of initiation complexes, ATP binding, and the primed DNA-dependent hydrolysis of ATP. Trinitrophenyl ATP inhibits all three reactions to a similar extent with an apparent Ki between 6 and 15 microM in the presence of 5 microM ATP. This suggests all of these reactions are related and that they proceed through a common ATP-binding site. We include an improved purification of the DNA polymerase III holoenzyme in this report. PMID- 3549727 TI - Human plasma platelet-activating factor acetylhydrolase. Association with lipoprotein particles and role in the degradation of platelet-activating factor. AB - Platelet-activating factor (PAF) is a bioactive phospholipid (1-O-alkyl-2-acetyl sn-glycero-3-phosphocholine) synthesized by a variety of mammalian cell types. PAF induces hypotension, and activates neutrophils and platelets, among other actions. Removal of the acetyl moiety abolishes biological activity, so this reaction may regulate the concentration of PAF and its physiological effects. We have studied the significance of this reaction, which is catalyzed in vitro by an acetylhydrolase present in mammalian plasma, blood cells, and tissues. We have shown that the plasma PAF-acetylhydrolase is responsible for the degradation of PAF in whole human blood and that alternate pathways for PAF degradation in plasma or blood cells are negligible. Human plasma PAF-acetylhydrolase is associated with low and high density lipoproteins (LDL and HDL with apoE). We have confirmed that the activity is a stable component of these particles by density gradient ultracentrifugation, chromatography on heparin-agarose, and immunoprecipitation. The LDL-associated activity accounts for most or all of the PAF degradation that occurs in plasma ex vivo, while the HDL-associated activity contributes little to this process. However, the two activities likely are due to a single protein since the HDL- and LDL-associated PAF-acetylhydrolase activities can transfer from one lipoprotein to the other. These transfer processes are pH dependent and specific, since they only occur from LDL to a well characterized subclass of HDL (apoE-containing HDL) and vice versa. We discuss the equilibrium between the two particles and the role that this process may have in vivo. PMID- 3549728 TI - In vitro synthesis of bean (Phaseolus vulgaris) chloroplastic and cytoplasmic leucyl-tRNA synthetases. Characterization and processing of a precursor polypeptide for the chloroplast enzyme. AB - Bean (Phaseolus vulgaris) chloroplastic and cytoplasmic leucyl-tRNA synthetases differ in their structural and catalytic properties and do not share common antigenic determinants. Polyadenylated mRNAs, prepared from young bean leaves, have been translated in vitro in a rabbit reticulocyte lysate cell-free system. The newly synthesized polypeptides have been submitted to immunoadsorption on protein A-Sepharose in the presence of the antibodies raised against the chloroplastic or the cytoplasmic leucyl-tRNA synthetase. The specificity of the immunoadsorption has been checked by competition experiments involving the pure enzymes. Bean chloroplastic leucyl-tRNA synthetase is synthesized in vitro from a polyadenylated mRNA as a precursor polypeptide of 130 kDa, which is somewhat larger than the mature enzyme of 120 kDa. Bean cytoplasmic leucyl-tRNA synthetase is synthesized in vitro as a polypeptide which has the size of the mature monomer (130 kDa). Processing of the precursor polypeptide of the chloroplastic leucyl tRNA synthetase, yielding the mature enzyme, has been obtained by performing the in vitro translation in the presence of canine pancreatic microsomal membranes. These results suggest that in vivo bean chloroplastic leucyl-tRNA synthetase could be synthesized in the cytoplasm as a precursor which would be transported into the chloroplasts. PMID- 3549730 TI - Phosphorylase kinase conformers. Detection by proteases. AB - A variety of proteases have been evaluated as potential structural and conformational probes of nonphosphorylated and phosphorylated phosphorylase kinase. In general, the enzyme's alpha subunit is rapidly degraded, followed in most cases by hydrolysis of the beta subunit; the gamma subunit is resistant to most proteases. Trypsin clearly distinguishes between the nonactivated and activated conformers of phosphorylase kinase, in that the beta subunit in phosphorylated enzyme, as opposed to nonphosphorylated enzyme, is markedly protected from tryptic attack. In contrast, only a small difference in the rates of proteolysis of the alpha subunit in phosphorylated and nonphosphorylated enzyme is seen, even when a protease is used that is highly selective for the alpha subunit, such as chymotrypsin or endoproteinase Arg C. Incubation of nonphosphorylated phosphorylase kinase with either Mg2+ or Ca2+, which are activating cations, also protects the beta subunit from tryptic hydrolysis, whereas Mn2+, which inhibits the kinase activity, has little effect on proteolysis. The allosteric activator ADP also causes the beta subunit to become refractory to trypsin and mimics the effects of phosphorylation. Similar effector induced conformational changes in the beta subunit are also observed with enzyme in which the alpha subunit has previously been selectively destroyed. These data indicate that activation of phosphorylase kinase by dissimilar mechanisms is associated with a conformational change in the enzyme's beta subunit that is detectable by trypsin and confirm earlier studies from this laboratory employing a chemical cross-linker as a conformational probe for activated and nonactivated conformers of the enzyme (Fitzgerald, T. J., and Carlson, G. M. (1984) J. Biol. Chem. 259, 3266-3274). PMID- 3549729 TI - Crystallization and preliminary x-ray diffraction studies of subtilisin GX from Bacillus sp. GX6644. AB - Subtilisin GX, a serine protease from Bacillus species GX6644, has been crystallized by the vapor diffusion method using ammonium sulfate as the precipitant. The space group is P212121 with a = 38.4 A, b = 70.3 A, c = 73.5 A, and one molecule in the asymmetric unit. The crystals diffract to beyond 2.0-A resolution and are suitable for a high resolution three-dimensional structure determination. All x-ray data used in the preliminary crystallographic study were collected with an electronic area detector. PMID- 3549731 TI - Formation of the alpha-bungarotoxin binding site and assembly of the nicotinic acetylcholine receptor subunits occur in the endoplasmic reticulum. AB - During the process by which newly synthesized subunits of the nicotinic acetylcholine receptor (stoichiometry = alpha 2 beta gamma delta) mature and acquire the properties of the fully functional cell surface receptor, they undergo numerous covalent and noncovalent modifications. Using ligand-mediated and subunit-specific immunoprecipitation, four forms in the maturation of the alpha subunit can be detected: the primary translation product; alpha subunit that can bind alpha-bungarotoxin; alpha subunit assembled with the other subunits; and surface receptor. The alpha subunit acquires the ability to bind alpha-bungarotoxin with a t1/2 of approximately 40 min after translation and becomes assembled with a t1/2 of 80 min after translation. Using metabolic labeling and sucrose gradient fractionation, we have determined the subcellular location of alpha subunit when it acquires the ability to bind alpha-bungarotoxin and when it is assembled. Golgi membranes were identified across the gradient by the enzymatic activities UDP-galactose:N-acetylglucosamine galactosyltransferase and alpha-mannosidase. Endoplasmic reticulum membranes were identified by the enzymatic activity glucose-6-phosphatase and by the presence of newly synthesized alpha and beta subunits. Pulse-labeled alpha subunit that bound alpha bungarotoxin was first detected co-migrating in the gradient with the glucose-6 phosphatase activity. Therefore, the capacity to bind alpha-bungarotoxin was acquired while the alpha subunit was in the endoplasmic reticulum. Assembled alpha subunit was detected by immunoprecipitating with an anti-beta subunit specific monoclonal antibody. By this method, assembled receptor was first detected 15 min after translation in both the endoplasmic and Golgi portions of the gradient. To validate this method of detecting assembled receptor, we determined the sedimentation coefficient of the receptor subunits in the endoplasmic reticulum. Both unassembled subunits with sedimentation coefficients of 5 S and assembled receptor with a sedimentation coefficient of 9 S were recovered from the endoplasmic reticulum portion of the gradient. Thus, our data concerning the subcellular site of assembly are consistent with assembly occurring in the endoplasmic reticulum followed by rapid transport to the Golgi. PMID- 3549732 TI - In vivo synthesis of carbamyl phosphate from NH3 by the large subunit of Escherichia coli carbamyl phosphate synthetase. AB - The cloned carAB operon of Escherichia coli coding for the small and large subunits of carbamyl phosphate synthetase has been used to construct a recombinant plasmid with a 4.16 kilobase ClaI fragment of the car operon that lacks the major promoters, P1 and P2. The plasmid, pHN12, carries a functional carB gene. A mutant E. coli strain lacking both subunits of carbamyl phosphate synthetase when transformed with pHN12 overproduces the large subunit by 200-fold (8-10% of the cellular protein). The elevated levels of the large subunit enable the transformed cells to utilize NH3 but not glutamine as nitrogen donor for carbamyl phosphate synthesis. The large subunit has been purified from the overexpressing strain. The purified native large subunit is capable of synthesizing carbamyl phosphate from ammonia, HCO-3, and ATP. The kinetic properties of the large subunit compared with the holoenzyme indicate that the Michaelis constants of the large subunit for HCO-3 and ATP are modulated by its association with the small glutamine binding subunit. PMID- 3549734 TI - Identification and isolation of a mammalian protein which is antigenically and functionally related to the phospholipase A2 stimulatory peptide melittin. AB - Antibodies prepared against the phospholipase A2 stimulatory peptide melittin were used to identify and isolate a novel mammalian protein with similar functional and antigenic properties. The mammalian protein of Mr 28,000 was isolated from cell sonicates by high performance immunoaffinity chromatography and size exclusion chromatography. This stimulatory protein was stable for several months when frozen at -70 degrees C. The purified protein selectively stimulated phospholipase A2 when phosphatidylcholine was used as a substrate but had no effect on phospholipase A2 activity when phosphatidylethanolamine was used as a substrate. Furthermore, this protein had no effect on phospholipase C activity or on pancreatic or snake venom phospholipase A2. The stimulatory activity was unaffected by RNase or DNase treatment. However, boiling or trypsin digestion inactivated the phospholipase stimulatory activity. The mechanism of phospholipase A2 stimulation appeared to result from an increase in the apparent Vmax of the enzyme. PMID- 3549733 TI - Effect of glycosylation on yeast invertase oligomer stability. AB - Yeast external invertase is a glycoprotein that exists as a dimer that can associate to form tetramers, hexamers, and octamers (Chu, F., Watorek, W., and Maley, F. (1983) Arch. Biochem. Biophys. 223, 543-555; Esmon, P. C., Esmon, B. E., Schauer, I. E., Taylor, A., and Schekman, R. (1987) J. Biol. Chem., 262, 4395 4401), a process that is facilitated by the attached oligosaccharide chains. We have studied this association by high performance liquid chromatography on a gel filtration matrix, by which procedure wild-type bakers' yeast invertase gives two peaks, and invertase from a core mutant (mnn1 mnn9) of Saccharomyces cerevisiae X2180 gives three peaks. Concentration of an invertase solution by freezing drives the dimers into higher aggregates that, at 30 degrees C, re-equilibrate to a mixture of smaller forms, the composition of which depends on pH, concentration, and time. The invertase from a mutant, mnn1 mnn9 dpg1, which underglycosylates its glycoproteins and produces invertase with 4-7 oligosaccharide chains, forms oligomers of much lower stability than the mnn1 mnn9 invertase, which has 8-11 carbohydrate chains. Both of these mutants release external invertase from the periplasm into the medium during growth, but we conclude that defects in the cell wall structure may be more important in this release than an altered tendency of the invertases to aggregate. Investigation of aggregate formation by electron microscopy revealed that all invertases, including the internal nonglycosylated enzyme, form octamers under appropriate conditions. PMID- 3549735 TI - A radioreceptor assay for pharmaceutical preparations of insulin. AB - A radioreceptor assay has been developed that is suitable for the measurement of the potency of crystalline insulin and pharmaceutical insulin formulations. It utilizes the well characterized and widely available IM-9 human lymphocyte cell line as the source of receptor. Bovine, porcine and human crystalline and formulated insulins have been assayed against the 4th International and European Standards for Insulin and the potencies compared with those obtained by the mouse blood glucose method. Results with bovine insulin were in full correspondence with the in vivo results. Porcine and human insulins were 15-20% more potent by the radioreceptor assay than by the in vivo method when the mixed bovine and porcine insulin 4th International and European Standards were used, but were equivalent when compared with like materials. Average 95% confidence limits for formulated insulins in two assays were +/- 6% of the mean. The coefficient of variation on repeated assay of the same sample was 3.8%. The three dose parallel line radioreceptor assay with appropriate species species standards is a candidate biological test capable of international adoption as an alternative to in vivo animal testing of insulin. PMID- 3549736 TI - Effect of the surface geometry of smooth and porous-coated titanium alloy on the orientation of fibroblasts in vitro. AB - The migration and orientation of human gingival fibroblasts in relation to the rim of smooth-surfaced and porous-coated titanium discs placed on multilayers in vitro was investigated. Samples were examined after 6 h, 24 h, 3 days, and 7 days of culture using phase-contrast and scanning electron microscopy. The cells migrated from the multilayer onto the smooth-surfaced discs forming bridges between them, and orientated along parallel circumferential grooves in the rim of the discs. This resulted in the cellular bridges orientating at an acute angle to the rim of the disc, and adjacent cells in the multilayer orientating parallel to the rim. Cellular bridges were also formed between the porous-coated discs and the multilayer but, because the cells that migrated onto, and between, the spheres of the porous-coat showed no preferred orientation, the bridges retained their orientation at right angles to the surface of the rim. This in turn resulted in the cells of the adjacent multilayer becoming similarly orientated. These observations suggest that the geometrical configuration of the surface of implants could influence whether a capsule or an orientated fibrous attachment is developed in relation to implants in vivo. PMID- 3549737 TI - Specific removal of paraquat by hemoperfusion through antiparaquat conjugated agarose-polyacrolein microsphere beads. AB - A novel specific adsorbent for removal of paraquat from blood has been developed. Immobilized antiparaquat antibodies provide the specificity and high affinity of the adsorbent. The antibodies were raised in rabbits and goats immunized with an analogue of paraquat, conjugated to bovine serum albumin (BSA). Specific antiparaquat antibodies were isolated from the animals' sera by affinity chromatography. The antibodies were polyvalently bound to crosslinked agarose polyacrolein microsphere beads (APAMB). Antiparaquat conjugated beads (APB) were used as packing material in a hemoperfusion column for detoxification of paraquat and were compared to activated charcoal. In vitro and in vivo experiments showed specific and enhanced rate of removal of paraquat from plasma and blood by using APB. Minimal alteration of the formed elements and plasma constituents of the blood was observed. PMID- 3549740 TI - Pre-operative evaluation of abdominal aortic aneurysms: ultrasound or computed tomography? AB - Evaluation of aortic aneurysms by ultrasound (US) or computed tomography (CT) is now commonplace and their use often reflects personal preferences given their similar diagnostic accuracy. Knowledge of anatomic details may be very helpful in the planning of the surgical procedure. Involvement of the supra-renal aorta, relative position of the renal arteries, intra-aneurysmal thrombus, and extension to the iliac arteries were retrospectively evaluated by both techniques to determine which modality was more valuable in the preoperative evaluation of abdominal aortic aneurysms. A group of 58 patients was reviewed. An infra-renal aortic aneurysm was identified in all instances by both methods. The supra-renal aorta was always well visualized by CT but not by US. The origin of at least one renal artery was seen in only 11% of the cases by US but in 100% by CT. CT demonstrated the left renal vein in all cases, while only 41% were demonstrated by US. Intra-aneurysmal thrombus was depicted by both methods but its distribution within the sac and the characteristics of the thrombus were apparent on CT but not on US. Aneurysmal involvement of the iliac arteries was present in 19% of the patients. CT detected all cases but only 14% were demonstrated by US. Both methods accurately diagnose abdominal aortic aneurysms. Supplementary data regarding proximal and distal extension, characteristics of the thrombus, relationship to the renal vessels, and adjacent major veins can be obtained by CT and usually not by US. This information is of value in the planning and execution of the indicated surgical procedure. PMID- 3549742 TI - Modulation of the nuclear antigen p105 as a function of cell-cycle progression. AB - The characterization of the proliferation-associated nuclear antigen designated p105 in quiescent and proliferating lymphocytes is described. Through the use of novel flow cytometric and cell-sorting strategies the intracellular content of p105 was assessed in situ on a per cell basis. These analyses demonstrated the presence of multiple cellular subpopulations within the cell cycle differing significantly in p105 content. The data revealed that the flow cytometric quantitation of p105 levels may effectively discriminate cycling from noncycling cells. Immunogold electron microscopy revealed that the modulation of this interchromatin-associated antigen was correlated with a significant degree of nuclear restructuring. In conjunction with cell sorting, immunogold electron microscopy and immunoblot controls demonstrated that the cell-cycle-related modulation in p105 cannot be accounted for by increased cellular mass or antigen sequestration. The significance of these controls and of the potential role of p105 in cellular proliferation is discussed. PMID- 3549739 TI - Cardiorespiratory effects of protamine sulphate in man: intra-aortic vs intra right atrial rapid administration after cardiopulmonary bypass. AB - The effects of protamine sulphate on several cardiorespiratory variables were studied under clinical situations in twenty patients following cardiopulmonary bypass. Because recent reports suggest that there may be advantages of intra aortic versus intra-venous administration we prospectively evaluated cardiorespiratory features 1 and 10 minutes after rapid administering of protamine sulphate either into the aortic arch (through a catheter percutaneously inserted via the radial artery for monitoring purposes) or into the right atrium. Significant variations in some parameters were found in the patients receiving the drug via the aorta, such as a drop of systemic vascular resistances (p less than 0.05), of coronary perfusion pressure (p less than 0.05), of aortic systolic pressure (p less than 0.01), of diastolic (p less than 0.01) and mean blood pressure (p less than 0.05) and a rise in the respiratory quotient (p less than 0.05). It is concluded that the results do not confirm the superior safety of intra-aortic administration of protamine particularly when replenishment of intravascular volume is not provided. PMID- 3549743 TI - Alpha and beta subunits of the LFA-1 membrane molecule are involved in human monocyte-endothelial cell adhesion. AB - Human monocyte adhesion to vascular endothelium is an important transitional event in mononuclear phagocyte development. The molecular mechanism involved in monocyte adhesion to endothelial cells was studied using purified human monocytes and a panel of monoclonal antibodies (MAb). The purified human monocytes were phenotypically characterized and expressed relatively low levels of HLA class II antigens. The monocytes were labeled with Indium-111 to provide high specific activity and a sensitive measure of adhesion. Using this radionuclide adhesion assay, monocytes demonstrated consistent and reproducible adhesion to a confluent monolayer of human umbilical vein-derived endothelial cells. To identify the cell surface molecules involved in human monocyte-endothelial cell adhesion, 15 MAb to 11 monocyte surface structures were used to attempt to inhibit adhesion. MAb recognizing 10 monocyte cell surface molecules did not inhibit adhesion. In contrast, MAb recognizing the alpha and beta subunits of LFA-1 (lymphocyte function-associated) significantly inhibited monocyte adhesion to endothelial cells. Monocyte adhesion was comparably inhibited by F(ab')2 and intact MAb. Significant inhibition was observed at 5 micrograms/ml of anti-LFA-1 MAb. These results indicate that the alpha and beta subunits of the LFA-1 membrane molecule are involved in human monocyte-endothelial cell adhesions. PMID- 3549744 TI - Insulin binding and processing by H4IIEC3 hepatoma cells: ultrastructural and biochemical evidence for a unique route of internalization and processing. AB - Biochemical and ultrastructural studies of insulin binding and cellular processing by cultured H4IIEC3 hepatoma cells were performed. Insulin binding and intracellular accumulation were rapid and after 30 min at 37 degrees C, 65% of the total cell-associated 125I-insulin was in an acid-stable compartment. Chloroquine had no significant effect on the amount of total cell-associated insulin or the percentage of insulin in the acid-stable compartment or cell associated insulin degradation under those conditions, but after 60-min incubations, it slightly decreased the rate of dissociation of internalized hormone. Ultrastructural analysis revealed that monomeric ferritin-insulin (Fm-I) initially bound to single or paired receptors on microvilli. Within 5 min occupied insulin receptors microaggregated and migrated to the intervillous cell surface. During the next 5-10 min occupied receptors aggregated into large clusters on the plasma membrane. Large amounts of insulin were internalized by macropinocytosis and the majority of internalized Fm-I was found in phagosomes. Less than 10% of the membrane-bound insulin was associated with pinocytotic invaginations or coated pits and less than 5% of the total cell-associated insulin was found in lysosomes. Chloroquine had no detectable effect on the amount of Fm-I or its distribution among the intracellular organelles. These studies demonstrated that, compared to previous studies with rat adipocytes or 3T3-L1 adipocytes, insulin interalization and intracellular processing in this hepatoma cell were unique. These differences provide further evidence that insulin binding and processing may be controlled by cell-specific mechanisms and that substantial heterogeneity exists in pathways previously presumed to be similar for all cell types. PMID- 3549745 TI - Assessment of goals and obstacles in data acquisition and analysis from emission tomography. Report of a series of international workshops. V. Anatomical considerations. PMID- 3549741 TI - Identification of sarcolemma-associated antigens with differential distributions on fast and slow skeletal muscle fibers. AB - We have identified three sarcolemma-associated antigens, including two antigens that are differentially distributed on skeletal muscle fibers of the fast, fast/slow, and slow types. Monoclonal antibodies were prepared using partially purified membranes of adult chicken skeletal muscles as immunogens and were used to characterize three antigens associated with the sarcolemma of muscle fibers. Immunofluorescence staining of cryosections of adult and embryonic chicken muscles showed that two of the three antigens differed in expression by fibers depending on developmental age and whether the fibers were of the fast, fast/slow, or slow type. Fiber type was assigned by determining the content of fast and slow myosin heavy chain. MSA-55 was expressed equally by fibers of all types. In contrast, MSA-slow and MSA-140 differed in their expression by muscle fibers depending on fiber type. MSA-slow was detected exclusively at the periphery of fast/slow and slow fibers, but was not detected on fast fibers. MSA 140 was detected on all fibers but fast/slow and slow fibers stained more intensely suggesting that these fiber types contain more MSA-140 than fast fibers. These sarcolemma-associated antigens were developmentally regulated in ovo and in vitro. MSA-55 and MSA-140 were detected on all primary muscle fibers by day 8 in ovo of embryonic development, whereas MSA-slow was first detected on muscle fibers just before hatching. Those antigens expressed by fast fibers (MSA 55 and MSA-140) were expressed only after myoblasts differentiated into myotubes, but were not expressed by fibroblasts in cell culture. Each antigen was also detected in one or more nonskeletal muscle cell types: MSA-55 and MSA-slow in cardiac myocytes and smooth muscle of gizzard (but not vascular structures) and MSA-140 in cardiac myocytes and smooth muscle of vascular structures. MSA-55 was identified as an Mr 55,000, nonglycosylated, detergent-soluble protein, and MSA 140 was an Mr 140,000, cell surface protein. The Mr of MSA-slow could not be determined by immunoblotting or immunoprecipitation techniques. These findings indicate that muscle fibers of different physiological function differ in the components associated with the sarcolemma. While the function of these sarcolemma associated antigens is unknown, their regulated appearance during development in ovo and as myoblasts differentiate in culture suggests that they may be important in the formation, maturation, and function of fast, fast/slow, and slow muscle fibers. PMID- 3549746 TI - [Liver transplantation in the rat. Technical considerations apropos of 247 cases]. AB - A technique is described for orthotopic liver transplantation in the rat using polyethylene cuffs to re-establish subhepatic cava and portal vascular anastomoses. This procedure reduces the time of portal clamping, an important factor of survival. The method was employed in 247 animals during studies to evaluate allograft tolerance and rejection mechanisms in rats of pure strain. PMID- 3549747 TI - [Disincarceration of a Kuntscher nail]. AB - Blockage of a Kuntscher nail during nailing of a femoral diaphysis was relieved by a vertical osteotomy extending to upper end of nail identified through a trephine hole. PMID- 3549738 TI - Multicellular spheroids. A review on cellular aggregates in cancer research. AB - Cellular aggregates have been used in developmental biology and in experimental cancer research for several decades. Spherical aggregates of malignant cells, i.e. multicellular tumor spheroids, may serve as in vitro models of tumor microregions and of an early, avascular stage of tumor growth. The similarities between the original tumor and the respective spheroids include volume growth kinetics, cellular heterogeneity, e.g. the induction of proliferation gradients and quiescence, as well as differentiation characteristics, such as the development of specific histological structures or the expression of antigens. Research using cell aggregates has been focussed on mechanisms involved in the control of proliferation, invasion and metastasis. Immunological studies with spheroids have resulted in the characterization of defense cells which are responsible for specific host-versus-tumor reactions. The vast majority of investigations on spheroids concerns the simulation of therapy with regard to various treatment modalities, combination treatments and systematic analyses of using various endpoints in predictive assays. Only a few pathophysiological studies on the interrelationship among tumor-specific micromilieu, cellular metabolism, proliferative status, and cellular viability have been undertaken with the spheroid model up to now. Since these studies are indicative of a large influence of the cellular microenvironment on basic biological properties of cancer cells, investigations of these epigenetic mechanisms should be intensified in future research on cell aggregates. Similarly, the molecular basis of the biological peculiarities found in malignant cells grown as three-dimensional aggregates has to be investigated more intensively. PMID- 3549748 TI - Enzymatic kinetic analyses that employ high-performance liquid chromatography. Competition between orotate- and hypoxanthine/guanine-phosphoribosyltransferases for a common substrate. AB - Enzymatic assay procedures that employ high-performance liquid chromatography (HPLC) have been proven to be sensitive and versatile methods for accomplishing kinetic analyses of enzyme-catalyzed reactions, with nucleotides as substrates or products. Both orotate phosphoribosyltransferase (OPRTase) and hypoxanthine/guanine phosphoribosyltransferase (HGPRTase) have been purified from Baker's yeast and analyzed kinetically using a modification of published HPLC procedures. Because these two enzymes exist in the cytosol of yeast and might compete for the limiting (approximately equal to 15 microM) concentration of phosphoribosyl alpha-1-pyrophosphate (PRibPP), we elected to examine both equilibrium and steady-state effects of one enzymatic reaction on the other with HPLC. First, under the condition of equivalent mass concentrations of OPRTase and HGPRTase, the initial rate of orotidine monophosphate synthesis and the equilibrium state were greatly affected by the presence of HGPRTase activity. In contrast, the presence of the OPRTase activity had no effect on the HGPRTase catalyzed reaction under these conditions. Second, to examine a competition by these enzymes for PRibPP in vivo, we have established that the total activities (units/ml) of OPRTase and HGPRTase in yeast cell extracts were 740 units/ml and 450 units/ml, respectively (a 1.7:1 ratio). These relative activities were then employed in an in vitro reaction competition analysis. The results were similar to the those obtained from experiments where equivalent OPRTase and HGPRTase activities were employed and reveal profound initial velocity and equilibrium effects of one reaction on the other. Thus a real competition between these enzymes for PRibPP may occur in the yeast cell cytosol, as determined by this unique HPLC competition assay procedure. PMID- 3549749 TI - High-performance liquid chromatographic analysis of norepinephrine and alpha methylnorepinephrine in microdissected noradrenergic cell groups of the rabbit brain. AB - A high-performance liquid chromatographic method with electrochemical detection has been developed to measure norepinephrine (NE) and alpha-methylnorepinephrine (alpha-MeNE) in microdissected noradrenergic cell groups of the rabbit brain stem. The method is shown to be specific, accurate and precise and has a sensitivity of 0.5 pmol per sample. The method has been applied to the measurement of NE and alpha-MeNE levels in the A1, A2, A5, A6 and A7 noradrenergic cell groups after administration of the antihypertensive drug alpha methyldopa (alpha-MD), so that the sites of action of alpha-MD within the central nervous system may be localised. PMID- 3549750 TI - Sensitive analysis of blood for amodiaquine and three metabolites by high performance liquid chromatography with electrochemical detection. AB - A high-performance liquid chromatographic method using oxidative electrochemical detection has been developed for selective and sensitive quantification of the antimalarial drug amodiaquine and three of its metabolites in the blood of dosed individuals. The method requires only one extraction step and has detection limits of 1 ng/ml for amodiaquine and its metabolites desethylamodiaquine and bisdesethylamodiaquine and 3 ng/ml for 2-hydroxydesethylamodiaquine. Minor modification of the mobile phase preserves the chromatographic separation and allows ultraviolet spectroscopic detection, which, although appreciably less sensitive, permits monitoring of levels of amodiaquine and the three metabolites in blood and urine samples if an electrochemical detector is unavailable. Levels of amodiaquine and the three metabolites were determined for two volunteers undergoing a nine-week chemoprophylactic regimen in connection with travel to a malarious area. Data are included to compare the in vitro antimalarial activities against three strains of Plasmodium falciparum of amodiaquine and the three metabolites considered. PMID- 3549751 TI - Simple and specific isocratic liquid chromatographic procedure for cyclosporine A determination in whole blood, compared with radioimmunoassay. PMID- 3549752 TI - Semi-preparative high-performance reversed-phase displacement chromatography of insulins. AB - A reversed-phase displacement chromatographic method has been developed for the purification of bovine and porcine insulin samples. Up to 500 mg of raw insulin could be purified on a Nucleosil C8 analytical column using a methanol-containing phosphate buffer carrier and a cetrimide-containing displacer. A proinsulin contamination level as low as 100 ppm in the collected fractions could be achieved. PMID- 3549753 TI - Sedimentation field flow fractionation and gas chromatography-mass spectrometry for characterization of streptococcal cell wall particles. PMID- 3549754 TI - Liquid chromatographic determination of cyclosporin A in serum with use of a solid-phase extraction. Comparison between high-performance liquid chromatography and radioimmunoassay levels in clinical investigations. AB - A simple reliable liquid chromatographic method for assay of cyclosporin A in serum or urine is described. Samples were cleaned up on a solid-phase extraction system (cyanopropyl column). The system involved a reversed-phase C18 Ultrasphere column maintained at 72 degrees C and an acetonitrile linear gradient (65 to 95%) in 0.14% triethylammonium phosphate. Liquid chromatographic analysis of radioimmunoassay standards shows that some samples contain a contaminant peak. Comparison of cyclosporin A levels obtained by radioimmunoassay and high performance liquid chromatography in clinical investigations show that the former values are generally, but not always, higher than the latter, and that cyclosporin A is very differently metabolized depending on the patient, disease and treatment. PMID- 3549755 TI - Nonspecific binding of immunoglobulins to coat proteins of certain plant viruses in immunoblots and indirect ELISA. AB - Nonspecific binding of immunoglobulins to coat protein of cucumber mosaic virus and several other plant viruses was observed in Western immunoblots, and to a much lesser extent in enzyme-linked immunosorbent assays. The binding appears to occur between immunoglobulin molecules and the basic domains of viral coat proteins which bind to RNA during encapsidation. In all cases tested, the nonspecific reactions could be prevented by addition of 5 U/ml of heparin to the incubation buffers. PMID- 3549756 TI - The association between migraine and cerebral vascular events: an analytical review. AB - This paper explores the uncertain relationship between migraine headache and thromboembolic stroke. In reviewing the literature that links migraine with thromboembolic cerebral vascular events, a distinction is made between two stroke events that occur in migraine patients: stroke associated with a migraine attack (a migrainous stroke) and stroke unrelated to a migraine attack (a non-migrainous stroke). In a recent community-based stroke register, migrainous strokes occurred at a rate of 3.4 per 100,000 per annum. Prevalence rates for migraine in young stroke populations (11-28%) are similar to those in the general population and do not support an additional long-term risk of non-migrainous stroke in migraine patients. The only study providing a controlled estimate of long-term thromboembolic stroke risk (odds ratio = 1.7; 95% CI 1.3, 2.2) included only women and has not been independently confirmed. The contribution of migraine to other known risk factors for thromboembolic stroke needs to be examined further by controlled studies. PMID- 3549757 TI - DIABEDS: a randomized trial of the effects of physician and/or patient education on diabetes patient outcomes. AB - To examine the effects of intensive patient and/or physician diabetes education on patient health outcomes, a controlled trial was conducted in which internal medicine residents and their 532 diabetic patients were randomly assigned to: routine care; patient education; physician education; or both patient and physician education. Patient outcome data were analyzed either by analysis of covariance on post intervention values (2-hour post-prandial plasma glucose [PPG]; body weight [BW]; blood pressure [BP]; or analysis of variance conducted on change values (fasting plasma glucose [FPG] and glycosylated hemoglobin [A1Hgb]). After patient education, significant improvements were observed in FPG, A1Hgb, BW, and systolic and diastolic BP. Physician education resulted in significant decreases in FPG, A1Hgb and BW. The combination of patient plus physician education resulted in the greatest improvements in patients' health outcomes including FPG, A1Hgb, PPG, BW and diastolic BP. Adjusted systolic BPs were not significantly different in the two groups. While these physiologic improvements were statistically and probably clinically significant, hyperglycemia and obesity still persisted. Thus, achieving optimal patient outcomes for a chronic disease like diabetes mellitus may require a greater or more effective use of resources than currently estimated. PMID- 3549758 TI - Self-care behaviors and glycemic control in type I diabetes. AB - This study investigated the degree of adherence to different aspects of the diabetic treatment regimen (insulin injections, glucose testing, diet, and exercise), the consistency of adherence across different regimen areas, and relationships between adherence and glycemic control. A predominantly adult community sample of 93 insulin dependent outpatients participated in the prospective study that involved two series of home interviews separated by a 6 month interval. Multiple measures of adherence (e.g. self-report, interview/recall, self-monitoring, and objective indices) were collected for each regimen area. Results indicated that the degree of adherence was higher for medication taking and glucose testing than for regimen tasks requiring greater lifestyle modifications such as diet and exercise; there were few strong relationships between subjects' adherence to one area of the regimen and the extent to which they adhered to other regimen tasks; and no clear relationship between adherence and glycemic control could be demonstrated through either bivariate or multivariate analyses. It is recommended that regimen adherence be considered in the context of other factors that may influence glycemic control (e.g. stress, individual metabolic factors, appropriateness of regimen prescriptions) rather than assuming a one-to-one relationship between adherence and control. PMID- 3549759 TI - Use of a variable insulin infusion to assess insulin action in obesity: defects in both the kinetics and amplitude of response. AB - To determine whether the severity of insulin resistance in obesity, as assessed by the traditional hyperinsulinemic glucose clamp, reflects the severity of resistance present during changing insulin concentrations, such as occur after meal ingestion, 9 moderately obese and 12 lean subjects were studied on 2 occasions: once during a primed continuous insulin infusion and once during a variable 8-step insulin infusion. Identical amounts of insulin were given on each occasion, and euglycemia was maintained by a glucose infusion. Stimulation of isotopically determined glucose utilization above the basal value was lower in the obese than in the lean subjects during the variable [2.4 +/- 0.5 (+/- SEM) vs. 5.4 +/- 0.7 g/m2; P = 0.004] and the constant (2.9 +/- 0.7 vs 4.2 +/- 0.9 g/m2; P = 0.32) insulin infusions; however, the differences were only significant with the variable insulin infusion. The variable insulin infusion also was associated with lower rates of activation of glucose utilization (slope, 0-90 min, 0.27 +/- 0.05 vs. 0.55 +/- 0.09 mg/m2 X min 2; P = 0.01) in obese compared to lean subjects. In contrast, rates of activation during the low constant infusion (0.24 +/- 0.05 vs. 0.29 +/- 0.06 mg/m2 X min 2; P = 0.51) did not differ in the lean and obese subjects. Despite identical amounts of insulin, stimulation of glucose utilization was greater (P less than 0.03) during the variable than during the constant insulin infusion in the lean subjects. In contrast, stimulation during the variable and constant insulin infusions was equal in the obese subjects. These observations indicate that insulin resistance in obesity is due to a defect in the rate as well as absolute response achieved and suggest that under conditions of daily living the contribution of insulin resistance to impaired carbohydrate tolerance is greater than that previously estimated by a constant insulin infusion. PMID- 3549760 TI - Intracellular insulin processing is altered in monocytes from patients with type II diabetes mellitus. AB - We studied total cell-associated A14-[125I]insulin radioactivity (including surface-bound and internalized radioactivity), insulin internalization, and its intracellular degradation at 37 C in monocytes from nonobese type II untreated diabetic patients (n = 9) and normal subjects (n = 7). Total cell-associated radioactivity was decreased in diabetic patients [2.65 +/- 1.21% (+/- SD) vs. 4.47 +/- 1.04% of total radioactivity; P less than 0.01]. Insulin internalization was also reduced in diabetic patients (34.0 +/- 6.8% vs. 59.0 +/- 11.3% of cell associated radioactivity; P less than 0.01). Using high performance liquid chromatography six intracellular forms of radioactivity derived from A14-[125I] insulin were identified; 10-20% of intracellular radioactivity had approximately 300,000 mol wt and was identified as radioactivity bound to the insulin receptor, and the remaining intracellular radioactivity included intact A14-[125I]insulin, [125I]iodide, or [125I]tyrosine, and three intermediate compounds. A progressive reduction of intact insulin and a corresponding increase in iodine were found when the incubation time was prolonged. Intracellular insulin degradation was reduced in monocytes from diabetic patients; intracellular intact insulin was 65.6 +/- 18.1% vs. 37.4 +/- 18.0% of intracellular radioactivity (P less than 0.01) after 2 min and 23.6 +/- 22.3% vs. 3.9 +/- 2.3% (P less than 0.01) after 60 min in diabetic patients vs. normal subjects, respectively. In conclusion, 1) human monocytes internalize and degrade insulin in the intracellular compartment in a stepwise time-dependent manner; and 2) in monocytes from type II diabetic patients total cell-associated radioactivity, insulin internalization, and insulin degradation are significantly reduced. These defects may be related to the cellular insulin resistance present in these patients. PMID- 3549761 TI - Insulin resistance and diminished glucose tolerance in powerlifters ingesting anabolic steroids. AB - To examine the effects of anabolic steroid use on glucose homeostasis, we determined oral glucose tolerance and serum insulin response to glucose in 15 male powerlifters, 6 obese men, and 10 sedentary nonobese men. Eight of the powerlifters had self-administered large doses (200 mg/day) of anabolic steroids for periods of up to 7 yr, whereas 7 had never used anabolic steroids. Powerlifters who ingested anabolic steroids had diminished glucose tolerance compared to the nonsteroid-using group, despite having substantially higher postglucose serum insulin concentrations. Postglucose insulin responses were also higher in steroid users than in the sedentary nonobese and sedentary obese reference groups. These results indicate that powerlifters who ingest anabolic steroids have diminished glucose tolerance, which is likely to be secondary to insulin resistance. PMID- 3549763 TI - [A study on estimating the gestational age in late pregnancy by ultrasonography]. PMID- 3549764 TI - [Basic and clinical observations on an improved microwave coagulation method for hemostasis after liver biopsy and splenic puncture under laparoscopy]. PMID- 3549762 TI - Elevated levels of plasma prorenin (inactive renin) in diabetic and nondiabetic patients with autonomic dysfunction. AB - We measured plasma inactive renin (prorenin) levels in 46 diabetic patients, 4 nondiabetic patients with idiopathic autonomic dysfunction, and 115 normal subjects. Plasma inactive renin levels were normal in the diabetic patients who had no complications (n = 6) and in those with microvascular disease (n = 8) who did not have coexistent autonomic dysfunction. Plasma inactive renin was either grossly elevated or in the upper limit of the normal range in diabetic patients with autonomic dysfunction (n = 18). No correlation was found between plasma inactive renin and glycemic control, as measured by hemoglobin A1c. High plasma inactive renin levels were also found in the 4 nondiabetic patients with idiopathic autonomic dysfunction. These data suggest that increased plasma inactive renin levels in diabetic patients are a consequence of coexistent autonomic dysfunction. This finding is consistent with other evidence that suggests autonomic regulation of the processing of prorenin to renin within the kidney. PMID- 3549765 TI - Epidemiology of human reproduction. AB - This study on the epidemiology of human fertility emphasizes the study and analysis of several parameters. These include: the measure and distribution of fertility. The incidence of sterility is low (3-5% of couples) and the fecundability of fertile couples is approximately 30% per cycle. Approximately 7% of newly-formed couples per year will undergo complex treatment for infertility. The results of clinical and diagnostic explorations. Among infertile couples, the woman is responsible in approximately 60% of cases, and the man in approximately 25% of cases, and both of these factors may be associated. Clinical and diagnostic explorations are negative in approximately 18% of couples and the infertility is termed idiopathic. 'Normal' sperm characteristics vary according to age, seasonal or environmental factors. Female factors varying as a function of age, menstrual cycle, ovulation and functional status of the genital organs. Infertility in both partners leads to specific difficulties for epidemiological analyses, where the base unit is not an individual. PMID- 3549766 TI - The use of gene probes in studying human reproduction and embryology. AB - Recent advances in molecular biology permit the analysis of gene structure and function during early embryonic development. Among the mammalian genes which are now cloned and available are several, such as chorionic gonadotrophin, fibronectin, and sequences homologous to homoeotic genes in Drosophila, which have been implicated in embryogenesis and differentiation. Gene expression in early human embryos can be analysed using in-vitro fertilization (IVF) and termination material, by RNA gel blotting and in-situ hybridization. These approaches may permit a better understanding of fertilization and of normal and abnormal embryonic development. PMID- 3549767 TI - The sonographic and endocrinologic evaluation of the endometrium in the luteal phase. AB - Follicular development and the endometrial thickness were determined sonographically in 19 outpatients with different causes of sterility, treated during natural or stimulated cycles. The estimates of the endometrial thickness, assessed by ultrasound in the mid-luteal phase, and the levels of 17 beta oestradiol and progesterone in the same patients sampled on the day of sonography were compared. Five patients became pregnant (group 1) and showed good progesterone values. Eight patients who were not pregnant showed progesterone values above 15 ng/ml in the mid-luteal phase (group 2). The progesterone values of group 3 were below 15 ng/ml by definition. The mean endometrial thickness in group 1 (means = 11.3 mm) and group 2 (means = 11.8 mm) were significantly higher than that of group 3 (means = 8.3 mm). The sonographic measurement of the mid luteal endometrium thickness serves as an additional criterion for the evaluation of the secretory phase of the menstrual cycle. PMID- 3549768 TI - The cryopreservation of human embryos. PMID- 3549769 TI - Chorion villus sampling in Europe. PMID- 3549771 TI - An historical survey of some basic contributions to causal mammalian embryology. PMID- 3549770 TI - The role of novel arachidonic acid metabolites in GnRH action on gonadotrophin release in vitro. AB - Lipoxygenase metabolites of arachidonic acid were shown to stimulate gonadotrophin release dose-dependently in rat pituitary cells. The secretory activity of the arachidonate metabolite leukotriene C4 (LTC4) was biphasic and 10 fold more potent than that of the physiological stimulus gonadotrophin-releasing hormone (GnRH). In pre-labelled, superfused pituitary cells, GnRH dose dependently enhanced the release of [3H]arachidonic acid, which occurred simultaneously with the secretion of luteinizing hormone (LH). When cells were pre-treated with GnRH for 24 h no response to a further stimulus by GnRH (10(-7) M) could be observed for either [3H]arachidonate nor LH, demonstrating that also in desensitized cells these two mechanisms react similarly. In addition, a GnRH antagonist did not affect the release of arachidonate or LH. These results suggest that arachidonic acid may be involved in the mechanism of GnRH action on gonadotrophins via its lipoxygenase metabolites and LTC4 could act as a very potent intracellular stimulus of LH secretion. PMID- 3549772 TI - The effect of clomiphene citrate on early embryonic development, endometrium and implantation. PMID- 3549773 TI - Isoelectric point restriction of cerebrospinal fluid and serum IgG antibodies to measles virus polypeptides in multiple sclerosis. AB - Thirty consecutive isoelectric point (pI)-discrete IgG fractions were isolated from multiple sclerosis (MS) cerebrospinal fluid (CSF) and used to immune precipitate measles virus (MV) polypeptides. Most basic fractions were enriched in activity against nucleocapsid protein (NP), and to a lesser extent against hemagglutinin (H) protein; intermediate fractions were enriched in activity against H and fusion (F) proteins; and more anodic pI fractions were almost exclusively enriched in activity against the large (L) protein of MV. In MS there are marked differences between CSF and autologous serum in regard to antibody activity to MV. In contrast, there were similar profiles of antibody response to MV proteins in SSPE CSF and serum. PMID- 3549774 TI - Sonography in septic arthritis of the hip in the child: report of four cases. AB - Sonography was used successfully in the investigation of septic conditions in the hip region of four children. In two patients, septic arthritis of the hip was confirmed; in two patients, intracapsular involvement was excluded in osteomyelitis of the hip region. PMID- 3549775 TI - Prostaglandin levels in a unicameral bone cyst treated by corticosteroid injection. AB - Unicameral bone cysts are benign processes of obscure origin. Surgical treatment has not been encouraging; however, in the past decade, corticosteroid injection has afforded good results. The reason for the efficacy of steroid treatment has not been demonstrated. We measured the prostaglandin level in the aspirated fluid of a unicameral cyst before and 4 months after corticosteroid injection. A basis for treatment of the benign bone cyst is postulated. PMID- 3549776 TI - Expenditure and storage of energy in man. PMID- 3549777 TI - Differential effects of hyperinsulinemia and hyperaminoacidemia on leucine-carbon metabolism in vivo. Evidence for distinct mechanisms in regulation of net amino acid deposition. AB - The effects of physiologic hyperinsulinemia and hyperaminoacidemia, alone or in combination, on leucine kinetics in vivo were studied in postabsorptive healthy subjects with primed-constant infusions of L-[4,5-3H]leucine and [1-14C]alpha ketoisocaproate (KIC) under euglycemic conditions. Hyperinsulinemia (approximately 100 microU/ml) decreased (P less than 0.05 vs. baseline) steady state Leucine + KIC rates of appearance (Ra) from proteolysis, KIC (approximately leucine-carbon) oxidation, and nonoxidized leucine-carbon flux (leucine--- protein). Hyperaminoacidemia (plasma leucine, 210 mumol/liter), with either basal hormone replacement or combined to hyperinsulinemia, resulted in comparable increases in leucine + KIC Ra, KIC oxidation, and leucine----protein (P less than 0.05 vs. baseline). However, endogenous leucine + KIC Ra was suppressed only with the combined infusion. Therefore, on the basis of leucine kinetic data, hyperinsulinemia and hyperaminoacidemia stimulated net protein anabolism in vivo by different mechanisms. Hyperinsulinemia decreased proteolysis but did not stimulate leucine----protein. Hyperaminoacidemia per se stimulated leucine--- protein but did not suppress endogenous proteolysis. When combined, they had a cumulative effect on net leucine deposition into body protein. PMID- 3549778 TI - Mechanisms for defects in muscle protein metabolism in rats with chronic uremia. Influence of metabolic acidosis. AB - Chronic renal failure (CRF) is associated with metabolic acidosis and abnormal muscle protein metabolism. As we have shown that acidosis by itself stimulates muscle protein degradation by a glucocorticoid-dependent mechanism, we assessed the contribution of acidosis to changes in muscle protein turnover in CRF. A stable model of uremia was achieved in partially nephrectomized rats (plasma urea nitrogen, 100-120 mg/dl, blood bicarbonate less than 21 meq/liter). CRF rats excreted 22% more nitrogen than pair-fed controls (P less than 0.005), so muscle protein synthesis and degradation were measured in perfused hindquarters. CRF rats had a 90% increase in net protein degradation (P less than 0.001); this was corrected by dietary bicarbonate. Correction of acidosis did not reduce the elevated corticosterone excretion rate of CRF rats, nor did it improve a second defect in muscle protein turnover, a 34% lower rate of insulin-stimulated protein synthesis. Thus, abnormal nitrogen production in CRF is due to accelerated muscle proteolysis caused by acidosis and an acidosis-independent inhibition of insulin stimulated muscle protein synthesis. PMID- 3549779 TI - Insulin stimulates volume absorption in the rabbit proximal convoluted tubule. AB - The present in vitro microperfusion study examined whether insulin affects volume absorption (Jv) in the proximal convoluted tubule (PCT). PCT were perfused with an ultrafiltrate-like solution and were bathed in a serum-like albumin solution. Addition of a physiologic concentration of 10(-10) M insulin to the bathing solution resulted in a stimulation of Jv and a more negative transepithelial potential difference (PD). There was a progressive stimulation of the lumen negative PD and Jv with higher insulin concentrations. Maximal stimulation occurred at 10(-8) M bath insulin. The insulin-induced stimulation of volume reabsorption was also observed when glucose and amino acids were removed from the luminal perfusate. Direct examination of the effect of insulin on glucose, chloride, and bicarbonate absorption demonstrated that the transport of all these solutes was stimulated by insulin. Addition of insulin to the luminal perfusate had no affect on Jv. These data show that insulin has a direct effect to stimulate Jv in the proximal tubule. PMID- 3549780 TI - Genetic epidemiology of the susceptibility to leprosy. AB - To test the hypothesis that genetic factors are operative in the predisposition to leprosy (Hansen's disease) in humans, a genetic epidemiologic investigation was performed on 269 leprosy kindreds containing 552 affected individuals from an isolated population in Papua New Guinea. The community, and not the family, was the basic social unit. Leprosy, an infectious disease, was not communal but strongly familial within the Karimui. Segregation analysis, to determine whether a major gene for the susceptibility to leprosy was segregating within a single multi-generational kindred, could not differentiate between a Mendelian genetic and a purely environmental hypothesis. The composite kindred data, however, suggest a genetic hypothesis for the non-immunologically induced susceptibility to leprosy per se. Within familial kindreds leprosy invariably emanated from a common ancestral sibship, and risk was associated with the closeness of kin but not with infectivity or severity. PMID- 3549782 TI - An enzyme-immunoassay for human interleukin-2. AB - A highly sensitive enzyme-immunoassay (EIA) for human interleukin-2 (IL-2) has been established. The assay is based on a sandwich method that uses two kinds of anti-IL-2 antibodies raised against Escherichia coli-derived recombinant IL-2 (rIL-2). An affinity-purified-anti-IL-2 goat IgG was used as the first antibody and the Fab' fragment of an affinity-purified-anti-IL-2 rabbit IgG was used as the second antibody after being coupled with horseradish peroxidase (HRP). As little as 30 pg/ml of IL-2 was detected by the EIA, indicating that this method was about 100 times more sensitive than the bioassay using an IL-2-dependent murine natural killer cell line, NKC3. There was a good correlation between the EIA and the bioassay (r = 0.998). PMID- 3549783 TI - Postero-lateral expansion osteotomy of maxilla. A case report. AB - The posterior-maxillary osteotomy introduced by Schuchardt was designed to close skeletal anterior open bite. Also, it can be used to reduce a posterior cross bite. But in this latter case, the most important problem is the difficulty in expanding the maxilla because of the relative inelasticity of the palatal mucosa. This paper reports on the result obtained by a surgical expansion technique without orthodontic treatment. The use of a local soft tissue flap is necessary; the anteroposterior part of the palatal incision is placed contralaterally to the bone incision. A palatal appliance is used for the retention of the palatal flap. PMID- 3549781 TI - Elevated bronchoalveolar lavage fluid histamine levels in allergic asthmatics are associated with methacholine bronchial hyperresponsiveness. AB - Using a sensitive single isotope enzymatic assay we measured bronchoalveolar lavage (BAL) fluid histamine in asymptomatic normal (nonallergic), allergic rhinitic, and allergic asthmatic subjects. Normal subjects were found to have little or no detectable amounts of histamine in BAL fluid (11 +/- 11 pg/ml), and few BAL fluid mast cells. In comparison, the allergic rhinitics and allergic asthmatics had much higher amounts of BAL fluid histamine (113 +/- 53 and 188 +/- 42 pg/ml, respectively), and a significantly greater number of BAL fluid mast cells. Furthermore, despite having equivalent baseline pulmonary function values, allergic asthmatics with BAL fluid histamine levels greater than 100 pg/ml required only 7 +/- 2 breath units of methacholine to induce a 20% drop in forced expiratory volume in 1 s (FEV1) (PD20FEV1) while asthmatics with BAL fluid histamine levels less than 100 pg/ml required 49 +/- 19 breath units (P less than 0.05). These data suggest that allergic asthmatics have ongoing lung mast cell degranulation that might contribute to the etiology of airway hyperresponsiveness. PMID- 3549784 TI - Embolization for traumatic epistaxis. Adjuvant therapy in severe maxillofacial fracture. AB - In a case of persistent traumatic epistaxis successful treatment by embolization therapy is reported. The method is described in detail and the advantages of the use of Digital Subtraction Angiography (DSA) are stressed. PMID- 3549785 TI - Artefacts created during oral biopsy procedures. AB - Biopsy specimens removed from the oral cavity are often small, and there is high potential for causing artefacts at several stages: during removal, fixation, embedding, or staining. This report describes several of the most common artefacts created by erroneous handling of oral tissue and lists recommendations for preventing them. PMID- 3549786 TI - Etiological factors in the development of PTSD in clinical samples of Vietnam combat veterans. AB - This paper presents a review of empirical literature that deals with etiological factors in combat-related post-traumatic stress disorder (PTSD). Variables implicated in PTSD from three time frames, premilitary, military, and postmilitary, are identified, and findings from relevant research are discussed. There is consistency across studies in showing significant correlations between PTSD and combat exposure and post-military psychosocial adjustment. Less consistent are the findings with regard to relationships between premilitary psychosocial factors and PTSD. Recent findings from studies that have explored possible physiological correlates of PTSD also are discussed. Based on current literature, implications for future research on etiological factors in combat related PTSD are presented. PMID- 3549787 TI - Theoretical and empirical issues in the treatment of post-traumatic stress disorder in Vietnam veterans. AB - This article reviews the current status of research on the treatment of combat related post-traumatic stress disorder (PTSD) in Vietnam veterans. Dynamic, behavioral, and biochemical models of treatment are presented, along with the findings of relevant treatment outcome studies. Examination of the treatment procedures employed in available studies revealed that direct therapeutic exposure to the memories of trauma emerged as the PTSD treatment technique common to all three theoretical models. The need for controlled investigations of the clinical efficacy of exposure-based interventions for combat-related PTSD is discussed. In addition, several other issues relevant to PTSD treatment research are presented and discussed, including the potential utility of studying untrained coping behavior in combat veterans; the effects of using heterogeneous subject samples in PTSD treatment research; and issues related to the measurement of treatment outcome. PMID- 3549788 TI - Conducting applied research on Vietnam combat-related post-traumatic stress disorder. AB - A paradigmatic shift in post-traumatic stress disorder (PTSD) research is underway. Formistic and mechanistic research designs, characterized by single category, single-cause, single-effect models, gradually are being replaced by contextual and organistic research designs that feature multi-category, multi cause, and multi-effect interactional models. Such changes in diagnostic and treatment outcome research require solving many methodological issues in such areas as: measuring types of traumas and stressors; measuring PTSD symptoms and subtypes; measuring subject dispositional characteristics (such as ethnic differences); assessing concurrent and/or pre-existing psychiatric (Axis I) disorders; classifying personality styles and concurrent and/or pre-existing personality (Axis II) disorders; evaluating phase in the development of PTSD as a disorder; measuring current environmental stresses and interpersonal interactions; and assessing secondary gains and readiness for treatment. These and other methodological problems must be addressed as research on PTSD shifts to longitudinal measurement of subjects randomly assigned to treatment conditions. PMID- 3549789 TI - Wise Anaerobic Work Station: an evaluation. AB - The Wise Anaerobic Work Station permitted the growth of type cultures of a range of fastidious obligate anaerobes. In the isolation of anaerobic bacteria from clinical specimens the performance equalled that of a standard anaerobic jar incubated for 48 hours, and gave results superior to those obtained when incubation of jar cultures was interrupted at 24 hours. The Wise Anaerobic Work Station was easy to use and provided comfortable working conditions; running largely on industrial nitrogen, it was more economic than anaerobic cabinets or jars using conventional gas mixtures. PMID- 3549790 TI - Expression of c-myc oncogene in coeliac disease. AB - A monoclonal antibody, produced by peptide immunisation was used to detect the distribution of p62c/myc by immunohistology in normal and coeliac small intestinal mucosa. The effect of gluten in four treated coeliac patients was investigated by taking serial jejunal biopsy specimens for six hours after a 10 g oral gluten challenge. There was a progressive increase in p62c/myc staining intensity in the villus enterocytes extending to the crypts, which accompanied the classical morphological changes occurring in the mucosa. PMID- 3549791 TI - Easier immunoperoxidase staining with labour saving incubator box. PMID- 3549792 TI - Long term freeze storage of Campylobacter pyloridis. PMID- 3549793 TI - Simple reagent sparing approach to immunocytochemical staining of haematological and other samples with APAAP technique. PMID- 3549794 TI - The effect on healing of the application of citric acid during replaced flap surgery. AB - The aim of this double-blind controlled clinical trial was to assess the effect on healing following conditioning the root surface with citric acid during replaced flap surgery. Healing was assessed in 18 pairs of sites in 12 patients before surgery and after 3 months; healing was also assessed in 13 pairs of these sites in 10 of the patients after 9 months. During surgery, the root surface at 1 site from each pair was treated with citric acid pH 0.6 for 3 min and the contralateral site was exposed to sterile saline. Healing was assessed by measuring attachment levels, probing depths and recession; in addition, gingival crevicular fluid flow was measured, as was the degree of bleeding on probing. The mean gain of attachment (mm) in the acid and control groups were 1.0 and 1.2, respectively, at 3 months and 1.1 and 0.9 respectively, at 9 months. The results of this study indicate, both clinically and statistically, that the difference in healing between the acid and the non-acid sites is not significant. Thus no additional benefit is shown by using citric acid in conjunction with replaced flap surgery on anterior teeth. PMID- 3549795 TI - Computerized evaluation of the effectiveness of subgingival scaling in jaw models. An introduction to the program developed at the School of Dentistry, University of Bergen. AB - The purpose of the present study was to improve the quality and the effectiveness of subgingival scaling managed by dental students. A training program was developed and the scaling was performed in jaw models. The teeth of these models were modified in order to ensure a quick inspection of the scaled root surfaces. Artificial "calculus", consisting of a mixture of shellac, umbra, pumice and plaster dissolved in ethanol, was painted on the root surfaces. Following the completion of the scaling test, remaining "calculus" was evaluated by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. A menu-directed computer program was developed in order to ensure a rapid transformation of surface scores into clinically-related variables. The output from this program gave valuable information about the proficiency of individual students, as well as about the whole class of students as one body. Other advantages and potentials of this system are described. PMID- 3549796 TI - The afferent input to the magnocellular division of the mediodorsal thalamic nucleus in the monkey, Macaca fascicularis. AB - The origin and termination of fibers to the mediodorsal thalamic nucleus, especially those to the medial, magnocellular part of the nucleus (MDm), have been studied using anterograde and retrograde axonal tracing methods, as well as electrophysiological recording. The results indicate that in addition to its well known connections to and from the prefrontal cortex, MDm receives fibers from many parts of the basal forebrain, including the ventral pallidum and other parts of the substantia innominata, the amygdaloid complex, the primary olfactory cortex, entorhinal and perirhinal cortex, and the cortex at the pole of the temporal lobe. Lighter projections arise in the subiculum, the ventral insula, and the superior and inferior temporal gyri. The cells that project to MDm tend to be large, polymorphic neurons. Throughout most of the basal forebrain they are diffusely distributed through several nuclei or cortical layers, without obvious relation to nuclear or laminar boundaries. The major exception to this is in the ventral pallidum, where there is a dense concentration of cells that project to MDm. The lateral part of the mediodorsal nucleus (MDl) receives few if any fibers from the basal forebrain and temporal lobe, but is innervated by several brainstem structures, especially the superior colliculus, the substantia nigra, the medial vestibular nucleus, and the midbrain tegmental fields. In MDm, the fibers are distributed in irregular patches. Three-dimensional analysis indicates that these patches are often clustered into separate bands or columns at different anteroposterior levels. In addition, the strongest projections from the three major regions that innervate MDm are organized in a complex three dimensional pattern. First, the fibers from the amygdaloid nuclei terminate most heavily (but not exclusively) in the rostral third of MDm. The parvicellular accessory basal amygdaloid nucleus and the amygdalohippocampal area project principally to the dorsal part of the nucleus. The parvicellular basal nucleus and the periamygdaloid cortex project to the ventromedial quadrant of MDm; and the magnocellular basal nucleus, the magnocellular accessory basal nucleus, and the lateral nucleus all project to the ventrolateral quadrant. Second, the substantia innominata projects preferentially to the caudal part of MDm. The medial part of the substantia innominata, especially the ventral pallidum, innervates the dorsomedial quadrant, while more caudal and lateral areas of this region project ventrolaterally. Third, the projections arising from the entorhinal and other temporal cortical areas terminate primarily in the mid rostrocaudal level of MDm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549797 TI - Distribution of choline acetyltransferase-immunoreactive neurons in the brain of a cyprinid teleost (Phoxinus phoxinus L.). AB - The distribution of putative cholinergic neurons in the brain of a cyprinid teleost was investigated by immunocytochemistry, with well-characterized polyclonal antibodies to porcine choline acetyltransferase (ChAT), correlated with acetylcholinesterase (AChE) histochemistry. AChE-positive neurons were more numerous than ChAT-immunoreactive (ChAT-IR) neurons. Regions with ChAT-IR neurons generally also contained AChE-positive ones, but regions with AChE-positive neurons often did not contain (or contained only small numbers of) ChAT-IR neurons. ChAT-IR neurons were located in the brainstem cranial nerve motor nuclei, in the brainstem reticular formation, in the nucleus lateralis valvulae and an adjacent subnucleus "a," in the nucleus isthmi, and in the stratum griseum periventriculare of the tectum opticum. All neurons in these areas were AChE positive. ChAT-IR neurons were also observed within the boundaries of the nucleus sensibilis nervi trigemini and the n. descendens nervi trigemini. The periventricular hypothalamus and the paraventricular organ, the pineal organ, and (possibly) the nucleus suprachiasmaticus also contained ChAT-IR neurons. In these areas, AChE activity was either low or located mainly in neurons other than the ChAT-IR ones. A small population of ChAT-IR neurons was observed in area ventralis telencephali pars lateralis. This was the only telencephalic ChAT-IR cell group. Furthermore, some previously unrecognized cell groups were observed. A small number of ChAT-IR neurons, located on the dorsal aspect of the fasciculus longitudinalis medialis (caudal to n. raphe dorsalis), emitted axons that passed caudally along the raphe midline and innervated some of the large reticular neurons. Another group of ChAT-IR neurons was observed caudal to the thalamic nucleus centralis posterior and was tentatively designed n. tractus rotundus, on the basis of the neuronal morphology. The almost Golgilike staining of some of the ChAT-IR cell groups permitted the identification of their efferent connections and the areas covered by their dendrites. PMID- 3549798 TI - Choline acetyltransferase immunoreactivity in the rat thalamus. AB - The distribution of choline acetyltransferase immunoreactivity in the rat thalamus was investigated by using a specific monoclonal antibody and was compared with the pattern of acetylcholinesterase staining. The only choline acetyltransferase-immunoreactive cell bodies in the thalamus were in the medial habenula. A wide range of densities of immunoreactive fibers and varicosities was found. The highest densities of stained varicosities were in the anteroventral, reticular, lateral mediodorsal, and intralaminar nuclei. At the other extreme, the anterodorsal, ventroposteromedial, and paraventricular nuclei were almost devoid of immunoreactive varicosities. A light density of fibers was observed in several medial nuclei, including parataenial, reuniens, and gelatinosus. Most other nuclei contained moderately dense regions of varicose fibers that were often heterogeneous or patchy. The pattern of choline acetyltransferase immunoreactivity in the thalamus was in general similar to that of acetylcholinesterase. A marked discrepancy, however, was found in the anterodorsal nucleus, which was intensely stained for acetylcholinesterase but contained no apparent choline acetyltransferase immunoreactivity. Numerous physiologic studies have demonstrated striking effects of acetylcholine on thalamic activity. The present study provides a description of choline acetyltransferase-immunoreactive structures in the thalamic nuclei, providing a first step toward elucidating the anatomical basis for the physiologic and functional importance of cholinergic transmission in the thalamus. PMID- 3549799 TI - Experimentally-induced border disease in goats. AB - Twelve of 14 pregnant goats were inoculated intramuscularly with a cytopathic strain of bovine virus diarrhoea (BVD) virus at different stages of gestation. All infected goats developed neutralizing antibodies against the virus. Four nannies infected at about 40 days of pregnancy each had an empty uterus when killed after four months of pregnancy. Out of five nannies infected at about 60 days gestation, one aborted three weeks before full term; the other four were killed at about four months gestation at which time one had an empty uterus, while the uteri of the other three, contained extremely small, autolyzed foetuses and 1.1 to 1.5 l of foetal fluid. Three nannies infected at about 100 days of pregnancy produced five clinically normal offspring. Histopathological lesions were found in the central nervous system in all examinable offspring from the infected nannies, this being consistent with reported findings in cases of border disease in goats. Both cytopathic and non-cytopathic BVD viruses were isolated in these cases. Kids from two nannies infected at 60 and 100 days of pregnancy, respectively, had precolostral antibodies against BVD virus. PMID- 3549800 TI - Androgenetic alopecia treated with topical minoxidil. AB - A randomized double-blind trial of topical minoxidil was carried out during a 12 month period in 56 patients with male pattern baldness. Subjects were randomly assigned to treatment with either 2% minoxidil solution, 3% minoxidil solution, or placebo. The placebo group was switched to 3% minoxidil after the first 4 months. Subjects using the 2% and 3% solutions of minoxidil showed a significant change in terminal and indeterminate hair counts (p less than 0.05) from the placebo group at 4 months. A progressive decrease in vellus hair counts with a concomitant increase in both indeterminate and terminal hair counts was noted during the 12-month period, suggesting that minoxidil applied topically partially reverses the balding phenomenon. PMID- 3549801 TI - Dose-response study of topical minoxidil in male pattern alopecia. AB - Fifty-eight men with Hamilton scale type III vertex or type IV male pattern baldness were studied to determine the dose-response activity of low concentrations of topical minoxidil in promoting hair growth. The patients were treated with topical minoxidil at doses of 0.01%, 0.1%, 1%, or 2% or placebo in a randomized double-blind design for 6 months. At the end of 6 months, patients using 0.1%, 1%, and 2% topical minoxidil solutions showed a significantly greater difference in the mean increase of nonvellus hair growth in comparison with those using 0.01% minoxidil or placebo. There was a clear dose-response correlation for the increase of nonvellus hairs in the 0.1%, 1%, and 2% minoxidil treatment groups. There was a statistically significant difference in patient's self evaluation of overall hair growth and degree of decreased hair shedding in the 1% and 2% minoxidil groups when compared with the other study groups. From this study we conclude that significant increases in nonvellus hair counts occur with 0.1% and greater doses of minoxidil. However, only in patients treated with the 1% and 2% solutions of minoxidil was there clinically perceptible hair growth. PMID- 3549802 TI - Safety and efficacy of topical minoxidil in the management of androgenetic alopecia. AB - Of 149 subjects with androgenetic alopecia, 102 completed 1 year of a double blind, randomized study comparing 2% minoxidil and 3% minoxidil solutions for safety and efficacy. One third of the subjects used a vehicle placebo for the first 4 months and then switched to 3% minoxidil. At 12 months the 2% minoxidil group switched to a 3% solution. During months 5 to 12 a steady increase in terminal hair counts occurred to an equal degree within the 2% and 3% minoxidil groups and the 3% treatment group switched from placebo. Total hair counts at 12 months increased from a baseline mean of 63.5 to 180.6 in the 2% treatment group, from 61.0 to 179.9 in the 3% group, and from 65.0 to 191.1 in the placebo to 3% crossover group. Although all 102 subjects completing 12 months of the study thought that visible hair growth had resulted, 89 were considered by the investigators to have visible growth. Dense hair growth, defined as hair long enough to cut or comb, was present in 48 subjects by their own evaluation and in 33 subjects by investigator evaluation. There were no serious side effects. Two instances of allergic contact dermatitis and four of pruritus were attributed to use of the drug. Two individuals complained of impotence, which disappeared within a few days of discontinuation of topical minoxidil. This effect has not been reported during the use of minoxidil in its oral form (Loniten) for the treatment of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549803 TI - Long-term follow-up of men with male pattern baldness treated with topical minoxidil. AB - Forty-one men with male pattern baldness completed 132 study weeks (2 years 9 months) with topical minoxidil and had follow-up 1-inch target-area vertex scalp hair counts. Initially these men were treated with either twice-daily 2% topical minoxidil for 12 months or 3% topical minoxidil for 8 to 12 months (one third of the subjects received placebo for the first 4 months). After 12 months all subjects continued to apply 3% topical minoxidil twice daily for 1 more year, after which they were randomized to once- versus twice-daily topical minoxidil for an additional 9 months. Those subjects who changed to once-daily application of topical minoxidil at 2 years had a mean change from baseline nonvellus hair count at 1 year of 291.2 (range of hairs four to 553) and at 2 years 9 months of 235 (two to 592 hairs). Those subjects who continued with twice-daily application of topical minoxidil throughout the study had a mean change from baseline nonvellus hair count at 1 year of 323 (15 to 589 hairs) and 335 (13 to 808 hairs) at 2 years 9 months with maintenance topical minoxidil. There were subjects on both maintenance schedules of topical minoxidil who lost some of the nonvellus hair they had initially gained with topical minoxidil; however, there was a greater mean loss in those patients following the once-daily versus twice-daily topical minoxidil regimen (p = 0.05). No subject lost nonvellus target hair as compared with baseline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549804 TI - Use of topical minoxidil in the treatment of male pattern baldness. AB - This 12-month, double-blind, randomized study evaluated the safety and efficacy of topical minoxidil in the treatment of male pattern baldness. Three formulations were compared: 2% minoxidil solution, 3% minoxidil solution, and placebo. After 4 months all placebo patients crossed over to treatment with the 3% solution. Of the 96 patients randomized into the study, 79 were evaluable at month 12; 25 of these were in the 2% minoxidil group, 24 were in the 3% minoxidil group, and 29 were in the placebo-to-3% solution switchover group. At monthly intervals a hair count was obtained within a 1-inch diameter area on the scalp vertex. In addition, a gross visual estimate of the degree of new hair growth over the entire balding area was made independently by the investigator and the patient. At the end of 4 months there was significant regrowth of nonvellus (terminal and indeterminate) hairs in the patients using the 2% and 3% solutions (p = 0.0001). The mean nonvellus hair count at month 4 was 162.8 in the 2% minoxidil group, 155.4 in the 3% minoxidil group, and 107.1 in the placebo group. The mean increase in the 2% and 3% treatment groups was 58.2 and 48.8, respectively, whereas the mean increase in the placebo group was 4.0. Total hair counts at month 4 demonstrated significantly more growth of hair in the 2% minoxidil group than in the placebo group (p = 0.013), with no significant difference between the 3% minoxidil group and the other two treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549805 TI - Androgenetic alopecia: treatment results with topical minoxidil. AB - A double-blind 12-month trial was conducted to evaluate the safety and efficacy of topical minoxidil in patients with androgenetic alopecia. During the first 4 months of the study, patients applied a topical solution containing either 2% minoxidil, 3% minoxidil, or placebo to their scalps twice daily. At the end of the fourth month, patients taking placebo were crossed over to treatment with 3% minoxidil solution. Of 60 patients enrolled in the study, 43 were evaluable at month 12. Hairs were counted in a 1-inch target area and classified as vellus, indeterminate, and terminal; the latter two classifications were combined as nonvellus hairs for further statistical analysis. All three groups had significant increases in total, nonvellus, and terminal hair counts between baseline and month 4 and between month 4 and month 12. At month 4 the average total hair counts increased from a baseline mean of 158.2 to 270.2 in the 2% minoxidil group, from 156.6 to 287.0 in the 3% minoxidil group, and from 162.6 to 246.9 in the placebo group. At month 12 the means were 415.6, 448.5, and 471.1 in the 2% minoxidil, 3% minoxidil, and placebo-3% minoxidil crossover subjects, respectively. The increases from month 4 to month 12 were highly significant for each group (p = 0.0001). Average increases in nonvellus hair counts between months 4 and 12 were 216, 181, and 264 in the 2% minoxidil, 3% minoxidil, and placebo-to-3% minoxidil crossover groups, respectively, all highly significant differences from zero (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549806 TI - Long-term efficacy of topical minoxidil in male pattern baldness. AB - A 24-month clinical trial, begun on a double-blind basis, was conducted in 153 men with discernible male pattern baldness of the crown with the use of either topically applied placebo, 2% minoxidil, or 3% minoxidil solution. After 4 months the patients using placebo were switched to 3% minoxidil solution. At 12 months, there were statistically significant increases in terminal hair growth within a 1 inch target area in those treated with 2% or 3% minoxidil solution, in comparison with baseline counts. However, there were few patients who had appreciable cosmetic restoration. At 12- and 24-month intervals, progressive regression or stabilization of the size of the bald area was noted in the majority of patients. This therapeutic or preventive effect was statistically significant. The data on actual target area hair counts suggested that the 2% minoxidil solution was equal to or more efficacious than the 3% minoxidil solution. Baseline vital signs and laboratory parameters remained essentially unchanged. Topical minoxidil was well tolerated, with no serious drug-related adverse reactions noted during the study. PMID- 3549807 TI - Topical minoxidil in early androgenetic alopecia. AB - A randomized, double-blind trial was conducted to determine the relative efficacy and safety of topical minoxidil solution for progressive male pattern baldness. One hundred fifty men with a discernible vertex balding spot were randomly assigned to treatment with either 2% topical minoxidil, 3% topical minoxidil, or placebo. After 4 months, patients receiving placebo were crossed over to 3% minoxidil. The study was concluded after 12 months of treatment, at which time 100 subjects were evaluable. Efficacy was determined primarily by objective hair counts at monthly intervals and by subjective patient evaluations at 4 and 12 months. Patients applying active medication had significantly greater growth of nonvellus hairs at 4 months than did their placebo counterparts (p = 0.0018 for 2% minoxidil vs placebo; p = 0.0167 for 3% minoxidil vs placebo). In patients crossed over from placebo to 3% minoxidil, the rate of growth of nonvellus hairs increased to fifteen hairs a month during the next 4 months and slowed to ten hairs a month during the last 4 months. Within-group analyses for month 12 evaluable patients demonstrated significant increases in total hair counts for all three groups (p less than or equal to 0.0001). According to investigator evaluations at month 12, 82% of the 2% minoxidil group, 78% of the 3% minoxidil group, and 83% of the placebo to 3% minoxidil group had new hair growth. Clinically insignificant minoxidil blood levels resulted from scalp absorption. Thirty-six medical events in twenty-six patients were deemed related to the study drug; twenty-seven of these events were dermatologic in nature, and all were mild and self-limiting. PMID- 3549808 TI - Deaths occurring during clinical studies of topical minoxidil. AB - Eight deaths that occurred during Upjohn-sponsored clinical trials of topical minoxidil and two deaths in subjects who used extemporaneous formulations of the drug are summarized. Of the eight patients in clinical trials, five had cardiovascular abnormalities and two had acquired immunodeficiency syndrome related pneumonia. One patient died of a self-inflicted gunshot wound. One of the subjects who was using extemporaneous topical minoxidil had hypertension and arteriosclerotic disease and the other died of a myocardial infarction. There is little likelihood of significant adverse effects attributable to topical minoxidil because of its low systemic absorption. The evidence suggests that these deaths were the result of causes other than use of the drug. PMID- 3549809 TI - Double-blind, placebo-controlled evaluation of topical minoxidil in extensive alopecia areata. AB - The safety and efficacy of 3% topical minoxidil were evaluated in the treatment of extensive patchy alopecia areata, alopecia totalis, and alopecia universalis. Patients with extensive patchy alopecia areata had greater than 50% scalp hair loss. In this double-blind study, thirty subjects applied minoxidil or placebo to half of the afflicted scalp area twice daily, with overnight petrolatum occlusion, for 1 year. Both male and female subjects, ranging in age from 9 to 65 years, were enrolled, fifteen subjects to each treatment group. Minoxidil applications were generally well tolerated except for three instances of scalp itching and dermatitis, two of which necessitated discontinuing the medication. Hair growth was seen in seven of eleven evaluable subjects (63.6%) in the minoxidil group and in five of fourteen evaluable subjects (35.7%) in the placebo group. Excellent, cosmetically acceptable hair growth was seen in three of eleven minoxidil-treated subjects (27.3%) and in one of fourteen placebo-treated subjects (7.1%). Examination of vital signs and laboratory measurements revealed no evidence of systemic effects of minoxidil. Seven of the twelve subjects assayed in the minoxidil group had detectable minoxidil serum levels, ranging from 0.4 to 7.5 ng/ml. PMID- 3549810 TI - Topical minoxidil (3%) in extensive alopecia areata, including long-term efficacy. AB - This study was conducted to further evaluate the safety and efficacy of 3% topical minoxidil in the treatment of extensive alopecia areata. Patients were assigned to one of two treatment regimens in a double-blind manner. One group applied 3% minoxidil to the scalp twice daily for 64 weeks; the other group applied placebo for the initial 12 weeks and then switched to 3% minoxidil for the remaining 52 weeks. Thirty male and female subjects, ages 7 to 63 years, with extensive alopecia areata affecting 25% to 100% of the scalp were enrolled, fifteen subjects to each treatment group. Twenty-four of the thirty subjects had greater than 75% scalp hair loss. At 12 weeks the group treated with 3% minoxidil had slightly more hair growth than the placebo group, but the difference was not statistically significant. At 64 weeks, thirteen of twenty subjects (65%) who began with less than full scalp involvement (25% to 99% scalp hair loss) had terminal hair growth that was incomplete or cosmetically acceptable; of these, nine (45%) were cosmetically acceptable, a response that is significant in patients with severe alopecia areata. No hair growth or only slight growth was seen in all nine patients with 100% scalp hair loss at baseline. Thus the extent of hair loss at baseline was correlated with response at 64 weeks. Twenty-one of the patients continued treatment for a second year. Of these, thirteen showed further growth, three had no further growth, and five who had cosmetically acceptable hair growth during the first year had some hair loss.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549811 TI - Topical minoxidil solution (1% and 5%) in the treatment of alopecia areata. AB - Topical minoxidil solution can induce hair regrowth in alopecia areata. A dose response effect was demonstrated when 48 patients treated with topical 1% minoxidil were compared with 47 patients treated with topical 5% minoxidil. A total of 66 patients were enrolled, 26 of them participating in both study groups. Patients with extensive (75% or greater) scalp hair loss showed a response rate of 38%, defined as terminal hair regrowth, with 1% minoxidil versus an 81% response rate with 5% minoxidil. The current 2% formulation is most likely to elicit cosmetically acceptable regrowth in those with patchy alopecia areata. Occlusion of the treated area appears to be necessary to achieve and maintain maximum results. Nonresponders are most likely to be found among those with the most extensive scalp hair loss. No other clinical features correlate with response to treatment. However, a finding of increased T cell blastogenesis before treatment may predict response. In patients with severe alopecia areata, hair loss generally recurs after treatment is stopped and may recur during treatment. Systemic absorption of topically applied and occluded minoxidil solutions (1% and 5%) was minimal; no clinically significant changes in blood pressure, weight, cardiovascular status, electrocardiogram, electrolytes, complete blood count, or urinalysis were seen. Mild local irritation occurred, and two of the 66 patients developed allergic contact dermatitis to minoxidil, as confirmed by patch tests. PMID- 3549812 TI - Transferrin receptor expression in normal skin and in various cutaneous tumors. AB - In the majority of human cells the transferrin receptor (TFR) plays an important role by mediating the cellular iron uptake. The TFR is especially expressed by proliferating cells and has been found in high amounts in malignant tumors. The distribution of the TFR in frozen sections of 89 skin biopsies of normal skin and of various cutaneous tumors was investigated using an anti-TFR monoclonal antibody (OKT9) and a 3-step immunoperoxidase method. Our results indicate that in normal human skin the TFR shows a characteristic microanatomical distribution in the basal cell layer correlated to the architectural pattern of the dermal epidermal interface. In cutaneous lymphomas of high grade malignancy the TFR was expressed in virtually all cells compared to only 25-75% in low grade lymphomas. Malignant melanomas were strongly positive in the whole tumor tissue, whereas benign melanocytic nevi were largely negative. Obviously the immunohistochemical demonstration of the TFR may serve as prognostic indicator or diagnostic aid, respectively. PMID- 3549813 TI - Meningioma of the scalp: a case report with immunohistological features. AB - We report a case of a long-standing subcutaneous nodule of the scalp in a young man, with the histological features of a primary cutaneous meningioma. The results of an immunohistological study using a panel of monoclonal antibodies gave a similar pattern to that seen in intracranial meningiomas, and distinct from other cutaneous lesions which may be considered in the differential diagnosis. PMID- 3549814 TI - The alkaline phosphatase anti-alkaline phosphatase technique in dermatopathology. AB - The APAAP technique is an unlabelled antibody bridge technique which can be used on either frozen or paraffinembedded sections. One applies first a monoclonal antibody, then a polyclonal bridge antibody, and finally a soluble complex of alkaline phosphatase and monoclonal mouse anti-alkaline phosphatase. Subsequently, the enzyme label is developed with a naphthol salt and new fuchsin as a dye. This technique was used in our laboratory on frozen and/or paraffin embedded sections by using 15 different monoclonal antibodies, which are commercially available. The reaction product was bright red and could easily be distinguished from the brown color of melanin, which makes the APAAP technique particularly suitable for dermatopathology. PMID- 3549815 TI - Effects of intake and postruminal casein infusion on performance and concentrations of hormones in plasma of lactating cows. AB - Four Holstein cows were utilized in a Latin square design with a factorial arrangement of treatments to examine the interaction between effects of dry matter intake (107 vs. 78% of energy requirements) and postruminal infusions (water vs. 395 g/d casein) on lactational performance, utilization of nitrogen and energy, and plasma concentrations of hormones. Yields of milk and milk protein were decreased by feed restriction and increased by casein infusion with no treatment interactions. Restricting feed intake decreased total nitrogen intake by 143 g/d and resulted in smaller quantities of fecal, absorbed, urinary, milk, and retained nitrogen compared with cows fed ad libitum. Casein infusion increased total nitrogen intake (55 g/d), absorbed nitrogen (54 g/d), urinary nitrogen excretion (28 g/d), and milk nitrogen (13 g/d). Casein by dry matter intake interactions were not significant for nitrogen utilization. Restricting feed intake increased plasma growth hormone and decreased concentrations of insulin and triiodothyronine. Glucagon, prolactin, and thyroxine were not affected by intake. Casein infusion did not affect growth hormone, insulin, prolactin, triiodothyronine, or thyroxine. Increased milk and milk protein yields obtained with casein infusion were apparently not mediated through changes in circulating concentrations of these hormones; however, plasma glucagon was increased by casein infusions. PMID- 3549816 TI - Inherent variability of the performance of the ultrasonic descaler. PMID- 3549817 TI - Dental materials: 1983 literature review. Part 1. PMID- 3549818 TI - [Psychophysiological effects, in the dentist, of exposure to the noise of instruments used in the dental office]. PMID- 3549819 TI - Dohi memorial lecture. Leukocytes and skin disease: conflicting patterns of inflammation in atopic dermatitis and psoriasis. PMID- 3549820 TI - Induction of chronic skin changes in intraperitoneally hematoporphyrin-injected mice with metal halide lamp irradiation. PMID- 3549821 TI - Ultrastructural observations of skin lesions in MRL mice--dermal infiltrations and capillary changes. PMID- 3549822 TI - Basal lamina of the dermal capillary: concentric multilamination following regeneration processes. PMID- 3549823 TI - Diabetic retinopathy and Campbell de Morgan's spots. PMID- 3549824 TI - A case of contact dermatitis due to betamethasone valerate--with a review of Japanese articles. PMID- 3549825 TI - Surgical treatment of speckled skin caused by dyschromatosis symmetrica hereditaria--case report. PMID- 3549826 TI - Familial benign chronic pemphigus generalized by Pseudomonas infection. PMID- 3549827 TI - Pseudo-Kaposi sarcoma with a possible relationship to obesity. PMID- 3549828 TI - The presidents. John Reinhart Abel 1961-1962. PMID- 3549829 TI - Reduced formation of supragingival calculus with use of fluoride-zinc chloride dentifrice. AB - Results of this comparative, double-blind, clinical study show that fluoride dentifrice with 2.0% zinc chloride is effective in reducing calculus accumulation after a dental prophylaxis. The data also confirm earlier observations on calculus formation in that accumulation was not constant during the two 3-month study phases. PMID- 3549830 TI - A critical look at posterior composite restorations. AB - The limited serviceability of posterior composite resins relates not only to the lack of a durable composite material, but also to other factors such as postoperative sensitivity, difficulty in achieving proximal contacts, marginal leakage, and recurrent caries. However, most of the problems can be overcome by attention to materials used, selection of teeth to be restored, and clinical techniques. PMID- 3549832 TI - The presidents. Gerald Desmond Timmons 1962-1963. PMID- 3549831 TI - Dentistry and Medicare. PMID- 3549833 TI - ADA evaluation programs: a proud history of service to the profession and the public. PMID- 3549834 TI - Chlorhexidine for prophylaxis against oral infections and associated complications in patients receiving bone marrow transplants. AB - Intensive chemoradiotherapy damages the mucosal barrier of the mouth and throat and is often associated with severe oral inflammation and infection. This study examined the use of a 0.12% chlorhexidine gluconate mouthrinse for prophylaxis against oral complications in patients receiving bone marrow transplants. Use of chlorhexidine mouthrinse produced reductions in oral soft tissue disease and oral microbial burden, including a significant decrease in oral mucositis and Candida infections. The advantage for patients undergoing intensive antineoplastic therapy, and potentially for other immunocompromised patients susceptible to oral infections, was studied. PMID- 3549835 TI - Periodontal considerations for overdentures. AB - Overdentures can offer an alternative to regular dentures with the correct factors. This paper discusses proper abutment selection and preparation coupled with appropriate periodontal maintenance and caries control to assure the success of overdentures. PMID- 3549836 TI - Dentistry on stamps (George Eastman). PMID- 3549837 TI - Efficacy and safety of sustained (48 hour) intravenous infusions of milrinone in patients with severe congestive heart failure: a multicenter study. AB - Milrinone is a new bipyridine inotrope that has shown promise in initial clinical testing when administered intravenously or orally. The present multicenter study was designed to evaluate the clinical effectiveness and safety of sustained (48 hour) intravenous infusions of different doses of milrinone, as would be used clinically, in a controlled fashion using invasive hemodynamic monitoring. Entry was limited to adult patients with chronic heart failure of functional class III or IV, with a cardiac index less than or equal to 2.5 liters/min per m2 or a pulmonary capillary wedge pressure greater than or equal to 15 mm Hg, or both. After stable baseline hemodynamic recordings were obtained, milrinone was given as loading (microgram/kg per 10 min) and maintenance infusions (microgram/kg per min) to 189 patients in one of four loading/maintenance dosage regimens: 37.5/0.375 (low dose, n = 26), 50/0.50 (intermediate dose, n = 95), 75/0.75 (high dose, n = 15) and 50/0.25 (lowest dose, n = 53). The lowest dose was shown to be ineffective for maintenance therapy. Effective individual patient responses were defined as greater than or equal to 20% increase in cardiac index or decrease in pulmonary capillary wedge pressure, or both. During early therapy (less than or equal to 3 hour), 99% of patients showed an effective maximal response, and 90% an effective mean response. An effective mean response was observed during days 1 and 2 in 80% of patients, with a positive dose-response trend (69% response, low dose; 80%, intermediate dose; 93%, high dose; day 1). Each loading regimen was effective, with maximal mean response occurring at 15 minutes. Cardiac index initially increased by an average of 24 to 42% for all patients in the three groups, whereas pulmonary capillary wedge pressure decreased by 24 to 33%. Initial decreases in systemic vascular resistance averaged 15 to 31%. Initial changes in heart rate (+4 to +13%) and mean arterial pressure (-2 to -13%) were modest. Significant mean hemodynamic responses were maintained over the 48 hours. Increases in cardiac index for days 1 and 2 averaged 38 and 39% for those completing constant low dose drug, 34 and 37% for intermediate dose and 73 and 44% for high dose. Decreases in pulmonary capillary wedge pressure for all patients averaged 18 to 32% on days 1 and 2, with little dose response. Heart rate changes were modest and variable, averaging -9 to 9%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549838 TI - Histologic predictors of acute cardiac rejection in human endomyocardial biopsies: a multivariate analysis. AB - To identify specific histologic abnormalities that could predict early cardiac rejection before the development of myocyte necrosis, 167 consecutive endomyocardial biopsy samples from 18 cardiac transplant recipients were retrospectively analyzed and 17 histologic variables were semiquantitatively graded from 0 to 3. Forty-five biopsy samples contained foci of myocyte necrosis and were labeled Rejectors. The two samples immediately preceding Rejector biopsies were labeled Predictors (n = 44). All remaining samples were labeled Others (n = 78). Endocardial and interstitial infiltrates, interstitial mononuclear cells, pyroninophilic mononuclear cells, polymorphonuclear leukocytes and other cells (eosinophils and plasma cells) were significantly increased in graded severity in Rejector biopsy samples as compared with Predictors or Others (p less than 0.001, ANOVA testing). These variables cannot distinguish Predictor biopsy specimens from Others. On the other hand, interstitial edema, perivascular karyorrhexis and perivascular infiltrate with intermyocyte extension are histologic abnormalities that can distinguish Predictor biopsy samples from Others (p less than 0.001, ANOVA testing). Multiple logistic regression analysis indicates that the relative risk of developing myocyte necrosis when a biopsy sample contains interstitial edema is 8.1. With perivascular infiltrate with intermyocyte extension in addition, the relative risk is 41.4. In summary, three histologic abnormalities have been identified that help predict the future development of myocyte necrosis within the next two endomyocardial biopsies. Biopsy specimens with these abnormalities probably represent early cardiac rejection before the development of myocyte necrosis. PMID- 3549839 TI - Retraction of two additional papers by Robert A. Slutsky, M.D. PMID- 3549840 TI - Occupational asthma caused by Voacanga africana seed dust. AB - We report a case of a nonatopic patient in whom exposure to Voacanga africana (VA) dust precipitated asthma. The patient was indirectly exposed to this dust by her husband, a chemist working in a pharmaceutical plant in which VA is used for the production of vinburnine, an alkaloid derivative. Vinburnine (Cervoxan) is widely used in conditions associated with cerebral circulatory insufficiency. Studies revealed the presence of immediate skin test reactivity to VA dust, and specific anti-VA antibodies were detected in the patient's serum by the reverse enzyme immunoassay technique. Bronchial challenge with a VA extract also resulted in an immediate asthmatic response without late reaction. These findings suggest a type I IgE-mediated immunologic mechanism as being responsible for the patient's respiratory symptoms. Unexposed persons did not exhibit reactivity to this seed with any of the tests referred to above. To the best of our knowledge, this is the first reported case of occupational asthma caused by VA seeds. PMID- 3549841 TI - Cross-reactivity between antigens of fungal extracts studied by RAST inhibition and immunoblot technique. AB - We have used the RAST-inhibition technique in homologous and heterologous inhibitions of the Aspergillus fumigatus, Alternaria tenuis, and Cladosporium herbarum RAST assays followed by the immunoblot technique to assess the degree of shared allergenic determinants in these extracts. In the Aspergillus RAST, there was little or no inhibition with Cladosporium and Alternaria, but considerable cross-reactivity was found between Alternaria and Cladosporium. Inhibition by Alternaria of the Cladosporium RAST was found in a dose-dependent fashion in one serum, whereas all four sera in the Alternaria RAST were inhibited by Cladosporium in this fashion. Logit transformation of the Alternaria RAST inhibition curves produced common slopes with Alternaria and Cladosporium in three of the four sera, indicating their immunologic identity. The immunoblot technique confirmed the degree of cross-reactivity found by RAST inhibition among the molds. This evidence of common allergenic determinants in these fungi could help to explain the observation that mold-allergic patients often have skin test reactions to several fungi. PMID- 3549842 TI - Effect of long-term treatment with inhaled corticosteroids and beta-agonists on the bronchial responsiveness in children with asthma. AB - Airway inflammation is assumed to be an important determinant in increased bronchial responsiveness (BR). We tested the hypothesis that treatment with an inhaled anti-inflammatory drug (i.e., budesonide) but not with an inhaled beta agonist (i.e., terbutaline) would reduce BR in children with asthma and with minimal or no bronchoconstriction. Twelve patients were treated with budesonide and seven with terbutaline for 6 months. BR decreased in 11 patients receiving budesonide and was significant in seven patients. BR decreased in none of the patients receiving terbutaline. FEV1 demonstrated a small increase with budesonide but remained unchanged with terbutaline. Except in one patient who received terbutaline, the clinical effect was good. We conclude that inhaled corticosteroids but not inhaled beta-agonists will decrease persistent BR in most children with asthma. PMID- 3549843 TI - The effect of indomethacin on the refractory period occurring after the inhalation of ultrasonically nebulized distilled water. AB - We examined the involvement of inhibitory prostaglandins in refractoriness induced by repeated ultrasonically nebulized distilled water (UNDW) challenge. Six male subjects with asthma who developed both UNDW-induced bronchoconstriction and refractoriness after UNDW were studied on 3 separate days, 1 week apart. On each study day, subjects had an initial UNDW challenge. UNDW responsiveness was assessed with dose-response curves of UNDW volume output versus the percent fall in FEV1. The output provoking a 20% fall in FEV1 (PO20 UNDW) was calculated. FEV1 was measured again at 5-minute intervals until it returned to within 5% of baseline value. UNDW challenge was then repeated. On day 1, the two successive UNDW challenges were performed in absence of any treatment (control day). Before days 2 and 3, subjects received placebo capsules or indomethacin, 100 mg per day, in a double-blind, randomized fashion for 3 days. On both the control and placebo days, repeated UNDW inhalation provoked a significant increase in PO20 UNDW (p less than 0.01), indicating refractoriness. On the indomethacin day, the mean PO20 UNDW during the second UNDW challenge was not significantly different from that obtained during the initial test on that day (p greater than 0.05), indicating that refractoriness did not occur. We suggest that inhibitory prostaglandins are involved in the development of refractoriness after UNDW inhalation. PMID- 3549844 TI - Daily multivitamin supplementation and vitamin blood levels in the elderly: a randomized, double-blind, placebo-controlled trial. AB - Despite the many questions being raised about multivitamin use by the elderly, it has not been proven that consuming an oral multivitamin alters vitamin blood levels in the aged. To address this question, we performed a randomized, prospective, placebo-controlled study of daily multivitamin supplementation in 101 noninstitutionalized ambulatory elderly persons (median age, 64 years). Vitamin levels were assayed at baseline, and at two and four months of supplementation. At four months, those taking multivitamins had statistically significant increased levels of water soluble vitamins (C, B2, B12, plasma, and erythrocyte folate) that were greater than changes noted for the placebo group. This was not true for fat soluble vitamins A and E. Greater storage pools of fat soluble vitamins help explain this discrepancy. We conclude that in the ambulatory elderly, oral multivitamins can raise levels of water soluble vitamins but the effect on fat soluble vitamins remains uncertain. PMID- 3549845 TI - Dopamine and serotonin systems in human and rodent brain: effects of age and neurodegenerative disease. AB - The nonpathological age-related changes in the dopamine- and serotonin-containing neurotransmitter systems in human and rodent brain are reviewed. The dopamine system exhibits age-related declines both presynaptically and postsynaptically. Presynaptically, both the levels of dopamine and the number of midbrain dopamine containing neurons decline by up to 50% at advanced ages in the absence of neurological disease. Postsynaptically, the density of D-2 dopamine receptors decreases by 40%, while D-1 dopamine receptors either increase (man) or remain stable (rodents). Additional reductions of dopamine levels and D-2 receptors have been reported in Alzheimer's disease (AD), but these changes are relatively small, and not consistently observed. The levels of serotonin appear stable during normal aging, and presynaptic markers such as (3H)imipramine binding may actually increase. In human brain, the two major classes of serotonin receptor (S 1 and S-2) decrease by 30 to 50% over the lifespan. In AD, both presynaptic and postsynaptic markers of the serotonin system are reduced, including a loss of the serotonin-containing raphe neurons. The additional loss of serotonin receptors in AD approaches 80% when compared with young normals. A hypothesis is presented to explain the typically young age at onset of schizophrenia (usually before 30 years of age) and the older age at onset of parkinsonism (rarely before 50 years of age) within the context of normal age-related declines in the dopamine system occurring in the absence of neurological disorders. The possibility that chronic cocaine abuse might accelerate the development of parkinsonism is discussed. PMID- 3549846 TI - A microwave method for the extraction of cellular ATP. PMID- 3549847 TI - Historical perspectives of ankle arthroscopy. AB - Ankle arthroscopy is a relatively recent specialty. This is because technology lacked the expertise to develop instrumentation small enough to be used effectively within a restricted joint space. This caused primary attention to be focused upon the larger knee joint, but both the knee and ankle had their common arthroscopic origin. This includes simple specula and crude cystoscopes and endoscopes. The lighting ranged from mere reflected sunlight, to wax candles, to crude burning filaments, to simple gas and electric lamps. Early workers included prism and lens grinders, optical physicists, and a host of other scientific specialists. This presentation includes many of the important pioneers and their contributions, as well as a chronicle of arthroscopy's most primitive roots and its transcendency into an accurate surgical instrument. PMID- 3549848 TI - Continuous passive motion--a podiatric overview. PMID- 3549849 TI - Talar compression syndrome. AB - The posterior process of the talus lies in a position of potential compression between the tibia and calcaneus. In an acute ankle sprain, not only are the ankle ligaments damaged, but, depending on the position of the foot at the time of injury, the posterior process may become fractured. The clinician must be aware of recalcitrant signs and symptoms that may lead him or her to the diagnosis of talar compression syndrome. Once the diagnosis has been made, either conservative or surgical treatment will usually provide complete relief. PMID- 3549850 TI - Posteromedial bowing of the tibia and fibula: a literature review and case presentation. AB - Congenital bowing of the tibia and fibula is a serious orthopedic condition rarely encountered by a podiatrist. However, with the increased number of hospital based podiatrists, it becomes imperative that a thorough knowledge of this disorder and the possible treatments be well understood. Deformities of this type are not very common. Most of the literature describes anterior and anterolateral bowing with pseudoarthrosis. The authors have only been able to document 128 cases of posteromedial bowing in the literature with no mention of it in the podiatric literature. This report will present a review of congenital angulation of the tibia and fibula with its associated deformities. Concentration will be given primarily to posteromedial bowing, including a case presentation from the Scholl College of Podiatric Medicine, Pediatric Foot Clinic. PMID- 3549851 TI - Microbiology of diabetic foot infections. PMID- 3549852 TI - Cephalosporin, thienamycin, and monobactam antibiotics: a review of antimicrobial activity, pharmacology, and safety. PMID- 3549853 TI - The pathogenesis of diabetic foot infections--immunopathy, angiopathy, and neuropathy. PMID- 3549854 TI - Regulation of thyroid hormone bioactivity. PMID- 3549855 TI - Principles of free hormone measurement. PMID- 3549856 TI - Clinical evaluation of free T4 techniques. AB - This paper describes the specificity and sensitivity performances of the new FT4 immunoextraction methods as compared to FT4I and sensitive TSH measurement. Only the Sclavo Lisophase, Clinical Assays 2 step, Spiria FT4, Mallinckrodt Spac ET and Abbott TDX methods offered improved diagnostic accuracy as compared to FT4I. The use of the albumin dependent analogue FT4 methods decreased test specificity and significantly increased laboratory costs relative to FT4I. Preliminary data is presented concerning the performance of a sensitive TSH assay in the clinical conditions where the diagnostic accuracy of FT4I is compromised. Diagnostic sensitivity for detection of "true" hypo and hyperthyroidism appears excellent as does test specificity when an appropriate reference range is selected. As the different tests had equivalent sensitivity for detection of "true" thyroid disease, a model was developed for the calculation of the relative laboratory cost effectiveness of using each test as a first line test of thyroid function. The model was constructed on the basis of reagent and technical costs, the prevalence of the clinical states, test specificity and the projected clinical and laboratory response to an abnormal result. The model suggested that the use of the albumin-dependent analogue methods would increase costs 3 fold compared to FT4I, whereas the use of the specific FT4 methods (Clinical Assays 2 step, Spiria FT4, Mallinckrodt Spac ET and Abbott TDX) would decrease costs 2 fold compared to FT4I. Sensitive TSH methods were projected to have equivalent or lower costs compared to the specific FT4 methods, depending on whether FT4I or specific FT4 was used as the confirmatory test. It thus appeared that sensitive TSH measurement may become the most cost effective first line test of thyroid function. PMID- 3549857 TI - When and how to follow patients after treatment for hyper- and hypothyroidism? PMID- 3549858 TI - Decisions of justice and health care. PMID- 3549859 TI - Lactation-induced changes in calcium handling by rat pancreatic islets. AB - Glucose-stimulated insulin release occurred at a lower rate in pancreatic islets removed from lactating than non-lactating rats. This defect was corrected in the presence of either gliclazide or a calcium-agonist. With both agents present, insulin release from islets of lactating rats was greater. When islets were prelabelled with 45calcium, gliclazide stimulated to the same extent 45Ca outflow in islets from lactating and non-lactating rats, respectively. However, when the islets were prelabelled with 45Ca in the presence of gliclazide, the administration of Ba2+ increased effluent radioactivity more markedly in islets from non-lactating than lactating rats. This suggests that lactation favours, in gliclazide-stimulated islets, the sequestration of 45Ca in non-labile subcellular pools. When D-glucose was used instead of Ba2+, the greater lability of 45Ca in islets from non-lactating animals was apparently masked by a lesser efficiency in the metabolism and cationic effects of D-glucose in the non-lactating rats. The calcium-ionophoretic effect of islet extracts was higher in lactating than non lactating rats. These results support the view that a depletion of endogenous calcium stores accounts, in part at least, for the decreased insulin secretory responsiveness to D-glucose in lactation, since the latter apparently favours the function of those systems involved in either the entry of calcium into or its sequestration within the islet cells. PMID- 3549860 TI - The effects of pancreatectomy on the plasma concentrations of insulin-like growth factors 1 and 2 in the sheep fetus. AB - The effects of hypoinsulinaemia and altered metabolite concentrations on the fetal plasma concentrations of insulin-like growth factors (IGF) have been investigated in chronically catheterized fetal sheep made insulin deficient by pancreatic ablation. Fetal pancreatectomy reduced significantly the plasma IGF-1 concentration and increased plasma IGF-2 activity in comparison with the values observed in sham operated fetuses. Mean plasma IGF-1 concentrations in the sham operated and pancreatectomized fetuses were 18.6 +/- 3.1 ng/ml (n = 7) and 13.4 +/- 1.4 ng/ml (n = 13) respectively. When all the data were combined, there was a significant positive correlation between the plasma concentrations of IGF-1 and insulin in utero. The mean IGF-2 activity was 2349 +/- 83 ng/ml (n = 7) in the sham operated fetuses and 3800 +/- 532 ng/ml in the pancreatectomized animals (n = 13). Plasma IGF-2 activity was correlated positively with plasma glucose, fructose and alpha-amino nitrogen levels and inversely related to the plasma insulin concentration in utero. These observations demonstrate that the fetal pancreas is essential for normal IGF production in the fetus and suggest that insulin, substrate availability and the IGFs may interact in the regulation of fetal growth. PMID- 3549861 TI - Autografts in the treatment of osseous defects in the forearm and hand. AB - Twenty-one patients were treated for large defects of the forearm or hand with autografts. Seventeen of the grafts were cortico-cancellous, three were hemiarticular, and one was a hemi joint replacement at each end of the graft. None of these cases involved the whole joint or the growth plate. Cancellous grafts used to fill bone cavities or repair pseudarthroses were excluded from the survey. Patients were followed from 3 to 10 years. In all cases the graft became incorporated and function was maintained. In two cases a second operation was necessary to apply further cancellous graft because of delayed union. PMID- 3549862 TI - Group B beta-hemolytic streptococcal arthritis and osteomyelitis of the wrist. AB - A case of septic arthritis and osteomyelitis of the wrist with group B beta hemolytic streptococci in an adult is reported. Neonatal septic arthritis and osteomyelitis caused by this organism have been previously reported. While rare in the adult, sporadic cases of septic arthritis and osteomyelitis have been seen. The elderly patient with diabetes seems to be a high-risk patient. Underlying chronic arthritis may confuse or delay the diagnosis. PMID- 3549863 TI - Primary prevention of gastrointestinal diseases. AB - In the belief that available information can provide reasonable guidance, we review the evidence identifying factors which increase or decrease the risk of developing several gastrointestinal diseases. In the absence of controlled studies, we review case control and other studies. As results from animal studies cannot be readily transferred to humans, we interpret them cautiously. We recommend appropriate personal behavior to reduce risk when they seem reasonably justified by the evidence. PMID- 3549864 TI - Laser therapy in gastrointestinal practice. AB - Use of the Nd:YAG laser in therapeutic endoscopy has caught the imagination of many physicians. Understanding the principles of laser physics to apply laser techniques correctly is not difficult. Currently, the laser is used for control of gastrointestinal hemorrhage and for debulking obstructing tumors in the upper and lower gastrointestinal tract. Hemostasis has been achieved in 70-100% of patients with a variety of bleeding lesions. Specific laser techniques vary in the power used and exposure time, but some standardization has been agreed on. Obstructing gastrointestinal neoplasms may now be safely and effectively ablated to achieve patency of the lumen. Perforation from laser therapy occurs in 1% or less of patients treated, making this a reasonably safe form of treatment. The high cost of laser unit (approximately $85,000) and the availability of equally effective and more reasonably priced alternatives require careful attention to the cost-effectiveness of the laser. Training physicians in the safe use of lasers is a problem that still must be solved by the users and instrument makers. PMID- 3549865 TI - The evolution of hospice in America toward organizational homogeneity. PMID- 3549866 TI - Acute digitalis poisoning: the role of intravenous magnesium sulfate. AB - Acute digitalis poisoning is a complex emergency with a reported mortality rate of 3% to 25%. In severe overdose, the sodium, potassium-adenosine triphosphatase system is severely inhibited, leading to cardiac dysrhythmias and an elevation of the serum potassium. Magnesium, a cofactor regulating this ion transport system, can successfully treat acute digitalis-induced rhythm disturbances and restore the transmembrane potassium gradient. This paper discusses the cellular mechanism involved in digitalis toxicity and reviews the literature concerning the use of magnesium in acute cardiac glycoside poisoning. PMID- 3549867 TI - Expression of MHC products by normal and abnormal bile duct epithelium. AB - Using antibodies directed to beta 2-microglobulin (b2-m) and HLADR antigens, the expression of MHC products by normal and abnormal bile ducts in 90 paraffin embedded biopsies showing various liver diseases, was studied. Normal and abnormal bile ducts constantly expressed b2-m. Increased b2-m expression was found in 17/19 PBC, and 4/7 chronic aggressive hepatitis or cirrhosis of viral etiology with hepatitic bile duct lesions. Normal bile ducts failed to express HLADR antigens. Aberrant HLADR display was found in 24/26 PBC and 10/16 chronic aggressive hepatitis or cirrhosis of viral etiology with hepatitic bile duct lesions. It is concluded that the pattern of the major histocompatibility complex (MHC) display does not discriminate between PBC and hepatitic bile duct lesions. Enhanced expression of class I MHC products at the surface of medium-sized bile ducts in PBC may render these structures more susceptible to lysis by cytotoxic T cells, whereas its significance in chronic aggressive hepatitis or cirrhosis remains unknown. Aberrant expression of HLADR antigens by abnormal bile ducts in PBC and chronic aggressive hepatitis or cirrhosis of viral etiology is probably induced by gamma-interferon, liberated by intra-epithelial lymphocytes, and may serve to enhance the immune response, either by attracting HLADR-restricted cytotoxic T-cells or by the presentation of non-self antigens at the surface of bile duct epithelium. PMID- 3549868 TI - Chronic hepatitis B virus infection. Viral replication and patterns of inflammatory activity: serological, clinical and histological correlations. AB - We have studied serum and tissue markers of viral replication in 39 patients with chronic hepatitis B virus (HBV) infection and correlated these with periportal and lobular activity in liver biopsies. HBV DNA positivity correlated with the presence of hepatitis B e antigen (HBeAg, P less than 0.001) and aspartate transaminase (AST) levels (P less than 0.005). The lobular but not the periportal inflammatory activity was significantly associated with the presence of HBV DNA (P less than 0.02) and HBeAg (P less than 0.001) and with higher AST levels. The periportal activity correlated with the periportal and lobular display of beta 2 microglobulin on hepatocytes (P less than 0.001 and P less than 0.002, respectively). In patients with chronic HBV infection therefore, the lobular rather than the periportal component of activity was related to viral replication. The association of display of beta 2-microglobulin on hepatocytes with the inflammatory process, in patients with active viral replication, is consistent with the hypothesis that increased display of HLA type I enhances recognition of hepatocytes bearing viral proteins and allows lysis of immune cells. PMID- 3549869 TI - The dexamethasone suppression test (DST) in predicting response to desipramine and amitriptyline in depressed outpatients. AB - The predictive value of the dexamethasone suppression test (DST) was evaluated in two consecutive clinical trials involving 99 individuals treated with amitriptyline or desipramine. Following one week observation, and following one week on low-dose desipramine or amitriptyline (50 mg), all patients who remained depressed (Hamilton score 16 or greater) were given a full clinical trial of either desipramine or amitriptyline (150-300 mg/day) over a minimum 3-5 week period. In all, 68 patients required this trial, 31 receiving amitriptyline and 37 receiving desipramine. For these patients there was no relationship between DST suppression/non-suppression vs clinical response to either desipramine or amitriptyline. There was a non-significant trend for suppressors (negative DST) to respond either spontaneously or to low-dose desipramine or amitriptyline as opposed to non-suppressors (positive DST). PMID- 3549870 TI - Brotizolam: a new short-acting hypnotic. AB - A new short-acting thieno-diazepine compound, brotizolam, has been compared to nitrazepam in a double-blind trial. Following an initial 3-day control period with no treatment, insomniac patients were allocated to 2 weeks treatment with one or the other drug according to random selection. This was then followed by a further 3-day no-drug control period. Morning and evening questionnaires were used to assess various sleep parameters and possible daytime "hang-over" effects. The patients also made actual records of the periods awake during the night (somnography). Highly significant effects were shown for both drugs in comparison to both control periods, in relation to all of the sleep parameters. However, no significant differences from either control period were demonstrated for either drug on the daytime measures, with the exception of how the patients felt at work with brotizolam and how they felt with others on nitrazepam, on both of which measures the patients felt better whilst on the drug. Comparing the figures between the initial and final no-drug control periods, did not reveal any evidence to suggest a rebound effect with either drug. PMID- 3549871 TI - Hyperactivity and methylphenidate: rate-dependent effects on attention. AB - The behavioral effects of CNS stimulants on attention deficit disorder (hyperactive) children's attention are inversely related to their pre-drug rate of behavior, i.e. the effects are rate-dependent. The strength and shape of this relationship are affected by dose and the child's unique reaction to the drug, yet appear unrelated to body weight. Dosage should be directly manipulated in pediatric psychopharmacological studies and the practice of using mg/kg dosage schedules may no longer be necessary. PMID- 3549872 TI - Piracetam in alcoholic organic mental disorder: a placebo controlled study comparing two dosages. AB - The following paper presents an investigation of the efficacy of piracetam in alcoholic organic mental disorder. A double-blind placebo-controlled study design was used to compare 2 dosages of the substance (2 X 3 g vs. 2 X 12 g). Cognitive function was assessed on days 0, 7, 14, 28, 42. Analysis of the results from 24 patients showed a clear-cut amelioration of cognitive functions in all 3 treatment groups. No difference could be demonstrated between the administration of placebo and the lower dose of piracetam. Patients on the higher dose showed an earlier improvement on one of the tests, but the final scores were similar in all three treatment groups. PMID- 3549873 TI - Improvement of symptoms in Tourette syndrome by piquindone, a novel dopamine-2 receptor antagonist. AB - We have hypothesized that symptoms of Tourette Syndrome (TS) may represent D2 (dopamine-2) receptor hyperactivity. We treated 4 TS patients with piquindone, a novel D2 receptor antagonist designed via a 3-dimensional model of dopamine receptors. All 4 patients experienced a clinically obvious reduction of tics. Sedation that decreased over time was the only adverse effect. Haloperidol, the current treatment of choice of TS, is limited primarily by its extrapyramidal side-effects. However, piquindone produced therapeutic effects without disabling side-effects. Motor tics responded at lower doses than vocal tics. All patients expressed a strong subjective preference for piquindone over haloperidol. Our results suggest that therapeutic efficacy of a D2 receptor antagonist in TS can be achieved without production of disabling extrapyramidal-side effects. These results also support the proposal that TS may be mediated by hyperactive D2 receptors. PMID- 3549874 TI - Cognitive and psychomotor effects of different antidepressants in the treatment of old age depression. PMID- 3549876 TI - Propranolol and atenolol in the treatment of anxiety. AB - Patients with generalized anxiety who have not responded to psychological treatment from their family doctor may require symptomatic drug treatment whilst awaiting specialist therapy. This study indicates that propranolol is effective and relatively safe for this purpose. Atenolol is also effective but has unacceptable cardiovascular effects in anxious patients. PMID- 3549875 TI - Effects of atropine and glycopyrrolate on cognitive function following anaesthesia and electroconvulsive therapy (ECT). AB - Memory changes are known to be associated with electroconvulsive therapy (ECT). The anticholinergic drugs used prior to the procedure have also been suspected of causing cognitive deficits. The present study was designed to assess memory and concentration in depressed patients receiving 0.6 mg atropine, 0.2 mg glycopyrrolate or placebo before anaesthesia and ECT. Glycopyrrolate is an anticholinergic agent lacking central nervous system effects. Anaesthesia and bilateral ECT resulted in significant short-term memory deficit, but this was seen equally in each of the groups of patients irrespective of which premedication was given. As no regimen was superior, as far as effect on memory is concerned, premedication for ECT should be chosen according to other criteria. PMID- 3549877 TI - Fluoxetine response: endpoint vs pattern analysis. AB - A 6-week double-blind trial of fluoxetine treatment of unipolar major depressive disorder in 49 patients was evaluated in terms of improvement in the Hamilton Depression Rating Scale (HDRS) and Clinical Global Improvement (CGI) scores. A relationship was found between change in HDRS (absolute and percentage decrease from baseline) and final CGI ratings. However, because of a few placebo responders, endpoint analysis with both the HDRS and CGI showed no differences between active drug and placebo. Pattern analysis of persistent response did successively separate active drug from placebo (less than 0.05). PMID- 3549878 TI - A comparative trial of haloperidol decanoate and fluphenazine decanoate in chronic schizophrenic patients. AB - A twenty-week double-blind study was conducted to compare the efficacy and side effect profile of haloperidol decanoate and fluphenazine decanoate, both given four-weekly, in fifty-one chronic schizophrenic patients. The mean dose of fluphenazine decanoate was 84 mg compared to 122 mg for the haloperidol decanoate group--suggesting a potency ratio of 1.0 : 1.4 in this study population. The CPRS sub-scale for schizophrenic symptoms showed a statistically significant improvement (p. less than 0.05) for the haloperidol decanoate group after twenty weeks treatment. A significant difference favouring haloperidol decanoate (p. less than 0.05) was also shown in the CPRS depression sub-scale at the end of the study. No significant between-group differences were found in the incidence of extrapyramidal side-effects at week 20, though consumption of the antiparkinsonian medication orphenadrine was significantly higher (p. less than 0.05) in the fluphenazine decanoate group (mean dose 102 mg) compared to a mean dose of 58 mg for the haloperidol decanoate group. More patients on fluphenazine decanoate gained weight than patients on haloperidol decanoate, but the difference was not statistically significant. PMID- 3549880 TI - Tschermak: a non-discoverer of Mendelism. I. An historical note. PMID- 3549879 TI - Weight gain and prolactin levels in patients on long-term antipsychotic medication: a double-blind comparative trial of haloperidol decanoate and fluphenazine decanoate. AB - A one year double-blind trial of haloperidol decanoate and fluphenazine decanoate was conducted in nineteen out-patients who had previously received at least one year's treatment with fluphenazine decanoate and were already overweight, as judged by a Body Mass Index of 25+. Although the difference was not statistically significant, patients treated with haloperidol decanoate showed a trend to less weight gain than patients who continued on fluphenazine decanoate, even though the haloperidol to fluphenazine dose ratio was 4:1. No statistically significant changes in mental state were observed and the incidence of extrapyramidal side effects in the two treatment groups was similar. PMID- 3549881 TI - David Hartley's Newtonian neuropsychology. AB - David Hartley's association psychology has been immensely influential. His vibrationist neurophysiology has, in contrast, been largely overlooked and forgotten. Hartley's vibration theory is examined. On the one hand it is shown how closely it is related to Sir Isaac Newton's mathematical physics and on the other how well it complements the association theory. The vibration theory, indeed, strongly influenced Hartley's associationist psychology and hence is of more than merely antiquarian interest. Although Hartley's understanding of the central nervous system has long been superseded, his general ideas prefigure some aspects of contemporary neurophysiology and philosophy of mind and thus provide a further reason for rescuing his vibrationism from oblivion. PMID- 3549882 TI - John B. Watson remembered: an interview with James B. Watson. Interview by Mufid James Hannush. AB - Little is known about the personal life of John B. Watson, and this interview aims at capturing the personality of the founder of American behaviorism through the eyes of his son, James B. Watson. Today, psychologists and other social scientists increasingly realize that there is an intimate link between the biography of a psychologist and the kind of psychology he or she founds. Thus biographical information about a founding psychologist can help researchers make explicit this essential link. PMID- 3549883 TI - In Hall's shadow: Edmund Clark Sanford (1859-1924). AB - Edmund C. Sanford of Clark University had earned a reputation by the end of the nineteenth century as a leading American psychologist. He had written the first training manual for experimental psychology and created numerous pieces of laboratory apparatus. He was also editor of the American Journal of Psychology and a charter member of the American Psychological Association. Although his peers elected him to the presidency of the APA in 1902, his standing had already begun to decline. Sanford's impact on early American experimental psychology is documented and the reasons for his reduced status as American psychology grew in the early years of the new century are explored. PMID- 3549884 TI - German psychological journals under National Socialism: a history of contrasting paths. AB - Five major German psychological journals are examined to determine the changes they manifested upon the advent of National Socialism, and the manner in which they responded to the challenges posed by the new regime's ideology and policies. Two of the journals remained largely unchanged in their content, scientific orientation, and overall tone, revealing predominantly minor forms of accommodation. Two other journals showed a pronounced change in their content, publishing a considerable amount of material of an ideological, racist, or propagandistic nature during the decade starting in 1933. The fifth journal proved an exceptional case. These differences appear to reflect the orientation and values of the editors of the respective journals. Where the editors provided the requisite leadership, scientific publication was maintained essentially free from political interference even under the difficult conditions presented by the fascist state. The article concludes with an examination of the response by postwar German psychology to this period of its history, revealing a disinclination to confront the subject, which was so until very recently. Possible bases for this response are also considered. PMID- 3549885 TI - From oysters to after-dinner mints: the role of the early food and drug inspector. PMID- 3549886 TI - Medical rivalries and medical politics in France: the physicians' union movement and the Medical Assistance Law of 1893. PMID- 3549887 TI - Four books that changed nursing. PMID- 3549889 TI - Understanding Medicare: different perspectives. An essay review. PMID- 3549888 TI - Inoperable cancer: an alternate diagnosis for Milly Theale's illness. PMID- 3549890 TI - Whole-body autoradiographic distribution of exogenously administered renal renin in rats. AB - We studied, by whole-body autoradiography, the distribution of exogenously administered renal renin in rat. Rat renal renin was completely purified and labeled with 125I ([125I]-renin) and was then injected into the tail veins of conscious rats at a dose of 30 microCi, 430 ng. After various intervals, rats were killed by an overdose of ether, the whole body rapidly frozen in acetone-dry ice, and autoradiography performed on sagittal whole-body sections. To remove breakdown products ([125I]-tyrosine and free 125I) from [125I]-renin, sections were treated with perchloric acid solution. The main accumulation of [125I]-renin acid-insoluble radioactivity was observed in liver and renal cortex. The accumulation in these organs was already evident 2 min after the injection, reached a maximum level by 15 min, then gradually decreased. A small amount of [125I]-renin was also evident in spleen, bone marrow, and adrenal gland. Thirty min after the injection, radioactivity began to appear in the thyroid gland, stomach, and small intestine, but disappeared with acid treatment, except in the thyroid. Radioactivity was negligible in other organs including brain, submaxillary gland, lung, heart, and testis. These autoradiographs clearly demonstrate that exogenously administered renal renin is distributed mainly in the liver and renal cortex. PMID- 3549891 TI - Immunohistochemical detection of proliferating cells in vivo. AB - Incorporation of the thymidine analogue 5-bromo-2'-deoxyuridine (BrUdR) into newly synthesized DNA provides the basis of a simple technique for identifying proliferating cells. BrUdR was administered to C57BL/6 mice by continuous infusion for 1-7 days, or by intraperitoneal injection for shorter intervals. Various tissue types, including gut, kidney, and liver, were excised, fixed in neutral buffered formalin, and paraffin-embedded for sectioning. De-paraffinized 4-micron tissue sections and bone marrow samples were incubated with an anti BrUdR antibody and cells that had traversed S-phase during the BrUdR exposure period were identified immunohistochemically. Proliferation and migration of intestinal epithelial cells were identified by antibody staining after continuous in vivo exposure to BrUdR for 1-4 days, and BrUdR incorporation into proliferating marrow cells was detected within 30 min. Tissues such as normal liver, known to have low levels of proliferation, remained unstained after 3 days' exposure to BrUdR. After we established that normal proliferating cells could be identified using this technique, BrUdR was administered to mice bearing B16 melanomas. Again, proliferating tumor cells were clearly identified in histological sections. The nuclei from these paraffin-embedded tumors were also collected for flow cytometric analysis after de-waxing, rehydration, and pepsin treatment. This combination of techniques made possible the comparison in adjacent tissue sections of labeling index, obtained from stained sections, with percentage S-phase, measured using DNA flow cytometry. The % S-phase was consistently higher than the labeling index obtained with immunocytochemistry, and two-parameter DNA vs BrUdR flow cytometry showed that this difference could be accounted for by a population of unlabeled cells with an S-phase DNA content. PMID- 3549892 TI - Immunohistochemical localization of acetylcholine receptors at human endplates using a monoclonal antibody. AB - We describe a simple indirect immunohistochemical method for localization of acetylcholine receptors (AChR) in motor endplates at the light and electron microscopic level. This method involves the use of a monoclonal antibody directed against the main immunogenic region (MIR) of AChRs and is applicable to periodate lysine-paraformaldehyde (PLP)-fixed tissue. We discuss the advantages of this method, as compared with the alpha-bungarotoxin-immunoperoxidase technique, and stress its value for diagnostic investigations of motor point biopsies from patients with neuromuscular transmission disorders. PMID- 3549893 TI - Reduced pupillary sensitivity to topical phenylephrine associated with the relaxation response. AB - Human pupillary dilatation after topical instillation of phenylephrine was assessed in a prospective, randomized, controlled experiment to measure alterations in alpha-end-organ responsivity after regular elicitation of the relaxation response. Baseline pupillometric measurements were taken in both experimental and control subjects. The experimental subjects then practiced daily a technique that elicited the relaxation response while the control subjects sat quietly for comparable periods of time without eliciting the relaxation response. After four to six weeks, both groups returned to the laboratory for an assessment identical to that of the first visit. Comparison between visits revealed that the pupillary dilatation in the experimental group was significantly diminished (p less than .02) as compared to that of the control group. This observation is consistent with reduced end-organ responsivity to an exogenous alpha-adrenergic agent after regular elicitation of the relaxation response. PMID- 3549894 TI - Human allospecific cytolytic T lymphocyte lysis of a murine cell transfected with HLA-A2. AB - A variety of molecules are involved in the interaction of human allospecific cytolytic T lymphocytes (CTL) with target cells. Monoclonal antibodies specific for these molecules inhibit CTL-target conjugate formation and/or lysis. To further study recognition and lysis of targets by human CTL, we used a murine mastocytoma cell line transfected with the histocompatibility leukocyte antigen (HLA)-A2 gene (P815-A2+) as a target for human HLA-A2-specific CTL. We find that only a subset of human HLA-A2-specific CTL can lyse murine P815-A2+ cells, suggesting that the murine cells may lack one or more accessory molecules needed for CTL recognition and lysis. PMID- 3549895 TI - Development of a cell with dendritic morphology from a precursor of B lymphocyte lineage. AB - Cells developing dendritic morphology were detected in cultures of highly purified human B cells incubated with 4 beta-phorbol 12-myristate 13-acetate (PMA). After 72 hr of culture, 2 to 7% of the cells had assumed a dendritic shape provided that contact with a plastic or glass surface also occurred. Dendritic cells developed in cultures of B cells prepared by positively selecting cells that stained with the B cell-specific monoclonal antibody B1 with the fluorescence-activated cell sorter. By contrast, dendritic cells could not be detected in cultures of cells obtained from patients with Bruton's type agammaglobulinemia that lacked B cells. Cells with dendritic morphology were nonspecific esterase negative and not phagocytic. They expressed HLA-DR, DQ, and DP antigens, receptors for interleukin 2 and transferrin, and were stained by B1 and 60.3, an antibody that identifies the beta-chain common to lymphocyte function associated antigen-1, complement receptor 3, and the p150,95 antigen, but not by monoclonal antibodies to monocytes, complement receptors 2 or 3, NK cells, T cells, or Langerhans' cells. Formation of dendritic cells was inhibited by microtubule poisons (vinblastine, colchicine), a microfilament inhibitor (cytochalasin B), and the 60.3 monoclonal antibody, but not by inhibition of DNA synthesis. These data indicate that a subset of B cells is capable of assuming dendritic morphology after stimulation with phorbol esters and attachment to a surface. These dendritic cells exhibit characteristics that are quite similar to the interdigitating cells found in T cell-dependent areas of lymph nodes. PMID- 3549896 TI - Effects of monoclonal anti-H-2Ld and anti-H-2Dd alloantibodies in the immunological enhancement of skin grafts and neonatal heart grafts in the mouse. AB - Three anti-H-2Ld and two anti-H-2Dd monoclonal alloantibodies were analyzed for their capacity to enhance skin graft and neonatal heart graft survival. Of two anti-H-2Ld antibodies with the same specificity but with different isotypes, IgG2a antibody 30-5-7S prolonged graft survival in a skin graft combination with an Ld difference, whereas IgM antibodies did not. A second IgG2a antibody, but with a specificity different from 30-5-7S, was ineffective on its own. However, when mixed with 30-5-7S, skin graft survival was augmented as compared with the prolongation by 30-5-7S alone. Enhancement by anti-H-2Ld antibodies was dependent on the extent of the H-2 graft barrier. It was abrogated on extension of the graft barrier to a D-end H-2 difference by using the B10.A----B10.BR combination. Also, anti-Dd antibodies, either alone or in combination with anti-Ld, were ineffective in this skin graft combination. By using the same graft combination but the less immunogenic neonatal heart graft model, anti-Ld antibodies were still ineffective, but both anti-Dd antibodies were able to enhance graft survival from 15 to 22 days. When mixed with anti-Ld antibody 30-5-7S, graft survival was augmented further to 30 days. These results indicate that two kinds of enhancing alloantibodies may be distinguished. One category interacts with immunodominant epitopes on H-2 molecules, but their effectiveness may be limited to a particular H-2 difference, because immunodominance may vary from one graft barrier to another. In the second category, antibodies are ineffective on their own but they are able to potentiate the effects of antibodies of the first kind. These allocations are relative, however, because they are dependent on the type of graft examined. PMID- 3549897 TI - Chemotactic activity of porcine insulin for human T lymphocytes in vitro. AB - T lymphocytes bear insulin receptors only after activation and entry into the cell cycle. To determine whether cell motility is concomitant with growth factor action in T lymphocytes, we measured the chemotactic activity of porcine insulin (10(-11) to 10(-5) M) for T lymphocytes. We found that the chemotactic response of human T cells activated with phytohemagglutinin (PHA) to porcine insulin was increased over that of resting T cells, with a concomitant two log leftward shift in the dose response. CD4+ and CD8+ subsets responded identically. Checkerboard analysis showed insulin to be chemotactic, as well as chemokinetic. The nature and time course of acquisition of the dose-response shift suggest that chemotaxis may be signaled by insulin acting on high affinity insulin receptors. The chemotactic effect of insulin exemplifies the general chemotactic effect of growth factors for motile target cells, and may be a useful model for the study of chemotactic signaling in T lymphocytes. PMID- 3549898 TI - Evaluation of human peripheral blood leukocytes for mast cell tryptase. AB - Murine monoclonal and goat polyclonal antibodies against tryptase, the dominant neutral protease and protein component in secretory granules of human mast cells, were used to assess the presence of tryptase in peripheral leukocytes. Carnoy's fluid-fixed cytocentrifuge preparations of enriched populations of lymphocytes, monocytes, eosinophils, and neutrophils showed no reactivity with anti-tryptase antibodies by a sensitive indirect immunoperoxidase procedure. Dispersed human lung mast cells showed strong granular cytoplasmic staining with both antibodies, whereas only approximately 50% of the peripheral blood basophils detectable with Wright's stain were detected with anti-tryptase antibodies, and these showed a staining pattern that was faint, granular, and cytoplasmic at high concentrations of antibody. At lower antibody concentrations mast cell staining was still intense, whereas basophils were not stained. Extracts of neutrophils and lymphocytes of up to 90% purity had undetectable amounts of tryptase by an ELISA sandwich immunoassay, as well as undetectable enzymatic activity with tosyl-L-gly pro-lys-p-nitroanilide (a sensitive substrate for tryptase) in the presence of soybean trypsin inhibitor. Extracts of basophil-enriched (6 to 50% purity) preparations contained 0.046 +/- 0.013 pg of tryptase per basophil by the immunoassay along with 2 X 10(-9) +/- 0.8 X 10(-9) U of tryptase-like enzyme activity per basophil, compared with corresponding values of 12 pg, 480 X 10(-9) U of tryptase per human lung mast cell. Thus very small amounts of tryptase are present in human basophils (approximately 0.4% of that found in mast cells), but not in other peripheral leukocytes. PMID- 3549899 TI - Apparent sensitivity of human K lymphocytes to the spatial orientation and organization of target cell-bound antibodies as measured by the efficiency of antibody-dependent cellular cytotoxicity (ADCC). AB - Although monoclonal antibodies (mAb) can elicit potent ADCC by human K lymphocytes, different mAb, even of the same antibody subclass or even of the same target antigen specificity, vary considerably as to their efficiency in eliciting ADCC. The extensive variability in ADCC efficiencies of murine IgG2a mAb is analyzed here. In cold-target inhibition experiments it was found that only cells coated with "ADCC-efficient" IgG2a mAb, and not "ADCC-inefficient" IgG2a mAb, inhibit K effector cell lysis of radiolabeled target cells by ADCC. This result indicates that the spatial orientation of the antibodies on the target cell membrane influences the net efficiency of ADCC reactions by affecting the efficiency of interaction between antibody and the Fc receptors (FcR) of K cells. It is proposed that a "favorable" orientation of antibodies on the target cell membrane is required for efficient ADCC reactions. This proposal is directly supported by the observation that one IgG2a mAb (20.8.4), which cross-reacts with several different H-2 alloantigens, was found to elicit efficient ADCC only when bound to certain of its possible target cell antigens. It was also observed in these studies that the organization of antibodies on a target cell membrane influences the net efficiency of ADCC reactions. It is proposed that a "favorable" antibody organization on the target cell membrane is also required for efficient ADCC reactions. This proposal is supported by the observation that certain antihuman beta 2m (anti-Hu beta 2m) IgG2a mAb, which elicit efficient ADCC lysis of human target cells, fail to elicit the lysis of murine cells having Hu beta 2m molecules coupled randomly to their external membrane surfaces. The differences in the way the Hu beta 2m was organized on the surfaces of the human cells and the murine-Hu beta 2m cell conjugates presumably caused differences in the way the bound antibodies were organized on the cell surfaces, which in turn resulted in the ADCC efficiency differences observed for the same mAb with the different target cell types. Because ADCC reactions appear to be sensitive to both the orientation and the organization of cell surface-bound antibodies, certain types of structural alterations or variations in the membrane molecules (relative to other neighboring structures on the target cell membrane) are potentially detectable by quantitative differences or variations in ADCC reactions. PMID- 3549900 TI - A comparison of the antigenic characteristics of rat and human Pneumocystis carinii by immunoblotting. AB - The antigenic characteristics of rat Pneumocystis carinii obtained from infected lungs and grown in tissue culture were compared with the properties of human P. carinii obtained from the lungs of AIDS and non-AIDS patients by the immunoblotting technique, using different sources of antibody. Major immunoreactive bands of 45, 50, and 116 kd were found in both lung and tissue culture-derived rat P. carinii, suggesting the organism retains its antigenic characteristics in short-term culture. The principal immunoreactive bands in human P. carinii included a band of 40 kd, and to a lesser extent, a band of 66 kd; these antigens were found in the lungs of six and seven AIDS patients but in only one of eight non-AIDS patients with pneumocystosis. The rat and human P. carinii antigens reacted with sera from immunized rabbits, from rats with pneumocystosis and prolonged environmental exposure to the organism, from AIDS and non-AIDS P. carinii patients, and from healthy blood donors. Reactivity of these antigens could be removed by adsorption of antisera with P. carinii infected lungs but not with normal lungs or lungs infected with bacteria and fungi. We conclude that rat and human P. carinii have shared, as well as species specific, antigenic determinants, which should be useful for a variety of studies with this organism. PMID- 3549901 TI - Purification and alpha subunit N-terminal sequences of human Mac-1 and p150,95 leukocyte adhesion proteins. PMID- 3549902 TI - B cell development and regulation after T cell-depleted marrow transplantation. AB - Antibody secreting B lymphocytes from immunized donors can be adoptively transferred after T cell-depleted marrow transplantation to produce protective levels of antibody in the recipient. We have investigated whether these transferred lymphocytes remain subject to continued clonal selection and subsequently became memory B cells even in the initial absence of T cells. Twenty eight donor/recipient pairs were randomized pretransplant to be immunized or not with tetanus toxoid (TT). The recipients were then vaccinated with TT at 3, 6, and 12 mo posttransplant, and the anti-TT antibody response (IgG and IgM) was measured. Only when both donor and recipient were immunized pretransplant could the recipient respond to antigen challenge within the first year posttransplant. Examination of the spectrotype pattern of the recipient anti-TT antibody shows that selection of B cell clones continues, so that T cell depletion does not prevent the appearance of oligoclonal antibody responses. However, because the spectrotype pattern of the recipient did not match the donors, B cell regulatory mechanisms in donor and recipient are nonidentical. These data contrast with observations made in recipients of non-T cell-depleted marrow and serve to illustrate the role of T lymphocytes in the induction and regulation of secondary antibody responses in man. The results also suggest that optimal humoral responses to any antigen after T cell depletion can only occur when both donor and recipient are immunized pretransplant, a prediction borne out by studies on the influence of donor cytomegalovirus status on the severity of cytomegalovirus infection in the recipient. PMID- 3549903 TI - Quantitation of histamine, tryptase, and chymase in dispersed human T and TC mast cells. AB - Levels of histamine, chymase, and tryptase were assessed in preparations of dispersed human TC (tryptase+, chymase+) mast cells obtained from foreskin and of dispersed human T (tryptase+, chymase-) mast cells obtained from lung. Consistent with previous immunohistochemical results, extracts of T mast cells, the predominant mast cell type in lung (93% T and 7% TC mast cells), were deficient in human chymase (less than 0.3 microgram and 0.04 U/10(6) mast cells) but not tryptase (10.8 micrograms and 0.3 U/10(6) mast cells) by corresponding immunologic and enzymatic (suc-L-ala-ala-pro-phe-p-nitroanilide in the presence of aprotinin and tosyl-L-gly-pro-lys-p-nitroanilide in the presence of soybean trypsin inhibitor, respectively) assays. The minor presence of chymase activity in lung could be accounted for by the minor presence of lung TC mast cells. Extracts of TC mast cells, the predominant mast cell type (1% T and 99% TC mast cells) in foreskin, contained both proteases. However, TC mast cells from adult foreskin contained eightfold to 10-fold higher levels of chymase (4.5 micrograms and 1.01 U/10(6) mast cells) and twofold to threefold higher levels of tryptase (11.5 micrograms and 0.27 U/10(6) mast cells) than did TC mast cells from newborn foreskin (less than 0.6 microgram and 0.09 U of chymase and 35 micrograms and 0.62 U of tryptase/10(6) mast cells). In contrast, histamine levels were not significantly different in adult foreskin TC (1.9 microgram/10(6) mast cells), newborn foreskin TC (1.6 microgram/10(6) mast cells), and adult lung T (1.5 microgram/10(6) mast cells) mast cells. The relative ratio of each mediator in newborn foreskin mast cells to that in adult foreskin mast cells is highest for histamine, followed by tryptase and then chymase. Tryptase from TC and T mast cells had identical subunit compositions by Western blot analysis and similar apparent specific activities. This study extends the previously reported immunohistochemical distinction between human T and TC mast cells in tissue sections by direct quantitation of chymase and tryptase in dispersed preparations of T and TC mast cells. PMID- 3549904 TI - Expression of hemopoietic histocompatibility antigens on H-2-loss variants of F1 hybrid lymphoma cells: evidence consistent with trans gene regulation. AB - H-2 heterozygous marrow stem cells, lymphoid progenitor cells, and leukemia/lymphoma cells do not express hemopoietic or hybrid histocompatibility (Hh) antigens, which are important transplantation antigens recognized during the rejection of normal or neoplastic hemopoietic cells. The Hh-1b determinant of the H-2b haplotype maps to the D region of H-2. We have tested the hypothesis that gene(s) at or near H-2D of the H-2d haplotype down-regulate the expression of Hh 1b in the trans configuration. We used Abelson leukemia virus-transformed pre-B lymphoma cells (ACCb) of BALB/c X BALB.B (H-2d X H-2b) origin, as well as variant lines of ACCb, which were selected for resistance to monoclonal anti-H-2 antibodies plus complement. B6D2F1 (H-2b X H-2d), C3B6F1 (H-2k X H-2b), or B6 (H 2b) mice were infused with inocula of 5 X 10(6) B6 bone marrow cells (BMC). Proliferation of donor-derived marrow cells was judged in terms of DNA synthesis by measuring the splenic incorporation of 5-iodo(125I)-2'-deoxyuridine (IUdR) 5 days after cell transfer. B6 BMC grew much better in B6 than in F1 hybrid host mice, an expression of "hybrid resistance". As observed previously, the injection of EL-4 (H-2b, Hh-1b) tumor cells prior to infusion of B6 (H-2b, Hh-1b) BMC enhanced the growth of B6 BMC in F1 hybrid mice. Therefore, this in vivo "cold target cell competition" type of assay can be used to detect the expression of Hh 1b antigens. Unlike EL-4 (H-2b) cells, hybrid resistance was not affected by prior infusion of (H-2b X H-2d) heterozygous ACCb cells. In contrast, three ACCb variant cell lines, H-2d-, Ld-Dd-, and Dd-, enhanced the growth of B6 BMC in F1 hosts. The ACCb H-2b- cell line did not affect hybrid resistance to B6 BMC. The loss of gene expression on the H-2d chromosome at or very near the H-2Dd locus is correlated with the appearance Hh-1b, as determined by the in vivo cold target competition assay. These results support the hypothesis that heterozygous cells possess trans-acting, dominant, down-regulatory genes mapping near H-2D that control the Hh-1 phenotype of lymphoid tumor cells. PMID- 3549905 TI - Re: Ultrastructural differences between Leu-7+,11- NK cells and Leu-11+ NK cells. PMID- 3549906 TI - Antibody chimera technique applied to the detection of Escherichia coli heat labile enterotoxin. AB - Covalently prepared chimera antibodies were tested in a ganglioside GM1 erythro immunoassay (CERIA) for E. coli heat-labile enterotoxin (LT) detection. The antibody specific for LT was conjugated with a polyclonal antibody specific for sheep erythrocytes. The assay is based on the specific binding of LT to polystyrene-adsorbed GM1 and subsequent erythro-adsorption via chimera antibody by which the bound toxin is visualized. Enterotoxin titers determined with this CERIA method were similar to those obtained with the Vero cell assay and with ELISA. 5 ng of cholera toxin/ml may be detected with the assay. The CERIA, as described, may be used either qualitatively or quantitatively and is well suited for routine laboratory diagnosis of LT in a culture supernatant of E. coli. PMID- 3549907 TI - Inguinal hernia repair using vas deferens. PMID- 3549908 TI - Maternal immunoglobulin allotype (Gm and Km) and neonatal group B streptococcal infection. AB - Gm and Km(1) allotypes in 37 mothers of neonates with severe Group B streptococcal (GBS) infection were compared with 115 mothers of non-infected infants, 36 of whom were known to be colonized with GBS. Deficits in G1m(1) and Km(1), and an increased incidence of G2m(23), were found in mothers of infected infants. Km(1) was associated mainly with the phenotype Gm(1, (2), 3, 17; 23; 5, 10, 11, 21) in mothers of infected infants while being uniformly distributed in mothers of non-infected infants. This study would seem, therefore, to support reports of Gm and Km(1) allotype involvement in maternal response to GBS infection and immunity in the new-born. PMID- 3549909 TI - The value of Rowatinex in the treatment of ureterolithiasis. AB - A randomized, double-blind study was carried out on forty patients with acute renal colic in order to evaluate the efficacy of Rowatinex in the treatment of patients with ureteric stones. Patients were randomized to Rowatinex and placebo tablets. In the Rowatinex-treated patients there was a significantly higher rate of expulsion of stones which were greater than or equal to 3 mm in diameter when compared with the placebo group (61% vs. 28%, respectively). A higher success rate (spontaneous stone expulsion and/or disappearance of dilatation of the collecting system on IVU) was noted in the Rowatinex group when compared to the placebo group (78% vs. 52%, respectively), although this was not statistically significant. No significant side effects were noted during the treatment with Rowatinex. PMID- 3549910 TI - Analysis of Biomphalaria glabrata (Gastopoda) hemolymph by sodium dodecyl sulfate polyacrylamide gel electrophoresis, high-performance liquid chromatography, and immunoblotting. PMID- 3549911 TI - Small nonoccluded viruses from triatomine bug Triatoma infestans (Hemiptera: Reduviidae). PMID- 3549912 TI - In vitro studies in nickel allergy: diagnostic value of a dual parameter analysis. AB - A comparison was made between the diagnostic value of assaying nickel-induced lymphocyte proliferation (lymphocyte transformation test, LTT) and migration inhibition factor (MIF) production in nickel contact sensitivity. Although lymphocyte proliferation was significantly increased in the group of patients with skin test reactivity to nickel, positive LTT were also frequently found in skin test-negative subjects: in 63% of subjects with and in 30% of subjects without a history of metal allergy. This would limit the value of the LTT as an in vitro correlate of skin test reactivity. However, in certain patients positive lymphocyte transformation may reveal nickel sensitization at a time of undetectable skin reactivity. Data obtained with the macrophage migration inhibition test (MMIT) showed a good correlation with nickel patch test reactions. Accurate determination of MIF became feasible by using cells from the human monocytoid cell line U937 as target cells in a microdroplet agarose assay. Using this MMIT, positive reactions occurred in 13% of the healthy controls and false-negative reactions were found in 26% of patients with positive skin test reactivity to nickel. As LTT and MMIT data appeared to be only weakly correlated in the individuals tested, a dual parameter analysis was performed. An excellent correlation [p = 1.8 (10(-8]] was found between skin test and in vitro reactivity for individuals with matching in vitro results (60% of all individuals tested). In those individuals with discordant in vitro data, skin testing will remain indispensable for diagnosing nickel allergy. PMID- 3549913 TI - Prolongation of murine skin allograft survival by the systemic effects of 8 methoxypsoralen and long-wave ultraviolet radiation (PUVA). AB - Systemic administration of the photoactive drug 8-methoxypsoralen to a group of mice bearing cutaneous allografts, followed by exposure to long-wave ultraviolet radiation (UVA, 320-400 nm) (PUVA) daily for 14 days at a site distant from the allograft, significantly increased the survival time of the allografts. This effect was seen both in donor-recipient combinations that differ at the major histocompatibility complex and in those differing only at minor histocompatibility loci. Treatment with 8-methoxypsoralen or long-wave UV radiation alone was ineffective in prolonging allograft survival, as were doses of mid-wave UV radiation (UVB, 280-320 nm) that produced greater inflammation than the PUVA protocol. Allografted, PUVA-treated animals also demonstrated decreased alloantigen reactivity against donor-strain spleen cells during the period of treatment by cytotoxicity assays. Allografts of skin in the murine system are highly immunogenic and are generally rejected faster than organ allografts; thus PUVA treatment appears to exert a potent effect on prolonging allograft survival. The systemic nature of the effect and the fact that adverse side effects from PUVA are largely limited to the skin suggest that PUVA might have a role in clinical organ transplantation management. PMID- 3549914 TI - Receptor-mediated clearance of Aspergillus galactomannan. AB - The fate of radiolabeled Aspergillus fumigatus galactomannan was studied after intravenous injection into rabbits and rats. At 1 hr, the liver contained 35% of the injected dose in rabbits and 30% in rats. Excretion of galactomannan into the urine, measured in rabbits, was another major catabolic route and accounted for 35% of the dose by 24 hr. Immunization of rabbits increased hepatic uptake and decreased urinary excretion. Hepatic uptake in unimmunized rats could be decreased by Saccharomyces cerevisiae mannan, alpha-methyl mannoside, and N acetylglucosamine, known inhibitors of the macrophage mannose receptor. Autoradiography showed hepatic radiolabeled galactomannan to be concentrated in Kupffer cells, which express the mannosyl receptor for glycoproteins. Macrophage mannosyl receptors may constitute a general mechanism for clearing fungal mannans from the bloodstream. PMID- 3549915 TI - Stimulation of T lymphocyte-dependent differentiation of activated human B lymphocytes by Plasmodium falciparum supernatants. PMID- 3549916 TI - Continuous-infusion quinidine gluconate for treating children with severe Plasmodium falciparum malaria. PMID- 3549917 TI - Comparative, randomized trial of one-day doxycycline versus 10-day tetracycline therapy for Mediterranean spotted fever. PMID- 3549918 TI - Local and systemic antibody responses to Shigella infection in rhesus monkeys. PMID- 3549919 TI - Rapid diagnosis of Chlamydia trachomatis rectal infection by direct immunofluorescence staining. PMID- 3549920 TI - Immunochemical specificity of cross-reactive antibodies to lipopolysaccharide from Escherichia coli J5. PMID- 3549921 TI - Susceptibility to experimental Candida albicans urinary tract infection in the rat. AB - The urinary tract is resistant to ascending infection due to Candida albicans. Host and microbial factors that may alter such resistance were evaluated in the rat after inoculating C. albicans into the urinary tract. Diuresis, diabetes, candidal germ-tube formation, and vaginal Candida colonization (alone or in concert) failed to promote ascending urinary tract infection with two vaginal isolates of C. albicans capable of producing renal infection by the hematogenous route. Both germinated and ungerminated Candida adhered poorly to bladder mucosa. Unlike prior urinary tract infection due to an enterococcus that failed to agglutinate Candida in vitro, prior urinary tract infection with a mannose binding strain of Escherichia coli that agglutinated C. albicans in vitro enhanced adherence of C. albicans to bladder mucosa and increased susceptibility to ascending C. albicans urinary tract infection. Thus, resistance to Candida ascending urinary tract infection is likely to be due to poor adherence of C. albicans to normal bladder mucosa. PMID- 3549922 TI - Emergence of resistance to ceftazidime during therapy for Enterobacter cloacae infections. AB - The mechanism of resistance to ceftazidime in two clinical isolates of Enterobacter cloacae that emerged during therapy with broad-spectrum beta-lactam antibiotics was studied. Both isolates acquired broad resistance to advanced spectrum beta-lactam drugs other than imipenem. Biotyping confirmed strain identity in both cases, and no new plasmids were detected in the resistant isolates. Both resistant isolates produced beta-lactamase constitutively. Slow but definite hydrolysis of ceftazidime was demonstrated by using purified beta lactamase in a spectrophotometric assay. Further evidence that beta-lactamase is responsible for resistance in these organisms was provided by the demonstration that cefoxitin, a potent inducer of beta-lactamase, antagonized the activity of ceftazidime against these isolates. This antagonism could be prevented by inhibition of derepression of beta-lactamase with clindamycin. Clindamycin also prevented regrowth of ceftazidime-treated cells in time-kill studies and markedly reduced production of beta-lactamase in induced cultures at concentrations as low as 2 micrograms/ml. PMID- 3549923 TI - Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. AB - To evaluate the antisecretory activity of berberine sulfate (BS), we studied 165 adult patients with acute diarrhea due to enterotoxigenic Escherichia coli (ETEC) and Vibrio cholerae in randomized controlled trials. In patients with ETEC diarrhea who received 400 mg of BS in a single oral dose, the mean stool volumes were significantly less than those of the controls during three consecutive 8-hr periods after treatment (P less than .05). At 24 hr after treatment, significantly more patients who were treated with BS and had ETEC diarrhea stopped having diarrhea as compared with the controls (42% vs 20%, P less than .05). In patients with cholera who received 400 mg of BS, the mean 8-hr stool volume during the second 8-hr period after treatment declined to 2.22 liters, which was significantly less than the 2.79 liters found in the controls (P less than .05). However, patients with cholera who received 1200 mg of BS plus tetracycline did not have significant reduction in stool output compared with patients who received tetracycline alone. No side effects of BS were noted. These results indicated that BS is an effective and safe antisecretory drug for ETEC diarrhea, whereas the activity against cholera is slight and not additive with tetracycline. PMID- 3549925 TI - The efficacy of Rochette bridges. PMID- 3549924 TI - Search for improved culture conditions for clonogenic growth of human colorectal cancer cells in vitro. AB - In order to analyze and define potentially better growth conditions for colonic stem cell proliferation, we chose four established human colorectal cancer cell lines that differed in biologic cell properties. We studied variables of standard cloning conditions including culture medium, serum supplement, solidifying agent, addition of specific growth factors and use of capillaries as an alternative culture vessel. While modulation of serum concentration as well as use of various standard formulations of culture base media did not result in a reproducible increase of plating efficiencies (PEs), a significant increase in colony formation (when compared to the conventional assay procedure) was achieved; by use of 0.3% agarose or boiled agar as semisolid matrix and by culturing of cells in enriched 'GMF medium'. Specific growth factors, such as EGF or glucagon resulted in "occasionally better" in vitro growth. This suggests a retention of the ability of cells in culture to respond to physiologic regulators of growth. To verify and extend these initial results obtained with continuous cell lines, growth enhancing modifications of the original cloning technique were subsequently applied to in vitro growth of 15 human colorectal cancer specimens obtained directly from patients. Specimens that grew 30 or more colonies under standard plating conditions displayed a more than two-fold increase in PEs which was reproducible for the two specific variables mentioned above, but the overall success rate of the assay could not be improved. In addition to the possibility that several deficient basic requirements for achieving optimal environmental conditions for colonic stem cell growth have not been defined, we believe a major reason for failing to improve the number of drug-assayable specimens is related to an inherent interneoplastic diversity in terms of growth requirements of human colorectal malignancies. PMID- 3549926 TI - A review of current local anaesthetic techniques in dentistry for children. PMID- 3549927 TI - Auxiliary retention of an overdenture. PMID- 3549928 TI - [Prolonged preservation of canine hearts followed by orthotopic heart transplantation]. PMID- 3549929 TI - [Effects of glucose-insulin-potassium administration on the carbohydrate metabolism during open heart surgery]. PMID- 3549930 TI - [A case of rhabdomyosarcoma--immunohistochemical study]. PMID- 3549931 TI - Historical aspects on the development of angiology in Germany. AB - Clinical angiology is mainly concerned with vessels and disorders of circulation which can be detected and appraised with clinical methods. The arteries and veins of the limbs as well as the major extracranial arteries supplying the brain are primarily involved. The consequences of a peripheral arterial disease were initially recognized as being due to disorders of blood flow only in their most severe forms. A certain correlation of organic arterial alterations with the clinical finding was first made possible by angiography. Initially, both surgeons and internists directed their attention to this new field. However, since only surgery could offer therapeutic measures promising success, angiology could not become established in internal medicine. Deviating from this general development, Ratschow in Germany and in German-speaking countries and regions was able to create the precondition for an internal medical angiology and to attract the clinical and scientific interest of young internists in this field. The development of modern angiology, which began in the 1950s with the introduction of reconstructive arterial operations hence encountered surgical and internal medical activities in German-speaking countries. In parallel with the improvement in the methods of surgery, the internist angiologists developed thrombolysis and catheter recanalization (angioplasty) into efficient methods of treatment. In addition, the purely conservative techniques of therapy (training, vasoactive substances, rheological methods, medical prophylaxis) as well as noninvasive diagnostics were improved. The ideal concept which is aspired to at present and which has already been put into practice in many places consists in constructive collaboration of internal medical angiology and reconstructive vascular surgery, if possible with the assistance of vessel-oriented radiology. PMID- 3549932 TI - Robert May memorial lecture: Advances in reconstructive venous surgery. AB - During the last decade progress in reconstructive venous surgery is mainly based on improvements of preoperative diagnosis and on changed surgical techniques (e.g. intraoperative lumen control by vascular endoscopy or angiography; temporary arteriovenous fistulas as protective measure; external supported vascular prostheses as substitutes). The main indications include acute ilio femoral phlebothrombosis, vein injuries and in selected cases the substitution of big veins in extended tumor surgery. The late results of venous thrombectomy in the ilio-femoral segment could be remarkably improved due to changed techniques of lumen restoration (combined ring- and balloon-disobliteration, temporary a.v. fistula in inguinal or popliteal position). In patients with persisting central occlusions in the iliac veins a second repair may be considered using a suprainguinal cross-over graft (external supported e-PTFE-prosthesis). For post thrombotic syndrome with pronounced deep venous insufficiency reconstructive procedures afford a critical selection of patients (Palma-operation, Husni-May operation, interposition of valve bearing venous segments in the superficial femoral vein). The remarkable contribution given by R. May to the advances in venous surgery is illustrated. PMID- 3549934 TI - Ultrasonographic measurements of fetal and neonatal adrenal glands. PMID- 3549933 TI - [Clinico-pathological study of choriocarcinoma localized in the lung with emphasis on hCG monitoring systems]. AB - We studied 15 cases of lung choriocarcinoma clinico-pathologically with emphasis on hCG monitoring systems. The results are as follows: Vivid tumor cells (VTC) were found to persist in 83.3% (5/6) of cases with a continued "LH level" of urinary hCG over 4 weeks. VTC were found to persist in all 4 cases with cellular response and in 6 of 8 cases with no cellular response. The syncytial cell element was observed in 75% (3/4) of cases with cellular response, but in only 25% (2/8) of cases with no cellular response. VTC were recognized in 83.3% of cases (5/6) with serum beta-hCG higher than the sensitivity of the beta-hCG-RIA system (0.2 ng/ml or 1.5 miu/ml). Even though serum beta-hCG was lower than 0.2 ng/ml or 1.5 miu/ml, VTC were found to persist in 2 of 3 cases. All of 5 cases with beta-hCG-CTP higher than the sensitivity of beta-hCG-CTP-EIA (Enzyme-Immuno Assay) system (0.2 miu/ml) showed VTC in operative specimens. These results indicate that beta-hCG-CTP-EIA is a most useful means to employ in the monitoring of serum hCG. PMID- 3549935 TI - [Prenatal diagnosis by X-ray radiography]. PMID- 3549936 TI - [Prenatal diagnosis by ultrasound]. PMID- 3549937 TI - Early tractata on leprosy. PMID- 3549938 TI - In vitro proliferation of lymphocytes from human volunteers vaccinated with armadillo-derived, killed M. leprae. AB - A killed, armadillo-derived Mycobacterium leprae vaccine was examined for its ability to induce cell-mediated responsiveness in purified protein derivative (PPD)-positive volunteers residing in a nonendemic country using the lymphocyte transformation test (LTT). A marked increase in the proliferative responses to a M. leprae-soluble antigen preparation was observed in the two groups which were vaccinated with the highest doses of the vaccine, i.e., 1.5 X 10(8) and 5 X 10(8) bacilli. This increase was observed in both groups 3 months after vaccination, and persisted for the study period of 1 year. The in vitro proliferative responses to whole bacilli, of both armadillo and human origin, showed a similar but smaller increase 3 months after vaccination. Some enhancement of responses to cross-reactive antigens, such as PPD, and to unrelated antigens such as streptokinase-streptodornase, tetanus toxoid and diphtheria toxoid, was also observed. Thus, the LTT revealed that while the killed M. leprae vaccine induced a specific cell-mediated response to M. leprae, it was also responsible for a nonspecific immune-enhancement effect in healthy volunteers. PMID- 3549939 TI - Enhanced cell-mediated immune responses in erythema nodosum leprosum reactions of leprosy. AB - Cell-mediated immune (CMI) responses were measured in 39 lepromatous, 44 erythema nodosum leprosum (ENL), and 22 post-ENL patients. The leukocyte migration inhibition test was used to measure CMI responses to mitogen phytohemagglutinin-P (PHA), crossreacting antigen purified protein derivative (PPD) of tuberculin, and armadillo-derived whole and sonicate Mycobacterium leprae. "Early T" lymphocytes of the peripheral blood were also enumerated using the rosetting technique. Significantly enhanced immune responses (lower migratory indices) were found to whole M. leprae during ENL. Although responses were high with PHA and PPD, they were identical in all of the groups, indicating that during ENL reaction M. leprae-specific responses are enhanced. "Early T" lymphocytes also showed a significant increase in ENL reactions compared to lepromatous patients. However, there was no response to the leprolin skin test in ENL patients in contrast to the enhanced in vitro CMI responses. PMID- 3549940 TI - Activities of pefloxacin and ciprofloxacin against Mycobacterium leprae in the mouse. AB - Because ciprofloxacin and pefloxacin are fluoroquinolones active against many mycobacterial species, both drugs were tested against Mycobacterium leprae in the mouse foot-pad system. Preliminary pharmacokinetic studies in the mouse showed that after a single oral dose of 150 mg/kg ciprofloxacin the peak serum concentration was 3.6 micrograms/ml, and after 50 mg/kg or 150 mg/kg pefloxacin peak serum concentrations were, respectively, 9.2 micrograms/ml and 16.9 micrograms/ml, the half-lives for serum elimination being about 2 hr for both drugs. The activity of daily 50 mg/kg and 150 mg/kg ciprofloxacin and pefloxacin against M. leprae was then tested in mice infected with 5 X 10(3) M. leprae. The growth of M. leprae was not prevented in mice treated continuously with either 50 mg/kg or 150 mg/kg ciprofloxacin, indicating that this drug had no or a limited bacteriostatic effect at the dosages used. In mice treated continuously with 50 mg/kg pefloxacin, growth of M. leprae was not prevented, but at monthly harvests the number of bacilli in the foot pads remained less than those of control mice (p less than 0.05). No growth of M. leprae occurred in mice treated continuously with 150 mg/kg pefloxacin. In mice treated for only 3 months with daily 150 mg/kg pefloxacin, the growth-delay that followed the stopping of the drug was 126 days, suggesting that approximately 99% of the M. leprae were killed. The pharmacokinetics of pefloxacin being more favorable in man than in the mouse, pefloxacin appears a possible drug for the chemotherapy of leprosy. PMID- 3549941 TI - Further studies of the killing of M. leprae by aminoglycosides: reduced dosage and frequency of administration. AB - The bactericidal activity of the aminoglycoside antibiotics streptomycin and kanamycin for Mycobacterium leprae in mice was assessed, both alone and in combination with rifampin, utilizing various dosage schedules. As in previous studies, 100 mg/kg five times weekly of streptomycin and kanamycin resulted, respectively, in 96% +/- 2% and 89% +/- 6% bactericide. Reducing the dosage of streptomycin to 50 mg/kg, 25 mg/kg, and even 12.5 mg/kg resulted in less but significant bactericidal activity. Such a reduction of kanamycin dosage resulted in no significant bactericidal activity. Reducing the frequency of administration of streptomycin (100 mg/kg) to twice weekly and once weekly resulted in a decreased but still significant killing of M. leprae; for kanamycin such a reduction in frequency of administration resulted in loss of bactericidal activity. Streptomycin when combined with rifampin was found more bactericidal than either drug alone, even when each was administered only once monthly. PMID- 3549942 TI - Events surrounding the recognition of Mycobacterium leprae in nerves. AB - Histological examination and immunocytochemistry of Schwann cells, macrophages, and mycobacterial antigen were used to study 48 nerves of untreated patients with leprosy. None of the patients was in reaction clinically, but microreactions, involving small clusters of Schwann cells and macrophages in all cases except LL, were marked by progressive degradation of acid-fast bacilli (AFB). This was thought to be the response to the recognition of mycobacterial antigen. In the first phase, the disintegration of one or more Schwann cells caused the release of AFB, accompanied by subacute inflammation. In the second phase, as edema and cellular infiltration subsided, the necrosis of Schwann cells was replaced by granuloma formation, mycobacterial antigen being in a soluble form. Myelinated cells harbored few degraded AFB, and there was evidence that antigen-associated myelin hastened the death of Schwann cells. Only then did antigen become immunologically detectable to induce an inflammatory response whose clearance and resolution was impeded by the restraint on cellular movement due to the structure of neural tissue. These developments were sporadic but continuous. AFB and antigen released by disintegrating Schwann cells were ingested by regenerating Schwann cells and by macrophages, producing a self-perpetuating cycle which might involve either small areas or the greater part of a fascicle, and could conceivably progress to a generalized reaction. PMID- 3549943 TI - [Tooth stain removal (IV)]. PMID- 3549944 TI - [Clinical evaluation of Odontoson 4N Special]. PMID- 3549945 TI - [Interleukin 1 in periodontitis]. PMID- 3549946 TI - [Prostaglandins]. PMID- 3549948 TI - Information processing and educational microcomputer technology: where do we go from here? PMID- 3549947 TI - Specialization of the cerebral hemispheres: implications for learning. PMID- 3549949 TI - Information processing theory and learning disabilities: a commentary and future perspective. PMID- 3549950 TI - A new monoclonal antibody, TRPM-3, binds specifically to certain rat macrophage populations: immunohistochemical and immunoelectron microscopic analysis. AB - An anti-macrophage monoclonal antibody designated TRPM-3 was produced using thioglycollate-elicited rat peritoneal macrophages as immunogen. By the immunoperoxidase method, TRPM-3 was found to be specific for certain macrophage populations, such as marginal zone macrophages and marginal metallophils of the spleen, sinus macrophages of the lymph nodes, and omentum macrophages. No epithelial cells, peripheral blood monocytes, granulocytes, or lymphocytes had reacted with TRPM-3. Immunoelectron microscopically, reaction to TRPM-3 was clearly demonstrated on the plasma membrane of splenic marginal zone macrophages, lymphatic sinus macrophages, omentum macrophages, and peritoneal macrophages. Accordingly, TRPM-3 was considered to have recognized the particular membrane antigen expressed by restricted macrophage populations. PMID- 3549951 TI - Monokines mediate decreased hepatic glucocorticoid binding in endotoxemia. AB - The purpose of this study was to determine whether endotoxin decreased hepatic glucocorticoid binding by the action of mediator(s). Steroid binding in liver cytosol, plasma glucose levels, and plasma corticosterone levels were assayed in C3HeB/FeJ LPS normoresponsive and C3H/HeJ LPS hyporesponsive mice. In C3HeB/FeJ mice, endotoxin significantly depressed the maximum number of steroid binding sites (Bmax) to 30% of control. Plasma glucose levels were decreased to 50% of control, and plasma corticosterone levels increased 4-fold. No changes in these parameters were seen in C3H/HeJ mice given endotoxin, except for decreased plasma glucose levels at the highest dose of endotoxin. Decreased steroid binding was observed in C3H/HeJ mice 4-6 hours after receiving C3HeB/FeJ peritoneal exudate cells (elicited with thioglycolate) and endotoxin. No change in steroid binding was observed in C3H/HeJ mice that received C3H/HeJ peritoneal exudate cells and endotoxin. Mediator-rich plasma was produced in CF-1 mice by infecting them with 1 X 10(7) BCG and by challenging them with endotoxin (2 micrograms) 2 weeks later for 2 h. Transfer of BCG-endotoxin plasma to C3H/HeJ mice also resulted in decreased steroid binding and plasma glucose. These results indicate that perturbation of glucocorticoid action during endotoxin shock is mediated by soluble factor(s) other than endotoxin. A likely source of mediator(s) is the mononuclear phagocyte. PMID- 3549952 TI - Application of osmometric methods to the study of lipids, lipoproteins, and apolipoproteins. AB - Membrane and vapor pressure osmometry are two colligative methods that can be useful in lipid research. The former method can be used to study proteins or other macromolecules whose molecular weight lies between 20,000 to 1,000,000. Vapor pressure osmometry is useful with smaller molecules having a molecular weight of 10,000 or less. These techniques can be used in aqueous or nonaqueous solutions. They are rapid, precise, nondestructive, and require relatively small amounts of material. These techniques provide information about the state of aggregation and also about interactions of lipids, lipoproteins, and apolipoproteins in solution. We will show how membrane osmometry can be used to study solutions of lipoproteins and apolipoproteins. The application of vapor pressure osmometry to the study of biologically important lipids such as cholesterol, cholesteryl esters, and bile salts is shown. PMID- 3549953 TI - Role of insulin in regulation of high density lipoprotein metabolism. AB - The effect of alloxan-induced insulin deficiency on high density lipoprotein (HDL) metabolism was studied in rabbits. Rabbits with alloxan-induced diabetes had significantly higher (P less than 0.001, mean +/- SEM) plasma concentrations of glucose (541 +/- 13 vs. 130 +/- 2 mg/dl), triglyceride (2851 +/- 332 vs. 101 +/- 10 mg/dl), and total plasma cholesterol (228 +/- 55 vs. 42 +/- 4 mg/dl) than did normal control rabbits. However, diabetic rabbits had lower plasma HDL cholesterol (7.2 +/- 1 vs. 51.3 +/- 1.3 mg/dl, P less than 0.001) and HDL apoA-I (38.3 +/- 6.0 vs. 87.2 +/- 4.3 mg/dl, P less than 0.001) concentrations. HDL kinetics were compared in diabetic and normal rabbits, using either 125I-labeled HDL or HDL labeled with 125I-labeled apoA-I, and it was demonstrated that HDL fractional catabolic rate (FCR) was slower and residence time was longer in the diabetic rabbits when either tracer was used. The slow FCR and the low apoA-I pool size led to reduced apoA-I/HDL synthetic rate in diabetic rabbits (0.97 +/- 0.11 vs. 0.34 +/- 0.07 mg per kg per hr). Thus, the reduced plasma HDL cholesterol concentrations seen in rabbits with alloxan-induced insulin deficiency was associated with a lower total apoA-I/HDL synthetic rate. Since insulin treatment restored to normal all of the changes in plasma lipoprotein concentration and kinetics seen in diabetic rabbits, it is unlikely that the phenomena observed were secondary to a nonspecific toxic effect of alloxan. These data strongly support the view that insulin plays an important role in regulation of HDL metabolism. PMID- 3549955 TI - [Molecular defects of coagulation factors and of the fibrinolytic system associated with thromboembolism]. AB - Some molecular defects of components of the coagulation or fibrinolytic system are associated with thromboembolism. One possibility is that physiologic inhibitors of the coagulation system have an abnormal function e.g. protein C, protein S, antithrombin III and cofactor II of heparin. Also a hindered activation of the fibrinolytic system may predispose to thrombosis; the impaired activation may be due to deficient synthesis and/or release of tissue-plasminogen activator, an increased level of its inhibitor or a functional defect of the plasminogen molecule. A few cases of congenital dysfibrinogenemia have been described in which the functional defects of the molecule are held responsible for recurrent thrombosis. An acquired thrombotic disorder is due to the presence of immunoglobulins which prolongs phospholipid-dependent coagulation by binding to epitopes of some phospholipids. This so-called lupus anticoagulant was originally described in patients with systemic lupus erythematosus but is a misnomer as it is more frequently encountered in patients without lupus. PMID- 3549954 TI - A dot-blot assay for the low density lipoprotein receptor. AB - We describe a new method for detecting the interaction of low density lipoprotein with its receptor using unmodified nitrocellulose as support for membrane protein. The method is specific and sensitive down to 3 micrograms of membrane protein. Unlabeled LDL, but not HDL, competes with 125I-labeled LDL for binding, and binding is abolished by pretreatment of the membranes with pronase and is dependent upon the presence of Ca2+. Furthermore, modification of arginine or lysine residues on LDL abolishes the lipoprotein interaction with the receptor protein supported on the nitrocellulose. When the membranes are solubilized with octyl glucoside, purification steps of the receptor can be directly followed with no interference of the detergent, therefore eliminating the need for its removal. The increased expression of LDL receptors on liver membranes from estradiol treated rats was also demonstrated. We suggest, therefore, that this method can be used to detect the presence of LDL receptors on minute amounts of membrane protein. PMID- 3549956 TI - Production and metabolic clearance of angiotensinogen in conscious rats as measured by steady-state isotope dilution. AB - Previous studies on the hormonal regulation of hepatic angiotensinogen relied on in-vitro liver preparations and on the measurement of changes in plasma concentration. In this study 125I-labelled angiotensinogen was used to measure simultaneously the production rate (PR) and metabolic clearance rate (MCR) in conscious rats by the constant-rate infusion and single-injection methods. Male rats received daily s.c. injections of isotonic saline (as control), 1 mg corticosterone acetate (CA), 25 micrograms 17 beta-oestradiol benzoate (OB) or 20 micrograms thyroxine (T4) per 100 g body weight. On day 7 of treatment 125I labelled angiotensinogen was infused into a jugular vein at a rate of 1 microliter/h by osmotic minipumps and blood samples taken 4, 5 and 6 days later. The PR of angiotensinogen increased from 576 +/- 28 (S.E.M.; n = 9) to 954 +/- 63 (n = 9), 1010 +/- 84 (n = 9) and 2359 +/- 150 (n = 10) micrograms/h per kg following treatment with CA, OB and T4 respectively. In contrast, the PR of rat albumin did not change significantly from 218 +/- 8 (n = 7) mg/h per kg. All three hormones increased MCR from 13 +/- 1 (n = 17) ml/h per kg to 17 +/- 1 (n = 9), 18 +/- 2 (n = 9) and 27 +/- 2 (n = 9) ml/h per kg for CA, OB and T4 respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549957 TI - Inhibition of first ovulation: administration of an LHRH antagonist to immature female rats. AB - Subcutaneous injections of an LHRH antagonist (ALHRH; Org.30093) were administered to immature female rats. Neither a single high dose (50 micrograms) nor repeated daily doses of 5-30 micrograms ALHRH/day, administered between 28 and 38 days of age, influenced the age and body weight at the time of vaginal opening or first ovulation. If repeated daily doses of 2 X 10 micrograms ALHRH were given from 32 to 42 or from 37 to 47 days of age, first ovulation was delayed by 3.0 and 6.3 days respectively. Administration of 10 micrograms ALHRH at 09.00 h and again at 17.00 h on the day of first pro-oestrus was found to be sufficient to block the expected first ovulation in 36 out of 38 rats. This effect could be repeated by administering the same doses of ALHRH at pro-oestrus and again on the next day: ovulation was blocked in eight out of eight rats. A single dose of 10 micrograms ALHRH, administered on the morning of pro-oestrus, blocked ovulation in five out of twelve rats. Both the preovulatory LH and FSH surge, as measured at 16.00 h on pro-oestrus, were found to be inhibited by ALHRH treatment. On the day after pro-oestrus no recruitment of new small antral follicles had occurred in rats with ovulatory blockade. Delayed ovulation took place 2-5 days after ALHRH injection at pro-oestrus; until 3 days after injection rats were able to ovulate their original preovulatory follicles, thereafter newly developed follicles ovulated and large ovarian cysts were found in the ovaries, next to fresh corpora lutea.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549958 TI - The renin-angiotensinogen reaction during pregnancy and oral contraception: estimation of kinetic parameters by an autologous plasma renin assay. AB - A method has been developed which allows estimation of the kinetic parameters of the plasma renin-angiotensinogen reaction from data obtained by autologous renin assays at several plasma dilutions. The quantitative aspects of the renin angiotensin system were examined in 28 plasma samples from 23 healthy, normotensive pregnant women. They were compared with 20 women who were not pregnant, of whom 12 were taking oral contraceptives and eight were not. In the first 3 months of pregnancy, there was a sharp increase in plasma renin activity and concentration. Plasma angiotensinogen rose steadily throughout pregnancy. The higher concentrations of renin and angiotensinogen would lead to an increase in angiotensin formation with potentially adverse consequences. However, this increase may be reduced by the fall in the affinity between renin and angiotensinogen which is suggested by the present observation that the Michaelis Menten constant (Km) attained values five to six times higher than those seen in women not taking oral contraceptives. The smaller increases in plasma renin and angiotensinogen induced by oral contraceptives were less effectively compensated by lower affinity. Circumstantial evidence is provided which suggests that the observed high Km values may be due to oestrogen/pregnancy-induced synthesis of an angiotensinogen with a lower affinity for renin. PMID- 3549959 TI - Expression in yeast of a Plasmodium vivax antigen of potential use in a human malaria vaccine. AB - DNA coding for 234 amino acids of the circumsporozoite (CS) protein of Plasmodium vivax was incorporated into yeast expression vectors. The DNA encoded all the repeat domain and codons for a highly conserved sequence, KLKQP, found in CS proteins from all malaria parasites. Yeast cells transformed with these autonomously replicating plasmids expressed, upon induction, high levels of the CS polypeptide. The malaria antigen was purified in good yields from yeast extracts and was injected into mice using alum as adjuvant. The antibodies recognized the authentic CS protein, and at high dilutions, they inhibited the invasion of hepatocytes by sporozoites in vitro. PMID- 3549960 TI - Elevated myc expression and c-myc amplification in spontaneously occurring B lymphoid cell lines. AB - Recently, a minor subpopulation of murine B lymphocytes, Ly-1+ B cells, has been distinguished by its unique ontogeny, tissue distribution, and prominence in certain autoimmune and neoplastic B cell diseases. We have previously described a simple murine spleen culture system that results in the spontaneous and exclusive outgrowth of long-term Ly-1+ B cell lines (B Ly-1 cells). Here, we report that the immortal growth property of B Ly-1 cells correlates with a 10-45-fold elevation of steady-state myc RNA and 2-10-fold amplification of the c-myc locus. While c-myc amplification has been observed in malignant cell lines derived from several tissues of origin, its occurrence in lymphoid cells has not been previously reported. The consistent c-myc amplification in B Ly-1 cells may reflect a unique state of this locus in the Ly-1+ B lymphocyte lineage, and contribute to the spontaneous immortalization of this B cell population in vitro, and its apparent predilection for malignant transformation in vivo. PMID- 3549961 TI - Rejection of bone marrow allografts by mice with severe combined immune deficiency (SCID). Evidence that natural killer cells can mediate the specificity of marrow graft rejection. AB - C.B-17 scid (H-2d) mice are homozygous for the gene that causes severe combined immune deficiency (SCID). These mice have no T or B cell function, yet display normal natural killer (NK) activity. Irradiated SCID mice were challenged with marrow grafts to determine if antibodies are necessary for marrow allograft rejection. SCID mice rejected H-2/Hh-1 allogeneic marrow grafts. Moreover, this rejection capability could be adoptively transferred using SCID marrow as a source of NK progenitors infused into irradiated B6 (H-2b) hosts. We conclude that NK cells can mediate marrow allograft reactivity in the absence of immunoglobulin. It follows that NK cells probably have specific receptors for Hh antigens. PMID- 3549962 TI - Synthesis and characterization of luciferin derivatives for use in bioluminescence enhanced enzyme immunoassays. New ultrasensitive detection systems for enzyme immunoassays, I. AB - Derivatives of luciferin, D-luciferin methyl ester, D-luciferyl-L-phenylalanine, D-luciferyl-L-N alpha-arginine, D-luciferin-O-sulphate and D-luciferin-O phosphate, were synthesized for use as highly sensitive substrates for enzyme assays. The luciferin derivatives were characterized by ultraviolet and fluorescence spectrophotometry, by amino acid analysis and by fast atom bombardement mass spectrometry. Enzymatic cleavage of the compounds by enzymes leading to the release of D-luciferin was demonstrated. Kinetic constants were determined for the following enzyme/substrate pairs: D-luciferin methyl ester/carboxylic esterase, D-luciferyl-L-phenylalanine/carboxypeptidase A, D luciferyl-L-N alpha-arginine/carboxypeptidase B, D-luciferin-O sulphate/arylsulphatase, D-luciferin-O-phosphate/alkaline phosphatase. All compounds proved to be acceptable substrates for the respective enzymes, D luciferin-O-phosphate being accompanied by an especially high turnover number (kcat = 1010 s-1) with alkaline phosphatase. PMID- 3549963 TI - Bioluminescence enhanced enzyme immunoassay. New ultrasensitive detection systems for enzyme immunoassays, II. AB - Ultrasensitive bioluminescence immunoassays for the determination of peptides and proteins (illustrated with human urinary kallikrein, bradykinin and the determination of human urinary kallikrein antibody titers) have been developed. The usable ranges of the standard curves are from 5 pg to 5000 pg per liter. The relative intra-assay coefficients of variation of the tests were between 2 and 6%, and the interassay coefficients of variation between 4 and 12%. PMID- 3549964 TI - Multi-centre study of a new CEA enzyme immunoassay using monoclonal antibodies. AB - The use of a new monoclonal enzyme immunoassay (EIA) for the carcinoembryonic antigen (CEA) (Enzymun-Test CEA) was evaluated in a multi-centre study. Fifteen different laboratories [participated in the study. Data from the investigation were analysed in terms of precision, sensitivity, specificity and correlation with other test methods. The intra-assay coefficient of variation was between 1.3% at 23.0 microg/l CEA and 13.9% at 1.3 microg/l CEA. Inter-assay reproducibility ranged from 3.6% to 19.2%. The apparent sensitivity of the new EIA for CEA was approx. 0.5 microg/l CEA. The findings indicate that lipaemic and haemolytic sera and samples taken from icteric, rheumatic and dialysis patients did not have any influence on the results. There was no evidence that drugs commonly used in the treatment of carcinoma patients have any influence on the assay results. A good correlation between the new EIA for CEA and six other CEA enzyme immunoassay or radioimmunoassay methods was registered. These results seem to be of significance in particular for the monitoring of therapy for carcinoma patients. The new EIA for CEA exhibits a high degree of sensitivity, specificity and reproducibility. PMID- 3549965 TI - Rapid diagnostic test and throat cultures for streptococcal pharyngitis. PMID- 3549966 TI - A randomized controlled evaluation of an educational program in adults with high psychosocial risk of morbidity. AB - This clinical trial tested the efficacy of a psychosocial intervention in a panel of white adults with a high level of recent stressful life changes and weak social supports. One hundred seventy users of three family practices were randomly assigned to receive a six-month educational program provided by a nurse practitioner or to a control group. Outcome variables were assessed over a 12 month follow-up period by mailed questionnaires and validated when possible by review of medical records. During the six months immediately following the intervention, recipients had a lower rate of restricted-activity days than controls. During the follow-up period, symptom experience, physical function, social function, and emotional function were similar in the two groups. While the overall improvement in social supports was not significantly better at the completion of the intervention for recipients than for controls, those recipients who developed strong supports had fewer restricted-activity days than those who continued to have weak supports. This educational program may provide temporary benefit to adults with high psychosocial risk for health impairment. PMID- 3549967 TI - Immunohistochemical study of calmodulin in developing mouse testis. AB - The purpose of this study was to determine the localization of calmodulin in the developing mouse testis by the indirect immunoperoxidase method. In addition, the amount of calmodulin in pachytene spermatocytes, spermatids, and residual bodies isolated from the mouse testis and epididymal spermatozoa was quantitated by the adenylate cyclase activation assay and by enzyme immunoassay. The relative levels of calmodulin in the developing mouse testis and in the isolated testicular germ cells were confirmed by western transfer staining. The level of immunoreactive calmodulin was very low in the testes from immature animals. In testes from the mature mouse, calmodulin was found to be localized in spermatocytes and spermatids, but was not found in spermatogonia, Sertoli cells, and interstitial cells. By contrast, immunochemical staining of tubulin was extremely intense in Sertoli cells. Biochemical determinations also showed that pachytene spermatocytes, round spermatids, spermatozoa, and residual bodies contained 14.9 micrograms, 15.8 micrograms, 2.3 micrograms and 5.2 micrograms of calmodulin per mg of protein, respectively. Both the immunochemical and the biochemical studies revealed that levels of calmodulin were high in the spermatocytes and in the round spermatids, as compared to the level in spermatozoa. This fact strongly suggests that the large amount of calmodulin in mammalian testes may be associated primarily with meiotic divisions and/or spermatogenesis. PMID- 3549968 TI - Pressure-adaptive differences in proteolytic inactivation of M4-lactate dehydrogenase homologues from marine fishes. AB - The inactivation by hydrostatic pressure of muscle-type lactate dehydrogenase (M4 LDH, EC 1.1.1.27; L-lactate: NAD+ oxidoreductase) homologues from five shallow living and six deep-living marine teleost fishes was compared. The pressures which inactivate these enzymes are much higher than the pressures experienced by any of the species. To determine whether hydrostatic pressure effects on protein aggregation state and conformation might influence proteolysis, the inactivation of LDH by the proteases, trypsin (EC 3.4.21.4) and subtilisin (EC 3.4.4.16) was determined at atmospheric pressure and 1,000 atm pressure. At 10 degrees C and atmospheric pressure, the enzymes of the shallow-living fishes are inactivated four times faster by trypsin and three times faster by subtilisin than are the homologues of the deep-living species. At 1,000 atm pressure, the homologues of shallow-occurring fishes were inactivated 28 to 64% more than predicted from the summed effects of denaturation by 1,000 atm pressure and tryptic inactivation at atmospheric pressure. In contrast, the homologues of the deep-sea species were inactivated by trypsin 0 to 21% more than expected. At 1,000 atm, inactivation by subtilisin increased to a similar degree for enzymes from both deep- and shallow living species. However, at 1,000 atm, the M4-LDH homologues of the deep-sea species lost less activity (55.3%) than did the homologues of the shallow species (86.4%). In comparisons made at 200 atm, a pressure typical of the habitat of the deep-occurring species, tryptic inactivation of the LDH of the shallow-living Sebastes melanops was increased 14%. No pressure inactivation of the enzyme is evident at 200 atm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3549969 TI - Exogenous GnRH overrides the endogenous annual reproductive rhythm in green iguanas, Iguana iguana. AB - Female green iguanas, Iguana iguana, were caught in Belize, Central America (17 degrees N), in December, at the onset of seasonal gonadal activity. The animals were immediately transferred to San Diego (32 degrees N). Ovarian follicular development continued, with peak plasma hormone levels measured in January and February; 200 pg/ml for progesterone (P) and 800 pg/ml for total estrogens (Et = estradiol [E2] + estrone [E1]). E2 was the predominant estrogen throughout the cycle. Follicular atrophy was indicated in April with circulating progesterone and estrogen levels decreasing to baseline (refractory phase) levels (P = 20 pg/ml; Et = 50 pg/ml). Approximately midway through the refractory phase of their annual reproductive cycle (late May), either the D-Arg6 analog of Chicken II or mammalian GnRH was administered via intraperitoneal osmotic pumps for 14 days to nine females. The analog of chicken II induced a fivefold increase in total circulating estrogens within 3-4 days after implantation. Both continuous and pulsatile delivery of the chicken II analog produced a similar pattern of steroidogenic response. A radical sham control animal showed no increase in steroidogenesis. Mammalian GnRH produced a pattern of similar duration, although the magnitude of the steroidogenic response was only half that produced by the chicken II analog. Estrogen titers approached baseline levels in all treatment groups two days after treatment ceased. Progesterone levels increased in all treatment groups during the delivery of exogenous GnRH, although the increases were not consistent. Untreated male cagemates housed with treated females exhibited increased territoriality, courtship behavior, and mating, which began on day 4 or 5 of the treatment period. The control female was not courted by its male cagemate. PMID- 3549970 TI - A method for time of death determination using ultrasound--a preliminary report. PMID- 3549971 TI - A comparison of acetaminophen and rimantadine in the treatment of influenza A infection in children. AB - Rimantadine was compared with acetaminophen in a double-blind randomly assigned therapeutic trial in 63 children presenting with influenzal symptoms. Forty-nine of the children were proven to have influenza A by culture on presentation. Forty three of the cultures, 88%, were influenza A/H1N1 strains. Both drugs were well tolerated. Rimantadine lowered the amount of virus shed in the first 2 days after initiation of therapy. Clinical resolution of illness was not different between the two therapeutic modalities. In individuals who shed virus for 4 days, strains recovered on the last day were relatively resistant to rimantadine. PMID- 3549972 TI - Nesidioblastosis: diagnosis and treatment. PMID- 3549973 TI - Clinical toxicology of one-day administration of 500 mg of clotrimazole. PMID- 3549974 TI - Late onset group A streptococcal bacteremia in a neonate. PMID- 3549975 TI - Information processing in rapid eye movement sleep. Possible neurophysiological, neuropsychological, and clinical correlates. AB - Studies on cerebral hemispheric specialization suggest that the right and left hemispheres process information in different and sometimes conflicting ways. Rapid eye movement (REM) and non-REM sleep may reflect relatively greater activation or efficiency of the right and left hemispheres, respectively. Much of the mentation in wakefulness is dominated by the left hemisphere and its heavy language orientation. Modern theories of dreaming suggest that new solutions or adaptations to existing problems (i.e., new attitudes) may be enhanced by REM sleep and reflected in dreams. This report reviews experimental and clinical evidence to find neurophysiological, neuropsychological, and clinical support for the view that information is processed during REM sleep through increased activation, efficiency, and/or relative functional isolation of the right hemisphere. PMID- 3549976 TI - Stress management for black nurses. PMID- 3549978 TI - A previously unreported cause of pain after total knee arthroplasty. AB - Total knee arthroplasty achieves consistently excellent results in most patients. The most common causes of failure are loosening and infection. This article reviews the records of five patients in whom intraarticular fibrous tissue hypertrophy was the cause of pain after total knee arthroplasty. All of the patients had increasing pain and decreasing knee motion. Evaluation for loosening, malalignment, intraarticular debris, and infection gave negative results. Examination revealed a blocked range of motion and a palpable, tender, intraarticular mass. Injection of anesthetic relieved the symptoms. Surgical excision of the hypertrophic fibrous tissue relieved symptoms and increased knee range of motion. This cause of pain in the total knee arthroplasty patient is rare. PMID- 3549979 TI - Role of bone grafting in correction of protrusio acetabuli by total hip arthroplasty. AB - A study of 27 hip arthroplasties derived from a pool of more than 200 total hip arthroplasties performed between 1976 and 1981 was conducted to assess the need for and benefits of bone grafting in the surgical management of protrusio acetabuli. The objective of surgery and the reason for augmentation by bone graft was to lateralize the acetabular component, normalize the center of rotation of the hip, and strengthen the deficient medial wall. Based on this study, the authors recommend: when protrusion is less than 5 mm in either direction and the medial wall is reasonably strong, bone graft is not indicated; in protrusion greater than 5 mm with a thin but intact medial wall, autogenous bone graft is indicated but artificial fixation devices need not be used; and a grossly deficient medial wall requires reconstruction with bone graft and additional fixation devices to achieve normalization of the center of rotation of the hip joint. PMID- 3549977 TI - Effects of polyhydroxyl alcohols on protein synthesis in brain slices. AB - Stressors such as tissue slicing, toxic chemicals, and heat shock applied to cultured cells, organ tissues, or whole animals in vivo induce the synthesis of a 71,000-kilodalton stress protein (SP71) that is not normally present in most organ tissues. In the present experiment, an attempt was made to inhibit selectively the synthesis of SP71 in rat brain tissue slices. Of several manipulations to the brain slice incubation medium that were examined, only addition of very high concentrations of certain polyhydroxyl alcohols, i.e., 1.0 M glycerol, selectively inhibited SP71 synthesis. Glycerol also selectively inhibited SP71 synthesis in heat-shocked cerebral microvascular cells in culture but failed to inhibit SP71 synthesis in anesthetized rats in vivo in response to heat shock. The effects of glycerol on SP71 synthesis are discussed in relationship to current hypotheses concerning the function of SP71. PMID- 3549980 TI - Conversion total hip replacement. Review of 140 hips with greater than 6-year follow-up study. AB - The authors compared 140 conversion with 433 primary total hip arthroplasties with a 40-month minimum follow-up period. All replacements were performed with a transtrochanteric technique. No conversion total hip arthroplasty had prior cementation. Pain was the indication for surgery. The average number of prior operations was 1.3 and the average number of months to total hip arthroplasty was 65.4. The patient characteristics for the two groups were similar. The overall results were uniformly good to excellent (94% or better) at greater than 6-year mean follow-up in both groups. The authors review important differences between the two groups. None of the differences are statistically significant. The overall results of conversion total hip arthroplasty were good to excellent, and the presence of a preoperative infection did not significantly alter the clinical results. The absence of prior bone cement in conversion total hip arthroplasty is proposed to explain these findings. PMID- 3549981 TI - Augmentation of human natural killer cell activity by influenza virus antigens produced in Escherichia coli. AB - A series of Escherichia coli cloned influenza viral gene products were assayed for their ability to augment human natural cytotoxicity in overnight cultures (18 h) at 37 degrees C. Nylon wool nonadherent peripheral blood mononuclear cells (PBMC) proved responsive to stimulation by a number of cloned viral proteins, the most effective being the nonstructural (NS1) protein (but not NS2 protein) and haemagglutinin and matrix antigen components fused to the N-terminal 81 amino acid sequence of NS1. Furthermore, interferon (IFN) was generated in cultures in which enhanced cytotoxicity was detected and was identified as mostly IFN alpha (greater than 90%) with less than 10% IFN gamma contamination. The cell type responding to antigen stimulation was present in Percoll fractions enriched for large granular lymphocytes (LGLs); furthermore PBMC activated by NS1 protein fractionated in the low density Percoll fractions (LGL enriched). Using specific anti-IFN antisera, it was shown that IFN alpha but not IFN gamma was responsible for the enhancement of cytotoxicity. Interferon induction and activation of cytotoxicity could not be ascribed to the presence of contaminating bacterial products. These results suggest that a particular NS1 protein configuration is capable of activating human natural killer cells via the induction of IFN alpha. PMID- 3549982 TI - The immunopathology of acute experimental allergic encephalomyelitis. IV. An ultrastructural immunocytochemical study of class II major histocompatibility complex molecule (Ia) expression. AB - Cell surface expression of Class II major histocompatibility complex (Ia) molecules is required for antigen recognition by T cells. To determine the ultrastructural cellular distribution of Ia molecules in the autoimmune disease model acute experimental allergic encephalomyelitis (EAE) we studied central nervous system (CNS) tissues from adult Strain 13 guinea pigs (GP). Experimental allergic encephalomyelitis was induced by sensitization with GP spinal cord homogenate in complete Freund's adjuvant (CFA). Nine of 11 sensitized GP had clinical and histologic EAE whereas unsensitized and CFA-sensitized controls were normal. Central nervous system tissues were reacted with monoclonal antibodies to either GP Ia or T cell surface antigen using an avidin-biotin immunoperoxidase technique and studied by electron microscopy; Ia was found on luminal but not abluminal surfaces of many meningeal and parenchymal vascular endothelial cells in GP with EAE. In EAE perivascular lymphocytes and macrophages and processes of unidentified cells in the parenchyma expressed surface Ia and Ia+ macrophages encircled and phagocytosed myelin. T cells were found predominantly in perivascular inflammatory cuffs. These observations indicate that following immunologic challenge Ia is expressed on luminal surfaces of vascular endothelium and on resident CNS cells, suggesting the possibility that these cells may have active antigen-presenting functions in CNS inflammatory reactions. PMID- 3549983 TI - Distribution of neurofilament antigens after axonal injury. AB - Phosphorylated and nonphosphorylated epitopes of neurofilament (NF) proteins are distributed in different regions of individual neurons. Immunocytochemical methods, with monoclonal antibodies directed against phosphorylated and nonphosphorylated NF, demonstrated nonphosphorylated NF in perikarya and proximal axonal segments of neurons in dorsal root ganglia, while phosphorylated NF proteins were present in axons of these cells. The distribution of these epitopes of NF were examined at various times following injury of axons in the rat sciatic nerve. Between one and 21 days after crush of the proximal nerve, phosphorylated NF were present in neuronal perikarya. We have compared patterns of perikaryal immunoreactivity at one time point (three weeks) following a more distal crush or complete transection of the sciatic nerve. At this time period, following transection/ligation, phosphorylated NF immunoreactivity was not present in perikarya, but abnormal staining was observed after nerve crush. These altered distributions of phosphorylated epitopes of NF are of interest because several recent reports have indicated that similar, but not identical, abnormal staining patterns occur in human neurological diseases, including Alzheimer's disease and Parkinson's disease. In accord with previous studies, this investigation indicates that one response of neurons to injury, or to disease, is an abnormal distribution of phosphorylated epitopes of NF proteins. PMID- 3549984 TI - Myotonic muscular dystrophy: structural changes visualized by ultrasound. PMID- 3549985 TI - Salvage treatment for Hodgkin's disease in relapse. PMID- 3549986 TI - Will monoclonal antibodies find a place in our therapeutic armamentarium? PMID- 3549987 TI - Multimodality therapy of esophageal carcinoma: still an experimental approach. PMID- 3549988 TI - High-dose cytosine arabinoside in the treatment of acute myelogenous leukemia: contributions to outcome of clinical and laboratory attributes. AB - High-dose cytosine arabinoside (HDAra-C) has been used for remission induction, and in conventional doses for maintenance in a trial of single-agent therapy in 43 previously untreated patients with acute myelogenous leukemia (AML). Rationale for the trial was provided by the observed decrease in leukemic blast cell self renewal in culture following exposure to Ara-C. Compared with a previous trial of 57 patients treated with multidrug therapy, single-drug Ara-C was associated with a significantly improved complete remission rate (P = .010), although the survival time was not increased. All patients with low self-renewal responded to HDAra-C in contrast to the previous trial where some patients with this phenotype failed remission induction. The clinical observations are consistent with the view that the antileukemic effect of Ara-C has some specificity for cellular events required for self-renewal of blast cells. Exposure in vivo to Ara-C was associated with an increase in blast stem cell renewal at relapse, indicating that maintenance with other drugs should be tested. The study demonstrates the importance of biological attributes in design and analysis of clinical trials. PMID- 3549989 TI - Radioimmunodetection and radioimmunotherapy of cutaneous T cell lymphomas using an 131I-labeled monoclonal antibody: an Illinois Cancer Council Study. AB - A radiolabeled murine monoclonal antibody (T101) was used for imaging and therapy of six patients with cutaneous T cell lymphoma (CTCL). Radioimmunodetection was performed with a 5.6 to 13.1 mCi 131I-T101 preparation (9.6 to 10.5 mg). A therapeutic dose of 100.5 to 150.1 mCi 131I on 9.9 to 16.9 mg of antibody was administered to five patients, with subsequent retreatment following plasmapheresis in three patients at the time of disease progression. All patients responded to their initial therapy and two patients responded to retreatment. Regression of skin lesions and peripheral adenopathy was witnessed. All patients reported resolution of their chronic pruritus. The duration of response ranged from 3 weeks to 3 months. Acute toxicity included fevers, pruritus, and mild dyspnea in two instances. Myelosuppression was seen in patients receiving the 144.7 mCi, 145.0 mCi, and 150.1 mCi 131I-T101 doses. Radioimmunodiagnostic and therapy studies included gamma scintigraphy, plasma, urinary, and wholebody antibody clearances, and biodistribution determined from skin, bone marrow, and liver biopsies. Immunologic studies included immunoperoxidase staining of target tissues, immunofluorescent flow cytometric analysis on peripheral blood and bone marrow, assays for serum blocking factors, determination of a human antimouse antibody (HAMA) response, and quantitation of circulating T101 levels. These preliminary data suggest that 131I-T101 has therapeutic potential in CTCL and that myelosuppression will be the limiting toxicity. PMID- 3549990 TI - Eastern Cooperative Oncology Group: a comparison of adjuvant doxorubicin and observation for patients with localized soft tissue sarcoma. AB - Forty-seven patients with stage I, II, or III soft tissue sarcoma were entered into a prospective randomized Eastern Cooperative Oncology Group (ECOG) adjuvant protocol. Eligibility included conservative or radical primary treatment for local cure. Patients were then randomized to control or Adriamycin (Adria Laboratories, Columbus, OH). Adriamycin was administered at 70 mg/m2 (slow push, every 3 weeks for seven courses for a maximum of 550 mg/m2). To date, 32 patients, 17 males and 15 females, with an age range of 17 to 75 years (median, 44 years) have been followed sufficiently long to be included in this analysis. Nine patients have died. The median follow-up of the remaining 23 patients is 30 months (range, 2 to 50 months). Survival was not significantly different between Adriamycin or control. However, the disease-free interval was slightly different in favor of observation. This preliminary report does not support the hypothesis that Adriamycin is an effective adjuvant therapy for soft tissue sarcoma. Due to the small numbers, these results must be interpreted in relation to our ability to detect a difference, if in fact one existed. These preliminary data suggest that adjuvant Adriamycin not be used outside the confines of a clinical trial such as the current intergroup adjuvant sarcoma study. PMID- 3549991 TI - Sequential chemotherapy and radiation for nasopharyngeal cancer: absence of long term benefit despite a high rate of tumor response to chemotherapy. AB - Between April 1981 and December 1983, patients with locoregional carcinoma of the nasopharynx were treated with two courses of chemotherapy administered before radiation therapy. Chemotherapy consisted of methotrexate, bleomycin, and cisplatin, which were administered at 3-week intervals, and radiation therapy was scheduled to commence 3 weeks after the start of the second course. Forty-nine of 51 consecutive patients were treated; only one patient progressed on chemotherapy, and of 36 patients with measurable neck nodes, eight had complete and 19 had partial clearance (greater than 50% decrease in cross-sectional area) of these nodes when assessed before initiation of radiotherapy. Despite the high rate of tumor response (75%; 95% confidence limits, 59% to 91%), the actuarial survival and disease-free survival curves were almost identical to those recorded for a consecutive group of 140 historical controls of similar stage distribution treated with radiation alone. This chemotherapy provided a high rate of tumor remission, but did not appear to convey long-term benefit to patients when used before radiation therapy. PMID- 3549992 TI - W-cells in the cat retina: correlated morphological and physiological evidence for two distinct classes. AB - Intracellular recording and iontophoresis of horseradish peroxidase were used to study the morphology of physiologically characterized W-cells in the cat retina. The recording experiments were performed in an in vivo preparation to allow the responses of these retinal ganglion cells to be compared with previous functional studies of these neurons. The physiological and morphological characteristics of 16 injected and recovered retinal W-cells were compared with similar data from 14 retinal X-cells injected in the same preparations. The soma sizes of retinal W cells were found to fall into two distinct groups. The somata of the phasic W cells, at every eccentricity, were smaller than the somata of tonic W-cells, with no overlap between the two distributions. Soma sizes of the tonic W-cells fell into the previously described "medium-sized" range of retinal ganglion cell soma sizes and were similar to, although slightly larger than, the soma sizes of physiologically identified beta- or X-cells. The dendritic arbors of all of the cells physiologically classified as tonic W-cells were similar. Every example of this type had four to five primary dendrites that branched a short distance from the soma to form a circular or cruciate dendritic arbor. The dendritic arrays of these cells were easily distinguishable from the compact dendritic arbors of the physiologically identified X-cells. The dendritic arbors of the phasic W-cells were much more heterogeneous, ranging from sparse, wide dendritic arbors to very compact dendritic arbors with many fine branches. No significant correlation was found between the extent of the dendritic arbor and the distance from the area centralis for either the tonic W-cells or the phasic W-cells. The axons of the tonic and phasic W-cells differed from one another and from X-cells on a number of different morphological and physiological measures. The intraretinal segments of the axons of the phasic W-cells had the smallest diameters of the three groups; the axons of X-cells in the retina were relatively large, and the axons of the tonic W-cells had diameters intermediate between the phasic W-cells and the X-cells. Although considerable overlap was seen between the X-cells, tonic W cells, and phasic W-cells in their antidromic latencies to electrical stimulation of the optic chiasm, the intraretinal and extraretinal components of the conduction velocities of the three groups were significantly different.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3549994 TI - Characterization of intermediate filaments in PC12 cells. AB - A 57 kDa protein is the major polypeptide in intermediate filament (IF)-enriched cytoskeletal preparations obtained from the neuronal cell line PC12 (rat pheochromocytoma). Under the conditions used to assemble IF in vitro from other cultured cell lines, 10 nm filaments are formed after 2 cycles of disassembly assembly from PC12 IF-enriched cytoskeletal preparations; the 57 kDa protein is the major component of the final IF pellet. The 57 kDa protein is immunologically related to the BHK-21 fibroblast 55 kDa protein (vimentin), but a comparison of the peptide maps of PC12 57 kDa and BHK 55 kDa indicates that they are different proteins. With the use of a polyclonal antiserum to the PC12 57 kDa protein, immunofluorescence observations of PC12 cells not treated with NGF reveal a juxtanuclear "knot"-like structure. After NGF treatment, the "knots" are less prominent and many IF arrays are seen coursing through the cytoplasm and extending into the neurites. These immunofluorescence observations of the distribution of IF are corroborated by fine-structural analyses. SDS-PAGE analyses indicate that IF-enriched cytoskeletons isolated from NGF-treated cells have a polypeptide composition similar to that of untreated cells, that is, the 57 kDa protein remains the major polypeptide. SDS-PAGE and immunoblotting analyses show that untreated and NGF-treated PC12 cells also contain relatively minor amounts of the 68, 150, and 200 kDa neurofilament triplet (NFT) proteins. Under immunofluorescence, only 5% of untreated PC12 cells are found to contain a juxtanuclear "knot" labeled with NFT antibodies, but with time following NGF treatment, the number of fluorescent cells increases. After about 2 weeks of NGF treatment, all of the PC12 cells appear to contain NFT antibody-positive filamentous structures. As assessed by immunofluorescence, the NFT polypeptides appear to codistribute with the 57 kDa protein in both untreated and NGF-treated PC12 cells. These data indicate that PC12 cells contain IF composed of a complex set of polypeptides, including a previously unidentified 57 kDa IF protein. While NGF may induce production of NFT polypeptides, there does not appear to be a "switch" from known mesenchymal IF polypeptide expression to NFT polypeptide expression upon stimulation of PC12 cells with NGF. PMID- 3549993 TI - Acetylcholine causes rapid nicotinic excitation in the medial habenular nucleus of guinea pig, in vitro. AB - The actions of ACh in the medial habenular nucleus (MHb) were investigated using extra- and intracellular recording techniques in guinea pig thalamic slice maintained in vitro. Applications of ACh to MHb neurons resulted in rapid excitation followed by inhibition. Neither of these responses was abolished by blockade of synaptic transmission, indicating that they are consequences of ACh action directly on MHb cells. Local applications of the nicotinic agonists nicotine and cytisine caused long-lasting excitation, while applications of another nicotinic agonist, 1,1-dimethyl-4-phenylpiperazinium caused both the excitatory and inhibitory responses. Applications of the muscarinic agonists DL muscarine and acetyl-beta-methylcholine did not consistently cause either the excitatory or inhibitory response. Adding the nicotinic antagonist hexamethonium to the bathing medium blocked both the excitatory and inhibitory ACh responses, while addition of the muscarinic antagonists atropine or scopolamine had no effect. These results indicate that the effects of ACh on MHb neurons are mediated by nicotinic receptors. Intracellular recordings revealed that ACh or nicotine cause an increase in membrane conductance associated with depolarizations that had an average reversal potential of -16 to -11 mV. These results indicate that the ACh-induced excitation is due to an increase in membrane cation conductance. The inhibitory response that follows ACh-induced depolarization and repetitive firing was associated with a hyperpolarization and an increase in membrane conductance. Similar postexcitatory inhibition could also be elicited by direct depolarization or by applications of glutamate, indicating that the hyperpolarizing response to ACh may be an endogenous postexcitatory potential that is not directly coupled to activation of nicotinic receptors. These results suggest that cholinergic transmission in the MHb may be largely of the nicotinic type. This nucleus may be of one of the major regions of the nervous system through which nicotine mediates its central effects. PMID- 3549995 TI - Proteolytic processing of the Aplysia egg-laying hormone and R3-14 neuropeptide precursors. AB - A number of animal behaviors are influenced by the actions of neuropeptides that arise from the processing of complex protein precursors. In this report we investigate the proteolytic processing of neuropeptide precursors expressed in the Aplysia californica bag cells, which govern egg-laying, and neurons R3-14, which mediate aspects of cardiac output. Peptides were purified by fractionation on 2 high-pressure liquid chromatography systems followed by determination of amino acid compositions. Most of these compositions are indicative of processing products derived from the egg-laying hormone (ELH) and R3-14 precursors by cleavage at basic residues. We characterized 9 peptides that arise from the ELH precursor by cleavage of the signal sequence, as well as 7 out of 8 dibasic residues and at least 1 single Arg residue. The peptides range in size from 5 to about 60 amino acids. The R3-14 neuropeptide precursor is cleaved at 2 internal dibasic residues in addition to the signal sequence, resulting in 3 peptides. Shortened forms of several peptides probably result from amino- and carboxy terminal peptidase action. It is likely that the complex mixtures of neuropeptides arising from these single protein precursors are co-secreted. PMID- 3549996 TI - Brain spectrin(240/235) and brain spectrin(240/235E): differential expression during mouse brain development. AB - Mouse brain contains at least 2 distinct spectrin subtypes: brain spectrin(240/235) and brain spectrin(240/235E) (Riederer et al., 1986). In this study, we demonstrate that these subtypes are differentially expressed during mouse brain development. Brain spectrin(240/235) can be detected in fetal tissue and increases 2-fold during brain development. This subtype is enriched in the cortical cytoplasm of germinative neural cells and is also found in fibers resembling axons as early as fetal life. Brain spectrin(240/235E), which is specifically detected with antibodies to red blood cell spectrin, is below the limits of detection in fetal and neonatal brain but rapidly increases in concentration during the second postnatal week. Brain spectrin(240/235E) is confined to the cell body and dendrites of differentiating neurons and to glial cells but is not expressed in mitotic cells. This subtype is most prominent in granule cells of the cerebellum and dentate gyrus in the hippocampus. PMID- 3549997 TI - Surgical therapy for medically intractable epilepsy. AB - There has been a recent renewal of interest in surgical therapy for medically intractable epilepsies. Cortical resection and callosotomy are the most widely accepted modes of surgical management. The indications for each of these approaches are reviewed. Although there has been much interest in imaging techniques, including positron emission tomography, to identify epileptogenic zones, identification still depends primarily on the electroencephalogram (EEG). There are several approaches to the evaluation and intraoperative management of patients undergoing cortical resection for temporal lobe epileptogenic zones. These range from selection based on scalp interictal EEG criteria, with resections guided by electrocorticography and functional mapping, to selection based on the location of ictal onset as recorded by chronically implanted depth electrodes, with an anatomically standard resection of the temporal lobe or resection limited to amygdalohippocampectomy. No one approach provides the optimum balance of benefits to risks and costs for all patients. The relative value of the different approaches for various populations of patients with medically intractable partial complex seizures is reviewed. Techniques for minimizing the morbidity of these operations, especially in regard to language and memory, are also discussed, as are the contributions to an understanding of the neurobiology of human epilepsy and human higher functions derived from the surgical therapy of epilepsy. PMID- 3549998 TI - A new fixation device for the Leksell stereotaxic system. Technical note. AB - A device is presented that permits several applications for the Leksell stereotaxic system. The patient is fixed in this new system by means of a rectangular instrument that connects to the standard Leksell stereotaxic coordinate frame and maintains spatial orientation after the frame itself is removed. Specific uses for this device include stereotaxic radiosurgery and stereotaxic guidance during microsurgery. Other attractive features of this device are its capability of being precisely reapplied, its compatibility with both computerized tomography and magnetic resonance imaging, and the availability of an accessory device to adapt it for animal stereotaxis. PMID- 3549999 TI - The control mechanisms activated by experimental intracranial hemodynamics changes. AB - The Authors describe an experimental model (rat) performed in order to evaluate the cerebrovascular changes which occur following the venous outflow impedance increase. This increase was obtained by bilateral occlusion of the external jugular veins at the neck. The rat was chosen because its intracranial and extracranial circulation is very similar to the human one, thus allowing the recording of blood flow velocity changes in the common carotid artery by means of a noninvasive technique such as Doppler ultrasound. Ligature of both the external jugular veins, performed on 35 rats, produced a decrease of common carotid artery blood flow velocity in 2/3 of the animals. The remaining 1/3 presented increased common carotid velocity. These changes were recorded within 15 minutes after ligation of the veins. On the contrary, the epidural pressure, measured in 6 cases, showed a constant increase. The results demonstrate that the different patterns of CBF and EDP do not permit univocal interpretation of the cerebrovascular reactivity control mechanisms, that is, myogenic, metabolic or neurogenic. PMID- 3550001 TI - Government involvement in maternal and child health care. A learning resource for the nurse-midwife. PMID- 3550002 TI - Evolution of the nursing curriculum. PMID- 3550000 TI - Daily fetal movement counting. A valuable assessment tool. PMID- 3550003 TI - A tribute to Mary Ann Garrigan. PMID- 3550004 TI - Mathilda Scheuer (1890-1974): a biographical sketch. PMID- 3550005 TI - A study of female military nurses in Vietnam during the war years 1965-1973. PMID- 3550006 TI - The cafeteria diet--an inappropriate tool for studies of thermogenesis. AB - Diet-induced thermogenesis (DIT) is defined as a regulatory, facultative component of energy expenditure, stimulated by overeating, which helps maintain energy balance. DIT may play a central role in the regulation of energy expenditure and in the etiology of certain types of obesity. Most experiments testing the existence or the mechanisms of DIT have used the cafeteria diet for the purposes of stimulating hyperphagia, a requisite for studies of DIT. Yet such a diet is inappropriate for studies of thermogenesis because its use prevents researchers from obtaining an experimental outcome that can be clearly interpreted. The primary limitation of the cafeteria diet is that its nutritional composition is uncontrolled. The diet is self-selected from a variety of supermarket foods that tend to be high in fat and/or carbohydrate and low in protein, vitamins and minerals. Hence, the diets consumed by the animals are likely to be deficient in protein, vitamins or minerals. There is evidence that dietary deficiency of protein, vitamins and minerals can increase thermogenesis and in protein-adequate diets, the balance of fat and carbohydrate in the diet can also influence thermogenesis with high carbohydrate diets increasing thermogenesis more than isoenergetic high fat diets. Hence, an observed increase in thermogenesis in cafeteria fed animals might be interpreted incorrectly to be the result of increased energy consumption when it is attributable to dietary imbalance or deficiency. Because the diet is self-selected, it is possible for each animal to choose a diet that varies in nutritional composition from that selected by every other animal, so control of dietary intake is compromised.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550007 TI - Effects of long-term moderate food restriction on growth, serum factors, lipogenic enzymes and adipocyte glucose metabolism in lean and obese Zucker rats. AB - The effects of long-term moderate food restriction were assessed in lean and obese male Zucker rats. A 30% reduction in food intake from 5 to 68 wk of age resulted in parallel lowering of body weight in both lean and obese rats compared to their respective ad libitum-fed control groups. In lean rats, epididymal and retroperitoneal fat pad weights and cell size were lowered by food restriction. In obese rats there was an effect of food restriction on growth of the epididymal pad but not the retroperitoneal pad. Hyperinsulinemia, hyperlipidemia and elevated serum albumin levels, as well as higher activity of lipogenic enzymes, were also not affected by food restriction in the obese rat. In a second experiment, long-term food restriction resulted in greater glucose conversion to CO2 in response to insulin in adipocytes from lean rats but not obese rats compared to their respective control groups. These results indicate that food restriction throughout the first year of life in the obese Zucker rat does not alter the development of hyperplastic obesity and insulin resistance. PMID- 3550008 TI - Do nonsteroidal anti-inflammatory drugs interfere with blood pressure control in hypertensive patients? AB - Exacerbation of hypertension by nonsteroidal anti-inflammatory drugs in hypertensive patients remains controversial among physicians and investigators. Because of the many differences among studies of oral nonsteroidal anti inflammatory drugs and blood pressure control in patients with hypertension, the authors critically evaluated the published clinical evidence on this subject using standardized methodologic criteria. A search of the literature from 1965 to 1986 identified 31 relevant studies, of which only eight were double-blind randomized controlled trials that provided the most clinically useful information. Of these eight best-designed studies, five of the six that studied indomethacin concluded that it may interfere with antihypertensive effectiveness in selected patients with treated, stable hypertension. The remaining double blind randomized studies included comparisons of other nonsteroidal anti inflammatory drugs. Their limited results suggest that sulindac is less likely than piroxicam, naproxen or indomethacin to cause an attenuation of antihypertensive therapy. More research on this subject is needed, with greater attention to methodologic details and identification of predisposing risk factors for impairment of blood pressure control by nonsteroidal anti-inflammatory drugs. PMID- 3550009 TI - A history of history-taking: the medical interview. PMID- 3550010 TI - Routine urine testing for evidence of drug abuse in workers: the scientific, ethical and legal reasons not to do it. PMID- 3550011 TI - Outpatient consultation: interaction between the general internist and the specialist. AB - To define the process of outpatient consultation, the authors conducted a prospective study of 716 consecutive outpatient consultations in a university based primary care internal medicine practice. The overall consultation rate was 11.9 per 100 patient visits, with 78% of the referrals to other physicians and 22% to non-physician specialists. Consultation rates and patterns of referral varied little between physicians with different levels of experience. Eighteen per cent of the consultations resulted in a no-show by the patient to the consultant. Referring physicians received communications from the consultants 80.5% of the time when appointments were kept. By multivariate regression two variables were shown to be most important in determining the internist's overall satisfaction: 1) how well the consultant aided the internist in his ongoing management of the patient's problem, and 2) how well specific questions were addressed by the specialist. Other statistically significant variables were the clarity and promptness of the consultant's reply, the educational value of the consultation, and specific management recommendations made by the consultant. To improve the consultation process no-shows must be minimized, communication from the consultant maximized, and the interaction between the internist and the consultant bolstered. PMID- 3550012 TI - Thyrotoxic hypokalemic periodic paralysis: report of four cases and review of the literature (2). PMID- 3550014 TI - Tissue expansion reconstruction of soft tissue avulsions of the face: report of two cases. AB - A technique utilized to increase the amount of skin available for repair of soft tissue defects with local flaps has been described. Indications for the use of tissue espansion and the surgical technique and possible disadvantages have been discussed. Two case reports are presented to illustrate the use of the tissue expander to repair avulsive craniofacial defects. PMID- 3550013 TI - Twelve years of Indiana school fluoridation. PMID- 3550015 TI - Periodontal disease in partial denture wearers--a biological index. AB - Studies on the adverse effects of partial dentures on the remaining tissues require both a yardstick of measurement to record the level of oral disease, and the use of controls, preferably within the same patient. A method was devised for pooling the individual values related to the level of periodontal disease on abutment and control teeth in partial dentitions. The difference in these combined values was expressed as the Biological Price. This value provided a useful means of evaluating partial denture designs and patient features, in attempting to assess the major contributing factors responsible for the Biological Price levied by the denture. Whilst wearing an acrylic partial denture at night adds to the price paid by the remaining tissues, the mechanical features of the partial denture, and the overall features of the patient and his remaining dentition appear to be insignificant in determining the Biological Price. PMID- 3550016 TI - A biometric comparison of face shape with denture tooth form. AB - Dentist and patient preferences are often used to select replacement teeth in prosthodontics. Face shape compared with inverted tooth form classifications based on Leon William's work are currently used. Shapes of teeth and faces have been referred to as square, ovoid or tapered, or some combination of these. Six patients, three male and three female, were selected as being classically square, tapered or ovoid in facial form. Three sets of dentures had been made for each patient with tapering, ovoid and square denture teeth. Using a standardized photographic technique, full face views with profiles and close-ups of the teeth were taken. Then from standardized enlarged tracings, key anatomic and derived points were marked, digitized and computer analysed. The face shapes and inverted tooth forms were digitized in the same manner. A comparison of tooth moulds versus the actual denture teeth shows a highly significant difference (P less than 0.001) between set and unset denture teeth. There is also a significant difference (P less than 0.001) between facial form and denture teeth using temporal zygomatic and gonial widths for faces, compared with incisal, contact, and cervical widths for the teeth. PMID- 3550017 TI - The mandibular rest position and electromyography--a review. AB - The objective of clinical methods for the establishment of the rest position of the mandible is to establish a position at which masticatory muscle activity is minimal. Several methods are in clinical use but these methods may not elicit a position which is coincident with the lowest level of muscle activity as determined electromyographically. PMID- 3550018 TI - A study of strain and stress levels in the circummaxillary sutural systems during rapid maxillary expansion: an approach using both the strain gauge technique and the theoretical stress analysis. PMID- 3550020 TI - The pathogenesis and biochemistry of amyloidosis. AB - The transformation of serum proteins into Congo red-sensitive fibrillar material is requisite for the onset and progression of amyloid disease. All the mechanisms which lead to the disease itself have not been elucidated, but our knowledge has increased significantly. It is apparent that in all types of amyloid fibrils, three common features are displayed by the major protein constituents. These are that the fibril protein has a serum precursor, a high degree of anti-parallel beta-sheet conformation and a distinctive ultrastructure on electron microscopy. In the AL and AA forms of amyloidosis, the putative precursors appear to undergo limited degradation to form the protein component of amyloid fibrils. It has been suggested that there may be certain primary structural characteristics inherent in precursor molecules which make them amyloidogenic, thus predisposing them to amyloid fibril formation. This would include certain subtypes of immunoglobulin light chains, possibly kappa I and lambda VI, in the AL type of amyloidosis and one of the polymorphic SAA species, SAA2, which has been identified as the predominating isotype found in AA amyloid fibrils. In AH amyloidosis, the mechanism of amyloid fibril formation appears to be simply a concentration phenomenon where elevated concentrations of B2-M are not handled normally and amyloid deposition is the result. Amyloidogenesis in the hereditary form of systemic amyloidosis may involve other factors in addition to the presence of a variant precursor prealbumin as indicated by the delayed onset of the disease. It is evident that the elucidation of the mechanism(s) which governs the onset and progression of the amyloidoses will allow future regulation and treatment of these all too often complex disorders. PMID- 3550019 TI - Effect of properties of investment molds on mechanical properties of Ni-Cr alloys for fixed prosthodontics. PMID- 3550021 TI - Safety and immunogenicity of Haemophilus influenzae type b polysaccharide and polysaccharide diphtheria toxoid conjugate vaccines in children 15 to 24 months of age. AB - To evaluate the safety and immunogenicity of the Haemophilus influenzae type b polysaccharide vaccine, PRP, and a new polysaccharide-diphtheria toxoid conjugate vaccine, PRP-D, a collaborative study was carried out in six centers in five states. Subjects were 585 infants 15 to 24 months of age. They were randomly assigned to receive a single dose of PRP or PRP-D vaccine. There were no significant differences in the rate of adverse reactions between the two vaccine groups. Minor local reactions occurred in 10.3% of PRP and 12.5% of PRP-D recipients, and fever in 27.4% of PRP and 23.8% of PRP-D recipients. All reactions resolved within 48 hours. Serum samples were obtained just before vaccination and after 1 month. Prevaccination antibody levels were similar for the PRP (0.035 micrograms/mL) and PRP-D (0.027 micrograms/mL) groups, with no differences in levels by age, sex, race, vaccine lot, or study site. Both groups had significant rises in geometric mean levels, but this difference was significantly greater for PRP-D (2.166 micrograms/mL) than for PRP (0.154 micrograms/mL). In addition, the percentage of responders as determined by three definitions (twofold titer rise, greater than 0.15 micrograms/mL, and greater than 1.0 micrograms/mL) was also significantly greater for PRP-D than PRP. In contrast to a marked age-related immunogenicity to PRP (P less than 0.001), there was no significant variation in immune response to PRP-D by age. PRP-D conjugate vaccine appears to be as safe and significantly more immunogenic than PRP vaccine for children vaccinated at 15 to 24 months of age. PMID- 3550022 TI - Liver transplantation before 1 year of age. AB - Since 1981, 20 infants younger than 1 year of age received 26 orthotopic liver transplants. Immunosuppression was with cyclosporine and corticosteroids. Thirteen (65%) of the recipients were discharged from the hospital. To date, 12 (60%) of the 20 recipients are surviving, with follow-up of 1 to 56 months (average 14 months). The 5-year actuarial survival is 53.8%. The allograft liver function in the majority of surviving infants is excellent. The predominant causes of mortality were primary nonfunction of the allograft (three patients) and sepsis (three). Major morbidity was caused by hepatic artery thrombosis (five patients), gastrointestinal complications (six), biliary tract complications (five), and bacterial and viral infections (13). Six patients underwent retransplantation; three of these six survived. Results could be improved by prevention of hepatic artery thrombosis, by decreasing the incidence of sepsis, and by procurement of more and better suited pediatric donors. PMID- 3550024 TI - Liver transplantation and Kasai operation in the first year of life: therapeutic dilemma in biliary atresia. PMID- 3550023 TI - Clinical course of immunoglobulin A nephropathy in children. AB - The clinical presentation, initial laboratory and renal biopsy findings, and subsequent clinical course of IgA nephropathy were studied retrospectively in 200 children, and findings in those with younger onset and older onset were compared. Eighty-three patients were 8 years of age or younger (group 1) and 117 were 9 years of age or older (group 2) at onset. There were no differences between the two groups with regard to sex, initial renal function, incidence of hypertension and macroscopic hematuria, degree of proteinuria, and pathologic findings. At the latest follow-up, two patients in group 1 and eight in group 2 had chronic renal failure, and five patients in group 1 and 21 in group 2 had heavy proteinuria with or without hypertension (P less than 0.01), whereas 36 (43%) patients in group 1 and 29 (25%) in group 2 had normal urine, blood pressure, and glomerular filtration rate (P less than 0.01); the disease followed a significantly more benign course in children with younger onset than in those with older onset. These observations suggest some age-related differences in the natural history of childhood IgA nephropathy. PMID- 3550025 TI - Evaluation of an ELISA for group A streptococcal antigen for diagnosis of pharyngitis. PMID- 3550026 TI - Improvements in self-concept after treatment of nocturnal enuresis: randomized controlled trial. AB - To determine whether changes in attitude and behavior occur after treatment of nocturnal enuresis, we randomly assigned 121 children aged 8 to 14 years to receive conditioning therapy (n = 66) or a 3-month waiting period (n = 55). All children completed the Piers-Harris Self-Concept Scale (P-H), the State-Trait Anxiety Scale (STAIC), and the Nowicki-Strickland Locus of Control test (NSLC) at entry and after treatment or delay. Parents completed the Achenbach Child Behavior Checklist (CBCL). There were no significant group differences in background demographic variables. Significant improvements in the P-H Scale (P = 0.04) and three of its subscales occurred in children in the treatment group compared with those in whom treatment was delayed. The changes were greatest for those who had the largest decreases in wetting frequency. Changes in CBCL, STAIC, and NSLC scores were not statistically significant. We conclude that there may be mental health benefits in children helped to master the symptom of enuresis, which in this age group is probably a chronic stressor. PMID- 3550027 TI - The effects of pH, time, temperature, and autoclaving on E. coli endotoxin in selected parenteral solutions. PMID- 3550028 TI - Approaches to cycle development for clean-in-place processes. PMID- 3550029 TI - Cell division in migratory and aggregated neural crest cells in the developing gut: an experimental approach to innervation-related motility disorders of the gut. AB - Extensive studies in the chicken embryo have recently supplied more insights into the development of the enteric nervous system, which mainly derives from the vagal neural crest (i.e., the neural crest opposite somites 1 to 7). Crest cells migrate from this region to and via the developing gut. By means of a double labeling technique of both neural crest cells and cells in the S-phase of the cell cycle, we found that these migrating crest cells still proliferate in the gut. Some cells even go through cell division after the formation of a nerve plexus. Some implications for the pathogenesis of congenital innervation abnormalities such as hyperganglionosis and the aganglionosis of Hirschsprung's disease are discussed. PMID- 3550030 TI - Immunohistochemical characterization of abnormal innervation of colon in Hirschsprung's disease using D7 monoclonal antibody. AB - Innervation patterns in normal and aganglionic colon were studied using a panel of antineuronal cell antibodies. One antibody, D7, which recognizes a subset of neuronal cells of the peripheral and central nervous system reacted strongly with nerve fibers in the circular muscle of the normal colon. Immunohistochemical scanning of the entire resected specimen of colon from three children with Hirschsprung's disease demonstrated large numbers of D7 immunoreactive nerve fibers in the circular muscle of the ganglionic colon, few fibers in the transitional zone, and no immunoreactive fibers in the aganglionic segment of bowel. While the absence of D7 immunoreactive fibers paralleled the absence of myenteric ganglion cells in the aganglionic segment, a critical region of colon was identified wherein D7 reactive fibers were evident ahead of the appearance of ganglion cells. These findings indicate that the fundamental pathology in Hirschsprung's disease is not only the absence of ganglion cells of the myenteric and submucuous plexuses but also the absence of D7 immunoreactive fibers in the circular muscle of the colon. PMID- 3550031 TI - Intraoperative bupivacaine during outpatient hernia repair in children: a randomized double blind trial. AB - Postoperative pain is a major problem following surgery in the ambulatory child. A study was undertaken to test the effect of intraoperative bupivacaine on postoperative pain in children undergoing outpatient hernia repair. Ninety-nine children aged 1 to 7 years underwent outpatient inguinal herniorrhaphy under general anesthesia. Each was randomly assigned to receive bupivacaine (group 1) or saline (group 2), infiltrating the ilioinguinal and iliohypogastric nerves. Drug administration and patient evaluation were double-blinded. The groups were similar with respect to age, sex, side of procedure, and length of operation. In the immediate postoperative period, 17 group 1 patients required analgesics compared with 39 in group 2 (P less than .01); total codeine dosage was lower in group 1 (4.0 +/- 7.1 mg v 11.8 +/- 10.5 mg, P less than .05). Activity level 45 minutes after surgery (using a standardized scale) was greater in group 1 (P less than .05). Acetaminophen requirements at home were lower in group 1 on the day of surgery (3.1 +/- 4.3 mL v 5.7 +/- 7.4 mL, P less than .05) and over the following 48 hours (1.5 +/- 3.4 mL v 4.9 +/- 10.7 mL, P less than .05). Activity level at home on the day of surgery did not differ significantly between groups, but activity level over the following 48 hours was higher in group 1 (P less than .05). The two groups were similar with respect to all other parameters. We conclude that intraoperative bupivacaine decreases post-operative pain and analgesic use, and promotes early ambulation in children undergoing hernia repair. PMID- 3550032 TI - The enema continence catheter in spina bifida: successful bowel management. AB - Patients with spina bifida who have fecal incontinence are managed by means of a large-volume saline enema. To facilitate administration of the enema, a special catheter has been devised that prevents leakage of the enema fluid. Continence has been achieved in 112 children and youths with spina bifida who were managed in this fashion. PMID- 3550033 TI - The effectiveness of the Titan-S sonic scaler versus curettes in the removal of subgingival calculus. A human surgical evaluation. AB - This study evaluated clinically the effectiveness of hand versus sonic subgingival scaling and root planing in the removal of calculus by visually examining the root surface at the time of periodontal flap surgery. Consideration was given to the method of instrumentation, probing depth, number of roots, and type of tooth surface. Eleven patients with moderate to advanced periodontal disease were evaluated. Four subjects were scaled and root planed with the Titan S only, four with curettes only, and three with the Titan-S + curettes. At reevaluation 3 to 6 weeks after scaling and root planing, the decision to perform periodontal flap surgery was made based upon probing depth, bleeding upon probing, previous access to the root surface, furcation involvement, and the patient's level of oral hygiene. A full thickness mucoperiosteal flap was elevated to gain access to the root surface and measure the distance from the cementoenamel junction to the residual calculus. A total of 690 surfaces were evaluated surgically. The percentage of surfaces with residual calculus for each method of instrumentation was: Titan-S only (31.9%), curettes only (26.8%), and Titan-S + curettes (16.9%). Overall, 15.7% of the surfaces probing 0 to 3 mm, 29.3% of the surfaces probing 4 to 5 mm, and 44.4% of the surfaces probing 6 to 12 mm had residual calculus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550034 TI - Relative influence of scaling and root planing and occlusal adjustment on sulcular fluid flow. AB - The aim of the investigation was to clarify the effects of the resolving of inflammation on one hand and the removal of occlusal trauma on the other hand on the rate of sulcular fluid flow (SFF) from deep periodontal pockets. Forty-seven adult patients having at least one tooth with an inflamed greater than 5 mm periodontal pocket and elevated mobility associated with occlusal trauma were selected for the study. After oral hygiene instruction and supragingival scaling, the rate of sulcular fluid flow of the test teeth was recorded on Day 0. After the baseline recording, each patient was randomly assigned to either Group A or Group B. The test teeth of Group A were subjected to subgingival scaling and root planing under local anesthesia, and the test teeth of Group B were subjected to occlusal adjustment. On Day 14 sulcular fluid flow was recorded for both groups, after which Group A received occlusal adjustment and group B received scaling and root planing. On Day 28 the sulcular fluid flow recordings were repeated for both groups. The mean flow rates of both Group A and Group B decreased significantly (P less than 0.05) from Day 0 to Day 28. When the occlusal interference was eliminated 2 weeks after scaling and root planing (Group A), no additional decrease in sulcular fluid flow was observed. When the occlusal interference was eliminated before scaling and root planing (Group B), the reduction in sulcular fluid flow remained statistically insignificant through the first 2-week observation period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550035 TI - The effects of antiformin-citric acid chemical curettage on the microbial flora of the periodontal pocket. AB - This study investigated the hypothesis that antiformin-citric acid chemical curettage combined with scaling and root planing (SRP/AF) would significantly reduce pathogenic bacteria of the periodontal pocket when compared to scaling and root planing alone (SRP). Ten patients with moderate periodontitis participated. Four pockets per patient, one in each posterior sextant, were chosen. Pocket depths, attachment levels, and gingival index (GI) were measured. Bacterial samples were examined under dark-field microscope for: (1) spirochetes, (2) motile rods, and (3) all others. A randomized four-sextant treatment design was used. One sextant received no treatment, a second received SRP, and the two remaining sextants received identical treatments of SRP/AF. Of these two sextants, one was sampled at baseline and 12 weeks only in order to serve as an additional control. The remaining sextants were sampled at 1, 4, 8, and 12 weeks. Both SRP and SRP/AF significantly reduced the percentage of spirochetes and motile rods. A significant reduction in GI and pocket depths was also noted. Attachment level showed no significant change. Results of both treatment groups showed no significant differences among any of the parameters. A comparison of the two SRP/AF groups indicated no significant difference among clinical or bacterial parameters due to sampling. PMID- 3550036 TI - Calculus removal by scaling/root planing with and without surgical access. AB - We assessed the presence and extent of calculus on subgingival root surfaces of teeth that received scaling and root planing (S/RP) alone, S/RP with modified Widman flap, or no treatment. After extraction, each surface was examined to determine the pocket depth (PD), area of root surface exposed to the pocket (A), and amount of pocket area showing retained calculus (C). Calculus-positive teeth (CPT) and surfaces (CPS) and percentage of pocket area occupied by calculus (C/A) were derived for each group. In general, CPT and CPS were significantly lower after S/RP with flap (37% and 14%, respectively) than after S/RP alone (62% and 24%). The advantage of S/RP with flap was greatest for facial and lingual surfaces and for anterior and premolar teeth. In both treatment groups CPS were similar over a pocket depth range of 0 to 6 mm. But in deeper pockets, CPS in teeth treated by S/RP with flap remained constant at 17% while after S/RP alone CPS increased linearly to approximately 45% at greater than 8 mm. The mean C/A was essentially equal in both treatment groups (11%) and was not related to pocket depth. PMID- 3550038 TI - Projective techniques in research and practice. PMID- 3550037 TI - Effects of labetalol on renin release from rat kidney cortical slices. AB - Effects of labetalol, a combined alpha- and beta-adrenoceptor blocking agent, on the changes in renin release in response to isoproterenol or norepinephrine were examined in comparison with those of propranolol and prazosin, using rat kidney cortical slices. Isoproterenol (10(-9) to 10(-5) M) produced a dose-related increasing effect on renin release from the slices, although the increased release was markedly attenuated by the higher dose (10(-4) M). On the other hand, norepinephrine, at relatively higher concentrations (over 10(-6) M), caused a significant decreasing action on the release. Labetalol alone (10(-9) to 10(-4) M) had no effect on basal renin release. However, the agent exerted a concentration-dependent blocking action on the renin response to 10(-6) M isoproterenol. Similar results were observed with propranolol. The decreased response of renin release to 10(-5) M norepinephrine was significantly inhibited by labetalol over 10(-6) M. Labetalol, at a concentration of 10(-5) M, abolished the decreased release by 10(-5) M norepinephrine. On the other hand, the decreasing effect of 10(-5) M norepinephrine was substantially reversed rather than abolished by prazosin over 10(-7) M. These results indicate that labetalol inhibited the response of renin in rat kidney cortical slices, by beta- and alpha 1-adrenoceptor antagonistic action, respectively. PMID- 3550039 TI - Modulating infant state in premature infants. PMID- 3550040 TI - Our roots: what we should know about nursing's Christian pioneers. PMID- 3550041 TI - Effect of methyl viologen and oxygen concentration on thermophilic bacteria. AB - The level of superoxide dismutase, catalase, and peroxidase was determined in obligately thermophilic bacteria after growth either in the presence of methyl viologen (paraquat) or exposed to an increased atmospheric oxygen concentration. In general, the superoxide dismutase level in these organisms was not altered by paraquat addition and had a varied response to oxygenation. Incorporation of paraquat in the growth medium resulted in minimally three-fold higher levels of catalase. The peroxidase level varied as a response to oxygen stress whereas cellular catalase levels were generally higher. PMID- 3550042 TI - Carcinogenicity of heptachlor and heptachlor epoxide. AB - Heptachlor and its metabolite heptachlor epoxide are unequivocally carcinogenic in rats and mice. The chemicals induced carcinomas of the liver, which were highly significant. There were neoplasms at other sites in rats. Neoplasms at all sites, as well as malignant tumors, were increased in heptachlor-treated male rats. There were similar increases in benign and malignant neoplasms of endocrine organs, particularly in female rats. Neoplasms of the thyroid and pituitary were increased in male rats and neoplasms of the reproductive system, including the ovary and uterus, in female rats given heptachlor. Mice also developed hepatic vein thrombosis and thrombosis of the atria of the heart. Nephritis, myocarditis, encephalitis, hepatitis, polyarteritis and atrophy of the testes were observed in rats. PMID- 3550043 TI - Diabetes: cataract extraction and intraocular lenses. AB - New findings concerning the use of anterior chamber angle-fixated lenses, especially with flexible loops, and posterior chamber lenses placed in the ciliary sulcus and in the bag reinforce previous findings that the safest procedure for diabetics is controlled extracapsular surgery with careful cleaning of the cortical material and in-the-bag implantation of a posterior chamber intraocular lens. PMID- 3550044 TI - Asteroid hyalosis affecting the choice of intraocular lens implant. AB - Asteroid hyalosis can create ultrasonic echoes capable of interfering with A-scan ultrasonic measurement of ocular length. Two cases are reported, one of which includes a measurement error necessitating a second implantation. Surgeons who entrust measurements to technicians should be aware of the measurement technique and should establish protocols that preclude such errors. PMID- 3550046 TI - Charging Medicare patients more than non-Medicare patients. PMID- 3550045 TI - Epikeratophakia for myopia. PMID- 3550048 TI - Alberta Hunter: a celebration in blues (and licensed practical nursing). PMID- 3550047 TI - Secretion control for active and inactive renin: effect of ouabain on release from rabbit kidney cortex slices. AB - Release of active and inactive renin by rabbit kidney cortex slices was investigated. Inactive renin was estimated as the increase in renin activity after acidification (pH 2.8) of slice supernatant solutions. For kidney slices incubated in complete Krebs bicarbonate buffer, the Na-K-ATPase inhibitor ouabain (100 microM) reduced the secretion of both active (-19.2%) and inactive (-78.9%) forms of renin. In low Na buffers ([Na+] = 23 mM) active renin release was increased and inactive renin was suppressed. Both of these changes were abolished by addition of ouabain (100 microM). The reduction in inactive renin secretion produced by ouabain in complete Krebs buffer did not occur in low [Na+] buffers. In zero Ca2+ buffers containing EGTA (5 mM), secretion of both active and inactive renin was increased but these changes were abolished by addition of ouabain (100 microM). Incubating kidney slices in low Na+, zero Ca2+ media revealed differences between the secretion control mechanisms for the two forms of renin. The separate stimulatory effects of low Na+ and low Ca2+ were not additive for the release of active renin and inclusion of ouabain resulted in similar secretion rates to those under control conditions. For inactive renin secretion, in the absence of Ca2+ release mechanisms still respond to reduction in Na+ with decreased secretion. Conversely, in low Na+ buffers, removal of Ca2+ still promotes inactive renin secretion. These changes were abolished by the addition of ouabain (100 microM). Slices did not change in weight during incubation in media which did not contain ouabain. Addition of this inhibitor to control buffers and low Na buffers did result in an increase in weight. This correlated with the presence of Ca2+ in the buffer and did not appear to be related to [Na+]. These studies again show that the mechanisms regulating the secretion of active and inactive renin are not identical and support the hypothesis that Na+ have differing roles to play in the regulation of these two forms of renin. PMID- 3550049 TI - The continuous brushing acid-etch technique. AB - The continuous brushing of an acid-etching agent onto the enamel surface of an extracted tooth resulted in a more debris-free surface. SEM photomicrographs showed dissolution of some of the apatite crystals and a reduction in size of the remaining crystals, thus increasing the potential space between them for retention of unfilled composite. PMID- 3550050 TI - Sprue design and its effect on the castability of ceramometal alloys. PMID- 3550051 TI - Effects of cementing on retention of a prefabricated screw post. PMID- 3550052 TI - The coronomaxillary space: literature review and anatomic description. AB - The dental literature has used a variety of terms to describe the distal buccal boundaries of the maxillae. The coronomaxillary space has been suggested as a more consistent descriptive term. It has been noted in the literature that this space narrows on mandibular opening. However, some authors recommend that overfilling this space aids retention. Explanations for this seeming contradiction in opinions have been suggested: In individuals with straight coronoid processes, the space can narrow on opening. The coronomaxillary denture may have to be thinned to maintain retention in function. In individuals with flared coronoid processes, the space can widen or remain constant on opening. The denture borders may have to be widened in contour to achieve retention. PMID- 3550053 TI - The frequency of various molds in a sample of natural and artificial dentitions. PMID- 3550055 TI - A review of masticatory muscle function. AB - Current reports of the actions of the major muscles of mastication are reviewed for clenching tasks in centric occlusion and eccentric jaw positions, mandibular opening, and unilateral chewing. The relationship of the mandible to the maxillae in the intercuspal position and, consequently, the relationship of the condyle to the fossa of the temporomandibular joint may be controlled by the clinician. Similarly, the number and site of tooth contacts in the intercuspal position and in eccentric jaw positions may be altered. These alterations all produce alteration of muscle activity during functional and parafunctional acts. Some of these alterations are now predictable. Nevertheless, much more study needs to be done before the outcomes of morphologic changes on the muscular system can be accurately predicted. Even now, however, clinicians must understand the nature of clenching and chewing muscle activity and how it can be altered to a more favorable situation for each individual. This review indicates that: The elevator muscles demonstrate maximum activity when even bilateral occlusal contacts occur during clenching in the intercuspal position. The elevator muscles are activated together in the intercuspal zone of tooth contact during chewing when the occlusal contacts are balanced bilaterally in this intercuspal position. Increasing the number of eccentric tooth contacts increases the muscle activity during both chewing and clenching. The medial pterygoid muscle is variable in its action. This variability appears to be related to the chewing pathway and the type of occlusion. Its action is enhanced during laterally directed chewing actions of the mandible. The inferior head of the lateral pterygoid muscle has a reciprocal role with the medial pterygoid muscle during chewing and contributes to forward and lateral bracing of the condyle of the mandible. Although the superior head of the lateral pterygoid muscle appears to be active during mandibular closing, the significance of this finding is not fully understood. PMID- 3550054 TI - Alternative prosthodontic technique for tissue-integrated prostheses. AB - This modified technique for fabrication of tissue-integrated prostheses saves valuable clinical time for the dentist and treatment time for the patient. The technique differs in that a modified denture is placed in the mouth the day of the second operation, impression copings are eliminated at the final impression, the framework is fabricated before jaw relation records, a high-content palladium alloy is used for the framework, the master cast is flasked similar to a complete denture technique, and the access openings are closed with a light-cured resin. Prerequisites for a tissue-integrated prosthesis are not violated and comparable results are achieved. The technique can also be used in maxillary arches and, with slight modifications, for partially edentulous patients. This technique has been used 3 years for 35 jaws in 37 patients, with 184 fixtures. Four fixtures have failed, producing a 98% success rate. All prostheses have remained continuously stable. Economy of clinical time and laboratory procedures in the prosthodontic phase increase the acceptance of osseointegration in clinical dentistry. The cooperative efforts of all disciplines will provide a greater acceptance of this treatment modality, which will enhance the patients' quality of life. PMID- 3550056 TI - A Kennedy class I removable partial denture with a resilient liner. PMID- 3550057 TI - Actinomycotic infection of a fibroid presenting in the puerperium. PMID- 3550058 TI - [The lesser omentum. Normal aspect and tumor pathology in ultrasonography and x ray computed tomography]. AB - The lesser omentum is a peritoneal partition that can be divided into two portions: superior or gastrohepatic ligament and inferior or duodenohepatic ligament, although differentiation is sometimes difficult. Ultrasound and CT scan imaging allowed perfect definition of vascular and glandular elements contained in the omentum, and normal morphology is described. Masses developing between the two leaves of which it is constituted usually project in front of adjacent vascular structures and/or prolonged into the liver hilum, and a fatty layer separates them from large prevertebral vessels. These different guidelines allow them to be distinguished from retroperitoneal celiomesenteric adenopathies. These expansive processes are almost always of glandular origin secondary to primary digestive, retroperitoneal, pelvic and even bronchial tumors. In contrast, primary tumors are rare in this region. PMID- 3550059 TI - [90 fine-needle punctures for diagnosis of the upper abdomen under ultrasonic guidance. Contribution of cyto- and histologic analysis]. AB - Fine needle puncture was performed of upper abdomen in 19 cases. The method is rapid, reliable, of low cost and only weakly traumatic. The recent possibility of coupling histologic and cytologic analysis with fine needles provides improved results by increasing diagnostic precision and identification of malignant tumors and benign tumors of difficult cytologic diagnosis. PMID- 3550061 TI - [Aneurysm of an aberrant right subclavian artery. Original contribution of x-ray computed tomography and digital subtraction angiography]. AB - An original aspect of a case of atheromatous aneurysm of an aberrant right subclavian artery was the evaluation of the complementary diagnostic value of CT scan and intravenous digital subtraction angiography imaging. The vascular anomaly was clearly identified, the CT scan visualizing the aneurysm sac more effectively and the angiography providing a vascular cartography. These two non invasive exploratory examinations provide complementary data for the preoperative diagnosis and investigation of the aberrant right subclavian artery aneurysm. PMID- 3550060 TI - [Ultrasonic diagnosis in postero-basal pulmonary sequestration in children. Apropos of 8 children including 4 with sequestration]. AB - Ultrasound imaging should be carried out in all children with posterior basal lesions of lungs suspected of being sequestration on standard images. Ultrasonography alone is capable of confirming diagnosis of branchopulmonary sequestration. Results are reported in 8 children, 4 of whom had sequestration. PMID- 3550062 TI - Thrombosed vascularized bone graft: viability compared with a conventional bone graft. AB - Previous reports in the literature have suggested that the viability of a thrombosed vascularized bone transfer is similar to that of a conventional bone graft. Our clinical impression, however, has been that this is not the case. The viability of thrombosed vascularized bone grafts was compared with that of conventional nonvascularized grafts in a canine model. Assessment included quantitating bone blood flow, tetracycline uptake, and osteocyte count. Results suggest that a thrombosed vascularized bone graft is less favorable for vascular invasion and the usual process of bone graft incorporation than a conventional bone graft. PMID- 3550063 TI - Retinopathy of prematurity. AB - This paper briefly reviews Retinopathy of Prematurity. It outlines the present incidence and risk factors, summarises the ophthalmic pathology and suggests a scheme of ophthalmic examination and management. PMID- 3550064 TI - Multiphasic oral contraceptives. Efficacy and metabolic impact. AB - The new multiphasic oral contraceptives represent an attempt to maximize contraceptive efficacy while minimizing physical and metabolic side effects. By varying the dose of progestin during the cycle, the total steroid dose per month has been reduced as compared to most fixed-dose preparations. Lowering the progestin dose appears to reduce the incidence of certain cardiovascular complications. Different oral contraceptive formulations may selectively alter lipid and carbohydrate metabolism. Norethindrone-containing multiphasics appear to have the greatest efficacy and the smallest metabolic impact. PMID- 3550066 TI - Sonographic findings in the prenatal diagnosis of cephalothoracopagus syncephalus. A case report. AB - The ultrasonic intrauterine diagnosis of cephalothoracopagus, a form of conjoined twinning, can be made when a monochorionic monoamniotic gestation contains a single head and torso accompanied by eight limbs. This is the second reported case of the syncephalus variety of cephalothoracopagus twins associated with clomiphene citrate use; however, the association is believed to be coincidental rather than causative. PMID- 3550065 TI - Elevation of plasma immunoreactive luteinizing hormone releasing hormone in hyperprolactinemic-amenorrheic women on bromocriptine therapy. AB - There is evidence to suggest that abnormalities in the secretion of prolactin (PRL) in patients with the hyperprolactinemia-amenorrhea syndrome are due to hypothalamic dysfunction. In an attempt to further define the inhibitory effect of excessive PRL release on luteinizing hormone releasing hormone (LHRH) and luteinizing hormone (LH) secretory patterns in human plasma, four amenorrheic women with known hyperprolactinemia were studied before and during bromocriptine (BRCR) therapy. Ten-minute blood samples collected with a continuous withdrawal pump for two hours were analyzed for immunoreactive LHRH (IR-LHRH), LH and PRL using previously established radioimmunoassay procedures. Three patients showed a significant rise in mean IR-LHRH plasma levels coincident with a significant decrease in mean PRL concentrations five days to two weeks following BRCR therapy, whereas mean LH titers increased significantly in only one patient. One patient showed no increase in IR-LHRH or LH with BRCR therapy and failed to show a decrease in serum PRL to normal levels after five days of this treatment. A defect in the control of PRL release in these patients seemed to result from the inability of dopaminergic inhibition to be mediated effectively and seemed to be associated with altered secretion of LHRH. PMID- 3550067 TI - Acute polyhydramnios recurrent in four pregnancies. A case report. AB - Acute idiopathic polyhydramnios recurred in four pregnancies. Laboratory and ultrasonographic examinations did not reveal the underlying pathology, and no anomalies were found in the infants. PMID- 3550068 TI - Pararenal hematoma as a complication of vaginal hysterectomy. A case report. AB - Following a vaginal hysterectomy, a woman developed a pelvic hematoma that expanded in the retroperitoneum to the level of the right kidney. Such a complication, a pararenal hematoma after vaginal hysterectomy, has not been reported on previously. The cuff hematoma was demonstrated clearly by ultrasonography. However, the extent and dimensions of the retroperitoneal hematoma were disclosed only by computed tomographic (CT) scanning. We recommend that a the CT scan be considered in the evaluation of any large posthysterectomy pelvic hematoma. PMID- 3550069 TI - Ultrasonic diagnosis of intracranial teratoma in utero. A case report and literature review. AB - Intracranial teratoma was detected ultrasonically in utero. The infant died before term. Neonatal mortality seems to be inevitable with this condition. It is important to distinguish this entity from hydrocephalus, which is recognized more frequently. PMID- 3550070 TI - Membrane attack complex of complement in rheumatoid synovial tissue demonstrated by immunofluorescent microscopy. AB - Rheumatoid and osteoarthritic synovial membranes were examined for evidence of terminal complement pathway activation. Using antiserum highly specific for C9 neoantigen, immunofluorescent microscopy was employed to study synovial membrane specimens from 4 patients with rheumatoid arthritis, one patient with psoriatic arthritis, and 5 patients with osteoarthritis. C9 neoantigen was detected in 3 of the 4 rheumatoid membranes, the one psoriatic membrane, and one of the 5 osteoarthritic membranes. Activation of the terminal pathway of complement through C9 should be added to the spectrum of immunologic events known to occur in some rheumatoid synovial membranes. PMID- 3550072 TI - beta 2-Microglobulin and systemic lupus erythematosus. AB - Serum beta 2-microglobulin (beta 2-M) was measured in 115 patients with systemic lupus erythematosus (SLE) on 192 occasions. Raised beta 2-M was found in 16.4% of patients with only extrarenal manifestations of SLE, in 29.2% of patients with renal manifestation but an endogenous creatinine clearance greater than 80 ml/min/1.73 m2 and in 65.7% of patients with decreased creatinine clearance. beta 2-M was higher in SLE than non-SLE glomerulonephritides matched for creatinine clearance. Using an arbitrary scoring system, renal, extrarenal and serological activity correlated with beta 2-M. Changes in clinical activity on repeat studies were reflected by changes in beta 2-M. Serum beta 2-M can serve as a monitor of disease activity in SLE. PMID- 3550071 TI - Clinical response to regional intravenous guanethidine in patients with rheumatoid arthritis. AB - A novel therapy for rheumatoid arthritis, regional sympathetic blockade using guanethidine, was investigated in 24 patients with active disease. In a randomized double blind short-term (14 days) study, we evaluated the effect of therapy on subjective responses, change in pain, stiffness, and morning stiffness and no objective responses, change in pinch strength, grip strength, and joint tenderness. Compared to placebo, guanethidine produced a decrease in pain (p less than 0.025) and an increase in pinch strength (less than 0.025) over the 2-week duration of the study. The therapeutic effect of guanethidine may be mediated by an interruption of the proinflammatory effects of the sympathetic nervous system. PMID- 3550073 TI - A controlled and blinded study of immunoreactant deposition at the dermal epidermal junction of patients with primary fibrositis syndrome. AB - The prevalence of immunoreactant deposition at the dermal-epidermal junction (DEJ) in clinically normal, sun exposed skin was assessed by direct immunofluorescence (IF) in 36 patients with primary fibrositis syndrome (PFS) and 12 clinically healthy control subjects. A granular or homogeneous deposition of IgG was seen at the DEJ in 52.8% (19/36) of patients with PFS and in 16.7% (2/12) of controls. The difference in IgG deposition between patients with PFS and controls was statistically significant (p = 0.030). Patients with PFS and controls did not demonstrate significant IF staining for IgA, IgM, or C3. Albumin deposition at the DEJ appeared to parallel IgG deposition in patients with PFS and control subjects who were positive for this immunoglobulin. No relationship was noted between IgG deposition and demographic or clinical characteristics of these patients' disease. These data suggest that IgG and albumin deposition at the DEJ is frequent in PFS and that further study of this skin phenomenon is warranted. PMID- 3550074 TI - Syndrome of temporal arteritis with perivascular infiltration by malignant cells in a patient with follicular small cleaved cell lymphoma. AB - A patient with follicular small cleaved cell lymphoma presented with Sjogren's syndrome and symptoms of polymyalgia rheumatica and temporal arteritis. Biopsy of the temporal artery showed an extensive perivascular infiltrate by malignant cells without evidence of giant cells. PMID- 3550075 TI - Can a diagnosis be made in retrospect? The case of Desiderius Erasmus. AB - Review of data in very old charts sometimes brings new insights and perspectives, and suggests new hypothesis for illnesses of patients long deceased. Such applications can be made if enough information is available, e.g., autobiographical letters, skeletal remains, pictorial representations. Finally the process must be discussed in the context of the major disease processes occurring at that time. When such an approach was applied to Erasmus (Rotterdam c 1466--Basle 1536), the differential diagnosis included gout, syphilitic arthritis and enteric rheumatism. PMID- 3550076 TI - Preoperative staging of local invasion in rectal cancer using endoluminal ultrasound. AB - Digital examination is the most commonly used method of assessing local invasion in rectal cancer, but it is highly subjective and accuracy is related to surgical experience. The use of transrectal ultrasound in the preoperative staging of rectal cancer has been assessed in 51 patients with histologically proven rectal cancers. Results showed a high degree of correlation when compared with postoperative histopathology (r = 0.91, P less than 0.001). Invasion beyond the muscularis propria was predicted with a sensitivity of 97%, specificity of 92% and predictive value of 97%. PMID- 3550077 TI - Von Pirquet, allergy and infectious diseases: a review. PMID- 3550079 TI - Wastage of drug from nebulisers: a review. PMID- 3550080 TI - Building or extending a hospital department: radiology. A path through the planning minefield. PMID- 3550078 TI - Pathogenesis of idiopathic hypercalciuria: a review. PMID- 3550081 TI - Linear IgA disease and oesophageal carcinoma. PMID- 3550083 TI - Building or extending a hospital department: radiology. A path through the planning minefield (2). PMID- 3550082 TI - Myocardial infarction and mental illness: a review. PMID- 3550085 TI - Animals at home--pets as pests: a review. PMID- 3550084 TI - Effectiveness of amantadine in reducing relapses in multiple sclerosis. AB - Fifty-three patients with multiple sclerosis were assessed in a double-blind multicentre study for the effect of amatadine. The patients were observed in general practices for up to four years. Relapses occurred in 5 of the 24 patients treated with amantadine and in 14 of the 29 placebo-treated patients. Neurological deterioration was not significantly different in the two groups. PMID- 3550086 TI - Design of alternate substrate inhibitors of serine proteases. Synergistic use of alkyl substitution to impede enzyme-catalyzed deacylation. PMID- 3550087 TI - Structure-activity studies of antagonists of luteinizing hormone-releasing hormone with emphasis on the amino-terminal region. AB - The structure-activity relationship of the hydrophobic amino terminal region of the antagonist [N-Ac-D-Nal1,D-pClPhe2,D-Trp3,D-Arg6,Phe7,D-Ala10]-LH- RH has been investigated by the incorporation of a variety of amino acids with emphasis on positions 1, 2, and 3. The analogues were prepared by routine solid-phase peptide synthesis. All purifications were performed in two stages: gel permeation chromatography followed by preparative, reversed-phase, high-performance chromatography. The analogues were assayed in a standard rat antiovulatory assay using a 40% propane-1,2-diol-saline vehicle. A simplified antagonist was developed that allowed the removal of the custom-synthesized D-pClPhe and the labile D-Trp while retaining antiovulatory potency. The compound [N-Ac-D-Nal1,D Phe2,3,D-Arg6,Phe7,D-Ala10]-LH-RH caused a 56% blockade of ovulation at the 500 ng dose and is approximately equipotent with the parent analogue in this system. PMID- 3550089 TI - Medical education in People's Republic of China. AB - The three types of physicians being educated in the People's Republic of China- practitioners in traditional Chinese medicine, traditional Mongolian medicine, and western-type medicine--and the nation's medical schools are discussed. The country officially recognizes 117 health professions educational institutions--23 colleges of traditional Chinese medicine, 91 western-type medical schools, two schools of pharmacy, and one institution that trains pharmacy, medical, and hygienic inspectors. Eight of the 91 western-type schools, in addition to providing training in western-type medicine, also offer education in traditional Chinese medicine. Training in Mongolian medicine is offered by one of these eight western schools and by one other western school. No schools offer only Mongolian medicine education. PMID- 3550090 TI - Information system linking a medical school with practitioners and hospitals. AB - A recently established medical information network uses computers and telephone lines to link rural Georgia medical practitioners, Georgia hospitals, and the Mercer University School of Medicine (MUSM) in Macon, Georgia. This network, the Georgia Interactive Network for Medical Information (GaIN), provides a service and educational support system for its members. The GaIN model embodies many of the educational and information management principles endorsed by two reports by the Association of American Medical Colleges: the 1984 report of the Project Panel on the General Professional Education of the Physician and a 1982 project report called "Academic Information in the Academic Health Sciences Center." The design, services, utilization patterns, and results of the GaIN project and implications for the network's future are described. Use of the GaIN has made MUSM students more at ease with computers, has connected MUSM with remote teaching sites and rural practices, and has served as a catalyst for Georgia physicians' investigation of computer applications to support health care delivery in the state. PMID- 3550091 TI - Western blot analysis of staphylococcal antibodies present in human sera during health and disease. AB - IgG antibodies directed against Staphylococcus aureus were examined by Western blotting in sera from 15 healthy individuals isolated for a year in Antarctica. Sera reacted with many staphylococcal antigens in whole-cell extracts and individuals showed unique and unchanging blot profiles. The IgG and IgM profiles of patients with deep-seated staphylococcal infections were also examined by Western blotting. Anti-staphylococcal IgM antibodies that reacted with an antigen of apparent molecular mass 31 X 10(3) were present in all patients with staphylococcal disease, and were absent from, or detected in much smaller amounts in, control sera. PMID- 3550092 TI - Effect of intravenous immunoglobulin on E. coli opsonization in multiple myeloma. AB - Infections are a major source of morbidity in multiple myeloma; E. coli is now the leading pathogen. Intravenous IgG may be a modality which could ameliorate the opsinopathy of multiple myeloma. We infused 6 patients with multiple myeloma with IgG (100 mg/kg) and compared E. coli opsonophagocytosis pre- and post-IgG infusions. Log phase, broth grown E. coli K12 (5 X 10(6)/ml) and normal, dextran sedimented human neutrophils (5 X 10(6)/ml) were combined in 10% heat inactivated, pre- or post-IgG infusion multiple myeloma serum with 5% agammaglobulinemic serum as a complement source and incubated at 37 degrees C for 30 min. Phagocytosis was quantified as percentage survival of the inoculum. Control survival in heat inactivated normal serum + complement + neutrophils was 1.7 +/- 0.8%. Pre- and post-IgG infusion sera were equally abnormal opsonin sources with 14.3 +/- 6.5% and 17.5 +/- 3.0% survivals. Individually, patients with poor opsonophagocytosis improved with IgG (e.g., pre = 45.2 +/- 3.7%; post = 29.5 +/- 2.3% survival), whereas patients with good opsonophagocytosis showed a deleterious effect (e.g., pre = 2.3 +/- 0.9%; post 23.3 +/- 6.3% survival). To explain these data, we measured deposited IgM and IgG on E. coli by pre- and post IgG infusion sera in a fluorescence immunoassay. Pre- and post-IgG infusion sera had equally depressed IgM deposition (pre = 13.7 +/- 2.1%; post = 14.5 +/- 2.6% of normal serum), and also equal IgG deposition (pre = 96.8 +/- 6.5%; post = 94.6 +/- 4.8% of normal serum).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550093 TI - Determination of complement activating circulating immune complexes and an example for antigen specific immune complex assays. AB - For the screening of complement activating circulating immune complexes a new fluorescence linked immunosorbent assay was developed. Anti-human C3 or anti human C4 F(ab')2 fragments were coupled to a nitrocellulose matrix. Nitrocellulose pieces of definite size covered with anti-C3 and anti-C4 were incubated with serum samples or standards for 15 min followed by a reaction with a fluorescence labelled anti-human IgG or anti-human-IgM. The nitrocellulose disks were then washed and the remaining fluorescence was read by a solid-phase fluorometer. The method was standardized by a WHO Tetanus toxoid anti-Tetanus immune complex reference substandard. (This standard and further controls were used to prove the reproducibility of the system.) Patients suffering from chronic inflammatory diseases were compared to healthy controls. The best discrimination between patients and controls was demonstrated by the determination of C3-IgG aggregates, followed by C3-IgM, C4-IgG, and C4-IgM aggregates. The easy performance, the stability of necessary chemical substances, the reliable standardization by a reference standard, and the clear-cut differences between patients and healthy control groups proved this test to be suitable for routine purposes. Furthermore, it could be demonstrated by means of an artificial model immune complex that this system can be expanded--by slight modifications--to antigen-specific CIC-assays. A CEA-anti-CEA CIC test is described as an example of an antigen specific CIC test not limited to complement activating CIC, and the data of 127 patients with colorectal carcinoma are given. PMID- 3550088 TI - Human chromosome 22. AB - The acrocentric chromosome 22, one of the shortest human chromosomes, carries about 52 000 kb of DNA. The short arm is made up essentially of heterochromatin and, as in other acrocentric chromosomes, it contains ribosomal RNA genes. Ten identified genes have been assigned to the long arm, of which four have already been cloned and documented (the cluster of lambda immunoglobulin genes, myoglobin, the proto-oncogene c-sis, bcr). In addition, about 10 anonymous DNA segments have been cloned from chromosome 22 specific DNA libraries. About a dozen diseases, including at least four different malignancies, are related to an inherited or acquired pathology of chromosome 22. They have been characterised at the phenotypic or chromosome level or both. In chronic myelogenous leukaemia, with the Ph1 chromosome, and Burkitt's lymphoma, with the t(8;22) variant translocation, the molecular pathology is being studied at the DNA level, bridging for the first time the gap between cytogenetics and molecular genetics. PMID- 3550094 TI - Demonstration of anti-mitochondria antibodies by ELISA. Comparison with the indirect immunofluorescence technique on organ sections. AB - We determined the optimal conditions for the detection of anti-mitochondria antibodies by an enzyme linked immunosorbent assay (ELISA). Pig heart mitochondria was used at 5 mg/ml to coat polystyrene microplates and a serum dilution of 1/200 to carry out testing. This procedure detects anti-M1, M2, M4 and M6 antibodies and is more sensitive than indirect immunofluorescence. Anti endoplasmic reticulum and anti-ribosome antibodies give negative results but anti ds-DNA at high titres are a possible cause of false positivity. PMID- 3550095 TI - Crown and bridge porcelains. PMID- 3550096 TI - Factors involved in dental implant abutments. PMID- 3550098 TI - Attempting to control blood pressure without systematic instruction: when advice is counterproductive. AB - The present study examined the effects of asking subjects to keep their blood pressure level low while in the presence of an arousing stimulus. It was hypothesized that, without assistance, subjects' attempts to keep their blood pressure low would actually produce increases in blood pressure, as compared to subjects simply asked to respond naturally to the arousing stimulus. Fifty male subjects watched a videotape containing a neutral (nonarousing) section and an erotic section while their blood pressure was recorded by means of an automated blood-pressure monitoring device. Some of the subjects were asked to relax and keep their blood pressure low during the erotic parts of the videotape; the rest of the subjects were asked to respond naturally. The results confirmed the hypothesis, suggesting that urging people to relax can be counterproductive if they do not also receive systematic instruction on how to relax or control blood pressure. Implications for health messages in the mass media and physician patient interactions are discussed. PMID- 3550097 TI - Client variables and the behavioral treatment of recurrent tension headache: a meta-analytic review. AB - Meta-analysis revealed that in studies evaluating behavioral treatments for tension headaches, the treatment outcome has varied with the client samples (e.g., age, gender, referral source) that have been used but not with the treatment procedures (e.g., type of behavioral intervention, length of treatment, whether or not efforts were made to facilitate transfer of training) or the research designs (e.g., internal validity, explicitness of diagnostic criteria) that have been used. Mean client age proved the best predictor of treatment outcome, accounting for 30% of the outcome variance following behavior therapy. Significantly poorer outcomes have also been reported in recent studies than were reported in early studies. These findings suggest that outcomes obtained with behavioral interventions have been less dependent upon the treatment variables that have been the primary focus of research attention than upon characteristics of client samples and behavioral interventions may be less effective in reducing headache activity than has previously been assumed. PMID- 3550099 TI - From consensus to chaos: a historical perspective of American attitudes toward illness. PMID- 3550101 TI - Pre-steady-state kinetics of ribosomal translocation. AB - The two partial reactions of elongation factor G dependent translocation, the release of deacylated tRNA from the P site and the displacement of peptidyl tRNA from the A to the P site, have been studied with the stopped-flow technique. The experiments were performed with poly(U)-programmed ribosomes from Escherichia coli carrying deacylated tRNAPhe in the P site and N-AcPhe-tRNAPhe in the A site in the presence of GTP. The kinetics of the reaction were followed by monitoring either the intensity or the polarization of the fluorescence of both wybutine and proflavine located in the anticodon loop or of proflavine located in the D loop of yeast tRNAPhe or N-AcPhe-tRNAPhe. Both displacement and release fluorescence changes could be described by three exponentials, exhibiting apparent first-order rate-constants (20 degrees C) of 2 to 5 s-1 (15 s-1, 35 degrees C), 0.1 to 0.3 s 1, and 0.01 to 0.02 s-1, measured with a saturating concentration of elongation factor G (1 microM). The activation energy for the fast process of both reactions was found to be 70 kJ/mol (17 kcal/mol), while the intermediate process exhibits an activation energy of 30 kJ/mol (7 kcal/mol). The fast step is assigned to the displacement of the N-AcPhe-tRNAPhe from the A to the P site, and to the release of the tRNAPhe from the P site. The reactions take place simultaneously to form an intermediate post-translocation complex. The latter, in the intermediate step, rearranges to form a post-translocation complex carrying the deacylated tRNAPhe in an exit site and N-AcPhe-tRNAPhe in the P site, both in their equilibrium states. In parallel, or subsequently, the deacylated tRNAPhe spontaneously dissociates from the ribosome, thus completing the translocation process. The slow process has not been assigned. PMID- 3550100 TI - Negatively stained 50 S ribosomal subunits of Escherichia coli. AB - Ribosomes are large nucleoproteins of approximately 3 X 10(6) Mr. In contrast to helical or spherical nucleoproteins (viruses) of similar size (which consist of several hundred small asymmetric units reproduced by symmetry), ribosomes are completely asymmetric; therefore, the amount of structural information (defined by the number of independent image elements) necessarily increases from about 10 to 20 to about 1000 to 2000 (at resolutions of the order of 2 nm). With present techniques, only stained single particles can be studied in the electron microscope. Our published work on the 30 S subunit and on the 50 S subunit has demonstrated that three-dimensional reconstructions of stained single particles show a great number of structural details that are reproducible if the particles have the same orientation. One of the main results of this paper is the final proof of this reproducibility from detailed comparisons of individual 50 S subunits and of independent averages over a few (3 to 5) particles in the kidney or crown orientation; in the latter case, even after a chemical modification. The 50 S subunit is non-uniformly stained along the optical axis. It displays a complicated, stain-filled channel-like structure, within which is approximately the partial volume expected for the RNA. The particle shows an irregular but reproducible boundary surface against the stain. At several sites, the channel structure protrudes to the surface. Since the secondary structure of the RNA is well known, one might try to locate it in the subunit after chemical identification of its surface contacts (the 3' end of 23 S RNA and the 3' end of the 5 S RNA have been localized). Most interesting is a groove on the surface, which might accommodate the mRNA. PMID- 3550102 TI - Residue-specific assignments of resonances in the 1H nuclear magnetic resonance spectrum of ribosomal protein E-L30 by systematic application of two-dimensional Fourier transform nuclear magnetic resonance methods. AB - A two-dimensional Fourier transform nuclear magnetic resonance study of the ribosomal protein E-L30 is reported. Five two-dimensional techniques, namely: nuclear magnetic resonance J-resolved spectroscopy, correlated spectroscopy, double quantum spectroscopy, relayed coherence transfer and nuclear Overhauser enhancement spectroscopy were used. Qualitative inspection of the spectra obtained by these techniques provided evidence that the E-L30 molecule has a well defined structure in solution. This analysis indicated that, despite the fact that the protein is stable only at moderate temperatures and neutral pH, a structural analysis of the molecule would be feasible. A detailed analysis of the spectra permitted unambiguous discrimination between the spin systems of different amino acids, resulting in residue-specific resonance assignments. We were able to assign all resonances of all six threonine, four valine, five alanine, two histidine, two serine, one phenylalanine, one asparagine and one aspartic acid residue of E-L30. Complete resonance assignment was obtained for two glycine residues. Partial assignments became available for all six isoleucine, three glycine and one glutamine residue. These results form a sound basis for the structure determination of the protein described in the accompanying paper. PMID- 3550103 TI - Nucleotide sequence of the phoR gene, a regulatory gene for the phosphate regulon of Escherichia coli. AB - Genes in the phosphate regulon of Escherichia coli are positively regulated by the products of the phoB and phoR genes with limited phosphate, and negatively regulated by the product of the phoR gene with excess phosphate. We present here the complete nucleotide sequence of the phoR gene. Together with the DNA sequence of the upstream phoB gene that we determined previously, this region shows the following features. The flanking regions of the operon are abundant in A-T base pairs. A possible stem-and-loop structure of the transcript followed by several U residues characteristic of rho-independent transcriptional terminators was distal to the phoR coding region. The operon is probably composed of only two cistrons. The nucleotide sequence of phoR indicates that its protein consists of 431 amino acid residues and has a molecular weight of 49,666. The amino acid sequence of the PhoR protein has significant homology with that of the EnvZ protein, which is a regulator for the omp regulon. Therefore, the sequences of the PhoB and PhoR proteins have considerable homologies with those of the OmpR and EnvZ proteins, respectively, indicating that the two operons share a common ancestor. The PhoR protein contains an extensive hydrophobic region in the amino-terminal portion. Thus the protein may be a membrane protein and function as a component of a signal transducer. PMID- 3550104 TI - Electron microscope study of the effect of temperature on the length of the tail of the myosin molecule. AB - The effect of temperature on the length of the tail of the myosin molecule has been studied by negative staining of molecules immobilized on carbon substrates at different temperatures. In buffers containing chloride as the principal anion, tail length was approximately constant up to 25 degrees C. Above this temperature, it shortened linearly with increasing temperature up to 42 degrees C, the highest temperature studied in this solvent. The amount of shortening per degree C was about 1.2 nm. A similar amount of shortening per degree C was seen in acetate-containing buffers up to 50 degrees C, but in this case it did not begin until the temperature exceeded about 40 degrees C. A large fraction of the observed shortening was localized in a region that lies roughly between the two positions in the tail where proteolysis results in production of short or long subfragment-2. Frequently, the tail had a different appearance in this region from elsewhere and could sometimes be seen to split into two strands that were separate but coiled around one another. PMID- 3550105 TI - Opposite initial effects of supply and demand ischemia on left ventricular diastolic compliance: the ischemia-diastolic paradox. PMID- 3550107 TI - Corneal transplantation. Guidelines for the refraction of patients with corneal transplantation. PMID- 3550109 TI - Implant dentistry forefront '85. Design and methods. PMID- 3550106 TI - Identification of heme oxygenase and cytochrome P-450 in the rabbit heart. AB - The regulation of cardiac heme oxygenase and cytochrome P-450 mixed function oxidase was studied in the rabbit heart. Heme oxygenase activity is found in ventricular and atrial microsomal fractions. This activity is NADPH dependent, and is inhibited by tin and zinc protoporphyrin, but not by either SKF 525A or 7,8-benzoflavone. Immunologic studies of cardiac heme oxygenase demonstrate that antibodies prepared against human purified hepatic heme oxygenase recognize rabbit atrial heme oxygenase and inhibit the enzyme activity by 92%. In contrast, control immunoglobulin does not inhibit heme oxygenase activity. Further, the western blotting technique demonstrates that a similar band of protein with a molecular weight of 32,000 exists in cardiac microsomes and that no protein cross reacts with purified hepatocyte heme oxygenase. Marked induction of atrial heme oxygenase is observed in microsomal fractions prepared from rabbits treated with cobalt chloride. Atrial microsomes possess 0.24 nmol of cytochrome P-450 as compared to 0.68 nmol/mg protein in microsomes from the liver. The levels of aryl hydrocarbon hydroxylase (AHH) activity, a cytochrome P-450-dependent enzyme, in ventricle and atrium are stimulated by a NADPH-generating system and are sensitive to 7,8-benzoflavone, and SKF 525A, known inhibitors of cytochrome P-450 mixed function oxidase. AHH activity in ventricular and atrial microsomes is 2-3% of that seen in liver microsomes whereas the P-450 content/mg protein is about 20% of that observed in the liver. AHH activity is mediated by a form of cytochrome P-450 that is inducible by 3-methylcholanthrene/beta-naphthoflavone. A possible new role of the heart cytochrome P-450 system in cardiac function is proposed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550108 TI - Keratoconus. PMID- 3550111 TI - Osseointegrated implants in clinical practice. PMID- 3550110 TI - Swiss screw: concept and experimental work. PMID- 3550112 TI - Dental implant design: biomechanics and interfacial tissue. PMID- 3550114 TI - Implant prostheses. Blade vs. cantilever--clinical trial. PMID- 3550113 TI - Tissue-integrated prosthesis. PMID- 3550115 TI - Blades--15-year clinical trial report. PMID- 3550116 TI - Titanium fiber-mesh metal implant. PMID- 3550117 TI - Direct morphological demonstration of the coexistence of vimentin and desmin in the same intermediate filaments of vascular smooth muscle cells. AB - The stable coexistence of the intermediate filament proteins desmin and vimentin in vascular smooth muscle cells raises questions about the relative amounts of the two proteins in different individual cells, and the distribution of the two proteins in individual intermediate filaments within each cell. These questions have been explored by double immunofluorescence microscopy and double immunoelectron microscopy on semi-thin and ultrathin frozen sections of chicken aorta. The former studies indicate that there is a surprisingly wide variation in the desmin/vimentin ratio in adjacent smooth muscle cells. The latter studies show that both proteins are present in individual intermediate filaments, in clustered arrays rather than uniformly distributed. These findings extend earlier related results, and suggest that the turnover of intermediate filaments may involve the remodelling of existing filaments rather than their de novo polymerization. PMID- 3550118 TI - Internalization of receptor and hormone after hormonal imprinting, as detected with colloidal gold labeled insulin in cultures of a permanent liver cell line. AB - The intracellular localization of internalized colloidal gold-labeled hormone differed markedly between Chang liver cells pretreated and not pretreated with insulin. While the non-imprinted cells bound little hormone in the coated pits and internalized it mainly inside smooth vesicles, the imprinted cells bound the bulk of hormone in coated pits and coated vesicles. Later the label appeared inside the lysosomes and in the imprinted cells it was abundantly present also in extra-lysosomal localizations, mainly on the nuclear membrane and inside the nucleus. These observations disclosed some new information on the internalization of the receptor-hormone complex, and on the mechanism of hormonal imprinting as well. PMID- 3550119 TI - Structural analysis of the cytoskeleton of Tritrichomonas foetus. AB - The cytoskeleton of Tritrichomonas foetus was studied by immunofluorescence microscopy, using anti-actin, anti-filamin, anti-myosin and anti-tubulin monospecific antibodies, and by high voltage electron microscopy of Triton X-100 extracted cells. Actin, filamin and myosin were distributed throughout the cytoplasm of T. foetus. Filamin, however, is more concentrated at the cell periphery. The peltar-axostylar system could be seen in interphasic and dividing cells using anti-tubulin antibodies. High voltage electron micrographs showed the spatial distribution of the microtubules and their association with the hydrogenosomes, and the association of the costa with the recurrent flagellum. PMID- 3550120 TI - [Bonding mechanisms of various metals for porcelain fused to metal crowns. III. A study of the oxidation and microstructure of base metals for metal-ceramic crowns]. PMID- 3550121 TI - [The root canal morphology of mandibular permanent premolars in the Chinese]. PMID- 3550122 TI - Mycetoma in Saudi Arabia. AB - The clinical and microbiological features of 31 cases of mycetoma seen in 8 years at a Riyadh hospital are described. Eighteen were due to Streptomyces somaliensis, 10 to Madurella mycetomatis and one each to Actinomadura madurae, Nocardia asteroides, and an unidentified species of Cladosporium. No immune defects were detected in the patients. Eleven had osteolytic lesions and 17 required surgery. Only seven patients were cured. Streptomyces infections were seen from all parts of Saudi Arabia outside the Rub Al Khali, but Madurella occurred mostly in highland regions where rainfall is higher. PMID- 3550123 TI - Immunopathological characteristics of nasal polyps. AB - The presence of immunoglobulins in nasal polyps and surrounding mucosa was studied by direct immunofluorescence in 14 patients. Specific and total IgE were determined in polyps and in the sera of this group. Significant immunofluorescence to IgE was demonstrated in 12 polyps but in only four samples of adjacent mucosa. Eight polyps showed significant immunofluorescence to IgM. Six patients had elevated total IgE levels within polyp sac fluid in the absence of elevated serum values. In seven cases, specific IgE was found in polyp sac fluid which could not be detected on skin or serum testing. These results may suggest local production of IgE and support the concept of nasal polyps being a manifestation of a local allergic phenomenon. PMID- 3550124 TI - A review of conventional and CT imaging in the evaluation of thyroid malignancies. AB - Conventional imaging modalities available for investigating suspected or confirmed malignancies of the thyroid are reviewed. CT scan, a relatively new tool in this area, is discussed in some detail, and its advantages outlined and illustrated with clinical examples. PMID- 3550125 TI - Sonographic diagnosis of tuberculoid leprosy. PMID- 3550126 TI - Sonographic observation of in utero fetal "masturbation". PMID- 3550127 TI - Focal hepatic lucencies. PMID- 3550128 TI - Prenatal sonographic diagnosis of isolated congenital cystic hygroma, unassociated with lymphedema or other morphologic abnormality. AB - We report the prenatal sonographic diagnosis of five cases of isolated cystic hygroma (lymphangioma), unassociated with lymphedema or other morphological abnormalities. This type of cystic hygroma appears different from the ones occurring at the back of the neck, which have other lymphatic anomalies and a poor prognosis. Four of the five fetuses did well after surgery. We describe the sonographic appearance of this type of cystic hygroma, which is different from the nuchal type as it is primarily complex. PMID- 3550130 TI - Lupus nephritis. New sonographic findings. AB - The value of sonography in the evaluation of patients with lupus nephritis has been limited to determination of location and size of the kidneys and the exclusion of hydronephrosis; quantitative estimation of the severity of renal compromise by sonographic appearance is less accurate than laboratory tests. Similarly, the lack of specificity of the sonographic changes in most nephritities makes sonography a poor predictor of the underlying etiology. We report a previously undescribed sonographic pattern first recognized in two cases of proven lupus nephritis. We successfully used this pattern to predict the presence of "silent" lupus nephritis in a previously undiagnosed case of systemic lupus erythematosus. PMID- 3550129 TI - High-resolution real-time ultrasound in Peyronie's disease. AB - Sonography is not considered to be a radiation hazard; it is noninvasive and can be widely used for examining external genitalia. We examined six cases of Peyronie's disease of the penis by high-resolution real-time ultrasound. The sonographic findings include a thick echogenic plaque with echogenicity similar to or higher than the tunica albuginea; a calcified plaque in thickened tunica albuginea; and are occasionally associated with calcification in the corpora cavernosa. Sonography may clearly localize the abnormal thickened area of collagen deposition and calcification. Repeated sonography after intracavernosal papaverine injection may further confirm the correlation of the plaque and the abnormally curved erectile penis. Doppler ultrasound may be used for further evaluation of the vascular condition if impotence coexists. PMID- 3550131 TI - Objective method of diagnosing oligohydramnios in postterm pregnancies. AB - Oligohydramnios is an important factor influencing the management of postterm pregnancies. However, sonographic assessment of oligohydramnios has been based largely on the subjective judgement of the sonologist. From January 1982 to December 1984, 54 patients had articulated-arm B-scan ultrasound examinations and were identified as postterm. Of these patients, 25 were subjectively diagnosed as having oligohydramnios. Five patients were considered to have low normal amounts of amniotic fluid. The remainder were considered to have normal or greater than normal quantities of amniotic fluid. From this population, an amniotic fluid index was determined for each patient by finding the product of the length, width, and depth of the largest amniotic fluid pocket. Patients with a fluid index less than 60 showed a strong association with the postmaturity syndrome. Indeed, all but one postmature infant was born of a pregnancy with a fluid index less than 60. No other fetal or perinatal complications were statistically correlated with oligohydramnios in this small patient series. PMID- 3550132 TI - Sonographic demonstration of combined quadruplet gestation, with viable ectopic and concomitant intrauterine triplet pregnancies. PMID- 3550133 TI - Prenatal sonographic appearance of diprosopus. PMID- 3550134 TI - Seminoma in an atrophic testis. Ultrasound evaluation. PMID- 3550135 TI - Visualization of tumor vascularity in a rabbit VX2 carcinoma by Doppler flow mapping. AB - Using an ultrasonic dynamic flow imager that displays both soft tissues and color coded flow in the same two-dimensional slice, we were able to display neovascularity in a rabbit VX2 carcinoma. Intravenous infusion of epinephrine altered the flow dynamics in two arteries, one within the tumor and one at the periphery. Further, we were also able to visualize areas of multidirectional flow presumably due to complex arterial patterns and arteriovenous shunts. It is concluded that the color-coded Doppler instrument may overcome some of the methodological problems associated with tumor diagnosis via flow characteristics in the human breast. The literature indicates that the vascular response to the vasoactive drugs or thermal stress may increase differentiation of malignant breast lesions. This experiment suggests that Doppler images and measurements may be made efficiently with color-coded Doppler images, particularly with the addition of more quantitative features to the imager. PMID- 3550136 TI - Tongue cancer. Sonographic assessment of tumor stage. AB - In an effort to improve preoperative evaluation of tumors of the tongue, a prospective study on the value of ultrasound (US) for the staging of 50 surgically proven cancers of the tongue and floor of mouth was performed. Sonography was correlated with clinical staging and surgical outcome. Real-time high-frequency transducers and an echo-free silicone interface were used. The dorsal and middle thirds of the tongue were scanned from a submental access and the tip of the tongue directly. US accurately defined tumor sizes and locations in all cases. US staged cancers correctly in all cases but one. In contrast, clinical staging was correct in only 66% of cases. Surgically relevant details, such as crossing of the midline of the tongue or infiltration of the lateral pharyngeal wall, were detected with US. The major limitations of US include the nonvisualization of the epiglottis and retropharyngeal space as well as bone infiltration. PMID- 3550137 TI - Ultrasonic "double track" sign in hypertrophic pyloric stenosis. AB - Ultrasound has been used in the diagnosis of hypertrophic pyloric stenosis since the first reports of its use with contact B mode scanners. Real-time imaging has allowed measurements of pyloric diameter, length, and muscle wall thickness. Wall thickness measurements taken with the pylorus in longitudinal (elongated) view improve diagnostic accuracy. Fluid aided real-time examination of 10 cases showed the ultrasound equivalent of the "double track" sign. This finding is the result of pyloric fluid compressed into smaller tracks as it is impinged upon circumferentially by the thickened circular muscle. This sign, previously seen in barium studies, although nonspecific, may prove to be a sensitive diagnostic criterion. PMID- 3550138 TI - Ectopic pregnancy. Diagnosis by sonography correlated with quantitative HCG levels. AB - Pelvic sonograms were correlated with simultaneous human chorionic gonadotropin (HCG) determinations in 150 women with early intrauterine pregnancy (N = 76) and ectopic pregnancy (N = 74). Of the 76 patients with intrauterine pregnancy (IUP), 55 had HCG levels exceeding 1,800 mIU/ml (Second International Standard), and in each case a gestational sac was identified. In comparison, 35 of 74 (47%) patients with ectopic pregnancy had HCG levels of 1,800 mIU/ml or more, and no case demonstrated a gestational sac. Although six patients (8%) with ectopic pregnancy demonstrated a "pseudogestational sac," no case was confused with a true gestational sac. We conclude that, when the HCG level exceeds 1,800 mIU/ml, an intrauterine gestational sac is normally detected and its absence is evidence for an ectopic pregnancy. PMID- 3550139 TI - Ultrasound examination of extracardiac chest masses in children. Doppler diagnosis of a vascular etiology. AB - The purpose of this paper is to describe the use of two-dimensional and Doppler ultrasound techniques in the evaluation of chest masses of unknown etiology. We reviewed the diagnosis of chest masses in 12 children seen over 3 years, all confirmed by surgery or pathology. The masses were vascular in three patients (pseudoaneurysm) and nonvascular in nine. Ultrasound yielded a correct differential diagnosis of the masses. Doppler sampling diagnosed the vascular etiology of the three pseudoaneurysms. We conclude that Doppler techniques can identify the vascular nature of chest masses, and that ultrasonography is valuable in the assessment of chest masses in children. PMID- 3550140 TI - Intrapericardial teratoma. Ultrasonic and pathological features. PMID- 3550141 TI - Congenital megacalyces. Ultrasound appearance. PMID- 3550142 TI - Macrosomia. PMID- 3550143 TI - Monoclonal antibodies: state of the art. PMID- 3550144 TI - Local failure after definitive therapy for prostatic cancer. PMID- 3550145 TI - Significance of immediate preoperative bacteriuria with pyuria in renal transplant recipients. AB - The presence of bacteriuria and pyuria on urinalysis immediately before renal transplantation has resulted in cancellation of surgery because of concern about post-transplant wound infection. Of 113 renal transplant recipients reviewed 41 (36 per cent) had 5 or more white blood cells per high power field with bacteria in either a voided urine or bladder washout specimen obtained just before grafting. Of those 41 patients 2 suffered postoperative wound infections. Of 72 patients (64 per cent) with less than 5 white blood cells or no bacteria on a preoperative specimen 1 suffered a wound infection (p not significant by Fisher's exact test). Preoperative urine cultures and operative bladder cultures of all 3 patients failed to yield the organisms found later in the wound infections. The factors of sex, insulin-dependent diabetes, delayed graft function, living related versus cadaver donor and pre-transplant splenectomy had no significant relationship to wound infection rates. Renal transplantation can be performed safely in patients who have pyuria and bacteriuria but no signs or symptoms of infection. PMID- 3550147 TI - Complications of ureteral endoscopy. AB - Use of the rigid ureterorenoscope has become widely accepted for the diagnosis of ureteral lesions, and for the removal and disintegration of ureteral calculi. Few complications have been reported. During the last 3 years 128 ureteroscopic procedures were performed for a variety of indications (98 for stone disease). There were 26 complications: 22 minor with no morbidity and 4 major that required surgical correction. Minor complications consisted of asymptomatic ureteral perforations in 6 patients, perforations with urinary extravasation, pain, ileus or fever in 4, migration of the stone into the kidney in 10 and migration of the stone outside the ureter with the calculus left in situ in 2. Major complications included ureteral perforation during basket extraction of an upper ureteral stone, urinoma following perforation and requiring drainage, stenosis of the intramural ureter that was corrected by marsupialization and aseptic necrosis of the ureter that was treated by ileal replacement. PMID- 3550149 TI - Intracavernous self-injection with phentolamine and papaverine for the treatment of impotence. AB - To evaluate the efficacy and safety of intracavernous self-injection of phentolamine and papaverine for the treatment of impotence, 30 patients were enrolled in a prospective, randomized, double-blind, placebo-controlled cross over study of papaverine and phentolamine versus normal saline. A total of 29 patients completed the study. The phentolamine plus papaverine combination resulted in erection in 24 patients (82.8 per cent) and no erection occurred after injection of saline. Of the patients 12 (41.4 per cent) experienced technical difficulties with the injection. Ecchymosis of the penis at the site of injection was common and 1 patient experienced priapism that resolved spontaneously. No other side effects occurred. Intracavernous self-injection with phentolamine and papaverine appears to be a safe and effective treatment of impotence but long-term effects must be determined. PMID- 3550150 TI - Symptomatic recurrent urinary tract infections in patients with renal scarring in relation to fecal colonization with P-fimbriated Escherichia coli. AB - We evaluated prospectively 49 women with renal scarring and a history of febrile urinary tract infections in regard to the incidence of recurrent symptomatic urinary tract infection and fecal colonization with P-fimbriated Escherichia coli. During a 3-year followup 26 patients (53 per cent) had symptomatic urinary tract infection (0.036 infections per patient-month), including 8 (16 per cent) who had 9 new episodes of febrile urinary tract infection, while 33 (67 per cent) had Escherichia coli bacteriuria (10(5) bacteria per ml. urine in pure culture). Thus, patients with previous febrile urinary tract infections and renal scarring have a high risk for recurrent infections. For comparison, the incidence of symptomatic urinary tract infection also was determined in 35 women with a recent episode of acute nonobstructive pyelonephritis and with normal kidneys on excretory urography. These patients had 0.031 symptomatic infections per patient month. The fecal flora were examined twice a year for P-fimbriated Escherichia coli in 48 patients with renal scarring. Of these patients 21 (44 per cent) had at least 1 fecal colonization with a P-fimbriated Escherichia coli strain. However, in only 1 instance was a relationship detected between the presence of P fimbriated Escherichia coli in the fecal flora and the development of subsequent febrile urinary tract infection. The findings indicate that fecal sampling twice a year is not of value to predict future urinary tract infections in adults with renal scarring. PMID- 3550151 TI - Ultrasonographic detection of false passages arising from the posterior urethra in spinal cord injury patients. AB - We report on false passages arising from the posterior urethra in 10 male spinal cord injury patients, of which 9 were well visualized on transrectal sonography, with real-time linear array equipment that was used to monitor a urodynamics catheter being introduced into the prostatic urethra. The only false passage not detected was at the bladder neck. Nevertheless the data show that transrectal sonography is an excellent tool to demonstrate false passages arising from the prostatic urethra. All 10 false passages were unroofed successfully with excellent results. PMID- 3550148 TI - Phase III comparison of cisplatin alone versus cisplatin, doxorubicin and cyclophosphamide in the treatment of bladder (urothelial) cancer: a Southeastern Cancer Study Group trial. AB - A prospective randomized trial compared cisplatin alone versus cisplatin, doxorubicin and cyclophosphamide in the treatment of advanced carcinoma of the bladder, ureter and renal pelvis. Objective responses were noted in 7 of 45 patients (16 per cent) given cisplatin alone and in 9 of 42 (21 per cent) treated with the combination. There was no significant difference in response rate, response duration or survival but the combination was more toxic. Other combination regimens should be evaluated. PMID- 3550146 TI - Liddle's syndrome, an uncommon form of hyporeninemic hypoaldosteronism: functional and histopathological studies. AB - Liddle's syndrome was diagnosed in a 72-year-old man who presented clinically with hypertension and muscle weakness. This disorder has been characterized by hyporeninemic hypoaldosteronism, hypertension, hypokalemia and enhanced erythrocyte sodium influx. Administration of spironolactone failed to correct the hypertension and electrolyte abnormality, which subsequently improved with triamterene therapy and a low salt diet. However, suppression of the renin angiotensin-aldosterone system remained unchanged after this treatment. In addition, an atrophic juxtaglomerular apparatus and hypertensive lesions in the arterioles were confirmed by kidney biopsy after triamterene therapy. Therefore, a process of intrinsic hyperactive distal sodium reabsorption, probably affected by aldosterone-independent sodium transport into erythrocytes, appears to be important in the pathogenesis of this syndrome. Triamterene therapy, which usually is performed in patients with this disease, might not be the ultimate therapy in the future even if electrolyte abnormalities were to be improved temporarily. PMID- 3550153 TI - Ultrasound detection of bilateral Leydig cell tumors in palpable normal testes. AB - We report a case of synchronous, nonpalpable, bilateral Leydig cell tumors that were detected only by ultrasound evaluation and gonadal vein sampling for estradiol. A review of the diagnostic and management options for Leydig cell tumors is presented. PMID- 3550152 TI - Cellulitis of the penis and scrotum due to group B streptococcus. AB - Group B streptococcus was isolated from the blood, penile exudate and needle aspirate of cellulitis in a severely ill neonate with a rapidly progressive infection of the scrotum, penis and lower abdominal wall. This case demonstrates the need to evaluate and to manage newborns with scrotal cellulitis differently than older children and adults. A different group of organisms and a greater likelihood for systemic involvement are to be anticipated in newborns. PMID- 3550154 TI - Foreign body migration to the genitourinary tract. AB - Foreign body migration from the gastrointestinal tract to any of several sites within the genitourinary tract has been well documented. We report 3 such cases involving the upper and lower urinary tract to highlight the varied presentations, manifestations and prognosis associated with this entity. PMID- 3550155 TI - Monoclonal antibodies for characterization of the heterogeneity of normal and malignant transitional cells. AB - We present two monoclonal antibodies (mab), Mano 4/4 and 486 P3/12, directed against tumor-associated antigens of different subpopulations of transitional cell bladder carcinoma tumors. A detailed description is given concerning their reactivity patterns in an ELISA assay against different cell lines. Using immunohistochemical staining against normal bladder mucosa, mab Mano 4/4 reacts with distinct cells in the basal layer and mab 486 P 3/12 recognizes single cells in the superficial layer. Analysing different transitional-cell carcinomas, mab Mano 4/4 reacts with 17 of 20 and mab 486 P 3/12 with 17 of 19 bladder tumors. It is emphasized that both mabs may add new information in respect to a better characterization of the heterogeneity of bladder carcinoma. A biochemical characterization of the mabs and their corresponding antigens is given. Mab Mano 4/4 is directed against a 28 kD glycoprotein and mab 486 P 3/12 is reacting with a 200 kD glycoprotein belonging to the family of CEA-like proteins. PMID- 3550156 TI - Ras related oncogene protein as a tumor marker in transitional cell carcinoma of the bladder. AB - An oncogene related protein has been detected in the urine of patients with transitional cell carcinoma (TCC). This is a 55 kilodalton protein (p55) which is immunologically related to the ras oncogene product p21. Sixteen patients with TCC (55%) and none of the controls exhibited high level of p55 expression (greater than or equal to 3X the level of background). There were ten cancer patients (35%) who had 2X the level of background and three patients (10%) who had the level of background. In contrast, there were two non-cancer patients with 2X level of expression (9%) and the remainder (91%) had the background level of p55 expression. The expression of the marker (p55) tends to correlate with tumor grade and stage and is elevated in patients with a history of multiple recurrences. The ras oncogene has been identified in the tissues of a wide variety of cancers and is not a marker which is specific for any single cancer. The identification of its related gene product in the urine may be useful as a marker for TCC. PMID- 3550157 TI - Adherence of Escherichia coli and Proteus mirabilis to human transitional cells. AB - This study utilizes a light microscopy assay for bacterial adherence to human male transitional cells. Prior light microscopy studies have used voided squamous cells, periurethral cells or scraped vaginal cells, which are less representative of the cells lining the majority of the urinary tract. Using a modification of previous bacterial adherence assays, the mean adherence for 28 strains of E. coli in 92 bacteria-cell incubations was 10.2 +/- 11.5 (standard deviation) bacteria per cell. The mean adherence for 20 strains of P. mirabilis in 60 bacteria cell incubations was 8.1 +/- 11.4. No statistically significant difference in adherence between E. coli and P. mirabilis was found (p greater than 0.05). Studies comparing the adherence of E. coli isolated from the urine of patients with pyelonephritis (eight strains), cystitis (10 strains) and anal swabs of females without urinary tract infections (10 strains), showed no statistically significant differences in mean adherence (p greater than 0.05). However, there was a trend toward higher adherence in the more virulent groups. Experiments comparing the adherence of P. mirabilis isolated from infected renal stones to P. mirabilis isolated from anal swabs of female patients without history of P. mirabilis UTI revealed no statistically significant differences in mean adherence between the two groups (p greater than 0.05). These data do not support previous contentions that P. mirabilis adhere poorly to human transitional cells. The absence of a significant difference in adherence among strains of E. coli and P. mirabilis that differ in clinical pathogenicity suggests that factors other than adherence contribute to their virulence. PMID- 3550158 TI - Precision in vascular surgery. PMID- 3550159 TI - Can carotid duplex scanning supplant arteriography in patients with focal carotid territory symptoms? AB - Previous reports have suggested that duplex ultrasonography might supplant arteriography as a guide to operative decision making in selected patients with cerebrovascular disease. This study was undertaken to test that tenet in patients with focal carotid territory symptoms. Seventy-two patients having independently interpreted arch and selective carotid arteriography and duplex scanning underwent 78 carotid endarterectomies. Operative specimens were analyzed in all cases and used as the standard in evaluating the accuracy of the preoperative studies. All patients had disease found at the time of operation. The sensitivity of duplex scanning was 99% vs. 91% for arteriography (p = 0.06). In seven cases the scan accurately predicted disease in patients with normal arteriograms and in a single case the scan was read as normal in a patient with a smooth minimally stenotic plaque read as an irregular 30% stenosis on arteriography. The accuracy of duplex scanning was markedly superior to arteriography in detecting intimal surface abnormalities (92% vs. 64%, p less than 0.001) and ulceration (90% vs. 54%, p less than 0.001). There was no difference between duplex scan and arteriography (p = 1.0) in predicting a greater or less than 50% stenosis (accuracy, 94% for arteriogram; 92% for duplex scanning). Of the patients with preoperative potentially reversible symptoms, 97% were free of symptoms at a mean follow-up of 9 months after operation. Eighty-nine percent (17 of 19 patients) of patients with concomitant, ipsilateral, intracranial, or intrathoracic cerebrovascular disease were free of symptoms after carotid endarterectomy. PMID- 3550161 TI - Prevalence of extracranial carotid artery disease: a survey of an asymptomatic population with noninvasive techniques. AB - To investigate the prevalence of internal carotid arterial stenosis in an unselected asymptomatic population over 50 years of age, 102 volunteers from one church congregation were studied with ultrasonic arteriography, spectral analysis, and ocular pneumoplethysmography. Fifty subjects were 50 to 59 years old; 33 were 60 to 69 years of age; and 19 were older than 70 years. Forty-five were men and 57 were women. Risk factors included diabetes mellitus (4%), heart disease (9%), hypertension (24%), peripheral vascular disease (20%), and smoking (46%). Disease was found in 11 subjects (10.8%). Of the 204 internal carotid arteries, 13 (6.4%) were abnormal. Two vessels had 20% diameter stenosis; four had stenoses of 20% to 39%; five had stenoses of 40% to 59%; one had a stenosis of 60% to 79%; and one was occluded. Stenoses greater than 40% occurred in 4% of the 50 to 59 years of age group, 6% of the 60 to 69 years of age group, and 11% of the greater than 70 years of age group. Although the prevalence of carotid stenosis was increased in all subjects who had risk factors, only the association with heart disease reached statistical significance. These results indicate that carotid stenosis is present in an appreciable number of asymptomatic subjects over the age of 50 years and suggest that its prevalence is associated with age and other risk factors. PMID- 3550160 TI - Compound polyglactin 910/polypropylene small vessel prostheses. AB - This study evaluated morphologic and functional characteristics of tissue reactions to compound prostheses of 69% absorbable polyglactin 910 (PG910) and 31% nonabsorbable polypropylene in the rabbit. Forty-two woven PG910/polypropylene prostheses (24 X 4 mm internal diameter) implanted into rabbit infrarenal aortas were harvested after 2 weeks to 12 months. Each explant was photographed and sectioned for light microscopy and transmission and scanning electron microscopy. Randomly selected explants underwent either compliance and bursting strength measurements or assays of production of prostacyclin and thromboxane metabolites by luminal surfaces of both regenerated conduits and normal control aortas in response to administered sodium arachidonate. Results showed 100% patency with no aneurysms and 2% stenoses (1 of 42 prostheses). Confluent endothelial-like cellular luminal surfaces covering oriented smooth muscle-like myofibroblasts comprised the inner capsules whose thicknesses stabilized at 1 to 2 months. Only residual polypropylene remained in the prostheses after 2 months. Compliance studies reflected a 0.65 mm (14%) change over a pressure range of 0 to 160 mm Hg. All regenerated prosthesis-tissue complexes had bursting strengths greater than the proximal perianastomotic native aortas, which burst between 600 and 2000 mm Hg. At 1 month the rate of production of 6-keto-PGF1 alpha per square millimeter of surface area of experimental segments was normal. Production of 6-keto-PGF1 alpha by experimental segments at 3 months had increased fourfold whereas thromboxane B2 (TxB2) production remained unchanged. The 6-keto-PGF1 alpha/TxB2 ratio increased from 1 to 4 months. This study demonstrates clinically efficacious morphologic, mechanical, and biochemical characteristics of PG910/polypropylene-elicited vascular prosthesis tissue complexes. PMID- 3550162 TI - Functional status changes following medical or surgical treatment for cerebral ischemia. Results of the extracranial-intracranial bypass study. AB - To determine the value of extracranial-intracranial arterial anastomosis (EC/IC bypass), we randomly allocated 1377 patients with symptomatic atherosclerosis of the internal carotid or middle cerebral arteries to medical care alone or to EC/IC bypass with continuing medical care. As previously reported, surgery did not reduce--or significantly increase--the risk of stroke. Functional status data collected during the trial provide new information. Six weeks following entry, surgical patients showed greater dysfunction in the following activities: fluency of speech, getting in and out of bed, sitting down and standing up, toileting, cutting food and pouring beverages, and dressing and undressing. At 4.5 months, surgical patients still exhibited greater dysfunction in toileting, with nonsignificant trends in several other activities. From six months onward, there were no significant differences between the groups. Thus, EC/IC bypass results in transient worsening of functional status beyond the immediate perioperative period. PMID- 3550163 TI - How the sacrum got its name. AB - The os sacrum (sacred bone) was so named by the Romans as a direct translation from the older Greek hieron osteon. Explanations of the attribute "sacred" or "holy" in the past have included misinterpretation of the Greek word hieron, use of the bone in sacrificial rites, the role of the bone in protecting the genitalia (themselves considered sacred), and the necessity for the intactness of this bone as a nidus for resurrection at the Day of Judgment. A more plausible explanation may be that the holiness of the sacral bone was an attribute borrowed from the ancient Egyptians, who considered this bone sacred to Osiris, the god of resurrection and of agriculture. PMID- 3550167 TI - [Independent lung ventilation with unilateral high-frequency jet ventilation during pulmonary surgery]. PMID- 3550166 TI - Medicine 100 years ago. II. The doctor and the law. PMID- 3550165 TI - US Preventive Services Task Force. Screening for breast cancer with breast self examination. A critical review. AB - We reviewed evidence regarding breast self-examination (BSE) and screening for breast cancer. To our knowledge, no controlled prospective trial links BSE to lives saved from breast cancer. Compared with clinical breast examination and mammography, the estimated sensitivity of BSE is low (20% to 30%) and is lower among older women. The potential sensitivity of BSE should be higher because women can detect small lumps (0.3 cm) in silicone models. Instruction increases BSE frequency over the short term. Sensitivity also increases, but specificity decreases. The psychological effects of teaching and performing BSE are not yet clear. The cost of screening by BSE is unknown but depends on the accuracy of the test as well as the training method used. Breast self-examination has potential as a screening test for breast cancer, but many questions require scientific examination before this procedure can be advocated as a screening test for breast cancer. PMID- 3550168 TI - [Anesthesia for surgical treatment of pediatric hyperinsulinism]. PMID- 3550164 TI - Why a little aspirin is better than a lot. PMID- 3550169 TI - [New antimicrobial agent series XVIII: Ceftriaxone]. PMID- 3550170 TI - [Mutation frequency test for isepamicin (HAPA-B)]. AB - Mutation frequency tests for isepamicin (HAPA-B), a new aminoglycoside antibiotic, were carried out using Salmonella typhimurium strains TA98, TA100, TA1535 and Escherichia coli WP2uvrA. After a 30-minute exposure of bacterial cells at 37 degrees C to HAPA-B in a buffer solution, the cells were washed twice with a buffer solution to minimize the cytotoxicity of the drug. Then washed cells were inoculated on minimum glucose agar plates to determine mutation frequency. The results should no significant increase in mutation frequency with increasing HAPA-B concentration; suggesting that the drug has no mutagenicity detectable by this test system. PMID- 3550171 TI - [Ultrasonographic diagnosis of intracystic breast tumors]. AB - Ultrasonography was performed on 1805 patients with breast diseases during the past 3 years and 20 (1.1%) intracystic tumors were detected. Among 20 intracystic tumors, 14 were finally diagnosed as benign and 6 as malignant. None of the 6 malignant lesions was judged as exclusively malignant and only 3 were considered as suspiciously malignant by ultrasonography. Ultrasonography is effective in making the location of intracystic tumors clear but not suitable for distinguishing malignant tumor from those that are benign. On the contrary, among the 6 malignant lesions, 5 were diagnosed as malignant and 1 as suspiciously malignant by aspiration cytology. Therefore, a combined examination of ultrasonography and aspiration cytology is a useful method for preoperative diagnosis of intracystic breast tumors. PMID- 3550172 TI - [On the long-term alternative immunochemotherapy against gastric cancer]. AB - To evaluate the effectiveness of adjuvant chemotherapy to prevent the recurrence of cancer, followed by surgical removal, controlled trial studies have been performed since 1956 as a combined program of many medical centers and hospitals. Recently, to prevent the destruction of the host defence mechanisms, non-specific immunotherapy has been used during the same time. In this report, the usefulness of "long-term alternative immunochemotherapy" in gastric cancer is mentioned in the clinical as well as in the experimental field. It is still too soon to find the best combination of these drugs and the best order in which to administer them. PMID- 3550173 TI - [Prediction of the time of ovulation]. PMID- 3550174 TI - [Enzyme activity and isozymes]. PMID- 3550175 TI - [Automation of tests for hemostasis and thrombosis]. PMID- 3550177 TI - [Detection of antinuclear antibodies using HEp-2 cells as nuclear substrates by the indirect immunofluorescent antibody technic]. PMID- 3550176 TI - [Analysis of the antigens reactive with anti-ENA antibodies by immunoblotting with the use of avidin-biotin enzyme immunoassay]. PMID- 3550178 TI - [Extracellular proteinases from Sporothrix schenckii]. PMID- 3550179 TI - [Changes in plasma secretin and gastrin levels in experimental obstructive jaundice]. PMID- 3550181 TI - [A surviving case of acute fatty liver in pregnancy with hyperthyroidism]. PMID- 3550180 TI - [Clinicopathological study of mucus-producing pancreatic tumors]. PMID- 3550182 TI - [An immunohistochemical study on prostaglandin E2 positive cells in rat gastric mucosa]. PMID- 3550183 TI - [Experiences by a medical social worker: a syndrome of resignation by unmarried pregnant girls]. PMID- 3550184 TI - [Clinical assessment of esophageal scintigraphy]. PMID- 3550185 TI - [An innovation for the Nishijin type scaler for insulin self-injection]. PMID- 3550186 TI - Neural control of blood glucose level. AB - All of the experimental results described above can be categorized as follows: the relationship between glucose levels and pancreatic and adrenal nerve activities; innervations of the liver and their role in the regulation of blood glucose level; central integration of blood glucose level; glucose-sensitive afferent nerve fibers in the liver and regulation of blood glucose; oral and intestinal inputs involved in reflex control of blood glucose level. We showed that an increase in blood glucose content produced an increase in the activity of the pancreatic branch of the vagus nerve, whereas it induced a decrease in the activity of the adrenal nerve. It was also shown that a decrease in blood glucose activated the sympatho-adrenal system and suppressed the vago-pancreatic system. It seems rational that these responses are involved in the maintenance of blood glucose level. Studies on the innervation of the liver led us to a conclusion that sympathetic innervation of the liver might play a role in eliciting a prompt hyperglycemic response through liberation of norepinephrine from the nerve terminals, and that the vagal innervation synergically worked with the humoral factor (insulin) for glycogen synthesis in the hyperglycemic condition. The glucose-sensitive afferents from the liver seem to initiate a reflex control of blood glucose level. The gustatory information on EIR response, reported by STEFFENS, is supported by the electrophysiological observations. MEI's reports also indicated the importance of information from the intestinal glucoreceptors in the reflex control of insulin secretion. The role of integrative functions of the hypothalamus and brainstem through neuronal networks on neural control of blood glucose levels is also evident. A schematic diagram of the nervous networks involved in the regulation of the blood glucose levels is shown in Fig. 3. PMID- 3550187 TI - Quantitative assessment of microvascular permeability in endotoxin-induced lung injury in anaesthetized dogs. AB - We quantitatively assessed the change of pulmonary microvascular permeability following E. coli endotoxin infusion (1 mg/kg) in anaesthetized dogs. We used mathematical analysis to estimate membrane parameters from lung lymph data. Lung lymph was collected from the afferent lymphatic connecting to the left tracheobronchial lymph node whose lymph could be considered to represent an average sample of lung tissue fluid. To separate the effects of changes in the driving pressures and surface area on lymph fluid and protein flux from those in membrane permeability, lymph flow (Jv) was increased greater than 6 times baseline by left atrial pressure (Pla) elevation until lymph protein concentration (CL) approached to a constant value independent of Jv. Membrane parameters for plasma total protein, i.e., osmotic reflection coefficient (sigma d), solvent-drag reflection coefficient (sigma f), permeability surface area product (PS), filtration coefficient (Kfc), were calculated from lung lymphatic data in control (Pla elevation alone (n = 10), and endotoxin group (n = 7). Among these parameters, osmotic reflection coefficient (sigma d) decreased significantly to 0.61 in endotoxin group from the value of 0.71 in control group. This result indicates a moderate increase in pulmonary microvascular permeability following E. coli endotoxin infusion. However, there was no significant difference in the other membrane parameters (sigma f, PS, Kfc) between control and endotoxin group. Based on these results, we conclude that sigma d could quantitatively represent the moderate change of the microvascular permeability in endotoxin-induced lung injury in anaesthetized dogs. PMID- 3550189 TI - [Needle handling of cardiac surgeons--its precision and direction]. PMID- 3550188 TI - [Respiratory failure]. PMID- 3550190 TI - Responsibility for the ED record. PMID- 3550191 TI - Descriptive outline of major poisoning treatment modes. PMID- 3550192 TI - Standardized care plans. Blunt abdominal trauma. PMID- 3550193 TI - Triage decisions: migrating pain in an adult man. PMID- 3550195 TI - Vietnam women's memorial project: Donna Marie Boulay highlights women's wartime roles. Interview by Marlene Jezierski. PMID- 3550194 TI - Let the family in. PMID- 3550196 TI - A modest proposal. PMID- 3550197 TI - Fire ant envenomation. PMID- 3550198 TI - Pediatric trauma: initial assessment and management. PMID- 3550199 TI - Men in emergency nursing. PMID- 3550200 TI - Criteria-based performance evaluations using the ENA standards of emergency nursing practice. PMID- 3550202 TI - Thrusts of Florence Nightingale in the social context of the 19th Century. PMID- 3550201 TI - Acute methyl bromide toxicity. PMID- 3550203 TI - St. Joseph Federated Nurses' Alumni Association unique to the annals of Kansas nursing. PMID- 3550204 TI - [Hypertension in advanced age: pathophysiologic and therapeutic problems]. PMID- 3550205 TI - [Disorders of carbohydrate metabolism as a potential risk factor of ischemic heart disease]. PMID- 3550206 TI - [Indications for surgical treatment of patients with aortic valve insufficiency]. PMID- 3550207 TI - [Use of pentoxifylline (trental) to correct microcirculatory disorders in patients with atherosclerosis of peripheral arteries]. PMID- 3550208 TI - [Alcohol and ischemic heart disease]. PMID- 3550209 TI - [Various aspects of the clinical use of Holter monitoring of the ECG]. PMID- 3550210 TI - [Fibronectin and its clinical significance]. PMID- 3550211 TI - [Comparison of the efficacy of different programs of physical rehabilitation for myocardial infarct patients and possibilities of increasing it by incorporating physical training at the hospital stage of rehabilitation therapy]. AB - The efficiency of rehabilitation can be improved through early activation of the patients and the beginning of exercise as early as the hospital stage of rehabilitation. The intensity of exercise should be rationed on a strictly individual basis, with regard to the patient's functional status. Hospital exercise in combination with purposeful psychotherapy are major prerequisites for the recovery of working capacity. PMID- 3550212 TI - Experimental models for IgA-associated nephritis. PMID- 3550213 TI - Ontogenesis of 28 kDa vitamin D-induced calcium-binding protein in human kidney. AB - The kidney distribution of 28 kDa vitamin D-induced calcium binding protein (CaBP) was studied in 15 fetuses (11 to 33 weeks old), six children and adults (12 days to 32 years old) by immunocytochemistry using a specific antibody to rat renal 28 kDa CaBP. Similar results were obtained on frozen and fixed tissues. Kidneys from one adult and three fetuses were studied by immunoelectronmicroscopy for antigen localization at the subcellular level using the indirect immunoperoxidase technique. The 28 kDa CaBP was present in all kidneys from the eleventh week of gestation. At that stage, all deep parts of collecting ducts were homogeneously stained and a few distal tubules located in the deep cortex were intensely labeled. No labeling was observed in the early stage of nephron differentiation (S-body). 28 kDa CaBP distribution changed with kidney maturation. There was a progressive reduction of the deep part of collecting duct labeling and a concomitant increase in the number and intensity of stained distal tubular cells. At the ultrastructural level, 28 kDa CaBP was observed in the cytosol and the nuclear euchromatin. Our study demonstrates the early cellular synthesis of 28 kDa CaBP and its transient expression by deep collecting duct cells during early fetal life, at a time when only a few distal convoluted tubular cells synthetize it. PMID- 3550215 TI - Urinary excretion of neutral proteinases in nephrotic rats with a glomerular disease. AB - A proliferative glomerulonephritis was induced in rats pre-immunized with rabbit IgG by injecting intravenously a sub-nephrotoxic dose of rabbit anti-glomerular basement membrane (GBM) IgG (A rats). Most rats (80%) developed a severe proteinuria (greater than 100 mg/24 hr) within two to five days after the injection of anti-GBM IgG. At the same time, microscopic examination of the kidneys revealed a glomerular infiltration by mononuclear phagocytes and a prominent decrease in the intensity of the colloidal iron reaction in glomeruli. A non-proliferative glomerular disease was induced in another group of rats (B rats) by intraperitoneal administration of aminonucleoside of puromycin. A marked proteinuria (greater than 100 mg/24 hr) occurred after six days in 90% of animals. Histochemical studies then revealed a decrease in staining intensity of glomeruli for polyanion. No glomerular hypercellularity was noted. In normal rats and in non-proteinuric A or B rats, the 24 hour urinary excretion of neutral proteinases ranged from 1.4 to 7.8 units (mean value +/- SEM, 4.69 +/- 0.60, N = 11), that of laminin ranged from 100 to 3,900 ng (mean value +/- SEM, 1,154 +/- 325, N = 10), and that of type IV collagen ranged from 160 to 420 ng (mean value +/- SEM, 306 +/- 26.5 ng, N = 8). In proteinuric rats from groups A (N = 11) and B (N = 9), the 24 hour urinary excretion of neutral proteinases significantly increased (mean values +/- SEM, 38.55 +/- 8.66 U for A rats and 42.17 +/- 7.92 U for B rats) and ran parallely with that of proteins, laminin and type IV collagen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550214 TI - Na+, K+, and BP homeostasis in man during furosemide: effects of prazosin and captopril. AB - Furosemide increases sodium (Na+) and potassium (K+) excretion but if dietary salt is provided, a compensatory reduction in Na+ and K+ excretion follows which restores neutral balances within 18 to 24 hours. This compensation is not interrupted by blockade of the renin-angiotensin-aldosterone system (RAA) alone with captopril. Since plasma norepinephrine concentration increases after furosemide and alpha 1 adrenoreceptors can mediate enhanced Na+ reabsorption, we administered prazosin (2 mg 6 hr-1) to six normal volunteers consuming a daily intake of 270 mmol of Na+ and 75 mmol of K+, and added captopril (25 mg 6 hr-1) for an additional day to block the RAA system concurrently. Furosemide (40 mg day 1) was given for the last four days. Prazosin given alone before the diuretic reduced (P less than 0.05) BP and plasma angiotensin II (AII) concentration and increased body weight and heart rate. However, when given with furosemide, neither prazosin nor prazosin with captopril modified the short-term natriuretic or kaliuretic responses to furosemide, or the ensuing compensatory reductions in Na+ and K+ excretion. Accordingly, cumulative balances for Na+ and K+ remained neutral over four days of diuretic administration. Neither drug altered the renal responsiveness to the diuretic which was assessed from the relationship between renal Na+ and K+ excretion and diuretic elimination. Although the BP was maintained when furosemide was given alone, when given with prazosin and captopril, the mean BP fell by 13 +/- 5 mm Hg (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550216 TI - Strict metabolic control and renal function in the streptozotocin diabetic rat. AB - Micropuncture studies were made on insulin-treated streptozotocin diabetic rats two weeks after the induction of diabetes and on age-matched control rats. Kidney size, GFR and single nephron GFR were higher in poorly controlled diabetic rats than in normal animals. Single nephron GFR rose as a result of an increase in the hydraulic pressure difference across the glomerular capillary wall caused mainly by a rise in the glomerular capillary pressure due to a diminished ratio of afferent to efferent arteriolar hydraulic resistances. Furthermore, the intratubular pressure was reduced as a result of a decrease in hydraulic resistance in the loop of Henle. Strict metabolic control prevented these changes. In conclusion, the increase in renal function in experimental diabetes is determined by the degree of metabolic control excluding a potential nephrotoxic effect of streptozotocin per se. PMID- 3550217 TI - Intrarenal hemodynamic alterations induced by anti-GBM antibody. AB - An isolated perfused kidney system (IPK) was used to study the direct intrarenal hemodynamic effects of binding of anti-glomerular-basement membrane (anti-GBM) antibody in the absence of all other circulating humoral and cellular inflammatory mediators. Control IPK's (perfused with Krebs-Henseleit buffered 5% albumin solution containing non-immune globulin) had a renal vascular resistance (RVR) mean +/- SEM 3.10 +/- 0.47 mm Hg/ml/min and a GFR mean +/- SEM 0.63 +/- 0.8 ml/min/g. Anti-GBM antibody administration raised RVR (4.83 +/- 0.52 mm Hg/ml/min, P less than 0.01) and lowered GFR (0.34 +/- 0.04 ml/min/g, P less than 0.01). Perfusate renin activity was higher after antibody administration (684 +/- 87 ng AI/ml/hr compared with control 308 +/- 42 ngAI/ml/hr, P less than 0.01). Treatment with Sar1Ala8All (3 X 10(-6) M) or captopril (10 mg/ml) attenuated antibody-induced vasoconstriction (RVR mm Hg/ml/min, Sara1Ala8All = 3.78 +/- 0.13 captopril = 3.26 +/- 0.12, both P less than 0.05 compared with anti-GBM alone). Both inhibitors of the renin-angiotensin system (RAS) also aggrevated the decline in GFR seen after antibody administration (GFR ml/min/g, Sara1Ala8All = 0.24 +/- 0.05, Captopril = 0.18 +/- 0.03, both P less than 0.05 compared with anti-GBM alone). These IPK studies demonstrate that anti-GBM antibody itself may directly induce intrarenal hemodynamic alterations in the absence of complement activation, neutrophil infiltration, neural influences or circulating vasoactive substances. The results from perfusate renin sampling and blockade of the RAS provide evidence that anti-GBM antibody deposition activates the intrarenal RAS and thereby induces significant hemodynamic alterations. PMID- 3550220 TI - Tribute to Robert Berliner. PMID- 3550219 TI - Symposium on the urinary concentrating mechanism. In honor of Robert W. Berliner. PMID- 3550218 TI - Renal excretion and cyst accumulation of beta 2microglobulin in polycystic kidney disease. AB - To determine the extent to which proximal tubule function is altered beta 2microglobulin (beta 2m), creatinine and Na were measured in serum, urine and cyst fluid of patients with autosomal dominant polycystic kidney disease and various degrees of renal insufficiency. Fractional excretion (FE beta 2m) was 0.11 +/- 0.03% in six normal subjects and 0.13 +/- 0.05% in nine patients with serum creatinine levels less than 1.6 mg/dl. In five patients with serum creatinine levels above 3.0 mg/dl, FE beta 2m was elevated (range 3.5 to 196%) and serum levels were higher than normal (30,600 +/- 6,910 micrograms/liter vs. 1,268 +/- 111). In seven patients beta 2m levels in 33 proximal cysts (cyst/serum Na greater than 0.8) equalled those in serum (cyst/serum beta 2m 0.98 +/- 0.20), whereas in 21 distal cysts (cyst/serum Na less than 0.4) beta 2m was less than in serum (cyst/serum beta 2m 0.17 +/- 0.07). Analysis of fluid in two patients with polycystic kidney nephrectomy several weeks posttransplant indicated that proximal cyst epithelium is permeable to beta 2m, but less so than to creatinine or urea. These studies show that proximal cysts cannot develop or maintain gradients for beta 2m, whereas distal cysts maintain low levels of the protein despite end-stage renal failure. The normal FE beta 2m values in nonazotemic autosomal dominant polycystic kidney disease patients and the low distal cyst levels of beta 2m in end-stage kidneys indicate that the cystic proximal nephrons do not contribute appreciably to the final urine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550221 TI - Effects of antidiuretic hormone on the collecting duct. PMID- 3550222 TI - Cycles and separations: the histotopography of the urinary concentrating process. AB - We have analyzed the histotopography of the renal medulla of the rat in terms of cycles and separations. Cycles are pathways by which solute leaving the medulla in an ascending structure (AVR, AHL) is returned to a deeper medullary level. Separations are based on spatial incontiguity and special characteristics of the interstitium and blood supply. The two concepts are complementary: the compartmentalization resulting from separations imparts specificity to the cycles. Structural lateral heterogeneity, consisting in distinct domains organized around vascular bundles, is present in one form or another in all three medullary zones. Such compartmentalization probably leads to heterogeneity in interstitial solute concentrations, a state of affairs inconsistent with the requirements of a "central core". In all such considerations of exchanges between compartments, the lack of a unitary interstitium must be borne in mind. Instead, three general types of interstitium may be distinguished: corresponding roughly to those of the OS and VB, the interbundle region of the IS, and the IM. Among the histotopographic features of the renal medulla not usually included in models of the urinary concentrating mechanism but likely to have functional significance are the association of CD with completely distinct populations of AVR and AHL in the OM and IM; a clear-cut separation throughout the medulla between cycles involving long loops and those involving short loops; the lack of an effective countercurrent association between ascending and descending limbs of short loops in the IS; and a pronounced separation of the venous drainage of the IM from that of the OM. PMID- 3550223 TI - Functional adaptation of thick ascending limb and internephron heterogeneity to urine concentration. PMID- 3550224 TI - Composition of renal medullary tissue. PMID- 3550225 TI - Osmotically active organic solutes in the renal inner medulla. PMID- 3550226 TI - Function of thin loops of Henle. PMID- 3550227 TI - The medullary thick limb: function and modulation of the single-effect multiplier. PMID- 3550228 TI - The cortical thick ascending limb and early distal convoluted tubule in the urinary concentrating mechanism. PMID- 3550229 TI - Short and long loop nephrons. AB - The explanation for the necessity to have both short and long loop nephrons for urinary concentration is unknown but may represent nature's resolution of conflicting ideal conditions for maximum urinary concentration. Ideally, one would like the thick ascending limb to extend throughout the entire medulla to the papillary tip and be supplied by a blood flow vigorous enough to provide oxygen and remove waste products as rapidly as needed. One would also like to have a progressively smaller volume of tissue to be concentrated toward the papillary tip to lessen the osmotic work required and a highly efficient vascular exchange system to sequester the medullary interstitial solute effectively. But the same efficiency of countercurrent exchange of oxygen causes the inner medulla to have a relatively low oxygen content. The presence of the thin loops of Henle in the inner medulla may represent a compromise between these conflicting ideals. The papilla tapers to a low mass, which allows a mechanism requiring only a modest energy supply to increase the tonicity of the interstitium enormously. The reduced work requirement obivates the need for thick ascending limbs to extend into the papilla where they would be highly vulnerable to anoxia. The outer medulla with its larger mass and thick ascending limbs supplied by a high blood flow can initiate the operation to reduce the volume of fluid and solute to be concentrated, and at the same time carry out other functions required of the filtration-reabsorption kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550230 TI - The role of the collecting duct in urinary concentration. AB - In summary, the three major segments of the collecting duct subserve three different functions in the urinary concentrating mechanism. The main function of the cortical collecting tubule is to raise the fractional solute contribution and absolute concentration of urea in fluid that it delivers to the outer medullary collecting duct. The function of the outer medullary collecting duct is to raise further the absolute intraluminal urea concentration. Finally, the inner medullary collecting duct has two major functions in urinary concentration: first, it adds net urea to the papillary interstitium, and second, it allows the generation of maximally concentrated urine due to osmotic water equilibration. Indeed, the urine osmolality can rise to levels higher than the papillary interstitial osmolality as a consequence of inequalities of the reflection coefficients of urea and sodium chloride. PMID- 3550231 TI - Physiological control of the urinary concentrating mechanism by peptide hormones. PMID- 3550232 TI - The renal pelvis. PMID- 3550233 TI - Pathways of urea transport in the mammalian kidney. PMID- 3550234 TI - GFR and the concentration of urine in the absence of vasopressin. Berliner Davidson re-explored. PMID- 3550235 TI - The medullary microcirculation. AB - Like other regional circulations, the medullary circulation supplies oxygen and other primary substrates to the medulla and removes carbon dioxide and other waste metabolites. It also acts as a countercurrent exchanger and simultaneously removes water reabsorbed from the renal tubule to preserve mass balance. Our present understanding of how the medulla serves both these functions at the same time is illustrated in Figure 3. Blood leaves the efferent arteriole with an elevated plasma protein concentration as a consequence of glomerular filtration, and flows down descending vasa recta within a vascular bundle. The increased interstitial osmotic-concentration coupled with a finite capillary reflection coefficient for small solutes causes additional water to be extracted so that at the termination of descending vasa recta, the plasma protein concentration exceeds that in the systemic circulation by approximately twofold. Solute, urea more than sodium chloride, also enters descending vasa recta. As blood flows through the interconnecting capillary plexus and up ascending vasa recta, transcapillary oncotic and osmotic pressure differences combine to cause capillary uptake of fluid. There is also simultaneous loss of urea such that the medullary trapping of urea is very effective. Countercurrent exchange of sodium chloride, however, appears to be less efficient and as a consequence, not only water but sodium chloride is removed from the medulla. Antidiuretic hormone reduces medullary blood flow, both directly by its vasoconstrictor (V1-receptor mediated) effect and indirectly by its antidiuretic (V2-receptor mediated) effects. Prostaglandins are able to enhance medullary blood flow by counteracting vasoconstrictive influences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550237 TI - Models of the medullary microcirculation. PMID- 3550236 TI - Models of the urinary concentrating mechanism. PMID- 3550238 TI - Functional transitions in the renal countercurrent system. PMID- 3550239 TI - Microalbuminuria as a predictor of clinical diabetic nephropathy. PMID- 3550240 TI - [Diagnosis of teratoma in childhood]. PMID- 3550241 TI - [Origin of the specialty and scientific establishment of pediatrics and its specialty society in the second half of the 19th century]. PMID- 3550242 TI - [Preventive use of antibiotics in abdominal surgery]. PMID- 3550243 TI - [A case of foreign body migration]. PMID- 3550244 TI - [Instrument for placing a ligature]. PMID- 3550246 TI - [Effect of ultraviolet irradiation of the blood on the body (review of the literature)]. PMID- 3550247 TI - [Comparative evaluation of methods of preparing the large intestine for surgery (review of the literature)]. PMID- 3550245 TI - [The wounding and death of Pushkin (clinical analysis)]. PMID- 3550248 TI - [The history of phalloplasty]. PMID- 3550249 TI - [Antibacterial effect of preparations for the local treatment of burns and suppurative wounds]. PMID- 3550250 TI - [Clinical evaluation of the Russian antibacterial preparation "Baliz-2"]. PMID- 3550251 TI - [Precision suture using a thread made of polyolefin compounds (prolene, polypropylene) in surgery of the bile ducts]. PMID- 3550252 TI - [Prediction and prevention of postoperative suppurative-septic complications of patients with biliary tract diseases (review of the literature)]. PMID- 3550254 TI - [Comparative evaluation of manual and mechanical sutures in papillo sphincteroplasty]. PMID- 3550253 TI - [Transplantation of the pancreas in clinical practice (review of the literature)]. PMID- 3550255 TI - [Roentgenologic and ultrasonic studies in the diagnosis of gallbladder diseases]. PMID- 3550256 TI - [Behcet syndrome]. AB - Behcet's syndrome is described on the basis of historical facts taken exclusively from original papers, and considering especially those symptoms which are usually neglected. The differentiation of certain symptom-oriented subforms such as angio Behcet, arthro-Behcet, entero-Behcet, neuro-Behcet, pneumo-Behcet, and uro-Behcet gives a better understanding of this syndrome and also stresses the fact that many fields of medical activity are concerned with it. The historical facts show that ophthalmology and dermatology share the credit for having identified this syndrome. PMID- 3550257 TI - [Pathogenesis of hurricane keratitis]. AB - Hurricane keratitis is an epithelial disorder of corneal transplants which occurs irrespectively of the type of local postoperative therapy used. The epithelial defects show a vortex-like arrangement resembling satellite photos of whirlwinds. Even before the development of punctate keratitis, fluorescein staining of the corneal surface reveals vortex-like figures corresponding to a varying thickness of the tear film in a vortex-like configuration. The irregularities in the tear film are due to an irregular profile of the corneal surface, the functional result of which is irregular astigmatism. The irregular surface profile in turn is caused by the approximation of incongruent wound edges and by sutures being too tightly drawn. Particularly when Healon is used, there is a tendency to draw the sutures tight, since a postoperative pressure increase with subsequent fistulation must be expected. Hurricane keratitis thus also appears to result indirectly from the use of Healon. PMID- 3550259 TI - [Conjunctival granuloma caused by synthetic fibers]. AB - Histopathological examination of a conjunctival lesion occurring in a two-and-a half-year-old boy revealed granulomatous inflammation surrounding filamentous foreign material. The main type of fiber was fairly uniform in diameter, generally round to oval in cross-section, with vivid birefringence, manifesting a "cracking phenomenon" and lacking a central core. These findings are typical of synthetic fibers. Synthetic fiber granulomas often occur in children, predominantly unilaterally. Comforting blankets, fabric toys or forcibly applied pullovers may cause initial inoculation. PMID- 3550258 TI - [Simultaneous study of ocular vascular reactions of the anterior and posterior segments following clonidine and propranolol in normotensive and hypertensive experimental animals]. AB - The influence of clonidine and propranolol on the vessels of the anterior segment and of the fundus, as well as on mean arterial pressure and heart rate, was investigated in normal rabbits, minipigs, and minipigs with experimentally induced hypertension. The vessel reactions were monitored by photography or fluorescein angiography. Following injection of clonidine, constrictions of episcleral and conjunctival vessels occurred in all the animals, but the fundus vessels of the rabbits were not affected. Difficulties were encountered in assessing the condition of the iris vessels. In minipigs, after administering 6 20 micrograms/kg, an average delay of 2 seconds in the inflow into the retinal vessels was recorded, due possibly to a (transitory?) vessel constriction upstream. Mean arterial pressure increased initially in all animals, but to a different extent in the two species. There was less uniformity as regards heart rate. The vessel reactions of the two species to propranolol were different: in rabbits, a reaction was only observed after administering 2.46 mg/kg bodyweight in episcleral and conjunctival vessels, though not in fundus vessels. Minipigs were given doses of 0.16, 0.5, and 0.8 mg/kg; after 0.5 mg/kg a vessel constriction took place in the episclera and the conjunctiva, becoming manifest after 20 minutes and attaining a maximum after 60 minutes. However, there appeared to be no reaction in the fundus vessels. After an abrupt decrease in mean arterial pressure, both this and the heart rate showed an almost identically slow decrease until the 50th minute, followed by a slight increase up to the 60th minute. The comparison of the circulation parameters reveals some interesting parallels, though also some contrasts. The mechanisms of action and characteristics of these two substances are discussed. PMID- 3550260 TI - [1% carteolol hydrochloride eyedrops: long-term experience in the treatment of chronic open-angle glaucoma]. AB - The response by 14 patients with open-angle glaucoma to treatment with carteolol 1% eye drops was investigated during a study lasting up to 15 months. Statistical analysis of the data revealed that carteolol had a highly significant IOP lowering effect in all the patients studied. The mean decrease in IOP was as much as 41% of the initial value after the first day of treatment and after one week of treatment all the IOP values were close to 16-17 mm Hg. No long-term drift was noticed during the period of the study; no patient experienced any adverse reactions which could be related to the treatment with carteolol. This study therefore confirms the results of former investigations into the IOP-lowering effect of carteolol performed on Japanese subjects and classifies carteolol as a safe antiglaucoma agent which is also effective in Caucasian patients. PMID- 3550261 TI - Clinical features and computer-aided analysis of chromosome aberration in a case with incontinentia pigmenti. AB - Incontinentia pigmenti (IP) is an X-linked dominant disease, usually lethal to males. IP belongs to rare diseases involving skin pathological findings, together with neurological and ophthalmological disorders. We here report a two-year old girl with typical symptoms of the IP. A hitherto unreported feature is partial deletion of short arms of one of the chromosomes 15, found in the girl and in her mother. Using an automatic chromosome picture analyzer, a densitometric analysis of the aberration was carried out, in order to determine the break point and to compare the normal and deleted chromosomes. PMID- 3550262 TI - [Analysis of diadochokinetic movement. Electronic data processing-aided diadochometry--a contribution to developmental neurologic diagnosis]. AB - A method of objective registration and analysis of diadochokinetic arm movement was tested in normal children and those with signs of minimal cerebral dysfunction (MCD). 44 children aged 4-10 yrs. (9 with the diagnosis of MCD, 31 controls) were investigated. By means of a special device 270 deg. twisting of the forearms were transduced linearly by foam-cushioned clamps at the wrists and a potentiometer into a direct current of 0-2,7 V, respectively. The analog DC signal was digitalized by 0.7 kHz and stored in a calculator, the identification of the first and last sectors were performed on monitor. After removing artificial currents by a special filtering program, the remaining sinus-like curves could be analyzed by a special program (BEWESI). Mathematical analysis was performed by 11 factors respecting right and left arm, unilateral or bilateral twisting. Statistical analysis showed significant differences in some parameters between normal and MCD-children. In addition, a significant difference between the velocity of pronation and supination was evident. The fact that a clear age relation of parameters was found, proves the practicability of this diagnostical method in developmental neurology. PMID- 3550263 TI - Pathophysiological and morphological aspects of cellular lesions. AB - Cell injury can result in cell death with sufficient intensity and prolongation of various noxae. Cell death exhibits specific local characteristics but is generally monomorphic. Since a cell cannot be considered as an individual unit, knowledge of the interactions among various cells and their systems provides the basis for effective cell and organ protection. In the case of cell or organ injury which threatens to generalize, with far-reaching consequences for the entire organism, the following therapeutic measures should be considered: timely intervention in the disturbed prostaglandin metabolism; activation of the RES; for example, substitution of opsonins; minimizing of the secondary invasion of enterogenic toxins. PMID- 3550264 TI - Current clinical management of organoprotection in hepatic surgery. AB - Ischemia of the liver in hepatic resection under inflow occlusion is tolerable for at least up to 60 min. For protection of the liver from ischemic injury, steroids are frequently used. In liver transplantation, cold ischemia of 6-8 h for the graft is considered to be acceptable. Organ preservation is most frequently accomplished by in situ perfusion of the liver with Euro Collins solution in the donor and consecutive hypothermic storage after hepatectomy, resulting in 96% of all grafts in primary function. PMID- 3550265 TI - Atherosclerosis of the carotid arteries documented by duplex scan as a predictor of coronary artery disease in familial hyperlipidemias. AB - The degree of atherosclerotic plaques in the carotid arteries was evaluated in 85 patients with familial hypercholesterolemia and in 43 patients with familial combined hyperlipidemia by means of Duplex scan which recognizes early atherosclerosis. In patients older than 40 years carotid atherosclerosis of moderate degree was associated with coronary heart disease in 90% of cases. The extent of elevated cholesterol, age, cigarette smoking, and hypertension determined the degree of carotid atherosclerosis. PMID- 3550266 TI - The clinical significance of prostaglandins and thromboxane as mediators of septic shock. AB - An evaluation was made of 106 surgical patients with Gram-negative septic shock, both for clinical criteria as well as the biochemical mediators endotoxin, prostaglandin F2 alpha, prostaglandin I2 (prostacyclin), and thromboxane. These data were correlated to various defined shock phases, functional data of vital organs, and clinical outcome. Patients underwent invasive organ function monitoring and the usual laboratory tests of intensive care. Prostaglandins and thromboxane were measured radioimmunologically, endotoxin by the limulus amebocyte lysate test. Endotoxin proved to be a more accurate predictor of severe sepsis than did positive blood cultures. Endotoxin as well as prostaglandins and thromboxane are predominantly released in early shock phases, appearing in plasma concentrations, which correlate with the severity of organ failure. Sepsis induced respiratory failure coincides with a deterioration of pulmonary prostaglandin inactivation, which contributes to the release mechanism. High systemic prostacyclin activity benefits the patients' organ functions and clinical outcomes, while a predominance of thromboxane seems to effect the opposite. Transpulmonary-thromboxane gradients correlate significantly with pulmonary hypertension in the early phases of septic shock. PMID- 3550268 TI - [G.I. Sokol'skii (on the centenary of his death and the 150th anniversary of the description of rheumatic heart disease)]. PMID- 3550267 TI - [Katacalcin--a new tumor marker in C-cell cancer of the thyroid gland]. AB - Katacalcin (KC) is situated on the C-terminal side of the procalcitonin molecule and is cleaved like calcitonin (CT) from this precursor peptide. Serum levels of KC were measured in 22 patients with C-cell carcinoma with a specific and sensitive radioimmunoassay (normal range, less than 0.1-0.15 ng/ml). Basal serum KC values in C-cell carcinoma patients were 0.32-290 ng/ml. There was a good correlation between KC and CT (r = 0.98, P less than 0.001). Serum KC, as well as CT, markedly increased after pentagastrin and calcium infusion. KC and CT were secreted in nearly equimolar amounts. During selective venous catheterization, KC and CT levels were increased in serum samples from veins draining tumor masses, which could be confirmed operatively. During the follow up, KC and CT measurements correlated well to the stage of disease. KC could be immunohistologically localized in C-cell carcinoma tissue. As a tumor marker, katacalcin is likely to be as useful as calcitonin in C-cell carcinoma. PMID- 3550269 TI - [The history of Chekhov's illness]. PMID- 3550270 TI - [The history of Dostoevsky's illness]. PMID- 3550271 TI - [Classification, diagnosis and treatment of hemochromatosis]. PMID- 3550273 TI - [Clinical significance of voice disorders]. PMID- 3550272 TI - [Electric stimulation of the diaphragm in the treatment of chronic nonspecific lung diseases]. PMID- 3550274 TI - [Parasitic arthropathies]. PMID- 3550275 TI - [Clinical effectiveness of the treatment of systemic lupus erythematosus with preparations of the methylxanthine group and T-activin]. PMID- 3550276 TI - [Hypokinesia as a disease risk factor]. PMID- 3550277 TI - [Intravital echotomographic estimation of the mass of neoplastic lesions of the kidneys and adrenal glands]. PMID- 3550278 TI - [P.D. White, a prominent cardiologist]. PMID- 3550279 TI - [Alcohol and smoking as risk factors of cerebral stroke]. PMID- 3550280 TI - [Drug treatment of cholelithiasis with chenodeoxycholic and ursodeoxycholic acids (review of the foreign literature)]. PMID- 3550281 TI - [Calcitonin]. PMID- 3550283 TI - [Extracardiac systemic pharmacodynamic effects of estulic (guanfacine)]. PMID- 3550282 TI - [Place of disopyramide in relieving ectopic arrhythmia]. PMID- 3550284 TI - [Ultrasonic cardiography in the diagnosis of thrombosis of post-infarction aneurysms of the left ventricle]. PMID- 3550285 TI - [Current problems in aviation physiology]. AB - Soviet aviation has developed an efficient system of medical support based on physiological knowledge and aimed at the solution of various problems associated with pilot selection and training, his professional activity, arrangement of his working place, etc. It is understood that the following lines of research hold great promise in protecting the human body against adverse flight effects: methods of protection against high altitude effects which also help maintain high operational efficiency; conditioning of transport, regulation and energy mechanisms of oxygen supply; methods of predicting man's tolerance to motion sickness; study of mechanisms of photoreception of blinding brightnesses; development of photoprotectors, etc. With respect to professional selection, it is important to use EEG data for prognostic purposes, to investigate lateral functions of paired organs, and to explore their relationship with body tolerance to flight factors and efficiency of training. The results of physiological investigations of the functional state of the pilot form the basis to standardize his workload, to develop rational work-rest cycles, and to prevent performance deterioration. Physiological recommendations can be used to formulate requirements for the configuration of the pilot working place. PMID- 3550286 TI - [Pedagogics, nursing care, computers: computer-assisted teaching]. PMID- 3550287 TI - Microsurgery in the clinic and laboratory. AB - Laboratory animals have been crucial to the development of modern microsurgical techniques which are now routinely used in many clinical departments worldwide. In return, microsurgical techniques are important in biomedical research as they allow many surgical procedures to be performed on rodents instead of dogs, pigs or primates. This has obvious advantages in terms of low cost, the use statistically valid numbers for comparison and the availability of genetically defined animals which are more likely to give valid answers to immunological questions. Microsurgical reconstruction is important in plastic, orthopaedic, urogenital, vascular and peripheral nerve surgery in man and it is likely that it will become part of every surgeon's training in the near future. In this review, the instrumentation essential to any microsurgical enterprise and the sutures available are described. Basic microsurgical techniques for end-to-end and end-to side anastomosis of small vessels and for joining peripheral nerves, oviducts and other tubular structures are given in outline. Techniques for transplanting kidney, heart, heart and lung, liver, spleen, pancreas, small bowel, stomach, testicle, ovary and whole joint are only outlined but key references are given. Finally, some of the clinical indications for microsurgical reconstruction are reviewed. PMID- 3550288 TI - Eosinophil peroxidase is detectable with a monoclonal antibody in collagen bands of nodular sclerosis Hodgkin's disease. AB - An IgG2a murine monoclonal antibody derived against human eosinophils was shown to immunoprecipitate the 78,000 dalton form of human eosinophil peroxidase (EPO). To confirm the specificity of the antibody, we used a glucose-oxidase avidin biotin procedure to immunostain 32 human cell lines and tissues. An eosinophilic subline of HL-60 promyelocytic leukemia was the only cell type other than eosinophils to be recognized by the antibody. Because previous reports have described occult eosinophilic degranulation in tissues with a variety of pathological conditions, we immunostained cryostat sections of four consecutive lymph node biopsies of nodular sclerosis Hodgkin's disease with the monoclonal antibody. Our objective was to characterize by immunohistology the eosinophilic infiltration in a lymphoma that frequently contains substantial numbers of eosinophils. In all four cases of nodular sclerosis Hodgkin's disease, there was striking and extensive deposition of EPO in a dendritic pattern throughout the connective tissue and collagen bands. The extent of deposition of EPO in the bands far exceeded the degree of infiltration by intact eosinophils, as determined by examination of routinely stained tissue sections. A similar dendritic pattern was not observed in any of six benign lymph nodes that were immunostained for EPO. We conclude that the monoclonal antibody described in this report is specific for EPO and that eosinophils extensively degranulate and release EPO in the bands of nodular sclerosis Hodgkin's disease. Moreover, the degree of eosinophilic infiltration in this disorder cannot be assessed solely on the basis of intact eosinophils. PMID- 3550289 TI - Samoyed hereditary glomerulopathy. Immunohistochemical staining of basement membranes of kidney for laminin, collagen type IV, fibronectin, and Goodpasture antigen, and correlation with electron microscopy of glomerular capillary basement membranes. AB - Recent immunofluorescence studies on the kidneys of most males with hereditary nephritis have demonstrated an absence of Goodpasture antigen (GPA) from glomerular capillary basement membranes (GCBM). In the present study, we used immunofluorescence to determine whether laminin, collagen type IV, fibronectin, and GPA could be detected in basement membranes of the kidneys of dogs with Samoyed hereditary glomerulopathy, which was previously shown to be a model for human hereditary nephritis. The results obtained were correlated with the appearance of GCBM by electron microscopy (EM). The rabbit polyclonal antibodies used (antilaminin, anti-collagen type IV, and antifibronectin) showed specificity for the appropriate antigens in a plate-binding radioimmunoassay. Serum from a patient with Goodpasture syndrome was used to detect the GPA component of dog GCBM. Laminin and collagen type IV were present in GCBM, mesangium, tubular basement membrane, vascular basement membrane, and Bowman's capsule of neonatal, unaffected, and affected male and carrier female dogs. Fibronectin was present in mesangial, perivascular, and interstitial regions of the kidneys of all dogs and, in addition, in GCBM of neonatal, affected male, and carrier female dogs. GPA was not detected in the kidneys of neonatal dogs and its absence from GCBM correlated with their immature appearance by EM. However, a fully formed, trilaminar GCBM was observed by 3 weeks of age in unaffected, affected male, and carrier female dogs, before the detection of GPA in GCBM, which occurred at 4 weeks in unaffected and carrier female dogs, but still not in affected males. In the unaffected dogs, the presence of GPA correlated with the persistence of a fully formed trilaminar GCBM, which lasted throughout life, while in the carrier females, the presence of GPA correlated with focal areas of multilaminar splitting of GCBM by EM. In the affected male dogs, although a trilaminer GCBM was seen by 3 weeks of age, the persistent absence of GPA correlated with the eventual onset of multilaminar splitting of GCBM. These immunofluorescence and EM results suggest that GPA is not required to form a trilaminar GCBM initially but is necessary subsequently to maintain its integrity. GPA is normally present in the C terminal (NC1) domain of the collagen type IV molecule. It is hypothesized that Samoyed hereditary glomerulopathy in dogs and human hereditary nephritis result from a defect in the NC1 domain. PMID- 3550290 TI - Levi Coke Stephens, M.D. 1838-1909. PMID- 3550291 TI - Indigents and Medicaid recipients. PMID- 3550292 TI - Lawrence Garvin Clayton, M.D. PMID- 3550293 TI - Separation and identification of two components of an estrogen-responsive, calcium-dependent arginine esteropeptidase. AB - Arginine esteropeptidase is an estrogen-responsive, calcium-dependent enzyme in rat uterine cytosol. It appears in increased amounts 3 h after administration of physiologic amounts of 17 beta-estradiol to an immature female rat. Its reaction was resolved into two parts: a calcium-dependent activation of the enzyme and a calcium-independent hydrolysis of the substrate. The esteropeptidase was separated by DEAE cellulose chromatography into two components. The properties of component A, the activator, are distinct from those of component B, the enzyme, which has the same response to inhibitors as serine proteinases. Both components are subject to estrogen control. Component A is present in significant amounts only after estrogen stimulation. Component B is increased 3-fold after estrogen stimulation. The responses of the two components to inhibitors, their different molecular weights and chromatographic behavior and the pH optima of their reactions distinguish them from each other and from other uterine proteinases previously described. PMID- 3550294 TI - Sterol hydroperoxide metabolism by Salmonella typhimurium. AB - In order to rationalize multiphasic dose-response data evincing mutagenicity towards Salmonella typhimurium TA1537 for sterol hydroperoxides 3 beta-hydroxy-5 alpha-cholest-6-ene-5-hydroperoxide and 3 beta-hydroxycholest-5-ene-7 alpha hydroperoxide their metabolism by the bacterial test strain was investigated. The 5 alpha-hydroperoxide was isomerized to the 7 alpha-hydroperoxide and reduced to 5 alpha-cholest-6-ene-3 beta,5-diol; the 7 alpha-hydroperoxide was reduced to cholest-5-ene-3 beta,7 alpha-diol and transformed to 3 beta-hydroxycholest-5-en-7 one. The 3 beta,5 alpha-diol and 3 beta,7 alpha-diol were not interconverted nor was either transformed to the 7-ketone. PMID- 3550295 TI - Early postoperative pancreatic endocrine function after segmental and pancreaticoduodenal allotransplantation in nonimmunosuppressed primates. AB - In this study we evaluated the short-term hormonal effects of segmental and whole pancreatic allotransplantation on the glucose intolerance produced by hemipancreatectomy in the primate. In hemipancreatectomized animals without grafts the K-values were reduced to 0.6 +/- 0.05, plasma insulin increased from 27.5 +/- 2.5 to 63.5 +/- 6.3 microU/ml, and glucagon levels declined from 252 +/- 29.9 to 216.5 +/- 33.0 pg/ml. Hemipancreatectomized segmental allograft recipients rendered K-values of 0.79 +/- 0.05, plasma insulin increased from 19.98 +/- 3.43 to 66.0 +/- 17.03 microU/ml, and glucagon release declined from 395.6 +/- 63.0 to 226.2 +/- 37.6 pg/ml during IVGTT postoperatively. Hemipancreatectomized, pancreaticoduodenal allograft recipients rendered K-values of 0.82 +/- 0.1, results not significantly different from hemipancreatectomized or segmental allograft recipients. Plasma insulin increased from 29.5 +/- 4.0 to 186.0 +/- 25.0 microU/ml, and glucagon release declined from 1,087.0 +/- 31.6 to 656.0 +/- 12.7 pg/ml. In summary, segmental pancreatic allotransplantation could not, in the short-term, restore the reduced K-values and hypoinsulinaemia in hemipancreatectomized primates to that of normal, unstressed controls. Although K values of hemipancreatectomized recipients were not significantly improved, whole pancreas transplantation resulted in improved insulin release and hyperglucagonaemia during IVGTT when compared to segmental allograft recipients. The unexpected findings of hypoinsulinaemia and hyperglucagonaemia in both transplant groups may only reflect a function of the stressed state of the animals in the immediate postoperative phase. PMID- 3550296 TI - [The spinal dopaminergic system]. AB - A new dopaminergic innervation has been described quite recently: the dopaminergic spinal cord system. In this review are presented the different steps which lead to the individualization of this dopaminergic system and the reported results actually available concerning its probable anatomical organization. Finally, most of the data which illustrate the possible functions of this system are discussed. Interestingly, its participation in the transmission of nociceptive signals and the control of cardiovascular patterns appear now well established. Such functional implications give new information on the possible targets of central dopaminergic agonists and antagonists, particularly at the cardiovascular level. PMID- 3550297 TI - Frequently used medicinal plants in Baja California Norte. AB - Herbalists in Baja California Norte, Mexico, were interviewed to determine the ailments and diseases most frequently treated with 22 commonly used medicinal plants. Those diseases which were most frequently mentioned by the herbalists provided the focus for initial assessments. The phytochemistry of the medicinal plants was determined from published research, and the likelihood of successful treatment of diseases was assessed by determining the known pharmacological actions of the plant constituents. Most of the plants contained substances which had recognized pharmacological effects in the treatment of the diseases being treated by the herbalists. PMID- 3550298 TI - Valve failure caused by cusp tears in low-profile Ionescu-Shiley bovine pericardial bioprosthetic valves. AB - The pathologic findings in two low-profile Ionescu-Shiley bioprostheses that failed because of cusp tears are presented. Both valves were in the mitral position, one in place 28 months and the other 40 months. Observation of the valves and their tears suggests that stress at the cusp alignment stitches may be important in the genesis of the tears. PMID- 3550300 TI - Autologous bone marrow transplantation in acute myeloid leukemia after in-vitro purging with an anti-lacto-N-fucopentaose III antibody and rabbit complement. AB - Two AML patients, whose leukemic clonogenic cells totally reacted to the anti lactofucopentaose III S4-7 monoclonal antibody (MoAb), underwent autologous bone marrow transplantation, in first complete remission, after in-vitro purging with S4-7 MoAb and complement. After ablative chemotherapy (BAVC regimen) and reinfusion of S4-7 purged cells, regeneration of marrow cells occurred with prompt recovery of granulopoiesis and erythropoiesis. A more delayed platelet recovery was observed. The two patients are in complete remission at 20 and 11 months from ABMT. The results indicate that immunologic purging with S4-7 MoAb is safe and suitable for selected AML patients undergoing ABMT. PMID- 3550299 TI - A prospective, randomized study of the effects of prostacyclin on neuropsychologic dysfunction after coronary artery operation. AB - This randomized, double-blind study was designed to evaluate the effect of prostacyclin (epoprostenol) on the incidence and severity of postoperative neuropsychologic dysfunction in patients undergoing coronary artery operation. Four days before operation and 1 week after operation, 100 patients having coronary artery bypass grafting underwent detailed neurologic and psychologic examinations and computed tomographic scans of the brain. The psychologic examination was repeated 2 months after operation. During cardiopulmonary bypass, all patients received 300 U/kg of heparin and then either buffer-diluent or prostacyclin (12.5 ng/kg/min from the time of heparinization until onset of cardiopulmonary bypass and 25 ng/kg/min during cardiopulmonary bypass). No deaths or major neurologic complications occurred in this series. Ninety-six patients completed the psychologic and neurologic evaluations 1 week after operation; 74 of these patients were evaluated psychologically 2 months after operation. Psychologic testing demonstrated similar declines in postoperative performance in both the prostacyclin-treated and the control groups; these changes were no longer present in either group 2 months after operation. Results of neurologic examinations and computed tomographic scans of the brain were unchanged. We conclude that the administration of prostacyclin during cardiopulmonary bypass in patients undergoing routine coronary artery operation has no effect on perioperative cognitive changes. PMID- 3550301 TI - Chromosome characteristics of therapy-related acute non-lymphocytic leukemia and preleukemia: possible implications for pathogenesis of the disease. AB - Most cases of therapy-related acute nonlymphocytic leukemia or preleukemia show chromosome aberrations, primarily loss of whole chromosomes No. 5 and/or No. 7 or the long arms of these two chromosomes. Other abnormalities involve chromosome No. 21, often rearranged at band 21q22, and chromosome No. 17, in some cases rearranged at band 17p13. Important cellular genes have recently been localized to these regions, including the gene for one hematopoietic growth factor and the gene for the receptor for another hematopoietic growth factor. It is suggested that the total loss or change of structure or expression of some of these genes resulting from the various chromosome aberrations may be of pathogenetic significance in therapy-related acute nonlymphocytic leukemia. PMID- 3550302 TI - Hemopoietic regeneration in murine spleen following transfusion of normal and irradiated marrow: different response of granulocyte/macrophage and erythroid precursors. AB - To investigate cell proliferation in regenerating spleen, bone marrow of normal and gamma-irradiated donor mice (3 weeks after 5 Gy) was transfused into lethally irradiated recipients. In the donors and in the recipient spleens numbers of CFU S and progenitor cells were determined. In the irradiated donors the progenitors were at control level after 3 weeks of recovery although CFU-S were still at 50% of control. Recipients of the irradiated marrow received therefore an increased proportion of progenitors. CFU-C appeared to be self-renewing and/or increased in number due to enhanced CFU-S differentiation, but not the erythroid progenitors. CFU-S self-renewal was reduced after 5 Gy. The data suggest that cell differentiation and maturation proceed during early splenic regeneration. The quantity of CFU-C does not necessarily mirror the situation in the stem cell compartment. PMID- 3550303 TI - A new look at the haemopoietic response to cytotoxic agents and stem cell regulation. AB - A re-evaluation of the response of haemopoietic stem cells, in mice, to radiation and anticancer drugs suggests a precise mechanism for the regulation of the number of stem cells through a control of their rate of differentiation. This analysis which has some counter-intuitive aspects, appears to be the first attempt to obtain a unified explanation for various effects of cytotoxic agents and has some important biological and clinical implications. PMID- 3550304 TI - [Correlation between changes in placental structure and fetal lung maturity in ultrasound examinations]. AB - In 228 pregnant women examined by ultrasound in the 30th to the 40th week of gestation, the first placental maturity degree was found in the 31.6 week, the second degree in the 35.8 week, and the third degree in the 38.2 week. In 60 women with on term pregnancy also amniocentesis was carried out and the lecithin sphingomyelin ratio (L/S) was compared with the ultrasound finding. In 6 of these pregnant women the third degree of placental maturity was observed, their L/S ratio was not below 2, and in their newborns no respiratory distress syndrome developed. Ultrasound estimation of placental maturity is a useful method in pregnancies in which no other methods could be applied. PMID- 3550306 TI - Musculoskeletal injuries in competitive swimmers. AB - Competitive swimming is a rigorous sport being engaged in by an increasing number of young athletes. In swimmers, shoulder pain is the most common musculoskeletal complaint and is usually due to supraspinatus or biceps tendinitis. Glenohumeral instability (often multidirectional) can also be a cause of shoulder pain in swimmers and may be more common than has been reported. Surgical treatment is seldom indicated. Physical therapy modalities and training modifications are the mainstay of treatment. Medial knee pain in breaststroke swimmers and extensor tendon inflammation over the dorsum of the foot are less common injuries and respond to conservative therapy. These overuse syndromes are best prevented by proper training schedules, strength training, flexibility exercises, and avoidance of errors in stroke technique. The rehabilitation program for a competitive swimmer should be chosen with an understanding of the goals of the swimmer and the cooperation of the coach. PMID- 3550305 TI - Enhanced prostaglandin I2-formation of human lymphatics during pulsatile perfusion. AB - Previous studies demonstrate that prostacyclin (prostaglandin I2, PGI2) is the main arachidonic acid product in human lymph vessels. Pulsatile perfusion increases and prolongs PGI2-formation as do leukotrienes (LT) such as LTC4. Thus, physical activity besides local mechanical and biochemical influences on lymph pressure and flow also stimulates local lymphatic PGI2 synthesis, a prime counterbalancing factor in lymphatic constriction induced by other eicosanoids. PMID- 3550307 TI - Ophthalmologist devised method of lens extraction. PMID- 3550308 TI - [Amyloid arthropathy in hemodialysis patients]. PMID- 3550309 TI - [Usefulness of bone marrow autotransplants without cryopreservation]. PMID- 3550310 TI - [Antihypertensive treatment with guanfacine in patients with type II diabetes mellitus]. PMID- 3550311 TI - [B-pseudolymphoma: lymphocytoma]. AB - We have revised the concept of pseudolymphoma, some of its classifications and its differences with the malignant lymphoma, which sometimes are only an evolution, not existing other elements of judgement. We publish the summary of ten lymphocytoma cutis cases studied by us, which we believe are the paradigm of the B pseudo-lymphoma due to the clinical and hystological controversy in our patients. One of them shifted to malignant lymphoma after 30 years of evolution as a lymphocytoma. Under the denomination of lymphocytoma we believe should be included a group of not well defined process, of unknown etiology, described in literature under the names of "Spiegler-Fendt Sarcoid", "lymphadenosis benigna cutis", "benign lymphocytic reticulosis" and "lymphocytic infiltration of Jessner" all of them with clinical evidences of papulo-tuberous lesion, covered by a yellowish to brownish red erythematous skin with the appearance of "orange skin" with no ulcers and usually located on the head (nose, forehead and scalp) or in any other part of the skin, looking sometimes, like the malignant lymphoma. Histologically characterized by a dense lymphocytic reaction proliferation; polymorphous with a diffuse or nodular pattern, characteristic in B pseudolymphoma. We should establish the differences between at least two clinical forms: the one of single lesion, of multiple lesions in the same area, called therefore single and multiple regional form, each one with its own characteristics and with certain clinical and hystological relations: single Nodular and multiple-diffuse. The existence of important adenopathies in the multiple form, its clinics, its long evolution and its developing in malignant lymphoma in one of our cases makes us especially aware of this form and we strongly recommend to keep a lifetime control. PMID- 3550312 TI - [Bowenoid basocellular carcinomas (basaliomas with cellular monstrosities]. AB - Marked cellular atypia was detected in 4 out of 2,000 consecutive specimens of basal cell carcinoma. The lesions occurred on the exposed skin of the head of 4 male patients with ages between 49 and 71 years. Besides the general pattern of basal cell carcinoma and cellular atypia there were remarkable differences from lesion to lesion resulting in variable difficulties of differential diagnosis, not only with Bowen's disease (3 cases) but with Darier's metatypical epithelioma as well, either of the mixed or intermediate type (1 case each). As with the other cases reported in the literature, the presence of cell atypia did not correlate with a more aggressive clinical behaviour of the lesions. PMID- 3550314 TI - [Netherton syndrome]. AB - The authors reported a case of Netherton's syndrome. This patient presented cutaneous lesions of ichthyosis linearis circumflexa, tricorrexis invaginata and atopy signs associated with cystinuria. Cutaneous and hair lesions were treated with etretinate. PMID- 3550313 TI - [Malignant melanoma (review of 68 cases)]. AB - A clinica pathologic revision was performed about 68 patients with malignant melanoma of the Hospital dos Servidores Publicos do Estado de Sao Paulo. The authors had checked the data concerning to color, age and sex of the patients, localisation, clinical aspect of the lesions and clinical evolution of the cases. They made comments on the histopathology related to Clark's levels, the depth of tumors (Breslow), solar elastosis and inflammatory infiltrate, in relation with the clinical evolution of the cases. PMID- 3550316 TI - [Clinical and epidemiological study of boutonneuse fever in Andalusia: apropos of 36 cases]. AB - Boutonneuse fever is a rare disease, it accounts for 0.091% of all the patients who consult the Department of Medical-Surgical Dermatology in the Faculty of Medicine of Seville. It is clearly a disease of seasonal incidence, appearing most frequently during the summer, which affects both sexes equally at middle age, and is most frequent in rural areas, although it is increasing in urban districts. The term "Mediterranean fever" is correct, understanding that it is a disease afflicting Mediterranean countries, but has nothing to do with proximity to the sea. PMID- 3550317 TI - [Giant hamartomatous nevus of undescribed complexity (development of an infiltrating malignant melanoma)]. AB - A case is reported of complex hamartoma with the aspect of a giant pigmented nevus, localized in one of the lower extremities. Histological examination revealed the involvement of different embryonal layers in order to give rise to dissimilar types of nevi: flat pigmented nevus, intradermal cellular nevus, epidermal verrucous nevus, Jadassohn's sebaceous nevus; Hoffman-Zurhelle's superficial lipomatous nevus, and fibrous hamartoma of the manifested at infancy. This malformation and more specifically the nevus cells constitute the subsequent transformation into an infiltrating malignant blastoma (malignant melanoma). PMID- 3550315 TI - [Lupus-pemphigus]. AB - A case of a woman of 23 years old with lesions in the exposed areas of the skin (face and lower neck) is presented. The histological study was compatible with pemphigus (subcorneal acantholysis and acantholytic cells). The direct immunofluorescence revealed the presence of IgG in intercellular spaces on all the surfaces of the epidermis. In the indirect immunofluorescence ANA (1/800), anti-DNA (1/200) and anti-ICS (1/200) was found. The rest of the analysis clearly showed thrombocytopenia and C4 consumption. The interesting aspect of this case rests in the coexistence of clinical and analytical findings of each of these of autoimmune diseases. PMID- 3550318 TI - [Intravascular vegetating hemangioendothelioma]. AB - In 1928, P. Masson described in hemorrhoids a peculiar lesions which he called "intravascular vegetating hemangioendothelioma". The possibility of cutaneous location of this lesion was demonstrated only in 1967. Rare if isolated, the intravascular vegetating hemangioendothelioma is often associated with other vascular lesions such as polyps, hemorrhoids, etc. Always benign, this tumor may be misdiagnosed as an angiosarcoma by inexperienced pathologists. In this article, three additional cases are described, the histological differences with an angiosarcoma are stressed and the pathogenesis of this lesion is discussed. PMID- 3550319 TI - [Perforating necrobiosis lipoidica]. AB - This is the case history of a woman with a 6 year history of insulin-dependent diabetes mellitus and a 5 year history of tuberous lesions on the dorsal aspect of the metacarpophalangeal joints. Histological examination revealed multiple necrobiotic foci throughout the dermis and subcutaneous tissue, with varying degrees of degeneration, alternating with fibrotic areas. This picture is compatible with lipoid necrobiosis. The existence of various foci of epithelial perforation, manifested clinically by a point hyperkeratosis similar in appearance to blackheads, suggests transfollicular elimination. This would explain the total absence of a pilosebaceous follicles in the lesion. PMID- 3550320 TI - [Fibroma of the tendon sheath]. AB - Fibroma of the tendon sheath (FTS) is a rare benign soft tissue tumor. Its location and clinical findings may be similar to the giant cell tumor of tendon sheath or to infantile digital fibromatosis. Accurate diagnosis of FTS depends on microscopic examination of the excised tumor. The present report deals with two cases. PMID- 3550321 TI - [Use of a bioluminescence method for determining the number of viable BCG particles]. PMID- 3550322 TI - [Interactions between the pathogenic fungi Candida and Torulopsis and the deadly strains of Saccharomyces cerevisiae and Torulopsis glabrata]. PMID- 3550323 TI - Satietins, alpha 1-glycoproteins in human plasma with potent, long-lasting and selective anorectic activity. PMID- 3550324 TI - The chemistry, pharmacology, and clinical applications of qinghaosu (artemisinin) and its derivatives. PMID- 3550325 TI - Site-specific drug delivery. PMID- 3550326 TI - Health and virtue: or, how to keep out of harm's way. Lectures on pathology and therapeutics by William Cullen c. 1770. PMID- 3550327 TI - The Syrian Medical Aid Association: British philanthropy in the Near East. PMID- 3550328 TI - Manual work, technology, and industrial health, 1918-39. PMID- 3550330 TI - The social problem of the English physician in the early seventeenth century. PMID- 3550329 TI - The Bell-Magendie-Walker controversy. PMID- 3550331 TI - Illustrations from the Wellcome Institute Library. Gachet and Johnston-Saint: the provenance of van Gogh's L'Homme a la Pipe. PMID- 3550332 TI - [Postpartum psychosis--new discoveries in an old disease]. PMID- 3550333 TI - [Diagnosis of suspected ectopic pregnancy using an immunoenzyme method for urinary HCG]. PMID- 3550334 TI - [Fetal blood sampling by umbilical vein puncture guided by ultrasonics]. PMID- 3550335 TI - [The thymus gland in infants--radiologic diagnosis and differential diagnosis]. PMID- 3550336 TI - [Routine use of ultrasonics in gynecology]. PMID- 3550337 TI - [Can the primary cardiologic treatment influence the prognosis of Eisenmenger syndrome?]. PMID- 3550339 TI - Pulsatile tinnitus. AB - Tinnitus is a frequent presenting symptom. Tinnitus that is rhythmic and synchronous with the patient's heartbeat is rare. Pulsatile tinnitus may be the only symptom of life-threatening and treatable diseases. The presence of hearing loss or vertigo focuses the diagnostic evaluation. The cause of pulsatile tinnitus may be found on otoscopic examination. Audiologic assessment and enhanced computed tomography often contribute to the diagnosis. Increased intracranial pressure should be excluded with a fundoscopic examination. Arteriography is required to diagnose life-threatening and treatable lesions in the presence of normal otoscopy, audiologic assessment, and enhanced computed tomography. PMID- 3550338 TI - [Optimization of the immunofluorescence test for antibodies in the serum of patients with inner ear diseases]. AB - Antibodies in the serum of patients with inner ear diseases can be demonstrated immunohistochemically with human kidney tissue. In this study a patient's serum with the typical positive reaction against proximal tubuli (antibodies against microsomes) and a serum with antibodies against mitochondria was tested with different dilutions of the fluorescein marked antiserum (FITC conjugate). For both sera a dilution of 1:160 showed positive reaction. The fluorescence of the control incubation was negligible. Employing the given technical details the immunohistochemical assay of antibodies with human kidney tissue has become a simple and reliable test for the most frequently found antibodies in patients with inner ear diseases. PMID- 3550340 TI - The effects of delay in standard treatment due to induction chemotherapy in two randomized prospective studies. AB - It is often suggested that tumors will respond to induction chemotherapy and result in improved survival for patients with squamous cell carcinoma of the head and neck. Two regimens of induction chemotherapy were studied in separate randomized, prospective trials over the last 6 years. Eighty-three patients with advanced disease were entered into the first study (43/chemotherapy; 40/control), and 60 into the second (27/chemotherapy; 33/control). Patient randomization was stratified by stage (III/IV) and site (oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, paranasal sinuses). The first study utilized bleomycin, Cytoxan, methotrexate and 5-fluorouracil in two cycles (one cycle if no tumor response), followed by standard treatment which consisted of combined irradiation and surgery or, in some instances, primary irradiation alone. The second study utilized cisplatin and 5-fluorouracil in three cycles prior to standard treatment. An objective tumor response to chemotherapy was observed in 68% in the first study and 85% in the second. The patient survival in both studies (at 24 months in the first; at 19 in the second) was better in the control than that in the experimental groups (43% to 31%; 69% to 46%). In the second study, the average length of delay of standard treatment was longer than in the first study (95 days vs. 66 days; P less than .02). Results combining the P-values of both studies indicate that the relative risk of having persistent disease was 2.9 times greater for patients who received chemotherapy. While toxicity to chemotherapy was not a factor in survival, the number of patients who withdrew from the studies and those who did not comply with treatment were greater in the chemotherapy groups. Except for new drug regimens of exceptional promise, it is recommended that future studies be designed so that chemotherapy is given concurrent with, or following the completion of standard treatment. PMID- 3550341 TI - Advances in oto-immunology: new trends in functional pathology of the temporal bone. AB - By using monoclonal and polyclonal antibodies against cell-membrane receptors and cytoskeletal proteins, the cellular and tissue composition of any organ can be far better determined. This is illustrated in the tympanic membrane, middle ear mucosa, and cholesteatoma. Immunotechnology applied to the temporal bone is shown with an animal-ototoxicity model. Antibodies to keratin and vimentin (i.e., to proteins of the fibrillar components that make up the cytoskeleton) stain specific tissue compartments. Langerhans' cell and T-lymphocyte subsets predominate in a cholesteatoma. The normal human tympanic membrane is devoid of these cells. Gentamicin can be traced with a polyvalent anti-gentamicin antiserum in serial sections of the cochlea and kidney. The drug accumulates in the outer hair cells and proximal tubular cells, respectively. A new technique of CT scanning, microslicing, plastic embedding, and semithin sectioning of undecalcified human temporal bone is described. Perspectives in applying immunotechnology to this method of human temporal bone processing are discussed. PMID- 3550342 TI - Subcutaneous suture placement. PMID- 3550343 TI - Delta sleep-inducing peptide (DSIP) stimulates LH release in steroid-primed ovariectomized rats. AB - Delta sleep inducing peptide (DSIP) has been shown to increase sleep in various animals and it is found in various parts of the brain including the hypothalamus. While intraventricular administration of DSIP (2 or 10 micrograms) failed to affect LH release in ovariectomized rats, in two separate experiments DSIP (2 or 10; 15 or 30 micrograms) promptly stimulated LH release in ovariectomized estrogen, progesterone-primed rats. However, DSIP (10(-8) or 10(-6)M) had no effect on either basal or luteinizing hormone-releasing hormone-induced in vitro LH release from the hemipituitaries of ovarian steroid-primed rats. These findings are in accord with the hypothesis that DSIP or DSIP-like peptide(s) may activate the hypothalamic neural circuitry responsible for stimulation of LH release reported to occur during sleep. PMID- 3550344 TI - Gentamicin and amikacin repress the growth of Plasmodium falciparum in culture, probably by inhibiting a parasite acid phospholipase. AB - Human erythrocytes were loaded with either gentamicin or amikacin and subsequently infected with the human malarial parasite Plasmodium falciparum and grown in culture. Parasite invasion of erythrocytes was unaffected by the drugs, but subsequent development was retarded. The digestion of host cell cytosol in ring-stage parasites was inhibited by the drugs. A substantial acid, Ca2+ independent phospholipase activity could be monitored in parasite cytosol and was found to be inhibited by the drugs. These results imply that phospholipases are involved in the feeding mechanism of the parasite and that gentamicin and amikacin exert their inhibitory activity by affecting these enzymes. PMID- 3550345 TI - Prostaglandins in enhanced pressor response in renal prehypertensive rabbits. AB - The role of prostaglandins (PGs) in the pressor response to norepinephrine (NE) was examined in one-kidney, one clip rabbits with renal artery stenosis for 3 day's duration (3-day clipped rabbits) and in sham operated rabbits with one kidney without renal artery stenosis. An exaggerated pressor response to NE, 800 ng/kg/min, was observed in the 3-day clipped rabbits, and it was abolished by angiotensin II antagonist, [Sar1, Ile8] angiotensin II (AIIA). Treatment with indomethacin, 10 mg/kg, induced hyperresponsiveness to NE in the sham operated rabbits and also produced a further increase in the response in the 3-day clipped rabbits: the enhanced responses with similar levels were not attenuated by AIIA in both groups. A subdepressor dose of PGE2, 800 ng/kg/min, abolished the hyperresponsiveness in the 3-day clipped rabbits, while subdepressor or depressor dose of PGI2, 10 or 20 ng/kg/min did not, but the concurrent infusion of AIIA with PGI2 attenuated it. These results indicate that PGs, in particular PGE2 might be involved in the enhanced pressor response to NE in the 3-day clipped rabbits in addition to the altered renin-angiotensin system. PMID- 3550346 TI - Sensitivity differences in reproductive/endocrine organs to chronically administered LHRH agonists in female rats. AB - The acute and chronic effects of two LHRH agonists on reproductive endocrine target organs were examined in female rats. Animals were injected twice daily with [(ImBzl)-D-His6,Pro9-NEt]LHRH (histrelin) or [D-Trp6,Pro9-NEt]LHRH for 1, 3, 5, 7, 11 or 28 days at 1, 10, 100 or 1000 micrograms/kg/day beginning in the luteal phase. The responses observed with the two agonists were similar. An initial stimulatory phase was observed on the first day of treatment with substantial increases in serum LH and progesterone levels. A significant diminution of hormone response was seen by day 3. Only 1000 micrograms/kg abolished the pituitary LH response at later treatment periods. Estrous cyclicity, ovarian and uterine weight, and progesterone and estradiol levels were inhibited in a time and dose dependent manner. The results demonstrate target organ sensitivity differences. In contrast to the relatively high doses needed to inhibit the pituitary response and decrease ovarian weight, doses as low as 1 microgram/kg were sufficient to decrease uterine weight. If these findings extrapolate to humans, it may be that conditions in which the desired therapeutic action is suppression of uterine tissue, may be treated with lower doses of LHRH agonists than conditions requiring complete gonadal suppression. PMID- 3550347 TI - Inhibitors of fatty acid oxidation. AB - This review discusses inhibitors of fatty acid oxidation for which sites and mechanisms of inhibition are reasonably well understood. Included in this review are hypoglycin, an inhibitor of butyryl-CoA dehydrogenase (EC 1.3.99.2), 4 pentenoic acid, 2-bromooctanoic acid, and 4-bromocrotonic acid all of which inhibit mitochondrial thiolases (EC 2.3.1.9 and 2.3.1.16) as well as several inhibitors of carnitine palmitoyltransferase I (EC 2.3.1.21) as for example 2 tetradecylglycidic acid, 2-bromopalmitic acid and aminocarnitine. Most of these inhibitors of fatty acid oxidation have been shown to cause hypoglycemia in animals and some also cause hypoketonemia. The advantages and limitations of using these inhibitors in metabolic studies are discussed. PMID- 3550348 TI - Participation of lymphoid cells in the withdrawal syndrome of opiate dependent rats. AB - Treatment of rats with 500 Rads whole-body ionizing irradiation prior to chronic administration of morphine reduced the severity of the naloxone induced withdrawal signs. In contrast, adoptive transfer of 2-6 X 10(8) lymphoid cells to irradiated rats prior to chronic morphine treatment completely restored the ability to manifest the withdrawal signs precipitated by naloxone. These observations offer the possibility that the immune system participates in opiate addiction. PMID- 3550350 TI - Current views of the pathobiochemistry of epilepsy. PMID- 3550349 TI - Renin release in anesthetized rats is enhanced by the calmodulin antagonist W-7. AB - In foregoing work, we found that the release of renin from rat kidney cortical slices was stimulated by the calmodulin antagonist W-7. The present work was done to determine whether W-7 would stimulate renin release in vivo. W-7 and its control agent, W-5 were directly infused into the renal artery of anesthetized rats. W-7 and W-5, at 50 micrograms/kg/min, produced no significant effects on renin release. Infusion of W-7 at 100 micrograms/kg/min resulted in a marked stimulation of renin release, but there was no significant alteration in the release when the same dose of W-5 was infused. Both compounds elicited a slight decrease in renal blood flow. The alterations in renin release and renal blood flow seen with W-7 were not affected by pretreatment with phentolamine or propranolol. As W-7 stimulates renin release in vivo, the hypothesis that Ca2+ calmodulin plays an inhibitory role in renin release from the kidney is given added support. PMID- 3550351 TI - Maurice C. Pincoffs MD: clinician and teacher, medical statesman, and distinguished soldier. PMID- 3550353 TI - [Radionuclide methods of determining glycosyltransferase activity]. PMID- 3550354 TI - [Radionuclide research in degenerative-dystrophic changes in the hip joint]. PMID- 3550352 TI - [Clinico-radiological assessment of the effectiveness of pathogenetic therapy in glomerulonephritis in children]. AB - Liver scintigraphy and hepatobiliary scintigraphy were employed for the assessment of kidney and liver function in children with glomerulonephritis at the stages of pathogenetic therapy with chlorambucil and prednisolone. Noticeable disturbance of nephron and hepatocytic function at the climax of clinical manifestations of the nephrotic syndrome was established. The use of maximum and maintenance doses of prednisolone and chlorambucil resulted in significant improvement of clinical and radionuclide indices. However the effective renal plasma flow and the rate of passage of the radionuclide from the plasma into the proximal canalicular cell did not return to normal even in the catamnesis 1 year after the discontinuation of treatment in 35% of the patients with chronic glomerulonephritis. The use of maximum doses of cytostatics in 98.5% of the children produced no damaging effect on the hepatocyte, in 1.5% of the children the authors observed the development of drug hepatitis. Hypokinetic dyskinesia of the gall bladder was detected in the overwhelming majority of the patients therefore drugs improving bile secretion should be recommended as part of treatment. PMID- 3550355 TI - [Physician revolutionaries--the vanguard of fighters for the health of the workers]. PMID- 3550356 TI - [G. I. Sokol'skii--a classic figure in Soviet medicine]. PMID- 3550357 TI - [Nurses of the Urals during World War II]. PMID- 3550358 TI - [69th anniversary of the Great October Revolution]. PMID- 3550359 TI - [Determination of hemodynamic parameters by blood electrical resistance using a dilution method]. AB - The theoretical basis and the experimental data of the hemodynamic parameter determination method have been described. The cardiac output and the circulating blood volume have been determined using intravenous injections of two solutions with different electrical resistance. A formula for blood electrical resistance was proposed. Tolerances for isoosmotic solutions were made. A system of three equations was made up on the basis of the results of two injections of solutions with different electrical conductance. From these equations blood characteristics, cardiac and circulating blood volumes can be obtained. Isoosmotic solutions of glucose and sodium chloride were used as indicators in treadmill tests with circulating blood. The measurement error practically didn't depend on the electrode type (either along or across the flow). PMID- 3550360 TI - [Basic principles of the design of motion converters in instruments for the mechanized treatment of bone tissues]. AB - The main tendency in designing mechanized medical instruments is developing systems with automatic fine adjustment and self-regulation. The automated gear adjustment, self-regulating mouthpieces and cutting tools create a flexible automated system with optimal cutting regime. The instruments do not overheat bone tissues which helps to avoid unnecessary traumatization. PMID- 3550362 TI - [The therapeutic community and schizophrenia]. PMID- 3550363 TI - [Neuroradiologic diagnosis of dementia. Morpho-structural and functional aspects]. PMID- 3550361 TI - [Determination of the volume of extravascular fluid in the lungs by blood electrical resistance using a dilution method]. AB - The theoretical basis of the method determining the volume of the extravascular lung fluid has been considered. The fluid volume is found by measuring the volume of water passing from the lung into the blood through the hyperosmotic indicator. The water volume is determined by comparing the curves of electrical resistance obtained as a result of intravenous injections of isoosmotic and hyperosmotic solutions. The electrical resistance of the blood is measured in the arterial bed. The lung fluid volume can be calculated using the parameters of the dilution curves and the equation for the crossing point. PMID- 3550364 TI - Monoclonal antibody HMFG-2 retains activity in vivo and binds to high molecular weight components expressed by metastatic breast cancers. AB - The monoclonal antibody HMFG-2 was raised against components of the human milk fat globule and human milk epithelial cells. It recognizes an epitope on glycoproteins of varying molecular weight; it is tumour-associated and expressed heterogeneously by most breast cancers. An intravenous injection of 131I-labelled HMFG-2 has been given to patients with recurrent cutaneous metastasis from breast carcinomas. Clearance of radioactivity from the plasma was measured and the label was shown to be carried on intact circulating antibody that had the ability to bind in vitro to the specific determinant as expressed by both the patients own tumour and by cultured breast cancer cells. Antibody was found to be associated with biopsy material taken from skin metastases 24 hours after administration of labelled antibody. However, the amount of radioactivity was insufficient for the production of a positive isotopic scan. PMID- 3550365 TI - Anterior expandable pedodontic bridge. PMID- 3550366 TI - [Efficacy and tolerance of the low molecular weight heparin fraction CY 216 in preventing postoperative venous thromboembolism]. PMID- 3550367 TI - [Pharmacologic profile of low molecular weight heparin]. PMID- 3550368 TI - [Recent data on the mechanism of action of the low molecular weight heparin fraction CY 216]. PMID- 3550369 TI - Failure of human insulin to influence endogenous basal insulin secretion in mild diabetics. AB - In evaluating the possibility of self-regulation of insulin secretion in man, human insulin may be more appropriate as an inhibitor to be considered than insulins from other species because the differences in the structure of the hormones might play some part in this conflicting proposal. The present study was carried out to examine whether human insulin per se can exert a feedback effect on the insulin secretion of B-cell in mild diabetics under physiologic condition. Fifteen mild diabetics were given a two-hour infusion of human insulin at a constant rate of 40 mU/m/min after a priming dose of 160 mU/m/min for the first two minutes. The plasma glucose in nine of these patients were maintained at their basal level of 92.8 +/- 3.7 mg/dL (Group A) with a glucose clamp technique (the coefficient of variation = 5.0 +/- 0.8% during the clamp), while that in the remaining six patients were intentionally altered, within physiologic range, from 114.5 +/- 8.4 mg/dL to 83.8 +/- 4.9 mg/dL (Group B). During insulin infusion the plasma immunoreactive insulin (IRI) level were well-maintained at about 50 microU/mL level in both groups, whereas the C-peptide reactivity (CPR) in group B decreased from 1.28 +/- 0.15 ng/mL to 0.59 +/- 0.14 ng/mL in parallel to the change of plasma glucose, in contrast to the relatively stable CPR level of 0.92 +/- 0.08 ng/mL in group A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550370 TI - Substrate cycling between triglyceride and fatty acid in human adipocytes. AB - Substrate cycles in metabolism require energy and generate heat, and they may be involved in thermogenesis. We have studied one such cycle between triglyceride and fatty acid in isolated human adipocytes using a nonisotopic technique. In the absence of added hormone, and with 5 mmol/L (90 mg/dL) glucose in the incubation medium, lipolysis and fatty acid reesterification coexisted such that 40 +/- 4% (mean +/- SEM) of the fatty acid produced was cycled back into triglyceride. In 51 individual subjects the range was from 0% to 100%. Both lipolysis and the quantity of fatty acid recycled correlated positively with cell volume (P less than .001 and P less than .005, respectively). Norepinephrine (10(-6) mol/L) alone (33 experiments) increased lipolysis 3.1-fold, and reduced the percentage of fatty acid reesterified. Cycling was similar to that in the basal state. Lipolysis was inhibited 46% by postabsorptive levels of insulin alone (18 experiments), but the proportion of fatty acid reesterified increased such that the quantity cycled back into triglyceride was similar to that observed in the basal state. In the presence of both norepinephrine and insulin (18 experiments), lipolysis was increased by 58% while 31 +/- 4% of the fatty acid released was reesterified. In consequence, the quantity of fatty acid cycled back into triglyceride increased 2.1-fold. Increasing the insulin level fivefold or the medium glucose concentration to 20 mmol/L produced no further increase in the quantity of fatty acid reesterified. A substrate cycle exists, therefore, between triglyceride and fatty acid in human adipose tissue, and its activity is modified by norepinephrine and insulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550371 TI - In vitro evidence that bone formation may be coupled to resorption by release of mitogen(s) from resorbing bone. AB - Bone-derived proteins have been shown to stimulate the proliferation of bone forming cells and to increase the rate of embryonic bone formation in vitro. The current studies were intended to determine the tissue distribution of bone cell active mitogen(s) in the embryonic chick, to determine the cellular origin and the target cell specificity of the bone cell-active mitogen(s) in embryonic chick bone, to determine whether the release of mitogenic activity from embryonic chick tibiae was proportional to bone resorption, and to compare mitogenic activities prepared from different skeletal sources, with respect to Mr, chemical stability, and mitogen activity kinetics. A bone cell-active mitogen(s) was identified in extracts of bone and cartilage but not in extracts of muscle, liver, intestine, or brain. (Mitogenic activity was determined as increased incorporation of 3[H] thymidine into DNA in serum-free, calvarial cell cultures.) Together, the following three observations indicate an osteoblastic origin for the bone cell active mitogen(s) in chick bone. First, the mitogen content of embryonic chick tibiae increased 4.5-fold, during eight days of serum-free in vitro growth (P less than .005). Second, conditioned medium (CM) from serum-free monolayer cultures of calvarial cells contained bone cell-active mitogen(s), but CM from parallel cultures of skin, liver, and intestinal cells did not. And, finally, the amount of bone cell-active mitogen(s) in calvarial cell CM was correlated with the amount of alkaline phosphatase (ALP) activity per cell, ie, an index of osteoblastic differentiation (r = .92, P less than .005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550372 TI - Glucose utilization in islets of hyperglycemic rat models with impaired glucose induced insulin secretion. AB - Under most experimental conditions islet glucose metabolism is well-correlated with short-term glucose-induced insulin secretion. Two hyperglycemic rat models (neonatal streptozotocin and glucose infusion) have been previously found to have markedly impaired insulin responses to glucose, and the glucose utilization of islets isolated from these models was therefore studied to see if reduced glucose metabolism might be related to the secretory abnormalities. It was found that glucose utilization in the islets of the two models was similar or higher than in comparable control islets. These data suggest that the secretory defect of these models, which is presumably induced by chronic hyperglycemia, is at a step in the secretion process distal to glucose metabolism. PMID- 3550373 TI - Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. AB - To determine if chromium (Cr) is involved in hypoglycemia, eight female patients with symptoms of hypoglycemia were supplemented with 200 micrograms of Cr as chromic chloride for three months in a double-blind crossover experimental design study. Chromium supplementation alleviated the hypoglycemic symptoms and significantly raised the minimum serum glucose values observed two to four hours following a glucose load. Insulin binding to red blood cells and insulin receptor number also improved significantly during Cr supplementation. These data suggest that impaired Cr nutrition and/or metabolism may be a factor in the etiology of hypoglycemia. PMID- 3550374 TI - Genotype-influenced changes in serum HDL cholesterol after short-term overfeeding in man: association with plasma insulin and triglyceride levels. AB - Six pairs of male monozygotic (MZ) twins were submitted to a 22-day overfeeding period during which they ingested a daily surplus of 1,000 kcal above their individual daily energy needs in the form of a mixed diet. Serum lipids, lipoproteins, and apoprotein A and B concentrations were measured before and after the overfeeding period. Percentage of body fat, fasting plasma glucose, and insulin levels as well as plasma glucose and insulin concentrations after a glucose challenge were also measured before and after overfeeding. Results showed that before overfeeding, MZ twins exhibited a significant intrapair resemblance for total serum cholesterol (CHOL), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), and for the high density lipoprotein-cholesterol/total cholesterol ratio (HDL-C/CHOL) (8.2 less than or equal to F ratios less than or equal to 32.7, P less than .01). The overfeeding experiment induced significant increases only in serum CHOL (P less than .01) and in serum LDL-C (P less than .05). However, although mean group values of serum TG, HDL-C, and HDL-C/CHOL ratio were not significantly modified by overfeeding, there were large interindividual variations in the response of these variables to the experiment. Results suggest that changes in serum TG, HDL-C, and in the HDL-C/CHOL ratio were significantly associated with the genotype of the subjects as a significant intrapair resemblance in the response to overfeeding was observed for these variables (0.69 less than or equal to r less than or equal to .85, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550375 TI - Insulin binding and biological activities in the FRTL-5 rat thyroid cell line. AB - A cloned rat thyroid cell line (FRTL-5) was examined for both insulin binding and responsiveness. The characteristics of insulin binding to thyroid cells were similar to those observed in typical insulin target cells. The 125I-insulin binding was time and temperature dependent and Scatchard analysis suggested the presence of two major binding sites with high and low affinity constant (Kd = 1.4 X 10(-10) mol/L and 1.5 X 10(-9) mol/L, respectively). 125I-insulin was also internalized and degraded in a temperature-dependent manner. IGF1 was weakly effective in completing 125I-insulin binding to FRTL-5 cells (57% inhibition at 333 nmol/L), whereas noninsulin-related peptide hormones were ineffective. Exposure of FRTL-5 cells to insulin stimulated both methyl-aminoisobutyric acid (M-AIB) and 2-deoxy-D-glucose (2DG) transport. These effects were evident at 10( 9) mol/L and maximal at 10(-7) mol/L insulin. Maximal stimulation was three- to four-fold over basal value for both M-AIB and 2DG transport. These data suggest that insulin specifically binds to FRTL-5 cells and regulates different biological functions of this thyroid cell line. PMID- 3550376 TI - Pancreatic beta-cell secretion after oral glucose and intravenous glucagon: different responses to dietary control of plasma glucose in newly diagnosed patients with NIDDM. AB - Pancreatic beta-cell secretion after oral glucose or intravenous glucagon stimulation was studied in newly diagnosed patients with non-insulin-dependent diabetes mellitus (NIDDM) before and after glycemic control by diet treatment alone. Insulin secretion to oral glucose showed significant improvement, while C peptide release by glucagon showed no significant difference before and after diet treatment. The finding suggests that pancreatic beta-cell response to oral glucose varies with different metabolic states, but this is not so after glucagon stimulation in NIDDM patients. PMID- 3550377 TI - The synthetic 32-46 fragment of human growth hormone increases insulin and glucagon levels in the conscious dog. AB - Human growth hormone (hGH, 22 K) has an acute insulinlike effect not observed with the 20 K variant form of hGH that lacks amino acids 32 to 46 (deletion peptide, hGH32-46). The possibility that hGH32-46 increases insulin secretion was examined by infusing hGH32-46 (1.6 nmol/kg/min) or saline in a crossover design study into each of four conscious 16-hour-fasted dogs for three hours (0 to 180 minutes) following a 40-minute control period. At 90 minutes, plasma glucose was raised to and maintained at 170 mg/dL by glucose infusion for three hours (until 270 minutes). After a lag period of 30 minutes hGH32-46 infusion caused glucagon to increase (P less than 0.05) by 67 +/- 20 pg/mL and insulin tended to rise by 8 +/- 3 microU/mL. Saline tended to cause glucagon and insulin to decline slightly (by 17 +/- 8 pg/mL and 6 +/- 2 microU/mL); hGH32-46 increased (P less than 0.05) tracer determined (3H-3-glucose) glucose production by 1.13 +/- 0.66 mg/kg/min while saline had no effect. Neither treatment changed plasma glucose (100 +/- 4 to 105 +/- 3 mg/dL with hGH32-46; 99 +/- 4 to 99 +/- 4 mg/dL with saline). Induction of hyperglycemia (168 +/- 2 mg/dL) caused glucagon concentrations to fall similarly to about 50 pg/mL with and without hGH32-46. Insulin rose in both protocols but to a greater extent (P less than 0.05) with hGH32-46 (+67 +/- 18 v +35 +/- 13 microU/mL at 180 minutes).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550378 TI - The time dimension in histology. PMID- 3550379 TI - A method of medical knowledge base augmentation. PMID- 3550380 TI - A flexible computer system for renal transplant information. PMID- 3550381 TI - The yeast 2 micron plasmid: strategies for the survival of a selfish DNA. AB - The designation of the yeast 2 mu circle as a "selfish" DNA molecule has been confirmed by demonstrating that the plasmid is lost with exponential kinetics from haploid yeast populations grown in continuous culture. We show that plasmid free yeast cells have a growth rate advantage of some 1.5%-3% over their plasmid containing counterparts. This finding makes the ubiquity of this selfish DNA in yeast strains puzzling. Two other factors probably account for its survival. First, the rate of plasmid loss was reduced by allowing haploid populations to enter stationary phase periodically. Second, it was not possible to isolate a plasmid-free segregant from a diploid yeast strain. Competition experiments demonstrated that stability in a diploid is conferred at the level of segregation and that plasmid-free diploid cells are at a selective advantage compared with their plasmid-containing counterparts. Yeast cells in nature are usually homothallic and must frequently pass through both diploid and stationary phases. The 2 mu plasmid appears to have evolved a survival strategy which exploits these two features of its host's life cycle. PMID- 3550382 TI - DNase I sensitivity of the chromatin of the yeast SUC2 gene for invertase. AB - The DNase I sensitivity of chromatin of the yeast SUC2 gene, which encodes two forms of invertase, has been studied both in the genome and in a multicopy plasmid carrying the gene and its flaking sequences. Whereas little if any difference in the DNase I sensitivity of the flanking regions was found between the repressed and the derepressed states, derepression of the gene was accompanied by a large increase in the sensitivity of the transcribed region. A well-defined DNase I hypersensitive site was found centered at approximately 120 bp downstream from the end of the coding region. This site seems to be flanked in the 3' non-coding region by strictly positioned nucleosomes, and the structure of this region changes upon derepression. In the 5' non-coding region two DNase I hypersensitive sites have been found flanking the TATA box and a set of three closely spaced hypersensitive sites occurs in an upstream regulatory sequence. The structure of these latter sites depends on the on-off state of transcription. PMID- 3550383 TI - Organization of the ribosomal RNA genes in Mycoplasma hyopneumoniae: the 5S rRNA gene is separated from the 16S and 23S rRNA genes. AB - In order to study the organization of the ribosomal RNA genes of Mycoplasma hyopneumoniae the rRNA genes were cloned in phage vectors lambda EMBL3 and lambda EMBL4. By subcloning the restriction fragments into various plasmids and analysing the resulting clones by Southern and Northern blot hybridization, a restriction map of the rRNA genes was generated and the organization of the rRNA genes was determined. The results show that the genes for the 16S and 23S rRNAs are closely spaced and occur only once in the genome, whereas the 5S rRNA gene is separated from the other two genes by more than 4 kb. PMID- 3550385 TI - The use of suicide substrates to select mutants of Escherichia coli lacking enzymes of alcohol fermentation. AB - Mutants of Escherichia coli resistant to chloroethanol or to chloroacetaldehyde were selected. Such mutants were found to lack the fermentative coenzyme A (CoA) linked acetaldehyde dehydrogenase activity. Most also lacked the associated fermentative enzyme alcohol dehydrogenase. Both types of mutants, those lacking acetaldehyde dehydrogenase alone or lacking both enzymes, mapped close to the regulatory adhC gene at 27 min on the E. coli genetic map. The previously described acd mutants which lack acetaldehyde dehydrogenase and which map at 63 min were shown to be pleiotropic, affecting respiration and growth on a variety of substrates. It therefore seems likely that the structural genes for both the acetaldehyde and alcohol dehydrogenases lie in the adhCE operon. This interpretation was confirmed by the isolation of temperature sensitive chloracetaldehyde-resistant mutants, some of which produced thermolabile acetaldehyde dehydrogenase and alcohol dehydrogenase and were also found to map at the adh locus. Reversion analysis indicated that mutants lacking one or both enzymes carried single mutations. The gene order in the adh region was determined by three point crosses to be trp-zch::Tn10-adh-galU-bglY-tyrT-chlC. PMID- 3550384 TI - Cytosine-specific DNA modification interferes with plasmid establishment in Escherichia coli K12: involvement of rglB. AB - Several chimeric pBR322/328 derivatives containing genes for cytosine-specific DNA methyltransferases (Mtases) can be transformed into the Escherichia coli K12/E. coli B hybrid strains HB101 and RR1 but not into other commonly used E. coli K12 strains. In vitro methylation of cytosine residues in pBR328 and other unrelated plasmids also reduces their potential to transform such methylation sensitive strains, albeit to a lesser degree than observed with plasmids containing Mtase genes. The extent of reduced transformability depends on the target specificity of the enzyme used for in vitro modification. The role of a host function in the discrimination against methylated plasmids was verified by the isolation of K12 mutants which tolerate cytosine methylated DNA. The mutations map in the vicinity of the serB locus. This and other data indicate that the host rglB function is involved in the discrimination against modified DNA. PMID- 3550386 TI - The pyridine nucleotide cycle of Salmonella typhimurium: genetic characterization of the pncXA operon. AB - A series of Mud1 and Tn10 insertions were identified in the pncA chromosome region of Salmonella typhimurium which is responsible for the production of nicotinamide deamidase. Both pncA (resulting in no nicotinamide deamidase activity) and pncX (resulting in lowered nicotinamide deamidase activity) insertions were constructed. In addition, mutants which could utilize nicotinamide as a sole source of nitrogen were isolated. These mutants, designated pncH, hyperproduce nicotinamide deamidase. Genetic studies utilizing pncX--lacZ and pncA--lacZ operon fusions indicate that pncX::Tn10 insertions reduce transcription of pncA--lac while pncH mutations increase the expression of both pncA--lacZ and pncX-lacZ. The gene order was determined as purB--pncA--pncX- gdh with transcription of both pncA and pncX occurring in the counterclockwise direction. Merodiploid studies suggest a model whereby pncX and pncA form an operon with the major promoter occurring upstream from pncX. A second, weaker promoter for pncA must be situated between pncX and pncA. The pncH mutations appear to occur in the pncX promoter (pncXp) increasing promoter activity. PMID- 3550387 TI - Identification and purification of the N gene product of bacteriophage phi 80. AB - To confirm the in vivo observation that the N gene product of phi 80, phi 80-pN, prevents termination of transcription at the tL1 region and is therefore a transcription antitermination factor (Tanaka and Matsushiro 1985), we demonstrated that phi 80-tL1 is a rho-dependent terminator, similar to lambda tL1, and that phi 80-pN has a transcription antitermination function at this site in an in vitro transcription system using a nucleic acid-free S-100 extract. In the presence of rho-protein, transcription termination at tL1 was suppressed completely with an S-100 extract prepared from Escherichia coli strain NT525 containing the pBN1-N+ plasmid. Starting from this pN-overproducing cell extract, we purified phi 80-pN to homogeneity by chromatography on DEAE-Sephacel, Sephadex G-150 and CM-Sephadex C-50. The molecular weight of purified pN was about 12,000 and the NH2-terminal sequence was NH2-Met-Ile-Asp-Asp-Ile-Lys, which was consistent with the sequence deduced from the DNA sequence. PMID- 3550388 TI - The Escherichia coli heat shock regulatory gene is immediately downstream of a cell division operon: the fam mutation is allelic with rpoH. AB - Several mutations which affect critical cell functions in Escherichia coli map at 76 min on the chromosome. The genes which map in this region are the cell division genes fts Y, E, X and S, the heat shock regulatory gene rpoH/htpR/hin, the lipoprotein biogenesis gene fam and another essential gene dnaM. We determined the relative positions of most of these genes and show that the rpoH gene lies immediately downstream of the last gene (ftsX) of a cell division operon and is transcribed in the same direction. We also show that the fam-715 mutation is allelic with rpoH and so the conditional lipoprotein deficiency of the fam mutation must be due to the pleiotropic nature of the heat shock response. PMID- 3550389 TI - Spot-transformation with plasmids. AB - A method is described which allows transformation of bacterial cells on the surface of agar plates. It is suitable for transferring large numbers of different plasmids, such as gene libraries, into a new genetic background. One nanogram of plasmid DNA is sufficient for transformation. PMID- 3550390 TI - Selection of bacterial pac sites recognized by Salmonella phage P22. AB - A gene library of chromosomal PstI fragments from Salmonella typhimurium strain DB5575 has been established. By means of phage P22 mediated transduction, ten different clones which contained inserts that promoted plasmid transduction were selected out of a total of about 7,000 clones. Seven of these clones carried inserts that stimulated transduction independently of general and int-promoted recombination and were interpreted as carrying pac analogous signals. The remaining three clones carried inserts that promoted transduction under recombination proficient conditions, whereas transduction occurred at reduced rate in the absence of recombination. These were believed to have short regions of homology with P22 DNA. PMID- 3550391 TI - Making waves: current controversies in obstetric ultrasound. PMID- 3550392 TI - Historical review of caudal epidural analgesia in obstetrics. PMID- 3550394 TI - Capillary tortuosity and degree of contraction or extension of skeletal muscles. AB - The effect of muscle contraction, and extension, on capillary anisotropy was investigated in rat m. soleus fixed by vascular perfusion at sarcomere lengths ranging from 1.62 micron (tetanizing stimulation of sciatic nerve) to 2.85 micron (ankle joint maximally flexed. Capillary length density and tortuosity were estimated by morphometry using two sets of sections (0 and 90 degrees to the fiber axis). Capillary orientation distribution was evaluated from a series of sections taken at 0 to 90 degrees (by steps of 5-10 degrees) to the fiber axis in six preparations (sarcomere length range, 1.62-2.85 micron; capillary length density, 900-2000 mm-2). The Fisher axial distribution provided a good fit for modeling capillary orientation distribution in each case. For a comparable capillary length density per volume of muscle fiber (approximately equal to 2000 mm-2), the degree of orientation of capillary segments parallel to the fiber axis was two and four times larger in extended m. soleus than in the muscles fixed at 1.98- and 1.62-micron sarcomere lengths, respectively. In preparations fixed at 2.85, 1.98, and 1.62 micron, capillary length density per volume of muscle fiber was, respectively, 14, 44, and 65% larger than revealed by capillary counts per sectional area of muscle fiber on transverse section only, an often used parameter to compare capillarity in different muscles. PMID- 3550393 TI - Intrapulmonary BCG cell wall vaccination in mice. AB - Mice of two inbred strains, Balb/c and C3H/He, were given three dosages of mycobacterium bovis BCG (5 X 10(4), 5 X 10(2) and 5 colony forming units) by either the intravenous route or by a direct intratracheal (non-aerosol) route. The magnitude of the infectivity of these inoculae given by these routes was assessed by measurement of weight changes and mycobacterial multiplication in the spleen and lung. As expected, the Balb/c strain was more susceptible to infection than the C3H/He strain. However, for both strains, infection by the intratracheal route resulted in mycobacterial counts in the lungs which were more than seven fold higher than mycobacterial counts after intravenous challenge. Naive Balb/c mice were immunized with BCG cell wall vaccine by the intratracheal route, by the intravenous route or by subcutaneous immunization. Four weeks later mice were challenged with live BCG by the intratracheal route. Following challenge, mycobacterial counts in the lungs of mice immunized by the intratracheal route, but not in the lungs of the mice immunized by the intravenous and subcutaneous routes, were significantly lower compared to controls. These results suggest that immunization with killed BCG by the intratracheal route imparts more effective mycobacterial intrapulmonary immunity than immunization by systemic routes. PMID- 3550395 TI - Medicaid funding update: RTL petition discriminates. PMID- 3550396 TI - [Examination of the role of C. trachomatis in genitourinary infections using enzyme immunoassay and Giemsa staining]. AB - In the past decade C. trachomatis (serotype D-K) has been established as an important etiologic agent in genitouriner tract infections in both women and men. Laboratory diagnostic tests for Chlamydia include direct microbiologic isolation and serologic and cytologic techniques. In studies lasting from Oct. 11th 1985 - to the Feb. 21st 1986, a total of 600 people were tested in parallel by EIA and giemsa staining. These people comprised three groups. The largest group, 380 patients, had genitourinary infections, the second, control group, of 127 people were healthy and the third, risk group (contacts of infected or suspected people) of 93 people were also healthy. C. trachomatis was found in 10.7% of the patients group, 7.2% of the risk group and 1.5% of the control group. PMID- 3550397 TI - The first 50 years of the International Permanent Commission on Occupational Health. PMID- 3550398 TI - From the PCIAOH to the ICOH: continuity and development. PMID- 3550400 TI - List of publications of the ICOH scientific committees. PMID- 3550399 TI - Eighty years of occupational diseases. PMID- 3550401 TI - The abuse of medicine as a political power in Nazi Germany. PMID- 3550402 TI - The history and development of medical physics instrumentation: nuclear medicine. PMID- 3550403 TI - [Modern diagnosis of thyroid cancer. Experience of the value of scintigraphy, sonography, determination of tumor markers and ultrasound-controlled fine-needle biopsy]. PMID- 3550404 TI - [Intensified insulin therapy: single dose substitution of meal unrelated (basal) need for insulin by long-acting human zinc insulin]. PMID- 3550405 TI - [Severe poisoning caused by Dolo-Neurotrate in a child]. PMID- 3550406 TI - [Digital radiography--new possibilities in vascular diagnosis]. PMID- 3550407 TI - [Bullosis diabeticorum: 2 follow-up studies]. PMID- 3550408 TI - Microbial metabolism of homocyclic and heterocyclic aromatic compounds under anaerobic conditions. PMID- 3550412 TI - Biliary atresia (continuing education credit). PMID- 3550411 TI - The graduate in an industrial environment. PMID- 3550410 TI - [Childhood poisoning by deadly poisonous Amanita ]. PMID- 3550413 TI - Strength evaluation in neuromuscular disease. AB - Strength evaluation in neuromuscle disease is necessary to track the natural history of the disease, to understand its pathophysiology, to determine the efficacy of treatment, and, most importantly, to evaluate an experimental treatment regimen. This article describes the physiology of muscle activity, discusses fatigue, examines various testing methods, and suggests appropriate measurements to assess the neuromuscular patient's strength and endurance in a variety of clinical settings. The minimal amount of equipment necessary to follow patients with NMD is a stop watch, a goniometer, a hand-held dynamometer, a hand grasp dynamometer, and a creative mind. PMID- 3550414 TI - Quantitative assessment of neuromuscular deficit in ALS. AB - Several criteria must be met in developing a test battery forr ALS. First, the test items should be designed to answer the specific questions being asked. If questions involve the amount and rate of deterioration, then the test items should generate interval data and show evidence that they reflect change in the disease itself. Second, the reliability of the test items should be carefully determined. Are the variances due to testing errors such as inconsistent positioning or changes in verbal instructions; or do they reflect human performance variation? Third, the test items must be sensitive to small changes, and one must be able to test the very strong as well as the severely debilitated patient. The TQNE was designed to measure degree of disease progression in ALS. The major portion of the protocol consists of isometric force measurement using an electronic strain gauge. Other quantitative segments include tests of pulmonary function, speech rates, and timed activities. Using z-score transformations, we have summarized these test items into five megascores: pulmonary function, bulbar function, timed hand activities, arm strength, and leg strength. Megascores have been used to characterize the natural history of the disease and to judge therapeutic efficacy. Quantitative methods to measure deficit in neuromuscular disease lag far behind other technologic advances in medical research. Future advances in the measurement of neuromuscular deficit depend on the commitment of researchers to invest the time and resources necessary to develop more sensitive and reliable testing techniques. PMID- 3550416 TI - Heavy metals and trace elements in amyotrophic lateral sclerosis. AB - The first descriptions of the clinical picture of ALS arose from knowledge of the toxic effects of lead on the nervous system. The place of lead in the etiology of ALS remains controversial over 150 years later. More recently, trace element studies have provided a novel approach in our attempts to demonstrate a fundamental metabolic abnormality in motor neurons. The evidence that has been presented in this general area is reviewed in this article. PMID- 3550415 TI - Endocrine function in amyotrophic lateral sclerosis. A review. AB - Endocrine and metabolic disturbances found in patients with ALS are reviewed. Pancreatic function, carbohydrate tolerance, calcium metabolism, testicular and ovarian thyroid and pituitary function are discussed. It is difficult to interpret these various metabolic dysfunctions as being either an epiphenomenon of ALS or possibly a clue to etiology of the disease. The data are reviewed and interpreted with these constraints. PMID- 3550417 TI - Respiratory system in amyotrophic lateral sclerosis. AB - Failure of the respiratory system is the most common cause of death in amyotrophic lateral sclerosis. This is due to weakened respiratory musculature resulting in respiratory failure, ineffective cough, and failure to protect the lungs from aspiration. Treatment is only supportive at present, but mechanical ventilation with either negative or positive pressure offer some life-extending possibilities. The respiratory system should be closely monitored as early identification of problems may allow better insight into the immediate prognosis. PMID- 3550409 TI - Transcription and replication of rhabdoviruses. PMID- 3550418 TI - Effects on mRNA splicing of mutations in the 3' region of the Saccharomyces cerevisiae actin intron. AB - Point mutations, deletions, and a sequence context change were introduced at positions 3' to the internal conserved TACTAAC sequence of the Saccharomyces cerevisiae actin intron. In vivo analysis of yeast mRNA splicing suggests that, in contrast to the importance of the polypyrimidine tract in metazoan introns, specific sequences in this region are not required for efficient excision of a yeast intron. However, a double point mutation near the 3' junction (GG/AC) does severely inhibit splicing. Although this mutagenesis of the 3' junction, as well as deletion of most nucleotides between the TACTAAC and the 3' junction, caused only a slight accumulation of primary transcript, the observed accumulation of lariat intermediate by these mutants demonstrates the significance of this region for a step(s) in the splicing process after lariat formation. PMID- 3550419 TI - Primary structure requirements for correct sorting of the yeast mitochondrial protein ADH III to the yeast mitochondrial matrix space. AB - Alcohol dehydrogenase isoenzyme III (ADH III) in Saccharomyces cerevisiae, the product of the ADH3 gene, is located in the mitochondrial matrix. The ADH III protein was synthesized as a larger precursor in vitro when the gene was transcribed with the SP6 promoter and translated with a reticulocyte lysate. A precursor of the same size was detected when radioactively pulse-labeled proteins were immunoprecipitated with anti-ADH antibody. This precursor was rapidly processed to the mature form in vivo with a half-time of less than 3 min. The processing was blocked if the mitochondria were uncoupled with carbonyl cyanide m chlorophenylhydrazone. Mutant enzymes in which only the amino-terminal 14 or 16 amino acids of the presequence were retained were correctly targeted and imported into the matrix. A mutant enzyme that was missing the amino-terminal 17 amino acids of the presequence produced an active enzyme, but the majority of the enzyme activity remained in the cytoplasmic compartment on cellular fractionation. Random amino acid changes were produced in the wild-type presequence by bisulfite mutagenesis of the ADH3 gene. The resulting ADH III protein was targeted to the mitochondria and imported into the matrix in all of the mutants tested, as judged by enzyme activity. Mutants containing amino acid changes in the carboxyl-proximal half of the ADH3 presequence were imported and processed to the mature form at a slower rate than the wild type, as judged by pulse-chase studies in vivo. The unprocessed precursor appeared to be unstable in vivo. It was concluded that only a small portion of the presequence contains the necessary information for correct targeting and import. Furthermore, the information for correct proteolytic processing of the presequence appears to be distinct from the targeting information and may involve secondary structure information in the presequence. PMID- 3550420 TI - Isolation of a Saccharomyces cerevisiae centromere DNA-binding protein, its human homolog, and its possible role as a transcription factor. AB - A protein that binds specifically to Saccharomyces cerevisiae centromere DNA element I was purified on the basis of a nitrocellulose filter-binding assay. This protein, termed centromere-binding protein 1 (CP1), was heat stable and renaturable from sodium dodecyl sulfate (SDS), and assays of eluates from SDS gels indicated a molecular weight of 57,000 to 64,000. An activity with similar specificity and stability was detected in human lymphocyte extracts, and analysis in SDS gels revealed a molecular weight of 39,000 to 49,000. CP1-binding sites occurred not only at centromeres but also near many transcription units, for example, adjacent to binding sites for the GAL4-positive regulatory protein upstream of the GAL2 gene in S. cerevisiae and adjacent to the TATA element of the adenovirus major late promoter. A factor (termed USF) that binds to the latter site and stimulates transcription has been isolated from HeLa cells by others. PMID- 3550421 TI - L-A double-stranded RNA viruslike particle replication cycle in Saccharomyces cerevisiae: particle maturation in vitro and effects of mak10 and pet18 mutations. AB - Previously, we found that log-phase cells of Saccharomyces cerevisiae contain a new type of viruslike particles containing only plus- strand L-A single-stranded RNA (ssRNA). These particles synthesize minus-strand RNA in an in vitro RNA polymerase reaction to produce L-A double-stranded RNA (dsRNA). The major class of particles contains L-A dsRNA and synthesizes plus-strand L-A ssRNA by a conservative mechanism. In this paper, we show that mutations in mak10 or the pet18 locus, which result in temperature-dependent replication of L-A dsRNA in vivo, also result in instability of the L-A dsRNA-containing (major class) viruslike particles in vitro. The L-A dsRNA (minus-strand)-synthesizing particles isolated by CsCl density gradient centrifugation synthesize plus-strand L-A ssRNA after completion of dsRNA (minus-strand) synthesis and have the same major coat protein as that of the major-class particles. Furthermore, the density of the dsRNA-synthesizing particles from wild-type cells shifts to that of the major class dsRNA-containing particles as a result of the in vitro RNA polymerase reaction. Thus, L-A dsRNA-synthesizing particles undergo functional and structural maturation in vitro. PMID- 3550422 TI - Position-dependent and -independent mechanisms regulate cell-specific expression of the SpoC1 gene cluster of Aspergillus nidulans. AB - Many genes that are expressed specifically in the differentiating asexual spores (conidia) of Aspergillus nidulans are organized into clusters. We investigated the effects of altered chromosomal position on expression of a gene from the conidiation-specific SpoC1 gene cluster. The gene became deregulated when integrated at nonhomologous chromosomal sites, in that transcript levels were elevated in vegetative cells (hyphae) and variably altered in conidia. We also investigated the effects on expression of insertion of the nonregulated argB gene into the SpoC1 region. Levels of argB transcripts were markedly reduced in hyphae. The results suggest that a cis-acting regional regulatory mechanism represses transcription of SpoC1 genes in hyphae. They also indicate that expression of individual SpoC1 genes is modulated during conidiation by trans acting factors. We propose that the two types of regulation act together to produce the major differences in transcript levels observed in hyphae versus conidia. PMID- 3550423 TI - Biochemical and biological properties of the human N-ras p21 protein. AB - We characterized the normal (Gly-12) and two mutant (Asp-12 and Val-12) forms of human N-ras proteins produced by Escherichia coli. No significant differences were found between normal and mutant p21 proteins in their affinities for GTP or GDP. Examination of GTPase activities revealed significant differences between the mutant p21s: the Val-12 mutant retained 12% of wild-type GTPase activity, whereas the Asp-12 mutant retained 43%. Both mutant proteins, however, were equally potent in causing morphological transformation and increased cell motility after their microinjection into quiescent NIH 3T3 cells. This lack of correlation between transforming potency and GTPase activity or guanine nucleotide binding suggests that position 12 mutations affect other aspects of p21 function. PMID- 3550424 TI - Transcriptional regulation of genes encoding insulin, glucagon, and angiotensinogen by sodium butyrate in a rat islet cell line. AB - The state of differentiation of various neoplastic cell lines is inversely correlated with the rate of cellular growth. To delineate the changes in hormone gene expression associated with an induced decrease in the growth rate of rat insulinoma cells, we studied the effects of sodium butyrate on the expression of the genes encoding insulin, glucagon, and angiotensinogen. Sodium butyrate inhibited cellular proliferation and decreased levels of c-myc mRNA. Concomitantly, steady-state levels of mRNAs encoding insulin and glucagon increased by 10- and 8.5-fold, respectively, as a result of a specific increase in the transcription of both genes. Sodium butyrate also inhibited angiotensinogen gene expression, which was ectopic in the insulinoma cells. These observations suggest that sodium butyrate induces a pattern of events leading to the differentiation of the rat insulinoma cells. PMID- 3550425 TI - Complementation of a polyamine-deficient Escherichia coli mutant by expression of mouse ornithine decarboxylase. AB - Mouse ornithine decarboxylase (ODCase) cDNA was expressed at a high level in an Escherichia coli mutant deficient in polyamine biosynthesis. The expression of mouse ornithine decarboxylase relieved the dependence of the mutant on an exogenous source of polyamines, presumably by providing putrescine, the product of the enzyme. The effect on the enzymatic activity of deletions that removed carboxy-terminal amino acids of the protein was determined. PMID- 3550426 TI - Alterations in the adenine-plus-thymine-rich region of CEN3 affect centromere function in Saccharomyces cerevisiae. AB - Centromere DNA from 11 of the 16 chromosomes of the yeast Saccharomyces cerevisiae have been analyzed and reveal three sequence elements common to each centromere, referred to as conserved centromere DNA elements (CDE). The adenine plus-thymine (A + T)-rich central core element, CDE II, is flanked by two short conserved sequences, CDE I (8 base pairs [bp]) and CDE III (25 bp). Although no consensus sequence exists among the different CDE II regions, they do have three common features of sequence organization. First, the CDE II regions are similar in length, ranging from 78 to 86 bp measured from CDE I to the left boundary of CDE III. Second, the base composition is always greater than 90% A + T. Finally, the A and T residues in these segments are often arranged in runs of A and runs of T residues, sometimes with six or seven bases in a stretch. We constructed insertion, deletion, and replacement mutations in the CDE II region of the centromere from chromosome III, CEN3, designed to investigate the length and sequence requirements for function of the CDE II region of the centromere. We analyzed the effect of these altered centromeres on plasmid and chromosome segregation in S. cerevisiae. Our results show that increasing the length of CDE II from 84 to 154 bp causes a 100-fold increase in chromosome nondisjunction. Deletion mutations removing segments of the A + T-rich CDE II DNA also cause aberrant segregation. In some cases partial function could be restored by replacing the deleted DNA with fragments whose primary sequence or base composition is very different from that of the wild-type CDE II DNA. In addition, we found that identical mutations introduced into different positions in CDE II have very similar effects. PMID- 3550427 TI - Substrate recognition and identification of splice sites by the tRNA-splicing endonuclease and ligase from Saccharomyces cerevisiae. AB - We have examined the substrate requirements for efficient and accurate splicing of tRNA precursors in Saccharomyces cerevisiae. The effects of Schizosaccharomyces pombe tRNASer gene mutations on the two steps in splicing, intron excision and joining of tRNA halves, were determined independently by using partially purified splicing endonuclease and tRNA ligase from S. cerevisiae. Two mutations (G14 and A46) reduced the efficiency of excision and joining in parallel, whereas two others (U47:7 and C33) produced differential effects on these two steps; U47:7 affected primarily the excision reaction, and C33 had a greater impact on ligation. These data indicate that endonuclease and ligase recognize both common and unique features of their substrates. Another two mutations (Ai26 and A37:13) induced miscutting, although with converse effects on the two splice sites. Thus, the two cutting events appear to be independent. Finally, we suggest that splice sites may be determined largely through their position relative to sites within the tRNA-like domain of the precursors. Several of these important sites were identified, and others are proposed based on the data described here. PMID- 3550428 TI - Nucleotide sequence and functional analysis of the RAD1 gene of Saccharomyces cerevisiae. AB - The RAD1 gene of Saccharomyces cerevisiae is involved in excision repair of damaged DNA. The nucleotide sequence of the RAD1 gene presented here shows an open reading frame of 3,300 nucleotides. Two ATG codons occur in the open reading frame at positions +1 and +334, respectively. Since a deletion of about 2.7 kilobases of DNA from the 5' region of the RAD1 gene, which also deletes the +1 ATG and 11 additional codons in the RAD1 open reading frame, partially complements UV sensitivity of a rad1 delta mutant, we examined the role of the +1 ATG and +334 ATG codons in translation initiation of RAD1 protein. Mutation of the +1 ATG codon to ATC affected the complementation ability of the RAD1 gene, whereas mutation of the +334 ATG codon to ATC showed no discernible effect on RAD1 function. These results indicate that translation of RAD1 protein is initiated from the +1 ATG codon. Productive in-frame RAD1-lacZ fusions showed that the RAD1 open reading frame is expressed in yeasts. The RAD1-encoded protein contains 1,100 amino acids with a molecular weight of 126,360. PMID- 3550429 TI - Regulation of RAD54- and RAD52-lacZ gene fusions in Saccharomyces cerevisiae in response to DNA damage. AB - The RAD52 and RAD54 genes in the yeast Saccharomyces cerevisiae are involved in both DNA repair and DNA recombination. RAD54 has recently been shown to be inducible by X-rays, while RAD52 is not. To further investigate the regulation of these genes, we constructed gene fusions using 5' regions upstream of the RAD52 and RAD54 genes and a 3'-terminal fragment of the Escherichia coli beta galactosidase gene. Yeast transformants with either an integrated or an autonomously replicating plasmid containing these fusions expressed beta galactosidase activity constitutively. In addition, the RAD54 gene fusion was inducible in both haploid and diploid cells in response to the DNA-damaging agents X-rays, UV light, and methyl methanesulfonate, but not in response to heat shock. The RAD52-lacZ gene fusion showed little or no induction in response to X ray or UV radiation nor methyl methanesulfonate. Typical induction levels for RAD54 in cells exposed to such agents were from 3- to 12-fold, in good agreement with previous mRNA analyses. When MATa cells were arrested in G1 with alpha factor, RAD54 was still inducible after DNA damage, indicating that the observed induction is independent of the cell cycle. Using a yeast vector containing the EcoRI structural gene fused to the GAL1 promoter, we showed that double-strand breaks alone are sufficient in vivo for induction of RAD54. PMID- 3550430 TI - Characterization of a positive regulatory gene, LAC9, that controls induction of the lactose-galactose regulon of Kluyveromyces lactis: structural and functional relationships to GAL4 of Saccharomyces cerevisiae. AB - Lactose or galactose induces the expression of the lactose-galactose regulon in Kluyveromyces lactis. We show here that the regulon is not induced in strains defective in LAC9. We demonstrate that this gene codes for a regulatory protein that acts in a positive manner to induce transcription. The LAC9 gene was isolated by complementation of a lac9 defective strain. DNA sequence analysis of the gene gave a deduced protein of 865 amino acids. Comparison of this sequence with that of the GAL4 protein of Saccharomyces cerevisiae revealed three regions of homology. One region of about 90 amino acid occurs at the amino terminus, which is known to mediate binding of GAL4 protein to upstream activator sequences. We speculate that a portion of this region, adjacent to the "metal binding finger," specifies DNA binding. We discuss possible functions of the two other regions of homology. The functional implications of these structural similarities were examined. When LAC9 was introduced into a gal4 defective strain of S. cerevisiae it complemented the mutation and activated the galactose melibiose regulon. However, LAC9 did not simply mimic GAL4. Unlike normal S. cerevisiae carrying GAL4, the strain carrying LAC9 gave constitutive expression of GAL1 and MEL1, two genes in the regulon. The strain did show glucose repression of the regulon, but repression was less severe with LAC9 than with GAL4. We discuss the implications of these results and how they may facilitate our understanding of the LAC9 and GAL4 regulatory proteins. PMID- 3550431 TI - RAD4 gene of Saccharomyces cerevisiae: molecular cloning and partial characterization of a gene that is inactivated in Escherichia coli. AB - In contrast to other Saccharomyces cerevisiae RAD genes involved in nucleotide excision repair of DNA, the RAD4 gene could not be isolated by screening a yeast genomic library for recombinant plasmids which complement the UV sensitivity of rad4 mutants (Pure et al., J. Mol. Biol. 183:31-42, 1985). We therefore attempted to walk to RAD4 from the neighboring SPT2 gene and obtained an integrating derivative of a plasmid isolated by Roeder et al. (Mol. Cell. Biol. 5:1543-1553, 1985) which contains a 4-kilobase fragment of yeast DNA including a mutant allele of SPT2. When integrated into several different rad4 mutant strains, this plasmid (pR169) complements UV sensitivity at a frequency of approximately 10%. However, a centromeric plasmid containing rescued sequences which include flanking yeast DNA no longer complements the phenotype of rad4 mutants. Complementing activity was restored by in vivo repair of a defined gap in the centromeric plasmid. The repaired plasmid fully complements the UV sensitivity of all rad4 mutants tested when isolated directly from yeast cells, but when this plasmid is propagated in Escherichia coli complementing activity is lost. We have mapped the physical location of the RAD4 gene by insertional mutagenesis and by transcript mapping. The gene is approximately 2.3 kilobases in size and is located immediately upstream of the SPT2 gene. Both genes are transcribed in the same direction. RAD4 is not an essential gene, and no increased transcription of this gene is observed in cells exposed to the DNA-damaging agent 4-nitroquinoline-1-oxide. The site of inactivation of RAD4 in a particular plasmid propagated in E. coli was localized to a 100-base-pair region by gene disruption and gap repair experiments. In addition, we have identified the approximate locations of the chromosomal rad4-2, rad4-3, and rad4-4 mutations. PMID- 3550432 TI - Concerted deletions and inversions are caused by mitotic recombination between delta sequences in Saccharomyces cerevisiae. AB - Deletions of a tyrosine tRNA suppressor gene, SUP4-o, are mediated by recombination between short repeated delta sequences in Saccharomyces cerevisiae. The arrangement of the five solo delta sequences that surround the SUP4 locus was established by DNA sequence analysis. Seven deletion classes were identified by genomic blotting. DNA sequence analysis also showed that the delta sequences within a 6.5-kilobase region of the SUP4 locus were the endpoints of these events. In three of these classes, an adjacent interval surrounded by delta sequences was inverted in concert with the deletion. The frequency of all deletion classes decreased in strains that contained mutations in the recombination and repair gene RAD52. We present two gene conversion mechanisms by which these rearrangements could have been generated. These models may also explain deletions between repeated sequences in other systems. PMID- 3550433 TI - Rat c-raf oncogene activation by a rearrangement that produces a fused protein. AB - In a previous study, activated rat c-raf was detected by an NIH 3T3 cell transfection assay, and a rearrangement was demonstrated in the 5' half of the sequence of the gene. In the present study, the cDNAs of normal and activated rat c-raf were analyzed. Results showed that the activated c-raf gene is transcribed to produce a fused mRNA, in which the 5' half of the sequence is replaced by an unknown rat sequence. This mRNA codes a fused c-raf protein. The normal and activated c-raf cDNAs were each connected to the long terminal repeat of Rous sarcoma virus and transfected into NIH 3T3 cells. Only the activated form had transforming activity. We conclude that the rearrangement is responsible for the activation of c-raf. PMID- 3550434 TI - Transcription of the ADH2 gene in Saccharomyces cerevisiae is limited by positive factors that bind competitively to its intact promoter region on multicopy plasmids. AB - Transcription of the ADH2 gene in the yeast Saccharomyces cerevisiae was inhibited by excess copies of its own promoter region. This competition effect was promoter specific and required the upstream activation sequence of ADH2 as well as sequences 3' to the TATA box. Introducing excess copies of ADR1, an ADH2 specific regulatory gene, did not alleviate the competition that was observed in these circumstances during both constitutive and derepressed ADH2 expression. Excess copies of the upstream region did not release ADH2 from glucose repression, consistent with the view that ADH2 is regulated by positive trans acting factors. PMID- 3550435 TI - The genome of Trypanosoma cruzi contains a constitutively expressed, tandemly arranged multicopy gene homologous to a major heat shock protein. AB - cDNA libraries have been constructed in the plasmid vector pUC18 with mRNA isolated from both epimastigotes and trypomastigotes of the Peru strain of Trypanosoma cruzi. Pools of randomly selected clones were analyzed by hybridization-selection-translation. Translation products were immunoprecipitated either with normal human sera or with sera from patients with Chagas' disease (chagasic sera), and the immunoprecipitates were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. With this approach, a cDNA clone (pEC5) was identified which encodes a portion of an 85,000-Mr polypeptide. A genomic clone was subsequently isolated (FG1) by using oligonucleotide probes derived from the DNA sequence of this cDNA clone. A portion of this clone was isolated and sequenced, and the coding region for the protein was identified. Computer analysis of the predicted protein sequence indicates that this protein is closely related to the 83,000-Mr heat shock protein (hsp83) of Drosophila melanogaster, the hsp90 of Saccharomyces cerevisiae, and the hsp90 of chicken. This gene is tandemly organized in the T. cruzi genome as a cluster of 6 to 10 copies. PMID- 3550436 TI - Insulin induction of Xenopus laevis oocyte maturation is inhibited by monoclonal antibody against p21 ras proteins. AB - Microinjection of transforming p21 ras protein induces maturation of Xenopus laevis oocytes, and the induction is blocked by coinjection of monoclonal antibody (Y13-259) against p21 ras proteins. Similar to other inducing agents, the effect of p21 ras protein is mediated via the appearance of maturation or meiosis-promoting factor activity. In addition, the neutralizing antibody markedly reduces oocyte maturation after insulin induction, whereas it fails to inhibit progesterone induction. Our results suggest that insulin induces maturation of oocytes via a different pathway than that of steroidal agents. The induction by insulin is ras dependent, and the action of ras may be directed at the steps before meiosis-promoting factor autocatalytic activation. These results suggest a role of p21 ras protein in the events associated with amphibian oocyte maturation. PMID- 3550439 TI - [Developmental physiologic aspects of volume and sodium regulation in premature and mature newborn infants]. AB - Concentrations of sodium and creatinine were measured in serum and time collected urine samples of 72 newborn infants in the first ten days of life. Creatinine clearances, fractional and absolute sodium excretions were calculated. For analysis the group of newborns was divided into three according to gestational age: group A: less than 33 weeks; group B: 33-37 weeks; group C: greater than 37 weeks. The GFR was correlated to the conceptional age. Renal sodium losses exceeded alimentary supplementation in premature infants during the observation period. An additional supplementation of sodium seems therefore to be indicated early in life, as sodium balance is negative from the first day on. Individual investigations are necessary to evaluate the amount of sodium needed. 3-5 mMol/kg/day seem to be well tolerated and preventive for hyponatriaemia. Fluid administration during the first days should be calculated so that a weight loss of about 10% of body weight is achieved in premature infants in order to prevent cardiovascular and gastrointestinal complications. Because of a higher insensible water loss the amount of fluids administered per body weight should be higher in prematures than in matures. PMID- 3550437 TI - Amino acid sequences in the alpha 1 domain and not glycosylation are important in HLA-A2/beta 2-microglobulin association and cell surface expression. AB - The role of the single carbohydrate moiety present on the HLA-A2 molecule was studied by introducing several amino acid substitutions (by site-directed mutagenesis of the HLA-A2 gene) in the consensus glycosylation sequence Asn-X Ser. Two different amino acid substitutions of the asparagine residue at position 86 (glutamine and aspartic acid) resulted in the synthesis of ca. 39,000 molecular-weight nonglycosylated heavy chains that were detected in the cytoplasm but not on the surface of mouse L-cell transfectants. However, a low level of surface expression was detected following transfection of human (rhabdomyosarcoma) cells or mouse L cells containing human beta 2-microglobulin. The defect in surface expression was not due to the absence of the glycan moiety, since the substitution of a glycine for a serine at amino acid 88 did not have the same drastic effect in the presence of human beta 2-microglobulin. These and other data suggest that the asparagine residue may play a critical role in the conformation of the HLA heavy chain and its interaction with beta 2 microglobulin. Immunofluorescence microscopy following permeabilization of the transfectants demonstrated that the unglycosylated HLA heavy chains are sequestered in an unidentified cellular compartment that is different from the Golgi structure. PMID- 3550441 TI - Transversion-specific purine analogue mutagens and the mechanism of hydroxylaminopurine mutagenesis. AB - The tryptophan synthetase gene A series of mutants in E. coli has been used to examine the mutational specificity of over 80 purine base analogues. 4 purine analogues have been discovered that solely cause transversions. Evidence is presented that hydroxylaminopurine mutagenesis is caused by a covalent reaction of these compounds with DNA. The transversion-causing purine analogues are derivatives of 2-aminopurine (2AP) and 2,6-diaminopurine (2,6DAP). They stimulate the full reversion frequency of those trp A which can revert through an AT----CG transversion. 8 purine base analogues have been found that induce the AT----CG transversion at the trp A88 site; and 2-amino-6-methylaminopurine (2A6MAP) stimulates by 124-fold, 2-amino-6-ethylaminopurine by 20-fold, 2 methylaminopurine (2MAP) by 9.4-fold, 2,6-bismethylaminopurine by 25-fold, 2AP by 230-fold, 2,6DAP by 15-fold, 2.6-diaminopurine riboside by 5-fold, and 2 hydroxylaminopurine by 11-fold. The last 4 analogues also cause transitions. 2A6MAP, 2-amino-6-ethylaminopurine and 2,6-bismethylaminopurine stimulate only the AT----CG transversion while 2MAP additionally gives rise to AT----TA transversions. By testing other negative 2AP derivatives, the structural requirements necessary for AT----CG transversion mutagenesis have been determined. All 12 hydroxylaminopurine base analogues tested, 2,6 dimethoxyaminopurine and 2-hydrazinopurine were found to cause transition mutations. All of the compounds stimulated the AT----GC transition (by up to 1000 fold) and 11 of the 14 base analogues raised the GT----AT transition (by up to 450-fold). On increasing the hydroxylaminopurine concentration, the mutation frequency also increased concomitantly. Since 6-hydroxylamino-9-methylpurine and 6-methylhydroxylaminopurine cause transitions, the mechanism of hydroxylaminopurine mutagenesis cannot be entirely due to an alteration in tautomeric equilibria or "wobble" type base mispairing. It is proposed that a major mechanism for hydroxylaminopurine mutagenesis is due to the reaction of these compounds with the O6-position of guanine and the O4-position of thymine. PMID- 3550438 TI - mRNA cap-binding protein: cloning of the gene encoding protein synthesis initiation factor eIF-4E from Saccharomyces cerevisiae. AB - We have isolated genomic and cDNA clones encoding protein synthesis initiation factor eIF-4E (mRNA cap-binding protein) of the yeast Saccharomyces cerevisiae. Their identity was established by expression of a cDNA in Escherichia coli. This cDNA encodes a protein indistinguishable from purified eIF-4E in terms of molecular weight, binding to and elution from m7GDP-agarose affinity columns, and proteolytic peptide pattern. The eIF-4E gene was isolated by hybridization of cDNA to clones of a yeast genomic library. The gene lacks introns, is present in one copy per haploid genome, and encodes a protein of 213 amino acid residues. Gene disruption experiments showed that the gene is essential for growth. PMID- 3550440 TI - [Molecular mechanisms of the antiviral activity of nucleoside analogs]. AB - The latest data are reviewed on the molecular biology mechanisms of antiviral effect exhibited by the analogues of nucleic acids components. Main effects of preparations used in medicine and virology are analyzed. The data are presented in proof of the existence of different as well as common pathways for virus inhibiting effects of different preparations. The pathways include the analogue interference with virus specific DNA-polymerases, affecting the posttranscriptional processes, etc. PMID- 3550442 TI - Acid-mediated mutagenicity of tobacco snuff: its possible mechanism. AB - Polar solvent extracts of tobacco snuff under acidic conditions were mutagenic in Salmonella typhimurium. Using the Griess reagent test, nitrite ranging from approximately 1.8 to 5.4 mg/g of snuff was found in the polar fraction of extracts. After acid treatment, nitroso compounds in the amount corresponding to the nitrite concentration were detected. The mutagenic potency of the acid treated extracts was consistent with the content of nitroso compounds generated. Formation of nitroso compounds and the mutagenic activity under acidic conditions was inhibited by ascorbic acid. The results indicate that a nitrosation process was involved in snuff extracts during acid treatment. Studies related to the source of nitrite in tobacco snuff demonstrated that snuff contained bacteria which were able to reduce nitrate to nitrite and that the amount of nitrite in snuff extracts could be further increased by incubation of the extracts with the bacteria. Since snuff contains a considerable amount of nitrate, it seems that reduction of nitrate in snuff to nitrite by bacteria, and nitrosation of certain constituents in snuff by nitrite under acidic conditions to form mutagenic nitroso compounds are possible mechanisms responsible for the acid-mediated mutagenicity of snuff extracts. PMID- 3550443 TI - Computer-assisted structure-activity relationships of nitrogenous cyclic compounds tested in salmonella assays for mutagenicity. AB - Study of the relationship between mutagenicity and molecular structure for a data set of nitrogenous cyclic compounds is reported. A computerized SAR system (ADAPT) was utilized to classify a data set of 114 nitrogenous cyclic compounds with 19 molecular descriptors. All of the descriptors represented at least 10% of the compounds in the data sets. The average correct predictability of the data base was calculated to be 89% after evaluating 100 training/prediction subsets. The actual predictive ability of the discriminants generated by the ADAPT system was demonstrated by predicting the mutagenicity of structurally similar compounds not in the data set. Weight vectors generated in the pattern recognition programs were used to predict the bacterial mutagenicity of 10 compounds which were not included in the data set. All of the compounds were predicted correctly which was actually better than the 89% calculated by the system. This displayed the ability of the system of classify compounds as mutagenic or nonmutagenic by using molecular descriptors and to predict the biological activity of untested chemicals with a high degree of confidence. This paper presents the uses of this type of SAR approach in a research laboratory. PMID- 3550444 TI - Development of a yeast system to assay mutational specificity. AB - We have developed a system wherein DNA alterations occurring in a target gene in the yeast Saccharomyces cerevisiae can be determined by DNA sequencing. The target gene, SUP4-o, an ochre suppressor allele of a yeast tyrosine tRNA gene, has been inserted into a shuttle vector (YCpMP2) which is maintained in yeast at a copy number of one per cell Mutations in SUP4-o are selected by virtue of their inactivation of suppressor activity. Rapid DNA preparations from these mutants are used to transform an appropriate bacterial strain. Since YCpMP2 also carries the M13 phage replication origin, superinfection of bacterial cells containing the plasmid with wild-type M13 phage yields single stranded YCpMP2 DNA suitable for dideoxynucleotide chain termination sequencing. We have used this system to examine mutations arising spontaneously in the SUP4-o gene. The spontaneous mutants occurred at a frequency of 3.2 X 10(-6)/viable cell, corresponding to a rate of 2.7 X 10(-7) events/cell division. Following bacterial transformation, 16% of the recovered plasmids tested displayed altered gel mobility consistent with loss of significant portions of the plasmid. Hybridization analysis of total yeast DNA and use of purified YCpMP2 revealed that these very large deletions were not generated in yeast but were associated with bacterial transformation. Among the SUP4-o mutants analyzed by DNA sequencing, we identified each type of single base pair substitution (transitions and transversions), small deletions of varying length (1-32 base pairs) and more extensive deletions of undetermined size. These results demonstrate that the SUP4-o system can be used to detect various types of mutation at numerous sites in a single eukaryotic gene and to characterize the DNA sequence changes responsible for the mutations selected. PMID- 3550445 TI - Comparative genotoxic effects of IQ and MeIQ in Salmonella typhimurium and cultured mammalian cells. AB - The food mutagens 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and 2-amino-3,4 dimethylimidazo[4,5-f]quinoline (MeIQ) were studied for their genotoxic potential using hepatocytes isolated from untreated and Aroclor 1254 (PCB) pretreated rats as an activation system. Monolayers of hepatocytes co-incubated with Salmonella typhimurium TA98 activated IQ and MeIQ to bacterial mutagens, with MeIQ being about twice as potent as IQ. The mutagenic activities of IQ and MeIQ were increased by using hepatocytes from PCB-pretreated rats. IQ and MeIQ also caused primary DNA damage in the hepatocytes as determined by increases in the rate of alkaline elution of DNA, as well as increases in DNA-repair synthesis. Furthermore, exposure of V79 cells co-cultured with PCB-pretreated hepatocytes to IQ and MeIQ showed evidence of increased sister-chromatid exchanges and a low and variable increase in the number of 6-thioguanine-resistant mutants. The genotoxic potency of IQ and MeIQ in mammalian cells was low or virtually absent compared to their extreme potency in bacteria. This could be due to a lower capacity of mammalian cells to further metabolize the so-called directly acting bacterial mutagens, formed by a cytochrome P-450 dependent N-hydroxylation, to their ultimate reactive forms. PMID- 3550446 TI - Structure-mutagenicity relationship among aminoquinolines, aza-analogues of naphthylamine, and their N-acetyl derivatives. AB - The mutagenicity of 7 positional isomers of aminoquinolines (AQ) and their N acetyl derivatives (AcAQ) was tested in Salmonella typhimurium TA100 and TA98 in the presence and absence of S9 mix. In a series of aminoquinolines, the order of mutagenic potency in the presence of S9 mix is: 5-AQ greater than 8-AQ greater than 7-AQ greater than 3-AQ greater than 2-AQ much greater than 4-AQ, 6-AQ. The alpha-positional isomers, 5-AQ and 8-AQ, are more mutagenic than the beta-isomer, 2-, 3-, 6-, 7-AQ's. These results are in contrast to the finding that beta naphthylamine is more mutagenic than alpha-naphthylamine. In a series of N acetylaminoquinolines, the order of mutagenic potency in the presence of S9 mix is: 7-AcAQ greater than 6-AcAQ greater than 8-AcAQ much greater than all the others. It is suggested that the AQ and AcAQ series might exert their mutagenicity through different molecular mechanisms (i.e., metabolic activation) from each other. The rate of metabolic activation does not seem to be correlated with the mutagenic potency of the compounds. It is noteworthy that 7-AQ and 8-AQ are mutagenic in both the strains tested in the absence of S9 mix. PMID- 3550447 TI - Mutagenic, recombinogenic and antimitochondrial effects of nitracrine analogues in Saccharomyces cerevisiae. AB - The mutagenic and recombinogenic potential of 9-[(3 dimethylaminopropyl)amino]acridine and its 1-, 2-, 3- and 4-nitro derivatives was studied using 3 different strains of Saccharomyces cerevisiae. The parent compound slightly enhanced the frequency of total aberrant colonies in diploid strains D5 and D7, but showed no evidence of recombinogenic effects. Each of the nitroacridines enhanced the frequency of total aberrant colonies in strains D5 and D7, but only the 1- and 4-nitro compounds significantly enhanced mitotic crossing-over (measured as twin spotted colonies in strains D5 and D7) or gene conversion in D7. The 3- and 4-nitro derivatives were effective mitochondrial mutagens, substantially increasing the frequency of 'petite' mutants in strains D5 and 5178B. PMID- 3550448 TI - Absence of mutagenic and antimutagenic activities of fluoride in Ames salmonella assays. AB - The mutagenicity of fluoride (as sodium fluoride, NaF) was investigated with Ames Salmonella/microsome assays in strains of TA97a, TA98, TA100, TA102 and TA1535. The concentrations of NaF tested ranged from 0.44 to 4421 micrograms/plate (0.1 to 1000 ppm F), both with and without microsome activation. In addition, the suggested antimutagenic effect of fluoride was evaluated with known mutagens at various concentrations of NaF (0.44-442.2 micrograms/plate, 0.1-100 ppm F). The data showed that NaF, in amounts from 0.44 to 442.2 micrograms/plate (0.1-100 ppm F), failed to significantly increase the number of the revertants over the number observed in the solvent (distilled deionized water) controls. Increases of NaF to, and beyond, 1100 micrograms/plate (250 ppm F) resulted in a toxic effect and a reduction of the revertants to various degrees among the strains. NaF in the presence of known mutagens did not significantly decrease the number of the revertants. The results of this study indicate that NaF does not have mutagenic or antimutagenic effects in the strains tested with Ames Salmonella assays. PMID- 3550449 TI - The effect of temperature or anoxia on Escherichia coli killing induced by hydrogen peroxide. AB - The cytotoxicity of hydrogen peroxide in Escherichia coli was investigated after various conditions of drug exposure. Two modes of killing were detected following a 15-min challenge with H2O2 under either aerated or anoxic conditions. Mode one killing occurred at levels below 2.5 mM and mode two killing at concentrations higher than 10 mM. Whereas mode one killing was similar at the two conditions of drug exposure, mode two lethality differed in that aerated cells were more sensitive than anoxic cells. Independently of O2 tension the hydroxyl radical scavenger, thiourea, prevented mode two but not mode one killing by H2O2. Cells treated with the drug at ice temperature did not display mode one killing and mode two lethality occurred only at very high concentrations. We suggest that hydroxyl radicals mediate mode two but not mode one killing by H2O2. PMID- 3550450 TI - Mutagenicity-enhancing effect of quercetin on the active metabolites of 2 acetylaminofluorene with mammalian metabolic activation systems. AB - The effects of quercetin on the mutagenicity of 2-acetylaminofluorene (AAF) and its 3 active metabolites, N-hydroxy-AAF (N-OH-AAF), aminofluorene (AF) and N acetoxy-AAF(N-OAc-AAF) were investigated. The mutagenicity assays were carried out with Salmonella typhimurium TA98, and S9, microsomes and cytosol were used as metabolic activation systems. In the presence of S9, quercetin enhanced the mutagenicity of AAF, N-OH-AAF, AF and N-OAc-AAF by 6.9-, 4.3-, 3.6- and 3.9-fold, respectively. Quercetin enhanced the mutagenicity of these substrates with microsomes, whereas it depressed the mutagenicity of these substrates with cytosol. From these results, it seemed probable that quercetin promotes the N hydroxylation and deacetylation in the microsomes, whereas it inhibits the deacetylation in the cytosol. It was shown that in the metabolism of AAF and its metabolites, quercetin modulates the balance between the mutagenicity activation and inactivation processes, which is catalysed by the enzymes in the microsomes and cytosol, and causes enhancement of the mutagenicity of AAF. PMID- 3550451 TI - Binary mixtures containing isomers of nitrobenzo[a]pyrene induce greater-than additive mutational responses in Salmonella typhimurium. I. Analysis by the total concentration-proportional mixture model. PMID- 3550452 TI - The mutagenicity of 2-nitrofluoranthene and its in vitro hepatic metabolites. PMID- 3550453 TI - O6-methylguanine specifically induces AT----GC transition mutations. PMID- 3550454 TI - Evaluation of methods for the estimation of mutation rates in cultured mammalian cell populations. AB - A systematic comparison of 5 different statistical methods for the estimation of mutation rate (mu) in cultured Chinese hamster V79 cells is presented. Fluctuation tests were performed with several large batches of parallel cell cultures each allowed to grow for a different length of time in order to reach different population size (Nt). Based on Lea and Coulson's theoretical distribution, a comparison has been made between the experimental data and the expected distribution of the number of ouabain-resistant mutants per culture in these hamster cell populations. The sum of squared deviation between the observed and expected values, or SSD, was used as a means of the adequacy of the estimation method; the method which gives the smallest SSD is regarded as the best one for the estimation of mu. Our results show that when Nt is small, the occurrence of mutation is infrequent, and SSDs from different methods are similar. However, when Nt is large, there is a great discrepancy of the SSD values, suggesting a preference of using the maximum likelihood method, the Po method, the median method, the upper quartile method and the mean method, in that order, for the estimation of mu. The order of preference is correlated with estimation efficiencies. Depending on the size of Nt and the method used, the estimated mu may vary up to more than 3-fold. At a large Nt, the mu obtained from the maximum likelihood method is very precise. This suggests the importance of choosing an appropriate Nt as well as method for the estimation of mu. PMID- 3550455 TI - Clinical investigation in Duchenne dystrophy. VI. Double-blind controlled trial of nifedipine. AB - Excessive accumulation of intracellular calcium in Duchenne muscular dystrophy (DMD) may be a necessary step in the process that causes muscle damage in this disease. Because of this possibility, a controlled trial of the calcium channel blocking agent nifedipine was undertaken. One hundred and five patients were randomized and treated in a double-blind manner for 18 months. Muscle strength, contractures, functional ability, cardiopulmonary changes, and laboratory data were monitored. The dose of nifedipine was 0.75-1 mg/kg/day in the first 6 months and 1.5-2 mg/kg/day for the next 12 months. Satisfactory blood levels of nifedipine were attained. The study had a power greater than 0.99 to detect a slowing of the illness to 25% of its original rate of progression. No significant improvement was demonstrated in the treated group. One or more of the frequent mild side effects of flushing, dizziness, and leg edema, often associated with the use of nifedipine in adults, occurred transiently in approximately one-half of the patients in the nifedipine group and in 21% of the placebo group. Four patients died, two on nifedipine and two on placebo. This study demonstrates that nifedipine is safe to administer in children, but that it is without beneficial effect on the course of DMD. PMID- 3550456 TI - Histopathology of organ lesions in mice after an intravenous or intratracheal or intrarenal infection with aspergillus fumigatus. PMID- 3550457 TI - Extracellular proteinases of Trichophyton rubrum and the clinical picture of tinea. PMID- 3550458 TI - Test methods for antifungal agents--a critical review. PMID- 3550459 TI - The serological response to Candida albicans in leukemic patients prophylactically treated with ketoconazole. PMID- 3550460 TI - Flocculated humulin N insulin. PMID- 3550462 TI - Surgery of the stomach, duodenum, gallbladder, and bile ducts. PMID- 3550461 TI - Cysteamine therapy for children with nephropathic cystinosis. AB - We treated 93 children with nephropathic cystinosis with oral cysteamine (mean dose, 51.3 mg per kilogram of body weight per day) for up to 73 months. This agent is known to be effective in depleting cells of cystine. In our study, the mean cystine depletion from leukocytes was 82 percent. A historical control group of 55 children received either ascorbic acid (27 children) or placebo (28). At age six, 2 of 17 controls had a serum creatinine level less than 1.0 mg per deciliter, as compared with 17 of 27 patients treated with cysteamine for at least one year (odds ratio, 12.8; 95 percent confidence interval, 2.1 to 33.9). At the end of the study, creatinine clearance was higher in the cysteamine group than in the control group (38.5 vs. 29.7 ml per minute per 1.73 m2; 95 percent confidence limits on the difference, 1.8 and 15.8), even though the cysteamine group was on average 1.4 years older than the control group. Cysteamine also improved growth; those in the cysteamine group between two and three years of age grew at 93 percent of the normal velocity, as compared with 54 percent in the control group. Fourteen percent of the patients could not tolerate the taste and smell of cysteamine. Concurrent controls treated in a blinded fashion with a placebo were not included in this study. With this limitation in mind, we conclude that oral cysteamine, by depleting cells of cystine, helps maintain renal glomerular function, improves growth, and constitutes the current treatment of choice for nephropathic cystinosis. PMID- 3550464 TI - Kidney transplantation from anencephalic donors. PMID- 3550465 TI - Bone marrow transplantation for genetic diseases. PMID- 3550463 TI - Marrow transplantation in patients with advanced thalassemia. AB - In a study of the outcome of marrow transplantation in patients with advanced thalassemia, 40 patients with homozygous beta-thalassemia who were 8 to 15 years of age (median, 10) received HLA-identical allogeneic marrow after treatment with busulfan and cyclophosphamide. Twenty-eight of the 40 patients were alive and free of disease 260 to 939 days after transplantation, and 2 patients were alive with thalassemia 372 and 1133 days after transplantation. The actuarial probabilities of survival and of disease-free survival at two years were 75 percent and 69 percent, respectively. Ten patients (25 percent) died. Three died of cardiac failure, interstitial pneumonitis, or septicemia within 14 days of transplantation. Three died of infectious complications associated with acute graft-versus-host disease at 46 to 97 days, and two died of infectious complications of chronic graft-versus-host disease at 249 and 290 days. Two patients had transplant rejection and died with marrow aplasia 115 and 192 days after transplantation. One patient had rejection after four months and while the marrow was aplastic underwent a successful second transplantation; the patient was alive without thalassemia 624 days after the first transplantation. The actuarial probability of grade 2 or higher acute graft-versus-host disease in the 32 patients with initial sustained engraftment was 35 percent. Three patients had chronic graft-versus-host disease, which was fatal in two and still active on day 710 in the third. We conclude that bone marrow transplantation can potentially save patients with advanced thalassemia from an otherwise inexorable progression to death from the complications of blood transfusions. The ultimate outcome in this group of patients must await a longer follow-up. PMID- 3550466 TI - Evaluation of SOC for the presumptive identification of Candida albicans and Cryptococcus neoformans. AB - SOC, a fungal growth medium composed of Solryth, oxgall, and caffeic acid, was evaluated as a medium to provide rapid, differential identification of Candida albicans and Cryptococcus neoformans. Using a variety of common isolation media to produce the yeast inocula, the germ tube methods tested ranked in the following order of decreasing sensitivity: SOC (97% +/- 1), serum (92% +/- 5), rabbit coagulase plasma with EDTA in combination with tryptic soy broth (89% +/- 5), TOC (89% +/- 6), and rabbit coagulase plasma with EDTA (83% +/- 4). In chlamydospore production, SOC also proved to be the most sensitive after 24 h incubation: SOC (96% +/- 2), TOC (80% +/- 2), and cornmeal-Tween 80 agar (14% +/- 3). Other medically important yeasts showed normal patterns of growth within 24 h on SOC, thus assisting in their identification. Eighty strains of Cryptococcus neoformans showed characteristic brown pigmentation on SOC and TOC within 18 h, while all other species of the genus Cryptococcus and 229 Candida isolates did not show a change in pigmentation. PMID- 3550468 TI - Objective: social continence. PMID- 3550469 TI - The perfect match! A computer and a tutor. PMID- 3550467 TI - Opportunistic zygomycotic infections. A literature review. AB - This is a literature review of 361 opportunistic fungal infections caused by the Zygomycetes. The clinical and laboratory diagnosis, pathogenesis, management, treatment, and outcome of infection are discussed. The Zygomycetes are a group of opportunistic fungi (orders Mucorales and Entomophthorales) which cause severe infections which may be fatal. Early clinical recognition, prompt diagnostic procedures, control of underlying disease and treatment with high doses of amphotericin B and aggressive surgery increases survival in an otherwise lethal infection. PMID- 3550470 TI - Cecilia makiwane: a pioneer in the nursing profession. PMID- 3550471 TI - Knowledge-based prediction of protein structures and the design of novel molecules. AB - Prediction of the tertiary structures of proteins may be carried out using a knowledge-based approach. This depends on identification of analogies in secondary structures, motifs, domains or ligand interactions between a protein to be modelled and those of known three-dimensional structures. Such techniques are of value in prediction of receptor structures to aid the design of drugs, herbicides or pesticides, antigens in vaccine design, and novel molecules in protein engineering. PMID- 3550472 TI - Ribosomal RNA sequence suggests microsporidia are extremely ancient eukaryotes. AB - The microsporidia are a group of unusual, obligately parasitic protists that infect a great variety of other eukaryotes, including vertebrates, arthropods, molluscs, annelids, nematodes, cnidaria and even various ciliates, myxosporidia and gregarines. They possess a number of unusual cytological and molecular characteristics. Their nuclear division is considered to be primitive, they have no mitochondria, their ribosomes and ribosomal RNAs are reported to be of prokaryotic size and their large ribosomal subunit contains no 5.8S rRNA. The uniqueness of the microsporidia may reflect their phylogenetic position, because comparative sequence analysis shows that the small subunit rRNA of the microsporidium Vairimorpha necatrix is more unlike those of other eukaryotes than any known eukaryote 18S rRNA sequence. We conclude that the lineage leading to microsporidia branched very early from that leading to other eukaryotes. PMID- 3550473 TI - The chronology of AIDS research. PMID- 3550474 TI - Defending Mendel merely perpetuating a myth. PMID- 3550475 TI - Cause of death of the American Indians. PMID- 3550477 TI - Knob-associated histidine-rich protein gene. PMID- 3550476 TI - Insulin, IGF-I and growth in diabetic rats. PMID- 3550478 TI - Labelling nucleic acids for hybridization. PMID- 3550480 TI - An inhibitory action of tetracyclines on guinea-pig myenteric plexus. AB - In plexus containing preparations of the longitudinal muscle of the guinea-pig ileum, an inhibitory action of tetracyclines on twitch-responses to electrical field stimulation was found. Tetracycline, chlortetracycline, minocycline and doxycycline, but not oxytetracycline (0.02 to 1.6 mmol/l) caused a concentration dependent presynaptic inhibition of acetylcholine release. The inhibitory effect of the tetracyclines was also obtained after ganglion block by hexamethonium (30 mumol/l). The inhibitory effect of the tetracyclines was not antagonized by piperoxan (2 mumol/l) or yohimbine (1 mumol/l) and was partly reduced by the presence of naloxone (1 to 50 nmol/l). After exposing the preparation the peptidase inhibitors, i.e., to the combination of bestatin (10 mumol/l), captopril (10 mumol/l) and thiorphan (0.3 mumol/l), the inhibitory effect of tetracyclines was significantly increased. From these results it would appear that twitch-inhibition caused by tetracycline, chlortetracycline, minocycline and doxycycline is mainly mediated via the release of endogenous opioids from the myenteric plexus. PMID- 3550481 TI - Medical Review of North Carolina--update on Medicare review. PMID- 3550479 TI - ["Artificial" chromosomes]. AB - The structural elements required for chromosome replication, segregation, and stability are replication origins, centromeres, and telomeres. DNA sequences capable of organizing these three elements have been isolated from yeast chromosomal DNA by means of recombinant DNA techniques and yeast cell transformation. It is now possible to combine these sequences into "artificial" chromosomes for yeast cells to obtain more insight into chromosome structure and function. Evidence is presented that the construction of artificial chromosomes functional in higher eukaryotes will be possible in the near future. PMID- 3550482 TI - [The myth of deinstitutionalization]. PMID- 3550483 TI - [Further developments in the treatment of acute myeloid leukemia with autologous bone marrow transplantation]. PMID- 3550484 TI - [Urinary tract problems as a result of tethered spinal cord syndrome]. PMID- 3550485 TI - [Spina bifida occulta: a minor cosmetic defect?]. PMID- 3550486 TI - [Free tissue transplantation with microsurgery]. PMID- 3550487 TI - [Genetic research and the application of results]. PMID- 3550488 TI - [Gallstone ileus]. PMID- 3550489 TI - Cautionary news for the diabetic. PMID- 3550490 TI - University of Nebraska Medical Center Department of Pathology and Microbiology. PMID- 3550491 TI - [Attachment system for cast etched bridges]. PMID- 3550492 TI - [Satisfaction with Branemark implants]. PMID- 3550493 TI - [Orthodontics in the 1st half of the 19th century]. PMID- 3550494 TI - [Dental health behavior in adolescence. A literature review]. PMID- 3550495 TI - [Use of a titanium screw implant in the edentulous mandible. Results after 4 years]. PMID- 3550496 TI - [Spontaneous dissection of arteries supplying the brain]. PMID- 3550497 TI - Chronic triiodothyronine supplementation does not improve the lipoprotein disorders of mildly uremic rats. AB - The present study was performed to appreciate the potential role that thyroid deficiency could play in the energy homeostasis and lipid metabolism of experimental chronic renal failure. For this purpose, 12 uremic rats that were supplemented with T3 (0.4 microgram/100 g body weight/day) during 5 weeks by means of osmotically driven minipumps were compared to 12 unsupplemented uremic rats and 12 control rats. The chronic supplementation of uremic rats with T3 induced no significant change in body weight gain or in the serum concentration of insulin, glucose, glycerol, nonesterified fatty acids, total triglycerides (TG), total cholesterol, and total choline phospholipids. Similarly, the metabolism of TG-rich lipoproteins was not affected by the supplementation with T3 in these uremic rats as appreciated by TG production or TG degradation (adipose tissue lipoprotein lipase activity). T3 administration induced a significant decrease in serum beta-hydroxybutyrate concentration and an increase in serum lactate concentration. Furthermore, heparin-releasable hepatic TG lipase activity as expressed per total liver mass was decreased in uremic rats treated with T3. The latter changes were observed in the absence of modifications of serum glucose or TG concentration. We conclude from these observations that rats with a moderate degree of chronic uremia do not seem to have a cellular thyroid deficiency sufficient to disturb their energy or lipid metabolism. PMID- 3550498 TI - Circadian rhythm of urinary beta 2 microglobulin excretion in patients with a nephrotic syndrome. AB - The changes in urinary beta 2 microglobulin excretion during the day were studied in 20 patients with a nephrotic syndrome under standardized conditions and compared with the known circadian variations in urinary albumin excretion in the same patients. Fifteen of the 20 patients (75%) had a circadian rhythm for beta 2 microglobulin in the urine. Phase as well as relative amplitude of the beta 2 microglobulin circadian rhythm varied between patients. In addition, its presence, normality, amplitude and phase were largely different from the albumin rhythm. Observations made in 10 healthy individuals suggest that day-night variability in the excretion of beta 2 microglobulin and albumin in the urine is also present in the absence of clinically important proteinuria. Circadian variations in urinary beta 2 microglobulin excretion are found in a majority of the patients with nephrotic syndrome and as they differ in several respects from the day-night fluctuation in urinary albumin excretion the mechanism is probably different. PMID- 3550499 TI - Kaposi's sarcoma in a renal transplant patient treated with cyclosporine A. PMID- 3550500 TI - Effect of captopril in nephrotic-range proteinuria due to renovascular hypertension. PMID- 3550501 TI - Endotoxemia in chronic renal failure. AB - In the past years dialyzers have been improved, and consequently pyrogenic reactions have become rare. However, some patients in our dialysis unit have shown symptoms during hemodialysis which we suspected could be caused by endotoxins. These patients, as well as controls without similar symptoms, had elevated levels of circulating endotoxin. We therefore measured endotoxin in blood from patients with chronic renal failure and different kinds of treatment. Serum samples were analyzed with a sensitive method described in the literature, using a chromogenic substrate and Limulus amebocyte lysate. In patients on hemodialysis (mean +/- SEM) the endotoxin value in samples taken immediately before dialysis was 40 +/- 4.7 ng/l and significantly elevated (p less than 0.001) compared with the endotoxin value (7 +/- 0.6 ng/l) found in the healthy reference group. Increased endotoxin levels were also seen in patients on hemofiltration (19 +/- 7.5 ng/l) and in patients with conservative treatment and various degrees of renal insufficiency (17 +/- 2.5 ng/l). Patients on peritoneal dialysis and renal-transplanted patients had levels not different from the controls. The mechanism behind endotoxemia in uremia is unknown but may partly be explained by reduced endotoxin elimination due to impaired liver macrophage function. The differences in endotoxin levels in patients on peritoneal or hemodialysis treatment may reflect that extracorporeal circulation enhances endotoxin entrance to the circulation and/or that endotoxin clearance is dependent on the dialysis regimen. PMID- 3550502 TI - CEA plasma levels in patients with intracranial tumours. AB - 210 patients harbouring an intracranial tumour were tested for CEA plasma levels. It could be shown that this investigation was neither a useful screening test for detecting brain neoplasms nor suitable for follow-up on operated brain tumours. However, with the CEA plasma investigation an additional preoperative test is available for distinguishing between primary and secondary brain tumours. The positive evidence is only 29%, but in case of a CEA plasma value above 5.0 ng/ml a metastasis is indicated with a probability of 91%. PMID- 3550504 TI - [Modern imaging and stereotaxy]. AB - The authors present their technique of utilization in stereotaxic neurosurgery of CT and IRM documents realized in standard condition. Besides, they present an original apparatus that allows to combine the advantages of Leksell and Talairach's stereotaxic system. PMID- 3550503 TI - [Prevention of risk in stereotaxic biopsy of various tumors of the pineal region. Apropos of 3 cases]. AB - During the last ten years, the authors have performed 750 stereotactic biopsies with 6 deaths. In 3 cases, the lesion was a pinealoblastoma, with comparable symptomatology and CT scan image. Safety measures are discussed. PMID- 3550505 TI - [New technic for intranasal cover of bone grafts after excision of ethmoidofrontal tumors]. AB - To prevent crusty rhinitis responsible for necrosis and sequestration of bone grafts used for anterior reconstruction following the extensive resection of ethmoido-frontal neoplasms, the authors propose lining the endocranial surface of these grafts by pericranium with a temporalis muscle based pedicle. The endonasal surface is covered by a pedicle galea flap taken from the frontal scalp and introduced via a para-latero-nasal E.N.T. approach. PMID- 3550506 TI - Neuroepidemiology of acquired immune deficiency syndrome. AB - Neuroepidemiology is that branch of chronic disease epidemiology dealing with disorders that affect the nervous system. The potential for neurological involvement in the diagnosis and pathogenesis of Acquired Immune Deficiency Syndrome (AIDS) has recently been noted. The following review outlines the spectrum of neurological conditions seen in AIDS patients to date. These conditions include: infectious central nervous system complications of viral, bacterial, fungal or protozoan origin; noninfectious central nervous system complications such as neoplasms or cerebral vascular accidents, and cranial and peripheral neuropathy. The incidence of neurological abnormalities among AIDS cases may be seriously underestimated due to a delay in the presentation of an overt neurological syndrome and/or the overlooking of subtle neurological signs and symptoms in such an overwhelming systemic disease. PMID- 3550507 TI - Transmissible virus dementia: evaluation of a zoonotic hypothesis. AB - Creutzfeldt-Jakob disease (CJD) and kuru are subacute transmissible dementing encephalopathies characterized by spongiform changes in the brain. Scrapie is a similar slow viral encephalopathy which affects sheep, goats and certain other animals. Anecdotal reports suggest that Creutzfeldt-Jakob disease could be a zoonosis. To evaluate the possibility that CJD is acquired from animals, a case control study was conducted on 26 well-documented CJD cases and 40 controls. Data were collected on exposure to animals through occupations, hobbies, sports and pets. An excess exposure to certain animals was noted among the patients compared to controls in relation to occupation (deer, monkey, squirrel; odds ratio (OR) = 8.9; p less than 0.10) and hobbies (deer, OR = 9.0; rabbit, OR = 6.0; p less than 0.05). Similarly, exposure to animal organs was significantly greater in the CJD group (OR = 20.9; p less than 0.005). Statistically significant increased exposure to sheep or goats was not found among the patients. However, since spongiform encephalopathy has a wider host range than sheep and goats, the increased exposure to certain other animals suggests that a zoonotic source for CJD should be further explored. PMID- 3550508 TI - Aluminum and Alzheimer's disease. AB - There is now substantial evidence indicating that an accumulation of aluminum occurs in grey matter in diseases associated with Alzheimer neurofibrillary degeneration. Four principle sites of aluminum accumulation have been identified in Alzheimer's disease: DNA containing structures of the nucleus, the protein moieties of neurofibrillary tangles, the amyloid cores of senile plaques and cerebral ferritin. Consideration of the extensive information now available on the toxic effects of aluminum in these four loci strengthens the hypothesis that aluminum could be important in the pathogenesis of this neurodegenerative process. The evidence, however, does not support an etiological role for aluminum in Alzheimer's disease. The primary pathogenic events responsible for Alzheimer's disease are presumed to have affected the genetically determined barriers to aluminum resulting in increased amounts of this toxic element to vulnerable target sites. PMID- 3550509 TI - Alzheimer's disease may begin in the nose and may be caused by aluminosilicates. AB - Genetic factors may interact with aging changes in the nasal mucociliary apparatus to increase the probability that ubiquitously occurring aluminosilicates may enter sensory neurons of the olfactory epithelium and spread transneuronally to several olfactory-related areas of the brain, thereby initiating changes that eventually result in neuronal damage typical of Alzheimer's disease. A speculative sequence of events is suggested by which neuronally-contained aluminosilicates might cleave or otherwise alter a normal cellular protein in such a manner that aggregates would arise that could interfere with cellular function and which also could act in a pseudo-infective manner, relaxing translational and transcriptional controls in the synthesis of the native protein. Some relevant experiments and potential therapies arising from the hypothesis presented are discussed. PMID- 3550510 TI - Fixation effects on synaptic vesicle density in neuromuscular junctions of young and old mice. AB - It was previously reported that in soleus neuromuscular junctions of old mice, synaptic vesicle density was decreased while transmitter release was increased (compared to results in young mice). In the present study, two hypotheses that might resolve this disparity were tested. The first was that the density of readily releasable vesicles close to the preterminal membrane, rather than those in the whole terminal, would correlate with the physiological results. This hypothesis was excluded because both vesicle density in the 200 nm region just within the presynaptic terminal membrane, and total vesicle density were similarly reduced in old soleus junctions. The second hypothesis was that more transmitter was released during fixation at old than at young neuromuscular junctions, leading to an age-related depletion of vesicles. This was tested by counting vesicles in muscles fixed after transmission block was attained in Krebs solution lacking calcium, and by direct recording of quantal release during conventional fixation. This second hypothesis was excluded: in neuromuscular junctions exposed to zero-calcium Krebs solution before fixation, the age-related reduction in vesicle density was still present, and intracellular recording revealed only a slight increase in quantal transmitter release during fixation. Therefore, as discussed, other mechanisms must be considered. PMID- 3550511 TI - [Angio-ultrasonography--a method of examining the extracranial arteries]. AB - The authors describe a method of investigations of the extracranial cerebral arteries--angioultrasonography based on the Doppler effect. The study was done with a Polish apparatus designed and produced by the Experimental Laboratory of the Institute of Basic Technical Problems, Polish Academy of Sciences. The study confirmed the usefulness of this method in the diagnosis of arterial diseases involving the extracranial arteries supplying the brain. A high agreement was demonstrated between the results of angioultrasonography and classical angiography. Owing to the use of a grey scale it was possible to localize accurately the site of stenosis or occlusion of the studied artery. PMID- 3550512 TI - [Multi-infarct dementia. II. Pathomechanism]. PMID- 3550513 TI - [Virion or prion? Second thoughts on the physicochemical structure of the infective agent in scrapie]. PMID- 3550514 TI - Involvement of H1 histamine receptor in basal and estrogen-stimulated luteinizing hormone-releasing hormone secretion in rats in vitro. AB - For determination of the roles of histamine and its receptors, H1 and H2, in the control of basal and estrogen-induced LH-RH secretion, the mediobasal hypothalamus (MBH) and/or pituitary was excised from normally cycling female rats and perifused in an in vitro sequential double chamber perifusion system. Administration of 10(-7) M histamine caused significant release (90-170% increase, p less than 0.05) of LH from the pituitary in sequence with the MBH, whereas 10(-7) M histamine had no effect on LH release from the pituitary perifused alone; administration of 10(-5) M 2-methylhistamine, an H1 agonist, induced significant release (50-120% increase, p less than 0.05) of LH-RH from the MBH, and addition of 10(-5) M mepyramine, and H1 antagonist, abolished this LH-RH release. The LH concentrations in the efflux were not affected by the administration of the H2 agonist 4-methylhistamine. Estradiol caused significant release of LH-RH from the MBH and LH from the pituitary in sequence with the MBH. The estradiol-induced release of LH-RH and LH were completely abolished by perifusion with medium containing 10(-5) M mepyramine. The H2 receptor antagonist ranitidine did not affect estradiol-induced LH release. Histamine did not change the LH release induced by 20 ng LH-RH. These findings suggest that histamine induces release of hypothalamic LH-RH, and that histamine H1 receptors in the hypothalamus are involved in the basal and estradiol-induced LH-RH release. PMID- 3550515 TI - Modification of drug-induced tremor by systemic administration of kainic acid and quisqualic acid in mice. AB - The effects of excitatory amino acids, kainic acid and quisqualic acid, on the tremorine- and harmaline-induced tremor were quantitatively examined in mice using the power spectral analyzing method. The severity of the tremor was determined quantitatively in terms of the cumulative sum of the mean square value of the data. Kainic acid enhanced the tremor induced by tremorine but depressed the tremor induced by harmaline. Quisqualic acid depressed the tremor induced by both tremorine and harmaline in a dose-dependent manner. Kainic acid shifted the frequency of each component of the tremor induced by tremorine to the high frequency side, but quisqualic acid did not affect the frequency of tremor of the tremor induced by tremorine. The frequency of tremor of the tremor induced by harmaline was shifted by both excitatory amino acids to the low frequency side, and another component of tremor in the power spectral densities developed, of which the mean square values were very small. The present results suggest that, at least in part, the glutamatergic system can take a role on the modification of drug-induced tremor. PMID- 3550516 TI - Brain grafting as a treatment for Parkinson's disease. AB - Parkinson's disease is an illness with neuropathological and neuroanatomical abnormalities in many areas of the central nervous system. Some clinical manifestations of this illness are correlated with pathological changes in the substantia nigra and with a loss of dopamine in the nigra and striatum. The most effective pharmacological treatments have used agents that either replace the lost dopamine or act as agonists on dopamine receptors. Recent studies in animal models of Parkinson's disease demonstrate that the loss of dopamine and many clinical manifestations of dopamine reduction can be reversed by transplantation of fetal dopamine-containing cells to specific dopamine-depleted areas of the brain. Long term viability of these transplants has also been demonstrated. The author suggests that the transplantation of dopamine neurons, even across species barriers, is a reasonable consideration for the treatment of human Parkinson's disease. This article reviews in detail the results of recent experiments and how the experience in these models might be utilized in determining a transplantation strategy for the treatment of specific clinical aspects of this illness. PMID- 3550517 TI - A. A. Ukhtomskii and the reflex theory of behavior. PMID- 3550518 TI - Antibodies to fragments of provasoactive intestinal peptide reveal subpopulations of vasoactive intestinal peptide containing neurons in the rat gut. AB - The cellular origin of peptides derived from preprovasoactive intestinal peptide has been studied in rat stomach and ileum. Antisera specific for the C-terminal regions of the N-terminal flanking peptide (preprovasoactive intestinal peptide 22-80), bridging peptide (preprovasoactive intestinal peptide 111-124), C terminal flanking peptide (preprovasoactive intestinal peptide 156-170) and vasoactive intestinal peptide were used in immunohistochemical studies on sections and whole mounts. All four antisera stained nerve fibres and cell bodies in the stomach and intestine. However, there were distinct differences in the pattern of colocalization of peptides derived from provasoactive intestinal peptide. In the sub-mucous plexus of the ileum virtually 100% of neurons reacting with vasoactive intestinal peptide antibodies also reacted with antibodies to the other three peptides. In contrast, in the stomach, while all vasoactive intestinal peptide-immunoreactive neurons of the myenteric plexus contained C terminal flanking peptide- and bridging peptide-like immunoreactivity, only 50% of these cells reacted with the antiserum to N-terminal flanking peptide. The data indicate that in a population of neurons in the myenteric plexus of the rat stomach, preprovasoactive intestinal peptide is processed in such a way that the antigenic determinant of the N-terminal flanking peptide is not produced. In a second population of enteric neurons in the stomach, and in the intestine, it appears that processing of preprovasoactive intestinal peptide results in the production of peptides reacting with antibodies to vasoactive intestinal peptide, the flanking and bridging peptides. PMID- 3550519 TI - Projections of two subclasses of vomeronasal nerve fibers to the accessory olfactory bulb in the rabbit. AB - The organization of the projections of subclasses of vomeronasal nerve fibers to the accessory olfactory bulb was analysed using monoclonal antibodies generated against a homogenate of the rabbit olfactory bulb. Monoclonal antibody R2D5 labels all the somata of vomeronasal receptor cells in the vomeronasal organ as well as all their axons (vomeronasal nerve fibers). Another monoclonal antibody (R4B12), which has been shown to selectively bind and thus identify a subclass of olfactory nerve fibers, also labels a subclass of vomeronasal nerve fibers. The R4B12-positive subclass of vomeronasal nerve fibers project to the glomeruli in the rostrolateral part of the accessory olfactory bulb. The third monoclonal antibody (R5A10) recognizes a complementary subclass of vomeronasal nerve fibers projecting to the glomeruli in the caudomedial part of the accessory bulb. In contrast to the clearly segregated terminations in the accessory bulb, the two subclasses of vomeronasal nerve fibers are intermingled with each other in the vomeronasal nerve bundles. Retrograde labeling of vomeronasal receptor cell somata following injection of horseradish peroxidase within the rostrolateral (R4B12-positive) part of the accessory bulb indicates that vomeronasal receptor cells of this subtype are widely distributed in the vomeronasal sensory epithelium. These results demonstrate the heterogeneity of vomeronasal receptor cells and the specificity of projections arising from subclasses of vomeronasal nerve fibers to the accessory olfactory bulb. PMID- 3550520 TI - Unusual interactions of excitatory amino acid receptor agonists: alpha- and beta kainate antagonize motor responses to N-methyl-D-aspartate in rodents. AB - The alpha- and beta-stereoisomers of kainate correspond sterically to the L- and D-isomers of glutamate. Alpha-Kainate is a potent excitant at a specific membrane receptor site (kainate receptor). Beta-Kainate has been proposed as a functional N-methyl-D-aspartate antagonist in vivo. Because of the structural similarities between the alpha- and beta-stereoisomers of kainate we have investigated the interactions of both compounds with N-methyl-D-aspartate-mediated excitation in two well established animal models for assessing the action of excitatory amino acids and their antagonists in vivo: determination of CD50 (convulsant dose) for myoclonic seizures in mice and electromyographic measurement of muscle tone in genetically spastic rats. We find that alpha-kainate and beta-kainate produce myoclonic seizures in mice when given intracerebroventricularly and increase the muscle tone in genetically spastic rats when given intrathecally. Alpha-Kainate is about 5000 times more potent than beta-kainate as a convulsant and about 1000 times more active than beta-kainate in increasing the muscle tone. The excitatory actions of alpha-kainate and of beta-kainate are blocked by gamma-D glutamylaminomethylsulphonate, a preferential kainate/quisqualate antagonist, but not by (+/-)-2-amino-7-phosphonoheptanoate, a specific N-methyl-D-aspartate antagonist. Surprisingly, alpha-kainate and beta-kainate antagonize the myoclonic seizures and the increase in muscle tone produced by N-methyl-D-aspartate, and potentiate both the anticonvulsant and myorelaxant actions of (+/-)2-amino-7 phosphonoheptanoate. Quisqualate induces myoclonic seizures in mice after intracerebroventricular application and increases muscle tone in genetically spastic rats following intrathecal injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550521 TI - James Leonard Corning and the early history of spinal puncture. PMID- 3550524 TI - [Echographic diagnosis of diffused liver diseases: histologic correlations]. AB - A personal series of 53 patients is reviewed. The patients were subjected to echography of the liver together with clinical and histological studies after closed biopsy. The cases are analysed and grouped according to stage and severity of the liver condition encountered. All groups showed a good match between echographic and clinicohistological results. The main echographic criteria for liver disease are summarised and illustrated in the light of personal experience and the data published in the most recent literature. PMID- 3550523 TI - Developmental venous anomalies (DVA): the so-called venous angioma. AB - Following a review of the literature it is possible to demonstrate the "normality" of the so called venous angiomas. They should be named Developmental Venous Anomaly (DVA). They illustrate in their two extreme types (superficial and deep) the hemodynamic equilibrium of the transcortical venous drainage in the periependymal zones. Venous ectasias and varices which can be encountered, associated with DVA constitute an acquired feature in relation to a venous outlet obstacle. The sinus pericranii represents an extracerebral DVA, but also corresponds to a normal variation. As any extreme anatomical variant, each DVA corresponds to a weak situation which may express itself clinically; only rare situations justify a radical treatment. PMID- 3550525 TI - [The prostate: development of anatomic and physiologic knowledge]. PMID- 3550526 TI - I.v. therapy 30 years ago: a look back. PMID- 3550522 TI - Vascular malformations of the central nervous system: a morphological overview. AB - Vascular malformations of the central nervous system (C.N.S.) are classified by size, location, and morphologic type, distinguishing capillary telangiectasias, cavernous malformations, venous angiomas, arteriovenous malformations (AVMs) including varix of the great vein of Galen, and other vascular malformations (e.g. Sturge-Weber syndrome). The morphology and predominant location pattern of the different types of vascular malformations in the brain and spinal cord, and their embryology are reviewed. In the brain and its coverings, all types mainly AVMs and venous angiomas do occur, representing 5-9% of all intracranial space occupying lesions and 20-40% of the sources of surgically treated intracranial hemorrhages. 50-80% of the angiomas are located in the cerebral hemispheres, 10 18% in central brain areas (basal ganglia, internal capsule, choroid plexus), and 10-30% in the posterior fossa. The major types of cerebral vascular malformations are described with reference to their anatomical features, location, chief arterial and venous supply, and prominent complications. Spinal vascular malformations, accounting for 3 to 12% of spinal space-occupying lesions, include vertebral, extradural, dural, subpial and intramedullary angiomas which occur as isolated or complex vascular anomalies and may involve various covering layers at the same level. The preferential occurrence of angiomas on the dorsal surface of the cord and in the caudal regions is related to the embryologic development of spinal vasculature. Frequent association of spinal angiomas (20-25%) with other vascular anomalies and dysplasias emphasizes their hamartomatous nature and developmental origin. Spinal angiomas include capillary telangiectasias with extra- or intradural and, rarely, intramedullary location, cavernomas, mainly arising in vertebral bodies, venous angiomas, mainly located in vertebral bodies and in the extradural space, and AVMs constituting the commonest type, that may affect both the pial and radicular vessels and can penetrate into the cord. They present as simple AV fistulas, cirsoid angiomas with localized vascular plexuses and large complex convolutions ("juvenile" type). The complications of spinal angiomas include subarachnoid hemorrhage, rare epidural hematoma, hematomyelia, compression lesions of the cord and roots, and ischemic changes causing chronic progressive radiculomyelopathy, previously referred to as Foix-Alajouanine syndrome. Chronic damage to the cord and spinal roots results from pressure effects, thrombosis of the abnormal vessels, disorders of venous drainage, and "steal" phenomena related to the vascular anomalies. PMID- 3550527 TI - Immunocytochemical localization of GABA in cat myenteric plexus. AB - Transverse sections through various levels of the feline gastrointestinal tract (antrum pyloricum, duodenum, jejunum, ileum and colon) were obtained from animals perfused with a mixture of glutaraldehyde and paraformaldehyde, and incubated with an antiserum specific for glutaraldehyde-fixed GABA. This antiserum has previously been characterized and shown to react selectively with presumed GABAergic neurons in the CNS. At all levels of the gastrointestinal tract, staining was observed in varicose fibers in the myenteric plexus and the circular muscle layer. Staining was abolished by glutaraldehyde complexes of GABA previously added to the antiserum, but not by similar complexes of related amino acids. The findings strongly suggest that GABA is concentrated in a subpopulation of gastrointestinal nerve fibers and add to previous evidence favoring a transmitter role for GABA in the enteric nervous system. PMID- 3550528 TI - Suppression by glucocorticoid of the immunoreactivity of corticotropin-releasing factor and vasopressin in the paraventricular nucleus of rat hypothalamus. AB - The effect of glucocorticoid on the production of corticotropin-releasing factor (CRF) and vasopressin in the paraventricular nucleus of the hypothalamus (PVH) was examined immunocytochemically. Intraperitoneal administration of dexamethasone sulfate in a dose of 0.1 mg/day suppressed the immunoreactivity of CRF and vasopressin in the medial parvocellular divisions of the PVH of the rat subsequent to bilateral adrenalectomy. In the magnocellular divisions, suppression of vasopressin-immunoreactivity was not observed. These results suggest that the vasopressin in the medial parvocellular divisions plays a distinct role from that in the magnocellular divisions, the former having functional significance in the hypothalamo-hypophysio-adrenal axis. PMID- 3550529 TI - Regrowth of lesioned dorsal root nerve fibers into the spinal cord of neonatal rats. AB - In postnatal rat pups the L4 and L5 dorsal roots were lesioned. After 3-6 months the spinal cord of the rats was subjected to tracing studies of regenerated dorsal root axons with transganglionically transported horseradish peroxidase (HRP) and immunohistochemistry with antibodies to calcitonin gene-related peptide (CGRP). In rats operated at birth (0-2 days old) HRP-filled profiles as well as CGRP staining were found in the outer lamina of the spinal cord dorsal horn. Signs of dorsal root nerve fiber regrowth in the spinal cord could not be found in rats which had been operated at the end of the first postnatal week or later. PMID- 3550530 TI - Cholinergic amacrine cells in the rabbit retina synapse onto other cholinergic amacrine cells. AB - Cholinergic amacrine cells in the rabbit retina have been detected by localizing choline acetyltransferase-like immunoreactivity. The characteristic array of normally placed and displaced amacrine cells was detected, as were two major synaptic plexuses in the inner plexiform layer. At the ultrastructural level, the most striking feature was the existence of contacts between the processes of cholinergic amacrine cells. Since this feature has also been detected in chicken and goldfish retina, it needs to be taken into account in any model which seeks to explain how the cholinergic amacrine cells are involved in generating directional selectivity at the ganglion cell level. PMID- 3550532 TI - Associate degree nursing programs accredited by the NLN 1986-87. PMID- 3550531 TI - Organization of ovine corticotropin-releasing factor immunoreactive neurons in the canine hypothalamo-pituitary system. AB - The distribution of corticotropin-releasing factor immunoreactive (CRF-i) cell bodies and varicose fibers in the hypothalamus and the pituitary of the canine brain was studied by indirect immunofluorescence. CRF-i cell bodies were demonstrated mainly in the periventricular zone of the third ventricle, while some CRF-i cell bodies were scattered throughout the ventral part of the caudomedial hypothalamus. CRF-positive fibers were mostly situated in the median eminence. In addition some CRF-positive fibers were detected in the ventromedial aspect of the lateral hypothalamus forming a pathway arising from the CRF-i cell bodies, running via the median eminence through the infundibular stalk and terminating in the pars nervosa of the pituitary. The localization of the cell bodies and their projection points towards a possible (patho)physiological role of this peptide-transmitter system in the release of ACTH and beta-endorphin. PMID- 3550533 TI - Influenza epidemic. Popular reaction in Camden 1918-1919. PMID- 3550534 TI - Advances in cancer: antibody targeting of cancer--prospects for detection and therapy. PMID- 3550535 TI - Myelination in the developing peripheral nerve. PMID- 3550536 TI - n-Hexane neurotoxicity: a mechanism involving pyrrole adduct formation in axonal cytoskeletal protein. PMID- 3550537 TI - Teaching nursing history. PMID- 3550538 TI - Obesity--a disease of nutrient or energy balance? PMID- 3550539 TI - A new technique for the assessment of diabetes. PMID- 3550540 TI - Nutrition classics. The Journal of Laboratory and Clinical Medicine, Vol. VII, 1922: The internal secretion of the pancreas. By F. G. Banting, and C. H. Best. PMID- 3550541 TI - Visual and artifactual materials in the history of early American medicine. PMID- 3550543 TI - The impact of smallpox on the native population of the 18th century South. PMID- 3550542 TI - Women healers and domestic remedies in 18th century America: the recipe book of Elizabeth Coates Paschall. PMID- 3550544 TI - Patterns of drug usage in colonial America. PMID- 3550545 TI - Implications of the recent clinical trials in hypertension. PMID- 3550546 TI - Arthur Donaldson Smith, MD. Physician, explorer, naturalist, and diplomat--Part I. PMID- 3550547 TI - Nicotine chewing gum: a review of the evidence. PMID- 3550549 TI - Omnibus Budget Reconciliation Act of 1986. PMID- 3550548 TI - Akathisia (restless legs) PMID- 3550550 TI - Caries removal to improve the bonding surface of dentine: a SEM Study. PMID- 3550551 TI - Endometriosis of the small bowel. Case reports and review of the literature. AB - Endometriosis has been reported with increasing frequency in the literature in recent years, particularly endometriosis in nongynecological sites. Primary endometriosis of the ileum is of particular concern due to the high incidence of small bowel obstruction. The treatment in the past has been castration and resection of the affected bowel, with no guarantee of cure. Two cases are presented which indicate that the hormonal therapy with Danocrine and laser vaporization of endometriotic lesions involving the ileum may alter the natural history of progressive ileal obstruction. A comprehensive review of the literature was undertaken which revealed 204 reported cases of endometriosis of the ileum. New recommendations regarding management of small intestinal endometriosis are proposed. PMID- 3550552 TI - Pregnancy with an artificial pacemaker. AB - Complete heart block in pregnancy is not a common encounter. The first case was reported in 1914 by Nanta and today some 100 cases are documented. Heart block may be congenital or acquired secondary to cardiac surgery, rheumatic heart disease, or infective disorders. Heart block, whether congenital or acquired, rarely creates any special obstetric problems. Today there is an increasing use of cardiac pacemakers in younger people and the first reported obstetric experience with a cardiac pacemaker implanted before pregnancy was by Shouse and Acker. This review will document the course and outcome of all reported pregnancies in women conceiving with an artificial pacemaker, and discuss complications and principles of management. We will also report our experience with a woman suffering from a complete heart block in whom an internal cardiac pacemaker was inserted before pregnancy. PMID- 3550553 TI - Resistant duodenal ulcers. PMID- 3550554 TI - [Breast cancer. Recommendations on diagnosis, therapy and after-care. Breast Cancer Project Group, Tumor Center, Munich]. PMID- 3550555 TI - Role of hyperthermic perfusion in the treatment of limb osteogenic sarcoma. AB - The role of hyperthermic perfusion (HP) for the treatment of limb osteogenic sarcoma was evaluated in 76 patients. Twelve patients were treated with HP alone, and a 5- and 10-year survival rate of 25.5% was obtained. When amputation was systematically associated to HP (12 patients), a 5- and 10-year survival rate of 50.9% was achieved. Twenty-seven patients were treated with hyperthermic antiblastic perfusion (HAP) followed by amputation 4 weeks later. With this treatment, the 5- and 10-year actuarial rates rose to 71.4 and 65%, respectively, with a 5-year disease-free survival rate of 67.4%. Fifteen patients were treated with HAP followed by an 'en bloc' resection and bone reconstruction. The 5- and 10-year actuarial survival rate obtained was 63.5% with a 5-year disease-free survival rate of 53.6%. These results seem to indicate that HAP permits carrying out conservative rather than ablative surgery for the treatment of limb osteogenic sarcoma. PMID- 3550556 TI - Complete remission following endocrine or combined cytotoxic and hormonal treatment in advanced breast cancer. A retrospective analysis. AB - Among 422 patients with advanced breast cancer treated in a randomized trial we observed 60 complete responses (CR). Sixteen were achieved among 206 patients treated with endocrine therapy alone and 37 among 216 patients treated with concomitant chemotherapy and endocrine therapy. The incidence of CR in women treated with the concomitant modality was higher in those with dominant soft tissue disease, intermediate in those with osseous or pulmonary involvement, and low in patients with liver metastases. Bone was shown to be the organ most responsive to therapy among patients treated with hormonotherapy, while patients with soft tissue metastases had an unexpectedly low rate of complete remission with this modality. The probability of achieving a CR was inversely proportional to the tumor burden in the patients treated with concomitant chemotherapy and endocrine therapy. For complete responders on hormone treatment alone and for those on combined endocrine and cytotoxic therapy, both median time to progression (26 and 29 months, respectively) and survival (52 and 53 months, respectively) were similar and statistically significantly longer than in partial or minor responders. This observation leads us to the conclusion that the hormonal component is the determinant for the length of a CR. PMID- 3550557 TI - Final surgical results with a suction trephine. AB - The suction trephine was studied in 31 aphakic and pseudophakic penetrating keratoplasty patients (31 eyes). The postoperative corneal astigmatism averaged 3.9 +/- 2.8 diopters overall. The 15 pseudophakic cases in nonscarred corneas showed a marked reduction in postoperative corneal astigmatism (3.59 diopters) when compared to previous reports. Our results have encouraged us to continue use of the suction trephine in all aphakic or combined keratoplasty procedures. PMID- 3550558 TI - Overcoming difficulties in trephining donor corneas for penetrating keratoplasty. AB - The complication of the donor button becoming trapped inside the barrel of the trephine blade can become a frustrating situation for the surgeon who is trying to recover it. The use of a sterile medicine dropper to apply slight suction to the epithelial side of the button allows for easy and secure removal of the trapped button without the risk of distortion or direct trauma to the endothelium as could occur with other methods. PMID- 3550559 TI - Autogenous dermis-fat "baseball" orbital implant. AB - A new procedure has been devised for the construction of an autogenous dermis-fat orbital implant, in which two figure-eight-shaped dermis-fat grafts are sutured together into a baseball shape. Correct implant size can be determined by preplacement of different-sized Mule spheres and testing for accurate fit. The "baseball" implant eliminates deep orbital fat which is distant from a vascular supply, and because it is covered with dermis, it maximizes graft vascularization, thus promoting survival of the implanted tissues. In eight patients, followed postoperatively for as long as 28 months, baseball implants have produced highly satisfactory results. PMID- 3550560 TI - New techniques in suture-aided tear duct intubation. AB - Modifications in the technique of nasolacrimal duct intubation by suture pull through are presented, improving suture accessibility within the nose. A method of joining the tubing ends without the disadvantages of a knot is described. PMID- 3550561 TI - Accommodative esotropia: review of current practices and controversies. AB - The treatment of accommodative esotropia requires a thorough evaluation at first presentation to elucidate all factors involved. The degree of hypermetropia, character of the esodeviation (i.e., intermittent or constant), presence or absence of amblyopia, and the AC/A ratio are all important in the initial management of these patients. In addition, the binocular status can be of prognostic value. Close follow-up is needed to ensure maintenance of binocularity and appropriate early intervention to modify the course before bifixation is lost. PMID- 3550562 TI - Immunohistochemical study of embryonic rhabdomyosarcomas. AB - 11 orbital embryonic rhabdomyosarcomas were studied immunohistochemically from patients under 4 years of age. One out of these cases, undifferentiated, showed to be myoglobin negative, and desmin positive. We point out the importance of this fact in immunohistochemical determination of the specificity of this entity. PMID- 3550563 TI - Congenital cataract with microcornea and Peters' anomaly as expressions of one autosomal dominant gene. AB - Hereditary congenital cataract is a well recognized but heterogeneous group of disorders; the cataracts may occur alone, or with other ocular or systemic abnormalities, and with all three common modes of inheritance. Peters' anomaly has usually been regarded as a sporadic condition with an insignificant risk of recurrence. A family is described in which congenital cataracts with microcornea, and Peters' anomaly, appear to be variable expressions of a generalized anterior segment disorder inherited as an autosomal dominant condition. PMID- 3550564 TI - Potential acuity meter for predicting postoperative visual acuity in penetrating keratoplasty. A new method using a hard contact lens. AB - An irregular corneal surface degrades the optical transmission and limits the effectiveness of the potential acuity meter (PAM) in predicting post-keratoplasty visual acuity. The authors investigated the efficacy of using a temporarily placed hard contact lens to neutralize surface irregularities in conjunction with the PAM in predicting post-keratoplasty visual acuity. A prospective evaluation was performed on 40 keratoplasty patients with a mean follow-up of 10.4 months. Of 27 patients with corneas clear enough to permit them to read letters on the PAM chart, 17 (63%) had very accurately predicted visual acuities by this new method, compared to only eight patients (30%) with the PAM alone. Three patients had predicted visions better than final vision, but this was due to a concurrent cataract in two cases and chronic cystoid macular edema (CME) in the third case. This study indicates that temporarily placing a hard contact lens for use with the PAM can increase its accuracy in predicting final visual acuity after penetrating keratoplasty. PMID- 3550565 TI - Latent oculogenital infection with Chlamydia trachomatis. AB - Thirty patients attending a sexually transmitted disease clinic were evaluated for genital and ocular infection with chlamydia. Eight patients had positive conjunctival immunofluorescent staining. This represents an asymptomatic, latent carrier state with important epidemiologic considerations. PMID- 3550566 TI - Limited choroidal hemorrhage mistaken for a choroidal melanoma. AB - Considerable progress has been made during the last few years in evaluating patients with suspected choroidal melanomas but difficulties continue to persist. In this report, the authors describe three cases with an unusual localized posterior choroidal hemorrhage, which were thought to be choroidal melanomas and referred for proton beam irradiation. These limited hemorrhagic choroidal detachments presented as a dark brown mass of considerable elevation, but were discrete, well localized, and located posterior to the equator. Fluorescein angiography and ultrasonography may be of some value in differentiating these lesions from choroidal melanomas. Serial observations over time will establish the correct diagnosis. PMID- 3550567 TI - Localized conjunctival amyloidosis associated with extranodal lymphoma. AB - A 62-year-old man was found to have a large asymptomatic amyloid nodule of the conjunctiva. Within the next year, a diffuse mixed small and large cell lymphoma of his scapula developed with amyloid in its stroma. No abnormal serum or urine protein was found. Subsequently, rib and paraspinal masses appeared. After irradiation and chemotherapy, the patient died of bronchopneumonia, 3 years after onset. By immunostaining, the amyloid of both conjunctiva and scapular tumor was of polyclonal immunoglobulin (AL) type, most prominently IgG and lambda chains, with lesser staining for IgA and kappa chains. The tumor cells showed a similar pattern. To our knowledge, this is the first report of systemic lymphoma and localized conjunctival amyloidosis without a serum paraprotein, and the first such association with a lymphoma of this cell type. Immunotyping of conjunctival amyloidosis should be performed to guide the workup for possible systemic disease. PMID- 3550568 TI - Orbital angiosarcoma with subconjunctival presentation. Report of a case and literature review. AB - An otherwise healthy 37-year-old woman had, over the course of 2 years, a recurring subconjunctival lesion associated with blepharoptosis. Computed tomography (CT) demonstrated a large anterior and superior orbital mass. A diagnosis of angiosarcoma (AS) was made from biopsy material. The patient is alive and well 18 months after exenteration and radiation therapy. The clinical and histopathologic features of this tumor are discussed with emphasis on the differential diagnosis of malignant vascular tumors of the orbit. PMID- 3550569 TI - Bone grafting. PMID- 3550570 TI - Biology of cancellous bone grafts. AB - Despite 30 years of experimental bone grafting research, the fresh cancellous bone graft remains the most osteogenic and reliable bone grafting material. Recent experimental data suggest that modification of the graft-host interaction by antigen matching or immune manipulation may allow increasingly successful use of allografts. PMID- 3550571 TI - Biology of bone transplantation. AB - A problem with bone grafting is the availability of the appropriate material and its acquisition. Thus, autogenous materials are obtained with certain costs to the patient. The alternative, allografting, has achieved moderate success, while synthetic implants as another alternative can be easily manufactured, but these materials are susceptible to wear, tear, and fixation. The intent of this article is to describe the biology of autogenous bone graft repair and its correlative biomechanics; to describe the biologic aspects of allograft repair; and to describe the alternatives when autogenous bone proves insufficient. PMID- 3550573 TI - Methods of banking bone and cartilage for allograft transplantation. AB - Storage of bone for use as allograft has become an important endeavor because banked bone is becoming increasingly useful and popular as a substitute for, or as a supplement to, autograft bone. Methods have been developed for safe and reliable bone banking, including standard criteria for acceptable donors, proven techniques of retrieval of tissue, and appropriate storage facilities and conditions. In contrast, cartilage banking is still an investigative procedure, but current research may provide more effective approaches to maintaining viable cells during freezer storage of osteochondral allografts. PMID- 3550572 TI - Current approaches to experimental bone grafting. AB - A number of osteogenic, osteoinductive, and osteoconductive substances currently are being investigated for use in bone repair. It is conceivable that a selected combination of osteogenic cells, osteoinductive factors, and osteoconductive matrices can be combined and fabricated into an implantable material custom suited to particular clinical demands. Consequently, it is crucial that potential graft substances be experimentally characterized in terms of their precise contribution to the bone-forming mechanisms. In this article, the authors review current areas of research in the realm of experimental grafting, including the current understanding of materials that manifest osteogenic, osteoinductive, or osteoconductive properties. PMID- 3550574 TI - Massive autogenous bone grafts. AB - Autogenous bone graft is the best biologic material available to repair a skeletal defect. These necrotic grafts are revascularized and repaired through creeping substitution to provide an almost identical structure for the one it replaced. There is a limited supply of autogenous bone, but it is the standard against which other methods should be measured. PMID- 3550575 TI - Clinical applications of vascularized bone autografts. AB - Our experience with microvascular transfer of fibular grafts and composite osteocutaneous iliac flaps has shown that massive autogenous bone grafting with an intact vascular pedicle decreases the time to bony union and the duration of immobilization required for functional reconstruction of an extremity. The technique has proven reliable (87 per cent success rate) in the reconstruction of bone defects of greater than 6 to 8 cm following tumor resection or defects existing in a fibrotic, avascular bed. More importantly, these techniques have been applied for limb salvage in patients with tumors or with severely traumatized extremities that were not candidates for more traditional methods of bone grafting. In many cases, amputation would have been the only alternative. PMID- 3550576 TI - The use of frozen cadaveric allografts in the management of patients with bone tumors of the extremities. AB - Since 1971, 314 frozen osteoarticular and intercalary cadaveric allografts have been implanted primarily in the management of patients with aggressive or malignant tumors of bone. The procedure, although arduous and sometimes resulting in complications, was successful in preserving the limb and restoring function to the part in over 70 per cent of the patients. Key to the system is the maintenance of a high-quality procurement and banking program. PMID- 3550577 TI - Allogeneic bone in the treatment of tumors, trauma, and congenital anomalies of the hand. AB - Because autogenous bone grafts are histocompatible by definition and because the hand does not require massive bone grafts, one may question the indications for using allogeneic bone in the hand. Although humans have been shown to develop donorgraft specific antibodies following large osteochondral allografts, these antibodies have not yet been noted after smaller bone grafts nor is the clinical significance of these antibodies clear. The use of allogeneic bone better satisfies the architectural and strength requirements for reconstruction when there is a need for osteochondral grafts, strong cortical grafts to allow secure fixation and early motion, and small tubular grafts that meet the demands of minimizing bulk in the hand. For the repair of osteochondral defects, autogenous grafts (ie, fibular head or metatarsal head) impose donor site deficits that can be clinically significant. In addition, grafts such as the fibular head do not provide reconstruction of a congruent joint surface. Strong cortical bone is an asset in metacarpal reconstruction; it enhances the quality of internal fixation, which in turn allows hand therapy to be started early, an essential treatment following hand injuries. A stiff hand after reconstruction will result despite excellent bony reconstruction if the fixation does not allow early motion. Autogenous cortical grafts donor sites (eg, ulna or tibia) can cause donor site morbidity, including fracture of weakened bone. The need for small tubular grafts is especially important in pediatric patients. Strong autogenous corticocancellous grafts are difficult to obtain in children, and these grafts are bulky and difficult to insert. In addition, for adults and children, the lack of a donor site means a much shorter hospital stay. PMID- 3550578 TI - [Method of brephoplasty in the complex surgical treatment of chronic hematogenous osteomyelitis in children]. PMID- 3550579 TI - [Surgical treatment of instability of the hip joint in children with spastic cerebral palsy (review of the foreign literature)]. PMID- 3550580 TI - [Pulsatory administration of gonadotropin-releasing hormone in hyperprolactinemic oligo- or amenorrhea]. PMID- 3550581 TI - [The periodical Gyogyszereszeti Hetilap was founded 125 years ago]. PMID- 3550582 TI - [Geza Takats (1892-1985). First Hungarian vascular surgeon-angiologist?]. PMID- 3550583 TI - [Industrial medicine for miners in the 18th century]. PMID- 3550584 TI - [Basic principles of modern management and care of multiple pregnancies (apropos of the first successfully managed case of quintuplets in Hungary)]. PMID- 3550585 TI - [Use of the Rotex II screw-shaped fine needle in ultrasound-guided biopsies]. PMID- 3550586 TI - [Comparative determination of beta-2-microglobulin levels in maternal serum, urine and amniotic fluid by radioimmunologic and enzyme immunologic methods]. PMID- 3550587 TI - [Experience with immunosuppressive treatment of autoimmune myocarditis proven by myocardial biopsy]. PMID- 3550588 TI - The genetics of neurologic syndromes. AB - Diagnosis and counseling represent the two primary functions of the clinical geneticist. To establish a diagnosis, the geneticist must be familiar with the entire gamut of genetic and nongenetic disorders. Even when the diagnosis is made by laboratory tests or physical examination, the pervasiveness of genetic/etiologic heterogeneity demands that the geneticist be skilled in the extraction of a thorough family history and in the subtleties of pedigree interpretation. Multiple specialty referrals may be solicited. Counseling is an involved process that includes a thorough discussion of the nature, etiology, and prognosis of the disorder; its burden; its recurrence risk; and the alternatives at the family's disposal for dealing with that risk. Calculation of the recurrence risk itself may require special mathematical techniques. For parents to assimilate this extensive information, they must be receptive. If they are grieving heavily, denying the existence of the problem, or busy tending to the medical or financial needs of their child, counseling is seriously compromised. For these reasons, geneticists may assume the responsibility of coordinator of services to facilitate the difficult experience of bearing a child with a serious developmental disorder. Only then can be adequately perform the functions for which he has been trained. PMID- 3550589 TI - Facial paralysis. AB - This article discusses peripheral facial paralysis of nontraumatic origin. The term idiopathic facial paralysis is used generically, in place of the often ambiguous term, Bell's palsy, to indicate all types of peripheral facial palsy/paralysis for which no cause is apparent. Included is a brief resume of the pertinent anatomy and pathophysiology, a synopsis of etiologic considerations, and a discussion of current therapeutic options. This article is aimed at practitioners of otolaryngology, neurology, and neurosurgery with the hope that it will be of value to them in caring for their patients. PMID- 3550590 TI - Clinical neurologic disorders in children with special otorhinolaryngologic relationships. AB - The anatomic (and functional) relationship of otorhinologic structures to the CNS has a potential for altered vascular supply, penetration by bacterial agents, and impaired gas exchange. The pathophysiologic relationship at times may be subtle or occult as indicated by examples. An awareness of potential relationships is critical for proper diagnosis and management. PMID- 3550591 TI - Disorders of smell and taste. AB - This article describes the anatomy and physiology of the gustatory and olfactory organs in man. Dysfunction of these senses is closely examined with respect to etiology, diagnosis, and treatment. Taste and smell are closely interrelated. An influence on the function of one sense often affects the function of the other sense. PMID- 3550592 TI - Vestibular schwannomas. AB - Over the past two decades, the emphasis on the management of acoustic neuromas has turned from the single goal of preserving the patient's life to early diagnosis and functional preservation of cranial nerves. PMID- 3550594 TI - Neuromuscular disorders. AB - Laryngeal innervation and the functional disorders associated with lower motor neuron paralyses are reviewed. Causes of diffuse denervation, such as drug toxicities and demyelinating disease, are also discussed. Symptoms and treatment of myasthenia gravis, amyotrophic lateral sclerosis, and botulism are discussed as examples of neuromuscular blockade at various levels. PMID- 3550593 TI - Spasmodic dysphonia. AB - Few speech disorders have been more controversial as to etiology and treatment as spasmodic dysphonia. This article reviews the historical background and origins of spasmodic dysphonia theories and the legacy of their implications on the current treatment of afflicted patients. The evolution and impact of "organic theories" is discussed and a personal perspective on the central nervous system investigations performed by the authors is briefly elucidated and their practical experience in managing spasmodic dysphonia patients is offered for the reader's consideration. PMID- 3550595 TI - Making sense of nystagmus--can it be done? AB - In recent years elegant recording techniques have been used to study the amplitudes, waveforms, velocities, and other characteristics of nystagmus and ocular oscillatory movement disorders. Mathematical modeling based on inferred neurophysiologic control systems and integrators have added some insight into the pathology of these conditions. From this data has developed a rather structured and complex classification system. Most specific, recognizable, localizing types of nystagmus can be diagnosed by a thorough office examination. Other types of nystagmus will be reviewed as well as those ocular movements that are oscillatory but not rhythmic and are referred to as nystagmoid movements. PMID- 3550596 TI - Vascular headache. AB - Vascular headache is an extremely common disorder. Current evidence points to an underlying neurogenic etiology, and the associated vascular changes are believed to be epiphenomena. Vascular headache tends to begin at a young age, is more common in women, and is frequently associated with a positive family history. Characteristics of the headache frequently suggest the diagnosis. The history and physical examination are keys to the diagnostic evaluation. A computed tomography scan when indicated is the single test with the highest yield of information. Non narcotic analgesics, ergot compounds, and metoclopramide are the most commonly used agents for acute attacks. Beta blockers and amitriptyline are the most widely used prophylactic medications. Nonpharmacologic measures are occasionally of great benefit. PMID- 3550597 TI - Vestibular disorders. AB - This article reviews and updates the pathology associated with the labyrinth and peripheral central nervous system. It serves as an overview to aid in the diagnosis and treatment of vertigo. PMID- 3550598 TI - Cushing's monsters. PMID- 3550599 TI - [Aortic coarctation and osteogenesis imperfecta]. AB - This is the report of a 4 year old patient with osteogenesis imperfecta tarda and aortic coarctation. The resection of the aortic coarctation was performed when the patient was 5 years old. Postoperative recovery and formation of scar tissue presented no problems. Increased operation risk due to osteogenesis imperfecta (White et al., 1983) and possible abnormal formation of scar tissue due to this collagen disorder necessitated detailed preoperative tests of collagen metabolism. We shall discuss the histological and biochemical results of these tests and evaluate the effect of therapy with catechin. PMID- 3550600 TI - Fridtjof Nansen: neuro-anatomical discoveries, Arctic explorations, and humanitarian deeds. PMID- 3550601 TI - Immune-mediated adherence of eosinophils to Toxocara canis infective larvae: the role of excretory-secretory antigens. AB - The participation of Toxocara canis larval excretory-secretory antigens in immune mediated adherence was determined in vitro. Adsorption of immune sera with excretory-secretory antigens removed some complement components, removed IgG antibody directed against larval surfaces, and abrogated all adherence observed with untreated immune serum. At least four antigens could be implicated in adherence, by Western blot analysis of adherence mediating sera. Scanning and transmission electron microscopic examination of larval-eosinophil interactions revealed that eosinophils adhered to a membranous sheath-like layer that was frequently detached from the larval epicuticle. The layers appeared to be composed of surface antigens and antibody, and may provide larvae with protection against antibody and eosinophil toxins by preventing their contact with the epicuticle. The release of surface antigens also may be important in allowing larvae to evade the host's immune response by facilitating the removal of antibody and eosinophils from the larval surface. PMID- 3550602 TI - Dipetalonema viteae infection in three species of rodents: species specific patterns of the antibody response. AB - Groups of jirds (Meriones unguiculatus), multimammate rats (Mastomys natalensis) and golden hamsters (Mesocricetus auratus) were infected with third stage larvae (L3) of Dipetaloneam viteae and the course of infection was followed until 20 weeks post infection. Worm growth was best and microfilaraemia was high and long lasting in jirds and in multimammate rats, whereas golden hamsters were poor hosts as measured by these parameters. The IgG and IgM antibody responses of the species were compared by immunoblotting and ELISA using proteins of D. viteae, separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE). The levels of antibodies against most proteins of high molecular weight declined during infection in jirds and in multimammate rats, whereas an increase was observed in golden hamsters. In contrast, several antigens of low molecular weight induced increasing antibody levels in all species. Species specific antigen recognition was observed for a number of protein bands of L3, microfilariae and female worms. The data suggest that susceptibility to immunesuppression and the species specific pattern of antigen recognition might determine the qualities of a rodent species as host for D. viteae. PMID- 3550603 TI - [Adriamycin and chemotherapy of breast cancer. Personal experience]. AB - The clinical results achieved for more than 10 years in patients with metastatic breast cancer have clearly demonstrated the efficacy of chemotherapy programs including Adriamycin. This therapeutic effect was confirmed when it is given in protocols of adjuvant chemotherapy. Some complementary studies have demonstrated 4 points in order to define the better modality of application of Adriamycin: the results of induction chemotherapy's protocols are not better if the treatment is given beyond 6 months, the alternative administration of 2 noncross resistant programs of chemotherapy is no more efficient than the continuous administration of a program of chemotherapy including Adriamycin, the increase of the doses of cytotoxic chemotherapy does not change the median of survival of the patients, the fractionated administration of Adriamycin is as effective as the conventional administration of the same total dose. PMID- 3550604 TI - [Structure and activity of anthracyclines]. AB - Several mechanisms are proposed for explaining the antitumor activity and the toxicity of anthracyclines. The first recognized biochemical target is DNA. Anthracyclines and DNA lead to the formation of complexes of intercalation. The intercalation can explain biochemical properties such as inhibition of DNA polymerase and of RNA polymerase. On the other hand, the intercalation cannot explain the chromosomal damages observed in cancer cells following in vivo administration or in vitro incubation. Additional mechanisms are proposed such as biological reduction of quinone C ring, leading to the formation of radical species able to react covalently with DNA. More recently, an interaction of anthracyclines with topoisomerase II has been also described. There is no clear correlation between antitumour efficacy and DNA intercalation. However it must be pointed out that no anthracycline has been found so far which shows antitumour activity dissociated from the ability of interacting with DNA. Anthracyclines interact with membranes: interaction with negatively charged phospholipids like cardiolipin; peroxidation of membrane lipids following biological reduction of the quinone C ring. These membrane effects are believed to be responsible for chronic cardiac toxicity. The clinical activity of daunorubicin and of doxorubicin leads to considerable work with the hope to discover more active and/or less toxic congeners. Several possibilities are investigated: isolation of new anthracyclines from natural sources (fermentation broths); chemical modifications of the whole molecule; total synthesis of new sugars and of new aglycones. PMID- 3550605 TI - [Anthracyclines in the treatment of epidermoid cancers: uterine cervix, esophagus, bronchi, head and neck]. AB - Anthracyclines certainly do not play a leading role in the treatment of squamous cell carcinomas. Their effectiveness in these malignancies is limited. In carcinomas of the uterine cervix, variable therapeutic (partial or complete) response rates ranging from 0% to 25% have been reported with doxorubicin as single drug therapy. Using combination chemotherapy, maximum response rates of 54% with cis-platinum and 66% with methotrexate have been achieved. In esophageal carcinoma, a low response rate, fairly consistent across studies, approximating 18%, has been recorded with doxorubicin alone. More satisfactory, although still mediocre results have been recorded with combination chemotherapy, e.g. 33% with FAP (doxorubicin, fluoro-uracile, cis-platinum). Only addition of VP 16 to FAP has yielded a good response rate (66%) in one study. In carcinoma of the lung also, doxorubicin alone has yielded low response rates, approximating 18%. Widely variable results have been reported for the numerous combination chemotherapy trials, with therapeutic response rate ranging from 5% to 66% and mean survivals ranging from 3 months for the least satisfactory trials to 18 months for the few more satisfactory series. In carcinomas of the head and neck, therapeutic response rates with doxorubicin alone have been 20 to 25%. With combination chemotherapy, rates exceeding 50%, occasionally by a fairly wide margin, have been achieved. However, the clinical response may be of fairly short duration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550606 TI - [Importance of anthracyclines in tumors of the ovary and endometrium and soft tissue sarcomas]. AB - Anthracyclines, especially Adriamycin stand as a major progress in cancer chemotherapy: in ovarian carcinoma anthracyclines are combined to cyclophosphamide and cisplatin to obtain a rapid and complete remission; in endometrial carcinoma Adriamycin is the most active drug for palliative treatment; in soft-tissue sarcomas, anthracyclines in combination with other drugs give 15 to 65% response rates (8 months of median duration) in metastatic situation; except in one study (NCl), all adjuvant studies with these drugs are actually negative. PMID- 3550607 TI - [Importance of locoregional chemotherapy by anthracyclines]. AB - With loco-regional chemotherapy high local concentration of antineoplastic products can be achieved without systemic toxicity. However local toxicity and technical problems are frequent and limit its use. Intra arterial chemotherapy (IAC) is interesting when the drugs used have a high total body clearance. One of the best indication of IAC is the intra-hepatic chemotherapy with anthracyclin for hepatocellularcarcinoma (40-60% objective response) and metastatic carcinoid. Among other IAC the IA limbs perfusions for soft tissue sarcoma have given interesting results. Chemoembolization with lipiodol and/or gelfoam mixed with anthracyclin is an interesting field of investigation in liver tumor and metastases. Intraperitoneal chemotherapy is used essentially for peritoneal carcinomatosis from ovarian origin and gives some positive results. However, intra peritoneal Adriamycin is not well tolerated and other anthracyclines are to be investigated. PMID- 3550608 TI - [Role of cell pharmacokinetics in the modulation of modalities in the administration of anthracyclines]. AB - The rate of the anthracycline uptake and retention differs with the drug structure and with the cell type. Here we present evidence to show that as compared to carcinoma cells, normal epithelial cells are naturally resistant to adriamycin. Moreover, it is shown that uptake of demethoxy-daunorubicin and THP ADM is a very rapid process as compared to ADM, epi-ADM or DNR. Cytotoxicity correlates with the intracellular concentration. The relevance of these in vitro findings is considered in the in vivo situation. Resistance to anthracyclines is in part related to decrease accumulation and retention. This resistance can be reversed not only by calcium transport and calmodulin inhibitors but also by co treatment with aclacinomycin. Wether changes which occurred in acquired resistance can be found in cells with natural resistance to adriamycin remain to be determined. PMID- 3550609 TI - [Pharmacokinetics and metabolism of anthracyclines in man]. AB - Although they differ only slightly from each other, the various anthracyclines have their own metabolic pathways and pharmacokinetic parameters. Doxorubicin and daunorubicin have a similar reduced metabolite which reaches low plasma levels in the case of doxorubicin, but is predominant in the case of daunorubicin: daunorubicinol. Aglycones are only formed in large quantities from aclarubicin: aklavinone. The plasma decay of doxorubicin levels is triphasic, with successive half-lives of 5 min, 1 h and 30 h. Unchanged daunorubicin is eliminated more rapidly from plasma, but its metabolite is eliminated more slowly. New anthracyclines such as pirarubicin are characterized by a large volume of distribution, suggesting a higher tissue fixation. These pharmacokinetic data must be kept in mind for the design of new protocols which are aimed to dose fractionation or tumor targetting. PMID- 3550610 TI - Approaches to the problem of individual doxorubicin dosing schedules. AB - Doxorubicin is one of the most commonly used antineoplastic agents today. Dosing schedules are inexact and there remains a need to develop predictive models for its administration. Data from prior work in humans is difficult to interpret because of poor patient selection, poor drug assays, lack of knowledge of metabolite toxicity, concurrent treatment with other hepatically metabolized drugs, and individual pharmacogenetics which are poorly described. We have developed a rabbit model of in vivo drug pharmacokinetics in the setting of enzyme inhibition and sublethal hepatocellular necrosis. Our data suggest that the rabbit may be used as a model of hepatic drug metabolism and that changes in drug pharmacokinetics and pharmacodynamics in isolated hepatic disease may be simulated in the rabbit. The results obtained may be applied in more directed and controlled studies in humans. PMID- 3550611 TI - [Models of preclinical studies of anthracyclines]. AB - Since the first discovery of antitumor properties of daunorubicin in 1962, several hundreds of anthracyclines have been evaluated. In 1969, the primary screening on L1210 leukemia allowed to detect doxorubicin which is more active than daunorubicin and has been found clinically active on several human solid tumors. Therefore, L1210 leukemia appeared to be a useful model for evaluating experimental antitumor activity of anthracyclines, indicating a possible correlation between this model and the clinic. Analogs which are equally or more active than doxorubicin in the primary screening are tested in the secondary screening, then eventually in models of cardiotoxicity in order to evaluate their therapeutic index. The secondary screening includes murine solid tumors (B16 melanoma, Lewis lung carcinoma, mammary adenocarcinomas, colon adenocarcinomas 26 and 38) and human tumor xenografts into nude mice or under the renal capsule of normal mice (LX1, lung - CX1, colon - MX1, breast). Various tumor localizations (i.p., i.v., s.c., i.m., i.c.), various routes of administration (mainly i.v. and p.o.), various schedules of treatment (early or delayed, repeated or intermittent) and models of polychemotherapy are used to obtain a better evaluation of the compound. P388 leukemia resistant to doxorubicin is useful to test cross resistance in vivo and also to screen compounds able to reverse this phenomenon. Until now, 17 new anthracyclines have been introduced into clinical trials. Aclacinomycin has a different mechanism of action from that of doxorubicin (induction of tumor cell differentiation, inhibition of B and T suppressor lymphocytes); it is less myelotoxic and it is not mutagenic in vitro. THP-doxorubicin is more active than doxorubicin against L1210 leukemia and some solid tumors; it seems less cardiotoxic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550612 TI - Rationale and strategy for prevention of anthracycline cardiotoxicity with the bisdioxopiperazine, ICRF-187. AB - Anthracyclines are amongst the most effective antitumor agents currently utilized. The major impediment to their use has been the development of cardiotoxicity with chronic administration. In an effort to overcome this limitation we have utilizated an approach to abrogate the cardiotoxicity with a drug, ICRF-187, which protects against the anthracycline cardiomyopathy in all animal species so far tested. This strategy assumes that separate mechanisms of cardiac toxicity and antitumor activity exist. We are currently testing this hypothesis in a randomized clinical trial of women with advanced breast cancer who are randomized to receive 5FU, doxorubicin, and cyclophosphamide (FAC) or FAC plus ICRF-187. PMID- 3550613 TI - [Recent data on anthracyclines]. PMID- 3550614 TI - [Combination of anthracyclines with radiotherapy. Value and problems]. AB - Association between radiotherapy and anthracyclines (especially adriamycin) early showed major toxicity on critical normal tissues so that its antitumor activity was concealed. This toxicity proved to be acute toxicity, recall phenomenon and cardiac toxicity. Clinical and experimental studies showed synergistic effect when drug and radiation are administered concomitantly and additive effect in sequential administration. So concomitant association must be rejected. The main point is the time interval between adriamycin injection and radiotherapy (at least seven days). These conditions are respected when alternating treatment schedule is applied: radiation split courses are integrated between two chemotherapy cycles including adriamycin. At this time new anthracycline analogs were not associated to radiotherapy. PMID- 3550615 TI - [Therapy of acute leukemia in the adult. Role of anthracyclines]. AB - Anthracyclines chemotherapy has changed the outcome of adult acute leukemia. Daunomycin, Adriamycin and Zorubicine are the three main analog derivatives. In adult ALL, in randomized study, anthracyclines in induction regimen improve significantly the remission rate up to 80%. In AML, combination chemotherapy of Ara-C and anthracyclines is the standard induction regimen. In randomized study, Daunomycin has the same activity than adriamycin at the same dose with less toxicity. Comparison of Daunomycin: 60 mg/m2 X 3 d with Zorubicin: 120 mg/m2 X 3 d shows the same activity in association with Ara-C with less toxicity. In protocol 01 AM 81, Zorubicin has been used at the dose of 200 mg/m2 X 4 d in association with Ara-C: 200 mg/m2 X 5 d. 444 patients has been included in the study. The complete remission rate is 83% with a mortality rate of 7% and only 11% failure. Zorubicin allows intensification of induction regimen with similar or less toxicity than conventionnal regimens. PMID- 3550617 TI - [Importance of anthracyclines in infants in the treatment of acute lymphoblastic and non-lymphoblastic leukemias]. AB - Induction treatment of acute non lymphoblastic leukemia in children and in adults must include anthracyclines, but the best anthracycline is still in discussion. In acute lymphoblastic leukemia the use of anthracycline is discussed according to the initial prognostic factors: needful in high risk patients, useless in good risk. In intermediate risk patient, most cooperative protocols include one anthracycline in induction. PMID- 3550616 TI - [Therapeutic trials of aclarubicin in previously treated acute leukemias and hematosarcomas]. AB - In a phase I-II trial, 38 patients with acute myeloid leukemia (AML) were given single drug induction therapy with aclarubicin (ACM) according to two dosing schedules: treatment 1: 10 to 30 mg/m2/d to a maximum total dose of 300 mg/m2 or until development of unacceptable toxicity: treatment 2: 15 mg/m2/d in ten-day courses separated by ten-day intervals. Response rates were 15% with treatment 1 and 44% with treatment 2 (overall response rate 34%). Complete remission (CR) was achieved in 6 patients who had previously failed to respond to adriamycin (ADM). Toxicity was more frequent and more severe in those patients given more than 150 mg/m2 ACM per course. The main side effects were oropharyngeal mucositis and diarrhea. Three patients exhibited T wave inversion and one had an episode of auricular flutter. In a separate trial in 16 patients with AML we used cyclic chemotherapy combining ACM (20 mg/m2/d) and ARA-C (200 mg/m2/d) for seven consecutive days. Complete remission rate was 50%. Severe ventricular rhythm disorders were seen in two patients. In a phase I-II study, 19 patients with acute lymphoid leukemia (ALL) and 8 patients with non-Hodgkin lymphoma (NHL) were given ACM alone according to the regimen designated treatment 1 described above. Response rates were 11% (2/19) in ALL and 25% (2/8) in NHL. A review of the literature is presented in the discussion of the original trials reported herein. PMID- 3550618 TI - [Role of adriamycin in the therapy of bone sarcomas]. AB - The improvement of bone sarcomas prognosis during the last fifteen years (60% disease free survival at 4 years for osteogenic sarcoma, 50% for Ewing's sarcoma) is due in a large measure, to introduction of chemotherapy. ADR is a very effective agent in the treatment of those tumors but its use is limited by its cardiotoxicity. In the current chemotherapy protocols, the best results are obtained with the combination of intensive ADR-HDMTX, ADR-CDDP in osteogenic sarcoma, and ADR-ACD-CTX in Ewing's sarcoma. The ADR-Ifosfamide association seems also to be promising. PMID- 3550619 TI - [Cardiotoxicity of anthracyclines in children. Contribution of anthracyclines in pediatric oncology]. AB - Anthracyclines induced cardiotoxicity in children remains a major problem. Classical data are found: cumulative dose, way of injection, anterior cardiopathy, cardiac area irradiation, interaction with other cytotoxic drugs ad age. 2 kinds of disorders are recorded: 1) Acute rhythmic dysfunctions, early and often transitory; 2) congestive heart failure often not reversible and depending on total dose. Prognostic is still poor and intricate with prognostic of the tumor. Over all incidence is 2.7%. Very young children seem to be more sensitive. Continuous infusion is less toxic than IV bolus. Studies with new anthracyclines are yet uncommon but seems to be comparative with adult literature. Monitoring is identical to adults. EKG is of minor interest. Endomyocardial biopsies have been reported. There is no prognostic value of ultrasound tomogram, but exercise echocardiography can be performed. Nuclide fraction ejection is more reliable. PMID- 3550620 TI - [The role of zorubicine in the treatment of acute myeloid leukemia. Evaluation of 15 years' use]. PMID- 3550621 TI - [Hepatopathy with a progressive course after one-time administration of (chloro-2 ethyl)-1-cyclohexyl-3-nitroso-1-urea (CCNU) in rats]. AB - A few cases of liver involvement have been reported in patients receiving treatment with CCNU. Nitrosourea CCNU is an antitumoral agent largely used in the treatment of some types of leukemia, Hodgkin's disease, bronchial or cerebral tumors. It was shown that CCNU induced pericholangitis and intra-hepatic cholestasis in rat: moderate after 20 mg/kg CCNU, these hepatic lesions were maximal on day 8. In the present report we were interested in the evolution of hepatic alterations a long time after cessation of drug administration. So we studied hepatic ultrastructure three months after a unique 20 mg/kg or 50 mg/kg CCNU administration. Lesions were stable after 20 mg/kg CCNU and no reversibility was observed 3 months after 50 mg/kg CCNU: evolution to cholangiolysis, to adenomatous transformation of parenchyma or biliary cirrhosis were noted. PMID- 3550622 TI - [Comparative study of the diagnostic contribution of C-terminal and medio regional determination of parathyroid hormone in man]. AB - In this study, we compared serum parathyrin radioimmunoassay values obtained with three commercially available kits in a series of normal subjects, patients on dialysis, patients with primary hyperparathyroidism and with hypercalcemia due to malignancy. The calcium of these subjects was simultaneously evaluated. Two of these three kits measure two different C-terminal portions of the molecule and the third the mid region of PTH. The Behring and Byk kits were most efficient in that the results were obtained rapidly. The mid region assay is not more contributive than the C-terminal assays. Among these, the Behringer kit seems to produce the best diagnostic discrimination when the PTH and calcium are coupled. As far as the diagnostic specificity is considered, the latter kit seems however less efficient than the two others. PMID- 3550624 TI - [Dynamic study of plasma and urine amino acid patterns after an oral load of tryptophan. Application to a patient with a complex deficiency syndrome]. AB - The aim of this work was to show that the dynamic study of the amino acid pattern in plasma and urine following an oral load of tryptophan might confirm anomalies suggested by inconsistent clinical data and below-normal biological values. Such oral loads were administered to five control subjects and one patient who had recovered from a celiac condition but was suffering from a complex deficiency syndrome associating a polyneuritis due to a lack of folic acid and the excretion of blue-colored transpiration. Thirty minutes following the load a slowing in the rate of tryptophan absorption was observed (p less than 0.05) and, during the first 6 hours, increased urinary excretion of tryptophan (p less than 0.01) and indican (p less than 0.05). Similarly, changes in the metabolism of other amino acids were either revealed or accentuated by this oral load test (ornithine, glycine, lysine, phenylalanine). It is probable that in this patient a problem of tubular re-absorption led to tryptophan being less available for metabolization along the kynurenine pathway, accounting for the increase in urinary excretion of the amino acids concerned. The diagnosis put forward is that of an unexpressed form of Hartnup's disease in association with a folic acid deficiency. PMID- 3550623 TI - [In vitro action of fosfomycin combined with rifampicin, pefloxacin and imipenem on staphylococci (checkerboard method in a liquid medium)]. AB - The combined activity of fosfomycin with rifampin, pefloxacin and imipenem was investigated, by the checkerboard method performed in liquid medium, against 50 clinical isolates of staphylococci (25 Staphylococcus aureus and 25 coagulase negative staphylococci). The combination of fosfomycin plus rifampin had an additive bacteriostatic effect and an antagonistic bactericidal effect. Fosfomycin combined with pefloxacin was found to be additive or moderately synergistic. Fosfomycin in combination with imipenem was generally highly synergistic, especially against meticillin-resistant strains; however the bactericidal effect was occasionally antagonistic. PMID- 3550625 TI - [Disparity between the level of activity and immunochemical determination of terminal deoxynucleotidyl transferase in leukemia]. AB - Terminal deoxynucleotidyl Transferase (TdT) is used in diagnostic investigation and in remission surveillance of leukaemias. We have compared the results obtained by enzyme activity measurement and by immunoperoxydase technic. Discrepancies between the two assays exist in 19% of the cases; they are due in particular to the anti-TdT nature who limits its specificity, and they restrict the TdT immunochemistry determination interest. PMID- 3550626 TI - [Characterization of Pasteurella species isolated from man]. AB - Fifty-four clinical isolates of Pasteurella are classified into different taxa. P. multocida subsp.multocida is more frequently encountered than other subspecies of P. multocida. P. canis is only identified from wounds inflicted by animals. The frequency of isolation of different species and subspecies is comparable with that observed from animal isolates. The distribution of the strains in the capsular types is different according to the origin, human or animal, of the strains. PMID- 3550627 TI - [Toxicity of oxygen and (Cu) superoxide dismutase and (Mn) superoxide dismutase in newborn infants with respiratory distress. Preliminary results]. AB - Twelve premature newborns mechanically ventilated with high FiO2 for hyaline membrane disease were tested for SOD contents during their first two weeks of life. CuSOD and MnSOD were measured in plasma, platelets and red cells using a radioimmunology method. No correlation was found between FiO2 levels neither with CuSOD and MnSOD contents. Furthermore no correlation was found between the SOD contents, at birth, and the constitution of bronchopulmonary dysplasia (BPD). Our results don't prove any relationship between lack of SOD and BPD. BPD pathogeny is certainly plurifactorial. Other protecting systems against O2 toxicity are also known to play an important role. PMID- 3550628 TI - [Isolation of Streptococcus pneumoniae from genital samples. Discussion of its pathogenic role]. AB - Within an eleven month period (September 1984 to July 1985) fourteen Streptococcus pneumoniae were isolated from varied genital samples (vaginal secretions, IUD, placentas, sperms). The possible carriage and the pathogenicity of pneumococcus are examined. The outbreak of several pooled cases last year, pose a difficult problem. PMID- 3550629 TI - [Changes in the pharmacokinetics of theophylline during estrus in rats]. AB - The influence of menstrual cycle on drug kinetics is not largely documented. Concerning theophylline it was of interest to investigate whether or not the kinetics of this drug is modified throughout the oestrous cycle. Though the kinetics of this drug was assessed in adult Wistar female rats at different stages of the oestrous cycle: proestrous (P), oestrous (O) and diestrus (D). Our preliminary data clearly indicate statistically significant differences (p less than 0.01) of theophylline kinetic parameters such as elimination half-life: 8.70 +/- 0.60 h (P), 4.61 +/- 0.16 h (O) and 5.01 +/- 0.85 h (D), area under concentration versus time curve (AUC): 214.61 +/- 3.58 micrograms.h/ml (P), 128.64 +/- 9.64 micrograms.h/ml (O) and 165.57 +/- 23.86 micrograms.h/ml (D). These results agree with clinical data reported on the influence of estroprogestative drugs on theophylline kinetics in women (higher elimination half-life and lower clearance). In order to explain some of our findings the possible variations of theophylline protein binding and metabolism throughout the oestrous cycle are under investigation. PMID- 3550631 TI - [Causes of error in the study of fibrinogen clumping and the diagnosis of Staphylococcus aureus: Micrococci and Acinetobacter]. AB - Rapid presumptive identification of S. aureus, particularly on the agar slant of biphasic blood culture bottles can be performed by modified slide clumping factor tests. We compared two commercial reagents (Staphyslide and Staphaurex) using strains of "Gram-positive cocci arranged in clusters" (S. aureus, S. epidermidis, Micrococcus) or diplococci-like organisms such as Acinetobacter. Micrococcus and Acinetobacter can be responsible for false-positive reactions with sensitized or not sensitized particles. Control reactions with not sensitized particles or autoagglutination tests in water rather than saline must be performed. PMID- 3550630 TI - [Lymphocyte phenotyping in the cord blood of newborn infants]. AB - Ontogeny and development of phenotypically defined T-cell subsets in humans, are the source of controversy. Cord blood represents a relevant model for the study of the normal T-cell differentiation pathway. We identified T lymphocytes subsets with monoclonal antibodies (Mab) in human cord blood and adults controls in an indirect immunofluorescence assay and B lymphocytes in a direct immunofluorescence assay. No difference was noted between the two populations with followed Mab: CD3-CD4-CD8-HLA class II-IL2 receptor, with a normal ratio CD4 CD8. The percentage of CD2+ cells was lower in neonatal blood. Double labeling studies characterized a lymphocyte population CD4-CD8 positive. This study revealed absence of immature T cells with CD1 monoclonal antibodies. PMID- 3550633 TI - [Anomalies of coagulation and thromboembolic complications of nephrotic syndromes]. AB - Thrombo-embolic events remain one of the most serious complications in patients with nephrotic syndrome (NS). A causal relationship between coagulation abnormalities and the occurrence of thrombosis in NS has been searched. Several studies have demonstrated multiples abnormalities in the coagulation factors and platelets; however those studies did not provide adequate explanations for the thrombotic tendency of NS. This thrombotic tendency could be related to deficiency in natural coagulation inhibitors. Plasma ATIII level has been reported to be decreased both in some adults and children. Protein C is found normal or high in NS whereas protein S is increased. Nevertheless a possible decrease in functional protein S cannot be excluded. PMID- 3550632 TI - [Endogenous counterinflammation and immunostimulation]. AB - It is known since a century that inflammation is the cornerstone of the resistance against pathogens at the site of penetration. Recently, it has been shown that this beneficial effect can be found in a remote site. Furthermore, it is known that, at a distance from the site of inflammation, a decreased inflammatory reaction is observed: a counterinflammation. Concerning this counterinflammation it was found, at least in mice, that this antiinflammatory effect is equivalent or even superior to those of glucocorticoids. In mice, this counterinflammation effect is observed only 6 hours following the primo inflammation, occurs in absence of T lymphocytes and is not mediated with bioproducts of the arachidonic metabolism. The increased host resistance against pathogens occurs later (3-10 days). It is observed against fungi, bacteria, parasites and even tumour cells. Among the possible effectors of such an increased resistance, a protein was purified to homogeneity (MW = 56 Kd, pI = 5, electrophoretic mobility of the alpha 1 globulins. This protein is with interferon gamma the more potent immunostimulant. Other effectors are presently under investigation: there are proteins involved in hematopoiesis and the cytostasis of tumour cells. It is therefore evident that in the course of certain inflammatory reactions, several substances may act as potent endogenous drugs: they are true phlogautacoids. PMID- 3550634 TI - [Determination of fosfomycin in biological fluids by gas chromatography]. AB - A method in gas chromatography is proposed to determine fosfomycin in biological and bacterial or cellular culture medium. This technique is carried out on capillary column OV 17-01 after "Flash Methylation" with a thermionic detector. The detection limit is about 1 microgram per millilitre of serum for a trial assay of 100 microliters. His characteristics have been furthered. The treatment by antibiotics generally associated with fosfomycin don't cause any chromatographic interference for plasmatic assays. PMID- 3550635 TI - [Cellular and metabolic pharmacology: an aspect of vascular research]. PMID- 3550636 TI - [International symposium on the biological effects of molsidomine and its metabolites. Lyons, 9 September 1986]. PMID- 3550637 TI - [Effects of SIN-1 on the early phases of blood platelet activation]. PMID- 3550638 TI - [Effects of SIN-1 on the activation of phospholipase C and calcium mobilization induced by thrombin in blood platelets]. AB - Ca2+ influx, Ca2+ mobilization and phospholipase C activation have been determined in human platelets stimulated by thrombin in the presence of increasing concentrations of SIN-1. Preliminary data indicate a major inhibitory effect of SIN-1 on Ca2+ influx, but also a significant inhibition of phospholipase C. However, the decrease of serotonin secretion by SIN-1 seems to be more related to phospholipase C inhibition. These data are discussed in relation to the known effects of SIN-1 on cGMP content of platelets. PMID- 3550639 TI - [Effects of SIN-1, a metabolite of molsidomine, on paf-acether-blood platelets interactions]. AB - The metabolite of molsidomine, 3-morpholino-syndnonimine (SIN-1) is a vasodilator and an inhibitor of platelet activation induced by adenosine-5'-diphosphate (ADP), arachidonic acid (AA) and thrombin. We present the results of SIN-1 on platelet aggregation induced by paf-acether and on the biosynthesis of this mediator by washed rabbit platelets. SIN-1 inhibits submaximal platelet aggregation induced by 50 pM paf-acether. This inhibition is dose-dependent (SIN 1 IC50: 37 +/- 10 nM, n = 3). SIN-1 also inhibits submaximal aggregations induced by ADP (IC50: 13 +/- 11 nM) and AA (IC50: 26 +/- 12 nM) (n = 3-5). Finally, SIN-1 inhibits dose-dependently the formation of lyso paf-acether (the precursor of paf acether) and of thromboxane A2, and AA freeing by thrombin-stimulated platelets. Thus SIN-1 has a wide spectrum activity on platelets. He is both capable of inhibiting platelet aggregation induced by all used agonists and to inhibit the formation of paf-acether and thromboxane A2, two powerful mediators of platelet aggregation. PMID- 3550640 TI - [Effects of SIN-1 on the oxygenated metabolism of arachidonic acid in blood platelets and endothelial cells]. PMID- 3550641 TI - [Ex vivo study of blood platelet activation in healthy subjects or coronary disease patients after oral intake of molsidomine]. AB - Platelet activation (aggregation, serotonin release, TXB2 synthesis) was studied in 8 normal subjects and 5 patients with unstable angina before and after molsidomine treatment. Serotonin release was the most altered parameter after molsidomine treatment in the group of normal subjects. No significant effect could be detected in patients since platelet reactivity varied in a wide range. PMID- 3550642 TI - [Inhibition of the formation of platelet thrombus by molsidomine and SIN-1 in the mesenteric vessels rats]. AB - Molsidomine and SIN-1 were tested in a thrombosis model in which thrombi are produced in small mesenteric vessels. An interference contrast system based on a Leitz Orthoplan microscope was used to visualize thrombus formation. Vascular lesions were produced with a Coherent CR-Z supergraphite ion laser (Argon laser) in vessel of 20-30 micron diameter. Molsidomine and SIN-1 i.v. at doses of 0.1 and 0.5 mg/kg had a marked and significant antithrombotic effect in arterioles and in venules. Molsidomine at doses of 0.1 and 0.5 mg/kg had no antithrombotic effect 90 min following intravenous injection. PMID- 3550643 TI - [Inhibition of platelet functions by molsidomine in animals]. AB - The effect of molsidomine on platelet function has been studied in various experimental models. Molsidomine prevented mortality induced by arachidonic acid as well as thrombocytopenia induced by collagenase, the combination of collagen plus adrenaline, or PAF-acether. Arterial bleeding time was prolonged. Carotid or coronary artery thrombosis and jugular venous thrombosis were inhibited. These effects were obtained in various animal species and were dose-dependent. They suggest the administration of molsidomine for the prevention of thrombotic disorders. PMID- 3550644 TI - [Antithrombotic properties of the active metabolite of molsidomine, SIN-1]. AB - Molsidomine and its active metabolite SIN-1 were examined in humans and animals for their fibrinolytic and antithrombotic activity. In humans six and eight hours after ingestion of molsidomine retard (8 mg) a marked shortening of euglobulin clot lysis time was observed. Neither molsidomine nor SIN-1 activated fibrinolysis in vitro. In rabbits SIN-1 decreased the size of arterial and venous thrombus. Similar results were obtained with urokinase. PMID- 3550645 TI - [Effects of SIN-1 on the metabolism of arachidonic acid in vascular smooth muscle cells in culture]. AB - The effects of SIN-1 on the metabolism of Eicosanoids (prostaglandins, hydroxylated derivatives) were investigated in cultured arterial smooth muscle cells. These cells can use arachidonic acid in two different metabolic pathways involving cyclooxygenase and lipoxygenases activities and leading to the formation of prostaglandins (mainly PGI2) and hydroxylated derivatives (HHT and 11, 15, 12 and 5 HETES). Results shows that SIN-1 produces no modification in PGI2 production, whether under baseline conditions or in the presence of activators for the cell type under study. SIN-1 seems to have no direct action on the sequence of enzyme activities (cyclooxygenase, lipoxygenases). However, SIN-1 significantly alters the distribution of 14C arachidonic acid within membrane structures. PMID- 3550646 TI - [Effects of sydnonimines derivatives on the antithrombogenic activity of endothelial cells in culture]. AB - The antithrombogenic activity of vessels walls is a result of still incompletely elucidated properties of the single layer of endothelial cells. These properties have been approached as a body designated endothelial cell antithrombogenic activity (ECATA). We report herein that, under experimental and acute pharmacologic conditions, molsidomine, but not its main metabolite SIN-1, can produce very marked stimulation of this ECATA. Prostacyclin does not seem to be involved in these phenomena. This property may, in part, explain in vivo the antiplatelet activity of molsidomine. PMID- 3550647 TI - [Permeability of the barrier formations of the eye for native autogenous serum globulins in rabbits with neurogenic dystrophy]. PMID- 3550648 TI - [Reaction of the system of bone marrow fibroblast precursor cells to exposure to ionizing radiation]. PMID- 3550650 TI - Diagnosis and management of tinea capitis. PMID- 3550651 TI - Patterns of alcohol and drug use among adolescents. AB - Trends and patterns in adolescent use of alcohol and other drugs over the past two decades are described. The pediatrician's role in preventing and treating drug use is also discussed. PMID- 3550652 TI - Alcohol and adolescence. AB - Alcohol is the drug of choice for most substance-abusing adolescents and is the drug most often associated with teenage deaths. This article summarizes what is known about the inheritance of alcohol abuse, as well as the physical, developmental, psychosocial, and behavioral factors related to adolescent alcohol use. PMID- 3550649 TI - [Neoplastic membrane-toxic activity as one of the pathogenetic factors in blood cell and tumor growth changes]. PMID- 3550653 TI - Marijuana: an overview. AB - Marijuana is a crude, intoxicating drug that has become much more potent in the past decade. Adolescents intoxicated from marijuana suffer from impairment of short-term memory and automobile driving skills. The drug is easily detected in users by means of immunoassay analysis of urine specimens. Frequent use by young adolescents can impede normal maturation and cause or contribute to an amotivational syndrome. PMID- 3550654 TI - Cocaine. AB - This article discusses cocaine as America's leading illicit drug of abuse. Cocaine pharmacology, metabolism, and methods of administration are related to medical symptoms and complications of use. Reasons for increased use as well as signs suggestive of individual abuse are given, and treatment issues specific to cocaine are discussed. Urine testing for cocaine and other abused drugs is encouraged, and specific reliable techniques are suggested. PMID- 3550655 TI - The abuse of volatile substances. AB - Volatile substances have been used to alter consciousness since ancient times. Societal trends have brought forth one inhalant fad after another. It would be reasonable to expect this pattern to change as certain of the inhalants come under greater control or become less available (e.g., leaded gasoline). Experimentation with these agents among younger adolescents probably will continue, and for this reason, pediatric practitioners should be aware of the use of these agents and their potential toxicities. PMID- 3550656 TI - Hallucinogens. AB - This article describes the various hallucinogens with which adolescents may come in contact. Perspective is provided as to the importance of the various hallucinogens and to their effects on adolescent users. PMID- 3550657 TI - Stimulants and narcotic drugs. AB - This article focuses on the use of stimulant and narcotic drugs, as well as lookalike preparations that are subject to abuse. There is a brief discussion of the pharmacology of these agents, demographic use patterns, and treatment modalities. PMID- 3550658 TI - Understanding and deterring tobacco use among adolescents. AB - This article discusses the addictiveness of tobacco and the health consequences of chronic tobacco use. Personality, environmental, and behavioral factors that promote the initiation of cigarette smoking by adolescents are identified. Age specific interventions are suggested. PMID- 3550659 TI - Interviewing guidelines for the clinical evaluation of adolescent substance abuse. AB - Pediatricians can learn to assess adolescent patients' use of drugs and alcohol. Their most important task is to determine whether use of chemicals is causing behavioral impairment. A general psychosocial assessment of an adolescent's functioning is the most important component of an evaluation for substance abuse. It provides the foundation for determining whether behavioral dysfunction exists. The pediatrician should address several topical areas: family relationships, school performance and attendance, peer relationships, legal difficulties, leisure activities and employment, and self-perception. The chemical use history helps the pediatrician in two ways. In general, it helps to provide focus to the pediatrician's educational counseling about the risks of chemical use. It also helps the pediatrician to determine whether substance abuse is the cause of any behavioral dysfunction that the pediatrician may have discovered during the general psychosocial assessment. Strategies to enhance more accurate disclosure of substance use by adolescents include postponing this section of the interview until rapport has been developed with the teenager, ordering questions so that illicit substances are addressed later, exploring peer involvement with chemicals as an antecedent to discussing the adolescent's personal use, and using an historical perspective, so that the teenager is asked to describe his or her initial experience with each substance class prior to addressing current use patterns. Dysfunctional consequences of chemical use may present an opportunity for adolescents and their families to accept intervention. If the pediatrician believes that an adolescent patient would benefit from a formal treatment program, the following steps help to ensure successful completion of the referral. The pediatrician should first summarize information learned during the evaluation that is relevant to the problem behaviors. Try to outline the dysfunctional behavior in the context of chemical use. Communicate concern for the teenager's well-being. Provide information without moralizing or lecturing. Clarify your role as pediatrician. Try to personalize the referral process to prevent feelings of rejection by the adolescent and family. If necessary, provide concrete assistance to the family to facilitate the referral process. PMID- 3550660 TI - Psychiatric issues of adolescent chemical dependence. AB - Pediatricians, as well as other health care professionals, must always consider psychoactive drug use by adolescents as possible causes of general health or emotional problems, such as poor appetite, insomnia, problem behavior, academic underachievement, and loss of energy and motivation. Early diagnosis and intervention with youth can result in enormous benefits for the lives of the youth, families, and society. The physician must be alert to the adolescent who manifests such signs of abuse. This article details the recognition and management of these problems. PMID- 3550661 TI - Adolescent substance abuse: diagnostic and treatment issues. AB - For teenagers, substance use initiation peaks between 16 and 18 years of age, with the greatest use occurring over the subsequent four years, after which time there is a significant reduction in usage. Factors associated with adolescent substance abuse include rebelliousness, relative indifference to school, tolerance for social deviance, family disruption, parental tolerance of alcohol or other drug use, and early onset of drug use. One major problem for teenagers is that the diagnosis and treatment of adolescent substance abuse is based primarily on adult models of alcoholism. PMID- 3550662 TI - Iatrogenic causes of large pleural fluid collections in the premature infant: ultrasonic and radiographic findings. AB - Ten cases of large pleural collections, all of which were iatrogenically induced in premature infants, are presented. There were five instances of hypopharyngeal tears communicating with the right pleural space, three of chylothorax secondary to superior vena caval obstruction in patients undergoing total parenteral nutrition catheterization (TPN), and two of direct erosion by the inferior vena caval TPN catheter into the pleural space. Ultrasonography was most helpful in detecting these pleural collections. It is important to recognize the presence of pleural fluid in these infants as a marker of iatrogenic injury. PMID- 3550663 TI - Ultrasonography and computed tomography for diagnosis and follow-up of biliary duct rhabdomyosarcomas in children. AB - The authors report eight cases of biliary duct rhabdomyosarcoma in children, examined by US and CT. There were five boys and three girls, aged 2 to 17 years. At presentation, US demonstrates the tumor mass within the liver or the hepatic hilum; it allows measurement of it and defines the relationship with portal vessels, biliary tract and other important structures. CT complements the US evaluation and determines operability. As US and CT cannot assess the histological origin of the tumor, a biopsy is mandatory before treatment. If complete surgical excision does not seem possible, percutaneous biopsy is preferable to incomplete excision and its possible complications. During the follow-up period, US can be repeated to measure tumor regression under chemotherapy. After surgery, CT seems preferable because of gas interposition. Both US and CT proved to be valuable for the early detection of local recurrence. The prognosis of these tumors remains bad. However, with more aggressive and hopefully more efficient chemotherapy a precise evaluation of the tumor extension by US and CT is very important. Surgery will then be performed only on localized tumors or on residual masses after chemotherapy. PMID- 3550664 TI - Ultrasonography and computed tomography for diagnosis and follow-up of pelvic rhabdomyosarcomas in children. AB - The authors report 18 cases of pelvic rhabdomyosarcomas in children examined at presentation and followed on US and CT. There were 11 boys, 7 girls; tumor location was bladder, prostate or uterus in 12, perineum in 4, buttock in 2. US is good to define tumoral extension within the bladder CT is better to delineate the extension outside the bladder and regional spread to iliac nodes. CT is the only useful examination for perineal tumors. During chemotherapy US can be frequently repeated to appreciate tumoral regression and to give measurement of the mass. Preoperative CT should be performed when tumoral regression seems sufficient to permit complete tumoral excision without pelvic exenteration. Correlation between US and CT and surgical findings proved to be good. US and CT are also very useful in the follow-up when the child has finished treatment as it can demonstrate a local recurrence before clinical symptoms appear. However, post surgical and post-radiation changes may be difficult to recognize. These aspects are discussed. PMID- 3550665 TI - Renal metastases from neuroblastoma. Report of two cases. AB - Neuroblastoma is one of the pediatric cancers that has the most unpredictable evolution. It can metastasize to almost any organ, but intrarenal metastases have never been reported. We report 2 such cases: the first patient had a left adrenal neuroblastoma completely resected 10 months before routine follow up ultrasound and CT scan demonstrated 3 right intrarenal metastases. The second patient was being investigated for a left abdominal mass when one left intrarenal metastasis was found during the same CT scan. An intrarenal mass found during investigation for staging or follow up of neuroblastoma should then be considered as a metastase until proven otherwise. PMID- 3550667 TI - Interposition of the gallbladder--or the absent common hepatic duct and cystic duct. AB - Interposition of the gallbladder is a rare anomaly, but its diagnosis is important since it represents a surgically correctable cause of jaundice. The patients present with jaundice, abdominal pain and sometimes an enlarged gallbladder. Radiological diagnosis may be difficult since the condition may be mistaken for a choledochal cyst, hydrops of the gallbladder or Caroli's disease. The ultrasound, cholangiogram and surgical findings of dilated intrahepatic ducts adjacent to a normal or enlarged gallbladder with no dilatation of the common bile duct are presented in two children with this condition. PMID- 3550666 TI - Radiologic management of fluid collections in children. AB - Percutaneous catheter drainage procedures have become widely accepted in the management of intraabdominal fluid collections in adults. We report our experience in 12 children with 15 fluid collections who underwent 22 procedures and emphasize the usefulness of this procedure in the pediatric population. Thirteen fluid collections were cured by the procedure. One collection improved with the procedure but needed definitive surgical correction to effect a cure. One other patient with an intestinal fistula did not respond. The complicated nature of many of our cases coupled with the high cure rate (87%) and low complication rate (4.5%) makes percutaneous drainage an excellent alternative to surgical drainage under general anesthesia. PMID- 3550668 TI - Intra-renal reflux: a new cause of medullary hyperechogenicity? AB - A 5-month-old infant with untreated severe urinary tract infection and bilateral vesico-ureteral reflux, had diffuse intrarenal reflux and hyperechogenicity of the medulla of two normal sized kidneys. We discuss the hyperechogenicity of the medulla in relationship to the intrarenal reflux. PMID- 3550669 TI - Urinoma and arterial hypertension complicating neonatal renal candidiasis. AB - During antibiotic treatment for E. coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abscess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal. PMID- 3550670 TI - Serendipitous diagnosis of childhood xanthogranulomatous pyelonephritis in a child with osteomyelitis. AB - Xanthogranulomatous pyelonephritis (XGP), a rare chronic renal infection in children, usually presents as high fever, pyuria and an abdominal mass. This child with clinical and radiologic evidence of osteomyelitis was not suspected of renal disease until a non-functioning kidney was discovered during a bone scan. The pathologic proven diagnosis of XGP could have been made by correlative imaging using renal ultrasound, a renal scan and a gallium scan. Computed tomography and voiding cystourethrography provided additional information as to the nature and extent of the disease process. PMID- 3550671 TI - Computerized tomography and ultrasound in the diagnosis of cerebro-hepato-renal syndrome of Zellweger. AB - Renal cortical cysts were demonstrated by computerized tomography and ultrasound in a patient with cerebro-hepato-renal syndrome who did not have patellar calcifications. PMID- 3550673 TI - Neutrophil function in an experimental model of hemolytic uremic syndrome. AB - To understand the role of neutrophil leukocytosis in hemolytic uremic syndrome, we studied the changes in neutrophil function in the modified generalized Shwartzman reaction in rabbits. This model resembles hemolytic uremic syndrome associated with endotoxemia. At the end of an endotoxin infusion, we observed leukopenia, thrombocytopenia, and a decrease in hematocrit associated with schistocytosis. Plasma B-glucuronidase levels increased and this was associated with a decrease in neutrophil content of the enzyme. The chemotactic index and neutrophil aggregation to zymosan-activated serum were impaired compared to controls. The neutrophil procoagulant content increased after endotoxin infusion. The serum creatinine concentration and proteinuria increased in the endotoxin treated animals. The changes returned to normal by 48 h. Renal cortical malondialdehyde, a reflection of lipid peroxidation, was higher in the endotoxin treated animals than in the controls. We have shown enzyme release by neutrophils, impairment of chemotaxis and aggregation, increased procoagulant content in neutrophils, and evidence of lipid peroxidation in renal cortical tissue in this model. These observations raise the possibility that leukocytes may have a role in the pathogenesis of the hemolytic uremic syndrome. PMID- 3550672 TI - Dyskinetic cilia syndrome: clinical, radiographic and scintigraphic findings. AB - The clinical, electron microscopic and radiographic data of 9 patients with dyskinetic cilia syndrome (DCS) are presented. Scintigraphic evaluation of mucociliary dynamics in six patients showed evidence of dyskinesia. Ventilation and perfusion studies were performed to evaluate obstructive lung disease. Retrospectively, bronchiectasis could be detected in 77% of the patients by analysis of the chest radiograph and lung scintigraphy, and bronchography potentially avoided in the seven patients who underwent this procedure. PMID- 3550674 TI - Immunoglobulin administration and ribavirin therapy: efficacy in respiratory syncytial virus infection of the cotton rat. AB - We studied the effects of combined administration of human immunoglobulin (IVIG) and ribavirin aerosol on respiratory syncytial virus (RSV) infection in cotton rats (Sigmodon hispidus). Cotton rats assigned to receive combined therapy were administered Gamimune, a preparation of purified IVIG with a high titer of anti RSV neutralizing activity, intraperitoneally 24 h prior to intranasal RSV challenge and then treated with ribavirin aerosol 3 days after challenge. Lung viral titers from these cotton rats (geometric mean titers [GMT] log10 = 0.15 +/- 0.5) were lower than titers from untreated animals (GMT, log10 = 3.7 +/- 0.6) and animals treated with either IVIG alone (GMT, log10 = 1.8 +/- 0.9) or ribavirin alone (GMT, log10 = 1.9 +/- 1.1). Only one of 12 cotton rats treated with both IVIG and ribavirin had a demonstrable titer of virus after RSV challenge. When IVIG administration was delayed until day 3 after virus challenge, lung viral titers were still lowest in animals receiving both IVIG and ribavirin. In comparison, there was no additive antiviral effect between IVIG and ribavirin against RSV infections of HEp-2 cells in vitro. Pathologic changes on histologic examination of pulmonary tissues from animals challenged with RSV were least prominent in animals treated with both IVIG and ribavirin. Despite the apparent absence of in vitro additive antiviral effect, combined use of IVIG and ribavirin was more efficacious against RSV infection in the cotton rat than use of either agent alone. PMID- 3550675 TI - Efficacy of human immunoglobulin and penicillin G in treatment of experimental group B streptococcal infection. AB - In an effort to develop more effective therapy for neonatal group B streptococcal infections, penicillin G and human immune serum globulin (ISG), alone and in combination, were evaluated for their therapeutic efficacy against experimental group B streptococcal bacteremia and meningitis in newborn rats. Infected rats received either penicillin G (200 mg/kg/day), ISG (2 g/kg) or penicillin G (200 mg/kg/day) + varying doses of ISG (0.25 to 2 g/kg). All animals receiving ISG alone died; otherwise, mortality rates did not differ significantly (17-30%). Therapy with penicillin G alone and in combination with ISG was equally effective in completely eradicating group B streptococcal from blood and cerebrospinal fluid. However, combinations of penicillin G and ISG were significantly more beneficial than penicillin G alone, as shown by a significantly lower incidence of bacteremia at the end of 1 day of therapy and by greater opsonophagocytic activity in sera of animals receiving penicillin G + ISG. These findings indicate that administration of ISG in conjunction with penicillin G rapidly clears bacteria from blood, suggesting that ISG may be a useful adjunct to antimicrobial therapy of neonatal group B streptococcal disease. PMID- 3550676 TI - [Zaditen in the treatment of children with allergies]. PMID- 3550677 TI - [Difficulties in establishing the final diagnosis of mediastinal tumor in a 9 year-old boy]. PMID- 3550678 TI - [Tadeusz Zelenski-Boy as a pediatrician]. PMID- 3550679 TI - Aerosolized ribavirin in the treatment of patients with respiratory syncytial virus disease. AB - Thirty children 1 to 33 months of age were enrolled in a study of aerosolized ribavirin therapy for respiratory syncytial virus lower respiratory tract illness. Twenty patients received ribavirin and 10 received placebo. There were no significant differences between the groups in chronologic or gestational age or in days of illness prior to admission. Among patients with pneumonia 17% of 6 placebo patients vs. 64% of 11 ribavirin patients had radiographic evidence that multiple lung lobes were affected (P = 0.06). Placebo patients received 42.5 to 94.7 hours (mean, 58.6) of aerosol therapy, whereas ribavirin patients received 36.3 to 95.6 hours (mean, 55.7). Seventy-seven percent of all study patients were discharged within 5 days of starting treatment. Severity of illness was evaluated daily using a scale of 0 (normal) to 4+ (most severe). Ribavirin patients initially had a mean severity score 0.5 higher than placebo patients. By Day 2, their rate of improvement was significantly greater than that of placebo patients (P = 0.001). By Day 5, 36% of ribavirin patients with rales showed improvement, whereas rales persisted in 100% of placebo patients. The rate of improvement of oxygen saturation from first to last day of treatment was statistically significant only for ribavirin patients (P = 0.02). On Day 3, 65% of ribavirin patients (13) vs. 50% (5) placebo patients shed 10(-0.5) 50% tissue culture infective dose virus per 0.2 ml of nasal wash. No side effects or toxicity were associated with aerosol therapy. A short course of ribavirin treatment (approximately 3 days) proved safe and beneficial. PMID- 3550680 TI - Evaluation of a commercially available latex agglutination test for rapid diagnosis of group B streptococcal infection. AB - We studied the clinical value of Wellcogen, a latex particle agglutination test designed to diagnose rapidly Group B streptococcal infections in 620 infants. The sensitivity and specificity were 18 of 20 (90%) and 18 of 22 (81%), respectively. False negatives were documented in 2 patients and false positive tests occurred in 4. Also 10 of 620 (1.6%) infants had detectable antigen in the absence of proved infection. In addition, in 4 other infants with Group B streptococcal bacteremia, antigenemia was absent in serum obtained on the day of hospitalization but antigen was detected in specimens obtained subsequently. We also assayed the sera of 102 randomly chosen hospitalized adults; 4 (4%) contained "antigen" but none had Group B streptococcal infection. None of 50 urines obtained from other randomly chosen hospitalized adults contained "antigen." In patients with Group B streptococcal meningitis cerebrospinal fluid and unconcentrated urine uniformly contained antigen but in bacteremia without focality, assay of blood and urine were both necessary to diagnose correctly all 7 patients with the Wellcogen test. We conclude that despite acceptable sensitivity and specificity, the interpretation of the Wellcogen test must be performed with caution and knowledge of its limitations. PMID- 3550681 TI - [Treatment of diabetes mellitus in children and adolescents with monopeak insulin]. PMID- 3550682 TI - [Features of the oxygen metabolism and lysosomal secretion of the polymorphonuclear leukocytes of premature infants]. PMID- 3550683 TI - [Pathogenesis of chronic bronchopulmonary processes]. PMID- 3550684 TI - Penicillins and cephalosporins. Physicochemical properties and analysis in pharmaceutical and biological matrices. AB - Penicillins and cephalosporins belong to the most prescribed antibiotics. Despite the relatively extended knowledge of these drugs, the qualitative and quantitative analysis of the compounds still gives rise to many problems. These difficulties are due to the chemical instability of the common beta-lactam nucleus, the minor differences in chemical structures between the analogues, and the complex and relatively fast degradation of the compounds in aqueous solutions. In this review a compilation of the physicochemical properties, the degradation routes and methods for analysis of these substances in biological and other matrices is presented. PMID- 3550686 TI - Home care agencies and community health services accredited by NLN October 1986. PMID- 3550687 TI - 1987 directory of educational software for nursing. PMID- 3550685 TI - Doctoral programs in nursing 1986-87. PMID- 3550688 TI - The effect of mastitis on milk progesterone concentration in dairy cows. AB - A within cow comparison was made between milk progesterone levels in healthy and mastitic quarters. Material was collected from cows with mastitis induced by bacterial inoculation, or by inoculation with bacterial endotoxin. Furthermore material from cows with spontaneous subclinical mastitis was used. Milk progesterone levels were lowered due to mastitis. However, the decrease was not large enough to cause misinterpretation of where in the oestrous cycle (luteal phase or non-luteal phase) the samples were taken. PMID- 3550689 TI - [Pregnancy diagnosis in thoroughbred mares using radioimmunoassay (RIA), enzyme immunoassay (kit) and ultrasound echography (scanning)]. AB - On the basis of progesterone determination on plasma or blood after RIA and the kit method respectively and consecutive scanning performed on a total number of 31 mares the following features were demonstrated: The overall material shows that in 20 mares (64.5%) embryonic vesicles were demonstrated. Of these mares 16 have conceived after service in the 1st estrous cycle and 3 mares in the 2nd estrous cycle. 18 mares were scanned in the time interval 13th-26th day after the latest service, while 2 mares were scanned on day 46 and 41 respectively. A total of 14 scanning positive mares were examined for progesterone by the RIA as well as by the kit method. For these mares (100%) agreement was found between the progesterone analyses as well as with the scanning results. For 19 mares (100%) there was agreement between kit and scanning results. 15 RIA progesterone determinations are in agreement with the scanning results. Progesterone values after the RIA method performed on 15 scanning positive mares were in average 8.40 +/- 2.79 ng/ml plasma. A total of 9 out of 10 scanning negative mares have been examined by the RIA as well as by the kit method. In 6 of these mares with 7 estrous cycles agreement has been found between progesterone analyses and the scanning results (77.8%). In 2 mares (no. 2 and 4) discrepancy has been found in the 2nd estrous cycle between RIA, kit and scanning results. For 1 mare (no. 7) discrepancy has been found in the 1st and 3rd estrous cycle between RIA and scanning.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550690 TI - Progress and perspectives of systemic anticancer treatment. AB - Cancer chemotherapy embodies an expanding breadth of molecular and biological disciplines and is evolving from approaches based solely on DNA synthesis to include approaches based on a vast number of cellular factors that may differ between malignant and normal tissues. These factors include response to growth factors, antigenic determinants on cell membranes, the ability to respond to signals of differentiation and/or proliferation, and the ability to stimulate cytotoxic recognition responses. Concurrently, the use of agents designed to interfere with DNA synthesis has led to a better understanding of the molecular events that cause drug resistance. The use of these drugs demonstrated that mechanisms operating in antimetabolite resistance may be quite different from those operating in resistance to alkylating agents. Further, multiple changes may frequently coexist in the same cells. Conceptual advances in the area of drug resistance continue to support the long-held concept that the probability of cure is greatest when the tumor burden is small. National Cancer Institute efforts in drug discovery are now designed to explore these recent developments using screening systems that employ human tumors that are usually resistant to therapy. This approach is expected to contribute substantially to the ability to cure malignant disease. PMID- 3550691 TI - Monocytes and vascular lesions. AB - Current literature has shown increasing indications of the involvement of monocytes in the generation of vascular lesions and atherosclerosis. Such involvement appears to be mediated by the ability of monocytes to disrupt the integrity of blood vessel wall, initiate and accelerate blood coagulation processes and/or regulate the growth pattern of blood vessel wall cells. At least in two pathological situations, namely hypercholesterolemia and diabetes mellitus, the association between monocytes and atherogenesis is strongly indicated. PMID- 3550692 TI - [Expansion of erythropoiesis and granulopoiesis after bone marrow grafts]. AB - Erythropoietic and granulopoietic expansion after bone marrow transplantation (BMT) are reviewed in 60 allogeneic and autologous BMT. Morphological dyserythropoiesis was more prominent than dysgranulopoiesis. Dyserythropoiesis was present with increased HbF synthesis and i antigen expression. We did not find nocturnal paroxysmal hemoglobinuria and leukocytic alkaline phosphatase level was high. CFU-GM progenitors were still reduced in number 1 year after BMT. The clusters/colonies ratio, increased at day 12 after BMT was normal by day 100. No difference between autologous and allogeneic BMT was observed. PMID- 3550693 TI - [Value of ultrasonics in diagnosing the onset of lymphomatous liver lesions]. AB - Ultrasound and anatomic findings were compared in 128 cases of lymphoma [87 non Hodgkin lymphomas (NHL), 41 Hodgkin's disease (HD). Lymphomatous or other hepatic anomalies were observed in 40 cases (33 NHL, 7 HD). The 33 NHL lesions included 22 lymphomatous sites and 13 non-lymphomatous pathologies (in particular 5 biliary cysts and 4 cavernous liver hemangiomas). The 7 cases of hepatic anomalies in patients with HD included 6 specific disease sites and 1 cavernous hemangioma. For NHL, the sensitivity of ultrasonography in our series was 72.7% and the specificity 97%. In HD, the sensitivity was 66.6% and the specificity 100%. The value of ultrasound for the detection of lymphomatous liver lesions appears comparable to the results obtained with CT published in the literature; ultrasonography should thus be the first examination performed for subdiaphragmatic exploration during the investigation and follow-up of lymphomas. PMID- 3550694 TI - In vitro construction of yeast tRNAAsp variants: nucleotide substitutions and additions in T-stem and T-loop. AB - A procedure for the construction of 3'-end labelled yeast tRNAAsp harboring substitutions or additions of any desired nucleotide in T-stem and T-loop (position 57 to 61) has been developed. This was done by in vitro enzymatic manipulations of the yeast tRNAAsp involving specific hydrolysis with RNases, phosphorylation and dephosphorylation with T4 polynucleotide kinase and ligation with T4 RNA ligase. Using this procedure we have replaced conserved or semi conserved nucleotides located in position 57 to 61 of yeast tRNAAsp. We have also constructed different yeast tRNAAsp with eight bases instead of seven in T-loop. Further use of these tRNAAsp variants will be discussed with the help of the crystallographic three-dimensional structure. PMID- 3550695 TI - The complete nucleotide sequence of the ilvGMEDA operon of Escherichia coli K-12. AB - In this report we present the complete nucleotide sequence of the ilvGMEDA operon of Escherichia coli. This operon contains five genes encoding four of the five enzymes required for the biosynthesis of isoleucine and valine. We identify and describe the coding regions for these five structural genes and the structural and functional features of the flanking and internal regulatory regions of this operon. This new information contributes to a more complete understanding of the overall control of the biosynthesis of isoleucine and valine. PMID- 3550696 TI - Karyotype comparison between P. chabaudi and P. falciparum: analysis of a P. chabaudi cDNA containing sequences highly repetitive in P. falciparum. AB - The molecular karyotypes of P. chabaudi and P. falciparum have been compared by pulse field gradient electrophoresis. P. chabaudi has 3 extra chromosomes in the 750-2000 Kb range although the overall number appears to be 14 as is the case for P. falciparum. The chromosomal location of the rRNA genes has been determined for P. chabaudi together with that of a 24 Kd antigen gene. The corresponding cDNA 443 may code for a protein unusually rich in tyrosine and contains sequences highly repetitive in P. falciparum. PMID- 3550698 TI - Messenger RNA stability in Saccharomyces cerevisiae: the influence of translation and poly(A) tail length. AB - A comparison between the half-lives of 10 specific yeast mRNAs and their distribution within polysomes (fractionated on sucrose density gradients) was used to test the relationship between mRNA translation and degradation in the eukaryote Saccharomyces cerevisiae. Although the mRNAs vary in their distribution across the same polysome gradients, there is no obvious correlation between the stability of an mRNA and the number of ribosomes it carries in vivo. This suggests that ribosomal protection against nucleolytic attack is not a major factor in determining the stability of an mRNA in yeast. The relative lengths of the poly(A) tails of 9 yeast mRNAs were analysed using thermal elution from poly(U)-Sepharose. No dramatic differences in poly(A) tail length were observed amongst the mRNAs which could account for their wide ranging half-lives. Minor differences were consistent with shortening of the poly(A) tail as an mRNA ages. PMID- 3550699 TI - Mono- through hexanucleotide composition of the Escherichia coli genome: a Markov chain analysis. AB - Several statistical methods were tested for accuracy in predicting observed frequencies of di- through hexanucleotides in 74,444 bp of E. coli DNA. A Markov chain was most accurate overall, whereas other methods, including a random model based on mononucleotide frequencies, were very inaccurate. When ranked highest to lowest abundance, the observed frequencies of oligonucleotides up to six bases in length in E. coli DNA were highly asymmetric. All ordered abundance plots had a wide linear range containing the majority of the oligomers which deviated sharply at the high and low ends of the curves. In general, values predicted by a Markov chain closely followed the overall shape of the ordered abundance curves. A simple equation was derived by which the frequency of any nucleotide longer than four bases in the E. coli genome (or any genome) can be relatively accurately estimated from the nested set of component tri- and tetranucleotides by serial application of a 3rd order Markov chain. The equation yielded a mean ratio of 1.03 +/- 0.94 for the observed-to-expected frequencies of the 4,096 hexanucleotides. Hence, the method is a relatively accurate but not perfect predictor of the length in nucleotides between hexanucleotide sites. Higher accuracy can be achieved using a 4th order Markov chain and larger data sets. The high asymmetry in oligonucleotide abundance means that in the E. coli genome of 4.2 X 10(6) bp many relatively short sequences of 7-9 bp are very rare or absent. PMID- 3550700 TI - The effect of codon usage on the oligonucleotide composition of the E. coli genome and identification of over- and underrepresented sequences by Markov chain analysis. AB - As shown in the accompanying paper (5), the oligonucleotide composition of the E. coli genome is highly asymmetric for sequences up to 6 bp in length when ranked from highest to lowest abundance. We show here that this largely reflects codon usage because heavily used codons were found in the highly abundant oligomers whereas rarely used codons, with some exceptions, occurred in sequences in low abundance. Furthermore, linear regression analysis revealed a strong correlation between the frequencies of each trinucleotide and its usage as a codon. Dinucleotides are also not randomly distributed across each codon position and the dinucleotide composition of genes that are transcribed but not translated (rRNA and tRNA genes) was highly related to that seen in genes encoding polypeptides. However, 45 tetra-, 8 penta-, and 6 hexanucleotides were significantly over- or underabundant by Markov chain analysis and could not be accounted for by codon usage. Of these underrepresented sequences, many were palindromes, including the Dam methylation site. PMID- 3550697 TI - Analysis of E. coli promoter sequences. AB - We have compiled and analyzed 263 promoters with known transcriptional start points for E. coli genes. Promoter elements (-35 hexamer, -10 hexamer, and spacing between these regions) were aligned by a program which selects the arrangement consistent with the start point and statistically most homologous to a reference list of promoters. The initial reference list was that of Hawley and McClure (Nucl. Acids Res. 11, 2237-2255, 1983). Alignment of the complete list was used for reference until successive analyses did not alter the structure of the list. In the final compilation, all bases in the -35 (TTGACA) and -10 (TATAAT) hexamers were highly conserved, 92% of promoters had inter-region spacing of 17 +/- 1 bp, and 75% of the uniquely defined start points initiated 7 +/- 1 bases downstream of the -10 region. The consensus sequence of promoters with inter-region spacing of 16, 17 or 18 bp did not differ. This compilation and analysis should be useful for studies of promoter structure and function and for programs which identify potential promoter sequences. PMID- 3550701 TI - Two transcriptional start sites found in the promoter region of Escherichia coli glutamine permease operon, glnHPQ. PMID- 3550702 TI - Identification and DNA sequence of an interspersed repetitive DNA element in the genome of the miniature swine. PMID- 3550703 TI - Purification and characterization of 3-methyladenine DNA glycosylase I from Escherichia coli. AB - We have purified 3-methyladenine DNA glycosylase I from Escherichia coli to apparent physical homogeneity. The enzyme preparation produced a single band of Mr 22,500 upon sodium dodecyl sulphate/polyacrylamide gel electrophoresis in good agreement with the molecular weight deduced from the nucleotide sequence of the tag gene (Steinum, A.-L. and Seeberg, E. (1986) Nucl. Acids Res. 14, 3763-3772). HPLC confirmed that the only detectable alkylation product released from (3H)dimethyl sulphate treated DNA was 3-methyladenine. The DNA glycosylase activity showed a broad pH optimum between 6 and 8.5, and no activity below pH 5 and above pH 10. MgSO4, CaCl2 and MnCl2 stimulated enzyme activity, whereas ZnSO4 and FeCl3 inhibited the enzyme at 2 mM concentration. The enzyme was stimulated by caffeine, adenine and 3-methylguanine, and inhibited by p hydroxymercuribenzoate, N-ethylmaleimide and 3-methyladenine. The enzyme showed no detectable endonuclease activity on native, depurinated or alkylated plasmid DNA. However, apurinic sites were introduced in alkylated DNA as judged from the strand breaks formed by mixtures of the tag enzyme and the bacteriophage T4 denV enzyme which has apurinic/apyrimidinic endonuclease activity. It was calculated that wild-type E. coli contains approximately 200 molecules per cell of 3 methyladenine DNA glycosylase I. PMID- 3550705 TI - The major ras induced protein in NIH3T3 cells is cathepsin L. PMID- 3550704 TI - Sequences of three minor tRNAsArg from E. coli. PMID- 3550707 TI - Inhibition of DNA chain elongation by N4-aminocytosine-bisulfite adduct on template. PMID- 3550706 TI - Chemical synthesis of the T4 endonuclease V gene and its expression in Escherichia coli. AB - A gene coding for T4 endonuclease V was constructed by joining chemically synthesized oligodeoxyribonucleotides. This gene was inserted into an expression vector and expressed in E. coli. PMID- 3550708 TI - Synthesis of a mutagenic nucleoside, 2'-deoxy-2-(p-nitrophenyl)-adenosine. AB - The reaction of 2-amino-6-chloropurine riboside with i-amyl nitrite in benzene in the presence of Cu2O, followed by treatment with NH3/MeOH gave 2-phenyladenosine (1). The crude sample of 1 was found to be mutagenic to bacteria (Salmonella typhimurium TA 98 and TA 100, without metabolic activation). When this material was subjected to high pressure liquid chromatography, the mutagenic activity was found only in contaminating minor components, whose structures were assigned as 2 (m- and p-nitrophenyl)-adenosines (2m,p). In order to study structure-activity relationships, several nucleoside and base analogues were synthesized. Among them, 2'-deoxy-2-(p-nitrophenyl)-adenosine (8) was the most potent mutagen as tested either with TA 98 or TA 100. PMID- 3550710 TI - A new method for DNA surface-property display and its application to E. coli promoter sequences. AB - A personal computer program to visualize and compare the property of double stranded DNA surface has been developed. Comparison of the surface property between Watson-Crick base-pairs in B-form DNA has elucidated that the base-pair replacement between a "degenerated base-pairs" conserves the pattern of potential hydrogen-bonding sites in both major and minor grooves. The idea of the "degenerated base-pairs" was applied for the problem of the base-sequence variation from the consensus sequence in the -35 region of E. coli promoter. The sequence variation is found to have tendency to occur among the degenerated base pairs. PMID- 3550709 TI - Misreading of 8-hydroxydeoxyguanosine-containing DNA in in vitro DNA replication. PMID- 3550711 TI - Differential scanning calorimetric and theoretical studies of ColE1 DNA. AB - The differential scanning calorimetry (DSC) of plasmid ColE1 DNA was carried out. The DSC curve under the solvent condition of 1.0 X SSC buffer gave eleven clear peaks over the temperature range of 83 to 98 degrees C. The DSC curves obtained here were essentially in good agreement with the optical melting curves of ColE1 DNA reported previously. The theoretical melting profiles of ColE1 DNA calculated from its entire nucleotide sequence showed a good agreement with the DSC curves. The theoretical analysis made by constructing the thermal stability map showed that there was the positional correlation between the boundaries of the cooperatively melting regions and the ends of the protein coding regions of genes of ColE1. It was shown that the helix-coil transition of many of the small genes had a single cooperatively melting region. However, the large genes such as cea and mob3 had two or more cooperatively melting regions. It was suggested that this is closely related to the domain structures of the proteins encoded by such genes. PMID- 3550712 TI - Campaigns of a Victorian lady. PMID- 3550713 TI - Helping hands. An equal place. PMID- 3550715 TI - Read the instructions! PMID- 3550714 TI - Organ transplants. Looking after Jodi. PMID- 3550716 TI - Midwives' Journal. Perineal suturing. PMID- 3550717 TI - Computers in Nursing News. Programming self-awareness. PMID- 3550719 TI - Documentation of a research report. PMID- 3550718 TI - The importance of the ratio of lithocholic to deoxycholic acid in large bowel carcinogenesis. PMID- 3550720 TI - [Modification of the method of quantitative evaluation of microorganisms in the sputum of patients with respiratory tract infections]. PMID- 3550721 TI - Lumbar puncture in the presence of increased intracranial pressure: the real danger. AB - Examination of cerebrospinal fluid remains a mainstay of the diagnosis of many acute central nervous system illnesses, including meningitis, encephalitis, and polyneuropathies such as Guillain-Barre syndrome. Although generally considered innocuous, there may be considerable danger when lumbar puncture is performed in the presence of increased intracranial pressure, especially when a mass lesion is present. We review the literature surrounding the danger of lumbar puncture when intracranial pressure is increased and discuss our approach to the problem in lieu of the advent of computerized tomographic scanning. PMID- 3550722 TI - Submersion injury in children. AB - After prevention, of all the elements in the care of the drowned child, none is more important than the early institution of respiration and appropriate resuscitation. Observation of the asymptomatic patient with any history of alteration of consciousness or respiration during a drowning accident for at least 12 to 24 hours is mandatory. Because of uncertainties regarding outcome, particularly in the presence of hypothermia, vigorous emergency department resuscitation of all drowning victims is advisable, regardless of presentation. However, it may prove that emergency department assessment of such patients, following successful cardiopulmonary resuscitation, is a prognostic indicator of great importance in dictating further care. Transfer of these severely injured patients to a pediatric referral center where intracranial pressure monitoring and intensive support are available offers the best hope. Provisions for psychosocial support and follow-up for family members are essential. PMID- 3550723 TI - Effect of hypophysectomy and growth hormone replacement on hypothalamic GHRH. AB - Long-term (7 and 14 days) hypophysectomy resulted in a striking decrease in growth hormone releasing hormone-like immunoreactivity (GHRH-LI) in the median eminence (ME) of adult male rats, evaluated by both radioimmunoassay and immunohistochemistry. Treatment with human GH (125 micrograms/rat, twice daily IP for 14 days) prevented, though partially, depletion of GHRH-LI from the ME, as assessed by both methods. These results demonstrate that circulating GH levels regulate the function of GHRH-producing structures, via a feedback mechanism. PMID- 3550724 TI - Copper deficiency in rats increases pancreatic enkephalin-containing peptides and insulin. AB - Free enkephalins (enk) and higher molecular weight enkephalin-containing peptides (enk-c-p) are present in the endocrine pancreas of rats, presumably in B cells. To determine whether these opioid peptides show dynamic alterations as insulin content of pancreas changes, we utilized a copper deficient rat model, in which the exocrine pancreas atrophies and the endocrine pancreas is "intact" and insulin (IRI) content increases. Dietary copper deficiency (-C) was produced in weanling male rats for 4 and 7 weeks. The deficient and copper supplemented (+C) groups were further subdivided to receive all dietary carbohydrate as either 62% fructose (F) or 62% starch (S). -CF rats showed the most severe deficiency. After 7 weeks, total units of pancreatic IRI in -CF were 7.5 +CF 2.1, -CS 7.9 and in +CS 2.8 (p less than 0.001). Pancreatic content of Met5- and Leu5-enk was measured in extracts which were purified on C-18 Seppaks with and without prior treatment with trypsin and carboxypeptidase B. -C animals showed progressive, significant increases in pancreatic content of Leu-enk-c-p, with a decrease in free Leu- and Met-enk (p less than 0.02-0.01). The pancreatic findings are compatible with a co-localization of enkephalins and insulin in the endocrine pancreas and are suggestive of co-regulation. PMID- 3550725 TI - Identification of diverse molecular forms of GnRH in reptile brain. AB - Gonadotropin-releasing hormone (GnRH) molecular forms in the brains of three reptiles, Alligator mississippiensis (alligator), Calcides ocellatus tiligugu (skink) and Podarcis s. sicula (lizard) were characterized by high performance liquid chromatography (HPLC) and radioimmunoassay with region-specific antisera, and by assessment of luteinizing (LH)-releasing activity in chicken dispersed pituitary cells. In alligator brain two GnRHs had identical properties to the two known forms of chicken hypothalamic GnRH (Gln8-GnRH and His5,Trp7,Tyr8-GnRH) in their elution on two reverse phase HPLC systems, cross-reaction with region specific GnRH antisera, and ability to release LH. In skink brain, one immunoreactive and bioactive GnRH form, which eluted in the same position as His5,Trp7,Tyr8-GnRH on reverse phase HPLC, was identified. Three bioactive and immunoreactive GnRHs were detected in lizard brain. One form had similar properties to salmon brain GnRH (Trp7,Leu8-GnRH). The other two GnRH-like peptides are novel forms. One of these forms eluted in the same position as Gln8 GnRH on HPLC but had different immunological properties, while the third form was a rather hydrophobic species which appeared to be modified in the middle region of the molecule. PMID- 3550726 TI - Delta-sleep-inducing peptide (DSIP): an update. AB - The isolation and characterization of delta-sleep-inducing peptide (DSIP) achieved from 1963 to 1977 were reviewed in 1984. The first reports describing sleep as well as extra-sleep effects of DSIP also were included in that work. Only two years later, much additional literature concerning DSIP has accumulated. Besides further sleep-inducing and/or -supporting effects of DSIP in animals, considerable work has been carried out to evaluate the potential use of the peptide for therapeutic purposes such as treatment of insomnia, pain, and withdrawal. Immunohistochemical as well as radioimmunochemical studies provided further insights into the natural occurrence of the nonpeptide and the distribution of DSIP-like material in the body, suggesting possible relations of the peptide to certain diseases. Various physiological functions of DSIP and a possible mechanism of action involving the modulation of adrenergic transmission remain to be established. PMID- 3550727 TI - Localization of melanin-concentrating hormone-like immunoreactivity in the brain and pituitary of the frog Rana ridibunda. AB - The distribution of melanin-concentrating hormone (MCH) in the central nervous system of the frog Rana ridibunda was determined by the indirect immunofluorescence technique using antibodies against synthetic salmon MCH, generated in rabbits. The most prominent group of MCH-like containing perikarya was detected in the preoptic nucleus. Comparatively, a moderate number of cell bodies was observed in the dorsal infundibular nucleus and in the ventral thalamic area. Brightly immunofluorescent nerve bundles were found in the preoptic nucleus and in the ventral infundibular nucleus, coursing towards the internal zone of the median eminence and the pituitary stalk. An intense network of immunofluorescent fibers was localized in the neural lobe of the pituitary. The subcellular localization of MCH-like material was studied in the neurohypophysis using the immunogold technique. It was demonstrated that MCH-like material was contained in dense core vesicles (80-90 mm in diameter) within specific nerve terminals. The present findings indicate that, in amphibians, MCH like peptide is located in specific hypothalamic neurons. Our data suggest that MCH may be released by neurohypophyseal nerve endings as a typical neurohormone. PMID- 3550728 TI - The effect of peripheral administration of peptides on food intake, glucose and insulin in wolf pups. AB - In the studies reported here we demonstrate that bombesin decreases food intake in wolf (Canis lupus) pups without altering glucose or insulin levels. A high dose of cholecystokinin-octapeptide (CCK, 5 micrograms/kg) decreased food intake. CCK produced a transient increase in insulin, without altering glucose. Glucagon (0.5 mg/kg) failed to decrease food intake despite producing a marked hyperglycemia and hyperinsulinemia. Calcitonin was ineffective at decreasing food intake, although it did decrease the time spent feeding. These studies suggest a potential role for peripheral peptides in food regulation in the wolf. PMID- 3550729 TI - [Ultrasonographic examination of the breasts]. PMID- 3550730 TI - [Idiopathic internal fistulas of the digestive tract]. PMID- 3550732 TI - [Paramagnetic fluids as contrast media in NMR tomography]. PMID- 3550731 TI - [Role of ultrasonic examination in the diagnosis of lesions of the transplanted kidney]. PMID- 3550733 TI - [Constant magnetic field as a pathogenetic factor in NMR tomography]. PMID- 3550734 TI - [Pancreatic calcinosis and kidney calculi in the roentgenologic picture]. PMID- 3550735 TI - Progress in radiologic examination of the temporomandibular joint. PMID- 3550736 TI - [Availability of roentgenologic examination at the level of health care units]. PMID- 3550737 TI - [Indications for tomocisternography in patients with communicating internal hydrocephalus]. PMID- 3550738 TI - [Ear examination in children. Attempts standardization]. PMID- 3550739 TI - [Diagnostic efficacy of zonography in examining the facial bones]. PMID- 3550740 TI - [Our evaluation of radioisotope angiocardiography in the diagnosis of intracardiac left-to-right shunts]. PMID- 3550741 TI - [Ultrasonographic examination and fine-needle aspiration biopsy in the diagnosis of cold thyroid nodule]. PMID- 3550742 TI - [Effect of nifedipine on polymyxin B-induced bronchial spasm in patients with atopic asthma]. PMID- 3550743 TI - [Changes in the principles of cardiopulmonary resuscitation]. PMID- 3550744 TI - [Treatment of advanced stomach cancer]. PMID- 3550745 TI - [Hypoglycemia in insulin-dependent diabetes mellitus]. PMID- 3550746 TI - [Evaluation of insulinemia in persons with peptic ulcer and obesity]. PMID- 3550747 TI - Role of the altered transmural permeability in the pathomechanism of arteriosclerosis. History of arteriosclerosis theories. Role of the altered permeability in experimental arteriosclerosis models. AB - After presenting an overview on classification and history of arteriosclerosis theories, the physiological factors involved in the transmural permeability of the arteries are discussed in detail. The development and characteristic features of the altered transmural permeability were studied in various experimental models such as in rat's hypercholesterolemia, local aortic hypoxia, lymphedema of the vascular wall and in hypertension. Results appear to show that alterations in permeability invariably developed in all of the pathological conditions examined, they were transient in nature and preceded the onset of intimal proliferation(s). The disturbance of transmural permeability might be the common pathologic clue which initiates uniform vascular responses to injuries produced by a variety of noxious stimuli. The possible role of the altered transmural permeability in the induction of smooth muscle cell proliferation is also discussed and evidence is provided that after withdrawal of stimulus for vascular injury intimal proliferation will not develop despite the manifest disorders in permeability. PMID- 3550749 TI - Use of retrograde bone grafting in the treatment of osseous defects of the lateral condyle of the knee. A preliminary report of three knees in two patients. PMID- 3550748 TI - Radioimmunoassay in blood plasma of arginine esterase: the major secretory product of dog prostate. AB - We have developed a radioimmunoassay to determine serum levels of arginine esterase, the major secretory product of the canine prostate. Although the antibodies recognized other related proteins in immunoblotting conditions, particularly in the pancreas, the radioimmunoassay appeared specific for arginine esterase of prostatic origin and reacted only slightly or not at all with cytosolic proteins from salivary glands, liver, skeletal muscles, and kidney. In serum samples, the sensitivity limit of the assay was about 2.5 ng per ml. The interassay and intraassay variations for serum samples that contained concentrations of arginine esterase ranging from 6 to 21 ng per ml were, respectively, 14% and 24%. Sera from 30 adult males and 14 adult females contained, respectively, 71 +/- 9 and 5.3 +/- 0.4 ng per ml. In a group of 12 dogs treated daily for 36-39 days with 50 micrograms of D-Trp6-luteinizing hormone-releasing hormone ethylamide, the concentrations of arginine esterase in the serum decreased progressively and became identical with those observed in the females. These results constitute the first evidence for the presence of a serum marker of the normal prostate in an experimental model. It should be particularly useful to test the effects of various agents on the prostate. PMID- 3550750 TI - Neonatal pemphigus vulgaris: transplacental transmission of antibodies. AB - A male infant with skin lesions was born to a 28-year-old mother who was under treatment for pemphigus vulgaris (PV), diagnosed eight years earlier. Circulating IgG class pemphigus antibody was found in the infant's blood, and deposition of IgG in the intercellular spaces of the epidermis was seen. The infant's lesions resolved within three weeks, and pemphigus antibody titer became negative by seven weeks. The pathogenetic role of PV antibodies and the risk for a fetus of a mother suffering from PV are discussed. PMID- 3550751 TI - A new look at the ichthyoses: disorders of lipid metabolism. PMID- 3550752 TI - [Acquired immunodeficiency syndrome (AIDS): research status 1981-1986]. PMID- 3550753 TI - [Centers and neural pathways modulating pain sensation]. PMID- 3550754 TI - [Clinical aspects of pain]. PMID- 3550755 TI - [Neurosurgical methods in the treatment of pain]. PMID- 3550756 TI - [Acupuncture analgesia--its mechanisms and use]. PMID- 3550757 TI - [Pain and depression]. PMID- 3550758 TI - [Mitotic condensation of chromosomes]. PMID- 3550759 TI - [Regulation of the urea cycle]. PMID- 3550760 TI - [Myosin phosphorylation in vivo and in vitro. I. Myosin of non-muscle cells]. PMID- 3550761 TI - [Structure and function of 3'-terminal sequences of eukaryotic mRNA]. PMID- 3550762 TI - [Carbamyl phosphate synthase or synthetase?]. PMID- 3550763 TI - [Monoclonal antibodies and their use in biochemical studies]. PMID- 3550764 TI - [Protein activators of the biosynthesis and metabolism of cholesterol]. PMID- 3550765 TI - [Biosynthesis of tocopherols]. PMID- 3550766 TI - [Role of histone H1 in the structure of chromosomes]. PMID- 3550767 TI - Liver transplantation today. AB - In summary, liver transplantation has truly come of age. To put things in perspective, the recipient waiting list at the University of Pittsburgh never includes fewer than 200 suitable candidates, and it continues to grow in spite of the fact that we are now doing essentially one transplant per day. There are many excellent transplant centers throughout the United States and Europe, the only limiting factor being the supply of donors. Orthotopic liver transplantation is now covered by most major health insurance carriers, and some form of government coverage is anticipated for the indigent. As the supply of donors increases with aggressive education programs, the need for transplantation centers will also increase. However, this should not be uncontrolled growth. Mandatory training in transplantation surgery will surely be required as a prerequisite to the establishment of transplant centers in the future. The field of organ transplantation is the newest and most dynamic in medicine today. The results are encouraging and acceptable and offer the only hope to many persons dying of end stage organ failure. With improvements in immune modulation at hand, organ transplantation will soon become a commonplace procedure offering a completely normal life expectancy. PMID- 3550768 TI - Corticosteroid therapy for chronic obstructive pulmonary disease. Is it worth the risks? AB - The majority of patients with chronic obstructive pulmonary disease (COPD) do not appear to benefit from long-term corticosteroid therapy. Nevertheless, a small minority demonstrate a response to treatment that is so dramatic that it may be worth the risk of chronic corticosteroid use. A corticosteroid trial is indicated in the patient with COPD who remains symptomatic despite adequate and aggressive routine treatment. If substantial improvement is noted in pulmonary function, chronic corticosteroid treatment should be considered. In patients without an objective response, long-term corticosteroid therapy should not be continued. PMID- 3550769 TI - Studies on the mechanism of acetamide hepatocarcinogenicity. AB - The hepatocarcinogen acetamide, in single doses of 100 and 400 mg/kg b.wt., was shown to act as an initiator in a dose-dependent fashion in rat liver using the Solt-Farber method. Acetamide and its putative metabolite N-hydroxy-acetamide did not cause liver necrosis in single dose experiments. Acetamide showed no evidence for genotoxicity in tests for mutations in Salmonella typhimurium, for DNA damage in rat hepatoma cells or for DNA repair in isolated rat hepatocytes. In contrast, N-hydroxy-acetamide displayed genotoxic activity in all 3 test systems. Neither acetamide nor N-hydroxy-acetamide induced transformation of primary Syrian hamster embryo cells or gave evidence of inhibition of metabolic cooperation in V79 cells. Radiolabelled acetamide and N-hydroxy-acetamide were not bound covalently to proteins in the presence of various metabolic activation systems (microsomes plus NADPH or xanthine/xanthine oxidase, cytosol or cytosol plus acetyl CoA or proline plus ATP). N-Hydroxy-acetamide was cytotoxic to monolayers of isolated hepatocytes at concentrations above 2.5 mM. This cytotoxicity was increased after diethyl maleate treatment, but N-hydroxy-acetamide did not deplete cellular glutathione. A HPLC system was developed for the separation and quantification of acetamide, N-hydroxy-acetamide and acetic acid. No significant excretion of N-hydroxy-acetamide or acetic acid in the urine could be demonstrated after treatment of rats with 100 or 1,000 mg/kg b.wt. of acetamide. The underlying mechanism for the observed initiating effect of acetamide is obscure. PMID- 3550770 TI - [The 1st Mexican dentist. Margarita Chorne y Salazar]. PMID- 3550771 TI - [Mandibular reconstruction]. PMID- 3550772 TI - [In the mid 19th century. An apocryphal story of a French dentist (Carlos Leiter)]. PMID- 3550773 TI - [Scaling and root planing. Its effect on dentin permeability (1)]. PMID- 3550775 TI - [A specialty clinic for children and adolescents in Wangen in the Allgau district (formerly the Wangen Pediatric Health Clinic in Allgau). In memory of Professor Heinrich Brugger 5 December 1895-4 November 1976]. PMID- 3550774 TI - Increased permeability in idiopathic pulmonary fibrosis and sarcoidosis--an index for activity of disease? PMID- 3550776 TI - [Virchow's pathology and the science of arteriosclerosis]. PMID- 3550777 TI - [The personal computer in the cytologic biopsy diagnosis exemplified by thyroid gland cytology]. PMID- 3550778 TI - [Paul Bert (1833-1886)]. PMID- 3550779 TI - New beginnings: the needs of liver transplantation patients, families, and caregivers. PMID- 3550781 TI - Immunocytochemical localization of pancreatic stone protein in the human digestive tract. AB - Recently, in our laboratory, a protein extracted from human pancreatic stones was characterized and purified and a specific antibody was obtained. This pancreatic stone protein (PSP) was shown to have an inhibitory effect on the CaCO3 crystal growth in vitro. The cellular origin of such a protein and its repartition along the digestive tract were studied by immunolocalization (protein A-colloidal gold method) at the ultrastructural level. Surgical biopsies of pancreata from normal or chronic pancreatitis patients, needle liver biopsies, gastric mucosa, and jejunum and duodenum biopsies were minced and fixed in the Karnovsky medium or in buffered 4% paraformaldehyde. The specimens were washed in buffer, dehydrated through ethanol, and embedded in Epon 812. Ultrathin sections, collected on uncoated nickel grids, were submitted to the following reactives at room temperature: protein A 1 mg/ml, anti-PSP (1:2 to 1:100), and protein A-colloidal gold. The specificity of the localization was checked by substituting buffer or nonimmune rabbit serum to anti-PSP. The stone protein was markedly present in the zymogen granules and condensing vacuoles of the normal pancreatic acinar cells, the label was found in the acinar and ductal lumen. In chronic pancreatitis, the localization of PSP, when it occurred, was extremely weak in the acinar cells. No PSP was specifically characterized in hepatocytes, gastric mucosa, and enterocytes. However, a weak but specific reaction was found in the secretory granules of Paneth cells. These results in pancreas confirm the acinar secretory origin of the PSP and are in good agreement with its possible function in stabilizing pancreatic juice in vivo, which is normally supersaturated in calcium carbonate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3550780 TI - Immunohistochemical study of islet amyloid in diabetes mellitus. AB - Amyloid was isolated from islets of amyloidotic pancreata of monkey and human beings by solubilization of non-amyloid materials from the pancreas and digestion of contaminating collagen and elastin. The resulting pellet was estimated to be greater than 90% pure islet amyloid. Antibodies specific for monkey islet amyloid and for monkey and human liver amyloid A (AA) were raised in rabbits. Immunohistochemical reaction using the peroxidase antiperoxidase method demonstrated that amyloidotic pancreas reacted with both anti-AA and anti-islet amyloid antibodies. Although the antibodies are specific toward antigens, they cross-react with tissues from human and monkeys. The immunochemical results suggest the possibility that more than one kind of amyloid is associated with islet amyloidosis, but that a significant portion of the islet amyloid is related to AA. Preliminary chemical analysis indicated that islet amyloid is enriched with hexosamines while AA contains both hexosamines and hexoses. Establishment of the islet amyloid composition(s) can give insight into its source and its role in diabetes in Macaca nigra and human beings. PMID- 3550782 TI - Effect of copper on insulin release by the intact rat pancreas and the perfused rat pancreas. AB - In previous studies, we have shown that rats fed a copper-poor diet have an impaired glucose tolerance and insulin response to an oral glucose load. Furthermore, CuCl2 X 2H2O added to the incubation medium stimulated glucose incorporation into the diaphragm glycogen and epididimal fat of rats. The purpose of the present study was to examine the effect of copper on insulin release in vivo and in the perfused pancreas. Copper chloride stimulated the insulin release by the perfused pancreas of rats fed laboratory chow (copper content, 6.7 ppm). Stimulation with 0.5 mg/dl CuCl2 X 2H2O for 20 min resulted in release of 14.7 +/ 3.1 compared with 18.9 +/- 4.3 mu insulin following stimulation with 16.7 mM glucose. The CuCl2 X 2H2O effect depended on the presence of calcium in the medium--as with other insulinotropic agents--but not on the presence of magnesium. Animals fed a copper-poor (1.2 ppm) sucrose diet have a selective impairment to i.v. glucose-induced insulin stimulation, but not to i.v. arginine or aminophylline stimulation when compared with controls fed a sucrose copper supplemented diet or a laboratory chow diet. This selective beta cell defect is not necessarily genetically inherited and may be acquired. The role of copper on insulin release is discussed. PMID- 3550783 TI - Immunologic and biologic evaluation of insulin degradation following prolonged storage in plastic syringes. AB - Insulin potency during storage in plastic disposable syringes for short periods of time is a concern of diabetics as well as syringe manufacturers. Previous studies have indicated that leaching of organic materials from rubber gaskets may have cytotoxic effects. The purpose of this study was to evaluate the immunologic and radioreceptor degradation of insulin storage in commercial plastic syringes. Insulin syringes were filled with insulin and stored at 4 degrees C for 2 weeks. Immunologic potency was assessed by radioimmunoassay while biologic potency was evaluated by binding to hepatic insulin receptors. Recoverable insulin was measured on days 1, 3, 7, and 14 and compared with highly purified porcine insulin. Insulin content of samples stored in all three plastic syringes showed no statistically significant (p less than 0.05) loss of immunologic or biologic potency for 2 weeks compared with stock controls. Lente insulin gave more variability in storage in the radioimmunoassay, possibly due to settling, and was less effective in displacing labeled insulin in the radioreceptor assay. We conclude that premeasured insulin may safely be stored in plastic disposable syringes under selected conditions, especially in blind and handicapped diabetic patients, for 2 weeks. PMID- 3550784 TI - Human pancreatic cell surface antigens with homologous expression in liver, sweat glands, and other exocrine tissues. AB - We have generated two panels of monoclonal antibodies (MoAbs) that represent a unique array of immunolabeling reagents specific for diverse cell surface and intracellular antigens of ductal epithelial cells (DEC) and of acinar cells (AC) within the human pancreas. Eight of the MoAbs are specific within the pancreas for the DEC plasma membrane (PM), three for DEC intracellular antigens, seven for AC-PM, and one for AC secretory granules. The MoAbs with PM reactivities have permitted us to substantially enhance our assessment of exocrine contamination in our human islet preparations. However, we have been unable to demonstrate consistently the effectiveness of these MoAbs in complement-mediated cytotoxicity protocols designed to improve the purity of our islet preparations by exocrine cytolysis. It is possible that primary cell isolates of pancreas or epithelial organs in general may lack inherent susceptibility to complement-mediated cytolysis or, instead, that this particular panel of MoAbs lacks the appropriate characteristics needed to achieve consistent complement-mediated cytolysis. We have also begun to explore the potentially broader applicability of the anti-DEC MoAbs as immunocytochemical tools and have observed intriguing patterns of cross reactivities in other exocrine tissues, particularly bile duct epithelial cells in the liver and functionally discrete subsets of DEC in the eccrine sweat gland and the parotid gland. These homologous antigenic patterns, by virtue of their specificities for ductal tissue, most likely reflect the molecular bases for functions common to these tissues, e.g., active ion transport and mucin secretion. In addition, the anti-DEC and the anti-AC MoAbs exhibit patterns of binding specificity for human cell lines derived from pancreatic adenocarcinoma that suggest the potential value of these MoAbs in tumor diagnosis and therapy. We believe that these panels of MoAbs will find broad utility in immunopathology and in experimental approaches to questions regarding the development, normal function, and pathogenetic mechanisms in the human pancreas and other related organs as well. PMID- 3550785 TI - Beta cell function in insulin-treated non-insulin-dependent diabetic patients. AB - Non--insulin-dependent diabetes mellitus (NIDDM) patients, 94 in number, who were treated with insulin for various reasons for periods ranging from 2 to 10 years, were investigated to study the effect of long-term insulin therapy and also the effect of anti-insulin antibodies on the beta cell function. Insulin antibody titer and the stimulated C-peptide (CP) did not correlate with the duration of insulin therapy, dose of insulin, or the severity of hyperglycemia. The antibody titers were low in 45%, moderate in 10%, and high in 45%; no correlation was found between the antibody titers and the CP values. Satisfactory control of hyperglycemia was obtained in 54 patients after change of treatment to oral hypoglycaemic agents (OHA). The other 40 patients required continued insulin therapy. The initial CP values were similar in both the groups before initiating the new therapeutic patterns. Those who responded to OHA showed improved CP values on follow-up. The beta cell response to exogenous insulin is heterogeneous in NIDDM patients. In many patients, adequate preservation of beta cell function is present even after long-term insulin therapy. Many of them respond to OHA. Insulin antibodies do not influence the secretory status of the beta cells in NIDDM patients. PMID- 3550786 TI - Pseudo-pseudocysts of the pancreas. AB - Pancreatic pseudocyst was erroneously diagnosed in three patients aged 52-57 years. Two patients had acute epigastric pain, hyperamylasemia (approximately 4,000 IU/L), and a retrogastric collection of fluid demonstrated by early ultrasonography. Laparotomy undertaken within 48 h of admission revealed the correct diagnosis in each case. One patient had perforation of a gastric ulcer into the lesser sac, and the other patient (who died) had perforation of an obstructed afferent loop 25 years after Polya partial gastrectomy. The third patient with renal failure, back pain, and marginal hyperamylasemia had a cystic mass in the lesser sac. Two internal drainage operations were performed before the correct diagnosis of epithelioid leiomyoma was established 6 years later. PMID- 3550788 TI - Increased insulin secretion in response to glucose in isolated islets of Langerhans from bile duct-occluded rats. AB - In a recent study, it was demonstrated that following i.v. injection of glucose, plasma insulin levels increased more in cholestatic rats than in control rats. This could theoretically be due to either a potentiated insulin secretion or an inhibited liver extraction of insulin in cholestatic rats. In the present study, we report the influence of obstructive jaundice on insulin secretion from isolated islets of Langerhans 3 weeks after bile duct occlusion or sham operation in rats. We found that insulin secretion from islets of control rats (250 +/- 29 microU/ml) and of bile duct-occluded rats (260 +/- 24 microU/ml) was not significantly different in a medium with a low glucose concentration (3.3 mM). In contrast, at a high glucose level (16.7 mM), an increased insulin secretion was seen from islets of cholestatic rats (469 +/- 14 microU/ml) as compared with control rats (370 +/- 19 microU/ml) (p less than 0.001). These results indicate that the increased plasma insulin levels found in vivo during cholestasis may not merely reflect a decreased liver clearance but be attributed to a potentiation of glucose-induced insulin secretion. PMID- 3550787 TI - A culture method for the isolation of pancreatic islet cells from young rats. AB - Following digestion of a single pancreas from 30- to 50-day-old Sprague Dawley rats, many single cells and small cell clusters were obtained. Over a succeeding 5-day interval in tissue culture, many islet-like cell clusters were noted. They were smaller than isolated intact rat islets and appeared to develop from selective aggregation of islet cells. More than 1,000 of these islet-like clusters were obtained from a single pancreas. The physiologic characteristics of these cells indicated preservation of insulin secretory responses to glucose (30, 50, 100, 150, 200, and 300 mg/dl), theophylline (1.5 mM), and arginine (10 mM). This appears to be a useful method to follow when large quantities of islet cells are required, as for transplantation. PMID- 3550789 TI - Prostaglandin E2 and I2 treatment of acute experimental pancreatitis in rats. AB - Acute pancreatitis can be induced experimentally in rats by the retrograde pancreatic duct injection of deoxycholic acid. In order to evaluate if prostaglandins have a protective or therapeutic role, pancreatitis was induced with 0.03, 0.1, or 0.2 ml of 3% deoxycholic acid. Then, 16,16 dimethyl prostaglandin E2 or prostaglandin I2 were infused i.v. for 30 min before the deoxycholic acid injection or for 1 or 24 h beginning 30 min or 1 h after the injection. Deoxycholic acid, 0.1 and 0.2 ml, produced an 80-100% mortality at 24 h after the induction of pancreatitis, and prostaglandin administration had no appreciable effect. Induction of pancreatitis with 0.03 ml deoxycholic acid was associated with a 15% mortality at 24 h, and both prostaglandins significantly increased the mortality. In the experimental model of pancreatitis tested, the administration of exogenous PGI2 and 16,16 dimethyl PGE2 significantly worsened the outcome. PMID- 3550790 TI - Pharmacokinetic approach to the estimation of hepatic removal of insulin. AB - We simultaneously measured hepatic insulin removal invasively and estimated hepatic clearance and extraction of insulin pharmacokinetically from cardiac output and peripheral plasma concentrations (relatively) noninvasively. The invasive methods involved continuous electromagnetic measurements of portal venous and hepatic arterial blood flow and simultaneous intermittent sampling of blood from the portal and hepatic veins and femoral artery for assay of insulin concentrations. The noninvasive method assumed that hepatic plasma flow is proportional to cardiac output and that hepatic clearance is a constant fraction of total body clearance of insulin. In anesthetized dogs (n = 6), endogenous insulin was suppressed with somatostatin (800 ng/kg/min) while biosynthetic human insulin (0.25, 0.50, and 1.00 mU/kg/min) was infused to steady state during three consecutive 90-min periods. Insulin concentrations were directly proportional to the infusion rate (p less than 0.01). Hepatic blood flow accounted for 20 +/- 2% of cardiac output. Measured hepatic clearance accounted for 51 +/- 5% of total body clearance of insulin and correlated with the pharmacokinetic estimates (p less than 0.01); the estimates of hepatic clearance ranged from 91 to 114% of the measured values. We conclude that this pharmacokinetic approach, which requires only samples of peripheral blood and estimates of hepatic blood flow, may be used to study the hepatic removal of insulin relatively noninvasively. PMID- 3550791 TI - Requirement for d(GATC) sequences in Escherichia coli mutHLS mismatch correction. AB - The involvement of d(GATC) sequences in Escherichia coli DNA mismatch correction was ascertained by analyzing in vitro repair efficiencies of a series of related, covalently closed circular DNA heteroduplexes that contained from zero to four d(GATC) sites. A heteroduplex with four d(GATC) sites was repaired with high efficiency by extracts of E. coli, whereas no significant correction occurred on a closely related molecule lacking such sequences. Heteroduplexes containing one or two d(GATC) sites were corrected at rates between 10% and 93% of that observed for the four-site molecule, but repair efficiency did not correlate in a simple way with the number of sites present. The methylation state at a single d(GATC) sequence was sufficient to direct strandedness of repair, and correction of heteroduplexes containing one or more d(GATC) sites required functional mutH, mutL, and mutS gene products. In addition, DNA repair synthesis dependent on mutH and mutS also required the presence of at least one d(GATC) site. Although mismatch correction was not observed on a covalently closed circular heteroduplex lacking a d(GATC) sequence, such molecules were subject to strand-specific repair if they contained a strand-specific single-strand break. However, this correction reaction did not require mutH, mutL, mutS, or uvrD gene products. Consequently, we have concluded that d(GATC) sequences are directly involved in mismatch correction mediated by the mutHLS system. PMID- 3550793 TI - Antenna size dependence of fluorescence decay in the core antenna of photosystem I: estimates of charge separation and energy transfer rates. AB - We have examined the photophysics of energy migration and trapping in photosystem I by investigating the spectral and temporal properties of the fluorescence from the core antenna chlorophylls as a function of the antenna size. Time-correlated single photon counting was used to determine the fluorescence lifetimes in the isolated P700 chlorophyll a-protein complex and in a mutant of Chlamydomonas reinhardtii that lacks the photosystem II reaction center complex. The fluorescence decay in both types of sample is dominated by a fast (15-45 psec) component that is attributed to the lifetime of excitations in the photosystem I core antenna. These excitations decay primarily by an efficient photochemical quenching on P700. The measured lifetimes show a linear relationship to the core antenna size. A linear dependence of the excitation lifetime on antenna size was predicted previously in a lattice model for excitation migration and trapping in arrays of photosynthetic pigments [Pearlstein, R.M. (1982) Photochem. Photobiol. 35, 835-844]. Based on this model, our data predict a time constant for photochemical charge separation in the photosystem I reaction center of 2.8 +/- 0.7 or 3.4 +/- 0.7 psec, assuming monomeric or dimeric P700, respectively. The predicted average single-step transfer time for excitation transfer between core antenna pigments is 0.21 +/- 0.04 psec. Under these conditions, excitation migration in photosystem I is near the diffusion limit, with each excitation making an average of 2.4 visits to the reaction center before photoconversion. PMID- 3550792 TI - Intramembrane translocation and posttranslational palmitoylation of the chloroplast 32-kDa herbicide-binding protein. AB - The 32-kDa herbicide-binding protein, a component of photosystem II, is synthesized as a membrane-associated 33.5-kDa precursor within the chloroplast. We show that membrane attachment of the precursor and processing to the 32-kDa form occur in the unstacked stromal lamellae. Once processed, the 32-kDa protein translocates, within the thylakoids, to the topologically distinct stacked granal lamellae. Posttranslational palmitoylation of the processed 32-kDa protein is also shown to occur. This modification takes place in a membrane-protected domain and is mainly confined to the protein assembled in the granal lamellae, where functional photosystem II centers are concentrated. PMID- 3550794 TI - Structure of a cytotoxic T-lymphocyte-specific gene shows a strong homology to fibrinogen beta and gamma chains. AB - Using a subtractive cDNA cloning method, we isolated a number of T-lymphocyte specific genes. One of these genes, represented by the cDNA clone pT49, is expressed in cytotoxic T lymphocytes but not in helper T lymphocytes or B lymphocytes. The protein structure deduced from the nucleotide sequence showed a high degree of homology to fibrinogen beta and gamma subunits. This might indicate that evolutionarily fibrinogen has its origin in lymphocytes. In spite of the strong homology of pT49 protein to the fibrinogen subunits, the positions of the introns in the pT49 gene are totally different from those of the fibrinogen genes. PMID- 3550795 TI - Paradoxical anticonvulsant activity of the excitatory amino acid N-methyl-D aspartate in the rat caudate-putamen. AB - We used limbic seizures induced in rats by systemic injection of the cholinergic agonist pilocarpine (380 mg/kg; i.p.) to study the neuronal pathways within the basal ganglia that modulate seizure threshold. N-Methyl-D-aspartate (N-Me-D-Asp) is an excitatory amino acid derivative that is a powerful convulsant agent when injected into the cerebral cortex, amygdala, or hippocampus in rats. Bilateral microinjections of N-Me-D-Asp into the caudate-putamen, however, protected against limbic seizures induced by pilocarpine (injected systemically), with an ED50 of 0.7 nmol (range 0.5-1.0 nmol). Lesioning the caudate-putamen (by bilateral microinjection of the excitotoxin ibotenate) converted subconvulsant doses of pilocarpine into convulsant ones. The anticonvulsant action of N-Me-D Asp in the caudate-putamen was reversed by blocking gamma-aminobutyrate-mediated inhibition in the substantia nigra pars reticulata or in the entopeduncular nucleus. The results suggest that the caudate-putamen and its gamma-aminobutyrate dependent efferent pathways modulate the threshold for seizures in the limbic forebrain. PMID- 3550796 TI - The terminus region of the Escherichia coli chromosome contains two separate loci that exhibit polar inhibition of replication. AB - The terminus region of the chromosome of Escherichia coli contains two separate sites, called T1 and T2, that inhibit replication forks. T1 is located near 28.5 min, which is adjacent to trp, and T2 is located at 34.5-35.7 min on the opposite side of the terminus region, near manA. The sites act in a polar fashion, and replication forks traveling in a clockwise direction with respect to the genetic map are not inhibited as they pass through T1 but are inhibited at T2. Similarly, counterclockwise forks are not inhibited at T2 but are inhibited at T1. Consequently, forks are not inhibited until they have passed through the terminus region and are about to leave it. Studies with deletion strains have located T2 within a 58-kilobase interval, which corresponds to kilobase coordinates 387-445 on the physical map of the terminus region. PMID- 3550797 TI - Inhibition of replication forks exiting the terminus region of the Escherichia coli chromosome occurs at two loci separated by 5 min. AB - The replication cycle of Escherichia coli strains duplicating their chromosome from the same plasmid origin placed at various locations or of strains having undergone a major inversion event along the origin-to-terminus axis was studied by marker-frequency analysis. It was observed that replication forks are unidirectionally inhibited at two loci of the termination region: counterclockwise-moving forks are inhibited at terminator T1 (28.5 min), and forks moving in the opposite direction are inhibited at terminator T2 (33.5 min). By determining the strand preference of Okazaki fragments that are specific for markers from the T1-T2 interval, it was shown that this interval is replicated in either direction, depending upon the strain analyzed. In addition, we also observed that forks moving in the "unnatural" direction along each oriC-T1 or -T2 arm are very slow, especially in the one-third portion of the chromosome around the terminators. We propose that this phenomenon is a consequence of nucleoid organization, which is proposed to be symmetrical on the two oriC-T1 or -T2 arms and polarized with respect to the direction of replication. We also propose that T1 and T2 are the terminal limits of these two polarized half-nucleoid bodies. PMID- 3550798 TI - Insulin-activated tyrosine phosphorylation of a 15-kilodalton protein in intact 3T3-L1 adipocytes. AB - Insulin stimulates phosphorylation of a tyrosine residue(s) on a 15-kDa protein (p15), and the cytosolic phosphorylated protein (pp15) accumulates only when 3T3 L1 adipocytes are treated with phenylarsine oxide. It has been shown previously that phenylarsine oxide, an agent that complexes vicinal dithiols, interrupts signal transmission from the insulin receptor to the glucose transport system. Several lines of evidence presented here indicate the involvement of pp15 in insulin receptor-initiated signal transduction to the glucose transport system. The reciprocal effects of phenylarsine oxide on the insulin-activated accumulation of pp15 and on insulin-stimulated hexose uptake are reversed by the vicinal dithiol 2,3-dimercaptopropanol but not by the monothiol 2 mercaptoethanol. Thus, a cellular dithiol appears to function in the signal transmission pathway downstream from pp15. Like the insulin-activated autophosphorylation of the receptor's beta subunit (on tyrosine), activation of phosphorylation of p15 is specific, with insulin-like growth factors 1 and 2, epidermal growth factor, and platelet-derived growth factor being inactive. Moreover, both processes exhibit identical insulin concentration dependence. The temporal kinetic relationship of insulin-activated receptor beta-subunit phosphorylation, followed by the phosphorylation of p15 and then increased hexose uptake rate, is consistent with an intermediary signaling role for pp15 in insulin-stimulated glucose uptake. PMID- 3550799 TI - Macromolecular crowding increases binding of DNA polymerase to DNA: an adaptive effect. AB - Macromolecular crowding extends the range of ionic conditions supporting high DNA polymerase reaction rates. Reactions tested were nick-translation and gap-filling by DNA polymerase I of Escherichia coli, nuclease and polymerase activities of the large fragment of that polymerase, and polymerization by the T4 DNA polymerase. For all of these reactions, high concentrations of nonspecific polymers increased enzymatic activity under otherwise inhibitory conditions resulting from relatively high ionic strength. The primary mechanism of the polymer effect seems to be to increase the binding of polymerase to DNA. We suggest that this effect on protein-DNA complexes is only one example of a general "metabolic buffering" action of crowded solutions on a variety of macromolecular interactions. PMID- 3550801 TI - Tubular lysosome morphology and distribution within macrophages depend on the integrity of cytoplasmic microtubules. AB - Pinocytosis of the fluorescent dye lucifer yellow labels elongated, membrane bound tubular organelles in several cell types, including cultured human monocytes, thioglycolate-elicited mouse peritoneal macrophages, and the macrophage-like cell line J774.2. These tubular structures can be identified as lysosomes by acid phosphatase histochemistry and immunofluorescence localization of cathepsin L. The abundance of tubular lysosomes is markedly increased by treatment with phorbol 12-myristate 13-acetate (10 ng/ml). When labeled by pinocytosis of microperoxidase and examined by electron microscopic histochemistry, the tubular lysosomes have an outside diameter of approximately 75 nm and a length of several micrometers; they radiate from the cell's centrosphere in alignment with cytoplasmic microtubules and intermediate filaments. Incubation of phorbol myristate acetate-treated macrophages at 4 degrees C or in medium containing 5 microM colchicine or nocodazole at 37 degrees C leads to disassembly of microtubules and fragmentation of the tubular lysosomes. Return of the cultures to 37 degrees C or removal of nocodazole from the medium leads to reassembly of microtubules and the reappearance of tubular lysosomes within 10-20 min. We conclude that microtubules are essential for the maintenance of tubular lysosome morphology and that, in macrophages, a significant proportion of the lysosomal compartment is contained within these tubular structures. PMID- 3550800 TI - Cytosynalin: a Mr 35,000 cytoskeleton-interacting and calmodulin-binding protein. AB - A Mr 35,000 calmodulin-binding protein, which also possesses the ability to interact with a number of cytoskeletal elements, was purified from bovine synaptosomal membranes, using hydroxylapatite and phosphocellulose column chromatography. We call this protein "cytosynalin," which is derived from a combination of the words "cytoskeleton" and "synapsis." Indirect immunofluorescent staining of cytosynalin revealed that it is distributed throughout neural cells including in dendrites, varicosities, and growth cones. In 3T3 cells, cytosynalin is located on the inner surface of the plasma membrane. The staining pattern of cytosynalin observed with anti-cytosynalin antibodies was similar to that observed with antibodies against calspectin (nonerythroid spectrin or fodrin). Cytosynalin binds to calspectin and to tubulin and actin filaments, as determined by binding assays, turbidity measurements, low-shear viscometry, and electron microscopy. Furthermore, after heating at 90 degrees C for 5 min, cytosynalin retains its binding activity toward calmodulin and cytoskeletal elements. These results lead to the conclusion that cytosynalin is colocalized with calspectin at the inner surface of the plasma membrane, probably in association with other cytoskeletal elements. PMID- 3550802 TI - Expression of senescent antigen on erythrocytes infected with a knobby variant of the human malaria parasite Plasmodium falciparum. AB - Erythrocytes infected with a knobby variant of Plasmodium falciparum selectively bind IgG autoantibodies in normal human serum. Quantification of membrane-bound IgG, by use of 125I-labeled protein A, revealed that erythrocytes infected with the knobby variant bound 30 times more protein A than did noninfected erythrocytes; infection with a knobless variant resulted in less than a 2-fold difference compared with noninfected erythrocytes. IgG binding to knobby erythrocytes appeared to be related to parasite development, since binding of 125I-labeled protein A to cells bearing young trophozoites (less than 20 hr after parasite invasion) was similar to binding to uninfected erythrocytes. By immunoelectron microscopy, the membrane-bound IgG on erythrocytes infected with the knobby variant was found to be preferentially associated with the protuberances (knobs) of the plasma membrane. The removal of aged or senescent erythrocytes from the peripheral circulation is reported to involve the binding of specific antibodies to an antigen (senescent antigen) related to the major erythrocyte membrane protein band 3. Since affinity-purified autoantibodies against band 3 specifically bound to the plasma membrane of erythrocytes infected with the knobby variant of P. falciparum, it is clear that the malaria parasite induces expression of senescent antigen. PMID- 3550803 TI - C3bi receptor (complement receptor type 3) recognizes a region of complement protein C3 containing the sequence Arg-Gly-Asp. AB - Human phagocytes express a receptor termed complement receptor type 3 (CR3) that recognizes the complement protein fragment C3bi. We show here that CR3 recognizes a region of C3 that contains the sequence Arg-Gly-Asp (RGD). CR3 is down modulated upon spreading of macrophages on surfaces coated with a synthetic 21 residue peptide from C3 (residues 1383-1403). This peptide was also attached to erythrocytes by coupling myristic acid to its amino terminus and allowing the myristoylated peptide to bind to erythrocytes through hydrophobic interactions. Erythrocytes coated with this RGD-containing segment of C3 were bound by macrophages, and binding could be blocked by specific monoclonal antibodies against CR3. Since CR3 recognizes a peptide sequence that contains the RGD triplet, it appears to be a member of a larger family of adhesion-promoting receptors that recognize RGD-containing proteins. However, since CR3 does not recognize a hexapeptide containing RGD, we presume that residues beyond the RGD triplet contribute to binding. We have compared the RGD-containing region of fibronectin and vitronectin, proteins known to be recognized by means of their RGD-containing regions, with those in human and murine C3. A striking homology is observed over an approximately equal to 50 amino acid sequence present in all four proteins. We suggest that this extended region of homology contains a structure recognized by adhesion-promoting receptors. PMID- 3550804 TI - Intrahypothalamic injection of insulin decreases firing rate of sympathetic nerves. AB - Injection of picomolar quantities of insulin into the ventromedial hypothalamus of rats significantly reduced the firing rate of sympathetic nerves that supply interscapular brown adipose tissue. The minimal firing rate was reached in 2 min, and the effect was gone within 4 min. The effect of insulin was dose-related and did not occur when comparable volumes of physiological saline were injected into the ventromedial hypothalamus. Destruction of neurons in the ventromedial hypothalamus by injection of kainic acid abolished the inhibitory effects of insulin. These data suggest that insulin may play a role in modulating the sympathetic firing rate to thermogenically important tissues. PMID- 3550805 TI - Graft-vs.-host disease elicits expression of class I and class II histocompatibility antigens and the presence of scattered T lymphocytes in rat central nervous system. AB - In the central nervous system (CNS) of healthy animals, T lymphocytes and cellular expression of major histocompatibility complex (MHC) gene products are virtually undetectable. Yet, in CNS immunological diseases, such as multiple sclerosis in humans, these constituents of the immune response must appear by some mechanism. Immunohistochemical examination of the CNS of F1 hybrid rats following induction of graft-vs.-host disease by parental lymphocytes revealed extensive parenchymal and vascular expression of host class I and II (Ia) MHC encoded cell surface molecules. In addition, occasional scattered T lymphocytes were detected in the CNS of these animals. F1 hybrid rats reconstituted during the neonatal period with bone marrow cells from one parental strain also expressed increased levels of MHC antigens in the CNS. Thus, evidence is presented that the "immunological privilege" of the CNS seems to decrease or disappear during a strong systemic immune response such as graft-vs.-host disease. These findings may have important implications concerning the mechanism of induction of human CNS immunological diseases. PMID- 3550806 TI - Castration reversibly alters levels of cholecystokinin immunoreactivity within cells of three interconnected sexually dimorphic forebrain nuclei in the rat. AB - Three sexually dimorphic cell groups in the forebrain of the rat--the central part of the medial preoptic nucleus, the encapsulated part of the bed nucleus of the stria terminalis, and the posterodorsal part of the medial nucleus of the amygdala--are larger in males, contain a high density of gonadal-steroid concentrating cells, and are thought to play important roles in the control of reproductive behavior and physiology. Since each of these regions contains a large number of cholecystokinin-immunoreactive cells, we used an indirect immunohistochemical method to examine the possibility that levels of this peptide are modulated by circulating gonadal steroids in adult male rats. Rats were castrated at 60 days of age, and one group each was pretreated with colchicine and then killed 3, 7, and 14 days after gonadectomy. Castration clearly decreased CCK immunoreactivity within cells of each region, with the most dramatic effects occurring 7 and 14 days after gonadectomy, and these effects were reversed by treatment with testosterone over a 14-day period. The results suggest that CCK levels within individual cells in each of the interconnected sexually dimorphic nuclei examined here are regulated by circulating gonadal steroids and may be related to the hormonal modulation of reproductive functions thought to be mediated by these cell groups. PMID- 3550808 TI - Primary structure of human neutrophil elastase. AB - The complete amino acid sequence of human neutrophil elastase has been determined. The protein consists of 218 amino acid residues, contains two asparagine-linked carbohydrate side chains, and is joined together by four disulfide bonds. Comparison of the sequence to other serine proteinases indicates only moderate homology with porcine pancreatic elastase (43.0%) or neutrophil cathepsin G (37.2%). In particular, many of the residues suggested to play important roles in the mechanism by which the pancreatic elastase functions are significantly changed in the neutrophil enzyme, indicating alternative types of binding with the human proteinase. PMID- 3550807 TI - Cancer genes: rare recombinants instead of activated oncogenes (a review). AB - The 20 known transforming (onc) genes of retroviruses are defined by sequences that are transduced from cellular genes termed protooncogenes or cellular oncogenes. Based on these sequences, viral onc genes have been postulated to be transduced cellular cancer genes, and proto-onc genes have been postulated to be latent cancer genes that can be activated from within the cell to cause virus negative tumors. The hypothesis is popular because it promises direct access to cellular cancer genes. However, the existence of latent cancer genes presents a paradox, since such genes are clearly undesirable. The hypothesis predicts that viral onc genes and proto-onc genes are isogenic; that expression of proto-onc genes induces tumors; that activated proto-onc genes transform diploid cells upon transfection, like viral onc genes; and that diploid tumors exist. As yet, none of these predictions is confirmed. Instead: Structural comparisons between viral onc genes, essential retroviral genes, and proto-onc genes show that all viral onc genes are indeed new genes, rather than transduced cellular cancer genes. They are recombinants put together from truncated viral and truncated proto-onc genes. Proto-onc genes are frequently expressed in normal cells. To date, not one activated proto-onc gene has been isolated that transforms diploid cells. Above all, no diploid tumors with activated proto-onc genes have been found. Moreover, the probability of spontaneous transformation in vivo is at least 10(9) times lower than predicted from the mechanisms thought to activate proto-onc genes. Therefore, the hypothesis that proto-onc genes are latent cellular oncogenes appears to be an overinterpretation of sequence homology to structural and functional homology with viral onc genes. Here it is proposed that only rare truncations and illegitimate recombinations that alter the germ-line configuration of cellular genes generate viral and possibly cellular cancer genes. The clonal chromosome abnormalities that are consistently found in tumor cells are microscopic evidence for rearrangements that may generate cancer genes. The clonality indicates that the tumors are initiated with, and possibly by, these abnormalities, as predicted by Boveri in 1914. PMID- 3550809 TI - Translocation of an unusual cAMP receptor to the nucleus during development of Dictyostelium discoideum. AB - cAMP has been implicated in the control of the expression of developmental genes in Dictyostelium discoideum. To determine the potential role of cAMP receptors as regulators of gene expression, we have used immunocytochemical and immunoblotting techniques to reveal the subcellular localization of a cAMP binding protein CABP1. Most of the CABP1 antigen in early developing cells is localized near the cell periphery, with a small amount found in the nucleus. The level of CABP1 in the nucleus increases approximately 30-fold during development. Moreover, immunofluorescence studies showed that CABP1 can also be detected on the cell surface. Binding of anti-CABP1 to intact cells followed by reaction with 125I labeled secondary antibody revealed that the cell-surface CABP1 activity peaks during aggregation and culmination. In addition, several proteins related to CABP1 are found mainly in the nuclear fraction of developing cells. The possible role of these proteins in the regulation of developmental gene activity is discussed. PMID- 3550810 TI - Mutations that inactivate a yeast transcriptional regulatory protein cluster in an evolutionarily conserved DNA binding domain. AB - The protein encoded by the GAL4 gene of the yeast Saccharomyces cerevisiae binds to DNA upstream of several genes and activates transcription. To try to understand these processes, we have undertaken a genetic analysis of GAL4. Here we report that nearly all missense mutations in GAL4, selected in vivo to lack function of the protein, cluster in the small region of the gene that encodes the DNA binding domain. About half of these mutations alters a cysteine-rich region of the protein highly homologous to several eukaryotic DNA binding proteins; the other half alters some of the 20 amino acids adjacent to the cysteine-rich region. Nearly all of the missense mutations that alter the DNA binding domain abolish the DNA binding activity of GAL4 protein measured in vitro. In contrast, nearly all of the mutations that alter the 3' 95% of the gene that encodes the transcription activation function are nonsense or frameshift mutations. These results support the idea that the conserved cysteine-rich sequence motif is directly involved in binding of several eukaryotic transcriptional regulatory proteins to DNA. PMID- 3550812 TI - Samuel James Meltzer, M.D. March 22, 1851-November 7, 1920. PMID- 3550811 TI - In vivo stimulation of granulopoiesis by recombinant human granulocyte colony stimulating factor. AB - Osmotic pumps containing Escherichia coli-derived recombinant human granulocyte colony-stimulating factor (rhG-CSF) were attached to indwelling jugular vein catheters and implanted subcutaneously into Golden Syrian hamsters. Within 3 days, peripheral granulocyte counts had increased greater than 10-fold with a concomitant 4-fold increase in total leukocytes. Microscopic examination of Wright-Giemsa-stained blood smears from rhG-CSF hamsters showed that only the neutrophil subpopulation of granulocytes had increased. No significant changes in lymphocyte or monocyte counts were observed during the course of continuous rhG CSF treatment. After subcutaneous injection at rhG-CSF doses of up to 10 micrograms X kg-1 X day-1 only granulocyte counts were affected. However, at higher dose levels, a transient thrombocytopenia was noted. Erythrocyte had lymphocyte/monocyte counts remained unaffected by rhG-CSF over the entire dose range (0.3-300 micrograms X kg-1 X day-1) studied. Total leukocyte counts increased 3-fold within 12 hr after a single s.c. injection of rhG-CSF. This early effect was associated with an increase in the total number of colony forming cells and the percent of active cycling cells in the marrow. A sustained elevation of peripheral leukocyte and marrow progenitor counts was observed following seven daily s.c. injections of rhG-CSF. The ability of rhG-CSF to increase the production and release of granulocytes from the marrow may underlie the beneficial effect it produced on the restoration of peripheral leukocyte counts in hamsters made leukopenic by treatment with 5-fluorouracil. PMID- 3550813 TI - Increased insulin mediated glucose metabolism in fat cells from I versus C57BL mice. AB - The purpose of this study was to determine whether adipocytes from I strain mice, which are characterized by a greater in vivo glucose tolerance than most other strains, had a higher capacity to utilize glucose in response to physiological concentrations of insulin. Using C57BL mice as a control strain, we examined the effect of insulin on glucose metabolism in epididymal and inguinal adipocytes from 2-month-old male mice. Body weight was only slightly less (7%) for the I mice than for the C57BL mice, but fat pad sizes were 60 and 20% less for epididymal and inguinal depots, respectively, in the I mice. Fat cell size was also smaller in epididymal adipocytes from the I mice than from the C57BL mice. Fat cell size of inguinal adipocytes was similar in the two strains. Without insulin the rates of [U-14C]glucose incorporation into CO2 or lipids were twofold higher in cells from the I mice than in those from the C57BL mice. Maximal insulin concentration (2.5 nM) increased glucose metabolism by 140 and 500% in epididymal and inguinal adipose cells, respectively, in the I mice versus 30 and 50% in the C57BL mice. The maximal effect of insulin was reached at a much higher insulin concentration in the I mice than in the C57BL mice. The activity of fatty acid synthetase was four- to sixfold higher in fat cells from I than in those from C57BL mice. These results demonstrate an increased insulin responsiveness of glucose metabolism in fat cells from the I mice related to an increased lipogenic capacity. Furthermore, they show that adipose tissue in mice exhibits significant regional differences in terms of insulin responsiveness of glucose metabolism. PMID- 3550814 TI - Effects of hypophysectomy on plasma levels of pancreatic polypeptide (APP) and insulin in adult chickens. AB - Adenohypophysectomy (hypox) was carried out in adult chickens in an attempt to assess what role, if any, the anterior pituitary gland plays in maintaining basal levels of plasma insulin (IRI) and avian pancreatic polypeptide (APP) both before and immediately after a fast-refeed regimen. Each bird was tube-fed 61 gms twice daily, body weights were taken daily, and blood samples drawn daily just before the second feeding. All birds were fasted for 24 hr on days 4-5, another blood sample taken, and then refed the usual gruel. Blood samples were taken at 5,15,30,90 and 180 min after refeeding. Hypox caused an immediate and sustained decrease in plasma IRI and a significant but transient increase in plasma APP which lasted 3-4 days before returning to normal; plasma glucose was marginally decreased. Refeeding resulted in a trend of less response (increase) in all three parameters studied in the hypox group. It is suggested that in chickens, hypox may lead to a release phenomenon from a normal inhibitory role which the anterior pituitary gland plays on APP release. PMID- 3550815 TI - Guinea pigs deficient in C2, C4, C3 or the C3a receptor. PMID- 3550816 TI - Rabbits deficient in C6. PMID- 3550817 TI - Biological functions of the complement system. PMID- 3550818 TI - Receptor deficiencies. Complement receptor type three. PMID- 3550819 TI - [Medicinal plants and decontamination]. PMID- 3550820 TI - Reevaluation of circulating prostacyclin and thromboxane in diabetes. AB - Although several investigators have attempted to measure the plasma levels of prostacyclin (PGI2) and thromboxane A2 (TXA2) in diabetes and normal subjects, their results have been controversial. In this study, we measured plasma PGI2 and TXA2 levels in diabetic patients and normal subjects. The plasma PGI2 and TXA2 were determined by RIA as 6-keto-PGF1 alpha and TXB2, respectively. The plasma levels of 6-keto-PGF1 alpha were significantly reduced in diabetics with microangiopathy (52.5 +/- 18.9 pg/ml, mean +/- SE, p less than 0.05) compared with those of normal subjects. Diabetics as a whole also showed lower levels of 6 keto-PGF1 alpha than normal subjects (57.8 +/- 26.1 vs. 70.2 +/- 20.7 pg/ml), though this was not significant statistically. The plasma 6-keto-PGF1 alpha levels did not significantly correlate with either age of the patients or duration of diabetes in diabetics. Interestingly, however, hemoglobin A1c significantly correlated inversely with 6-keto-PGF1 alpha levels in diabetics without microangiopathy (r = -0.60, p less than 0.05). The plasma levels of TXB2 in diabetics were significantly higher than those of normal subjects (155.2 +/- 69.5 vs. 108.0 +/- 30.0 pg/ml, p less than 0.05). These data suggest that an imbalance of circulating PGI2 and TXA2 may contribute to the development of diabetic microangiopathy. PMID- 3550821 TI - Stability study of prostacyclin in solution. AB - The proton-catalyzed hydrolytic decomposition of prostacyclin was assayed by UV spectroscopic and HPLC methods. Changes of the absorbance in aqueous solutions were measured at 220 nm. HPLC studies were performed on C18 column using NH4Cl (0.03 mol X l-1)/NH4OH (0.03 mol X l-1)/methanol (1 : 1 : 4) eluent. Temperature and pH dependence of the hydrolytic process was determined. Effects of alcohol and glycols on the degradation rate were studied. PMID- 3550822 TI - [Drugs and historical determinism]. PMID- 3550823 TI - The surgical residency: then, now, and future. PMID- 3550824 TI - Volume fifty of "The Pharos". PMID- 3550825 TI - Striking memories of medical education: a glimpse of three physician writers. AB - Each of these three works focused on indelible memories of its writer's medical education. Thomas Browne spoke about autopsies, medical theories, religion. Tobias Smollett exposed the horrendous conditions aboard naval vessels and some of the problems facing young physicians. John Brown depicted surgery before anesthesia and antisepsis. Uniformly, the events and circumstances that seemed to have affected them were on the forefront of medical and social history. Religio Medici, Roderick Random, and "Rab and His Friends" were each the first major literary work of the authors discussed; each achieved instant success, yet somehow their popularity waned. Perhaps, the evolution of medicine has eclipsed what was once sensational, disturbing, interesting, and marketable, leaving only the dry and lifeless bones of stories--remnants of what once they were. PMID- 3550826 TI - House officership--then and now. PMID- 3550827 TI - [Analgesic effect of RAP cream in the pain syndrome of venous insufficiency of the lower extremities]. PMID- 3550828 TI - [Introduction of a disposable dermatome]. AB - Skin grafts in vascular pathology, which were until now the prerogative of surgeons when the technique is complex and requires specific devices, are currently becoming available to all mainly with the use of the disposable Sanchez dermatome, at a very reasonable cost. This dermatome is characterized by a sharp edge which is only but a common razor blade, easy to get. Its use is so simple that it may be used even without a large experience of the grafting technique. The authors describe their technique in ambulatory. They point out its efficacy, its simpleness, its reduced cost for the patient as well as for social bodies. They insist on: preparation of the ulcer bed, the graft itself, the treatment of the cause. "A closed ulcer is not a cured ulcer". PMID- 3550829 TI - Photobinding of psoralens to bacterial macromolecules in situ and induction of genetic effects in a bacterial test system. Effects of singlet oxygen diagnostic aids D2O and DABCO. PMID- 3550831 TI - Studies of rhodopsin and bacteriorhodopsin using modified retinals. PMID- 3550830 TI - Damages induced in nucleic acids by photosensitization. PMID- 3550832 TI - Recent progress in vertebrate photoreception. PMID- 3550833 TI - Photoreactivation of ultraviolet radiation damage in dark repair deficient PHR mutants of Escherichia coli K-12. PMID- 3550834 TI - Lateral interactions between vertebrate photoreceptors. PMID- 3550835 TI - Photoadducts of 8-methoxypsoralen to cytosine in DNA. PMID- 3550836 TI - Mutagenic and recombinogenic action of DNA monoadducts photoinduced by the bifunctional furocoumarin 8-methoxypsoralen in yeast (Saccharomyces cerevisiae). PMID- 3550837 TI - Effects of selective irradiation on mammalian mitochondria. PMID- 3550839 TI - The physiology of transferrin and transferrin receptors. PMID- 3550840 TI - Local fluid shifts in humans and rats: comparison of simulation models with actual weightlessness. PMID- 3550838 TI - Cellular analysis of associative learning. PMID- 3550841 TI - Changes of cardiac systems of decerebellated hamsters in hypergravity conditions. PMID- 3550842 TI - Cardiovascular responses to central hypovolaemia in man: physiology and pathophysiology. PMID- 3550843 TI - Development of methods for prevention of acceleration induced blackout and unconsciousness in World War II fighter pilots. Limitations: present and future. PMID- 3550844 TI - Organization of maculo-ocular pathways via y-group nucleus and its relevance to cerebellar flocculus in cats. PMID- 3550845 TI - Sexually transmitted diseases in adolescents. AB - Sexually transmitted organisms cause significant morbidity in adolescents, their sexual partners, and their offspring. The primary care physician may be effective in reducing the prevalence and sequelae of STDs in teenagers by being aware of the scope of this problem in the adolescent population as well as treatment options. PMID- 3550846 TI - Menstrual disorders in the adolescent age group. AB - Menstrual problems of adolescence are routinely encountered by physicians caring for teenagers. The spectrum of menstrual and associated reproductive problems ranges from minor disorders to serious life-threatening diseases. Many diagnostic and therapeutic modalities are available; however, a sound knowledge of the physiology of maturational events in the hypothalamic-pituitary-ovarian axis is necessary for correct diagnosis and management. The physician must always consider the patient's sensitivity and vulnerability in evaluating and treating various abnormalities of menstruation. PMID- 3550847 TI - Anorexia nervosa. AB - Anorexia nervosa is a complex neuroendocrine-psychiatric illness that affects adolescents; its origins and pathophysiology are still poorly understood. The typical psychologic and physiologic characteristics of the illness are discussed, and the multidisciplinary team approach to diagnosis and management is outlined. PMID- 3550848 TI - Sexuality and the adolescent: issues for the clinician. AB - The acquisition of a sexual identity is one of the key developmental tasks of adolescence. Physicians treating adolescents should be familiar with and comfortable with addressing both sexual behavioral norms and sexual dysfunction. This review attempts to describe current adolescent sexual belief systems and behaviors, as well as more problematic areas such as sexual dysfunction, unintended pregnancy, and sexual orientation issues. A developmentally based approach to addressing these issues is presented. PMID- 3550849 TI - Mutagenicities of nitrosated carboline derivatives. AB - Food-borne amines have been considered as the potential precursors of endogenous carcinogenic N-nitroso compounds in humans. A compound which yields a direct mutagen after nitrite treatment was isolated from soy sauce and was identified as 1-methyl-1,2,3,4-tetrahydro-2-carboline-3-carboxylic acid (MTCA) (Wakabayashi, et al., 1983). The mutagenicities of other carboline derivatives such as harman, norharman, harmaline, harmalol, harmine, and harmol were studied. Like MTCA, the nitrosated carboline derivatives showed higher mutagenic activity as compared to their corresponding parent compounds. The demethylated analogue of MTCA, 1,2,3,4 tetrahydro-2-carboline-3-carboxylic acid was synthesized and its nitrosated products were shown to be mutagenic to Salmonella typhimurium TA 100 and TA 98. The potent mutagen Trp-P-2 is a typical 3-carboline derivative. The mutagenicity of Trp-P-2 was suppressed remarkably after nitrosation. Several 3-carboline derivatives also showed the similar property. Nitrosation of MTCA gave several derivatives which were isolated and showed direct mutagenicity to Salmonella typhimurium TA 98. Further characterization of these new carboline derivatives is in progress. PMID- 3550850 TI - Professionalism, bureaucracy and patriotism: the VA as a health care megasystem. AB - The Veterans Administration supports the largest integrated psychiatry service in the country. As our oldest and largest "megasystem," this service offers a unique opportunity for examining distinctive features of such large health care delivery systems. Characteristic experiences of mental health professionals in this system are described and the system is analyzed in terms of its organizational tasks, structure and cultures. Psychiatry will be practiced, in the future, in similarly large scale organizations. Understanding the nature and workings of such organizations is likely to become essential to effective and satisfying professional work. PMID- 3550852 TI - [Classic texts--newly read. W. Mayer-Gross: "Clinical Aspects of Schizophrenia"]. PMID- 3550851 TI - Preserve but limit the insanity defense. PMID- 3550853 TI - Working through: 1914-1984. AB - This paper reviews the various meanings given to "working through" by Freud and others. The relation of "working through" to "analysis" is discussed and illustrated. PMID- 3550854 TI - Predicting compliance with home relaxation training. PMID- 3550855 TI - Physiological interactions of the basic rest--activity cycle of the brain: pulsatile luteinizing hormone secretion as a model. AB - The hypothesis of the "basic rest--activity cycle" (BRAC) as an ultradian rhythm of CNS activity which integrates many somatic, visceral, and behavioral functions is supported by a variety of studies which demonstrate similar periodicities in the expression of a remarkable number of critical physiological systems. However, the existence of this BRAC has been supported primarily only by this similarity in cyclicity, and the argument in support of this potentially meaningful CNS oscillator is thus largely inferential. Since resolving consistent temporal relationships between a variety of these apparently otherwise unrelated rhythmic functions would strongly support the hypothesized existence of the BRAC, this article first presents methodology for reliable evaluation of these difficult to analyze interactions. Then, a relationship between rhythmic physical activity and pulsatile luteinizing hormone (LH) secretion is employed as a model interaction which allows analysis of the rhythmicity of the BRAC itself. This BRAC entrainment of pulsatile LH secretion is also utilized as a model to demonstrate how the BRAC may modulate the activity of various physiological functions via relatively direct mechanisms, secondary interactions, or entrainment of tissue with its own intrinsic pacemaker activity. The physiological function of the BRAC is discussed relative to this entrainment of pulsatile LH release. PMID- 3550856 TI - Ross osteounification standard-tooth replacement system: a clinical report including S.E.M. evidence of healing to a titanium anchor with a 60 day human block section. PMID- 3550858 TI - Liaison psychiatry in the heart transplant unit. PMID- 3550857 TI - [The Tegel castle sanitarium of Ernst Simmel--on the history and development of the first psychoanalytic clinic]. PMID- 3550859 TI - The medical philosophy of R.T.H. Laennec (1781-1826). PMID- 3550860 TI - Parkinsonian rigidity: the first hundred-and-one years 1817-1918. PMID- 3550861 TI - Puericulture, and the style of French eugenics. PMID- 3550862 TI - [Another approach to the Chinese concepts of health and disease. "Medizin in China. Eine Ideengeschichte." By Paul U. Unschuld. Essay review]. PMID- 3550864 TI - Celiac-superior mesenteric artery anastomosis in pancreatic transplantation: a new technique. AB - In whole organ pancreas transplantation, the vascular anastomosis is routinely based on the portal vein and a Carrel patch of the aorta containing the origin of the celiac artery and superior mesenteric artery. For end-to-side anastomosis to the external iliac, extensive dissection is necessary. A new technique involving bench surgery has been developed to avoid this large anastomosis between the Carrel patch and the external iliac artery. The single artery end-to-side anastomosis is accomplished between the distal end of the superior mesenteric artery and the external iliac, after anastomosis of the celiac artery to the proximal end of the superior mesenteric artery. PMID- 3550863 TI - Mechanisms of hyperpigmentation. PMID- 3550865 TI - Indirect composite resin veneers: clinical technique and two-year observations. PMID- 3550866 TI - The tensile bond strength of various composite resins to alloy. PMID- 3550867 TI - Rehabilitation of the edentulous mandible with a tissue-integrated fixed prosthesis: a six-year longitudinal study. PMID- 3550868 TI - Radiosensitization by hypoxic pretreatment with misonidazole: an interaction of damage at the DNA level. AB - Prolonged exposures to misonidazole (MISO) in vitro under hypoxic conditions result in radiosensitization which is characterized by a decrease in the size of the radiation survival curve shoulder for cells irradiated under hypoxic or aerobic conditions after drug removal. Although intracellular glutathione (GSH) was depleted during hypoxic exposures to MISO, this could not account for the dose-additive radiosensitization (decrease in shoulder size) since GSH depletion by diethylmaleate had no effect on the sensitivity of cells irradiated in air. The alkaline elution assay was used to measure DNA strand breaks and their repair after exposure to MISO, graded doses of X rays, and the combination of MISO pretreatment with X rays. The elution rate of DNA from irradiated cells increased linearly with X-ray dose, with and without MISO pretreatment. However, the DNA elution rates measured after MISO pretreatment were greater by a constant amount at all X-ray doses greater than 1 Gy. In terms of both cell survival and DNA elution rate, MISO-pretreated cells behaved as though they had received an extra 1.5 Gy. Although the initial damage after X rays was greater in MISO-pretreated cells, there was no effect of MISO pretreatment on the rate of repair of radiation-induced DNA strand breaks. The agreement between the differences in survival levels and DNA elution rates for irradiated control and MISO-pretreated cells and absence of an effect on DNA repair rates suggest that the pretreatment sensitization is due to an additive interaction of damage at the DNA level. PMID- 3550869 TI - The induction of DNA-protein crosslinks in hypoxic cells and their possible contribution to cell lethality. AB - The induction of single-strand breaks (SSBs) in the DNA of Chinese hamster ovary cells by X rays under different irradiation conditions was measured by the alkaline elution technique. The oxygen enhancement ratio (OER) for SSB induction determined for cells irradiated in air versus irradiation of cells made hypoxic by metabolic depletion of O2 was 9.7. However, when proteinase K was included in the cell lysis solution the OER was reduced to 4.2. The proteinase affected the elution rate only of the cells irradiated under hypoxic conditions, suggesting that DNA-protein crosslinks (DPCs) are preferentially produced in hypoxic cells by radiation. The ability to repair these DPCs was compared in two cell lines: the wild-type AA8 line and an excision-repair-deficient mutant line, UV-41. The AA8 line removed about 80% of the DPCs induced by radiation under hypoxic conditions within a 24-h repair incubation. The UV-41 line, on the other hand, removed only about 20% of the DPCs in the same time. The OERs for cell survival of these two lines are 3.1 for AA8 but only 1.9 for UV-41, suggesting that the DPCs preferentially induced in the DNA of cells irradiated under hypoxic conditions may contribute to cell killing when the normal DNA-repair mechanisms are compromised. PMID- 3550870 TI - Acute radiation-induced vomiting in area postrema-ablated cats. AB - A dose-response relationship was established in normal unanesthetized cats for emetic incidence, latency to onset of vomiting, and duration of emetic activity over a period of 24 h after whole-body exposure to 60Co radiation at selected doses between 7.5 and 90 Gy. Each episode of vomiting, i.e., retching and expulsion, was recorded oscillographically as its characteristic intrathoracic pressure waveform by means of a catheter inserted some days before into the superior vena cava. The gamma-radiation dose of 45 Gy evoked vomiting optimally with an incidence of 92% and an average onset time of 98 min. When administered to animals prepared chronically with surgical ablation of the area postrema, the same dose of radiation evoked vomiting in four of five test cases and with an average time to onset that was not by either measure significantly different from normal. Vomiting was also elicited in all of six normal cats exposed to an intestinal dose of 45 Gy X radiation with the head shielded. The same form of irradiation evoked vomiting in two of three chronically postremectomized cats. Successful ablation of the area postrema was determined functionally by emetic refractoriness to an injection of digitalis and confirmed for completeness by histological examination. It is concluded that the area postrema is not an essential element in the reflex mechanism of radiation-induced vomiting and, therefore, no physiological basis exists for dependence on a centrally acting chemogenic factor in radioemesis. PMID- 3550871 TI - Enhancement of X-ray-induced sister chromatid exchanges in hypoxic cells. AB - In these studies we have used wild-type Chinese hamster ovary cells (AA8) and a mutant cell line (UV-41) deficient in excision repair to compare sister chromatid exchange (SCE) induction after X irradiation under oxic and hypoxic conditions. X irradiation of AA8 cells under oxic conditions induced only a slight increase in SCEs, whereas at each dose tested a significantly greater number of SCEs were induced in hypoxic cells. When AA8 cells were X-irradiated and the addition of bromodeoxyuridine (BrdU) was delayed for 20 h to allow DNA lesions to be repaired, the levels of SCEs detected in both oxic and hypoxic cells returned to background levels. X irradiation of UV-41 cells also induced only a slight increase of SCEs in oxic cells, whereas a significant number of SCEs were induced in hypoxic cells. However, in contrast to results with AA8 cells, when hypoxic UV 41 cells were X-irradiated and the addition of BrdU was delayed for 20 h, the number of SCEs remained significantly above background levels. In combination with previous alkaline elution data, these results are consistent with the possibility that DNA-protein crosslinks are responsible for the SCEs induced by X irradiation of hypoxic cells. Irrespective of the mechanism(s) involved, the data presented suggest that the SCE assay may potentially aid in the detection of hypoxic tumor cells. PMID- 3550872 TI - Mathematical description of the interactions between cellular inactivating agents. AB - A mathematical technique for characterizing the interactive effects that may occur when cells are treated with two or more toxic agents is developed. This technique is used to account for the previously unexplained properties of the dose-response relations for the uv-X-ray interaction in Escherichia coli B/r. PMID- 3550873 TI - Diagnosis of combined intra and extra uterine gestations. AB - The ultrasound diagnosis of an ectopic pregnancy can be extremely difficult to achieve even for an experienced operator. The two case studies show that however rare any phenomenon might be, this should not be a reason for excluding it as a possible diagnosis. I hope that this article will help sonographers in the future to be aware of the possible existence of a combined intra and extra uterine pregnancy. PMID- 3550874 TI - Magnification radiography. AB - Magnification radiography is the purposeful production of an image larger than the object being studied. This technique can be utilized to image detail that is not resolvable by normal means. An overview of magnification radiography, including the physics and equipment considerations, is presented to better acquaint the radiographer with this increasingly popular technique. PMID- 3550875 TI - Considerations in the humane use of laboratory animals in radiology research. AB - Our institution has recognized both the scientific and ethical responsibilities for the humane treatment of laboratory animals in the Radiology Research Laboratory. The Laboratory Animal Resource Center is specific in its requirements for the procurement, housing, and general care given to those animals used in our laboratory. In accordance with NIH guidelines, Animal Care Committee rules require investigators to provide detailed descriptions of research protocols so that appropriate care can be assured. The investigator is responsible ultimately for the thoughtful treatment of the animals before, during, and after the investigation. In the forseeable future, the use of laboratory animals will continue to be of paramount importance to the advancement of biomedical and imaging technology. PMID- 3550877 TI - AIDS-related cholangitis: radiographic findings in nine patients. AB - Acalculous inflammation of the biliary tract is a recently reported complication of the acquired immunodeficiency syndrome (AIDS). In a 33-month period, nine men with AIDS were evaluated because of right upper quadrant and/or epigastric pain, jaundice, or abnormal liver function test results. Each patient underwent ultrasonography and endoscopic retrograde cholangiopancreatography; seven also underwent computed tomography. In eight of nine patients the imaging studies disclosed intrahepatic and extrahepatic bile duct changes identical to those seen in sclerosing cholangitis (strictures, focal dilatation, thickened duct walls). Isolated papillary stenosis and ductal dilatation were present in one patient, while eight patients had some stricturing of the distal common duct. The combination of papillary stenosis and intrahepatic ductal strictures appears unique to AIDS-related cholangitis. Endoscopic papillotomy provided variable relief to symptoms and biochemical abnormalities. Cholangitis caused by cytomegalovirus and/or Cryptosporidium infection is the proposed pathophysiologic mechanism. PMID- 3550876 TI - Small bowel radiography: how, when, and why? AB - Since the advent of endoscopy for evaluating the upper and lower gastrointestinal (GI) tracts, it has become clear that only in the small bowel does barium radiography remain unchallenged. Regrettably, barium examination of the small bowel has traditionally been regarded by many radiologists as a study of minor importance. Small bowel follow-through techniques and enteroclysis methods differ in their diagnostic purpose, potential, and methods of performance. This review examines in detail the spectrum of barium examination techniques currently available for evaluating the small bowel. The benefits of enteroclysis in the majority of clinical situations requiring contrast examination of the small bowel are stressed. Radiologists play the crucial role in the diagnostic evaluation of the small bowel and should strive to refine and advance the accuracy of small bowel radiography. PMID- 3550878 TI - Perfluorochemicals as US contrast agents for tumor imaging and hepatosplenography: preliminary clinical results. AB - In animals, perfluorochemicals (PFCs) are effective ultrasound (US) contrast agents that produce hepatic, splenic, and tumor enhancement. The use of Fluosol DA 20%, an emulsion of perfluorodecalin and perfluorotripropylamine, was studied in nine non-critically ill patients with cancer who had liver lesions. US studies without Fluosol were compared with studies obtained 24, 48, and 72 hours after Fluosol infusion. Vital signs and extensive laboratory analyses are performed before and after Fluosol infusion. Liver metastases from colonic, pancreatic, and gastric carcinoma exhibited rim or diffuse enhancement after a Fluosol dose of 1.6 g/kg or greater. Fluosol produced echogenic enhancement of the liver and spleen relative to kidney at a dose of 2.4 g/kg, allowing the detection of nonenhancing lesions. In addition, Fluosol at a dose of 1.6 g/kg or greater allowed detection of lesions not seen before contrast medium was administered in three of the seven patients studied. There was a mild increase in the level of serum glutamic oxaloacetic transaminase in two patients, one given 2.4 and the other 3.2 g/kg of Fluosol. Mild and transient allergic reactions without change in vital signs were experienced by two patients. PMID- 3550879 TI - Pelvic abnormalities in children: assessment with MR imaging. AB - Multiplanar images of 62 pelvic lesions in 58 children and adolescents (aged 7 months to 19 years; mean, 10.6 years) were obtained with 0.3-T magnetic resonance (MR) imaging. Lesions were divided into three categories: congenital anomalies, cystic lesions and fluid collections, and neoplasms. MR demonstrated lesions well in all categories. Midline lesions were best imaged sagittally, and lesions of paired structures, axially. The coronal plane was useful in evaluating the superoinferior extent of lesions and in defining the extent of lymphadenopathy. T1-weighted sequences were sufficient to depict most congenital and cystic lesions. T2-weighted sequences were useful in demonstrating the extent of neoplasms and the position of ectopic gonads. Ultrasonography (US) was also performed in 45 cases. MR and US delineated lesions equally well in 25 cases (55.5%), MR was superior in 19 (42.4%), and US was superior in one (2.2%). Computed tomography (CT) was performed in 13 cases. MR and CT delineated lesions equally well in eight cases (61.5%), MR was superior in four (30.8%), and CT was superior in one (7.7%). PMID- 3550880 TI - Biliary atresia and noncardiac polysplenic syndrome: US and surgical considerations. AB - Ten percent of children with biliary atresia have an associated complex of anomalies, including polysplenia, azygous continuation of the inferior vena cava, preduodenal portal vein, hepatic arterial anomalies, and bilaterally bilobed lungs. These abnormalities will not be detected if the preoperative workup is limited to hepatobiliary nuclear scanning. Ultrasonography is important in the preoperative evaluation of patients suspected of having biliary atresia. It is important to identify the associated abnormalities preoperatively because they have an impact on the initial portoenterostomy and may preclude subsequent orthotopic liver transplantation. PMID- 3550881 TI - Abnormalities of the neonatal brain: MR imaging. Part I. Intracranial hemorrhage. AB - The authors prospectively evaluated 82 neonates, ranging in gestational age from 29 to 44 weeks postconception, with magnetic resonance (MR) imaging at 0.6 T. Twenty-two cases of hemorrhage in 15 infants were identified. Ultrasound (US) and computed tomography (CT) were superior to MR in the first few days after parenchymal hemorrhage, since at this time lesions were apparent on only T2 weighted images. After the first 3 days, MR was the single best modality because (a) hemorrhage on CT became imperceptible in the 2d week, whereas the high signal of hemorrhage on MR persisted for 2-11 weeks; (b) MR permitted rough dating of hemorrhage according to changes in signal intensity; and (c) MR was superior in identifying subdural or epidural hemorrhage. Because of the nonspecificity and restricted field of view of US and the inability of CT to depict hemorrhage after 7-10 days, the authors conclude that MR significantly improves the detection of intracranial hemorrhage in neonates. PMID- 3550882 TI - Abnormalities of the neonatal brain: MR imaging. Part II. Hypoxic-ischemic brain injury. AB - Eighty-five infants, 82 of whom were 29-44 weeks postconceptional age, were imaged with a 0.6-T magnet. Eight infants had cerebral infarction. In premature neonates with very water, low-intensity white matter on T1-weighted images, ultrasound was better than both computed tomography and magnetic resonance (MR) imaging in depicting parenchymal changes of infarction or edema. However, after 37 weeks gestation, MR imaging was superior. Cerebral atrophy, present in seven infants, was consistent with subarachnoid space widths of 7 mm or more, or subarachnoid space widths of 5-6 mm with ventricular/brain ratios of 0.36 or greater. Delayed myelination was seen in a total of 18 infants with histories of hypoxic-ischemic insult. MR imaging shows promise in the neonatal period. It facilitates recognition of infarcts in full-term infants and may be used to predict abnormal neurologic outcome in infants who have initial delayed myelination. PMID- 3550883 TI - Needle aspiration and core biopsy of prostate cancer: comparative evaluation with biplanar transrectal US guidance. AB - Biplanar, transrectal ultrasound (US) guidance of needles was used in the transperineal biopsy of possibly malignant prostatic lesions in 80 patients (83 biopsies). A 22-gauge cytologic needle was used to locate and fixate the lesion, and aspiration specimens for cytologic and histologic evaluation were obtained (with 22- and 14-gauge needles, respectively). Twenty-one 19-gauge needle core biopsies were also performed. Forty-nine patients (61%) had histologically prove adenocarcinoma. The rate of cancer diagnosis was 53% with cytologic evaluation and 54% with histologic evaluation (combined yield, 61%). This included 34% of cancers less than 1.0 cm in diameter and 56% of those 1.0-1.5 cm. Thirteen of 23 (57%) of these lesions were nonpalpable or equivocal on digital rectal examination. These results suggest that transrectal US guidance of thin-needle biopsies is useful in diagnosing early prostate cancer. PMID- 3550884 TI - Testicular cysts: US findings. AB - Testicular cysts have been considered rare. However, of 307 men who underwent high-resolution ultrasonography (10 MHz) of the scrotum, 30 (9.8%) had testicular cysts. Thirty-three testes were involved, 23 with single cysts, eight with clusters of multiple tiny cysts, and two with more than one focus of cyst. One cyst was aspirated intraoperatively, and one cyst of the tunica albuginea was proved at surgery. Eighty cadaveric testes were scanned also, and cysts were found in one. In two cases, the pathologic report, reviewed retrospectively, failed to mention the cyst, but these cysts could have been overlooked. Further work is needed to determine when or if these testicular lesions need follow-up and what significance they have, if any. PMID- 3550886 TI - Usage of diagnostic imaging procedures: a nationwide hospital study. AB - In 1980, the Center for Devices and Radiological Health of the U.S. Public Health Service (PHS) conducted a survey of the numbers and types of diagnostic radiologic examinations performed in a sample of 81 general, short-stay, U.S. hospitals. Data include information on patient age and sex for all conventional radiographic, computed tomographic (CT), nuclear medicine, and ultrasound (US) procedures. An estimated 130.2 million conventional radiographic, 2.2 million CT, 6.4 million nuclear medicine, and 6.0 million US procedures were performed in all general, short-stay hospitals in 1980. Numbers and rates of procedures are presented by patient age and sex. Comparisons made to the last PHS radiographic survey in 1970 show an increase of 59% in the total number of radiographic procedures in hospitals, with the greatest increase occurring in patients in the age group 65 years and over. PMID- 3550885 TI - ICON: a computer-based approach to differential diagnosis in radiology. AB - ICON is a computer-based expert system being developed to help radiologists with the process of differential diagnosis. ICON focuses on the domain of lung disease as seen on a chest radiograph in patients with lymphoproliferative disorders. Rather than attempt to tell the radiologist what the diagnosis is, the system asks him or her to propose a diagnosis and then discusses the evidence supporting that diagnosis or competing diagnoses. The system's output is in the form of an English prose critique. This approach combines the computer's ability to recall detailed information with human reasoning skills PMID- 3550887 TI - Greenfield filter placement via the femoral vein: improved technique with extra long sheath and purse-string suture. AB - An improved technique for percutaneous placement of Greenfield filters via the femoral vein is described. The technique involves the use of an extra-long sheath for filter placement and the application of a purse-string suture at the venipuncture site to facilitate hemostasis. PMID- 3550888 TI - What is a useful adjunct to mammography? PMID- 3550889 TI - Regulation of multiple peptides in CRF parvocellular neurosecretory neurons: implications for the stress response. PMID- 3550890 TI - The LHRH family of peptide messengers in the frog nervous system. PMID- 3550891 TI - Neuropeptide Y: coexistence with noradrenaline. Functional implications. PMID- 3550892 TI - Detection of carcinogen-DNA adducts in human cells and antibodies to these adducts in human sera. PMID- 3550893 TI - Intravenous immunoglobulin therapy for the treatment of idiopathic thrombocytopenic purpura. AB - Intravenous immunoglobulin is not only a very dramatic clinical therapy but also extremely interesting from the point of view of understanding its mechanism of action. The difficulty of delivery and especially the high cost of therapy limits its application; yet it appears to be equal to or perhaps slightly more effective than corticosteroids as a treatment of ITP and is less toxic with prolonged use. The appropriate place for its exact usage remains to be determined, and further controlled trials are urgently needed. Existing studies on its mechanisms of actions are very interesting and have furthered our understanding of the pathophysiology of ITP. Although future work may lead to further applications, initial enthusiasm for the use of IVGG in other autoimmune diseases has been limited by subsequent clinical experience. PMID- 3550894 TI - Porcine von Willebrand disease: implications for the pathophysiology of atherosclerosis and thrombosis. AB - A role of von Willebrand factor-mediated platelet function in porcine atherogenesis is strongly suggested by these studies. This influence of platelet function is probably most important in experimental systems that involve long term observation and low or moderately elevated levels of serum cholesterol. On the other hand, effects of platelet function on development of atherosclerosis in animals with extremely high serum cholesterol levels are difficult to demonstrate and may be of relatively less importance. These observations are consistent with the results of numbers of recent studies describing the relationship of vascular injury to intimal smooth muscle cell proliferation. There is considerable evidence that lipid-rich intimal lesions occur in hypercholesterolemic animals with no antecedent denudation of endothelium or platelet adherence. It is difficult to ascribe intimal proliferation to platelet effects in this setting. On the other hand, endothelial cells, smooth muscle cells, and monocytes, which are all known to be involved in the atherosclerotic process, can produce mitogenic and chemotactic proteins, including platelet-derived growth factor. Therefore, metabolic aberrations of various kinds, including those initiated by mechanical injury or hypercholesterolemia, may promote proliferation in the vascular wall and resultant lesion development. Data from studies of pigs with vWD suggest a contribution of platelets to this process, but the effects of this contribution are modulated by numbers of variables, most of which are yet to be identified. The control of these multiple variables will be necessary before a clear understanding of the magnitude of the platelet-mediated effects can be gained. This will require carefully defined conditions of hypercholesterolemia, special attention to the immunologic variables and study of properly selected vascular segments under known conditions of flow. This later element will be especially important in the study of vWF-mediated platelet function, since shear forces are a critical determinant of vWF function. Systems that model flow conditions in various segments of the aorta, carotid, and coronary arteries are presently under development for this purpose. Finally, studies examining the molecular basis of vWF-mediated and other platelet functions will probably guide the most productive use of these models. Platelet membrane glycoprotein (GP) receptor Ib and the complex GP IIb and IIIa have been shown in ex vivo studies to be binding sites for vWF molecules.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3550895 TI - [Gene transfer into mammalian cells by electroporation]. PMID- 3550896 TI - [Excision repair and homology of repair genes]. PMID- 3550898 TI - [Autocrine growth factor derived from human leukemia cells grown in a protein free medium]. PMID- 3550897 TI - [The mechanism of biosynthesis and secretion of bacterial lipoprotein]. PMID- 3550899 TI - [Molecular mechanism of color discrimination]. PMID- 3550901 TI - ["Balm on a painful wound." 2 hitherto unknown letters of Sigmund Freud about his relationship with Josef Breuer]. PMID- 3550902 TI - [Psychoanalysis in films 1925/26 (Berlin/Vienna)]. PMID- 3550900 TI - Analysis of 6-keto PGF1 alpha, 5-HETE, and LTC4 in rat lung: comparison of GM/MS, RIA, and EIA. AB - The recent availability of fast and sensitive radioimmunoassay (RIA) and enzyme immunoassay (EIA) procedures to measure icosanoids has led to utilization of these techniques by many investigators. A major concern has been that techniques based on immunoreactivity may lack specificity, in particular if complex biologic fluids or tissue extracts are evaluated. The purpose of this investigation was the comparison of icosanoid measurements obtained either with EIA or RIA with those obtained by gas chromatography/mass spectrometry (GC/MS). Rats were injected with Salmonella enteritidis endotoxin, killed at various times after the injection and the lung extract assayed for 6-keto-PGF1 alpha, 5-HETE and LTC4. By EIA lung tissue was found to contain large quantities of 6-keto-PGF1 alpha after endotoxin stimulation. Comparisons made between EIA and GC/MS analysis showed good correlation between 6-keto-PGF1 alpha amounts in lung as determined by each technique. It was also determined that little purification of lung extract was needed to obtain reliable quantitation of 6-keto-PGF1 alpha, probably due to the specificity of the antibody and the large quantity of this prostaglandin produced. Crudely purified (Sep-Pak) lung extracts gave 5-HETE levels by RIA which were highly correlated with GC/MS values, but RIA values were 70% higher than those obtained by GC/MS. The presence of other components in lung extract which cross react with this 5-HETE antibody was probably responsible for the higher values obtained by RIA. LTC4 was measured by immunoassay in crude lung extracts, as well as after Sep-Pak purification and HPLC purification. LTC4 levels were identical in unpurified lung extract and after Sep-Pak purification, but decreased substantially after HPLC purification. Thus, by validating the icosanoid immunoassays, we have found that they can give accurate and reproducible results in lung tissue, although LTC4 and 5-HETE must be purified prior to analysis. PMID- 3550903 TI - Ultrasonographic measurement of tumor regression in radiation therapy. AB - Ultrasonography was evaluated as a measurement procedure for investigating the tumor regression of cervical lymph nodes. Preliminary results suggested that interobserver compatibility in the measurement of nodes deteriorates when the diameter of the node is less than 15 mm. There was no systematic disparity between ultrasonographic and manual measurements. The tumor regression line fit the exponential line with a correlation coefficient of more than 0.95 in seven of 16 nodes. During the sequential examination, a central low-echo area suddenly appeared in one node at 15 Gy/6 Fr. PMID- 3550905 TI - [Echographic monitoring of 80 renal transplants. Critical analysis of signs of graft rejection]. AB - In a period of one year and a half, the follow-up of 80 patients after renal transplant has been monitored with echography. Altogether were made 418 echographies, which later were correlated with the clinical conditions of the patients at the moment of each echography. As rejection represents the most important complication, care was particularly given to the possibility of sonographic identification of such pathology. The sensitivity, specificity and diagnostic accuracy of each echographic sign in the diagnosis of rejection were evaluated. The absent or reduced renal sinus (sensitivity 63%) and hyperechogenicity of the cortical parenchyma (sensitivity 50%) resulted the most important signs in the diagnosis of rejection, while the increase of renal volume and the increased hypoechogenic pyramids resulted less reliable. The combination of three or more signs proved to be particularly significant. PMID- 3550904 TI - [Recent trend and future of the cardiovascular nuclear medicine]. PMID- 3550906 TI - [Instrumental diagnosis of non-glandular superficial inflammation]. AB - The study of soft tissues has greatly improved since the introduction of ultrasonography (US) and computed tomography (CT). In order to define the role of instrumental investigations, 51 patients affected by non glandular superficial soft tissue masses underwent US and 9 were also examined with CT. US proved to be accurate to define the size, the structure of the mass (93%), the benign or malignant nature (91%). US was also useful for percutaneous biopsy. However, US cannot be considered the only investigation because it does not give enough data about bony and articular structures: a conventional X-ray film must be performed in order to define the relation of the mass with the adjacent bone and to clarify the possible presence of fatty tissue in a solid mass shown at US. CT has a role in case of large masses, surrounding a bone diaphysis, when the malignant nature is suspected and to define the relationship with vessels and muscles. PMID- 3550907 TI - [History of the Argentinian Dental Association. 37 presidents]. PMID- 3550909 TI - Alcohol treatment and society: overview. PMID- 3550908 TI - Ethanol intoxication and memory. Recent developments and new directions. AB - A qualitative description of the acute effects of ethanol intoxication on learning and memory is presented. Mechanisms underlying the acquisition impairments observed in intoxicated subjects are discussed. Recent studies on retroactive facilitation are also considered. The importance of considering changes in attention, arousal, and mood in any account of the effects of ethanol on higher mental functions is emphasized. In the future, studies are needed in which the effects of ethanol are compared and contrasted with those of other agents. Such studies will not only improve our knowledge about ethanol's effects but will also enhance our understanding of cognition. PMID- 3550911 TI - Sociological perspectives on the alcoholism treatment literature since 1940. AB - From a sociological perspective there are many different worlds of alcoholism treatment. The present time may be crucially opportune for sociological research on the characteristics and development of alcoholism treatment. The last few decades have been characterized by an ongoing theoretical and empirical restructuring in a way that can be described as an emergence of a "new reality" in the perception of the problem area. Central assumptions have been challenged, and new concerns have entered the debate. This chapter analyzes some of the developments that led to these theoretical and ideological changes in viewing the alcoholism treatment field. This is undertaken by a quantitative analysis of the alcoholism treatment literature that was conducted some 10 years ago and that covers the period between 1940 and 1972. In hindsight, it seems that this period leading up to the first years of the 1970s is now of special interest, since the pieces for a more holistic alternative restructuring began to emerge during that time. PMID- 3550910 TI - Inebriety, doctors, and the state. Alcoholism treatment institutions before 1940. AB - This chapter recounts what is known about the international development of treatment institutions for inebriates in the century before 1940. It begins with the origins of treatment in the self-help temperance movement of the 1830s and 1840s and the founding of the first inebriate homes, tracing in the United States the transformation of these small, private, spiritually inclined programs into the medically dominated, quasipublic inebriate asylums of the late 19th century. A similar institutional development occurred in other English-speaking countries. Both in the United States and Britain, these institutions almost disappeared by the end of the First World War. In Germany and Switzerland, a three-tier system of community advice bureaus, inpatient sanatoria, and work camps developed at the turn of the century; an analogous system, with temperance boards at the community level, developed in Nordic countries between 1912 and 1940. The societal emphasis on the problem of impoverished inebriates often turned inebriate treatment efforts in the direction of coercive and custodial handling. PMID- 3550912 TI - The social ecology of alcohol treatment in the United States. AB - This chapter reviews the literature on the social ecology of alcohol-related treatment in the United States. It begins with an examination of differences in the population characteristics of alcoholics and problem drinkers within and without alcohol treatment institutions. Recent trends in treatment populations are described. Also considered are a variety of factors that influence both entry into treatment and the distribution of clients across the treatment system, including gender, ethnicity, problem severity, social networks, client wants, gatekeeping practices among treatment providers, and referral patterns. The general applicability of the "health belief model" to treatment entry is assessed as well as the place of a number of well-known barriers to alcohol-related treatment in accounting for nonentry. The distribution of the society's alcohol related caseload--both across alcohol-specific and other health and social service institutions--is considered. Also examined are recent trends in the social handling of alcohol-related problems, with special reference to the growing reliance on coercion in case recruitment. Finally, the review offers a number of suggestions regarding implications for further research and broad directions the evolution of American alcohol-related treatment institutions may take. PMID- 3550913 TI - The great controlled-drinking controversy. AB - This chapter reviews the controlled-drinking controversy. It presents cameo descriptions of the controversy's three major episodes--those occasioned by D. L. Davies' 1962 report, the 1976 publication of the first Rand Report, and the 1982 publication in Science of a paper by Pendery, Maltzman, and West--as well as a cameo for the long "interepisode" period between Davies' paper and the Rand Report. I argue that the controversy has emerged out of the failure of the "new scientific approach" to alcoholism, initiated a half century ago, to advance alcoholism treatment significantly beyond the point from which it began. Lack of progress, in turn, has generated tensions and reverberations along many of the normative dimensions that define scientific/treatment activity, both internally and in relation to the broader society. Some of the changing social and valuative forces at work in the controversy's history are examined. PMID- 3550914 TI - Studying drinking problems rather than alcoholism. AB - This chapter focuses primarily on the implications of quantitative, nonclinical studies of drinking practices and problems in planning primary prevention programs. The discussion utilizes the findings of the national probability surveys, directed by the author and his colleagues over the last 20 years, to illustrate how vastly different the survey findings are from studies of clinical alcoholics in terms of prevalence among various age and subcultural groups, and how longitudinal studies have cast question on much of the predictive utility of the disease concept of alcoholism. In closing, the chapter draws attention to the importance of cross-cultural surveys, conducted at intervals, in achieving greater success in primary prevention of severe physical and social problems associated with overconsumption of alcohol. PMID- 3550915 TI - Social drinking as a health and psychosocial risk factor. Anstie's limit revisited. AB - This chapter reviews empirical evidence dealing with the risk of using beverage alcohol in quantities generally considered to be within the range of moderate or social drinking. It begins with a discussion of terms and concepts typically employed to define the limits of moderate and social drinking. The historical debate over moderate drinking is considered next, using Francis Anstie's daily limit of 1.5 oz of absolute ethanol as an example of an influential and enduring approach to this issue. The scientific evidence relevant to the association between moderate drinking and damage is reviewed in sections dealing with the risks of acute ingestion of alcohol and the hazards of chronic drinking. In a final section, a multidimensional model of risk is developed to serve as a basis for early intervention and prevention planning. It is concluded that both social and moderate drinking entail risk of health hazards and psychosocial consequences. These risks are not always a direct function of the amount of ethanol consumed but rather reflect complex interactions among a host of antecedent and mediating variables. When these are taken into account, a better estimate of the relative risk of different consequences of drinking can be made. PMID- 3550916 TI - Techniques to modify hazardous drinking patterns. AB - There is an enormous empirical literature evaluating and comparing the effectiveness of the many available intervention techniques for alcohol abuse. This chapter is restricted to a description and evaluation of methods designed to modify hazardous drinking patterns at early stages, before the emergence of severe problems and dependence. Thus, the methods described are not limited to interventions with an intended goal of total abstinence. Their common aim is to decrease the quantity and frequency of alcohol consumption to a level at which drinking no longer presents a significant risk to the individual's physical and psychological health. The complete cessation of drinking represents one way in which this can be accomplished, but a more common outcome is moderate and nonproblem drinking. PMID- 3550917 TI - The chronic effects of alcohol on memory. A contrast between a unitary and dual system approach. AB - Recent studies have indicated that impairment of memory is a common cognitive deficit related to long-term alcohol consumption. Such deficits range from subtle disturbance through a "subclinical" amnesic disorder to full-blown Korsakoff syndrome. This finding is congenial with the hypothesized continuum of alcohol related impairment of memory. Among alcoholics, this memory impairment appears to be etiologically distinct from the commonly observed deficits in abstracting and problem-solving abilities. In the present chapter, a dual and a unitary formulation of memory are contrasted in their ability to present a coherent account of what memory tasks Korsakoff amnesics can and cannot do. The explanations offered by unitary theory are weak compared to those derived from the theory that memory consists of two distinct systems--experiential and abstractive memory. We indicate how the pattern of responding on standard clinical tests of memory can be coherently analyzed post hoc within the dual formulation. A number of experimental predictions are also presented based on the theory that Korsakoff amnesics have a profound impairment of experiential memory, whereas the abstractive system is essentially normal. Such experiments should clarify the nature both of Korsakoff amnesia and of memory itself. In conclusion, we indicated that memory disorders related to alcoholism can be understood in terms of a gradient, or continuum, of impairment of the experiential system. PMID- 3550918 TI - Cognitive deficits related to memory impairments in alcoholism. AB - Cognitive impairments related to alcoholism are examined in terms of input, intervening, and output variables. Respectively, the dysfunctions are represented by visuospatial/perceptual abnormalities, affective/conative deficits, and strong perseverative response tendencies. Defects in one or more of these aspects of cognitive functioning may appear as problems of memory. Functional differences between subgroups of alcoholics who do and do not develop severe anterograde amnesia characteristic of Korsakoff's syndrome presumably are attributable to differences in the distribution and extent of brain pathology. Both subgroups have widespread cortical pathology, which may play an important role in stimulus processing deficiencies observed in both. Korsakoff's have demonstrated a more significant degree of pathology in diencephalic and basal forebrain structures than that observed in non-Korsakoff alcoholics; this may contribute to the greater memory and affective impairments in the former. However, in no subgroup of alcoholics can a single functional system or brain region be implicated as the major contributory factor. Rather, damage to multiple brain regions likely is responsible for the plethora of cognitive difficulties reported in the alcoholism literature. PMID- 3550919 TI - Specificity of memory deficits in alcoholism. AB - Inferences of specific impairments in memory from prolonged abuse of alcohol have come from initial studies reporting that visuospatial memory and problem solving were impaired but verbal memory and learning were not. The apparent specificity, however, is demonstrated to be an artifact of the more difficult visual tests. With task complexity increased, impairments are shown also in both learning and recall of words, story, or designs. A common condition for deficits to be detected is the demand for effort in encoding and retrieving of to-be-remembered information. In general, deficits are mild and diffuse and do not seem to be clearly specific to material or modality. Furthermore, deficits are more pronounced in old alcoholics, although these tend to have longer drinking careers. Age and length of abstinence are more significant predictors of impairment than length or rate of alcohol drinking; however, concomitant disease and familial history of alcoholism are recognized to contribute to wide differences in effort-requiring memory processing. PMID- 3550920 TI - [Course of recurrence of focal and segmental glomerulosclerosis after renal transplantation]. PMID- 3550921 TI - [Practical points in fixed prosthetics]. PMID- 3550923 TI - [Choosing teeth according to morphologic type]. PMID- 3550924 TI - [Pubic osteoarthropathy caused by symphyseal instability or chronic painful symphysiolysis: treatment by symphysiodesis. Apropos of a case and review of the literature]. AB - The authors describe a case of pubic pain in a 42 year old woman engaged in leisure sporting activity. She had had, 17 years earlier, a difficult delivery. Standard X-Ray showed narrowing of the symphysis pubis. Radiographs when bearing weight on one leg showed instability of the symphysis pubis. Conservative treatment was unsuccessful and grafting and plating was performed. The result was most satisfactory. A review of the literature shows ten similar cases. The obstetrical consequences are discussed. PMID- 3550922 TI - [Prestige of dentistry]. PMID- 3550925 TI - [A peculiar tumor. Adamantinoma of the long bones. Apropos of 7 consecutive cases followed up after resection]. AB - Seven cases of tibial adamantinoma have been reviewed. All were treated by en bloc resection and followed for one to twenty years after operation. Of five patients followed for more than three years, three have had a good result after 3, 12 and 20 years of follow-up. One patient suffered a recurrence in the soft tissues seven years after resection and remained well after thirteen years follow up. One patient required amputation two years after resection and died from a mediastinal tumour of undetermined nature sixteen years after amputation. The two failures occurred in patients seen secondarily following recurrence after initial curettage. The tibial shaft was reconstructed in three cases by massive allografts. One of these failed because of infection but was reconstructed using autografts; one had a late fracture which united spontaneously. The third, after sound union, had to be amputated for recurrence. Two smaller resections were treated successfully by tibial and iliac autografts. Two cases were treated by free vascularised fibular transplants which united, though one suffered a late fracture which united spontaneously. Curettage, which is almost always followed by recurrence, should be rejected in favour of extensive resection. Resection is successful when done primarily but poses severe problems in reconstruction and requires a prolonged period of treatment. The small numbers in this series do not allow a judgement to be made as to the superiority of one technique over another. PMID- 3550926 TI - [Pharmacokinetic evaluation of 2 oral forms of chloramphenicol in children with typhoid]. PMID- 3550928 TI - [Membranoproliferative glomerulonephritis. Clinico-pathological and therapeutic correlations]. PMID- 3550927 TI - [Intermittent peritoneal dialysis in pediatrics]. PMID- 3550930 TI - [Human oncogenes]. PMID- 3550929 TI - [Toxoplasmosis in pregnant women. 4 years' experience]. PMID- 3550931 TI - [Treatment of hypertensive crisis with sublingual captopril]. PMID- 3550932 TI - [Nettle-shaped pityriasis versicolor]. PMID- 3550933 TI - [Parasitism and appendicitis. Our experience]. PMID- 3550934 TI - [Abuje or abujo, Eutrombicula alfreddugesi (Oudemans, 1910) (Acarina:Tromboculidae), a mite of biomedical importance in the eastern provinces in Cuba]. PMID- 3550935 TI - [Ecological studies of fresh water mollusks of medical significance]. PMID- 3550936 TI - [Seasonal study of resting sites of anophelines (Diptera: Culicidae). Preliminary report]. PMID- 3550937 TI - [Behavior of the body length and weight of Marisa cornuarietis (Mollusca: Prosobranchia) in semi-natural conditions]. PMID- 3550938 TI - [Diagnostic confirmation by the culture of the causative agent in 2 cases of occupational histoplasmosis]. PMID- 3550939 TI - [Resting sites of Culex (C.) quinquefasciatus Say, 1823 (Diptera: Culicidae)]. PMID- 3550940 TI - [Comparative study of various culture media for mycobacteria, including the new UIT-A modification]. PMID- 3550941 TI - [Occupational biological risk and safety measures in medical laboratories]. PMID- 3550942 TI - [Importance of immunologic diagnosis in congenital toxoplasmosis]. PMID- 3550943 TI - [Behavior of Aedes (O) taeniorhynchus Wiedeman, 1921 and Aedes (O) sollicitans Walker, 1856]. PMID- 3550944 TI - [Comparison of the complement fixation test, hemagglutination inhibition test and solid-phase enzymatic immunoassay, for the serologic diagnosis of dengue]. PMID- 3550945 TI - [Epidemiologic considerations on an imported case of typhoid fever]. PMID- 3550946 TI - [Parasitologic enrichment methods. Galvez equipment and technic (Patent no. 34945)]. PMID- 3550949 TI - [Medical care services at the Pedro Kouri Institute of Tropical Medicine]. PMID- 3550948 TI - [Isolation of Dirofilaria immitis antigens. I. Preliminary study of fractionation using ion exchange chromatography]. PMID- 3550947 TI - [Odonata as bio-regulators of mosquito larval phases]. PMID- 3550950 TI - [Isolation of dermatophytes from children without clinical signs of dermatophytosis. Report]. PMID- 3550951 TI - [Separation of Fasciola hepatica antigens by gel chromatography]. PMID- 3550952 TI - [Morphometric comparison of 2 populations of Tarebia granifera (Lamarck)(Mollusca: Prosobranchia)]. PMID- 3550953 TI - [Hematophagia activity of Culex (C.) Quinquefasciatus Say, 1823 (Diptera: Culicidae)]. PMID- 3550954 TI - [Seasonal variations of a mollusk competing with intermediate hosts of tropical diseases]. PMID- 3550955 TI - [Bacteriologic diagnosis of acute pulmonary inflammatory processes at various institutions in the country]. PMID- 3550957 TI - [Main species of larvivorous fishes of the Poecilidae family and its effectiveness under natural conditions in Cuba]. PMID- 3550956 TI - [Infestation of Romanomermis culicivorax Ross and Smith, 1976 (Rhabditida, Mermithidae) in larvae of Anopheles (Nyssorhynchus) albimanus Wiedeman, 1821 (Diptera: Culicidae) under laboratory conditions]. PMID- 3550958 TI - [Separation of Dirofilaria immitis antigens: II. DEAE-cellulose chromatography]. PMID- 3550959 TI - [Serologic diagnosis of lymphatic forms of toxoplasmosis]. PMID- 3550960 TI - [Proposal for the classification of the intestinal impact of giardiasis]. PMID- 3550961 TI - [Effectiveness of Bacillus thuringiensis israelensis H-14 variety in different mosquito breeding grounds in the City of Havana and Santiago de Cuba provinces]. PMID- 3550962 TI - [Congenital malaria. Presentation of a case]. PMID- 3550963 TI - [Evaluation of the incidence of anencephaly and spina bifida in Brittany (1975 1984)]. AB - Brittany is celtic, like Ireland and Wales where the incidence of neural tube defects is raised. We searched the hospital files in Brittany for all live and still births, and terminations of pregnancy after prenatal diagnosis for the years 1975-1984. 225 cases of spina bifida and 210 cases of anencephaly were identified; giving an incidence of 0.60 per 1000 births for spina bifida and 0.56 per 1000 births for anencephaly. No seasonality was found for both malformations. Analysis of the sex ratio for anencephaly indicated significantly higher proportion of females to males. Maternal age in the affected group was similar to the normal population. Casual heterogeneity among neural tube defects patients was presumed because 14% of our cases had other congenital anomalies. PMID- 3550965 TI - [Design of a new system of anesthetic ventilation for use in intermittent mandatory ventilation]. PMID- 3550964 TI - [Prevention of occupational carcinogens: perspectives opened by the evaluation of risks and preventive actions]. AB - The first part of the review deals with the present situation in terms of prevention against potential carcinogenic substances in France. A significant effort should be devoted to the measurement of contaminants--not only carcinogenic substances--in the workplace. This is a prerequisite for setting a data base in terms of potential occupational risk. Moreover gaps exist also as far as the definition of the technical means aimed at the reduction of risk is concerned. These conclusions put into light the importance of the contribution that "industrial hygienists" would bring in France. In the second part of the review, the methodological content of the risk assessment and risk management procedures is described and illustrated. Risk assessment of carcinogens deals: with the identification of potential carcinogens through epidemiology, animal bio assays and short term tests; with the quantitative estimation of the magnitude of the potential carcinogenic risk among the exposed workers. It appears necessary to carry out systematic surveys of the number of workers exposed to the carcinogenic substances. The risk assessment procedure is applied to 5 substances BCME, MOCA, Acrylonitrile, Chromium, Nickel and some compounds of these metals. The number of potential excess cancers related to a unit lifelong exposure to Nickel compounds is estimated. This requires exposure-response models which are critically analysed. Risk management is devoted to the choice of primary health care policies. The methodology of risk management consists of: identifying various control policies; quantitative estimation of their efficiency--indicators of the efficiency are discussed--and of their cost; choice among these policies with the help of a cost-effectiveness analysis when necessary. The procedure is illustrated in the case of Acrylonitrile control in a facility. PMID- 3550966 TI - [A new technic for ventilatory support in pediatric anesthesia. Use of intermittent mandatory ventilation]. PMID- 3550967 TI - [Long analgesic duration of epidural morphine in a single dose in the postoperative period in renal transplants]. PMID- 3550968 TI - [Value of orthotopic liver transplantation in swine as an experimental model]. PMID- 3550969 TI - [Allogeneic hepatocellular transplantation into the spleen of normal rats]. PMID- 3550970 TI - [Hepatocellular transplant; a new perspective in liver care]. PMID- 3550971 TI - [Echographic diagnosis of hepatic hernias]. PMID- 3550972 TI - [Subhepatic abscess caused by a retained surgical gauze. Echographic diagnosis]. PMID- 3550973 TI - [Failures in removable partial dentures]. PMID- 3550974 TI - [Behavioral psychology in dentistry. An introduction]. PMID- 3550975 TI - [Role of the macula densa and beta-adrenergic system in the control of the circadian rhythm of renin and aldosterone]. PMID- 3550976 TI - [Historical development of the concepts of hunger, satiety and appetite]. PMID- 3550977 TI - [Food ingestion in ruminants: modalities and associated phenomena]. AB - This paper synthesizes the literature on modalities of food intake in ruminants and their main associated phenomena. Firstly, circadian distribution of feeding and ruminating activities has been examined. Ruminants spend a large part of their time chewing. Their meals have been described in detail; changes in rates of intake, time spent eating, the effect of restricting the amount fed or the period of feed accessibility have been discussed. When food is distributed, the animals have a "long" meal. These meals have been analysed in relation to the type of animal and the feed offered. The other meals ("small" meals) have been briefly described. The paper next examines the phenomena associated with meals, or induced by them, and implied in the control of food intake. Forestomach motricity varies according to ruminant feeding behavior and plays a basic role in digesta transit. Rumen content varies with the meal and its chemical composition due to the arrival in the rumen of food, water and saliva. Rumination may require 600 to 650 min/day and is important in the comminution and sorting of rumen particles. The digestive phenomena associated with meals are related to control of intake. The influence of rumen fill has been thoroughly discussed. Finally, main humoral changes due to intake have been reviewed. The influence of volatile fatty acids (VFA) and metabolites has been discussed as well as the role of glucose, amino acids and fatty acids. Among the hormones, insulin and glucagon seem to play an important role in controlling food intake. The amounts of gastrointestinal hormones increase during intake and may also play an important part. Despite a net improvement in the knowledge of phenomena related to intake, much still remains to be done in setting up models to describe these phenomena in relation to feeding activities and to aid in understanding the mechanisms controlling feed intake in ruminants. PMID- 3550978 TI - [Adaptation of food ingestion to energy expenditure]. AB - Body energy balance is regulated in adults. The accuracy of the phenomenon is particularly evident in laboratory animals under steady conditions. Moreover, it has been repeatedly demonstrated that this balance is maintained in spite of fluctuations in food intake or energy expenditure. When animals such as rats, dogs or rabbits are presented with a diluted or concentrated version of familiar food, they compensate rapidly by increasing or decreasing their ponderal intake. This is achieved first by a change in meal frequency, then meal size adapts to the new caloric content and meal frequency returns to the original pattern. This adaptation is based on the learning of post-ingestive cues. Hypo or hyperphagia leads to reduced or increased energy expenditure, as the case may be; the basal metabolic rate is modulated by thyroid hormones and diet-induced thermogenesis by the sympathetic system. These variations are partly regulatory. In a cold environment, the increase in energy expenditure caused by increased thermogenesis is rapidly compensated by increased caloric intake. Physical activity activates the sympathetic system responsible for numerous hormonal changes, the most important of which is insulin hyposecretion. In animals or humans, moderate aerobic exercise induces a small weight loss; afterwards, weight gain is normalized and increased caloric intake compensates for energy expenditures such as exercise, increased basal metabolic rate and diet-induced thermogenesis. Extreme changes in body weight and fat are produced by gestation and lactation; they are satisfactorily explained by concomitant hormonal changes. Especially during lactation, food intake is regulated so that it allows body weight to return to pregestation level. Studies on the mechanisms implicated in the regulation of body energy balance are still in progress. Friedman and Ramirez (1985) suggest that the way fatty acids are utilized is important. Kasser et al. (1985) show a striking difference in the cellular metabolism of hypothalamic regions, depending on the metabolic state or the animal, and Woods et al. (1985) strongly suggest a role for the central insulin level. These hypotheses are well documented and not exclusive of each other. PMID- 3550979 TI - Enzymatic properties of 13,14-dihydroprostaglandin F2 alpha synthetase in ovarian cytosol of the rat. AB - The activity of 13,14-dihydroprostaglandin F2 alpha (13,14 H2-PGF2 alpha) synthetase, which catalyzes the conversion of 13,14-dihydro-15-keto-PGF2 alpha (15KD-PGF2 alpha) to 13,14H2-PGF2 alpha, was examined in ovarian cytosol of rat, hamster, mouse, rabbit, guinea-pig, pig, cow and dog. The activity was very low in all species except the rat. The tissue distribution of 13,14H2-PGF2 alpha synthetase in the rat was next studied, and the highest activities were observed in the ovary and adrenal gland, whereas the activities in the lung and kidney, which possess higher activities of 15-hydroxy-PG dehydrogenase, were much lower. The bulk (80%) of the activity in the ovary was recovered in the cytosol fraction. The enzyme from rat ovarian cytosol showed two optimum pH values, at pH 7.0 and pH 8.0. The enzyme activity was strongly inhibited by sulfhydryl reagents and quercitrin, but not by phenobarbital. It is suggested that 13,14H2-PGF2 alpha synthetase in rat ovarian cytosol is a carbonyl reductase, and may be involved in drug metabolism in the female reproductive system. PMID- 3550980 TI - Airway responsiveness to histamine or methacholine: advances in measurement and interpretation. AB - A number of topical aspects of histamine or methacholine inhalation tests were discussed. First, the reporting of results as the dose delivered to the mouth by the method of aerosol generation and inhalation may allow better interpretation of results between laboratories. However, this requires investigation. Second, the histamine or methacholine dose-response curve differs in asthmatics with a moderate to severe increase in airway responsiveness from asthmatics with a mild increase in responsiveness or nonasthmatics. In the latter groups, the dose response curve is positioned to the right and has a maximal response plateau. The disappearance of this limited maximal airway narrowing in asthmatics appears to be due to added abnormalities. Third, histamine or methacholine inhalation tests provide a sensitive and specific measure of the presence of variable airflow obstruction (asthma). They are useful to validate the diagnosis when symptoms are suggestive but spirometry is normal. The symptoms of asthma are not specific, and without objective confirmation the diagnosis is frequently misjudged even by the specialist. Finally, airway hyperresponsiveness to histamine or methacholine is not diagnostic of asthma when chronic airflow limitation is present; hyperresponsiveness to isocapnic hyperventilation may be more specific. PMID- 3550982 TI - Management of nausea and vomiting induced by outpatient cisplatin (Platinol) therapy. PMID- 3550981 TI - Nifedipine decreases sensitivity and reactivity to methacholine in mild asthmatics. AB - The protective effect of the calcium antagonist nifedipine (20 mg sublingually) on methacholine-induced bronchospasms was investigated in 14 mild asthmatics, 8 extrinsic and 6 intrinsic, in stable situations and with FEV1 greater than or equal to 80% of the one predicted. On separate days cumulative dose-response curves to methacholine were constructed, basal and 20 min after nifedipine administration; on both occasions basal FEV1 varied less than 5%. The sensitivity threshold (PD20) and reactivity (slope of the curve) were obtained. The shape of the curves analyzed from the PD20 point on, was linear (r2 = 0.99). There was a strong hyperbolic correlation between sensitivity and reactivity (r2 = 0.89). Nifedipine did not modify basal FEV1. After nifedipine, the sensitivity to methacholine decreased from 36.7 +/- 10.5 to 61.0 +/- 15.8 SEM (p less than 0.01) and likewise the reactivity from 2.2 +/- 0.7 to 1.1 +/- 0.5 SEM (p less than 0.02). Protection was greater when the basal sensitivity was higher (r = 0.59, p less than 0.05) but no such correlation was found for reactivity. Protection is explained by the blocking effect of nifedipine of calcium flux through voltage dependent channels, provided that muscarinic agonists, at low doses, act preferentially through electromechanical coupling. These results indicate that a distinction between sensitivity and reactivity does not provide more information than each separate parameter. PMID- 3550983 TI - [Complement system]. PMID- 3550984 TI - [Physiopathology and treatment of diabetic polyneuropathy]. PMID- 3550985 TI - [A rare complication of captopril: ulceration of the lingual and jugal mucosae]. PMID- 3550986 TI - [Detection of platelet antibodies in idiopathic thrombopenic purpura]. AB - The authors report the results of Dixon's assay modified by Follea in 24 cases of idiopathic thrombocytopenic purpura. The level of immunoglobulin G bound to platelet membrane was increased in 91 p. 100 of patients in the acute phase of the disease. An inverse correlation was demonstrated between platelet-bound antibody levels and platelet count as well as platelet survival. In all cases of refractory idiopathic thrombocytopenic purpura, the assay was positive and the mean level was higher. When the platelet count improved after prednisone therapy or after splenectomy, the level decreased. Platelet antibody determination seems to be useful for predicting the course of the disease. Patients with normal immunoglobulin G bound to platelet might have only C3, IgM or IgA. Dixon's assay is not specific to idiopathic thrombopenic purpura, since it is positive in other types of thrombocytopenia, but immunoglobulin G bound to platelet probably represents specific antiplatelet antibodies. PMID- 3550989 TI - The Mainz pouch for augmentation or substitution of the bladder and continent diversion. PMID- 3550987 TI - [Cyclosporin and autoimmune diseases. 1: Experimental bases]. AB - Cyclosporine is an 11 aminoacid cyclic peptide of fungal origin endowed with potent immunosuppressive activity. Unlike the conventional immunosuppressants, cyclosporine does not interfere with DNA metabolism, but it selectively and reversibly inhibits lymphocyte T-helper activation by inhibiting the production of interleukin-2 which plays a role in immune response development. Cyclosporine has little effect on lymphocytes B and does not modify the production of antibodies when it is in progress. The drug is effective in preventing spontaneous or autoantigen-induced auto-immune diseases in animals. The best studied models are experimental allergic encephalomyelitis, uveitis in the rat and spontaneous diabetes of BB rats. However, cyclosporine has no effect on diseases exclusively due to the pathogenic action of antibodies, such as spontaneous thyroiditis of the obese chicken. It is also possible to obtain a curative effect, this type of model being nearer to therapeutic conditions in humans than the previous models. PMID- 3550988 TI - [Cyclosporin and autoimmune diseases. 2: Human autoimmune diseases]. AB - The effectiveness of cyclosporin against human auto-immune diseases has been well established in uveitis, rheumatoid arthritis and insulin-dependent diabetes. No firm conclusion can be drawn from trials conducted in other diseases, since the results are discordant or based on an insufficient number of subjects. In view of the side-effects, and notably the risk of nephrotoxicity, of the drug, the blood levels of cyclosporine must be measured and the patient's renal function evaluated at regular intervals. For the time being, these risks reduce the prescription of cyclosporin to the severe forms of autoimmune diseases, i.e. those which resist conventional corticosteroid therapy. Things are different with diabetes, since cyclosporin is the only immunosuppressant which has proved effective in inducing remissions. But whether such remissions can be maintained in the long term remains uncertain, and this type of treatment is still limited to therapeutic trials. PMID- 3550990 TI - [Treatment of renal insufficiency in children]. PMID- 3550991 TI - [Is a diagnostic and therapeutic strategy still possible in early neoplasms of the cervix uteri?]. PMID- 3550992 TI - [The evolution of concepts concerning blood circulation throughout the ages and the introduction of transfusion in the 17th century]. PMID- 3550993 TI - [Aortocoronary bypass surgery at Liege: 10 years have already passed ...]. PMID- 3550994 TI - [Coronary surgery 20 years later]. PMID- 3550995 TI - [Treatment of breast cancer. Our stance in 1986]. PMID- 3550996 TI - [Direct methods of measuring ciliary beats]. PMID- 3550997 TI - [Imaging diagnosis of renal diseases based on indications]. PMID- 3550998 TI - [Rapid antigen tests for the diagnosis of group A streptococci in practice]. PMID- 3550999 TI - [Verapamil poisoning]. PMID- 3551000 TI - [Skin manifestations of AIDS]. PMID- 3551001 TI - [What is the role of systemic retinoids in practice?]. PMID- 3551002 TI - [Treatment of hepatic metastases of colo-rectal origin. Role of surgical excision and chemotherapy]. PMID- 3551003 TI - [Paul-Louis Ladame (1842-1914) and the medical uses of electricity in Geneva. Apropos of a series of articles appearing in the Revue in 1885]. PMID- 3551004 TI - [Hydrocarbons and the kidneys]. PMID- 3551005 TI - [Osteoarthritis. Status in 1986]. PMID- 3551006 TI - [Immunofluorescence in dermatology]. PMID- 3551008 TI - [Dopaminergic innervation of the parahippocampal and hippocampal regions in the rat]. AB - In spite of extensive investigations of the rat's meso-cortico-limbic system, the dopaminergic (DA) innervation of the hippocampal formation (HF) has not heretofore been visualized by histochemical techniques. However pharmacological and biochemical studies strongly suggested its existence. We used tyrosine hydroxylase (TH) as an immunocytochemical marker of DA neurons in rats in which the noradrenaline cortical innervation was previously destroyed by neurotoxins. The absence of noradrenergic axons was routinely controlled with dopamine-beta hydroxylase immunocytochemistry. TH-positive axons, thus DA axons, reach the HF primarily through the fimbria in which they occupy a specific lateral sector. They innervate the ventral and caudal parts of the HF, the subiculum and the adjacent CA1 hippocampal field being the main targets. This DA terminal field in the HF, matches with the area projecting toward the nucleus accumbens. Thus the hippocampo-striatal projections which represent a link of functional importance between the limbic and central motor systems might be modulated by the dopaminergic meso-cortico-limbic pathway. The present immunocytochemical study confirms the very dense innervation of the entorhinal cortex (EC): DA axons are organized in dense fiber islands and occupy primarily the superficial layers (I II-III). Da innervation predominates in the lateral part of EC, which is the site of multimodal cortical afferences and therefore relays information between the whole neocortex and the hippocampus. Thus the DA system could play an important role of modulation on hippocampal and parahippocampal functions. PMID- 3551007 TI - [Biological determinants of cerebral dominance]. AB - This review summarizes the present evidence for a biological basis of functional brain asymmetry. Morphological asymmetries, despite long-standing knowledge, have only recently aroused general interest. The most striking asymmetries involve regions of the cerebral cortex located around the posterior end of the Sylvian fissures: mainly studied was the planum temporale, but others include the parietal operculum, inferior parietal lobule, and inferior frontal gyrus. In most instances, cortical areas proved to bear asymmetries favouring the left hemisphere. Architectonic studies also revealed asymmetrical features; especially area "Tpt", roughly similar to Wernicke's posterior language area, has been found up to 7 times larger on the left than on the right hemisphere. Similar asymmetries were discovered in fetal brains, as early as the 30th gestational week, as well as in the cerebral cortex of some apes. These data suggest that morphological asymmetries need not be the consequence of functional effects but rather a predetermined feature, probably widely spread throughout animal kingdom. An open question remains as to the functional significance of these asymmetries. In this regard, studies have dealt with possible correlations between morphological asymmetries (as assessed in vivo by cerebral neuro-imaging methods) and features of functional asymmetry, especially handedness and hemispheric dominance for language. Despite incomplete results, available data suggest a significant correlation, at least in dextrals. The exact nature of these relationships remains speculative. Knowledge about the contribution of genetic factors in determining cerebral dominance followed observations of familial clustering of functional asymmetries, especially sinistrality, as well as studies in mono- and dizygotic twins. However, a purely genetic model seems to be unable to account consistently for the data. Hypotheses emphasizing birth stress may be only exceptionally verified. Actually, current evidence points to a specific period in the fetal life, probably around the 6th gestational month, during which neurons in post-migrational stage set up their synaptic contacts. The final gyral pattern of the brain probably builds up during this period, as a consequence of a mechanism of competition for synapses among different cortical areas which regulates the amount of neuronal growth and death. Such a mechanism probably also accounts for the development of cortical asymmetries.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3551010 TI - Mandibular posterior blade implants. A twelve year clinical and statistical evaluation. PMID- 3551011 TI - [Comparative study of anticholinergic and betamimetic agents in the treatment of asthma attacks]. AB - Four regimens of bronchodilatation therapy administered on 2 consecutive days were tested in 4 randomly selected groups of 6 asthmatic patients: 1) intravenous atropine + inhaled oxitropium bromide; 2) intravenous atropine alone; 3) intravenous salbutamol + inhaled salbutamol; 4) intravenous salbutamol alone. On the second day the treatments were crossed over, i.e. the groups which had received the intravenous + inhaled treatment on the first day received the same drug in i.v. form alone and vice versa. The intravenous doses of atropine and salbutamol were 0.5 mg each administered over 1 hour, and those of oxitropium and salbutamol aerosol were 100 mcg hourly for 6 hours. In addition, all patients received methylprednisolone 20 mg i.v. on each day of the study. Peak expiratory flow rate (PEFR), heart rate (HR) and arterial pressure were recorded before treatment, then hourly for 6 hours. All 4 regimes produced significant improvement in PEFR (P less than 0.01). Bronchodilatation was not significantly different in the 4 groups, but improvement was markedly better when intravenous injections were associated with inhalations. No side-effects were recorded with the anticholinergic drugs, whereas a slight but significant increase in HR (P less than 0.05) was observed with the adrenergic drug. This study suggests that anticholinergic agents provide a therapeutic alternative for severe acute asthma when beta 2-adrenergic stimulants cannot be used. PMID- 3551009 TI - Osseous grafting procedures in periodontal therapy. PMID- 3551013 TI - [Treatment of post-traumatic hemobilia by arterial embolization]. PMID- 3551012 TI - [Prevention of caries and periodontal diseases in children]. PMID- 3551014 TI - [Hematologic changes in C57BL mice exposed to whole body irradiation with radioactive cobalt]. PMID- 3551015 TI - [Vaginal agenesis: report of a case of post-coital urethral dilatation]. PMID- 3551016 TI - [Non-Hodgkin's malignant lymphoma with primary localization in the breast. Apropos of 2 cases: review of the literature]. AB - The malignant non-hodgkinian lymphoma (M.N.H.L.) with pripary mammary localization is relatively rare, but deserves to be accounted for in the evaluation of breast cancers. The diagnosis of the primary localization in the breast responds to definite criteria, well established by Wiseman and Liao. On the other hand, the initial mammary localization is more frequent, revealing a hemato-sarcoma clinically silent until then, but with nodal spread (most of the time lumbo-aortic). The problem is to know whether it is possible, in front of a breast nodule, to evoke lymphoma in view of some clinical and paraclinical characteristics. An accurate pathological diagnosis (International Formula for clinical use of the National Cancer Institute-1982) and a minutious work-up for spread determination (AnnArbor Classification) represent the two essential aspects of the prognosis. It is advised to resort to surgical excision-biopsy in order to obtain an exact histology with analysis of immunological markers, rather than an extemporaneous examination which often leads to the wrong diagnosis of cancer and a mutilating and unnecessary surgery. Progresses in chemotherapy have greatly contributed to improve survival of these hematosarcomas with extranodal localization, which remain however a neoplastic disease with a disseminating tendency. PMID- 3551017 TI - [Antinuclear antibodies, anti-SSA(Ro) and SSB(La) in diffuse connective tissue diseases]. PMID- 3551018 TI - [Antinuclear antibodies in children with connective tissue diseases]. PMID- 3551019 TI - [What should be known about nursing]. PMID- 3551020 TI - [Proceedings and nursing records]. PMID- 3551021 TI - [Liver transplantation? A revolution]. PMID- 3551022 TI - [Experimental malaria: contamination of strains and experimental animals by Eperythrozoon coccoides]. PMID- 3551023 TI - Delayed results of treatment of paracoccidioidomycosis with amphotericin B plus sulfamides versus amphotericin B alone. PMID- 3551024 TI - Health care--1986-87. "It was the best of times, it was the worst of times". PMID- 3551025 TI - Onchocerciasis in Sudan: the distribution of the disease and its vectors. AB - The distribution of onchocerciasis and its vectors in Sudan has been reviewed with special emphasis on the hyperendemic foci where there is serious visual handicap caused by the disease. These blinding foci lie primarily in the south west of the country, along the rivers flowing north and east from the borders with Central African Republic and Zaire, though at least one such focus is known from the eastern part of the country close to the Ethiopian border. In the blinding foci, often small villages localized to short stretches of the rivers, ocular onchocerciasis is as severe as that found in any other African foci. Only the S. damnosum s.l. species complex has been implicated in disease transmission and only the two dangerous, morphologically similar, savanna cytospecies, S. damnosum s.s. and S. sirbanum, have been identified from breeding sites close to known onchocerciasis foci. Near to the Uganda and Zaire borders it is very likely that other, less anthropophilic, cytospecies occur. Different Onchocerca-Simulium complexes (different strains of parasite with different pathogenicities transmitted by different vector species) may be responsible for the different severities of disease found in the 3 main areas of onchocerciasis in North, East and South-West Sudan. The localized, focal distribution of the communities seriously blinded by onchocerciasis, suggests that a strategy of tackling the disease on a focus basis may prove optimal. A control scheme, planned to treat all the vector breeding sites with insecticide, as in West Africa, would receive extensive invasion from the Zaire/Congo River Basin and the headwaters of the White and Blue Niles in neighbouring countries. While some foci are situated beside major river rapids, with vector breeding only controllable by regular insecticide treatments, several foci have been identified as lying close to removable man-made objects which provide excellent breeding sites at certain water levels e.g. causeways. The destruction of such breeding sites should be considered since localized vector control may produce substantial reductions in onchocerciasis transmission. PMID- 3551027 TI - The Testryp CATT (Card Agglutination Test for Trypanosomiasis): a field study on gambiense sleeping sickness in Liberia. AB - The inhabitants of three Liberian villages in a known gambiense sleeping sickness area with a low prevalence were examined comparatively with the haematocrit centrifugation technique (HCT), the miniature anion exchange centrifugation technique (m-AECT), the indirect fluorescent antibody test (IFAT) and the Testryp CATT (Card Agglutination Test for Trypanosomiasis). Among 418 persons examined was one individual from whom trypanosomes could be isolated with the HCT and m AECT. This positive case and another 21 individuals had positive titres of 1:40 and more in the IFAT. The same number, but not the same individuals, showed positive reactions in the CATT in the 1:5 serum dilution. The 1:25 dilution of blood and serum was inferior to the corresponding 1:5 dilution and could therefore be omitted. The 'false positive' rate in the CATT was 5.0% in the serum, 10.1% in the blood, and 11.5% in blood or serum. The combination of HCT and m-AECT in the field did not achieve better results than the CATT or IFAT. Thus the CATT can be recommended as the preferable technique for screening of gambiense trypanosomiasis in the field. PMID- 3551026 TI - T-cell dependent and T-cell independent immune response in normal and in with Litomosoides carinii infected cotton rats. AB - The immune responses to SRBC and LPS were examined in immunized and non-immunized inbred cotton rats at different times after an infection with Litomosoides carinii. During the infection, the T-cell dependent immune response to SRBC was significantly suppressed in non-immunized animals as compared to non infected controls. In contrast, after immunization with SRBC the antibody levels of infected animals were significantly higher in three of five events. At the onset of patency the response to SRBC was significantly depressed transiently in immunized animals. A corresponding depression could be provoked by injections of isolated microfilariae as well as by FCS in immunized animals, infected and non infected. The level of the antibodies was dependent on the density of microfilariae in the peripheral blood. The T-cell independent response to LPS was equal in non-immunized infected animals as in controls. After immunization with LPS during prepatency and at onset of patency a distinct but commensurate reaction was observed. Only after immunization at the peak of patency, the immune response of infected animals was significantly suppressed. In general, the antibody levels to LPS were not influenced by the microfilaremia. PMID- 3551028 TI - Open heart surgery: caring for bypass and transplant patients. PMID- 3551029 TI - [Significance of digital subtraction angiography in evaluating peripheral arteriovenous shunts in dialysis patients]. AB - Direct and indirect examination of arteriovenous shunts was performed in 50 patients undergoing haemodialysis. The various methods of puncture of the vessels, the indications and the limitations of DSA are considered. The advantages of direct puncture of the arteriovenous shunt are emphasised. Puncture of the venous branch is almost without risk and allows immediate diagnosis. Only in a very few cases it will be necessary to perform the risky puncture of the arterial branch or the time-consuming central venous injection of a bolus of the contrast medium. PMID- 3551031 TI - [Ultrasonic methods of studying cerebral circulation]. PMID- 3551032 TI - Neuropeptides--clinicobiological implications in neurology and psychiatry. PMID- 3551030 TI - [Cystic form of meconium peritonitis--a case report]. AB - In this case report the cystic form of meconium peritonitis is presented. The aetiology and differential diagnosis of this rare entity are discussed. PMID- 3551033 TI - [Use of metabolites of vitamin D in therapy. I. Metabolism and physiological action of vitamin D]. PMID- 3551034 TI - [Multicentric reticulohistiocytosis. A case with electron microscopy and enzyme study]. PMID- 3551035 TI - [Intramasseteric hemangioma: therapeutic problems]. AB - Intramuscular localization of hemangioma is rare, especially the intramasseteric one. With regard to three recent cases, the authors review the literature and discuss different treatments available: sclerosing agents, compression, surgery or embolization. New trends favor a modern combined approach: embolization associated with surgery. PMID- 3551036 TI - [Value of ultrasound in preoperative exploration of parotid tumors]. AB - Ultrasound image were compared with operative findings and gross pathology and histology appearances in 28 patients with parotid gland tumors (24 benign and 4 malignant). Ultrasound exploration provides precise data on localization, shape, size, outline, homogenicity of tumor contents and position of lesion in relation to pharyngeal wall. Clearly defined ultrasound images were detected in all benign but few malignant tumors, which presented mainly diffuse images. Non-homogeneous density of images, showing presence of intratumoral necrotic zones, was identified in all cases of malignant tumors but very few cases of benign lesions. Ultrasound imaging defines probable nature of a parotid tumor, probability enhanced by combining other exploratory investigations, but provides precise data on physical nature of tumor, of value during surgery. PMID- 3551037 TI - [Bone dysplasias and dystrophies. The viewpoint of the anatomo-pathologist]. AB - After a short summary of the bone histophysiology, the general characteristics, the nosology and the differential diagnosis of dystrophic and dysplastic lesions of bone are related. Then, their main varieties are classified in two chapters: osteogenic and osteolytic lesions. PMID- 3551038 TI - [Evaluation of the mid-term results of trident osteotomy using orthodontic goniometry]. AB - The authors study a series of twenty patients who underwent a "trident" maxillary osteotomy for transversal deficiency. They try to have a good evaluation of the exact value of the inter-molar distance after one year, in comparison with the expected value on the plaster casts before operation. Furthermore, they measure the axial modifications of the first molar, which consists in vestibulo or linguo version. For this study, they use a simple method which is called "orthodontic goniometry" and give a great precision. The transversal augmentation seems to be quite stable, with only fifteen per cent lost in the measured intermolar distance. But there are dental axial changes in eighty per cent of the patients. The most common modification consist in vestibular inclination, without damage for the result. But in thirty per cent of the cases, a palatal inclination is observed, with deterioration of the results. This is a good reason for maintaining a palatal contention during at least six months after surgery. PMID- 3551039 TI - Resin bond to electrolytically etched cobalt-chromium alloys. AB - Disks of four cobalt-chromium alloys were electrolytically etched and bonded together using a microfilled restorative resin. The bonds of the resin to two of the tested alloys, Bondi-loy and Vitallium, showed tensile strengths of approximately 18 MPa. The bonds were significantly stronger than those obtained using the other two alloys, Dentitan and Novarex. The tensile bond strengths of etched Dentitan and Novarex were 5.3 and 7.5 MPa respectively. The etched and debonded surfaces were studied in SEM. PMID- 3551040 TI - Replica patterns on composite restorations performed in vitro with different acid etch procedures and dentin adhesives. AB - 160 experimental Class V restorations using two chemically cured composite resins were inserted in extracted human teeth with conventional and modified acid-etch restorative procedures. The modifications included cavity treatment with non composite resin, ethanol, or four different dentin adhesives. Following demineralization of the teeth the fillings were examined in the SEM concerning their replica patterns of the etched cavity walls. In vitro conditions favored resin penetration into pretreated enamel and dentin, but resulted in minor variations between different acid-etch procedures compared with those previously seen on resin restorations placed in vivo in teeth with vital pulps. PMID- 3551041 TI - Comparison between a micromethod and a conventional method for estimation of salivary Streptococcus mutans. AB - Two methods for estimating the number of S. mutans in 501 paraffin-wax stimulated whole saliva samples were compared. A highly significant correlation was found between the results of a micropipette method and conventional agar plating. The micropipette method is simple, reliable and economical and is a suitable alternative to conventional plating for determination of the S. mutans infection level. PMID- 3551043 TI - Interexaminer variability in common ratings in reading Streptococcus mutans dip slides with or without a microscope. AB - The observer variability in reading 145 S. mutans dip-slides was assessed by a test panel consisting of a professional bacteriologist, practising dentists and unskilled laymen. The cultivated slides were read and classified into four categories by comparing them with standard photographs of previously cultivated slides with known numbers of S. mutans colonies. For reference, all the slides were also counted under a stereomicroscope. The results showed both under- and overestimation in the visual reading, but the scoring trend was logically increasing in relation to the microscopic reference scores in each case. The significance of the agreement on the ratings was high and it further increased when the results were recombined by classifying them into three categories. The individual agreement percentages varied then from 54 in the laymen to 79 in the bacteriologist. The use of a microscope did not significantly increase the number of common readings and cannot be considered necessary in practice. Reading the slides, however, definitely requires understanding and experience of the method. PMID- 3551042 TI - Comparison of polyclonal and monoclonal antibodies to Actinomyces and Arachnia species. AB - Polyclonal (PoAbs) and monoclonal (MoAbs) antibodies were produced to Actinomyces israelii serotypes 1 and 2, to Actinomyces naeslundii, and to Arachnia propionica, and their specificities were studied by an enzyme immunoassay (EIA). All PoAbs except those to A. propionica reacted also with at least one other Actinomyces species. Only the MoAb to A. naeslundii proved to be more specific than the corresponding PoAbs. This MoAb did not crossreact with other Actinomyces or Arachnia species, nor with any other anaerobic or aerobic bacteria studied by inhibition EIA. Immunoblotting studies indicated that the antibody specific to A. naeslundii is directed against a large molecular weight antigen (greater than 150 kd), probably polysaccharide in nature. The produced PoAbs and MoAbs can be used for further analyses of the antigenic determinants of different Actinomyces and Arachnia species. PMID- 3551044 TI - Identification of cellulose fibers in oral biopsies. AB - Oral biopsies comprising five periapical cysts, three cases of exuberant granulation tissue in extraction sockets and one case of a mandibular radiopaque structure, all displaying material consistent with cellulose fibers on routine histologic examination, were subjected to histochemical, polarization, fluorescence and scanning electron microscopical, energy dispersive X-ray and chemical investigations. Routine screening of periapical lesions with polarization microscopy and identification of possible cellulose fibers with Calcofluor White is advocated. Further, attention is drawn to endodontic paper point material as an etiologic factor in postendodontic periapical inflammatory processes. PMID- 3551045 TI - Activation marker analysis of mononuclear cell infiltrates of oral lichen planus in situ. AB - Monoclonal activation markers (Ia, Tac, T9, and 4F2) were used to detect the degree of activation of mononuclear cells in the inflammatory infiltrates of oral lichen planus in situ. In addition the specimens were stained with the following monoclonal antibodies: T4, T8, T11, M1, and pan-B. T-lymphocyte was the predominant cell type in the inflammatory infiltrates. According to the results of the activation marker analysis, the majority of the T-lymphocytes were resting. However, activated cytotoxic T8 and 4F2 T-cells were located close to damaged basal cells; this finding may suggest that they are responsible for the damage and supports the claim that a cell-mediated immune response participates actively in local pathogenetic mechanisms in oral lichen planus. PMID- 3551046 TI - Non-steroidal anti-inflammatory drugs and the lower gastrointestinal tract. PMID- 3551047 TI - The probability of pancreatitis after pancreatic parenchymatography with a non ionic contrast medium. A sequentially designed clinical trial. AB - Endoscopic retrograde pancreatography (ERP) with parenchymatous contrast filling may result in clinical pancreatitis. The aim of the present prospective trial was to assess the frequency of acute pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium, metrizamide. For ethical reasons the examination was designed as a sequential study with clearly defined stopping rules. None of the 48 patients studied developed clinical pancreatitis. This indicates that the probability of pancreatitis after parenchymatography is less than 5%. A high degree of contrast filling was obtained both in patients with normal and in those with pathologic pancreatic ducts. The contrast filling of the ducts was associated with not more than a slight pain. The rise in serum amylase was considerable but was not associated with clinical pancreatitis and returned to preexamination levels within 48 h. The examination shows that the non-ionic contrast medium used is well tolerated in ERP. PMID- 3551048 TI - The effect of 20 Mg omeprazole daily on serum gastrin, 24-h intragastric acidity, and bile acid concentration in duodenal ulcer patients. AB - Serum gastrin, 24-h intragastric acidity, and bile acid concentrations were measured during physiologic conditions in 10 patients with duodenal ulcer disease. Omeprazole, 20 mg daily, for 8 days reduced acidity by greater than or equal to 99% in six patients and by 47-54% in four patients. The degree of acid reduction was related to the area under the plasma omeprazole concentration time curve (AUC). Serum gastrin levels were not significantly increased by omeprazole. Intragastric bile acid concentrations were increased by omeprazole, but this seems to be of little importance for the healing of duodenal ulcers. PMID- 3551049 TI - Pancreatic and granulocytic endoproteases in faecal extracts from patients with active ulcerative colitis. AB - Faecal samples from 16 patients with acute attacks of ulcerative colitis, 7 with quiescent disease, and 8 healthy subjects were studied with regard to extractable amounts of casein digestion capacity, immunoreactive anionic trypsin, cationic trypsin, chymotrypsin, pancreatic elastase, and granulocytic elastase. Patients with acute attacks of colitis had significantly higher levels of casein digestion, pancreatic elastase, and granulocytic elastase in faecal samples than patients with quiescent disease and controls. The non-specific proteolytic activity in faecal extracts from patients with acute colitis was mainly due to the pancreatic proteases anionic elastase, cationic elastase, and anionic trypsin to the granulocytic proteases elastase and neutral protease. These active proteases may cause further destruction of the already damaged mucosa found in patients with severe ulcerative colitis. PMID- 3551050 TI - Simultaneous transplantation of pancreas and kidney in patients with advanced diabetic complications. AB - From June 1983 to October 1985, 25 uremic diabetic patients aged 24 to 52 (mean 38) years were treated with combined pancreas and kidney transplantation. Mean duration of diabetes was 24 years, and end-stage renal disease was associated with severe extrarenal diabetic complications in all recipients. All transplants were harvested from cadaveric, heart-beating donors aged 5-55 years. The segmental pancreas transplant was duct-occluded with neoprene before it was transplanted to the left iliac fossa. Immunosuppressive treatment was given with cyclosporine and steroids in all cases while azathioprine was added in the last 5 cases. The one year survival of patient, kidney and pancreas was 96, 79 and 60 per cent respectively. Of 17 patients with functioning pancreas transplants, 13 are insulin independent and have normal or near normal glucose homeostasis. Based on the excellent patient survival and the improvement in quality of life experienced by the recipients, it is concluded that simultaneous transplantation of pancreas and kidney should be the treatment of choice for uremic diabetic patients when a living related kidney donor is unavailable. PMID- 3551052 TI - Protease-antiprotease imbalance, hemodynamic and regional blood flow changes in experimental pancreatitis. AB - Pathologic proteolysis in pancreatitis is an important clue to understand the pathophysiology in pancreatitis. Impairment of pancreatic circulation is also important in the development of severe pancreatitis. In an attempt to study some of the biochemical and circulatory events in experimental pancreatitis in the pig the following experiments were undertaken. Pancreatic and splanchnic blood flow were studied in severe and mild pancreatitis with the microsphere method, together with cardiac output and mean arterial pressure. Kininogen, alpha-2 macroglobulin and alpha-1-proteinase inhibitor were measured in plasma and in peritoneal fluid. In severe pancreatitis consumption of kininogen in the peritoneal cavity was demonstrated together with a final lowering of the plasma protease inhibitors. This was accompanied by a rapid reduction of cardiac output and finally mean arterial blood pressure. Pancreatic blood flow was profoundly diminished in this group. No such changes were found in mild pancreatitis. It is concluded that pancreatic ischemia in pancreatitis is associated with protease antiprotease imbalance. PMID- 3551051 TI - Enzyme substitution in chronic pancreatitis: effects on clinical and functional parameters and on the hydrogen (H2) breath test. AB - Ten patients with chronic pancreatitis (with abdominal pain and/or diarrhoea) were treated in a double-blind multiple cross-over trial with Pankreon granules 20 g per day or placebo during three periods of one month each. Pain and bowel habits were recorded. Faecal fat and breath hydrogen (H2) excretion were analyzed during the last days of each treatment period. The pain score was initially low in all patients and was not affected by enzymes. The number of daily bowel movements was reduced from 3.16 to 2.32 (n.s.). Faecal fat excretion per 72 hrs was reduced from 357 +/- 158 mmol free fatty acid to 226 +/- 98 mmol (p less than 0.05). With placebo treatment H2 excretion (from 60 and 180 min after a standard breakfast) was significantly increased compared with 19 healthy volunteers (p less than 0.05). It was not significantly reduced by enzymes. In 28 comparisons the H2 output between 60 and 180 min was correlated to faecal fat. In eight patients the oro-coecal transit-time could be determined by the H2 breath test. The transit-time did not differ from that of ten healthy volunteers and remained unchanged by enzymes. Carbohydrate maldigestion occurs parallel to fat maldigestion in chronic pancreatitis, and is not sufficiently reduced by 20 g of pancreatic enzymes. PMID- 3551053 TI - The penetration of ceftazidime into the inflamed rabbit eye. AB - Acute endophthalmitis was unilaterally induced in 8 rabbits by intravitreal injection of 5 micrograms Escherichia coli endotoxin. A reproducible increase in aqueous humour polymorphonuclear neutrophils and total protein content was observed after 24 h (mean +/- SD: 2400 +/- 274 X 10(6)/l and 3.7 +/- 0.4 g/l, respectively). In the opposite eye only minor changes occurred, making it suitable as a paired control. The intraocular penetration of ceftazidime was then studied in 30 rabbits after i.v. injection of 50 mg/kg body weight. The mean penetration into aqueous humour of the eyes with and without endophthalmitis was 64 and 10%, respectively. In the vitreous body the corresponding penetration was 5 and 1%. The concentration of ceftazidime achieved in the intraocular structures was sufficient to inhibit the growth of pathogens, i.e. Enterobacteriaceae, commonly responsible for intraocular infections. PMID- 3551054 TI - Yersiniosis as a gastrointestinal disease. AB - Anti-yersinia antibodies were assessed in sera from 630 patients admitted to a department of surgery for acute abdominal disease, using an enzyme-linked immunosorbent assay (ELISA). In 21 patients a high concentration of yersinia antibodies confirmed recent yersinia infection. Eight patients had an appendicectomy performed; in all patients with antibodies against Y. enterocolitica 9 or Y. pseudotuberculosis IA a true appendicitis was found at operation. Two patients with Y. enterocolitica 3 antibodies had acute terminal ileitis and mesenterial lymphadenitis. In 4 patients a diagnosis of acute pancreatitis was established; 2 of these had cholecystitis. Two further patients had cholecystitis without pancreatic affection. Two patients had colonic diverticulitis, 1 with perforation. The results demonstrate that yersinia infection may commonly give rise to a variety of acute abdominal inflammations, and stress the importance of serological and bacteriological diagnostic procedures. PMID- 3551056 TI - Informed consent. PMID- 3551055 TI - Orthopaedic infections by Serratia marcescens: a report of seven cases. AB - In recent decades, Serratia marcescens has been established as a cause of infections difficult to treat, and several outbreaks of nosocomial infections have been reported, mostly from the USA. However, serratia infections affecting bones and joints are very rare; only a few such cases have previously been reported from Europe. We report 7 patients with orthopaedic infections by S. marcescens chiefly of nosocomial origin where previous antibiotic therapy apparently was a predisposing factor. The clinical course was generally protracted, often requiring repeated surgical interventions. Also, in some cases adequate therapy was considerably delayed as serratia was considered to be a nonpathogenic saprophyte. Multiresistance to antibiotics was a major clinical problem. However, the third generation cephalosporins are often effective against serratia and the aminoglycosides can thus be avoided. The increased use of prophylactic antibiotic therapy in orthopaedic surgery may bring about an increase in the incidence of infections by multiresistant microorganisms in orthopaedic wards. PMID- 3551057 TI - Nordisk Thoraxkirkurgisk Forening. The Scandinavian Association for Thoracic and Cardiovascular Surgery. 1949-1984. PMID- 3551058 TI - [On the history of kidney disease]. AB - Except for infections (pyelonephritis, abscess of the kidney), which cause symptoms such as pyuria, pain and fever, most diseases of the renal parenchyma were unknown in Greek and Roman antiquity. Even in the Renaissance they were not yet properly identified. Edema was generally thought to be related to liver disease. Proteinuria was discovered at the end of the 18th century. In 1827 Bright provided the first, almost complete clinical description of the various forms of acute and chronic glomerulonephritis and showed that they were accompanied by macroscopic changes in the kidneys. Between 1850 and 1885, Frerichs, Klebs and Langhans described the primary glomerular lesions. The amount of new knowledge acquired during the 20th century has been tremendous, and covers the mechanism of urine formation, the role of sodium retention in edematous states, the physiology and physiopathology of the renin-angiotensin-aldosterone system, the glomerular origin of the nephrotic syndrome, new methods of investigation, progress in histology and immunology, the discovery of many tubular syndromes, the introduction of antibiotics and antihypertensive drugs, and the development of dialysis and transplantation. PMID- 3551059 TI - [From surgical pain to pain surgery]. AB - From the historical viewpoint, a change of attitude towards pain and the possibilities opened up by general anesthesia from 1846 onwards were needed to bring about the advent of a surgery specialized in the cure of pain. The individual stages in this development, up to Leriche's "Chirurgie de la douleur", are illustrated by reference to the relevant sources. PMID- 3551060 TI - [C-peptide determination in diabetics for the evaluation of insulin requirements]. AB - 45 non-insulin dependent diabetic subjects with "secondary failure" of oral treatment were observed for 2 years; during this period 23 of the 45 became insulin requiring. Plasma C-peptide concentrations at study entry and several clinical parameters of the patients were analysed statistically using discriminant analysis to test their value in predicting the need for later insulin therapy. The results demonstrated the fasting C-peptide concentrations and, independently of this, the simultaneously measured glucose level had a significant predictive power, e.g. only patients with fasting glycemia of greater than 12 mmol/l and C-peptide concentrations exceeding 700 pmol/l did not require insulin during follow-up. Increased C-peptide concentrations pointed to a predominance of insulin resistance which correlated with an increased chance of being treatable without insulin. A further group of 44 elderly, insulin-treated diabetic subjects were examined for clinical markers of type 1 and type 2 diabetes when these patients were separated into type 1 and 2 diabetes according to their fasting C-peptide concentrations. It was demonstrated that age, weight and duration of diabetes did not significantly differ between the 2 types of diabetes in this group of patients. The studies demonstrate that determination of plasma C-peptide concentration is a valuable tool in distinguishing the two types of diabetes (type 1 and type 2). This distinction has clinical implications with regard to genetic counselling or the search for other endocrinopathies. In addition, fasting C-peptide measurement is a valuable tool, in conjunction with blood sugar determination, in deciding whether patients with secondary failure of oral antidiabetic treatment require long-term insulin therapy. PMID- 3551061 TI - [Current possibilities in immunotherapy of cancer]. AB - Recent developments in biotechnology have resulted in a substantial renewal of cancer immunotherapy. In particular, the availability of murine monoclonal antibodies and recombinant biological response modifiers by genetic manipulation has made it possible to re-test abandoned concepts of adoptive humoral and cellular immunotherapy and to reconsider the biomodulation of the patient's immune system. Thus, the utilization of monoclonal antibodies to purge ex vivo autologous marrow from residual tumor cells has reached an advanced stage of clinical investigation in the field of autologous bone marrow transplantation for leukemia or lymphoma. Numerous promising clinical trials are being performed by the injection of monoclonal antibodies directed at tumor-associated antigens, coupled with cytotoxic agents (isotopes, drugs, toxins). In the area of recombinant technology, interferon-alpha has become the drug of choice for a particular form of chronic leukemia (hairy-cell leukemia). Interleukin-2 administered in conjunction with autologous activated lymphocytes has been shown to mediate significant anti-tumor activity in metastatic cancer patients. This review briefly describes recent clinical results obtained in cancer immunotherapy and discusses the potential of these new approaches. PMID- 3551063 TI - [Drugs: a component of periodontitis therapy?]. PMID- 3551062 TI - [Importance of ultrasonic diagnosis for adequate resection in benign and malignant goiter]. AB - In the Basel area, with a considerable prevalence of benign uni- and multinodular goiter, the diagnosis or exclusion of malignant goiter is often difficult. A frequent result is unnecessary hemithyroidectomy for benign nodules, and delayed and inadequate surgery inasmuch as 25% of patients with a malignancy. The diagnostic contribution of ultrasonography was investigated prospectively in a consecutive series of 162 patients referred to a surgical unit. No surgical indication was found in 42 subjects in whom the clinical finding of small benign goiter was confirmed by ultrasonography. In the remaining patients the diagnostic procedure proved rather accurate in ruling out malignancy: in uni- and multinodular goiter the specificity was 94% and 80% respectively; the specificity of the diagnostic signs of benignity was 92% and 98% respectively. Sensitivity in detecting malignant goiter and atypical adenoma was 79% in uninodular and 73% in multinodular goiter. The frequent occurrence of a benign, nonhypercellular hypoechogenic structure (such as fibrosis, small cystic lesions, coloid cyst) results in low sensitivity (40%) for this sonographic sign in multinodular goiter, whereas in uninodular goiter the sensitivity of the sign was 85%. In 2 out of 16 patients (16%) with malignant goiter hemithyroidectomy was missed as the minimal primary procedure. PMID- 3551064 TI - [Minipreparation of proximal cavities]. PMID- 3551065 TI - The old Royal Infirmary of Edinburgh. PMID- 3551066 TI - The last public execution in Glasgow: the case of Dr Edward Pritchard, M.D. AB - Dr Edward Pritchard, a Glasgow medical practitioner, was the last person to be executed in public in Glasgow. In a famous trial of the time, he was condemned to death for murdering his wife and his mother-in-law, and he was hanged on Glasgow Green in 1865. An account of Dr Pritchard's life, his trial and his death is given here, together with a reference to the medical examination which was carried out on Pritchard's remains when his grave was exhumed in 1910. PMID- 3551067 TI - Ultrasound placental localisation in early pregnancy. AB - A retrospective study of 400 consecutive case records was made to establish the clinical significance of the low lying placenta found on ultrasound. Diagnostic accuracy is discussed. 30% of the patients had a low lying placenta on early scan. Of these, 73% had a follow up scan. There was a progressive drop in the incidence of low lying placentae through pregnancy until at term, in this study, there was no placenta previa. It is considered that a repeat scan is necessary to exclude placenta previa, but not until 34 weeks gestation. Amongst the patients with early low lying placentae the incidence of antepartum haemorrhage of indeterminate type was significantly high (P less than 0.001). A careful surveillance of these patients is therefore required. Dynamic placental migration may be the cause of this bleeding. Further study is necessary to determine the effect of early placental position on subsequent fetal development. PMID- 3551068 TI - Electrochemical methods. A collection of invited papers dedicated to the memory of Professor Dr Hans Wolfgang Nurnberg. PMID- 3551069 TI - Metal ion binding by biological surfaces: voltammetric assessment in the presence of bacteria. AB - Voltammetric techniques (differential pulse polarography (DPP) and differential pulse anodic stripping voltammetry (DPASV)) were evaluated for their capability to distinguish, without prior separation of the solid phase (e.g. filtration, centrifugation), between dissolved and particulate concentrations of Zn(II), Pb(II) and Cu(II), and to measure the extent of binding of these metals to the surface of a bacterium (Klebsiella pneumonia, formaldehyde treated). From titration curves of bacterial cell suspensions with metals the specific adsorption of metals was determined and quantified in terms of average surface complex formation constants and differential equilibrium functions. The following stability sequence for surface complexes was found: Cu2+ greater than Pb2+ greater than Zn2+ much greater than Ca2+. Simultaneous analytical determination permitted the measurement of both the binding of Cu(II) to the cell surface, and the binding to the solute exudate ligands. The affinity of the metal ions for the functional groups of the cell surface is strongly pH-dependent, and, at a given pH, decreases with increasing metal loading of the bacterial surfaces. This indicates that metal ions bind first to the highest affinity surface ligands and subsequently to those of lesser activity. Copper(II) appears to form stronger surface complexes with the high affinity ligands of the bacterial surface than with the functional groups of hydrous oxides. PMID- 3551070 TI - Malaria diagnosis. PMID- 3551072 TI - Broad issues debated at AIDS vaccine workshop. PMID- 3551071 TI - Perpich to head new Hughes program. PMID- 3551073 TI - Efficacy of murine malaria sporozoite vaccines: implications for human vaccine development. AB - As part of a study of potential vaccines against malaria, the protective efficacy of sporozoite subunit vaccines was determined by using the Plasmodium berghei murine malaria model. Mice were immunized with recombinant DNA-produced or synthetic peptide-carrier subunit vaccines derived from the repetitive epitopes of the Plasmodium berghei circumsporozoite gene, or with radiation-attenuated sporozoites. Immunization with subunit vaccines elicited humoral responses that were equivalent to or greater than those elicited by irradiated sporozoites, yet the protection against sporozoite challenge induced by either of the subunit vaccines was far less than that achieved by immunization with attenuated sporozoites. Passive and adoptive transfer studies demonstrated that subunit vaccines elicited predominantly antibody-mediated protection that was easily overcome whereas irradiated sporozoites induced potent cell-mediated immunity that protected against high challenge doses of sporozoites. These studies indicate that new strategies designed to induce cellular immunity will be required for efficacious sporozoite vaccines. PMID- 3551074 TI - Structural and functional characterization of factor XII. AB - In this article we have reviewed the current knowledge regarding the involvement of Factor XII in contact activation. Clearly in the past decade an overwhelming amount of data and hypotheses have been published regarding the central role of this zymogen in the initiation and further propagation of contact activation reactions. Therefore we feel that it will be helpful to conclude this article with a figure that summarizes those interactions and reactions that are generally believed to reflect the major molecular events occurring during surface-dependent contact activation. The contact factors are capable of very efficient interation with each other, provided a suitable negatively charged surface is present. Such surfaces are thought to stimulate the interactions between the contact factors through binding of the proteins and thus bringing the proteins together. Factor XII readily binds to the negatively charged surface, but for the binding of prekallikrein and Factor XI, the cofactor HMW kininogen is likely to be necessary. Bound at the surface, the zymogens Factor XII and prekallikrein are thought to be involved in a so-called reciprocal activation mechanism in which Factor XIIa activates prekallikrein to kallikrein, which in turn converts Factor XII to Factor XIIa. The formation of Factor XIIa is further promoted by the fact that surface-bound Factor XII is likely more susceptible to proteolytic cleavage and by the fact that the activated Factor XIIa is capable of auto-activating its own zymogen Factor XII. However, the latter effect, although undoubtedly contributing to the formation of Factor XIIa at the surface, seems to be of less importance than the reciprocal activation mechanism. This is underscored by the fact that Factor XII activation is rather slow in prekallikrein-deficient plasma. Surface-bound Factor XIIa is then responsible for the activation of Factor XI to Factor XIa, thereby propagating the initial trigger. Presumably, Factor XIa must leave the surface in order to be able to become involved in the activation of blood coagulation Factor IX. PMID- 3551075 TI - Biochemical and functional properties of factor XI and prekallikrein. PMID- 3551077 TI - The importance of surfaces in contact phase reactions. PMID- 3551076 TI - Contact factors in health and disease. PMID- 3551078 TI - Interaction of polymorphonuclear cells with contact activation factors. PMID- 3551079 TI - Use of a binary search pattern and discriminator analysis in the radiologic diagnosis of arthritis. PMID- 3551081 TI - Raynaud phenomenon. PMID- 3551080 TI - Magnetic resonance imaging: a review of rheumatologic applications. PMID- 3551082 TI - Eicosanoids in the developing gastrointestinal tract. PMID- 3551083 TI - Arachidonic acid metabolites and control of breathing in the fetus and newborn. AB - Considerable evidence indicates that prostaglandins participate in the control of breathing in the fetus, during parturition and at birth. Further studies are required to fully define the physiologic role of prostaglandins, their exact site of action, their mechanism of action and their interaction with other physiologic factors. With regard to prostaglandins and the control of breathing, currently available data are consistent with the following: the stimulatory effects of PGSI on fetal breathing movements are due to a decrease in PGE2; endogenous PGE2 inhibits fetal breathing movements during HV-ECoG; the site of action is at the lower pons or medulla; the rise in concentration of PGE2 with parturition may contribute to, but is not essential for, the decrease in fetal breathing movements at that time; it is likely that the decrease in circulating concentration of PGE2 contributes to the onset of continuous breathing at birth; although prostaglandins can affect ventilation in the newborn, their physiologic role, if any, at that time is not known. PMID- 3551084 TI - Role of prostaglandins, thromboxanes, and leukotrienes in the control of the pulmonary circulation in the fetus and newborn. PMID- 3551085 TI - Ductus arteriosus: current theories of prenatal and postnatal regulation. PMID- 3551086 TI - Settlement formation in north-central Massachusetts, 1700-1850. PMID- 3551087 TI - Mortality after bereavement: a review of the literature on survival periods and factors affecting survival. AB - Mortality rates for widowed people in every age group are known to be higher than for married people. Research suggests that the widowed have a greater risk of dying than married people of a similar age, the excess risk being greater for men. Little is known, however, about the causes of their apparently higher mortality rates. This paper examines the evidence relating to mortality rates and survival periods after bereavement. Explanations for the excess risk are discussed. PMID- 3551088 TI - A randomized control trial of cardiac rehabilitation. AB - A randomized trial using controls tested whether psycho-social rehabilitation of acute myocardial infarction (MI) patients would improve significantly their return to work rate and assessed the importance of various psychological, social, occupational, socio-demographic, and medical factors in facilitating or impeding rapid return to work. Eighty-nine patients were assigned randomly to participate in an experimental cardiac rehabilitation program (rehab care), and 91 patients were controls who received conventional hospital rehabilitation (usual care). By the first follow-up interview at three months, patients assigned to experimental treatment were significantly less distressed psychologically and less dependent on family support than controls (P = 0.04 and P = 0.05, respectively). By the final follow-up interview at 13 months, there was a marginally significant difference in favor of the experimental group in the frequency of reported deterrents to work resumption (P = 0.07). However, the intervention did not result in a statistically significant difference in the return to work rate (P greater than 0.10). In each group, 88% were back at work by approximately the first year after infarction. In addition, the two groups were similar in the amount of time patients remained out of the workforce (median days rehab care = 75, usual care = 81; P greater than 0.10). A multi-stage data analysis procedure utilizing the Cox regression technique indicated that while several independent variables had significant univariate associations with the length of time patients convalesced, outcome was most influenced by the patient's initial cardiological status and clinical course, by the patterns of family support, and by the several variables measuring the presence of obstacles to resuming work. Our findings suggest that rehabilitation programs intervening on multiple levels (psychological, social, occupational, and physical) may best meet the needs of chronically ill cardiac patients. Results indicate that implementing measures addressing the patient's general psycho-social adjustment to MI may improve existing programs. PMID- 3551089 TI - [The tuberculin reaction]. PMID- 3551090 TI - [Computers and retardation]. PMID- 3551091 TI - [Relaxation]. PMID- 3551093 TI - Ethics and cancer: a survey of the literature. AB - We have identified 776 articles, books, book chapters, and letters published since 1945 dealing with both ethics and cancer. Of this number, 473 (61%) were discussions in medical and scientific journal articles; they were published in 188 journals, demonstrating the scattered nature of this literature. The recent increase of writing in ethics and cancer has been dramatic, the median year of publication being 1979. Although the majority of articles addressed more than one ethical issue, the most common topic was whether patients should be told the truth about their diagnosis and prognosis (found in 241 of the items identified). The ethics of cancer research has only recently assumed importance in the medical literature, the median year of publication being 1981. The great interest in the ethics of cancer research is evident in that 255 (33%) of the 776 items dealt with research, 104 of these focusing on randomized trials. Besides truth-telling and research, 78 other issues are being discussed, among them informed consent for adults (119 items), the physician's responsibility for psychologic management of patients (79 items) and their families (68 items), responsibilities of nurses (58 items), the use and testing of laetrile (55 items), and euthanasia (38 items). Surgery was discussed in 90 items, pediatrics in 71, and radiotherapy in 44. The authors of this literature relied upon at least nine identifiable ethical positions. Only a limited number of authors were aware of the philosophic literature and of the complexities inherent in defining such terms as "benefit," "harm," and "quality of life." PMID- 3551092 TI - Pathologic features of sudden cardiac death: an overview. AB - Sudden cardiac death is a frequent initial manifestation of underlying heart disease. We review the most frequent pathologic cardiovascular findings in victims of sudden cardiac death. We also discuss the role of exercise as a precipitant of sudden cardiac death. PMID- 3551094 TI - Problems in filariasis control and the need for human behaviour and socio economic research. PMID- 3551095 TI - A metropolitan nurse. PMID- 3551097 TI - [Medical provisions for the 2d Kamchatka expedition (1733-1743)]. PMID- 3551096 TI - [M. S. Maslov as a medical historian]. PMID- 3551098 TI - [Historico-medical monuments of Podoliia]. PMID- 3551099 TI - [Controversial questions relating to the concept and nomenclature of functional cardiovascular pathology]. PMID- 3551100 TI - [Pathogenesis of diabetic microangiopathy]. PMID- 3551101 TI - [Quantitative radionuclide angiography of the carotid arteries]. PMID- 3551103 TI - [Ultrasonic diagnosis of hypotonic dyskinesia of the gallbladder]. PMID- 3551102 TI - [Pathogenesis of botulism]. PMID- 3551104 TI - [Method of preserving a scalped finger]. PMID- 3551105 TI - [Primary arterial pulmonary hypertension]. PMID- 3551106 TI - [Malignization of gastric polyps]. PMID- 3551107 TI - [Polymer-drug complexes in the chemotherapy of malignant tumors]. PMID- 3551108 TI - [Autodermoplasty in diseases of the perineum and sacrococcygeal area]. PMID- 3551109 TI - [Interferon in the treatment of amyotrophic lateral sclerosis]. PMID- 3551110 TI - [Methods of diagnosing pulmonary hypertension]. PMID- 3551111 TI - [Dumping syndrome and endocrine functions of the digestive organs]. PMID- 3551112 TI - [Ways to improve functional diagnostic services]. PMID- 3551114 TI - [Diseases of the gallbladder not induced by calculi in the sonogram]. PMID- 3551113 TI - Altered expression of ribonucleotide reductase and role of M2 gene amplification in hydroxyurea-resistant hamster, mouse, rat, and human cell lines. AB - Five hamster, mouse, and rat cell lines resistant to the cytotoxic effects of hydroxyurea have been characterized. All cell lines contained increased ribonucleotide reductase activity, elevated levels of the M2 component of ribonucleotide reductase as judged by electron paramagnetic resonance spectroscopy, and increased copies of M2 mRNA as determined by Northern blot analysis. Two species of M2 mRNA were detected in rodent cell lines, a high molecular-weight species of approximately 3.4 kb in hamster and rat cells and about 2.1 kb in mouse cells. The low molecular-weight M2 mRNA was about 1.6 kb in all rodent lines. Northern blot analysis showed that the mRNA for the other component of ribonucleotide reductase, M1, was not markedly elevated in the drug resistant cells and existed as a single 3.1-kb species. Four of the five resistant lines contained an M2 gene amplification as determined by Southern blot analysis, providing direct evidence to support earlier suggestions that hydroxyurea resistance is often accompanied by amplification of a ribonucleotide reductase gene. An increase in gene dosage was detected even in cells exhibiting only modest drug-resistance properties. No evidence for amplification of the M1 gene of ribonucleotide reductase was found. In keeping with these observations with drug-resistant rodent lines, a human (HeLa) cell line resistant to hydroxyurea was also found to contain increased levels of two M2 mRNA species (about 3.4 and 1.6 kb) and exhibited M2 gene amplification. One hamster cell line resembled the other resistant rodent lines in cellular characteristics but did not show amplification of either the M1 or M2 gene, providing an example of a drug-resistant mechanism in which an elevation of M2 mRNA has occurred without a concomitant increase in M2 gene copy number. PMID- 3551115 TI - [Sonography and CT in Caroli syndrome]. PMID- 3551116 TI - [Value of ultrasound diagnosis in staging, therapy planning and after-care of ENT tumors]. PMID- 3551117 TI - [Non-prosthetic arthroplasty]. PMID- 3551118 TI - [Complement subcomponent C1q in rheumatic diseases]. PMID- 3551119 TI - Cisapride does not reduce postoperative paralytic ileus. PMID- 3551120 TI - [Paediatric cadaver renal donors at Johannesburg Hospital]. PMID- 3551121 TI - Oesophageal cancer--chemotherapy overview. PMID- 3551122 TI - Pneumocystis carinii pneumonia. AB - Pneumocystis carinii pneumonia (PCP) has become one of the most important of the opportunistic pulmonary infections of the 1980s. In view of the rapidly expanding population of immunosuppressed patients, many more cases of PCP may be expected in the future. The history, microbiology, pathogenesis, pathology, clinical and laboratory features, diagnosis, treatment, course and prognosis of this disease are reviewed. PMID- 3551124 TI - Reversible renal failure and captopril therapy in renovascular hypertension. PMID- 3551123 TI - The Transvaal Medical Journal, 1905-1913. AB - The Transvaal Medical Society, founded in Johannesburg in 1889, started publication of the Transvaal Medical Journal in August 1905. When the Society became the Witwatersrand Division of the Transvaal Branch of the British Medical Association in 1912, the TMJ was continued as the Medical Journal of South Africa from August 1913. During its 8 years' existence, the TMJ's contents reflected the many aspects of private medical practice, hospital cases, talks at medical societies and congresses, and topics of preventive health specifically in Johannesburg; however, items referring to South Africa and overseas were also dealt with. Medical expertise in Johannesburg was revealed as adequate and efficient for those times. PMID- 3551125 TI - The extra-embryonic coelom on ultrasonography. PMID- 3551126 TI - Plasma C-peptide and insulin responses to intravenous glucagon stimulation in idiopathic haemochromatosis. AB - Beta-cell reserve was investigated in 15 patients with proven idiopathic haemochromatosis (IHC) (7 normoglycaemic haemochromatotic patients, 4 non-insulin requiring diabetics and 4 insulin-requiring diabetics) by measuring the response of plasma C-peptide, insulin and glucose to a 2 mg intravenous bolus of glucagon, and compared with that in 5 lean normal subjects. The corresponding C peptide/insulin molar ratios were also calculated. Despite the significant fasting hyperglycaemia in the insulin-requiring haemochromatotic diabetics, mean fasting C-peptide concentrations were similar in all four groups. However, after glucagon stimulation the C-peptide response was significantly reduced in the insulin-requiring group over the whole period of observation. A trend in insulin response to glucagon was noted, with the highest values in the non-diabetic haemochromatotic patients, followed by the controls and then by the non-insulin requiring diabetics, although there were no significant differences. In contrast, C-peptide/insulin molar ratios after glucagon were significantly reduced in the normoglycaemic IHC group. These results suggest the presence of at least two abnormalities of insulin metabolism in IHC--a progressive reduction in beta-cell function and a diminished rate of removal of insulin by the liver. PMID- 3551128 TI - The immunocompromised host. AB - The immunocompromised patient, with or without superimposed granulocytopenia, provides a wide range of life-threatening challenges for the primary medical and nursing care management group. In the context of haematological malignancy, particularly leukaemia and bone marrow transplantation, special expertise needs to be developed which includes competence in many aspects of general medical, nursing, and intensive care techniques. Clearly, the range of essential knowledge extends to other disciplines including respiratory, cardiac, and renal medicine, with important contributions from microbiology, virology, dietetics and parenteral nutrition. The increasing cure rate achieved in haematological malignancy and the ever-widening indications for bone marrow transplantation require a dedicated and experienced group, able to handle all challenges. Integral to managing the complete patient, both through the acute phase and into periods of recovery and long-term rehabilitation, is inclusion of the paramedical specialists--social workers, occupational therapists, physical medicine physicians and physiotherapists. Proper balance in the cost-effective use of expertise from each of these groups and the provision of a suitable physical facility with protected environment and intensive care facilities are the cornerstones on which individual patient survival and ultimately increase in cure rates depend. PMID- 3551127 TI - Comparison of labetalol and dihydralazine in hypertensive emergencies of pregnancy. AB - Labetalol (Trandate; Allen & Hanburys), a combined alpha- and beta-adrenergic blocking agent, was compared with the more commonly used peripheral vasodilator, dihydrallazine (Nepresol; Ciba), each administered as an infusion, in the treatment of severe hypertension in 20 primigravidas at greater than or equal to 32 weeks' gestation. With the dosage regimen used in this study there was a tendency towards more effective blood pressure control with dihydrallazine. The pulse rate was unaffected by labetalol therapy and there were no harmful effects on the neonate or fetus directly attributable to either drug. PMID- 3551129 TI - Cancer prevention, detection and survival--how hopeful is the outlook? AB - Recent overall appraisals of cancer occurrence, detection, treatment and survival have noted: rising incidences; relatively steady mortality rates; and disappointingly small improvements in survival time (the magnitudes of which are controversial). In this review attempts have been made to answer questions on countermeasures--principally, what could be done, and what is likely to be done. It is concluded, broadly, that in Western populations the only ameliorative changes likely are reductions in frequency and intensity of cigarette smoking, and improvements in early detection of certain cancers by screening procedures. Accordingly, the outlook is very unpromising. Claims of halving cancer mortality by the year 2000 would seem to be hyperbole. As to developing populations, frequencies of certain cancers (oesophageal, liver and cervix) are likely to fall, but they will be replaced by increases in cancers characteristic of Western populations. Yet rises in incidence of diet-related cancers (breast, colorectal, and possibly prostate) may be retarded by slow rises in socio-economic state. PMID- 3551130 TI - Samuel Patton Impey, M.D. (Aberdeen) (1856-1928). Cape Town's primordial leprologist, dermatologist, radiotherapist and rock-art enthusiast. AB - Samuel Impey was a noteworthy medical pioneer of the Cape Colony. He was the author of what was probably the first medical textbook of note to be written in South Africa, a Handbook of Leprosy, published in London in 1896. He carried much of the frontier spirit into the medical life of the time, entering vigorously into controversy and fresh developments. As an amateur artist, he also put forward some individual views on rock paintings. PMID- 3551131 TI - Urogenital tuberculosis in children. AB - The clinical and radiological features of 16 children with urogenital tuberculosis are reviewed. The possibility of urinary tract involvement should be considered in all children with evidence of past or active pulmonary tuberculosis, or who are primary contacts. PMID- 3551132 TI - Diabetes in pregnancy. The use of home blood glucose monitoring and intensive monitoring to ensure favourable perinatal outcome. AB - A combined clinic for pregnant diabetic women was established at Baragwanath Hospital to assess the effects of intensive monitoring of mother and fetus and of good glycaemic control on perinatal outcome. Home blood glucose monitoring was introduced as a method for assessing glycaemic control. Standard methods of maternal and fetal monitoring were used. Sixty-two diabetic pregnancies were evaluated prospectively. Twenty women had diabetes diagnosed for the first time in the current pregnancy and the remaining 42 had established diabetes. All patients followed a diabetic diet, and 95% were treated with insulin. The technique and accurate recording of blood glucose were managed by all patients, and a mean capillary blood glucose of 6.5 mmol/l for the group was achieved. Caesarean section was performed in 52% of cases with a mean period of gestation at the time of delivery for the total study population of 37 weeks. The mean neonatal weight was 3,130 g. The perinatal mortality rate of 64/1,000 was accounted for by 3 stillbirths and 1 early neonatal death. No major congenital anomalies occurred. PMID- 3551133 TI - Ultrasonographic and computed tomographic appearance of focal tuberculosis of the liver. A case report. AB - A 50-year-old woman presented with a focal liver mass which mimicked the clinical and imaging (ultrasonographic and computed tomographic) characteristics of a pyogenic or amoebic abscess. Ultrasonographic-guided liver biopsy demonstrated features of a focal tuberculous abscess of the liver. PMID- 3551134 TI - On onanism. PMID- 3551135 TI - Quality of life for patients in an end-stage renal disease programme. AB - A group of 128 patients in an end-stage renal disease programme in Natal was studied in order to assess the relative success of the different treatment modalities in achieving optimal patient rehabilitation in regard to employability and social, psychological and medical status. Confirmation that successful transplantation achieves the best quality of life was obtained. PMID- 3551136 TI - Sensitivity and specificity of a latex agglutination test for detection of cryptococcal antigen in meningitis. AB - A cryptococcal latex agglutination test (Crypto-La; International Biological Laboratories, Canbury, New Jersey, USA) was evaluated for its ability to detect cryptococcal antigen in cerebrospinal fluid (CSF) specimens obtained from black patients with a clinical diagnosis of meningitis. Of the 445 Gram-stained and bacterial culture-negative CSF specimens routinely tested for cryptococcal antigen, 34 (7,6%) were positive. With the exception of 1 false-positive result, the remaining 33 specimens were obtained from 12 patients in whom the diagnosis of cryptococcal meningitis was confirmed by the isolation of Cryptococcus neoformans. The Crypto-La test gave false-positive results on 1% (4/384) of control CSF specimens tested. Nonspecific agglutination reactions were observed with 1,6% (13/829) of all CSF specimens and 22% (10) of sera tested. The ethylenediaminetetra-acetic heat-extraction method proved reliable in eliminating false-positives and nonspecific agglutination reactions in CSF and serum specimens. PMID- 3551137 TI - Recent advances in urinary stone management. AB - The treatment of urolithiasis is one of the branches of urological surgery that has undergone great changes during the last decade. Since all the new modalities will soon be available to patients in this country an overview of the different treatments and overseas trends in urinary stone management is presented. PMID- 3551138 TI - Adenocarcinoma of the stomach in pregnancy--ultrasonographic diagnosis. A case report. AB - The ultrasonographic findings in a rare case of adenocarcinoma of the stomach in pregnancy are described. The patient presented with hyperemesis gravidarum in the second trimester. PMID- 3551140 TI - [Systems for prolonged venous access in patients with severe hemopathies. Review]. PMID- 3551139 TI - [Our experience with the use of central tunnelized silicone catheters in patients with severe hemopathies]. PMID- 3551141 TI - [Comparison of 3 methods of antibody elution with the enzyme-linked antiglobulin test]. PMID- 3551142 TI - [A monoclonal antibody produced against the surface immunoglobulin of B prolymphocytic leukemia]. PMID- 3551143 TI - [A different treatment for acute promyelocytic leukemia?]. PMID- 3551144 TI - Fine-needle biopsy cytology and DNA analysis. Their place in the evaluation and treatment of patients with thyroid neoplasms. AB - Fine-needle aspiration allows sampling of tissues without surgical biopsy. This technique provides accuracy, speed, patient acceptance, and individual cells for the study of neoplasia. When this procedure is combined with DNA analysis, it is possible to obtain preoperatively additional diagnostic and prognostic information superior to that obtained by clinical and morphologic methods alone. This information is of utmost importance when planning appropriate treatment. PMID- 3551145 TI - The thyroid nodule. Diagnosis and surgical treatment. AB - A definitive evaluation of different therapeutic approaches to patients with papillary and follicular thyroid carcinomas requires a prospective multicenter long-term study, with careful documentation of variations in histologic classification and all other factors that can possibly influence prognosis. Until such information is available, every patient with a thyroid nodule should be given the treatment that offers the best prospect for cure to the greatest possible number of patients; this treatment appears to be hemithyroidectomy for benign unilateral thyroid tumors and total thyroidectomy for carcinomas. These operations can be done safely by experienced surgeons without exceeding the morbidity or complication rate of less extensive treatments. PMID- 3551146 TI - Management of goiter and thyroid nodules in an area of endemic goiter. AB - This article discusses the diagnostic and therapeutic measures we have used during the past five years to treat 861 patients from an edemic goiter area with various thyroid disorders. The similarities and differences between these patients, with nontoxic goiter, toxic goiter, and thyroid cancer, were compared with those seen in patients with thyroid problems who live in iodine-rich areas. PMID- 3551147 TI - The value of lymph-node dissection in patients with differentiated thyroid cancer. AB - The perithyroidal and ipsilateral cervical lymphatic system not only is commonly involved by thyroid cancer but also is a common site of recurrence. Modified radical neck dissection, with preservation of the sternocleidomastoid muscle and spinal accessory nerve, is the treatment of choice for patients with clinically evident lymph node metastases due to differentiated thyroid cancer. It is also recommended, by us, for patients over 40 years of age who have primary thyroid tumors greater than 1.5 cm in size whether or not nodes are clinically palpable. This is because at least 75 per cent of these patients have metastases, and their discernment at operation is unreliable. With more aggressive surgery, the recurrence-free survival rate can be improved substantially without cosmetic deformity or postoperative dysfunction. PMID- 3551148 TI - Current management of the patient with autonomously functioning nodular goiter. AB - Autonomously functioning thyroid nodules (AFTNs) are presumably independent of TSH for growth and function and appear "hot" on scintiscan because they selectively concentrate radionuclide to a greater extent than the remaining thyroid gland, which is controlled by the normal TH-TSH feedback mechanism. Such autonomously functioning tissue may occur in "patchy" areas, as a solitary nodule, or as multiple nodules (classic Plummer's disease), with the mass of hyperfunctioning tissue and the related secretion of thyroid hormones determining whether the patient is euthyroid or hyperthyroid. Important diagnostic tests include a 99mTc thyroid scan, T4 RIA, T3 uptake, FTI, TSH RIA, and occasionally T3 RIA ("T3 thyrotoxicosis"). Solitary autonomous nodules in adult patients characteristically progress slowly over many years, with toxicity rarely developing in nodules less than 2.5 cm in diameter and occurring primarily in nodules 3 cm or larger and in older patients. The decision to treat a solitary nodule depends upon the size and degree of function of the nodule and the patient's age. Surgery and radioactive iodine are effective therapies. Hyperfunctioning thyroid nodules in children and adolescents (under age 18) have a more rapidly progressive course than those in adults and should be treated by thyroid lobectomy at the time of diagnosis. Subtotal thyroidectomy is the preferred treatment for most patients with toxic multinodular goiter, because it achieves prompt control of the hyperthyroidism and removes the goiter. Radioiodine therapy and long-term antithyroid drug therapy are alternative forms of treatment for patients who are poor surgical risks or who develop recurrent hyperthyroidism following thyroid surgery. PMID- 3551149 TI - How to recognize and treat parathyroid carcinoma. AB - Parathyroid carcinoma is a rare tumor and its clinical course is variable. Differentiation of patients with parathyroid carcinoma from those with parathyroid adenoma is often difficult both preoperatively and at operation. For good results, the surgeon must recognize this disorder and perform an en bloc resection at the initial surgery. A neck dissection is necessary only when there is evidence of regional node metastases. After surgery, periodic follow-up of the serum calcium and iPTH levels is essential. When hypercalcemia recurs or the serum iPTH increases, localization studies with the use of thallium-201 scanning help detect local recurrence and regional lymph node metastases, but unfortunately, this method often fails to localize pulmonary metastases. Chest radiographs and CT scanning are useful for delineating pulmonary metastases. A wide excision of locally recurrent tumor, an en bloc radical neck dissection and mediastinum dissection for lymphatic metastases, and an aggressive surgical resection of lung metastases are recommended. Although these operations are rarely curative, they usually offer definite palliation of the marked hypercalcemia, often for a considerable period. Drugs to lower the serum calcium level and systemic chemotherapy are currently of only limited benefit, and radiation therapy is generally ineffective. PMID- 3551150 TI - Hyperparathyroidism associated with renal disease. Pathogenesis, natural history, and surgical treatment. AB - Hyperparathyroidism associated with renal failure is due to chronic parathyroid stimulation by hypocalcemia, which, in turn, results from hyperphosphatemia and low circulating 1,25(OH)2D3. If prophylactic measures and medical treatment of hyperparathyroidism fail, parathyroidectomy should be performed to prevent the progression of bone disease. Resolution of renal hyperparathyroidism is often seen after kidney transplantation, but some hypercalcemic patients require prophylactic or therapeutic parathyroidectomy. Hypocalcemia is the most common complication after parathyroidectomy. Our long-term results with subtotal parathyroidectomy are satisfactory. Total parathyroidectomy plus parathyroid autograft should be used in selected cases. PMID- 3551152 TI - Diagnosis and treatment of functioning and nonfunctioning adrenocortical neoplasms including incidentalomas. AB - The most important functional tumors of the adrenal cortex are those that secrete cortisol or aldosterone in excess. Biochemical testing when appropriately utilized can diagnose and differentiate the cause of Cushing's syndrome, and when an adrenal adenoma is found, surgical excision is curative. The diagnosis and surgical treatment of primary aldosteronism are straightforward today, and localization of the usual small cortical tumor producing the syndrome can be achieved by CT and NP-59 scanning or selective venous assays. Adrenocortical carcinomas are relatively rare, are usually incurable when diagnosed, and are an important consideration in the incidentally discovered adrenal mass found by CT scanning. PMID- 3551151 TI - Diagnosis and treatment of hypoglycemic disorders. AB - Many other hypoglycemic states can be confused with an insulinoma. This article presents the diagnosis, localization, and therapy of these islet cell tumors. Also presented is a discussion of the role of nesidioblastosis in persistent hyperinsulinemic hypoglycemia in the neonate. PMID- 3551153 TI - Intra-arterial perfusion with prostaglandin E1 in patients with intermittent claudication. PMID- 3551154 TI - Clinical effects of intravenously administered prostaglandin E1 in patients with rest pain due to peripheral obliterative arterial disease (POAD)--a preliminary report on a placebo-controlled double-blind study. PMID- 3551155 TI - Renal transplant nephrectomy. AB - There is surprisingly little about the problems of transplant nephrectomy reported in the literature, despite the frequency of the procedure and the recognition that it can be a difficult technical challenge. Of 480 kidneys transplanted during a ten year period, 154 (32 per cent) were later removed. One hundred and eleven (72 per cent) nephrectomies were performed because of uncontrollable acute rejection within three months of transplantation. Thirty eight (25 per cent) nephrectomies were performed because of graft failure due to chronic rejection and five (3 per cent) were carried out for other reasons. The only significant problem that occurred during graft nephrectomy was difficulty in controlling bleeding which occurred at nine (6 per cent) operations. No patient died during the operation. In the postoperative period, there were two (1 per cent) complications, perforated peptic ulcer and pseudomembranous colitis, which led to death and 22 (14 per cent) which were successfully treated. These consisted of nine infections, five lymph leaks, four hematemeses, three secondary hemorrhages and one urine leak. No significant difference could be shown in morbidity and mortality with respect to the time lapse between transplantation and graft nephrectomy. Transplant nephrectomy need not be as hazardous a procedure as has often been recorded provided it is not performed by an inexperienced surgeon, although the decision as to when to abandon a graft is often a finely balanced one. PMID- 3551156 TI - Two alternative methods for tying the surgeon's knot with one hand. AB - After a recent description of a one handed method of tying a surgeon's knot, two further methods are described. It is suggested that three double throws produce a safe knot for monofilament sutures. Using a method described herein, such a knot can be tied elegantly and quickly. PMID- 3551157 TI - Single plus double lumen intra-atrial [corrected] venous access in bone marrow transplant recipients. AB - BMT recipients require large volumes of fluids, drugs and PN. To reduce manipulation of central catheters and the risk of PN line sepsis, both single and double lumen intra-atrial [corrected] catheters were placed in ten BMT recipients through the internal jugular (double lumen) and cephalic or external jugular (single lumen) vein. Patients were observed for two to seven months. Two partially clotted catheters were cleared with intraluminal urokinase. Skin breakdown at two exit sites responded to local care. The nursing staff and patient tolerated the procedure well. During BMT, fluid administration of 4,900 +/- 150 milliliters a day was possible without interruption of PN. Line or catheter site infections did not occur. Use of three intra-atrial [corrected] lumens eased the care of BMT patients and eliminated PN interruption. Decreased line manipulation may also have led to fewer catheter related infections. PMID- 3551158 TI - Gastric epithelioid leiomyomatous tumors. AB - Gastric epithelioid leiomyomatous tumors can present in three patterns; intramural, endogastric and exogastric based upon the relation to the gastric muscular wall. Patients may experience no symptoms from this tumor or may complain of symptoms suggesting peptic ulcer disease. Upper gastrointestinal tract series are the most reliable diagnostic tests but important additional information can be obtained by ultrasound and abdominal computerized tomography. The overwhelming majority of epithelioid leiomyomatous tumors are found in the gastric antrum. Round or polygonal cells are seen histologically. Often these cells have a clear zone that surrounds the nuclei. The origin of these tumors is debated. Less than one-third of these tumors metastasize. Complete surgical excision can often achieve cure. The exogastric lesions are the ones most readily cured by resection. Prognosis also correlates with clinical parameters including size of tumor, duration of symptoms and weight loss. Adjuvant therapy has not proved beneficial. PMID- 3551159 TI - Richard Wiseman, a Royalist surgeon of the English Civil war. AB - The contribution to the treatment of head injuries from Richard Wiseman, a Royalist surgeon during the English Civil War culminating in the battle of Worcester (1651), is presented. Wiseman's surgical surgical skill and vast experience was expressed in his book based on 600 personally treated patients. PMID- 3551160 TI - Randomized phase III trial of single versus multiple chemotherapeutic treatment following surgery and during radiotherapy for patients with anaplastic gliomas. AB - In 81 patients with anaplastic supratentorial gliomas, single versus multiple chemotherapeutic agents were selected for treatment following surgery and during radiotherapy in a prospective randomized study. Time to treatment failure and survival were not significantly enhanced by multiple agent chemotherapy, as administered in this study. PMID- 3551161 TI - Posterior lumbar interbody fusion with the keystone graft: technique and results. AB - The technique of posterior lumbar interbody fusion reported here consists of the following steps: The confluence of the spinous process and lamina removed en bloc during the exposure is contoured into three keystone plugs; the anterior third of the disc space is packed with bone fragments; the keystone plugs are tapped in posterior to the bone fragments and locked into place; and excess bone fragments are laid over the facets bilaterally and over the transverse processes if necessary to fuse the facet joints and create a posterior fusion. This fusion technique precludes the need for banked bone or for the harvest of autogenous iliac bone, and provides posterior stability with the facet fusion despite the removal of the posterior elements. This technique has been used in 172 patients, with excellent or good results in 129 patients (75%); included in that number were 82 patients expecting compensation and 25 patients with failed-back syndrome. PMID- 3551162 TI - Obstructive hydrocephalus treated by ventriculocystocorticostoma. AB - The present report describes the late treatment of obstructive hydrocephalus in a patient in whom all conventional drainage techniques failed due to foreign-body reaction. A combination of subdural autodrainage and the ventriculostoma principle carried out by means of laser surgery was successful in achieving adequate drainage. The patient subsequently showed considerable improvement both clinically and psychologically after the operation. Sixteen months postoperatively the patient is in good health and a computed tomography scan confirmed well-functioning autodrainage. PMID- 3551163 TI - Suturing the aneurysm clip to the aneurysm sac. Perforated aneurysm clips: a technical note. PMID- 3551164 TI - Extracranial-intracranial bypass trial. PMID- 3551165 TI - [Ultrasonic diagnosis, computed tomography and lymphography of retroperitoneal lymphomas--re-evaluation of lymphography]. AB - Regarding the present results and the review of literature, we are of the opinion that negative attitude towards lymphography is not justified. In diagnostic procedure, priority is given to sonography and computed tomography because of their non-invasiveness. Lymphography is indispensable in all cases where sonography or computed tomography show negative findings and where the therapy planning depends on evidence or exclusion of retroperitoneal lymphomas. In general the combination of both computed tomography and lymphography is the most sensitive and consequently, the safest method in the diagnosis of retroperitoneal lymphomas. PMID- 3551166 TI - Liver transplantation in patients with patent splenorenal shunts. AB - Patent distal splenorenal shunts (Warren shunt) have been reported to cause decreases in the portal perfusion pressure and the total hepatic blood flow. Such hemodynamic alterations could have adverse effects on the transplanted liver. The experience with hepatic replacement in four patients with patent Warren shunts is reported. Operative findings were phlebosclerotic portal veins of small size and diminished portal blood flows. Hepatofugal collateral channels created by the construction of the Warren shunt were eliminated by division of the shunt and splenectomy in three patients and splenectomy alone in the other. All patients recovered; thus the presence of a patent Warren shunt should not be a contraindication for hepatic transplantation. PMID- 3551168 TI - [Historical perspective: distribution of work--sex and power]. PMID- 3551167 TI - Plasmacytoma of the thyroid: a case report, a study with use of the immunoperoxidase technique, and a review of the literature. AB - A case of solitary plasmacytoma of the thyroid is reported. A monoclonal component (IgG lambda) was identified in the serum of the patient and disappeared after total thyroidectomy and radiotherapy. The use of the immunoperoxidase technique on thyroid, bone marrow, and lymph node specimens allowed us to demonstrate the production of IgG lambda by the tumor, and to rule out the possibility of multiple myeloma. Previously reported cases are reviewed (15 cases). The diagnostic criteria, the association with thyroiditis, and the treatment of this rare disorder are discussed. PMID- 3551169 TI - [Historical perspective--Norwegian Nurses' Association on barricades for education from the first moment]. PMID- 3551170 TI - [That's what I remember best: night shift 4 weeks on end]. PMID- 3551171 TI - [Nurses should satisfy need for current technology in nursing]. PMID- 3551172 TI - [Allergy to stinging insects]. PMID- 3551173 TI - [Efficacy of methotrexate in the treatment of rheumatoid arthritis]. PMID- 3551174 TI - [Calendar of anniversary dates in the history of therapy 1987]. PMID- 3551175 TI - [Votchal Boris Evgen'evich (1895-1971) (on the 90th anniversary of his birth)]. PMID- 3551176 TI - [Treatment of imported tropical malaria caused by chloroquine-resistant strains of P. falciparum]. AB - The chloroquine-resistant strains P. falciparum are widely spread in the countries of South-East Asia, Latin America. Since the middle of the 70s the strains also occurred in Eastern Africa. The given paper is concerned with 4 patients suffering from imported chloroquine-resistant tropical malaria. Of these, 3 patients come from Africa, and one from Vietnam. In the latter patient, the disease ran a grave course and was attended by coma, acute renal insufficiency, hepatitis, and hemolytic anemia. The patient was registered as having grade III resistance of P. falciparum to chloroquine. The schedules of the disease treatment including quinine with fansidar, metakelphin (or with sulphalene and chloridine), mafloquine or tetracycline are presented. PMID- 3551177 TI - Shakespeare, genetics, malformations, and the Wars of the Roses: hereditary themes in Henry VI and Richard III. AB - The four plays in the Henry VI-Richard III sequence well illustrate Shakespeare's recognition of hereditary influences upon the human condition. The inheritance of physical characteristics as manifest particularly by resemblance between fathers and sons is noted frequently. The absence of such resemblance is cited occasionally as evidence of illegitimacy. Personality traits are also viewed as inherited, although less consistently and there are important exceptions. Physical and mental traits when not derived from parents are ascribed to "nature" in the sense in which the term is often used today. Such traits are seen as being congenital or inborn even if not obviously "hereditary." Important exceptions to this are provided by the characters of the two lead characters in the play sequence. The weak-willed Henry VI is markedly different from his father, grandfather, and son who were all valiant, warlike, and brave. Shakespeare never explains this abrupt difference among generations. And the source of the evil character of Richard III is somewhat ambiguous. It seems most likely that in the first three plays of the sequence Shakespeare intended Richard's villainousness to be perceived as innate, caused by the same forces of nature that produced Richard's deformities (which are not further explained). But when Shakespeare wrote Richard III and gave more conscious consideration to what was now his central character he invoked an "environmentalist" explanation. Richard now is presented, albeit somewhat inconsistently, as evil in response to social ostracism because of his ugly deformities. This rather modern interpretation of the social origins of the personality of the deformed is particularly striking because it goes beyond anything in Shakespeare's historical sources, although Francis Bacon, a contemporary of Shakespeare, also recognized the effect of social forces upon the personality of the deformed. PMID- 3551179 TI - Variations in physician practice and covert rationing. PMID- 3551178 TI - Effects of metabolic factors in the diabetic state on the in vitro development of preimplantation mouse embryos. AB - The effects of insulin, glucagon, beta-hydroxybutyrate, and acetoacetate on the in vitro development of preimplantation mouse embryos were studied. In controls, 24% of blastocysts failed to develop successfully when grown for 72 h in Eagle's medium supplemented with 10% fetal calf serum. Insulin at concentrations of 1.0 and 2.0 IU/ml of culture medium interfered with development in 62-63% of the blastocysts. Preimplantation embryos showed a threshold pattern in their reaction to glucagon: its addition in concentrations of 0.0015 mM (5 micrograms/ml) did not significantly inhibit blastocyst development, while concentrations of 0.003 mM (10 micrograms/ml) inhibited 70% of blastocysts. The embryotoxic effects of ketone bodies were manifested only in relatively high doses. beta-hydroxybutyrate was embryotoxic at concentrations greater than 5 mg/ml, and its effects were dose dependent: 48 mM (6 mg/ml) inhibited 45% of blastocysts, while 80 mM (10 mg/ml) arrested 87% of embryos from further development. Acetoacetate at concentrations of 0.1 mM (10 micrograms/ml) inhibited the development of 50% of the blastocysts, and its effects were not dose dependent: concentrations of 1 mM (100 micrograms/ml) inhibited development in 63% of the embryos. The combination of the diabetic metabolic factors in relatively low concentrations was highly embryotoxic, especially when accompanied by hyperglycemia. PMID- 3551180 TI - Low molecular weight heparin (KABI 2165) as thromboprophylaxis in elective visceral surgery. A randomized, double-blind study versus unfractionated heparin. AB - In two randomized double-blind studies perioperative bleeding complications and thromboembolic events were assessed in 189 patients (pts) undergoing elective visceral surgery after subcutaneous administration of a low molecular weight (LMW) heparin fragment (KABI fragment 2165) or unfractionated (UF) heparin. The first study comparing 1 X 7'500 anti-factor Xa IU LMW heparin daily with 2 X 5'000 IU UF heparin was interrupted because of excessive bleeding complications (LMW heparin: 11/23 pts, UF heparin: 2/20 pts, p less than 0.01). In the second study (146 pts) the dose of LMW heparin was reduced to 1 X 2'500 anti-factor Xa IU. Bleeding complications (LMW heparin: 14.9%, UF heparin: 15.3%) and thromboembolic events (LMW heparin: 2.86%, UF heparin: 2.94%) were equal among the two groups. 2'500 anti-factor Xa IU/day of this LMW heparin fragment, corresponding to 15 mg/day, is the lowest dose of a LMW heparin used in a randomized clinical trial and was found to be a safe and efficient regimen in perioperative thrombosis prophylaxis. An advantage of LMW heparin over UF heparin is its once daily administration. PMID- 3551181 TI - Different effects of aspirin, dipyridamole and UD-CG 115 on platelet activation in a model of vascular injury: studies with extracellular matrix covered with endothelial cells. AB - Cultured endothelial cells produce an extracellular matrix (ECM) which activates platelets, similarly to deendothelialized vascular segments. Platelet-rich plasma (PRP) was incubated with endothelial cells cultures seeded in various densities on ECM. The interaction of the platelets with this artificial intima was evaluated by phase microscopy and by thromboxane A2 (TXA2) and prostacyclin (PGI2) measurement. Large platelet aggregates were formed on exposed ECM. Platelets aggregation but not adhesion on the ECM was markedly inhibited by the presence of endothelial cells. Pretreatment of the endothelial cells with 0.1 mM aspirin reduced their PGI2 synthesis and was associated with platelet aggregation on the ECM. 10 microM dipyridamole markedly inhibited platelet activation by ECM when the drug was added to citrated whole blood before PRP preparation. UD-CG 115 which elevates cyclic AMP in cardiac muscle, inhibited platelet aggregation and TXA2 production induced by ECM, in the presence as well as in the absence of endothelial cells, without any effect on endothelial PGI2 production. PMID- 3551183 TI - Free fatty acids and platelet prostacyclin binding. PMID- 3551182 TI - Comparison of tryptic fragments of von Willebrand factor involved in binding to thrombin-activated platelets with fragments involved in ristocetin-induced binding and binding to collagen. AB - Previously we have studied the binding domains on von Willebrand factor (vWF) involved in ristocetin-induced binding to platelets (ristocetin binding domain, RBD) and in the binding of vWF to collagen (collagen binding domain, CBD) using tryptic fragments of 125I-labelled vWF (21, 23). We have also reported on the RBD, CBD and the domain on vWF involved in the binding to thrombin activated platelets (thrombin binding domain, TBD) using vWF-fragments prepared by digestion with staphylococcal protease V8 (25). In the present study, we have digested 125I-vWF with TPCK-trypsin and we have performed at various times of digestion immuno-precipitation with Mab 9, the antibody inhibiting binding of vWF to thrombin activated platelets. The data were compared with the immunoprecipitation patterns simultaneously obtained with CLB-RAg 35 which inhibits binding of vWF in the presence of ristocetin and with CLB-RAg 201, which inhibits binding of vWF to collagen. At 90 min, Mab 9 and CLB-RAg 201 precipitated similar high molecular weight bands, whereas CLB-RAg 35 precipitated bands at 180 and 120 kDa. After 24 h, Mab 9 precipitated bands at 200, 155, 116 and 85 kDa; CLB-RAg 201 precipitated a band at 48 kDa and CLB-RAg 35 a band at 116 kDa. Two-dimensional electrophoresis demonstrated that the high molecular weight bands, precipitated by Mab 9 and CLB-RAg 201 at 90 min, were identical. The 116 kDa fragment recognized by CLB-RAg 35 had a different subunit composition than the 116 kDa fragment precipitated by Mab 9.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551184 TI - [Monoclonal antibodies: therapeutic possibilities and limitations]. AB - Monoclonal antibodies offer a unique possibility for specific recognition of a particular cell type. They can, in principle, be used for immunotherapy, for instance to destroy tumour cells, or to induce immunosuppression by eliminating T lymphocytes. The Fc moiety is essential for the biological effects of the antibody. The interaction of the Fc moiety with natural effector mechanisms (like complement, and Fc receptor positive cells of the monocytic-phagocytic system) is strongly dependent on the subclass and origin (species) of the antibody, and may be a limiting factor for its in vivo use. Furthermore, the binding of a monoclonal antibody may induce antigenic modulation (the selective removal of the antigen from the cell surface) thus making the cell resistant to antibody mediated elimination. Another phenomenon affecting the therapeutic efficacy of a monoclonal antibody, is the antibody response evoked by the administration of the heterologous immunoglobulin. PMID- 3551185 TI - [A baby who is too pink]. AB - A 5 week old preterm boy born by caesarean section on maternal indication at a gestational age of 33 weeks is described, who developed a symptomatic zinc deficiency. He developed diarrhea, dermatological problems and convulsions. IV zinc supplements and subsequent oral zinc medication induced a complete remission of symptoms. Pathofysiologic sequences as well as disease states (sub-normal intake before and after birth, decreased absorption and increased loss) that can lead to zinc deficiency are discussed. To prevent a deficiency, an intake of 300 450 mcg/kg/day i.v. of elementary zinc in case of total parenteral nutrition and 700 mcg/kg/day p.o. in case of oral feeding is recommended. PMID- 3551186 TI - Extracellular matrix-cytoskeletal interactions in vascular cells. PMID- 3551187 TI - Fixation of neural tissue for electron microscopy with an electronically controlled perfusion pump. AB - Many attempts to improve the perfusion of mammalian tissues aim at changes of the osmotic pressure. We describe a method for fixation of nervous tissues controlling both the hydrostatic pressure and the flow rate of a perfusion solution. The constancy of these parameters is guaranteed by an electronically controlled perfusion pump. Thus, a more uniform and complete preservation can be achieved. Further advantages of this method include provision for a rapid succession of rinsing and fixation solution and a continuous control of the hydrostatic pressure during perfusion. PMID- 3551188 TI - Congenitally osteosclerotic (oc/oc) mice are resistant to cure by transplantation of bone marrow or spleen cells from normal littermates. AB - The osteosclerotic mouse is a new, lethal recessive skeletal mutation which inherits osteopetrosis as an autosomal recessive. Affected mice are hypocalcemic and also have rickets. Osteoclasts are small and numerous with little evidence of function. This report examines the effects of bone marrow and spleen cell transplantation from normal littermates on survival and the radiographic appearance of the skeleton in 29 mutants. This procedure did not significantly prolong life or effect radiographic changes in the skeleton of most (27) recipients. However, two treated mutants lived for almost a year with radiographically normal skeletons. These variable responses to stem cell transplantation in an osteopetrotic mutant with rickets deserve further study. PMID- 3551189 TI - Protective effect of prostaglandin I2 on hepatic mitochondrial function of the preserved rat liver. AB - Mitochondrial function of the liver is one of the limiting factors in liver preservation. Nowadays, prostaglandin I2 (PGI2) is used as a cytoprotective agent in liver preservation without full understanding its mechanism involved. It is the objective of the present study to evaluate the protective effect of PGI2 on mitochondrial function of the rat liver during hypothermic preservation. Collins' solution was used as a preservation solution and PGI2 was added to it in some experimental groups. Both ischemic and non-ischemic livers were perfused with the preservation solution and preserved under simple hypothermia for 8 hr. Parameters of the mitochondrial function such as respiratory control, oxygen consumption rate in state 3 respiration, ADP/O ratio and the rate of ATP synthesis were decreased significantly after 8 hr hypothermic preservation, even if ischemic injury was not induced prior to preservation. ADP/O ratio, which represents the efficiency of oxidative phosphorylation in mitochondria, was improved significantly (p less than 0.01) when PGI2 was used as a cytoprotective agent. The rate of ATP synthesis, a parameter of energy producing reaction, showed a tendency to be increased by PGI2, but was not significant. It was concluded that hypothermic preservation of the rat liver is associated with the deterioration of the mitochondrial function and PGI2 has a favorable effect on the impaired ADP/O ratio of oxidative phosphorylation in mitochondria. PMID- 3551190 TI - Two cases of saline-responsive metabolic alkalosis associated with high urinary chloride concentrations. AB - Two particular cases of saline-responsive metabolic alkalosis associated with high urinary chloride concentrations were documented. In the first case, pseudoaldosteronism with long term glycylrrhetinic acid ingestion, and in the second case, probably salt losing nephropathy with extracellular fluid volume contraction were the putative causes of metabolic alkalosis, respectively. Sodium chloride loading with saline (0.9% NaCl) infusion to these patients corrected the accompanying hypopotassemic metabolic alkalosis. Recent trends in the pathophysiology of both saline-responsive and saline-resistant metabolic alkalosis were discussed. PMID- 3551192 TI - HMOs: financial feasibility, planning, and control. PMID- 3551191 TI - Adaptation of a human monocytic leukemia cell line (THP-1) in a protein-free chemically defined medium. AB - We have adapted a human monocytic leukemia cell line [THP-1c12(+)] so that it can proliferate in a completely protein-free chemically defined medium of an equal mixture of Dulbecco's modified Eagle's minimum essential medium and Ham's F12. This cell line was designated as THP-1c12(-). When a sufficient number of THP 1c12(-) cells was seeded in culture, the maximum cell density after 6 days of culture was 1 X 10(6)/ml with a doubling time of 30 hr. Transferrin showed a slight stimulative effect on the growth of THP-1c12(-) cells, but insulin did not. The surface profile of THP-1c12(-) was the same as that of THP-1c12(+), which possessed Mol. Mo5, LeuM3, My9 and Ia-like antigens as well as a large number of Fc receptors. Phagocytic ability with respect to IgG-coated sheep red blood cells was evident in both THP-1c12(+) and THP-1c12(-) cells. A small percentage of THP-1c12(-) cells retained the ability to reduce nitroblue tetrazolium when stimulated with 12-tetradecanoyl-phorbol-13-acetate. Culture supernatant from THP-1c12(-) stimulated the incorporation of 3H-thymidine into its own cells, suggesting an autocrine mechanism by which the growth of THP-1c12( ) cells is induced in a protein-free medium. PMID- 3551193 TI - HMOs and CMPs: federal regulations. PMID- 3551194 TI - Free-standing emergency centers and ambulatory surgery centers: evaluating feasibility and assessing impact on hospital operations. PMID- 3551195 TI - The effects of low doses of cadmium-metallothionein on the renal uptake of beta 2 microglobulin in rats. AB - The urinary excretion of beta 2-microglobulin (beta 2-m) was followed up in rats given increasing intravenous doses (15, 30, or 60 micrograms Cd/kg) of rat hepatic cadmium-metallothionein (Cd-MT). At the two highest doses, Cd-MT was found to induce two peaks in the urinary excretion of rat beta 2-m: a first narrow peak occurring immediately after the injection, followed 20 hr later by a broader peak. While the latter peak is caused by the well-known tubular toxicity of Cd-MT, the former most likely results from competition between rat Cd-MT and beta 2-m for a common renal transport system. This explanation is supported by the fact that the renal accumulation of MT-bound Cd can be inhibited by human beta 2-m. The Cd concentration in renal cortex of rats challenged with the lowest tubulotoxic dose of Cd-MT was only 3.4 ppm 4 hr following the injection. Since the Cd-MT nephrotoxicity is caused by the non-MT-bound Cd, which at this time represents about 70% of the renal Cd, it can be tentatively estimated that the critical concentration of free Cd in renal cortex is only 2 ppm, i.e., about 100 times less than the currently accepted critical value for the total concentration of this metal in kidney cortex. PMID- 3551196 TI - Allylamine cardiovascular toxicity. AB - The chemistry, industrial usage, general toxicity, and experimental use of allylamine are briefly reviewed. This highly reactive unsaturated alkylamine has had industrial applications in a variety of organic processes, and continues to be utilized, although accurate data concerning production is not readily available. The general toxic effects of the freebase form are primarily related to irritation of the mucous membranes, whereas the relatively long history of experimental use of this chemical has emphasized its' extraordinarily deleterious effects on heart and vascular tissue. Allylamine has been given by a variety of routes to many species in attempts to cause lesions which mimic human acute vasculitis, acute myocardial necrosis, and atherosclerosis; examples of typical lesions are illustrated. More recent in vivo and in vitro experimental work concerning the cellular toxicity of allylamine are summarized, and possible mechanisms of this chemicals' toxic action are discussed. PMID- 3551197 TI - Experimental intoxication with fruit and purified toxins of buckthorn (Karwinskia humboldtiana). AB - To determine the extent of extraneural lesions in buckthorn poisoning, 180 CD1 mice were administered either green or ripe fruit or toxins T-544 or T-514 obtained from the fruit of the plant and were observed over a period of three weeks. Marked weakness, hyporeflexia, hair bristling, ptosis, spinal deformity, weight loss and dypsnea were prominent signs. Mortality in mice given green fruit was 100% at all doses; with toxin T-514 the mortality was 100% at 45 mg/kg. One hundred and sixty-two necropsies were performed and major lesions were found in liver and lung. The pulmonary lesions consisted of progressive vascular congestion and hemorrhage. Alterations in liver consisted of congestion, hemorrhage, hepatocyte degeneration, central zone necrosis and acute diffuse necrosis. Green fruit was more toxic than ripe fruit and T-514 was more active than T-544. PMID- 3551198 TI - History of the International Society on Toxinology and Toxicon. I. The formative years, 1954-1965. PMID- 3551199 TI - A case report of aldosterone producing adenoma with masked hyperaldosteronemia. AB - A 50-year old female with primary aldosteronism and masked hyperaldosteronemia is reported. Her blood pressure was 176/110 mmHg with no paralysis of hypokalemia. Serum potassium, aldosterone and renin activity were 4.3 mEq/L, 17 ng/dl and 0.6ng/ml/h, respectively. Following a stimulation test by sodium loading and furosemide plus standing, neither aldosterone nor renin activity responded. Adrenal computed tomographic scanning, ultrasonography and cortical scintiscanning failed to reveal the tumor mass. A definite diagnosis of aldosterone producing adenoma was made after adrenal venous sampling in which the concentration of aldosterone was 15-fold greater in the right adrenal vein than in the left. The diagnosis of right adrenal cortical adenoma was confirmed by surgery. Thus, this case indicates the usefulness of the sampling technique in making an accurate diagnosis for primary aldosteronism with normo-kalemia, normo aldosteronemia and normo-reninemia. PMID- 3551200 TI - [Production of placental-type alkaline phosphatase isoenzyme in periapical granuloma]. PMID- 3551201 TI - [Combined therapy of experimental candidiasis of the oral mucosa]. PMID- 3551202 TI - [Gingival fluid--an objective criterion for assessing the status of periodontal tissues]. PMID- 3551203 TI - [Use of the intraoral bone suture in mandibular fractures]. PMID- 3551204 TI - [The high-filler material Airodent-02 for plastic facings of unit-cast bridge dentures]. PMID- 3551205 TI - [Method of fabricating a complete removable denture for the maxilla]. PMID- 3551206 TI - [Morphological changes in the trigeminal ganglion and inferior alveolar nerve following suture application in mandibular fractures in an experiment]. PMID- 3551207 TI - [The Moscow Dental Institute during World War II (1941-1945)]. PMID- 3551208 TI - [Concepts of the etiology and pathogenesis of periodontal diseases]. PMID- 3551209 TI - [Basic trends in the study and development of alloys for orthodontics]. PMID- 3551210 TI - Steroid hormone feedback on LH in prepubertal Holstein heifers. AB - A significant dose-response relationship between gonadotropin-releasing hormone (GnRH) and time to luteinizing hormone (LH) peak, peak serum LH and total serum LH was obtained in prepubertal Holstein heifers (28 weeks of age) (Experiment 1). For the second experiment, the effect of steroid feedback on the anterior pituitary was determined. A steady infusion of saline, estradiol-17 beta or progesterone was maintained for 24 h while GnRH, in various schemes, was administered 8 h after the beginning of steroid infusion. Estradiol-17 beta infusion (2.08 micrograms/h), although it did not affect peripheral concentrations of estrogen, caused an LH release 24 to 30 h later in 37.5% of the heifers. This amount of exogenous estrogen did not affect the LH response to a single GnRH (4 micrograms) challenge. When the same GnRH dosage (4 micrograms) was administered 6 times at hourly intervals, the heifers infused with estradiol had a lower response after the first 2 injections of GnRH and a greater response after the last 4 injections than heifers infused with saline. When GnRH was infused (4 micrograms/h) for 6 h, beginning 8 h after steroid infusion, estradiol infusion caused a significantly higher peak LH and total LH release than an infusion of either saline or progesterone (7.3 micrograms/h). The progesterone infusion had no effect on the GnRH-stimulated LH release. We conclude that prepubertal dairy heifers have an anterior pituitary capable of responding to the feedback effect of estrogen in a positive manner. PMID- 3551211 TI - Cerebral amyloid angiopathy. A critical review. PMID- 3551212 TI - Intravenous prostacyclin in acute nonhemorrhagic stroke: a placebo-controlled double-blind trial. AB - The therapeutic efficacy of prostacyclin in nonhemorrhagic cerebral infarction was assessed in a placebo-controlled double-blind trial. A total of 80 patients with stroke onset within 24 hours were randomized into placebo (37 patients) and prostacyclin (43 patients) groups. Demographic data and risk factors were comparable. Patients in the prostacyclin group received a continuous i.v. infusion of prostacyclin at an average rate of 8.5 ng/kg/min for an average of 64 hours. The placebo group received vehicle only in a similar fashion. During treatment hemodynamic changes were more prominent in the patients receiving prostacyclin and included reduction of systolic and diastolic blood pressure and increase in pulse rate. In contrast there was only a slight (but significant) reduction of diastolic blood pressure in the placebo group. Neurologic deficit scores were determined on admission, at Day 3, and at Weeks 1, 2, and 4. Mean neurologic deficit scores upon entry were comparable in the placebo and prostacyclin groups, and a significant improvement in the score for neurologic deficit was noted in both. The placebo group tended to fare better throughout the study, with a significant difference in neurologic deficit score favoring the placebo group at Week 2 (p = 0.0048). Two patients in the placebo and one in the prostacyclin group died. The only difference in adverse reactions was flushing (6 patients in prostacyclin vs. 0 in placebo group, p less than 0.05). The results of this study suggest a lack of therapeutic efficacy of prostacyclin in a defined population of patients with nonhemorrhagic cerebral infarction. PMID- 3551213 TI - [Establishing the origin of blood taken from the female genital tract by using antifibrinogen serum]. PMID- 3551214 TI - [Use of antisaliva heteroimmune sera in the immunofluorescence reaction in research on sperm stains]. PMID- 3551215 TI - [Possibility of eliminating the nonspecific effect of the rectal contents on serum reagents]. PMID- 3551216 TI - [Current status and prospects in establishing the menstrual origin of blood in stains for material evidence]. PMID- 3551218 TI - The fourth annual scientific meeting of the Transplantation Society of Australia and New Zealand. Canberra, Australia, April 1986. Proceedings. PMID- 3551217 TI - [Current status of the problem of traumatic shock in its forensic medical relationship]. PMID- 3551219 TI - Long-term follow-up of a prospective trial of low-dose versus high-dose steroids in cadaveric renal transplantation. PMID- 3551220 TI - Effect of cyclosporine A on risk factors in renal transplantation. PMID- 3551221 TI - Combination immunosuppressive therapy in cadaveric renal transplantation: initial experience with a flexible regimen. PMID- 3551222 TI - Detrimental effect of a positive B lymphocyte crossmatch in renal transplantation. PMID- 3551223 TI - Psychosocial complications in living related kidney donors: an Australian experience. PMID- 3551224 TI - The effect of blood pretransfusion on orthotopic cardiac transplantation. PMID- 3551225 TI - Effects of low-dose cyclosporine A on toxicity and rejection in cardiac transplantation. AB - In conclusion, the low doses of CsA have significantly reduced nephrotoxicity and infectious complications. The patient survival has been acceptable, but there has been a disappointing incidence of rejection and graft loss in patients who have survived the first 3 months. We feel our experience would indicate that by targeting our CsA dosages to such low serum levels some of our patients receive suboptimal immunosuppression. Perhaps the best way of overcoming this is add a third maintenance immunosuppressive agent such as azathioprine to supplement immunosuppression. In fact, we have now changed our immunosuppressive protocol to include azathioprine while maintaining our CsA therapy at its current level. PMID- 3551226 TI - Corneal transplantation: collection, assessment, storage, and distribution of corneas for grafting. PMID- 3551227 TI - T cell depletion of human bone marrow for allogeneic marrow transplantation. PMID- 3551228 TI - The role of T cells in hemopoietic engraftment. PMID- 3551229 TI - Target susceptibility in cell-mediated lympholysis assays correlates with major histocompatibility complex surface antigen expression. PMID- 3551230 TI - The expression of specific differentiation antigens on macrophages infiltrating rejecting renal allografts. PMID- 3551231 TI - Cells infiltrating inflamed and vascularized corneas. PMID- 3551232 TI - Cyclosporine dosage requirements for rabbit skin allograft enhancement due to perioperative blood transfusion and cyclosporine synergy. PMID- 3551233 TI - Resistance to engraftment in irradiated dogs receiving T cell-depleted bone marrow transplants. PMID- 3551234 TI - Comparison of liver, spleen, and kidney as sites for xenografting human fetal pancreas in the nude mouse. PMID- 3551235 TI - Induction of immune unresponsiveness in mice with organ-cultured fetal pancreas allografts. PMID- 3551236 TI - Skin hypersensitivity of the delayed type in renal transplant patients receiving azathioprine or cyclosporine. PMID- 3551237 TI - De novo occurrence of hemolytic-uremic syndrome in a cyclosporine-treated renal allograft patient. PMID- 3551238 TI - Successful cadaveric and living related donor renal transplantation in patients with historical positive and pretransplant negative crossmatch. PMID- 3551239 TI - Pneumatosis cystoides intestinalis following lactulose and steroid treatment in a liver transplant patient with an intermittently enlarged scrotum. PMID- 3551240 TI - A technique for transplantation of a large adult kidney into an infant. PMID- 3551241 TI - A simple technique for anastomosis of the pancreatic duct to the jejunum in dogs: implications for pancreas transplantation. PMID- 3551243 TI - Transient elevation of serum rheumatoid factor following bone marrow transplantation. PMID- 3551242 TI - Japanese Multicenter Trial of Cyclosporine in Renal Transplantation: overall results and analysis of the factors influencing graft survival rate. PMID- 3551244 TI - Drug-induced tolerance to allografts in mice. XIII. Tolerance to the H-Y antigen. PMID- 3551245 TI - First International Symposium on Renal Failure and Transplantation in Blacks. Dedication to Samuel Lee Kountz, MD, FACS, 1930-1981. PMID- 3551246 TI - Rehabilitation: how can more dialysis and transplant patients be fully rehabilitated? PMID- 3551247 TI - The rehabilitation of dialysis and transplant patients. PMID- 3551248 TI - Kidney transplant rehabilitation at Howard University Hospital: a retrospective analysis. PMID- 3551249 TI - Nursing care of the black renal patient--the role; challenge and reward. AB - The care of the black renal patient is similar in many ways to the care of most renal patients. In spite of this, we must appreciate the differences and the challenges and prepare ourselves appropriately. With proper planning, the advantages/rewards will be felt by all. PMID- 3551250 TI - Is there a role for kidney transplantation in developing countries? PMID- 3551252 TI - Results of cadaver renal transplants in Caribbean Hispanics as compared with North American patients. PMID- 3551251 TI - Transplantation in Kuwait--a middle eastern and North African perspective. PMID- 3551253 TI - National study in natural history of renal allografts in sickle cell disease or trait: a second report. PMID- 3551254 TI - Organ donation in the black population: where do we go from here? PMID- 3551255 TI - The use of low-dose cyclosporine A in combination with azathioprine and steroids in renal transplantation. PMID- 3551256 TI - Ocular complications of chronic renal disease. PMID- 3551257 TI - Race and diabetic nephropathy. AB - Blacks who are at a greater risk of renal failure than whites also experience a greater prevalence of diabetic nephropathy. Preliminary data suggest that black uremic diabetics fare less well than whites following a kidney transplant. Planning treatment for the diabetic with progressive renal insufficiency requires an allowance for the high probability that coincident multisystem disease will develop. We now understand that the mysterious concept of unmanageable "brittle diabetes" was a myth derived from flawed interaction between patient and physician. By establishing a team approach, the patient is protected from the stress of having conflicting treatment protocols prescribed by physicians concerned with only one organ or system. Black diabetics who may often have less family income than whites may require more intensive support from social workers and diabetes educators to understand and cope with the burden of kidney failure. The majority of uremic diabetics, both black and white, can survive at least the first 3 years of dialysis or renal transplantation with preserved sight and intact limbs. It may be anticipated that the proportion of nephropathic diabetics who attain rehabilitation will continue to increase. PMID- 3551258 TI - Is diabetic nephropathy reversible? PMID- 3551259 TI - Diabetic renal-retinal syndrome: does tight control help? PMID- 3551261 TI - Poststreptococcal glomerulonephritis: how important is it as a cause of chronic renal diseases. PMID- 3551260 TI - Kidney transplantation in diabetic patients. PMID- 3551262 TI - [Effect of hyperbaric oxygenation on the survivability, mutagenesis and recombinogenesis of single-cell organisms]. AB - The hyperbaric oxygenation (HBO) has been studied for its ability to induce the cell death and different genetic variations in normal and repair defective strains of bacteria (Escherichia coli and Salmonella typhimurium) and of yeast (Saccharomyces cerevisiae) strains with different ploidy. HBO is shown to induce an increase in the mutability of excision-repair defective strains and a decrease in the survival rate of error-prone repair defective strains of the procaryote. HBO is a weak recombinogen for yeast and induces no mutations of the haploid strain. The results obtained reflect doubt on the community of the mechanisms of radiation and HBO actions on the cell. PMID- 3551264 TI - [Use of the indirect immunofluorescence method for the comparative analysis of histones]. AB - With the help of indirect immunofluorescence on the model systems--a ploid line of wheat, haploid and diploid cells of Chlamydomonas reinhardii, glass beads with adsorbed histones--a study was made of the dependence of ultimate dilutions (UD) of antihistone sera on the quantity, density and immunochemical properties of histones--antigens. The UD value in the artificial model system (glass beads) increased with the rise in the quantity and density of histones on bead to some definite limits, and then the UD remains constant to be determined only by the titre of antiserum. In natural model system (wheat, Chlamydomonas reinhardii), with the rise in quantities of DNA and histones in the nucleus their densities remain constant, with no changes of UD values being observed. The results obtained are discussed in terms of establishing the dependence of UD on immunochemical properties of histones-antigens. Thus, the method of indirect immunofluorescence may be used for comparative analysis of immunochemical properties of histones in various objects. PMID- 3551263 TI - [Diagnosis of mosaic forms of karyotype anomalies in clinical cytogenetic research]. AB - Mosaicism cases have been statistically analyzed with the aim to develop a general scheme of the cytogenetic study. Using the Bernoulli formula it is shown that when P = 0.95 and proportion of clones is 10:90% and more 29 cells should be initially analyzed. If all the cells are of the same chromosomal constitution (m = 0) the mosaicism is rejected. Mosaicism is highly probable when m = 4 and more among n = 29. When m = 1, 2 or 3 the number of cells should be increased to 44 in accordance with calculations by the formula: 1--Cnm.pm.(1--p)n-m = P. PMID- 3551265 TI - [Effect of dihydrocytochalasin B on the induction of DNA synthesis by epidermal growth factor, insulin and serum in Swiss 3T3 cells]. AB - The addition of a microfilament-disorganizing agent--dihydrocytochalasin B B (5 10 micrograms/ml)--to to quiescent confluent or sparse (in 0.5% serum) Swiss 3T3 cells, 1-2 hours prior to stimulation, inhibited the initiation of DNA synthesis induced by an epidermal growth factor (7.5-10 ng/ml) and insulin (0.5-1.0 micrograms/ml), but exerted a low effect on serum stimulation. DNA synthesis was measured 21-23 hours after the growth factor administration by 14C-thymidine incorporation in acid-insoluble material and the ratio of this fraction to exogenous thymidine uptake. Moreover, the polar solvent dimethylsulfoxide, present in culture medium at low concentration (0.1-0.5%), also caused a decrease in the basal level of 14C-thymidine incorporation in resting cells, and a less decrease in the induced incorporation. PMID- 3551266 TI - [Contact interactions of spreading thrombocytes]. AB - Contact interactions of rabbit platelets was studied in the course of their spreading over the siliconized glass surface. When the density of cells adhered to the substratum surface is high enough, the platelets are spreading in such a way that their edges are in a close proximity, while the overlapping of cells is very rare and scarcely pronounced. A morphometric analysis of the probability of such an organization of platelets at their random and independent disposition on the substratum proves the existence of a contact inhibition of platelets spreading on the substratum. Thus, a phenomenon of the contact inhibition seems to be a common feature not only of large nucleated cells but also of small anuclear platelets. PMID- 3551267 TI - [Effect of different fixation methods and partial chemical sympathetic denervation on cell size and 3H-leucine incorporation by rat sympathetic neurocytes]. AB - Dimensions of sympathetic nerve cells and of their nuclei were studied using various methods of fixation and embedding media, as well as autoradiographic indices of the protein synthesized system of neurocytes in normal rats, and in rats partially sympathectomized at an early age. On the ground of different changes in the average size of neurocytes seen under various methods of fixation, and of decreased labeling intensity of large neurocytes after the injection of the labeled protein biosynthesis precursor there is some reason to believe that large neurocytes may appear in the late reproductive age mainly due to the nerve cell cytoplasm swelling as a consequence of exhaustion of their growth resources. PMID- 3551268 TI - [Effect of amines on the binding, internalization and degradation of epidermal growth factor and the induction of DNA synthesis in a 3T3 cell culture]. AB - The role of intracellular processing of epidermal growth factor (EGF) in the induction of proliferation of quiescent Swiss 3T3 cells was studied using various inhibitors. The number of amines (dansylcadaverine, chloroquine, cystamine, 5 methoxytryptamine) dimethylurea and monensin were shown to block the mitogenic effect of EGF. The majority of these substances while used in concentrations sufficient to inhibit the proliferation do not significantly influence 125I-EGF binding and internalization. The level of EGF degradation was reduced only by chloroquine. The inhibitory effect of amines and monensin on the generation of proliferative signal was supposed to take place at the stages of EGF processing in "specialized" endosomes and in Golgi apparatus. PMID- 3551269 TI - The variation of sonic plesio-velocity in dose dependent lathyritic rabbit femurs. AB - It has been hypothesized that the origin of the increased elastic modulus of mineralized bone compared with the demineralized bone matrix is in the higher crosslinking density of the collagen in bone. Osteolathyrism is ascribed to an inhibition of crosslinking of the collagen by the lathyrogen and should be accompanied by a decrease in the elastic modulus of the bone. Dose dependent osteolathyrism was induced by varying the amount of BAPN ingested per day by young New Zealand white rabbits until they were mature. The femurs exhibited dose dependent properties, including wet bone density and sonic plesio-velocity in the radial direction. It was found that there is no minimum critical dose. Even though no overt osteolathyritic stigmata could be observed, both the sonic properties and the wet bone density could be affected at any dose level. The sonic plesio-velocity and the longitudinal elastic modulus decreased with BAPN dose level, most rapidly at the lower dose levels and then less so at higher dosages. Since BAPN acts to inhibit the crosslinking density, it appears that the elastic moduli of bone are dependent on the crosslinking density. PMID- 3551270 TI - Bibliography of biomedical ultrasound. No. 61. PMID- 3551271 TI - In vitro study of continuous wave Doppler spectral changes resulting from stenoses and bulbs. AB - Quantitative analysis of continuous wave (CW) Doppler spectra by measurements of peak frequency and spectral broadening is an important non-invasive method for detecting disturbed flow caused by carotid arterial stenosis. It is known that severe stenoses can be detected; however, the spectral changes associated with minor or moderate stenoses may not be detected or can potentially be confused with those produced by flow disturbances in the normal carotid bulb. In order to determine if the flow disturbances in a normal bulb and those associated with a minor stenosis produce significant spectral changes, Doppler spectra were recorded from straight tubes with bulbs or stenoses in an in vitro model with steady flow rates of 400, 600, and 800 cc/min (Reynolds numbers of 1700, 2600, and 3500). Stenoses greater than approximately 30% cross-sectional area were associated with an increased peak frequency and increased spectral broadening as measured by spectral broadening index (SBI), coefficient of variation (CV), coefficient of skewedness (CS) and coefficient of kurtosis (CK). Stenoses less than 30% were not detected. With flow rates of 400 and 600 cc/min, the presence of a bulb did not affect peak frequency or the extent of spectral broadening. With a higher flow rate (800 cc/min), there was an increase in SBI, CV and CS but no increase in peak frequency. Based on the results of these in vitro steady flow experiments in straight tubes, we conclude that increased peak frequency and spectral broadening are the result of a stenosis greater than 30% cross-sectional area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551272 TI - [Individualized bibliographic research using the MEDLINE system]. PMID- 3551273 TI - [Value of orally-induced hyperglycemia in predicting the insulin requirement in gestational diabetes]. PMID- 3551274 TI - [Cardiovascular pharmacology and heart rejection: hemodynamic aspects]. PMID- 3551276 TI - [Transcutaneous removal of renal and ureteral calculi]. PMID- 3551275 TI - [Transrectal longitudinal scanning in the diagnosis of diseases of the prostate gland]. PMID- 3551279 TI - Vas reapproximator for vasovasostomy. PMID- 3551278 TI - Calcified renal masses. AB - A review of the literature and the University of Kentucky Medical Center/Lexington Veterans Administration Medical Center experience regarding calcification of renal masses was undertaken. Twenty per cent of calcified renal masses cannot be easily characterized by CT scan as malignant or benign and are indeterminate. These lesions must be followed closely with follow-up CT scanning or undergo surgical exploration, as 40 per cent may be malignant. PMID- 3551277 TI - [Tumors of solitary or single functioning kidneys]. PMID- 3551280 TI - Sonography in evaluation of carcinoma of bladder. AB - Transabdominal ultrasonography of the bladder was performed in 25 examinations on 20 patients being treated for bladder carcinoma. The presence or absence of tumor was accurately gauged in all 20 patients. As compared to cystoscopy, tumor staging was less accurate. Eleven of 15 patients with tumor present were accurately staged. Edema, intravesicular clot, and tumor calcification caused overstaging of tumors. Poor bladder distensibility limited examinations. Three patients were followed up with serial examinations, and sonography accurately determined the response to therapy. PMID- 3551281 TI - Intravesical 50% dimethyl sulfoxide (Rimso-50) in treatment of interstitial cystitis. PMID- 3551282 TI - Pathology and pathogenesis of interstitial cystitis. PMID- 3551285 TI - [Alcoholic intoxication and the organ of vision]. PMID- 3551284 TI - [Value of the ultrasonic diagnosis of posterior uveitis in the rehabilitation of patients with posttraumatic ocular subatrophy]. PMID- 3551283 TI - [Status of the ocular hemodynamics in patients with occlusive diseases of the brachiocephalic branches of the aortic arch]. PMID- 3551287 TI - [Proteolytic activity of the perilymph in patients with otosclerosis after conservative therapy]. PMID- 3551286 TI - [Political, cultural and public health figures starting out as ophthalmologists]. PMID- 3551288 TI - [Treatment of patients with vasomotor rhinitis using snake venom]. PMID- 3551289 TI - [Clinical aspects of studying vestibulo-ocular reflexes in the normal state and in lesions of the vestibular system at various levels]. PMID- 3551290 TI - [Free bone and skin-bone autoplasty on a vascular pedicle in patients with defects and pseudarthroses]. AB - Radical sequestr- and necrectomy followed by skin, bone or skin-bone autoplasty on the vascular pedicle with microvascular anastomoses between the autotransplant vessels and those of the extremity was successfully fulfilled in 16 patients with defects of tubular bones and false joints complicated by chronic osteomyelitis. The pedicled autografts were taken from the upper flaring portion of the ilium (13), from the fibula (2) and from the external surface of the femur (1). The two step method of autoplasty is described. PMID- 3551291 TI - [Hypertension syndrome in kidney transplantation]. AB - Removal of the recipient's own kidney is indicated in cases with non-controlled arterial hypertension before and after transplantation of the kidney with the exclusion of chronic rejection and stenosis of the transplant artery. Embolization of the renal arteries is indicated to patients of high surgical risk. Roentgen-endovascular catheter dilatation of the stenosed artery of the transplanted kidney allows the operative treatment of recipients with chronic rejection of the transplant to be avoided. Surgical correction of stenosis is indicated to patients with a short-term hypotensive effect after dilatation. PMID- 3551292 TI - [Reinnervation of a transplanted muscle by the facial nerve isolated from its bony canal]. PMID- 3551293 TI - [Restoration of the thumb with a free vascularized skin flap from the toe]. PMID- 3551294 TI - [Method for closing the duodenal stump in gastric resection]. PMID- 3551295 TI - [Nikolai Ivanovich Pirogov and the St. Petersburg Medico-Surgical Academy]. PMID- 3551296 TI - [Sorption detoxification in severe mechanical injury and its complications]. PMID- 3551297 TI - [Body immunological reactivity and the infectious complications of injuries. Immunotherapy and immunocorrection]. PMID- 3551298 TI - [Intramural hematoma of the gastrointestinal tract]. PMID- 3551299 TI - [Comparative data on the healing of surgical wounds of the stomach made by ordinary, laser and ultrasonic scalpels]. AB - The article presents comparative morphological data on the healing of operative wounds on the stomach of rabbits made by an ordinary, laser and ultrasound scalpels. In all the cases the wound was sutured by a one-row interrupted sero muscular stitches. Clear distinctions in the healing of postoperative gastric wounds made by different scalpels were established. The formation of a zone of coagulative necrosis, followed by rejection of necrotic masses was invariably noted after the laser and ultrasound scalpels. These zones were not so considerable after dissecting the stomach with an ordinary scalpel. No incompetent sutures, failure of their hermetic quality or any other complications in the process of scar formation were detected in all the series. PMID- 3551300 TI - The impact of zoonotic diseases transmitted by pets on human health and the economy. AB - In the context of all causes of human morbidity and mortality, or even within the context of all infectious diseases affecting the public health, pet-associated zoonotic infections are of moderate importance. The data documented in Table 1, however, indicate that they do exact significant human health and economic costs. If complete data were available for all of the infections shown in Table 1, the costs would be considerably higher. Moreover, most of these diseases are preventable through educating the public, particularly pet owners, of the zoonotic potential of these diseases, so that they may take precautions to minimize the risks leading to infection. These measures include appropriate health care of pets to eliminate infectious agents, reducing the number of uncontrolled, ownerless pets as well as unwanted or poorly supervised pets, preventing pets from soiling public places with their feces, excluding animals from areas where children play, enforcing leash laws, and promoting responsible pet ownership. Veterinarians, physicians, and public health agencies can aid in these efforts; ultimately, however, the responsibility lies with the pet owner. PMID- 3551301 TI - Zoonotic dermatoses of dogs and cats. AB - Zoonotic dermatoses in dogs and cats are an important cause of skin disease in human beings. In addition, human dermatoses may occasionally be transmitted to dogs and cats. The veterinarian and the physician form a critical "health care team" in the proper management of these disorders. PMID- 3551302 TI - Gastrointestinal zoonoses. AB - Infectious gastrointestinal diseases affect man and animals throughout the world. Certain etiologic agents (for example, Salmonella spp., Campylobacter jejuni, Yersinia enterocolitica, Cryptosporidia, Strongyloides stercoralis, Echinococcus granulosa) seem to have the potential to be transmitted from pets to people, causing severe disease in the latter. Other agents seem unlikely to be transmitted but may have the potential to be zoonoses. This article discusses proved, suspected, and possible zoonotic agents that may originate from the gastrointestinal tract of dogs and cats. PMID- 3551303 TI - Risks of pet ownership. The family practitioner's viewpoint. AB - In this article, I have tried to give the reader some idea of the variety and the magnitude of problems that exist with pet-related ailments and to present some suggestions as to possible solutions. A recent editorial in a medical journal was titled "Caution: Pets May Be Hazardous to Your Health." Although it is a very appropriate warning, I doubt whether we will ever get it printed on the sides of all pets. Rather, it will be up to us in the medical and veterinary communities to educate the population about the risks of pet ownership and to keep ourselves educated about the problem. That way we can more readily recognize pet-related ailments and provide the appropriate care. PMID- 3551304 TI - Selected arthropod-borne diseases. Plague, Lyme disease, and babesiosis. AB - The incidence of plague, one of the oldest arthropod-borne diseases, has increased during the past 10 years in the United States. Domestic carnivores are playing an increased role in the occurrence of human cases. The cat is now the principal cause of primary human pneumonic plague in the United States. Lyme disease and babesiosis, which were initially thought to be limited to specific local regions, are much more widespread than originally thought. PMID- 3551305 TI - Bite wounds inflicted by dogs and cats. PMID- 3551306 TI - Zoonoses acquired from pet birds. AB - The diagnosis, treatment, pathology, and epidemiology of psittacosis, the principal zoonotic disease contractible from birds, in human beings and in birds is discussed at length. Salmonellosis, toxoplasmosis, and allergic alveolitis are also considered. Several bacterial, viral, fungal, and parasitic organisms are mentioned as potential zoonoses. PMID- 3551307 TI - Zoonoses acquired from pet primates. AB - Laws regulating the importation of primates have drastically reduced the number of primates seen as pets and, thus, the hazard both to the potential owner and veterinarian. Active disease and latent carrier states in primates potentially have severe consequences for the contact person. This potential for human transmission makes it imperative that medical and veterinary professionals collaborate to educate the public on the danger of the primate as a pet. PMID- 3551308 TI - Bacterial diseases of fish associated with human health. AB - As this country continues to increase its food fish output without increasing the water acreage, and environmental wastes continue to plague fish production, we can expect to encounter more zoonotic organisms, especially enteric-like organisms. Since 1972, the number of enteric genera has doubled and the species have tripled. The veterinarian engaged in aquatic animal medicine should be aware that aquatic pets or food fish can be associated with human disease and respond accordingly. In such cases, the veterinarian plays a major role in maintaining human health. PMID- 3551309 TI - Legal responsibilities of veterinarians in the control of zoonotic diseases. AB - This discussion of legal issues that may arise from the existence of zoonotic diseases is not meant to cause alarm; rather, it is meant to alert members of the profession to possibilities, not probabilities. The very nature of any discussion of legal issues, especially a discussion of case law in which someone is always suing somebody else, exaggerates the true-life situation. Although it is everyone's hope that they will not be involved in litigation, it is wise to be aware of the problems that may arise in connection with zoonotic diseases. PMID- 3551310 TI - Zoonotic visceral and ocular larva migrans. AB - Infection of children with the larval stage of the dog roundworm Toxocara canis usually produces few, if any, clinical signs. In some children, however, the disease may be severe, with permanent ocular or neurologic sequelae. Because the prevalence of infection may exceed 10 per cent in some population subgroups, it is important to understand the modes of transmission and risk factors for infection. The clinical presentations of toxocariasis as well as recommendations for their prevention are described. PMID- 3551311 TI - Toxoplasmosis. AB - Infection with T. gondii can have devastating effects on the development of the unborn human fetus. As veterinarians or physicians, we should be able to accurately assess the true risk of exposure of a person to meat-borne tissue cysts or to oocysts based on the age, health, roaming and feeding habits of their cats, and the occupational or recreational activities of the individual. When time precludes an in-depth discussion of preventive measures to decrease exposure to the parasite, the whole client education program can be neatly summarized in the admonition, "When pregnant, wash your hands thoroughly before eating or touching your face, and cook your meat thoroughly." In this way, the risk of exposure to toxoplasmosis and all other meat- or soil-borne diseases is greatly reduced. PMID- 3551312 TI - Rabies. AB - The practicing veterinarian has a key role to play in rabies control in the maintenance of protection in the companion animal populations, in the education of the pet-owning community on rabies, and in the decision-making process that accompanies human exposure to potentially rabid animals. This role encompasses far more than the routine maintenance of health and well-being in pet animal populations. Although it is important to remain diligent in the immunization of domestic pets against rabies to provide a barrier between wildlife, the main reservoir of infection, and man, it is also important to be aware of the current trends in wildlife rabies within a region. Research is currently underway to investigate methods of immunizing wildlife populations, but the effective and widespread control of rabies in these species is still a long way off; in the meantime, there will be an increasing demand for practicing veterinarians to take the lead in the control of this most fearful zoonotic disease. PMID- 3551313 TI - Cat scratch disease. A therapeutic dilemma. AB - Cat scratch disease, a relatively common infectious disease, is caused by a small gram-negative pleomorphic bacillus. The course of CSD is usually benign and self limiting and is characterized by tender regional chronic (3 weeks or longer) lymphadenopathy and frequently preceded by a primary skin lesion following cat contact or scratches. Persistence of adenopathy for several months in a generally healthy patient with gradual spontaneous resolution of the enlarged node is the natural course. PMID- 3551314 TI - Bacteriology of caudal vena caval thrombosis in slaughter cattle. PMID- 3551316 TI - A review of toxoplasmosis in cattle. AB - Worldwide reports of natural and experimentally-induced Toxoplasma gondii infections in cattle are reviewed and tabulated. Serologic tests employed in most studies in the past are of suboptimal sensitivity for the diagnosis of T. gondii infection in cattle; therefore data need to be interpreted with caution. From the evidence available it is concluded that: T. gondii is probably not important in causing abortion or clinical illness in cattle but further experimental studies are desirable; T. gondii is eliminated quickly from bovine tissues; Whether beef plays a part in the epidemiology of toxoplasmosis is unresolved; Milk from T. gondii-infected cows is of negligible importance in the epidemiology of toxoplasmosis. PMID- 3551315 TI - Additional studies on the therapeutic efficacy of sulphadimidine sodium in experimental Escherichia coli infection of broilers. AB - In contrast with the recommended dose of 2,000 ppm sulphadimidine sodium in the drinking water for treatment of broilers against colibacillosis, it appeared that under experimental conditions, treatment at 500 ppm (60 mg/kg body weight) gave the best therapeutic effects. At higher concentrations, drinking water consumption and body weight gain were reduced significantly. During treatment high blood plasma-concentrations were measured. PMID- 3551317 TI - Orchitis in a camel (Camelus dromedarius) infected with Sarcoptes cameli. PMID- 3551318 TI - Influence of the vaccination regime on the herd immune response for swine fever. AB - Surveys in three areas with emergency vaccination programmes revealed that 86-94% of the pigs vaccinated in the initial mass campaign had developed an adequate antibody titre against swine fever as compared with 29-55% of the pigs involved in supplementary vaccination campaigns. The serological response of piglets born from immunised sows rose with the age of vaccination from 11% at 5-6 weeks to 42% at 7-8 weeks and 77% at 9-10 weeks. In piglets born from immunised sows, a 50% 'take' of the vaccine was not obtained before the age of 8-9 weeks. Re vaccination of gilts born from immunised dams improved the immune status to almost the level observed after mass campaigns. To strengthen herd immunity in vaccination areas, the age of supplementary vaccination has been raised to 7-9 weeks, while breeding gilts are re-vaccinated when 6-7 months old. PMID- 3551319 TI - Bacteriostatic activity of bovine lactoferrin in mastitic milk. AB - The antibacterial activity of milk against a virulent strain of Escherichia coli was investigated using milk fractions from normal or inflamed glands. Mastitic whey exhibited either bactericidal or bacteriostatic activities, depending on whether bacteria were enumerated by the pour plate technique or by surface plating onto sheep blood agar. The former activity was not due to lactoferrin (Lf), which never exerted bactericidal activity, even when assayed in distilled water. Milk whey ultrafiltrate (UF) (mol. wt. less than 5000 d) was used to assay the ability of normal and mastitic milk to support the antibacterial activities of Lf against a strain of E. coli. The addition of purified Lf to UF from mastitic whey resulted in bacteriostasis, whereas Lf was without effect in UF from normal whey. It was concluded that Lf can actually slow down the growth of Lf-sensitive bacteria during mastitis, provided that plasma exudation takes place. PMID- 3551320 TI - Growth of Mycoplasma bovis in organ cultures of bovine foetal trachea and comparison with Mycoplasma dispar. AB - Inoculation of tracheal organ cultures from bovine foetuses with Mycoplasma bovis resulted in a loss of cellular structure of the lamina propria, followed 20-22 days later by lifting and detachment of overlying epithelium. The effect was associated with large numbers of M. bovis, identified by immunoperoxidase labelling and electromicroscopy, infiltrating between the epithelial cells and amassing in the lamina propria, especially in the region of the basement membrane of the epithelium. Ciliary activity was undiminished for up to 18 days following inoculation and little or no cytopathic effect on the ciliated epithelium was seen in spite of the close proximity of large numbers of organisms. In contrast, M. dispar was restricted to the margin of the ciliated epithelium where, as previously reported, it caused pyknosis, sloughing and flattening of the epithelium with consequent loss of ciliary activity. The cytopathology observed for each mycoplasma bore a close similarity to the behaviour of the two mycoplasmas in vivo and it is suggested that the organ culture system may be a useful and relevant system to elucidate the pathogenic mechanisms for each mycoplasma. PMID- 3551321 TI - [A proposal for the promotion of virus research]. PMID- 3551322 TI - [DNA packaging by double stranded DNA phages]. PMID- 3551323 TI - [RNA synthesis of influenza A viruses--temperature-sensitive mutants defective in RNA synthesis]. PMID- 3551324 TI - [Molecular evolution of influenza A virus]. PMID- 3551325 TI - [Cancer in children]. PMID- 3551326 TI - [Heterogeneity of the tumor cell population in soft tissue neoplasms and its possible causes]. PMID- 3551327 TI - [Results of the combined treatment of cancer of the cardial region of the stomach (a cooperative, randomized study)]. AB - Immediate and long-term results of treatment of cancer of the proximal part of the stomach were compared in two groups of patients: (1) surgery and (2) combined treatment (preoperative Co-60 teletherapy + radical surgery). The patients were randomly assigned to the treatment schedules. The study was cooperative. Study group 1 included 128 patients, group 2-106. Radiotherapy was accompanied by mild complications; it neither adversely affected the terms of surgery nor resulted in an increased postoperative complication rate. Combination treatment was followed by a significant increase in 3-year survival matched by a decrease in relapse rate as well as metastasis development at a later stage, as compared with surgery alone. Application of standard preoperative irradiation procedures (NSD-20 Gy) led to degree 1-2 radiation pathomorphosis of tumor. Further search for higher effectiveness of the radiation component in causing injury to tumor should be continued. PMID- 3551328 TI - [Milk caseins and their physiologically active peptides]. PMID- 3551329 TI - [Level of prostaglandins, cyclic nucleotides, renin and aldosterone in the plasma of patients with essential hypertension]. PMID- 3551330 TI - [Echography with fine-needle aspiration biopsy of the pancreas]. AB - The results from 116 echographic investigations of 74 females and 42 males with confirmed pancreas carcinoma are discussed, the patient aged from 27 to 80 years. The diagnosis has been confirmed operatively in 92, at necropsy--in 16 and clinically--in 8. Thin needle aspiration biopsy (TAB), under echographic control was performed to 47 patients. The results were compared with the results obtained by computer tomography, endoscopic retrograde cholangiopancreatography and selective angiography. It has been established that the combination of echography with TAB results in 81.9% accuracy of the method, in 6% presumed neoplastic diagnosis and in 22.1% the diagnosis was not made. The results are significantly better than those obtained only by echography (p less than 0.01). A diagnostic scheme for the timely diagnosis of pancreatic cancer is presented. PMID- 3551331 TI - [Interrelations of blood levels of contrainsular hormones and titers of insulin antibodies in diabetics treated with insulin]. AB - According to literature data, the hormones are one of the factors, affecting immunogenesis. On the other hand, the factors and mechanisms, related to insulin antibody formation, are not sufficiently elucidated in diabetics, insulin treated. The relationships between the changes of a broad spectrum of contrainsular hormones and those of immunoglobulins were studied in that aspect. A low correlation relationship was established between them. PMID- 3551332 TI - [Use of a biofeedback method and other therapeutic technics in preparing patients for surgery]. PMID- 3551333 TI - [Burns coexistent with multi-organ injuries]. PMID- 3551334 TI - [The Royal Holy Spirit Hospital in Biecz]. PMID- 3551335 TI - [Effect of long-term hydrochlorothiazide treatment on blood pressure and plasma volume in patients with normal and low-renin arterial hypertension]. PMID- 3551336 TI - [Pathomechanism of hereditary vasomotor edema]. PMID- 3551337 TI - [Immunologic aspects of the etiopathogenesis of chronic recurrent aphthous ulcers of the mouth mucosa]. PMID- 3551338 TI - [Institutions and social organizations in the control of tuberculosis in Poland prior to the outbreak of World War II]. PMID- 3551339 TI - [Experience using bone marrow transplantation in the treatment of hematologic neoplasms and solid tumors]. AB - Between October 1983 and October 1985, 12 allogeneic bone marrow transplantations from HLA-identical siblings were performed for treatment of malignant disease (11 haemopoietic malignancies) or severe aplastic anaemia (1 case). All patients showed prompt and complete engraftment of donor cells on average around day 17 after transplantation. 10 patients are alive and well 50-760 days after transplantation, without any signs of recurrence and partly without immunosuppressive therapy. Two patients died, one due to relapse of the leukaemia, and one as a result of CMV interstitial pneumonia. Graft versus host disease was seen in 6 of the 12 patients. Additional immunosuppressive therapy was necessary in 4 of them. The incidence of idiopathic interstitial pneumonia in our group of patients was low (two cases). Also tested was an experimental protocol for the treatment of chemotherapy-resistant metastatic solid tumours. After removal of all clinically detectable tumour tissue by maximal surgical therapy in 5 patients, residual systemic metastases were treated by means of total body irradiation and high-dose cyclophosphamide, followed by autologous bone marrow transplantation with curative intention. Relapse occurred in 4 patients between day 100 and 720 after BMT bone marrow transplantation. Only one patient remains without sign of relapse. PMID- 3551340 TI - [Protective effect of forskolin in acetylcholine provocation in healthy probands. Comparison of 2 doses with fenoterol and placebo]. AB - Forskolin, a potent adenylate cyclase activating diterpene-derivative, isolated from the Indian plant Coleus forskohlii, was tested double-blind and cross-over in 12 healthy volunteers (nonsmokers) by whole body plethysmography. All drugs were administered by metered dose inhalers. The bronchodilating effect (after 5 minutes) was as good as following fenoterol. At the beginning (after 3 and 5 minutes) the protective effect against inhaled acetylcholine was as good as following fenoterol while later on (after 15 and 30 minutes) fenoterol resulted in a stronger action. PMID- 3551341 TI - Socioeconomic status and survival for breast and cervical cancer. AB - This paper considers the association between socioeconomic status (SES) and survival from breast and cervical cancers, two major health problems for women. For both cancers, lower SES women appear to have poorer survival. Factors which may account for this are discussed, including biological and nutritional factors. Major emphasis is placed on early detection since this appears to play a critical role in the survival differential. Factors which act as barriers to early detection among poor women are considered, including those related both to the health behaviors of the poor and to the health care system available to the poor. PMID- 3551342 TI - Silent myocardial ischemia and infarction. PMID- 3551343 TI - Saying goodbye--a dying doctor's reflections on his profession and on his life. PMID- 3551344 TI - Remembering Annie M. P. Smithson: nursing made her a best seller. PMID- 3551345 TI - Bone growth after free vascularized grafting of the upper radius including its epiphysis in puppies. PMID- 3551347 TI - [Socialistic awareness of history and the history of public health politics]. PMID- 3551348 TI - [Perioperative short-term prevention with chloramphenicol in acute abdominal surgery]. PMID- 3551346 TI - Dietary effects of fish oils on human health: a review of recent studies. AB - The beneficial effects in humans of ingesting fish oils have attracted much attention among medical scientists and nutritionists recently. Human studies conducted in populations of Eskimos, Japanese, and Caucasians since 1970 are reviewed in this paper. The evidence shows that a diet rich in omega-3 fatty acids significantly reduces plasma cholesterol and triglyceride levels, improves fat tolerance, prolongs bleeding times, reduces platelet counts, and decreases platelet adhesiveness. PMID- 3551349 TI - [40 years ago--Regulation No. 297 of the Soviet Military Administration of Germany]. PMID- 3551351 TI - [Use of biofeedback in neuropsychiatry. A short historical review]. PMID- 3551350 TI - [Effect and side effects of a depot theophylline preparation within the scope of a clinical trial]. AB - Effects and side effects of the Aminophylline-retard-preparation V 37 are studied during a four week period of monotherapy on 50 patients suffering from obstructive lung disease. Treating with a standard dosis (2 X 700 mg daily) the concentrations of Theophylline in serum were in the therapeutical range in 50% of patients. A dosis correction was not proposed. Therefore 9 patients have to be excluded from the trial (5 unsufficient effects, 4 unreasonable side effects). Two further patients must be excluded because of an acute exacerbation of their disease. An optimization of therapy is possible by a stepwise increase of the dosis and by an adaptation of the dosis considering the body weight, the effects (estimating the FEV1) and the side effects. Clinical aspects are more relevant for dosis correction than the estimation of the Theophylline concentration in serum. Its measurement should be performed in special cases. PMID- 3551352 TI - [Medical management of miners in Banat and Transylvania 1718-1848 from the occupational medicine viewpoint]. PMID- 3551353 TI - [Lead poisoning in the transactions of the former Erfurt Academy of Sciences in the late 18th century]. PMID- 3551355 TI - [Secret medical studies. Polish physicians, university faculty and students resisting. Fascist extermination actions]. PMID- 3551354 TI - [Robert Koch's discovery of the tuberculosis bacillus and its effect on the public health campaign of the German Social Democracy in the 19th century]. PMID- 3551356 TI - [Ars medica Anhaltina (V): Physicians and scientists of the Anhalt territories in Goethe's circle of friends]. AB - From the view of regional history for the Anhaltine territory several medical and natural scientists are to be mentioned whom a remarkable role can be ascribed in the Weimarian circle round Goethe. The Bernburg physician and pharmaceutist Bucholz became there for many years his consultee for questions of natural sciences; Gren, who also came from Bernburg, became the antipode in the dispute about problems of optics. Goethe visited Gilbert, who was educated in Dessau, in his laboratory in Halle. In old age the poet was supported as physician and friend by Carl Vogel, born in Dessau, who described Goethe's last disease. PMID- 3551357 TI - [Ars medica Anhaltina (VI): Status, rights and responsibilities of physicians and pharmacists with reference to medico-legal aspects of the 18th and early 19th century]. AB - The medicinal legalities of the Anhaltine territories developing under the influence of Enlightenment and Pietism and then characterized by philanthropism contain numerous progressive and for their age exemplary components. When comparing other relevant decrees their progressive character becomes clear by the accentuation of the necessities for provision of the population above all in rural regions. The in other places still strictly observed borders of the various groups of medical profession are varied according to the necessities. Earlier than in many other countries the representatives of surgery and pharmacy experience a reevaluation of the state leading to the insertion into medicinal organizational authoritative bodies. PMID- 3551358 TI - [Stomach tolerance of nonsteroidal antirheumatic drugs]. PMID- 3551359 TI - [Bacterial colonization of the gastric mucosa]. AB - In 380 histologically prepared biopsy specimens taken from the mucous membrane of the stomach, the employment of Giemsa staining and Warthin-Starry silver staining has revealed an often surprisingly abundant (i. e., to the extent of 66.1%) bacterial colonization of the surface of the gastric mucous membrane and of the gastric foveolae. The bacteria encountered here involve gram-negative and morphologically uniform flora of thin, S-shaped or slightly curved bacteria designated as campylobacter-like organisms (CLO). Evidence for Campylobacter pyloridis was also obtained in 55.1% of cultures from 49 native, microbiologically prepared gastric biopsy specimens. Bacterial colonization of the gastric mucous membrane by CLO is definitely correlated with inflammatory alterations in gastric membranes. Active forms of gastritis, however, are not more abundantly colonized by bacteria than are dormant forms. The positive correlation between inflammatory gastric alterations of various degrees and bacterial colonization of the gastric mucous membrane, furthermore, is not proof of an etiological relationship. These bacteria, obviously adapted to the mucus in the gastric foveolae and on the surface of stomach lining, are not evidence of an aggressive behavior or of penetration tendencies. Facultatively pathogenetic significance cannot, however, be excluded for bacteria occurring in such abundance in intimate epithelial contact. Pathogenetic influence of abundant colonization by CLO could well develop if additional noxae become effective. PMID- 3551360 TI - [Bacteriologic studies of the amniotic fluid following amniocentesis]. AB - After transabdominal amniocentesis puncture needles and samples of amniotic fluid were microbiologically examined. The antibacterial activity of the amniotic fluid after inoculation of different germs was compared. Positive microbiological results were found in 43 of total 573 puncture needles, but there were germs of the skin flora in 40 cases. Five amniotic fluid samples out of total 424 were contaminated, whereby skin commensals were detected in four samples. The bacteriostatic activity against the examined germs was individually. Complete growth inhibition over 24 hours was observed in cultures with coagulase-negative Staphylococcus, Staph. aureus and E. coli, a less growth inhibition over nearly 10 hours for Pseudomonas aeruginosa. The growth of Strep. faecalis was not suppressed. As result of the frequent observation of skin commensals in amniocentesis puncture needles and amniotic fluid samples clear lines for the performance of the amniocentesis on antiseptic condition basis and for the diagnostic and therapeutic procedure in case of positive microbiological findings were recommended. PMID- 3551361 TI - [Reflections on the quantification of aortic valve insufficiency by digital subtraction aortography]. PMID- 3551362 TI - [Quantifying aortic valve insufficiency by digital subtraction aortography]. AB - The purpose of this study was to assess the contribution of digital subtraction angiography (DSA) to the quantification of aortic valve regurgitation in 21 patients undergoing heart catheterization. The digital image subtraction was used for densitometric evaluation. The regurgitation was derived from the distribution of contrast volumes during diastole in aortic and left ventricular "regions of interest". DSA-measurements were compared with results of conventional cineangiography. Results showed the following correlation between DSA measurements and cineangiographic estimates (grades I-III): regurgitation 1.7 9.8% in grade I (n = 11), 8.9-22.3% in grade II (n = 5), 31.7 and 32.5% in grade II-III (n = 2), 37-42.4% in grade III (n = 3). DSA and digital densitometry seem to be valuable methods for the quantification of regurgitation. Concerning quantitative measurements in left heart catheterization the digital subtraction aortography is superior to conventional cineangiography and will be helpful to characterize patients with aortic regurgitation more completely. PMID- 3551363 TI - [Use of immunologic isoenzyme diagnosis and its limits]. PMID- 3551364 TI - [Recent aspects of the biocompatibility of carbon fibers. A histologic and electron microscopy analysis]. AB - Twenty out of 36 patients who had been treated with a carbon fiber syndesmoplasty were followed up 12-19 months after surgery. Reoperation was performed on 11 patients, in 3 cases for removal of the material and in 8 because of persistent pain, although the syndesmoplasties were stable in the majority of cases. Histologic and electron-microscopic study of the explanted ligaments revealed a considerable foreign-body reaction to the carbon fibers and insufficient metaplasia of the allogenic material to connective tissue. PMID- 3551365 TI - [Tuberculosis of the pelvic girdle]. AB - Between 1955 and 1980 a total of 67 patients (42 female, 25 male) with advanced tuberculosis of the pelvic girdle underwent surgery at the authors' clinic. In 43 patients the sacroiliac joint was affected (in 2 cases bilaterally), in 11 the ischium, in 9 the pubic bone, and in 2 each the ilium and the sacrum. The average of the patients (who included 4 migrant workers) was 44. The youngest patient was 8, the oldest 67 years old. The average interval between the onset of complaints and diagnosis was 4.6 years (minimum 1 month, maximum 20 years). Thirty-eight of the patients had already had treatment for an organic or osteoarticular tuberculosis. Although 24 (35.8%) of the patients were simultaneously suffering from a florid, specific infection localized elsewhere, and abscesses, fistulas, or a combination of these were identified in 40 patients (59.7%), only 17 (25.4%) were in slightly impaired general condition, and in over one-half of the patients, the hourly blood sedimentation rate was normal or only slightly elevated (up to 20 mm n.W.). In 9 cases (13.4%) the only pointers to tuberculosis were the patient's history, clinical and radiological findings, and the subsequent evolution of the disease. In these cases the diagnosis could not be confirmed either by histologic or by bacteriologic study of focal tissue. In 67 patients, 66 osseous foci were removed and in 2 cases merely an abscess (after an average of 2-3 weeks' tuberculostatic therapy), the bone cavities were filled with a mixture of heterogeneous or autogenous spongiosa and tuberculostatics or merely with chemotherapeutic drugs, and primary closure of the wound was performed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551366 TI - [Late clinical and roentgenologic results following surgical treatment of chronic shoulder dislocation using Lange's technic]. AB - In German speaking countries the M. Lange procedure is a well known method in the treatment of recurrent shoulder dislocations. In order to study the longterm results 21 shoulder joints of 20 patients were examined clinically and radiologically after an average postoperative period of 13.5 years. According to the subjective judgment of the patients good results were obtained in 19 of the 21 cases. True recurrent dislocation occurred in 5.2%. In 57% of the cases signs of degenerative arthritis of the shoulder joints were found radiologically. Our examination shows that the M. Lange procedure is a reliable method with good longterm results. It should be used in cases of glenoidial dysplasia and in cases of a defect of the anterior glenoid rim. PMID- 3551367 TI - [Development of the electrical and mechanical activity of the myocardium during ontogenesis]. PMID- 3551368 TI - [The color spatial vision of primates]. PMID- 3551370 TI - [Abu Iusuf al-Kindi on the treatment of skin diseases]. PMID- 3551369 TI - [Optical studies of neuronal structures]. PMID- 3551371 TI - [Role of humoral factors in the etiology of immunopathologic lesions of connective and epithelial tissues in patients with systemic dermatoses]. PMID- 3551372 TI - [Pathomorphogenesis of skin lesions in experimental candidiasis]. PMID- 3551373 TI - [Humoral immunologic regulation in patients with syphilis]. PMID- 3551374 TI - [Articles on the subjects of psoriasis, eczema and neurodermatitis in the "Vestnik dermatologii i venerologii" 1950-1982]. PMID- 3551375 TI - [Bullous form of sclerotic and atrophic lichen]. PMID- 3551376 TI - [Clinico-morphological parallels in annular granuloma and necrobiosis lipoidica and their association with diabetes mellitus (review of the literature and personal data)]. PMID- 3551377 TI - [Use of diadynamic currents in patients with orchoepididymitis]. PMID- 3551378 TI - [A problem of speciation and adaptive norm]. PMID- 3551379 TI - [Primary biotopes in the animal kingdom]. PMID- 3551380 TI - [Adaptive role of biochemical polymorphism of populations]. PMID- 3551382 TI - [Experiences with the Port-A-Cath system, a fully implantable central venous access system, in children]. AB - The Port-A-Cath-system is a totally implantable catheter system for central venous access. It consists of a subcutaneous injection port, fixed on the pectoral fascia, and a silicone catheter, positioned via a jugular vein into the right atrium. This system was utilised in 14 children (between 10 weeks and 14 years of age) for administration of chemotherapy, total parenteral nutrition, delivery of drugs or blood products, and venous blood sampling over a 15 months period. The device presents only few problems in respect of biocompatibility. Three complications occurred: one case of sepsis, one of catheter dislocation and one of catheter occlusion. The advantage of the total implantability of the system and the low complication rate are attractive alternatives to other methods of prolonged central venous access. PMID- 3551381 TI - Carbohydrate metabolism in infants with biliary atresia. AB - Carbohydrate metabolism in 9 infants with biliary atresia (BA) was investigated preoperatively and during the early postoperative period when these infants were on parenteral nutrition for 7 days. Findings were compared with data on infants without liver dysfunction. Changes of plasma glucose, immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) in the biliary atresia group with moderate liver fibrosis were the same as those in the control group. However, in one patient with marked liver fibrosis, the molar IRI/CPR ratio was significantly low, thereby suggesting an increased hepatic insulin extraction. This change, however, was transient and the molar IRI/CPR ratio gradually returned to the level of other BA patients and the control groups after the 1st postoperative day. This study shows that in infants with BA, the glucose intolerance seen in adults with obstructive jaundice is absent and the parenteral nutrition can be performed without severe changes of carbohydrate metabolism. PMID- 3551383 TI - Spontaneous perforation of the stomach in the neonate. AB - Three full-term female neonates developed gastric perforation during their first week of life. All three experienced severe postnatal asphyxia and improved following resuscitation. A linear perforation located in the prepyloric area was found in these patients. Direct closure was successfully performed in all three neonates. Asphyxia seems to be a major predisposing factor in neonatal gastric perforations. Focal gastric ischaemia and acid peptic activity may play part in the pathogenesis in these cases. PMID- 3551384 TI - [Short and long-term changes in cortical circulation caused by autogenic training]. AB - The well-known hyperfrontal pattern of hemispheric blood flow measured with 133 Xenon is not found in 12 healthy resting men who have been practicing Autogenic Training for at least six months. This might indicate a long-term decrease in the level of activation. Successfully practiced exercises of Autogenic Training lead to an increased blood flow in the Rolandic area representing the body sceme and to a decreased blood flow in regions related to acoustical attention and to autonomic functions. Left hemispheric cerebral blood flow ist lower in rest. The relative activation of the left hemisphere during Autogenic Training is discussed. PMID- 3551385 TI - [Incidence of antibody-coated bacteria in patients with chronic pyelonephritis]. AB - Of 168 urine sediments, which were obtained from 55 patients with chronic pyelonephritis in the course of 3 years when a significant bacteriuria with E. coli was present, we demonstrated antibody-loaded bacteria in 81 cases (48.21%). In the active stage of the disease with 54.10% were found significantly more than in the inactive with 32.61%. In obstructive chronic pyelonephritis the positive rate was 54.79% in contrast to 43.16% in non-obstructive chronic pyelonephritis. While in the active stage of the obstructive chronic pyelonephritis with 57.41% more antibody-containing bacteria were excreted than with 47.31% in the inactive stage, the positive rate in the active stage of the non-obstructive chronic pyelonephritis was with 54.47% significantly increased in contrast to 22.22% in the inactive stage. 25.71% of the patients excreted only ACB+-, 34.29% only ACB( )- and 40% ACB+- and ACB(-)-germs in the course of the disease. The ACB-positive quote was in rough forms with 62.50% statistically significantly increased in contrast to 45.54% in O-typable and 42.86% in non-O-typable strains. In the ACB+- group the immunofluorescence titres to the homologous strain and the C3-activator in the serum as well as the urine lysozyme were significantly higher than in the ACB(-)-group. PMID- 3551386 TI - [Defense mechanisms of the macro-organism in bacteriuria in chronic pyelonephritis]. AB - In the course of 4 years we isolated 193 E. coli strains of 55 patients with chronic pyelonephritis. In patients with obstructive chronic pyelonephritis the mean value of the immunofluorescence titre (in the serum) to the E. coli strain excreted in the urine as well as the total complement were significantly increased, the serum lysozyme was significantly lower than in patients with non obstructive chronic pyelonephritis. A relation to the activity of the disease was existing only in the non-obstructive chronic pyelonephritis, where in the active stage the total complement was significantly decreased, the complement factors C3 and C4 as well as the urine lysozyme were significantly increased in comparison to the inactive stage. 94.64% of all immunofluorescence titres obtained to the homologous strain in the patients' serum were above the border of the normal area of 1:40. A relation between level of the titre and activity of the disease could not be established. No significant differences could be proved between the titres taken to serum-sensitive and serum-resistant strains. In 32.73% of the patients we observed disturbances of the serum bactericidia against the homologous serum sensitive E. coli urine strain at one or several points. They fall to equal shares to patients with obstructive and non-obstructive chronic pyelonephritis and were found at 66.67% in the active stage of the two forms of the disease. In patients with and without disturbances of bactericidia no significant differences in the total complement, in the complement factors C3 and C4, the C3-activator, the serum lysozyme and the immunofluorescence titres could be proved. PMID- 3551387 TI - [Phagocytosis in patients with chronic pyelonephritis]. AB - In 30 patients with a non-obstructive chronic pyelonephritis and two to three clinically manifest urinary tract infections per year as well as in 50 healthy test persons we determined the rate of phagocytosis and the index of phagocytosis of neutrophil granulocytes in absence of serum with Candida albicans and latex particles in double disposition. The mean values of the phagocytosis rate und phagocytosis index of the patients were significantly decreased both for Candida albicans with 40.80% and 1.29 and for latex particles with 67.80% and 2.33 compared with healthy test persons with 54.24% and 1.69 and 86.54% and 3.51, respectively, disturbances of the cell metabolism of the neutrophil granulocytes with an impairment of the function of the cell membrane were discussed as cause of the reduced effect of phagocytosis. PMID- 3551388 TI - [In vitro sensitivity of T lymphocytes to theophylline in healthy adults and patients following cadaver kidney allotransplantation]. AB - In the peripheral blood of healthy adults the number of theophylline-resistant T lymphocytes (T-res) is 51 +/- 4% and 1,161 +/- 326/microliter, respectively, and the number of theophyllins-sensitive 11 +/- 2% and 252 +/- 95/microliters. The membrane markers show a heterogeneous distribution. The quotient from T-res/T sens is 4.9 +/- 1.3. Within the T-sens 14% are CD4+ and 30% CD8+, 29% carry Fc IgC and 34% Fc-IgM-receptors. Thus the T-res in their netto-function were helper cells and the T-sens suppressor/cytotox cells. Before the transplantation the preoperative ratio of the two subpopulation is significantly diminished (Q = 3.66 +/- 1.53), however, prognostic statements cannot be deduced from this. Activations of the immune system (rejection crises, cytomegalovirus infections) are accompanied by significant diminutions of the T-sens, whereby the T-res/T sens-Quotient increases. Thus they are unequivocally included into immunoregulatory processes. PMID- 3551389 TI - [Initial results of tm-PAH studies in children with kidney transplants]. AB - In 15 children 2 months to 5 years after a transplantation of a cadaver kidney the renal function was determined by means of a clearance- and Tm-PAH examination. Only in 4 children the Tm-PAH reached the normal value of a kidney. The calculation of the glomerulo-tubular balance results in increased values. The result for the relative tubular blood supply is normal. Compared with the values of children with an overcome haemolytic-uraemic syndrome or with a chronic glomerulonephritis or pyelonephritis shows that the renal function in children who underwent a transplantation similarly behaves as in a chronic pyelonephritis. PMID- 3551390 TI - [Results of percutaneous biopsy of kidney transplants. Analysis of 200 successful puncture biopsies]. AB - During a period of about 4 3/4 years 200 biopsy specimens (= 100%) with judgeable tissue of kidney grafts were examined; from these 99 had been performed during the first 6 months. The best assessment concerned the interstitial cellular rejection which was observed in 73.5%, furthermore, in 9.5% cellular infiltrates of uncertain pathogenesis were found. In 19.5% acute subacute and in 35% chronic transplant vasculopathy occurred while other vascular lesions were relatively rare. Transplantat glomerulopathy was diagnosed in 25% and glomerulonephritis in 14.5%--mostly de novo. In further 26% different minor glomerular abnormalities and in 14.5% chronic ischaemic glomeruli (mostly focally) were observed. The assessment was limited in those cases with lack of arteries (15.5%) or glomeruli (8.5%) within the specimen. However, by judging tubular atrophy and interstitial fibrosis certain conclusions on chronic stenosing arterial processes may be drawn. In the early stage usually the condition of the parenchyma can be assessed well which allows some recommendation for further treatment (conservative therapy or ectomy). On the whole renal biopsy is the best method to assess the state of the transplant. PMID- 3551391 TI - [Importance of tubulo-interstitial changes in glomerular excretory and urine concentrating function of the kidney]. AB - Results are presented for morphologic investigations on the correlation between structural and functional alterations in various inflammatory and non inflammatory glomerular and extraglomerular renal diseases. The role of the glomeruli in the excretion of substances excreted exclusively by the urinary tract is dependent, to a degree not previously appreciated, on the condition of the postglomerular vasculature as well as on the functional status of the tubular epithelium. All processes which result in damage to the post-glomerular vasculature negatively influence glomerular excretory function by limiting the flow of blood out of the glomeruli and reducing glomerular perfusion. It is further assumed that all processes which negatively influence tubular reabsorption will also be detrimental to glomerular function as a result of increased pressure in the proximal renal tubule as well as via the Thurau mechanism. Finally it is suggested that the kidney's concentrating ability is partially dependent on tubular interstitial factors: with increasing width of the renal cortical interstitium and increasing atrophy of the renal tubule (as measured by the proximal tubules) the kidney's concentrating ability steadily diminishes. PMID- 3551392 TI - [Histopathology of drug and toxin induced kidney lesions]. AB - An overview is presented of the morphologic patterns associated with drug or toxin induced renal lesions. Most prominent are the arteritis, glomerulonephritis, tubular necrosis, renal cortical necrosis, intratubular crystal deposition, acute and chronic interstitial fibrosis, interstitial granulomas and acute renal insufficiency with normal renal histology. Findings are correlated with the nature of the noxious substances. Sources of error arising from the insufficient specificity of the morphological findings and the differential diagnostic considerations are fully and critically presented. The review can serve to direct the recognition of etiologic relationships through the interpretation of morphological findings in the kidney. PMID- 3551393 TI - [Analgesic nephropathy]. AB - Analgesic nephropathy, its morphology, development and pathogenesis are described. The earliest analgesic-caused lesion is capillary sclerosis of the urinary tract mucosa. Later focal necroses can be found in the papillae surrounding the collecting ducts. Foci of necrosis progress and become confluent, resulting in complete papillary necrosis. Later renal cortical lesions develop due to retained areas of papillary necrosis. The cortical changes include chronic interstitial nephritis with cortical atrophy in the suprapapillary region as well as hypertrophy of the columnae Bertini with segmental, focal glomerulosclerosis. The analgesic-related lesions are the result of toxic damage to endothelial, tubular and interstitial cells. Analgesic-induced kidney and urinary tract changes are quite specific. Frequent complications include hypertension, pyelonephritis, hydro- or pyonephrosis and urinary tract tumors. The clinical picture is characterized by the consequences of distal tubular damage: impairment of urine concentrating capacity, acidosis, electrolyte loss. Analgesic nephropathy is an example of an absolutely preventable drug induced nephropathy. It is the most important single manifestation of the analgesic syndrome. It is recommended that prescriptions for mixed analgesics (multi-component analgesics) should be made obligatory. Monocomponent analgesics could be sold over-the counter. PMID- 3551394 TI - [Biopsy findings in kidney transplants after treatment with cyclosporin A]. AB - 51 renal transplant biopsies of 37 patients immunosuppressed with Cyclosporin A were histologically reevaluated. Lesions related as well as unrelated to Cyclosporin A treatment were found. Cyclosporin A related findings corresponding to the so-called Cyclosporin A nephropathy were divided into early postoperative (diffuse fibrosis), acute (toxic tubulopathy and others) and chronic changes (arteriolopathy, striped fibrosis with tubular atrophy). Since there is often a combination of Cyclosporin A related and unrelated lesions, it is necessary to define the main lesion in the individual case. Accordingly, the following diagnostic groups were present in the biopsies: Cyclosporin A nephropathy (19 cases), rejection nephropathy (18), rejection and Cyclosporin A nephropathy (9), acute renal failure (3) and other diagnoses (2 cases). For the further management of the patients, the exact diagnosis of Cyclosporin A related and unrelated pathology is important in renal biopsies. PMID- 3551395 TI - [Rejection nephropathy before and after therapeutic administration of cyclosporin A]. AB - During 1983 to 1986 41 patients were treated with Cyclosporin A (CyA) following kidney allotransplantation (TPL). 31 received the first (29 extra- and 2 intrafamilial) graft; in 10 there was second TPL, in 9 cases under high-risk conditions, where the first graft had been destroyed by (hyper)acute rejection or by rapidly progressive rejection with early vascular lesion. 21 needle biopsies and 5 excised grafts which had been collected 5 days to 18 months after TPL were examined by light microscopy and in addition 6 of the former also underwent electron and immunofluorescence microscopic study. The glomeruli showed discrete, inconstant segmental lesions but the ultrastructure also revealed severe general endothelial swelling. The tubular system had nonspecific degenerative changes of varying extent. In 11 patients focal cytoplasmic microvacuoles appeared in proximal tubular epithelia; there were also inconstant hyaline droplets, microcalcifications, and intratubular crystals. Electron microscopy revealed multiple round dense intramitochondrial inclusions in proximal tubules. The ultrastructure of the microvacuoles resembled that of "osmotic nephropathy". The rejection infiltrate and interstitial fibrosis of various degree did not essentially differ from those of conventionally treated grafts. In 7 patients cortical arterioles and small arteries exhibited a stenosing lesion (toxic?). In 3 cases metachromatic "mucoid" thickening of intima was prominent. Ultrastructure studies showed swollen endothelial cells with numerous globular dense bodies and a severe defect in the leiomyofibrils of muscle cells of the media. Hyperplasia of juxtaglomerular apparatus was apparent in 7 patients. Immunofluorescent microscopy of two biopsies from subsequently excised grafts visualized IgM, C3, and fibrinogen in small arteries and some glomerular capillary loops. Three early nephrectomies were caused by infarct-like necrosis. The discussion deals with differences between CyA- and conventionally treated grafts, diagnostic features, interpretation of findings, and measures following biopsy. In our patients with continual CyA-treatment no case of clinically and morphologically typical obliterative arterio-arteriolopathy (OA) and rapidly progressive irreversible rejection has as yet been noted. PMID- 3551396 TI - [Surgical treatment of pectus excavatum by "turn over" of the sternum]. AB - Operations were performed on 20 children for Pectus excavatum in five years. 'Turn over' of the sternum was chosen as surgical approach. About five years have passed from those operations, and results still are better than those obtained from earlier methods based on stabilisation of the sternum. PMID- 3551398 TI - [Our surgical heritage. The Dresden surgeon Johann August Wilhelm Hedenus (1760 1836). On the occasion of the 150th anniversary of his death 29 December 1986)]. PMID- 3551397 TI - [Serum level of antibiotics in burn patients]. AB - Antibiotic serum levels were recorded from 100 patients with burns. Antibiotic doses to ensure effective serum levels were found to be in excess of maximum values quoted as necessary by manufacturers, provided that serum creatinine was normal. These findings were in agreement with literature data. This was the first instance to check on serum levels, following oral administration of antibiotics. Differences between individual patients may be considerable, probably due to variable renal blood supply and other factors. Individual dosage with control of serum levels is, therefore, recommended. Specific dosage recommendation for patients with burns would be desirable for hospital practice. PMID- 3551399 TI - [Value of diagnostic procedures in pancreatic cancer]. AB - At the Surgical Department of Munster University in-patient treatment was applied to 320 patients for pancreas carcinoma, between 1977 and 1984. These cases were concomitantly studied for informative potentials of computed tomography (CT), sonography (Sono), and endoscopic retrograde cholangiopancreatography (ERCP). CT was performed on 163 patients (50.3 per cent), Sono on 180 (56.3 per cent), and ERCP on 90 (28.1 per cent). Highest sensitivity was recorded from ERCP, with 91.1 per cent of correctly positive diagnoses. CT gave correct positive findings in 70.5 per cent of all cases and Sono in 61.1 per cent. Resection rates were not increased by introduction of these new techniques, but the rate rather stayed at 14.8 per cent. While the period between hospitalisation and operation was slightly reduced, surgical intervention was too late for curative resection in most cases. In some highly advanced cases with distant metastases but absence of symptoms on the basis of CT findings, exploratory laparotomy was abandoned. The new methods have improved diagnostic accuracy rather than prognosis of pancreas carcinoma. PMID- 3551400 TI - [Surgical treatment possibilities in tumors of the spine. Indications, technics, experiences]. AB - Widely normal stability of the vertebral column with adequate load-bearing capacity should be achieved, following osseous reconstruction of a defect area from which benign tumours or tumour-like lesions had been removed by radical surgery. In malignant processes, surgical tumour removal may add to the effectiveness of chemotherapy or radiotherapy. Postoperative restoration of the vertebral column will also improve the psychic, physical, and social quality of survival. PMID- 3551401 TI - [Thoracic epidural analgesia (TEA) with morphine as an alternative to the administration of general anesthesia in thoracotomized patients]. AB - A randomised prospective study was conducted into 60 patients who had undergone thoracotomy for spontaneous pneumothorax or bronchial carcinoma. Pyrazolone was intramuscularly and intravenously injected for postoperative pain relief to some of these patients. Another group received morphine through an epidural catheter (TEA). Postoperative spirometric checks were made on the first, third, and fifth days from surgery. The degree of analgesia was measured by means of the Twycross method. The ventilation parameters recorded from patients with epidural morphine treatment were clearly better than those measured from patients who had received pyrazolone. The amount of pain relief reported by TEA patients were better than that recorded from the pyrazolone group. PMID- 3551403 TI - [Our surgical heritage. Witnesses of surgical history]. PMID- 3551402 TI - [Recurrent heart dislocation following intrapericardial pneumonectomy]. PMID- 3551404 TI - [Obstetricians and gynecologists as members of the former Erfurt "Academy of Practical Sciences" (1754-1945)]. AB - After a short historical survey on the foundation of the scientific association of Erfurt at 1754 some famous gynaecologists and obstetricians as members of this academy are being described. In this way the development of obstetrics and gynaecology and the relations between historical base, medical specialization and personalities are illustrated, too. PMID- 3551405 TI - [Animal experiment studies of combined suture and glue microanastomoses using a fibrin glue based on the Cohn I human plasma fraction]. AB - A total of 48 end-to-side microvascular anastomoses between the A. and the V. femoralis of Albino Wistar rats were established with and without an additional gluing using the human plasma fraction Cohn I (Cohn-I adhesive) and clinically and histologically examined after 3-4 weeks--group 1 with 4 single button sutures and gluing, group 2 with 8 single button sutures and gluing as well as a control group with the usual suture technique with 12-14 single knob sutures (in each case 16 anastomoses). The time required for anastomosing could not be considerably reduced by the suture-gluing technique. In group 1 the thrombotic occlusion due to vascular wall dehiscences with penetration of the adhesive material into the lumen could not be prevented in eight anastomoses. Owing to the exact vascular wall adaptation with 8 single button (group 2) 14 anastomoses were free just as in the control group. Histologically the tissue-preserving influence of the gluing could be confirmed by the reduction of the number of sutures. Summarising it can be said that the perfectly performed suture technique should continue to play the dominating role, but that the combined suture-gluing technique can be a great help for the surgeon in special cases. PMID- 3551406 TI - Glomerular lesions in MRL mice. A light and immunofluorescence microscopic study. PMID- 3551407 TI - Differences in IgG1 and IgG2 responses of goats to chlamydial abortions and to clinically inapparent infections detected by the Western blot technique. PMID- 3551409 TI - Aeromonas salmonicida from salmonids and cyprinids--serological and cultural identification. PMID- 3551410 TI - [60th anniversary of the Khabarovsk Research Institute of Epidemiology and Microbiology]. PMID- 3551408 TI - [Comparative studies of the direct demonstration of K 99 antigen in calf fecal samples with special reference to the latex agglutination technic]. PMID- 3551411 TI - [Cultivation of asporogenous anaerobic microorganisms in media of various compositions]. AB - The comparative evaluation of the quality of experimental dried culture medium for the isolation and cultivation of anaerobic microorganisms, developed on the basis of locally produced ingredients without unavailable raw material suitable for human consumption, and enriched thioglycolic medium has revealed the advantage of the former and permits its recommendation for practical use in laboratories. PMID- 3551412 TI - [Development of laboratory diagnostic methods for slow infections of the human central nervous system caused by nonclassical viruses]. AB - The theoretical foundations of the laboratory diagnosis of Creutzfeldt-Jakob disease and amyotrophic leukospongiosis in living patients are discussed and practical diagnostic methods are proposed on the basis of the study of the biological properties of nonclassical viruses and the pathogenesis of slow infections of the central nervous system. The use of the retrobulbar method of infecting susceptible animals has permitted, besides a considerable decrease in the incubation period in modeling slow infections, the improvement of the in vivo biological test. Thus, as the result of the multiplication of non-classical viruses in the visual nerve and the retina, experimental animals develop retinopathy which can be detected 1.5-2.5 weeks after the animals are injected with the spinal fluid or blood taken from the patient under examination. To diagnose amyotrophic leukospongiosis, the in vitro biological test, based on the capacity of the causative agent for inducing a considerable (2- to 5-fold) increase in the mitotic activity of HEp-2 cells, has been developed. The comparative studies have shown the expediency of using the method for the detection of antibodies to nerve-fiber proteins as an additional test for the differential diagnosis of slow infections of the central nervous system. PMID- 3551413 TI - [Ultrastructural characteristics of Proteus vulgaris and Proteus mirabilis cells differing in the capacity for swarming]. AB - Specific differences in the structure of colonies and the location of microbial cells in colonies, characteristic for aggregating and nonaggregating genetically related pairs of P. vulgaris and P. mirabilis strains, have been demonstrated by means of transmission and scanning electron microscopy. In calculating the number of flagellae per 100 outlines of microbial bodies revealed in negatively stained preparations, the fact that both aggregating and nonaggregating bacteria possess practically the same number of flagellae, on the average 4-8 flagellae per microbial cell outline, has been established. This fact indicates that the presence of flagellae in microbial cells is unrelated to their capacity for swarming. PMID- 3551414 TI - [Purification of a corpuscular influenza vaccine by means of immunoaffinity chromatography]. AB - Two immunoaffinity chromatographic methods for the purification of corpuscular influenza vaccine from the admixture of chick embryo components have been examined. The isolation of the virus on immobilized antiviral antibodies has proved to be unsuitable for preparative purposes. The method for the purification of the vaccine from ovalbumin with the use of immobilized anti-ovalbumin antibodies has proved to be highly effective. When introduced into guinea pigs in 3 injections, the vaccine purified by immunosorption has been found to produce no anaphylactic reactions. PMID- 3551415 TI - [Isolation and characteristics of Shigella antigens during the course of dysentery]. AB - In 2,436 fecal samples and 1,272 urinary samples taken from 633 patients with dysentery caused by S. flexneri, S. newcastle and S. sonnei, Shigella antigens were detected by means of the passive hemagglutination test with antibody diagnostic agents and the antibody neutralization test. The antigen-binding activity of shigellae in urine dynamically increased in the course of dysentery. The comparison of the parallel results of both serological tests made it possible to evaluate the dispersion of the released antigen: it dynamically increased in the course of the disease, this increase being particularly high in feces. The dispersion of Shigella antigens in urine was greater than in feces over the entire course of the disease. These regularities in the release of the antigens and especially the specific features of the serological tests determined the scheme of the serological diagnosis of dysentery by the indication of Shigella antigens. PMID- 3551416 TI - [Experimental study of the immunological activity of a preparation made from the antigenic complexes of opportunistic microorganisms administered by different routes]. AB - The data obtained in the experimental study of the humoral factors of local and systemic immunity, as well as the morphofunctional changes of internal organs, after multiple subcutaneous and aerosol immunization with the combined preparation of Proteus, Staphylococcus, Klebsiella pneumoniae and Escherichia coli antigens (preparation nC-4) are presented. The subcutaneous and aerosol administration of preparation nC-4 has been found to induce an increase in the levels of antibodies to all components of the preparation in the blood serum and in respiratory tract secretions. The introduction of the preparation through the respiratory tract resulted in an earlier intensive accumulation of specific antibodies and IgA in respiratory tract secretions. The results of the quantitative cytological study of respiratory tract secretions and the morphofunctional changes of the lymphoid tissue associated with the lungs are indicative of an important role played by cell-mediated immunity factors in the formation of local postvaccinal immunity. PMID- 3551417 TI - [Relation of the stability of microbial cells in air to their phospholipid composition]. AB - The phospholipid composition of 8 Escherichia coli strains differing in their capacity for survival in the air with a relative humidity of 30% has been studied. The study has revealed that, irrespective of the phase of growth and the nature of the culture medium, the capacity of E. coli cells for survival in the air is related to their phospholipid composition, this capacity being the higher, the greater the content of total phospholipids and cardiolipin and the lower the concentration of phosphatidyl glycerine. PMID- 3551418 TI - [Genetics of the immune response of Karakul sheep immunized with E. coli and Salmonella vaccines. An analysis of the intensity of the immune response in 2d generation and reverse-cross hybrids]. AB - For the genetic analysis of the character of inheriting the immune response and the study of the possibility of immunoselection in astrakhan sheep, the test crossing of the previously selected and raised animals in different genetic combinations has been made. Regularities in inheriting the intensity of immune response in hybrids F2 and BC1 of astrakhan sheep, highly responsive to E. coli and Salmonella vaccines, confirm the dominant character of the capacity for intensive immune response. The second-generation hybrids obtained by the crossing of the animals, either highly responsive or weakly responsive to E. coli or Salmonella vaccine, show a high degree of concordance in their capacity for response to this antigen. This confirms the possibility for the immunoselection of sheep by their capacity for response to a given vaccine. PMID- 3551419 TI - [Problems in maintaining hybridomas in vivo]. AB - The literature data on the regularities of the manifestation of tumorigenic capacity in somatic hybrids, on the correlation of this sign with the features of the in vitro transformation of hybrid cells, on the chromosomal stability and taking capacity of hybridomas have been analyzed. The expediency of the inoculation of animals with hybridomas, made considerably earlier than required by the traditional scheme of obtaining monoclonal antibodies, with a view to the selection of tumorigenic hybridoma variants is suggested. The aims of the experimental work have been determined. PMID- 3551420 TI - [Cultivation of murine B-cell hybridomas in the spleen]. AB - The tumorigenic capacity of mouse B-cell hybridomas in both cloned and primary cultures was studied. The cells were selected for inoculation from 24-well plates and introduced into the spleen of syngeneic mice. The cells took in 50% of the animals. The cells of hybridoma tumors induced as the result of intrasplenic inoculation, when subcultured in the second passage following the standard scheme, i.e. inoculated intraperitoneally in a dose of 1 X 10(7) cells into mice previously treated with vaseline oil or pristane, produced tumors in 100% of the animals. PMID- 3551421 TI - [Activities of the Central Institute of Epidemiology and Microbiology during World War II]. PMID- 3551423 TI - Metabolic burst and motility in granulocytes following trauma and endotoxinaemia in the anaesthetized pig. AB - The early effects of trauma and endotoxinaemia in pigs have been studied with regard to granulocyte motility and metabolic burst (chemiluminescence). Increased spontaneous chemiluminescence was observed following a moderate aseptic trauma (osteotomies) or endotoxin infusion in healthy pigs. Zymosan-opsonized chemiluminescence was increased post trauma. Endotoxin infusion, however, led to unchanged values during infusion but a significant decreased Zymosan-opsonized chemiluminescence 3 h after ended infusion. Migration capacity was unchanged by trauma, but markedly reduced following endotoxin infusion. When traumatized pigs had an endotoxin infusion 24 h post trauma, the increase in spontaneous chemiluminescence was significantly more pronounced than following endotoxin infusion in healthy pigs, and Zymosan-opsonized chemiluminescence less decreased. Motility, however, was equally reduced as following endotoxin infusion in healthy pigs. These findings correspond well with the known decreased phagocytic capacity of granulocytes in septicaemia, but also indicate a rapid post-traumatic reaction which might be an attempt to reduce the lethal danger of a subsequent infection. PMID- 3551422 TI - [Etiology of brain abscesses in children]. AB - Data on 67 children treated for abscess of the brain in 1966-1984 years are analysed. The work deals with study of the etiology of brain abscesses in children and the possibility of their prevention. Comparative analysis of the causes of brain abscesses in different age groups (from 10 weeks to 15 years) shows pyoinflammatory skin diseases to be the most common cause of brain abscesses in young children, in those under the age of 12 months in particular. In the next age groups the incidence of cerebral abscesses caused by pyogenic diseases of the skin reduces whereas that of abscesses of otorhinosinusogenic origin increases. PMID- 3551424 TI - Doppler spectral analysis of the internal carotid before and after endarterectomy. AB - In 37 randomly selected patients, stenosis of the internal carotid artery was evaluated with Doppler spectral analysis before and 6-10 weeks after endarterectomy. Postoperatively 20 of the vessels were entirely within the normal variation range and four, though not normal, showed significantly lower blood flow velocity, indicating wider vascular lumen. In ten cases there were no significant postoperative change, and in three significant worsening of the Doppler shift was seen without clinical implications. The method is useful for evaluating the endarterectomized carotid noninvasively without use of contrast medium, and when bilateral operation is contemplated the analysis is most valuable for ruling out occlusion in the artery first operated on. PMID- 3551425 TI - A prospective randomized comparison of gastric bypass and gastroplasty. Complications and early results. AB - Fifty-seven morbidly obese patients were randomized to gastric bypass (29) or gastroplasty (28) and observed for 24 months postoperatively. Operating time and hospital stay were longer and peroperative and postoperative complications somewhat more common in the bypass than in the gastroplasty group. But weight loss at 1 year was significantly greater and failures significantly fewer after gastric bypass. Four gastroplasties were converted to bypass after 18-24 months because of failure to lose weight. Gastric bypass was judged to be much the preferable of the two operations. Dumping occurred in some patients with bypass but not after gastroplasty. Dumping was not associated with greater weight loss. Peroperatively measured pouch volume showed significant correlation with weight loss after gastroplasty, but not after bypass. Peroperative pouch volume and postoperatively measured stoma diameter were co-acting factors, which in multiple regression analysis could explain observed variance in weight loss to about 40% after gastroplasty, but to a negligible degree after gastric bypass. PMID- 3551426 TI - Amniotic fluid prolactin, decidual prolactin content and decidual prolactin secretion into hypo-, iso-, and sodium chloride hyperosmotic media in vitro in pregnant diabetics at term. AB - This study evaluated in pregnant women with diabetes mellitus (DM) the prolactin (PRL) concentration in amniotic fluid (A-PRL), the initial decidual PRL content (D-PRL), and the decidual PRL secretion (D-PRL-s) in vitro into isosmotic (315 mmol/kg), hyperosmotic (426 mmol/kg) and hyposmotic (252 mmol/kg) media. Decidual tissue was collected at term from 18 normal pregnancies and from 23 women with DM (White's classification: 7 of class A (without insulin treatment) and 16 of the classes B-F. Twelve of the women with DM had signs of hydramnion. Amniotic fluid specimens were collected from 52 normal pregnancies and 17 of the women with DM. No significant difference was found between normals and diabetics when D-PRL, D PRL-s into isosmotic medium and A-PRL were compared. No trends could be detected when the insulin treated women were grouped according to White's classification. The increment of D-PRL-s into hyperosmotic medium was 15% in normals (p less than 0.001 compared with isosmotic medium), in the DM group 23% for the non-insulin treated women (p less than 0.05 when compared with normals) and 25% for the insulin treated women (p less than 0.01). In normals the hyposmotic medium reduced D-PRL-s by secretion 19% (p less than 0.001 compared with isosmotic medium) but no significant difference was observed between normals and diabetic groups (p greater than 0.10). In the group of diabetics no significant difference was found in any of the PRL quantities investigated between those with and without hydramnion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551427 TI - The human cellular immune response to insulin: a study in unexposed control subjects and type I diabetic patients on acute and chronic treatment. AB - Using a cellular cytotoxicity assay, we have investigated the antigenicity of pharmaceutical insulins and of highly purified insulin constituents (unformulated monocomponent (MC) insulin, insulin B-component and C-peptide) in control, insulin naive, subjects and in three groups of type I diabetic patients. These were: Group 1, newly diagnosed patients receiving either porcine or bovine MC insulins for less than one week; Group 2, established patients receiving porcine or bovine MC insulin for 2-6 years; Group 3, established patients receiving conventional bovine insulin for 2-6 years, and tested within two weeks of switching to either porcine or bovine MC insulins. In control subjects, there was a higher incidence of cytotoxic reactions with beef (72%) than with porcine (33%) pharmaceutical preparations (p less than 0.01) but there was a similar incidence of reactions with the purified beef and pork constituents. All patients, except those Group 3 patients receiving bovine MC insulins, had a significantly increased incidence of aggregate reactions to the spectrum of antigens. In porcine treated patients, there was an increase in the incidence of reactions to pharmaceutical preparations in Group 1 (p less than 0.05) and Group 3 (p less than 0.001), but this was absent from each of the bovine treated groups. All patient groups showed significant increases in the incidence of reactions against insulin constituents of their therapeutic analog. In Groups 1 and 2, but not 3, there was significant analog cross reactivity. We deduce that the reactivity seen in control subjects is principally directed against unidentified formulation constituents of bovine pharmaceutical preparations. Patients on both acute and chronic therapy with insulin show T-cell sensitization to MC insulin and its components. Chronic therapy with conventional bovine insulin induces tolerogenesis, but this is reversed on exposure to a fresh insulin analog. PMID- 3551428 TI - Residual B-cell function in insulin-dependent (type I) diabetics with and without retinopathy. AB - In order to evaluate if residual B-cell function is a protecting factor against the development of diabetic retinopathy in type I diabetics we measured C-peptide levels before and after glucagon stimulation (1 mg i.v.) in 74 type I diabetics. In all patients retinopathy was assessed by fluorescein angiography and retinal lesions were classified as: grade 0, normal; grade 1, background retinopathy; grade 2, proliferative retinopathy. We then correlated the degree of retinopathy to sex, age, duration of diabetes, smoking, percentage of ideal body weight, systolic and diastolic blood pressure, serum cholesterol, triglycerides, creatinine and C-peptide by means of multiple linear regression analysis. Twenty three out of 74 type I diabetics had retinopathy. In all 7 subjects with proliferative retinopathy duration of diabetes exceeded 10 years. There was significant correlation between retinopathy and duration of diabetes (r = 0.373, p less than 0.001). No correlation was found between retinopathy and all the other variables, in particular between retinopathy and basal C-peptide or C peptide increment (delta). An inverse correlation was found between the increment of C-peptide and duration of diabetes (r = -0.404, p less than 0.01). Our data show that residual B-cell function cannot be considered a protecting factor against the development of diabetic retinopathy. PMID- 3551429 TI - Effect of sera from male type I (insulin-dependent) diabetics on human aortic smooth muscle cells in culture. AB - The effects of sera from male type I (insulin-dependent) diabetics in variable metabolic control were studied on the proliferation and the synthesis of hyaluronic acid, collagen and non-collagenous proteins in cultured human aortic smooth muscle cells (HSMCs). Sera from diabetics in poor metabolic control had a decreased growth-promoting effect on HSMCs as compared with that of sera from non diabetic healthy male controls. The synthesis of hyaluronic acid in HSMCs was increased in the presence of type I diabetic sera, irrespective of the metabolic control of serum donors. The synthesis of collagen by HSMCs was stimulated only by the diabetic sera which were derived from diabetics in poor metabolic control. The synthesis of non-collagenous proteins in HSMCs was not affected by type I diabetic sera. The stimulatory effect of diabetic sera on hyaluronic acid synthesis by HSMCs correlated inversely with plasma HDL cholesterol of serum donors, whereas the effect of diabetic sera on DNA and collagen syntheses in HSMCs showed an inverse correlation with plasma triglycerides of serum donors. Plasma insulin-like growth factor-I did not correlate with the above functions of HSMCs. Addition of insulin and growth hormone directly into HSMC cultures had no effect on the proliferation or synthesis of connective tissue macromolecules of HSMCs. The results suggest that type I diabetic sera contain factors other than insulin, growth hormone or insulin-like growth factor-I that affect the proliferation and synthesis of hyaluronic acid and collagen of HSMCs in culture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551430 TI - The effect of a luteinizing hormone-releasing hormone antagonist on experimental endometriosis in the rat. AB - The effect of a Salk LRH analogue (Antagonist I) on growth of endometrial explants in the intact female rat was studied. Subcutaneous injection of the analogue was begun 3 weeks after transplantation of a section of endometrium to the peritoneal wall. The animals were laparotomized and the volume of the explant (length X width X height) in mm was measured with calipers on day 1 of treatment. The animals were injected daily for 3 weeks with 50, 250 or 500 micrograms of Antagonist I at which time the animals were again laparotomized and the volume of the explant measured. Eight weeks after cessation of treatment the animals were sacrificed and the volume of the explant measured. The degree of inhibition of explant growth was directly correlated with the amount of Antagonist I administered; a significant inhibition was obtained with doses of 250 or 500 micrograms. Eight weeks after cessation of treatment all explants demonstrated renewed growth, although explants in rats which had been treated with 250 or 500 micrograms had returned to only 51 and 61% of their initial volume, respectively. The results of this study demonstrate the LRH antagonists may be useful in the treatment of endometriosis although at doses considerably higher than those of the super agonists. PMID- 3551431 TI - Further observations on the autoregulation of the prolactin receptor in rat ventral prostate explants. AB - In confirmation and extension of an earlier preliminary communication, ovine prolactin was found to elevate prolactin binding by approximately 100% in rat ventral prostate explants incubated for 20 h in vitro. A stimulation was observed with low doses of ovine hormone (150 micrograms/l) which, from available data on the relative biological potencies, could be considered equivalent to the upper limit of the physiological range of endogenous rat prolactin. The response was associated with a lag period of 3-6 h. The effect could be obtained with other lactogenic hormones, including human and rat prolactin and human growth hormone, but not with non-lactogenic hormones such as insulin, hCG, corticosterone, testosterone or oestradiol. The prostaglandin synthesis inhibitor, indomethacin, and the Ca2+-antagonist, verapamil, could not counteract the increase in prolactin binding induced by prolactin treatment, nor could dibutyryl cyclic AMP alone mimic the response. These data suggest that prostaglandins, Ca2+ or cAMP do not mediate the alteration in receptor binding. Furthermore, inhibition of lysosome activity by chloroquine could not alone increase the prolactin binding in the control tissues, suggesting that up-regulation does not simply reflect a protective action of prolactin on receptor degradation. PMID- 3551432 TI - Diurnal plasma profiles of metabolite and hormone concentration in insulin dependent diabetic patients during conventional insulin treatment and continuous subcutaneous insulin infusion. A controlled study. AB - In addition to hyperglycaemia, derangement of metabolic and hormonal control may play an important role in the development of microvascular complications in diabetes. Little, however, is known about the impact of insulin pump treatment on metabolic and hormonal parameters. In a 6-month prospective randomized study in insulin-dependent diabetics we therefore investigated the effects of continuous subcutaneous insulin infusion by pump (10 patients) and conventional insulin treatment (10 patients) on the 24-h profiles of blood glucose, glycerol, lactate, 3-hydroxybutyrate, insulin, glucagon and growth hormone by measuring the respective concentrations every 2 h. We found that average blood glucose levels and HbA1c were significantly lower in the group treated by continuous subcutaneous insulin infusion as compared with the group on conventional insulin treatment. Furthermore, we observed an improvement in diurnal levels of lactate and 3-hydroxybutyrate in the pump-treated group which was not seen in the conventionally treated group. A slight increment in alanine was seen in the group treated with insulin pump. Serum growth hormone, glycerol, plasma free insulin as well as the daily insulin supply were unchanged and identical in the two groups. It is noteworthy that in the pump group, the decrease in blood glucose and 3 hydroxybutyrate takes place concomitantly with a significant suppression of glucagon. PMID- 3551433 TI - Present status of nuclear hematology. PMID- 3551434 TI - Present status of bone marrow transplantation in Japan. PMID- 3551435 TI - Biologic abnormalities in the myelodysplastic syndromes and myeloproliferative disorders. PMID- 3551436 TI - Iron absorption: molecular aspects and its regulation. PMID- 3551437 TI - Refractory anemia. PMID- 3551438 TI - The anticoagulant role of heparin-like molecules in the endothelial cell surface in hemostasis--endothelial heparin-like molecules. PMID- 3551439 TI - Structure of transferrin and transferrin receptor. PMID- 3551440 TI - Pathogenesis of myeloma and its regulation by cytokines. PMID- 3551441 TI - Morphological polysome analysis and surface expression of human myeloma cells: presence of heterogeneity. PMID- 3551442 TI - A comparison of cocaine, oxymetazoline, and saline for nasotracheal intubation. PMID- 3551443 TI - Cerebral ventricles of the Friesian cow (Bos taurus L.). Conformation, relations and stereotaxic topography. AB - Six heifers, aged 8-10 months, and 4 cows, aged 4-12 years, were used for studying the conformation of the cerebral ventricles on mouldings, and the topography on scanographs and frozen cuts. The morphologic changes with age concern the height of the 3rd ventricle, the extension of the pellucid septum and the stereotaxic topography. The stress is put on the variability of the volume of the lateral ventricles and the permanence of a vast and patent recessus olfactorius, with easy external landmarks. PMID- 3551444 TI - [Epidemiologic technics applied to leprosy]. PMID- 3551445 TI - [Course of the leprosy endemy throughout the world]. PMID- 3551446 TI - [Leprosy in Tunisia]. PMID- 3551447 TI - [Historical stages of leprosy in Tunisia]. PMID- 3551448 TI - [Epidemiology of leprosy in Guadeloupe from 1970 to 1984]. AB - Analysis of computerized data compiled according to the OMSLEP system in the leprosy control service in Guadeloupe has shown that from 1970 to 1984, 80% of the patients were detected by passive case-finding (symptomatic patients), 10% by active case-finding among the school population and 10% by active case-finding among the house-hold contacts of known patients. During the same period of time, global incidence of new cases of leprosy declined from 24 to 11 per 100,000 inhabitants. The decline was greater for paucibacillary cases (y = -0,94) than for multibacillary cases (y = -0,45), and much greater among persons under 15 years of age (y = -3,22) than among those older ones (y = -0,67). Simultaneously 118 relapses, an annual incidence of 1,3%, were observed among the multibacillary patients previously treated by dapsone monotherapy for five years or more. All cases the biopsies of whom were inoculated for drug sensitivity testing in the mouse foot pad yielded dapsone-resistant M. leprae. The proportions of relapses among the annual sources of infection increased from 16% in 1970 to 47% in 1984. Chemoprophylaxis of relapses among multibacillary patients already treated for more than five years with dapsone monotherapy is one of the priorities for leprosy control in Guadeloupe. PMID- 3551449 TI - [Epidemiological profile of leprosy in Algeria]. PMID- 3551450 TI - [Course of the leprosy endemy in Maroc from 1950 to 1984]. PMID- 3551451 TI - [Results of a retrospective survey on medical files: apropos of 109 Hansen disease patients in the Department of Mfoundi (Cameroon) screened over a 3-year period (November 1984)]. PMID- 3551452 TI - [Leprosy in Reunion]. PMID- 3551453 TI - [Leprosy health education in Martinique 1981-1985]. PMID- 3551454 TI - [Clinical and developmental aspects of lepromatous leprosy]. PMID- 3551455 TI - [Clinical and developmental aspects of tuberculoid leprosy]. PMID- 3551456 TI - [Eruptions in the course of immunologic reversions in lepromatous patients treated with immunomodulating agents]. PMID- 3551457 TI - [Forms of T leprosy as a function of development]. PMID- 3551458 TI - [Leprosy in young children in Western Africa]. PMID- 3551459 TI - [New findings on the osteoarticular lesions of leprosy]. PMID- 3551460 TI - [Reactive states: general review]. PMID- 3551461 TI - [Progress in reaction identification and the clinical aspects of Hansen's neuritis]. PMID- 3551463 TI - [New trends in the medical and anti-reactive treatment of leprotic neuritis]. PMID- 3551462 TI - [Necrotic course of erythema nodosum leprosum]. AB - During 2 years, 25 lepromatous patients were hospitalised in the Hansen complications room of Institut Marchoux. Between these patients, 9 developed a Necrotic Erythema Nodosum Leprosum. A review of the observed clinic effects is established and 3 types of signs are isolated and discussed: necrotic extension after big nodes on chest and arms, a punch crater complicating small nodes, and a sclerous xylodermia on arms and legs. The course of this complication is estimated about six months average, with pauses and relapses with general and subjectives symptoms. The final course shows side effects: anemia, denutrition, functional disabilities of joint movements and cutaneous straps. In the group of 9 patients, 3 died. We did not find relations between the necrotic phenomenon and therapy or occurred diseases. The best drug to stop the necrotic processus is thalidomide 400 mg daily and decrease 100 mg when the signs fall near normality. One or two mg/kg each day coricosteroides were tested: the effect is unconstant, the duration of action is shorter. Side effects occur rapidly and patient will become corticosteroid dependent. The importance of bath with disinfectants is high. We did not observed surinfection. PMID- 3551464 TI - [Analysis of the results of treatment of Hansen's neuritis]. AB - The authors expose a retrospective study about 133 nervous contingents treated exclusivement by steroid-therapy. The objective is to study the influence on nerve-function recovery of the following parameters: clinic form, function (sensitive or motor) of the nerve, position of the nerve (ulnar, median...), nature of the antibiotherapy. The method is based on the comparison for average progress in relation with the initial score. It appears that tuberculoid nerves recovery is better and faster than the lepromatous one. But lepromatous nerves improvement keeps on the end of the second year. On the other hand, the results are not influenced by the nerve itself or its function. Concerning antibiotherapy, our results show a significant difference, in consideration of a better improvement in PCT-treated nerves. Nevertheless, these results have to be confirmed by a comparative experimentation. PMID- 3551465 TI - [Histopathologic diagnosis of leprosy and leprotic reactions]. PMID- 3551466 TI - [Drug resistance of Mycobacterium leprae]. PMID- 3551467 TI - [Vaccination against leprosy]. PMID- 3551468 TI - [Dynamics of establishing resistance of M. leprae to dapsone and rifampicin in Martinique]. PMID- 3551470 TI - [Immunogenetics of leprosy]. PMID- 3551469 TI - [Inadequate rifampicin treatment in multibacillary leprosy and the incubation time of relapse]. PMID- 3551471 TI - [Visualization of IL2 and IL2 receptor in leprous dermal granulomata]. PMID- 3551472 TI - [Immunologic examinations in lepromatous leprosy]. PMID- 3551473 TI - The "Hansen-anergic fringe". AB - The Hansen-Anergic Fringe ("HAF") of the population is the minority genetically incapable of developing that variety of specific immunity to Myco. hansenii which leads to the positivity of the Mitsuda reaction. In spite of the fact that the HAF was identified as early as 1937, its real proportion in the human species is still not exactly known. Considering that Myco. tuberculosis has been proved to induce Mitsuda-positivity in the genetically capable majority, studies with the tuberculin reactions and cross-stimulation with BCG should be instrumental for the determination of the width of the HAF in various races and different endemic and non-endemic areas. In Brazil it stands around 20-25%, but more accurate studies are necessary. Between the HAF and the Mitsuda-positive or potentially positive majority there is a zone of "intermediate reactivity" which also needs quantification. The specific HAF reacts normergically to all other tests so far investigated and has not yet been associated with any other kind of immuno deficiency. Also, it has not been associated with any of the known genetical markers, although HLA studies seem promising. If its postulated genetical nature is confirmed, the possibility of effective vaccination will be doubtful. PMID- 3551474 TI - [Antibacterial chemotherapy in leprosy: principles, objectives and recommendations]. PMID- 3551475 TI - [Efficacy and tolerance of daily combined treatment of multibacillary leprosy]. PMID- 3551477 TI - [Lesions of the rotator cuff: the specific value of echography]. PMID- 3551476 TI - The effects of cannabispiro compounds and tetrahydrocannabidiolic acid on the plasmid transfer and maintenance in Escherichia coli. AB - Some cannabispiro compounds and tetrahydrocannabidiolic acid were tested for antibacterial plasmid curing activity and inhibition of plasmid transfer. MIC values of the compound were above 1500 micrograms/ml. Cannabispirol and tetrahydrocannabidiolic acid eliminated the F'lac plasmid from Escherichia coli, but acetylcannabispirol, cannabispirone and cannabispirenone were ineffective as curing agents. Each compound, except acetyl-cannabispirol, selectively killed plasmid carrying bacteria. The compounds inhibited R144 plasmid transfer from E. coli into E. coli cells via inhibition of mating pair formation, zygotic killing and inhibition of transconjugal DNA synthesis in a lesser extent. All of the cannabispiro compounds and tetrahydrocannabidiolic acid inhibited the transformation with pBR322 plasmid DNA when the bacteria were pretreated with the compounds, via inhibition of the DNA penetration or decreasing the synthesis of plasmid DNA during bacterial growth. Although each of the compounds, except acetyl-cannabispirol, had a weak antibacterial effect which was more definite on plasmid carrying bacteria than plasmidless ones, and inhibited intercellular plasmid transfer and transforming activity of plasmid DNA, only two of them were able to cure F'lac plasmid showing that plasmid elimination is a complex process which strictly depends on the stereochemical configuration of curing agents. PMID- 3551478 TI - Static ultrasound examination in the diagnosis of soft tissue masses. PMID- 3551479 TI - [Pediculated bone grafts as vascularization aids. At the wrist level]. PMID- 3551480 TI - Observations on the structure and the biomechanics of the cricothyroid articulation. AB - We examined quantitatively the ventrodorsal gliding occurring along a sagittal plane in the cricothyroid articulation. For this purpose we used 10 fresh excised human larynges taken at autopsy. Furthermore we examined the morphology, the hydroxyproline content and collagen types of the ligaments and the articular capsule of the cricothyroid articulation. This articulation appeared to be a synovial joint, supported by two ligaments: the lateral and posterior ceratocricoid ligament and articular capsule. The ligaments and the capsule contained both type I and type III collagen fibres and they were rich in elastin fibres 1-2.5 microns in diameter. Ventrodorsal gliding was generally possible when the joint was not rotated to its extremes. The marked individual variation was not essentially affected by sex or age. The collagen content of the lateral ceratocricoid ligament showed a statistically significant negative correlation with the gliding. The articular facet of the cricoid cartilage, which was not usually well-shaped, limits the gliding. A force of +/- 1.0 N caused on the average a change of +/- 1.0 mm in the length of the vocal cord. Further research is needed to evaluate the physiological importance of these findings. PMID- 3551481 TI - A histological study of formation and growth of nasal polyps. AB - Chronic infection and allergy are considered to be the two major etiologic factors of nasal polyps. Whatever its cause may be, the initial phase of nasal polyp formation is represented by increased exudation from vessels, edema of the lamina propria and the bulging of the nasal mucosa. Nasal polyps were histologically classified into three types: edematous type, glandular and cystic type (ductal type) and fibrous type. Those of the edematous type and the glandular and cystic type are in the active stage of tissue reaction because of permeation of vascular fluid and marked infiltration of round cells. Contrastingly, the fibrous type polyps are in the healing stage of tissue reaction because of marked proliferation of fibroblasts and collagen fibers. The morphological structure of the nasal glands involved in the bulging mucosa determines the type of nasal polyps, whether edematous type or glandular and cystic type. PMID- 3551482 TI - Immunohistochemical method for the diagnosis of olfactory disturbance. AB - To confirm the diagnosis and determine the cause of the olfactory disturbance, we used an immunohistochemical method to examine biopsy specimens of the olfactory mucosa from a patient who complained of anosmia after head injury. Neuron specific enolase immunoreactivity was found in the olfactory vesicles and dendrites of the receptor cells in the olfactory epithelium. S-100 protein immunoreactivity was found in the ductal cells of Bowman's gland in the olfactory epithelium and in the acinar cells of Bowman's gland in the lamina propria. This suggests that the olfactory receptor cells and Bowman's gland were normal. The olfactory disturbance in this patient was not caused by nerve transection due to the head injury, but by already existing chronic sinusitis. Immunohistochemical methods are useful for diagnosing olfactory disturbance when used in combination with biopsy of olfactory mucosa. PMID- 3551483 TI - Glottography, the electrophysiological investigation of phonatory biomechanics. AB - Some details of phonatory biomechanics, meaning the vibratory movements of the vocal folds during phonation, are described in the introduction. Here a special emphasis is laid on the multicomponent structure of the vocal folds. Glottography is a general term used for methods to monitor the vibrations of the vocal folds. Four different types of glottography are generally recognized (fig. 2), viz. photoglottography, electroglottography, ultrasound glottography and glottography by inverse filtering the acoustic or laryngeal air flow signal. In the main part of the communication the four methods are described and their applicability is discussed. PMID- 3551484 TI - Anti-inflammatory properties of human milk. AB - An hypothesis was developed which predicts that human milk protects against infections of the alimentary tract of the breast-fed infant by non-inflammatory mechanisms. Human milk is poor in the initiators and mediators of inflammation and rich in anti-inflammatory agents. Furthermore, many of the anti-inflammatory agents are comparatively resistant to digestive enzymes and therefore might be expected to remain active in the gastrointestinal tract of the recipient. Further studies of these factors in in vivo models will be required to validate the hypothesis. PMID- 3551485 TI - Long-term follow-up of ventilator treated low birthweight infants. I. Chest X ray, pulmonary mechanics, clinical lung disease and growth. AB - Chest X-ray, pulmonary mechanics, clinical lung disease and growth were studied in 48 low birthweight infants surviving after ventilator treatment in the neonatal period. Bronchopulmonary dysplasia (BPD) was present in 14 infants shortly after weaning off ventilator. At 4 to 6 years of age most patients had normal chest radiographs but 13 still showed signs of pulmonary fibrosis and hyperinflation. Most patients had low dynamic compliance and high pulmonary resistance shortly after ventilator treatment. All but 8, however, had normal findings at 1 to 1 1/2 years of age. Pneumonias and bronchitis were common during the first two years but thereafter declined in frequency. Weight and length development were retarded for BPD patients during the first two years and for non BPD patients for the first year. Both groups had a complete catch-up. PMID- 3551486 TI - Hip joint instability in breech pregnancy. AB - 222 consecutive fetuses found by ultrasound to be in breech presentation in the 33rd gestational week were followed with repeated examinations in weeks 35 and 38. Ninety-one of these fetuses persisted in breech presentation until delivery, while cephalic version occurred in 131. The frequency of hip joint instability was 21% in the breech delivered group and 1.5% in the vertex delivered group. The position of the fetal legs was established at each ultrasound examination. The intrauterine fetal attitude was classified as extended when the fetuses had extended knees and maximally flexed hips at all ultrasound examinations. This occurred in 30 breech delivered fetuses, 47% of which developed hip joint instability. Only 8% of the breech born infants with flexed legs in utero developed hip joint instability. It is concluded that instability of the hip joint is a consequence of the intrauterine attitude, rather than of the breech delivery per se. PMID- 3551487 TI - Immunoglobulin G to Bifidobacterium bifidum in children's sera. PMID- 3551488 TI - Type 4 renal tubular acidosis (sub-type 2) associated with idiopathic interstitial nephritis. AB - An 18-month-old girl presenting with anorexia and failure to thrive, was referred for adenoidectomy. Arterial hypertension was discovered on physical examination. Laboratory results revealed hyperkalaemic, hyperchloraemic, metabolic acidosis, with slight azotemia. Urinary aldosterone excretion and plasma renin were decreased. Renal biopsy showed idiopathic interstitial nephritis. The diagnosis of type 4 renal tubular acidosis, sub-type 2, i.e. primary hyporeninaemic secondary hypoaldosteronism was proposed. According to our knowledge, this disease has not previously been reported in young children, but is well known in azotaemic adults. We therefore propose the inclusion of this uncommon renal disease in the differential diagnosis of failure to thrive in childhood. PMID- 3551489 TI - Continuous wave ultrasound measure of neonatal cerebral blood flow. AB - We report cerebral blood flow (CBF) values for healthy neonates in five gestational age categories for 9 single and 7 combination measures of continuous wave Doppler ultrasound. Combinations of measures, particularly those from the anterior cerebral artery with a 5.0 MgH probe, increased the reliability and validity. The most reliable and valid single measure was mean flow velocity from the anterior cerebral artery (5.0 MgH probe). CBF values were lower for neonates with respirator support than for neonates without respirator support. No significant differences were found in CBF measures between intubated neonates who developed IVH and intubated neonates who did not develop IVH. Neonates who were intubated and developed intraventricular hemorrhage (IVH) were treated more vigorously than those who were intubated and did not develop IVH. By day 6, neonates with IVH had a significantly higher mean pH, mean serum bicarbonate, and mean positive base balance. PMID- 3551490 TI - Early childhood hyperkalemia: variety of pseudohypoaldosteronism. AB - Fractional excretion of electrolytes, renal acidification capacity and the renin aldosterone system have been studied in 5 non-azotemic children, 19-25 months old, with mineralocorticoid resistant hyperkalemia, discovered in the first month of life. Although fractional potassium excretion was similar in patients and in a group of control healthy children (13.8 +/- 5.2% vs. 8.7 +/- 6.4%) it was inappropriately low in the patients for their higher potassium concentration. Fractional sodium excretion was significantly increased in the patients (1.6 +/- 0.3% vs. 0.67 +/- 0.4, p less than 0.02). Normal net acid and ammonium excretion and intact ability to lower urinary pH during acid loading were observed in all patients. Mean values for plasma aldosterone (37.0 +/- 9.1 vs. 13.9 +/- 11.2 ng/dl), plasma renin activity (12.5 +/- 3.9 vs. 8 +/- 2.8 ng/ml/h) and plasma aldosterone/plasma potassium ratio (7.11 +/- 1.5 vs. 3.08 +/- 1.7) were higher in the patients than in the control subjects (all p less than 0.001). These data support the hypothesis that a partial lack of response of the renal tubule to endogenous mineralocorticoids was present in the patients. This type of pseudohypoaldosteronism is less severe than that described for the classic form and for early childhood renal acidosis. PMID- 3551491 TI - Long term effects of artificial ventilation in neonates. AB - In order to evaluate long term effects of artificial ventilation, 27 children, who had been ventilated for more than five days in their neonatal period, were reinvestigated at school age. In 5 of them bronchopulmonary dysplasia had been diagnosed. Seven had more than 10 upper respiratory tract infections per year and 9 had recurrent obstructive airway disease. On pulmonary function testing (n = 23) 19% showed some airway obstruction, and in 43% bronchial hyperreactivity was found by bronchial provocation with histamine. There was a significant correlation (p less than 0.05) between bronchial hyperreactivity and the duration of neonatal ventilation. The degree of hyperreactivity (PC20, FEV1) also correlated with birth weight (p less than 0.005) and gestational age (p less than 0.02). It is concluded that prolonged neonatal ventilation might be followed by bronchial hyperreactivity, especially in the small and premature newborn. PMID- 3551492 TI - Complement-dependent bactericidal activity for E. coli K12 in serum of preterm newborn infants. AB - Complement-dependent serum bactericidal activity for E. coli K12 was assessed in 12 term infants and in 16 preterm infants. In both groups of newborns, at birth, bactericidal reaction by the classical pathway of complement activation was impaired with respect to normal controls at less than 0.001 level of significance (as estimated by Student's t-test). The serum bactericidal reaction by the alternative pathway of complement activation was significantly impaired only in preterm newborns, being normal in term infants. At a time corresponding to 40 weeks' gestational age also in preterm newborns alternative pathway mediated bactericidal activity for E. coli K12 was found normal. Classical pathway mediated bactericidal activity became normal only at an age corresponding to 52 weeks' gestational age. PMID- 3551493 TI - Pancreatic enzyme supplementation as acid-resistant microspheres versus enteric coated granules in cystic fibrosis. A double placebo-controlled cross-over study. AB - In order to compare the efficacy of pancreatic enzyme supplementation as pH sensitive enteric-coated microspheres Pancrease to that of conventional supplementation with enteric-coated Pancreatin in cystic fibrosis, a double blind cross-over study was conducted. Eleven patients under 12 years of age received each of the enzyme preparations for four weeks. Treatment efficacy was evaluated by means of a symptom score card recording stool frequency, consistency, colour, odour, abdominal cramps and appetite as well as a 3 days fat absorption test. Weight increments were recorded 3 months before the study when patients were on Pancreatin, and 3 months after the study when patients were on Pancrease. In eight of the patients fat absorption was improved on Pancrease, but the difference did not reach statistical significance. However, the patients experienced significantly less dyspeptic symptoms, decreased stool frequency, better appetite and increments in weight were significantly higher on Pancrease compared to Pancreatin. PMID- 3551494 TI - Beneficial effects of palatable guar and guar plus fructose diets in diabetic children. AB - This randomized cross-over study evaluates the effects of extended, guar and guar + fructose diets on the metabolic balance of children with insulin-dependent diabetes mellitus (IDDM). We studied 22 children; mean age 12.2 years, mean duration of diabetes 4.4 years. The diet was supplement for three weeks with guar in palatable form (5% of daily carbohydrate intake) and with guar + fructose (1 g of fructose/kg body weight, max 30 g/d) for another three weeks. A control group (8 children, mean age 12.3, duration of diabetes 4.3 years) followed the same experimental protocol without guar supplementation. The metabolic balance was assessed by glucosuria index (per cent of tests with less than 1% glucosuria from all urine tests) and measurements of red cell glycohaemoglobin A1c (HbA1c). Serum total and HDL-cholesterol, C-peptide, pancreatic and enteroglucagon were also measured. HbA1c decreased during guar (p less than 0.001) and guar + fructose diet (p less than 0.001). The glucosuria index improved (p less than 0.02) and the serum total cholesterol concentration decreased (p less than 0.02) during the experimental guar diets. Guar in acceptable form and quantity in the diet appears to improve metabolic control of diabetic children. PMID- 3551496 TI - Thomsen-Friedenreich-related antigen in non-neoplastic ureter urothelium and transitional cell tumours of the urinary bladder. An immunohistochemical study employing the monoclonal antibody 49H.8. AB - This study, which is part of a larger immunohistochemical investigation of blood group antigens in non-neoplastic urothelium and bladder cancer, reports our findings on the expression of an antigen related to the cryptic Thomsen Friedenreich antigen (beta Gal 1-3 GalNAc) of erythrocytes. De-waxed sections of 19 ureters and of 93 transitional cell tumours, either untreated or pretreated with neuraminidase, were subjected to an indirect immunoperoxidase staining, employing the monoclonal antibody 49H.8. Staining results were compared to Lewis secretor types, morphology, and in tumours to the clinical course as regards recurrence rate and the development of either stroma invasive recurrence or papillomatosis as well. Ureters not subjected to neuraminidase were unstained, whereas urothelium in 12 of 19 ureters subjected to neuraminidase showed staining. Serial dilution of antibody disclosed quantitative differences related to the Lewis-secretor types. Lea+b- urothelium, i.e., non-secretor urothelium, had the highest end-point titers. Endothelium was unstained. Thirty-six of the 93 tumours showed staining without prior neuraminidase treatment, 31 showed staining after neuraminidase treatment only, while 26 were unstained. Staining correlated with the pathological stage and grade (p less than 0.05), but not with the clinical course (p greater than 0.05). The results do not support previous observations on the prognostic value of Thomsen-Friedenreich antigen determination in superficial bladder cancer. PMID- 3551495 TI - Y-body detection in formalin-fixed lymph nodes, using proteolytic enzymes and oxidative deamination. AB - The effect of proteolytic enzymes (Protease and Trypsin) and oxidative deamination (Chloramine-T and Sodiumhypochlorite) on formalin-fixed paraffin embedded lymph nodes with regard to detection of fluorescent Y-bodies was examined. Protease was found to be more suitable than the others; acid hydrolysis was found to be unsuitable. The results of Y-body detection were further improved by adding fixation of 30 minutes in Carnoy's solution. PMID- 3551497 TI - Intraabdominal granuloma reaction in rats after introduction of maize-starch powder. AB - A total of 32 Wistar rats were given 1, 10, 100 and 1000 mg glove powder (Biosorb) intraperitoneally for 4, 11, 18 or 25 days. Four control rats received physiological saline. Examination of the abdominal cavity displayed granulomatous inflammation which was clearly dose-dependent in the experimental animal, but not in the controls. A biphasic time-sequence of the granulomatous reaction was observed in those rats receiving 100 and 1000 mg Biosorb with a minimum at day 18. The mean size of the granules (8.1 microns) within the inflammatory tissue was almost identical with the size of powder granules found on the external surface of the gloves (8.8 microns). X-ray microanalysis demonstrated maize starch additives of magnesium and aluminium. The study indicates a foreign body reaction to maize-starch. In addition, immunological factors may play a role later in the development of the disease. PMID- 3551498 TI - Repeated passage of freshly isolated group A streptococci on blood agar. II. Effect on adherence capacity. AB - Group A streptococcal strains (three T-type 1, two T-type 2 and three T-type 4), freshly isolated from throat cultures, were subjected to 25 serial passages on blood agar. All strains changed their M protein production and/or opacity factor (OF)-activity during the passages. The capacity of each strain to adhere to a pool of buccal cells from six healthy individuals was studied both before and after passage. Five of six strains with decreased OF-activity/M protein production diminished significantly in adherence capacity, whereas one of two strains with increasing OF-activity adhered better to the epithelial cells. The results are discussed in relation to the clinical view of asymptomatic carriers of group A streptococci. PMID- 3551499 TI - beta-lactamase production in coagulase-negative micrococcaceae. AB - A total of 8 penicillin-susceptible and 55 penicillin-resistant coagulase negative Micrococcaceae were investigated for their beta-lactamase production by one quantitative and three qualitative methods. Seven of the 8 penicillin susceptible strains had no beta-lactamase production; one had a very low production. Among the 55 penicillin-resistant strains, 54 produced beta-lactamase (mean 63 units/mg bacteria). Methicillin/gentamicin-resistant strains produced less enzyme than strains susceptible to these antibiotics. The percentage extracellularity (mean 18%) was lower than in Staphylococcus aureus, whereas the induction ratio (mean 56) was higher. No significant difference between the different species could be observed, but 70% of the strains were Staphylococcus epidermidis. Among the 55 beta-lactamase producing strains, the microbiological clover-leaf method detected 51, the iodometric method 40 and the chromogenic cephalosporin method 38. None of the three qualitative methods gave any false positive reactions. PMID- 3551500 TI - Failure to detect hydrogen-sulphide production in lactose/sucrose-fermenting Enterobacteriaceae, using triple sugar iron agar. AB - Triple Sugar Iron agar failed to detect hydrogen sulphide in 44 out of 69 hydrogen-sulphide producing strains of Enterobacteriaceae, which at the same time fermented lactose and/or sucrose. The species involved were Salmonella typhi, Salmonella enteritidis, Citrobacter freundii, Escherichia coli, and Proteus vulgaris. By contrast, no false-negative reactions were observed in 74 strains, which fermented neither lactose nor sucrose. Failure to detect hydrogen sulphide was probably due to acidification of the medium following the fermentation of carbohydrates. A medium without carbohydrates is preferable in diagnostic situations where hydrogen-sulphide detection is of great importance. PMID- 3551501 TI - The anal transitional zone. AB - The macroscopical appearance of the human anal canal was first described by Glisson (1597-1677) and Morgagni (1717), who mentioned the anal valves and anal columns, respectively. The first detailed light microscopic description of the three anal canal zones originates from Robin & Cadiat (1874). The present definition of the anal canal, extending from "the pelvic floor to the anal opening" was suggested by Symington (1888). There are no generally accepted names for the three epithelial zones of the anal canal. A review of the literature shows that no less than three different names have been used for the upper zone, 14 for the middle zone and 9 for the lower zone, as well as 10 names for the line comprising the anal valves and the base of the anal columns. In the present work the middle zone is termed the anal transitional zone (ATZ), and is defined as "The zone interposed between uninterrupted colo-rectal type mucosa above and uninterrupted squamous epithelium below, irrespective of the type of epithelium present in the zone itself". The line corresponding to the anal valves and anal sinuses is termed the dentate line (DL), as this name seems to be employed in more common textbooks. The location and extent of the ATZ has previously been measured by light microscopy on a small number of sections from a few anal canals. In the present work the extent of the zone has been elucidated from a large material, where macroscopic demonstration of the zone has been carried out by means of staining with Alcian dyes on fixed surgical specimens, by stereomicroscopy and finally by light microscopic control of both methods, achieved by systematic sectioning of the specimens. The results have shown that normally the ATZ reaches from the DL and almost 1 cm upward, but that it can be observed over a considerably larger area than previously reported, namely from 0.6 cm below to 2.0 cm above the DL, and eventually may be absent altogether. Further, it has been shown that the ATZ frequently has a map-like appearance. Light microscopically, the major part of the ATZ consists of a characteristic epithelium, which is provisionally termed the ATZ-epithelium. This appears to be composed of 5-9 cells layers. The surface cells can be columnar, cuboidal or somewhat more flattened. In the first case, signs are often seen of some mucin production.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3551502 TI - Exercise in human physiology. International symposium in memory of Lars Hermansen. Vettre, June 1985. PMID- 3551503 TI - Satellite cells express the trophic factor IGF-I in regenerating skeletal muscle. AB - The expression of insulin-like growth factor I (IGF-I, somatomedin C) was studied in regenerating skeletal muscle. Irreversible damage to skeletal muscle cells was induced in the extensor digitorum longus muscle (EDL) of adult rats by ischaemia, preceded by glycogen depletion, and the regeneration process was studied for periods up to 14 days after injury. The IGF-I was demonstrated by indirect immunofluorescence. Immunoreactivity against ribonucleotide reductase (RR) was used as a marker for DNA synthesis, that is, cell proliferation. Increased IGF-I immunoreactivity could be demonstrated within 24 h after injury in satellite cells, intramuscular nerves and in blood vessels. The IGF-I immunoreactivity remained virtually unchanged in the contralateral, undamaged EDL. An increasing number of satellite cells, expressing high IGF-I immunoreactivity, could be demonstrated in the injured EDL, and within 72 h myoblasts, expressing high IGF-I and RR immunoreactivity, were formed. Small immature muscle cells, displaying high IGF-I immunoreactivity, were observed 4 days after injury. Increased IGF-I immunoreactivity was still obvious in the regenerated muscle cells 14 days after injury while RR immunoreactivity was seen only in scattered satellite cells. It is concluded that IGF-I may act as a trophic factor during regeneration of skeletal muscle after injury. PMID- 3551504 TI - Freud and biology: the hidden legacy. AB - The author underlines the nineteenth-century biological roots of Freudian psychoanalysis and concludes that much that is wrong with psychoanalytic theory, as Freud conceived it, may be traced back to these outmoded biological assumptions. he then analyzes the development of the "Freud Legend" considering that psychoanalytic history has, like history in general, its origins in myth, a myth however which has continued to rule this history. PMID- 3551505 TI - Immunogenicity of semisynthetic human insulin. PMID- 3551506 TI - Is it possible to characterize recurrent urinary stone formers who benefit from thiazide prophylaxis? Application of discrimination analysis. AB - Twenty-three patients with recurrent urinary stones have been treated for 12-54 months with hydrochlorthiazide and 25 with placebo. Discrimination analysis was performed in order to distinguish patients with new stone formation (non responders) from those without stone recurrence (responders) during the treatment. The discriminant function classified 16 out of 18 responders as such and 5 non-responders as such by using a combination of the three initial variables urinary pH, 24-h urine volume and serum phosphate. Eighteen other analysed variables and patient factors did not contribute to this discrimination. By using "leaving-one-out-technique", the probability for erroneously classifying a patient increased from 9 to 17%. Applying the discriminant function on the group receiving placebo, 92% of these patients were classified as responders to thiazide. It is concluded that discrimination analysis may give valuable information in characterizing patients who will benefit from a special therapy. PMID- 3551507 TI - The effect of the calcium-entry blocker nifedipine on cold-induced digital vasospasm. A double-blind crossover study versus placebo. AB - The effects of the calcium-entry blocker nifedipine 20 mg, two 10 mg capsules, t.i.d. in patients with cold-induced digital vasospastic disease of idiopathic or traumatic origin was tested in 28 patients, using double-blind crossover technique on both symptoms and test results. The effect of treatment on digital blood pressure during local cooling was assessed using the Nielsen-Lassen method. Symptomatic improvement was reported by 5 patients during placebo treatment and 17 during nifedipine treatment (p less than 0.01). The symptomatic improvement was significant in the total group of patients and in the group of patients with idiopathic vasospastic disease. The digital blood pressure during local cooling improved significantly with nifedipine at 5, 10, 15 (p less than 0.001) and 20 degrees C (p less than 0.05) for the total study population and for the two subgroups except for the change at 20 degrees C in the IDIOP group. At a digital temperature of 10 degrees C, 2 patients reached normal digital blood pressure during placebo treatment compared to 16 during nifedipine treatment (p less than 0.001). The number of side-effects increased significantly (p less than 0.05) during nifedipine treatment. We consider the use of nifedipine in patients with cold-induced digital vasospastic disease to be of great value, especially in patients with digital vasospastic disease of idiopathic origin. PMID- 3551508 TI - Antacid treatment of duodenal ulcer. AB - Sixty-seven consecutive outpatients with endoscopically verified duodenal ulcer were randomised to a double-blind treatment with either 10 ml of an antacid suspension (buffering capacity 85 mmol/10 ml, packed in single dosage pads) 1 and 3 h after each meal and at bedtime or cimetidine 400 mg b.i.d. The double-dummy technique was employed. Endoscopy was performed after 4 weeks treatment and, if the ulcer had not healed, after 8 weeks treatment. When ulcer healing had occurred, the patient entered a 1 year follow-up study. The cumulative healing rates after 4 and 8 weeks treatment were 83 and 97% vs. 69 and 94% in the antacid and cimetidine groups respectively. No significant differences were observed between the treatment groups regarding ulcer healing, symptom relief or compliance. Adverse reactions were few and only 3 (9%) patients in the antacid group had to discontinue the treatment due to diarrhoea. Of the cimetidine treated patients, 61% had symptomatic relapse during the 1 year follow-up compared to 71% of the antacid treated patients. There were no significant differences in recurrence rate or time to relapse. The moderate dose antacid treatment used here is efficient, well tolerated, safe, convenient and is a good alternative treatment of the duodenal ulcer patient. PMID- 3551509 TI - Changing behavior following myocardial infarction. PMID- 3551510 TI - Clinical applications of stress reduction interventions in the rehabilitation of postcoronary patients. PMID- 3551511 TI - The role of exercise testing in the diagnosis of coronary heart disease. PMID- 3551512 TI - The role of exercise testing in risk stratification. PMID- 3551513 TI - The anaerobic threshold: definition, physiological significance and identification. AB - During exercise, the oxygen consumption above which aerobic energy production is supplemented by anaerobic mechanisms, causing a sustained increase in lactate and metabolic acidosis, is termed the anaerobic threshold (AT). The oxygen consumption at the AT depends on factors that affect oxygen delivery to the tissues. It is increased when oxygen flow is enhanced and decreased when oxygen flow is diminished. Its value is quite low in patients with heart disease. The AT is an important functional demarcation since the physiological responses to exercise are different above the AT compared to below the AT. Above the AT, in addition to the development of metabolic acidosis, exercise endurance is reduced, VO2 kinetics are slowed so that a steady state is delayed, and VE increases disproportionately to the metabolic requirement and a progressive tachypnea develops. The AT can be measured directly from the lactate concentration with precise threshold detection from a log-log transformation of lactate and VO2. This threshold also defines the VO2 above which the lactate/pyruvate ratio increases. As bicarbonate changes reciprocally with lactate, its measurement can also be used to estimate the lactate threshold. But most convenient are gas exchange measurements made during exercise testing which can be used to noninvasively detect the lactate or anaerobic threshold. These methods are based on the physical-chemical event of buffering lactic acid with bicarbonate, and the increased CO2 output which occurs in association with the acute development of a metabolic acidosis. PMID- 3551514 TI - Modification of cardiovascular function by 'metabolic drugs'. PMID- 3551515 TI - The anaerobic threshold concept: a critical evaluation. PMID- 3551516 TI - Respiratory markers of the anaerobic threshold. PMID- 3551517 TI - Blood flow in exercising muscles. PMID- 3551518 TI - Anaerobic threshold and aerobic capacity in the evaluation of chronic cardiac or circulatory failure. PMID- 3551519 TI - Dynamical aspects of animal grouping: swarms, schools, flocks, and herds. AB - Grouping of animals is a natural phenomenon in which a number of animal individuals are involved in movement as forming a group. Examples are insect swarms and fish schools. In this article an attempt is made to describe the motion of grouping individuals kinematically as distinct from simple diffusion or random walk, to model the grouping on the basis of dynamics of animal motion, and to interpret the grouping from the standpoint of advection-diffusion processes. Also presented is dynamical modeling for the group size distribution as a result of amalgamation and splitting processes of groups. Examples of animal grouping are described in detail. They are insect swarms, zooplankton swarms, fish schools, bird flocks, and mammal herds. The presented mathematical models are compared with data of these animal groupings. PMID- 3551520 TI - Molecular assembly of tobacco mosaic virus in vitro. AB - TMV assembly starts with a specific interaction between the assembly origin on the RNA and a disk aggregate of coat protein. The assembly origin is located in the 30K protein cistron for common and tomato strains of TMV and in the coat protein cistron for cowpea strain of TMV and for CGMMV. All the assembly origins have three essential structures: a long base-paired hairpin loop structure; a target sequence, GAPuGUUG, at the top of the hairpin loop structure; and a tract where every third base is a purine. The protein aggregate responsible for the initiation of TMV assembly is a 20S disk, a two-layered aggregate of 34 protein subunits. The two layers of a disk open apart onto the central hole and this structure may be critical for the disk to interact with the assembly origin on the RNA. The target sequence may bind specifically to this structure. Although only a low concentration of 20S disks exists in the usual assembly condition, one disk is enough to initiate TMV assembly. TMV elongation proceeds in two directions. Elongation to the 5'-end proceeds rapidly by preferential incorporation of protein subunits (or A protein) and in 5-7 min gives rise to 260 nm intermediate particles whose 5'-end is coated. A model of elongation toward the 5'-end is shown in Fig. 15. Protected RNAs from nuclease digestion during the assembly reaction produce a banding pattern on gels by electrophoresis. The banding pattern reflects features of the RNA rather than protein that are used in the assembly reaction, since the pattern was the same for assembly between TMV RNA and CGMMV protein subunits as for assembly between TMV-RNA and TMV protein containing 20S aggregates. The 20S aggregate in the assembly solution has a helical structure with 39 protein subunits rather than the disk structure. Rapid addition of 20S helical aggregates to the top of the growing rod seems to be impossible because of its topological complexity. Elongation toward the 3'-end does not start for at least the first 4 min after initiation. It probably cannot begin until the 5'-end RNA tail disappears into the intermediate rod. Elongation toward the 3'-end favors 20S aggregates as the protein source and gives rise to the full-length rods in about 30 min after the initiation. There are no topological difficulties in adding 20S helical aggregates to the protruding RNA tail.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3551521 TI - Pelvic inflammatory disease and the IUD. AB - The evidence for the association between IUD use and PID is reviewed based on the results of case-control and cohort studies. Both types of epidemiologic studies are described briefly. Most case-control studies are hospital-based and show that IUD users have a higher risk of having PID compared to women using other contraceptive methods. The results of case-control and cohort studies, however, are not in agreement. Considered collectively, cohort studies show that the PID rates are the same for users of all types of IUDs. This rate is similar to the PID rate in the general population not associated with abortion, childbirth or surgery. PMID- 3551522 TI - Longterm use of the Today contraceptive sponge. AB - Users of the Today contraceptive sponge who participated in a comparative trial of the sponge and diaphragm were followed up for an additional year. There were no serious adverse effects attributable to sponge use during the second year of use. The second year life-table pregnancy rate for sponge users was significantly lower (p less than 0.05) than the first year rate. The pregnancy rates for first time sponge and diaphragm users were similar (p greater than 0.10) and both rates improved with increasing user experience. PMID- 3551523 TI - Metronidazole-containing vaginal sponges for the treatment of bacterial vaginosis. AB - Currently, there is no FDA approved treatment for bacterial vaginosis (BV), although various oral dosages of metronidazole are used to treat this condition. A vaginal therapeutic sponge (VLI Corporation) that releases metronidazole over a 24 h use period has been developed for the treatment of BV. Each sponge contains 250 mg of metronidazole. The safety and effectiveness of using one or three metronidazole-containing vaginal sponges for the treatment of BV was evaluated in 40 patients. Use of a single sponge resulted in a cure rate of 38.9%. With three sponges the cure rate was 94.4%. Cure was defined as the absence of signs and symptoms (vaginal discharge, elevated pH, KOH prep odor, and 'clue' cells) at the one and four week follow-up visits. The sexual partners of most women were also treated with metronidazole (2 g po in one dose). None of the women were discontinued from treatment because of any adverse effects. Side-effects were minimal and required no treatment. The cure rate with the three vaginal sponge dosage appears to be similar to that associated with oral dosages of metronidazole. PMID- 3551524 TI - The effect of copper ions in vivo on specific hormonal endometrial receptors. AB - A comparative randomized study was made of three intrauterine contraceptive devices: the Nova-T, MLCu250 Short and MLCu375. An endometrial biopsy was performed on the 25th day of the menstrual cycle before and after IUD insertion. The tissue obtained was analyzed to determine estrogen and progesterone receptor concentration and endometrial morphology patterns in IUD users. Both estrogen and progesterone receptors decreased proportionally to the increased amount of copper in the IUD. The histologic study showed changes in endometria relative to the amount of copper, but these changes were transitory and disappeared after a year of IUD use. PMID- 3551525 TI - The pill, the heart and HDL: facts and fictions. PMID- 3551526 TI - Calcium transport by the proximal tubule. AB - Taken together the results of these in vivo microperfusion experiments indicate that calcium absorption by the proximal tubule depends on more than one transport mechanism. We have observed that net calcium flux is affected by changes in calcium ion activity (even with constant total calcium concentration) and in transepithelial voltage. This sensitivity of calcium flux to changes in electrochemical driving force points to a diffusional component of calcium transport. Ng et al. (1984) have recently concluded that simple diffusion accounts for the majority of calcium absorption by superficial proximal convoluted tubules of the rabbit. The pathway for this diffusional component may involve paracellular channels. The permeability of this pathway appears to be as high for calcium as it is for sodium, potassium and chloride. Calcium flux is also affected by changes in osmotic water flow. The effect of changes in volume flow on calcium transport occurs even in the absence of concentration changes in bulk solutions. Thus, it does not appear to be the result of changes in passive driving forces secondary to dilution or concentration of tubule fluid. At present we are not able to distinguish between two other possible mechanisms: solute polarization in a microscopic unstirred fluid layer adjacent to the cell membrane, or true entrainment of calcium in the stream of osmotically driven water flow (solvent drag). Either mechanism could provide an additional component of total calcium transport independent of changes in bulk phase ion concentrations and electrical driving forces. A third component of total calcium absorption appears to involve active transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551527 TI - Primary hyperparathyroidism (PHP) revisited. PMID- 3551528 TI - Mechanisms of calcium transport in the thick ascending limb of the loop of Henle. PMID- 3551529 TI - Calcium transport in the distal convoluted tubule. PMID- 3551530 TI - Renal tubular disorders associated with hypocalciuria. PMID- 3551531 TI - Renal magnesium wasting disorders. PMID- 3551532 TI - Mechanisms and regulation of intestinal phosphate transport. PMID- 3551533 TI - Intestinal absorption of phosphate in man: effect of drugs. PMID- 3551534 TI - Analysis of calcium transport in rat intestine. PMID- 3551535 TI - Cellular mechanisms of bone remodeling evaluated at the intermediary level of organization of bone. PMID- 3551536 TI - The local regulation of bone remodeling. PMID- 3551537 TI - High energy phosphates, phospholipids, and calcium in ischemic renal tubular cell injury. AB - Substantial data is available supporting critical roles for high energy phosphates, calcium, and phospholipids in ischemic cell injury. Although it has been proposed that one of these compounds may be most critical and defines the "final common pathway" for lethal cell injury, it is more accurate to define the pathogenesis of ischemic cell injury as the simultaneous derangement of several critical metabolic process which act in concert to produce a cascade of events that finally lead to plasma and subcellular membrane dysfunction incompatible with the maintenance of cell viability and integrity. As detailed in Figure 1, a tentative scheme is proposed interrelating high energy phosphate depletion, cellular calcium derangements, and membrane phospholipid degradation and loss. Ischemia directly leads to declines in the rate of oxidative phosphorylation due to a lack of oxygen availability. A fall in cellular ATP levels develops. Ischemia also promotes a redistribution of intracellular calcium pools and results in phospholipase activation and phospholipid degradation. When phospholipid degradation occurs concomitantly with a decline in high energy phosphate levels, phospholipid synthesis cannot keep pace with phospholipid degradation and net membrane phospholipid loss occurs. An increase in plasma membrane calcium permeability develops and the influx of calcium down its electrochemical gradient from extracellular to intracellular spaces occurs. This calcium is taken up and sequestered in mitochondria and causes further alterations in mitochondrial structure and function, leading to further declines in cellular ATP content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551538 TI - Parathyroid hormone antagonists effective in vivo. PMID- 3551540 TI - Calcium as a mediator of salt sensitive hypertension. PMID- 3551539 TI - Theoretical mechanisms of dietary calcium's antihypertensive action. AB - Theoretical mechanisms underlying dietary calcium's antihypertensive action are reviewed. Based upon known defects in the regulation of membrane Ca2+ transport and regulation of intracellular free Ca2+ concentration, we conclude that maneuvers that favorably modify calcium homeostasis such as dietary calcium supplementation or 1,25 (OH)2 vitamin D3 administration appear to favorably modify these defects. Consequent improvements in vascular smooth muscle function may mediate the reductions in blood pressure that follows chronic dietary calcium supplementation in experimental hypertension and in the clinical setting. PMID- 3551541 TI - The effect of calcium on renin, aldosterone and prostaglandin release. PMID- 3551542 TI - Dissociation between the hypotensive effect of thiazides and plasma divalent cations. PMID- 3551543 TI - Therapeutic modalities for the prevention of nephrolithiasis. PMID- 3551544 TI - Factors controlling the intracellular concentration of orthophosphate (Pi) in mammalian cells. PMID- 3551545 TI - Effects of different insulin administration modalities on vitamin D metabolism of insulin-dependent diabetic patients. PMID- 3551546 TI - Mechanisms of NAD action in regulation of renal brush border membrane transport of phosphate. PMID- 3551547 TI - Calcium, cell function and cell death. PMID- 3551548 TI - Intrarenal phosphate reabsorption: role of nephron heterogeneity. PMID- 3551550 TI - Perspectives in the teaching of human genetics. PMID- 3551549 TI - Genetics of steroid receptors and their disorders. PMID- 3551552 TI - Avicenna and his regimen of old age. PMID- 3551551 TI - A comparative study of lormetazepam and chlormethiazole in elderly in-patients. AB - Sixty-two elderly in-patients suffering from insomnia were studied in a double blind, double-dummy, placebo-controlled trial. Each group received either lormetazepam 1 mg, chlormethiazole 384 mg or placebo for 7 nights. Both lormetazepam and chlormethiazole significantly increased sleep duration, reduced sleep latency and improved quality of sleep and feelings on awakening. For both drugs, reaction times the next morning were unimpaired and there was no clinical evidence of accumulation after 7 nights continuous dosing. Lormetazepam and chlormethiazole in these doses are effective and safe hypnotics for frail elderly patients. PMID- 3551553 TI - [The diagnostic value of echography in maxillofacial surgery]. PMID- 3551554 TI - [Parotid hemangioma]. PMID- 3551555 TI - [Recognition of form in mathematic morphology, application to diagnostic echography of prostatic cancer]. PMID- 3551556 TI - [Expert management system in medical imaging]. PMID- 3551557 TI - [The role of echography in nephritic colic]. PMID- 3551558 TI - [Importance of intravenous urography in the diagnosis of tumors of the excretory tract]. PMID- 3551559 TI - [Magnetic resonance imaging of the transplanted kidney]. PMID- 3551560 TI - [The status of medical imagery in pediatric urology]. PMID- 3551561 TI - [Contribution of echography in neurologic lesions of the urinary tract]. PMID- 3551562 TI - [Respective roles of intravenous urography and echography in 1986]. PMID- 3551563 TI - [Interventional echography of the emptying of the seminal vesicles with sperm analysis in the diagnosis of male sterility]. PMID- 3551564 TI - [24 hours in the life of a urologist performing echography in 1986]. PMID- 3551565 TI - 46XX male; report of case. AB - Chromosomal studies on a prepubertal 7-year-old boy with a normal male phenotype except for undescended testes showed a 46XX normal female karyotype. An H-Y antigen assay done at the same time on peripheral blood was positive in a titer similar to that of normal male subjects. Although the microscopic findings for both testes were normal, hypergonadotropic hypogonadism was suggested from both LH-RH and hCG stimulation tests. PMID- 3551566 TI - The infant mortality and teen-age pregnancy rates among Alabamians. PMID- 3551567 TI - Retroperitoneal mass: testicular tumor. PMID- 3551568 TI - Metallic objects seen in radiographs of the maxilla and mandible. AB - A variety of metallic objects may be seen on x-ray films of the head, facial structures, neck or chest. Among them are subperiosteal and endosseous implants, used to replace missing or damaged portions of the maxilla or mandible and to anchor dental prostheses. Wires, condylar head and neck replacements, surgical clips and silver amalgam may also be seen. PMID- 3551569 TI - Assessment of coronary artery stenoses by digital subtraction angiography: a pathoanatomic validation. AB - Automated computer assessment of coronary stenoses from digital subtraction angiographic images comparing geometric and videodensitometric algorithms was performed. Digital subtraction angiograms were acquired on a 512 X 512 X 8 bit pixel matrix at 8 frames/second. Fifteen segments from nine human cadaver coronary arteries, with lesions ranging from 0% to 97%, were analyzed. Hand injections of radiopaque dye were made during the pulsatile infusion of saline solution at physiologic pressures and flows. Individual frames best demonstrating a lesion were digitally magnified and the stenosis was measured; the operator identified only the segment of interest. The artery was then injected with a rapidly hardening gel during the same rate of infusion as that used during image acquisition. Histologic sections were cut at 2 mm intervals after fixation and elastic stains applied. Photographs of the section comparable to the site determined from the angiogram were taken, and hand planimetry by a blinded investigator was performed. There was an excellent correlation between histopathology and videodensitometry (r = 0.93; p less than 0.0001). The two geometric algorithms studied also had very good correlations (r = 0.90 and 0.84) with pathology. Two experienced angiographers, despite excellent agreement with each other, had lower correlations with pathology than any of the three computer algorithms studied (r = 0.79 and 0.83, respectively), although this difference did not attain statistical significance. This in vitro model simulating in vivo conditions validates the use of automated videodensitometric and geometric computer algorithms to interpret coronary angiography and assess severity of stenosis. PMID- 3551570 TI - Doppler measurement of left atrial depressurization and mitral valve area in patients with suspected mitral stenosis: validation of a new method. AB - Atrial depressurization time measurement by Doppler ultrasound can be used to quantify stenotic mitral valve area. In this report, we present the results of a blinded trial comparing the standard Doppler method for "pressure half-time" (A) and another Doppler method we devised (B) for measurement of atrial depressurization time. Both methods were tested against valve area data from catheterization performed within 24 hours after Doppler echocardiography. Ten readers analyzed each of 10 Doppler profiles by methods A and B, in random order. After decoding, each of the 200 Doppler readings was compared to the catheterization result. Method B proved more accurate than method A by repeated measures analysis of variance (p less than 0.0001). Furthermore, method B took less than half as long to perform (p less than 0.0001). The methods presented herein provide a simple alternative means to follow the progression of mitral stenosis noninvasively and to determine optimal timing for surgery. PMID- 3551571 TI - Does transducer selection affect aortic arch velocities? AB - The hypothesis tested was that transducers of different types and shapes would produce different peak and mean ascending aortic (AAo) velocities. Additionally, we sought to determine if mean and peak velocity recorded from the descending aorta (DAo) were similar to velocities in the AAo. Twenty-eight consecutive individuals who had normal hearts were studied. AAo velocities were measured with four transducers including a nonimaging device that transmitted Doppler at right angles to the transducer handle, a 30-degree angled continuous wave transducer, an imaging transducer that transmitted Doppler in line with the transducer handle, and a second imaging transducer that sectored at 25 degrees to the transducer handle. DAo was studied with a standard in-line imaging transducer. Results showed that mean and peak AAo velocities recorded by transducers that transmitted off the axis of the transducer handle were similar, but the transducer that imaged along the transducer handle axis produced significantly lower peak and mean velocities. The problem that caused lower velocity for the on axis transducer was inability to image the area immediately posterior to the sternum to permit alignment in the azimuthal dimension. The continuous wave transducer provided a wide spectral dispersion. Mean DAo velocity was similar to mean AAo velocity, but variability was large. PMID- 3551572 TI - Peak aortic blood acceleration reflects the extent of left ventricular ischemic mass at risk. AB - Peak aortic blood velocity (Vel), peak acceleration (Acc), stroke volume (SV), and left ventricular (LV) ejection fraction (EF) have been used as noninvasive indicators of global LV performance. The purpose of this study was to determine which of these indices of LV performance relates best to the extent of LV ischemic mass at risk. Studies were performed in 24 open-chest anesthetized dogs. Acute ischemia was produced by occlusion of various levels of the left anterior descending and circumflex coronary arteries. LV ischemic mass, measured as a percent of total LV mass, was delineated by injection of Evans blue dye into the nonischemic zone. Acc and Vel were measured with continuous-wave Doppler ultrasound. EF was measured angiographically. All parameters were measured during a control period and within 6 minutes of coronary occlusion. The percent change during ischemia of each parameter relative to control (% delta) was calculated. The correlation coefficient between the percent ischemic mass at risk and % delta Acc was 0.88. It was 0.84 for % delta EF, 0.77 for % delta Vel, and 0.17 for % delta SV. These results indicate that among the various global indices of LV performance that have been used noninvasively, Acc correlates most closely with the extent of LV ischemic mass at risk. PMID- 3551574 TI - A centennial note on Waller and the first human electrocardiogram. PMID- 3551573 TI - Glucose tolerance and insulin response to glucose in nondiabetic young male survivors of myocardial infarction. AB - Intravenous and oral glucose tolerance, as well as insulin response to glucose ingestion and a glucose infusion test, were investigated in 104 male nondiabetic survivors of myocardial infarction under the age of 45 years and in 100 matched control subjects randomly selected from the general population. Reduced oral glucose tolerance and hyperinsulinemic responses to both oral glucose challenge and to a glucose infusion test were present in a substantial number of the young patients. The very low density lipoprotein triglyceride concentration tended to rise progressively with increasing severity of glucose intolerance in both patients and control subjects. The magnitude of the early insulin response during the glucose infusion test, along with the high density lipoprotein cholesterol concentration, correlated inversely and independently with degree and extent of coronary atheromatosis, whereas the low density lipoprotein cholesterol level showed a positive correlation with severity of coronary atheromatosis. The present data argue against the concept of direct atherogenic action of high plasma insulin levels. In contrast, a low and delayed early insulin response might be a marker of enhanced liability to evolution of severe diffuse coronary atheromatosis. PMID- 3551575 TI - High-dose chemotherapy. Concepts and strategies. AB - In experimental tumors, a steep dose-response curve has been demonstrated for chemosensitive malignancies. In clinical practice, increasing dose over the conventional dose results in higher responses. These observations have prompted efforts to use chemotherapy in higher doses. Initial empiricism lends itself to more rational use of high-dose chemotherapy. Strategies are based on alteration in drug schedules [e.g., high-dose cytosine arabinoside (Ara-C)], drug-to-drug interaction [e.g., high-dose methotrexate (MTX) with citrovorum rescue], and drug pharmacokinetics (e.g., regional chemotherapy). In general, increasing the dose of cytotoxic agents leads to increasing toxicity. Methods to circumvent unacceptable toxicity have been explored. Autologous bone marrow transplant is one such method that provides new avenues of therapy and has resulted in the emergence of a new spectrum of dose-limiting toxicity. Despite the improved response rate, high-dose chemotherapy has resulted in short response durations and no significant impact on the survival of cancer patients as yet. The greater benefit of such a modality may be in the consolidation of drug-sensitive tumors (e.g., lymphoma and small cell carcinoma) with minimal residual disease after minimal conventional therapy. We review various factors and concepts as they relate to the current use of high-dose chemotherapy. We conclude that drug resistance is multifactorial, and one variable that can be manipulated by clinicians is drug dose. The drug concentration appears crucial in enhancing cytotoxicity. All frontiers examining this approach in clinical practice deserve continued enthusiasm and cautious exploration while other factors are being fully understood and exploited. PMID- 3551576 TI - CBDCA: phase II evaluation in advanced colorectal carcinoma. AB - Carboplatin (CBDCA) (NSC-241240) was administered to 25 consecutive patients with measurable colorectal carcinomas. Twenty-four patients were previously untreated, with a median performance status of 80. The dose schedule was 400 mg/m2 every 28 days and was escalated to 450 mg/m2 if no side effects or grade I toxicities occurred. All patients are assessable for toxicity and response. No complete response was observed; one partial response, lasting 23 weeks, was noted. Toxicity was primarily hematological. Neither auditory nor renal toxicities were observed. CBDCA administered in the above schedule has little therapeutic efficacy in previously untreated colorectal carcinoma patients. PMID- 3551577 TI - A randomized study of two schedules of copovithane in patients with advanced colorectal carcinoma. AB - Copovithane (BAY i 7433), a copolymer of 1,3-bis(methylaminocarboxyl)-2 methylenepropanecarbamate and N-vinyl pyrrolidone, has antitumor activity in vitro and in vivo. The mechanism of this polymer is unknown. Thirty patients with advanced colorectal carcinoma with measurable tumors were treated in an open randomized study with two schedules of copovithane (schedule A: 6 g/m2 i.v. over 30 min daily for 5 consecutive days and repeated every 3 weeks; schedule B: 10 g/m2 i.v. over 30 min once a week until progression, unacceptable toxicity, or up to 18 months). Fifteen patients received copovithane on a weekly schedule, and 15 patients received it on an intermittent schedule. None of the patients on either schedule achieved a complete or partial remission. Copovithane was ineffective against colorectal carcinoma by both schedules selected in this study. PMID- 3551579 TI - Mixed dentition treatment case report. AB - Malocclusions can be successfully treated in the mixed dentition (Phase I), which can usually significantly reduce the need for comprehensive orthodontic treatment in the permanent dentition. Phase I of orthodontic treatment is designed to correct the skeletal and dental malocclusions at an early age. Treatment usually lasts for 12 to 20 months. Following Phase I treatment, there is a supervision phase of 18 to 30 months in which to hold the correction achieved during early treatment while supervising the eruption of the remaining permanent teeth. If a second phase of orthodontic treatment is required, the treatment time is usually limited to 6 to 18 months, depending on the malocclusion, growth direction, and increments. Treatment time for the patient in this report was extended primarily because of the teaching clinic environment. At the University of the Pacific, we have observed that Phase I of orthodontic treatment produces a more stable long term orthodontic result, reduces the need for premolar extractions, creates less temporomandibular joint problems at a later age, and achieves a better profile balance. PMID- 3551578 TI - The maxillary sagittal appliance: a clinical study. AB - A clinical review of the maxillary sagittal appliance is presented. The appliance is an active plate with expansion screws in the anteroposterior direction, hence the name. It is used to advance the maxillary incisors and to distalize the maxillary molars, thereby increasing arch length. No control or reference group was used. The maxillary incisors were advanced approximately 2 mm and the inclination was increased approximately 8 degrees. Cephalometrically, the maxillary molars were not distalized, possibly because no second molars were extracted. A minor advancement was noted at A point and the upper lip was advanced 1.4 mm. Very little change was noted in the mandibular dentition or mandibular skeletal measurements except for the overall mandibular length, which increased 3.00 mm during the 7.4 months of average treatment time. The lower anterior facial height increased 2.85 mm, which was more than expected and many contraindicate the appliance in long-faced patients. The appliance is easy to manage clinically and provides another appliance that may be used to decompensate the maxillary teeth before functional jaw orthodpedic (FJO) therapy or fixed therapy in Class II, Division 1 or Class II, Division 2 patients with a flat or recessive upper lip. PMID- 3551580 TI - "Mr. ABO", Dr. Earl E. Shepard--a special tribute. PMID- 3551581 TI - Use of rapid group A strep throat screening tests. PMID- 3551582 TI - Sonography of the normal, prepubertal, and polycystic ovary: potential diagnostic pitfall. PMID- 3551583 TI - Radiological case of the month. Postasphyxial total cerebral necrosis: ultrasonographic diagnosis. PMID- 3551584 TI - Campylobacter pyloridis gastritis: the past, the present, and speculations about the future. AB - Campylobacter pyloridis infection of the stomach has been associated with gastric ulcer, duodenal ulcer, nonulcer dyspepsia, and gastritis. The etiological role of C. pyloridis in most of those conditions remains unclear. We reviewed what is known about C. pyloridis infections in man. Considerable clinical data on C. pyloridis infections was available in older literature concerning gastritis and gastric urease. C. pyloridis causes a form of type B gastritis. In some individuals the acute infection is associated with abdominal pain and transient hypochlorhydria. C. pyloridis infection is difficult to eradicate with current therapies. The mechanisms by which C. pyloridis infection may lead to development of peptic ulcers, nonulcer dyspepsia, or atrophic gastritis are discussed. Recent technological advances, such as the 13C-urea breath test, provide rapid noninvasive methods of identifying active C. pyloridis infection. These methods will permit the rapid execution of definitive investigations of the epidemiology, transmission patterns, and possible reservoirs of C. pyloridis infection and will delineate the spectrum of C. pyloridis-associated disorders. PMID- 3551585 TI - Intramural duodenal hematoma: an unusual complication of endoscopic small bowel biopsy. AB - We report a case of intestinal obstruction secondary to intramural duodenal hematoma after endoscopic small bowel biopsy. Review of the literature indicates that intramural duodenal hematoma occurs mainly in infants and children after trauma to the abdomen. The diagnosis can be made by upper gastrointestinal series and confirmed by computerized axial tomography of the abdomen. Conservative management in the form of nasogastric suction and total parenteral nutrition resulted in amelioration of obstructive symptoms within 10 days. Physicians should be alerted to the possibility of developing intramural duodenal hematoma after small bowel biopsy. This is the first report of such an unusual complication after endoscopic small bowel biopsy in children. PMID- 3551586 TI - Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment. AB - A middle-aged man presented with diarrhea, fever, and leukocytosis 7 days after discontinuation of clindamycin therapy for a urinary tract infection. Proctosigmoidoscopy showed adherent, raised plaques studding the bowel wall consistent with antibiotic-associated pseudomembranous colitis. Vancomycin therapy was begun, but progressive abdominal distension, nausea, vomiting, and loss of bowel sounds occurred. Serial abdominal radiographs demonstrated colonic wall edema without dilatation. Subtotal colectomy was performed and resulted in complete resolution of symptoms. PMID- 3551587 TI - Do pressurized bronchodilator aerosols cause death among asthmatics? PMID- 3551588 TI - Interpretation and choice of effect measures in epidemiologic analyses. PMID- 3551589 TI - Regression toward the mean in a two-stage selection program. II. Correlated within-subject observations. AB - A model for a two-stage selection program based upon normally distributed variables is examined. The within-subject variation is described by a stationary first-order autoregressive process. The expected regression toward the mean and the mean and variance of the distribution of retained subjects are given as functions of the classification points in each stage, the number of observations, the autocorrelation coefficient, and the time interval between observations. Because the time interval between observations affects the within-subject correlation, this interval must be considered in designing selection programs. If high autocorrelation is present, an investigator should space the observations more widely to decrease the correlation and thereby obtain more information from a given number of observations. PMID- 3551590 TI - Predictive value of enzyme-linked immunoassay platelet crossmatching for transfusion of platelet concentrates to alloimmunized recipients. AB - Some evidence has shown that platelet crossmatching is useful in multitransfused patients with hypoplastic bone marrows who are refractory to platelet therapy through alloimmunization. Several immunoglobulin binding assays other than enzyme linked immunospecific assay (ELISA) have been studied previously. We performed 51 ELISA crossmatches on six patients receiving single donor platelets. One bone marrow transplant patient receiving 33 single donor HLA matched (related and unrelated) was also studied. Effectiveness of transfusion was closely monitored by patient evaluation and corrected platelet count increment (CCI) at 1-2 and 18 24 hours posttransfusion. We found the ELISA method very sensitive, specific, and predictive, 85, 96, and 95.6% respectively in the 51 crossmatches studied in six patients with either leukemia, solid tumors, or aplastic anemia. However, variation existed among individual recipients, with sensitivity ranging from 70 100%. The distribution of true positives and negatives and false positives and negatives in the 33 crossmatches performed in the bone marrow transplant patient differed significantly (chi 2 = 101.2; P less than 0.001) from single donor recipients. The specificity in the 51 crossmatches on the six patients was also significantly different from the 33 crossmatches performed in the bone marrow transplant (96 vs 74%). This suggests individual variation occurs as well as differences in diseases and bone marrow suppressive agents affecting platelet crossmatching. PMID- 3551591 TI - Screening for sickle cell trait: the Veterans Administration National Sickle Cell Program. AB - Results of the Veterans Administration Sickle Cell Program for a period of 10 years are presented. We screened 370,250 patients; 404,341 attended educational sessions, and 38,347 had individual counseling sessions. Sickle cell trait was present in 6.4% of patients, and HbC trait was present in 1.8%. The clinically significant disorders HbSC disease, sickle cell anemia, and sickle beta thalassemia were present in 0.41% of individuals screened. A large number of uncommon variants were detected. The program enhanced the awareness of and the approach to evaluation of hemoglobinopathies. PMID- 3551592 TI - Nutrition and sickle cell disease. AB - The role of protein and calorie deficiency in sickle cell disease remains poorly defined. While such features as growth retardation, impaired immune function, and delayed menarche do suggest a relationship between sickle cell disease and undernutrition, measurement of more direct nutritional parameters in these patients have yielded mixed results. Anthropometric measurements such as skinfold thickness are subnormal in many but not all reports. Serum protein levels are normal, but low values for serum lipids have been reported. Finally, one small study shows an improvement in both growth parameters and clinical course following caloric supplementation. A variety of micronutrient deficiencies have been suggested in sickle cell disease. Numerous case reports describing an exacerbation of the chronic anemia that was reversed by folic acid therapy led to routine folate supplementation. More recent studies have shown, however, that clinically significant folic acid deficiency occurs only in a small minority of sickle cell patients. Clearly, more work is necessary to define the cost/benefit ratio of routine folic acid supplementation. Pharmacological amounts of vitamin B6 and certain of its derivatives possess in vitro antisickling activities. Nevertheless, a small clinical trial failed to demonstrate any consistent hematologic effects of B6 supplementation. Several reports indicate that vitamin E levels are low in sickle erythrocytes. Since these abnormal red cells both generate excessive oxidation products and are more sensitive to oxidant stress, and because oxidants appear to play a role in ISC formation, vitamin E deficiency could well be linked to ISC formation and hemolysis. Small clinical trials, however, have again failed to produce a clear hematological response in sickle cell anemia. The role of zinc in sickle cell disease has received considerable attention. Though studies are generally small, most do support a relationship between sickle cell disease and zinc deficiency. Etiologic associations between zinc deficiency and such complications of sickle cell disease as poor ulcer healing, growth retardation, delays in sexual development, immune deficiencies, and high ISC counts have all been suggested. Most of these studies need further corroboration. Iron deficiency is now known to be a relatively common occurrence in sickle cell anemia, especially in children and pregnant women. The theoretical benefits of concomitant iron deficiency and sickle cell anemia remain to be proven in a controlled clinical trial.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3551594 TI - Technologic innovation. PMID- 3551595 TI - Pharmacist participation in the management of incidents involving hazardous materials. AB - The role of the pharmacist as a hazardous materials consultant is described. Pharmacists in a university-affiliated teaching hospital are contacted by either emergency medical services or the emergency department to assist in the management of incidents involving toxic hazardous materials. These incidents can range from major chemical spills or leaks to long-term exposures involving generalized, nonspecific symptoms. An advanced pharmacy resident in emergency medicine is the primary pharmacy contact for hazardous materials consults. The services provided by the clinical pharmacist include identification of the hazardous materials involved, initiation of special precautions for rescue-squad and hospital-based personnel, clinical assessment of the toxicologic problem, and formulation of therapeutic recommendations. Teaching programs have been developed for pharmacy, nursing, and medical students, hospital employees, and emergency response agencies. Pharmacy participation in the management of hazardous materials incidents has been well received by emergency department physicians and nurses, as well as by rescue personnel. During the period between January 1 and July 1, 1986, the pharmacy was consulted on 66 hazardous materials incidents. Since pharmacists have traditionally been used as information resources for clinical toxicology questions, it follows that their participation can extend into the field of environmental toxicology, specifically involving hazardous materials. The pharmacist's input as a hazardous materials consultant in our institution has been well received, and we believe that pharmacy departments can play an important role in the management of incidents involving hazardous materials. PMID- 3551593 TI - Role of replication time in the control of tissue-specific gene expression. AB - Late-replicating chromatin in vertebrates is repressed. Housekeeping (constitutively active) genes always replicate early and are in the early replicating R-bands. Tissue-specific genes are usually in the late-replicating G bands and therein almost always replicate late. Within the G-bands, however, a tissue-specific gene does replicate early in those cell types that express that particular gene. While the condition of late replication may simply be coincident with gene repression, we review evidence suggesting that late replication may actively determine repression. As mammals utilize a developmental program to Lyonize (facultatively heterochromatinize) whole X chromosomes to a late replicating and somatically heritable repressed state, similarly another program seems to Lyonize individual replicons. In frogs, all genes begin embryogenesis by replicating during a very short interval. As the developmental potency of embryonic cells becomes restricted, late-replicating DNA gradually appears. This addition to the repertoire of gene control--i.e., repression via Lyonization of individual replicons--seems to have evolved in vertebrates with G-bands being a manifestation of the mechanism. PMID- 3551596 TI - Modified enzyme immunoassays for tobramycin using reduced sample and reagent volumes. AB - The accuracy of two modified enzyme immunoassay (EMIT) methods using reduced sample and reagent volumes for determining serum tobramycin concentrations was compared with that of the standard method. The modified EMIT assays used sample and reagent volumes of 25 and 30 microL instead of the standard 50-microL volumes. Solutions of tobramycin sulfate with known concentrations of 1, 2, 4, 8, and 12 mg/L were assayed five times using each of the three methods. Fourteen blood samples containing unknown concentrations of tobramycin were obtained from patients over a four-week period and assayed once by each method. The mean percentage recovery of tobramycin using the standard 50-microL sample-volume method (104.4 +/- 8.8%) was not significantly different from that of the 30 microL (106.6 +/- 9.9%) or the 25-microL (100.4 +/- 11.4%) assay method. There was good correlation between the standard method and the 25-microL (r = 0.993) and the 30-microL (r = 0.988) methods for determining unknown tobramycin concentrations. If the 25- and 30-microL assays were used in place of the standard 50-microL assay, costs would be reduced and the number of assays per kit would increase. The 30-microL and 25-microL sample and reagent volumes used in this study for the tobramycin EMIT assay allow substantial cost savings without a significant loss in accuracy. PMID- 3551597 TI - Organizational approach to implementing bar-code technology in a university hospital. PMID- 3551598 TI - Report from the war zone. PMID- 3551599 TI - Diuretics and potassium/magnesium depletion. Directions for treatment. AB - The effects of diuretics on renal handling of potassium and magnesium can result in depletion of these electrolytes. Associations between these deficits and the occurrence of increased ventricular ectopy raise the issue of potential relationships to increased risk of sudden unexpected death in hypertensive patients taking diuretics, especially patients with electrocardiographic and electrolyte abnormalities. Review of diuretic effects on the kidneys provides evidence that diuretic regimens that conserve potassium also conserve magnesium, and suggests the important role of these agents in protecting against potassium and magnesium abnormalities. PMID- 3551600 TI - Sodium intake, high blood pressure, and calcium channel blockers. AB - Although there is much circumstantial and some direct clinical evidence suggesting that a high consumption of salt predisposes patients to the development of essential hypertension, the mechanism by which such consumption causes high blood pressure is not clear. It has been suggested that due to an inherited abnormality in renal sodium excretion, high salt intake triggers an increase in the levels of sodium transport inhibitor. Although this may help to restore sodium balance, it may also increase the concentration of intracellular sodium in arteriolar smooth muscle and, thereby, stimulate smooth muscle reactivity. It has been shown that intra-arterial infusion of calcium channel blockers into the forearm produces an enhancement of forearm blood flow that is proportional to the degree of hypertension. Other studies have demonstrated a linear relationship between the degree of hypertension and the magnitude of blood pressure reduction following treatment with a calcium channel blocker. These clinical findings, combined with evidence from studies in animals, suggest that a functionally abnormal response of smooth muscle cells to calcium channel blockers occurs as blood pressure increases. Whether this functional abnormality is related to an increased level of intracellular calcium and/or inhibition of the sodium pump is not known. The short-term blood pressure lowering effect of nifedipine appears to be enhanced when sodium intake is increased. PMID- 3551601 TI - Calcium channel blockers and atherogenesis. AB - The events involved in atherogenesis include platelet deposition on damaged endothelial surfaces; migration and proliferation of smooth muscle cells; the formation of elastin, collagen, and glycosaminoglycans, followed by the penetration and complexing of lipoproteins; and, calcification. Since calcium is involved in these and other events, considerable data exist on the effects of altering calcium influx in experimental atherosclerosis. Interventions that increase calcium deposition tend to increase the severity of experimental atherosclerosis, whereas interventions that reduce calcium entry into cells tend to reduce its progression. Using rabbits, researchers have recently focused on the ability of calcium channel blockers, such as nifedipine, verapamil, and diltiazem, to attenuate the development of experimental atherosclerosis. Studies also suggest that although calcium channel blockers may protect against the development of experimental atherosclerosis, they are less effective in inducing its regression. Further, studies with calcium channel blockers in rabbits deficient in low-density lipoprotein receptors did not show protection against the development of atherosclerosis. However, no clinical studies are yet available to judge the potential protective effects of calcium channel blockers in humans. Since many patients are now receiving long-term calcium blocker therapy for hypertension, these findings may be relevant in the selection of antihypertensive therapy, provided that protective effects can be demonstrated. PMID- 3551602 TI - Comparison of nifedipine and propranolol used in combination with diuretics for the treatment of hypertension. AB - One hundred patients participated in a double-blind, randomized study to compare the antihypertensive efficacy of sustained-release nifedipine and propranolol in hypertensive patients whose diastolic blood pressure exceeded 95 mm Hg while receiving diuretic therapy. Nifedipine (mean dose, 79.6 mg per day) decreased blood pressure by 11.4/10.5 mm Hg; propranolol (mean dose, 198.4 mg per day) decreased blood pressure by 13.5/10.3 mm Hg. Reduction of diastolic blood pressure to below 90 mm Hg was achieved in 63 percent of nifedipine-treated patients and in 57 percent of propranolol-treated patients. Nifedipine therapy was associated with an increase in high-density lipoprotein cholesterol levels and a decrease in serum triglyceride levels. In contrast, propranolol therapy was associated with a decrease in high-density lipoprotein cholesterol levels and an increase in serum triglyceride levels. Nifedipine is as effective as propranolol in the treatment of patients with mild to moderate hypertension whose blood pressure is inadequately controlled by diuretic therapy. PMID- 3551603 TI - Calcium and vascular smooth muscle tone. AB - Recent technologic advances have improved the monitoring of intracellular ionized calcium concentrations ([Ca2+]i) in living vascular smooth muscle cells. The changes in cytoplasmic ionized calcium concentrations ([Ca2+]) that occur during a contraction-relaxation cycle of vascular smooth muscle are reviewed, as is recent evidence indicating that vascular smooth muscle tone can be increased by increasing the sensitivity of the contractile apparatus to calcium without a necessary change in [Ca2+]i levels. Data obtained using intracellular calcium indicators suggest that agonists that produce similar force profiles often produce very different profiles in [Ca2+]i. The amount of force produced at a specific level of [Ca2+]i is a variable of intact vascular smooth muscle, i.e., some agonists produce sizable tonic contractions with little elevation of cytoplasmic [Ca2+], whereas other agonists require much larger increases in cytoplasmic [Ca2+] to produce comparable increases in tone. These data also indicate that very small changes in [Ca2+]i can cause large changes in vascular tone. Designing therapeutic agents that would decrease [Ca2+]i or decrease the sensitivity of the contractile apparatus to ionized calcium would directly decrease intrinsic myogenic tone. Although a causative role for abnormal [Ca2+]i in the etiology of hypertension is controversial, it is obvious that a decrease in these levels in the vascular smooth muscle cell could be therapeutically beneficial. PMID- 3551605 TI - Aging, long-distance running, and the development of musculoskeletal disability. A controlled study. AB - Four hundred ninety-eight long-distance runners aged 50 to 72 years were compared with 365 community control subjects to examine associations of repetitive, long term physical impact (running) with musculoskeletal disability and medical service utilization in a cross-section study. Runners had less physical disability than age-matched control subjects (p less than 0.01) and maintained more functional capacity (p less than 0.001) as measured by a modified Health Assessment Questionnaire Disability Index. Runners sought medical services less often, but one third of the visits that they did make were for running-related injuries. No differences were found between groups in conditions thought to predispose to osteoarthritis and musculoskeletal disability. Ligamentous laxity and family history of arthritis were similar in both groups. Runners demonstrated better cardiovascular fitness and weighed less. Differences persisted after adjustment for age, occupation, and sex, and after inclusion or exclusion of subjects with major medical problems. Musculoskeletal disability appeared to develop with age at a lower rate in runners (0.003 units per year versus 0.028) than in community control subjects, and the decreased rate was observed with both lower extremity and upper extremity functions. These data suggest positive effects of systematic aerobic running activity upon functional aspects of musculoskeletal aging. PMID- 3551604 TI - Improved survival with coronary bypass surgery in patients with three-vessel coronary disease and abnormal left ventricular function. Matched case-control study in patients with potentially operable disease. AB - Recent studies have suggested that patients with three-vessel coronary disease and abnormal left ventricular function have better survival rates with bypass surgery than with medical therapy alone. Case-control studies may give accurate survival estimates, but to be valid, selection biases must be taken into account. A matched case-control method was used to compare survival patterns in patients treated medically or surgically during the 1980s. Fifty medical patients with potentially operable coronary disease and 46 surgical patients were matched for significant three-vessel disease and abnormal ventricular function. These two groups had no significant differences with regard to 24 variables, including age (64 +/- 8 versus 63 +/- 10 years), chest pain class, congestive heart failure signs, ejection fraction (36 +/- 8 versus 37 +/- 9 percent), segmental wall score, or a coronary score evaluating lesion site and severity. There were slight differences between the two groups with regard to congestive heart failure symptoms (p = 0.04). Patients undergoing bypass surgery had improved four-year survival rates compared with the medical group (89 versus 55 percent; p = 0.01). Thus, this study used an effective case-control method to suggest that, in the 1980s, coronary surgery improves prognosis substantially in surgically approachable patients with severe coronary disease and ventricular dysfunction. PMID- 3551606 TI - Severe flare of rheumatoid arthritis after discontinuation of long-term methotrexate therapy. Double-blind study. AB - To determine if long-term methotrexate-induced improvement of rheumatoid arthritis is sustained after the drug is discontinued, 10 unselected patients with responses to weekly oral methotrexate given for at least 36 months (mean 40.1) were randomly assigned to receive methotrexate or identical-appearing placebo tablets for two months. After one month, all five patients receiving placebo had to have the study terminated due to a flare of their disease manifested by statistically significant deterioration in multiple clinical parameters. It is concluded that patients receiving long-term methotrexate must continue the drug to maintain clinical benefits. PMID- 3551607 TI - Surgery for addiction-related tricuspid valve endocarditis: caveat emptor. PMID- 3551608 TI - Update on methylxanthine therapy. PMID- 3551610 TI - The reno-hepatic axis of blood pressure control: further studies. AB - A reno-hepatic axis of blood pressure (BP) control has been proposed primarily by two developments: the lag period between the injection of the antihypertensive neutral renomedullary lipid (ANRL) into the vena cava and the beginning of the drop of the BP is significantly reduced by injection of this lipid into the portal vein; and a reno-portal shunt (RPS) accelerates markedly the drop of the BP following unclipping the Goldblatt hypertensive rat. In the present studies, three maneuvers were performed: perfusion of the isolated, blood-drained rat liver with plasma containing ANRL and delivery of the plasma into the jugular vein of a hypertensive rat; injection of captopril, establishment of a RPS of a hypertensive rat (one-kidney, one-clip) followed by unclipping; and establishment of a RPS in a normal rat. The blood-drained liver was capable of decreasing significantly the lag period of ANRL. Captopril did not potentiate the antihypertensive action of the kidney when RPS was coupled with unclipping. Following the RPS, the BP of the normal rat dropped modestly over a 3-hour period. These results further support the concept of reno-hepatic axis of BP control. PMID- 3551609 TI - Transferrin-mediated cellular iron uptake. AB - The basic model for cellular uptake of iron relies on the iron-chelating protein transferrin (Tf), which is capable of binding iron under one set of conditions and releasing it under another set of conditions. Tf has specific membrane receptors on the surface of the cells that require iron. Tf-receptor binding is followed by internalization through a system of coated pits and vesicles. The rapid decline of pH of these vesicles leads to release and sequestration of iron by the cell. Apotransferrin-receptor complex returns to the cell surface, where, under neutral pH conditions, apotransferrin is dissociated. Other models for cellular uptake of iron include extraction of iron from Tf on the cell surface without internalization, uptake by adsorptive mechanism, and fluid-phase endocytosis. Recent advances in cellular and molecular biology, gene cloning, and monoclonal antibody technique have elucidated many features of these processes at a molecular level. These advances are reviewed and prospects for future work discussed. PMID- 3551611 TI - Neural tube defects and sex ratios. AB - The sex ratio of 147 fetuses with presumed multifactorial neural tube defect (NTD) was studied. Overall, the ratio (males:females) was 0.73 with expected female excess. However, when the NTDs were subdivided according to the site of the lesion, the sex ratios varied. Total craniorachischisis, anencephaly with cervical spina bifida, holoacrania, and thoracic spina bifida showed a greater female excess than that overall; the sex ratio for meroacrania was close to unity, while that for low spinal lesions, particularly those involving the sacrum, showed an extreme bias towards males. These findings are related to the mode of formation of the neural tube. Females seem prone to defects of neurulation and males to defects in canalization. An explanation for these findings is suggested in possible sex differences in rate of early embryonic development. PMID- 3551612 TI - Phosphate retention and the genesis of secondary hyperparathyroidism. PMID- 3551613 TI - Ultrastructural study of gaps of the glomerular basement membrane in IgA nephropathy. AB - Renal biopsy specimens from 163 patients with IgA nephropathy were examined by electron microscopy to clarify the significance of gaps of the glomerular basement membrane (GBM) in IgA nephropathy. Gaps of the GBM were observed in 21 cases. In 1 case the capillary lumen was partially filled with fibrin-like materials, basement membrane-like materials, and epithelial cells, and in 6 cases wide gaps of the GBM were observed. In 10 cases the gaps of the GBM were covered by epithelial and/or endothelial cells, and in 4 cases spherical microparticles were seen at the gaps of the GBM. Microscopic hematuria of less than 5 red blood cells per high-power field of vision at the time of biopsy was less frequently observed in patients with gaps of the GBM than in patients without (p less than 0.05). Marked local thinning or splitting of the GBM and electron-dense deposits or spherical microparticles on peripheral capillary walls were more frequently observed in patients with gaps of the GBM than in those without (p less than 0.001, less than 0.005, less than 0.05, and less than 0.001, respectively). PMID- 3551614 TI - Comparing Moi-Stir to lemon-glycerin swabs. PMID- 3551615 TI - Wrapping software inside learning packages. PMID- 3551616 TI - 1987 Directory of Nursing Organizations. PMID- 3551617 TI - Effectiveness of ketorolac tromethamine 0.5% ophthalmic solution for chronic aphakic and pseudophakic cystoid macular edema. AB - The effect of ketorolac tromethamine 0.5% ophthalmic solution (a new nonsteroidal anti-inflammatory agent) treatment was compared to placebo treatment in patients with chronic, angiographically proven aphakic or pseudophakic cystoid macular edema (visual acuity less than or equal to 20/40 for six months) during a three- to four-month double-masked, randomized study. Twenty-six patients completed this study without significant ocular or systemic toxicity. The improved distance visual acuity observed in the ketorolac treatment group (8/13 patients) was statistically different from the improved vision observed in the placebo treated group (1/13 patients) (P = .005). No patient on a regimen of ketorolac therapy had a significant decrease in Snellen distance visual acuity while on treatment, but two patients in the placebo group demonstrated a decrease in visual acuity of two lines or more. Fluorescein angiography was consistent with changes in visual acuity. PMID- 3551618 TI - Management of increased intraocular pressure after cataract extraction. AB - We measured the change in intraocular pressure prospectively after extracapsular cataract extraction in 80 eyes after treatment with either pilocarpine gel, pilocarpine 4% solution, timolol 0.5% solution, or placebo. Intraocular pressure, pupil size, and anterior chamber cellular reaction were measured in a masked fashion on the first day after surgery. A significant increase in intraocular pressure was found in all groups postoperatively when compared with baseline values (P less than .001). Eyes treated with pilocarpine gel had an average intraocular pressure increase of 4.2 +/- 2.1 mm Hg (mean +/- 1 S.E.), eyes treated with pilocarpine 4% eyedrops had an average increase of 9.8 +/- 2.8 mm Hg, and eyes treated with timolol demonstrated an intraocular pressure increase of 8.25 +/- 3.19. The intraocular pressure in untreated eyes (controls) increased by an average of 12.9 +/- 2.7 mm Hg. Only the difference in intraocular pressure change between the eyes treated with pilocarpine gel and control eyes was statistically significant (P = .025). Postsurgical intraocular pressure exceeding 25 mm Hg was observed in three of 20 pilocarpine gel treated eyes (15%) and 11 of 20 control eyes (55%). Pilocarpine treatment was not associated with noticeable changes in intraocular inflammatory response, nor were significant ocular or systemic adverse reactions observed. A single administration of pilocarpine gel is effective in reducing increased intraocular pressure for the first 24 hours after extracapsular cataract extraction. PMID- 3551620 TI - Mycobacterium chelonae keratitis. PMID- 3551619 TI - Long-term results of scleral reinforcement surgery. AB - Of 40 scleral reinforcement operations for progressive severe myopia, 23 patients were followed up for a minimum of five years. Ten of 23 patients showed an essentially stable postoperative course (43%) while 13 (57%) had increases in myopia of -1.0 diopter or more. Among the operated on eyes, 17 of 23 eventually had some increase in myopia. Of the 20 eyes that had preoperative axial measurements, 18 (90%) had increases in axial diameter of 0.3 mm or more. There were complications in six of the 40 eyes, including anterior uveitis, motility disorders, and retinal detachment. Progression of posterior staphyloma formation or the onset of myopic fundus degeneration was observed in ten eyes. Two problems with this surgery are the limited scleral area reinforced by narrow grafts and the possible late involvement of graft collagen in the disease process of host sclera. PMID- 3551621 TI - The efficacy of the ROM Dance Program for adults with rheumatoid arthritis. AB - This study examined the efficacy of an exercise and relaxation program for adults with rheumatoid arthritis. The program integrates principles of occupational therapy and T'ai-Chi Ch'uan and was expected to be more effective than traditional exercise and rest regimens because of its expressive and pleasurable elements. There were significant differences between 17 experimental and 16 control subjects on two categories of dependent variables after the former group's participation in the experimental program. These dependent variables were range of motion measures and subject self-reports of frequency, enjoyment, and benefits of home exercise and rest routines. Pretest, posttest, and 4-month follow-up data were analyzed. Program participants showed significantly greater upper extremity range of motion 4 months after completing the program although the reported frequency of exercise and rest was greater in the control group. Postprogram reports of enjoyment were significantly higher for experimental than for control subjects. If these initial results are confirmed in further studies, the efficacy of the use of purposeful activity for exercise and rest will be supported. This study also supports the integration of Eastern and Western frames of reference in the treatment of patients with chronic illness. PMID- 3551624 TI - Portrait of an artist with deafness and tinnitus: George Catlin. PMID- 3551622 TI - Genetically mast-cell-deficient W/Wv and Sl/Sld mice. Their value for the analysis of the roles of mast cells in biologic responses in vivo. PMID- 3551623 TI - Development of plasmacytoid cells with Russell bodies in autoimmune "viable motheaten" mice. AB - Mice homozygous for the autosomal recessive mutation "viable motheaten" (mev) are severely immunodeficient, show polyclonal B-cell activation, and express multiple autoantibodies over a maximum life span of 25 weeks. Lymphoid tissues from these mice contain large numbers of atypical plasma cells in which discrete glycoprotein inclusions are found within the endoplasmic reticulum. Such plasma cells are termed "Mott cells," and the inclusions are called "Russell bodies." Dense accumulations of Mott cells are present in the marginal zones of the spleen and in the lymph nodes of mev/mev mice. Russell bodies in Mott cells from mev/mev mice contain immunoglobulin (Ig) as shown by immunofluorescence microscopy at the light-microscopic level and by indirect protein A-immunogold localization at the electron-microscopic level. Ultrastructural analyses reveal the presence of amorphous, lamellar, and crystalline Russell bodies. These Ig crystals have a periodicity of 150-190 A. Lymph node cell preparations which were enriched in Mott cells by velocity sedimentation failed to secrete Ig in a polyclonal reverse plaque assay. An obligate role of the thymus in Mott cell development is evidenced by the absence of Mott cells in neonatally thymectomized mev/mev mice and in mice doubly homozygous for the nude (nu) and mev mutations. These data suggest that Mott cells in mev/mev mice are thymic-dependent plasmacytoid cells resulting from chronic B-cell activation accompanied by impaired Ig secretion. PMID- 3551625 TI - Insulin action on electrophysiological properties of apical and basolateral membranes of frog skin. AB - We measured the effects of insulin on the current-voltage (I-V) relations of frog skins impaled with an intracellular microelectrode. The current across the cell membranes was assumed to be equal to the amiloride-inhibitable current. Insulin increased short-circuit current (Isc) approximately 40% from the control value. The increase in Isc was associated with a depolarization of the cell membrane. In addition there was an increase in the value of the parameters that describe the ease of movement of Na+ across the apical membrane, namely, slope conductance (ga), chord conductance (Ga), and permeability (PNa). The values of these parameters show remarkable linear correlations with membrane current both before and after stimulation. Intracellular Na+ activity (acNa) was determined from the I-V relations of the apical membrane. Insulin did not significantly modify acNa. Insulin also increased the value of the basolateral membrane conductance, however, the relationship between this parameter and current was complex. These experiments show that the stimulatory effect of insulin on Isc is associated with an increase in the conductance of both the apical and basolateral membranes. PMID- 3551627 TI - Deprivation of corticosterone does not prevent onset of obesity in Zucker fa/fa pups. AB - Adrenalectomy has been shown to reduce the development of obesity in adult Zucker fatty rat. In this study, we examined whether adrenalectomy could prevent the emergence of obesity and correct any of the first abnormalities to develop in fa/fa pups. Four-day-old Zucker pups were adrenalectomized and fed by adrenalectomized wet nurses until 11 days of age. The frequency distribution curves of fat cell volume clustered in two groups as they do in control litters, providing evidence that two phenotypes were present. Oxygen consumption measured at 8 days of age was significantly lower in fa/fa than in Fa/fa. Adrenalectomy did not restore the decreased oxygen consumption of fa/fa. In control litters, the GDP binding to brown adipose tissue mitochondria was twofold lower, whereas fatty acid synthase activity of this tissue was significantly increased in fa/fa pups. In inguinal adipose tissue of fa/fa pups, fatty acid synthase, and lipoprotein lipase activities were twice as active as in the tissue of lean pups. In adrenalectomized fa/fa pups, none of these metabolic abnormalities was corrected. The results demonstrate that adrenalectomy early in life did not prevent the emergence of obesity in suckling fa/fa rats. PMID- 3551626 TI - Effect of insulin and glucocorticoids on glucose transporters in rat adipocytes. AB - The ability of glucocorticoids to modify the effect of insulin on glucose transport was investigated in both intact isolated rat adipocytes and in membranes isolated from hormone-treated adipocytes. In intact adipocytes, dexamethasone, a potent synthetic glucocorticoid, inhibited insulin-stimulated 3 O-methylglucose transport at all concentrations of insulin tested (0-2,000 microU/ml). Insulin sensitivity, as well as the maximal response to insulin, was decreased by dexamethasone in the absence of a change in insulin binding. The inhibition was observed regardless of which hormone acted first, was blocked by actinomycin D, and resulted from a decrease in Vmax rather than an increase in Kt of transport. In plasma membranes isolated from insulin-treated adipocytes, glucose transport activity and the amount of glucose transporter covalently labeled with [3H]cytochalasin B were increased in parallel in a dose-dependent fashion. The amount of labeled transporter in a low-density microsomal fraction (LDMF) was decreased in a reciprocal fashion. In contrast, addition of dexamethasone to insulin-stimulated cells caused decreases in both transport activity and amount of labeled transporter in the plasma membranes. This was accompanied by a small increase in the amount of [3H]cytochalasin B incorporated into the glucose transporter in the LDMF. These results are consistent with both insulin and glucocorticoids altering the distribution of glucose transporters between the plasma membrane and LDMF, in opposite directions. PMID- 3551628 TI - Effect of insulin on osmoregulation of vasopressin. AB - Patients with uncontrolled insulin-dependent diabetes mellitus have elevations in plasma vasopressin that cannot be completely accounted for by recognized stimuli. To determine whether insulin deficiency per se increases plasma vasopressin, we investigated the effect of acute insulin depletion on the osmoregulation of plasma vasopressin in insulin-dependent diabetics. When intravenous insulin infusion was stopped, plasma vasopressin, osmolality, and glucose increased over the ensuing 5 h, whereas plasma sodium decreased, and blood volume and pressure did not change. This increase in vasopressin was not due to a loss of osmoregulation, because changes in plasma osmolality and sodium, induced by infusion of hypertonic saline or water loading, induced appropriate vasopressin responses under insulin deplete as well as replete conditions. However, when plasma osmolality and glucose were raised by infusion of hypertonic dextrose, plasma vasopressin increased significantly in diabetic patients under insulin deplete but not under insulin-replete conditions and actually decreased in healthy controls. These results indicate that acute insulin depletion increases vasopressin secretion by sensitizing the osmoreceptor to stimulation by hyperglycemia. This change in osmoreceptor specificity may be explained by postulating that glucose transport by osmoreceptor neurons as insulin dependent. PMID- 3551629 TI - The early proximal tubule: a high-capacity delivery-responsive reabsorptive site. AB - The proximal convoluted tubule is responsible for reclaiming almost all of the filtered bicarbonate, glucose, and amino acids, as well as 40% or more of the filtered sodium, fluid, chloride, and phosphate. Walker and co-workers demonstrated the importance of this nephron segment as a high-capacity transport site in the first mammalian micropuncture studies, and they suggested that the first portion of the proximal tubule played a particularly important role in the ability of the nephron to adapt to variations in filtered load. Since then, many studies using micropuncture and in vivo and in vitro microperfusion techniques have confirmed that the early proximal tubule has a higher transport capacity than the late proximal tubule for a number of solutes. Moreover, at least for bicarbonate, fluid, and chloride, the transport capacity is not static, but is in a dynamic state, adapting in response to changes in filtration. In this review we have focused on the high capacity and load dependence of early proximal bicarbonate and fluid reabsorption. In addition, we summarize the evidence for axial heterogeneity along the proximal convoluted tubule for transport of a variety of other solutes. PMID- 3551630 TI - Inner medullary hemodynamics in dogs with aortocaval fistula. AB - To investigate the role of medullary hemodynamics and vasoactive hormones in sodium retention in dogs with aortocaval fistula, we examined papillary plasma flow (PPF), solute content, and renal output of renin, norepinephrine, and prostaglandin E2 (PGE2) in anesthetized normal and fistula dogs. During hydropenia, cardiac output was elevated and systemic vascular resistance reduced in fistula dogs, accompanied by markedly increased renal output of renin, norepinephrine, and PGE2. In fistula dogs the blunted diuretic and natriuretic response to saline loading was not due to impaired myocardial contractility. During hydropenia and after saline loading, glomerular filtration rate (GFR) and renal blood flow were similar in normal and in fistula dogs; however, PPF was significantly lower in fistula dogs, accompanied by significantly greater papillary tissue osmolality and sodium content. These findings indicate that in fistula dogs enhanced medullary sodium reabsorption is associated with decreased PPF and stimulation of the renin-angiotensin and adrenergic nervous system. Furthermore, the reduced PPF obviates medullary solute washout during saline loading, and may contribute to the blunted diuretic and natriuretic response. PMID- 3551631 TI - Cyclosporine nephrotoxicity: sodium excretion, autoregulation, and angiotensin II. AB - Cyclosporine-induced nephrotoxicity (CIN) was studied in rats treated for 7 days with cyclosporine (10 mg x kg-1 x day-1 im) or vehicle (CON). CIN rats displayed characteristic reductions in glomerular filtration (GFR) and renal blood blood flow (RBF), and electron microscopy showed injury to proximal cells. Metabolic studies (7 day) showed significantly lower renal sodium excretion in conscious CIN rats compared with CON. In anesthetized rats at similar blood pressures, nephron GFR (SNGFR) was lower in CIN than CON, but fractional Na reabsorption was similar. In CIN, SNGFR, measured proximally to block flow to the sensing site of tubuloglomerular feedback (TGF) at the macula densa, was not significantly different than distal SNGFR. The rate of distal fluid delivery was significantly lower in CIN than in CON. Inhibition of the renin-angiotensin system (RAS) with captopril (CAP, 10 mg/kg iv), or saralasin (SAR, 0.3 mg x kg-1 x h-1 iv) caused marked arterial hypotension in CIN and a fall in renal vascular resistance (RVR). With arterial pressure controlled, CAP or SAR increased GFR and RBF, and reduced RVR in CIN, but did not reverse the renal deficits compared with similarly treated CON. RBF autoregulation in CIN was impaired between 90 and 140 mmHg but was partially restored by CAP. We conclude that both the filtered load and excretion rate of sodium in CIN are significantly reduced compared with controls, that SNGFR in CIN is not depressed by TGF in response to elevated distal fluid delivery, and that the RAS is not a primarily mediator of the renal vasoconstriction in CIN. PMID- 3551632 TI - Prostanoids and pial arteriolar diameter in hypotensive newborn pigs. AB - Effects of hypotensive hemorrhage on pial arteriolar diameter and cortical subarachnoid fluid prostanoid concentrations were investigated in newborn pigs. Chloralose-anesthetized piglets were equipped with closed cranial windows over the parietal cortex for observation of pial arterioles and collection of cerebrospinal fluid (CSF) passing over the cerebral surface (cortical subarachnoid CSF). Prostanoids in the CSF were determined by radioimmunoassay. Measurements of pial arterioles were made during normotension (63 +/- 4 mmHg) and hypotension (28 +/- 3 mmHg). Hypotension caused pial arteriolar diameters to increase from 162 +/- 22 to 193 +/- 22 microns. During normotension, the cortical subarachnoid prostanoid concentrations were (in ng/ml) prostaglandin E2 (PGE2) 2.6 +/- 0.7, 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) 1.7 +/- 0.4, thromboxane B2 (TXB2) 0.25 +/- 0.02. Hypotension caused 6-keto-PGF1 alpha to increase 245 +/- 104% and PGE2 to increase 132 +/- 38%. TXB2 increased slightly (37 +/- 21%). Topical application of PGE2 and prostacyclin caused marked dilation of pial arterioles. Treatment of hypotensive newborn pigs with indomethacin caused constriction of pial arterioles to diameters not significantly different from the normotensive diameters. These data are consistent with the hypothesis that the prostanoid system contributes to the maintenance of cerebral blood flow during hypotension in piglets. PMID- 3551633 TI - Fluorodeoxyglucose rate constants, lumped constant, and glucose metabolic rate in rabbit heart. AB - The isolated arterially perfused rabbit interventricular septum was used to measure myocardial metabolic rate for glucose (MMRGlc) and rate constants and lumped constant (LC) for the glucose analogue [18F]fluorodeoxyglucose (FDG) using a tracer kinetic model. FDG was delivered by constant infusion during coincidence counting of tissue 18F radioactivity. The MMRGlc was measured by the Fick method. Control septa were paced at 72 beats/min and perfused at 1.5 ml/min with oxygenated perfusate containing 5.6 mM glucose and 5 mU/ml insulin. The following conditions were tested: 3.0 and 4.5 ml/min; insulin increased to 25 mU/ml; insulin omitted; 2.8 mM and 11.2 mM glucose; 144 beats/min and 96 paired stimuli/min; and anoxia. Under all conditions studied the phosphorylation (hexokinase) reaction was rate limiting relative to transport. Compared with control conditions, the phosphorylation rate constant was significantly increased with 2.8 mM glucose as well as in anoxia. With 4.5 ml/min and 11.2 mM glucose, conditions that should increase glucose flux into tissue without increasing demand, the phosphorylation rate constant decreased significantly. With 11.2 mM glucose, 96 paired stimuli/min, and anoxia without insulin, a significant increase in the hydrolysis rate of FDG 6-phosphate was observed and suggests that hydrolysis is also an important mechanism for regulating the MMRGlc. Increased transport rate constants were observed with increased flow rates, 96 paired stimuli/min, and anoxia at 96 beats/min. The LC was not significantly different from control in 11 of 14 conditions studied. Therefore, under most conditions, an average LC can be used to calculate MMRGlc estimates. PMID- 3551634 TI - Sympathetic function in spontaneously hypertensive rats after chronic administration of captopril. AB - The cardiovascular effects of electrical stimulation of the posterior hypothalamus, intravenous administration of norepinephrine (NE), and direct sympathetic nerve stimulation (SNS) were compared in spontaneously hypertensive (SHR) and Wistar-Kyoto rats (WKY) given captopril (osmotic minipump, 1.25 micrograms/h icv) or vehicle for 4 wk beginning at age 7 wk. Mean arterial pressure (MAP) and renal and mesenteric flows (pulsed Doppler flow probes) were monitored in anesthetized rats. Following chronic administration of captopril the MAP was 141 +/- 4 mmHg in SHR receiving captopril and 183 +/- 6 mmHg in SHR receiving vehicle. Posterior hypothalamic stimulation, intravenous NE, and SNS resulted in lesser increases in MAP and renal and mesenteric vascular resistances in SHR treated with captopril. Response curves were shifted to the right, and the initial slopes and rate of change of slopes of the curves were less in captopril treated SHR than vehicle-treated rats. The decrease in sensitivity to posterior hypothalamic stimulation was greater than the decrease in response to NE or SNS. The decrease in vascular reactivity in captopril-treated SHR was not due to increased sensitivity of the baroreflex for control of vascular resistance nor to a decrease in arterial pressure per se. WKY treated with captopril also showed lesser increases in MAP and renal and mesenteric vascular resistances in response to posterior hypothalamic stimulation, intravenous NE, and SNS. The depressor effects of intracerebroventricular captopril in SHR may be due, in part, to an attenuation in sympathetic vasoconstrictor tone. This attenuation involves both a decrease in vascular smooth muscle responsiveness to NE as well as a decrease in central stimulation of sympathetic outflow. PMID- 3551635 TI - Effect of endotoxic shock on skeletal muscle intracellular electrolytes and amino acid transport. AB - Soleus muscle intracellular electrolytes and alpha-aminoisobutyric acid (AIB) uptake and its regulation by insulin were investigated during endotoxic shock in vivo. Fasted rats (90 g) were injected with [14C]AIB (1-10 mg/kg, iv) and Salmonella enteritidis endotoxin (20 mg/kg, iv) or saline and killed 1-5 h later. AIB uptake into muscle was corrected for uptake into extracellular space (measured as insulin distribution in muscle in vivo) and expressed as [AIB]/[AIB] ratios to assess active transport. The maximum level of active AIB cell transport by extracellular endotoxic muscles [3.3 +/- 0.2 (SE)] was lower than control muscles (4.9 +/- 0.3) at the time when plasma insulin concentration in endotoxic rats (16.8 +/- 2.0 uU/ml) was greater than controls (7.9 +/- 1.7 uU/ml). Insulin stimulated AIB transport was significantly lower in endotoxic muscles (from a basal value of 3.3 +/- 0.2 to 4.4 +/- 0.5, 5.0 +/- 0.3, and 4.9 +/- 0.3 at 125, 250, and 500 mU/kg intravenous insulin, respectively) than in control muscles (from 4.9 +/- 0.3 to 5.7 +/- 0.2, 8.0 +/- 0.4, and 10.8 +/- 0.8). The intracellular electrolyte concentrations in endotoxic soleus muscles ([Na] = 15.87 +/- 0.9, [K] = 145 +/- 1.7, [Cl] = 14.61 +/- 0.9) were substantially altered when compared with control muscles ([Na] = 9.33 +/- 1.1, [K] = 164 +/- 1.5, [Cl] = 4.1 +/- 0.6) 5 h postinjection. The membrane potential, estimated from chloride equilibrium potential was lower in endotoxic muscles (-52.7 +/- 1.6 mV) when compared with control muscles (-89 +/- 3.5 mV).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551638 TI - The Soviet view of paranoid disorder. PMID- 3551636 TI - Pressor action of intravenous angiotensin II reduces drinking response in rats. AB - We investigated whether the pressor response to intravenous angiotensin II (ANG II) suppresses drinking. All experiments were done on conscious water-replete rats (200-400 g) with chronic vascular cannulas. Two rates of ANG II infusion (16.7 and 100 ng/min for 90 min) were tested; captopril (0.33 mg/min) was infused simultaneously to prevent endogenous production of ANG II. Both doses of ANG II increased mean arterial pressure (MAP) by 40-50 mmHg for the duration of the infusions, but water intakes were small. The drinking response was increased as much as fivefold, however, when the pressor response was reduced by injecting either isoproterenol (0.01 or 0.1 mg/kg, sc), diazoxide (20, 30, or 75 mg/kg, sc), or minoxidil (10 mg/kg, ip) 15 min after starting the ANG II infusion. The closer MAP was returned to normal, the greater was the drinking response. Since lowering MAP also reduced urinary water losses, net fluid intake increased even more dramatically. It is unlikely that the vasodilators directly stimulated thirst in the experiments because the dose of captopril used completely blocked drinking to these agents given alone. A situation of high circulating levels of ANG II but with MAP near or below normal more closely resembles physiological conditions of dehydration. Our results demonstrate that intravenous ANG II is a very potent dipsogen under these conditions. PMID- 3551637 TI - Schizoaffective mania reconsidered. AB - Schizoaffective mania refers to a heterogeneous group of disorders characterized by mixtures of schizophrenic and manic (or bipolar) symptoms. Of the proposed diagnostic criteria, the Research Diagnostic Criteria (RDC) most clearly distinguish relevant subgroups. Family, clinical, and treatment studies suggest that the RDC's mainly affective subtype of schizoaffective mania is a variant of psychotic bipolar disorder. Limited available data suggest that the mainly schizophrenic subtype has a poorer prognosis and includes cases more closely related to schizophrenia. Schizoaffective mania also overlaps with proposed categories such as reactive and cycloid psychosis. It is premature to assume that all schizoaffective manic disorder represents a bipolar variant. Further studies that differentiate patients according to subtype, drug response, and course are needed. PMID- 3551639 TI - The evolution of maternal birthing position. PMID- 3551640 TI - An improved immunobead test procedure for detecting sperm antibodies in serum. AB - In order to improve the efficiency of IBT screening of sera for sperm antibodies, the use of immunobeads with attached rabbit antibodies directed against whole human immunoglobulin (IBT-GAM) was investigated and compared with the use of separate immunobeads specific for each of the main immunoglobulin classes (IBT IgG, IBT-IgA, IBT-IgM). Sera found positive by the IBT-GAM procedure were then tested by IBT-IgG, -IgA, and -IgM procedures to determine the immunoglobulin class or classes of the sperm antibody. The new procedure is much more efficient for screening larger batches of sera and gives results identical with those from the old procedure when greater than or equal to 50% sperm coating is used as criterion of positivity. We now use the IBT-GAM procedure for initial screening of all sera, followed by further testing of positive sera on the same preparation to determine the immunoglobulin class or classes of the antibody. PMID- 3551641 TI - Use of anti-skeletal muscle antibody from myasthenic patients in the diagnosis of childhood rhabdomyosarcomas. AB - Rhabdomyosarcoma (RMS), a common soft tissue tumor in children, may often be difficult to distinguish from Ewing's sarcoma, neuroblastoma, and malignant lymphomas. Confirmation of the skeletal muscle origin of RMS depends partly on the demonstration of striations in tumor cells that are usually undetectable in poorly differentiated tumors. A number of tissue markers (e.g., myoglobin and desmin) are currently being used to establish the origin of RMS. However, most of these markers lack specificity and have relatively low sensitivity. We have investigated the specificity and sensitivity of anti-skeletal muscle antibody (ASMA) from patients with myasthenia gravis in the diagnosis of childhood RMS. Out of eight cases of childhood RMS (four embryonal and four alveolar) examined, two showed striations with hematoxylin and eosin and four with phosphotungstic acid hematoxylin. Myoglobin was detected in five tumors; only well-differentiated tumor cells contained myoglobin. Anti-desmin antibody and ASMA reacted with cells in all the eight tumors whether or not the tumor cells were well differentiated. Anti-skeletal muscle antibody did not react with nine lymphomas, four Ewing's sarcomas, four neuroblastomas, four osteogenic sarcomas, four lipomas, eight duct carcinomas of the breast, and eight squamous cell carcinomas of the lung. Eight leiomyomas and four leiomyosarcomas of the uterus were compared for their reactivity with anti-desmin antibody and ASMA. All the tumors stained with anti desmin antibody and none with ASMA. The results show that ASMA is useful in the diagnosis of childhood RMS and is a more sensitive reagent than anti-myoglobin antibody. Unlike anti-desmin antibody, it can distinguish skeletal muscle tumors from smooth muscle tumors. PMID- 3551642 TI - Mantle-zone lymphoma: additional arguments for its origin. PMID- 3551644 TI - Intestinalization of pancreatic fragments in dogs: improvement in survival rate after acute segmental pancreatitis. AB - Intestinalization, a new method of pancreatic preservation in which vascularized pancreatic fragments are placed inside a jejunal pouch, has been tested for its effectiveness in the prevention of shock and death due to segmental pancreatitis. Intestinalization of the fragment resulted in the survival of eight of nine animals (89 percent) in which recovery was uneventful, whereas animals with pancreatitis in situ or in a mobilized fragment without intestinalization had a mortality rate of 100 percent within 2 days. We conclude that intestinalization ameliorates the outcome of hemorrhagic pancreatitis in the pancreatic fragment by effectively draining toxic products. The procedure may also be useful in pancreatic transplantation since no reintervention is necessary if graft failure or rejection occurs because the pancreas is accessible by endoscopy. PMID- 3551643 TI - Antibiotic prophylaxis of 1,036 patients undergoing elective surgical procedures. A prospective, randomized comparative trial of cefazolin, cefoxitin, and cefotaxime in a prepaid medical practice. PMID- 3551645 TI - Closed-suction versus Penrose drainage after cholecystectomy. A prospective, randomized evaluation. AB - Closed-suction drainage was compared prospectively to open, passive drainage (Penrose drains) in 128 patients undergoing cholecystectomy. Patients were randomized at the time of operation to receive either closed-suction drains (Group I, 67 patients) or Penrose drains (Group II, 61 patients). The preoperative clinical parameters of the two groups were similar. The patients in Group I when compared with those in Group II had a shorter duration of drainage (3.3 days and 4.1 days, respectively, p less than 0.01), a lesser volume of drainage in the first 48 hours postoperatively (78 ml and 132 ml, respectively, p less than 0.001), a decreased incidence of fever on the night of operation (24 of 67 patients and 39 of 61 patients, respectively, p less than 0.05) and on the first postoperative day (26 of 67 patients and 32 of 61 patients, respectively, p less than 0.05), and a lower leukocyte count on the first postoperative day (12,000 cells/mm3 and 14,100 cells/mm3, respectively, 0.05 less than p less than 0.1). Patients in Group I tended to have a lower rate of wound infection (1 of 67 patients versus 5 of 61 patients in Group II, 0.05 less than p less than 0.1) and had a much lower incidence of drain site tenderness (8 of 67 patients in Group I versus 24 of 61 patients in Group II, p less than 0.05). This study demonstrates the superiority of closed-suction drains over open, passive drains after cholecystectomy. PMID- 3551646 TI - Technique of simultaneous renal pancreatoduodenal transplantation with urinary drainage of pancreatic secretion. AB - There are many advantages to transplanting the pancreas in the right iliac fossa and draining the pancreatic exocrine secretions into the bladder. This technique has been performed successfully in nine patients and the details have been discussed herein. PMID- 3551647 TI - [Technology for the indirect measurement of blood pressure and biological rhythms]. PMID- 3551648 TI - [Fetal echocardiography]. PMID- 3551649 TI - [Ultrasonic evaluation of anatomo-functional features of the major vessels of the fetus]. PMID- 3551650 TI - [Feasibility of ultrasonic biometry in determining the gestational age of fetuses of pregnant women with diabetes mellitus]. PMID- 3551651 TI - [The role of A. Ia. Krassovskii in organizing the 1st Russian society of obstetricians and gynecologists (on the 100th anniversary of the founding of the society)]. PMID- 3551652 TI - ["Journal of Obstetrics and Women's Diseases" (1887-1935)]. PMID- 3551653 TI - History of medicine in Alaska--Robert D. Whaley, M.D. PMID- 3551654 TI - Pigmented dermatofibrosarcoma protuberans. Report of two cases as a variant of dermatofibrosarcoma protuberans with partial neural differentiation. AB - Two cases of so-called Bednar tumor are reported. The histopathological finding of a typical storiform pattern composed of fusiform tumor cells resembled dermatofibrosarcoma protuberans (DFSP) except for the presence of melanin containing cells scattered within the lesion. Ultrastructurally, the predominant tumor cells in case 1 possessed extensive cytoplasmic processes, convoluted nuclei, and intercellular junctions, but lacked basal lamina. Melanocytic tumor cells contained melanosomes and were surrounded by basal lamina. Immunohistochemical examinations revealed a positive reaction for S-100 protein and neuron-specific enolase in the pigment-laden cells. Consequently, these two tumors were considered to be a variant of DFSP with partial neural differentiation. PMID- 3551655 TI - Identification and possible significance of HNK-1+ human lymphocytes, macrophages, and non-neoplastic T-cells in cutaneous lymphoma. AB - Experimental work on animal models suggests that various lymphoid subpopulations (K/NK, lymphocytes, macrophages, T-cells) may play a role in immunity against neoplasia, including lymphomas. The incidence and possible role of these cells in spontaneously occurring human tumors is less clear. The prevalence of these lymphoid subpopulations was studied in 60 cutaneous biopsy specimens using in situ immunocytochemistry. Monoclonal HNK-1 (Leu 7), which detects human granular lymphocytes with K/NK function, was used to detect K/NK lymphocytes; macrophages were identified by diffuse cytoplasmic esterase activity; T-cells were identified using monoclonal antibodies OKT3 and Leu 1. HNK-1+ lymphocytes, esterase-positive macrophages, and infiltrating T-cells were identified in varying numbers in the cases studied. The demonstration of HNK-1+ lymphocytes, macrophages, and T lymphocytes in cutaneous lymphoma lesions is of potential therapeutic application. Whatever the naturally occurring role of these immune cells, it is possible that they may be manipulated pharmacologically for the benefit of the patient. PMID- 3551656 TI - Familial benign chronic pemphigus. PMID- 3551657 TI - The man behind the eponym. Sir Jonathan Hutchinson. An obstinate genius. PMID- 3551658 TI - A little lexicon of archaic and obsolete medical terms. PMID- 3551659 TI - What is really the Biblical "shechin"? PMID- 3551660 TI - Essential fatty acids, prostaglandins, and nonsteroidal antiinflammatory agents: physiological and behavioral interactions. PMID- 3551662 TI - The role of essential fatty acids in alcohol dependence and tissue damage. AB - Evidence for the role of essential fatty acids in alcohol dependence is reviewed. If alcohol-induced tissue damage is associated with impaired fatty acid and phospholipid metabolism, supplements of essential fatty acids might be beneficial in the treatment of alcoholics. The evidence for this effect is examined. PMID- 3551663 TI - Respiratory responsiveness in male alcoholics after withdrawal. AB - Peripheral and central chemosensitivity were assessed in eight abstinent male alcoholic patients and in seven healthy normal male subjects. Hypoxic rebreathing (15% O2, 7% CO2) was used to stimulate the peripheral and central chemoreceptors together. Hyperoxic rebreathing (93% O2, 7% CO2) was used to examine the central chemoreceptor response independently of the peripheral chemoreceptors. Minute ventilation was examined in relation to end-tidal PACO2 under the two conditions. Neither peripheral nor central chemoreceptor responses were significantly altered in the alcoholic as compared to the control subjects. Abnormal chemoreceptor function is therefore unlikely to be an important factor in the development of abnormal respiratory events during sleep in abstinent alcoholic subjects. PMID- 3551661 TI - Alcohol, pregnancy, and prostaglandins. AB - Basic scientists and clinicians alike are in agreement that children of alcoholic mothers are at risk for a variety of birth defects. These defects have been labeled fetal alcohol syndrome or, in a milder form, fetal alcohol effects. Prevention or therapeutic intervention of this disorder requires an understanding of the mechanism of action of alcohol on the developing fetus. This paper addresses the possible role of prostaglandins as biochemical mediators of the teratogenic actions of alcohol. PMID- 3551664 TI - Individual differences in behavioral and subjective responses to alcohol. AB - The reinforcing properties and subjective effects of alcohol were assessed in 29 normal volunteers using a seven-session choice procedure. On the first four sessions, subjects sampled an alcohol (0.5 g/kg) and a placebo beverage twice each. On three subsequent choice sessions, subjects chose the drink they preferred. The number of times they chose alcohol was the measure of its reinforcing properties. On all sessions subjects completed mood questionnaires before and several times after consuming the beverage. Other dependent measures during the experiment included a cognitive performance task, drug liking and identification questionnaires, and breathalyzer alcohol determinations. Demographic and personality data also were obtained. Approximately one-third of the subjects chose the alcohol-containing beverage on all three choice sessions, one-third alternated in their choices of alcohol and placebo, and one-third consistently chose the placebo. When the subjective effects of alcohol (determined during sampling sessions) were compared across the three choice groups, qualitative differences in response to alcohol were observed. For example, alcohol increased elation and vigor scores in the consistent choosers of alcohol, whereas it decreased scores on these measures in the consistent placebo choosers. Consistent alcohol choosers did not differ from placebo choosers in gender or age but they reported more marijuana use and slightly more alcohol use outside the laboratory. They also scored higher on certain measures of arousal and depression, on the Sensation Seeking Scale and on the Psychopathic State Inventory. The results are discussed in terms of individual differences in vulnerability to excessive use of alcohol. PMID- 3551665 TI - Purification of human liver aldehyde dehydrogenase by high-performance liquid chromatography and identification of isoenzymes by immunoblotting. AB - Human liver aldehyde dehydrogenase (ALDH) exists in multiple molecular forms. Two different isoenzymes of ALDH have been purified which will oxidize acetaldehyde to acetate. ALDH1 is localized principally in hepatocyte cytosol and exhibits a Km for acetaldehyde of about 0.1 mM at pH 9.5. ALDH2 is mitochondrial in origin and exhibits low Km for acetaldehyde, about 1 microM. We have developed rapid purification procedures for ALDH1 and ALDH2 by use of agarose-AMP affinity chromatography and high-performance anion-exchange liquid chromatography (HPLC). The method takes less time and affords higher yields of the labile ALDH isoenzymes than conventional column chromatography methods. A previously uncharacterized ALDH form has been identified by anion-exchange HPLC which exhibits high Km for acetaldehyde, about 1 mM, and is very labile. Polyclonal antibodies to the purified ALDH1 and ALDH2 isoenzymes have been prepared. As evidenced by immunoblotting of starch gels containing the purified isoenzymes, anti-ALDH1 does not crossreact with ALDH2 and anti-ALDH2 does not crossreact with ALDH1. The anti-ALDH2 antibody identifies the "inactive" variant of ALDH2 in Japanese livers exhibiting the "deficient" ALDH2 phenotype. The sensitivity of detection of ALDH isoenzymes in liver homogenate-supernatants by immunoblotting of starch gels is about 10-fold greater than that by activity staining. PMID- 3551666 TI - Estimating health care savings associated with alcoholism treatment. PMID- 3551667 TI - Hepatic protein synthetic activity in vivo after ethanol administration. AB - Hepatic protein synthetic activity in vivo was measured by the incorporation of [3H]puromycin into elongating nascent polypeptides of rat liver to form peptidyl [3H]puromycin. Our initial experiments showed that saturating doses of [3H]puromycin were achieved at 3-6 mumol/100 g body weight, and that maximum labeling of nascent polypeptides was obtained 30 min after injection of the labeled precursor. Labeled puromycin was found to be suitable for measuring changes in the status of protein synthesis, since the formation of the peptidyl [3H]puromycin was decreased in fasted animals and was increased in rats pretreated with L-tryptophan. [3H]Puromycin incorporation into polypeptides was then measured after acute ethanol administration as well as after prolonged consumption of ethanol which was administered as part of a liquid diet for 31 days. Acute alcohol treatment caused no significant change in [3H]puromycin incorporation into liver polypeptides. In rats exposed to chronic ethanol feeding, peptidyl-[3H]puromycin formation, when expressed per mg of protein, was slightly lower compared to pair-fed controls, but was unchanged compared to chow fed animals. When the data were expressed per mg of DNA or per 100 g body wt, no differences in protein synthetic activity were observed among the three groups. These findings indicate that neither acute nor chronic alcohol administration significantly affects protein synthetic activity in rat liver. They further suggest that accumulation of protein in the liver, usually seen after prolonged ethanol consumption, is apparently not reflected by an alteration of hepatic protein synthesis. PMID- 3551669 TI - [The eosinophil]. PMID- 3551668 TI - Essential fatty acid supplementation during early alcohol abstinence. AB - Interactions between ethanol, prostaglandins, and essential fatty acids (EFA) have led to the hypothesis that acute alcohol withdrawal and the sequelae of chronic alcoholism may be related to an EFA/prostaglandin deficiency. To test this hypothesis, EFA profiles in blood-lipid fractions, serum liver enzymes, cognitive function, and alcohol craving were measured in 27 acutely abstinent alcoholics before and after a 3-week double-blind trial of EFA supplementation. Upon entry into the study, alcoholics had significant differences in EFA levels as compared to normal controls, and serum levels of liver enzymes tended to correlate with these EFA levels. After 21 days, cognitive function, alcohol craving, and liver enzymes all improved in both the EFA and placebo groups; most EFA levels also approached normal values. There were no treatment effects of EFA supplementation at the dose used. PMID- 3551670 TI - Seasonal allergic rhinitis and depot injection of a corticosteroid. Evaluation of the efficacy of medication early and late in the season based on detailed symptom recording. AB - It was the aim of this investigation to study the efficacy of a corticosteroid given as a depot injection in seasonal allergic rhinitis, the efficacy profile with regard to specific symptoms, and whether the injection is best given early in the season or later at the peak of the pollen count. An injection of 80 mg methylprednisolone showed a marked effect on nasal blockage lasting more than 4 weeks, and a moderate effect on eye symptoms, while the effect on nasal hypersecretion and sneezing could not be demonstrated. It is concluded that systemic corticosteroids may be indicated in severe hay fever, when symptoms, especially blockage, occur in spite of other types of therapy. If the physician prefers to give the corticosteroid as a depot injection, it is preferably given in the first half of the season when the pollen count is increasing. PMID- 3551671 TI - Nebulization treatment with saline compared to bromhexine in treating chronic sinusitis in asthmatic children. AB - Twenty children aged 3 to 14 years with a history of bronchial asthma complicated by chronic sinusitis were studied in a double-blind study. Patients received, at random, over a period of 2 weeks, either 2 ml saline or 2 ml bromhexine (2 mg/ml) t.i.d. by means of a home nebulizer. A significant decline of clinical symptoms during both nebulization treatments as compared to the pretreatment symptom score was observed (mean score of 1.5 +/- 0.7 and 0.5 +/- 0.8, respectively, P less than 0.01). Both types of nebulization were equally efficient in reducing the symptom score. Radiological abnormalities were significantly more reversed after saline nebulization as compared with bromhexine (P less than 0.05), although both treatments showed radiological improvement (P less than 0.01). The present study indicates that nebulization with saline may have some beneficial effect on chronic sinusitis in asthmatic children. Bromhexine was not superior to saline for this purpose. PMID- 3551672 TI - Inhibition of T cell-dependent antibody production by D-penicillamine. Different requirements for Cu2+ in suppression of polyclonal and antigen-specific B cell responses. AB - The effects of D-penicillamine (D-Pen) on the production of immunoglobulins (Ig) and anti-microbial antibodies (Ab) by human mononuclear cells (MNC) cultured in vitro were analysed by haemolytic plaque forming cell (PFC) assays. Polyclonal Ig and Ab production, induced by pokeweed mitogen (PWM), was not affected by D-Pen in pharmacologically relevant concentrations, unless Cu2+ was added. Likewise, D Pen + Cu2+, but not D-Pen alone, affected polyclonal Ig production induced by Epstein-Barr virus. The production of interleukin-2 and B cell growth factor by phytohaemagglutinin-stimulated T cells was not inhibited by D-Pen; again D-Pen + Cu2+ markedly reduced the production of these cytokines. By contrast, D-Pen significantly reduced the antigen-induced antibody production without requirement of additional Cu2+. Addition of cytokine-containing supernatant to MNC treated with D-Pen + Cu2+ tended to increase the PWM-induced Ig responses, but had no effect on the antigen-induced Ab production of MNC cultured with D-Pen. Thus, the mechanisms by which D-Pen suppresses polyclonal and antigen-induced B lymphocyte responses are different. PMID- 3551673 TI - Maternal abstention from cow milk and egg in allergy risk pregnancies. Effect on antibody production in the mother and the newborn. AB - To study the possibility of intrauterine sensitization, 212 women were enrolled on a voluntary basis into a prospective, randomized study, comparing the effects of an elimination diet and normal food during late pregnancy. The diet group took no cow milk and no egg from week 28 to delivery, and extra calcium and casein hydrolysate (Nutramigen) supplement was given to fill the nutritional needs of mother and child. The control group took normal food, including approximately 1/2 liter of milk/day and 3-5 eggs/week. All families had a history of allergy in mother, father, or sibling. Maternal weight gain during pregnancy was significantly lower in the diet group. Birth weights showed no significant difference between the two main groups, but smokers in the elimination diet group had significantly smaller babies. IgE antibodies to cow milk and egg were significantly higher in atopic than in non-atopic women before the trial. The diet caused a significant fall in IgG-antibodies to cow milk and egg in both atopic and non-atopic subjects. Cord blood IgE determination revealed no significant difference between the groups. No IgE antibodies to cow milk or egg were detected in any of the cord sera. The participating babies are being followed up until 18 months of age. PMID- 3551674 TI - A prospective randomised trial comparing spinal anaesthesia using hyperbaric cinchocaine with general anaesthesia for lower limb vascular surgery. AB - One hundred and one patients were randomly allocated to have their peripheral vascular surgery performed under general anaesthesia (51 patients) or spinal anaesthesia (50 patients). Intraoperative haemodynamic changes were markedly different between the two groups with a higher incidence of hypotension in the spinal group (72% vs 31%) and a higher incidence of hypertension in the general anaesthesia group (22% vs 0%). Blood loss was significantly less in the spinal group (560, SD 340, ml vs 792, SD 440, ml). Postoperatively three patients from the general anaesthesia group died from causes unrelated to the anaesthesia, and one had a myocardial infarct. Two patients in the spinal group had myocardial infarcts, both had been treated for bradycardia and hypotension intraoperatively, and one died. There was a significantly higher incidence of postoperative chest infection in the general anaesthesia group (33% vs 16%). There was no significant difference between the groups in the incidence of postoperative confusion, or lower limb amputation rate or need for further surgery prior to hospital discharge. PMID- 3551675 TI - Shivering related to epidural blockade with bupivacaine in labour, and the influence of epidural pethidine. AB - A prospective survey of two hundred patients who received an epidural block in labour was performed in order to determine the incidence and severity of shivering, and the influence of likely associated factors. Twenty-two of the patients who shivered took part in a double-blind trial to see if epidural pethidine 25 mg, versus saline, had any effect upon shivering. Fifty per cent of patients shivered soon after the initial dose of bupivacaine. Shivering was more common among patients who had experienced shivering before epidural block, and in those who had received nitrous oxide (P less than 0.005). Prior intramuscular injection of pethidine did not significantly affect the incidence of shivering, and it was not influenced by the concentration of epidural bupivacaine used (0.5 or 0.25%). Shiverers were more likely to feel cold than non-shiverers (P less than 0.001) but shivering was generally regarded by patients as a trivial symptom, only 13% describing it as very irritating. Shivering was abolished or considerably diminished within ten minutes in all patients who received epidural pethidine 25 mg, whereas there was no change in eight out of eleven patients who received epidural saline. These results are significant (P less than 0.01), and demonstrate that shivering following epidural blockade can be effectively treated with small epidural doses of pethidine. PMID- 3551676 TI - Positive end-expiratory pressure increases plasma catecholamine levels in non volume loaded dogs. AB - Positive end-expiratory pressure (PEEP) is commonly used in the treatment of critically ill patients whose sympathetic nervous system is stressed; however, PEEP's actions on sympathetic nervous system activity are unknown. We therefore measured the plasma noradrenaline response (an index of sympathetic nervous system activity) to graded doses of PEEP in nine mongrel dogs. After 30 minutes at each level of PEEP, plasma noradrenaline concentrations increased from baseline mean values of 300 (SD 108) pg/ml to 388 (SD 225) pg/ml (P less than 0.05) at 5 cm, 433 (SD 255) pg/ml (P less than 0.01) at 10 cm and 1194 (SD 882) pg/ml (P less than 0.01) at 20 cm water pressure of PEEP. The increases in plasma noradrenaline concentrations correlated inversely (r = -0.43, P less than 0.01) with PEEP-induced changes in cardiac output. Plasma adrenaline levels did not change significantly in response to 5 or 10 cm of PEEP; however, plasma adrenaline increased, while heart rate and mean arterial blood pressure fell, at 20 cm water pressure of PEEP (P less than 0.05). Within 15 minutes after discontinuation of PEEP, the plasma catecholamine concentrations returned to baseline levels. CONCLUSIONS: 1. PEEP significantly increases sympathetic nervous system activity in a rapid, dose-dependent, reversible manner; 2. the PEEP induced increases in sympathetic activity may explain the reductions in organ blood flow which others have observed following the initiation of PEEP; 3. PEEP related changes in sympathetic nervous system activity are a consequence of PEEP induced reductions in cardiac output. PMID- 3551677 TI - Repeated asystole following PAM in organophosphate self-poisoning. PMID- 3551678 TI - Obituary: Geoffrey Kaye 1903-1986. PMID- 3551679 TI - Drinker tank respirators. PMID- 3551680 TI - The role of pharmacokinetics in anaesthesia: application to intravenous infusions. AB - Pharmacokinetic concepts describe the relationship between drug dose and resulting plasma concentration. A drug's pharmacokinetic profile can be described by distribution and elimination half-lives, initial volume of distribution, steady-state distribution volume, and metabolic and distributional clearance. After initiating a fixed rate of drug infusion, four to five terminal elimination half-lives are required to reach a steady state of constant plasma concentration. If a loading dose is given, a steady state can be achieved more rapidly. The most rapid method of achieving a constant plasma concentration involves using a variable rate of drug infusion that adjusts for the metabolic clearance and distribution of the drug. Computer-driven infusion pumps can be used to rapidly achieve, then maintain, constant plasma concentrations of a drug. PMID- 3551681 TI - Continuous infusions of muscle relaxants--why and how. AB - The degree of neuromuscular blockade that occurs in an individual patient following the administration of competitive neuromuscular blocking agents cannot be accurately predicted because of the large individual variation in the pharmacokinetics and pharmacodynamics of these agents. Without monitoring of the neuromuscular blockade, this unpredictability predisposes to the occurrence of residual curarisation with its potentially lethal consequences. Variable rate continuous infusion of a short-acting competitive neuromuscular blocking agent with monitoring of the neuromuscular blockade is a flexible and accurate method for maintaining a precise degree of neuromuscular blockade during prolonged surgical procedures which ensues reliable reversability of the residual neuromuscular blockade. A system for the continuous infusion of atracurium with manual monitoring of the neuromuscular blockade is described, together with the results of a study demonstrating its efficacy. PMID- 3551682 TI - Hypnotics in infusion anaesthesia--with particular reference to thiopentone. AB - Hypnotics are a group of drugs whose primary action is to produce unconsciousness. This contrasts to the opioids whose primary action is to reduce the sensation of pain and the tranquillisers whose primary action is to calm and to attenuate psychotic disease. Hypnotics of interest to the anaesthetist are the inhalational agents and intravenously administered drugs, including the barbiturates thiopentone and methohexitone, chlormethiazole, etomidate and propofol. Knowledge of the use of hypnotics to maintain anaesthesia is largely confined to the volatile anaesthetic agents, while knowledge of the use of the intravenous hypnotics is largely restricted to their use as intravenous induction agents and as sedative for regional procedures. The use of intravenous hypnotics to maintain anaesthesia requires careful control of infusion rates based on pharmacokinetic predictions. Once techniques are established, favourable operating conditions can be achieved, as well as acceptably short recovery times. With such techniques, the benefits of freedom from many of the adverse aspects of inhalational anaesthesia can be realised. PMID- 3551683 TI - The search for a symbol. PMID- 3551684 TI - Extraction of cellular DNA from human cells and tissues fixed in ethanol. AB - DNA can be extracted from ethanol-fixed lymphoid cells and tissues. The fixation procedure is simple and rapid, and the DNA extraction itself is the same as that normally used for fresh tissue or cells. DNA extracted from ethanol-fixed material is indistinguishable from DNA extracted from fresh samples based on its purity, its ability to be digested with restriction endonucleases, and its ability to specifically hybridize to DNA probes. The capability to extract DNA from ethanol-fixed cells and tissues eliminates the need for stringent handling and storage requirements of fresh or frozen specimens. PMID- 3551686 TI - Homogeneous immunochemical technique for determination of human lactoferrin using excitation transfer and phase-resolved fluorometry. PMID- 3551685 TI - A micromethod for the determination of an unbound radioactive iodine in radiolabeled glycoproteins by means of uranyl acetate. AB - A method for determination of an unbound radioactive iodine in radiolabeled glycoproteins is based on coprecipitation of these macromolecules with uranyl and phosphate ions. Under these conditions unbound 125I is not precipitated. The method is simple, rapid, and very sensitive. PMID- 3551687 TI - Use of specific bacteria for the determination of mutagenic and carcinogenic compounds. PMID- 3551688 TI - Immunocytochemical demonstration of glial fibrillary acidic protein in the cortical perivascular glial sheat of the cat. AB - The peroxidase-antiperoxidase method was used on paraffin embedded material to demonstrate the distribution of the glial fibrillary acidic protein (GFA protein) in the perivascular glial membrane of the cortical blood vessels of cats. The nature of the dense zones was determined by ultrastructural immunocytochemistry with anti-GFA protein. Immunoreactivity was seen exclusively in the dense zones of the perivascular glia and in the astrocytic processes of the neuropil. The dense zones may exert a stabilizing function on the basal membrane during the changes in the caliber of the vessels. PMID- 3551689 TI - [The importance of electron microscopy in research and clinical otorhinolaryngology]. AB - The current state of electronmicroscopy in research and clinical applications in otorhinolaryngology is reviewed. The recognition of cytoarchitectonic relationships by means of transmission electronmicroscopy, tracer studies and freeze fracture technique provides functionally interesting findings on the sensory epithelium and the permeability barriers of the inner ear. Knowledge of the fine structure of the animal and human ear also facilitates the understanding of the pathomechanism of the inner ear. Experimental and clinical findings of seromucotympanon are also described, as well as the morphology of normal and diseased respiratory mucosa. A viral origin for laryngeal papilloma is clearly confirmed. New findings in the pathohistology of otosclerosis are described. Finally, the use of electronmicroscopy in the diagnosis of ENT tumours is considered. The demonstration of pathognomonic cell organelles is useful not only in the diagnosis of rare tumours, e.g. esthesioneuroblastoma or carcinoid. The epithelial origin of anaplastic tumours can also be shown or excluded. Electronmicroscopy also offers important clues in the case of neck metastases from an unknown primary tumour. PMID- 3551690 TI - Dependent PEEP during two-lung ventilation in the lateral decubitus position. PMID- 3551691 TI - The anesthetization of Fanny Longfellow for childbirth on April 7, 1847. PMID- 3551692 TI - Modified rigid bronchoscope for Nd-YAG laser resection of tracheobronchial obstructing lesions. PMID- 3551693 TI - Plethysmography: history and recent advances. AB - A short historical note on plethysmography is given and the development of the modern computerized pneumoplethysmograph is described. The computer-aided pneumoplethysmogram (CAP), with proper programming, makes possible numerous computations that give new, useful, and rapid information about the patient. New applications of the CAP will quickly develop and the data collected will be quickly analyzed and displayed. PMID- 3551694 TI - Portal hypertension workup by DSA. AB - To provide information for preoperative planning, combined, selective intravenous (IV) and intraarterial (IA) digital subtraction angiography (DSA) studies were performed on 42 portal hypertension patients scheduled for portal systemic shunt procedures. Selective IV-DSA was performed to demonstrate the hepatic venous system, left renal vein, and inferior vena cava. Portal venous anatomy, direction of flow, and portal systemic collaterals were evaluated by selective IA-DSA. In addition, selective IA-DSA was performed postoperatively on 8 patients to assess shunt patency. Technically adequate DSA studies, suitable for surgical planning or postoperative assessment, were obtained in all of the 50 patients examined. Patient or internal organ motion was not a limiting factor in any study. Such use of DSA represents an efficacious, safe, and cost-effective alternative to conventional film-screen angiography for the evaluation of patients with portal hypertension. PMID- 3551695 TI - Effect of oral treatment with pantethine on platelet and plasma phospholipids in IIa hyperlipoproteinemia. AB - In a single-blind, crossover, completely randomized study, the effects of oral treatment with pantethine or placebo on fatty acid composition of plasma and platelet phospholipids were investigated in 10 IIa hyperlipoproteinemic patients. A significant decrease of total cholesterol and total phospholipids was observed both in plasma and in platelets after a twenty-eight-day treatment. In plasma, pantethine induced a decrease of the ratio sphingomyelin/phosphatidylcholine. Moreover, a relative increase of n3-polyunsaturated fatty acids both in plasma and in platelet phospholipids and a decrease of arachidonic acid in plasma phospholipids were observed. These results indicate that pantethine can affect plasma and platelet lipid composition with possibly favorable influences on the determinants of cell membrane fluidity. PMID- 3551696 TI - MAST and i.v. infusion: do they help in prehospital trauma management? PMID- 3551697 TI - Antibody activity to Babesia canis in dogs in North Carolina. AB - Sera from 600 dogs from 6 geographic regions of North Carolina were analyzed for antibody activity to Babesia canis, using an indirect fluorescent antibody test. Overall, 3.8% of the dogs had an antibody titer greater than or equal to 1:80, which was considered to be indicative of infection. Dogs were more likely to be seropositive if they were housed at humane facilities and were located within areas of the state with a milder climate than were pet animals living within colder regions of North Carolina. PMID- 3551698 TI - Immunohistochemical diagnosis of toxoplasmosis in fetuses and fetal membranes of sheep. AB - A peroxidase antiperoxidase technique was developed for visualizing intact Toxoplasma gondii and its antigenic residues in sections of formalin-fixed, paraffin-embedded tissues from fetal membranes recovered from ewes with induced toxoplasmosis. The peroxidase antiperoxidase method was specific and sensitive, allowing the detection of T gondii antigen even in severely decomposed tissues. Toxoplasma gondii infection was most commonly demonstrated in the cotyledons, heart, lungs, brain, and skeletal muscles of the fetus. PMID- 3551699 TI - Demonstration of colonies of Cowdria ruminantium in midgut epithelial cells of Amblyomma variegatum. AB - The development of colonies of Cowdria ruminantium was studied in midgut epithelial cells of adult Amblyomma variegatum that had become infected by feeding as nymphs on cattle with experimentally induced heart-water disease. Colonies were not observed in gut tissues obtained from nymphs during the feeding period, but were present in midgut epithelial cells of ticks obtained at 15 days after they were replete through molting to the adult stage. Colonies were small (1 to 10 micron) initially, but as tick development progressed, their diameter increased to as much as 60 micron. With electron microscopy, colonies were observed to be membrane bound and contained pleomorphic organisms that were reticulated. The organisms seemed to be dividing by binary fission. Many colonies contained a large, electron-dense inclusion that was morphologically similar to hemoglobin deposits found in the cytoplasm of midgut epithelial cells of recently fed ticks. Cowdria ruminantium was often observed adhered to these inclusions. PMID- 3551700 TI - Complement immunofluorescence in sera of dogs with pemphigus foliaceus. AB - Sera from 14 dogs with active pemphigus foliaceus were tested for the presence of circulating antiepithelial antibodies. These antibodies could not be detected in the dogs with indirect immunofluorescent staining or in vitro complement-staining methods. PMID- 3551701 TI - Virulence of wild and mutant strains of Salmonella typhimurium in ligated intestinal segments of calves, pigs, and rabbits. AB - A ligated intestine model in calves, pigs, and rabbits was tested for its value as an indicator of virulence of potential vaccine strains of Salmonella typhimurium. A wild virulent strain (3860C), a laboratory strain LT2, and mutants of these 2 strains were evaluated. Inoculation of calf intestinal segments with strain 3860C revealed that fluid responses were greatest in the proximal portion of the small intestine and that doses greater than 10(7) organisms were required to produce fluid responses and mucosal damage. Immunoperoxidase-stained sections of intestine revealed that a large dose of Salmonella organisms was required before mucosal invasion could be detected. Aromatic (aroA), galactose epimerase (galE), and diaminopimelic acid (dap) mutants of strain 3860C all resulted in much less fluid response, mucosal invasion, and mucosal damage compared with those by the parent organism. Strain LT2 induced such weak responses that it was not possible to evaluate reductions in virulence of its mutants. In 6-week-old pigs, there was no fluid response to any strains; however, in 1-week-old pigs, there was fluid response to the wild strain and some of its mutants. In adult rabbits, fluid responses were not observed, except when the wild strain was inoculated in the proximal portion of the small intestine. The calf and 1-week old pig models appeared to be best suited for assessment of virulence of mutant strains of S typhimurium. PMID- 3551702 TI - Nation's health is focus of ANA efforts. PMID- 3551703 TI - Prediction of airway reactivity from responses to a standardized respiratory symptom questionnaire. AB - A standardized respiratory symptom questionnaire was administered to 200 male insulators who then underwent inhalational bronchial challenge to measure their airway reactivity. The results were analyzed to determine the value of questionnaire information in predicting airway reactivity measured objectively. Questionnaire information was grouped according to topic, scored according to severity, and then combined to create several airway reactivity indices by stepwise multivariate analysis. The final index selected for testing contained information on a history of "asthma," "wheeze," "episodes of cough with sputum," and "pneumonia." It had a sensitivity ranging from 5% to 67% and positive predictive value from 67% to 28% depending on the cutoff point chosen as indicative of increased airway reactivity. These results indicate that questionnaire information is not adequate for discriminating between those with and those without increased airway reactivity in population screening. PMID- 3551704 TI - The role of titratable acidity in acid aerosol-induced bronchoconstriction. AB - We evaluated the importance of pH, titratable acidity, and specific chemical composition in acid aerosol-induced bronchoconstriction in 8 asthmatic subjects. We administered aerosols of HCl and H2SO4 at pH 2.0 in an unbuffered state and buffered with glycine. The buffered acids were given in order of increasing titratable acidity (defined as the number of ml of 1 N NaOH required to neutralize 100 ml of acid solution to pH 7.0). Each set of buffered or unbuffered acid aerosols was given on a separate day and each aerosol was inhaled through a mouthpiece during 3 min of tidal breathing. Bronchoconstriction was assessed by measurement of specific airway resistance (SRaw) before and after inhalation of each aerosol. SRaw increased by more than 50% above baseline in 1 of 8 subjects after inhalation of unbuffered HCl and in no subjects after inhalation of unbuffered H2SO4, even at pH 2.0. In contrast, SRaw increased by greater than 50% in all 8 subjects after inhalation of HCl and glycine at pH 2.0 and 7 of 8 subjects after inhalation of H2SO4 and glycine at pH 2.0. The mean titratable acidity required to increase SRaw by 50% above baseline was calculated for each challenge by linear interpolation; these values for H2SO4 and glycine (5.1 ml of 1 N NaOH) and HCl and glycine (2.2 ml of 1 N NaOH) were slightly, but significantly, different (p = 0.01) and were considerably higher than the titratable acidity of the unbuffered acids at pH 2 (1.0 ml of 1 N NaOH).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551706 TI - Accelerated solute clearance in Pneumocystis carinii pneumonia. AB - A radioaerosol clearance test was used to detect lung injury in 12 patients with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii pneumonia documented by bronchoscopy. The clearance of 99mTc-DTPA was elevated over most regions of interest in all of these patients. In each of 7 subjects who responded to trimethoprim-sulfamethoxazole therapy, clearance returned toward normal. Average clearances were either normal or very slightly above the 95% expected upper limit of normal in each of 6 patients with either AIDS or AIDS-related complex without clinical evidence of Pneumocystis infection. The radioaerosol diffusion test may prove useful for determining whether patients who are predisposed to this infection require bronchoscopy and may provide information concerning their response to therapy. PMID- 3551707 TI - Airway smooth muscle. PMID- 3551705 TI - Sulfur-dioxide-induced bronchitis in dogs. Effects on airway responsiveness to inhaled and intravenously administered methacholine. AB - Chronic bronchitis was induced in 7 dogs of mixed breed by chronic exposure to SO2 gas. Within the first 2 to 4 wk of exposure, the dogs developed cough and mucous hypersecretion, chronic airway obstruction (increased pulmonary resistance), and persistent lung inflammation as demonstrated by an increase in the number of neutrophils recovered in the bronchoalveolar lavage (BAL) fluid. Airway responsiveness to methacholine aerosol decreased 2- to 3-fold within 8 wk of SO2 exposure. In contrast, airway responsiveness to intravenous administration of methacholine did not change. The data suggest that the decreased airway responsiveness observed during persistent pulmonary inflammation in SO2-exposed dogs is not due to an altered state of airway contractile elements but likely reflects expression of an inhibitory influence of the mucoepithelial barrier. PMID- 3551708 TI - Ultrasonography and thoracentesis. PMID- 3551709 TI - [A new experimental model of liver transplant in pigs]. AB - Authors show a new experimental protocol in pigs based on new techniques and modifications of others already used. This model provides us security and quickness, we spend about 4 hours and we obtain results comparable to the best of other authors. All fifteen transplanted animals survived at least 12 hours except one who died just at the end of the operation, possibly due to an air-embolus at the moment of withdrawing bypass. We point out the importance of experimental surgery to reach a human program and the need for implementing a state pediatric hepatic transplantation program with coordination of all centers in order to have the best possibilities for children to obtain an appropriate organ. PMID- 3551711 TI - Diagnosis of human immunodeficiency virus infection by immunoassay using a molecularly cloned and expressed virus envelope polypeptide. Comparison to Western blot on 2707 consecutive serum samples. AB - To detect human immunodeficiency virus (HIV) antibodies in a simple enzyme-linked immunoassay (CBre3-EIA), we used an Escherichia coli-expressed polypeptide antigen, representing the carboxy-terminal third of the external membrane glycoprotein gene fused with the amino-terminal half of the transmembrane glycoprotein gene. Over a 3-month period, 2707 consecutive serum samples referred for confirmatory testing for human T-lymphotrophic virus type III (HTLV-III) antibodies were evaluated by both Western blot and CBre3-EIA. On a single determination for each sample, the CBre3-EIA was found to have an estimated sensitivity (99.9%) and specificity (99.1%) similar or superior to the more cumbersome Western blot method. This study shows that all HIV-seropositive subjects have antibodies to the virus envelope protein; no other virus antigens are required for construction of highly sensitive immunoassays. PMID- 3551710 TI - Prolonging tamoxifen therapy for primary breast cancer. Findings from the National Surgical Adjuvant Breast and Bowel Project clinical trial. AB - OBJECTIVE: To determine whether prolonging the duration of tamoxifen administration beyond the cessation of a combined chemotherapy regimen benefits patients with primary breast cancer with positive findings in axillary nodes who benefit initially from the combined regimen. DESIGN: Nonrandomized, nonconcurrent cohort study. SETTING: National Surgical Adjuvant Breast and Bowel Project, conducted in 68 institutions in North America. PATIENTS: Women were included if they had breast cancer with positive nodes and were aged 49 years or less with both estrogen and progesterone receptor levels of 10 fmol or more, aged 50 to 59 years with progesterone receptor levels of 10 fmol or more, or aged 60 to 69 years. Two cohorts were compared: patients who were randomly assigned to the tamoxifen arm of the adjuvant chemotherapy trial (randomized patients) and women who were added to this arm after randomization had ceased (registered patients). Three hundred seventy-seven women in each group who were disease free at the end of the initial 2-year treatment period were followed for an additional 3 years. INTERVENTIONS: All received melphalan, fluorouracil, and tamoxifen (10 mg twice daily by mouth) for 2 years. Registered patients (but not randomized patients) were offered tamoxifen for a third year after the initial 2-year treatment period, and 273 (72%) agreed. MEASUREMENTS AND MAIN RESULTS: Women receiving a third year of tamoxifen had a better disease-free survival rate (odds ratio, 1.54; 95% confidence interval, 1.14 to 2.07; p = 0.004) and survival rate (odds ratio, 1.56; 95% Cl, 1.02 to 2.37; p = 0.04) through their fifth postoperative year. Women aged 50 years or more benefited, but those aged 49 years or less did not. CONCLUSIONS: The benefit of tamoxifen given to tamoxifen-responsive patients in conjunction with melphalan and fluorouracil appears to be enhanced when the tamoxifen treatment is continued beyond cessation of treatment with these agents. PMID- 3551712 TI - Isotope-dilution assay for urinary methylmalonic acid in the diagnosis of vitamin B12 deficiency. A prospective clinical evaluation. AB - Vitamin B12 deficiency is a frequently considered diagnosis for which there is no single, commonly available and accurate test. A urinary methylmalonic acid assay using gas chromatography-mass spectrometry has been proposed as the preferred test. We reviewed vitamin B12 assays on 1599 consecutive patients and prospectively studied all patients with low serum B12 levels (n = 75) and a random sample of patients with normal levels (n = 68). Of 96 evaluable patients, 7 had clinical deficiency. All 7 deficient patients had urinary methylmalonic acid levels greater than 5 micrograms/mg creatine (sensitivity, 100%; confidence interval, 65% to 100%). Of the 89 patients who were not clinically deficient, 88 had urinary methylmalonic acid levels less than or equal to 5 micrograms/mg creatinine (specificity, 99%). The overall test accuracy in this population was 99%. If the high sensitivity and specificity of the gas chromatography-mass spectrometry assay for urinary methylmalonic acid is supported by other clinical studies, the methylmalonic acid assay may become the reference standard for the diagnosis of vitamin B12 deficiency. PMID- 3551713 TI - Use of pyrimethamine-sulfadoxine (Fansidar) in prophylaxis against chloroquine resistant Plasmodium falciparum and Pneumocystis carinii. AB - The widespread emergence of chloroquine-resistant Plasmodium falciparum led to the formulation of an effective, fixed combination of two antimalarial agents, pyrimethamine and the long-acting sulfonamide sulfadoxine, for prophylaxis and treatment. These drugs act at sequential steps to inhibit the formation of tetrahydrofolate in the parasite. Recently, their use for malaria prophylaxis has been associated with severe, at times fatal, cutaneous reactions including erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. These reactions have necessitated a major reassessment of the indications for pyrimethamine-sulfadoxine use and increased the search for pharmacologic, immunologic and behavioral approaches to the prophylaxis and treatment of infection with P. falciparum. Pyrimethamine-sulfadoxine may be effective in preventing recurrent pneumonia caused by Pneumocystis carinii in patients with the acquired immunodeficiency syndrome, but life-threatening cutaneous reactions have also been reported in this setting. PMID- 3551714 TI - The living donor in kidney transplantation. AB - Kidney transplantation using either kidneys from living or nonliving donors is now generally regarded as the primary therapy for most patients with end-stage kidney failure. In 1984, 32% of all kidney transplantations done in the United States involved living donors. Reasons justifying the use of kidneys from living donors are the higher success rate and the inadequate supply of cadaveric kidneys. In addition, with a living donor, it is easier to arrange for kidney transplantation before dialysis therapy needs to be started. An analysis of 2495 donor nephrectomies reported in the literature, and 5698 donor nephrectomies reported from the 12 largest centers that do kidney transplantation with living donors, indicates an approximate incidence of 1 donor death per 1600 nephrectomies. Although long-term follow-up in kidney donors has shown only that mild, nonprogressive proteinuria develops in about 33% and that the frequency of hypertension may increase, we advise that the kidney donor have a careful long term follow-up and avoid a high protein intake because of its potential to lead to progressive glomerular damage. PMID- 3551715 TI - History of the specialty of infectious diseases in the United States. AB - Infectious diseases in the United States were for generations so integral to health and medicine that a special interest in the field, except for investigative purposes, could hardly be contemplated. With declining mortality and morbidity from infections, and the advent of major antimicrobial drugs, interest in infectious disease flagged in clinical and microbiological departments. Several factors have caused a new interest in infectious disease, including the appearance of newly recognized infectious disease syndromes; advances in microbiologic, immunologic, virologic, and epidemiologic understanding; increased societal interest; proliferation of effective therapeutic and preventive agents; and the general thrust toward specialization. This interest led to the formation of societies, subspecialty boards, and journals, and accounts for the prominence of infectious disease in clinical departments and in national thought. Similar developments are taking place at various rates in other countries, with renewed attention to the toll of infectious diseases in developing countries. PMID- 3551716 TI - PaperChase. PMID- 3551717 TI - [Immunology of bone marrow grafts]. PMID- 3551718 TI - [Computer-assisted study of states of destructuring referred to as "schizophrenic"]. PMID- 3551719 TI - [The fate of the Szondi Test in France. "History, critical testing, validity"]. PMID- 3551720 TI - [Leopold Szondi, a destiny, an achievement]. PMID- 3551721 TI - The usefulness of the high voltage electron microscope in biomedical ultrastructure analysis. AB - We now have the tools to quantitate and correctly interpret the size, shape, and distribution of organelles in cells. It appears likely that the results will require some changes in some basic assumptions of ultrastructural cytology. This should also result in some new biochemical hypotheses about control of cell metabolism. PMID- 3551722 TI - The extraction of three-dimensional information from stereo micrographs of thick sections using computer graphics methods. PMID- 3551723 TI - Z-contrast in biology. A comparison with other imaging modes. PMID- 3551724 TI - Intracellular structure and elemental analysis in rapid-frozen neurons. PMID- 3551725 TI - Scanning transmission electron microscope (STEM) elemental mapping by electron energy-loss spectroscopy. PMID- 3551726 TI - Immunophotoelectron microscopy of the cell surface and cytoskeleton. PMID- 3551727 TI - A new method for three-dimensional reconstruction of single macromolecules using low-dose electron micrographs. PMID- 3551729 TI - Pharmacological approaches to thrombin regulation. PMID- 3551728 TI - Structure-function relationships of thrombin based on the computer-generated three-dimensional model of the B chain of bovine thrombin. AB - The advent of sophisticated computer graphics systems that permit the representation of macromolecular structure has made it possible to examine protein structure in detail. We have used one aspect of this technology to develop a model of thrombin. The model is based on structural and functional similarities this enzyme exhibits with respect to proteins found in the family of serine proteinases. This review has covered interpretations of the structure of the model based on analyses of data that had been collected before and after the model was developed. On one hand, the conceptualization of primary and secondary features in the model of the active site of thrombin has for the most part been preceded by data from experiments on the interaction of thrombin with naturally occurring substrates and inhibitors. The features of the model explain these data adequately. On the other hand, the model has been more recently used in an interactive way to derive information about the bioregulatory aspects of thrombin. The realization that the amino-terminus portion of the cyanogen-bromide fragment was probably not part of the chemotactic activity, because it was probably internalized in the native protein, has suggested that synthetic analogs should focus more on the carboxyterminus of the peptide. It is hoped that in the future the model will continue to serve more in this function and that it can be used to explore further other aspects about the structural and functional relationships of this enzyme. PMID- 3551730 TI - Difference in enzymatic properties between "staphylothrombin" and free alpha thrombin. AB - Bacterial protein, staphylocoagulase, binds stoichiometrically to human prothrombin resulting in a coagulant complex, staphylothrombin. The enzymatic properties of staphylothrombin differ from those of alpha-thrombin in their substrate specificities toward natural and synthetic substrates, in addition to their interaction with protease inhibitors. In order to obtain information about the region of staphylocoagulase that interacts with human prothrombin, staphylocoagulase was cleaved by alpha-chymotrypsin. This limited alpha chymotryptic cleavage of staphylocoagulase yielded three large fragments, fragments of 43, 30, and 20 kDa. The 43-kDa fragment exhibited a high affinity for human prothrombin (Kd = 1.7 nM), which is comparable to the affinity observed using intact staphylocoagulase (Kd = 0.46 nM). A complex of the 43-kDa fragment and prothrombin possessed both clotting and amidase activities essentially identical to those observed in a complex of intact staphylocoagulase and prothrombin. The 30-kDa fragment exhibited weaker affinity for prothrombin (Kd = 120 nM). While a complex of this fragment and prothrombin did not exhibit clotting activity, it nonetheless possessed a weak amidase activity. The 20-kDa fragment was found only to bind to prothrombin. The NH2-terminal sequence analyses of these fragments revealed that the 43-kDa fragment constitutes the NH2 terminal portion of staphylocoagulase, and contains the 30-kDa and 20-kDa fragments. It is therefore concluded that the functional region of staphylocoagulase for binding and activation of prothrombin is localized in the NH2-terminal region of the intact protein. The 43-kDa fragment contains 324 amino acids with a molecular weight of 38,098. The 43-kDa fragment has an unusual amino acid composition based on the sequence, in which the sum of Asp (28 residues), Asn (22), Glu (35), Gln (9), and Lys (52) residues accounts for more than 45% of the total residues. A comparison of the amino acid sequence of the 43-kDa fragment with that of streptokinase did not reveal any obvious sequence homology. There was also no sequence homology with those of trypsin, alpha-chymotrypsin, and elastase. PMID- 3551731 TI - Thrombin interactions with central nervous system tissue and implications of these interactions. AB - A monospecific antibody was developed to human alpha-thrombin. This antibody stained neurons but not astrocytes in murine spinal cord cultures incubated with 1-10 nM alpha-thrombin using the avidin-biotin-peroxidase technique. Staining did not occur when the primary or linking antibodies were eliminated, and staining was blocked with hirudin. Preliminary studies showed release of arachidonic acid from the cultures when exposed to thrombin. It was proposed that arachidonate release from the membranes of neurons upon exposure to thrombin was similar to that observed in platelets, for example, by activation of phospholipases. Moreover, prostanoids were formed that could have a deleterious effect on cellular elements in the central nervous system. The potential role of thrombin receptors on neurons was discussed. PMID- 3551732 TI - Responses of aortic smooth muscle to thrombin and thrombin analogues. PMID- 3551733 TI - Thrombin. PMID- 3551734 TI - The prothrombin gene and serine proteinase evolution. AB - The gene coding for human prothrombin has been isolated from two human genomic DNA libraries using a human prothrombin cDNA. Present evidence indicates that the gene is approximately 24 kb in length with about 90% of the DNA representing intervening sequence. Thirteen intervening sequences were found to interrupt the region coding for the mRNA into 14 exons. These intervening sequences vary greatly in size and contain at least 11 copies of Alu repetitive DNA. The positions where several of the intervening sequences interrupt the coding region appear to separate functional and structural domains of the protein. A similar placement of intervening sequences in genes coding for proteins homologous to prothrombin has been observed and provides additional evidence that these proteins have evolved from a common ancestor. PMID- 3551735 TI - The biology of non-myelin-forming Schwann cells. PMID- 3551736 TI - Parasexual approaches to the study of human genetic disease. AB - We have used two different strategies to construct hybrid cells in which specific, individual human chromosomes or fragments thereof are maintained by direct selective pressure. Our first approach was to introduce a drug-resistance gene into human chromosomes using a retroviral vector, and to transfer the marked chromosomes via microcells into mouse cells. The second method was to fuse gamma irradiated human cells with rodent cells to produce hybrids containing fragments of the human X chromosome. Such hybrid cell lines should greatly facilitate both human gene mapping and the isolation of human genes by molecular cloning. The gene-transfer technologies described here can also be used to construct cell lines in which the expression of genes involved in human diseases can be studied in vitro. PMID- 3551737 TI - Removable-suture closure of the lamellar scleral flap in trabeculectomy. AB - Removable-suture closure of the lamellar scleral flap was attempted in trabeculectomy, with the goal of increasing the degree of filtration during the immediate postoperative period by removing the suture so as to undo the closure whenever the need arose. The incorporation of the removable-suture closure of the lamellar scleral flap resulted in an additional mechanism of control over the degree of filtration after trabeculectomy. Furthermore, the availability of such a mechanism allowed the surgeon to close the lamellar scleral flap relatively tightly; this resulted in a decreased incidence of postoperative complications. PMID- 3551738 TI - Cerebro-oculo-facio-skeletal syndrome. AB - A three-month-old infant was referred with bilateral corneal opacities and microphthalmos. Pediatric examination as well as genetics consultation resulted in a diagnosis of the cerebro-oculo-facio-skeletal syndrome and should be included in the differential diagnosis of congenital cloudy corneas. PMID- 3551739 TI - [Nerve grafts in iatrogenic intratemporal facial paralysis]. AB - The paper reviews the question of nerve grafts in iatrogenic facial palsies caused lesion of the tympanic or mastoid portion. The approaches used by different specialists are discussed and the controverse on the question is analyzed. The authors present their experience in six cases of successful operations. PMID- 3551740 TI - Reinnervation of skeletal muscle: a comparison of nerve implantation with neuromuscular pedicle transfer in an animal model. AB - In recent years there has been increased interest in the possibility of reinnervating paralyzed muscles, particularly the muscles of the face and of the larynx. There has been dispute over the relative effectiveness of different approaches. This study was undertaken to compare direct nerve implantation with the transfer of a neuromuscular pedicle using denervated strap muscles in a rabbit model. Reinnervation was carried out both immediately after denervation and after a delay period. Evidence of return of function was obtained by a method of long-term electromyographic monitoring and was confirmed electrically by evoked electromyography and muscle tension measurement and histologically by brain stem uptake of horseradish peroxidase. Both methods of nerve transfer produced consistently functional neuromuscular units, with physiological activity and muscle strength comparable with those in normally innervated controls. Return of function was apparent within 6 weeks of both nerve implantation and neuromuscular transfer; with this model, neither method showed a clear advantage over the other. PMID- 3551741 TI - Three-year experience of treating recurrent respiratory papilloma with interferon. AB - This paper presents the 3-year follow-up of the original 19 patients with recurrent respiratory papilloma treated with exogenous alpha human leukocyte interferon (alpha-IFN) at the University of Iowa. Two patients were dropped from the study because of poor patient compliance, and one was lost to follow-up. After approximately 1 year of alpha-IFN treatment, five patients were clear, and the rest continued to have disease: seven mild, two moderate, and two severe. A second course of alpha-IFN was administered to eight patients, all of whom had a decrease in the volume of the papilloma. The reduction in anatomic distribution was variable. During the observation period all patients either cleared (50%), improved (25%), or continued with severe disease (25%). In summary, the response of recurrent respiratory papilloma to alpha-IFN therapy is dramatic in some patients and slight in others. PMID- 3551742 TI - Sternomastoid myoperiosteal flap for reconstruction of the subglottic larynx. AB - Reconstruction of the subglottis is usually required after resection of cricoid cartilage or tracheal tissue in cases of trauma, subglottic stenosis, or invasive thyroid carcinoma. There are multiple techniques available for reconstruction of the subglottic larynx, but most of them have a high rate of complications or graft failure. We have found the sternocleidomastoid myoperiosteal flap to be an ideal means of reconstruction. In an experimental study, we performed subglottic reconstruction using the sternomastoid myoperiosteal flap on 15 mongrel dogs to determine the presence of bone formation versus calcified fibrous scar. Radiologic studies suggested apparent metaplastic bone formation at the graft site, and histologic studies confirmed this. Functionally, 12 dogs had stable airways without stridor or subglottic narrowing. Three dogs died of complications. With successful reconstruction of large defects in the canine subglottis, attempts to repair large subglottic and tracheal defects in the human are feasible. PMID- 3551743 TI - Effect of experimentally induced otitis media on cochlear implants. AB - Cat cochleas implanted with scala tympani prostheses were investigated histologically after inoculating the bullae with a suspension of group A streptococci. The prosthesis was passed through the round window membrane in one ear. In the other the prosthesis bypassed the round window via an opening anteroinferior to the round window niche. Before death, horseradish peroxidase was administered as a tracer for possible pathways of infection. Results showed that group A streptococci were pathogenic to the cat and caused inflammation in the bulla. The unimplanted round window membrane and the seals around the electrode entry points prevented infection from entering the cochlea. The seals around electrodes inserted either through the round window membrane or an opening drilled anteroinferior to the niche were equally effective. The horseradish peroxidase tracer studies showed, however, that a gap existed between the electrode and membranous seal, and this could be a potentially vulnerable site under certain conditions. Drilling an anteroinferior opening into the cochlea resulted in bony sequestra entering the cochlea. This can be avoided by blue lining the opening and removing bone with picks before making an opening through the endosteum. PMID- 3551744 TI - Supracricoid hemilaryngopharyngectomy. Analysis of 240 cases. AB - The supracricoid hemilaryngopharyngectomy consists of resection of the supracricoid hemilarynx and ipsilateral pyriform sinus. Two hundred forty patients underwent this procedure from 1964 through 1983. Two hundred twenty-two patients had no airway impairment, and 204 recovered normal deglutition. The local recurrence rate was 5.2%. Indications for the procedure are carcinoma of the supracricoid upper part of the pyriform sinus and carcinoma of the lateral laryngeal margin with normal vocal cord mobility. PMID- 3551745 TI - [Erythema annulare centrifugum revealing linear IgA dermatitis of childhood]. AB - Linear IgA dermatitis was diagnosed in a 13-year old girl with erythema annulare centrifugum (EAC) on the basis of the criteria laid down by Jablonska: vesiculo bullous eruption with specific patterns on subsequent flare-ups, subepidermal vesicles and bullae with papillary eosinophilic abscesses in erythematous areas, positive linear IgA antibody response at direct immunofluorescence in the lamina basal, absence of intolerance to gluten and responsiveness to sulfapyridine and dapsone. This patient was followed up for 10 years. During the first 5 years any attempt at withdrawing dapsone resulted in quick relapse which always remained responsive to that drug. After 5 years discontinuing dapsone was no longer followed by relapse, and the girl was considered clinically cured. Yet direct immunofluorescence in healthy skin remained positive for 2 years after treatment was stopped, as has previously been reported. At the age of 23, after 5 years without treatment the patient remained cured. This case demonstrates that linear IgA dermatitis is one of the causes of EAC. Autoimmune bullous diseases, such as pemphigus with eosinophilic spongiosis, bullous pemphigoid and dermatitis herpetiformis, are known to present as EAC. Direct cutaneous immunofluorescence is necessary to the aetiological diagnosis of EAC. PMID- 3551746 TI - [Immediate treatment of bullous pemphigus with a corticosteroid-cyclophosphamide combination]. AB - Optimal management of the patient with generalized bullous pemphigoid (BP) should both control the disease rapidly to avoid fluid losses and superinfection, and have minimal side-effects. Although their initial dosage is subject to some controversy, corticosteroids (CS) provide currently the basis of therapy. Immunosuppressants have been advocated to decrease CS dosages more rapidly and to reduce potential hazards of long-term systemic steroid therapy, because of their sparing effect on cumulated CS doses. They have a delayed activity ranging from three to six weeks after beginning of therapy. Chloraminophene has been used in most previous studies. The aim of this study was to assess retrospectively a combined CS-cyclophosphamide (CP) regimen. Ten patients with generalized BP were treated. In nine, dexamethasone sodium phosphate was given intravenously (mean: 1.56 mg/kg/day in prednisone equivalents; range: 1 to 1.90 mg/kg/day) at onset of treatment. Prednisolone was given orally when complete control--absence of any new lesion--was achieved. CP was given d'emblee at a daily dosage of 100 mg for at least 6 months when feasible (mean: 4 months; range 9 days to 15 months). Patients characteristics are summarized in table I. Results are shown in tables II and III. In brief, three deaths occurred following major side-effects of the drugs during the first three months of treatment. Further non lethal untoward effects included bone marrow toxicity due to CP and septicemia (4 patients). At the end of follow-up, 5 patients were in remission without treatment for 22 +/- 6 months and one was controlled with prednisolone alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551747 TI - [Nikolowski's trichoadenoma. Immunohistological study of a new case]. PMID- 3551749 TI - [Post-transfusion malaria. Partial statistical data. Preventive approach to detecting blood donors at risk]. AB - The authors demonstrate the reality of post-transfusion malaria, define the plasmodial species involved, and insist on the responsibility of Plasmodium falciparum in the occurrence of major complications. A prophylactic approach is proposed, by researching anti-malarial antibodies in donors at risk. An I. F. A. (Indirect Immunofluorescence Assay) is performed (Falciparum Spot I. F., Bio Merieux, Lyon, France). The screening procedure relies heavily on medical history taking, but subsequent results are satisfying; moreover it seems they could be bettered by using specific monoclonal antibodies. PMID- 3551748 TI - [External photoprotection]. PMID- 3551750 TI - Peyronie's disease. AB - More than 16 years' experience with approximately 1,000 cases of Peyronie's disease and a review of 110 patients evaluated more than 1 year postoperatively are presented. Peyronie's disease is difficult to treat. There is no known etiological agent, and because occasional spontaneous disappearance of the lesion occurs, the assessment of therapy is difficult. Our operation has been successful in relieving penile curvature and pain in a substantial number of patients (84%). Therefore, we recommend that in all severe, sexually disabling cases of Peyronie's disease unresponsive to conventional therapy, excision of the diseased tunica albuginea and replacement with dermal graft be considered. Organic impotence, which is occasionally seen preoperatively in association with Peyronie's disease, requires thorough investigation, sex counseling, and consideration of a penile implant. PMID- 3551751 TI - The Holbein painting: a further note. PMID- 3551752 TI - Large echogenic kidneys in biliary atresia. PMID- 3551753 TI - Multicystic dysplastic kidney: evolving concepts. In utero diagnosis and post natal follow-up by ultrasound. PMID- 3551754 TI - Normal and abnormal gyral development of the premature infant on transfontanelle ultrasound. PMID- 3551755 TI - The present standard of ultrasonography in newborn and young infant hips. PMID- 3551756 TI - Changes in tracheobronchial width in bronchopulmonary dysplasia. A result of altered transmural pressures? PMID- 3551757 TI - Neurosecretion: beginnings and new directions in neuropeptide research. PMID- 3551758 TI - Molecular biology of visual pigments. PMID- 3551759 TI - Neuron specific enolase, a clinically useful marker for neurons and neuroendocrine cells. PMID- 3551760 TI - The neurobiology of fever: thoughts on recent developments. PMID- 3551761 TI - Computational maps in the brain. AB - The nervous system performs computations to process information that is biologically important. Some of these computations occur in maps--arrays of neurons in which the tuning of neighboring neurons for a particular parameter value varies systematically. Computational maps transform the representation of information into a place-coded probability distribution that represents the computed values of parameters by sites of maximum relative activity. Numerous computational maps have been discovered, including visual maps of line orientation and direction of motion, auditory maps of amplitude spectrum and time interval, and motor maps of orienting movements. The construction of the auditory map of space is the most thoroughly understood: information about interaural delays and interaural intensity differences is processed in parallel by separate computational maps, and the outputs of these maps feed into a higher order processor that integrates sets of cues corresponding to sound source locations and creates a map of auditory space. Computational maps represent ranges of parameter values that are relevant to the animal, and may differentially magnify the representation of values that are of particular importance. The tuning of individual neurons for values of a mapped parameter is broad relative to the range of the map. Consequently, neurons throughout a large portion of a computational map are activated by any given stimulus, and precise information about the mapped parameter is coded by the locations of peak activity. There are a number of advantages of performing computations in maps. First, information is processed rapidly because the computations are preset and are executed in parallel. Second, maps simplify the schemes of connectivity required for processing and utilizing the information. Third, a common, mapped representation of the results of different kinds of computations allows the nervous system to employ a single strategy for reading the information. Finally, maps enable several classes of neuronal mechanisms to sharpen tuning in a manner not possible for information that is represented in a non-topographic code. PMID- 3551763 TI - The analysis of visual motion: from computational theory to neuronal mechanisms. PMID- 3551762 TI - Molecular mechanisms for memory: second-messenger induced modifications of protein kinases in nerve cells. PMID- 3551764 TI - Molecular genetic insights into neurologic diseases. PMID- 3551765 TI - Gustatory neural processing in the hindbrain. PMID- 3551766 TI - Extrathalamic modulation of cortical function. PMID- 3551767 TI - Visual motion processing and sensory-motor integration for smooth pursuit eye movements. AB - The function of smooth pursuit is to keep the fovea pointed at a small visual target that moves smoothly across a patterned background. Chemical lesions, single cell recordings, and behavioral measures have shown that the cortical motion processing pathways form the afferent limb for pursuit. Important areas include at least the striate cortex and the middle temporal visual area, and probably the medial superior temporal visual area and the posterior parietal cortex. We argue that the visual inputs are transmitted through a simple sensory motor interface in the pons, to the efferent limb in the brain stem and cerebellum. The efferent limb uses neural velocity memory to maintain pursuit automatically. We present evidence that the velocity memory is provided, at least in part, by eye velocity positive feedback between the flocculus of the cerebellum and the brain stem. Finally, we use a computer model to show how the maintenance of pursuit can be simulated on a millisecond time scale. The structure and internal elements of the model are based on the biological experiments reviewed in our paper. In the past five years, progress on the neural basis of pursuit eye movements has been rapid. Several areas of research have made substantial contributions, by using combinations of new and conventional methods. Many of the pathways that contribute to pursuit have been identified, and their physiological activity and functions are becoming understood. Continuing progress promises to yield an understanding of one specific form of visually guided movement, at the level of neuronal circuits and behavior, in the primate. PMID- 3551768 TI - [Cystic lymphangioma of the anterior mediastinum. Study of a case encompassing the right innominate vein]. PMID- 3551769 TI - [Cefazolin in thoracic surgery]. PMID- 3551770 TI - [Continuous electrocardiogram recording (Holter). Normality criteria]. AB - The interpretation of a continuous electrocardiographic recording according to Holter's method is valid only in terms of well defined standard criteria. These criteria are beginning to become more specific, in spite of uncertainties linked especially to study protocols. Finally, if these criteria were established among healthy populations, their application to pathological situations comes up against the notion of physical condition which may modify all norms. PMID- 3551771 TI - Connective tissue diseases: mutations of collagen genes. PMID- 3551772 TI - DNA, hyperlipidaemias and atherosclerosis. PMID- 3551773 TI - Myc family genes: a dispersed multi-gene family. PMID- 3551774 TI - Proto-oncogene amplification: role in tumour progression. PMID- 3551776 TI - Gene therapy of somatic cells, the principle and techniques. PMID- 3551775 TI - Activation of c-ras oncogenes by mutations and amplification. AB - About 15% of all human tumours, including carcinomas, sarcomas, melanomas and leukaemias, contain c-ras oncogenes, which can be detected by a variety of methods. The activating lesion in the c-ras oncogenes is most often a point mutation affecting certain critical amino acid residues of its protein product. The clinical significance of c-ras oncogenes is not yet clear. PMID- 3551777 TI - Microbial diagnostics by nucleic acid hybridization. AB - Recombinant DNA techniques have enabled the selection and production of any specific gene and thus allowed the development of nucleic acid hybridization techniques as diagnostic tests for microbial identification. In the hybridization reaction sample nucleic acids, rendered single stranded by denaturation, are allowed to anneal with known specific probes carrying isotopic or nonisotopic label thus enabling the homologous target sequences in samples to be identified. Several hybridization tests have been established and used for the detection of many subviral, viral, bacterial and eukaryotic pathogens, which are difficult to diagnose by other methods. The most important challenge now for the hybridization techniques is in the development of practical tests, simply and rapidly performed, with high sensitivity, automation and nonisotopic detection system. PMID- 3551778 TI - Production of medically important proteins. PMID- 3551779 TI - Tissue polypeptide antigen (TPA) and beta 2-microglobulin (beta 2-MG) as tumour markers in nasopharyngeal cancer. AB - The levels of tissue polypeptide antigen (TPA) and beta 2 microglobulin (beta 2 MG) were measured in the serum of 38 patients with nasopharyngeal carcinoma (NPC). Using sera from 35 normal volunteers and blood donors, a normal range for these two tumour markers was established. The normal range for TPA was 40-148 IU/L (mean = 93), while that for beta 2-microglobulin was 0.9-2.0 mg/L (mean = 1.3). In the patients with NPC but without known metastases the range was 63-178 IU/L for TPA (mean = 111) and for beta 2-MG, the range was 1.0-3.1 mg/L (mean = 1.7). For those NPC patients with metastases to bone or liver, the mean TPA was 464 IU/L and the mean beta 2-MG was 4.3 mg/L. It appears that TPA and beta 2-MG are useful markers for the monitoring of NPC patients for metastatic disease, particularly TPA. PMID- 3551780 TI - Radionuclide measurement of liquid and solid gastric emptying in normal subjects in Singapore. AB - Scintigraphic methods for liquid and solid gastric emptying were utilised to study normal patterns in 21 volunteers. Of these, 19 had solid emptying studies and 14 had liquid emptying studies. The liquid study lasted 1/2 hour, while the solid study was for 1 hour. The gastric emptying half-time (T 1/2), as well as percentage retention at 15 minutes (liquids), and at 60 minutes (for solids) were noted. The time-activity curves were also corrected for tissue attenuation. Results indicated normal average liquid emptying T 1/2 to be 14.2 minutes, while that for solids was 116 minutes. PMID- 3551781 TI - The measurement of renal function with radionuclides. AB - It should be considered unethical to operate on a kidney without knowing its contribution to total renal function. This and the measurement of renal transit times are important in the management of patients with obstructive nephropathy. PMID- 3551782 TI - Nuclear medicine: non-invasive evaluation of coronary artery disease. AB - Non-invasive evaluation of coronary artery disease is accomplished in Nuclear Medicine by resting and exercise right and left ventriculography and/or by myocardial perfusion studies performed also at rest and exercise by means of Thallium-201. The development of new radiopharmaceuticals such as ultra short lived radionuclides and Technetium-99m labelled myocardial imaging agents allow simultaneous evaluation of both left ventricular function and left ventricular myocardial perfusion. Myocardial perfusion imaging is performed by means of planar imaging and recently by means of single photon emission tomography. The sensitivity and specificity of stress left ventriculography for uncomplicated coronary artery diseases are 85% and 95% respectively. For diagnosis of acute myocardial infarction with Thallium-201 in the first hours after onset of pain, the sensitivity is 99% and specificity is 80%. This diminishes after a 6 hour period to 90% and 80% respectively, while wall motion analysis stays with a sensitivity of 79% and 93%. The prognostic value of this determination is therefore a strong, cost-effective contributor to the non-invasive evaluation of coronary artery disease. PMID- 3551783 TI - Case report of a parathyroid adenoma demonstrated by dual tracer (T1-201 and Tc 99m) subtraction scan. AB - It is generally agreed that the Technetium-Thallium Subtraction Scan is a reliable method for locating abnormal parathyroid glands in patients with clinical and biochemical evidence of parathyroid hyperactivity. This report illustrates the value of scintigraphy in diagnosis and in the subsequent surgical management of a patient with primary hyperparathyroidism. PMID- 3551784 TI - Legionnaires' disease--report of Singapore's first local case. AB - A previously healthy 27 year-old male plumber presented with six days of fever, nausea, vomiting, malaise and headache. The subsequent development of cough, dyspnoea and pleuritic pain coincided with the simultaneous development of progressive bilateral cavitary pneumonia with pleural effusion. Leucocytosis, thrombocytopenia, hyponatraemia, hypoalbuminaemia, hypophosphataemia and hypoxaemia were the main laboratory abnormalities. Clinical suspicion of Legionnaires' disease was confirmed by the presence of serum antibody to Legionella pneumophila (titre 1:512) by an indirect fluorescent antibody test. Treatment with erythromycin and rifampicin resulted in clinical recovery with minimal residual bilateral pleural effusion six months after presentation. This patient is the first to acquire Legionnaires' disease in Singapore. PMID- 3551785 TI - Clonogenic assay combined with flow cytometric cell sorting for cell-cycle analysis of human leukemic colony-forming cells. AB - The purpose of this study is to develop a method combining clonogenic assay and flow cytometric cell sorting based on DNA content for determination of percentage distribution of human malignant clonogenic cells over cell-cycle phases. Flow cytometric cell sorting was carried out for Chinese Hamster Ovary (CHO) and human leukemic bone marrow cells under sterile conditions using a supravital dye for DNA, 4',6-Diamidino-2-phenylindole dihydrochloride (DAPI). The fraction sorted for G0/G1 CHO cells was verified to be almost completely free of G2/M cells and partially cleared of S-phase cells. Cells sorted for G0/G1 fraction were successfully grown as colonies in culture for both CHO and human leukemic marrow cells. The plating efficiency of sorted cells was lower than that of unsorted cells, and the relative contribution of cell damage versus cell selection cannot be determined for this reduction of plating efficiency. The purity of sorted cells must still be improved, and the reason for reduced plating efficiency remains to be defined by further studies. Nonetheless this report represents initial data demonstrating the feasibility of combining two technologies: clonogenic assay and flow cytometric cell sorting based on DNA content. As such, it paves the way for a new approach to studying the cell cycle kinetics of clonogenic cell subpopulations of malignant tissues freshly obtained from patients. PMID- 3551786 TI - [Real-time echography in the evaluation of the venous extension of cancer of the kidney. Prospective study of 50 cases]. AB - Fifty patients with renal carcinoma were evaluated with real time ultrasonography: 15 tumors involved the renal vein (group Ia), 12 of them presented with caval tumor extension (group Ib); 35 tumors did not involve the renal veins (group II). In 3 cases, the renal vein could not be visualized. If the renal veins could be adequately delineated, evaluation of venous extension could be achieved in 100% cases (groups Ia and II). Nevertheless, caval tumor extension could be detected in only 70% cases (group Ib). This prospective study suggests that in the case of renal vein free of thrombus on ultrasonography, further investigations are not necessary to evaluate the venous extension of renal carcinoma. In case of inadequate delineation, or tumor involvement of the renal vein on ultrasonography, evaluation of inferior vena cava is mandatory, either by computed tomography, or inferior cavography. PMID- 3551788 TI - [Evaluation of endorectal ultrasonography in the diagnosis of prostatic cancer using a high-frequency sectorial intracavitary probe]. AB - Endorectal ultrasonography was evaluated in the diagnosis of prostatic cancer, using a high frequency (7,5 MHz) mechanical sectorial endocavitary probe developed by the authors. In a first study, sonograms from a series of 213 patients were interpreted retrospectively without any knowledge of the clinical or pathological findings. Specificity for the diagnosis of cancer (true non malignant/total non-malignant) reached 79%, whereas sensitivity (true malignant/total malignant) was only 48%. Pathology was available for 132 patients. In a second study, 72 ultrasonically guided biopsies were performed in patients presenting either with a suspicious induration without nodule (47 cases) or a palpable nodule (25 cases). Good quality biopsy specimens, and absence of complication were remarkable. However, the 10 cancer cases (5 diagnosed in each group) did not show sonographically clearly different from the remaining adenoma, prostatitis and normal cases. PMID- 3551787 TI - [Value of the echography of the maternal kidney during pregnancy]. AB - Routine ultrasonographic detection of renal tract dilatations in pregnant women is used to define a high risk population for urinary tract infections. In a first group of 96 patients with symptomatic urinary tract infection, 34% of the cases of uncomplicated infection were accompanied by ultrasonographic abnormalities, while 73% of cases of pyelonephritis presented such signs. Antibody coated bacteria were only found in 12% of uncomplicated urinary tract infections and in 30% of cases of pyelonephritis. In a second group of 273 patients, routine ultrasonography revealed abnormalities in 11.5% of cases. 7.5% of patients had dilatations of the upper renal tract, 2% had renal stones and 2% had occult renal malformations. Dilatations of the upper renal tract were associated with asymptomatic urinary tract infections in 30% of cases. Screening for upper renal tract dilatations is recommended between the 17th and 20th weeks of pregnancy. The presence of such lesions constitutes a risk factor for urinary tract infection and appropriate prophylactic treatment should be prescribed. PMID- 3551790 TI - A silver spoon. PMID- 3551789 TI - [Urinary diversions and intestinal grafts in renal transplantation in children. Report of 8 cases]. AB - In a series of 400 transplantations, 8 children presented a severe lesion of the lower urinary tract requiring an intestinal graft to divert the urine or to replace the useless bladder: 4 cases of posterior urethral valves and 4 cases of neurogenic bladder. Four permanent urinary diversions and 4 bladder enlargements, including 3 temporary diversions, were performed. The sigmoid colon was used in 5 cases and the ileum was used in 3 cases. The preparation of the intestinal graft was always performed prior to the transplantation. The uretero-intestinal anastomosis included an antireflux device in 3 of the 8 cases. There were no deaths in this series. Three occlusions and 2 lymphoceles occurred in the immediate post-transplantation period, but were corrected by re-operation. Two cases of calculi occurred in the long term, one of which required operation. Moderate stenosis of the renal artery in one case resulted in systemic hypertension which was well controlled by medical treatment. An episode of acute pyelonephritis resolved rapidly with antibiotic treatment. Two cases of acidosis were corrected by salt supplementation. There was one case of early graft rejection on the 15th day and a delayed rejection after 18 months, leading to removal of the transplant. At the present time, 6 renal grafts function normally (75%) with a follow-up of 1 to 8 years. PMID- 3551791 TI - Scaling energetics of homeothermic vertebrates: an operational allometry. PMID- 3551792 TI - What does the power function reveal about structure and function in animals of different size? PMID- 3551793 TI - Structural and functional limits to oxidative metabolism: insights from scaling. PMID- 3551794 TI - Scaling of structural and functional variables in the respiratory system. PMID- 3551795 TI - Lateral diffusion of proteins in membranes. AB - Membrane protein lateral diffusion can be constrained in several ways: Diffusion can be slower than that predicted for a simple, fluid lipid bilayer; diffusion can be confined to certain regions within the total membrane; and diffusion may not be equally probable in all directions, i.e. it may be anisotropic. We know that protein diffusion is reduced by increasing concentrations of membrane proteins and by interactions of the diffusant with structure(s) peripheral to the membrane. The molecular nature of such peripheral constraints has been difficult to pinpoint, but attention is now being directed to the extracellular matrix in addition to the membrane-associated cytoskeleton. There are many proteins that are confined to lateral domains in differentiated, isolated cells and in cells organized into tissue. The mechanisms that maintain such inhomogeneous distributions should be elucidated in the next few years. Whether lateral diffusion of membrane proteins over distances of a few micrometers is usually isotropic or anisotropic will be ascertained in the near future using imaging methods combined with photobleaching. PMID- 3551796 TI - Red cell deformability and its relevance to blood flow. PMID- 3551797 TI - Regulation of intracellular pH in the stomach. AB - The following picture emerges from the relatively small literature concerned with pHi regulation in the stomach. Oxyntic cells have a H,K-ATPase at the luminal membrane and both Na+-H+ and Cl(-)-HCO3 exchangers at the serosal membrane. The intrinsic buffer capacity is 40-50 mM/pH. In the resting state, when the H, K ATPase is inactive, pHi is 7.1. The Na+-H+ exchanger prevents acidic shifts of pHi, and the Cl(-)-HCO3 exchanger prevents alkaline shifts. The combined operation of the two appears to contribute directly to the net Cl- secretion (and short-circuit current) generated by resting OC. In the stimulated state, H+ secretion into the gland lumen via the H,K-ATPase increases, and Cl- movement across the serosal membrane via exchange for HCO3 doubles or triples; however, pHi remains roughly constant (delta pHi less than or equal to 0.1 units). The large increase in Cl- and HCO3 movement across the serosal membrane requires one (or all) of the following events: The anion exchanger changes its characteristics (Km or Vmax); [Cl-]i decreases; or other membrane mechanisms must be activated. Chief cells also have a pHi of 7.1 and a Bi of 40-50 mM/pH. They exhibit Na+ dependent and Cl(-)-dependent changes of pHi that are consistent with the presence of both Na+-H+ and Cl(-)-HCO3 exchangers. The Na+-dependent changes of pHi are larger and the Cl(-)-dependent changes are smaller in CC than in OC. Surface cells exhibit changes of AO fluorescence that indicate that there is a Na+-H+ exchanger and a HCO3 conductance. The H+ permeability of the luminal membranes of all cells is very low, while that of the serosal membrane (via the cation and anion exchangers) is high. PMID- 3551798 TI - Intracellular lipid transport in eukaryotes. PMID- 3551799 TI - Erythrocyte membrane elasticity and viscosity. PMID- 3551800 TI - Red cell biochemical anatomy and membrane properties. PMID- 3551801 TI - The tubuloglomerular feedback mechanism: functional and biochemical aspects. AB - Tubuloglomerular feedback is an intrarenal control mechanism designed to regulate the amount of salt entering the distal nephron. Its regulatory efficiency depends upon the magnitude of the vascular response to changes in the luminal signal (the feedback relationship) and on the adjustments in proximal absorption, which determine the macula densa signal (the feedforward relationship). Studies of the feedback relationship have established that the vascular response is related to macula densa solute concentration in a sigmoidal fashion, with the normal operating point located somewhere in the steep portion of the curve. Thus, tubuloglomerular feedback tonically suppresses glomerular filtration rate, an effect that may be even more pronounced in juxtamedullary nephrons. An alteration in the feedforward function and thus in the macula densa signal is likely to participate in the vascular resistance changes initiated by changes in arterial pressure, elevated protein intake, or ADH administration. Our understanding of the intra- and intercellular mechanisms underlying information transfer across the JGA is currently incomplete, but there is some information about the biochemical characteristics of the cellular components. The enzymatic and surface properties establish the distinct nature of the macula densa cells and indicate a distinct function. PMID- 3551802 TI - Altered reactivity of tubuloglomerular feedback. AB - The efficiency of coupling between salt delivery to the sensing site in the macula densa and the glomerular vascular effector response is altered by changes in extracellular fluid volume, in the amount of dietary protein, and many other conditions, including growth and maturation, and the development of hypertension in Okamoto-Aoki and Milan strains of genetically hypertensive rats. Examination of feedback-mediated responses by perfusion of Henle's loop reveals a tendency for multiple changes in characteristics of feedback curves for SNGFR and SFP. In general, inhibition of TGF activity is evidenced by a smaller maximum glomerular response, reduced reactivity, and a shift in the inflection point to a higher flow rate. The opposite responses are frequently noted during exaggerated TGF activity. It is not known at present whether one or more mechanisms are involved in mediating or modulating the functional correlates of these characteristics. Insight into these functional correlates may be provided by selective, graded inhibition and stimulation of the sensing and effector elements in the feedback loop. Investigations of potential extrarenal mechanisms of resetting indicate that atrial natriuretic factor and an unidentified factor present in the proximal tubular fluid may play a role under certain circumstances. In addition to the renin-angiotensin and arachidonic acid-prostanoid systems, the kallikrein-kinin system appears to modulate TGF activity. A large body of evidence indicates TGF activity is inversely correlated with renal interstitial pressure. Whether this correlation reflects causality or a phenomenological association awaits further investigation. PMID- 3551803 TI - Thyroid hormones and brain development. AB - We have limited ourselves to the deleterious effects of the absence of thyroid hormones on the development of the central nervous system and have not discussed the problems caused by hyperthyroidism. A short "critical period" during which thyroid hormones are essential for normal maturation of the CNS is evident at anatomical, biochemical, and neurophysiological levels. In the last decade we have made progress toward understanding the mechanism of action of thyroid hormones, due in part to numerous studies of the ontogenesis and distribution of the nuclear T3 receptor. These studies can indicate where the molecular events that control the growth and maturation of the brain are initiated. However, much further research in this area is needed to comprehend further the relation between thyroid hormones and brain development. PMID- 3551804 TI - Insulin in the brain. PMID- 3551805 TI - Sex steroids and afferent input: their roles in brain sexual differentiation. PMID- 3551806 TI - Central actions of ovarian steroids in the feedback regulation of pulsatile secretion of luteinizing hormone. AB - I have considered the neural organization of the system responsible for pulsatile LH and GnRH secretion and have described the feedback actions of two ovarian steroids, estradiol and progesterone. These steroidal feedbacks are complex: They are time and dose dependent; they include both inductive and inhibitory effects; they reflect actions at multiple sites within the hypothalamo-hypophyseal axis. In this review we emphasized two ovarian steroids especially important to this regulatory system and observations in females of two species that have been particularly well studied in this regard. This emphasis required exclusion of excellent studies in other species, with other steroids, and in the other sex. This focus, however, permitted a more detailed evaluation of current concepts in an area of fundamental importance to the neuroendocrine regulation of reproduction. PMID- 3551807 TI - Gastroenteropancreatic peptides and the central nervous system. PMID- 3551808 TI - Adrenocortical steroids and the brain. AB - In summary, a wide variety of effects of adrenal steroids on the brain have been reported and have been recently and exhaustively reviewed. From the viewpoint of endocrine physiology, however, what is often forgotten is the extraordinary difference in signal level between the two unique products of the adrenal cortex, the mineralocorticoid and glucocorticoid hormones. Levels of cortisol or corticosterone are 2-3 orders of magnitude higher than those of aldosterone, a difference that is tempered by perhaps one order of magnitude by the much higher binding of glucocorticoids to plasma protein. The signal-detecting mechanisms for the lower-intensity signal, i.e. the mineralocorticoid receptor, must therefore have powerful specificity-conferring mechanisms to enable it to recognize, bind, and respond to aldosterone. In vitro studies from a number of laboratories have shown that Type I receptors, in both classic mineralocorticoid target tissues (kidney, parotid, gut) and nontarget tissues (pituitary, hippocampus), cannot distinguish between aldosterone and corticosterone. This finding highlights the problem of aldosterone-selectivity in the kidney (Na+ transport) or the brain (Na+ appetite). In vivo studies, in contrast, show that corticosterone is very poorly taken up and/or retained in kidney, colon, parotid, and pituitary (but not in hippocampus) in mature and 10-day-old (minimal transcortin) rats, whereas aldosterone is well taken up and/or retained by all tissues, evidence for tissue specific aldosterone selectivity in vivo. Two nonexclusive (i.e. possibly additive) models for such aldosterone selectivity are proposed, one "prebinding" and the other "postbinding". Both models accommodate the experimental findings of the nonselectivity of cytosol preparations in vitro and the stringent specificity seen in in vivo receptor and effector studies. In any real sense, the action of adrenal steroids on the brain is still largely an area of unconnected phenomenology, despite the efforts of a number of talented individuals and groups over the past two decades. Without descriptions of phenomena, even of the most basic ablation and replacement type, we have no chance of making physiological statements. It is equally important, in the attempt to make a coherent physiology, to erect a scaffolding of hypothesis that can be tested against the existing experimental findings and that can serve to suggest further studies in a logical sequence. These hypotheses themselves, and the models used to reify them, may be validated, altered, or rejected by the studies over the next few years.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3551810 TI - Cardiovascular responses to chronic hypoxia. PMID- 3551809 TI - Functions of angiotensin in the central nervous system. AB - In this review, the emerging functional roles of the brain angiotensin system have been considered. The major effects of Ang II can be classified into three groups, which imply three possible functions: The first, and largest, group is actions associated with the regulation of body fluid volume in response to hypovolemia. These include thirst, blood pressure increase, vasopressin release, sodium appetite and excretion, and ACTH and aldosterone release. This function alone has important implications for the control of blood pressure and the disease of hypertension. Another possible function is a role for angiotensin in the activity of gonadotropic hormone releasing hormones and pituitary hormones during the reproductive cycle and pregnancy. A third group of functions is the synaptic, neurotransmitter interactions of Ang II with catecholamines, serotonin, prostaglandins, and other peptides, not all of which could be reviewed here due to space limitations. This interaction is significant for all functions mentioned and leads to alterations in motivation (thirst, pain), memory (and possibly learning), and motor control. The amount of data available, however, is so limited that to claim angiotensin plays any major role in the latter functions would be premature. Throughout this review, we compared the central and peripheral effects of Ang II. We suggest that normally, a blood-CVO barrier prevents diffusion of peripheral Ang II to brain receptors inside the BBB. Because of this mechanism, the responses to the two routes of administration are distinctly different. When systemic peptide levels are low, Ang II activates only receptors in the CVOs; however, when these levels are high, the peptide diffuses to receptors that are normally activated only by brain Ang II. PMID- 3551811 TI - Cardiac muscle changes in senescence. PMID- 3551812 TI - Polypeptide-containing neurons in airway smooth muscle. PMID- 3551813 TI - Innervation of airway smooth muscle: fine structure. PMID- 3551814 TI - Organization of central control of airways. PMID- 3551815 TI - [Sporulation in Bacillus licheniformis strains that do not synthesize bacitracin and serine exo- and endoproteases]. AB - Sporulation and synthesis of bacitracin, a peptide antibiotic and serine exoproteases and endoproteases were studied in 6 strains of Bacillus licheniformis at various periods of cultivation in sporulation media. Thermostable spores in all the strains were shown to form in the absence of both the exogenic and endogenic antibiotic and proteases. It was suggested that bacitracin and the serine proteases were not specific regulators of sporogenesis in B. licheniformis and their biological function under the natural conditions included, respectively, the antibiotic action and hydrolysis of proteins and peptides of the environment and cells. PMID- 3551816 TI - [Effect of oleandomycin on the growth of the producer Streptomyces antibioticus itself and on its antibiotic synthesis]. AB - It was shown that addition of oleandomycin to the fermentation broth during development of Str. antibioticus inhibited the mycelium growth within the first 2 days and lowered the level of its further biosynthesis. The inhibitory effect depended on concentration of the added antibiotic and medium composition. An excess of glucose increased the inhibitory effect of oleandomycin. The antibiotic influenced both synthesis of the oleandomycin macrolide ring and methylation of the molecule. PMID- 3551817 TI - [Antibiotic prophylaxis in surgery]. PMID- 3551818 TI - [Distributed automatic control system for experiments on the cultivation of microorganisms]. AB - Hard- and software of a distributed system for computer control of experiments on cultivation of microorganisms is described. The system is based on microprocessor techniques and minicomputer CM-4(1420). It provides intensification of microbiological studies due to rational management of experiments, accumulation and long-term storage of experimental data and their processing with specific algorithms for providing additional information on biosynthetic processes and optimization of fermentation conditions. PMID- 3551819 TI - [Experimental Candida infection in mice due to intracerebral contamination]. AB - Candida infection caused by intracerebral administration of collection and clinical strains of C. albicans was studied on 1000 albino mice. The infecting doses ranged from 5 X 10(6) to 200 X 10(6) cells. Developing infection might be characterized as Candida encephalomeningitis complicated by generalized candidiasis. Acute purulent inflammations in the tissues of the brain, kidneys and myocardium developing at early periods after the infection were replaced by granulomatous reaction and fibroplastic processes. Generalization of the infection was confirmed by C. albicans isolation from blood and internal organs. Development of multiple microabscesses in the brain tissue and early severe affections in the kidneys and myocardium were a pathomorphological characteristics of the infectious process due to administration of a clinical virulent strain of C. albicans to the brain. Intracerebral administration of various C. albicans strains to mice provided their differentiation by the virulent properties. PMID- 3551820 TI - [Antibiotics of the phosphonic acid group]. PMID- 3551821 TI - [Transparent nutrient medium for culturing Francisella tularensis]. AB - A transparent nutrient medium T (tularemic) for cultivation of F. tularensis was developed on the basis of heart-brain infusion, yeast extract, bactotryptone, technical casamino acids, bactoagar, salts, L-cysteine and glucose. Introduction of an antibiotic (polymyxin B, 100 units/ml) to the medium composition provided selective conditions for growth of F. tularensis. Comparative study of the medium growth properties revealed that medium T by this parameter was not inferior to the Emel'ianova and Antsiferov media and by the yield of the bacterial mass was superior to them. A liquid variant of the medium (broth T) may be successfully used in various experiments requiring broth cultures of F. tularensis (interspecies conjugation, transformation, mutagenesis, etc.). The medium provides the use of wider temperature ranges for cultivation of F. tularensis. Because of transparency the medium may be used in identification of strains and their description by certain biochemical features. Medium T may be also used in studies with field materials (dead rodents, water). PMID- 3551822 TI - [Use of a method of fusing actinomycete protoplasts for obtaining recombinant strains that form new antibiotics]. PMID- 3551823 TI - Treatment duration for urinary tract infections in adults. PMID- 3551824 TI - Five-year survey of changing patterns of susceptibility of bacterial uropathogens to trimethoprim-sulfamethoxazole and other antimicrobial agents. AB - We analyzed the antibiotic susceptibility of 5,348 urinary isolates of Escherichia coli, "Klebsiella aerogenes," and Proteus mirabilis grown in three laboratories from 1980 to 1985. A continuous rise in resistance to trimethoprim sulfamethoxazole was observed; 63% of the strains from inpatients in 1984 and 51% of those from outpatients in 1985 were resistant to this drug. Isolates from outpatients in 1985 were mostly susceptible to nitrofurantoin (mean susceptibility, 92%) and to oral cephalosporins (mean susceptibility, 84%). As for isolates from inpatients, none of the antimicrobial agents now used was satisfactory for initial chemotherapy, indicating a need for new antibacterial strategies. PMID- 3551825 TI - Inoculum effect with chloroquine and Plasmodium falciparum. AB - In the studies reported here, we examined the inoculum effect observed with chloroquine and Plasmodium falciparum. The 50% effective doses observed with both chloroquine-susceptible and -resistant parasites increased five- to sevenfold from their baseline values as the inoculum was increased from 2 X 10(5) to 2 X 10(7) parasitized erythrocytes per ml (parasitemias of 0.1 to 10% with a hematocrit of 2%). Increasing the inoculum also decreased the chloroquine uptake per parasitized erythrocyte 15- to 20-fold with both chloroquine-susceptible and resistant parasites. However, because of the 100-fold increase in the inoculum, the total amount of chloroquine taken up actually increased sufficiently to reduce the extracellular chloroquine concentration in vitro by 60 to 90%. These studies suggest that a chloroquine uptake of greater than or equal to 2.0 pmol/10(6) parasitized erythrocytes is necessary for chloroquine to inhibit parasite growth. More marked reductions in the amount of chloroquine uptake per parasitized erythrocyte were observed with a hematocrit of 40% using similar parasitemias of 0.1 to 10% (inocula of 4 X 10(6) to 4 X 10(8) parasitized erythrocytes per ml). Thin-layer chromatography of [3H]chloroquine taken up by chloroquine-resistant P. falciparum revealed no evidence of drug alteration by the parasite. These studies define the mechanism responsible for the inoculum effect observed with chloroquine and P. falciparum in vitro. PMID- 3551826 TI - Effect of antifungal agents on lipid biosynthesis and membrane integrity in Candida albicans. AB - Eight antifungal agents were examined for effects on lipid biosynthesis and membrane integrity in Candida albicans. Lipids were labeled in vivo or in vitro with [14C]acetate and analyzed by thin-layer and gas chromatography. Membrane integrity was measured by a recently developed [14C]aminoisobutyric acid radiolabel release assay. The imidazole antifungal agents miconazole, econazole, clotrimazole, and ketoconazole, at concentrations inhibiting ergosterol biosynthesis (0.1 microM), decreased the ratio of unsaturated to saturated fatty acids in vivo but not in vitro. Similarly, naftifine, tolnaftate, and the azasterol A25822B, at concentrations inhibiting ergosterol biosynthesis (10, 100, and 1 microM, respectively), decreased the ratio of unsaturated to saturated fatty acids in vivo only. This suggests that the effect on fatty acids observed with ergosterol biosynthesis inhibitors may be secondary to the effect on ergosterol. With imidazoles, oleic acid antagonized inhibition of cell growth but not inhibition of ergosterol. This suggests that, with the C-14 demethylase inhibitors, decreased unsaturated fatty acids, rather than decreased ergosterol, are responsible for growth inhibition. Cerulenin, previously reported to be a potent inhibitor of both fatty acid and ergosterol biosynthesis, was found in the present study to inhibit the former (at 5 microM) but not the latter (up to 100 microM). Of the antifungal agents tested, econazole and miconazole (at 100 microM) produced complete release of [14C]aminoisobutyric acid, which is consistent with membrane damage. PMID- 3551827 TI - Clinical study evaluating efficacy of praziquantel in clonorchiasis. AB - In 74 patients with clonorchiasis, the efficacy and safety of praziquantel was evaluated in a two-phase study: a double-blind, randomized controlled trial of praziquantel versus placebo (42 patients) and an open study (32 patients). All but one of the patients were Laotians. The intensity of clonorchiasis was light in 85% (63 of 74) and moderate in 15% (11 of 74) of the patients. Cure based on our established criteria was noted in 67 of 67 patients (100%) treated with praziquantel at a dose of 75 mg/kg per day. In contrast, four patients (20%) in the placebo group, each with light infection, ceased passing eggs and were, according to our established protocol, considered spontaneous cures (P less than 0.0001). Adverse effects of praziquantel were transient and included nausea and vomiting (15%), vertigo (12%), hepatomegaly (4.5%), headache (1.5%), rash (1.5%), and hypotension (1.5%). Of 20 patients who received placebo, 1 (5%) developed transient skin rash, fever, and chills. Clinically minor and transient, but statistically significant, changes in hemoglobin, total protein in serum, and levels of uric acid, cholesterol, and bilirubin in serum were noted. Results of this study showed that praziquantel is safe, well tolerated, and effective and should be considered as the drug of choice for treatment of clonorchiasis. In moderate infections, a second course of praziquantel therapy may be necessary to eliminate infection. PMID- 3551829 TI - Randomized prospective study of ceftazidime versus ceftazidime plus cephalothin in empiric treatment of febrile episodes in severely neutropenic patients. AB - In a prospective randomized study, ceftazidime monotherapy was compared with a combination of ceftazidime plus cephalothin in 102 febrile neutropenic patients. Thirty bacteriologically documented infections, of which 23 were bacteremias, in 48 clinically assessable patients were treated with ceftazidime alone. Twenty four bacteriologically proven infections, of which 18 were bacteremias, in 42 clinically assessable patients were treated with a combination of ceftazidime and cephalothin. The clinical response rates in assessable patients were 77% for ceftazidime monotherapy and 88% for the combination. The bacteriological clearance rate was 70% for ceftazidime monotherapy and 79% for the combination. Efficacy against gram-negative pathogens appeared to be excellent, with 93% clearance for ceftazidime monotherapy and 100% clearance for the combination. The bacteriological clearance of gram-positive infections was only 60% for both regimens, with failures mainly due to Streptococcus faecalis and Streptococcus sanguis, which are primarily resistant to both ceftazidime and cephalothin. After addition of vancomycin to those infections which did not respond to empiric therapy, bacteriological clearance rates of 94% (ceftazidime plus vancomycin) and 90% (ceftazidime and cephalothin plus vancomycin) were achieved. Three superinfections were registered in the ceftazidime group and two were seen in the combination group. Other adverse effects of ceftazidime were minimal and were not enhanced by combination with cephalothin. It is concluded that ceftazidime is an effective drug for the empiric treatment of febrile neutropenic patients, especially if one is prepared to modify therapy if resistant gram-positive strains or mycotic infections are encountered. Neither the clinical nor bacteriological cure rates could be substantially improved by adding cephalothin to ceftazidime in initial empiric treatment of febrile neutropenic patients. PMID- 3551828 TI - Roxithromycin (RU 965): effective therapy for experimental syphilis infection in rabbits. AB - Roxithromycin (RU 965), a new macrolide antibiotic, was shown to be effective for therapy of active syphilis in rabbits. Dark-field-positive lesions were produced in adult male rabbits by intradermal inoculation of approximately 10(6) Treponema pallidum organisms at each of 11 sites. Beginning 7 days after infection, six animals per group were treated with benzathine penicillin G (200,000 U, intramuscularly, weekly for 2 weeks) or roxithromycin (15 mg/kg of body weight, orally, twice daily for 15 days); six animals were not treated. Chancres in untreated animals were dark-field positive throughout the 16-day observation period; all benzathine penicillin-treated rabbits were dark-field negative 1 day after the initiation of therapy. Five of six animals treated with roxithromycin were dark-field negative on day 3 following the initiation of therapy; the sixth animal was dark-field negative by day 6. Lesions in untreated animals reached a mean (+/- standard deviation) maximum diameter of 14.7 +/- 1.91 mm compared with 8.4 +/- 3.6 mm for benzathine penicillin-treated (P less than 0.005) and 10.4 +/- 1.2 mm for roxithromycin-treated (P less than 0.001) animals. Ulceration occurred at 62 of 66 lesions in untreated animals compared with 0 of 66 lesions in each treated group. At 3, 6, and 12 weeks postinfection, Venereal Disease Research Laboratory antibody titers were significantly higher (P less than 0.05) in untreated than in treated animals. Titers in penicillin-treated versus roxithromycin-treated animals were significantly different at 6 weeks postinfection but not at 3 and 12 weeks postinfection. Transfer of tissue from treated rabbits to seronegative recipient animals did not reveal any evidence of persistent infection in the benzathine penicillin- or roxithromycin-treated animals. These findings indicate that benzathine penicillin and roxithromycin, at the doses indicated above, are effective in treating active syphilis in rabbit model. PMID- 3551830 TI - In vivo evaluation of tigemonam, a novel oral monobactam. AB - Tigemonam, a new monobactam with excellent activity against gram-negative bacteria, was evaluated for in vivo efficacy and absorption after oral administration to laboratory animals. Tigemonam is absorbed when administered orally to mice and dogs. In a variety of gram-negative systemic infections in mice, orally administered tigemonam was efficacious in all infections studied. Comparison drugs such as amoxicillin, cephalexin, and cefaclor were less efficacious, especially in infections caused by beta-lactamase-producing organisms. In localized infections, tigemonam also demonstrated excellent in vivo activity. In acute pyelonephritis in mice caused by Escherichia coli or Proteus sp., tigemonam was very effective. In a rat lung model with Klebsiella pneumoniae, tigemonam was active with a median effective dose of 46 mg/kg compared with 160 mg/kg for cefaclor and over 200 mg/kg for amoxicillin. Tigemonam was well absorbed in laboratory animals and with its excellent gram negative spectrum of activity should prove of value in oral antibiotic therapy in humans. PMID- 3551831 TI - Entry of ketoconazole into Candida albicans. AB - To define characteristics that determine the entry of ketoconazole (KTZ) into Candida albicans cells, we studied the uptake of [3H]KTZ. The cells rapidly and markedly concentrated the drug: 30% of the final 80-fold intracellular concentration was attained in less than 1 min, and greater than 60% was attained in 10 min. Penetration of [3H]KTZ at an extracellular concentration higher than 0.1875 microM (0.1 microgram/ml) occurred by a simple diffusion mechanism. At lower concentrations, accumulation of the drug was an active, energy-requiring process, dependent at least in part on glycolysis, and pH dependent (optimal pH, 6.6). The active transport system had a high binding affinity (Km = 50 nM) and a high maximum velocity of uptake (Vmax = 1.4 mumol min-1 10(-7) cells). It was not possible to displace intracellular [3H]KTZ with high concentrations of unlabeled KTZ or other antifungal agents. These findings suggest that KTZ is rapidly taken up, highly concentrated, and tightly bound to cellular components of C. albicans. PMID- 3551832 TI - Antibacterial activity and mechanism of action of 3'-azido-3'-deoxythymidine (BW A509U). AB - The thymidine analog 3'-azido-3'-deoxythymidine (BW A509U; azidothymidine [AZT]) had potent bactericidal activity against many members of the family Enterobacteriaceae, including strains of Escherichia coli, Salmonella typhimurium, Klebsiella pneumoniae, Shigella flexneri, and Enterobacter aerogenes. AZT also had bactericidal activity against Vibrio cholerae and the fish pathogen Vibrio anguillarum. AZT had no activity against Pseudomonas aeruginosa, gram-positive bacteria, anaerobic bacteria, Mycobacterium tuberculosis, nontuberculosis mycobacteria, or most fungal pathogens. Several lines of evidence indicated that AZT must be activated to the nucleotide level to inhibit cellular metabolism: AZT was a substrate for E. coli thymidine kinase; spontaneously arising AZT-resistant mutants of E. coli ML-30 and S. typhimurium were deficient in thymidine kinase; and intact E. coli ML-30 cells converted [3H]AZT to its mono-, di-, and triphosphate metabolites. Of the phosphorylated metabolites, AZT-5'-triphosphate was the most potent inhibitor of replicative DNA synthesis in toluene-permeabilized E. coli pol A mutant cells. AZT-treated E. coli cultures grown in minimal medium contained highly elongated cells consistent with the inhibition of DNA synthesis. AZT-triphosphate was a specific DNA chain terminator in the in vitro DNA polymerization reaction catalyzed by the Klenow fragment of E. coli DNA polymerase I. Thus, DNA chain termination may explain the lethal properties of this compound against susceptible microorganisms. PMID- 3551833 TI - Cloning and expression of genes responsible for altered penicillin-binding proteins 3a and 3b in Haemophilus influenzae. AB - A Haemophilus influenzae strain (T-1,3) possessing clinical beta-lactam resistance due to altered penicillin-binding protein 3 was used to construct a recombinant cosmid gene bank in Escherichia coli. Three of the recombinant cosmids were capable of transforming a susceptible H. influenzae strain (Rdnov) simultaneously to moxalactam resistance and altered the binding of penicillin binding proteins 3a and 3b to [35S]penicillin G. Restriction endonuclease mapping of one of the recombinant cosmids, pLB100, was performed to facilitate subsequent subcloning of the gene(s) responsible for the altered penicillin-binding protein 3 (a and b) binding phenotype. Subcloning of individual fragments derived from pLB100 indicated that two adjacent fragments of DNA were both capable of transforming a susceptible Haemophilus strain to moxalactam resistance and altered penicillin-binding protein 3 binding. Expression of plasmid-coded proteins in minicells indicated that one fragment coded for a major 55,000 molecular-weight polypeptide and that the second contained a C-terminal coding region that expressed a 28,000-molecular-weight polypeptide when fused to the N terminal region of the tetracycline resistance gene. Initial attempts at labeling the plasmid-coded proteins expressed in minicells with [35S]penicillin G were unsuccessful. PMID- 3551834 TI - Molecular hybridization versus isoelectric focusing to determine TEM-type beta lactamases in gram-negative bacteria. AB - Isoelectric focusing and molecular hybridization with a TEM DNA probe were used to screen for TEM beta-lactamase in 328 bacterial isolates representing 11 gram negative genera. The TEM enzyme was detected in 50% of isolates, and nine additional types of beta-lactamase could be identified in 36.9% of isolates. The TEM gene was detected in 53.6% of isolates. The results obtained by both methods were concordant in 92.7% of the entire sample. In situ colony hybridization with a specific probe therefore appears to be a convenient method to screen rapidly for the presence of homologous genetic sequences among a large number of isolates. Positive hybridization was observed for 16 isolates in which no TEM beta-lactamase was detected by isoelectric focusing. The significance of this hybridization remains to be determined. PMID- 3551835 TI - Impaired clearance of ceftizoxime and cefotaxime after orthotopic liver transplantation. AB - The pharmacokinetics of ceftizoxime (CZX) and of cefotaxime (CTX) were studied in five children and five adults after orthotopic liver transplantation (OLT). Delayed clearance of CZX (clearance of 0.21 to 1.26 ml/min per kg [body weight]) and CTX (clearance of 0.40 to 1.49 ml/min per kg) occurred in 7 of the 10 OLT patients. We conclude that abnormal CZX and CTX clearance is common after OLT and may be associated with minimal change in serum creatinine. PMID- 3551836 TI - Effect of Candida morphology on amphotericin B susceptibility. AB - We showed that brief exposures to amphotericin B (AmB) inhibited the induction of new Candida germ tubes and the lengthening of partially induced germ tubes. Blastoconidia with germ tubes were more susceptible to AmB killing, and this varied directly with the induction period and the AmB exposure period. AmB did not preferentially affect germ tube adherence to fibrin matrices. PMID- 3551837 TI - Single-dose ciprofloxacin at 100 versus 250 mg for treatment of uncomplicated urinary tract infections in women. AB - Two single-dose regimens of ciprofloxacin, 100 and 250 mg, were compared in the treatment of uncomplicated urinary tract infections in women. Cure rates 5 days after therapy did not significantly differ, being 16 of 19 (84%) with the 100-mg dose and 17 of 19 (89%) with the 250-mg dose. Ciprofloxacin was well tolerated. PMID- 3551838 TI - Additional bone preservation method. PMID- 3551839 TI - Ambulatory surgery design. A consultant's perspective on facility planning. PMID- 3551840 TI - Tracheal resection. Opening a patient's airway. PMID- 3551841 TI - Stress urinary incontinence. Endoscopic suspension of the vesical neck. PMID- 3551842 TI - Cafeteria diet promotes sleep in rats. AB - Sleep patterns were continuously recorded in male Wistar rats receiving a palatable, mixed, high-energy diet with chow for ten consecutive days. Results were compared with sleep data obtained from the same rats when offered only normal laboratory chow. The "cafeteria" choice of diets resulted in a significant increase of the daily duration of both slow wave sleep (SWS) and paradoxical sleep (PS). SWS was increased during the light and dark phases of the day-night cycle, whereas PS was augmented only during the light phase. The increased sleep duration was mainly due to a significant lengthening of the respective episodes. When the cafeteria-diet was withdrawn, SWS and PS remained elevated for 3 days and 1 day, respectively before returning to normal levels. The present findings are discussed with regard to present knowledge of sleep mechanisms. A possible role of increased sleep in the development of obesity is also suggested. PMID- 3551843 TI - Mitochondrial DNA in Candida pintolopesii, a yeast indigenous to the surface of the secreting epithelium of the murine stomach. AB - Candida pintolopesii 108-1 is an indigenous yeast which colonizes the surface of the secreting gastric mucosa of mice. We have been exploring the aerobic respiratory capacities of this organism in reference to its capacity to colonize the stomach surface, an environment that could contain little oxygen for microbial growth. In this paper, we report mitochondrial DNA and membranes in cells of a strain of this yeast isolated from the gastric epithelium of a mouse and compare the findings with those made by other investigators in studies of Saccharomyces cerevisiae. Putative mitochondrial DNA was isolated from crude lysates of C. pintolopesii and S. cerevisiae as fluorescing bands in CsCl gradients containing 4',6-diamidino-2-phenylindole. The DNA from C. pintolopesii hybridized with a 32P-labeled DNA probe for the 21S rRNA gene encoded by mitochondrial DNA in S. cerevisiae. Postvital cell staining with 4',6-diamidino-2 phenylindole and rhodamine 123 revealed mitochondrial DNA and membranes, respectively, in the cytoplasm of intact C. pintolopesii cells. The staining patterns were generally similar to those reported for S. cerevisiae. Finally, structures similar to those reported to be mitochondria in electron micrographs of S. cerevisiae were seen in preparations of C. pintolopesii cells examined by transmission electron microscopy. These data confirm findings from studies of its respiratory capacity published earlier that a strain of C. pintolopesii isolated directly from its native habitat has functional mitochondria. PMID- 3551844 TI - Susceptibility of Campylobacter jejuni and Yersinia enterocolitica to UV radiation. AB - Two enteric pathogens, Campylobacter jejuni and Yersinia enterocolitica serogroup O:3, together with Escherichia coli, were investigated for susceptibility to UV radiation at 254 nm. The UV dose required for a 3-log reduction (99.9% inactivation) of C. jejuni, Y. enterocolitica, and E. coli was 1.8, 2.7, and 5.0 mWs/cm2, respectively. Using E. coli as the basis for comparison, it appears that C. jejuni and Y. enterocolitica serogroup O:3 are more sensitive to UV than many of the pathogens associated with waterborne disease outbreaks and can be easily inactivated in most commercially available UV reactors. No association was found between the sensitivity of Y. enterocolitica to UV and the presence of a 40- to 50-megadalton virulence plasmid. PMID- 3551845 TI - [Trials on expanding the clinical application of cisplatin]. AB - Recent phase II trials of cisplatin indicated a significant single agent activity on gastric cancer and non-Hodgkin lymphoma and, therefore, clinical usefulness in combination with other agents has been under investigation. Single agent efficacy on colorectal cancer and malignant melanoma is limited but investigation of combination regimens containing cisplatin is in progress to obtain additive or synergistic effect. Past results suggest some activity on pancreatic cancer and hepatoma. However, more data need to judge the effectiveness on both tumors. PMID- 3551846 TI - [Second-generation cisplatin analogs]. AB - Since the introduction into clinical practice in 1972, cisplatin (CDDP) has assumed an important role in the treatment of various tumors such as testicular, ovarian or pulmonary cancer. Its toxicities include emesis, renal impairment, neuropathy, hearing loss and anemia. In clinical trials renal toxicity has been proved to be dose limiting factor. Thus the total number of courses which may be given is limited. For this reason second-generation CDDP analogues with reduced toxicity have been tried to develop and are reaching clinical testing. A number of studies have now been published relating the results of these trials. The best studied of these analogues is carboplatin (CBDCA, JM-8) which was noted to be less nephrotoxic, but more myelosuppressive than CDDP in preclinical study. Phase I trials have shown that CBDCA is relatively free of renal toxicity and that its dose limiting factor is myelosuppression, especially thrombocytopenia. In phase II trials CBDCA has been shown to be an active agent in advanced carcinomas of the ovary, head and neck, lung and urogenital organs. Similar results have been obtained in clinical trials of iproplatin (CHIP, JM-9) which is synthesized as an analogue of CDDP. Two other analogues developed in Japan have been evaluated to be active for various mouse tumors in preclinical studies. Phase I trials of these agents is now ongoing. PMID- 3551847 TI - [Late effects of cancer chemotherapy]. AB - Patients with specific types of cancer have achieved substantial prolongation of survival after successful cancer chemotherapy. Furthermore, cancer chemotherapeutic agents are being widely used as immunosuppressive drugs in patients with benign conditions. Both of these patient populations are at risk for development of late complications of treatment. Though the late effects of chemotherapy are less well defined, they are insidious in onset and not manifested clinically until damage have become overt and irreversible. Many reports on the late effects of chemotherapy demonstrate the importance of assessing not only the therapeutic results of various treatment program but also of evaluating the long-term complications of therapy in order to maximize the benefit of the treatment. Thus, skillful and judicious application of chemotherapy produces a minimum of delayed consequences. PMID- 3551848 TI - [Bone marrow transplantation in pediatric patients: review of progress]. PMID- 3551849 TI - Vasoactivity of the major intracranial arteries in newborn infants. AB - Blood flow to the head and arms was measured by a new volumetric Doppler technique in 30 preterm infants and 10 full term infants. At least 80% of this blood flow is considered to perfuse the brain. At the same time mean blood velocity in the middle and anterior cerebral arteries was measured by Duplex Doppler scanning. While blood flow to the head and arms remained substantially constant in both groups over the first 48 hours of life (60 ml/100 g brain weight/min), blood velocity doubled in both cerebral arteries in the preterm group. The term infants had higher blood velocities in both arteries at all times, but the velocities also increased over 48 hours, although to a lesser extent than in the preterm group. These findings imply that the major intracranial arteries are themselves vasoactive, being dilated at birth and subsequently constricting, possibly as an autoregulatory response to rising arterial blood pressure. While vasodilated, the cerebral arteries will be less efficient at damping pressure transients, placing preterm infants at particular risk of periventricular haemorrhage during the early hours of life. The implications for possible approaches to the prevention of cerebral haemorrhage are discussed. PMID- 3551852 TI - Child molestation: assessing impact in multiple victims (Part I). PMID- 3551851 TI - Clinical and endocrinologic study of precocious puberty in girls. AB - We describe 30 girls with precocious puberty whom we have seen during the last ten years. Modern procedures such as cerebral computer tomography and abdominal sonography increase diagnostic accuracy so that the incidence of idiopathic precocious puberty is likely to diminish. Abdominal sonography is of value in detecting and monitoring the growth of ovarian cysts and thus exploratory laparotomy can be avoided in those cases in which cysts regress rapidly. A modified classification of precocious is proposed. PMID- 3551853 TI - Coded nursing diagnoses on Axes: a prioritized, computer-ready diagnostic system for psychiatric/mental health nurses. PMID- 3551850 TI - Controlled trial of trimeprazine tartrate for night waking. AB - Mild hypnotics are often recommended for young children with sleep problems. This study assesses the efficacy of trimeprazine tartrate in 1 to 3 year old children with persistent and severe night waking in a double blind crossover trial with placebo. Children on treatment with trimeprazine had significantly fewer wakings, less time awake at night, and more night time sleep compared with those on treatment with placebo. There were no differences in these sleep variables when the first and last (fourth) week of treatment with drugs were compared. Follow up observations showed no significant difference in any sleep variables from baseline measures. The results are consistent with the idea that trimeprazine tartrate may be a useful short term treatment for night waking in young children. PMID- 3551854 TI - [Localized benign fibrous tumors of the pleura. Anatomo-clinical and immunohistochemical study of 6 cases]. PMID- 3551856 TI - [Development of P. falciparum sensitivity to chloroquine, to quinine and to mefloquine between 1983 and 1985 in Zaire]. PMID- 3551855 TI - Plasmodium falciparum drug resistance in West Africa. PMID- 3551857 TI - Complications of venous reconstruction in human orthotopic liver transplantation. AB - In 313 consecutive recipients of 393 orthotopic liver grafts, there were 51 (16.3%) and nine (2.9%) patients who had pre-existing portal vein and inferior vena cava abnormalities, respectively. These abnormalities required adjustments in the transplant operation and were a source of morbidity and mortality. The incidence of thrombosis of the reconstructed portal vein was 1.8%. Only three (0.8%) vena caval thromboses were seen after 393 liver replacements. Venous stenoses or disruptions were rare. Six women with the Budd-Chiari syndrome had liver replacement. Although this disorder is a veno-occlusive disease, five of the recipients achieved prolonged survival, only one had recurrence of disease, and three are alive after 2-6 years. PMID- 3551859 TI - External ureteroneocystostomy and ureteroureterostomy in renal transplantation. AB - Reported are 204 primary external ureteroneocystostomies and 16 primary ureteroureterostomies in a series of 220 consecutive renal transplants. A total of 12 (5%) complications occurred; however, only seven (3%) required major operative repair, whereas five (2%) were minor and were repaired by cystoscopic or transvesical procedures. There was no mortality and no allograft loss from these complications, which tend to occur late and be amenable to prompt repair. Since the complications of external ureteroneocystostomy differ from those of the internal ureteroneocystostomy, a discussion of their treatment is provided. A review of literature shows that the external repair is growing in popularity because of its good results. The good results are attributable to the use of a short length of ureter, to the use of a continuous monofilament suture that produces an anastomosis less likely to leak, and to the need of a very small cystostomy. PMID- 3551858 TI - The reversal of the hepatorenal syndrome in four pediatric patients following successful orthotopic liver transplantation. AB - Four pediatric patients are presented in whom profound renal failure (hepatorenal syndrome) developed in association with severe end-stage liver disease. All four patients had successful orthotopic liver transplantation. Special emphasis is given to the preoperative and postoperative renal function in the patients, and the criteria used to establish the diagnosis of the hepatorenal syndrome are discussed. In the initial work on liver transplantation and reversal of the hepatorenal syndrome, two of the three patients recovered renal function but died in the perioperative period. The four patients presented in this report have not only had reversal of the hepatorenal syndrome after successful orthotopic liver transplantation but have also survived long term. The four patients have been followed up for periods ranging from 18 months to 4.5 years. Three of the four patients have maintained near normal renal function, whereas the fourth patient (who had a left nephrectomy for obstruction and sepsis) has had a significant decline in renal function. PMID- 3551860 TI - Complications of transthoracic needle biopsy decreased with isobutyl 2 cyanoacrylate: a pilot study. AB - To explore the possibility of performing percutaneous lung biopsy safely in patients mechanically ventilated with positive-end expiratory pressure (PEEP), transthoracic needle biopsy was performed in 16 anesthetized mongrel dogs mechanically ventilated with 10 cm H2O of PEEP. To obtain the biopsy sample, a 25 gauge "skinny needle" was passed through a 20-gauge sheath and placed up to 6.25 cm deep. After satisfactory samples were obtained, both needles were withdrawn in the control group, but in the treated group, the outer sheath was used to inject 0.5 ml of isobutyl 2-cyanoacrylate to seal the needle track. Pneumothorax was present in 7 (87.5%) of 8 dogs in the control group and in 2 (25%) of 8 dogs in the treated group (p = .0147). Lung tissue exhibited an apparent foreign-body granulomatous inflammatory reaction. This technique could extend the benefits of transthoracic needle biopsy to mechanically ventilated patients, but further studies to prove the safety of isobutyl 2-cyanoacrylate are necessary. PMID- 3551862 TI - Transthoracic transatrial endocardial lead placement for permanent pacing. PMID- 3551861 TI - Use of in situ pericardium for surgical relief of pulmonary venous obstruction following Mustard's operation. AB - A technique is described for relief of pulmonary venous obstruction following the Mustard procedure. The functional left atrium is enlarged by using the pericardium in situ. This is expected to allow for growth of the pericardial patch and to avoid recurrent obstructions. This technique has also been used in reoperations for systemic venous obstruction after enlargement of the systemic baffle with a patch. PMID- 3551863 TI - The Blalock-Hanlon operation. PMID- 3551864 TI - A practical approach to prosthetic valve endocarditis. AB - Prosthetic valve endocarditis (PVE) is an infrequent but dread complication, occurring in 1 to 2% of patients both early (less than 60 days) and late postoperatively. Diagnosis is always (99%) possible by two sets of blood cultures, but occasional exogenous causes of bacteremia may cloud the diagnosis, as will culture-negative cases of PVE and skin contaminants. With obvious exogenous sources of bacteremia, achieving sterile blood cultures after eradication of the noncardiac source permits discontinuation of antibiotics after two weeks. When skin contaminants are suspected, withholding antibiotics and obtaining two sets of blood cultures is recommended, because the bacteremia with PVE is continuous. Preventive measures, including perioperative antibiotics, are warranted but will probably not significantly reduce the low incidence of infection already achieved. The major cause of improved survival in recent years is earlier operation (valve rereplacement). This has been demonstrated in the last ten years and is absolutely indicated for major heart failure, ongoing sepsis, fungous etiology, valve obstruction, new-onset heart block, and unstable prosthesis by fluoroscopy. PMID- 3551865 TI - [Cannabinoid intake by passive smoking]. AB - The presence of cannabinoids in the urine can be produced by passive inhalation of hashish resp. marihuana smoke. The height depends on the intensity of exposure. Under extreme conditions concentrations between 40 to 50 ng/ml of cannabinoids had been found in the urine. In regard to the maximum variation coefficient of the immunoassay methods, which is about 30%, we think it is useful to define a threshold value of 65 ng/ml of cannabinoids to distinguish between active and passive inhalation. PMID- 3551866 TI - [Diagnosis of neonatal Streptococcus B infection by the latex test]. AB - The detection of group B streptococcal soluble antigens was performed in 139 newborn infants suspected of infection. A qualitative agglutination test of sensitized latex particles (Wellcogen Strep B) was performed in the urine. The diagnosis of group B streptococcal infection was assessed by retrospective analysis of patient files using previously defined criteria. The correlation between the agglutination test result and the presence or absence of streptococcal infection was statistically significant; the test had a sensitivity of 81%, specificity of 97%, positive predictive value of 76% and negative predictive value of 98%. This study confirms the interest of such a test in the early diagnosis of group B streptococcal infection in infants. PMID- 3551867 TI - [Submaxillary streptococcal B cellulitis in young infants]. AB - The authors report 3 cases of young infants with B streptococcal cellulitis revealed by submandibular inflammatory induration. The clinical findings, similar to the cases reported in literature, were characteristic, due to the infants' ages, the aspect and localization of the cellulitis. Bacteriologic diagnosis relies on blood cultures and aspiration of the lesion. PMID- 3551868 TI - [Kidney function and water-electrolyte balance in the newborn infant]. PMID- 3551869 TI - [A review. Current problems of experimental and clinical radiotherapy]. AB - Although there has been dramatic progress in radiotherapy for several tumor types during the last decades, it cannot be overlooked that the overall success is far from being satisfactory. Since in the course of their disease, radiotherapy is indicated for more than two-thirds of cancer patients, improvement of treatment results become of great health-political importance. As a rule a successful procedure can be realized only, if radiotherapy is integrated into the multidisciplinary overall concept of cancer treatment and the patients will receive optimal attention in diagnosis, therapy and after-care in centralized oncological institutions. Based on the principle of individualized cancer therapy, possibilities are outlined to improve quality in carrying out the different steps of the process of radiotherapy. Special importance is attached to measures of the modification of the radiation effect. In particular, scientific tackle of questions of dose fractionation, the use of neutron therapy as well as radiosensitizers and protectors and of local hypothermia are considered starting points for further improvement of radiotherapeutic results. In addition to these problems, topical research tasks are outlined. PMID- 3551870 TI - Three types of photoreceptors in the pineal and frontal organs of frogs: ultrastructure and opsin immunoreactivity. AB - The pineal complex in frogs (Rana esculenta, R. temporaria, R. tigrina, R. arvalis) was studied by conventional electron microscopy and postembedding rhodopsin immunoelectron microscopy. Three types of photoreceptor cells were found in both the pineal and frontal organs. In the pineal organ, most of the photoreceptors exhibited rhodopsin-immunoreactive outer segments and large inner segments with a large ellipsoid of densely packed mitochondria ("rod-like" photoreceptors). A small number of photoreceptors was rhodopsin-immunonegative ("cone-like" photoreceptors). In both Rana esculenta and R. temporaria, the latter were either supplied with an oil droplet and an ellipsoid in their inner segment, or they were electron-lucent with a small inner segment without an ellipsoid. In contrast, the frontal organ displayed many immunonegative "cone like" outer segments and few rhodopsin-immunoreactive "rod-like" photoreceptors. In both organs, the basal processes of the photoreceptor cells were found to form ribbon-containing axonal pedicles which synapsed with the dendrites of secondary neurons. The latter rarely received any further afferences by conventional synapses. The frog pineal organ is considered a predominantly "rod-type" and the frontal organ a "cone-type" photosensory organ. The presence of three kinds of pineal/frontal photoreceptors is discussed in connection with the occurrence of different photopigments (rhodopsin/porphyropsin, iodopsin, ultraviolet and/or blue pigments) enabling the animal to discriminate by the pineal complex environmental light in various ranges of the spectrum. PMID- 3551871 TI - Histogenesis of the mouse pyloric mucosa with special reference to the development of surface mucous cells and pylorocytes, and the formation of the generative zone. AB - The distribution of proliferative cells and maturation of epithelial cells were studied in the pyloric mucosa of developing mice by 3H-thymidine autoradiography, carbohydrate histochemistry and electron microscopy. The formation of the gastric foveola and pyloric gland were seen to begin as an invagination in the epithelial surface and/or the formation of intraepithelial cavity on day 13 of gestation (day E13). Surface mucous cells and pylorocytes were first identified on day E16 by carbohydrate staining as well as by their fine structure. Both types of cells rapidly acquired abundant membranous organelles and secretory granules within the first postnatal day, maturing in fine structure by day 28. Proliferative cells were distributed over the epithelium by day E15, while they were rarely found at the mucosal surface after day E16. Concomitantly with the elongation of foveolae and glands during postnatal development, the proliferative capability of surface mucous cells diminished from the foveolae and that of pylorocytes from the glands, respectively; the generative zone was restricted to the isthmus by day 21, as in the adult animal. These results reveal that the histogenesis of the mouse pyloric mucosa is accomplished by the end of the weaning period. PMID- 3551873 TI - Immunohistochemical localization of inhibin in porcine and bovine ovaries. AB - The immunohistochemical localization of inhibin in porcine and bovine ovaries was studied, using monoclonal antibodies to bovine follicular fluid 32K inhibin (bFF 32K inhibin) and a polyclonal antiserum to porcine follicular fluid 32K inhibin (pFF 32K inhibin). In order to obtain a precise immunohistochemical staining, various fixations were tested with an immunoblotting procedure. Acetone fixation followed by celloidin embedding proved to be most appropriate for the immunohistochemical study of inhibin. A consistent pattern emerged in all sections prepared from porcine and bovine ovaries. Granulosa cells were specifically stained by the antibodies, and especially the cells constituting the inner layer were more intensely stained than the cells close to the theca. PMID- 3551872 TI - Immunohistochemical studies on the GABAergic system in the rat supraoptic nucleus using the PAP method with an application of electron microscopy. AB - GABAergic neuronal profiles in the supraoptic nucleus of the rat were immunohistochemically identified by using a purified GABA antibody with the peroxidase-antiperoxidase method. The localization of GABA-like immunoreactivity in nerve terminals on the neurosecretory neurons was examined electron microscopically. A few small GABAergic neurons were found inside the supraoptic nucleus while only a very few medium-sized ones were detected in the perinuclear zone. Intrinsic, non-GABAergic small neurons covered by GABAergic neuropil were also detected. The neuropil with GABAergic axo-somatic synapses evenly encompassed unlabeled neurosecretory perikarya throughout the supraoptic nucleus. The GABAergic system seems to inhibit both vasopressin and oxytocin cells. In this area, glia cells showed clear outlines of unlabeled somata around counter stained nuclei. Blood capillaries in the supraoptic nucleus were only slightly covered with a GABAergic neuropil. Electron microscopic observations demonstrated the presence of GABAergic axo-somatic symmetrical and axo-dendritic asymmetrical synapses on the neurosecretory neurons. GABA-like immunoreactivity was localized on the membranes of microtubules and synaptic vesicles, on the external membranes of the mitochondria, and on the inner leaf of the presynaptic sites. Numerous pairs of non-immunoreactive synapses were arranged along these immunoreactive synapses. PMID- 3551875 TI - Amyloid deposits in pituitary adenomas. Differentiation of two types. AB - Two different types of amyloid deposits in pituitary adenomas are described herein. The deposits of the first type are stellate and perivascular masses, with fibrillary inclusions occurring in the intercellular space. No immunoreactive cytokeratin can be detected in the deposits, and the masses are secreted by the adenoma cells. A second, rarer type is characterized by spheroids (40 to 1500 micron in diameter) in which immunoreactive cytokeratin fibrils are present. The fibrils originate in the adenoma cells adjacent to the deposits. The amyloid nature of both types of deposits can be proved by intense red staining with Congo red, green dichroism, and positive immunostaining with antibodies raised against serum amyloid P component. Adenomas with amyloid spheroids are very rare, and most have been proved or suspected prolactin-producing adenomas. PMID- 3551874 TI - Strumal carcinoids of the ovary. An immunohistologic and ultrastructural study. AB - A series of six ovarian strumal carcinoids was examined. The presence of thyroid follicular epithelium was conclusively proved by the presence of follicular cells immunohistochemically positive for thyroglobulin, and by the ultrastructural identification of non-neuroendocrine cells with features of thyroid epithelium lining the follicles. Progressive replacement of thyroid epithelial cells by carcinoid cells accounts for the predominance of neuroendocrine granule containing cells and the scarcity of thyroid epithelial cells lining many of the follicles. A variety of neuroendocrine hormones and other immunoreactive substances was demonstrated within carcinoid cells, including somatostatin (five cases), chromogranin (five cases), serotonin (five cases), glucagon (four cases), insulin (two cases), and gastrin (one case). Only one case contained calcitonin positive cells. None were carcinoembryonic antigen-positive or had amyloid deposits. The carcinoid element in five cases stained positively for prostatic acid phosphatase. While strumal carcinoid shares some features with medullary carcinoma of the thyroid gland, it has sufficient differences to warrant a separate designation. PMID- 3551876 TI - Primary choriocarcinoma of the lung. AB - A case of primary choriocarcinoma of the lung in a postmenopausal woman is described and the literature is reviewed. To our knowledge, this is the first report in the English-language literature of pulmonary choriocarcinoma documented by immunoperoxidase staining for human chorionic gonadotropin, and shown to be primary in the lung by a thorough autopsy. Extragonadal, nongestational choriocarcinoma rarely occurs in the lung; less than 15 cases interpreted as primary pulmonary choriocarcinoma have been reported. This tumor exemplifies expression of a fetal gene in a malignancy of somatic cell origin. We propose that primary pulmonary choriocarcinoma arises from epithelial cells which may undergo metaplasia or divergent differentiation. Such differentiation may occur in visceral carcinomas as a focal change, and rarely as the sole pathway of tumor differentiation in extragonadal organs, where it has been termed primary choriocarcinoma or giant cell carcinoma with ectopic human chorionic gonadotropin production. PMID- 3551877 TI - The sustained release of cefotaxim from a fibrin-cefotaxim compound in treatment of osteitis. Pharmacokinetic study and clinical results. AB - Following a survey of the literature regarding clinical examinations and experimental studies of local absorbable carrier for an antibiotic in treatment of osteitis, a study is presented concerning clinical experience with 46 patients treated with a cefotaxim-loaded fibrin sealant. In connection with simultaneous focal sanitation the clinical results were satisfying. When autogenous cancellous bone was added at the same time, only one surgical operation was necessary in some cases to show results equivalent to other methods. Postoperatively, the cefotaxim levels in the blood and in the wound drainage fluid were measured. The serum cefotaxim concentrations were low and only identifiable for a period of 36h, whereas the wound drainage fluid contained very highly effective antibacterial concentrations over a measured period of 3.5 days. The best results were seen in cases of hematogenic osteomyelitis. The disadvantage of this system is the quick release of the antibiotic by diffusion. Therefore, high concentrations can be obtained only for a short period of several days. PMID- 3551878 TI - Experimental osteoinduction in rats: collagen-apatite versus osteogenin containing gelatine. AB - An experimental study in rats was done to investigate the bone-regenerating properties of collagen apatite (Collapat) and to compare it with osteoinduction dependent on osteogenin-containing gelatine (OCG). The test substances were implanted orthotopically (calvarial defect--7 mm in diameter) and heterotopically (paravertebral muscles, abdominal muscles). The results were evaluated histologically and enzymatically (alkaline phosphatase). Collapat caused neither osteoinduction in the heterotopic site nor healing of the bone defects. Foreign body reaction without new bone formation was encountered. OCG implantation leads to new bone formation in the muscles within 3 weeks, associated with a significant increase in alkaline phosphatase activity, and to extensive new bone formation in the calvarial defect within 4 weeks. The defects did not heal if left empty. The value of clinical application of Collapat appears to be doubtful. Osteoinduction with OCG requires further experimental investigation. PMID- 3551879 TI - Wagner resurfacing arthroplasty of the canine hip. AB - Twelve surface replacement arthroplasties were performed on the hips of ten mongrel dogs using scaled-down replicas of the Wagner prosthesis. The contralateral hips and two further animals served as nonoperated controls. Animals were killed 5 months postoperatively. Clinical, radiological, histological and fluorochrome-labelling studies were employed to assess the bony and soft tissue reaction to resurfacing arthroplasty. There was no clinical or radiographic evidence of prosthetic loosening. Histological examination disclosed a thick foreign body and chronic inflammatory membrane containing acrylic cement and polyethylene wear particles at the bone-cement interface of both components. Generally, the bone marrow and trabecula were viable. There was evidence of increased bony remodelling and new bone formation in the subchondral area. The similarity between the above findings and those of aseptic component loosening in man suggests a mechanism whereby wear debris initiate a biological foreign body reaction culminating in component loosening. PMID- 3551880 TI - Hepatic cryosurgery with intraoperative ultrasound monitoring for metastatic colon carcinoma. AB - We utilized cryosurgery with intraoperative ultrasound (IOUS) monitoring in ten patients to treat multiple unresectable hepatic metastases from colorectal carcinoma. The liver was exposed at laparotomy, and tumors were subjected to three cycles of freezing (eight minutes each) and thawing. Freezing was monitored by IOUS, which visualized frozen tumor as a hyperechoic rim with posterior acoustic shadowing. Frozen normal liver appeared hypoechoic after thawing compared with normal unfrozen liver. There were no significant complications. The follow-up ranged from four months to 17 months (median, 7.5 months). Tumor response was documented by pathologic findings (coagulative necrosis), progressive fall of carcinoembryonic antigen levels, and computed tomographic scan evidence of necrosis and shrinkage of tumor. One patient underwent repeated laparotomy five months after cryosurgery and had the frozen lesions resected; there was no residual tumor. This study establishes the technical feasibility and antitumor response of hepatic cryosurgery and the use of IOUS for precise localization and monitoring of cryoablations. PMID- 3551881 TI - Monoclonal antibody-mediated modulation of parathyroid hormone secretion by dispersed parathyroid cells. AB - Available data suggest that ionized calcium may interact with a cell surface "sensor" or "receptor" to produce changes in one or more intracellular second messengers that ultimately regulate the release of parathyroid hormone (PTH). Recently, we developed a series of monoclonal antibodies directed toward specialized differentiation antigens expressed on endocrine cells. Since many of these monoclonal antibodies displayed exquisite specificity for cell surface molecules on the parathyroid cell, we used these reagents as probes to investigate signal recognition/transduction mechanisms associated with abnormal calcium-regulated PTH secretion. Depending on their binding site on the respective target antigen molecules, these monoclonal antibodies either stimulated or inhibited hormone secretion. Thus, defects in membrane-associated structures may contribute to deranged calcium-regulated PTH secretion in abnormal parathyroid cells. PMID- 3551882 TI - Amino acid clearance in cirrhosis. A predictor of postoperative morbidity and mortality. AB - The central plasma clearance rate of amino acids (CPCR-AA), the ratio of peripheral amino acid entry rate into blood plasma to arterial amino acid concentration, was measured preoperatively in 149 noninfected cirrhotic patients. In 50 survivors of shunting or general surgical procedures, the mean (+/- SEM) CPCR-AA was 201 +/- 17 mL/m2/min; in 39 subsequent deaths, the mean ratio was 87 +/- 14 mL/m2/min. Comparing Child's classification with CPCR-AA reveals the following values: class A (mortality, two of ten patients) survivors, 152 +/- 23 mL/m2/min; class A deaths, 96 +/- 54 mL/m2/min; class C (mortality, 13 of 19 patients) survivors, 214 +/- 47 mL/m2/min; class C deaths, 101 +/- 13 mL/m2/min. The preoperative CPCR-AA of 46 patients receiving liver transplants was 91 +/- 9 mL/m2/min; 69% of these patients survived. Preoperative CPCR-AA values correlated significantly with rates of hepatic protein synthesis in incubated liver slices obtained by biopsy at operation in 22 patients. Thus, CPCR-AA determination is a true liver function test, valuable in predicting surgical mortality and selecting transplantation or other operations for cirrhotic patients. PMID- 3551883 TI - Mode of hypocholesterolemic action of probucol in animals and man. AB - Probucol is a widely used serum-cholesterol lowering drug. It is proposed that in humans probucol stimulates the plasma clearance of low density lipoproteins (LDL), which accounts for the drug-induced decrease in LDL cholesterol levels. In the liver the enhanced uptake of LDL cholesterol stimulates the conversion of cholesterol into bile acids, which in turn causes an increase in the output of bile acids with the feces. The increased flux through the bile acid biosynthesis pathway tends to deplete the liver pools of cholesterol. This causes stimulation of cholesterol synthesis, which is associated with a higher hepatic efflux of LDL. Thus in humans taking probucol cholesterol turnover is enhanced. In this way a new equilibrium is reached in which LDL production equals LDL catabolism, and in which cholesterol turnover is increased. The probucol-induced reduction in high density lipoprotein (HDL) cholesterol may be caused by inhibition of HDL synthesis. If we assume that the absolute rate of HDL clearance from the plasma is proportional to HDL concentration, then serum HDL will settle at a new, lower level where the clearance rate equals the rate of production. In contrast to humans, probucol may decrease the turnover of cholesterol in rats. The relatively large amounts of probucol generally fed inhibit cholesterol absorption, and this may account for the reduction in serum total cholesterol, which essentially represents HDL cholesterol. The decrease in absorption diminishes intestinal formation of HDL, which in turn leads to a diminished flux of serum cholesterol into the liver, and causes inhibition of bile acid synthesis because substrate availability is depressed. The effect of probucol on cholesterol synthesis is not clear, but the drug must lower the sum of cholesterol absorption and synthesis. In this way, serum cholesterol settles at a new, lower level, where cholesterol input equals its output. PMID- 3551884 TI - [Reactions to heterogeneous lyophilized tissue material implanted into the peritoneal cavity of the rat]. AB - Resorption rate of heterogeneous implants (lyophilized tissues of the rabbit liver and cerebriform cancer of the human stomach) has been studied 6, 24 h and 3, 7, 21, 30 days after their simultaneous implantation into the rat peritoneal cavity. The area of separate cellular zones, contents of granulocytes and immune competent cells in the zone macrophage-fibroblasts, mitotic coefficient and index of 3H-thymidin-labelled fibroblast nuclei have been taken into consideration. Resorption and elimination rate of the protein implants applied, as well as proliferation of the connective tissue elements and maturation of the granulation tissue in the organization focus take place more quickly at implantation of the lyophilized tumoral tissue. Antigenic reaction to the native hepatic proteins and to the stomach cancer occurs in the same way as to alive cells. Its index is appearance of the zone consisting of lymphocytes with plasma cells in the periphery of the implants. PMID- 3551885 TI - [Morphofunctional features of the development of the thyroid gland of Dicrostonyx torquatus during the drop in population stage]. AB - By means of the histostereometrical method, peculiarities of the thyroid gland formation have been studied in the lemming (Dicrostonyx torquatus) fetuses and newborns at the stage of the population quantity drop, as well specificity of the organ's morphofunctional state during the postnatal period. On the 14th prenatal day the thyroid gland already has the follicular structure. Up to the 19th day progressive follicular growth, accumulation of colloid and increase of its density occur. On the 19th-20th days, as well as in newborn animals, there are certain signs, demonstrating as essential activation of the thyroid gland function. In the newborn animals cavities of the completely formed follicles are devastated. During the postnatal period again growth of follicles, accumulation of colloid are observed, signs of hypersecretion of the hypophysis appear. PMID- 3551886 TI - [Current concepts concerning the histophysiology and reparative regeneration of the endothelium of large blood vessels]. PMID- 3551887 TI - [Current concepts concerning the structure and function of nerve sheaths]. PMID- 3551888 TI - [Features of the extracellular matrix of fibroadenomas and leaf-shaped tumors of the human breast (immunomorphologic study)]. AB - Fibronectin and collagen I, III, IV, V distribution in preexisting and newly formed connective tissue of fibroadenomas and leaf-like human breast tumour was studied by the immunofluorescent method. Extracellular matrix of a newly formed connective tissue was characterized by the predominance of collagen type III, the presence of collagen type IV, a high content of fibronectin in a leaf-like tumour. Such characteristics of the extracellular matrix structure in benign tumours are interpreted as a manifestation of desmoplasia. PMID- 3551889 TI - [Morphology and pathogenetic problems of the crush syndrome]. AB - Morphofunctional studies of muscles, heart, liver and kidneys after different periods of compression and decompression, as well as literature data indicate that crush syndrome is one of the most severe forms of traumatic shock. A wide range of pathologic effects of catecholamines and other shock-causing agents in response to the emotional stress and pain occurs already at the compression period and results in hemodynamic disturbances in microcirculation of organs and tissues with the development of dystrophic and necrobiotic processes, depression of the monocytic phagocyte system and immune system. The consequences of shock are mostly manifest after decompression: hypercatecholaminemia, hypovolemia, intoxication with myolysis and pathogenic microflora products result in aggravation of monocytic phagocyte failure, as well as immune system, intravascular coagulation, membrane penetration insufficiency, cell necrosis. Monocytic macrophage depletion favours the progression of hepatic necrobiosis, formation of renal failure and detritus organization in the muscles of the extremities. Hypercatecholaminemia and hypoxia (leading to electrolyte-imbalance contractures of myofibrillar apparatus, metabolism disorder and intracellular conductivity disturbance) from the basis for cardiac insufficiency. Inadequate cardiac function, in its turn, maintains hemodynamic and hypoxic disturbances in tissues. Changes in renal blood flow, hemofiltration and tubular system are shown to reflect different aspects of pathogenesis of the acute renal failure in crush syndrome. PMID- 3551890 TI - [Clinico-morphological tests to assess the function of neutrophilic granulocytes]. AB - Clinico-morphological tests for the estimation of neutrophil granulocyte function were compared by their reproducibility, reliability and availability for standard clinical laboratories, and the results were analysed. Lysosomal-cationic test was offered for clinical practice, as it gives qualitative and quantitative assessment of the phagocytosis process, allows prediction of complications before their clinical onset, performance of rapid evaluation of the therapy used, reveals shifts in the level of non-specific resistance of the body. Methods of application of lysosomal-cationic test in the pathoanatomic practice have been developed for the study of intravital biopsy samples and surgical material. PMID- 3551891 TI - [Cellular apoptosis: its morphology, biological role and the mechanisms of its development]. AB - The literature review reports data on morphology, biological role and mechanisms of apoptosis as a special type of cell destruction. Apoptosis is very common in humans and animals in health and disease, and therefore needs further investigation. PMID- 3551892 TI - [Nifedipine in the treatment of pulmonary hypertension. I--Primary pulmonary hypertension]. PMID- 3551893 TI - Homage to Prof. Margot Shiner, M.D. PMID- 3551895 TI - Nocardia asteroides as a cause of corneal ulcer. Case report. PMID- 3551894 TI - [Prevention of infection in closure surgery in colostomies. Double-blind study with tinidazole]. AB - A comparative double-blind study of tinidazole vs placebo was conducted in order to assess the prophylaxis of post-surgical abdominal infections in 40 patients undergoing closure colostomy surgery. During three days the patients were kept on a low residue diet, and underwent a colon mechanical cleansing. About 10 to 12 hours prior to surgery the patients were given placebo or tinidazole in tablets of identical appearance; the dose of tinidazole was of 2 g (4 tablets) in a single oral dose. Evaluation performed after surgery showed that in the tinidazole group occurred two surgical mild infections (10%), while in placebo group occurred nine infections (45%)--four of them severe and one very severe, showing a significative difference between the two groups (p less than 0.05). In placebo group 21 bacteria were isolated, 3 of them were anaerobic; only two aerobic species were identified in the tinidazole group (p less than 0.001). No adverse reactions were reported in both groups. The authors concluded that in this study, tinidazole showed a prophylactic effect on post-surgical abdominal infections in patients who underwent closure colostomy surgery. PMID- 3551896 TI - Langerhans cells in organ-cultured corneas. AB - We examined the effect of corneal preservation in organ culture at 34 degrees C on Langerhans cells in murine and human corneas. The presence of Langerhans cells was demonstrated by an adenosine triphosphatase stain. Langerhans cells were identified on fresh corneas and on corneas that had been in organ culture for one week or less. However, Langerhans cells were not found on most corneas after the second to third week in culture. The absence of Langerhans cells was found to be directly related to the condition of the corneal epithelium. During the second and occasionally as late as the third week in culture, the superficial layers of epithelium are sloughed. Examination of the corneas lacking Langerhans cells disclosed Langerhans cells in the sloughed epithelium. The results demonstrate that most corneas preserved in organ culture at 34 degrees C do not contain Langerhans cells at the time of transplantation. PMID- 3551897 TI - The occurrence of IgG in the endolymphatic sac of the guinea pig. AB - We investigated the occurrence of immunoglobulin G (IgG) in the endolymphatic sac (ES) of the guinea pig in order to show that the ES is an organ involved in the immunoreactivity of the inner ear. By using an immunohistological technique, we were able to show that IgG is located mainly in the subepithelial layer of the ES. We also found that IgG is present in some epithelial cells of the ES as well as in free floating cells in the ES lumen. Although plasma cells have been described previously in the subepithelial layer, none could be recognized in this layer of the ES in our specimens. Our results suggest that the ES is an immunoreactive organ of the inner ear in some pathological states, while IgG in the normal ES is primarily of systemic origin. PMID- 3551898 TI - The significance of calcium antagonists in rat experimental tympanosclerosis. AB - The effect of calcium antagonists in experimental tympanosclerosis following infection with Streptococcus pyogenes and vitamin D3 intoxication has been analyzed in a rat animal model. Compared with untreated animals, calcium antagonists exert a positive effect on the degenerative process and on secondary calcification in the subepithelial layer. This effect could be substantiated planimetrically. PMID- 3551899 TI - Major pre-prosthetic surgery. A review. PMID- 3551900 TI - In vitro bond strength of cements to treated teeth. PMID- 3551902 TI - Steroid-induced anterior open bite. Case report. PMID- 3551901 TI - Anisotropic setting expansion of phosphate bonded investment. PMID- 3551903 TI - Successful pregnancy in a renal transplant recipient taking cyclosporin A. AB - A 27 year old woman with a fourth cadaveric renal transplant successfully completed a 33 week pregnancy whilst taking cyclosporin A and prednisolone. Her renal function remained stable despite recurrent urinary tract infections, hypertension, gestational diabetes, and Clostridium difficile associated diarrhea. The infant, delivered electively at 33 weeks, was small for gestational age but otherwise normal. PMID- 3551904 TI - Asymptomatic carotid stenosis: a review. PMID- 3551905 TI - Plasma exchange in the treatment of glomerulonephritis and other renal diseases. PMID- 3551906 TI - Towards the control of hepatitis B: an historical review. PMID- 3551907 TI - The emergence of Serratia marcescens as a pathogen in a newborn unit. AB - During a 12 month period, the Waikato Hospital Newborn Intensive Care Unit experienced an epidemic of Serratia marcescens infection. Seventeen serious infections occurred, resulting in three deaths. A further 15 cases of minor infection were also noted. Although no point source of introduction was found, gut colonization proved to be the most important reservoir for nosocomial spread of the organism. At the peak of the outbreak, a 95% incidence of rectal colonization with S. marcescens was observed. Eradication was achieved within a 4 month period using cohort isolation of affected infants. PMID- 3551908 TI - Squibb academic lecture: attitudes towards mental illness in antiquity. PMID- 3551910 TI - Filariasis in Mirpur area of Dhaka city. PMID- 3551909 TI - The interrelationship between growth hormone, cortisol, and insulin in diabetic patient. PMID- 3551911 TI - Overview of double-stranded RNA replication in Saccharomyces cerevisiae. AB - There are five families of double-stranded RNA (dsRNA) in strains of Saccharomyces cerevisiae, called L-A, L-BC, M, T, and W. Of these, L-A, L-BC, and M are found in intracellular virus-like particles (VLPs). Their replication is controlled by over 40 chromosomal genes; some (called MAK genes) promote dsRNA replication or maintenance, others (called SKI genes) negatively control dsRNA replication. Extensive genetic interactions among the dsRNAs and the chromosomal genes are known. The VLPs containing dsRNA produce a message (+) strand RNA copy in vitro, while the VLPs containing a (+) strand synthesize a (-) strand copy to make dsRNA. The genes MAK10 and PET18 (= MAK31 + MAK32) are necessary for the structural stability of L-A dsRNA-containing particles, but not of those containing L-A (+) strand RNA. The M1 VLPs can have either one or two M1 dsRNA molecules per particle, a fact that we explain by a sort of "head-full" hypothesis. [D] (for disease) is a new cytoplasmic genetic element which, when introduced into a ski M1 strain, makes the strain unable to grow at 20 degrees C or at 37 degrees C. [D] is not located on L-A, L-BC, M, or W dsRNA. Element [D] is heat-curable, and chromosomal mutants unable to maintain [D] (mad-) have been isolated. They can maintain M1 and L-A. [B] is a cytoplasmic genetic element which suppresses the usual need of M1 for MAK11 and several other MAK genes. Element [B] is not located on L-A or M and is distinct from [D]. PMID- 3551912 TI - Molecular characterization of chromosomal genes affecting double-stranded RNA replication in Saccharomyces cerevisiae. AB - We cloned MAK11, MAK18, and MKT1 utilizing their genetic map positions. The MAK11 gene is close to CDC16 on chromosome XI. Both genes were cloned on a single 7-kb fragment, and both have now been sequenced. The MAK18 gene is located close to PET3 on chromosome VIII. A large plasmid carrying PET3 was obtained from R. Elder and R.E. Esposito and was found to also have the MAK18 gene. The MAK16 gene has been subcloned and sequenced starting with a clone provided by J. Crowley and D. Kaback. The MKT1 gene was mapped near the gene for topoisomerase II. The topoisomerase II clone was used as the starting point for chromosome-walking to isolate MKT1. A deletion-insertion mutation (disruption) of MKT1 results in an inability to maintain M2, but does not affect M1 or L-A maintenance. Clones of SKI3 and SKI8 were selected using the cold sensitivity for cell growth of ski- M1 strains. The SKI8 gene was disrupted and found to be nonessential for cell growth in the absence of M double-stranded RNA (dsRNA). The SKI3 and SKI8 genes were mapped using these clones. We have also obtained other clones suppressing the pathology caused by the high M titer in ski- strains. These clones are not the SKI genes themselves but somehow avoid the growth defect without repressing M copy number. PMID- 3551913 TI - The replication of double-stranded RNA. PMID- 3551914 TI - Sequence of the M1-2 region of killer virus double-stranded RNA. AB - A full-length complementary DNA (cDNA) copy of the M1-2 region of the double stranded genome of the yeast killer virus was synthesized by reverse transcription, utilizing the m in vitro transcript as template and synthetic primers for both strands. The sequence lacks any long open reading frames (ORFs). The internal portion of the M1-2 region includes the sequence that is linked to the subterminal 229 bases of the M1-1 homologous region in the S3 defective interfering mutant of killer virus double-stranded RNA (dsRNA). Thus, the probable site at which the deletion occurred in S3 has been identified. PMID- 3551915 TI - Analysis and utilization of the preprotoxin gene encoded in the M1 double stranded RNA of yeast. AB - The yeast type 1 toxin is a secreted protein which, along with immunity to the toxin, is encoded by an encapsidated double-stranded RNA (dsRNA) as a precursor protein, the preprotoxin. This chapter reviews recent work that has led to sequencing of complementary DNA (cDNA) copies of the preprotoxin gene, expression of toxin and toxin-immunity from cDNA, and use of the cDNA to effect secretion from yeast of a bacterial cellulase. PMID- 3551917 TI - Site-specific recombination promoted in vitro by the FLP protein of the yeast two micron plasmid. PMID- 3551916 TI - Survival strategies of the yeast plasmid two-micron circle. AB - The multicopy yeast plasmid 2-micron circle uses a number of strategies to insure its persistence in its host. The plasmid confers no selective phenotype to the cell in which it is resident. Nonetheless, the plasmid is lost at less than 1 per 10(5) cell divisions during continuous exponential growth. We have determined that the plasmid persists at least in part due to the ability of the plasmid to amplify its mean copy number when its cellular copy level is low and to distribute plasmid molecules equally between mother and daughter cells at mitosis. We have found that amplification of plasmid copy number occurs by a novel mechanism in which site-specific recombination induces a transient shift in the mode of replication from theta to rolling circle. Equitable partitioning of plasmid molecules requires plasmid-encoded proteins and a centromere-like segment on the plasmid. We have accumulated evidence consistent with a model of partitioning in which the partitioning proteins form a transnuclear structure that is responsible for distributing plasmid molecules throughout the nucleus prior to cell division. In this chapter we describe evidence supporting the existence and mode of action of these two plasmid strategies and discuss the extent to which these strategies may be a pervasive facet of the biology of eukaryotic extrachromosomal elements. PMID- 3551918 TI - Site-specific recombination of the yeast plasmid two-micron circle: intermediates in the binding process. PMID- 3551919 TI - Yeast DNA replication. AB - We have explored various strategies for exploiting the yeast genetic and biochemical system for understanding DNA replication. Because of the long time that has intervened between the isolation of random replication mutants of yeast and the identification of the gene products affected, an alternative approach to elucidating the molecular basis of replication has been needed. One such alternative involves purifying replication proteins, isolating the genes encoding them, and constructing the appropriate mutant from the cloned gene. We have applied this "reverse genetics" strategy to three different replication activities: DNA polymerases, single-stranded DNA binding proteins, and proteins that bind to autonomously replicating sequence (ARS) elements. PMID- 3551920 TI - Distribution of telomere-associated sequences in yeast. AB - Two middle repetitive DNA sequences called X and Y' are found near the telomeres of many chromosomes in Saccharomyces cerevisiae. Orthogonal field gel electrophoresis (OFAGE) was used to examine the distribution of X and Y' on different yeast chromosomes. Although the distribution of X and Y' varies among different laboratory strains of yeast, most yeast chromosomes in four different strains carry both X and Y'. However, at least one chromosome in each strain lacks the Y' element. This result indicates that Y' is not essential for replication or segregation of at least some yeast chromosomes. PMID- 3551922 TI - Gene cloning and mutant isolation of subunits of RNA polymerases in the yeast Saccharomyces cerevisiae. PMID- 3551921 TI - Host factors in nuclear plasmid maintenance in Saccharomyces cerevisiae. AB - In yeast, the initiation of DNA replication on chromosomes is believed to occur at specific sequences known as autonomously replicating sequences (ARSs). We previously isolated a number of mutants that are defective in the maintenance of minichromosomes. Analysis of these mutants suggests that although ARSs differ greatly from one another in their primary sequences, they appear to share a common enzyme complex for the initiation of DNA replication. However, this initiation enzyme complex probably binds with differential affinity to different ARSs. This idea is corroborated by our identification of an ARS-binding protein that binds to different ARSs with different efficiencies. PMID- 3551923 TI - Viability of Salmonella typhimurium in different environmental conditions (feed, litter; temperature). AB - In countries with a prevailing poultry production, salmonellosis is of growing importance. The poultry contaminated with salmonellae plays a significant role in the food poisoning of men and in decreasing the breeding results. The study investigated the viability of Salmonella typhimurium in feed and litter contaminated with this germ, at different temperatures. The organism remained viable at 37 degrees C in feed up to 6 weeks, in litter for 2 weeks, at room temperature in the feed up to 71 weeks in the litter up to 78 weeks, and at 7 degrees C in feed and litter up to 79 weeks. Recommendations are given for the control of salmonellosis by referring to the sources and possibilities of contamination. PMID- 3551924 TI - A high-molecular-mass neutral endopeptidase-24.5 from human lung. AB - A high-Mr neutral endopeptidase-24.5 (NE) that cleaved bradykinin at the Phe5 Ser6 bond was purified to apparent homogeneity from human lung by (NH4)2SO4 fractionation, ion-exchange chromatography and gel filtration. The final enzyme preparation produced a single enzymically active protein band after electrophoresis on a 5% polyacrylamide gel. Human lung NE had an Mr of 650,000 under non-denaturing conditions, but after denaturation and electrophoresis on an SDS/polyacrylamide gel NE dissociated into several lower-Mr components (Mr 21,000 32,000) and into two minor components (Mr approx. 66,000). The enzyme activity was routinely assayed with the artificial substrate Z-Gly-Gly-Leu-Nan (where Z- and -Nan represent benzyloxycarbonyl- and p-nitroanilide respectively). NE activity was enhanced slightly by reducing agents, greatly diminished by thiol group inhibitors and unchanged by serine-proteinase inhibitors. Human lung NE was inhibited by the univalent cations Na+ and K+. No metal ions were essential for activity, but the heavy-metal ions Cu2+, Hg2+ and Zn2+ were potent inhibitors. With the substrate Z-Gly-Gly-Leu-Nan a broad pH optimum from pH 7.0 to pH 7.6 was observed, and a Michaelis constant value of 1.0 mM was obtained. When Z-Gly-Gly Leu-Nap (where -Nap represents 2-naphthylamide) was substituted for the above substrate, no NE-catalysed hydrolysis occurred, but Z-Leu-Leu-Glu-Nap was readily hydrolysed by NE. In addition, NE hydrolysed Z-Gly-Gly-Arg-Nap rapidly, but at pH 9.8 rather than in the neutral range. Although human lung NE was stimulated by SDS, the extent of stimulation was not appreciable as compared with the extent of SDS stimulation of NE from other sources. PMID- 3551925 TI - Cytosolic ratios of free [NADPH]/[NADP+] and [NADH]/[NAD+] in mouse pancreatic islets, and nutrient-induced insulin secretion. AB - When the extracellular concentration of glucose was raised from 3 mM to 7 mM (the concentration interval in which beta-cell depolarization and the major decrease in K+ permeability occur), the cytosolic free [NADPH]/[NADP+] ratio in mouse pancreatic islets increased by 29.5%. When glucose was increased to 20 mM, a 117% increase was observed. Glucose had no effect on the cytosolic free [NADH]/[NAD+] ratio. Neither the cytosolic free [NADPH]/[NADP+] ratio nor the corresponding [NADH]/[NAD+] ratio was affected when the islets were incubated with 20 mM fructose or with 3 mM-glucose + 20 mM-fructose, although the last-mentioned condition stimulated insulin release. The insulin secretagogue leucine (10 mM) stimulated insulin secretion, but lowered the cytosolic free [NADPH]/[NADP+] ratio; 10 mM-leucine + 10 mM-glutamine stimulated insulin release and significantly enhanced both the [NADPH]/[NADP+] ratio and the [NADH]/[NAD+] ratio. It is concluded that the cytosolic free [NADPH]/[NADP+] ratio may be involved in coupling beta-cell glucose metabolism to beta-cell depolarization and ensuing insulin secretion, but it may not be the sole or major coupling factor in nutrient-induced stimulation of insulin secretion. PMID- 3551926 TI - The occurrence of N-methyl-D-aspartic acid in muscle extracts of the blood shell, Scapharca broughtonii. AB - A novel ninhydrin-positive compound, N-methyl-D-aspartic acid, was identified in the muscle extracts of the blood shell, Scapharca broughtonii. This compound is already known to have potent neuroexcitatory activity, inducing hypermotility and strong releasing action of serum luteinizing hormone in mammals. This may be, however, the first finding of N-methyl-D-aspartic acid in natural products. PMID- 3551927 TI - Tripeptidyl peptidase II in haemolysates and liver homogenates of various species. AB - Rabbit antibodies against purified tripeptidyl peptidase II (TPP II) of human erythrocytes have been prepared and used in immunoblot analysis. Antibodies affinity-purified against the denatured 135,000-Mr subunit of the human peptidase were shown to cross-react with purified rat liver TPP II, as well as a polypeptide of Mr 135,000 in haemolysates and liver homogenates from several other species. TPP II activity in haemolysates from monkey, hog, horse and rabbit corresponded to the levels found in human erythrocytes, whereas this activity was absent or low in erythrocytes from calf and hen. On immunoblot analysis of the calf haemolysates, the 135,000-Mr polypeptide could not be detected. In contrast, analysis of liver homogenates from these species revealed both TPP activity and immunoreactive polypeptides. Immunoreactive polypeptides with Mr about 105,000 and 84,000 of variable occurrence were also detected. In addition, extracts of Escherichia coli showed no TPP II activity under the conditions of the standard assay, although polypeptides of Mr 135,000 and 40,000 were revealed on immunoblot analysis of this species. PMID- 3551928 TI - Insulin causes insulin-receptor internalization in human erythrocyte ghosts. AB - The effect of incubation with insulin on insulin-receptor internalization by erythrocyte ghosts was investigated. The number of surface insulin receptors decreased by 30-40% after incubation of ghosts with insulin. Total insulin receptor binding to solubilized ghosts was the same in insulin-incubated and control ghosts, whereas insulin binding to an internal vesicular fraction was substantially increased in insulin-incubated ghosts. Our findings suggest that erythrocyte-ghost insulin receptors are internalized to a vesicular compartment in response to incubation with insulin. PMID- 3551929 TI - Insulin stimulates tyrosine phosphorylation of its receptor beta-subunit in intact rat hepatocytes. AB - We studied the phosphorylation of the beta subunit of the insulin receptor in intact freshly isolated rat hepatocytes, labelled with [32P]Pi. Insulin receptors partially purified by wheat-germ agglutinin chromatography were immunoprecipitated with either antibodies to insulin receptor or antibodies to phosphotyrosine. Receptors derived from cells incubated in the absence of insulin contained only phosphoserine. Addition of insulin to hepatocytes led to a dose dependent increase in receptor beta-subunit phosphorylation, with half-maximal stimulation being observed at 2 nM-insulin. Incubation of cells with 100 nM insulin showed that, within 1 min of exposure to the hormone, maximal receptor phosphorylation occurred, which was followed by a slight decrease and then a plateau. This insulin-induced stimulation of its receptor phosphorylation was largely accounted for by phosphorylation on tyrosine residues. Sequential immunoprecipitation of receptor with anti-phosphotyrosine antibodies and with anti-receptor antibodies, and phosphoamino acid analysis of the immunoprecipitated receptors, revealed that receptors that failed to undergo tyrosine phosphorylation were phosphorylated on serine residues. The demonstration of a functional hormone-sensitive insulin-receptor kinase in normal cells strongly supports a role for this receptor enzymic activity in mediating biological effects of insulin. PMID- 3551930 TI - Increased sensitivity of ventricular myocardium to intracellular calcium-overload in Syrian cardiomyopathic hamster. AB - Papillary muscles of Syrian hamsters with morphologically defined cardiomyopathy (CM), and of control hamsters (Co) have been studied electrophysiologically. Co and CM muscles differ significantly in the following electrophysiological parameters: resting potential (-79.8 +/- 2.9 mV in Co, -74.3 +/- 5.5 mV in CM), action potential duration at 25% repolarization (30.0 +/- 3.6 ms in Co, 25.1 +/- 2.7 ms in CM), and at 90% repolarization (120.0 +/- 21.9 ms in Co, 171.6 +/- 24.1 ms in CM), upstroke velocity of phase 0 depolarization (73.7 +/- 12.8 V/s in Co, 48.4 +/- 8.7 V/s in CM). When superfused with K+-free solutions Co muscles did not show any oscillatory after-potentials up to 15 mmol/l CaCl2. In contrast to this CM muscles respond to K+-free superfusion with oscillatory afterpotentials, transient spontaneous activity and dramatically reduced upstroke velocity. CM muscles respond much more sensitively to an intracellular Ca2+ overload than Co preparations. PMID- 3551931 TI - Monoclonal antibodies against rat mast cells. AB - Four hybridomas have been isolated which secrete monoclonal antibodies against surface determinants of rat peritoneal mast cells. This could be demonstrated by an indirect immunofluorescence assay. The monoclonal antibodies did also react with a portion of mononuclear phagocytes from the peritoneal cavity but not with other lymphatic cells. PMID- 3551933 TI - Molecular mechanisms of the chromosome condensation and decondensation cycle in mammalian cells. PMID- 3551932 TI - Functional effects of splenin32-34 on antibody formation in immunosuppressed mice. AB - Sublethally irradiated AB/Bln mice (500 cGy) were treated with splenotritin (fragment 32-34 of the splenic hormone splenin) and tested for their capability of producing antibodies against target sheep red blood cells. In x-ray plus splenotritin treated mice antibody forming cells were found earlier and in a higher frequency than in mice treated with x-rays alone. PMID- 3551935 TI - The amdS gene of Aspergillus nidulans: control by multiple regulatory signals. PMID- 3551934 TI - Lymphocyte homing receptors and the immune response in vivo. PMID- 3551937 TI - The use of vaccinia virus for the construction of recombinant vaccines. PMID- 3551936 TI - Site-specific mutagenesis of large DNA viral genomes. PMID- 3551938 TI - Retrovirus vectors and their uses in molecular biology. PMID- 3551939 TI - Coronavirus leader-RNA-primed transcription: an alternative mechanism to RNA splicing. PMID- 3551941 TI - The impact of monoclonal antibodies on virus diagnosis. PMID- 3551940 TI - Cell surface receptors for picornaviruses. PMID- 3551942 TI - Prions are novel infectious pathogens causing scrapie and Creutzfeldt-Jakob disease. PMID- 3551943 TI - DNA interactions with the nuclear matrix and spatial organization of replication and transcription. PMID- 3551944 TI - Regulation of expression of the c-myc proto-oncogene. PMID- 3551945 TI - Low energy pulsing electromagnetic fields modify biomedical processes. PMID- 3551946 TI - Instituto de Investigaciones Bioquimicas 'Fundacion Campomar': the new laboratories of Luis F. Leloir. PMID- 3551947 TI - Multifunctional polypeptides for purine de novo synthesis. PMID- 3551948 TI - Molecular approaches to the study of mesoderm formation in amphibians. PMID- 3551950 TI - The lin-12 locus of Caenorhabditis elegans. PMID- 3551949 TI - Molecular genetic aspects of sex determination in Drosophila. PMID- 3551951 TI - The Department of Embryology of the Carnegie Institution of Washington. PMID- 3551952 TI - P. falciparum invasion of human red cells and cytoadherence to endothelial cells is dependent upon a parasite produced glycosidase. AB - This report describes biochemical and immunological evidence that P. falciparum produces an neuraminidase-like activity on invasion into the human red cell. The enzyme-like activity modifies the surface of glycophorin A on the infected red cell membrane to prevent further invasion of other merozoites, as well as to enhance the binding capabilities of the red cell to the host's endothelial cells (EC). PMID- 3551953 TI - GnRH-associated peptide (GAP) is cosecreted with GnRH into the hypophyseal portal blood of ovariectomized sheep. AB - The secretion of gonadotropin-releasing hormone (GnRH) and GnRH-associated peptide (GAP) into sheep hypothalamo-hypophyseal portal blood was investigated in ovariectomized ewes. GAP and GnRH were cosecreted into portal blood as determined in pooled 'peak' and 'trough' samples. The temporal pattern of GAP secretion into portal blood was coincidental with that of luteinizing hormone (LH) secretion into peripheral blood in three individual animals. The data provide the first evidence that GAP is a secretory product from mammalian hypothalamus and establish the temporal coexistence of the two peptides which appears to be of physiological significance in the regulation of pituitary function. PMID- 3551954 TI - Proton nuclear magnetic resonance measurement of the amide hydrogen exchange rates of group A streptococcal polysaccharide in H2O. AB - The solvent exchange rates of the acetamido hydrogen of the 2-acetamido-2-deoxy beta-D-glucopyranosyl unit of group A streptococcal polysaccharide dissolved in H2O have been measured and compared with the corresponding exchange rates in the solvated model compound 1-O-methyl-2-acetamido-2-deoxy-beta-D-glucopyranoside. Amide hydrogen exchange rates were measured at 25 degrees C over a wide pH range by a combination of two separate NMR techniques: the transfer of solvent saturation and the amide hydrogen saturation recovery NMR experiments. The data indicate that the acetamido hydrogen essentially exists in a solvated environment and that its contribution to the conformational stability of this polysaccharide through intramolecular hydrogen bonding is negligible. PMID- 3551955 TI - Use of antibodies to probe membrane glycoproteins associated with drug-resistant J774.2 cells. AB - Three drug-resistant sublines of the murine macrophage-like cell line J774.2 were selected in vitro for their ability to grow in high concentrations of either taxol, vinblastine, or colchicine. Each contains a major plasma membrane glycoprotein (130-150 kDa), which is barely seen in the drug-sensitive parental cell line. Polyclonal antibodies, raised against the glycoproteins present in the colchicine- and vinblastine-resistant cells, were used to probe for relationships among the three glycoproteins. Our observations suggest that the glycoproteins from the different drug-resistant cell lines share many common domains but are not identical. PMID- 3551956 TI - Complete amino acid sequence of the human progesterone receptor deduced from cloned cDNA. AB - A lambda gt10 library containing DNAs complementary to messenger RNAs from human breast cancer T47-D cells was constructed and screened with a cDNA probe encoding the rabbit progesterone receptor. Four overlapping clones have been sequenced. The open reading frame corresponds to a protein of 933 amino acids with a molecular weight of 98,868 Da. The cysteine rich basic region supposed to be involved in DNA binding is completely homologous in the human and rabbit receptors, whereas the C-terminal end, where hormone binding is thought to take place, differs by a single amino acid change. The human progesterone receptor is characterized, as is the rabbit receptor, by the very high proline content of its N-terminal region. When mRNAs from either human breast cancer cell lines T47-D and MCF-7 or from normal human uterus tissue were blotted and probed with the cloned cDNA, four main bands were observed (5100, 4300, 3700, and 2900 nucleotides). PMID- 3551957 TI - C-terminally extended ocytocin and pro-ocytocin: neurophysin peptide converting enzyme in bovine corpus luteum. AB - Purified secretory granules from the corpus luteum of super ovulated and fecundated cows, at day 7-8 after the heat period, were used as a source of pro ocytocin/neurophysin (pro OT/Np) processing enzymes. An endoprotease comparable to the previously described pituitary enzyme both by its catalytic properties and sensitivity to various inhibitors was characterized. This protease cleaves pro OT/Np (1-20) after the basic Lys11Arg12 doublet to release OT Gly10 Lys11 Arg12. Moreover C-terminally extended ocytocin, i.e. OTGlyLys and OTGlyLysArg together with ocytocin were identified in extracts from the corpus luteum. Together these data argue strongly in favor of pro OT/Np processing pathways in which cleavage of the precursor at the Arg12-Ala13 peptide bond is the primary event. PMID- 3551958 TI - Effect of S-adenosylhomocysteine on insulin-independent release of pyruvate dehydrogenase activator from rat adipocyte plasma membranes. AB - The addition of insulin to adipocyte plasma membranes has been shown to release a low molecular weight, acid stable mediator which activates mitochondrial pyruvate dehydrogenase. The insulin-dependent release of this activator is dependent on the method used to prepare the plasma membranes. Adipocyte plasma membranes prepared in 0.25 M sucrose, 10 mM MOPS, pH 7.4 released an activator of pyruvate dehydrogenase in an insulin-independent manner. Insulin is required to stimulate phospholipid methylation in these membranes. The inhibition of insulin-stimulated phospholipid methylation with 1 mM S-adenosylhomocysteine resulted in a significant increase in amount and/or activity of the pyruvate dehydrogenase activator. The insulin-dependent dependent release of mediators of insulin action from adipocyte plasma may be regulated by phospholipid methylation. PMID- 3551959 TI - Effect of diabetes, adrenalectomy and hypophysectomy on D-3-hydroxybutyrate dehydrogenase activity and substrate oxidation by rat mitochondria. AB - In good agreement with previous observations, D-3-hydroxybutyrate dehydrogenase (OHBD) activity in disrupted liver mitochondria decreased significantly in chronic diabetic rats, whereas insulin treatment prevented this decrease. Similar effects were observed with kidney mitochondria. Adrenalectomy increased OHBD activity in liver and brain mitochondria from normal rats and in liver mitochondria from diabetic rats. Corticosterone depressed OHBD activity in liver mitochondria of normal rats and restored the normal level of OHBD in adrenalectomized rats. Hypophysectomy increased OHBD activity in normal rats, this effect being further increased by growth hormone administration. D-3 hydroxybutyrate (OHB) oxidation by liver mitochondria from diabetic, adrenalectomized or hypophysectomized rats varied as expected from OHBD activity in disrupted mitochondria, but to a relatively lesser degree. Submitochondrial particles from diabetic rats showed significant diminution in OHB-, succinate- and NADH-oxidase activities, whereas mitochondria from diabetic rats oxidized succinate and L-malate + L-glutamate at a slower rate than the corresponding controls. PMID- 3551960 TI - Absorption of protein via the intestinal wall. A quantitative model. AB - Intact, biological active insulin and pancreatic RNase can be absorbed from the intestinal lumen into the blood circulation. The absorption is dependent on the addition of bile acid (sodium cholate) and proteinase inhibitor. The quantitative absorption of insulin and pancreatic RNase has been demonstrated in an in situ model. The amount of insulin absorbed after 30 min from the ileum to the mesenteric vein was 0.025% of the initial amount. Sodium cholate (10 mg/ml) and 3000 KIU/ml aprotinin enhanced this absorption by 30 times. The amount of pancreatic RNase which was absorbed from the ileum to the blood was 0.002% of the initial amount during 30 min. Sodium cholate (10 mg/ml) and 3000 KIU/ml aprotinin increased the absorption by a factor of 200. No damage occurred to the intestine during the experimental procedures. The sieving characteristics of the intestinal wall were not altered by the presence of sodium cholate and proteinase inhibitor in the intestinal lumen. These results suggest that sodium cholate and proteinase inhibitors can facilitate the absorption of intact, biologically active proteins across the intestinal wall. PMID- 3551961 TI - Proteoglycan degradation by a chondrocyte metalloprotease. Effects of synthetic protease inhibitors. AB - Synthetic inhibitors of a chondrocyte metalloprotease (CMP) were assessed for potency. Proteoglycan core protein was used as substrate. The IC50 values were between 2 X 10(-6) and 7 X 10(-6) M for two types of inhibitors, thiol tripeptides and N-carboxyalkyl peptides. Hydroxamic acid peptides were more potent, with IC50 values of 3.2 X 10(-8) to 6.0 X 10(-8) M. These results confirm inhibitory concentrations reported using a proteoglycan-polyacrylamide bead assay. The slopes of the dose-response curves for the thiol compounds were steeper than the slopes for the other two types of compounds. All of the culture media tested inhibited CMP to some extent. Some media also interfered with inhibitor activity. In Ham's F10 nutrient medium, minimum CMP inhibition occurred, and all four hydroxamic acid peptides retained their activity for 1-2 days at 37 degrees. One thiol peptide compound assayed lost activity in 1 hr in thiocyanate-treated serum. All four hydroxamic acid peptides assayed retained activity in thiocyanate-treated serum after 3 days at 37 degrees. The hydroxamic acid peptides may provide a way to block endogenous CMP activity in vivo and to assess the role of CMP in normal and experimentally altered cartilage. They are more potent than other known CMP inhibitors. They retain activity in culture media and serum conditions used for in vivo and in vitro tests of CMP activity and toxicity. PMID- 3551962 TI - [The vector containing a signal for specific degradation of chimeric proteins. Synthesis of [Leu5]enkephalin using enteropeptidase]. AB - A plasmid vector (pEK1) coding, in framework of beta-galactosidase gene, for the amino acid sequence (Asp)4Lys which is recognized by bovine enteropeptidase has been constructed. Using this vector and chemically synthesized DNA coding for the [Leu5]-enkephalin, a plasmid (pEK-ENK) has been obtained in which the beta galactosidase gene is fused, through the enteropeptidase linker, with the gene for [Leu5]enkephalin. The chimeric protein produced by expression of this plasmid has been isolated and then cleaved by the enteropeptidase to give [Leu5]enkephalin with the yield 74%. PMID- 3551963 TI - [Prokaryotic and eukaryotic DNA-polymerase. I. The role of internucleotide phosphate groups in the binding of a primer with the enzyme]. AB - The mechanism of binding and elongation of the oligothymidylate primers in the systems of the DNA polymerase alpha from human placenta and DNA polymerase I from E. coli with the poly(dA) as a template was investigated. Both dTMP and dTTP were shown to be the minimal primers of DNA polymerase alpha, the affinity and V increasing 1.8- and 1.4-fold respectively upon lengthening the primer by each unit from dTMP to d(Tp)9T. Further elongation is accompanied by 1.3-fold affinity enhancement and a decrease in V. For the E. coli enzyme, a similar dependence of affinity of primer d(Tp)4T-d(Tp)14T was observed with the inflexion point corresponding to d(Tp)8T. The individual diastereomers of oligothymidylate ethyl esters (with p' and p'' corresponding to enantiomeric configuration) such as d[Tp'(Et)Tp]3Tp'(Et)T, d[Tp''(Et)Tp]3Tp''(Et)T, d(Tp)8Tp'(Et)T, d(Tp)8Tp''(Et)T, d(Tp)8Tp'(Et)TpT, d(Tp)8 X X Tp''(Et)TpT and completely esterified analogues d[Tp(Et)]7T, d[Tp(Et)]14T were shown to initiate the poly (dA)-dependent polymerization catalyzed by both enzymes. A sum of the obtained results provided the basis for a number of conjectures on the mode of primer and template binding to the enzyme, possible role of their preformed complex, as well as electrostatic interactions and hydrogen bonding. PMID- 3551964 TI - [Eukaryotic and prokaryotic DNA-polymerase. II. The role of internucleotide phosphate groups of a template in its binding with the enzyme]. AB - The affinity of different ligands (phosphate, nucleoside monophosphates, oligonucleotides) to the template binding site of DNA polymerase alpha from human placenta was estimated. To this goal, dependences of rate of the enzyme inactivation by the affinity reagent d(pT)2pC[Pt2+(NH3)2OH](pT)7 on the concentration of these ligands as competitive inhibitors were determined. Minimal ligands capable to bind with the template site of DNA polymerase alpha were shown to be triethylphosphate (Kd 600 microM) and phosphate (Kd 53 microM). Ligand affinity increases by the factor 1.71 per added monomer unit from phosphate to d(pT) and then for oligothymidylates d(Tp)nT (n 1 to 14). The partial ethylation of phosphodiester groups does not change the efficiency of the oligothymidylate binding with the enzyme. However, the complete ethylation of these groups lowers affinity of the oligothymidylates to the enzyme by 7-9 times. The decrease is comparable with the change of Pt2+-decathymidylate affinity to the enzyme caused by Mn2+-ions. The data obtained led to suggestion that an electrostatic contact (most likely, Me2+-dependent) of phosphodiester group with the enzyme takes place. The type of contact is confirmed by Gibbs' energy change 1.1-1.4 kcal/mole. Formation of a hydrogen bond with the oxygen atom of P = O group of the same phosphate is also assumed (delta G =--4.4 . . .--4.5 kcal/mole). The other internucleotide phosphates and all bases of oligonucleotides form neither hydrogen bonds nor electrostatic contacts with the template binding site. Gibbs' energy changes by 0.32 kcal/mole when the template is lengthened by one unit. We suppose that this value characterizes the energy gain in the transition of oligonucleotide template from aquous medium to the hydrophobic environement of the enzyme active site. Comparison of Km values of oligothymidylates and their partially or completely ethylated analogues as templates in the reaction of DNA polymerization catalysed by DNA polymerase alpha from human placenta and Klenow's fragment of E. coli DNA polymerase I suggests a similar mechanism of template recognition by both enzymes. PMID- 3551965 TI - Failure of Klebsiella pneumoniae antibodies to cross-react with peripheral blood mononuclear cells from patients with ankylosing spondylitis. AB - Cross-reactivity between antibodies to 2 strains of Klebsiella pneumoniae (K43 and F77) and the peripheral blood lymphocytes of patients with ankylosing spondylitis (AS) was examined in 3 separate antibody binding and cytotoxicity assays. Using K pneumoniae antisera in a chromium release cytotoxicity assay, we found no difference in the reactions of cells from AS patients and those from control subjects. This result contrasts with the results of previous studies. Similarly, using an enzyme-linked immunosorbent assay, we detected no significant increase in antibody binding to peripheral blood mononuclear cells (PBMC) in HLA B27 positive patients with AS. Low levels of antibody binding were detected by a fluoresceinated antibody binding assay; however, normal rabbit serum, which was used as a control, was shown to have a binding affinity for PBMC that was significantly greater than that of specific K pneumoniae antisera. The results of our present study do not support the concept of a specific cross-reactivity between antibodies to K pneumoniae and the PBMC of patients with AS who are HLA B27 positive. PMID- 3551967 TI - Regarding the ankylosing spondylitis/Klebsiella/HLA-B27 problem. PMID- 3551966 TI - IgM rheumatoid factor plaque-forming cells in juvenile rheumatoid arthritis. AB - Using a direct, plaque-forming cell (PFC) assay with sensitized sheep erythrocytes, lymphocytes that secrete IgM rheumatoid factors (RF) have been detected in the peripheral blood of patients with juvenile rheumatoid arthritis. Of 15 juvenile rheumatoid arthritis patients tested, 8 were seropositive and 7 were seronegative, but 6 of the seronegative patients had hidden 19S IgM-RF. Ten patients (5 seropositive and 5 with hidden 19S IgM-RF) demonstrated RF-PFC in their peripheral blood (range 15 to greater than 200 RF-PFC/10(6) mononuclear cells). Of 11 patients who had active disease, 10 had RF-PFC, and the 4 patients who had inactive disease had no PFC in their peripheral blood. HLA typing of all 15 patients revealed no correlation between the presence of RF-PFC and HLA type. PMID- 3551968 TI - Acute effects of ibopamine hydrochloride on hemodynamics, plasma catecholamine levels, renin activity, aldosterone, metabolism and blood gas in patients with severe congestive heart failure. AB - Acute effects of 200 mg of orally given 4-[2-(methylamino)ethyl]-o-phenylene diisobutyrate hydrochloride (ibopamine hydrochloride) which is a new diisobutyric ester of N-methyldopamine, on hemodynamics and metabolism were evaluated in 11 patients with severe heart failure (New York Heart Association class IV). Significant effects occurred within 30 min and persisted for 6 h after dosing. Peak effects were observed at 2 h. At peak effects, cardiac index increased from 2.53 to 3.07 l/min/m2 (+20%, p less than 0.01), stroke volume index from 35 to 41 ml/beat/m2 (+18%, p less than 0.05), stroke work index from 35 to 44 g X m/beat/m2 (+26%, p less than 0.05), epinephrine from 0.05 to 0.15 ng/ml (+200%, p less than 0.05), urine volume from 50 to 81 ml/h (+61%, p less than 0.05), pulmonary capillary wedge pressure decreased from 23 to 18 mmHg (-24%, p less than 0.001), mean pulmonary arterial pressure from 33 to 27 mmHg (-19%, p less than 0.001), right atrial pressure from 10 to 7 mmHg (-27%, p less than 0.001), systemic vascular resistance from 1735 to 1546 dyne X s X cm-5 (-11%, p less than 0.1), pulmonary vascular resistance from 204 to 168 dyne X s X cm-5 (-25%, p less than 0.05), arterio-venous oxygen difference from 6.09 to 5.36 ml/dl (-12%, p less than 0.05), norepinephrine from 0.45 to 0.34 ng/ml (-24%, p less than 0.1), renin activity 1.80 to 1.26 ng/ml/h (-30%, p less than 0.05), respectively, whereas there were no significant changes in blood gases, heart rate, blood pressure, double product, aldosterone, urine Na+, K+ or lactate/pyruvate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551970 TI - Short-term sleep laboratory evaluation of midazolam in chronic insomniacs. Preliminary results. AB - The effects of 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine (midazolam, Ro 21-3981, Dormicum) in oral formulation of 15 and 30 mg on the sleep cycle of patients suffering from insomnia were assessed by means of polysomnographic recordings using a double-blind cross-over design. Both doses of midazolam were effective in improving sleep on short-term administration. In addition, significantly larger decrements of non-REM (NREM) sleep latency and of wake time through the 3rd third of night and nonsignificant trends toward smaller number of awakenings as well as shorter total wake time and longer NREM sleep time were induced by the 30 mg dose. Irrespective of the dosage sleep was almost exclusively increased at the expense of NREM sleep. Following 3 days treatment there was no rebound insomnia. These preliminary results suggest that the 15 mg dose could be appropriate in patients with difficulties in falling asleep, while the 30 mg dose would be more appropriate for patients who also experience difficulties in staying asleep. PMID- 3551969 TI - A multicenter double-blind controlled trial comparing lidamidine HCl and loperamide in the symptomatic treatment of acute diarrhoea. AB - The efficacy of 1-(2,6-dimethylphenyl)-3-methyl-amidinourea hydrochloride (lidamidine HCl, WHR-1142 A) an aryl-substituted amidinourea recently synthesized, was compared with that of loperamide in 32 patients with acute diarrhoea. The results of the study show that lidamidine HCl and loperamide had comparable effects in the pharmacological treatment of acute non-specific diarrhoea. Lidamidine HCl was also shown to be well tolerated; side-effects were generally minor and self-limiting. PMID- 3551971 TI - [Tumor cell immunogenicity and T-cell-mediated antitumor immune reactions. Modulation and application to immunotherapy]. AB - Several approaches to increase tumor cell immunogenicity and anti-tumor T-cell reactivity have been reviewed. In contrast to unspecific immune stimulation, the activation of specific T-cell reactivity can lead to long-lasting anti-tumor immunity. In several instances, immunization with modified tumor cells led to the induction of tumor immunity against the original non-modified tumor cells. In our own studies two types of approaches were also effective with the highly metastatic mouse tumor line ESb which carries a weak tumor associated antigen. Postoperative immunization with either virus modified ESb cells or with mutagenized variants of ESb cells led to the survival of a significant proportion of the treated animals. These animals had been cured of their micrometastases and developed long lasting anti-tumor immunity. It is hoped that such modified tumor cells could become useful reagents for tumor immunotherapy, especially in situations where the tumor burden is low. Future efforts should be directed towards testing the effectiveness of immunogenic modified tumor variants in combination with surgery or chemotherapy for treatment of micrometatases. PMID- 3551972 TI - [Therapy of malignant systemic diseases: hemoblastoses and malignant lymphomas]. AB - Recent progress in the treatment of acute leukemias in adults includes combination chemotherapy (TAD) and the use of high-dose antimetabolites (methotrexate plus citrovorum rescue or high-dose cytosine-arabinoside). The role of post-induction chemotherapy is still controversial especially with regard to the maintenance chemotherapy. The German AML (acute myeloid leukemia) Cooperative Group started a cooperative multi-center comparative trial to evaluate the validity of maintenance chemotherapy in patients with AML. A complete remission rate of 61% was achieved. The median time to complete remission was 33 days, and a complete remission was obtained in 68% of responders after only 1 course of therapy. Patients in complete remission were eligible for randomization for TAD consolidation with or without monthly maintenance chemotherapy. The up-dated life table analysis revealed a predicted rate of continuous complete remission at 2 1/2 years of 30% for the maintenance and 17% for the non-maintenance group of patients (p = 0.003). On the basis of these results post-induction myelosuppressive chemotherapy appears to be substantial for achieving long-term remissions in AML. In addition, consolidation chemotherapy together with monthly maintenance seems to be superior to consolidation in prolonging the remission duration. In adult ALL/AUL (acute lymphatic/undifferentiated leukemia) complete remission rates amount to 60-85% and remission durations of 9-25 months have been reported.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551974 TI - Congenital midline porencephaly. Prenatal sonographic findings and review of the literature. AB - A case of congenital midline porencephaly, including the prenatal sonographic findings, is presented. A review of the literature showed that six cases of congenital midline porencephaly have been reported, though none had sonographic evaluation in the prepartum period. The prenatal sonographic diagnosis of this rare disorder is discussed along with the clinical and pathologic findings and outcome of all reported cases. PMID- 3551973 TI - Management of the insulin-dependent diabetic during labor and delivery. Influences on neonatal outcome. AB - Infants of insulin-dependent diabetic mothers are at risk for neonatal polycythemia, hyperbilirubinemia, respiratory distress syndrome (RDS), and hypoglycemia. The purpose of this study was to determine whether labor and delivery management of diabetes may influence the rate of these complications. We hypothesized a priori that: infants of diabetic mothers delivered by cesarean section have a lower rate of neonatal polycythemia and hyperbilirubinemia, but a higher rate of RDS, than infants of diabetic mothers delivered by vaginal route, and poor glycemic control during labor increases the rate of neonatal hypoglycemia. We therefore prospectively studied 122 pregnancies in 100 well controlled insulin-dependent diabetic mothers. Intravenous glucose and/or insulin was infused during labor to maintain capillary glucose concentration between 70 and 100 mg/dl. Fifty-six pregnancies were concluded by primary or elective cesarean section (group 1), 36 by cesarean section following spontaneous or induced labor (group 2), and 30 by spontaneous or induced vaginal delivery (group 3). Hemoglobin A1, birthweight, and gestational age were similar in all three groups. The rate of neonatal polycythemia was significantly lower in the cesarean section subjects, groups 1 and 2, as compared to group 3 (P less than 0.04). The rate of neonatal hyperbilirubinemia was significantly lower in group 1 (P less than 0.05) as compared to groups 2 and 3. The rate of RDS was higher in group 1 (versus groups 2 or 3), but did not reach significance on initial analysis (P = 0.06); however, group 1 was associated with a significant risk for RDS when corrected for the confounding variables of gestational age and neonatal asphyxia as defined by Apgar scores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3551975 TI - Ultrasound in obstetric decision making. How accurate are late ultrasound scans in gestational age and fetal weight assessment? AB - Gestational age determination based on obstetric dating criteria, early pregnancy ultrasound scans, Dubowitz examinations, and ultrasound scans performed shortly before delivery were reviewed for 69 preterm infants requiring neonatal intensive care. The last ultrasound scans underestimated gestational age by a median of 8 days, and by 2 weeks or more in 20 of the 69 cases, as opposed to best dating criteria. Ultrasonic fetal weight estimation was more accurate, but erred by more than 20% in 10% of cases. When obstetric decisions regarding preterm neonates must be made without prior information regarding gestational age, late ultrasound findings must be applied with extreme care. PMID- 3551976 TI - Ultrasound investigation of the posterior fossa in the fetus. AB - One hundred and thirty normal pregnancies, ranging in gestational age from 15 to 40 weeks, were investigated to evaluate the capability of ultrasound to demonstrate the anatomy of the fetal posterior fossa. The cerebellum, including the cerebellar hemispheres, the superior and inferior vermis, the fourth ventricle, and the cisterna magna could be demonstrated easily. The ultrasound interpretation of the brain structures was verified by the anatomic dissection of the brains of 10 stillborn premature infants. A systematic approach to the prenatal ultrasound examination of the posterior fossa is described. PMID- 3551977 TI - Neonatal tracheobronchomegaly. AB - Tracheobronchomegaly is rarely reported in neonates. We present five cases of tracheobronchomegaly occurring in neonates receiving intensive ventilatory and oxygen support. Barotrauma is speculated to be the primary pathophysiologic factor in these cases. PMID- 3551978 TI - Recognition of the overgrown fetus: in utero ponderal indices. AB - In a cross-sectional study of 210 pregnancies resulting in above-average-sized term infants, ponderal and ponderal-like indices were found to be highly correlative with fetal overgrowth. Clinical usefulness, however, is limited because for each index, most large-for-gestational age infants remain unidentified. PMID- 3551979 TI - Memories of the early days of arthroscopy: 1965-1975. The formative years. AB - In the decade from 1965 to 1975, arthroscopy advanced from a medical curiosity to a useful adjunct in the treatment of joint disease. The International Arthroscopy Association was established in 1974, with the prime purpose of teaching arthroscopy and disseminating information regarding the technique. Rapid advances were made in the field of instrumentation, courses were organized, and regular meetings were held as a forum for the exchange of information. Hence, in only 10 years, the technique became an established part of knee joint surgery, and the door was opened for the exploration of other joints. Dr. Masaki Watanabe deserves full credit for his contribution, which medical historians will undoubtedly establish as one of the great advances in orthopaedic surgery in the twentieth century. PMID- 3551980 TI - [Esthetics and prevention in a new composite]. PMID- 3551982 TI - [Immediate dentures with superior fidelity]. PMID- 3551981 TI - [Restorations with composite materials: class III]. PMID- 3551983 TI - [From this articulator gnathology was born]. PMID- 3551984 TI - [Bonded ceramic veneers]. PMID- 3551985 TI - [Clinical-prosthetic problems in overdentures with unilateral retention. An anchor to be saved]. PMID- 3551986 TI - [Automatic repositioning of canal posts]. PMID- 3551987 TI - [Complete dentures over implants using magnetic retention--procedures. Esthetics and stability]. PMID- 3551990 TI - [Natural retention and instrumentation in the restoration of devitalized teeth]. PMID- 3551988 TI - [All of edentulism in 5 classes]. PMID- 3551989 TI - [Esthetics and prosthetics]. PMID- 3551991 TI - [Retention of overdentures]. PMID- 3551992 TI - [Carious tooth? No, it's false]. PMID- 3551993 TI - Beta 2-microglobulin, different fragments and polymers thereof in synovial amyloid in long-term hemodialysis. AB - Amyloid deposits of a patient with long-term hemodialysis were immunohistochemically identified as beta 2-microglobulin (beta 2m)-derived. Amyloid proteins were isolated from fibril concentrates from the synovia by HPLC permeation chromatography. Further analysis included dot immunoassay, immunodiffusion, SDS-polyacrylamide gel electrophoresis and Western blotting. Proteins with molecular masses of 8.5, 12, 17 and 24 kDa as well as polymers of higher molecular mass were detected. Neither the 24-kDa dimer nor the higher polymers could be significantly reduced by disulfide reagents. The N-terminal amino-acid sequence analyses of the two major proteins of 12 and 24 kDa showed the same two sequences each: one commencing with position 1 and the other with position 7 of beta 2m. These results suggest that limited proteolysis and polymer formation independent from interchain disulfide bridging, both play a role in the genesis of beta 2m-derived amyloid in the synovia. PMID- 3551994 TI - Applications of a monoclonal antibody to human ferritin in various immunoassays. AB - Monoclonal antibodies to human liver ferritin were generated by an improved hybridoma technique using a semisolid medium containing methylcellulose for initial cloning after the cell fusion. Out of more than 1000 hybrid clones, only 1 was shown to secrete high-affinity monoclonal antibodies to human liver ferritin. The immunoglobulin subclass of this antibody was determined to be IgG2. The association constant between liver ferritin and this antibody was determined to be greater than 1 X 10(10) M-1. Due to the oligomeric nature of ferritin, this antibody can be simultaneously utilized as the first and second antibody in solid phase sandwich immunoradiometric and enzyme immunoassays. This immunoassay procedure can be performed within 30-45 min and has a sensitivity of about 1 ng/ml. Under identical assay conditions, ferritin isolated from human spleen and human heart gave 50 and 30% cross-reactivity, respectively. PMID- 3551995 TI - [A double-blind clinical trial of a topical preparation with a base of biochemical precursors of glucosaminoglycan (GAG) in patients suffering from Raynaud's disease]. PMID- 3551996 TI - A comparison of three methods of oral reconstruction. AB - A protocol is presented that was designed to provide comparative data on the two primary oral cavity functions affected by surgery: speech and swallowing. Three types of reconstruction (skin grafts, hemitongue flaps, and myocutaneous flaps) and results of a series of tests given to 15 surgical patients with T2 and T3 tongue and/or floor of mouth lesions were evaluated. The patients who had split thickness skin grafts had the best oral function results. The study suggests that tongue mobility is the most significant variable in determining post-operative speech results. PMID- 3551997 TI - Evaluation of poorly differentiated head and neck neoplasms. Immunocytochemistry techniques. AB - Despite the use of strict morphologic criteria, some head and neck neoplasms remain classified as "poorly differentiated" or "undifferentiated." To circumvent this diagnostic quandary, newer techniques primarily based on immunocytochemistry are being utilized to study tumor specimens. These methods rely on the binding of specific antibodies to cellular antigens in order to better define the tumor according to cell type. We treated six patients in whom a definitive pathologic diagnosis could not be obtained without the use of immunohistologic stains. In each case, the definition of a specific tumor category altered patient management. The approach to the evaluation of patients with undifferentiated head and neck neoplasms is important. Close cooperation between the clinician and pathologist is necessary in such cases; this is assisted by a knowledge of the uses and limitations of the current diagnostic modalities being used, as well as proper tissue handling and processing. PMID- 3551998 TI - Monoclonal antibodies to bovine and human acrosin. AB - Monoclonal antibodies to human acrosin were required for studies of immunological interference with fertilization. Since human acrosin was not available in adequate amounts, monoclonal antibodies have been raised in mice against purified bovine acrosin and screened for cross-reaction with human sperm cells. Two of these antibodies are described, B4F6 and C2E5. Data from enzyme-linked immunosorbent assays, immunoblots, immunoprecipitation, and indirect immunofluorescence on sperm cells indicate that B4F6 binds only to bovine acrosin, and that C2E5 binds both to bovine and to human acrosin at a conformationally determined epitope. The antibodies do not inhibit the hydrolysis of benzoylarginine ethyl ester by acrosin, but C2E5 did inhibit the dissolution of the hamster zona pellucida by purified human acrosin. The antibodies have also been used for affinity purification of acrosin and proacrosin. PMID- 3551999 TI - Posttranslational modifications of proopiomelanocortin in rat intermediate lobe cells. AB - Proopiomelanocortin (POMC), the common precursor to beta-endorphin and alpha melanocyte-stimulating hormone synthesized in rat intermediate lobe cells, exhibits both charge and size heterogeneity on two-dimensional gels. Pulse labeling and pulse-chase studies revealed that this heterogeneity is due to co- and post-translational modifications of a single common polypeptide. Short 5-min pulse incubation with [3H]phenylalanine allowed the preferential labeling of two major forms characterized by an identical isoelectric point (8.2), but slightly different apparent molecular weights (MW = 34,000 and 36,000). These peptides could be labeled with [3H]mannose and the analysis of their tryptic fragments by high-pressure liquid chromatography revealed that they correspond to polypeptides bearing one or two N-linked carbohydrate side chains. Accumulation of more acidic forms was observed during subsequent chase incubations in the absence of phenylalanine. These acidic forms were shown to incorporate sulfate and (or) phosphate groups. Sulfation and phosphorylation occurred on POMC within 5 min after its synthesis and were concomitant with the processing of the N-linked carbohydrates from the high mannose to the complex structure. Finally, partial digestion of the phosphorylated and nonphosphorylated analogs of POMC with either Staphylococcus aureus (V8 strain) protease or chymotrypsin suggests that the presence of a phosphate group may alter POMC sensitivity to exogenously added proteases. PMID- 3552000 TI - Cytolocalization artifacts with immunofluorescent probes. AB - Formaldehyde fixation, nonionic detergent extraction, and ligand binding are commonly used in conjunction with immunofluorescence microscopy to visualize antigens and lectin-reactive molecules in cytoskeletal preparations. These procedures have the potential to produce serious artifacts in cytolocalization studies, as is shown in the present investigation of wheat-germ agglutinin (WGA) binding and localization in BeWo choriocarcinoma cells. Formaldehyde fixation of intact cells reduced the binding of 125I-labeled WGA by 30% and altered the pattern of staining with fluorescein isothyocyanate (FITC)-WGA. Except for perinuclear sites which were brightly stained, the binding of FITC-WGA to other cell surface regions was significantly decreased. Nonionic detergent extractions had two different effects on lectin binding activity depending on whether or not the cells had been pretreated with lectin. In lectin-pretreated cells, 50% of bound lectin was solubilized by detergent but all of the surface binding sites appeared to be retained in active form in the detergent-insoluble residue. Nuclear-cytoskeletal monolayers prepared from cells that were not lectin pretreated lost considerable binding activity, however. These results suggest that a number of erroneous conclusions can be drawn from studies on cytoskeletal associations with membrane components using immunofluorescence microscopy on fixed and detergent-extracted cells. PMID- 3552001 TI - Activities of both ribonucleotide reductase subunits, M1 and M2, decrease upon serum starvation of baby hamster kidney 21/C13 cells. AB - Ribonucleotide reductase from mammalian cells is composed of two nonidentical subunits M1 and M2 which are both required to form the catalytic site. The level of ribonucleotide reductase activity is cell cycle controlled and several reports suggest that this control is achieved mainly by the regulation of M2 subunit synthesis. In the present study, we have found that the activities of both subunits decreased markedly upon serum starvation in the Syrian baby hamster kidney 21/C13 cell line. These decreases did not seem to be correlated with the appearance of an inhibitory factor in serum-starved cells. Quantification of the amount of the M1 subunit protein (89,000 molecular weight) by [32P]dTTP photoaffinity labelling revealed that the decrease in M1 activity was not due to variation in M1 protein level. Therefore, a posttranslational mechanism probably exists which inactivates M1 subunit when cells stay in the quiescent (G0) state and this mechanism could play an important role in the control of ribonucleotide reductase activity. PMID- 3552002 TI - Variability in the posttranslational processing of penicillin-binding protein 1b among different strains of Escherichia coli. AB - Screening of a number of unrelated strains of Escherichia coli confirms the existence of at least two patterns of molecular forms for penicillin-binding protein 1b in E. coli cell envelopes. Our data support that the beta-form of this protein is produced by posttranslational modification of the alpha-form and suggest that the absence of the beta-form in some strains is due to a strain dependent variability in the alpha-form processing mechanism. PMID- 3552003 TI - Purification and characterization of a membrane-bound neutral endopeptidase from human placenta. AB - A membrane-bound neutral endopeptidase which hydrolyzes Suc-(Ala)3-pNA to succinyl dialanine and Ala-pNA has been purified from human placenta. The enzyme was solubilized from membranes with DOC and papain, and was purified about 5000 fold by successive chromatographies on Sephadex G-200, DEAE-Sephacel, butyl Toyopearl 650, and Sephacryl S-300. It was found to be homogeneous on SDS polyacrylamide gel electrophoresis and to have a molecular weight of about 70,000. It was strongly inhibited by phosphoramidon, thiorphan, and metal chelating agents, but was not affected by most other protease inhibitors. These findings indicate that it can be classified as a phosphoramidon-sensitive neutral endopeptidase. With biologically active peptides as substrates, the enzyme preferentially cleaved the bonds at the amino side of hydrophobic amino acid residues. The physiological significance of this enzyme is discussed with reference to the placental barrier. PMID- 3552004 TI - Infective endocarditis 1937-1987. PMID- 3552005 TI - Fish and coronary artery disease. PMID- 3552006 TI - Treatment of primary pulmonary hypertension intravenous epoprostenol (prostacyclin). AB - Ten patients with severe primary pulmonary hypertension and pronounced disability who were unresponsive to oral vasodilators were treated with intravenous epoprostenol (prostacyclin). All had been referred for heart and lung transplantation. Short term administration of epoprostenol (mean dose 5.5 ng/kg/min) increased the mean cardiac index from 1.8 to 2.2 1/min/m2, improved pulmonary artery oxygen saturation from 48% to 57%, and increased calculated tissue oxygen delivery from 10 to 11.8 ml/kg/min. The mean pulmonary vascular resistance fell by 18% while mean systemic artery pressure fell by 32%. Pulmonary artery pressure rose in only two patients. Continued intravenous infusion of epoprostenol for 1-25 months was associated with subjective and clinical improvement. Exercise tolerance improved as measured by an increase in the maximum rate of oxygen consumption during progressive exercise testing. In those six patients who were able to exercise before treatment it rose from a mean of 7 to 15 ml/kg/min. Those who had been unable to exercise before treatment achieved comparable rates of oxygen consumption after treatment. Two patients died on treatment, three have undergone heart-lung transplantation, and in five the treatment is continuing. Complications included episodes of septicaemia and ascites. In this uncontrolled study of patients with severe pulmonary hypertension epoprostenol seemed to offer a means of optimally dosing the patients with a vasodilator to reduce pulmonary vascular resistance and thus increasing cardiac output and oxygen tissue delivery. There was no evidence to suggest that this treatment influenced the progress of the disease. PMID- 3552008 TI - Life events and addiction: a critical review. PMID- 3552007 TI - Anaesthesia for paediatric tonsillectomy. Comparison of spontaneous ventilation and intermittent positive pressure ventilation. AB - Fifty children undergoing tonsillectomy were anaesthetized using either a spontaneous ventilation (SV) technique with halothane (and nitrous oxide in oxygen) or intermittent positive pressure ventilation (IPPV) (with nitrous oxide, in oxygen) facilitated by atracurium 0.5 mg kg-1. Time to full recovery was significantly less in the IPPV group (1.8 +/- 3.79 min) than the SV group (20.0 +/- 6.77 min) (P less than 0.001) and ventilated children had a better quality of long-term recovery (sleep score 1.02 for the SV and 1.44 for the IPPV groups) (P less than 0.01). Apart from a significantly greater E'CO2 in the halothane group (7.3 kPa +/- 0.9 compared with 5.1 kPa +/- 0.5) (P less than 0.001), there was no significant difference in operative or postoperative morbidity. PMID- 3552009 TI - Alcohol and alcohol problems research 14. Israel. PMID- 3552011 TI - Clinical pharmacology: the interface between medicine and the pharmaceutical industry. In memory of Professor James Crooks. PMID- 3552010 TI - Sedation for gastroscopy: a comparative study of midazolam and Diazemuls in patients with and without cirrhosis. AB - A double-blind controlled study comparing the effects of intravenous Diazemuls (0.15 mg kg-1) with midazolam (0.07 mg kg-1) in patients with normal liver function and with cirrhosis and portal hypertension is described. The clinical effect of the two drugs was assessed by serial tests of psychomotor function before and at varying intervals after administration. Using this dosage regime, midazolam caused significantly greater impairment in psychomotor function in both cirrhotic and non cirrhotic subjects, and the time taken for recovery of normal function was also significantly prolonged. Patients with cirrhosis showed a significantly prolonged recovery time following administration of either benzodiazepine compared with the controls. Administration of midazolam in a lower dose might reduce the degree of sedation and shorten the recovery time, but this could also lead to a loss of some of the amnesic effect. Caution is recommended in the administration of benzodiazepines to patients with cirrhosis. PMID- 3552012 TI - Development of drug regulating authorities. PMID- 3552013 TI - Drug-targeting by monoclonal antibodies. PMID- 3552014 TI - The effects of melphalan and misonidazole on the vasculature of a murine sarcoma. AB - A method for estimating both structural and functional vascular volumes in murine sarcomas is described. Intact vessels were demonstrated by the presence of laminin, a basement membrane-associated antigen, using an immunofluorescent technique, and functional vessels in the same sample by prior injection with the DNA binding dye Hoechst 33342. No significant vascular effects were seen after melphalan but a very pronounced decrease in both functional and structural vascular volume was seen after MISO. Combined chemotherapy of a murine sarcoma with melphalan and MISO induced a rapid decrease in the functional vascular volume, and there was a resumption of blood flow prior to measurable regrowth. The fully regrown tumour retained the vascular characteristics of untreated tumours of similar size. PMID- 3552015 TI - Effects of in vivo modulation of splenic natural killer cell activity on the growth of spleen-seeking tumour variants. AB - A novel tumour system has been used to study the effect of natural killer cells on tumour growth by using agents which modify natural killer cell activity. The tumour cells are hybridoma cells which secrete antibody specific for red blood cells so that tumour growth can be quantitated by a haemolytic plaque assay. Spleen-seeking variants have been derived from original hybrids which are sensitive to natural killer cells. Treatment of mice with polyinosinic polycytidylic acid substantially enhanced natural killer cell activity and correlated closely with a reduction in the growth of the hybridoma tumour cells in the spleen and life extension. Conversely, a single injection of anti-asialo GM, antibody resulted in a substantial increase in the number of plaque forming splenic tumour cells and virtual elimination of natural killer cell activity. These data demonstrate the important role of natural killer cells in constraining the growth of a tumour of B cell origin and establishes the usefulness of this tumour model in studying the biology of effects on tumour growth. PMID- 3552017 TI - Micrometastases to axillary lymph nodes from carcinoma of breast: detection by immunohistochemistry and prognostic significance. AB - Metastases to axillary lymph nodes is an important factor in predicting prognosis and survival in primary operable carcinoma of the breast. A series of post mastectomy lymph nodes (150 cases) was selected in this retrospective study, in which the initial diagnosis had been no metastases by light microscopy and in which a long follow-up was available (average 10 years). The original H&E sections from these cases were immunostained to detect metastases which might not have been previously appreciated. The study was performed using a cocktail of 5 monoclonal antibodies directed against epithelial antigens. The object was to explore the possibility of detection of occult micrometastases by immunohistochemistry and to evaluate their prognostic significance. Micrometastases with individual cells and cell clusters were readily detected by this technique in 14% of all cases. It also became apparent towards the end of the study that micrometastases could be detected with equal sensitivity by any one of the 5 monoclonal antibodies. Positive staining of malignant cells was found to be more frequent in invasive lobular carcinoma (ILC) than in invasive ductal carcinoma (IDC). However, for the IDC group a striking association was found between micrometastases and both recurrence and survival rate. The ILC sample was considered too small for meaningful interpretation. We recommend the use of immunohistochemical techniques using monoclonal antibodies for the detection of occult metastases in lymph nodes to improve the prediction of recurrence and survival in invasive ductal carcinoma of the breast. PMID- 3552016 TI - Flow cytometric quantitation of DNA and c-myc oncoprotein in archival biopsies of uterine cervix neoplasia. AB - The c-myc nuclear associated oncoprotein has been quantitated simultaneously with DNA in nuclei extracted from archival biopsies of uterine cervix neoplasia. The oncoprotein and DNA were measured fluorimetrically in a flow cytometer using a mouse monoclonal antibody (MYC 1-6E10) and propidium iodide. Normal biopsies exhibited higher oncoprotein levels than carcinomas (P less than 0.00001). Furthermore, the maximum fluorescence signal in the normal tissue occurred at a lower antibody concentration compared with tumour tissue. There was no correlation between oncoprotein levels and histological grade, stage of disease, age of the patients or prognosis in the carcinomas. Aneuploidy, defined as a distinct second peak separate from the diploid distribution, was not a significant feature. The c-myc oncoprotein nuclear content does not appear to be a prognostic indicator in carcinoma of the cervix from the results of these studies but there is clearly diagnostic potential, particularly for automated analysis of cervical screening. PMID- 3552019 TI - The localization of the binding site of circulating IgA antibodies in linear IgA disease of adults, chronic bullous disease of childhood and childhood cicatricial pemphigoid. AB - Biopsies from suction blisters raised in three normal volunteers were used as substrate in the indirect immunofluorescence technique to determine the binding site of circulating IgA antibodies in serum from three patients with adult linear IgA disease (LAD), nine with chronic bullous disease of childhood (CBDC), three with childhood cicatricial pemphigoid (CCP), and four with bullous pemphigoid (BP). Direct immunofluorescence was done using suction blisters raised in two patients with LAD and one with CCP. The circulating IgA antibodies in LAD and CBDC bound mainly to the roof of the blister but also to the base, and in CCP they bound only to the base of the blister. The circulating IgG antibodies in BP bound to the roof and base of the blister. These results demonstrate that the antigens in the various linear IgA dermatoses are heterogenous and are localized at different sites. The LAD and CBDC antigens are present in the lamina lucida, and the antigen in CCP is associated with the basal lamina. PMID- 3552018 TI - Presence and possible significance of immunohistochemically demonstrable prolactin in breast apocrine metaplasia. AB - Paraffin wax embedded formalin-fixed benign breast disease tissue taken from 17 patients (15 with microcystic disease and 2 with fibroadenoma) was studied for the presence of tissue bound prolactin using a rabbit antiserum against human prolactin applied in conjunction with a highly sensitive modified version of the dinitrophenyl (DNP)-hapten sandwich staining (DHSS) procedure. Sections taken from 14 of the 15 cases showing apocrine cystic changes exhibited strong prolactin staining restricted to the cytoplasm of metaplastic apocrine cells lining the cysts. Normal lobules and ducts and blunt duct proliferations were all negative, as were also the two cases of fibroadenoma. In contrast 6 out of 8 cases of breast cancer examined showed heterogenously distributed cytoplasmic staining in the cancer cells. Maximal prolactin staining in the apocrine cells was observed at antiserum dilutions as high as 1:60,000. This compared favourably with a 1:120,000 dilution that gave maximal levels of staining in the prolactotrophs present in serial sections taken from formalin fixed paraffin wax embedded post mortem human anterior pituitaries. In both types of tissues the specific staining was abolished by pre-absorption of the antiserum with human prolactin (10 micrograms ml-1). No staining was observed when the anti-prolactin serum was either omitted or substituted with DNP-labelled normal rabbit serum. Apocrine metaplasia in cystic disease of the breast has recently been found to be associated with an increased breast cancer risk. The strong and selective presence of immunohistochemically demonstrable prolactin in the metaplastic cells may be of significance in view of the hormone's known growth stimulating effect on the breast epithelium. PMID- 3552020 TI - Hydroxychloroquine in polymorphic light eruption: a controlled trial with drug and visual sensitivity monitoring. AB - A double-blind controlled trial of oral hydroxychloroquine (HC) treatment in polymorphic light eruption (PLE) was completed in 13 patients on active treatment and 15 on placebo during June, July and August 1982. HC dose was 400 mg daily for the first month and 200 mg daily thereafter. Exposure to ambient solar ultraviolet radiation (UVR) was monitored throughout the trial by polysulphone film lapel badges. Patients scored their symptoms on a visual analogue scale. Drug concentration was monitored in plasma and hair, and oculotoxicity was assessed by visual contrast sensitivity. Moderate clinical improvement occurred, associated with a statistically significant improvement in skin rash (P less than 0.01). PMID- 3552021 TI - Hybrid acute leukaemia. PMID- 3552023 TI - Rapid reappearance of large granular lymphocytes (LGL) with concomitant reconstitution of natural killer (NK) activity after human bone marrow transplantation (BMT). AB - The frequency of large granular lymphocytes and their relationship to functional NK-activity as assessed by the capacity to lyse the K562 tumour target was analysed in five allogenic and two autologous human bone marrow transplant recipients. Date revealed: almost identical disappearance and reconstitution of both parameters further indicating that LGL represent effector cells of spontaneous lysis of K562 targets; a long-lasting suppression of the absolute numbers per ml of blood of both LGL and functional NK activity which we believe was not the consequence of reconstitution with immature effector cells but rather reflected immunosuppressive therapy; LGL exhibits the fastest reappearance rate subsequent to total body irradiation of all populations of circulating leucocytes. PMID- 3552022 TI - Immunohistochemical determination of growth fractions in human permanent cell lines and lymphoid tumours: a critical comparison of the monoclonal antibodies OKT9 and Ki-67. AB - OKT9 and Ki-67 monoclonal antibodies have recently been proposed as useful tools for evaluating the growth fraction in malignant tumours, with special reference to non-Hodgkin's lymphomas. In particular, while the former is commonly thought to detect a transferrin receptor present on the cytoplasmic membrane of proliferating cells, the latter recognizes a nuclear antigen, which is expressed in G1, S, G2 and M phase of continuously cycling elements. To further verify their reliability, OKT9 and Ki-67 were applied to seven permanent cell lines (four myeloid and three B-lymphoblastoid) and 100 lymphoid tumours (70 non Hodgkin's and 30 Hodgkin's lymphomas) phenotypically characterized on frozen sections. The results obtained showed that OKT9 and Ki-67 cannot be employed as equivalent means in assessing the growth fraction. In fact, OKT9 is directed to a transferrin receptor which is not only expressed by proliferating cells, but also by some resting elements. On the other hand, Ki-67 provides a nuclear, easily detectable positivity which is restricted to proliferating cells only. Therefore, it seems to represent the only monoclonal which can confidently be employed in the assessment of the growth fraction. Furthermore, the present study underlines that the immunocytochemical analysis of the proliferation rate in tumours gives similar information to the radionucleide uptake assay, while it represents a more sensitive method than the cytofluorimetric evaluation of the DNA content. PMID- 3552024 TI - Autologous bone marrow transplantation for acute leukemia in remission. PMID- 3552025 TI - Influence of underlying disease and donor sex on the incidence of graft-versus host disease in allogeneic bone marrow transplantation. PMID- 3552026 TI - Treatment of a post-traumatic headache. AB - After fantasy work in a trance state a patient with post-traumatic headaches experienced some relief as other symptoms appeared, and then total relief along with the disappearance of the other symptoms. He was able to withdraw from all medications. PMID- 3552027 TI - Episiotomy repair--immediate and long term sequela. A randomised study of three different methods of repair. PMID- 3552029 TI - Lactitol, a new hydrogenated lactose derivative: intestinal absorption and laxative threshold in normal human subjects. AB - In the first part of the study, the absorption of lactitol, a new disaccharide analogue of lactose, was studied using an in vivo jejunal perfusion technique in man. Intestinal uptake of lactitol from isotonic solutions containing 10, 30, 60, and 100 mmol lactitol/l was insignificant. In the second part of the study the laxative threshold of lactitol was determined and compared with that of sorbitol in a double-blind, randomized, cross-over study on twenty-one normal subjects. Laxative threshold was considered to be either the maximum dose tolerated without unacceptable diarrhoea or gastrointestinal side effects, or when the maximum dose in the study was reached. Increasing amounts of lactitol, sorbitol or placebo were administered in two divided doses each day until subjects developed diarrhoea or severe gastrointestinal side effects. The laxative threshold of lactitol (74 (SE 5) g/d) was similar to that of sorbitol (71 (SE 5) g/d). These findings indicate that lactitol is not absorbed by the human small intestine. Although diarrhoea or other gastrointestinal side effects occurred as the dose was increased, 40 g lactitol/d was well tolerated. PMID- 3552028 TI - Nutritional anaemia in pregnant Beninese women: consequences on the haematological profile of the newborn. AB - An assessment of iron and folic acid status, blood thick film and haemoglobin (Hb) electrophoresis was performed on 126 pregnant women (and their newborn infants) and in ninety-five menstruating women in Cotonou (Benin). Anaemia (according to the World Health Organization (1972] was observed in 55% of pregnant women and in 39% of menstruating women. Fe-deficiency was defined as a low serum ferritin concentration (12 micrograms/l or less), combined with a low transferrin saturation (less than 16%) or a high erythrocyte protoporphyrin level (more than 3 micrograms/g Hb), or both. A moderate elevation in the serum ferritin concentration (between 13 and 50 micrograms/l), associated with a low transferrin saturation or a high erythrocyte protoporphyrin level, or both, indicated Fe-deficiency in an inflammatory context. Fe-deficiency was present in 73% of pregnant women and in 41% of menstruating women. Folate deficiency (defined as erythrocyte folate below 160 micrograms/l) was observed in 45% of pregnant women. In pregnant women, anaemia was associated with Fe-deficiency in 83% of cases and with folate deficiency in 48% of cases. Haemoglobinopathies were mainly heterozygous and did not seem to contribute significantly to anaemia. Intensity of malaria was not related to Hb level, but Plasmodium falciparum was found in 99% of subjects. Hb concentration and mean corpuscular volume were significantly lower in babies born of Fe-deficient mothers than in babies born of Fe-sufficient mothers. Hb concentration in newborn infants was positively correlated with maternal serum ferritin. PMID- 3552030 TI - Selective radiolabeling of cell surface proteins to a high specific activity. AB - A procedure was developed for selective radiolabeling of membrane proteins on cells to higher specific activities than possible with available techniques. Cell surface amino groups were derivatized with 125I-(hydroxyphenyl)propionyl groups via 125I-sulfosuccinimidyl (hydroxyphenyl)propionate (125I-sulfo-SHPP). This reagent preferentially labeled membrane proteins exposed at the cell surface of erythrocytes as assessed by the degree of radiolabel incorporation into erythrocyte ghost proteins and hemoglobin. Comparison with the lactoperoxidase [125I]iodide labeling technique revealed that 125I-sulfo-SHPP labeled cell surface proteins to a much higher specific activity and hemoglobin to a much lower specific activity. Additionally, this reagent was used for selective radiolabeling of membrane proteins on the cytoplasmic face of the plasma membrane by blocking exofacial amino groups with uniodinated sulfo-SHPP, lysing the cells, and then incubating them with 125I-sulfo-SHPP. Exclusive labeling of either side of the plasma membrane was demonstrated by the labeling of some marker proteins with well-defined spatial orientations on erythrocytes. Transmembrane proteins such as the epidermal growth factor receptor on cultured cells could also be labeled differentially from either side of the plasma membrane. PMID- 3552031 TI - Blood coagulation induced by the venom of Bothrops atrox. 1. Identification, purification, and properties of a prothrombin activator. AB - In this paper, we show that the procoagulant action of Bothrops atrox venom is due in part to a protein component that activates prothrombin. The venom prothrombin activator was purified by ion-exchange chromatography and gel filtration. It was separated from a protease by affinity chromatography in a p aminobenzamidine-CH-Sepharose column. It is a protein of about Mr 70,000, consisting of a single polypeptide chain. We have studied the kinetics of activation of prothrombin under different experimental conditions. The prothrombin activator from B. atrox venom is insensitive to reagents of serine and thiol proteases but is inactivated by ion chelators and by various divalent ions. These results suggest that it is a metalloenzyme. The prothrombin activator from B. atrox venom is inactive on the chromogenic substrates S-2337 and S-2238, and it is selective for prothrombin since it does not act on other blood coagulation factors such as fibrinogen and factor X. We have also studied the pattern of peptide cleavages produced in the human prothrombin molecule during the activation by the activator from B. atrox venom and compared it to that obtained with ecarin, a prothrombin activator from Echis carinatus venom. In the presence of thrombin inhibitors, e.g., hirudin, we found that the activators from B. atrox venom and ecarin act in a similar, or identical, manner by producing a thrombin intermediate, meizothrombin. In the absence of thrombin inhibitors, several peptides are generated, and alpha-thrombin is produced as a consequence of meizothrombin action. PMID- 3552032 TI - Blood coagulation induced by the venom of Bothrops atrox. 2. Identification, purification, and properties of two factor X activators. AB - We have characterized and purified the two components of the venom of Bothrops atrox that activate the coagulation factor X. Activator 1 and activator 2 were separated by ion-exchange chromatography but otherwise presented similar characteristics. They consist of a heavy polypeptide of Mr 59,000 and either one or two light chains forming a doublet of Mr 14,000-15,000. They are inactive on synthetic substrates and on prothrombin or fibrinogen and thus appear to act specifically on factor X. They are not sensitive to inhibitors of serine proteases or thiol esterases. The activation of factor X is activated by Ca2+ ions with a Hill coefficient of 2.4 and is inhibited by Hg2+, Ba2+, and Cd2+. Its pH dependency suggests that the activity depends on the ionization of a group with an apparent pK of 6.9. We studied the cleavage of purified bovine factor X by B. atrox activators and compared it to that obtained with the factor X activator from Vipera russelli venom. Like the physiological activators, the venom's activators cleave the heavy chain of factor X, producing the activated factor Xa alpha. They produce however two other cleavages: one near the N terminal end of the heavy chain of factor X, generating factor Xmu, and a second one located at one extremity of the heavy chain of factor Xa alpha, generating factor Xav. PMID- 3552033 TI - Dynamics of fd coat protein in the bacteriophage. AB - The dynamics of the coat protein in fd bacteriophage are described with solid state 15N and 2H NMR experiments. The virus particles and the coat protein subunits are immobile on the time scales of the 15N chemical shift anisotropy (10(3) Hz) and 2H quadrupole (10(6) Hz) interactions. Previously we have shown that the Trp-26 side chain is immobile, that the two Tyr and three Phe side chains undergo only rapid twofold jump motions about their C beta-C gamma bond axis [Gall, C. M., Cross, T. A., DiVerdi, J. A., & Opella, S. J. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 101-105], and that most of the backbone peptide linkages are highly constrained but do undergo rapid small amplitude motions [Cross, T. A., & Opella, S. J. (1982) J. Mol. Biol. 159, 543-549] in the coat protein subunits in the virus particles. In this paper, we demonstrate that the four N-terminal residues of the coat protein subunits are highly mobile, since both backbone and side-chain sites of these residues undergo large amplitude motions that are rapid on the time scales of the solid-state NMR experiments. In addition, the dynamics of the methyl-containing aliphatic residues Ala, Leu, Val, Thr, and Met are analyzed. Large amplitude jump motions are observed in nearly all of these side chains even though, with the exception of the N-terminal residue Ala-1, their backbone peptide linkages are highly constrained. The established information about the dynamics of the structural form of fd coat protein in the virus particle is summarized qualitatively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552034 TI - Dynamics of fd coat protein in lipid bilayers. AB - The dynamics of backbone and side-chain sites of the membrane-bound form of fd coat protein are described with solid-state 2H and 15N NMR experiments. The samples were isotopically labeled coat protein in phospholipid bilayers in excess water. The protein itself is immobile and does not undergo rapid rotation within the bilayer. Like the structural form of the protein, the membrane-bound form has four mobile residues at the N-terminus. The membrane-bound form differs from the structural form in having several mobile residues at the C-terminus. Many of the side chains of residues with immobile backbone sites undergo large amplitude jump motions. The dynamics are generally similar in both the structural and membrane bound forms of the protein. PMID- 3552035 TI - Spectroscopic characterization of thioredoxin covalently modified with monofunctional organoarsenical reagents. AB - Thioredoxin upon reduction with mercaptoethylamine was subjected to covalent modification by the monofunctional organoarsenical reagents H2NPhAsO and HO(CH2)4AsCl2. The degree of modification was monitored by the percentage loss in free thiol content as measured by the reaction with the thiol reagent 5,5' dithiobis(2-nitrobenzoic acid). The modification results in the formation of a stable 15-membered cyclic dithioarsenite ring that readily extrudes the arsenic moiety upon the addition of 2,3-dimercaptopropanol. The conformational effects of this modification were monitored by steady-state fluorescence and circular dichroism. On the basis of circular dichroic spectra, it appeared that the protein experiences no significant backbone conformational change from this modification. The degree of conformational change was found to be within the range observed upon reduction of the oxidized thioredoxin. Steady-state fluorescence revealed that the arsenicals caused strong quenching of the tryptophan fluorescence. Stern-Volmer titrations revealed that the quenching was a function of both the nature of the organic group and its covalent attachment to the "spatially close" thiols. The analysis of the spectroscopic results obtained with the arsenical reagents provides further insight into the nature of the conformational change that has been observed upon reduction of thioredoxin. PMID- 3552036 TI - Effects of calcium ion on ternary complexes formed between 4-(2 pyridylazo)resorcinol and the two-zinc insulin hexamer. AB - As a means for probing the microenvironment of zinc in the insulin hexamer and to investigate the effects of calcium ion on the assembly and the structure of the two-zinc insulin hexamer, the thermodynamics and kinetics of the reaction between the chromophoric divalent metal ion chelator 4-(2-pyridylazo)resorcinol (PAR) and zinc-insulin have been investigated over a wide range of conditions. For [PAR]0 much greater than [Zn2+]0 and [Zn2+]/[In] less than or equal to 0.33, the reaction leads to the sequestering and ultimate removal of all of the insulin bound Zn2+; for [Zn2+]0 much greater than [PAR]0, two stable ternary complexes are formed where Zn2+ has ligands derived from PAR as well as from hexameric insulin. For [Zn2+]/[In] ratios below 0.33, the equilibrium distribution between the two ternary complexes is dependent on the [Zn2+]/[In] ratio. One of the complexes is assigned to the monoanion of PAR coordinated to Zn2+ that resides in a His-B10 site. The other complex is proposed to involve the coordination of (PAR)Zn to the site formed by the alpha-NH2 group of Phe-B1 and the gamma carboxylate ion of Glu-A17 across the dimer-dimer interface on the surface of the hexamer. With either PAR or zinc-insulin in large excess, the kinetics of the PAR optical density changes are remarkably similar and biphasic. The faster step is first order in PAR and first order in insulin-bound Zn2+ (k congruent to 3 X 10(3) M-1 s-1) and involves the formation of an intermediate in which PAR is coordinated to insulin-bound zinc at the His-B10 site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552037 TI - Catalytic and allosteric mechanism of AMP nucleosidase from primary, beta secondary, and multiple heavy atom kinetic isotope effects. AB - Adenosine 5'-phosphate was synthesized with specific heavy atom substitutions to permit measurement of V/K kinetic isotope effects for the N-glycohydrolase activity of the allosteric AMP nucleosidase and the acid-catalyzed solvolysis of these compounds. The effects of allosteric activation on the kinetic isotope effects together with the kinetic mechanism of AMP nucleosidase [DeWolf, W. E., Jr., Emig, F. A., & Schramm, V. L. (1986) Biochemistry 25, 4132-4140] indicate that the kinetic isotope effects are fully expressed. Comparison of individual primary and secondary kinetic isotope effects with combined isotope effects and the isotope effect of the reverse reaction indicated that kinetic isotope effects in AMP nucleosidase arise from a single step in the reaction mechanism. Under these conditions, kinetic isotope effects can be used to interpret transition state structure for AMP nucleosidase. Changes in kinetic isotope effects occurred as a function of allosteric activator, demonstrating that allosteric activation alters transition-state structure for AMP nucleosidase. Kinetic isotope effects, expressed as [V/K(normal isotope]/[V/K(heavy isotope)], were observed with [2' 2H]AMP (1.061 +/- 0.002), [9-15N]AMP (1.030 +/- 0.003), [1'-2H]AMP (1.045 +/- 0.002), and [1'-14C]AMP (1.035 +/- 0.002) when hydrolyzed by AMP nucleosidase in the absence of MgATP. Addition of MgATP altered the [2'-2H]AMP effect (1.043 +/- 0.002) and the [1'-2H]AMP effect (1.030 +/- 0.003) and caused a smaller decrease of the 14C and 15N effects. Multiple heavy atom substitutions into AMP caused an increase in observed isotope effects to 1.084 +/- 0.004 for [1'-2H,1'-14C]AMP and to 1.058 +/- 0.002 for [9-15N,1'-14C]AMP with the enzyme in the absence of ATP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552038 TI - Transition-state structures for N-glycoside hydrolysis of AMP by acid and by AMP nucleosidase in the presence and absence of allosteric activator. AB - The mechanism of acid and enzymatic hydrolysis of the N-glycosidic bond of AMP has been investigated by fitting experimentally observed kinetic isotope effects [Parkin, D. W., & Schramm, V. L. (1987) Biochemistry (preceding paper in this issue)] to calculated kinetic isotope effects for proposed transition-state structures. The sensitivity of the transition-state calculations was tested by "arying the transition-state structure and comparing changes in the calculated kinetic isotope effects with the experimental values of the isotope effect measurements. The kinetic isotope effects for the acid-catalyzed hydrolysis of AMP are best explained by a transition state with considerable oxycarbonium character in the ribose ring, significant bonding remaining to the departing adenine ring, participation of a water nucleophile, and protonation of the adenine ring. A transition-state structure without preassociation of the water nucleophile cannot be eliminated by the data. Enzymatic hydrolysis of the N glycosidic bond of AMP by AMP nucleosidase from Azotobacter vinelandii was analyzed in the absence and presence of MgATP, the allosteric activator that increases Vmax approximately 200-fold. The transition states for enzyme-catalyzed hydrolysis that best explain the kinetic isotope effects involve early SN1 transition states with significant bond order in the glycosidic bond and protonation of the adenine base. The enzyme enforces participation of an enzyme bound water molecule, which has weak bonding to C1' in the transition state. Activation of AMP nucleosidase by MgATP causes the bond order of the glycosidic bond in the transition state to increase significantly. Hyperconjugation in the ribosyl group is altered by enzymatic stabilization of the oxycarbonium ion. This change is consistent with the interaction of an amino acid on the enzyme. Together, these changes stabilize a carboxonium-like transition-state complex that occurs earlier in the reaction pathway than in the absence of allosteric activator. In addition to the allosteric changes that alter transition-state structure, the presence of other inductive effects that are unobserved by kinetic isotope measurements is also likely to increase the catalytic rate. PMID- 3552039 TI - Kinetic investigation of the DNA platination reaction: evidence for a transient adduct between deoxyribonucleic acid and cis-platinum(II). AB - Kinetics of the synthesis of adducts between salmon testis DNA and platinum(II) compounds were measured by their effects on DNA synthesis, circular dichroism, and ethidium bromide dependent fluorescence. Transient incorporation of [14C]cyanide into DNA adducts of of cis-diammineaquochloroplatinum(II) and respectively cis-diamminediaquoplatinum(II) compounds but not of trans diammineaquochlorplatinum(II) was observed. A minimal kinetic scheme is derived, in which a transient monodentate DNA-platinum(II) adduct is formed in a bimolecular reaction between DNA and aquated platinum(II) compounds. Second-order rate constants are 2000-3000 M-1 min-1 for cis-diamminediaquoplatinum(II) and 280 400 M-1 min-1 for cis- and trans-diammineaquochloroplatinum(II), respectively. The dependence of pseudo-first-order rate constants is not linear for high concentrations of DNA, suggesting competitive formation of more than one primary adduct. The monodentate adducts inhibit DNA polymerase catalyzed DNA synthesis. The biomolecular reaction is followed by a rearrangement (rate constant 0.22 min 1) that gives rise to most of the decrease in the fluorescence intensity and that depends on the state of aquation of the DNA-bound platinum(II) complex. By exchange of coordinated water with a second nucleotide, the monodentate adduct can form cross-links in a reaction joining the rearrangement. Adducts containing a chloro group liberate it by hydrolysis prior to cross-linking. In the case of the trans-platinum(II) adduct, the hydrolysis is aided by the trans effect of the bound first nucleotide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552040 TI - Synthesis of dihydrothymidine and thymidine glycol 5'-triphosphates and their ability to serve as substrates for Escherichia coli DNA polymerase I. AB - 5,6-Dihydrothymidine 5'-triphosphate (DHdTTP) was synthesized by catalytic hydrogenation of thymidine 5'-triphosphate (dTTP). Thymidine glycol 5' triphosphate (dTTP-GLY) was prepared by bromination of dTTP followed by treatment with Ag2O. The modified nucleotides were extensively purified by anion-exchange high-performance liquid chromatography (HPLC). Alkaline phosphatase digestion of DHdTTP and dTTP-GLY gave the expected products (5,6-dihydrothymidine and cis thymidine glycol), the identities of which were confirmed by reverse-phase HPLC using authentic markers. HPLC analysis of the alkaline phosphatase digested DHdTTP revealed that DHdTTP was a mixture of C5 diastereoisomers [(5S)- and (5R) DHdTTP]. Despite the significant distortion of the pyrimidine ring in DHdTTP, it was incorporated in place of dTTP during primer elongation catalyzed by Escherichia coli DNA polymerase I Klenow fragment. The rate of incorporation of DHdTTP was about 10-25-fold lower than that of dTTP. On the other hand, dTTP-GLY, which also has a distorted pyrimidine ring, did not replace dTTP, and no elongation of the primer was observed. In order to study the preference of incorporation of the diastereoisomers of DHdTTP into DNA, salmon testes DNA, activated by exonuclease III, was used as a template for DNA polymerase I Klenow fragment in the presence of [3H]DHdTTP (S and R mixture) and normal nucleotides. After enzymatic digestion of the DNA to nucleosides, the products were analyzed by HPLC. The ratio of the isomers incorporated into DNA (S:R = 73.27) was virtually the same as that of the [3H]DHdTTP substrates (S:R = 79.21).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552041 TI - Pseudomonas cepacia 3-hydroxybenzoate 6-hydroxylase: stereochemistry, isotope effects, and kinetic mechanism. AB - A neutral flavin semiquinone species was formed upon photoreduction of Pseudomonas cepacia 3-hydroxybenzoate 6-hydroxylase whereas no flavin radical was detected by anaerobic reduction with NADH in the presence of m-hydroxybenzoate. In the latter case, the formation of flavin semiquinone is apparently thermodynamically unfavorable. A stereospecificity for the abstraction of the 4R position hydrogen of NADH has been demonstrated for this hydroxylase. Deuterium and tritium isotope effects were observed with (4R)-[4-2H]NADH and (4R)-[4 3H]NADH as substrates. The DV effect indicates the existence of at least one slow step after the isotope-sensitive enzyme reduction by dihydropyridine nucleotide. A minimal kinetic mechanism has been deduced on the basis of initial velocity measurements and studies on deuterium and tritium isotope effects. Following this scheme, m-hydroxybenzoate and NADH bind to the hydroxylase in a random sequence. The flavohydroxylase is reduced by NADH, and NAD+ is released. Oxygen subsequently binds to and reacts with the reduced flavohydroxylase-m hydroxybenzoate complex. Following the formation and release of water and gentisate, the oxidized holoenzyme is regenerated. The enzyme has a small (approximately 2-fold) preference for the release of NADH over m-hydroxybenzoate from the enzyme-substrates ternary complex. PMID- 3552042 TI - Role of cysteine residues in the lac permease of Escherichia coli. AB - Oligonucleotide-directed, site-specific mutagenesis has been utilized to replace cysteine residues 117, 333, or 353 and 355 with serine in the lac permease of Escherichia coli. Replacement of Cys-117 or Cys-333 has no significant effect on permease activity, while permease with serine residues in place of Cys-353 and Cys-355 has about 50% of wild-type permease activity. The results provide a clear demonstration that cysteine residues at positions 117, 333, 353, and 355 are not obligatory for lactose/H+ symport. When considered in conjunction with previous findings, the results indicate that, of the eight cysteine residues in the lac permease, only Cys-154 is important for lactose transport. As discussed, the conclusion has important implications for the hypothesis that sulfhydryl disulfide interconversion plays an important role in the symport mechanism. PMID- 3552043 TI - Effect of hydrogen peroxide on the iron-containing superoxide dismutase of Escherichia coli. AB - The iron-containing superoxide dismutase from Escherichia coli is inactivated by H2O2 to a limit of approximately 90%. When corrected for the H2O2-resistant portion, this inactivation was first order with respect to residual activity and exhibited a pseudo-first-order rate constant of 0.066 min-1 at 25 degrees C in 0.24 mM H2O2 at pH 7.8. The superoxide dismutase activity remaining after treatment with H2O2 differed from the activity of the native enzyme with respect to heat stability, inhibition by azide, and inactivation by light in the presence of rose bengal and by N-bromosuccinimide. The native and the H2O2-modified enzymes were indistinguishable by electrophoresis on polyacrylamide gels. Inactivation of the enzyme by H2O2 was accompanied by loss of tryptophan and some loss of iron, but there was no detectable loss of histidine or of other amino acids. H2O2 treatment caused changes in the optical spectrum of the enzyme. Inactivation of the enzyme by H2O2 depends upon the iron at the active site. Thus, the apoenzyme and the manganese-substituted enzyme were unaffected by H2O2. We conclude that reaction of H2O2 with the iron at the active site generates a potent oxidant capable of attacking tryptophan residues. A mechanism is proposed. PMID- 3552044 TI - Subunit interface of triosephosphate isomerase: site-directed mutagenesis and characterization of the altered enzyme. AB - We have replaced asparagine residues at the subunit interface of yeast triosephosphate isomerase (TIM) using site-directed mutagenesis in order to elucidate the effects of substitutions on the catalytic activity and conformational stability of the enzyme. The mutant proteins were expressed in a strain of Escherichia coli lacking the bacterial isomerase and purified by ion exchange and immunoadsorption chromatography. Single replacements of Asn-78 by either Thr or Ile residues had little effect on the enzyme's catalytic efficiency, while the single replacement Asn-78----Asp-78 and the double replacement Asn-14/Asn-78----Thr-14/Ile-78 appreciably lowered kcat for the substrate D-glyceraldehyde 3-phosphate. The isoelectric point of the mutant Asn 78----Asp-78 was equivalent to that of wild-type yeast TIM that had undergone a single, heat-induced deamidation, and this mutant enzyme was less resistant than wild-type TIM to denaturation and inactivation caused by elevated temperature, denaturants, tetrabutylammonium bromide, alkaline pH, and proteases. PMID- 3552045 TI - Structure of human tumor necrosis factor alpha derived from recombinant DNA. AB - Recombinant DNA derived tumor necrosis factor alpha, when expressed at a high level in Escherichia coli, appeared in the pellet and soluble fractions of disrupted cells. The protein was purified from the pellet fraction by solubilizing it in urea and reducing agent and was refolded into a buffer without these additives. The structure of the protein was identical with that purified from the soluble fraction without exposure to both reducing and denaturing agents, as demonstrated by circular dichroism, gel filtration, and sulfhydryl titration. As a reflection of the structural similarity, both purified proteins showed identical cytolytic activity on mouse L929 cells. The protein was characterized as an essentially nonhelical and beta-sheet-rich structure and possibly as a noncovalently associating oligomer. Two cysteine residues form an intrapolypeptide disulfide bond. PMID- 3552046 TI - Equilibrium and kinetic measurements of the conformational transition of reduced thioredoxin. AB - The single disulfide bond in Escherichia coli thioredoxin was reduced by reaction with a 20-fold excess of reduced dithiothreitol at neutral pH and 25 degrees C. For some measurements, reduced thioredoxin was further reacted with iodoacetamide to alkylate the cysteinyl residues. The denaturation transitions of oxidized, reduced, and reduced alkylated thioredoxin were observed by using far-ultraviolet circular dichroic and exclusion chromatographic measurements. Cleavage of the disulfide bond lowers the stability of the native thioredoxin to denaturation by about 2.4 kcal/mol, and subsequent alkylation lowers the stability by a further 1.6 kcal/mol. The kinetics of the conformational change of reduced thioredoxin in guanidine hydrochloride were observed by using exclusion chromatography at moderate pressure and 2 degrees C. Analyses of single and multimixing protocols are consistent with a predominant nonnative configuration in the denatured state and the transient accumulation of a compact nativelike intermediate during refolding. The intermediate can incorporate the nonnative configuration and can accommodate its isomerization. No compelling chromatographic evidence was found for a conformation having an elution time different from that characteristic for either the native or the denatured protein. PMID- 3552047 TI - The role of choline on the activity-temperature relationship of brush-border alkaline phosphatase. AB - We have studied the effect of choline on the activity and temperature dependency of the brush-border alkaline phosphatase isoenzymes from rat intestine (tissue specific type), and from kidney and placenta (tissue-nonspecific type). The removal of choline with phospholipase D resulted in the loss of enzyme activity in all the membranes, whereas in situ loss in the discontinuity of Arrhenius plots occurred in the kidney and the placental membranes, but not in the intestinal membranes. The lost activity was restored either by addition of free choline or phosphatidylcholine or by the removal of the enzyme from the membrane surface. Intestinal enzyme was removed by papain, while the tissue-nonspecific enzyme was released by subtilisin and by phosphatidylinositol-specific phospholipase C. The enzyme from kidney and placental membranes aggregated (rho = 1.13) upon removal of choline, and addition of choline resulted in disaggregation (rho = 1.03). Conversion of discontinuous to continuous linear plots of alkaline phosphatase in the kidney and placental membranes paralleled the increase in membrane phosphatidic acid content, and the decrease in total phosphatidylcholines. The intestinal enzyme produced plots with break points at all phosphatidic acid/phosphatidylcholine ratios. The change brought about by treatment with phospholipidase D was not due to changes in the half-saturation kinetics (Km) for the substrate. Based on these studies we conclude that the active site of the tissue-nonspecific phosphatase is approximated to exterior membrane cholines, as in the case of the intestinal isoenzyme; that despite similar effects on the membrane content of phospholipids, phospholipase D treatment caused much greater effects on the tissue-nonspecific enzyme, as assessed by Arrhenius plots and density centrifugation; that these effects are due to different protein structures rather than to a lipid milieu unique to each brush-border membrane. PMID- 3552048 TI - Dexamethasone inhibition of cholesterol-stimulated glucose transport in 3T3-L1 cells. AB - This study investigates the effects of dexamethasone on cholesterol-stimulated glucose uptake in confluent 3T3-L1 fibroblasts. Dexamethasone pretreatment blocked both insulin-stimulated glucose transport, and the increase produced by exogenous free cholesterol. The dexamethasone effect was inhibited in both cases by cycloheximide. Concentrations of cholesterol which increased glucose transport failed to produce a significant increase in measurable free cholesterol content in the plasma membrane. PMID- 3552049 TI - Protein glycosylation in yeast. AB - S. cerevisiae contains many mannose-rich glycoproteins that possess N- and O linked carbohydrate chains, and both types may even occur on one and the same protein. The steps in the synthesis of asparagine-linked chains begin with assembly and transfer of the lipid-linked precursor to protein in a way common to all eucaryotes. Subsequent modifications lead to mannosyl extensions of various lengths, but complex type carbohydrate structures are not formed. Oligosaccharides O-linked to serine/threonine consist exclusively of mannose in S. cerevisiae. The mannose residue attached directly to the protein is transferred from Dol-P-Man in a unique way, which has been observed so far for fungal cells only. The cellular localization of the glycosylation reactions is summarized and the problem of transmembrane translocation of the sugar precursors at the ER and the Golgi is discussed. Some aspects of secretory (sec) and asparagine linked glycosylation (alg) mutants have been covered, and the various hypotheses related to the possible functions of this costly protein modification process are discussed. The article may also be helpful for those, who want to exploit the yeast's protein synthesizing machinery by genetically manipulating the cells. PMID- 3552050 TI - myc oncogenes: activation and amplification. PMID- 3552051 TI - Cell-free translation of avian adipose tissue lipoprotein lipase messenger RNA. AB - Poly(A)+ mRNA isolated from chicken adipose tissue directed cell-free translation in a rabbit reticulocyte lysate system. Immunoadsorption with polyclonal antibodies against lipoprotein lipase detected a protein of 56 +/- 2 kDa. Immunodetection of this protein was prevented by inclusion of purified lipoprotein lipase in the assay mixture. Identification of the 56 kDa protein as lipoprotein lipase was confirmed by immunoadsorption to the monoclonal antibody CAL 1-11. Inclusion of dog pancreatic microsomal membranes in the translation system resulted in isolation of an additional protein of 62 kDa. Treatment of the 62 kDa protein with endo-beta-N-acetylglycosaminidase H or endo-beta-N acetylglucosaminidase F decreased the observed molecular mass to that of the primary translation product, indicating that the increase in molecular mass resulted from the addition of N-linked oligosaccharides. Starving and refeeding chickens prior to poly(A)+ mRNA isolation resulted in a 3-fold increase in the amount of immunodetectable lipoprotein lipase synthesized. PMID- 3552052 TI - Purification procedure and N-terminal amino acid sequence of yeast malate dehydrogenase isoenzymes. AB - A method has been devised for the rapid isolation of malate dehydrogenase isoenzymes. First, anionic proteins were precipitated with polyethyleneimine, whilst hydrophobic malate dehydrogenase remained in the supernatant fluid. Secondly, the supernatant was 30% saturated with ammonium sulfate and the two isoenzymes were separated by hydrophobic phenyl-Sepharose CL-4B chromatography. For further purification the enzymes were chromatofocused, and polybuffer was removed by hydrophobic chromatography. Affinity chromatography with blue Sepharose CL-6B [1] was used as final purification step. The purified isoenzymes were homogeneous as shown by isoelectric focusing and could be used for N terminal sequencing. 34 amino acid residues could be identified for the cytoplasmic isoenzyme and 56 amino acid residues for the mitochondrial isoenzyme. Although there are regions of strong homology between both isoenzymes, the sequence differences clearly showed support that both isoenzymes are coded by different genes. Sequence comparison clearly indicated that the N-terminus of the cytoplasmic enzyme extended that of the mitochondrial enzyme by 12 amino acid residues. The amino acid sequence of the extending sequence resembled that of leading sequences known for enzymes which are transported into the mitochondria. The assumed leading sequence is discussed with respect to its possible role in glucose inactivation. PMID- 3552053 TI - Influence of lipid environment on insulin binding in cultured hepatoma cells. AB - The influence of alterations of plasma membrane physico-chemical properties on insulin binding have been characterized in an insulin-sensitive rat hepatoma cell line adapted to grow for several generations in culture medium enriched with linoleic acid (18:2) or with 25-hydroxycholesterol. The cells took up 18:2 and 25 hydroxycholesterol added to the culture medium, without exhibiting any sign of intolerance or intoxication. These compounds respectively increased and decreased membrane fluidity at 37 degrees C. The cells demonstrated extensive changes in insulin binding parameters in response to experimental modifications of their membrane lipid composition. When determined at 4 degrees C, insulin receptors were present in the control cells at 136,000 sites/cell but this fell to 111,000 (P less than 0.05) in cells enriched in 18:2, and rose to 176,000 (P less than 0.001) in hydroxysterol-grown cells. According to a two-site model, the main effect of 18:2 was a significant increase of the number of high-affinity sites with a concomitant decrease of low-affinity sites. The hydroxysterol had the opposite effects on these parameters. The high-affinity insulin binding capacity of the hepatoma cells was affected by lipid supplementation in a similar way, whether it was determined at 4 degrees C or at 37 degrees C. Assuming a negative cooperativity model, 18:2 enhanced the degree of negative cooperativity among the sites, while 25-hydroxycholesterol reduced it. The time-course of insulin-induced receptor down-regulation was accelerated in the cells enriched in polyunsaturated fatty acids, but reduced in cells exposed to 25-hydroxycholesterol. These insulin binding alterations cannot be directly related to modifications of cellular growth rate, receptor internalization or membrane fluidity per se, and are discussed as being more likely due to membrane lipid composition than to overall cell metabolism modifications. PMID- 3552054 TI - Modifications of cellular lipids induce insulin resistance in cultured hepatoma cells. AB - We altered the cellular lipid composition of an insulin sensitive rat hepatoma cell line through supplementation of the culture medium with linoleic acid (18:2) or 25-hydroxycholesterol, and we studied the effects on insulin stimulation of aminoacid transport system A and glycogen synthesis. The basal rate of sodium dependent aminoisobutyric acid uptake was slightly reduced in hydroxysterol treated cells and increased in 18:2-enriched cells. Maximal insulin stimulation of transport was decreased by about 40% in both 18:2 and 25-hydroxycholesterol modified cells, as compared to control cells. In addition to reduced responsiveness, the hydroxysterol-treated cells also showed a diminished sensitivity to insulin, as revealed by a right-shift of the dose-response curve leading to a ED50 of 1.2 X 10(-8) M (P less than 0.02), as compared to 2.45 X 10( 9) M in control cells and 2.13 X 10(-9) M in 18:2 enriched cells. Concerning glycogen synthesis, the basal rate was unaffected by 25-hydroxycholesterol supplementation and slightly reduced in cells enriched in 18:2. Maximal insulin stimulation of glycogen synthesis was reduced by about 40% in both types of lipid modified cells. 25-Hydroxycholesterol again provoked a decrease in sensitivity to insulin: the ED50 was enhanced to 4.9 X 10(-9) M (P less than 0.05), as compared to 1.25 X 10(-9) M in control cells and 1.57 X 10(-9) M in 18:2-supplemented cells. Taken together with the previously reported changes of insulin binding to lipid modified hepatoma cells (Bruneau et al. (1987) Biochim. Biophys. Acta 928, 287-296) our results demonstrate an influence of alterations of the cellular lipid composition on both binding and biological actions of insulin, leading to an insulin-resistant state. Divergences between insulin binding and action were obtained and it was suggested that post-binding events may be responsible for the observed changes. Our findings may be relevant to experimental and clinical states of insulin resistance. PMID- 3552055 TI - Differences between glucose and insulin stimulation of glycogenesis in cultured fetal hepatocytes. AB - The glycogenic effects of a glucose load (15 mM) and/or insulin (10 nM) were studied in 18-day-old fetal rat hepatocytes after 2 days of culture when medium contained 4 mM glucose. A glucose load led to a stimulation of [14C]glucose glycogen labelling (20 min) earlier than with insulin (30-40 min); maximal stimulations were 3-fold after 1 h for the glucose load and 5-fold after 2-3 h for insulin. Simultaneous addition of the two agents produced synergic effects. When insulin was added 4 h after a glucose load (or vice versa), a second glycogenic response was elicited: a further addition of the same glycogenic agent was ineffective. The early glycogenic effects (up to 2 h) also occurred in the presence of 10 microM cycloheximide, with, however, some decrease of insulin stimulation. The contribution of medium glucose to the glycogen formed for 2 days (67% in the absence of glycogenic agent) was clearly enhanced by a glucose load and to a lesser degree by insulin after a 4-h exposure (83 and 71%, respectively). This was accompanied by a related modification of the participation of glucogenic precursors such as fructose and galactose. Thus, acute glycogenic response to glucose and insulin appeared both synergic and independent, and quite different in several aspects in cultured fetal hepatocytes. PMID- 3552056 TI - Placental function in maternal-fetal fat transport in diabetes. AB - High levels of triglycerides (TG) and free fatty acids (FFA) in maternal plasma, in diabetes, promote fat passage to the fetus. In the streptozotocin-diabetic rat a significant correlation exists between maternal plasma and fetal tissue lipid contents, as shown by the accretion of labeled fatty acids or linoleate used as markers of maternal fat transfer. The passage of lipids through the placenta is not direct--this organ serves as an interim storage barrier with its lipid content increasing in proportion to the maternal TG and FFA level. Very low density lipoprotein (VLDL) TG are taken up with the aid of lipoprotein lipase as evident from TG = glycerol exchange when doubly labeled VLDL-TG are presented to the placenta. Esterification rate of albumin-bound FFA is considerably higher indicating that the rate of TG lipolysis is rate limiting and that the FFA are the main precursor of the placental lipids. The uptake of both FFA and VLDL-TG is associated with the retention of a substantial amount of FFA in the placenta. The size of the FFA pool corresponds to the size of the extracellular fluid space. The FFA cannot be eluted by repeated washing, suggesting that they are membrane bound. Placental slices with prelabeled TG gradually release FFA into the medium upon reincubation with FFA-free albumin, indicating that TG and FFA traverse the placenta in part by a sequential process of esterification and lipolysis and in part by diffusion as FFA. The latter are probably moving from the maternal to the fetal side within the interfacial capillary membrane lipids. PMID- 3552057 TI - Mechanisms of congenital malformations in diabetic pregnancy. AB - The reasons for the increased rate of congenital malformations in diabetic pregnancy are unclear. Several different teratological agents may be considered. In clinical investigations and animal experimentation hyperglycemia and hypoglycemia, hyperketonemia, altered trace metal metabolism, and a genetic predisposition have been suggested to be of significance in the teratogenic process of diabetic pregnancy. Studies of these possible etiological factors have so far failed to reveal a single agent or mechanism as the most important. The diabetic pregnancy, therefore, appears to be of multifactorial origin. PMID- 3552058 TI - Research priorities in diabetic pregnancy today: the role of animal models. AB - Strict metabolic control has resulted in a striking fall in the rates for stillbirths, neonatal deaths and neonatal morbidity in diabetic pregnancy. However, clinical problems and challenges for research remain, particularly in relation to a high incidence of congenital malformation, low birth weight, and early growth delay; the detection and management of gestational diabetes; insulin delivery systems; the consequences of maternal hypoglycaemia on organogenesis and fetal well-being; the mechanisms underlying various categories of neonatal morbidity, and possible long-term morbidity in the children born to diabetic mothers. The nature of these problems determines that certain fundamental aspects of reproduction which are difficult to study in human pregnancy will have high priority for research. Progress in this field will be heavily dependent on animal models in the foreseeable future. PMID- 3552059 TI - Glucose metabolism in pregnancy. AB - Pregnancy is characterized by a number of maternal metabolic modifications in order to meet the energy requirements of the growing fetus. A progressive alteration of maternal glucose homeostasis develops throughout gestation and becomes maximal during the last trimester. A relative hypoglycemia is observed during the postabsorptive period despite an elevated plasma insulin concentration and an enhanced hepatic glucose production. In addition, the glucose utilization rate by peripheral maternal tissues is lowered in late gestation indicating that the mother supplies glucose to the fetus at the expense of her own tissues. Concomitantly, an insulin-resistant state develops in the mother to help sparing glucose for the pregnant uterus. It involves both glucose-producing (liver) and glucose-utilizing tissues. So far, the factor(s) responsible for the development of pregnancy-induced insulin resistance has not been identified although a number of circulating hormones are known to counteract insulin effects. PMID- 3552060 TI - Lipid metabolism in pregnancy. AB - On the basis of bibliographic references and new own data, major adaptations of lipid metabolism occurring at late gestation are reviewed. Maternal hypertriglyceridemia at late gestation results from the juxtaposition of several factors: enhanced adipose tissue lipolysis facilitating the availability to the liver of substrates for triglyceride synthesis and contributing to augmented flux of very low density lipoproteins (VLDL) into the circulation; maternal hyperphagia and unmodified gut lipid absorption increasing chylomicron formation from dietary lipid; reduced lipoprotein lipase (LPL) activity in extrahepatic tissues (especially adipose tissue) which does not allow a triglyceride removal proportional to their enhanced production. It is proposed that these changes are also responsible for the altered composition of VLDL in late pregnancy. In conditions of food deprivation the use of glycerol released from adipose tissue as preferential gluconeogenic substrate, and the enhanced maternal ketogenesis warrants the availability of fuels for the fetus. Just prior to parturition the increase in mammary gland LPL activity is responsible for the reduction in circulating triglycerides and prepares the mother for lactation. PMID- 3552061 TI - Accelerated starvation in pregnancy: implications for dietary treatment of obesity and gestational diabetes mellitus. AB - The biological significance of ketonemia of brief duration and moderate proportions during pregnancy remains uncertain. Thus, controversy persists about whether caloric restriction for obese women during pregnancy, particularly when the obesity is complicated by gestational diabetes mellitus (GDM), constitutes appropriate therapy. We have demonstrated, in a rigorously controlled setting using a Clinical Research Center, that all of the features of 'accelerated starvation' become manifest after 14 h and before 18 h of dietary deprivation. Women with GDM exhibit the same capacity for early 'accelerated starvation' as in normal pregnancy; thus, their insulin deficiency and insulin resistance do not appear to be sufficient to render them increasedly at risk for uncontrolled catabolism. Some cautious exploration of the use of hypocaloric diets as a therapeutic approach to the metabolic disturbances of GDM may be justified. PMID- 3552063 TI - Placental transfer of non-esterified fatty acids in normal and diabetic pregnancy. AB - The placental transfer of non-esterified fatty acids, predominantly in the direction of mother to fetus, is regulated on a gross scale by the transplacental non-esterified fatty acid gradient. This is maintained by fetal liver lipid uptake and by enhanced lipolysis of circulating triacylglycerol in the pregnant mother. It is also dependent upon maternal placental blood flow, which is reduced in diabetes, upon the fetal umbilical blood flow, upon maternal and fetal albumin concentrations and upon intratrophoblastic fatty acid binding protein, which appears to be altered in diabetes. Circulating maternal triacylglycerols also directly contribute non-esterified fatty acids to the fetus by intraplacental hydrolysis and the hypertriglyceridaemia associated with maternal diabetes, in concert with changes in lipase levels will enhance maternal to fetal lipid flux. PMID- 3552062 TI - Maternal factors modulating nutrient transfer to fetus. AB - Current knowledge of the modulation of maternal-fetal transfer of metabolites is reviewed and new data on the actual placental transport of D-glucose, L-alanine and glycerol in the rat are presented. Twenty-one day pregnant rats were infused with the 14C-labelled substrates throughout the left uterine artery. Radioactivity appearing in fetuses was corrected by the specific dilution of the tracer at maternal arterial plasma and the uterine artery blood flow to estimate placental transfer. This parameter appeared to be 127 mumol X kg-1 fetal b.w. X min-1 for D-glucose, 23 for L-alanine, and 1 for glycerol--values which are much higher than those described for larger species. There is a parallelism between the magnitude of transfer to fetus and arterial concentration in mother for each studied metabolite and actually variations in their plasmatic levels affect this transport process. This is clearly seen in the case of glucose where placental transfer is reduced during fasting hypoglycemia and greatly increased in diabetes. Placental transfer of L-alanine and blood flow to the placenta were reduced in both 48-hour starved and streptozotocin-induced diabetic late pregnant rats. Results show the main role of maternal nutrient concentration as a modulator of their transfer to fetus, the deleterious effect of reductions of uterine blood flow on placental transport of amino acids as well as the small placental transfer of glycerol as compared to either glucose or alanine. PMID- 3552064 TI - History of lithium. PMID- 3552065 TI - Experimental reconstruction of mouse eggs and embryos: an analysis of mammalian development. AB - The scope of experimental approaches applicable to the study of mammalian eggs and embryos has advanced in recent years to provide unprecedented opportunities for understanding mammalian embryology. Amongst these significant advances has been the ability to alter the genetic constitution of eggs by pronuclear and nuclear transplantation as well as by the introduction of specific cloned genes into eggs and embryos. These techniques can be used in conjunction with the experimental reconstruction of preimplantation embryos to investigate more precisely a number of aspects of mammalian embryology. Recently, a most intriguing aspect of development has been uncovered, one that is apparently unique to mammals; experiments have revealed that the parental genomes are not functionally equivalent during embryogenesis. Hence, the parental origin of chromosomes determines their influence during embryogenesis. The mechanistic aspects responsible for the germ line modifications of homologous chromosomes, their role during development, and the wide-ranging implications of these findings for mammalian development have yet to be fully defined. An understanding of this process will provide the basis for developing genetic and reproductive strategies that can be applied to domestic animals and to humans. PMID- 3552066 TI - Coexistence and cooperation between neuropeptide Y and norepinephrine in nerve fibers of guinea pig vas deferens and seminal vesicle. AB - Fluorescence immunocytochemistry of guinea pig vas deferens and seminal vesicle revealed dense networks of nerve fibers containing both neuropeptide Y (NPY) and dopamine-beta-hydroxylase (DBH), a marker for adrenergic neurons. The effects of norepinephrine (NE) and NPY on the smooth musculature of these organs were studied in vitro. NE inhibited the response to electrical nerve stimulation and increased the basic tension in the vas deferens and contracted the smooth muscle of the seminal vesicle, but had no effect on the contractile response to transmural stimulation in the latter organ. NPY had similar effects on the vas and vesicula, i.e. it inhibited the electrically induced contractions and had no effect on the basic tension. The results suggest a role for NPY as a transmitter that acts before the site of the neuromuscular junction to modulate the release of other transmitters from motor nerve fibers in the smooth musculature. PMID- 3552067 TI - Uptake of an oviductal antigen by the hamster zona pellucida. AB - Using an antiserum raised against hamster oviductal zona pellucida, we observed specific immunogenic components of the reproductive tract on the zonae of oviductal eggs and in oviductal fluid. Results of immunohistochemical studies suggested that these oviductal components may originate from epithelial cells of the isthmus and, to a lesser extent, of the ampulla and fimbria. The oviductal immunogenic components have also been observed within the bursal cavity, which contains the ovary. These observations suggest that these oviductal components may play an important role in the first steps of the hamster reproductive process. PMID- 3552068 TI - Interactions between prolactin and dopaminergic neurons. AB - The secretion of prolactin from the adenohypophysis is tonically inhibited by dopamine that is released into the hypophysial portal blood from terminals of tuberoinfundibular neurons located in the external layer of the median eminence. These tuberoinfundibular neurons are unique among other dopaminergic neurons in the brain (including the well-characterized nigrostriatal neurons) in that they are not directly regulated by dopaminergic receptor-mediated mechanisms, but instead are selectively responsive to changes in prolactin concentrations in blood and cerebrospinal fluid. In the rat, the activity of the tuberoinfundibular dopaminergic neurons is higher in the female than in the male, exhibits a characteristic cyclical pattern during the first half of pregnancy and is constantly high as a result of stimulation by placental lactogen during the last 9 days of pregnancy, and is reduced in lactating animals and acutely inhibited during suckling. PMID- 3552069 TI - Supplementary analysis at the conclusion of a sequential clinical trial. AB - Suppose that a clinical trial has been carried out using a sequential design. Any analysis that neglects the monitoring of the trial is potentially biased, and this holds for analyses of responses not directly used to determine whether the study should be stopped. Although valid methods exist to deal with the responses actually used in the sequential design, little has been written about secondary analyses of further responses. In this paper, two approaches to secondary analyses are explored. One is a conditional approach that avoids the problems of bias, the other an unconditional approach that allows for the sequential nature of the trial. The two methods are illustrated by application to three examples, each concerning a different type of response variable. PMID- 3552070 TI - Theoretical analysis of single-round transcription experiments on trp leader region. AB - A kinetic model is proposed to reproduce the time courses of the concentration change in paused leader RNA, terminated leader RNA, and readthrough RNA in the single-round transcription experiments on trp leader region of Escherichia coli and its mutants, L132, L75, and L75L135 (Winkler, M. E., and C. Yanofsky, 1981, Biochemistry, 20:3738-3744; Fisher, R., and C. Yanofsky, 1983, J. Biol. Chem., 258:9208-9212). This model fits the experimental results well and also captures the essential aspects of the processes of transcriptional pausing and termination. In the wild type template, under optimal conditions, it is found that the transcription rate at the pause and attenuation sites is of the same order of magnitude, 10,000-fold lower than the transcription rate at the other sites, and the high termination level at the attenuation site is attributable to a higher dissociation rate. This analysis also provides a clue as to how the template base change, various concentrations of ribonucleoside triphosphates, and the presence or absence of L-factor affect the transcription and dissociation rates to yield different termination levels at the pause or attenuation site. It also discusses the molecular mechanism of the transcriptional pausing and termination. PMID- 3552071 TI - [Monoclonal antibodies against group A streptococcal polysaccharide reacting with basal-cell antigen of tumors histogenetically related to epidermal tissues]. AB - Immunofluorescence of tumour tissues histogenetically related to tissues containing cross-reacting squamous epithelial basal-cell antigen (BCAg) was performed using monoclonal antibodies (McAb) A6/I-D to squamous epithelial basal cell antigen cross-reacting with group A staphylococcal polysaccharide. BCAg was found in tumour cells arising from surface tissues of the epidermal type (basal cell cancer, squamous-cell cancer of the skin, esophagus, cervix uteri and other organs) and was not found in glandular tumours (adenocarcinoma of the stomach, intestine, mammary glands). The results obtained indicate that McAb A6/I-D against cross-reacting BCAg may be used while characterizing the majority of normal epidermal tissues and tumours arising from tissues containing cross reacting BCAg. PMID- 3552072 TI - [Characteristics of hematopoiesis regeneration in subcutaneous bone implants in aging mice]. AB - Femurs from both young and old mice were implanted subcutaneously to young syngeneic recipients. 2-2.5 months after surgery femoral marrow grafts were repopulated with nucleated cells and macrophage-granulocyte precursor cells irrespective of the donor's age. Marrow depletion of femurs prior to implantation caused a sharp decrease in hemopoietic repopulation of implants from old, but not young, donors. It is concluded that age-dependent functional peculiarities of stromal microenvironment can be visualized owing to the extraordinary local regenerative demand. PMID- 3552073 TI - [Determination of lymphokine-induced cytolytic activity of macrophages by measuring the 3H-thymidine residue in prelabeled tumor cells]. AB - A technique of macrophage-activating factors (MAF) detection by the in vitro determination of macrophage (Mph) antitumour cytolytic activity by 3H-thymidine residue in the pre-labelled neoplastic target cells (TC) is suggested. Peptone induced Mph were cultivated for 20-22 hours in the presence of crude supernatants from concanavalin-A-stimulated spleen cells or from the secondary mixed lymphocyte culture. 3H-thymidine-labelled cells of mastocytoma P815 were then added to the washed Mph. The lysis was measured in 48 hours according to the isotope remainder in the non-acid-soluble fraction. The optimal conditions for MAF detection have been selected. Parallel MAF testing with this particular method and with a standard technique using labelled 51Cr TC made it possible to conclude that the method suggested is more sensitive because it permits a combined cultivation of Mph and TC for a relatively long time period. PMID- 3552074 TI - Monoclonal antibody 7D5 raised to cytochrome b558 of human neutrophils: immunocytochemical detection of the antigen in peripheral phagocytes of normal subjects, patients with chronic granulomatous disease, and their carrier mothers. AB - We have established a monoclonal hybridoma clone that produces IgG1 against the cytochrome b558 of human neutrophils. The antibody 7D5, secreted by the hybridoma, bound to solubilized cytochrome b of the neutrophils but not to other proteins such as hemoglobin, myeloperoxidase, and pig cytochrome P-450. Immunocytochemical studies of normal human peripheral blood showed that 7D5 bound to neutrophils and monocytes but not to lymphocytes or erythrocytes. The neutrophils of male patients but not of a female patient with chronic granulomatous disease lacked the antigen of 7D5 as well as the absorption spectrum for cytochrome b558. A mosaic of the antigen-positive and -negative neutrophils was observed in mothers of the male patients. These biochemical and immunocytochemical results indicate that 7D5 is a specific antibody against cytochrome b558 of human phagocytes. PMID- 3552075 TI - Evaluation of four methods for platelet compatibility testing. AB - Four platelet compatibility assays were performed on serum and platelet or lymphocyte samples from 38 closely HLA-matched donor/recipient pairs involved in 55 single-donor platelet transfusions. The 22 patients studied were refractory to transfusions of pooled random-donor platelets. Of the four assays (platelet suspension immunofluorescence, PSIFT; 51Cr release; microlymphocytotoxicity; and a monoclonal anti-IgG assay, MAIA), the MAIA was most predictive of platelet transfusion outcome (predictability, 74% for one-hour posttransfusion platelet recovery and 76% for 24-hour recovery). The only other assay to reach statistical significance was the PSIFT (63% predictability for one-hour posttransfusion recovery). The degree of HLA compatibility between donor and recipient (exact matches v those utilizing cross-reactive associations) was unrelated to the ability of the MAIA to predict transfusion results. The MAIA may be capable of differentiating HLA antibodies, ABO antibodies, and platelet-specific antibodies responsible for failure of HLA-matched and selectively mismatched single-donor platelet transfusions. PMID- 3552076 TI - Comparison of three remission induction regimens and two postinduction strategies for the treatment of acute nonlymphocytic leukemia: a cancer and leukemia group B study. AB - Patients with acute nonlymphocytic leukemia were randomized to receive remission induction therapy consisting of seven days of cytosine arabinoside and three days of daunorubicin ("7 + 3") or to receive the same regimen intensified by either the addition of 6-thioguanine or by extension of the administration of cytosine arabinoside to ten days. Additionally, all patients were randomized to receive or not to receive cotrimoxazole antibacterial prophylaxis during the remission induction phase. Neither an increase in intensity of chemotherapy nor the antibacterial prophylaxis increased the remission rate above the 53% for patients treated with the standard "7 + 3" regimen. The second part of this study addressed the issue of the utility of long-term maintenance chemotherapy. To this end, patients were randomized to discontinue all treatment after 8 months of maintenance chemotherapy or to continue maintenance therapy for a total of 3 years. Although there was a transient increase in the relapse rate for patients who discontinued therapy, the proportion of long-term remitters was identical in the two patient groups. Additionally, there is a suggestion of a survival advantage for patients randomized to discontinue all therapy at 8 months. PMID- 3552077 TI - Neutrophil-mediated protection of cultured human vascular endothelial cells from damage by growing Candida albicans hyphae. AB - Interactions were studied between human neutrophils and cultured human umbilical vein endothelial cells invaded by Candida albicans. In the absence of neutrophils, progressive Candida germination and hyphal growth extensively damaged endothelial cell monolayers over a period of 4 to 6 hours, as determined both by morphological changes and release of 51Cr from radiolabeled endothelial cells. Monolayers were completely destroyed and replaced by hyphae after 18 hours of incubation. In contrast, when added 2 hours after the monolayers had been infected with Candida, neutrophils selectively migrated toward and attached to hyphae at points of hyphal penetration into individual endothelial cells (observed by time-lapse video-microscopy). Attached neutrophils spread over hyphal surfaces both within and beneath the endothelial cells; neutrophil recruitment to initial sites of leukocyte-Candida-endothelial cell interactions continued throughout the first 60 minutes of observation. Neutrophil spreading and stasis were observed only along Candida hyphae and at sites of Candida endothelial cell interactions. These events resulted in 58.0% killing of Candida at 2 hours and subsequent clearance of Candida from endothelial cell monolayers, as determined by microcolony counts and morphological observation. On introduction of additional neutrophils to yield higher ratios of neutrophils to endothelial cells (10 neutrophils:1 endothelial cell), neutrophil migration toward hyphal elements continued. Despite retraction or displacement of occasional endothelial cells by invading Candida and neutrophils, most endothelial cells remained intact, viable, and motile as verified both by morphological observations and measurement of 51Cr release from radiolabeled monolayers. From these studies, we conclude that neutrophils are capable of killing Candida hyphae selectively within human vascular endothelial cell monolayers and may have protective rather than detrimental effects on endothelial cell integrity. PMID- 3552078 TI - Glucose-6-phosphate dehydrogenase of malaria parasite Plasmodium falciparum. AB - Plasmodium falciparum growth is impaired in glucose-6-phosphate dehydrogenase (G6PD)-deficient red blood cells (RBCs), and malaria has been implicated in the spreading of deficient variants in malaria-endemic areas. Recent reports suggest that the malaria parasite can adapt itself to grow in these variant RBCs by producing its own G6PD, but studies on parasite G6PD are very limited. In this report, we define the properties of the parasite G6PD. G6PD was partially purified from infected and uninfected variant RBCs associated with severe G6PD deficiency. G6PD from infected RBCs contained two components separable by starch gel electrophoresis: a major component (approximately 90% activity) with a very slow anodal electrophoretic mobility and a minor component (approximately 10% activity) with the same mobility as the host G6PD. Parasite G6PD exhibited much higher affinity (low Km) to G6P and nicotinamide-adenine dinucleotide phosphate (NADP) than did human G6PD. Southern blot hybridization indicated that the parasite genome contained nucleotide sequences that were hybridizable with the human G6PD cDNA. These data indicate that the parasite is capable of adapting to G6PD-deficient RBCs by producing its own G6PD. PMID- 3552079 TI - Pre- and postsynaptic effects of angiotensins in the femoral artery of spontaneously hypertensive and Wistar-Kyoto rats. AB - The effects of angiotensin I (AI) and angiotensin II (AII) on ring segments of femoral arteries from spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) were studied. AI and AII elicited significantly greater direct contractile response in arteries from SHR than those from WKY. These peptides also potentiated the contractile response to transmural adrenergic nerve stimulation (TNS) in both preparations, but to a greater extent in those of WKY than SHR, without potentiating the contractile response to exogenous norepinephrine (NE). The potentiation of the TNS response and direct contraction caused by AI were markedly attenuated by captopril, an AI-converting enzyme inhibitor. Destruction of endothelium failed to alter the contractile response to AI in both WKY and SHR but augmented that to AII in WKY. Isoproterenol and salbutamol produced significant potentiation of TNS response only in arteries of SHR. Yohimbine and prostaglandin F2 alpha potentiated TNS response to a similar extent in arteries of WKY and SHR. These results suggest that AII locally generated from AI can act postsynaptically to cause contraction and presynaptically to promote adrenergic neurotransmission in the isolated rat femoral artery. The AI to AII conversion appears to take place mainly at sites other than endothelial cells. The postsynaptic effect of AII is greater in SHR than WKY, but its presynaptic effect is diminished in SHR unlike some other agents which facilitate adrenergic neurotransmission, and unlike that in mesenteric arteries of SHR. PMID- 3552081 TI - Pregnancy and delivery after bone marrow transplantation (BMT) for severe aplastic anemia (SAA). A case report. AB - A 23 years old multiple pretransfused female with severe aplastic anemia (SAA) underwent bone marrow transplantation (BMT). Cyclophosphamide (200 mg/kg) was used for conditioning, donor buffy coat cells were given as rejection prophylaxis. Seven months after BMT regular menses started in the absence of exogenous hormonal manipulation and 21 months after BMT the patient became pregnant. Pregnancy was complicated by mumps in the 14th week. It was terminated at term by cesarean section. The normally developed newborn girl (3,450 gm) presented with a "persistent fetal circulation syndrome". After surgical correction of the patent ductus arteriosus Botalli the girl baby recovered quickly. PMID- 3552080 TI - Suppression of the neoplastic phenotype and "anti-oncogenes". PMID- 3552083 TI - [Metastatic cancer of the breast. Study of intensive induction of remission chemotherapy. Controlled clinical trial]. PMID- 3552082 TI - Persistence of recipient cells after syngeneic BMT of Ph-positive CML. PMID- 3552084 TI - [Aid to the clinical and biological diagnosis of malignancy in a nodular hepatic image discovered by echography]. AB - When ultrasound examination of the upper abdomen detects a liver nodule, the malignancy of this lesion must be discussed. If past history of cancer is known, a benign lesion cannot be excluded. Conversely, if the examination is performed without a history of cancer, we must raise the possibility of a malignant lesion. We attempted to demonstrate that the simple clinical and biological findings allow, if well used, a diagnosis of malignancy or benign nature, rather than performing further investigations, sometimes costly or invasive. We therefore compared three different methods: the well known bayesian diagnostic process; the multivariate analysis using logistic regression model; the Decision Theory, constructing a binary discrimination tree. The three methods lead to approximately the same rate of well classified patients (93 to 95%). Advantages and disadvantages are discussed. PMID- 3552085 TI - Comedy or cruelty: the dentist as portrayed in literature and art. PMID- 3552086 TI - William G.A. Bonwill: a leading light of dentistry in the 19th century. PMID- 3552088 TI - Robert J. Nelsen and the development of the high speed handpiece. PMID- 3552087 TI - The historical development of dentistry in China. PMID- 3552090 TI - Dental remedies of the botanic healers of early America. PMID- 3552089 TI - Developments in prosthetic dentistry in the nineteenth century. PMID- 3552091 TI - Dentistry and folk art XXIV: Saint Apollonia. Jacques Callot (1592-1635)--French. PMID- 3552092 TI - The history of the characteristic Japanese wooden denture. PMID- 3552093 TI - [Studies on the quality of enzyme preparations (VII)--serrapeptase preparation]. PMID- 3552094 TI - Recent advances in the treatment of burns--1843-1858. PMID- 3552096 TI - Improved total-body irradiation dosimetry. AB - The total-body irradiation (TBI) technique at St Bartholomew's Hospital has been developed to improve dose homogeneity within the patient. Using a standard 6 MV linear accelerator in an orthodox-sized treatment room, the midpoint doses in head, neck, shoulders, mid-mediastinum, pelvis, knees and ankles are +/- 5% of that of the umbilicus in our current technique. This homogeneity has been achieved by a four-field technique, a reproducible patient set-up, careful use of a new bolus material and an additional beam-flattening filter mounted near the machine head. In addition, thermoluminescent dosimetric data collected at a test irradiation before TBI are used to influence field weightings and further improve dosimetry. This individualised and empirical TBI technique has dosimetric advantages over theoretical TBI dosimetric considerations in reducing dose gradients within the patient. These advantages are discussed. PMID- 3552095 TI - Adamantane derivatives: a new class of insulin secretagogues. AB - Adamantane derivatives were found to increase insulin release in vitro. Mouse islets were used to study the mechanisms and molecular requirements of that hitherto unrecognised property. At a non-stimulatory concentration of glucose (3 mM), 1-adamantanamine (1 mM) reversibly inhibited 86Rb efflux from islet cells, depolarized the beta-cell membrane, induced electrical activity, stimulated 45Ca uptake and efflux, and triggered insulin release. Omission of extracellular Ca2+ abolished the secretory response but only partially inhibited the acceleration of 45Ca efflux. At a stimulatory concentration of glucose (10 mM), 1-adamantanamine reversibly increased 86Rb efflux, potentiated electrical activity (lengthening of the slow waves with spikes), augmented 45Ca uptake and efflux, and increased insulin release. The effects of adamantanamine were dose-dependent, with a threshold concentration of 10 microM for stimulation release. 2-Adamantanamine was as potent as 1-adamantanamine. In contrast, substitution of the amino group by a carboxyl group (1-adamantanecarboxylic acid) decreased the effectiveness by about 65%, and substitution by a hydroxyl group (1-adamantanol) suppressed it. It is concluded that adamantane derivatives bearing an amino group decrease K+ permeability of the beta-cell membrane and thereby cause depolarization. This activates voltage-dependent Ca channels, permits Ca2+ influx and eventually stimulates insulin release. They may also mobilize cellular Ca2+, but this effect is not sufficient to cause release. PMID- 3552097 TI - The implications of in-vitro radiation-survival curves for the optimal scheduling of total-body irradiation with bone marrow rescue in the treatment of leukaemia. AB - A mathematical model for optimal scheduling of total-body irradiation (TBI) in the treatment of leukaemia is described. A survey of the radiosensitivities of human leukaemic cells indicate that they are highly radiosensitive with little fraction size dependence (median D0 = 0.74 Gy; median Dq = 0.14 Gy). These properties, when considered alongside the high repair capacity of lung, suggest that TBI schedules of the "accelerated hyperfractionation" type are optimal. The antileukaemic effects of alternative schedules, chosen to be isoeffective for lung damage to a reference schedule of 6 X 2 Gy in 3 days, were compared. A modestly hyperfractionated schedule of 10 fractions of 1.3-1.5 Gy in 5 days has theoretical advantages while retaining practicality of clinical administration. PMID- 3552098 TI - Superior mesenteric artery aneurysm diagnosed by ultrasound. PMID- 3552099 TI - The ultrasonic demonstration of acute multiple gastric ulcers in a child. PMID- 3552100 TI - Low-dose total-body irradiation in the management of refractory rheumatoid arthritis. PMID- 3552101 TI - Stomas continent and incontinent. PMID- 3552102 TI - 99mTc DTPA scanning with diuretic washout. Is it useful in the investigation of obstruction in the presence of gross renal tract dilatation? AB - Diuretic-enhanced 99mTc DTPA renal scanning aims to determine whether or not a kidney is obstructed. In the presence of gross renal tract dilatation the validity of this technique is questioned. Twenty-eight patients (51 kidneys) with the prune belly syndrome, characterised by gross dilatation and tortuosity of the ureters, were studied. These patients underwent diuretic 99mTc DTPA scanning at the time of diagnosis and at yearly intervals thereafter. Long-term clinical follow-up (3 years) with serial serum creatinine was available in all children. In all cases renal function remained stable and on this basis urinary tract obstruction was excluded. Analysis of the first 99mTc DTPA scan included differential function, whole kidney mean transit time (WKMTT) and the time taken for tracer activity to fall to 75% of peak activity after diuretic stimulus (T75). Using the 99mTc DTPA scan, obstruction can be excluded if the WKMTT is less than 5 min or, in the presence of a prolonged WKMTT, if the diuretic stimulus results in a T75 of less than 5 min. A T75 of between 5 and 10 min is considered equivocal and a T75 exceeding 10 min means that obstruction cannot be excluded. 99mTc DTPA scanning, using these criteria for diagnosis, provided false positive information in 22 kidneys (43%). There were no false negatives. 99mTc DTPA scanning with diuretic washout, using WKMTT and T75 criteria, is not appropriate for the detection of renal tract obstruction in the presence of marked upper renal tract dilatation, since the false positive rate of 43% is unacceptably high. PMID- 3552103 TI - Management and early reconstruction of urinary tract abnormalities detected in utero. AB - Pre-natal detection of urinary tract anomalies by ultrasound prevents delay in post-natal diagnosis and enables appropriate treatment to be instituted for potentially destructive uropathies. Over a 3-year period 42 cases (60 renoureteric units) of fetal urinary tract abnormality were diagnosed by maternal ultrasound. Sixteen of the 35 survivors underwent corrective urological surgery during the first months of life. Follow-up studies indicate that this early management results in satisfactory preservation of renal function. PMID- 3552104 TI - Transrectal ultrasonography compared with voiding cystourethrography after spinal cord injury. AB - Transrectal ultrasonography was compared with voiding cystourethrography (VCU) in 27 patients after spinal cord injury. Both techniques gave clear images of the bladder and posterior urethra. Ureteric reflux, intraprostatic reflux and anterior urethral diverticula were seen only on VCU. Ultrasonography showed soft tissue detail and muscle contraction not seen on VCU. Other advantages of ultrasonography included the lack of radiation hazard, allowing prolonged observation; no contrast medium was required and this eliminated the need for catheterisation. PMID- 3552105 TI - Twenty-four hour ambulatory oesophageal pH monitoring: an update. PMID- 3552106 TI - Single dose antibiotic prophylaxis in high risk patients undergoing transurethral prostatectomy. AB - In a randomized controlled clinical trial single dose antibiotic prophylaxis (gentamicin 80 mg IV) was evaluated in 36 patients with indwelling urethral catheters undergoing transurethral prostatic resection. Prophylaxis resulted in a significant reduction in postoperative bacteriuria (P less than 0.01), pyrexia (P less than 0.001), bacteraemia (P less than 0.01) and septicaemia (P less than 0.05). During the same period there was one case of postoperative bacteriuria but no systemic infection in 25 consecutive patients undergoing elective prostatectomy with no local risk factors and in the absence of prophylaxis. A policy of selective antibiotic prophylaxis is justified and in high risk patients with in-dwelling catheters single dose prophylaxis is highly effective. PMID- 3552107 TI - Accuracy of suture placement. AB - Three groups of seven surgeons were each randomly selected from three larger groups with surgical experience of less than 1, 6-10 and 16-20 years. Each surgeon was asked to aim a needle at an exit point using two methods: 'jiggling' (readjustment of the needle in aiming at the target) allowed and jiggling not allowed. The results were not as precise as expected. An improvement from group 1 to group 2 was noticed in both methods (P less than 0.01), but from group 2 to 3 there was improvement only in the method where jiggling was allowed (P less than 0.01). All groups showed a tendency to overshoot the target (P less than 0.01): a shift towards the surgeon in group 1 (P less than 0.05) and towards the opposite side in groups 2 (P less than 0.01) and 3 (P less than 0.05). Jiggling significantly reduced the inaccuracy, and it was concluded that pinpoint accuracy improved with surgical experience. However, the experienced surgeons improve their accuracy by jiggling, with the potential danger of tissue damage by needle adjustment. PMID- 3552108 TI - Infusion cholecystography as the initial investigation in acute biliary disease. PMID- 3552109 TI - The role of insulin resistance in the pathogenesis of myotonic muscular dystrophy. AB - A study of glucose, insulin, lipids and lipoproteins in myotonic dystrophy (MyD) has shown elevation of fasting plasma insulin, triglycerides and very low density lipoproteins (VLDL) but no significant difference from normal in the fasting plasma glucose, total cholesterol or low and high density lipoproteins. Elevation of the total triglyceride and VLDL levels showed a direct relationship to hyperinsulinaemia. Insulin binding to cultured MyD fibroblasts under optimal conditions was significantly reduced but there was no difference in receptor affinity between MyD and control cells. In contrast to insulin binding, LDL binding to MyD fibroblasts was normal although there was a tendency to reduced LDL binding at 37 degrees C that may reflect mildly reduced lipid metabolism. The alterations in lipids and insulin in MyD are compatible with insulin resistance. Laboratory and clinical findings in MyD were compared with other inherited insulin-resistant diseases. MyD showed marked similarity to a group of disorders that have mild insulin resistance and mildly elevated plasma insulin in contrast to others with severe hyperinsulinaemia and insulin resistance. It is suggested that at least some clinical features of MyD may be due to diminished overall effect of insulin or other trophic factors on cell metabolism. PMID- 3552110 TI - Sexual dimorphisms in the neural vocal control system in song birds: ontogeny and phylogeny. AB - Sex differences in the neural song system in oscine song birds develop in response to estradiol secreted during early periods of development. Estradiol produces sex differences in cell number and in the proportion of cells which are steroid targets. The pattern of development of these sex differences varies in different brain regions, suggesting that the mechanisms of estradiol regulation of neural development may also vary. The magnitude of sexual dimorphism in the neural song system varies across species, and is generally correlated with the magnitude of sexual dimorphism in vocal ability. Large species differences in neural structure can potentially be explained by small differences in the ontogenetic pattern of estradiol secretion, as is suggested by studies of neural development. PMID- 3552112 TI - Speculations on the role of frequency in sound localization. AB - This presentation reviews behavioral and physiological evidence suggesting that the perceived power spectrum of a sound, as modified by the external ears, provides important cues for horizontal and vertical sound localization. This spatial information is mostly likely encoded by the relative levels of excitation among the tonotopically organized hair cells of the cochlea. This suggests that the preservation of the cochlear frequency map within the central auditory system contributes an anatomical substrate for the localization of sound. PMID- 3552111 TI - Steroid-sensitive neuroeffector pathways for sonic and electric communication in fish. AB - A neuroeffector pathway for communication consists of at least two elements: a peripheral effector organ and a central motor nucleus. Two communication systems are discussed here: the sonic motor and electromotor systems of fish. The electromotor system is used to illustrate species diversity of a peripheral effector, the electric organ. The sonic motor system is discussed in the context of species differences in the organization of a central motor nucleus for communication. Both systems share several anatomical and physiological features related to the generation of a stereotyped communication signal. Moreover, both systems appear to be sensitive to the influences of gonadal steroid hormones in the development of sexually dimorphic communication signals. PMID- 3552113 TI - Effects of lesions of hypothalamic catecholamines on blood pressure, fluid balance, vasopressin and renin in the rat. AB - Fluid balance, systolic blood pressure (BP) and serum vasopressin (VP) and renin activity (SRA) in the basal state and in response to blood volume depletion were examined in unanesthetized rats previously given intrathecal 6-hydroxydopamine (6 OHDA) to destroy catecholaminergic (CA) input to supraoptic nucleus (SON). Sham operated rats, unoperated ad libitum hydrated rats and rats undergoing 4 days of water deprivation served as controls. The 6-OHDA lesion resulted in adipsia, a failure to conserve administered fluids and a decrease in systolic BP. Despite decreased blood volume secondary to dehydration, and decreased systolic BP, the 6 OHDA group failed to show the expected increase in serum VP. However, when blood volume was further decreased following intraperitoneal polyethylene glycol, lesioned rats showed robust VP and SRA responses. Thus, CA input to critical target areas in the hypothalamus may be necessary for maintenance of sensitivity to stimuli that normally elicit VP release. Decreased systolic BP following 6 OHDA lesions most likely results from dehydration coupled with inadequate VP responses. PMID- 3552115 TI - A search for choline acetyltransferase-like immunoreactivity in neurons of cat striate cortex. AB - The goal of this study was to determine whether cat striate cortex contains neurons with choline acetyltransferase-like immunoreactivity. Two different monoclonal antibodies were applied with various fixation protocols. As controls served selected regions of the cat brain and the rat neocortex where cholinergic neurons had been demonstrated previously with independent methods. All experimental protocols labelled the presumptive cholinergic neurons in the central regions but revealed only a few weakly stained neurons in cat striate cortex. These had a non-pyramidal morphology and were scattered throughout all layers. PMID- 3552114 TI - Histamine-immunostaining in the rat median eminence: an unexpected form of cross reactivity with LH-RH. AB - By use of two antisera (alpha HA-1, alpha HA-2) raised to histamine (HA) a similar distribution of HA-positive cell bodies and fibres in the rat brain has been demonstrated, except for a dense plexus in the median eminence which was only found with alpha HA-1. The HA-immunostaining in the median eminence was similar in distribution to that of luteinizing hormone-releasing hormone (LH-RH). In gelatin models containing LH-RH a concentration-dependent increase in immunofluorescence intensity (range: 0.01-10 microM) was found with alpha HA-1 but not with alpha HA-2. To evaluate the significance of the cross-reaction of alpha HA-1 with LH-RH, antero- or postero-lateral deafferentations of the rat mediobasal hypothalamus were made to discriminate between LH-RH and HA projections to the median eminence. The LH-RH- and HA-immunostaining in the median eminence was not affected by posterolateral deafferentations but was abolished in rats with an anterolateral lesion. We conclude that the HA immunostaining in the rat median eminence is due to a cross-reaction of alpha HA 1 with LH-RH. PMID- 3552116 TI - Dipeptidyl peptidase-II activity in cultured astroglial cells from neonatal rat brain. AB - Astrocytic glial cells in primary culture from neonatal rat brain possess prominent dipeptidyl peptidase-II activity. This enzyme has been previously isolated and purified from whole brain tissue. The glial enzyme characteristically hydrolyzed glycyl-proline-p-nitroanilide (GPN) substrate to release glycyl-proline dipeptide plus p-nitroaniline products. At the enzyme's optimal pH of 5.4, the activities of other tested amino exopeptidases were virtually zero. At pH greater than 8, activity was less than 2% of the activity at pH 5.4, which suggested a paucity of the related enzyme, dipeptidyl peptidase IV. No competitive inhibition was observed for glycine, proline nor their permuted dipeptides. Glial dipeptidyl peptidase-II activity was strongly inhibited by Hg2+, while other redox sulfhydryl agents were ineffective. Tested cations did not affect activity, except K+ which was mildly inhibitory. Chelating agents were not inhibitory. Of the peptidase inhibitors tested, only phenylmethylsulfonyl fluoride and puromycin were partially inhibitory. We suggest that dipeptidyl peptidase-II may play a role in glial processing of brain peptides which possess an N-terminal penultimate proline residue. PMID- 3552117 TI - Projections of nucleus paragigantocellularis lateralis to locus coeruleus and other structures in rat. AB - The projections of the retrofacial portion of nucleus paragigantocellularis lateralis (retrofacial PGCL) were mapped in the rat with the Phaseolus vulgaris leucoagglutinin anterograde tracing technique. This structure projects to a restricted number of bulbar or spinal nuclei involved in autonomic regulation, principally the intermediolateral cell column of the spinal cord, the nucleus tractus solitarius complex, the lateral parabrachial and Kolliker-Fuse nuclei and the ventrolateral medulla. Retrofacial PGCL also densely innervates the locus coeruleus. This projection originates in large part from phenylethanolamine-N methyltransferase-immunoreactive cells (C1 adrenergic cluster) as demonstrated by immunohistochemistry combined with the retrograde transport of rhodamine-tagged microbeads. A very small suprabulbar projection of retrofacial PGCL was also detected in some cases. PMID- 3552118 TI - Fiber pathways of basal forebrain cholinergic neurons in monkeys. AB - In rhesus monkeys, autoradiographic tracing methods, complemented by immunocytochemical and histochemical techniques, were used to delineate pathways by which cholinergic neurons of the nucleus basalis of Meynert (nbM) and nucleus of the diagonal band of Broca (ndbB) project to forebrain targets. Following injections of [3H]amino acids into these nuclei, 5 major fiber pathways were identified: axons of the nbM and ndbB project medially, principally within the cingulum bundle, to dorsomedial portions of the hemispheres; nbM and ndbB fibers exit laterally beneath the pallidum and striatum, enter the external and extreme capsules, and pass within the corona radiata to terminate in lateral and caudal regions of neocortex; axons coursing ventrally from the nbM project to portions of the temporal lobe, including the amygdala; some fibers pass through the fibrae pass orbitofrontales to the orbitofrontal cortex; and, finally axons of the nbM/ndbB project via the fimbria/rornix and a ventral pathway to the hippocampus. The presence of these 5 radiolabeled pathways arising from basal forebrain cholinergic neurons was confirmed by acetylcholinesterase histochemistry and choline acetyltransferase immunocytochemistry. PMID- 3552119 TI - Characteristics of primary cultured neurons from embryonic mutant El mouse cerebral cortex. AB - To elucidate the differences between neurons of epileptogenic animals and those of normal animals, cellular characteristics of neurons of mutant strain El mice which are highly susceptible to seizures were investigated using immunocytochemical techniques. In neurons of 3-day primary cultures, the control ddY mouse neurons showed dividing stages in about 0.2% of neurofilament (NF) positive neurons, whereas no dividing neurons were observed among the NF-positive El mouse neurons. In 7-day cultures, localization of GD3 ganglioside in the proliferating control ddY mouse neurons was observed, but there was no GD3 ganglioside in the mutant El mouse neuron. The content of GD3 ganglioside detected by high-performance thin-layer chromatography of El mouse cultured cells was ca. 1/4 of that of ddy mice. These findings suggest that neurons of the El mouse are differentiated earlier than those of the control ddY mouse. PMID- 3552120 TI - An immunohistochemical study of methionine-enkephalin-Arg6-Gly7-Leu8-like immunoreactivity-containing neurons in the parasympathetic preganglionic regions of the rat spinal cord. AB - The localization of the methionine-enkephalin-Arg6-Gly7-Leu8 (Met-Enk-Arg-Gly Leu)-like immunoreactivity-containing neurons in the rat lumbosacral spinal cord was immunohistochemically examined by an antiserum very specific to Met-Enk-Arg Gly-Leu. The immunoreactive neurons occupied the positions corresponding to the parasympathetic preganglionic nuclei determined by the previous horseradish peroxidase (HRP)-tracing experiments. The present study suggests that the parasympathetic preganglionic neurons in the rat lumbosacral spinal cord produce preproenkephalin A and its related peptides. PMID- 3552121 TI - Localization of serotonin-immunoreactivity in the central nervous system of Octopus vulgaris by immunohistochemistry. AB - 5-Hydroxytryptamine (5-HT, serotonin)-containing cells were localized in the central nervous system of Octopus vulgaris by use of the unlabelled peroxidase antiperoxidase complex (PAP) immunohistochemical method employing highly specific antibodies to 5-HT present in paraformaldehyde-fixed tissue. Antibodies were raised in rabbits against an immunogen prepared by coupling 5-HT to bovine thyroglobulin (BTG) or to bovine serum albumin (BSA) with formaldehyde as the coupling reagent. The specificity of the immune reaction was studied by both absorption test and radioimmunoassay. The distribution of 5-HT immunoreactivity observed in octopus brain was essentially similar to that reported by other workers who used formaldehyde- or glyoxylic acid-induced fluorescence method. In addition, this immunohistochemical technique revealed 5-HT-containing perikarya in both the chromatophore and the palliovisceral lobes which were not detected by the previous fluorescence histochemical method. Thus, this immunocytochemical procedure appears to be a specific and very sensitive technique for the localization of 5-HT within the central nervous system of cephalopod Mollusca. PMID- 3552122 TI - Differentiation of the suprachiasmatic nucleus in fetal rat anterior hypothalamic transplants in oculo. AB - The capacity of the rat anterior hypothalamus, and particularly the suprachiasmatic nucleus (SCN), to develop and differentiate when removed from its normal environment was examined in this study using light and electron microscopy. The hypothalamus from fetuses ranging in age from embryonic day 12 (E 12) to E 16 was transplanted to the anterior chamber of the eye of adult rats. In initial experiments, we found that transplants from E 15 fetuses and older routinely differentiated into fields of neurons with extensive neuropil with an appearance similar to the anterior hypothalamic area. Groups of small, compactly organized neurons were observed only occasionally in this tissue. Ultrastructural analysis of these transplants typically revealed well-differentiated neuronal perikarya and neuropil with a complex synaptic organization similar in appearance to the normal rat anterior hypothalamic area. Occasionally both mature and immature tissue coexisted in some of the transplants. Tissue from young embryos (E 12-14) frequently showed development of a compact, small neuron nucleus with the cytoarchitectonic appearance of the SCN. At least 45 days were required after transplantation for the successful differentiation to occur in this situation. The SCN in these transplants displayed vasoactive intestinal polypeptide immunoreactive cells and fibers surrounded by vasopressin-immunoreactive cells and fibers, similar to the pattern observed in the normal adult SCN. Our results indicate that the anterior hypothalamus will differentiate normally in oculo and that the phenotypic specification of the SCN occurs prior to the birthdate of its component neurons. PMID- 3552123 TI - Retinal ganglion cell survival and neurite regeneration requirements: the change from Muller cell dependence to superior colliculi dependence during development. AB - A study has been made of the effects of Muller conditioned media or neonatal superior collicular extracts on the survival in dissociate culture of retinal ganglion cells (RGC) from differently aged rats. Embryonic and neonatal RGC were identified either by retrograde horseradish peroxidase (HRP) or Thy-1 antibody labelling techniques. Muller conditioned media supported the survival, over 24 h in culture, of 85% of the RGC plated from 17-day embryos (E17); in contrast, superior collicular extract only maintained 45% of these RGC. With further development there was a decline in the survival enhancing effects of the Muller conditioned media and an increase in the survival due to superior collicular extracts: by postnatal day 12 (P12), the survival of RGC had declined to 20% in the Muller media, but had increased to over 90% in the colliculus extract. This transition in the dependence of RGC from Muller cells to superior colliculi was examined with homogeneous cultures of RGC, obtained using cell sorting techniques. RGC in these cultures showed the same transition in dependence from Muller cells to superior colliculi, indicating that the survival-enhancing effects were not mediated by the other intrinsic cells of the retina. The results suggest that the survival of RGC is at first dependent on the intrinsic glia of the retina and only later, as development proceeds, on the targets of the RGC in the superior colliculus. The normal RGC death period in the rat extends from near birth to about 6 days postnatal. The question then arises as to the timing of trophic support from Muller glia and from neurones in the tectum in relation to the duration of the normal RGC death period. This has been examined in the present work. PMID- 3552125 TI - Somatosensory detection of microgeometry, macrogeometry and kinesthesia in man. PMID- 3552124 TI - Human corticoliberin hypothalamic neuroglandular system: comparative immunocytochemical study with anti-rat and anti-ovine corticotropin-releasing factor sera in the early stages of development. AB - Development of the paraventriculo-infundibular corticoliberin system was studied by immunocytochemical analysis of human hypothalamic sections using antisera raised against rat or ovine corticotropin-releasing factor (CRF). This comparative study confirms the presence of a significant number of CRF immunoreactive fibers in the median eminence during the 16th week of fetal development and suggests they may appear as early as the 14th week. Some hypothalamic peri- and paraventricular neurons, observed from the 12th week, are rat-CRF-immunoreactive but not ovine CRF-immunoreactive. There appears to be chronological differences concerning the ability of the two antisera to recognize hypothalamic structures during the early stage of development. PMID- 3552126 TI - Somatosensory detection of microgeometry, macrogeometry and kinesthesia after localized lesions of the cerebral hemispheres in man. PMID- 3552127 TI - Purification of FSH-releasing factor: its dissimilarity from LHRH of mammalian, avian, and piscian origin. AB - Sheep stalk median eminence fragments were lyophylized, extracted and filtered through a column of Sephadex G-25. The fractions were then assayed for the presence of LHRH by radioimmunoassay (RIA) and bioassayed for FSH and LH releasing activity following their IV injection into ovariectomized, estrogen progesterone-blocked rats. The radioimmunoassayable LHRH emerged from the column at the same position from which it emerged many years before when LH was measured by bioassay. This same region also contained the LH-releasing activity as measured by bioassay. FSH-releasing activity was present in two tubes just preceding the emergence of the bio- and immunoassayable LHRH. The activity was highly significant and there was no LH-releasing activity in the fractions. They contained much less LHRH as determined by RIA than is sufficient to evoke LH release in this assay. The FSH-releasing activity was recovered in the same fractions in which it was found many years ago with this same assay but with measurement of plasma FSH by bio-rather than immunoassay as employed here. A dose related release of LH was obtained by injection of LHRH in this assay but there was no significant FSH release even with a dose of 27 ng of LHRH per rat. To determine if one of the LHRHs of lower forms might be FSH-RF, Chicken I and II LHRH and Salmon LHRH were also assayed for FSH- and LH-releasing activity. Each of these peptide possessed LH-releasing activity, albeit much less than that of the mammalian peptide but had no FSH-releasing activity whatsoever.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552128 TI - Oxytocin-immunoreactive projections onto medullary adrenaline neurons. AB - With the use of two-color immunoperoxidase staining, oxytocin-like immunoreactive (OLI) processes have been observed along the surface of phenylethanolamine N methyl transferase-like immunoreactive (PNMTLI) cells in the ventrolateral and dorsomedial medulla of the rat. OLI boutons were also observed on PNMTLI cells retrogradely labeled with HRP injected into the rostral thoracic spinal cord. The close spatial relationships between OLI processes and PNMTLI cells argues for a functional connection which could provide for direct hypothalamic control of medullary adrenaline cells involved in cardiovascular regulation. PMID- 3552130 TI - Appendicitis in Bristol--100 years ago. PMID- 3552129 TI - Coexistence of melanin-concentrating hormone (MCH) and alpha-melanocyte stimulating hormone (alpha-MSH) in the preoptic nucleus of the frog brain. AB - Coexistence of MCH- and alpha-MSH-like peptides in specific neurons of the frog hypothalamus has been investigated on serial frozen sections using the indirect immunofluorescence method. In the anterior region of the preoptic nucleus, perikarya containing MCH- and alpha-MSH-immunoreactive materials were co distributed and the two peptides were generally co-sequestered within the same neurons. In contrast, alpha-MSH immunoreactive neurons of the ventral infundibular nucleus did not contain any MCH-like peptide. These data suggest that MCH and alpha-MSH are transported by the same nerve fibers originating from preoptic perikarya and are likely released together by axon terminals. Since MCH and alpha-MSH exert antagonistic hormonal activities on dermal melanophores, our results suggest that the two regulatory peptides may also interact in the central nervous system. PMID- 3552131 TI - The assessment of the urological opprobria. PMID- 3552132 TI - The Bristol Eye Hospital--an historical perspective. PMID- 3552133 TI - [Demonstration of persistence of the radiosensitizing effect of nitrous oxide in the mouse after a delay of return to atmospheric air]. PMID- 3552134 TI - [Antagonistic and antidote effects of calcium channel modulators on imipramine toxicity]. PMID- 3552136 TI - [Depression in general medicine]. PMID- 3552135 TI - [Human cancers of viral origin. Burkitt's disease as a model of human carcinogenesis]. PMID- 3552137 TI - [An unrecognized case of Marfan syndrome: Talleyrand's case]. PMID- 3552139 TI - [Microtubules in the cellular lesions of Alzheimer's disease]. PMID- 3552138 TI - [Alcohol dependence and serotonin: new data]. PMID- 3552140 TI - [Drug-induced pemphigus: clinical review and pathogenic mechanism]. PMID- 3552141 TI - [Professional secrets in the face of notebooks and health cards]. PMID- 3552142 TI - [Is it necessary to discontinue captopril before heart surgery?]. AB - Interaction between kininase II and anaesthesia is not well described. Twenty two patients treated by kininase II for congestive heart failure are studied during anaesthesia for cardiovascular surgery. A first group of seventeen homogeneous hemodynamic data are reported. High cardiac index contrasts with severe clinical cardiac failure. A second group of inhomogeneous patients are separately described. Vasoconstrictor can be codified in the situation of low systemic resistance with high cardiac index. Preoperative treatment can be continued, under requirement of hemodynamic monitoring. PMID- 3552143 TI - [Hematologic effects of autologous blood transfusion in heart surgery in the adult]. PMID- 3552144 TI - [Sixty years of medical care in several rural departments]. PMID- 3552145 TI - [Founding and scope: expansion of the French Society of Alcohology from 1978 to 1985]. PMID- 3552146 TI - Polioencephalomalacia. AB - Polioencephalomalacia, a disease of ruminants, is most likely due to a thiamine deficiency and is most frequently associated with intensive feeding conditions or with recent changes in management. The clinical signs of incoordination and blindness followed by recumbency and opisthotonus can resolve relatively rapidly when treated early with thiamine and supportive care. The disease can frequently be prevented by thiamine supplementation and inclusion of a minimum amount of roughage in feedlot rations. PMID- 3552147 TI - Nutritional and metabolic diseases involving the nervous system. AB - This article will discuss eight diseases that alter normal nervous system function: hypovitaminosis A, water deprivation/salt toxicity, ammonia toxicosis, hypomagnesemia, hypocalcemia, nervous ketosis, hepatoencephalopathy, and rumen metabolic acidosis. PMID- 3552148 TI - Lead poisoning in cattle. AB - Lead poisoning is a frequent cause of poisoning in domestic animals. Signs of encephalopathy and gastroenteritis are commonly observed in cattle following lead poisoning. This article discusses the etiology, epidemiology, pathogenesis, clinical signs, diagnosis, postmortem findings, and treatment of lead poisoning in cattle. PMID- 3552149 TI - Congenital defects of the bovine central nervous system. AB - Congenital brain defects in cattle are usually obvious at birth, but detection may depend on the nature and extent of the defect. The cause may be genetic or environmental, or the cause may be unknown. Many central nervous system defects are inherited as a simple autosomal recessive trait and may have a significant economic impact on purebred and commercial cattle operations. A common structural defect of genetic nature is internal hydrocephalus. A functional defect of simple autosomal recessive inheritance is bovine progressive degenerative myeloencephalopathy. The most significant teratogenic agents causing central nervous system defects are prenatal viral infections such as bovine virus diarrhea and bluetongue viruses. Many other defects of the central nervous system are reviewed. PMID- 3552150 TI - Clinical pathology of bovine neurologic disease. AB - This article describes the general and specific interpretations of common laboratory tests used to evaluate bovine neurologic disease. Cerebrospinal fluid analysis is emphasized. Comments are made about general conclusions such as hemorrhage, inflammation, infection, and neoplasia as well as specific diseases like thromboembolic meningoencephalitis. Tests in commonly available serum chemistry profiles like total calcium concentration and aspartate aminotransferase activity are described in terms of their usefulness in diseases such as parturient paresis or hepatic encephalopathy. The indications for more specific tests like ionized calcium, blood ammonia concentration, or erythrocyte transketolase are included. PMID- 3552151 TI - Neurologic disease caused by Haemophilus somnus. AB - Haemophilus somnus is an important cause of neurologic disease in young cattle. Controversy exists over the taxonomic classification of this organism, but the name has persisted. Although the clinical signs and postmortem findings have been well described, the epidemiology and pathogenesis are poorly understood. With early detection, the disease can be successfully treated with antimicrobial therapy. Prevention of the disease may be possible with commercial bacterins. PMID- 3552152 TI - Bacterial meningitis and diseases caused by bacterial toxins. AB - Bacterial meningitis most commonly occurs in young calves secondary to septicemia. Clinical signs of hyperirritability are usually seen. Meningitis can be confirmed by cerebrospinal fluid analysis and culture or by necropsy. Intoxications by the exotoxins of Clostridium perfringens types C and D, C. botulinum, and C. tetani are difficult to confirm. The clinical signs of these intoxications vary from flaccid paralysis (botulism) to muscular rigidity (tetanus). Treatment of affected cattle has been unrewarding in botulism and enterotoxemia, whereas early aggressive treatment of tetanus cases can often be successfully resolved. Botulism and enterotoxemia can be proved using mouse inoculation tests, whereas tetanus is diagnosed largely by ruling out other diseases. PMID- 3552154 TI - "The mercury scare". PMID- 3552153 TI - Parasitic disease of the bovine nervous system. AB - Parasitic disease of the nervous system of cattle is mainly caused by migrating nematodes, expanding cestode cysts, or by rickettsiae and protozoa in the central nervous system. Common parasitic causes of neurologic diseases in cattle in the United States are Hypoderma larvae, toxins produced by Dermacentor ticks, and metabolic changes associated with intestinal coccidiosis. PMID- 3552155 TI - "A moral and dental dilemma"--rebuttal. PMID- 3552156 TI - Traumatic herniation of the buccal fat pad. Case report. PMID- 3552157 TI - Care of the pregnant patient. PMID- 3552158 TI - Chronic nasolabial cyst. PMID- 3552159 TI - [Immunofluorescence as a diagnostic aid in oral medicine (2)]. PMID- 3552161 TI - [Recent developments in periodontal bone grafting]. PMID- 3552160 TI - Acute diabetes mellitus does not impair survival rate in rats submitted to left coronary artery ligation. AB - This study was designed to assess whether the acute metabolic disturbances associated with diabetes mellitus of three-days duration could influence the survival of rats submitted to experimental myocardial infarction. Diabetes was induced with streptozotocin (50 mg/kg) in male Wistar rats and three days later left coronary artery ligation was performed in both control (n = 34) and diabetic (n = 31) animals. Diabetic rats had significant alterations in plasma levels of glucose (424 +/- 6 vs 143 +/- 3 mg/dL; p less than 0.001), insulin (10 +/- 1 vs 32 +/- 2 microU/mL; p less than 0.001) and free carnitine (37 +/- 2 vs 52 +/- 2 microM; p less than 0.001). There was no significant difference in the survival rate of diabetic animals, either early after coronary artery ligation (32 vs 42% at 20 min; p greater than 0.1) or later (21 vs 25% at 1 week; p greater than 0.1). This suggests that the increased mortality rate found in diabetic subjects suffering from myocardial infarction is due to some long-term changes associated with chronic diabetes mellitus rather than to the acute metabolic disturbances present at the time of this event. PMID- 3552162 TI - Thiol protease and cathepsin D activities in selected tissues and cultured cells from normal and dystrophic mice. AB - Thiol protease and cathepsin D activities were studied in extracts from hindlimb muscle of 60-day-old normal and dystrophic mice, strain 129 ReJ, and from cultured normal and dystrophic cells. Total thiol protease activity in dystrophic muscle extracts was 3.5 times higher than in normal muscle extracts, while cathepsin D, activity was 2.2 times greater in dystrophic muscle compared with normal muscle. Activation (pH 4.5, 30 degrees C) of latent thiol protease activity in extracts of muscle occurred concomitant with the inactivation or dissociation of endogenous protease inhibitors. Thiol protease assays revealed a higher ratio of active to inactive protease activity in extracts from dystrophic muscle than from normal muscle. Cultured myoblasts (L69/1) were found to contain 30-fold more thiol protease(s) and 6-fold more cathepsin D activity than whole muscle. Cells established from dystrophic muscle and grown in culture for periods up to 6 months were more responsive to thiol protease activation conditions than similar cultures derived from normal muscle. From data on the rate and extent of thiol protease activation in extracts from dystrophic cells and hindlimb muscle compared with normal tissue, it appears that cells and tissues from dystrophic mice contain a lower level of protease inhibitors than cells and tissues from normal mice. PMID- 3552163 TI - The role of insulin in nonshivering thermogenesis. AB - The regulation of nonshivering thermogenesis by insulin was studied in cold acclimated rats (2 weeks at 5 degrees C) made diabetic after injection with streptozotocin (75 mg/kg, i.p.) and maintained in the warm (25 degrees C) for 2-7 days. To investigate whether thermogenesis was activated in brown adipose tissue (BAT) of diabetic rats under physiological conditions, conscious rats were briefly exposed to cold (2 h at 5 degrees C) and the temperature of interscapular BAT (Tbat) was compared with the colonic temperature (Tcol). It was found that Tbat, Tcol, and Tbat-Tcol (an index of thermogenesis activation in BAT) were significantly reduced in 7-day diabetic rats (P less than 0.01) but not in 2-day diabetic animals, suggesting that diabetes progressively decreases BAT thermogenic capacity. To further assess whether the maximal capacity of BAT for nonshivering thermogenesis was affected by the lack of insulin, the calorigenic response to noradrenaline (0.4 mg/kg, i.m.) was determined at 25 degrees C in anesthetized animals using an open circuit respirometer. The results showed that the calorigenic response to noradrenaline was inhibited by 50 and 70% in 2- and 7 day diabetic rats, respectively. Significantly, tissue weight, protein content, and cytochrome oxidase activity of interscapular BAT were also decreased by 30 40% and 50-70% in the same animals. Insulin treatment of 3-day diabetic rats for 4 days (6.5 U/day per rat) restored their calorigenic response to noradrenaline to control levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552164 TI - Influence of right atrial stretch on plasma renin activity in the conscious rat. AB - Rats were prepared with inflatable balloons at the superior vena cava - right atrium junction. After recovery 1 week later, when blood was taken from conscious, normovolaemic animals plasma renin activity was found not to be influenced by right atrial stretch. Plasma renin activity was then measured in rats in which an extracellular fluid deficit had been produced by peritoneal dialysis against a hyperoncotic, isotonic solution. Although basal plasma renin activity was elevated (6.8 +/- 0.9 from 1.5 +/- 0.2 ng X mL X h, n = 19), no depression was observed in the experimental group after 15 or 90 min of balloon inflation. In rats pretreated with isoprenaline (10 micrograms/kg body wt.) plasma renin activity was also increased over basal levels, but again balloon inflation caused no reduction in plasma renin activity. It would appear that right atrial stretch has little, if any, influence on renin release in the conscious rat. PMID- 3552165 TI - Comparison of bacterial counts obtained from naturally contaminated foods by means of Stomacher and blender. AB - Four Regional Health Protection Branch laboratories each compared aerobic colony counts obtained after "stomaching" and blending, for a minimum of 10 samples in each of the seven food groups: dry pastas; chocolate and cocoa powders; frozen entrees (macaroni and cheese, chow mein, chop suey, fried rice, seafood casseroles, and Salisbury steak); nonfat dry milk; shrimp and crabmeats; spices; and breakfast sausages. Overall, counts obtained after using the Stomacher were equivalent to or higher than counts obtained after using the blender in 73% of the comparisons (alpha = 0.05). Where differences existed, counts obtained after using the Stomacher tended to be higher than counts obtained after using the blender from milk powder and lower from sausage. Aerobic colony counts from these foods are not unacceptably biased when obtained by Stomacher. PMID- 3552166 TI - Metabolism of Escherichia coli injured by copper. AB - Escherichia coli injured by copper in carbonate buffer simulating the drinking water environment showed decreased oxygen utilization. Oxygraph measurements revealed that copper-injured bacteria had a rate of oxygen utilization that was less than 25% of that of control cells. Respirometry experiments measured rates over a longer period of time and showed similar trends. Nuclear magnetic resonance spectroscopy (13C nmr) and gas chromatography were used to identify differences in metabolism between healthy and injured populations of E. coli. The rate of glucose utilization by injured cells under anaerobic conditions was 64% of that of healthy cells. The rates of lactate and ethanol accumulation were 88 and 50% of the control, respectively. The 13C nmr studies of oxygenated cultures revealed differences in the accumulation of acetate and glutamine. Aerobic utilization of glucose and succinate by injured cells were 87 and 21% of the rate of the controls, respectively. Additional studies revealed injured cells had a decreased ability to reduce 2-(p-iodophenyl)-3-(p-nitrophenyl)-5 phenyltetrazolium chloride (INT) with a variety of carbohydrate substrates. Injured cells reduced greater quantities of INT than healthy cells when NADH was used as a substrate. A comparison of metabolic end products suggested that injured cells also had considerable differences in carbon flow compared with healthy cells. PMID- 3552167 TI - From Osler to Olafson. The evolution of veterinary pathology in North America. AB - Most branches of biological science in North America developed first in the United States, and later were taught and practiced in Canada. An exception was veterinary pathology, which as a discipline taught in veterinary colleges and as a field of research, developed first in Canada, and from there crossed the border to the United States. Pathology was first taught at the Montreal Veterinary College, founded in 1866 by Duncan McEachran, a graduate of the Edinburgh Veterinary College. From the outset, he formed a close association with the medical faculty of McGill University, permitting his students to attend the same classes in the basic subjects with the medical students. Eventually, the Montreal Veterinary College became formally affiliated with McGill University, as the Faculty of Comparative Medicine and Veterinary Science. The McGill veterinary faculty was forced to close for economic reasons in 1903, but it left an enduring legacy, particularly in the field of veterinary pathology. The legacy, a novel concept in the 1870's, was that pathology was the cornerstone of a veterinary education; the place where anatomy, physiology, chemistry and botany met with the clinical subjects, and gave the latter meaning. This tradition was formed at the Montreal Veterinary College by the world renowned physician William Osler, North America's leading medical teacher, whom McEachran had invited to teach at the College in 1876 in addition to his duties in the faculty of medicine. Osler had studied with Virchow in Berlin and applied his methods of autopsy technique and of scientific inquiry to his teaching of both human and veterinary pathology at McGill. Osler also undertook investigations into various diseases of domestic animals, at the request of McEachran, who doubled as Chief Veterinary Inspector for the Dominion Department of Agriculture. Osler left McGill University in 1884. Only after that year did other North American veterinary schools adopt pathology as a discipline of instruction. However, by 1884, Osler had already left his indelible imprint on the students (both medical and veterinary) he had taught in Montreal, one of whom took over the teaching of pathology in the veterinary college. Another, who followed Osler's example and also studied in Berlin with Virchow, wrote the first book in the English language on veterinary post mortem technique in 1889.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552169 TI - The demonstration of rabies antigen in paraffin-embedded tissues using the peroxidase-antiperoxidase method: a comparative study. AB - Mice experimentally infected with challenge virus standard rabies virus as well as skunks and foxes experimentally infected with street rabies virus were used to demonstrate rabies viral antigen in paraffin-embedded tissue by the peroxidase antiperoxidase method. Tissues fixed with different fixatives (10% formalin, Bouin's, acetone, ethanol) for various times and fresh frozen tissues were stained by the fluorescent antibody and the peroxidase-antiperoxidase method. Formalin- and Bouin's-fixed tissues were tested with and without use of digestive enzyme (pepsin). The results demonstrated that a procedure using formalin-fixed paraffin-embedded tissue treated with pepsin and stained by peroxidase antiperoxidase was the best method for both preservation of morphological details and demonstration of antigen. PMID- 3552168 TI - Avidin-biotin-peroxidase complex immunohistochemistry to detect immunoglobulin in formalin fixed skin biopsies in canine autoimmune skin disease. AB - Avidin-biotin-peroxidase complex immunohistochemistry was used on formalin fixed, paraffin embedded, trypsin digested, skin biopsies to detect immunoglobulin deposition in dogs with autoimmune skin disease. Immunostaining by the avidin biotin-peroxidase complex technique revealed intercellular and/or basement membrane immunoglobulin deposits in 27 of 28 dogs considered to have autoimmune skin disease by clinical and histological evaluation and in six of 19 dogs considered to have autoimmune skin disease by clinical evaluation but without histological confirmation. Similar immunostaining was not evident in five biopsies of normal skin or in biopsies from four dogs with noninflammatory dermatoses, but was present in biopsies from one of ten dogs considered by clinical and histological criteria to have an inflammatory dermatosis other than autoimmune skin disease. Detection of immunoglobulin deposits in skin biopsies by avidin-biotin-peroxidase complex immunohistochemistry offers numerous advantages over conventional immunofluorescence methods including the opportunity to precisely compare histological and immunological findings. PMID- 3552172 TI - Congress reassessing its priorities as health insurance emerges as hot topic. PMID- 3552170 TI - In vitro growth inhibition of mastitis pathogens by bovine teat skin normal flora. AB - One factor contributing to differences in the susceptibility of cows to mastitis may be differences in the teat skin normal flora, which could inhibit or enhance the growth of pathogenic bacteria. Using in vitro cross-streaking methods, we found that 25% of the isolates of teat normal flora of non-lactating heifers inhibited the growth of selected mastitis pathogens, but enhancers were not detected. Gram-positive pathogens were inhibited to a greater extent than Gram negative pathogens. Inhibition was not a characteristic of specific genera or species of normal flora, but rather a property of certain variants within a species. This phenomenon of inhibition of mastitis pathogens in vitro by normal flora may be useful as an in vivo biological control method to reduce the incidence of mastitis. PMID- 3552171 TI - Premenstrual mood changes in affective disorders. AB - Mood changes during the premenstrual phase have been the focus of considerable research in recent years. Although there has been significant progress in the diagnosis and etiology of major affective disorders, the relation between these disorders and menstrual changes remains controversial. There have been contradictory reports and speculations on women's susceptibility to psychiatric disorders during the premenstrual phase. We describe three patients with a history of mood swings associated with menstruation in whom major affective disorders developed, necessitating intensive psychiatric treatment or admission to hospital. Among women who manifest menstrual mood changes, manic-depressive illness may develop only in a subgroup with genetic predisposition. In such cases the possibility of postpartum mania or depression should be kept in mind in follow-up. PMID- 3552173 TI - The dilemma of isolated systolic hypertension. AB - Isolated systolic hypertension, characterized by elevated systolic blood pressure (greater than 150 to 165 mm Hg), normal diastolic blood pressure (less than 90 to 95 mm Hg) and, often, atherosclerosis, is now recognized as an important risk factor for cardiovascular disease. When the systolic pressure is 200 mm Hg or greater, or when it is 180 mm Hg or greater and accompanied by target organ damage, therapeutic intervention may be of value in patients under the age of 80 years. Low doses of thiazide diuretics have been shown to be safe and effective in lowering the systolic pressure. If the blood pressure remains high, treatment with methyldopa may be added. PMID- 3552174 TI - Remembering Dr. Kernohan: "She enjoyed helping people". PMID- 3552175 TI - Computers in health care: we're entering a new phase. PMID- 3552176 TI - The effect of cephalothin prophylaxis on postoperative ventriculoperitoneal shunt infections. AB - Postoperative infection is an important complication after insertion of a ventriculoperitoneal (VP) shunt in children with hydrocephalus. A randomized double-blind placebo-controlled study was performed to determine the efficacy of cephalothin in preventing postoperative shunt infection. Sixty-three children who presented for elective VP shunt insertion between January 1982 and December 1985 and who did not have a history of shunt infections were randomly assigned to receive four doses of prophylactic cephalothin, 25 mg/kg (32 patients), or of a multivitamin placebo (31 patients). Postoperative infection developed in 6% of the treatment group, compared with 10% of the placebo group, a difference that was not statistically significant, although a clinical significance may have been masked by the small sample size. A large multicentre trial is needed to determine the efficacy of antibiotic prophylaxis in reducing the incidence of postoperative VP shunt infections. PMID- 3552177 TI - Dr. Randy Gregg: operating with finesse, but in a different theatre. PMID- 3552178 TI - Bullous pemphigoid. PMID- 3552179 TI - Historical perspective of bullous pemphigoid. PMID- 3552180 TI - Immune complex-mediated complement activation in bullous pemphigoid. PMID- 3552182 TI - The molecular pathogenesis of bullous pemphigoid. PMID- 3552181 TI - Animal models for bullous pemphigoid. PMID- 3552183 TI - Childhood bullous pemphigoid. PMID- 3552184 TI - Bullous pemphigoid: disease of the aging immune system. PMID- 3552185 TI - Bullous pemphigoid. Therapy and management. PMID- 3552186 TI - Pemphigoid in domestic animals. PMID- 3552187 TI - Oral involvement in mucous membrane pemphigoid. PMID- 3552188 TI - Ocular pemphigoid. PMID- 3552189 TI - Cicatricial pemphigoid of upper digestive and respiratory tracts. AB - Cicatricial pemphigoid can no longer be considered a "benign" bullous disorder. The most critical lesions are those involving the larynx and esophagus. Endoscopy, biopsy, and culture are essential as early in the patient's course as possible. Surgical intervention might include tracheostomy or gastrostomy and possibly surgical rehabilitation of the airway. PMID- 3552190 TI - Cutaneous involvement in localized forms of bullous pemphigoid. AB - In summary, there is much overlap among the three types of localized cutaneous pemphigoid discussed. They all tend to affect the same age group, in general. They all may remain regional or be associated with a generalized eruption consistent with bullous pemphigoid. These three variants of subepidermal blistering disease also appear to be susceptible to koebnerization. Direct immunofluorescence findings are identical, as well, with linear IgG and C3 at the basement membrane. Indirect immunofluorescence tends to be negative for all three variants, with a tendency to positivity with increased extent and severity of skin involvement. There are differences, though, between them. BPP tends to affect men more than women, unlike BMMP-CP and localized cutaneous nonscarring BP. Localized cutaneous nonscarring BP usually involves the legs, whereas the other two conditions affect the head and neck, with resultant scarring. Histology is similar to that seen in BP, but dermal fibrosis and sclerosis result in skin affected by BMMP-CP and BPP. Localized cutaneous nonscarring BP is more amenable to topical steroid therapy, whereas BMMP-CP and BPP are more persistent and resistant to systemic immunosuppressive therapy. Clinical, histologic, and immunologic similarities among the pemphigoid variants may reflect common antigenic features. On the other hand, clinical, histologic, and immunologic differences may imply that there are more than one bullous pemphigoid antibody directed at a variety of antigenic structures. PMID- 3552192 TI - Bullous pemphigoid. Clinical features. PMID- 3552191 TI - Death in bullous pemphigoid. PMID- 3552193 TI - Pemphigoid and malignancy. PMID- 3552194 TI - Bullous pemphigoid: associated diseases. AB - Bullous pemphigoid is a fairly common chronic disease of elderly persons, many of whom have other medical conditions and problems. In the main, a search for commonly associated diseases is not warranted. PMID- 3552195 TI - Pathology of pemphigoid. AB - In summary, there is a wide range of pathologic alterations in pemphigoid lesions. Frequently, the pathologist is confident of the diagnosis on light microscopy alone. There are sufficiently similar findings in other conditions, however, to justify direct or indirect immunofluorescence or both in every case. This is particularly true as epidermolysis bullosa acquisita is being defined based on immunopathologic criteria and there is recognition of a broadening of the histologic spectrum of this disease, which includes cases that would have previously been designated bullous pemphigoid. PMID- 3552197 TI - Bullous pemphigoid and other basement membrane antigens. PMID- 3552196 TI - The immunopathology of bullous pemphigoid. PMID- 3552198 TI - The microcomputerized Diagnostic Interview Schedule: clinical use in an out patient setting. AB - While the validity of the Diagnostic Interview Schedule (DIS) is still controversial, enough data exists to support a trial in a clinical setting. A new microcomputerized version presents the diagnostic profile of the patient within minutes after the interview and reduces the possibility of errors in data collection and transcription, thus making the interview appropriate and available for widespread use. The present study examines the use of this instrument in a psychiatric out-patient department. Forty-one referrals to a psychiatric out patient department were assessed by each of two methods: the standard problem oriented non-structured clinical interview (NSI) and the microcomputerized DIS. The mean time taken for the DIS was 111.6 minutes, and patient acceptance of the microcomputerized format was high. The DIS provided a mean of 5.5 diagnoses per person compared to 2.56 for the NSI, but 31.7% of the patients had no clinically significant current DIS diagnosis. Approximately one-half the patients were assigned a diagnosis by the NSI which was beyond the 38 DSM-III diagnoses covered by the DIS. A comparison of the diagnostic results of both interviews reveals large differences in the group, and very little agreement in individual patients. The proportion of patients assigned diagnoses of substance abuse, affective disorder, psychosexual disorder, and personality disorders by each interview were quite different. Many of the patients diagnosed as having primarily Personality Disorder by the NSI were found to have an affective disorder by the DIS. The reasons for these differences and the resulting implications are discussed. This study supports the use of the microcomputerized DIS as a clinically useful adjunct to the diagnostic process. PMID- 3552199 TI - Serum antibody against Tamm-Horsfall protein in patients with renal cell carcinoma. AB - We assayed sera from 24 patients with metastatic renal cell carcinoma for class specific antibody against urinary Tamm-Horsfall protein (THP) using indirect solid-phase radioimmunoassay techniques. Overall, 16 patients had elevated antibody levels (greater than 2 SD above the mean levels of control subjects). IgG against THP was elevated in eight of the patients, IgA in 12, and IgM in five. However, THP was not identifiable by immunohistochemical techniques in the sections of 15 of 24 tumors available for study. Nine of the 15 tumors were from patients with elevated antibody levels. Serum antibody against THP in patients with renal cell carcinoma appears to result from antigenic stimulation by THP derived from the urine rather than from the neoplasm. PMID- 3552200 TI - A renal cell carcinoma neoplastic antigen detectable by immunohistochemistry is defined by a murine monoclonal antibody. AB - BALB/c mice were hyperimmunized with ACHN (ATCC CRL 1611, American Type Culture Collection, Rockville, Maryland), a stable in vitro cell line derived from a malignant pleural effusion in a 22-year-old man with renal cell carcinoma. The hyperimmune spleen cells were fused with NS-1 murine myeloma cells using polyethylene glycol. Hybridoma supernatants were screened for the presence of IgG reactive with detergent extracts of ACHN and nonreactive with detergent extracts of normal kidney tissue. A stable, rapidly growing clone named 5F4 was isolated. Supernatant from 5F4 was used as a primary antibody preparation for avidin-biotin complex immunoperoxidase staining of multiple cases of renal cell carcinoma, normal tissues, and other tumors. 5F4 produced IgG which reacted with a cytoplasmic structure in paraffin-embedded sections of all renal cell carcinomas tested. There was occasional, weak, granular, cytoplasmic staining of isolated tubular lining cells in adjacent normal kidney. PMID- 3552201 TI - Association in the expression of Kirsten-ras oncogene and the major histocompatibility complex class I antigens in fibrosarcoma tumor cell variants exhibiting different metastatic capabilities. AB - The metastatic properties of the methylcholanthrene-induced T-10 sarcoma tumor variants which originated in C3H x C57Bl/6 F1 mice are correlated with the relative expression of class I major histocompatibility complex antigens. Both the nonmetastatic and the highly metastatic clones were found to lack the H-2K region-controlled H-2Kb and H-2Kk antigens. However, the nonmetastatic clones express only the H-2Db molecule whereas the metastatic clones express both the H 2Db and the H-2Dk molecules. Transfection of the highly metastatic lines with cloned H-2K genes (Kb, Kk) reduced their tumorigenicity and abolished the formation of metastasis in syngeneic mice, while the transfection of the nonmetastatic lines with cloned H-2Dk genes resulted in shifting the cells to the metastatic phenotype. The present study is aimed to investigate the expression of protooncogenes in the T-10 fibrosarcoma lines that exhibit distinct metastatic properties in correlation with the expressed H-2 antigens. The major oncogene which showed differential expression in the T-10 clones is Ki-ras. The amounts of specific Ki-ras messenger RNA and the Ki-ras Mr 21,000 protein are expressed in elevated levels in the H-2Dk-negative nonmetastatic clones in comparison with a low level of expression in the H-2Dk-positive highly metastatic clones. Expression of H-2K antigens following transfection with cloned H-2K genes had no effect on the expressed Ki-ras oncogene in the T-10 clones. However, transfection of the nonmetastatic cells with the cloned H-2Dk gene resulted in shifting of the cells to a highly metastatic phenotype and in reduction of the expressed c-Ki-ras oncogene. PMID- 3552203 TI - Suppression of B16 melanoma lung colonization by syngeneic monoclonal antibodies. AB - Syngeneic monoclonal antibodies (MAbs) were produced to B16 melanoma by hybridization of spleen cells from B16-F1 or B16-F10 tumor-bearing C57BL/6J mice. Two antigens were identified by the immunofluorescence reactions of anti-F1 MAbs, 2G10 (IgG1) and 3C10 (IgM). Both antigens are membrane associated in 97-99% of fixed F1 and F10 cells and are cross-reactive with normal syngeneic thymocytes, and other normal and transformed cultured mouse cells. An anti-F10 Mab, 3E9 (IgG3), reacts with a membrane antigen found in about 40% of F1 and F10 cells and in all transformed mouse cells tested, but was not found in normal cells. The 3C10 and 3E9 antigens are shed into the medium of cultured cells. 125I-Labeled membrane components of Mr 48,000 and 40,000 (3C10) and 25,000 (3E9) were immunoprecipitated. Some 3C10 immunoprecipitates also contained components of Mr 25,000 and 15,000. The three MAbs were tested for suppression of lung colonization by B16-F1 and B16-F10 metastatic variants in C57BL/6J mice. MAbs were injected 1 day prior to and 1 week after injection of tumor cells. 2G10 was highly suppressive for both B16-F1 and B16-F10 cells. 3C10 and 3E9 were suppressive for B16-F10 cells but were nonsuppressive and enhancing for B16-F1 cells (P less than or equal to 0.05). A novel immunotherapy model was tested. Delayed hypersensitivity was selectively induced to the 3C10 MAb in C57BL/6J mice by sensitization with lipid-conjugated purified MAb. Sensitized mice were injected with B16 cells and MAb to determine whether a cellular reaction with cell bound MAb in vivo could be suppressive for tumor cells. The treatment was suppressive for B16-F1 lung colonies, but caused augmentation of lung colonies from B16-F10 cells (P less than or equal to 0.05). PMID- 3552202 TI - Regulation of estrogen and progestin receptor concentrations in an experimental rat prostatic carcinoma by estrogen, antiestrogen, and progesterone. AB - In order to assess prostatic tissue as a target for receptor-mediated estrogen action, we have examined the regulation of estrogen (ER) and progestin receptors (PgR) by estrogen, antiestrogen, and progesterone in cytosolic and nuclear fractions of the R3327H (Dunning) prostatic adenocarcinoma of the rat. Twenty micrograms diethylstilbestrol (DES) with or without 800 micrograms tamoxifen (Tam) were injected s.c. in oil 5 times weekly for 2 weeks. Controls were given oil only. Estrogen receptor assays were carried out using [3H]estradiol and a hydroxylapatite exchange method. Progestin receptors were assayed using [3H]R5020 and dextran-coated charcoal to separate free and bound steroid. All binding data were evaluated by using Scatchard analysis. Treatment with DES depleted cytosolic ER, promoted association of ER with the nuclear fraction, and concomitantly increased PgR concentrations in amounts proportional to nuclear ER. Treatment with Tam alone resulted in higher nuclear ER concentrations than treatment with DES, but induced only one-fifth the amount of PgR. Treatment with DES plus Tam resulted in similar nuclear ER concentrations as with Tam alone, but PgR concentrations were intermediate between those observed with DES alone and Tam alone. Thus Tam exhibited both estrogenic and antiestrogenic properties. In this experiment, the same cytosolic and nuclear extracts were also assayed for ER by using monoclonal antibodies to the receptor in an enzyme immunoassay. No significant differences were observed between the results obtained by the radioligand and enzyme immunoassay methods in the cytosol and nuclear fractions from the control and DES-treated tumors. However in both Tam-treated groups, the ER values obtained by the enzyme immunoassay method were significantly higher than those obtained by the radioligand method in both cytosolic and nuclear fractions. This confirms the observations made by others in female target organs, that monoclonal antibody to ER reacts differently with the Tam-bound ER complex than with the estradiol-bound ER complex. In a separate experiment, administration of progesterone with DES decreased the concentration of nuclear ER to less than one-half that observed after administration of DES alone, with proportional decreases in both cytosolic and nuclear PgR. All these observations indicate that the control of ER and PgR concentrations in this prostatic tumor is identical to that observed in female rat target organs. Use of an immunohistochemical method for the detection of ER in frozen sections indicated that the receptor was localized in the glandular epithelium in both control and DES-treated tumors. PMID- 3552204 TI - Plasma pharmacokinetics of cyclophosphamide and its cytotoxic metabolites after intravenous versus oral administration in a randomized, crossover trial. AB - Since cyclophosphamide is used by both oral and i.v. routes in the treatment of hematological and solid malignancies, we designed a randomized, crossover clinical trial to evaluate the pharmacokinetics of this anticancer agent after either administration route. Plasma levels of cyclophosphamide and its two cytotoxic metabolites, 4-hydroxycyclophosphamide and phosphoramide mustard, were determined in seven cancer patients randomly assigned to treatment initially with either orally or i.v. administered cyclophosphamide with a 30-day interim between alternate therapy courses. Oral treatment was used initially in five patients and i.v. treatment in two patients, and the pharmacokinetic parameter, area under the plasma disappearance curve, was determined for each metabolite in each patient for both routes of drug administration. Statistical comparison of area under the plasma disappearance curve values for this set of patients indicated no significant differences for either metabolite for oral versus i.v. drug treatment, suggesting equal efficacy for these two routes of cyclophosphamide administration. PMID- 3552206 TI - Induction of common patterns of polypeptide synthesis and phosphorylation by calcium and 12-O-tetradecanoylphorbol-13-acetate in mouse epidermal cell culture. AB - Terminal differentiation can be induced in cultured basal cells by either increasing the Ca2+ level in the medium from 0.05 to 1.4 mM or by exposure to the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). If Ca2+ and TPA act by a common mechanism, then a common pattern of protein synthesis and/or phosphorylation would be expected. Computer-assisted analysis of radioactively labeled polypeptides separated by two-dimensional-polyacrylamide gel electrophoresis was utilized to study protein synthesis and phosphorylation. Within 1 h of increasing the Ca2+ level in the medium, the synthesis of 57 polypeptides was altered by 2-fold or more. Similarly, exposure to TPA for 1 h affected the synthesis of 106 polypeptides. Sixteen polypeptides were affected by both Ca2+ and TPA; the synthesis of nine was increased and seven was decreased, with changes in the same direction for both effectors. By 4 h, the synthesis of 32 polypeptides was similarly modulated by both Ca2+ and TPA. Only one polypeptide which was increased at 1 h was still elevated at 4 h. These results suggest that a common dynamic program of protein synthesis, likely to be related to terminal keratinocyte differentiation, is induced by both Ca2+ and TPA. Overall phosphorylation of epidermal proteins was increased after 30 min of TPA treatment, but was not increased by Ca2+ at this time. Keratin polypeptides were heavily phosphorylated in low Ca2+ medium, but the level or pattern of phosphorylation of these proteins was not altered by either Ca2+ or TPA. Although phosphorylation of a minor polypeptide (pI 5.1/Mr 45,000) was increased 2-3-fold by both Ca2+ and TPA, most of the specific protein phosphorylation changes induced in keratinocytes by Ca2+ and TPA appear to be unique. Thus, if protein phosphorylation is an early signal for epidermal differentiation by each effector, only a single apparent common substrate is involved and multiple kinases are activated. Alternatively, substrate specificity of a single kinase may be differentially altered by each effector. PMID- 3552205 TI - Progressive formation of DNA lesions in cultured Ehrlich ascites tumor cells treated with hydroxyurea. AB - We have previously demonstrated an accumulation of strand breaks in mature DNA of cultured Ehrlich ascites tumor cells treated with methotrexate. We postulated that the strand breaks arose from unrepaired spontaneous DNA lesions. The present study describes a progressive accumulation of strand breaks in mature DNA of Ehrlich ascites cells treated with hydroxyurea (HU). Strand breaks were determined by alkaline elution. Accumulation of strand breaks was dependent on the length of incubation (0-16 h) and on HU concentration (0-10 mM). About 70% of strand breaks were repaired when cells were incubated without HU. About 67% of strand breaks were prevented by 0.4 mM deoxyadenosine, deoxyguanosine, and deoxycytidine, with or without thymidine. Prevention was less effective by deoxyadenosine and deoxyguanosine and ineffective by deoxycytidine. Free radical scavengers did not prevent strand breaks. S-phase cells accumulated about twice the number of strand breaks as non-S-phase cells. Cell survival decreased in proportion to the increase in HU concentration (0-10 mM). The results demonstrate that lack of purine, as well as of pyrimidine, nucleotides results in strand breaks in mature DNA, suggest that HU cytotoxicity is due to fragmentation of mature DNA, and caution against the use of HU in DNA repair studies. PMID- 3552207 TI - Coordinate polypeptide expression during hepatocarcinogenesis in male F-344 rats: comparison of the Solt-Farber and Reddy models. AB - The Solt-Farber resistant hepatocyte (RH) and Reddy (dietary peroxisome proliferator) hepatocarcinogenesis protocols were utilized to induce both preneoplastic and neoplastic nodules in male F-344 rats. Total cellular polypeptides from normal liver, ciprofibrate (CP)-induced and RH nodules were analyzed for both qualitative and quantitative changes using computer-assisted, high resolution two-dimensional polyacrylamide gel electrophoresis. Approximately 800-1000 cytosolic and 1000-1200 particulate polypeptides were readily separated and detected using an ultrasensitive silver stain. The two-dimensional polyacrylamide gel electrophoresis patterns were very similar for each tissue with respect to both the number of polypeptides detected and the overall patterns. Three cytosolic polypeptides, E, 6.90/47; F, 6.90/46; and G, 6.50/28 (designated pI/Mr X 10(-3], and two particulate polypeptides, B, 5.90/43; and D, 5.70/21; were detected in CP nodules but not in normal liver. Polypeptides B and D were also detected in RH nodules. No qualitative polypeptide differences were detected among the individual preneoplastic or individual neoplastic CP nodules or between preneoplastic and neoplastic CP nodules. Numerous quantitative changes in both known markers for hepatocarcinogenesis and in as yet unidentified polypeptides were noted. In RH nodules the Ya subunit of glutathione-S transferase B (GST-B) and the Yb subunit of GST-A were increased 2-4-fold as compared to normal liver or in replicating liver following a 70% partial hepatectomy, while in CP nodules the Yb subunit was unaltered and the Ya subunit increased 4-fold as compared to normal. The Yp subunits of GST-P were increased from almost nondetectable levels in normal liver to one of the most abundant cytosolic polypeptides in RH nodules. In contrast, the Yp subunits were not detected in any of the CP nodules either on the two-dimensional polyacrylamide gel electrophoresis gels themselves or following Western transfer and immunoblot analysis with antibody against GST-P. Two additional polypeptide spots, which may represent Yc charge shift variants, appeared at the same molecular weight as the constitutively expressed Yc subunit of GST-B but shifted one charge unit each toward the acidic region in CP nodules. DT-diaphorase which was increased 2-3 fold in RH nodules was unaltered in CP nodules. In addition to these changes in known markers, 34 (22 cytosolic and 12 particulate) polypeptides were significantly increased while 27 (12 cytosolic and 15 particulate) polypeptides were decreased during CP-induced hepatocarcinogenesis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552208 TI - Immunohistochemical study of the expression of a Mr 34,000 human epithelium specific surface glycoprotein in normal and malignant tissues. AB - Monoclonal antibody HEA125 was used to study the tissue distribution of an epithelial cell surface glycoprotein of Mr 34,000 (Egp34). A large panel of normal and neoplastic tissues was examined for immunoreactivity with HEA125 by means of a sensitive immunoperoxidase technique. HEA125 labeled most epithelial cell types throughout the body but did not label any nonepithelial tissue. Major exceptions were epidermal keratinocytes, gastric parietal cells, hepatocytes, thymic cortical epithelial, and myoepithelial cells. Normal mesothelial cells were unreactive. In normal glandular epithelia and tubular adenocarcinomas exclusively the basolateral cell membranes were stained. HEA125 intensely reacted with all tested carcinoma specimens derived from colorectum, stomach, pancreas, liver, lung, mammary gland, ovary, thyroid, kidney, urinary bladder, and prostate including a number of anaplastic, diffusely infiltrating carcinomas. Metastatic lesions of these tumors were consistently positive. Generally, the staining of tumor cells was very homogeneous. The majority of squamous cell carcinomas were less strongly labeled than adenocarcinomas; keratinizing areas of the tumor masses were negative. Germ cell tumors and mesotheliomas of epithelioid type focally expressed the antigen. Egp34 was found to be absent from sarcomas, lymphomas, melanomas, and neurogenic tumors. Hence, HEA125 is a useful reagent for the distinction of carcinomas from nonepithelial neoplasms, even at very low degrees of histological differentiation. Furthermore, HEA125 allows the immunohistochemical detection of micrometastases originating from carcinomas. The antigen is detectable in formalin-fixed paraffin sections. PMID- 3552209 TI - Immunocytochemical evidence for phorbol ester-induced directional translocations of protein kinase C in HL60, K562, CHO, and E7SKS cells: possible role in differentiation. AB - The effects of phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) on the directions of protein kinase C (PKC) translocation in two leukemic cell lines (HL60 and K562) and two fibroblastic cell lines (CHO and E7SKS), related to their susceptibility to the differentiating effect of TPA, were examined. Immunocytochemical evidence indicated that TPA induced a redistribution (outward) of PKC to the plasma membrane in TPA-sensitive HL60 cells, whereas it caused a translocation (inward) of the enzyme to the nucleus or the perinuclear region in K562, CHO, and E7SKS cells, which are resistant to TPA in terms of cell growth and differentiation. Immunoblot analysis of the nuclear proteins from K562 cells revealed that TPA induced an increase in the amount of immunoreactive proteins. TPA, however, did not increase the amount of these immunoreactive species in nuclei isolated from CHO and E7SKS cells, indicating that the translocated PKC was associated only with perinuclear structures of the TPA-treated cells. It is suggested that directional redistribution of PKC to the plasma membrane, as opposed to the nuclear and perinuclear region, might represent an early event required for the TPA-induced differentiation and maturation of HL60 cells. PMID- 3552210 TI - Expression of N-myc and c-src during the development of fetal human brain. AB - We studied N-myc RNA by in situ hybridization and S1 nuclease protection analysis in human fetal cerebrum, retina, lung, liver, and placenta during the second trimester. High levels of N-myc RNA were found in the early fetal cerebral germinal layer and the primordial cortex, with lower levels in the intermediate layer. After the twentieth week, N-myc expression declined in the attenuated germinal layer, remained high in the undifferentiated outer cortex, but declined in the differentiating inner cortex, which now expressed c-src. The primitive retina had high levels of N-myc RNA in the inner nuclear and ganglion cell layers between 12 and 21 weeks of fetal age. During this time, c-src RNA increased with fetal age in the ganglion cell layer. Lower levels of N-myc RNA were expressed in some cells of lung and placenta. Thus, appreciable N-myc RNA elevation is present in immature neural cells, disappears with differentiation, and may be unrelated to mitosis since high levels occur in the primordial cortex, which grows by accretion, and not by cell division. PMID- 3552211 TI - cis-Diamminedichloroplatinum(II)-induced DNA adducts in peripheral leukocytes from seven cancer patients: quantitative immunochemical detection of the adduct induction and removal after a single dose of cis-diamminedichloroplatinum(II). AB - The same four platinum-containing products identified in nucleolytic digests of DNA treated with cisplatin (cisDDP) in vitro now have been shown to be present in digested DNA originating from human cells after in vivo exposure. The immunochemical detection of these products at the fmol level became possible by the application of an existing and two newly raised rabbit antisera with specificities towards the various cisDDP-DNA derived products. In DNA isolated from white blood cells of a number of cancer patients treated with the drug for the first time, intrastrand cross-links on pGpG base sequences appeared to be the main adduct, followed by the intrastrand cross-links on pApG sequences, interstrand cross-links, and/or intrastrand cross-links on two guanines separated by one or more bases and a very low amount of monofunctionally bound cisDDP to guanine; typical proportions were 65, 22, 13, and less than 1%, respectively. The induction and removal of the main adduct, the intrastrand cross-link on pGpG sequences, have been studied in DNA from blood samples of six male patients after their first cisDDP treatment. The results indicate that the susceptibility of blood cells to cisDDP-DNA adduct formation can show strong individually determined differences. From the data it is also clear that a substantial part of the adducts is removed within the first 24 h after the cisDDP-infusion. PMID- 3552212 TI - 2,6-Diaminopurinedeoxyriboside as a prodrug of deoxyguanosine in L1210 cells. AB - The mode of action of the antiproliferative nucleoside analogue 2,6 diaminopurinedeoxyriboside (DAPdR) has been characterized in cultured L1210 cells. A marked concentration-dependent decrease in DNA synthesis and ribonucleotide reductase activity occurred in L1210 cells exposed to 0.05 to 1.0 mM DAPdR. Concomitantly, dGTP levels increased as much as 1100-fold as compared to untreated controls. Adenosine deaminase efficiently catalyzed DAPdR conversion to deoxyguanosine in vitro. In a comparative study, DAPdR and deoxyguanosine gave similar results. A 50% inhibition of cell growth during a 72-h incubation was achieved with 0.14 mM DAPdR or 0.26 mM deoxyguanosine. Deoxycytidine rescued the L1210 cells from DAPdR and deoxyguanosine toxicity to the same extent. DAPdR and deoxyguanosine counteracted the toxic effects of mycophenolic acid with the same efficiency. While DAPdR was not metabolized to its 5'-triphosphate, 2,6 diaminopurine was converted to 2,6-diaminopurineriboside 5'-triphosphate in L1210 cells; accordingly 50% inhibition of cell growth occurred at 0.015 mM 2,6 diaminopurine. Combinations of DAPdR with erythro-9-(2-hydroxy-3-nonyl)adenine or deoxycoformycin resulted in antagonism instead of an expected synergism. These data suggest that DAPdR exerts its toxicity on L1210 cells as a prodrug of deoxyguanosine. PMID- 3552213 TI - Reduction by caffeine of adriamycin-induced cell killing and DNA damage in Chinese hamster cells: correlation with modulation in intracellular adriamycin content. AB - The effect of caffeine, at concentrations between 10 microM and 20 mM was studied on Adriamycin-induced cytotoxicity and DNA damage in exponentially growing Chinese hamster V79 cells. Simultaneous administration of caffeine with 0.4 micrograms/ml (0.69 microM) Adriamycin for 1 h resulted in a concentration dependent reduction in cell killing. The surviving fraction increased from 0.001 for cells treated with Adriamycin alone to 0.14 for cells treated in the presence of 1 mM caffeine and to 0.8 for cells treated at caffeine concentrations higher than 6 mM. A significant reduction in Adriamycin-induced cell killing was also caused by caffeine at micromolar concentrations where the surviving fraction increased from 0.00076 to 0.0014 (2-fold) after treatment with 10 microM, to 0.0038 (5-fold) after treatment with 20 microM and to 0.01 (13-fold) after treatment with 100 microM caffeine. Treatment of cells with caffeine for 1 h immediately after Adriamycin exposure (0.4 micrograms/ml, 1 h) resulted in a dose dependent increase in survival as well, but the effect was smaller than that observed after simultaneous administration (increase in the surviving fraction from 0.003 to about 0.05 at concentrations higher than 5 mM). The reduction of Adriamycin-induced cytotoxicity by caffeine was reflected by a decrease in the slope of the survival curve, and it was similar over the entire range of Adriamycin and caffeine concentrations examined. The ability of cells to accumulate Adriamycin was reduced by caffeine from 43 ng/10(6) cells after treatment for 1 h in the presence of 0.5 micrograms/ml Adriamycin to 16 ng/10(6) cells for cells treated in the presence of 2 mM and to 8 ng/10(6) cells for cells treated in the presence of 10 mM caffeine. Induction by Adriamycin of DNA breaks, as assayed by the alkaline filter elution technique, was linear with concentration and was decreased in the presence of caffeine. The response to caffeine of Adriamycin-induced killing and DNA damage was similar, and it was only slightly different from the modulation induced in intracellular Adriamycin content. Compared to the effect of caffeine on cells exposed to ionizing radiations or other cytotoxic compounds, the results indicate an entirely different mode of caffeine action with anthracyclines. In addition, the results suggest caffeine-induced modulations in intracellular drug accumulation as an important determinant for the effect and may have useful implications in the clinical application of these compounds. PMID- 3552214 TI - A new in vitro model for investigation of tumor cell-platelet-endothelial cell interactions and concomitant eicosanoid biosynthesis. AB - We have developed a new in vitro model system to examine tumor cell-platelet endothelial cell interactions under dynamic conditions. Using the same model, we can determine endogenous eicosanoid metabolism and alterations in the prostacyclin-thromboxane A2 balance associated with interactions among tumor cells, platelets, and endothelial cells. The model consisted of cloned rat aortic endothelial cells grown on gelatin microcarrier beads under dynamic conditions (i.e., spinner culture). Interactions of these endothelial cells with platelets (heparinized rat platelet rich plasma) and/or tumor cells (rat Walker 256 carcinosarcoma) were assessed in an aggregometer. Gelatin beads alone or microcarrier grown endothelial cells did not elicit spontaneous aggregation of platelet rich plasma over a time period of 30 min. Microcarrier grown endothelial cells inhibited tumor cell induced platelet aggregation in a dose dependent fashion (i.e., depending on endothelial cell number). The ability of microcarrier grown endothelial cells to inhibit tumor cell induced platelet aggregation depended on endogenous production of prostacyclin. This conclusion is based on the following results: an increased number of microcarrier grown endothelial cells caused a prolongation of the aggregation lag time; an increased number of microcarrier grown endothelial cells caused a proportionate increase in 6-keto prostaglandin F1 alpha concentration; an increased number of microcarrier grown endothelial cells was inversely correlated with thromboxane A2 production by platelets; indomethacin pretreatment of microcarrier grown endothelial cells caused a decrease in prostacyclin production and therefore overcame the associated inhibition of tumor cell induced platelet aggregation; and the inhibition of tumor cell induced platelet aggregation in the presence of endogenous prostacyclin produced by microcarrier grown endothelial cells was the same as that observed in the presence of exogenous prostacyclin. Scanning electron microscopy of aggregometry samples revealed: little or no platelet or tumor cell adhesion to gelatin beads alone, a low basal adhesion of tumor cells to microcarrier grown endothelial cells, and large aggregates of platelets and tumor cells located primarily at gaps in the monolayer of indomethacin treated microcarrier grown endothelial cells. This new in vitro model provides a method for examining the effects of eicosanoid metabolism by endothelial cells on tumor cell-platelet-endothelial cell interactions under dynamic conditions. PMID- 3552215 TI - Analysis with monoclonal antibodies of the molecular and cellular heterogeneity of human high molecular weight melanoma associated antigen. AB - Monoclonal antibodies (MoAbs) 225.28, 657.9, and 902.5 recognizing distinct epitopes of the human high molecular weight melanoma associated antigen (HMW-MAA) were used to investigate the molecular and cellular heterogeneity of the HMW-MAA synthesized by human melanoma cells. Sequential immunodepletion and immunoprecipitation experiments showed that not all HMW-MAA molecules synthesized by a melanoma cell line express the antigenic determinants recognized by the three monoclonal antibodies. The majority of the HMW-MAA molecules expressed the epitope defined by MoAb 657.9 since this monoclonal antibody depleted the melanoma cell lysate of all antigen molecules recognized by the other two monoclonal antibodies. Depletion with MoAb 902.5 resulted in the removal of a large proportion of the HMW-MAA molecules precipitated by MoAb 657.9. The MoAb 225.28 depleted the cell lysate of only a fraction of the HMW-MAA molecules recognized by MoAb 657.9 and 902.5. Two-dimensional gel electrophoresis and peptide mapping analysis did not detect any significant difference among the HMW MAA immunoprecipitated by the three monoclonal antibodies. The heterogeneity of the epitopes recognized by the three monoclonal antibodies is, at least partly, due to glycosylation of the antigen molecule, since treatment of melanoma cells with glycosidases differentially affects their ability to bind the three anti-HMW MAA monoclonal antibodies. Fluorescent activated cell sorting analysis of the melanoma cells showed that the heterogeneity exhibited by the HMW-MAA is not due to the presence of different cell clones in the culture but reflects a differential distribution of epitopes on the HMW-MAA expressed on the surface of individual cells. Immunohistochemical staining of surgically removed benign and malignant lesions of melanocytic origin, of normal tissues, and of malignant lesions has shown a differential tissue distribution of the determinants recognized by the three monoclonal antibodies. Staining of melanoma cell lines and of surgically removed melanoma lesions with combinations of the three monoclonal antibodies did not cause any significant change of the percentage of stained cells but markedly increased the intensity of staining. These results indicate that combinations of monoclonal antibodies to distinct determinants of HMW-MAA can markedly increase the sensitivity of immunohistochemical techniques to detect melanoma cells. PMID- 3552216 TI - Adjuvant aminoglutethimide therapy for postmenopausal patients with primary breast cancer. AB - Three hundred and twenty-two postmenopausal patients with primary breast cancer and ipsilateral axillary node involvement were randomized to receive aminoglutethimide and hydrocortisone or placebo for 2 years in a double blind randomized trial between April 1980 and March 1985. Two hundred and eighty-six patients were eligible for the study of whom 145 received active drug and 141 received placebo. At the present time significantly fewer patients have relapsed or died without previous relapse in the treatment arm (P = 0.002); 43 of 145 (30%) patients receiving aminoglutethimide have relapsed or died compared with 63 of 141 (40%) of those receiving placebo. Local recurrence is also significantly reduced (P = 0.002) since only 6 patients receiving active treatment developed local recurrence compared to 21 receiving placebo. Side effects were severe enough to necessitate complete withdrawal or reduction of therapy in 27 of 145 (19%) in the treatment arm of the study compared with 21 of 141 (15%) in the placebo arm. A single treatment-related death occurred, due to agranulocytosis. Aminoglutethimide and hydrocortisone therefore delay relapse after surgery for primary breast cancer in postmenopausal women. It is too early to assess any effect on overall survival. PMID- 3552217 TI - Plasma monitoring of tricyclic antidepressants: defining the therapeutic range for imipramine in depressed children. PMID- 3552218 TI - Comparison of oral and intravenous treatment of depressive states: preliminary results of a WHO collaborative study. PMID- 3552219 TI - Antimanic effects of the calcium-antagonist D600. A double-blind placebo controlled study. PMID- 3552220 TI - Retinoids as preventive and therapeutic anticancer agents (Part II). PMID- 3552221 TI - Indicine N-oxide: clinical use of a pyrrolizidine alkaloid. PMID- 3552222 TI - Dietary fat and breast cancer. AB - This paper reviews the relationship between dietary fat and breast cancer. The incidence of breast cancer is discussed with regard to dietary habits, geographic location, and economic status. The roles of Trans-fatty acids and urinary as well as plasma estrone, estradiol (E2), estriol (E3), and estrogen are reviewed. Specific hypotheses are proposed to explain the relationship between fatty acid intake and breast cancer. PMID- 3552223 TI - Production of monoclonal antibodies for the immunohistochemical detection of gastric carcinomas. AB - About 700 antibody-secreting hybrids were obtained by fusion of lymphocytes, (harvested from mice hyperimmunized with the human gastric carcinoma line KATO III) and P3-X63-Ag8-653 myeloma cells. Antibody specificity was screened in ELISA performed on glutaraldehyde-fixed cultured cells and on paraffin-embedded tissue sections stained with the method of avidin-biotin-peroxidase. When tested in ELISA, the monoclonal antibody produced by the hybrid clone BD-5 was found to bind only to the cell line used as immunogen, among the many neoplastic or normal human cell lines tested. When assayed on paraffin sections with the avidin-biotin peroxidase method, the BD-5 monoclonal antibody stained gastric carcinomas, but not the normal mucosa. Pancreatic carcinomas were also stained, while the corresponding normal gland was not. The antibody strongly stained the normal colonic and small intestinal mucosa. Among the other normal or neoplastic tissues tested, a weak reactivity was observed only with some epithelial cells of the salivary glands and with some carcinoma cells of the uterus and of the lung. It is concluded that the BD-5 antibody reacts with an epitope normally present on intestinal mucosa, which, following neoplastic transformation, is ectopically expressed also on gastric and pancreatic carcinomas. This monoclonal could represent a useful reagent for histopathological diagnosis. PMID- 3552224 TI - Using a mesh framework for resin-bonded retainers. PMID- 3552225 TI - Fiorinal with Codeine in the management of tension headache: impact of placebo response. AB - The well-known difficulty in distinguishing the response to a combination headache medication and its individual components in the presence of a high placebo response was again demonstrated in a randomized, double-blind, placebo controlled, multi-center trial comparing Fiorinal with Codeine and its Fiorinal and codeine phosphate components in relieving the pain, tension, and muscle contraction associated with tension headache. In the original analysis of the study data, no distinction was apparent between patient response to Fiorinal with Codeine and the response to the individual components, a finding that appeared to conflict with the results of a similar earlier study. This apparent discrepancy was attributable to a high placebo response in the later study. Separation of study subjects according to their baseline level of anxiety and pain identified a subset of less anxious patients with mild to moderate pain severity who were least likely to respond to placebo. Analysis of data from these patients showed that Fiorinal with Codeine was significantly better than placebo in improving patients' self-ratings of various symptoms of tension headache at 0.5, 1, 2, 3, and 4 hours after ingestion of the study medication. The combination drug was also consistently superior to Fiorinal alone and codeine alone in improving the patients' self-evaluation items, and differences between the combination and its components were generally of statistical or borderline significance during the last half of the study. The investigators' assessments of the effect of treatment on the three principal variables in tension headache (namely, headache pain, psychic tension, and muscle contraction of the head, neck, and shoulders) at the final patient visit also showed Fiorinal with Codeine to be not only significantly superior to placebo but also consistently superior to either component. The superiority of the combination over Fiorinal alone achieved borderline significance for headache pain and psychic tension. PMID- 3552226 TI - An anticaries vaccine: report on the status of research. PMID- 3552227 TI - Changes in caries prevalence of Isle of Lewis children, a historical comparison from 1937 to 1984. PMID- 3552228 TI - Histochemical studies on the pancreas of dogs rescued by fetal liver cell transplantation after lethal total body X-irradiation. PMID- 3552229 TI - [Changes in biochemical parameters of the blood after experimental devitalization of the intestines]. PMID- 3552230 TI - [Dysentery. 100 years' since the important discovery of Prof. Jaroslav Hlava]. PMID- 3552231 TI - [100 years' since the founding of the 2d Internal Medicine Clinic of the School of General Medicine at Charles University in Prague. A brief history of the clinic based on the achievements of its chiefs]. PMID- 3552232 TI - Gonadotropin production and release in female goldfish (Carassius auratus) after administration of pimozide and an LHRH analogue as studied by electron microscopy and radioimmunoassay. AB - The effect of pimozide and an LHRH-analogue (LHRH-A) on gonadotropic cells of the goldfish pituitary gland were described qualitatively and quantitatively. A scale of four categories was devised to reflect various ultrastructural appearances of the cells. Experimental animals were divided into a control group, a group injected with LHRH-A alone, pimozide alone, and groups receiving these two substances in combination. Fish injected with the single substance were killed 12 h after injection while the groups receiving the combined treatments were killed at 4, 12 and 48 h. Serum levels of gonadotropin measured by radioimmunoassay were used to indicate whether an increase in hormone release had occurred. An immunocytochemical technique, the protein A-gold procedure, assured that the cells studied were gonadotropes. The control group showed variation in the profiles of gonadotropic cells. The single treatment groups showed some increase in secretory inclusions. At 4 h after injection the combined treatment caused a significant increase in hormone granules; at 12 and 48 h there was a gradual decrease in content of secretory products, and an increase in vacuolization. The results indicate that the combined pimozide and LHRH-A treatment stimulated gonadotropin production as well as release. PMID- 3552233 TI - Histological characterization of a monoclonal antibody raised against the branchial arches of the chick embryo: reactivity with myogenic lineages and a few non-mesodermal derivatives. AB - Monoclonal antibody A7H2 has been selected from a library of monoclonals raised against the branchial arch cells of 3-day-old chicken embryos, and its histological distribution was examined at different embryonic stages and levels. The immunoreactivity appeared during neurulation and was almost general in extraembryonic areas. As the embryo formed, A7H2-fluorescence disappeared from most tissues, but was concentrated in the splanchnomesoderm-derived smooth muscle lineages and epithelial linings of the coelomic cavity. A strong and durable reactivity was also observed in the myogenic condensations constituting the axis of the branchial arches, whereas myotomal cells of the differentiating somites were labelled more weakly and for a shorter time. Interestingly, non-mesodermal fluorescence was restricted to the branchial arch epithelium and some ectodermal placodes, to the thinning-out zones of the neural tube destined to form the choroid plexus, and to the pharyngeal and cloacal extremities of the digestive tract. PMID- 3552234 TI - Immunocytochemistry of GABA in the brain and suboesophageal ganglion of Manduca sexta. AB - We have used specific antisera against protein-conjugated gamma-aminobutyric acid (GABA) in immunocytochemical preparations to investigate the distribution of putatively GABAergic neurons in the brain and suboesophageal ganglion of the sphinx moth Manduca sexta. About 20,000 neurons per brain hemisphere exhibit GABA immunoreactivity. Most of these are optic-lobe interneurons, especially morphologically centrifugal neurons of the lamina and tangential neurons that innervate the medulla or the lobula complex. Many GABA-immunoreactive neurons, among them giant fibers of the lobula plate, project into the median protocerebrum. Among prominent GABA-immunoreactive neurons of the median protocerebrum are about 150 putatively negative-feedback fibers of the mushroom body, innervating both the calyces and lobes, and a group of large, fan-shaped neurons of the lower division of the central body. Several commissures in the supra- and suboesophageal ganglion exhibit GABA-like immunoreactivity. In the suboesophageal ganglion, a group of contralaterally descending neurons shows GABA like immunoreactivity. The frontal ganglion is innervated by immunoreactive processes from the tritocerebrum but does not contain GABA-immunoreactive somata. With few exceptions the brain nerves do not contain GABA-immunoreactive fibers. PMID- 3552235 TI - Receptors to agglutinin from Dolichus biflorus (DBA) at the synaptic basal lamina of rat neuromuscular junction. A histochemical study during development and denervation. AB - The binding of agglutinin from Dolichus biflorus (DBA) and other lectins (Concanavalin A, agglutinin from wheat germ and lectin from Bandeiraea simplicifolia) to synaptic and extrasynaptic portions of the basal lamina of muscle fibers, was studied with histochemical methods. In rat muscle, DBA-binding is specifically detected at the basal lamina of neuromuscular junction. However, long-term (6 months) denervated end-plate in adult rat muscle failed to bind DBA. During normal development, synaptic DBA receptors appear later than acetylcholine receptors or acetylcholinesterase at the rat neuromuscular junction. Generalized DBA-binding to motor end-plates is first visualized in 3-day-old rats, but section of sciatic nerve in 1-day-old rats prevents the appearance of synaptic DBA-binding on the leg end-plates. It is suggested, therefore, that the synaptic DBA receptors could be related to the postnatal stabilization of rat neuromuscular synapses. PMID- 3552236 TI - Connective tissue influences on the expression of epithelial cell-surface antigens. AB - Adult mice were found to show regional variation in the epithelial expression of some molecules of the blood-group antigen series. To investigate connective tissue influences on such differences, heterotypic recombinants of epithelia and connective tissues from various regions were prepared and examined using monoclonal antibodies directed against bloodgroup antigens H and Ley. The results indicate that epithelia may maintain a preexisting regionally specific pattern following recombination but that, in some recombinant matches, the connective tissue is capable of signalling redirection of the pattern of expression towards that typical of the epithelium with which it is normally associated. PMID- 3552237 TI - The distribution of nuclear progesterone receptor in the hypothalamus and forebrain of the domestic hen. AB - Cell nuclei containing progesterone receptor were identified immunohistochemically in the hypothalamus and forebrain of the domestic hen using an antiserum to the steroid binding "B" subunit (110 kDa) of chicken oviduct progesterone receptor and the avidin-biotin complex procedure. Cell nuclei containing progesterone receptor were widely distributed in the anterior, medial and basal hypothalamus with the highest density occurring in the lamina terminalis and the preoptic area. Abundant, though less intensely reacting progesterone receptor was present in cell nuclei in the tuberal infundibular area and in the internal zone of the median eminence. A large group of cell nuclei containing progesterone receptor occurred in the dorsal anterior hypothalamus between the anterior commissure and the lateral ventricle. This group of nuclei extended anteriorly into the telencephalon. A small number of cell nuclei containing progesterone receptor was also found in the ventral telencephalon in the region of the nucleus accumbens. PMID- 3552238 TI - Localization of melanotropin-like peptides in the central nervous system of two insect species, the migratory locust, Locusta migratoria, and the fleshfly, Sarcophaga bullata. AB - By use of well characterized antisera in the peroxidase-antiperoxidase method, we were able to demonstrate alpha MSH and beta MSH immunoreactive cells and nerve fibres within the nervous system of adults and larvae of Locusta migratoria and 3 , 5- and 8-day-old adult Sarcophaga bullata. In neither of these insect species, any immunoreaction was obtained with a gamma 3MSH-antiserum. Double immunohistochemical stainings revealed that alpha MSH-like and beta MSH-like substances are located in different cells. These cells show no immunoreactivity to a number of antisera against other POMC-derivatives (anti-beta lipotropin, anti beta endorphin, anti-ACTH1-24); thus they appear to contain alpha MSH- or beta MSH-like material in a specific way. The function of the immunologically detected peptides remains to be demonstrated. The distribution of the immunoreactive material suggests that, like in amphibians and other lower vertebrates, the synthesis or release of melanotropins might be under the influence of external stimuli. The present observations support the recently developed concept that even some of the smallest neuropeptides, the melanotropins, have been highly conserved during a long period of evolution. PMID- 3552239 TI - A fetuin-related glycoprotein (alpha 2HS) in human embryonic and fetal development. AB - The human plasma protein, alpha 2HS glycoprotein, has an amino acid composition very similar to that of fetuin, the major protein in fetal calf and lamb serum. Immunohistochemical studies of human fetuses (6-33 weeks gestation) showed that alpha 2HS glycoprotein and fetuin have similar distributions in developing brain and several other tissues, e.g., bone, kidney, gonads, gastrointestinal tract, respiratory and cardiovascular systems. There were notable differences in the liver and thymus in the distribution of the two proteins. Fetuin and alpha 2HS glycoprotein are present in plasma and cerebrospinal fluid of both human and sheep fetuses; their concentrations are reciprocally related: in human plasma and cerebrospinal fluid alpha 2HS glycoprotein concentration is high and fetuin low; the reverse is the case in sheep fetuses. Estimates of the concentration of alpha 2HS glycoprotein in human fetal cerebrospinal fluid and plasma were obtained. It is suggested that alpha 2HS glycoprotein may play a role in developing tissues, especially in the human fetus, similar to that of fetuin in other species. PMID- 3552240 TI - Neuropeptide Y: intrapancreatic neuronal localization and effects on insulin secretion in the mouse. AB - The intrapancreatic localization and the effects on basal and stimulated insulin secretion of neuropeptide Y (NPY) were investigated in the mouse. Immunocytochemistry showed NPY to be confined to intrapancreatic nerve fibers mainly associated with blood vessels. Fine varicose NPY fibers were also detected in the exocrine parenchyma and occasionally also within the islets. Double staining experiments with the use of antisera for both NPY and tyrosine hydroxylase (TH) indicated that most of the NPY fibers were nonadrenergic in nature. Only a population of the NPY fibers occurring around blood vessels showed TH immunoreactivity. Under in vivo conditions, NPY was found to elevate plasma insulin levels slightly when injected intravenously at the high dose level of 8.5 nmol/kg. At lower dose levels, NPY did not affect basal plasma insulin levels, but instead inhibited glucose-induced insulin secretion. Thus, the glucose induced increment in plasma insulin levels, which was 120 +/- 7 microU/ml in controls, was reduced to 87 +/- 5 microU/ml by NPY at 4.25 nmol/kg (p less than 0.01) and to 98 +/- 6 microU/ml by NPY at 1.06 nmol/kg (p less than 0.05). In contrast, the insulin secretory response to the cholinergic agonist carbachol was not affected by NPY. We conclude that NPY nerve fibers occur in the mouse pancreas and that most of these NPY nerve fibers are nonadrenergic. Furthermore, in the mouse, NPY enhances basal plasma insulin levels at high dose levels and inhibits glucose-induced, but not cholinergically induced insulin secretion at lower dose levels under in vivo conditions. PMID- 3552241 TI - Bipolarity of duodenal enterochromaffin cells in the rat. AB - Enterochromaffin cells of the rat duodenum have been studied immunocytochemically by use of a specific antiserum to serotonin. At the light-microscopic level serotonin immunoreactivity was observed in enterochromaffin cells located in the epithelium of the duodenal mucosa. Most of the serotonin-immunoreactive material was localized to the basal portion of the enterochromaffin cells, but small amounts of immunoreactive material were regularly observed in the apical portion. At the electron-microscopic level serotonin immunoreactivity in enterochromaffin cells was found to be concentrated over the dense cores of the cytoplasmic granules. The majority of these granules was located in the basal cytoplasm of the enterochromaffin cells, but serotonin-immunoreactive granules were also observed in the apical cytoplasm immediately beneath the microvilli. These observations indicate that duodenal enterochromaffin cells are bipolar and that they secrete serotonin both basally, to the circulation, and apically, to the gut lumen. Rat duodenal enterochromaffin cells thus appear to have an exocrine as well as an endocrine function. PMID- 3552242 TI - Immunocytochemical localization of S-100 protein in astrocytes and Muller cells in the rabbit retina. AB - The localization of S-100 protein was studied in histological sections of retinae from adult rabbits. By use of double-immunolabeling techniques it was shown that most but not all radially oriented vimentin-positive Muller cells were co-labeled by an antiserum to S-100 protein. Glial fibrillary acidic protein-positive astrocytes, which in the rabbit retina are restricted to the medullary rays formed by myelinated optic nerve fibers, consistently showed S-100 protein immunoreactivity. The present report shows that, with respect to S-100 protein staining, Muller cells represent a heterogeneous population of glial elements. PMID- 3552243 TI - Tropomyosin co-localizes with actin microfilaments and microtubules within supporting cells of the inner ear. AB - The distribution of tropomyosin, actin and tubulin in the supporting cells of the organ of Corti was studied by immunofluorescent localization of antibodies to these proteins. Tropomyosin colocalizes with actin and tubulin in the regions of the tunnel pillar and Deiters cells where actin microfilaments and microtubules had previously been observed ultrastructurally. Despite the implications of the presence of antiparallel actin filaments in the supporting cells, the presence of tropomyosin and the absence of myosin suggest that the role of tropomyosin may be to confer rigidity to the actin filaments. Thus the primary function of the cytoskeletal proteins in the supporting cells may be structural. PMID- 3552244 TI - Localization of neuropeptides in efferent terminals of the eye in the marine snail, Bulla gouldiana. AB - Like several other opisthobranch molluscs, the marine snail Bulla gouldiana possesses two circadian pacemakers, one in each eye. The two ocular pacemakers are mutually coupled such that: the circadian rhythms of spontaneous electrical activity recorded from the optic nerve are normally synchronous and; if experimentally desynchronized the rhythms will return to the synchronized state. This coupling of the pacemakers is mediated by efferent fibers in the optic nerve, terminating in neuropil adjacent to the basal retinal neurons (BRNs), the putative circadian pacemaker cells. Attempts to identify neurotransmitters in efferent terminals that may be involved in the coupling process have failed. In the present study we demonstrate axons in the optic nerve and axon terminals adjacent to the BRNs that exhibit FMRF-amide- (molluscan cardioexcitatory peptide) and NPY-like (neuropeptide-Y) immunoreactivity. The pattern of immunoreactivity to both antisera is identical. Blocking studies indicate that both antisera are recognizing the same site, most likely the arginine phenylalanine-amide terminus of FMRF, or an FMRF-like molecule. We conclude that FMRF is a candidate for the chemical mediator involved in the interaction between the two ocular pacemakers in Bulla gouldiana. PMID- 3552245 TI - The cytoskeleton of chick retinal pigment epithelial cells in situ. AB - Gelatin-coated slides were used to obtain en face preparations of retinal pigment epithelium (RPE) from 6- to 21-day-old chick embryos in order to study the distribution of F-actin in microfilaments (MF) and the MF-associated proteins, myosin, tropomyosin, alpha-actinin and vinculin in situ at different stages of development by fluorescence microscopy. The epithelial sheets were fixed in formaldehyde and then extracted in a solution containing 0.1% Triton X-100. NBD Phallacidin was used to visualize the F-actin in MF, and antisera against myosin, tropomyosin, alpha-actinin and vinculin were used to determine the distribution of these four MF-associated proteins. F-actin, myosin, tropomyosin, alpha-actinin and vinculin were present in cortical rings around the apical ends of the RPE cells throughout this period of development. Of these proteins, only F-actin was identified in the apical processes of RPE cells. The increase in the amount of F actin could be followed as the length and the number of apical processes increased with age and maturation of RPE cells. F-actin was first detected in numerous short apical processes on the surface of each RPE cell on day 12. From day 12 to day 17, they were at an intermediate stage of elongation and from day 17 onward all of the RPE cells had long F-actin-containing apical processes. These results indicate that the F-actin-containing MF assemble much later in the apical processes than in the cortical rings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552246 TI - Expatriate attitudes toward malaria prophylaxis in Zambia. PMID- 3552247 TI - Recognition of the TACTAAC box during mRNA splicing in yeast involves base pairing to the U2-like snRNA. AB - The U2 snRNP binds to the site of branch formation during splicing of mammalian pre-mRNA in vitro. In Saccharomyces cerevisiae the branch site is within the so called TACTAAC box (UACUAAC box), an absolutely conserved intron sequence required for splicing. Based on the identification and sequence of a U2 analogue in yeast, a specific base pairing interaction between the UACUAAC box and a highly conserved region of this snRNA can be proposed. To test this hypothesis, we have taken advantage of two mutations constructed previously in the UACUAAC box of an actin-HIS4 fusion. These mutant strains were transformed with stable plasmids bearing U2-like snRNAs into which changes predicted to restore base pairing had been introduced. Allele-specific suppression of biological and biochemical phenotypes was observed in both cases. Recognition of the UACUAAC box thus relies, at least in part, on Watson-Crick base pairing with the yeast U2 analogue. PMID- 3552248 TI - Determination of the yeast cell lineage. PMID- 3552249 TI - A ras-like protein is required for a post-Golgi event in yeast secretion. AB - Secretion is blocked at the post-Golgi stage within 5 min of a shift of sec4-8 cells from 25 degrees C to 37 degrees C. Analysis of SEC4 predicts a protein product of 23.5 kd molecular weight that shares 32% homology with ras proteins and is essential for growth. The regions of best homology are those involved in the binding and hydrolysis of GTP. Duplication of SEC4 suppresses post-Golgi blocked mutations in three sec genes. These mutations are lethal when combined with sec4-8 at 25 degrees C. Mutations that block elsewhere on the pathway are not suppressed by the SEC4 duplication and are not lethal when combined with sec4 8. We propose that the SEC4 product is a GTP-binding protein that plays an essential role in controlling a late stage of the secretory pathway. PMID- 3552250 TI - Free intermingling of mammalian beta-tubulin isotypes among functionally distinct microtubules. AB - Mammalian cells express a spectrum of tubulin isotypes whose relationship to the diversity of microtubule function is unknown. To examine whether different isotypes are segregated into functionally distinct microtubules, we generated immune sera capable of discriminating among the various naturally occurring beta tubulin isotypes. Cloned fusion proteins encoding each isotype were used first to tolerogenize animals against shared epitopes, and then as immunogens to elicit a specific response. In experiments using these sera, we show that there is neither complete nor partial segregation of beta-tubulin isotypes: both interphase cytoskeletal and mitotic spindle microtubules are mixed copolymers of all expressed beta-tubulin isotypes. Indeed, a highly divergent isotype normally expressed only in certain hematopoietic cells is also indiscriminately assembled into all microtubules both in their normal context and when transfected into HeLa cells. PMID- 3552251 TI - Cell cycle regulation of SW15 is required for mother-cell-specific HO transcription in yeast. AB - In haploid homothallic yeast, cell division gives rise to a mother cell that transiently transcribes the HO gene (as it undergoes START) and a daughter cell that does not. Consequently, only mother cells switch their mating types. Here, we test the proposition that a transcription factor called SWI5 is the "determinant" of mother-cell-specific HO transcription; that is, that SWI5 is the only factor missing in daughter cells. We show that SWI5 RNAs are cell-cycle regulated so that they are only produced after the post-START window of HO transcription. This regulation is vital for mother-cell specificity since constitutive transcription of SWI5 causes daughter cells to switch their mating types. We propose that SWI5 gene products are partitioned asymmetrically at cell division. PMID- 3552253 TI - An attempt to assay the state of determination by using transfected genes as probes in transdifferentiation of neural retina into lens. AB - Hybrid genes coding for chloramphenicol acetyltransferase (CAT) with a non specific retroviral, lens-specific delta-crystallin or lens-specific alpha crystallin promoters were constructed to transfect the transdifferentiating (lentoidogenic) and non-transdifferentiating (non-lentoidogenic) cultures of chicken embryonic neural retina for assaying the state of determination towards lens differentiation. The expression occurred only when CAT genes with lens specific promoters were transfected to the cultures maintained in the conditions permissive to lentoidogenesis. The expression of these exogenous, lens-specific CAT genes began at stages of culturing that were earlier than the expression of endogenous crystallin. Presumably, there are two steps in the transdifferentiation of neural retina into lens; acquisition of capacity to express crystallin genes and derepression of the endogenous crystallin genes. PMID- 3552252 TI - Importance of a fibroblastic support for in vitro differentiation of intestinal endodermal cells and for their response to glucocorticoids. AB - Microexplants of 14- or 15-day-old fetal rat intestinal endoderm, separated from mesenchyme by collagenase, were placed on culture dishes coated with different extracellular matrix components or on confluent monolayers of intestinal mesenchymal cells or of fetal skin fibroblasts. Only small variations in the attachment or spreading of the endodermal cells could be observed when they were cultured on the different acellular substrata, and their survival never exceeded one week. When cocultured with intestinal or skin fibroblasts, endodermal cells proliferated and the survival time was prolonged to 2 or 3 weeks. Furthermore, differentiation, as assessed by the polarization of the cells, occurred and was characterized by the maturation of apical brush borders and by the synthesis of microvillar digestive enzymes visualized immunocytochemically with monoclonal antibodies. Glucocorticoids accelerated structural differentiation and stimulated or induced brush border enzymes only in the coculture conditions. These experiments emphasize the role of a fibroblastic support without tissue specificity on the cytodifferentiation of intestinal endodermal cells. They also suggest a mesenchymal dependence on the hormonal response. PMID- 3552254 TI - The metrial gland. AB - The information available about the metrial gland of the pregnant rodent uterus with its content of granulated metrial gland (GMG) cells is reviewed. Recent research shows that GMG cells differentiate from bone marrow cells and supports the suggestion that GMG cells are involved in the immunological relationship between mother and foetus. There is probably a complex association between GMG cells and stromal cells of the metrial gland, and it is suggested that the association between GMG cells and the placental labyrinthine cells represents a functional interaction. PMID- 3552255 TI - Antireceptor antibodies in the study of EGF-receptor interaction. PMID- 3552256 TI - Monoclonal antibody analysis of skin in chronic murine graft vs host disease produced across minor histocompatibility barriers. AB - Chronic graft vs host disease (GVHD) across minor histocompatibility barriers was produced in BALB/c mice by the injection of spleen cells from B10.D2 mice. Changes in the skin were analyzed in frozen sections using a panel of monoclonal antibodies detected by immunoperoxidase methods. Compared to control animals, a number of changes occurred in the skin of animals with chronic GVHD. In the epidermis, there were increased numbers of Thy-1-positive dendritic cells; keratinocytes expressed Thy-1 and Ia antigens. T lymphocytes appeared in both dermis and epidermis. In the early stages, cells with "helper" and "suppressor" phenotypes were present, while at later times "helper" cells remained in the epidermis and "suppressor" cells remained in the dermis. Cells bearing markers of macrophages were prominent in both dermis and epidermis after the second week. Of great interest was the appearance of spindle-shaped cells in the dermis which expressed Thy-1 and Ia. These cells resembled fibroblasts which may be activated to produce the excess collagen seen in the skin of chronic GVHD. PMID- 3552257 TI - Reflexes elicitable in jaw muscles and their role during jaw function and dysfunction: a review of the literature. Part I: Receptors associated with the masticatory system. PMID- 3552258 TI - Recent concepts in bone grafting and banking. PMID- 3552259 TI - Identification of the 190 kD microtubule-associated protein in cultured fibroblasts and its association with interphase and mitotic microtubules. AB - We previously investigated the biochemical characteristics of microtubule associated proteins (MAPs) of the adrenal medulla and adrenal cortex and found that they contain a new kind of MAP with a molecular weight of 190,000 (190 kD MAP) as a major species (Kotani, S., H. Murofushi, S. Maekawa, C. Sato, and H. Sakai. Eur. J. Biochem. 156, 23-29, 1986). We now have used an affinity purified anti-(190 kD MAP) antibody and show by indirect immunofluorescent microscopy the association of this MAP with microtubules in situ in TIG-3 cells (human embryonic lung fibroblasts). The 190 kD MAP was present along the interphase and mitotic microtubules, and there was no marked difference between the staining pattern with anti-tubulin and that with anti-(190 kD MAP) antibodies, evidence that the localization of 190 kD MAP is not restricted to the subset of microtubules. We also isolated MAPs from TIG-3 cells and identified their 190 kD MAP as a major heat-stable component. Several other unidentified polypeptides were recovered in the MAP fraction specifically. PMID- 3552260 TI - Fish plasminogen activators: their identification and characterization. AB - Immunoblots of proteins extracted from the skin of a small viviparous fish (Xiphophorus) showed that a monoclonal antibody against human urokinase recognizes multiple molecular weight species of antigens. The immunoaffinity purified antigens had serine-protease activity for the hydrolysis of a chromogenic substrate and could convert human plasminogen to plasmin in a manner similar to that for human urokinase in vitro. Two antigens with apparent molecular weights of 55 and 50 kilodaltons that had been purified on a fibrin Celite column were separable on SDS-polyacrylamide gels and were characterized as major plasminogen activators on fibrin-agar indicator plates. The 125I-tryptic peptide maps of both antigens were similar to that of human urokinase; therefore, the fish activators and human urokinase are structurally and functionally related. PMID- 3552261 TI - Visualization of surface antigens on yeast protoplasts by gold or ferritin markers. AB - Surface antigens of Saccharomyces cerevisiae protoplast were visualized immunocytochemically with protein A-gold or ferritin conjugated antibodies. Ferritin particles were densely distributed at the surface of yeast protoplast after treatment with rabbit anti-protoplast serum and ferritin conjugated antibody against rabbit IgM. Control experiments demonstrated that the binding of these ferritin markers was specific for surface antigens. The composition of these surface antigens, however, remain to be investigated. PMID- 3552263 TI - Adhesion and growth of rat liver epithelial cells on an extracellular matrix with proteins from fibroblast conditioned medium. AB - We previously reported that proteins from serum-free conditioned medium (PCM) of rat embryo fibroblasts promote the adhesion of nonmalignant rat liver epithelial cells (RL34) seeded on a collagen substratum (Yamada, M. and Okigaki, T., Cell Biol. Int. Rep. 7, 1115(1983)). We now have compared the adhesion and growth of RL34 cells seeded on an extracellular matrix (RLECM), a product of RL34 cells, or on a collagen (type I) substratum with or without PCM in the medium. The adhesion rate for RL34 cells on RLECM was higher than on collagen, and once RL34 cells adhered to the collagen substratum they showed no growth, whether or not PCM was present. Cells that adhered to RLECM grew, and the growth rate was markedly higher in medium containing PCM than in medium without it. Immunological, enzymatic and chemical analyses revealed that the adhesion- and growth-promoting activities of RLECM involved trypsin-sensitive proteins other than collagens, fibronectin (FN) or laminin (LN), and that heparan sulfate proteoglycan may be a major component of RLECM. PMID- 3552262 TI - Distinct effects of Na+ and Li+ on the induction of morphological changes in A431 cells mediated by epidermal growth factor. AB - Epidermal growth factor (EGF) induced the formation of thin sheetlike extensions (lamellipodia) and filamentous extensions at the edges of colonies of A431 cells. To determine the necessary processes for the induction of the morphological changes mediated by EGF, the effects of a variety of ions on these changes were examined. In a NaCl solution supplemented with CaCl2, MgCl2 and glucose, no EGF induced morphological changes were observed. However, when the NaCl was replaced with LiCl, fingerlike extensions were formed, but sheetlike extensions were not. Addition of vanadate to the NaCl solution also induced fingerlike extensions in cells treated with EGF. In contrast, sheetlike lamellipodia were formed in EGF treated cells by the addition of K+ or PO4(3-) to the NaCl solution or by the addition of PO4(3-) to the LiCl solution. These findings indicate that Li+, K+, PO4(3-) and vanadate are involved in the processes of EGF-induced morphological changes. Since vanadate and Li+ have been shown to inhibit phosphatases, an EGF dependent phosphorylation step may play an important role in the induction of the morphological changes observed. PMID- 3552265 TI - [Galen, galenica, Galena--in the modern pharmaceutical vocabulary]. PMID- 3552264 TI - Growth cones in developing cultured cortical neurons. AB - Large numbers of growth cones were present in 6-day-old primary cultures of cerebral hemispheres from fetal rats. The average size of the growth cones was 24 by 28 microns. Many of these growth cones had both veil-like lamellipodia and filopodia. A few cones remained in 21-day-old cultures. These also had lamellipodia and filopodia. Ganglioside GM1 was present in both 6-day-old and 21 day-old cultured growth cones. PMID- 3552267 TI - [Idiopathic sterility--differential diagnosis]. PMID- 3552266 TI - [Preparation of the uterine cervix before induction of labor using the prostaglandin E2 (PGE2) vaginal tablet]. PMID- 3552268 TI - [Sodium transport mechanisms in the colon]. PMID- 3552269 TI - [Stress analgesia and opioid peptides]. PMID- 3552270 TI - [The life and work of Gustav Gellner, the founder of Czechoslovak-Soviet medical relations]. PMID- 3552271 TI - Toxicity, mutagenicity, intracellular drug concentration and DNA binding in Escherichia coli treated with cis-platinum(II) complexes. AB - The genotoxic effects of six cis-platinum(II)chloramine complexes with different alkyl substituents on their amine ligands have been measured using Escherichia coli. The toxicity and mutagenicity of these compounds were compared, after exposure of bacteria, to drug concentrations which gave known quantities of platinum-DNA lesions. The results permit several observations concerning structure-activity relations of platinum(II) complexes. Firstly, methyl substitution on the amine ligands of cis-diamminedichloro-platinum(II) (DDP) is reported to reduce its antitumor activity. The methyl group did not exert an effect in bacteria where the toxicity and mutagenicity of cis bis(methylamine)dichloroplatinum(II) and DDP were equivalent. In fact, at equal levels of DNA binding, complexes with substituted amines were generally more toxic toward bacteria than DDP. Secondly, replacement of the chloro groups of DDP by nitrato ligands increased its toxicity and mutagenicity at a given level of DNA binding. Hence, although DDP and its dinitrato derivative have identical ammine ligands, they may form different platinum-DNA lesions in bacteria. Finally, cis-bis(cyclohexylamine)-dichloroplatinum(II) was unique among the compounds studied since it did not cause bacterial filamentation or mutagenesis. These results suggest that, although this compound binds to the bacterial genome, it may not induce the SOS response. PMID- 3552273 TI - A new type of enzyme immunosensor using antigen-bound membrane and multivalent antibody (Fab'-alpha-amylase conjugate). PMID- 3552272 TI - Acute organophosphorus insecticide poisoning: a review. PMID- 3552274 TI - Studies on Fe complexes produced by yeast. I. Separation of Fe complexes from wine and their incorporation into hemoglobin in rats. PMID- 3552275 TI - [Trans-sphincteric approach by the Mason method in the local excision of neoplasms of the medium third of the rectum]. AB - The authors report on the trans-sphincteric access to the rectum according to Mason's technique for the local excision of rectal tumors. On the basis of their experience, they confirm that this technique is easy to perform and that it is reliable as regards preservation of anal continence. PMID- 3552276 TI - [Measurement of the thickness of the cornea using an ultrasonic pachymeter]. PMID- 3552277 TI - [Descemetopexy: apropos of 2 cases]. PMID- 3552278 TI - Definition of mixing rate of indicator by indicator dilution method: evaluation of relationship between mixing rate of indicator and cardiac output determination. AB - It is generally agreed that complete mixing of the indicator is one of the most important factors of the indicator dilution method, however, no clear definition of the mixing state has been established. We established a formula for the mixing rate of the indicator by the indicator dilution method, using the concept of entropy in the information theory, and compared the mixing rate of indocyanine green in one mixing chamber (left ventricle) with that in the two mixing chamber system (including the aortic system). The mixing rate of the indicator (M) is shown as M(%) = 100 H/Hcm = -100 (lk sigma ni = 1 Ci + log Ci + log k) (l & k: correction factors in each dye dilution curve, C: mean concentration of the indicator in the region). Left heart and aortic catheterizations by retrograde femoral and carotid artery approach were performed in five anesthetized dogs. Simultaneous dye dilution curves were recorded at the aortic root and at the bifurcation of the abdominal aorta, following the injection of indocyanine green (2.5 mg/1 ml of indocyanine green for each injection) by impulse into the left ventricle at the endsystole, triggered on the R wave of ECG, using the automatic injector devised by the authors. Twenty-five pairs of dye dilution curves were obtained by simultaneous recording in the aortic root and the abdominal aorta under several hemodynamic conditions, and the cardiac output, mean circulation time and the mixing rate of the indicator were determined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552279 TI - Activation of lymphocyte anti-tumour responses in man: effector heterogeneity and the search for immunomodulators. AB - Data continues to accumulate on the immunological reaction against solid human cancers. The evidence at the present time supports the view that rather than being immunologically invisible, tumour cell antigens are recognised by at least three lymphocyte subsets. Helper T cells can be induced to proliferate upon exposure to cells of the autologous tumour and to secrete detectable levels of interleukin 2 (IL-2). Cultured T cell lines and clones can be shown to respond in primed lymphocyte tests not only to autologous tumour cells but also to allogeneic tumour cells of the same histology and anatomic location. Cytotoxic T cells manifest specific reactivity against cells of the autologous tumour which is distinguishable from natural killing (NK) on the basis of specificity and organ distribution. Natural killer cells can lyse freshly isolated autologous tumour cells after purification on Percoll gradients or when activated by IL-2. There is thus a demonstrable heterogeneity of response to human cancer in unseparated lymphocyte populations and at the clonal level. In limiting dilution assays lymphocytes at the tumour site respond more frequently to autologous tumour relative to NK targets. For at least some tumours there is evidence that the expression of auto-tumour reactivity but not NK correlates with the clinical course of the disease and is a favourable prognostic indicator. The finding of these auto-tumour reactivities has important implications for the search for immunomodulating drugs for cancer treatment. However, it must be recognised that the response is heterogeneous and that the immune system comprises multiple interactive elements that exhibit both positive and negative control. Any treatment modality must take this into account and seek to focus on specific activation of the tumour lytic populations or the inhibition of negative regulatory elements as opposed to seeking a more general augmentation of immune reactivity which may, by stimulating suppressor cells, have a counterproductive effect. PMID- 3552282 TI - A comparison of Escherichia coli endotoxin single bolus injection with low-dose endotoxin infusion on pulmonary and systemic vascular changes. AB - The purpose of this study was to compare effects of single bolus endotoxin injection with sustained low-dose endotoxin infusion on systemic and pulmonary hemodynamics in anesthetized dogs. When administered as a bolus (.01 mg/kg), endotoxin induced systemic vascular changes whose evolution could be divided into two consecutive phases. In the early phase, marked hepatic venoconstriction caused a rise in portal pressure followed by abrupt decreases in both cardiac output and blood pressure. Mean pulmonary artery pressure remained unchanged. Because of lowered blood flow, both peripheral and pulmonary resistances increased. The rise in the latter was due to a prominent vasoconstriction of pulmonary arteries. Following a partial spontaneous recovery from shock, the late phase was characterized by a low-output state combined with high systemic vascular resistances. In contrast, when endotoxin was given at a slow infusion rate (250 ng/kg/min) over a 2-hour period of time, cardiovascular effects were basically different from the preceding ones, and they were measurable only after a certain period of time had elapsed from the start of endotoxin insult. First, blood pressure decreased gradually, while cardiac output remained almost unchanged. Therefore, peripheral resistance was decreased. Second, in the pulmonary circulation, the site of vasoconstriction was shifted from arteries to veins. We conclude that there is a fundamental difference in the response of the dog's systemic and pulmonary circulation as a function of endotoxin administration as either a bolus or slow infusion. This difference might be due to sudden elevated portal pressure responsible for an abrupt cardiovascular collapse in dogs subjected to bolus injection. PMID- 3552283 TI - An examination of the measurement of flow heterogeneity in striated muscle. AB - This review leads us to a number of conclusions and suggestions for further study. First, we find wide differences in the meaning of flow heterogeneity, arising as a result of the different methods used. These differences will have to be reconciled to form a comprehensive view of the role of heterogeneity in determining vascular function. Second, in the future, the meaning of heterogeneity must be clearly defined and related to a particular microvascular component, and it is imperative that the differences in scale of heterogeneity be appreciated when comparing data from various laboratories. These heterogeneities have different implications for function, and failure to distinguish among them leads to confusion. Third, the degree to which perfusion heterogeneity is regulated in the microcirculation remains in doubt. Reports of variations in flow heterogeneity in response to physiological stimuli are for the most part based on highly questionable indirect methods. Fourth, the heterogeneity that can be demonstrated at the capillary level within striated muscle does not appear to be large relative to the capacity for the microcirculation to exchange most diffusible solutes. Thus, the inferences regarding heterogeneity, as evidenced by diffusible indicators, are likely to be the result of different preparations, damage to the preparations, or perhaps large-scale heterogeneities in the tissue. An alternate possibility would be that the heterogeneity occurs at the microvascular level but reflects some other aspect of microcirculatory function, such as length or hematocrit heterogeneities, but not flow heterogeneities. Fifth, flow heterogeneity within microvessels implies important consequences for capillary exchange and tissue oxygenation. Heterogeneities of velocity of a magnitude comparable to those observed by direct visualization of microcirculation can clearly produce reductions in oxygen supply to small tissue regions of a degree that may limit oxygen delivery, and thereby, tissue function. Sixth, flow heterogeneity may also influence capillary hematocrit and/or red cell spacing by producing cell separation at bifurcations and a resultant reduction in mean capillary tube hematocrit. There is as yet no agreement on why and how these hematocrits influence tissue oxygenation and function. Although several hypotheses are advanced to explain the distribution of blood flow and red cells within microcirculation, each lacks a critical experimental test at present.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552284 TI - Myocardial contractile function during ischemia and hypoxia. AB - There is good evidence that elevated [Ca2+]i, produced by an influx of Ca2+ in exchange for Na+, is the underlying pathology in reperfusion or reoxygenation damage. Further measurements of [Na+]i and [Ca2+]i during ischemia and reperfusion, coupled with information about metabolic levels, are needed to confirm or refute this hypothesis. Contributions to cell damage by other mechanisms, e.g., oxygen free radicals, certainly cannot yet be excluded. PMID- 3552286 TI - [The malaria situation in China, 1985. Malaria Commission, Committee of Medical Sciences]. PMID- 3552285 TI - Serotonin as an alternative transmitter in sympathetic nerves of large cerebral arteries of the rabbit. AB - The distribution of serotonin (5-HT)-like immunoreactive (5-HT-LI) nerves and the potential role of 5-HT as a vasoconstrictor transmitter in large cerebral arteries of the rabbit were examined. 5-HT-LI fibers with weak immunofluorescence were observed in the anterior cerebral, middle cerebral, and basilar arteries when fixed by immersion after dissection from exsanguinated animals. The 5-HT-LI fibers, however, were not detected in these arteries when fixed either in vitro or in situ after first being perfused with Krebs solution in situ to flush the blood component from the lumen prior to dissection. In these arteries, 5-HT-LI nerve fibers with intense immunofluorescence, however, reappeared following incubation with 5-HT in vitro. The intensity of the 5-HT-LI fibers seemed to be proportional to the duration and 5-HT concentration during incubation. Following chronic surgical sympathectomy, 5-HT-LI fibers were not detected in arteries before or after incubation with 5-HT. Transmural nerve stimulation elicited constriction in 50% of the control arterial segments examined. The constriction was not affected by ketanserin but was prevented by guanethidine and chronic surgical sympathectomy. The remaining arterial segments that did not respond on transmural nerve stimulation, however, became constrictive on transmural nerve stimulation following incubation with 5-HT in vitro. The constriction was blocked by ketanserin and clonidine. These results demonstrate that the large cerebral artery of the rabbit brain has extremely sparse or no authentic 5-HT-LI nerves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552287 TI - [Integrated approach in malaria control including environmental management to reduce man-mosquito contact and the reduction of infection source in Huanghuai Plain]. PMID- 3552281 TI - N-methyl antitumour agents. A distinct class of anticancer drugs? AB - This article reviews the structure-activity characteristics, mode of action, pharmacokinetics and clinical utility of a group of chemically dissimilar antitumour agents which have as a common structural feature the N-methyl moiety. The importance of this feature is shown by the fact that molecules without a substituent on the nitrogen or compounds with N-alkyl groups other than methyl are usually inactive in experimental systems. This observation is supported by structure-activity studies with N-alkyl derivatives of s-triazines, triazenes, formamides, hydrazines and nitrosoureas. Representatives of these structural types which have found clinical application are, respectively, hexamethylmelamine, dacarbazine, N-methylformamide, procarbazine and streptozotocin. Mode of action studies have shown that dacarbazine, procarbazine and streptozotocin can give rise to species capable of methylating nucleic acid. This may be the lesion which produces antitumour activity. The mechanism of action of N-methylmelamines and N-methylformamide remains unclear. There is good evidence that, with the exception of N-methylnitrosoureas, host metabolism is prerequisite for activity with these agents. Although not pronounced, the clinical activity of N-methyl antitumour agents is useful, particularly as activity is not associated with severe haematological toxicity. Furthermore, responses may be observed in patients resistant to bifunctional alkylating agents. It is concluded that the drugs reviewed herein show a degree of coincidence in terms of their biological properties which may warrant a common classification. The term N-methyl antitumour agent is proposed. PMID- 3552280 TI - Tumor hypoxia: its impact on cancer therapy. AB - The presence of radiation resistant cells in solid human tumors is believed to be a major reason why radiotherapy fails to eradicate some such neoplasms. The presence of unperfused regions containing hypoxic cells may also contribute to resistance to some chemotherapeutic agents. This paper reviews the evidence that radiation resistant hypoxic cells exist in solid tumors, the assumptions and results of the methods used to detect hypoxic cells, and the causes and nature of tumor hypoxia. Evidence that radiation resistant hypoxic cells exist in the vast majority of transplanted rodent tumors and xenografted human tumors is direct and convincing, but problems with the current methodology make quantitative statements about the magnitude of the hypoxic fractions problematic. Evidence that radiation resistant hypoxic cells exist in human tumors is considerably more indirect than the evidence for their existence in transplanted tumors, but it is convincing. However, evidence that hypoxic cells are a significant cause of local failure after optimal clinical radiotherapy or chemotherapy regimens is limited and less definitive. The nature and causes of tumor hypoxia are not definitively known. In particular, it is not certain whether hypoxia is a chronic or a transient state, whether hypoxic cells are proliferating or quiescent, or whether hypoxic cells have the same repair capacity as aerobic cells. A number of new methods for assessing hypoxia are reviewed. While there are still problems with all of the new techniques, some of them have the potential of allowing the assessment of hypoxia in individual human tumors. PMID- 3552288 TI - [Opsonization and cytotoxicity of monoclonal antibodies against Plasmodium falciparum]. PMID- 3552289 TI - [Comparison of the effectiveness of two kinds of media for in vitro microtest of sensitivity of Plasmodium falciparum to chloroquine and mefloquine]. PMID- 3552290 TI - [Effects of qinghaosu on the surface structure of erythrocytes infected with Plasmodium berghei and the erythrocyte-free parasites]. PMID- 3552291 TI - [Ultrastructural study on the effect of pyronaridine on the erythrocytic stages of chloroquine-resistant strain of Plasmodium berghei]. PMID- 3552292 TI - [In vitro activity of chloroquine, two enantiomers of chloroquine, desethylchloroquine and pyronaridine against Plasmodium falciparum]. PMID- 3552293 TI - [Use of ELISA to the diagnosis and seroepidemiological survey of filariasis]. PMID- 3552294 TI - [AIDS and intestinal opportunistic protozoan infections]. PMID- 3552295 TI - Inhibition of prostacyclin and thromboxane A2 generation by low-dose aspirin at the site of plug formation in man in vivo. AB - In a double-blind placebo-controlled crossover study, we investigated in seven healthy male volunteers the effect of a low-dose aspirin regimen (35 mg acetylsalicylate per day for 7 days) on the formation of thromboxane A2 (TxA2) and prostacyclin (PGI2) in blood emerging from a standardized injury of the microvasculature made to determine skin bleeding time. When subjects were treated with placebo, there was rapid and substantial generation of TxA2 and PGI2 at the site of platelet-vessel wall interaction within the first 2 min after vascular injury. This was reflected by a greater than 100-fold and greater than 10-fold increase in thromboxane B2 (TxB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) in blood obtained from incisions made to determine bleeding time as compared with the corresponding plasma values. Low-dose aspirin caused a significant inhibition of both TxA2 and PGI2 generation in blood sampled from the skin incisions, represented by a 85% and 92% and 81% and 84% inhibition of TxB2 and 6-keto-PGF1 alpha, respectively, as compared with controls. We therefore conclude that rapid activation of both platelet prostaglandin metabolism and vascular PGI2 biosynthesis occurs at the site of platelet-vessel wall interaction, and low-dose aspirin results in a significant inhibition of both platelet and vascular cyclooxygenase activity. Thus, our data fail to confirm the concept of a differential effect of low-dose aspirin on platelet and vascular prostaglandin synthesis in man in vivo. PMID- 3552296 TI - Impairment of cardiopulmonary baroreflex after cardiac transplantation in humans. AB - There is ample evidence for efferent cardiac denervation in patients after cardiac transplantation. However, little is known regarding the effects of the cardiac deafferentation that also results. We examined responses to graded lower body negative pressure and thus cardiopulmonary baroreceptor unloading in 23 patients 3 to 12 months after cardiac transplantation and compared their responses with those of nine normal subjects. Responses of mean arterial pressure, forearm vascular resistance, and plasma norepinephrine were assessed during lower-body negative pressure and the cold pressor test. Reflex increases in forearm vascular resistance (1.5 +/- 1, 5.0 +/- 1.4, and 6.4 +/- 2.1 vs 14.5 +/- 4.5, 20.3 +/- 6.5, and 34 +/- 11 units) and plasma norepinephrine (42 +/- 12, 58 +/- 15, and 62 +/- 13 vs 49 +/- 14, 94 +/- 25, and 173 +/- 36 pg/ml) during lower-body negative pressure (at -10, -20, and -40 mm Hg) were strikingly smaller in cardiac transplant patients than in normal subjects. The impaired responses of the cardiac transplant patients were not the result of a nonspecific depression of cardiovascular reflexes, since increases in mean arterial pressure (12 +/- 3 vs 10 +/- 2 mm Hg), forearm vascular resistance (19.5 +/- 3.4 vs 18 +/- 5.8 units), and plasma norepinephrine (56 +/- 8 vs 42 +/- 11 pg/ml) during cold pressor test were not significantly different in the two groups. Furthermore, the impaired responses were not caused by the immunosuppressive agents used to treat the cardiac transplant patients, since patients with renal transplants on similar regimens had augmented forearm vasoconstrictor responses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552297 TI - Decreased prostacyclin biosynthesis preceding the clinical manifestation of pregnancy-induced hypertension. AB - Patients who develop pregnancy-induced hypertension exhibit a lesser increment in prostacyclin biosynthesis than healthy pregnant subjects. Whether this precedes the development of clinical disease and therefore may be important in the pathogenesis of pregnancy-induced hypertension or is a secondary event is unknown. We prospectively determined prostacyclin biosynthesis in pregnant subjects at risk of developing pregnancy-induced hypertension by use of noninvasive approach, measurement of the urinary metabolite 2,3-dinor-6-keto prostaglandin F1 alpha. Patients were recruited at less than 20 weeks gestation. After delivery, patients were retrospectively allocated by use of preset criteria, to one of four groups: pregnancy-induced hypertension (n = 12), hypertension in labor (n = 22), chronic hypertension (n = 9), and normotension (n = 24). There was a significant increase in prostacyclin biosynthesis in all study groups during gestation. However, patients who developed pregnancy-induced hypertension exhibited a lesser increment and this difference persisted throughout gestation. These results are consistent with a pathophysiologic role for altered prostacyclin biosynthesis in women with pregnancy-induced hypertension. In addition, decreased prostacyclin formation identifies a population at risk of developing pregnancy-induced hypertension. Such information would assist the design of clinical trials of drugs, such as aspirin, that might prevent the development of this disease. PMID- 3552298 TI - Survival of patients with congestive heart failure: past, present, and future prospects. AB - Over the past several decades, pharmacologic advances have made it possible to markedly alleviate symptoms in most patients with congestive heart failure. However, the prognosis for these patients remains poor. Five years after the onset of congestive heart failure, only approximately 50% of patients are alive; when cardiac failure develops after myocardial infarction mortality is even higher. Survival rates are only 40% to 60% after 1 year in patients with advanced symptoms who are followed in referral centers. Thirty to fifty percent of deaths are sudden and unexpected. Mortality is highest in patients with severe or progressive symptoms, but it appears to be unrelated to the cause of heart failure or its duration. In general, rate of survival is lowest in patients with the most severe depression of left ventricular function, but no hemodynamic index is capable of providing prognostic information in individual patients. Survival is also reduced in patients with frequent ventricular arrhythmias, marked electrolyte disturbances, and elevated plasma catecholamines, but again, none of these measurements are powerful discriminators between survivors and nonsurvivors. A number of pharmacologic and other interventions have the potential to alter the prognosis of congestive heart failure, either by improving or perhaps even by worsening survival. The pooled data from several short-term controlled trials have raised the possibility that the angiotensin converting enzyme inhibitors may have a beneficial effect on survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552299 TI - Why patients with heart failure die: hemodynamic and functional determinants of survival. AB - The high mortality of heart failure is associated with hemodynamic abnormalities, depressed cardiac function, and reduced exercise capacity. That these factors can be modified by drug treatment is of potential prognostic significance. Hemodynamic variables are related to survival, and long-term prognosis is better in patients with only midly abnormal cardiac output or ventricular filling pressures. Indexes of left ventricular function such as ejection or shortening fraction tend to be higher in patients who survive for longer periods. The relation between exercise capacity and survival, however, is unclear. Those patients with severe exercise intolerance (maximal oxygen uptake below 10 ml/min/kg) or with severe symptoms are at great risk of dying. However, exercise capacity and functional class are not related to prognosis when all classes of patients are considered together, especially if class IV patients are excluded. Most of the available data derive from retrospective analyses of trials involving heterogeneous patient populations and aimed at improving left ventricular performance or functional capacity. Large prospective trials aimed primarily at affecting mortality in a broad spectrum of patients are needed to learn more about determinants of survival in heart failure. PMID- 3552300 TI - Why patients with congestive heart failure die: arrhythmias and sudden cardiac death. AB - Patients with congestive heart failure have a high incidence of sudden cardiac death that is attributed to ventricular arrhythmias. The mortality rate in a group of patients with class III and IV heart failure is about 40% per year, and half of the deaths are sudden. Half of the patients with New York Heart Association class III or IV heart failure have unsustained ventricular tachycardia detected on a 24 hr continuous electrocardiographic recording. The presence of ventricular tachycardia in patients with congestive heart failure increases the probability of dying; in class III or IV heart failure, the presence of unsustained ventricular tachycardia on a 24 hr continuous ECG recording increases the odds of dying about threefold over a 1 to 2 year follow up period. Many electrical, mechanical, humoral, and electrolyte abnormalities may promote ventricular arrhythmias in patients with heart failure. Correction of these predisposing factors could reduce the risk of lethal ventricular arrhythmias and therefore every effort should be made to do so. Because there has been no definitive study of the impact of antiarrhythmic drug treatment on the survival of patients with heart failure and ventricular arrhythmias, the role of therapy with antiarrhythmic drugs remains uncertain at the present time. PMID- 3552301 TI - Medical treatment of congestive heart failure: where are we now? PMID- 3552303 TI - Survival in congestive heart failure during treatment with drugs with positive inotropic actions. AB - Retrospective studies have shown that patients with severe chronic heart failure who receive long-term treatment with positive inotropic agents have a high mortality rate, but in the absence of controlled trials it remains unclear whether the high incidence of fatal cardiovascular events in these patients is related to treatment or to the severity of the underlying disease. Most of the evidence that suggests a detrimental effect of positive inotropic therapy on survival remains circumstantial. The pooling of data from long-term studies of patients after an acute myocardial infarction suggests that use of digitalis may be associated with an unfavorable effect on survival. The prolonged administration of intravenous or oral catecholamines is associated with a high mortality rate, which may not be seen in similar patients treated conventionally. The presence of intrinsic sympathomimetic activity appears to neutralize the benefits of beta-blockade during the first year after an acute myocardial infarction; treatment with such agents after the first year may increase mortality. Long-term treatment with phosphodiesterase inhibitors is associated with a high mortality rate, which exceeds that reported in earlier years with vasodilator therapy. Nevertheless, most of these studies of positive intropic agents were not performed to evaluate the issue of survival and did not randomly assign patients to treatment groups. Hence, we do not know that the patients entered into these studies were truly comparable to their proposed control groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552302 TI - Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure: influence of prerandomization variables on the reduction of mortality by treatment with hydralazine and isosorbide dinitrate. AB - The Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure was designed to determine whether vasodilator drugs could alter the survival of patients with chronic congestive heart failure treated with digoxin and diuretics. Among the 642 patients entered into the study, 273 were randomly assigned to placebo, 186 were randomly assigned to the combination of hydralazine and isosorbide dinitrate, and 183 patients were randomly assigned to prazosin; all patients were followed for periods ranging from 6 months to 5.7 years. Treatment with hydralazine-nitrate produced a 28% reduction in mortality compared with that in patients receiving placebo (95% confidence interval, 3% to 46%), whereas prazosin exerted no apparent beneficial effect. Data were further examined to determine if any baseline variables had an impact on the response to treatment. Mortality in the placebo group was higher in those with coronary artery disease, with a history of antiarrhythmic drug use, and with values lower than the median for ejection fraction and exercise tolerance. A reduction in mortality with hydralazine-isosorbide dinitrate was observed in all of the above pairs of subgroups as well as in those above and below 60 years of age and those with and without a history of hypertension or excess alcohol ingestion. The benefit of hydralazine and isosorbide dinitrate was particularly prominent in younger patients with a lower ejection fraction and those with a history of hypertension and without an alcoholic history.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552304 TI - Use of antiarrhythmic drugs in patients with heart failure: clinical efficacy, hemodynamic results, and relation to survival. AB - Patients with chronic heart failure have a high incidence of both complex ventricular arrhythmias and sudden death. Therefore administration of antiarrhythmic agents to these patients to prevent lethal ventricular arrhythmias is theoretically appealing. However, at present there are no prospective randomized studies supporting this approach, whereas retrospective studies have yielded conflicting results. Moreover, the use of antiarrhythmic agents in patients with heart failure has two potentially serious side effects: worsening of ventricular pump function and exacerbation of ventricular arrhythmias. Such information suggests that the use of antiarrhythmic agents to treat patients with heart failure who do not have symptomatic ventricular arrhythmias is currently not indicated. PMID- 3552305 TI - Recent advances in the identification of patients at risk of ventricular tachyarrhythmias: role of ventricular late potentials. PMID- 3552306 TI - Quantitative analysis of narrowings of intramyocardial small arteries in normal hearts, hypertensive hearts, and hearts with hypertrophic cardiomyopathy. AB - To clarify the pathophysiologic role of intramyocardial small artery (IMSA) diseases in hypertrophied hearts, narrowings of the IMSA were quantitatively evaluated in 39 autopsied hearts, 10 from patients with typical hypertrophic cardiomyopathy (HCM), four from patients with HCM showing features mimicking dilated cardiomyopathy (DCM-like HCM), 10 from patients with hypertension, and 15 from normal adults. The relations of narrowings of the IMSA to myocytic hypertrophy, myocardial fiber disarray, and fibrosis were also examined. The external caliber and the ratio of the luminal area to the total vascular area (percent luminal area, % lumen) were calculated by an image analyzer in 85 to 203 IMSAs from each patient. The external calibers of the IMSAs were similar among groups of hearts with HCM, hypertensive hearts, and normal hearts but were greater in those with DCM-like HCM. The mean % lumen of the IMSAs was similarly reduced in the hearts with HCM (29 +/- 5% in the ventricular septum and 31 +/- 5% in the left ventricular free wall) and in hypertensive hearts (30 +/- 8% and 31 +/- 7%) compared with that in normal hearts (40 +/- 5% and 38 +/- 5%) and was the lowest in the ventricular septum of hearts with DCM-like HCM (17 +/- 3%). The mean % lumen of the IMSA was inversely correlated with heart weight (r = -.59), the mean size of myocytes (r = -.66 in the ventricular septum, r = -.63 in the free wall), and percent fibrotic area in the septum (r = -.68). The mean % lumen values of the IMSAs in the tissues with and without disarray in the hearts with HCM were similar. Thus IMSA disease is of pathophysiologic importance in patients with HCM, DCM-like HCM in particular, or with hypertension. PMID- 3552307 TI - Cardiac morbidity and mortality due to Chagas' disease: prospective electrocardiographic study of a Brazilian community. AB - The evolution of Chagas' cardiomyopathy is poorly understood. We therefore examined the development of cardiac lesions in a rural Brazilian community for a period of 7 years. Initially, 42% of 1017 residents were seropositive for infection with Trypanosoma cruzi. Age-specific infection rates indicated that most had become infected before the age of 20 years. On follow-up, it appeared that those persons who developed cardiac lesions did so soon after infection, since the incidence of right bundle branch block and other ventricular conduction defects (VCDs) was also highest before age 20 years. The progressive nature of these lesions was demonstrated by frequent development of additional electrocardiographic abnormalities and high mortality among infected adults with VCDs. In contrast, mortality was low and approximately the same for seropositive and seronegative adults under 60 years who had normal electrocardiograms. Electrocardiography during the early asymptomatic stage of infection was able to distinguish persons with potentially lethal cardiac lesions from those with a benign prognosis. PMID- 3552308 TI - Does the quantitative assessment of coronary artery dimensions predict the physiologic significance of a coronary stenosis? AB - To study the relationship between the quantitatively assessed coronary artery dimensions and the regional coronary flow reserve as measured by digital subtraction cineangiography, we investigated 17 coronary arteries with a single discrete proximal stenosis and 12 normal coronary arteries before and after intracoronary administration of papaverine. Coronary flow reserve was found to be curvilinearly related to minimal luminal cross-sectional area (r = .92, SEE = 0.73) and to percentage area stenosis (r = .92, SEE = 0.74). Normal coronary arteries had a coronary flow reserve of 5.0 (+/- 0.8 [SD]), which differed significantly from the coronary flow reserve of the coronary arteries with obstructive disease, in which values ranging from 0.5 to 3.9 were found. Coronary arteries with a percentage area stenosis between 50% and 70% and a minimal luminal cross-sectional area between 2 and 4.5 mm2 differed significantly (p = .001), with respect to the coronary flow reserve, from coronary arteries with a percentage area stenosis in excess of 70% and a minimal luminal cross-sectional area less than 2 mm2. With the use of hemodynamic equations that describe the pressure loss over a stenosis, a theoretical pressure-flow relationship can be inferred that characterizes the severity of the stenosis. Based on this theoretical pressure-flow relationship, coronary arteries that have a limited coronary flow reserve and critical stenosis (distal coronary perfusion pressure below 40 mm Hg at coronary flow of 3 ml/sec) can be identified with high sensitivity (83%) and specificity (82%). Thus, in coronary artery disease the consequent reduction in coronary flow reserve can be predicted with reasonable accuracy by quantitative assessment of coronary artery dimensions. PMID- 3552309 TI - Cardiovascular and risk factor evaluation of healthy American adults. A statement for physicians by an Ad Hoc Committee appointed by the Steering Committee, American Heart Association. AB - Cardiovascular disease is the major cause of death in American adults. The chief form of cardiovascular disease is coronary heart disease (CHD). Prevention of CHD depends on the identification of risk factors in asymptomatic individuals. The American Heart Association recommends that all adults be examined periodically for the presence of silent cardiovascular disease and coronary risk factors. The major risk factors for CHD are smoking, high blood pressure, and high blood cholesterol. Additional factors associated with CHD are high blood triglycerides, reduced levels of high-density lipoproteins, diabetes mellitus, obesity, sedentary lifestyle, and certain behavioral characteristics. Available data suggest that the predominance of CHD among Americans can be attributed to these risk factors, and increasing evidence indicates that appropriate modification of these factors will markedly reduce coronary risk. The purpose of this report is to identify the risk factors, indicate their relation to coronary disease, and recommend an approach to their detection in adults during periodic health examinations. PMID- 3552310 TI - Treatment of angina pectoris and hypertension with sustained-release calcium channel-blocking drugs. AB - Sustained-release diltiazem (D-SR) and sustained-release verapamil (V-SR) when given twice a day have been successfully used to treat both essential hypertension and angina pectoris. Review of available studies indicates that 120 to 180 mg D-SR twice a day and 240 mg V-SR once or twice a day can lower diastolic pressure in 40% to 80% of patients with essential hypertension and that the drugs may be especially useful in patients with low-renin hypertension such as elderly and black populations. D-SR and V-SR prolong treadmill capacity and reduce frequency of angina in patients with stable effort angina. Improvement is mediated primarily by a reduction in resting and submaximal exercise heart rate. Biopharmaceutics of D-SR and V-SR feature a prolonged apparent plasma half-life and reduced peak-to-trough plasma concentration ratios during steady-state dosing. PMID- 3552311 TI - Secondary prevention with calcium channel-blocking drugs in patients after myocardial infarction: a critical review. AB - The rationale for evaluating the efficacy and safety of calcium entry-blocking drugs to prevent secondary complications in patients after myocardial infarction is presented. The data currently available from postinfarction trials involving verapamil, nifedipine, and diltiazem are critically reviewed, and a comparison of the findings from three major trials of calcium entry-blocking drugs is provided. PMID- 3552313 TI - Comparison of calcium-entry blockers and diuretics in the treatment of hypertensive patients. AB - This review compares the calcium antagonists with diuretics in the management of mild-to-moderate essential hypertension. The antihypertensive efficacy of calcium antagonists appears comparable to that of oral diuretics such as hydrochlorothiazide when used as monotherapy. Peripheral vascular dilation appears to be the principal mechanism of the long-term blood pressure-lowering effects of both calcium antagonists and diuretics. Peripheral vasoconstrictor responses to cardioreflex-mediated sympathetic nervous system activation is attenuated by calcium antagonists but not by diuretics. Long-term calcium antagonist therapy is generally not associated with reflex activation of the sympathetic nervous system or of the renin-angiotensin-aldosterone axis, whereas diuretic therapy results in considerable activation of the renin-angiotensin aldosterone system. Calcium antagonists appear to have a greater beneficial effect than diuretics with respect to maintenance of renal blood flow and glomerular filtration rate. Calcium antagonists, because of their effects on coronary blood flow and heart rate-blood pressure product, offer advantages over diuretics in the treatment of hypertensive patients with concomitant ischemic heart disease. Metabolic abnormalities associated with diuretic antihypertensive therapy, such as hypokalemia, hypercalcemia, hyperuricemia, lipid changes, and hyperglycemia, are generally not observed with calcium antagonists. Many of these deleterious metabolic changes observed with diuretic therapy may be minimized by the use of smaller doses of these agents than have generally been employed in the past. Diuretics are less expensive and require less frequent dosing than calcium antagonists. Thus, they continue to be preferable first-line antihypertensive agents in many patients with mild-to-moderate hypertension. PMID- 3552312 TI - Calcium-channel blockers for combined systemic hypertension and myocardial ischemia. AB - Scientific rationale suggests a potentially important role for the calcium channel blockers in the treatment of patients with coexisting systemic hypertension and coronary artery disease. Clinical investigation confirms the usefulness of these drugs as monotherapy in the treatment of patients with chronic stable angina and mild-to-moderate hypertension. There are several therapeutic effects of the calcium-channel blockers in coronary artery disease. 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 drugs allow for increased coronary blood flow and alleviation of coronary vasospasm. The effectiveness of the calcium-channel blockers in hypertension appears to be primarily due to their ability to induce systemic vasodilation. Improvements in ventricular compliance, regression of left ventricular hypertrophy, and cardioprotection appear to be additional beneficial effects of the drugs. Calcium-channel blockers compare favorably with beta blockers; they appear to be more effective than some beta-blockers in the treatment of hypertension in the elderly and black population and can be given to patients with bronchospasm or peripheral vascular disease. Calcium-channel blockers are a welcome addition to existing drug regimens available for the management of patients with concomitant coronary artery disease and systemic hypertension. PMID- 3552314 TI - The role of calcium entry blockers in hypertensive emergencies. AB - This review focuses on the potential use of the calcium antagonists diltiazem, nifedipine, and verapamil in the treatment of hypertensive emergencies. Prompt reduction of blood pressure can be achieved after either intravenous administration of diltiazem or verapamil or sublingual/oral administration of nifedipine. Effects on cardiac hemodynamics with these drugs are variable. Effects on the kidney are predictable; administration is associated with prompt diuresis and natriuresis. Effects on the cerebral circulation are more complex; although cerebral vasodilation may occur, the potential exists for uneven cerebral perfusion and an increase in intracranial pressure. Precipitous decreases in mean arterial pressure may decrease cerebral blood flow below the lower limit of autoregulation, inducing cerebral ischemia. Because of the complex interaction of these drugs on the heart, kidney, and brain, short-term therapy should be instituted only in the hospital setting, with appropriate supervision and hemodynamic monitoring. PMID- 3552315 TI - Interpretation of changes in coronary flow that accompany pharmacologic interventions. AB - The interpretation of a change in coronary flow that accompanies administration of a calcium-entry blocker or other pharmacologic agent remains complicated by the variety of factors potentially altered by the agent that can themselves affect flow. These factors are reviewed in the context of steady-state coronary pressure-flow relationships, emphasizing the complexities induced by coronary artery disease. Limitations of currently available approaches for the measurement of coronary reserve, examination of flow heterogeneity, and the calculation of coronary vascular resistance are also addressed. Calcium entry-blocking agents have a number of hemodynamic effects that are likely to augment coronary flow favorably. However, parodoxical and potentially deleterious effects on local flow also seem possible in selected situations. PMID- 3552317 TI - Calcium-channel blockade in the management of severe chronic congestive heart failure: a bridge too far. AB - Because vasodilator therapy has become an established approach to the treatment of patients with severe chronic heart failure, there has been increasing interest in the use of the calcium channel-blocking drugs in the management of this disorder. This approach has particular appeal because approximately 60% of patients with heart failure have severe left ventricular dysfunction associated with coronary artery disease, and left ventricular systolic and diastolic performance in these patients may improve after interventions directed at improving myocardial blood flow. Unfortunately, all available calcium channel blocking drugs possess potent negative inotropic effects; these are normally offset in patients without heart failure by activation of the sympathetic nervous system. Patients with severe left ventricular dysfunction, however, are exquisitely dependent on the transmembrane transport of calcium for maintenance of contractile function and show marked attenuation of adrenergic reflexes, which can no longer serve a homeostatic support function; hence, such patients are likely to experience notable cardiodepressant effects after calcium-channel blockade. In clinical trials, although some patients with severe chronic heart failure have been reported to benefit from short-term calcium-channel blockade, the hemodynamic benefits seen are modest compared with those from conventional vasodilator drugs, and little long-term improvement has been observed in randomized, double-blind trials. In addition, 10% to 40% of patients who receive short- and long-term therapy with verapamil, nifedipine, and diltiazem show evidence of serious hemodynamic or clinical deterioration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552316 TI - The effects of calcium-entry blockade on left ventricular systolic and diastolic function. AB - The hemodynamic properties of the calcium entry-blocking agents result principally from the inhibition of transcellular calcium flux in the myocardium and in vascular smooth muscle. The composite effect(s) of these compounds on cardiovascular function derive from a complex interplay between their direct (myocardial depression) and indirect (afterload reduction by peripheral arterial vasodilation, reflex sympathetic stimulation) actions. While qualitatively similar, the currently available agents (diltiazem, nifedipine, verapamil) differ considerably in relative negative inotropic, vasodilator, and reflex properties. The hemodynamic actions of a particular calcium blocker also critically depend on the baseline cardiocirculatory status. Current information regarding these issues from basic and clinical investigations is reviewed. PMID- 3552318 TI - Characteristics and significance of ischemia detected by ambulatory electrocardiographic monitoring. AB - Ambulatory electrocardiographic (ECG) monitoring of ischemia in patients with coronary artery disease (CAD) provides a new technique for the assessment of ischemic activity and the evaluation of therapies outside of the hospital. Numerous studies have demonstrated that the majority of patients with CAD have episodes of symptomatic and asymptomatic ST segment depression during routine daily activities. Rubidium-82 positron-emission tomographic studies have provided evidence for decreased myocardial perfusion during these episodes of ST segment depression. The prognostic importance of asymptomatic ischemia has been shown in patients with unstable angina to be a marker for early unfavorable cardiac events. Preliminary results suggest a poorer outcome for those patients with chronic stable angina who show episodes of ischemia as well. Ambulatory monitoring studies suggest that total ischemic activity may be underestimated by conventional testing. Whether all ischemic activity detected by ambulatory monitoring requires treatment awaits further study. PMID- 3552319 TI - Acute myocardial ischemia: role of atherosclerosis, thrombosis, platelet activation, coronary vasospasm, and altered arachidonic acid metabolism. AB - Potential causes for the development of acute myocardial ischemia include extracardiac factors, rapid progression of atherosclerosis, dynamic coronary artery thrombosis, platelet activation in diseased vessels, abnormal constriction of a coronary artery, and abnormal arachidonic acid metabolism. It is entirely possible that all or many of these potential causes may be occurring in the individual patient. PMID- 3552321 TI - A novel CK isoenzyme migrating between CK-MB and CK-BB. AB - A CK isoenzyme migrating between CK-MB and CK-BB was detected in the serum of three patients with metastatic prostatic carcinoma. CK-BB was detected in the serum of all three patients and mitochondrial CK in two of the patients. Total CK activity was either normal or elevated, and the atypical CK isoenzyme, CK-BB and the mitochondrial CK isoenzyme were present in serum for up to 1.5 months. This atypical CK isoenzyme was not CK-MB, an albumin-ligand complex, or adenylate kinase, and was not bound to an immunoglobulin. This atypical CK isoenzyme did not contain immunologically normal CK-M subunits but had some CK-B subunits and could be a variant CK-BB or CK-MB isoenzyme. Its appearance in serum could be indicative of a serious illness. PMID- 3552320 TI - Clinical varieties of carnitine and carnitine palmitoyltransferase deficiency. AB - Several clinical entities are associated with disorders of fatty acid oxidation or transfer across the inner mitochondrial membrane. Over 40 cases of the primary carnitine deficiency syndrome have been reported to date and various subtypes have been characterized. This represents a large clinical spectrum. The deficiency of carnitine in muscle is at the basis of a syndrome characterized by muscle weakness and lipid storage myopathy. The systemic form of carnitine deficiency is more generalized and includes recurrent episodes of hepatic encephalopathy as well as lipid storage in muscle, liver and heart. In one subtype, hypoglycemia upon fasting and cardiomyopathy are found. There are also several causes of secondary carnitine deficiency states which are either acquired or associated with inborn errors of metabolism (organic acidurias, defects of acyl-CoA dehydrogenases). Clinically, Carnitine palmitoyltransferase (CPT) deficiency is a rather homogeneous syndrome presenting with recurrent episodes of myoglobinuria provoked by fasting or prolonged exercise. The only exception is an infantile variety associated with severe hypoglycemia and hepatic CPT deficiency. Using malonyl-CoA, a specific inhibitor of CPT-I, we had suggestions in five adult patients with myoglobinuria that CPT-II is lacking in muscle, liver and platelets while CPT-I is above the control level. The enzyme abnormality seems partial and limited to CPT-II or to its binding to the inner mitochondrial membrane. PMID- 3552322 TI - Cellular oncogenes and human carcinogenesis. AB - Experimental studies over the past decade have identified 30 or so cellular genes as potential oncogenes. The genetic events that lead to cellular oncogene activation may result in the excessive or inappropriate expression of the gene, or the expression of an aberrant gene product. Although the involvement of these putative cellular oncogenes in human oncogenesis has not been proven, the accumulation of considerable experimental evidence strongly implicates some role of these genes in the malignant process. The inactivation of certain genetic loci (suppressor genes) may also contribute to tumor progression. PMID- 3552323 TI - Rapid, qualitative immunoenzymometric technique evaluated for detecting choriogonadotropin in serum and urine. PMID- 3552324 TI - Laboratory performance and director qualifications. AB - Since 1971, federal laboratory regulations have required that directors of approved laboratories possess earned doctorates. Private accrediting agencies and some states also require doctoral directorship of accredited laboratories. No empirical studies have demonstrated that a director's earned doctorate is necessary to assure laboratory quality. Laboratories in physicians' offices (POLs) are exempt from federal regulation but receive federal reimbursement on the basis of the physicians' medical degree. No empirical studies have demonstrated that unregulated laboratories perform comparably with regulated laboratories. This investigation found no statistically discernible differences in quality when 1983 proficiency test data were used to compare statistically the performance of doctoral- and non-doctoral-directed Medicare-certified independent laboratories in California. When regulated non-doctoral-directed full-service laboratories were statistically compared with unregulated limited service POLs, regulated non-doctoral-directed laboratories consistently demonstrated superior per formance to POLs. Evidently a director's earned doctorate is neither a necessary nor a sufficient condition to assure laboratory performance. Government regulation appears to provide substantial quality assurance in the clinical laboratory field. PMID- 3552325 TI - Simple asymptomatic orthotopic ureterocele in pregnancy: analysis of a clinical case. AB - In the present paper the authors, taking for a starting point the occasional recognition of an asymptomatic orthotopic ureterocele in pregnancy, refer to the present knowledge of its embryology, pathological anatomy and the form of therapeutic approach. In the light of such experience they confirm the role of clinical-instrumental diagnostic investigations of purely gynecological and obstetric pertinence in the recognition of pathologies of urological interest. PMID- 3552326 TI - Detailed ultrasound as a screening method for craniospinal abnormalities. AB - High resolution diagnostic ultrasound was assessed as a screening method for craniospinal anomalies during the second trimester of pregnancy in a population at low risk for neural tube defects (83,403 mothers). The effectiveness of the test was about 60% and the failure rate mainly due to late attendance. In a subgroup (9325) where the screening purposes were satisfactorily fulfilled, the detection rate (87%) was substantially greater. The significance of the results and the cost/benefit ratio, especially compared with serum alpha-feto protein screening services, are then discussed. PMID- 3552328 TI - Radioimmunoassay of glandular kallikrein in human plasma after partial purification by immunoaffinity column. AB - Glandular kallikrein in human plasma was partially purified by immunoaffinity column (1.0 X 2.0 cm) and was measured by a radioimmunoassay (RIA). Plasma (5-10 ml) was diluted with an equal volume of 10 mmol/l sodium phosphate buffer, pH 7.4, containing 0.9% NaCl (PBS) and was applied to an immunoaffinity column from which glandular kallikrein was eluted with 3 mol/l NaSCN (20 ml). The enzymic fraction was concentrated with an Amicon PM 10 filter and dialyzed against PBS. The final recovery of the enzyme was 51.6 +/- 1.6% (mean +/- SD), determined by using [125I]kallikrein. The usable range of the standard curve covered 2.5-100 ng/tube. The coefficient of variation within the series was 5.9%, and the coefficient of variation between the series was 7.6%. In healthy controls (n = 25), the plasma content of glandular kallikrein was 1.36 +/- 0.39 ng/ml. In patients with acute pancreatitis (n = 6), the plasma concentration was 8.02 +/- 6.15 ng/ml, significantly different from the control group (p less than 0.01). PMID- 3552327 TI - Obesity as a risk factor for endometrial cancer. AB - The epidemiology and risk factors for endometrial cancer are reviewed, with current data. Obesity seems to be the main risk factor for this neoplasia, both because it is very common in the female population, and because the other risk factor (i.e. estrogen replacement therapy) has almost disappeared with the addition of progesterone therapy. The pathogenesis of obesity as risk factor, although it is not completely clear and unique, is examined. PMID- 3552329 TI - Coeliac disease: a critical review of aetiology and pathogenesis. PMID- 3552330 TI - Urinary protein/creatinine ratio as an indicator of allograft function following live related donor renal transplantation. AB - In a study of 656 urine specimens from 53 consecutive recipients of live related donor renal allografts we found an excellent correlation between the protein content of 24-h urines and protein/creatinine ratio (Up/Ucr) in overnight urine samples. Using this ratio, we evaluated proteinuria up to 180 days after renal transplantation (overnight urine samples analysed, n = 2745). Heavy proteinuria in the immediate post-operative period had no prognostic significance. Eighty nine percent of all clinically observed acute rejection episodes were accompanied by an increase over baseline of Up/Ucr; in 56.5% of these episodes elevation of Up/Ucr preceded that of serum creatinine. However, as a marker of rejection the usefulness of this parameter was limited owing to large number of false positive elevations. In 50 recipients whose grafts survived for more than 3 mth, proteinuria was graded into minimal, moderate and heavy. Renal function at the end of six months was good in all patients who exhibited proteinuria with Up/Ucr less than 100 mg/mmol creatinine. Persistent proteinuria with Up/Ucr above 100 mg/mmol preceded significant deterioration of graft function. Therefore, a protein-creatinine ratio of 100 mg/mmol can be considered as an apparent cut-off to differentiate stable from deteriorating graft function in long term evaluation of transplant recipients. PMID- 3552331 TI - Total and free disopyramide by fluorescence polarization immunoassay and relationship between free fraction and alpha-1 acid glycoprotein. AB - Disopyramide is an antiarrhythmic drug with concentration dependent protein binding within the therapeutic range. We found good agreement between fluorescence polarization immunoassay (FPIA, Abbott TDX) and high performance liquid chromatography (HPLC) for total disopyramide among 27 admission patients' sera (FPIA = 1.12 (HPLC) -0.002, r = 0.982, SEE = 0.378 mg/l). Agreement between FPIA and HPLC for free disopyramide was similarly good (FPIA = 0.867 (HPLC) 0.003, r = 0.986, SEE = 0.09 mg/l, n = 27). Serum alpha 1 acid glycoprotein concentration (AAG) and free fraction (FF) percent of disopyramide correlated inversely (FF = -0.0112 (AAG) + 31.3 r = 0.707, SEE = 6.41 mg/l, n = 24), and the free disopyramide fraction varied greatly. For two pooled sera with 12 different disopyramide concentrations (range from 0.5-20.0 mg/l), the proportion of free fraction ranged from 6.5 to 73.2%. Overall, we found the free disopyramide fraction variable with each individual, total drug, and protein concentration. Therefore, free drug concentration should be monitored in disopyramide therapy, and FPIA is reliable for free as well as total drug assay. PMID- 3552332 TI - A simple immunotechnique for the determination of serum concentration of apolipoprotein E. AB - Immunoturbidimetric assay for the determination of serum apolipoprotein E was developed on the Cobas-BIO centrifugal analyzer using commercially available antisera and reference sera. Within-run imprecision was 2.9% while day-to-day imprecision was 7.9%. Addition of up to 50 g/l hemoglobin or 0.15 g/l bilirubin to sera did not interfere with the determination of this apolipoprotein. Apolipoprotein E concentration was measured in sera from 40 normolipidemic and hyperlipidemic subjects by this immunoturbidimetric method (dependent variable) and radial immunodiffusion assay (independent variable). A slope of 0.90, an intercept of -7.9, and a correlation coefficient of 0.94 were obtained. Reference range for apolipoprotein E was established using sera from 100 normolipidemic subjects. The mean + 1 SD for apolipoprotein E levels of males and females were 36 + 13 mg/l and 29 + 8.4 mg/l, respectively. The distribution of apolipoprotein E among the various lipoprotein fractions of normals was significantly different than that of hypertriglyceridemic subjects. PMID- 3552333 TI - Carrier detection in DMD. PMID- 3552334 TI - Parameters of T cell mediated immunity to commensal micro-organisms in patients with chronic purulent rhinosinusitis: a comparison between delayed type hypersensitivity skin test, lymphocyte transformation test and macrophage migration inhibition factor assay. AB - In 75 patients with unexplained chronic purulent rhinosinusitis T cell mediated immunity to three micro-organisms frequently colonizing the human upper respiratory tract, viz. Haemophilus influenzae, streptococci and Candida albicans, was assessed. Delayed type hypersensitivity (DTH) skin test reactivity was measured in vivo, whereas the blastogenic responsiveness (lymphocyte transformation test; LTT) and lymphokine production (e.g. migration inhibition factor; MIF) of the lymphocytes upon antigen stimulation were measured in vitro. MIF was assayed with a recently developed test system using the human monocytoid cell-line U937 as indicator cells in agarose microdroplets. Two-thirds of the 75 patients tested showed a defective DTH response to one or more of the microbial antigens; this contrasted to the findings in 25 healthy subjects, of whom over 90% showed a positive DTH reaction to any of the three antigens. PHA skin tests were entirely normal in both patients and healthy controls. Microbial antigen specific LTT responses fluctuated considerably in time from strongly positive to negative and vice versa in healthy individuals as well as in patients. In general however, blastogenic responses in patients were comparable to or even higher than those of healthy persons. In the MIF assay, lymphocytes of all healthy individuals tested showed production of MIF upon stimulation with all three antigens; this again contrasted to two-thirds of the patients, whose lymphocytes showed a defective MIF production. Fluctuations of MIF-production in time could not be established and a very good correlation existed between the data obtained in the MIF assay and those of the DTH skin tests. These results indicate that apart from skin testing, the MIF assay seems to be the most suitable parameter to assess defects in T cell reactivity towards microbial antigens. These defects exist in two-thirds of our patients suffering from chronic purulent rhinosinusitis. PMID- 3552335 TI - Topical cyclosporin A in nickel contact hypersensitivity: results of a preliminary clinical and immunohistochemical investigation. AB - Four out of eighteen (22%) patients with nickel contact sensitivity showed inhibition of skin patch test responses to the allergen in the presence of topical cyclosporin A (CsA; 5% v/v). No systemic drug absorption or side effects were detected. The clinical response to CsA was accompanied by marked diminution of the T cell infiltrate, although no alteration in the helper/suppressor cell ratio was observed. Expression of the Leu 6 marker on epidermal Langerhans cells and of major histocompatibility complex (MHC) class II antigens (HLA-DR, DQ and DP) on lymphocytes and Langerhans cells was unaffected by topical CsA. The incidence of IL-2 receptor positive lymphocytes in all biopsies was too small to ascertain the influence, if any, of CsA. The prospective use and method of application of CsA in immune contact dermatitis and other immunologically-based skin disorders warrants further evaluation. PMID- 3552336 TI - Phenotypic characterization of the early cellular responses in allergic and irritant contact dermatitis. AB - Despite qualitative similarities there were subtle differences between the nickel allergic and dithranol irritant dermatitis reactions. In both responses, dermal and epidermal cellular infiltrates developed, which were predominantly of Leu 3a phenotype with lesser numbers of Leu 2a positive cells. Dermal infiltrates were larger in the allergic response, but epidermal invasion was greater in the irritant reaction. In the allergic challenge response, Leu 3a reactive cells appeared in the dermis and epidermis by 4 h. At 48 h, both reactions showed skin infiltration by Leu M3 positive macrophages, and had increased numbers of cells in the epidermis expressing class II antigens. The number of Leu 6 reactive Langerhans cells in the epidermis was almost halved at 48 h in the irritant reaction, but Langerhans cell counts were increased by a third between 24 and 48 h of the allergic response. Ultrastructural studies showed disruption of the Langerhans cell mitochondrial cristae at 8 h in the irritant reaction, with few identifiable epidermal Langerhans cells at 48 h. At 1 h in the allergic response, electron microscopy identified two populations of Langerhans cells; the majority showed an electron-dense cytoplasm with vacuoles, and the rest appeared normal. Peripolesis was noted in both types of reaction. PMID- 3552337 TI - Relationship of macrophages to defective delayed-type hypersensitivity in B6/lpr mice. AB - These experiments were undertaken to clarify whether or not suppressor macrophages contribute to deficiency of delayed-type hypersensitivity induced by BCG CW immunization in B6/lpr mice. Addition of indomethacin in vitro did not increase MIF production by immunized lpr lymph node cells. Adherent cells in lymph node cell suspensions from lpr mice did not interfere with MIF production by nonadherent lymph node cells from immunized B6 mice. On the other hand, MIF production by nonadherent lymph node cells from immunized B6/lpr mice was not restored even if they were cultured with adherent lymph node cells from immunized B6 mice. In addition, macrophages from nonimmunized B6/lpr mice showed normal reactivity to MIF when lymphocytes coexisting with the macrophages in large proportions were depleted from PEC. These results suggest that macrophages make no contribution to the deficiency of DTH expression of B6/lpr mice. PMID- 3552338 TI - Change in alpha 1-antitrypsin phenotype after orthotopic liver transplant. AB - The aim of the present study was to determine the interval after orthotopic liver transplant during which the alpha 1-AT phenotype in the serum changes. Eleven patients could be evaluated because the donor and recipient had different alpha 1 AT phenotypes. The results showed that within 1 to 3 days of the transplant donor alpha 1-AT is already present in the serum of the recipient, and subsequently the transplanted liver continued to synthesize alpha 1-AT of the donor phenotype. The result confirmed that liver parenchymal cells are the main site of alpha 1-AT synthesis. PMID- 3552339 TI - Fungicidal activity of murine inflammatory polymorphonuclear neutrophils: comparison with murine peripheral blood PMN. AB - A characteristic of inflammation is the influx of polymorphonuclear neutrophils (PMN) from peripheral blood to the inflammatory reaction. We report on metabolic alterations and alterations in fungicidal activity in PMN elicited intraperitoneally with different inflammatory agents. The fungicidal activity of murine peripheral blood PMN (PB-PMN) against phagocytosable Candida albicans and nonphagocytosable Blastomyces dermatitidis was compared to that of murine inflammatory PMN. PMN elicited with sodium caseinate exhibited enhanced killing of B. dermatitidis (93 +/- 3%) compared to PB-PMN (38 +/- 11.7%). In contrast, thioglycollate medium elicited PMN had significantly less ability to kill B. dermatitidis (3 +/- 5%) than PB-PMN. Incubation of caseinate PMN with thioglycollate medium for 1 h significantly reduced their ability to kill B. dermatitidis (95% vs 25%). This effect was not due to cytotoxicity of thioglycollate medium for PMN. Candidacidal activity of inflammatory PMN (caseinate or proteose peptone-elicited) was not significantly greater than that of peripheral blood PMN. However, inflammatory PMN had significantly greater candidacidal activity than thioglycollate-elicited PMN. PMID- 3552340 TI - Functional effects of epidermal cell culture supernatants (ECCS) on human B-cell activation. AB - Epidermal cells (EC) were cultured without stimulation and the effect of these EC culture supernatants (ECCS) on human in vitro B-cell response was determined. Supernatants obtained between Days 5 and 7 were able to replace monocytes in the antibody response to the particulate antigen trinitrophenyl-polyacrylamide (TNP PAA). These results were obtained when highly monocyte-depleted cultures (less than 0.5% peroxidase-positive cells) were used and were reproduced with supernatants from several different EC cultures. ECCS could not substitute for T cells in the T-dependent response to TNP-PAA. They contained an interleukin 1 (IL 1) activity but no interleukin 2 or B-cell growth factor (BCGF) activities. We tested the effect of ECCS on the proliferative response of highly monocyte depleted B cells cultured at low cell density costimulated with anti-u antibody and BCGF. ECCS had no BCGF-like activity of its own but did potentiate the effect of BCGF. Thus EC cultures produce IL-1-like factor(s) which act directly on the early stages of B-cell activation. PMID- 3552341 TI - Humoral immune function in severe, active rheumatoid arthritis. AB - Peripheral blood mononuclear cells (PBMC) from 30 patients with definite or classic active rheumatoid arthritis who were on no remittive drugs were studied for spontaneous and pokeweed mitogen (PWM)-stimulated immunoglobulin plaque forming cell frequency (IgPFC), spontaneous IgM-rheumatoid factor (IgM-RF) secretion, and in vitro proliferative responses to soluble recall antigens. Rheumatoid spontaneous total (IgG + IgM + IgA) IgPFCs were higher than those of normal controls when assayed after 7 days in culture. Spontaneous and PWM stimulated IgM-PFCs, in contrast, were significantly less than normal regardless of when assayed. Spontaneous synthesis of IgM-RF was observed in 56% of the RA patients, but absolute amounts produced were widely heterogeneous. Spontaneous IgM-RF production by RA PBMC was associated with low or absent spontaneous IgM PFC production. Moreover, a strong association was found between the median amount of IgM-RF secreted and depressed proliferative responses to soluble recall antigens. Our results define several abnormalities of immunoglobulin production in a clinically homogeneous and highly active rheumatoid population and delineate methodologic variations that can complicate the interpretation of similar data in the literature. In addition, our findings suggest that subgroups of rheumatoid patients that show distinct cellular and humoral immune abnormalities can be identified. PMID- 3552342 TI - Follow-up studies of three subtypes of acute postinfectious glomerulonephritis ascertained by renal biopsy. AB - Quantitative correlative investigations by means of light, immunofluorescence and electron microscopy carried out in the early phase of the disease on 58 patients (children and adults) with acute postinfectious glomerulonephritis (APGN) formed the basis of subtyping APGN into a starry sky type, a mesangial type and a garland type [Sorger et al. 1982 and 1983]. The subtypes also showed differences in the clinical picture. The garland type was of special interest since most patients had severe proteinuria. This caused us to follow-up the patients with these three subtypes (up to 10 years and 7 months). Proteinuria proved to be the most reliable follow-up parameter. A comparison of the three groups showed that proteinuria rapidly declined as a rule in the patients with the starry sky and the mesangial patterns. In the garland pattern there were also cases with a complete disappearance of proteinuria, especially in younger patients, but other patients still had a distinct proteinuria after months to years indicating a protracted or chronic course. The morphological findings of the rebiopsies correlated with the clinical courses, especially with the course of proteinuria. The three morphological subtypes are thus significant for estimating the prognosis of APGN, which is favorable as a rule in patients with the starry sky and mesangial types, but much more unfavorable in patients with the garland type. Even if fewer cases with demonstrated streptococcal etiology were found in the garland pattern group, i.e., among patients with the most uncertain prognosis, than in the remaining groups, these differences were not statistically significant. Therefore, our investigations do not provide any indications that different etiological factors are responsible for the three subtypes. The individual immune response of the host body is likely to be very much more decisive. PMID- 3552343 TI - IgA nephropathy in Korea: a morphological and clinical study. AB - IgA nephropathy (IgA N) is the most common type of primary glomerulonephritis (27.5%) in South Korea and leads to renal failure in a significant number of cases. To evaluate the possible prognosticators of this disease, renal biopsy material from 142 Korean patients with IgA N was studied by light-, electron- and immunofluorescent microscopy, and a clinicopathologic correlation was made. Modified classification of Meadow et al. [1972] for Henoch-Schoenlein nephritis was adopted for the histologic grading of glomerular lesions. Twenty-three biopsies (16.2%) exhibited histologic grades IV and V lesions in association with high levels of proteinuria, serum creatinine and blood pressure and a low frequency of gross hematuria when compared to the remaining 119 biopsies with histologic grades I to III lesions. Ninety-one patients were followed for one to 6.5 years (mean, 3.4 years). Seventeen patients (18.7%) had chronic renal insufficiency, of whom eleven eventually showed endstage renal failure. More than 70% of the patients with histologic grades IV and V exhibited progressive renal disease, whereas patients with grades I to III lesions had a benign course (p less than 0.0005). These results suggest that histologic grading may be the best index to predict the present state or the subsequent progression of the lesion in IgA N. PMID- 3552344 TI - Immunotactoid glomerulopathy with leucocytoclastic skin vasculitis and hypocomplementemia: a case report. AB - Immunotactoid glomerulopathy is a recently described entity characterized clinically by proteinuria, hematuria and hypertension, and on renal biopsy by various glomerular lesions including extracellular microtubules composed of immune reactants. Furthermore a defined immunological disease or cryoglobulinemia are absent. We report the case of a patient with immunotactoid glomerulopathy and hypocomplementemia (low C3 level) who developed several episodes of leucocytoclastic skin vasculitis with large immune deposits in and around small vessels. It is suggested that skin and renal involvement are part of the same systemic disease. PMID- 3552346 TI - 5q- and disordered haematopoiesis. PMID- 3552345 TI - Chromosome abnormalities in the myelodysplastic syndromes. PMID- 3552347 TI - Secondary myelodysplastic syndromes and leukaemias. AB - Secondary MDS, or AL induced by the treatment of another primary disease, occurs at an average of 48-71 months after that treatment. A high percentage of the 2 MDS convert to AL. Survival of either is less than 1 year. A constellation of morphological abnormalities from all three cell lines produces a unique appearance. The 2 AL are difficult to classify by the FAB system. With the exception of cytogenetic analysis, the biology of 2 MDS/AL remains largely unexplored. Alterations of chromosomes 5 and 7 predominate, but other associated cytogenetical abnormalities are increasingly being recognized. A review of the development of 2 MDS/AL in a variety of primary diseases generates the following tentative conclusions: many of the commonly used alkylating agents, and the non classical alkylating agent procarbazine, are leukaemogens; procarbazine is probably the important leukaemogen in the MOPP programme; cyclophosphamide appears to be a less potent leukaemogen than other alkylating agents; the method in which a drug is administered probably influences its leukaemogenic potential; the duration of therapy with a drug, or the total amount of drug delivered, is probably an important factor in leukaemogenesis; irradiation alone appears to be a weak leukaemogen; irradiation has little or no synergism with chemotherapy in leukaemogenesis; the older patient treated with leukaemogenic drugs is at substantial risk to develop a 2 MDS/AL; most studies show no plateau in the actuarial incidence of developing a 2 MDS/AL, despite lengthy follow-up. Benzene is the only chemical agent for which strong evidence of leukaemogenesis exists. Nonetheless, the similarities in the karyotypic alterations of leukaemic cells between those whose occupations expose them to chemical hazard and those who are exposed to cytotoxic agents lend support to the idea that more environmental leukaemogens have yet to be discovered. Aggressive therapy should be considered for a patient of any age with an adequate performance status and a diagnosis of secondary AL, especially if the karyotype in the malignant cell is predictive of a high response rate. The therapy of 2 MDS remains investigational. To mitigate the development of a leukaemic complication, maintenance therapy should be restricted to diseases in which its efficacy is established or to an investigational setting, and consideration of the leukaemogenic potential of equally effective regimens should be part of the therapeutic planning in the older patient. PMID- 3552349 TI - Pathogenesis and clinical variations in the myelodysplastic syndromes. PMID- 3552348 TI - The treatment of myelodysplastic syndromes. AB - The available data fail to support a standard therapy for MDS. Any therapy should therefore, include participation in a well designed clinical trial. The MDS include patients with a variety of prognoses. Since most studies show that death from infection and bleeding are more likely than progression to frank leukaemia, attention to supportive care is crucial for all patients with MDS. Some patients with MDS may be successfully supported with transfusions and observation for prolonged periods. Patients with significant comorbid disease or patients without increased marrow myeloblasts are good candidates for this conservative approach. Conversely, young patients have a better likelihood of benefit from aggressive therapy, and intensive chemotherapy or allogenic bone marrow transplantation should be considered. Patients with preleukaemia related to prior cytotoxic therapy are another poor prognosis group for whom aggressive therapy may be the best alternative. Therapy with low-dose ara-C or other differentiating agents should be considered investigational and unproven until comparative trials can demonstrate a definitive survival advantage. In addition to comparative trials, innovative clinical studies are needed to address differentiation as an in vivo mechanism of action and its importance in MDS therapy. PMID- 3552350 TI - Myelodysplastic syndromes: natural history and features of prognostic importance. PMID- 3552351 TI - In vitro culture techniques defining biological abnormalities in the myelodysplastic syndromes and myeloproliferative disorders. PMID- 3552352 TI - Guillain-Barre syndrome: an ultrastructural study of peripheral nerve in 65 patients. AB - 65 biopsies of peripheral nerve from patients suffering from Guillain-Barre syndrome were studied by electron microscopy. In 48 cases there was macrophagic invasion of the Schwann cells of certain myelinated fibers, and in 32 of these cases some myelin sheaths were stripped away by an elongated macrophagic process. Vesicular disruption of the myelin sheath was observed in only 8 cases and in less than 1% of the myelinated fibers. Uncompacted myelin lamellae were observed in a few myelinated fibers. These ultrastructural lesions are analysed and commented on with a view to selecting patients who are to undergo plasma exchange. PMID- 3552353 TI - Adult-onset subacute sclerosing panencephalitis: immunocytochemical and electron microscopic demonstration of the viral antigen. AB - We report a case of subacute sclerosing panencephalitis (SSPE) in a 52 year-old man, who developed rapidly progressive mental deterioration, myoclonic seizures, quadriplegia, and remained incapacitated until his death 4 years after the onset of symptoms. Immunocytochemical and electron microscopic studies are reported. Titers of measles virus antibodies were consistently high in both serum and cerebrospinal fluid, and periodic synchronous discharges were recorded on EEG. Suppressed cellular immunity was noted in skin test with phytohemagglutinin. The brain was extensively destroyed by inflammatory processes. There were either laminar or widespread areas of cortical necrosis associated with neuronophagia, neuronal loss, glial proliferation, and perivascular lymphocytic cuffing. Numerous intranuclear inclusions, in the neurons and glial cells, stained with immunoperoxidase using antiserum to SSPE virus; ultrastructurally, these inclusions were made of tubular nucleocapsids of paramyxovirus. Neurofibrillary changes were occasionally encountered in the pigmented neurons. The white matter showed extensive loss of myelinated fibers and increased numbers of astrocytes with bizarre nuclei. This well-documented case of SSPE in an adult might be related to a condition of impaired cellular immunity. PMID- 3552354 TI - Proximal femoral fractures. AB - The absolute number of hip fractures is large, increasing, and related to osteoporosis as well as other factors. By 65 years of age, 50% of women will exhibit bone mineral below the fracture threshold; by age 85, 100%. Trabecular bone loss, which occurs before cortical bone loss, is characteristic of postmenopausal osteoporosis, while cortical bone loss, which increases with age (especially after the age of 70), is characteristic of senile osteoporosis. Estrogen treatment is reasonable for early postmenopausal osteoporosis, less so for the senile variety. The elderly often lose the renal ability to 1-alpha hydroxylate 25-OH vitamin D and thus lose the ability to absorb calcium; they are refractory to D3 therapy, and may require more expensive therapy with 1,25-(OH)2 vitamin D. "Trivial" trauma with falls caused by loose rugs, electric cords, and the like may often be the primary cause of proximal femoral fractures. Sedative drugs are also hazardous. The polyfactorial problem of proximal femoral fractures requires treatment by a multidisciplinary medical team. PMID- 3552355 TI - Incorporation of autoclaved autogeneic bone supplemented with allogeneic demineralized bone matrix. An experimental study in the rabbit. AB - Resected, autoclaved, and reimplanted bone supplemented with allogeneic demineralized bone matrix (DABM) was compared with nonsupplemented bone in the reconstruction of bilateral ulnar defects in seven adult rabbits. The reconstructions were studied in vivo with the use of serial radiography, scintigraphy (99mTc-MDP), and bone mineral determination. After sacrifice at 16 weeks, the ulnar specimens were analyzed with the use of high-resolution radiography, autoradiography (45Ca), and histologic study. Scintigraphically, the uptake was significantly higher in the DABM-supplemented implants during the entire investigation. Bone mineral content was significantly higher at four and eight weeks in the DABM-supplemented implants, compared with the nonsupplemented implants, but later it equalized. New bone formation, as reflected by 45Ca incorporation, still occurred at 16 weeks in both types of implants, but it was more intense in the DABM-supplemented ones. Radiography and histologic analysis showed more new bone in the DABM-supplemented reconstructions than in the nonsupplemented ones. High-resolution radiography showed complete incorporation of all seven DABM-supplemented implants, whereas there was nonunion in five of seven nonsupplemented reconstructions. The current study indicates that resected, autoclaved, and reimplanted diaphyseal segments supplemented with demineralized allogeneic bone matrix incorporate better than nonsupplemented implants of autoclaved autologous bone. PMID- 3552356 TI - Deep-freezing versus 4 degrees preservation of avascular osteocartilaginous shell allografts in rats. AB - Osteocartilaginous allografts (distal femurs of rats) were stored at 4 degrees for six, 12, 24, and 48 hours and at -80 degrees for five days and then evaluated for viability of the bone and cartilage. Storage at 4 degrees for 12 or 24 hours had little effect on cartilage viability but decreased bone viability to 40% and 10% of controls, respectively. Storage at -80 degrees for five days resulted in nonviable bone in all cases but showed an either/or response of cartilage, with high viability in two cases and nonviability in the other eight cases. In a second set of experiments, femurs from rats were stored in situ at 4 degrees for 12 or 24 hours or were harvested and stored at -80 degrees for five days, after which they were transplanted into rats of a different strain. The antibody response to each set of femurs was measured at two, six, and 12 weeks after operation. The 4 degrees storage resulted in a moderately decreased immunogenicity, whereas the storage at -80 degrees resulted in significantly reduced immunogenicity. PMID- 3552357 TI - The classic. The treatment of fractures of the neck of the femur by immediate reduction and permanent fixation. By Nicholas Senn. 1889. PMID- 3552358 TI - The effects of verapamil and propranolol on exercise tolerance in hypertensive patients. AB - In a single-blind, placebo-controlled crossover study the effects of verapamil (450 +/- 30 mg/day) and propranolol (160 +/- 20 mg/day) on endurance time during submaximal exercise were compared in eight patients with essential hypertension. The drugs were given in randomized order. Each active drug period was preceded by a placebo phase. Endurance tests were performed during both placebo periods and treatment with verapamil and propranolol by bicycle ergometry. Both drugs were equally effective in decreasing resting blood pressure. Verapamil and propranolol reduced exercise heart rate, the effect of propranolol being more pronounced. With placebo, endurance time during exercise was 57 +/- 11 minutes; with propranolol it was 32 +/- 7 minutes (P less than 0.05). Verapamil had no influence on endurance time. The study demonstrates that in contrast to propranolol, verapamil has no influence on exercise tolerance during submaximal work in patients with hypertension. PMID- 3552359 TI - Hemodynamic effects of orally administered Sunitang in humans. AB - The hemodynamic effects of Sunitang, an ancient Chinese remedy for general weakness, weak pulse, and cold extremities, were studied. In study, 1, 10 patients with left ventricular failure received Sunitang in single oral doses of 250, 500, and 1000 mg in a double-blind manner. Sunitang showed dose-related positive inotropic, chronotropic, and vasodilator effects. The effects reached their maximum within 30 to 60 minutes and lasted for 6 hours. In study 2, 77 patients with left ventricular failure who had not been treated satisfactorily by the conventional methods entered a controlled (parallel design), double-blind study for 1 month. When they entered the study they were in steady states. They continued their original medications throughout the month. Sunitang showed additional positive inotropic, chronotropic, and vasodilator effects. In this study no apparent adverse effects of Sunitang were noted. We conclude from these results that Sunitang may be useful in heart failure and bradycardia. PMID- 3552360 TI - Fluradoline and aspirin for orthopedic postoperative pain. AB - Fluradoline (150 or 300 mg), a novel tricyclic with both antidepressant and analgesic properties in animals, was compared with aspirin, 650 mg, and placebo when given orally for postoperative orthopedic pain in a double-blind, single dose, parallel-group study. Analgesic measurements were made by two trained nurse observers using standard verbal rating and visual analogue scales. Aspirin was statistically superior to placebo on all analgesic measures, demonstrating assay sensitivity. Fluradoline, 300 mg, was distinguished from placebo and fluradoline, 150 mg, but not from aspirin, 650 mg. Overall, fluradoline, 300 mg, was equivalent to aspirin, 650 mg. Fluradoline, 300 mg, produced a significant elevation in mood score. Neither aspirin, 650 mg, nor fluradoline caused untoward side effects, but fluradoline, 300 mg, increased blood pressure. PMID- 3552361 TI - Glycaemic control in diabetic patients transferred from therapy with animal insulins to human crystalline zinc insulin of recombinant DNA origin: a multicentre study. AB - 87 stable insulin-dependent diabetic patients from 6 diabetic clinics within the UK were transferred from their existing once or twice daily regimen of subcutaneous animal insulin to a similar regimen of human insulin of recombinant DNA origin in neutral soluble and crystalline zinc suspension formulations. Seven point blood glucose profiles, glycosylated haemoglobin concentrations and insulin dose were examined, in each patient, before and after 6 weeks therapy with human insulins. The 67 patients on twice daily insulin showed no significant change in mean blood glucose values or glycosylated haemoglobin but required a significantly higher dose of human crystalline zinc suspension than their previous long-acting animal insulin. In contrast the 17 patients on a once daily regimen experienced a significant deterioration in glycaemic control without a significant change in insulin dose or glycosylated haemoglobin. Three patients on twice daily insulin withdrew shortly after transfer to human insulin. The combination of human soluble and crystalline zinc suspension appears to be a more satisfactory substitute for animal insulin when used in a multi-dose regime rather than on a once daily basis. PMID- 3552362 TI - Xiaoke, a traditional Chinese treatment for diabetes. Studies in streptozotocin diabetic mice and spontaneously diabetic BB/E rats. AB - Xiaoke tea is consumed as a traditional herbal treatment for diabetes mellitus in China. An aqueous extract of Xiaoke (1 g of dried plant preparation in 64 ml of water), supplied ad lib in place of drinking water during the induction and development of streptozotocin diabetes in mice, reduced (about 30%) plasma glucose concentrations by 25 days. The polydipsia and hyperphagia of the streptozotocin diabetic mice were also reduced by Xiaoke, and the effects lapsed after treatment was withdrawn. Xiaoke did not significantly alter plasma insulin concentrations. Consumption of the Xiaoke extract by insulin-treated diabetic BB/E Wistar rats did not affect glycaemic control or body wt. When insulin treatment was reduced and discontinued, Xiaoke failed to prevent the progression of severe hyperglycaemia and weight loss. The results suggest that the slowly generated antihyperglycaemic effect of Xiaoke in streptozotocin diabetic mice may involve an extrapancreatic effect on food intake, glucose production or glucose clearance. However, as evidenced in BB/E rats, Xiaoke does not substitute for insulin in the absence of endogenous insulin secretion. PMID- 3552363 TI - Relationship of blood pressure and left ventricular mass to serum insulin levels in newly diagnosed non-insulin-dependent (type 2) diabetic patients and in non diabetic subjects. AB - The relationship of blood pressure to fasting and postglucose serum insulin and lipid levels was examined in 133 (70 men, 63 women) newly diagnosed, non-insulin dependent diabetic patients and 144 (62 men, 82 women) non-diabetic control subjects. In addition, the frequency of left ventricular hypertrophy by ECG criteria and left ventricular mass determined by M-mode echocardiography in diabetic patients were compared to that in non-diabetic subjects. Fasting serum insulin showed a significant correlation with systolic and diastolic blood pressure levels in male non-diabetic subjects, but not in male and female diabetic or in female non-diabetic subjects. Postglucose serum insulin levels showed no significant correlations with systolic or diastolic blood pressure levels in men, but in female diabetic and non-diabetic subjects significant correlations were found in particular with systolic blood pressure level. The correlations between serum insulin and blood pressure levels could not be accounted for by obesity. In male and female diabetic subjects serum triglycerides correlated positively with systolic and diastolic blood pressure levels even after adjustment for obesity. No significant difference was found in the prevalence of left ventricular hypertrophy based on ECG criteria between diabetic and non-diabetic subjects, but female diabetic subjects showed in echocardiography an increased left ventricular mass related to body surface area compared to their non-diabetic counterparts. Elevated systolic blood pressure and high postglucose serum insulin levels showed an independent, significant association with left ventricular mass in female diabetic subjects. PMID- 3552364 TI - Comparison of blood glucose profile and glycemic control in type 1 diabetic patients treated with Actrapid-Monotard or Actrapid Protaphane (NPH) human insulins. AB - The aim of this study is to compare the blood glucose profile and the glycemic control in Type 1 diabetic patients under two conventional semi-synthetic human insulin regimens (2 daily injections) combining regular (Actrapid) and intermediate acting insulins (Monotard or Protaphane). Actrapid-Monotard (scheme A) and Actrapid-Protaphane (scheme B) were administered during 3 months each, in a randomized order, to 18 outpatients. The glycemic control was evaluated by home glucose monitoring, as well as by the monthly measurements of HbA1. The total daily dose of insulin was comparable during each treatment period: 0.68 +/- 0.06 (scheme A) and 0.71 +/- 0.06 U/kg body wt. (scheme B) (mean +/- SEM). However, the total percentage of regular insulin was higher with Monotard than with Protaphane: 58 +/- 3 vs 48 +/- 5% in the morning (p less than 0.005) and 51 +/- 2 vs 46 +/- 3% in the evening (p less than 0.05). In C-peptide positive patients, the blood glucose values were comparable at all times with either insulin scheme. In contrast, in C-peptide negative patients, the blood glucose levels were higher in the afternoon with scheme B: 11.8 +/- 1 vs 8.6 +/- 1 mmol/l at 3 pm (p less than 0.02) and 12.2 +/- 1.3 vs 9.7 +/- 1.6 mmol/l at 6 pm (p less than 0.01). A slight but not significative increase of HbA1 was observed during the B period. In conclusion, an Actrapid-Protaphane scheme requires the use of a lower proportion of regular insulin than an Actrapid-Monotard treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552366 TI - Absorption kinetics and action profiles of intermediate acting human insulins. AB - The effects of the currently available intermediate acting human insulins on plasma insulin levels and action profiles, assessed by the euglycaemic clamp technique for a period of 8 hr following the administration, were studied in 8 healthy volunteers. The amount of insulin administered was 0.33 IU/kg body wt., using the NPH-insulins Humulin NPH, Insulatard Human, and Protaphane HM and the zinc insulins Monotard-HM and Humulin Zinc. After administration of NPH-insulins an earlier rise of plasma insulin levels was observed, reaching a plateau after about 3 hr, whereas after injection of zinc insulins the plasma insulin levels only gradually increased during at least the first 5-6 hr after administration. Glucose requirements followed a more or less similar pattern, although within the NPH-insulins Protaphane-HM lagged slightly behind during the first 2 hr when compared to Humulin NPH. We conclude therefore, that human NPH-insulins show a faster action profile as compared to human zinc insulins. This difference should be taken into account when switching over from one insulin to another. PMID- 3552365 TI - Insulin binding to circulating monocytes and erythrocytes in patients with non insulin-dependent diabetes in the young. AB - 125I-insulin binding to circulating monocytes and erythrocytes was carried out in 9 patients with non-insulin-dependent diabetes in the young (NIDDY), who belonged to families in which non-insulin-dependent diabetes was transmitted through 3 generations. The diabetics had a decreased mean maximum specific binding to monocytes 2.1 (1.1-4.1%) compared to 4.0 (2.6-6.2%) in their age, sex and weight matched reference subjects. This decreased binding was primarily due to a decrease in receptor number as all diabetics had normal affinity values (2-10 ng/ml). We have attributed the decreased binding in NIDDY to the down regulatory effect of the basal hyperinsulinemia (23.6 +/- 3.2 vs 11.7 +/- 0.5 microU/ml). By contrast the maximum specific binding to erythrocyte was similar in both groups (9.7 +/- 0.5; 8.9 +/- 0.5%; p greater than 0.5). PMID- 3552367 TI - Pharmacokinetics and miscibility of 4 highly purified porcine insulins: a study in vitro and in healthy volunteers. AB - In this study 4 new, highly purified porcine insulin preparations (ORGANON) were characterized by their time action profiles and in vitro and in vivo miscibility. These insulin preparations were soluble insulin, and suspensions of amorphous zinc insulin, mixture of 30% amorphous and 70% crystalline zinc insulin and NPH insulin. The time action profiles, assessed with the euglycaemic clamp technique and measurements of plasma insulin levels, in healthy volunteers were very similar to corresponding, already available, insulins of other manufacturers. In vitro miscibility was assessed for the soluble insulin with the 3 intermediate acting insulins in mixing ratios varying from 1:1-1:5. The recovery percentages of added soluble insulin, 75 sec after mixing in a 1:1 ratio with NPH, Tardum and Sub Tardum insulin, were 97.1%, 67.8% and 42.4%, respectively. The recovery of added soluble insulin decreased significantly with time of contact and with lowering of the mixing ratio for all insulins tested. In vivo insulin miscibility was performed for soluble and NPH insulin in a mixing ratio of 2:3, administered immediately after mixing in the syringe. The insulin action profiles were not altered when soluble and NPH insulin were administered after mixing as compared with the separate injections into contralateral thighs. In conclusion, the pharmacokinetics of these highly purified porcine insulins are in agreement with corresponding already available insulins. NPH insulin can be mixed with soluble insulin without affecting the absorption kinetics of either insulin. PMID- 3552369 TI - Evaluation of peripheral vascular disease by intravenous digital subtraction angiography with the Fuji computed radiography (FCR) system. AB - Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management. PMID- 3552368 TI - Interaction between D-glucose and Ca2+ in the priming of the pancreatic B-cell. AB - Prior exposure of the endocrine pancreas to a high as distinct from low concentration of D-glucose is thought to result in either an increased (priming action) or decreased (glucotoxic action) responsiveness of the B-cell to a subsequent stimulation by the hexose. In order to investigate these phenomena in vitro, rat pancreatic islets were preincubated for 180 min at increasing concentrations of D-glucose in the absence or presence of extracellular Ca2+, and then stimulated with the hexose (16.7 mM) in the absence or presence of theophylline (1.4 mM). Under these conditions, a dose-related priming action of D glucose was observed without evidence of any glucotoxic effect. The priming effect persisted when the islets were preincubated in the absence of Ca2+, although such a prior Ca2+ deprivation itself decreased the magnitude of the further secretory response to D-glucose. The presence of theophylline in the final incubation medium minimized but failed to abolish the priming action of D glucose. It is proposed that Ca2+ and cyclic AMP availability may interfere with the priming action of D-glucose. Moreover, the present results suggest that a more stringent or more prolonged pretreatment of the islet cells may be required in order to allow for the occurrence of the postulated cytotoxic action of D glucose upon the pancreatic B-cell. PMID- 3552371 TI - [Peripheral venous and peripheral arterial digital subtraction angiography in occlusive diseases of the lower extremity]. AB - The possibility of employing peripheral venous and peripheral arterial digital subtraction angiography was examined in 351 patients of 65 to 95 years of age with arterial occlusive disease of the lower extremity. After peripheral venous contrast medium injection (using a Venflon needle 1.7-2.0 mm, 40 ml nonionic contrast medium, 20-30 ml NaCl, flow 15/s), conclusive assessment of vascular tone is possible in 86% of the cases. Indication for IV DSA is supplied chiefly by stenoses and occlusions situated proximally or bilaterally in the region of the distal aorta abdominalis, the iliacal, femoral and popliteal arteries. The distal adjacent segment is demonstrated well in 81 to 95 per cent of the cases up to the level of the trifurcation. Image quality is poor in 30% of the images of the lower leg, whereas no assessment is possible in 11% of the cases. IA DSA with fine needle (needle 0.8 mm, 3-5 ml contrast medium, 3-7 ml NaCl) is indicated in 8% of the patients to clarify the distal lower leg arteries, especially in preceding extensive proximal vascular occlusions. Conventional angiography can be largely replaced by combining peripheral venous and peripheral arterial DSA with fine needle technique. PMID- 3552370 TI - [Effect of new imaging procedures on conventional roentgen diagnostic methods]. AB - The diagnostic radiology workload of a general hospital served as basis to assess the statistical distribution of various diagnostic radiology methods and the inroads made by new imaging methods on the conventional ones: CT, DAS, sonography and endoscopy. In particular, the statistical breakdown shows how these methods have been applied in examining the gastrointestinal tract, the kidneys, the gallbladder and biliary tract, and how they have influenced the frequency rate of special examination methods such as angiography and myelography. Statistic assessment of the results obtained during the past ten years shows an increasing predominance of less invasive examination methods and increasing use of endoscopic methods for examining the gastrointestinal tract, the sum total of examinations remaining approximately the same throughout. PMID- 3552372 TI - Whither radiotherapy. PMID- 3552373 TI - Obituary. Duncan McCallum Gregg. PMID- 3552374 TI - The ultrasound appearance of positive hip instability tests. AB - In a study assessing the use of ultrasound in the detection of neonatal hip abnormalities, the clinical findings in unstable hips were correlated with the ultrasound appearance during the instability provocation tests. Both hip displacement and concentric reduction of the femoral head in relation to the acetabulum could be defined with the ultrasound image. PMID- 3552375 TI - Real-time ultrasound scanning in the planning and guidance of pericardiocentesis. AB - Real-time ultrasound scanning is a rapid and readily available way of detecting pericardial fluid. We have successfully and safely used real-time ultrasound scanning to plan and guide pericardiocentesis on 24 occasions in the last 2 years, in each case for therapeutic purposes in patients with malignant pericardial effusions. The procedure may be readily performed in the ultrasound department or on the ward. We advise the use of real-time ultrasound guidance in all instances of pericardiocentesis. PMID- 3552376 TI - Sonography in complicated hepatic amoebic abscess. AB - Ultrasound examination was conducted on 150 patients with hepatic amoebic abscesses. Twenty of 150 patients were found to have various complications such as direct thoracic involvement, peritoneal rupture, subphrenic collection, obstructive jaundice and ascites. Ultrasound examination of the liver is not only useful in demonstrating the abscess cavity but it also depicts the complications extremely well. PMID- 3552377 TI - Ultrasound of the empty gestation sac in threatened abortion. AB - The major concern when an empty gestation sac is encountered during threatened abortion is whether or not the pregnancy is viable. Viable pregnancies are managed expectantly, whereas non-viable pregnancies are treated by evacuation of the uterus. Early evacuation of the non-viable pregnancy spares the patient considerable anxiety and discomfort. This study shows that a single ultrasound examination is useful in differentiating viable from non-viable empty gestation sacs. The size of the empty gestation sac was found to be the most useful criterion for determining non-viability. Empty gestation sacs with sizes greater than 26 mm were non-viable, a specificity of 100%, accounting for 43% (42 out of 102) of patients in our series. Other ultrasound criteria found to be useful were shape, position, wall and decidual reaction. The positive predictive value for a successful outcome to a pregnancy was low, being only 41% (9 out of 22). PMID- 3552378 TI - Ultrasound imaging of the eye through the closed lid using a non-dedicated scanner. AB - Through-the-lid eye scanning with general ultrasound equipment was initiated in a District General Hospital, to determine whether the technique is accurate in diagnosing ocular pathology. Two hundred consecutive scans were carried out on 184 patients. The examination was simple to perform with production of good images. One hundred and thirty-eight abnormalities were demonstrated, 80 of which were not previously known, with one false positive. The latter was an incorrect interpretation of an abnormal scan, which was diagnosed as a tumor but proved to be a haemorrhage. Ninety-four scans were negative, four of which were false negatives. Three of these were small, almost resolved vitreous haemorrhages, and one was a small melanoma. The method proved sensitive (92%) and specific (99%) in the detection and exclusion of intra-ocular disease. The investigation is, therefore, within the scope of the radiologist who does not have access to dedicated equipment. PMID- 3552379 TI - Magnetic resonance imaging in hydatid disease. AB - Magnetic resonance imaging was evaluated in 12 patients with hydatid disease (Echinococcus granulosus). Patients also underwent real time ultrasound and computed tomography imaging. Clear images of hepatic hydatid cysts were produced by magnetic resonance imaging, and intracyst structures were demonstrated. Changes in the appearance of cysts were seen following chemotherapy. Whilst not cost effective at present, if further improvements allow differentiation of simple (epithelial) and hydatid cysts or viable and dead hydatid cysts this technique could be of clinical value. PMID- 3552380 TI - Is ureteric compression still necessary? AB - A prospective randomised trial was performed to examine the value of ureteric compression in intravenous urography. Calyceal distension improved during the urogram in 68% of kidneys when compression was used, in contrast to an improvement of 43% in patients not receiving compression. In both heavy patients and those with a large girth a trend towards improved distension was shown but was significant only in the former group. PMID- 3552381 TI - Bile duct carcinoma in a focal dilatation of the intrahepatic bile duct. AB - A 40 year old male with bile duct carcinoma arising in a localised dilatation of the intrahepatic bile duct is presented. The patient presented with recurrent upper abdominal pain, fever and jaundice. Computed tomography showed a localised duct dilatation and ultrasound clearly demonstrated a tumor mass arising within the bile duct. At surgery, papillary adenocarcinoma was confirmed. This case suggests that the tumour arose from the pre-existing cyst. A localised dilatation of the bile duct on computed tomography and ultrasound may harbour a bile duct carcinoma. PMID- 3552382 TI - Prion diseases and central nervous system degeneration. PMID- 3552383 TI - The endogenous mediator of endotoxic shock. PMID- 3552384 TI - Applied potential tomography: a new non-invasive technique for assessing gastric function. AB - Applied potential tomography is a new, non-invasive technique that yields sequential images of the resistivity of gastric contents after subjects have ingested a liquid or semi-solid meal. This study validates the technique as a means of measuring gastric emptying. Experiments in vitro showed an excellent correlation between measurements of resistivity and either the square of the radius of a glass rod or the volume of water in a spherical balloon when both were placed in an oval tank containing saline. Altering the lateral position of the rod in the tank did not alter the values obtained. Images of abdominal resistivity were also directly correlated with the volume of air in a gastric balloon. Profiles of gastric emptying of liquid meals obtained using APT were very similar to those obtained using scintigraphy or dye dilution techniques provided that acid secretion was inhibited by cimetidine. Profiles of emptying of a mashed potato meal using APT were also very similar to those obtained by scintigraphy. Measurements of the emptying of a liquid meal from the stomach were reproducible if acid secretion was inhibited by cimetidine. Thus, APT is an accurate and reproducible method of measuring gastric emptying of liquids and particulate food. It is inexpensive, well tolerated, easy to use and ideally suited for multiple studies in patients, even those who are pregnant. A preliminary study is also presented that assesses the technique as a means of measuring gastric acid secretion. Comparison of resistivity changes with measured acid secretion following the injection of pentagastrin shows good correlations. APT might offer a non-invasive alternative to the use of a nasogastric tube and acid collection. PMID- 3552385 TI - Diagnosis of bacterial infections of the lung. AB - This report reviews basic principles behind the choice of specimens in the identification of respiratory bacterial pathogens. It then reviews the major bacterial pathogens and specific specimen sources, covering the strong points, drawbacks, and controversies surrounding the various diagnostic techniques such as sputum Gram stain and culture, transtracheal aspiration, transthoracic needle aspiration, and bronchoscopy. PMID- 3552386 TI - Role of serodiagnostic tests and skin tests in the diagnosis of fungal disease. AB - Serodiagnostic tests have a significant role in the diagnosis of a number of fungal infections. The bases for these tests are reviewed and their sensitivity, specificity, and applications are discussed. Skin test antigens are also reviewed. Their diagnostic role is currently limited, but they have some utility as epidemiological tools. PMID- 3552387 TI - Pulmonary vascular imaging. AB - A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any "ideal" technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the "gold standard" for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques. PMID- 3552388 TI - Noninvasive evaluation of right ventricular function. AB - Numerous technologic advances have greatly facilitated the noninvasive analysis of right ventricular function. Nevertheless, important clues continue to be available to the astute clinician by physical examination. The chest x-ray is of rather limited utility. The electrocardiogram can show evidence of right atrial enlargement or right ventricular hypertrophy. Unfortunately, both sensitivity and specificity are deficient. Echocardiography is a widely available and potentially very accurate source of information concerning right ventricular dysfunction. Careful temporal analysis of the M-mode echocardiogram can give information beyond chamber size and wall thickness. Two-dimensional echocardiography allows more accurate determination of chamber size and wall thickness and also permits analysis of segmental wall motion and chamber contour. Doppler echocardiography allows measurement of pressure differences and flow kinetics. Preliminary data indicate that one can accurately assess pulmonary artery pressure and possibly right ventricular diastolic function. Color-flow mapping allows for accurate determination of valvular regurgitation and enhances the accuracy of standard Doppler echocardiographic techniques. Radionuclide analysis of the right ventricle by blood-pool imaging allows accurate determination of ejection fraction and wall motion. In addition, it may be possible to estimate pulmonary artery pressure. Use of short-acting radionuclides allows for serial imaging of the right ventricle after pharmacologic intervention or exercise. Perfusion scanning can show evidence of exercise-induced ischemia, although applicability to the right ventricle is somewhat limited. Avid scanning allows localizing of myocardial injury to the right ventricle. CT scanning of the heart is of limited clinical utility, because cardiac motion occurs too rapidly for accurate imaging. The advent of the cine-CT may overcome this problem and allow evaluation of right ventricular volumes and wall motion. Digital subtraction imaging allows for accurate video densitometric calculation of ejection fractions, but offers no advantage over other currently available techniques. Magnetic resonance imaging may prove to be the methodology of choice for analysis of right ventricular function, because it can give accurate measurement of right ventricular wall motion, ejection fraction, and (similar to Doppler flow studies) some indication of flow within the right-sided chambers. It will soon be possible to generate information concerning the biochemical content of the right ventricular myocardium, perhaps providing early evidence of hypertrophy or myopathy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552389 TI - Comparative evaluation of medium and atmosphere of incubation for isolation of Streptococcus pyogenes. AB - To evaluate the effects of medium and atmosphere of incubation for the isolation of group A (GA) streptococci from throat cultures, we compared 1098 throat swabs plated on each of three blood agar plates (BAP). Two plates contained trimethoprim-sulfamethoxazole (SXT) and one had no antibiotics. The antibiotic free medium and one SXT plate were incubated anaerobically (AnO2) at 35 degrees C, whereas the other SXT plate was incubated in air (O2) at 35 degrees C. The BAP AnO2 identified 85% of 201 GA compared with 96% for SXT-AnO2 and 92% for SXT-O2. GA were confirmed from only 29% of the beta-hemolytic colonies on BAP-AnO2 compared with 53% from SXT-AnO2 and 44% from SXT-O2. SXT, however, appeared to delay recognition of GA; since 94% of positives were found on day 1 with BAP-AnO2 versus 80% and 62% with SXT-AnO2 and SXT-O2, respectively. We conclude that BAP SXT (AnO2 or O2) is more sensitive and more specific than BAP-AnO2, but that a second day of incubation is required for optimal recovery of GA on the SXT selective media studied. PMID- 3552390 TI - Nontyphoid salmonella urinary tract infections. AB - Urinary tract infection caused by nontyphoid salmonella is rare. A case is described in a patient with acquired immunodeficiency syndrome who had multiple recurrences. A review of cases in which salmonella involved the urinary tract indicates that this infection usually occurs in patients who are structurally or immunologically compromised. Recurrence is expected and treatment plan should include an extended course of antibiotic therapy. PMID- 3552391 TI - Serodiagnosis of New World leishmaniasis by using a genus-specific antigen in enzyme linked immunosorbent assays. AB - A genus-specific monoclonal antibody (83L-5G9), generated against promastigotes of Leishmania braziliensis panamensis (WRAIR-470), has been used as a ligand in immunochromatography columns for the recovery and purification of the genus specific antigen. When the purified polypeptide, actually a doublet comprised of a 58 kd and a 31 kd moiety, was used as the antigen in enzyme linked immunosorbent assays (ELISA), it was reactive with 36 of 85 sera from Leishmania patients and with 1 of 49 sera from confirmed cases of Chagas' disease. An additional 25 sera from an unexposed population and five specimens from individuals seropositive for Toxoplasma gondii were nonreactive. PMID- 3552393 TI - Review of ankylosing spondylitis. PMID- 3552392 TI - Pyogenic liver abscess. AB - Liver abscess is an uncommon condition, with an incidence of one to four cases per year in most hospitals in the United States. It can affect persons of any age but is most commonly seen in patients 50 to 70 years old. Clinical findings are nonspecific in a large number of patients and, therefore, one should maintain a high clinical index of suspicion and be aware of abnormal laboratory data, particularly liver function tests. On the basis of these factors, one of the imaging techniques discussed earlier--particularly the ultrasound and the CT scan -should be ordered for the patient immediately. Once the diagnosis of liver abscess is made, the primary source of infection should be determined. Prompt antibiotic treatment and percutaneous drainage or open surgery, depending on the circumstances, should be used. This approach should minimize the morbidity and mortality in this disease that was otherwise always fatal just a few decades ago. PMID- 3552394 TI - Cancer and nutrition: a review. PMID- 3552395 TI - Atrial myxoma: overview, recognition, and management. AB - The evaluation of a patient suspected of having an atrial myxoma is based initially on a unique association of physical findings and symptoms referrable to obstructive, embolic, and/or constitutional manifestations of the tumor. Objective confirmation is sought with the use of M-mode and 2D echocardiography. A nondiagnostic echocardiogram, especially with recurrent or progressive symptoms and signs of atrial myxoma, should prompt more invasive methods of confirmation. The hemodynamic and angiographic data previously discussed may provide the clues needed for diagnosis, especially with nonprolapsing myxomas. The use of other techniques, such as a gated blood pool scanning or computerized tomography, affects primarily the incidental discovery of a "silent" tumor. Urgent surgical removal of the myxoma is mandatory to avoid progressive obstructive and embolic complications. Postoperative examination should be directed specifically at evaluating the patient for intracardiac tumor recurrence or growth of a peripheral embolic fragment. The incidence of these complications is small, but they are frequently overlooked. A second echocardiogram should be obtained as an initial baseline study. The asymptomatic patient should have subsequent routine clinical examinations to detect the growth of tumor embolic fragments and an echocardiographic examination every year or two to detect intracardiac tumor recurrence. Immediate evaluation is necessary should the patient develop recurrent symptoms. PMID- 3552397 TI - Comparison of fibre optic transillumination with clinical and radiographic caries diagnosis. AB - Fibre optic transillumination (FOTI) has been employed during the course of a 3 yr clinical dentifrice trial which initially involved 3003 children. At the initial examination, a subgroup of 813 13-yr-olds, and at the following annual visit, 2247 14-yr-olds, were examined using a 150 W lamp and 0.5 mm diameter probe. Routine clinical and radiographic examinations were performed separately. Compared to the clinical scores for anterior teeth, FOTI detected an additional 64% of interproximal lesions at the first visit while, for the larger number of children at the second visit, the increase in lesion detection level using FOTI was 37%. For the posterior teeth the comparable figure at the second examination was 92%. When FOTI data were compared to radiographic data for more than 52,000 posterior interproximal surfaces, FOTI could only detect 17% of radiographic Grade 2 lesions and 48% Grade 3 lesions. Thus any assumption that FOTI diagnoses may be a substitute for bitewing radiography appears premature. PMID- 3552396 TI - Oral hygiene habits, denture plaque, presence of yeasts and stomatitis in institutionalised elderly in Lothian, Scotland. AB - The purpose of the present study was to examine the relation between oral hygiene habits, denture plaque, presence of yeasts and stomatitis in institutionalised elderly. A sample of 201 residents, 48-99 yr of age (mean age 82 yr), was selected from four different institutions in Lothian, Scotland. Clinical recordings were carried out under standardised circumstances using well recognised indices. Information about oral hygiene habits was obtained through structured interviews conducted immediately before the clinical examination. A multivariate analysis, principal component, was carried out on the correlated five maxillary denture plaque scores and two components, accounting for 74% and 12% of the variation, were identified. Using these two independent variables, an analysis of variance was carried out testing for significance between the four effects: soaking habits, brushing habits, denture stomatitis and growth of yeasts in the palate together with their interactions. The analysis showed a significant relation between maxillary denture plaque, soaking habits and the presence of denture stomatitis. There was no relation between denture plaque and brushing habits or between denture plaque and growth of yeasts. PMID- 3552398 TI - A sensitive specific hemolytic assay for proenzyme C1. AB - The traditional hemolytic assay of the functional activity of C1, the first component of the classical complement pathway, was modified to permit differentiation between proenzyme (unactivated) C1 and the activated state of the enzyme (C1). A two-step assay was developed to quantitate proenzyme C1. The C1 sample to be assayed was first preincubated with C1 inhibitor, a process that specifically inhibits the enzymatic activity of C1 without affecting the subsequent activation of proenzyme C1 by EAC4, a model immune complex. Since the rate of reaction between C1 inhibitor, a serum regulatory protein, and C1 is concentration-dependent, this step is performed at high C1 and C1 inhibitor concentrations. Subsequent dilutions of the sample prevents C1 inhibitor-mediated inactivation of the C1 that is activated during the C1 hemolytic assay. Thus, in the presence of C1 inhibitor, the level of C1 hemolytic activity specifically reflects the activity of proenzyme C1, while in the absence of C1 inhibitor, the hemolytic activity reflects the total activity of C1. Both the absolute and the relative amounts of the proenzyme (unactivated) and activated C1 can thereby be quantitated in most samples. Furthermore, a partially purified C1 inhibitor reagent, easily prepared from serum, was shown to function identically to the purified C1 inhibitor, obviating the need for a multistep isolation procedure for this protein. Using this simple yet sensitive assay to investigate the efficiency of reconstitution of C1 activity from the purified components C1q, C1r, and C1s, we also find evidence for temperature- and concentration-dependent reaction steps in the formation of functional C1. PMID- 3552399 TI - Wound care: tried and tested. PMID- 3552401 TI - The great builder. President Stanley E. McCaffrey. PMID- 3552400 TI - Contact dermatitis. A review. AB - In recent years, there has been a dramatic rise in our understanding of contact dermatitis. This paper is a review of our knowledge of the mechanisms involved in contact dermatitis and related phenomena, the investigation of these events and the emergence of significant new allergens during the last 5 years. PMID- 3552402 TI - Effect of (D-Trp6, Pro9-NEt)-GnRH on the function and ultrastructure of pituitary and testis in male rats. AB - Groups of ten adult male Wistar rats were treated chronically with GnRH agonist for different durations. The responses of pituitary and testis to GnRH agonist were evaluated by serum and testicular testosterone, serum and pituitary LH, and testicular LH receptors. Testicular testosterone and LH receptors were decreased very significantly under our experimental regimen, irrespective of the duration of the treatment Serum testosterone levels were reduced after 10 and 15 injections, but only rats receiving 10 injections showed a significant increase in serum LH levels and decrease of pituitary LH content. The type II gonadotropes of the pars distalis of pituitary were increased in number but showed a higher degree of dilated smooth endoplasmic reticulum with few secretory granules. Many large lipid droplets appeared in the cytoplasms of the Leydig cells. Degenerative changes were observed in most seminiferous tubules following GnRH agonist treatment. Obvious abnormal acrosome and nuclear caps of some spermatids were also observed. The functional changes caused by GnRH agonist coincided with their ultrastructural appearance. PMID- 3552403 TI - Ciclosporin in renal transplantation. International Workshop on Ciclosporin in Renal Transplantation. Milano, October 25-26, 1985. Proceedings. PMID- 3552404 TI - A new approach to current problems in organ donation for kidney transplantation. PMID- 3552406 TI - Side effects and safety of Sandimmun in long-term treatment of renal transplant patients. PMID- 3552405 TI - Infections in ciclosporin-treated patients. PMID- 3552407 TI - Renin-angiotensin system and glomerular prostaglandins in early nephrotoxicity of ciclosporin. PMID- 3552408 TI - Renal toxicity of ciclosporin. Clinical studies. PMID- 3552409 TI - Acute tubular necrosis and arterial hypertension in renal transplant patients treated with ciclosporin. PMID- 3552410 TI - Ciclosporin and ischemia time in renal transplant. PMID- 3552411 TI - Perfusion time anuria and nephrotoxicity in cadaveric renal transplant. PMID- 3552412 TI - Reduction of the risk of acute tubular necrosis in ciclosporin-treated patients. PMID- 3552413 TI - Monitoring of ciclosporin toxicity by exfoliative urinary cytology in renal transplantation. PMID- 3552415 TI - Renal biopsy in ciclosporin-treated kidney transplant patients. PMID- 3552414 TI - Brief review of the morphology of ciclosporin nephropathy. PMID- 3552416 TI - Pharmacokinetics, metabolism and interactions of ciclosporin. PMID- 3552417 TI - Ciclosporin in renal transplantation: identification of two populations with different drug metabolism. PMID- 3552418 TI - Two years of ciclosporin in the North Italy Transplant Program. PMID- 3552419 TI - Ciclosporin in acute and chronic renal graft rejection. PMID- 3552420 TI - The Milano clinical trial of ciclosporin in cadaveric renal transplantation. PMID- 3552421 TI - Ciclosporin in cadaveric renal transplants. PMID- 3552422 TI - Clinical experience with ciclosporin at the Rome University Hospital. PMID- 3552423 TI - Immunosuppressive therapy in high-risk patients. PMID- 3552424 TI - Low-dose ciclosporin in cadaveric renal transplantation. PMID- 3552425 TI - Low doses of ciclosporin in renal transplantation. A single center experience. PMID- 3552426 TI - Ciclosporin alone or associated with steroid for immunosuppression of cadaveric renal transplants? PMID- 3552427 TI - Controlled study of steroid withdrawal after 6 months in renal transplant patients treated with ciclosporin. PMID- 3552428 TI - Management of chronic ciclosporin-related nephrotoxicity. PMID- 3552429 TI - Hypertension in glomerulonephritis. PMID- 3552430 TI - Hypertension in renovascular disease. PMID- 3552431 TI - Catecholamines and their possible role in hypertension associated with impaired renal function. PMID- 3552432 TI - Cardiovascular complications in chronic renal failure. PMID- 3552433 TI - Pathophysiology and management of hypertension in continuous ambulatory peritoneal dialysis patients. PMID- 3552434 TI - Causes of arterial hypertension in kidney transplantation. PMID- 3552435 TI - The diagnostic approach to the hypertensive patient. PMID- 3552436 TI - Management of essential hypertension. Whom, when and how to treat. PMID- 3552437 TI - Role of hypertension in the evolution of renal diseases. PMID- 3552438 TI - Prostaglandins in experimental and clinical hypertension. PMID- 3552439 TI - An induced synovitis disease model in ponies. AB - The effects of intra-articular injection of small amounts of E. coli lipopolysaccharide (LPS) into the intercarpal joint of 5 ponies were studied. The LPS induced predictable changes all of which were analogous to acute bacterial infection, except that the development of signs occurred sooner after the LPS injection, and subsided within 36 hours. Fever was monophasic and peaked at 5-7 hours. The ponies exhibited depression, reduced or absent appetite, increased pulse and respiration rates, and lameness. The lameness became evident between 1 and 2 hours after injection, at which time warmth, articular effusion, and resentment to palpation of joint flexion were evident. Hematological changes included neutrophilic leucocytosis, and changes in copper, iron and zinc serum concentrations. The synovial fluid total protein, leucocyte, and alkaline phosphatase levels increased within 2 hours. The mucin precipitation, total protein and leucocyte counts in synovial fluid remained elevated long after clinical and hematological changes had subsided. The model is useful for the study of some aspects of infectious joint disease. PMID- 3552440 TI - Enteroliths in horses. AB - Many cases of enteroliths were reported in the nineteenth century but the number greatly decreased in the early twentieth century. However, in recent years the number of cases in certain parts of the United States such as California has greatly increased. The reasons for the increase are obscure. The intake of nitrogen, magnesium and phosphorus (the primary components of enteroliths) from water and food is likely to be a factor. Arabians may be more likely to develop enteroliths than horses of other breeds. A nidus such as a small stone is needed because a nidus has been found in every enterolith that has been examined. Further studies in which the effect of mineral intake and form of the mineral on enterolith formation are needed. Studies of enterolith formation in the past have all been retrospective. Models for the development of enteroliths are needed. PMID- 3552441 TI - Applications of laser microprobe mass analysis in medicine. AB - An instrument for laser microprobe mass analysis (LAMMA) has been available for applied research for several years. The value of this sensitive microanalytical technique has been demonstrated in various fields of science, including medicine and biology. The LAMMA instrument comprises two laser systems. The first is a weak continuous pilot laser that can be aimed at a region of interest of the sample, e.g., a histological microtome section, using a light microscope. The second is a powerful pulsed laser that can evaporate the selected area. The generated ions are then analyzed in a time-of-flight mass spectrometer. The advantages of LAMMA present new perspectives in biomedical research. Elements can be located and analyzed down to the parts per million-level with a 1 micron spatial resolution. Speciation and/or fingerprinting of (in)organic molecules may be obtained. However, the technique is destructive, the quality of the light microscopic view is poor, and quantification is still under investigation. In this review, the analytical characteristics of LAMMA are evaluated, including instrumental features, detection sensitivity, ionization parameters, molecular speciation, and quantification. Applications of LAMMA in medicine are reviewed, covering the microanalysis of a wide range of physiological and toxic constituents (alkali metals, calcium, aluminum, titanium, fluorine and iodine, heavy metals, transition elements, and molecular compounds). PMID- 3552442 TI - Recent advances in routine thyroid function testing. AB - Thyroid function tests are one of the most common of endocrine laboratory investigations requested by general clinicians. The tests used therefore have to be efficient at identifying thyroid disease, monitoring treatment, and handling large numbers of tests. Recent advances in methodology have expanded both the range of in vitro thyroid function tests available and the techniques by which the well-established tests may be performed. This article reviews the methods and analytical and clinical performance of the routine tests currently available, concentrating particularly on the relatively new ones, and speculating on their role in strategies for the laboratory investigation of thyroid function. PMID- 3552443 TI - Airway pressure release ventilation. AB - Airway pressure release ventilation (APRV) delivers continuous positive airway pressure (CPAP) and may support ventilation simultaneously. This investigation tested whether, after acute lung injury (ALI), APRV promotes alveolar ventilation and arterial oxygenation without increasing airway pressure (Paw) above the CPAP level and without depressing cardiac function. Ten anesthetized dogs randomly received either intermittent positive-pressure ventilation (IPPV) or APRV. APRV was delivered with a continuous-flow CPAP system. Expiration occurred when a switch in the expiratory limb opened and Paw decreased to near-ambient, which decreased lung volume. After baseline data collection, ALI was induced by infusing oleic acid iv. Two hours later, IPPV and APRV were administered randomly, and data were collected. With normal lungs, APRV and IPPV achieved similar gas exchange and hemodynamic function. During ALI, arterial oxygenation was improved, and peak Paw which did not exceed the CPAP level, was lower during APRV. Similar minute ventilations were delivered by both modes but resulted in lower PaCO2 with APRV. Thus, APRV decreased physiologic deadspace ventilation. Hemodynamic status was similar during both modes. Therefore, APRV is an improved method of oxygenation and ventilatory support for patients with ALI that will allow unrestricted spontaneous ventilation and may decrease the incidence of barotrauma. PMID- 3552445 TI - Evaluation of a closed-tracheal suction system. AB - A new tracheo-bronchial closed-suction system has been recently introduced. The Trach Care catheter can be connected to the endotracheal tube of a patient on mechanical ventilation and be left in place as long as 24 h. Thus, suctioning does not require disconnection from the mechanical ventilator. We evaluated the benefits of this new system in 20 patients receiving mechanical ventilation; ten patients required PEEP of 10 cm H2O and under, while the other ten patients needed PEEP over 10 cm H2O to maintain acceptable oxygenation. PaCO2, arterial oxygen saturation, and alveolar-arterial oxygen tension difference were measured before and after suctioning, using a conventional catheter and the Trach Care closed-suction method. Oxygenation only deteriorated when the open technique was used in patients receiving over 10 cm H2O of PEEP. The changes were statistically, but not clinically, significant. The Trach Care system is approximately 25 times as expensive as conventional suctions catheter, so its use cannot be justified economically. A potential advantage of the technique is preventing the dissemination of contaminated secretions, which are dispersed when the patient is disconnected from the ventilator and inspiratory gas flow persists. While no universal advantage of the closed-suction system was found, potential benefits may be considered on a case-by-case basis. PMID- 3552444 TI - Cryoprecipitate infusion fails to improve organ function in septic shock. AB - Plasma fibronectin may be of critical importance for the septic patient through its proposed function as the major opsonin for macrophage clearance of circulating, noncellular debris. As a rule, critically ill, septic patients are depleted of fibronectin. In earlier uncontrolled studies, infusion of fibronectin rich cryoprecipitate had resulted in improved renal and pulmonary functions and changes in peripheral hemodynamics. In this controlled study, 32 septic ICU patients (mean initial fibronectin level = 60% of normal) received cryoprecipitate or control infusions. Although the fibronectin level was significantly elevated to the normal range in the cryoprecipitate group, no effects were seen in hemodynamics, oxygen metabolism, or lung and kidney functions. Our results indicate that this form of fibronectin therapy does not influence the impaired organ function in septic shock. PMID- 3552447 TI - Is 50% oxygen harmful? AB - Pulmonary gas exchange after tracheal extubation was evaluated in 25 patients to determine the effect of 50% oxygen administered during mechanical ventilation following aortocoronary bypass grafting. Twenty-five patients received postoperative mechanical ventilation for 16 to 24 h, 13 with an inspired oxygen fraction (FIO2) of no more than 0.30 and 12 with an FIO2 of 0.50. After tracheal extubation, all patients spontaneously breathed room air (FIO2 0.21). Postextubation the calculated venous admixture of patients who had received 50% oxygen (0.20 +/- 0.03 [SD]) was significantly (p less than .01) greater than that calculated for patients who received lower oxygen concentrations (0.13 +/- 0.04). Consequently, the PaO2 of patients who had received 50% oxygen (60 +/- 5 torr) was significantly (p less than .03) lower than the PaO2 of patients who had received no more than 30% oxygen (66 +/- 7 torr). Thus, administration of 50% oxygen, supposedly nontoxic, to mechanically ventilated patients may cause impairment of pulmonary gas exchange after tracheal extubation. Although high concentrations of supplemental oxygen are sometimes required, unnecessary elevation of FIO2 is not likely to significantly increase oxygen delivery and may contribute to postextubation pulmonary dysfunction. PMID- 3552446 TI - Patent ductus arteriosus during high-frequency ventilation for hyaline membrane disease. AB - The cardiovascular effects of a patent ductus arteriosus (PDA) in a premature baboon model of hyaline membrane disease treated with conventional positive pressure ventilation (CPPV) or high-frequency ventilation (HFV) were studied. Twenty-seven (84%) of 32 infant baboons delivered at 75% gestation had positive retrograde aortograms at one hour of life. Eleven (34%) of these infant baboons had persisting evidence for retrograde flow over the first 24 h by Doppler examination. Significantly higher fluid requirements and bicarbonate requirements were present in the animals with a persisting PDA. Mean aortic BP values were significantly lower in these same animals. No significant differences were found between groups when mean airway pressure, heart rate, urine output, or form of ventilation were compared. The only significant differences found between the conventional and high-frequency ventilated animals with PDA were higher peak airway pressures and lower PEEP levels in the conventionally ventilated infants. The premature baboons can be a useful primate model to study the PDA. There appears to be no significant difference regarding the clinical effects of HFV and CPPV on PDA. PMID- 3552448 TI - Transcutaneous pacing as an alternative to prophylactic transvenous pacemaker insertion. PMID- 3552449 TI - Group B streptococcal bacteremia after cardiac catheterization. PMID- 3552450 TI - Remyelination in demyelinating diseases of the central nervous system. AB - It is well accepted that a thorough understanding of pathogenetic mechanisms involved in demyelination and remyelination of the central nervous system (CNS) is fundamental to a better understanding of the etiology and pathogenesis of clinical demyelinating disease. In this review, experimental and clinical models of demyelination are discussed in an attempt to elucidate the mechanism by which they cause breakdown of the myelin sheath and/or damage to the oligodendrocyte. An attempt is made to determine whether mechanisms operating during experimental diseases may be applicable to the human situation. In a similar fashion, the occurrence of remyelination within the CNS in experimental animals and its relationship to the potential for remyelination following not only demyelinating disease but also remyelination following trauma and other destructive lesions are explored. The evidence for meaningful remyelination in the clinical situation is assessed, and the importance of such theoretical factors as the ability of oligodendrocytes to proliferate and migrate is evaluated. PMID- 3552451 TI - The adrenoleukodystrophies. AB - Clinical, biochemical, and genetic studies of adrenoleukodystrophy (ALD) are of current interest for six main reasons. First, assays of plasma lipids or cultured skin fibroblasts or amniocytes permit precise diagnosis of persons affected by the disease, as well as prenatal diagnosis and carrier detection. Second, the general nature of the enzymatic defect has been identified and the ALD gene has been mapped to the q28 segment of the X-chromosome. Third, the disease is more common than had been previously recognized. We have identified 350 patients in over 200 kindreds. Fourth, phenotypic variability is a striking feature. The illness may present as a rapidly fatal neurological disorder in early childhood or as a chronic progressive paraparesis in young, middle-aged, or even older adults. The latter syndrome is referred to as adrenomyeloneuropathy (AMN). It is of particular interest that these variants occur regularly within the same kindred, so that the phenotypic variation cannot be attributed to different genetic mutations. A fifth feature of interest is that in this X-linked disorder 12 to 40% of female carriers show various degrees of neurological disability, although almost always milder than in the hemizygous male. Studies with cultured fibroblasts suggest that mutant ALD cell lines have a competitive advantage over normal cell lines, a phenomenon which has not been observed in any other disorder. Finally, ALD appears to be one example of a peroxisomal disorder. Knowledge about the normal function of this subcellular organelle has emerged only recently, and further studies of ALD and related disorders will contribute to this. PMID- 3552452 TI - Vitamin E and the nervous system. AB - There is increasing evidence that vitamin E is essential for normal neurological function. In abetalipoproteinemia, which is the most severe deficiency state known in man, development of the associated spinocerebellar syndrome can be prevented by early vitamin E therapy. A neurological disorder similar to that seen in abetalipoproteinemia, comprising progressive ataxia, hyporeflexia, and proprioceptive loss, has been described in children and adults with chronic fat malabsorption and vitamin E deficiency. The neuropathological changes in such patients resemble those seen in vitamin E-deficient monkeys. Recent reports suggest that spinocerebellar degeneration may be caused by a selective defect of vitamin E absorption without other evidence of gastrointestinal disease. PMID- 3552453 TI - Effects of cryopreservation on the mononuclear cells of patients with lung cancer and normal controls. AB - Studies were carried out to determine the effects of cryopreservation on the mitogen-induced proliferative and immunoglobulin-producing abilities of peripheral blood mononuclear cells (MNC) of patients with lung cancer and normal controls. One-half of each sample of cells was tested fresh, while the other half was frozen, thawed immediately, and cultured at the same time. The responses of each sample of cryopreserved cells were compared to the responses of fresh cells from the same individual in simultaneous assays. The cryopreserved mononuclear cells of most of the lung cancer patients showed significantly enhanced plaque forming cell (PFC) responses after stimulation with pokeweed mitogen (PWM). No such significant differences were observed between the proliferative responses of cryopreserved and fresh cells against phytohemagglutinin (PHA) or PWM stimulation. The cryopreserved MNC of some of the normal controls also showed a similar increase in the PFC responses, although to a lesser extent. Coculture of cryopreserved B cell-enriched populations of cells with fresh T cell-enriched fractions obtained from these patients also resulted in the generation of a higher number of PFCs as compared to the number of PFCs observed after coculture of fresh B and T cell-enriched populations. The results indicate that the suppressor activities of monocytes/macrophages and other non-T cells (NK cells) are sensitive to cryopreservation. The results also show that the MNC of patients with lung cancer can be cryopreserved and used for subsequent B and T cell assays. PMID- 3552454 TI - The influence of yeast growth phase in vivo on the efficacy of topical polyenes. AB - We compared the efficacy of two polyenes, amphotericin B and natamycin, in two models of yeast infection. In one, treatment was begun immediately after inoculation, in the other it was delayed 24 hours. In each model infection with Candida albicans was established in the corneal stroma of dutch-belted rabbits and treated topically with 5% natamycin or amphotericin B 0.15% and 0.075%. Quantitative isolate recovery techniques were used to assess response after 5 days of treatment. A significant therapeutic effect was present for amphotericin B in both models. However, delayed treatment with natamycin was ineffective using treatment schedules efficacious when begun 1 hour after inoculation. A therapeutic effect was present only with administration of the drug every 1/2 hr. This altered response may reflect a difference in susceptibility between different growth phases in yeasts. PMID- 3552455 TI - Evaluation of two local anaesthetic sprays for the relief of post-episiotomy pain. AB - Aerosol formulations of lignocaine (5%) and cinchocaine (2%) were compared with a water-only placebo spray in a single-dose study in 76 primiparous patients complaining of moderate or severe post-episiotomy pain. In comparison with a water-only placebo, both local anaesthetic formulations gave significant relief when administered to the perineal wound but the lignocaine spray proved to be the more effective. The only side-effect reported was slight stinging occurring immediately after administration of the lignocaine spray in 2 cases. Serum concentrations of local anaesthetic post-administration were negligible. An interesting finding was that breast-feeding patients responded less well to this form of analgesia than patients in whom lactation had been suppressed with frusemide. PMID- 3552456 TI - A comparison of alcoholic and aqueous formulations of local anaesthetic as a spray for the relief of post-episiotomy pain. AB - A comparison of pain relief after a single perineal application of alcoholic and aqueous formulations of lignocaine (5%) spray with an aqueous formulation of cinchocaine (2%) spray was made in 72 primiparous patients complaining of moderate or severe post-episiotomy pain. All three formulations were similar in efficacy, the aqueous lignocaine preparation appearing slightly more effective than the others. PMID- 3552457 TI - Comparison of two formulations of lignocaine spray with mefenamic acid in the relief of post-episiotomy pain: a placebo-controlled study. AB - The analgesic effectiveness of aqueous and alcoholic formulations of lignocaine (5%) spray was compared with that of mefenamic acid (500 mg) or placebo in a double-blind study in 103 primiparous patients complaining of moderate or severe perineal pain associated with episiotomy. The results, assessed after a single dose, showed that the aqueous lignocaine formulation provided a level of pain relief superior to that obtained with the alcoholic formulation or placebo, and similar to that obtained with mefenamic acid. PMID- 3552459 TI - Nifedipine monotherapy in the hypertensive elderly: a placebo-controlled clinical trial. AB - A single-blind, placebo-controlled study was carried out to evaluate the suitability of slow-release nifedipine as antihypertensive monotherapy for the elderly. After a wash-out period, nifedipine slow-release tablets (20 mg twice daily) followed by matching placebo were administered, each for 4 weeks, to 23 patients over 60 years of age with essential mild to moderate hypertension. Nifedipine significantly reduced the systolic and diastolic blood pressure, and increased the pulse rate in both supine and upright positions. The pre-treatment supine systolic blood pressure proved the best single predictor of the blood pressure decreases in both positions. The decrease in mean arterial blood pressure correlated significantly with the nifedipine plasma concentration. Significant biochemical changes were observed with nifedipine, namely increased serum K+ level and decreased levels of serum Na+, cholesterol and triglycerides. Side-effects in general were mild and transient; nevertheless, 3 patients dropped out because of severe leg oedema. PMID- 3552458 TI - Efficacy of a fixed-dose combination of 40 mg penbutolol with 6 mg piretanide in the treatment of mild to moderate hypertension: a double-blind study against placebo. AB - The antihypertensive efficacy and tolerability of a fixed-dose combination containing 40 mg penbutolol (a beta-blocking agent) and 6 mg piretanide (a diuretic) in comparison to placebo was investigated in a double-blind, crossover study in 20 patients with mild to moderate essential hypertension. After a 1-week period on placebo, patients were allocated at random to receive 1 tablet daily for 4 weeks of either the combination preparation or placebo and were then crossed over to the alternative medication for a further 4 weeks. The reduction in systolic and diastolic blood pressure both at rest, during maximal ergometric exercise and isometric word load, and also in the diurnal blood pressure profile over 24 hours was significantly greater in the group treated with the fixed-dose combination than in the placebo group. Pulse rate was also decreased to a greater extent. Mean diastolic blood pressure before exercise was reduced to normal (85.5 mmHg) after 4-weeks' treatment with the fixed-dose combination. Biochemical, haematological and urinary parameters showed no clinically relevant changes after either treatment. One patient complained of transient dizziness during treatment with the fixed-dose combination. No patient withdrew prematurely from the study because of side-effects. PMID- 3552460 TI - Influenza vaccine: the effects of the 1986/1987 viral strains. AB - One hundred and twenty healthy volunteers were recruited for a study to evaluate the reactogenicity and serological response of differing doses of the 1986/87 World Health Organization-recommended influenza viral strains. Each vaccine was prepared by Institut Merieux and contained A/Mississippi/1/85, A/Chile/1/83 and B/Ann Arbor/1/86. One vaccine was formulated as a 10/10/10 micrograms HA and the other as a 15/10/15 micrograms HA. No significant advantage could be found with the 15/10/15 micrograms HA combination and it was recommended, therefore, that a 10/10/10 micrograms HA formulation was to be preferred. This vaccine demonstrated a minimal cross-sensitivity to the A/Singapore/6/86 influenza strain. In view of the prevalence of the A/Singapore strain, a second study was subsequently undertaken with a monovalent A/Singapore/6/86-like vaccine in a further 62 volunteers. This demonstrated an overall sero-conversion rate of 90%. Local side effects with both vaccines were lower than in a similar study in 1984 and this may reflect a reduction in endotoxin levels achieved by a minor modification in the manufacturing technique. These studies confirmed the efficacy of a trivalent A/Mississippi, A/Chile, B/Ann Arbor influenza vaccine and the efficacy of, and necessity for, an additional A/Singapore vaccine. PMID- 3552461 TI - The timing of surgery in mitral and aortic valve disease. PMID- 3552462 TI - Neonatal hyperviscosity syndromes. PMID- 3552463 TI - Exocytosis in Saccharomyces cerevisiae treated with congo red. AB - When dividing cells of Saccharomyces cerevisiae were exposed to the polysaccharide-binding dye Congo red, the walls and septa became sites of chitin accumulation. In addition, the cytoplasm showed many vesicles that were different from those accumulating in the growing bud and from the lytic vacuoles of the untreated yeasts. To obtain information about these membranous structures, living cells were observed under phase contrast and UV light microscopes. Furthermore, ultrathin sections of Congo red-treated cells were processed by cytochemical techniques to reveal the chitin areas. Observations suggest that the aberrant vesicles were involved in a secretory process, and that pre-assembled chitin was not among the components transported to the cell periphery. PMID- 3552464 TI - Nifedipine in asthma. Dose-related effect on resting bronchial tone. AB - In order to study the dose-related effect of nifedipine on expiratory flow rates, 15 asthmatic patients were given sublingually 10 mg and 20 mg of the drug on two different days and the FVC and FEV1 were measured during 90 minutes. Then they received 2.5 mg albuterol (Salbutamol) by inhalation, and the two parameters were measured again after 30 minutes. It was found that the drug has a dose-related effect on expiratory flow rates. Indeed, 20 mg nifedipine produced a mild (less than 10 percent) but significant improvement in FVC (p less than 0.01) and FEV1 (p less than 0.05), while the response to 10 mg was mild, not significant and manifested rather by a decrease in both parameters. In three patients, the forced expiratory flow rates markedly worsened. No correlation could be established between the effect of nifedipine and the severity of the disease. In contrast, the improvement produced by albuterol was strongly related to the degree of airway obstruction (p less than 0.001). Nifedipine in both doses did not potentiate the bronchodilatation induced by albuterol. PMID- 3552465 TI - Airway hyperresponsiveness in allergic rhinitis. A risk factor for asthma. AB - In order to study whether the methacholine inhalation challenge could predict which patients with allergic rhinitis were at risk to develop asthma, we prospectively studied a group of ragweed-sensitive patients over a four to five year period. On the initial study, 16 of 40 patients (40 percent) were found to be hyperresponsive to methacholine. On the follow-up study, three of these 16 patients (19 percent) were found to have developed asthma from one and one-half to five years after the initial testing. Each had greater methacholine responsiveness on repeat study. The degree of methacholine hyperresponsiveness, judged by the PD20, could not predict which of the initial responders would develop asthma. Twenty-four (60 percent) of our patients showed normal responses to methacholine on initial study; none developed asthma and 88 percent remained nonresponders on repeat study. Our study shows that allergic rhinitis patients hyperresponsive to methacholine are at greater risk to develop asthma than those with normal bronchial challenges (p less than 0.05). PMID- 3552466 TI - Ventricular assist by cardiac cycle-specific increases in intrathoracic pressure. AB - Changes in intrathoracic pressure can influence cardiac performance by altering ventricular loading conditions. Since ventricular loading, both from systemic venous return (preload) and from left ventricular wall stress (afterload), varies during the cardiac cycle, we reasoned that appropriately placed, phasic, cardiac cycle-specific (synchronous) increases in intrathoracic pressure might augment ventricular ejection in acute ventricular failure. Recent studies in animals suggest that synchronous increases in intrathoracic pressure during systole increase ejection. We compared the hemodynamic effect of synchronous increases in intrathoracic pressure with similar increases delivered at random in the cardiac cycle in patients with congestive cardiomyopathy (n = 9). Intrathoracic pressure was estimated by measuring esophageal pressure. High-frequency jet ventilation (HFJV) synchronized with the electrocardiogram (synchronous HFJV) was compared with HFJV at a fixed frequency within 15 percent of the heart rate (asynchronous HFJV) and with intermittent positive-pressure breathing (IPPB) (tidal volume = 10 ml/kg; f = 15). All forms of ventilation resulted in the same mean airway pressure and esophageal pressure. Mean pulmonary arterial occlusion pressure and arterial pressure were constant in all conditions. Cardiac output was greater with synchronous HFJV than with either IPPB or asynchronous HFJV (4.5 +/- 0.7 L/min compared with 3.5 +/- 0.7 and 3.4 +/- 0.6 L/min [mean +/- SE], respectively; p less than 0.05). Mixed venous oxygen saturation covaried with cardiac output (p less than 0.05), such that calculated oxygen consumption remained constant for all conditions. We conclude that synchronous HFJV augments cardiac output more efficiently than do similar increases in intrathoracic pressure delivered randomly in the cardiac cycle. PMID- 3552468 TI - Bypass surgery in patients with coronary artery disease. Indications based on the multicenter randomized trials. PMID- 3552467 TI - The causes and evaluation of chronic hypercapnea. PMID- 3552469 TI - CPAP with minimal work of breathing. PMID- 3552470 TI - Autonomic control and mucociliary functions. PMID- 3552471 TI - Anticholinergic agents in COPD. PMID- 3552472 TI - Aerosol therapy of reversible airflow obstruction. Concepts and clinical applications. PMID- 3552473 TI - Inducing capacity of the combinations mecillinam-ampicillin and mecillinam ceftazidime in comparison with the capacity of the compounds administered separately. AB - The inducing capacity of mecillinam in combination with ampicillin or ceftazidime was compared with that of the compounds administered separately and related to the inducing capacity of cefoxitin (1 and 10 micrograms/ml) for the chromosomal beta-lactamases from Enterobacter cloacae, Serratia marcescens, Citrobacter freundii, indole-positive Proteus, and Acinetobacter strains. In the majority of the strains all compounds tested alone or in combination showed a lower inducing capacity than cefoxitin at both concentrations (less than twofold); in a few strains a moderate inducing capacity was observed. In general, the inducing capacity of cefoxitin 10 micrograms/ml was similar to that of 1 microgram/ml. Only in two E. cloacae, two S. marcescens and two indole-positive Proteus strains did 10 micrograms/ml cefoxitin show a distinctly higher inducing capacity. The variation in inducing capacity within one species and between the species was remarkable. PMID- 3552474 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3552475 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3552476 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3552477 TI - [Roman medical practice. 2--Teeth and dentists]. PMID- 3552478 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3552479 TI - [Clinical study of the Canal Finder System]. PMID- 3552480 TI - [Results of the surgical treatment of injuries of the ulnar nerve]. PMID- 3552481 TI - [10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. II. Which factors modify the recurrence of inguinal hernia?]. AB - Many factors seem to influence the recurrence rate after adult inguinal hernia repair. A statistical analysis of data derived from 726 transversalis fascia repairs examined by the authors (with a follow-up rate of 82.5% and a mean follow up time of 5.5 years) revealed a significantly higher recurrence rate in patients with chronic bronchitis (p less than 0.05) or with postoperative complications (p less than 0.001). Lower recurrence rates were found after resection of lipomas of the cord (p less than 0.01) or cremasteric muscle resection (p less than 0.05). No significant difference of recurrence rate could be established for following parameters: Sex, side, age distribution, profession, prostatism, obesity, type of hernia (direct, indirect, combined, sliding), suture material (silk, polyglycolic acid), surgeon, anesthesia (local, spinal, full), elective or emergency operation, and whether the repair was unilateral or simultaneously bilateral. Recurrent repairs showed no significantly higher recurrence rate than primary repairs. PMID- 3552482 TI - [Gastropexy in combination with percutaneous endoscopic gastrostomy]. PMID- 3552484 TI - [Rectopexy by peritoneal strips for the treatment of rectal prolapse]. PMID- 3552483 TI - [10 years' experience using a modified Shouldice surgical technic for inguinal hernia in adults. I. Method and results in 726 operations with follow-up]. AB - Since 1973 we have used a modified Shouldice repair to treat inguinal hernias in adults. The repair was performed on unselected patients. The procedure was performed by both senior surgeons and surgeons in training. Over a 10-years period, 880 transversalis fascia repairs were done and 726 (82.5%) were examined by the authors 12-142 months after the operation (mean time 66.1 months). In 94.2% of the 726 repairs the patients were satisfied with the result. Follow-up studies revealed testicular atrophy in 0.6%, deep wound infection in 0.8% and an overall recurrence rate of 5.8%. The recurrence rate was not significantly different after direct, indirect, combined or sliding hernias. In 25% of recurrences the patients were asymptomatic and unaware of the recurrence. PMID- 3552485 TI - [Indications of mechanical and manual sutures in digestive surgery. An evaluation of 607 cases in 8 years]. PMID- 3552487 TI - [Direct surgery of the brachial plexus. 10 years' experience. Apropos of 262 surgically treated cases]. PMID- 3552486 TI - [Limb reimplantation. Long-term evaluation]. PMID- 3552488 TI - [Effect of a vitamin B2 derivative on recurrent oral ulcers; sequential analysis]. PMID- 3552489 TI - [Histopathological analysis of desquamative gingival lesions]. PMID- 3552490 TI - [Condylar guidance of dental articulators]. PMID- 3552491 TI - [Asymptomatic myocardial ischemia]. PMID- 3552492 TI - [Significance of PHA labeling in the diagnosis of gastric cancer]. PMID- 3552494 TI - [Advances in clinical studies of gastrointestinal motility]. PMID- 3552493 TI - [Prostacyclin and other drugs protective against experimental liver damage in rats]. PMID- 3552495 TI - [Present status and trends in antidiabetic drugs]. PMID- 3552496 TI - [Advances in the study of leptospirosis]. PMID- 3552497 TI - [Preliminary analysis of results of the genetic toxicity test of 23 kinds of chemicals and the selection of its methods]. PMID- 3552498 TI - [Experimental study of the effects of end-to-side mesocaval shunt on the liver]. PMID- 3552499 TI - [Experimental farmer's lung: a light and electron microscopy and immunohistochemical study]. PMID- 3552500 TI - [Aspiration needle biopsy with ultrasonic guide in chest diseases: a report of 11 cases]. PMID- 3552501 TI - [Re-expansion pulmonary edema]. PMID- 3552502 TI - Compressive strengths of renaissance foil and porcelain-fused-to-metal crowns. PMID- 3552503 TI - The Rio Azul archaeological project. PMID- 3552504 TI - Preparation for elective colorectal surgery. A randomized, blinded comparison between oral colonic lavage and whole-gut irrigation. AB - An oral colonic lavage solution containing sodium sulfate and polyethylene glycol was compared with whole-gut irrigation using saline via a nasogastric tube in a randomized blinded study of 34 consecutive well-matched patients undergoing elective colorectal surgery. Both methods were safe and rapid. Patients receiving oral colonic lavage, however, had significantly less (P less than 0.05) water retention, overall distress, cramps, and other complaints. No significant differences were found with regard to fullness, nausea, and rectal discomfort. The bowel cleansings were equally adequate, and most patients achieved a good-to excellent preparation. Surgical complications appeared not to be related to the preparation used, and wound sepsis were equally frequent. Oral colonic lavage proved to be the most attractive preoperative cleansing method. PMID- 3552505 TI - Clinical and hormonal conditions associated with sodium retention in cirrhotic patients with ascites. Evaluation by univariate and multivariate analyses. AB - Using multiple regression analysis, we have evaluated the clinical and hormonal conditions associated with impaired urinary sodium excretion in normoazotemic patients with cirrhosis and ascites. We retrospectively identified 13 patients with a urinary sodium excretion lower than 15 mmol/day and 13 patients with a sodium excretion higher than 15 mmol/day. Using univariate analysis, all the patients with poor sodium excretion had abnormally high levels of plasma renin activity, plasma aldosterone, and arginine vasopressin. In addition, they had a diastolic blood pressure lower than patients with high urinary sodium excretion, although otherwise were comparable as regards clinical and biochemical data. The consistency of the above associations was then tested by multiple-regression analysis in an attempt to control for potentially confounding factors and to identify only true, independent associations. After a discriminant stepwise procedure, we found that low diastolic blood pressure (P less than 0.01) and high plasma aldosterone levels (P less than 0.05) were the only two conditions independently associated with abnormally low urinary sodium excretion. These findings are consistent with the view that sodium retention in decompensated cirrhosis results from a concomitant severe contraction in the effective blood volume and an increased production and/or retention of aldosterone. The concordance between our results and several pathophysiological findings supports the validity of this statistical approach to confirm physiological and/or clinical predictions. PMID- 3552506 TI - Mucosal coating agents and other nonantisecretory agents. Are they cytoprotective? AB - Gastric cytoprotection is protection against gross and histological gastric mucosal injury by a mechanism other than inhibition of neutralization of gastric acid secretion. Animal studies have shown that a variety of agents afford such a protective effect. With some of these agents, a similar protective effect has been shown in man. This protective effect must be distinguished from an action that enhances healing of an already established mucosal lesion as an ulcer. It is yet to be established that the cytoprotective effect of an agent enhances ulcer healing. Agents other than prostaglandins that have been shown to possess such a cytoprotective effect in animals are reviewed. Some, such as sucralfate, act via stimulation of endogenous prostaglandin synthesis, while others, such as DeNol, neomycin, and meciadanol, do not. Investigation of the mechanism through which these agents enhance gastric mucosal defense is a fertile field for investigation. PMID- 3552507 TI - Review of drug interference with urine glucose tests. AB - Many drugs have been reported to interfere with copper-reduction or glucose oxidase tests used to measure urine glucose. However, only a few drugs or drug classes have been well documented to clinically interfere with these tests. The interfering drugs include ascorbic acid, beta-lactam antibiotics (e.g., cephalosporins and penicillins), levodopa, and salicylates. Several other drugs may also interfere with certain urine glucose tests, but the interactions are poorly documented. These drugs include chloral hydrate, hyaluronidase, nalidixic acid, nitrofurantoin, p-aminosalicylic acid, phenazopyridine, probenecid, and X ray contrast media. Drugs or their metabolites that are strong reducing substances produce false-positive results by the copper-reduction method and false-negative results by the glucose oxidase method. The beta-lactam antibiotics interfere with copper-reduction tests by producing copper compounds of various colors that confuse interpretation of test results. Tables are provided that summarize the drug interferences discussed. PMID- 3552508 TI - Ambulatory glucose profile: representation of verified self-monitored blood glucose data. AB - Sixty-nine individuals with diabetes (23 with type I, 15 with pregestational, and 31 with gestational) used specially modified reflectance meters containing memory chips enabling the instruments to store 440 individual blood glucose values with corresponding time and date. These data were organized into 14-day periods and then collapsed into a graphic depiction, the Ambulatory Glucose Profile (AGP), which was represented as the pattern of the 25th, 50th, and 75th percentiles of blood glucose values. These three curves illustrate the median level of control and provide an index of variability in control at each hour of a "typical day." We observed distinctive AGPs related to the variability in metabolic control and the type of diabetes. Comparisons between diagnostic groups showed consistent differences between groups, independent of level of glycemic control. Review of serial AGPs obtained for sequential 2-wk periods for 23 non-pregnant individuals with type I diabetes and 10 women with gestational diabetes revealed changes in AGP corresponding to alterations in regimen. The AGP provides a new approach to the evaluation of glycemic control, with applications to patient and physician education, clinical investigation, and individual patient care. PMID- 3552509 TI - Role of metformin in treatment of diabetes mellitus. AB - Metformin, a biguanide antidiabetic agent that can be administered either alone or in combination with sulfonylureas, has been extensively used in Europe and Canada. The mechanism of action of metformin and other biguanides is not completely understood, but recent in vitro and in vivo studies suggest that metformin may act in part by both increasing the binding of insulin to its receptor and potentiating insulin action. Metformin, because of its chemical structure, does not interact with the liver and has a short half-life. Consequently, lactic acidosis, which is a rare complication of metformin, has not been associated with the proper use of this drug. In addition to its antidiabetic actions, metformin causes weight loss in obese diabetic patients and may be useful in managing associated lipid disorders. PMID- 3552510 TI - Variations in insulin dosage. PMID- 3552511 TI - Prevalence of fasting hyperglycemia and known non-insulin-dependent diabetes mellitus classified by plasma C-peptide: Fredericia survey of subjects 60-74 yr old. AB - A Danish population of 5699 individuals (60-74 yr old) was screened by fasting blood glucose (FBG) and interviewed about known diabetes. The distribution of FBG in individuals not known to have diabetes showed no sex difference or significant variation with age. Fasting hyperglycemia (FH), defined as FBG greater than or equal to mM in subjects without a history of diabetes, was found in 1.7% of men and women. Known diabetes (KD) had a prevalence of 3.9 and 5.0% in men and women, respectively. The prevalence rates of FH and KD increased significantly with age. In the two subgroups, plasma C-peptide was measured after overnight fasting and subsequently 6 min after an intravenous injection of glucagon. Based on the distribution of the C-peptide concentrations in non-insulin-treated KD subjects, lower limits for non-insulin-dependent diabetes mellitus (NIDDM) of 0.30 pmol/ml for fasting C-peptide and 0.60 pmol/ml for stimulated C-peptide were arbitrarily chosen. According to these cutoff points, only 38.5% of KD subjects treated with insulin had insulin-dependent diabetes mellitus, corresponding to 9.3% of all KD subjects. After exclusion of these patients, the prevalence of recognized NIDDM was 3.5% in men and 4.5% in women. All FH subjects except one had C-peptide values in the NIDDM interval. A close agreement between fasting and glucagon stimulated C-peptide was seen. In epidemiological studies with an expected high prevalence of NIDDM, we propose to use fasting C-peptide for classification of patients with insulin-treated diabetes. PMID- 3552512 TI - Residual beta-cell function in children with IDDM: reproducibility of testing and factors influencing insulin secretory reserve. AB - Reproducibility of C-peptide secretion was assessed in 20 children (group 1) by their responses to two Sustacal- (a mixed liquid meal) stimulation tests performed 7-14 days apart. For the 12 C-peptide-positive children (basal C peptide greater than or equal to 0.03 pmol/ml) there were no differences in the basal or stimulated values between tests 1 and 2. The effect of exogenous insulin on C-peptide secretion was assessed in 20 other children (group 2) by their responses to two Sustacal tests, one test without and one with soluble insulin (0.25 U/kg) injected subcutaneously before testing. Eleven children were C peptide positive and had no differences in C-peptide response between tests 1 and 2. The results from test 1 in groups 1 and 2 were combined with those from 44 others undergoing a single Sustacal test (group 3, N = 84). There was a close correlation between basal and peak C-peptide concentrations in the 44 C-peptide positive children (r = .88, P less than .001). Peak C-peptide concentrations correlated inversely with HbA1 (r = -.29, P less than .01), insulin dose in units per kilogram (r = -.40, P less than .001), and duration of diabetes (r = .33, P less than .001) and positively with age at onset of diabetes (r = .34, P less than .001). The C-peptide-positive children had reduced glucose response to Sustacal, lower HbA1 concentration, lower insulin requirement, later age of onset, and shorter duration of diabetes than children who were C-peptide negative. PMID- 3552513 TI - Prednisone treatment in newly diagnosed type I diabetic children: 1-yr follow-up. AB - Thirty-one children suffering from type I diabetes mellitus were arranged at onset of the disease in two different groups. Group 1 was treated with oral prednisone (60 mg X m-2 X day-1 for 14 days, 30 and 15 mg X m-2 X day-1 for 7 days). Group 2 matched the control group. All patients were treated with continuous subcutaneous insulin infusion for the first 15 days of treatment, and then with two daily injections of a mixture of intermediate- and fast-acting insulin. All subjects were followed for 1 yr. Group 1 required more insulin than group 2 after 30 days (1.5 +/- 0.3 vs. 0.6 $ 0.2 U X kg-1 X day-1, P less than .001) and after 60 days (0.8 +/- 0.1 vs. 0.5 +/- 0.06 U X kg-1 X day-1, P less than .001). After 3 mo, both groups reached the lowest mean stable HbA1 level (8.4 +/- 0.4 and 8.3 +/- 0.4% group 1 and 2 respectively). Between the 2nd and 9th mo of follow-up, mean postbreakfast C-peptide concentration increased in both groups. The highest levels of fasting C-peptide were reached by group 1 after 90 days (0.77 +/- 0.32 nM) and group 2 after 60 days (0.34 +/- 0.09 nM). The largest partial remission (C-peptide 0.3 nM, insulin requirement less than 0.5 U X kg-1 X day-1 and no glycosuria) was observed in group 1 after 180 days (5 of 16 patients) and in group 2 after 60 days (5 of 15 patients).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552514 TI - Changes in insulin resistance with long-term insulin therapy. AB - Thirteen newly diagnosed diabetic subjects, 5 with insulin-dependent diabetes mellitus (IDDM) and 8 with non-insulin-dependent diabetes mellitus, mean age 37.1 yr (range 25-64 yr), underwent glucose-clamp studies at diagnosis of diabetes at plasma glucose 200 mg/dl. Each subject was then treated twice daily with insulin for 6 mo with improvement in glycemic control, and the glucose-clamp studies repeated. Changes in glucose uptake at an insulin infusion rate of 1.0 mU X kg-1 X min-1 varied greatly from diagnosis to 6 mo. There were significant negative correlations between change in glucose uptake and diabetes type (r = -.78, P less than .002), C-peptide secretion (r = -.66, P less than .05), and age (r = -.62, P less than .05). At an insulin infusion rate of 10 mU X kg-1 X min-1 there was improvement in glucose uptake from diagnosis to 6 mo that did not reach statistical significance. During the steady-state periods of the glucose-clamp studies at diagnosis, growth hormone (GH) rose above basal, which reached statistical significance at the higher insulin infusion rate. This increase in GH was not apparent at the time of the glucose-clamp studies after insulin therapy. Our results indicate that in the clinical situation, only patients with IDDM can expect an improvement in their sensitivity to physiologic insulin levels with long-term insulin therapy. In all subjects, improvement in glycemic control leads to abolition of GH secretion in the presence of hyperglycemia. PMID- 3552515 TI - Effect of metformin on insulin-stimulated glucose turnover and insulin binding to receptors in type II diabetes. AB - Euglycemic insulin glucose-clamp and insulin-binding studies on erythrocytes and monocytes were performed in seven type II (non-insulin-dependent) diabetic subjects before and after 4 wk of metformin treatment (850 mg 3 times/day) and in five obese subjects with normal glucose tolerance. Glucose turnover was also measured at basal insulin concentrations and during hyperinsulinemic euglycemic clamps. During euglycemic insulin-glucose clamps, diabetic subjects showed glucose disposal rates of 3.44 +/- 0.42 and 7.34 +/- 0.34 mg X kg-1 X min-1 (means +/- SD) before metformin at insulin infusion rates of 0.80 and 15.37 mU X kg-1 X min-1, respectively. With the same insulin infusion rates, glucose disposal was 4.94 +/- 0.55 (P less than .01) and 8.99 +/- 0.66 (P less than .01), respectively, after metformin treatment. Glucose disposal rates in normal obese subjects were 5.76 +/- 0.63 (P less than .01) and 10.92 +/- 1.11 (P less than .01) at 0.80 and 15.37 mU X kg-1 X min-1, respectively. Insulin maximum binding to erythrocytes in diabetics was 9.6 +/- 4.2 and 5.8 +/- 2.6 X 10(9) cells (means +/- SD) before and after metformin treatment, respectively (NS). Insulin maximum binding to monocytes in diabetics was 6.2 +/- 2.3 X 10(7) cells before and 5.0 +/ 1.6% after metformin. Hepatic glucose production was higher in the diabetic patients at basal insulin levels, but not at higher insulin concentrations, and was not significantly changed by drug treatment. Basal glucose and insulin concentrations decreased with metformin. Thus, metformin treatment improved glucose disposal rate without significant effect on insulin-binding capacity on circulating cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552516 TI - Effects of relaxation therapy on patients with type I diabetes mellitus. AB - We investigated the effect of treatment with biofeedback-associated progressive muscle relaxation on 10 patients with poorly controlled type I diabetes mellitus compared with 10 equivalent untreated patients. In contrast to previous studies of patients with type II diabetes, no improvement occurred in glucose tolerance after 1 wk of intensive in-hospital relaxation training or in glycohemoglobin and total daily insulin dose after 6 wk of practicing relaxation techniques at home. This and other studies suggest that this type and amount relaxation therapy may not be as useful for enhancing blood glucose control in patients with type I diabetes as in those with type II diabetes. However, subpopulations of type I diabetic patients who have demonstrated stress-induced hyperglycemia should be further investigated. PMID- 3552517 TI - Medical expenditures and insurance coverage for people with diabetes: estimates from the National Medical Care Expenditure Survey. AB - Access to health insurance and protection against expenditures for medical care are of special concern to diabetic patients in the United States. This study examines some information on the extent and breadth of public and private health insurance for individuals with diabetes, as well as some estimates of their use of health-care services and their mean expenses for this care. About 12% of all diabetic patients less than 65 yr old (approximately 311,000 individuals) were uninsured throughout 1977, a rate not much different from that for the rest of the United States population. Those with diabetes who are uninsured tend to be younger, Black or Hispanic, in excellent or good health, and live outside of metropolitan areas and in the South or West. As expected, diabetic patients use more medical care than others of their age and sex, and their medical expenses are also much higher, particularly in younger age groups. In 1977, average total medical-care expenses for people with diabetes were $1514 compared with $548 for the rest of the population. They and their families paid approximately 20% out of pocket (approximately $355). Their health insurance premiums were not much different from those without diabetes, averaging approximately $1000 in 1977 for those under age 65. The private insurance coverage for diabetic patients was similar to that for others, although slightly fewer had major medical coverage than the general population. PMID- 3552518 TI - Consensus statement on self-monitoring of blood glucose. PMID- 3552519 TI - Methodological aspects and application of the immunoperoxidase staining technique in diagnostic fine-needle aspiration cytology. AB - The immunoperoxidase method was modified and adapted for use on cells obtained by fine-needle aspiration biopsy for routine diagnostic cytology. Combinations of different modes of fixation and graded trypsinization were tested. Best results were obtained with fixation in formol-acetone followed by enzyme digestion for 3 6 min; exact times were adjusted for the individual antigen. With optimal conditions as to fixation and proteolytic digestion, the method was found to be sensitive and reproducible and without artifactual background staining. Various intracytoplasmic antigens of diagnostic importance such as immunoglobulins, prostate-specific antigen, keratin, thyroglobulin, S-100, alpha-1-antitrypsin, and lysozyme in lymphoid cells, bone marrow cells, and tumor cells of epithelial and mesenchymal origin were detected. Staining of newly prepared or up to 2-yr old specimens gave equally good results. Both cellular morphology and the results of immunoperoxidase staining can be studied simultaneously. The method is considered valuable for increasing accuracy of diagnostic cytology. PMID- 3552520 TI - Gastrointestinal peptides and insulin secretion. PMID- 3552521 TI - Gluconeogenesis and its regulation. PMID- 3552522 TI - Role of counterregulatory hormones in the regulation of hepatic glucose metabolism. PMID- 3552524 TI - Beta cell function in the preclinical period of insulin-dependent diabetes. PMID- 3552523 TI - Metabolic zonation of liver parenchyma: significance for the regulation of glycogen metabolism, gluconeogenesis, and glycolysis. PMID- 3552525 TI - Insulin, glucagon, and glucose as regulators of hepatic glucose uptake and production in vivo. PMID- 3552526 TI - The kinetics of insulin in man. I. General aspects. PMID- 3552527 TI - The kinetics of insulin in man. II. Role of the liver. PMID- 3552528 TI - The impact of sulfonylureas on hepatic glucose metabolism in type II diabetics. AB - Fasting hyperglycemia in subjects with NIDDM appears to be the final result of abnormalities in endogenous insulin secretion combined with diminished peripheral insulin action secondary to a combined receptor and postbinding defect in cellular insulin action and accelerated hepatic glucose production. Of these various abnormalities, the accelerated rate of hepatic glucose production appears to be of major importance in determining the overall severity of the hyperglycemia. The hyperglycemia, which is maintained by the accelerated rate of hepatic glucose release, appears to compensate for the decrease in insulin action at the level of the peripheral tissues, as well as the liver. Although this compensatory effect of hyperglycemia appears to match the decrease in insulin action in the peripheral tissues rather precisely, the compensation at the level of the liver does not totally restore normal homeostasis. These observations suggest that the liver and peripheral tissues are intimately linked via mechanisms that remain to be delineated. Recent observations of alterations in the activities of key rate-limiting enzymes in the pathway for oxidiative glucose metabolism suggest that an abundance of glucose precursors may be made in peripheral tissues, which then recycle to the liver to support and/or drive the accelerated rates of hepatic glucose production. Additional studies are clearly needed in these areas to further delineate these crucial issues. In a similar manner, the role of the liver in determining the success of various therapeutic modalities in these subjects appears to be of paramount importance. The data reviewed regarding the mechanisms of action of sulfonylurea agents indicate that the quality of glycemic control achieved in subjects treated with these agents is largely determined by the ability of the drug to lower the elevated rates of hepatic glucose production. This suggests that new compounds that are more effective in this regard will prove to be more efficacious. PMID- 3552529 TI - Regulation of hepatic glucose metabolism in humans. PMID- 3552530 TI - Diabetes and atherosclerosis: an epidemiologic view. AB - Diabetes is associated with changes in plasma lipids and lipoproteins into atherogenic direction. In IDDM these changes are small or absent if good metabolic control can be maintained. Diabetic nephropathy is, however, associated with the appearance of dyslipoproteinemia. In NIDDM plasma total and VLDL triglyceride levels are elevated, and HDL-cholesterol level is decreased, and this pattern of dyslipoproteinemia does not always respond to improved control of hyperglycemia. Abnormalities of lipoprotein metabolism, not reflected in conventional plasma lipid and lipoprotein level measurements, and glucosylation of lipoproteins and resulting alterations in lipoprotein catabolism may be of importance in the enhanced atherogenesis in diabetes. Both IDDM and NIDDM are associated with an increased frequency of hypertension, but the underlying mechanisms appear to be different. In IDDM hypertension is usually associated with the development of diabetic nephropathy and thus with a long duration of the disease. In NIDDM hypertension is often present already at the time of diagnosis, and also in IGT, the precursor stage of NIDDM, the prevalence of hypertension is already increased. Obesity explains only in part the high prevalence of hypertension in patients with NIDDM. Diabetes is known to be associated with multiple abnormalities in hemostatic factors and, although these abnormalities may contribute importantly to the increased risk of ASVD in diabetic patients, information about their real role is scanty and conflicting. The impact of general major risk factors for ASVD, elevated plasma cholesterol, elevated blood pressure, and smoking, on the risk of ASVD appears to be similar in diabetics and nondiabetics. Only a relatively small proportion of the excessive occurrence of ASVD in diabetics can, however, be explained by the effects of diabetes on the levels of general risk factors for ASVD. This proportion mediated through the effects of diabetes on risk factors is larger in female diabetics than in male diabetics. The major proportion of the excess of ASVD in diabetics remains, however, unexplained and must be due to effects of diabetes itself through mechanisms that are incompletely understood. PMID- 3552531 TI - Genetic polymorphisms related to glucose and triglyceride intolerance. PMID- 3552532 TI - Lipoprotein lipase in diabetes. AB - Lipoprotein lipase has a central role in the metabolism of both triglyceride-rich particles and high density lipoproteins, and it is one determinant of both serum triglyceride and HDL concentrations. In man the enzyme activity in both adipose tissue and skeletal muscle is insulin dependent, and therefore it varies in diabetes according to ambient insulin level and insulin sensitivity. In insulin deficiency (untreated Type 1 diabetes) the enzyme activity in both adipose tissue and muscle tissue is low but increases upon insulin therapy. In chronically insulin-treated patients with good control, the enzyme activity in postheparin plasma is increased. In untreated Type 2 diabetic patients, the average enzyme activity in adipose tissue and postheparin plasma is normal or subnormal. Therapy with oral agents or insulin, resulting in good glycemic control, is followed by an increase of LPL activity in both adipose tissue and postheparin plasma. In both Types 1 and 2 diabetes, changes of LPL activity are associated with relevant alterations in lipoprotein pattern. In insulin deficiency with low LPL, serum total and VLDL triglyceride levels are elevated, and HDL concentration is reduced. In chronically insulin-treated patients with high LPL activity, VLDL triglyceride concentrations are normal or subnormal, and HDL level is increased. In untreated Type 2 diabetic patients subnormal LPL activity may contribute to the elevation of serum triglycerides and to the reduction of HDL level. PMID- 3552533 TI - Very low density lipoprotein metabolism in diabetes mellitus. AB - The concentration of VLDL and their major lipid, triglyceride, are regulated at many levels from the initial availability of the substrates needed for their synthesis all the way to the function of the enzymes and receptors involved in their removal from plasma. It should be clear from this review that in diabetes mellitus metabolic derangements resulting from the absolute lack of insulin or from resistance to the actions of insulin can affect VLDL triglyceride metabolism at any or all of these regulatory points. The outcome of this interplay between diabetes and VLDL metabolism is the common occurrence of elevated plasma VLDL and triglyceride concentrations in individuals with both Type 1 and Type 2 diabetes mellitus. Mildly elevated plasma levels of triglycerides are nearly universal in diabetics; more significant hypertriglyceridemia can be the consequence of either metabolic decompensation or the concomitant inheritance of a familial pattern of hyperlipoproteinemia. The combination of the latter two situations usually presents with as severe hypertriglyceridemia. Although deregulation can occur at many points, the most common abnormality associated with hypertriglyceridemia in human diabetes appears to be overproduction of VLDL triglycerides. Increased rates of synthesis of VLDL apoB may also be a common consequence of diabetes. The basis for this belief is the accumulated data from kinetic studies in humans and in experimental models of diabetes in rats. Although the latter may also demonstrate defects in catabolism when insulin deficiency is severe, catabolic abnormalities appear to be uncommon as the primary force in the development of hypertriglyceridemia in humans. Finally, despite the complexity of the systems regulating VLDL metabolism and the many metabolic abnormalities that may be present in diabetic subjects, it appears that reduction of the hyperglycemia by means of dietary or pharmacologic interventions is associated with normalization of the rates of synthesis and catabolism of the VLDL and their triglycerides. In view of the probable atherogenecity of VLDL, particularly in individuals with diabetes, such intervention must be aimed at both plasma glucose and lipid concentrations. PMID- 3552534 TI - [Serum beta 2-microglobulin and carcinoembryonic antigen in patients with bronchogenic carcinoma]. AB - In patients with bronchogenic carcinoma of various types and stages, serum beta 2 microglobulin (beta 2-M) and carcinoembryonic antigen (CEA) were assayed simultaneously. The concentrations of serum beta 2-M and CEA were found to be statistically related to complete remission of the tumor (P less than 0.01). But it was also found that there was no correlation between the levels of beta 2-M and CEA (r = 0.0621). In follow-up, the CEA was found to be increasing incessantly as the disease progressed. For the level of serum beta 2-M, as the patients' condition got worse, it first rose, then dropped and became markedly lower before the patient died. The serum beta 2-M was often elevated 3-5 months earlier than CEA, and frequently resumed the normal level later than CEA after the carcinoma had a complete remission. With the progression of the bronchogenic carcinoma, elevation of beta 2-M was not necessarily a sign of poor prognosis. In contrast, with the serum beta 2-M markedly lowered after an initial elevation, the serum CEA became elevated, the prognosis was usually poor. The authors believe that, in patients with lung cancer, CEA produced from the lung cancer cells would give a level fluctuating with the size of the primary focus and the extent of the metastasis. But its positive rate is rather low. The serum beta 2-M is produced indirectly by certain immunologic function against bronchogenic carcinoma or its metabolites and not by the cancer cells directly. The positive rate of beta 2-M is high, so slightly is its false positive rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552535 TI - [Fetal liver cell transfusion in chemotherapy of malignant tumors and blood diseases]. AB - From Feb. to Dec. 1985, 15 patients were treated with fetal liver cell transfusion (FLT). They were 10 cases with malignant tumors treated by chemotherapy (tumor group) and 5 with blood diseases (blood group). Under strict aseptic technique, 3 1/2-6 month old fetus was selected for preparing suspension of the fetal liver cells on the superclean table. The speed of FLT should be increased gradually from slow to rapid. There are 1.8 X 10(8)-4 X 10(12) fetal liver cells in a fetus of more than 5 months old, in which most are CFU-C. In the tumor group, after FLT, white blood cell, platelet and hemoglobin increased by 700-3,900/mm3, 5,000-116,000/mm3 and 0.5-2.0 gm/mm3 respectively. But in the blood group, they increased by 800-1,300/mm3, 14,000-84,000/mm3 and 0.4-11.0 gm/mm3. In most of the cases, these hematological indexes reached up to the highest in 2 weeks after FLT. It suggests that FLT can improve the peripheral blood picture obviously and stimulate bone marrow. Experiment confirms that there are considerable hematopoietic stem cells in the fetal liver, by which the functions of hematopoiesis and immunity are able to recover. It is more marked in the tumor group than in the blood group. FLT provides a favourable condition for high dose chemotherapy. PMID- 3552536 TI - Response of plasma glicentin to fat ingestion in piglets. AB - In order to elucidate the response of plasma glicentin to fat ingestion, butter, glycerol or palmitate was administered into the duodenum of piglets in a fully conscious state and plasma glicentin and glucagon were determined. Butter instillation did not change blood glucose. Plasma triglyceride rose gradually 120 min after butter loading. Plasma insulin and glucagon measured by antiserum specific to the C-terminal slightly increased following butter administration and plasma total glucagon and glicentin increased gradually and significantly. The increments of total glucagon and glicentin were 179 and 158%, respectively. However, chromatography of porcine plasma obtained during fat loading revealed heterogeneity of glicentin-related peptides. Glycerol ingestion induced a slight rise of plasma total glucagon. Administration of palmitate revealed an increase in plasma total glucagon and glicentin. The present study clearly demonstrates the secretion of glicentin following fat ingestion, which might be caused by the hydrolysates of triglyceride, as suggested in previous dog experiments. PMID- 3552538 TI - [Morpho-functional differences at the tissue level between rodents from arid zones, the common vole and laboratory C57Bl mice with different degrees of radiation resistance]. PMID- 3552539 TI - Chemical teratogenesis: testing methods and the role of metabolism. PMID- 3552537 TI - Lack of effect of gliclazide on early diabetic nephropathy and retinopathy: a two year controlled study. AB - This study has attempted to document a specific haemovascular action of gliclazide on the reversal of early diabetic microangiopathy. A prospective double-blind controlled study was performed over 2 years, comparing gliclazide versus placebo in insulin-treated and gliclazide versus glibenclamide in non insulin-treated diabetic subjects, after a 1-year run-in period. Glycaemic control was not significantly different in gliclazide- and non-gliclazide-treated subjects before or after the commencement of active therapy. Following treatment with gliclazide in 17/32 insulin-treated and 8/17 non-insulin-treated subjects with Albustix-negative proteinuria, there was no difference in retinopathy score, total proteinuria or the renal clearance of creatinine, albumin, transferrin and immunoglobulin G. In the insulin-treated group, progression of retinopathy was observed in approximately one-third of subjects, but no parameter of proteinuria progressed over 2 years. Thus, this study did not detect a reversal of the parameters measured and does not support an action of gliclazide on diabetic microangiopathy, independent of its hypoglycaemic action. PMID- 3552540 TI - Predictive models for human glucose-6-phosphate dehydrogenase deficiency. AB - The present paper has discussed available test systems for determination of the response of G-6-PD-deficient human erythrocytes to environmental agents. The limitations and advantages of each model have been examined, and the results of research using each model have been presented. The future development of suitable animal models or in vitro test systems may rely on advances in fields such as genetics and biochemistry. Genetic engineering may allow researchers to develop cells with a genetic deficiency of G-6-PD. These deficient cells could then be used to simulate human G-6-PD-deficient erythrocyte responses to various agents. Advances in biochemistry, in areas such as metabolism and enzymology, may also have an impact on future test systems. Due to the fact that present model systems are limited and their predictions often unreliable, the establishment of safe environmental health standards will depend upon advances in modern science and the converging of developments from various disciplines. PMID- 3552541 TI - Peptides and related drugs: a review of their absorption, metabolism, and excretion. PMID- 3552542 TI - Pharmacokinetics of mitoxantrone in man and laboratory animals. AB - Mitoxantrone (NOVANTRONE), an anthracenedione, is a novel anticancer agent with a wide spectrum of antitumor activity. Its anticancer activity is comparable to that of doxorubicin but with apparently significantly reduced cardiotoxicity. The recommended dosage regimen for the treatment of breast carcinoma is 12-14 mg/m2 given intravenously once every 21 days. Intravenously administered mitoxantrone disappears from the plasma of man and laboratory animals with multiexponential kinetics and with the terminal half-life ranging from 38 h to several days. It is rapidly cleared from the plasma by extensive sequestration into the tissues of the rat, dog, monkey, and man. However, redistribution back into the plasma and elimination from the body are slow processes. In both animals and man it is metabolized to the mono- and dicarboxylic acid derivatives, as well as glucuronide conjugates of these acids. Following intravenous administration, it is unchanged mitoxantrone that binds to most tissues. Rats, dogs, monkeys, and man, all eliminate mitoxantrone and its metabolites slowly by both renal and biliary excretion, with the biliary route predominating. PMID- 3552543 TI - Clinical significance of magnesium: a review. AB - With the increased concern surrounding diuretic-induced electrolyte losses, numerous articles have surfaced investigating the detrimental effects of diuretic induced hypomagnesemia. This article's purpose is to familiarize the reader with hypomagnesemia and hypermagnesemia. Methods of detection, symptoms, etiologies, and potential modes of therapy are discussed. Particular attention is given to the role magnesium plays in the cardiovascular system with additional discussion on lipid alterations and glucose handling. Specific suggestions are given for the inpatient and outpatient treatment of hypomagnesemia. PMID- 3552544 TI - Current concepts in the treatment of prostate cancer. AB - Carcinoma of the prostate is one of the most common cancers in men over 50 years of age and is the second leading cause of cancer death in men over 75. As a general rule, symptoms usually are not apparent until the tumor is far advanced. Between 80 to 90 percent of patients have metastatic disease at the time of presentation and are not curable by surgery. Endocrine manipulation remains the most effective and commonly used treatment for metastatic carcinoma of the prostate. PMID- 3552545 TI - Local treatment of respiratory infections with antibiotics. AB - Local administration of antibiotics for the treatment of respiratory infections has the potential advantage of reduced systemic toxicity and increased drug concentration at the site of infection. This article reviews the basic principles of pulmonary drug delivery using aerosols and the clinical efficacy of local antibiotic therapy of respiratory infections. Clinical studies have been conducted with locally administered aminoglycosides, penicillins, cephalosporins, and polypeptides. The results of these investigations and the pharmacokinetic aspects of pulmonary antibiotic delivery are summarized. PMID- 3552546 TI - Amsacrine evaluation. AB - Amsacrine, an antineoplastic agent currently undergoing clinical trials in the U.S., has been shown to be active against adult and pediatric leukemias, Hodgkin's disease, and non-Hodgkin's lymphomas. Amsacrine is highly bound to plasma proteins and is eliminated primarily via hepatic metabolism. Severe hepatic dysfunction will result in a decreased excretion rate of the drug. The primary side effect is a dose-related suppression of bone marrow function. Other reported toxic effects include mucositis, nausea, vomiting, cardiotoxicity, liver dysfunction, and alopecia. Despite these negative effects, amsacrine appears to have a role in the combination therapy of acute leukemias. PMID- 3552547 TI - Glucose effect on drug action, metabolism, and pharmacokinetic parameters in mice. AB - The glucose effect on hepatic drug metabolism (decreased) of barbiturates was maximum after 2 days of increased glucose intake as indicated by increased barbiturate sleep time in mice. However, this effect was not observed after 5 days of glucose treatment, and barbiturate sleep time was similar to the control after 6 days of treatment. Serum glucose and liver glycogen were, in general, not significantly different from control, even after chronic glucose intake, indicating that neither hypoglycemia nor alteration of liver glycogen levels were required for the glucose effect on drug action. However, in contrast to the decreased metabolism of barbiturate, there was increased metabolism of glucose in the glucose-treated animals. Brain levels of barbiturate in 48 hours glucose treated mice were higher and declined at approximately half the rate of controls (Ke(G) 0.009 vs Ke(C) 0.015). A similar trend in barbiturate blood concentration indicated decreased metabolism of the barbiturate and/or decreased clearance of drug and metabolites. The glucose treatment altered the pentobarbital dose response curve, but there appeared to be no alteration of the sensitivity to insulin; exogenase insulin still produced significant hypoglycemia and prolonged barbiturate S.T. after 7 days of glucose treatment. Other factors may be involved in the glucose effect; increased permeability of the brain to barbiturate, decreased permeability to outflow so that brain concentrations remain higher for a long period of time. PMID- 3552548 TI - [Antithrombotic treatment following aortocoronary bypass operation]. PMID- 3552549 TI - [Immune scintigraphy with monoclonal antibodies. Experiences and prospects]. PMID- 3552550 TI - [Skin changes in HIV-infected patients]. PMID- 3552551 TI - [Toxic drug-induced myocardial diseases]. PMID- 3552552 TI - [Distribution of adipose tissue and complications of obesity in overweight women with and without hirsutism]. AB - A correlation between the serum androgen levels and the distribution pattern of adipose tissue as well as occurrence of complications of obesity were investigated in 24 obese women with and without hirsutism. The hirsute women (n = 12) displayed higher androgen levels than the women without hirsutism (n = 12) of the same age and weight and possessed a more abdominally pronounced distribution of adipose tissue measured as the quotient of waist and hip circumference (0.87 +/- 0.08 as compared to 0.76 +/- 0.06; P less than 0.05). In addition, the overweight women with hirsutism had higher fasting triglyceride levels as well as higher values of systolic and diastolic blood pressure. Overall, a positive correlation was found between testosterone and the ratio of waist and hip circumference (r = 0.40; P less than 0.05) and the values of diastolic blood pressure (r = 0.51; P less than 0.01). Moreover, the ratio of waist and hip circumference correlated with the systolic blood pressure values (r = 0.61; P less than 0.001), the fasting triglyceride levels (r = 0.42; P less than 0.05) as well as the basal insulin concentration (r = 0.48; P less than 0.05). These results are an indication that raised androgens predispose to accumulation of fat in the abdominal region. In turn, an android distribution of adipose tissue is associated with more frequent metabolic disorders and vascular hypertension. PMID- 3552553 TI - [Coronary heart disease and heart valve diseases in patients with terminal kidney insufficiency]. AB - Cardiac catheterisation and coronary angiography were performed in 100 patients preceding a planned renal transplantation. Coronary heart disease was revealed in 64 patients: stenoses of 50-70% in 28, 71-90% in 16, over 90% in 20 patients. For stenoses above 50% the sensitivity of clinical symptoms was 0.52, their specificity 0.64. For stenoses over 70% the specificity was 0.58; over 90% it was 0.70. Typical symptoms of angina were less common in dialysis patients with coronary heart disease than is usual in other patients with coronary heart disease. Total duration of dialysis as well as frequency and severity of coronary heart disease did not correlate. In 19 of the 100 patients valvar disease was also present, with a discrepancy between the severity of clinical and of hemodynamic findings. Incidence and severity of valvar disease increased with the duration of dialysis. Transplantation was postponed in 11 patients (bypass operation in 3, balloon dilatation in 2, valve replacement in 6). Transplantation was advised against in four (severe coronary heart disease in 2, cardiomyopathy in 2). PMID- 3552554 TI - [Differential diagnosis of a hemorrhagic-necrotizing epiploic appendix]. AB - In a 52 year old pyknic patient in whom very violent pain had suddenly occurred in the left lower abdomen, an acute hemorrhagic infarction of an epiploic appendix of the sigmoid colon with adhesion to the anterior abdominal wall was found to be the cause of the symptoms. A hernia, above all a hernia of the semilunar line of Spigelius, an inflammatory process and a granuloma had to be considered in the differential diagnosis. PMID- 3552556 TI - [Hypertension and sports]. PMID- 3552555 TI - [Diagnosis and therapy of congenital pigment-cell nevi]. PMID- 3552557 TI - [Campylobacter pylori: a procedure for its detection]. PMID- 3552558 TI - [Relation of muscle mass and body size compared in mice, rats, rabbits, dogs, humans and horses]. PMID- 3552559 TI - [Spontaneous diseases as limiting factors in the life expectancy of laboratory rats]. PMID- 3552560 TI - [Development of kidney morphology and protein excretion in MWF/Ztm rats]. PMID- 3552561 TI - [Comparative histometric studies of the size of kidney glomeruli in the mouse, rat and hamster]. PMID- 3552563 TI - [Ultrastructural alterations in Clara cells in horses with chronic obstructive lung diseases]. PMID- 3552562 TI - [Tumors of undomesticated beasts of prey (Fissipedia)]. PMID- 3552564 TI - [Cryptosporidiosis in humans and animals]. PMID- 3552565 TI - [Histopathology of Cyathocephalus truncatus infections in the rainbow trout]. PMID- 3552567 TI - [Advanced training presentation: the changed animal welfare law. The Animal Welfare Law of 18 August 1986]. PMID- 3552566 TI - [Morphologic demonstration and pathogenetic evaluation of amniotic fluid aspiration with regard to the diagnosis "pulmonary asphyxia" in newborn calves and foals]. PMID- 3552568 TI - [Problems in examining horses for purchase from the viewpoint of internal medicine]. PMID- 3552569 TI - [High-frequency cinematographic measurement of the horse during capriole]. PMID- 3552570 TI - [The modification of central venous pressure in the horse]. PMID- 3552571 TI - [Determination of bacterial reproduction disorders in horse breeding and suggestions for treatment]. PMID- 3552572 TI - [Effect of bodily stress on lung function in the horse]. PMID- 3552573 TI - [The blood supply of healthy and diseased navicular bones]. PMID- 3552574 TI - [The origin of thrombophlebitis in the horse--the contribution of acquired hypercoagulability]. PMID- 3552575 TI - [The increase of physiological dead space volume as a parameter for a pulmonary gas exchange disorder in the anesthetized horse]. PMID- 3552577 TI - [Vitamin C in cattle: occurrence and effects]. PMID- 3552576 TI - [Tongue injuries in the horse--2 case reports]. PMID- 3552578 TI - The management of pain. AB - Pain is a complex phenomenon involving both neurophysiological and psychological components. Pathophysiological mechanisms involve neural pathways, and a variety of pain-producing substances and modulating mechanisms. These include acetylcholine, serotonin, histamine, bradykinin, prostaglandins, substance P, somatostatin, cholecystokinin, vasoactive intestinal polypeptide, noradrenaline and endogenous opioid peptides. In assessing patients with pain, it is essential to evaluate the cause of the pain, its severity, type, location, duration, quality, and response to therapies, among other factors. The measurement of pain is dependent on subjective responses, which are evaluated by methods which have been well developed over the last three decades. Alleviation of pain by non-drug treatments must be considered as well as use of pharmacological treatments. These include psychological support, placebos, relaxation training, biofeedback, hypnosis, heat, cold, physical supports and surgery. Oral drugs are generally preferable to parenteral drugs, as are drugs with few side effects and low addictive liability. Both overtreatment and undertreatment are to be avoided. Patients can be expected to differ in their needs and responses, and economic considerations ought not be ignored. Newer approaches to pain management include self-administration of parenteral drugs, the search for new types of analgesics and appreciation of the relationship between age, sex, race, etc. and the response to analgesics. Tricyclic antidepressants, phenothiazines and the new non steroidal anti-inflammatory drugs have pointed the way to possible improvements in our ability to tailor specific drugs to the needs of individual patients. PMID- 3552579 TI - Effects of non-narcotic analgesics on the kidney. AB - Non-narcotic analgesics have acute and chronic effects on the kidney. Until quite recently chronic effects have received much more attention than acute effects. Renal papillary necrosis attributed to prolonged intake of analgesic compounds was first described from Switzerland in the 1950s, and subsequently in many countries including Scandinavia, Australia, Belgium and Canada. Renal papillary necrosis is now accepted as an effect of over-the-counter analgesic compounds and has also been recorded with many individual non-steroidal anti-inflammatory drugs (NSAIDs). Evidence suggests that uroepithelial tumours also occur as a complication of prolonged abuse of analgesic compounds. Clinical evidence associating renal papillary necrosis with compound analgesics and NSAIDs has been backed up by experimental evidence showing that these drugs cause renal papillary necrosis in animals. Acute effects of non-narcotic analgesics have been described mainly in association with aspirin and NSAIDs. In high renin states, including salt-depleted normal subjects, NSAID administration may be associated with an acute decrease in renal function, which is more obvious in patients who have underlying renal disease. Clinical syndromes which occur in association with NSAIDs include oedema, hyperkalaemia and acute renal failure and the acute nephrotic syndrome. Acute renal failure may be associated with acute interstitial nephritis and the nephrotic syndrome or may be due to acute tubular necrosis. Patients who have the nephrotic syndrome show fusion of foot processes of glomerular epithelial cells on electron microscopy as well as acute interstitial nephritis. Patients who suffer these episodes of acute renal function deterioration associated with NSAIDs recover slowly after withdrawal of the drugs, and the recovery may not be complete. PMID- 3552580 TI - Effects of non-narcotic analgesics on the liver. AB - Serious hepatotoxicity is uncommon with the proper therapeutic use of non narcotic analgesics but experience with new non-steroidal anti-inflammatory drugs (NSAIDs) is limited. Drugs such as ibufenac, fenclofenac and benoxaprofen were withdrawn from the market because of hepatotoxicity, and liver damage has been reported on occasion with virtually all non-narcotic analgesics. However, a clear pattern of toxicity with characteristic clinical, biochemical and histopathological abnormalities has emerged with relatively few. With the exception of acute hepatic necrosis following overdosage of paracetamol, little is known of the mechanisms of liver injury induced by non-narcotic analgesics. Involvement of the liver in a generalised drug reaction does not imply specific hepatotoxicity. About 50% of patients given aspirin regularly in anti inflammatory doses develop mild, dose-dependent reversible liver damage as shown by elevation of the plasma aminotransferase activity. Liver damage is more severe in a small minority and it may rarely be complicated by disseminated intravascular coagulation and encephalopathy with a fatal outcome. There have also been isolated reports of chronic active hepatitis associated with the use of salicylates. Salicylate hepatitis has been reported most often in young females with connective tissue diseases. Many patients with Reye's syndrome have been given aspirin during the prodromal phase, and this serious condition closely resembles subacute salicylate intoxication in children. Salicylate probably has a causal or contributory role in Reye's syndrome, but many refuse to accept this and the issue is the subject of heated debate. Paracetamol in overdosage causes acute hepatic necrosis, and liver damage has been attributed to its therapeutic use. However, most reports have involved chronic alcoholics who took excessive doses and in these patients the clinical, biochemical and pathological findings were typical of paracetamol overdosage. Many authors have failed to make the distinction between therapeutic use and a therapeutic dose. In other cases liver damage could have been caused by exposure to other agents, viral infection or naturally occurring liver disease. If these cases are excluded, there are very few reports of liver damage associated with the proper therapeutic use of paracetamol. In some cases, the picture resembled chronic active hepatitis but no causal relationship has been established between this condition and paracetamol use. Paracetamol does not cause deterioration in liver function in patients with chronic liver disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552581 TI - Analgesics, allergy and asthma. AB - Intolerance to analgesics is common in patients with bronchial asthma, nasal polyps and urticaria. Symptoms of intolerance resemble those of allergy, but the events precipitating them can rarely be traced to reactions between the drug and a specific antibody or sensitised T-lymphocytes. In 8 to 20% of adult asthmatics, aspirin and several other analgesics provoke asthmatic attacks, probably through inhibition of cyclo-oxygenase. This is a distinct and important clinical syndrome with a specific history, course and clinical presentation and a number of unique peculiarities which still require elucidation at the biochemical level. Up to 40% of patients with chronic urticaria develop an obvious increase in weals and swelling after taking aspirin. These reactions occur only when urticaria is active, and though the reason for them is not known, it appears that different mechanisms may be responsible in different patients. Skin reactions other than exacerbation of chronic urticaria are less common, but may create serious clinical problems. The clinical background of a patient often determines the type of adverse response to an analgesic. Thus, in certain individuals, analgesics can produce anaphylactic reactions and/or urticaria, probably through an immunological mechanism, while in some asthmatics they precipitate bronchoconstriction, probably through inhibition of bronchial cyclooxygenase. Study of untoward reactions to analgesics not only leads to safer pharmacotherapy, but it also offers a fascinating model for better understanding of some diseases. PMID- 3552582 TI - Non-narcotic analgesics. Use in pregnancy and fetal and perinatal effects. AB - Aspirin and related non-narcotic analgesics such as paracetamol (acetaminophen) are present in almost every 'Western' household and are so commonly used that the public often does not think of them as drugs. Although the toxic effects of overdoses are well recognised by the medical and related professions, the potential adverse effects of repetitive dosing, within the commonly recommended therapeutic range, are not. This is particularly true during pregnancy, where the relative overall general safety of the agents is overshadowed by the possible subtle but potentially pervasive effects on the fetus. Marketing publicity, particularly about recently introduced related agents, has at times failed to take into account these less obvious, but nevertheless potentially lethal, side effects. It is now likely that aspirin and/or paracetamol are used during pregnancy by most women and that the earlier figures are underestimates. Although animal studies have shown significant effects of non-steroidal anti-inflammatory agents (NSAIDs) on the fetal circulation, particularly on the developing pulmonary circulation, the data on human pregnancy are less convincing. Nevertheless, the possible association of these drugs with prolonged gestation, and an increased incidence of the syndrome of persistent pulmonary hypertension of the newborn and of intracranial haemorrhage, demand that prudence be exercised when using these drugs during pregnancy. At the very least, more conclusive evidence is necessary that fetal and neonatal complications are not increased. PMID- 3552584 TI - Non-steroidal anti-inflammatory analgesics other than salicylates. AB - The largest group of non-narcotic analgesics are the arylalkanoic acid derivatives, comprising derivatives of arylacetic acid, propionic acid, heteraryl acetic acid and indole acetic acid. Common to all of these drugs is their inhibition of prostaglandin biosynthesis, which contributes to their analgesic and other pharmacological properties as well as to their principal side effect, gastrointestinal irritation. Although these drugs all cause some gastric microbleeding, they do so to a lesser extent than aspirin. The arylalkanoic acid derivatives, as well as the anthranilic acid and oxicam derivatives, are peripherally acting as evidenced by their lack of activity in classical tests of central analgesic activity. After oral administration of these drugs, their peak plasma concentrations are generally attained in 1 to 3 hours; absorption is not generally influenced by food. Volume of distribution is mostly low (less than 0.2 L/kg) and protein binding is high (usually 95 to 99%). Elimination is by glucuronide formation for several of the propionic acid derivatives and generally by biotransformation for derivatives of arylacetic acid, indole and indene acetic acid, and the oxicams. The elimination half-life of the arylalkanoic acid derivatives is in most instances about 2 to 5 hours, although notable exceptions include carprofen (approximately equal to 20 h), fenbufen (10 h), naproxen (12-15 h) and sulindac (16 h for the active metabolite). The elimination half-life of indomethacin varies considerably between and within individuals. Piroxicam has the longest half-life, averaging 45 hours. The pharmacokinetic properties of the anthranilic acid derivatives (fenamates, glafenine) generally resemble those of the arylacetic acids. Few clinically significant drug interactions are associated with concomitant administration of the arylalkanoic acids or piroxicam and other drugs. Since the arylalkanoic acids are highly bound to plasma proteins (mainly albumin) there is a theoretical potential for displacement reactions with drugs that are used at plasma concentrations high enough to exceed the binding capacity of their own primary binding sites. However, such reactions have rarely been reported. Although the concomitant administration of aspirin and several of the propionic acid derivatives results in a significant decrease in the plasma concentration of the latter, the clinical significance of such interactions is uncertain and probably minimal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552585 TI - Paracetamol and phenacetin. AB - Since their synthesis in the late 1800s paracetamol (acetaminophen) and phenacetin have followed divergent pathways with regard to their popularity as mild analgesic/antipyretic drugs. Initially, paracetamol was discarded in favour of phenacetin because the latter drug was supposedly less toxic. Today the opposite is true, and paracetamol, along with aspirin, has become one of the two most popular 'over-the-counter' non-narcotic analgesic agents. This marked increase in the wide approval attained by paracetamol has been accompanied by the virtual commercial demise of phenacetin because of its role, albeit somewhat circumstantial, in causing analgesic nephropathy. Both paracetamol and phenacetin are effective mild analgesics, suitable for treating mild to moderate pain, and their actions are broadly comparable with those of aspirin and related salicylates, although they do not appear to possess significant anti-inflammatory activity. Since a major portion of a dose of phenacetin is rapidly metabolised to paracetamol, it seems possible that phenacetin owes some of its therapeutic activity to its main metabolite, paracetamol, whereas its most troublesome side effect (methaemoglobinaemia) is due to another metabolite, p-phenetidine. The mechanism of action of paracetamol is poorly defined, although it has been speculated that it may selectively inhibit prostaglandin production in the central nervous system, which would account for its analgesic/antipyretic properties. The lack of any significant influence on peripheral cyclooxygenase would explain the absence of anti-inflammatory activity. At therapeutic doses paracetamol is well tolerated and produces fewer side effects than aspirin. The most frequently reported adverse effect associated with paracetamol is hepatotoxicity, which occurs after acute overdosage (usually doses greater than 10 to 15g are needed) and, very rarely, during long term treatment with doses at the higher levels of the therapeutic range. Paracetamol damages the liver through the formation of a highly reactive metabolite which is normally inactivated by conjugation with glutathione. Overdoses of paracetamol exhaust glutathione stores, thus allowing the accumulation of this toxic metabolite which covalently binds with vital cell elements and can result in liver necrosis. Glutathione precursors (notably intravenous N-acetylcysteine) have proved remarkably successful in treating paracetamol overdose, as long as treatment is initiated within 10 hours.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552586 TI - Pyrazolone derivatives. AB - In many countries, the pyrazolone derivatives, which include dipyrone, antipyrine, aminopyrine and propyphenazone, are widely used analgesics. Dipyrone, the most widely used pyrazolone, has been the most studied. The pyrazolidine derivatives, phenylbutazone and oxyphenbutazone, which are not generally used for analgesia since they differ from the pyrazolones in terms of efficacy and tolerance, are not discussed in this article. Dipyrone is an inhibitor of cyclo oxygenase but, unlike aspirin, its effect is rapidly reversible. The inhibition of prostaglandin biosynthesis contributes to the analgesic activity of the pyrazolone derivatives. Peak plasma concentrations of the pyrazolone derivatives generally occur 1 to 1.5 hours after oral administration. Half-lives vary from 1 to 2 hours with propyphenazone, to about 7 hours with dipyrone (2 hours for the active metabolite of dipyrone, 4-methylaminoantipyrine, MAA). Half-life of antipyrine varies considerably between individuals (5 to 35 hours). Unlike the NSAIDs generally, the pyrazolone derivatives antipyrine, aminopyrine and propyphenazone are minimally bound to plasma proteins. The pyrazolones undergo extensive biotransformation, aminopyrine and dipyrone being converted to active metabolites. Dipyrone is the only drug for which results of recent double-blind trials are available. Oral dipyrone has been shown to be more effective than an equal dose of aspirin or paracetamol in alleviating postoperative pain, and intravenous dipyrone 2.5g was similar in efficacy to pethidine 50 mg. In patients with acute ureteral or biliary colic, dipyrone 2.5g intravenously was similar in efficacy to indomethacin 50 mg or pethidine 50 mg. The most frequently reported side effects of the pyrazolone derivatives are skin rashes. Gastrointestinal side effects are rare. Blood dyscrasias, mostly associated with aminopyrine, have received wide attention in the medical literature, but their true incidence with dipyrone is considerably lower than the often quoted incidence for amidopyrine reported more than 30 years ago. PMID- 3552587 TI - Gastrointestinal intolerance and bleeding with non-narcotic analgesics. AB - Aspirin and paracetamol (acetaminophen) are the most commonly used minor analgesics, but their effects on the gastrointestinal tract differ widely. The effects of other nonsteroidal anti-inflammatory drugs (NSAIDs), including phenylbutazone, are intermediate. Aspirin is significantly associated with major upper gastrointestinal haemorrhage, whereas paracetamol is not. Short term use of aspirin produces erythema, erosions and occasionally ulcers; paracetamol does not, while other NSAIDs do so to varying degrees. Chronic gastric ulcer is linked to aspirin intake in patients with rheumatic disease, and epidemiologically in all heavy aspirin users. In only one epidemiological study was a paradoxical significant association reported between paracetamol intake and chronic gastric ulcer. Faecal occult blood loss is increased in most regular aspirin users but not in those taking paracetamol. Although formal studies in children have apparently not been made, in isolated small clinical series it has been reported that gastrointestinal bleeding and anaemia do occur in the paediatric age group after the use of aspirin. Pathophysiologically, aspirin alters the gastric mucosal barrier to hydrogen ions and lowers gastric potential difference; paracetamol has no effect on these parameters. Such changes correlate ultrastructurally with damage in surface epithelial cells and microerosions after the use of aspirin, but not after the use of paracetamol. Aspirin and other NSAIDs cause a dramatic reduction in the ability of gastric mucosa to generate protective prostaglandins; however, paracetamol also reduces prostaglandins. Other postulated mechanisms of aspirin damage include reduction in gastric mucosal secretion, reduction in bicarbonate output, and alteration of cell turnover. Because damage to gastric mucosa by aspirin and NSAIDs is often 'silent', the clinician needs a high level of suspicion and awareness regarding this problem. In patients prone to gastric damage, or in those with a past history of aspirin-induced gastric damage, paracetamol is the drug of choice when a minor, non-inflammatory problem requires an analgesic. PMID- 3552583 TI - Non-narcotic analgesics. Problems of overdosage. AB - The first cases of fulminant hepatic failure due to paracetamol poisoning were reported in 1966, and in the United Kingdom this condition is now responsible for more cases of acute hepatic failure than any other cause. Adults account for the majority of serious and fatal cases of paracetamol poisoning and it is extremely rare for young children to ingest sufficient paracetamol to cause more than minimal liver damage. A single measurement of the plasma paracetamol concentration is an accurate predictor of liver damage provided that it is taken not earlier than 4 hours after ingestion of the overdose. Peak disturbance of liver function occurs 2 to 4 days after the overdose, often accompanied by mild jaundice, after which recovery is usually rapid and complete. In a few patients, fulminant hepatic failure, manifested by increasing jaundice and encephalopathy, may develop by the third to fifth day. Acute renal failure may complicate paracetamol poisoning, often in the context of severe liver damage. Renal failure, which is often non-oliguric, typically becomes apparent 24 to 72 hours after overdosage. The treatment of paracetamol intoxication should include gastric lavage, which has been shown to be of value for up to 6 hours after ingestion of a paracetamol overdose. Further general treatment may include parenteral fluid replacement and a prophylactic infusion of dextrose (5-10%) in patients at risk of hepatic failure. Specific protective agents in those patients at risk of paracetamol-induced liver damage include N-acetylcysteine and methionine which are most effective if given within 8 to 10 hours of ingestion of the overdose. Hepatic and renal failure should be managed conventionally. In recent years in the United Kingdom there has been a gradual decline in the number of hospital admissions and the number of deaths from aspirin poisoning. Salicylates in overdose directly stimulate the respiratory centre and so cause a respiratory alkalosis. Metabolic acidosis occurs in severe poisoning because of impairment of the oxidative metabolism of energy substrates. At very high salicylate concentrations respiratory depression may occur, possibly associated with neuroglycopenia, adding respiratory acidosis to the worsening metabolic acidosis. In addition to a mixed acid-base disturbance, hypokalaemia and hypoglycaemia may be present. Nausea and vomiting increase the fluid deficit. If dehydration is sufficiently severe, decreasing cardiac output may hasten development of lactic acidosis and acute renal failure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552588 TI - Aspirin and related derivatives of salicylic acid. AB - After almost 90 years of clinical use, aspirin remains one of the world's most extensively used 'over-the-counter' drugs, and it is still recognised as the standard analgesic/antipyretic/anti-inflammatory agent by which newer drugs are assessed. However, its pre-eminent position as the analgesic of choice for mild to moderate pain has been seriously challenged with the introduction of many 'new' non-steroidal non-narcotic analgesic drugs. Indeed, there is convincing scientific evidence that many of the 'newer' non-steroidal drugs such as diflunisal, ibuprofen, flurbiprofen etc. are significantly superior analgesics and, in many cases, have a longer duration of action. In recent years the salicylates, aspirin in particular, have been the focus of much attention regarding their side effect profiles. At usual dosages for relief of pain and during occasional use, aspirin is well tolerated by the vast majority of patients. Adverse reactions, of which there is a wide spectrum, most frequently accompany anti-inflammatory doses of aspirin, or may be the result of accidental overdosing (particularly in children and the elderly)--probably a reflection of the lay population's acceptability of aspirin's presumed safety. As with other non-steroidal analgesic drugs, gastrointestinal complaints are the most commonly reported side effects. The existence of many shared clinical, adverse and toxic effects of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) is thought to be accounted for by a common mechanism--inhibition of the ubiquitous cyclo-oxygenase enzyme. Thus, suppression of prostaglandin biosynthesis is widely considered to explain the common properties of NSAIDS, although further research is still necessary to clarify some inconsistencies and to complete our understanding of the processes involved. Aspirin and salicylates have been reported to have a wide range of drug interactions but only relatively few seem to be clinically important. Many of the interactions are pharmacokinetic in nature. Drugs considered to produce the most significant interactions with salicylates include anticoagulants and thrombolytic agents, uricosuric agents, corticosteroids, methotrexate and sulphonylurea hypoglycaemic agents. PMID- 3552589 TI - Haematological effects of non-narcotic analgesics. AB - By far the largest proportion of side effects caused by non-steroidal anti inflammatory drugs (NSAIDs) belong to the category of so-called PAR (pseudo allergic reactions). The sensitising potential of a drug is probably connected with its protein-binding capacity. The strongly protein-binding compounds are particularly liable to produce serious immunological complications. The clinical picture depends on the type of immune reaction as well as its location within the organism. Cellular immunity usually leads to skin reactions. However, it is possible that some of the haematological side effects may be caused by T lymphocytes reacting specifically with haemopoietic cells to which a drug adheres. Antibody-mediated immune reactions are more common. Currently we can distinguish five different mechanisms. IgE-mediated drug reactions usually lead to eosinophilia, sometimes with eosinophilic infiltrates in the lung. In such cases, patients frequently develop urticarial rashes. In a number of drug-induced cytopenias the underlying mechanism derives from the action of soluble immune complexes on red cells, leucocytes or platelets as in the case of type I agranulocytosis. IgG and/or IgM may be implicated in the formation of the immune complexes. In this system, blood cells are affected when incubated with the serum from an allergic subject which has previously been incubated with the offending drug or one of its metabolites. Some drugs or drug metabolites have a strong affinity for certain blood cells to which they become attached. If a patient develops antibodies to these drugs, an antibody interaction with the drug-coated cells can lead to the destruction of the cells. This mechanism may be operative not only in the periphery, but also within the bone marrow. On serological testing, preincubation of the serum with the offending drug will inhibit the reaction of the antibody to drug-coated cells. This mechanism may coexist with the immune complex type of blood cell damage. It now appears that patients may develop antibodies whose specificity depends on a drug as well as on a component of the blood cell membrane. The haematological specificity of the immune reaction would then be explained by the autoantigenic constituent of the drug-autoantigen complex. This mechanism has been demonstrated with regard to blood group specificities of certain drug reactions in the case of red cells. In the case of quinidine and quinine thrombocytopenia, the antiplatelet activity has been shown to be connected with the presence of the glycoprotein GP1b which acts as a receptor for platelet factor VIII.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552590 TI - The role of vasodilator therapy in the treatment of severe chronic heart failure. AB - The rationale for the use of vasodilating agents in the treatment of congestive heart failure is to reverse the systemic vasoconstriction that characterises patients with this disorder, and which may further limit cardiac performance. Nitrates were the first vasodilators used, followed by arterial vasodilators (hydralazine, minoxidil), alpha-adrenergic blockers (prazosin, trimazosin) and, more recently, calcium antagonists, ACE inhibitors, beta-agonists and phosphodiesterase inhibitors. The choice of vasodilator should be based on consideration of overall benefit-risk profiles. Consideration of pharmacological action together with classification of patients into haemodynamic subsets has been used as a basis from which to initiate vasodilator therapy. However, such a classification may not lead to a logical choice of drug and there is no evidence to suggest that patients so selected do better when given long term treatment with peripherally specific drugs than with agents that are not tailored to pretreatment haemodynamic variables. Moreover, changes in central haemodynamics after administration of specific vasodilator drugs may differ from those expected on the basis of their presumed actions on the peripheral vasculature. Dosage requirements are difficult to predict with many vasodilator drugs. Traditionally, such requirements have been established by titrating vasodilating drugs to achieve an arbitrarily defined haemodynamic response. However, there is little correlation between haemodynamic end-points and clinical efficacy in patients with heart failure, and short and long term haemodynamic responses to vasodilator drugs are not necessarily related. Drug-specific haemodynamic and clinical tolerance occurs during the course of treatment with all vasodilator drugs; the extent and frequency with which it develops differs between agents. Tolerance is thought to arise from a reduction in drug receptor affinity and/or density or activation of counter-regulatory forces (mainly neurohormonal) that limit the magnitude of vasodilatation that can be achieved. Development of tolerance to a single agent does not usually preclude efficacy of other agents. ACE inhibitors have been associated with a relatively low incidence of tolerance. This may relate to their natriuretic effect and ability to decrease the degree of neurohormonal activation, actions not shared by other vasodilators. Tolerance is the principal reason for failure of prazosin and nitrates as therapeutic agents in severe chronic heart failure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552591 TI - Topical minoxidil. A preliminary review of its pharmacodynamic properties and therapeutic efficacy in alopecia areata and alopecia androgenetica. AB - When minoxidil is administered orally for periods in excess of 1 month, hypertrichosis occurs as a side effect in a majority of patients. Consequently, topical minoxidil has been developed to try to improve hair growth in patients with alopecia areata and alopecia androgenetica. Preliminary studies have shown that topical minoxidil promotes cosmetically acceptable hair regrowth in a variable proportion of patients with alopecia areata. Data from a large multicentre trial indicate that cosmetically worthwhile results are achieved in about one-third of subjects with alopecia androgenetica after 1 year of treatment. A much higher proportion (about 80%) of patients with alopecia androgenetica exhibited some non-vellus hair regrowth after 1 year, and whether more of these patients would develop a cosmetically acceptable result with a longer treatment period is an important area of future investigation. Initial indications suggest that less severe disease is a predictor of likely response. Thus, topical minoxidil would seem to be a useful treatment modality for patients with alopecia androgenetica--a disease for which no other safe and effective drug therapy exists. Results from treating patients with alopecia areata with topical minoxidil, although encouraging, have been more variable and require further evaluation. Even though a number of questions remain to be answered about topical minoxidil (as would be expected at this stage in its development), it would seem to be the first available drug with the potential to promote substantial hair regrowth in these divergent diseases. PMID- 3552593 TI - The insulin receptor concept and its relation to the treatment of diabetes. AB - The initial step in insulin action is binding to specific receptors. Two covalent receptor modifications possibly involved in producing pharmacodynamic effects as a result of insulin receptor binding are autophosphorylation and disulphide insulin binding. Insulin receptor numbers are 'down regulated' by insulin, but this effect may be minimised by pulsatile insulin secretion. Insulin receptor affinity is modulated rapidly by fasting, exercise and dietary composition. In non-insulin-dependent diabetes coupling of receptor binding to bioeffects is impaired. Binding is also reduced in those subjects with hyperinsulinaemia and non-insulin-dependent diabetes. Insulin-dependent diabetics have reduced insulin sensitivity, which is only partially reversed by conventional insulin therapy. 'Post-binding defects' in some diabetics could be related to defective covalent receptor modifications resulting from genetic receptor defects. High carbohydrate diets improve diabetes control through effects on the binding and coupling defects. In addition to stimulating insulin secretion, oral hypoglycaemics stimulate post-binding insulin action in vivo and in vitro. Insulin therapy in diabetes also tends to reverse post-binding defects. Pulsatile insulin delivery is more effective in lowering blood sugar than continuous administration, and produces less 'down regulation' of receptors. Combined insulin and sulphonylurea drugs reduce insulin requirements only in insulin-dependent diabetics with some endogenous insulin secretion, whereas metformin reduces insulin requirement in C peptide negative insulin-dependent diabetes mellitus. PMID- 3552594 TI - Current status of postmenopausal oestrogen therapy. PMID- 3552592 TI - Nitrendipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of hypertension. AB - Nitrendipine is a calcium entry blocker shown to inhibit the movement of calcium through the 'slow channel' of cardiac and vascular smooth muscle, thus inducing peripheral vasodilation with consequent reductions in elevated blood pressure. As evidenced by clinical trials, nitrendipine promptly lowers blood pressure in patients with mild to moderate hypertension, and sustains this effect during long term administration. Combining nitrendipine with other antihypertensive agents such as diuretics or beta-blockers often results in successful treatment in patients unresponsive to nitrendipine monotherapy. Headache, oedema, flushing and palpitations commonly occurring during treatment with nitrendipine are generally mild, usually subsiding with continued therapy. Thus, although additional long term studies are required to properly assess the relative merits of the drug compared with other antihypertensives, by providing the clinician with an effective and safe alternative to traditional therapies, nitrendipine represents a step forward in the treatment of mild to moderate hypertension. PMID- 3552599 TI - [Experiences with anterior/cuspid-controlled complete dentures]. PMID- 3552596 TI - Pentamidine isethionate. A review of its antiprotozoal activity, pharmacokinetic properties and therapeutic use in Pneumocystis carinii pneumonia. AB - Pentamidine isethionate, an aromatic diamidine, is an antiprotozoal agent proven to decrease mortality from Pneumocystis carinii pneumonia in debilitated infants and immunodeficient adults and children. Like the combination antimicrobial agent co-trimoxazole, pentamidine has been shown in retrospective studies to resolve episodes of pneumonia in approximately 41 to 87% of patients, including those with the acquired immunodeficiency syndrome (AIDS), when used alone or as sequential therapy. Although about 45% of all patients given pentamidine experience side effects--which may include nephrotoxicity, hypotension, hypoglycaemia or local reactions--in patients with AIDS the incidence of side effects is less with pentamidine than with co-trimoxazole. Thus, despite its profile of potentially severe side effects, pentamidine isethionate is a proven antimicrobial agent with a distinct place in the treatment of Pneumocystis carinii pneumonia in the growing population of AIDS patients. PMID- 3552600 TI - [Findings and data in complete denture wearers. A statistical survey]. PMID- 3552598 TI - Polymyalgia rheumatica. Its correct diagnosis and treatment. AB - Giant cell (temporal) arteritis was first described by Horton and colleagues in 1932, and polymyalgia rheumatica in 1957 by Barber who suggested this title for an entity resembling, but distinct from, rheumatoid arthritis of unknown aetiology in the elderly. Arteritic features were sufficiently common in polymyalgia rheumatica to suggest an arteriopathy as a cause, further evidence of this being the change from the clinical picture picture of polymyalgia rheumatica to giant cell arteritis and vice versa in many patients such that the alternative title polymyalgia arteritica was suggested. The clinical picture of polymyalgia rheumatica is that of an elderly patient, more often female than male, usually over 60 years of age, with painful stiffness in the girdle joints and muscles of the shoulders and hips, but seldom with findings in peripheral or intermediate joints. The painful stiffness in the shoulders, hips and thighs is worse in the early morning. An erythrocyte sedimentation rate over 50mm in 1 hour is usual, and there is a rapid and dramatic response to small doses of corticosteroids (around 10mg prednisolone daily). Arteritic and axial arthritic features have been noted by different authors in different ratios, the disorder gradually abating naturally over periods varying from several months to 7 to 10 years. Deaths, when they occur in this elderly group of patients, have usually been unrelated to the disease or its treatment, but osteoporotic vertebral crush fractures are not uncommon. Partial or complete blindness may occur in patients with either giant cell arteritis or polymyalgia rheumatica, often appearing rapidly after cessation of corticosteroid therapy or rapid reduction of dosage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552601 TI - [The effect of denture adhesives in long-term tests]. PMID- 3552602 TI - [The effect of differently-shaped palatal plates on the palatogram and the computerized analysis of speech]. PMID- 3552597 TI - Lipid-lowering drugs. An overview of indications and optimum therapeutic use. AB - Drug treatment of patients with hyperlipoproteinaemia is indicated to reduce the risk of atherosclerosis in patients with increased concentrations of atherogenic lipoproteins, and to lower the plasma concentrations of triglyceride-rich lipoproteins in patients with severe hypertriglyceridaemia who are at risk of abdominal pain and pancreatitis. Such therapy should be initiated only after satisfactory exclusion of secondary causes of hyperlipoproteinaemia, and should be regarded as an adjunct to rather than a substitute for appropriate dietary therapy. Drug therapy should be strongly considered in those patients with concentrations of atherogenic lipoproteins which exceed the 90th to 95th percentile for age. In patients with increased plasma concentrations of low density lipoproteins (LDL), agents which enhance the rate of LDL catabolism (cholestyramine and colestipol) or reduce the rate of LDL synthesis [e.g. nicotinic acid (niacin)] are the 'drugs of choice'. For those patients with concurrent hypertriglyceridaemia, nicotinic acid is the preferred initial drug, and in both patient groups combined drug therapy is often necessary to attain optimal reductions in LDL cholesterol concentrations. Clofibrate remains the 'drug of choice' for the rare patient with type III hyperlipoproteinaemia, whereas the newer agent gemfibrozil should be used in patients with plasma triglyceride concentrations above 1000 mg/dl who are at increased risk of abdominal pain and pancreatitis. Although currently limited to investigational use, mevinolin and related compounds, which are specific inhibitors of the rate limiting enzyme in cholesterol biosynthesis (HMG Co-A reductase), offer considerable promise in the therapy of patients with primary hypercholesterolaemia due to elevated levels of LDL cholesterol. PMID- 3552603 TI - [Superstructures of implants in edentulous jaws--results in controlled case studies]. PMID- 3552605 TI - [Early treatment of partial maxillary resection]. PMID- 3552604 TI - [The history of prosthetics]. PMID- 3552607 TI - [The prosthetic management of the upper and lower jaw after defect-producing surgeries]. PMID- 3552606 TI - [Indications, construction and success of reconstructive prosthetics in the maxilla]. PMID- 3552595 TI - Imipenem/cilastatin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy. AB - Imipenem is the first available semisynthetic thienamycin and is administered intravenously in combination with cilastatin, a renal dipeptidase inhibitor that increases urinary excretion of active drug. In vitro studies have demonstrated that imipenem has an extremely wide spectrum of antibacterial activity against Gram-negative and Gram-positive aerobic and anaerobic bacteria, even against many multiresistant strains of bacteria. It is very potent against species which elaborate beta-lactamases. Imipenem in combination with equal doses of cilastatin has been shown to be generally well tolerated and an effective antimicrobial for the treatment of infections of various body systems. It is likely to be most valuable as empirical treatment of mixed aerobic and anaerobic infections, bacteraemia in non-neutropenic patients and serious hospital-acquired infections. PMID- 3552608 TI - [In vivo corrosion studies of gold-containing alloys]. PMID- 3552609 TI - [Reproduction of the saddle components on the model]. PMID- 3552610 TI - [The effect of ultrasonic dental calculus removal on amalgam fillings]. PMID- 3552611 TI - [Scanning electron microscopy studies on protozoa in periodontal pocket exudate]. PMID- 3552612 TI - [Dynamic imaging of the temporomandibular joint in sagittal ultrasonic tomography (sagittal temporomandibular sonoarthrography)]. PMID- 3552613 TI - [Histological study of fungi in denture stomatitis]. PMID- 3552615 TI - [Problems in apical sealing during therapeutic replantation]. PMID- 3552614 TI - [Model studies on the remote action of intra-dentally applied immunogens]. PMID- 3552616 TI - [The Stutz pin-and-sleeve system for apicoectomy]. PMID- 3552617 TI - [Scanning electron and direct light microscopy comparative studies of the marginal configuration of various bonding technics during apicoectomy]. PMID- 3552618 TI - [Secondary splinting of fractured tooth roots using endodontic traction screws. Long-term results]. PMID- 3552619 TI - Studies on LHRH and physiological fluid amino acids in human colostrum and milk. AB - Various physiological fluid amino acids including essential, nonessential and neuroinhibitory as well as excitatory entities in human milk, colostrum, and infant formula were determined on a microcolumn ion-exchange analyzer equipped with ninhydrin detection system and integrator. The levels of 6 essential and 6 nonessential amino acids were significantly lower in infant formula than those in milk and colostrum. The neurotransmitter amino acids were also high in milk except taurine. Peptide hormones like LHRH were undetectable in infant formula, but were found in appreciable quantities in milk and colostrum by high pressure liquid chromatography. LHRH levels in milk were 6 to 7 fold higher than the corresponding plasma values as measured by radioimmunoassay. These and other several unique ingredients in human breast milk play a very prominent role in the development of the neonate. The presence of such complex components makes it impossible to humanize cow's milk or any other alternate formulation and to serve as a substitute for human milk. Further extensive work in defining the role of such essential components in milk on the development of the infant is indicated. PMID- 3552620 TI - Failure to detect acute effects of insulin hypoglycemia on serum PTH and calcium in normal subjects. AB - The effect of insulin induced hypoglycemic stress on parathyroid hormone serum level in man were evaluated. Porcine crystalline insulin (0.2 U kg-1 i.v.) caused symptomatic hypoglycemia and increase of adrenaline level in serum in all subjects. In the present study we could not detect any significant effects of insulin and of insulin induced hypoglycemia on serum parathormone and calcium levels, though such hypoglycemia is a potent stimulus to endogenous catecholamine secretion. The results support the view that the adrenergic system does not play any major role in regulating the secretion of parathormone which is contrasting to some findings reported by others. PMID- 3552621 TI - Biochemical and immunocytochemical characterization of neuropeptide Y in the immature rat ovary. AB - Neuropeptide Y (NPY)-like immunoreactivity has been found in nerves that innervate the rat ovary. In this study, we used immunohistochemical and biochemical methods to identify NPY in the prepubertal rat ovary. The normal distribution of NPY-containing nerve fibers and the route by which these nerves enter the ovary were analyzed with indirect immunofluorescence techniques. In ovaries with intact nerves, a profuse network of NPY-labeled fibers was observed surrounding blood vessels. Immunoreactive fibers were also seen in the interstitial tissue and coursing between follicles. Occasionally some fibers appeared to enter the follicles. Surgical transection of the superior ovarian nerve had no effect on NPY immunoreactivity; however, transection of the plexus nerve completely eliminated NPY-labeled nerve fibers in all ovarian compartments. The nature of this immunoreactivity was examined in extracts of pooled ovaries that were subjected to reverse phase HPLC and then analyzed by RIA. The major peak of NPY immunoreactivity in each extract eluted at the same time or slightly before synthetic porcine NPY. Two additional peaks of NPY-like immunoreactivity that eluted much earlier than porcine NPY were found in each extract. We conclude that the plexus nerve carries NPY afferents to the ovary and that the ovary contains NPY-like peptides, one of which has a retention time on reverse phase HPLC nearly identical to that of porcine NPY, whereas two others elute with earlier retention times. While the identity and composition of these substances remain to be determined, the presence of peptides that display NPY-like immunoreactivity in the ovary as well as the profuse network of NPY-containing fibers strongly imply a physiological involvement of NPY in the regulation of ovarian function. PMID- 3552622 TI - Phasic effects of glucose, phospholipase A2, and lysophospholipids on insulin secretion. AB - Arachidonic acid and lysophospholipids generated by glucose stimulation of phospholipase A2 may be related to the biphasic pattern of insulin secretion. Therefore, we examined the effects of glucose, exogenous phospholipase A2, lysophospholipids, and pharmacological agents which perturb the reesterification or oxygenation of arachidonic acid in superfused monolayer cultures of neonatal rat islet cells. Nordihydroguaiaretic acid (20 microM), an inhibitor of islet lipoxygenase, significantly decreased phasic glucose-stimulated insulin secretion, especially during phase 1, suggesting that stimulatory lipoxygenase metabolites of arachidonic acid contribute to the effects of glucose stimulation. Treatment with exogenous phospholipase A2 (10 mU/ml) or melittin (1.0 or 2.0 micrograms/ml) to generate arachidonic acid and lysophospholipids de novo caused a monophasic release of insulin, followed by a gradual decline in insulin secretion despite the continued presence of these agonists. Conversely, p hydroxymercuribenzoate (15, 30, and 50 microM), which blocks the reacylation of lysophospholipids with arachidonic acid, evoked a concentration-dependent biphasic stimulation of insulin secretion which was reversible. Lipoxygenase inhibition had no effect upon phase 1 secretion by p-hydroxymercuribenzoate, although it did partially reduce phase 2 secretion. However, lysophosphatidylcholine (50, 75, and 100 micrograms/ml) also caused a concentration-dependent biphasic stimulation of insulin secretion which resembled that seen with p-hydroxymercuribenzoate, suggesting that lysophospholipids were mediating the effects of p-hydroxymercuribenzoate. We speculate that during glucose stimulation of the islet, the following three phospholipase A2-initiated changes may be important: generation of lysophospholipid to stimulate directly insulin secretion, generation of arachidonic acid and lipoxygenase-mediated arachidonate metabolites, which positively modulate insulin secretion, and generation of cyclooxygenase-mediated arachidonate metabolites, which negatively modulate insulin secretion. PMID- 3552623 TI - Modulation of the effect of acetylcholine on insulin release by the membrane potential of B cells. AB - Mouse islets were used to test the hypothesis that the B cell membrane must be depolarized for acetylcholine to increase insulin release. The resting membrane potential of B cells (at 3 mM glucose) was slightly decreased (5 mV) by acetylcholine, but no electrical activity appeared. This depolarization was accompanied by a Ca-independent acceleration of 86Rb and 45Ca efflux but no insulin release. When the B cell membrane was depolarized by a stimulatory concentration of glucose (10 mM), acetylcholine potentiated electrical activity, accelerated 86Rb and 45Ca efflux, and increased insulin release. This latter effect, but not the acceleration of 45Ca efflux, was totally dependent on extracellular Ca. If glucose-induced depolarization of the B cell membrane was prevented by diazoxide, acetylcholine lost all effects but those produced at low glucose. In contrast, when the B cell membrane was depolarized by leucine or tolbutamide (at 3 mM glucose), acetylcholine triggered a further depolarization with appearance of electrical activity, accelerated 86Rb and 45Ca efflux, and stimulated insulin release. Acetylcholine produced similar effects (except for electrical activity) in the presence of high K or arginine which, unlike the above test agents, depolarize the B cell membrane by a mechanism other than a decrease in K+ permeability. Omission of extracellular Ca abolished the releasing effect of acetylcholine under all conditions but only partially decreased the stimulation of 45Ca efflux. The results show thus that acetylcholine stimulation of insulin release does not result from mobilization of cellular Ca but requires that the B cell membrane be sufficiently depolarized to reach the threshold potential where Ca channels are activated. This may explain why acetylcholine alone does not initiate release but becomes active in the presence of a variety of agents. PMID- 3552625 TI - Insulin specific binding sites in the myometrium of pregnant rats. AB - Insulin (INS) specific binding sites were detected in the myometrium of pregnant rats. The apparent equilibrium dissociation constants for the higher and lower affinity INS binding components were 0.01 X 10(-9) M and 2.5 X 10(-9) M, respectively. During the latter half of pregnancy INS binding increased gradually and peaked on the day of parturition (159.9 +/- 19.8, 196.3 +/- 24.6, 254.7 +/- 36.8, and 272.6 +/- 29.1 and femtomolars per mg protein, mean +/- SEM on days 15, 20, 21, and 22 of gestation, respectively). The pattern of increased INS binding paralleled the prepartum increase in myometrial cell nuclear estrogen receptors as well as myometrial glycogen levels. In contrast, low INS binding was associated with elevated cell nuclear progestin receptor levels, on day 15 and immediately postpartum. These results suggest that, during the latter half of pregnancy, myometrial INS binding capacity and glycogen concentration gradually increase. Since INS receptor levels begin to increase in parallel with increasing nuclear estrogen receptors, INS receptor synthesis may be under estrogen control. PMID- 3552626 TI - Fetal rat intestinal cells in monolayer culture: a new in vitro system to study the glucagon-like immunoreactive peptides. AB - To establish an in vitro model to investigate the glucagon-related peptides, fetal rat intestinal cells were enzymatically dispersed and placed into culture for up to 7 days. After 1 day in culture, the presence of epithelial-like cells containing glucagon-like immunoreactivity (GLI) was demonstrated using immunocytochemical techniques. The cell peptides were extracted by passage through a cartridge of octadecylsilyl silica and characterized by gel filtration and RIA. Two GLI moieties were detected with apparent mol wts of 11,000-12,000 and 5,000-6,000. The immunoreactive profile obtained for the cells in culture was identical to that of both whole fetal rat intestine and adult rat ileum. The presence of glucagon could not be demonstrated in any of the extracts. The basal levels of GLI and apparent immunoreactive glucagon (IRGa) were 1,457 +/- 381 and 198 +/- 57 pg/dish, respectively, on day 1 of culture. The GLI content of the cells, but not the IRGa, declined with time in culture for up to 5-7 days (P less than 0.03). Addition of insulin to the culture medium (10 or 100 mU/ml) did not influence the decrease in GLI content of the cells, but did inhibit the production of IRGa (P less than 0.05). Addition of 500 mg/dl glucose to the cells in the presence of 20 microU/ml insulin increased the secretion of GLI by 42 +/- 7% over 2 h (P less than 0.05). The stimulation by glucose was not seen in the absence of insulin or with higher insulin concentrations (100 microU/ml), nor did insulin alone (100 microU/ml) have any effect on the release of GLI. Thus, fetal rat intestinal cells in culture produce the GLI peptides, and secrete them in response to glucose. This system may provide a means by which the synthesis and control of secretion of the glucagon-related peptides can be investigated. PMID- 3552624 TI - Neuropeptide Y levels in microdissected regions of the hypothalamus and in vitro release in response to KCl and prostaglandin E2: effects of castration. AB - Intracerebroventricular administration of neuropeptide Y (NPY) has been shown to modify LH secretion, with the direction of the response dependent on the steroid background. To study further the role of gonadal steroids in the regulation of NPY secretion, the basal and KCl-evoked release of NPY from the medial basal hypothalamus (MBH) of intact and castrated male rats was assessed twice with the use of an in vitro incubation system. In each experiment, the amounts of NPY released in response to a 15-min pulse of KCl (45 mM) were significantly smaller from the MBH of castrated rats than of intact rats (P less than 0.05). Next, to assess the possible effects of prostaglandin E2 (PGE2), the MBH were exposed in a similar manner to two 15-min pulses, 30 min apart, of 0.568 and 56.8 mumol PGE2. Unlike KCl, PGE2 failed to stimulate NPY release from the MBH of either intact or castrated rats. However, a similar 56.8 mumol concentration of PGE2 was effective in stimulating the release of LHRH. We next examined the effects of castration on NPY levels in several microdissected regions of the hypothalamus. Whereas NPY concentrations were unchanged in the medial preoptic area, paraventricular nucleus and dorsomedial nucleus, NPY levels were significantly decreased in the median eminence, arcuate nucleus, and ventromedial nucleus 2 weeks after castration. These studies show that KCl can stimulate NPY release from the MBH in vitro, like that of LHRH, the KCl-induced NPY response is significantly smaller from the MBH of castrated than intact males, castration can significantly reduce the levels of NPY in the median eminence, arcuate nucleus, and ventromedial nucleus, thereby suggesting that testicular secretions may modulate NPY levels and release from the MBH, and because PGE2 stimulated the release of LHRH but not of NPY, separate regulatory neural events may underlie the secretion of these two neuropeptides. PMID- 3552627 TI - Detection of vitamin D binding protein on the surface of cytotrophoblasts isolated from human placentae. AB - Vitamin D binding protein (DBP), a Mr 56,000-58,000 alpha 2-glycoprotein, is the major serum protein involved in the transport of vitamin D sterols. Recently it has been suggested that DBP may also be involved in immunoglobulin G binding to cells. Because the trophoblast is involved in the transport of molecules such as vitamin D and immunoglobulin G to the fetus, we asked whether DBP could be detected on the surface of human placental trophoblast cells. Cytotrophoblasts purified from human term placentae were fixed and made permeant with Triton X-100 and examined by indirect immunofluorescence after incubation with a monoclonal antibody to DBP. Greater than 90% of these cells stained positively, whereas no staining was observed with nonimmune antiserum. The presence of DBP on/in the surface of cytotrophoblasts could also be demonstrated by fluorescent cytometry. When cell surface-associated proteins of cytotrophoblasts were radioiodinated, a Mr 57,000 radiolabeled protein could be immunoisolated from the cell lysate with a purified monospecific polyclonal antibody to DBP. Immunoisolation of this radiolabeled protein was prevented by the addition of excess unlabeled human DBP to the cell lysate before incubation with antibody. This Mr 57,000 radiolabeled protein could also be isolated by affinity chromatography selecting for proteins that bind to globular actin. When cytotrophoblasts were incubated with [35S]methionine for 3 or 18 h, active synthesis of DBP could not be demonstrated by immunoisolation techniques. These studies demonstrate the presence of DBP on the surface of well washed, human cytotrophoblasts. This DBP may be maternally derived, since active synthesis of DBP could not be demonstrated. PMID- 3552628 TI - Insulin regulation of rat growth hormone gene expression. AB - Insulin has been shown previously to inhibit basal and glucocorticoid- or T3 stimulated rat GH (rGH) synthesis, secretion, and mRNA levels in cultured rat pituitary tumor cells (GH3 cells) or pituitaries. The effects of insulin on rGH gene expression in GH3 cells were examined in greater detail in the current studies. Cells were deinduced for 5 days in medium devoid of steroids, T3, and insulin. Cells were then treated for 48 h with insulin (5 X 10(-9) M), dexamethasone (Dex; 10(-6) M), T3 (10(-8) M), insulin plus Dex, or insulin plus T3. When media and hormones were not replaced daily the results were similar to those obtained previously. Insulin decreased both basal and glucocorticoid stimulated rGH mRNA levels to approximately 70% of control levels, as measured by cytoplasmic dot hybridization. By contrast, when media and hormones were replaced daily, rGH mRNA levels increased by 1.5 to 7-fold in response to insulin in the absence or presence of Dex or T3, measured by both cytoplasmic dot hybridization and RNA (Northern) blotting. Dex increased rGH mRNA levels under both sets of conditions, verifying the specific nature of the insulin influence. Maximum rGH gene expression was achieved after a 48-h exposure to insulin. The observed insulin effects were probably mediated through insulin rather than insulin-like growth factor I or II receptors, since the concentration of insulin employed was near the Kd of the hormone for its receptor measured in the same cells. These results suggest that insulin is capable of regulating rGH gene expression. The action of insulin can be either positive or negative and is influenced by the metabolic state of the cell. PMID- 3552629 TI - Insulin-like growth factor I gene expression in GH3 rat pituitary cells: messenger ribonucleic acid content, immunocytochemistry, and secretion. AB - Insulin-like growth factor I (IGF-I) is present in multiple tissues and cell types. Expression of the IGF-I gene was examined in GH3 cells, a rat pituitary tumor cell line secreting GH and PRL. Increasing concentrations of RNA extracts of GH3 cells yielded a linear increase in hybridization intensity with a 32P labeled mouse IGF-I cDNA probe. Northern analysis of GH3 cells poly(A) RNA revealed IGF-I mRNA transcripts 1.3, 5.3, and 7.7 kilobases in size. Poly(A) RNA extracts of BALBc/3T3 fibroblasts, a cell line dependent on exogenous somatomedins for DNA synthesis, and of JEG-3 cells, a choriocarcinoma cell line, did not hybridize with the IGF-I cDNA probe. GH3 cells showed positive immunoperoxidase staining using a rabbit anti[Thr59]IGF-I antibody which was largely blocked by prior incubation of the antibody with excess IGF-I. Negligible background peroxidase activity was present in cells incubated with a rabbit nonimmune serum and PBS. Furthermore, BALBc/3T3 fibroblasts showed only weak specific staining with the IGF-I antibody. Finally, GH3 cells secreted IGF-I into the culture medium in a time-dependent fashion, while neither 3T3 nor JEG-3 cells produced detectable medium levels of the peptide after 72 h of incubation. As IGF I is known to inhibit GH production by the pituitary, the data shown suggest that locally produced IGF-I may regulate GH secretion in an autocrine or paracrine fashion. PMID- 3552630 TI - Is the decrease in the hypophysiotropic signal frequency normally observed during the luteal phase important for menstrual cyclicity in the primate? AB - The two phases of the ovulatory menstrual cycle of the primate are characterized by divergent activities of the GnRH pulse generator. During the luteal phase, LH pulse frequency is significantly reduced below that observed during the follicular phase. In this report we investigate whether the decrease in pulse frequency during the luteal phase is of physiological relevance to normal menstrual cyclicity. We have tested the effect of a pulsatile GnRH infusion given iv at hourly intervals for a period of 8-10 days during the luteal phase on the subsequent three to five cycles in eight female rhesus monkeys. Three of the eight animals received two treatment courses. Amounts of GnRH infused were 1.5 micrograms/pulse (n = 2 trials); 3.0 micrograms/pulse (n = 7); and 4.0 micrograms/pulse (n = 2). LH response to GnRH pulses of 1.5 and 3.0 micrograms resembled spontaneous LH pulses observed during the luteal phase. During the GnRH infusion period, the monkeys were fitted with a primate vest and tethered. Eleven control experiments were performed in these monkeys under similar conditions. GnRH therapy during the luteal phase affected subsequent cycles significantly, while no differences were observed in the control experiments. Overall mean follicular phase length in the control cycle was 13.4 days; it was significantly increased (P less than 0.005) in all post-GnRH treatment cycles to reach 34.4 (+/ 10.9), 43.9 (+/- 12.7), 40.4 (+/- 13.0), and 23.1 (+/- 4.8) days (+/- SE) in the first to fourth post-GnRH cycles, respectively. Progesterone secretion was significantly lower (P less than 0.05) in the first two post-GnRH cycles than in the control cycles: progesterone, 46.4 (+/- 2.1) in all control cycles, decreased to 27.7 (+/- 3.7), 24.8 (+/- 4.3), 34.0 (+/- 5.4), and 32.0 (+/- 6.5) surface units (+/- SE) from the first to fourth post-GnRH cycles, respectively, while luteal phase length remained relatively unchanged. The data indicate that significant disturbances in the menstrual cycle of the rhesus monkey follow imposed changes in the normal frequency pattern of the GnRH hypophysiotropic signal during the luteal phase and suggest that the naturally occurring slowing of GnRH-LH pulse frequency during the luteal phase is a relevant phenomenon in the sequence of events which control menstrual cyclicity. PMID- 3552631 TI - Analysis of relaxin release from cultured porcine luteal cells by reverse hemolytic plaque assay: influence of gestational age and prostaglandin F2 alpha. AB - Relaxin release from dispersed luteal cells was detected by a reverse hemolytic plaque assay to determine the influence of gestational age on basal relaxin secretion. Monodispersed luteal cells were derived by collagenase treatment of corpora lutea obtained from pigs in early (days 19-26), mid-(days 47-62), and late (days 80-99) gestation. The rate of plaque development under nonstimulated conditions progressively accelerated as gestation advanced, as did the rate of increase in plaque size. These results unequivocally demonstrate that basal relaxin release increases with advancing gestation. However, only about 50% of large luteal cells released relaxin at all stages of pregnancy examined up to day 100. These data indicated not only that basal relaxin release increases during pregnancy, but also that considerable heterogeneity exists with respect to relaxin output by individual cells. In contrast, both the basal rate of relaxin release and the percentage of cells committed to relaxin release declined significantly when luteal cells derived from preparturient sows (days 107-112 of gestation) were examined. Exposure of cultured luteal cells to prostaglandin F2 alpha (10(-8) and 10(-6) M) resulted in a rapid stimulation of relaxin secretion, but this agent did not recruit additional cells into the secretory pool. These data are consistent with the idea that autonomous changes and the action of secretagogues may combine at different times to achieve overall regulation of relaxin release by the corpus luteum. The significance of nonrelaxin-releasing luteal cells remains to be determined. PMID- 3552632 TI - Diabetes decreases liver and kidney nuclear 3,5,3'-triiodothyronine receptors in rats. AB - The liver and kidney nuclear T3 content and the maximal nuclear T3-binding capacity (MBC) were measured 1 month after streptozotocin administration and compared with values in controls either fed ad libitum (C) or offered a restricted diet (FR). A group of insulin-treated diabetic (D+I) rats was also included. Plasma T4 and T3 concentrations decreased to low levels in diabetic (D) rats. Plasma T3 levels were decreased in FR rats, whereas circulating T4 was in the normal range for C animals. The MBC (nanograms of T3 per mg DNA) for liver and kidney nuclear T3 was determined by an in vivo saturation technique. The respective results for all groups were as follows (asterisks denote values differing from C with P values less than 0.05): C, 0.601 and 0.414; FR, 0.583 and 0.369; D, 0.310 and 0.220; D+I, 0.630 and 0.394. Nuclear T4 and T3 concentrations were determined by an isotopic equilibrium technique. Nuclear T3 (nanograms per mg DNA) for liver and kidney were, respectively, 0.298 and 0.176 for C, 0.208 and 0.135 for FR, 0.109 and 0.070 for D, and 0.270 and 0.168 for D+I rats. The decreased liver and kidney nuclear T3 content in D rats appears to be due to a marked reduction of their available intracellular T4 pool, from which T3 could be generated, but most likely represents a decreased T3 uptake into liver and kidney nuclei, as the nuclear to plasma ratios of labeled T3 were decreased in D rats. The low levels of T3 in nuclei of FR rats could be attributed to an inhibition of T4 to T3 conversion, since the intracellular pool of T4 appears to be normal. The possibility that diabetes and food restriction might affect the thyroid activity was examined by measurement of the activities of alpha-glycerophosphate dehydrogenase and cytosol malic enzyme, two liver and kidney enzymes regulated by thyroid hormone. Furthermore, although the measurements made in FR rats excluded the possibility that the alterations in MBC found in D animals were nutrition dependent, the reduced nuclear T3 content concomitant with food restriction may account for some of the quantitative changes in the alpha-glycerophosphate dehydrogenase and cytosol malic enzyme activity found in D rat tissues. In conclusion, the present findings suggest that the observed changes in indices of thyroid hormone action in liver and kidney of D rats could be related to alterations in nuclear T3 receptor concentrations and the concentration of T3 bound to the receptor. PMID- 3552633 TI - Decreased insulin responsiveness in fat cells rendered protein kinase C-deficient by a treatment with a phorbol ester. AB - Insulin stimulation of 2-deoxyglucose transport and lipogenesis from glucose was examined in fat cells in which protein kinase C had been down-modulated by a 3 h pretreatment with 5 X 10(-7) M 4 beta-phorbol 12 beta-myristate, 13 alpha-acetate (PMA). As compared to control fat cells, the down-modulated cells exhibited a 55 65% decrease in insulin responsiveness with no change in either the hormone sensitivity or the insulin receptor affinity. The present study shows that fat cells made protein kinase C-deficient by chronic treatment with PMA exhibit an insulin-resistant state, distal to the initial step of hormone binding. PMID- 3552634 TI - A comparative study of the distributions of renin and angiotensinogen messenger ribonucleic acids in rat and mouse tissues. AB - Previous studies have reported the presence of renin mRNAs in several mouse tissues and angiotensinogen mRNAs in various rat tissues. Clarification as to whether renin and angiotensinogen mRNAs are coexpressed in the same tissues of the same animal species is important for understanding the biology of the tissue renin-angiotensin system. We employed mouse renin cDNA and rat angiotensinogen cDNA to compare tissue distributions of renin and angiotensinogen in RNAs of the rat and mouse. Both cDNA probes readily cross-hybridize with the corresponding mRNA of the other species. Our results demonstrate several patterns of distribution. Renin and angiotensinogen mRNAs are readily detected in kidney and adrenals of both species. In brain and heart, angiotensinogen mRNAs are present in concentrations that far exceed renin mRNA levels in these organs in both species. In mouse and rat livers, angiotensinogen, but not renin, mRNA is demonstrated. In rat testis, only renin mRNA can be detected, whereas in mouse testes both renin and angiotensinogen mRNA are present. In CD-1 male mouse submandibular gland, renin mRNA exists in high concentrations, whereas angiotensinogen mRNA is present in low levels. In contrast, neither renin nor angiotensinogen mRNA could be detected in rat salivary gland. In summary, our study demonstrates the widespread codistribution of renin and angiotensinogen mRNAs in many tissues of both species, allowing for the possibility of local angiotensin production. However, tissue and species differences in these gene expressions also exist. Understanding differential tissue expressions of these genes will provide additional important insight into the biology of the renin angiotensin system. PMID- 3552635 TI - Adenosine modulates insulin activation of insulin receptor kinase in intact rat adipocytes. AB - Endogenous adenosine enhances the insulin sensitivity of isolated rat adipocytes. We studied whether this effect was related to an ability of adenosine to alter the activation of insulin receptor kinase by insulin. It was found that depletion of endogenous adenosine by adenosine deaminase treatment decreases insulin's ability to activate the receptor kinase at submaximal insulin concentrations. This occurred without changes in insulin binding. At 4 ng/ml insulin, adenosine deaminase decreased insulin activation of insulin receptor kinase by 25%, a reduction that equalled the effect of adenosine deaminase on insulin stimulation of 2-deoxyglucose transport. The effects of adenosine deaminase on both insulin activation of insulin receptor kinase and insulin stimulation of 2-deoxyglucose transport were reversed by the addition of N6-phenylisopropyl-adenosine, a nonhydrolyzable adenosine analog. Our data are consistent with the view that adenosine modulates the coupling of insulin binding to biological actions of insulin at or before the level of activation of insulin receptor kinase. PMID- 3552637 TI - Acid etching and composite resin restorations. A culturing and histologic study on bacterial penetration. PMID- 3552636 TI - A serum-free medium for culturing lactogen dependent and autonomous NB2 node lymphoma cells. AB - A serum-free, hormone-free medium (SF2) was designed for the Nb2 rat lymphoma bioassay for lactogens as batches of horse serum (HS), which were commonly used, were found to be inconsistent in their suitability and to contain factors modulating the PRL-induced growth response of clone Nb2-11C. In a 3-day incubation with less than 500 pg/ml human GH (hGH), SF2 was better than the traditional medium in supporting Nb2-11C growth, although the comparative efficiency of SF2 decreased at higher hGH levels. Known growth factors (epidermal growth factor, fibroblast growth factor, platelet derived-growth factor, recombinant somatomedin-C, multiplication-stimulating activity) and insulin had no consistent effect on the cell growth in SF2 either in the presence or absence of hGH. Corticosterone (12.4-150 nM) was toxic to the Nb2-11C cells. SF2 could support the growth of Nb2-11C cells for at least 30 passages in the presence of 5 ng/ml hGH, and that of 2 spontaneously proliferating cell lines (Nb2-SP and Nb2 HSP) for the same length of time in the absence of lactogen. However, in all cases the growth rate in SF2 was lower than that seen in the presence of 10% HS. Long-term culture of Nb2-SP and Nb2-HSP cells in SF2 led to an increase of the growth rate with time. There was a change in the responsiveness of Nb2-SP cells to lactogens after long-term culture in SF2 which was only apparent in the presence of HS. After 10 passages in SF2, Nb2-11C cells showed no apparent changes in lactogen-induced growth response, cell phenotype, cell size, or binding capacity for [125I]hGH. PMID- 3552638 TI - Effect of a tight seal on survival of bacteria in saliva-contaminated cavities filled with composite resin. PMID- 3552639 TI - Efficacy of monopolar electrocoagulation in the treatment of bleeding gastric ulcer: a controlled trial. AB - With the aim of evaluating, in a controlled prospective fashion, the efficacy of monopolar electrocoagulation in the emergency treatment of bleeding gastric and stomal ulcers, 37 patients were studied: 16 were electrocoagulated (EC group) while the remaining 21 were treated by conventional methods (control group). The hemorrhage recurred in only one of the 16 patients belonging to the EC group, but in 11 of the 21 control patients (p less than 0.0005). Transfusion requirements were also reduced in the EC group (p less than 0.05), with no significant difference in relation to mortality. Stratifying the results according to hemorrhagic activity, electrocoagulation should be clearly effective in those patients with spurting hemorrhage, taking into account several limitations: deep ulcers bearing gross vessels, and lack of cooperation by the patient. Prophylactic treatment of the bleeding ulcer with a visible non-spurting vessel may be indicated whenever we make a proper selection of the patients with a greater possibility of hemorrhagic recurrence. PMID- 3552640 TI - Assessment of depth of invasion in rectal cancer by endosonography. AB - Pre-operative staging of rectal cancer could be significantly improved by the imaging method of endorectal ultrasound. Using high-frequency transducers a complex rectal wall pattern was demonstrated. Depending on in vitro or in vivo examinations and on US probes of different frequency the current interpretation is not uniform. Agreement exists on the interpretation of the muscularis propria which is of clinical importance. Objective and precise criteria for lymph node differentiation have yet to be worked out. PMID- 3552641 TI - Foreign body ingestion: review and suggested guidelines for management. AB - Eighty percent of ingested foreign bodies which reach to stomach will pass uneventfully through the gastrointestinal tract. The remainder may cause obstruction, perforation or hemorrhage. The risk of complications is increased with long sharp metal objects and animal bones, and may be higher in patients with adhesions due to prior abdominal surgery. Pre-existing intestinal disease such as Crohn's or intestinal stenosis may predispose to complications. The use of overtubes has made endoscopic removal of sharp objects safer. In patients at increased risk for complications, we recommended early endoscopic retrieval of ingested foreign objects. PMID- 3552642 TI - Endoscopic treatment of bleeding gastric varices with bucrylate. PMID- 3552644 TI - Macrophages, dust, and pulmonary diseases. PMID- 3552643 TI - 15N-labeled P22 c2 repressor for nuclear magnetic resonance studies of protein DNA interactions. AB - The salmonella phage P22 c2 repressor was produced with 90% 15N isotope labeling of all leucines, using the expression system E. coli W3110 lac IQ?P 125. The N terminal DNA-binding domain 1-76 was obtained by chymotrypsin cleavage. Its characterization by biochemical techniques, mass spectrometry, and one- and two dimensional nuclear magnetic resonance (NMR) showed that highly residue-selective isotope labeling was achieved with the minimal growth medium used. The ability to obtain such isotope labeling opens new avenues for NMR studies of protein-DNA interactions in the P22 operator system. PMID- 3552645 TI - Identification of the Ames mutagen tester strains as Salmonella typhimurium. PMID- 3552646 TI - Coffee is highly mutagenic in the L-arabinose resistance test in Salmonella typhimurium. AB - The present study shows that the L-arabinose resistance test in Salmonella typhimurium detects coffee as a strong mutagen in the absence of mammalian microsomal activation. The response of the Ara forward mutation assay was 8.5 times higher than that of TA104, which is the most sensitive to coffee of the tester strains of the Ames test. Both the mutagenesis protocol (preincubation test) and the additional genetic characteristics of the bacterial tester strain (excision repair deficiency, normal lipopolysaccharide barrier, and the presence of plasmid pKM101) were critical factors in the optimal induction by coffee of forward mutations to L-arabinose resistance. All ten samples of roasted coffee analyzed with the Ara assay were highly mutagenic: one cup of coffee (150 ml) was calculated to induce 3-4 X 10(6) AraR mutants. In contrast, coffee prepared from unroasted beans (green coffee) had no mutagenic activity. Regular- and sugar roasted coffees showed similar mutagenicities, but the specific mutagenic activity of instant coffees (1559 AraR mutants/mg) was almost 2 times that of noninstant ones (834 AraR mutants/mg). The Ara assay allowed the direct testing of coffee, although it was demonstrated that lyophilization has no effect on the mutagenicity of this beverage. Like roasted coffee, roasted barley induced a large number of AraR mutants per mg (227), though its specific mutagenic activity was approximately 4 and 7 times lower than that of noninstant and instant coffees, respectively. PMID- 3552647 TI - Mutagenicity testing of 5-(4-nitrophenyl)-2,4-pentadien-1-al (spy dust) and its metabolites in vitro and in vivo. AB - 5-(4-Nitrophenyl)-2,4-pentadien-1-al (NPPD; spy dust) was tested for mutagenicity in Salmonella and for its ability to induce chromosome aberrations and sister chromatid exchanges (SCE) in cultured Chinese hamster ovary (CHO) cells and mouse bone marrow. Two metabolites of NPPD produced by the rat, 4-nitrobenzoic acid (NBA) and 4-nitrohippuric acid (NHA), were also tested in Salmonella and CHO cells. NPPD was mutagenic in Salmonella, and induced low-level increases in chromosome aberrations and SCE in bone marrow. It did not induce aberrations in CHO cells. NBA was positive in Salmonella and CHO cells, while NHA was negative. The mutagenicity of NPPD in Salmonella was partially, but not completely, eliminated in a strain lacking one of the bacterial nitroreductases. PMID- 3552648 TI - Mutagenicity and toxicity studies of several alpha,beta-unsaturated aldehydes in the Salmonella typhimurium mutagenicity assay. AB - alpha,beta-Unsaturated aldehydes are reactive compounds which are ubiquitous in the environment. This class of compounds has been tested for mutagenicity in Salmonella typhimurium by a number of groups who have obtained differing results. The present studies were undertaken to test the mutagenicity and toxicity of two novel alpha, beta-unsaturated aldehydes, specifically trans, trans-muconaldehyde and trans-4-hydroxynonenal, and to re-examine the mutagenicity of crotonaldehyde. Trans, trans-muconaldehyde is a newly found microsomal metabolite of benzene, and trans-4-hydroxynonenal is a toxic aldehyde formed endogenously during lipid peroxidation. Compounds were tested in S. typhimurium strain TA 100 using a 30 min liquid preincubation procedure. The present mutagenicity studies indicate that these alpha, beta-unsaturated aldehydes at first appear to be mutagenic, although only at concentrations which decrease survival counts, and result in a disappearance of the bacterial lawn. The colonies observed on mutagenicity test plates are not mutants but rather pin point survivors. PMID- 3552649 TI - Some reflections of H.J. Muller. PMID- 3552650 TI - Salmonella mutagenicity tests: III. Results from the testing of 255 chemicals. AB - The results and data from the testing of 255 chemicals for mutagenicity in Salmonella are presented. All chemicals were tested under code using a preincubation modification of the Salmonella/microsome test in the absence of exogenous metabolic activation and in the presence of liver S-9 from Aroclor induced male Sprague-Dawley rats and Syrian hamsters. PMID- 3552651 TI - Selenium and immune responses. AB - Selenium (Se) affects all components of the immune system, i.e., the development and expression of nonspecific, humoral, and cell-mediated responses. In general, a deficiency in Se appears to result in immunosuppression, whereas supplementation with low doses of Se appears to result in augmentation and/or restoration of immunologic functions. A deficiency of Se has been shown to inhibit resistance to microbial and viral infections, neutrophil function, antibody production, proliferation of T and B lymphocytes in response to mitogens, and cytodestruction by T lymphocytes and NK cells. Supplementation with Se has been shown to stimulate the function of neutrophils, production of antibodies, proliferation of T and B lymphocytes in response to mitogens, production of lymphokines, NK cell-mediated cytodestruction, delayed-type hypersensitivity reactions and allograft rejection, and the ability of a host to reject transplanted malignant tumors. The mechanism(s) whereby Se affects the immune system is speculative. The effects of Se on the function of glutathione peroxidase and on the cellular levels of reduced glutathione and H2Se, as well as the ability of Se to interact with cell membranes, probably represent only a few of many regulatory mechanisms. The manipulation of cellular levels of Se may be significant for the maintenance of general health and for the control of immunodeficiency disorders and the chemoprevention of cancer. PMID- 3552652 TI - Cadmium concentration in the kidney cortex of occupationally exposed workers measured in vivo using X-ray fluorescence analysis. AB - A method for in vivo X-ray fluorescence analysis of the cadmium concentration in the kidney cortex has been improved and tested in 20 selected male occupationally cadmium-exposed workers (duration of exposure 7-39 years). The concentration of cadmium in kidney cortex ranged from 47 to 317 (median 141) micrograms/g. The concentration of cadmium in blood was 32-160 (median 64) nmole/liter, cadmium in urine was 2.5-13 (median 5.4) nmole/mmole creatinine, and beta 2-microglobulin in urine was 3.3-68 (median 14) micrograms/mmole creatinine. In individuals, the relationship between duration of exposure, time-integrated exposure, and cadmium level in urine on the one hand and cadmium level in the kidney on the other varied considerably. Direct in vivo analysis of the concentration of cadmium in the kidney cortex is therefore valuable as a complement to the other tests when monitoring cadmium exposure. Our method is sensitive, practically free from risk, and can b performed by routine at low costs. PMID- 3552653 TI - Cadmium, zinc, and copper in rabbit kidney metallothionein--relation to kidney toxicity. AB - Twenty-two rabbits were given repeated subcutaneous injection of cadmium chloride. The cumulative cadmium dose given ranged from 13 to 214 mumole/kg body weight. Five rabbits served as controls. The treatment resulted in cadmium concentrations in kidney cortex that ranged from 0.3 to 3.2 mmole Cd/kg and a subsequent production of metallothionein. The molar ratio of cadmium, zinc, and copper in metallothionein fractions from kidneys with different concentrations of cadmium was determined. At low concentrations of cadmium in rabbit kidneys, zinc was the dominating metal bound to metallothionein (70-90%). At high concentrations of cadmium in kidneys, cadmium was the dominating metal in metallothionein. Evidence of kidney toxicity, in the form of beta2 microglobulinuria, was seen when cadmium constituted 85% of the metal ions recovered from metallothionein fractions. The remaining 15% was zinc. This indicates that at most six of the seven metal-binding sites in mammalian metallothionein are occupied by cadmium and that the remaining site is occupied by zinc. Our data provide further support for the hypothesis that chronic cadmium nephrotoxicity develops when there is a lack of metal-binding sites available for cadmium in metallothionein. PMID- 3552654 TI - Inactivation and degradation of yeast glucose-6-phosphate dehydrogenase selectively modified by pyridoxal-5-phosphate. AB - Modification by pyridoxal-5-phosphate of glucose-6-phosphate dehydrogenase (EC 1.1.1.49) purified from Saccharomyces cerevisiae produces an inactivation effect, partially reversible by dilution in the presence of substrates. Spectroscopic analysis of the enzyme pyridoxal-5-phosphate complex reduced with NaBH4 provides the values expected for the binding of the aldehydic group to Lys residue. One Lys residue appears to be responsible for the observed enzyme inactivation, and the presence of the phosphate group is required for the effect. Besides the change of activity, the binding of pyridoxal-5-phosphate to the enzyme causes an increase in susceptibility to degradation by the intracellular yeast proteinase A at pH 7.6. PMID- 3552655 TI - Immunoassay of circulating enzymes: current status. AB - This report reviews the current status of immunoassays for circulating enzymes. The necessity for measuring the protein concentration of circulating enzymes is evident in the light of the inability of conventional enzyme assays to measure the levels of released enzymes accurately, especially when these enzymes are inactivated, bound to an inhibitor, or present as proenzymes. In some cases, therefore, measurement of enzyme protein concentrations rather than their catalytic activities provide more relevant information for detection of lesions and evaluation of their extent in the organs from which the enzymes are derived. Facts to be considered in the measurement and interpretation of the values obtained by immunoassays are discussed. PMID- 3552656 TI - Chemical modification of tryptophanase from E. coli with polyethylene glycol to reduce its immunoreactivity towards anti-tryptophanase antibodies. AB - Escherichia coli tryptophanase was modified with 2,4-bis(O-methoxypolyethylene glycol)-6-chloro-s-triazine (activated PEG2, MW 5,000 x 2). The modified tryptophanase, in which approximately 43% of the total 120 amino groups and 38% of the total 16 sulfhydryl groups in the molecule were coupled, completely lost the immunoreactivity towards anti-tryptophanase serum from rabbit. Approximately 10% of the enzymic activity was retained. The modified enzyme showed the same physicochemical properties as the native enzyme: Km value for L-tryptophan (0.3 mmol/l), optimum pH (8.0) and optimum temperature (50 degrees C). The modified enzyme was more resistant than the native counterpart against proteolytic digestion with trypsin. PMID- 3552657 TI - Qualitative aspects of the incorporation of equine cancellous bone grafts. AB - The incorporation of autogenous cancellous bone graft was studied in eight yearling ponies. The site for the defect to be grafted was chosen so that the effect on the graft, of both the host cortical and trabecular bone, could be assessed. To obtain information concerning the vitality of the graft and the dynamic aspects of the modelling and remodelling processes of graft incorporation, a double and treble tetracycline intravital labelling technique was used. Radiographs of the graft and host tissues of all ponies were obtained regularly, but were of little assistance in assessing graft incorporation. The ponies were destroyed humanely at regular intervals between nine and 241 days after installation of the graft, followed by histological examination of undecalcified sections. The study revealed that all installed graft trabeculae showed signs of non-vitality at nine days after installation and gradually disintegrated. Two processes of new bone formation were observed. First, finger like projections of immature new trabeculae were found to originate from the graft/host interfaces. Second, a gradual process of accretion of osteoid and woven bone upon disintegrating graft trabeculae occurred uniformly throughout the graft. The graft adapted to the structure of opposing host bone by corticalisation and trabecularisation. The present study confirmed clinical observations relating to convalescence time following grafting of large osseous defects in horses and indicated that equine bone reacts to autogenous bone grafts in a similar manner to other mammals. PMID- 3552658 TI - Preliminary study of quantitative aspects and the effect of pulsed electromagnetic field treatment on the incorporation of equine cancellous bone grafts. AB - The quantitative aspects of equine cancellous bone graft incorporation and the possibility of influencing graft incorporation by daily exposure to a pulsed electromagnetic field (PEMF) was studied in eight yearling ponies. In order to be able to quantify formative aspects of graft remodelling, a double and treble tetracycline intravital labelling technique was used. Intravital radiographs were obtained at regular intervals throughout the trial, but were found to be of little assistance in assessing any differences between stimulated and non stimulated grafts. The ponies were humanely destroyed at regular intervals between nine and 241 days after installation of the graft. Light microscopy and fluorescent light microscopy were used to evaluate quantitative aspects of graft incorporation and to compare PEMF-stimulated grafts with control grafts. There was a small but statistically significant effect of PEMF-stimulation on cancellous bone graft incorporation. In view of this, these observations can only be considered as indicative of a possible trend, but should encourage further studies using different signal modalities. PMID- 3552659 TI - Three protocols for measuring subcutaneous fat thickness on the upper extremities. AB - Three protocols for measuring subcutaneous fat thickness were compared and their level of association determined in young adults. Subjects included 21 men and 21 women, 18-24 years of age. Skinfold calipers, A- and B-mode ultrasound were used to measure the thickness of the subcutaneous fat layer overlying the anterior and posterior aspects of the upper arm. Each protocol was independently administered within a 30-min block of time in a randomly rotated sequence. Significant differences (p less than 0.05) between protocols were observed depending upon site of measurement and gender of the subject. At both the anterior and posterior sites for men, B-mode and halved skinfold were similar but significantly less than A-mode measurements. At the anterior site for women, A-mode and skinfold were similar but significantly greater than B-mode measurements. At the posterior site for women, all three measurements were similar. Correlations between the protocols were positive with men's levels ranging from 0.59 to 0.74, while women's levels were from 0.39 to 0.89. It was concluded that although skinfold calipers, A-mode ultrasound, and B-mode ultrasound may be used to obtain moderately associated measurements of upper-arm subcutaneous fat thickness in young adults, the three protocols yield inconsistently similar data. PMID- 3552660 TI - Relative effects of the supine posture and of immersion on the renin aldosterone system at rest and during exercise. AB - The relative influences of the supine posture and of immersion on the renin aldosterone system (RAS) were studied at rest and during moderate exercise in five healthy men. When supine, resting or immersion to the neck for 20 min in a thermoneutral environment both induced a decrease in plasma renin activity (PRA) when compared with the levels measured after 15 min sitting at rest (resting: 44%, p less than 0.05. Immersion: -45%, p less than 0.05). There was no significant difference in PRA decrease between the two situations. Aldosterone (ALDO) values were lower after supine rest or immersion than those observed after sitting at rest, but the difference was not significant. Two types of exercise at a constant relative work load (40-50% maximal oxygen uptake), namely cycling on an ergocycle in the supine position and free-style swimming, induced increases in PRA and ALDO when compared with the levels measured after 15 min rest when sitting (respectively, PRA = +35%, p less than 0.05, and +45%, p less than 0.05, ALDO = +32%, p less than 0.01 and +35%, p less than 0.05). Increases in PRA and ALDO did not differ between the two exercises. Thus inhibitory effects on RAS of change in external pressure are negligible during water immersion to the neck in the supine position and during swimming at moderate intensity. PMID- 3552662 TI - Detection of immunoglobulin M antibodies to Treponema pallidum in a modified enzyme-linked immunosorbent assay. AB - The indirect enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin M (IgM) antibodies to Treponema pallidum in sera of syphilitic patients is complicated by false positive reactions due to the interference of IgM rheumatoid factor (IgM-RF) activity and the presence of treponemal IgG antibodies. Another source of error producing false negative results is the competition between treponemal IgG and IgM antibodies for the binding sites on the antigen. To avoid these complications in the indirect Treponema pallidum specific IgM-ELISA, total IgG was immunoprecipitated from sera of syphilitic patients prior to the assay. The IgM-RF from non-precipitated sera reacted in an IgM-RF-ELISA and in the Treponema pallidum-IgM-specific ELISA with identical titers. After precipitation of total IgG no reaction of the IgM-RF in the assay could be demonstrated. Competition between IgG and IgM antibodies can be prevented almost completely by the precipitation procedure. The sensitivity and specificity of the Treponema pallidum-specific IgM-ELISA after immunoprecipitation of total serum IgG were shown to be higher than 97 percent. PMID- 3552661 TI - Metabolic and circulatory responses to the ingestion of glucose polymer and glucose/electrolyte solutions during exercise in man. AB - Six men exercised on a cycle ergometer for 60 min on two occasions one week apart, at 68 +/- 3% of VO2max. On one occasion, a dilute glucose/electrolyte solution (E: osmolality 310 mosmol X kg-1, glucose content 200 mmol X l-1) was given orally at a rate of 100 ml every 10 min, beginning immediately prior to exercise. On the other occasion, a glucose polymer solution (P: osmolality 630 mosmol X kg-1, glucose content equivalent to 916 mmol X l-1) was given at the same rate. Blood samples were obtained from a superficial forearm vein immediately prior to exercise and at 15-min intervals during exercise; further samples were obtained at 15-min intervals for 60 min at rest following exercise. Heart rate and rectal temperature were measured at 5-min intervals during exercise. Blood glucose concentration was not different between the two tests during exercise, but rose to a peak of 8.7 +/- 1.2 mmol X l-1 (mean +/- SD) at 30 min post-exercise when P was drunk. Blood glucose remained unchanged during and after exercise when E was drunk. Plasma insulin levels were unchanged during exercise and were the same on both trials, but again a sharp rise in plasma insulin concentration was seen after exercise when P was drunk. The rate of carbohydrate oxidation during exercise, as calculated from VO2 and the respiratory exchange ratio, was not different between the two tests.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552664 TI - Detection of circulating antigens in immunocompromised patients during reactivation of chronic toxoplasmosis. AB - One hundred and fifteen sera from nineteen patients undergoing bone marrow transplant and four recipients of kidney transplant who showed serological or clinical reactivation of chronic toxoplasmosis were tested for Toxoplasma gondii circulating antigen (TCA) by enzyme-linked immunosorbent assay using antitoxoplasma IgG antibody coupled to alkaline phosphatase. Seven bone marrow transplant patients and one kidney transplant recipient were TCA positive either before or at the time of antitoxoplasma IgG antibody increase. TCA continued to be detected in one patient with neurological toxoplasmosis until his death. In the other patients, TCA disappeared when IgG antibodies rose, probably due to the formation of immunocomplexes consisting of TCA and immunoglobulins. In the TCA seronegative patients, the presence of circulating immunocomplexes or TCA kinetics of short duration may explain these results. Patients receiving immunosuppressive therapy should be tested for TCA. PMID- 3552665 TI - Monospecific antibodies for detection of Clostridium difficile enterotoxin. AB - Tests of polyclonal antisera to homogeneous enterotoxin preparations of Clostridium difficile by immunoblotting demonstrated that cross-reactions occurred with proteins from cell lysates of nearly all Clostridium species. There was a notable reduction in the amount of crossreaction when only culture supernatants were analysed. The enterotoxin could be easily identified by its unique high molecular weight of 230,000. The findings suggest that care must be taken when immunological tests other than immunoblotting are used for detection of Clostridium difficile enterotoxin. PMID- 3552663 TI - Laboratory diagnosis of infections caused by legionellae. AB - Legionnaires' disease can be diagnosed by detection of antibody to the organism or by direct detection of the bacterium and/or its products using immunological means, culture or a DNA probe. Culture isolation, still the most specific and sensitive test, can be done with sputum samples if proper selective techniques are used. Antibody detection is more suited for epidemiological purposes than individual cases. It has been overused to the exclusion of more specific and rapid methods, such as culture and other means of bacterial detection. Immunofluorescent microscopy remains an important tool in diagnosis, although urinary antigen detection and DNA probes are promising alternative tests. For optimal sensitivity, culture must be performed, regardless of which test is used. PMID- 3552666 TI - Lysis centrifugation and slide blood culture systems for diagnosis of bacteremia in immunocompromised patients. AB - Compared with a slide blood culture system, a lysis centrifugation system detected significantly more positive blood cultures and more episodes of bacteremia in immunocompromised patients (even when on antibiotics), while giving results more rapidly and even at significantly lower CFUs. However, it had a high contamination rate and did not detect Pseudomonas aeruginosa as often. Use of the two systems together is recommended for diagnosing bacteremia early in immunocompromised patients. PMID- 3552667 TI - Differentiation of obligate anaerobes by assay of pyruvate:ferredoxin oxidoreductase activity. AB - In the described assay system a blue colour develops within 30 min after inoculation of obligate anaerobes, even under aerobic conditions. The simple and rapid assay may be of use in differentiating obligate anaerobes of clinical importance. PMID- 3552668 TI - Purification and characterization of a light-harvesting chlorophyll-a/b-protein of photosystem I of Lemna gibba. AB - The photosystem I (PSI) complex of Lemna gibba, isolated by deriphat/polyacrylamide gel electrophoresis of thylakoids solubilized in glycosidic surfactants, has been fractionated into its two chlorophyll-protein complexes: a core component (CCI) and a light-harvesting component (LHCI), using either non-denaturing gel electrophoresis or ion-exchange chromatography/sucrose gradient centrifugation. Both methods yielded an LHCI component that contained only one apoprotein of approximately 20 kDa. All the chlorophyll b and lutein of the PSI complex is associated with this LHCI preparation. The chlorophyll a/b ratio of this chlorophyll-protein is 2.5, and lutein is essentially the only carotenoid present. While the purified LHCI from Lemna cross-reacts with antibodies raised against spinach LHCPIb of Lam et al. [FEBS Lett. 168, 10-14 (1984)], no cross-reactivity occurred between it and the major light-harvesting chlorophyll-a/b-protein of PSII, LHCII beta. This and a comparison of the amino acid and pigment compositions of the apoproteins of the LHCI and LHCII beta chlorophyll-proteins indicate that these are two distinct but similar chlorophyll proteins. PMID- 3552669 TI - Unfolding of the trp repressor from Escherichia coli monitored by fluorescence, circular dichroism and nuclear magnetic resonance. AB - The denaturation of the trp repressor from Escherichia coli has been studied by fluorescence, circular dichroism and proton magnetic resonance spectroscopy. The dependences of the fluorescence emission of the two tryptophan residues on the concentration of urea are not identical. The dependence of the quenching of tryptophan fluorescence by iodide as a function of urea concentration also rules out a two-state transition. The circular dichroism at 222 nm decreases in two phases as urea is added. Normalised curves for different residues observed by 1H NMR also do not coincide, and require the presence of at least one stable intermediate. Analysis of the dependence of the denaturation curves on the concentration of protein indicate that the first transition is a partial unfolding of the dimeric repressor, resulting in a loss of about 25% of the helical content. The second transition is the dissociation and unfolding of the partially unfolded dimer. At high concentrations of protein (500 microM) about 73% of the repressor exists as the intermediate in 4 M urea. The apparent dissociation constant is about 10(-4) M; the subunits are probably strongly stabilised by the subunit interaction. The native repressor is stable up to at least 70 degrees C, whereas the intermediate formed at 4 M urea can be denatured reversibly by heating (melting temperature approximately 60 degrees C, delta H approximately 230 kJ/mol). PMID- 3552670 TI - A nuclear mutation affecting mitochondrial transcription in Saccharomyces cerevisiae. AB - Mitochondrial transcription was studied in a nuclear temperature-sensitive pet mutant of Saccharomyces cerevisiae. The mitochondrial RNA levels in vivo and the in vitro transcriptional activities of isolated mitochondria were analysed. In comparison to the wild-type an overall reduction of mitochondrial gene expression together with a changed expression pattern was observed for the mutant, indicating a defect in mitochondrial RNA synthesis. These findings were supported by studies with a purified DNA-protein complex from yeast mitochondria. This complex was able to synthesize ribosomal and messenger RNAs in an in vitro system. Proteins from wild-type and mutant transcription complexes were tested for their DNA-binding abilities; one of the proteins identified in the wild type had either lost this ability or was absent in the mutant. PMID- 3552672 TI - Nitrogen catabolite regulation of proline permease in Saccharomyces cerevisiae. Cloning of the PUT4 gene and study of PUT4 RNA levels in wild-type and mutant strains. AB - The proline permease gene PUT4 has been cloned. Nitrogen-source regulation ('ammonia sensitivity') of this and at least two other amino-acid permeases is believed to occur at two distinct levels, i.e. permease synthesis and permease activity. Therefore, PUT4 transcription/messenger stability was examined in the ammonia- and proline-grown wild type as well as in mutant strains supposedly affected at only one or at both of these levels. We report transcript-level repression of proline permease synthesis in ammonia-grown cells. Repression is lifted at this level in gdhCR, gln1ts and gdhA mutants which exhibit pleiotropically derepressed permease and catabolic enzyme activities. On the other hand, the npi1 and npi2 mutations, formerly called mut2 and mut4, relieve an inactivation process which seems only to affect permeases. These mutations do not affect the detected PUT4 RNA level. The only known positive factor in proline permease regulation, the nitrogen permease reactivator protein Npr1, is believed to counteract the inactivation process on derepressing media. This protein appears to have an additional, indirect effect on PUT4 transcription/messenger stability: it would actually mediate repression via its activating effect on ammonia uptake. PMID- 3552673 TI - Isolation of the NPR1 gene responsible for the reactivation of ammonia-sensitive amino-acid permeases in Saccharomyces cerevisiae. RNA analysis and gene dosage effects. AB - The NPR1 gene codes for a protein, called the nitrogen permease reactivator protein or Npr1, which appears to promote the activity of several permeases for nitrogenous substances under conditions of nitrogen catabolite derepression, but fails to do so in the presence of ammonium ions. This gene has been cloned. Its transcription seems unaffected by growth on ammonia, so any ammonia regulation of Npr1 function most likely occurs at another level. In order to elucidate further the mechanism of permease inactivation, which requires an intact NPI1 gene product (NPI1 for nitrogen permease inactivator gene, formerly termed MUT2) and the role of Npr1 in counteracting this process, we have studied the effects of NPR1 and NPI1 gene dosage on general amino-acid permease activity. On nitrogen derepressing media, NPR1 gene dose can be increased from 1 copy in a diploid to 16 plasmid-borne copies in a haploid strain without altering general amino-acid permease activity. On minimal ammonia medium, the plasmid-bearing haploid cells exhibit low but increased general amino-acid permease activity with respect to non-transformed cells. The adverse effect of the NPI1 gene product on general amino-acid permease activity is reduced when NPI1 gene dose is decreased to 1 gene copy in a diploid strain, regardless of the nitrogen source. We hypothesize that this product inactivates the permease by stoichiometric binding and that the Npr1 protein or a product of its catalytic action opposes this binding under conditions of nitrogen derepression. PMID- 3552671 TI - Light-dependent accumulation and localization of photosystem II proteins in maize. AB - We have raised antibodies against several major components of photosystem II. These antisera, which are directed against the apoproteins of two chlorophyll binding proteins (CPa-1 and CPa-2), the apoprotein of light-harvesting complex II and the 33-kDa extrinsic protein of the oxygen-evolving complex, were used to examine the light regulation of photosystem II assembly in maize. The principal findings of this study are as follows. The 33-kDa protein is present in dark grown maize and the content increases 5-10-fold upon illumination. The level of the protein is mediated at least in part by phytochrome and is independent of the accumulation of chlorophyll. In contrast, none of the three chlorophyll-binding proteins examined was detectable in leaves of maize grown in darkness or under other light regimes where chlorophyll does not accumulate. Even in the absence of photosystem II assembly, the 33-kDa protein is properly transported across the thylakoid into the lumen. However, the protein does not attach in the normal way to the inner surface of the membrane under these conditions. PMID- 3552674 TI - Studies on the effect of serine protease inhibitors on activated contact factors. Application in amidolytic assays for factor XIIa, plasma kallikrein and factor XIa. AB - Amidolytic assays have been developed to determine factor XIIa, factor XIa and plasma kallikrein in mixtures containing variable amounts of each enzyme. The commercially available chromogenic p-nitroanilide substrates Pro-Phe-Arg-NH-Np (S2302 or chromozym PK), Glp-Pro-Arg-NH-Np (S2366), Ile-Glu-(piperidyl)-Gly-Arg NH-Np (S2337), and Ile-Glu-Gly-Arg-NH-Np (S2222) were tested for their suitability as substrates in these assays. The kinetic parameters for the conversion of S2302, S2222, S2337 and S2366 by beta factor XIIa, factor XIa and plasma kallikrein indicate that each active enzyme exhibits considerable activity towards a number of these substrates. This precludes direct quantification of the individual enzymes when large amounts of other activated contact factors are present. Several serine protease inhibitors have been tested for their ability to inhibit those contact factors selectively that may interfere with the factor tested for. Soybean trypsin inhibitor very efficiently inhibited kallikrein, inhibited factor XIa at moderate concentrations, but did not affect the amidolytic activity of factor XIIa. Therefore, this inhibitor can be used to abolish a kallikrein and factor XIa contribution in a factor XIIa assay. We also report the rate constants of inhibition of contact activation factors by three different chloromethyl ketones. D-Phe-Pro-Arg-CH2Cl was moderately active against contact factors (k = 2.2 X 10(3) M-1 s-1 at pH 8.3) but showed no differences in specifity. D-Phe-Phe-Arg-CH2Cl was a very efficient inhibitor of plasma kallikrein (k = 1.2 X 10(5) M-1 s-1 at pH 8.3) whereas it slowly inhibited factor XIIa (k = 1.4 X 10(3) M-1 s-1) and factor XIa (k = 0.11 X 10(3) M-1 s-1). Also Dns-Glu-Gly-Arg-CH2Cl was more reactive towards kallikrein (k = 1.6 X 10(4) M-1 s 1) than towards factor XIIa (k = 4.6 X 10(2) M-1 s-1) and factor XIa (k = 0.6 X 10(2) M-1 s-1). Since Phe-Phe-Arg-CH2Cl is highly specific for plasma kallikrein it can be used in a factor XIa assay selectively to inhibit kallikrein. Based on the catalytic efficiencies of chromogenic substrate conversion and the inhibition characteristics of serine protease inhibitors and chloromethyl ketones we were able to develop quantitative assays for factor XIIa, factor XIa and kallikrein in mixtures of contact activation factors. PMID- 3552675 TI - 17th Sir Hans Krebs lecture. Signals guiding proteins to their correct locations in mitochondria. PMID- 3552676 TI - Cell surface distribution and intracellular fate of human beta-very low density lipoprotein in cultured peritoneal mouse macrophages: a cytochemical and immunocytochemical study. AB - The receptor-mediated endocytosis pathway of colloidal gold labeled beta-very low density lipoprotein (beta-VLDL-Au) derived from patients with familial dysbetalipoproteinemia was analyzed at the ultrastructural level in macrophages. The results showed that beta-VLDL-Au complexes were specifically recognized by a cell surface receptor of the macrophages. beta-VLDL-Au particles once bound to the randomly distributed cell surface receptors clustered in coated pits and were taken up by coated vesicles. Subsequently, the beta-VLDL-Au particles passed through tubular structures and small endosomes before deposited into large electron lucent smooth surfaced endosomes. As revealed by ruthenium red and enzyme cytochemistry the endosomes appeared to be separated from the extracellular space and did not contain acid phosphatase. There were no clear signs of passage of beta-VLDL through the Golgi complex. The accumulation of many flocculated gold particles within Ac-Pase positive vesicles suggests that beta VLDL once internalized by the macrophages is diverted into a degradative pathway. Incubation of beta-VLDL-loaded macrophages with the hydrophobic fluorescent dye nile red revealed numerous large fluorescent bodies within the cells indicating that the macrophages accumulate large amounts of lipid droplets with time. Additional studies large amounts of lipid droplets with time. Additional studies with native beta-VLDL in conjunction with postembedding immunocytochemical techniques were used to delineate further the intracellular pathway. Immunolabeling was carried out on thin sections of LR White embedded cells using affinity-purified polyclonal rabbit antibodies against apolipoprotein B with the protein A-gold or goat anti-rabbit IgG-gold technique. Indirect visualization of beta-VLDL by these immunocytochemical studies yielded results comparable to those with gold-labeled beta-VLDL. On the basis of both indirect immunocytochemical and direct cytochemical localization of beta-VLDL it is concluded that although colloidal gold labeling of beta-VLDL molecules unquestionably modifies their morphology, their function appears to be unaltered, at least with respect to the process of receptor-mediated endocytosis. PMID- 3552677 TI - Immunocytochemical localization of lysosomal acid phosphatase in normal and "I cell" fibroblasts. AB - This study represents the first example of immunological localization of lysosomal acid phosphatase. The intracellular localization of lysosomal acid phosphatase was investigated with immunocytochemical methods at the light and electron microscopical level in cultured fibroblasts obtained from normal subjects and from a patient with I-cell disease. Double-labeling studies using fluorescence microscopy showed that acid phosphatase is present in the same organelles as other hydrolases. At the electron microscopic level in control fibroblasts acid phosphatase was found in the rough endoplasmic reticulum, lysosomes, at the plasma membrane, in vesicles just below the plasma membrane and in multivesicular bodies. This localization was comparable with that of other lysosomal enzymes tested (acid alpha-glucosidase, N-acetyl-beta-hexosaminidase, beta-galactosidase). Acid phosphatase labeling was mainly found in association with the lysosomal membrane and with membranous material present within the lysosome. In I-cell fibroblasts the label was present in the same subcellular organelles but always associated with membranous structures. We suggest that the association of acid phosphatase with membranes might explain the normal enzyme activity found in I-cell fibroblasts. PMID- 3552678 TI - Identification of two major components of the lateral elements of synaptonemal complexes of the rat. AB - This paper describes the identification of two major components of the lateral elements of synaptonemal complexes of the rat by immunocytochemical techniques. We prepared monoclonal antibodies against synaptonemal complexes (SCs) by immunization of mice with purified SCs. One of these antibodies, II52F10, reacts with a 30 and a 33 kDa polypeptide, which are major components of purified SCs. Using this antibody, we studied the localization of its antigens light microscopically, by means of the indirect immunoperoxidase technique, as well as ultrastructurally, by means of the immunogold labeling technique. The immunolocalization was carried out on whole-mount preparations of lysed spermatocytes. The antibody reacts with paired as well as unpaired segments of zygotene, pachytene and diplotene SCs. In light microscopic preparations, the attachment plaques, particularly those of late pachytene and diplotene SCs, also appear to react strongly. In electron micrographs the lateral elements in paired as well as unpaired segments could be seen to react. No reaction was observed in the attachment plaques; however, in late pachytene and diplotene SCs the swollen terminal segments of the lateral elements did react with the antibody. Thus, we conclude that a 30 and a 33 kDa polypeptide make part of the lateral elements of synaptonemal complexes of the rat. PMID- 3552679 TI - Towards improved control of atrial fibrillation. AB - Patients with atrial fibrillation frequently show a wide variation in heart rate with digoxin therapy. We have compared the effect on heart rate variability, of doubling the digoxin dosage or adding verapamil 120 mg daily in a randomized cross-over study in 14 patients. Twenty-four hour ambulatory electrocardiographic recordings, six minute walking tests and palpitation and breathlessness scores were obtained on each regime. All patients exhibited a diurnal pattern in heart rate variability. Both treatments significantly lowered heart rate but high dose digoxin lowered minimum heart rate significantly more than digoxin and verapamil, causing more night time bradycardia. Overall, digoxin with verapamil produced significantly less heart rate variability than digoxin alone. Day time but not night time pauses were prolonged by digoxin and verapamil but were prolonged more by high dose digoxin. Five (36%) patients had serum digoxin levels in the toxic range when taking high dose digoxin. Palpitations were significantly reduced by both treatments but most improvement occurred with digoxin and verapamil. No significant effect was found on six minute walking distances or breathlessness scores. In conclusion, the addition of verapamil to digoxin was superior to increasing the dose of digoxin alone, producing significantly better control of heart rate variability with less night time bradycardia. PMID- 3552680 TI - A comparison of verapamil and digoxin in the treatment of atrial fibrillation. AB - Twelve patients (including 2 females) with chronic atrial fibrillation were entered into a randomized, double blind crossover study to compare the effects of digoxin and verapamil upon heart rate, exercise tolerance and symptom control. The dose of digoxin was adjusted so as to give serum concentrations within the range 1.3 to 2.6 nmol l-1 between four and six hours after dosing, and was continued for six weeks. The dose of verapamil was increased from 40 mg tds to 80 mg tds to 120 mg tds at fortnightly intervals. Three patients did not complete the study; two because of adverse effects attributable to verapamil. In the remaining nine patients, mean post exercise heart rates were significantly lower during treatment with verapamil 80 mgs tds (126.7 bpm) than with verapamil 40 mg tds (148.6 bpm) or digoxin (146.7 bpm). However, exercise tolerance was similar with both verapamil and digoxin and the superior control of exercise induced tachycardia achieved with higher doses of verapamil was not associated with improved exercise endurance. Visual analogue scale scores for constipation were significantly higher during treatment with verapamil; scores for other possible side effects and for overall wellbeing were similar. The results do not confirm the findings of others who have reported that verapamil is superior to digoxin in the treatment of atrial fibrillation. PMID- 3552681 TI - Intravenous digital subtraction angiography in the diagnosis and management of acute aortic dissection. AB - Eleven patients presenting with the clinical diagnosis of suspected aortic dissection underwent intravenous digital subtraction aortography. In nine patients digital subtraction angiography (DSA) was performed as the investigation of first choice. In five of these the diagnosis was confirmed with this technique alone and surgical repair was undertaken without further investigation. Direct cine aortography was also undertaken in the other four patients and confirmed the DSA findings, demonstrating aortic dissection in one case and no dissection in three others. In two of the eleven patients, direct cine aortography was performed as the initial investigation. The results of subsequent digital aortography concurred in both cases, aortic dissection being demonstrated in one patient. In two cases, despite normal cine and digital aortography, aortic dissection was confirmed by computed tomography. We have found DSA to be a valuable technique for diagnosing aortic dissection, with no false positive or false negative findings when compared to direct cine aortography. Since it is a less traumatic procedure than direct aortography it should be the investigation of choice if computed tomography is not immediately available. PMID- 3552682 TI - Importance of Langerhans cells in the immune origin of carcinoma of the uterine cervix. AB - Based on personal studies, Langerhans' cells are described. The origin of these cells, their morphology, their distribution and function in genital tract, and their relation with the origin of cervical cancer, are studied. PMID- 3552683 TI - Antiemetic combination for PAC (cisplatin-adriamycin-cyclophosphamide) chemotherapy-induced emesis in ovarian cancer. AB - Twenty-six patients suffering from disseminated epithelial ovarian cancer (FIGO stages III and IV) under treatment with Cisplatin (80-100 mg/m2 in 8 hours) in combination on the same day with Cyclophosphamide (500 mg/m2 IV) and Adriamycin (50 mg/m2), a severely emetogenic regimen, entered a randomized, double-blind, cross-over trial comparing the antiemetic activity of high-dose IV Metoclopramide (1 mg/kg/dose X 5 doses) with that of a combination of Metoclopramide (same schedule) plus Nortriptyline (50 mg PO X 2 doses) plus Thiethylperazine (10 mg IV X 3 doses). The antiemetic combination was designed in an attempt to act simultaneously on gastrointestinal motility and neuroreceptors at the central emetic pathways (dopamine D-2, histamine H-1 and muscarinic cholinergic). This combination significantly reduced the emesis due to chemotherapy when compared with Metoclopramide alone and was also preferred by a significant number of patients after passing through both the antiemetic arms being compared. PMID- 3552685 TI - Extrarenal scintigraphic aspects of kidney transplant scans obtained with 99mTc DTPA. AB - In a retrospective study, 300 scans obtained with 99mTc-DTPA of 100 kidney transplant recipients were studied. The aim was to look for extrarenal scintigraphic aspects encountered specifically in renal transplant scintigraphy and to determine whether some of these phenomena could interfere with adequate interpretation. The most important phenomena seen were radioactivity in the uterus and a cold spot in the pelvis minor caused by a urine filled bladder. If the phenomena that can be encountered are known, the risk of incorrect evaluation is small. In addition, we report on the occurrence of stasis due to disturbed urine flow. PMID- 3552684 TI - Renography and biopsy-verified acute rejection in renal allotransplanted patients receiving cyclosporin A. AB - Acute impairment of renal function caused by cyclosporin A can be hard to differentiate from acute rejection. Therefore, kidney function after cadaveric allograft transplantation was repeatedly determined by renography in 42 patients receiving either high dose cyclosporin A (32 patients) or azathioprine and prednisone (10 patients) until a graft biopsy showed either acute rejection or no rejection within the first 5 postoperative weeks. The graft function as judged from the renograms was significantly poorer when cyclosporin A was used than when azathioprine and prednisone were the immunosuppressants. In the azathioprine and prednisone group a biopsy showing acute rejection was always preceded by a deterioration in the renogram. In cyclosporin A treated patients a graft biopsy following an early deterioration in the renogram showed acute rejection in only 56% of the biopsies. It was not possible to identify a time course or a function level of the renogram that could predict rejection in these patients. It is concluded that graft biopsies should be used liberally to diagnose rejection during cyclosporin A treatment if surgical complications after transplantation have been ruled out. Radionuclide studies may offer an invaluable aid in determining a nonnephrotoxic initial dose of the drug. PMID- 3552686 TI - CAPD fluid: a common cause of photon deficient lesions on 99mTc-D.T.P.A. scans in renal transplant patients. AB - Single or multiple transient photon deficient areas on 99mTc-DTPA scintigrams were found in 40% of a series of 34 patients who had undergone renal transplantion directly from CAPD maintenance. Ultrasound showed only loculated intraperitoneal CAPD fluid adjacent to the transplant with no evidence of local complications. We conclude that such collections are a common cause of photon deficient areas on 99mTc-DTPA transplantscintigrams and in the absence of ultrasound, these appearances should be interpreted with caution. PMID- 3552687 TI - Objective evaluation of scintigraphic diagnosis of bone metastasis. AB - Using bone scintigraphs (B.S.) from neoplasic patients, a quantitative analysis of the relation existing between objective scintigraphic signs and the diagnosis of presence or absence of bone metastases was carried out. In this way, an attempt was made to increase the specificity of the B.S. for this diagnosis. Thus, a group of signs from the B.S. was chosen and an analysis of the frequency of their presence in relation to the diagnosis of bone metastasis was carried out. For each sign, considered as discrete mathematical variables, an index arising from the following expression: Sensitivity - (1 - Specificity) was calculated. In this manner, each scintigraph may be quantified by the addition of the indices which correspond to the signs present in it. The set of possible numerical values was divided into 7 intervals, each of which establishes a different degree of reliability in the diagnosis of bone metastasis. This approach permitted ROC analysis and the formation of the representative curve. PMID- 3552688 TI - Prognostic value of 123-IODO-heptadecanoic acid imaging in patients with acute myocardial infarction. AB - This trial aimed to test if the half life of radioiodinated heptadecanoic acid (HDA) in acutely infarcted myocardium is of prognostic value. Twenty patients had an HDA scan and a MUGA scan within 6 days of acute myocardial infarction, eighteen of these had a visible defect on the HDA images. The mean half life of the areas of acute infarction (15.50 min +/- 7.82 min) was significantly shorter than that of normal myocardium (20.77 min +/- 4.00 min). The MUGA scan was repeated after 6 months in 15 patients. The mean acute infarct half life was longer in patients with an LVEF improvement of at least 5% at 6 months (16.92 min +/- 10.56 min), compared to those with a deterioration of more than 5% (11.75 min +/- 4.03 min), although the difference is not statistically significant. While the results in a few individuals suggested that the half life may be of prognostic significance, the variable response of the group reduced the ability of the half life to act as a prognostic indicator. Improvements in imaging and background subtraction techniques may be necessary before the half life is of practical value. PMID- 3552689 TI - Estimation of glomerular filtration rate using 99mTc-DTPA and the gamma camera. AB - Two methods of glomerular filtration rate estimation have been evaluated, based on the intravenous administration of 99mTc-DTPA and the measurement of renal time activity curves by means of a computer linked gamma camera. A single 20 min plasma sample was also required. These methods were designed to minimize the component of error arising from decay statistics. One method was based on using a constant fraction of the cardiac activity in lieu of a perirenal region of interest for the background correction, the other was based on deconvolution by a constrained least squares technique. The first method, based on modifying the background correction, led to poor results (residual standard deviation 18.9 ml/min when compared with the plasma clearance method). The second method, based on constrained least squares deconvolution, worked as well as previously reported methods (residual standard deviation 14.5 ml/min) and appears suitable for clinical use. PMID- 3552690 TI - The nontreatment of childhood idiopathic thrombocytopenic purpura. AB - Despite the sudden and often alarming clinical manifestations of ITP, few patients in the pediatric age group develop serious complications or long-term sequellae. Conservative therapy, without use of pharmacologic or surgical intervention, is the most convenient, safe, and cost-effective approach in the vast majority of patients. There is a definite role for corticosteroids and IV gamma globulin in certain selected patients with both acute and chronic forms of ITP. Splenectomy may be of value in some chronically affected patients. Other forms of treatment are rarely if ever indicated. In summary, the best therapy for most children with ITP is no treatment at all. PMID- 3552692 TI - Monuril in lower uncomplicated urinary tract infections in adults. AB - Fosfomycin trometamol is a new fosfomycin salt with much improved intestinal absorbtion, thus providing high levels of the drug both in serum and urine. The range of activity and the pharmacokinetic characteristics of this new salt emphasize its usefulness in therapy of urinary tract infections (UTIs), either as a single dose or in short courses. In a multicentric, open, non-controlled trial, fosfomycin trometamol was employed in the treatment of 365 UTIs (84 males and 281 females, of whom 13 were pregnant). 144 UTIs were community acquired, while 221 were hospital acquired; 48 were diagnosed as asymptomatic bacteriurias, 201 as lower uncomplicated symptomatic UTIs, 49 as lower complicated UTIs, 59 as recurrent lower symptomatic UTIs, and 8 as cystopyelitis. The drug was administered as a single dose, i.e. 3 g at once, in 198 cases and in short courses, i.e. 3 g daily for 2-3 days (in a few patients, though, for 11 days) in 167 cases. High success rates were attained using the single dose in asymptomatic bacteriurias (78.1%), in lower uncomplicated symptomatic UTIs (89.5%), as well as in UTIs of the female (85.3%) and community-acquired UTIs (97.4%). In all these cases, the single-dose regimen seems to be the most rational form of clinical use, since the multiple-dose regimen did not add any further advantage. In infections of the male, or in hospital-acquired or complicated UTIs, short therapy courses gave better results. The drug was well tolerated, even by pregnant women, and clinically irrelevant side effects were recorded in a small number of patients. PMID- 3552693 TI - Activity of Monuril in lower urinary tract infections due to fosfomycin-resistant bacteria. AB - Oral single-dose therapy with fosfomycin-trometamol (F-T) was used in 18 patients with lower urinary tract infections. The isolated bacterial strains presented a minimum inhibitory concentration of greater than 128 micrograms/ml in vitro. In spite of this 'resistance' in vitro, a clinical and bacteriological cure was obtained in 12 cases (66%). There were relapses in 2 cases, and clinical and bacteriological failure in only 2 cases. These results are due to the high urinary levels and prolonged bactericidal activity of urine after single-dose therapy with 3-5 g F-T. The clinical and biological tolerance was very good. PMID- 3552691 TI - Interaction between endocrine and paracrine peptides in prenatal growth control. AB - The evidence reviewed here shows that the endocrinology of fetal growth is very different from that operating postnatally. Pituitary hormones play little part in stimulating growth of the lean body mass or skeleton although growth hormone (GH) may be involved, in some as yet ill defined way in the ontogeny of the fetal pancreatic islet and insulin secretion. Insulin is important because it stimulates fetal cellular anabolism but acts in a permissive manner: with too little insulin growth is inhibited, with too much growth proceeds at a genetically predetermined rate. Placental lactogen (PL), or other peptides within the GH/PL family, may act as a true growth-promoting hormone in the fetus; it stimulates both cellular metabolism and mitosis. The part played by endocrine control mechanisms in the fetus is set in context by an appreciation of the importance of locally acting tissue growth factors, and in particular the somatomedins. Their part in fetal growth control is intimately bound up with the plane of nutrition experienced by the fetus. It is concluded that the simplest analysis that makes biological sense involves a consideration of hormones, tissue growth factors and nutrition, not hierarchically but as mutually interacting variables. PMID- 3552695 TI - Trometamol salt of fosfomycin (Monuril). Preliminary pharmacokinetic and clinical experience in the treatment of urinary tract infections in children. PMID- 3552694 TI - Urinary tract infections in pregnancy: Monuril single-dose treatment versus traditional therapy. AB - Today, it is widely accepted that a short-course or single-dose treatment with antimicrobial agents in pregnancy is the optimal therapy to minimize the risk of toxicity both for the mother and the fetus. A randomized trial comparing single dose (3 g) treatment with fosfomycin trometamol (FT) versus pipemidic acid (200 gram doses b.i.d. for 7 days) in bacteriuric pregnant women is presented. The preliminary results show that single-dose FT has the same cure effect as conventional therapy with pipemidic acid. PMID- 3552696 TI - Trometamol salt of fosfomycin versus netilmicin: randomized multicenter study in children's lower urinary tract infections. PMID- 3552698 TI - Microbiological aspects of chemotherapy of lower urinary tract infections. PMID- 3552697 TI - Prophylactic chemotherapy with fosfomycin trometamol salt during transurethral prostatic surgery: a controlled multicenter clinical trial. AB - A prospective, randomized controlled study was carried out in 24 Italian urology wards in 675 patients undergoing transurethral prostatic resection, utilizing three different chemoprophylactic treatments with either amoxycillin (AMX), co trimoxazole (CTX) or fosfomycin trometamol salt (FT) in order to prevent postoperative urinary tract infections. FT significantly lowered the incidence of both postoperative bacteriuria and symptomatic infections in comparison to AMX and CTX. Transient side effects, mild or moderate, were observed in 6.6% of cases. Similar safety and protective results were obtained in 233 patients undergoing different transurethral instrumentations who were chemoprophylactically treated with FT. PMID- 3552700 TI - The microbiological and pharmacokinetic profile of an antibacterial agent useful for the single-dose therapy of urinary tract infection. AB - Single-dose therapy of uncomplicated urinary tract infection (UTI) has been shown to be effective in many trials in adult women. The question which will be explored in this presentation is what properties constitute the ideal agent for the therapy of UTI. Important microbiological properties include spectrum of activity to include all common urinary pathogens, bactericidal action in urine and low prevalence of resistant bacteria. The vital feature of an antibacterial drug useful in the therapy of UTI is prolonged urinary concentrations. The agent must therefore be well absorbed and have slow renal excretion. Most beta-lactam drugs do not have these combined properties. Aminoglycosides are effective drugs but cannot be administered orally. Quinolones and the calcium salt of fosfomycin are useful but do not have an ideal pharmacokinetic profile. Cotrimoxazole, trimethoprim alone and the trometamol salt of fosfomycin all have good antibacterial activity combined with slow urinary excretion. PMID- 3552699 TI - Single-dose treatment of bacteriuria in pregnancy. AB - Comparison of the results of single-dose treatment of urinary tract infection in women is confused by differences between published series in the duration of follow-up and in the diagnosis of infection. Pregnancy allows prolonged follow-up in a motivated population, but increases the possibility of false positive diagnosis of infection from midstream urines due to increased vulvovaginal contamination. Suprapubic aspiration (SPA) is safe in pregnancy and accurately confirms the presence or absence of bacteria in the bladder urine. Bacteriuria was diagnosed by SPA in 86 pregnant women. Thirty-seven of these were treated with a single dose of 3 g cephalexin and 49 with 3 days of cephalexin 1 g or of a combined preparation of pivmecillinam-pivampicillin. Both single-dose and 3-day treatments prevented further bacteriuria in 65% of the patients for the remainder of their pregnancies. This is similar to the results achieved with 10-day treatment. If extended trials confirm that single-dose treatment is as effective as conventional treatment with the same drug, then single-dose treatment has the advantages in pregnancy of minimal medication, good patient compliance and lack of side-effects. PMID- 3552701 TI - Bacterial host interaction in the pathogenesis and management of lower urinary tract infection. PMID- 3552702 TI - The trometamol salt of fosfomycin: microbiological evaluation. AB - The spectrum of activity of fosfomycin and its pharmacological behaviour make it an attractive candidate for the oral treatment of uncomplicated urinary tract infection. Various factors affect the antibacterial activity so that results in different culture media vary widely. The highest activity was displayed in Eugonbroth and such results correlated well with those obtained in pooled human urine. The activity was enhanced in acid conditions such as commonly exist in infected urine. Glucose-6-phosphate potentiated the activity of fosfomycin against Escherichia coli and some other bacteria when tested in Eugonbroth (but less predictably in human urine) and the potentiating effect may be necessary in order to obtain therapeutically meaningful results in susceptibility tests. Experiments in an in vitro model of the treatment of bacterial cystitis (carried out in the absence of glucose-6-phosphate) indicated that both sensitive and 'resistant' strains of E. coli respond to concentrations of fosfomycin achievable by high-dose oral therapy with the trometamol salt. Resistance did not emerge in previously sensitive strains (or in one of the 2 'resistant' strains), providing a high peak level of antibiotic was achieved. PMID- 3552703 TI - Effect of fosfomycin trometamol on bacterial adhesion in comparison with other chemotherapeutic agents. AB - The effect of fosfomycin trometamol in comparison with that of norfloxacin and co trimoxazole on the hemagglutination, yeast cell aggregation and adhesive properties of both gram-positive and gram-negative microorganisms was studied. The strains were isolated from the urine of patients with urinary tract infections, or from vaginal swabs. At sublethal concentrations (1/4 and 1/8 of the minimal inhibitory concentration), the ability of the bacteria to adhere to human uroepithelial cells was reduced by any of the 3 drugs assayed. The reduction corresponded to a decrease in the agglutinating activity of the gram negative bacteria tested, such providing further evidence for the efficacy of the different chemoantibiotics. In particular, fosfomycin trometamol and norfloxacin proved to be more effective than co-trimoxazole in affecting the adhesive properties of all the strains employed. PMID- 3552704 TI - Spectrum of bacterial pathogens in uncomplicated and complicated urinary tract infections. AB - The spectra of bacterial organisms of urinary tract infections (UTI) in patients with and without abnormalities in the urinary tract (complicated and uncomplicated UTIs) are compared. Data from the United Kingdom and the Federal Republic of Germany are included. In addition, the susceptibility of the pathogens to antibiotics (for oral or parenteral application) in both countries are compared. In conclusion, rational antibiotic therapy of complicated UTIs should strictly follow the antibiogram of the causative organism. For therapy of uncomplicated UTIs, the regional state of antibiotic susceptibility of the pathogens according to geographical location should be considered and kept up to date. PMID- 3552705 TI - LFA-1 beta-chain synthesis and degradation in patients with leukocyte-adhesive proteins deficiency. AB - The defective membrane expression of the adhesive protein family (LFA-1, Mo1 and p150,93) on leukocytes from certain patients with recurrent bacterial infections was shown to be secondary to the absence of synthesis of mature beta chain that is common to all three antigens (Springer et al., 1984, Lisowska-Grospierre et al., 1986). In all patients, studies of beta-chain biosynthesis that lead to this conclusion were performed using the monoclonal anti-beta chain antibody to isolate the beta subunit. Since this antibody detects the mature form of beta chain only, the potential presence of a precursor or of an abnormal beta chain in the patient's cells could not be tested. The availability of the polyclonal antibody to the purified beta subunit allowed us to re-examine the biosynthesis of the LFA-1 subunits in 3 affected children. In all 3 patients, the absence of membrane expression of the LFA-1, CR3 and p150,95 proteins was confirmed. The LFA 1 alpha-chain precursor of 170 kDa was detected in the lysates of PHA blasts of two children, but was not detected in the third. The beta-chain precursor of 85 kDa was isolated by the polyclonal anti-beta chain antiserum from the cytoplasm of phytohemagglutinin and Epstein-Barr virus-induced blasts of one patient. The same antibody precipitated some peptides of smaller mol. wt. from the cell lysates of 2 other patients. These results suggest that in this disorder the membrane nonexpression of the adhesive proteins is probably due to the structural abnormality of beta chain which, although synthesized, is rapidly degradated. PMID- 3552707 TI - Captopril reduces renal excretion of prostaglandin E2 in the sodium-depleted rabbit. AB - The effects of captopril on renal function and prostaglandin E2 excretion were investigated in rabbits undergoing chronic sodium depletion. Captopril administered for six days, via rate-controlled osmotic pumps, caused diuresis and marked natriuresis which were accompanied by a significant reduction of urinary prostaglandin E2 excretion and of glomerular filtration rate. It is concluded that captopril reduces the renal excretion of prostaglandin E2 and that its diuretic and natriuretic effects are prostaglandin E2-independent. PMID- 3552706 TI - Characteristics of the P2 purinoceptor that mediates prostacyclin production by pig aortic endothelial cells. AB - Release of prostacyclin was studied by superfusing small columns containing cells cultured on microcarrier beads. Transient dose-dependent stimulation of prostacyclin release by up to 500-fold was induced by adenosine 5'-triphosphate (ATP; 0.5-50 microM). Adenosine 5'-diphosphate (ADP) gave similar responses, whereas adenosine 5'-phosphate (AMP) and adenosine were essentially inactive. Of other natural nucleotides tested only uridine 5'-phosphate (UTP) was active. The L-enantiomers of ATP and ADP were inactive. 2-Cl-ATP was approximately 100 times more potent than ATP; 2-MeS-ATP was also more potent (threshold 0.05 microM) but its maximal effectiveness was less than 20% that of ATP; 2-EtS-ATP had a similar threshold to ATP but was even less effective than 2-MeS-ATP. Phosphorothioate nucleotide analogues of ATP or ADP were active, with no stereoselectivity between Rp and Sp diastereoisomers. No analogue tested showed antagonist activity. We conclude that ATP mediates endothelial prostacyclin release apparently via a P2Y receptor, although there are some striking differences from the previously described P2Y receptor mediating endothelium-dependent vasodilation in pig aorta. PMID- 3552708 TI - Responses of femoral resistance vessels to angiotensin in vitro. AB - The effect of angiotensin II and angiotensin I on isolated rat resistance vessels (inner diameter ca. 200 micron) was investigated. Angiotensin II caused a contraction (ED50 = 0.58 +/- 0.17 X 10(-8) M) of rat femoral and cerebral arteries and to a lesser extent of mesenteric and renal arteries. However, all vessels showed strong tachyphylaxis on repeated stimulation with angiotensin II. Tachyphylaxis was avoided by inducing submaximal tone in the vessels with either K, noradrenaline or serotonin. The response to angiotensin II was inhibited by saralasin but not by captopril. Angiotensin I also caused contraction of the femoral arteries (ED50 = 2.68 +/- 0.32 X 10(-8) M). These responses were inhibited by captopril and saralasin. Functional removal of the endothelium had little effect on the contractile responses to either angiotensin I or II. These results indicate that there are functional receptors to angiotensin II in the resistance vessels of the rat and that, in the presence of tone (a more physiological condition), the vessels contract to angiotensin II without tachyphylaxis. In addition, angiotensin II may be formed from angiotensin I by the angiotensin converting enzyme which may be situated in the vessel wall as well as in the endothelium. PMID- 3552709 TI - The Fao cell. A tissue culture model for lipoprotein synthesis and secretion. I. Characterization of the system. AB - In this study we found that a differentiated cultured rat hepatocyte cell line, Fao, synthesizes and secretes lipoproteins qualitatively similar to those synthesized by the rat hepatocyte in vivo, but quantitatively differing considerably in apoprotein composition and density distribution. Immunoprecipitation demonstrates that all the major apoproteins are synthesized, including both forms of apoB, apoE and apoA-I. Particles of all density classes are formed, apoB associating with the lighter particles and apoA-I with the heavier. ApoE is a major apoprotein in all but the lightest density classes. The general finding is that most particles formed have a density exceeding 1.10 g/ml, while very few of the lighter, apoB-containing particles form, probably because the normal growth medium of the cultured cells is lipid-poor as compared with rat serum. In ref. [20] we show that the composition of the lipoproteins synthesized can be effectively modulated by lipid depletion and lipid supplementation of the growth medium. PMID- 3552710 TI - The cytoplasmic pH, ATP content and total protein synthesis rate during heat shock protein inducing treatments in yeast. AB - In S. cerevisiae the induction of heat-shock protein (HSP) synthesis is accompanied by a decrease in the cytoplasmic and vacuolar pH as determined by means of [31P]NMR spectroscopy. The relationship of HSP synthesis and acidification of the cytoplasmic pH is dose-dependent under a variety of treatments (temperature increases (23-32 degrees C), addition of 2,4 dinitrophenol (greater than 1 mM), sodium arsenite (greater than 3.75 X 10(-5) M) or sodium cyanide (greater than 10 mM]. Changes in the intracellular pH occur within 5 min after treatment, attain a maximum within 30 min and are subsequently stable. HSPs 98, 85 and 70 show maximum synthesis rates 1-2 h after a 40 degrees C heat shock. The synthesis rates then decline. HSPs 56, 44 and 33 reveal a smaller and slower increase and almost no decrease in the synthesis rate within 4 h at 40 degrees C. The similar dose dependencies of HSP synthesis and cytoplasmic pH. as well as the immediate response of the pH, can also be demonstrated in the mitochondrial mutant of S. cerevisiae (Q0). This result indicates that the heat shock response is mainly independent of intact oxidative phosphorylation. No correlation was observed between HSP synthesis rate and total intracellular ATP content. PMID- 3552711 TI - Megakaryocytopoiesis and platelet production: a review. AB - During the past 10-15 years, there has been a rapid expansion in our knowledge about the hematopoietic system which maintains homeostasis of the peripheral blood platelet concentration. This interpretive review attempts to consolidate recent in vitro and in vivo observations into a unified framework. Evidence for a two-level regulatory model of megakaryocytopoiesis is presented and interactions among developmental levels are proposed. PMID- 3552712 TI - Plasmodium falciparum: immunogenicity of circumsporozoite protein constructs produced in Escherichia coli. AB - The immunogenicity of Plasmodium falciparum recombinant circumsporozoite protein constructs R16tet32, R32tet32, and R48tet32 in mice was examined by measuring antibody responses by enzyme linked immunosorbent assay, immunofluorescence, circumsporozoite precipitation, and inhibition of sporozoite invasion. All three constructs were found to be immunogenic when administered alone, but antibody responses were greater for the larger constructs, R32tet32 and R48tet32. Increased dose, boosting, and the use of adjuvants further augmented antibody responses. R32tet32 was found to be the most immunogenic of the three constructs, and high levels of protective antibodies were found to persist for at least 44 weeks when the construct was given with alum. Clinical trials with alum adjuvanted R32tet32 have now begun. PMID- 3552713 TI - Dirofilaria immitis: identification and characterization of circulating parasite antigens. AB - A method for the identification of circulating parasite antigens in filarial nematode infections was developed using canine infections with Dirofilaria immitis as a model. Filarial antigens ranging in molecular weight from 211 to 13 kDa were extracted from the sera of microfilaremic dogs by a solid phase immunobinding procedure and identified by immunostaining of Western blots. A major antigen of 104 kDa was selected for further characterization. The 104 kDa circulating antigen showed antigenic and biochemical identity with 104 kDa peptides found in extracts of adult male and microfilarial stages of the parasite. The 104 kDa peptide was antigenically stable under a variety of storage conditions. Its potential as a diagnostic target is discussed. PMID- 3552714 TI - Plasmodium falciparum: S-adenosyl-L-methionine decarboxylase. AB - Putrescine-dependent S-adenosyl-L-methionine decarboxylase has been detected in the malaria parasite Plasmodium falciparum. Mg2+ did not affect the enzyme activity. The apparent Km value of the plasmodial enzyme for adenosyl-methionine was found to be 33 microM. Methylglyoxal bis(guanylhydrazone) competitively inhibited the enzyme activity with respect to adenosylmethionine. The inhibition constant for methylglyoxal bis(guanylhydrazone) was determined to be 0.46 microM. Spermidine was the main polyamine detected in the parasite. There was significant decrease in the S-adenosyl-L-methionine decarboxylase activity when the infected erythrocytes were incubated with chloroquine and mefloquine for 2 hr at 1 and 10 microM, respectively. Since at similar concentrations these drugs did not directly affect the plasmodial enzyme activity, the interaction of these drugs with the polyamine biosynthesis remains unclear. PMID- 3552715 TI - Ultrastructure of liver in acute experimental pancreatitis in dogs treated with prostacyclin. AB - The ultrastructure of the liver was studied in 3 groups of dogs (5 in each) with acute experimental pancreatitis (AEP) induced by injection of bile-trypsin mixture into the pancreatic duct. Experiments were terminated after 12 h. In the group of untreated animals, severe degeneration of mitochondria, extensive autophagocytosis, hyperactivity of Kupffer cells, depletion of glycogen granules, dilatation of endoplasmic spaces and vacuolisation of cytoplasm were found. In the group treated with prostacyclin PGI2 (20 ng/kg/min) in continuous i.v. infusion for 12 h, ultrastructural alterations were less advanced. Even better results were obtained in the group additionally pretreated for 1 h with the same rate of prostacyclin infusion. The results indicate a protective effect of prostacyclin against damage to the liver in the course of AEP. PMID- 3552716 TI - Research on Aeromonas and Plesiomonas. IV. Virulence factors. PMID- 3552717 TI - Human gene therapy: possibilities and limitations. AB - Gene therapy provides new options for medicine, and implies new responsibilities for making decisions relating to the limitations which reason and morality impose upon manipulation of the human genome for the benefit both of patients and of society. This contribution outlines the possibilities and limits of gene therapy in man from a medico-technical viewpoint. PMID- 3552719 TI - Aclarubicin: preclinical and clinical data suggesting less chronic cardiotoxicity compared with conventional anthracyclines. PMID- 3552718 TI - Relationship of prodigiosin condensing enzyme activity to the biosynthesis of prodigiosin and its precursors in Serratia marcescens. AB - Prodigiosin condensing enzyme (PCE) activities were present in Serratia marcescens wild type 08, mutants OF, WF and 9-3-3. Their specific activities exhibited different maxima and at different times during the late log phase or the early stationary phase of cell growth. The levels of prodigiosin and its precursors also showed a significant increase at this period. The results support that prodigiosin and/or its precursors are secondary metabolites. The ubiquity of the PCE activity in mutants deficient in prodigiosin biosynthesis suggest that this particular enzyme may also be present in non-pigmented clinical isolates. PMID- 3552720 TI - Pharmacodynamic aspects of aclarubicin with special reference to daunorubicin and doxorubicin. PMID- 3552721 TI - When is a parent out of the picture? Different custody, different perceptions. AB - This study investigated how 200 children from mother-, father-, or joint-custody arrangements perceived their divorced families. The authors argue that it is not the type of custody that shapes the child's view of whether one parent is peripheral but, rather, the nature of relationships within the various custody arrangements. PMID- 3552722 TI - Family interaction coding systems: a descriptive review. AB - Summaries and critique of 13 coding systems used in the observation of family interaction are presented. Each system is first described in terms of its theoretical origins and key constructs. Comparative analyses are presented for physical descriptions of the codes, administrative procedures, reliability, validity, and clinical and research utility. Recommendations for further development of family interaction coding systems are presented. PMID- 3552723 TI - Intron-dependent evolution: preferred types of exons and introns. AB - Exon insertions and exon duplications, two major mechanisms of exon shuffling, are shown to involve modules that have introns of the same phase class at both their 5'- and 3'-ends. At the sites of intronic recombinations exon insertions and duplications create new introns which belong to the same phase class as the recipient introns. As a consequence of repeated exon insertions and exon duplications introns of a single phase class predominate in the resulting genes, i.e. gene assembly by exon shuffling is reflected both by this nonrandom intron phase usage and by the correlation between the domain organization of the proteins and exon-intron organization of their genes. Genes that appeared before the eukaryote-prokaryote split do not show these diagnostic signs of exon shuffling. Since ancestral introns (e.g. self-splicing introns) did not favour intronic recombination, exon shuffling may not have been significant in the early part of protein evolution. PMID- 3552724 TI - The effects of protein synthesis inhibition, and of mutations rna1.1 and rna82.1, on the synthesis of small RNAs in yeast. AB - Strains of Saccharomyces cerevisiae have been constructed that possess temperature-sensitive defects in tRNA precursor (pre-tRNA) splicing and which also lack the processing endonuclease that acts at the 3'-terminus of 5 S rRNA and 35 S rRNA precursors (pre-rRNAs). The unspliced pre-tRNAs accumulated by such strains at the nonpermissive temperature are identical in structure to those accumulated by pre-tRNA splicing-defective strains with a functional pre-5 S RNA processing enzyme. The pre-RNA processing activity is therefore not obligatorily involved in maturation of several yeast tRNAs. However, gels of the pulse labelled RNAs of RNA82+ and rna82.1 strains provide evidence that this enzyme acts upon a few small unstable transcripts that are not 5 S RNA forms. The most prominent of these transcripts on gels was, in wild-type strains, an RNA 145 +/- 2 nucleotides in length. PMID- 3552725 TI - Fatty acid synthesis in mitochondria from Saccharomyces cerevisiae. AB - The ability of purified mitochondria isolated from S. cerevisiae to synthesize fatty acids and especially very long chain fatty acids (VLCFA) has been investigated. The VLCFA synthesis requires malonyl-CoA as the C2 unit donor and NADPH as the reducing agent. Moreover the yeast mitochondrial elongase is able to accept either exogenous long chain fatty acyl-CoAs as substrates or elongate endogenous substrates. In the latter case, ATP is required for full activity. Besides this important VLCFA formation, the mitochondria from S. cerevisiae were also able to synthesize C16 and C18. PMID- 3552726 TI - Computer-aided design and physiological testing of a luteinising hormone releasing hormone analogue for 'adjuvant-free' immunocastration. AB - An analogue of LHRH containing an extension of Gly-Cys at the carboxyl-terminus has been designed to permit reproducible coupling to a suitably modified carrier via a thioether bond. Potential energy calculations indicated that this analogue adopted a conformation in solution virtually identical to the type II' turn around Gly-6-Leu-7 predicted for native LHRH. Intradermal administration of a conjugate of this analogue with purified protein derivative of tuberculin to male rats previously primed with BCG vaccine rapidly led to complete testicular regression. This adjuvant-free immunisation protocol may represent an alternative to castration for the veterinary control of reproductive function. PMID- 3552727 TI - The catalytic mechanism of aspartic proteinases. AB - The highly symmetric active site of an aspartic proteinase, endothiapepsin, binds a water molecule ideally situated for nucleophilic attack on a substrate peptide bond whose distortion from planarity is stabilised by interactions of the substrate with the extended binding cleft. The apparent electrophilicity of the catalysis results from this distortion. The scissile peptide bond is orientated with the carbonyl oxygen hydrogen bonding to the tip of the beta-hairpin 'flap' which lies over the cleft. Nucleophilic attack by the bound water leads to a tetrahedral intermediate similar to observed complexes with hydroxyl inhibitors and stabilised by hydrogen bonds with the flap. PMID- 3552728 TI - Near-infrared-excitation resonance Raman spectra of bacterial photosynthetic reaction centers. Implications for path-specific electron transfer. AB - The first near-infrared (Qy)-excitation resonance Raman spectrum of photosynthetic reaction centers (Rb. sphaeroides wild type) is reported. This spectrum exhibits features which are not observed with excitation into either the Qx or Soret absorption bands. The spectral data indicate that the partial double bond character is induced in the C9C10 bond of the isocyclic ring of one of the pigments via interactions with the protein. It is proposed that this modified pigment is the L-subunit bacteriopheophytin and that the preference for electron transfer to this molecule could be in part due to the change in electronic structure induced by the site-specific pigment-protein interaction. PMID- 3552730 TI - The NH2-terminal cleavage of Escherichia coli translational initiation factor IF3. A mechanism to control the intracellular level of the factor? AB - A short form of Escherichia coli translational initiation factor IF3, repeatedly found both in vivo and in vitro, lacking the positively charged N-terminal hexapeptide has been produced by mild trypsinization. The properties of this short form of IF3 have been studied. Compared to the long native form of the factor, the shortened IF3 displays a markedly decreased thermal stability and affinity for the 30 S ribosomal subunit, as well as a reduced biological activity in protein synthesis. Following the loss of the N-terminal hexapeptide, a second peptide bond (Lys-90-Val-91) becomes easily accessible to proteolytic attack suggesting that formation of the short IF3 may be the first step in the physiological degradation of the factor. PMID- 3552729 TI - Effect of insulin on aminoisobutyric acid uptake by human non-rheumatoid and rheumatoid synovial cells. AB - The biological sensitivity of cultured non-rheumatoid human synovial cells (NRSCs) and rheumatoid synovial cells (RSCs) was examined in terms of the ability of insulin to stimulate the uptake of alpha-aminoisobutyrate (AIB). NRSCs, like numerous fibroblastic lines, were sensitive to physiological concentrations of the hormone: half-maximal stimulation was obtained with (4 X 10(-10) M) insulin, while maximum transport was found with a 60-90 min association time. On the contrary, although the basal transport was similar in RSCs, insulin was totally unable to accelerate AIB transport in these cells. Inflammatory processes lead to an insulin resistance which most likely involves a post-receptor step at the cellular level. PMID- 3552731 TI - Mode of disulfide bond formation of a heat-stable enterotoxin (STh) produced by a human strain of enterotoxigenic Escherichia coli. AB - To determine the modes of three disulfide linkages in the heat-stable enterotoxin (STh) produced by a human strain of enterotoxigenic Escherichia coli, we synthesized STh(6-18), which consists of 13 amino acid residues and has the same intramolecular disulfide linkages as native STh [(1985) FEBS Lett. 181, 138-142], by stepwise and selective formation of disulfide bonds using different types of removable protecting groups for the Cys residues. Synthesis of the peptide with different modes of disulfide bond formation provided three peptides consistent with standard STh(6-18) in their physicochemical and biological properties, thereby indicating that the disulfide bonds in STh(6-18) are Cys-Cys-Glu-Leu-Cys Cys-Asn-Pro-Ala-Cys-Thr-Gly-Cys. PMID- 3552732 TI - On the role of the light-harvesting B880 in the correct insertion of the reaction center of Rhodobacter capsulatus and Rhodobacter sphaeroides. AB - The purple, non-sulfur photosynthetic bacteria Rhodobacter capsulatus and Rhodobacter sphaeroides have two types of pigment-protein complexes that absorb incident light and funnel it to the photochemical reaction center. One of these, B880, is present at an essentially constant ratio to the reaction center, while the abundance of the other, B800-850, varies with growth conditions. Independent work in our two laboratories has indicated that while the absence of B800-850 permits photosynthetic growth in both organisms, the lack of B880 produces a different phenotype in the two species. Thus R. sphaeroides is still photosynthetically competent when it lacks this complex, while R. capsulatus is not. This unanticipated difference in what appear to be very closely related organisms has caused us to reexamine the properties of the two mutants simultaneously, under identical conditions. We find that the original descriptions are indeed correct; the reaction center of R. capsulatus is not correctly inserted into the photosynthetic membrane in the absence of B880, while that of R. sphaeroides is. PMID- 3552733 TI - Glucose stimulates the biosynthesis of rat I and II insulin to an equal extent in isolated pancreatic islets. AB - The effects of glucose on insulin biosynthesis were studied by measuring the incorporation of radiolabelled amino acids into proinsulin/insulin in isolated rat islets. The islets were pulse labelled for 15 min with [3H]leucine (present in rat insulin I and II) or [35S]methionine (unique to rat insulin II) and then incubated for a 165 min post-label (chase) period during which the majority of labelled proinsulin was converted to insulin but under conditions whereby greater than 95% of radiolabelled proinsulin or insulin was retained in the islets. The newly synthesized, labelled, insulin was analyzed by high performance liquid chromatography. Rat I and II insulin biosynthesis was stimulated by 16.7 mM glucose to the same extent. PMID- 3552734 TI - Phosphorylation of spinach chlorophyll-protein complexes. CPII, but not CP29, CP27, or CP24, is phosphorylated in vitro. AB - Previous studies have indicated that the reversible phosphorylation of a population of antenna complexes that can donate energy to PS II ('mobile LHC II') plays a regulatory role in the state 1-state 2 transition in thylakoid membranes. The relationship of phosphorylated LHC II to the multiple PS II-associated chlorophyll a/b-proteins resolvable on green gels is currently unclear. We have used a high resolution gel system to analyze thylakoids phosphorylated in vitro. The only PS II-associated antenna complex to become phosphorylated is CPII, indicating that this complex represents the mobile LHC II. The other putative PS II antenna complexes, CP29, CP24, and the new complex designated CP27 which comigrates with CPII, are not phosphorylated and are probably components of the bound 'LHC II' antenna. PMID- 3552735 TI - Is phylloquinone an obligate electron carrier in photosystem I? AB - Comparative quantitative analysis of phylloquinone content and photochemically competent P-700 has been performed on photosystem I particles subjected to photolysis with ultraviolet irradiation. Nonirradiated control particles exhibit a phylloquinone/P-700 stoichiometry of 1.9 +/- 0.2. Photolysis of the photosystem I particles induces a progressive depletion of phylloquinone, however, photochemistry as assayed at room temperature by the photooxidation of P-700 is unaffected. These data are not consistent with the assignment of phylloquinone as a functional intermediate at room temperature between P-700 and the iron-sulfur clusters, center A and center B. PMID- 3552736 TI - Physiology and biophysics of chloride and cation cotransport across cell membranes. AB - Many important questions remain to be answered about the mechanism that mediates coupled Na,K,Cl cotransport. We still do not know what the ATP requirement involves. Is ATP the direct energy source? Such an energy source does not seem to be necessary, inasmuch as the net free energy in the combined transmembrane chemical gradients of Na, K, and Cl is quite sufficient to maintain the observed high Cl(i). Could a protein kinase-mediated mechanism be responsible for the ATP requirement? How does reducing Cl(i) stimulate the transporter? What are the kinetic relationships for the co-ions at the outward- and inward-facing transport sites? Are they symmetrical? Can the squid axon regulate its cell volume? If so, is the Na,K,Cl transporter directly involved? Thus, the squid axon remains a fruitful preparation to study a transport mechanism similar to that found in a variety of cells. Its large size confers unique experimental advantages that should help us in our quest to understand this widely distributed transport mechanism. PMID- 3552737 TI - Capillary plugging by granulocytes and the no-reflow phenomenon in the microcirculation. AB - Granulocytes are large, stiff viscoelastic cells that adhere naturally to the vascular endothelium. On their passage through the capillary network they have to be deformed, and recent evidence indicates that they may impose a significant hemodynamic resistance. The entry time of granulocytes into capillaries is about three orders of magnitude longer than that for red cells. Inside the capillary the granulocytes move with a lower velocity than red cells. Under conditions when the capillary perfusion pressure is reduced and/or elevated levels of inflammatory products are present that increase the adhesion stress to the endothelium, granulocytes may become stuck in the capillary. In such a situation, the granulocytes form a large contact area with the capillary endothelium, they obstruct the lumen, and they may initiate tissue injury. After the restoration of the perfusion pressure the granulocytes may not be removed from the capillary owing to the adhesion to the endothelium. Capillary plugging by granulocytes appears to be the mechanism responsible for the no-reflow phenomenon, and together with oxygen free radical formation and lysosomal enzyme activity may constitute the origin for ischemic injury as well as other microvascular occlusive diseases. PMID- 3552738 TI - Conjugation-deconjugation reactions in drug metabolism and toxicity. PMID- 3552739 TI - Molecular genetics of the fourth component of human complement. AB - The fourth component of complement in humans is coded for by two closely linked loci, i.e., C4A and C4B, that have been positioned within the class III region of the human major histocompatibility complex along with the genes for C2, Bf, and steroid 21-OH. Both C4 loci are highly polymorphic and certain alleles, particularly the nulls, are associated with susceptibility to autoimmune disease. About one-half of the null alleles are due to a large deletion that includes both a C4 and flanking 21-OH gene. Despite the near identity of the products of the two loci, the proteins differ dramatically in their efficiency of covalent binding to antigen. The amino acid substitutions responsible for the functional differences have been identified and they are clustered relatively near the covalent binding site within the C4d region of the alpha chain. These observations support the hypothesis that the susceptibility to autoimmune disease is related to the structural variation of the C4 protein. PMID- 3552740 TI - [Psychiatrist F. I. Gertsog (1785-1853)]. PMID- 3552741 TI - [The 1st Russian professor of medicine at Moscow University S. G. Zybelin]. PMID- 3552742 TI - [The role of the congresses of zemstvo physicians in the development of health organization in Vladimir Guberniya]. PMID- 3552743 TI - [The 1st all-Russian Congress on Preventing Drunkeness]. PMID- 3552744 TI - [Stamps on the topic of blood transfusion and donorship]. PMID- 3552745 TI - Ectopic pregnancy: its relationship to tubal reconstructive surgery. AB - Ectopic pregnancy is the shady companion of tubal surgery. Among patients with ectopic pregnancy, relatively few have a history of tubal surgery as their underlying etiologic factor when compared with other etiologies such as PID. Nevertheless, a history of tubal surgery should place the patient at a higher risk group for ectopic pregnancy; 3% to 20% of these patients will encounter an ectopic pregnancy after the corrective surgery. The incidence of ectopic pregnancy after tubal surgery is extremely variable and is closely linked to the degree of restoration of normal functional and anatomic integrity after the surgical procedure. This depends, to a large extent, on the amount of previous damage to the tube and its potential reversibility. Major improvements in surgical technique can, therefore, have reduced, but not eliminated, the occurrence of tubal pregnancy. The incidence of ectopic pregnancy associated with any given tubal surgical procedure should be taken into consideration when surgery is contemplated. When the risk of ectopic pregnancy is unacceptably high, or when the patient is reluctant to be exposed to a high risk of ectopic pregnancy, IVF-ET could be offered as an alternative. Table 11 represents the incidence of ectopic pregnancy associated with the various surgical procedures. The figures demonstrate the wide variation in outcome for the same procedure. PMID- 3552747 TI - Mycoplasmas and in vitro fertilization. AB - Semen samples taken from 135 patients attending an in vitro fertilization clinic were shown to be colonized, 53 with Ureaplasma urealyticum (39%) and 16 with Mycoplasma hominis (12%). An unidentified mycoplasma species was isolated from the sperm of two patients. M. hominis was recovered from all the washed sperm samples taken from colonized semen, whereas washing the sperm eradicated U. urealyticum from 71% of colonized semen. The presence of mycoplasmas in semen made no significant difference to the sperm count, sperm motility, sperm abnormalities, or fertilization of eggs. PMID- 3552746 TI - Relationship of antisperm antibodies to oocyte fertilization in in vitro fertilization-embryo transfer. AB - Antisperm antibodies (ASA) appear to impair reproduction; however, their clinical significance in in vitro fertilization-embryo transfer (IVF-ET) is unestablished. For examination of this question, the immunobead binding technique was used to identify IgA, IgG, and IgM ASA in the serum, semen, and follicular fluid (FF) of 40 couples undergoing IVF-ET. ASA binding to sperm tail tip did not predict the fertilization rate of uniformly inseminated mature oocytes. Similarly, ASA binding to sperm head in semen and male serum did not predict fertilization. However, the fertilization rate in couples with ASA to sperm head (ASA-H) of at least one isotype in female serum (n = 6) was significantly less than in those without ASA-H (n = 34; 34% versus 74%, P less than 0.01). Among these women, oocyte fertilization rates were 33% versus 71% (P less than 0.001). Sixty percent of women whose ova did not fertilize (n = 5) had ASA-H in their serum versus 6% of those whose ova did (n = 35; P less than 0.05). The presence of ASA-H in FF also correlated with fertilization. ASA-H in female serum reduced the zygote cleavage rate from 91% to 67% (P = 0.51). We conclude that the presence of ASA-H in female serum and FF is associated with reduced fertilization in IVF-ET. PMID- 3552748 TI - The use of sperm penetration assay in evaluation of men with varicocele. AB - In order to study the ability of the sperm penetration assay (SPA) to correctly classify the fertility status of men, we prospectively examined the results of the SPA performed on the semen of three groups of men of known fertility status. The groups included 67 normal men without varicoceles whose wives were pregnant (VARN), 51 men with a palpable varicocele whose wives were pregnant (VARF), and 30 infertile men with varicoceles (VARI). Two SPAs were done on each subject. Ninety-seven percent of the VARIs showed less than 15% penetration on a single test, and 91% showed less than 15% on both tests. On a single test 61% of the VARNs and 68% of the VARFs were less than 15%. If 0 penetration were used as the criteria of infertility, then 40% of the VARIs, 27% of the VARFs, and 12% of the VARNs would be classified as being infertile. These data suggest that the SPA cannot independently define male fertility status and should be used in conjunction with the standard semen analysis and clinical evaluation of the couple to assess male fertility potential. PMID- 3552750 TI - Sonography of endometrium in IVF. PMID- 3552749 TI - Temperature-dependent effects of the components of kallikrein-kinin system on sperm motility in vitro. AB - The effect of kallikrein and bradykinin on sperm motility was studied. For investigation of whether the effect is not temperature dependent, sperm motility and velocity were measured after incubation with kallikrein or bradykinin at different temperatures. The effect of kallikrein on sperm motility and velocity was demonstrated significantly at 22 degrees C. At 37 degrees C, this effect was absent, but with captopril the effect of kallikrein on sperm velocity was observed. Bradykinin stimulated sperm motility and velocity at 22 degrees C and at 33 degrees C. However, it did not stimulate sperm motility at 37 degrees C. With 1.10 phenantroline, the effect of bradykinin on sperm motility was detected. These results indicate that kallikrein and bradykinin stimulate sperm motility and velocity and that their effects are strongly temperature dependent. PMID- 3552751 TI - Oral contraceptives and neoplasia: 1987 update. PMID- 3552752 TI - A prospective multicenter trial of the ovulation method of natural family planning. V. Psychosexual aspects. World Health Organization. AB - During the 13-cycle effectiveness phase of a five-center study of the ovulation method of natural family planning, there were substantial differences, particularly between the two developed and the three developing countries, in the stated degree of satisfaction with the frequency of intercourse (most couples were satisfied in Bangalore, Manila, and San Miguel, whereas one-third of the subjects and half of their partners would have preferred more frequent intercourse in Auckland and Dublin) and in expressed difficulties associated with abstinence (e.g., 62% had occasional difficulty in Auckland, 14% in Bangalore, 55% in Dublin, 28% in Manila, and 5% in San Miguel). Cumulative net probabilities of discontinuation due to pregnancy were 1.8%, 18.6%, and 54.7% for couples in whom the male partner's degree of satisfaction was described as "no difficulty," "occasional difficulty," and "always some difficulty," respectively. PMID- 3552753 TI - Pharmacologic production of luteinized unruptured follicles by prostaglandin synthetase inhibitors. AB - Serial ultrasonic scans of follicular development were performed throughout 46 spontaneous cycles in 20 healthy female volunteers. Human chorionic gonadotropin was then given to induce follicle rupture on a particular day. Luteinized unruptured follicles (LUFs) were seen in 10.7% of untreated cycles. When prostaglandin synthetase inhibitor drugs were administered over the ovulatory period the incidence of LUF was greatly increased (to 50% with azapropazone and 100% with indomethacin). Serum estradiol concentrations and length of luteal phase were unaltered in LUF cycles. Progesterone concentrations were lower in the first half of the luteal phase if follicles remained unruptured. PMID- 3552754 TI - Spontaneous return of menstruation in hypothalamic amenorrhea following gonadotropin-releasing hormone-induced pregnancy. PMID- 3552755 TI - The evolution of polycystic ovaries in a girl with hypogonadotropic hypogonadism before puberty and during puberty induced with pulsatile gonadotropin-releasing hormone. AB - We describe a girl of 12.7 years who had GnRH deficiency after surgery and radiotherapy for a craniopharyngioma at age 5 years. She had large cystic ovaries with a small uterus in the absence of spontaneous gonadotropin pulsatility. Puberty was induced by low-dose pulsatile GnRH treatment over a 1.5-year period. In the perimenarcheal period, ovarian morphology became typical of PCO with abnormal diurnal pulsatile gonadotropin secretion. These data suggest that PCO is primarily a disorder of the ovary and that the observed gonadotropin abnormalities are secondary to the ovarian lesion. PMID- 3552756 TI - [Various elements in the construction of the theory of a metasympathetic nervous system]. AB - Structural and functional evidence determines the metasympathetic nervous system as the third, independent portion of the autonomic (vegetative) nervous system. Problems of its onto- and phylogenesis, evolutionary advances of its relative independence, interrelationship among electrical behaviour of neurons, integrative function of nets' local neurons, transmitter mechanisms in every link of the reflex arch of this level, are considered. Neurobiological properties, structural-organizational similarity to the brain nuclear formations connections of the metasympathetic nervous system with the central nervous system and its relationships with sympathetic and parasympathetic systems, are discussed. The metasympathetic system is suggested to perform basic control over the majority of visceral organs. The concept unites V. N. Tchernigovsky's theory of interoception and K. M. Bykov's theory of cortico-visceral relationships, advancing each of them. PMID- 3552757 TI - [Neurophysiologic basis of pain: various results]. PMID- 3552759 TI - Preliminary observations on development of quinine sulphate resistance in Plasmodium berghei. PMID- 3552758 TI - Two-dimensional gel electrophoresis of myc gene products after cleavage by viral protease p15. AB - An analysis of myc-specific protein (p58myc), precipitated from cells transformed by virus OK10, by means of two-dimensional gel electrophoresis revealed the presence of two variants of p58myc differing in their isoelectric point. Both variants are completely cleaved by protease p15 as is the c-myc gene product precipitated from 16Q cells. The cleavage fragments of c-myc and v-myc protein do not differ in size but differ in their stability. PMID- 3552760 TI - Feasibility of IHA and ELISA in seroepidemiology of malaria. PMID- 3552761 TI - In vitro susceptibility of chloroquine resistant Plasmodium falciparum to mefloquine in Delhi. PMID- 3552762 TI - [Maryland bridge: presentation of 2 bonded complete upper fixed dentures]. PMID- 3552763 TI - [Clinical study of a new oral anti-inflammatory: Zami 642]. PMID- 3552765 TI - [Overdentures]. PMID- 3552764 TI - [Hemocoagulant effect of Topical Reptilase]. PMID- 3552766 TI - Techniques that promote esthetic dentistry. PMID- 3552767 TI - Noncariogenic sweeteners. Sugar substitutes for caries control. PMID- 3552768 TI - Oral contraceptive therapy. Effects on the oral tissues. PMID- 3552769 TI - [Psoriasis vulgaris partim inversa and bullous pemphigoid. Case report and short review of the literature]. PMID- 3552770 TI - [Pustulosis subcornealis Sneddon-Wilkinson and metastasizing seminoma--random coincidence or cutaneous paraneoplasia?]. PMID- 3552771 TI - Bleached dentures: misuse of a denture-cleaning agent. PMID- 3552772 TI - Metformin enhances insulin binding to "in vitro" down regulated human fat cells. AB - Insulin binding to human adipose tissue from surgical patients was determined after three different preincubation conditions: a) 24 hrs in the presence or absence of 80 ng/ml insulin; b) 24 hrs in the presence of 80 ng/ml insulin or insulin plus 4 micrograms/ml metformin; c) 48 hrs pre-incubation as in b). We found that insulin down regulated its own receptor after 24 hours pre-incubation; when metformin was present in the pre-incubation medium together with insulin, insulin binding to adipose tissue was significantly higher than in tissue exposed to insulin alone after 48 hrs pre-incubation; a similar effect of metformin was already seen after 24 hrs, but was not statistically significant. We suggest that metformin can correct down regulation of the insulin receptor. This finding could explain discrepant results among studies dealing with the influence of metformin on insulin binding. Moreover, these results could be useful in understanding the mechanism of action of metformin in insulin-resistant states, e.g. type II diabetes. PMID- 3552773 TI - Pancreatic beta cell response in insulin treated NIDDM patients limitations of a random C-peptide measurement. AB - Pancreatic beta cell function was evaluated in 30 insulin treated non-insulin dependent diabetic patients, by estimating serum C-peptide after meal stimulation. C-peptide response was low (less than 0.6 pmol/ml) in 15 patients and it was significant (greater than 0.6 pmol/ml) in the other 15 patients. All the patients were then started on a high carbohydrate, high fibre diet and a combination of glibenclamide and metformin. In 18 patients, optimal regulation of hyperglycemia was achieved in one week and the others required insulin treatment. Among the 15 with low C-peptide values, 8 patients responded to oral hypoglycaemic agents and their C-peptide responses improved (from 0.17 +/- 0.16 to 0.78 +/- 0.2 pmol/ml). Among the 15 with significant C-peptide values, 10 responded well to oral drugs and their C-peptide values improved further (from 0.79 +/- 0.21 to 1.17 +/- 0.44 pmol/ml); but the others required insulin despite the good beta cell reserve. This study shows that the beta cell response in insulin treated NIDDM varies widely as it is influenced by the exogenous insulin and hyperglycaemia a random estimation of C-peptide will be of limited value in predicting the response to therapy. PMID- 3552774 TI - Estimation of B-cell function by the urinary excretion rate of C-peptide in diabetic patients: comparison with C-peptide response to glucagon and to a mixed meal. AB - This study examined the relationship between the C-peptide response to intravenous glucagon and mixed meal stimulation and the 24 h urinary excretion rate of C-peptide and its urinary excretion during the glucagon test in nine control subjects, eighteen Type 1 (insulin-dependent) and twenty-two Type 2 (non insulin-dependent) diabetic patients. Compared to controls (61.0 +/- 7.1 micrograms), the 24-h urine excretion rate of C-peptide was 8.2 +/- 3.1 micrograms (p less than 0.001) in Type 1 and 89.8 +/- 12.9 micrograms (p = NS) in Type 2 diabetic patients. C-peptide urinary excretion rate during the glucagon test was 6.92 +/- 1.11 micrograms, 0.42 +/- 0.10 microgram (p less than 0.001) and 6.47 +/- 1.13 micrograms (p = NS) respectively. Fasting serum C-peptide values were 1.53 +/- 0.16 ng/ml in controls, 0.42 +/- 0.09 ng/ml in Type 1 (p less than 0.0001) and 2.08 +/- 0.22 ng/ml in Type 2 diabetics (p = NS); C-peptide areas under the curve after glucagon stimulation were, respectively, 241.6 +/- 20.3 ng/ml, 29.2 +/- 5.9 ng/ml (p less than 0.0001) and 170.9 +/- 17.9 ng/ml (p less than 0.03) and after the meal test they were 204.7 +/- 15.6, 68.7 +/- 19.8 ng/ml (p less than 0.0001) and 265.5 +/- 32.9 ng/ml (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552775 TI - [The cephalic phase of insulin secretion]. AB - Human studies had suggested that the cephalic phase of digestion induced a cephalic phase of insulin secretion. A detailed study of the intensity and time course of the phenomenon was performed in the free feeding rat and confirmed in other mammals. This secretion is reflexly triggered by food-related sensory stimuli and is vagally mediated. Anatomical, neurochemical electrophysiological and behavioural studies, showed that the reflex might be organized at the brain stem level receiving major modulation influences from the hypothalamus. The cephalic phase of insulin release is a conditioned reflex. One consequence of that early secretion is to damp down the important variations in the levels of circulating metabolites following absorption. The relationships between the amplitude of the cephalic phase insulin response and the basal insulin level on the one hand, the nutritional composition of the ingested food on the other, are still not clear. Some evidence exists that palatability, meal size and the amplitude of the cephalic phase insulin secretion are linked. This could be a possible etiology in some cases of nutritional obesity. PMID- 3552776 TI - [Spontaneous oscillations in basal blood insulin]. AB - Many studies show that basal insulinemia is not stable over time, but oscillates significantly. The period and amplitude of oscillations appear species-specific. Studies on living animals have established that neither central autonomic command nor liver-pancreas feedback play a determining role on these cycles. Work on the isolated, perfused, canine pancreas has demonstrated the existence of an intrinsic pancreatic oscillator. Studies on human subjects confirm and complete animal data. The amplitude of insulinemia cycles is less in humans than in animals. In obese humans, insulin cycles are normal. In non-insulin-dependent diabetics, insulin oscillations are very irregular; after partial pancreatectomy (removal of the head of the pancreas), the normal insulin cycles disappear. The insulinemia cycles thus seem to reflect the behavior of an intrinsic pancreatic oscillator which synchronizes the activity of beta cells. Spontaneous oscillations in plasma insulin could play a role in the regulation of receptor affinity in target-tissues. PMID- 3552777 TI - The endothelium of the high endothelial venule: a specialized endothelium with unique properties. AB - High endothelial venules (HEV) in lymphoid organs are specialized to facilitate the passage of lymphocytes into lymphoid parenchyma. This is accomplished by a ligand-receptor system on the endothelium and lymphocytes, which differs between lymph nodes and Peyer's patch. Experiments discussed in this paper show that other non-HEV-derived endothelial cells can acquire the characteristics of HEV and that HEV may differentiate under influences from their local micro environments. PMID- 3552778 TI - Protein synthesis in heterotopically transplanted rat hearts. AB - This study examines protein synthesis in heterotopically transplanted rat hearts and several tissues of recipient rats. Donor hearts and recipient tissues synthesized many of the normally occurring proteins observed in tissues of unstressed rats. In addition, a stress-induced protein with a molecular mass of 71 kilodaltons was synthesized in donor heart, recipient heart and lung. Donor hearts incorporated more L-[35S]-methionine than did recipient hearts. Tissues of recipient rats also incorporated more label than the respective tissues of sham recipient rats. These results suggest that ischemia, endured by the donor hearts during transplantation, induced these changes in protein synthesis. PMID- 3552779 TI - Effect of adenosine on the serum levels of glucose, insulin and glucagon in vivo. AB - The in vivo effect of adenosine on the serum levels of glucose, insulin and glucagon in rats fasted for twenty four hours or after an oral glucose load were studied. Under fasting conditions adenosine produced an hyperglycaemia without change in the insulin or glucagon serum levels. After a glucose load adenosine induced a marked hyperglycaemia concomitant to a decrease in insulin serum levels and an increase in glucagon serum levels. Adenosine did not alter the relationship between insulin and glucagon. In vivo adenosine administration altered the secretion of hormones by the islets of Langerhans (increased the release of glucagon and decreased the secretion of insulin) but this was only clearly observable under stimulated conditions. Adenosine did not alter the regulatory mechanism(s) that modulate the relationship between insulin and glucagon. PMID- 3552780 TI - Inactivation of yeast nucleotidyl transferase and its effect on the integrity of the aminoacid acceptor end of transfer RNA. AB - Yeast tRNA nucleotidyl transferase rapidly inactivates (half life c. 2 hr) upon nitrogen starvation of exponentially growing cells. The inactivation does not occur when glucose together with the nitrogen source is removed or when glucose is replaced by ethanol. The transferase activity reappears shortly after replenishment of the nitrogen source and this appearance of the enzymatic activity is blocked by cycloheximide, indicating the need for protein biosynthesis during the process. The nucleotidyl transferase activity is also very low in stationary phase yeast cells. A ten fold decrease in the transferase activity is not paralleled by loss of the integrity of the 3' end of the tRNA chains. It seems that there is a large excess of enzymatic activity over that needed to keep the tRNA chains complete. The observed lack of the 3' end of tRNAs from late stationary phase yeast cannot be accounted for by the observed drop in transferase activity in these cells. PMID- 3552781 TI - Quantitative structure activity relationship studies on the activation of yeast AMP deaminase by polyamines. AB - Quantitative structure activity relationship studies on the activation of AMP deaminase by polyamines were carried out. Polyamine enhanced the maximal velocity of AMP deaminase without changing the affinity for the substrate AMP. Activation by polyamines of AMP deaminase can be accounted for by the simple Michaelis Menten mechanism in the presence of ATP. A close correlation between the structure and activation constants for polyamines suggests that the binding of polyamine to AMP deaminase involves primarily polar interactions. PMID- 3552782 TI - Identification of an insulin fragment produced by an insulin degrading enzyme, neutral thiopeptidase. AB - Previous studies have shown that neutral thiopeptidase (E.C.3.4.22.11, insulinase) degrades (processes) insulin with a high affinity (Km = 30 X 10(-9) M). In the current studies, insulin was subjected to digestion with a highly purified rat liver neutral thiopeptidase and the peptides generated were separated by HPLC using a C8 column. With the use of structural analysis (which included the determination of amino terminal residues and amino acid composition), the major product was identified as a peptide containing portions of both chains of insulin, A1 to A13 and B1 to B9 having two disulfide bonds, an interchain disulfide bond and presumably the intra-A chain disulfide bond as well. Examination of insulin-like biological activity using a primary cultured hepatocyte test system showed that the fragment promoted neither short-term (alpha-aminoisobutyric acid uptake) nor long-term (glycogen synthesis) bioactivities of insulin. PMID- 3552783 TI - Potentiation of insulin stimulation of hexose transport by kallikrein and bradykinin in isolated rat adipocytes. AB - Kallikrein and bradykinin additively increased adipocyte hexose transport under conditions of maximal intrinsic insulin stimulation, while no such effect occurred in the absence of insulin. The potentiation of insulin action follows a dose-response relationship with kallikrein and bradykinin concentrations consistent with a physiological role for the latter in the modulation of insulin action. Insulin degradation by isolated adipocytes and insulin binding to its receptors on adipocyte plasma membranes were not affected by either kallikrein or bradykinin. Thus, the kallikrein and bradykinin potentiation of insulin action occur at post-insulin binding sites. In conclusion, the kallikrein-bradykinin system increases the supply of substrates to target tissues through vasodilation and augmented blood perfusion, and it also stimulates glucose uptake and metabolism via its potentiation of insulin action. These actions suggest that the kallikrein-bradykinin system regulate both the availability and utilization of metabolic substrates, in target tissues. PMID- 3552784 TI - Potentiators of insulin secretion modulate Ca2+ sensitivity in rat pancreatic islets. AB - Insulin secretion stimulated by 10 mM glucose was potentiated by forskolin, an activator of adenyl cyclase, by acetyl choline which may enhance turnover of inositol phospholipids, and by tetradecanoyl phorbol acetate (TPA), an activator of protein kinase C. None of these agents initiated insulin secretion in the presence of 2 mM glucose. Glucose-stimulated insulin secretion was markedly dependent on the concentration of extracellular Ca2+: at or below 10 microM Ca2+ no insulin secretion was evoked by glucose in freshly isolated islets. The threshold Ca2+ requirement was increased after culture of islets for 44 h. In both fresh and cultured islets the presence of a potentiator of secretion produced both a marked increase in the maximum rate of glucose-stimulated insulin secretion and a lowering of the requirement for extracellular Ca2+. Thus potentiation of insulin release involves an increase in the sensitivity of the B cell to Ca2+. PMID- 3552786 TI - Wound healing of human skin transplanted onto the nude mouse. II. An immunohistological and ultrastructural study of the epidermal basement membrane zone reconstruction and connective tissue reorganization. AB - The reconstruction of human epidermis during healing of human skin wounded after grafting onto the nude mouse was described in a previous paper (M. Demarchez, P. Sengel, and M. Prunieras, 1986, Dev. Biol. 113, 90-96). The regeneration of the epidermal basement membrane zone (BMZ) and the reorganization of the connective tissue are the subjects of the present study. They were investigated by two complementary methods: electron microscopy to analyze the BMZ reorganization, and indirect immunofluorescence with species-specific and cross-reacting antibodies directed against laminin, bullous pemphigoid antigen, mouse or human collagens of types I or IV, human elastic fibers, fibronectin, fibrin, actin, and human vimentin, to examine the species origin and distribution of BMZ and connective tissue components during the regeneration process. It is reported that grafted human skin preserves its own immunological markers not only in the epidermis but also in the BMZ and dermis as well, and that, after injury, its regeneration proceeds according to the following sequence of overlapping events: production of a mouse granulation tissue; reepidermization by human cells; reconstruction of a BMZ with human characteristics; formation of a human neodermis. It is concluded that human skin grafted onto the nude mouse is able to regenerate its three structural compartments, namely, the epidermis, BMZ, and dermis. Interestingly, it appeared, also, that the connective tissue regeneration would be a two-step mechanism including the sequential formation of two tissues of distinct sources, namely, a granulation tissue and a neodermis. PMID- 3552785 TI - Induction of maturation in small Xenopus laevis oocytes. AB - The competence of Xenopus laevis oocytes in various stages of growth to respond to progesterone treatment was investigated. Full-grown (stage 6) oocytes undergo nuclear membrane dissolution and resume meiosis in response to progesterone exposure, while smaller oocytes (stages 3-5; less than 1100 micron in diameter) do not. The defect which prevents 750- to 1050-micron oocytes from responding to progesterone can be overcome by microinjecting cytoplasm withdrawn from a stage 6 oocyte. Germinal vesicle breakdown in these small oocytes occurs on a timetable similar to that of stage 6 oocytes exposed to progesterone and is accompanied by a twofold increase in protein synthesis as well as the activation of MPF. The results argue that a cytoplasmic factor(s) which probably first appears at late stage 5 is required for progesterone responsiveness. The identity and role of the factor(s) in the development of maturation competence and the regulation of maternal mRNA translation are discussed. PMID- 3552788 TI - Neural crest cell migratory pathways in the trunk of the chick embryo. AB - Neural crest cells migrate during embryogenesis to give rise to segmented structures of the vertebrate peripheral nervous system: namely, the dorsal root ganglia and the sympathetic chain. However, neural crest cell arise from the dorsal neural tube where they are apparently unsegmented. It is generally agreed that the somites impose segmentation on migrating crest cells, but there is a disagreement about two basic questions: exactly pathways do neural crest cells use to move through or around somites, and do neural crest cells actively migrate or are they passively dispersed by the movement of somite cells? The answers to both questions are critically important to any further understanding of the mechanisms underlying the precise distribution of the neural crest cells that develop into ganglia. We have done an exhaustive study of the locations of neural crest cells in chick embryos during early stages of their movement, using antibodies to neural crest cells (HNK-1), to neural filament-associated protein in growing nerve processes (E/C8), and to the extracellular matrix molecule laminin. Our results show that Some neural crest cells invade the extracellular space between adjacent somites, but the apparent majority move into the somites themselves along the border between the dermatome/myotome (DM) and the sclerotome. Neural crest cells remain closely associated with the anterior half of the DM of developing somites as they travel, suggesting that the basal lamina of the DM may be used as a migratory substratum. Supporting this idea is our observation that the development of the DM basal lamina coincides in time and location with the onset of crest migration through the somite. The leading front of neural crest cells advance through the somite while the length of the DM pathway remains constant, suggesting active locomotion, at least in this early phase of development. Neural crest cells leave the DM at a later stage of development to associate with the dorsal aorta, where sympathetic ganglia form, and to associate with newly emerging fibers of the ventral root nerve, where they presumably give rise to neuronal supportive cells. Thus we propose that the establishment of the segmental pattern of the peripheral ganglia and nerves depends on the timely development of appropriate substrata to guide and distribute migrating neural crest cells during the early stages of embryogenesis. PMID- 3552787 TI - Gastrulation in the sea urchin embryo requires the deposition of crosslinked collagen within the extracellular matrix. AB - This study demonstrates that a collagenous extracellular matrix (ECM) is necessary for gastrulation in the sea urchin embryo. The approach taken was to disrupt collagen processing with two types of agents (a lathyritic agent, beta aminopropionitrile (BAPN), and three types of proline analogs: dehydroproline, cis-OH-proline, and azetidine carboxylic acid) and to assess the effect on embryogenesis by morphological, immunological, and biochemical criteria. Embryos chronically exposed to either of the agents following fertilization displayed no detectable developmental abnormalities before the mesenchyme blastula stage. These embryos, however, did not gastrulate nor differentiate any further and remained at the mesenchyme blastula stage for at least 36 hr. Upon removal of the agents, the embryos resumed a normal developmental schedule and formed pluteus larvae that were indistinguishable from control embryos. By immunofluorescence studies with monospecific antibodies to type I and type IV collagens it is seen that the lathyritic agent BAPN reduces the accumulation of collagens within the ECM. This effect is confirmed and quantitated by use of an ELISA and by a biochemical determination of OH-proline. When the agents are removed from the inhibited embryos, collagen deposition returns to normal, coincident with gastrulation. Western-blot analysis, using monospecific antibodies to collagen, demonstrates that the effect of the lathyritic agent is to reduce the stability of the extracellular collagen by inhibiting the intra- and intermolecular crosslinking of collagen molecules. BAPN exhibits a dose-dependent effect on morphogenesis, but has no effect on respiration nor on protein synthesis of the embryos throughout development. Although the lathyritic agent affects collagen deposition, it is shown to not affect the expression of other molecules of the ECM, nor that of several cell surface molecules. However, a cell surface molecule that is expressed specifically in the endoderm, termed Endo 1, is not expressed in the inhibited embryos. Endo 1 is expressed after removal of the lathyritic agent and its appearance is coincident with gastrulation in the recovered embryos. These results suggest that a collagenous ECM is important for gastrulation and subsequent differentiation in the sea urchin, but not for earlier developmental processes. In addition, the dependence of Endo 1 expression on the collagenous ECM raises the possibility that this cell surface molecule is in some way regulated by interactions of the presumptive endodermal cells with the ECM. PMID- 3552789 TI - Archenteron elongation in the sea urchin embryo is a microtubule-independent process. AB - Earlier studies using colchicine (L. G. Tilney and J. R. Gibbins, 1969, J. Cell Sci. 5, 195-210) had suggested that intact microtubules (MTs) are necessary for archenteron elongation during the second phase of sea urchin gastrulation (secondary invagination), presumably by allowing secondary mesenchyme cells (SMCs) to extend their long filopodial processes. In light of subsequently discovered effects of colchicine on other cellular processes, the role of MTs in archenteron elongation in the sea urchin, Lytechinus pictus, has been reexamined. Immunofluorescent staining of ectodermal fragments and isolated archenterons reveals a characteristic pattern of MTs in the ectoderm and endoderm during gastrulation. Ectodermal cells exhibit arrays of MTs radiating away from the region of the basal body/ciliary rootlet and extending along the periphery of the cell, whereas endodermal cells exhibit a similar array of peripheral MTs emanating from the region of the apical ciliary rootlet facing the lumen of the archenteron. MTs are found primarily at the bases of the filopodia of normal SMCs. beta-Lumicolchicine (0.1 mM), an analog of colchicine which does not bind tubulin, inhibits secondary invagination, indicating that the effects previously ascribed to the disruption of MTs are probably due to the effects of colchicine on other cellular processes. The MT inhibitor nocodazole (5-10 micrograms/ml) added prior to secondary invagination does not prevent gastrulation or spontaneous exogastrulation, even though indirect immunofluorescence indicates that cytoplasmic MTs are completely disrupted in drug-treated embryos. Transverse tissue sections indicate that a comparable amount of cell rearrangement occurs in nocodazole-treated and control embryos. Significantly, SMCs in nocodazole-treated embryos often detach prematurely from the tip of the gut rudiment and extend abnormally large broad lamellipodial protrusions but are also capable of extending long slender filopodia comparable in length to those of control embryos. These results indicate that cytoplasmic MTs are not essential for either filopodial extension by SMCs or for the active epithelial cell rearrangement which accompanies elongation during sea urchin gastrulation. PMID- 3552790 TI - Inhibition of glycogenolysis and glycogen phosphorylase by insulin and proinsulin in rat hepatocyte cultures. AB - The inhibitory action of insulin and proinsulin on basal and glucagon-activated glycogenolysis was studied in cultured rat hepatocytes containing [14C]glycogen. Insulin or proinsulin given as sole hormones in the presence of 5 mM glucose decreased basal release of [14C]glucose from [14C]glycogen to 20%. Half-maximal effective concentration of insulin was approximately 0.15 nM and of proinsulin was approximately 5 nM. Inhibition of [14C]lactate release from [14C]glycogen required slightly higher hormone concentrations with a similar difference in potency for insulin and proinsulin. The glucagon-stimulated release of [14C]glucose was completely blocked by insulin or proinsulin with half-maximal effective concentrations of approximately 0.2 and approximately 8 nM, respectively. In contrast, release of [14C]lactate in the presence of glucagon was increased slightly by insulin and proinsulin. Basal and glucagon-activated phosphorylase activity was inhibited by approximately 50% in a dose-dependent manner by both hormones, with differences in potency similar to those for the inhibition of glycogenolysis. These data point to a direct regulatory role of insulin in the control of hepatic glycogen breakdown even when acting as sole hormone. The results do not support the notion of a preferential inhibitory potency of proinsulin on hepatic glycogenolysis. PMID- 3552791 TI - Quantitative changes of cerebral neocortical structure in insulin-treated long term streptozocin-induced diabetes in rats. AB - The brains of rats with streptozocin-induced diabetes treated with a low-dose insulin regimen (1 IU/day) were studied with morphometric techniques. After 1 yr of diabetes, brain weight decreased slightly (1350 +/- 71 vs. 1521 +/- 55 mg, 2P less than .01) as did the volume of the neocortex (498 +/- 36 vs. 567 +/- 40 mm3, 2P less than .05). A significant loss of neocortical neurons occurred (38 +/- 2 X 10(6) vs. 46 +/- 3 X 10(6), 2P less than .01), and the length of the capillary network in the neocortical tissue shortened disproportionately (405 +/- 102 vs. 631 +/- 47 m, 2P less than .01), leading to increased diffusion distance. The mechanisms underlying cerebral loss in this model are unknown, but abnormalities of the vascular supply with prolongation of the route of diffusion might play a role. PMID- 3552792 TI - Reduced urinary insulin clearance in patient with abnormal insulinemia. AB - We recently reported a new case of abnormal insulinemia with LeuA3 insulin. Herein, we measured urinary insulin clearance during oral glucose tolerance tests in proband with abnormal insulinemia (44-yr-old female), three affected family members, two unaffected family members, two other hyperinsulinemic patients with obesity, five non-insulin-dependent diabetic patients, and five normal control subjects. Urinary insulin-to-creatinine clearance ratio in the proband and her affected family members was 0.22 X 10(-3) +/- 0.07 (mean +/- SD, n = 4) and was markedly reduced compared with those of other groups: 1.73 X 10(-3) in two unaffected family members, 2.77 X 10(-3) in two other hyperinsulinemic patients with obesity, 2.99 X 10(-3) +/- 1.48 in five non-insulin-dependent diabetic patients, and 2.54 X 10(-3) +/- 0.67 in five normal control subjects. In contrast, urinary C-peptide clearance in these groups was not significantly different from controls. Binding of immunopurified insulins extracted from urine of the patients with abnormal insulinemia to guinea pig kidney membrane was slightly decreased (71% of standard insulin), in contrast with the observation that serum insulin of the proband had much less receptor-binding activity. Reverse-phase HPLC analysis of the immunopurified insulin of the proband revealed that the ratios of normal insulin to abnormal insulin were 8:3 in urine and 1:7 in serum, respectively. These results suggest that excretion of abnormal insulin in urine is much less than that of normal insulin. PMID- 3552793 TI - Direct and indirect effects of insulin to inhibit hepatic glucose output in obese subjects. AB - The effects of small increases in plasma insulin on hepatic glucose production are incompletely understood. To partially elucidate this issue we have studied seven obese subjects with the euglycemic clamp technique with a low-dose insulin infusion rate of 15 mU X m-2 X min-1 over 3 h. Basal insulin levels were 24 +/- 7 microU/ml and increased to steady-state levels of 35 +/- 3 microU/ml during insulin infusion. Endogenous insulin secretion, quantitated by C-peptide measurements, decreased by 58% of the basal value after peripheral insulin infusion. Based on C-peptide measurements and the contribution of the peripheral insulin infusion to the circulating insulin concentrations, calculated portal insulin levels either decreased or remained unchanged during the clamp studies. Basal glucagon levels were 165 +/- 18 and did not change during the insulin infusion. The basal glucose disposal rate was 86 +/- 2 mg X m-2 X min-1 and did not increase significantly during the clamp studies. In contrast, hepatic glucose output (HGO) was suppressed by 82 +/- 5% of the basal value. In summary, in a group of insulin-resistant obese subjects, glucose-clamp studies were performed at peripheral insulin levels of 35 +/- 3 microU/ml; glucose disposal did not increase, whereas HGO was suppressed by 82%. At the same time, glucagon levels remained constant and estimated portal insulin levels either decreased or remained unchanged. These findings suggest that insulin can suppress HGO through indirect extrahepatic actions. PMID- 3552794 TI - Development of obesity in Zucker rats. Early insulin resistance in muscles but normal sensitivity in white adipose tissue. AB - Euglycemic-hyperinsulinemic clamps were performed on 4- and 12-wk-old anesthetized lean and obese Zucker rats. During the clamp studies, total glucose production and utilization were assessed with a 3-[3H]glucose perfusion, whereas local glucose utilization was determined by measuring 2-deoxy-1-[3H]glucose 6 phosphate accumulation in various tissues. In the basal state, 4 wk-old obese rats were hyperinsulinemic (159 +/- 8 vs. 82 +/- 9 microU/ml), whereas glucose turnover rate was similar to that observed in lean rats (14.9 +/- 1.9 vs. 12.5 +/ 1.9 mg X min-1 X kg-1). Glucose utilization was identical in skeletal muscles, whereas it was increased in white adipose tissue of obese rats (22 +/- 4 vs. 8 +/ 2 ng X min-1 X mg-1). At plasma insulin level of 500 microU/ml, glucose production was totally suppressed in both groups, whereas overall glucose utilization was slightly less in 4-wk-old obese than in lean rats. This was due to a reduced stimulation of glucose utilization in skeletal muscles and brown adipose tissue. In contrast, glucose utilization in periovarian white adipose tissue was similarly increased in lean and obese rats. For a maximal insulin concentration (1500 microU/ml), all the differences were abolished between lean and obese young Zucker rats. In older (12-wk-old) obese rats, glucose utilization in various tissues was markedly reduced at maximal insulin level compared with that observed in age-matched lean animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552795 TI - Mechanism of metformin action in non-insulin-dependent diabetes. AB - The mechanism of action of metformin was studied by comparing glucose turnover before and after a 75-g oral glucose load in 10 nonobese men with non-insulin dependent diabetes mellitus (NIDDM) during metformin and placebo therapy by the combined application of the forearm and double-isotope techniques. During the study, 9 of the 10 patients were regularly receiving glibenclamide therapy. In 5 of the men, the first study was performed during metformin therapy, and the second study was done during placebo administration; in the other 5 subjects, the order was reversed. The interval between the studies was at least 3 mo. The metformin dosage was 1 g twice daily in 9 of the patients and 850 mg thrice daily in the 10th subject. In the basal state, metformin administration reduced plasma glucose levels from 172 +/- 14 to 103 +/- 9 mg/dl (P less than .005), hepatic glucose output (HGO) from 2.67 +/- 0.15 to 2.20 +/- 0.20 mg X kg-1 X min-1 (P less than .02), and forearm glucose uptake (FGU) from 0.106 +/- 0.18 to 0.039 +/- 0.016 mg X 100 ml-1 forearm X min-1 (P less than .005), whereas insulin (23 +/- 6 microU/ml) and lactate (1.56 +/- 0.18 mM) levels were unchanged. Although the oral glucose tolerance curve (OGTC) was significantly lowered by metformin, the incremental area under the curve and the insulin response were unchanged. The systemic appearance of ingested glucose was unaffected by metformin; 64 +/- 2% of the load was recovered peripherally in 3 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552796 TI - Islet cytotoxicity of interleukin 1. Influence of culture conditions and islet donor characteristics. AB - We recently demonstrated that the macrophage product interleukin 1 (IL-1) is cytotoxic to isolated pancreatic islets and hypothesized that IL-1 is responsible for beta-cell destruction in insulin-dependent diabetes mellitus (IDDM). We studied whether the variation in IDDM preponderance with age, sex, and genetic background in vivo is reflected in different susceptibility to IL-1 toxicity of islets in vitro. In addition, we studied the effect of preculture conditions that support endocrine islet cell function and decrease nonendocrine passenger-cell survival on the susceptibility of beta-cells to IL-1 because it is unknown whether IL-1 acts directly on beta-cells or via passenger cells. No differences in susceptibility to various doses of IL-1-containing mononuclear cell supernatants were found between islets isolated from newborn or adult rats, male or female rats, or rats of four inbred strains, indicating that age, sex, and genetic background do not influence the susceptibility of the beta-cell to IL-1. Preculture of islets for 1-7 days in normal atmosphere and preculture of islet clusters in 95% O2 to delete passenger cells did not affect IL-1-mediated cytotoxicity, suggesting that IL-1 acts directly on beta-cells. Increasing the glucose concentration (22 mM) in the culture medium, which is known to protect beta-cells against alloxan toxicity, reduced IL-1 toxicity. Five or 25% normal human serum as well as 5% normal rat serum, but not equivalent concentrations of human serum albumin, inhibited IL-1 toxicity, indicating the presence of IL-1 inhibitors, IL-1 antagonists, or beta-cell-protecting factors in normal serum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552797 TI - Abnormalities in glucose-stimulated insulin release, 45Ca uptake, and 86Rb efflux in diabetic Chinese hamster islets. AB - We loaded islets from normal and diabetic Chinese hamsters with 86Rb (an analogue for K+) and measured 86Rb efflux during stimulation with 20 mM D-glucose. Genetically diabetic Chinese hamsters were selected from a subline (L) known for subnormal pancreatic insulin release and excessive pancreatic glucagon release in vitro. 86Rb accumulation in 1 mM glucose was normal in the diabetic islets. Similar to the pattern of 86Rb efflux previously seen from normal rat and mouse islets, 20 mM glucose suppressed 86Rb efflux within 1-2 min, and efflux remained suppressed until return to 1 mM glucose in both normal and diabetic hamster islets. After the first 2 min of 20 mM glucose, suppression of 86Rb efflux was somewhat greater in the diabetic hamster islets than in the normals. In addition, glucose-stimulated insulin release and 45Ca uptake were significantly reduced in the diabetic islets. Therefore, in the diabetic hamster islets, there is at least no impairment in the initial suppression of 86Rb efflux by glucose. This suggests that the diabetic beta-cells recognize glucose and carry out the initial steps in the stimulus-secretion coupling sequence normally. The later, excessive suppression of 86Rb efflux may be due to impaired Ca2+-induced changes in 86Rb efflux, suggesting that defective regulation of intracellular Ca2+ activity, rather than defective regulation of K+ permeability, may lead to the impaired insulin secretion. PMID- 3552798 TI - Insulin binding and glucose transport in adipocytes in neonatal streptozocin injected rat model of diabetes mellitus. AB - The neonatal streptozocin (STZ)-injected rat (NSIR) model of diabetes mellitus resembles human non-insulin-dependent diabetes mellitus (NIDDM) with respect to abnormalities in insulin secretory responses. The suggestion that insulin deficiency leads to insulin resistance, a prominent feature of human NIDDM, led us to examine insulin binding and glucose transport in the NSIR during the development of hyperglycemia. Male Wistar rats were injected at 2 days of age with STZ (90 mg/kg i.p.) or vehicle alone. Mild insulin deficiency, reflected by minimally decreased fed plasma insulin concentrations, was apparent at 4 wk (mean +/- SE, control vs. NSIR, 2.32 +/- 0.19 vs. 1.75 +/- 0.21 ng/ml) and at 8 wk. Pancreatic insulin content was dramatically reduced in NSIR to 12 and 5% of control values at 4 and 8 wk, respectively (P less than .001). Fed plasma glucose concentrations increased in the NSIR between 4 and 5 wk and were significantly elevated at 8 wk (251 +/- 25 vs. 527 +/- 52 mg/dl, P less than .001). 125l labeled insulin binding showed a progressive increase as a function of adipocyte volume in control and NSIR. Epididymal fat pad weights and adipocyte volumes were significantly decreased in the NSIR. Thus, insulin binding did not differ when expressed per cell number but was increased in NSIR when corrected for cell size (percent specific binding X 10(2), 8.49 +/- 0.96 vs. 11.56 +/- 1.08/microliter cell vol; P less than .05, all ages combined).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552799 TI - Treatment with artificial beta-cell decreases very-low-density lipoprotein triglyceride synthesis in type I diabetes. AB - The effect of restoration of euglycemia with the artificial beta-cell (Biostator GCIIS) on triglyceride metabolism was studied in seven normolipidemic patients with type I diabetes mellitus. Very-low-density lipoprotein triglyceride (VLDL TG) transport was determined with [3H]glycerol as an endogenous precursor of VLDL TG; the resultant kinetic data were evaluated by multicompartmental analysis. Studies of triglyceride metabolism were performed in diabetic patients taking their usual dose of subcutaneous insulin (control study) and after 72 h of euglycemia with the artificial beta-cell (Biostator study). Treatment with the artificial beta-cell resulted in a decrease in mean (+/- SE) 24-h plasma glucose levels from 199 +/- 9 to 123 +/- 7 mg/dl and an increase in mean plasma free insulin levels from 12.3 +/- 1.9 to 27.6 +/- 4.2 microU/ml (P less than .05). These changes were accompanied by a decrease in mean plasma TG levels from 134 +/ 29 to 88 +/- 15 mg/dl (P less than .05). Kinetic studies demonstrated that the change in plasma triglyceride levels was primarily due to a decrease in VLDL-TG transport (i.e., synthesis), which fell from 11.7 +/- 2.5 mg X h-1 X kg-1 ideal wt during the control study to 7.5 +/- 2.0 mg X h-1 X kg-1 ideal wt during the Biostator study (P less than .05). There was no significant change in fractional catabolic rates of VLDL-TG between the two studies (0.35 +/- .05 vs. 0.38 +/- .07 h-1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552800 TI - Therapeutic modulation of growth-promoting activity in platelets from diabetics. AB - Proliferation of vascular smooth muscle is thought to be involved in the major diabetic complication atherosclerosis. We have previously reported an increase of growth-promoting activity (GA) in platelets from insulin-dependent diabetics. In this study, GA was measured in the platelet extract (PE) from eight diabetic patients who had been treated by conventional insulin therapy. Vascular smooth muscle cells from rat aorta were cultured and used as an assay system for GA. Incorporation of [3H]thymidine into DNA of cultured cells was stimulated by diabetic PE significantly more (P less than .05) than by normal PE. Diabetic PE incubated with cells for 4 days increased cell numbers significantly more (P less than .05) than normal PE. These abnormalities were corrected by long-term intensive insulin treatments (continuous subcutaneous insulin infusion and Pen infuser). The decrease of platelet extract GA appeared to correlate with the amount of insulin administered before meals as short-acting boluses, whereas the level of basal or long-acting insulin appeared to correlate with an increase of PE GA. Thus, the growth-promoting potential of platelets can be normalized by intensive insulin therapy. The relationship of insulin levels to this activity needs further evaluation. PMID- 3552801 TI - Lack of rapid enhancement of insulin action after oral glucose challenge in myotonic dystrophy. AB - Oral glucose administration to normal humans stimulates insulin release and simultaneously enhances the action of insulin by producing a rapid increase in tissue insulin sensitivity by a mechanism separate from the amount of hormone released. We determined whether insulin-resistant patients with myotonic dystrophy lose the ability to produce the normal rapid increase in tissue insulin action after oral glucose. Nine ambulatory, nonobese men with myotonic dystrophy were studied with 120-min euglycemic insulin infusions (20 mU X m-2 X min-1) given before and after glucose ingestion (4 and 5 patients received 15- and 25-g loads, respectively). Identical studies were performed in nonobese normal volunteers (16 and 13 patients received 15- and 25-g oral glucose loads, respectively). Glucose infusion rates at 20-120 min (GIR20-120) during euglycemic insulin infusions without prior glucose were 2.87 +/- 0.6 mg X kg-1 X min-1 in patients with myotonic dystrophy compared to 4.70 +/- 0.3 mg X kg-1 X min-1 in normal subjects. Euglycemic insulin infusions after glucose ingestion were begun after arterialized blood glucose values had returned to baseline. After glucose ingestion by normal subjects, GIR20-120 increased by 44.4 +/- 7.1% (P less than .0001) and by 46.8 +/- 8.6% (P less than .0002) with 15- and 25-g glucose loads, respectively. GIR20-120 in the nine patients with myotonic dystrophy showed no significant increase after glucose ingestion. These results confirmed the existence of a decrease in whole-body insulin sensitivity in myotonic dystrophy and indicated that the patients lack the normal mechanism that enhances insulin action after oral glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552802 TI - HPLC analysis of insulin degradation products from isolated hepatocytes. Effects of inhibitors suggest intracellular and extracellular pathways. AB - Isolated rat hepatocytes were incubated with A14-[125I]monoiodotyrosyl insulin for 30 min, and labeled material was extracted from the cells and incubation media. The medium and the cell extract were chromatographed on a Sephadex G-50 column, and radioactivity eluting in the position of intact insulin was concentrated and analyzed on HPLC. The HPLC analysis of the cell extract showed two major products eluting from the column at 19 and 23 min, whereas medium extracts showed one prominent product eluting at 14 min. Inclusion of chloroquine in the incubation blocked the formation of cellular products at 19 and 23 min and caused the accumulation of a product eluting at 41 min while not affecting the media products. After sulfitolysis all cellular products contained an intact A chain. Dansylcadaverine increased media products and altered the cell-extracted product pattern such that it had a major peak at 14 min, similar to media. These results suggest that two pathways for insulin degradation exist within hepatocytes. The extracellular process forms products that are essentially unchanged by chloroquine and dansylcadaverine. The intracellular process is altered by chloroquine and apparently inhibited by dansylcadaverine. PMID- 3552803 TI - Multiple aspects of insulin resistance. Comparison of glucose and intermediary metabolite response to incremental insulin infusion in IDDM subjects of short and long duration. AB - Glucose and intermediary metabolite responses during incremental insulin infusion (basal, 0.005, 0.01, and 0.05 U X kg-1 X h-1) were examined in IDDM subjects with duration of diabetes of greater than 5 yr (group D5: n = 8, duration 13.5 +/- 3.9 yr, mean +/- SD) and less than 1 yr (group D1: n = 8, duration 0.3 +/- 0.1 yr) from diagnosis. Group D5 had significantly elevated basal plasma free-insulin levels (D5 27.4 +/- 9.6, D1 15.5 +/- 9.4 mU/L; P less than .05). Nonetheless, basal blood glucose (D5 13.8 +/- 4.8, D1 7.1 +/- 1.5 mM; P less than .01), plasma nonesterified fatty acid (NEFA) (D5 1.26 +/- 0.12, D1 0.89 +/- 0.10 mM; P less than .01), blood glycerol (D5 0.12 +/- 0.05, D1 0.07 +/- 0.02 mM; P less than .05), and blood ketones (D5 1.25 +/- 0.91, D1 0.26 +/- 0.20 mM; P less than .01) were higher in group D5. During insulin infusion, group D5 had significantly elevated plasma free-insulin (P less than .05) and blood glucose (P less than .01) levels. Isotopically determined glucose turnover showed metabolic clearance rates were significantly diminished in group D5 during all insulin infusions, indicating a marked impairment of peripheral glucose metabolism. In individual subjects the relationship of blood glucose, plasma NEFA, and blood total ketones (log scale) with the simultaneously occurring plasma insulin level (log scale) was linear for each metabolite.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552804 TI - Pulsatile secretion of fuel-regulatory hormones. PMID- 3552805 TI - Variables affecting bond strength of resin-bonded bridge cements. PMID- 3552806 TI - Tensile bond strengths of Comspan to electrolytically etched metal with and without enamel bonding agent. PMID- 3552807 TI - Shear strengths of ten commercial dentin bonding agents. PMID- 3552809 TI - Radiologic and endoscopic appearance of intrabiliary rupture of hydatid liver disease. AB - Intrabiliary rupture of hydatid liver cyst was diagnosed in 6 patients presenting with obstructive jaundice. All patients underwent ultrasonography and endoscopic retrograde cholangiopancreatography prior to surgical drainage of the liver cyst. Hydatid debris were found in the common bile duct preoperatively in 3 patients, and postoperatively in an additional 3 patients. Accurate diagnosis was made in all patients based on combined duodenoscopic, cholangiographic and sonographic findings. It is concluded that the combination of ultrasonography and endoscopic retrograde cholangiopancreatography can accurately detect intrabiliary rupture of hydatid liver cyst and that both techniques should be performed early in the investigation of suspected ruptured hydatid liver cyst. PMID- 3552808 TI - Effect of endotoxin tolerance on drug hepatotoxicity: amelioration of taurolithocholate cholestasis in the perfused rat liver. AB - Induction of endotoxin tolerance may cause resistance not only to endotoxin itself but also to the hepatotoxic effects of other membrane-active agents. To further study this effect, we tested whether endotoxin tolerance could ameliorate the adverse effects of taurolithocholate (TLCA) which causes cholestasis by altering liver plasma membrane organization. Isolated perfused rat livers from endotoxin-tolerant rats had a lower basal bile flow than control livers. However, a bolus addition of TLCA at 3 X 10(-5) or 5 X 10(-5) M in the perfusate caused a marked and prolonged decrease of bile flow in controls, but only a transient and significantly less pronounced diminution of bile flow in endotoxin-tolerant livers. Likewise, TLCA caused a significantly lower alteration of hepatocyte membrane permeability, as measured by sucrose permeability studies, in endotoxin tolerant livers than in controls. Analysis of bile acid composition of bile from endotoxin-tolerant livers demonstrated that they excreted greater amounts of total bile acids, in particular TLCA and taurocholate, than controls. These results demonstrated a protective effect of endotoxin-tolerance against TLCA toxicity which may result from an altered interaction of TLCA with liver membranes and an increased clearance of TLCA. PMID- 3552810 TI - Medical manpower planning/impact analysis. PMID- 3552812 TI - Skin nerve sympathetic activity during insulin-induced hypoglycaemia. AB - Microelectrode recordings of skin nerve sympathetic activity, consisting of sudomotor and vasoconstrictor signals, were performed in the peroneal nerve in seven healthy subjects during insulin-induced hypoglycaemia. The nerve activity was recorded at rest and for 90 min after intravenous injection of 0.15 IU insulin/kg body weight. The net outflow of skin nerve sympathetic activity was increased during hypoglycaemia, with the exception of one subject who exhibited a high initial level of activity. In all subjects a change of the temporal pattern of the outflow was found, suggesting a shift from mixed (sudomotor and vasoconstrictor) to pure sudomotor activity. This change coincided with a sensation of warmth, sweating and varying degrees of cutaneous vasodilatation, and was followed by a fall in body temperature. It is concluded that hypoglycaemia has a differential effect on sympathetic activity in skin nerves, with a strong increase of sudomotor impulses and simultaneous inhibition of vasoconstrictor signals. Thus, neurally mediated thermoregulatory adjustment contributes to heat loss during hypoglycaemia. PMID- 3552813 TI - Distribution of endogenous albumin in the glomerular wall of streptozotocin induced diabetic rats as revealed by high-resolution immunocytochemistry. AB - Endogenous albumin was revealed with high resolution in the glomerular wall of renal tissue from normoglycaemic and long-term streptozotocin-induced hyperglycaemic rats applying the protein A-gold immunocytochemical approach. In tissues from normal animals, albumin antigenic sites were detected at the level of the endothelial cell basal plasma membrane and in the subendothelial side of the lamina densa of the glomerular basal laminae. The epithelial side of the laminae was weakly labelled, while the urinary space was devoid of labelling. In the podocytes, labelling for albumin was confined to few lysosomal structures. In diabetic animals, concomitant with hyperglycaemy, low insulin levels, significant glycosuria, proteinuria and albuminuria, the glomerular basal laminae displayed the characteristic increase in thickness found in diabetic microangiopathy (404 +/- 45 nm versus 190 +/- 10 nm). Major basal laminae deposits were also found in the mesangial regions. Albumin antigenic sites were detected throughout the entire thickness of the glomerular basal laminae without any preferential accumulation at any particular site. Labelling was also found over flocculent material present in the urinary space. Numerous densely labelled lysosomal structures were present in the podocytes. The basal laminae deposits in the mesangial regions were labelled for albumin. Morphometrical evaluations made on the distribution of the labelling confirmed the qualitative observations. Two sites for albumin retention were revealed in the glomerular wall of the normal animal: the endothelial cell basal membrane (less than 10 nm) and the subendothelial side of the lamina densa (50 nm).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552811 TI - The physiological basis of insulin treatment--clinical aspects. PMID- 3552815 TI - High-performance liquid chromatography (HPLC): a rapid, flexible and sensitive method for separating islet proinsulin and insulin. AB - Evaluating islet function in vitro involves studying both insulin biosynthesis and release. For the former, it is necessary to resolve insulin from its precursor, proinsulin. This has been achieved in the past by various procedures, each of which suffers from major drawbacks in terms of resolution and the time involved. We show here that reversed phase high-performance liquid chromatography (HPLC) outperforms previous methods for separating proinsulin from insulin in islet extracts without any prepurification or concentration steps. This HPLC method is rapid (90 min for a complete cycle, including washing the column) and reproducible, while allowing for unambiguous separation and quantification of proinsulin and insulin. PMID- 3552814 TI - Polyamine-enhanced casein kinase II in mouse pancreatic islets. AB - The occurrence of polyamine-stimulated protein kinase (casein kinase II) in cytosol of mouse pancreatic islets was investigated. Islet protein phosphorylation was enhanced by spermidine, spermine, lysine-rich histone and polylysine; the major endogenous substrates in the cytosol were three proteins of Mr 50,000, 55,000 and 100,000. Cadaverine and putrescine were without effects. A Mr 100,000 protein is a major substrate for Ca2+-calmodulin-dependent protein kinase, and Mr 50,000 and 55,000 proteins are substrates for cyclic adenosine 3',5'-cyclic monophosphate (AMP) dependent protein kinase in mouse islets. However, neither cyclic-AMP-dependent protein kinase inhibitor nor trifluoperazine inhibited polyamine-enhanced protein phosphorylation. Both basal and polyamine-enhanced protein phosphorylation patterns were identical when either [gamma-32P] adenosine 5'-triphosphate (ATP) or [gamma-32P] guanosine 5' triphosphate (GTP) was used as phosphate donors, indicative of the presence of a polyamine-stimulated casein kinase II in pancreatic islets. It is suggested that polyamines and polyamine-enhanced casein kinase II activity may have an important role in regulation of protein phosphorylation in pancreatic islets. PMID- 3552816 TI - Non-linearity of insulin kinetics. PMID- 3552817 TI - Basal and 24-h C-peptide and insulin secretion rate in normal man. AB - An understanding of the metabolic abnormalities rising from inappropriate insulin delivery in diabetic patients demands a knowledge of 24-h and basal insulin secretion rates in normal man. We have used biosynthetic human C-peptide to determine its kinetic parameters in 10 normal subjects and applied these to measurements of plasma concentrations in the same subjects to determine pancreatic secretion rate. Metabolic clearance rate measured by stepped primed infusion of biosynthetic human C-peptide at rates of 10, 19 and 26 nmol/h was 4.7 +/- 0.7 (+/- SD) ml X kg-1 X min-1, and was independent of infusion rate. Fractional clearance (T1/2, 26 +/- 3 min) and distribution volume (0.178 +/- 0.039 l/kg) were calculated from the decline in concentration after cessation of the highest rate infusion. Basal insulin secretion calculated from the C-peptide metabolic clearance rate and plasma concentrations for the period 02.00 to 07.00 hours was 1.3 +/- 0.4 U/h. Over 24 h total insulin secretion on a standard high carbohydrate diet was 63 +/- 15 U, calculated from the area under the C-peptide concentration curve. Basal insulin secretion, therefore, accounted for 50 +/- 8% of total insulin secretion. Although only 5.6 +/- 1.1% of C-peptide was detected in 24-h urine collections, urinary C-peptide excretion was significantly related to 24-h C-peptide secretion (r = 0.74, p less than 0.02). PMID- 3552818 TI - Possible role of cell surface insulin degrading enzyme in cultured human lymphocytes. AB - The kinetic changes of insulin receptors and cell surface insulin degrading enzyme were examined in Bri-7 cultured human lymphocytes after preincubation with or without insulin. The concentration of cell surface insulin degrading enzyme was determined by immunoenzymatic labeling method using a polyclonal antiserum to insulin degrading enzyme. In Bri-7 cells preincubated with 10(-10) to 10(-5) mol/l insulin for 18 h, the surface insulin receptors and insulin degrading enzyme decreased progressively as a function of the concentration of insulin in the preincubation medium. The surface insulin receptors and insulin degrading enzyme of cells preincubated with 10(-6) mol/l insulin were decreased to 25 and 35% of the control respectively. In Bri-7 cells preincubated with 10(-6) mol/l insulin for 30 min to 18 h, the loss of surface insulin degrading enzyme was slightly slower than that of the receptors; however, the curves were essentially parallel to each other. Thus, the treatment of Bri-7 cells with insulin caused down-regulation of insulin receptors in a dose- and time-dependent manner. Cell surface insulin degrading enzyme also decreased simultaneously. A combination of several insulin degradation assays (trichloroacetic acid precipitation, gel filtration and receptor rebinding) demonstrated that cell surface bound insulin remained intact, and that the degradation in Bri-7 cells seemed to be a limiting proteolysis of insulin. Furthermore, by the receptor rebinding method insulin degrading activity in cells after preincubation with 10(-6) mol/l insulin (19.6 +/- 4.6%) was decreased, although not significantly, as compared with cells after preincubation without insulin (24.6 +/- 4.8%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552819 TI - Effect of a hypoglycaemic agent M&B 39890A on glucagon secretion in isolated rat islets of Langerhans. AB - Administration of the compound M&B 39890A lowered serum glucose levels significantly (p less than 0.001) in genetically obese mice, while no effect on serum insulin levels was observed. In in vitro experiments with isolated rat islets of Langerhans M&B 39890A inhibited arginine-stimulated glucagon release at all concentrations tested (0.5, 5.0 and 50 mumol/l). Insulin secretion was not inhibited by M&B 39890A (0.5 and 5.0 mumol/l), but was slightly decreased at 50 mumol/l. M&B 39890A (5 mumol/l) also inhibited glucagon secretion in vitro in the presence of 2 mmol/l, 6 mmol/l and 20 mmol/l glucose, while exerting no effect on insulin secretion. These results suggest that the hypoglycaemic action of M&B 39890A may be due to its direct and selective effect on glucagon secretion; this appears to operate by a mechanism different to that of glucose. PMID- 3552820 TI - Near-normoglycaemia and microvascular complications. PMID- 3552821 TI - Insulin and plasma magnesium in normal and obese subjects. PMID- 3552822 TI - The haemochromatotic human pancreas: a quantitative immunohistochemical and ultrastructural study. AB - Insulin, glucagon, somatostatin and pancreatic polypeptide cells were quantified after immunoperoxidase staining in sections of pancreases obtained from nine control subjects and seven diabetic patients with primary or secondary iron overload. One was normoglycaemic, two had glucose intolerance and four presented insulin-requiring diabetes. The whole pancreas was studied, taking into account the heterogeneous distribution of the endocrine cells. In the diabetic patients, the weight of the pancreas tended to be lower. Iron overload predominated in the exocrine tissue, whereas in islets iron concentration was quite variable from case to case. At the Haemalun-Eosine staining the histological appearance of the islets was normal, their shape and size being unchanged; amyloid deposits were absent, as were atrophic islets. Immunoperoxidase staining revealed a severe reduction in the number of immunoreactive B cells in the four diabetic patients. The mass of immunoreactive B cells was calculated from their volume density and from the weight of each lobe of the pancreas. It averaged 950 mg in control subjects, 1580 mg in the normoglycaemic patient, 1010 mg in patients with glucose intolerance and 180 mg in insulin-requiring diabetic patients. The electron microscopic examination, performed in four cases, revealed that the iron deposits were restricted to B cells and associated with progressive loss of their endocrine granules. The study shows that the pancreatic islet abnormalities in iron overloaded diabetic patients are completely different from those of Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic patients. This constitutes a further argument for a specific role of iron in the pathogeny of diabetes in haemochromatotic patients. PMID- 3552823 TI - Skeletal growth of fetuses from streptozotocin diabetic rat mothers: in vivo and in vitro studies. AB - For largely unknown reasons severe or moderate diabetes of pregnant rats results in pronounced fetal growth retardation. Therefore, some skeletal growth parameters of fetal rats from streptozotocin diabetic mothers were studied in vivo and in vitro. Two days post conception rats were intravenously injected with 65 mg/kg body weight streptozotocin. On day 20 post conception 8 normal and 8 diabetic rat mothers received 5 mu Ci 3-H thymidine intraperitoneally. One day later the experiments were terminated. Fetal body weight and body length were significantly (p less than 0.05-0.001) reduced in the hyperglycaemic rats compared to normal rats, as was the thymidine incorporation into rib cartilage (p less than 0.02). In the cell culture colony formation from isolated chondrocytes of normal and hyperglycaemic fetuses was determined. Proinsulin, insulin (62.5 250 ng/ml), insulin-like growth factor I and II (6.25-25 ng/ml) significantly (p less than 0.05-0.001) augmented colony formation in a dose-dependent manner, with the somatomedins being 8 times more effective than proinsulin or insulin. Isolated chondrocytes from hyperglycaemic compared to normal fetuses formed significantly (p less than 0.05-0.001) fewer colonies in the basal state and in response to all 4 hormones. The results confirm the growth retardation of fetuses from diabetic rat mothers. A reduced responsiveness of chondrocytes from hyperglycaemic fetuses to various growth factors could be demonstrated as compared to cells from normal fetuses. PMID- 3552824 TI - Expression of class II major histocompatibility complex antigens on pancreatic B cells in the NOD mouse. AB - To elucidate the role of class II major histocompatibility complex antigen expression on pancreatic B cells in the development of diabetes in the non-obese diabetic (NOD) mouse, indirect immunofluorescence was employed for I-A staining on Bouin-fixed pancreas sections of NOD mice (I-A of which was reported as d), B10.GD (I-A, d), BALB/c (I-A, d) and C3H/He (I-A, k). I-A positive islets were observed in all NOD mice examined. Positive reaction was detected in islets both with and without lymphocytic infiltrations. Double staining with anti-insulin, glucagon, somatostatin or pancreatic polypeptide antibodies revealed that I-A positive cells corresponded with insulin cells, while other types of pancreatic islet cells were virtually negative for I-A. Weaker staining was seen in islets of B10.GD and, to a lesser extent, in those of BALB/c mice. C3H/He mouse islet cells showed no I-A expression. These results demonstrated the expression of I-A antigens on pancreatic B cells in the NOD mouse. PMID- 3552825 TI - Ultrastructural localization of gamma amino butyric acid immunoreactivity in B cells of the rat pancreas. AB - The purpose of this study was to determine the ultrastructural localization of gamma amino butyric acid (GABA) within the B cell of isolated rat islets, particularly with respect to the B cell secretion granules. GABA immunoreactivity was localized ultrastructurally, with colloidal gold, in the B cells and absent in the A cells and D cells. Quantitative analysis of the colloidal gold particle distribution in the B cell revealed 29.5 +/- 5.2 gold particles/micron 2 in the nuclei, 29.3 +/- -6.9 gold particles/micron 2 in the mitochondria and 4.9 +/- 1.0 gold particles/micron 2 in the secretion granules. Particle density in the remainder of the cytoplasm was 41.9 +/- 4.1 particles/micron 2. The paucity of gamma amino butyric acid in the B cell secretion granules differs from observations on gamma amino butyric acidergic neurons, where there is an accumulation of gamma amino butyric acid within the neurosecretory vesicles. These findings indicate that if gamma amino butyric acid is released from the islet, then it is by a nongranular mechanism. In addition, the results are compatible with the hypotheses that gamma amino butyric acid within the B cell functions in the regulation of insulin biosynthesis, and/or functions as an alternative energy source for the B cell through the gamma amino butyric acid shunt. PMID- 3552826 TI - On the way to the automated (blood) glucose regulation in diabetes: the dark past, the grey present and the rosy future. XII Congress of the International Diabetes Federation, Madrid, 22-28 September 1985. AB - The development of the artificial pancreas represents an important step forward in modern diabetology. The practical and theoretical findings obtained by its application to Type 1 (insulin-dependent) diabetic patients has given new insights into modes of insulin secretion, pathophysiology of diabetes mellitus, and new forms of treatment, i.e. the development of portable insulin pumps and intensified conventional insulin therapy. All of these therapies provided better results than conventional insulin administration. However, there is no doubt that the restoration of normoglycaemia in a real sense is obtainable only by an implantable artificial pancreas or pancreas transplantation. The development of the implantable artificial pancreas, on the other hand, is dependent upon the development of a reliably working permanently implantable glucose sensor. The first attempts in that direction have opened new vistas as to the differences between blood and interstitial tissue glucose measurements, displaying different modes of regulation under normal and pathologic conditions. A number of barriers have to be overcome until the final goal has been attained: to obtain, by automated blood glucose control, narrow glycaemic fluctuations of the normal subject, and to prevent, hopefully, relentless diabetic complications. PMID- 3552827 TI - Diabetes and glucose tolerance in New South Wales coastal Aborigines: possible effects of non-Aboriginal genetic admixture. AB - A survey of adults living in two predominantly Aboriginal communities in eastern New South Wales revealed a crude prevalence of clinically diagnosed diabetes of 6.7% in Aboriginals. 1.4% of Aboriginal subjects investigated with 75 g oral glucose tolerance tests were found to have previously undiagnosed diabetes, and 2.8% had impaired glucose tolerance. 53% of women and 27% of men were obese as judged by body mass index. The age-sex standardised prevalence of diabetes in Aboriginals (previously diagnosed and newly detected) was 7.8%, which is substantially lower than the 15.6% prevalence found in the Aboriginal population of Bourke (central New South Wales). HLA antigen studies on these same individuals suggest approximately 60% genetic admixture from non-Aboriginal sources. Insulin response to oral glucose and mean body mass index were both related to non-Aboriginal genetic admixture with higher values in Aboriginal subjects than in their non-Aboriginal neighbours, and highest values were found in those with no detectable non-Aboriginal HLA haplotypes. The extent of genetic admixture in these communities may partly explain the lower prevalence of diabetes when compared with that found in the Aboriginal population of Bourke. PMID- 3552830 TI - Differentiation properties of renal collecting duct cells in culture. AB - In the present study, we were particularly interested in distinguishing specific patterns of structural and functional proteins in the collecting duct system of neonatal and adult kidneys and in cultured renal collecting duct epithelia in order to ascertain the degree of differentiation in the cultures. We studied the distribution of specific renal collecting duct cell markers using morphological, immunohistochemical and biochemical procedures. Cultured renal collecting duct epithelium undergoes maturation in vitro. Examples of morphological differentiation include the appearance of cilia and microvilli at the apical cell pole, and a basement membrane at the basal aspect of the epithelium. Tight junctions with five to seven strands separate the wide intercellular spaces from the apical cell surface. Physiological maturation from a 'leaky' to a 'tight' epithelium is evident from the acquisition of the alpha-subunit of Na/K-ATPase and the development of a high transepithelial potential difference and resistance. Biochemical differentiation is revealed by the expression of specific proteins. The simple-epithelium cytokeratins, PKK1 and PKK2, which are typical intracellular-matrix proteins of mature collecting duct epithelium, maintain the same distribution in cell culture as in neonatal and adult kidneys. An indicator of maturation in vitro is the expression of the collecting duct-specific proteins, PCD2 and PCD3. Newly developed monoclonal antibodies against these antigens reacted similarly with cultured cells and cells of the mature collecting duct system, but they did not label the embryonic ampullae in the cortex of neonatal rabbit kidneys. In contrast, a third collecting duct-specific protein, PCD1, is not expressed by the cultured cells, which indicates the retention of an embryonic characteristic in vitro. Embryonic collecting duct ampullae of the neonatal kidney in situ contain laminin during their development. Laminin is, however, absent in cultured collecting duct epithelium. Biochemical stimulation of the adenylate cyclase system by arginine vasopressin resulted in a twofold stimulation of the enzyme activity. This degree of stimulation is similar to that found in maturing kidneys of neonatal rabbits and indicates another embryonic feature of the cultures. PMID- 3552828 TI - Insulin Wakayama: familial mutant insulin syndrome in Japan. AB - We describe a family from Japan displaying the mutant insulin syndrome with hyperinsulinaemia and an increased insulin: C-peptide molar ratio. Serum insulin isolated from several family members showed reduced in vitro biological activity, and analysis by high performance liquid chromatography revealed a peak co-eluting with human insulin and a second species of increased hydrophobicity co-migrating with the previously reported Insulin Wakayama. The insulin genes from the propositus were cloned and sequenced, revealing one normal allele; the second allele, encoding a leucine for valine amino acid substitution at position 3 of the insulin A chain, was similar to that previously described for Insulin Wakayama. Synthesized [LeuA3] insulin showed 0.14% of receptor binding activity on rat adipocytes and a 10-fold prolonged half-life in a somatostatin-infused dog compared with human insulin. The finding of the same mutant gene in two unrelated Japanese families suggests that Insulin Wakayama may be discovered in additional Japanese families with hyperinsulinaemia and/or diabetes. PMID- 3552829 TI - Identification and analysis of the regulation of a prestalk cell-surface antigen of Dictyostelium discoideum. AB - The properties of two differentiation antigens, rsa 4.2 and rsa 3.1, were examined. Both appear on the cell surface early in differentiation, but they differ with respect to their cell-type specificity. rsa 4.2 appears 1-2 h after differentiation has begun and is present on all cells during all stages of differentiation. In contrast, rsa 3.1 appears after 1-2 h on all aggregating amebae and later becomes restricted to prestalk cells. The pattern of regulation of rsa 3.1 indicates that this prestalk antigen appears on all cells early in differentiation but disappears in cells that differentiate along the prespore pathway. As a result, only cells in the anterior of migrating slugs carry this antigen. Predictions of two competing models of Dictyostelium pattern formation, i.e., position-dependent differentiation and random, position-independent differentiation, were tested by flow cytometry and immunochemical staining of sections of cells at the mound and mound-with-tip stages. Our results do not rule out either model, although they are incompatible with the simplest interpretation of the model for position-independent differentiation. The results clearly indicate that cells that ultimately differentiate along the spore pathway pass through an earlier cell state that includes the presence of a prestalk cell surface antigen identified as rsa 3.1. PMID- 3552831 TI - Management of the edentulous elderly patient. PMID- 3552832 TI - What doctors tell about themselves to patients: implications for intimacy and reciprocity in the relationship. PMID- 3552833 TI - Contemporary scientific principles and family medicine. AB - Twentieth century developments in the sciences of physics, chemistry, and biology have led to new principles and paradigms with which the social, philosophical, and clinical tenets of family medicine are fully consistent. Familiarity with these new scientific models can give not only validation for the concepts inherent in family medicine but also a rigorous framework to guide family medicine research in a direction of the richest intellectual integrity. PMID- 3552834 TI - Self-care and primary care of dyspepsia: a review. AB - Digestive disorders are common in the community and a frequent reason for consultation in primary care, yet there is considerable uncertainty about their prevalence, natural history and management. This paper reviews knowledge of the epidemiology of dyspepsia and acid-peptic disease and goes on to examine issues in self-care and primary care of these conditions. PMID- 3552835 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: General intra-hospital results and a 1-year follow-up]. AB - The paper summarizes the main and final results of the G.I.S.S.I. trial, with respect to the in-hospital phase and to the one year follow-up, which had as a primary end-point the assessment of cumulative and post-hospital mortality. Data on the hospital phase have been already reported and do not need any further summary. The results of the one year follow-up document that the benefit produced by SK in the hospital period remains substantially unchanged at least up to 12 months. The differences in mortality in favour of SK vs C are highly statistically significant for the whole population and specifically for the subgroups 0-3, 3-6 hrs from onset of diagnostic pain. The amplitude of the benefit shown for the subgroups treated within 1 hr is further increased during the post-hospital phase. The opposite phenomenon is documented for the subgroup with ST depression, where a disadvantage of SK treatment appears to be confirmed and strengthened at the end of the follow-up. The G.I.S.S.I. results document conclusively that an acute thrombolytic treatment with SK in AMI patients is effective in reducing mortality not only over the short, but also over the long period. This beneficial effect is specifically evident in the population treated within 6 hours from AMI occurrence; it appears particularly dramatic in the subgroup treated within 1 hr from diagnostic pain onset. PMID- 3552836 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Concomitant and successive pharmacological treatments]. AB - The profile of the treatments received by patients admitted to CCU has been derived from the data collected on cardiovascular drugs prescription through the ad hoc forms. The perfectly balanced distribution of the treatments in the two groups, SK and C, has allowed the analysis of the data with respect to their descriptive content and their relationship to relevant cardiac events and mortality. The analysis has been concentrated specifically on anticoagulant and antiplatelet therapies, which do not appear to influence the course of AMI neither with respect to mortality nor to occurrence of re-infarction. PMID- 3552838 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Evaluation of the enzymatic curve of creatine kinase]. AB - Within the multicentre trial of the Italian Group for the Study of Streptokinase in Infarct (G.I.S.S.I.), a particular study was planned for the analysis of plasma creatine kinase curves (CK). Serial measurements of total plasma CK from 11,806 pts (5.905 treated with Streptokinase (SK) and 5,901 control pts (C)) were evaluated by the compartment method (Fig. 7), which is commonly used in pharmacological studies. By this method, the plasma enzyme curve is interpreted on the basis of the following kinetic parameters: the fractional rate of input (Ki) and of disappearance (Kd) of enzyme into and from the blood; the plasma cumulative CK activity (Dp); the time interval between the onset of symptoms and the beginning of the ascending CK curve (To); the time from To to the peak CK (Tp). The Dp/Ki ratio was employed for the estimate of myocardial infarct size. From the available data, acceptable CK curves could be derived in 7,632 cases (3,568 treated with SK, 4,064 control pts.). Compared with control group (Fig. 1- Tab. I) the SK treated pts presented increased Ki and Kd values and reduced To, (p greater than 0.001), Dp/Ki (p greater than 0.05). The earlier SK treatment was started, the higher difference (Fig. 2) was observed between the two groups (SK and C). No significant difference was found between the two groups (SK and C) with regard to sex (Fig. 3), age, history of previous myocardial infarct, re infarction, early post-infarction angina. Statistically significant similar differences of the above parameters between SK and C groups, were also found when various infarct locations were considered, with the only exception of not-Q infarct (Fig. 4). In the cases complicated by pericarditis (Tab. II, Fig. 5), independently of treatment, reduced reperfusion related indexes and increased Dp/Ki ratio were observed. Severe left ventricular impairment (Killip class 4) tends to reduce (Tab. III) the differences in enzyme parameters between the two groups (SK and C). The patients who died (18 hours after the onset of symptoms) exhibited as the only significant difference compared to survivors the infarct size related CK parameters (Dp/Ki), independently from the treatment. The mathematical model used in this study proved to be easily feasible and useful for the evaluation of the effect of the treatment in acute myocardial infarct.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3552837 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Analysis of intrahospital causes of death]. AB - Aim of the present study was to analyse the causes of death of the patients admitted to the G.I.S.S.I. Study. Clinical records of the 1386 in-hospital deaths were centrally analysed by two independent clinicians, who were not aware of the performed treatment and based their classification criteria upon clinical and anatomic data. Death causes were classified as follows: cardiac failure, electromechanical dissociation, cardiac rupture, sudden death and extracardiac deaths. Cardiac failure was the most frequent cause of mortality, as 725 pts out of the 1386 (52%) died from this complication in the whole group. 392 pts were part of the control group (6.7%), while 333 had received SK (5.6%): the difference was significant. No difference was observed between treated patients and control group for what concerns the remaining causes of death. Mortality from cardiac failure was strikingly reduced in a few groups of patients: females (from 11.4 down to 8.7%); age less than 65 years (from 4.1 down to 3.2%); early treated pts (up to 3 hrs): from 6.3 down to 5.2%; anterior location of AMI (9.2 down to 7.4%); first AMI episode (from 5.9 down to 4.7%). Such a reduction was remarkable for patients who remained alive after the 7th day from onset of symptoms: cardiac failure was the cause of death in 65 out of 5385 treated patients, and in 100 out of 5333 control group patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552839 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Study of electrocardiographic changes]. AB - The twofold purpose of the ECG sub-group study of G.I.S.S.I. (Gruppo Italiano per lo Studio della Streptokinasi nell'Infarto miocardico) is to evaluate whether exist different ECG evolution in pts with AMI treated with streptokinase (SK YES) and/or with coronary reperfusion (early CK peak) with respect to pts non treated with streptokinase (SK NO) and/or without coronary reperfusion (late CK peak) and to establish whether the ECG is useful to recognize the patients in which reperfusion occurs. Among 365 pts randomized for G.I.S.S.I., 209 pts with first myocardial infarction, admitted within 6 hours from the onset of pain, alive for at least 24 hours, were included. 98 were SK YES and 111 SK NO: 48 cases (group A) had the CK peak before 15th hour; 59 cases (group B) had the CK peak between 15th and 21th hour: 102 cases (group C) had the CK peak after 21th hour. In all the patients ECG was analyzed on admission and thereafter at 3rd, 6th, 9th, 12th, 24th hours and on 2nd, 3rd, 7th and 14th days. RESULTS--Anterior myocardial infarction--SK YES pts had in respected to SK NO pts a significantly lower sum of ST elevation on anterior leads (sigma ST increases V1-V6) at all times after admission starting from 6th hour. A similar behaviour was observed in groups A and B in respect to group C. SK YES pts when compared to SK NO pts had an earlier loss of the sum of R wave in anterior leads (sigma RV1-V6), although the difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552840 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Changes in surface cardiac potentials. Study with chest electromaps]. AB - The electrocardiographic changes during and after the thrombolytic treatment with streptokinase (SK) were assessed by means of body surface potential mapping. The aim of the study was to identify potential patterns suggesting reperfusion and revealing possible short-term effects on the infarct size of the recanalization. We studied 23 patients enrolled in the G.I.S.S.I. trial; 11 had an anterior and 12 had an inferior myocardial infarction; 14 were treated with SK and 9 were controls. Body surface maps were recorded from 105 lead points located on the anterior thoracic surface using an automated instrument. The maps were obtained immediately before the SK infusion (or at the time of randomization in the control patients), 30, 60, 120 minutes thereafter and then 24 hours and 7 days after the onset of the infarct symptoms. In each patient the surface potential distribution at 100 msec after the end of QRS was considered and the sum of all the positive potential values was calculated (sigma ST). In addition, the potential time integrals relating to two intervals of the cardiac cycle (first 100 msec of ST and first 40 msec of QRS) were calculated at each lead point and transferred to diagrams representing the chest surface explored (isointegral map). With respect to Q-40 maps, deviation index maps were calculated as follows: the mean Q-40 map (obtained from 30 normal subjects) was subtracted from the map of each patient; the value obtained at each lead point was then divided by the standard deviation of the normal values for that point. An area where the integral values were at least 2 SD lower than normal was considered a reliable index of infarct. By considering as index of reperfusion an early peak of CPK (less than 12 hours from the onset of infarct symptoms), we divided the patients into 2 subsets: reperfused (R) and not reperfused (NR). The mean values of sigma ST at 100 msec progressively decreased in all patients from the baseline to the subsequent recordings in both control and SK groups, without significant differences; nevertheless, the highest percent reductions of sigma ST were observed only in some R patients. The maximum on the ST-100 isointegral maps also showed a similar behaviour.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552841 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Study of arrhythmias]. AB - The purpose of the trial "Arrhythmias" was to evaluate all the arrhythmic events in the control and treated patients by considering, in the latter, the chronological relation to the infusion of Streptokinase (SK). This was done in order to determine if the presence of arrhythmias was significantly greater in the treated patients, and if these arrhythmias could be considered as possible markers of reperfusion. 10 Centres participated by recording and evaluating all the hyperkinetic and hypokinetic arrhythmic events in the treated and control patients for an observation period of 2 hours including infusion of SK. The recording method used was computerised UCIC or Holter recording. The centre for data handling carried out storage and statistical elaboration of the data. The Lown and the Italian Modified Lown classifications were used. When appropriate, the statistical significance of observed differences was assessed with chi-square and t tests. 433 patients, 227 treated and 206 controls, were randomised. No statistically significant differences were observed between the two groups as regards the quantity and quality of the hyperkinetic or hypokinetic arrhythmias. On the contrary, on dividing the patients into two groups in accordance with the incidence of Hyperkinetic Ventricular Arrhythmias (HVA), more serious HVA were observed in the controls both in absolute value and in relation to those with better functional class, younger patients (less than 65 yrs.) and with multiple site infarct. The results of the search for arrhythmias which can be markers of reperfusion, show that the Slow Ventricular Tachycardia is the only arrhythmia which can be used as such. PMID- 3552842 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Echocardiographic study]. AB - Seventeen of the centres participating to the G.I.S.S.I. trial performed also, before discharge from the Hospital, an echocardiographic examination of patients (pts) included in the study. 561 pts were included, 280 assigned to the streptokinase (SK) treatment, and 281 to the control (CT) group. The echocardiographic asynergic area score index was lower in the SK pts than in the CT group (p less than 0.01). The difference was more evident in pts treated within 6 hours from the onset of symptoms (p less than 0.005), in pts without previous infarct (p less than 0.005), and in pts aged over 65 (p less than 0.005). The end diastolic (EDV) and the end-systolic (ESV) volumes were lower in SK pts (p less than 0.01 and p less than 0.025 respectively) than in the CT group; the ejection fraction (EF) did not differ. The reduction of EDV and ESV was more evident in pts treated within 6 hours, in pts without previous infarct, in pts aged over 65, and in anterior infarcts. At the 6-month follow-up examination, in SK pts the asynergic area score index, the EDV, the ESV and the EF were unmodified; in CT pts, on the contrary, the EDV and the ESV were significantly increased (p less than 0.05 and p less than 0.025 respectively). PMID- 3552844 TI - [Thrombolytic therapy in myocardial infarct and its assumptions. Experiences of the Italian Group for the Study of Streptokinase in Myocardial Infarct]. PMID- 3552843 TI - [The Italian Group for the Study of Streptokinase in Myocardial Infarct: Coronarographic and ventriculographic study]. AB - The effects of intravenous thrombolytic treatment on the reperfusion of infarct related coronary artery and left ventricular function were assessed in 251 pts. with first episode of myocardial infarction, enrolled in the G.I.S.S.I. trial, in which coronary angiography and left ventriculography have been performed within the second and third week from the onset of symptoms. A total of 251 pts. were randomized in two groups--133 treated with streptokinase (SK) and 118 controls. Among those treated with SK, in 71 (57.9%) the treatment was started within 3 hours and in 56 (42.1%) after 3 hours from the onset of symptoms. The infarct related vessel was occluded in 43 (32.3%) patients treated and in 60 (50.9%) controls (p less than 0.01). No significant difference was found in the left ventricular ejection fraction among the treated patients and controls while a significant difference resulted in the percentage of patients who had left ventricular ejection fraction greater than or equal to 50% in the group of patients with SK within 3 hours in comparison to controls. Left ventricular ejection fraction remained normal without any correlation with the type and time of the treatment, if the infarct related vessel resulted open at the coronary angiography. The study of the regional wall motion of left ventricle did not show any significant difference neither in the infarct size nor in the type and the time of treatment. In conclusion, the thrombolitic treatment with SK in acute myocardial infarction using the protocol adopted in the G.I.S.S.I. trial, obtains the reopening of infarct related vessel in an high percentage of patients; this event helps in great measure to conserve left ventricular function, especially in patients with anterior myocardial infarction if the treatment was started within the first 3 hours from the onset of symptoms. PMID- 3552845 TI - [Comparative effectiveness of ranitidine (150 mg X 2) and cimetidine (400 mg x 2) in the treatment of acute duodenal ulcer. A French multicenter controlled clinical trial]. AB - In a single-blind multicenter trial, 444 patients with duodenal ulcer (DU) proven by endoscopy were randomly assigned to treatment with either ranitidine, 150 mg, or cimetidine, 400 mg, morning and evening. Clinical assessments were carried out at 2 and 4 weeks and endoscopy at 4 weeks. The patients in the 2 groups were comparable. Cumulative healing rates at 4 weeks were 78.3 p. 100 in the ranitidine group (n = 226) and 65.6 p. 100 in the cimetidine group (n = 218) (p less than 0.003). Pain at the start was of similar severity in both groups, and disappeared at the same rate under ranitidine or cimetidine: 64 p. 100 patients were painless at 1 week, 80 p. 100 at 2 weeks and 88 p. 100 at 4 weeks. Thirty eight patients complained of mild side effects: 22 on ranitidine (2 trial withdrawals) and 16 on cimetidine (1 trial withdrawal). Multifactorial analysis (logistic model) revealed that linear ulcers had a lower healing probability than round ulcers (p less than 0.002) whatever the treatment group (cimetidine: 47 p. 100 vs 68 p. 100, ranitidine 57 p. 100 vs 80 p. 100 respectively). Smoking habits (p less than 0.057) and age less than 40 years (p = 0.056) did not significantly influence healing rates, although smokers and younger patients under cimetidine had the lowest healing rate. Thus, at the dosage used in our trial, ranitidine is more efficient for healing DU at 4 weeks than cimetidine but not for pain relief.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552846 TI - [Duodenogastric reflux. Pharmacologic bases of medical treatment]. PMID- 3552848 TI - IgA1 & IgA2 distribution in the intestine. AB - The distribution of IgA1- and IgA2-containing cells was studied in 27 normal specimens taken from 3 parts of the intestine: the upper jejunum (8), the terminal ileum (5), and the large bowel (14). IgA1- and IgA2-containing cells were identified by an immunoperoxidase staining using mouse anti-IgA1 or IgA2 monoclonal antibody. The sum of IgA1-containing cells (IgA1+) and IgA2-containing cells (IgA2+) was greatest in the large bowel and least in the terminal ileum. IgA1+ were most frequent in the jejunum and least in the terminal ileum while IgA2+ were most frequent in the large bowel and least in the jejunum (p less than 0.005). The ratio of IgA1+/IgA2+ was 1.63 +/- 0.41 in the jejunum which was significantly higher than 0.65 +/- 0.46 in the terminal ileum (p less than 0.05) and 0.63 +/- 0.2 in the large bowel (p less than 0.001). These results lead to the new recognition that there is a shift in preponderance of IgA subclasses in the intestine, namely IgA1+ cells predominate in the jejunum and IgA2+ cells predominate in the intestine distal to the terminal ileum. PMID- 3552847 TI - Definite spontaneous cell-mediated cytotoxicity and HNK-1 cells in the human large intestine. AB - Spontaneous cell-mediated cytotoxicity (SCMC) and the marker of natural killer (NK) cells mediating SCMC of the human large intestine were studied. Lamina proprial lymphoid cells (LPL) were isolated by sequential dithiothreitol-EDTA collagenase treatment of the gut specimen. SCMC was measured by the chromium release method. Target cells included P4788 in monolayer, a cell line derived from colon cancer, Chang cells in monolayer, and K562 in suspension. Target cells in monolayer including colon cancer cell line were chosen because they were thought to be more appropriate to assess SCMC for lymphoid cells in the solid organ. While lower compared to cytotoxicities (CT) by peripheral blood lymphoid cells (PBL), define CT were observed in LPL against all three targets. NK cells marker was studied both on LPL by an indirect fluorescent antibody method and on the gut tissue by indirect immunoperoxidase staining using anti HNK-1 monoclonal antibody which defines virtually all NK cells. HNK-1 positive (HNK-1 +) cells were identified in both methods. HNK-1 + cells were observed in the epithelium, lamina propria, and lymph follicle with or without germinal centers. These results clearly demonstrated the presence of SCMC and HNK-1 + cells in the human large bowel. PMID- 3552849 TI - Clinicopathological study on cystadenocarcinoma of the pancreas. AB - Although rare, mucinous cystadenocarcinoma of the pancreas is an established pathological entity. However, its characteristic features on diagnostic imaging have not yet been defined. Based upon clinicopathological studies on 5 cases, two subgroups of mucinous cystadenocarcinoma of the pancreas are proposed: the endophytic and the exophytic types. The former consist of large well-demarcated cystic tumors with numerous inward-growing cauliflower-like excrescences in mucinous material, which were characteristically demonstrated either by CT or ultrasonography. Tumors of this subtype were visualized as hypervascular masses in the capillary phase of angiography. Areas of malignant tissue were well demarcated without capsular invasion, and tumors were free from lymph node or distant metastasis. Though cystic, the exophytic subtype had negligible inward growing papillary projections. Corresponding to their macroscopic features, these tumors were demonstrated as cystic lesions lacking papillary projections on ultrasonography or CT. No tumor stains could be demonstrated by angiography. Despite of their smaller size than the former subtype, cancerous growth penetrated through the cyst wall and metastasized to lymph nodes, causing poorer prognosis than in the former. PMID- 3552850 TI - Angelchik antireflux prosthesis associated with pericarditis and complete transmural migration. PMID- 3552851 TI - [The sinus-parenchyma border of the human kidney as the place of origin of intracanicular and extravascular diffusion of fluids. II: References]. PMID- 3552852 TI - [Constitution and nutrition. III: On the constitution and nutrition of the Germans in early history]. AB - This documentation is part of an inquiry about constitution and nutrition in Germany since early history. In this documentation, authorities of antiquity and modern researches about constitution and nutrition in early Teutonic history were collected and then possible influences of nutrition of that period on constitution of early Teutons were analysed. The early Teutons were characterised by great and strong stature, tendence to dolichocephalie and were of spectacular vigour. Their food was characterised by vitality and growth stimulating ingredients (like milk, meat, barley, oats, millet), but with differences in quantity in course of the year. A comparisation between nutrition and constitution of early Teutons shows a connection among typical patterns of early Teuton-constitution and these nutrition. Differences in constitution to the southern neighbours, Celts and Romans, were not so marked, that constitutional changes in Germany, especially in southern Germany, in the middle ages can be explained by mixed race. PMID- 3552853 TI - [Induction of fetal lung maturation using ambroxol and betamethasone. Results of an open multicenter study]. AB - In a randomized open multicenter study the results of antenatal prophylaxis against neonatal RDS by administration of betamethasone were compared with those obtained with the bromhexine VIII metabolite Ambroxol. Ambroxol was administered for a maximum of 5 days - 1000 mg in an infusion solution; betamethasone was injected intramuscularly in 2 daily doses of 8 mg. One of these two substances was given to 123 pregnant women for pulmonary maturation in the fetus, in accordance with a randomization plan. The patients were either being treated for premature labor or pregnancy was terminated on the basis of indication between the 28th and 36th week. Therapy had to be discontinued in 4 cases in each group, because of continued labor and birth, and in one case because of an amniotic infection syndrome. A full analysis of the treatment records of 57 pregnancies in the Ambroxol group was carried out; the corresponding figure for the betamethasone group was 58. In 39 patients the duration of pregnancy was 37 weeks or more, so that no assessment on the basis of neonatal pulmonary maturity was possible. In the remaining pregnancies, RDS morbidity was estimated on the basis of clinical and radiological findings and blood gas analysis. Related to a maximum duration of pregnancy of 34 weeks, RDS morbidity after Ambroxol therapy was 18.2% (2 out of 11), as opposed to 35.7% (5 out of 14) after betamethasone treatment. The results confirm that antenatal administration of Ambroxol can bring about a reduction in neonatal RDS corresponding to that achieved with betamethasone therapy. However, with Ambroxol the occurrence of side-effects is potentially lower; it therefore has advantages over betamethasone while being equally efficacious. PMID- 3552854 TI - [Conservative procedures in 64 pregnant patients with myoma: the course of pregnancy, labor, and the puerperium]. AB - During this period, the number of deliveries was 28235. Our results contradict the wide spread opinion concerning the high risk of a pregnancy in a myomatose uterus. In two thirds of the cases, the pregnancies showed a normal course, this applying also to myoma nodes of 8 cm or more dimater. Threat of premature delivery was ovserved in 11 cases; in two cases premature delivery did occur. More than nine out of ten pregnancies reached the 38th week of gestation. Spontaneous delivery was twice as frequent as Caesarean section. This, however, does not apply to myoma nodes with diameters of 8 cm or more, in which case the frequency of Caesarean section represented 50%. Puerperium was normal in 47 cases; complications were observed in 13 cases due to retarded uterine retraction. In 2 out of 4 cases with atonic post-partum haemorrhage, curettage was performed. Pregnancies in a myomatose uterus are high-risk pregnancies which require close observation. Sonography plays an important role in such cases. One of the authors (D.) proposes high-dose gestagen treatment as a useful therapy when threat of abortion is observed in myomatose uteri. In cases of menacing premature delivery, hospitalisation and tocolysis are highly recommended. PMID- 3552855 TI - [Intrauterine detection of dorsolateral diaphragmatic hernia using ultrasound]. AB - Congenital posterolateral diaphragmatic hernia occurs in one out of 2,500 live births. Prenatal diagnosis is made via sonographic demonstration of the displaced abdominal organs that can be found in the thoracic cavity as a cystic or solid mass. Early antenatal evidence of this malformation can improve the normally poor prognosis of the newborn, as planned delivery and prompt operative treatment can be performed. Antenatal sonographic diagnosis of a left-side diaphragmatic hernia is demonstrated in two cases. PMID- 3552856 TI - [Prenatal diagnosis of non-viable fetuses caused by developmental disorders--an indication for abortion for fetal reasons?]. AB - Between October 1st 1983 and January 31st 1986 we diagnosed various anomalies on 116 foetuses at the Department of Obstetrics and Gynaecology, Klinikum Grosshadern, Munich. In 103 cases we made a correct diagnosis. This group of patients included 45 non-viable foetuses. Severe anomalies of the foetal central nervous system and lethal dwarfism were diagnosed correctly. On the other hand, antenatal diagnosis of bilateral nonfunctional kidneys and non-correctable cardiac malformations poses problems. We feel that in the case of a definitive prenatal diagnosis of an anomaly for which there is no known medical treatment and which is not compatible with life, the decision as to further procedure should be made at this stage. Before 24 weeks gestation, termination of pregnancy on foetal grounds should be discussed with the parents. Thereafter, preterm labour is preferable to the dangers of obstructed labour at term and should be conducted without foetal monitoring. PMID- 3552857 TI - [The single-layer uterine suture in cesarean section. A comparative study]. AB - Caesarean section had to be carried out in 297 cases (4.9 per cent) out of 6064 births (infant mortality 0.44 per cent). A comparison between 96 Caesarean sections with a one-layer suture of the myometrium (32 per cent) and 201 Caesarean sections with a two-layer suture (68 per cent) clearly shows less morbidity (19 per cent vs. 37 per cent) in case of a one-layer uterus suture. In those cases the postoperative loss of blood, the involution of the uterus and the healing of the scar are also more favourable. Afebrile courses clearly predominate in one-layer sutures (92 per cent to 76 per cent in two-layer sutures). Most important of all are the ability and experience of the surgeon, not the use of antibiotica. PMID- 3552858 TI - [Sonographic diagnosis of fetal liver cysts]. AB - The authors report on prenatal ultrasonic diagnosis of foetal liver cysts with a massively thickened and cystic placenta in the twenty-third week of pregnancy. Karyotyping and serological examination of foetal blood samples of the umbilical vein gave normal results. The liver cysts were tapped twice subsequently, because they displaced other foetal abdominal and thoracic organs. In the thirty-fifth week of pregnancy the foetus died due to malnutrition resulting from the changes of the placenta, the origin of which remained unclear. PMID- 3552859 TI - [The single hormone hypothesis. An instructive episode in the history of ovarian endocrinology]. AB - In the mid-twenties of the present century renowned scientists held the opinion that only one female sex hormone is secreted by the ovary. A survey is given how this hypothesis arose, for which reasons it was favoured and why it had to be given up. The importance of the Allen-Doisy test (1923) and the Corner-Allen test (1929) and of the publications by these authors is stressed. Finally, it is shown that Thomas S. Kuhn's theory, explaining how scientific advance is promoted by changing a paradigm, is also applicable to this phase of research in ovarian endocrinology as well. PMID- 3552860 TI - [Pathology of proximal tubal occlusion--morphologic evaluation. Results following microsurgical anastomosis]. AB - Even today, the etiology of proximal tubal occlusion is still a controversial subject. The introduction of microsurgery in gynecology has provided a method of eliminating the main symptom of proximal tubal occlusion, i.e., sterility. Pregnancy rates of 25-30% can be achieved in overall patient collectives. Accurate histologic analyses of the specimens are essential for clinicopathological classification in three prognosis groups. For stage I patients, pregnancy rates of up to 50% (patient-related) can be achieved. Postoperative counseling can thus be differentiated on the basis of the histological results. For stage III patients the pregnancy rate is unlikely to be acceptable, even after waiting for a prolonged period of time. It has not been established whether reconstructive tubal surgery or alternative therapeutic procedures (I.V.F. and E.T.) have better chances of success in stage II. Accurate histologic analysis of the surgical specimens is an essential prerequisite for individualized sterility counseling and therapy. PMID- 3552861 TI - Actions of some prostaglandins and leukotrienes on rat cerebral and mesenteric arteries. AB - The effects of some prostaglandins (PG's) and leukotrienes (LT's) on rat middle cerebral, basilar and mesenteric arteries were evaluated in vitro. The order of potency of some prostanoids with respect to their contractile effects in basilar arteries was: U44069 greater than PGF2 alpha greater than PGI2 approximately equal to PGE2 greater than 6-keto-PGE1 greater than 6-keto-PGF1 alpha, whereas 6,15-diketo-PGF1 alpha was inactive. Middle cerebral and basilar arteries were 3 5 times more sensitive than mesenteric arteries to PGF2 alpha. LTD4 and LTC4 were inactive in all three vessel types. PGI2 produced a concentration-related relaxation of similar potency in all three arteries contracted by PGF2 alpha. Arteries preactivated by other agents (K+, noradrenaline, 5-hydroxytryptamine) either failed to relax or inconsistently relaxed after PGI2 application. Among the PGI2 metabolites (6-keto-PGF1 alpha, 6,15-diketo-PGF1 alpha, 6-keto-PGE1), only 6-keto-PGE1 elicited relaxation in the PGF2 alpha-contracted basilar artery. However, the drug potency was significantly smaller than that of PGI2. Nifedipine inhibited the PGF2 alpha-induced contraction by 68% in middle cerebral arteries and by 80% in mesenteric arteries. Exposure to Ca2+-free medium for a time period which almost completely abolished the contractile response to K+ (less than 5% left), reduced the PGF2 alpha-induced contraction by 54, 61 and 85% in middle cerebral, basilar and mesenteric arteries, respectively. The PGF2 alpha-induced contraction of cerebral arteries in Ca2+-free medium was usually composed of a rapidly developing first phase, which levelled off after 1-2 min, and a second slowly developing tonic phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552862 TI - Blood rubidium level in patients with major affective disorders. PMID- 3552864 TI - Possible involvement of an impaired baroreflex mechanism but not the renin angiotensin system and vasopressin in the enhanced pressor responsiveness to physostigmine in spontaneously hypertensive rats. AB - Effects of physostigmine on heart rate, mean arterial pressure (MAP), plasma renin concentration (PRC) and vasopressin (AVP) release were investigated in spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats. Physostigmine (100 micrograms/kg, i.a.) produced a greater and prolonged hypertensive response in the SHR than in the WKY. Heart rate was increased by physostigmine in SHR rats while it was unchanged in the WKY. PRC was unchanged or even slightly decreased in these animals when MAP was increased by physostigmine. An AVP pressor antagonist did not attenuate the pressor and cardiac effects of physostigmine in these animals. These data indicate that an impaired baroreflex mechanism or a different mode of sympathetic neuronal activation by physostigmine through the central mechanism appears to be contributory, at least in part, to the enhanced pressor responsiveness in the SHR. The renin-angiotensin system and AVP do not appear to be involved in the enhanced pressor responsiveness to physostigmine in SHR rats. PMID- 3552863 TI - Neuropharmacology of zonisamide, a new antiepileptic drug. AB - Zonisamide readily crosses the blood-brain barrier and is readily absorbed after oral administration with a Tmax of about 3 hr. The half-life of ZNA in epileptic patients is about 28 hr. Zonisamide has a broader therapeutic range than other antiepileptic drugs. Neurotoxic, hemapoietic, renal, and liver effects have been minimal in patients participating in controlled clinical studies. It is effective in several experimental models of epilepsy and in initial clinical trials has been shown to be effective in generalized tonic-clonic, simple, and complex partial seizures. PMID- 3552865 TI - A simplified border molding technique for complete denture impressions. PMID- 3552866 TI - Split palatal bar as a stress-breaker for a Kennedy Class II maxillary removable partial denture. PMID- 3552867 TI - Intentional replantation to prevent loss of an abutment tooth. PMID- 3552868 TI - The midline crisis--esthetically. PMID- 3552869 TI - Multipoint mapping: determining the order of the beta-globin, ADJ, insulin and c Ha-ras-1 loci. PMID- 3552870 TI - Seventy years ago in Genetics: H.S. Jennings and inbreeding theory. PMID- 3552871 TI - Genetic mapping of the amino-terminal domain of bacteriophage T4 DNA polymerase. AB - The DNA polymerase of bacteriophage T4 is a multifunctional enzyme that harbors DNA-binding, DNA-synthesizing and exonucleolytic activities. We have cloned in bacterial plasmids about 99% of the structural gene for this enzyme (T4 gene 43). The gene was cloned in six contiguous 5'-terminal DNA fragments that defined seven intragenic mapping regions. Escherichia coli hosts harboring recombinant plasmids carrying the gene 43 subsegments were used in marker-rescue experiments that assigned a large number of ts and nonsense polymerase mutations to different physical domains of the structural gene. Conspicuously, only one missense mutation in a large collection of mutants mapped in the 5'-terminal 450 base-pair segment of the approximately 2700 base-pair gene. To test if this indicated a DNA polymerase domain that is relatively noncritical for biological activity, we mutagenized a recombinant plasmid carrying this 5'-terminal region and generated new conditional-lethal mutations that mapped therein. We identified five new ts sites, some having mutated at high frequency (nitrosoguanidine hot spots). New ts mutations were also isolated in phage genes 62 and 44, which map upstream of gene 43 on the T4 chromosome. A preliminary examination of physiological consequences of the ts gene 43 mutations showed that they exhibit effects similar to those of ts lesions that map in other gene 43 segments: some were mutators, some derepressed gene 43 protein synthesis and they varied in the severity of their effects on T4-induced DNA synthesis at nonpermissive temperatures. The availability of the gene 43 clones should make it possible to isolate a variety of lesions that affect different activities of the T4 DNA polymerase and help to define the different domains of this multifunctional protein. PMID- 3552872 TI - A new epistasis group for the repair of DNA damage in bacteriophage T4: replication repair. AB - The gene 32 mutation amA453 sensitizes bacteriophage T4 to the lethal effects of ultraviolet (UV) irradiation, methyl methanesulfonate and angelicin-mediated photodynamic irradiation when treated particles are plated on amber-suppressing host cells. The increased UV sensitivity caused by amA453 is additive to that caused by mutations in both the T4 excision repair (denV) and recombination repair (uvsWXY) systems, suggesting the operation of a third kind of repair system. The mutation uvs79, with many similarities to amA453 but mapping in gene 41, is largely epistatic to amA453. The mutation mms1, also with many similarities to amA453, maps close to amA453 within gene 32 and is largely epistatic to uvs79. Neither amA453 nor uvs79 affect the ratio of UV-induced mutational to lethal hits, nor does amA453 affect spontaneous or UV-enhanced recombination frequencies. Gene 32 encodes the major T4 ssDNA-binding protein (the scaffolding of DNA replication) and gene 41 encodes a DNA helicase, both being required for T4 DNA replication. We conclude that a third repair process operates in phage T4 and suggest that it acts during rather than before or after DNA replication. PMID- 3552873 TI - Biochemical genetics of the cryptic gene system for cellobiose utilization in Escherichia coli K12. AB - The cellobiose catabolic system of Escherichia coli K12 is being used to study the role of cryptic genes in microbial evolution. Wild-type E. coli K12 do not utilize the beta-glucoside sugars, arbutin, salicin and cellobiose. A Cel+ (cellobiose utilizing) mutant which grows on cellobiose, arbutin, and salicin was isolated previously from wild-type E. coli K12. Biochemical assays indicate that a cel structural gene (celT) specifies a single transport protein that is a beta glucoside specific enzyme of the phosphoenolpyruvate-dependent phosphotransferase system. The transport protein phosphorylates beta-glucosides at the expense of phosphoenolpyruvate. A single phosphoglucosidase, specified by celH, hydrolyzes phosphorylated cellobiose, arbutin, and salicin. The genes of the cel system are expressed constitutively in the Cel+ mutant, whereas they are not expressed at a detectable level in the wild-type strain. The transport and hydrolase genes are simultaneously silenced or simultaneously expressed and thus constitute an operon. Cel+ strains which fail to utilize one or more beta-glucosides express the transport system at a lower level than do Cel+ strains which grow on all three beta-glucosides. Other strains inducibly express a gene which specifies transport of arbutin but not the other beta-glucosides. The arbutin transport gene, arbT, maps outside of the cel locus. PMID- 3552874 TI - Cryptic genes for cellobiose utilization in natural isolates of Escherichia coli. AB - The ECOR collection of natural Escherichia coli isolates was screened to determine the proportion of strains that carried functional, cryptic and nonfunctional genes for utilization of the three beta-glucoside sugars, arbutin, salicin and cellobiose. None of the 71 natural isolates utilized any of the beta glucosides. Each strain was subjected to selection for utilization of each of the sugars. Only five of the isolates were incapable of yielding spontaneous beta glucoside-utilizing mutants. Forty-five strains yielded cellobiose+ mutants, 62 yielded arbutin+ mutants, and 58 strains yielded salicin+ mutants. A subset of the mutants was screen by mRNA hybridization to determine whether they were expressing either the cel or the bgl beta-glucoside utilization operons of E. coli K12. Two cellobiose+ and two arbutin+-salicin+ strains failed to express either of these known operons. It is concluded that there are at least four gene clusters specifying beta-glucoside utilization functions in E. coli populations, and that all of these are normally cryptic. It is estimated that in any random isolate the probability of any particular cluster having been irreversibly inactivated by the accumulation of random mutations is about 0.5. PMID- 3552875 TI - STE16, a new gene required for pheromone production by a cells of Saccharomyces cerevisiae. AB - Genes required for mating by a and alpha cells of Saccharomyces cerevisiae (STE, "sterile," genes) encode products such as peptide pheromones, pheromone receptors, and proteins responsible for pheromone processing. a-specific STE genes are those required for mating by a cells but not by alpha cells. To identify new a-specific STE genes, we have employed a novel strategy that enabled us to determine if a ste mutant defective in mating as a is also defective in mating as alpha without the need to do crosses. This technique involved a strain (K12-14b) of genotype mata1 HML alpha HMR alpha sir3ts, which mates as a at 25 degrees and as alpha at 34 degrees. We screened over 40,000 mutagenized colonies derived from K12-14b and obtained 28 a-specific ste mutants. These strains contained mutations in three known a-specific genes--STE2, STE6 and STE14--and in a new gene, STE16. ste16 mutants are defective in the production of the pheromone, a-factor, and exhibit slow growth. Based on the distribution of a specific ste mutants described here, we infer that we have identified most if not all nonessential genes that can give rise to a-specific mating defects. PMID- 3552876 TI - Allosuppressors that enhance the efficiency of omnipotent suppressors in Saccharomyces cerevisiae. AB - Two recessive Mendelian-allosuppressors have been isolated and have been shown to enhance the efficiency of omnipotent suppressors thought to be translational ambiguity mutations. These allosuppressors are unlinked to each other or to the omnipotent suppressors on which they act. They also increase the efficiency of the serine-inserting UAA-suppressor, SUP16. One allosuppressor is allelic or tightly linked to the previously isolated sal2. Another allosuppressor, called sal6, represents a new locus, unlinked to the previously isolated sal1-sal5 that enhance the efficiency of the UAA-suppressors. When present singly in the absence of suppressors or other modifiers the sal2 and sal6 mutations do not have suppressor activity. However, when sal2 and sal6 are combined together in a haploid cell they do suppress weakly. In addition sal2 becomes a weak suppressor in the presence of the [eta +] modifying factor. PMID- 3552877 TI - The effectiveness of mental health consultation and referral in ambulatory primary care: a research lacuna. AB - This article reviews the research literature on referral to and consultation with mental health specialists for patients in ambulatory medical settings. Very few controlled trials measuring the efficacy of such liaison could be located. They were mainly from the British literature, usually involved psychologists, and (with the exception of one study) tested only the model of referral to the mental health specialist for treatment. More research needs to be done in this important area. Methodologic issues and topics for further study are discussed. PMID- 3552878 TI - Psychogenic/idiopathic pain syndromes. AB - The concept of psychogenic pain is discussed and reviewed from multiple theoretical perspectives. The validity of psychogenic pain disorder as a clinical diagnosis is also examined, as are regional pain syndromes such as psychogenic abdominal, facial, pelvic, chest, and headache pain. The term "psychogenic pain" is considered to have limited clinical or diagnostic usefulness and the preferred term "idiopathic pain syndrome" used in DSM-III-R is advocated. PMID- 3552879 TI - [Genetic study of plasmid integration into yeast chromosomes. III. Selection for a phenotype of Saccharomyces cerevisiae (Meyen ex Hansen) clones which lost the 2 micron DNA and their genetic testing]. AB - We used the coloured adeI (cir+) haploid strain containing an episomal plasmid integrated into the chromosome I for visual detection and genetic testing of Saccharomyces cerevisiae clones having lost 2 microns DNA. During incubation, colonies of this strain were covered with numerous papillae of the same genotype. Stable clones which did not generate such papillae were isolated. Hybrids of these clones with (cir0) partner were not shown to exhibit destabilization of the chimeric chromosome. The stable clones isolated proved to lack 2 microns DNA, as shown by colony hybridization technique. We conclude therefore that the loss of the cryptic yeast plasmid may be phenotypically detected. PMID- 3552880 TI - [Genetic study of plasmid integration into yeast chromosomes. IV. Integration of the plasmid pYF91 into different yeast chromosomes]. AB - Integration of the episomic chimeric plasmid pYF91 into yeast chromosomes has been studied. Plasmid insertion into the chromosomes was observed to occur with the frequency of 4 X 10(-8). 379 integrants were selected from the highly unstable (cir0) transformants. The fact of plasmid integration into particular chromosomes was confirmed for 318 integrants. Genetic analysis showed that the plasmid can integrate into the region of LEU2 gene or into another arm of chromosome III (227 integrants), and also into other chromosomes: I, II, IV, V, VI, VII, VIII, IX, XII, XV (91 integrants). It is suggested that integration is the result of recombination between yeast chromosomes and homologous plasmid regions carrying LEU2 gene or Ty element and "delta" sequence. PMID- 3552881 TI - Genomic structure of phage F22, a hybrid between serologically and morphologically unrelated Salmonella typhimurium bacteriophages P22 and Fels 2. PMID- 3552882 TI - Effect of the bncA gene on the instability of Aspergillus nidulans. PMID- 3552883 TI - A method for unidirectional deletion mutagenesis with application to nucleotide sequencing and preparation of gene fusions. AB - A method is described for the preparation of deletions that extend in one direction from a fixed point. The method is based on the ability of deoxynucleoside [1-thio]triphosphates to be incorporated into DNA by DNA polymerase I, Klenow fragment, and the fact that alpha-thiophosphate-containing phosphodiester bonds are resistant to hydrolysis by the 3'-to-5' exonucleolytic activity of phage T4 DNA polymerase. Therefore, linear duplex DNA molecules blocked at one 3'-terminus with a thiophosphate were prepared and then degraded from the other end with the exonuclease. Digestion for different lengths of time followed by treatment with nuclease S1 and ligation allowed the preparation and recovery of a nested set of deletion mutants. Importantly, it was observed that a significant fraction of deletion mutants of recombinant M13 phages carrying the target gene in the same orientation as 'lacZ alpha' yielded phage that produced lacZ alpha-complementing activity. Nucleotide (nt) sequencing showed that these phages carried in-frame fusions between the target gene and 'lacZ alpha'. The deletion mutagenesis procedure is applied to the nt sequencing of a gnd gene from a natural isolate of Escherichia coli. PMID- 3552884 TI - A cosmid vector for systematic chromosome walking. AB - We describe the construction of a cosmid, LoristB, that contains SP6 and T7 phage encoded RNA polymerase promoter sequences that are oriented towards and immediately adjacent to HindIII and BamHI cloning sites. We describe techniques for rapidly generating RNA probes from these promoters that must be complementary to the extreme left or right ends of the cloned DNA and can be used for library screening. Probe preparation requires neither prior knowledge of restriction sites nor fragment isolation. We also make extensive use of cos mapping restriction-mapping protocols that we have devised for our cosmid vectors for generation and alignment of steps in a cosmid walk. PMID- 3552885 TI - Reciprocal and non-reciprocal homologous recombination between Escherichia coli chromosomal DNA and ultraviolet light-irradiated plasmid DNA. AB - Plasmid DNA substrates were used to study ultraviolet (UV)-induced recombination events in Escherichia coli host cells. Plasmids derived from pBR322, containing all or part of the lac operon of E. coli, were irradiated with ultraviolet light before transformation into E. coli strains of different recA and lacY genotypes. Recombinational exchanges were identified by phenotypic changes in lactose utilization and were confirmed by restriction analysis of isolated plasmids. Ultraviolet-induced reciprocal plasmid-chromosome recombination occurred at a slightly higher frequency then non-reciprocal chromosome-to-plasmid recombination, and at a much higher frequency than non-reciprocal plasmid-to chromosome recombination. These frequencies did not depend on segregative mechanisms. The asymmetry of non-reciprocal exchange was not due to the particular arrangement of wild-type and lacY1 alleles because the same results were observed when these were interchanged. The host recA gene was required for plasmid-chromosome recombination, and slightly enhanced plasmid survival. Evidence for plasmid replication prior to recombination was found in reciprocal recombinants, but rarely in the non-reciprocal recombinants analyzed. Irradiation of competent bacterial host cells prior to transformation did not effectively induce plasmid-chromosome recombination. PMID- 3552886 TI - The nucleotide sequence of gene 21 of bacteriophage T4 coding for the prohead protease. AB - We have sequenced gene 21 coding for the bacteriophage T4 prohead protease. The sequence codes for a protein of 212 amino acids (aa) with an Mr of 23,251. A second possible in-frame initiation site was also found which would code for an Mr 18,440 protein. Evidence is presented that this second site is used in vivo. The only striking homology of gp21 to other proteins is with the serine proteases. The protein is homologous to a short aa sequence around the active site, but has a His where the active site Ser is normally found. However, mutation of this His to Ser gave a functional protein that could not be inhibited by serine protease inhibitors. We have located three sites in the gene that give rise to temperature-sensitive mutations. One of these is towards the N-terminus of the gene, the other two flank the region that shows homology with serine proteases. Attempts to overproduce the protein in Escherichia coli failed due to the extreme lability of the enzyme. A frame-shift mutation in the gene was therefore constructed which allowed the synthesis of large amounts of a stable N terminal fragment of the protein. PMID- 3552887 TI - The MET2 gene of Saccharomyces cerevisiae: molecular cloning and nucleotide sequence. AB - A 5.1-kb DNA fragment from Saccharomyces cerevisiae, which complements a yeast met2 mutant strain, has been cloned. This fragment contains the wild-type MET2 gene which codes for the homoserine O-transacetylase, one of the methionine biosynthetic enzymes. The presence of the MET2 gene has been shown by integrative transformation experiments and genetic analyses of the resulting transformants. The complete nucleotide sequence of a 2826-bp DNA fragment carrying the MET2 gene has been determined. The sequence contains one major open reading frame of 438 codons, giving a calculated Mr of 48,370 for the encoded protein. We have identified the transcriptional product of the MET2 gene and estimated its size at 1650 nucleotides. PMID- 3552888 TI - A vector for the construction of translational fusions to TEM beta-lactamase and the analysis of protein export signals and membrane protein topology. AB - A plasmid vector, pJBS633, that facilitates the construction of translational fusions of genes of interest to the coding region of the mature form of TEM beta lactamase has been developed. Transformants containing in-frame fusions can be identified by their ability to grow when plated at high inocula on agar containing ampicillin (Ap). The cellular location of the beta-lactamase moiety of the fusion proteins can then be determined since only those that direct the translocation of the beta-lactamase across the cytoplasmic membrane to the periplasm result in the ability of individual cells of Escherichia coli to form isolated colonies in the presence of Ap. Conversely, those fusion proteins in which the beta-lactamase moiety remains cytoplasmic do not protect individual cells against Ap. Transformants expressing the latter class of fusion proteins can, however, be identified when plated at high inocula since, as cells start to lyse, the cytoplasmic beta-lactamase activity is released and provides Ap resistance to the surrounding cells. The vector contains the origin of replication of f1 phage so that single-stranded plasmid DNA can be obtained in the appropriate orientation to allow sequencing across the fusion junction using a universal primer complementary to the start of the coding region of mature TEM beta-lactamase. pJBS633 should be useful as a general vector for the construction of beta-lactamase fusions and, in particular, for the analysis of protein export signals and the determination of the organisation of proteins in the E. coli cytoplasmic membrane. PMID- 3552889 TI - First position wobble in codon-anticodon pairing: amber suppression by a yeast glutamine tRNA. AB - A 2.4-kb fragment of DNA isolated from the Saccharomyces cerevisiae genome was found to suppress amber mutations when its carrier plasmid was present in high copy number. A 1.2-kb subclone of this fragment was sufficient to confer suppressor activity. Sequencing has established that this fragment carries a normal glutamine tRNA gene. Deletion of this tRNA gene from the subclone resulted in the loss of suppressor activity. The tRNAGln has the anticodon CUG that normally recognizes the glutamine codon CAG. We propose that suppression occurs via an inefficient readthrough of the UAG amber stop codons during translation. Such readthrough requires wobble in the first position of the codon. PMID- 3552890 TI - Alterations in cloned Xenopus ribosomal spacers generated by high-frequency plasmid recombination. AB - In an attempt to understand the mechanisms that have led to the complex intraspecific heterogeneity in spacer organisation found in Xenopus r.DNA, we have transformed Escherichia coli strains that exhibit high levels of plasmid recombination with Xenopus laevis r.DNA sequences inserted in pBR322. We have found that in these recBC sbcA strains, plasmid recombination results in the generation of many types of altered r.DNA spacer at a high frequency. The altered spacers result from two types of deletion/duplication events that occur in the promoter-derived sequences making up much of the spacer. The alterations caused by these events mimic in several ways the different types of organisation found among spacers in the genome. The sbcA-dependent plasmid recombination apparently provides a test system for reconstructing some of the recombinational events that operate during the evolution and maintenance of spacer DNA sequences in vivo. PMID- 3552891 TI - Plans for clinical evaluation of dynamic, computer-controlled radiation therapy at the Joint Center for Radiation Therapy. PMID- 3552892 TI - Cryotherapy for active retinopathy of prematurity. AB - Twenty-eight patients with bilateral symmetrical stage-III retinopathy of prematurity and plus disease had one eye treated using cryotherapy, while the other acted as a control. Eleven patients showed improvement in both the treated and untreated eye, while 11 others were noted to improve in the treated eye while demonstrating deterioration in the untreated eye. The P value obtained by applying binomial distribution tests suggested that, in the sampled population, cryotherapy was preferable to no treatment. PMID- 3552893 TI - An experimental comparison of three methods for trephination of the cornea and the consequent variations in the configurations of the trephine openings. AB - We used the pig eye as an experimental model. The corneas of 51 whole eyes were trephined in a laboratory setting, using three different techniques to compare the variations in the trephine openings. Since it is difficult to assess the diameter of the hole created by trephination, we measured both the epithelial and endothelial diameters, as well as the angle between the epithelial surface and the cut of the excised corneal button, since these dimensions reflect the true shape of the hole. Trephination with either a free-standing trephine blade without a handle or with a motor-driven instrument gave the same results. However, our findings showed that the results obtained using a trephine in a holder--as is commonly used in clinical practice--were statistically significantly inferior. PMID- 3552894 TI - [Medico-biological research in environmental health at the present time]. PMID- 3552895 TI - [Lower aliphatic amines as precursors of carcinogenic nitrosamines in atmospheric air]. PMID- 3552896 TI - [Results and prospects for toxicologic research in the hygienic evaluation of new polymers of the polyolefin class for the food industry and divisions of the agro industrial complex]. PMID- 3552898 TI - [Results of the scientific pedagogical activity of the Department of Social Hygiene of the L'vov Medical Institute]. PMID- 3552897 TI - [Results and prospects for the hygienic regulation of monomers migrating out of materials designed for contact with food products (styrene, alpha methylstyrene)]. PMID- 3552899 TI - [Modern hygienic problems of regulated bodies of water]. PMID- 3552900 TI - [Toxicologic-hygienic characteristics of BMK]. PMID- 3552901 TI - [Value of peritoneal fluid analysis in gynecology]. PMID- 3552902 TI - [Sophrology in dentistry]. PMID- 3552903 TI - Fine needle biopsy: cytology, histology or both? PMID- 3552904 TI - Histologic differential diagnosis of focal liver lesions by ultrasonically guided fine needle biopsy. AB - Ultrasonically guided fine needle biopsies were carried out in 84 patients with focal liver lesions and were subsequently evaluated histologically. A correct diagnosis of malignancy was made in 46 of 52 patients with proven hepatic malignancy, showing an overall accuracy of 93%. The specificity of the procedure was 100%. Such histological examination not only enables the differentiation between primary and secondary hepatic malignancy; it has the additional advantage of making a more precise tumour description and at the same time it pinpoints the primary site of the tumour. PMID- 3552905 TI - Comparison of ultrasonography, computed tomography and 99mTc liver scan in diagnosis of Budd-Chiari syndrome. AB - Ultrasonography, computed tomography and 99mTc liver scanning are all useful in diagnosis of patients with the Budd-Chiari syndrome. In a study to determine their comparative value characteristic findings were recorded in all nine patients at ultrasonography and in seven patients at computed tomography. In contrast 99mTc liver scan showed a characteristic pattern in only one of eight patients. In our experience intrahepatic venous abnormalities were seen better at ultrasonography than at computed tomography. In addition, abnormality in the direction of blood flow could be detected by pulsed Doppler examination. Ultrasonography is relatively inexpensive, readily accessible, does not require administration of radiation or contrast agents and therefore should be the primary non-invasive investigation of patients with Budd-Chiari syndrome, or those at risk of developing it. PMID- 3552906 TI - Effect of chronic administration of cisapride on gastric emptying of a solid meal and on dyspeptic symptoms in patients with idiopathic gastroparesis. AB - In a double blind crossover comparison with placebo, the effects of cisapride (10 mg tid for two weeks), a non-antidopaminergic gastrointestinal prokinetic drug, on gastric emptying times and on symptoms were evaluated in 12 patients with chronic idiopathic dyspepsia and gastroparesis. Gastric emptying was studied by a radioisotopic gamma camera technique. The test meal was labelled in the solid component (99mTc-sulphur colloid infiltrated chicken liver). Nine symptoms (nausea, belching, regurgitations, vomiting, postprandial drowsiness, early satiety, epigastric pain or burning, heartburn) were graded weekly on a questionnaire. Cisapride was significantly more effective than placebo in shortening the t1/2 of gastric emptying (p2 = 0.04), but no significant difference was observed between the two treatments with regard to the improvement of total symptom score (p2 = 0.09). No side effects were reported during the study. PMID- 3552907 TI - Immunohistochemical localisation of vitamin B12 R-binder in the human digestive tract. AB - The distribution of vitamin B12 R-binder in the human digestive tract was studied using an indirect immunoperoxidase technique. Positive staining for R-binder was found in the mucous cells and ductal epithelial cells of the salivary glands and the oesophageal glands. In normal gastric mucosa, no positive staining for R binder was found, but in the area with intestinal metaplasia, the columnar epithelial cells and goblet cells showed positive staining. Epithelial cells of the gallbladder, intrahepatic bile ducts and pancreatic ducts were also positive for R-binder. In the small intestine and colon, R-binder was found in the columnar epithelial cells and goblet cells. The measurement of unsaturated vitamin B12 binding capacity and cobalamin content in the extracts from intestinal mucosa also indicated the presence of R-binder in the intestinal mucosa. PMID- 3552908 TI - 70+ and going strong. Eleanor Hasenour: inventor. PMID- 3552909 TI - Methylprednisolone in cis-platinum induced nausea and emesis: a placebo controlled trial. AB - In a double-blind, placebo-controlled trial, the antiemetic efficacy of a total of 1-2 g methylprednisolone sodium succinate (MPSS) alone versus placebo was evaluated over the first three courses of chemotherapy in a group of 27 women receiving moderate to high-dose cis-platinum (50-118 mg/m2) for ovarian or cervical carcinomas. Antiemetic protection was classified as total (no emesis), major (one or two bouts), minor (three to five bouts), or minimal (six or more bouts). Total or major protection occurred in 10/26 (38.5%) of the MPSS cycles and in 6/24 (25%) of the placebo cycles (NS). A significant number of placebo patients (7/14 placebo versus 1/13 MPSS, P = 0.02) dropped out of the study due to lack of efficacy. Patient evaluations completed 24 hr before and after each course of chemotherapy indicated no treatment effect on pain, appetite, nausea, drowsiness, anxiety, sense of well-being, or sleep. Physician and patient global evaluations of antiemetic efficacy favored treatment with MPSS. Evidence of the efficacy of single-drug MPSS antiemetic therapy during non-cis-platinum or low dose cis-platinum (less than 50 mg/m2) chemotherapy can be found in the literature. The results of this study, however, do not support the use of MPSS alone with high-dose cis-platinum chemotherapy. PMID- 3552910 TI - Detection of chromogranin in argyrophil cells of endometrial carcinoma. AB - Normal and neoplastic endometrial tissues were examined immunohistochemically for chromogranin which was shown to be a specific marker for neuroendocrine cells. All 20 normal endometriums and 20 endometrial carcinomas without argyrophilia were chromogranin negative. Endometrial carcinomas with argyrophilia tested were composed of three groups; 10 with type I argyrophil cells, 20 with type II argyrophil cells, and 10 with both type I and II argyrophil cells. Type I argyrophil cells of 20 endometrial carcinomas were all chromogranin positive. Chromogranin immunoreactivity was also intimately correlated with the Grimelius reactivity in type II argyrophil cells of 19 endometrial carcinomas, 13 with only type II argyrophil cells and 6 with mixed type of argyrophil cells. Chromogranin was absent in type II argyrophil cells of 11 endometrial carcinomas, 7 with type II argyrophil cells and 4 with mixed type of argyrophil cells. Chromogranin negativity was related to the disappearance of argyrophilia after diastase digestion in 5 of these 11 tumors, and also partly to mucinous substances in the remaining 6 tumors. In conclusion, the results obtained suggest that some of type II argyrophil cells are neuroendocrine in nature as well as type I argyrophil cells. PMID- 3552912 TI - [Safety of the diagnostic use of ultrasonics in pregnancy]. PMID- 3552911 TI - [Neuroendocrinology of the menstrual cycle]. PMID- 3552913 TI - [Complications and failures in free-flap transplantations]. AB - Complications and failures in nine cases of free flap transfer are reported. With increasing experience the number of failures declines. In six of seven cases with total flap necrosis technique and tactics in microsurgical procedure were responsible for the disaster. The failure in the other case was due to thrombosis of an axillary vein and thoracodorsal vein leading to necrosis of a latissimus dorsi flap. A dorsalis pedis flap was saved by arterial inflow through a flap vein. The fact that not one flap could be saved by revision is accounted for by the circumstance that the monitoring looks at capillary filling alone. It is possible that the Laser-Doppler-flowmetry is a useful and practical method for objective monitoring. PMID- 3552914 TI - [Value of intra-arterial digital subtraction angiography in microvascular anastomosis in tissue transplantation]. AB - The technique of selective intraarterial digital subtraction angiography is less time-consuming and requires less contrast medium than conventional angiography thus reducing both the invasiveness and the risk associated with angiography. With this method both the morphology and the functional status of the vasculature can be determined. Anatomic variations in the blood supply which influence the operative technique can thus be known preoperatively and no longer threaten the success of the operation. PMID- 3552915 TI - [Clinical evaluation of the surgical treatment of ureterovaginal fistula (data of the Urologic Clinic at the Cracow Medical Academy]. PMID- 3552916 TI - [Thyroid diagnosis--uses of imaging procedures. 1: Diagnostic value]. PMID- 3552917 TI - Ethanolamine oleate is superior to polidocanol (aethoxysklerol) for endoscopic injection sclerotherapy of esophageal varices: a prospective randomized trial. AB - Thirty-four consecutive patients with liver cirrhosis and esophageal varices were included in a prospective randomized trial done to investigate the efficacy and safety of two sclerosants 5% ethanolamine oleate (EO) and polidocanol (1% Aethoxysklerol [AS]) for use in endoscopic injection sclerotherapy (EIS). Eighteen patients were randomly allocated to the group given EO and 16 to the AS group. These two groups were comparable with regard to age, sex, etiology and severity of the liver disease. The bleeding rate from esophageal ulcers which developed during the course of repeated EIS was significantly (P less than 0.05) higher in the AS group (31.3%, 5/16) than in the EO group (0%, 0/18). In 4 occasions bleeding from the esophageal ulcer could not be controlled with AS. In 3 of these 4 bleeding episodes, EO successfully halted bleeding from esophageal ulcer. In the other patient, a Sengstaken-Blakemore tube was inserted to stop the hemorrhage. The period and number of sessions of EIS for eradication of esophageal varices were significantly (P less than 0.05) shorter in the EO group than the AS group (EO: 4.0 +/- 0.8 [means +/- SD] sessions during 4.7 +/- 1.5 weeks versus AS: 4.8 +/- 1.2 sessions during 5.4 +/- 1.6 weeks). The rate of early mortality did not differ between the two groups. We conclude that 5% ethanolamine oleate seems to be superior to 1% Aethoxysklerol when used for sclerosing esophageal varices. PMID- 3552918 TI - Study of insulin response to oral glucose load after acute and chronic glycemic control in type 2 diabetic subjects. AB - To investigate whether correction of fasting hyperglycemia per se improves the insulin secretion in type 2 diabetic subjects, plasma insulin response to 75 g oral glucose load has been studied after acute and chronic normalization of fasting plasma glucose levels in 7 overt type 2 diabetic subjects. For the acute normalization of elevated fasting plasma glucose levels, an artificial endocrine pancreas was employed. Although fasting plasma glucose concentrations were normalized before the oral glucose challenge, insulin response to oral glucose was not improved compared to those without normalization of fasting plasma glucose levels. After 1-3 month control of hyperglycemia, the insulin response to glucose in the subjects was significantly improved compared to those without treatments. Results indicate that chronic metabolic control is essential for the improvement of insulin response to glucose in type 2 diabetic subjects, and also suggest that the impaired insulin secretion in type 2 diabetes is not due to hyperglycemia per se, but due to the metabolic derangements which lead to chronic hyperglycemia. PMID- 3552919 TI - Reversal of the LH response to oestrogen administration after orchidectomy in a male subject with the androgen insensitivity syndrome. PMID- 3552920 TI - Sclerotherapy vs. distal splenorenal shunt in the elective treatment of variceal hemorrhage: a randomized controlled trial. AB - One hundred and twelve consecutive Child Class A and B cirrhotic patients were included in a prospective controlled trial aimed at investigating the efficacy and safety of endoscopic sclerotherapy vs. distal splenorenal shunt in the elective treatment of hemorrhage from esophagogastric varices. Fifty-seven patients were randomly allocated to splenorenal shunt and 55 to endoscopic sclerotherapy. Since only 4 of the 55 patients assigned to endoscopic sclerotherapy had to be excluded after randomization and before treatment as compared to 14 of the 57 patients assigned to splenorenal shunt, it is suggested that the applicability of endoscopic sclerotherapy is greater than that of splenorenal shunt. One patient in each group died within 30 days of the procedure and two in the endoscopic sclerotherapy group were lost to follow-up just after discharge. Variceal rebleeding during follow-up occurred in 37.5% (18/48) of patients in the endoscopic sclerotherapy group and in 14.3% of those in the splenorenal shunt group (6/42) (p less than 0.02), whereas hepatic encephalopathy was more frequent in patients submitted to splenorenal shunt (10/42, 24%) than in those treated by endoscopic sclerotherapy (4/48, 8%) (p less than 0.05). The therapeutic modality was the only variable with independent predictive value for rebleeding during follow-up, whereas for hepatic encephalopathy, the therapeutic modality, and the presence of encephalopathy related to the bleeding episode each showed independent predictive value. Early and long-term mortality, did not differ between the two therapeutic groups, being the 2-year survival was 71% for splenorenal shunt and 68% for endoscopic sclerotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552921 TI - The role of propranolol in congestive gastropathy of portal hypertension. AB - Heavy diffuse bleeding from congested gastric mucosa (congestive gastropathy) was treated by propranolol (dose = 24 to 480 mg per day) in 14 consecutive patients with portal hypertension. Thirteen patients (93%) stopped bleeding within 3 days. Gastric mucosal cherry red spots (a sign of severe gastropathy) were unchanged in 5 patients, became less obvious in 4 and appearances returned to normal in 5. Propranolol was discontinued electively in seven patients after 2 to 6 months; four of these patients rebled from the same lesion and stopped bleeding when propranolol was recommenced. No patient has rebled from congestive gastropathy while receiving propranolol during follow-up of 12 to 42 (median = 23) months. A further 24 patients with nonbleeding congestive gastropathy received 160 mg long acting propranolol per day in a double-blind placebo controlled cross-over trial. Twenty-two patients completed the study; in nine patients, endoscopic grading of congestive gastropathy improved after propranolol compared to three after placebo (p less than 0.05). Although the mechanism of action is not understood, propranolol appears to have a clinically significant role in the management of nonvariceal gastric bleeding in portal hypertension. PMID- 3552922 TI - Anti-liver-kidney microsome antibody is a marker for the rat hepatocyte endoplasmic reticulum. AB - Human sera, containing anti-liver-kidney microsome antibody as demonstrated by indirect immunofluorescence, were obtained from a subgroup of young patients with autoimmune chronic hepatitis. The anti-liver-kidney microsome antibody-positive sera were used to study the localization of the liver-kidney microsome antigen in hepatocytes. Immunoblot analysis of microsomal subfractions, lysosomal membranes, plasma membranes, mitochondria and purified ribosomes obtained from rat liver demonstrated that this antibody recognizes a protein of 50 kD present only in endoplasmic reticulum membranes. Immunogold labeling of ultrathin frozen sections and immunoperoxidase staining of 11 to 15 micron cryostat sections were used to detect the liver-kidney microsome antigen in rat liver tissue. The anti-liver kidney microsome antibody binds to antigenic domains on the cytoplasmic face of smooth and rough endoplasmic reticulum membranes of hepatocytes. No labeling was observed of the Golgi apparatus, peroxisomes, mitochondria, lysosomes, nuclei or plasma membranes. Not only was the antigen recognized by the anti-liver-kidney microsome antibody specific for endoplasmic reticulum membranes, but it was also specific for the endoplasmic reticulum of hepatocytes only, since no labeling was observed in any organelle of Kupffer or endothelial cells. Therefore, the anti liver-kidney microsome antibody can be considered as a marker for endoplasmic reticulum in rat hepatocytes. PMID- 3552923 TI - The acute vanishing bile duct syndrome (acute irreversible rejection) after orthotopic liver transplantation. AB - The acute vanishing bile duct syndrome can be defined as an irreversible, rejection-related condition that affects hepatic allografts within 100 days after orthotopic liver transplantation and whose presence requires retransplantation. We have observed the acute vanishing bile duct syndrome in 5 of 48 consecutive patients (approximately 10%) who underwent orthotopic liver transplantation. In 4 cases, the condition progressed relentlessly within approximately 7 to 11 weeks after orthotopic liver transplantation from mild rejection to severe rejection to acute vanishing bile duct syndrome. A fifth patient had severe rejection in the first week and required retransplantation after 17 days because of thrombotic venoocclusive disease complicating the acute vanishing bile duct syndrome. Clinically, signs of impending acute vanishing bile duct syndrome included abrupt onset of fever and jaundice and marked elevation of serum bilirubin and alkaline phosphatase levels which persisted despite antirejection treatment. Biopsy specimens revealed destructive cholangitis (rejection cholangitis), ductopenia, and, if retransplantation was delayed, presence of noninflammatory, "burnt-out" portal tracts without bile ducts. We recommend to base the diagnosis of acute vanishing bile duct syndrome on documentation of severe ductopenia in at least 20 portal tracts which may require several consecutive needle biopsies. Rejection arteriopathy which was found in 3 of our 5 cases might have been another important diagnostic clue but could not be recognized prior to retransplantation. The pathogenesis of acute vanishing bile duct syndrome is not clear; until the condition had manifested itself, we found no qualitative differences between acute reversible and irreversible rejection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552924 TI - Orthotopic liver transplantation for acute and subacute hepatic failure in adults. AB - The role of liver transplantation in 29 patients with fulminant and subacute hepatic failure due to a variety of different causes was examined by comparing the outcome and a variety of "hospitalization" variables. Transplanted patients (n = 13) were more likely to survive (p less than 0.05), were younger (p less than 0.05) and spent more time in the hospital (p less than 0.025) than did those who were not transplanted (n = 16). Despite spending a much longer time in the hospital, transplanted patients spent less time in the intensive care unit (p less than 0.05) in coma (p less than 0.01) and on a respirator (p less than 0.01) than did those not transplanted. Most importantly, the survival rate for transplanted patients was significantly improved (p less than 0.05) as compared to those not transplanted. We conclude that liver transplantation can be applied successfully to the difficult clinical problem of fulminant and subacute hepatic failure. PMID- 3552925 TI - Effect of corticosteroid therapy on levels of antibody to hepatitis B core antigen in patients with chronic type B hepatitis. AB - Serum levels of antibody to hepatitis B core antigen and IgM antibody to hepatitis B core antigen were tested in 15 patients who participated in a randomized, placebo-controlled trial of a 28-day course of prednisolone therapy. During treatment, serum levels of antibody to hepatitis B core antigen and IgM antibody to hepatitis B core antigen decreased in all 10 treated patients, but in none of five controls (p less than 0.05). Also during therapy, ALT activity decreased by an average of 50% and serum IgG levels by 30% (both p less than 0.05). Serum levels of hepatitis B virus DNA and DNA polymerase activity did not change significantly. Four to 10 weeks after discontinuation of prednisolone, a rebound of serum ALT and IgM antibody to hepatitis B core antigen levels occurred, which usually resolved within the subsequent months of follow-up evaluation. In three patients, however, there was a prolonged exacerbation of the disease following prednisolone withdrawal; in these three, levels of IgM antibody to hepatitis B core antigen and ALT remained elevated above pretreatment values. The close correlation between changes in serum ALT activity and IgM antibody to hepatitis B core antigen levels suggests that corticosteroids can modulate disease activity in chronic type B hepatitis by suppression of the host-immune response to hepatitis B virus antigens. PMID- 3552926 TI - The myelodysplastic syndrome--a practical guide. PMID- 3552927 TI - Peripheral blood stem cell autografting. AB - Transplantation of haemopoietic stem cells provides a means whereby patients with malignant disease may be treated with increased doses of chemotherapy or chemoradiotherapy. Until recently, the bone marrow has been the sole source of these cells. However, haemopoietic progenitors can also be demonstrated in the blood and it has been known for more than twenty years that peripheral blood mononuclear cells are capable of repopulating the marrow in animals. This phenomenon has recently been reproduced in man. The use of peripheral blood rather than bone marrow for autologous stem cell rescue may have advantages in terms of ready access, availability in patients with compromised pelvic bone marrows, a lower risk of tumour contamination and more rapid granulocyte and immune recovery. However, clinical experience with peripheral blood stem cell autografting is still very small. This review discusses the characteristics of circulating stem cells, the methods by which they can be collected and stored and the information which has come from recent studies of their transplantation in man. PMID- 3552928 TI - The histological diagnosis of cutaneous graft versus host disease: relationship of skin changes to marrow purging and other clinical variables. AB - Punch biopsies of skin were taken from allogeneic marrow recipients routinely before transplantation, at 14-22 and 90-107 d after grafting and in the event of a clinical rash. Three histological appearances were encountered: graft versus host disease (GvHD), epidermal abnormalities, and normal. Graft versus host disease was characterized by epidermal basal vacuolation, spongiosis and individual cell necrosis associated with mononuclear cell infiltration of the upper dermis and lower epidermis, while epidermal abnormalities were identical to GvHD but without the mononuclear cell infiltrate. Graft versus host disease occurred only in patients receiving marrow unpurged of T-cells while epidermal abnormalities occurred with equal frequency in recipients of purged and unpurged marrow and were also noted in a high proportion of pre-transplant biopsies. Patients whose skin biopsies exhibited epidermal abnormalities showed no greater incidence of subsequent clinical or histological GvHD than those with normal biopsies. For these reasons, we conclude that epidermal abnormalities cannot be regarded as a minor manifestation of GvHD as has often been previously assumed. We also conclude that they cannot be regarded as the cause of a rash as, unlike GvHD, the incidence was not significantly different in patients with and without rashes. The cause of epidermal abnormalities is not entirely clear; cytotoxic drugs and irradiation appear to play a part but their occurrence in patients with previously normal post-transplant biopsies suggests that other factors may also be important. Some patients with strong clinical evidence of GvHD had negative biopsies; these should be regarded with caution especially within the first 24 h after the onset of a rash as the diagnostic histological picture may take time to develop. In some cases, GvHD was confined to pilosebaceous units; this seems to represent a minor form of the disease with only a limited capacity for progression. Dysplastic epidermal changes which have previously been attributed to the use of cyclosporin A were found with equal frequency in patients who did not receive this drug and must therefore have some other cause. PMID- 3552929 TI - An update on multiple personality disorder. AB - Within the last decade, multiple personality disorder has been diagnosed, treated, and studied with increasing frequency. A growing body of literature suggests that this condition is not a rarity but that its manifestations, often coexisting with or obscured by other phenomena, frequently go unrecognized for years within the mental health care delivery system. The author reviews recent advances in the understanding of the etiology, diagnosis, and treatment of multiple personality disorder. The thrust of the contemporary literature is that it is a difficult-to-diagnose condition that usually follows severe child abuse, that it is most parsimoniously understood as a chronic dissociative posttraumatic stress disorder, and that it has an excellent prognosis when intensive and prolonged psychotherapy with an experienced clinician is available. PMID- 3552930 TI - Expressed emotion in families: a critical review. AB - Research on expressed emotion in the families of schizophrenic patients has seemed to offer a new perspective on environmental factors that cause relapse in schizophrenia. A review of the literature, however, reveals that while expressed emotion may predict relapse, there is no evidence that it causes relapse. Nor does the evidence support the continued linkage of the three components of expressed emotion--criticism, hostility, and emotional overinvolvement--in a single global variable. The authors also question the clinical significance of expressed emotion ratings and believe that treatment strategies based on them tend to blame relatives for the patient's continuing difficulties. They suggest that clinicians assess family responses in the context of the patient's behavior and life situation before helping families develop more effectual coping strategies. PMID- 3552931 TI - Computer-based monitoring of clinical care in a public psychiatric hospital unit. AB - A computer-based clinical monitoring system on a 40-bed university hospital psychiatric unit provides documentation to justify clinicians' diagnosis and choice of treatment and facilitates evaluation of patients' progress at scheduled intervals. The microcomputer system was developed to meet state guidelines for monitoring patients receiving neuroleptic drug treatment. A weekly status report generated for each patient alerts the treating physician to cases in which data do not justify clinical decisions, identifies potential problems, and suggests considering for discharge patients whose symptoms have sufficiently abated. The system is also useful in supervision and research. PMID- 3552933 TI - Industry calls for release of outlier data from HCFA. PMID- 3552932 TI - Rural issues move up on Congress's agenda. PMID- 3552934 TI - HCFA challenges state's retention of Medicaid funds. PMID- 3552936 TI - Rebasing seen as reality; adjustments undecided. PMID- 3552935 TI - HMOs slam Senate aging committee's report. PMID- 3552937 TI - Congress wrestles with financing catastrophic care. PMID- 3552938 TI - Physician payment reform catches Congress's eye. PMID- 3552939 TI - Interest on clean claims may not get paid. PMID- 3552940 TI - Troubled IMC: is it finally down for the count? PMID- 3552941 TI - HCFA may not like IMC, but its members do. PMID- 3552942 TI - Fraud bill steams toward passage. PMID- 3552943 TI - Medicare denials threaten the health of home care. PMID- 3552944 TI - Quality, access in forefront for HHS's Bowen. Interview by Jeffrey Finn. PMID- 3552945 TI - Congress set to tackle spousal impoverishment. PMID- 3552946 TI - Congress's (in)action will determine capital's fate. PMID- 3552948 TI - HFMA: hospitals will lose 1.1% on Medicare in '88. PMID- 3552947 TI - CPT4 system puts additional burden on hospitals. PMID- 3552949 TI - SC Blues plan drops Medicare risk contract. PMID- 3552950 TI - GHAA, AMCRA pan federal HMO/CMP review proposal. PMID- 3552951 TI - HHS ponders tying MDs incentives to HMO/CMP review. PMID- 3552952 TI - States opt for hospice Medicaid reimbursement. PMID- 3552953 TI - Histogenesis of unique elastinophilic fibers of elastofibroma: ultrastructural and immunohistochemical studies. AB - Electron microscopy and both light and electron microscopic immunohistochemical tests for elastin were employed to study the morphogenesis of the unique elastinophilic fibers of an elastofibroma removed from the subscapular region of a 62-year-old woman. Ultrastructurally, as shown by tannic acid stain, elastinophilic fibers of the elastofibroma consisted of central cores and outer zones. The latter were composed of various sizes of vaguely demarcated, irregularly shaped amorphous components and compactly and randomly arranged large amounts of microfibrils. The electron microscopic immunohistochemical results showed that the small-sized amorphous components and microfibrils in the outer zones of the elastinophilic fibers were stained evenly and of granular texture, but the vaguely outlined large amorphous components were not stained. These findings were interpreted as indicating that the amorphous components of the outer zones of elastinophilic fibers were less compact and allowed the penetration of antielastin antibody. The unique elastinophilic fibers of elastofibromas appear not to be formed by the degeneration of the fibers but by abnormal elastogenesis, including an abnormal arrangement of microfibrils. PMID- 3552954 TI - The role of coronary artery lesions in ischemic heart disease: insights from recent clinicopathologic, coronary arteriographic, and experimental studies. PMID- 3552955 TI - Immunohistochemical characterization of seminoma and its inflammatory cell infiltrate. AB - Monoclonal antibodies and the avidin-biotin immunoperoxidase technique were used to study the expression of major histocompatibility complex antigens and the nature of the inflammatory cell infiltrate in 10 testicular seminomas. Tumor cells did not react with anti-HLA-A,B,C, anti-HLA-DR, anti-HLA-DQ, and anti-beta 2 microglobulin antibodies to major histocompatibility antigens. All of the 10 tumors contained a slight to marked inflammatory cell infiltrate at the periphery of the tumor, in the connective tissue septa, and in the tumor lobules. The lymphocytes were predominantly T cells; B lymphocytes were rare. The tissue available for study from seven tumors showed tumor lobules separated by delicate fibrovascular septa; T lymphocytes with a cytotoxic-suppressor phenotype predominated in this area in six tumors. In the four tumors in which peripheral tissue was available for study, cells with a helper-inducer phenotype predominated at the tumor margin. Tissue from three tumors showed stromal sclerosis and a dense lymphohistiocytic infiltrate separating individual and small nests of tumor cells; T cells with a helper-inducer phenotype predominated in these cases. Aggregates of macrophages that expressed OKM-1 and Leu-M3 were present in eight of 10 tumors. These findings indicate that two types of immune reactions may be operating: a delayed-type hypersensitivity response at the periphery and a cytotoxic-suppressor effector mechanism in the tumor lobules. Furthermore, major histocompatibility complex antigens are not involved in eliciting the inflammatory response. PMID- 3552956 TI - Identification of a male-specific (H-Y) antigen on the flagellar plasma membrane of ram epididymal spermatozoa. AB - H-Y (male-specific) antigen has been detected on the plasma membranes of both caput and caudal ram spermatozoa using both immunoperoxidase and immunofluorescence labelling techniques. In these spermatozoa the distribution of H-Y antigen appears to be confined to both the posterior region of the head and the mid-piece region of the flagellum. In addition, caput spermatozoa also exhibit intense immunoperoxidase staining of the cytoplasmic droplet which is situated on the flagellum at the base of the head. Western blot analyses of purified plasma membranes from the flagella of caudal spermatozoa have revealed the presence of a male-specific protein with an estimated molecular weight of 25,000-27,000. PMID- 3552957 TI - The effect of Gc genotype on fasting insulin level in Dogrib Indians. AB - The metabolically active form of vitamin D, 1,25-(OH)2D3, is involved in the regulation of insulin level. Because the serum group-specific component (Gc) binds vitamin D, it is worth knowing whether differences in basal insulin levels are associated with Gc genotype. Such differences would warrant further investigation to clarify whether selection maintains Gc polymorphism through differential risk of Gc genotypes to diseases that involve insulin. Blood samples were collected in a study designed to address issues in the etiology of non insulin-dependent diabetes mellitus in Amerindians. Fasting insulin levels and Gc genotype (including subtypes of Gc1) were determined for 144 adult Dogrib Indians of the Northwest Territories, Canada. Hierarchical regression of log10 transformed fasting insulin on age and adiposity within each sex showed that age had no effect on insulin level, but adiposity as measured by the body mass index (BMI) had a very highly significant effect. Analysis of covariance of log10 fasting insulin by sex, by Gc genotype and with adjustment for the effects of the covariate, BMI, was very highly significant. All interaction terms in the model were nonsignificant. The only variable that had a significant effect after adjustment for the BMI was Gc genotype (F4,133 = 3.71; P = 0.007). Covariance analysis was repeated on a subset of the sample (124 people). The reduced data set excluded all individuals who had, on at least one occasion, abnormal response to oral glucose challenge [impaired glucose tolerance (IGT) or non-insulin dependent diabetes mellitus (NIDDM]). Again, after correction for the effects of the BMI, only Gc genotype had a significant effect on fasting insulin level (F4,113 = 2.61; P = 0.040). Homozygotes for Gc 1F-1F had the lowest measures of fasting insulin. PMID- 3552958 TI - Altered antigenicity of human monoclonal antibodies derived from human-mouse heterohybridomas. AB - We have generated milligram quantities of human monoclonal antibodies (Hu-MAbs) in the ascites of pristane-primed nude mice injected with human-mouse heterohybridomas. After contaminating mouse immunoglobulins were removed by affinity chromatography, an enzyme immunosorbent assay (EIA) was used to measure the concentrations of human immunoglobulins. Ten different partially purified preparations were tested. The titration curves with all 5 IgG Hu-MAbs were unusual, reaching a plateau at a very low apparent maximum concentration of antibody. In contrast, the EIA yielded more usual titration curves and thus apparently more reliable estimates of the concentrations of 4 IgM and 1 IgA monoclonal antibodies. An analogous EIA for the quantitation of mouse IgG monoclonal antibodies also gave accurate estimates. To understand the nature of the discrepancy with human IgG, 5 Hu-MAbs of the 3 classes (2 IgG, 2 pentameric IgM and 1 IgA) were purified to homogeneity for a more detailed analysis. The inability to quantitate the human IgG monoclonal antibodies by EIA was not due to defective molecules, as shown by SDS polyacrylamide gel electrophoresis. The human IgG monoclonal antibodies were found to consist of intact heavy and light chains, as were the IgM and IgA antibodies. The possibility that the human IgG monoclonal antibodies differed antigenically from polyclonal IgG was explored by comparing the concentrations by EIA with the protein concentrations determined by absorbance at 280 nm. This analysis permitted a comparison of the detectability of antigenic determinants on Hu-MAbs with those on polyclonal Ig with goat antibodies to Ig or Ig subclass. The IgG monoclonal antibodies differed from polyclonal IgG in both their heavy and light chains. Goat antiserum monospecific for the gamma chain in fact underestimated the concentration by as much as one hundred-fold. IgM and IgA monoclonal antibodies were less antigenically distinct from their polyclonal counterparts even though their light chains were also underestimated, because goat monospecific antibodies were more efficient at recognizing their heavy chains. The molecular basis for the observed difference in antigenicity is not yet known. These findings have important implications for the analysis of the binding of IgG Hu-MAbs. A direct binding assay with the label directly conjugated to the Hu-MAb should be used in preference to an indirect assay with a labeled detecting antibody to maximize the sensitivity of the assay. The altered antigenicity of IgG Hu-MAbs may also imply decreased immunogenicity when they are given in vivo as carriers for radionuclides or cytotoxic antitumor materials. PMID- 3552959 TI - Quality control of murine monoclonal antibodies using isoelectric focusing affinity immunoblot analysis. AB - Quality control of murine hybridoma secretory products was performed using two variations of the isoelectric focusing affinity immunoblot analysis. The first approach employed antigen-coated nitrocellulose placed on top of an acrylamide gel containing isoelectrically focused ascites to bind antigen specific monoclonal antibody (MoAb). Murine antibody bound to the insolubilized antigen was then detected with enzyme-conjugated anti-mouse IgG. In a second variation, focused ascites proteins were passively blotted onto nitro-cellulose and specific monoclonal antibody was detected with enzyme-conjugated antigen. Several batches of ascites containing anti-human IgG antibodies that were produced by 6 hybridomas over a 1-3 year period were assessed by IEF-affinity immunoblot analysis. Both immunoblot approaches permitted effective monitoring of immunoreactive antibody for pI microheterogeneity. IEF-affinity immunoblot patterns of unprocessed ascites displayed specific MoAb banding patterns with narrow pI ranges (less than or equal to 0.6 pH units), in contrast to the reported 5.5-8.0 pI range of polyclonal mouse IgG. Banding patterns obtained in the IEF affinity immunoblot typically displayed 3-5 major dense bands flanked by 2-4 minor fainter bands. Batches of ascites obtained years apart produced similar immunoblot patterns, indicating constant antibody production and confirming the stability of these hybridoma clones. Minor bands appeared in 2 earlier lots of ascites, suggesting possible modification of antibody during storage. IEF affinity immunoblot analysis is a useful tool for monitoring MoAb pI microheterogeneity as an indicator of antibody quality without the need for isolation of monoclonal antibody from culture medium or ascites. PMID- 3552960 TI - Newer positive inotropic agents in congestive heart failure. PMID- 3552961 TI - Echocardiographic demonstration of pulmonary valve vegetation in a child with infundibular pulmonic stenosis and closed VSD. PMID- 3552962 TI - Inactivation of aldolase by proteolytic enzymes in denervated rat muscle. PMID- 3552963 TI - [Wegener's granulomatosis: immunologic aspects of diagnosis, etiology and therapy]. AB - Wegener's granulomatosis (WG) is a rare disease, which has, however, been diagnosed more frequently in the past few years. The etiology is unclear; the pathogenesis is only vaguely understood. The association between HLA-DR2 and/or B8 and WG indicates that there is a genetic predisposition. Without treatment WG is said to run a malignant course with a median survival time of approx. 6 months. With immunosuppressive treatment, however, it is said to be possible to induce long-term remission in about 90% of the cases. Our experience only partially confirms these figures from other countries. From the clinical point of view it is particularly important to point out that there are two phases the disease can run through: In one third of the cases WG begins with an initial stage that can last for many years, but generally does not cause any life threatening complications. This stable phase can lead into the generalized stage. Untreated, the disease, a fulminant WG characterized by a syndrome of rapidly progressive renal failure and/or respiratory insufficiency, now rapidly leads to death. The clinical diagnosis must always be confirmed by biopsy. Whether the newly discovered disease-specific autoantibody will make a histological examination superfluous in the future is not clear, but at the moment it appears rather unlikely. This antibody against intracytoplasmic antigens of cells of the myelomonocytic line (ACPA) is found in only 60% of the cases with WG. ACPA is often demonstrable in the acute generalized phase, but also during instable partial remissions. In contrast, it is only seldom during the initial stage or in full remission. According to this experience it appears clear that we must adapt the treatment of WG to the stage the disease is in. Low-dose cyclophosphamide cortisone treatment is considered to be a reliable treatment for the acute generalized stage. Whether the fulminant form can be influenced positively by additive (e.g., plasmapheresis) or alternative (e.g., pulse treatment with cyclophosphamide and cortisone) protocols must remain open at present. We must assume that at least the stable phase of the disease (initial stage) can be treated less aggressively. This will only be possible if close-meshed controls can be carried through at a center for vasculitis, where interdisciplinary cooperation (otorhinolaryngology-ophthalmology-general internal medicine) will make it possible to recognize any exacerbation, so often appearing unexpectedly, at an early point, so that the patient is not endangered unnecessarily. PMID- 3552964 TI - [Classification and pathogenesis of vasculitis]. PMID- 3552965 TI - [Leukocytoclastic vasculitis]. AB - Leukocytoclastic vasculitis is one of the more frequent syndromes of the spectrum of vasculitis. It represents a heterogeneous group of diseases, characterized by the cutaneous phenomenons of palpable purpura and persistent urtica, and the histologic patterns of vessel wall necrosis, leukocytoclasia, and hemorrhage. Pathogenetic and clinical aspects, just as therapeutic approaches are discussed in this report. PMID- 3552966 TI - Distribution of T-lymphocyte subsets in porcine lymphoid tissues. AB - The distribution of the functional subsets of porcine T cells, the cytolytic/suppressor (Tc/s) and the helper/inducer (Th/i) cells was studied in cryostat sections of thymus, lymph nodes, tonsils, Peyer's patches, spleen and liver using the indirect immunoperoxidase technique. Three murine monoclonal antibodies (mAb) were used. The mAb 8/1 reacts with an antigen present on all T cells and on cells of the myeloid lineage; the antigen has not yet been characterized biochemically. The mAb 295/33 (anti-T8) binds to the porcine T8 antigen and defines the Tc/s subset, while mAb PT-4 (anti-T4) detects the porcine T4 antigen and defines the Th/i subset. Practically all thymocytes were stained by mAb 8/1. The majority of cortical thymocytes apparently co-expressed T8 and T4, whereas distinct fractions of medullary cells were labelled by either anti-T8 or anti-T4. In peripheral lymphoid organs all three mAb reacted with cells in the thymus-dependent areas and with cells scattered in the lymphoid follicles. In lymph nodes, tonsils and Peyer's patches, anti-T8 and anti-T4 each labelled approximately half of the cells stained by mAb 8/1. In the periarteriolar lymphoid sheath of the spleen, anti-T4 labelled more cells than did anti-T8. The reactivity of mAb 8/1 with the Kupffer cells of the liver demonstrated the expression of the 8/1 antigen on cells of the monocyte lineage. The T8 and T4 antigens could not be detected in acetone-fixed and paraffin-embedded sections, while the antigen recognized by mAb 8/1 remained preserved. Altogether, despite an inverted microanatomical structure of porcine lymph nodes, the frequency and distribution of T8+ and T4+ cells in thymus-dependent areas proved to be similar to those found in other species. PMID- 3552967 TI - Structure and specificity of complement receptors. AB - Fifteen to 16 cell surface proteins which interact with soluble components of the complement system have now been identified. Most of these--CR1, CR2, CR3, "CR4", DAF, HSV-1 c glycoprotein, Gp 45-70, p150,95, cell-surface Factor H, and a 90 kD protein--interact with C3 or C4 and their degradation products. Other receptors for C1q, Factor H, C5a, and the C5b-9 complex have been identified. Receptors for additional complement proteins such as Factor B or its fragments are likely to exist. Complement receptors have a wide tissue distribution and have major roles in controlling the turnover of the complement system, and regulating behaviour and growth of leukocytes. PMID- 3552968 TI - Human diseases associated with C3 receptor deficiencies. AB - Genetic deficiencies of complement receptors have recently been described. CR1 expression is reduced on erythrocytes, leucocytes and podocytes of many patients with systemic lupus erythematosus because of both genetic and acquired mechanisms. CR1 deficiency is also found in AIDS and AIDS-related syndromes and correlates with clinical subpopulations of HIV-infected patients. The pathogenic significance of CR1 deficiency relates to the functions of CR1 in clearance of immune complexes, phagocytosis and immune regulation. CR3 deficiency occurs as an autosomal recessive inherited disease characterized by the lack of or severe reduction in expression of the leucocyte antigens CR3, LFA1, p150,95 and their common chain. The disease is associated with severe defects in neutrophil and lymphocyte functions and recurrent bacterial infections. The in vivo effects of C3 receptor deficiencies emphasize the critical role of these membrane molecules in immunity. PMID- 3552969 TI - Studies of antibody and complement function in host defense against bacterial infection. PMID- 3552970 TI - Generation of an activated form of human C5 (C5b-like C5) by oxygen radicals. AB - Treatment of purified human C5 with hydrogen peroxide leads to a reduction of functional activity in the classical immune haemolysis assay. The effect of H2O2 is enhanced by traces of iron-EDTA, and becomes even stronger when ascorbic acid is present in addition. The enhancement by iron and protective effects of various radical scavengers indicate that the conversion of C5 is brought about by hydroxyl radicals mainly, generated from H2O2 during its decomposition. By the conversion C5 acquires a new functional property: it becomes capable of binding C6, and the resulting complex C56 lyses non-sensitized red cells in cooperation with the late components C7, C8, and C9 (reactive lysis). In this respect, H2O2 treated C5 resembles the activation fragment of C5, C5b. However, unlike C5b, C5(H2O2) is not fragmented but comprises the whole molecule, according to polyacrylamide gel electrophoresis. In accordance with the lack of cleavage, no chemotactic activity indicating formation of C5a, became apparent after H2O2 treatment of C5. In whole human serum, however, the H2O2 system induces additional processes leading to the generation of C5a activity and indicating C5 cleavage. The pathways to this reaction are as yet not clear. The effect of oxygen radicals on C5 may be the basis of the enhancing effect of stimulated leukocytes on C5 activation in body fluids. Activated leukocytes are known to produce H2O2 and oxygen radicals. PMID- 3552971 TI - The classical pathway of complement prevents the formation of insoluble antigen antibody complexes: biological implications. AB - There is now clear evidence for a complement dependent physiological system which is capable of processing immune complexes in and outside the vascular compartment so that they remain soluble, and transporting such complexes to the fixed macrophage system where they are safely eliminated. Defects in physiological immune complex disposal can occur at various stages described in this article, and it could well be that several of these stages could present subtle defects which are, however, additive so that under a given set of circumstances immune complexes end up in the wrong places, i.e. outside the fixed macrophage system. PMID- 3552972 TI - Involvement of complement in B-cell, T-cell and monocyte/macrophage activation. AB - In the early 70's it had been shown, that for the immune response against T dependent antigens C3 was necessary, while T-independent antigens, although activating the alternative pathway of complement, triggered antibody formation also in C-deficient mice. During recent years functional and biochemical knowledge about complement binding structures on B-cells and monocytes/macrophages continuously increased and, also, on T-cells C3 binding entities have been detected. In the case of B-cells and, at least in special experimental conditions, in the case of T-cells C3 can exert a proliferative response as long as the cells are prestimulated (excited) by anti-Ig or IL-2, respectively. Monocytes can bind C3b- or iC3b-carrying particles, but only when progressed to macrophages can they phagocytose such particles. Thus the concept evolves that B-cells, T-cells and monocytes can acquire competence for a C3 driven response when excited properly. The involvement of molecules such as CR1, CR2, factor H, IL-2-receptor and others with a basic structure of repeating units of 61 amino acids in the triggering processes is a surprising finding and certainly suggests their functional importance. In the case of T-independent antigens the structures triggering the alternative pathway of complement are the structures triggering monocytes directly. Whether these two functions have a causal relationship has to be shown. PMID- 3552975 TI - Force transfer by osseointegration implant devices. PMID- 3552973 TI - A human cytotoxic lymphocyte subdividing the DQ1 antigen. PMID- 3552974 TI - Clinical trial of gugulipid--a new hypolipidemic agent of plant origin in primary hyperlipidemia. PMID- 3552976 TI - Screening for ovarian cancer. PMID- 3552977 TI - Hormonal responses and blood pressure maintenance in normal and hypertensive subjects during acute blood loss. AB - Blood pressure (BP) and plasma indices of three major pressure control systems- plasma norepinephrine and epinephrine, plasma renin activity (PRA), and plasma arginine vasopressin--were measured simultaneously in 12 normal and 15 mildly essential hypertensive subjects before and after removal of 480 ml of blood by phlebotomy, to determine if there were differences in the compensatory response to acute blood loss. Responses to postural stress (change from supine to sitting position) following phlebotomy were also compared in a second group of subjects. Before phlebotomy, supine plasma hormone levels did not differ in the two groups. After phlebotomy, both groups exhibited only slight decreases (5 mm Hg) in systolic BP and a transient rise in heart rate. Only plasma norepinephrine increased significantly in both groups (35% above control in normal and 43% in hypertensive subjects). Similar results were obtained in a second group of normal and hypertensive subjects, who were also subjected to a 10-minute postural challenge after phlebotomy. After 10 minutes in a sitting position, BP in these subjects remained unchanged but heart rate and plasma norepinephrine increased further to levels almost twice that produced by phlebotomy alone. Plasma epinephrine levels and PRA also increased with this additional stress, but plasma vasopressin remained unchanged. Changes in BP, heart rate, plasma norepinephrine and epinephrine, and PRA did not differ significantly between the two groups. These data indicate that hypertensive subjects are as capable as normal subjects of maintaining BP when subjected to standard phlebotomy, the sympathetic nervous system appears to be the predominant pressor mechanism activated following an acute, nonhypotensive blood loss in both groups of subjects,(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3552978 TI - Effect of muralytic enzyme degradation of streptococcal cell wall on complement activation in vivo and in vitro. AB - Rats given a single intraperitoneal injection of an aqueous suspension of peptidoglycan-polysaccharide polymers derived from group A streptococcal cell wall (PG-APS) develop a severe, chronic, erosive arthritis which resembles human rheumatoid arthritis. The treatment of PG-APS-injected rats with a single intravenous injection of 0.4 mg of mutanolysin prevents the development of chronic arthritis, even when administration of the enzyme is delayed until severe acute arthritis has developed. PG-APS activates complement both in vitro and in vivo. Digestion of PG-APS with mutanolysin in vitro destroys the ability to activate both the alternate and classical pathways of human serum complement, and the loss of complement activation parallels the extent of PG-APS degradation. There is also a reduction in the in vivo complexing of C3 with PG-APS in the limbs of PG-APS-injected rats treated with mutanolysin, compared to control rats injected with PG-APS and treated with phosphate-buffered saline. This association between loss of arthropathic activity and loss of activation of complement is consistent with the hypothesis that activated complement products form a part of the inflammatory mediators involved in the acute and chronic phases of bacterial cell wall-induced arthritis. This may also partially explain how mutanolysin treatment alleviates cell wall-induced arthritis in the rat. PMID- 3552979 TI - Characterization of polymorphonuclear leukocyte aggregation in vitro induced by heat-inactivated group B streptococcus. AB - We studied the aggregatory characteristics of human polymorphonuclear leukocytes (PMNs) in response to heat-inactivated group B streptococcus. PMNs suspended in physiologic salt solution do not aggregate to heat-inactivated group B streptococcus (GBS) unless the GBS is previously opsonized in autologous plasma. The aggregating activity of both opsonized GBS and activated plasma are reduced if the plasma is decomplemented before incubation with GBS. Pretreatment of PMNs with pronase inhibited opsonized GBS-induced aggregation, suggesting aggregation via cell membrane receptors for opsonic fragments of C3. Pronase pretreatment had no significant effect on aggregation induced by activated plasma or arachidonic acid. Unlike PMNs in physiologic salt solution, PMNs suspended in plasma aggregate when stimulated by unopsonized GBS. GBS aggregates PMNs via complement cascade activation, opsonization, and interaction with cell membrane receptors to stimulate cellular mechanisms resulting in PMN aggregation. PMID- 3552981 TI - [The sublingual seal]. PMID- 3552980 TI - [The border seal]. PMID- 3552982 TI - The hyaluronidase associated with Treponema pallidum facilitates treponemal dissemination. AB - Treponema pallidum contains hyaluronidase (Hase) associated with its surface. Experiments were performed to determine the functional role of this enzyme in syphilitic infection. The effects of incubating organisms with rabbit anti-bovine Hase or normal or immune sera were compared. Preincubation of treponemes with anti-Hase resulted in inhibition of treponemal degradation of hyaluronic acid, indicating that these antisera did in fact retard enzyme activity. Anti-Hase did not immobilize or neutralize T. pallidum. In addition, rabbits were immunized with bovine Hase and then challenged intradermally with organisms; subsequent lesion development was not affected. Anti-Hase did not block treponemal attachment to cultured testicular fibroblasts but did inhibit attachment to isolated capillaries. Rabbit amnions were used as an in vitro model for dissemination of T. pallidum. Anti-Hase retarded the penetration of organisms through the amnions. This inhibitory effect was dependent on the presence of amniotic hyaluronic acid. When this glycosaminoglycan was selectively removed, the anti-Hase lost its ability to inhibit treponemal penetration. When exogenous hyaluronic acid was added back to treated amnions, the inhibitory effect of anti Hase was restored. Evans blue experiments were used to characterize treponeme induced vascular leakage following intradermal inoculation of T. pallidum. Prior treatment of organisms with anti-Hase reduced dermal leakage of the dye, indicating the involvement of the treponemal Hase in causing vessel leakage. Finally, rabbit testicular infections were used as an in vivo model for dissemination; one testis was infected, and after 10 to 13 days, treponemes in the opposite testis were quantitated. The anti-Hase restricted dissemination of organisms. These findings point to the functional role of the treponemal Hase in facilitating disseminated syphilis. PMID- 3552983 TI - Antibody specific for Escherichia coli J5 cross-reacts to various degrees with an Escherichia coli clinical isolate grown for different lengths of time. AB - Rabbit antiserum raised against the rough mutant of Escherichia coli O111:B4, designated J5, was examined for cross-reactivity to an E. coli clinical isolate (A2385). In whole-cell enzyme-linked immunosorbent assays, J5 antiserum reacted to a greater extent with A2385 grown for 5 h than with the same bacteria grown for 19 h, while the homologous antiserum reacted similarly with bacteria grown for different lengths of time. J5 antiserum reacted to the greatest extent with lipopolysaccharide (LPS) from A2385 grown for up to 10 h, and reactivity greatly diminished thereafter; homologous antiserum showed no difference in reaction over time. LPS from smooth bacteria grown for 19 h showed no reaction with J5 antiserum in immunoblots, while LPS from A2385 grown for 5 or 10 h showed a positive reaction. Little or no difference among the three LPS samples could be seen when homologous antiserum was used. Mice vaccinated with J5 LPS before lethal challenge with live A2385 were protected from this challenge, whereas most nonimmunized mice died. Toxicity tests in mice showed LPS from A2385 grown for 19 h to be twice as lethal as LPS from A2385 grown for 3 h. Mice vaccinated with J5 LPS were protected to a greater extent when challenged with a lethal dose of LPS from A2385 grown for 3 h than when challenged with LPS from A2385 grown for 19 h. The results reported here may explain the means by which J5 vaccination (active or passive) sometimes protects against heterologous challenge. PMID- 3552984 TI - Serum-mediated suppression of lymphocyte transformation responses in coccidioidomycosis. AB - Lymphocyte transformation (LT) responses to coccidioidin (CDN) and spherulin were suppressed in 11 (73%) of 15 patients with active coccidioidomycosis when their mononuclear cells were assayed in autologous serum as compared to serum from healthy, CDN skin test-positive subjects. Suppressed LT responses were specific for Coccidioides immitis antigens in 7 (64%) of the 11 patients. Immunoaffinity chromatography of patient sera with Staphylococcus protein A adsorbed the suppressor component(s) and thereby established that suppression was attributed to immunoglobulin G, either alone or complexed with antigen. The possibility that suppression was mediated by immune complexes was examined by adding complexes formed in vivo or in vitro to mononuclear cell cultures of healthy CDN-reactive persons before LT assays. Although complexes prepared in this manner were reactive in an enzyme-linked immunosorbent assay designed to detect Coccidioides antigen-specific immune complexes, no suppression of LT responses was observed. We conclude that serum-mediated suppression of LT responses in coccidioidomycosis is attributed to monomeric and not immune-complexed immunoglobulin G antibody. PMID- 3552986 TI - Modulation of murine Peyer's patch immunoglobulin A response by enterotoxigenic Escherichia coli. AB - Enterotoxigenic Escherichia coli (ETEC) may have profound effects on the capacity of gut-associated lymphoid tissue to mount a secretory immune response because of the potential ability of heat-stable toxin or heat-labile toxin to modulate the immune response. To examine the effects of ETEC or its purified enterotoxins upon the humoral immune response of murine small intestinal Peyer's patch lymphocytes, BDF1 (lipopolysaccharide-responder) and C3H/HeJ (lipopolysaccharide-nonresponder) mice were orally primed with sheep erythrocytes (SRBC) four times during a 2-week period to initiate differentiation of Peyer's patch B lymphocytes to cells committed to anti-SRBC immunoglobulin A (IgA) production. Halfway through the oral priming regimen the mice were gastrically intubated with 10(8) ETEC, 10(8) non-ETEC, or saline. ETEC persisted in the small intestine for at least 7 days at a level of 10(3) to 10(4) bacteria per mouse. Seven days after the last oral dosing with SRBC, Peyer's patch lymphocytes were removed from infected or saline treated mice and incubated in vitro with SRBC. The ETEC infection had a small effect on the anti-SRBC IgM plaque-forming cell response of SRBC-primed mice but inhibited significantly the anti-SRBC IgA plaque-forming cell response in both BDF1 and C3H/HeJ mice as compared with uninfected controls. The non-ETEC, an isolate from normal mouse small intestine, had no significant effect on either IgM or IgA anti-SRBC plaque-forming cell response. Purified heat-labile toxin, not heat-stable toxin, alone in a dose-dependent manner significantly inhibited both the IgA and IgM plaque-forming cell response of Peyer's patch lymphocytes from primed mice. These data suggest that ETEC can inhibit the development of the gut-associated lymphoid tissue IgA immune response through the immunopharmacological effect of an enterotoxin, the heat-labile toxin. PMID- 3552985 TI - Investigation of synthetic Escherichia coli heat-stable enterotoxin as an immunogen for swine and cattle. AB - In its native form Escherichia coli heat-stable enterotoxin (STa) is nonantigenic; however, neutralizing antibodies are elicited in animals vaccinated with toxin-carrier conjugates. To study the immunogenicity of STa, peptides STa1 18 and STa5-18 were synthesized, characterized, and conjugated to carrier proteins. Pregnant gilts and heifers were hyperimmunized with the respective conjugates. Following parturition neonates were challenged with virulent E. coli (K99+ STa+). Peptides coupled to ovalbumin and emulsified with Freund adjuvant elicited antibodies that neutralized toxin-induced fluid accumulation in suckling mice. Peptides coupled to particulate carriers, with or without muramyl dipeptide adjuvant, failed to induce a measurable response. Peak antibody levels in sera were observed following three doses of conjugate and persisted for several weeks. The serological response in cattle was superior to that observed in swine; however, antibody levels in porcine colostrum were higher than those observed in cattle. Clinical observations of neonates from vaccinated dams indicated that passively obtained antibody provided partial protection from disease, but not as complete as that demonstrable with whole cell bacterins that induce antibody to pili. However, the data suggest the potential for utility of synthetically prepared antigens. PMID- 3552987 TI - Stimulation of complement component C3 synthesis in macrophagelike cell lines by group B streptococci. AB - Complement levels and complement activation are key determinants in streptococcus induced inflammatory responses. Activation of macrophage functions, such as complement synthesis, by group B streptococci (GBS) was examined as a possible component of GBS-induced chronic inflammation. Using an enzyme-linked immunosorbent assay, secreted C3 from mouse macrophagelike cell lines (PU5-1.8 and J774A.1) was monitored after cultivation with GBS. Whole, heat-killed GBS (1 to 10 CFU per macrophage) of both type Ia and III strains induced 25 to 300% increases in secreted C3 in both cell lines after a 24-h cultivation. GBS-treated cell lines exhibited increases in secreted lysozyme (10%) and in cellular protein (25 to 50%). Inhibition of macrophage phagocytosis by cytochalasin B inhibited GBS stimulation of C3. Purified cell walls of GBS type III strain 603-79 (1 to 10 micrograms/ml) also enhanced C3 synthesis. Local enhancement of macrophage C3 production by ingested streptococci or by persistent cell wall antigens may serve to promote chronic inflammatory responses. PMID- 3552989 TI - Protective efficacy in humans of killed whole-vibrio oral cholera vaccine with and without the B subunit of cholera toxin. AB - Natural protection from cholera is associated with local intestinal antibacterial and antitoxic antibodies, which appear to act synergistically. Although current parenteral cholera vaccines offer insufficient protection, new vaccines administered orally have more promise. Killed Vibrio cholerae, alone or given with the B subunit of cholera toxin, was evaluated in adult volunteers. Vaccinees, who received three doses of either vaccine, and unvaccinated controls ingested 10(6) V. cholerae organisms to determine the protective efficacy of the vaccines. The combination vaccine provided 64% protection, and the whole vibrio vaccine given alone provided 56% protection. In addition, illnesses in vaccines were milder than those in controls, and both vaccines gave complete protection against more severe disease. This substantial level of protection against a dose of V. cholerae that caused cholera in nearly 90% of controls suggests that these vaccines might provide at least as high a level of protection if given to the population of an endemic area. Indeed, a field efficacy trial is underway in Bangladesh, and preliminary data indicate a protective efficacy of 85% for a killed whole vibrio plus B subunit vaccine similar to that tested in volunteers and an efficacy of 58% for the killed whole vibrio vaccine alone. Thus, the studies in human volunteers were successful in predicting the substantial protection afforded by the vaccines in a cholera endemic area. PMID- 3552988 TI - Identification and purification of a recombinant Treponema pallidum basic membrane protein antigen expressed in Escherichia coli. AB - A recombinant plasmid designated pLVS3 previously was described that harbored a 14-kilobase insert of Treponema pallidum genomic DNA. Escherichia coli maxicells programmed with this plasmid synthesized three treponemal protein antigens of molecular weights 39,000, 35,000, and 25,000 (39K, 35K, and 25K proteins, respectively). In this study, a detailed deletion analysis of pLVS3 demonstrated that the genetic information for all three protein antigens is contained within a 1.5-kilobase EcoRI-HpaI restriction fragment. The DNA sequence of this fragment revealed a single open reading frame of 361 codons that most likely encodes a signal peptide-bearing precursor to the 39K protein that can be transiently detected in E. coli maxicells. Evidence indicated that the 35K and 25K protein antigens are derivatives of the larger protein and are only produced in maxicells. A significant elevation in expression of the 39K treponemal protein antigen in E. coli was obtained by using the E. coli lpp and lac promoters and a genetic construction in which the signal peptide and first four residues of the "mature" 39K protein were replaced by six amino acids encoded by the vector. This hybrid protein exhibited an unusually high pI, which greatly facilitated its purification to homogeneity. By using antibody prepared against the hybrid protein, the native treponemal protein counterpart, also of molecular weight 39,000, was identified as a membrane component of T. pallidum. Since the native protein also exhibited a net positive charge, it has been designated the T. pallidum basic membrane protein. PMID- 3552990 TI - Cloning and expression in Escherichia coli of the Ibc protein genes of group B streptococci: binding of human immunoglobulin A to the beta antigen. AB - Total-cell DNA isolated from a highly virulent serotype Ic strain of a group B streptococcus was used to construct a gene bank with bacteriophage lambda L47.1 in Escherichia coli K-12. Recombinant phage plaques in the bank were immunoblotted by using anti-alpha- and anti-beta-specific antibodies directed towards the Ibc proteins purified from the streptococcal cell surface, and hybrid phages expressing the alpha protein (lambda alpha +) and the beta protein (lambda beta +) were identified. DNA inserts in these phages were subcloned into E. coli high-copy-number plasmid vectors to produce stable alpha + (pPHC10) and beta + (pPHC8 and pPHC33) recombinant plasmids, and restriction maps of the cloned streptococcal sequences were constructed. Antibodies against the two Streptococcus-derived proteins reacted with high-molecular-weight polypeptides made in E. coli cells carrying the corresponding hybrid plasmids and with several degradation peptides from them. A 190-kilodalton alpha protein, previously undetected, was identified; this species may be the native alpha protein or a precursor of it. In addition, mutagenesis of the cloned sequences was carried out by using the omega fragment to determine the direction of transcription. In E. coli, the beta protein, but not the alpha protein, bound human immunoglobulin A (IgA) in Western blots, and neither protein bound IgG or IgM. PMID- 3552991 TI - Identification of a Streptococcus agalactiae protein antigen associated with bovine mastitis isolates. AB - Immunoblotting was used to analyze the immune response of cows to Streptococcus agalactiae. Antibody from the milk of cows immunized (via the superficial inguinal lymph node) with formalinized S. agalactiae cells or from the milk of cows with S. agalactiae mastitis reacted strongly with a group of high-molecular weight proteinaceous antigens. The two most predominant antigenic polypeptides in this group had apparent molecular weights of 97,000 and 104,000. Because the data indicated that these two antigens, as well as several minor antigens sometimes observed in the 70- to 100-kilodalton size range, seemed to be different forms of the same protein, we refer to the entire group as Sas97/104. A monoclonal antibody that was reactive with Sas97/104 was derived and was used to purify the antigen by affinity chromatography. Whole-cell and colony blot enzyme-linked immunoassays with either the monoclonal antibody or a polyclonal serum sample raised against the affinity-purified antigen indicated that this antigen (or cross-reactive proteins with higher molecular weights) is present on the S. agalactiae strains that were freshly isolated from mastitic cows. However, the antigen was not detected in S. agalactiae of human origin, bovine strains of S. agalactiae maintained for a prolonged period in the laboratory, or other streptococci. The data are consistent with the notion that Sas97/104 is a surface antigen and does not correspond to previously described type-specific antigens of group B streptococci. PMID- 3552992 TI - Molecular cloning, characterization, and complete nucleotide sequence of the gene for pneumolysin, the sulfhydryl-activated toxin of Streptococcus pneumoniae. AB - A recombinant lambda bacteriophage has been isolated that carries DNA from Streptococcus pneumoniae and expresses a potent hemolysin that has been shown to be pneumolysin, the sulfhydryl-activated toxin of the pneumococcus. Hemolytic activity is inhibited by cholesterol and neutralized by serum against streptolysin O. The cloned gene expresses two polypeptides (Mrs, 56,000 and 53,000) in an Escherichia coli in vitro transcription-translation system, and both are precipitated by the addition of anti-alveolysin serum and anti streptolysin O serum in the presence of Staphylococcus aureus cells. Expression of pneumolysin occurs when the gene is cloned in both possible orientations in pUC8. The DNA sequence of a 5-kilobase ClaI fragment that carries the pneumolysin gene has been determined. An open reading frame was identified that encodes a polypeptide of 471 amino acids that is hydrophobic in character and has an N terminal amino acid sequence which is identical to that deduced from amino acid sequencing of the purified protein. The predicted amino acid sequence of the polypeptide reveals a single cysteine residue located 44 residues from the C terminus. Putative promoter and ribosome binding sites have been identified 5' to the pneumolysin coding sequence. PMID- 3552993 TI - Metabolism of Mycobacterium leprae in macrophages. AB - The incorporation of 14C-labeled palmitic acid ( [U-14C]PA) into the phenolic glycolipid-I (PGL-I) fraction of Mycobacterium leprae was studied in a murine macrophage system in vitro. Peritoneal macrophages from Swiss Webster mice were infected with fresh viable or Formalin-killed M. leprae harvested from infected footpads of nu/nu mice, and [U-14C]PA was added to the culture medium. Labeled glycolipid synthesized by live M. leprae was fractionated on a Florisil-silicic acid column and identified as PGL-I by using thin-layer chromatography and localization on a polysulfone membrane with an anti-PGL-I monoclonal antibody. Increased incorporation of [U-14C]PA into the PGL-I fraction was observed in macrophages infected with only live M. leprae. Treatment of the infected macrophages with rifampin caused a significant reduction in the incorporation of palmitic acid into PGL-I. These preliminary studies suggest that PGL-I synthesis can be used to quantitate the metabolism of M. leprae in macrophages in vitro. PMID- 3552995 TI - Passive immunization with antibodies against iron-regulated outer membrane proteins protects turkeys from Escherichia coli septicemia. AB - Escherichia coli septicemia is a common disease of young poultry and several species of mammals. Rabbit antiserum was prepared against iron-regulated outer membrane proteins of E. coli. Eighteen-day-old turkeys were passively immunized with antiserum and challenged by air sac inoculation of 1 X 10(6) to 2 X 10(6) CFU of E. coli O78:K80:H9. Turkeys injected with normal rabbit serum or saline solution before challenge served as controls. Fatalities (8 of 51 turkeys inoculated) occurred only in groups given saline solution or normal rabbit serum. The remaining turkeys were necropsied 96 h after challenge. Passive immunization with antiserum significantly (P less than 0.05) reduced the frequency of bacteremia at 96 h after challenge, the frequency of recovery of E. coli from air sacs, and the severity of gross lesions in inoculated birds as compared with birds given normal rabbit serum or saline solution. PMID- 3552994 TI - Bacterial virulence versus host resistance in the urinary tracts of mice. AB - The relative contributions of host resistance and bacterial virulence were analyzed in a mouse model for ascending urinary tract infection. The congenic mouse strains C3H/HeJ and C3H/HeN were used in parallel. They differ in their reactivity to lipopolysaccharide (LPS) and susceptibility to experimental urinary tract infection. C3H/HeJ cells are susceptible to infection and are nonresponders to LPS (Lpsd Lpsd), whereas C3H/HeN cells respond to LPS and are resistant to infection (Lpsn Lpsn). The Escherichia coli pyelonephritis isolate GR-12, serotype O75K5, expressing adhesins specific for globoseries glycolipids (P fimbriae) and for mannosides (type-1 fimbriae), and its derivatives deficient in these factors were used, either singly or in combination, to establish experimental infections. In C3H/HeN mice, the relative persistence of E. coli was inversely proportional to its phagocytosis in vitro. Loss of the O75 and K5 antigens increased the tendency toward hydrophobic interaction, promoted phagocytosis, and reduced persistence in the kidneys. This was not the case in C3H/HeJ mice, in which O75- and K5- serotypes persisted in the same extent as did the parent strain. The total number of bacteria recovered from the kidneys of C3H/HeJ mice was about 1,000-fold higher than the number recovered from kidneys of C3H/HeN mice 24 h after infection. Previous studies have demonstrated a delayed influx of polymorphonuclear leukocytes into the urinary tracts of C3H/HeJ mice. The results are consistent with the hypothesis that phagocyte activation through LPS is a major defense mechanism against E. coli in the kidney, a property in which C3H/HeJ mice are deficient. PMID- 3552996 TI - Effect of differences in antibody and complement requirements on phagocytic uptake and intracellular killing of "c" protein-positive and -negative strains of type II group B streptococci. AB - The influence of antibody and complement on the polymorphonuclear leukocytic uptake and killing of type II group B streptococci (GBS) was examined with 11 adult sera and three type II strains possessing the trypsin-resistant and trypsin sensitive components (II/TR+TS) of the "c" (formerly Ibc) protein or two type II strains lacking both components (II/no c) of the c protein. All tested sera mediated a greater than 1 log10 reduction in colony-forming units (CFUR) of a type II/no c strain, even in the absence of measurable type-specific antibody (less than 1.08 micrograms/ml), but only 5 of 11 mediated a greater than 1 log10 CFUR of any type II/TR/TS strain, even in the presence of moderate levels of type specific antibody. The classical pathway of complement activation appeared to be more important than the alternative pathway, and even absorbed or immunoglobulin G (IgG)-depleted serum (IgG, 10 mg/dl) mediated a greater than 1 log10 CFUR without magnesium ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N' tetraacetic acid (magnesium EGTA) chelation. Chelation with magnesium EGTA reduced the CFUR in 4 of 11 test sera and greatly reduced the CFUR in absorbed or IgG-depleted sera for type II/no c strains. Despite variation in the phagocytic killing of two representative strains of type II GBS, both strains were well phagocytized, as measured by radiolabeled bacterial uptake or electron microscopy. This study suggested that poorly killed type II/TR+TS GBS were easily phagocytized but apparently resisted intracellular killing. PMID- 3552998 TI - Enterotoxigenic strains of Escherichia coli O128 are not restricted to subgroup ac but also belong to subgroups ab and abc. AB - Ninety strains of Escherichia coli O128 isolated in many different countries were examined. The majority (77 strains) belonged to the antigenic subgroup O128ab, and 41 of these strains produced heat-stable enterotoxin (ST), heat-labile enterotoxin (LT), or both. Eight strains were of the antigenic subgroup O128ac; six produced ST only, and two were nontoxigenic. Five strains were of the antigenic subgroup O128abc; two produced ST and LT, and three were nontoxigenic. Ten of the strains studied produced Vero cytotoxin, and all belonged to the antigenic subgroup O128ab. It was concluded that, contrary to the report of Guth et al. (B. E. C. Guth, M. L. M. Silva, I. C. A. Scaletsky, M. R. F. Toledo, and L. R. Trabulsi, Infect. Immun. 47:338-340, 1985), enterotoxigenic strains of E. coli O128 are not restricted to subgroup ac but also belong to the most common subgroup, ab. PMID- 3552997 TI - Conservation and diversity of Campylobacter pyloridis major antigens. AB - Infection with Campylobacter pyloridis has been strongly associated with gastritis in humans although its etiologic significance is currently undefined. We examined the structure and antigenicity of whole-cell, outer-membrane, acid extractable surface protein, and proteinase K-treated whole cell lysate preparations from eight C. pyloridis strains by sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunoblotting with homologous and heterologous immune rabbit serum. Whole-cell and outer-membrane profiles observed in all strains of C. pyloridis were nearly identical; none were similar to those of C. jejuni and C. fetus. Major whole-cell bands migrated at 26,000, 29,000, 56,000, and 62,000 molecular weights. The acid-extracted protein profiles of all C. pyloridis strains also were similar to one another and showed similarities with acid-extracted proteins from C. jejuni, with major bands migrating at 29,000, 48,000 to 53,000, and 62,000. All proteinase K-treated lysates showed different lipopolysaccharide (LPS) profiles, ranging from rough to smooth with multiple repeating side chains. Immunoblots of whole-cell and proteinase K treated preparations of the C. pyloridis strains showed that there was antigenic cross-reactivity of proteins migrating at 62,000 and 56,000, but not in other regions, and cross-reactivity between LPS core regions but not side chains. These results suggest that C. pyloridis has both protein and core LPS group antigens and strain-specific protein and LPS side chain antigens. PMID- 3552999 TI - Characterization of a 96-kilodalton thermostable polypeptide antigen of Plasmodium falciparum related to protective immunity in the squirrel monkey. AB - Protective immunity against Plasmodium falciparum malaria in the squirrel monkey (Saimiri sciureus) is, in part, antibody mediated. We have previously shown that polypeptides of 41, 76, and 96 kilodaltons (kDa) are specifically immunoprecipitated with monkey sera which are protective in passive transfer experiments. We report here that three different 96-kDa polypeptides, of pI 5.15, 5.25, and 5.35, can be visualized when parasite extracts are analyzed in bidimensional gels. Only one of them (of pI 5.25) was stable after being heated at 100 degrees C for 5 min. The 96-kDa thermostable polypeptide of pI 5.25 was immunoprecipitated by protective monkey sera and by sera from adult humans living in hyperendemic areas and thus seems to be correlated with humoral protective immunity. This antigen was found in culture supernatants at the time of schizont rupture. It was synthesized during the schizont stage and is apparently not a glycoprotein. PMID- 3553000 TI - Congo red binding phenotype is associated with hemin binding and increased infectivity of Shigella flexneri in the HeLa cell model. AB - Wild-type isolates of Shigella flexneri bind the dye Congo red from solid media, thus producing red (Crb+) colonies. Mutants which fail to bind the dye produce white colonies (Crb-) and are avirulent in a variety of systems. In S. flexneri the ability to bind Congo red correlates with the ability to bind hemin and protoporphyrin IX. Binding of hemin by Crb+ S. flexneri was observed both in solid media and in liquid assays. Results of competition experiments suggest that Congo red and hemin bind to the same site on the bacterial cell and are retained on the cell surface. Binding of hemin by Crb+ S. flexneri is independent of hemin transport since both Crb+ and Crb- cells can utilize hemin as a sole source of iron. Both Crb- and Crb- organisms were able to grow in HeLa cell lysates, indicating that the gene(s) that is responsible for Congo red binding does not play a role in the acquisition of intracellular heme iron. By using the HeLa cell invasion system, the effect of hemin prebinding on the invasiveness of Crb+ S. flexneri was determined. Crb+ cells which had prebound hemin exhibited increased invasiveness, indicating a possible role for the crb gene product in the initial stages of invasion by S. flexneri. PMID- 3553001 TI - Anti-infectious activity of liposomal muramyl dipeptides in immunodeficient CBA/N mice. AB - Two muramyl dipeptides, N-acetylmuramyl-L-alanyl-D-isoglutamine and its adjuvant inactive isomer N-acetylmuramyl-D-alanyl-D-isoglutamine, were examined for their ability to protect mice carrying the CBA/N immune deficiency gene (xid) against lethal bacterial challenge. Prophylactic treatment with N-acetylmuramyl-L-alanyl d-isoglutamine gave significant protection against Streptococcus pneumoniae, Salmonella typhimurium, and Salmonella enteritidis infection. N-Acetylmuramyl-D alanyl-D-isoglutamine was unable to confer protection. Incorporation of the lipophilic glycerol dipalmitate derivatives of the two muramyl dipeptides within liposomal carriers resulted in a significant enhancement of anti-infectious activity, both with respect to number of survivors and length of survival. Liposomal muramyl dipeptides were 10- to 15-fold more potent than free muramyl dipeptide; enhanced potency was most evident with N-acetylmuramyl-D-alanyl-D isoglutamine. Prophylactic treatment with liposomes containing the lipophilic muramyl dipeptides resulted in enhanced clearance of bacteria from the blood (greater than 3-fold increase in rate) when compared with that of hydrosoluble N acetylmuramyl-L-alanyl-D-isoglutamine, indicating a correlation between reticuloendothelial stimulation and anti-infectious activity. PMID- 3553002 TI - Enhanced resistance of mice to bacterial infection induced by recombinant human interleukin-1a. AB - The effect of recombinant human interleukin-1a on the survival rate of Std-ddY male mice systemically infected with Pseudomonas aeruginosa 12 or Klebsiella pneumoniae P-5709 was evaluated. In P. aeruginosa infection, interleukin-1a given intramuscularly twice, 3 days and 1 day before inoculation of bacteria, most effectively protected animals from death due to infection. The effect was dose dependent, with a maximum survival rate of 92.5% at 10 micrograms per mouse, while only 8.3% of the control group survived until the end of the observation period. The 50% effective dose of interleukin-1a was 0.261 microgram per mouse. In K. pneumoniae infection, interleukin-1a given intramuscularly twice, simultaneously with and 1 day after the inoculation of bacteria, was most effective. The protective effect of interleukin-1a was again dose dependent and was generally more marked than in P. aeruginosa infection. The 50% effective dose was 0.034 microgram per mouse. In both infections, there was no significant increase in the survival rates of animals injected with human albumin or heat inactivated interleukin-1a. These observations raise the possibility that human interleukin-1a could serve as a therapeutic tool for patients with bacterial infections. PMID- 3553004 TI - Chemiluminescent responses of alveolar macrophages from normal and Mycobacterium bovis BCG-vaccinated rabbits as a function of age. AB - Luminol-dependent chemiluminescence (CL) responses of alveolar macrophages (AM) from normal and Mycobacterium bovis BCG-vaccinated infant and adult rabbits were compared. AM from 1-, 7-, and 14-day-old normal rabbits exhibited much lower peak CL responses than did AM from 28- and 42-day-old normal animals as well as rabbits 2 to 3 or 5 to 6 months and 1 to 2 years of age. The most striking differences among AM from infant and adult rabbits were noted when AM were obtained from 28-day-old and 5- to 6-month old rabbits 21 days after the rabbits were immunized with 200 micrograms of BCG intravenously. In this case, AM from 5- to 6-month-old animals gave peak counts per minute of 400,000 to 500,000 whereas AM from 28-day-old rabbits vaccinated with BCG (harvested at 49 days of age) gave peak counts per minute of only 40,715 +/- 2,688. These data reveal that AM from neonatal animals are grossly deficient as responders to phorbol myristate acetate induced CL. This deficiency, which improved with age, is still apparent in AM from 28-day-old animals. The data also reveal that BCG vaccination of 28-day-old animals yields AM that are poor responders to phorbol myristate acetate compared with AM from BCG-vaccinated animals 2 to 3 and 5 to 6 months of age. AM from animals vaccinated with BCG at 28 days of age contained fewer and smaller electron-dense lysosomelike structures than did AM from adult rabbits similarly vaccinated. These findings provide an explanation for the difficulties infants have in developing effective cell-mediated immune responses against intracellular parasites. PMID- 3553003 TI - Characterization, sequence determination, and immunogenicity of a 64-kilodalton protein of Mycobacterium bovis BCG expressed in escherichia coli K-12. AB - We report the DNA sequence of a previously cloned Mycobacterium bovis BCG gene encoding an immunogenic 64-kilodalton protein. This protein, MbaA, was purified from overproducing Escherichia coli K-12 cells, and the presence of antibodies to MbaA in human sera was determined by an enzyme-linked immunosorbent assay. In about 80% of serum samples from tuberculosis patients and in about 60% of samples from BCG-vaccinated individuals, significant levels of anti-MbaA antibodies were found. Surprisingly, in about 30% of the control serum samples obtained from children, anti-MbaA antibodies were also observed. Guinea pigs sensitized with M. bovis BCG or MbaA showed a delayed-type hypersensitivity reaction after challenge with purified MbaA, supporting the previously observed strong reactivity of human T-cell clones with this, for mycobacteria, common antigen. PMID- 3553005 TI - Induction of biologically active antibodies by a polyvalent synthetic vaccine constructed without carrier. AB - Four synthetic peptides that copy fragments of two bacterial antigens (Streptococcus pyogenes M protein and diphtheria toxin), one viral antigen (hepatitis B surface antigen), and one parasitic antigen (circumsporozoite protein of Plasmodium knowlesi) were covalently bound within the same construct. This totally synthetic polyvalent administered to mice with Freund complete adjuvant or in saline with murabutide (an adjuvant-active muramyl peptide) elicited high levels of antibodies which, in certain cases, were shown to be biologically active. The results indicated that these antibodies recognized specifically the four peptides. None of the epitopes were immunodominant. It was also demonstrated that the association of several peptides enhanced their respective immunogenicities as compared with those of their homopolymers. Finally, this study shows that a totally synthetic vaccine administered in saline with a synthetic adjuvant can be immunogenic in the absence of a protein carrier. PMID- 3553006 TI - Elimination of group A streptococcal cell walls from mammalian tissues. AB - The precise levels in mammalian tissues of rhamnose (a constituent of the group specific polysaccharide) and muramic acid (a constituent of peptidoglycan) at various times after systemic administration of streptococcal cell walls were noted for the first time. The extreme resistance of the streptococcal cell wall to degradation by mammalian enzymes can now be clearly appreciated. The results help explain the chronic nature of certain inflammatory diseases elicited by streptococcal cell wall debris. PMID- 3553007 TI - Antimicrobial binding of a radiolabeled cationic neutrophil granule protein. AB - A 57,000-dalton protein (CAP57) purified from human polymorphonuclear leukocytes has antimicrobial activity against a number of gram-negative bacteria. We developed a procedure using solid-phase Iodo-gen to radiolabel CAP57 without destroying its antibacterial activity. Iodinated and native CAP57 were electrophoretically identical. Autoradiographs of sodium dodecyl sulfate polyacrylamide gels revealed greater than 95% of the 125I in a single heavy band in the 57,000-molecular-weight region. The quantity of [125I]CAP57 bound to bacterial test strains was directly proportional to the sensitivity to CAP57. PMID- 3553009 TI - Evaluation of the apical seal obtained with two calcium hydroxide based endodontic sealers. PMID- 3553010 TI - Effects of endodontic instrumentation using a macroradiographic subtraction technique: a preliminary investigation. PMID- 3553011 TI - Trauma management: the anesthesiologist's role. PMID- 3553008 TI - [Immunoglobulins in the treatment of bacterial meningitis in childhood]. AB - In a prospective, clinical study forty-four children with bacterial meningitis were treated with antibiotics and underwent a special intravenous treatment with 7-S-immunoglobulins. The children's age ranged between two days and thirteen years. Two of the children died. The other forty-two children did not show any signs of neurological deficiencies upon release from the hospital. The apparently improved prognosis, due to the immunoglobulin therapy, was confirmed by a retrospective study of thirty-six patients, that had an unfavorable prognosis of pneumococcal meningitis. All fourteen patients that had acquired pneumococcal meningitis, and had been treated with immunoglobulins, were clinically cured, whereas in comparison, the sixteen patients of the other group exhibited severe sequelae, and two of them died. PMID- 3553013 TI - Preexisting medical problems in the trauma patient: do they matter? AB - The answer to the question posed by the title of this chapter (preexisting medical problems in the trauma patient: do they matter?) has by now become obvious. The type and severity of the initial injury are the major determinants of outcome. Trauma prevention is therefore a compelling social goal. Skillful and timely resuscitation efforts favorably affect survival statistics. Even though detailed outcome data do not yet exist in all areas regarding pre-existing illness, it is clear that underlying disease may directly cause trauma, may necessitate modification in trauma management, and may even adversely effect the health-care providers themselves. PMID- 3553012 TI - Acute renal failure following traumatic injury or major operation. AB - Acute oliguria in the critically ill postoperative patient, or in the trauma victim after resuscitation, is a substantial clinical problem. The mortality associated with ARF in these settings remains unacceptably high. Evaluation of the oliguric patient must include thorough monitoring for, and correction of, prerenal and postrenal causes of oliguria. In this sense, diagnosis of ARF is one of exclusion. Differential diagnosis is facilitated by microscopic examination of urine and by biochemical analyses of blood and urine for calculating indices of tubular function (urinary-to-plasma ratios of blood urea nitrogen and creatinine, sodium excretion, and clearances of sodium, creatinine, solute, and water). The early detection of an intrarenal defect, as accomplished by using serial measurements of free water clearance, may allow interruption of the process and prevention of ARF. Preventive measures include optimization of hemodynamic status and the use of osmotic diuretic agents (mannitol) and loop diuretics (furosemide, ethacrynic acid, and bumetanide). Dopamine is useful for increasing both renal blood flow and urine flow and may be useful for preventing ARF, but this is not firmly established. Experimentally, other approaches such as modulating the renin angiotensin system, prostaglandin system, and cellular calcium fluxes have been attempted, but the clinical applicability of these measures is not established. The best approach to ARF is preventing it by knowing which patients are at high risk, by studiously preventing renal insults, and by aggressively treating early indications of renal malfunction using established therapies. PMID- 3553014 TI - Battlefield anesthesia. PMID- 3553015 TI - Shock: a systemic or cellular disease? PMID- 3553016 TI - Wartime trauma: lessons and perspectives. PMID- 3553017 TI - Crystalloid versus colloid: is colloid worth the cost? PMID- 3553018 TI - Massive transfusion. AB - The physiological stress of anesthesia, hemorrhage, and operation can all contribute to postoperative morbidity and mortality in the patient who has experienced massive trauma. However, the problems of massive transfusion are not insurmountable. More important than achieving an adequate blood pressure in the hemorrhaging patient is the need to reestablish adequate tissue perfusion, thus maintaining oxygen transport and appropriate tissue oxygen consumption. Oxygen consumption will decrease after hemorrhagic shock, reflecting a metabolic deficit at the cellular level, and may contribute to end-organ failure. Through blood transfusion, the oxygen consumptive needs of the tissues can be met. Whether the blood administered is autologous or homologous, no superior medium for oxygen transport is yet available. Close attention to the hazards associated with massive transfusion will result in improved outcome and decreased mortality. PMID- 3553019 TI - Anesthetic agents in trauma surgery: are there differences? AB - Overall, no ideal induction or maintenance technique is available for the traumatized, hypovolemic patient. As a result of the multiple insults that produce hypovolemia and the heterogeneous population of patients sustaining trauma, it is unlikely that a controlled human study of this anesthetic dilemma will ever be performed. One must balance the potential incidence of recall of operation or unacceptable sympathectomy-induced vasodilation against the anesthetic techniques available. Bogetz and Katz addressed the recall issue by documenting how many patients sustaining major trauma and requiring operation were really anesthetized. They stressed that many of the patients evaluated were too hemodynamically unstable to tolerate the usual dose of anesthetics administered during elective operations. They postulated that hypotension, hypothermia, and acute alcohol intoxication found in many trauma patients should make recall infrequent. Two groups of patients were analyzed for incidence of recall. The groups were separated based on the continuity of anesthetic administered. In 37 patients given ketamine for induction and low-dose inhalational agent for maintenance, with no gaps in anesthetic administration of over 20 minutes, 4 of 37 (11%) patients had recall. Recall was reported by 6 of 14 (43%) patients in whom it was considered clinically unwise to administer an anesthetic for intubation or whose anesthetic needed to be interrupted for more than 20 minutes secondary to hemodynamic instability. If these figures are representative of the worldwide incidence of recall in our traumatized patients, we may need to redefine the role of anesthesia in trauma. We may need to consider ourselves, not inappropriately, resuscitologists rather than anesthesiologists. PMID- 3553020 TI - Trauma and pulmonary insufficiency: mediators and modulators of adult respiratory distress syndrome. AB - Adult respiratory distress syndrome is a complex disease resulting in lung dysfunction secondary to a primary nonpulmonary catastrophic event. Many mediators are involved in the destructive chain of events occurring at the cellular level. Investigation of ARDS continues, with efforts directed toward blocking those mediators and thereby alleviating the lung damage and hypoxia once this cascade has been initiated. Even with these advances, however, current optimal therapy is directed toward reversing the primary inciting event and providing the supportive care required to survive the acute episode. PMID- 3553021 TI - New aspects of allergic diseases, immunoregulation and immunodeficiencies. 16th symposium of the Collegium Internationale Allergologicum. Goteborg, August 17-21, 1986. Festschrift for Paul Kallos. PMID- 3553022 TI - Investigations of rat mast cell heterogeneity. AB - In the rat, two distinct mast cell subsets have been identified. One, represented by the easily accessible and purified peritoneal mast cell, differs from the other, the intestinal mucosal mast cell, in staining properties, fixation sensitivity, mediator content, and responsiveness to various secretagogues and antiallergic drugs. To investigate the molecular basis and control mechanisms of mast cell heterogeneity, we have initiated sodium dodecylsulfate polyacrylamide gel electrophoretic analysis of the constituents of rat peritoneal and intestinal mucosal mast cells; developed subcellular fractionation protocols to facilitate these comparisons; produced a mast cell specific rabbit antiserum, and established methods to isolate mast cell RNA. These approaches require refinement, but will prove to be useful in further investigations of mast cell biology. PMID- 3553023 TI - Contribution of basophil/mast cell and eosinophil growth and differentiation to the allergic tissue inflammatory response. AB - The mechanisms underlying allergic tissue basophil/mast cell (BMC) or eosinophil (Eo) accumulation are unclear, especially since chemotaxis or IgE levels do not offer a sufficient explanation. We have found that a formaldehyde-blockable, steroid-responsive nasal metachromatic cell (NMC) population predominates in epithelium and correlates well with symptoms and signs in patients with allergic rhinitis. Circulating BMC and Eo progenitors (colony-forming cells in culture; CFU-c) are increased in atopic patients, inversely related to NMC counts, and fall as NMC numbers rise during seasonal allergen (ragweed pollen) stimulation. The metachromatic cell progeny of these CFU-c are also formaldehyde-blockable in their staining reaction and thus may correspond to NMC. Human nasal polyps yield BMC CFU-c. Nasal polyp epithelial scrapings or mononuclear cells, T lymphocytes or keratinocytes in vitro all produce potent BMC or Eo colony-stimulating activities (CSA) as well as an interleukin-3-like activity, each of which is partially separable from the others. Nasal epithelial cells cultured from scrapings of atopic, as opposed to nonatopic, patients also produce BMC or Eo CSA with an enhanced effect of the former on atopic peripheral blood CFU-c growth. These studies support the hypothesis that BMC and Eo accumulate in allergic inflammation as a result of in situ growth and differentiation of progenitors stimulated by soluble hemopoietic factors derived from mucosal cell populations. PMID- 3553024 TI - Eosinophil activation in allergic disease. AB - The eosinophil granulocyte is a pro-inflammatory cell which in its granules contains an abundance of highly cytotoxic proteins such as eosinophil cationic protein, eosinophil-derived neurotoxin, eosinophil peroxidase, eosinophil protein X and major basic protein. Upon stimulation of the cell, these proteins as well as a number of lipid mediators such as leukotriene C4, prostaglandin and platelet activating factor are released to the exterior. The molecules which are produced during inflammatory reactions of the allergic type attract eosinophils to the target organ and stimulate them to liberate their products. The physiological meaning of this reaction is probably to combat invading parasites; however, in their absence accumulation and activation of eosinophils may cause disease, and one such disease may be chronic asthma. PMID- 3553025 TI - Structure and function of intestinal mucin: developmental aspects. AB - Mucin glycoproteins are thought to play an important role in protecting the intestine from chemical or physical injury but the mechanisms of protection and the possible relationship between mucin structure and function are incompletely understood. Structurally, purified intestinal mucins are a heterogeneous and polydisperse group of large-molecular-weight glycoproteins which have regional and developmental differences in composition. Newborn mucin contains more protein and less carbohydrate than adult mucin and differs from adult mucin in buoyant density and mobility on electrophoresis. The primary function of mucin, protection of the intestine, appears to be dependent upon at least four factors: the rate and quantity of mucin release; the physical barrier of the viscous mucus blanket; the provision of specific inhibitory binding sites to infectious agents and proteins, and the inclusion of secretory immunoglobulins to provide a link to the immunologic component of the intestinal host defense system. Immune as well as infectious and chemical agents appear to play an important role in mucus release but developmental effects have not been studied. Preliminary studies indicate that developmental differences may exist in the provision of inhibitory binding sites and the inclusion of secretory immunoglobulins in mucin. These studies indicate that mucus may provide a link between the physical and immunological components of the intestinal host defense system and point to the need for further studies in this area. PMID- 3553026 TI - Immune regulation of goblet cell development. AB - In rats, goblet cells were found in the bronchiole epithelium surrounding enlarged lymphoid noduli. The goblet cell number increased with age. Old rats had goblet cells in the columnar epithelium. Immunization with aerosolized antigen increased goblet cell hyperplasia in bronchioli with a luminal diameter of 0.5 1.0 mm. In mice, goblet cell differentiation in the respiratory epithelium was caused by local delayed-type hypersensitivity reactions. Manipulations of the delayed hypersensitivity reactions with immune suppression and depletion of helper T cells eliminated the increase in goblet cell number. PMID- 3553027 TI - T cell factors involved in the regulation of the IgE synthesis. AB - The IgE-potentiating and IgE-suppressive factors share a common structural gene and therefore a common polypeptide chain, and their biologic activities are decided by a post-translational glycosylation process. Under physiological conditions, this process is controlled by two T cell factors, i.e., the glycosylation-enhancing factor (GEF) and glycosylation-inhibiting factor (GIF). GIF is a fragment of phosphorylated lipocortin and has immunosuppressive effects. Repeated injections of this lymphokine into antigen-primed mice switched their T cells from the formation of IgE-potentiating factor to the formation of IgE suppressive factor and facilitated the generation of antigen-specific suppressor T cells, which form antigen-specific GIF upon antigenic stimulation. The antigen specific GIF suppressed the antibody response in a carrier-specific manner and has properties similar to antigen-specific suppressor T cell factors. PMID- 3553029 TI - Screening for anti-HTLV-III/LAV antibody in high-risk subjects: sensitivity and specificity of commercial tests. AB - 1,834 serum samples from high-risk subjects were tested for anti-HTLV-III/LAV antibody by using the enzyme immuno assay (EIA) of Abbott (A), or the EIA of Abbott and Pasteur (P), or those two EIA plus Western blot analysis (WB). 983 samples were negative in A, 766 were strongly positive when tested in duplicate with both A and P, and 85 were slightly positive in A (23 samples) or discordant (62 samples) when tested further in P and WB. Of 62 discordant samples, 38 were reproducible. The pattern A+P-WB- was by far the most frequently encountered (26 samples) and interpreted as reflecting the higher incidence of positive results in the assay A. If one assumes that WB results are correct, the specificities of A and P are 93 and 100%, respectively (p less than 0.01), whereas the sensitivities are similar (98 and 99%). PMID- 3553028 TI - Regulation of the human allergic response. AB - Over the last several years our laboratory has been engaged in the in vitro study of the regulation of IgE synthesis. We have found that polyclonal B cell activators fail to induce IgE synthesis in human B cells. Alloreactive T cell helper clones induced synthesis in B cells only under conditions of interaction and in B cells from allergic donors under cognate conditions of bystander stimulation as well. Isotype-specific regulation of the IgE response was mediated in the secretion of IgE-binding factors by T cells suppressing Fc receptors for IgE. Finally, IgE immune complexes in sera from patients with hyper-IgE states were shown to downregulate T cell proliferation to antigen and to stimulate monocytes to resorb 45Ca-labelled bone and to release prostaglandins. The implications of these in vitro findings for disease states in which IgE is elevated are discussed. PMID- 3553030 TI - Primary and secondary effector cells in the pathogenesis of bronchial asthma. AB - The immediate and late asthmatic reactions provoked by inhaled allergens have provided useful models enabling the dissection of individual inflammatory cells and their mediators that may contribute to the pathogenesis of asthma. The immediate reaction is considered to be mast cell-mediated on the basis that about 50% of the response is inhibitable by potent and selective H1-receptor antagonists such as terfenadine and astemizole. Additional inhibition (approximately 30%) by the potent cyclooxygenase inhibitor flurbiprofen implies an important role for prostanoids in the immediate response, the most likely mast cell-derived product being prostaglandin (PG) D2. In man, PGD2 is selectively metabolised to 9 alpha 11 beta-PGF2, a unique prostaglandin which shares with PGD2 contractile properties on guinea-pig and human airways smooth muscle. The inability of piriprost, a potent leukotriene synthesis inhibitor, to influence the allergen-provoked immediate reaction raises the possibility that sulphidopeptide leukotrienes play a minor role in this response. The late asthmatic reaction is considered to resemble clinical asthma since it is accompanied by increased responsiveness of the airways to a wide range of stimuli. The late reaction in man is inhibited by nedocromil sodium (4 mg) but only marginally attenuated by salbutamol (200 micrograms) if both drugs are administered prior to allergen challenge. Since salbutamol, in the dose administered, is a potent mast cell-stabilising agent, these findings must question the obligatory role of mast cell mediator release in the pathogenesis of the late response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553031 TI - Double-blind, placebo-controlled immunotherapy with a high-molecular-weight, formalinized allergoid in grass pollen allergy. AB - Specific immunotherapy is effective in grass pollen allergy with standardized extracts and formalinized allergoids; but systemic reactions are not uncommon. A high-molecular-weight (greater than 85,000 daltons), formalinized allergoid was investigated in a double-blind, placebo-controlled study to assess its safety and efficacy. Twenty patients received a placebo and 39 the allergoid using a rather aggressive protocol. Five patients developed a mild and transient systemic reaction with high doses of allergoid and one had a more severe reaction requiring treatment. Nasal challenges performed with orchard grass pollen grains showed that the threshold number of grains eliciting nasal symptoms was significantly (p less than 0.01) greater in the treated group. This group had significantly (p less than 0.01) less nasal symptoms during the season and specific IgG levels were significantly (p less than 0.01) elevated. There was a significant (p less than 0.01) correlation between nasal challenges and nasal symptoms during the season but no correlation between IgG and symptoms. There was no dose-dependent effect of allergoids. PMID- 3553032 TI - Increased production of antibodies to spermatozoa and seminal fluid in rabbits used as semen donors. AB - Sera of 20 male rabbits that were used as frequent donors of semen and age matched normal male and female rabbit controls were examined by an enzyme-linked immunosorbent assay (ELISA), with sperm and seminal fluid as antigens. Five of the 20 semen donors developed an especially high humoral response to seminal fluid and spermatozoa, similar to that observed in some female breeders. The antibodies increased gradually during the 9 months of semen collection. The specificity of the antibodies was demonstrated by total or partial absorption with seminal fluid or spermatozoa. The antibodies were virtually all IgM and were directed against the acrosomal cap region of the spermatozoa, but variable fluorescence was also observed in the postnuclear region and tail. PMID- 3553033 TI - Presence of Ia-positive cells in the central nervous system of the rat during various pathological conditions. AB - The rat central nervous system (CNS) was analyzed immunohistochemically during various pathological conditions by using monoclonal antibodies specific for rat T lymphocytes, rat macrophages and Ia antigen. It was found that in immunologically mediated disease infiltrating macrophages do express the Ia antigen, whereas in nonimmunologically mediated disease they do not. The results suggest that based on the composition of the mononuclear phagocyte infiltrate a clear distinction can be made between different inflammatory reaction types within the CNS. PMID- 3553034 TI - Eosinophil response in mast cell-deficient W/WV mice. AB - The combination of cyclophosphamide treatment and Toxocara canis infection is known as an effective way of causing a high level of eosinophilia in mice. When this treatment was applied to congenitally anemic, mast cell-deficient W/WV mice, eosinophil response was far less than that of their normal littermate +/+ mice. The degree of the defective eosinophil response in the peripheral blood of W/WV mice was severer than that in the bone marrow. The defective eosinophil response of W/WV mice was completely restored by bone marrow grafting 8 weeks prior to cyclophosphamide treatment and T. canis infection. The kinetics of the recovery of eosinophil response in the bone marrow of W/WV mice after bone marrow grafting was faster than that in the peripheral blood. Chemotactic reactivity of eosinophils obtained from bone marrow or peritoneal cavity of W/WV mice was essentially comparable to that of +/+ mice. These results suggest that, in addition to the production of eosinophils in the bone marrow, mast cell-derived factors play an important role in the mediation of peripheral blood eosinophilia. PMID- 3553035 TI - Ejaculate composition after masturbation and coitus in the human male. AB - The levels of fructose, acid phosphatase, citric acid, zinc, maltase, testosterone, prostaglandin E, putrescine, spermidine and spermine were compared in ejaculates collected by masturbation and after coitus in the same individuals. Coitus was associated with a significantly larger semen volume and increased concentrations and total amounts of prostaglandin E and polyamines in the ejaculate. In contrast, the concentrations of the conventional glandular parameters remained relatively unaffected, although a slight dilution of the seminal vesicle contribution to the ejaculate occurred after coitus. In the majority of cases, ejaculates provided by masturbation were significantly enriched in spermatozoa, but the total contributions under both conditions remained the same. It is concluded that the assessment of semen quality in male individuals using the conventional parameters of accessory gland function can be made with ejaculates provided by masturbation or coitus. PMID- 3553036 TI - ECMO revisited. PMID- 3553037 TI - Physical work capacity in chronic renal disease. AB - We studied the physical fitness of 71 patients with renal disease before dialysis, after starting dialysis, and after successful renal transplantation. Maximal muscle strength was determined in 58 patients and maximal cardiovascular capacity was assessed in 36 patients. Before dialysis there was a 31 percent reduction in muscle strength in men and 47 percent in women. The loss of muscle strength was most pronounced in the leg extensors. Cardiovascular capacity and muscle strength was positively correlated in the dialysis patients (p less than or equal to 0.05). The cardiovascular capacity was decreased 29% in predialysis patients, 45% in dialysis patients and 37% in transplanted patients compared to untrained healthy controls. The predialysis patients had a 19% greater cardiovascular capacity than the dialysis patients and a 9% greater cardiovascular capacity than the transplanted patients. While hemoglobin concentrations showed a positive correlation (p less than or equal to 0.05) with maximal cardiovascular capacity and creatinine concentration showed a negative correlation (p less than or equal to 0.05) with maximal cardiovascular capacity in the predialysis patients, hemoglobin concentrations and creatinine concentrations did not correlate with cardiovascular capacity in the dialysed and transplanted patients. In dialysis patients as well as in patients after kidney transplantation hemoglobin and creatinine concentrations, muscle strength, height, weight, and age are factors influencing the physical work capacity, but none of these variables alone seems to be a strong determination factor. Besides the complications of kidney disease which may itself reduce physical fitness, the lack of physical training is an important factor in determining the residual muscle strength and cardiovascular capacity for all patients with renal insufficiency. PMID- 3553038 TI - Glucose concentration in the dialysate and lipid abnormalities in chronic hemodialysis patients. AB - In order to assess the effect of varying glucose concentrations on plasma lipids, we first compared the hormonal response of nine non-diabetic patients during dialysis with a high (200 mg/dl) and a low (100 mg/dl) glucose bath. Insulin and growth hormone production increased (p less than 0.05) only with the high glucose bath, and no hemodynamic differences were noted during either dialyses. We then compared lipid profiles of 18 patients for 6 months, changing the glucose dialysate concentrations in each patient after three months. We found that all patients had hypertriglyceridemia, mild hypercholesterolemia, low HDL, normal LDL, and high VLDL cholesterol. We therefore conclude that episodic hyperinsulinemia and episodic excessive growth hormone secretion do not contribute significantly to the lipid abnormalities of the dialysis patients. PMID- 3553039 TI - Enhancement of metabolism of jeopardized myocardium by nifedipine. AB - To define effects of nifedipine on regional metabolism in jeopardized myocardium we quantified accumulation of carbon-11 labeled palmitate ([11C]palmitate) in patients with acute myocardial infarction by positron emission tomography in a randomized, double-blind, placebo controlled study. Tomographic studies were performed prior to treatment as soon as possible after hospital admission. Subsequent studies were performed seven days later. Twenty-two patients with acute myocardial infarction were randomized to treatment with nifedipine (n = 13) or placebo (n = 9). The dosage of active medication was guided by a "third party observer" to avoid iatrogenic hypotension. Treatment was initiated within 9.6 +/- 1 hours after the onset of symptoms of infarction. The extent of the zone of abnormal accumulation of [11C]palmitate was similar in pre-treatment positron emission tomograms from patients subsequently given nifedipine compared with those given placebo. In subsequent positron emission tomography studies, patients treated with nifedipine exhibited improved metabolism of [11C]palmitate (by 16 +/ 10%, SE, P less than 0.05) compared with no change in patients given placebo. Neither enzymatic estimates of infarct size nor scintigraphic estimates of left ventricular ejection fraction differed in the two groups. Patients given nifedipine and manifesting substantial improvement in accumulation of [11C]palmitate had a high incidence of chest pain and recurrent infarction compared with those given placebo in whom no improvement was evident. These observations suggest that some regions of myocardium were benefited transiently by nifedipine but that they remained at high risk for recurrent injury. Thus, patients benefited transiently by drugs early after the onset of infarction may require aggressive intervention such as angioplasty or early coronary bypass surgery. Accordingly, they should be evaluated angiographically early for identification of lesions with unusually high risk. PMID- 3553040 TI - The Albert Moll hypnosis collection. PMID- 3553041 TI - Squamous cell carcinoma complicating discoid lupus erythematosus. PMID- 3553043 TI - Primary cutaneous amyloidosis. PMID- 3553042 TI - Alexander Russell and the Aleppo ulcer. PMID- 3553044 TI - Nonsteroidal anti-inflammatory drugs. Their use in dermatology. PMID- 3553045 TI - Atopic dermatitis revisited. PMID- 3553046 TI - Skin organ culture: why? PMID- 3553047 TI - Cimetidine in dermatology. PMID- 3553048 TI - The relationship between smoking and the response to anti-hypertensive treatment in mild hypertensives in the Medical Research Council's trial of treatment. AB - The antihypertensive efficacy of propranolol in the treatment of mild hypertension was significantly impaired in cigarette smokers, whereas that of bendrofluazide was not affected by smoking habit. This diminished efficacy of propranolol in smokers may be one of several possible factors operating to reduce its primary preventive action against strokes, and possibly against coronary events. PMID- 3553050 TI - Determination of enzyme variants of glucose phosphate isomerase in Plasmodium falciparum by isoelectric focusing and polyacrylamide electrophoresis. PMID- 3553049 TI - Impaired glucose-induced thermogenesis in skeletal muscle in obesity. The role of the sympathoadrenal system. AB - From a 7-day food recording in 29 morbidly obese patients two groups of six patients each were selected: a high-energy-intake group (HEI) and a low-energy intake group (LEI). The groups were otherwise comparable. Five lean subjects served as controls for some observations. Oral glucose tolerance tests showed that all patients in the HEI group and the lean controls had normal glucose tolerance, whereas it was abnormal in all subjects in the LEI group. The fasting metabolic rate did not differ between the obese groups but was significantly lower in the lean group. The glucose-induced thermogenesis during 180 min expressed as a percentage of the energy content of the glucose load was lower in both obese groups compared with the lean controls (lean: +11.5 per cent, HEI: +5.3 per cent and LEI: -4.2 per cent, HEI vs lean: P = 0.04 and LEI vs lean: P = 0.005), and lower in the LEI group compared with the HEI group (P = 0.02). The integrated increase in leg oxygen consumption after glucose was also smaller in the LEI group than in the HEI group (15 +/- 269 vs 987 +/- 356 ml, P less than 0.05). The arterial noradrenaline response to glucose was significantly diminished in both obese groups compared with the lean controls. Glucose induced a similar increase in leg noradrenaline release in both obese groups, whereas the arterial adrenaline level was lower in the LEI group compared with the HEI group and with the lean controls (P = 0.04). Among the obese subjects the degree of glucose intolerance was inversely correlated with the post-glucose arterial adrenaline level (r = -0.55, and P = 0.04), and positively correlated with the fractional leg adrenaline extraction (r = 0.71, and P = 0.003). The results suggest that patients who are obese in spite of a fairly low energy intake have a reduced glucose-induced facultative thermogenesis, and that the defect is at least in part located in skeletal muscle. Since the sympathetic nervous system is partly responsible for the glucose-induced thermogenesis, the reduced thermogenic response in the obese patients may be due to an impaired activation of the sympathetic nervous system. It is hypothesized that the reduced arterial adrenaline level in the LEI group is caused by hyperglycaemic suppression of the adrenomedullary secretion and further that this may be a link connecting deterioration of glucose tolerance and a thermogenic defect in obesity. PMID- 3553052 TI - Alkaline step elution analysis of gamma-ray induced DNA strand breaks and repair in diploid yeast. AB - Gamma-ray induction of DNA strand breaks and their repair was analysed in the diploid yeast strain D7 (Saccharomyces cerevisiae) by means of the alkaline step elution technique. A dose-dependent increase of DNA strand breakage was observed in the dose range 25-2000 Gy corresponding to 100 and 0.01 per cent survival. When, after exposure to gamma-irradiation, the cells were incubated for 2 h in liquid growth medium, the elution profiles reached the pattern of unirradiated controls, thus indicating the restoration of cellular DNA due to repair. The alkaline step elution analysis is found to be a useful and reproducible technique for studying the induction of DNA strand breaks and repair in yeast. In comparison with other current methods, such as alkaline sucrose gradients and DNA unwinding, this method appears to be more rapid, versatile and easier to handle. PMID- 3553051 TI - Effects of peroxide and catalase on near ultraviolet radiation sensitivity in Escherichia coli strains. AB - The role of peroxide and catalase on NUV radiation sensitivity was examined in two repair competent E. coli strains, AB1157 and B/r. Exponential phase B/r is considerably more sensitive to NUV radiation than exponential phase AB1157. However, resistance to 5 mmol dm-3 H2O2 was induced in both AB1157 and B/r by pretreating growing cells with 30 mumol dm-3 H2O2. Pretreatment also induced resistance to broad-band NUV radiation in these strains. The addition of catalase to the post-irradiation plating medium increased survival to the same extent as that provided by pretreatment with 30 mumol dm-3 H2O2, in both strains. The NUV radiation sensitivity seen in B/r does not appear to be due to a deficiency in enzymes that scavenge H2O2, as a catalase deficient mutant, E. coli UM1, is more resistant to NUV radiation than B/r. Also, assays for H2O2 scavenging ability show little difference between AB1157 and B/r in this respect. Two hypotheses are put forward to account for the sensitivity of exponential phase B/r. Whilst it is apparent that peroxides and catalase do have a role in NUV radiation damage, it is clear that other factors also influence survival under certain conditions. PMID- 3553053 TI - Review of the 4-quinolones. AB - Improvements in antimicrobial activity and pharmacokinetics have moved the 4 quinolones into the forefront of antibiotic research. The 4-quinolones are analogues of nalidixic acid, and there are presently at least six agents in this group under investigation in the United States. It is difficult to generalize their clinical usefulness, since these agents exhibit different pharmacokinetic profiles, antimicrobial activity (with varied minimum inhibitory concentrations among similar organisms), and dosage regimens. The 4-quinolones are potential therapeutic alternatives for infections caused by a variety of organisms. They include: Neisseria gonorrhoeae; Pseudomonas aeruginosa; Haemophilus influenzae; Staphylococcus aureus; common enteric pathogens (salmonella, shigella, campylobacter, etc); and intracellular bacteria (legionella, chlamydia, mycobacteria, etc). Clinical efficacy has been demonstrated in urinary tract infections, respiratory tract infections, and sexually transmitted diseases. Future studies will undoubtedly demonstrate effectiveness in numerous additional infectious processes. The purpose of this article is to compare the 4-quinolones in regards to pharmacokinetics and spectrum of activity and review the clinical studies involving these agents. PMID- 3553054 TI - [Liver transplantation. Current status and indications]. PMID- 3553055 TI - [Diagnosis and therapy of lung embolism]. PMID- 3553056 TI - [What is established in the treatment of psoriasis?]. PMID- 3553057 TI - [What is established in exercise therapy?]. PMID- 3553058 TI - Main intrinsic polypeptide proteolysis and fiber cell membrane domains. AB - The main intrinsic polypeptide (MIP) of ocular lens fiber cells, a putative gap junctional polypeptide, has been shown to undergo a physiologic proteolytic reduction in relative molecular weight with age. Electron microscopic studies of isolated lens fiber cell membranes have revealed the existence of two distinct classes of gap junction-like membrane-membrane interactions, which differ from each other in profile thickness by about 4 nm ("thick" and "thin" fiber cell junctions). The authors report that both classes of membrane-membrane interaction are seen in situ as well. Using exogenous and endogenous proteases to mimic the molecular "aging" of the MIP, we have explored the hypothesis that one junctional class is derived from the other as the MIP is proteolytically degraded. From the results presented the authors conclude that neither limited or exhaustive proteolytic degradation of the MIP substantially alters the relative percentages of the three identifiable fiber cell membrane domains (thick junctions, thin junctions, and unit membranes); thick fiber cell junctions, because they possess a gap between the membrane outer leaflets, are, by definition, gap junctions; thin junctions are not artifacts of tannic acid fixation; and unit membranes are capable of associating in a manner that mimics thin junctions. PMID- 3553059 TI - Colchicine reverts cell shape but not collagen phenotypes in corneal endothelial cells modulated by polymorphonuclear leukocytes. AB - The authors have shown previously that polymorphonuclear leukocytes (PMN) modulate rabbit corneal endothelial cells (CEC) into cells that irreversibly acquire the characteristics of fibroblasts, including multilayering of spindle shaped cells and deposition of interstitial extracellular matrix composed predominantly of type I collagen. In an attempt to determine if the changes in cell shape caused by the disruption of cytoskeleton are correlated with the alteration of collagen phenotypes in fibroblastic corneal endothelial cells (FCEC), colchicine and cytochalasin B (CB) were used. A series of dose-response studies were performed, and correlated with exposure time. When cells were exposed to the drugs (ranging from 0.01-4.0 micrograms/ml) 24 hr after plating, the majority of cells treated with colchicine dramatically changed from fibroblastic to polygonal shape: cells became flattened and cytoplasmic processes disappeared. Conversely, no apparent changes were observed in the CB-treated cells. On removal of colchicine, the cells resumed fibroblastic morphology within 24 hr; most of the cells again developed cytoplasmic processes. When collagen phenotypes were analyzed by electrophoresis, types I, III, and V collagen were present in either the colchicine or CB-treated cells, regardless of the concentration of drug used. However, synthesis of type I trimer and type III collagen was significantly increased in the cells treated with colchicine at concentrations greater than or equal to 1.0 microgram/ml; the alpha 1:alpha 2 ratio was approximately 4.5, and type III accounted for 35-40% of the total collagen. CB did not induce a similar alteration. These observations indicate that changes in cell shape are not related to the switch of collagen phenotypes in FCEC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553060 TI - In vitro and in vivo susceptibility of Candida keratitis to topical polyenes. AB - The susceptibility of Candida albicans to topical amphotericin B and natamycin was evaluated in a model of stromal keratitis in Dutch-belted rabbits and compared with minimal inhibitory concentrations in vitro. Treatment was delayed 24 hr to allow invasive disease to occur and was then continued for 5 days. Ten strains of Candida albicans comprised the test panel. For amphotericin B, the minimal inhibitory concentration (MIC) by tube dilution classified the same strains as resistant or susceptible as did the in vivo response. A dose-response was observed with different concentrations of the drug. For natamycin, the MIC misclassified two strains. The rate of administration of natamycin required in this model was much higher than for amphotericin B, a therapeutic effect being observed with natamycin only when the drug was administered every 30 min during the in vivo efficacy and in vitro susceptibility with these strains is in agreement with that observed in the authors' previous studies using a model of immediate treatment. PMID- 3553061 TI - Bullous pemphigoid autoantibodies are markers of corneal epithelial hemidesmosomes. AB - Sera from patients with bullous pemphigoid (BP) contain autoantibodies that bind to the BP antigen, which is a component of the epithelial-stromal junction of the cornea. Previous studies, employing direct immunoelectron microscopy (IEM) on perilesional skin of patients have localized the BP antigen to the lamina lucida. On this basis, studies of corneal epithelial-stromal adhesion and wound healing have employed BP antigen as a marker of the lamina lucida of the corneal basement membrane zone (BMZ). The authors used indirect IEM with BP autoantibodies on frozen sections of cornea and found that the majority of the BP antigen is intracellular and is closely associated with the corneal epithelial hemidesmosome. Only a small amount of BP antigen appears to be extracellular, limited to the portion of the lamina lucida directly beneath individual hemidesmosomes. When rabbit corneal epithelium is extracted and analyzed by Western immunoblotting, BP autoantibodies recognize two polypeptides of molecular weights of 240 and 180 kilodaltons, which comigrate with BP antigens extracted from epidermis. BP autoantibodies are a specific marker of corneal epithelial hemidesmosomes and can be used as a probe to identify and study the role of hemidesmosomes in epithelial-stromal adhesion. PMID- 3553063 TI - Perinatal mortality: arrested progress? PMID- 3553062 TI - Tobacco rattle virus. PMID- 3553064 TI - Postpartum hemolytic uremic syndrome: correlation between clinical course and serial renal sonograms. PMID- 3553065 TI - The languages of the brain. The Charles E. Smith International Symposium in honor of Prof. Joel Elkes. 7, 9 June, 1985, Jerusalem, Israel. Proceedings. PMID- 3553066 TI - Alteration of immune function in mice following carcinogen exposure. AB - Treatment of mice with the direct-acting alkylating agent methyl methanesulfonate produced marked suppression of the humoral response to sheep erythrocytes and suppression of T cell responses to foreign antigens. These effects occurred without loss of spleen, thymus or body weight and in the absence of peripheral blood, splenic or bone marrow cytotoxicity. In comparison, exposure to urethan decreased spleen weights, number and viability of spleen cells, and numbers of circulating lymphocytes. Significant suppression of T cell mitogen responsiveness was observed at all dose levels of urethan. Thymus weights, proliferative responses to the B cell mitogen lipopolysaccharide and delayed hypersensitivity responses were decreased at the highest urethan dose. Cyclophosphamide treatment significantly depressed thymic weight, lymphoproliferative responses of T and B cells, antibody production and delayed hypersensitivity responses. These results suggest differential sensitivity in components of the host defense system to weak carcinogens. PMID- 3553067 TI - Total condylar knee prosthesis with posterior stability. A mid-term follow-up of 74 cases with severe deformity. AB - The midterm results of 74 posterior stability total condylar prostheses were studied (average follow-up 3 1/2 years). The average age of the patients was 65 years with a predilection for females (73%). The most frequent diagnosis was osteoarthritis (70%) followed by rheumatoid arthritis (28%): in 20% of the cases previous operations had been performed. Most of the patients had severe deformity which was not susceptible to other surgical treatment. The most frequent deformity was varus (average 13 degrees), followed by valgus (average 25 degrees), and flexion contracture (average 37 degrees). Bone defect in the tibia requiring surgical treatment were present in 18% of the cases. The most frequent general complication was pulmonary embolism (5%), which was never fatal; minor complications related to wound healing were observed in 17.5% of the cases. The results, evaluated with a numerical recording form devised by the Hospital for Special Surgery (New York) were: excellent 72%, good 21%, fair 4%, poor 3%. Of the 4 fair results, one had lateral laxity following lysis for valgus knee, one had loosening of the tibial component, and one had painful patellar clicks. Painless, small patellar clicks were observed in 4 other patients. The two poor results were due to low-grade infection and detachment of both components. Seventy per cent of the knees had normal or almost normal function with maximum flexion averaging 100 degrees. In 78% of the cases a study of the cement-bone interface revealed either no radiotranslucent line or present in only one area of the tibia. Radiotranslucent lines around the femoral or patellar component was rare and of no clinical significance. PMID- 3553068 TI - Long-acting propranolol in the prophylaxis of migraine. PMID- 3553070 TI - Timolol maleate, a beta blocker, in the treatment of common migraine headache. PMID- 3553069 TI - Nimodipine versus flunarizine in common migraine: a controlled pilot trial. PMID- 3553071 TI - Effervescent ASA versus solid ASA in the treatment of tension headache. A double blind, placebo controlled study. PMID- 3553072 TI - [Immunohistologic differential diagnosis of skin tumors in routinely embedded paraffin sections]. AB - Thirty-nine skin tumors of epithelial, mesenchymal, and neuroectodermal origin were studied using antibodies against intermediate filaments and other cell proteins. Formol-fixed and paraffin-embedded material was reconstituted and stained with antibodies against epithelial cells (keratin, epithelial membrane antigen, carcinoembryonic antigen), mesenchymal and histiocytic cells (vimentin, alpha-1-antichymotrypsin, alpha-1-antitrypsin, lysozyme), nerve tissue (neurofilament, glial fibrillary acidic protein, myelin basic protein, myelin associated protein, neuron-specific enolase), vessels (factor-VIII-related protein), basal cell lamina (laminin) and S-100 protein. Tumor cells displayed the same antibody pattern found in the normal cell type. It is recommended that immunotyping be started with three antibodies to allow gross classification into epithelial (keratin positive), mesenchymal (vimentin positive) and neuroectodermal (vimentin and S-100 protein positive) tumors; then, in a second step, the tumors can be subclassified by the other more specific antibodies listed above. All antibodies used in this study are commercially available and provide reliable results. PMID- 3553073 TI - [Value of the 19S IgM FTA ABS test in the diagnosis and therapy of syphilis. Personal experiences and remarks on the method]. AB - Sera from patients with syphilis in various stages (525 sera specimens from untreated and 496 from treated patients) were tested, as were 17 sera specimens from infants with suspected neonatal syphilis. The tests employed for the detection of treponemal and reaginic antibodies were IgG-FTA-ABS, IgM-FTA-ABS, 19S-IgM-FTA-ABS, TPHA, VDRL and the complement fixation test. The purpose of this study was to see whether in all cases the demonstration of antitreponemal antibodies of the IgM class is a reliable criterion for treatment of seropositive patients. This was shown to be valid in nearly all cases where specific IgM was demonstrated by the 19S-IgM-FTA-ABS test. Possible biological or technical factors leading to erroneous results of this test are discussed. PMID- 3553074 TI - Elimination of 131I in meadow voles (Microtus pennsylvanicus) measured by whole body gamma spectrometry. PMID- 3553075 TI - The occurrence of chemically induced hormesis. AB - This paper will provide an overview of the potential general applicability of chemical hormesis. Evidence will be presented on the occurrence of chemical hormesis by chemical classes studied (e.g. heavy metals, polycylic aromatic hydrocarbons, etc.), by affected biological and toxic end points (e.g. growth enzyme activities, DNA-repair capacity, life span, tumor incidence) and by biological/taxonomic systems. Several specific examples of possible hormetic effects with respect to agents of environmental concern, such as chloroform, will be presented along with a discussion of future research directions. PMID- 3553076 TI - Physiology of the hormetic effect. AB - Beneficial (hormetic) effects of ionizing radiation have been largely ignored in developing radiobiological theory, chiefly because a suitable explanatory hypothesis is lacking. Examination of the relevant literature has revealed that food restriction effects in animals resemble those of low-level, low-LET, whole body ionizing radiation exposure (without food restriction) in two major respects: increased longevity and change in the variance of longevity. These physiological changes can be interpreted as resulting from alteration of the "steady-state" flux of oxygen radicals which affect the endocrine balance. Oxy radical-producing, low-level ionizing radiation exposure (whole body) is interpreted by the body as excess food intake, thus lowering the appetite and reducing caloric intake which, in turn, increases longevity. The greater variance in longevity accompanying increases in the median age at death with food restriction alters the ratio of long-lived to short-lived descendants and hastens the population's adaptation to semi-permanently diminished rates of food supply. Less variance and earlier mean ages at death result from an increased rate of food supply. Whole-body ionizing radiation exposure results in a mixed response, because it reduces caloric intake while signaling that an increase has occurred. PMID- 3553077 TI - Adaptation of cell renewal systems under continuous irradiation. AB - There are adaptive changes in the proliferative characteristics of renewal tissues under the stress of continuous low-dose-rate irradiation which indicate that cell and tissue kinetics will have a considerable effect on the radiation response. Factors that determine the adaptation response involve cellular radiosensitivity, i.e. cell cycle effects, which determine the rate of cell sterilization and death, and compensatory cell proliferation and the capacity for regeneration, i.e. changes in the patterns of cell population kinetics, which determine the rate of cell birth. In rapidly dividing cell renewal systems, there is an effective elimination of damaged cells, with almost complete repair of cellular nonlethal damage. In slowly dividing renewal tissues, there is some repair or elimination of cellular radiation damage and the pattern of cell proliferation during regeneration is relatively little disturbed by prior continuous irradiation. Experimental data on intestinal epithelium, immunohematopoietic tissues, seminiferous epithelium and regenerating liver are presented. Discussion includes differences in adaptation to continuous low-dose rate irradiation involving intracellular and extracellular control mechanisms which regulate cellular proliferation and differentiation and, thereby, control cell population levels and physiological function. PMID- 3553078 TI - Radiation hormesis: its expression in the immune system. AB - The effects of low-dose single and continuous whole-body irradiation on immune functions were studied in C57BL/6 mice. Plaque-forming cell reaction of the spleen was found to be stimulated by single doses of x rays in the range of 0.025 to 0.075 Gy and by continuous exposure to gamma rays with a cumulative dose of 0.065 Gy. The reactivity of thymocytes to interleukin 1 showed a dose-dependent depression in the dose range of 0.025 to 0.25 Gy, but there was an increase in cell number in the thymus between doses of 0.025 and 0.10 Gy, resulting in enhancement of reaction of the whole organ. Unscheduled DNA synthesis of spleen cells was stimulated by single irradiation with 0.05 Gy and continuous irradiation with a cumulative dose of 0.13 Gy. The implications of these immunologic changes under low-dose radiation are discussed. PMID- 3553079 TI - A review of certain low-level ionizing radiation studies in mice and guinea pigs. AB - Starting in the early 1940s, Egon Lorenz and collaborators at the National Cancer Institute began an extended study of chronic low-level ionizing radiation effects in what was then the tolerance range for man. Observations on life span, body weight and radiation carcinogenesis, among others, were made in mice, guinea pigs and rabbits. At the then-permissible exposure level, 0.1 R** per 8-h day until natural death, experimental mice and guinea pigs had a slightly greater mean life span compared to control animals. In addition, there was marked weight gain during the growth phase in both species. Increased tumor incidence was also observed at the 0.1-R level in mice. The primary hypothesis for increased median life span has been rebound regenerative hyperplasia during the early part of the exposure; in the presence of continuing injury, there is physiological enhancement of defense mechanisms against intercurrent infection. The body weight gain has not been explained. PMID- 3553080 TI - Radiation hormesis in plants. AB - Many reports discuss plant growth stimulation by exposure of seeds or plants to low doses of ionizing radiation. The reported effects include increased height, weight, growth rate, flowering and yield. The magnitude of the effect(s) is usually small, being about 10% of control values; and the effects often are not reproducible. None has been independently confirmed. The exposure level reported to induce such effects is about an order of magnitude greater than that reported for similar hormetic responses in animals. There is no understanding of the mechanism(s) of such responses or of the cellular and physical factor(s) pertinent to the induction of such effect(s). However, observations that certain low-level exposures result in increased yield (e.g. more branches, flowers and fruits) are consistent with known mechanisms of cellular damage and known responses of plants to a compromise in apical dominance. PMID- 3553081 TI - Clinical and experimental aspects of single-lung transplantation. AB - Recent progress in immunosuppressive therapy for lung transplantation, improvements in surgical technique, advances in lung preservation methods, and appropriate management of cadaver organ donors have all improved the prospects for lung transplantation as a feasible therapeutic procedure for selected patients with end-stage pulmonary disease. The major limiting factor in the application of this operation will be the scarcity of good lung donors. PMID- 3553083 TI - Nursing perspectives for the patient receiving postoperative ventricular assistance in the critical care unit. PMID- 3553082 TI - Rejection of the transplanted heart. PMID- 3553084 TI - Autonomous nursing interventions for treating the patient in acute pain: a standard. PMID- 3553085 TI - Identification of stressors related to patients' psychologic responses to the surgical intensive care unit. PMID- 3553086 TI - An examination of the differences that occur between direct and indirect blood pressure measurement. PMID- 3553087 TI - Public policy, politics, and home health care. Comment. PMID- 3553088 TI - Coping with by-discipline cost limits. PMID- 3553089 TI - [Aneurysms of the great vessels: radiologic diagnosis]. PMID- 3553090 TI - [Carotid surgery without angiography]. PMID- 3553091 TI - [Significance of upright body position in angiography for the diagnosis of thoracic outlet syndrome]. PMID- 3553092 TI - [Angiographic and sonographic demonstration of the umbilical vein 5 years after implantation in the distal femoral region]. PMID- 3553093 TI - Distribution of G-cells in the gastric mucosa in peptic ulcer. PMID- 3553094 TI - Preservation of actin immunoreactivity in paraffin section by tannic acid fixation on chick embryonic heart: comparison with phalloidin staining on frozen section. PMID- 3553097 TI - Sensory influences on food intake and utilization in humans. AB - Sensory, particularly chemosensory, experiences play an important role in food intake as well as digestive and metabolic processes which influence nutrient utilization in humans. This review first presents evidence that the sensory properties of foods and the sensory capacities of individuals with marked, marginal or no apparent nutrient deficiencies influence dietary practices. This is followed by a consideration of data demonstrating an impact of oral sensory stimulation on salivary, gastric and both exocrine and endocrine pancreatic secretion. Next, because of the absence of human studies, animal models are described which demonstrate that chemosensory stimulation can alter nutrient absorption. Finally, studies on preterm infants are presented as evidence that oral stimulation alone can influence growth efficiency. While an understanding of these issues remains incomplete, applications of existing knowledge could hold important nutritional and clinical implications. PMID- 3553096 TI - Existence of VIP and PHI-like immunoreactivities in the amphibian gut. PMID- 3553095 TI - Adherence of Candida albicans to urinary catheters. PMID- 3553098 TI - An immunohistochemical study of serotonin-containing nerves in the colon of rats. AB - The localization of the serotonin-like immunoreactive nerves of the rat colon was investigated by means of immunohistochemistry, utilizing an antibody against serotonin. In non-treated colons, serotonin-positive neuropils were consistently detected around the myenteric plexus. In pargyline-treated colons, serotonin-like fibres were demonstrated in association with either the small intramural blood vessels of the submucosa or the extramural nerve bundles. Treatment with 5 hydroxytryptophan (5-HTP) permitted the visualization of additional serotonin immunoreactive fibres around the large extramural blood vessels. Immunoreactive nerve cell bodies were demonstrated in the myenteric plexus of colons treated with 5-HTP or colchicine. From these observations, it is suggested that the serotoninergic nerves of the rat colon comprise both intrinsic and extrinsic elements. PMID- 3553099 TI - The fate of prorenin during granulopoiesis in epithelioid cells. Immunocytochemical experiments with antisera against renin and different portions of the renin prosegment. AB - Comparative immunocytochemical experiments with antisera directed against renin and three synthetical peptides (Pro 1, Pro 2A and Pro 3) covering almost the entire span of human renin prosegment were performed on human kidney tissue. With anti-Pro 1, i.e. the antiserum which recognizes the NH2 terminus of human prorenin, no clear immunolabeling of juxtaglomerular epithelioid cell secretory granules could be obtained. It is therefore concluded that the corresponding portion of human prorenin may be cleaved off in the Golgi complex. After application of anti-Pro 3, the antiserum which recognizes the COOH terminus of the prosegment, only the juvenile secretory granules of epithelioid cells were consistently labeled, whereas, in contrast, some of the intermediate and most of the mature secretory granules were anti-Pro 3-negative. As the immunoreactivity of mature renin increased remarkably from protogranules to mature secretory granules, it is suggested that the cleavage of the COOH terminus of the prosegment, i.e. the activation of renin, takes place in juvenile and intermediate granules during condensation of the enzyme. The immunoreactivity of Pro 2A, corresponding to the middle portion of the prosegment, disappeared in a somewhat earlier stage of granulopoiesis than that of Pro 3. It is therefore concluded that the corresponding segmental cleavage, the result of which is a truncated version of intact prorenin, occurs in the protogranules of epithelioid cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553100 TI - GABAergic input of cholecystokinin-immunoreactive neurons in the hilar region of the rat hippocampus. An electron microscopic double immunostaining study. AB - Double immunostaining was performed for electron microscopy to analyze the synaptic connections between glutamate decarboxylase (GAD)-immunoreactive axons and cholecystokinin (CCK)-immunoreactive neurons in the hilar region of the rat hippocampal formation. Following immunostaining for CCK, the diaminobenzidine (DAB) reaction product was silver-intensified and gold-substituted. In a subsequent second immunostaining for GAD, the immunoreactive elements were labeled using a single DAB reaction. Electron microscopic analysis of the double stained Vibratome sections demonstrated that the single DAB-labeled GAD immunoreactive boutons form symmetrical synaptic connections on the soma and primary dendrites of the DAB-gold-labeled CCK-immunoreactive neurons. PMID- 3553101 TI - Electron microscopic localization of a fucose-binding protein in acrosome reacted boar spermatozoa by the fucosyl-peroxidase-gold method. AB - In this study we have examined the behaviour and the localization of the fucose binding protein (FBP) in boar spermatozoa during ionophore induced acrosome reaction (AR) by means of normal TEM and specimen preparation in toto. During early stages of AR the FBP is first localized at the border between equatorial segment and anterior acrosome. With the propagation of the AR the FBP is dramatically expressed and visible over the entire surface of the acrosome and equatorial segment. TEM pictures of this stages show that the FBP is associated with the OAM. At later stages of AR, when acrosomal ghost formation occur, the FBP is associated with the acrosomal ghost, and equatorial segment and to a very low degree also with the IAM. It is concluded from this data that the FBP is responsible for the specific binding of the ghost-sperm unit to the zona pellucida. PMID- 3553102 TI - The early expression of immunoreactivity for calmodulin in the nervous system of mouse embryos. AB - Calmodulin (CaM) is a major calcium-binding protein in the brain, where its immunoreactivity is mainly localized in the neurons. In this study, ontogenical changes in the distribution of CaM in the nervous system of mouse embryos were investigated immunohistochemically using a specific antibody against CaM and an indirect immunoenzyme method. Immunoreactive staining was first observed in the marginal layer of the cranial neural tube after 9.5 days of gestation; thereafter, the amount of stained structures increased rapidly. Particularly intense staining was observed in the long neuronal processes extending from or into the brain and spinal cord primordia. Intense immunostaining was also observed in the optic nerve layer of early retinae from 12.5 days of gestation. The appearance of CaM immunoreactivity is thus an early event during neuronal differentiation, apparently concomitant with the initiation of axon extension and the appearance of neurofilament proteins. PMID- 3553104 TI - An immunocytochemical method for the localization of fibronectin in Araldite embedded specimens. AB - The detection of fibronectin (FN) in osmium-fixed and Araldite-embedded frog skin fragments was studied using a modification of Baskin's procedure (Baskin et al. 1979). Following the removal of Araldite from the semi-thin sections (0.5-1.0 micron) with ethanol-NaOH solution, the sections were bleached with hydrogen peroxide. FN was detected by indirect immunoperoxidase method. For precise localization of FN, careful attention was paid to the temperature, antibody concentrations and the quality of the ethanol-NaOH solution. Our results were in agreement with those that we had obtained previously for polyethylene glycol (PEG) sections, suggesting that the present procedure is useful for the detection of FN in Araldite-embedded biological specimens. PMID- 3553103 TI - Ultrastructural localization of exocytotic release sites in immunocytochemically characterized cell types. A combination of two methods. AB - Preembedding visualization of exocytosis by tannic acid treatment and postembedding immunocytochemical identification of cell types were combined to demonstrate the release of secretory products by exocytosis of characterized cell types. Treatment with tannic acid was carried out by perfusion with Ringer containing tannic acid, followed by fixation, dehydration and embedding. For electron microscopical immunocytochemistry protein A-gold was used as marker. In this study, exocytotic release was demonstrated for prolactin by cells in the pars distalis, and for oxytocin by axon terminals in the pars nervosa of the pituitary gland of the rat. PMID- 3553105 TI - Intensification of 3,3'-diaminobenzidine precipitation using the ferric ferricyanide reaction, and its application in the double-immunoperoxidase technique. AB - As in double-immunoperoxidase methods, colour mixing usually indicates unwanted interactions between reagents of the first and second sequences, it is desirable to prevent such superimposition of colours by eliciting adequate colour intensity in the first immunoperoxidase sequence. The brown oxidation product of 3,3' diaminobenzidine (DAB) in the first immunoperoxidase sequence can be intensified by applying the ferric ferricyanide reaction, resulting in intense greenish-blue staining. When the primary antibody is used at a sufficient concentration, cells labelled in the first sequence do not cross-react with the red chromogen, 3-amino 9-ethylcarbazole (AEC), used in the second sequence. Thus, this double immunoperoxidase method results in different cell populations being clearly labelled in contrasting colours. Primary antibodies from the same species and the same type of link antibodies can be used in the two separate immunoperoxidase sequences. When primary antibodies raised in different species and two types of link antibodies are used, the method can, without loss of sensitivity, be shortened by performing the first two incubation steps simultaneously. PMID- 3553106 TI - Demonstration of fibronectin in normal and acutely inflamed appendix. AB - The presence and localization of fibronectin in normal and acutely inflamed appendices in man was studied using indirect immunoperoxidase technique on sections of formaldehyde fixed and paraffin embedded tissue, following pretreatment with pepsin and testicular hyaluronidase. In the normal appendix fibronectin was demonstrated in the region of the basement membrane of the surface epithelium, in the loose connective tissue, in the perimysium around the individual smooth muscle cells and in the vessel walls. In the acutely inflamed appendices, fibronectin was found in the luminal necrotic area, both intercellularly and in the cytoplasma of some inflammatory cells. In relation to the surface inflammation and in the tissue matrix corresponding to the acute inflammatory reaction fibronection was, compared to the normal appendix, found in increased amount. Furthermore, a comparison between the use of a primary antibody to fibronectin, produced in our collaborating laboratory and two different commercial primary antibodies showed that the staining results concerning the localization of fibronectin were equal for all three antibodies, whereas the commercial antibodies showed a weaker staining intensity and some unspecific staining compared to the antibody produced in our collaborating laboratory. PMID- 3553107 TI - The immunohistochemical demonstration of thyroglobulin in human thyroid tumour xenografts using a monoclonal antibody. AB - A monoclonal antibody (RBU/01) was raised against human thyroglobulin and its suitability for the immunohistochemical staining of thyroglobulin was determined on fixed, wax-embedded tissue, using the peroxidase anti-peroxidase (PAP) method. The antibody was then used to demonstrate the expression of human thyroglobulin in sections of a human follicular carcinoma of the thyroid which had been grown in immunodeficient mice. It is concluded that the immunohistochemical evaluation of the xenografts with the antibody provides useful information on this xenograft system as a potential model for thyroid carcinoma. PMID- 3553108 TI - [Scar neuroma following tumor operations of the head and neck. Immunohistologic studies, differential diagnosis, therapy]. AB - Amputation neuromas occasionally follow division of the cervical plexus during classical neck dissection. They present as painful, subcutaneous, and fixed tumours. They must be removed to exclude recurrence of the primary disease. The differential diagnosis includes neurilemmoma, solitary neurofibroma, neurofibromatosis, neuro-muscular hamartoma, and benign myxoid tumours. Histological diagnosis is particularly easy especially if immunohistochemistry with markers against neural tissues is used. However, to prevent recurrence, the central nerve stump should be exposed, ligated after removal of the neuroma and then transposed to scar free subcutaneous tissue. PMID- 3553109 TI - Characterization of mononuclear cell subpopulations in normal fetal peripheral blood. AB - It is now possible to characterize fetal peripheral blood mononuclear cells (FPBMC) from normal fetuses sampled in utero under ultrasound guidance. The surface phenotype of FPBMC from 25 fetuses, between the 20th and the 26th week of gestation, was studied using standard reagents that are known to delineate mononuclear cell subsets in adult peripheral blood. Results were compared with those obtained in neonates (cord blood) and adults. The major subsets of adult PBMC are represented in fetal blood with few qualitative differences: 20% of FPBMC are not recognized, the percentage of T cells is lower with a higher ratio T4/T8, the fraction of cells that express DR molecule is very high, and the distribution of NK antigens is different in fetuses. B cells and monocytes are in equal proportion. This work represents a prerequisite for future functional studies, and provides normal fetal values that will be useful for prenatal diagnosis of congenital immunodeficiency. PMID- 3553110 TI - Smoking prevention, cessation, and maintenance: review for the primary care physician. PMID- 3553111 TI - Postoperative radiotherapy in stage II and III renal adenocarcinoma. A randomized trial by the Copenhagen Renal Cancer Study Group. AB - Since 1979, 11 urological and surgical departments and 2 oncological departments in the greater Copenhagen area have been investigating the role of postoperative radiotherapy (XRT) in patients with renal adenocarcinoma Stage II and III staging modified from Holland. After nephrectomy, patients were randomized to receive XRT (50 Gy in 20 F to the kidney bed, regional ipsi- and contralateral lymph nodes) or no further treatment. Patients in both arms were followed until relapse, death, or 5 years after operation. Seventy-two were randomized by January 1984. An update of the treatment results showed the following: 7/72 were excluded from further analysis because of major protocol violations, 34/65 were in Stage II and 31/65 in Stage III. There were 43 men and 22 women, median age 61 years, range 34 75; 33/65 were randomized in observation, 32/65 to XRT. Relapse was found in 28/65 or 43% during the follow-up period without any difference between the two groups. According to protocol criteria 27/32 randomized to XRT accomplished treatment. Significant complications from stomach, duodenum, or liver occurred in 12/27 or 44%, median 5 mo. range 1-44 mo. after XRT. In 5/27 or 19% the postirradiatory complications contributed to the death of the patients. The median survival in the XRT-group was 26 mo. The survival at 26 mo., in the observation group, was 62%. This difference is not statistically significant. We conclude that postoperative XRT, as given in the present study in patients nephrectomized for Stages II and III renal adenocarcinoma, is without any beneficial effect on relapse rate and survival. Moreover, XRT is associated with an unacceptable complication rate and the protocol has been closed for further patient accrual since January 1984. PMID- 3553112 TI - Skeletal metastases from cancer of the uterine cervix: frequency, patterns, and radiotherapeutic significance. AB - The records of eight hundred two patients who received primary radiotherapy for invasive cervical cancer between 1969 and 1985 were reviewed. The incidence of bone metastasis was 1.9% (15/802). Lumbar spine involvement was the most common site, followed by the pelvic bones. Lumbar spine involvement was characterized by unilateral destruction of one or several contiguous vertebrae. All 10 patients with lumbar spine involvement were associated with a para-spinal mass. In seven of ten patients, this bone destruction due to direct extension from metastatic para-aortic tumor was the only recurrent cancer. In contrast, involvement of a long bone, a rib or the skull indicates hematogenous bone metastasis. When a spine X ray or bone scan is positive in the lumbar area in a cervical cancer patient with back pain, a CT scan should be performed to determine the extent of the underlying tumor. This will allow more accurate establishment of a radiation treatment plan, and will improve the chances for successful palliation. PMID- 3553113 TI - Integration of chemotherapy into the combined modality therapy of head and neck squamous cancer. PMID- 3553114 TI - Prospective comparison of ultrasound and computed tomography in the evaluation of the size of the uterus: can these methods be used for intracavitary treatment planning of carcinoma of the uterus? AB - A prospective evaluation of computed tomography and ultrasound was performed on 34 patients with Stage I and II endometrial carcinoma. All patients underwent immediate surgery following intracavitary treatment directed to vaginal mucosa. Pathologic measurements of the uterus were compared to those obtained by imaging technologies. The results of the study suggest that all but height measurements were rather accurately determined by both ultrasound and CT scan. However ultrasound was significantly better in determining the size of the cervix. Therefore ultrasound measurements could be used routinely for intracavitary treatment planning in endocervical carcinoma and endometrial carcinoma. PMID- 3553115 TI - The thirtieth anniversary of the American Academy of Psychoanalysis: an historical appreciation. PMID- 3553116 TI - Strains of group B streptococci. PMID- 3553117 TI - Comparative metabolism of copper. AB - Copper is required in trace amounts for many body functions. The prominent effects of Cu deficiency or Cu toxicosis differs greatly between animal species. Along with iron, Cu is necessary for the transfer of O2 via a cascade of enzymes so that energy may be available for vital body functions without overheating of the tissues through rapid oxidation. As a part of lysyl oxidase, Cu has an obligate function in the maturation of all connective tissue (including elastic tissue and bone) maintaining the form and integrity of all body organs. As a constituent of tyrosinase, Cu is involved in the formation of melanin, thus preventing albinism. Copper also is involved in the myelination of nerve fibers and the production of neutrophils, enkephalins, lipoproteins, and cholesterol. Copper must be properly sequestered to prevent toxicosis. Copper is stored primarily as metallothioneins and as superoxide dismutase and is transported primarily as ceruloplasmin or as low molecular weight proteins, peptides, and amino acids. PMID- 3553119 TI - Chemical hazards and chemical warfare. PMID- 3553118 TI - Disseminated Mycobacterium paratuberculosis infection in a cow. AB - A cow with chronic diarrhea and weight loss caused by localization of Mycobacterium paratuberculosis in the intestinal tract (Johne's disease) had gross and microscopic changes indicative of a disseminated infection. A direct association between the remote lesions and the intestinal infection was shown by isolation of M paratuberculosis from renal tissue, detection of intracellular M paratuberculosis antigen(s), using an indirect immunoperoxidase method, and by the characteristic granulomatous nature of the lesions. This case illustrates the potential for extra-intestinal lesions in M paratuberculosis infection of cattle and should cause veterinarians to consider mycobacterial disease when confronted with multinodular lesions of the bovine kidney. The immunoperoxidase method was useful in determining the cause of the inflammatory lesion in which intact organisms were not evident. PMID- 3553120 TI - Subepidermal bullous drug eruption resembling bullous pemphigoid in a dog. PMID- 3553121 TI - Canine prostatic disease--comparison of ultrasonographic appearance with morphologic and microbiologic findings: 30 cases (1981-1985). AB - A retrospective analysis was made of 30 cases of canine prostatic disease, with the objective of identifying (via a prepubic approach) the 2-dimensional, gray scale ultrasonographic appearance most often associated with the various spontaneous prostatic diseases. Ultrasonography was of value in characterizing the parenchymal architecture as normal vs focally hyperechoic and diffusely hyperechoic (associated with chronic inflammation and neoplasia) or focally hypoechoic or anechoic (either accompanied by distant enhancement), which was associated with retention cyst or abscess. Further specificity based only on abnormal echotexture was not possible. Ultrasonography facilitated the differentiation of radiographically identifiable prostatomegaly attributable to abscess or neoplasia from apparent prostatomegaly attributable to paraprostatic cyst. An imaging protocol consisting of distention retrograde urethrocystography and prepubic ultrasonography was recommended, as a distended bladder aided ultrasonographic identification of the prostate gland. In addition, the combination of urethral morphologic features and urethroprostatic reflux appearance complemented the ultrasonographic appearance for differentiation of prostatic abscess from prostatic carcinoma. A classification scheme for spontaneous canine prostatic disease combining germane imaging morphologic features with microscopic and microbiologic findings was proposed. PMID- 3553122 TI - A single assay for simultaneously testing effectors of alanine racemase and/or D alanine: D-alanine ligase. AB - The biosynthesis from L-alanine of D-alanyl-D-alanine, required for the peptidoglycan layer of the cell wall of many bacterial species, is catalyzed by two enzymes in series, alanine racemase and D-alanine: D-alanine ligase. A simple in vitro method, called the combined assay, for simultaneously testing for effectors of either or both enzymes in a single assay by coupling these enzymes to each other is described here. The experiments used to derive the optimum conditions for the assay are also described. Each enzyme is included in the assay in rate-limiting amounts, wherein the product of the initial racemase reaction, D alanine, becomes the substrate for the subsequent ligase. The product of the overall reaction, [14C]-D-alanyl-D-alanine, is separated chromatographically from the L-[1-14C]alanine substrate, and from any D-[1-14C]alanine intermediate, at the end of the incubation, is counted and the percent conversion of substrate to product calculated. The inhibitory effects of 3-fluoro-D-alanine-2d, a known inhibitor of the racemase, and D-cycloserine and DL-1-aminoethylphosphonic acid, inhibitors of both enzymes, were readily detectable. The sensitivity of the combined assay to these inhibitors appears similar to that of earlier assays. This assay has the advantage over previous ones of being able to detect inhibitors of either enzyme in a single assay, thereby avoiding the need to screen each compound in a separate assay of each enzyme. PMID- 3553123 TI - Prolongation of rat heart allograft survival by 15-deoxyspergualin. PMID- 3553124 TI - Central endocrine regulation of the development of hormone responses in porcine fetal adipose tissue. AB - Experiments were performed to determine whether central endocrine or neural regulation is primarily involved with the development of endocrine responses in fetal adipose tissue metabolism. Fetuses within one uterine horn were either decapitated (decap) or spinally cauterized at 45 d of gestation, with fetuses in the other horn serving as sham controls (intact). Fetuses were removed by cesarean section at 110 d of gestation. Slices of subcutaneous adipose tissue (100 mg) were incubated in media supplemented with radioactive glucose and insulin (1.0 mU/ml) to measure the metabolic response of the tissue to insulin. Other slices were incubated in medium supplemented with norepinephrine bitartrate (1 microgram/ml) to measure lipolytic response by glycerol release. Basal glucose utilization for oxidation, total lipid and fatty acid synthesis was higher in decap adipose tissue than intact adipose tissue. Cauterized and intact fetuses did not differ in adipose tissue glucose metabolism. Only decap adipose tissue demonstrated an insulin stimulation of glucose oxidation and lipogenesis. Norepinephrine stimulated lipolysis in both cauterized and intact adipose tissue but had no effect upon decap adipose tissue lipolysis. These results demonstrate central endocrine regulation but not central neural regulation has an important function in the development of porcine fetal adipose tissue metabolism and its responses to systemic hormones. PMID- 3553125 TI - Mechanisms controlling feed intake in ruminants: a review. AB - The purpose of this paper is to review our understanding of the involvement of central and peripheral factors in the control of feed intake in ruminants. The regulation of body weight under various states of energy need depends on an animal's ability to control feed intake to meet these needs. In the central nervous system (CNS), the ventromedial and lateral hypothalamus appear to be the areas involved in satiety and hunger, respectively; other important areas are the paraventricular nucleus and rostral brain areas. Intracerebroventricular injection of neurotransmitters, alpha- and beta-adrenergic agonists, 5 hydroxytryptamine and gamma aminobutyric acid (GABA) agonists, has stimulated feeding in ruminants; intravenous administration of benzodiazepines stimulated feed intake in sheep and cattle, possibly by increasing GABA levels in the brain. Neuropeptides of the opioid and cholecystokinin families have reciprocal hunger stimulating and satiety-eliciting effects when administered centrally in sheep. Further, concentrations of these neuropeptides in specific areas of the hypothalamus have been shown to change with the state of hunger-satiety of sheep. In the periphery, none of the hormones associated with the pituitary, adrenal gland, pancreas or gastrointestinal tract has been shown to have significant effects on the control of feed intake. In addition, the physical properties of the ingested feed in the gastrointestinal tract, while possibly influencing the rate or pattern of feeding, do not appear to be primary factors in the control of feed intake under many feeding conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553126 TI - Effects of norgestomet on follicular development in postpartum beef cows. AB - To examine effects of norgestomet pretreatment on development of follicles and their response to administration of gonadotropin releasing hormone (GnRH), 45 pluriparous suckled beef cows were assigned at random to receive a 6-mg implant of norgestomet for 9 d (inserted 24 d postpartum) or serve as untreated controls. Ovaries were obtained 48 h after removal of implants or 10 to 11 or 20 to 22 h after im administration of 150 micrograms GnRH at 48 h after removal of the implant. The largest follicle (F1) and all follicles within 3 mm in diameter of the F1 were dissected from the ovaries. Theca, granulosa and follicular fluid were separated and assayed for steroids and prostaglandins. Diameters and weights of F1 and weights of follicular components remained unchanged in control cows, but increased by 10 h and declined by 20 h in norgestomet-pretreated cows (treatment X time, quadratic, P less than .05). Ovarian volume and numbers of follicles at the surface of the ovary did not differ with treatment, but the diameter of the second-largest follicle (F2) was smaller (P less than .05) in norgestomet-pretreated cows than in controls (6.0 +/- .9 vs 8.2 +/- .7 mm). The F1 were embedded in the ovary in fewer norgestomet-pretreated than control cows (2/22 vs 8/23; P less than .05). Changes in steroids in F1 paralleled those in size (treatment X time, quadratic, P less than .05). Overall, F1 from norgestomet pretreated cows had higher (P less than .05) contents of estradiol. Contents of prostaglandins in F1 follicles did not differ with treatment, but increased (P less than .05) following treatment with GnRH. The F2 had lower contents of estradiol than F1. It is suggested that norgestomet effected the maturation of a single follicle which produced more estradiol. PMID- 3553127 TI - Influence of cottonseed meal supplementation on voluntary intake, ruminal and cecal fermentation, digesta kinetics and serum insulin and growth hormone in mature ewes fed prairie hay. AB - To determine the influence of protein supplementation on intake and fermentation of low-quality hay, six ruminal- and cecal-cannulated Rambouillet ewes (avg wt 43.6 kg) in a crossover design were given ad libitum access to prairie hay with or without 80 g of cottonseed meal (CSM) X head-1 X d-1. Voluntary hay intake was measured the last 7 d of each 18-d period. Ruminal, cecal and blood samples were collected at 0, 1 (except cecal), 3, 6, 9, 12, 15, 18, 21 and 24 h post supplementation on d 14 of each period to measure fluid dilution rate, fermentation characteristics and serum concentrations of insulin and growth hormone. An intraruminal dose of Yb-labeled hay, followed by fecal sampling on d 15 through 18, was used to measure particulate passage rate. Voluntary intake of prairie hay was increased (P less than .04) from 23.7 to 28.3 g/kg of body weight by CSM supplementation. Particulate passage rate constants did not differ (P greater than .15) between supplemented (3.76%/h) and control (3.72%/h) ewes, and total mean retention time was not altered (P greater than .15) by CSM supplementation. Ruminal retention time of particulates did not differ (P greater than .15) between treatments; however, intestinal transit time was faster (P less than .03; 18.1 vs 22.6 h) in supplemented than in control ewes. Estimated gastrointestinal dry matter fill was greater (P less than .05; 14.3 vs 12.9 g/kg body weight) in supplemented ewes. Ruminal fluid volume did not differ (P greater than .15) between treatments; however, supplemented ewes tended to have faster fluid dilution rates (P less than .14) and fluid outflow rates (P less than .11) than control ewes. Cecal fluid volume, dilution rate and outflow rate did not differ (P greater than .15) between groups. Ruminal and cecal pH and total volatile fatty acids were similar between treatments. Similarly, cottonseed meal supplementation did not affect (P greater than .15) ruminal or cecal ammonia concentrations. Molar proportions of ruminal and cecal individual fatty acids were not affected (P greater than .15) by CSM supplementation. Feeding cottonseed meal increased (P less than .05) serum insulin, decreased (P less than .07) serum growth hormone and increased (P less than .06) serum free fatty acids, but did not influence (P greater than .15) either serum urea N or glucose concentrations. Cottonseed meal supplementation in ewes fed prairie hay caused increased hay intake but had minimal effects on ruminal and cecal fermentation. PMID- 3553128 TI - Current trends and advances in bacterial vaccines today. PMID- 3553129 TI - Bactericidal effect of hydrogen peroxide on Salmonella typhimurium in liquid whole egg. AB - The effect of hydrogen peroxide on Salmonella typhimurium in whole egg was evaluated. The bactericidal effects observed on the test organism at 5 degrees and 20 degrees C were found to be similar. There was a 99% kill in the presence of 0.5% and 1.0% H2O2. Addition of the test organism and H2O2 after pre-heating the egg material at 40 degrees C for 15 min caused a rapid kill which was 10,000 fold greater than that produced by H2O2 alone. PMID- 3553130 TI - A note on the effect of the lactoperoxidase systems on salmonellas in vitro and in vivo. AB - The lactoperoxidase system (LPS), a natural bactericidal system in milk, was investigated for its activity against salmonellas in vivo and in vitro. In acidified raw milk, in which the LPS was supplemented with an exogenous supply of H2O2, the numbers of salmonellas decreased rapidly. Different salmonella serotypes were affected to the same extent; rough strains, however, were more susceptible than smooth strains. When calves were fed on fresh milk, containing the LPS, and challenged with Salmonella typhimurium in doses of either 10(9) or 10(10), the clinical findings and salmonella excretion patterns were similar to those of control calves fed on heated milk. It was concluded that further studies, perhaps in the field, are necessary to evaluate LPS as a possible non antibiotic system to control salmonellosis. PMID- 3553131 TI - Fate of salmonellas and competing flora in meat sample enrichments in buffered peptone water and in Muller-Kauffmann's tetrathionate medium. AB - Studies have been carried out in which growth patterns of a Salmonella sp. and competing micro-organisms, especially other Enterobacteriaceae, were followed during pre-enrichment in buffered peptone water (BPw) and subsequent selective enrichment in tetrathionate broth (TBB). Pre-enrichment cultures were inoculated with minced meat and three reference samples containing nalidixic acid-resistant salmonellas. Irrespective of their initial numbers in BPw, Enterobacteriaceae increased to 10(8)/ml or more. During incubation in TBB at 43 degrees C, numbers of lactose-positive Enterobacteriaceae decreased in most enrichments which resulted in a positive salmonella isolation, but remained constant in the majority of those that did not. Levels of lactose-negative Enterobacteriaceae did not decrease in most salmonella-positive tests, but did so in half of the salmonella-negative ones. In the salmonella-positive tests the numbers of salmonellas had increased to 10(3)-10(7)/ml in BPw and after transfer to TBB slowly reached 10(4)/ml or more. In all cases the numbers of salmonellas exceeded those of the competing flora on brilliant green agar (BGA). In the salmonella negative tests the numbers of salmonellas had increased less in BPw and decreased in most of the TBB enrichments. In none of these negative tests did the numbers of salmonellas exceed those of the competing flora on BGA. Escherichia coli dominated in most of the salmonella-negative tests. The results suggest more influence of lactose-positive than lactose-negative Enterobacteriaceae on the detection of salmonellas. The effect of competing microorganisms seems to depend not only upon their initial numbers, but also upon the types that can interact with salmonellas during selective enrichment. PMID- 3553132 TI - Antimicrobial resistance in Bacteroides. PMID- 3553133 TI - The use of a tissue culture model to assess the penetration of antibiotics into epithelial cells. AB - A tissue culture model was developed in which enteroinvasive Escherichia coli invaded and survived within HEp-2 epithelial cells. The bacteria were shown to be intracellular by light and electron microscopy and immunofluorescence. The model was then used to assess the ability of antimicrobial agents to penetrate into cells and alter the morphology of the bacteria. Chloramphenicol, tetracycline, trimethoprim and ciprofloxacin penetrated more easily than beta-lactam antibiotics. Ampicillin and its derivatives penetrated more easily than cephalosporins, latamoxef or aztreonam. Only ciprofloxacin was able to kill intracellular bacteria. PMID- 3553134 TI - Enoxacin pharmacokinetics and efficacy in CF-1 mice. AB - Mean peak enoxacin serum concentrations in nonfasted CF-1 mice following a single 50, 100, or 200 mg/kg oral dose were 2.0, 4.0 and 11.4 mg/l, respectively, with proportional increases in area under the serum concentration curves. Oral enoxacin was significantly more effective than tobramycin or dicloxacillin in experimental Pseudomonas aeruginosa and Staphylococcus aureus infections respectively. Enoxacin was as effective as tobramycin against P. cepacia and Escherichia coli infections. Enoxacin may be useful as an oral antimicrobial for the treatment of selected systemic bacterial infections. PMID- 3553135 TI - Comparative efficacy and safety of ceftizoxime, cefotaxime and latamoxef in the treatment of bacterial pneumonia in high risk patients. AB - One hundred and thirty-five patients with bacterial pneumonia who had risk factors (alcoholism, chronic obstructive pulmonary disease, corticosteroid therapy diabetes mellitus, advanced age, solid tumours) were randomly allocated in a double-blind fashion to receive either ceftizoxime (2-4 g every 8 h), cefotaxime (1-2 g every 4 h), or latamoxef (2-4 g every 8 h). Of the 84 patients evaluable for efficacy, clinical cure was achieved in 91%, 85%, and 89% of ceftizoxime- (20/22), cefotaxime-(23/27), and latamoxef-treated (31/35) patients, respectively. Adverse reactions occurred in one of 45 ceftizoxime-treated patients, one of 43 cefotaxime-treated patients, and seven of 47 latamoxef treated patients. Abnormal laboratory values during therapy were seen in 50% of latamoxef-treated and 43% of cefotaxime-treated patients and in 29% of ceftizoxime-treated patients. Hypoprothrombinaemia occurred in five latamoxef treated patients and one of these patients experienced an episode of haematemesis. In this study, ceftizoxime, cefotaxime, and latamoxef were similarly effective; however, the incidence of side effects was most frequent with latamoxef. PMID- 3553136 TI - The treatment of campylobacter infections in man. PMID- 3553137 TI - Elevation of superior vena caval pressure increases extravascular lung water after endotoxemia. AB - In many sheep Escherichia coli endotoxin results in pulmonary hypertension, increased microvascular permeability, pulmonary edema, and increased central venous pressure. Since lung lymph drains into the systemic veins, increases in venous pressure may impair lymph flow sufficiently to enhance the accumulation of extravascular fluid. We tested the hypothesis that, following endotoxin, elevating the venous pressure would increase extravascular fluid. Thirteen sheep were chronically instrumented with catheters to monitor left atrial pressure (LAP), pulmonary arterial pressure (PAP), and superior vena caval pressure (SVCP) as well as balloons to elevate LAP and SVCP. These sheep received 4 micrograms/kg endotoxin, and following the pulmonary hypertensive spike the left atrial balloon was inflated so that (PAP + LAP)/2 = colloid osmotic pressure. It was necessary to control PAP + LAP in this way to minimize the sheep-to-sheep differences in the pulmonary hypertension. We elevated the SVCP to 10 or 17 mmHg or allowed it to stay low (3.2 mmHg). After a 3-h period, we killed the sheep and removed the right lungs for determination of the extravascular fluid-to-blood-free dry weight ratio (EVF). Sheep with SVCP elevated to 10 or 17 mmHg had significant increases in EVF (5.2 +/- 0.1 and 5.6 +/- 1.2) compared with the sheep in which we did not elevate SVCP (EVF = 4.5 +/- 0.4). These results indicate that sustained elevation in central venous pressure in patients contributes to the amount of pulmonary edema associated with endotoxemia. PMID- 3553138 TI - Neurohumoral and cardiopulmonary response to sustained submaximal exercise in the dog. AB - Neurohumoral, cardiovascular, and respiratory parameters were evaluated during sustained submaximal exercise (3.2 km/h, 15 degrees elevation) in normal adult mongrel dogs. At the level of activity achieved (fivefold elevation of total body O2 consumption and threefold elevation of cardiac output), significant (P less than 0.05) increases in plasma norepinephrine and epinephrine concentration (from 150 +/- 23 to 341 +/- 35 and from 127 +/- 27 to 222 +/- 31 pg/ml, respectively) were present, as well as smaller but significant increases in plasma renin activity and plasma aldosterone concentration (from 2.2 +/- 0.3 to 3.1 +/- 0.6 ng X ml-1 X h-1 and from 98 +/- 8 to 130 +/- 6 pg/ml, respectively). Plasma arginine vasopressin increased variably and insignificantly. The cardiovascular response (heart rate, systemic arterial and pulmonary arterial pressures, left ventricular filling pressure, and calculated total peripheral and pulmonary arteriolar resistance) closely paralleled that of human subjects. Increased hemoglobin concentration was induced by exercise in the dogs. The ventilatory response of the animals was characterized by respiratory alkalosis. These data suggest similarities between canine and human subjects in norepinephrine, plasma renin activity, and plasma aldosterone responses to submaximal exercise. Apparent species differences during submaximal exertion include greater alterations of plasma epinephrine concentration and a respiratory alkalosis in dogs. PMID- 3553139 TI - Pulmonary pressor responses in sheep to chemically defined precursors of E. coli endotoxin. AB - The toxicity of various monosaccharide and disaccharide endotoxin precursors has now been studied in sheep. We measured the early pulmonary arterial pressure responses after injections of the monosaccharides lipid X (2,3-diacylglucosamine 1-phosphate) and MAGP (2-monoacylglucosamine 1-phosphate), of the tetraacyl disaccharide diphosphate precursor of lipid A, IV-A (Federation Proc. 43: 1567, 1984), and of Escherichia coli bacterial endotoxin (lipopolysaccharide). We also measured the response of lipid X after prior administration of indomethacin and MAGP. Lipid X, at a total cumulative dose of 40 micrograms/kg, produced an immediate, but transient dose-dependent pulmonary arterial vasoconstrictive response. MAGP, at a total dose of 40 micrograms/kg, had no pulmonary pressure activity but did increase extravascular lung water and produce some histological changes in the lung. Disaccharide precursor IV-A, at a total dose of 40 micrograms/kg, produced an immediate dose-dependent pulmonary arterial vasoconstrictive response that was prolonged for greater than 2 h. E. coli endotoxin caused a delayed (15-min) increase in the pulmonary arterial pressure but one that also persisted for greater than 2 h. Prior administration of indomethacin blocked the pulmonary pressor activity of lipid X, whereas prior administration of MAGP increased both the magnitude and the duration of the pulmonary pressure response of lipid X. We conclude that the initial pulmonary hypertension seen after lipid X injection may involve cyclooxygenase-dependent formation of prostaglandins and that the genesis of this pulmonary pressor activity is at least in part dependent on the ester-linked hydroxymyristoyl moiety at position 3 of the lipid X molecule.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553140 TI - Airway reactivity in infants: a positive response to methacholine and metaproterenol. AB - Because the presence of bronchial smooth muscle reactivity in infants remains controversial, airway reactivity was assessed in 10 normal, asymptomatic male infants less than 15 mo of age by measuring the changes that occurred in the maximal expiratory flows at functional residual capacity (VmaxFRC) during a methacholine bronchial challenge test. Sleeping infants inhaled doubling concentrations of methacholine by 2 min of tidal breathing, starting with a concentration of 0.075 mg/ml, and the bronchial challenge was stopped when VmaxFRC decreased by at least 40%. The threshold concentration of methacholine required to produce a decrease in VmaxFRC by 2 SD's of the control value was 0.43 mg/ml (0.11-0.90). By a methacholine concentration of 1.2 mg/ml, all infants decreased VmaxFRC by at least 40% (range 40-75%), and the mean dose required to produce a 40% decrease was 0.72 mg/ml. The airway reactivity was not related to base-line flows. During the methacholine challenge, no infant developed wheezing, but the percent oxygen saturation for the group decreased significantly (P less than 0.05) from 94 to 92%. Following the methacholine, the infants inhaled the bronchodilator metaproterenol, and 10 min later, VmaxFRC returned to base line. This study demonstrates that infants exhibit airway reactivity as evidenced by bronchoconstriction with methacholine and the subsequent bronchodilation with metaproterenol. PMID- 3553141 TI - Epithelial and endothelial flux after bypass in dogs: effect of positive end expiratory pressure. AB - Cardiopulmonary bypass (CPB) causes lung injury that occasionally progresses to the adult respiratory distress syndrome (ARDS). We measured the effect of 10 cmH2O of positive end-expiratory pressure (PEEP) on small solute and protein flux in dogs 1 wk before and 2 h after the completion of CPB. As an index of alveolar epithelial permeability, the clearance from lung to blood of inhaled technetium 99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) was measured. To assess microvascular endothelial integrity, the rate of accumulation in the lung interstitium of intravascular 113mIn-transferrin was measured. The clearance half time (t 1/2) for 99mTc-DTPA in the study dogs declined from 18.8 +/- 1.9 min (mean +/- SE) at base line to 9.4 +/- 2.0 min during PEEP (P less than 0.05). Two hours after CPB, the t 1/2 was 8.1 +/- 1.6 min at base line and unchanged during PEEP. The 113mIn-transferrin rate of accumulation was unchanged by PEEP before CPB. After CPB, the index was 3.25 +/- 0.95 slope/min X 10(-3) (P less than 0.05). Of the five dogs with a significant slope, four showed a decrease in microvascular flux during PEEP, although for the group the mean change in slope was not significant (P = 0.10). We conclude that the application of PEEP does not increase 99mTc-DTPA clearance in lungs already injured by CPB, and may actually decrease the apparent microvascular protein flux in some cases. PMID- 3553142 TI - Partitioning of airway responses to inhaled methacholine in the rat. AB - We measured the changes in upper and lower airway resistance after inhalation of aerosols of methacholine (MCh) in doubling concentrations (16, 32, 64, and 128 mg/ml) in 11 anesthetized nonintubated spontaneously breathing rats. Upper airway resistance (Ru) increased from a control value of 0.48 +/- 0.04 cmH2O X ml-1 X s (mean +/- SE) to 0.85 +/- 0.15 after 128 mg/ml MCh, whereas lower airway resistance (Rlo) increased from 0.11 +/- 0.03 to 0.21 +/- 0.04. However, there was no correlation between the magnitudes of the changes in Ru and Rlo. In a further seven anesthetized spontaneously breathing rats aerosols of MCh were delivered into the lower airways via a tracheostomy and resulted in increases in Rlo from a control value of 0.20 +/- 0.03 to 0.66 +/- 0.12 after 128 mg/ml MCh. Ru also increased to approximately double its control value. We conclude that inhaled MCh causes narrowing of both Ru and Rlo in the anesthetized rat, the changes in Ru and Rlo are not correlated, and changes in Ru can occur when MCh deposition occurs only in the lower airways. PMID- 3553143 TI - Effects of lung volume on maximal methacholine-induced bronchoconstriction in normal humans. AB - We examined the effects of lung volume on the bronchoconstriction induced by inhaled aerosolized methacholine (MCh) in seven normal subjects. We constructed dose-response curves to MCh, using measurements of inspiratory pulmonary resistance (RL) during tidal breathing at functional residual capacity (FRC) and after a change in end-expiratory lung volume (EEV) to either FRC -0.5 liter (n = 5) or FRC +0.5 liter (n = 2). Aerosols of MCh were generated using a nebulizer with an output of 0.12 ml/min and administered for 2 min in progressively doubling concentrations from 1 to 256 mg/ml. After MCh, RL rose from a base-line value of 2.1 +/- 0.3 cmH2O. 1-1 X s (mean +/- SE; n = 7) to a maximum of 13.9 +/- 1.8. In five of the seven subjects a plateau response to MCh was obtained at FRC. There was no correlation between the concentration of MCh required to double RL and the maximum value of RL. The dose-response relationship to MCh was markedly altered by changing lung volume. The bronchoconstrictor response was enhanced at FRC - 0.5 liter; RL reached a maximum of 39.0 +/- 4.0 cmH2O X 1-1 X s. Conversely, at FRC + 0.5 liter the maximum value of RL was reduced in both subjects from 8.2 and 16.6 to 6.0 and 7.7 cmH2O X 1-1 X s, respectively. We conclude that lung volume is a major determinant of the bronchoconstrictor response to MCh in normal subjects. We suggest that changes in lung volume act to alter the forces of interdependence between airways and parenchyma that oppose airway smooth muscle contraction. PMID- 3553144 TI - Lung epithelial permeability to aerosolized solutes: relation to position. AB - The lung epithelial permeability to inhaled solutes is primarily attributed to the degree of distension of the interepithelial junctions and thus of the alveolar volume. To assess this hypothesis, a submicronic aerosol of technetium 99m-labeled diethylenetriamine pentaacetate (99mTc-DTPA) was inhaled by eight normal subjects in left lateral decubitus (LLD). The regional lung clearance of 99mTc-DTPA was measured in LLD, then in right lateral decubitus (RLD) to reverse the relative distension of the alveoli. Although in LLD the deposition of the aerosol is the greatest in the gravity-dependent regions of the left lung, their 99mTc-DTPA clearances are significantly lower than those of the nondependent regions of the right lung (0.7 +/- 0.3 vs. 2 +/- 0.8%/min, P less than 0.001). In RLD, these regions placed in opposite positions significantly reversed their clearances (1.6 +/- 0.8 vs. 0.6 +/- 0.2%/min, P less than 0.001). Results indicate in lateral decubitus a gravity gradient of 99mTc-DTPA clearances independent of the aerosol deposition. This gradient of epithelial permeability to solutes appears to be influenced by the gradient of alveolar volume. PMID- 3553147 TI - Biological photographic collections: The picture archives of the Institute of the History of Medicine, University of Vienna. PMID- 3553145 TI - The nerve growth factor thirty-five years later. PMID- 3553146 TI - Epidermal growth factor. PMID- 3553148 TI - Suppression of a signal sequence mutation by an amino acid substitution in the mature portion of the maltose-binding protein. AB - An unusual spontaneous pseudorevertant of an Escherichia coli strain carrying the signal sequence point mutation malE14-1 was characterized. The suppressor mutation, malE2261, resulted in a single substitution of an aspartyl residue for a tyrosyl residue at position 283 in the sequence of the mature maltose-binding protein. The precursor retained the malE14-1 point mutation in the signal sequence. The pseudorevertant carrying both malE14-1 and malE2261 exported twice the amount of maltose-binding protein as that of the mutant carrying the malE14-1 allele alone but only 18% of the amount exported by a strain producing wild-type maltose-binding protein. A strain carrying the suppressor allele malE2261 in combination with a wild-type signal sequence exported normal quantities of maltose-binding protein to the periplasm. Mature MalE2261 had a Kd for maltose of 27 microM, compared with 3.6 microM for mature wild-type maltose-binding protein. The precursor species than contained both changes resulting from malE14-1 and malE2261 was significantly less stable in the cytoplasm than was the precursor containing only the change encoded by malE14-1. PMID- 3553149 TI - New phenotypes associated with mucAB: alteration of a MucA sequence homologous to the LexA cleavage site. AB - Most mutagenesis by UV and many chemicals in Escherichia coli requires the products of the umuDC operon or an analogous plasmid-derived operon mucAB. Activated RecA protein is also required for, or enhances, this process. MucA and UmuD proteins share homology with the LexA protein, suggesting that they might interact with the RecA protein as LexA does. We used oligonucleotide-directed mutagenesis to alter a site in MucA homologous to the Ala-Gly cleavage site of LexA. The mutation, termed mucA101(Glu26), results in a change of Gly26 of MucA to Glu26. A lexA(Def) recA441 umuC122::Tn5 strain carrying a mucA101(Glu26)B+ plasmid did not exhibit the greatly increased frequency of spontaneous mutagenesis in response to RecA activation that a strain carrying a mucA+B+ plasmid did but retained a basal recA-dependent ability to confer increased spontaneous mutagenesis that was independent of the state of RecA activation. These results are consistent with a model in which RecA plays two distinct roles in mutagenesis apart from its role in the cleavage of LexA. A pBR322-derived plasmid carrying mucA+B+, but not one carrying mucA101(Glu26)B+, inhibited the UV induction of SOS genes, suggesting that MucA+ and MucA(Glu26) proteins may have different abilities to compete with LexA for activated RecA protein. The spectrum of UV-induced mutagenesis was also altered in strains carrying the mucA101(Glu26) mutation. These results are consistent with the hypothesis that activated RecA protein interacts with wild-type MucA protein, possibly promoting proteolytic cleavage, and that this interaction is responsible for facilitating certain mutagenic processes. PMID- 3553150 TI - Reconstitution of signaling in bacterial chemotaxis. AB - Strains missing several genes required for chemotaxis toward amino acids, peptides, and certain sugars were tethered and their rotational behavior was analyzed. Null strains (called gutted) were deleted for genes that code for the transducers Tsr, Tar, Tap, and Trg and for the cytoplasmic proteins CheA, CheW, CheR, CheB, CheY, and CheZ. Motor switch components were wild type, flaAII(cheC), or flaBII(cheV). Gutted cells with wild-type motors spun exclusively counterclockwise, while those with mutant motors changed their directions of rotation. CheY reduced the bias (the fraction of time that cells spun counterclockwise) in either case. CheZ offset the effect of CheY to an extent that varied with switch allele but did not change the bias when tested alone. Transducers also increased the bias in the presence of CheY but not when tested alone. However, cells containing transducers and CheY failed to respond to attractants or repellents normally detected in the periplasm. This sensitivity was restored by addition of CheA and CheW. Thus, CheY both enhances clockwise rotation and couples the transducers to the flagella. CheZ acts, at the level of the motor, as a CheY antagonist. CheA or CheW or both are required to complete the signal pathway. A model is presented that explains these results and is consistent with other data found in the literature. PMID- 3553151 TI - Cloning and nucleotide sequence of the chlD locus. AB - The nucleotide sequence of a Sau3A1 restriction nuclease fragment that complemented an Escherichia coli chlD::Mu cts mutant strain was determined. DNA and deduced amino acid sequence analysis revealed two open reading frames (ORFs) that potentially codes for proteins with amino acid sequence homology with binding protein-dependent transport systems. One of the ORFs showed a sequence that encoded a protein with properties that were characteristic of a hydrophobic inner membrane protein. The other ORF, which was responsible for complementing a chlD mutant, encoded a protein with conserved sequences in nucleotide-binding proteins and hydrophilic inner membrane proteins in active transport systems. A proposal that the chlD locus is the molybdate transport operon is discussed in terms of the chlD phenotype. PMID- 3553152 TI - Contraction of filaments of Escherichia coli after disruption of cell membrane by detergent. AB - The osmotic pressure within a living bacterium creates stresses in the peptidoglycan that stretch the sacculus. We measured the amount of stretch by monitoring the shrinkage of growing cells of Escherichia coli after removal of the osmotic pressure by disruption of the phospholipid membranes with sodium dodecyl sulfate. Because the rods of the wild type are so short, length changes of filaments of longer than 7 microns were measured on phase-contrast micrographs. The filaments were prepared by growing ftsA and ftsI strains under permissive conditions in rich medium and then shifting them to 42 degrees C for 40 to 180 min. During this time, the mutant cells became elongated but did not divide. The growing filaments were mounted on a glass surface that had been treated with poly-L-lysine or RNase. The filaments were photographed before being treated with sodium dodecyl sulfate. The filaments were rephotographed at the time when the first change in phase contrast was noted. Some filaments were also measured at 10-min time intervals from 0 to 60 min. The reduction in phase contrast signaled the leakage of solutes and the loss of turgor pressure. The average length of the filaments decreased 17%. If the circumference were stretched to the same degree, then the surface area in vivo would be 45% greater than in the relaxed state. For comparison, a fully cross-linked monolayer of E. coli peptidoglycan in its most compact conformation could stretch up to 300% in achieving the most extended conformation possible without splitting covalent bonds. PMID- 3553153 TI - Characterization of an outer membrane mannanase from Bacteroides ovatus. AB - Bacteroides ovatus utilizes guar gum, a high-molecular-weight branched galactomannanan, as a sole source of carbohydrate. No extracellular activity was detectable. Approximately 30% of the total cell-associated mannanase activity partitioned with cell membranes. When inner and outer membranes of B. ovatus were separated on sucrose gradients, the mannanase activity was associated mainly with fractions containing outer membranes. Enzyme activity was solubilized by 3-[(3 cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS) or by Triton X-100 at a detergent-to-protein ratio of 1:1. The enzyme was stable for only 4 h at 37 degrees C and for 50 to 60 h at 4 degrees C. Analysis of the products of the CHAPS-solubilized mannanase on Bio-Gel A-5M and Bio-Gel P-10 gel filtration columns indicated that the enzyme breaks guar gum into high-molecular-weight fragments. The CHAPS-solubilized mannanase was partially purified by chromatography on a FPLC Mono Q column. The partially purified mannanase preparation contained three major polypeptides (Mr 94,500, 61,000, and 43,000) and several minor ones. High mannanase activity was seen only when B. ovatus was grown on guar gum. Cross-absorbed antiserum detected two other guar gum associated outer membrane proteins: a CHAPS-extractable 49,000-dalton polypeptide and a 120,000-dalton polypeptide that was not solubilized by CHAPS. Neither of these polypeptides was detectable in the partially purified mannanase preparation. These results indicate that there are at least two guar gum associated outer membrane polypeptides other than the mannanase. PMID- 3553154 TI - Klebsiella pneumoniae 1,3-propanediol:NAD+ oxidoreductase. AB - Fermentative utilization of glycerol, a more reduced carbohydrate than aldoses and ketoses, requires the disposal of the two extra hydrogen atoms. This is accomplished by sacrificing an equal quantity of glycerol via an auxiliary pathway initiated by glycerol dehydratase. The product, 3-hydroxypropionaldehyde, is then reduced by 1,3-propanediol NAD+:oxidoreductase (1,3-propanediol dehydrogenase; EC 1.1.1.202), resulting in the regeneration of NAD+ from NADH. The pathway for the assimilation of glycerol is initiated by an NAD-linked dehydrogenase. In Klebsiella pneumoniae the two pathways are encoded by the dha regulon which is inducible only anaerobically. In this study 1,3-propanediol:NAD+ oxidoreductase was purified from cells grown anaerobically on glycerol. The enzyme was immunochemically distinct from the NAD-linked glycerol dehydrogenase and was an octamer or hexamer of a polypeptide of 45,000 +/- 3,000 daltons. When tested as a dehydrogenase, only 1,3-propanediol served as a substrate; no activity was detected with ethanol, 1-propanol, 1,2-propanediol, glycerol, or 1,4 butanediol. The enzyme was inhibited by chelators of divalent cations. An enzyme preparation inhibited by alpha,alpha'-dipyridyl was reactivated by the addition of Fe2+ or Mn2+ after removal of the chelator by gel filtration. As for glycerol dehydrogenase, 1,3-propanediol oxidoreductase is apparently inactivated by oxidation during aerobic metabolism, under which condition the enzyme becomes superfluous. PMID- 3553155 TI - Use of on-section immunolabeling and cryosubstitution for studies of bacterial DNA distribution. AB - Escherichia coli cells were very rapidly frozen and substituted at a low temperature with 3% glutaraldehyde in acetone. Infiltration and embedding with Lowicryl K4M were carried out at -35 degrees C. This procedure resulted in good structural preservation of both the nucleoid morphology and its DNA plasm, such that immunolabeling with the protein-A gold technique could be carried out. With antibodies specific for either double-stranded DNA (dsDNA) or single-stranded DNA (ssDNA), it was shown that dsDNA was present throughout the nucleoid but that ssDNA was located on the nucleoid periphery. Chloramphenicol-treated cells, in which protein synthesis but not DNA replication is stopped, produced a characteristic ringlike nucleoid shape and had both dsDNA and ssDNA present throughout the annular section of the DNA plasm. The relationship between metabolically active DNA and overall bacterial genome organization is discussed. PMID- 3553156 TI - Purification and properties of a protein linked to the soluble hydrogenase of hydrogen-oxidizing bacteria. AB - In Alcaligenes eutrophus, the formation of the hydrogenases and of five new peptides is subject to the hydrogenase control system. Of these, the B peptide was purified to homogeneity. This protein (Mr, 37,500) was composed of two identical subunits (Mr, 18,800). Antibodies against the B protein were used for its quantification by rocket immunoelectrophoresis. About 4% of the total protein consisted of the B protein; its molar ratio to the NAD-linked hydrogenase was about 4:1. The B protein appeared to be associated with the NAD-linked hydrogenase, as shown by gel filtration analysis with Sephadex G-200. The B protein was not detected in cells that had not expressed the hydrogenase proteins or that lacked the genetic information of the hydrogen-oxidizing character; it was also not detected in Tn5 insertional mutants that were unable to form soluble hydrogenase antigens. Immunochemical analysis of other species and genera than A. eutrophus revealed that only strains able to form a NAD-linked hydrogenase also formed B-protein antigens. The B protein is not required for the catalytic activity of soluble hydrogenase in vitro; its function is at present unknown. PMID- 3553157 TI - Induction of proteins in response to low temperature in Escherichia coli. AB - When the growth temperature of an exponential culture of Escherichia coli is abruptly decreased from 37 to 10 degrees C, growth stops for several hours before a new rate of growth is established. During this growth lag the number of proteins synthesized is dramatically reduced, and at one point only about two dozen proteins are made; 13 of these are made at differential rates that are 3 to 300 times increased over the rates at 37 degrees C. The protein with the highest rate of synthesis during the lag is not detectably made at 37 degrees C. The identities of several of these cold shock proteins correlate with previous observations that indicate a block in translation initiation at low temperatures. PMID- 3553158 TI - Regulation of dipeptide transport in Saccharomyces cerevisiae by micromolar amino acid concentrations. AB - Prototrophic Saccharomyces cerevisiae X2180, when grown on unsupplemented minimal medium, displayed little sensitivity to ethionine- and m-fluorophenylalanine containing toxic dipeptides. We examined the influence of the 20 naturally occurring amino acids on sensitivity to toxic dipeptides. A number of these amino acids, at concentrations as low as 1 microM (leucine and tryptophan), produced large increases in sensitivity to leucyl-ethionine, alanyl-ethionine, and leucyl m-fluorophenylalanine. Sensitivity to ethionine and m-fluorophenylalanine remained high under either set of conditions. The addition of 0.15 mM tryptophan to a growing culture resulted in the induction of dipeptide transport, as indicated by a 25-fold increase in the initial rate of L-leucyl-L-[3H]leucine accumulation. This increase, which was prevented by the addition of cycloheximide, began within 30 min and peaked approximately 240 min after a shift to medium containing tryptophan. Comparable increases in peptidase activity were not apparent in crude cell extracts from tryptophan-induced cultures. We concluded that S. cerevisiae possesses a specific mechanism for the induction of dipeptide transport that can respond to very low concentrations of amino acids. PMID- 3553159 TI - Involvement of a new enzyme, glyoxal oxidase, in extracellular H2O2 production by Phanerochaete chrysosporium. AB - The importance of extracellular H2O2 in lignin degradation has become increasingly apparent with the recent discovery of H2O2-requiring ligninases produced by white-rot fungi. Here we describe a new H2O2-producing activity of Phanerochaete chrysosporium that involves extracellular oxidases able to use simple aldehyde, alpha-hydroxycarbonyl, or alpha-dicarbonyl compounds as substrates. The activity is expressed during secondary metabolism, when the ligninases are also expressed. Analytical isoelectric focusing of the extracellular proteins, followed by activity staining, indicated that minor proteins with broad substrate specificities are responsible for the oxidase activity. Two of the oxidase substrates, glyoxal and methylglyoxal, were also identified, as their quinoxaline derivatives, in the culture fluid as secondary metabolites. The significance of these findings is discussed with respect to lignin degradation and other proposed systems for H2O2 production in P. chrysosporium. PMID- 3553160 TI - Modification, processing, and subcellular localization in Escherichia coli of the pCloDF13-encoded bacteriocin release protein fused to the mature portion of beta lactamase. AB - A fusion between the pCloDF13-derived bacteriocin release protein and beta lactamase was constructed to investigate the subcellular localization and posttranslational modification of the bacteriocin release protein in Escherichia coli. The signal sequence and 25 of the 28 amino acid residues of the mature bacteriocin release protein were fused to the mature portion of beta-lactamase. The hybrid protein (Mr, 31,588) was expressed in minicells and whole cells and possessed full beta-lactamase activity. Immunoblotting of subcellular fractions revealed that the hybrid protein is present in both the cytoplasmic and outer membranes of E. coli. Radioactive labeling experiments in the presence or absence of globomycin showed that the hybrid protein is modified with a diglyceride and fatty acids and is processed by signal peptidase II, as is the murein lipoprotein. The results indicated that the pCloDF13-encoded bacteriocin release protein is a lipoprotein which is associated with both membranes of E. coli cells. PMID- 3553162 TI - Response to temperature shifts of expression of the amp gene on pBR322 in Escherichia coli K-12. AB - Synthesis of beta-lactamase, the product of the amp gene on pBR322, in Escherichia coli K-12 was reversibly repressed with a shift-up of the growth temperature from 30 to 42 degrees C. The temperature shift, however, did not affect the level of mRNA encoding beta-lactamase, which suggested the involvement of translational control. PMID- 3553161 TI - Oxidative mechanisms of toxicity of low-intensity near-UV light in Salmonella typhimurium. AB - The exposure of Salmonella typhimurium to environmentally relevant near-UV light stress has been studied by the use of a low-intensity, broad-band light source. The exposure of cells to such a light source rapidly induced a growth delay; after continuous exposure for 3 to 4 h, cells began to die at a rapid rate. The oxidative defense regulon controlled by the oxyR gene was involved in protecting cells from being killed by near-UV light. This killing may be potentiated by the overexpression of near-UV-absorbing proteins. These results are consistent with near-UV toxicity involving the absorption of light by endogenous photosensitizers, leading to the production of active oxygen species. We have shown, however, that one such species, H2O2, is not a major photoproduct involved in killing by near-UV light. Strains lacking alkyl hydroperoxide reductase were more sensitive to near-UV light, indicating that such hydroperoxides may be photoproducts. Near-UV exposure induced sensitivity to high salt levels, indicating that membranes may be a target of near-UV toxicity and a possible source of alkyl hydroperoxides. The demonstration of the inactivation of the heme containing protein catalase indicates that direct destruction of UV-absorbing macromolecules could be another factor in near-UV toxicity. Cells which have been exposed to near-UV light for long, but sublethal, periods of time (up to 4 h) can recover and resume growth if the UV exposure is stopped but become progressively more sensitive to further stresses, such as H2O2. This result indicates that cells gradually accumulated damage during near-UV exposure until toxic levels were reached. PMID- 3553164 TI - Alprazolam in the treatment of posttraumatic stress disorder. PMID- 3553163 TI - Temperature sensitivity of the penicillin-induced autolysis mechanism in nongrowing cultures of Escherichia coli. AB - The effect of incubation temperature on the ampicillin-induced autolysis of nongrowing Escherichia coli was determined. The autolysis mechanisms in amino acid-deprived relA mutant cells treated with chloramphenicol were temperature sensitive. This temperature-sensitive autolysis was demonstrated in three independent ways: turbidimetric determinations, viable cell counts, and solubilization of radiolabeled peptidoglycan. PMID- 3553165 TI - Dementia syndromes: neurobehavioral and neuropsychiatric features. AB - Dementia is seen in a wide variety of conditions that, in general, lack specific laboratory features. Etiologic classification depends on a combination of historical/clinical and radiologic/EEG considerations. Neurobehavioral and neuropsychiatric characteristics of the dementia syndromes may be key to accurate diagnosis. The diseases that produce dementia syndromes, including degenerative, vascular, myelinoclastic, traumatic, infective, and metabolic disorders, are reviewed, and the principles that permit differential diagnosis are discussed. PMID- 3553166 TI - Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. AB - Limited information is available regarding the incidence, nature, and treatment of behavioral problems in Alzheimer's disease (AD). A chart review of 57 outpatients with a diagnosis of AD was conducted to examine these issues. Thirty three (58%) patients had significant behavioral symptomatology (most commonly delusions, nonspecific agitation, and diurnal rhythm disturbances). Twenty-seven were treated with thioridazine (10-250 mg/day), 15 (55.6%) of whom were judged to have a positive response (mean maximum dose = 55 mg/day). Information regarding the characteristic phenomenology of the behavioral symptoms studied was used to design a clinical rating instrument for AD patients, the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), which should be useful in prospective studies of behavioral symptoms as well as in pharmacologic trials. PMID- 3553167 TI - New strategies for the determination of macromolecular structure in solution. AB - Non-crystallographic approaches to the determination of protein structure must solve the problem of insufficient and low information content experimental data. Most successful methods augment experimentation with theoretical constraints (for example, potential energy functions or optimization error metrics). We believe it is important to separate the contributions of experimentation and theory in the construction of protein structure. The PROTEAN system defines protein topology on the basis of experimental data alone. Its performance on three data sets, derived from the lac-repressor headpiece of E. coli, sperm whale myoglobin, and domain 1 of bacteriophage T4 lysozyme, indicates that there may be families of related conformations that are consistent with the experimental data. These conformations provide insight into the strengths and weaknesses in the data sets. They also provide a set of structures with which to begin theoretical refinements. We outline here a strategy which maintains a clear distinction between refinements based on theory and those based on experiment, and thus allows a careful analysis of the properties of such refinement methods. PMID- 3553168 TI - Analysis of Escherichia coli ribosomal proteins by an improved two dimensional gel electrophoresis. I. Detection of four new proteins. AB - Kaltschmidt and Wittmann's two dimensional gel electrophoresis was improved in the following points. Preruns using radical scavengers were carried out to eliminate free radicals remaining in gels. Gelation of sample solutions was not performed to avoid immobilization of proteins in the sample gels. Instead, for preparing sample gels, prior to the first dimension (1-D) electrophoresis, another electrophoresis was performed to charge proteins into gel pieces polymerized previously. Proteins migrated together with charged reductants to avoid formation of artificial disulfide bridges during migration. The second dimension (2-D) electrophoresis was carried out at a more acidic pH, 3.6, to get better separation of very small and basic proteins. With these modifications, quantitative yield and reproducibility became better, and many faint spots disappeared not only at the high molecular weight side but also in the region containing primary spots of ribosomal proteins. The proportionality of the migration distance to the logarithm of molecular weight was also increased. On the improved 2-D electrophoretogram of Escherichia coli ribosomal proteins, four new spots, called protein A, B, C, and D, were found in the basic region. Proteins A, B, and C belong to 50S subunits but D to 30S. Their molecular weights were determined electrophoretically as 6,400, 4,900, 8,200, and 5,900, respectively. Their copy numbers in crude ribosomes were estimated to be 0.6, 0.4, 0.3, and 0.1, respectively, by using 14C-labeling. PMID- 3553169 TI - Analysis of Escherichia coli ribosomal proteins by an improved two dimensional gel electrophoresis. II. Characterization of four new proteins. AB - Four new proteins, A, B, C, and D, found in Escherichia coli ribosomes by an improved two dimensional gel electrophoresis were characterized by oxidation, reduction, and carboxymethylation of cysteine residues, and CsCl fractionation. The cysteine contents of proteins A, B, C, and D were determined to be 1 +/- 0, 3 +/- 1, 5 +/- 1, and 0 +/- 0 by carboxymethylation with iodoacetic acid. The components of protein complexes, which formed numerously under non-reducing conditions, were analyzed. Including protein A, B, and C, every ribosomal protein (r-protein) having cysteine residue(s) except unconfirmed S1 was proved to form such complexes with various combinations. The cysteine residue in protein A, in particular, was highly reactive to make intermolecular S-S bridges so that spot A almost disappeared on the second dimension gel under the non-reducing conditions. Proteins B and C shifted their spots by reduction towards upper left side as do all known r-proteins having plural cysteine residues except S1. This suggests that proteins B and C change their conformation by intramolecular S-S bridges. The CsCl density gradient centrifugation of high salt washed 70S ribosomes showed that protein A belonged to the insoluble split proteins, proteins B and C to the core particles, and protein D and a small population of B to the soluble split proteins. The electrophoretic behaviors, CsCl fractionation and stoichiometry of the four new proteins suggested strongly that they were intrinsic ribosomal constituents different from known ribosomal proteins or factors. PMID- 3553170 TI - Immunoblotting analysis of plasma protein processing in the secretory pathway of rat liver: identification of proteolytic conversion sites of complement pro-C3 and prohaptoglobin. AB - Using an immunoblotting technique, we have studied the processing of plasma proteins in subcellular fractions of rat liver including rough and smooth microsomes and the Golgi subfractions. Each subcellular fraction was directly subjected to SDS-polyacrylamide gel electrophoresis and analyzed by immunoblotting with antibodies against alpha 1-protease inhibitor, haptoglobin, and the third component of complement (C3) in combination with 125I-protein A or 125I-rabbit anti-(goat IgG)-IgG. The results demonstrated that proteolytic processing of precursors of complement C3 and haptoglobin occurs in different compartments along the secretory pathway; conversion of prohaptoglobin takes place in the endoplasmic reticulum, while that of pro-C3 occurs in the Golgi complex. The processing in oligosaccharide chains of glycoproteins was also analyzed. The Golgi fraction was characterized by the presence of the mature 56 kDa alpha 1-protease inhibitor, which was indistinguishable from the serum alpha 1-protease inhibitor in SDS-polyacrylamide gel electrophoresis. In contrast, the immature 51 kDa form was the only form of alpha 1-protease inhibitor found in the microsomal fraction. Similar results were obtained for the beta subunit of haptoglobin; the immature 33 kDa form was detected in the microsomal fraction, while the mature 36 kDa form was found in the Golgi fraction. Taken together, these results identified the intracellular sites where these plasma proteins are modified by selective proteolysis and/or glycosylation. PMID- 3553171 TI - Purification of caldesmon and myosin light chain (MLC) kinase from arterial smooth muscle: comparisons with gizzard caldesmon and MLC kinase. AB - We have developed a simple and conventional purification method for caldesmon and MLC kinase from bovine arterial smooth muscle, and compared the arterial and gizzard proteins. Arterial caldesmon shares the alternative binding to calmodulin or F-actin in a Ca2+-dependent manner and the antigenic determinants with the gizzard protein. Both caldesmons have the same association constant with F-actin (1.3-1.7 X 10(7) M-1) and the same maximum binding (1 caldesmon per 12-14 actins). However, the molecular weight of arterial caldesmon (dimer of a 148 kDa polypeptides) was slightly different from that of gizzard caldesmon (heterodimer of 150/147 kDa polypeptides). The molecular weight of arterial MLC kinase (160 kDa) was much larger than that of the gizzard enzyme (135 kDa). The enzyme activities of both MLC kinases were comparable (Km = 9.5 microM, Vmax = 12.5 mumol/min X mg). The association constant of the arterial enzyme to F-actin (5.1 X 10(6) M-1) was much larger than that of the gizzard enzyme (9.0 X 10(5) M-1) but the maximum binding was the same (1 enzyme per 12-13 actins). Immunocytochemical examinations showed that caldesmon and MLC kinase in cultured arterial cells have a restricted localization along the stress fibers, suggesting functional linkages between both proteins and actin filaments in vivo. PMID- 3553172 TI - Production and isolation of recombinant somatomedin C. AB - High-level production of a growth promoting peptide hormone somatomedin C (insulin-like growth factor I) has been achieved using recombinant DNA techniques in Escherichia coli. We found a new structural protein, designated as LH, to stabilize somatomedin C in vivo, and constructed expression vectors for somatomedin C fusing to LH through a methionine and through a tryptophan, respectively. Each of the fused proteins was produced at approximately 4.5 X 10(5) molecules per single E. coli cell and comprised more than 20% of the total cellular proteins. Somatomedin C was obtained in high yield by limited cyanogen bromide degradation of the methionine-type fused protein, in spite of somatomedin C itself having a Met at the 59th position, followed by renaturation of the resultant reduced peptide. The tryptophan-type fused protein was also converted to the peptide hormone by treating with 3-bromo-2-nitrophenylsulphenyl skatole or N-chlorosuccinimide. The recombinant somatomedin C obtained by these procedures was identical with the native one in amino acid sequence as well as in biological activity of stimulation of DNA synthesis in BALB/c 3T3 cells. PMID- 3553173 TI - Homology of Escherichia coli B glutathione synthetase with dihydrofolate reductase in amino acid sequence and substrate binding site. AB - Glutathione synthetase from Escherichia coli B showed amino acid sequence homology with mammalian and bacterial dihydrofolate reductases over 40 residues, although these two enzymes are different in their reaction mechanisms and ligand requirements. The effects of ligands of dihydrofolate reductase on the reaction of E. coli B glutathione synthetase were examined to find resemblances in catalytic function to dihydrofolate reductase. The E. coli B enzyme was potently inhibited by 7,8-dihydrofolate, methotrexate, and trimethoprim. Methotrexate was studied in detail and proved to bind to an ATP binding site of the E. coli B enzyme with K1 value of 0.1 mM. The homologous portion of the amino acid sequence in dihydrofolate reductases, which corresponds to the portion coded by exon 3 of mammalian dihydrofolate reductase genes, provided a binding site of the adenosine diphosphate moiety of NADPH in the crystal structure of dihydrofolate reductase. These analyses would indicate that the homologous portion of the amino acid sequence of the E. coli B enzyme provides the ATP binding site. This report gives experimental evidence that amino acid sequences related by sequence homology conserve functional similarity even in enzymes which differ in their catalytic mechanisms. PMID- 3553174 TI - Kinetic studies of wheat carboxypeptidase-catalyzed reaction: differences in pressure and temperature dependence of peptidase and esterase activities. AB - A kinetic study of hydrolytic catalysis by wheat bran carboxypeptidase (carboxypeptidase W) was carried out using 3-(2-furyl)acryloyl-acylated (Fua-) synthetic substrates. This enzyme showed high esterase activity in addition to the intrinsic carboxypeptidase activity. The optimum pH for the peptidase activity (kcat/Km) was at pH 3.3 and the kcat/Km value decreased with increasing pH with an apparent pKa of 4.50, while the esterase activity increased with pH up to pH 8 with an apparent pKa of 6.04. Optimum pH's for kcat for the peptidase and esterase reactions were also very different and their apparent pKa values were 3.80 and 6.15, respectively. From a measurement of the pressure dependences of kcat and Km, the activation volumes (delta V not equal to) and reaction volumes (delta V), respectively, were determined. delta V not equal to for kcat was -7 to -8 ml/mol for peptidase and -2 to -3 ml/mol for esterase. These results lead us to propose that the peptidase and esterase activities of carboxypeptidase W are different not in the rate-determining steps in a common reaction pathway, but in the binding modes and/or catalytic site(s). PMID- 3553175 TI - Isomerization of 6-lactoyl tetrahydropterin by sepiapterin reductase. AB - Isomerization of 6-1'-oxo-2'-hydroxypropyl tetrahydropterin (6-lactoyl tetrahydropterin) to 6-1'-hydroxy-2'-oxopropyl tetrahydropterin has been attributed to sepiapterin reductase. The activity is N-acetylserotonin insensitive and has a well defined pH optimum of 8.6. The product of the reaction was detected on a HPLC chromatogram by means of electrochemical oxidation at 200 mV according to Smith and Nichol (J. Biol. Chem. 261, 2725-2737 (1986]. The C2' keto structure of the product was confirmed by 1H-NMR spectroscopy. PMID- 3553177 TI - Evidence for the involvement of metalloendoproteases in the acrosome reaction in sea urchin sperm. AB - An essential initial step in fertilization in the sea urchin Strongylocentrotus purpuratus is an intracellular membrane fusion event in the sperm known as the acrosome reaction. This Ca2+-dependent, exocytotic process involves fusion of the membrane of the acrosomal vesicle and the plasma membrane. Recently, metalloendoproteases requiring divalent metals have been implicated in several Ca2+-dependent membrane fusion events in other biological systems. In view of the suggested involvement of Zn2+ in the sea urchin sperm acrosome reaction (Clapper, D.L., Davis, J.A., Lamothe, P.J., Patton, C., and Epel, D. (1985) J. Cell Biol. 100, 1817-1824) and the fact that Zn2+ is a metal cofactor for metalloendoproteases, we investigated the potential role of this protease in the acrosome reaction. A soluble metalloendoprotease was demonstrated and characterized in sperm homogenates using the fluorogenic protease substrate succinyl-alanine-alanine-phenylalanine-4-aminomethylcoumarin. The protease was inhibited by the metal chelators EDTA and 1,10-phenanthroline, and activity of the inactive apoenzyme could be reconstituted with Zn2+. The metalloendoprotease substrate and inhibitors blocked the acrosome reaction induced either by egg jelly coat or by ionophore, but had no effect on the influx of Ca2+. These observations suggest that inhibition occurs at a step independent of Ca2+ entry. Overall, the results of this study provide strong indirect evidence that the acrosome reaction requires the action of metalloendoprotease. PMID- 3553176 TI - Glucitol-specific enzymes of the phosphotransferase system in Escherichia coli. Nucleotide sequence of the gut operon. AB - The complete nucleotide sequence of the glucitol (gut) operon in Escherichia coli has been determined. The glucitol-specific Enzyme II and Enzyme III of the phosphoenolpyruvate:sugar phosphotransferase system as well as glucitol-6 phosphate dehydrogenase which are encoded by the gutA, gutB, and gutD genes of the gut operon, respectively, are predicted to consist of 506 (Mr = 54,018), 123 (Mr = 13,306), and 259 (Mr = 27,866) amino acyl residues, respectively. The hydropathic profile of the Enzyme IIgut revealed 7 or 8 long hydrophobic segments which may traverse the cell membrane as alpha-helices as well as 2 or 4 short strongly hydrophobic stretches which may traverse the membrane as beta-structure. The number of amino acyl residues in the sum of the molecular weights of the glucitol Enzyme II-III pair are nearly the same as those of the mannitol Enzyme II. The ratio of hydrophobic to hydrophilic amino acyl residues and the numbers of the hydrophobic segments are also nearly the same for both transport systems. However, no significant homology was found in the nucleotide or amino acyl sequences of the two systems. Glucitol-6-phosphate dehydrogenase was found to exhibit sequence homology with ribitol dehydrogenase. A repetitive extragenic palindromic sequence was found in the 3'-flanking region of the gutD gene, suggesting the presence of a gene downstream from the gutD gene. PMID- 3553178 TI - The primary structure of rabbit liver cytosolic serine hydroxymethyltransferase. AB - The complete amino acid sequence of cytosolic serine hydroxymethyltransferase from rabbit liver was determined. The sequence was determined from analysis of peptides isolated from tryptic and cyanogen bromide cleavages of the enzyme. Special procedures were used to isolate and sequence the C-terminal and blocked N terminal peptides. Each of the four identical subunits of the enzyme consists of 483 residues. The sequence could be easily aligned with the sequence of Escherichia coli serine hydroxymethyltransferase. The primary structural homology between the rabbit and E. coli enzymes is about 42%. The importance of the primary and predicted secondary structural homology between the two enzymes is discussed. PMID- 3553179 TI - Imbalanced deoxyribonucleoside triphosphate pools and spontaneous mutation rates determined during dCMP deaminase-defective bacteriophage T4 infections. AB - DNA precursor imbalances are known to be mutagenic in both eukaryotic and prokaryotic systems. Almost certainly, such mutagenesis involves competition between correctly and incorrectly base-paired precursors at replication sites. Since other factors may be involved, it is important to identify specific mutations induced by specific pool imbalances. Using bacteriophage T4, we have developed a system for such analysis. We prepare double mutants of T4; one mutation affects a phage-coded enzyme of deoxyribonucleoside triphosphate (dNTP) metabolism, while the second is an rII mutation known to revert along a specific pathway. We determine dNTP pools in infection by such a mutant and measure both the spontaneous reversion rate of the rII mutation and, in some cases, the nucleotide sequence at the mutant site. In this paper we analyze mutations induced by a deficiency of T4-encoded deoxycytidylate deaminase. This causes pools of 5-hydroxymethyl-dCTP to expand some 30-fold, while dTTP pools contract. This specifically stimulates AT-to-GC reversion. One of the four AT-to-GC reverters tested, rIIUV215, increases its reversion rate at least 1000-fold under these pool-imbalance conditions, while the other mutants tested show increases of only about 10-fold. Therefore, factors other than dNTP competition, including local DNA sequence environment, must be invoked to fully explain mechanisms of dNTP pool imbalance-induced mutagenesis. We discuss models for this, and we also report unexpected effects of the dCMP deaminase deficiency upon pools of ribonucleoside triphosphates. PMID- 3553180 TI - Isolation and characterization of the receptor on human neutrophils that mediates cellular adherence. AB - The receptor on human neutrophils (polymorphonuclear leukocytes or PMN) that mediates cellular adherence has been purified from the peripheral blood PMN obtained from an individual with chronic myelogenous leukemia (CML). This receptor consists of two noncovalently associated subunits, designated alpha M (Mac-1 alpha, CD11b) (Mr = 170,000) and beta (Mac-1 beta, CDw18) (Mr = 100,000), respectively, which are identical on normal and CML PMN. The subunits were purified by monoclonal antibody 60.1-Sepharose (anti-alpha M) affinity chromatography and separated in 5-nmol quantities by high pressure liquid chromatography on a TSK-4000 gel filtration column. Subunits were characterized by amino acid composition, NH2-terminal amino acid sequence, and carbohydrate content. The NH2-terminal sequence of the human PMN alpha M subunit contains regions of homology with the human platelet glycoprotein IIb alpha. We conclude that nanomole amounts of individual alpha M and beta subunits of the receptor on human PMN that mediates cellular adherence can be isolated and separated using CML PMN. PMID- 3553181 TI - A kinetic isotope effect study and transition state analysis of the S adenosylmethionine synthetase reaction. AB - The biosynthesis of S-adenosylmethionine occurs in a unique enzymatic reaction in which the synthesis of the sulfonium center results from displacement of the entire polyphosphate chain from MgATP. The mechanism of S-adenosylmethionine synthetase (ATP:L-methionine s-adenosyltransferase) from Escherichia coli has been characterized by kinetic isotope effect and substrate trapping measurements. Replacement of 12C by 14C at the 5' carbon of ATP yields a primary Vmax/Km isotope effect (12C/14C) of 1.128 +/- 0.003 in the absence of added monovalent cation activator (K+). At saturating K+ concentrations (10 mM) the primary isotope effect diminishes slightly to 1.108 +/- 0.003, indicating that the step in the mechanism involving bond breaking at the 5' carbon of MgATP has a small commitment to catalysis at conditions near Vmax. No alpha-secondary 3H isotope effect from [5'-3H]ATP was detected, (1H/3H) = 1.000 +/- 0.002, even in the absence of KCl. There was no significant primary sulfur isotope effect from [35S]methionine at KCl concentrations from 0 to 10 mM. Substitution of the methyl group of methionine with tritium yielded a beta-secondary isotope effect (CH3/C3H3) = 1.009 +/- 0.008 independent of KCl concentration. The reaction of selenomethionine and [5'-14C]ATP gave a primary isotope effect of 1.097 +/- 0.006, independent of KCl concentration. Substrate trapping experiments demonstrated that the step in the mechanism involving bond making to sulfur of methionine does not have a significant commitment to catalysis at 0.25 mM KCl, therefore intrinsic isotope effects were observed. Substrate trapping experiments indicated that the step involving bond breaking at carbon 5' of MgATP has a 10% commitment to catalysis at 0.25 mM KCl. The isotope effects are interpreted in terms of an Sn2-like transition state structure in which bonding of the C5' is symmetric with respect to the departing tripolyphosphate group and the incoming sulfur of methionine. With selenomethionine as substrate an earlier transition state is implicated. PMID- 3553182 TI - Transcriptional elements of the yeast ribosomal protein gene CYH2. AB - The sequences responsible for specifying and regulating the transcription of the yeast ribosomal protein gene CYH2 have been studied using deletion analysis. We have identified a region between 235 and 260 nucleotides upstream of the transcription initiation which is necessary for transcription to occur. This region includes sequences which have been identified upstream of most yeast ribosomal protein genes. In the wild type gene the initiation of transcription occurs at several sites spread over about 15 nucleotides. Two TATA regions separated by about 40 nucleotides direct initiation to those sites. Deletion of those two TATA regions reveals a cryptic TATA which directs transcription initiation to specific sites downstream. PMID- 3553183 TI - Expression of rat intestinal fatty acid-binding protein in Escherichia coli. Purification and comparison of ligand binding characteristics with that of Escherichia coli-derived rat liver fatty acid-binding protein. AB - Rat intestinal fatty acid-binding protein (I-FABP) is an abundant, 15,124-Da polypeptide found in the cytosol of small intestinal epithelial cells (enterocytes). It is homologous to rat liver fatty acid-binding protein (L-FABP), a 14,273-Da cytosolic protein which is found in enterocytes as well as hepatocytes. It is unclear why the small intestinal epithelium contains two abundant fatty acid-binding proteins. A systematic comparative analysis of the ligand binding characteristics of the two FABPs has not been reported. To undertake such a study we expressed the coding region of a full length I-FABP cDNA in Escherichia coli and purified large quantities of the protein. We also purified rat L-FABP from a similar, previously described expression system (Lowe, J. B., Strauss, A. W., and Gordon, J. I. (1984) J. Biol. Chem. 259, 12696-12704). Analysis of fatty acids associated with each of the homogeneous E. coli-derived FABPs suggested that the two proteins differed in their ligand binding specificity and capacity. All of the fatty acids associated with I-FABP were saturated while 30% of the E. coli fatty acids bound to L-FABP were unsaturated (16:1, 18:1, 18:2). We directly analyzed the ability of I- and L-FABP to bind fatty acids of different chain length and degree of saturation using a hydroxyalkoxypropyl dextran-based assay. Scatchard analysis revealed that each mole of L-FABP can bind up to 2 mol of long chain fatty acid while each mole of I FABP can bind only 1 mole of fatty acid. L-FABP exhibited a relatively higher affinity for unsaturated fatty acids (oleate, arachidonate) than for saturated fatty acid (palmitate). By contrast, we were not able to detect a significant difference in the affinity of I-FABP for palmitate, oleate, and arachidonate. Neither protein exhibited any appreciable affinity for fatty acids whose chain length was less than C16. The observed differences in ligand affinities and capacities suggest that these proteins may have distinct roles in metabolism and/or compartmentalization of fatty acids within enterocytes. PMID- 3553184 TI - Purification and characterization of the nickel-containing multicomponent urease from Klebsiella aerogenes. AB - Klebsiella aerogenes urease was purified 1,070-fold with a 25% yield by a simple procedure involving DEAE-Sepharose, phenyl-Sepharose, Mono Q, and Superose 6 chromatographies. The enzyme preparation was comprised of three polypeptides with estimated Mr = 72,000, 11,000, and 9,000 in a alpha 2 beta 4 gamma 4 quaternary structure. The three components remained associated during native gel electrophoresis, Mono Q chromatography, and Superose 6 chromatography despite the presence of thiols, glycols, detergents, and varied buffer conditions. The apparent compositional complexity of K. aerogenes urease contrasts with the simple well-characterized homohexameric structure for jack bean urease (Dixon, N. E., Hinds, J. A., Fihelly, A. K., Gazzola, C., Winzor, D. J., Blakeley, R. L., and Zerner, B. (1980) Can. J. Biochem. 58, 1323-1334); however, heteromeric subunit compositions were also observed for the enzymes from Proteus mirabilis, Sporosarcina ureae, and Selemonomas ruminantium. K. aerogenes urease exhibited a Km for urea of 2.8 +/- 0.6 mM and a Vmax of 2,800 +/- 200 mumol of urea min-1 mg 1 at 37 degrees C in 25 mM N-2-hydroxyethylpiperazineN'-2-ethanesulfonic acid, 5.0 mM EDTA buffer, pH 7.75. The enzyme activity was stable in 1% sodium dodecyl sulfate, 5% Triton X-100, 1 M KCl, and over a pH range from 5 to 10.5, with maximum activity observed at pH 7.75. Two active site groups were defined by their pKa values of 6.55 and 8.85. The amino acid composition of K. aerogenes urease more closely resembled that for the enzyme from Brevibacter ammoniagenes (Nakano, H., Takenishi, S., and Watanabe, Y. (1984) Agric. Biol. Chem. 48, 1495 1502) than those for plant ureases. Atomic absorption analysis was used to establish the presence of 2.1 +/- 0.3 mol of nickel per mol of 72,000-dalton subunit in K. aerogenes urease. PMID- 3553185 TI - Molecular cloning of glucokinase cDNA. Developmental and dietary regulation of glucokinase mRNA in rat liver. AB - A rat liver cDNA library enriched for glucokinase sequences was constructed using the phage expression vector lambda gt11 and screened with an antiserum to glucokinase. A positive phage clone termed lambda-GK223 was isolated by several rounds of plaque purification. When introduced in the high frequency lysogenization strain Y1089, the phage was shown to encode a fusion protein containing epitopes specific to rat liver glucokinase. The 1800-base pair cDNA insert of lambda-GK223 was subcloned in a pUC plasmid, and a resulting recombinant termed pUC-GK1 was used for hybrid selection of mRNA. The selected mRNA directed the synthesis in a cell-free translation system of a protein identified as glucokinase by electrophoresis and immunoprecipitation. The cloned cDNA was then used as a probe to measure the amount of glucokinase mRNA in rat liver during postnatal development. Glucokinase mRNA, 2.4 kilobases in length, was first detectable at day 14 after birth and increased 40-fold in amount from this age to day 31, in parallel with the emergence of glucokinase enzyme activity. In the adult rat, glucokinase mRNA was low during fasting and increased more than 50-fold above the fasting level within 6 h of an oral glucose load. However, maximal accumulation of glucokinase mRNA was short-lived and the mRNA level returned toward basal values by 18 h of refeeding. These data point to rapid and massive effects on the expression of the glucokinase gene at the transcriptional or post-transcriptional levels during ontogenic development and dietary changes in the adult animal. PMID- 3553186 TI - Left-handed Z-DNA binding by the recA protein of Escherichia coli. AB - recA binding to left-handed Z-DNA was measured using nitrocellulose filter binding assays with four DNA polymers with defined nucleotide sequences and four recombinant plasmids. Two to 7-fold preferential binding of recA to Z-DNA polymers was observed. Left-handed Z-DNA polymer binding by recA required ATP or its nonhydrolyzable analog, ATP(gamma S), while ADP inhibited binding. Complex formation with both B- and Z-forms was influenced by polymer length; recA bound longer DNAs better. recA binding to recombinant plasmids containing supercoil stabilized Z-DNA was essentially similar to that found for the control vector; thus, no preferential binding of recA to the Z-form was observed. Comparative experiments with the rec1 protein of Ustilago maydis and the Escherichia coli recA protein were performed. In our hands, recA and rec1 have a similar capacity for binding left-handed Z-DNA polymers and for binding recombinant plasmids containing B- and/or Z-regions. recA contains a left-handed Z-DNA-stimulated ATPase activity. This activity differs from the right-handed B-DNA-stimulated activity since it is less sensitive to increasing pH. The kinetics of ATP hydrolysis in B-DNA/Z-DNA mixing experiments showed that the turnover of the Z DNA recA complex was slower than for B-DNA suggesting that left-handed Z-DNA is more stably bound by recA. Our results are consistent with the postulate that left-handed Z-DNA is involved in genetic recombination. PMID- 3553187 TI - Partial purification and characterization of an insulin-like material from spinach and Lemna gibba G3. AB - The existence in invertebrates, unicellular eukaryotes, and prokaryotes of materials that resemble several vertebrate peptide hormones led to the suggestion that these peptide messengers may have arisen earlier in evolution than had previously been thought. Consistent with this hypothesis, we describe here material in two plants, spinach and Lemma gibba G3, that is very similar to mammalian insulin, yet distinctive. In each of the early purification steps, which consisted of acidic methanol chloroform extraction and sequential chromatography on C-18 hydrophobic resin, Sephadex G-50, CM-Sepharose, and a short C-3 high performance liquid chromatography column, the immunoactive material from plants resembled the common vertebrate insulins. The protein nature of the material was suggested by its destruction by Pronase but not by the inactivated enzyme. In addition, on TSK chromatography it eluted in a position similar to that of insulin, i.e. equivalent to a protein of 6000 daltons. Using an isocratic high performance liquid chromatography system, the plant immunoactivity eluted earlier, and thus was more hydrophilic, than most of the common mammalian insulins, including pork insulin. The interaction of the plant material with anti-insulin antibodies in a radioimmunoassay was confirmed by using an affinity column of anti-insulin antibodies which adsorbed the plant immunoactivity at neutral pH, and released the material with acid elution. Using a quantitative double radioimmunoassay, the plant insulin-like material was distinguished immunologically from chicken insulin. Although the plant insulin like material is clearly distinct from pork insulin chromatographically, and from chicken insulin immunologically, it resembles vertebrate insulins in its overall configuration. The plant insulin-like material bound to insulin receptors on IM-9 lymphocytes and stimulated glucose oxidation and lipogenesis in isolated adipocytes from young rats. The bioactivity was neutralized in the presence of anti-insulin antibodies, but not in the presence of normal guinea pig IgG. The role of this insulin-like material in plants is unknown but its existence is consistent with an early evolutionary origin of the insulin messenger peptide family. Alternatively we cannot exclude a later convergent development of this family or introduction of vertebrate DNA into plants. PMID- 3553188 TI - Heparin decreases the degradation rate of lipoprotein lipase in adipocytes. AB - The mechanism responsible for the stimulation of secretion of lipoprotein lipase by heparin in cultured cells was studied with avian adipocytes in culture. Immunoprecipitation followed by electrophoresis and fluorography were used to isolate and quantitate the radiolabeled enzyme, whereas total lipoprotein lipase was quantitated by radioimmunoassay. Rates of synthesis of lipoprotein lipase were not different for control or heparin treatments as judged by incorporation of L-[35S]methionine counts into lipoprotein lipase during a 20-min pulse. This observation was corroborated in pulse-chase experiments where the calculation of total lipoprotein lipase synthesis, based on the rate of change in enzyme specific activity during the chase, showed no difference between control (8.13 +/ 3.1) and heparin treatments (9.1 +/- 5.3 ng/h/60-mm dish). Secretion rates of enzyme were calculated from measurements of the radioactivity of the secreted enzyme and the cellular enzyme-specific activity. Degradation rates were calculated by difference between synthesis and secretion rates of enzyme. In control cells 76% of the synthesized enzyme was degraded. Addition of heparin to the culture medium reduced the degradation rate to 21% of the synthetic rate. The presence of heparin in cell media resulted in a decrease in apparent intracellular retention half-time for secreted enzyme from 160 +/- 44 min to 25 +/- 1 min. The above data demonstrate that the increase in lipoprotein lipase protein secretion, observed upon addition of heparin to cultured adipocytes, is due to a decreased degradation rate with no change in synthetic rate. Finally, newly synthesized lipoprotein lipase in cultured adipocytes is secreted constitutively and there is no evidence that it is stored in an intracellular pool. PMID- 3553189 TI - Properties of an Escherichia coli rhodanese. AB - A rhodanese enzyme of less than 20,000 molecular weight has been purified from Escherichia coli. The enzyme is accessible to substrates upon addition of whole cells to standard assay mixtures. This rhodanese has a Stokes radius of 17 A which for a globular protein corresponds to a molecular weight close to 14,000. It undergoes autoxidation to a polymeric form which is probably an inert dimer. Enzyme inactivated by oxidation can be reactivated by millimolar concentrations of cysteine. Steady-state initial velocity measurements indicate that the enzyme catalyzes the transfer of sulfane sulfur by way of a double displacement mechanism with formation of a covalent enzyme-sulfur intermediate. The turnover number for the enzyme-catalyzed reaction, with thiosulfate as donor substrate and cyanide ion as the sulfur acceptor, is 260 s-1. This value corresponds to a catalytic efficiency 60% of that measured for a previously characterized bovine liver enzyme of more than twice the molecular weight. Furthermore, KmCN is 24 mM which is 2 orders of magnitude higher than the value observed previously for the bovine enzyme. Evidence from chemical inactivation studies implicates an essential sulfhydryl group in the enzyme activity. It is proposed that this group is the site of substrate-sulfur binding in the obligatory enzyme-sulfur intermediate. Furthermore, a cationic site important for binding of the donor thiosulfate is tentatively identified from anion inhibition studies. Tests of alternate acceptor substrates indicate that the physiological dithiol, dihydrolipoate, is a more efficient acceptor than cyanide ion for the enzyme bound sulfur. Of possibly greater physiological significance, it has been found that the enzyme catalyzes the formation of iron-sulfur centers. Other work indicates the E. coli rhodanese is subject to catabolite repression and suggests a physiological role for the enzyme in aerobic energy metabolism. PMID- 3553190 TI - Arachidonate 5-lipoxygenase of porcine leukocytes studied by enzyme immunoassay using monoclonal antibodies. AB - The cytosol fraction of porcine leukocytes contained 5-lipoxygenase, the activity of which was masked by a predominant activity of 12-lipoxygenase. The 5 lipoxygenase was partially purified to a specific activity of about 10 nmol of arachidonic acid oxygenated/min/mg of protein and given to mice as an antigen to prepare monoclonal antibodies against the enzyme. Two species of antibodies recognized separate sites of the 5-lipoxygenase protein and did not cross-react with 12-lipoxygenase. They were utilized to develop a peroxidase-linked immunoassay of sandwich-type, which allowed a quantitative determination of the 5 lipoxygenase protein. The assay was applied to a screening of the 5-lipoxygenase content in various porcine tissues. By far the highest content of 5-lipoxygenase was found in leukocytes. About one-tenth the amount of the enzyme was found in lung, pancreas, ileum, and thymus, which could not be attributed to the contaminating leukocytes in these tissues. PMID- 3553191 TI - Initiation by the yeast viral transcriptase in vitro. AB - All double-stranded RNA viruses have capsid-associated transcriptase activities. In the yeast viruses, as in reovirus, transcription appears to be the first stage of replication. We have found that the yeast viral transcriptase initiates RNA transcription in vitro and that the resultant plus strand RNA has the 5' terminus ppGp. No pre-existing primers are normally utilized in vitro. Like other double stranded RNA viruses of eucaryotes, the yeast viruses have a primer-independent capsid-associated transcriptase. Unlike these viruses of higher eucaryotes, the yeast viruses synthesize uncapped mRNAs. Viral particles with only a single major capsid polypeptide are active in transcription and replication, while reovirus particles active in transcription have 5 or 6 polypeptides. PMID- 3553192 TI - Human skin chymotrypsin-like proteinase chymase. Subcellular localization to mast cell granules and interaction with heparin and other glycosaminoglycans. AB - The subcellular localization of human skin chymase to mast cell granules was established by immunoelectron microscopy, and binding of chymase to the area of the dermo-epidermal junction, a basement membrane, was demonstrated immunocytochemically in cryosections incubated with purified proteinase prior to immunolabeling. Because heparin and heparan sulfate proteoglycans are major constituents of mast cell granules and basement membranes, respectively, the ability of chymase to bind to glycosaminoglycans (GAG) was investigated. Among a variety of GAGs, only binding of chymase to heparin and heparan sulfate appears physiologically significant. Binding was ionic strength-dependent, involved amino groups on the proteinase, and correlated with increasing GAG sulfate content, indicating a predominantly electrostatic association. Interaction with heparin was observed in solutions containing up to 0.5 M NaCl, and interaction with heparan sulfate was observed in solutions containing up to 0.3 M NaCl. Binding of heparin did not detectably affect catalysis of peptide substrates, but may reduce accessibility of proteinase to protein substrates. Measurements among a series of serine class proteinases indicated that heparin binding was a more common property of mast cell proteinases than proteinases stored in other secretory granules. Binding of chymase to heparin is likely to have a storage as well as a structural role within the mast cell granule, whereas binding of chymase to heparan sulfate may have physiological significance after degranulation. PMID- 3553193 TI - Post-translational acquisition of insulin binding activity by the insulin proreceptor. Correlation to recognition by autoimmune antibody. AB - The post-translational acquisition of ligand binding activity by the insulin receptor was examined in 3T3-L1 adipocytes. In pulse-chase experiments with [35S] methionine, labeled receptor species were separated into "active" and "inactive" forms by affinity chromatography on insulin-agarose and then were characterized and quantitated. It was found that the newly translated high molecular weight proreceptor lacks the capacity to bind insulin. The acquisition of binding activity is relatively slow (t1/2 = 45 min) and occurs prior to conversion of the proreceptor to the mature alpha- and beta-subunits by proteolytic cleavage and maturation of its N-linked oligosaccharide chains (t1/2 = 3 h). Glycosylation appears to be required for this activation since the aglycoproreceptor, synthesized in the presence of tunicamycin, does not acquire insulin binding activity. However, once the proreceptor has acquired ligand binding activity, removal of its N-linked oligosaccharide chains with endoglycosidase H has no effect on the ability of the proreceptor to bind insulin. The modification of the proreceptor to bind insulin. The modification of the proreceptor that gives rise to insulin binding activity most likely involves a conformational change in the binding domain. A human autoimmune antibody that recognizes only the active insulin binding site does not interact with the inactive proreceptor, whereas a rabbit polyclonal antireceptor antibody recognizes all forms. Thus, the autoimmune antibody must recognize a new epitope created during conversion of the inactive proreceptor to the active form. PMID- 3553194 TI - Disruption of intracellular processing of epidermal growth factor by methylamine inhibits epidermal growth factor-induced DNA synthesis but not early morphological or transcriptional events. AB - Upon internalization, epidermal growth factor (EGF) is proteolytically processed from its COOH terminus as it traverses intracellular vesicles and lysosomes. This report describes experiments which were conducted to determine whether lysosomotropic amines such as methylamine, which are known to inhibit degradation of EGF, are able to significantly inhibit the COOH-terminal processing of EGF, and whether disruption of EGF processing would negatively affect EGF-stimulated events such as DNA synthesis and induction of specific mRNA species. The results of these experiments indicated that, whereas methylamine treatment had no effect on EGF binding or internalization, vesicular translocation from endocytic vesicles to lysosomes was halted and processing of EGF was severely inhibited. The stimulation of DNA synthesis beginning 12 h after EGF exposure was also markedly inhibited by methylamine treatment. However, addition of methylamine alone produced a non-specific inhibition of DNA synthesis. The ability of EGF to induce specific transcription of the rat transin gene within 6 h of treatment was also not inhibited by methylamine treatment, but was actually increased in the presence of methylamine. These results suggest that at least some early transcriptionally regulated events induced by EGF do not require vesicular processing of EGF (or its receptor) and that the signal transduced by the binding of EGF to its receptor occurs in, or proximal to, the endocytic vesicles. PMID- 3553195 TI - Porous-surfaced metallic implants for orthopedic applications. AB - The fixation of orthopedic implants in bone by tissue ingrowth presents a possible solution to the problem of long-term implant loosening. To achieve this objective, metallic implants formed with porous surface coatings have been developed. This article reviews the methods proposed for fabricating such implants. Some possible problems related to loss of mechanical properties due to the processing to form the porous surface zone are described. For some of the porous-surfaced implant systems, processes have been developed to avoid the occurrence of such changes. It is particularly important at this stage of the evaluation of porous-surfaced implants in clinical situations that manufacturers are fully cognizant of the effects of processing on mechanical properties of these devices. PMID- 3553196 TI - Cardiac valve prostheses: review of clinical status and contemporary biomaterials issues. PMID- 3553197 TI - Condensing osteitis of the clavicle. A review of the literature and report of three cases. AB - Condensing osteitis of the clavicle is a rare and benign idiopathic entity that is probably degenerative or mechanical in etiology. It is usually seen in women of late child-bearing age as a variably painful and tender swelling over the medial end of the clavicle. Radiographs show sclerosis and slight expansion of the medial one-third of the clavicle. Although malignant tumor of bone must be considered in the differential diagnosis of a disease that has such radiographic findings, numerous and expensive screening tests for a presumed primary malignant lesion are not recommended for most patients. It is recommended, however, that an excisional or (preferably) incisional biopsy be performed in all patients unless pain is insignificant and the clinical presentation strongly supports the diagnosis of condensing osteitis. Many patients who have slight pain do not need treatment. Anti-inflammatory medications are variably effective. Patients in whom the lesion is refractory respond well to excision of the medial one-third of the clavicle. PMID- 3553198 TI - The immune response to osteochondral allografts in dogs. AB - Dog leukocyte antigen (DLA)-matched and mismatched, fresh and frozen (cryopreserved) osteochondral allografts of the proximal part of the radius were implanted orthotopically in beagles. The systemic and local (intra-articular) immune responses were monitored for eleven months using a 51chromium release assay with donor peripheral-blood lymphocytes as target cells. DLA-mismatched fresh grafts markedly and persistently stimulated the formation of antibody directed against donor cell-surface antigens, while DLA-matched grafts did not elicit systemically detectable antibody. The same general pattern was noted when antibody-dependent cell-mediated cytotoxicity was assayed. There was measurable cell-mediated immunity to donor cells from six weeks after surgery onward, although no distinct pattern or differences between experimental groups were noted. Higher titers of anti-DLA antibody were found in synovial fluid than in serum; in fact, synovial antibody was detectable when systemic antibody was not. Joints that received DLA-mismatched grafts had the highest titer of antibody and the intra-articular response was significantly reduced when the graft had been frozen. PMID- 3553199 TI - Electrical stimulation of repair of bone. PMID- 3553200 TI - Ceftazidime therapy versus aminoglycoside therapy in patients with gram-negative burn wound infections. PMID- 3553201 TI - Neomycin sulfate dressing for meshed split-thickness skin grafts. PMID- 3553202 TI - Use of TENS for pain reduction in burn patients receiving Travase. PMID- 3553203 TI - Effect of two new immunomodulators on normal and burn injury neutrophils and macrophages. PMID- 3553204 TI - In vitro DNA synthesis in the macronuclear replication band of Euplotes eurystomus. AB - Isolated macronuclei from the hypotrichous ciliated protozoan Euplotes eurystomus incorporate biotinylated dUTP specifically into the replication band (RB) as detected with immunofluorescence, using rabbit anti-biotin antibodies followed by fluorescein-conjugated goat anti-rabbit IgG. When gold-conjugated goat anti rabbit IgG was used in a preembedded reaction, subsequent immunoelectron microscopic analysis demonstrated that the biotinylated nucleotide appeared more concentrated in the rear zone of the RB, with almost no labeling in the forward zone. It was possible to use the immunofluorescent assay to establish that incorporation of biotinylated dUTP is inhibited by simultaneous addition of N ethyl maleimide or aphidicolin, and by omission of any one of the other unlabeled dNTPs. In addition, prolonged heat shock of the intact cells, before lysis and in vitro assay, yielded markedly reduced incorporation. Comparison with published data on the in vivo incorporation of [3H]thymidine into Euplotes eurystomus RBs indicates the fidelity of the in vitro reaction. PMID- 3553205 TI - Sea urchin maternal and embryonic U1 RNAs are spatially segregated in early embryos. AB - We have used in situ hybridization and cell fractionation methods to follow the distribution of U1 RNA and immunofluorescence microscopy to follow the distribution of snRNP proteins in oocytes, eggs, and embryos of several sea urchin species. U1 RNA and U1-specific snRNP antigens are concentrated in germinal vesicles of oocytes. Both appear to relocate after oocyte maturation because they are found primarily, if not exclusively, in the cytoplasm of mature unfertilized eggs. This cytoplasmic residence is maintained during early cleavage and U1 RNA is first detectable in nuclei of micromeres at the 16-cell stage. Between morula and gastrula stages the steady-state concentrations of both RNA and antigens gradually increase in nuclei and decrease in cytoplasm. Surprisingly, analysis of the distribution of newly synthesized U1 RNA shows that it does not equilibrate with the maternal pool. Instead new transcripts are confined to nuclei, while cytoplasmic U1 RNAs are of maternal origin. This lack of equilibration and the conversion of maternal U1 RNAs from nuclear species in oocytes to cytoplasmic in embryos suggests that these RNPs (or RNAs) are structurally altered when released to the cytoplasm at oocyte maturation. PMID- 3553206 TI - Translocation of globin fusion proteins across the endoplasmic reticulum membrane in Xenopus laevis oocytes. AB - We have studied the translocation of a normally cytoplasmic protein domain across the membrane of the endoplasmic reticulum in cell-free systems and in Xenopus laevis oocytes. Coding regions for the normally cytoplasmic protein globin were engineered in frame either 3' or 5' to the coding region for the signal sequence of either Escherichia coli b-lactamase or bovine preprolactin, respectively, in SP6 expression plasmids. RNA transcribed from these plasmids was microinjected into oocytes as well as translated in cell-free systems. We demonstrate that both in vivo and in vitro, a previously amino-terminal signal sequence can direct translocation of domains engineered to either side. Moreover, the domain preceding the signal sequence can be as large as that which follows it. While, in general, cell-free systems were found to faithfully reflect translocation events in vivo, our results suggest that a mechanism for clearance of signal peptides after cleavage is present in intact cells that is not reconstituted in cell-free systems. PMID- 3553207 TI - The posttranslational processing of sucrase-isomaltase in HT-29 cells is a function of their state of enterocytic differentiation. AB - The biosynthesis of sucrase-isomaltase was compared in enterocyte-like differentiated (i.e., grown in the absence of glucose) and undifferentiated (i.e., grown in the presence of glucose) HT-29 cells. Unlike differentiated cells, in which the enzyme is easily detectable and active, undifferentiated cells display almost no enzyme activity and the protein cannot be detected by means of cell surface immunofluorescence or immunodetection in membrane-enriched fractions or cell homogenates. Pulse experiments with L-[35S]-methionine show that the enzyme is, however, synthesized in these undifferentiated cells. As compared with the corresponding molecular forms in differentiated cells, the high mannose form of the enzyme in undifferentiated cells is similarly synthesized and has the same apparent Mr. However, its complex form is less labeled and has a lower apparent Mr. Pulse-chase experiments with L-[35S]methionine show that, although the enzyme is synthesized to the same extent in both situations, the high-mannose and complex forms are rapidly degraded in undifferentiated cells, with an apparent half-life of 6 h, in contrast to differentiated cells in which the enzyme is stable for at least 48 h. A comparison of the processing of the enzyme in both situations shows that the conversion of the high-mannose to the complex form is markedly decreased in undifferentiated cells. These results indicate that the absence of sucrase-isomaltase expression in undifferentiated cells is not the consequence of an absence of biosynthesis but rather the result of both an impaired glycosylation and a rapid degradation of the enzyme. PMID- 3553208 TI - Modulation of the expression of an apical plasma membrane protein of Madin-Darby canine kidney epithelial cells: cell-cell interactions control the appearance of a novel intracellular storage compartment. AB - Experimental conditions that abolish or reduce to a minimum intercellular contacts between Madin-Darby canine kidney epithelial cells result in the appearance of an intracellular storage compartment for apical membrane proteins. Subconfluent culture, incubation in 1-5 microM Ca++, or inclusion of dissociated cells within agarose or collagen gels all caused the intracellular accumulation of a 184-kD apical membrane protein within large (0.5-5 micron) vacuoles, rich in microvilli. Influenza virus hemagglutinin, an apically targeted viral glycoprotein, is concentrated within these structures but the basolateral glycoprotein G of vesicular stomatitis virus and a cellular basolateral 63-kD membrane protein of Madin-Darby canine kidney cells were excluded. This novel epithelial organelle (VAC), which we designate the vacuolar apical compartment, may play an as yet unrecognized role in the biogenesis of the apical plasma membrane during the differentiation of normal epithelia. PMID- 3553209 TI - Skelemins: cytoskeletal proteins located at the periphery of M-discs in mammalian striated muscle. AB - The cytoskeletons of mammalian striated and smooth muscles contain a pair of high molecular weight (HMW) polypeptides of 220,000 and 200,000 mol wt, each with isoelectric points of about 5 (Price, M. G., 1984, Am. J. Physiol., 246:H566-572) in a molar ratio of 1:1:20 with desmin. The HMW polypeptides of mammalian muscle have been named "skelemins," because they are in the insoluble cytoskeletons of striated muscle and are at the M-discs. I have used two-dimensional peptide mapping to show that the two skelemin polypeptides are closely related to each another. Polyclonal antibodies directed against skelemins were used to demonstrate that they are immunologically distinct from talin, fodrin, myosin heavy chain, synemin, microtubule-associated proteins, and numerous other proteins of similar molecular weight, and are not oligomers of other muscle proteins. Skelemins appear not to be proteolytic products of larger proteins, as shown by immunoautoradiography on 3% polyacrylamide gels. Skelemins are predominantly cytoskeletal, with little extractable from myofibrils by various salt solutions. Human, bovine, and rat cardiac, skeletal, and smooth muscles, but not chicken muscles, contain proteins cross-reacting with anti-skelemin antibodies. Skelemins are localized by immunofluorescence at the M-lines of cardiac and skeletal muscle, in 0.4-micron-wide smooth striations. Cross sections reveal that skelemins are located at the periphery of the M-discs. Skelemins are seen in threads linking isolated myofibrils at the M-discs. There is sufficient skelemin in striated muscle to wrap around the M-disc about three times, if the skelemin molecules are laid end to end, assuming a length-to-weight ratio similar to M-line protein and other elongated proteins. The results indicate that skelemins form linked rings around the periphery of the myofibrillar M-discs. These cytoskeletal rings may play a role in the maintenance of the structural integrity of striated muscle throughout cycles of contraction and relaxation. PMID- 3553210 TI - Immunoelectron microscopical localization of phospholamban in adult canine ventricular muscle. AB - The subcellular distribution of phospholamban in adult canine ventricular myocardial cells was determined by the indirect immunogold-labeling technique. The results presented suggest that phospholamban, like the Ca2+-ATPase, is uniformly distributed in the network sarcoplasmic reticulum but absent from the junctional portion of the junctional sarcoplasmic reticulum. Unlike the Ca2+ ATPase, but like cardiac calsequestrin, phospholamban also appears to be present in the corbular sarcoplasmic reticulum. Comparison of the relative distribution of phospholamban immunolabeling in the sarcoplasmic reticulum with that of the sarcolemma showed that the density of phospholamban in the network sarcoplasmic reticulum was approximately 35-fold higher than that of the cytoplasmic side of the sarcolemma, which in turn was found to be three- to fourfold higher than the density of the background labeling. However, a majority of the specific phospholamban labeling within 30 nm of the cytoplasmic side of the sarcolemma was clustered and present over the sarcoplasmic reticulum in the subsarcolemmal region of the myocardial cells, suggesting that phospholamban is confined to the junctional regions between the sarcolemma and the sarcoplasmic reticulum, but absent from the nonjunctional portion of the sarcolemma. Although the resolution of the immunogold-labeling technique used (60 nm) does not permit one to determine whether the specific labeling within 30 nm of the cytoplasmic side of the sarcolemma is associated with the sarcolemma and/or the junctional sarcoplasmic reticulum, it is likely that the low amount of labeling in this region represents phospholamban associated with sarcoplasmic reticulum. These results suggest that phospholamban is absent from the sarcolemma and confined to the sarcoplasmic reticulum in cardiac muscle. PMID- 3553213 TI - Molecular mechanisms of fibrinolysis and their application to fibrin-specific thrombolytic therapy. AB - The fibrinolytic system comprises a proenzyme, plasminogen, which can be converted to the active enzyme, plasmin, which degrades fibrin. Plasminogen activation is mediated by plasminogen activators, which are classified as either tissue-type plasminogen activators (t-PA) or urokinase-type plasminogen activators (u-PA). Inhibition of the fibrinolytic system may occur at the level of the activators or at the level of generated plasmin. Plasmin has a low substrate specificity, and when circulating freely in the blood it degrades several proteins including fibrinogen, factor V, and factor VIII. Plasma does, however, contain a fast-acting plasmin inhibitor, alpha 2-antiplasmin, which inhibits free plasmin extremely rapidly but which reacts much slower with plasmin bound to fibrin. A "systemic fibrinolytic state" may, however, occur by extensive activation of plasminogen and depletion of alpha 2-antiplasmin. Clot-specific thrombolysis therefore requires plasminogen activation restricted to the vicinity of the fibrin. Two physiological plasminogen activators, t-PA and single-chain u PA (scu-PA) induce clot-specific thrombolysis, via entirely different mechanisms, however. t-PA is relatively inactive in the absence of fibrin, but fibrin strikingly enhances the activation rate of plasminogen by t-PA. This is explained by an increased affinity of fibrin-bound t-PA for plasminogen and not by alteration of the catalytic rate constant of the enzyme. The high affinity of t PA for plasminogen in the presence of fibrin thus allows efficient activation on the fibrin clot, while no significant plasminogen activation by t-PA occurs in plasma. scu-PA has a high affinity for plasminogen (Km = 0.3 microM) but a low catalytic rate constant (kcat = 0.02 sec-1). However, scu-PA does not activate plasminogen in plasma in the absence of a fibrin clot, owing to the presence of (a) competitive inhibitor(s). Fibrin-specific thrombolysis appears to be due to the fact that fibrin reverses the competitive inhibition. The thrombolytic efficacy and fibrin specificity of natural and recombinant t-PA has been demonstrated in animal models of pulmonary embolism, venous thrombosis, and coronary artery thrombosis. In all these studies intravenous infusion of t-PA at sufficiently high rates caused efficient thrombolysis in the absence of systemic fibrinolytic activation. The efficacy and relative fibrinogen-sparing effect of t PA was recently confirmed in three multicenter clinical trials in patients with acute myocardial infarction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3553212 TI - Filopodia are enriched in a cell cohesion molecule of Mr 80,000 and participate in cell-cell contact formation in Dictyostelium discoideum. AB - During the early phase of Dictyostelium discoideum development, cells undergo chemotactic migration to form tight aggregates. A developmentally regulated surface glycoprotein of Mr 80,000 (gp80) has been implicated in mediating the EDTA-resistant type of cell cohesion at this stage. We have used a monoclonal antibody directed against gp80 to study the topographical distribution of gp80 on the cell surface. Indirect immunofluorescence studies showed that gp80 was primarily localized on the cell surface, with a higher concentration at contact areas. Immunoelectron microscopy was carried out by indirect labeling using protein A-gold, and a nonrandom distribution of gp80 was revealed. In addition to contact regions, gold particles were found preferentially localized on filopodia. Quantitative analysis using transmission electron microscopy (TEM) showed that approximately 60% more gold particles were localized in contact regions in comparison with the noncontact regions, and the filopodial surfaces had a twofold higher gold density. Both TEM and scanning electron microscopy showed that contact areas were enriched in filopodial structures. Filopodia often appeared to adhere to either smooth surfaces or similar filopodial structures of an adjacent cell. These observations suggest that the formation of stable cell-cell contacts involves at least four sequential steps in which filopodia and gp80 probably play an important role in the initial stages of recognition and cohesion among cells. PMID- 3553211 TI - Adhesion molecules during somitogenesis in the avian embryo. AB - In avian embryos, somites constitute the morphological unit of the metameric pattern. Somites are epithelia formed from a mesenchyme, the segmental plate, and are subsequently reorganized into dermatome, myotome, and sclerotome. In this study, we used somitogenesis as a basis to examine tissue remodeling during early vertebrate morphogenesis. Particular emphasis was put on the distribution and possible complementary roles of adhesion-promoting molecules, neural cell adhesion molecule (N-CAM), N-cadherin, fibronectin, and laminin. Both segmental plate and somitic cells exhibited in vitro calcium-dependent and calcium independent systems of cell aggregation that could be inhibited respectively by anti-N-cadherin and anti-N-CAM antibodies. In vivo, the spatio-temporal expression of N-cadherin was closely associated with both the formation and local disruption of the somites. In contrast, changes in the prevalence of N-CAM did not strictly accompany the remodeling of the somitic epithelium into dermamyotome and sclerotome. It was also observed that fibronectin and laminin were reorganized secondarily in the extracellular spaces after CAM-mediated contacts were modulated. In an in vitro culture system of somites, N-cadherin was lost on individual cells released from somite explants and was reexpressed when these cells reached confluence and established intercellular contacts. In an assay of tissue dissociation in vitro, antibodies to N-cadherin or medium devoid of calcium strongly and reversibly dissociated explants of segmental plates and somites. Antibodies to N-CAM exhibited a smaller disrupting effect only on segmental plate explants. In contrast, antibodies to fibronectin and laminin did not perturb the cohesion of cells within the explants. These results emphasize the possible role of cell surface modulation of CAMs during the formation and remodeling of some transient embryonic epithelia. It is suggested that N-cadherin plays a major role in the control of tissue remodeling, a process in which N-CAM is also involved but to a lesser extent. The substratum adhesion molecules, fibronectin and laminin, do not appear to play a primary role in the regulation of these processes but may participate in cell positioning and in the stabilization of the epithelial structures. PMID- 3553214 TI - Viral p21 Ki-RAS protein: a potent intracellular mitogen that stimulates adenylate cyclase activity in early G1 phase of cultured rat cells. AB - Rat kidney (NRK) cells infected with a temperature-sensitive mutant of the Kirsten sarcoma virus were arrested in the G0/G1 phase of their cell cycle by incubation in serum-deficient medium at a p21-inactivating temperature of 41 degrees C. These quiescent ts K-NRK cells were then stimulated to transit G1 and initiate DNA replication by lowering the temperature to 36 degrees C, which rapidly reactivated p21. Reactivating the viral Ki-RAS protein by temperature shift led to an increase in adenylate cyclase activity in early G1 phase. The Ki RAS protein increased the sensitivity of adenylate cyclase to guanyl nucleotides by a mechanism that seemed to involve inactivation of the enzyme's inhibitory G1 regulatory protein. PMID- 3553215 TI - Transforming growth factors and control of neoplastic cell growth. AB - Transforming growth factors (TGFs) are peptides that affect the growth and phenotype of cultured cells and bring about in nonmalignant fibroblastic cells phenotypic properties that resemble those of malignant cells. Two types of TGFs have been well characterized. One of these, TGF alpha, is related to epidermal growth factor (EGF) and binds to the EGF receptor, whereas the other, TGF beta, is not structurally or functionally related to TGF alpha or EGF and mediates its effects via distinct receptors. TGF beta is produced by a variety of normal and malignant cells. Depending upon the assay system employed, TGF beta has both growth-inhibitory and growth-stimulating properties. Many of the mitogenic effects of TGF beta are probably an indirect result of the activation of certain growth factor genes in the target cell. The ubiquitous nature of the TGF beta receptor and the production of TGF beta in a latent form by most cultured cells suggests that the differing cellular responses to TGF beta are regulated either by events involved in the activation of the factor or by postreceptor mechanisms. The combined effects of TGF beta with other growth factors or inhibitors evidently play a central role in the control of normal and malignant cellular growth as well as in cell differentiation and morphogenesis. Since transforming growth factor as a concept has partially proven misleading and insufficient, there is a need to find a new nomenclature for these regulators of cellular growth and differentiation. PMID- 3553216 TI - Picornaviral processing: some new ideas. AB - Mature picornaviral proteins are derived by progressive, post-translational cleavage of a giant precursor polyprotein. At least three viral-encoded proteolytic activities are involved in the processing. The first cleavage takes place while the polyprotein is still nascent on a ribosome. In poliovirus, this event is probably catalyzed by peptide 2A, a protein from the middle portion of the genome. Most subsequent processing is effected by viral protease 3C, a thiol type enzyme, responsible for eight to ten self-cleaving and autocatalytic reactions within the polyprotein. The final proteolytic processing event, maturation of the VPO peptide, may occur by a novel, autocatalytic, serine-type mechanism, where viral RNA serves as proton-acceptor during the cleavage reaction. PMID- 3553217 TI - Redesigning trypsin via genetic engineering. PMID- 3553218 TI - Growth factors, oncogenes, and multistage carcinogenesis. AB - This paper presents evidence that the full repertoire of cellular genes involved in the carcinogenic process is several times larger than that of the known list of proto-oncogenes. Furthermore, this repertoire includes genes whose normal function is related to growth stimulation, as well as genes whose normal function is to inhibit growth or induce terminal differentiation. Multistage carcinogenesis probably results from a complex series of changes in both categories of genes. Despite this complexity, carcinogenesis can be conceived in terms of disturbances in biochemical functions that normally control the expression or function of growth factors, receptors, and pathways of signal transduction. Several protein kinases play a central role in the process of signal transduction. Our laboratory has recently isolated cDNA clones for the enzyme protein kinase C (PKC). These clones should be useful for clarifying the role of PKC in growth control and tumor promotion. Finally, the existence of genes whose normal function is to inhibit cell growth provides a rationale for new strategies of cancer prevention and treatment. PMID- 3553219 TI - [Intersubclavian bypass. Technic. Indications. Remote results]. AB - Between 1974 and 1984, 34 patients were treated by inter-subclavian bypass operation for occlusive lesions of proximal subclavian artery or brachiocephalic trunk. Patients treated in this way were those in whom other methods were inapplicable. Results showed it to be a valid procedure: absence of morbidity or mortality related to the operation itself (one postoperative death from myocardial infarction); excellent early and late permeability if the need for absence of parietal or stenosing lesions in the arteries of origin and supply is respected. Doppler ultrasound imaging showed satisfactory hemodynamic results. PMID- 3553220 TI - Role of dopamine in the regulation of growth hormone secretion: dopamine and bromocriptine augment growth hormone (GH)-releasing hormone-stimulated GH secretion in normal man. AB - The role of the dopaminergic system and its interaction with GH-releasing hormone (GHRH) in the regulation of GH secretion was investigated in normal men in two complementary studies. The men were given continuous iv infusions of 0.15 M saline (5 h), dopamine (4 micrograms/kg X min; 1 h), GHRH (2 ng/kg X min; 2 h), and GHRH (2 ng/kg X min; 2 h) plus dopamine (4 micrograms/kg X min; 1 h) on four separate occasions, and serum GH responses were measured. In a second study, on separate days, placebo or bromocriptine (2.5 mg/dose) was administered, and GH and PRL responses to a single iv GHRH dose were measured. A continuous infusion of dopamine and GHRH on separate days stimulated GH secretion in all subjects. The mean integrated GH secretion was 13.2 +/- 3.1 (+/- SEM) ng/mL X h during the dopamine infusion and 14.7 +/- 4.6 during GHRH, compared with 1.7 +/- 0.4 during the saline infusion. The combination of GHRH and dopamine resulted in the greatest stimulation of GH secretion (29.8 +/- 5.7 ng/ml X h; P less than 0.05 vs. 3 other study days). The oral dopamine agonist bromocriptine also augmented GHRH-stimulated GH secretion. Integrated GH secretion after a single iv injection of GHRH following two doses of bromocriptine was 160 +/- 29.5 ng/ml X h compared with 81.3 +/- 22.2 after placebo (P = 0.04). We suggest that these findings are compatible with the hypothesis that dopamine inhibits hypothalamic somatostatin secretion, which then allows for a greater stimulatory effect of GHRH. PMID- 3553221 TI - Variations in insulin-stimulated glucose uptake in healthy individuals with normal glucose tolerance. AB - Measurements were made of both glucose disposal (M) during hyperinsulinemic clamp studies and plasma glucose and insulin responses to an oral glucose challenge in 100 individuals with normal glucose tolerance. The subjects were divided into 4 quartiles on the basis of M values, ranging from a low mean (+/- SEM) value of 140 +/- 3 mg/m2 X min (quartile 1) to a high of 349 mg/m2 X min (quartile 4). The plasma insulin response to oral glucose inversely correlated with the M value (r = -0.60; P less than 0.001), being highest in those with the lowest M (quartile 1) and lowest in those with the highest M (quartile 4). On the other hand, the plasma glucose responses of the 4 quartiles were virtually identical. These results document that insulin-stimulated glucose uptake varies widely in subjects with normal glucose tolerance, and that these differences are independent of any change in the plasma glucose response to oral glucose. Furthermore, the results indicate that insulin resistance in normal individuals is associated with hyperinsulinemia. PMID- 3553222 TI - Preferential release of bioactive luteinizing hormone in response to endogenous and low dose exogenous gonadotropin-releasing hormone pulses in man. AB - We used the rat interstitial cell testosterone (RICT) bioassay to assess biological LH activity secreted in response to endogenous and low dose exogenous GnRH pulses in normal men. The absence of nonspecific plasma effects in the LH bioassay was demonstrated by the finding of undetectable levels of LH bioactivity despite low but measurable immunoactivity in 10 hypogonadotropic men. Moreover, bolus injections of human LH in 6 hypogonadotropic men defined a curvilinear relationship between plasma bioactive and immunoactive LH concentrations, in which the extrapolated concentration of plasma bioactive LH at a zero dose of immunoactive LH was indistinguishable from zero. Zero bioactive LH intercepts were also found when physiological bio- and immunoactive LH concentrations derived from 7 intensively sampled normal men were subjected to linear regression using 2-dimensional error fitting. In these men, exogenous low dose (10 micrograms) iv GnRH administration resulted in preferential release of bioactive LH, with a consequent significant increase in the median plasma bio- to immunoactive (bioimmuno) LH ratio. This pattern mimicked that of endogenous LH pulsatility, in which median intrapulse bio:immuno LH ratios were significantly higher than median interpulse ratios in the same individuals (P = 0.006). Increases in spontaneous plasma bio:immuno LH ratios were not attributable to spurious rises in bioactive LH concentrations associated with decreases in serum immunoactive LH levels. Rather, sample cross-correlation analyses demonstrated positive correlations between bio- and immunoactive LH at lags of 0-40 min, indicating that both hormones increased or decreased concomitantly. These results demonstrate that LH is secreted physiologically in pulses of increased biological activity, presumably reflecting the release of a functionally compartmentalized LH pool relatively enriched in biologically active hormone. Accordingly, evaluation of the plasma bio:immuno LH ratio can provide a useful and sensitive index of qualitative changes in the LH molecule in response to endogenous (spontaneous) and exogenous GnRH stimulation. PMID- 3553223 TI - A gonadotropin-releasing hormone (GnRH)-like protein in human ovaries: similarity to the GnRH-like ovarian protein of the rat. AB - The rat ovary contains significant amounts of a GnRH-like protein, but does not contain readily detectable GnRH. We, therefore, determined whether human ovaries contain a similar GnRH-like protein. Extracts of human ovaries as well as rat ovaries, rat hypothalami, and rat plasma were examined for their content of both GnRH-like protein and GnRH. GnRH-like activity was detected by inhibition of binding of GnRH to rat ovarian membrane receptors [radioreceptor assay (RRA)]. GnRH was detected with a specific GnRH RIA. Equivalent amounts of GnRH-like activity were found in both human and rat ovaries, whereas GnRH was not detected. The human and rat ovarian GnRH-like materials had identical retention times after reverse phase high pressure liquid chromatography, and these were clearly different from that of authentic GnRH. Furthermore, the ovarian GnRH-like activity was clearly separated by HPLC from GnRH and GnRH-like activities extracted from rat hypothalami. Plasma contained neither GnRH-like nor GnRh activity. The ovarian GnRH-like activity was protease and heat sensitive, whereas hypothalamic GnRH and GnRH-like activity were protease sensitive, but not heat sensitive. The ovarian GnRH-like protein did not inhibit the specific binding of prostaglandin F2 alpha to rat ovarian membranes under conditions of assay similar to the GnRH RRA. The ovarian GnRH-like protein did not have GnRH peptidase activity, its inhibition of GnRH binding in the RRA was reversible, and bacitracin (protease inhibitor) had no effect on assay of the ovarian GnRH-like protein by RRA. We conclude that the human ovary contains a GnRH-like protein similar, if not identical, to the GnRH-like protein of the rat ovary, which is different from GnRH and the GnRH-like protein of the hypothalamus. The presence of the same GnRH-like material in human and rat ovary raises the possibility that this protein may mediate responses in the human ovary similar to the antigonadotropic actions of GnRH in the rat ovary. PMID- 3553224 TI - Plasma catecholamines after insulin hypoglycemia in Sheehan's syndrome. AB - The plasma catecholamine response to hypoglycemia was studied in a group of hypopituitary patients with Sheehan's syndrome before (group A) and after (group B) combined cortisol and thyroid hormone treatment as well as in a group of normal women (group C). The mean basal plasma norepinephrine (NE) level was significantly increased in group A compared to levels in groups B and C, in which values were similar. The mean basal plasma epinephrine (E) level was not significantly altered by hypopituitarism. The plasma NE response to hypoglycemia was similar in the three groups, while the plasma E response was blunted in groups A and B. However, the plasma E response was significantly decreased only in half of the patients. The basal E/NE ratio was similar in the three groups, but it was significantly decreased in groups A and B compared to that in group C at the peak. From these data we conclude that 1) hypopituitarism is characterized in the basal state by increased adrenergic tone, probably related to secondary hypothyroidism; and 2) during hypoglycemia adrenal stimulation is impaired only in some patients. The role of ACTH in the regulation of E secretion is minor. Impaired neurogenic regulation in some patients with Sheehan's syndrome could contribute to their illness. PMID- 3553225 TI - Comparison of indirect immunofluorescence and Western blot for detection of anti human immunodeficiency virus antibodies. AB - There was 100% agreement between the results of indirect immunofluorescence (IF) and Western blot testing when these methods were used to detect antibodies to the human immunodeficiency virus in sera from 25 patients with acquired immune deficiency syndrome (AIDS), 20 patients with AIDS-related complex, 186 subjects at high risk for AIDS, and 40 healthy heterosexuals. However, there was only an 88.7% correlation between IF and Western blot results for 728 sera from blood and plasma donor centers that were selected on the basis of screening enzyme immunoassay reactivity. IF tests yielded nine false-negatives and were equivocal, yielding a nonspecific pattern of reactivity for both infected and uninfected cells for 73 of these specimens. The IF and Western blot methods were equal in performance for the detection of anti-human immunodeficiency virus antibodies in the high-risk and unselected low-risk groups, proving to be a practical approach for testing specimens from these subjects. However, the Western blot was the most acceptable method for the validation of specimens from groups at low risk for AIDS that were selected based on enzyme immunoassay reactivity. PMID- 3553226 TI - Specificity study of kits for detection of group A streptococci directly from throat swabs. AB - A total of 78 Streptococcus strains, 15 Staphylococcus strains, and 2 Stomatococcus strains were used to test the specificity of 18 different antigen detection systems for group A streptococci and five products that detect a specific enzyme associated with group A streptococci. All streptococcal strains possessing the group A antigen were correctly identified with 31 different lots of reagents in the 18 antigen detection systems. The specificities of the 31 different lots of reagents ranged between 88.5 and 100%. A limited number of nonspecific reactions were observed with Enterococcus gallinarium, group C Streptococcus strain C23, and Staphylococcus aureus F49 and Cowan 1. The antigen detection kits that used enzymes as the extraction reagent gave slightly more specific results than did the kits that used chemical extraction reagents. The reagents in the five kits designed to detect the enzyme pyroglutamic acid arylamidase in Streptococcus pyogenes reacted positively with S. pyogenes (group A streptococcus); however, the reagents also reacted positively with all group D enterococcal streptococci and with about half of the staphylococcal strains treated. The nonspecificity of tests based on pyroglutamic acid arylamidase detection would seem to limit the usefulness of these kits with mixed cultures. PMID- 3553227 TI - Cellular and humoral immune response to a phenolic glycolipid antigen (PhenGL-I) in patients with leprosy. AB - The ability of phenolic glycolipid I (PhenGL-I) of Mycobacterium leprae to stimulate in vitro lymphocyte proliferation (LP) was tested in cultures of peripheral blood cells from 42 patients with leprosy in Chicago and Thailand, 9 individuals with household contact in Thailand, and 10 unexposed North American controls. Only 10 responders (24%) were found among the patients, and the degree of LP was small. Responders were found among patients with lepromatous (18%) or tuberculoid (30%) leprosy without relation to age, complications, duration of treatment, or lepromin responsiveness. The specificity of the response was supported by a lack of response to two other glycolipids, by responses by T cells but not B cells, and by the observation that three of four responders tested maintained their responses to PhenGL-I for at least 1 year. Serum immunoglobulin M (IgM) and IgG antibodies were measured in the same patients by using PhenGL-I or its terminal monosaccharide conjugated to a bovine serum albumin carrier in an enzyme-linked immunosorbent assay. The presence of IgM antibody correlated negatively with LP to lepromin and to PhenGL-I in patients with tuberculoid leprosy. We conclude that circulating T cells from some leprosy patients proliferate in the presence of PhenGL-I in vitro, but the response is weak, possibly due to concomitant suppression or inhibition. The predominance of IgM antibody to PhenGL-I may be related to a lack of a T-helper-cell-mediated switch to IgG antibody response. PMID- 3553228 TI - Modification of Grimont biotyping system for epidemiologic studies with nosocomial Serratia marcescens isolates. AB - A modification of the Grimont biotyping system for Serratia marcescens permitted the rapid testing of nosocomial strains by a plate-disk assimilation technique instead of with individual substrate tubes. PMID- 3553229 TI - Rapid detection of group B streptococci directly from vaginal swabs. AB - Duplicate vaginal swabs were obtained from patients who attended obstetric or gynecologic clinics affiliated with the Magee Womens Hospital in Pittsburgh. One swab was cultured semiquantitatively on 5% sheep blood agar to detect group B streptococci (GBS). The other swab was subjected to a rapid method (25 min) for antigen detection and micronitrous acid exposure to extract the GBS antigen, followed by latex particle agglutination. A total of 464 swabs were evaluated by direct plating. Fifty-two swabs (11.2%) were found to contain GBS. Overall, the rapid method detected 21 of 52, or 40.4%, positive specimens. The sensitivity of the rapid method for identifying the most heavily colonized samples was 85.7%. This method can be used to identify maternity patients who are heavily colonized with GBS and are at high risk of delivering septic infants. PMID- 3553230 TI - Rapid automated method for screening of enteric pathogens from stool specimens. AB - A total of 800 colonies suggestive of Salmonella, Shigella, or Yersinia species isolated on stool differential agar media were inoculated onto both conventional biochemical test media (triple sugar iron agar, urea agar, and phenylalanine agar) and Entero Pathogen Screen cards of the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.). Based on the conventional tests, the AutoMicrobic system method yielded the following results: 587 true-negatives, 185 true-positives, 2 false-negatives, and 26 false-positives (sensitivity, 99%; specificity, 96%). Both true-positive and true-negative results were achieved considerably earlier than false results (P less than 0.001). The Entero Pathogen Screen card method is a fast, easy, and sensitive method for screening for Salmonella, Shigella, or Yersinia species. The impossibility of screening for oxidase-positive pathogens is a minor disadvantage of this method. PMID- 3553231 TI - Evaluation of the Bio-EnzaBead test for syphilis. AB - The sensitivity and specificity of the Bio-EnzaBead test for syphilis and the fluorescent treponemal antibody-absorption (FTA-ABS) test were determined by examining 262 serum samples, including 202 serum samples from patients with confirmed syphilis in various stages. Overall correlation with patient history was 95.8% with both tests. False-negative Bio-EnzaBead tests occurred in 9 of 86 (10.5%) cases of late-latent syphilis (greater than 2 years) and in 1 of 38 (2.6%) cases for which the stage of disease could not be determined. False negative FTA-ABS tests occurred in 5 of 86 (5.8%) cases of late-latent syphilis (greater than 2 years) and in 2 of 38 (5.3%) cases for which the stage of disease could not be determined. One false-positive test occurred with Bio-EnzaBead, and the cause could not be determined. The reproducibility of the Bio-EnzaBead test was excellent when spectrophotometric readings were calibrated against either air or substrate blanks. The Bio-EnzaBead test for syphilis is a suitable alternative to the FTA-ABS test. PMID- 3553232 TI - High levels of antibodies to streptococcal cell membrane antigens specifically bound to monoclonal antibodies in acute poststreptococcal glomerulonephritis. AB - We produced 15 immunoglobulin G class monoclonal antibodies against antigens of the streptococcal cell membrane (SCM) of Streptococcus pyogenes (T type 12, Tanaka strain) and determined the levels in human sera of antibodies against Triton-X-extracted antigens specifically bound to each of these 15 monoclonal antibodies by enzyme-linked immunosorbent assay. Sample sera were obtained from 10 normal controls (group 1), 10 patients with streptococcal pharyngitis without sequelae (group 2), and 8 patients with acute poststreptococcal glomerulonephritis (APSGN) (group 3). Anti-streptolysin O (ASO) titers of the sera increased in the order of groups 1, 2, and 3. There was no relationship between ASO titer and the level of anti-SCM antibodies, and there was no significant difference in the level of anti-SCM antibodies determined with each of the 15 monoclonal antibodies between group 1 and group 2 sera. Group 3 sera had higher levels of antibodies to SCM antigens specifically bound to each of 14 of these 15 monoclonal antibodies than group 1 or group 2 sera did. Of these 14 monoclonal antibodies, 9 reacted with the four SCM antigens separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and electrophoretically transferred to a nitrocellulose sheet. These results suggest that high levels of antibodies to SCM antigens are related to the development of APSGN and that the systemic immune response to SCM antigens is involved in the pathogenesis of APSGN. PMID- 3553233 TI - Evaluation of immuno-dot-blot assay for detection of cholera-related enterotoxin antigen in Salmonella typhimurium. AB - Twenty-five strains of Salmonella typhimurium isolated in India were examined for the presence of cholera/coli-related enterotoxin antigen by a previously described latex particle agglutination test and by a newly developed immuno-dot blot test using immunopurified goat antibody against the cholera-related enterotoxin isolated from an Escherichia coli strain of human origin. The immuno dot-blot assay could detect 0.02 ng of purified enterotoxin. The amount of toxin antigen detected varied widely from strain to strain. Fourteen of the 25 polymyxin B-treated extracts of bacteria harvested from 6-h Casamino Acids-yeast extract broth cultures gave positive results in both serologic assays as well as in rabbit skin tests for delayed permeability factor. An additional strain was positive only in the immuno-dot-blot. Five of six stool isolates and six of seven blood isolates tested gave positive reactions. Two isolates of Salmonella enteritidis tested were also positive. The immuno-dot-blot test appears to be a simple, rapid, and reliable method for detection of cholera-related enterotoxin antigen in S. typhimurium. The demonstration of a cholera-related enterotoxin, even in small amounts, in a facultative intracellular pathogen raises interesting questions regarding its potential role in pathogenesis both of diarrheal disease and systemic infections caused by salmonellae. PMID- 3553235 TI - Nutritionally variant Streptococcus pyogenes from a periorbital abscess. AB - A nutritionally variant Streptococcus pyogenes strain was isolated from a periorbital abscess. The organism was identified with the use of three rapid biochemical test kits, and the group A antigen was detected by conventional serology as well as direct antigen detection tests. PMID- 3553234 TI - Peroxidase-antiperoxidase assay for rapid detection of respiratory syncytial virus in nasal epithelial specimens from infants and children. AB - A peroxidase-antiperoxidase (PAP) assay for the rapid detection of respiratory syncytial virus was compared with the indirect immunofluorescence method and with viral culture. Nasal epithelial specimens from 147 infants and children with acute respiratory infections were obtained and evaluated for the presence of respiratory syncytial virus antigens. Sensitivity, specificity, and accuracy by PAP were 91.7, 84.8, and 87.1%, respectively, and 87.0, 88.5, and 88.0%, respectively, by immunofluorescence compared with viral culture. The PAP assay was found to be as accurate as the indirect immunofluorescence method and more convenient to perform, since the color reaction and cell morphology were more easily observable by light microscopy. A new specimen collection method is reported; gentle scraping of the superficial nasal mucosa by the Rhino-probe method provided sufficient numbers of epithelial cells to perform multiple assays. PMID- 3553236 TI - Comparison of three rapid diagnostic techniques for detection of respiratory syncytial virus from nasal wash specimens. AB - We report results of three rapid tests for respiratory syncytial virus antigen detection. An immunofluorescence assay using commercial antibody and two commercial enzyme immunoassays (Ortho Diagnostics, Inc., Raritan, N.J., and Abbott Laboratories, North Chicago, Ill.) were applied to 199 nasal wash specimens. The Abbott enzyme immunoassay was the most sensitive technique, with a sensitivity of 93.8%. The specificities of the three techniques were comparable and greater than 95%. The availability of reliable rapid diagnostic techniques will allow for better care of infants with severe respiratory syncytial virus infection. PMID- 3553237 TI - The modulation of class II histocompatibility antigens and 'activated' macrophage determinant in the spinal cord during the development of chronic relapsing experimental allergic encephalomyelitis (CREAE) in the guinea pig--relevance to the induction of remission? AB - Cryostat sections of spinal cord of guinea pigs with chronic relapsing experimental allergic encephalomyelitis (CREAE) were stained with monoclonal antibodies recognising a Strain 13-specific Ia epitope, a non-strain-specific Ia antigen and an 'activated' macrophage determinant. It was found that both Ia antigens and the 'activated' macrophage determinant, observed on infiltrating cells within both perivascular and meningeal compartments, appeared to be modulated during the course of CREAE. This correlated with the neurological symptoms of the disease. Blood vessels and 'glial' cells expressed both Ia determinants. 'Glial' cells also expressed the 'activated' macrophage antigen. These antigens were modulated with the course of the disease. PMID- 3553238 TI - Resin fiberglass bonded retainer. PMID- 3553239 TI - Novel type of proliferating lymphoplasmacytoid cell with a characteristic spotted immunofluorescence pattern. AB - We examined bone marrow from myeloma patients for the presence of cells with the characteristics of the clonogenic cell in the myeloma stem cell assay. We identified a novel type of cell that contained cytoplasmic immunoglobulin of the relevant idiotype located in a cytoplasmic spot. This "spotted" Ig could be located in the rough endoplasmic reticulum. Spotted cells are highly proliferative, as evidenced by the nuclear staining with the antibody Ki67, and were found in the bone marrow from most of the myeloma patients studied. This type of cell was also present in patients with immunocytomas, in some cases of benign monoclonal gammopathy, and in patients in the state of polyclonal hypergammaglobulinemia. IgG subclass distribution of so-called spotted cells and plasma cells, found in a patient with pseudo biclonal gammopathy, indicates that spotted cells are intermediate between B cells and plasma cells. Spotted cells express the B cell-associated antigens HB4 and HB6 but do not express other B cluster of differentiation antigens or plasmacytoid antigens tested. PMID- 3553240 TI - Hypokalemic nephropathy in the rat. Role of ammonia in chronic tubular injury. AB - Chronic potassium deficiency results in progressive tubulointerstitial injury, associated with augmented renal ammoniagenesis. We investigated the role of elevated renal ammonia levels and the interaction of ammonia with the complement system in this injury. Potassium deficiency was induced in rats by feeding a low potassium diet. Experimental animals received 150 mM NaHCO3 or equimolar NaCl, as drinking water. After 3 wk, NaHCO3 supplemented rats demonstrated decreased ammonia production, less renal hypertrophy, less histologic evidence of injury, and less proteinuria. In in vitro studies on normal cortical tubular fragments, the addition of ammonia to serum in concentrations comparable to renal cortical levels in potassium-deficient animals significantly increased tubular deposition of C3 as quantitated by a radiolabeled antibody binding technique. Thus, alkali supplementation reduced chronic tubulointerstitial disease in a rat model of hypokalemic nephropathy. We propose that increased cortical ammonia levels contribute to hypokalemic nephropathy through ammonia-mediated activation of the alternative complement pathway. PMID- 3553243 TI - Biofeedback and stress management in the treatment of headache. PMID- 3553241 TI - Platelet-activating factor mediates hemodynamic changes and lung injury in endotoxin-treated rats. AB - Within 20 min after intraperitoneal injection of Salmonella enteritidis endotoxin in rats, blood platelet-activating factor (PAF) increased from 4.3 +/- 1.3 to 13.7 +/- 2.0 ng/ml (P less than 0.01) and lung PAF from 32.3 +/- 4.9 to 312.3 +/- 19.6 ng (P less than 0.01), but not lung lavage PAF. We tested the effect of PAF receptor antagonists, CV 3988 and SRI 63-441, on endotoxin-induced hemodynamic changes and lung vascular injury. Pretreatment with CV 3988 attenuated systemic hypotension, preserved hypoxic pulmonary vasoconstriction, and prolonged survival of awake catheter-implanted endotoxin-treated (20 mg/kg) rats. Pretreatment with SRI 63-441 prevented the depressed hypoxic pulmonary vasoconstriction after low dose (2 mg/kg) endotoxin. Both CV 3988 and SRI 63-441 blocked the increased extravascular accumulation of 125I-albumin and water in perfused lungs isolated from endotoxin-treated rats. We conclude that PAF is produced in the lung during endotoxemia and may be an important mediator of the systemic and pulmonary hemodynamic changes as well as the acute lung vascular injury after endotoxemia. PMID- 3553242 TI - Parasite-specific anergy in human filariasis. Insights after analysis of parasite antigen-driven lymphokine production. AB - The antigen-specific immune unresponsiveness seen in bancroftian filariasis was studied by examining lymphokine production in peripheral blood mononuclear cells (PBMC) or PBMC subpopulations from 10 patients with asymptomatic microfilaremia, 13 patients with elephantiasis and 6 normal North Americans. In each group of patients, the kinetics of the lymphokine response and the response to mitogens and nonparasite antigens did not differ significantly. In marked contrast, when antigen-induced lymphokine production was examined, most patients with microfilaremia were unable to produce either interleukin 2 (IL-2) or gamma interferon (i.e., were nonresponders), and the few who could (hyporesponders, generally with quite low microfilaremia levels) did so at levels significantly less than those of patients with elephantiasis, all of whom showed strong responses to parasite antigen. Removal of neither adherent cells or T8+ cells affected the parasite-specific anergy seen in those with microfilaremia, suggesting a state of T cell tolerance to the parasite in patients with this most common clinical manifestation of bancroftian filariasis. PMID- 3553244 TI - Gestalt dialogues as a treatment for mild depression: time works just as well. AB - In a treatment analogue design, 44 moderately depressed volunteer subjects were divided randomly into four groups: attention-placebo; Gestalt empty chair dialogues designed to be personally relevant and high in affect; dialogues designed to be personally irrelevant and neutral in affect; and groups in which strong affect was encouraged, but no dialogues enacted. Groups met 1 hour per week for 4 weeks. Each group was pretested, post-tested, and follow-up tested with an abbreviated MMPI, the Depression Adjective Check List, and experimenter questionnaires. A series of 4 X 3 ANOVAs indicated significant main effects for time across all dependent variables. Also, anxiety and social introversion decreased over time in all groups. No other main or interactional effects were significant. These results suggest that mild depression, as well as anxiety and social introversion, dissipated over time and remained lower regardless of whether the subject had any treatment. PMID- 3553245 TI - The gonadotropin-releasing hormone containing ventral hypothalamic tract in the fetal rhesus monkey (Macaca mulatta). AB - A well-defined, gonadotropin-releasing hormone (GnRH)-containing fiber pathway, the ventral hypothalamic tract (VHT), is described by immunostaining in fetal rhesus macaques (109-156 days gestation). The VHT arises above the lateral aspects of the optic chiasm near the supraoptic nucleus, and courses ventromedially close to the ventral hypothalamic surface to terminate in the infundibulum and zona externa of the median eminence. It is formed by the confluence of GnRH-immunopositive (GnRH+) axons from local neurons, from a few GnRH+ cells in the inferior thalamic peduncle, and probably from more anterior neurons in the septum and preoptic area. Bipolar GnRH+ neurons contributing directly to the VHT are grouped at its origin dorsolateral to the optic chiasm, dorsal and medial to the optic tracts, at the infundibular lip, and within the pathway between. At the infundibular lip, GnRH+ perikarya are generally lateral or ventral to the infundibular (arcuate) nucleus, and are rarely within the nucleus itself. Cell bodies here are sometimes tripolar, but GnRH+ intercellular contacts are seldom seen. A few VHT fibers extend to the ventral surface of the brain just beneath the pia mater. Abundant capillaries in the subarachnoid space suggest a possible route for delivery of GnRH to the adenohypophysis in early gestation, before maturation of the hypophysial portal system occurs. Posterior to the infundibulum, a few VHT fibers are joined by descending periventricular fibers forming a dense fiber band beneath the premammillary recess of the third ventricle. Totals of GnRH+ cell bodies in the prosencephalon of the fetal rhesus macaque are estimated to be 5,600 in females (n = 2) and 2,600 in males (n = 3). More than 60% of VHT neurons are located in the medial basal hypothalamus, and the majority of basal hypothalamic GnRH+ neurons (86%) are associated with the VHT. Furthermore, reports of the autonomy of the medial basal hypothalamic hypophysial unit in control of gonadotropin secretion suggest that the VHT may be the most important GnRH system involved in primate reproduction. It is clear that fetal material may offer the best model to study the GnRH neuronal system in primates. PMID- 3553246 TI - Quantitative analysis of the choline acetyltransferase-immunoreactive axonal network in the cat primary visual cortex: II. Pre- and postnatal development. AB - The pre- and postnatal development of cholinergic projections was investigated in the cat striate cortex by applying immunohistochemical methods based on a monoclonal antibody against choline acetyltransferase (ChAT). The earliest age investigated was gestational day 54. At this stage a sparse network of ChAT(+) fibers was distributed throughout the striate cortex. Subsequent postnatal maturation of ChAT(+) fibers was characterized by an increase in fiber density that started in layer VI and gradually progressed toward more superficial layers. By 4 weeks of age the density of ChAT(+) fibers and varicosities had reached adult levels in layers V and VI but was still subnormal in layers I-IV. The mature pattern of cholinergic innervation was established by 13 weeks of age. There was no evidence for developmental gradients in the anteroposterior and mediolateral directions within area 17. These results indicate that the cholinergic projection to striate cortex develops continuously in an inside-out sequence as is characteristic for most cortical maturation processes. There was no indication that striate cortex receives an especially dense cholinergic input during the critical period. PMID- 3553247 TI - Superpotent topical steroid treatment of psoriasis vulgaris--clinical efficacy and adrenal function. AB - Multiple clinical and laboratory evaluations, including morning plasma cortisol levels, were done in forty patients having moderate to severe psoriasis vulgaris prior to and during treatment with either betamethasone dipropionate in optimized vehicle or clobetasol-17-propionate ointment. The study was randomized, double blind, and of parallel group design, lasting 3 weeks. Both drugs were effective (3 of 4 achieving at least 75% or more improvement). Temporary reversible suppression of the hypothalamic-pituitary-adrenal axis, as reflected by low morning plasma cortisol determinations, was found in eight of forty patients (20%). The clinician should respect the potential for superpotent topical steroids to cause laboratory evidence of adrenal suppression. PMID- 3553248 TI - Gold therapy and its indications in dermatology. A review. AB - Gold compounds have long been known as therapeutic agents and have been used extensively in the treatment of rheumatoid arthritis. Their mechanisms of action in vivo, however, remain unclear. In comparison to parenteral gold, the pharmacokinetics of a newly available oral compound, auranofin, differ greatly. Auranofin also appears to have specific immunomodulatory actions and to be associated with fewer and milder toxic effects. The role of chrysotherapy in dermatology has been reemphasized recently. It may be used as an adjuvant in pemphigus or other steroid-responsive diseases to help control disease activity and to taper or eliminate corticosteroid therapy more rapidly. Reports on the use of gold in dermatology are otherwise limited. They include one case of epidermolysis bullosa acquisita and psoriatic arthritis. The benefits of gold treatment have to be weighed against the risks inherent in its adverse reactions, some of which are serious and unpredictable. PMID- 3553249 TI - The incidence of second malignancies in subsets of Kaposi's sarcoma. AB - There is strong evidence linking Kaposi's sarcoma with an increased risk of developing a second primary malignancy. This risk of a second malignancy appears to depend in part on the clinical setting in which Kaposi's sarcoma develops. This paper examines these risks by relating them to specific subsets of Kaposi's sarcoma and to specific types of second malignancies. PMID- 3553250 TI - Blood eosinophilia as a severity marker for bullous pemphigoid. PMID- 3553251 TI - Correction of spatial distortion in MR imaging: a prerequisite for accurate stereotaxy. AB - With magnetic resonance (MR) imaging, accurate spatial information--critical for effective stereotaxy--demands a homogeneous static field and linear gradients. Inhomogeneities and nonlinearities induced by eddy currents during the pulse sequences distort the images and produce spurious displacements of the stereotactic coordinates in both the x-y plane and the z axis. These errors in position can be assessed by means of two phantoms placed within the stereotactic guidance system--a "two-dimensional phantom" displaying "pincushion" distortion in the image (i.e., x, y) plane, and the "three-dimensional phantom" displaying displacement, warp, and tilt of the image plane itself. The pincushion distortion can be "corrected" (reducing displacements from 5 to 1-2 mm) by calculations based on modeling the distortion as a fourth order two-dimensional polynomial. Based on these corrected images, errors in the z coordinate and tilt of image planes may be corrected by adjustment of the gradient shimming currents. Such correction not only implements stereotaxy under MR guidance but also provides for the accurate transfer of anatomic/pathologic information between MR and CT images. PMID- 3553252 TI - Endotoxin of Escherichia coli and permeability of the mammary gland of goats. AB - Serial collections of milk were used to determine where in the mammary gland endotoxin of Escherichia coli was effective in altering the transfer of selected milk components into blood and blood components into milk. Lactating goats had half the gland infused with 1 microgram of endotoxin and the other half served as a control. Sodium-24 and 42K or [14C] lactose were included with 141Ce in the infusate in some experiments, whereas in others 99mTc-labelled albumin or 24Na and 42K were given intravenously 2 h after the endotoxin infusion. Milk was collected 3 h after endotoxin infusion. Endotoxin increased the loss of 24Na, 42K, and [14C] lactose from the mammary gland and increased the transfer of 24Na and 99mTc-albumin into the gland. The transfer in of 42K was reduced compared with control halves. Movement of stable Na and K was in accord with the movement of the 24Na and 42K. Endotoxin was effective in all parts of the gland but particularly from the mid-portion upward to the alveoli. For the control halves there was evidence that some 24Na and 42K crossed the ductal or cisternal epithelium into blood outside of the alveoli, whereas only 42K provided evidence for transfer from blood to milk in these same regions. There was no demonstrable transfer of lactose and albumin in regions other than the alveoli. PMID- 3553253 TI - Response of insulin, glucagon, and growth hormone to intravenous glucose challenge in cows fed high fat diets. AB - Effect of feeding high fat diets on peripheral plasma concentrations of immunoreactive insulin, glucagon, and growth hormone following intravenous glucose challenge (100 mg D-glucose/kg body weight) at 50 and 100 d of lactation in 16 multiparous Holstein cows was evaluated. The high fat diet contained 18.5% whole cottonseed on a dry matter basis as the source of extra dietary fat. Feeding the high fat diet had no apparent effect on energy balance. Basal plasma insulin and insulin:glucagon ratio were increased in cows fed the high fat diet relative to those of controls. Glucagon, insulin, and insulin:glucagon ratio response to glucose challenge were not affected by diet. Response of growth hormone to glucose challenge at 50 d of lactation was depressed in cows fed the high fat diet. Plasma glucose peaked at greater concentrations in cows fed the high fat diet. Feeding a high fat diet to dairy cows appears to increase basal insulin concentration and insulin:glucagon ratio, which has actions opposed to glucose synthesis. Thus, endocrine effects of a high fat diet appear to favor decreased milk production. PMID- 3553254 TI - Yersinia enterocolitica in milk and dairy products. AB - Yersinia enterocolitica was first recognized during the 1960's as an important human enteropathogen. The species as later redefined includes both pathogenic and nonpathogenic forms. Pathogenic strains that retain the virulence plasmid can be identified in several animal models and four indirect tests (calcium dependency, autoagglutination, Congo red uptake, serological detection of outer membrane antigen) and by tissue culture assay, serotype, and biotype. Y. enterocolitica and related bacteria have frequently been isolated from raw milk, but none of the isolates, with the possible exception of serotype 05,27, are recognizable as pathogens. Under normal circumstances Y. enterocolitica does not survive pasteurization. If introduced into pasteurized milk, it can grow well at refrigeration temperatures. Two outbreaks of yersiniosis have occurred that involved pasteurized milk. Pigs, which frequently carry pathogenic Y. enterocolitica in their throat, were the probable source in one of these outbreaks. The most rapid enrichment procedure available for isolation of Y. enterocolitica requires 6 d. No isolation method is available for selective isolation of pathogenic Y. enterocolitica in the presence of related bacteria common in milk and other foods. PMID- 3553255 TI - Milk, milk products, and dental health. PMID- 3553256 TI - Milk intolerance and microbe-containing dairy foods. AB - The relationship between primary lactase deficiency, the amount of lactose in the diet, and symptoms of intolerance continues to be debated. Primary adult lactase deficiency is common with a worldwide occurrence of near 70%. Lactase-deficient individuals malabsorb lactose but may or may not show intolerance symptoms. The development of symptoms appears to depend on the dose of lactose ingested, whether it is accompanied by a meal or other food, rate of gastric emptying, and small intestine transit time. Lactose loads of 15 g or greater produce symptoms in the majority of lactase-deficient persons. However, when lactose loads of up to 12 g are fed, symptoms can be minimal or absent. Tolerance to yogurt, acidophilus milk, and other microbe-containing dairy foods has been suggested and is thought to be due to either a low lactose content or in vivo autodigestion by microbial beta-galactosidase. Up to 20 g of lactose in yogurt is tolerated well by lactase-deficient persons. Associated with the consumption of yogurt is a three- to fourfold reduction in lactose malabsorption as compared with similar lactose consumption in milk. Improved lactose digestion appears due to autodigestion by microbial beta-galactosidase. This enzyme may be released from yogurt culture by gastric or bile acid digestion. Feeding yogurt that was pasteurized following fermentation, with only trace amounts of microbial beta galactosidase activity, results in a threefold increase in lactose malabsorption as compared with feeding yogurt with a viable culture. However, pasteurized yogurt also is tolerated well by lactase-deficient persons, suggesting that tolerance of up to 20 g of lactose in yogurt may be independent of lactose malabsorption. The enhanced lactose absorption and tolerance observed with yogurt feeding are not apparent when unfermented acidophilus milk or cultured milk are fed. PMID- 3553257 TI - Protein and fiber digestion, passage, and utilization in lactating cows. Microbial growth and flow as influenced by dietary manipulations. AB - The accuracy of prediction of microbial growth in the rumen and flow of microbial protein to the small intestine is important in predicting protein and carbohydrate utilization in dairy cattle as well as the development of a protein and carbohydrate feeding system that will be an improvement over present systems. Empirical multiple and simple regression equations are presented that demonstrate the impact of body size, proportion of forage in the diet, and dry matter intake on flow of microbial protein into the small intestine from the rumen. Concepts are developed and validated for a mechanistic, dynamic approach for prediction of microbial growth and flow of microbial protein based on Michaelis-Menton equations, microbial substance affinities, and rumen liquid flow kinetics. Emphasis is placed on the importance of quantifying dynamics of rumen function, the need for experimentation to develop a carbohydrate system that will include methods for analysis, and a factorial approach to digestion and utilization. PMID- 3553258 TI - Physiology of the somatotropic axis with particular reference to the ruminant. AB - The physiology of growth hormone and the insulin-like growth factors are reviewed with particular reference to the dairy industry. Growth hormone secretion in the ruminant is pulsatile in nature and nutritional factors have a major impact on its secretion. Isolation of growth hormone-releasing factor has allowed further progress in understanding the mechanisms underlying growth hormone release. The receptors appear to be under active endocrine and metabolic control, and nutritional influences on the somatotropic axis are in large part mediated through changes in somatotropic receptors. The mode of action of growth hormone to induce acute metabolic affects and lipolysis remains to be resolved, but there is increasing evidence that its anabolic actions are mediated by the insulin-like growth factors. Recent studies of measurement of insulin-like growth factor-1 and -2 in the ruminant and the role of growth hormone, nutrition, insulin, and sex steroids in their regulation are reviewed. The relative role of the two factors and the multiple forms of their receptors remain to be resolved. It is well documented that growth hormone is galactopoietic. The evidence that this effect is largely due to enhanced nutrient supply to the mammary gland is not convincing. Effects of growth hormone are indirect and may be mediated by the insulin-like growth factors. The potential is considerable for manipulating the growth hormone insulin-like growth factor axis to enhance lactation. PMID- 3553260 TI - Validity of Millon's computerized interpretation system for the MCMI: a controlled study. PMID- 3553259 TI - Somatotropin and lactation. AB - Somatotropin, which can now be produced by biotechnology, could have an enormous impact on the dairy industry. Milk yield has been increased up to 40% with daily injections of somatotropin. Cows adjust their nutrient intake to support this increase. Somatotropin does not adversely affect cows' health, although all studies to date have been for less than one complete lactation. The search for a single biochemical or physiological event to account for the effects of somatotropin on milk production is elusive. Coordinated changes in many tissues and physiological processes occur to support the increases in the synthesis of lactose, fat, and protein in the mammary gland. Changes in the irreversible loss and oxidation rates of two key metabolites, glucose and free fatty acids, can quantitatively account for increases in lactose and milk fat during the short term administration of somatotropin. Similarly, feed intake and live weight changes can account for increases in milk production in the longer experiments. Parallels between physiological changes that occur during somatotropin administration and differences between genetically high and lower yielding cows are highlighted, and the rates of improvement that can be expected from various new technologies are quantified. Existing data on the safety of somatotropin to both the consumer and the animal are evaluated. PMID- 3553261 TI - Methodological issues on the study of transgenerational effects of the holocaust: comment on Nadler, Kav-Venaki, and Gleitman. PMID- 3553263 TI - Two-, three, and four-year follow-up on the self-regulatory treatment of chronic headache. PMID- 3553262 TI - Conditioned side effects induced by cancer chemotherapy: prevention through behavioral treatment. PMID- 3553264 TI - Guidelines on the use and presentation of statistical methods. PMID- 3553265 TI - Retention after computer-assisted instruction in intraoral radiography. PMID- 3553266 TI - The swivel-joint suture holder. PMID- 3553267 TI - International dermatosurgery: reconstructive treatment of the vulva--a new procedure: experience on 23 cases over 4 years. AB - The postvulvectomy reconstruction caused the authors diverse problems in the first three operations. The use of a bipedicle advancement flap obtained from the anterointernal region of the thigh, modified depending on the extension of the vulvectomy and the elasticity of the skin allow us to suggest the use of this technique due to its safeness, the facility with which it is carried out, and reduction of the hospital stay, as this makes the method socially economical. PMID- 3553268 TI - [Sensitivity to a highly dispersed copper powder of mutants of Escherichia coli B resistant to CuCl2]. PMID- 3553269 TI - Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome. AB - Sixteen patients with acute respiratory failure (ARF) were studied. In group I (12 patients, 15 explorations) patients were treated with continuous positive pressure ventilation (CPPV) during conventional ventilation (CV), pulmonary lesions (PL) were severe (Qsp/Qt = 0.24 +/- 0.16 with PEEP = 14 +/- 7 cm H2O) and high-frequency jet ventilation (HFJV) was performed without spontaneous ventilation (SV). In group II (5 patients, 12 explorations) patients were treated with intermittent mandatory ventilation (IMV) during CV, PL were moderate (Qsp/Qt = 0.13 +/- 0.05 with PEEP = 8 +/- 3 cm H2O) and HFJV was performed with SV. In both groups, frequency was 120 c/mn and I:E ratio = 1:2. The cannula size, the driving pressure and the PEEP (water column) were progressively adapted to obtain the same blood gases as those observed during CV, FIO2 being the same. Results on HFJV were compared to CV. In both groups there were no differences between PaCO2, PaO2, FIO2, Qsp/Qt during CV and HFJV. In group I peak airway pressure (PAWP), mean artery pressure (MAP), heart rate (HR), transmural mean pulmonary and wedge pressure (MPAPtm, PWPtm) were not different. Mean airway pressure (MAWP), PEEP and pleural pressure (PP) were higher, cardiac index (CI) was lower. In group II, PP, CI, MAP, HR, MPAPtm, MPWPtm were not different. PAWP was lower, MAWP and PEEP were higher. We conclude that during HFJV it is possible to obtain the same blood gas as during CV, but HFJV without CV may not be indicated in patients with severe PL, because circulatory impairment is higher. PMID- 3553270 TI - Pessi's law and curve. PMID- 3553271 TI - Organ dysfunction after cardiopulmonary bypass. A systemic inflammatory reaction initiated by the extracorporeal circuit. PMID- 3553272 TI - Joseph Francis Volker--Alabama's most distinguished adopted son. Part IV. The spawning of dental deans. PMID- 3553273 TI - Families with disabled children: stress and social networks in three samples. AB - Mothers and fathers of 125 handicapped/chronically ill children were compared with parents of 127 matched nondisabled children from three separate samples with respect to personal stress, marital satisfaction, and social network size and density. Only mothers of disabled children experienced higher levels of stress than comparison parents. No differences were found in marital satisfaction. Few group differences were found for social network variables, although mothers of handicapped children had higher-density networks than comparison mothers. A series of ANOVAs examined differences among the three types of families of handicapped children. Significant differences among the groups were found for social network but not family stress variables. The results are discussed in terms of general differences between families with and without a disabled child, and point to the need to identify patterns within different types of family systems in conducting future research in this area. PMID- 3553274 TI - The effects of essential fatty acid supplementation by Efamol in hyperactive children. AB - Thirty-one children, selected for marked inattention and overactivity, were studied in a double-blind, placebo-controlled crossover study of essential fatty acid (EFA) supplementation. Subjects received the active treatment and placebo conditions for 4 weeks each and were assessed on a variety of cognitive, motor, and standardized rating scale measures. EFA supplementation (evening primrose oil; Efamol) resulted in significantly lower levels of palmitoleic acid (a nonessential fatty acid) and higher concentrations of dihomogammalinolenic acid, an EFA previously found to be deficient in some hyperactive children. Supplementation was also associated with significant changes on two performance tasks and with significant improvement to parent ratings on the subscales designated as Attention Problem and Motor Excess of the Revised Behavior Problem Checklist. However, a variety of eight other psychomotor performance tests and two standardized teacher rating scales failed to indicate treatment effects. When the experiment-wise probability level was set at .05, only 2 of 42 variables showed treatment effects. Baseline EFA concentrations appeared to be unrelated to treatment response. It was concluded that EFA supplementation, as employed here, produces minimal or no improvements in hyperactive children selected without regard to baseline EFA concentrations. PMID- 3553275 TI - Monitoring the bioenergetics of cardiac allograft rejection using in vivo P-31 nuclear magnetic resonance spectroscopy. AB - Monitoring human cardiac allograft rejection is currently accomplished by endomyocardial biopsy. Available noninvasive methods for identifying rejection have lacked the necessary sensitivity or specificity, or both, for routine clinical application. In vivo phosphorus-31 (P-31) nuclear magnetic resonance (NMR) spectroscopy has been used for monitoring phosphorus metabolism in both animal models and humans. In the present study this technique was employed as a noninvasive means to assess the bioenergetic processes that occur during cardiac allograft rejection in a rat model. Brown Norway rat hearts were transplanted subcutaneously into the anterior region of the neck of Lewis rat recipients (allografts). Control isografts employed Lewis donors and recipients. Phosphocreatine to inorganic phosphate (PCr/Pi), phosphocreatine to beta adenosine triphosphate (PCr/ATP beta), beta-adenosine triphosphate to inorganic phosphate (ATP beta/Pi) ratios and pH of the transplanted hearts were monitored using surface coil P-31 NMR spectroscopy (at 4.7 tesla) daily for 7 days. To allow recovery from the compromise induced by the surgical procedure, the measurements obtained on day 2 were taken as a baseline. PCr/Pi was unchanged or increased in the isografts but decreased continually in allografts, with the difference becoming significant by day 4 when compared with levels in day 2 allografts (p less than 0.005) and by day 3 when compared with levels in the isograft group (p less than 0.05). PCr/ATP beta in isografts did not change throughout the study; however, allografts demonstrated a significant decrease as early as day 3 (p less than 0.01), although a significant difference between isografts and allografts did not become manifest until day 4 (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553276 TI - Quantitative and qualitative effects of intracoronary streptokinase in unstable angina and non-Q wave infarction. AB - Thrombolytic therapy has been shown to be effective in reopening totally occluded arteries in acute myocardial infarction. Coronary thrombus is also believed to play a role in the pathophysiology of unstable angina and non-Q wave infarction. However, few patients with these two acute coronary syndromes have been treated with intracoronary streptokinase. Therefore, 100,000 to 300,000 IU (mean 177,000 +/- 80,000 IU) of intracoronary streptokinase was infused into 36 consecutive catheterized patients who either presented with an acute episode of unstable angina or had had a recent non-Q wave infarction and in whom a less than 100% occluded ischemia-producing artery could be identified. Qualitative techniques utilizing vessel magnification and quantitative analysis with digital subtraction were performed on the ischemia-producing coronary lesion before and immediately after streptokinase therapy and 3 to 10 days later in 18 patients who were restudied at the time of transluminal coronary angioplasty. Before streptokinase treatment, 24 (67%) of 36 ischemia-producing arteries contained eccentric, irregular lesions. The percent diameter stenosis and percent area stenosis in all ischemia-producing arteries averaged 83.8 +/- 8.3% and 94.8 +/- 3.3%, respectively. After streptokinase treatment there were 23 arteries (64%) with eccentric irregular lesions. The percent diameter stenosis and percent area stenosis in all ischemia-producing arteries were similar to pre-streptokinase values (82.9 +/- 5.9% and 93.8 +/- 4.0%, respectively). At restudy, there were also no significant changes in any quantitative or qualitative variable. Five individual patients showed a significant reduction in percent stenosis after streptokinase. This improvement was independent of duration of symptoms, use of heparin before angiography, streptokinase dose or reduction of fibrinogen levels post-streptokinase. Two additional patients deteriorated clinically and developed total occlusion of the ischemia-producing artery within 12 hours of streptokinase infusion. These data suggest that intracoronary streptokinase may be of limited utility in either unstable angina or recent non-Q wave infarction with a less than 100% occluded ischemia-producing artery. In these syndromes, thrombus may be organized or short infusions may be given too late to be effective. In some cases, thrombus may even be absent. Whether longer infusion of streptokinase or other thrombolytic agents will be of benefit remains to be determined. PMID- 3553277 TI - Comparison of inhaled albuterol powder and aerosol in asthma. AB - In this multicenter, randomized, double-blind study comparing the efficacy and safety of aerosolized albuterol with the dry powder formulation, 231 patients with chronic reversible obstructive airway disease were randomly allocated to receive either placebo albuterol aerosol followed immediately by active albuterol powder (200 micrograms) or active albuterol aerosol (two puffs, 180 micrograms) followed immediately by placebo lactose powder four times a day for a period of 12 weeks. No statistically significant differences were found between the powder and aerosol formulations with respect to pulmonary function, length of time mean FEV1 remained greater than or equal to 15% above baseline, physicians' assessments of patients' clinical response, or patients' subjective symptom scores. There were also no significant differences between treatment groups in cardiovascular effects, laboratory values, or adverse events. Among patients who expressed a preference for one of the delivery systems, half preferred using the powder. Results of this study demonstrate that 200 micrograms of albuterol powder is as safe and effective as 180 micrograms of albuterol aerosol. PMID- 3553278 TI - Ultrastructural and immunohistochemical evidence for release of eosinophilic granules in vivo: cytotoxic potential in chronic eosinophilic pneumonia. AB - We studied a patient with relapsing idiopathic chronic eosinophilic pneumonia. Each one of four attacks observed during a 4-year period was characterized by dyspnea, wheezing, peripheral blood eosinophilia, elevated serum IgE levels, and pulmonary infiltrates. Glucocorticoid therapy caused prompt resolution of symptoms and disappearance of blood eosinophilia and pulmonary shadowing. Electron microscopy and tissue immunofluorescence studies for major basic protein documented extensive eosinophil degranulation and the presence of free granules within the pulmonary microvasculature. In addition, exfoliation of the alveolar lining cell was observed in association with a clustering of free intact and disintegrating extracellular eosinophil granules against a denuded basement membrane. These findings suggest a cytotoxic potential of the eosinophil at the level of the pulmonary parenchyma in a case of idiopathic chronic eosinophilic pneumonia. PMID- 3553279 TI - The effect of an oral leukotriene antagonist L-649,923 on histamine and leukotriene D4-induced bronchoconstriction in normal man. AB - We have studied the effect of prior treatment with an oral leukotriene (LT) antagonist L-649,923, on histamine and LTD4-induced bronchoconstriction in 12 normal male subjects in a double-blind, placebo-controlled, randomized, crossover trial. L-649,923 had no effect on histamine-induced bronchoconstriction but antagonized LTD4-induced bronchoconstriction, causing a mean shift to the right of the dose-response curves of 3.8-fold. This study demonstrates that LT antagonism is possible and safe in man and that LTD4-inhalation challenge testing can be used to detect LT antagonism. PMID- 3553280 TI - Food allergy challenges: guidelines and implications. AB - Double-blind placebo-controlled food challenges were used to determine the presence or absence of food hypersensitivity in 120 children with atopic dermatitis. Foods to be challenged were selected on the basis of history, allergy skin tests, nutritional significance, and patient desires. Dehydrated foods were hidden in capsules or juice and administered twice a day. Antigens were obtained commercially or prepared through a process of freeze-drying and subsequent pulverization. Cutaneous, gastrointestinal, nasal, and/or respiratory symptoms occurred following 133 challenges. Although patients exhibited multiple positive skin tests to foods, 86% experienced a positive response on blinded challenge to only one or two foods. Double-blind placebo-controlled food challenges accurately diagnose food hypersensitivity and minimize the number of foods eliminated from allergy avoidance diets. A new method of elimination diet management and education is based on the identification of "key words" on food labels. Instructional diet sheets were developed to teach this concept, which was found to promote greater confidence, compliance, and creativity in diet planning. PMID- 3553281 TI - A double-blind placebo controlled evaluation of the safety and efficacy of vinpocetine in the treatment of patients with chronic vascular senile cerebral dysfunction. AB - In a double-blind clinical trial, vinpocetine, a synthetic ethyl ester of apovincamine, was shown to effect significant improvement in elderly patients with chronic cerebral dysfunction. Forty-two patients received 10 mg vinpocetine three times a day (tid) for 30 days, then 5 mg tid for 60 days. Matching placebo tablets were given to another 42 patients for the 90 day trial period. Patients on vinpocetine scored consistently better in all evaluations of the effectiveness of treatment including measurements on the Clinical Global Impression (CGI) scale, the Sandoz Clinical Assessment-Geriatric (SCAG) scale, and the Mini-Mental Status Questionnaire (MMSQ). There were no serious side effects related to the treatment drug. PMID- 3553282 TI - The use of mental health measures in nursing home research. AB - To examine the quality of mental health research in nursing homes, 130 articles published in six geriatric specialty and health care delivery journals were reviewed. Thirty-nine (30%) articles used a mental health measure. Measures of cognitive function were most common, being used in 32 (25%) of the articles reviewed. Twenty-three (18%) studies measured abnormal mental experiences and 17 (13%) articles measured behavioral disorder. Many articles used measures or determinations with no established reliability. Twenty-six of the articles which used a mental health measure also used a measure of activities of daily living or physical function. Retrospective and prospective studies were similar in number. A minority of articles used control groups, random samples, or prepost measures while a majority (64%) identified an outcome measure. We conclude that nursing home research can be improved by the increased use of reliable measures of cognition and abnormal mental experiences and by the development of reliable measures of behavioral disorder. Study design can be improved by identifying a priori hypotheses and by the increased use of random sampling and control/comparison groups. PMID- 3553283 TI - Sympathochromaffin system activity in the elderly. PMID- 3553285 TI - Multiple nutrients in the treatment of Alzheimer's disease. PMID- 3553284 TI - The coagulase-negative staphylococci: little brother grows up. PMID- 3553286 TI - Use of ambulatory care resources by Medicare-age patients in a primary care group practice. AB - The increase in the number of persons age 65 and over-the Medicare-age group-and the increasing cost of providing medical care to patients in this group have focused attention on enrollment of these persons in capitated plans as a means of containing costs. Although much is known about resources used for inpatient care for Medicare-age patients, detailed information organized on a per-patient, per year basis about ambulatory care of these patients is lacking. In order to address this problem and to investigate possible differences in resource use by age groups within the Medicare-age population, a study was made of a primary care group practice in which 523 patients, including 174 patients in the Medicare-age group, were followed for one year to determine their use of ambulatory care resources. A comparison of annual resource use by patients age 75 and over with patients age 65 through 74 showed that patients age 75 and over made more visits for primary care (8.15 vs. 6.46), made more visits to specialty and subspecialty clinics (3.41 vs. 2.33) and had higher total charges for ambulatory care ($749 vs. $623). The pattern of use of specialty and subspecialty clinics suggests that the primary care physicians functioned effectively as gatekeepers because most medical problems were handled without referrals to medical subspecialty clinics. The pattern also suggests that the projected rapid increase between now and the year 2000 in the number of persons age 75 and over may result in a greater than anticipated demand for services provided by ophthalmologists, podiatrists, and otolaryngologists. PMID- 3553287 TI - Antecedents of death in the men of a Veterans Administration nursing home. AB - This study aims to learn whether the annual clinical and laboratory screening of nursing home residents provides significant information about their chance of dying during the following year. In August 1984, a comprehensive clinical data base was compiled for 176 male residents of this VA nursing home. During the next 14 months, 12 men were discharged to other locations and were dropped from the study; among the remaining 166, who comprised the study group of this report, 24 died. The most common immediate causes of death were infections (67%) and cardiac disorders (25%). Twenty of the deaths occurred after transfer to the acute hospital services. Among the 67 items in the clinical data base (including absence or presence of 17 diagnoses and 16 drugs), eight were significantly correlated with death rate. Age and functional impairment were directly related, and inversely related were the following: body weight as percent of ideal, triceps skin fold, hematocrit, hemoglobin, serum albumin, and serum cholesterol. Multivariate analysis showed cholesterol and hematocrit to be the most informative of the eight mortality predictors and to correlate with death independently of age and functional level. Subgroups defined on the basis of combinations of mortality-related attributes differed many fold in their death rates. For example, men with cholesterol less than or equal to 156 mg/dl and hematocrit less than or equal to 41% died at a rate 42 times the rate of men with values above both thresholds. For each mortality-related attribute, death rate varied with the level of the attribute. This relationship extended into the generally accepted "normal ranges" for cholesterol, hematocrit, hemoglobin, and albumin. PMID- 3553288 TI - Correlates of depression and burden for informal caregivers of patients in a geriatrics referral clinic. AB - Caregiver burden has been associated with patient dementia. In this study we tested the hypothesis that caregiver burden and depression are related to patient cognitive impairment. We analyzed records of 127 elderly male patients from a Veterans hospital geriatrics referral clinic. The patients and their informal caregivers had been referred to the clinic because the complexity and multiplicity of their problems were beyond the treatment capability of other clinics. There was a high prevalence of dementia (73%) and depression (69%) in these patients according to Diagnostic and Statistical Manual (DSM-III) criteria. Quantitative measures of patient dementia and dependency in activities of daily living were not statistically associated with measures of caregiver depression or burden. In contrast, measures of patient depression were significantly correlated with measures of caregiver depression and burden. We hypothesize that caregivers of chronically ill, elderly men cope better with physical and cognitive incapacity than with affective symptoms. Because caregiver support is the most important factor in maintaining a disabled elder in the community, we suggest evaluating patients and caregivers for depression as part of standard practice in geriatric clinical settings. PMID- 3553289 TI - DNA repair in relation to the aging process. PMID- 3553290 TI - Bioethics in clinical medicine: coming of age. PMID- 3553291 TI - Geriatrics. An updated bibliography. AB - This is the author's fourth revision of a geriatrics bibliography. Approximately one-third of the previous references have been replaced by more current or more detailed articles. Because the literature pertinent to geriatrics has continued to grow ever more rapidly, it has been necessary to omit many informative articles from the bibliography. Preference is given to recent publications; almost all of the references date from the past four years. Some articles were selected to highlight current controversies or changes in viewpoint. An occasional unreferred article is cited to amplify geriatric aspects of common diseases. Most of the references deal specifically with an elderly patient population, though few use a multidisciplinary approach. Studies of the elderly are confounded by concomitants of aging frequent but not universal in our society: inactivity, obesity, malnutrition, and psychosocial trauma. The articles cited concern primarily medical ailments of the elderly but legal, ethical, and sociologic topics are also covered. The references are divided into categories. The first set deals with some possible causes of aging, the second with physiologic decline accompanying aging, the third with the atypical and nonspecific characteristics of illness among geriatric patients, the fourth with the elderly and society, and the fifth with care options. The remainder of the references are cited by pertinent medical specialty. Within each category, references are divided by disease process. Articles are further subgrouped by aspects of those diseases such as evaluation or therapy. PMID- 3553292 TI - The aging kidney: structure, function, mechanisms, and therapeutic implications. PMID- 3553293 TI - Under/uninsured: getting the shaft. PMID- 3553294 TI - [Larrey and Egyptian ophthalmia]. AB - During the napoleonic expedition to Egypt (1798-1801), a new ophthalmic disease, the "egyptian ophthalmia", was discovered by the french physicians. We analysed a contemporary study published by the surgeon Jean-Dominique Larrey. The accuracy of the clinical description enables us to suggest hypotheses upon the origin if the egyptian ophthalmia: Weeks' conjunctivitis, gonorrheal conjunctivitis, trachoma. Treatments are also reviewed. Larrey is to be seen as a symbol of the transition from the old medical vision to modern clinical medicine. PMID- 3553295 TI - [Glaucoma and pseudophakia]. PMID- 3553296 TI - [Fibronectin and corneal repair]. PMID- 3553297 TI - [Antiseptic eye drops]. PMID- 3553298 TI - [Contrast sensitivity]. AB - In some patients with neural or ophthalmological lesions, normal visual acuity co exists with a significantly diminished ability to see larger objects. The converse may also occur. Based upon many years of academic research and some years of clinical application, spatial contrast sensitivity function appears to give the most general description available for the basic aspects of spatial vision performance. This review surveys the main theoretical and experimental works in neurophysiology and psychophysiology which established the significance of contrast sensitivity. PMID- 3553299 TI - Intracellular proteolytic systems may function as secondary antioxidant defenses: an hypothesis. AB - In recent years it has become clear that various free radicals and related oxidants can cause serious damage to intracellular enzymes and other proteins. Several investigators have shown that in extreme cases this can result in an accumulation of oxidatively damaged proteins as useless cellular debris. In other instances, proteins may undergo scission reactions with certain radicals/oxidants, resulting in the direct formation of potentially toxic peptide fragments. Data has also been gathered (recently) demonstrating that various intracellular proteolytic enzymes or systems can recognize, and preferentially degrade, oxidatively damaged proteins (to amino acids). In this hypothesis paper I present evidence to suggest that proteolytic systems (of proteinases, proteases, and peptidases) may function to prevent the formation or accumulation of oxidatively damaged protein aggregates. Proteolytic systems can also preferentially degrade peptide fragments and may thus prevent a wide variety of potentially toxic consequences. I propose that many proteolytic enzymes may be important components of overall antioxidant defenses because they can act to ameliorate the consequences of oxidative damage. A modified terminology is suggested in which the primary antioxidants are such agents as vitamin E, beta carotene, and uric acid and such enzymes as superoxide dismutase, glutathione peroxidase, and DT-diaphorase. In this classification scheme, proteolytic systems, DNA repair systems, and certain lipolytic enzymes would be considered as secondary antioxidant defenses. As secondary antioxidant defenses, proteolytic systems may be particularly important in times of high oxidative stress, during periods of (primary) antioxidant insufficiency, or with advancing age. PMID- 3553301 TI - Sexual factors and prostatic cancer: results from a case-control study. AB - A case-control study of a number of factors of possible etiologic significance for prostatic cancer was conducted in the Minneapolis-St. Paul area. The focus was primarily on sexual factors. Two hundred and fifty incident cases of prostatic cancer, 238 hospital controls, and 240 neighborhood controls were included. Controls were matched to cases on age, sex, and race. Cases were somewhat more educated than controls. An association was found between prostatic cancer and a history of venereal disease in their sexual partners: odds ratio (OR) = 2.71, 95% confidence interval (CI) = 1.14 to 6.46 and OR = 2.09, 95% CI = 1.02 to 4.29 for hospital and neighborhood controls, respectively. Cases had more sexual experiences with prostitutes, although their overall lifetime frequency of sexual intercourse with all partners was somewhat lower. Cases also reported more homosexual partners than controls. The results from the study lend some support to an infectious hypothesis for prostatic cancer. The lower frequency of sexual intercourse (OR = .54, 95% CI = .34 to .83 and OR = .68, 95% CI = .47 to 1.01 for hospital and neighborhood controls, respectively) is also noteworthy and may be indicative of a hormonal difference related to sexual interest or drive. PMID- 3553300 TI - Oxygen free radicals play a role in cellular differentiation: an hypothesis. AB - Evidence from a variety of sources supports the view that oxygen free radicals play a role in cellular differentiation. It is postulated that cellular differentiation is accompanied by changes in the redox state of cells. Differentiated cells have a relatively more prooxidizing or less reducing intracellular environment than the undifferentiated or dedifferentiated cells. Changes in the redox balance during differentiation appear to be due to an increase in the rate of O2- generation. Differentiated cells, in general, exhibit higher rates of cyanide-resistant respiration, cyanide-insensitive SOD activity, and peroxide concentration and lower levels of GSH as compared to undifferentiated cells. The effects of free radicals on cellular differentiation may be mediated by the consequent changes in ionic composition. PMID- 3553302 TI - Human serum pancreatic lipase and trypsin 1 in aging: enzymatic and immunoenzymatic assays. AB - Two major human pancreatic proteins, lipase and trypsin I, were measured in human sera from 35 elderly healthy adults and 51 young healthy adults. Lipase enzymatic activity was determined by a turbidimetric assay in the presence of colipase; lipase immunoreactive protein and trypsin immunoreactive protein were measured by using immunoenzymatic assays. Serum levels of the pancreatic enzymes were similar in young and elderly adults, with no significant differences between the groups for any of the assays. There was a close correlation between lipase enzyme activity and immunoreactivity in all participants, suggesting that the catalytic activity of lipase was not affected by aging. There were also significant correlations between the levels of immunoreactive lipase protein and immunoreactive trypsin protein, within and between the two groups, suggesting an age-independent relationship between these two pancreatic enzymes. PMID- 3553303 TI - The timing and necessity of bone graft surgery. PMID- 3553304 TI - Characteristics of aeromonas species and their association with human diarrhoeal disease. PMID- 3553305 TI - A transferable resistance plasmid in Vibrio cholerae and Escherichia coli isolated from the same patient. PMID- 3553306 TI - Prospective payment in perspective. AB - Prospective payment promises improvement for a health care system plagued by inefficiency and rising costs, but is likely to disappoint. Serious efforts to control costs threaten the system's access and quality objectives and will be resisted. Moreover, serious cost containment, whether the result of all-payer regulation or competition, requires a stronger civil service than America seems capable of providing. A comparison with the experience in defense demonstrates the important limitations in applying incentive-based models in policy areas with conflicting goals. The search for panaceas will go on, but there are none. PMID- 3553307 TI - The effect of nonsteroidal antiinflammatory drugs on upper gastrointestinal tract symptoms and mucosal integrity. AB - Gastrointestinal side effects are the most common adverse reactions to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), but their true incidence is controversial. Studies have shown an approximate 20% incidence of upper gastrointestinal symptoms in patients using aspirin and a 10% incidence in patients using some other NSAIDs, such as ibuprofen. Because symptom assessment is subjective and may correlate poorly with objective evidence of gastroduodenal injury, studies of endoscopic and fecal blood loss have been used to assess mucosal injury. Whereas high doses of aspirin may produce overt mucosal injury in a majority of patients and normal volunteers, ibuprofen causes significantly less qualitative and quantitative damage in a dose-dependent manner. Daily doses of 1,200 mg of ibuprofen may produce endoscopic injury and fecal blood losses similar to placebo. Although epidemiologic evidence shows a strong correlation of daily aspirin use to gastric ulcer and upper gastrointestinal hemorrhage, other NSAIDs have not been definitively linked to these lesions; no epidemiologic study has established NSAIDs as a cause of duodenal ulcer or gastric lesions when given in low doses. NSAIDs, particularly ibuprofen, in low doses can be considered to have low gastroduodenal toxicity. PMID- 3553308 TI - Hepatic effects of acetaminophen. Enhanced toxicity in alcoholics. AB - Alcoholic patients run an increased risk of developing hepatotoxicity from doses of acetaminophen within or only moderately above the recommended usual therapeutic doses. In this review I examine the scientific evidence and clinical observations that indicate such a heightened susceptibility of the alcoholic to acetaminophen-induced injury. PMID- 3553309 TI - Thyroid hormones and alcoholic liver disease. AB - Alcoholic liver disease shares with other nonthyroidal illnesses patterns of serum thyroid hormones that usually do not reflect true thyroid function. Although ethanol can affect the thyroid gland and also may directly interfere with thyroid hormone metabolism, most patients with alcoholic liver disease are euthyroid. However, some have mild hypothalamic pituitary axis dysfunction. In persons who chronically and continuously drink alcohol, there are demonstrable biochemical abnormalities similar to the effects of thyroid hormone on the liver. However, a primary pathogenetic role in alcoholic hepatitis has not been proven for this thyroid hormone mimicry. There is good clinical evidence, however, that serum thyroid hormones can serve as prognostic indicators of the course of liver disease. PMID- 3553310 TI - Cognitive-behavioral intervention for irritable bowel syndrome. AB - A 41-year-old white man with a 2-year history of irritable bowel syndrome (IBS) was referred for psychological treatment. At the time of assessment he was being treated with Metamucil and Darvocet N-100s with little success. A detailed psychosocial assessment indicated several areas for cognitive-behavioral intervention. Nine months after the patient began treatment, the frequency of IBS episodes had greatly reduced, he was off narcotic pain medication, and his general health was improved as measured by clinic and emergency room visits. We suggest that psychological interventions of the type described here can be an efficacious and cost-effective treatment for IBS. PMID- 3553311 TI - A field evaluation of pirimiphos methyl for control of malaria in Tirap district, Arunachal Pradesh, India. PMID- 3553312 TI - Lymphatic filariasis: in vitro lymphoproliferation in Wuchereria bancrofti infection. PMID- 3553313 TI - Effect of P. vivax malaria on G-6-PD pH-optima of host red cells. PMID- 3553314 TI - Hepatic echinococcosis ruptured into the biliary tract. Clinical, radiological and therapeutic features during five episodes of spontaneous biliary rupture in three patients with hepatic hydatidosis. AB - Three patients are described with hepatic involvement by Echinococcus granulosus, complicated by spontaneous rupture into the biliary tract. Clinical features consisted of upper abdominal pain, jaundice, fever, anorexia, and vomiting. Hepatomegaly and marked epigastric tenderness were consistently observed. Laboratory findings included obstructive liver function tests, leucocytosis, eosinophilia, and hyperamylasemia. Abdominal computed tomography, showing the cystic wall, the presence of wall calcifications, daughter cysts and wall enhancement, provided a correct diagnosis of hepatic hydatidosis in all patients. Dilatation of the bile ducts with the presence of intraluminal material was clearly shown by sonography and endoscopic retrograde cholangiography. These abnormalities were most frequently found in the common bile duct and in the left hepatic duct. On sonography, the intraluminal material appeared as amorphous, sludge-like hydatid sand, and as daughter cysts. On ERCP, the intrabiliary parasitic material appeared as non-homogeneous, irregularly shaped and mobile filling defects. Other findings at ERCP were displacement and distortion of intrahepatic bile ducts by the hepatic cysts and a mild dilatation of the pancreatic duct. In one occasion, evacuation of a daughter cyst through the papilla was observed. The therapeutic value of mebendazole and endoscopic sphincterotomy in our patients is discussed. PMID- 3553315 TI - Liver transplantation. A review. PMID- 3553316 TI - A controlled trial of antidepressant medication in elderly in-patients. AB - A multi-centre controlled trial of amitriptyline, dothiepin and mianserin in the treatment of depressive illness was undertaken in psychiatric inpatients over the age of 65. Despite the co-operation of many of the leading practitioners in this field in Great Britain, it proved impossible to recruit sufficient patients for firm conclusions to be drawn. Forty-five patients were entered into the trial, 13 withdrew because of lack of improvement, 4 because of intercurrent physical illness, 3 because of adverse effects of trial medication and 2 because of lack of compliance. Only 11 of the 23 patients completing had a final score on the Hamilton Depression Rating Scale of 10 or less. No treatment showed a significant superiority over the others, nor was there any difference in tolerance. PMID- 3553317 TI - Medical museum notes (Dr. John Stough Bobbs & David J. Lee). PMID- 3553318 TI - In situ localization of cartilage extracellular matrix components by immunoelectron microscopy after cryotechnical tissue processing. AB - Localization and distribution of proteoglycans within rat growth plate cartilage were investigated by immunoelectron microscopy. By use of a mixture of three monoclonal antibodies directed against chondroitin sulfate chains and of post embedding staining by protein A-gold, the immunosensitivity and resolution achieved by electron microscopy within tissue processed by high-pressure freezing, freeze-substitution, and low-temperature embedding were compared with those in tissue preserved by three alternative procedures (i.e., mild chemical fixation in combination with either low-temperature embedding or conventional embedding, and high-pressure freezing and freeze-substitution followed by conventional embedding). The loss of matrix components incurred during each stage of high-pressure freezing, freeze-substitution, and low temperature embedding was also determined by measuring the loss of [35S]-proteoglycans from tissue labeled in vivo, and the results compared with previously determined estimates for tissue processed using conventional techniques. Immunosensitivity, determined as the number of gold particles per unit area, was highest in tissue processed by high pressure freezing, freeze substitution, and low-temperature embedding. Comparable results (with a reduction of only 3-7%) were achieved within tissue preserved by mild chemical fixation followed by low-temperature embedding. In both procedures where conventional embedding was adopted, sensitivity was considerably reduced (by 51% for high-pressure freezing and freeze substitution and by 74% for mild chemical fixation). Loss of matrix components was negligible during all stages of high-pressure freezing, freeze-substitution, and low-temperature embedding. Such information, and that derived from morphological inspection of the various matrix compartments in cartilage processed by high-pressure freezing, freeze substitution, and low-temperature embedding (J Cell Biol 98:277, 1984), together demonstrate that application of this technique results in successful immobilization of proteoglycans in situ within cartilage matrix. Although loss of proteoglycans from mildly fixed cartilage embedded under low-temperature conditions is minor, morphological examination of this tissue reveals considerable shifting of proteoglycans within matrix compartments. Hence, even though immunosensitivity may be high, resolution is poor. The beauty of the high pressure freezing, freeze-substitution, and low-temperature embedding technique is that it combines high immunosensitivity with precise localization of matrix components at the molecular level. PMID- 3553320 TI - High resolution image analysis. PMID- 3553319 TI - Cytochemical detection of carbohydrate and immunocytochemical detection of relaxin in the same secretory granule. AB - We administered estradiol and progesterone to spayed guinea pigs, with resultant accumulation of secretory granules in endometrial gland cells. By initially employing protein A-colloidal gold immunolocalization of relaxin, followed by cytochemical staining of carbohydrate with the thiocarbohydrazide-silver proteinate method on the same section, we showed clearly that the secretory granules were composed of a central core containing relaxin and a cortex of carbohydrate-rich material. Use of normal rabbit serum rather than relaxin antiserum, and omission of periodic acid, demonstrated the specificity of the technique. PMID- 3553321 TI - Bacteriological examinations of drinking water in the district of Melut (Upper Nile Province) South Sudan. AB - In October and November 1983 bacteriological examinations of drinking water were done in the district of Melut/Upper Nile Province/South Sudan. The samples were taken from the middle of the White Nile, from handpumps along the river-bank, from the bank of the river and from drinking water bowls in the village of Melut and other surrounding villages within about 100 kilometers. All together 213 water samples were bacteriologically examined. The examinations of the samples taken from the river-bank and from the drinking water bowls showed very high plate counts (10(4)-10(7) colonies/ml) and a very high identification rate of Escherichia coli (11.1-31.5%) and of coliforms (82.1-92.8%). The water from the middle of the White Nile and from the handpumps, which are pumping water from a distance of 25 meters from the river-bank, had a better bacteriological quality. The plate counts were about 10(3)-10(4) colonies/ml. Escherichia coli could only be identified in one sample from the handpumps (4.4%) and coliforms were found in 40% of the samples of the middle of the Nile and in 48.8% of the samples from the handpumps. The trial to get qualitative better water with handpumps from regions far away from the river-bank, can be viewed as successful. PMID- 3553322 TI - Normalizing effect of immunoglobulins in the treatment of endogenous infection and intestinal dysbacteriosis in irradiated mice. AB - It has been demonstrated in experiments on 2160 CBA mice and mice of mixed breed, irradiated by LD90/30, that therapeutical administration (subcutaneous or intraperitoneal) of immunoglobulins - homologous (polyglobulin, IgG, IgM) or heterologous - polyglobulin, IgG (from human, equine, canine blood) repeated three times, i.e., 2, 24 and 48 hours after irradiation, not only induces longer survival, but also shows a normalizing effect on the commonly developing dysbacteriosis and increased amount of intestinal microflora and, in addition, leads to suppression of postirradiation endogenous infection. Enterobacteria, enterococci, staphylococci, yeasts, disappear from the small intestine or their quantity decreases substantially in treated irradiated mice in contrast to untreated irradiated mice. In the large intestine, the amount of these organisms decreases considerably while the content of lactobacteria increases; no microbes can be found in the internal organs and in blood (or their content is small). Other conditions being equal, homologous immunoglobulins are more efficient in comparison with heterologous, this applying also to preparations containing normal antibodies to tissues. PMID- 3553324 TI - Effect of immunodeficiency on diabetogenesis in genetically diabetic (db/db) mice. AB - The pathogenesis of diabetes in C57BL/KsJ-db/db mice has been proposed to entail autoimmune mechanisms. We have combined immunodeficiency genes with the db mutation to determine whether beta cell necrosis and establishment of severe diabetes would occur in the absence of normal T and/or B lymphocyte functions. Inbred mice carrying the recessive mutations, severe combined immunodeficiency (scid), X-linked immunodeficiency (xid), nude (nu), and the Y-linked autoimmune accelerator (Yaa), were crossed with strains congenic for the db mutation. The diabetes syndrome was studied in double homozygotes produced in the F2 generation. In another experiment, C57BL/KsJ-db/db males were made T cell function deficient by adolescent thymectomy followed by lethal irradiation and bone marrow reconstitution. None of these manipulations served to prevent the induction of a severe diabetes syndrome in any of the model systems analyzed. Thus, diabetogenesis characterized by massive necrosis of the pancreatic beta cells and atrophy of the pancreatic islets was observed in both the absence of normal T cell function (as assessed by absence of T cell mitogen response) and humoral autoimmunity against beta cell antigens (insulin, retroviral p73). In conclusion, our data indicate that anti-beta cell autoimmunity is not a primary event in the etiopathogenesis of diabetes in the db/db mouse. PMID- 3553323 TI - Activation of human B cells: alternate options for initial triggering and effects of nonmitogenic concentrations of anti-IgM antibodies on resting and activated cells. AB - The monoclonal antibody 1F5, which is reactive with the CD20 (Bp 35) pan-B cell antigen, was shown to activate resting human peripheral blood B cells into the middle to late G1 phase of the cell cycle. However, in contrast to F(ab')2 fragments of polyclonal anti-mu, 1F5 synergized only weakly with B cell growth factor (BCGF) for DNA synthesis in these cells. We provide evidence that the CD20 molecule and surface immunoglobulin represent two alternative activation pathways in resting B cells. We also show that anti-immunoglobulins, during co-stimulation with BCGF, may play an important role in G1 as well as for the initial cell triggering. Thus, anti-mu in nonmitogenic concentrations was shown to provoke distinct effects on 1F5-pretreated G1 cells, as monitored by increases in cellular volumes as well as in cytoplasmic Ca2+ levels. Moreover, anti-mu could increase c-myc mRNA levels in 1F5-primed cells, implying that c-myc expression can be regulated in G1 as well as during the initial G0 to G1 transition. Partially purified human BCGF neither induced G1 entry in resting peripheral blood cells nor primed the cells for DNA synthesis. The finding that BCGF did not influence c-myc mRNA levels in resting or in activated B cells suggests that its mitogenic action does not involve the c-myc function. PMID- 3553325 TI - IL 1-like activities present in murine amniotic fluid. A significantly larger amount of IL 1 beta-like activity is present in the amniotic fluid of autoimmune NZB mice. AB - Rapid progress in studies of cytokines have clarified their roles in processes of lymphocyte proliferation and differentiation. However, the involvement of these molecules in lymphopoiesis during embryonic development has not yet been well documented. In this study we screened for possible existence of cytokines that influence lymphopoiesis in murine amniotic fluid (AF) obtained from non autoimmune prone "normal" strains of mice (CBA/J, BALB/c, A/J, SWR, and C57B/6) and autoimmune-prone NZB mice. Significant colony stimulating activity-1 (CSA-1) like activities were found in AF of all of the strains tested, but relatively low activities were present in AF of NZB mice. No interleukin 2 (IL 2) or interleukin 3 (IL 3)-like activities were detected, Weak IL 1-like activity was found in AF of most of the strains tested; however, the results of the standard thymocyte proliferation assays varied with each AF sample. This variation is probably related to the presence of nonspecific inhibitors including alpha-fetoprotein in murine AF. Therefore, pooled AF from CBA and NZB strains of mice were subjected to several purification procedures to assess the actual amount of IL 1-like activity present in murine AF. After (NH4)2SO4 precipitation and hydrophobic phenyl-Sepharose chromatography, the measurable level of IL 1-like activity could be increased significantly. With lentil-lectin affinity chromatography, IL 1-like activity was completely dissociated from CSA-like activity. Moreover, a significantly larger amount of IL 1-like activity was found in NZB AF fractions (approximately sixfold higher). Apparent pI values estimated by preparative isoelectric focusing (IEF) were 5.9, 7.2, and 7.4 in CBA AF fractions, and 6.5 and 7.3 in NZB AF fractions. The NZB AF fraction with pI of 7.3 showed significantly higher IL 1 activity than the other fractions studied. These partially purified molecules were found to be resistant to pH 2 and the reducing agent, 2-mercaptoethanol, but were inactivated by heat (56 degrees C, 1 hr) or trypsin. None of the fractions showed IL 2-like activity but some that had IL 1 like activity induced IL 2 production in a IL 1-dependent, IL 2-producing B lymphoma cell line. Apparent m.w. of these IL 1-like activities were 14,000, 14,500, 17,000, 18,000, and 21,000 in CBA AF fractions, and 15,000, 19,000, and 21,000 in NZB AF fractions according to SDS-polyacrylamide gel electrophoresis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3553326 TI - The diversity of the secondary Salmonella typhimurium-specific B cell repertoire. AB - This report describes the first analysis of the expressed B cell repertoire specific for a bacterium. In this study, responses to an acetone-killed and dried preparation of Salmonella typhimurium strain TML (AKD-TML) are described. The results show that AKD-TML can stimulate splenic B cells from primed CBA/Ca mice over a wide dose range. The average frequency of secondary TML-specific B cells is 16.4 per 10(5) splenic B cells. This frequency is similar to that observed for another complex, natural antigen, the hemagglutinin of influenza virus. The majority of all secondary TML-specific B cells (greater than 70%) secrete immunoglobulin M, but most of these clones also secrete other isotypes of which immunoglobulins G2 and A are the most prevalent. Analysis of the specificity of secondary TML-specific B cells showed that the vast majority of these B cells were specific for the lipopolysaccharide (LPS) molecule. Moreover, fine specificity analysis demonstrated that approximately two-thirds of these anti-LPS specific B cell clones are directed against the core polysaccharides or lipid A regions of the LPS molecule, while only about one-third are directed toward the O antigen region. Since anti-S. typhimurium serum antibodies are directed primarily against the O antigens, these studies suggest that the serum levels of antibodies to a given epitope on a bacterial antigen may not be a true reflection of the expressed B cell repertoire when analyzed at the single B cell level. These studies also suggest that the role of antibodies to lipid A molecules in the development of protective immunity to S. typhimurium be reevaluated. PMID- 3553327 TI - Neutrophil recruitment and bacterial clearance correlated with LPS responsiveness in local gram-negative infection. AB - The inflammatory response to Gram-negative infection was studied in LPS responder and nonresponder C3H mice. Twenty-four hours after ascending E. coli urinary tract infection, an influx of neutrophils into the urine was observed in C3H/HeN mice (Lpsn,Lpsn); no significant neutrophil influx occurred in C3H/HeJ mice (Lpsd,Lpsd) at this time. A second peak of urinary neutrophil excretion was observed in both strains of mice approximately 6 days post-infection. The first, but not the second peak was inducible by inoculation with formalin-killed E. coli but not by Gram-positive bacteria. This finding suggested that the first peak is triggered by LPS, whereas the second peak emanates from other bacterial components which activate both LPS responder and nonresponder mice. The first peak of the inflammatory response was inversely related to bacterial clearance. C3H/HeJ mice (Lpsd,Lpsd) retained about 2000-fold more E. coli in the kidneys than C3H/HeN mice (Lpsn,Lpsn). The infection persisted despite the late-occurring influx of neutrophils in C3H/HeJ mice. These results suggest that an inflammatory response to LPS is required for the elimination of a local Gram-negative infection. PMID- 3553328 TI - Measurement of antibody to Jo-1 by ELISA and comparison to enzyme inhibitory activity. AB - Antibody to the Jo-1 antigen (histidyl-tRNA synthetase) is found almost exclusively in myositis patients, usually those with adult PM, but has been found in only 30% of that group by immunodiffusion or other techniques thus far reported. We have reexamined the prevalence of antibody to Jo-1 in sera from 130 patients and 82 controls by using the sensitive ELISA technique. The ELISA used affinity-purified, enzymatically active bovine Jo-1 antigen. A wide range of antibody level by ELISA was found among 24 immunodiffusion positive sera. Six myositis and two control sera had apparent specific antibody detectable only by ELISA. Overall, however, the antibody continued to show high myositis specificity with predominance in adult PM (35.8% in that group). Because the antibody inhibits enzymatic activity of the synthetase antigen, we also studied the quantitative inhibitory activity of these sera to compare with the antibody activity as determined by ELISA. Twenty-four immunodiffusion-positive sera, 29 immunodiffusion-negative sera, and 15 normal sera were tested at 1/50 dilution in the reaction mixture. There was background inhibition by all normal sera tested that averaged 30.5%. All but one immunodiffusion negative myositis sera (a high binder by ELISA) inhibited less than 50% of the average with normal serum. Twenty three of 24 immunodiffusion positive sera inhibited greater than 80% of this normal average; the other inhibited 66%. The serum dilution giving 50% inhibition was highly correlated (R = 0.83) with the ELISA activity. Thus, inhibition of histidyl-tRNA synthetase activity is a relatively accurate measure of Jo-1 antibody. This method should be applicable to measuring antibody to other aminoacyl-tRNA synthetases. PMID- 3553329 TI - Murine monoclonal anti-DNA antibodies bind directly to glomerular antigens and form immune deposits. AB - The capacity of monoclonal anti-DNA antibodies, derived spontaneously from MRL lpr/lpr mice, to bind directly to intrinsic glomerular antigens and form immune deposits was evaluated. Two antibodies, H130 (IgM-kappa) and H241 (IgG2a-kappa), bound to normal glomeruli in vitro. This binding was not inhibited by DNAase, but it was, in the case of H130, inhibited by the anti-idiotype anti-H130. Both antibodies also bound to glomerular digests on nitrocellulose. After i.v. injection, however, H241 bound to glomeruli and formed glomerular immune deposits, whereas H130 did not. Similarly, after i.p. injection of H241 hybridomas to normal mice, all mice developed glomerular immune deposits. In contrast, administration of H130 hybridomas, other anti-DNA-producing hybridomas, and other unrelated hybridomas did not lead to glomerular immune deposit formation. We conclude that certain lupus auto-antibodies can form glomerular immune deposits by binding directly to non-DNA antigenic structures that are normally present in extracellular locations within normal glomeruli. PMID- 3553330 TI - Identification and partial characterization of a parasite antigen in sera from humans infected with Wuchereria bancrofti. AB - The purpose of this study was to identify and characterize soluble parasite antigens present in sera from humans infected with the filarial nematode Wuchereria bancrofti. Affinity chromatography and immunoblot methods were used to demonstrate a 200,000 m.w. circulating parasite antigen in sera from infected humans which corresponded to an antigen released by adult W. bancrofti during in vitro culture. Two monoclonal antibodies were produced to this antigen by immunizing mice with antigens from Dirofilaria immitis, a filarial parasite that is closely related to W. bancrofti, and screening cell fusion supernatants by enzyme immunoassay and counterimmunoelectrophoresis inhibition. The antibodies bound to a single repeated epitope (not phosphorylcholine) that was resistant to heat, acid, and protease treatments but sensitive to periodate oxidation. Immunoperoxidase studies showed that the epitope was concentrated in the cuticle and reproductive organs in D. immitis, and it was released in relatively large amounts by adult female D. immitis in vitro. The epitope is also present in antigens of other species of filarial and nonfilarial nematodes, but on the basis of preliminary studies, its presence in human serum appears to be specific for W. bancrofti infection. PMID- 3553331 TI - The quantitation of HLA-DR expression on human cells using immunocytochemistry. AB - An immunocytological method that can be used to quantify the comparative expression of Class II HLA-DR antigens on human cells has been developed. Tissue sections or cytospins are incubated with the monoclonal antibody RFDR1 (anti-HLA DR), conjugated to the enzyme glucose oxidase (GO). The bound McAb is identified by incubation with the substrate beta-D-glucose and capture of the reducing equivalents generated by a tetrazolium salt forming an insoluble formazan. Under standard conditions the amount of formazan precipitated is proportional to the amount of McAb bound to the cells or tissue and thus the amount of HLA-DR expressed. The reaction has been quantified both by spectrophotometry (on tissue sections) and by microdensitometry (on cell spreads). Computer analysis has been used to relate density of HLA-DR expression to cell area. Repeated 'blind' measurements by separate investigators have confirmed the reproducibility of the results. It is suggested that this method adds a new dimension to immunohistological/cytological analysis of tissues and single cells. PMID- 3553332 TI - Multiple solid-phase system for storage of dry ready-for-use reagents and efficient performance of immunoenzymatic and other assays. AB - A modular system of independent but matching solid phases coated with the reagents for the slide immunoenzymatic assay (SIA) was developed. Antigen, antiserum, second antibody labeled with enzyme, and substrate are immobilized as dry films onto circles surrounded by a hydrophobic material on separate glass slides. The reagents stay on the circles ready for use for at least 1 year. Circles coated with the two reagents involved in each step of the assay are approximated to one another by pairing slides, one on top of the other. Hinged slide frames ensure exact superposition of circles with matching reagents separated by a gap 1 mm thick. This is occupied by a liquid column that forms from a 10 microliters drop of water or buffer pre-deposited onto the circles of the bottom slide. The liquid bridge provides the milieu for interaction of reagents. Pairs of slides are incubated as needed for each step. The enzymatic reaction of the last step is read with a vertical beam spectrophotometer. The same multiple-phase system can be used for immunofluorescence. Reactions occur faster using the system than when reagents are admixed in solution. PMID- 3553333 TI - Purification of C1 inhibitor. A new approach for the isolation of this biologically important plasma protease inhibitor. AB - C1 inhibitor (C1-INH) acts to inhibit active enzymes of both the classical complement and Hageman factor-dependent pathways. Previously reported C1-INH purification procedures were multistep and most have been associated with significant loss in specific functional activity. We have developed a simple chromatographic procedure which yields a pure C1-INH protein from normal human plasma with a specific activity equal to or greater than the starting sample. Briefly, protease inhibitor-treated, pooled human citrated plasma was fractionated with polyethylene glycol (PEG 4000); the supernatant fraction that remained soluble at 16% was obtained. The inhibitor was precipitated with 45% PEG. The resulting precipitate was solubilized and chromatographed on DEAE Sephacel using a linear salt gradient. The eluted fractions containing the C1-INH and other contaminants were pooled and dialyzed against the starting buffer of the next chromatographic step. A unique separation procedure using zinc ion chelate-coupled agarose was employed as the second chromatographic step. The eluted C1-INH, after zinc ion chromatography, displayed a significant enhancement in purity and maintained a specific functional activity twice that of plasma. The final procedure utilized immunoadsorption chromatography using an anti contaminant column. Under reducing conditions on sodium dodecyl sulfate polyacrylamide gel electrophoresis, the purified C1-INH migrated as a single band with an apparent molecular weight of 90,000-105,000, but under non-reducing conditions, a doublet with apparent molecular weights of 94,000-100,000 and 85,000-93,000 was seen. C1-INH antigenic concentrations were measured and shown to be correlated in serum, citrate plasma, and EDTA plasma from 16 normal subjects. PMID- 3553334 TI - A monoclonal-based, two-site enzyme immunoassay of human insulin. AB - A procedure is described for the efficient production of insulin-specific monoclonal antibodies, which involves primary and secondary immunization of BALB/c mice in the hind footpads with bovine or porcine insulin and fusion of lymphocytes from popliteal lymph nodes with a P3x63 murine myeloma line. With this protocol, over 200 positive hybrids were obtained from four separate fusions. Dissociation constants of 31 purified monoclonals, cross-reacting with human insulin, were determined by two different methods and ranged between 4 X 10(-10) and 2 X 10(-6) mol/l. 24 monoclonals were biotinylated, paired in all possible combinations and tested by ELISA for their capacity to simultaneously bind to human insulin in a two-site assay. More than 40 monoclonal pairs were found which formed a sandwich with the hormone. The development of a simple and rapid one-step enzyme immunoassay is described, which involves a first monoclonal bound to the wells of a microtiter plate and a second monoclonal conjugated to alkaline phosphatase. With this assay, insulin can be determined in a range between 0.08 and 7.5 ng/ml in 3-4 h. PMID- 3553335 TI - Extranodal lymphoma in the head and neck region. PMID- 3553336 TI - Double-blind comparative trial of standard (commercial) and antibody-affinity purified tetanus toxoid vaccines. AB - Tetanus toxoid purified by antibody-affinity chromatography, was compared with conventionally purified material in a double-blind trial in 205 healthy blood donors. There was neither any difference in immunogenicity as assessed by enzyme linked immunoassay nor in side-reactions between the two vaccines. This study confirms that side-reactions to tetanus toxoid are not eliminated by purifying it. PMID- 3553337 TI - The antibody response to Cryptosporidium: development of a serological test and its use in a study of immunologically normal persons. AB - The demonstration of an immune response in the relatively newly recognised infection of human beings, cryptosporidiosis, is essential for assessing pathogenicity, for diagnostic purposes, and for epidemiological studies. In addition, serological methods may be applied to the detection and definitive identification of the parasite. Earlier reports were of histologically based methods with tissue from experimentally infected animals and did not define the nature of the response. The method described here is simple and rapid. It may be done in laboratories not equipped to perform the earlier methods. Results confirm that oocysts may be used to detect antibody in the blood of human beings, to determine when sero-conversion takes place and to define the nature of the response in terms of the class of immunoglobulin. Some sero-epidemiological observations have been made. PMID- 3553338 TI - Salmonella infections of the abdominal aorta cured with prolonged antibiotic treatment. AB - Three cases of endovascular infection of atherosclerotic aneurysm of the abdominal aorta due to Salmonella spp. are described. 'Breakthrough' or relapsing bacteraemia were major clues for diagnosis in each case. They were treated with a prolonged course of bactericidal antibiotics before surgery. Resection with an interposed graft was performed in all cases and antibiotic treatment continued. Two of our patients have survived for more than two years and the other for 18 months without evidence of relapse. Thus, it would appear possible at times to treat successfully mycotic aneurysm of the abdominal aorta with antimicrobial agents plus resection of the aneurysm followed by in situ bypass grafting. Extra anatomical grafts should be kept for infections due to antimicrobial-resistant organisms or when periaortic infection is widespread. PMID- 3553339 TI - Unsuspected streptococcal infection presenting with diarrhoea in late pregnancy. PMID- 3553341 TI - Demonstration of Skn antigens on mouse epidermal cells by immunofluorescence and flow cytometry. AB - C57BL/6 (B6) mice that were lethally irradiated and reconstituted with (B6XA/J)F1 spleen cells were immunized against the skin-specific antigens, Skn, by grafting with A/J tail skin. Serum from these mice was shown to contain Skna-specific antibody by a flow cytometric assay using indirect immunofluorescence. PMID- 3553340 TI - Dermatitis herpetiformis: extraction of intact IgA from granular deposits in dermal papillae. AB - Dermatitis herpetiformis (DH) is characterized by the granular deposition of IgA in the dermal papillary tips. The source and antigenic specificity of this IgA are unknown, largely because of the previous inability to isolate it for study. These granular IgA deposits, pathognomonic of DH, have been specifically isolated from 4-mm punch biopsies. Specific isolation was achieved by removing contaminating serum IgA by a combination of washes in saline and sodium dodecyl sulfate without a reducing agent present and mechanical isolation of papillary dermis. The tissue IgA was then solubilized by a buffer containing 1% sodium dodecyl sulfate and 0.2 mM dithiothreitol, a reducing agent. Immunoreactive alpha chains were recovered in eluates of DH skin in 6-fold greater amounts than in eluates of normal skin, coincident with disappearance of immunofluorescent staining granular deposits of IgA. Extracted specific IgA was recovered in sufficient quantity for detection by immunoenzymatic stain, was partially composed of a native (165 Kd) molecular mass, and had alpha and kappa staining material, all indicating that the extracted immunoglobulin was in part intact. PMID- 3553342 TI - Blood flow, temperature, and heat loss of skin exposed to local radiative and convective cooling. AB - The relationship between skin blood flow (SBF) and temperature was evaluated and the heat loss calculated for locally applied thermal stimuli. In 10 subjects the palm was exposed to room climate, pure convective air currents, and pure radiation, which resulted in skin temperatures between 23 and 36 degrees C. Skin blood flow was estimated by laser Doppler flowmetry and local skin temperature was measured by a thermistor probe. Linear regression of SBF on skin temperature revealed significant correlations (r = 0.87, p less than 0.05) within subjects and large variations in estimated slopes (s/m = 34%) between subjects. Therefore, SBF was normalized to the room climate value in each separate experiment. When skin temperature and normalized SBF from all subjects were included in the regression analysis, a nearly linear relationship was confirmed (r = 0.88, p less than 0.0005). Radiative cooling (17 degrees C) doubled the heat loss, reduced skin temperature by 3.7 degrees C, and left SBF virtually unchanged compared with room climate values. When convective cooling (19 degrees C) was applied at 2 air current velocities (0.5 and 1.0 ms-1), palm blood flow diminished to 60 and 53%, respectively, of room climate values. Corresponding heat losses with convective cooling decreased to 68 and 70%, respectively, of room climate values. Linear regression of local heat loss on normalized SBF gave a significant correlation coefficient of 0.79 (p less than 0.001). PMID- 3553344 TI - Antibody response to human immunodeficiency virus after primary infection. AB - The antibody response to human immunodeficiency virus (HIV) after primary infection was monitored in eight homosexual men with the acute mononucleosis-like illness associated with seroconversion. Multiple sera from each subject, taken at frequent intervals after onset of acute illness, were tested for antibody to HIV by IgM and IgG immunofluorescent assays (IFAs), four commercial enzyme-linked immunosorbent assays (ELISAs), and Western immunoblot (WB). Antibody to HIV was detected first by IgM IFA (mean +/- SD, 5 +/- 3 days), followed by IgG IFA (11 +/ 3 days); the IgM antibody titer peaked at 24 +/- 17 days and disappeared by 81 +/- 27 days, whereas the IgG antibody titer peaked at 133 +/- 63 days and has not disappeared in any subject. Antibody to HIV was first detected by ELISA from 31 +/- 14 to 58 +/- 32 days, depending on the assay kit used. Antibody to p24 and gp41 was first detected by WB at 24 +/- 10 days, followed by antibody to p55 (40 +/- 20 days), p68 (57 +/- 19 days), and p34 (71 +/- 22 days). PMID- 3553343 TI - Ultrasonic assessment of skin and wounds with the scanning laser acoustic microscope. AB - The aim of the present study was to test the hypothesis that ultrasonic propagation properties in skin and wound tissue would correlate with material properties such as collagen content, water content, and tensile strength of those tissues. Both ultrasonic speed and ultrasonic attenuation coefficient were directly correlated with tissue collagen content, [r = 0.80 and r = 0.56, respectively (p less than 0.001)]. In addition, ultrasonic speed and attenuation coefficient were inversely correlated with tissue water content, [r = -0.57 and r = -0.73, respectively (p less than 0.001)]. Tensile strength also correlated very significantly with ultrasonic speed (r = 0.90, p less than 0.001), and significantly with attenuation coefficient (r = 0.58, p less than 0.001). The results demonstrate the feasibility of using ultrasound for noninvasively determining the material properties of biologic tissues including healing cutaneous wounds. PMID- 3553345 TI - Unusual occurrence of an epidemic of type Ib/c group B streptococcal sepsis in a neonatal intensive care unit. AB - An epidemic of late-onset sepsis due to type Ib/c group B Streptococcus (Ib/c GBS) occurred in a neonatal intensive care unit (NICU). During a seven-week period, five very low birth weight infants (index cases [ICs]) more than four weeks of age became bacteremic. Bacteriologic surveillance of neonates revealed persistent colonization in three ICs and identified three asymptomatic carriers (ACs). All ICs and one AC acquired Ib/c-GBS nosocomially, whereas the other two ACs were colonized at birth. Among nursery personnel, 39% carried GBS, but only two harbored Ib/c-GBS. Although phage typing of Ib/c-GBS isolates identified two patterns of susceptibility, we believe a single strain was involved in the epidemic, because the patterns overlapped and most isolates carried the same lysogenic phage. Analysis of events suggested infant-to-infant spread via the hands of personnel, but acquisition from the colonized staff was also possible. The control measures instituted prevented further spread of Ib/c-GBS in the NICU. PMID- 3553346 TI - Immunization with glycoprotein subunits of respiratory syncytial virus to protect cotton rats against viral infection. AB - The cotton rat model of respiratory syncytial virus infection was used to study immunization with viral glycoproteins. Animals immunized with the purified attachment protein (G) or the fusion protein (F) developed complete pulmonary resistance, but only partial nasal resistance, to challenge with respiratory syncytial virus. Antibody produced to the G protein neutralized virus, whereas antibody to the F protein neutralized virus and also inhibited fusion of infected cells. There was no evidence of enhanced pulmonary pathology in any immunized group. PMID- 3553347 TI - Efficacy of malaria prophylaxis in American and Swiss travelers to Kenya. AB - The protective effect of malaria chemoprophylaxis with either Fansidar (pyrimethamine-sulfadoxine) or chloroquine was estimated by determining the attack rates of Plasmodium falciparum infections acquired in Kenya and imported by U.S. and Swiss travelers who had used no chemoprophylaxis, who had used only chloroquine for prophylaxis, and who had used Fansidar weekly, either alone or in combination with chloroquine. The estimated attack rates were almost identical in U.S. and Swiss travelers. The attack rate per 100,000 travelers averaged 280 in those who did not use chemoprophylaxis, 162 in those who took 4-aminoquinolines (P greater than .05), and 27 in those who used Fansidar for prophylaxis (P less than .001). Non-immune travelers to Kenya have an appreciable risk of acquiring a P. falciparum infection and need to be informed of current guidelines for chemoprophylaxis. The changing drug susceptibility patterns in Africa require continuous evaluation of the efficacy of recommended drug regimens for malaria prophylaxis. PMID- 3553348 TI - Selective ceftazidime resistance in Escherichia coli: association with changes in outer membrane protein. AB - A strain of Escherichia coli (MG/32) was recovered from the blood of a patient who had received ceftazidime for eight weeks. The isolate was resistant to ceftazidime but susceptible to other third-generation cephalosporins. Alterations in outer membrane proteins were implicated in this selective ceftazidime resistance. As ceftazidime susceptibility was regained, the quantity of outer membrane proteins of 37,000 and 39,000 molecular weight increased. Although the isolate possessed a TEM-1 beta-lactamase, this enzyme was not involved in the selective resistance to ceftazidime; it did not disappear on reacquisition of ceftazidime susceptibility and did not hydrolyze the drug. Potassium clavulanate enhanced the activity of ceftazidime against E. coli strain MG/32, but this enhancement was due to a direct effect on outer membrane proteins and not to beta lactamase inhibition. PMID- 3553349 TI - Effect of antimicrobial therapy for experimental infections due to group B Streptococcus on mortality and clearance of bacteria. AB - In an effort to develop more effective antimicrobial therapy, we evaluated three alternative regimens currently available to clinicians for their efficacy against experimental bacteremia and meningitis due to group B Streptococcus (GBS) in newborn rats: various doses of penicillin G (100, 200, 400, or 800 mg/kg per day), combined penicillin G-gentamicin vs. penicillin G, and ceftriaxone vs. penicillin G. Higher doses of penicillin G and ceftriaxone exhibited significantly greater bactericidal activity in blood and cerebrospinal fluid (CSF), whereas the bactericidal activity of penicillin G plus gentamicin was not significantly different from that of penicillin G. Clearance of GBS from blood was significantly more rapid in animals receiving ceftriaxone. However, differences in death rates were not apparent with any single regimen. These findings suggest that clearance of GBS from blood and CSF can be improved by more potent antimicrobial agents, but further reduction in the death rate may be difficult to achieve by antimicrobial therapy alone. PMID- 3553350 TI - Colonic hemorrhage produced in mice by a unique vero cell cytotoxin from an Escherichia coli strain that causes hemorrhagic colitis. AB - A Vero cell cytotoxin that produces colonic lesions and subsequent colonic hemorrhage in mice has been purified from a strain of Escherichia coli O157:H7 that causes hemorrhagic colitis in humans. This toxin is different in physicochemical properties from the Shiga-like toxin previously associated with this organism and may be responsible for the unique diffuse mucosal hemorrhage in the colon of individuals with E. coli O157:H7 infections. PMID- 3553351 TI - An oligonucleotide probe for detecting Plasmodium falciparum: an analysis of clinical specimens from six countries. PMID- 3553352 TI - Plasmodium falciparum malaria and Salmonella infections in Gambian children. PMID- 3553353 TI - An interlaboratory study of antibody to Borrelia burgdorferi. PMID- 3553354 TI - Chloroquine and Fansidar prophylaxis--a reply. PMID- 3553355 TI - Differentiation and transdifferentiation of mast cells; a unique member of the hematopoietic cell family. AB - Information about the differentiation of mast cells has increased remarkably in the past ten years. This progress has resulted from the introduction of techniques which developed in other fields of experimental hematology. Once mast cells were recognized as a progeny of multipotential hematopoietic stem cells, their unique differentiation processes were clarified. Although most of the progeny of stem cells leave the hematopoietic tissue after maturation, undifferentiated precursors of mast cells leave the hematopoietic tissue. Morphologically, unidentifiable precursors migrate in the bloodstream, invade the connective tissues or the mucosa of the alimentary canal, proliferate, and differentiate into mast cells. Even after their morphological differentiation, some mast cells retain an extensive proliferative potential. There are at least two subpopulations of mast cells: a connective-tissue type and a mucosal type. Connective tissue-type and mucosal mast cells can be distinguished by histochemical, electron microscopical, biochemical and immunological criteria; however, these two types can interchange, and their phenotypes are determined by the anatomical microenvironment in which their final differentiation occurs. Although biochemical natures of the anatomical microenvironment are unknown, molecules that support proliferation and differentiation of mast cells in vitro have been characterized, i.e., interleukin 3 and interleukin 4. In the next ten years, increased information about the differentiation processes will probably induce further understanding of mast cell functions. PMID- 3553356 TI - The human tumor clonogenic assay as a model system in cell biology. AB - The human tumor stem cell (clonogenic) assay (HTCA) is a soft agar system designed for growing fresh human tumor specimens in vitro. The assay has been extensively used in studies both of individual patients' response to chemotherapy and for screening new agents. The technical limitations of this assay have been extensively discussed. The use of this test as a model system to study fundamentals of tumor cell growth has not been stressed. The potentials and limitations of this assay for the study of the regulation of tumor growth are presented. PMID- 3553357 TI - A seroepidemiological study of visceral leishmaniasis in two different districts in Alexandria, Egypt. PMID- 3553358 TI - Antischistosomal chemotherapy. PMID- 3553359 TI - Malaria in El-Taif, Saudi Arabia. PMID- 3553360 TI - Effect of dosage and route of inoculation on parasitaemia in white rats and guinea pigs to Plasmodium berghei infection. PMID- 3553361 TI - A comparative study of the efficacy of WHO and IAL multidrug therapy regimens for leprosy--an in-vivo and in-vitro study. AB - In the absence of definite evidence on utility of intensive therapy with rifampicin in multibacillary leprosy cases, a laboratory based investigation was undertaken basically to compare the efficacy of WHO and IAL regimens. In each group 4 untreated BL-LL patients were included and their skin biopsies were subjected for viability test both in vitro and in vivo systems. A consistant fall in BI with good clinical improvement was observed in both the groups. However good viability was maintained till about third pulse dose in WHO group whereas under IAL group rapid fall in viability was observed after intensive phase. Viable bacilli were seen even after 12,15,18 and 24 doses in both groups. These findings question the need for additional 21 doses of rifampicin in IAL schedule. However such studies are to be repeated on larger samples. PMID- 3553363 TI - On the "Culture medium for cultivation of M. leprae" published by Dr. Laszlo Kato. PMID- 3553362 TI - Multiple relapses in borderline leprosy--a case report. AB - A case of borderline lepromatous leprosy with a history of 5 years duration of disease, was first seen in 1971 and treated with graded doses of dapsone in the OP Clinic of the Institute. He became inactive and bacteriologically negative in 3 years. While continuing on dapsone therapy he relapsed into active dapsone resistant leprosy 3 1/2 years later. He was admitted in the hospital and given Rifampicin 600 mg. daily for 15 days along with dapsone 100 mg. daily. He again became inactive and bacteriologically negative within 3 years. 3 years later under regular dapsone therapy he relapsed again for the second time into active BT leprosy, but remained bacteriologically negative. He was given 3 drug regimen subsequently and became clinically inactive within 15 months. PMID- 3553364 TI - Bacillaemia in smear negative leprosy. PMID- 3553365 TI - Obligate intracellular parasites do not synthesize ATP. PMID- 3553366 TI - [A new model of heterotopic cardiac transplantation for biventricular bypass in the dogs]. PMID- 3553368 TI - [Rudolf Schoenheimer: a biographical essay]. PMID- 3553367 TI - [Renal function after open heart surgery--clinical evaluation of beta 2 microglobulin concentration in serum and urine]. PMID- 3553369 TI - [Structure and biological activity of complement receptors, CR1, CR2 CR3]. PMID- 3553370 TI - [Glucokinase and insulin secretion]. PMID- 3553371 TI - [Cellular and molecular basis for tissue construction: role of cadherins in selective cell adhesion]. PMID- 3553372 TI - T cell receptor gene rearrangements in cells with natural killer activity in the mouse. AB - Cell-mediated recognition can operate at different levels of complexity and specificity based largely on the time of appearance of effector mechanisms during the course of evolution. Antigen-specific cytotoxic T lymphocytes require both T cell receptor genes and lectin-like cell adhesion molecules (LFA-1, LFA-2, lymphocyte function-associated) to initiate and maintain stable effector target cell conjugates. Natural killer (NK) cells, on the other hand, do not require expression of T cell receptor genes in the recognition and killing of tumor cells and virally infected cells. Adhesion is mediated by a family of glycoprotein molecules, of which the LFA-1 and LFA-2 molecules appear as the most likely candidates. NK-mediated cytolysis proceeds in the absence of MHC restriction, but nevertheless appears to be triggered by depressed levels of self MHC products on the cell surface of target cells. Finally, interleukin 2-dependent, cloned cell lines with NK-like cytotoxic activity should no longer be considered as bona-fide NK cells but rather reclassified as a subset of T cells which displays NK function. PMID- 3553373 TI - Expression of recombinant immunoglobulin genes to produce novel molecules with specific functions. PMID- 3553376 TI - [Pathophysiology and treatment of thrombosis. (3) Protein C deficiency and thrombosis]. PMID- 3553374 TI - Induction of MHC-restricted specificity and tolerance in the thymus. PMID- 3553375 TI - [Clinical features of adrenocortical carcinoma--report of 6 patients]. PMID- 3553377 TI - [Pathophysiology and treatment of thrombosis. 2. Pathophysiology and diagnosis of thrombosis. (1) Hemorheological approach to the pathogenesis of thrombosis, with special reference to diabetic microangiopathy]. PMID- 3553378 TI - [Pathophysiology and treatment of thrombosis. 1. Hypercoagulable state. (1) Study on the role of tissue thromboplastin in the formation of thrombosis]. PMID- 3553379 TI - [Pathophysiology and treatment of thrombosis. (3) Hypercoagulative state in cerebral thrombosis]. PMID- 3553380 TI - [Pathophysiology and treatment of thrombosis. 3. Prevention and treatment of thrombosis. (1) The role of intracoronary thrombi, platelet function and prostaglandins in the pathogenesis of myocardial infarction; with special reference to intracoronary thrombolysis treatment]. PMID- 3553381 TI - [Pathophysiology and treatment of thrombosis. (2) The effect of ticlopidine on TIA compared with aspirin. A double-blind, 12-month and open 24-month follow-up study]. PMID- 3553382 TI - [Plasma noradrenaline level after oral administration of captopril]. PMID- 3553383 TI - [Pathophysiology and treatment of thrombosis. (2) Blood coagulation disorders and their modulation system]. PMID- 3553384 TI - [A case of single splenic abscess with intra-peritoneal rupture]. PMID- 3553385 TI - The use of semipermeable dressings in fingertip injuries. AB - A randomised prospective trial was carried out to compare the use of semipermeable and petroleum gauze dressings in fingertip injuries. The results demonstrate advantages in the use of semipermeable dressings. PMID- 3553386 TI - Hands and the artist--Henry Moore. PMID- 3553387 TI - Ultrasound in the diagnosis of scaphoid fractures. AB - A prospective study of the possibility of confirming clinically suspected scaphoid fractures was carried out over one year. Analysis of the results suggest that ultrasound scanning of suspect scaphoid fractures is a reliable method of assessing this condition. It has one weakness in that the diagnosis is based on subjective sensation and this may at times be faulty. Our results, however, suggest that once practice in the technique has been achieved, then mistakes are rarely made. PMID- 3553388 TI - Micro-surgical fascicular nerve repair: a morphological study of the endoneurial bulge. AB - The phenomenon of 'endoneurial bulging' from the cut end of the divided nerve fasciculus in the rat sciatic nerve has been examined with light and scanning electron microscopy and the morphological changes compared when dividing the fasciculus with either micro-scissors or a sharp razor blade. PMID- 3553389 TI - Soft tissue expanders in hand reconstruction. AB - Eight cases in which soft tissue expanders have been used as an adjunct to reconstruction in the hand are reported. Cases involved reconstruction after skin grafting for burns and crush injuries as well as skin resurfacing in the management of the painful hand. Patient tolerance was excellent and the final result was significantly aided by the use of this technique. The technical details of expansion as well as complications are discussed. PMID- 3553390 TI - Monitoring cardiac function. PMID- 3553391 TI - Human liver and conjugation of catecholamines. AB - To investigate the role of the liver in conjugation of catecholamines we measured the concentrations of free and conjugated norepinephrine, epinephrine, and dopamine in plasma of patients with severe liver disease who were undergoing liver transplantation. Comparisons were made with catecholamine levels in plasma of euhepatic patients who were undergoing abdominal aortic aneurysmectomy. We were also able to determine the importance of the liver in conjugation of exogenous dopamine because this compound was given to both groups of patients. The concentrations of conjugated amines were within the normal range in the patients undergoing liver transplantation, and administered dopamine was conjugated to a similar extent in the two groups of patients. The data suggest that the liver is not indispensable for the conjugation of circulating catecholamines. PMID- 3553392 TI - Karl Paul Link and the hemorrhagic agent in spoiled sweet clover. PMID- 3553393 TI - The first hundred years. PMID- 3553394 TI - The life and times of the Institute of Laryngology and Otology. PMID- 3553395 TI - Who was who and what did they do? A biography of contributors to otolaryngology from Great Britain and Ireland. PMID- 3553396 TI - A century of British otorhinolaryngology 1887-1987. PMID- 3553397 TI - Who should treat epistaxis? AB - A prospective study was undertaken of 75 patients complaining of epistaxis who presented to an Accident and Emergency Department. The patients were placed into four groups according to their presenting features, and various forms of appropriate management applied. It was found that in the group that had ceased bleeding on presentation, whether or not a bleeding point was visible, there was no benefit obtained by treatment. If the nose was still bleeding on presentation, and the bleeding point was visible, successful management could be obtained by cauterising the bleeding point. This is a treatment that could be carried out by either the General Practitioner or the Accident Department. If the nose was actively bleeding, and the bleeding point could not be seen, then even initially successful treatment by the Accident Department was usually found to be ineffective within forty-eight hours. It is suggested that this group should be referred to an ENT unit on presentation. PMID- 3553398 TI - Blom-Singer puncture (practicalities in everyday management). PMID- 3553399 TI - Pathology as it relates to ear surgery. VI. Cochlear implantation. AB - The surgical anatomy and pathology of the cochlea have been reviewed in relation to cochlear implant surgery. Animal experimentation, as well as human temporal bone studies, have shown that the implant electrodes were well tolerated by the cochlea. The possible chemical and mechanical trauma induced by the electrodes can be avoided by better choice of shape, size, length and material of the implants. Long-term electrical stimulation did not seem to cause any deleterious effects on the neuronal population of the cochlea. In the present state of the art, cochlear implantation seems justified in well chosen cases. PMID- 3553400 TI - Effects of instructional design variables on vocabulary acquisition of LD students: a study of computer-assisted instruction. PMID- 3553401 TI - Direct visualization of formylpeptide receptor binding on rounded and polarized human neutrophils: cellular and receptor heterogeneity. AB - We have used light microscope autoradiography to visualize binding of the formylhexapeptide, N-formyl-norleucyl-leucyl-phenylalanyl-norleucyl-(125I)tyrosyl lysine to rounded and spontaneously polarized human polymorphonuclear leukocytes. These cells possess receptors known to bind with high specificity and great avidity to the chemotactic formylpeptides. Cells adherent to glass slides were exposed to (125I)-hexapeptide at 4 degrees C, fixed, and autoradiographed. Hexapeptide binding was studied over the biologically active range of peptide concentrations varying from 0.63 nM to 10 nM and autoradiographic silver grains counted on 200 rounded or 50 polarized cells at each concentration. Examination of histograms plotted from these data revealed for rounded cells: two major peaks at each concentration indicating the existence of two neutrophil subpopulations, the predominant subpopulation binding one-half as much formylpeptide (peak I) as the other (peak II); progressively increasing proportions of cells in peak II as the free hexapeptide concentration increased. Accordingly, at 0.63 nM hexapeptide, peak II comprised only 8% of the total cell number, whereas at 10 nM, this peak represented 35% of the total cells. This suggested that different types of receptors may exist in the two cell subpopulations (high/low affinity or high/low negative cooperativity) and that these receptor types were expressed differentially on these subpopulations. Thus, cellular heterogeneity within the neutrophil population and receptor heterogeneity among hexapeptide receptors on an individual cell were both observed here. Each of these may significantly affect neutrophil functional responses to the chemotactic formylpeptides and may explain, at least in part, the curvilinearity in the Scatchard plots of formylpeptide receptor binding that has recently been reported. At higher concentrations of peptide (greater than or equal to 5 nM), spontaneously polarized PMN bound hexapeptide more or less uniformly over the entire cell surface. However, at lower concentrations, hexapeptide binding was markedly shifted toward the cell anterior. As a group, polarized PMN bound similar total quantities of hexapeptide, as did rounded PMN at each peptide concentration tested. Receptors displaying high- and low-affinity characteristics were, however, distributed asymmetrically over the cell surface, with the high-affinity type receptors predominantly on the anterior one-half of the cell. Such an asymmetric distribution may serve to initiate or perpetuate cell locomotion. PMID- 3553402 TI - Interstitial fluid lipoproteins. AB - While a wide variety of techniques has been used to collect samples of interstitial fluid, most of our detailed knowledge about the composition of interstitial fluid lipoproteins has come from lymph collection studies. The considerable variability of lymph data probably reflects the effect of variable metabolic modification and different capillary permeabilities on the lipoprotein composition of interstitial fluid. All density classes of plasma lipoproteins are present in lymph. In peripheral lymph, the lymph/plasma concentration ratios of lipoproteins vary from 0.03 for VLDL-sized particles to 0.2 for HDL. Lymph from more permeable vascular beds, such as lung and myocardium, contains proportionately more lipoproteins. Their lymph/plasma concentration ratios vary from 0.1 to 0.6. In general, lymph lipoproteins are more heterogeneous in size than their plasma counterparts. Lymph HDL and LDL contain larger and smaller particles than their plasma equivalents. Lymph lipoproteins have unusual shapes (square packing and discoidal), chemical compositions, and molecular charge, which suggest de novo formation and/or extensive peripheral modification. Lymph HDL and LDL are enriched in free cholesterol. Lymph HDL also has increased cholesterol/protein and phospholipid/protein (especially sphingomyelin) ratios (Sloop, C.H., L. Dory, and P.S. Roheim, unpublished observations). Lymph HDL apoprotein composition differs from that of plasma, with an increase in apoE and apoA-IV content relative to apoA-I. These discoidal HDL particles may be products of an initial stage of reverse cholesterol transport. We believe further study of their metabolic fate would give important information concerning the later stages of reverse cholesterol transport. PMID- 3553403 TI - Steady-state kinetics of serum bile acids in healthy human subjects: single and dual isotope techniques using stable isotopes and mass spectrometry. AB - Techniques have been developed for the measurement of the complete steady-state kinetics of both chenodeoxycholic (CDCA) and cholic (CA) acid and the pool size of deoxycholic acid (DCA) from the serum of healthy subjects using stable isotopes and capillary gas-liquid chromatography-mass spectrometry (GLC-MS). Serum bile acids were purified by a method employing a C18 chromatographic cartridge, acid solvolysis, enzymic hydrolysis, methylation, a C8 chromatographic cartridge, and TMS-ether derivatization. Fifty mg each of [24-13C]CDCA and [24 13C]CA was given to five healthy subjects and kinetics were measured from serum and bile. In each case, the measurements from serum (S) equalled those from bile (B) (CDCA (S vs. B): fractional turnover rate (FTR) (d-1) 0.17 +/- 0.03 vs. 0.18 +/- 0.04; pool (g) 0.64 +/- 0.1 vs. 0.68 +/- 0.14, synthesis (g d-1) 0.12 +/- 0.03 vs. 0.1 +/- 0.03; CA (S vs. B): FTR (d-1) 0.28 +/- 0.05 vs. 0.29 +/- 0.07, pool (g) 0.84 +/- 0.29 vs. 0.82 +/- 0.29, synthesis (g d-1) 0.24 +/- 0.10 vs. 0.25 +/- 0.12). In addition, a dual isotope technique for measuring the steady state kinetics of CDCA was developed using [11,12-2H]CDCA, [24-13C]CDCA, and a single sample of serum. In ten subjects, the FTR, pool and synthesis of CDCA measured from serum was similar to that measured from bile. Finally, a technique for estimating the deoxycholic acid (DCA) pool from serum using the ratio of the 370 ion of DCA to that of CDCA was developed. In summary, these data demonstrate that the steady-state kinetics of CDCA and CA and the pool size of DCA can be measured from the serum of healthy subjects. PMID- 3553405 TI - The Medical Association of Georgia House of Delegates. 1913. PMID- 3553406 TI - Heart transplantation in Georgia: the Emory experience. PMID- 3553404 TI - Development of a noncompetitive, solid phase, bridged biotin-avidin enzyme immunoassay for measurement of human leukocyte microsomal HMG-CoA reductase protein concentration. AB - Methods were developed for determination of human mononuclear leukocyte HMG-CoA reductase protein concentration by a noncompetitive, solid phase, bridged biotin avidin enzyme immunoassay procedure. Leukocyte microsomal HMG-CoA reductase, first immobilized onto a nitrocellulose filter, is sequentially reacted with 1) monospecific, polyclonal rabbit anti-rat liver HMG-CoA reductase antiserum, which crossreacts with the human liver and leukocyte enzymes; 2) biotinylated donkey anti-rabbit immunoglobulin; 3) a streptavidin-horseradish peroxidase conjugate; and 4) 4-chloro-1-naphthol and H2O2 to visualize the quantity of horseradish peroxidase bound to the immunocomplex. Color development was proportional to the quantity of either purified liver or leukocyte microsomal HMG-CoA reductase applied to the nitrocellulose. Color development was not observed, however, when HMG-CoA reductase was omitted from the nitrocellulose, when one of the reactant species was omitted from the incubation reactions, or when anti-rat liver HMG-CoA reductase antiserum was pre-absorbed with either rat liver or human leukocyte HMG CoA reductase. Immunoreactivity of microsomal HMG-CoA reductase was independent of the phosphorylation state of the enzyme, but was inversely related to the concentration of thiol-reducing agents present in the microsomal preparation up to 4 mM. Further increases in thiol-reductant failed to produce changes in immunoreactivity. Freshly isolated mononuclear leukocyte microsomal HMG-CoA reductase protein concentration in leukocytes from 31 healthy, normocholesterolemic subjects was a linear function of HMG-CoA reductase activity (R = 0.65; P less than 0.001). The catalytic efficiency of the freshly isolated mononuclear leukocyte enzyme was 313 +/- 34 pmol of mevalonate formed per min of incubation at 37 degrees C per mg immunoreactive protein. This methodology, in conjunction with that recently developed to measure human leukocyte HMG-CoA reductase activity (1984. J. Lipid Res. 25: 967-978), should prove useful in discriminating between HMG-CoA reductase regulatory mechanisms involving changes in enzyme protein concentration and those resulting from changes in enzyme catalytic efficiency. PMID- 3553407 TI - Bone marrow transplantation. PMID- 3553409 TI - Red cell survival in patients with Plasmodium falciparum malaria. PMID- 3553408 TI - Combined chlorpropamide-insulin in the treatment of non-insulin-dependent diabetes mellitus with secondary failure of sulfonylurea therapy. PMID- 3553410 TI - Mycobacteria. PMID- 3553411 TI - Immunohistochemical localization of serotonin in the third ventricular wall of the lamprey, using backscattered electron imaging. PMID- 3553413 TI - Retraction: A lymphokine that activates the cytolytic program of both cytotoxic T lymphocyte and natural killer clones. PMID- 3553412 TI - Pulpal reactions to a dentin bonding agent: Dentin Adhesit. PMID- 3553414 TI - Antigenic variation of cloned Plasmodium fragile in its natural host Macaca sinica. Sequential appearance of successive variant antigenic types. AB - The course of infection of Plasmodium fragile in its natural host, the toque monkey Macaca sinica, consists of a primary peak of parasitemia followed by several distinct, successive peaks of lower parasitemia. In the S+ host, the late intraerythrocytic asexual developmental stages of P. fragile induce the expression of antigens on the surface of infected erythrocytes, which could be detected using the technique of surface immunofluorescence. Immunofluorescence using unfixed erythrocytes in suspension has shown that antigens are recognized by immune serum on the surface of the erythrocytes infected with more mature stages of the parasite. These antigens undergo variation, each successive peak of parasitemia being characterized by a different variant antigenic type (VAT). The appearance of the successive VATs occurs in a sequential manner, following the same order in different sets of animals. This constitutes the first example of a sequential expression of antigens in a malaria parasite; it indicates that, in P. fragile, antigenic variation is not the result of random mutations selected by antibody. Parasite-induced antigens on the surface of infected erythrocytes could not be detected in the S- host. However, when nonexpressing parasites from the S- host were transferred by blood passage into a naive S+ animal, they began to express antigens on the surface of infected erythrocytes within two erythrocytic cycles. We have demonstrated that the ability of S- parasites to switch to a particular VAT when passaged into a S+ animal changes during the course of an infection in the S- animal, indicating that, although surface antigens are not expressed, the processes leading to antigenic variation occurs even in the S- host. Antibodies directed against these surface antigens inhibit the growth of intra-erythrocytic parasites. The growth inhibition effects of antibodies are also variant specific, indicating that these variant surface antigens are functionally important for parasite survival. PMID- 3553416 TI - Excretion of urinary N-acetyl-beta-D-glucosaminidase isoenzymes after renal transplantation in the rat. AB - The urinary excretion of N-acetyl-beta-D-glucosaminidase isoenzymes A and B following kidney transplantation was studied in rats. High enzymuria with permanent marked isoenzyme B excretion occurred from the immediate post-operative period to the irreversible rejection episode. Isoenzyme B could represent as much as 10-40% of total N-acetyl-beta-D-glucosaminidase activity and it reflected the intensity of tubular lesions as observed by histological examination of allograft specimens. Thus, N-acetyl-beta-D-glucosaminidase B isoenzyme determination may reinforce the diagnostic value of total (A + B) urinary N-acetyl-beta-D glucosaminidase activity determination during the various complications which can occur after transplantation. PMID- 3553415 TI - High resolution two-dimensional polyacrylamide gel electrophoresis of cerebrospinal fluid in patients with neurological diseases. AB - The protein pattern of cerebrospinal fluid (CSF) of 334 patients with various neurological and systemic diseases was investigated by high resolution two dimensional electrophoresis (2-DE). 2-DE gels of normal CSF contain proteins which are not detectable in 2-DE gels of serum. Disturbances of the blood-brain or blood-CSF barrier, and degenerative diseases of the brain and malignant diseases produce specific changes on 2-DE gels of the CSF. The appearance of 10 spot areas in the light chain region of 2-DE gels seem to be connected with the diagnosis of multiple sclerosis. The sensitivity and the specificity of these spot areas for the diagnosis of multiple sclerosis are described. Proteins within the ten spot areas are immunoglobulin light chains or substances which cross react very strongly with light chain antibodies as demonstrated by immunoblotting and immunoabsorption. PMID- 3553417 TI - A method for the determination of MN antigens in dried blood. AB - MN phenotypes of experimentally prepared dried blood samples, some as old as six months, were obtained using sodium dodecyl sulfate polyacrylamide gels, electroblotting, and monoclonal antibodies. PMID- 3553418 TI - Voice stress evaluators and lie detection. AB - Proponents of vocal stress analysis systems argue that they are able to detect spoken deception by analysis of "stress" in the voice signal. Presumably, they do so by examining traces made by laryngeal microtremors which, they claim exist in the voice, are associated with stress, and ultimately are associated with lying. However, most research that seeks to identify the relationships between microtremors and laryngeal function has produced negative results, and data on the ability of voice analyzers to detect stress from speech--or to identify spoken deception--have been negative or "mixed" in nature. Since perspectives based on available results leave a number of questions unanswered, a series of experiments has been undertaken. The first was focused on the basic acoustic/temporal correlates of stress in voice (the subject of an earlier report), the second on examination of stress by commercial voice analyzers, and the third on the detection of relatively high-risk lies by this same type of voice analysis procedure. It was found that correct stress/nonstress identifications occurred only at chance levels; the lie/nonlie identification scores were quite similar with professional "examiners" performing at about the same level of accuracy as other auditors. The following review is divided into two parts: a history of the controversy and a presentation of the two cited experiments. PMID- 3553419 TI - A rapid screening technique for the detection of spermatozoa. AB - Phase contrast microscopy has been used for some time to search for and identify spermatozoa. An enhancement to the technique using xylene in conjuction with phase contrast microscopy is discussed. The method has been found to save time by allowing identification of spermatozoa with xylene-enhanced phase contrast microscopy in many cases that would have been unsuccessful using the normal "dry" phase contrast microscopy techniques. This eliminates a staining and reexamination step. PMID- 3553420 TI - Arizona Health Care Cost Containment System. PMID- 3553421 TI - System dynamics modeling of renin aldosterone and electrolyte changes induced by furosemide in hypertensive patients. PMID- 3553422 TI - Ultrastructure and immunoelectron microscopy of human T-cell leukaemia virus type I-producing lymphoid and non-lymphoid human tumour cells. AB - The ultrastructure and distribution of some viral and cellular antigens was examined in lymphoid C91/PL and fibroblastic HOS/PL cells infected with human T cell leukaemia virus type I. Tubuloreticular structures in the endoplasmic reticulum, characteristic of virus-infected or interferon-treated cells, were found in both cell types. Virions were observed particularly in the HOS/PL cells in budding and mature forms and in coated pits, coated vesicles and lysosomes, indicative of receptor-mediated endocytosis. Using immunogold indirect labelling, viral antigens, recognized by sera of infected patients and by monoclonal antibody, were detected in patches on the cell surface and in material loosely attached to the envelope of some virions. Beta 2-microglobulin was associated with virion envelopes from C91/PL and HOS/PL cells, but major histocompatibility complex class 1 (HLA) antigens were not associated with virions even when produced by HLA-positive HOS/PL cells. PMID- 3553423 TI - Lack of effect of thymus and spleen on the incubation period of Creutzfeldt-Jakob disease in mice. AB - Genetically athymic and asplenic (Lasat), athymic (Nude), asplenic (Dh) or normal littermate (Hetero) mice with a BALB/c genetic background were injected either intracerebrally or intraperitoneally with a 1% or 10% homogenate of mouse brains infected with the Fukuoka 1 strain of the Creutzfeldt-Jakob disease (CJD) agent. As there were no significant differences in incubation periods among the five groups (Lasat, Nude, Dh, Hetero and BALB/c) inoculated with the same dilution, via the same route, it was concluded that cell-mediated immunity dependent on the thymus plays no significant role in host defence against the CJD agent, and the spleen, a critical site of agent replication, is apparently not an obligatory source from which infection spreads to the central nervous system. PMID- 3553424 TI - Expression of the respiratory syncytial virus 22K protein on the surface of infected HeLa cells. AB - Immunofluorescent staining of unfixed respiratory syncytial virus-infected HeLa cells with monoclonal antibodies (MAbs) demonstrated that the 22K protein is expressed on the cell membrane along with the fusion (F) protein and large glycoprotein (G). All three proteins were detected in the cytoplasm at 17 h post infection and in the case of the F and G proteins this coincided with their appearance on the cell surface. However, the 22K protein could not be detected on the surface until approximately 16 h after its detection in the cytoplasm, when cytopathic effect was extensive. No evidence for the surface expression of the phosphoprotein (P), matrix (M) or nucleocapsid (N) proteins was found. Trypsin treatment of infected cells prior to unfixed immunofluorescent staining and Western blot analysis indicated that, unlike the G protein, the quantity of 22K protein detected on the cell surface constituted only a small proportion of the total present in the cell. A comparison of the patterns of immunofluorescent staining produced by MAbs on acetone-fixed infected cells suggested that the N, P and 22K proteins, but not the M protein, may be associated with the same intracellular structures. PMID- 3553425 TI - Baculovirus expression vectors: the requirements for high level expression of proteins, including glycoproteins. AB - The requirements for high level expression of three foreign proteins using the polyhedrin gene promoter of Autographa californica nuclear polyhedrosis virus (AcNPV, Baculoviridae) have been investigated. In Spodoptera frugiperda cells infected with the appropriate recombinant baculoviruses, the synthesis of the two S RNA coded genes of lymphocytic choriomeningitis virus (LCMV; i.e. the nucleoprotein, N, and glycoprotein precursor, GPC), or the haemagglutinin gene of influenza A virus, appears to be related to the degree of integrity of the 5' upstream sequence of the polyhedrin gene. No effect on the level of N protein expression was detected when all the polyhedrin gene coding sequences or some of the immediate 3' downstream sequences were deleted. Using the most efficient expression viruses derived from a new transfer vector, pAcYM1, it has been estimated that LCMV N protein represented approximately 50% of the total cellular protein, an observation consistent with the presence of numerous inclusion bodies in the cytoplasm of infected cells. For recombinant viruses derived from the pAcYM1 transfer vector containing the LCMV GPC gene, the level of synthesis of the arenavirus glycoprotein was equivalent to approximately 20% of the cellular protein. Thin sections of cells infected with the GPC recombinant revealed a highly vacuolated cytoplasm. PMID- 3553426 TI - Reassortment of Thogoto virus (a tick-borne influenza-like virus) in a vertebrate host. AB - Reassortment is an important factor in the evolution of segmented genome viruses. For arthropod-borne viruses it is important to determine whether the vertebrate host acts as a site of reassortant virus formation since vertebrates often act as amplifying hosts. Mutants of Thogoto virus, a tick-borne orthomyxo-like virus, were shown to produce wild-type progeny in a dually infected permissive host (hamster), when hamsters were infected with two mutant viruses either by direct inoculation or by oral transmission from infected ticks. Viral dose and time of co-infection of the host affected the incidence of reassortment. This is the first report of reassortment of an arbovirus following infection of a vertebrate host via an arthropod vector. PMID- 3553427 TI - Posttraumatic stress disorder. The stressor criterion. AB - Posttraumatic stress disorder (PTSD) was officially introduced into psychiatric nomenclature in 1980, when it was incorporated into DSM-III. There is as yet little empirical research on the validity of the diagnosis. Literature on disasters, civilian and wartime, and on more ordinary stressful life events does not support the view that extreme stressors form a discrete class of stressors in terms of the probability of psychiatric sequelae or the distinctive nature of subsequent psychopathology. Extraordinary stressors are like more ordinary stressful events with respect to their complex differential effects upon individuals. Personal characteristics and the nature of the social environment modify the likelihood and form of the response of individuals to all types of stressors. PMID- 3553428 TI - Generation of subunit-specific antibody probes for Torpedo acetylcholinesterase: cross-species reactivity and use in cell-free translations. AB - The assembly of the collagen tailed A12 form of acetylcholinesterase (AChE) is regulated by muscle contraction. To begin to study this regulation, we derived antibody probes for the three subunits (100 kd, catalytic, and collagen tail) of AChE purified from Torpedo californica electric tissue. These included a polyclonal antiserum that recognizes all 3 subunits and 19 monoclonal antibodies; 16 of the monoclonals recognized the catalytic subunit, 2 recognized the tail subunit, and 1 recognized the 100 kd subunit on Western blots. We used immunohistochemical procedures to show that several of the anticatalytic and one of the antitail monoclonals cross-reacted with frog muscle AChE and Western blotting to show that several of the anticatalytic monoclonals cross-react with rat brain AChE. These antibodies were then used to immunoprecipitate AChE precursors from a cell-free translation system. There were generally three primary translation products, corresponding to the three enzyme subunits. Therefore, each subunit is probably derived from a separate mRNA. Occasionally there were two translation products corresponding to the catalytic subunit alone. The catalytic subunit was glycosylated following addition of canine microsomal membranes to the translation mix. The mRNA coding for this subunit appeared to be present in the poly(A)- RNA pool. PMID- 3553429 TI - The Donald Munro memorial lecture. The VA and spinal cord injury: a record of service. PMID- 3553431 TI - Monoclonal antibody Tor 23 recognizes a determinant of a presynaptic acetylcholinesterase. AB - A significant proportion of the acetylcholinesterase that is present in the electric organ of Torpedo californica exists as a presynaptic membrane molecule. The monoclonal antibody Tor 23 binds the Torpedo presynaptic nerve membrane where it recognizes a polypeptide of 68,000 daltons. Our present studies indicate that Tor 23 identifies acetylcholinesterase. From the homogenates of Torpedo nerve terminals, Tor 23 immunoprecipitates measurable esterase activity. Esterase precipitation was not observed with no Tor 23 added; nor was it observed with any other test antibodies, including other Tor antibodies, in particular, Tor 70, which binds, as does Tor 23, to the presynaptic nerve membrane. The esterase activity was specific for acetylcholinesterase. Our studies indicate the molecule defined by Tor 23 has the solubility properties described for that of presynaptic acetylcholinesterase: it is soluble in detergent-treated electroplax homogenates and insoluble in high-salt extractions. In sections of Torpedo back muscle, both nerve and endplate acetylcholinesterase can be detected histochemically. Tor 23 localizes to the nerve and is not clustered at the endplate. The utility of the antibody Tor 23 thus includes biochemical and histological analyses of the multiple forms of acetylcholinesterase. PMID- 3553430 TI - Synthesis and biocidal activity of Zn(II) complexes of some 2,2'-substituted diphenylamines. AB - Binary as well as ternary complexes of Zn(II) with diphenylamine-2,2' dicarboxylic acid (dpdc), diphenylamine-2-amino-2'-carboxylic acid (dpac), diphenylamine-2-hydroxy-2'-carboxylic acid (dphc), diphenylamine-2-mercapto-2' carboxylic acid (dpmc), and N-(2-pyridino) anthranilic acid (npa) have been synthesized and characterized by their elemental analysis, IR spectral data, and molar conductance measurements. Antimicrobial activity of these ligands and their respective Zn(II) complexes have been determined on gram positive (Staphylococcus aureus) and gram negative (Escherichia coli) bacteria and on Aspergillus niger and Aspergillus nidulense, two common fungi by the serial dilution method. A considerable increase in the biocidal activity of these ligands on being coordinated with the metal ion has been reported in terms of their minimum inhibitory concentration (MIC) values. PMID- 3553432 TI - Studies on the biosynthesis of antibiotics. AB - In the framework of studies on the biosynthesis of several antibiotics, specifically asukamycin, acarbose, reductiomycin, actinorhodin, and granaticin, a variety of different approaches to biosynthetic problems are illustrated. These include multiple labeling with stable isotopes in conjunction with modern methods of nmr analysis, as illustrated by the development of a new triple-quantum 2D INADEQUATE experiment for biosynthetic studies, the use of stereochemical probes, as illustrated by the synthesis and stereochemical analysis of chiral [13C, 2H]malonate, and combinations of genetic and chemical approaches, as illustrated by examples of the production of new hybrid antibiotics by genetic engineering. PMID- 3553433 TI - Nifedipine in the treatment of myotonia in myotonic dystrophy. AB - Abnormal calcium transport may be implicated in the membrane defect in myotonic dystrophy. A single blind crossover trial of placebo (t.i.d.), nifedipine 10 mg (t.i.d.) and nifedipine 20 mg (t.i.d.), was performed in 10 patients with myotonic dystrophy. The severity of myotonia was assessed by measuring finger extension time after maximum voluntary finger flexion. A significant improvement in myotonia, after nifedipine, was recorded by this technique and supported by a subjective improvement in 50% of patients and clinical improvement of greater than 20% in five patients. Initial grip strength and muscle fatiguability measured by grip strength ergometry were not significantly altered. PMID- 3553434 TI - Blood-brain barrier permeability during Cuprizone-induced demyelination. Implications for the pathogenesis of immune-mediated demyelinating diseases. AB - Blood vessels in the superior cerebellar peduncles were studied in Cuprizone-fed mice for leakage of proteins into the parenchyma. The status of the blood-brain barrier was determined at various stages of demyelination both by tracer methods using horseradish peroxidase and immunochemically using antisera to extravasated serum proteins and was compared to three positive and negative control conditions. The results showed no evidence of significant protein leakage into the subendothelial basement membrane or extravascular space in Cuprizone mice, during the development of demyelination. The apparent lack of damage to the blood brain barrier found in Cuprizone animals as compared to the blood-brain barrier alterations previously reported for immune-mediated demyelinating diseases, confirms the theory that these alterations are not a non-specific association of any demyelinating process, but are of primary pathogenetic importance in immune mediated demyelination. PMID- 3553435 TI - A strategy for evaluation of new treatments in untreated patients: application to a clinical trial of AMSA for acute leukemia. AB - This clinical trial (DT7995) was designed to evaluate amsacrine (AMSA) plus cytosine arabinoside (ara-C), vincristine, and prednisone (OAP) therapy in previously untreated patients with adult acute leukemia and to investigate a new strategy for assignment of patients to treatment using estimated probabilities of complete remission (PPR) based on six prognostic factors. In the first stage of the trial, patients with unfavorable prognosis (PPR less than .40) received AMSA OAP for remission induction and patients with favorable prognosis (PPR greater than or equal to .40) received Adriamycin [Adria Laboratories, Columbus, OH] plus OAP (Ad-OAP). As AMSA-OAP was found to be promising in patients with unfavorable prognosis, it was administered to relatively more favorable patients (PPR less than .60) in the second stage of the trial and to all patients in the third stage. There were 242 patients entered into study; 134 received AMSA-OAP and 108 received Ad-OAP. Outcomes were compared with 242 paired patients who received Ad OAP therapy from 1973 to 1977. The estimated complete remission rate in previously untreated adults with acute leukemia is 61% for patients receiving Ad OAP (95% confidence interval, 59% to 64%). Overall, the survival experience for the 242 patients on DT7995 was significantly better than that in the control series (P = .03), but there was no strong statistical evidence (P = .10) that the 134 patients receiving AMSA-OAP had better survival than control patients receiving Ad-OAP, with a median of 32 v 21 weeks, respectively. It is concluded that AMSA-OAP is equivalent to Ad-OAP in the induction of complete remissions (estimated complete remission rate, 61%) and that assignment of patients to treatment based on predicted prognosis is an ethical and efficient strategy for the evaluation of new therapies in previously untreated patients with acute leukemia. PMID- 3553436 TI - Marrow transplantation for acute nonlymphocytic leukemia following therapy for Hodgkin's disease. AB - Seven patients with acute nonlymphocytic leukemia (ANL) following therapy for Hodgkin's disease (HD) were treated with cyclophosphamide (Cy) alone or combined with 10.00 to 15.75 Gy total body irradiation (TBI) and marrow transplantation. Five patients were transplanted without an attempt at prior remission induction, one patient following failure of remission induction and one patient in first remission following successful induction. Four patients died of multiorgan failure, 15 to 70 days after transplant. Three patients died of progressive or recurrent leukemia 56, 120, and 280 days after transplant. These results illustrate the difficulty of treating patients for secondary leukemia with marrow transplantation and suggest that transplantation in the preleukemic phase should be studied. PMID- 3553437 TI - Prolongation of survival for high-grade malignant gliomas with adjuvant high-dose BCNU and autologous bone marrow transplantation. AB - Employment of postoperative brain irradiation in the initial management of high grade malignant glial tumors has now become standard. The addition of conventional chemotherapy to irradiation has not significantly improved median survival beyond 1 year. We treated 25 consecutive patients (13 pilot patients and 12 protocol patients) with histologically confirmed unresectable grade 3 or 4 malignant gliomas with high-dose BCNU (carmustine) followed by autologous bone marrow transplantation and whole brain irradiation. Within 3 weeks of initial surgery, each patient had autologous bone marrow stored (median 2 X 10(8) nucleated cells/kg), and then received BCNU 1,050 mg/m2 intravenously (IV). Peripheral granulocytes recovered (greater than 500/microL) at a median of 19 days (range, 10 to 37 days), and platelets recovered (greater than 20,000/microL) at a median of 18 days (range, 13 to 40 days), following bone marrow infusion. Patients received 60 Gy whole brain irradiation when granulocytes were greater than 1,500/microL. Toxicity was well tolerated. Nausea occurred in 19 patients (76%); however, only eight patients (32%) experienced vomiting (mild in three, moderate in five). Eleven patients (44%) did not require empiric antibiotics, six of whom never developed an absolute granulocyte count less than 500/microL. Three patients with a poor performance status died early (one seizure with vomiting and asphyxiation; one, klebsiella urinary tract infection (UTI) with bacteremia; one, candidal pneumonia), and one additional patient who was performing well died of pulmonary hemorrhage. The 13 pilot patients have now been followed for a median of 23 months, with a significant survival advantage compared with the 52 consecutive historical control patients who received similar surgery and radiotherapy without high-dose BCNU (P = .037). The overall study group of 25 patients also has a significant survival advantage when compared with the same historical control group, with a projected median survival of 26 months (P = .007). This new approach using early postoperative intensive therapy consisting of high-dose BCNU, autologous bone marrow transplantation, and whole brain irradiation appears to significantly improve survival. PMID- 3553438 TI - CT scans, stereotactic equipment, and the location of a tumor biopsy. PMID- 3553439 TI - Serial stereotactic biopsies and CT scan in gliomas: correlative study in 100 astrocytomas, oligo-astrocytomas and oligodendrocytomas. AB - Histologic features of 100 supra-tentorial astrocytomas, oligodendrogliomas and oligo-astrocytomas obtained from serial stereotactic biopsies were compared with the corresponding CT scans. Topographic comparisons provided by visualization of the biopsy trajectories on post-biopsy CT scans were available in 24 cases. Areas of contrast enhancement and low attenuation were compared with the histologic grade of malignancy, tumor delimitation and structural type. The latter was determined as follows: Type I-solid tumor tissue without significant peripheral isolated tumor cells; Type II-solid tumor tissue associated with peripheral isolated tumor cells; Type III-isolated tumor cells only. There was a strong correlation between areas of contrast enhancement and tumor microvascularity. In addition, contrast enhancement occurred only in the solid tumor tissue component of the neoplasm. This correlation accounted for the relationship observed between CT images and the structural type of glioma. Contrast enhancement was constant in structural type I gliomas, inconstant in structural type II, and absent in structural type III. No correlation was found between malignancy and contrast enhancement. Contrast enhancement occurred in all grades of malignancy but was a constant feature of grade 4 gliomas. The volume of the tumors could not be reliably determined from CT images alone. Areas of low attenuation on contrast CT scans could correspond to either peritumoral edema or to edematous parenchyma infiltrated by isolated tumor cells. Serial stereotactic biopsies combined with calculations based on the CT scan provided a more precise definition of the tumor volume and identification of structural type. Such classification may prove useful in prospective analysis of various modes of therapy. PMID- 3553440 TI - Cross reactivity of anti-epithelial membrane antigen monoclonal for reactive and neoplastic glial cells. AB - An anti-epithelial membrane antigen monoclonal (Clone E29) was used as part of a panel of antisera in the investigation of primary CNS and metastatic tumours. In contrast to others, definite and often strongly positive cross-reactivity has been demonstrated on glial cells. The material consisted of fourteen astrocytomas, two ependymomas, six cerebral metastases and two cases of gliosis. PMID- 3553441 TI - Dentistry and CAD/CAM: another French revolution. PMID- 3553442 TI - Adrenalectomy-induced enhancement of CRF and vasopressin immunoreactivity in parvocellular neurosecretory neurons: anatomic, peptide, and steroid specificity. AB - Following adrenalectomy (ADX), corticotropin-releasing factor (CRF) and vasopressin immunoreactivity are jointly expressed by a population of parvocellular neurosecretory neurons in the paraventricular nucleus of the hypothalamus (PVH). Because these cells stain positively for CRF, but not for vasopressin, after pretreatment with colchicine, the results suggest the existence of state-dependent alterations in the expression of peptides by neuroendocrine neurons. The present study sought to determine whether other neuropeptides (e.g., neurotensin, met-enkephalin) that have been colocalized with CRF in the parvocellular division of the PVH are influenced similarly by ADX; whether the enhancement of CRF and/or vasopressin immunoreactivity after ADX is limited to neurons of the PVH; and what factors might be involved in the regulation of the expression of these peptides in the PVH. The results confirmed that CRF and vasopressin immunoreactivity are both enhanced, and may be colocalized in a substantial population of parvocellular neurosecretory neurons after ADX; no comparable enhancement of staining for met-enkephalin or neurotensin was observed. The effect of ADX on CRF immunoreactivity was not limited to cells in the PVH, as neurons in the cerebral cortex, amygdala, and the bed nucleus of the stria terminalis also showed heightened CRF immunostaining after ADX; vasopressin immunoreactivity was never colocalized with CRF in these extrahypothalamic sites. Hypophysectomy produced an enhancement of CRF and vasopressin staining in the PVH that was comparable to that seen after ADX, implicating adrenal steroids as primary regulators of peptide expression in this system. Corticosteroid replacement studies in ADX rats indicated that lower doses of dexamethasone attenuated, and higher doses essentially abolished, the expected enhancement of both CRF and vasopressin immunoreactivity after ADX. The relative potency of steroids in mitigating these effects was dexamethasone greater than corticosterone greater than deoxycorticosterone greater than aldosterone. Collectively, these results indicate that the ADX-induced enhancement of CRF and vasopressin immunoreactivity in parvocellular neurosecretory neurons is at least somewhat specific to these peptides and to this cell type. Both peptides would appear to be regulated similarly by adrenal steroids, with glucocorticoids playing a primary role. PMID- 3553443 TI - Cell lineage, cell death, and the developmental origin of identified serotonin- and dopamine-containing neurons in the leech. AB - The nervous system of the glossiphoniid leech includes segmentally iterated neurons that contain serotonin (5-HT) and dopamine. These have been investigated in Helobdella triserialis, Theromyzon rude, and Haementeria ghilianii. Five types of 5-HT neurons are identified by immunocytochemistry in the abdominal ganglia of the ventral nerve cord: the bilaterally paired Retzius, anteromedial, ventrolateral and dorsolateral neurons, and the unpaired posteromedial (pm) neuron. Three types of bilaterally paired dopamine neurons are identified by glyoxylic acid-induced fluorescence in the segmental body wall: MD, LD1, and LD2. Each left or right half of the segmental complement of the leech nervous system is known to develop from 6 distinct ectodermal primary blast cells (ns, nf, o, p, qs, and qf). To identify the blast cells of origin of the 5-HT and dopamine neurons, fluorescent cell lineage tracers were injected into the various precursors of the blast cells in early (stage 6) embryos. The embryos were then raised until their 5-HT and dopamine neurons could be scored (stage 11) for the presence or absence of lineage tracer. We find that the Retzius, anteromedial, and posteromedial 5-HT neurons are derived from the ns blast cell, while the ventrolateral and dorsolateral 5-HT neurons are derived from the nf blast cell. The unpaired pm 5-HT neuron arises as one of a bilateral pair of neurons, of which one later dies. Whether the left or right pm neuron survives in any given ganglion is the consequence of some form of competitive interaction between cells derived from the left and right n primary blast cells, possibly between the left and right pm neurons themselves. We find that, of the dopamine neurons, the LD1 neuron is derived from the o blast cell, the LD2 neurons from the p blast cell, and the MD neuron from one of the 2 kinds of q blast cells. These results show that the 5-HT and dopamine neurons arise from 5 different primary blast cells in a highly determinate manner, and they support the view that cells of a similar phenotype need not be closely related in the developmental cell lineage tree. PMID- 3553444 TI - Biochemical and immunocytological localization of the neuropeptides FMRFamide, SCPA, SCPB, to neurons involved in the regulation of feeding in Aplysia. AB - The localization of the neuropeptide FMRFamide in the buccal ganglia and buccal muscles of Aplysia was studied by immunocytology and high-pressure liquid chromatography (HPLC) combined with either a sensitive bioassay or 35S-methionine labeling. Immunocytology with an antiserum directed to FMRFamide stained a large number of fibers, varicosities, and neuronal somata. Two groups of stained neurons were of particular interest. One was the S cells, a group comprised of many small neurons, the majority of which were stained. HPLC of pooled labeled S cells confirmed that at least some of these neurons synthesize FMRFamide. The other group of stained neurons were in the ventral cluster, a group comprised of a small number of large neurons, many of which are motor neurons that innervate the buccal muscles involved in producing biting and swallowing movements. Several of the ventral neurons were previously shown to contain 2 other neuropeptides, the small cardioactive peptides SCPA and SCPB. These neurons are sufficiently large to permit HPLC analyses of the neuropeptides synthesized by individual neurons. This procedure confirmed that individual ventral neurons synthesized FMRFamide, or the SCPs, or all 3 peptides. The coexistence of FMRFamide and the SCPs in the same neuron was confirmed by simultaneous staining of sections from the buccal ganglia with a monoclonal antibody to the SCPs and an antiserum to FMRFamide. The coexistence of the 3 peptides in the same neuron was surprising in light of the observations that these peptides often have opposite biological activity. The ventral neurons are large and potentially identifiable as individuals. Thus, these neurons may be particularly useful for studying the physiological and behavioral roles of neuropeptides in generating complex behaviors. PMID- 3553445 TI - Visualization of endogenous glycine in cat retina: an immunocytochemical study with Fab fragments. AB - Fab fragments of a glycine antiserum were prepared and used for immunocytochemical visualization of glycine in the cat retina. The use of Fab fragments in conjunction with Fab-specific secondary and tertiary antisera improved tissue penetration and made it possible to identify a number of the immunoreactive neurons. Staining was observed in several subpopulations of amacrine cells, including the A7(AII) rod amacrine. Multiple subpopulations of cone bipolar cells were also seen to be immunoreactive. Many neurons exhibited no detectable immunostaining, indicating that general metabolic levels of glycine do not interfere with the visualization of those cells that contain large amounts of endogenous glycine. The distribution of immunostaining appears to parallel the pattern of glycine labeling seen previously with autoradiographic techniques and implicates these cells in glycine-mediated neurotransmission. PMID- 3553446 TI - Local circuitry of identified projection neurons in cat visual cortex brain slices. AB - The relationship between pyramidal cell morphology and efferent target was investigated in layer 6 of cat primary visual cortex (area 17). Layer 6 has 2 projections, one to the lateral geniculate nucleus (LGN) and another to the visual claustrum. The cells of origin of each projection were identified by retrograde transport of fluorescent latex microspheres. The labeled cells were visualized in brain slices prepared from area 17, using an epifluorescence compound microscope modified for intracellular recording. Individual retrogradely labeled cells were penetrated and intracellularly stained with Lucifer yellow to visualize the patterns of axons and dendrites associated with each projection. The neurons that give rise to the 2 projections had very different patterns of dendrites and local axonal collaterals, but the patterns within each group were highly stereotyped. The differences between their axonal collaterals were particularly dramatic. Claustrum projecting cells had fine, horizontally directed collaterals that arborized exclusively in layer 6 and lower layer 5. Most LGN projecting cells had virtually no horizontal arborization in layer 6. Instead, they sent widespread collaterals vertically, which arborized extensively in layer 4. The apical dendrites of the 2 groups also differed markedly. Claustrum projecting cells had apical dendrites reaching to layer 1, with branches in layer 5 only, while LGN projecting cells never had an apical dendrite reaching higher than layer 3, with side branches in layers 5 and 4. Therefore, each efferent target must receive inputs from neurons whose synaptic connections within area 17 are significantly different from those of neurons projecting to other targets. This further suggests that distinct visual response properties should be associated with each projection. In addition to the claustrum and LGN projecting cells, about 20% of layer 6 pyramidal neurons lacked an efferent axon. Morphologically, most resembled LGN projecting neurons, but a few had characteristics of claustrum projecting cells. These neurons may represent cells that either failed to make an efferent connection or cells that lost an efferent axon during development. Their frequency suggests that such intrinsic, presumably excitatory, neurons may play a significant role in cortical processing. PMID- 3553447 TI - Molecular markers of neuronal subpopulations in layers 4, 5, and 6 of cat primary visual cortex. AB - Cat primary visual cortex has been used as an immunogen to produce monoclonal antibodies that detect subpopulations of neurons. When tested by immunofluorescence on tissue sections of areas 17 and 18, 2 of these antibodies, VC1.1 and VC5.1, outlined a rare subpopulation of neurons located mainly in layer 4 but also in layers 5 and 6. Double-labeling immunofluorescence experiments in area 17 revealed that all VC1.1-reactive cells were also VC5.1-reactive and 83% of VC5.1-reactive cells were VC1.1-reactive, suggesting that the antibodies were reacting with the same subpopulation of cells. Both antibodies labeled similar or identical subpopulations of cells in other areas of the cat CNS, including the superior colliculus, parts of hippocampus, cerebellar deep nuclei, and rostral spinal cord. Neither antibody labeled cell bodies in the lateral geniculate nucleus. In the retina, VC1.1 labeled cell bodies and processes of some horizontal and amacrine cells, whereas VC5.1 labeled only ganglion cell axons. In the cerebellar cortex, the most prominent labeling of VC1.1 was of Purkinje cells, whereas that of VC5.1 was of Lugaro cells. Immunoblotting analyses of cat cortical homogenates demonstrated that VC1.1 recognized a major polypeptide band of Mr 95,000-105,000 and additional bands of Mr 145,000 and Mr 170,000. VC5.1 recognized bands of Mr 97,000 and Mr 150,000. Subcellular fractionation and extraction studies showed that the VC1.1 antigens were integral membrane proteins preferentially located in a synaptosomal plasma membrane fraction. The VC5.1 antigens were preferentially located in a soluble cytoplasmic or extracellular fraction. The results indicate that antibodies VC1.1 and VC5.1 recognize unique epitopes in the cat CNS and define a previously unrecognized subpopulation of cells in cat visual cortex. PMID- 3553448 TI - The molecular structure of microtubule-associated protein 1A (MAP1A) in vivo and in vitro. An immunoelectron microscopy and quick-freeze, deep-etch study. AB - We studied the distribution of microtubule-associated protein 1A (MAP1A) in Purkinje cell dendrites by means of electronmicroscopic immunocytochemistry, using a monoclonal antibody (McAb) against MAP1A; this was combined with the observation of the 3-dimensional cytoskeletal ultrastructure in dendrites via the quick-freeze, deep-etch technique (QF-DE). We prepared a McAb against rat brain MAP1. This McAb recognized MAP1A on a nitrocellulose filter through use of the immunoblotting method, and stained immunofluorescently Purkinje cell perikarya, dendrites, and axons. Using the McAb, we labeled rat cerebellum extracted with Triton X-100 and simultaneously fixed with aldehyde, followed by gold-labeled rabbit anti-mouse IgG. Gold particles were attached to the filamentous, fuzzy materials, mostly those connected to microtubules (MTs), but were hardly localized on those attached to neurofilaments (NFs). The 3-dimensional cytoskeletal ultrastructure of fresh Purkinje cell dendrites was revealed by QF DE. In Purkinje cell dendrites, MT was a predominant cytoskeletal element, whereas only a few NFs were found. Fine, elaborate cross-bridges filled up the interstices among MTs, and between MTs and other cellular components. Cross bridges linking MTs to one another were composed mainly of a fine filamentous structure, frequently branching and anastomosing at several sites, and appeared somewhat granular. We ensured that the cross-bridges observed in saponin extracted tissues were not a result of artifactual condensations or precipitations of soluble proteins during deep etching. The molecular structure of MAP1A was further investigated by the rotary shadowing technique. The affinity purified MAP1A was a long, thin, filamentous, and very flexible molecule.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553449 TI - Monoclonal antibodies against rat brain protein kinase C and their application to immunocytochemistry in nervous tissues. AB - Three monoclonal antibodies were prepared against rat brain soluble protein kinase C. Two of the antibodies, CKI-97 (IgG2b subclass) and CKII-90 (IgG1 subclass), showed weak binding to native protein kinase C. The third antibody, CKI-33 (IgG2b subclass), showed no binding. However, the mixture of CKI-97, CKII 90, and CKI-33 exhibited much stronger binding activity to this protein kinase than any of the antibodies alone. Although none of these antibodies showed protein kinase C-neutralizing activity, Western blot analysis indicated that these antibodies reacted specifically with protein kinase C, presumably its subspecies, that is present predominantly in nervous tissues. Immunocytochemical studies shows that these antibodies can be used for identification of this enzyme in nervous tissues. In rat Purkinje cells, the immunoreactive material was present throughout the cytoplasm, including dendrites and axons, but was poorly represented in the cell nucleus. In cerebellum, the localization of protein kinase C appears to be very similar to that of cGMP-dependent protein kinase. PMID- 3553450 TI - Morphological and immunocytochemical identification of indoleamine-accumulating neurons in the cat retina. AB - The type and distribution of indoleamine-accumulating neurons were studied in the cat retina. The neurons were characterized by their capacity to take up an exogenous indoleamine, 5,6-dihydroxytryptamine, which could then be visualized using formaldehyde-induced fluorescence. Under direct microscopic control, intracellular injection of Lucifer yellow into the labeled cells revealed that the indoleamine-accumulating neurons comprise 2 distinct morphological types of amacrine cell and 1 class of ganglion cell. The dendritic morphology and retinal distribution of these cells were studied in detail. The proportion of retinal cells that accumulate 5-HT was measured using 5-HT (5-hydroxytryptamine) preloading in vitro and immunocytochemistry with an anti-5-HT antibody. Only 1 type of amacrine cell showed uptake of 5-HT at a concentration of 10(-7) M. Cells containing endogenous 5-HT were not detected by immunocytochemistry. PMID- 3553451 TI - Correction of acrylic denture tooth wear with light-cured composite resin. PMID- 3553452 TI - Geoffrey Jefferson (1886-1961), neurosurgeon, physiologist, philosopher. AB - In the centenary year of his birth, the work of Sir Geoffrey Jefferson (1886 1961) is reviewed with special reference to his views on the seat of consciousness and on the application to medicine of the scientific method. PMID- 3553453 TI - Vertebrobasilar insufficiency. Part 1: Microsurgical treatment of extracranial vertebrobasilar disease. AB - Extracranial vertebrobasilar artery thrombo-occlusive disease may cause repetitive transient ischemic episodes and, less frequently, brain-stem or cerebellar infarction. This report describes 40 patients who experienced repetitive vertebrobasilar ischemic symptoms despite maximal medical therapy. The natural history, pathogenesis, and treatment options for each causative lesion are reviewed. The operative approaches to symptomatic disease of the proximal vertebral arteries, arterial compression by cervical osteophytes, traumatic lesions of the vertebral arteries, and thrombo-occlusive pathology of the distal extracranial vertebral arteries are outlined. Specific anesthetic and surgical techniques that have proved successful while achieving zero operative mortality and low perioperative morbidity rates are reported. PMID- 3553454 TI - Vertebrobasilar insufficiency. Part 2. Microsurgical treatment of intracranial vertebrobasilar disease. AB - Posterior circulation transient ischemic attacks have an associated risk of subsequent infarction of approximately 5% per year. Intracranial vertebrobasilar thrombo-occlusive lesions appear particularly likely to result in repetitive ischemic symptoms and in infarction due to hemodynamic insufficiency. The authors present their experience with 45 patients with symptomatic intracranial vertebrobasilar vascular disease despite maximal medical therapy. The specific operative approaches for intracranial vertebral artery endarterectomy and extracranial to intracranial posterior circulation revascularization procedures are outlined. PMID- 3553455 TI - Perioperative antibiotic prophylaxis for prevention of postoperative neurosurgical infections. A randomized clinical trial. AB - The authors report the results of a randomized, prospective study to assess the effectiveness of perioperative antibiotic prophylaxis in preventing postoperative infections following clean neurosurgical operations. The study group comprised 846 patients treated between October, 1979, and June, 1984. Antibiotics, including cefazolin and gentamicin, were administered only in the immediate preoperative and intraoperative periods. Sixteen patients, none of whom developed infections, were excluded from final statistical analysis because they had inadvertently been entered into the study while failing to meet entry criteria. Fifteen wound infections (3.64%) developed in the group of 412 patients who did not receive antibiotics, whereas only four infections (0.96%) were identified among the 418 patients who received antibiotics. The difference is statistically significant (p = 0.008) and represents a 74% reduction in infection rate with antibiotics. An analysis of subgroups of surgical procedures revealed a dramatic decrease in craniotomy infections from 6.77% to 0% (p = 0.003). Of the four infections that occurred among the antibiotic-treated patients, three were in cases where foreign bodies had been implanted. No complications of antibiotic usage were identified. The rates of infection in areas of the body other than the surgical wound were no different in the antibiotic-treated and nontreated groups. All wound infections in both antibiotic-treated and nontreated patients involved similar types of Gram-positive organisms, suggesting that antibiotic prophylaxis did not produce infections with resistant or unusual organisms. This study, combined with other recently published analyses, suggests that routine perioperative antibiotic prophylaxis can significantly reduce the incidence of postoperative neurosurgical infections. PMID- 3553456 TI - Time course of blood velocity changes related to vasospasm in the circle of Willis measured by transcranial Doppler ultrasound. AB - Fifty patients with ruptured aneurysms were operated on within 72 hours after the first subarachnoid hemorrhage (SAH). To prevent symptomatic vasospasm, the patients were given the calcium channel blocker, nimodipine, intravenously (2 mg/hr) for 14 days and orally (60 mg four times daily) for another 7 days. At short intervals (at least every 3rd day) the blood flow velocity in the different segments of the circle of Willis was measured with a noninvasive transcranial Doppler ultrasonography method. Within the first 72 hours after SAH, the velocity was normal in the large branches of the circle of Willis and angiography revealed no signs of vasospasm. The Doppler frequency changes that relate to blood flow accelerated between Days 3 and 10, and maximum blood flow velocities were recorded between Days 11 and 20, with normalization occurring within the following 4 weeks. The changes showed a significant relationship to the source of SAH, the side of the operative approach, and the method of nimodipine administration. A comparison between the angiographically proven diameter of spastic arteries and the Doppler-measured blood flow velocity showed an inverse relationship in flow of the middle cerebral artery and the internal carotid artery that was statistically highly significant (p less than 0.001) while this correlation was only slightly significant in the A1 segment of the anterior cerebral artery (p = 0.054). Seven patients (14%) developed delayed ischemic deficits (DID's), which were all functionally reversible. One patient (2%) died as a result of decompensated vasospasm. Based on the information provided by Doppler measurement of the individual blood flow velocity changes due to vasospasm, preventive hypertensive treatment was introduced to improve the perfusion pressure while patients were still in an asymptomatic stage. Among the last 40 patients who were treated according to this regimen, reversible DID's were observed in only three patients (7.5%) and postoperative angiography to detect vasospasm was not necessary. PMID- 3553458 TI - Ultrasound- versus CT-guided stereotaxic biopsy. PMID- 3553457 TI - One-knot microvascular anastomosis. An experimental study in rats. AB - Experimental microvascular anastomosis using a glutide copolymer (lactide:glycolide, 80:20) as an external splint was undertaken in 33 rats between the carotid artery and the jugular vein. Both vessels were dissected free over a 1-cm length and cut at the cranial end of the dissected part. The carotid artery was then introduced into a glutide pipe-splint. The arterial wall was turned 180 degrees over the edge of the splint. This reflected artery wall and the glutide were covered by the freed-up jugular vein. One stitch was made around the vein, the artery, and the glutide in a manner similar to binding steel wire over a barrel. Thus, the "one-knot anastomosis" was completed. The patency rate at the anastomosed site was 100%, confirmed by angiography in 30 rats and by direct surgery in three. The time required to produce the anastomosis was between 5 and 7 minutes. Light microscopic observation showed that there was no obstruction by thrombus formation at 1 and 5 weeks after the anastomotic surgery. This technique may be clinically applicable for extracranial-intracranial bypass surgery, reconstruction of venous sinuses, and other vascular procedures. PMID- 3553459 TI - Late surgical treatment of unilateral coronal synostosis using methyl methacrylate. AB - Three techniques combining the shaping of calvarial and facial bone with onlay of methyl methacrylate are presented for use in the late treatment of unilateral coronal synostosis deformities. The procedures described are suggested as possible alternatives to extensive bone repositioning procedures. They have the advantage of being quicker and are therefore potentially safer operations. Acrylic is malleable and does not resorb; thus, permanent superior esthetic results may be achieved. The two most serious risks when using this technique are infection and limitation of growth. The risk of infection may be reduced by attaching the acrylic implant securely to surrounding bone, under sterile conditions, beneath well-vascularized skin. Growth limitation may be obviated by not placing acrylic across sutures in children with enlarging skulls. PMID- 3553460 TI - Evaluation of the lung uptake of iodine-131 HIPDM by the single-pass multiple indicator dilution technique in a rabbit model. AB - The first-pass lung uptake of [131I]HIPDM was studied in a rabbit model using a conventional single-pass multiple indicator dilution (SPMID) technique with [99mTc]HSA as the intravascular marker. Lung extraction of [131I]HIPDM determined by the SPMID method was saturable, decreasing from 89.5 +/- 5.8% (mean +/- s.d., n = 4) at 4 nmol kg-1 to 63.8 +/- 6.2% at 1.5 X 10(4) nmol kg-1 relative to the intravascular tracer. The first-pass extraction of [131I]HIPDM derived from gamma camera emission imaging data correlated well (R = 0.834) with simultaneously derived SPMID data. The extraction efficiencies were 94.4 +/- 3.3 and 87.9 +/- 3.2 at 200 nmol kg-1 and 68.0 +/- 6.2 and 64.0 +/- 10.7 at 1 X 10(4) nmol kg-1 (n = 4) for the SPMID and gamma-camera methods, respectively. Analysis of the lung arterial effluent blood indicated that no appreciable de-iodination or metabolism of [131I]HIPDM, within the limits of detection, occurred during the first pulmonary transit. PMID- 3553461 TI - Three-hour volume of distribution method: an accurate simplified method of glomerular filtration rate measurement. AB - Eight hundred studies of glomerular filtration rate (GFR) measurements were performed by the standard slope-intercept method using [99mTc]DTPA and results were compared with a simultaneous measurement of the 3-hr tracer volume of distribution. A wide range of human renal function was studied and a nonlinear relationship between GFR and the volume of distribution resulted with an excellent correlation (r = 0.989). Agreement between the two measured parameters was not constant for all levels of renal function with the greatest accuracy being found for GFR = 60 to 100 ml/min. PMID- 3553462 TI - Volume expansion diuretic renal scan in urinary tract obstruction. AB - The diuretic renal scan is used to differentiate the obstructed dilated urinary system from the nonobstructed dilated system. The technique, however, has a false positive and indeterminate rate of 10%-15%. This usually is due to variables such as the degree of dilatation of the pelvicalyceal system or ureter, the degree of bladder distention, the diuretic dose, and the state of hydration. We developed the volume expansion diuretic renal scan (VEDRS) to overcome these variables and to improve the accuracy of the technique. Twelve patients who had obstructive patterns on the diuretic renal scan were evaluated. Ten patients were shown to be dilated but not obstructed. Two patients were confirmed as obstructed. This technique improves the accuracy of the diuretic renal scan. PMID- 3553463 TI - Rapid method for the measurement of differential renal function: validation. AB - The precise measurement of glomerular filtration rate (GFR) and renal plasma flow (ERPF) usually requires continuous intravenous administration of adequate substances, with multiple blood and urine analysis, and does not allow measurement of separate renal function. Schlegel et al. and Gates described isotopic methods for the measurement of global and unilateral GFR and ERPF based on the determination by scintillation camera of the fraction of the injected dose ([99mTc]DTPA-[131I]hippuran) present in the kidneys 1-3 min after its administration. These methods require counting of the injected dose and correction for attenuation, but no blood or urine sampling. We have validated these techniques by simultaneous infusion of inulin and PAH in patients with various levels of global renal function (anuric to normal). To better define unilateral renal function we have also studied nine kidneys in patients either nephrectomized or with a nephrostomy enabling unilateral function measurement. A good correlation between inulin or PAH clearances and fractional uptake of [99mTc]DTPA or [131I]hippuran by the kidney was observed. Very good reproducibility of both isotopic techniques was shown. We conclude that determination of the fractional uptake of [99mTc]DTPA and [131I]hippuran between 1 and 3 min allows good and reproducible prediction of global and especially of unilateral kidney function with great rapidity and simplicity, rendering this technique suitable for clinical practice. PMID- 3553464 TI - Extrapulmonary radioactivity in lung permeability measurements. AB - The pulmonary clearance rate of aerosolized and deposited [99mTc]DTPA is used to assess pulmonary epithelial permeability to solutes. To evaluate whether it is necessary to correct these measurements for radioactivity in the chest wall and pulmonary vasculature five patients with no ventilation to one hemithorax were studied. After inhaling a submicronic aerosol of [99mTc]DTPA a gamma camera measured count rates over both hemithoraces for 20 min. The observed T1/2 for clearance from the normal hemithorax was 56 min (range 18-115 min), and when this was corrected for chest wall contribution (derived from the abnormal hemithorax) the average T1/2 was 52 min (range 17-107 min). To simulate infinitely permeable lungs we measured thoracic radioactivity in two adults and six children who were injected i.v. with a known amount of [99mTc]DTPA. The count rate over the thorax was only 8.1% (range 2.7%-11%) of that obtained when a similar amount of aerosolized [99mTc]DTPA was deposited in the lungs during a subsequent study. We conclude that it is not necessary to correct for nonpulmonary epithelial radioactivity during the measurement of [99mTc]DTPA clearance rate from the lungs. PMID- 3553465 TI - Evaluation of the renal clearance of technetium-99m PAHIDA in dogs. AB - The renal clearance of the technetium-99m complex of para[(biscarboxylmethyl) aminomethylcarboxyamino]hippuric acid ([99mTc]PAHIDA), has been previously studied in rodents and falls between that of [99mTc]DTPA (diethylenetriaminepentaacetic acid) and iodine-131 (131I) orthoiodohippuran (OIH). To investigate the effect of species variation, the plasma clearance of [99mTc]PAHIDA was investigated in dogs. The plasma disappearance of the renal agent approached that of [99mTc]DTPA and was significantly less than that of OIH. Despite the structural similarities of the PAHIDA ligand and aminohippurate, the [99mTc]PAHIDA complex undergoes little, if any, tubular secretion in the canine kidney. PMID- 3553466 TI - Radiophosphate visualization of the foreign body reaction to wear debris from total knee prosthesis. AB - Three patients with total knee arthroplasties, in which the tibial and patellar articulating surfaces consisted of a polyethylene-carbon fiber composite, demonstrated technetium-99m methylene diphosphonate (MDP) deposition in the intraarticular space, whereas, the gallium-67 citrate images were normal. This was shown to be due to a synovial giant cell foreign body reaction to particulate carbon fiber debris in one patient who required surgical revision of the prosthesis. PMID- 3553467 TI - Herman James Almquist (1903- ): biographical sketch. PMID- 3553468 TI - Effects of fructose, levamisole and vanadate on insulin action in rat adipose tissue. AB - The effects of dietary fructose, levamisole and vanadate on insulin-stimulated conversion of D-[U-14C]glucose to 14CO2 and to 14C-labeled lipid were examined in rat epididymal adipose tissue. Male weanling rats were fed isoenergetic diets containing either 27% (wt/wt) fructose or glucose for 11 wk. During the final 4 wk, rats in each group were either untreated (control) or treated orally with 20 mg/kg body wt levamisole or 0.5 ppm vanadate via their drinking water. Basal glucose oxidation to CO2 was 45% higher in the fructose-control than in the glucose-control group. Insulin-stimulated glucose oxidation in both control groups was not higher than the basal rate in fructose-fed rats. Basal lipogenesis was 31% lower in the fructose-control than in the glucose-control group. Insulin stimulated lipogenesis was much higher than basal, but was not different between fructose- and glucose-control groups. Levamisole increased basal lipogenesis in fructose-fed rats. Vanadate acted synergistically with fructose in greatly diminishing insulin-stimulated glucose oxidation. Fasting plasma insulin levels were lower and fasting plasma glucose and triglycerides were higher in fructose- than in glucose-fed rats, irrespective of treatment. Results suggest that adaptation to dietary fructose enhances basal oxidative capacity in an insulin like fashion and reduces the basal lipogenic capacity of adipose tissue. Treatment with levamisole and vanadate lowers the overall rate of glucose metabolism and alters the effects of fructose. PMID- 3553470 TI - CGRP: a novel neuropeptide from the calcitonin gene is the most potent vasodilator known. AB - The calcitonin gene has been shown to give rise to another peptide, calcitonin gene-related peptide (CGRP). The structure of human CGRP has been determined by mass spectrometry. Calcitonin gene-related peptide-containing neurons have been detected in a number of species, particularly in association with heart and blood vessels. Pharmacological studies have shown that CGRP is a potent vasodilator in a number of vessels and vascular beds, including the skin and coronary circulation. Investigations in humans have also reported the potent vasodilator action of CGRP. The evidence from these studies suggests that CGRP is an important regulator of vascular tone and blood flow. PMID- 3553469 TI - Group B streptococcus: the pregnant woman and her neonate. AB - Within the past 10 years, group B streptococcal disease has emerged as a major causative agent in neonatal morbidity and mortality. A brief history of this pathogen and its epidemiologic factors regarding maternal colonization and carriage is presented. Group B streptococcal disease in the neonate and concurrent treatment and prevention modalities also are presented. A case study is included. Suggestions for nursing assessment, intervention, and future considerations are offered. PMID- 3553471 TI - Serotonin and the blood-vessel wall. AB - In hypertension, vasoconstrictor responses to serotonin are augmented while the vasodilator effects of the monoamine are decreased. In animal models of the disease the constrictor response to serotonin is increased more than those to other agonists, which suggests a functional adaptation of the hypertensive blood vessel wall. In hypertension the turnover of circulating platelets, the major source of peripheral serotonin, is accelerated and the mechanisms for its removal (endothelial metabolism, uptake by platelets) are slower. The functional changes of the blood-vessel wall of the platelets could play a role in the maintenance of the increased peripheral vascular resistance in chronic hypertension. These changes could be involved in the pathogenesis of complications of the hypertensive process. The concept that serotonin plays a role in chronic hypertension is further supported by the antihypertensive properties of the S2 serotonergic antagonist ketanserin. PMID- 3553472 TI - Effects of altered dietary calcium intake in experimental hypertension: role of intracellular free magnesium. AB - Blood pressure, ionic and hormonal effects of high (1.8%) versus low (0.2%) dietary calcium intakes were explored in uninephrectomized DOC-NaCl rats, in two kidney, one clip (2K, 1C) Goldblatt hypertensive rats and their respective controls. High-calcium diets lowered blood pressure (P less than 0.05) in DOC NaCl and in control uninephrectomized rats drinking 1% NaCl. However, calcium loading in renin-dependent 2K, 1C rats elevated blood pressure (P less than 0.05) but had no effect in sham-operated controls. Plasma renin activity rose in all animals, while serum ionized calcium rose significantly only in dietary salt loaded animals. Intracellular free magnesium levels were consistently, inversely linked to blood pressure (r = -0.92, P less than 0.001). This linkage was independent of plasma renin activity, serum ionized calcium values and dietary calcium content. These results demonstrate that the same alteration in dietary mineral content can produce opposite blood pressure effects in different pathophysiological subtypes of hypertensive disease. We conclude that intracellular free magnesium levels directly participate in the final common pathway of events regulating blood pressure and vasoconstrictor tone. PMID- 3553473 TI - Natriuresis and the renin axis in sodium-sensitive man. AB - We analysed the blood pressure, natriuretic and hormonal responses of 378 normal volunteers and 198 essential hypertensives after an intravenous infusion of 2 litres of isotonic saline and after a low-sodium diet and furosemide. Those in whom mean arterial blood pressure decreased by greater than 10 mmHg after sodium and volume depletion were considered sodium-sensitive, and those in whom a decrease of less than 5 mmHg was observed were considered sodium-resistant. Sodium-sensitive individuals had lower renin values than those who were resistant to sodium. Both normal and hypertensive sodium-sensitive individuals exhibited an 'exaggerated' natriuresis compared with resistant subjects. Sodium-sensitive subjects exhibited greater aldosterone responses to renin stimulation after volume depletion than resistant subjects. Sodium sensitivity is associated with exaggerated natriuresis as well as tighter coupling between renin and aldosterone. Relative volume expansion could account for the differences observed between sensitive and resistant individuals. PMID- 3553474 TI - Ontogeny of plasma renin activity in the Dahl rat model of essential hypertension. AB - Plasma renin activity (PRA) is characteristically lower in the Dahl salt sensitive (S) rat than in the salt-resistant (R) rat. To establish whether PRA differs between these strains at birth or subsequently becomes suppressed in the Dahl S rat, the ontogeny of PRA was studied in inbred Dahl hypertension-prone (S/JR) and hypertension-resistant (R/JR) rats from 5 to 51 days of age. Pregnant dams and postweaning pups were maintained on diets containing either 0.15% or 0.69% sodium chloride (w:w). Although PRA clearly distinguished the two strains in young adulthood, it was not lower in the S/JR pups at 5 and 15 days of age. However, PRA was greater in rat pups suckling dams consuming the low salt diet. These results suggest that suppressed PRA in S/JR rats is an acquired trait, perhaps occurring secondary to other physiological abnormalities and that maternal diet influences PRA in the suckling Dahl rat. PMID- 3553475 TI - Antihypertensive therapy must control glomerular hypertension to limit glomerular injury. AB - Male Munich-Wistar rats wer subjected to 1 2/3 nephrectomy. One group received no therapy. A second group received the angiotensin converting enzyme (ACE) inhibitor enalapril. A third group received triple therapy (TRX) with reserpine, hydralazine and hydrochlorothiazide. Half of the rats underwent micropuncture study 4 weeks after nephrectomy. Untreated rats exhibited high systemic blood pressure (SBP) and single-nephron hyperfiltration due to high values for the mean glomerular capillary hydraulic pressure (-PGC) and glomerular capillary plasma flow rate (QA). The ACE inhibitor therapy controlled both SBP and -PGC. In contrast, TRX normalized SBP but failed to lower -PGC. After 12 weeks untreated rats demonstrated systemic hypertension, progressive proteinuria and extensive glomerular sclerosis. The ACE inhibitor dramatically limited proteinuria and sclerosis. Despite equivalent SBP control with TRX, failure to control -PGC resulted in proteinuria and sclerosis comparable with the untreated rats. Thus unless -PGC is controlled, SBP control may be insufficient to prevent renal injury. PMID- 3553476 TI - Effect of captopril and hydrochlorothiazide on glomerular haemodynamics and histological damage in Goldblatt hypertension with partial renal ablation. AB - Increased glomerular capillary pressure (GCP) mediates glomerular damage in hypertension. The efficacy of captopril, an angiotensin converting enzyme (ACE) inhibitor, and captopril-hydrochlorothiazide (captopril-TZ) in lowering GCP and preventing glomerular damage was evaluated in rats with two-kidney, one clip (2K, 1C) Goldblatt hypertension and partial ablation of the unclipped kidney. Thirty days after surgery nine rats received captopril, 11 received captopril-TZ and eight served as untreated control rats. Sixty days later systemic hypertension was associated with increased GCP and severe structural damage in the unclipped kidney of C rats. Captopril lowered arterial pressure (AP), and prevented the rise in GCP and structural lesion. Captopril-TZ decreased AP and GCP to a greater extent, but did not reduce structural damage further. Captopril lowered GCP, preventing structural damage; greater reduction of GCP with captopril-TZ did not provide further protection. PMID- 3553477 TI - An epidemiological perspective on dietary electrolytes and hypertension. AB - This review of epidemiological studies has several general implications. First, the most relevant population data for extrapolation in providing public health or medical advice should come from intra-population studies, either observational or interventional. Second, the observational studies require follow-up with long term intervention trials in representative segments of the population before broad pronouncements are made. Third, not all people respond uniformly to changes in the intake of a single electrolyte, at the levels that can be safely achieved in our society. Finally, there are clear indications of useful directions in which to alter dietary electrolytes, either singly or multiply, but the most effective, safe and achievable combinations of dietary change remain to be defined and tested over prolonged periods in naturalistic settings. PMID- 3553478 TI - Prediction of response to sodium intervention for blood pressure control. AB - In the Dietary Intervention Study of Hypertension (DISH) we found that patients formerly treated with drugs and assigned to sodium-reduction intervention were twice as likely to remain off medication for up to 56 weeks as were the controls assigned to no-diet intervention, after adjusting for covariates. Within the sodium-restriction group approximately 60% of 131 people were Intervention Successes (IS) (urinary sodium less than or equal to 100 mmol/day at 8 weeks). The rest were classed as Non-Intervention Successes (NIS). Of the IS group, 54% were responders (drug-free for at least 56 weeks), but about 56% of the NIS group also remained drug-free. Multiple logistics showed that no one factor was able to predict response among the IS. We conclude that the IS likely to respond to sodium reduction are not readily identifiable a priori. Furthermore, since both IS and NIS showed similar blood-pressure effects from the sodium-restriction regimen compared with controls, the questions arise: whether a factor other than sodium reduction affects the blood pressure response for the sodium-restriction group; or whether the measurement of sodium intake and excretion is sufficiently precise to distinguish compliers from non-compliers. PMID- 3553479 TI - Potassium-rich and sodium-poor salt reduces blood pressure in hospitalized patients. AB - To investigate whether a K-rich/Na-poor salt is able to reduce blood pressure, 10 mildly hypertensive inpatients (six males) aged 28-53 years, with supine diastolic blood pressure (DBP) greater than 95 mmHg after 5 days of hospitalization, on a standard diet containing about 20 mmol Na plus 4 g common salt (CS) were randomly given, in double-blind conditions, 2 g twice daily of either CS (five patients) or K-rich/Na-poor salt (five patients) to add to food for a further 8 days. Mean blood pressure was significantly (P less than 0.01) reduced to a similar extent in both groups in the first 4 days, and declined significantly (P less than 0.01) only in the K/Na group in the following 8 days, reaching values significantly (P less than 0.01) lower than those of the CS group. The heart rate did not change significantly while body weight decreased to a similar extent in both groups. Urinary sodium excretion was similarly and significantly (P less than 0.01) reduced in both groups in the first 4 days (CS 100.8 +/- 7.9 and K/Na 100.2 +/- 11.0 mmol/24 h, and remained unchanged in the CS group (109.9 +/- 4.3 mmol/24 h) but declined significantly (P less than 0.05) by about 50% in the K/Na group (62.9 +/- 3.6 mmol/24 h) in the following 8 days. Plasma renin activity (PRA) and plasma noradrenaline did not differ significantly between the two groups, nor among the days of treatment, but the mean blood pressure response to mental stress was reduced significantly (P less than 0.4) in the Na/K group compared with the CS group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553480 TI - Effects of oral calcium carbonate on blood pressure in subjects with mildly elevated arterial pressure. AB - Recent investigations suggest that calcium supplementation may cause a lower arterial pressure in hypertensive individuals. We studied 32 patients with mildly elevated arterial pressure (diastolic pressure 88-95 mmHg) and inadequate dietary calcium intake (less than 750 mm/day), who were randomly assigned to placebo or 1500 mg/day elemental calcium for 4 weeks. Baseline and post-treatment urinary calcium concentrations and 3 biweekly supine blood pressures were recorded. Supine systolic blood pressure in the calcium group rose during the first 2 weeks of treatment (delta systolic blood pressure +5.9 mmHg; P less than 0.025) compared with no change in supine blood pressure for the placebo group. Within the calcium group, seven out of 15 patients had decreased or unchanged supine blood pressure during treatment. A lower urinary calcium concentration and a lower dietary sodium intake were found in this subgroup compared with those whose supine blood pressure increased with calcium administration. PMID- 3553481 TI - Renin relationship to sex, race and age in a normotensive population. AB - The relationship of renin activity to sex, race (black or white) and age (less than 50 or greater than or equal to 50 years of age) was examined in 236 normal subjects measure yearly for up to 9 years. There were 58 white women (34 less than 50 years, 24 greater than or equal 50 years), 66 white men (30 less than 50 years, 36 greater than or equal to 50 years), 57 black women (34 less than 50 years, 23 greater than or equal to 50 years) and 55 black men (34 less than 50 years, 21 greater than or equal to 50 years). The results showed men had higher mean renin activities than women, whites had higher activities than blacks and those of under 50 years had higher activities than those of over 50 years. However, the sex and race differences primarily occurred as a consequence of a lack of decline in renin activity with age among white men. The relationship with age as a continuous variable was weak (r = -0.21) and no relationship with age was found in 22 subjects with a least 7 years of data. No significant differences in urinary sodium excretion were observed between the groups. These results suggest that renin activity tends to be lower in older subjects and that differences in renin activity related to sex and race, while statistically significant, may not be physiologically important. PMID- 3553482 TI - Amiloride with or without salbutamol versus placebo: effects on lipoproteins in hypertensive patients treated with timolol-hydrochlorothiazide. AB - Because thiazides and beta-blockers have adverse effects on lipoproteins, while magnesium repletion (shown to occur with amiloride) and beta 2 agonists improve lipids, we studied the effects of 3 months each of amiloride with and without salbutamol with and without placebo in a 2 X 2 factorial crossover study in which all patients took timolol-hydrochlorothiazide twice daily for 1 year. A total of 118 subjects entered, and 97 patients completed all four crossovers of amiloride + salbutamol, amiloride + placebo, salbutamol + placebo and placebo + placebo. No significant differences were seen among the four study regimens with respect to blood pressure, total cholesterol, triglycerides or high-density lipoproteins (HDL). The study power was 99% for total cholesterol, 46% for triglycerides and 93% for HDL. Timolol-hydrochlorothiazide had no significant effect, suggesting that the use of such drugs to offset the adverse effects of antihypertensive drugs on lipoproteins is not effective; the selection of alternative antihypertensive agents appears to be a preferable strategy. PMID- 3553483 TI - Evidence suggesting that mild hypertension need not be treated. AB - Clinical practice should be based on the results of good clinical trials, not on hypotheses generated from epidemiological data. For many reasons it was difficult to translate the results of early hypertension trials into clinical practice, but from recent trials it is clear that the main benefit that can be expected from treating mild hypertension is the reduction in strokes. The benefit to an individual patient will be very small, and will be obtained at a price of adverse effects from treatment. A patient can now be allowed to decide for himself whether treatment is worthwhile. PMID- 3553485 TI - The case for caution in the treatment of mild hypertension. PMID- 3553484 TI - Should mild hypertension be treated? A guide for the perplexed. PMID- 3553486 TI - Acid-activatable inactive renin in cat plasma and kidney. AB - Inactive renin has been identified in cat plasma and kidney extracts. It is identical to human plasma prorenin in all respects tested except that the pH optimum of activated cat inactive renin is slightly different from that of active renin. To further investigate whether cat inactive renin is indeed prorenin we examined whether it could be reversibly acid-activated, an unusual characteristic of human prorenin. We found that dialysis of partially purified, cat renal inactive renin to pH 3.3 caused reversible acid activation. In plasma, when acidification was followed by a second dialysis to pH 7.4 at 4 degrees C, irreversible activation took place, just like human prorenin. Unlike human angiotensinogen, cat angiotensinogen was apparently not affected by acid dialysis. These results suggest that cat inactive renin is most likely prorenin. PMID- 3553487 TI - Mineralocorticoid hypertension due to hyperaldosteronism and hyperdeoxycorticosteronism. AB - Hypermineralocorticoid hypertension is usually due either to aldosterone or deoxycorticosterone excess. Only in hyperaldosteronism due to adenoma or primary adrenocortical hyperplasia is cure achieved by surgery. Idiopathic hyperaldosteronism may be due to different aldosterone stimulators not related to hypertension. Rare adrenocortical tumours (benign or malignant) producing hyperdeoxycorticosteronism have suppressed aldosterone and in malignancy, cortisol. They provide evidence for a separate non-adrenocorticotrophic regulator of the deoxycorticosterone pathway. The dissociation of normal or reduced cortisol from elevated deoxycorticosterone levels suggests either an adrenal enzymatic disorder or tumour. PMID- 3553488 TI - Is there a common link between the mechanisms of mineralocorticoid-induced and genetic hypertension? AB - We have shown that (1) mineralocorticoids increase vascular smooth muscle (VSM) membrane permeability to Na+ through a receptor-mediated mechanism as mineralocorticoid-induced hypertension develops, and (2) prehypertensive spontaneously hypertensive rats (SHR) have elevated plasma aldosterone and expanded interstitial fluid volumes, both of which normalize as the rats reach the early hypertensive phase. Others have reported elevation in other mineralocorticoids, VSM membrane permeability changes to Na+ and exaggerated adrenocorticotrophic hormone (ACTH) response to stress in SHR. We hypothesize the SHR have a genetically determined, generalized membrane defect of increased Na+ permeability, not unlike that which is inducible by excessive exogenous mineralocorticoid and which accompanies the hypertension induced by mineralocorticoids. Further, we hypothesize that the insidious onset of hypertension in SHR is at least partly due to the absence or the low activity of Na/Ca exchange in VSM of young SHR, delaying the intracellular accumulation of Ca2+ with its consequent increase in VSM tension. Finally, we predict that the anticipated haemodynamic changes accompanying interstitial fluid volume expansion are not necessary to the development in SHR. PMID- 3553489 TI - Control of aldosterone secretion by pituitary hormones. AB - Pro-gamma-melanotropins (pro-gamma-MSH) are implicated in the control of aldosterone secretion by the normal adrenal cortex and in idiopathic hyperaldosteronism. In contrast with other melanotropins (alpha- and beta-MSH), the pro-gamma-MSH increase aldosterone secretion by normal adrenals only in the presence of adrenocorticotrophic hormone (ACTH). However, in aldosteronoma cells this stimulatory effect of the pro-gamma-MSH is not ACTH-dependent. The mechanism of pro-gamma-MSH action on aldosterone biosynthesis may involve activation of cholesteryl ester hydrolase in zona glomerulosa, resulting in an increased provision of cholesterol for steroidogenesis. PMID- 3553491 TI - Correlation between plasma renin activity and birth weight in hypertensive pregnancy. AB - Plasma renin activity (PRA) was measured in the late third trimester in 26 hypertensive pregnant women and correlated with their infants' birth weights. Seven pre-eclamptics, six chronic hypertensives and 13 chronic hypertensives with superimposed pre-eclampsia were studied. Plasma renin activity was lower in 13 mothers with small for gestational age (SGA) infants (5.2 +/- 0.89 ng/ml per h, compared with 13 mothers with appropriate for gestational age (AGA) infants (16.65 +/- 2.37 ng/ml per h, P less than 0.001. The mean PRA was also lower in mothers with babies weighing less that 2500 g, regardless of gestational age, compared with 11 mothers with babies weighing more than 2500 g, (7.58 +/- 1.61 versus 15.86 +/- 2.73 ng/ml per h, P less than 0.050. Mean PRA was not significantly different in the different hypertensive groups, although women with chronic hypertension appeared to have lower PRA than pre-eclamptics. Our data suggest that in gestational hypertension, low PRA is associated with low infant birth weight, and that late third trimester PRA may therefore identify those at risk for poor fetal outcome. PMID- 3553490 TI - Plasma prorenin during early pregnancy: ovarian secretion under gonadotropin control? AB - To explore the time-course and the source of the changes in plasma prorenin that occur in early pregnancy we studied a normal subject (subject 1), an in vitro fertilization (IVF) patient (subject 2) and an ovarian failure patient who received a donor egg (subject 3). Day 0 was the luteinizing hormone (LH) peak (subject 1), the day of human chorionic gonadotropin (hCG) administration (subject 2) or 3 days before embryo transfer (subject 3). In subjects 1 and 2 prorenin increased transiently (three- and ninefold respectively) on days 0-4, then returned towards baseline and began to increase again around day 12 to a maximum (six- and 26-fold baseline) around day 20. Active renin was consistently less than 10% of total renin. In the ovarian-failure patient only small fluctuations occurred in total renin yet her hCG was 137 mlU/ml on day 15, proving that she was pregnant. These results suggest that the prorenin rise that occurs at mid-menstrual cycle and following conception may be due to ovarian prorenin secretion in response to stimulation by gonadotropic hormones. PMID- 3553492 TI - Stress management, blood pressure and quality of life. AB - This paper addresses three questions. First, we examine the effectiveness of relaxation and stress management in reducing hypertension and its complications by reviewing published studies including our own. Secondly, we report quality of life under such treatment, and thirdly, we discuss possible mechanisms. There is considerable evidence to show the effectiveness of a variety of non pharmacological measures. In a randomized, controlled trial we showed that relaxation and stress-management training was associated with a reduction in blood pressure (BP) maintained over 4 years of observation. There were signs of a possible reduction in coronary heart disease (CHD) risk while maintaining or even enhancing the quality of life. Significantly more subjects in the relaxation group reported improved relationships at work, general health, enjoyment of life, and personal and family relationships than those in the control group at a 4-year follow-up. A similar but statistically insignificant trend was shown for the general level of physical energy, sexual life, concentration at work, mental well being and social life. The relaxation group also displayed a belief in greater control over their health. There was no consistent relationship between the degree of reduction in BP and improvement in the above aspects of life, but those who practised relaxation regularly, who integrated relaxation in everyday activities and who used cognitive reappraisal as part of their stress-management strategies, showed greater reduction in BP than those who did not. Other studies have shown that this therapy can contribute significantly to the better control of BP with smaller doses of antihypertensive drugs, thus reducing the chances of side effects. PMID- 3553493 TI - Impact of antihypertensive therapy on quality of life: effect of hydrochlorothiazide. AB - Six hundred and twenty-six male patients with mild to moderate hypertension were enrolled in a multicentre randomized double-blind clinical trial to determine the effect of methyldopa, captopril and propranolol on the quality of life of these patients. During the 6-month trial hydrochlorothiazide was added to the treatment programme of those patients whose blood pressure was not normalized. More individuals in the captopril group (33%) required hydrochlorothiazide than in the propranolol group (22%). As a group, those individuals who required a diuretic were heavier and had higher basal and end-of-study blood pressure than those individuals requiring only monotherapy. However, the basal quality-of-life indices were similar in the six treatment subgroups. The withdrawal rate from the study was twice as high for those patients treated with propranolol and methyldopa as for those treated with captopril, whether a diuretic was added or not. More individuals requiring a diuretic experienced sexual dysfunction and a substantial worsening of their general well-being and of physical symptom indices over the 24 weeks of the study (P less than 0.01), particularly in the captopril and propranolol treatment subgroups. In summary, the present results suggest that diuretic therapy may have a greater negative impact on the quality of life of hypertensive patients than captopril, propranolol or methyldopa alone. PMID- 3553494 TI - Initial therapy in hypertension: quality-of-life considerations. AB - Treatment has one of two fundamental goals, relief of symptoms or a change in natural history. In general, a treatment goal of symptom relief is easier to achieve. One treats each day for symptoms that day, and a patient's compliance is maintained when symptoms are relieved. Treatment that has as its goal a change in natural history, without providing symptom relief, is fundamentally more difficult: one treats today for events that might occur tomorrow--or months or years later. The revolution in what we have available for treatment has been accompanied by an evolution in expectations. In the area of hypertension the expectations are stringent. The physician cannot provide the patient with symptom relief, because there are no symptoms directly attributable to the hypertension- although few individuals are free of symptoms. The short-term goal is to control the high blood pressure at a minimal cost in adverse reactions; the long-term goal is to change natural history. Two decades ago antihypertensive therapy was restricted to very severe hypertension. The available agents were difficult to use, and they produced substantial side effects. Over the past several decades each wave of new agents has provided some improvement in efficacy, but primarily a reduction in the frequency and severity of adverse reactions. Today, at a time when we often wish to treat mild hypertension, the goal is to have patients feel as well on treatment as they do off it. A progressive reduction in the frequency and severity of central nervous system side effects is one of the major features of the evolution of therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553495 TI - Disparate effects of initial antihypertensive therapy on well-being. AB - We investigated the effects of baseline antihypertensive therapy on well-being in a randomized single-blind study in patients with recently diagnosed essential hypertension (WHO stage I). Sixty middle-aged men were treated either with a beta blocker (oxprenolol) or a calcium-entry blocker (nitrendipine). Well-being was assessed by questionnaires on mood and anxiety. Both regimens were equally effective at lowering blood pressure. Differences in mood were found between patients on the beta-blocker and those on the calcium-entry blocker in the first week of therapy. Responders and non-responders to calcium-entry blocker did not differ in mood and anxiety. Non-responders to beta-blocker had a less balanced mood after the onset of therapy than patients effectively treated with this regimen over 9 months. These results suggest that the impact of therapy on well being should be carefully assessed during antihypertensive therapy, and might be considered a major determinant of patients' compliance. PMID- 3553496 TI - Work performance, absenteeism and antihypertensive medications. AB - Relationships between antihypertensive medications and selected aspects of work performance and absenteeism were explored in a multicentre, randomized, double blind, clinical trial with 626 male hypertensive patients assigned to regimens of captopril, methyldopa or propranolol, either alone or supplemented as needed by a diuretic for blood pressure control. Patients previously on antihypertensive therapy did not differ from new patients in work absenteeism, both before and throughout the clinical trial. After a 24-week treatment period patients on captopril alone improved significantly over baseline in work-performance measures of mental acuity and job satisfaction-morale, while significant worsening in the methyldopa group and no change in the propranolol group occurred among patients given these drugs alone. When 24-week changes between groups not on diuretic were compared, significant differences in the measures appeared in favour of captopril. However, patients also taking a diuretic did not differ from baseline either within or between the three groups. Withdrawal from the trial because of lethargy and fatigue was significantly greater among patients on methyldopa and propranolol than among those receiving captopril. Absenteeism did not differ between the drug groups. The study shows that there are measurable differences in the impact of the antihypertensive drugs on aspects of work performance, and it underlines the importance of considering this factor in assigning patients to therapy. PMID- 3553497 TI - Interpreting quality-of-life clinical trial data for use in the clinical practice of antihypertensive therapy. AB - The use of quality-of-life indices in therapeutic trials is gaining recognition as important outcome variables for evaluating the total impact of antihypertensive therapy. While the statistical significance of treatment differentials in quality-of-life indices has been well documented, their clinical relevance still remains unclear. The interpretation of clinical trial quality-of life treatment differentials depends on a clear understanding of the normal variability in the index due to changes in day-to-day living and the relationship between the size of the differential and shifts in population responses. Using the results from a large-scale randomized clinical trial on quality of life and antihypertensive therapy, a rationale for the interpretation of clinical trial results for use by the practicing clinician is presented. PMID- 3553498 TI - Gingival retraction for collarless ceramometal crowns. PMID- 3553499 TI - Leaders in medicine. Richard E. Carpenter, MD. PMID- 3553500 TI - Preventive management of root caries: state of the art. PMID- 3553501 TI - Particulate allogeneic bone grafts into maxillary alveolar clefts in humans: a preliminary report. AB - The purpose of this study was to determine the ability of particulate allogeneic bone graft to adequately bridge unilateral maxillary alveolar clefts in humans. Twenty patients with unilateral alveolar clefts and oronasal fistula underwent alveolar cleft grafting with a clinically appropriate amount of particulate allogeneic bone. The grafted cleft area was followed radiographically for three to six months postsurgery. Although it was difficult to quantitate, it was both clinically and radiographically apparent at three months that bone bridging and filling of the cleft had occurred in 100% of the cases. From this study, it appears that allogeneic bone is a viable alternative for repairing alveolar clefts and that its use has a significant benefit to the patient by eliminating the morbidity of a second operative site. PMID- 3553502 TI - Surgical management of the patient with osteogenesis imperfecta. PMID- 3553503 TI - Surgical guidestents for placement of implants. PMID- 3553504 TI - [Immunohistochemical study of complements and complement receptor (CR1) in chronic sinusitis]. PMID- 3553505 TI - Distribution of Ca (Oxford) antigen on placental trophoblast. AB - The distribution of the Ca (Oxford) antigen in 75 human placentae has been studied using an immunohistological technique. The antigen was not detected until nineteen weeks gestation, when it first appeared on the surface of syncytial sprouts. Thereafter it spread to the syncytiotrophoblast of chorionic villi of all sizes, becoming more strongly expressed towards term. The antigen was consistently not detected on extravillous trophoblast. The significance of these findings is discussed in relation to competing theories as to its function. PMID- 3553506 TI - Detection of leptospiral antigen in the human liver and kidney using an immunoperoxidase staining procedure. AB - Detection of leptospiral antigen using an immunoperoxidase staining (IP) procedure was carried out on fifteen samples of human liver, (nine from autopsies and six from biopsies) and nine samples of human kidneys (eight autopsies and one biopsy). The IP staining procedure to detect leptospiral antigen (L. interrogans serovar icterohaemorrhagiae) in human liver and kidney proved to be a reproducible method useful on paraffin embedded tissues after formalin, Bouin's or Helly's fluid fixation. Furthermore, the IP procedure on paraffin-embedded tissue appears to have potential as an aid to the diagnosis. IP stained leptospiral antigen was detected in portal spaces of the liver, engulfed by cells of the mononuclear phagocyte system, in the interstitium of the kidney, and lining vessel walls of both liver and kidney. The results suggest that in acute human leptospirosis (L. interrogans serovar icterohaemorrhagiae) the main factors in the pathogenesis of the lesions are related to the presence of organisms and/or their virulence, including products released by lysis. PMID- 3553507 TI - Immunostaining for S-100 protein: another suitable tool for analysing dendritic reticulum cells in AIDS-related lymphadenopathy. PMID- 3553508 TI - Malignant lymphoma--a clinician's view. PMID- 3553509 TI - The diagnosis of malignant lymphoma using monoclonal antibodies reactive in routinely fixed wax embedded tissue. PMID- 3553510 TI - The histogenesis of the Reed-Sternberg cell and its mononuclear counterparts. PMID- 3553511 TI - A useful low temperature method for post-embedding electron immunocytochemistry in routine histopathology. AB - Using a low temperature resin, we have developed a reliable technique for post embedding electron immunocytochemistry which is rapid enough to be used in a routine histopathology laboratory. Glutaraldehyde fixed human tissues were dehydrated and embedded at -25 degrees C in a new acrylic resin called LR-Gold. Using the immunogold technique, ultra-thin sections of the tissues were labelled with monoclonal antibodies to cytokeratin, human milk fat globule and HLA-D region antigen; and with polyclonal antisera to lysozyme, kappa and lambda light chains and immunoglobulin M. The resin was easy to section and the preservation of fine structure was excellent. Immunolabelling procedures gave clean and consistent results, and electron micrographs of examples of this are included. It was felt that the preservation of ultrastructure and antigenicity compared well with the results of other workers using low temperature resins such as Lowicryl K4M, but LR-Gold was superior to Lowicryl K4M because sectioning was considerably easier and the sections were more stable in the electron beam. PMID- 3553512 TI - Sudden infant death syndrome: 1987 perspective. AB - The pathophysiology of SIDS remains unknown. Although a multifactorial cause appears plausible on the basis of available data, new data are needed to determine which components of this multifactorial hypothesis are most important and whether other factors need to be added. We need to better understand control of breathing in the newborn infant and the manner in which maturation of cardiorespiratory control progresses during infancy. The unique period of vulnerability for SIDS, in which risk is less in the neonate than at 2 to 6 months of age, remains unexplained. Is there a worsening in some aspect of cardiorespiratory control in infants destined to die of SIDS? An improved understanding of the increased risk in black infants, preterm infants, and infants with intrauterine drug exposure, although only a small percentage of all SIDS deaths, should contribute substantially to our understanding. Appropriately designed and well-controlled prospective studies are needed in asymptomatic infants at risk, to determine the true contemporary nonintervention rate of SIDS and the extent to which any assessment or intervention lowers this rate. Prospective pneumogram screening studies have demonstrated significant group differences in respiratory patterns in normal infants compared with later SIDS victims, but have failed to achieve sufficient sensitivity and specificity to be useful for populationwide prospective screening. To assess aspects of brainstem cardiorespiratory control in addition to those assessed by a conventional pneumogram, future studies will need to be based on an expanded or modified technology. On the basis of both physiologic considerations and available technology, addition of an oxygen saturation channel offers the most promise for providing a more comprehensive assessment of cardiorespiratory control. If there is an underlying deficiency in asphyxic arousal responsiveness, for example, with or without other respiratory control deficits, continuous monitoring of oxygen saturation as part of a second-generation pneumogram system currently has the greatest promise for providing a modified pneumogram assessment of greater clinical use. The use of continuous oxygen saturation as a home monitoring technique should also be investigated. Power spectrum analysis of cardiorespiratory variability also appears to have potential advantages over conventional pneumogram analyses, and needs to be evaluated in prospective studies. The following statements summarize our current knowledge regarding SIDS, apnea, pneumograms, and home monitors: The cause(s) of SIDS remains unknown.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3553513 TI - Efficacy of benzathine penicillin G in group A streptococcal pharyngitis: reevaluation. AB - The rate of streptococcal eradication after intramuscular administration of benzathine penicillin G in 66 children with acute group A streptococcal pharyngitis was determined and possible reasons for treatment failure explored. Bacteriologic treatment failure, defined as isolation of the same serotype at 3- or 6-weeks follow-up, occurred in eight (12%) patients. The treatment failure rate was 21% in those with immunologically significant infection, versus 8% in those without antibody rises (P greater than 0.1). All group A beta-hemolytic streptococcal (GABS) strains isolated from patients with treatment failure, both before and after benzathine penicillin G therapy, were exquisitely susceptible to penicillin G (minimum inhibitory concentration less than or equal to 0.02 microgram/mL), and none showed evidence of tolerance (minimum bactericidal concentration less than or equal to 0.04 microgram/mL). Thus, we found GABS eradication rates to exceed 10% in children given benzathine penicillin G. The failure rate did not appear to be related to enrichment of the patient population with a high proportion of asymptomatic carriers nor to the presence of penicillin tolerant GABS. PMID- 3553514 TI - Histological and ultrastructural localization of antigen B in the metacestode of Taenia solium. AB - The morphological localization of antigen B (AgB) in the tissues of the Taenia solium metacestode was studied by immunological and biochemical methods. Indirect immunofluorescence carried out on vibratome sections showed that AgB is widely distributed throughout the tissue. A more intense fluorescence was observed in the tegumentary cytons of the bladder wall and in the lumen of the spiral canal of the invaginated scolex. Ultrastructural analysis of larvae washed in PBS after dissection from meat and then incubated with rabbit antibodies against AgB, followed by peroxidase-labeled goat anti-rabbit IgG, did not exhibit electron dense material on the external surface. Larvae fixed in glutaraldehyde immediately after dissection and exposed to the immunoperoxidase reagents did exhibit electron-dense material on microtriches, indicating that AgB is only loosely bound to the external surface. Crude extracts of surface-radioiodinated cysticerci analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) contained no labeled proteins with the molecular weight of AgB. Autoradiography of the immunoelectrophoretograms in which the crude extract was confronted with antibodies to AgB demonstrated that this antigen was not labeled, and therefore is not exposed on the tegumentary surface. The results suggest that AgB is synthesized by the tegumentary cytons of the parasite and secreted through the tegumental membrane into the host tissues and the lumen of the spiral canal. PMID- 3553515 TI - The specific anti-parasite immune responses of germ-free and conventional rats infected with Trypanosoma lewisi. AB - To test the hypothesis that the rapid immune response of rats to Trypanosoma lewisi is elicited by prior exposure to cross-reacting environmental antigens, the early immune response to infection with this nonpathogenic protozoan was studied in germ-free and conventional rats. In germ-free rats, initial levels of both IgG and IgM were significantly lower than those of conventional rats. After infection, the germ-free rats made more immunoglobulins of both classes, and made them more quickly, than did conventional rats. Trypanosome-specific antibodies appeared earlier and in higher titers in the germ-free rats. Because they lacked intestinal microflora, it is unlikely that the germ-free rats' responses had been primed; thus, these observations indicated that the conventional rats' responses to some trypanosome antigens had been down-regulated by their prior exposure to environmental antigens. However, protective antibodies that inhibited parasite reproduction (ablastin) may have been primed, because these appeared in sera 2 days earlier in conventional rats. Despite much lower rates of production of trypanosome-specific antibodies, the conventional rats had the same peak parasitemias and times to crisis as germ-free rats. Thus it is apparent that protective immunity to this nonpathogenic parasite is not down-regulated by prior exposure to environmental antigens, as would be predicted. PMID- 3553517 TI - Long-term immunological response induced by attenuated Trypanosoma cruzi in mice. PMID- 3553516 TI - Proteolytic cleavage of IgG and other protein substrates by Dirofilaria immitis microfilarial enzymes. AB - Proteases were detected in aqueous extracts of Dirofilaria immitis microfilariae. Enzymes within the extract were capable of hydrolyzing Azocoll, a general protease substrate, at pH's 7, 8, and 9. Sensitivities to a variety of protease inhibitors indicated that multiple azocollytic enzymes were present in the extract, most prominent of which appear to belong to the serine class of proteases. By incorporating various substrates into the matrices of polyacrylamide gels, 2 SDS-resistant, mercaptoethanol-sensitive proteases in the MF extract were identified at 22 and 76 kDa. These proteases showed differential abilities to digest casein, fibrinogen, hemoglobin, and IgG. The MF extract hydrolyzed radiolabeled IgG into 8-10-kDa fragments following a 20-hr incubation. A similar degree of digestion was observed in 2 hr when viable microfilariae were used. The potential significance of these proteases in the evasion of host effector mechanisms is discussed. PMID- 3553518 TI - The exploitation of host immune responses by parasites. PMID- 3553519 TI - Classroom social interactions of attention deficit disorder with hyperactivity children as a function of stimulant medication. PMID- 3553520 TI - Differences in development of keratomycosis after Candida inoculation in the central and peripheral cornea. AB - To compare the development of keratomycosis after central or peripheral corneal inoculation, Candida albicans was inoculated in the central portion of the right eyes of 24 rabbits and in the peripheral cornea, near the limbus, of the left eyes in the same rabbits. The clinical scores of the central ulcers were significantly higher than those of the peripheral lesions. On the 12th day after inoculation, all cultures of corneal specimens from the peripheral ulcers were negative, while 10 cultures from the central ulcers were still positive. Histopathologic examination showed earlier and more extensive inflammatory reactions in eyes with peripheral lesions, compared with those in eyes with central lesions. PMID- 3553521 TI - Quantification of vaginal Candida albicans infections in rodents. AB - Estradiol-treated mice and estradiol-treated ovariectomized rats support vaginal infections with Candida albicans for several months; low-grade uterine infections occur in around half the animals. A comparison has been made and the relative advantages discussed of quantifying these infections by sampling with a wire loop and plating on BiGGY agar, sampling by vaginal washing, or removal and homogenization of the vagina followed by dilution and plate counting. PMID- 3553522 TI - Adhesion of Candida albicans to mouse intestinal mucosa in vitro: development of the assay and test of inhibitors. AB - This study describes an in-vitro assay for estimating numbers of Candida albicans adherent to mouse intestinal mucosa. No significant differences were observed in the capacity of C. albicans to adhere to genetically distinct mouse strains nor in the binding ability of three C. albicans strains. Chitin soluble extracts, prepared from chitin isolated from C. albicans or from chitin obtained commercially, inhibited adhesion of the yeasts to duodenal tissue by 48% and 43%, respectively. PMID- 3553523 TI - Increased drug sensitivity in Candida albicans cells accumulating 14-methylated sterols. AB - Multiple increases in drug sensitivity were observed in Candida albicans cells that were accumulating 14-methylated sterols as a result of a mutation or clotrimazole treatment. The possibility was suggested that a change in membrane permeability caused by the alteration in sterol composition was responsible for the increased susceptibility. PMID- 3553524 TI - The effect of Candida albicans on the permeability of rat palatal epithelium: an ultrastructural and biochemical study. AB - The effect of a palatal acrylic appliance and/or infection with Candida albicans on the permeability of rat palatal epithelium has been investigated. Although normal rats, or rats inoculated with Candida albicans but without a prosthesis, had a barrier to perfused lanthanum, some low-molecular-weight proteins were able to pass through the epithelium. When infection was established by inoculation of Candida albicans under an acrylic plate, the epithelium became permeable to perfused lanthanum. Polyacrylamide gel electrophoresis of perfusates showed that a selective permeability to proteins was retained in such animals. Removal of acrylic plates from infected animals resulted in healing and restoration of the barrier to lanthanum. PMID- 3553525 TI - The lipid composition and permeability to azole of an azole- and polyene resistant mutant of Candida albicans. AB - Candida albicans 6.4, which is resistant to both polyene and azole groups of antifungal antibiotics, has a larger lipid content and lower polar lipid to neutral lipid ratio compared with other strains that are sensitive or resistant only to azoles. C. albicans 6.4 contains a relatively greater proportion of triacylglycerol in its neutral lipid in the exponential phase of batch culture compared with other strains, but, unlike them, does not accumulate triacylglycerols or any other stored lipid in the stationary phase. Like other strains, in C. albicans 6.4 the major phospholipids are phosphatidylcholine, phosphatidylethanolamine and phosphatidylinositol, but sphingomyelin is absent; the major fatty acids are palmitic, palmitoleic, oleic and linoleic acids. In common with other C. albicans strains, strain 6.4 contains non-specific (lyso)phospholipase activity. The main distinctive feature of the lipid composition of C. albicans 6.4 is the absence of ergosterol, which is replaced by methylated sterol; mainly lanosterol, 24-methylene-24,25-dihydrolanosterol and 4 methylergostadiene-3-ol. It is suggested that the altered membrane sterol pattern provides a common basis for the double resistance by preventing polyene binding and reducing azole permeability. PMID- 3553526 TI - Host-parasite relationships in paracoccidioidomycosis. AB - A viewpoint of host-parasite relationships in paracoccidioidomycosis is presented. The characteristics of the fungus which are important to the host parasite interaction are discussed. Aspects of inhibition of mycelium-to-yeast transformation by estrogens acting at receptors on the fungal wall and in the cytoplasm, and the role of polysaccharide components of the cell wall in virulence are reviewed. The natural mechanisms of host defense are also examined, including phagocytosis, complement system, natural-killer cells and genetic control of resistance and susceptibility. Finally, a discussion of granuloma morphogenesis and its relationship to the humoral and cellular anti-P. brasiliensis immune response is presented. PMID- 3553528 TI - Congenital ureteral valves in children: case report and review of the literature. AB - Congenital ureteral valves are a rare cause of ureteral obstruction. While only 17 pediatric cases have been reported in the literature, this condition should be considered in the differential diagnosis of the child with upper urinary tract obstruction. The pediatric cases are reviewed, and we present an additional case in which unilateral hydronephrosis caused by a ureteral valve was first detected by ultrasound in utero. PMID- 3553527 TI - Surgical aspects of parasitic disease in childhood. AB - This is a review article concerning the surgical aspects of parasitic disease in childhood. The surgeon encounters parasitic disease for a variety of reasons. Many forms of infestation produce or mimic anatomic diseases of the gastrointestinal tract. Others are characterized by soft tissue or visceral mass lesions, lymphadenopathy, portal hypertension, etc. The surgical aspects of parasitism extend to all subspecialties, including ophthalmology, gynecology, and plastic surgery. PMID- 3553529 TI - Mutagenicity of some hydroxylaminotoluene derivatives towards Salmonella typhimurium in esterification systems. AB - The mutagenicity of 2-hydroxylamino-4-nitrotoluene (2HA4NT), 4-hydroxylamino-2 nitrotoluene (4HA2NT), 2-hydroxylamino-6-nitrotoluene (2HA6NT) or 4-acetylamino-2 hydroxylaminotoluene (4AA2HAT) towards Salmonella typhimurium strains TA98 and TA100 was investigated in the absence and presence of uridine-5' diphosphoglucuronic acid (UDPGA), acetyl CoA or 3'-phosphoadenosine-5' phosphosulfate (PAPS) systems, or S9 mix. None of the hydroxylaminonitrotoluenes (2HA4NT, 4HA2NT or 2HA6NT) were mutagenic in both strains while 4AA2HAT was a base-pair substitution mutagen in the UDPGA and PAPS systems. The indirect mutagenic activity was markedly decreased by omission of microsomal fraction (MCF) or UDPGA from the UDPGA system and by addition of beta-glucuronidase to the system. Similarly, the mutagenic activity was markedly decreased either when 105000 X g supernatant fluid (S105), adenosine triphosphate (ATP) or Na2SO4 was omitted from the PAPS system or when pentachlorophenol (PCP) or aryl sulphatase was added to the system. Moreover, the mutagenic activity in either system was markedly decreased by the addition of glutathione (GSH). These results suggested that two esterifications with glucuronic acid and sulfuric acid may play an important role in the appearance of mutagenic activity of 4AA2HAT. PMID- 3553530 TI - Mercury methylation by bacteria. AB - Bacteria capable of methylating Hg2+ have been isolated from sediment, water, soil and the gastrointestinal tract of humans. However, very little is known about the physiology and genetics of the mechanisms controlling Hg2+ methylation. Mercury methylation can be either chromosomal or plasmid-encoded in bacteria. In addition, the extent of nonbiological methylation is not well understood in environmental samples, where there are numerous physical, chemical and biological factors that control the methylation process. It is known that methylation of Hg2+ is mediated by a series of enzymatic reactions that are also responsible for the anaerobic evolution of methane. However, under highly reduced environments the reaction can also occur nonbiologically. It is possible that certain bacteria use methylation as a resistance/detoxification mechanism. PMID- 3553531 TI - Construction of bacterial strains with novel degradative capabilities for chloroaromatics. AB - Biodegradation of most naturally occurring compounds is relatively fast, since microorganisms have evolved appropriate enzyme systems. However, biodegradation is less likely in the case of man-made compounds like haloaromatics, which have structural features rarely or never encountered in natural products. One strategy to develop new metabolic activities for novel compounds by strains of microorganisms is by the alteration of their existing genetic information. The present paper summarizes results of studies where the degradation capabilities of bacteria were expanded by genetic material from external sources either by natural exchange or by cloning procedures. PMID- 3553532 TI - Deep versus appositional suturing of the scleral pocket incision for astigmatic control in cataract surgery. AB - A study was performed to determine whether alternative suturing techniques of a standard wound play a significant role in the immediate and long-term postoperative course of corneal astigmatism. Two groups of patients had phacoemulsification and posterior chamber lens implantation through a scleral pocket incision closed with a continuous suture. In one group, the sutures were apposed to the posterior edge of the scleral incision; in the second group, deep suture placement designed to incorporate the internal layer of the scleral pocket was used. The deep suture group demonstrated significantly reduced transient iatrogenic astigmatism but the eventual healed astigmatic results were similar for the two groups. The deep suture group developed no filtration blebs; these did occur in three of 50 cases sutured with the appositional technique. PMID- 3553533 TI - Histologic findings after successful posterior chamber lens implantation. AB - The eyes of a 50-year-old diabetic hypertensive woman who had had successful bilateral cataract surgery with posterior chamber lens implantation were examined post mortem. On gross examination, each eye was found to contain a Simcoe-style C loop lens with its optic centered satisfactorily and its inferior loop in the capsular bag. In the right eye the superior loop was in the ciliary sulcus; in the left eye most of the superior loop was in the ciliary sulcus but its distal end was in the capsular bag. Histologic sections confirmed the location of the haptics. PMID- 3553534 TI - [Effect of tooth mobility on periodontal (repair) healing following treatment (literature review)]. PMID- 3553535 TI - [Determination of periodontal disease activity: traditional approach and current data]. PMID- 3553536 TI - Acute regional vascular effects of intravenous captopril in a rat model of myocardial infarction and failure. AB - The effects of i.v. captopril on regional blood flow (radioactive microspheres, 15 +/- 5 micron), hemodynamics and maximal oxygen consumption were evaluated in conscious rats with congestive heart failure due to large myocardial infarction (n = 9, infarct size 39.5 +/- 2% of left ventricle) and compared to data obtained from rats subjected to sham surgical procedures (n = 8). In both groups data were obtained at rest and during submaximal treadmill exercise during alternate infusion of captopril and saline. In the congestive heart failure group captopril reduced systemic vascular resistance, mean arterial pressure and left ventricular systolic pressure (P less than .05 each). Blood flow to the renal, gastrointestinal and coronary circulations was reduced in the heart failure group treated with saline vehicle. Flow to the renal and gastrointestinal beds of heart failure animals was enhanced to values similar to those observed in sham animals during captopril treatment. Left ventricular coronary flow was also increased significantly by captopril in both sham and heart failure animals. The most prominent effects of captopril occurred in the renal circulation of the heart failure group in which blood flow increased by 55%. Blood flow to skeletal muscle and skin was unchanged by captopril both in sham and heart failure animals at rest and during exercise. Maximal oxygen consumption was not affected by captopril treatment. Thus, captopril induced a differential pattern of vasodilation with the greatest effect in the renal bed and a less intensive effect in the gastrointestinal and coronary beds. The unchanged flow to skeletal muscle may explain the failure of captopril to improve exercise capacity after short-term administration. PMID- 3553537 TI - Discriminative stimulus properties of lisuride revisited: involvement of dopamine D2 receptors. AB - Although the discriminative stimulus effects of the clinically useful ergot derivative lisuride have previously been related to dopamine (DA) neuronal systems, the involvement of DA D1 and D2 receptor subtypes in the lisuride cue has been characterized for the first time in the present experiment. In rats trained to discriminate lisuride (0.04 mg/kg) from saline, appropriate doses of the putative D2 agonist LY 171555 (0.008-0.063 mg/kg) substituted completely whereas the D1 agonist SKF 38393 (2.0-16.0 mg/kg) evoked primarily saline-lever responding. When given in combination with lisuride (0.04 mg/kg), the D2 antagonist (-)-sulpiride (5-30 mg/kg), but not the D1 antagonist SCH 23390 (0.125 0.5 mg/kg), blocked the lisuride cue. Combination tests also suggested that bromuride and pirenperone have DA antagonist properties. Although the specificity of these agents is not fully known, these results support the conclusion that D2 but not D1 receptors play an important role in the stimulus effects of lisuride. Although a role for serotonin in the similar stimulus properties of lisuride and SCH 23390 cannot be ruled out, partial substitution of SCH 23390 (0.0625-0.35 mg/kg; administered alone) for lisuride complements previous observations which suggest that the two DA subtypes may be functionally linked in vivo. PMID- 3553538 TI - Pharmacological analysis of the apomorphine discriminative stimulus in rhesus monkeys. AB - Four rhesus monkeys were trained to discriminate apomorphine (APO) from saline in a two lever, food-reinforced drug discrimination paradigm. After acquisition of the discrimination (average = 161 sessions), they were tested with a series of compounds selected to characterize the neuronal mechanism(s) of the discrimination and to determine whether the site of action was central or peripheral. APO produced a dose-related increase in the percentage of responses that occurred on the drug lever during test sessions. The D2 dopamine (DA) agonist piribedil substituted completely for APO and the D2 DA antagonist pimozide antagonized the APO discriminative stimulus in a manner consistent with a competitive antagonism. On the other hand, the D1 agonist SKF 38393 engendered principally saline lever responding in all monkeys, whereas the D1 DA antagonist SCH 23390 was ineffective as an APO antagonist. The APO effect was neither mimicked by DA nor blocked by the D2DA antagonist domperidone, both of which fail to cross the blood-brain barrier to any significant extent. In substitution tests the norepinephrine reuptake blocker nisoxetine, the serotonin agonist quipazine and the cholinesterase inhibitor physostigmine, as well as d-amphetamine, cocaine and morphine engendered principally saline lever responding up to doses that substantially reduced rate of responding. Taken together these results suggest that the APO discriminative stimulus is based principally upon an action at a D2 receptor in the central nervous system and that this preparation can be used for studying the functional properties of central nervous system D2 receptors. PMID- 3553540 TI - Selective breeding for levorphanol-induced antinociception on the hot-plate assay: commonalities in mechanism of action with morphine, pentazocine, ethylketocyclazocine, U-50488H and clonidine in mice. AB - Selective breeding (selection) was used to bidirectionally alter gene frequencies affecting levorphanol antinociception on the hot-plate assay in mice. After 12 generations of selective breeding, the high antinociceptive response line exhibited about 7 times steeper dose-response curve than did the low antinociceptive response line whereas only small differences were seen with saline alone. The authors sought to determine whether these large, genetically mediated differences in sensitivity bred into the high and low antinociceptive response lines (lineages) with levorphanol would also be evident with other analgesics. Should this occur with any particular drug, this would imply common mechanisms of action between that drug and levorphanol mediated by common gene action. This was found to be the case with morphine, but progressively less similarity to levorphanol was seen with other analgesics with the following rank order: morphine greater than pentazocine greater than ethylketocyclazocine greater than U-50488H greater than clonidine. Thus, the mechanisms of action for the latter compounds are different from levorphanol in varying degrees. The role of sedation produced by some of these drugs was also evaluated and was found to be independent of the antinociceptive effects. Thus, the latter was not confounded by the former in these genetic lines of mice. PMID- 3553539 TI - Tyramine neurotoxicity and first-pass brain technetium-99m-diethylenetriamine penta-acetic acid. AB - Tyramine induces coma in phenelzine-treated dogs with liver disease. The objective of the present investigation was to examine the influence of tyramine in these monoamine oxidase-inhibited dogs on the kinetics of Tc-99m diethylenetriamine penta-acetic acid (Tc-99m-DTPA) during its first passage through the brain by nuclear imaging techniques. The study began with anesthetized mongrel dogs (n = 10) in a supine position over the camera detector. Data acquisition was started simultaneously after the rapid intracarotid injection of Tc-99m-DTPA (5 mCi) and 60 0.5-sec images of the brain were taken. Tyramine induced increased uptake with a concomitant impairment in the elimination of Tc-99m-DTPA from the brain of these phenelzine-treated animals with hepatic injury (n = 5) as compared to pretreated animals serving as a control group or phenelzine-treated animals without liver disease. This was accompanied by an appreciable reduction in hemispheric cerebral blood flow (50.5 +/- 19.3 vs. 110 +/- 16 ml/100 g/min), respectively. Increased cerebrovascular permeability of Tc-99m-DTPA and decreased cerebral blood flow occurred concomitantly with increased cerebrospinal fluid pressure and elevation in cerebrospinal fluid catecholamines of monoamine oxidase-inhibited animals with hepatic injury. PMID- 3553541 TI - Suppression by muscarinic M2 stimulation of the contractile mechanism via histamine H1 receptors in the longitudinal muscle of guinea pig ileum. AB - The longitudinal muscle of the guinea pig ileum is well known to contract in response to stimulation of either muscarinic or histamine H1 receptors. However, we found that simultaneous application of agonists to both receptors, methacholine (MeCh) and histamine (Hist), at their maximum concentrations (both at 10(-5) M), induced a contraction of the muscle with a pattern very similar to that observed with MeCh alone. In the muscle contracted by MeCh, a muscarinic antagonist, atropine, caused a transient relaxation, but a histamine H1 blocker, pyrilamine, had no effect on the tension. Experiments using pirenzepine indicated that muscarinic-M1 receptors did not seem to be involved in the mechanism of this phenomenon. The atropine-induced relaxation was not affected by phentolamine (10( 6) M), propranolol (10(-6) M) or tetrodotoxin (10(-6) M). After pretreatment of the muscle with 10(-5) M MeCh for 10 min, the contractile effect of 10(-5) M Hist was suppressed intensely for a certain time period, but that of 10(-5) M MeCh was not diminished. On the other hand, pretreatment of the muscle with 10(-5) M Hist for 10 min did not influence the contraction by either MeCh or Hist. The suppression by MeCh of the Hist action developed dependently on the concentration of MeCh and the time length of exposure to MeCh, and the persistence was temperature-dependent. Furthermore, this suppression was not surmounted by the elevation of Hist concentration. A similar phenomenon was also observed in the muscle which was immersed in the nutrient solution without CaCl2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553542 TI - The quantal release at a neuro-neuronal synapse is regulated by the content of acetylcholine in the presynaptic cell. AB - Transmitter release was studied with respect to the presynaptic acetylcholine (ACh) content at a central identified inhibitory synapse (Cl- conductance) of Aplysia californica. Statistical analysis of the synaptic noise evoked by sustained depolarization of the presynaptic neuron allowed us to calculate the quantal parameters of the postsynaptic responses. Loading of the presynaptic neurone with injected ACh led to an increase in the postsynaptic responses whereas the calculated miniature postsynaptic current (MPSC) was unmodified. Destruction of choline by choline oxidase either applied extracellularly and coupled to intense stimulations of the presynaptic cell or injected into the presynaptic neuron induced a depression of the postsynaptic response although the amplitude of the calculated MPSC remained constant. As the size of the MPSC, i.e. the size of the quantum, did not change in these experiments, it was concluded that the presynaptic ACh content controls the number of quanta released by a given presynaptic depolarization. As additional evidence, effects of abrupt increase in tonicity of the external medium were studied. The observed transient enhancement of the quantal content of the postsynaptic response could be attributed to an increase in the presynaptic concentration of ACh, resulting from the reduction in cellular volume. PMID- 3553543 TI - [Fluidity and lipid dynamics in biomembrane from a fluorescence depolarization study]. PMID- 3553544 TI - A practical approach to full mouth rehabilitation. AB - The concepts of traditional full mouth reconstruction have been reviewed. A practical full mouth rehabilitation technique has been described combining the chairside advantages of the programmed quadrant reconstruction with the laboratory advantages associated with the complete mouth simultaneous rehabilitation. PMID- 3553545 TI - A marriage of convenience: bonds of retention pins and composites. PMID- 3553546 TI - An alternate method for establishing porcelain margins. AB - The technique described is simple, safe, and requires no special training or expertise in its application. Hi-Temp special liquid is readily available and has an indefinite shelf life. The technique enables easy fabrication of ceramometal crowns with porcelain margins with fewer problems and greater accuracy. PMID- 3553547 TI - An evaluation of post length within the elastic limits of dentin. AB - Posted teeth were evaluated to determine the reinforcement capabilities of various post lengths. The results suggest that as internal tooth structure is removed from the tooth the tooth becomes weaker, that teeth with posts do show more reinforcement than nonposted teeth with the same manipulation characteristics, and that some load transfer appears to exist with cemented posts. PMID- 3553548 TI - Root stresses with tapered-end post design in periodontally compromised teeth. PMID- 3553549 TI - A comparison of the compatibility of elastomeric impression materials, type IV dental stones, and liquid media. PMID- 3553550 TI - Microscopic examination of resin bond to enamel and retainer with a phosphate monomer resin. PMID- 3553551 TI - Incidence of impression material found in the gingival sulcus after impression procedure for fixed partial dentures. AB - After impression-making procedures, remnants of Xantopren impression material were found in the gingival crevices in eight of 125 patients. In three of the eight patients, remnants were only discovered subsequent to a systematic exploration with a fine curette. In all eight of the patients in which material was found in the crevice, the location corresponded with defects in the impression itself. Although eight of 125 is not a statistically significant number, it would be nonetheless prudent to consider a routine curettage of abutment sulci after impression-making. This procedure is even more strongly recommended should a defect be detected in the crevicular region of the impression. Impressions should remain in the mouth until full setting and maximum tear strength is reached. Strict adherence to the manufacturers' instructions is necessary. PMID- 3553552 TI - Vertical alveolar bone changes related to overdenture abutment teeth. PMID- 3553553 TI - The influence of removable prosthodontic procedures and concepts on the esthetics of complete dentures. PMID- 3553554 TI - Abutment tooth movement measured in vivo by using stereophotogrammetry. PMID- 3553555 TI - A technique for fabrication of a cheek recontouring prosthesis. AB - A technique has been described for fabrication of a removable prosthesis that restores proper cheek contour. This prosthesis is a modified removable partial denture with a retentive surface to hold an acrylic resin bolus to recontour the cheek from within. The advantages of such a prosthesis for the patient with facial nerve paralysis include restoration of fullness and proper contour to the cheek (Figs. 7 and 8), prevention of trauma to the buccal mucosa during mastication, and stretching of the cheek, which indirectly improves oral hygiene in the buccal sulcus. The disadvantages of this technique include limited improvement in esthetic and functional contour of the cheek, and food accumulation beneath the acrylic resin bolus, which requires more meticulous hygiene. PMID- 3553556 TI - Potential health hazards of ceramic ring lining material. PMID- 3553557 TI - Distribution of acid-etched, fixed, and removable prostheses in dental patients. AB - This report describes the pattern of tooth replacement for a random sample of adult dental patients in a major urban area in the northeastern United States. The data were collected by using a practitioner-based epidemiologic monitoring system that had been established with the local dental society. Nearly 90% of the randomly selected dentists collected the data on all adult patients seen during a 1-week period. The 2069 patients examined were predominantly regular users of dental care with a relatively even distribution across 10-year age groups. There was a slight preponderance of women in the sample (55%). There were no significant differences between men and women in terms of mean numbers of missing teeth. Overall, 92% were dentulous in both arches, 6% were edentulous in one arch, and 2% were totally edentulous. When the space was available for replacement, molars and premolars showed the lowest percentages of replacement in both arches for each age group. Overall, 14.4% of the replaced teeth were replaced by a fixed partial denture, of which acid-etched fixed partial dentures contributed 0.6% and conventional fixed partial dentures the remaining 13.8%. Removable prostheses replaced 85.6% of the missing teeth. The proportion of fixed replacements was highest in the youngest age groups and the proportion of removable replacements was dominating in the older age groups. Acid-etched fixed partial dentures were found most frequently in the youngest and oldest age groups. PMID- 3553558 TI - Custom contoured temporary crowns. PMID- 3553559 TI - Esthetic modification of removable partial denture teeth with light-cured composites. PMID- 3553560 TI - The staining characteristics, transverse strength, and microhardness of a visible light-cured denture base material. PMID- 3553561 TI - Odontic trisection: an alternative therapy. AB - The purpose of this article is to familiarize dentists with alternative methods of therapy for trifurcation involvement. Because failures with complex treatment are a reality, patients should be informed of the risks before treatment is instituted. Despite the potential for failure, longitudinal clinical results support the extraordinary measures to retain teeth in critical arch positions. PMID- 3553562 TI - Compressive strengths of a new foil and porcelain-fused-to-metal crowns. AB - This study evaluated the compressive strengths of Renaissance foil and porcelain fused-to-metal crowns on polycarbonate test dies. Both crown types were veneered with feldspathic porcelain. The compressive strength of the PFM crowns, 1895 +/- 317 N, was statistically higher than that of the Renaissance foil crowns, 1060 +/ 89 N. Comparison of the Renaissance foil crown's compressive strength to published biting forces indicated that the Renaissance crown should function without difficulty. PMID- 3553563 TI - Effect of cavity varnish on retention of cemented cast crowns. PMID- 3553564 TI - The relationship of the position of crown margins to gingival health. AB - A survey was conducted of 423 crown margins that were divided into 355 subgingival margins and 68 supragingival margins. The plaque index, gingival bleeding, and recession surrounding the artificial crown were recorded and compared to the unprepared contralateral tooth. Gingival tissues tended to bleed 2.42 times more frequently with subgingival margins and have a 2.65 times higher chance of gingival recession. Crowns with supragingival margins did not differ significantly compared with the contralateral tooth, but crowns with subgingival margins had greater bleeding and recession compared with the contralateral tooth. It is recommended that supragingival margins become standard clinical procedures when feasible. A further analysis will be instituted to determine whether different crown materials affect the gingivae. PMID- 3553565 TI - Factors affecting the retention and fit of gold castings. AB - A study was designed to simulate clinical conditions. Several factors were evaluated for effect on retention and fit (margin adaptation) of gold castings. Twenty-six castings (13 pairs) were made by different investigators using a standard preparation but with varying fabrication techniques. One of each pair of castings was made on a spaced die and one on an unspaced die. A significant difference in the postcementation retention was observed in the varying techniques of each investigator. Retentive values varied from 29 to 129 lbs. Complete seating of the castings during cementation was improved by the use of die spacer. Castings made on the spaced dies had more retention than corresponding unspaced castings. Die spacing has positive benefit when properly used. Moderate roughness of axial surfaces improves retention when zinc phosphate cement is used. Physical properties of restorative materials are important, but the individual technique and care of each investigator has a major effect on the ultimate fit and retention of the cast restoration. PMID- 3553566 TI - Bond strengths of the lost salt procedure: a new retention method for resin bonded fixed prostheses. AB - Shear bond tests were described for a new lost salt procedure for developing retention to the metal framework for a resin-bonded fixed partial denture. It was found that different salt crystal sizes influence the bond strength. The salt crystal size range of 150 micron to 250 micron was significantly stronger than the smaller and larger size ranges tested. This size range produced a surface more easily evaluated visually than an etched metal surface for retention. The bond failure observed was a fracture of the bonding resin and not an adhesive pulling our of the resin from the cubic surface voids. PMID- 3553567 TI - A photoelastic study to determine the location of the nonrigid connector in a five-unit intermediate abutment prosthesis. PMID- 3553568 TI - Tongue position in relation to edentulous mandibular impressions. AB - An adjustable easily located impression tray handle was used as a device to control tongue position and muscular forces for mandibular complete denture impression-making. This technique is indicated where advanced residual ridge resorption is present. A denture made with a lingual guiding ramp conforming to such an impression is not a panacea for all mandibular denture problems, which have many complex causes. However, the lingual guiding ramp technique gains support from established physiological findings and can yield gratifying clinical results. PMID- 3553569 TI - An altered-cast impression technique that eliminates conventional cast dissecting and impression boxing. AB - An altered-cast impression technique that eliminates conventional cast-dissecting and impression-boxing procedures has been described. The master cast obtained by this method reproduces the teeth in anatomic form and the residual alveolar ridges in functional form. PMID- 3553570 TI - Transfer impression for accurate adjustment of a metal coping insert for the submerged implant. AB - A technique allowing accurate alignment and interocclusal spacing of the coping insert for submerged implants has been described. Transferring the coping from the mouth to the master cast will provide predictable treatment results and is particularly useful when intraoral visualization is difficult. PMID- 3553571 TI - Response of processed resilient denture liners to Candida albicans. PMID- 3553572 TI - Evaluation of hard direct reline resins. AB - Peak curing temperatures of hard, direct, autopolymerizing reline resin materials tested were all within ADA specification guidelines. A temperature range of 10 degrees C was demonstrated among materials, with the highest polymerization temperatures recorded for Perm and Lang's Self-Curing Rebase Acrylic, and the lowest for KOOLiner, Flexacryl, and COE-Rect. This temperature difference is probably clinically detectable. However, intraoral testing of polymerization temperatures yielded lower peak values than those observed with specification testing, and the temperature peaks occurred earlier with intraoral conditions. There were significant color changes with simulated aging for three of the products tested: Flexacryl, COE-Rect, and Lang's Self-Curing Rebase Acrylic. The color changes occurred after only 24 hours of accelerated aging. Although there was only a small change in color with aging for Perm and KOOLiner, there was a moderate shift in the color of KOOLiner (delta E = 2.2) before aging. Thus only Perm demonstrated little color change with simulated aging. Of the reline products, one material, KOOLiner, demonstrated lower bond tensile strengths to denture base materials. However, the clinical significance of this was not known. One denture base material (Astron) recorded significantly higher bond strength values for all reline products and failure always took place within the denture base. PMID- 3553573 TI - Improved adhesion of denture acrylic resins to base metal alloys. PMID- 3553575 TI - Adding retention loops to partial dentures. PMID- 3553574 TI - Stabilized bases using available undercuts for retention and stability. AB - When resilient tissue conditioner is adapted into the undercuts and bonded to acrylic resin base material, its resilience allows freedom to insert and remove the trial base and its softness provides protection from excessive abrasion of the cast. Available undercuts and intimate tissue contact provide greater stability and retention of the trial base. PMID- 3553576 TI - Reviewing the literature: a treasure hunt. PMID- 3553577 TI - Development of thermotolerance in HMV-I human malignant melanoma cells grown in vitro as multicellular spheroids. PMID- 3553578 TI - [Multinodular hepatic steatosis. Ultrasonic and x-ray computed tomographic aspects. Apropos of a case]. AB - Focal hepatic steatosis can present as definite hepatic nodules, this particular form being rare and poorly documented. Ultrasound images show hyperechogenic type nodules assisting diagnosis of cases with affections known to provoke steatosis. CT scan images provide a positive diagnosis of steatosis if these solid nodules are very hypodense and do not take up contrast. In difficult cases, guided puncture cytology establishes a definite histologic diagnosis. PMID- 3553579 TI - [Ultrasonic diagnosis of non-palpable germinal tumors of the testis. Apropos of 2 cases]. AB - The germ cell tumors are the most common type of testicular malignant tumors (90%). About 30% are revealed by metastasis usually into the retroperitoneum, with clinically normal testis. Ultrasound reveals a bright echogenic focus into the testis which is typical, considering the clinical presentation, for a regressed germ-cell tumor and guides the side of the orchidectomy which allows to suppress a still active tumoral tissue which will not be eradicated by chemotherapy. Two typical cases with sonographic guidance are reported herein and confronted with the cases previously described in the literature. PMID- 3553580 TI - [Ectopic renal artery]. AB - A case of aberrant origin of the right renal artery from the aorta at level Th 12, above the origin of the visceral arteries is reported. The literature of these rare anomalies of the origin of the renal arteries is reviewed. PMID- 3553581 TI - [Cystic lymphangioma of the mediastinum. Radiologic data apropos of 7 cases]. AB - Cystic mediastinal lymphangiomas are rare benign uncommon slow-growing tumors. Seven cases of cystic mediastinal lymphangioma in adults are presented. In both cases a mediastinal opacity is evident on plain chest radiographs. Roentgen findings are not specific. The mass is noted to be non-pulsatile, and well circumscribed smooth-surfaced. There are no evidence of invasion to the neighboring structures and no calcification are seen within the lesions. In two patients, sonography examination confirmed the cystic nature of the mass. Four patients underwent computed tomography (CT) scan. Ct can offer considerable additional information: CT will show well circumscribed and uniform low density lesions without invasive characteristics. Attenuation values in CT scan cannot be considered conclusive for diagnosis in all cases, on the non contrast scan, attenuation varied between -49 to +27 UH, there was no contrast enhancement. PMID- 3553582 TI - Trends in the prevalence of dental fluorosis in the United States: a review. AB - This paper assesses, by comparing recent published evidence with Dean's pioneering work, whether an increase in the milder forms of dental fluorosis may have occurred since Dean's time. To the extent that the crude comparisons of recent research with historic studies are valid, the data indicate a slight trend toward more fluorosis today than would be expected based upon findings in the late 1930s and early 1940s. This suggested increase in fluorosis is not as clear cut nor as widely accepted as the recent decline in the prevalence of dental caries. Thus, further study of the prevalence of fluorosis and caries in relation to fluoride ingestion will be required to help validate the trend, and to allow dental researchers and decision makers to plan for the future. PMID- 3553583 TI - Hormonal requirements and the influence of age on the decidual cell reaction in the bank vole (Clethrionomys glareolus). AB - Laboratory bred bank voles of different age and reproductive status were bilaterally ovariectomized, treated with exogenous oestrogen or progesterone or both, and given an artificial decidual stimulus (crushing with artery forceps). An hormonal regimen of oestrogen (100 ng) followed by progesterone (1 mg) and small amounts of oestrogen (10 ng) was necessary for maximal development of the decidual cell reaction (DCR). A DCR did not develop if the animals were treated with only oestrogen or progesterone. Middle-aged virgin females 5-7 months old had larger responses than did young virgin females 2-3 months old, and parous females, 15-19 months old and having had at least 10 litters, had a response similar to that of virgin females of about the same age. The size of the DCR in old parous females was inversely related to the time elapsing since the last litter. It is concluded that in its hormonal requirements for a successful DCR the bank vole is similar to the mouse. The results also suggest that the increase in fertility of bank voles up to the age of about 100 days may in part be explained by increased response of the endometrium to blastocysts. The reduction in size of the DCR in old animals is a consequence of ageing rather than of repeated pregnancies. PMID- 3553584 TI - Cervical incompetence. A review. AB - Cervical incompetence is one of the main contributors to repeated pregnancy loss, accounting for approximately 25% of the cases. Typically it results in progressive cervical dilatation, leading to a painless second- or early-third trimester abortion. In most instances cervical incompetence is the result of previous obstetric or gynecologic trauma; a congenital etiology is unusual. Despite the various reported diagnostic procedures, the obstetric history and frequent visual and digital examinations during pregnancy remain the most important factors in arriving at the correct diagnosis. In spite of the fact that numerous procedures have been advocated as treatment, the McDonald purse string closure technique is by far the most simple and effective corrective surgical technique, yielding an overwhelming number of successful pregnancies. PMID- 3553585 TI - The limited spectrum of antinuclear antibodies in leprosy. AB - Sera from 46 consecutive patients with leprosy were collected and tested against an extensive panel of defined nuclear antigens. Antinuclear antibodies (ANA) were present in 16% of patients, but the titer was uniformly low and there was no consistent fluorescence pattern. None of the ANA positive sera contained antibodies which reacted with native DNA, or which were directed against histones, centromeres, SSB, Sm, or ribonucleoprotein. These more specific autoantibody assays thus retained their clinical utility in the differential diagnosis of rheumatologic complaints in patients with leprosy. PMID- 3553586 TI - A double blind comparison of diclofenac and indomethacin in the treatment of ankylosing spondylitis. AB - During almost 12 years of development and clinical trials, diclofenac sodium has been shown to be both effective and safe as a new nonsteroidal antiinflammatory drug (NSAID) for the treatment of rheumatic diseases including ankylosing spondylitis (AS). We compared the safety and efficacy of 75, 100, or 125 mg/day of diclofenac with the same doses of indomethacin in a multicenter, randomized, parallel group trial in patients with AS. A single blind placebo washout period of 2 days to 2 weeks preceded the 13-week double blind treatment period. Both diclofenac and indomethacin produced significant (p less than 0.001) improvement from baseline for all 14 efficacy variables analyzed. There were no significant between treatment differences. Differences favored diclofenac in the frequency and the severity of adverse experiences reported and in the frequency of complaints affecting the central nervous system. PMID- 3553587 TI - Hypertrophic osteoarthropathy associated with a rejected liver transplant. AB - A patient with severe hepatic transplant rejection presented with evidence of hypertrophic osteoarthropathy. The classic triad of clubbing, periostitis, and arthritis was present along with typical radiographic and bone scan findings. A second liver transplant was not successful and the patient died secondary to massive bleeding. Although hypertrophic osteoarthropathy is known to occur rarely in association with chronic liver disease, it has not been reported accompanying liver transplant rejection. This syndrome is to be differentiated from other causes of arthritis and musculoskeletal pain in liver transplant patients and may contribute towards additional morbidity in these patients. PMID- 3553589 TI - Popular literature on gout in the 16th & 17th centuries. PMID- 3553588 TI - Dural sinus thrombosis: a mechanism for pseudotumor cerebri in systemic lupus erythematosus. AB - We report a young woman with systemic lupus erythematosus complicated by pseudotumor cerebri which resolved with high dosage corticosteroid therapy. The cause of the raised intracranial pressure proved to be thrombosis of the torcular herophili and lateral sinuses. Despite laboratory evidence of a hypercoagulable state, the presence of a lupus anticoagulant could not be shown. PMID- 3553590 TI - Evaluation of the American Rheumatism Association preliminary criteria for remission in rheumatoid arthritis: a prospective study. AB - This study evaluates the American Rheumatism Association criteria for remission in rheumatoid arthritis (RA) using data gathered prospectively in 2 distinct patient groups: Americans (n = 181) and Peruvians (n = 44). The criteria were found to be highly specific in both patient groups but the sensitivity of the criteria was low in the American patients. The criteria most frequently not satisfied in the American patients with RA were subjective. Several explanations are offered: differences in disease severity, problems in using a translated questionnaire, differences in practice level among rheumatologists, but none of them fully explain the lower sensitivity of the criteria among the American patients. PMID- 3553591 TI - A multicenter double blind controlled study of lipo-PGE1, PGE1 incorporated in lipid microspheres, in peripheral vascular disease secondary to connective tissue disorders. AB - Lipo-PGE1 is a drug preparation of PGE1 (prostaglandin E1) incorporated in lipid microspheres similar in properties to liposomes. A multicenter, placebo controlled, double blind test of lipo-PGE1 was carried out in patients with severe peripheral vascular disease secondary to diffuse connective tissue disorders. A total of 135 patients received a 90 min intravenous infusion of either 10 micrograms lipo-PGE1 or placebo every day for 4 weeks. A significant improvement was noted in the lipo-PGE1 group compared with the placebo group in the final overall improvement of peripheral vascular disease (p less than 0.001) and in the healing of ulcers (p less than 0.01), whereas, there was no difference in Raynaud's syndrome between the 2 groups. Side effects in the lipo-PGE1 group were few and were no different from controls. These results indicate that lipo PGE1 at a low dose is beneficial in the treatment of peripheral vascular disease, and that lipid microspheres are useful as a drug delivery system for such purposes. PMID- 3553592 TI - Multicultural studies and the nature schizophrenia: a review. PMID- 3553593 TI - Paraneoplastic rheumatic disorders: a review. PMID- 3553594 TI - Building or extending a hospital department: radiology. A path through the planning minefield. (3). PMID- 3553595 TI - Effect of ivermectin on the reproductive potential of breeding rams. AB - Ivermectin was administered orally 6 times at 21d intervals at 400 micrograms/kg (double the recommended dosage) to 10 Merino rams. Ten other rams served as untreated controls. Semen samples were collected serially before and after each treatment, and evaluated for volume, density, colour, motility, pH, percentage live sperm and sperm morphology. One testis was removed from each ram 9d after the last treatment, and histological examinations were performed on testicular sections. The semen of the 2 groups was similar before the first and after the last treatments. The seminal pH of treated rams was lower during the periods following the first 5 treatments. The volume of ejaculates of treated rams was generally higher during the periods following the first 5 treatments, but not consistently so. No histological differences were observed in the testicular tissue of treated and control animals 9 days after the sixth treatment. It was concluded that repeated treatment with ivermectin at the recommended dosage of 200 micrograms/kg will not impair the reproductive potential of rams. PMID- 3553596 TI - The immune system of the neonatal and weaner piglet: a review. AB - The article reviews aspects of the immune system of the piglet from birth to weaning which may have practical application for the veterinarian. Subjects discussed are colostral immunity, the ability of the piglet to mount an immune response, the effect of weaning on the immune system, factors involved in the cause of post-weaning scours and its control. PMID- 3553597 TI - [The clinical pharmacology of glycerol guaiacolate ether in the horse--a review]. AB - The physical and chemical properties, administration, biotransformation, pharmacological effects, clinical applications, side-effects, toxicity and contraindications of glyceryl guaiacolate ether in the horse are reviewed. PMID- 3553598 TI - Effect of a gonadotropin-releasing hormone analog injected in bulldog bitches at the time of mating. PMID- 3553599 TI - Synthesis and antimalarial effects of 4-[(7-chloro-4-quinolinyl)amino]-2 [(diethylamino)methyl] -6-alkylphenols and their N omega-oxides. AB - A series of 4-[(7-chloro-4-quinolinyl)amino]-2-[(diethylamino)methyl]-6 alkylphenols and their N omega-oxides were synthesized by the condensation of 4,7 dichloroquinoline and 4,7-dichloroquinoline N omega-oxide with appropriately substituted 4-amino-2-[(diethylamino)methyl]-6-alkylphenol dihydrochlorides. The latter precursors were prepared in a six-step synthesis starting from available 2 alkylphenols. Several of the title compounds display potent antimalarial activity in mice. PMID- 3553601 TI - Infinite thickness in autoradiographs of carbon-14. PMID- 3553600 TI - [Perinatal prevention of dental caries: gynecologists, pediatricians and pedodontists share responsibility]. PMID- 3553602 TI - Floating on a water bath and mounting glycol methacrylate and hydroxypropyl methacrylate sections influence final dimensions. AB - This paper reports the dimensional changes occurring in the different steps of the histoprocessing of tissues for light microscopy. Two water-miscible methacrylates used for embedding, namely 2-hydroxyethyl methacrylate and 2 hydroxypropyl methacrylate, were investigated. It was found that during stretching on the water bath and in the mounting step considerable size changes occur, which are of the same magnitude as during the dehydration step of histoprocessing. The final dimensions of the sections and of microscopic images are dependent on the response to surface tension at the water surface and mounting of the glycol and hydroxypropyl methacrylate sections, respectively. Between the two resins under study, significant differences in the size of the resin sections, with and without embedded liver tissue, were found. It is shown that the temperature at which the sections are mounted is of great importance. These observations indicate the importance of standardizing histotechniques if morphometry is to be applied. PMID- 3553603 TI - The relative efficiency of cryogens used for plunge-cooling biological specimens. AB - Coolants used for freezing biological specimens were tested for cooling performance in the continuous plunge mode. Results from bare thermocouples showed that ethane cooled faster than propane or a propane:pentane mixture, even when warmed to 25 K above its freezing point. Propane coolants were more efficient than Freon 22 and the slowest cooling occurred in boiling liquid nitrogen. Hydrated gelatin specimens showed similar results with ethane cooling about 33% faster than propane. Epoxy resin specimens cooled faster than hydrated gelatin specimens of similar size. Hydrated and resin specimens cooled over increasing distances as plunge velocity increased. A bare thermocouple, however, cooled over a constant distance when plunged above a critical velocity. This phenomenon may reflect vapour formation and its suppression at high plunge velocities. The rate of cooling in hydrated specimens is shown to have an absolute limit and cannot be modelled by bare thermocouples or resin specimens. PMID- 3553604 TI - Particle number can be estimated using a disector of unknown thickness: the selector. AB - A new stereological method is presented whereby the number of particles in a material can be estimated unbiasedly using a few parallel sections from a block of the material, without having to know either section thickness or the distance between sections, and irrespective of particle size, shape and orientation. All that is needed is the final magnification. The method consists of three steps. Firstly, a few particles are sampled with identical probabilities using a disector (Sterio, 1984) of unknown thickness, namely a selector. Secondly, the volume of each sampled particle is unbiasedly estimated by means of point-sampled intercepts (Gundersen & Jensen, 1985) on a few particle transects. Thus, the mean individual particle volume vN in the population is estimated directly without having to refer to any containing volume. Finally, the particle volume fraction VV is estimated on a random section (by point-counting, say) and the numerical density of particles is estimated via the identity NV = VV/vN. Multiplying the estimate of NV with the reference volume we get an estimate of the total number of particles. The selector may be used not only for counting but also for choosing particles with identical probabilities in order to make, say, serial reconstructions of them. The practical details of the counting method are explained with the aid of a worked synthetic example and a real one involving hepatocytic nuclei. The mathematical proofs are given in two appendices. PMID- 3553605 TI - Acute appendicitis presenting as a scrotal abscess. PMID- 3553606 TI - Differences in kidney donations between blacks and whites: a retrospective study. AB - The differences in patterns of kidney donation between whites and blacks were examined over a four-year period. A statistically significant difference in living-related kidney donation between blacks and whites was observed: blacks acted as living-related donors far less frequently than their white counterparts. PMID- 3553607 TI - Identification of two cell surface proteins of rat brain oligodendrocytes in culture. AB - Antibodies specific for the surface of oligodendrocytes were prepared by incubating living cultures of pure oligodendrocytes with a crude anti oligodendrocyte antiserum. These specific antibodies, when used in the technique of immunoelectroblotting, led to the characterization of at least two major plasma membrane proteins of 43 kilodaltons (kDa) and 53 kDa, respectively, as accessible at the external surface of the oligodendrocytes. The 53-kDa protein was also found in oligodendrocyte-conditioned medium in significant amounts. Additional oligodendrocyte surface proteins were also detected in the Wolfgram protein fraction. PMID- 3553608 TI - Complications of surgically treated supracondylar fractures of the femur. AB - Surgical treatment of supracondylar fractures of the femur has become commonplace. A variety of surgical implants are available. In carefully chosen patients treated with appropriate surgical technique, early motion and good knee function can be obtained with open reduction and internal fixation. However, the morbidity (and mortality) are substantial following complications of open reduction and internal fixation of supracondylar fractures of the femur. We present a series of 30 consecutive patients referred to Rancho Los Amigos Medical Center for complications following open reduction and internal fixation of supracondylar femur fractures. Three patients with septic pseudarthrosis underwent above-knee amputations. Two of these three patients died of systemic sepsis. Fourteen additional patients were treated for nonunions, with 13 patients achieving union at an average time of 36.5 months from the date of injury. Six patients underwent quadricepsplasties for residual knee stiffness. Only 16 patients were returned to their preinjury ambulatory status. PMID- 3553609 TI - Avulsion of tibialis anticus and peronei muscles resulting in acute anterior and lateral compartment syndrome. AB - We present a case of compartment syndrome caused by an avulsion of the anterior tibial and peroneal muscles from their point of origin. At operation, the avulsed muscles were restored to their bed, and 1 week later a split-thickness skin graft was applied after further debridement. At 2-year followup the patient showed a slight limp. PMID- 3553610 TI - Immunomodulators and wound healing. AB - The synthetic immunomodulators muramyl dipeptide (MDP), thymopoietin pentapeptide (TP5), and CP-46,665 were examined for their effects on wound healing in mice. We found no differences in wound disruption strength between immunomodulator-treated animals and saline controls on days 11, 14, and 21. The only exception was with high-dose CP-46,665, which produced weakened wounds on day 14 (p less than 0.05) and 21 (p less than 0.01). CP-46,665 was further studied by injecting high and low doses 48 hours before or after wounding. No differences were seen for these groups compared to controls at 11 and 21 days. Finally, to simulate a common clinical situation, mice were subjected to a 10% total body surface area (TBSA) burn to the right paraspinal region. Twenty-four hours later, a left paraspinal incision was performed with simultaneous injection of saline, Corynebacterium parvum (C. parvum), or low-dose TP-5, MDP, or CP-46,665. At 11 days, no detriment in wound healing was found for burned control or any of the immunomodulator treated animals except in the C. parvum-treated mice, with significantly weakened skin strips (p less than 0.001). While C. parvum may be detrimental to wound healing, the synthetic modulators tested appear to have little effect on wound healing. PMID- 3553611 TI - Firearms as a cause of death in the United States, 1920-1982. AB - We present the epidemiologic history of firearms in the United States. Firearms are among the nation's ten leading causes of death. Nearly one million firearm deaths occurred in the half-century 1933-1982. Suicide is the leading type of firearm death. Teenagers, young adults, and males 75 years old and older are currently at highest risk. An individual's risk of suffering a firearm death has generally risen with age. Increased firearm availability is associated with increased rates of firearm homicide and suicide. Strategies to prevent firearm deaths and injuries should be formulated in light of these findings, and heightened efforts to design, implement, and evaluate preventive measures are urgently needed. PMID- 3553614 TI - Effectiveness of topically administered neutralizing antibodies in experimental immunotherapy of respiratory syncytial virus infection in cotton rats. AB - Initial studies of the prophylactic effect of parenterally administered respiratory syncytial virus (RSV)-neutralizing antibodies in cotton rats indicated that virus replication in lung tissues was restricted when animals with preexisting antibody titers in serum of 1:100 or more (as measured by plaque reduction) were challenged intranasally with 10(4) PFU of virus. Subsequently, a therapeutic effect of parenterally administered RSV antibodies (present in human gamma globulin) was demonstrated in both cotton rats and owl monkeys. Parenteral inoculation of RSV-infected cotton rats or owl monkeys with purified human immunoglobulin licensed for intravenous administration in humans (IVIG) effected a 10(-1.7) to 10(-2.7) reduction in the level of pulmonary virus at the height of infection. Because of these encouraging results, we examined topical administration of IVIG to determine whether it was also effective and whether it offered an advantage over the parenteral route with regard to simplicity and the dose required for full therapeutic effect. IVIG (0.025 g/kg) administered topically by the intranasal route to anesthetized cotton rats at the height of RSV infection effected a 10(2.2)-fold reduction in viral titers of pulmonary tissues and a complete clearance of detectable virus in 92% of the animals within 24 h. In contrast, 4 g of IVIG per kg was required to produce a comparable therapeutic effect when the material was administered parenterally. Thus, the therapeutic effect of IVIG was 160 times greater by the topical route than by parenteral inoculation. PMID- 3553612 TI - Processing of the Semliki Forest virus structural polyprotein: role of the capsid protease. AB - The protease activities responsible for the cotranslational processing of the Semliki Forest virus structural polyprotein were investigated by using an in vitro transcription-translation system. Three cleavages released the individual chains from the nascent polyprotein in the order capsid, p62, 6K (a nonstructural peptide), and E1. We showed directly that the protease activity responsible for the release of the capsid protein resides in the capsid itself: by progressive truncation of the cDNA used for the SP6 transcription, we showed that a precursor containing as few as 38 residues of the p62 protein left at the C terminus of the capsid was still very efficiently cleaved in vitro. We further tested the possibility that serine-219 of the capsid is involved in autoproteolysis by site directed in vitro mutagenesis. A change in the sequence Gly-Asp-Ser(219)-Gly, a tetrapeptide conserved among several animal serine proteases, to Gly-Asp-Arg-Ser Thr was shown to completely abolish in vitro cleavage. This supports the notion that the capsid is a serine protease. The role of the capsid protease in the processing of the 6K junctions was then investigated by translations of a hybrid polyprotein in which the capsid and most of the p62 sequences are replaced by those of the secretory protein lysozyme. The cleavages and concomitant appearance of the 6K peptide occurred efficiently and were shown to require the presence of membranes. This demonstrates that the capsid protease is not required for those cleavages and suggests that a membrane-associated host protease is responsible for the cleavage. PMID- 3553613 TI - Evidence that the sigma 1 protein of reovirus serotype 3 is a multimer. AB - In this report, we study the reovirus serotype 3 (strain Dearing) sigma 1 protein obtained from various sources: from Escherichia coli expressing sigma 1 protein, from reovirus-infected mouse L cells, and from purified reovirions. We demonstrate that the sigma 1 protein is a multimer in its undisrupted form and present biochemical evidence suggesting that the multimer is made up of four sigma 1 subunits. PMID- 3553616 TI - Antigenic similarities among rodent urinary tract glycoproteins. AB - Urinary glycoconjugates (glycosaminoglycans, glycoproteins, mucopolysaccharides) have been postulated as the natural defense mechanisms which prevent urinary tract infections. As a direct approach to establish the validity of this hypothesis, we have prepared a glycoprotein fraction (GP1) from rabbit bladder mucosal tissue and shown that it may be involved in the prevention of bacterial adherence. Immunohistochemical studies using fluorescence have demonstrated that murine antibodies raised to rabbit GP1 can be used as a semiquantitative index of glycoprotein production. The present investigation addresses the question of the species restriction of the glycoprotein--whether it is confined to the rabbit or whether a similar or identical substance occurs in other species. Using an immunoperoxidase staining technique, we have examined the genitourinary tracts of Sprague Dawley rats, Golden hamsters, and Hartley guinea pigs. Mouse anti-rabbit GP1 was used as the primary antibody with an avidin-biotin complexing system. All three species reacted well with the murine antiserum but were negative with normal sera. Semiquantitative estimates of the relative amounts of this material in different areas of the genitourinary tract showed that the distal renal tubules, renal pelvic mucosa, ureters and bladders were rich in this glycoprotein while urethra and vagina were not. PMID- 3553617 TI - Physiology of erection and pharmacological management of impotence. PMID- 3553618 TI - Renal transplantation in patients with indwelling continuous ambulatory peritoneal dialysis catheters. AB - Controversy exists regarding management of the continuous ambulatory peritoneal dialysis catheter in patients undergoing renal transplantation. We performed 30 transplants (23 cadaveric and 7 living related) in 27 patients with indwelling continuous ambulatory peritoneal dialysis catheters. Dialysis was necessary in the immediate post-transplantation period in 9 of 30 patients (30 per cent). Of these 9 patients 3 had temporary hemodialysis and 6 resumed continuous ambulatory peritoneal dialysis with the indwelling catheter. Two postoperative complications clearly were related to the continuous ambulatory peritoneal dialysis catheter: 1 patient required abdominal exploration for control of bleeding related to disruption of peritoneal adhesions at the time the continuous ambulatory peritoneal dialysis catheter was removed and 1 suffered an abscess at the catheter site 1 month after the catheter was removed. No patient experienced peritonitis during immunosuppression after transplantation. We support leaving the continuous ambulatory peritoneal dialysis catheter during and after transplantation to simplify pre-transplantation patient care and to avoid the possible need for temporary post-transplantation hemodialysis in many patients. PMID- 3553615 TI - Structure of the feline c-fes/fps proto-oncogene: genesis of a retroviral oncogene. AB - The nucleotide sequence of the feline c-fes/fps proto-oncogene was analyzed. Comparison with v-fes and v-fps revealed that all v-fes/fps homologous sequences were dispersed over 11 kilobase pairs in 19 interspersed segments. All segments, numbered exon 1 to exon 19 as in the chicken and human loci, were flanked by consensus splice junctions. The putative promoter region contained a CATT sequence and three CCGCCC motifs which were also found in the human locus at similar positions. About 200 nucleotides downstream of a translational stop codon in exon 19, a putative poly(A) addition signal was identified. Using the putative translation initiation codon in exon 2, a 93,000-molecular-weight protein could be deduced. This protein resembled very well the putative protein of the human c fes/fps proto-oncogene (94% overall homology) and, although less well, the putative protein of the chicken c-fes/fps proto-oncogene (70% overall homology). As far as the feline c-fes/fps proto-oncogene sequences transduced to the Gardner Arnstein (GA) and Snyder-Theilen (ST) strains of feline sarcoma virus (FeSV) are concerned, homology in deduced amino acid sequences between the GA- and ST-v-fes viral oncogenes and the proto-oncogene was 99%. Analysis of the recombination junctions between feline leukemia virus and v-fes sequences in GA- and ST-FeSV proviral DNA revealed for the left-hand junction the involvement of homologous recombination, presumably at the DNA level. The right-hand junction, which appeared identical in the GA-FeSV and ST-FeSV genomes, could have been the result of a site-specific recombination at the RNA level. PMID- 3553619 TI - NonHodgkin's lymphoma of the female urethra. AB - A 63-year-old woman presented with a massive proliferative growth in the urethral region. Fine needle aspiration and biopsy revealed nonHodgkin's lymphoma. No other tumor localization was found and complete remission occurred after 3 courses of chemotherapy. Primary localization of a lymphoma to the urethra is rare. PMID- 3553620 TI - Clinical and technical factors influencing recurrent carotid stenosis and occlusion after endarterectomy. AB - Carotid endarterectomy was performed in 152 patients during a 27-month period. The first 82 patients had primary closure of the arteriotomy, whereas the subsequent 70 patients underwent closure with Dacron patch angioplasty. Duplex scanning was undertaken postoperatively in 102 of these patients with a mean follow-up period of 17 months. Perioperative thrombosis occurred in two patients (1.3%), late postoperative recurrent stenosis in 14 patients (13.7%), and late postoperative occlusion in three patients (2.9%). Of the various factors investigated for their correlation with late recurrent stenosis or occlusion, only three were significant: the female sex (recurrent stenosis in 29% vs. 8%, p less than 0.05), a small (less than 4 mm) internal carotid artery (37% vs. 12%, p less than 0.05), and failure to close the arteriotomy with a patch (29% vs. 6%, p less than 0.05). The development of recurrent carotid lesions appeared independent of smoking history, antiplatelet therapy, use of a shunt, or extent of carotid plaque. These data suggest that patients with small internal carotid arteries, specifically female patients, are at greater risk for recurrent carotid stenosis. Patch angioplasty may decrease this risk and should be considered in these patients. PMID- 3553621 TI - Residual lesions and early recurrent stenosis after carotid endarterectomy. A serial follow-up study with duplex scanning and intravenous digital subtraction angiography. AB - In 109 internal carotid endarterectomies a complete serial follow-up study with ultrasonic duplex scanning was performed at 3, 6, and 12 months after operation. A duplex scan was also performed 2 years postoperatively in 75 cases. Moreover, the state of the endarterectomized carotid bifurcations was documented by intravenous digital subtraction angiography during hospitalization and at 12 months. At 3, 6, 12, and 24 months after operation the rate of significant recurrent stenosis was 6%, 12%, 6%, and 8%, respectively. Approximately half of the arteries with a significant stenosis at 1 year already demonstrated this lesion with intravenous digital subtraction angiography performed 1 week after operation. Persistent significant recurrent stenosis in the remaining arteries was probably the result of excessive myointimal proliferation. This occurred with a higher frequency in women (14.8%) than in men (4.1%). The greater number of the arteries with minimally or mildly disturbed spectral waveforms 3 months after endarterectomy spontaneously normalized or remained stable during the follow-up period. On the other hand, 40% of the arteries with a significant stenosis (diameter reduction of 50% or more) at the three-month control follow-up period increased to a more severe degree of stenosis during the first postoperative year. Most of the operated arteries did not significantly change during the second year. PMID- 3553622 TI - Peripheral arterial missile embolization: a case report and 22-year literature review. AB - The present case report is that of an air pistol missile injury with perforation of a common femoral artery and subsequent arterioarterial embolization to the anterior tibial artery. Included in this report is a review and analysis of a 22 year experience in the vascular trauma literature with missile injuries resulting in cardioarterial or arterioarterial embolization. In-depth analysis of this collective literature review revealed small weapon caliber (79%), usually .22. Soft tissue tamponade at the injury site in the form of mediastinal hematoma, retroperitoneal hematoma, or hemopericardium preventing exsanguination occurred in 37% of cases. Cardiac and thoracic aortic entry sites represented 70% of the series with distinct patterns of peripheral vascular embolization found resulting from anatomic relationships and laminar flow. Diagnostic evaluation by means of remote x-ray screening documented 86% of the emboli and was supplemented with arteriographic studies in 36%. Direct transverse arteriotomy overlying the projectile was favored; most of the delayed embolectomies stemmed from a failure to recognize those patients with peripheral embolization and a compensated asymptomatic limb. An appropriate management plan and diagnostic algorithm for this rare vascular phenomenon have been generated by this study. PMID- 3553623 TI - Control of infection in the diabetic foot: the role of microbiology, immunopathology, antibiotics, and guillotine amputation. AB - Newer culture techniques have demonstrated that diabetic foot infections are polymicrobial, involving both anaerobic and aerobic bacteria. These infections are characteristically foul-smelling and create immense tissue destruction. Occasionally, despite the absence of clostridial organisms, subcutaneous gas may be present. The importance of adequate surgical debridement has been emphasized. In the event of advancing, unremitting infection involving the foot, ankle guillotine amputation may be a life-saving technique. Finally, the role of host defense mechanism in diabetes is important. Polymorphonuclear leukocyte chemotaxis and phagocytosis are energy-dependent processes that are deficient in the diabetic. Better diabetic control with maintenance of normal blood sugars and avoidance of ketoacidosis may be the key to prevention of these morbid, lower extremity infections. PMID- 3553624 TI - The diabetic foot: amputations and drainage of infection. AB - Neuropathy, peripheral ischemia, and an altered host defense make the diabetic patient particularly prone to the development of infected foot ulcers. Successful treatment must be directed at these three primary pathologic situations. Since a limb-threatening infection carries a 25% risk of major amputation, early and prompt recognition and reporting of all foot problems are essential. Neuropathy requires total rest of the injured part. An altered host defense requires knowledge of the bacteria involved and proper use of antibiotics. It requires strict adherence to sound surgical principles that ensure debridement of all necrotic material and adequate dependent drainage of the wound while conserving as much viable skin and tissue for later revision or conservative amputations. Once sepsis is controlled, ischemic extremities can be revascularized. Because of the peculiar nature of the diabetic's vascular disease, revascularization procedures require the maximum skill and experience of the operating vascular surgeon. After revascularization, revisions or more conservative distal amputations can be achieved. Patient and physician education and understanding still remain essential not only to prevention but to successful management of all diabetic foot-related problems. PMID- 3553625 TI - Vascular disease, matrix abnormalities, and neuropathy: implications for limb salvage in diabetes mellitus. PMID- 3553626 TI - Distal arterial reconstruction: patency and limb salvage in diabetics. AB - Controversy regarding efficacy and durability of distal bypass grafting of the diabetic patient exists. A 22-year-long series of 259 vascular procedures with 100% follow-up (57% in diabetic individuals) is examined to compare these results with those of non-diabetic patients. Extensive review of predisposing factors, operative indications, preoperative medical evaluation, as well as techniques and peculiarities of angiography is rendered. Peripheral arterial case mix between the two groups is examined. The high utilization rate of solely venous conduits (94%) in diabetics compared with 76% in nondiabetics, along with anastomosis site selection, provides the most reasonable explanation for the successful outcome in both groups. Modifications in revascularization techniques contributing to successful outcome are presented. In the diabetic patients, both the cumulative graft patency rate (63%) and the limb salvage rate (77%) at 6 years were superior to those of the non-diabetics (52% and 65%, respectively). Diabetes mellitus does not predispose the person requiring revascularization for limb salvage to a lesser likelihood of success. PMID- 3553628 TI - Leukocytes and the risk of ischemic diseases. AB - Predictive indexes for atherosclerotic risk are imperfect, suggesting that there are predictive factors not commonly considered. Such a factor may be the white blood cell (WBC) count. Epidemiologic studies have shown correlations between the WBC count and the risk of myocardial infarction and stroke. The risk of acute myocardial infarction is approximately four times as great in persons with WBC counts high in the normal range (greater than 9000/microL [9 X 10(9)/L]) as in persons with WBC counts low in the normal range (less than 6000/microL [6 X 10(9)/L]); only 50% to 65% of the excess risk of the high-count individuals is explainable by tobacco smoking (which covaries with WBC count). A high WBC count also predicts greater risk of reinfarction and of in-hospital death. Less rigorously studied, the constitutional neutropenia of Yemenite Jews appears to afford protection against atherosclerotic disease. Among WBC types, the strongest epidemiologic association has been with the neutrophil count. Such a predictive value of WBC count is plausible and satisfying, because WBCs make a major contribution to the rheologic properties of blood; alter adhesive properties under stress--including the stress of ischemia, enhancing their rheologic importance; and participate in endothelial injury, both acutely and chronically, by adhering to endothelium and damaging it with toxic oxygen compounds and proteolytic enzymes. Techniques newly developed or under development may allow us to refine the predictive value of the WBC count by combining it with measures of cell activation and/or activatability. PMID- 3553629 TI - Leads from the MMWR. Update: Salmonella enteritidis infections in the northeastern United States. PMID- 3553627 TI - Hospital-acquired complications in a randomized controlled clinical trial of a geriatric consultation team. AB - As part of a controlled clinical trial of a geriatric consultation team (GCT), we investigated whether a GCT could affect the incidence of hospital-acquired complications in elderly patients. One hundred eighty-five patients, aged 75 years and older, were randomized into an intervention (N = 92) and a control (N = 93) group. Members of the intervention group received a GCT consultation and were routinely followed up throughout their hospitalization. The incidence of hospital acquired complications for the entire study population was 38%. The type and rate of hospital-acquired complications in the intervention and control groups were not significantly different. Functional status on admission and admission to the psychiatry service were predictive for the occurrence of a hospital-acquired complication. In a broadly selected population such as this, the intensity of care available through a GCT was unable to reduce the occurrence of hospital acquired complications. However, since this is only one aspect of a GCT function, and others may be of great importance, such aspects, and more targeted populations, must be evaluated before final conclusions can be reached about GCT efficiency. PMID- 3553630 TI - The radiological evaluation of hepatic cavernous hemangioma. PMID- 3553631 TI - Directory lists overseas service opportunities for physician volunteers; possible factors outlined for consideration in making decision. PMID- 3553632 TI - Leads from the MMWR. Chloroquine-resistant Plasmodium falciparum malaria in West Africa. PMID- 3553633 TI - Differences in the prevalence of Chlamydia trachomatis reported by two laboratories using the direct immunofluorescence test. PMID- 3553634 TI - Use of prophylaxis for malaria by American travelers to Africa and Haiti. PMID- 3553635 TI - The evolution of selective biomedical libraries and their use in the developing world. PMID- 3553636 TI - Fibromyalgia syndrome. An emerging but controversial condition. AB - The clinical manifestations, laboratory findings, and treatment results of 118 patients with fibromyalgia followed up by one investigator were compared with those of other recent reports. The history of this syndrome and recent efforts to establish diagnostic criteria and to understand underlying pathophysiologic mechanisms were studied. A practical, noninvasive office-based evaluation and conservative treatment approach were developed, determined by an understanding of the natural history of this common but controversial disorder. PMID- 3553637 TI - Landmark article Sept 8, 1945: Cyanosis in infants caused by nitrates in well water. By Hunter H. Comly. PMID- 3553638 TI - Landmark perspective: The legacy of well-water methemoglobinemia. PMID- 3553640 TI - A review of medical education in alcohol and other drug abuse. PMID- 3553639 TI - Whatever became of chlorosis? PMID- 3553641 TI - A decrease in plasma factor which stimulates prostaglandin I2 synthesis in patients with acute myocardial infarction. AB - PG I2 stimulating plasma factor was measured in patients with ischemic heart disease and age-matched controls. The plasma factor measured by bioassay using rat aorta was 3.2 +/- 0.6 (n = 21), 2.7 +/- 0.8 (n = 7), 1.6 +/- 1.5*** (n = 18) and 2.2 +/- 0.06** (n = 3) PG I2 ng/mg rat aorta (mean +/- SD; * p less than 0.05, ** p less than 0.01, *** p less than 0.001) in control, angina pectoris, acute myocardial infarction and old myocardial infarction with angina pectoris groups, respectively. The plasma factor measured by radioimmunoassay was 43.5 +/- 19.5 (n = 11), 35.4 +/- 13.1 (n = 4), 38.5 +/- 18.0 (n = 9), 26.0 +/- 20.1* (n = 7) and 59.5 +/- 31.2 (n = 5) ng/mg rat aortic protein/15 min in control, variant angina, stable angina, acute myocardial infarction and old myocardial infarction groups, respectively. The factor in deproteinized plasma of the acute myocardial infarction group was also smaller than that of the control group. PG I2 synthesis by rat aortic ring was inhibited by mepacrine, which inhibits phospholipase A2. The plasma factor was not inactivated by heating. The results indicate that a heat-stable plasma factor which acts on phospholipase A2 or on its surrounding reaction systems is deficient in the early stage of acute myocardial infarction. A decrease in the factor may cause PG I2 deficiency, resulting in coronary thrombosis or vasospasm and consequently in acute myocardial infarction. PMID- 3553642 TI - [Heart metastasis of gallbladder cancer--a case report]. AB - A 42-year-old man with gall bladder cancer was given a pancreatoduodenectomy. Chest-roentgenograms revealed a prominence of the left cardiac silhouette 6 months after operation. Two months later, the patient developed exertional dyspnea and chest pain. A diagnosis of heart metastasis of gall bladder cancer was established by aspiration cytology. Intravenous administration of 5-FU and cis-DDDP proved ineffective in controlling the disease. The patient died 14 months after operation. An autopsy revealed metastasis to the left ventricle of the heart. This is the 6th such case of gallbladder cancer in the literature. PMID- 3553643 TI - [Timing of allogeneic bone marrow transplantation in chronic myelogenous leukemia patients]. PMID- 3553644 TI - [Heterogeneity of T gamma-lymphoproliferative disorder-- case report and review of the literature]. PMID- 3553645 TI - [Allogeneic bone marrow transplantation in a case of acute myelofibrosis developing after a 2 year-long myelodysplastic syndrome]. PMID- 3553646 TI - [Primary ovarian non-Hodgkin lymphoma--case report and brief review]. PMID- 3553647 TI - [Clinical study of 4 patients with hematological malignancy treated with allogeneic bone marrow transplantation after conditioning including hyperfractionated total body irradiation]. PMID- 3553648 TI - [Clinical courses of 13 cases of long-term survivors after allogeneic bone marrow transplantation]. PMID- 3553649 TI - [Spinal cord reflex and posture control]. PMID- 3553650 TI - [Transcortical reflex]. PMID- 3553651 TI - [Partition of the motor cortex and its output--a. The parietal lobe--the space control function of voluntary movement]. PMID- 3553652 TI - [Partition of the motor cortex and its output--b. The motor cortex]. PMID- 3553653 TI - [Partition of the motor cortex and its output--c. The premotor cortex]. PMID- 3553654 TI - [Partition of the motor cortex and its output--d. The supplementary motor area]. PMID- 3553655 TI - [Activity of neurons of the prefrontal cortex and voluntary movement]. PMID- 3553656 TI - [Somatic sense and voluntary movement]. PMID- 3553657 TI - [Role of vision and hearing in the control of movement]. PMID- 3553658 TI - [Equilibrium and movement]. PMID- 3553659 TI - [Role of the cerebellum in the control of movement]. PMID- 3553660 TI - [Role of cerebral basal nuclei in the control of movement]. PMID- 3553661 TI - [Gait and its control]. PMID- 3553662 TI - [The gait of robots]. PMID- 3553663 TI - [Neural mechanism of vertical eye movement]. PMID- 3553664 TI - [Neural mechanism of handwriting]. PMID- 3553665 TI - [Disorders of motor function: apraxia]. PMID- 3553666 TI - [Disorders of motor function: akinesia]. PMID- 3553667 TI - [Disorders of motor function: abnormal behavior in Alzheimer disease--analysis of high-level mental function]. PMID- 3553668 TI - [Disorders of higher motor function: changes in movement disorders with growth- age dependency of clinical findings in essential basal nuclei diseases]. PMID- 3553669 TI - [Memory disorders and classification]. PMID- 3553670 TI - [Ultrasonography of the breast]. PMID- 3553671 TI - [Intussusception of inverted Meckel's diverticulum: a case report]. PMID- 3553672 TI - [A case report of infantile cortical hyperostosis]. PMID- 3553673 TI - [A case of primary non-Hodgkin lymphoma of the left adrenal gland]. PMID- 3553674 TI - [Cavernous hemangioma of the liver in a high risk group of liver cancer]. PMID- 3553675 TI - [Low-dose contrast material vs. diluted contrast material: which is better in IADSA?]. PMID- 3553676 TI - [Diagnostic value of serum immunoreactive trypsin assay in pancreatic diseases using enzyme immunoassay]. PMID- 3553677 TI - [Enzyme immunoassay for human epidermal growth factor]. PMID- 3553678 TI - [Diagnostic efficacy of m-[131I] iodobenzylguanidine (I-131 MIBG) scintigraphy in locating pheochromocytoma: comparison with computed tomography and ultrasonography]. PMID- 3553679 TI - [Comparative studies of ultrasonography, CT, RN-imaging and MRI in detecting the parathyroid gland in primary hyperparathyroidism]. PMID- 3553680 TI - [Supervision of self-injection of insulin by a patient with loss of eyesight due to diabetes mellitus]. PMID- 3553681 TI - [Evaluation of the thickness of the subcutaneous adipose tissue of the gluteal region in relation to subcutaneous injection of insulin]. PMID- 3553683 TI - Antithrombotic effect of TRK-100, a novel, stable PGI2 analogue. AB - TRK-100, a stable PGI2 analogue structurally different from carbacyclines, was compared with other antiplatelet drugs for its effect on platelet functions using animal models. TRK-100 (10-300 nM) inhibited rat platelet aggregation induced by ADP (3 microM), collagen (12.5 micrograms/ml) and A23187 (10 microM), and its potency was about 1/3-1/7 that of PGI2. TRK-100 (0.3-3 mg/kg, p.o.) dose dependently inhibited rabbit platelet adhesion (ED50: 2.2 mg/kg), and its effect lasted over at least 5 hr. In contrast, aspirin and ticlopidine (both at 300 mg/kg, p.o.) showed only a slight inhibition (4-7%). In the thrombocytopenia induced by collagen injection in rats, TRK-100 (3-300 micrograms/kg, i.v.; 0.1-3 mg/kg, p.o.) dose-dependently inhibited a decrease in platelet number, and its ED50 was 0.48-0.62 mg/kg orally and 13.7-16.4 micrograms/kg intravenously, while the inhibition by aspirin and ticlopidine (both at 1000 mg/kg, p.o.) was 40 and 37%, respectively. In the experimental thread thrombosis in rats. TRK-100 (0.03-3 mg/kg, p.o.) dose-dependently inhibited thrombus formation, and its ED50 was 0.46 mg/kg, being 21 and 87 times as potent as aspirin and ticlopidine, respectively. These results reveal that TRK-100 has a potent antiplatelet activity and is orally and intravenously effective for a variety of thrombosis models, suggesting that it may have a therapeutic value as an antithrombotic drug. PMID- 3553682 TI - Computerized glucose clamp method for the determination of insulin sensitivity in diabetic subjects. AB - A new, simplified computerized glucose clamp method was performed for estimation of glucose utilization at the insulin level of postprandial level. The program for the method is based on the mathematical algorithm using values of blood glucose, changes of its concentration and the desired glucose level. The coefficients of variation of the clamped blood glucose values during the last 60 minutes was 6.3 +/- 1.7(%) in normal, 3.7 +/- 0.3(%) in NIDDM, which was within satisfactory limit, and also indicated an attainment of steady state. Glucose infusion curves showed some bumps for the initial 60 min, which did not seriously affect the glucose utilization rate at steady state. In some cases, whose insulin sensitivity was high, CV was not low enough and occasional manual adjustment of K values was required. Average glucose infusion rate was 7.59 +/- 0.85 (mg/kg/min) in normal, and this was significantly lowered in NIDDM (42.3 +/- 3.4) at steady state, indicating a decreased insulin sensitivity for glucose utilization in NIDDM. PMID- 3553684 TI - Consequences and prognosis of convulsive status epilepticus in infants and children. PMID- 3553685 TI - Segmental auto-transplantation of the pancreas. AB - A total pancreatectomy was performed in a 39-year-old man diabetic with diffuse calcification of the whole pancreas, a pseudocyst and intrapancreatic bile duct obstruction. The body of the excised pancreas was immediately transplanted into the left groin. The postoperative responses of plasma glucagon and insulin were not impaired compared with their preoperative responses. The patient was relieved of unremitting pain and is doing well six months after this operation. PMID- 3553686 TI - Parathyroid imaging: comparison of 201Tl-99mTc subtraction scintigraphy, computed tomography and ultrasonography. AB - From 1982 to 1985, twenty-nine patients with suspected hyperparathyroidism were examined using 201Tl-99mTc subtraction scintigraphy (Tl-Tc), computed tomography (CT) and ultrasonography (US). For diagnosing neoplasm (adenoma or cancer), the sensitivities of the three procedures were 80 per cent or more, with no statistically significant differences. For diagnosing hyperplasia of the parathyroid glands, CT scan had the highest sensitivity (47 per cent). The most frequent source of error was minimally enlarged glands, weighing less than 500 mg. The second highest source of error was thyroid nodules, such as adenomatous goiter or cancer. Serum calcium and c-PTH levels were significantly higher in those with a parathyroid neoplasm than in those with hyperplasia (p less than 0.01, p less than 0.05, respectively). We concluded that hyperplasia is less easy to detect than neoplasm, and CT scan is superior to Tl-Tc or US scan for localizing hyperplasia. PMID- 3553688 TI - An immunohistochemical study on the distribution of endocrine cells in the gastrointestinal tract of the pig. PMID- 3553687 TI - [A comparative clinical trial of intravesical BCG and adriamycin treatment in superficial bladder cancer. A South West Oncology Group Study]. PMID- 3553689 TI - Localization of eosinophil chemotactic factors in adult worms and third-stage larvae of Metastrongylus apri. PMID- 3553690 TI - 50 years National Cancer Institute 1937-1987...making a difference. Semicentennial celebration. May 26, 1987, Bethesda, Maryland. PMID- 3553691 TI - Role of insulin in development of cancer cachexia in nongrowing sarcoma-bearing mice: special reference to muscle wasting. AB - This study evaluated whether altered insulin metabolism is a key factor behind weight loss during sarcoma growth in nongrowing mice (C57BL/6J). Fasted sarcoma bearing mice had decreased blood glucose concentrations but unchanged levels of insulin, compared with those in pair-weighed and freely fed controls. During refeeding, insulin levels were inappropriately low for the degree of glycemia in sarcoma-bearing mice compared with those of pair-weighed and freely fed controls. Injections ip of glucose to tumor-bearing animals resulted in insulin levels comparable to postabsorptive values in healthy control animals, indicating that hypoinsulinemia in freely eating tumor-bearing animals was due to a reduced glycemic sensitivity for pancreatic insulin release. Insulin supplementation at doses [4 IU/100 g (body wt)] that increase body fat in normal animals could not protect the tumor-bearing host from progressive loss of body fat or lean tissues. Exogenous insulin in excess of endogenous insulin production did not stimulate tumor growth. Nitrogen and RNA-DNA content were significantly decreased in the quadriceps muscle of tumor-bearing mice. This reduction was independent of altered insulin levels and could not be prevented by exogenous insulin. The depressed capacity of protein synthesis in extensor digitorum longus (EDL) muscle could be entirely attributed to the state of malnutrition in tumor-bearing animals. The sensitivity and responsiveness of protein synthesis in EDL muscles to insulin were normal in tumor-bearing mice, regardless of whether exogenous insulin exerted its effect in vivo or in vitro. This study confirms insulin resistance for glucose metabolism in an experimental sarcoma animal model. Such changes are concluded to be secondary to anorexia and necessary to counteract hypoglycemia. In non-growing sarcoma-bearing mice, malnutrition and anorexia account entirely for depressed muscle protein synthesis, which is not explained by insulin resistance at the translational level. Insulin metabolism is not a key factor behind progression of wasting in sarcoma-bearing mice, but anorexia is. PMID- 3553692 TI - Inhibition by prostacyclin of the tumor cell-induced platelet release reaction and platelet aggregation. AB - Prostacyclin was examined for its inhibitory effects on the tumor cell-induced platelet release reaction. Prostacyclin inhibited in a dose-dependent manner tumor cell-induced release of platelet dense granules and alpha-granules concomitant with an inhibition of platelet aggregation. Release was determined by assay of biochemical markers (serotonin for dense granules and beta thromboglobulin for alpha-granules). A tenfold higher concentration of prostacyclin was required to inhibit completely serotonin release as compared to the concentration required for beta-thromboglobulin release. Correlative ultrastructural studies demonstrated that prostacyclin at doses of over 10 ng/ml inhibited the ultrastructural changes associated with tumor cell-induced platelet shape change and platelet granule release. Platelet aggregates exhibited the retention of granule reservoirs that could potentially be involved in long-term release of biologically active substances. PMID- 3553694 TI - Post-splenectomy sepsis. PMID- 3553695 TI - [Bio-defense-expression in the protection against microbial infections]. PMID- 3553696 TI - [Congenital rotational anomaly of the heart: anatomy, diagnosis and surgical treatment]. PMID- 3553693 TI - Fibrin deposition in autochthonous Syrian hamster pancreatic adenocarcinomas induced by the chemical carcinogen N-nitroso-bis(2-oxopropyl)amine. AB - Immunofluorescence studies have demonstrated the presence of fib (a group of fibrinogen- and fibrin-related proteins that react with antibodies raised against fibrinogen) in the stroma of several transplantable animal and autochthonous human tumors. Acceptance of these reports was tempered by the possibility of artifactual clotting and fibrinolysis associated with tumor removal or tumor transplantation and by the relatively poor histology inevitable when immunofluorescence is performed on frozen tissue sections. An immunoperoxidase study therefore was undertaken of the ductal pancreatic carcinomas induced in female LGV Syrian hamsters by N-nitroso-bis(2-oxopropyl)amine [(BOP) CAS: 60599 38-4]. Artifactual clotting and fibrinolysis associated with tumor removal were avoided by systemic anticoagulation and antifibrinolysis. Fibronectin and residual fib were prominent components of tumor stroma. Prominent fib deposits also were found in a new location: the basement membrane zones of atypical pancreatic ducts and invasive carcinomas. In contrast, fib deposits were never found in the basement membranes of blood vessels, nerves, or pancreatic acini of BOP-treated or normal animals, or in the ductal basement membranes in the normal pancreas. Ducts with marked atypicality and invasive pancreatic carcinomas frequently exhibited discontinuous basement membrane staining for fib, which often paralleled loss of staining for the integral basement membrane proteins- type IV collagen and laminin. Loss of acquired fib basement membrane staining with malignant disease progression may serve as a new marker for local tumor invasion. PMID- 3553697 TI - [Thrombocyte sensitivity to prostacyclin in myocardial infarct complicated by acute left ventricular failure]. AB - A study of platelet aggregation and platelet sensitivity to prostacyclin in 82 patients with acute myocardial infarction demonstrated a relationship between clinical pattern of the disease and platelet hemostasis. Platelet functional activity was the highest by the end of week 2 in uncomplicated myocardial infarction. In cases where myocardial infarction was complicated by acute left ventricular insufficiency, platelet function differed depending on the severity and outcome of the complication. Some patients with pulmonary edema showed protracted low-grade, yet irreversible, two-wave platelet aggregation. Platelet sensitivity was significantly lower in pulmonary edema, as compared to cardiac asthma, while the lowest sensitivity was associated with terminal pulmonary edema. PMID- 3553698 TI - [Ultrasonic diagnosis of thrombosis of the inferior vena cava]. AB - Ultrasonic scanning was used in 115 patients with suspected occlusion of vena cava inferior. Details of ultrasonic diagnosis of non-occlusive and occlusive thrombosis of vena cava inferior and vena cava compression from the outside, monitoring of the thrombosed vena cava and the antiembolic cava filter are discussed. PMID- 3553699 TI - [Thrombolytic therapy in myocardial infarction]. PMID- 3553700 TI - [Various approaches to optimizing the hemodynamics of myocardial infarct patients]. AB - Combined investigation of systemic and intracardiac hemodynamic parameters (radiocardiography and Fick's procedure, transvenous catheterization, and right ventricular and pulmonary arterial blood pressure measurement) was carried out in 428 myocardial infarction patients admitted to hospital within the early hours after the attack; changes in necrotic area were monitored for 7 days (precordial ECG cartography and serial serum CPK assays). Computer-assisted combined data analysis made use of image identification techniques, the images being based on a general approximation algorithm and informative coefficient. The algorithm permitted a classification of patients' condition by left-ventricular insufficiency (a 77.4% reliability) and by the spread of necrotic area (a 72.5% reliability). The prognosis chart, constructed on the basis of comparison between actual hemodynamic values and their standard vectors, brought out optimum regimens for every parameter associated with the least risk of left-ventricular insufficiency and necrotic spread. PMID- 3553701 TI - Potassium recycling. PMID- 3553702 TI - Size restriction in the glomerular capillary wall: importance of lamina densa. AB - Cationized monomeric, dimeric and oligomeric ferritins (pI maxima 9.3 to 9.6) were used to study size restriction in the rat glomerular capillary wall. Monomer and dimer ferritins were able to penetrate the lamina densa; trimer and larger aggregates could not, even though they were able to enter the lamina rara interna. This demonstrates that the lamina densa is a size restrictive barrier, cationic molecules with a Stokes-Einstein radius exceeding a value between 6 to 12 nm are excluded. Monomeric and dimeric cationic ferritins were handled differently in the lamina rara externa; monomer accumulated perferentially immediately below the slit membrane whereas dimer was found within the inner regions of the rara externa, nearer to the lamina densa. PMID- 3553703 TI - The existence of a protracted course in crescentic glomerulonephritis. AB - We describe a spectrum of clinical and morphologic features which may occur in idiopathic crescentic glomerulonephritis. Of note are patients who pursue a more indolent course to renal failure in contrast to typical rapidly progressive glomerulonephritis (RPGN). Patients following this protracted course have an insidious presentation with hematuria and renal insufficiency, and at the time of renal biopsy (usually after many months of clinical illness) show less extensive involvement with crescents, which are often in both cellular and fibrous stages. This form of crescentic glomerulonephritis is further distinguished from RPGN by frequent hypertension and the nephrotic syndrome, the absence of oligo-anuria and progression to renal failure over many months or even years. PMID- 3553705 TI - [Kidney transplantation--treatment goal of decompensated kidney failure (previous results)]. PMID- 3553704 TI - Identification of a target antigen in human anti-tubular basement membrane nephritis. AB - Sera from two patients with primary anti-tubular-basement-membrane-mediated tubulointerstitial nephritis, one a renal allograft recipient and the other with spontaneous anti-tubular-basement-membrane disease, were analyzed for the specificity of their autoantibodies. Both sera had circulating antibodies that reacted by ELISA with extracts of tubular basement membrane from several species, but failed to react significantly with extracts of glomerular basement membrane. Reactive antigen was solubilized with 6 M guanidine-HCl, 6 M urea, with reduction and alkylation, and with sodium dodecylsulfate. Digestion of the basement membrane with collagenase released relatively small quantities of antigen from the membrane, and trypsin and pepsin destroyed its antigenicity. The antigenic activity was characterized with respect to its size distribution by gel filtration and by immuno-overlay analysis of protein blots. Collectively, the results indicate that the major reactivity of both sera is directed towards a Mr 58,000 component that is unique to the tubular basement membrane. Minor reactivities toward high molecular weight components common to both glomerular and tubular basement membranes were detected by immuno-overlay analysis. This study identifies an antigen that is involved in human anti-tubular-basement membrane-mediated tubulointerstitial nephritis, and demonstrates an advantage of the use of denaturing extraction over proteolytic methods to prepare the antigen. PMID- 3553707 TI - [Method of using compression sutures in surgery of the small intestine]. PMID- 3553706 TI - [Treatment large ventral and postoperative hernias by the technic of autodermal plasty]. PMID- 3553708 TI - [The talented Kiev surgeon A. S. Iatsenko, M.D]. PMID- 3553709 TI - [Function of the prekallikrein-kallikrein system of convalescent burn patients with uncorrected deformities and contractures]. PMID- 3553710 TI - [Procedure for the surgical treatment of postburn contractures in children]. PMID- 3553711 TI - [New skin-fatty tissue flap for free plastic repair in deep burns and frostbite]. PMID- 3553712 TI - [Vascular catheterization in the intensive hemostatic therapy of hemophilia patients]. PMID- 3553713 TI - [Aleksandr Khristianovich Rinek and his school (on the 150th anniversary of his birth)]. PMID- 3553714 TI - [Acute pseudo-obstruction of the large intestine]. PMID- 3553715 TI - [Patient consent for surgery]. PMID- 3553717 TI - [S-100 protein in non-pigmented melanocytic and neuro-ectodermal tumors of the conjunctiva]. AB - Using an immunoperoxidase method, S-100 protein was localized in 51 nonpigmented or slightly pigmented nevi, eight malignant melanomas, three neurofibromas, and one neurilemmoma of the conjunctiva. Clinico-immunohistochemical correlations are presented. Cells of these neuroectodermal tumors contain S-100 protein. Epithelial invaginations arising from the conjunctival surface and lying between melanocytes are S-100 protein-negative. This facilitates the differential diagnosis of particularly amelanotic lesions of the conjunctiva. Immunohistochemical identification of the S-100 protein represents an improvement in current histochemical differential diagnosis of these tumors. PMID- 3553716 TI - [Primary isolated amyloidosis--a rare corneal degeneration]. AB - Report on a 47-year-old woman patient in whom an eccentric tumorlike corneal change was found in the left eye. Only after penetrating keratoplasty was the exact diagnosis--a primary isolated corneal amyloidosis--established, by light microscopic examination. The graft remained clear. Familial and systemic amyloidosis were ruled out by further examinations. The prognosis is favorable. PMID- 3553718 TI - [Toxic retinopathy in cyclosporin A therapy]. AB - A bone marrow transplantation was performed in a 17-year-old male patient suffering from acute undifferentiated leukemia. The patient received Cyclosporin A--a powerful immunosuppressive agent--to prevent a severe, chronic graft-versus host disease. While undergoing this therapy the patient suffered a loss of visual acuity in both eyes 17 months after bone marrow transplantation. The substrates of the visual acuity loss were multiple retinal changes. Cotton-wool spots, intraretinal and preretinal hemorrhages were found in both eyes, and a macula edema in the left eye. The possible role of the immuno-suppressive agent Cyclosporin A in the pathogenesis of these changes is discussed. PMID- 3553719 TI - [Dr. Stanislaw Markiewicz (1902-1944)]. PMID- 3553720 TI - [Zofia Okolow-Hrynkiewiczowa (1903-1966)]. PMID- 3553721 TI - Influence of genetic variance on sodium sensitivity of blood pressure. AB - To examine the effect of genetic variance on blood pressure, sodium homeostasis, and its regulatory determinants, we studied 37 pairs of monozygotic twins and 18 pairs of dizygotic twins under conditions of volume expansion and contraction. We found that, in addition to blood pressure and body size, sodium excretion in response to provocative maneuvers, glomerular filtration rate, the renin angiotensin system, and the sympathetic nervous system are influenced by genetic variance. To elucidate the interaction of genetic factors and an environmental influence, namely, salt intake, we restricted dietary sodium in 44 families of twin children. In addition to a modest decrease in blood pressure, we found heterogeneous responses in blood pressure indicative of sodium sensitivity and resistance which were normally distributed. Strong parent-offspring resemblances were found in baseline blood pressures which persisted when adjustments were made for age and weight. Further, mother-offspring resemblances were observed in the change in blood pressure with sodium restriction. We conclude that the control of sodium homeostasis is heritable and that the change in blood pressure with sodium restriction is familial as well. These data speak to the interaction between the genetic susceptibility to hypertension and environmental influences which may result in its expression. PMID- 3553722 TI - A case of pneumonia caused by Legionella pneumophila serogroup 8 in West Germany. Etiological diagnosis by immunofluorescence, enzyme immunoassay, and immunoblot. AB - The severe and complicated course of a Legionella pneumonia in an 18-year-old female patient is reported. The serogroup 8 of Legionella pneumophila was identified as the infecting agent for the first time in West Germany. The etiological diagnosis was confirmed by immunofluorescence, enzyme immunoassay, and immunoblot. We emphasize the importance of serological testing of all Legionella pneumophila serogroups available. PMID- 3553723 TI - Metabolism and function of membrane lipids. PMID- 3553724 TI - [Neopterin in the serum and urine in the differential diagnosis of disorders of kidney function following kidney transplantation]. AB - In a period of 10 months neopterin in serum and urine was determined by radioimmunoassay in 33 renal allograft recipients treated with cyclosporin A. While in allograft rejections the highest neopterin concentrations were found in the serum, patients with viral infections after renal transplantation showed the most elevated concentrations in the urine. For early diagnosis of allograft rejection the ratio of neopterin clearance and serum-neopterin was the most significant criterion of the parameters measured in this study. Patients without complications during the follow-up showed slightly elevated and stable neopterin levels in serum and urine. The presented results indicate that neopterin is a useful parameter for the follow-up after renal allograft transplantation and for the diagnosis of immunological complications. PMID- 3553725 TI - [Methodical ultrasonic examination of the abdominal cavity]. PMID- 3553726 TI - [M. V. Lomonosov--founder of the materialistic tradition in Soviet natural science and medicine (on the 275th anniversary of his birth)]. PMID- 3553727 TI - [A disease named by A. P. Chekhov. Febris sachaliniensis]. PMID- 3553728 TI - [Calcium antagonists in the treatment of congestive heart failure]. PMID- 3553729 TI - [Effect of a glucose-insulin-potassium mixture on the course and outcome of myocardial infarction]. PMID- 3553731 TI - [Touching in order to heal--body, massage and training]. PMID- 3553730 TI - [Extracorporeal immunosorption in the treatment of pollinoses]. PMID- 3553732 TI - [What does "rebirthing" mean? To be reborn by breathing]. PMID- 3553733 TI - Biology of tumor progression in human melanocytes. AB - Tumor progression in the human melanocyte system can be delineated into 6 sequential stages. The first three steps represent nonmalignant melanocyte lesions from focal proliferations of structurally normal melanocytes to lesions with architectural and cytologic atypia. Primary melanoma may be divided into radial growth phase without competence for metastasis and vertical growth phase with metastatic competence. Melanocytes isolated from normal skin, nonmalignant pigmented lesions, and melanomas and maintained in culture have properties that are characteristic for each stage of tumor progression. Cytogenetic studies revealed nonrandom chromosomal abnormalities of advanced melanomas involving chromosomes 1, 6, and 7. Recent progress in tissue culture techniques has allowed studies of growth regulation of normal and malignant cells. Six growth factor receptor-growth factor systems seem to be of biologic significance in the melanocyte system: EGF, NGF, FGF, PDGF, insulin, and beta-TGF. Monoclonal antibodies have characterized a large number of antigens on melanocytes of the various stages of tumor progression, making melanoma one of the most widely studied human tumor systems. PMID- 3553734 TI - Laminin in the anterior pituitary gland of the rat. Laminin in the gonadotrophic cells correlates with their functional state. AB - The distribution pattern of laminin in the rat anterior pituitary gland under physiological and hormonally altered conditions was studied immunohistochemically. Intense immunoreactivity of the capillaries and of the basement membranes surrounding parenchymal cells was found. Five to 10% of the parenchymal cells of normal adult rat pituitary gland exhibited also intense positive cytoplasmic staining. These were identified as gonadotrophic cells on the basis of their topographic distribution and typical 700-nm light bodies. By immunoelectron microscopy it was shown that the light bodies contain laminin and tubulin. After treatment with estrogen, which is known to suppress the function of the gonadotrophic cells, virtually no cytoplasmic laminin was found. Ultrastructurally, the number of light bodies in the gonadotrophic cells diminished significantly, from approximately 3 to 8 per cell to 0 to 1 per cell in a given section. In contrast, after castration, the number of laminin positive cells increased to a number above that found in the normal adult male rat, and the number of light bodies increased two to four times. Based on these results, it appears that the presence of cytoplasmic laminin and the number of light bodies reflects the hormonal activity of the gonadotrophic cells of the rat pituitary gland. PMID- 3553735 TI - Acrylamide-induced sympathetic autonomic neuropathy resulting in pineal denervation. AB - The effect of acrylamide on the sympathetic innervation of the rat pineal gland was examined by using ultrastructural, immunohistological, biochemical, and physiological methods. Separation of sympathetic terminals from perivascular pineocyte processes was facilitated by administration of the false neurotransmitter 5-hydroxydopamine, which preferentially labeled sympathetic terminals, shortly before sacrifice. Administration of acrylamide (50 mg/kg/day, intraperitoneally) for 1 to 2 weeks resulted in the near-total loss of pineal parenchymal perivascular axons and axons intercalated between individual pineocytes. More proximal portions of these sympathetic axons located within the capsule of the pineal gland developed markedly enlarged swellings containing neurofilaments and tubulovesicular elements. The ultrastructural appearance of axons swollen by tubulovesicular elements resembled that of regenerating axons and axons whose regenerative progress had been frustrated. The activity of pineal dopamine-beta-hydroxylase, a noradrenergic marker enzyme confined to sympathetic axons and their terminals and absent in pineocytes, was determined in an attempt to develop a quantitative measure of the extent of sympathetic denervation. The loss of 50% of pineal dopamine-beta-hydroxylase activity underestimated the extent of parenchymal denervation due to the marked engorgement of remaining capsular sympathetic axons by immunoreactive dopamine-beta-hydroxylase. The daily rhythm of pineal serotonin N-acetyltransferase (NATase) activity, which is dependent on the circadian variation in the activity of pineal sympathetic axons, was decreased 90% by chronic acrylamide administration. Pineal NATase activity increased 25- to 50-fold in acrylamide intoxicated rats in which isoproterenol was used to stimulate pineocyte beta-adrenergic receptors directly, which is evidence against a nonspecific toxic effect of acrylamide on pineocytes. Administration of N,N'methylene-bis-acrylamide, a non-neurotoxic analog of acrylamide, was without effect on pineal ultrastructure or NATase activity. PMID- 3553736 TI - Relationship between the integrity of Bowman's capsule and the composition of cellular crescents in human crescentic glomerulonephritis. AB - Cell constituents of glomerular crescents still remain controversial. We examined cellular crescents in ten cases of crescentic glomerulonephritis (GN) using indirect immunoperoxidase technique and monoclonal antibodies against T cells (OKT3) and subsets: T helper/inducer cell (T4), T suppressor/cytotoxic cell (OKT8), T activated cell (IoT14 and IoT15); B cells (B1, B4, OKB2 and IoB3) and subsets (B2 and IoB1); monocytes/macrophages (LeuM3); DR Ag (I2) and renal native cells: podocytes (IoT5), Bowman's capsule (BC) parietal epithelial cell (OKB2, IoB3). Studied cases were 2 anti-glomerular basement membrane (GBM) GN, 4 immune complex GN, 3 vasculitis and 1 idiopathic GN. When the BC continuity was preserved almost all crescent cells were identified; they originated in majority from the BC parietal epithelium and ranged from 55 to 95 per cent. The other main constituents which represented 15 to 35 per cent of the crescent cells were monocytes (LeuM3+) and T-activated cells (IoT15+). In the interstitial infiltrate, which was mostly periglomerular, LeuM3+ cells and IoT15+ cells accounted for more than 70 per cent of the cell population. On the other hand, when BC were ruptured, mononuclear inflammatory cells, mainly LeuM3+ and IoT15+ cells accompanied by significant number of T4+ and T8+ cells, constituted the glomerular crescents. At this time, BC parietal epithelial cells were rarely identified (15 per cent). These findings strongly support the importance of BC integrity to discriminate the nature of crescent cells. PMID- 3553737 TI - Dexamethasone-prepared Escherichia coli-induced disseminated intravascular coagulation. Animal model. AB - We have developed a new model of disseminated intravascular coagulation in rats based on the induction of immunosuppression by prolonged high-dose dexamethasone treatment. Most models of disseminated intravascular coagulation are based on the generalized Shwartzman reaction, which is observed characteristically in experimental animals after two separate inoculations of bacterial endotoxins. These produce massive deposition of thrombi in the microcirculation and significant hemorrhagic and ischemic phenomena. We have demonstrated that the administration of glucocorticosteroids at the specific doses and intervals can adequately replace the first (preparatory) injection of endotoxin. For this reason, we have attempted to experimentally simulate a frequent clinical situation, such as sepsis secondary to peritonitis, by intraperitoneal inoculation of Escherichia coli and hog gastric mucin into rats pretreated with dexamethasone. This inoculation was equivalent to the second injection of endotoxin in the Shwartzman model (triggering inoculation). A typical picture of disseminated intravascular coagulation induced by bacterial endotoxins developed, as demonstrated by the anatomopathologic, microbiologic, and hematologic studies performed. These results were then compared to those obtained in rats treated exclusively with dexamethasone or given, in addition, an effective antibiotic therapy. PMID- 3553738 TI - Enhancement of amyloid induction by amyloid fibril fragments in hamster. AB - An extract (fibril amyloid-enhancing factor) prepared by sonication of a suspension of water-purified hamster AA-amyloid fibrils showed an amyloid enhancing effect upon intraperitoneal injection into hamsters. The fibril amyloid enhancing factor was identical to the original fibrils according to the results of infrared spectroscopy, gel filtration, gel electrophoresis, and Western blotting; although lyophilized samples of the extract did not show any green birefringence after staining with Congo red. From these results, it was concluded that fibril amyloid-enhancing factor represents small fragments of amyloid fibrils which enhance in vivo formation of amyloid fibrils. PMID- 3553739 TI - Immunohistochemical localization of 6-keto-prostaglandin F1 alpha and prostaglandin E2 in the human umbilical cord before and after labor. AB - In this report immunohistochemical localization of 6-keto prostaglandin (PG)F1 alpha (the stable metabolite of prostacyclin (PGI2], PGE2, and its stable metabolite bicyclic PGE2 in umbilical amnion and vasculature is described. Umbilical cords were obtained at cesarean section from women who were not in labor (N = 7) and from women (N = 6) who went through normal labor and delivery at term. Study of both groups of umbilical cords allowed assessment of differential prostanoid metabolite localization pre- and post-labor. Formalin fixed, paraffin-embedded sections were stained by the avidin-biotin peroxidase complex method. PGE2, bicyclic PGE2, and 6-keto-PGF1 alpha localized to the amniotic cells covering the umbilical cord as well as to the endothelium of the umbilical veins in both groups (pre- and post-labor). No immunostaining was identified in the umbilical arteries. These findings suggest that amniotic cells and endothelial cells of the umbilical vein but not arteries are sites of synthesis or storage for the prostanoids 6-keto-PGF1 alpha and PGE2. PMID- 3553740 TI - As the health care system bypasses children, pressure mounts on schools to fill the gap. PMID- 3553741 TI - The effect of donor specific transfusions and dietary fatty acids on rat cardiac allograft survival. AB - A rat heterotopic cardiac transplant model was used to study the effect of dietary lipids on the immune response. Animals receiving linoleic acid (LA), oleic acid (OA), and fish oil (FO) enriched diets showed significant prolongation of allograft survival when compared to the control diet fed animals. When LA was given to animals who had received a single donor specific transfusion (DST) augmentation of the beneficial DST effect was observed, while the OA and FO fed groups showed no differences from control DST animals. Dietary regulation of the immune response, possibly through manipulation of arachidonic acid metabolism, is implied. PMID- 3553742 TI - Effect of sepsis and starvation on amino acid uptake in skeletal muscle. AB - Sepsis and starvation are catabolic conditions often occurring simultaneously. We recently found that uptake of the nonmetabolized amino acid analog, alpha aminoisobutyrate (AIB), was reduced in skeletal muscle during sepsis, and data were presented suggesting that this reduction was caused by a factor present in septic plasma. The purpose of the present study was to determine the effect of starvation on amino acid uptake and to investigate possible interactions between sepsis and starvation regarding effects on muscle amino acid uptake. Soleus muscles were removed intact from rats fasted for 0, 24, 48, or 72 hr. Muscles were incubated for 2 hr in Krebs-Henseleit bicarbonate buffer (pH 7.4) and glucose (5 mM) with or without 0.25 ml of septic plasma (total volume 3 ml). Muscle AIB uptake progressively decreased by approximately 50% during the first 48 hr of starvation, with no further decrease at 72 hr. Addition of septic plasma in vitro reduced AIB uptake in muscles from fed rats and from rats which had been fasted for 24 hr, but did not further reduce uptake after longer periods of starvation. The results suggest that starvation reduces amino acid uptake in skeletal muscle and that the nutritional status of muscle is an important component of the response to the factor(s) in septic plasma capable of inhibiting amino acid uptake. PMID- 3553743 TI - Altered peripheral amino acid uptake in obstructive jaundice. AB - To characterize amino acid metabolism in obstructive jaundice, the amino acid uptake in tissues of bile duct-ligated (BDL) rats was determined. Fischer 344 rats underwent either bile duct ligation or sham laparotomy and were pair fed for 72 hr. Amino acid uptake was determined in peripheral skeletal muscle (quadriceps femoris, soleus, and rectus abdominis), liver, blood, and other tissues by accumulation of alpha-[14C]-aminoisobutyric acid following intracardiac injection. Although total hepatic amino acid uptake was unaltered in the BDL animals compared with the sham-operated controls, amino acid uptake in peripheral skeletal muscle was significantly decreased in all muscle groups studied in the BDL rats. The relative concentration (percentage dose per gram normalized to the animal mass) for quadriceps femoris was 0.16 +/- 0.02 for BDL and 0.32 +/- 0.04 for sham-operated rats, P less than 0.005. Muscle protein was lower in BDL animals when compared with sham-operated rats (P less than 0.05). Total trunk blood amino acid levels were not significantly different in the two groups; however, there was a decreased serum level of branched-chain amino acids in the BDL group, P less than 0.05. No differences in plasma glucose or serum insulin were found in the two groups; lactate levels were lower in the BDL group, and plasma triglyceride levels were three times higher in the BDL animals. These data suggest that obstructive jaundice in the rat is associated with organ-specific metabolic abnormalities consistent with impaired peripheral amino acid uptake. PMID- 3553744 TI - Exclusion of small bowel from pelvis for postoperative radiotherapy for rectal cancer. AB - The pelvis is the preferential site of disease when recurrence occurs after curative resection of rectal cancer. Postoperative adjuvant radiotherapy decreases local recurrence rates for Dukes stages B and C; however, after abdominoperineal or anterior resections, the small bowel descends into the lower pelvis, and, due to its low tolerance to radiation, optimal doses cannot be safely delivered unless the small bowel can be excluded from the pelvis. This can be achieved by cystopexy and/or by creating a pelvic sling with a knitted polypropylene mesh. Three cases are presented in which radiotherapy was satisfactorily delivered with these techniques. PMID- 3553745 TI - Constant postoperative monitoring of cardiac output after correction of congenital heart defects. AB - A new method has been developed that permits constant postoperative monitoring of mean and phasic cardiac output in patients after correction of congenital heart defects. A miniature ultrasound probe is attached to the adventitia of the ascending aorta at the conclusion of the operative procedure. This is connected to the monitoring equipment by means of polyurethane-covered wires that exit the chest wall through a small stab wound. The probe can easily be removed by gentle traction when the patient's condition is stable. The technique was developed, validated, and refined in extensive animal studies, and this report describes the first series of 20 consecutive human implants, performed between August 1984 and September 1985, in which the absolute cardiac output determination obtained with the ultrasound probe at the time of its application was correlated with cardiac output as measured with a standard electromagnetic flow probe. Fourteen male and six female patients (mean age 5.5 years) were studied. Operations performed included eight atrial septal defect repairs, four procedures for tetralogy of Fallot, three ventricular septal defect repairs, three stenotic valve corrections, and two Senning operations. One operative death occurred, but no complications were related to probe application or removal. The average cardiac output in the 20 patients as measured with the ultrasound probe was 2.2 +/- 1.1 L/min (range 0.67 to 5.27 L/min). This is nearly identical to the results noted with the electromagnetic flow probe, where the mean cardiac output was 2.3 +/- 1.2 L/min (range 0.7 to 6 L/min). Regression analysis revealed a high linear correlation (r = 0.9) between the two techniques. A monitor can display the cardiac output trend with 1 minute updates, which greatly enhance management of intravenous drug therapy and volume administration. In conclusion, this new extraluminal removable probe allows virtually continuous monitoring of the postoperative cardiac output after correction of congenital heart defects and should become a standard technique in the postoperative care of these patients. PMID- 3553746 TI - A comparison of blood and crystalloid cardioplegia during heart transplantation after 5 hours of cold storage. AB - Four methods of protecting the heart during implantation were compared. All hearts were arrested in situ by perfusing 4 degrees C cardioplegic solution into the aortic root and were stored by a nonperfused cold storage technique for 5 hours at 4 degrees C. The hearts were then transplanted orthotopically with the use of topical iced slush alone or with infusions of either blood cardioplegic solution or one of two crystalloid cardioplegic solutions after each atrial anastomosis. Five dog hearts were included in each group. Biopsy samples to test for adenylates were taken before the arrest, at the end of storage, before cross clamp removal, and 3.5 hours after cross-clamp removal. The dogs were removed from cardiopulmonary bypass, and with the chest open, left ventricular function curves were measured at 1, 2, and 3 hours after cross-clamp removal. At 3.5 hours of reperfusion time, a full-width section was obtained from the left ventricle for measurement of tissue sodium and water content. No differences in tissue water, sodium, or potassium content were found among the groups. Left ventricular function was significantly better in the blood cardioplegia group than in any other groups. Adenosine triphosphate levels were significantly reduced 3.5 hours after reperfusion in the crystalloid cardioplegia groups but were not significantly depressed at any other measurement time. Excellent early graft function was observed after crystalloid cardioplegic arrest and blood cardioplegic reperfusion during graft implantation. PMID- 3553747 TI - Cardiac xenotransplantation in primates. AB - Successful cardiac xenotransplantation would alleviate the severe shortage of donor organs that presently limits the availability of cardiac transplantation. Early attempts at human xenotransplantation achieved minimal success. However, the effectiveness of cyclosporine in nonhuman xenotransplant models has received little experimental investigation. We have therefore studied the effect of cyclosporine-based immunosuppression in primate cardiac xenograft models using cynomolgus monkey donors and baboon recipients. Donor hearts were transplanted heterotopically into the necks of recipients or in the orthotopic position. Recipients were treated with no immunosuppression (controls), cyclosporine and steroids, or cyclosporine, steroids, azathioprine, and antithymocyte globulin. Statistically significant prolongation of graft survival compared to the control group was observed in the heterotopic groups. Mean survival time of the cyclosporine-treated and steroid-treated heterotopic grafts was 61 days compared to 6 days for grafts in the control group (p = 0.01); the addition of azathioprine and antithymocyte globulin yielded a mean survival of 84 days (p less than 0.01). No significant increase in graft survival was noted in the orthotopic groups treated with either immunosuppressive regimen. Although long term use of human xenografts as an alternative for heart replacement is not supported by these data, further investigation of the orthotopic model is clearly justified. PMID- 3553748 TI - Positive end-expiratory pressure and the damaged right ventricle. An experimental open versus closed chest study. AB - Hemodynamic changes after isolated impairment of right ventricular function (produced by increasing afterload by temporary banding of the pulmonary artery) were studied in 22 ventilated pigs during increased levels of positive end expiratory pressure (4, 8, 12, and 16 cm H2O). In the open chest group, application of positive end-expiratory pressure produced only a slight decrease of cardiac index. After right ventricular damage a decrease of cardiac index of more than 25% occurred only when higher levels of positive end-expiratory pressure were applied. In contrast to the open chest group, the closed chest group showed more distinct cardiovascular responses after positive end-expiratory pressure. In the damaged right ventricle with a positive end-expiratory pressure of 16 cm H2O, right ventricular end-diastolic pressure increased more than 100%. With positive end-expiratory pressure, cardiac index decreased 34% before and 47% after right ventricular damage. We conclude that positive end-expiratory pressure induces a more pronounced decrease in cardiac index if right ventricular function is impaired. During open chest conditions with lower levels of positive end expiratory pressure, these changes are only small, however, and probably irrelevant. During closed chest conditions, the hemodynamic changes are much more pronounced. High right ventricular end-diastolic pressures resulting from impaired right ventricular contractility as well as from high levels of positive end-expiratory pressure may have an impact on biventricular function and right ventricular coronary driving pressure. PMID- 3553749 TI - Transtracheal migration of an intravertebral Steinmann pin to the left bronchus. AB - Foreign body aspiration only rarely occurs by migration into the lung from other sites in the body. This report describes the migration of an intracervical Steinmann pin through the posterior tracheal membrane into the left bronchus and its successful removal via the rigid bronchoscope. PMID- 3553750 TI - Immunohistochemical classification of acute leukemias using peripheral blood smears. AB - Immunophenotypic classification of the acute leukemias (AcL) is of well documented value in those of lymphoid or uncertain origin and of increasing importance in those of nonlymphoid origin. Most of these studies have been performed on viable cell suspensions. To study the efficacy of a simpler immunohistochemical approach to the classification of the acute leukemias requiring only peripheral blood smears, 15 AcL (including three CGL-BC) were studied using an immunoalkaline phosphatase method and a panel of anti-lymphoid and anti-myeloid monoclonal antibodies. Routine cytochemistries were also performed (Sudan black, PAS). Using immunohistochemistry, five cases marked as common ALL (four were undifferentiated by cytochemistry, one ALL), eight cases as ANLL (all ANLL by cytochemistry) and two cases marked only with anti-HLA-DR (AUL by cytochemistry). These results show that immunophenotypic analysis of AUL, ALL and ANLL can be successfully performed even when only air dried peripheral blood smears are available. PMID- 3553751 TI - [The use of CAI (computer-assisted instruction) in nursing education]. PMID- 3553752 TI - Measurement of magnesium in human tissues and fluids: a historical perspective. AB - The history of the development of methods to measure magnesium in biological systems is reviewed. The current optimal methods are discussed in detail as are some highly sensitive methods which may be used in special circumstances. PMID- 3553753 TI - Repetitive electromyographic activity, spasmorhythmia and spasmophilia. AB - Spasmorhythmia (SR) can be defined as repetitive electromyographic activity lasting for longer than 4 min under conditions of cuff-induced ischemia. In a study on more than 180 'normal' subjects, this electrical anomaly was found in 21% of men and 30% of women, and was independent of age. Spontaneous variation in SR several hours or weeks apart is relatively slight, an average of 2 min, with the electrical diagnosis being confirmed by a second test in three quarters of cases. Correlations between SR and magnesium metabolism have not been proved as yet. SR has no pathological significance on its own. It assumes diagnostic importance when found in association with various vascular conditions; when found in association with a characteristic symptomatology, it may be used to support a diagnosis of latent tetany. PMID- 3553754 TI - Application of DNA-based diagnosis to patient care: the example of hemophilia A. AB - DNA-based carrier testing and prenatal diagnosis are rapidly expanding medical applications of recombinant-DNA technology. The ultimate goal of DNA-based diagnosis is the determination of the causative mutation, but, in general, this is possible only for large deletions, insertions, or certain nonsense mutation that, in most diseases, involve only a few percent of affected families. If direct diagnosis of the carrier state or fetal disease state is not feasible, indirect diagnosis can be performed by following the segregation of linked polymorphisms through the family pedigree. For such indirect diagnosis, DNA from multiple family members must be analyzed. Although this procedure is highly accurate in many families, errors can potentially occur because of meiotic recombination, genetic heterogeneity, new mutations, and nonpaternity. In this review, a general introduction to DNA-based diagnosis of mendelian diseases is presented and the methods and strategy are outlined. The use of these techniques for the diagnosis of hemophilia A is then described to illustrate the principles of diagnosis and to highlight some of the complexities encountered. DNA-based diagnosis is in its infancy and has the potential to revolutionize preventive medicine. PMID- 3553755 TI - Francois Magendie: early French physiologist. PMID- 3553756 TI - Marijuana testing--how good is it? AB - Testing for the use of marijuana necessitates one or more levels of assessment, depending on the clinical application of the test results. The EMIT-dau screening test with a sensitivity limit of 20 ng/ml is highly satisfactory for screening for the absence of marijuana in the urine. This test has a virtual 100% true negative rate as long as an unadulterated urine specimen is analyzed. Positive results by the EMIT-dau procedure are presumptive because the test seems to produce false-positive results when applied to a random population of suspected drug users. In a population in a specific clinical environment such as in drug treatment programs in which 20 of every 100 specimens will yield positive THC COOH results by EMIT-dau screening, 3 (15%) of the 20 positive results will likely be false-positive. Our experience with the EMIT-dau suggests that of 100 test results, 3 will be false-positive, an overall 3% false-positive rate. If a positive test result will put the patient in considerable jeopardy and the screening result is the only evidence of drug use, confirmatory testing is imperative. Of the confirmatory tests, GC/MS seems to have the specificity necessary to provide a high level of confidence in the results. A combination of the EMIT procedure with a sensitivity level of 20 ng/ml and GC/MS confirmation yields virtually 100% accuracy in detection of marijuana abuse. PMID- 3553757 TI - Stereotactic histologic correlations of computed tomography- and magnetic resonance imaging-defined abnormalities in patients with glial neoplasms. AB - In 39 patients who harbored previously untreated astrocytomas (21 patients), oligoastrocytomas (9 patients), or oligodendrogliomas (9 patients), computed tomographic (CT) and magnetic resonance imaging (MRI) findings were correlated with stereotactic serial biopsy findings. The 39 patients were classified as having one of three types of tumor: type I (1 patient), which consisted only of circumscribed tumor tissue; type II (26 patients), which consisted of tumor tissue and isolated tumor cells; or type III (11 patients), which consisted of intact parenchyma infiltrated by isolated tumor cells. (In one patient, the biopsy sampling was inadequate for determining the type of tumor.) In high-grade lesions, tumor tissue was obtained from CT contrast-enhancing regions, and the area of enhancement accurately defined the tumor tissue volume. In low-grade lesions, tumor tissue was hypodense and indistinguishable from parenchyma infiltrated by isolated tumor cells on both CT and MRI. Isolated tumor cells usually extended as far as the prolongation of T2 on T2-weighted MRI of high grade and low-grade tumors. CT and MRI detection of boundaries and stereotactic serial biopsies are necessary for the demarcation of glial neoplasms into tumor tissue and isolated tumor cell volumes as well as for the determination of the spatial extent of each component. This information is important for determining appropriate treatment. PMID- 3553758 TI - Charles-Marie de la Condamine: early advocate of inoculation for smallpox. PMID- 3553760 TI - Pulmonary alveolar phospholipoproteinosis: experience with 34 cases and a review. AB - A retrospective review of Mayo Clinic records through 1983 revealed 84 patients (24 male and 10 female; mean age, 41 years) with the diagnosis of pulmonary alveolar phospholipoproteinosis. The major clinical features were dyspnea, cough, fever, and chest pain. Chest roentgenograms usually showed bilateral symmetric alveolar infiltrates, but asymmetric, unilateral, and chronic patchy patterns were also noted. Diagnosis was established by thoracotomy-lung biopsy in 26 patients. Histologic analysis revealed uniform filling of the alveoli by periodic acid-Schiff-positive material and maintenance of normal alveolar architecture. Electron microscopy showed enlarged alveolar macrophages with lamellar osmiophilic inclusions, dense granules, and myeloid bodies. Of the 21 patients who underwent therapeutic bronchoalveolar lavage, 13 had no recurrence of the disease during a mean follow-up of 8.8 years. In patients who underwent pulmonary function testing both before and after lavage, significant restrictive dysfunctions present before the procedure were alleviated afterward. Three deaths occurred among the 34 patients. Pulmonary alveolar phospholipoproteinosis may result from defective clearance of phospholipids by the alveolar macrophages, excessive production of phospholipids by type II pneumocytes, or both. It is likely a nonspecific response to a variety of injuries to the alveolar macrophage or type II pneumocyte or both, including exposure to certain dusts and chemicals and occurrence of hematologic diseases or infections. The uncommon occurrence of this disorder suggests individual susceptibility. PMID- 3553759 TI - Respiratory impedance in normal humans: effects of bronchodilatation and bronchoconstriction. AB - Total respiratory resistance and reactance from 3 to 30 Hz were determined by the method of forced random noise oscillation in 12 normal male subjects before and after bronchodilatation and bronchoconstriction induced by deep breaths of aerosols of isoproterenol and atropine and of methacholine and histamine. Isoproterenol and atropine induced small decreases in total respiratory resistance at most frequencies, and isoproterenol decreased resonant frequency slightly (P less than 0.01). After administration of both methacholine and histamine, resonance frequency increased (P less than 0.01) and total respiratory resistance became more frequency-dependent, increasing mainly in the lower frequency range. In six of the subjects, we attempted to produce central deposition of methacholine by rapid, shallow breathing and peripheral deposition of the drug by slow, deep breathing. Only two subjects had suggestive evidence of central bronchoconstriction. No difference was noted, however, in the impedance behavior with either type of breathing. In awake humans, impedance analysis does not seem to distinguish between central and peripheral airway constriction. PMID- 3553761 TI - Age-related changes in rabbit articular chondrocytes. AB - Cell culture techniques have been used extensively in the study of the aging process at the cellular level. The "senescent" articular chondrocyte seems to be a good model to examine the responses to aging in osteoarthritis, one of the most frequent diseases of old age. Thus in vitro chondrocyte "senescence", established by weekly subculture was characterized by a declining proliferation rate during late passages, from a rapid growth rate in early subculture to a complete loss of the proliferation capacity after 8 +/- 1 passages. Flow cytometric analysis show a time course decrease in the fraction S and G2 + M during the subculture, and a concomitant enhancement in protein content related to the increase of cell size. The immunocytochemistry assays revealed an appearance of a rigid cytoarchitecture with an increase in the number, and organization, of three cytoskeletal components: actin, tubulin and vimentin. The cultured chondrocytes therefore undergo in vitro aging analogous to that described for diploid fibroblasts, and could constitute a cellular model for pharmacological and toxicological assays. PMID- 3553763 TI - [Disorders of the emotional function in neurology]. PMID- 3553762 TI - Clonal aging in Paramecium tetraurelia. II. Evidence of functional changes in the macronucleus with age. AB - The contribution of the macronucleus of Paramecium tetraurelia to the long term proliferation potential of a cell line was tested using a nuclear transplantation protocol. Macronuclei from young or old wild-type cells were injected into genetically marked host cells of a standard clonal age. The subsequent proliferation to clonal death of successfully and stably transformed hybrids was compared to the proliferation of injected but untransformed lines (injection controls). Young macronuclear donor material significantly prolonged the proliferation of the hybrid cell lines over that of the injection controls, but old donor material caused only a slight increase in post-injection proliferation of the hybrids. Total cell proliferation was also considered. Comparison of the total life spans of injected, non-transformed lines with uninjected host controls demonstrates that the injection itself has no significant effect upon proliferation potential. The mean life spans of uninjected donor controls and the mean total life spans of the transplanted macronuclear material (donor age at injection plus subsequent hybrid proliferation) are similar, regardless of the age of the donor at the time of transplantation. These results suggest that there is an age-related decrease in the ability of a macronucleus to support subsequent cell growth and division. The results also show that the proliferation potential of the donor macronucleus does not appear to be changed to any great degree by transplantation into a host cell of different clonal age. The macronucleus thus "remembers its age" after transplantation. Coupled with an absence of any detectable cytoplasmic effects upon aging during vegetative growth, these results argue in favor of a macronuclear determination of the proliferation potential of a cell line. The identification of a macronuclear basis for clonal aging in P. tetraurelia should permit a better directed approach for further research in this area. PMID- 3553764 TI - [Use of captopril in refractory arterial hypertension]. PMID- 3553765 TI - [Antigens and antigenic systems]. PMID- 3553766 TI - Prophylactic antibiotics for surgery. AB - This article discusses the determination of surgical patients to be given antibiotic prophylaxis. In addition, current concepts regarding selection of antibiotic prophylaxis necessary for a variety of surgical procedures are reviewed. PMID- 3553767 TI - Prophylaxis for deep vein thrombosis and pulmonary embolism in the surgical patient. AB - This article reviews the pathophysiology for the development of deep vein thrombosis and pulmonary embolism in the surgical patient. Patients are stratified into risk groups based on predisposing criteria for the development of thrombosis. Seven modalities of prophylaxis are reviewed with respect to appropriate application. Five major types of surgery are described assessing incidence and prophylaxis of choice. The final section deals with the special consideration of patients with thrombotic disease undergoing surgery. PMID- 3553768 TI - Preoperative identification and evaluation of the patient with lung disease. AB - Preoperative pulmonary function evaluation begins with the bedside, clinical identification of the presence of significant lung disease. Once a patient is so identified, preoperative pulmonary-function studies are indicated. The optimal screening studies for most patients are spirometry and arterial blood gas analysis. Patients who are identified as having marginal function by screening techniques should be studied further by more specialized studies, including radioisotopic evaluation of regional lung function. If a patient is identified as an operative candidate, but one who has increased risk of postoperative morbidity, prophylactic measures should be instituted to reduce postoperative complications. The essence of such measures is increased care preoperatively, intraoperatively, and postoperatively. The use of preoperative evaluation of pulmonary function presents a different magnitude of problem in defining the risk of morbidity in contrast to that of mortality. Available data provide a firm basis for the identification of the patient at increased risk of morbidity. After 23 years and dozens of spirometric studies involving thousands of patients, it is apparent that there is no spirometric number, percentage, or category that will absolutely separate the operable from the inoperable patient. There are estimates of risk--guidelines, to be sure--but no absolutes. The patient whose lung function would have been considered to prohibit lung resection in the 1950s has been successfully operated on in the 1980s. In dealing with the risk of mortality, the physician should always bear in mind that, although statistics apply to groups, they often do not apply to individual patients. PMID- 3553769 TI - Noncardiac surgery in the patient with heart disease. AB - Optimal care of the patient with heart disease undergoing noncardiac surgery requires that the members of the surgical team, including anesthesiologist, internist-cardiologist, and surgeon, be familiar with the cardiovascular response to surgery, preoperative cardiac risk stratification, and the unique pathogenesis of cardiac complications that may occur in the perioperative period. Preoperative evaluation and computation of cardiac risk, anesthetic considerations, along with perioperative care of the patient with ischemic heart disease, valvular heart disease, congestive heart failure, arrhythmias and conduction disorders, and hypertension is discussed. PMID- 3553770 TI - Medical care of the surgical patient with gastrointestinal disease. AB - Common perioperative gastrointestinal disorders of surgical patients are presented. Recommendations for appropriate medical evaluation and management are described. PMID- 3553771 TI - Surgery in the patient with liver disease. AB - This article deals with the effects of anesthesia and surgery on the healthy and diseased liver and the preoperative assessment of patients with liver disease. Emphasis is placed on estimating surgical risk. Guidelines for optimal preoperative preparation are discussed. PMID- 3553772 TI - Hematologic problems in the preoperative patient. AB - A number of topics have been reviewed pertaining to hematologic problems in preoperative patients. Most if not all of the problems discussed can be evaluated reasonably well by history, physical examination, and a few simple laboratory tests. Because the morbidity arising from some of these abnormalities can be quite significant, evaluation and treatment should be completed prior to surgery whenever possible. It is also critical to recall that therapy for a number of hematologic problems involves the transfusion of blood or blood products. This therapy should not be taken lightly as both immediate reactions (fever, anaphalaxis, hemolysis) as well as delayed effects (allosensitization and viral infections) occur frequently. The prudent clinician should try to minimize his patients' exposure to these potentially toxic materials by using alternative therapies. PMID- 3553773 TI - Surgery in the patient with acute or chronic renal failure. AB - Medical management of the surgical patient with renal dysfunction revolves primarily around the application of sound medical principles used in the care of all patients. In this article, the unique peculiarities associated with renal failure are stressed. Knowledge of these points is vital in securing a favorable outcome for the patient. PMID- 3553774 TI - Surgery in patients with endocrine dysfunction. AB - Patients with diabetes mellitus, thyroid dysfunction, and adrenal suppression from exogenous steroid therapy frequently undergo surgery. An understanding of the pathophysiology of these disorders enables the medical consultant to have valuable input into the preoperative evaluation and perioperative management of these patients. This article serves as a practical guide in following such patients through surgery, thereby decreasing overall morbidity and mortality. PMID- 3553775 TI - Preoperative management of the surgical patient with neurologic disease. AB - This article reviews neurologic problems that have been categorized into two groups: parenchymal and vascular disease. Each disease has a brief summary of key clinical points, followed by recommended management strategies. The neurologic diseases most frequently encountered by the medical consultant are presented. PMID- 3553776 TI - Preoperative evaluation of the oncology patient. AB - This chapter has served to highlight many of the important medical problems seen in the oncology patient. These problems stem from the effects of malignancy itself as well as from treatment. An overall understanding of these disorders and their management is essential to the proper preoperative evaluation of the cancer patient. PMID- 3553778 TI - Nonobstetric surgery in pregnancy. AB - Diagnostic and judgmental uncertainty that results in operative delay, leading to a more severe degree of illness and more complex surgery, is the major factor effecting both maternal and fetal morbidity and mortality in pregnant surgical patients. The acute abdomen is responsible for most errors in diagnosis and therapy. An understanding of anatomic, physiologic, and laboratory changes occurring in pregnancy and a timely interdisciplinary approach will expedite management and optimize outcome. PMID- 3553777 TI - Pharmacologic management of the critically ill patient in the perioperative period--emphasis on the sepsis syndrome. AB - The critically ill perioperative patient requires complex pharmacologic management. The ability to measure circulating drug concentrations has helped the clinician to properly modulate therapy, especially with potentially toxic agents. Postoperative sepsis remains a difficult therapeutic problem. Controversial therapies, such as the use of corticosteroids and the utility of newer pharmacologic approaches, are beginning to be properly tested in multicenter trials. Improvements in technology (e.g., development of monoclonal antibodies), biochemistry, and pharmacology have resulted in the development of exciting, new pharmacologic avenues for the management of the critically ill perioperative patient. PMID- 3553779 TI - Perioperative management of the ophthalmology patient. AB - The overall risk of eye surgery is quite low, and it can generally be performed in all but the sickest patients. Ambulatory eye surgery is becoming more and more frequent, with improvement in surgical techniques and changes in reimbursement schedules. For most patients it seems quite safe. However, there are a number of specifics, reviewed previously, regarding the eye patient with which the consulting physician should be familiar. PMID- 3553780 TI - Preoperative considerations in the geriatric patient. AB - Because of the "graying" of the population, the increasing availability of surgeons, and the improvement of surgical techniques and intensive care, more and more surgery will be done on geriatric patients. Sometimes, however, surgery will not be considered in a geriatric patient because of mistaken underestimation of life expectancy. The medical consultant is charged with confirming that surgery represents the consequence of the patient's informed decision, a task that is usually time consuming and often difficult. The medical consultant next identifies patient-related and procedure-related factors that affect surgical morbidity and mortality. General physiologic declines in all organ systems are characteristic of aging, but the most important ones affecting surgical risk are those of cardiovascular, pulmonary, immunologic, and central nervous systems. These systems must be assessed by an orderly preoperative evaluation that aims to optimize the patient's status and anticipate and minimize postoperative complication. PMID- 3553781 TI - Inhibitors of leukocyte elastase and leukocyte cathepsin G. Agents for the treatment of emphysema and related ailments. PMID- 3553782 TI - Bromocriptine. PMID- 3553783 TI - Dietary sodium variation, erythrocyte cationic transport and plasma renin aldosterone in men. AB - Erythrocyte concentrations and fluxes of sodium and potassium were investigated in normal white male subjects during dietary sodium restriction and repletion, each period lasting for 16 weeks. Intraerythrocyte sodium concentration decreased and red cell ouabain-sensitive 86Rubidium-uptake increased during dietary sodium restriction while no significant changes were observed in the total, furosemide resistant and furosemide-sensitive sodium-efflux and the sodium, lithium countertransport. The decrease in intraerythrocyte sodium concentration could have resulted from the observed increase in sodium, potassium-ATPase pump activity. The latter increase could have been secondary to the early decrease in a digitalis-like plasma inhibitor and the later increase could have been facilitated by the late rise in the intracellular adenosine triphosphate concentration, which is the energy supplier for this pump. During the subsequent first month of sodium repletion intraerythrocyte sodium concentration remained low. Red cell ouabain-sensitive 86Rubidium-uptake and adenosine triphosphate concentration remained elevated and returned to baseline only after 16 weeks. This long-term effect suggests either the involvement of a mechanism which can only be slowly reversible or a mechanism which is irreversible so that normalization takes place only when new red cells are released into the circulation. PMID- 3553784 TI - [The blood supply of manually sutured and stapled colonic anastomoses]. AB - The blood supply of end-to-end staple and suture lines in the pig colon was compared. In 15 operated animals there was no anastomotic leak. Sporadic circumscribed areas of restricted circulation could be noticed in hand-sewn anastomoses. This effect was marked on the 7th and 14th postoperative day, when vascularisation of the anastomoses was increased. Such lack of vascular supply was not seen in stapled anastomoses. The intramural arteries passed through the B shaped staples without hindrance. An unremarkable vascular pattern and a completed healing of the anastomoses were observed after 3 weeks in staple lines and after 4 weeks in suture lines. PMID- 3553785 TI - [Effect of forced respiration on the stress on puncture channels of sutures in transverse laparotomies of the upper abdomen; experimental studies in the anesthesized dog]. AB - In 11 mongrel dogs in propiophenylpromazine-pentobarbital-anaesthesia the influence of forced respiration on the load of puncture channels of a suture was investigated. For this horizontal suture in the upper abdominal wall, threads No. 3 USP and round needles No. ECT-4 were used. The experiments were carried out in supine position with stretched hindlegs, in supine position with relaxed hindlegs, in lateral position, and in hanging abdominal position. Measurements were performed with a selfconstructed resistance strain gauge element. Rising forced respiration pressure increased the inspiratory load of puncture channels, but there were no significant differences between spontaneous breathing and forced respiration with pressure of 10 cm H2O. In contrary to this there were highly significant differences between spontaneous breathing and forced respiration with pressure of 20 and 30 cm H2O (multiple variance analysis). For instance the load during forced respiration with a pressure of 30 cm H2O in supine position with relaxed hindlegs rose about 67% above pressure values of spontaneous breathing. It could be shown that the expiratory load in the puncture channels was not influenced by forced respiration pressure, but depended on the body position; in dogs it was minimal in side position (45-48 g), higher in supine position with relaxed hindlegs (67-71 g), even higher in supine position with stretched hindlegs (88-92 g), and maximal in hanging abdominal position (109 113 g). By this investigation the increase of load in the puncture channels during forced respiration with pressures of 20 and 30 cm H2O was quantified. PMID- 3553786 TI - [Lymphadenitis toxoplasmotica--a zoonosis]. AB - Between 1975 and 1985, 49 in-patients suffering from Toxoplasmosis of head and neck lymph nodes, have been treated chirurgically at the ENT clinics of the universities of Cologne and Homburg/Saar. In the collective there are as much men as women. The patients have an average age of 30 years, the anamnesis is about 3 months. The patients were complaining of swellings of lymph nodes of the angle of mandible or of the submandibular region, but without fever or other signs of infection. Typically, the lymph nodes were not fixed but mobile, hard and indolent. Blood parameters and electrolytic levels are not pathologically changed. The patients do not feel sick in general. The diagnosis is to be confirmed by serological investigations, supported by lymph node histology (Lymphadenitis Piringer-Kuchinka). In the present study, three acute cases of Toxoplasmosis with high serological titers could be diagnosed. The differential diagnosis of the lymphadenitis toxoplasmotica will be discussed. PMID- 3553787 TI - [Surgical therapy of severe carotid sinus syndrome]. AB - A 76 year old female, suffering from a severe carotid sinus syndrome, is presented. Conventional therapeutic measures with medication, radiation and implantation of a pacemaker did not influence her syncopal attacks. She sustained several syncopes daily and was forced to almost permanent bedrest. Only with an operative procedure, consisting of bilateral microsurgical carotid sinus denervation, the patient could finally be relieved from her syncopal attacks. PMID- 3553788 TI - Fungal colonization of tracheoesophageal voice prosthesis. AB - Laryngectomized patients fitted with tracheoesophageal (TE) puncture voice prosthesis may experience frequent failures in adequate production of neophonation. In some cases, these phonatory problems result from obstruction of the voice prosthesis with various deposits. The nature of these deposits was studied with mycologic techniques and by light and scanning electron microscopy. Candida albicans and other fungal species were identified. PMID- 3553789 TI - Comparison of microsurgical suture and CO2 laser-welded anastomoses of rabbit uterine cornua. PMID- 3553790 TI - Efficacy of the neodymium:YAG laser in vasovasostomy: a preliminary communication. PMID- 3553791 TI - Mechanisms of healing in the injured lung treated with the Nd-YAG laser. AB - An experimental study was done to evaluate the pattern of healing after sealing an incision in the pulmonary parenchyma with the Nd-YAG laser. Gross and histologic examinations of healing were compared with those of lung cauterized or sutured with chronic catgut. The results indicate that the use of the Nd-YAG laser to seal small vessels and air leaks has distinct advantages over cautery or suture closure of incisions in pulmonary tissue. PMID- 3553792 TI - Head and neck applications of the milliwatt laser. AB - The head and neck surgeon often uses the carbon dioxide laser. With the advent of new instrumentation, the frequency of usage will increase. The CO2 miliwatt laser offers the advantages of tissue welding, as well as cutting and ablation by virtue of the small spot size produced combined with low power output. Potential applications include microvascular and microneural anastomoses. The milliwatt laser can be used endoscopically for tissue resection with a high degree of precision with power densities comparable to current CO2 lasers. Moreover, the milliwatt laser can be applied to otology for cutting and welding of the tympanic membrane, tissue removal, and stapedotomy. PMID- 3553793 TI - The contribution of Charles C. Shepard to leprosy research: from the mouse footpad model to new DNA technology. PMID- 3553794 TI - Immunology of leprosy. Proceedings of an international symposium. Oslo, Norway, September, 1986. Dedicated to the memory of Charles C. Shepard. PMID- 3553795 TI - The specificity of the immunodeficiency in lepromatous leprosy. PMID- 3553796 TI - Anti-mycobacterial antibodies in saliva. PMID- 3553797 TI - Cloning of Mycobacterium leprae genes in Streptomyces. PMID- 3553798 TI - Induction of protective immunity to malaria. PMID- 3553799 TI - The development of a vaccination model using two microorganisms and its application in leprosy and leishmaniasis. PMID- 3553800 TI - The relationship between delayed type hypersensitivity and protective immunity induced by mycobacterial vaccines in man. PMID- 3553801 TI - The Karonga prevention trial--which BCG? PMID- 3553802 TI - Humoral immune responses to M. leprae in human volunteers vaccinated with killed, armadillo-derived M. leprae. PMID- 3553803 TI - Murine T-cell reactivity to cloned Mycobacterium leprae antigens. PMID- 3553804 TI - The carbohydrate-containing antigens of Mycobacterium leprae. PMID- 3553805 TI - The characterization and immunoreactivity of a 70 kD protein common to Mycobacterium leprae and Mycobacterium bovis (BCG). PMID- 3553806 TI - Characterization of the 36 K antigen of Mycobacterium leprae. PMID- 3553807 TI - The use of rodent models in assessing antimicrobial activity against Mycobacterium leprae. PMID- 3553808 TI - Limited in vitro multiplication of Mycobacterium leprae: application to screening potential antileprosy compounds. PMID- 3553809 TI - Single bacterial cell mass analysis: a rapid test method in leprosy therapy control. PMID- 3553810 TI - Metabolism in Mycobacterium leprae: possible targets for drug action. PMID- 3553811 TI - Host-pathogen interaction--new in vitro drug test systems against Mycobacterium leprae--possibilities and limitations. PMID- 3553812 TI - Isolation of environment-derived Mycobacterium leprae from soil in Bombay. PMID- 3553813 TI - Investigations into the cultivation of Mycobacterium leprae. A multifactorial approach. PMID- 3553814 TI - Development of inhibitors of mycobacterial ribonucleotide reductase. PMID- 3553815 TI - Efficacy of different regimens in multibacillary leprosy. PMID- 3553817 TI - [Lyme borreliosis--another new infectious disease]. PMID- 3553816 TI - [Comparative clinical study of the antihypertensive effects of urapidil versus diazoxide in patients with severe arterial hypertension]. PMID- 3553818 TI - [Monoclonal antibodies--a new tool for research, diagnosis and therapy]. PMID- 3553819 TI - Coexistence of inhibitory dopamine D-1 and excitatory D-2 receptors on the same caudate nucleus neurons. AB - Microiontophoretic studies using cats anesthetized with alpha-chloralose were performed to determine whether or not dopamine D-1 and D-2 receptors co-exist in the same caudate nucleus (CN) neurons that receive inputs from the substantia nigra (SN), and in which spikes elicited by SN stimulation were blocked by domperidone, a selective D-2 antagonist. Iontophoretic application of dopamine produced a dose-dependent inhibition of spontaneous firing in 2 of 4 spontaneously active CN neurons and an increase in firing in the remaining 2 neurons. However, dopamine inhibited the glutamate-induced firing in 31 of 32 CN neurons that were not spontaneously active. Similar inhibition with iontophoretically applied SKF 38393, a selective D-1 agonist, was observed in 33 of 34 spontaneously inactive neurons tested. When the effects of dopamine, SKF 38393 and bromocriptine (D-2 agonist) were examined on the same CN neurons, the inhibitory effects of both dopamine and SKF 38393 were seen in 14 of 15 neurons, and both an inhibition by SKF 38393 and an excitation by bromocriptine were observed in 15 of 17 neurons. The inhibitory effects of dopamine and SKF 38393 were antagonized by haloperidol and SCH 23390 (D-1 antagonist) without being affected by domperidone. Furthermore, the dopamine-induced inhibition was converted to an excitation during simultaneous application of SCH 23390 in 6 of 10 CN neurons, and this excitation was antagonized by domperidone. These results strongly suggest that the inhibitory D-1 and excitatory D-2 receptors co-exist on the same CN neurons receiving inputs from the SN. PMID- 3553820 TI - Ultrasound-guided fine-needle aspiration biopsy in the diagnosis of hepatic hemangioma. AB - Fine-needle biopsy of hepatic hemangioma is discussed on the basis of a series of 10 biopsies performed on eight patients. The fine needle biopsies were executed because of the atypical sonographic pattern of some lesions, or in order to exclude malignancy for others (five patients were known to have neoplasms). No complication presented during or after the punctures. In six cases cytologic samples included capillary vessels or endothelial cells, supplying the diagnosis of hemangioma. It is concluded that fine-needle biopsy of a hepatic hemangioma is not loaded with complications, and moreover can yield true positive information in 60% of cases. PMID- 3553821 TI - Acute hepatic failure due to Plasmodium falciparum liver injury. AB - Nine patients with acute liver failure due to Plasmodium falciparum liver injury admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences during 1982-84 are presented. The liver was palpable in all the patients, and eight had splenomegaly. Investigations revealed mild to moderate abnormality in liver function tests. All were negative for the markers of acute infection due to hepatitis A and B viruses. Blood film examination showed P. falciparum alone in seven and along with P. vivax in the remaining two patients. Liver histology, which was identical in all eight patients where liver biopsy was done, showed centrizonal necrosis and hyperplastic Kupffer cells loaded with malarial pigment. All the patients recovered with specific anti-malarial and supportive treatment. Our observations suggest that malaria due to P. falciparum may present as jaundice and encephalopathy which stimulates acute hepatic failure due to fulminant hepatitis. PMID- 3553822 TI - Glandular elements around the intrahepatic bile ducts in man; their morphology and distribution in normal livers. AB - The morphology and distribution of the glandular elements around the intrahepatic bile ducts, hitherto poorly described, were examined in autopsied human livers with the aid of postmortem cholangiographs. The glands could be divided into intramural and extramural. The former were small in number, scattered within the bile duct walls, and were simple tubular mucous glands. The latter were more abundant, located in the periductal connective tissue, and were branched tubuloalveolar seromucous glands. Serial section observations revealed that neither gland communicated with the hepatic parenchyma, and the extramural glands drained into the large bile duct lumina via the conduits. The mucous cells of both glands contained neutral, carboxylated and sulfated glycoproteins. The extramural glands were distributed from the hepatic to the segment ducts in almost all livers, and were also discerned around the area ducts in two-fifths of the livers. The glands seemed to decrease in number as the bile ducts became more branched. PMID- 3553823 TI - Differential diagnosis of jaundice: applicability of the Copenhagen Pocket Chart proved in Stockholm patients. AB - This paper shows that an algorithm for differential diagnosis of jaundice developed in Denmark has been successfully transferred for use in a Swedish hospital. The algorithm, which is based on data from nearly 1000 patients, utilises 21 items of information from the medical history, physical examination and blood chemistry. The algorithm recognises four diagnostic groups: benign obstructive jaundice, malignant obstructive jaundice, acute non-obstructive jaundice, and chronic non-obstructive jaundice. To each item of information, a score is attached reflecting its weight of evidence. Summing the scores for the symptoms and signs that are present leads to a probabilistic statement about the diagnosis. Because of missing data in the Swedish patient material, three of the items were excluded from the original algorithm. Corrections were made for differences in the distribution of diseases. In reclassification of 985 Danish patients the modified algorithm's "best bid", i.e. the diagnosis given the highest probability, was correct in 78% of cases. More important, 93% of the cases given a "confident" diagnosis (probability greater than 0.80) were correct. The corresponding figures when the algorithm was applied to Swedish patients were 76% and 93%, respectively. In both series the predicted probabilities were matched by a corresponding proportion of actual diagnostic hits. It is concluded that the algorithm leads to reliable estimates of diagnostic probabilities in jaundice and that the algorithm seems to work well in Sweden also. PMID- 3553824 TI - Physician countersuits. A chronology of losses and wins. Part I. PMID- 3553825 TI - Physician countersuits. A chronology of losses and wins. Part II. PMID- 3553826 TI - Physician countersuits. A chronology of losses and wins. Part III. PMID- 3553827 TI - The brain-damaged learner driver: screening. PMID- 3553828 TI - Evaluating rapid tests for streptococcal pharyngitis: the apparent accuracy of a diagnostic test when there are errors in the standard of comparison. AB - The evaluation of new rapid antigen detection tests for streptococcal pharyngitis is complicated by the presence of errors in the standard of comparison. Even "gold standard" throat cultures are not perfectly accurate. This article is an analysis of how errors in the comparison cultures affect the apparent accuracy of new tests for streptococcal pharyngitis. One of the questions addressed is whether throat cultures performed in a physician's office are accurate enough to use as a standard in a clinical trial of a new rapid test. While the accuracy of office cultures is accepted by many to be adequate for diagnostic purposes, this analysis shows that when evaluating a new test stricter conditions must be placed on the accuracy of the cultures used for comparison. PMID- 3553829 TI - Discotest. PMID- 3553830 TI - A computerized approach to dysmorphology. PMID- 3553832 TI - Gastrointestinal mucosal lesions. A drug formulation problem. PMID- 3553833 TI - Drug-induced cholestasis. AB - Intrahepatic cholestasis, defined as arrested bile flow, mimics extrahepatic obstruction in its biochemical, clinical and morphological features. It may be due to hepatocyte lesions of which there are three types, termed canalicular, hepatocanalicular and hepatocellular, respectively; or it may be due to ductal lesions at the level of the cholangiole or portal or septal ducts. Defective bile flow due to hepatic lesions reflects abnormal modification of the ductular bile. Defective formation of canalicular bile may involve bile acid-dependent or independent flow. It appears to result most importantly from defective secretion of bile acid-dependent flow secondary to defective uptake from sinusoidal blood, defective transcellular transport and defective secretion; or from regurgitation of secreted bile via leaky tight junctions. An independent defect in bile acid independent flow is less clear. Defective flow of bile along the canaliculus may reflect increased viscosity and impaired canalicular contractility secondary to injury of the pericanalicular microfibrillar network. Impaired flow beyond the canaliculus may result from ductal injury. Sites of lesions that contribute to cholestasis include the sinusoidal and canalicular plasma membrane, the pericanalicular network and the tight junction and, less certainly, microtubules and microfilaments and Golgi apparatus. A number of drugs that lead to cholestasis have been found to lead to injury at one or more of these sites. Other agents (alpha-naphthylisothiocyanate, methylenedianiline, contaminated rapeseed oil, paraquat) lead to ductal injury resulting in cholestasis. Reports of inspissated casts in ductules (benoxaprofen jaundice) and injury to the major excretory tree (5-fluorouridine after hepatic artery infusion) have led to other forms of ductal cholestasis. Most instances of drug-induced cholestasis present as acute, transient illness, although important chronic forms also occur. The clinical features include the reflection of the cholestasis (pruritus, jaundice), systemic manifestations and extrahepatic organ involvement. While nearly all classes of medicinal agents include some that can lead to cholestasis, there are differences among the various categories. Phenothiazines and related antipsychotic and 'tranquillizer' drugs characteristically lead to cholestatic hepatic injury. The tricyclic antidepressants may lead to cholestatic or hepatocellular injury.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3553834 TI - The role of naltrexone in the management of drug abuse. PMID- 3553831 TI - HeartLab. PMID- 3553835 TI - [Sketches on the history of the training of paramedical personnel in Russia]. PMID- 3553836 TI - Functional vs chronologic age. AB - Chronologic age, by itself, is seldom a reliable index of an individual's ability to perform strenuous physical work. Therefore, age should not be viewed as a bona fide occupational qualification. Instead, each individual should be judged on the basis of his or her functional capabilities. This paper discusses the concept of functional or physiologic age and then considers how functional age can be determined in a specific job-related context. Physiologic age is viewed as a generalized measure of senescence that would be a useful tool for research studies on aging. Functional age could employ many of the marker variables used in the physiologic age (VO2max, strength, etc.) in a task-specific manner. However, since all the variables involve assumptions concerning the rate of decline with age, they may not stand up in a courtroom test. Therefore, the regular use of job-related tests is recommended as an alternative to the use of chronologic or functional age to determine a person's ability to perform on the job. PMID- 3553837 TI - Gas exchange and hemodynamics in patients with bacterial pneumonia ventilated with high PEEP levels. PMID- 3553838 TI - Detection of T. cruzi antigens reactive with IgG antibodies from patients with chronic Chagas' disease. PMID- 3553839 TI - [Aplastic anemia, diarrheas and bacteremia]. PMID- 3553840 TI - [Ceftazidime: a new cephalosporin of broad spectrum]. PMID- 3553841 TI - [Life before death]. PMID- 3553842 TI - Suppression of plasma aldosterone during stimulation of cardiopulmonary mechanoreceptors in man. PMID- 3553844 TI - [Clinical trial with a new drug in acquired immunodeficiency syndrome]. PMID- 3553843 TI - Antagonistic effect of insulin and cortisol on stimulated lymphocytes. PMID- 3553845 TI - The neurologic presentation of vasculitic and rheumatologic syndromes. A review. AB - Most rheumatologic and vasculitic syndromes can affect the central nervous system (CNS). In the vast majority of cases, however, the systemic disease is present at the time of first CNS manifestations. Certain of these diseases, including SLE, PSS, Behcet syndrome, cryoglobulinemia and lymphomatoid granulomatoses can present with CNS findings in the absence of any peripheral evidence of the underlying process. The CNS presentations of these and the other rheumatologic and vasculitic syndromes which may affect the CNS are discussed. Isolated CNS vasculitis may be due to granulomatous angiitis of the nervous system (GANS) or delayed contralateral hemiplegia following HZO. These are distinct clinical entities which can be differentiated by clinical and angiographic findings. The former is often severe and diffuse in nature, whereas the latter is usually milder and more focal. There are few if any peripheral findings in either syndrome. The cause of GANS is unknown, but the hemiplegia following HZO is clearly due to a virus-induced vasculitis spread from the overlying Gasserian nucleus; the history of preceding herpes zoster ophthalmicus strongly suggests the diagnosis. The collected evidence suggests that an aggressive evaluation, including meningeal biopsy, and early therapy with steroids (and perhaps cytotoxic agents) can alter the prognosis in GANS. It is not clear that hemiplegia following HZO requires treatment. GANS and HZO-associated CNS damage should be considered in the differential diagnosis of isolated CNS dysfunction in the absence of history, signs, or laboratory abnormalities suggestive of systemic disease. PMID- 3553846 TI - [Problems in preventing occupational neoplasms of chemical etiology]. AB - Authors present the grounds of prophylactic system and discuss some following elements of it: identification of chemical cancerogens, collection of data on location and magnitude of exposure, monitoring of health effects resulting from exposure, and application of preventive means. Necessity of novelization of sanitary regulations on toxicological examinations of chemicals, both the already used and introduced to industrial technology is considered. The need of setting up an informatic system on occupational exposure to cancerogenic substances is underlined by authors as well. PMID- 3553847 TI - A simple method for assessing the binding of concanavalin A to mononuclear cell surfaces: no interference of visceral leishmaniasis serum on this binding. AB - We report a simple method for evaluating the binding of concanavalin A (ConA) to human peripheral blood mononuclear cells (PBMC). The binding is evidenced by an immunoenzymic assay using peroxidase-conjugated immunoglobulins of a rabbit anti ConA serum. Using the method we show that sera from patients with American leishmaniasis do not interfere with binding of ConA to PBMC. PMID- 3553849 TI - Kinetics of circulating endogenous insulin, C-peptide, and proinsulin in fasting nondiabetic man. AB - Plasma concentrations of insulin, C-peptide, and proinsulin were measured in different vascular beds in order to determine renal, hepatic, and systemic kinetics of the endogenous peptides in the fasting condition. Nineteen nondiabetic subjects were studied, two were normal, nine had minor vascular disorders, four had cirrhosis without organic kidney disease, and four had organic kidney disease with moderately decreased glomerular filtration rate. In subjects without organic kidney disease the arteriorenal venous extraction ratios of insulin, C-peptide, and proinsulin were mean 0.27, 0.20, and 0.21, respectively (n = 14). These values were significantly reduced in kidneys with organic disease. Renal plasma clearance values of insulin, C-peptide, and proinsulin were mean 113, 87, and 90 mL/min, respectively (n = 6). Urinary clearances were substantially lower (0.8, 13, 3.5 mL/min, respectively), indicating that a significant degradation of these peptides also takes place in the normal kidney. In subjects without liver disease the estimated hepatic extraction ratio of insulin was mean 0.48, under the assumption that no C-peptide is removed by the liver. Endogenously released insulin was removed from plasma in kidney, liver, and elsewhere in the approximate proportion 10%:65%:25%, whereas, C-peptide was removed by one half in kidney and the other half elsewhere. The overall metabolic clearance rates of insulin and C-peptide were estimated to be 15 and 4.5 mL/min/kg, respectively. The results indicate that the kidney contributes substantially to removal of insulin, C-peptide, an proinsulin, mainly by degradation, less by urinary excretion. PMID- 3553848 TI - The effect of short-term alpha-glucosidase inhibition on carbohydrate and lipid metabolism in type II (noninsulin-dependent) diabetics. AB - With use of the alpha-glucosidase inhibitor bay g 5421 (acarbose), it is possible to improve glycemic profiles in diabetics without a concomitant increase in insulin levels or weight reduction. We have taken advantage of this feature to test whether an improvement in glycemic control alone can ameliorate some of the known abnormalities of type II diabetes (ie, impaired insulin secretion, elevated rate of basal hepatic glucose output, peripheral insulin resistance). We have studied eight type II diabetics (mean +/- SE fasting serum glucose 193 +/- 25 mg/dL) before and after 2 weeks of acarbose therapy (100 mg with each meal). Assessment of endogenous insulin secretion, peripheral and hepatic insulin sensitivity, and adipose tissue lipoprotein lipase (ATLPL) activity were performed. Results showed significant lowering of postprandial glucose excursions above basal but no change in basal serum glucose levels, marked reduction in fasting and day-long triglyceride levels and in spite of a reduction in ATLPL activity, an increase in hepatic sensitivity to insulin's ability to suppress hepatic glucose output, and no effect on peripheral insulin sensitivity. In conclusion, inhibition of carbohydrate digestion with alpha-glucosidase inhibitors ameliorates many of the metabolic abnormalities in type II (noninsulin dependent diabetics), suggesting that agents of this type can be of therapeutic value. PMID- 3553850 TI - Acute effects of endurance exercise on human adipose tissue metabolism. AB - In order to study the acute effects of exercise on adipose tissue metabolism, 27 sedentary male subjects, 18 to 27 years of age, performed a prolonged aerobic exercise test. Biopsies of adipose tissue were obtained from the suprailiac fat depot before and immediately after a 90-minute period of exercise on ergocycle at an average intensity of 88% of maximal heart rate. Fat cells, isolated by collagenase digestion, were measured for their glucose conversion into triglycerides and for lipolytic activity. Adipose tissue lipoprotein lipase activity released by heparin was also determined. Mean basal and insulin stimulated glucose conversion into triglycerides decreased significantly with exercise (P less than .05) while adipose tissue lipoprotein lipase activity increased (P less than .01). Fat cell lipolysis increased during exercise only for its epinephrine-stimulated values (P less than .05). The total amount of work performed during the test was correlated only with changes in lipoprotein lipase activity (r = .42, P less than .05). Finally, the changes induced by exercise in lipoprotein lipase activity (r = .37, P less than .05) and insulin-stimulated glucose conversion into triglycerides (r = .61, P less than .01) were positively correlated with fat cell weight. These results indicate that adipose tissue metabolic activities are selectively influenced by endurance exercise. They also suggest that these metabolic changes are not closely coupled with the amount of work performed in a prolonged exercise bout. PMID- 3553851 TI - Effect of intravenous insulin treatment on in vivo whole body leucine kinetics and oxygen consumption in insulin-deprived type I diabetic patients. AB - In vivo leucine metabolism was studied after an overnight fast in nine type I diabetic patients and nine healthy control subjects using L-[1-13C] leucine as a tracer. In the insulin-deprived state, leucine flux (reflecting proteolysis), leucine oxidation, and plasma leucine concentrations were higher in the diabetic patients than in the control subjects (P less than .001). In 4 of the 9 insulin deprived diabetic patients, a four-hour intravenous insulin treatment decreased plasma glucose and leucine concentrations and leucine flux, but failed to decrease leucine oxidation. In the remaining 5 of the 9 diabetic patients, uninterrupted insulin treatment prior to the study and a seven-hour intravenous insulin treatment during the study period decreased not only the concentrations of plasma glucose and leucine and leucine flux, but also leucine oxidation (P less than .01). In all 9 diabetic patients the nonoxidative portion of leucine flux (reflecting protein synthesis) decreased during insulin treatment (P less than .01), but this decrease was lower than that of leucine flux (reflecting proteolysis), and therefore protein was conserved during insulin treatment. We conclude that the effect of insulin on proteolysis (reflected by leucine flux) is more rapid than its effect on leucine oxidation, but on aggressive insulin treatment accelerated leucine oxidation also was decreased in type I diabetic patients. PMID- 3553852 TI - Acute elevation of free fatty acid levels leads to hepatic insulin resistance in obese subjects. AB - Raised levels of free fatty acids (FFA) compete with glucose for utilization by insulin-sensitive tissues, and, therefore, they may induce insulin resistance in the normal subject. The influence of experimental elevations in FFA levels on glucose metabolism in native insulin-resistant states is not known. We studied seven women with moderate obesity (63% above their ideal body weight) but normal glucose tolerance with the use of the insulin clamp technique with or without an infusion of Intralipid + heparin. Upon raising plasma insulin levels to approximately 60 microU/mL while maintaining euglycemia, whole body glucose utilization (3H-3-glucose) rose similarly without (from 66 +/- 7 to 113 +/- 11 mg/min m2, P less than .02) or with (from 70 +/- 7 to 137 +/- 19 mg/min m2, P less than .02) concomitant lipid infusion. In contrast, endogenous glucose production was considerably (73%) suppressed (from 66 +/- 7 to 15 +/- 8 mg/min m2, P less than .001) during the clamp without lipid, but declined only marginally (from 70 +/- 7 to 48 +/- 7 mg/min m2, NS) with lipid administration. The difference between the control and the lipid study was highly significant (P less than .02), and amounted to an average of 3.8 g of relative glucose overproduction during the second hour of the clamp. Blood levels of lactate rose by 34 +/- 15% (.1 greater than P greater than .05) in the control study but only by 17 +/- 10% (NS) during lipid infusion. Blood pyruvate concentrations fell in both sets of experiments (by approximately 45% at the end of the study) with similar time courses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553853 TI - Activator proteins for lysosomal glycolipid hydrolysis. PMID- 3553854 TI - Electro-optical reflection methods for studying bioactive substances at electrode solution interfaces--an approach to biosurface behavior. PMID- 3553855 TI - Isoelectric focusing in immobilized pH gradients: theory and newer methodology. PMID- 3553856 TI - The radiation inactivation method as a tool to study structure-function relationships in proteins. PMID- 3553857 TI - Immunoassay with electrochemical detection. PMID- 3553858 TI - The role of membrane sulfhydryls in passive, mediated transport processes and for the barrier function of the erythrocyte membrane. PMID- 3553859 TI - Receptor specificity of the short tail fibres (gp12) of T-even type Escherichia coli phages. AB - Short tail fibres of T-even like phages are involved in host recognition. To determine the specificity of the fibres, the region containing gene 12 of phages T2, K3, and K3hx was cloned. The genes 11, 12, wac, and 13, coding for the baseplate outer wedge, short tail fibres, collar wishes, and a head completion component, respectively, were localized on the cloned fragments. Plasmid-encoded gene 12 could be expressed without helper phage. Efficient expression of gene 12 from T2 and K3hx made an extraction of protein 12 possible. Hybrid phages obtained by in vitro complementation, recombination analysis and protein 12 binding to host range mutant bacteria excluded a role of the short tail fibres from T2, K3 or K3hx in the recognition of outer membrane proteins. Binding patterns of protein 12 to different Escherichia coli lipopolysaccharide mutants and inhibition of binding of protein 12 by a monoclonal antibody against the core region of E. coli K12 lipopolysaccharide suggested that heptose residues are necessary for efficient binding. The binding site of the same monoclonal antibody is different from the short tail fibre binding site in an E. coli B strain suggesting different binding specificities of protein 12. Thus, the ability of different bacterial strains to inactivate phage could be related to differences in the binding specificity of the short tail fibres for the lipopolysaccharides of these bacteria. PMID- 3553860 TI - Uncoupling of synthesis and release of cloacin DF13 and its immunity protein by Escherichia coli. AB - The synthesis of the bacteriocin cloacin DF13 and its release into the culture medium were genetically uncoupled by subcloning the gene encoding the bacteriocin release protein (BRP) from pCloDF13. The gene was cloned under the control of the IPTG-inducible lpp-lac promoter-operator system on the expression vector pINIIIA1, giving pJL1. A 4 kb DNA fragment of pJL1, containing the tandem lpp-lac promoter, the BRP gene and lacI (BRP cassette), was cloned into the pCloDF13 derivative plasmid pJN67, which encodes cloacin DF13 but not the release protein. Furthermore, the pCloDF13 immunity protein gene was subcloned downstream of the temperature-inducible PL promoter of the expression vector pPLc236, together with the BRP cassette. Growth, induction and excretion experiments with Escherichia coli cells harbouring the constructed plasmids revealed that: the BRP is the only pCloDF13-derived gene product responsible for the observed growth inhibition and apparent lysis of strongly induced cells. This growth inhibition and lysis can be prevented by Mg2+ ions added to the culture medium, and involves induction of phospholipase A activity. The expression of the BRP gene can be regulated by varying the IPTG concentration. A separately controlled and moderate induced BRP synthesis can be used to bring about the release of large amounts of cloacin DF13 under conditions that allow a strong induction of the bacteriocin and which do not result in lysis of cells. Preliminary results indicated that the BRP can stimulate the release of immunity protein in the absence of cloacin or cloacin fragments. PMID- 3553861 TI - Characterization of a promoter up mutation in the -35 region of the promoter of the primer for ColE1 replication. AB - A point mutation in the -35 region of the promoter of the primer for initiation of DNA replication in the plasmid pMB1 was characterized. This base change causes a promoter up phenotype. The analysis of a second mutant obtained by site directed mutagenesis allowed the exclusion of a role in the phenotype for the potential intrastrand secondary structure as well as for the methylation state of the DNA in the promoter region. The promoter up phenotype is concluded to be due to a change in the primary structure of the -35 element with the consequent production of a better cluster of hydrogen bond donors and acceptors for the RNA polymerase. PMID- 3553862 TI - The bacteriophage T4 dexA gene: sequence and analysis of a gene conditionally required for DNA replication. AB - We have cloned and sequenced a bacteriophage T4 EcoRI fragment that complements T4 del (39-56) infections of an optA defective Escherichia coli strain. Bacteria containing this recombinant plasmid synthesize two new proteins with molecular weights of 9 and 26 kilodaltons. We have identified the gene encoding the 26 kilodalton protein as essential for T4 infections of optA defective E. coli. Genetic and biochemical results are consistent with the identification of this protein as the product of the dexA gene, which encodes a 3' to 5' exonuclease. PMID- 3553863 TI - Post-menopausal bone loss: effects of oestrogens and progestogens. A review. PMID- 3553864 TI - Common antigens of human intestinal treponemes and of swine Treponema hyodysenteriae. AB - The antigenic cross-reactivity between intestinal treponemes of human and swine origin (T. hyodysenteriae and T. innocens) was studied by sodium-dodecylsulfate polyacrylamide gel electrophoresis and western blotting techniques. Several distinct peptides, ranging in molecular weight from 14,400 to about 150,000 daltons, were recognized by SDS-PAGE analysis of twelve human and two swine hemolytic intestinal treponemes. Thirty antigenic bands were develope by homologous antiserum against treponeme D87, one of 12 human intestinal hemolytic treponemes isolated in our laboratory. An identical number of cross-reacting antigens was found when Western blots of human treponemes D87 were tested with antisera against ten other human treponemes or with antisera against swine treponemes (T. hyodysenteriae, T. innocens). Similar results were obtained when Western blots of swine T. hyodysenteriae were tested for cross-reactivity with antisera against all human intestinal treponemes. PMID- 3553865 TI - Mercury and antibiotic resistance in clinically significant E. coli isolates. AB - A study for mercury and antibiotic resistance carried out on 126 clinically significant E. coli isolates from sporadic cases showed that 30.2% (38/126) was Hg2+-resistant. A significantly positive association between mercury and multiple antibiotic resistance was observed although mercury resistance could not be correlated with any single antibiotic tested. In addition, conjugational experiments showed that mercury and antibiotic resistance determinants were not always genetically linked. It is suggested that mercury resistance may be a further marker useful in epidemiologic investigations. PMID- 3553866 TI - Degradation of the pyrimidine bases uracil and thymine by Escherichia coli B. AB - Degradation of the pyrimidine bases uracil and thymine by Escherichia coli B was investigated. The known products of the reductive pathway of pyrimidine base catabolism were tested to determine if they could support the growth of E. coli B cells as sole sources of nitrogen or carbon. As might be expected if the reductive pathway was present, it was found that dihydrouracil, N-carbamoyl-beta alanine, beta-alanine, dihydrothymine and beta-aminoisobutyric acid could sustain the growth of the bacterial cells as sole nitrogen sources by at least a fourteen fold greater level than that observed if they were included as sole carbon sources. The existence of the reductive pathway of pyrimidine base degradation was confirmed in this micro-organism, since dihydrouracil, N-carbamoyl-beta alanine and beta-alanine were detected following thin-layer chromatographic separation of the catabolic products of uracil and dihydrouracil. PMID- 3553867 TI - Asymptomatic bacteriuria in the Port Harcourt metropolis of Nigeria. AB - The Port Harcourt metropolis of Nigeria was screened to establish the prevalence of asymptomatic bacteriuria (ABU) over a 3 year period. An occurrence rate of 15% was detected. The females presented a higher incidence rate (9%) than the males (6%). Previous history of urinary tract infection (UTI) was seen to be contributory to ABU; so also was sexual activity. Of the isolates obtained, Escherichia coli was found to be predominant (45%). An isolation rate of 3.7% was realised for Staphylococcus epidermidis. This emphasizes its role in UTI. The advantages of screening for ABU was examined and it is suggested that individuals should be screened for ABU at least twice a year. PMID- 3553868 TI - Cytopathogenic effect of Salmonella typhi GIFU 10007 on M cells of murine ileal Peyer's patches in ligated ileal loops: an ultrastructural study. AB - An electron microscopic study revealed that, within 30 min after inoculation into the ligated ileal loop of anesthetized mice, cells of Salmonella typhi GIFU 10007 adhered to the M cell surface of Peyer's patch lymphoid follicle epithelium, and induced almost complete destruction of M cells. The M cell cytoplasms were pinched off and extruded from the epithelial lining into the luminal space together with the lymphoid cells primarily enfolded into the corresponding M cells. When two or more M cells were destroyed, a large defect in the epithelial lining was apparent, and a number of bacteria appeared near the basal lamina of the epithelial lining. These findings suggest, as far as anesthetized murine ileal loops and strain 10007 are concerned, that ileal M cells are the target cell at an early stage of S. typhi infection and the infection may further progress to deeper tissues and to the general circulation. PMID- 3553869 TI - Characterization of an intergroup serological mutant from group II RNA phage GA. AB - Starting from the group II RNA phage GA which has an amber mutation in the maturation protein cistron, a spontaneous mutant of group II phage GA, whose serological and electrophoretic properties became similar to those of group I phage MS2, was isolated and analyzed. The mutant has now become sensitive to anti MS2 serum and resistant to anti-GA serum. Analysis of the nucleotide sequence of the coat protein gene revealed that G----A transition was the main change. The deduced amino acid sequence showed that five amino acids were substituted in the mutant, and three of the five became identical to MS2, resulting in increased molecular weight of the coat protein. However, it did not complement MS2. These results suggested that the serological change from group II phage GA type to group I phage MS2 type is induced spontaneously at high frequency by minor nucleotide changes in coat protein gene, and confirmed the previous results at the RNA level that MS2 and GA were related although the closeness between them seems somewhat remoter than that of groups III and IV (18, Inokuchi et al, unpublished data for the nucleotide sequence of group IV phage SP). PMID- 3553870 TI - Rabbit autoantibodies to actin induced by immunization with modified homologous actins. AB - Actin is a major antigen involved in the reaction of smooth muscle antibody positive sera from patients with chronic active hepatitis. In the present study, actin extracted from rabbit skeletal muscle was denatured by sodium dodecyl sulfate and was immunized into the rabbit, a homologous animal for actin. The rabbits, thus immunized, produced antibodies reactive with actins of homologous and heterologous animals. In addition, the antibodies showed reactivity with autologous actin. It indicates that the denatured homologous actin is capable of terminating immunological tolerance to actin and induces formation of autoantibody to rabbit actin. This phenomenon may be implicated in the occurrence of anti-actin antibody in sera from patients with chronic liver disease and several other diseases. PMID- 3553871 TI - Role of thymus-derived lymphocytes in acquired immunity to salmonellosis in mice. AB - The relative role of thymus-derived (T-) lymphocytes and bone marrow-derived (B-) cells in acquired immunity to salmonellosis was examined in mice. The results demonstrate that the protective capacity of the donor immunized mice could be passively transferred to the recipient mice by spleen cells but not with peritoneal exudate cells or sera. A high cell number of spleen cells (2 X 10(8)/mouse) were required before passive transfer of immunity could be obtained. Of the T-lymphocytes and B-cell populations of spleen cells, T-cells from immune mice were effective in conferring protection to the recipient mice. PMID- 3553872 TI - Isolation of a spotted fever group Rickettsia from a patient with febrile exanthematous illness in Shikoku, Japan. PMID- 3553873 TI - The physiology of intestinal oxygenation and the pathophysiology of intestinal ileus. AB - Intestinal Ileus is Gut Shock caused by Bowel Hypoxia. The morbidity and mortality of Intestinal Ileus has puzzled more than two generations of investigators because they have overlooked the fact that the gas which collects in obstructed small intestine is mostly (90+%) Nitrogen. For some strange reason a gut full of nitrogen has not been looked on as comparable to a lung full of nitrogen, even though the lung and gut have a common embryological origin. My proposal is that intestinal epithelium lining a nitrogen filled lumen becomes as oxygen starved as alveolar lining in a similar circumstance. Bowel hypoxia may be brought about either by failure of the intestine to "breathe out", having breathed in due to mechanical block, or gut paralysis, from any cause, of which one may be failure of blood borne oxygen transport to the bowel, Individually, or together, these may reduce or stop the flow of air and/or aerated intestinal contents along the lumen. Local (bowel) or general underperfusion +/- hypovolaemia +/- anaemia may be a particular cause of paresis or paralysis (aperistalsis) of intestinal muscle. The non-contracting gut then fails to transport the luminal current of fluid and air (oxygen), and adds lumenal to blood-borne oxygen deficiency. The intestinal mucosa utilises oxygen from the current of air churned along the bowel by normal peristalsis to mix with and dissolve in the luminal contents. Should this current be obstructed or the propulsive churning activity cease, oxygen will be "used up", the residual gas become almost entirely nitrogen, and the mucosa must necessarily become oxygen starved and suffocated. Hypoxic mucosa lives in a dangerous environment, at risk of autodigestion by self-produced proteolytic or other enzymes secreted into the lumen by exocrine glands, and it may rapidly become necrotic and gangrenous. Different presentations of Ileus are different degrees of the same Gut Shock due to different levels and durations of tissue hypoxia brought about by different mechanisms with that final common path, complicated by different degrees of autodigestive mucosal destruction, bowel wall oedema, and fluid exudation into the lumen comparable to that through BURNED skin. This idea is new only in so far as it has been put together in this way. Parts have been anticipated by other writers. No new ways of managing ileus are proposed, but it is suggested that existing empirical methods be rationalised and applied more widely and logically. PMID- 3553874 TI - Age-related responses to influenza vaccination in the Newcastle region during 1983 and 1984. AB - A study was carried out in Newcastle to assess responses to influenza vaccines in elderly nursing home patients and in younger adults during 1983 and 1984. The decision to vaccinate the elderly subjects was made by their general practitioners. A concurrent randomized placebo-controlled trial of the same vaccine was performed in young adult volunteers. Elderly subjects generally possessed higher levels of pre-existing antibody to the influenzal haemagglutinins that were present in the vaccines than did younger subjects. The highest levels were observed in the 52-63 years' age group. Younger subjects showed significantly greater responses to vaccines compared with elderly subjects (P less than 0.05). Peak responses were noted in the 16-24 years' age group. Of a total of 326 elderly subjects (70% of whom had been vaccinated), six participants, two of whom had been vaccinated, contracted laboratory-proven influenza during 1983. Only one unvaccinated subject of a total of 365 subjects (50% of whom had been vaccinated) contracted influenza during 1984. In both years illness was produced by strain A/Philippines/2/82. PMID- 3553875 TI - Corticosteroid agents in renal disease. AB - Corticosteroid agents have a major role in the treatment of several renal disorders which have an immune basis. They remain the treatment of choice for minimal-change glomerulonephritis, inducing remission in over 90% of patients. The role of corticosteroid therapy in patients with membranous glomerulonephritis remains controversial, although an extensive controlled trial indicated benefit from a two-month course of alternate-day therapy. Intravenously-administered methylprednisolone has been shown to benefit rapidly progressive crescentic glomerulonephritis; the benefit is probably comparable to that which is obtained with immunosuppression and plasma exchange. Corticosteroid therapy has improved dramatically the prognosis of glomerulonephritis that is associated with systemic lupus erythematosus and the various forms of vasculitis (excluding Wegener's granulomatosis), although the concomitant use of immunosuppressive therapy in these disorders reduces the required doses of corticosteroid drugs. For the last 20 years prednisolone and azathioprine have been standard therapy to prevent renal allograft rejection. However, corticosteroid agents are used currently in much lower doses or have been replaced by cyclosporin A. PMID- 3553876 TI - Drug-bone marrow interactions. Old and new issues in 1987. PMID- 3553877 TI - Ultrasound scans in early pregnancy. PMID- 3553879 TI - The state of health of aborigines in the Kimberley region. PMID- 3553878 TI - The Sydney multicentre study of Parkinson's disease. The first 18 months. AB - Low-dose bromocriptine therapy and low-dose levodopa-carbidopa therapy are being compared in a double-blind study over a five-year period as treatment for newly diagnosed patients with Parkinson's disease. Ninety-four patients had entered the study by January 1986 and of these, 50 had been followed for six months or more. Preliminary results confirm that many patients with Parkinson's disease can be managed satisfactorily in the early stages of the disease with low-dose therapy. Three patients, all of whom were receiving levodopa-carbidopa therapy, developed dyskinesia. Twelve patients who had received bromocriptine had an inadequate response or developed confusion or postural hypotension. Of these patients, six had a poor response to subsequent levodopa-carbidopa therapy. While the initial improvement that results from low-dose bromocriptine therapy and low-dose levodopa-carbidopa therapy is less than one would expect with conventional doses of these agents, it is hoped that this approach will reduce the incidence of long term side-effects such as dyskinesia and fluctuations. PMID- 3553880 TI - Treatment of chlamydial and mycoplasmal genital infections. PMID- 3553881 TI - Aztreonam (Azactam). PMID- 3553882 TI - Monooctanoin for gallstones. PMID- 3553883 TI - The influence of killed Propionibacterium granulosum on experimental infection with Escherichia coli. AB - Mice infected subcutaneously with 5 X 10(3) viable cells of Escherichia coli ATCC 25922 incorporated in liquified agar developed a systemic infection. Increasing bacterial numbers could be recovered from the liver at several days following infection. Ultimately, the animals died 6 days after infection. Treatment of mice with 1 mg killed Propionibacterium granulosum KP-45 lead to an increased spleen weight at day 7 after intraperitoneal injection. Hence, the animals were highly susceptible to the lethal action of endotoxin. They were, however, markedly protected against infection with E. coli, since definitely lower bacterial counts were found in the liver of pretreated mice in comparison to controls. PMID- 3553884 TI - Assay for heat-labile Escherichia coli enterotoxin using sandwich erythroimmunoassay. AB - We investigated the possibility of using a sheep erythrocyte-antibody conjugate as reagent in a sandwich erythroimmunoassay (SERIA) procedure to detect and titrate Escherichia coli heat-labile enterotoxin (LT) with the naked eye. In this assay, which is based on the immunological similarity between Vibrio cholerae toxin (CT) and LT, rabbit anti-CT IgG was used as immunosorbent, and sheep erythrocytes, sensitized with the rabbit anti-CT antibodies, were used as indicator. The sensitivity of the test was demonstrated by a comparative study using an enzyme-linked immunosorbent assay (ELISA). The results obtained by SERIA with 130 samples correlated well with those of a Vero cell assay and a GM1-ELISA. The test is easy, relatively cheap and as sensitive as other standard techniques; it is particularly suited for field laboratories, especially in tropical countries, and a large number of strains may be examined daily. PMID- 3553885 TI - [Evaluation of larvicidal effects of Bacillus thuringiensis var. israelensis (serotype H-14) and Bacillus sphaericus preparations and the susceptibility of adult mosquitoes to malarial plasmodia]. PMID- 3553886 TI - [Methods of a quantitative assessment of rickettsial contents in mites (review of the literature)]. PMID- 3553888 TI - [Constructive characteristics of intracanal retentive pins assessed on the basis of general principles of mechanics]. PMID- 3553887 TI - [Aulin: a new modern drug in the treatment of inflammation in dentistry]. PMID- 3553889 TI - [Primary reticulosarcoma of the mandible. Clinical and histopathological observations]. PMID- 3553890 TI - [The extent of lymph node excision in early gastric cancer]. PMID- 3553891 TI - [Assessment of the viability of a preserved heart--birefringence test with a polarizing microscope]. PMID- 3553893 TI - Studies on the ligand specificity and potential identity of microsomal antiestrogen-binding sites. AB - Synthetic nonsteroidal antiestrogens are bound intracellularly by two high affinity saturable bindings sites, the estrogen receptor and the microsomal antiestrogen-binding site (AEBS). In order to further define the structural requirements for ligand binding to AEBS from rat liver and the MCF 7 human breast cancer cell line, the relative binding affinities of an extensive series of structurally related ligands were investigated using competitive binding assay techniques. The groups of compounds studied were: analogues of the triphenylethylene antiestrogens, Cl 628 and tamoxifen; analogues of cyclofenil; bibenzyl and stilbene derivatives; analogues of the cytochrome P-450 inhibitor SKF-525A; phenothiazine derivatives; and a series of structurally related compounds with a variety of pharmacological activities. High affinity binding to AEBS required the presence of both a hydrophilic basic aminoether side chain and a hydrophobic aromatic ring structure (di- or tricyclic for maximal affinity). Structural modifications to either influenced binding affinity. Aromatic substitution either raised (CF3) or lowered (OH, OCH3) affinity, apparently by electronic effects transmitted through the benzene nucleus. Side chain structure was the major determinant of binding affinity, but its influence was complex and dependent upon terminal amino group structure, side chain branching and substitution, and tissue source of AEBS. Optimal binding affinity was shown by side chains bearing basic heterocyclic amino terminal groups. Other cellular sites that are known to bind antiestrogens with relatively high affinity include calmodulin, cytochrome P-450, and histamine, dopamine, and muscarinic receptors. Binding studies using a variety of pharmacologically active and radiolabeled ligands selective for these sites, including those for dopamine D1 and D2 receptors ([3H]fluphenazine, [3H]flupenthixol, [3H]spiperone, and [3H]SCH 23390) and histamine H1 receptors ([3H]pyrilamine), demonstrated that several of these compounds interact with AEBS with high affinity. However, the ligand specificity and other binding properties of the AEBS as determined by competitive binding studies and Scatchard analysis show this site to be a molecular entity truly distinct from these other cellular binding sites. PMID- 3553894 TI - [Conformation states of thymopentin and its synthetic analogs]. AB - Spatial structures of the biologically active fragment Arg-Lys-Asp-Val-Tyr of tymopoetin (tymopentin) and its synthetic analogs: [Lys1-Arg2]-, [Glu3]- and [Gly3] have been investigated by theoretical conformational analysis. These results indicate that the conformational properties of fragments are represented in aqueous solution by five different backbone forms. PMID- 3553892 TI - Kinetic and molecular properties of the dihydrofolate reductase from pyrimethamine-sensitive and pyrimethamine-resistant clones of the human malaria parasite Plasmodium falciparum. AB - Dihydrofolate reductase (DHFR) (5,6,7,8-tetrahydrofolate: NADPH+-oxidoreductase; EC 1.5.1.3) was partially purified by affinity chromatography from three clones of the human malaria parasite Plasmodium falciparum. The three clones were representative of pyrimethamine-sensitive (clone 3D7) and pyrimethamine-resistant (clone HB3 and clone 7G8) parasites with ID50 values of 0.53 nM (3D7), 210 nM (HB3), and 540 nM (7G8), when tested in vitro against the drug. The specific activities of the partially purified DHFR differed by less than a factor of 2 between the sensitive clone 3D7 (442 +/- 39 nmol min-1 mg-1 protein) and the resistant clones HB3 (634 +/- 25 nmol min-1 mg-1 protein) and 7G8 (565 +/- 85 nmol min-1 mg-1 protein). The number of catalytic sites in partially purified DHFR from the three clones was similar and ranged from 151 to 194 pmol mg-1 protein. The Km value for NADPH was similar in all three clones (4.5-11.6 microM). The Km value for dihydrofolate was altered 13-fold comparing the sensitive clone 3D7 (3.2 +/- 0.6 microM) with the resistant clone HB3 (42.6 +/- 1.6 microM), with the Km for the resistant clone 7G8 falling in between (11.9 +/- 1.2 microM). The inhibition constants for pyrimethamine increased from 0.19 +/- 0.08 nM (3D7) to 2.0 +/- 0.3 nM (HB3) to 8.9 +/- 0.8 nM (7G8). The inhibition by pyrimethamine of the sensitive clone 3D7 was noncompetitive and competitive for the two other clones. The titration of partially purified DHFR with pyrimethamine revealed a 500-fold increase in the concentration of the drug needed to inhibit the DHFR activity by 50%, when the sensitive clone 3D7 (0.18 +/- 0.02 nM) was compared to the resistant clone 7G8 (95 +/- 16 nM). From the comparison of the specific activities and the catalytic center activities with the Km values for the substrate and the inhibition constants for pyrimethamine, both of which are altered in the resistant clones, we conclude that the molecular mechanism for pyrimethamine resistance in the three clones studied is not based on an overproduction of the DHFR but is due to a decreased affinity to antifolates by a structurally altered enzyme. PMID- 3553895 TI - [The role of heat shock proteins in the osmoregulation of Escherichia coli]. AB - E. coli has a number of biochemical systems which protect cells from different chemical and physical damages. The aim of this work is to characterize the interaction between two of these: the osmoregulation system and the heat shock system. It is shown that exposure of E. coli to 42 degrees C to induce hsps synthesis, abolish the growth inhibition by high (0.45 M) NaCl concentration. Also, transient pretreatment of cells with high NaCl protect them from heat damage. It is shown that osmotic shock induces the hsps synthesis. The cell growth restoration after the complete inhibition by high (0.6 M) NaCl concentration correlates with the hsps accumulation. Moreover the heat shock treatment reduces the adaptation time. PMID- 3553896 TI - [Flow cytometry and cell sorting: current state and prospects for use in molecular biology]. AB - A survey of the specific features of flow cytometry, principals of instrumentation and main parameters of the modern cell sorting cytometers is given. Analytical capacities of flow cytometry as well as the main directions of its applications in cell biology, clinical diagnostics, immunology, biotechnology and molecular biology are considered. Also a possible future development of flow cytometry instrumentation and applications in molecular biology are briefly discussed. PMID- 3553897 TI - [Recognition of Escherichia coli promoters from the primary structure of DNA]. AB - The perceptron algorithm has been applied for E. coli promotors searching. To choose the appropriate promoter signs the statistical analysis was performed. By the modified perceptron method a vector, which exactly divides promoters and non promotors in the learning sequences and gives nearly the same results as the statistical vector, has been obtained. By using this vector two potential promotors have been found at the phoE-proB chromosome region. PMID- 3553899 TI - [Regulation of the replication of bacterial plasmids]. AB - This is a survey of the available data on the structure of the replication apparatus and the control mechanisms of bacterial plasmids replication. All plasmids are classified as having three types of replicons according to the mechanisms of replication initiation. The role of plasmid--determined positive and negative regulatory elements involved in controlling the number of copies and incompatibility is discussed. PMID- 3553898 TI - [Effect of the concentration ratio of bi- and monovalent ions on the functional activity of 30S ribosome subunits of Escherichia coli]. AB - Experiments on poly(U)-dependent binding of Phe-tRNAPhe to 30S subunits revealed the existence of a critical [Mg2+]/[NH4+] ratio in a medium (approximately 0.05 0.1) with respect to the binding capacity of subunits. If the ratio is greater than the critical one, 30S subunits undergo reversible inactivation even at the highest Mg2+ concentrations (up to 20 mM). The stronger is the deviation from the [Mg2+]/[NH4+] value = 0.05-0.1, the greater are both the rate and extent of such an inactivation. Two sites for tRNA in initially active 30S subunits have been shown to be inactivated in an interdependent way. On the other hand, a progressive decrease of [Mg2+]/[NH4+] ratio in a medium (from the value of 0.05 and lower) does not produce inactivation, but rather results in reduced affinity constants of Phe-tRNAPhe for active sites of 30S subunits. PMID- 3553900 TI - [Stereomicroscopy comparison of radiographic images and clinic findings in endodontics]. PMID- 3553901 TI - [Preoperative diagnosis of abdominal space-occupying lesions in childhood]. AB - Between 1977 to 1986 results of ultrasonography in 56 patients has been compared with computed tomography (CT), excretory urography, and in 19 cases with arteriography. In comparison to ultrasonography CT proved superior in diagnosing dignity (87% vs. 78%); in appointing to the original organ, and in diagnosing the type of tumour angiography turned out to be clearly superior to CT (89% vs. 65%, and 79% vs. 43%, resp.) Addition of CT to ultrasonography resulted in a gain of 10% concerning dignity, of 30% concerning appointing to the origin, and of 24% with respect to typing. With the question of renal or extrarenal origin of a mass lesion the EUG proved to be indispencable. The following procedure is recommended: in kidney-related tumours US plus EUG, in other cases additional imaging techniques only for special problems, or specific questions preoperatively. The routine implementation of computed tomography in abdominal masses seems not to be necessary. PMID- 3553902 TI - Infantile apnea and home monitoring. PMID- 3553903 TI - Platelet transfusion therapy. PMID- 3553904 TI - Stress and medical illness in the elderly. PMID- 3553905 TI - Stress and the gastrointestinal tract. PMID- 3553906 TI - Stress and visual function. PMID- 3553907 TI - [The nature of typhimuricin--a substance produced by Salmonella typhimurium LT2 and relation of its synthesis to the cryptic plasmid]. AB - The effect of typhimuricin on Escherichia coli K12 cells and the properties of this substance produced by Salmonella typhimurium LT2 have been studied. The obtained data permit one to conclude that typhimuricin is similar to the aminoacid L-valine or the chemical very similar to it in properties. The synthesis of typhimuricin is not controlled by the cryptic plasmid present in Salmonella typhimurium LT2 cells. The experiments aimed at isolation of enterobacterial strains producing low molecular mass antibiotics--microcines have been done. It was found that the capability to produce macrocines is not widespread among the isolates of enterobacteria. PMID- 3553908 TI - [The genosystematics of yeast genera Willopsis zender and Zygowillopsis kudriavzev]. AB - The data have been compared on the yeast genomic divergence obtained in genetic molecular and biological studies of the yeast genera Williopsis and Zygowilliopsis taken as an example. The hybridization analysis, the enzyme electrophoresis and DNA reassociation comprise the noncontradictory estimation of the yeasts relation. Different methods demonstrate a convincing species discreteness among the yeast genomes. The reproductive isolation of the yeast taxons is defined more invariably by the genetic methods. A new combination Williopsis sargentensis (Wickerham et Kurtzman) Naumov comb. nov. has been formed. PMID- 3553909 TI - [Intracellular proteolytic cleavage of the influenza virus protein NP as a sign of the epidemicity of virus strains?]. AB - The main nucleocapsid protein (NP) of human epidemic viruses was found to be cleaved via NP56----HP53 mol. wt. reduction in infected cells, while the NP of animal influenza viruses was refractory to analogous intracellular modification. Like animal influenza viruses, the strain A/Baku/799/82(H1N3) isolated from a sick child has been observed to exhibit the intracellular resistance of NP to intracellular proteolysis. The similar NP resistance has been revealed for A/New Jersey/8/76(H1N1) and A/seal/Massachusetts/81 (H7N7) viruses, which are able to induce only a sporadic human influenza viral infection. Thus, the results reveal a correlation between the viral strains epidemicity and intracellular cleavability of their NPs. The influenza viral strains epidemic for humans are characterized by cleavable NP, whereas the strains, which are known to induce the sporadic influenza human infection are found to exhibit the resistance of NP to intracellular proteolysis. It is reasonable to consider the phenomenon of NP56--- NP53 proteolytic modification as a sign of viral strain epidemicity for humans. PMID- 3553910 TI - [Analysis of mutations affecting the expression of catabolite-sensitive operons in Escherichia coli K12 mutants defective in the HPr-component of the carbohydrate transport system]. AB - Expression of catabolite-sensitive operons in mutants devoid of HPr (a component of the glucose transport system) is severely repressed. ptsH mutants do not utilize substrates of the phosphoenolpyruvate: carbohydrate system (PTS) and many other sugars. Analysis of mutations suppressing the effect of the delta ptsH mutation revealed a new class of reversions which restore the growth of bacteria on different substrates. This mutation (named ptsS) intensifies the growth rate of ptsH mutants and increases the differential rate of beta-galactosidase production. ptsS mutation was mapped in the region of ptsF gene (coding for the fructose specific enzyme II of the PTS) on the 46th min. of the E. coli chromosome map. The effect of the ptsS mutation on the expression of catabolite sensitive operons manifests only in the presence of the intact enzyme I of the PTS. PMID- 3553911 TI - [Alcoholism and heredity: clinico-genetic aspect]. PMID- 3553912 TI - [Hybridization of DNA from Actinomycetes of the genus Frankia with nitrogenase structural genes (nifHDK) of Klebsiella pneumoniae and nod-genes of Rhizobium melioti]. AB - DNA sequence homology with the plasmid pSA30 carrying the cloned nifHDK genes from Klebsiella pneumoniae was revealed in ten Frankia spp. strains, nitrogen fixing symbionts of non-legumes, irrespective of the strain phenotype (Nod+Fix+, Nod+ Fix- or Nod- Fix?). None of the Frankia spp. DNAs exhibited homology with the plasmid pRmSL26 harbouring the Rhizobium meliloti nod-genes encoding for early symbiotic functions. PMID- 3553913 TI - Detection of mutagenic activity in urine samples using a new concentration procedure. AB - A study performed with cyclophosphamide (CP) and nor-nitrogen mustard (NNM), one of its main urinary metabolites, has shown that separation on Polygosil C-18 resin is preferable to one on XAD-2 resin as a means of concentrating the mutagenic activity present in urine of rats given cytostatics such as CP. Mutagenic activity was detected, using Salmonella typhimurium tester strain TA1535. While NNM is irreversibly bound to XAD-2 resin, it can be recovered after elution with methanol on Polygosil C-18. The better efficacity of Polygosil C-18 in concentrating CP and its metabolite(s) was confirmed with experiments with urine of rats treated with increasing doses of CP. PMID- 3553914 TI - Identification of the mutagenic quinoxaline isomers from fried ground beef. AB - Two mutagens isolated from fried-beef patties were compared to a series of synthetic structural isomers of 2-aminodimethylimidazo[4,5-f]quinoxaline (MeIQx) and 2-aminotrimethylimidao[4,5-f]quinoxaline (DiMeIQx). Comparison by NMR spectrometry and HPLC coelution showed that one beef mutagen (molecular weight of 213) was identical to the 8-MeIQx isomer not the 7-Me isomer. Another quinoxaline beef mutagen, having 3 methyl groups (molecular weight of 227), had an NMR spectrum different from the 5,8- or 7,8-DiMeIQx isomers, but not clearly distinguishable from the 4,8- or 4,7-DiMeIQx isomers. The HPLC separation of the DiMeIQx isomers and subsequent addition of the beef mutagen showed the beef derived compound to coelute with the 4,8-DiMeIQx and not with the 4,7-DiMeIQx. The number and position of methyl groups was responsible for a 7-fold range of mutagenic response in the Ames/Salmonella assay. In conclusion, the major quinoxaline mutagens isolated from fried beef were identified as 8-MeIQx and 4,8 DiMeIQx isomers. PMID- 3553915 TI - High mutagenic activity of 3-azido-1,2-propanediol (azidoglycerol, AG) in strain D7 of Saccharomyces cerevisiae. AB - 3-Azido-1,2-propanediol (azidoglycerol, AG) showed a high mutagenicity in strain D7 of Saccharomyces cerevisiae. At 5 mM it increased the spontaneous frequency of isoleucine revertants 3500 times and the frequency of gene convertants 3000 times during 24 h of growth, reducing the growth rate to 30%. In non-growth conditions, treatment with 150 mM of AG for 3 h reduced cell survival to 60% and enhanced the frequency of isoleucine revertants 490 times and tryptophan-independent convertants 50 times. At equal survival levels, AG was found to be 3000-fold more mutagenic and 200-fold more convertogenic than sodium azide. PMID- 3553916 TI - Mutation frequency decline in Escherichia coli B/r after mutagenesis with ethyl methanesulfonate. AB - Nonsense-defective auxotrophic strains of Escherichia coli B/r were used to study mutation frequency decline (MFD) after mutagenesis with ethyl methanesulfonate (EMS). The mutation frequencies for prototrophic revertants that were either converted or de novo glutamine tRNA suppressor mutations declined as treated auxotrophic parental cells were incubated with glucose but without required amino acids (a condition typically producing MFD). The decline for converted suppressor mutations was more rapid than the decline for de novo suppressor mutations after low or moderate EMS treatment, but both suppressor mutation types showed the same slow decline after extensive treatment. The declines for both types of suppressor mutation were eliminated in uvrA-defective cells, and the rapid decline seen for converted suppressor mutations appeared as a slow decline in mfd-defective cells. The results are interpreted that true MFD (the rapid process) affects only the EMS-induced converted glutamine tRNA suppressor mutations. This would account for the rapid decline that is blocked in cells with an mfd defect and in cells with deficient excision repair activity (uvrA or excessive DNA damage). In addition, a second non-specific antimutation mechanism is proposed that is dependent on excision repair only and accounts for the slow decline seen with converted suppressor mutations in some instances and with de novo suppressor mutations at all times. The true MFD mechanism may consist of a physiologically dependent facilitated excision repair specifically for premutational residues located in the transcribed strand of the target DNA sequence (for O6-ethylguanine in cells treated with ethyl methanesulfonate or pyrimidine-pyrimidine photoproducts after UV irradiation). PMID- 3553917 TI - 5-Hydroxymethyluracil-DNA glycosylase activity may be a differentiated mammalian function. AB - To determine the prevalence of the repair enzyme HMU-DNA glycosylase we assayed its activity in whole cell extracts of several bacterial species, the eukaryotic yeast Saccharomyces cerevisiae, mammalian cell lines and murine tissue. Enzyme activity was constitutively present in murine, hamster and human cell lines. It was not inducible by exposing cells to oxidative stress from ionizing radiation or by incubating cells with the 2'-deoxynucleoside of HMU, HMdU. In murine tissue, enzyme activity was highest in brain and thymus. HMU-DNA glycosylase activity was not detectable in bacteria or yeast nor could activity be detected after exposure of cells to H2O2. These results suggest that, in contrast to other DNA-repair enzymes, HMU-DNA glycosylase is a differentiated function limited to higher eukaryotic organisms. PMID- 3553918 TI - A study of mechanisms of carcinogenesis by gene transfer of oncogenes into mammalian cells. AB - Recent work has shown that individual oncogenes can be involved in several steps of the multistage process of carcinogenesis. Evidence comes from studies on the expression of cloned oncogenes transfected into early passage mammalian cells and into immortalized non-tumorigenic cell lines. Transformation of epithelial cells in vitro with cloned cellular and viral oncogenes is of special interest since most human tumors are of epithelial origin. An important aspect of cell transformation by oncogenes is the induction of transforming growth factors (TGFs). The role of oncogenes in differentiation has been examined by introducing the human myc and mutant T24 Ha-ras1 genes into mouse erythroleukemic cells which were then induced to differentiate. In several clones differentiation was inhibited by myc or ras genes. Studies are reported using oncogenes linked to transcriptional control elements that can be regulated in vitro, such as the human metallothionein (hMT-IIA) promoter region, by cadmium and dexamethasone. Phenotypic properties of transfectants including morphological transformation, anchorage dependence and TGF release are shown to be dependent on the regulators of the hMT-IIA control region. PMID- 3553919 TI - Genotoxicity, toxicity, and carcinogenicity of the antihistamine methapyrilene. AB - The antihistamine methapyrilene hydrochloride (MP) has been shown to be a potent hepatocarcinogen in rats, but not in hamsters or guinea pigs. This finding is in contrast to the relative nongenotoxicity of this compound. MP has been evaluated for genotoxicity in a wide variety of short-term tests and has generally demonstrated little genotoxic activity. One exception to this is the mouse lymphoma L5178Y mutagenesis assay, in which MP produced a very significant increase in small colony mutants with concomitant chromosomal damage in these cells. MP also induced positive responses in several cell transformation assays. One potentially very significant effect of MP is that it induces a large increase in hepatic cell proliferation coupled with mitochondrial proliferation in the livers of treated animals. This effect is discussed as a possible mechanism of liver tumor induction in rats. PMID- 3553920 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. Prediction of mammalian germ cell mutagenicity by the Salmonella assay. PMID- 3553921 TI - Investigation of the mutagenic activity of tobacco smoke. AB - The genotoxic effect of whole tobacco smoke was studied employing the Salmonella/microsome mutagenicity assay, the micronucleus test in mouse bone marrow and UDS in peripheral human lymphocytes. It was established that tobacco smoke (120-480 cm3 in a 16-1 glass chamber, at 1-10 min exposure time) induced a 3-9-fold increase of spontaneous his+ reversion mutation rate in S. typhimurium TA98, but not in strains TA97a, TA100 and TA102. Addition of S9 mix obtained from the liver of Aroclor 1254-treated rats was necessary to reveal the mutagenic activity of tobacco smoke. Treatment of BDF1 mice placed in a 14-1 glass chamber with tobacco smoke (600 cm3 smoke, 2 exposures of 30 min each, with a 1-min interval between them) caused a 2-fold dose-dependent elevation of the number of micronucleated PCE in bone marrow. No cumulative effect was detected when mice were treated with tobacco smoke during 2-28 consecutive days. The effect observed 24 h after tobacco-smoke exposure was abolished 48 h later. Tobacco smoke (180 or 360 cm3) passed through the culture medium (with or without S9 mix) of human peripheral lymphocytes (the cells were then incubated for 60 min at 37 degrees C) did not increase the spontaneous rate of UDS. Both the Salmonella/microsome mutagenicity assay employing S. typhimurium TA98 strain and the micronucleus test in mouse bone marrow might be useful in studying tobacco smoke-induced mutagenesis. PMID- 3553922 TI - Mutagenicity of bithionol sulfoxide and its metabolites in the salmonella/mammalian microsome test. AB - The mutagenic effects of bithionol sulfoxide and its two major metabolites, bithionol and bithionol sulfone, on 4 Salmonella typhimurium strains (TA97, TA98, TA100 and TA102) were investigated. Bithionol sulfoxide was found to be mutagenic to TA98 and TA100. However, mutagenicity was abolished in the presence of rat liver S9 fractions. PMID- 3553923 TI - Bacterial assays of complex mixtures and carcinogenicity. PMID- 3553924 TI - Inhibition of pyrimidine dimer excision in ultraviolet-irradiated Escherichia coli overproducing RecA protein. AB - Escherichia coli Br Hcr+ cells transformed with the recombinant multicopy plasmid pBR322 carrying recA gene contain increased amounts of RecA protein. When these cells were UV-irradiated, excision of pyrimidine dimers was reduced by about 50%. It is suggested that the damaged DNA strands may be coated with RecA protein which makes them insensitive to the action of the uvrABC excision nuclease. PMID- 3553925 TI - Genotoxicity studies with two antichagasic drugs. PMID- 3553926 TI - Structure-activity relationships of the N-methylcarbamate series in Salmonella typhimurium. AB - Aromatic hydrocarbons of low molecular weight, hydroxy and N-methylcarbamate derivatives were tested for mutagenicity by the reversion of histidine-dependent Salmonella typhimurium TA98 and TA1535 in the presence of a rat-liver 9000 X g supernatant fraction. The presence of 2 or 3 aromatic rings resulted in a weak increase in revertants. Hydroxylation and carbamylation of aromatic rings increased the mutagenic activity of these aromatic compounds. In order to evaluate the structure-activity relationship, the specific molecular connectivity indices were calculated. A significant inverse relationship exists between mutagenicity and zero- and second-order specific molecular connectivity indices. Only compounds with second-order specific molecular connectivity indices lower than 0.300 increased mutagenic activity. PMID- 3553927 TI - UV response of the temperature-conditional rad 54 mutant of the yeast Saccharomyces cerevisiae. AB - The survival of the yeast mutant rad 54-3, which is temperature-conditional for the repair of double-strand breaks, was measured after exposure to UV-light (254 nm) and incubation at 23 degrees C and 36 degrees C. It was found that survival was drastically reduced with incubation at the restrictive temperature. Temperature-shift experiments indicated that repair of UV-induced damage which is controlled by the rad 54 gene proceeds with a half-value-time of about 7 h. PMID- 3553928 TI - [Electron microscopy demonstration of the capsule of Cryptococcus neoformans]. PMID- 3553929 TI - Cryptococcosis in Kashmir. PMID- 3553930 TI - Role of membrane N-linked oligosaccharides in host cell interaction with invasive forms of Trypanosoma cruzi. AB - The removal of N-linked oligosaccharides by peptide-N4-[N-acetyl-beta glucoseaminyl]asparagine amidase (previously known as aspartoglycosylamine amidohydrolase and abbreviated N-glycanase) from the surface of blood or insect transmissible forms of Trypanosoma cruzi markedly increased the capacity of these organisms to associate with (i.e., bind and penetrate) either mouse peritoneal macrophages or rat heart myoblasts. This effect was evidenced by a significant elevation in both the percentage of infected host cells and the average number of parasites per 100 cells. Conversely, N-glycanase treatment of either host cell markedly reduced both parameters to levels significantly below those obtained with cells mock treated with medium alone. The N-glycanase effect on the parasites was inhibited by heat inactivation of the enzyme or by the presence of fetuin, an N-glycanase substrate. The enhanced capacity of N-glycanase-treated T. cruzi to engage the host cells started to subside 2 h after the treatment, indicating the reversibility of the effect. The decreased reactivity of N glycanase-treated macrophages or myoblasts with T. cruzi suggests that N-linked oligosaccharides on these host cells are involved in the initial phase of the cell infection process. Instead, because T. cruzi interacted more effectively with host cells after treatment with N-glycanase, parasite surface N-linked oligosaccharides would seem to interfere with the association. PMID- 3553931 TI - Trypanosoma cruzi exhibits inter- and intra-strain heterogeneity in molecular karyotype and chromosomal gene location. AB - Molecular karyotypes of 6 strains and 6 clones of Trypanosoma cruzi were determined using orthogonal-field-alternation gel electrophoresis. At least 15 different chromosome-sized DNA molecules, ranging in size from less than 200 kilobase pairs to greater than 2000 kilobase pairs, were resolved for each of the isolates examined. Many of the bands were present in different relative intensities suggesting that the number of individual chromosomes per organism may be considerably higher. Significant inter- and intra-strain differences in molecular karyotype and in the chromosomal locations of the genes for the spliced leader, tubulins, 5S ribosomal RNA and a heat shock protein were found. These marked chromosomal differences among T. cruzi strains and clones may be related to the high degree of phenotypic heterogeneity previously found in this parasite. PMID- 3553932 TI - Detection of Plasmodium falciparum DNA using repetitive DNA clones as species specific probes. AB - Repetitive sequences were identified in genomic libraries of Plasmodium falciparum and analyzed for their potential use as specific DNA probes. Nucleotide sequencing revealed inserts composed of 21 base pair tandem repeats. Clone 26 containing an insert of 147 base pairs in M13mp18 was used in three different approaches as a probe to detect P. falciparum DNA: the replicative form of clone 26 was labeled by nick translation; the single strand DNA of clone 26 was labeled by primer extension and a two step sandwich assay was employed hybridizing single strand unlabeled clone 26 DNA to the target DNA (first step) and using nick translated M13 DNA in a second step to detect the vector part of clone 26. The most sensitive probes detected 25 pg of P. falciparum DNA after 2 h of film exposure, 3 pg after 14 h and 0.78 pg after 40 h. Hybridization to genomic blots of Plasmodium vivax and human DNA using clone 26 as a probe revealed that the 21 base pair repeats specifically hybridized with P. falciparum DNA while failing to react with either human or P. vivax DNA. PMID- 3553933 TI - Subcellular localization of leucine aminotransferase and alpha-hydroxyacid dehydrogenase in Trypanosoma cruzi. AB - Homogenates of Trypanosoma cruzi epimastigotes (Tulahuen strain) show L-leucine aminotransferase activity (EC 2.6.1.6). Subcellular distribution of this enzyme and of alpha-hydroxyacid dehydrogenase, enzymes which share a common substrate/product (alpha-ketoisocaproate), has been studied by means of differential centrifugation, digitonin treatment of entire parasites, isopycnic centrifugation and determination of latency of enzymes in the large granule fraction. The results indicate that both enzymes have a dual localization, in the cytosol and in the mitochondrion, probably in the matrix. On the basis of this location, it is proposed that they operate in a shuttle system transferring reducing equivalents between the cytosol and the mitochondrion. PMID- 3553934 TI - Characterization and complete nucleotide sequence of a 5.8S ribosomal RNA gene from Plasmodium falciparum. AB - The 5.8S and 5S rRNA components from the FCR-3/The Gambia strain of Plasmodium falciparum have been identified and the complete nucleotide sequence of a 5.8S ribosomal RNA gene determined. Unlike the 5S rRNA species, the 5.8S is a single homogeneous population of molecules of 157 nucleotides. Comparison of its nucleotide sequence with previously reported 5.8S rRNA sequences indicates that it is homologous to these molecules, but distantly related to them. The sequence of the 5.8S rRNA coding region from the pfrib-2 recombinant of the HG13 Gambian isolate of P. falciparum is identical. PMID- 3553935 TI - Biophysical properties of the surface lipid of parasitic nematodes. AB - The biophysical properties of the surface lipid layer (the epicuticle) of living parasitic nematodes (Trichinella spiralis and Toxocara canis) were examined using fluorescent lipid analogues. A variety of such probes were screened, and only 5-N (octadecanoyl)-aminofluorescein was found to insert into the outer lipid layer. Fluorescence quenching experiments showed that this probe was confined to the surface, and the rate of its lateral diffusion was then measured by Fluorescence Recovery After Photobleaching. This showed that the probe was not free to diffuse within the plane of the epicuticle. This structure is, therefore, extraordinary in its selectivity to lipid probes, and in the restricted lateral mobility of inserted lipid components. PMID- 3553936 TI - Studies on glutathione reductase and methemoglobin from human erythrocytes parasitized with Plasmodium falciparum. AB - An improved protein-blotting procedure and a thin layer isoelectric focusing technique are introduced to study glutathione reductase and methemoglobin (Met Hb). According to our results, there is only one form of glutathione reductase in normal red blood cells. A similar protein was shown to be present at higher concentration in isolated merozoites. Both proteins have a subunit Mr of ca. 50,000 and react with anti-human glutathione reductase serum. Red cells with schizonts do not possess a higher proportion of Met-Hb than non-parasitized erythrocytes. This finding suggests that Met-Hb is not an indicator of metabolic alterations in malaria-infected erythrocytes. PMID- 3553937 TI - Amino-sugars inhibit the in vitro cytoadherence of Plasmodium falciparum-infected erythrocytes to melanoma cells. AB - Twenty-two sugars and related compounds, nine neoglycoproteins, dopamine, four polyamines and oligomers of glucosamine were examined for their effect on the cytoadherence of Plasmodium falciparum-infected erythrocytes to melanoma cells. Inhibition of cytoadherence was high in the presence of the amino-sugars, glucosamine, galactosamine and mannosamine, and dopamine, and significant, although lower, in the presence of the polyamines, spermine, spermidine and putrescine. N-acetylated amino-sugars and the other compounds were not significant inhibitors of cytoadherence. PMID- 3553938 TI - Temperature modulation of growth rates and glucosephosphate isomerase isozyme activity in Trypanosoma cruzi. AB - In an attempt to understand the conditions which might influence the geographical distribution of Trypanosoma cruzi isozyme profiles (zymodemes), the thermal response of different glucosephosphate isomerase (GPI) phenotypes was studied. T. cruzi clones with single- and triple-banded GPI phenotype showed a similar response to temperature with respect to both growth rates and GPI kinetic parameters. However, the relative activity of each GPI isozyme was dependent on parasite incubation temperature. In view of the similar kinetic properties of the isozymes, enzyme regulation is not a consequence of an adaptative response to thermal conditions and the suggestion of a phenotype distribution determined selectively by temperature is not supported by the present study. PMID- 3553939 TI - Putative glycophorin-binding protein is secreted from schizonts of Plasmodium falciparum. AB - A cDNA clone expressing an antigen of Plasmodium falciparum, selected by screening an expression library cloned in Escherichia coli, encodes a portion of the protein identified as a glycophorin-binding protein [Kochan et al. (1986) Cell 44, 689-696]. Human antibodies affinity-purified on extracts from this clone were used to characterize the antigen by immunoblotting. This protein was present in all isolates tested, restricted to mature trophozoites and schizonts. It was abundant in culture supernatants at the time of merozoite release but present in minor amounts if at all in merozoites. The pattern of antigen distribution over schizont-infected cells observed by immunoelectron microscopy differed from that of the precursor of the major merozoite surface antigens in that most of the antigen appeared to be located over the erythrocyte cytoplasm without any obvious association with organelles. It thus appears unlikely that this antigen is present on the merozoite surface prior to schizont rupture. PMID- 3553940 TI - Polymorphism of proteins in malaria parasites following mefloquine treatment. AB - Proteins in malaria parasites (Plasmodium falciparum) isolated from a patient in Thailand before treatment, and after recrudescence of infection subsequent to mefloquine treatment, were compared by two dimensional polyacrylamide gel electrophoresis (2D-PAGE) analysis. Nine 'pre-treatment' and six 'recrudescent' clones were studied. Variants of the enzyme glucose phosphate isomerase were also noted and mefloquine susceptibility of each clone was measured by in vitro tests. The 'pre-treatment' isolate was found to contain at least four genetically distinct clones, all sensitive to mefloquine, while the 'recrudescent' isolate contained at least two other types of clone, both showing increased tolerance to mefloquine. These two more tolerant types of clone differed from all the sensitive ones studied in regard to several different protein variants as shown by 2D-PAGE analysis. It is concluded that at least two (and probably more) genetically distinct clones of parasites with increased tolerance to mefloquine were present in the parasite population before mefloquine treatment was given, and were selected under mefloquine pressure. PMID- 3553941 TI - Medical indigency and the public health care crisis. The need for a definitive solution. PMID- 3553942 TI - Neonatal group B streptococcal disease. PMID- 3553943 TI - Practical problems in the respiratory care of patients with muscular dystrophy. PMID- 3553944 TI - Transfer of congenital factor XI deficiency from a donor to a recipient by liver transplantation. PMID- 3553945 TI - Dipyridamole. PMID- 3553946 TI - Enzyme-substitution therapy with the yeast Saccharomyces cerevisiae in congenital sucrase-isomaltase deficiency. AB - Sucrase-isomaltase deficiency is an inherited disaccharidase deficiency that leads to malabsorption of sucrose, with resulting diarrhea and abdominal distention and cramps. We investigated the sucrose-splitting effect of viable yeast cells in eight children with congenital sucrase-isomaltase deficiency, by means of the sucrose hydrogen breath test. This test is based on the fact that hydrogen is released from the malabsorbed sucrose by the colonic microflora. We found that 0.3 g of lyophilized Saccharomyces cerevisiae, given after loading with 2 g of sucrose per kilogram of body weight, reduced hydrogen excretion in all patients, on average by 70 percent, in parallel with a complete loss or evident reduction of clinical symptoms. In vitro, lyophilized and fresh S. cerevisiae (fresh baker's yeast) had appreciable sucrase activity, a low isomaltase and maltase activity, and virtually no lactase activity. The sucrase activity was more inhibited by undiluted than by diluted gastric juice. We conclude that patients with congenital sucrase-isomaltase deficiency who intentionally or unintentionally consume sucrose can ameliorate the malabsorption by subsequently ingesting a small amount of viable yeast cells, preferably on a full stomach. PMID- 3553947 TI - Yellow professionalism. Advertising by physicians in the Yellow Pages. AB - We compared the specialty listings of physicians in the Yellow Pages of the 1983 Hartford, Connecticut, telephone book with the board certifications in specialties of the American Board of Medical Specialties as listed in the American Medical Association directory or the Marquis Directory of Medical Specialists. There were 1179 listings by 946 physicians under 61 specialty headings in the Yellow Pages. We found that a mean of 12 percent of "specialists" listed in the Yellow Pages were not board-certified in a specialty, although they had had ample opportunity to obtain board certification. We conclude that specialty advertising in the Yellow Pages is potentially misleading to consumers and that member boards of the American Board of Medical Specialties should consider ways to diminish this possible misrepresentation. PMID- 3553948 TI - Current concepts: immunology. The basic components of the immune system. PMID- 3553949 TI - Defective glucose counterregulation after strict glycemic control of insulin dependent diabetes mellitus. AB - We infused small doses of insulin (0.3 mU per kilogram of body weight per minute; range, 0.9 to 1.7 U per hour) for three hours into 8 subjects who did not have diabetes, 11 patients with well-controlled diabetes (hemoglobin A1, 7.6 +/- 0.7 percent), and 10 patients with poorly controlled diabetes (hemoglobin A1, 11.5 +/ 1.7 percent) to simulate the mild peripheral hyperinsulinemia observed during insulin treatment. Normoglycemia was established in the patients during the night before study. During the insulin infusion, the plasma glucose level stabilized at 60 to 70 mg per deciliter (3.3 to 3.9 mmol per liter) in the subjects without diabetes and the patients with poorly controlled diabetes, because of a rebound increase in hepatic glucose production. In contrast, hypoglycemia developed in the patients with well-controlled diabetes (42 +/- 2 mg of glucose per deciliter, or 2.3 +/- 0.1 mmol per liter, P less than 0.01) as glucose production remained suppressed. The hypoglycemia in the patients with well-controlled diabetes was associated with a lowering of the plasma threshold of glucose that triggered a release of epinephrine (less than 45 mg of glucose per deciliter, or 2.5 mmol per liter, vs. greater than 55 mg per deciliter, or 3.1 mmol per liter, in the other groups, P less than 0.01) as well as an enhanced sensitivity to the suppressive effects of insulin on hepatic glucose production. Nearly identical disturbances in glucose counterregulation and decreased perception of hypoglycemia developed when four of the subjects with poorly controlled diabetes were restudied after intensive treatment. We conclude that strict control of diabetes induces physiologic alterations (delayed release of epinephrine and persistent suppression of glucose production) that impair glucose counterregulation to doses of insulin in the therapeutic range. These defects may contribute to the increased incidence of severe hypoglycemia reported during intensive insulin therapy. PMID- 3553950 TI - Multiple-drug resistance in human cancer. PMID- 3553951 TI - Effect of antiidiotypic antibodies to HLA on graft survival in renal-allograft recipients. AB - Although the presence in the recipient of preformed antibodies to HLA antigens in the kidney of a renal-transplant donor may be associated with early graft failure, such grafts are often well tolerated. We have investigated the possibility that anti-anti-HLA (antiidiotypic) antibodies influence the outcome of renal transplantation in recipients with a history of presensitization to their donor's HLA antigens. A retrospective analysis of 20 such cases showed that in 10 patients the transplanted kidney was rejected within one month, whereas in the remaining 10 the graft was tolerated for more than a year. Nine of the 10 patients in whom the graft was tolerated had anti-anti-HLA antibodies at the time of transplantation. Nine of the 10 patients in whom the graft was rejected had antibodies that potentiated, rather than blocked, the cytotoxic activity of anti donor-HLA antibodies. These results suggest that patients with anti-anti-HLA antibodies specific for a potential donor can safely undergo transplantation, despite a prior history of anti-HLA antibodies. At the time of transplantation, patients who have antibodies that potentiate the cytotoxic activity of a historically positive serum are at high risk of graft rejection within a short period. Taking these considerations into account may improve the reliability of cross-matching in renal transplantation. PMID- 3553953 TI - Heart transplantation. PMID- 3553952 TI - Generic drug substitution revisited. PMID- 3553954 TI - Second thoughts about HMOs for Medicare patients. PMID- 3553955 TI - Rapid fungicidal action of tioconazole and miconazole. PMID- 3553956 TI - Conservation treatment for breast cancer. PMID- 3553957 TI - Charlotte Friend (1921-1987). PMID- 3553958 TI - Bacterial sex timely. PMID- 3553959 TI - Structure of the repressor-operator complex of bacteriophage 434. AB - The crystal structure of a specific complex between the DNA-binding domain of phage 434 repressor and a synthetic 434 operator DNA shows interactions that determine sequence-dependent affinity. The repressor recognizes its operators by its complementarity to a particular DNA conformation as well as by direct interaction with base pairs in the major groove. PMID- 3553960 TI - Effect of non-contacted bases on the affinity of 434 operator for 434 repressor and Cro. AB - The repressor of phage 434 binds to six operator sites on the phage chromosome. A comparison of the sequences of these 14-base-pair (bp) operator sites reveals a striking pattern: at five of the six sites, the symmetrically arrayed outer eight base pairs (four in each half-site) are identical and the remaining site differs at only one position (Fig. 1b). In contrast, the sequences of the inner four base pairs are highly variable. Crystallographic analysis of the repressor-operator complex shows that at each half-site, the 'recognition alpha-helix' of the repressor is positioned in the major groove such that it could contact the outermost five base pairs, but not the innermost two (Fig. 1a). We show in this paper that the sequence of the central base pairs of the operator (two in each half-site) have a significant role in determining operator affinity for repressor, despite the evidence presented here and in the accompanying paper that these base pairs are not contacted by repressor. We also show that these central base pairs influence operator affinity for Cro, a second gene regulatory protein encoded by phage 434. We discuss the likely structural basis for this evidently indirect, but sequence-dependent, effect of the central base pairs of the operator on its affinity for the two regulatory proteins. PMID- 3553961 TI - A new-specificity mutant of 434 repressor that defines an amino acid-base pair contact. AB - The repressor encoded by bacteriophage 434 binds to its operators by inserting a 'recognition' alpha-helix into the major groove of the DNA. We have identified an amino acid-base pair contact that determines (in part) the DNA-binding specificity of 434 repressor. The identification is based on the properties of a 'new-specificity' mutant, named Repressor [Ala 28], which bears the substitution of Ala for Gln at the first residue of its recognition alpha-helix. Repressor [Ala 28] binds with high affinity to a particular doubly mutant operator bearing the same substitution at position 1 in each half-site, but does not bind to either the wild-type operator or to other mutant operators. We describe molecular models of residue 28-base pair 1 interactions that account for the binding specificities of both the mutant and wild-type proteins. PMID- 3553962 TI - Complementation used to clone a human homologue of the fission yeast cell cycle control gene cdc2. AB - A human homologue of the cdc2 gene has been cloned by expressing a human cDNA library in fission yeast and selecting for clones that can complement a mutant of cdc2. The predicted protein sequence of the human homologue is very similar to that of the yeast cdc2 gene. These data indicate that elements of the mechanism by which the cell cycle is controlled are likely to be conserved between yeast and humans. PMID- 3553963 TI - Independence of fushi tarazu expression with respect to cellular density in Drosophila embryos. AB - Regularly spaced repeated morphological structures are a common developmental theme among higher eukaryotes. In Drosophila, this is evident in the repeated segments of the larval and the adult cuticle. It has been demonstrated through cell transplantation and more recently through molecular techniques that these repeated segmental units are established as early as nuclear cycle 14 in the blastoderm embryo. A number of genes have been shown to express their transcripts, and in two instances their protein products, in a spatially restricted manner at this early stage. Immunofluorescence probes against the protein product of one such gene, fushi tarazu (ftz), reveal that it is distributed in seven evenly spaced stripes across the cellularized cycle-14 blastoderm embryo. The mechanisms that determine such spatial patterns of gene expression are of fundamental importance for the development of multicellular organisms, but in no case are they well understood. Here we examine the ftz pattern on blastoderm embryos derived from maternal-haploid 1182 (mh 1182) and daughterless-abo-like (dal) females which possess cell densities and sizes both above and below the wild-type levels. The number, spacing and width of the ftz protein positive bands are not altered in these abnormal embryos relative to the wild-type pattern, suggesting that the mechanism by which distance is measured with respect to the ftz protein is independent of cell size and density. PMID- 3553964 TI - Antibodies against the paramyxovirus SV5 in the cerebrospinal fluids of some multiple sclerosis patients. AB - Multiple sclerosis is a demyelinating disease of the central nervous system and although there is little doubt that an infectious agent (or agents) is involved it has not been possible to demonstrate this unequivocally by any direct relationship to a given agent. Here we show that a significant proportion of patients with multiple sclerosis have antibodies against the paramyxovirus SV5 (simian virus 5) in their cerebrospinal fluid and in some of these such antibodies form a major proportion of the total immunoglobulin content. Further, we have been able to demonstrate that the oligoclonal bands displayed on electrophoresis of the cerebrospinal fluid of these patients can be removed by prior absorption with SV5 virus antigen. PMID- 3553965 TI - The role of cytoplasmic (newly synthesized) dopamine for the spontaneous and electrically evoked release of dopamine and its metabolites from the isolated neurointermediate lobe of the rat pituitary gland in vitro. AB - Isolated rat NILs were incubated in Krebs-HEPES solution. The release of dopamine and its metabolites (DOPAC, HVA and MOPET) was determined by HPLC with electrochemical detection. The spontaneous release of the sum of metabolites was about 40 times that of dopamine. The spontaneous outflow of dopamine metabolites was unaffected after inhibition of dopamine uptake (by GBR 12921) or after pretreatment with reserpine (5 mg/kg, 12 h before the experiments), but it was reduced by 50% after preincubation with the irreversible DOPA decarboxylase inhibitor, (MFMD, 10 microM, for 10 min). The combination of pretreatment with reserpine and preincubation with MFMD resulted in an 80% inhibition of the spontaneous outflow of dopamine metabolites. Treatment with reserpine caused a 98% depletion of the dopamine tissue content, whereas 60 min after exposure to MFMD the dopamine tissue content was decreased by 40%. Electrical stimulation of the pituitary stalk (3-15 Hz, in the presence of GBR 12921) caused a frequency dependent release of dopamine. Stimulation at 7 or 15 Hz caused also a significant release of dopamine metabolites. After pretreatment with reserpine, the release of dopamine evoked by stimulation at 15 Hz was abolished, whereas the evoked release of the metabolites was only reduced by about 55%. After MFMD, the evoked release of dopamine decreased by a percentage similar to that of dopamine tissue content, but the reduction of the evoked release of metabolites was more pronounced. In conclusion, the spontaneous release of dopamine metabolites from the dopaminergic nerve endings in the NIL largely reflects the catabolism of newly synthesized dopamine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553967 TI - [Initial experiences with prospective echographic studies of the hip joint of infants]. PMID- 3553968 TI - [Diagnosis of deep venous thrombosis in the Netherlands]. PMID- 3553966 TI - A boy (a bleeder) and a bloody revolution. PMID- 3553969 TI - [Virological diagnosis in the Netherlands 1981-1985]. PMID- 3553970 TI - [The dissecting aneurysm; problems in diagnosis]. PMID- 3553971 TI - [6-years' evaluation of the C-denture in Amsterdam. Results of the construction of a complete denture in relation to the postgraduate dental education complete denture course]. PMID- 3553972 TI - [Methods and materials for impressions in the handling of cast restorations]. PMID- 3553974 TI - Diabetic nephropathy. PMID- 3553975 TI - Hypertension in primary immunoglobulin A nephropathy (Berger's disease): hemodynamic alterations and mechanisms. AB - Twenty-two patients with primary IgA nephropathy (Berger's disease), 12 with normal and 10 with high blood pressure, were studied. The mean intra-arterial pressure was 88 +/- 6 mm Hg in the normotensive group and 113 +/- 10mm Hg in hypertensive patients; plasma renin activity was high in normotensives and normal in hypertensives. The glomerular filtration rate was 83 +/- 23 and 73 +/- 26 ml/m in 1.73 m2 in normotensive and hypertensive patients, respectively (p = n.s.). Blood volume was high in IgA nephropathy patients: 82 +/- 12 ml/kg body weight in normotensives and 96 +/- 7 ml/kg body weight in hypertensives. Mean arterial pressure was significantly correlated with blood volume (r = 0.541, p less than 0.01), but not with plasma renin activity and glomerular filtration rate. The cardiac index was high in both groups: 4.20 +/- 0.88 liters/min/m2 in normotensive and 3.95 +/- 0.87 liters/min/m2 in hypertensive patients. The total peripheral resistance index was significantly lower than normal in normotensives (1,659 +/- 387 dyn/s/cm-5/m2) and significantly higher (2,419 +/- 562 dyn/s/cm-5 m2) in hypertensives. The cardiac index did not correlate with blood volume and mean arterial pressure; a positive correlation was found between mean arterial pressure and peripheral vascular resistance (r = 0.630, p less than 0.01). No correlation was observed between blood volume and plasma renin activity. Our study indicates that hypertension in IgA nephropathy is primarily volume dependent, and that this increase in blood volume is not related to the deterioration of renal function. The role of the renin-angiotensin system in the maintenance of the hypertension is not well-defined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3553976 TI - Unilateral hydronephrosis and hypertension: cause or coincidence? AB - In the present study, the frequency and the mechanism of hypertension associated with unilateral hydronephrosis (UHY) were investigated in 115 patients. Hypertension (blood pressure greater than 140/90 mm Hg) was found in 20% of 101 consecutive patients with UHY. Twenty-six patients with UHY and hypertension were followed for 35 months and the effect of surgery on blood pressure was analyzed. Blood pressure fell from 178 +/- 4/108 +/- 4 to 135 +/- 2/84 +/- 2 mm Hg after surgery. Hypertension was cured in 62%, improved in 19% and unchanged in 19%. In 73% of the cured patients the PRA-ratio was greater than or equal to 1.5, while all unchanged patients had a value of less than 1.5. Hypertensive patients were significantly older than normotensive patients, but did not differ in kidney function, underlying cause of hydronephrosis, incidence of urinary tract infection or frequency of interstitial nephritis. We conclude that in UHY the incidence of hypertension is not particularly high. However, in a substantial number of patients, high blood pressure is reversible by surgery. In most of these patients the renin-angiotensin-aldosterone system seems to play an important role in sustaining high blood pressure, although in some patients other mechanisms might be operative as well. Since the overall incidence of hypertension is not particularly high in UHY, this secondary form of hypertension appears to be rare. PMID- 3553977 TI - Monoclonal antibody to aldolase C: a selective marker for Purkinje cells in the human cerebellum. AB - A monoclonal antibody to the glycolytic enzyme aldolase C was used in an immunoperoxidase technique on unfixed and formalin-fixed paraffin-embedded tissues from the human central nervous system (CNS) and other tissues. No staining outside the CNS was detected. In the central nervous system the antibody gave a selective and intense staining of Purkinje cell perikarya, axons and dendrites in both fixed and unfixed tissues. In the human fetal brain, positive staining of Purkinje cells was seen from 35-36 weeks' gestation onwards. This coincides with the conversion of Purkinje cells to a tetraploid state, and may reflect increased glycolytic activity accompanying the rapid dendritic growth at this stage of development. Preliminary investigations on a variety of disease states suggest that this antibody may be useful in studies of ischaemic damage, congenital abnormalities and degenerative conditions affecting the cerebellum. PMID- 3553978 TI - Immunoelectron microscopic study of corticotropin-releasing factor in the human hypothalamus and pituitary gland. AB - Ultrastructural localization of immunoreactive corticotropin-releasing factor (CRF) was visualized for the first time in the human hypothalamus and pituitary gland with specific antibodies against human/rat CRF. In the hypothalamus most of the positive immunoreactivity to CRF was present in granules with a wide range of diameters, 50-250 nm, in the perikarya of parvocellular neurons in the paraventricular nucleus. Among these, neurosecretory type granules, 100-150 nm in diameter, were dominant, and small vesicles, 50-80 nm in diameter, were sparse. Some of surfaces of rough endoplasmic reticulum and polyribosomes were also positive in some of these cells. CRF-positive reactions were also observed in the nerve fibers of the pituitary stalk and the posterior pituitary gland revealing two types of granules: small vesicles, 50-80 nm in diameter, and neurosecretory granules, 100-150 nm in diameter. These results support the theory that the human CRF, which is identical to rat CRF, is synthesized in parvocellular neurons of paraventricular nucleus, transported in nerve fibers, and controls ACTH secretion in the human anterior lobe of pituitary gland via the portal system. PMID- 3553979 TI - Immunocytochemical localization of the gonadotropin-releasing hormone-associated peptide of the LHRH precursor. AB - Using specific rabbit anti-GAP (gonadotropin-releasing hormone-associated peptide) serum, we have immunocytochemically localized GAP in the rat brain. Immunostaining of neuronal perikarya, fibers and terminals was demonstrated with GAP antiserum under conditions of tissue preparation which make immunostaining with LHRH antisera difficult or undetectable. GAP-immunoreactive perikarya were observed in sections of perfused or nonperfused brains without colchicine pretreatment. Using a double immunoperoxidase staining method, both GAP and LHRH immunoreactivities were shown to coexist in the same neurons. The common distribution of LHRH and GAP immunoreactivity in the rat brain is strongly supportive of GAP representing the non-LHRH portion of the LHRH precursor. The use of GAP antisera that can distinguish between LHRH and the remaining portion of its prohormone represents a valuable tool for studies of LHRH-prohormone processing and distribution. PMID- 3553980 TI - In vivo activity of the LHRH pulse generator as determined with push-pull perfusion of the anterior pituitary gland of unrestrained intact and castrate male rats. AB - In the present article we report that in vivo LHRH output as measured at the anterior pituitary following castration significantly increased, due to larger and more frequent LHRH signals arriving to this gland. This contrasts with the decreased amplitude and overall mean LHRH release of castrate males bearing a push-pull cannula within the hypothalamus. These divergent results have generated a new thesis regarding the role of gonadal steroids upon the LHRH pulse generator. This thesis submits that following castration there is an increased frequency and decreased amplitude of the LHRH signal from discrete loci within the medial basal hypothalamus, but an increased synchrony of LHRH release throughout the entire hypothalamus, resulting in an increased frequency and amplitude of LHRH arriving at the anterior pituitary. PMID- 3553981 TI - LHRH-stimulated release of stored and newly synthesized gonadotrop polypeptide (GP-87) by cultured rat gonadotrophs. AB - Enriched gonadotrophs from rat pituitaries were used to analyze the kinetics of release in vitro of the Gonadotrop Polypeptide (GP-87) under LHRH stimulation. Proteins in cultured cells were labeled with [35S]methionine. Labeling of the intracellular GP-87 pool was effected during 16 hours prior to LHRH (10(-7) M) stimulation. Proteins were analyzed either by one-dimensional SDS-PAGE (Medium content) or by two-dimensional PAGE (Cell content). An apparent half-life (intracellular catabolism + release) of 31 h for GP-87 was estimated from control cells; it dropped to 2.5 h in stimulated cells due to intense release (26% after 1 h and about 80% after 8 h of stimulation). When cells were simultaneously labeled and stimulated, the newly synthesized species appeared in the medium after a lag phase of 30 minutes, time required for synthesis and full subsequent processing. From both series of experiments, it is concluded that the hypothalamic decapeptide promotes exocytosis of the newly synthesized GP-87 well before the endogenous GP-87 pool is exhausted. Furthermore, the release of another discrete protein (B2, Mr: 81 kDa) is also stimulated by LHRH. These proteins being co-released with LH could be part of the sorting and/or routing process of hormones towards exocytosis. PMID- 3553982 TI - Stereotactic resection of juvenile pilocytic astrocytomas of the thalamus and basal ganglia. AB - Six patients with juvenile pilocytic astrocytomas of the thalamus or basal ganglia underwent seven computer-assisted stereotactic laser craniotomies with complete or nearly complete removal of the tumor in all cases. The tumor was located in the right basal ganglia in one patient, the left basal ganglia in one patient, and the left thalamus in four patients. Postoperative assessment of the completeness of tumor removal was confirmed by contrast-enhanced computed tomographic scanning within the first 2 weeks after operation. None of the patients was neurologically worse after the procedure, and five were improved. The duration of follow-up ranged from 6 months to 3.5 years. In this group of patients, the computer-assisted, stereotactically guided resection of these deeply located, benign tumors was accomplished with no morbidity or mortality. PMID- 3553983 TI - Brain stem abscess managed with computed tomography-guided stereotactic aspiration. AB - The importance of stereotactic aspiration to the successful management of three cases of brain stem abscess is discussed with special reference to the advantages offered over medical treatment alone. Stereotactic aspiration allows evacuation of pus, accurate bacteriological diagnosis, selection of an optimal antibiotic regimen, and instillation of antibiotics directly into the abscess cavity. In two of the three cases described here, the abscess reaccumulated after initial aspiration despite appropriate maximal medical therapy. A repeat aspiration was required before resolution occurred. We conclude that medical management alone is not adequate for some cases of brain stem abscess. There was no morbidity that could be attributed to the procedure, suggesting that the risk of stereotactic aspiration is probably quite low and is likely to be less than the risk of incorrect diagnosis, suboptimal choice of antibiotics, or progression of the lesion despite appropriate maximal medical therapy. PMID- 3553984 TI - Brain metastasis of an invasive thymoma. AB - A rare case of a thymoma metastatic to brain is reported. This tumor was localized intraoperatively with the use of transdural ultrasound imaging, and gross total resection was accomplished. Radiation therapy was administered to both brain and mediastinum. The growth characteristics, classification, and treatment of thymomas are discussed. PMID- 3553985 TI - Technical controversies in carotid artery surgery. AB - Carotid endarterectomy has become a routine and safe therapeutic strategy in most neurovascular centers. Wide diversity of opinion and considerable debate, however, persists concerning the ideal methods of anesthetic management, cerebral protection, intraoperative monitoring, and arterial repair. We have examined and summarized the current status of these controversies and have identified several new techniques that hold promise for further development. PMID- 3553986 TI - Guillain-Barre syndrome: quantitative measurement of plasma exchange therapy. AB - A prospective, controlled study with quantitative measurement of hand muscle force for plasma exchange treatment in acute Guillain-Barre polyradiculitis was done. Of the 29 patients with severe symptoms, every second patient was selected to the plasma exchange group and all others to the control group. The muscle forces increased and CSF protein decreased significantly more in the plasma exchange group than in the control group, but there were no differences in hospitalization or recovery periods. PMID- 3553987 TI - Total lymphoid versus total body irradiation for immunosuppressive therapy. PMID- 3553988 TI - [Short- and long-term results in 60 patients operated on for thromboendarterectomy of the carotid bifurcation]. PMID- 3553989 TI - [Anomalies of the course of the carotid vessels in relation to ischemic cerebrovascular pathology]. PMID- 3553990 TI - [Arterial digital angiography in patients with supratentorial reversible ischemic arteriopathy]. PMID- 3553991 TI - [Surgical pain]. PMID- 3553992 TI - [Bacteriological test on multidose flagons]. PMID- 3553993 TI - Pancreatic duct obliteration: clinical application, morphological and functional effects. AB - Pancreatic duct obliteration is a procedure to abolish exocrine secretion in order to prevent complications such as leakage, abscess and fistula occurring formation after diversion techniques like pancreatico-enterostomy. Pancreatic duct obliteration is applicable after all sorts of partial pancreatic resections, pancreas transplantation included. Although the method is safe, experiments have shown that not only complete exocrine atrophy is induced, but that also the endocrine architecture is destroyed. In dogs, the destruction of islet architecture leads to about 70% reduction of the insulin secreting capacity. It is not known whether such a severe reduction of endocrine function also occurs after pancreatic duct obliteration in man. This would discard duct obliteration as a procedure suitable for pancreas transplantation, since optimal endocrine pancreas function is the aim of pancreas transplantation in patients suffering from type-I diabetes mellitus. PMID- 3553994 TI - Indications for pancreas transplantation. PMID- 3553995 TI - A model for direct and quantitative assessment of pancreatic hormone secretion. AB - The usual parameters for the assessment of pancreatic endocrine function are oral or intravenous tolerance tests with various kinds of stimuli, generally glucose. Such tests provide information as to the pancreatic endocrine capacity in an indirect fashion, and the actual hormone output cannot be readily determined. The results are presented of a model in dogs with which the hormone producing capacity of the left lobe of the pancreas can be quantitatively assessed directly. The complete and undiluted venous blood from the left pancreatic lobe is sampled by cannulation of the splenic and the portal vein, under general anaesthesia. Removal of the right lobe is obligatory. With this model pancreatic blood flow, hormone secretion, and oxygen consumption can be studied after different sorts of stimuli. Moreover there is opportunity to determine the effect of various manipulations of the pancreas on its hormone secreting capacity directly. PMID- 3553996 TI - Pancreas transplantation in The Netherlands: report of the first case. AB - This case report describes the first clinical pancreas transplant performed in The Netherlands. A duct-obliterated segmental graft from a cadaver donor was transplanted to a male recipient who was insulin-dependent after total pancreatectomy eight years earlier. The recipient was off insulin for four postoperative months; during this period a rejection crisis was successfully treated. The graft was removed eight months after transplantation. Histologic examination indicated both fibrosis and rejection to have presumably contributed to graft failure. The patient is well but again insulin-dependent. PMID- 3553997 TI - Pancreatic transplantation in patients with type-I diabetes: the experience in Maastricht with a new model. AB - A successful pancreatic transplant together with a kidney graft makes type-I diabetic patients with end-stage diabetic nephropathy independent from insulin and dialysis. Several surgical techniques for the pancreatic graft are employed. Major problems are thrombosis of the graft and the handling of the exocrine secretion of the pancreas. A transplant model is presented that reduces the risk of thrombosis by including the spleen in the graft. The exocrine secretion is handled by transplanting a segment of duodenum with the graft and by connecting this segment to the recipient's bladder. Experience has been gained in four patients. All are insulin-independent. Severe complications have not been observed, which makes this model suitable for further assessment of the effect of pancreatic transplantation on the course of type-I diabetic patients. PMID- 3553998 TI - Glucose metabolism after pancreas transplantation. AB - After pancreas transplantation in type-I diabetics the dependency on exogenous insulin usually vanishes rapidly. In about 50% of patients fasting and postprandial blood glucose concentrations are normal but by oral glucose tolerance tests the glucose metabolism is classified as normal in a minority. Some of the reasons for failure in obtaining good metabolic control are discussed. Attention is focused on the inevitable peripheral hyperinsulinemia and concomitant portal hypoinsulinemia related to the extra-portal administration of insulin. PMID- 3553999 TI - Pancreas tissue transplantation. PMID- 3554000 TI - [Diffuse liver diseases: possibility or limitations of echography?]. AB - Reports on echography as a diagnostic tool in diffused liver diseases are quite numerous in the literature. As it is shown by the analysis of such reports there is no general agreement as far as including echography into the diagnostic protocol of liver diseases is concerned. Reliability of echography for the assessment of fat liver is quite ascertained, while its role in the diagnosis of acute and chronic hepatitis is still quite controversial. On the basis of personal experience, percent incidence of the most relevant echographic features is checked retrospectively and their diagnostic reliability is evaluated. The role of echography in the follow-up of sclerotic liver diseases is discussed as far as the evaluation of parenchymal structure, of associated features and of complications is concerned. Echographic data should always be completed by clinical data, laboratory tests and histological examination, during diagnosis and follow-up of patients with liver diseases. PMID- 3554001 TI - [Simulation, dissimulation, and simulation games in teaching and in surgical diagnosis]. AB - The characteristic aspects of the year's course in Surgical Symptomatology included in the curriculum of the degree course in Medicine and Surgery are examined. The report covers the student's behaviour at the first contact with the patient, his initial reaction and subsequent professional acclimatization, the techniques of didactic simulation and the new diagnostic technologies that essentially follow the dialectic of the "electronic game". Direct personal evidence and selected technical documentation constitute the demonstrative back up for the various points under discussion. PMID- 3554002 TI - [Diagnostic problems in the echographic demonstration of appendiceal mucocele. Description of a case]. AB - The ultrasound diagnosis of appendicular mucocele may sometimes present problems in relation to its differentiation from other space-occupying intra or extra peritoneal lesions. An observed case is described in which the echographic pattern of the mass suggested other diagnostic possibilities. PMID- 3554003 TI - [Reaction to ultrasonic diagnosis in the adjustment to anticipated image of the child]. PMID- 3554004 TI - [Ultrasonic study of carcinoma of the endometrium]. PMID- 3554005 TI - [Efficacy and tolerability of danazol in the treatment of menorrhagia syndrome: multicenter study]. PMID- 3554006 TI - The morphology and distribution of serotonin-like immunoreactive fibers in the cat dorsal column nuclei. AB - Fibers showing serotonin-like immunoreactivity (5-HT-LI) are demonstrated in the gracile, cuneate and external cuneate nuclei of the cat using avidin-biotinylated horseradish peroxidase and indirect fluorescence immunohistochemical methods. 5 HT-LI fibers are located in all cytoarchitectural subdivisions of the gracile and cuneate nuclei but are restricted to the medial half of the external cuneate nucleus. In all nuclei, 5-HT-LI fibers consist of long, varicose strands showing a wide range in the diameters of both varicosities and intervaricose segments. Results support the concept that serotonergic systems may be involved in the processing of non-noxious somatosensory submodalities. PMID- 3554007 TI - Immunohistochemical evidence for the adrenergic medullary longitudinal bundle as a major ascending pathway to the locus coeruleus. AB - The present study describes the first experimental evidence for a direct projection of the medulla oblongata adrenergic (Ad) neurons to the rat pontine structures by using the indirect immunoperoxidase technique. Three weeks after unilateral electrolytic lesion of the longitudinal axon bundle in the medulla oblongata, the morphological changes of the phenylethanolamine-N methyltransferase (PNMT)-immunoreactive (IR) structures located in the rat brainstem have been analysed. In the lesioned rats we observed a decrease in the number of PNMT-IR structures in virtually all regions of the brainstem ipsilateral to the lesion, especially in the locus coeruleus (LC). These results indicate that the PNMT-IR terminal-like fibers of the LC are derived from the ipsilateral medulla oblongata Ad neurons and are mainly provided by the longitudinal axon bundle. PMID- 3554008 TI - Co-distribution of neuropeptide Y and its C-terminal flanking peptide in the brain and pituitary of the frog Rana ridibunda. AB - By means of the peroxidase-anti-peroxidase technique, the distribution of neuropeptide tyrosine (NPY) and its C-terminal flanking peptide (C-PON) has been studied on serial sections of the brain and pituitary of the frog Rana ridibunda. Throughout the brain, NPY and C-PON-immunoreactive perikarya exhibited a remarkable co-distribution. These two peptides were found to be co-located within the same cell bodies in various brain regions including the dorsal and ventral pallium, the dorsal and ventral infundibular nuclei and the preoptic nucleus. The distribution of NPY- and C-PON-containing fibers in the brain and pituitary was similar. Sequential double immunohistochemical staining using the indirect immunofluorescence method, showed that NPY and C-PON were actually located within the same nerve processes throughout the frog brain and in the intermediate lobe of the pituitary. These studies indicate that the deduced C-PON sequence is present within the frog precursor to NPY and is formed in vivo in the frog brain. Like NPY, C-PON is transported distally in nerve terminals and is likely released with NPY in various regions of the brain and in the intermediate lobe of the pituitary. PMID- 3554009 TI - Calcitonin gene-related peptide in the ventral tegmental area: selective modulation of prefrontal cortical dopamine metabolism. AB - The distribution of calcitonin gene-related peptide (CGRP) in the A10 dopamine (DA) cell group region of the ventral tegmental area (VTA) of the rat was examined using immunohistochemical techniques. CGRP-like immunoreactivity was localized to axons innervating the rostral and dorsal VTA. Direct administration of CGRP to the VTA of the rat resulted in a dose-related increase in DA utilization in the medial prefrontal cortex, but not other mesocortical, mesolimbic, or striatal DA terminal field regions. These data suggest that CGRP may function to selectively modulate the activity of VTA dopaminergic neurons which innervate the prefrontal cortex. PMID- 3554010 TI - N-methyl-D,L-aspartate-induced locomotor activity in a spinal cord-hindlimb muscles preparation of the newborn rat studied in vitro. AB - Bath-applied N-methyl-D,L-aspartate (NMA) was found to elicit locomotor electromyogram (EMG) activity in ankle flexor and extensor muscles in an in vitro lumbar cord-hindlimb preparation of the newborn rat. The frequency and burst duration of the NMA-induced rhythmic EMG activity varied in a dose-dependent manner. The locomotor activity was also observed in a mid sagittally split lumbar spinal preparation, in which the frequency was much lower. It is concluded that spinal neurones with N-methyl-D-aspartate (NMDA) receptors are involved in producing locomotor activity in the rat and that each spinal half can generate hindlimb locomotion on the ipsilateral side. PMID- 3554011 TI - Myocardium and cortex cerebri xenografts transplanted into the anterior chamber of the eye of athymic rats: a morphologic and electrophysiologic profile. AB - Heart atria and cortex cerebri from fetal rabbits (E14 and E18, respectively) were grafted into the anterior eye chamber of anesthetized athymic nude rats and allowed to mature for 2-11 weeks. All grafts received a rich vascular supply from the host iris. Atrial transplants survived well but showed no significant growth while cortex grafts increased in size an average of 320%. Spontaneous action potentials were recorded from cellular elements in both tissues and, in the case of the atria, were accompanied by observable contractions. Functional cholinergic innervation from the autonomic ground plexus of the iris was elicited in both types of grafts by phasic retinal illumination. No evidence of immunologic rejection was found by histological analysis. Taken together, these data suggest that athymic rats may provide an appropriate host environment to study transplants of the central nervous and peripheral tissue from immunologically otherwise incompatible mammalian species. PMID- 3554012 TI - Neurons and glia in purified retinal cultures identified by monoclonal antibodies to intermediate filaments. AB - Two monoclonal antibodies known to bind intermediate filaments were used to identify neurons and glia from embryonic chick neural retina. Neurofilament specific antibody RT-97-F1, bound neuroepithelial cells, migrating neurons, as well as the photoreceptor layer, plexiform layers and optic fiber layer. The other, 3A7, bound intermediate filaments of Muller cells. In purified neuronal cultures, RT-97-F1 bound 75, 83 and 98% of the cells present at 24, 48 and 72 h respectively, while 3A7 bound 26, 15 and 0.3% for the same times in vitro. In purified glial cultures, RT-97-F1 showed a weak perinuclear binding, while 3A7 strongly bound intermediate filaments of nearly 100% of the cells. These antibodies confirmed and quantitated the high purity of our cultures. PMID- 3554013 TI - Steroids: reactions and partial syntheses. PMID- 3554014 TI - Muscarine, imidazole, and peptide alkaloids, and other miscellaneous alkaloids. PMID- 3554015 TI - Carotenoids and polyterpenoids. PMID- 3554017 TI - 1985 E.V. McCollum International Lectureship in Nutrition. Animals in the service of human nutrition. PMID- 3554016 TI - Guidelines for doing a computerized literature search. PMID- 3554018 TI - The role of the ileum in food intake regulation. PMID- 3554019 TI - Carnitine therapy in disorders of propionate metabolism. PMID- 3554020 TI - Fluoride in food and water. PMID- 3554021 TI - Recently described defects in vitamin B12 metabolism. PMID- 3554022 TI - Nutrition classics. The Journal of Nutrition, Volume 91, 1967: The paths to the discovery of vitamins A and D. By Elmer Verner McCollum. PMID- 3554023 TI - Use of cells in culture to solve basic nutrition problems. PMID- 3554024 TI - Pyridoxal phosphate regulates enzyme induction with corticosteroids. PMID- 3554025 TI - An ascorbate shuttle drives catecholamine formation by adrenal chromaffin granules. PMID- 3554026 TI - Alkaline hydrogen peroxide unlocks energy in high-fiber lignified by-products. PMID- 3554027 TI - Toxicologic consequences of oral aluminum. PMID- 3554028 TI - Mystery of the E-Ferol syndrome. PMID- 3554029 TI - Vitamin C intake and mortality. PMID- 3554030 TI - Cystinuria is reduced by low-sodium diets. PMID- 3554031 TI - Nutrition classics. Science, Volume 104, April 16, 1948: Activity of Vitamin B12 for the growth of Lactobacillus lactis. By Mary S. Shorb. PMID- 3554032 TI - Single amino acid deficiencies and protein quality evaluation. PMID- 3554033 TI - Does dietary tryptophan influence serotonin release from brain neurons? PMID- 3554034 TI - Fish oil and the development of atherosclerosis. PMID- 3554035 TI - Insulin allergy in clinical practice. AB - Insulin allergy, either localized or systemic, is a clinical problem that may be encountered by nurse practitioners. Studies have shown that 10 to 37 percent of patients started on animal-source insulin developed an allergic reaction to the agent. With the advent of purified animal-source insulins and of human insulin, this number has decreased, but the problem is unlikely to be completely eradicated. This article presents information about the diagnosis, treatment and management of patients presenting with localized or systemic insulin allergy. A brief discussion of the antigenicity of insulin and the basic immune processes operating in insulin allergy will be included. It is hoped that by acquainting nurse practitioners with the manifestations of insulin allergy and the treatment involved, earlier recognition and intervention will occur. This will help remove an extra burden from a patient who is already trying to adjust to the necessity of daily insulin injections. PMID- 3554036 TI - Diabetes management: the time is right for tight glucose control. PMID- 3554037 TI - Advances in respiratory management. PMID- 3554038 TI - Opioids and sexual behavior. AB - Opioids have long been known to inhibit sexual behavior. However, it is only within the last decade that the effects of opioids on sexual behavior have been studied extensively and a number of hormonal and neurochemical correlates established. In this review, the experimental literature on opioids and sexual behavior in humans and laboratory animals is examined. Clinical and anecdotal accounts of opioid use are also discussed, in addition to the pharmacology, neuroendocrinology, and biochemistry of opioid administration, to provide a synthesis of critical information. New research directions involving the study of endogenous opioid systems, opioid receptor subtypes, and the opioid modulation of neurotransmitter systems are outlined. Finally, a comprehensive bibliography of the human and animal literature is included. PMID- 3554039 TI - Conditioned taste aversion induced by self-administered drugs: paradox revisited. AB - In this paper we have reviewed the literature on Conditioned Taste Aversion (CTA) with specific attention to the "apparent paradox" in this literature. This paradox refers to the fact that drugs which are self-administered (SA) by animals and are therefore presumed to possess positive reinforcing properties are also endowed with the capacity to induce a CTA. We have argued that the CTA literature contains evidence of the existence of two qualitatively distinct types of CTA, one which is mediated by emetic agents and the other induced by SA drugs. We first provided evidence to support the notion that the traditional explanation of CTA as a function of "drug toxicity" and its resultant gastrointestinal distress does not fit the data on the nature of CTA induced by SA drugs. We proposed instead that "drug shyness" or the novelty of the drug state of these psychoactive SA drugs constitutes a better explanation of the CTA of SA drugs. We provided further evidence suggesting a functional relationship between the positive reinforcing and aversive properties of SA drugs. We have based this contention on a review of the behavioral, physiological and neurochemical data concerning the nature of CTA of SA drugs. The examination of these data reveals that the neural mechanisms underlying both the positive and aversive properties of SA drugs are the same and at the same time different from the neural mechanisms underlying the induction of CTA by emetic agents. Finally, we discussed the relevance of this interaction between the positive and aversive properties of SA drugs in the context of their abuse liability and the control they exert on drug-oriented behavior. PMID- 3554040 TI - Adverse effects of cyclosporine A on the microcirculation of the cold preserved kidney. PMID- 3554041 TI - Arthur Donaldson Smith. Physician, explorer, naturalist, and diplomat--Part II. PMID- 3554042 TI - History of school meals in Great Britain. AB - This paper describes the early origins of the school meals service, their rapid growth in the second world war, their post war development and their recent retrenchment. The factors contributing to their early success and the problems to be overcome are discussed. PMID- 3554043 TI - Nutrition in adolescence. AB - This review discusses five questions concerning nutrition in adolescence. Do adolescents have special nutritional needs? What are the recommended dietary intakes? What do adolescent schoolchildren eat? What nutritional disorders occur at this age? The prevalence of iron deficiency anaemia, rickets, coeliac disease, iodine deficiency, dental caries, weight disorders, zinc deficiency and pellagra are discussed. What is the role of school meals or other food supplementation programmes? PMID- 3554044 TI - Eating patterns in childhood and adult health. AB - This paper first reviews the evidence that the pathogenesis of many diseases which present in adult life begin in childhood, and that intervention in childhood may delay their onset. The diseases discussed include ischaemic heart disease, malignancy, cerebrovascular accidents, hypertension and obesity. The factors determining food habits are described and the possibilities of influencing food preferences and eating patterns in childhood are explored. PMID- 3554045 TI - Anorexia nervosa and related conditions in schoolchildren. AB - The clinical features of anorexia nervosa and the prevalence of the eating orders in different societies is described. The role of physiological, cultural and biological factors in the aetiology of eating are reviewed. Finally ways of preventing eating disorders are considered. PMID- 3554046 TI - Clinical applications for dentin bonding. PMID- 3554047 TI - The silk wrap technique for composite bonding. PMID- 3554048 TI - Extending sealant therapy to the adult population. PMID- 3554049 TI - Radio-iodine-labelled 5-iodo-2-thiouracil: a potential radiopharmaceutical for establishing the viability of ocular melanoma after radiation therapy. AB - Radio-iodine-labelled thiouracil has been evaluated as a radiopharmaceutical for establishing the viability of ocular melanoma after radiation treatment. The uptake of 125I-5-iodo-2-thiouracil (125I-ITU) was studied in X-ray irradiated and non-irradiated melanotic melanomas implanted in Syrian golden hamsters. Uptake of 125I-ITU in melanomas 4 days after irradiation with 40 Gy X-ray was 25% of the value found in non-irradiated controls, 12 days after such treatment it was 10% of that value. Twenty-one days after radiation treatment the melanomas showed regrowth and uptake of 125I-ITU was about equal to that in non-treated controls. Uptake of 125I-ITU in melanomas after 10 Gy X-ray irradiation was higher and uptake in tumours after 20 Gy was only slightly lower than the uptake by non irradiated melanomas. The results indicate that the iodine labelled-thiouracil uptake test may be useful as an additional diagnostic issue for assessing the viability of ocular melanoma after radiation therapy. PMID- 3554050 TI - GFR measurement by simulating constant infusion with data acquired using a CdTe detector. A feasibility study. AB - Conventional nuclear medicine methods for measuring glomerular filtration rate, GFR, are invalidated if the initial injection of radiopharmaceutical is tissued. An analytical method proposed by Veall and Gibbs in 1982 overcomes this difficulty but does require multiple blood samples. This paper investigates whether it is feasible to use the analytical method on data acquired with a CdTe detector system and thereby reducing to one the number of blood samples required. Synthetic data were used to investigate the effect of (a) duration of sampling (b) statistical noise and (c) non-stationarity on the GFR values derived by the Veall and Gibbs method. A sampling duration of 100 min is shown to be adequate and statistical noise is not a limiting factor. However, data fluctuations, mainly due to detector motion, do reduce the accuracy of the method. When the analytical technique is applied to data obtained using a CdTe detector on 40 patients the GFR values are similar to those derived by the conventional method (r = 0.957, Syx = 9.1 ml min-1). The technique is sufficiently attractive to warrant further studies to establish its absolute accuracy. PMID- 3554051 TI - 99Tcm-(tin) colloid scans in the evaluation of renal transplant rejection. AB - Technetium-99m-(tin) colloid uptake in renal transplants was quantified to evaluate rejection. A dynamic acquisition following i.v. injection of 110 MBq of this radiopharmaceutical enabled quantification of 15 to 20 min transplant uptake (PU), in terms of percentage of an injected dose after allowing for attenuation in the patient. An uptake ratio (UR) i.e. the ratio of 15 to 20 min uptake over the 0 to 5 min uptake was also derived. Normal values were obtained in 20 stable functioning transplants (normal PU less than or equal to 1%, normal UR less than or equal to 0.7). In 66 patients, PU and UR were compared with clinical, biochemical, histological and radiological, evidence of rejection. A sensitivity of 70% and specificity of 85% was obtained for this 99Tcm-(tin) colloid study in the diagnosis of renal transplant rejection. PMID- 3554052 TI - The implications of decreased performance of new generation gamma-cameras on the interpretation of 131I-Hippuran renal images. AB - Several patients with renal failure in whom the kidneys were more clearly imaged with 99Tcm-DTPA than 131I-Hippuran were recently observed. We have postulated that our newer generation gamma-cameras have a reduced capacity to image 131I in comparison to older generation cameras. This hypothesis was tested by comparing representative older and newer imaging systems. Full-width tenth-maximum 99Tcm linespread functions were 1.20 and 1.55 cm for the older and newer cameras, respectively. The 99Tcm count rate on the newer camera was 111% that of the older camera, and the observed kidney to background count ratios in a phantom model were virtually identical for the two cameras imaging a number of simulated 99Tcm count distributions. Full-width tenth-maximum 131I linespreads were 1.55 and 4.78 cm, respectively, on the older and newer cameras and the 131I count rate on the newer camera was 27% of the count rate on the older system. The phantom model demonstrated a consistently lower 131I perceived kidney to background count ratio on the newer gamma-camera compared to the older system. These findings should be considered in the interpretation of 131I-Hippuran studies on newer-generation equipment until revised criteria of interpretation have been established. Non visualization of the kidney may not have the same prognostic implication using modern cameras as has been reported from studies with older generation detector systems. PMID- 3554053 TI - Second trimester diagnosis of fetal skeletal dysplasias. PMID- 3554054 TI - Recurrence risks for common complications of pregnancy--a review. AB - A review of the literature concerning the more common complications of pregnancy indicates that recurrence risks are available for most and can be summarized as follows: hydatidiform mole--1.3 to 2.9 per cent; recurrent miscarriage--20 to 30 per cent; ectopic pregnancy--20 to 30 per cent; severe preeclampsia--7.5 per cent; mild preeclampsia--29 per cent; preterm labor--15 per cent after one and 30 per cent after two. While recognizing that each individual case merits full investigation and careful assessment, it is proposed that these risk figures provide a useful basis for use in pre- and postpregnancy counseling. PMID- 3554055 TI - A randomized trial of electronic fetal monitoring in preterm labor. AB - Intrapartum electronic fetal heart rate (FHR) monitoring and fetal blood gas sampling were compared with periodic auscultation of FHR in a multicentered randomized trial of preterm singleton pregnancies with fetal weights of 700-1750 g. Two hundred forty-six pregnancies were studied (electronic FHR monitoring N = 122, auscultation N = 124). Perinatal or infant death was associated with 14% of pregnancies with electronic FHR monitoring and 15% with auscultation. No significant differences were noted in the prevalence of low five-minute Apgar scores, intrapartum acidosis, intracranial hemorrhage, or frequency of cesarean section (P greater than .10). Compared with electronic FHR monitoring, intrapartum auscultation as done in this study is unlikely to be associated with detectable differences in perinatal outcomes within the high-risk setting of preterm labor. PMID- 3554056 TI - Ovarian cysts in pregnancy: does ultrasound make traditional management inappropriate? AB - In a retrospective series of 131 ovarian tumors associated with pregnancy, 81 (including one carcinoma and six tumors of borderline malignancy) were removed. Eighty-three cysts were examined by ultrasound. All 15 of less than 5 cm in diameter resolved spontaneously. Of 68 larger than 5 cm in diameter, 39 had a simple internal echo pattern and a smooth wall; 19 of these disappeared, and the histology of seven others suggested they might have resolved if treated conservatively. Three of the tumors of borderline malignancy also showed a simple ultrasound pattern, but higher-resolution machines may have differentiated two of these. We suggest a policy of selective conservative management of ovarian cysts during pregnancy on the basis of the ultrasound appearance. PMID- 3554057 TI - Routine or selective ultrasound examinations in early pregnancy. AB - Two thousand fifty-four women were routinely screened with ultrasound in the tenth to 14th week of pregnancy. The clinical outcome was compared with a group of 1358 gravidas examined selectively with ultrasound. In the test group, 95% of all women had an ultrasound examination early in pregnancy; the corresponding figure in the control group was 50%. Neonatal outcome was similar, but the frequency of labor inductions decreased in the group routinely screened with ultrasound. Induction of labor for suspected postdatism increased the risk for emergency cesarean section in comparison with spontaneous onset of labor. In about 20% of all cases, prediction of the time of delivery was altered according to the ultrasound examination, and analysis of the patients with spontaneous onset of labor showed that ultrasound was a better predictor of the time of delivery than was the last menstrual period. PMID- 3554058 TI - Sonographic patterns of ovarian tumors: prediction of malignancy. AB - Four hundred four women with suspected pelvic masses or histories suggesting ovarian cancer (eg, low abdominal pain) entered a prospective study designed to assess the accuracy of sonography in confirming or excluding the presence of ovarian cancer. Three hundred twelve of these patients were operated on and evaluated within three weeks after sonography. The predictive value of the sonographic evidence of malignancy was 73% (38 of 52 patients), whereas benign tumors were predicted correctly in 95.6% (177 of 185). Sonographic reassessment of masses with patterns suggesting benign disease may be an alternative to immediate surgical exploration in a selected population (ie, those with poor surgical risk). The sonographic detection of ovarian malignancy requires further improvement; as a diagnostic tool it continues to present a challenge. PMID- 3554059 TI - Perspectives on perinatal brain damage. AB - The author presents a perspective on perinatal brain injury from the point of brain development, and discusses subsequent adverse outcomes. It is stressed that injury is frequently attributed to perinatal causes and avoidable circumstances when in fact the obstetrician could not possibly foresee or circumvent it. Evidence of the dramatic recuperative powers of many infants, even when dying and being resuscitated, are compared with the minimal provocations frequently associated with handicap, underscoring the concept of prior injury or unique fragility. The review is presented to provoke new insights and perspectives. PMID- 3554060 TI - Is the Papanicolaou smear useful for diagnosing sexually transmitted diseases? AB - To examine the validity of cervical cytologic diagnosis of sexually transmitted diseases, we reviewed the literature and calculated the efficacy of the Papanicolaou smear as a diagnostic technique. The predictive value of a positive test varied widely, but was generally higher for Trichomonas vaginalis (0.81 1.00) than for other organisms. For Chlamydia trachomatis, the predictive value of a positive test ranged from 0.40-1.00. Cytologic diagnosis of sexually transmitted diseases has not been studied adequately, but the available literature suggests that its sensitivity is low. In general, the Papanicolaou smear should not be used to diagnose sexually transmitted diseases, and treatment should not be based on cytologic findings alone. At best, cytologic indications of sexually transmitted diseases should prompt a definitive laboratory test. PMID- 3554061 TI - Cardiac size during prenatal development. AB - In this study, the cardiac circumference as measured in a four-chamber view was analyzed to determine its relationship to three linear, sonar measurements- biparietal diameter, femoral length, and abdominal circumference--and two sonographically derived fetal parameters--gestational age and estimated fetal weight. The results showed that the cardiac circumference correlates significantly with these direct and derived variables. It is recommended that the magnitude of the cardiac circumference as a function of any or all of these variables be used as an index of organ size when assessing fetuses at risk for anomalous cardiac development. PMID- 3554062 TI - Hysterography in patients with suspected uterine cancer: radiographic and histologic correlations and clinical implications. AB - The present study correlated the hysterographic and nonradiation-affected uterine histologic findings in 91 patients with suspected uterine cancer. Hysterography helped diagnose correctly a benign or malignant lesion, and helped identify the correct primary site of a malignant lesion in 11 patients. In 65 patients with a final diagnosis of endometrial carcinoma, all five cases of true endocervical involvement were identified, 69% were determined to have either no residual tumor or no myometrial invasion, and 88% were predicted correctly to have a myometrial invasion of greater than one-half. Prediction of the volume, distribution, and point of maximum invasion permitted the uterus to be opened so as to permit the best histologic assessment of the depth and extent of the lesion. PMID- 3554063 TI - Lamicel versus laminaria for cervical dilation before early second-trimester abortion: a randomized clinical trial. AB - Lamicel is a synthetic osmotic cervical dilator reported to work within two hours. To evaluate its efficacy and side effects, we conducted a double-blind, randomized clinical trial comparing Lamicel with multiple laminaria for cervical dilation in 219 patients before second-trimester abortion. A single Lamicel produced significantly less initial dilation (two-tailed P value = .03) than did multiple laminaria, but the techniques had comparable degrees of difficulty in subsequent dilation to 43 French units (two-tailed P value greater than .05) and rates of achieving dilation of 43 French units with rigid dilators (relative risk 1.0; 95% confidence interval 0.9-1.1). Lamicel removal resulted in a significantly lower rate of bleeding from the os (relative risk 0.3; 95% confidence interval 0.2-0.5). Because of its greater convenience, lower cost per patient, and comparable efficacy, Lamicel appears to be an attractive alternative to multiple laminaria for cervical dilation before abortion at 14-16 menstrual weeks' gestation. PMID- 3554064 TI - Fetal and maternal Doppler blood flow parameters in postterm pregnancies. AB - In this preliminary investigation, we sought evidence of increasing impedance to placental blood flow from both sides of the placenta and evidence of compromised fetal aortic blood flow in 35 human pregnancies exceeding 42 weeks' gestation. Fetal age was confirmed by biparietal diameter (BPD) measurements obtained before 21 weeks. Pourcelot's Index, calculated from Doppler sonograms recorded with a noninvasive technique from small arteries in the myometrium and from an umbilical cord artery, did not correlate with the duration of the pregnancy beyond term. However, this "resistance index" of Pourcelot was higher in the umbilical cord arteries of fetuses with a worse clinical outcome. Doppler blood cell velocity in the fetal descending aorta correlated significantly and negatively with the prolongation of gestation. Fetal aortic velocities appeared to be lower in fetuses who passed meconium before delivery. Our findings suggest that fetal compromise in prolonged pregnancy is more a fetal-placental problem than a uteroplacental problem. PMID- 3554065 TI - Fetal blood flow in pregnancies complicated by intrauterine growth retardation. AB - A noninvasive pulsed Doppler ultrasound technique was used to characterize blood flow in the descending thoracic aorta and the intra-abdominal part of the umbilical vein in 159 fetuses suspected of intrauterine growth retardation (IUGR) on the basis of ultrasound fetometry. From this group, 74 infants with IUGR (defined as gestational age-related birth weight of 2 standard deviations [SD] or more below the population mean) were born. The blood flow results were not available to the clinicians managing the pregnancies. Blood flow mean velocity in the fetal aorta was lower, pulsatility index and rising slope higher, and umbilical volume flow and umbilical flow per 100 g placental tissue were lower in the pregnancies with IUGR than in 21 normal pregnancies. The waveform of the maximum aortic velocity envelope was related to operative delivery for fetal distress, Apgar score, and umbilical cord blood pH. The pulsatility index and the configurational assessment of the diastolic part of the waveform were combined to form a new concept, the blood flow class. The blood flow class was abnormal in 57% of the fetuses classified as having IUGR at birth and in 93% of those growth retarded fetuses who subsequently developed signs of fetal distress requiring operative delivery. Waveform analysis, in terms of blood flow class, seems to be a useful tool in the surveillance of fetuses when IUGR is suspected. Abnormal blood flow class is a marker of fetal distress and probably gives an earlier indication than antenatal nonstressed cardiotocography. The results of this study point to a strong association between IUGR and impaired fetal blood flow. The aortic volume blood flow, unlike waveform analysis, does not seem to be a variable sensitive enough to predict fetal outcome in the individual pregnancy. PMID- 3554066 TI - The role of antepartum testing in the management of postterm pregnancies with heavy meconium in early labor. AB - The documented association between heavy meconium in early labor and increased perinatal morbidity and mortality has alerted physicians to the presence of a potential high-risk fetal condition and to the possible need for immediate fetal blood pH determination. The purpose of this study was to determine whether antepartum fetal assessment can predict whether a postterm fetus with heavy meconium in early labor is at low or high risk for an adverse perinatal outcome. Eight hundred thirty-nine postterm patients were followed with antepartum testing, consisting of twice-weekly fetal heart rate (FHR) testing and ultrasonic amniotic fluid volume estimation. Overall, patients with heavy meconium in early labor had a significantly greater frequency of fetal distress. However, when women with heavy meconium in early labor were separated according to their antepartum testing results, those with normal results were found to have no greater risk for fetal distress or perinatal morbidity than women with normal testing and subsequently clear amniotic fluid. These findings suggest that postterm patients with heavy meconium in early labor and normal antepartum testing can be managed in labor in the same manner as low-risk patients without meconium. PMID- 3554067 TI - A prospective study of the accuracy of ultrasound in predicting fetal microcephaly. AB - A prospective study of the diagnostic accuracy of ultrasound in the prediction of fetal microcephaly was performed on a study population of 24 patients. An occipitofrontal diameter larger than the predicted mean -2 standard deviations (SD), a head perimeter larger than the predicted mean -2 SD, and a head perimeter/abdominal perimeter larger than the predicted mean -1 SD were found to exclude fetal microcephaly. An occipitofrontal diameter smaller than the predicted mean -4 SD, a head perimeter smaller than the predicted mean -5 SD, a head perimeter/abdominal perimeter smaller than the predicted mean -3 SD, and a femur length/head perimeter larger than the predicted mean +3 SD were found to cause no errors in the diagnosis of microcephaly. If neither of these two groups of tests is satisfied, fetal microcephaly cannot be reliably diagnosed or excluded on the basis of a single ultrasound examination. PMID- 3554069 TI - Anesthesia for the high-risk parturient. AB - High-risk pregnancies require specialized obstetric and anesthetic care. A basic understanding of how specific pathophysiology and pharmacologic therapy interact with anesthetic care is essential for both obstetrician and anesthesiologist. This paper selectively focuses on preeclampsia/eclampsia, diabetes mellitus, prematurity, multiple gestations, infectious disease, preexisting neurologic disease, and preexisting cardiac disease, reviewing anesthesia for labor and vaginal and cesarean delivery for each high-risk problem, as practiced at a Level III perinatal unit. Emphasis will be placed, when appropriate, on recent experience with monitoring and aggressive pharmacologic therapy of the critically ill parturient. PMID- 3554068 TI - Hyperinsulinemia and hyperandrogenemia: in vivo androgen response to insulin infusion. AB - The plasma androgen responses to multiple-dose insulin infusions were determined in six normal females, four normal males, five obese females, and in three females with severe insulin resistance, hirsutism, and acanthosis nigricans. During the insulin infusions, the plasma glucose concentrations were maintained at 85 +/- 1 mg/dL by variable infusions of dextrose. Plasma androstenedione was augmented by 27-39% at physiologic insulin concentrations in the normal subjects and the obese group, and by 25% at hyperinsulinemic levels in the insulin resistant group with acanthosis nigricans. The increased androstenedione concentrations achieved in the normal females and obese females were similar to the hyperandrogenemic levels seen in the acanthotic subjects in the basal state. Plasma cortisol also increased in all groups from 19% in normal females to 135% in obese females during the insulin infusions, but these changes did not reach statistical significance. These studies suggest that hyperinsulinemia may play a pathogenic role in the hyperandrogenemia of polycystic ovarian disease. PMID- 3554070 TI - Management of the selected term breech presentation: assessment of the risks of selected vaginal delivery versus cesarean section for all cases. AB - In this study, the concepts of decision theory have been applied to a clinical obstetric controversy--the management of the selected mature breech presentation. We have reviewed in detail the literature published since 1974 and estimated the probabilities of various outcomes after different treatment strategies. We conclude that a policy of selected vaginal delivery will result in four perinatal deaths for every 1000 patients delivered. A similar probability of neurologic handicap, at least until discharge from hospital, can also be attributed to this method of delivery. These unfavorable outcomes were reported less frequently in more recent reports covering the years since 1974. In these cases, the probability of fetal death due to a trial of vaginal delivery is approximately two in 1000. Cesarean section rates have risen, however, and 18-40% of trials of labor for breech presentation now result in "emergency" cesarean section. Decision analysis has demonstrated that a policy of elective cesarean section for all cases would not necessarily increase maternal mortality and morbidity. Thus the greater dangers of emergency compared with nonelective surgery may abolish the advantages of attempting a vaginal delivery. Depending on the relative dangers of elective and emergency cesarean section, planned delivery becomes the safer option when 16-30% of trials of vaginal breech delivery are unsuccessful. The strength and limitations of this probabilistic approach to the breech presentation are discussed in detail. PMID- 3554071 TI - Dental health and the chocolate factory. PMID- 3554072 TI - Common roots. PMID- 3554073 TI - Notes on Mouton's Essay D'Odontotechnie of 1746. PMID- 3554074 TI - Lost teeth and mind over matter. PMID- 3554075 TI - Historical aspects of the use of fluorides. PMID- 3554076 TI - London dentists in the 18th century: a listing from the trades directories in the Guildhall Library. PMID- 3554077 TI - [Use of an addition method in occlusal reconstruction of posterior teeth using ceramic]. PMID- 3554079 TI - [Use of mathematical models and computers in the complex diagnosis of various tumors of the orbit]. PMID- 3554078 TI - Preparation and use of slurry water. PMID- 3554080 TI - [Ultrasonic diagnosis of foreign bodies in the coats of the eye taking into consideration the pulsatile conditions of radiation]. PMID- 3554081 TI - [Dynamics of proteolytic and antiproteolytic activity in corneal burns]. PMID- 3554082 TI - Plasma levels of retinol in cancer patients supplemented with retinol. AB - Previous studies have indicated that plasma levels of retinol are decreased in some cancer patients and that lower levels of retinol could be associated with a poor response to chemotherapy. This pilot study was conducted to determine whether it is possible to increase plasma levels of retinol in cancer patients by supplementation with retinol. Plasma levels of retinol were measured by high performance liquid chromatography in 46 patients treated with chemotherapy for various malignancies and in 43 control individuals; cancer patients were supplemented orally either with 25,000 or 50,000 IU of retinol daily during up to 3 months. Initial levels of retinol were lower in cancer patients than in the control group; the decrease was significant in women with liver metastases but not in men. Women supplemented with 25,000 IU had a significant increase of their retinol levels after 1 month but this effect was not maintained during continued supplementation; in women receiving 50,000 IU daily, a sustained increase in retinol level was maintained during the 3 months of supplementation. In men, a similar trend was produced by the supplementation but the increases were not significant. Retinol levels decreased to initial levels within 1 month of discontinuation of supplementation, indicating the need for continuous supplementation. PMID- 3554083 TI - Activity of epirubicin in combination chemotherapy of advanced ovarian cancer. Results of the South-East European Oncology Group (SEEOG) Study. AB - The therapeutic efficacy of the combination of cyclophosphamide + epirubicin + cisplatin was evaluated in 107 previously treated or untreated patients with advanced ovarian cancer. The overall response rate was 58.8%, complete remission 36.4% (mean duration-7.62 months) and partial remission 22.4% (mean duration-6.74 months). The response was rated in function of age, menopausal status, performance status and previous therapy. Toxicity (in case of 109 patients) was evaluated according to the WHO recommendation. The similar therapeutic effectiveness and less toxicity of the above drug combination compared to CAP regimen is demonstrated. PMID- 3554084 TI - Randomized trial comparing two short courses of moderate-dose metoclopramide for moderate-dose cisplatin-induced emesis. AB - To better define the dose-response relationship of moderate-dose (MD) metoclopramide (MCP), 42 patients receiving their first course of cisplatin (50 mg/m2) were randomly allocated to receive a short-course regimen of MCP, either at 1 mg/kg X 1 dose, 30 min before cisplatin (regimen A) or 1 mg/kg X 2 doses, 30 min before and 1 h after cisplatin (regimen B). The antiemetic response was assessed only by objective means (duration and volume of emesis over a 6-hour period). The results obtained in the two groups show a significantly better antiemetic effect (p = 0.03) employing the higher dose of this short-course regimen, with as much as 76% of the patients experiencing no vomiting or only a low degree of emesis. Furthermore, the lower-dose MCP regimen seems to be inadequate for preventing emesis, especially in the subgroups at higher emetic risk (patients with prior chemotherapy exposure and those concurrently receiving adriamycin. No significant side effects were present with either treatment. Further studies are required to define the best short-course regimen of MCP for patients receiving MD cisplatin. PMID- 3554086 TI - Antiemetic therapy in patients treated with high-dose cytosine arabinoside. AB - The antiemetic efficacy of metoclopramide (MCP) was evaluated in 33 consecutive patients treated with high-dose cytosine arabinoside (HiDAC), greater than or equal to 3 g/m2, a highly emetogenic agent increasingly used in patients with hematologic malignancies for which no previous formal antiemetic trials have been reported. Administration of MCP in conjunction with prophylactic diphenhydramine resulted in major antiemetic responses (0-2 episodes of emesis in the 24 h after therapy) in 23 of 33 (70%) patients. The addition of lorazepam (LZP) to MCP resulted in major antiemetic response in 7 or 8 (88%) patients who failed to respond to MCP alone. Major side effects were extrapyramidal reactions (5%) and moderate diarrhea (18%). MCP alone or in conjunction with LZP is effective antiemetic therapy in patients treated with HiDAC. PMID- 3554085 TI - Adjuvant immunochemotherapy in colorectal cancer Dukes C. AB - The initial aim of the present study was to verify in a randomized trial whether the addition of Levamisole, an immunomodulator, could increase the effectiveness of postoperative chemotherapy (MeCCNU + 5-FU) in Dukes C colorectal cancer patients. After entering 29 consecutive patients, the poor results of most studies of adjuvant therapy in colorectal cancer prompted an early end to patient accrual. After 8 years, the lack of significance in survival (48.9 versus 37.3%) and disease-free survival (50 versus 38.8%) between the two treatment arms rules out any improvement associated with Levamisole administration. PMID- 3554087 TI - Involutional ectropion: a review of the management. PMID- 3554088 TI - Involution entropion: a review of the management. PMID- 3554089 TI - Pre- and postoperative therapy in cataract extraction. AB - This review is an update on the subjects directly or indirectly concerning pre- and postoperative therapy in cataract extraction. Topics were selected from those which the authors thought to be significant mainly from the clinical point of view. The review covers antiprostaglandins therapy, intraocular lens, Nd-YAG laser and others. The authors briefly summarize the latest trends in the above topics and give critical comments. PMID- 3554090 TI - Orbital histiocytic lymphoma arising from the ethmoid sinus. AB - Histiocytic lymphoma has been reported previously as an orbital manifestation of systemic malignancy. We report herein a 49-year-old white male with orbital involvement from a sclerosing lesion in the ethmoid sinus that initially caused a biopsy-proven orbital inflammatory mass. This report of an orbito-sinus histiocytic lymphoma underscores the need to re-biopsy symptomatic orbital inflammatory lesions that continue to enlarge. PMID- 3554091 TI - Survival of corneal grafts from donors supported by mechanical ventilation. AB - Eighty-five patients undergoing penetrating keratoplasty with tissue from donors supported by mechanical ventilation (Ventilator group) were compared to a surgeon and diagnosis-matched group (Control group). Age at surgery, duration of follow up, and sex of recipient patients were similar in the two groups. The mean donor age in the Ventilator group (26.4 years) was significantly less than in the Control group (45.8 years, P less than 0.0001). Mean time on the ventilator was 99.4 hours (range, 4 hours to 21 days). Overall graft survival rates in the Ventilator and Control groups were similar (P greater than or equal to 0.72). Time on the ventilator did not affect graft survival. Cultures of corneoscleral donor rims were positive more often in the Ventilator group than in Controls (39.7 versus 23.1%), but the difference was not significant (P = 0.09). Prolonged ventilator time was not associated with a higher rate of positive corneoscleral rim cultures, nor did positive cultures affect graft survival. The most common cause of graft failure in both groups was allograft rejection. In no case could postoperative bacterial infection be attributed to contamination of the donor material. One case of primary donor failure occurred in the Ventilator group, but the incidence (1.2%) is similar to that of previously reported studies. The data indicate that corneal tissue from ventilator-supported donors should be considered for use in penetrating keratoplasty. PMID- 3554093 TI - Meniscocondylar plication: a modified operation for surgical repositioning of the ectopic temporomandibular joint meniscus. Rationale and operative technique. AB - A historical review of temporomandibular joint (TMJ) surgical meniscal repositioning procedures is presented, and three operations that are currently used to manage this problem are compared and contrasted. Each operation produces iatrogenic deviations in intra-articular anatomy and retains the potential to create significant alterations in TMJ biomechanics. Meniscocondylar plication has been performed on 84 patients (89 joints) with arthrographically confirmed internal derangement of the TMJ. A 90.7% success rate was achieved. The operation is technically facile, surgically uncomplicated and clinically effective. It should rank as a justifiable and viable alternative to those operations that are presently being performed to treat patients with internal derangement of the TMJ. PMID- 3554092 TI - Screening cornea donors for antibodies against human immunodeficiency virus. Efficacy of ELISA testing of cadaveric sera and aqueous humor. AB - Coded cadaveric sera from 35 patients with acquired immunodeficiency syndrome (AIDS), from 45 cadavers at high risk of human immunodeficiency virus (HIV) infection, and from 262 cadavers without known signs or risk of AIDS were assessed using three commercially available enzyme-linked immunosorbent assays (ELISA) kits and Western blot analysis. Greater than 94% sensitivity and 99% specificity was achieved with each of the ELISA test kits using cadaveric sera. The Western blot method gave 97.1% sensitivity compared with the autopsy-proven diagnosis of AIDS. Positive results were obtained on sera from AIDS cadavers even if the time of blood draw was delayed 35 hours from death and the time of sera preparation was delayed up to 176 days. False-negative or false-positive ELISA results did not appear to correlate with hemolysis or any parameter of sera preparation. In contrast to the high sensitivity in testing sera, only 16 to 26% of aqueous humor samples from AIDS cadavers were ELISA-positive and 79% were positive by Western blot. These results indicate that three commercially available ELISA test kits are an effective means of screening cadaveric sera for antibodies to HIV, but that aqueous humor cannot be reliably substituted for cadaveric sera to screen potential cornea donors by an ELISA assay. PMID- 3554094 TI - Acanthosis nigricans. AB - Acanthosis nigricans (AN) is a well-defined skin disorder characterized by velvety hyperkeratotic macules that can be accompanied by various degrees of pigmentation. Other manifestations of AN are marked papillomatous growths and deep skin markings. These changes can affect the entire skin but preferentially are observed in the axilla, neck, genitals, and oral cavity. The presence of AN around and within the oral cavity as well as its well-known association with internal malignant conditions, especially adenocarcinoma of the stomach, and/or its association with insulin resistance, has prompted this review article, which emphasizes the oral manifestations of AN. PMID- 3554095 TI - An evaluation of the clinical analgesia/anesthesia efficacy on acute pain using the high frequency neural modulator in various dental settings. AB - The purpose of this study was to evaluate the effectiveness of high frequency neural modulation as a substitute for traditional local anesthesia in various dental procedures. This double-blinded study was done to evaluate patient comfort and degree of satisfaction as well as manageability of pain control by the operator during the dental procedures. Procedures included restorations, tooth extractions, root planing, pulp extirpation, and temporomandibular joint therapy. In the experimental group, favorable responses ranged from 0.0% to 92.8%, depending on the procedures. An overall favorable rating of 71.8% was given by the experimental group, and an overall favorable response of 8.5% was given by the placebo group. PMID- 3554097 TI - [Bone graft by a microvascular method in mandibular reconstruction]. PMID- 3554096 TI - [Evaluation of metabolism in diabetics among a group of ophthalmologic patients]. PMID- 3554098 TI - [Clinical significance of ultrasonic examination of fetal and placental circulation]. PMID- 3554099 TI - [Descriptions of diseases in medieval chronicles]. PMID- 3554100 TI - [Problems of a new medical faculty at the turn of the century]. PMID- 3554101 TI - [In memory of Miklos Jancso Jr]. PMID- 3554102 TI - [The role of ultrasound-guided percutaneous transhepatic gallbladder puncture in the treatment of acute cholecystitis]. PMID- 3554103 TI - [Binding of human and porcine insulin to erythrocyte and monocyte receptors in healthy subjects and type I and II diabetic patients]. PMID- 3554104 TI - [Use of computers in gastroenterology]. PMID- 3554105 TI - [Computer-assisted diagnosis of malformation syndromes]. PMID- 3554106 TI - [Peter Veghelyi 1908-1986]. PMID- 3554107 TI - [What did they celebrate in France in 1686? (circumstances of the successful operation of the Sun King)]. PMID- 3554108 TI - [Imre Toth, M.D., distinguished practitioner of occupational medicine for the metallurgy and mining industries]. PMID- 3554110 TI - [150th anniversary of the founding of the Royal Medical Society of Budapest]. PMID- 3554109 TI - [Pancreato-duodenectomies performed in chronic pancreatitis]. PMID- 3554112 TI - [Orthography of Hungarian medical terminology]. PMID- 3554111 TI - [Jozsef Jakab Plenck, most prominent factor in Austro-Hungarian medical relations]. PMID- 3554113 TI - [Technic of ventral spondylodesis of the lower cervical spine]. AB - Anterior fusion of the lower cervical spine is usually performed without difficulty. The surgical technique is simple and normally involves little risk. The indication and technique depend completely on the clinical picture; otherwise, the results are unavoidably poor. A slipped cervical disc is operated on using the Smith-Robinson or Cloward procedure. If extensive decompression with resection of dorsal osteophytes is required, the Cloward technique is preferable due to the superior view of the spinal canal. In dislocations or dislocation fractures of the cervical spine requiring decompression and fusion from the anterior approach, the spine should be stabilized with a bone graft and plate. An anterior approach increases the instability due to damage to the posterior ligaments in flexion injuries. Fusion is usually performed with autologous iliac or fibular grafts, which show good ingrowth but different load-bearing properties. Multisegmental fusions or defects following tumor resections can be bridged with deep-frozen homologous grafts. To achieve immediate stability PMMA implants may be necessary. Implants of bioactive glass ceramics may prove useful in the future. PMID- 3554114 TI - [The history of the Otorhinolaryngologic Clinic in Cracow]. PMID- 3554115 TI - Psychological factors influencing chronic phantom limb pain: an analysis of the literature. AB - The behavioral literature concerning chronic phantom limb pain was reanalyzed in order to determine the role of psychological factors in initiating and controlling the intensity of its episodes. Some of the behavioral literature presents an inaccurate picture of amputees who have phantom pain. This apparently happened because many of the data were gathered from those amputees requesting treatment for phantom pain who were referred to mental health professionals. We conclude that phantom pain is similar to other chronic pain syndromes in that episodes are greatly influenced by psychological factors such as stress and depression. Repeated requests for treatment are influenced by personality structure. There is no convincing evidence that major personality disorders are important in the etiology of chronic phantom pain nor that they are more prevalent among those amputees reporting phantom pain than among those not reporting it. PMID- 3554116 TI - Relaxation of the pars membranacea of the trachea. Surgical treatment. PMID- 3554117 TI - Depression of virus-specific cytotoxic T-cell responses during murine malaria. AB - Mice with self-limiting P. yoelii or fatal P. berghei infections exhibited a markedly impaired ability to mount specific splenic cytotoxic T-lymphocyte responses to immunization with infectious ectromelia (EV), vaccinia (VAC), or lymphocytic choriomeningitis viruses (LCMV). Lymph node responsiveness, however, was not impaired. Primary CTL responses were depressed in mice immunized 7 days after P. berghei infection, while in P. yoelii-infected mice, depressed responses were detected only during the period corresponding with maximal parasitemia (days 9-12). Secondary VAC-specific CTL responses in vitro by spleen cells of mice previously immunized during P. yoelii infection were also depressed if UV inactivated rather than infectious VAC was used for immunization. In addition, spleen cells of mice already immune to VAC failed to yield normal secondary CTL responses in vitro during the period of maximal P. yoelii parasitaemia. Collectively, these findings indicate that, during patent malaria infections, priming for and expression of virus-specific CTL responses may be inhibited. PMID- 3554118 TI - Thymocyte-dependent immunity to toxoplasmosis in the normal and immunocompromised guinea-pig host. AB - Guinea-pigs made T-cell deficient by thymectomy and irradiation, and protected with syngeneic bone marrow cells (TXB) have a greatly reduced capacity to express normal cell-mediated immune functions, based on their poor responses to T-cell mitogens, prolonged acceptance of skin allografts, and susceptibility to the lethal effects of graft-versus-host disease. Further evidence for impaired T-cell activity in TXB guinea pigs was based on their inability to be fully sensitized to mycobacterial antigens, and increased susceptibility to an intradermally induced infection with the intracellular protozoan parasite, Toxoplasma gondii (RH strain). After challenge at multiple sites with 10(6) or 10(5) parasites, toxoplasmosis in thymus-intact, fully immunocompetent guinea pigs is a self limiting and survivable infection, whereas the disease takes an acutely lethal course in the majority of TXB guinea-pigs. The latter also had more parasites disseminating to various tissues sites than their euthymic counterparts. The reduced capacity of TXB guinea-pigs to respond to mycobacterial products, and to generate anti-Toxoplasma immunity can be restored by an intravenous infusion of normal syngeneic thymocytes. These findings provide substantial direct evidence strengthening the concept that protection against toxoplasmosis is heavily dependent upon an intact T-cell component of the host's immune response. PMID- 3554119 TI - Generation of reactive oxygen species in whole blood from patients with acute falciparum malaria. PMID- 3554120 TI - Chlamydia trachomatis infection of the female genital tract. Pathogenetic and clinicopathologic correlations. AB - Further studies are needed to define the clinicopathologic manifestations of CT infection. Many questions remain regarding the natural history and pathogenetic mechanisms of CT and its biologic and clinical interactions with other prevalent STDs. However, it is apparent that CT is a major cause of STD in the Western world and that its incidence and prevalence have increased to epidemic proportions in young, sexually active women and men. As with other STDs, epidemiologic control of CT infection is of paramount importance. The clinician and pathologist should develop a heightened awareness of the probability of Chlamydia infection in all patients at risk for STD, and in clinical settings, only a high index of suspicion will result in timely therapeutic intervention. Although more simplified and less expensive diagnostic procedures for CT are being investigated, presently, culture isolation is the best and most accurate diagnostic method for CT genital infection and its use should be popularized and made more easily available. Immunofluorescent staining using monoclonal and heterologous antibodies to extracellular CT elementary bodies in preselected smears appears promising as a diagnostic technique and requires further study. There is no apparent role for the use of routine cyto- and histologic microscopy in the diagnosis of CT infection and the practice of diagnosing presumed chlamydial vacuoles or inclusions from cervicovaginal Pap smears should be actively discouraged. Although CT cervicitis plays a dominant role in the pathogenesis and dissemination of CT infections, it should be remembered that multiple sites of genital involvement occur commonly with CT infection and this multifocality should be considered when CT cervical cultures are negative and in post-treatment follow-up. Cultures should be obtained from sites of suspected involvement and should include scrapings or biopsy sampling of the tissue surface to insure the presence of sufficient numbers of epithelial cells. Local secretions or exudate should not be considered adequate. In the female, sampling of the urethra, rectum, and endometrium may facilitate accurate diagnosis. Scraping or sampling of the tubal epithelium by biopsy may provide diagnostic material in acute salpingitis and PID and should be considered if laparoscopy or laparotomy are performed. Routine screening by culture for CT cervicitis has been suggested in high-risk clinical groups and in antepartum patients for prophylaxis of fetal and neonatal disease and requires serious consideration because of the high prevalence of CT infection.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3554121 TI - Primary malignant non-Hodgkin's lymphoma of the central nervous system. PMID- 3554122 TI - Comprehensive bone marrow diagnosis on a single aspiration sample. Plastic sections and cell suspensions for enzyme and immunohisto- and cytochemistry. PMID- 3554124 TI - Recognition and management of IgG subclass deficiencies. PMID- 3554123 TI - A group B streptococcal extract reduces neutrophil counts and induces neutrophil aggregation. AB - The possibility that group B streptococci (GBS) may induce neonatal neutropenia by promoting neutrophil aggregation and the entrapment of aggregates in the lung was studied in vivo and in vitro utilizing a cell free GBS extract [(GBS) trichloroacetic acid (TCA)]. The intravenous infusion of the extract into neonatal lambs induced reductions of circulating white blood cells (0 time, 3.1 X 10(3)/mm3 +/- 0.5 versus 2.2 X 10(3)/mm3 +/- 0.7) 5 min after infusion (p less than 0.01). At necropsy these lambs had prominent accumulation of polymorphonuclear leukocytes in their pulmonary interstitium. Subsequently, neutrophil aggregation was studied by incubating GBS-TCA in human serum or phosphate-buffered saline with subsequent addition to human polymorphonuclear leukocytes in an aggregometer. GBS-TCA incubated in human serum induced prompt polymorphonuclear leukocyte aggregation (mean delta T 12.3% +/- 2.8 in human serum versus delta T 2.5% +/- 2.1 in phosphate-buffered saline, p less than 0.001). Preincubation of GBS-TCA followed by incubation in human serum with human GBS hyperimmune IgG significantly reduced aggregation (GBS-TCA in serum mean delta T 14.9 +/- 2.44 versus 5.42 +/- 1.80, p = 0.002). Cell-free GBS products may induce polymorphonuclear leukocyte aggregation in the presence of whole serum. This phenomenon might contribute to the pulmonary injury experienced by infants with GBS pneumonia and sepsis. PMID- 3554125 TI - Amoxicillin-clavulanate potassium compared with cefaclor for acute otitis media in infants and children. AB - One hundred thirty-three infants and children with documented acute otitis media (OM) were randomized to receive the oral suspension of either amoxicillin clavulanate potassium or cefaclor. Beta-lactamase-producing bacteria were found in 10.9 and 14.5% of subjects treated with amoxicillin-clavulanate potassium and cefaclor, respectively. Subjects were reexamined at 5, 10, 30, 60 and 90 days after the initiation of therapy and whenever signs/symptoms of acute otitis media recurred. All but two children had resolution of otalgia/otorrhea during the initial treatment period. The drug groups were not significantly different in the percentage of evaluable subjects with otitis media with effusion at each scheduled follow-up visit. Recurrence of acute OM/otorrhea [corrected] developed in a similar percentage of subjects in both treatment categories. Both subjects with and those without middle ear effusion at 10 days had approximately a 50% recurrence rate of subsequent middle ear disease. Adverse side effects/complaints, which occurred in significantly more children treated with amoxicillin-clavulanate potassium, were generally mild and primarily gastrointestinal. PMID- 3554127 TI - Role of anaerobic beta-lactamase-producing bacteria in upper respiratory tract infections. AB - Bacteroides sp. (Bacteroides melaninogenicus, Bacteroides oralis and Bacteroides fragilis), peptostreptococci and Fusobacterium sp. are important pathogens in upper respiratory tract infections. A recent increase in numbers of beta lactamase-producing strains of anaerobic Gram-negative bacteria in upper respiratory tract infections has been associated with increased failure rates of penicillins in eradication of these infections. These infections include chronic otitis media, chronic sinusitis and mastoiditis, chronic recurrent tonsillitis and lung abscesses. The indirect pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy but also to protect penicillin-susceptible pathogens from the drug. These direct and indirect virulence characteristics of anaerobic bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections. PMID- 3554126 TI - Chloramphenicol-induced cardiovascular collapse in an anephric patient. PMID- 3554128 TI - Management of infections of the lower respiratory tract in children. AB - Different microorganisms can cause similar clinical patterns of lower respiratory tract disease, and a variety of clinical presentations can be caused by the same organism. Nevertheless by considering such factors as epidemiology, patient age, manifestations of nonrespiratory diseases, state of nutrition and course of illness, the physician can make reasonable assumptions as to the etiology of a child's respiratory infection. On this basis he or she can make a rational choice of initial therapy. The patient's response to treatment, as well as information gained from laboratory and radiographic studies, if available, can be used to change the management plan as necessary. PMID- 3554129 TI - Penicillins and macrolides in the treatment of community-acquired respiratory tract infections. AB - The use of penicillins and macrolides in the management of community-acquired respiratory tract infections is evaluated in relation to such factors as antimicrobial activity, stability, pharmacokinetics and adverse reactions. Attention is directed to the side effects of drugs, e.g. to the clear advantages of 16 (e.g. spiramycin) vs. 14 (e.g. erythromycin)-membered ring macrolides, and examples are drawn to illustrate the tactics of antimicrobial therapy in the management of pneumonias. PMID- 3554130 TI - Synergistic combinations of antimicrobial agents against anaerobic bacteria. AB - Studies evaluating the in vitro and in vivo synergistic potential of combined antimicrobial agents against anaerobic bacteria are reviewed. Most studies evaluated therapy against Bacteroides sp. (mostly Bacteroides fragilis group). The combinations found to be most effective against B. fragilis were between metronidazole and clindamycin, spiramycin or gentamicin and between clindamycin and aminoglycosides. Against Bacteroides melaninogenicus the effective combinations were penicillin or clindamycin plus gentamicin and metronidazole and spiramycin or gentamicin. Occasional synergy was observed against Clostridium sp. and anaerobic cocci with clindamycin and gentamicin. Synergistic combinations have the potential of clinical use in serious anaerobic infections. PMID- 3554131 TI - Safety education in a pediatric primary care setting. AB - Parents of 171 children coming to the Yale-New Haven Hospital Primary Care Center for their 6-month checkup were randomized into an intervention group (n = 85) and a control group (n = 86). Parents in the intervention group received a three-part individualized course in child safety that required active parental participation. Parts 1, 2, and 3 were given at the 6-month, 9-month, and 12-month well-child visits, respectively. Parents in the control group received routine safety education as provided at well-child visits. The educational phase of the study was completed by 129 families, 65 in the intervention group and 64 in the control group. Safety knowledge, number of hazards in the home, and reported accidents were assessed by a "blinded" community health worker approximately 1 month after the 12-month well-child visit. A total of 109 home visits were made, 55 for the intervention group and 54 for the control group. Parental safety knowledge was assessed based upon pictorial hazard recognition. Of 13 possible hazards, the mean number of hazards recognized by the intervention group parents was 9.4 (n = 55) v 8.4 (n = 50) by the control group parents (t = 2.1, P less than .05, two-tailed). A hazard score was determined for each family based on nine possible hazards observed at the home visit. The mean hazard score for the intervention group was 2.4 (n = 55 v 3.0 (n = 54) for the control group (t = 2.4, P less than .02, two-tailed). Parentally reported accidents and accidents reported in hospital records were similar for both groups. Results of this study suggest that age-appropriate safety education that is repetitive and individualized and that requires active parental participation results in an increase in parental knowledge and an improvement in certain safety practices. PMID- 3554132 TI - [Disorders of hemostasis in the nephrotic syndrome in children]. PMID- 3554133 TI - [Cardiovascular diseases in muscular dystrophy with X-linked recessive inheritance]. PMID- 3554134 TI - [Calcification of the hip (circumscribed myositis ossificans of the tendon of the anterior rectus femoris)]. AB - For a young boy, without antecedent, the discovery of a calcification from the upper side of the hip is reported to an injury with extension of the thigh, six months before. The radiologic characteristics of the picture bring to the diagnostic of myositis circumscripta of the anterior muscle, which is confirmed by biopsy. PMID- 3554135 TI - [Implantation in dental practice. Results of a survey]. PMID- 3554136 TI - Nursing educational research: planning to achieve our future. PMID- 3554137 TI - Strategic planning: a rational activity. PMID- 3554138 TI - Strategic educational planning: a giant step into our future. PMID- 3554139 TI - Nursing education's locus of control: where is the future? PMID- 3554140 TI - Analyzing past performance--creating a better future. PMID- 3554141 TI - Educational outcomes: assessment of quality--an annotated bibliography. PMID- 3554142 TI - Isolation, structure and expression of mammalian genes for histidyl-tRNA synthetase. AB - A full length cDNA clone that codes for human histidyl-tRNA synthetase (HRS) and cDNA clones that span the full length transcript of hamster HRS have been isolated. The full length human HRS cDNA was expressed after transfection into Cos 1 cells and a CHO ts mutant defective in the gene for HRS. The complete nucleotide sequence of the hamster and human gene were obtained and extensive homologies were observed in three regions on comparing these sequences between themselves and with the sequence of HRS derived from yeast. These results provide unequivocal evidence that we have indeed cloned the hamster and human gene for HRS. Three overlapping phage recombinants containing the complete hamster chromosomal gene for HRS have also been isolated. The genomic HRS is divided into 13 exons. The precise locations of each of the 5' and 3' exon-intron boundaries were defined by sequencing the appropriate regions of the cloned genomic DNA and aligning them with the sequence of HRS cDNAs. These studies provide the basis for future structural and functional analysis of the gene for HRS. In particular, it will be of interest to examine if different exons of HRS correlate to different domains of the HRS polypeptide. PMID- 3554144 TI - Compilation and comparison of the sequence context around the AUG startcodons in Saccharomyces cerevisiae mRNAs. AB - The nucleotide sequence of the translation initiation regions of 96 Saccharomyces cerevisiae mRNAs was compiled and compared. The entire 5' untranslated sequence of most mRNAs is very rich in A-residues. G-residues are underrepresented in the untranslated region. The AUG startcodon context appeared to be distinctly different from that of animal mRNAs, although an A-residue at -3 also occurs very frequently (81 percent) in yeast mRNAs. The prevailing codon 3' adjacent to the AUG is the UCU serine codon. All these features are more extreme in the highly expressed genes. Fifty percent of all highly expressed genes use the UCU serine codon as second triplet. In this group G-residues are completely absent in the 7 bases preceding the startcodon and an A-residue occurs at position -1 and -3 at a frequency of 89 percent and 100 percent, respectively. The abundance of A residues throughout the leader suggests that unstructured mRNA is required for efficient translation initiation in yeast. The consensus sequence for the AUG context in highly expressed genes can be summarized as follows: (Sequence: see text). PMID- 3554143 TI - Sequence and S1 nuclease mapping of the 5' region of the dihydrofolate reductase thymidylate synthase gene of Leishmania major. AB - The 5' structure of mRNA transcribed from the dihydrofolate reductase-thymidylate synthase (DHFR-TS) gene of the protozoan parasite Leishmania major has been characterized. S1 nuclease mapping identifies a heterogenous 5' structure which is not affected by growth phase or developmental stage. The DNA sequence of the 5' region of the DHFR-TS gene does not reveal homology with other trypanosomatid genes, eukaryotic consensus genetic elements, or the mammalian DHFR promoter element. This latter finding is especially significant as we show that the 5' region of the E. coli DHFR gene exhibits homology to the mammalian DHFR promoter element, despite their greater evolutionary distance. PMID- 3554145 TI - Chromosomal variations in Candida albicans. PMID- 3554146 TI - Compilation of tRNA sequences and sequences of tRNA genes. PMID- 3554147 TI - Health education: a message to housewives. PMID- 3554148 TI - Innovative surgical procedures and stoma care in the future. AB - Innovative surgical procedures require particular attention to the technical, educational, and emotional issues. Patients need thorough education to understand surgical options, complications, and expected outcomes. Because of the new aspect of these procedures, patients and significant others may feel quite isolated from others. Recognizing behaviors which may indicate this problem and seeking opportunities to provide emotional support and role modeling from other patients are most therapeutic. The quest for continence provides the patient with alternatives to be cured of disease and avoid the need for an external appliance and an abdominal stoma. PMID- 3554149 TI - Pressure ulcers: etiology and prevention. AB - Pressure ulcers are a major health care problem that nurses can directly impact by identifying contributing factors and taking measures to determine patients at risk. Prevention of pressure ulcers is based on an understanding of their origin. The purpose of this article is to review the etiology of pressure ulceration and to explore recent advances toward prevention of this clinically significant problem. PMID- 3554150 TI - A clinical trial of the Braden Scale for Predicting Pressure Sore Risk. AB - The purpose of this article was to describe the protocol by which predictive instruments can be tested for validity and to evaluate the usefulness of an instrument for predicting pressure sore risk in an AICU. The Braden Scale for Predicting Pressure Sore Risk was described. Methods for measuring predictive validity and for calculating sensitivity, specificity, and per cent predictive value of positive and negative tests were discussed. Sixty consecutively admitted AICU patients who were pressure sore free were rated for pressure sore risk within 24 to 72 hours after admission. The skin condition of each patient was systematically assessed every 2 days. Twenty-four subjects developed pressure sores during the study period. The critical cut-off point at which the patient could be judged to be at risk for pressure sore formation was a Braden Scale score equal to or less than 16. The sensitivity and specificity of the scale at this score were 83 to 64 per cent, respectively. The per cent predictive value of a positive and negative test were 61 and 85 per cent, respectively. The Braden Scale compared favorably with the Norton Scale in respect to sensitivity. The specificity, or the tendency of a scale to overpredict, was greater for the Norton than for the Braden Scale. The Norton Scale overpredicted by 64 per cent, whereas the Braden Scale overpredicted by 36 per cent. This difference may be important clinically if all patients who were judged to be at risk received additional nursing care or protective devices. A greater number of patients may receive unnecessary and expensive treatments using the Norton Scale. PMID- 3554151 TI - [The concept of automatization in studying and monitoring the course of disease at an outpatient pneumonologic clinic]. PMID- 3554152 TI - Restoration of fractured immature maxillary central incisors using the crown fragments. PMID- 3554153 TI - [Multicenter study on bronchopneumonia treated in a hospital environment in Friuli-Venezia Giulia: 1) Epidemiology]. AB - Results are presented of a vast analysis into Bronchopneumonia (B.P.) conducted in North East Italy as activity of the Regional Section of the Italian Paediatric Society. The survey of the 14 Paediatric Centres in the Friuli Venezia Giulia Region, produced a total of 536 cases of B.P. in the period January-December 1982. Some significant connections between the several epidemiologic parameters investigated, with special interest in length of hospitalization, are commented. Bed occupancy, short vs. long stays, efficient management are discussed having also in consideration specific possible necessities of some local communities. PMID- 3554154 TI - [Multicenter study on bronchopneumonia treated in a hospital environment in Friuli-Venezia Giulia: 2) Antibiotic therapy]. AB - An analysis of a year's admissions for Pneumonia in all the Paediatric Department of the Region Friuli Venezia Giulia is presented. The study was conducted as activity of the Regional Section of the Italian Paediatric Society. The survey of the 14 Paediatric Centres produced a total of 536 cases of Pneumonia in the period January-December 1982 and was focused on antimicrobial therapy adopted pre and after hospitalization. General and specific therapeutic choices are discussed. Drawing the attention on the differences among centres. PMID- 3554155 TI - [Determination of the urinary secretion of beta 2-microglobulin combined with sequential renal scintigraphy using H123 for the early diagnosis of pyelonephritis in children]. AB - The acute pyelonephritis diagnosis in the infancy is often known very late or it is even underestimate that's why the general adopted criteria normally give no a certainty of the exact centre and the real damage entity. For this reason the authors have adopted a diagnostic protocol, which is based on the association of the urinary excretion dosage of beta 2 microglobulin, with sequential renal scan with Hippuran 123. In cases when the urinary beta 2 microglobulin was increasing, we could check a correspondent alteration of scintigraphic secretory phase. All that has permitted, in whale cases, of establishing with precision and at the right time the centre and the renal damage entity. PMID- 3554156 TI - Fluoxetine: a serotonin-specific, second-generation antidepressant. AB - Fluoxetine is a bicyclic antidepressant that is a specific and potent inhibitor of the presynaptic reuptake of serotonin. It has essentially no effect on the reuptake of norepinephrine or other neurotransmitters. Similarly, it has negligible binding affinity for neurotransmitter receptor sites. It is well absorbed after oral administration, with absolute bioavailability in dogs of approximately 72 +/- 27.6%. The mean Tmax is between 4 and 8 hours, and it is approximately 94% protein bound. After a single dose, the elimination half-life is 1-3 days. After long-term administration, the elimination half-life averages 4 days. Its pharmacokinetics appear nonlinear. It is metabolized to an active metabolite norfluoxetine, which is also specific for the inhibition of serotonin reuptake. Norfluoxetine's elimination half-life averaged 7 days after long-term administration. Little is known about potential drug interactions; however, fluoxetine appears to have minimal clinically relevant interactions. Fluoxetine is indicated in the treatment of major depression. Its efficacy is comparable to the tricyclics and it has a similar onset of action. Although doses as high as 80 mg/day have been used, the optimal dosage range appears to be 20-40 mg once daily. Fluoxetine has been used with success in obsessive-compulsive disorder and intention myoclonus, however, its use in these disorders remains investigational. The frequency of side effects is low and dose related; the most common effects are nausea, anxiety, insomnia, anorexia, diarrhea, nervousness, and headache. Eight reports of intentional overdose with fluoxetine alone resulted in no deaths and mild adverse effects. It will be marketed as 20-mg capsules under the brand name of Prozac. Although fluoxetine should be added to formularies, its use should be reserved for treatment of those who do not respond to or do not tolerate tricyclic agents. PMID- 3554157 TI - Carprofen: a new nonsteroidal antiinflammatory drug. Pharmacology, clinical efficacy and adverse effects. AB - Because a patient with arthritis (especially rheumatoid arthritis) may respond to one NSAID but not another, any addition to the ranks of these agents may be of clinical benefit to at least some of the millions of patients afflicted with rheumatoid arthritis, osteoarthritis and related conditions. In terms of potency both as an antiinflammatory and as an analgesic, carprofen appears to be in the middle of the NSAID range--roughly one-fourth as potent as indomethacin, and five times as potent as ibuprofen, milligram for milligram. The two most obvious potential advantages of carprofen are that it seems to have a low profile of major gastrointestinal adverse reactions (it may cause minor complaints similar to those seen with indomethacin, but thus far has caused no documented gastric or duodenal ulcers at 300 mg/d); and that, like naproxen, it offers the convenience of twice-a-day dosing. In clinical experience thus far, the two most bothersome adverse effects seen with carprofen have been a rare but serious photosensitivity reaction and minor, temporary elevations of liver function tests in approximately 14-20% of patients treated (although as yet there have been no reported cases of jaundice or hepatitis). For some patients with rheumatoid arthritis, osteoarthritis or related conditions, particularly for those who cannot tolerate aspirin or indomethacin or who want or need the convenience of twice-a-day dosing, carprofen may represent a useful therapeutic option to the NSAIDs previously available in this country. PMID- 3554158 TI - Molsidomine: alternative approaches to treat myocardial ischemia. AB - The long-acting antianginal drug molsidomine has been shown experimentally to reduce myocardial infarct size when administered prior to or after cardiac insult. This is due to several drug actions. Dilation of postcapillary capacitance vessels diminishes venous return, preload, heart dimensions, and myocardial oxygen consumption. Relaxation of stenosed conductive coronary arteries increases the perfusion of myocardial areas at risk of infarction due to enhanced collateral circulation. Increased regional blood supply nourishes predominantly subendocardial cardiac muscles as a result of reduction of extravascular coronary pressure, and resistance. The stable heart rate and cardiac contractility favor improved heart performance. The inhibition of platelet aggregation in vivo by molsidomine or its active metabolites, SIN-1 and SIN-1A, is linked to the stimulation of prostacyclin synthesis, inhibition of thromboxane release with induction of thrombosis and vasoconstriction, and enhanced concentrations of cyclic guanosine monophosphate. Dilation of coronary arteries after intracoronary administration of SIN-1, with inhibition of platelet aggregation by restrained release of adenosine diphosphate and stabilization of platelet membranes, facilitates the recanalization of stenosed arteries and reduces coronary muscle tone at the site of thrombosis. Activation of the human fibrinolytic system and drug-induced release of a plasminogen activator favor dysaggregatory effects. The drug's inhibiting actions on lipoxygenase products of arachidonate (e.g., 12-hydroperoxy-eicosatetraenoic acid and leukotrienes) may shift prostaglandin catabolism to cyclooxygenase products (e.g., prostacyclin) that protect against the expansion of ischemia and the induction of coronary spasm. Experimentally, the hemodynamic effectiveness of molsidomine can be antagonized by catecholamines (afterload effects) and dihydroergotamine (preload and afterload effects) respectively. Further clinical investigations will clarify the application of these mechanisms for the therapeutic success of the drug in human myocardial infarction. PMID- 3554159 TI - Economical basis of digestive disorders management with special emphasis on endoscopy. PMID- 3554160 TI - [Role of ultrasonography in biopsy studies of the abdominal organs]. PMID- 3554161 TI - [Biological activity of semisynthetic human insulin in healthy persons and in patients with diabetes mellitus]. PMID- 3554162 TI - [Effect of insulin of various degrees of purity on post-insulin lipoatrophy]. PMID- 3554163 TI - [Immunogenicity of MC Lente Novo insulin]. PMID- 3554164 TI - Neurotensin-like immunoreactivity in the pituitary and hypothalamus of bony fishes. AB - Using an antiserum raised against synthetic neurotensin (NT), the distribution of immunoreactivity in the pituitary and hypothalamus has been examined by immunocytochemistry at light and electron microscope level in a number of species of bony fishes. In most species immunoreactive perikarya were found in the preoptic region of the hypothalamus, with fibres throughout the tuberal hypothalamus and neurohypophysis (neural lobe and median eminence). In the neurohypophysis of teleosts NT-like immunoreactivity was seen in a dense band of fibres bordering the ACTH cells of the rostral pars distalis: absorption controls showed that this was due to the presence of an NT(8-13)-like or xenopsin-like sequence, which, according to electron microscopic observations, was contained in small dense cored vesicles. The antiserum also stained the pituitary ACTH cells of some species, apparently due to cross-reaction with the 17-19 sequence of ACTH. These results suggest that an NT-like peptide may have a role in control of the adenohypophysis in fishes. PMID- 3554165 TI - Immunocytochemical localization of neuropeptide Y-like immunoreactivity in adrenergic and non-adrenergic neurons of the rat gastrointestinal tract. AB - The immunocytochemical location of neuropeptide Y (NPY)-like immunoreactivity (LI) within the neuronal structures of the rat gastrointestinal (GI) tract was investigated with the indirect immunofluorescence method. NPY immunoreactive neurons were found throughout all regions of the GI tract with the largest number in the duodenum. NPY immunoreactive perikarya were mainly located in the submucosal ganglia. NPY labeled processes were extensively seen in the submucosal and myenteric plexuses, smooth muscles, muscularis mucosa, mucosa and surrounding blood vessels. Following 6-hydroxydopamine (6-OHDA) treatment, NPY immunoreactive nerve fibers around blood vessels disappeared completely and the reactive fibers in other regions were reduced in number. NPY immunoreactive nerve cell bodies in the ganglionic plexuses, however, were not affected by 6-OHDA treatment. Serial sections of the coeliac ganglion showed that NPY-LI was present in cell bodies which also displayed tyrosine hydroxylase (TH) immunoreactivity. Our results suggest that NPY is abundantly contained in both adrenergic and non-adrenergic neurons of the gut and may play an important role in the regulation of the GI tract. PMID- 3554166 TI - Identification of Gln8-GnRH and His5,Trp7,Tyr8-GnRH in the hypothalamus and extrahypothalamic brain of the ostrich (Struthio camelus). AB - Gonadotropin-releasing hormone (GnRH) molecular forms were studied in extracts of ostrich hypothalamus and extrahypothalamic brain using high performance liquid chromatography, radioimmunoassay with region-specific antisera and assessment of luteinizing hormone (LH)-releasing activity using chicken dispersed pituitary cells. Two molecular forms of GnRH with chromatographic, immunological and biological properties identical to those of Gln8-GnRH and His5,Trp7,Tyr8-GnRH were demonstrated in both the hypothalamic and extrahypothalamic brain extracts. A greater proportion of His5,Trp7,Tyr8-GnRH was present in the hypothalamus than in extrahypothalamic brain. It is likely that these two forms of GnRH are present in all bird species, since the chicken and the ostrich have evolved separately. PMID- 3554167 TI - Substrate specificity of a hypothalamic neurosecretory granule enzyme capable of processing pro-gonadotropin releasing hormone precursor protein. AB - We examined the specificity of a bovine hypothalamic neurosecretory granule enzyme which we discovered and which is capable of processing pro-gonadotropin releasing hormone precursor protein to yield gonadotropin associated peptide and a C-terminal extended form of gonadotropin releasing hormone (Palen et al.). The sequence in the precursor protein that separates the two active peptides is -Gly Gly-Lys-Arg- where the pair of basic residues, -Lys-Arg-, is the anticipated cleavage site. On the basis of Vmax/Km as the measure of substrate specificity, Benzoyl(Bz)-Gly-Gly-Lys-Arg-2-Napthylamide (NA) greater than Bz-Gly-Gly-Arg-Lys-2 NA much greater than Bz-Gly-Gly-Arg-Arg-2-NA approximately equal to Bz-Gly-Gly Lys-Lys-2-NA. Bz-Gly-Gly-Lys(N(epsilon)-acetyl)-Arg-2-NA is a very poor substrate. Our results indicate that the composition and sequence of the pair of basic residues at the primary cleavage site is important for enzyme specificity and that changes in the P1 or P2 residues of a potential substrate may affect both Km and Vmax. Hydrolysis of all substrates occurs at the P1-2-NA bond. We had previously shown that there is no cleavage between the pair of basic residues. With longer peptide substrates, Bz-Gly-Leu-Arg-Pro-Gly-Gly-Lys-Arg-2-NA greater than Bz-Gly-Leu-Arg(NO2)-Pro-Gly-Gly-Lys-Arg-2-NA greater than Bz-Gly-Gly-Lys-Arg 2-NA. Extending the substrate sequence to more closely resemble the amino acid sequence in the precursor protein improves Km 10-fold and Vmax about 5 fold.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3554168 TI - Gastrin releasing peptide (GRP): effects on basal and stimulated insulin and glucagon secretion in the mouse. AB - GRP is a pancreatic neuropeptide and may be of importance for the neural control of insulin and glucagon secretion. In this study, we investigated the effects of GRP on basal and stimulated insulin and glucagon secretion in the mouse. Intravenous injections of GRP at dose levels exceeding 2.12 nmol/kg were found to rapidly increase basal plasma levels of both insulin and glucagon. Furthermore, at a low dose level without effect on basal plasma insulin levels, GRP was found to potentiate the insulin response to both glucose (by 40%; p less than 0.05) and to the cholinergic agonist carbachol (by 57%; p less than 0.01). Also, GRP was at this dose level found to potentiate the glucagon response to carbachol (p less than 0.01). Glucose abolished GRP-induced glucagon secretion. Moreover, methylatropine given at a dose level that totally abolishes carbachol-induced insulin secretion inhibited GRP-induced insulin secretion by 39% (p less than 0.05) and GRP-induced glucagon secretion by 25% (p less than 0.01). L-Propranolol at a dose level that totally abolishes beta-adrenergically-induced insulin secretion inhibited GRP-induced insulin secretion by 52% (p less than 0.01) and GRP-induced glucagon secretion by 15% (p less than 0.05). In summary, we have shown that GRP stimulates basal and potentiates stimulated insulin and glucagon secretion in mice, and that the stimulatory effects of GRP on insulin and glucagon secretion are partially inhibited by muscarinic blockade by methylatropine or by beta-adrenoceptor blockade by propranolol. We conclude that GRP activates potently both insulin and glucagon secretion in the mouse by mechanisms that are partially related to the muscarinic and the beta-adrenergic receptors. PMID- 3554170 TI - Antibodies to the C-terminus of the cholecystokinin precursor: radioimmunoassay and immunohistochemical studies in adult and developing rat gut. AB - Antibodies to the extreme C-terminal pentapeptide of procholecystokinin, YEYPS (in the single letter notation), have been used in radioimmunoassay and immunohistochemistry to characterize the material in rat intestine. There is a single major immunoreactive peptide in intestinal extracts that has the properties of the C-terminal tryptic peptide of the CCK precursor. Similar material has previously been found in rat brain. In immunohistochemistry, a population of cells in rat small intestine is revealed, these also contain C terminal gastrin/CCK activity, but for the most part do not react with gastrin specific antibodies. During postnatal development their numbers increase considerably. We conclude that the C-terminal flanking peptide of proCCK is a useful marker for sites of CCK production. PMID- 3554169 TI - Acetorphan, an enkephalinase inhibitor, decreases gastric secretion in cats. AB - Acetorphan is an inhibitor of "enkephalinase" (EC 3.4.24.11) which has been shown to reduce in vivo and in vitro the degradation of enkephalins and other peptides. The effects of acetorphan on gastric secretion were studied in cats fitted with gastric fistulae and Heidenhain pouches. Acetorphan inhibited by 40-60% the acid secretion from the gastric fistulae after stimulation by submaximal doses of pentagastrin, histamine and 2 deoxy-D-glucose. These inhibitions were reduced or suppressed by naloxone. The meal-stimulated secretion from the fistulae was not changed after acetorphan. Acetorphan slightly and progressively reduced the pentagastrin-stimulated acid output from the Heidenhain pouches, and this effect was naloxone resistant. No change was found in the secretion from Heidenhain pouches under histamine stimulation, while meal-induced secretion of the pouches was increased by acetorphan, and this increase was not prevented by naloxone. Endogenous opioids probably exert an inhibitory regulatory control upon the gastric secretion of cats. In addition, non-opioid factors may be involved in the effect of acetorphan on meal-stimulated secretion. PMID- 3554171 TI - [Splitting of the lateral shift of the frontal horns and septum pellucidum as an indicator of the dynamics of expanding processes in the temporal lobe]. PMID- 3554172 TI - [Advances in radiologic examination after surgical reconstruction of the mandible using bone transplants]. PMID- 3554173 TI - [Value of CT in detecting complications after reparative surgery in aorto-iliac arterial occlusion]. PMID- 3554174 TI - [Biophysical effects of the ultrasonic field on peripheral blood erythrocytes]. PMID- 3554175 TI - [Value of ultrasonic transrectal examination in diagnosing rectal neoplasms]. PMID- 3554176 TI - [Clinical value of ultrasonography of the scrotal and inguinal canal contents in non-neoplastic testicular diseases]. PMID- 3554177 TI - [The planning of teletherapy using computerized tomography]. PMID- 3554178 TI - Arthrography of the temporomandibular joint. Description of the technic and a review of its current status. PMID- 3554179 TI - Major depression and physical illness. Special considerations in diagnosis and biologic treatment. AB - Major depression is a painful and debilitating condition that often occurs in association with severe physical illness. Accurate diagnosis is problematic because sadness is a frequent "normal" reaction to physical illness and because many other symptoms of depression, such as anorexia and fatigue, can also be caused by the physical illnesses themselves. We review the clinical research that helps to clarify these diagnostic issues and present guidelines for the diagnosis and biologic treatment of patients with concomitant major depression and physical illness. PMID- 3554180 TI - Alcoholism and the consultation-liaison psychiatrist. AB - This article hopes to remind the practitioner that alcohol abuse and dependence is the most common of psychiatric disorders, impacts on the general hospital at a variety of levels, repels our referrant-colleagues, and is difficult to diagnose but is eminently treatable. Because both clinicians and their patients are subject to alcohol abuse and dependence, the consultation-liaison psychiatrist is in an ideal position to impact therapeutically on alcoholism at all levels of presentation. Alcoholism is a natural object of a consultation-liaison psychiatrist's time, interest, and energy. PMID- 3554181 TI - Mitral valve prolapse, panic states, and anxiety. A dilemma in perspective. AB - The inter-relationship of mitral valve prolapse and psychiatric symptoms as a model for the approach to illness for psychiatrists is considered. The clinical usefulness of the concept of mitral valve prolapse is discussed and placed in perspective to consultation-liaison psychiatry. The special role of an integrative, multidimensional model of all illness is emphasized. PMID- 3554182 TI - Pain in the neck, face, and head. Role of the consultation-liaison psychiatrist. AB - The special nature of pain in the face, head, and neck is not emphasized in the psychiatric literature on chronic pain. Although chronic pain of all types and locations share many features the psychological and symbolic significance of the head in the development of self-esteem, body image, and interpersonal relationships often confers special characteristics of pain on this area. As psychiatric consultation is not likely to be requested for patients with head, face, and neck pain in the absence of blatant "psychiatric" problems, it behooves the psychiatrist to exercise his liaison functions to enhance patient care in the inpatient setting and to help physicians recognize the utility of early psychiatric assessment on an outpatient basis with patients not yet requiring hospitalization. A collegial relationship with internists, dentists, neurologists, and surgeons facilitates the psychiatrist's role as a "team participant," often more effective in providing brief diagnostic, therapeutic, and management recommendations for patients who are usually not psychologically minded and reluctant to pursue ongoing psychiatric treatment. However, the consultation-liaison psychiatrist can play an important role in expanding his colleagues' awareness of the multiple meanings of pain and the accompanying illness behavior, provide pedagogic help in the interviewing or history-taking process, offer suggestions about psychopharmacologic and other drug treatment, and serve as a resource for appropriate referral to sources of a variety of chronic pain treatments, including biofeedback, acupuncture, and family consultation. To fulfill both his consultative and liaison functions, it is incumbent upon the psychiatrist to be knowledgeable as well about nonpsychiatric aspects of pain of the head, face, and neck. We must acknowledge also how much we yet do not know: for example, why the psyche "chooses" a locus of pain in the body; how an external (or internal) stimulus is converted via cognitive, neuroendocrine, enzymatic, and other pathways to a somatic representation; the biochemistry of pain reduction by naturally occurring and synthetic drugs; and what characteristics distinguish the continuously creative individual who sustains persistent pain with barely an utterance from another who may "cave in" to seemingly trivial distress that results in total invalidism. PMID- 3554183 TI - Psychiatric aspects of head and neck cancer surgery. AB - Psychiatric problems of patients with head and neck cancer include reactions to disfiguring illness and treatment; adjustment to alterations of speech, eating, and other functions, including sex; changes in body image; alcohol and tobacco addiction; pain; organic brain syndromes; and dealing with terminal illness. Although speech is often compromised, head and neck patients can communicate and psychiatric work is possible. The consultation-liaison psychiatrist can provide considerable assistance by utilizing psychodynamic, behavioral, and pharmacologic modes of treatment and by working with family members and staff. PMID- 3554184 TI - The influence of insulin on 5-methoxytryptamine-induced wet dog shake behavior in rats. AB - The administration of insulin intraperitoneally (2 U/kg) and intracerebroventricularly (4 U per rat) caused an increased wet dog shake response to 5-methoxytryptamine, suggesting an increase in reactivity of central serotonergic structures. Glucose, in doses which prevented hypoglycemia virtually did not change the effect of insulin. PMID- 3554185 TI - 20 years of the Polish Pharmacological Society (1965-1985). PMID- 3554186 TI - Symptomatic relief following carpal tunnel decompression with normal electroneuromyographic studies. AB - Carpal tunnel syndrome is a frequently encountered clinical entity. A retrospective study of a selected patient population revealed 12% of patients to have normal electrodiagnostic studies. Operative release of the transverse carpal ligament in these patients alleviated median nerve entrapment symptoms. Entrapment neuropathy of the median nerve remains a clinical diagnosis, and absolute reliance on electrodiagnostic studies is unwarranted when making a decision to surgically treat a patient with a suspected carpal tunnel syndrome. PMID- 3554187 TI - A technique for studying the kinematics of human joints. Part I: Theory. AB - A novel analytical method that allows iterative synthesis and analysis of the structure and physiology of human joints from a kinematic viewpoint is presented. The technique may be used for both anatomical and physiological joints. The joints are modeled as contacting rigid bodies connected by muscles and ligaments. The muscles and ligaments are regarded as flexible connections, either connecting the articulating bones or acting across the joints. A taut ligament or muscle is converted to a constraining force on the moving bone and used with the geometry of the bone in determining the degrees of freedom of the joint. The method uses a unique approach of measuring coordinates of points from a coordinate system local to each bone to avoid compounding errors. It is shown how these could then be used with the measured or estimated maximum lengths of the flexible connections to predict such kinematic joint properties as type, mobility, and range of motion in an iterative manner. PMID- 3554188 TI - The composite bridge. PMID- 3554189 TI - [Jakub Karol Parnas: his life and work]. PMID- 3554190 TI - [Prof. Jakub Karol Parnas: reminiscences by Wanda Mejbaum]. PMID- 3554191 TI - [Molecular and colloidal aspects of the micellar structure of casein]. PMID- 3554192 TI - [Effect of the modification of haptoglobin structure on its biologic properties]. PMID- 3554193 TI - [Biologically active peptides of the gastrointestinal tract and pancreas]. PMID- 3554194 TI - [The 1985 Nobel Prize for achievements in the fields of physiology or medicine]. PMID- 3554195 TI - [Thymidylate biosynthesis: its biological role and regulation in animal cells]. PMID- 3554196 TI - [Gene fusion in studies on gene expression regulation and protein analysis. Use of lac fusion]. PMID- 3554197 TI - [Thermostable enzymes in food technology]. PMID- 3554198 TI - Immunotherapy in type I diabetes. Approaches to prevention and treatment. AB - Considerable advances in the understanding of the immune basis of type I diabetes have encouraged trials of a number of forms of immunotherapy. Preliminary evidence indicates that cyclosporin (Sandimmune) treatment can halt beta cell destruction in about 50% of patients with newly diagnosed type I diabetes. Further studies are necessary to define the toxicity of this and other protocols prior to clinical use. Efforts to define the target antigen in type I diabetes may lead to development of more specific forms of immunotherapy or, possibly, a vaccine. PMID- 3554199 TI - Insulin-dependent diabetes mellitus. Flexibility in contemporary management. AB - Management of insulin-dependent (type I) diabetes mellitus has vastly changed over the past decade. New tools and updated philosophies have permitted the development of an approach known as intensive therapy, which emphasizes patient self-direction under the guidance of a physician. Current insulin regimens have multiple components and consist of several daily injections or the use of an insulin pump. Diets are flexible and individually tailored to the patient's needs. Self-monitoring of blood glucose, an integral component of management, guides decision making in an attempt to achieve defined blood glucose values. With this approach, many patients who have been educated and motivated in diabetes management attain meticulous control. PMID- 3554200 TI - Non-insulin-dependent diabetes mellitus. Current status of oral hypoglycemic therapy. AB - Proper treatment of non-insulin-dependent (type II) diabetes presents the physician with a number of choices. Diet and exercise should be tried first in many patients; if this regimen is unsuccessful, treatment with either insulin or a first- or second-generation sulfonylurea must be considered. Theoretically, second-generation agents are more advantageous than first-generation agents because they do not interact with other drugs. I do not believe that they are more efficacious, however, and they probably do not have fewer side effects if chlorpropamide (Diabinese) is eliminated from consideration. Future well-designed crossover studies may help to clarify this issue. Combined insulin and sulfonylurea therapy can be tried in obese patients resistant to large doses of insulin, although results are not dramatic. In all patients the goal is to reach acceptable fasting glucose levels and near-normal glycosylated hemoglobin values. PMID- 3554201 TI - The neck mass. 2. Inflammatory and neoplastic causes. AB - Several inflammatory processes can cause nodules or swelling in the neck. A complete physical examination and, usually, laboratory testing are required to establish the diagnosis. Common infections include cervical lymphadenitis and tuberculous lymphadenitis, cat-scratch disease, infection in the neck spaces, infectious mononucleosis, and syphilis. Primary or metastatic cancer may also be the cause. Cervical metastasis often presents as a neck mass. Although a primary tumor may not be found immediately when a neck mass is being evaluated, one is often discovered later. Other types of malignancy that may be present are histiocytic lymphoma, Hodgkin's disease, rhabdomyosarcoma, thyroid cancer, and a salivary (most often parotid) gland tumor. Symptomatic treatment is sometimes adequate for infectious disease, but administration of antituberculous drugs or antibiotics may also be necessary. Incision and drainage are required for some nodes and abscesses. For neck masses caused by neoplasms, fine-needle aspiration cytology or biopsy is performed. Depending on the diagnosis, treatment consists of dissection, radiation therapy, and/or chemotherapy. PMID- 3554202 TI - Diuretic-induced hypokalemia. The debate over its relationship to cardiac arrhythmias. PMID- 3554203 TI - Methods for detecting and enumerating Campylobacter jejuni and Campylobacter coli in poultry. AB - Methods, media, and biochemical tests for detecting, enumerating, isolating, and identifying Campylobacter jejuni and C. coli in foods are summarized with special consideration of poultry and poultry products. Information is drawn largely from the American Public Health Association Compendium of Methods for the Microbiological Examination of Foods and the US Food and Drug Administration Bacteriological Analytical Manual for Foods. Reference is also made to recently advanced techniques and procedures. PMID- 3554204 TI - Relative importance of dietary aflatoxin and feed restriction on reproductive changes associated with aflatoxicosis in the maturing White Leghorn male. AB - A study was conducted to investigate the relative contribution of dietary aflatoxin and feed restriction on reproductive and endocrine changes associated with aflatoxicosis. Pair-feeding was used to factor out nutritional and toxicological effects of aflatoxin on reproduction in the maturing White Leghorn male. Birds were randomly assigned to treatment groups at 9 weeks and fed experimental diets for 3 weeks. Experiment 1 involved the partitioning of toxicological and nutritional effects of aflatoxin on both physiological and reproductive parameters. Aflatoxin-fed males had significantly greater relative liver weights and liver lipid content than control or pair-fed males; no differences in testicular weights were found among treatments. Plasma testosterone levels in controls were significantly higher than in pair-fed birds; aflatoxin-treated males exhibited the lowest concentrations. Pituitary and testicular responsiveness to synthetic luteinizing hormone-releasing hormone (LHRH) were monitored in Experiment 2. Plasma luteinizing hormone (LH) levels in aflatoxin-fed males were significantly higher than in control or pair-fed males prior to LHRH administration. Additionally, the LH response of pair-fed birds to exogenous LHRH was qualitatively different from that observed in the other two treatments; this indicates that hormonal changes observed during aflatoxicosis and feed restriction are a result of different physiological mechanisms. Plasma testosterone also increased after LHRH injection. This response was significantly greater in controls than in pair-fed males, and nonexistent in aflatoxin-treated birds.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3554205 TI - The importance of androgen metabolism in the regulation of reproductive behavior in the avian male. PMID- 3554206 TI - Hormones and husbandry: control of nesting behavior in poultry production. AB - Nesting behavior in laying hens is controlled by an interaction of internal and external factors. Initiation of nesting is under hormonal control, but the exact timing, location, and form of the behavior are all affected by husbandry practices. These have important effects on the economics of poultry production. Nesting behavior is triggered by ovulation. Estrogen and progesterone released from the post ovulatory follicle result in the initiation of nest site selection and nest building about 24 hr later. Oviposition then occurs, although it may be delayed by factors such as feeding or disturbance. Selection of nest site is important in deep litter systems, where eggs must be laid in nest boxes for efficient collection. Both the ability of hens to reach nest boxes, and their preference for boxes rather than the floor, are affected by husbandry. Genetic selection, rearing conditions, and design of houses and nest boxes all influence this behavior in different ways. In some circumstances hens show intensive activity before laying. This is particularly common when light hybrids are housed in battery cages: apparently cages do not provide adequate stimuli for sitting and nest building in these birds. This activity is wasteful of energy and may indicate reduced welfare. The problem may be reduced by modification of the environment or selection of stock. PMID- 3554207 TI - Circadian and interval timing mechanisms in the ovulatory cycle of the hen. PMID- 3554208 TI - Biochemical and functional evidence for nerve sprouting in the decentralized, hypertrophied rat urinary bladder. AB - The preganglionic nerves of the rat urinary bladder were cut. The decentralized bladders gained markedly in weight. Both one and four weeks post-operatively, transmural nerve stimulation evoked contractile responses of the muscle strips of the decentralized bladders, that were of the same magnitude as those of the control bladders. However, four weeks post-operatively, the atropine resistant fraction of the response was decreased; consequently, the atropine sensitive (cholinergic) fraction was increased. The activity of the acetylcholine synthesizing enzyme, choline acetyltransferase, was increased at the late time of observation. The present biochemical and functional findings may suggest outgrowth of branches from the decentralized post-ganglionic cholinergic nerves. PMID- 3554209 TI - Kinetic models for insulin disappearance from plasma in type I diabetic patients. AB - We have tested whether our previous finding in normal subjects that the disappearance of insulin from plasma obeys saturation kinetics alone also applies to type I diabetic patients. In six long-term diabetic patients steady state plasma insulin concentrations resulting from constant insulin infusion at different rates were compared with the predictions of three models for the kinetics of insulin in plasma. The models allowed the existence of non-saturable (first order equation) or saturable (Michaelis-Menten equation) mechanisms, or both. The minimal acceptable model included saturation kinetics alone in four subjects and first order kinetics alone in two subjects. The clearance of insulin in diabetic patients, calculated from the best fitting model, was 18.0 (median, range 10.0-23.7) ml X kg-1 X min.-1 versus 25.0 (18.6-47.1) ml X kg-1 X min.-1 in six normal subjects (2p = 0.008). Insulin thus disappears from plasma at a lower rate in diabetic patients than in normal subjects at physiological plasma concentrations. PMID- 3554210 TI - Prenatal diagnosis and obstetrical management of multicystic dysplastic kidney disease. AB - Multicystic dysplastic kidney disease (MDKD) is one of the most common congenital renal anomalies. We report 16 consecutive cases of MDKD recognized in the antenatal period by sonography. Diagnosis is usually easy as MDKD has in the vast majority of cases a striking ultrasound appearance including enlargement of the kidney and multiple renal cysts. However, differentiation from obstructive uropathy may be difficult, and we made a total of five erroneous diagnoses. Unilateral MDKD has almost invariably a good prognosis. However, severe life threatening associated anomalies were found in six cases. Therefore, a detailed survey of fetal anatomy and determination of karyotype are strongly recommended. PMID- 3554211 TI - Second trimester prenatal diagnosis of the Jarcho-Levin syndrome. AB - The Jarcho-Levin syndrome (spondylothoracic dysostosis) is a rare autosomal recessive disorder characterized by a short neck, short trunk and a constricted thorax due to multiple rib and vertebral defects; other visceral malformations are occasionally present. Most cases die in infancy due to respiratory failure. In this report we describe two cases in one family from the United Kingdom. Prenatal diagnosis by ultrasound examination during the second trimester was successfully accomplished in the second case. PMID- 3554212 TI - [Nephelometric parameters of plasmolytic reactions in Escherichia coli K-12]. AB - Nephelometric parameters of plasmolysis in Escherichia coli K-12 are presented. The relationship between these parameters and intracellular osmotic pressure, barrier properties of the cytoplasmic membranes and transport of inorganic ions was investigated in the present work. The nephelometric parameters can be used for quantitative estimation of the physiological state of the bacteria. PMID- 3554213 TI - [Effectiveness of chemotherapy in patients with newly detected pulmonary tuberculosis and its recurrence]. PMID- 3554214 TI - [Activity of proteolytic enzymes and their inhibitors in the sputum of patients with pulmonary tuberculosis]. PMID- 3554215 TI - The influence of magnesium ion and ascorbic acid on the erythrocytic schizogony of Plasmodium vivax. AB - Asexual erythrocytic stages of Plasmodium vivax have been cultivated for one schizogonic cycle to investigate parasite requirements for metal ions and vitamins. Waymouth and RPMI 1640 (GIBCO) media were used in varying proportions resulting in varying concentrations of organic salts, vitamins, and growth factors. A 1:3 mixture gave the highest percentage (62.6%) of parasite development from the amoeboid forms to mature segmenters after 44 h of cultivation in a candle jar atmosphere at 38.5 degrees C. Nevertheless, the total parasite count was significantly higher (P less than 0.50) in the mixture which had a Waymouth: RPMI ratio of 1:2. Differentiation of schizonts to merozoites as well as parasite counts could be further enhanced by the addition of magnesium chloride to a final concentration of 1.8 mM magnesium ions. The minimal requirement for ascorbic acid which was studied in Science Mahidol (SCMI 612) medium appeared to vary among isolates. For example, all parasite population of four isolates tested declined proportionally with the decrease in concentration of ascorbic acid, the critical point being 3 micrograms/ml medium. However, two isolates used in this study could no longer differentiate to segmenters when the ascorbic acid concentration of the medium was less than 6 micrograms/ml. PMID- 3554216 TI - Characterization of a 19,000 mol. wt. flagellum-specific protein of Trypanosoma cruzi, T. dionisii and T. vespertilionis by a monoclonal antibody. AB - The flagellum-specific monoclonal antibody VESP 9.1 raised against Trypanosoma vespertilionis reacts with a single protein band of 19,000 mol. wt.. This antigen is present on the flagellum of T. cruzi, T. dionisii and T. vespertilionis as well on the epimastigote and the metacyclic trypomastigote developmental stage. A comparative study using indirect immunofluorescence with 15 different trypanosomatids confirmed the specific reactions. PMID- 3554217 TI - Improvement in glucose tolerance of diabetic dogs after implantation of neonatal pancreatic fragments. AB - Minced neonatal pancreatic tissue from 3-6 canine littermates was placed in the peritoneal cavity of five alloxan diabetic dogs without separation of endocrine and exocrine tissue. Fasting blood glucose levels declined from a preimplant level of 211 +/- 57 mg/dl to 111 +/- 6 mg/dl. The maximum blood glucose following a glucose challenge declined from 387 +/- 26 mg/dl to 175 +/- 37 mg/dl. These levels were slightly higher than the 92 +/- 6 mg/dl fasting and 140 +/- 34 mg/dl maximum obtained in control dogs. Insulin levels before implant ranged from 6 to 11 microU/ml and showed no response to a glucose challenge. Insulin responses to a glucose challenge after implant were variable. Three of the dogs showed some hyperinsulinemia without hypoglycemia. Another dog showed a delayed insulin response of normal magnitude. Improvement in glucose tolerance lasted for 2-6 weeks. These results indicate that neonatal tissue can survive and function within the peritoneal cavity. It was not necessary to obtain isolated islets to achieve hormone secretion. However, additional purification may be needed to decrease the side effects of acinar enzymes. PMID- 3554218 TI - Classification of pancreatitis: state-of-the-art, 1986. AB - In 1983 and 1984 two international interdisciplinary groups convened for the purpose of improving the existing 1963 Marseille Classification of pancreatitis. In this article, the new classifications of pancreatitis resulting from these conferences are examined from the perspective of earlier efforts which preceded the Conference and a recent analysis of the usefulness, similarities, and differences between the two classifications by an International group of surgeons and gastroenterologists. PMID- 3554219 TI - Pancreatic mass due to Strongyloides stercoralis infection: an unusual manifestation. AB - A 30-year-old man returning from a trip through India complained of epigastric pain, diarrhea, loss of weight, and jaundice. Stool examination was positive for Strongyloides stercoralis. On ultrasonographic investigation, intravenous cholangiography, and endoscopic retrograde cholangiopancreaticography, stenosis of the distal common bile duct and enlargement of the pancreatic head were observed. The patient was treated for the Strongyloides infection. The jaundice disappeared within days, the laboratory finding normalized, and the patient recovered rapidly. However, the ultrasonographic examination showed a complete recovery in the course of about 2 years. From this report we conclude that in patients with obstructive jaundice and Strongyloides stercoralis infection, serious abnormalities resembling pancreatic tumour or pancreatitis can be found on ultrasonographic and radiological investigations, and this should be considered in the differential diagnosis of pancreatic mass in patients living in or returning from endemic areas. PMID- 3554220 TI - Redistribution of clathrin heavy and light chains in anoxic pancreatic acinar cells. AB - In the present study, antibodies directed against clathrin light (33 kDa-36 kDa) and heavy (180 kDa) chains were used to confirm, by immunocytochemistry, that coated vesicles increase in number in the exocrine cells of pancreatic lobules incubated under anoxic (N2) conditions. The same antibodies were used to check whether or not the fibrillar aggregates, which appear under the same conditions on the cis side of the Golgi stacks of these cells, contain clathrins. By immunofluorescence, clathrin light chains were localized among zymogen granules and in small masses at the periphery of the Golgi complex in acinar cells incubated under N2. By electron microscopy, antibodies for light and heavy chains reacted with numerous coated vesicles located in clusters on the trans side of the Golgi stacks, scattered individually or in small clusters among zymogen granules throughout the apical region of the cell, and associated with both the apical and basolateral plasmalemma of the exocrine cells incubated under N2. The fibrillar aggregates cis to the Golgi complex stained less intensely and much less uniformly than the coats of the coated vesicle population. These findings suggest that the fibrillar aggregates which characteristically appear on the cis side of the Golgi stacks under anoxic conditions contain only small amounts of focally distributed clathrins. Their main components are probably other proteins whose relationship (if any) to clathrins and other clathrin cage constituents remains to be investigated. The findings also indicate that pancreatic acinar cells redistribute large amounts of clathrin, presumably from preexisting pools, when the transport of secretory and other proteins into the Golgi complex is inhibited. In control cells (incubated under O2-CO2), clathrin antigens had the same structural associations as in anoxic cells but the reactive sites were considerably less numerous and the reaction less intense. PMID- 3554221 TI - Insulin response in obese and nonobese offspring of conjugal Indian diabetic parents with increasing glucose intolerance. AB - Pancreatic beta cell function in response to glucose was assessed in three different groups of offspring of conjugal diabetic parents (OCDP): those with normal glucose tolerance, those with impaired glucose tolerance (IGT), and those with diabetes. Serum immunoreactive insulin (IRI), C-peptide (CP), insulin/glucose (I/G) ratio, and IRI/CP ratios were estimated at fasting and 90 min after glucose load. Insulin secretion, measured as CP, was found to be low even in normal nonobese OCDP, but the change was not reflected in IRI value as the IRI/CP ratio was found to be elevated. The values decreased with increasing glucose intolerance. In obese OCDP, all the parameters were abnormal even among those with normal glucose tolerance, and further deterioration occurred with increasing glucose intolerance. The study shows that insulin secretory defects are detectable even in normal OCDP, and these changes deteriorate with increasing glucose intolerance. Differences are noted in the peripheral concentrations of IRI and CP between obese and nonobese OCDP before development of diabetes. After development of diabetes mellitus, these differences disappear, and the CP and IRI values in both groups are similar and low. PMID- 3554222 TI - Endocrine and exocrine pancreatic function in treated coeliac disease. AB - Pancreatic function was assessed prospectively in a group of 18 treated adult coeliac patients, most of whom were asymptomatic. The para-aminobenzoic acid (PABA) test indicated exocrine pancreatic insufficiency in three patients, all of whom had persisting gastrointestinal symptoms. Arginine, 5 g intravenously, was used to stimulate pancreatic islet cells; basal and stimulated concentrations of plasma insulin, C-terminal glucagon, N-terminal glucagon, and blood glucose did not differ from asymptomatic nondiabetic control subjects. After gluten withdrawal, coeliac patients who responded clinically had no evidence of significant pancreatic impairment, but consideration of exocrine pancreatic insufficiency is worthwhile in those patients with persisting symptoms. PMID- 3554223 TI - Noninvasive diagnosis of advanced pancreatic cancer by real-time ultrasonography, carcinoembryonic antigen, and carbohydrate antigen 19-9. AB - One-hundred-forty patients with clinical impression of pancreatic cancer were examined prospectively with three noninvasive tests: real-time ultrasonography, determination of serum carcinoembryonic antigen (CEA), and carbohydrate antigen (CA 19-9). Among them, 24 (17.1%) patients were found to have pancreatic cancer. The sensitivity of ultrasonography, CEA, and CA 19-9 was 72.9%, 70.8%, and 83.3%, respectively; the specificity was 94.0%, 77.6%, and 90.5%, respectively, and the diagnostic accuracy was 91.4%, 76.4%, and 89.3%, respectively. The combination of ultrasonography and determination of serum CA 19-9 had better sensitivity (95.8%), comparable specificity (84.5%), and comparable diagnostic accuracy (86.4%) to any individual test alone or any other combination. It was suggested that combined use of real-time ultrasonography and determination of serum CA 19-9 provided excellent noninvasive screening for patients suspected of having pancreatic cancer. PMID- 3554224 TI - The pathophysiology of alcoholic pancreatitis. AB - The causal relationship between alcohol abuse and pancreatitis is undisputed. However, why some alcoholics manifest pancreatitis whereas others do not remains unexplained. Epidemiological data increasingly point toward an adjuvant role for genetic, dietary, and environmental factors. Significant advances have taken place in the last several years in the characterization of the pathophysiology of both experimental and human alcoholic pancreatitis. However, the pathogenesis of alcoholic pancreatitis remains unsettled. Toxic effects of alcohol on pancreatic acinar cells, "plugging" of pancreatic ductules by proteinaceous material, and reflux of bilio-duodenal juice into the pancreatic ducts have been suggested as putative pathogenetic mechanisms. Whereas at the present time only hypotheses can be formulated, it seems likely that the genesis of alcohol-related pancreatitis follows one or several of these proposed mechanisms. Pain in alcoholic pancreatitis is common and yet unexplained. Understanding the mechanism of pain in such patients is the key to our ability to manage it successfully. In this review, I have attempted to summarize and critically analyze our current understanding of these challenging problems. PMID- 3554225 TI - Distribution of extracellular matrix proteins in pancreatic ductal adenocarcinoma and its influence on tumor cell proliferation in vitro. AB - Affinity-purified antibodies to major components of the extracellular matrix (fibronectin and collagen type I) and basal lamina (laminin) were used in indirect immunofluorescence studies on frozen sections of 12 pancreatic ductal adenocarcinoma of the human and on sections of normal and inflamed pancreatic tissue of the same patients. Laminin-specific immunoreactivity was distributed in close correlation to the grade of differentiation of the tumor tissue. Intact basement membranes, also with some structural irregularities were found only in the highest grade of differentiation where tumor cells grew as tubular structures. With progressive dedifferentiation basal laminae were either absent or the laminin-positive material was focally distributed without spatial association with tumor cells. In all cases of pancreatic tumors a remarkable increase in interstitial connective tissue was observed, as demonstrated by antibodies specific for human collagen type I and for human serum fibronectin. Tumor extracts contained high amounts of collagen type I and V but no significant amount of collagen type III as visualized by analytical SDS gel electrophoresis. A similar distribution of collagen types was observed in lymph node and liver metastases, and in tumors xenografted into nude mice. Since previously a close correlation between grading and growth kinetics of primary tumors had been observed, in vitro experiments were performed analyzing the effect of purified extracellular matrix proteins on tumor cell proliferation. In vitro cultivation of two established cell lines of pancreatic carcinoma on collagen type I or on laminin resulted in an arrest of proliferation on laminin substrates, while normal proliferation comparable to growth on regular culture dishes was found using collagen type I and fibronectin as substrates. Fine structural studies demonstrated a higher degree of cell differentiation in the presence of laminin, as compared to collagen type I or fibronectin. PMID- 3554226 TI - The partially diabetic pancreas: a histological study of a new animal model. AB - An animal model in which part of the pancreas was made diabetic due to almost total loss of insulin-secreting B cells, while the remainder of the gland remained normal, is described. In rabbits, a vascular clamp was placed across the junction of the body and tail of the pancreas, thus occluding the circulation to the tail. Alloxan (200 mg/kg) was injected i.v., and 4 min later dextrose (0.5 g/kg) was given by the same route. After a further 2 min the clamp was removed. Thirty-four animals were studied, 17 of which died in the first postoperative week of surgical complications or of alloxan-induced toxicity to the liver and kidneys. The survivors were killed between 4 and 12 weeks after surgery and were not metabolically diabetic. They had a virtually complete absence of B cells but a normal population of A, D, and PP cells in the head and body of the pancreas. The islets in the tail of the pancreas appeared entirely normal. This model appears suitable for studying the effects of locally produced insulin on pancreatic exocrine function in metabolically normal animals. PMID- 3554227 TI - Pancreatic endocrine responses to nutrients and bombesin after segmental pancreas autotransplantation in dogs. AB - The capacity of autotransplanted (ATP) distal pancreas segments with systemic venous and peritoneal exocrine drainage to support physiologic control of plasma glucose levels was tested, and compared with the functions of "simulated autotransplants" (SATP) prepared with similar dissection and peritoneal exocrine drainage, but with hepatic portal venous drainage, in dogs. In ATP in the postabsorptive state, plasma levels of glucose, immunoreactive insulin (IRI) and immunoreactive glucagon (IRG1) were normal. Autotransplants resulted in impaired glucose tolerance after meals with impaired early insulin responses, and the normal brisk rise of IRG1 in the plasma was delayed and reduced through the first 30 min of feeding. In ATP, also, the response to bombesin was abnormal; the normal stimulation of release of both IRI and IRG1 was delayed in both cases. In studies of responses to oral and intravenous glucose in ATP and SATP dogs, similar mild degrees of glucose intolerance were found with both routes of administration; however, whereas in ATP dogs increases of IRI were highly exaggerated with both routes of administration of glucose, in SATP dogs plasma IRI rose from subnormal levels in the postabsorptive state through subnormal increments with both routes of administration. Further studies are necessary to determine the relative importance of denervation and reduction of the mass of the pancreas in these effects, and to assess the significance of the differences in blood insulin levels in the two preparations. PMID- 3554228 TI - Perspectives in the study of neuroses in contemporary psychiatric practice. AB - Although DSM III has removed the category of neurosis, the implied fragmentation of the generic concept has been regretted by some investigators. Since its introduction in 1769, when the term was used to denote conditions which had a hysterical and hypochondriacal character, the technical use of the term has undergone revisions and reinterpretations which at one extreme have been embedded in psychoanalytic theory, and at the other have resulted in the replacement of the single concept by a proliferation of operationally defined syndromes. The present paper discusses some of the nosological problems implicit in recent trends. Whereas depression appears in 10 ICD9 categories does the psychiatric/neurotic dichotomy in relation to depression still have meaning in the absence of the generic term 'neurotic'? The hierarchical principle is widely accepted as a basis for classification, and yet the hierarchically minor syndromes may be a source of major distress. The paper reviews epidemiological studies of prognosis and follow-up of neuroses, and shows a significant excess of mortality, which is both behavioural and organic in origin. One important difficulty with the loss of the generic term is the potential loss of generic research where, for example, evaluation of treatment of panic disorder is considered distinct from other types of anxiety and phobia. The paper argues for the practical and theoretical benefits of retaining an umbrella term such as 'neuroses'. PMID- 3554229 TI - Candidate genes and favoured loci: strategies for molecular genetic research into schizophrenia, manic depression, autism, alcoholism and Alzheimer's disease. AB - It is argued that further research to achieve more detailed diagnostic systems in many psychiatric disorders is unlikely to be productive without taking genetic effects into account. Even when this is done, for example when carrying out segregation analysis to determine a mode of genetic transmission, mental illnesses often pose specific problems that preclude accurate analysis. Because techniques in molecular biology and genetics have made it possible to study gene effects in human disease systematically it should now be possible to specify the genes that are involved. When this has been achieved then a diagnostic system based on genetic causation can develop. This will have the advantage of helping to pinpoint environmental factors more accurately. Specific strategies will need to be adopted to overcome uncertain modes of inheritance, incomplete or non penetrance of disease alleles and disease heterogeneity. Highly speculative hypotheses can be put forward for a locus causing Alzheimer's disease on a portion of the long arm of chromosome 21. For autism it is plausible that there is a disease locus at or near the fragile X site on the X chromosome. A locus for manic depression has been very tentatively mapped using DNA markers to chromosome 11 and in a small proportion of families DNA markers have also shown some evidence for X linkage. Schizophrenia does not seem to be associated with any favoured loci. Candidate genes for schizophrenia include those encoding dopamine, other neurotransmitter receptors or enzymes and various neuropeptides such as enkephalin and beta endorphin. PMID- 3554230 TI - Specific inhibition of Trypanosoma cruzi neuraminidase by the human plasma glycoprotein "cruzin". AB - Plasma of normal human individuals was shown to contain an inhibitor of Trypanosoma cruzi neuraminidase (NAase; acylneuraminyl hydrolase, sialidase, EC 3.2.1.18). The inhibitor has been purified to homogeneity by PEG precipitation, CM Affi-Gel Blue Sepharose chromatography, and gel filtration. The purified preparation inhibits T. cruzi NAase at a concentration as low as 10(-9) M and has no effect at concentrations at least 100 times higher on any of the other NAases tested, including those from influenza virus, the closely related trypanosome Trypanosoma rangeli, and mammalian NAases. The inhibitor is unique in that it prevents T. cruzi desialylation of intact mammalian cells but does not prevent desialylation of soluble glycoconjugates. In addition, the isolated material is effective in inhibiting the T. cruzi NAase whether the enzyme is on the parasite outer membrane or in solution. Molecular characterization indicates that the inhibitor is a glycoprotein with a Mr of 246,000 +/- 20,000 composed of subunits of Mr 28,000 +/- 2000. Its plasma concentration is at least 60 micrograms/ml. The mechanism of action has not been fully elucidated, but it appears to be noncompetitive. Attempts to match the isolated NAase inhibitor with known plasma glycoproteins have not been successful. In view of this and of the specificity of the inhibitor for T. cruzi, we have named the inhibitor "cruzin." This finding suggests a different approach in investigating the role that NAase plays in host parasite interaction. PMID- 3554231 TI - Properties of a genetically engineered G domain of elongation factor Tu. AB - The G domain of elongation factor Tu (EF-Tu), representing the N-terminal half of the factor according to its three-dimensional model traced at high resolution, has been isolated by genetic manipulation of tufA and purified to homogeneity. The G domain, whose primary structure shares homology with the eukaryotic protein p21, is capable of supporting the basic activities of the intact molecule (guanine nucleotide binding in 1:1 molar ratio and GTPase activity). However, it is no longer exposed to the allosteric mechanisms regulating EF-Tu. The G-domain complexes with GTP and GDP display similar K'd values in the microM range, in contrast to EF-Tu that binds GDP much more tightly than GTP. Its GTPase shows the characteristics of a slow turnover reaction (0.1 mmol X sec-1 X mol-1 of G domain), whose rate closely corresponds to the initial hydrolysis rate of EF-Tu X GTP in the absence of effectors and lies in the typical range of GTPase of the p21 protein. Of the EF-Tu ligands only the ribosome displays a clear effect enhancing the G-domain GTPase. Our results suggest that the middle and C-terminal domain play an essential role in regulating the activity of the N-terminal domain of the intact molecule as well as in the interactions of EF-Tu with aminoacylated tRNA, elongation factor Ts, and kirromycin. With the isolation of the G domain of EF-Tu, a model protein has been constructed for studying and comparing common characteristics of the guanine nucleotide-binding proteins. PMID- 3554232 TI - Apparent lack of discrimination in the reading of certain codons in Mycoplasma mycoides. AB - We report a cluster of four tRNA genes from Mycoplasma mycoides as well as the sequence of the alanine, proline, and valine tRNAs and the serine tRNA reading the UCN codons (where N stands for G, A, C, or U). This brings the total number of tRNA genes that we have so far characterized in this organism to 14, 6 of which code for tRNAs that read the codons of family boxes. In each of these latter cases, we found only one gene per family box, and the gene sequence contains a thymidine in the position corresponding to the wobble nucleotide, with the exception of the arginine tRNA gene that has an adenosine in this position. Furthermore, all of the tRNA structures reported here have an unsubstituted uridine in the wobble position. These findings are similar to those reported for mitochondria, especially yeast mitochondria, that contain an arginine tRNA with the anticodon ACG. However, the resemblance is not complete since we have demonstrated the presence of two isoacceptor tRNAs for threonine having uridine and adenosine, respectively, in the wobble position. It is suggested that in the M. mycoides at least some of the family codon boxes are read by only one tRNA each, using an unconventional method without discrimination between the nucleotides in the third codon position. PMID- 3554233 TI - lac repressor blocks in vivo transcription of lac control region DNA. AB - Transcription of the Escherichia coli lac repressor gene (lacI) in vivo produces monocistronic mRNAs with discrete 3' ends in the lac control region, although the DNA sequence of this region does not specify a strong termination signal of the traditional form. Direct analysis of lac transcripts was used to show that the DNA sequence alone does not provide the signal to end the repressor mRNA and to establish that of the proteins with specific binding sites on control region DNA only the lac repressor has a striking effect on the continuity of lacI gene transcription. RNAs with 3' ends in the control region sequence are major mRNA species produced from a repressor-bound template, reflecting as much as a 50-fold increase over their levels in the repressor's absence. Repressor binding to the operator thus has a dual function. In addition to blocking initiation of transcription from the lacZ promoter, repressor serves as a termination factor by setting the length of its own transcript and separating lacI and lacZYA into two distinct transcription units. PMID- 3554234 TI - Expression of p21ras in normal and malignant human tissues: lack of association with proliferation and malignancy. AB - Proteins encoded by cellular ras oncogenes (p21ras) are expressed in a wide variety of malignant tumors, including carcinomas, lymphomas, and neuroectodermal tumors. The function of p21ras in these tumors and the distribution and role of p21ras in corresponding normal tissues are unclear. This immunohistochemical study examined the relationship between p21ras expression and malignant transformation, cellular differentiation, and proliferative activity in vivo. p21ras was found to be widely expressed in normal tissues, but within those tissues expression was often sharply restricted to cells at specific stages of differentiation; terminally differentiated cells generally showed stronger reactivity with antibodies to p21ras than did rapidly proliferating cells. Fetal and adult tissues had corresponding patterns of p21ras expression, and the distribution of p21ras in neoplasms paralleled the pattern in normal tissue from which they were derived. Thus, p21ras seems to play a role in many fully differentiated cell types, and levels of p21ras expression do not correlate with proliferative activity in normal cell or, in contrast to past reports, with the transformed phenotype. PMID- 3554235 TI - Firefly luciferase is targeted to peroxisomes in mammalian cells. AB - Although several enzymes known to reside in peroxisomes have been studied extensively, no cis-acting amino acid sequences involved in the transport of these proteins to peroxisomes have been described. As a first step towards the determination of a putative peroxisomal targeting sequence, we have expressed the cDNA encoding the firefly luciferase [Photinus-luciferin:oxygen 4-oxidoreductase (decarboxylating, ATP-hydrolyzing), EC 1.13.12.7] in monkey kidney cells and found that the product of the gene is transported to peroxisomes. Luciferase is derived from the firefly (Photinus pyralis) and is synthesized and stored in the cells of the firefly's lantern organ, where it is also found in peroxisomes. The fact that this protein is similarly targeted in cells from such different organisms suggests that the process of protein transport to peroxisomes has been highly conserved through evolution. PMID- 3554236 TI - Homology between the DNA-binding domain of the GCN4 regulatory protein of yeast and the carboxyl-terminal region of a protein coded for by the oncogene jun. AB - The product of the recently described oncogene jun shows significant amino acid sequence homology with the GCN4 yeast transcriptional activator protein. The similarity is restricted to the 66 carboxyl-terminal amino acids, thought to be the DNA-binding domain of the GCN4 protein. In these alpha-helix-permissive regions of the jun and GCN4 products there is also a lesser but still significant amino acid resemblance to the fos protein and a marginal degree of similarity to myc proteins. The amino acid sequence homology between GCN4 and jun gene products suggests that the jun protein may bind to DNA in a sequence-specific way and exert a regulatory function. PMID- 3554237 TI - A family of short, interspersed repeats is associated with tandemly repetitive DNA in the human genome. AB - A family of short, interspersed repeats in the human genome, designated the Mst II family, is described. The canonical structure of the repeat consists of a 220 base-pair (bp) left arm joined to a 160-bp right arm by a 39-bp junction sequence. The right arm is absent in some isolates. Some homology with the "O" and "THE" (transposon-like element) families of repeats was observed, suggesting that the Mst II elements could be a subgroup of a SINE superfamily. The 39-bp junction sequence is tandemly repeated in one of our clones. The association of tandemly repetitive sequences with Mst II elements or the putative superfamily is probably nonrandom; a search of DNA sequence data bases revealed that approximately 80 bp of the Mst II left arm occurs immediately adjacent to the tandem repeat that comprises the human homologue to the BK virus enhancer. The fortuitous occurrence of a gene duplication event involving an Mst II repeat has allowed us to estimate a mutation rate for human DNA. PMID- 3554238 TI - Comparative anatomy of the human APRT gene and enzyme: nucleotide sequence divergence and conservation of a nonrandom CpG dinucleotide arrangement. AB - The functional human adenine phosphoribosyltransferase (APRT) gene is less than 2.6 kilobases in length and contains five exons. The amino acid sequences of APRTs have been highly conserved throughout evolution. The human enzyme is 82%, 90%, and 40% identical to the mouse, hamster, and Escherichia coli enzymes, respectively. The promoter region of the human APRT gene, like that of several other "housekeeping" genes, lacks "TATA" and "CCAAT" boxes but contains five GC boxes that are potential binding sites for the Sp1 transcription factor. The distal three, however, are dispensable for gene expression. Comparison between human and mouse APRT gene nucleotide sequences reveals a high degree of homology within protein coding regions but an absence of significant homology in 5' flanking, 3' untranslated, and intron sequences, except for similarly positioned GC boxes in the promoter region and a 26-base-pair region in intron 3. This 26 base-pair sequence is 92% identical with a similarly positioned sequence in the mouse gene and is also found in intron 3 of the hamster gene, suggesting that its retention may be a consequence of stringent selection. The positions of all introns have been precisely retained in the human and both rodent genes, as has an unusual AG/GC donor splice site in intron 2. Particularly striking is the distribution of CpG dinucleotides within human and rodent APRT genes. Although the nucleotide sequences of intron 1 and the 5' flanking regions of human and mouse APRT genes have no substantial homology, they have a frequency of CpG dinucleotides that is much higher than expected and nonrandom considering the G + C content of the gene. Retention of an elevated CpG dinucleotide content, despite loss of sequence homology, suggests that there may be selection for CpG dinucleotides in these regions and that their maintenance may be important for APRT gene function. PMID- 3554239 TI - Sequence analysis of spontaneous mutations in a shuttle vector gene integrated into mammalian chromosomal DNA. AB - We have studied the molecular mechanisms of spontaneous mutations in mouse cells carrying a selectable bacterial gene. The mouse cells carry the Escherichia coli xanthine (guanine) phosphoribosyltransferase (gpt) gene in a retroviral shuttle vector integrated into chromosomal DNA in a proviral form. Cells with spontaneous mutations in the gpt gene were selected as resistant to 6-thioguanine and then were fused with COS cells for recovery of the mutant genes. Out of a total of 77 independent 6-thioguanine-resistant cell lines isolated in this study, vector sequences could be rescued from 43 of the mutant lines, and the base sequences were determined for the gpt genes in all 43 of these lines. There was a variety of mutational events among the mutant gpt genes sequenced. The most frequent mutational event was a deletion (in 29 of the 43 mutant genes), and the next most frequent event was a base substitution mutation (in 11 of the 43 mutant genes). Among the deletion mutants, the great majority represent deletions of less than 10 base pairs. In fact, 19 of the 29 deletion mutants had deletions of 3 base pairs, and among the mutants with 3-base-pair deletions, there was a very strong deletion hot spot appearing in 16 independent mutants. All 19 of the 3-base-pair deletions resulted in the "in frame" loss of an aspartic acid codon. Among the base substitution mutations, transitions and transversions occurred with approximately equal frequency. Our results raise the possibility that small deletions represent the predominant mechanisms by which spontaneous mutations occur in mammalian cells. PMID- 3554240 TI - Development of a monoclonal antibody specifically reactive to gastrointestinal goblet cells. AB - A mouse monoclonal antibody (7E6A5) of IgG isotype, reacting specifically with mucin-producing goblet cells of the human gastrointestinal tract, has been developed. 7E6A5 reacts by an ELISA with colonic protein eluted from a DEAE column. A screening by immunoperoxidase assay of 76 specimens from 19 different human tissues showed that the immunoreactivity of 7E6A5 was confined exclusively in the globules of goblet cells in the colon, the appendix, and the small intestine. Nongoblet small and large intestinal epithelial cells did not react. Immunoelectron microscopy demonstrated the reactivity with mucin droplets in a homogeneous granular pattern inside the globules of goblet cells. Mucus-secreting cells from remaining parts of the gastrointestinal tract and other mucus secreting organs such as respiratory, genitourinary tracts, salivary and mammary glands did not show any reactivity to 7E6A5. These findings indicate that the antigen recognized by 7E6A5 is shared by the goblet cells of both the small and large intestines and is unique to them. The monoclonal antibody may be useful in the study of function of mucus-secreting goblet cells and may represent an important tool in the evaluation of diseases such as ulcerative colitis, colon cancer, and intestinal metaplasia in gastric mucosa that are associated with quantitative changes in goblet cell numbers or with qualitative differences in mucin secretion. PMID- 3554241 TI - Neuropeptide Y-like immunoreactivity in rat cranial parasympathetic neurons: coexistence with vasoactive intestinal peptide and choline acetyltransferase. AB - Neuropeptide Y (NPY) is widely distributed in the sympathetic nervous system, where it is colocalized with norepinephrine. We report here that NPY immunoreactive neurons are also abundant in three cranial parasympathetic ganglia, the otic, sphenopalatine, and ciliary, in the rat. High-performance liquid chromatographic analysis of the immunoreactive material present in the otic ganglion indicates that this material is very similar to porcine NPY and indistinguishable from the NPY-like immunoreactivity present in rat sympathetic neurons. These findings raise the possibility that NPY acts as a neuromodulator in the parasympathetic as well as the sympathetic nervous system. In contrast to what has been observed for sympathetic neurons, NPY-immunoreactive neurons in cranial parasympathetic ganglia do not contain detectable catecholamines or tyrosine hydroxylase (EC 1.14.16.2) immunoreactivity, and many do contain immunoreactivity for vasoactive intestinal peptide and/or choline acetyltransferase (EC 2.3.1.6). These findings suggest that there is no simple rule governing coexpression of NPY with norepinephrine, acetylcholine, or vasoactive intestinal peptide in autonomic neurons. Further, while functional studies have indicated that NPY exerts actions on the peripheral vasculature which are antagonistic to those of acetylcholine and vasoactive intestinal peptide, the present results raise the possibility that these three substances may have complementary effects on other target tissues. PMID- 3554242 TI - Initial localization of the acoustic conditioned stimulus projection system to the cerebellum essential for classical eyelid conditioning. AB - Previous experiments have demonstrated a sufficient and necessary involvement of mossy fibers in projecting conditioned stimulus information to the cerebellum during classical eyelid conditioning in rabbits. Presented here are electrophysiological, anatomical, and lesion data that suggest that cells within the lateral pontine nuclear region may be essentially involved in projecting information concerning the occurrence of acoustic conditioned stimuli to the cerebellum during classical conditioning. PMID- 3554243 TI - Three-dimensional structure of flavocytochrome b2 from baker's yeast at 3.0-A resolution. AB - The structure of flavocytochrome b2 from baker's yeast was solved at 3.0-A resolution by the multiple isomorphous replacement method combined with solvent leveling procedures, using data collected from an area detector. The tetramer of Mr 230,000 has 4-fold symmetry. Each subunit contains a cytochrome domain consisting of the first 100 residues, a flavin-binding domain containing the next 386 residues, and an extended C-terminal tail of 25 residues. The cytochrome domain closely resembles microsomal cytochrome b5, whereas the flavin-binding domain contains a parallel beta 8/alpha 8 barrel motif similar to glycolate oxidase and trimethylamine dehydrogenase. Two of the four cytochrome domains are disordered in the crystals. The flavin ring and heme group are separated by about 16 A between their centers, and their planes are inclined by about 17 degrees to each other. PMID- 3554244 TI - A common positive trans-acting factor binds to enhancer sequences in the promoters of mouse H-2 and beta 2-microglobulin genes. AB - Using gel retardation and in vitro "footprinting", we have analyzed the interactions between nuclear proteins derived from various mouse cells and the enhancer and interferon response sequences of the H-2Kb gene. We have found that a protein factor binds a site in the enhancer sequence that partially overlaps the interferon response sequence. This factor also binds to a similar sequence lying in the opposite orientation in the promoter of the mouse beta 2 microglobulin gene, suggesting a common regulatory mechanism. Transfection competition experiments indicate that this factor acts as a positive element in the expression of H-2 and beta 2-microglobulin genes. PMID- 3554245 TI - Monoclonal antibody to the gastrin receptor on parietal cells recognizes a 78-kDa protein. AB - Four monoclonal antibodies reactive by immunofluorescence and by flow microfluorimetry with canine and porcine gastric parietal cell membranes were produced by fusion of mouse NS-1 myeloma cells with splenocytes from mice immunized with a population of canine gastric mucosal cells containing 60-70% parietal cells. One of these, an IgM antibody designated 2C1, reacted with the surface membranes of parietal cells by immunofluorescence, flow microfluorimetry, and immunogold electron microscopy; competed with 125I-labeled gastrin for binding to gastric cells; and inhibited by 56% maximal gastrin stimulation of [14C]aminopyrine uptake in parietal cells. The antibody immunoprecipitated 125I labeled samples of a 78-kDa gastrin-binding protein purified from membrane extracts of porcine gastrin mucosa but did not recognize the same protein labeled covalently with 125I-labeled gastrin-(2-17)-hexadecapeptide. These observations suggest that the previously identified 78-kDa gastrin-binding protein is the gastrin receptor and that the antibody 2C1 is directed against the gastrin binding site of the gastrin receptor. PMID- 3554246 TI - Induction of superoxide dismutase in Escherichia coli by heat shock. AB - Exposure of midlogarithmic-phase cultures of Escherichia coli B to 48 degrees C for 1 hr elicited an induction of the manganese-containing superoxide dismutase (MnSOD), which became more pronounced during 1 hr of recovery at 37 degrees C. This induction required protein biosynthesis, since it was suppressed by chloramphenicol. Induction of MnSOD appeared to be a response to a heat-mediated increase in O2- production because it was dioxygen-dependent and because heating to 48 degrees C doubled the cyanide-resistant fraction of the total respiration. PMID- 3554247 TI - Intracellular pH is increased after transformation of Chinese hamster embryo fibroblasts. AB - These studies reveal that a series of tumorigenic Chinese hamster embryo fibroblast (CHEF) cell lines maintain an internal pH (pHi) that is 0.12 +/- 0.04 pH unit above that of the nontumorigenic CHEF/18 parental line. This increase of pHi in the tumorigenic CHEF cells is not due to autocrine growth factor production or to the persistent activation of pathways previously shown to modulate Na+/H+-antiporter activity present in the CHEF/18 line. These findings suggest that the defect in pHi regulation in the tumorigenic CHEF/18 derivatives lies in the Na+/H+ antiporter itself. Further studies to determine the biological significance of an increased pHi show that the external pH (pHo)-dependence curve for initiation of DNA synthesis in the tumorigenic CHEF lines is shifted by approximately 0.2 pH unit toward acidic values relative to that of the nontumorigenic CHEF/18 parent. These data show a critical role for pHi in the regulation of DNA synthesis in Chinese hamster embryo fibroblasts and demonstrate that aberrations in pHi can contribute to the acquisition of altered growth properties. PMID- 3554248 TI - Temperature-sensitive mutations in the yeast DNA polymerase I gene. AB - Seven mutations that yield thermolabile DNA polymerases have been isolated in the DNA polymerase I gene, POL1, of Saccharomyces cerevisiae. Strains carrying the mutant genes are temperature sensitive for growth. The pol1 mutants were identified by a method that has general applicability for identification of both temperature-sensitive and null mutations. A plasmid containing a mutagenized pol1 gene was transformed into a strain in which the only functional copy of the POL1 gene was carried on an unstable plasmid. The genes conferring temperature sensitive growth were detected after elimination of the unstable plasmid containing the wild-type gene. DNA polymerase I isolated from each of the mutants is defective at both 23 degrees C and 36 degrees C. DNA synthesis is deficient in vivo at 36 degrees C in all the mutants, while RNA synthesis is normal in all but one of the mutants. The terminal phenotype of pol1 temperature-sensitive mutants is dumbbell-shaped cells in which the nucleus has migrated to, but apparently not entered, the isthmus separating the mother and the daughter. The POL1 gene is located on chromosome XIV approximately 2 centimorgans away from met4. PMID- 3554249 TI - A segment of GCN4 mRNA containing the upstream AUG codons confers translational control upon a heterologous yeast transcript. AB - GCN4 encodes a transcriptional activator in Saccharomyces cerevisiae that is regulated at the translational level. We show that an approximately 240 nucleotide segment from the GCN4 mRNA leader containing four AUG codons is sufficient to confer translational control typical of GCN4 upon a GAL1-lacZ fusion transcript. Regulation of the hybrid transcript is dependent upon multiple positive (GCN) and negative (GCD) trans-acting factors shown to regulate GCN4 expression post-transcriptionally. This result limits the target sequences for these factors to a small internal segment of the GCN4 mRNA leader. The elimination of AUG codons within this segment substantially reduces the usual derepressing effect of mutations in five GCD genes upon GCN4-lacZ expression. This supports the idea that the products of these negative regulatory genes act by modulating the effects of the upstream AUG codons on translation of GCN4 mRNA. PMID- 3554250 TI - Monoclonal antibodies with exclusive reactivity against parathyroid cells and tubule cells of the kidney. AB - Four monoclonal anti-parathyroid antibodies were generated after immunization of mice with intact cells from human parathyroid tissue. All four monoclonal antibodies reacted in immunohistochemistry with structures present on parathyroid epithelial cells and proximal-tubule cells of the kidney but were unreactive with all other human tissues investigated. Immunofluorescence microscopy on suspended human parathyroid cells showed that the antibodies reacted with structures present on the cell surface. Two of these antibodies efficiently blocked the increase in cytoplasmic calcium concentration of parathyroid cells that is normally associated with increased concentrations of extracellular calcium. The results indicate that these two antibodies interfere with a calcium-sensing mechanism of parathyroid cells--i.e., a potential calcium receptor by which extracellular calcium regulates cytoplasmic calcium and hormone release in these cells. PMID- 3554252 TI - Neural control and neurosensory functions of the liver. PMID- 3554251 TI - Merozoite surface coat precursor protein completely protects Aotus monkeys against Plasmodium falciparum malaria. AB - Groups of Aotus (owl) monkeys were immunized with either the Plasmodium falciparum merozoite surface-coat precursor protein and its processing fragments or a complex of high molecular mass rhoptry proteins and challenged with a lethal infection of the homologous P. falciparum Uganda Palo Alto (FUP) strain. No patent parasitemia could be detected on thick blood films of monkeys immunized with the merozoite surface antigens; however, only one of three monkeys immunized with the rhoptry proteins was partially protected, while two required drug therapy. The experiment clearly demonstrates that the merozoite surface-coat precursor protein can completely protect Aotus monkeys against a lethal infection of the human malaria parasite. PMID- 3554253 TI - Control of white and brown adipose tissues by the autonomic nervous system. PMID- 3554254 TI - Free radical problems of the newborn. PMID- 3554255 TI - Insulin interaction with the central nervous system: nature and possible significance. PMID- 3554256 TI - Insulin-like effects in the rat of the purified growth factor from Spirometra mansonoides plerocercoids. AB - The acute effects of injections of the human growth hormone-like factor purified from plerocercoids of the tapeworm Spirometra mansonoides on carbohydrate, lipid, and protein metabolisms were determined in intact rats. Male rats were injected ip with saline, insulin, or various doses of partially purified PGF. The rats injected with insulin had significantly reduced serum glucose concentrations but no dose of PGF caused a change in serum glucose levels. Insulin and PGF stimulated [14C]glucose and [14C]leucine oxidation to 14CO2 in adipose tissue and muscle and increased incorporation of both [14C]glucose carbons into lipids and [14C]leucine into protein in fat and muscle. The responses to PGF were dose dependent and persisted after 3 hr of incubation in vitro. Injections of naloxone prior to injecting PGF to block the stress response did not prevent the stimulation of insulin-like responses by PGF. Therefore, PGF has intrinsic insulin-like activities in normal male rats. PMID- 3554257 TI - Measurement of plasma adenosine concentration: methodological and physiological considerations. AB - This study tested the hypothesis that measurements of plasma adenosine concentration made on samples of blood obtained in dipyridamole and EHNA (i.e., "stopping solution") may be falsely elevated as a result of ongoing in vitro production and accumulation of adenosine during sample processing. Studies were performed with samples of anticoagulated blood obtained from anesthesized domestic swine. Adenosine concentration of ultra filtrated plasma was determined by high-pressure liquid chromatography (HPLC). The following parameters were evaluated: (i) rate of clearance of [3H]adenosine added to plasma, (ii) endogenous adenosine concentration of matched blood samples obtained in "stopping solution" alone, "stopping solution" plus EDTA, and perchloric acid (PCA), (iii) plasma and erythrocyte endogenous adenosine concentration in nonhemolyzed samples, and (iv) plasma adenosine concentration of samples hemolyzed in the presence of "stopping solution" alone or "stopping solution" plus EDTA. We observed that (i) greater than or equal to 95% of [3H]adenosine added to plasma is removed from it by formed elements of the blood in less than 20 s, (ii) plasma adenosine concentration of samples obtained in "stopping solution" alone is generally 10-fold greater than that of matched samples obtained in "stopping solution" plus EDTA, (iii) deliberate mechanical hemolysis of blood samples obtained in "stopping solution" alone resulted in substantial augmentation of plasma adenosine levels in comparison with matched nonhemolyzed specimens- addition of EDTA to "stopping solution" prevented this, and (iv) adenosine content of blood samples obtained in PCA agreed closely with the sum of plasma and erythrocyte adenosine content of samples obtained in "stopping solution" plus EDTA. The data obtained demonstrate that (i) plasma adenosine concentrations are falsely elevated in samples of blood obtained in "stopping solution" alone, and (ii) addition of EDTA to "stopping solution" blocks in vitro production and accumulation of adenosine. Finally, rapid removal of adenosine from plasma by formed elements of blood may make it difficult to employ measurements of plasma adenosine concentration to assess physiological processes even in the absence of in vitro production of the nucleoside. PMID- 3554258 TI - Metallothionein. AB - Early research on metallothionein centered on aspects related to a detoxification role. As our understanding of the complex endocrine control that regulates metallothionein gene expression increases, a wider appreciation of a functional role(s) is emerging. Medical implications of control of metallothionein turnover include diagnosis of specific diseases and regulation of its expression as a host defense component. PMID- 3554259 TI - Bacterial adherence to the upper respiratory tract of ferrets infected with influenza A virus. AB - A ferret model was used to study bacterial adherence in animals with influenza. Ferrets were inoculated intranasally with influenza A3/Hong Kong/1/68 virus. Antiviral serum antibodies were apparent by Day 5. On Days 3, 5, 7, 9, and 11, three virus-inoculated and two uninoculated controls were anesthetized, exsanguinated, and decapitated, and the lower jaw was removed. Each animal was inoculated intranasally with a 1-ml suspension containing 20 mg (dry wt) of either 3H-labeled Staphylococcus aureus or 3H-labeled group B Streptococcus type Ia and incubated for 45 min at ambient temperature. In animals challenged with staphylococci, 80% of the original inoculum remained free in suspension; of the remaining 20%, the distribution in the upper respiratory tracts of virus-infected and control animals was significantly different. Of the staphylococci remaining in the nasopharynx of control animals, 74% was present in mucinous plugs, 11% was bound to host cells present in washes of the nasal cavity, and 15% was released by protease treatment of the nasopharynx. Of the staphylococci remaining in the upper respiratory tract of virus-infected ferrets, 36% was recovered in plugs, 24% was bound to cells in nasal washes, and 40% was released by enzyme treatment. Overall, adherence-positive staphylococci represented 64% of recoverable bacteria in virus-infected ferrets versus 26% in controls. Adherence was increased twofold (Days 5 and 7) to threefold (Days 3, 9, and 11) in virus-infected ferrets compared to uninfected controls. In contrast, only 7% of the original streptococcal inoculum was recovered from virus-infected and uninfected control animals and virus infection did not enhance streptococcal adherence except for an approximately threefold increase that was seen on Day 11. PMID- 3554261 TI - Erythrocyte deformability in canine septic shock and the efficacy of pentoxifylline and a leukotriene antagonist. AB - Decreased microcirculatory flow in the case of endotoxic shock has been extensively reported. The flexibility of the red blood cell plays an important role in tissue perfusion. The present study with a canine shock model was designed to investigate the changes in erythrocyte flow properties during septic shock. Deformabilities of canine erythrocytes were found to decrease considerably 6 hr after infusion of Escherichia coli organisms (P less than 0.05). Pretreatment of dogs with pentoxifylline reduced the effect by improving erythrocyte deformability significantly and by increasing animal survival times. The leukotriene antagonist LY171883 also increased survival time, but did not change red cell filterability. The mortality of the dogs was not affected by either pentoxifylline or the leukotriene antagonist. Both drugs aided the concentration recovery of circulating leukocytes by 6 hr post-E. coli infusion. PMID- 3554260 TI - Functional heterogeneity correlates with structural heterogeneity of breast carcinoma acid-soluble glycoproteins. AB - Patients with malignant tumors, specifically with metastatic breast carcinoma (BCa), are immunosuppressed and have defective lymphocyte responsiveness to antigenic and mitogenic stimulation. The present study examined the role of perchloric acid (PCA)-soluble glycoproteins and their oligosaccharide moieties from tumor cells and from sera of patients with metastatic BCa. Sera from 15 patients and from age-matched healthy adults were examined for immunoregulatory glycoproteins. BCa tissue was obtained from 9 of the 15 patients. The PCA extracts from tumor tissue were resolved into six (GP-I to GP-VI), and from serum into three (GP-II, GP-IV, and GP-V), BCa-associated glycoproteins. After alkaline borohydride treatment, six groups of BCa-associated oligosaccharides were obtained. Peripheral blood mononuclear (MNC) and natural killer (NK) cells were obtained from patients with metastatic BCa and from age-matched healthy adults. These were used as effector cells in the well-established 4-hr cytotoxicity assay. The results indicated that interleukin 2 (IL-2) significantly (P less than 0.001) enhanced the cytotoxic activities of MNC and NK cells from healthy adults, but it had a nonsignificant effect on MNC and NK cells from patients with metastatic BCa. The BCa-associated glycoproteins and their oligosaccharides varied in their effects on MNC and NK cells from both the healthy adults and the patients with metastatic BCa. IL-2 activated MNC cytotoxic activity against BCa cells. GP-I, GP-II, GP-III, and GP-IV inhibited MNC inherent cytotoxicity and blocked MNC stimulation by IL-2, GP-IV fraction had a statistically nonsignificant effect, whereas GP-V enhanced both MNC inherent and IL-2-activated cytotoxic activities. Oligosaccharides obtained from PCA extracts of BCa tissue and by alkaline borohydride treatment differentially bound and inhibited a series of monoclonal antibodies raised against BCa-associated glycoproteins. These results indicated that the oligosaccharide moieties of the BCa-associated glycoproteins modulate recognition of the BCa cells by the effector cells. PMID- 3554262 TI - Workshop on Environmental Toxicity and the Aging Processes. Keynote address. PMID- 3554263 TI - Workshop on Environmental Toxicity and the Aging Processes. Concluding remarks. PMID- 3554264 TI - Interactions of aging and environmental agents: the gerontological perspective. AB - This article attempts to briefly review the current status of knowledge of biogerontology as a basis for a beginning set of discussions on the potential roles of environmental agents in the modulation of rates of aging in man. The article has tried to summarize "what the toxicologist should know about gerontology," whereas a companion review, by Dr. Jerry Williams, summarizes "what the gerontologist should know about toxicity." The review begins by defining some basic terminology, including introduction of the term "gerontogens" for those putative environmental agents that may in fact modulate the times of onset and/or rates of development of specific aspects of the senescent phenotype. That phenotype is then briefly described from the level of populations to the level of molecules, including an organ systems approach with emphasis on what is observed in humans. Among the important points that emerge from this description are: the variety of phenotypic alterations; the multiplicity of phenotypic alterations in any one aged individual; the special vulnerability in humans of the arterial system; the loss of proliferative homeostasis; the decline in the efficiency of enzyme adaptation; the decline in protein synthesis; the increasing evidence of post-translational modifications of proteins and DNA; the evidence for chromosomal instability (and, therefore, the potential importance of environmental clastogens). Arguments for a genetic basis for differential rates of aging are then developed, and a number of "genotropic" theories of aging are tabulated (i.e., those theories that invoke crucial roles for alterations of the genomes of somatic cells, whether changes in gene expression, gene structure, or both). It is concluded that no single theory is supported by a preponderance of evidence. Because aging appears to involve numerous processes and is highly polygenic in its determination, it is likely that a number of different mechanisms are responsible for the phenotypic alterations and that different individuals exhibit various patterns of aging based upon their specific inheritance and environmental experiences. At this early stage in the development of experimental approaches to the study of environmental-genetic interactions in the genesis of different aspects of senescence, the most vital issue involves the question of suitable model systems. Clearly, a number of different model systems will be required. A selection of these is tabulated based upon their amenability to a reasonable degree of genetic definition and genetic manipulation. Only by controlling the genotype can the environmental influences be properly assessed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3554266 TI - [The monopoly of the pharmacist and the delivery of drugs by through physicians in the Berne Canton: an aspect of legal development]. PMID- 3554267 TI - [Importance of methods used for microbiologic control of topical drugs]. PMID- 3554265 TI - Interactions of aging and environmental agents: the toxicological perspective. PMID- 3554268 TI - Effects of selenium, vitamin E and vitamin C on human prostacyclin and thromboxane synthesis in vitro. AB - The effects of three antioxidants, selenium, vitamin E and vitamin C, on the production of anti-aggregatory prostacyclin (PGI2) by human endothelial cells and lung tissue as well as on the production of pro-aggregatory thromboxane A2 (TxA2) by human platelets and lung tissue in vitro were studied. Selenium had no effect on endothelial PGI2 synthesis but it dose-dependently inhibited the platelet production of TxA2 (84% at 10(-3) mol/l) and productions of PGI2 (64%) and TxA2 (72%) by human lung. Selenium inhibited platelet TxA2 synthesis much less in the presence of exogenous arachidonic acid (AA) (14% instead of 84%), suggesting that selenium exerts its effect predominantly on phospholipase A2. Vitamin E had no effect on endothelial PGI2, pulmonary PGI2 or TxA2 syntheses but it strongly inhibited platelet TxA2 production (50% at 10(-3) mol/l). This inhibition was only partly (from 50% to 30%) counteracted by exogenous AA suggesting that vitamin E affects both phospholipase A2 and a further step(s) in the TxA2 synthetizing cascade. Vitamin C stimulated endothelial cell PGI2 production (80% at 10(-2) mol/l) but it could not counteract the inhibition of PGI2 production (83%) exerted by 10(-2) mol/l tert-butyl hydroperoxide (TBHP), a promoter of lipid peroxidation. Vitamin C had no effect on pulmonary PGI2 production but it inhibited pulmonary TxA2 formation (38% at 10(-3) mol/l). Slight inhibition of platelet TxA2 production from endogenous AA (6%) turned to slight stimulation (8%) with exogenous AA. The in vivo significance of these results is not yet known. PMID- 3554269 TI - Exaggerated peripheral responses to catecholamines contributes to stress-induced hyperglycemia in the ob/ob mouse. AB - The present study investigated the contribution of altered sympathetic reactivity to the stress-induced hyperglycemia observed in the c57BL/6J (ob/ob) mouse, an animal model of type II diabetes. Blood glucose and insulin responses to sympathetic agonist and antagonist administration were evaluated in ob/ob mice and their nondiabetic, lean (ob/?) littermates. In addition, the ability of nutritional status to modify these responses was determined. These studies demonstrated that epinephrine administration to ob/ob mice caused an exaggerated increase in blood glucose and decrease in plasma insulin in ob/ob mice relative to lean littermates. The dose response curve for epinephrine-induced increases in blood glucose were shifted to the left, and the duration of the blood glucose and plasma insulin responses was longer. Differences between ob/ob mice and their nondiabetic littermates were greater when animals were tested in the fasted state. In addition, administration of the alpha adrenergic antagonist phentolamine caused a larger increase in plasma insulin in ob/ob mice than was observed in lean littermates. These results suggest that altered peripheral responses to sympathetic stimuli contribute to stress-induced hyperglycemia in ob/ob mice, and raise the possibility that altered sympathetic function is an etiologic factor in development of diabetes in these animals. PMID- 3554270 TI - The actions of SCH 23390, a D1 receptor antagonist, on operant and avoidance behavior in rats. AB - Previous studies have shown that dopamine antagonists such as haloperidol, pimozide and metoclopramide will produce gradually increasing decrements of operant and avoidance responding. The present study was carried out to investigate whether the dopamine D1 blocking agent, SCH 23390, would exert a similar effect. In the first experiment, SCH 23390 produced a dose-related (0.03 0.1 mg/kg) reduction in responding maintained by an FR 10 schedule of food reinforcement. However, the compound gave rise to similar reductions of response rate throughout the 15 min session. In a second experiment, higher doses of SCH 23390 (0.1-1.0 mg/kg) disrupted one-way avoidance performance in a shuttle-box. Again, there was no within-session decline in responding after administration of SCH 23390 although injection of a dose of 0.4 mg/kg of haloperidol produced a greater response deficit during the second half of the session. During 4 daily administrations of 0.3 mg/kg of SCH 23390 the degree to which avoidance responding was disrupted neither increased nor decreased. SCH 23390 disrupts operant bar pressing and one-way avoidance responding but its actions in these behavioral tests are not identical to the effects of typical neuroleptics such as haloperidol. PMID- 3554271 TI - [The history of pharmaceutical science. 21. The development of pharmacy at the University of Greifswald between 1903 and 1968. 4. The development of the teaching curriculum as well as objectives, forms and methods of education and training]. PMID- 3554272 TI - [The work of Carl Wilhelm Scheele]. AB - On the occasion of C. W. Scheele's 200th anniversary of death corrections and complements to some of his important investigations and theories including discussions of priorities, are given to elucidate his works and to avoid misunderstanding (element term; tartaric, oxalic and benzoic acid; pyrolusit; earths/spar/Bologneese luminous stone/barite; Scheele/Bergman/Lavoisier; fire theory/discovery of oxygen; graphite/Wolfram; Scheele/Wenzel). PMID- 3554273 TI - [Marine substances]. PMID- 3554274 TI - [The history of pharmaceutical science. 21. The contribution of Erwin Rupp to the development of pharmaceutical sciences]. PMID- 3554275 TI - Clearance approaches in pharmacology. PMID- 3554277 TI - The measurement of exposure to ultrasound and its application to estimates of ultrasound 'dose'. PMID- 3554276 TI - Cobalt-protoporphyrin suppresses thyroid and testicular hormone concentrations in rat serum: a novel action of this synthetic heme analogue. AB - Treatment of rats with Co-protoporphyrin, a synthetic metalloporphyrin which produces a marked and sustained induction of hepatic heme oxygenase and decline in cellular cytochrome P-450 content, caused a significant reduction in serum testosterone, serum thyroxine (T4) and 3,5,3'-triiodothyronine (T3) levels. These endocrine changes were not accompanied by reciprocal elevations in either serum luteinizing hormone (LH) or thyroid-stimulating hormone (TSH) concentrations. Seminal vesicles from Co-protoporphyrin-treated animals were atrophic. The pituitary response to luteinizing hormone-releasing hormone (LHRH) in Co protoporphyrin-treated animals was moderately attenuated (approximately equal to 50%) but the response to thyrotropin-releasing hormone (TRH) was normal. These findings suggest that at least part of the effects of the metalloporphyrin are mediated at the level of the hypothalamus, such that suppression of serum levels of testosterone, T4 and T3 fails to elicit compensatory pituitary outputs of the respective trophic hormones. It is not known whether these effects are due to direct actions of Co-protoporphyrin on the endocrine system or whether they are secondary consequences of other metabolic derangements, such as those related to the pronounced cellular depletion of heme and cytochrome P-450 caused by the synthetic metalloporphyrin. PMID- 3554278 TI - [Efficacy of O-(beta-hydroxyethyl)-rutosides in the treatment of venous leg ulcers]. AB - In a prospective 6 weeks study, done in 3 phlebology practices on 107 patients presenting an acute leg ulcer, we compared the efficacy of a combination of compression and HR (O-(Beta-hydroxyethyl)-rutosides with compression alone, based on objective and subjective parameters. These objective and subjective parameters are improved in both groups. A statistically significant superiority of the therapeutic combination is demonstrated in the cure of ulcers. PMID- 3554279 TI - [Medical and surgical treatment of Raynaud's phenomenon]. PMID- 3554280 TI - RNA protein crosslinks introduced into E. coli ribosomes by use of the intrinsic probe 4-thiouridine. PMID- 3554281 TI - Inactivation by monochromatic near-UV radiation of an Escherichia coli hemA8 mutant grown with and without delta-aminolevulinic acid: the role of DNA vs membrane damage. PMID- 3554282 TI - Sensitivities to monochromatic 254-nm and 365-nm radiation of closely related strains of Saccharomyces cerevisiae with differing repair capabilities. PMID- 3554283 TI - Males increase serum estrogen and estrogen receptor binding in brain of female voles. AB - Sexual development of female prairie voles does not occur unless females are exposed to stimuli from an unfamiliar male. Three experiments were conducted to determine whether a saturable high-affinity estradiol binding site (ERN) is present in cell nuclei of brain tissue from females exposed to male stimuli and whether serum estradiol and brain ERN are correlated with the duration of male exposure. Brain ERN were detected and found to be correlated with serum estradiol levels. Significant increases in brain ERN were observed within 18 hours after females were exposed to a male for either a continuous (uninterrupted) or transient (1 1/4 hour) period. A significant increase in serum estradiol was observed for females given continuous male exposure. The rate of increase of ERN in brain was significantly higher for females given continuous as opposed to transient male exposure. The results suggest that the continued presence of a male can accelerate the rate of increase of ERN in the brain, presumably through increases in circulating estradiol. PMID- 3554284 TI - Herbal medicine in America. PMID- 3554285 TI - A competitive solid-phase enzyme immunoassay for the evaluation of tropane alkaloids in plant material, using anti-DL-tropic acid antibodies. PMID- 3554286 TI - Zeta potential of synthetic and biological skin substitutes: effects on initial adherence. AB - Early adherence of a skin substitute to the wound surface is paramount if it is to function as a skin equivalent. A surface electrical property (the zeta potential) was evaluated, and a positive correlation was found in which 5-hour adherence properties increased as the zeta potential became more positive. The following materials were tested: nylon-silicone composite (Z = -24.8 mV), Biobrane (Z = -15.2 mV), fresh-frozen porcine skin (Z = +12.5 mV), Opsite (Z = +14.9 mV), human amnion (Z = +18.2 mV), and human skin (Z = +23.0 mV). This order was also followed for increasing adherence values at 5 hours, which ranged from a low of 48.9 gm/cm2 for the nylon-silicone composite to a high of 88 gm/cm2 for human skin. Also determined was that both adherence and zeta potential decreased as increasing concentrations of glutaraldehyde were used to cross-link fresh frozen porcine skin. Values ranged from a maximum of 85.5 gm/cm2 (0% glutaraldehyde; Z = +12.5 mV) to a minimum of 42.5 gm/cm2 (10% glutaraldehyde; Z = -26.4 mV). Additionally, deliberate biochemical modifications of porcine skin were undertaken in an attempt to increase zeta potential and adherence. PMID- 3554287 TI - Professor Frantisek Burian and Czechoslovak plastic surgery. PMID- 3554288 TI - [Carl Westphal--a progressive university teacher of neurology and psychiatry in the 19th century]. AB - Carl Westphal (1833-1890) is described on the basis of his theoretical considerations concerning the teaching of psychiatry and neurology and his influence on the contents and organization of teaching in these fields at the then Charite as a university teacher with progressive pedagogic and didactic aims and methods. His other scientific work shows that C. Westphal was a worthy heir and like-minded successor to W. Griesinger (1817-1868). PMID- 3554289 TI - Adjustment disorder and psychiatric practice: cultural and historical aspects. AB - A universal concern of healers and health practitioners of all social groups is that of caring for individuals reacting to social and interpersonal hardships. One could view individuals experiencing such hardships as prototypical patients of a society's health profession, however this may be defined. In contemporary psychiatry, such individuals are diagnosed as showing an "adjustment disorder." In view of the time-honored legitimacy of caring for individuals meeting criteria for an adjustment disorder, it is ironic that the status of this "disorder" in the discipline's contemporary nosology is controversial and anomalous. In this paper, these and related issues are discussed. Emphasis is given to some of the cultural, historical and clinical-epidemiologic factors that render disturbances that can be diagnosed as adjustment disorder important in psychiatry and, indeed, worthy of inclusion in DSM-III. Theoretical and empirical problems that would render this entity a more legitimate one in contemporary biomedical psychiatry are reviewed. PMID- 3554291 TI - Depressive symptomatology and treatment in patients with end-stage renal disease. AB - A sample of 60 patients selected at random from an adult population of 419 patients with end-stage renal disease was assessed for major depression. Diagnoses were based on a structured interview using DSM-III criteria. Eighteen patients (30%) met criteria for a major depression on a lifetime basis. In addition, depressive symptoms and treatment for each depressed patient are reported. PMID- 3554290 TI - Which boys respond to stimulant medication? A controlled trial of methylphenidate in boys with disruptive behaviour. AB - Thirty-eight boys, referred for psychiatric treatment because of serious problems of behaviour, underwent a double-blind, placebo-controlled, crossover trial of methylphenidate and placebo. Methylphenidate was an effective treatment over a 3 week period. A good response to methylphenidate was predicted by higher levels of inattentive and restless behaviour, impaired performance on tests of attention, clumsiness, younger age and by the absence of symptoms of overt emotional disorder. DSM-III and ICD-9 diagnoses of 'hyperactivity' were not good predictors. The results support the validity of a construct of hyperactivity in describing childhood psychopathology, but emphasize the need for a refinement of diagnostic criteria. PMID- 3554292 TI - Demonic possession and mental disorder in medieval and early modern Europe. AB - Western European belief in demonic possession as a cause of mental disorder has been traced through the medieval and early modern periods. Generally it appears that the range of disorders attributed to demonic possession has gradually narrowed. In any period, however, there seem to have been marked individual and cultural differences in outlook; some of these differences are still evident today in the survival of belief in demonic possession in pentecostal sects. PMID- 3554293 TI - A representative psychiatrist: the career, contributions and legacies of Sir Aubrey Lewis. PMID- 3554294 TI - Psychologic treatment for the type A behavior pattern and for coronary heart disease: a meta-analysis of the literature. AB - The Type A behavior pattern (TABP) is a recognized risk factor for coronary heart disease (CHD), and yet treatments aimed at its modification are not in widespread use. We reviewed the literature of controlled studies (N = 18) of the psychologic treatment of the TABP and of CHD with the statistical method of "meta-analysis." The results of each study were converted to a standardized "Effect Size" (ES). The mean ES for TABP measures was 0.61 +/- 0.20 (95% confidence interval) (p less than 0.001), indicating that after treatment subjects across all studies reduced their TABP scores by half a standard deviation. The combined significance probability (pc) across studies for reduction in 3-year combined mortality and myocardial infarction was pc less than 0.0001, corresponding to a reduction in coronary events of roughly 50% after psychologic treatment. This finding must be approached with caution because it is based on only two studies. The analysis suggested that a combination of treatment techniques is most effective in reducing TABP and CHD recurrences. The literature was critiqued, and limitations of the findings are discussed. We conclude that psychologic intervention to reduce TABP may improve clinical outcome of CHD and that this deserves further study and preliminary clinical application. PMID- 3554295 TI - Methodological problems in polydiagnostic research. AB - The growing application of the polydiagnostic approach makes it necessary to examine the methodological problems associated with the simultaneous assessment of multiple competing diagnoses. This paper contrasts the method of nonstandardized consecutive judgement of nonintegrated criteria lists with the method of a structured polydiagnostic interview with integrated criteria lists. The comparison of two polydiagnostic studies using both methods of assessment confirms that the unstructured use of nonintegrated and consecutively judged criteria lists is biased by a halo effect. This halo effect leads to a reduction of differences between the classifications of competing operational diagnoses and influences the type of patient distribution along the diagnostic dimension. This finding is interpreted as an argument to switch over to integrated criteria lists applied on the basis of an unstructured clinical examination or a structured interview. PMID- 3554296 TI - A century of psychiatry. AB - This sketch of the history of psychiatry since 1886 comprises the following points: cocaine addiction; psychoanalysis; sexology; psychiatric clinics and their recent abolition in Italy; nosology; heredity and environmental factors in mental disease; therapeutics. PMID- 3554297 TI - New pharmacological developments in antidepressants. AB - The new pharmacological developments in antidepressants are reviewed with particular reference to MAOIs. Combining an MAOI with amitriptyline reduces the risk of a tyramine-induced rise of blood pressure but does not eliminate the risk which is comparable to that of one of the new reversible MAO-A inhibitors (CGP 11305A). PMID- 3554298 TI - Limits to chemotherapy of depression. AB - A large number of depressed patients are undiagnosed and therefore untreated. A substantial proportion of those patients who are treated are allegedly 'refractory', 'resistant' or 'non-responsive' to anti-depressant drug therapy. Definitions and criteria for the use of these terms vary, or are totally lacking, and incidence figures in the literature vary between 10 to 50%. In addition, 3 to 15% of depressed patients otherwise satisfactorily treated suffer unwanted effects. Such observations clearly illustrate limits to successful antidepressive therapy. Some of these may require new approaches on the part of medical education or further research and development of psycho-active drugs on existing lines. However, the limitations imposed by the unwanted effects of antidepressives are more tangible and might be substantially influenced when manufacturers actively and succinctly inform the medical profession about changes in the ADR profiles of their products. As an example, the evolution of the ADR profile of the antidepressant maprotiline is demonstrated: the frequency of reports on convulsions in association with maprotiline treatment in the USA and the UK decreased about four-fold and seven-fold respectively after appropriate adjustments of daily-dose ranges were recommended. PMID- 3554299 TI - Light therapy for depression: present status, problems, and perspectives. AB - Bright white light (WL) improves depressive symptomatology in seasonal affective disorders (SAD). Different dosage regimens are effective: photoperiod extension (3, 2, or 1 hr WL at dawn and dusk); morning only (2, 1, or 1/2 hr); midday only (4 or 2 hr); and evening only (5 or 2 hr). Late evening WL may be deleterious. The placebo effect of WL has not yet been adequately resolved. Only SAD patients and not major depressive disorders have responded to WL. The mechanism of action of WL is unknown: however melatonin does not appear to play a major role. PMID- 3554300 TI - Cognitive therapy for depression. AB - Cognitive therapy alone without concurrent behavioral components seems to be ineffective in the treatment of depressive patients. However, the combination of cognitive and behavioral treatment procedures including social skills training is effective even in the therapy of definite endogenous depression. Three important characteristics are mentioned explaining the therapeutical effectiveness: a concrete rationale, a highly structured therapy program and feedback- and support techniques. Effectiveness and outcome of the various treatment methods are discussed in the light of three aetiological cognitive hypotheses: the Precipitation theory, the Vulnerability theory and the 'depression about depression' hypothesis. PMID- 3554301 TI - Depression in children and adolescents. AB - Current research is centered mainly on the age group between 6-12 years. The assessment in preschool age and in adolescence seems to present additional difficulties. DSM III criteria for major depression in childhood are slowly recognized internationally. Newly developed rating scales help to standardize clinical and research assessment methods. Biologic markers show deviations similar to those in depressed adults. Epidemiologic data are still not sufficient. The bridging to the development and disturbances of affect attunement between caretaker and child, to family interactions and to environmental stresses has not yet been established in a satisfactory manner. PMID- 3554302 TI - Alcohol and depression. AB - The relationship of alcohol and depression has always been a subject of clinical and scientific interest. Though many studies have been carried out to clarify the mode of this relationship it still remains in its complexity an area for further research. The two basic ideas of a possible connection are on one hand symptomatic alcoholism with a preexisting depression and on the other hand alcoholism leading to a symptomatic depression. There is in literature a great variability of results with regard to this problem which will be discussed in view of the results of an own study on 444 chronic alcoholic patients. PMID- 3554303 TI - Depression and suicide. AB - It is widely known that during the depressive psychotic stages of depression, the risk of suicide is extremely high. In 17 of the follow-up studies reviewed, death and suicide data were presented. The data indicate that these affective disorders were associated with very high suicide rates. Suicide accounted for at least 12% of all deaths in every study. In nine studies suicide accounted for 12-19% of deaths, while in the other eight studies it accounted for 35-60%. The ratio of suicides to all deaths levelled off at about 15% as the deaths approached 100%. PMID- 3554304 TI - Epidemiology of depression in Latin America. AB - The focus of this review will center on the Epidemiology of affective disorders in Latin America. The prevalence seems to be very similar in the general population. Argentina reports 12%, Chile 15.3%, Dominican Republic 9.8% and Peru 11%. In non-psychiatric outpatient program, the prevalence is 53% in Costa Rica, 40% in Cuba, 39% in Dominican Republic and 19% in Mexico. Women outnumber men in all samples. There are reports of higher prevalence in special groups: Mariategui found 25% in Lima and Vega 26% in Mexico. It is suggested that the Latin American Socio-Economic situation may be an important determinant of these high rates. PMID- 3554305 TI - Self-help attempts of depressive patients. AB - The paper, based on the theoretical analysis of the problem and a review of the pertinent literature, focuses on the following questions: Which behaviour patterns can be understood as self-healing attempts in depressive disorders? Are there any scientific findings with regard to the efficacy of such self-healing attempts? In which phase of a depression are such attempts being applied? Are self-healing techniques teachable and learnable? The label 'depressive disorders' covers not only brief and mild affective disturbances but also persistent severe depressions. PMID- 3554306 TI - Therapy for sleep disorders in depressives. AB - The treatment of sleep disorders in depressives depends basically on the nature of the underlying affective disorder (endogenous, organic, psychogenic or constitutional depression). Therapeutic approaches may be categorized in: psychological, somatic and pharmacological ones. The former include psychotherapies and behavioral treatments which are useful in psychogenic and constitutional depressions with sleep-onset insomnia but may also be supportive in endogenous depressions. The basic therapeutic factor common to all is anxiety reduction. Somatic therapies, such as ECT, total, partial and REM-sleep deprivation, sleep schedule shifts and bright light (EL) are utilized mostly in endogenous depressions. Sleep laboratory findings and different hypotheses concerning the mode of action of these alternative treatment methods are reviewed. Somnopolygraphic, psychometric, and neuroendocrinological data of our comparative trial with BL and partial sleep deprivation in normals and patients are discussed. The similarity of changes after BL, antidepressants and lithium points to a chronobiological factor in the pathogenesis and treatment of affective disorders. Electrosleep is still controversial, hydro-, ergo- and physical therapy are supportive therapies and as such indicated in all depressions. Exercise, fatigue and nutritional factors may influence sleep. Psychopharmacological treatment has to be regarded as the most important therapeutic approach for sleep disorders in depressives. Antidepressants are the drugs of choice for most patients. Based on their effects on sleep-induction, maintenance, and -architecture and REM measures, one may differentiate at least two subtypes: sedative antidepressants of the amitriptyline type and nonsedative antidepressants of the desipramine type. Bedtime infusions of antidepressants may have sleep promoting properties, which was objectivated by an EEG spectral analysis during infusion and subsequently by all night sleep studies. Measures indicative of therapeutic outcome are still controversial. Tranquilizers, hypnotics, neuroleptics and serotonin precursors are utilized if the antidepressants alone do not ameliorate insomnia. However, as evidence of a shared diathesis of origin of depressive and anxiety disorders is building up, benzodiazepines are increasingly prescribed as monotherapy too. Finally, sleep laboratory data concerning the hypnotic properties of a pharmacological 80 mg doses of melatonin are demonstrated. PMID- 3554307 TI - Epidemiology of depression in India. AB - Depressive disorders constitute one of the major mental health problems. The cross and intracultural differences in etiology, clinical features and course and outcome vary maximally in depressives than in any other mental illness, and epidemiological studies have been a major strategy to delineate the same. In this report the author has attempted to review available Indian epidemiological literature in the field of depressive disorders, and suggestions have been provided for improving the quality of future research in this area. PMID- 3554308 TI - Recognizing the role of bereavement and reactive depression in modern psychiatry. AB - In the modern world the recognition, understanding and treatment of bereavement in recent widows, widowers, those who experienced severe medical and surgical trauma, and victims of disasters is essential for all physicians, rescue workers such as the International Red Cross, and the community in general. This paper reviews the consequences of personal encounters with catastrophic events, as well as methods of immediate and long-term management. Similarly, the dynamic manifestations and treatment of psychologic dissonance in the family of victims, the community, and survivors are addressed. Of special interest are the problems of rescue workers, witnesses and reporters involved in disasters. PMID- 3554309 TI - Cross-cultural research on depression. AB - A critical review of evidence about the following issues is presented: frequency of depression, clinical picture of depression, suicide, treatment, appearance of disease, terminology, and future trends. In each instance questions that have remained unanswered and may deserve scientific investigation are listed. Although much has been learned already, numerous problems remain unsolved. It is concluded that properly conducted cross-cultural research can yield results which can help to resolve the conundrum of depression and respond to the challenge which depression poses to the society, to public health authorities and to the individuals who suffer from it. PMID- 3554310 TI - Laboratory procedures and clinical implications in the making of casts. PMID- 3554312 TI - Selecting an esthetic veneering technique. PMID- 3554311 TI - Direct tooth addition to an existing removable partial denture. PMID- 3554313 TI - Anterior guidance. PMID- 3554314 TI - The dual-arch impression. PMID- 3554315 TI - Effect of ionizing radiation on prostaglandins and gastric secretion in rhesus monkeys. AB - Early radiation toxicity is characterized by nausea and vomiting. We have previously shown that gastric emptying, gastric motility, and gastric secretion were suppressed after total body exposure to irradiation. In the present studies, we evaluated the relation between vomiting and gastric function in nine rhesus monkeys and explored the possible role of prostaglandins (PG) in these phenomena. The concentration of PG in plasma and gastric juice was determined using a standard radioimmunoassay and gastric acid output was measured concurrently using a marker dilution technique. The animals were studied in the basal state and after total body exposure to 800 cGy 60Co delivered at a rate of 500 cGy/min. Acid output was abolished from 40 min to 2 h after irradiation but had returned to preirradiation levels 2 days later. Plasma PGE2 and PGI2 (as measured by 6 keto-PGF1 alpha determination) were not significantly modified by irradiation. In contrast, irradiation produced an immediate significant increase (P less than 0.05) in gastric juice concentration of PGE2 (318 +/- 80 to 523 +/- 94 pg/ml; mean +/- SE) and PGI2 (230 +/- 36 to 346 +/- 57 pg/ml); both had returned to basal levels 2 days later. Thus, an increase in gastric juice concentration of both PGE2 and PGI2 is associated with the radiation induced suppression of acid output. PMID- 3554316 TI - [Postradiation activation of proteinases associated with the hepatocyte nuclear matrix in rats]. AB - Proteinase activity of the nuclear matrix of rat hepatocytes was 7-8-times as high as that of initial nuclei. Activity of nuclear matrix proteinases was optimum at pH 8-9. Proteolytic activity associated with the nuclear matrix, increased by 1.4-2.8 times 2 h following irradiation with doses from 5 to 30 Gy. Cycloheximide, a protein synthesis inhibitor, administered to animals failed to suppress the radiation-induced increase of proteinase activity of the nuclear matrix. PMID- 3554318 TI - [Survival of diploid yeasts after gamma irradiation: genetic control of the maturation effect]. AB - A study was made of the influence of rad mutation, leading to radiosensitivity increase, on the effect of additional growth in diploid Saccharomyces cerevisiae yeast exposed to gamma-radiation. The most radiosensitive mutants of this series, rad52/rad52 and rad54/rad54, did not virtually vary from the wild type cells in the value of the additional growth effect. Some other mutants, for instance, rad53/rad53 and rad55/rad55, exhibited a significantly lesser effect of additional growth. It was shown that the effect of additional growth did not depend upon the rate of rapid and slow postirradiation recovery of the wild type cells. The results of the studies prompt the conclusion that the processes responsible for the additional growth effect and those responsible for recovery of cells from radiation damages are mutually independent. PMID- 3554317 TI - [Effect of 2-amino-2-thiazoline on the level of lipid peroxidation products in different yeast species]. AB - The influence of 2-amino-2-thiazoline on lipid peroxidation in yeasts Saccharomyces cerevisiae and Pichia guilliermondii has been studied in vivo and in vitro. In the case the radioresistance of diploid yeasts-saccharomycetes is changed the radioprotector can produce a direct effect on lipid peroxidation. Different radioprotective efficiency of the preparation with regard to different strains of one and the same yeast culture is explained by its different influence on the content of endogenous radioprotective factors exerting a control over the accretion of lipid peroxidation products. The observed differences in the lag periods of peroxidation in Saccharomyces cerevisiae and Pichia guilliermondii correspond to the level of their natural antioxidant activity of lipids. PMID- 3554319 TI - [Effect of chronic gamma irradiation on dehydrogenase activity in the tissues of root voles and their progeny dwelling in a habitat with increased radioactivity]. AB - Chronic gamma-irradiation during 3.5 and 6 months (at a dose = rate of 46.2 pC/kg X c) of Microtus oeconomus living in conditions of normal and increased (by 50 100 times) gamma-radiation background, and of their progeny (the 1st, 2nd, 3d, and 4th generations) causes in homogenates of cardiac muscle, liver, and brain different changes in activity of succinate dehydrogenase (1.3.99.1, EC), pyruvate dehydrogenase (1.2.4.1, EC), and lactate dehydrogenase (1.1.1.27, EC) associated with the discordance of the processes of tissue respiration and glycolysis. The changes in dehydrogenases activity in Microtus oeconomus subjected to chronic irradiation were nearly the same as those found in their parents. PMID- 3554320 TI - [Effect of autologous marrow transplantation on bone marrow recovery following large-field fractionated irradiation of dogs]. AB - After large-field fractionated irradiation of dogs at a cumulative dose of 54 Gy, a stable bone marrow depletion occurs persisting for a year following irradiation. The automyelotransplantation after the end of the exposure elicits a transient recovery of the exposed bone marrow, 1.5-2 months after the beginning of irradiation, followed by a secondary depletion of the exposed haemopoietic sites. The control and the automyelotransplanted animals exhibited bone marrow recovery one year and six months after irradiation, respectively, the cellularity being maintained at a high level for 3 years of observation. PMID- 3554321 TI - [Changes in the resistance of mice to whole-body lethal irradiation after local irradiation of the abdominal area]. AB - The resistance of mice to whole-body irradiation with lethal doses, after preirradiation of part of the abdomen, was studied with a reference to radiation dose, the volume of local exposure, and the interval between exposures. The radioresistance was found to increase when the preirradiated zone corresponded to the spleen projection, the interval between exposures was 3-7 days, and the dose of local exposure, 2 Gy. PMID- 3554323 TI - [Radiation biological principles, irradiation technic and clinical tolerance of whole body irradiation before bone marrow transplantation in leukemia]. PMID- 3554322 TI - [Lysosomal proteinase activity in the small intestine and liver of irradiated animals following thermal exposure]. AB - A study was made of a modifying effect of heat on acid proteinase activity in the liver and small intestine tissues of irradiated (6 Gy) albino mongrel mice. During the first few hours following thermal affection proteinase activity in the organs under study was inhibited. PMID- 3554324 TI - [Whole body irradiation in acute leukemias--experiences and results in Tubingen]. PMID- 3554325 TI - MPG modification of adrenal response in Swiss albino mice exposed to gamma radiation. PMID- 3554326 TI - The effects of X-rays on the survival of Xenopus tadpoles. PMID- 3554327 TI - Normal direct multiplanar CT anatomy of the orbit with correlative anatomic cryosections. AB - This article presents high-resolution thin-section in vivo CT scans of the normal orbit, scanned directly in the transverse, coronal, and sagittal planes, compared with correlative anatomic cryosections of fresh frozen cadaver specimens. The techniques used are described. PMID- 3554328 TI - Imaging in ophthalmology, Part I. PMID- 3554329 TI - Magnetic resonance imaging fundamentals and system performance. AB - The underlying physical principles of magnetic resonance (MR) imaging are discussed. MR imaging system components are described, and system performance criteria are discussed and demonstrated. Examples of image quality variables are shown, and measurement techniques and apparatus are given. PMID- 3554330 TI - Orbital imaging: factors determining magnetic resonance imaging appearance. AB - This article addresses the dependence of the image characteristics in MR imaging of the orbit. Among the variables discussed are signal-to-noise (SNR), field of view (FOV), spatial resolution, and their interdependence. It is further shown how image contrast can be controlled by judicious choice of pulse timing parameters and how contrast depends on the intrinsic tissue MR parameters T1, T2, and proton density. PMID- 3554331 TI - Orbital ultrasonography. AB - Ultrasonography is a harmless, painless procedure that can qualitatively and quantitatively evaluate various orbital abnormalities. The characteristic acoustic changes that typify orbital lesions and the techniques used to best display them are described. The internal reflectivity of an orbital lesion can be correlated with its histologic features. The demonstration of subtle enlargements of the ocular muscles and optic nerve by ultrasound techniques is emphasized. PMID- 3554332 TI - Uveal melanoma and similar lesions: the role of magnetic resonance imaging and computed tomography. AB - The uvea provides a suitable substrate for tumor cells because it is the most vascular portion of the eye. Most primary and metastatic ocular neoplasms involve the choroid, with the most common being malignant melanoma. We review the features of uveal melanomas seen on MRI and CT images and evaluate certain neoplastic and non-neoplastic intraocular lesions that may simulate uveal melanomas. PMID- 3554333 TI - Magnetic resonance imaging of the orbit. AB - Technological advances in MRI have resulted in the ability to obtain thin sections with high resolution; thus, MRI has become a serious competitor to CT in the evaluation of the orbit. MRI permits normal and pathologic anatomy to be visualized with exquisite detail in several planes. In addition to precise localization of lesions, in certain cases MRI also adds some specificity. PMID- 3554334 TI - [Modern imaging procedures in splenic diseases]. AB - Imaging procedures have lately become important in pathologic conditions of the spleen, because they are simple to use and do not cause much stress to the patient. Ultrasonography is the method of choice for determination of the position, shape, size and volume of the spleen, and also for the diagnosis of changes within the spleen. Circumscribed lesions cannot be detected by ultrasonography until they have reached a size of 0.5-1.0 cm; the same limit of detection applies for CT, which has approximately the same diagnostic reliability. In the presence of generalized splenic disease (e.g. splenomegaly in myeloid leukaemia) imaging procedures are being used increasingly for staging and for monitoring of the results of treatment. Perhaps in future histochemical determinations made with the aid of core-spin spectroscopy will present a further means of diagnosis without the necessity for biopsy. Angiography was the leading diagnostic technique for spleen conditions for many years, and continues to occupy this place for primary disease of the spleen (aneurysm, arterioportal fistula, haemangioma); it is currently gaining in importance with the advent of therapeutic embolization as an option. For diffuse spleen disease and also for circumscribed lesions, however, it has now been superseded by the non-invasive methods of diagnosis. PMID- 3554335 TI - [Microabscesses of the spleen in patients with acute leukemia]. AB - Eight patients with acute myelogenous leukemia in complete remission after induction chemotherapy developed septic fever. Fever was unresponsive to broad spectrum antibiotic therapy. Ultrasonography showed multiple 0.5-2 cm in diameter, anechoic densities and some 1-3 cm "target" appearances in spleen and liver. Computed tomography demonstrated multiple, round, 0.5-2 cm areas of diminished attenuation in spleen and liver, which did not enhance like the surrounding parenchyma. These microabscesses increased in size and number without equivalent antifungal therapy and decreased or disappeared after specific treatment. Candida-infection was confirmed by histologically from liver specimens in four patients, fungal organisms were seen microscopically an liver-biopsy in one patient and at autopsy one patient was found to have candida disseminated to the spleen, liver, kidneys, lung and CNS. PMID- 3554336 TI - [Leiomyosarcoma of the inferior vena cava. Diagnosis--therapy--prognosis]. AB - Leiomyosarcoma of the vena cava inferior is a mesenchymal tumor originating from the smooth muscle fibers of the vascular wall. This tumor is usually slow-growing and expansile growth. Prior to the sonographic and computer-tomographic era the tumor was usually only discovered during autopsy or surgery without any preoperative suspicion. Today, the most efficient imaging methods for exact localization, delineation or demonstration of relations to the vascular lumen and local extent are sonography and computer tomography. Caudal cavography is called upon for preoperative demonstration of the venous collateral circulation and thrombotic vascular occlusion. PMID- 3554337 TI - [Sonography of the knee joint]. AB - The results of the ultrasound investigation of 300 patients are described. The procedure and the normal anatomy are demonstrated. Pathological findings are effusion, joint ganglion, chondromalacia, loose bodies in the joint, Baker-cysts and ligamentous lesions. It is probable that future improvement of the equipment will enlarge the diagnostic possibilities. PMID- 3554338 TI - [Complications of brachiocephalic catheter angiography using a non-ionic contrast medium]. AB - In 713 patients 749 catheter-arteriographies of aortic-arch and cerebral vessels were performed using non-ionic contrast media. The patients were examined either with DSA or conventional film techniques. In 80 examinations of 76 patients complications or side-effects were noted, which resolved completely within one hour in 69 cases, showed a duration up to 7 days in 6 cases, and persisted longer than 7 days in 5 patients. Neurological complications were seen in 6.4% of the studies. There was no death. Patients, who received anti-hypertensive drugs before or during angiography and patients with a pathological angiogram had a significantly higher complication-rate. The rising number of patients with atherosclerotic cerebrovascular disease showed an unfavorable effect upon the overall complication-rate. The use of a non-ionic contrast medium did not drastically lower the rate of neurological complications. PMID- 3554339 TI - [Extravasation of contrast medium from kidney calices in overfilling of the urinary bladder]. AB - The most frequent cause of contrast media extravasation from the renal pelvis is a nephrourolithiasis. There are frequent causes enumerated in the literature, that are also characterized by a mechanical obstruction of the contrast media excretion. The presented case reports are characterized by a technical dependency, namely a long angiographic investigation and an overfilling of the urinary bladder without any indication of an organical excretory impediment. The clinical consequence of such observations should be discussed. 150 ml contrast media should not be exceeded during one examination. PMID- 3554340 TI - Imaging of the gallbladder, 1987. AB - Gallbladder disease, and the patients with symptoms suggestive of gallbladder disease, remains a widespread clinical problem that requires investigation by imaging techniques. Sonography, and to a lesser extent cholescintigraphy, has facilitated the evaluation of these patients and allows the diagnosis of cholelithiasis, and its principal complication of cholecystitis, with a high degree of reliability and accuracy. Interventional techniques are being developed that may provide nonsurgical approaches to improved therapy of gallbladder calculi and their complications. PMID- 3554341 TI - Pancreatic duct: US-guided percutaneous opacification. AB - Percutaneous pancreatography was attempted in 28 patients. In 18 cases, the examinations were performed after failure of endoscopic retrograde cholangiopancreatography (ERCP); in ten patients, ERCP was not attempted. Under real-time ultrasonic guidance, a 22-gauge needle was inserted into the pancreatic duct, which ranged in size from 3 to 15 mm. After aspiration of pure pancreatic juice, 10-20 ml of contrast medium was injected under fluoroscopic control. The examination was successful in 25 patients. The only significant complication was bile leakage in a patient with obstructive jaundice. Of the six patients who subsequently underwent surgery, evidence of the puncture site was present in only one. PMID- 3554342 TI - In vitro fertilization: sonographic perspective. AB - The applications of sonography were evaluated in 220 patients undergoing 354 in vitro fertilization cycles. A baseline sonogram demonstrated adnexal abnormalities in 10.7% of cycles. Serial sonograms were beneficial in monitoring follicular development. Oocyte harvest was canceled in 18.4% of cycles owing to inadequate follicle growth progression, as demonstrated by ultrasound. An additional 9% of cycles were canceled owing to the development of a single lead follicle. Six percent of cycles were accompanied by a spontaneous rise in serum luteinizing hormone values, necessitating sonographic correlation to exclude ovulation. PMID- 3554343 TI - Deep venous thrombosis of the leg: US findings. AB - In a prospective study, 121 consecutive patients with a clinical diagnosis of deep venous thrombosis of the leg were examined with real-time ultrasonography. The findings were correlated with the results of venography. The common femoral vein and the popliteal vein were evaluated for intraluminal echoes and compressibility, and the common femoral vein was also evaluated for an increase in diameter in response to the Valsalva maneuver. The superficial femoral vein and the calf veins were not evaluated. The results indicate that compressibility of the common femoral and popliteal veins is the best indication of deep venous thrombosis, with a sensitivity of 96% and a specificity of 97%. The accuracy of detection was not improved by including data from thrombus visualization or the response of the common femoral vein to the Valsalva maneuver. PMID- 3554344 TI - Deep venous thrombosis of the lower extremity: US evaluation. AB - The sensitivity of duplex ultrasonography (US) for detecting deep venous thrombosis of the lower extremity was compared with that of venography in a prospective study of 54 patients. Doppler analysis of the common femoral vein and US imaging of the deep venous system from the common femoral vein to the popliteal vein was performed. Common femoral vein response to the Valsalva maneuver was recorded. Sonographically visible thrombi and abnormal vein compressibility were 91% sensitive for the common femoral vein, and 94% sensitive for the superficial femoral or popliteal veins, with no false-positive examinations. Abnormal Doppler flow and abnormal response of the common femoral vein to the Valsalva maneuver enabled thrombi to be detected only in the common femoral and iliac veins. Combined data allowed accurate diagnoses in all patients with deep venous thrombosis proximal to the deep calf veins. US should be the screening examination of choice for evaluating patients with suspected lower extremity deep venous thrombosis. PMID- 3554345 TI - Effects of maternal hydration on fetal renal pyelectasis. AB - Fetal renal pyelectasis is a frequent finding on routine obstetrical sonography. The cause of this pelvocalyceal dilatation is often not apparent, although urinary tract obstruction is the most important condition to be excluded. One of the many hypothetical explanations for minimal fetal renal pyelectasis suggests that aggressive maternal hydration before sonography leads to fetal diuresis with resultant pelvocalyceal dilatation. In this study, 20 pregnant volunteers underwent sonography after 10-12 hours of dehydration, after which 1,000 ml of fluid was administered and repeat sonography was performed. Despite a significant increase in the state of maternal hydration as determined by a decrease in urine specific gravity, there was no significant change in the degree of fetal renal pyelectasis before and after hydration. Therefore, pelvocalyceal dilatation identified prenatally should not be attributed to maternal hydration. PMID- 3554346 TI - Empty-bladder (hysterographic) view on US for evaluation of intrauterine devices. Work in progress. AB - Ultrasound scanning of the pelvis with an empty bladder permits a true frontal view of the uterus to be easily obtained. This view is comparable to the en face view seen at hysterography performed with contrast material. Good definition both of the endometrium and the uterine wall makes this the optimal method for the evaluation of an intrauterine contraceptive device. PMID- 3554347 TI - Breast masses: US-guided fine-needle aspiration biopsy. PMID- 3554348 TI - The current status of the cortical cholinergic system in Alzheimer's disease and Parkinson's disease. PMID- 3554349 TI - Cognitive, emotional and behavioral dysfunctions in aging and dementia. PMID- 3554350 TI - Lipofuscin: characteristics and significance. PMID- 3554351 TI - Dendritic proliferation in the aging brain as a compensatory repair mechanism. PMID- 3554352 TI - Neuronal cytoskeleton in aging and dementia. PMID- 3554353 TI - DNA damage, DNA repair and the genetic basis of Alzheimer's disease. PMID- 3554354 TI - The old animal as a model in research on brain aging and Alzheimer's disease/senile dementia of the Alzheimer type. PMID- 3554355 TI - Behavioral and biochemical effects of nucleus basalis magnocellularis lesions: implications and possible relevance to understanding or treating Alzheimer's disease. PMID- 3554356 TI - Experimental studies on the induction and prevention of retrograde degeneration of basal forebrain cholinergic neurons. PMID- 3554357 TI - Aluminum: a role in degenerative brain disease associated with neurofibrillary degeneration. PMID- 3554358 TI - Interrelations among the lesions of normal and abnormal aging of the brain. PMID- 3554359 TI - Environmental influences on brain and behavior in aging and Alzheimer's disease. PMID- 3554360 TI - The striatal dopaminergic system as a model for modulation of altered neurotransmitter action during aging: effects of dietary and neuroendocrine manipulations. PMID- 3554361 TI - Muscarinic cholinergic agonists: pharmacological and clinical perspectives. PMID- 3554362 TI - Transplantation of basal forebrain cholinergic neurons in the aged rat brain. PMID- 3554363 TI - Measurement and imaging of cerebral function in ageing and dementia. PMID- 3554364 TI - Postinfarct risk stratification. PMID- 3554365 TI - Intraoperative myocardial protection in the context of coronary revascularization. PMID- 3554366 TI - Cytochemistry of the gas-exchange area in vertebrate lungs. AB - Considerable progress has been made in the localization of chemical substances within the gas-exchange zones of vertebrate lungs since cytochemical techniques suitable for use with the electron microscope have been developed. The light microscope, an instrument with an effective resolution limit of about 0.2 micron, is ill-suited for studying regions such as these where small tissue elements are arranged in a complex manner. A wide range of acid hydrolases have been detected in the vacuoles and dense bodies of alveolar macrophages by means of cytochemical techniques. The enzymes demonstrated in this way include acid phosphatase, aryl sulphatase, cathepsin D, beta-glucuronidase, acetyl glucosaminidase, nonspecific esterase, dipeptidyl peptidase II and dipeptidyl peptidase IV. Such enzymes are, of course, to be expected in the lysosomes of cells which have a primary phagocytic role. Nevertheless, it must be confessed that very little is yet known about the actual mechanism of phagocytosis or of the fate of the digested material. It is fortunate, however, that some of the tools which are likely to be of value in research on these aspects of macrophage function are currently being developed. Of particular interest in this connection are the immunocytochemical techniques which permit the localization of surface-associated antigens and intracellular contractile proteins. It must be emphasized that phagocytosis is not the only function of macrophages in the gas-exchange zone of the lung. These cells are thought to be involved in the presentation of exogenous antigenic material to the reactive cells of the lymphoid system. Recent research has also indicated that mammalian alveolar macrophages synthesize a diverse range of substances. Furthermore, the elastases associated with pulmonary macrophages are now thought to be involved in the pathogenesis of emphysema. All of the above mentioned activities are of great biological and clinical significance and, consequently, merit the cytochemists' attention in future. The epithelial lining of the greater part of the pulmonary gas-exchange area is composed of type I pneumonocytes. In terms of ultrastructure, these are very specialized cells; their extensive and highly-attenuated cytoplasmic processes form the outer layer of the air-blood barrier. No special carrier systems have been identified within type I pneumonocytes and this is in keeping with the claims that oxygen is transferred across the alveolar tissue barrier by a process of simple diffusion. Type II pneumonocytes, in contrast, have considerable metabolic activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3554367 TI - [Transgenic mice and carcinogenesis in vivo]. PMID- 3554368 TI - The lack of involvement of central nervous system in the antiarrhythmic effects of prostaglandins E2, F2 alpha, and I2 in cat. AB - The role of the central nervous system (CNS) in the antiarrhythmic effects of prostaglandins (PGs) E2, F2 alpha, and I2 was studied by administering each agent into the left lateral cerebral ventricle (i.c.v. administration) of chloralose anaesthetized cats. The cardiac arrhythmias were produced by intravenous (i.v.) infusion of ouabain (1 microgram/kg/min). The PGs E2, F2 alpha and I2 on i.c.v. administration in the dose range of 1 ng to 10 micrograms failed to inhibit ouabain-induced cardiac arrhythmias. However, when infused i.v., PGE2 (1 microgram/kg/min), PGF2 alpha (5 micrograms/kg/min), and PGI2 (2 micrograms/kg/min) effectively suppressed these arrhythmias. The standard antiarrhythmic drug propranolol (0.5-8.0 mg) on i.c.v. administration also significantly reduced the ouabain-induced cardiac arrhythmias. It is suggested that the CNS is not the site of action of PGs E2, F2 alpha, and I2 in antagonising the ouabain-induced cardiotoxicity in cats. PMID- 3554369 TI - Search of prostaglandins and related compounds in plants. A review of the occurrence of prostaglandins and prostaglandin-like compounds in plants. PMID- 3554370 TI - Biliary, fecal and urinary excretion of [3H]-prostaglandins in the rat. AB - The profiles of biliary, fecal and urinary excretion of tritium labeled prostaglandins (PG's) of differing biological activity were investigated in the rat. The PG's (10 micrograms/kg: 2 to 50 microCi/rat, in 1 ml polyethylene glycol 400) were administered intragastrically. Excretion data were expressed as a percentage of the total administered radioactivity. For the orally administered PG's 11R-methyl-16R-fluoro-15R-hydroxy-9-oxoprosta-ci s-5-trans-13-dienoic acid and its methyl ester, excretion was equally divided between urine and feces. The fecal and urinary profile of excretion of 3H after prostacyclin (PGI2) was similar to that following administration of 11R, 16, 16-trimethyl-15R-hydroxy-9 oxoprosta-cis-5-trans-13-dienoic acid (trimoprostil), a PG with antisecretory antiulcer potential. However, PGI2 was very poorly absorbed from the intestine, while the absorption of trimoprostil was very efficient. Biliary excretion, with little entero-porto-hepatic biliary circulation, was the main route of elimination of trimoprostil, thereby resulting in rapid elimination of drug related products and diminishing the potential for systemic liability in the rat. PMID- 3554372 TI - [Malaria in Polish sailors 1983]. PMID- 3554371 TI - Regulation of microvascular prostacyclin and thromboxane with inhibitors of arachidonic acid metabolism. AB - The levels of the stable degradation products of prostacyclin (PGI2) and thromboxane A2 (TXA2): 6-oxo-prostaglandin E1 alpha (6-oxo-PGE1 alpha) and thromboxane B2 (TXB2) respectively were determined in the effluent of the rabbit epigastric skin flap after infusion of exogenous arachidonic acid. The blood to the flap passes through the microcirculation and thus the changes in eicosanoid biosynthesis in this part of the vasculature were recorded. The aim was to use inhibitors of arachidonic acid metabolism to increase the PGI2/TXA2 ratio. This may be potentially beneficial to ischaemic skin flaps by reducing platelet aggregation associated with damaged microvascular endothelium, overcoming vasospasm and increasing microvascular blood flow. Increased PGI2/TXA2 ratios (up to 5-fold) were best achieved using TXA2 synthetase inhibitors such as dazoxiben hydrochloride. These were significantly more potent than the phosphodiesterase inhibitor dipyridamole, and the lipoxygenase inhibitor Bay g6575. No increase in blood flow was achieved. The cyclooxygenase inhibitor indomethacin did slow the blood flow at high concentrations (above 10(-5) M), and inhibited both PGI2 and TXA2 synthesis. Approximately 2-fold higher concentrations of dazoxiben hydrochloride and dipyridamole were required to produce the same TXA2 synthetase inhibition in the flap microvasculature in vivo compared with platelets in vitro. PMID- 3554374 TI - [10 years' activities of the Polish Albert Schweitzer Organization]. PMID- 3554373 TI - [Evaluation of bacteriologic cure of S. enteritidis infection in children based on 3- and 7-culture methods of feces control]. PMID- 3554375 TI - [Value of determining beta 2 microglobulin level in the diagnosis of selected nephropathies]. PMID- 3554376 TI - [25th issue dedicated to the medical problems during the occupation under Hitler. On the 42d anniversary of the liberation of the Auschwitz-Birkenau concentration camp]. PMID- 3554377 TI - [Quarantine of male prisoners in Birkenau]. PMID- 3554378 TI - [The physician and mass murderer Joachim Mrugowsky]. PMID- 3554379 TI - ["Tabun" war gas and the Dyhernfurth subcamp]. PMID- 3554381 TI - [Escapes from concentration camps]. PMID- 3554380 TI - [Widows of prisoners in concentration camps. Psychological and social studies]. PMID- 3554382 TI - [Health care for prisoners in occupied Lvov]. PMID- 3554383 TI - [Hospital for prisoners of war in Cracow and Silesia]. PMID- 3554384 TI - [At the hospitals of Ravensbruck and Sachsenhausen concentration subcamps]. PMID- 3554385 TI - [Under the pressure of hopelessness in the concentration camp]. PMID- 3554386 TI - [Dr. Leon Wojciech Jan Bazala]. PMID- 3554387 TI - [Dr. Jan Oktawian Jodlowski]. PMID- 3554388 TI - [From the correspondence on the Auschwitz issue of Przeglad Lekarsi (IX)]. PMID- 3554389 TI - [Medical subjects appearing in 1986 Polish publications during the German occupation]. PMID- 3554390 TI - [Contents of the preceding issues of Przeglad Lekarski (Medical Review) devoted to medical problems during the occupation under Hitler]. PMID- 3554391 TI - [25th issue dedicated to the medical problems during the occupation under Hitler. Introduction]. PMID- 3554392 TI - [The K-Z syndrome (concentration camp syndrome) in prisoners of the Miranda de Ebro concentration camp]. PMID- 3554393 TI - [The Auschwitz vocabulary (G). A model]. PMID- 3554394 TI - [Health service of the "Pomerania" Army (1-6, September 1939)]. PMID- 3554395 TI - [Martyrology of physicians in the city of Tomaszow Mazowiecki (1939-1945)]. PMID- 3554396 TI - [The "Guardian Angel" pharmacy in Brzeszcze. Maria Bobrzecka, Master of Pharmacy]. PMID- 3554397 TI - [Problem of interpretation of Auschwitz factography]. PMID- 3554399 TI - Gold occlusal surfaces for acrylic denture teeth with vertical parallel pin castings. PMID- 3554398 TI - Laboratory procedures for constructing a cast metal based palateless denture. PMID- 3554400 TI - Using clear polypropylene splints in the fabrication of anterior porcelain-fused to-metal fixed restorations. PMID- 3554401 TI - Identification of gastrin molecular variants in gastrinoma syndrome. AB - The molecular species of gastrin in the circulation and in tumor extracts were studied in two groups of patients: (1) with benign gastrinoma and (2) with gastrinoma with liver metastases. Radioimmunoassays (RIAs) and immunoaffinity chromatography for the amino (NH2)- and amidated COOH-terminus of gastrin-17 (antiserum G17) and the NH2-terminus of gastrin-34 (antiserum G34) were employed. In both benign and metastatic tumors the molecular forms of gastrin in boiling water extracts measured by the gastrin-17 NH2- and COOH-terminal assays were similar. In addition to a molecular component resembling the amidated gastrin-17, there were also significant amounts of larger molecular weight (mol. wt.) forms. The larger mol. wt. forms absorbed by the NH2-terminus of G17 antiserum corresponded to the COOH-terminus-extended forms of gastrin-17. Furthermore, larger mol. wt. gastrins immunopurified by antiserum to the NH2-terminus of gastrin-34 corresponded to gastrin-34 extended molecules. Sera of patients with liver metastases had higher concentrations of the NH2-terminal of gastrin-17 whereas sera of patients with benign gastrinoma contained predominantly gastrins detected by the COOH-terminal assay. These results suggest that: (a) there are differences in the molecular pattern of gastrin in the circulation of patients with benign and metastatic gastrinomas; (b) gastrins which are fully processed with carboxy-terminal amidation predominate in the circulation of patients with benign gastrinoma; and (c) gastrins containing the gastrin-17 and COOH-terminally extended gastrin-17 and gastrin-34 precursor molecules occur in high concentration in the circulation of gastrinoma patients with metastases to the liver. PMID- 3554402 TI - [The Newbery roots]. PMID- 3554403 TI - [The history of dentistry. Histories--bibliographies--museums]. PMID- 3554404 TI - [The oral suffering of Sigmund Freud]. PMID- 3554405 TI - [The School of Dentistry on its 40th anniversary]. PMID- 3554406 TI - [In honor of Dr. Leon Pereira]. PMID- 3554407 TI - [Role of echography in the study of retroperitoneal tumors]. AB - Fourteen patients affected by primitive retroperitoneal tumors were examined by means of sonography in order to assess the value of this technique in this type of pathology. Ten patients underwent fine needle biopsy, 5 barium meal examination, 2 intravenous pyelography. In 8 patients CT was also performed. Surgical removal or explorative laparotomy followed by histological examination was performed in all patients. Sonography proved reliable in identifying and in assessing the type of the lesion (if associated with fine needle biopsy which was performed in 10 out of 14 patients). Sonography proved little less satisfactory in determining the site and the local extension of the lesion since the huge dimensions of the tumor did not always allow to use those semeiologic signs described in the literature. All tumors examined presented, in fact, as large masses, this fact indicating the scanty progress sonography has taken in the field of the early diagnosis. Since the huge dimensions of these tumors do not always allow a complete surgical removal, and because of their proven tendency of relapsing, the prognosis of these tumors seems to persist unfavourable notwithstanding the widespread use of sonography. PMID- 3554408 TI - [High-resolution echography and angiography in the study of vascular accesses for hemodialysis]. AB - In 23 hemodialytic patients with clinically presumed complications of the vascular access the arteriovenous shunt was studied by high resolution ultrasonography (US) and by angiography. In 21/23 cases US identified the shape of the shunt correctly; in these patients US always showed the alterations of vascular size (stenosis, aneurysm) and complete occlusion, also detecting the intravascular extension of thrombosis. In 3 patients US identified partial venous thrombosis missed on angiography; furthermore, unlike angiography, US gave precise information on the vascular wall and perivascular tissue changes. These findings suggest that US may represent the first imaging procedure in the study of the vascular access in hemodialytic patients; angiography might be performed when US findings are uncertain or when a vascular map is needed for surgery. PMID- 3554409 TI - [Echographic diagnosis of the abdomen]. PMID- 3554410 TI - [Echographic diagnosis of organs and surface structures]. PMID- 3554411 TI - [Echo-guided percutaneous biopsy]. PMID- 3554412 TI - [Echo-guided abdominal drainage]. PMID- 3554413 TI - [Subcapsular hematoma of the liver in the newborn infant]. PMID- 3554414 TI - [Splenic abscess: unique localization in infection]. PMID- 3554415 TI - [Clinical and toxicologic study of axillary plexus block with prilocaine or mepivacaine]. AB - A prospective controlled double-blind study was designed to compare the efficacy and the toxicity of mepivacaine and prilocaine for the axillary blockade of the brachial plexus. Twenty patients in each group received 40 ml of either 1.5% mepivacaine or 1.5% prilocaine. The sensory and the motor blockade achieved in both groups were comparable. The mean plasma levels attained following mepivacaine were significantly higher than those attained after prilocaine (peak plasma level (mean +/- SD): 2.02 +/- 0.28 micrograms/ml vs 5.37 +/- 1.83 micrograms/ml). In four patients of the mepivacaine group, the plasma levels entered the toxic range. While no methemoglobinemia could be detected following mepivacaine, four of the patients receiving prilocaine developed methemoglobinemia with a maximum level of 10%. No complications due to methemoglobinemia were observed in any of the patients. Because of its significantly lower toxic potential, prilocaine seems to be the better local anaesthetic for axillary blockade of the brachial plexus. PMID- 3554416 TI - Maleic hydrazide residues in tobacco and their toxicological implications. PMID- 3554417 TI - Fate and persistence of aquatic herbicides. PMID- 3554418 TI - Organophosphorus pesticide residues in fruits and vegetables in the United Kingdom and some other countries of the European community since 1976. PMID- 3554419 TI - A comparison of chairside and laboratory etching techniques for cast metal bridge retainers. PMID- 3554420 TI - [The glued prosthesis]. PMID- 3554421 TI - [Migration of the disk of a Bjork-Shiley mitral prosthesis. Diagnosis using M mode echocardiography]. PMID- 3554422 TI - Effect of feed intake level in late gestation on arterial blood concentrations of energy substrates, insulin and glucagon in the chronically catheterized gilt. AB - The aim of the present work was to study, in the unstressed catheterized gilt, the effect of pregnancy on arterial substrate and pancreatic hormone concentrations in relation to the feed intake level. The experiments were performed on 14 pregnant gilts during the last month of gestation and 5 non pregnant gilts after cannulation of one carotid artery. Blood samples have been collected regularly after an overnight fast. After catheterization of the pregnant gilt, a 4 day-period is required to obtain steady-state conditions. As compared with non-pregnant animals fed on the same standard conditions (i.e. 2 kg/d: crude protein: 130 g/kg; digestible energy: 12.8 MJDE/kg), pregnant gilts exhibit similar and constant blood glucose, lactate, ketone body and plasma free fatty acid concentrations. By contrast, blood alanine concentrations progressively increases. A reduction of the feed intake level by 40% does not modify the blood glucose concentrations but leads to reduce blood lactate and alanine concentrations. On the contrary, plasma free fatty acid levels rise progressively with a limited increase in blood ketone body concentrations. While plasma glucagon concentrations are constant whatever the physiological state or the feed intake level, plasma insulin levels progressively decrease in the pregnant gilt. These data are discussed to display some aspects of the adaptation of the maternal metabolism in the gilt in late gestation. PMID- 3554423 TI - Von Hippel-Lindau disease: case report of a patient with spontaneous regression of a retinal angioma. AB - We report clinicopathologic features of a case of von Hippel-Lindau disease in a patient who had been clinically followed for bilateral retinal and cerebellar involvement. Two of the patient's retinal hemangiomas appeared to show evidence of spontaneous regression. PMID- 3554424 TI - [Calcium antagonists and lung disease]. PMID- 3554425 TI - [Home care ventilation; the present state and the future]. PMID- 3554426 TI - [Treatment of intractable heart failure by the extracorporeal ultrafiltration method]. PMID- 3554427 TI - Vanity Fair, Spy and Jonathan Hutchinson. PMID- 3554428 TI - [Experience at Lille in plastic and reconstructive surgery using a fibrinogen glue produced by C.R.T.S]. PMID- 3554429 TI - [In vitro reconstruction of the human skin]. PMID- 3554430 TI - Economics of chemotherapy. PMID- 3554431 TI - Nursing's role in chemotherapy administration. PMID- 3554432 TI - [Central intravenous catheters: study of risk factors in infection]. PMID- 3554434 TI - [The evaluation of diagnostic tests]. PMID- 3554433 TI - [Isotopic evaluation of renal transplantation and its complications in 36 patients]. PMID- 3554435 TI - [Dr Agustin Nataniel Cox at the University of Chile and, later, in Valparaiso]. PMID- 3554437 TI - [Characteristics of HeLa cells adhesiveness in enteropathogenic Escherichia coli strains isolated from Chilean infants with diarrhea and their controls]. PMID- 3554436 TI - [Antinuclear antibodies in progressive systemic sclerosis]. PMID- 3554438 TI - [Comparative study of ranitidine in a single daily dose and in 2 doses in the short-term treatment of duodenal ulcers]. PMID- 3554439 TI - [Identification and treatment of risk factors during recovery from myocardial infarction]. PMID- 3554440 TI - [Forensic pharmacognosy: plant-derived drugs--myth and reality (I)]. PMID- 3554441 TI - ["Borderline" arterial hypertension in adolescents--a reality? Epidemiological and physiopathological significance]. PMID- 3554442 TI - [Endoscopic sclerotherapy of esophageal varices]. PMID- 3554443 TI - Maximum likelihood estimation and likelihood ratio test for square tables with missing data. AB - Missing data complicate the analysis of paired categorical data. This paper considers with the use of the EM algorithm, the maximum likelihood estimation and likelihood ratio test for incomplete square tables with missing data. An example involving the susceptibility of micro-organisms to antimicrobial drugs illustrates the procedure. PMID- 3554444 TI - [Enlightened medicine as viewed by an 18th-century physician, Samuel August Tissot (1728-1797)]. PMID- 3554445 TI - [Historical pathography and its problems]. PMID- 3554446 TI - [Vitamin D--metabolism and rickets]. PMID- 3554447 TI - [Medical, dental and hospital relations]. PMID- 3554448 TI - [Jaw injuries and the facial prosthesis as a part of rehabilitation]. PMID- 3554449 TI - [Physiopathology of brain edema]. AB - Brain edema (BE), defined as an increase in tissue water content leading to an increase in tissue volume, is a common histopathologic response associated with a number of acute and subacute brain lesions. In some cases BE is a result of an unbalance of physical forces, hydrostatic or osmotic gradients driving the water in the tissue (hypertensive encephalopathy, hydrocephaly, plasma hypoosmolarity). In most cases however BE is associated with complex brain tissue alterations. According to Klatzo (1967) two physiopathological types can be described: vasogenic edema follows a breakdown of blood brain barrier to proteins. Edema fluid enlarges the extra-cellular space and spreads within the white matter; cytotoxic edema is an intra-cellular retention of water due to various disorders of ionic balance across the plasmic cell membrane. In both cases the hydrostatic gradient between the vascular lumen and the tissue plays a major role in the amount and spread of the edema fluid. In both cases also, toxic substances produced by tissue destruction act as factors of secondary damage causing more blood brain barrier lesions and/or cellular membrane alterations and eventually enhance edema. In various pathological conditions vasogenic and cytotoxic edema are associated: edema around circumscribed lesions such as hematomas, traumatic contusions, tumors, abscesses is basically a vasogenic edema with a secondary cytotoxic component. Ischemic edema is initially a pure cytotoxic phenomenon with a secondary osmotic edema and lately a vasogenic component. The formation of BE leads to an increase in tissue pressure which may reduce local cerebral blood flow. If blood supply is already impaired this can lead to energy shortage and further tissue destruction. If the bulk of edema is large enough intracranial pressure rises up, brain shifts and herniations may occur. Hypertonic solutions and corticoids are the more widely used drugs against brain edema. Hypertonic solutions remove water from the normal brain and hence may reduce intracranial pressure rather than treat edema. Corticoids, through various discrete mechanisms interfere with some toxic substances, enhance energetic metabolism and allow tissue restitution with a rather limited effect on edema itself. PMID- 3554450 TI - [The French Society of Neurology. List of members (1987)]. PMID- 3554451 TI - [Periodontal diseases in children and adolescents]. PMID- 3554452 TI - [A direct technic for splinting the anterior teeth using a bonded splint]. PMID- 3554453 TI - [Bonded amalgams: direct and indirect or minimal preparation and obturation of caries cavities]. PMID- 3554454 TI - Potential role of trimethoprim-sulfamethoxazole in the treatment of serious hospital-acquired bacterial infections. AB - Although trimethoprim-sulfamethoxazole (TMP-SMZ) has become a standard agent for the treatment of a broad range of infections, it may often be overlooked as a choice for treatment of serious hospital-acquired infections. A review of the literature shows that a number of common and uncommon gram-negative and gram positive organisms susceptible to TMP-SMZ are frequently resistant to cephalosporins. TMP-SMZ has, in addition to its exceptional microbiologic activity, pharmacokinetic characteristics that make it a potentially cost effective alternative to third-generation cephalosporins in the treatment of serious hospital-acquired infections caused by susceptible organisms. PMID- 3554455 TI - Use of trimethoprim-sulfamethoxazole in pediatric infections: relative merits of intravenous administration. AB - Trimethoprim-sulfamethoxazole (TMP-SMZ) has traditionally been employed as an oral formulation for infections in ambulatory pediatric patients. However, therapeutic concentrations of TMP and SMZ in serum and CSF are more consistently attained after intravenous administration. Serum half-life increases with the age of the child, and few significant toxic effects are observed with intravenous administration. Either the necessity to optimize bioavailability because of the underlying seriousness of disease or a desire to avoid other drugs that may be responsible for adverse reactions or hypersensitivity should direct the clinician to administer an intravenous preparation. Serious pediatric infections that might warrant the consideration of intravenous TMP-SMZ include shigellosis, salmonellosis, typhoid fever, nocardiosis, gram-negative bacillary septicemia or meningitis, and infections due to Pneumocystis carinii and malarial parasites. Infections due to Listeria will respond to TMP-SMZ, and infections due to Citrobacter diversus, Acinetobacter species, Pseudomonas cepacia, and Flavobacterium meningosepticum are especially susceptible to TMP-SMZ. PMID- 3554456 TI - Use of trimethoprim-sulfamethoxazole singly and in combination with other antibiotics in immunocompromised patients. AB - Experience with trimethoprim-sulfamethoxazole (TMP-SMZ) alone or in combination with other agents in the treatment of immunocompromised patients other than those with Pneumocystis carinii pneumonitis and the acquired immunodeficiency syndrome is reviewed. A comparative study involving 126 episodes of fever showed a higher rate of response to a TMP-SMZ-carbenicillin regimen than to a gentamicin carbenicillin combination (85% vs. 69%, respectively, P less than or equal to .04). In another study TMP-SMZ was used after unsuccessful therapy with the combination of an antipseudomonal penicillin and an aminoglycoside; 54% of the 35 patients treated orally and 49% of 86 treated intravenously responded to TMP-SMZ regimens. Other studies document successful results with TMP-SMZ used in combination with either an aminoglycoside or an antipseudomonal penicillin. TMP SMZ has a role in the treatment of infections due to gram-negative bacilli in immunocompromised hosts, particularly when the infecting agent is not Pseudomonas aeruginosa and is resistant to moxalactam but susceptible to gentamicin. PMID- 3554457 TI - Use of trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonitis in patients with acquired immunodeficiency syndrome. AB - This report reviews the use of trimethoprim-sulfamethoxazole (TMP-SMZ) in individuals with Pneumocystis carinii pneumonitis (PCP) and the acquired immunodeficiency syndrome (AIDS). Before AIDS, TMP-SMZ was at least as effective as pentamidine in pediatric and adult populations and was notably less toxic. In a study prospectively comparing TMP-SMZ with pentamidine in patients with AIDS, the toxicity associated with either therapy was very high, a problem suggesting a need for the development of additional types of therapy. There was no difference in the clinical responses to the different therapeutic regimens; the majority of patients showed some improvement. The rates of both major and minor toxic reactions were similar in the two groups, although the reactions differed qualitatively. In patients with AIDS rash was frequently associated with TMP-SMZ therapy and was almost never associated with pentamidine therapy. Neutropenia was common with both drugs. Pentamidine may produce hypoglycemia, which, though infrequent, may be life threatening. Neutropenia and rash are two adverse effects of TMP-SMZ therapy being described with great frequency in patients with AIDS. Mild neutropenia is common in patients with AIDS, even when therapy is not being administered. The high rate of toxic reactions limits the usefulness of TMP-SMZ for routine prophylaxis. PMID- 3554459 TI - Prophylaxis with trimethoprim-sulfamethoxazole in abdominal, pelvic, and prostatic surgery. AB - The literature on use of trimethoprim-sulfamethoxazole (TMP-SMZ) for prophylaxis in abdominal, pelvic, and prostatic surgery is meager. There is some evidence that TMP-SMZ may be effective prophylactically in biliary surgery (in patients with functioning gall bladders). Further study is needed to clarify the mixed results seen in prostatic and pelvic surgery. An evaluation was made of the effectiveness of TMP-SMZ in the prevention of endomyometritis following cesarean section in 206 women who were comparable in terms of risk factors. Among patients given a placebo, a total of 44 infections (42%) occurred, whereas among those given TMP-SMZ prophylaxis, 22 infections (22%) occurred, a statistically significant difference (P = .037, chi 2). The rate of endomyometritis among placebo recipients was 33%, as contrasted with one of 19% in those given TMP-SMZ (P = .02, chi 2). Prophylactic treatment resulted in lower rates of endomyometritis in both high- and low-risk women, but the results reached statistical significance only among high-risk patients. In essence, prophylaxis changed high-risk patients into low-risk patients. PMID- 3554458 TI - Recurrent urinary tract infections in female patients: an overview of management and treatment. AB - Several major factors have contributed to the current availability of highly successful techniques for the management of recurrent urinary tract infection (UTI) in female patients. Since UTI cannot be diagnosed by symptoms alone, greater accuracy in diagnostic techniques that establish whether bacteria in the voided urine are present in the bladder urine is the most important factor. Second, the recognition that almost all recurrent UTIs are reinfections is crucial. Third, it has been observed that bacteriuria in female patients is preceded by colonization of the introital mucosa of the vagina and urethra with Enterobacteriaceae from the rectal flora; it is at these sites that oral antimicrobial agents can determine the character of subsequent reinfections of the urinary tract. A fourth factor is the development of highly effective prophylactic regimens, including trimethoprim-sulfamethoxazole, nitrofurantoin, cinoxacin, and cephalexin. In addition, the management of patients with UTI has improved because correctable causes of bacterial persistence are now well recognized and there is an improved understanding of the kinds of patients at increased risk. Finally, new antimicrobial agents with more favorable pharmacokinetic properties have become available. PMID- 3554460 TI - [Cancer of the ovary. Comparative value of serum CA-125, immunochemistry and biological tests of inflammation]. AB - The marker CA-125 is not specific of malignant ovarian tumors but, when its titration is positive, its evolution permits to follow correctly the development of the tumor. The authors report their experience with 180 titrations coupled with the titration of inflammation markers. PMID- 3554461 TI - [Prospective randomized study comparing the efficacy and tolerance of clindamycin gentamycin versus metronidazole-gentamycin in acute utero-adnexal infections in hospitalized patients]. AB - The efficacy and safety of two antibiotic combination (clindamycin + gentamycin [C + G] versus metronidazole + gentamycin [M + G]) have been compared in 45 in patients suffering from pelvic inflammatory disease in a clinical prospective randomized trial. The rates of clinical and bacteriological recovery reached respectively 85.7% and 71.4% for C + G group compared to 83.3% and 78.6% for M + G group (no significant differences). Side effects (vomiting, gastralgia and vaginal mycosis) developed in four occasions in each group. The most frequently isolated organisms were chlamydiae, E. coli and Neisseria gonorrheae (around 50% of overall isolated organisms). Due to the lack of significant differences between the two antibiotic combinations, the final choice will depend on potential risks generated by these products. PMID- 3554462 TI - [A modification in technology improves the specificity of the Du Pont de Nemours immunoenzyme kit for the detection of anti-HIV antibodies]. AB - Du Pont De Nemours perfected a new enzyme immunoassay for the screening of anti HIV 1 antibodies, characterized by its rapidity: 2 hours of incubation, when the normal procedure needed 3 hours 30 minutes of incubation. We tested with the normal procedure and the shortened one 4,025 randomly selected blood donors. 55 samples of the SNTS panel and 10 sera representing the Western-Blot reference panel of the "Retrovirus" study group of the SNTS. We can say that shortening the incubation time results in certain advantages opposite the previous procedure: time saving (1 hour 30 minutes); improved specificity: the rate of false positive, 0.37% with the normal method, drops to 0.07% with the short one; good sensitivity, since all the individual positive samples were detected but it seems slightly less sensitive than the normal method for the diluted positive samples. PMID- 3554463 TI - Fast and accurate cast repairs. PMID- 3554464 TI - Predictive value of nasal bacterial culture for etiological agents in acute maxillary sinusitis. AB - Nasal secretion, aspiration yield and lavage content from the sinus were studied for bacteria in 175 patients (247 sinuses) with acute maxillary sinusitis. The same pathogen was cultured from the nose and aspiration fluid in 91% of cases of acute purulent sinusitis. This indicated a significant predictive value of the nasal bacteriological culture for presence of pathogenic bacteria in the sinus in purulent cases. In cases with no growth of pathogens in the aspirate, the nasal culture showed pathogenic bacteria in about 50%. Examination of the aspiration fluid may occasionally give false negative result in purulent maxillary sinusitis (at least 3% in the present series). In these cases, culture of the irrigation yield may prove helpful. PMID- 3554465 TI - Metabolism of xenobiotics in hepatocyte nodules. PMID- 3554466 TI - HMP-shunt and cholesterol metabolism in experimental models involving normal and preneoplastic liver growth. AB - Previous studies from our laboratories have shown a stimulation of HMP-shunt, cholesterol metabolism and DNA synthesis during cell proliferation. In order to understand the co-ordinated regulation of these pathways during cell growth, the above metabolic pathways were studied in: liver regeneration after partial hepatectomy, lead-induced liver hyperplasia, liver cell proliferation induced by insulin in streptozotocin-diabetic rats, liver cell proliferation in fasted rats after refeeding and, hepatocyte nodules induced by a selection procedure. The results indeed indicate that changes in HMP-shunt and cholesterol metabolism occur at a very early stage during the process of normal as well as preneoplastic cell growth. The coordinated regulation between cell growth and changes in these metabolic pathways needs further study. PMID- 3554467 TI - Free radical injury and liver tumor promotion. AB - One of the underlying mechanisms of tumor promotion both in the skin and liver involves free radical mediated injury to informational macromolecules of target cells. A choline-deficient (CD) diet, which is an efficient liver tumor promoter, induces peroxidative damage of liver cell membrane lipids. By modifying components of a CD diet, we have shown that the efficacy of the promotion is correlated with the extent of lipid peroxidation. The substitution of fats in a CD diet with predominantly polyunsaturated fat and the addition of methapyrilene to a CD diet enhances membrane lipid peroxidation and the promoting effects. An antioxidant (BHT) and hypolipidemic peroxisome proliferators (BR931 and DEHP) suppress both of these effects. Contrary to these findings, phenobarbital did not induce membrane lipid peroxidation, and its addition to a CD diet inhibited the diet-induced lipid peroxidation, though such a combination exerted a stronger promoting action. Thus, a CD diet and phenobarbital exert their promoting actions through different mechanisms. The consequence of membrane lipid peroxidation in the liver cells induced by a CD diet may be multiple. Our recent study of surface membrane insulin receptors of liver cells of rats fed a CD diet showed a decrease in number and an enhanced binding affinity leading to altered responsiveness of liver cells to insulin mediated glycogen synthesis. It is suggested that CD diet induced lipid peroxidation leads to functional alterations of membrane receptors involved in cell growth control and may thereby exert its promoting action. PMID- 3554468 TI - Quantitative assessment of trimethyltin induced pathology of the hippocampus. AB - The pathology induced by trimethyltin in the hippocampus was investigated using a detailed morphometric model. Male Long-Evans rats were dosed with 3 mg/kg trimethyltin chloride (TMT) for three consecutive days and sacrificed at subsequent interim period. Total brain volume was not significantly affected; hippocampus volume decreased within 4 days after completion of dose. Pyramidal cells were more sensitive to the toxic effects of TMT than granule cells, in addition, dorsal pyramidal cells appeared to be more sensitive than ventral pyramidal cells. The dorsal CA4 region appeared to be the most susceptible to cell loss, although the dorsal CA1 region also exhibited significant reductions. The most dramatic reduction in cell numbers occurred between 14 and 28 days post dose. Cell loss within the CA3c and CA4 but not the CA1 region was preceded by decreased nuclear volume. In addition cellular loss within the dorsal CA1 region appeared to be most pronounced within a well defined rectangular patch of cells immediately adjacent to the CA3-CA1 junction. The data further suggest that TMT is a potent toxicant to the hippocampus. This toxicity is delayed, and selectively affects well defined groups of cells within the structure. Additionally, differences in nuclear pathology suggest that more than one mechanism may be involved in the destruction of these target cell populations. PMID- 3554469 TI - Induction of a novel Ca2+-dependent serine protease in rat liver treated with various promoters of liver carcinogenesis. AB - The induction of a novel Ca2+-dependent protease in rat liver treated with various liver promoters, as well as its increase in preneoplastic lesions during liver carcinogenesis, was demonstrated. Six groups of male Fischer 344 rats (150 g body weight) were fed separately diets containing one of the following promoters: 0.05% phenobarbital (PB), 0.05% dichlorodiphenyltrichloroethane (DDT), 0.25% ethyl-alpha-chlorophenoxyisobutyrate (CPIB), 0.5% butylated hydroxytoluene (BHT), 10 ppm 17-alpha-ethynylestradiol (EE), and 0.05% of the non-promoter diphenylhydantoin (DH). After feeding the indicated diets for 1 week, rats were killed and protease activity in the microsomal fraction of liver tissue was determined using N-benzoyl-L-tyrosine ethyl ester as substrate. The activity of protease increased 3- to 5-fold after treatment with the promoters and compared with normal liver; the non-promoter (DH) induced a slight increase in activity. Hyperplastic nodules were induced according to the method of Solt and Farber. The activity of protease was significantly high in these preneoplastic lesions compared with the surrounding liver tissue. Biochemical characterization of this protease revealed the following properties: high Ca2+ dependency, different molecular weight and optimum pH from previously reported proteases, and preferential distribution in the SER fraction. These results suggest that a novel type of protease is induced specifically in the liver by promoters of liver carcinogenesis. The possible importance of this protease in the carcinogenic process is discussed. PMID- 3554470 TI - Transplantation of preneoplastic rat hepatocytes by intraportal injection. AB - Hepatocyte suspensions prepared from inbred male Wistar-Kyoto rats were transplanted to the livers of syngeneic recipients by injection into the portal venous system immediately after partial hepatectomy. Donor cells were labelled with 51Cr in vitro before transplantation. Animals were sacrificed 1 hr, 10 hr, 48 hr, or 1 week later and the liver radioactivity was measured in a gamma counter. Total liver radioactivity declined rapidly during the first 10 hr after transplantation, and then stabilized. After 1 week, 15-20% of the injected radioactivity still remained, indicating that this fraction of the injected cells was retained by the liver. The percentage was unaffected by the number of cells injected. In another experiment, 10(6) hepatocytes from a carcinogen-treated rat were transplanted to syngeneic rats fed 0.05% phenobarbital in the diet. Recipients developed liver carcinomas from 7 weeks after transplantation, and at 5 months 4 out of 5 animals showed severe debility and had large hepatocellular carcinomas. This model generates tumors considerably faster than those previously described, and is well suited for the study of the tumorigenic potential of subclasses of cells in liver carcinogenesis. PMID- 3554471 TI - Prostacyclin, thromboxane and prostaglandin F2 alpha; plasma levels in breast cancer. AB - In this study, 6-keto-prostaglandin F1 alpha, TXB2, and 15-keto-13,14-dihydro prostaglandin F2 alpha plasma levels (i.e., theprostacyclin, thromboxane, and PGF2 alpha-metabolites, respectively) were determined, using a radioimmunoassay, in 32 breast cancer patients (21 without evidence of disease and 11 with metastases), and in a control group of 16 patients. Neither group of breast cancer patients showed an increased plasma level of any of these products compared with the control group. This study suggests that the increased 6-keto prostaglandin F1 alpha, TXB2 and prostaglandin F2 alpha levels which have been observed in breast cancer tissues are not detectable in the plasma. PMID- 3554472 TI - [Changes in the anterior cerebral artery in relation to stenoses of the carotid arteries--a DSA study]. AB - DSA of the supraaortal extracranial arteries and intracranial arteries was performed in 568 patients suffering from cerebrovascular insufficiency. The results of this study showed a relationship between the atherosclerotic stenosis of the extracranial arteries and the occlusion of the A 1 segment of the anterior cerebral artery. PMID- 3554473 TI - [An extremely malignant uveal melanoma]. AB - The authors present an extremely pronounced involvement of the orbita in malignant uveal melanoma with a ten-year course of disease. The results of imaging diagnostics (ultrasound, computed tomography, magnetic resonance tomography) are discussed. PMID- 3554474 TI - [Clinical and biological diagnosis of acute lymphoblastic leukemia]. PMID- 3554475 TI - [Treatment of acute lymphoblastic leukemia in children]. PMID- 3554476 TI - Endocrine and metabolic effects of phenytoin. PMID- 3554477 TI - [The mechanistic paradigm of modern Western medicine: an anthropological perspective]. PMID- 3554478 TI - [Occurrence in Brazil of Thiara (Melanoides) tuberculata (O.F. Muller, 1774) (Gastropoda, Prosobranchia), the 1st intermediate host of Clonorchis sinensis (Cobbold, 1875) (Trematoda, Plathyhelmintes)]. PMID- 3554479 TI - [A focus on malaria in the State of Sao Paulo (Brazil)]. PMID- 3554480 TI - Cochlear micromechanics in understanding otoacoustic emission. PMID- 3554481 TI - Receptoneural and innervation aspects of the inner ear anatomy with respect to cochlear mechanics. AB - The important features of the innervation pattern of the organ of Corti are reviewed and the possible functional implications discussed. The numerical characteristics, the pattern, the structural features and the central connections of the afferent and efferent innervation of the inner and outer hair cells indicate that the information-transfer from the organ of Corti to the central nervous system occurs essentially in the inner hair cell system with its numerous associated neurons and that the functional emphasis of the outer hair cell system is in the periphery at the receptor cell level, probably by monitoring the receptor organ. PMID- 3554482 TI - Cochlear potentials in the study of cochlear physiology. AB - Cochlear potentials have been used for many years as probes of cochlear mechanics. Early studies of cochlear microphonics addressed the pattern of wave motion and linearity of the basilar membrane motion. Since the development of techniques to record from single receptor cells and sensory neurons, these potentials have also been used in studies of the mechanics. Although techniques exist for recording cochlear mechanical motion directly, cochlear potentials can be powerful supplements, since the methods used cause minimal damage to the cochlea and can be applied throughout the cochlear spiral. Unlike existing direct methods, cochlear potentials can be used to characterize the micromechanics of the organ of Corti. PMID- 3554483 TI - Pharmacological treatment of tinnitus with special reference to the role of melanin. AB - Local anaesthetics have hitherto been thought to exert their effects on tinnitus through a centrally operative mechanism, analogously to their effects in epilepsy and central pain. Evidences for a peripheral mechanism, probably related to the affinity of these drugs to inner ear melanin, are reviewed. The physico-chemical properties of melanin and findings indicating that this substance plays a role in hearing are also discussed. PMID- 3554484 TI - Pharmacological treatment of Meniere's disease. A review of common remedies with special emphasis on vasodilators, including hyperosmolar substances and hearing. AB - A review is given of common pharmacological therapies for Meniere's disease. The use of vasodilators and hyperosmotic agents is discussed on the bases of clinical and experimental investigations. Osmotic reduction of intralabyrinthine water seems to play a major role in the induced hearing gain but positive effects on the inner ear blood flow cannot be excluded. PMID- 3554485 TI - The effect of buflomedilhydrochloride (Loftyl) on temporary hearing threshold shift. AB - Buflomedilhydrochloride (Loftyl, Abbott) is a vasodilating agent which has proved not only to influence peripheral blood vessels but also cerebral vascular disease. We tested the ability of Buflomedil to prevent noise-induced temporary threshold shift (TTS). Ten individuals tested the active substance and placebo 5 times each at random. In the individual analysis comparing Buflomedil and placebo sessions, there was a statistically significant decreased TTS after Buflomedil. PMID- 3554487 TI - Pathophysiological aspects on eustachian tube function and SOM. PMID- 3554486 TI - Epidemiology and SOM. A review. PMID- 3554488 TI - Enzyme-linked immunosorbent assay and radioimmunoassay of serum pepsinogen A. AB - The determination of serum pepsinogen A (= pepsinogen I) levels is of clinical importance in the study of duodenal ulcer, atrophic gastritis and gastric cancer. In the present study two different quantitative immunological techniques for serum pepsinogen A were compared: a radioimmunoassay (RIA) (Helsinki) and an enzyme-linked immunosorbent assay (ELISA) (Amsterdam). Serum samples of 177 subjects with various gastric diseases were tested in a double blind study. The correlation was excellent (r = 0.954 in the range 0-760 micrograms/l and r = 0.971 in the range 0-100 micrograms/l). The functional relationship between ELISA (x) and RIA (y), determined by weighted model II regression, was y = 1.12x-0.54. Initially the use of goat anti-PGA in the ELISA resulted in falsely high values in about 10% of the individuals. This was caused by circulating antibodies cross reacting with goat IgG. This artefact was eliminated by pre-incubation of all samples with non-immune goat serum. PMID- 3554489 TI - Formation of prostacyclin-sensitive platelet aggregates in human whole blood in vitro. Part II. The occurrence of the phenomenon in males suffering from acute myocardial infarction. AB - The de-aggregatory effect of prostacyclin (PGI2) and the rate of spontaneous platelet aggregation (SPA) were studied in vitro in whole blood of 24 males with acute myocardial infarction (MI) and 18 males, patient controls (PC). The de aggregatory effect of PGI2 and the rate of SPA (measured as a percentage of changes in free platelet number in whole blood) were higher (p less than 0.01) in MI than PC. The de-aggregatory effect of PGI2 in whole blood was higher (p less than 0.05) on the first day of MI than on day 14 following MI. The highest de aggregatory effect of PGI2 was found in whole blood of patients with MI complicated by ventricular fibrillation. In neither of the groups did the de aggregatory effect of PGI2 correlate with patients' age, haematocrit, erythrocyte and leucocyte counts, triglycerides, HDL, LDL or total cholesterol levels. In the MI group, de-aggregatory effect of PGI2 was correlated with free platelet concentration (r = -0.59, p less than 0.05), elevation of glutamic oxalacetic transaminase (r = 0.53, p less than 0.05) and creatinine phosphokinase (r = 0.69, p less than 0.001). The de-aggregatory effect of PGI2 in blood of patients with evolving MI did not differ from that in PC. It is concluded that the increased rate of SPA and formation of PGI2-sensitive platelet aggregates in vitro in whole blood of MI patients are secondary to myocardial necrosis. PMID- 3554491 TI - Cisapride in non-ulcer dyspepsia. Results of a placebo-controlled trial. AB - The effect of cisapride, 10 mg three times daily, was evaluated in a double-blind randomized study in 118 patients with non-ulcer dyspepsia. Peptic ulcer disease was excluded by endoscopy, gallstones by ultrasonography, and chronic pancreatitis by a series of non-invasive tests. Symptomatic improvement was evaluated by interview after 2 and 4 weeks; the patients also kept a diary. Cisapride caused significant improvement compared with placebo with regard to frequency and severity of symptoms and may therefore be useful in the therapy of non-ulcer dyspepsia. PMID- 3554492 TI - A randomized trial of fistulotomy in perianal abscess. AB - In a randomized trial we compared the treatment of perianal abscess by incision only (18 patients) with that by incision followed by fistulotomy 3 days later (20 patients). All patients were observed for 12 months. There were no differences between the two groups with regard to recurrent abscess/fistula, but the fistulotomy group had a statistically significantly higher prevalence of flatus incontinence. Further, fistulotomy was followed by significantly longer duration of hospitalization and by delayed healing. We recommend that fistulotomy is used only in patients with recurrent abscess. PMID- 3554490 TI - Beta-adrenoceptor blockade in the treatment of postoperative adynamic ileus. AB - Abdominal trauma, such as surgery and peritonitis, leads to inhibition of intestinal motility, partly mediated by alpha- and beta-adrenoceptors. To investigate the effect of nonselective beta-blockade on adynamic ileus, propranolol was compared with placebo in the postoperative course after elective colonic surgery in a double-blind randomized study. Ten patients received 4 mg propranolol intravenously twice daily, and ten received 10 mg intravenously twice daily. Nineteen patients received placebo. The time to first passage of stool was 110 +/- 9 h in the placebo group and 82 +/- 11 h in the 4-mg propranolol group. In the 10-mg propranolol group, the time was 79 +/- 8 h. The difference between the placebo-treated group and the propranolol-treated groups was significant (p less than 0.01). The effect of propranolol was most marked in older patients and after surgery on the distal colon. In patients older than 60 years the time to first stool in the placebo group was 127 +/- 13 h (n = 8), compared with 73 +/- 8 h (n = 11) in the propranolol group (p less than 0.01). In patients who had undergone surgery on the distal colon the time to first stool was 125 +/- 13 h (n = 8) in the placebo group and 76 +/- 8 h (n = 11) for propranolol (p less than 0.01). Adverse effects on the respiratory or cardiovascular system were not seen during medication. It is concluded that propranolol shortens the period of adynamic ileus after colonic surgery. PMID- 3554494 TI - Immunological involvement in the pathogenesis of pristane-induced arthritis. AB - Evidence is presented that the development of arthritis induced in mice by 2,6,10,14-tetramethylpentadecane (pristane) involves the immune response. Mice irradiated (500 rad) before injection of pristane failed to develop arthritis. By contrast, irradiated mice given lymphoid cells from normal donors and challenged with pristane developed arthritis. Other experiments showed that lymphoid cells from irradiated mice given pristane suppressed the development of arthritis in recipients challenged with pristane. Finally, the incidence of arthritis was significantly higher in CBA/Igb mice given pristane than in the allotypic congenic strain CBA/H, suggesting that a gene linked to the heavy chain immunoglobulin locus controls the development of arthritis. PMID- 3554493 TI - Gastric emptying rate after gastric bypass and gastroplasty. AB - Fifty-seven morbidly obese patients were randomized into two surgical treatment groups, gastric bypass (n = 29) and gastroplasty (n = 28). Studies of the gastric emptying with radionuclide-labelled food were performed preoperatively (12 patients) and postoperatively at 2 months (28 patients) and 12 months (49 patients). Pouch emptying after gastric bypass was slower at 2 months than at 12 months. After gastroplasty the emptying rate was the same at 2 and 12 months and the same as that of gastric bypass at 12 months. A statistically significant correlation between stoma diameter and emptying rate was seen 1 year after gastroplasty but not after gastric bypass. No correlation between emptying rate and weight loss was shown in either group. Differences in the mechanisms of action between these two methods are apparent and are discussed. PMID- 3554495 TI - The gene for the Leu-M2 (Mac-120) antigen is located on human chromosome 11. AB - Leu-M2 (Mac-120) antigen is a cell-surface marker present on a subpopulation of human blood monocytes and platelets. Its expression on monocytes and macrophages is necessary for their ability to present antigen to T lymphocytes. Only Leu-M2+ cells display the human Ia-like determinant, HLA-DS, which seems important in antigen presentation and stimulation in the autologous MLR. Expression of the Leu M2/Mac-120 antigen was studied by indirect immunofluorescence analysis and flow cytofluorometry in mouse-human somatic cell hybrids segregating human chromosomes. In the mouse-human hybrid clones, expression of the Leu-M2/Mac-120 antigen was dependent on the presence of human chromosome 11. This was verified by fluorescence-activated cell sorting of heterogeneous hybrid cell populations into antigen-positive and-negative fractions. The Leu-M2 antigen co-segregated with chromosome 11. The gene controlling the expression of the Leu-M2/Mac-120 antigen thus is assigned to human chromosome 11. PMID- 3554496 TI - Psychological stress experienced by health care personnel. AB - Health care personnel consider the challenge of their work to be the principal reason for job satisfaction. Problems of work organization and the small number of personnel cause quantitative overload that has been perceived as problematic by various professional groups in health care units. Role ambiguity and role conflicts are also experienced frequently. Social contacts between patients and personnel, as well as social contacts among the personnel themselves, are sometimes thought to be very problematic. The increase in violent behavior towards health care personnel is a central stressor of their work. The way that work characteristics and strain are experienced, however, is affected by the profession and, especially, by the workplace. Psychological stress reactions are relatively common among health care personnel. The effects of work reorganization, the clarification of responsibilities, increased supplementary training and professional supervision, and the application of directions for the prevention of violence on the stress and strain of health care professionals should be studied as a means to diminish stress and increase well-being and productivity. PMID- 3554497 TI - [Extracorporeal shockwave lithotripsy: experience with 1000 treatments]. AB - 6 1/2 years after the first clinical trials in Munich, extracorporeal shockwave lithotripsy is a well established method for the treatment of urinary tract calculi. The number of open surgical interventions in urolithiasis has therefore markedly diminished. In hospitals with lithotriptors open surgical procedures are less than 1% today. In the first 16 months the Department of Urology at the University of Berne performed 1000 treatments with a kidney stone lithotriptor. The treatment was successful in 93.8%, a result comparable with those of other stone centres. During the last few months the indication for the treatment has been considerably enlarged. The new lithotriptors differ in several respects from the standard model by Dornier, though basically the principle of shockwaves remains unchanged. PMID- 3554498 TI - [On the history of kidney disease]. PMID- 3554499 TI - [Post-traumatic/postoperative immune deficiency syndrome]. AB - Severe trauma, major surgery and burns (TSB) are often followed by infections, adult respiratory distress syndrome and multi-organ failure, complications which are thought to be the consequence of the post-TSB immunodeficiency syndrome. The most important data and hypotheses in this regard are summarized. After a TSB event large amounts of tissue debris, endotoxins and microorganisms have to be eliminated. Further important factors in TSB are stress reactions, malnutrition, loss and replacement of fluids and therapeutic measures. The elimination of unwanted elements is partly carried out by non-specific mechanisms such as opsonisation, chemotaxis and phagocytosis by granulocytes and cells of the macrophage/monocyte lineage, while specific reactions of humoral and cellular immunity also play a role. Severe TSB is thought to be associated with growing exhaustion of the unspecific defense system, leading to deficient specific immune reactions. Routinely measurable parameters only partly reflect the complex events after TSB: there is a decline in serum levels of fibronectin, immunoglobulins and some components of complement, in chemotaxis, phagocytosis and intracellular killing, and in circulating T3 and T4 lymphocytes as well as some lymphocyte functions. Some of these measurable parameters of defense mechanisms are statistically predictive for the occurrence of infections and other sequelae of TSB. Specific prophylactic and therapeutic measures can only be taken, if at least some of the complex events after TSB are better understood. PMID- 3554500 TI - [Quantitative sensitivity determination of bacteria. Indications and methods]. AB - The authors describe the indications for quantitative susceptibility tests and also the methods themselves (agar dilution, macrodilution, combination tests, tests for beta-lactamase production). This study forms part of a series on susceptibility methods which started with a paper on disk susceptibility testing (this journal, 1984; 114: 1079-1086). PMID- 3554501 TI - [Infectious diarrhea in children. Results of a prospective study concerning various epidemiological and clinical aspects of infectious diarrhea in children]. AB - Over a 3-year period (from October 1981 to September 1984) 352 pediatric patients were treated for infectious diarrhea at the Division for Pediatric Infectious Diseases, Department of Pediatrics, University of Berne, Switzerland. Routine diagnostic tests on stool samples included cultures for Salmonella, Shigella, Campylobacter and Yersinia, and enzyme-linked immunosorbent assay (Rotazyme) for rotaviruses. In selected cases special tests for parasitic pathogens were also performed. The patients were divided into three etiologic groups to compare epidemiological, clinical and laboratory characteristics; group 1 = rotavirus, group 2 = no detectable pathogen, and group 3 = bacterial agents. Specific etiology of diarrhea was established in 210 of the 352 patients (59.5%). Rotaviral gastroenteritis represented the most common diagnosis (42.5%), whereas Salmonella was isolated from fecal cultures in 9% and Campylobacter jejuni in 3%. A parasitic etiology was documented in only 1%. In 5 patients two pathogens were recovered from stools: rotavirus and Salmonella in 4 cases and Salmonella and Campylobacter in 1 case. Relevant features of rotavirus, Salmonella and Campylobacter gastroenteritis in childhood are described in detail. PMID- 3554502 TI - [Lamination technic and the clinical use of glass cermet cements by the McLean method. A review article]. PMID- 3554503 TI - [Glass ionomer cement for band attachment and further uses in orthodontic practice. A practical study with statistical data]. PMID- 3554504 TI - [The glass ionomer symposium--what will change in my own practice?]. PMID- 3554505 TI - [A case of nodular lymphatic leukosis in an aborted calf fetus]. PMID- 3554506 TI - Lead in ancient human bones and its relevance to historical developments of social problems with lead. AB - Concentrations of metabolic lead in buried ancient bones are obscured by replacement of calcium in apatite by excessive amounts of soil moisture Pb. Concentrations of metabolic barium in bones are affected in a similar way. Added soil Pb and Ba, expressed as log(Pb/Ca) versus log(Ba/Ca) among various bones at a given burial site, are positively covariant, with about 5-fold more soil Pb added for each unit of added soil Ba. The typical natural metabolic Ba/Ca ratio in contemporary people can be measured unambiguously because it as unaffected by industrial pollution. It applies to ancient people because it has not changed historically. The intercept of the covariance curve for buried bones of a given ancient population at the known metabolic Ba/Ca ratio indexes the corresponding metabolic Pb/Ca ratio in bones of that population. Lead levels which prevailed in Romans appear to have been similar to those in contemporary people, which are approximately 1000-fold above natural levels in humans determined by this method in ancient Peruvians. This indicates that studies of natural biochemical reactions in cells free of industrial Pb should be made, because most present biochemical knowledge is founded on data obtained from systems polluted with Pb 1000 to 100000-fold above natural levels. The 5000 year history of smelting Pb by humans indicates that a system of education fostered by genetically common lower brain center functions operated on hundreds of successive generations in a context of cultural changes invoked by feedback from developments in engineering technologies to give rise to the difference between present typical and prehistoric natural levels of Pb in humans. Archaeological and anthropological studies of early developments in writing, music and metallurgy by ancient Peruvians and Persian peoples should be combined with PET-scan studies of their descendants to discover if, as preliminary archaeological data suggest, the two ancient populations differed on a genetic basis in higher brain functions, yet are indistinguishable as metallurgical engineers. This would demonstrate that higher centers of the human brain did not exercise guiding control, through hundreds of generations, over those developments of engineering technologies which resulted in the extreme pollution of the earth's biosphere with poisonous Pb. PMID- 3554507 TI - Proteolytic self-cleavage of hepatitis B virus core protein may generate serum e antigen. AB - A model is proposed to explain the presence of the e antigen (HBeAg) of hepatitis B virus (HBV) in the serum of individuals infected with this virus. The e antigen, which has only recently been characterized, is a fragment of the virus core, or nucleocapsid, protein. Serum HBeAg is a valuable clinical marker for active HBV infection because its appearance correlates both with virus replication in the liver and with the presence of circulating virions. In this study a protease-like amino acid sequence was identified at the amino terminus of the core protein sequence. Experimental evidence indicates that HBeAg may be produced by proteolytic self-cleavage of the core protein. PMID- 3554508 TI - Human trials of malaria vaccine. PMID- 3554509 TI - Human trials of new cancer therapy begin. PMID- 3554511 TI - EDB: persistence in soil. PMID- 3554510 TI - Ras p21 as a potential mediator of insulin action in Xenopus oocytes. AB - The oncogene protein product (p21) of the ras gene has been implicated in mediating the effects of a variety of growth factors and hormones. Microinjection of monoclonal antibody 6B7, which is directed against a synthetic peptide corresponding to a highly conserved region of p21 (amino acids 29 to 44) required for p21 function, specifically inhibited Xenopus oocyte maturation induced by incubation with insulin. The inhibition was dose-dependent and specific since (i) the same antibody had no effect on progesterone-induced maturation, (ii) immunoprecipitation and Western blotting indicated that the antibody recognized a single protein of molecular weight 21,000 in oocyte extracts, and (iii) inhibition was not observed with identical concentrations of normal immunoglobulin. Thus, p21 appears to be involved in mediating insulin-induced maturation of Xenopus oocytes. Furthermore, the mechanism may involve phosphorylation of p21, as p21 was found to be a substrate of the insulin receptor kinase. PMID- 3554512 TI - Prediction of chemical carcinogenicity in rodents from in vitro genetic toxicity assays. AB - Four widely used in vitro assays for genetic toxicity were evaluated for their ability to predict the carcinogenicity of selected chemicals in rodents. These assays were mutagenesis in Salmonella and mouse lymphoma cells and chromosome aberrations and sister chromatid exchanges in Chinese hamster ovary cells. Seventy-three chemicals recently tested in 2-year carcinogenicity studies conducted by the National Cancer Institute and the National Toxicology Program were used in this evaluation. Test results from the four in vitro assays did not show significant differences in individual concordance with the rodent carcinogenicity results; the concordance of each assay was approximately 60 percent. Within the limits of this study there was no evidence of complementarity among the four assays, and no battery of tests constructed from these assays improved substantially on the overall performance of the Salmonella assay. The in vitro assays which represented a range of three cell types and four end points did show substantial agreement among themselves, indicating that chemicals positive in one in vitro assay tended to be positive in the other in vitro assays. PMID- 3554513 TI - What myosin might do. PMID- 3554514 TI - Computer assisted instruction in RN upward mobility. PMID- 3554515 TI - Blood flow and metabolism in the developing brain. AB - The newborn brain has mechanisms that act to preserve the blood flow to the brain stem. When challenged with an asphyxial episode, there is a redistribution of blood flow in the brain. The brain stem structures have increased blood flow, and telencephalic structures, particularly white matter, have decreased flow. These changes are made possible in part because the newborn brain stem vascular appears to be much more sensitive to pCO2 than the telencephalic vasculature. In fact, several brain stem regions exhibit a higher sensitivity to CO2 than the adult cortex. Consequently, vessels in this region are able to vasodilate more effectively. In addition, the sympathetic vascular innervation in the newborn brain appears more profuse in the forebrain. So this system could produce a widespread vasoconstruction and participate in the shift of blood flow from the cerebral hemispheres to the brain stem. This capacity to preserve blood flow to the critical brain stem regions may explain, in part, the ability of the neonatal animal to survive long periods of asphyxia. This phenomena might also explain the clinical findings of white matter loss and stroke in the cerebral hemispheres, since these regions seem to be selectively deprived of blood flow during insult. This relationship is summarized in Fig 1. PMID- 3554516 TI - Plasticity and responses of the immature nervous system to injury. PMID- 3554517 TI - Intraventricular hemorrhage of the preterm neonate. PMID- 3554518 TI - Perinatal cerebral infarction. PMID- 3554519 TI - Neonatal seizures. PMID- 3554520 TI - Perinatal neurosurgical problems. PMID- 3554521 TI - The sequelae of hypoxic-ischemic encephalopathy. PMID- 3554522 TI - Premature infants in later childhood: some recent follow-up results. PMID- 3554523 TI - Neuroembryology--clinical aspects. PMID- 3554525 TI - In utero neurosonography: neuroembryologic and encephaloclastic lesions. PMID- 3554524 TI - In utero neurosonography: the normal fetus and variations in cranial size. PMID- 3554526 TI - [Effect of PGE2 on alloxan-induced inhibition of insulin release in isolated neonatal rat pancreatic islets]. PMID- 3554527 TI - A two-year study on the retention of pit and fissure sealants applied by different dental operators. PMID- 3554528 TI - Binucleated form of plasma cells in oral lesions ... a review. PMID- 3554529 TI - Granulomatous pseudotumors in total joint replacement. AB - Fourteen patients (15 joints) developed a foreign body reaction to methylmethacrylate, polyethylene, or metal adjacent to a total joint implant, a condition we would like to term granulomatous pseudotumors. There were eight male and six female patients. Their average age was 61 years. The hip was involved in 14 joints (femoral component 11 times, acetabulum 7, and greater trochanter once). One patient presented with granulomatous pseudotumors of the knee. The principal findings included increasing pain and radiographic evidence of loosening occurring on average 2.7 years following the implant. This was followed by a characteristic and gradually developing radiographic pattern of discrete rounded lucencies. These developed into large ovoid lytic areas, destroying both methylmethacrylate and bone. Histologically, the appearances were characterized by histiocytic infiltration and the presence of multiple foreign body giant cells. Foreign material was identified in 9 of 11 cases. The pathogenesis is unknown but appears related to micromovement or loosening of the implant. PMID- 3554530 TI - The nationalization of the Swedish pharmacies. AB - The first Swedish parliamentary bill suggesting government-owned pharmacies was introduced in 1907 and was rejected. A number of official proposals were put forward until 1970 when the government decided to nationalize the Swedish pharmacies. The process leading to nationalization was influenced by background and by more specific 'release' factors operating in the 1960s. The opposition in parliament to nationalization was only minor. The new organization formed, Apoteksbolaget AB, was given a drug selling monopoly and was organized as a limited company regulated by an agreement between the government and Apoteksbolaget. PMID- 3554531 TI - Syncope. AB - The isolated syncopal episode, most commonly a benign and self-limited event, may also represent serious neurologic or cardiologic disease. In evaluating patients with syncope, the clinician must differentiate the benign from the more serious etiology. Considerable progress has been made in the past 20 years in understanding the causes of syncope and in determining prognosis. This paper reviews our current appreciation of syncope and in determining prognosis. This paper reviews our current appreciation of these issues and defines the clinical utility of diagnostic testing in patients with syncope. PMID- 3554532 TI - Sternocostoclavicular hyperostosis: rheumatologic, radiologic, and dermatologic characteristics. AB - Two recently observed patients with sternocostoclavicular hyperostosis exemplify the characteristic presentation of this rheumatologic disorder. We describe its manifestations, review the literature on this subject, and discuss clinical and radiologic aspects, including the frequently associated dermatologic disorder palmoplantar pustulosis. Sternocostoclavicular hyperostosis is an increasingly common diagnosis, and practicing physicians should be aware of the distinctive features that allow accurate differentiation from psoriatic arthritis and other diseases. PMID- 3554533 TI - Oral rehydration therapy. PMID- 3554534 TI - Pruritus in pregnancy. AB - Pruritus occurs frequently during pregnancy; the reported incidence ranges from 3% to 14% of all pregnancies. Pruritus may occur with or without skin lesions, and may be an exaggerated response to a physiologic adaptation to pregnancy, a manifestation of a systemic disorder, or a primary skin disease. We review the most serious skin disorders associated with pregnancy and present an easy, logical approach to their diagnosis and management. PMID- 3554536 TI - Joseph Jones, MD: an early clinical investigator. PMID- 3554535 TI - Management of osteoarthritis. PMID- 3554537 TI - Administration of the Medical Department of the Confederate States Army, 1861 to 1865. AB - During its brief existence, the Confederate States of America created many new institutions. This paper concerns one of these, the Medical Department of the Confederate States Army. From a very small nidus of experienced physicians, this organization expanded to supervise thousands of officers, to build many huge hospitals, and to expend millions of dollars. The Medical Department also experienced some administrative failures, the most obvious of which were the failure to vaccinate against smallpox and the inability to control the loss of manpower associated with medical furlough. Like all institutions, the Medical Department produced both successes and failures. The fact that the South lost the War Between the States tends to obscure the successes and emphasize the failures. PMID- 3554538 TI - The calomel rebellion. PMID- 3554539 TI - Insulin-insensitive variety of combined types A and B diabetes mellitus progressing to systemic lupus erythematosus. AB - We have described a patient whose clinical course suggests that Kahn's types A and B insulin-resistant diabetes mellitus can exist as insulin-insensitive variants, type A can progress to type B, and type B insulin-insensitive diabetes can be associated with classical SLE long after the diabetes (and acanthosis nigricans) have resolved. PMID- 3554540 TI - Meckel's diverticulum in a femoral hernia: a Littre's hernia. AB - We have described a patient with strangulation of a Meckel's diverticulum in a femoral hernia. In the case of Littre's hernia, true diagnosis before surgical intervention is rare if not impossible. It is therefore important that the surgeon be well versed in the management of such cases, as well as in distinguishing a Littre's hernia from a Richter's hernia during the intraoperative period. PMID- 3554541 TI - Surgical maggots. PMID- 3554542 TI - In vitro assay of antimalarials: technologies, applications, and prospects. PMID- 3554543 TI - Cross-sectional seroepidemiological survey of malaria in endemic areas with different activities of malaria control. AB - A single cross-sectional seroepidemiological survey of malaria antibody was conducted in 1982 in Klang District, Rayong Province in three villages under different phases of malaria control activity to determine whether a single survey could be used to delineate malaria endemicity in Thailand and to compare the usefulness of ELISA and the indirect haemagglutination test (IHA) in the assessment of malaria endemicity. Village 11 was a control area with high infection rate with an annual slide positive rate of 16.3% in 1981. Village 6 was also a control area but was in the late attack phase in which residual insecticide spraying has been ceased since 1976. Village 7 was a consolidation area. Finger-tipped blood was collected from 189, 191 and 132 individuals from villages 11, 6 and 7 respectively, and the plasma tested for anti-P. falciparum antibody with ELISA and IHA. With ELISA, it was shown that the seropositive rate in population of village 11 (84.6%) was significantly higher than those of other two villages (48.9% in village 6 and 28.8% in village 7). After age stratification, it was shown that the differences were observed in every age group except in the greater than or equal to 45 year age group of village 6. With IHA, a significantly higher seropositive rates in population of village 11 was evident when they were compared with the corresponding age groups of 6-14, 15-29 and 30-44 years in village 7, and the age group of less than or equal to 5 year in village 6.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3554544 TI - Attempt to culture Wuchereria bancrofti in vitro. AB - Third-stage larvae of Wuchereria bancrofti recovered from laboratory raised Aedes togoi and Anopheles maculatus fed on a human volunteer were recovered by mass dissection methods and introduced into in vitro culture. LLC-MK2 cells were used as feeder cells, and the culture medium consisted of RPMI-1640 buffered with Hepes and sodium bicarbonate and supplemented with human AB serum. The third stage larvae molted as early as 12 days and those surviving had all molted by 16 days. The fourth-stage parasites averaged in length from 1.4 mm to a maximum of 1.8 mm. Some larvae remained alive in culture as long as 40 days and while the worms were distorted in fixation, possible primodial cells of a spicule could be visualized in the rectal region. The cuticle also appeared to be separating in the posterior end. Although complete development was not achieved, it seems that with a continuing effort, success could be obtained using this culture system with feeder cells. PMID- 3554545 TI - Treatment of parasitic infections in Thailand. PMID- 3554546 TI - Recent advances in bacterial diarrhoea. PMID- 3554547 TI - The interaction between the malaria parasite and the red cell membrane. AB - The malaria parasite intimately interacts with the host red cell membrane throughout the cycle of invasion and intracellular development. Direct interaction between the merozoite surface and the red cell membrane involves specific binding between the surface components of both cells, which leads to the subsequent endocytotic process still incompletely understood. Intracellular development of the parasite is accompanied by various changes in the structure and function of red cell membrane components. Some changes may benefit parasite survival while others trigger host immune response. An understanding of both the direct interaction between the surface components of the parasite and the red cell during invasion, and the subsequent changes in the red cell membrane following invasion, should lead to better ways of controlling malaria. PMID- 3554548 TI - [Ultrasonic study of the thyroid gland]. PMID- 3554549 TI - [The prostacyclin-thromboxane A2 system in ischemic heart disease]. PMID- 3554550 TI - [Features of the clinical picture and pathogenesis of diseases of the gastrointestinal tract in alcoholism]. PMID- 3554551 TI - [Primary multiple cancer of the breast]. PMID- 3554552 TI - [Use of single-row sutures in anastomoses of the gastrointestinal tract]. PMID- 3554553 TI - Epidural morphine for pain relief after lumbar laminectomy. AB - A prospective randomized trial was conducted to evaluate the effectiveness of epidural morphine for pain relief after lumbar laminectomy. Thirty-three male patients were studied in two groups. At the end of surgery, Group 1 patients (15) received 2 mg morphine in 5 ml saline through an epidural catheter. Doses were repeated on demand. Group 2 patients (18) received 10 mg morphine intramuscularly on request in the postoperative period. Pain was assessed at 2, 6, 12, and 24 hours postoperatively by the linear analog of pain scale. There was significantly greater pain relief in Group 1 than in Group 2 after 2, 6, and 12 hours, respectively. Furthermore, Group 2 received larger doses of morphine than Group 1. There was no respiratory or cardiovascular depression detected in patients in either group. Nine patients in Group 1 and five patients in Group 2 had transient postoperative urinary retention that required catheterization. Only one patient in Group 1 had mild pruritus and three patients in Group 2 had nausea. PMID- 3554554 TI - Lytic spondylolysis. Repair by wiring. AB - A technique for repairing the defect in spondylolysis by wiring is presented together with the results achieved in seven patients; the follow-up ranged from 2 to 12 years. The relative simplicity of the technique is stressed; and the technical problems likely to be encountered, together with the modifications of the basic technique necessary to cope with them, are noted. When conservative methods have been tried without success and the patient has a lesion at one or more levels and is less than 30 years old at presentation, then the technique described will give predictable results with regard to union of the defect and patient function. PMID- 3554555 TI - Primary lymphocytic lymphoma of the dorsal spine apparently cured by radiochemotherapy. PMID- 3554557 TI - Adult idiopathic scoliosis treated by posterior spinal fusion and Harrington instrumentation. AB - Ninety-one patients with idiopathic scoliosis, who underwent posterior spinal fusion and instrumentation from January 1977 to December 1982, were reviewed. All patients were 20 years or older at the time of surgery and none had undergone a prior surgical procedure. Indications for surgery included pain, progressive deformity, and pulmonary symptoms. All patients had a posterior spinal fusion with Harrington instrumentation and autogenous iliac bone graft, with the addition of segmental wiring in only eight. No patient had an anterior fusion or fusion to the sacrum. Follow-up averaged 3.5 years (range: 2-7 years). The average correction at the time of surgery was 38%, and 32% at the time of last follow-up. Seventy-nine percent of the patients reported complete relief of the symptom(s) for which they had surgery. There were 34 complications in 30 (33%) patients. Pseudarthrosis occurred in 14 (15%), requiring 15 additional procedures to achieve a solid arthrodesis. Urinary tract infection occurred in 8 (9%) patients and Harrington hook dislodgement in 5 (5%). One patient sustained a partial paraparesis with recovery to a minimal deficit. No deaths occurred. Although largely successful, posterior fusion with Harrington instrumentation for adult scoliosis has a significant incidence of pseudarthrosis and instrumentation problems. PMID- 3554556 TI - Posterior cervical fusions using cerclage wires, methylmethacrylate cement and autogenous bone graft. An experimental study of a canine model. AB - Forty-eight adult mongrel dogs underwent posterior exposure of C4-C5, fixation of the two posterior spinous processes together with a no. 20-gauge cerclage wire, posterior element decortication, wound irrigation and the following: bone fusions (application of a standard volume of iliac crest autograft), polymethylmethacrylate (PMMA) fusions (application of a standard volume of methylmethacrylate cement), Combination 1 fusions (application of one-half the volume of graft used in the bone fusions, over the facet joints. Methylmethacrylate cement was pressed into position centrally to surround the posterior spinous processes and cerclage wire), Combination 2 fusions (application of the same volume of graft used in the bone fusions, over the facet joints. Methylmethacrylate cement was applied as in the Combination 1 fusions). For each preparation, six animals survived 2 weeks or 3 months. All had monthly lateral cervical radiographs. At the appropriate times, they were killed and their C4-C5 segments excised and studied mechanically and histologically. At 2 weeks all of the above preparations were mechanically inferior to normal C4-C5 segments in respect to at least one of the parameters studied. At 3 months, the bone fusions and both combination fusions had developed sufficient mechanical stability so that they were equivalent to normal segments. At this time, the PMMA fusions remained inferior to the "normals." The mechanical data for the PMMA and both combination fusions was corroborated by the histology which demonstrated a fibrosynovial layer between the cement masses and underlying posterior element bone. In the 3-month combination fusions, the lateral aspects of the posterior elements had been spanned by a fusion mass. CLINICAL RELEVANCE: Previously, the authors defined some of the problems associated with constructs modeled by their PMMA fusions. This work confirms the previous research. It also demonstrates that ultimate spinal stability is produced by combination constructs. Because of the 2 week mechanical data, it is recommended that when combination constructs are used clinically, the patient's neck be protected by an external orthosis in the early postoperative period. PMID- 3554558 TI - [Image quality and systemic reactions in phlebography using iohexol with various concentrations of iodine]. PMID- 3554559 TI - Steroids in asthma. A review of the literature. PMID- 3554560 TI - The effects of forskolin eye drops on intra-ocular pressure. AB - Two studies were performed to investigate the effects of forskolin (Hoechst Research) on intra-ocular pressure (IOP). In the first study two 1.0% formulations of forskolin eye drops were compared with placebo in 10 healthy volunteers. Oxybuprocaine eye drops were used for local anaesthesia before measurement of IOP by applanation tonometry. This was followed by instillation of either medication or placebo on a randomised cross-over basis and hourly measurement of IOP. No significant differences were present between the forskolin treatments and placebo. For 6 hours after drug application a definite decrease in IOP relative to base-line values was observed after each of the forskolin treatments as well as after placebo. In a subsequent study only one formulation of 1% forskolin was compared with placebo. Proxymetacaine eye drops were used for local anaesthesia. Forskolin resulted in a significant reduction in IOP relative to placebo. It is concluded that forskolin reduces IOP in healthy volunteers, and that oxybuprocaine reduces IOP in its own right. PMID- 3554561 TI - Management of diabetes mellitus. AB - The management of diabetes mellitus involves patient education and dietary modifications, both of which play a key role in determining the success of therapy. Other therapeutic measures include oral hypoglycaemic agents and insulin. In type II diabetic patients not responding to diet alone the second generation sulphonylureas are preferred. Biguanides are indicated in the very obese type II diabetic, provided there are no contraindications. Where insulin therapy is indicated (e.g. type 1 diabetes mellitus), the trend is to use a human preparation because it evokes a very weak antibody response. Optimal diabetes control, as gauged by home blood glucose monitoring and glycosylated haemoglobin levels or, in the case of type II diabetics, fasting blood glucose levels, prevents the acute symptoms of diabetes mellitus as well as coma and in addition appears to minimise the risk of vascular complications. PMID- 3554562 TI - That up-going toe. PMID- 3554563 TI - Unusual presentation of malaria as a leukaemoid reaction. A case report. AB - In a 4-year-old black patient with Plasmodium falciparum malaria the diagnosis was established by observing plentiful gametocytes in the peripheral blood, although ring forms were very scanty. The blood picture was that of a leukaemoid reaction with severe anaemia, high total leucocyte count and thrombocytosis. Treatment with chloroquine and primaquine, together with packed red cell transfusions, was successful in eliminating both the malaria parasites and the leukaemoid blood picture. The rarity of malaria presenting as a leukaemoid blood picture is discussed. PMID- 3554564 TI - A prospective study of thymopentin in severely burned patients. AB - A randomized prospective double-blind study of thymopentin was performed upon 24 severely burned patients to evaluate its efficacy in correcting postburn immunologic abnormalities and preventing infectious morbidity and mortality. Patients in the treated group received 50 milligrams of thymopentin daily for the first two weeks after injury and three times weekly thereafter until the patient was no longer at risk for having infections develop. The placebo group received saline solution intravenously. The rate of infectious complications was recorded. Immunologic tests used at least weekly were: white blood cell counts, OKT4 to OKT8 ratios, lymphocyte blastogenesis and neutrophil bactericidal index. There were no differences noted in patient mortality, infectious complications or antibiotic use. There were two significant differences noted among the immunologic tests. First, there was a decreased lymphocyte blastogenic response in the treated group at two weeks after injury without a difference in T4 to T8 ratios. Second, there was less leukopenia during the first week after injury in the treated group. PMID- 3554565 TI - A comparative study of cefotetan and metronidazole against metronidazole alone to prevent infection after appendectomy. AB - The role of metronidazole in reducing the incidence of infectious complications after appendectomy has been established, but the value of an additional antibiotic to act against aerobic pathogens remains controversial. Patients who received 2 grams of cefotetan intravenously at the time of appendectomy and those who did not were compared for the incidence of infection. All patients received 1 gram of metronidazole per rectum preoperatively and every 12 hours for five days postoperatively. Infection occurred in three patients who received cefotetan and 16 of those who did not (p less than 0.01). We conclude that a single dose of cefotetan, an antibiotic which is effective against aerobic and anaerobic organisms, produces a significant reduction in the incidence of infection when added to metronidazole in the management of patients after appendectomy. PMID- 3554566 TI - The surgical principles of John Hunter. PMID- 3554567 TI - Collateral mesenteric circulation. AB - The origins of historical terms, such as "Arc of Riolan" and "marginal artery of Drummond" are traced herein with emphasis on the inherent confusion caused when these terms are used. Basic mesenteric anatomy is briefly mentioned and pathologic anatomy with its altered direction of blood flow induced by atherosclerosis is stressed. The significance of the meandering mesenteric artery as the main collateral vessel between the superior and inferior mesenteric artery is emphasized along with preoperative and intraoperative ways to ascertain whether or not the origin of this latter vessel can be safely ligated. Specific operations, such as abdominal aortic aneurysmorrhaphy and sigmoid colectomy, which can potentially interfere with blood flow in the meandering mesenteric artery, are discussed in an attempt to prevent postoperative necrosis of any portion of the intestine that may have deficient mesenteric blood flow. PMID- 3554568 TI - Macewen's sign--"the cracked pot sound". PMID- 3554569 TI - Three-dimensional digitizer (neuronavigator): new equipment for computed tomography-guided stereotaxic surgery. AB - A new device was invented as an adjunct for computed tomography (CT)-guided stereotaxic or open neurosurgery. It is composed of a multijoint three dimensional digitizer (sensor arm) and a microcomputer, which indicates the place of the sensor arm tip on preoperative CT images. Computed tomography scan is performed preoperatively with three markers placed on the nasion and ears. At surgery, after fixing the patient's head and the sensor arm, sampling of the standard points was done to translate the position of the tip of the sensor arm onto the CT images displayed on a computer screen. In this way positional data from conventional preoperative CT scan can be directly transferred into the surgical field. This system has the unique feature of introducing CT-guided stereotaxis into conventional open neurosurgery. PMID- 3554570 TI - 2nd Tubingen Radiotherapy Symposium: Whole body, large field and whole skin irradiation. April 11th and 12th, 1986. Proceedings. PMID- 3554571 TI - Postoperative astigmatism. AB - With the numerous significant advances in surgical methodology--e.g., microinstrumentation, the operating microscope, the surgical keratometer, and intraocular lenses--that have been developed over the past two decades, both surgeons and patients have become increasingly aware of the final optic result of any surgical intervention. This is especially so since the development of refractive surgery, where good uncorrected vision is frequently the final arbiter of success. We have progressed to the stage where the optic manipulation of the cornea, whether intentional or otherwise, can be understood in terms of a number of variables. These include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations. Where these have failed and postoperative astigmatism still occurs, a number of surgical procedures are available to reduce the astigmatic error to an acceptable level. PMID- 3554572 TI - Skin flaps in periorbital reconstruction. AB - Soft tissue defects of the periorbital region are best repaired with local skin or skin-muscle flaps. Flaps have functional and aesthetic advantages over skin grafts in that they provide a better color and texture match to the thick periorbital skin. The general physiological and biomechanical principles of skin flap survival and orientation are discussed with modification according to peculiarities of the periorbital area. The four basic groups of skin flaps are the sliding flap, advancement flap, rotation flap, and transposition flap. Selected standard and modified designs of each group are illustrated, and each surgical technique is described in stepwise fashion. The specific applications of the flaps to periorbital reconstruction are emphasized. The indications for use of various skin flaps, the local factors involved in flap selection, and proper preoperative planning are also discussed. PMID- 3554573 TI - A patient remembers Sir Stewart Duke-Elder. AB - The author shares a personal glimpse of Sir Stewart's wit, candor, and gallantry, observed during her more than 15-year relationship with him as a glaucoma patient. PMID- 3554574 TI - Role of precapillary arteriovenous shunting in the pathogenesis of varicose veins and its therapeutic implications. AB - The conventional pathogenesis of varicose veins and their subsequent development is essentially based on primary valvular insufficiency of the main saphenous trunk and incompetence of the perforating veins. In contrast, the concept of the pathogenesis of varicose veins presented in this review is based on the presence of arteriovenous (AV) shunting that occurs primarily in the venous tributaries and rarely in the main trunks of the saphenous system. Identification of arteriovenous communications (AVCs) with varicose veins has been documented by visual observation during surgery and especially by use of high-powered microscopes or magnifying lenses. The AVCs have been found consistently to originate subfascially and to terminate in tributaries extrafascially, thus bypassing the capillary network. By means of serial arteriography it was shown that in more than 80% of varicose veins there is premature venous opacification. By means of Doppler ultrasonography, it was demonstrated that AV shunting was present in 80% of the cases. A correlative study of these parameters has shown that the initial significant pathology in varicose veins is mostly confined to the tributaries, although at an advanced stage the main trunk may also be subsequently affected to a lesser degree. In terms of management, these data strongly imply that sclerotherapy or surgical treatment (ligation or excision) should be confined to the tributaries and that high saphenofemoral ligation and stripping should be avoided except in cases where evidence shows valvular involvement and incompetency of the latter. As a result, this study strongly suggests that one could most often spare the main trunk of the saphenous vein for eventual use as a vascular graft. PMID- 3554575 TI - Percutaneous aspiration of peripancreatic fluid collections: a safe method to detect infection. AB - During the past 5 years, we have used percutaneous aspiration of peripancreatic fluid collections guided by computed tomography (CT) or ultrasonography (US) to facilitate diagnosis of infection in selected cases. Fifteen of 18 patients undergoing guided needle aspiration had persistent fevers (greater than 38.3 degrees C). The three afebrile patients all had abdominal pain and leukocytosis, and two of the three also had elevated serum amylase levels. Percutaneous aspiration was guided by CT in 14 patients and by US in four. On the basis of aspirate Gram stains and cultures, as well as surgical (15) and percutaneous drainage (1) findings, the final diagnosis was pancreatic abscess in nine patients, infected pseudocyst in four, uninfected pseudocyst in four, and cystadenoma in one. Diagnosis based on percutaneous aspiration was correct in 17 of 18 patients (94%), and no complications could be directly attributed to the procedure. We conclude that CT- or US-guided percutaneous aspiration is a safe and accurate diagnostic procedure for patients with peripancreatic fluid collections in whom secondary infection is suspected. PMID- 3554576 TI - Pancreaticojejunostomy after Whipple's operation--in vivo evaluation of long-term patency: a preliminary report. AB - Evaluation of the patency of the pancreaticojejunostomy was conducted in four patients who had undergone Whipple's procedure. Three patients had a mucosa-to mucosa anastomosis, and in one patient the pancreatic remnant had been invaginated into the jejunal loop. The longest interval between the operation and the present study was 9.7 years. After intravenous infusion of secretin (1 microgram/kg), the temporal changes in the pancreatic ductal caliber were measured by means of either ultrasonography (two patients) or computed tomography (two patients). The presence of adequate functional pancreatic tissue was assumed in all four patients on the basis of their clinical status and the normal ductal caliber before the secretin provocation. In two patients, the ductal system showed an initial dilatation following secretin administration and then gradually emptied. There were no changes of the Wirsung duct in the other two patients. These data suggest that the pancreaticojejunal anastomoses were patent in all four patients but had different degrees of stenosis. The present method allows a safe and noninvasive evaluation of the anastomosis in vivo. Since long-term patency of the pancreaticojejunostomy is feasible, it should be attempted whenever possible in patients undergoing Whipple's procedure. PMID- 3554577 TI - Cystic adventitial degeneration of the femoral artery: is evacuation and cyst excision worthwhile as a definitive therapy? AB - A case of cystic adventitial degeneration of the left common femoral artery in a patient with localized left groin pain, normal distal pulses, and normal arteriographic findings is reported. This patient was first treated with evacuation and cyst excision. Recurrence was noted after 20 months, and an excision of the cyst and a segment of the common femoral artery with graft interposition was required. At gross examination, the cyst was unilocular and contained gelatinous material. The cyst appeared to be situated in the tunica adventitia and did not communicate with the vascular lumen. No synovial lining was present. Histologically, it was similar to a ganglion cyst with contents rich in hyaluronic acid. A review of the literature was undertaken to determine the results of treating this lesion. The disease is rare. All senior authors of case reports were contacted to construct follow-up information. A high incidence of recurrence was noted in patients treated by evacuation and cyst excision. We believe that total cyst excision with the involved artery and graft interposition at the femoral site can be done easily, safely, and with virtually no chance for recurrence. PMID- 3554578 TI - Nonoperative management of the ultrasonically evaluated appendiceal mass. AB - Forty patients with an ultrasonically evaluated appendiceal mass were studied. Abscesses were diagnosed in 31 patients (78%). Seventeen patients had an ultrasonically guided percutaneous drainage performed, and all but one patient had resolution of symptoms without further treatment or complications. Fourteen patients were treated conservatively without drainage, and 12 had resolution of symptoms without interference. Ultrasonograms in the remaining nine patients (22%) revealed phlegmonous inflammation only, and all recovered without treatment. The three patients considered failures had surgery because of intestinal obstruction or suspected but unverified perforation. Three patients (8.5%) had recurrent appendicitis within 5 months after the initial attack. Diagnostic errors delayed proper therapy for 1 month in a patient with a cecal carcinoma and for 5 months in a patient with Crohn's disease. Late sequelae were observed in four patients, three of whom had surgery. Nonoperative treatment and if possible ultrasonically guided percutaneous drainage of verified abscesses are safe procedures with few complications and late sequelae. However, diligent in hospital observation and close follow-up are mandatory. PMID- 3554579 TI - Long-term results of silicone elastomer ring vertical gastroplasty for the treatment of morbid obesity. AB - This article reviews 305 silicone elastomer ring vertical gastroplasties that were used to treat morbid obesity. All patients underwent surgery 2 or more years ago. The average weight loss was 101 pounds, 35.7% of initial total body weight, or 60.8% of excess body weight. Fourteen patients failed to lose an adequate amount of weight and in four (1.3%) of these patients the surgery failed because the gastric partition disrupted; in these cases, another operation was required. There were no pulmonary emboli, gastric perforations, or deaths in this series. Banding of the vertical gastroplasty stoma with silicone elastomer rings is safe and effective and offers distinct technical advantages over other methods of banding. PMID- 3554580 TI - [Phew, what a whitewash!]. PMID- 3554581 TI - [Therapia antiqua]. PMID- 3554582 TI - [The effect of a denture cleansing agent on plaque--a clinical study]. PMID- 3554583 TI - [Denture adhesives and denture hygiene]. PMID- 3554584 TI - [The cleansing effect of denture brushes]. PMID- 3554585 TI - [Ultrasonography in the diagnosis of metastases of cancer of the large intestine to the liver]. AB - Ultrasonography using a method of sectional and contact scanning is a valuable method of diagnosis of metastatic liver involvement in colon cancer. The diagnostic accuracy of the method is 95.6%. It has been noted that metastases of the same colon tumor type have different echostructure which depends on a period of disease and size of metastases. The author has defined 6 types of changes in the echostructure of metastases. In individual cases in a certain structure of metastasis changes in the liver parenchyma at ultrasonography were undetectable. PMID- 3554586 TI - [Echographic diagnosis of calculous lesions of the bile ducts]. AB - The author presented methods and results of ultrasonic diagnosis of concrements in intrahepatic (4), lobar (5), cystic (24) and common bile (20) ducts. In technically difficult cases the starting point of an acoustic shadow route was the only sign permitting concrement localization in the duct. Indirect signs of occluding choledocholithiasis were dilatated lumen of intrahepatic and proximal (with respect to the site of occlusion) extrahepatic ducts, a concrement filled cavity and the tense gall bladder wall, the absence of echographic signs of tumor involvement of the peritoneal cavity organs. The dilatation of the ducts and gall bladder cavity were more noticeable in patients with a long history of cholestasis. The lamination of the gall bladder content into zones of different echogenicity, the filling of the dilatated ducts with the content of inhomogeneous acoustic transparency indicated the complication of occluding choledocholithiasis by purulent cholangitis. PMID- 3554587 TI - [Ultrasonic examination in diagnosing diseases of the stomach and intestines]. PMID- 3554588 TI - [The use of thermography in gastroenterology]. PMID- 3554589 TI - [Role of changes in the hormonal system of the gastrointestinal tract after vagotomy]. AB - The level of gastrin, serotonin, insulin and cortisol in the blood was raised after different types of vagotomy. Raised hormone secretion depends on the time following operation, the severity of a pathological process, to a lesser degree, on the type of surgical intervention and nature of postvagotomic disturbance. Shifts in the hormonal apparatus are caused by operation and associated with it functional-morphological changes of the digestive organs, the preservation of preoperative changes and developing compensatory-adaptive reactions. An excess of intestinal hormone secretion in the postoperative period can be responsible for the development of pathological disorders, in particular the dumping syndrome. PMID- 3554591 TI - [Evaluation of the effectiveness of differentiated therapy in patients with chronic erosions of the gastric mucosa]. AB - Potentialities of differentiated therapy of patients with recurrent chronic erosions using medicinal and nonmedicinal methods in 119 patients were studied. During differentiated therapy one should take into account the condition of pathological microflora and circulatory disturbances. At the first stage routine therapy with subsequent incorporation of biogastrone was employed. At the second stage in the absence of a therapeutic effect local administration of a granulocytic concentrate was performed, and in insufficient effectiveness, electrocoagulation of chronic erosions of the gastric mucosa was indicated. The use of differentiated therapy contributed to a favorable prognosis of disease in these patients. PMID- 3554590 TI - [The synthetic peptide preparation dalargin in the treatment of peptic ulcer]. AB - The paper is concerned with the results of clinical assessment of a new peptide drug dalargin in therapy of duodenal peptic ulcer. Assessment of the efficacy of dalargin was compared to that of tagamet and placebo using double "blind" control. A total of 180 males with exacerbation of duodenal ulcer were examined, of them 90 received dalargin only, 70 received tagamet and 20 persons participated in an experiment based on a method of double "blind" control. An average period of duodenal ulcer healing in the patients on dalargin therapy was 21.4 +/- 1.2 days, and by the 28th day complete cicatrization was observed in 87.5% of the patients. In tagamet therapy an average period of cicatrization was 23.7 +/- 1.8 days, by the 28th day ulcer healing was observed in 87.3%. With placebo ulcer healing by the 4th week was observed in 30% of the examinees, in dalargin therapy in 80%. A conclusion was made of high efficacy of dalargin for therapy of peptic ulcer. PMID- 3554592 TI - Effect of various etching times on two glass ionomer lining cements. PMID- 3554593 TI - Cutaneous melanoma: a review of clinical management. PMID- 3554594 TI - Anatomy of a Medicare lawsuit. PMID- 3554596 TI - [Respiratory complications of drugs used in neurology and psychiatry]. PMID- 3554595 TI - [Pulmonary complications of anti-infective agents]. PMID- 3554597 TI - [Evaluation of the activity of vindeburnol by spectral analysis of human EEG]. PMID- 3554598 TI - Thromboxane and prostacyclin formation in patients with deep vein thrombosis. AB - The urinary excretion of 2,3-dinor-TxB2 and 2,3-dinor-6-keto-PGF1 alpha (the major urinary metabolites of thromboxane B2 and prostacyclin) was measured in ten patients with confirmed deep vein thrombosis, using specific methods based on gas chromatography - mass spectrometry with deuterium-labelled internal standards. Measurements of these major urinary metabolites makes it possible to monitor the in vivo formation of thromboxane A2 and prostacyclin. The results demonstrate an abnormally high and very variable excretion of 2,3-dinor-TxB2 and 2,3-dinor-6 keto-PGF1 alpha in patients with deep vein thrombosis. This indicate that both thromboxane A2 and prostacyclin are involved in the course of events associated with this disease. PMID- 3554599 TI - Dentistry's Olympic heroes. II Olympiad: two Americans in Paris. PMID- 3554600 TI - Dentistry moves into space (Robert M. Donahue). PMID- 3554601 TI - [Use of ultrasonics in Norwegian obstetric departments]. PMID- 3554602 TI - [Edvard Munch--during 1902-1909. A psychiatric study]. PMID- 3554603 TI - [Symptomatic aortic aneurysms. A difficult diagnosis?]. PMID- 3554604 TI - [Effects of naproxen on the postoperative course. A study of the effects of naproxen on the immediate postoperative period in the surgical treatment of crural fractures]. PMID- 3554605 TI - [Ultrasound in urologic practice]. PMID- 3554606 TI - [Interpretation of results of serologic analyses in large animal practices]. AB - The backgrounds to and possibilities of serological studies for the purpose of establishing are reviewed, all this with regard to bovine disease. The serology of the virus infections infectious bovine rhinotracheitis (IBR), bovine viral diarrhoea (BVD), para-influenza virus 3 infection (PI3), bovine respiratory syncytial virus (BRS) and Chlamydia is discussed in greater detail. Likewise, the interpretation of serological findings in cases of brucellosis, leptospirosis and Johne's disease is dealt with. In addition, attention is paid to the results of serological testing in cases of lung-worm disease and fascioliasis. PMID- 3554608 TI - [Swine erysipelas: from yesterday to today]. AB - The history of swine erysipelas in the Netherlands is reviewed, with special reference to the significance of vaccination and the views on epidemiology. The paper of D. A. de Jong Jzn. (1891) is discussed. The activities of the National Serum Institute in Rotterdam in this regard are discussed in detail. In conclusion, it is stated that vaccinations designed to prevent swine erysipelas are no longer required under conditions prevailing in the Netherlands. PMID- 3554609 TI - Restorative dentistry. AB - Various restorative methods like composite crowns, parapulpar pin reconstructions or vast crowns and bridges, are evaluated against each other. Also new methods for repair of jaw-fractures in dogs and cats by means of parapulpar pins and composites are discussed. PMID- 3554610 TI - Basic principles for reconstruction of problem skin defects: trunk, head, and neck. AB - When dealing with skin defects, the veterinary surgeon should always use the simplest, least time consuming, least expensive techniques first and use the more involved techniques only as they are necessary. For closing skin defects the 3 techniques that can be used are: shifting local tissue; flaps, or grafts. Shifting local tissue to close skin defects is the simplest means of reconstruction. Because of the abundance of loose elastic skin on dogs and cats, many defects can be closed using either this technique or local skin flaps. PMID- 3554607 TI - [Swine diseases and their prevention. By D. A. de Jong Jzn, 1891]. PMID- 3554611 TI - Basic principles for reconstruction of problem skin defects on the limbs and feet. AB - Skin defects on the limbs of animals present a problem from the standpoint that there is not an abundance of skin on the limbs to reconstruct with as there is on the trunk of an animal. Shifting local tissues can be used to correct small limb defects, and skin flaps from the upper limbs or body can be used to correct upper limb defects. Defects on the lower limbs and feet may require distant flaps or free grafts for reconstruction. Foot pads require special attention when being sutured. When foot pads have large defects or are missing there are techniques for replacement: however, there are certain principles that must be abided by when replacing foot pads. PMID- 3554612 TI - Reconstructive eyelid surgery. AB - A review will be presented of some available eyelid reconstructive methods--such as the inverse triangles; and the H and rotation flap method for the correction of lid defects, e.g. after lidtumor removal. Emphasis will be put on the choice of method, handling, reconstruction and suturing of skinflaps and lid edges. PMID- 3554613 TI - Glucose-induced responses of insulin and gastric inhibitory polypeptide in various animal models. AB - In order to clarify the role of gastric inhibitory polypeptide (GIP) in an enteroinsular axis, 19 healthy mongrel dogs were divided into following groups: 5 normal dogs (N), 4 dogs with gastrojejunostomy (GJ), 5 dogs with duodenal fistula (D) and 5 vagotomized dogs (V). Four weeks after the operation glucose was administered orally or intraduodenally in a conscious state. In group D, glucose administration was repeated under atropine injection (A). Glucose-induced response of plasma GIP was exaggerated in all the groups compared with group N. The regression equation reported by Lauritsen and Moody was obtained in each dog from the ratio of plasma insulin to blood glucose and from plasma GIP. The slope of the regression line was elevated in group GJ and reduced in group V. However, groups D and A did not reveal any difference in the slope of the regression line compared with group N. From the present study, it might be concluded that the B values in Lauritsen and Moody's equation indicates the sensitivity of the B cell in the pancreatic islet and that GIP secretion plays an important role in the glucose-induced insulin response even in the conditions with various surgical modifications. PMID- 3554614 TI - Erythrocyte insulin receptor in insulin autoimmune syndrome: effects of corticosteroid therapy. AB - Changes in the erythrocyte insulin receptors were studied in a patient with insulin autoimmune syndrome before and after corticosteroid therapy. In this case, despite a quite low fasting plasma glucose value (29 mg/100 ml), a 75 g oral glucose tolerance test (OGTT) showed a diabetic curve and extremely high immunoreactive insulin (IRI) levels were observed. After 6 months duration of the disease, corticosteroid was given to the patient and hypoglycemic attacks disappeared with an improvement of the levels of plasma glucose. The number of insulin receptors decreased from 58 to 29 sites/erythrocyte and an increase in binding affinity or maximal binding ability were observed after the treatment with corticosteroid. These receptor changes, for the most part, might be derived from the steroid effects, since there were similar results when we administered steroid for a long term to a certain disease. There was a 20% reduction in the amount of insulin binding IgG purified from the serum one month after treatment with corticosteroid as compared with that purified from the serum before the treatment. The results suggest the usefulness of corticosteroid therapy in treatment of the insulin autoimmune syndrome. PMID- 3554615 TI - Production of a monoclonal antibody selective to human transitional cell carcinoma. AB - In order to detect the bladder tumor specific antigens, the monoclonal antibody (MoAb) No. 10 to human transitional cell carcinoma of the bladder (T.C.C.B.) was obtained. Hybridomas were prepared by cell fusion between the mouse myeloma cell line X 63 Ag 8.653 and the spleen cells of BALB/c mouse hyperimmune to the bladder cancer cells (grade 2) from a patient, and were cloned. Consequently 12 MoAb-producing clones were obtained for the panel screening by enzymeimmunoassay (EIA) and then 3 MoAbs (No. 10, 11 and 14) were selected for the testing of reactivity to bladder cancer cells from patients including normal epithelia. Finally No. 10 was selected as the most appropriate MoAb for this study and was determined IgM with kappa-light chains by EIA. PMID- 3554616 TI - The effects of nickel on immune function in the rat. AB - The immunotoxic potential of NiCl2 was evaluated in Fischer 344 rats following a single intramuscular injection at doses ranging from 10 to 20 mg/kg. Twenty-four hours following treatment, selected cellular and humoral immune function parameters were examined. Significant (P less than 0.05) decreases in body weights were observed in rats injected with 15 and 20 mg/kg NiCl2 as were decreases in spleen weights of rats receiving 20 mg/kg. The lymphoproliferative responses of splenocytes to the T cell mitogens concanavalin A (Con A), phytohemagglutinin (PHA), the T and B cell mitogen pokeweed mitogen (PWM) and the B cell mitogen Salmonella typhimurium mitogen (STM) were not significantly different from controls. No significant differences were observed between control and Ni-treated rats in the primary antibody response to sheep red blood cells (SRBC). On the other hand, natural killer (NK) cell activity was significantly (P less than 0.05) suppressed in rats injected with 10, 15, or 20 mg/kg NiCl2. NK cell suppression was observed in both male and female rats and for both allogeneic W/Fu-G1 target cells as well as xenogeneic YAC-1 target cells. Ni induced suppression of NK activity was transient, with levels returning to control values within three days following treatment. Ni-induced suppression of NK activity was also manifested by an increase in mortality of rats injected with MADB106 tumor cells. These results extend to a second species our earlier findings that Ni suppresses NK activity. PMID- 3554617 TI - Dose-response and time course of hypothyroxinemia and hypoinsulinemia and characterization of insulin hypersensitivity in 2,3,7,8-tetrachlorodibenzo-p dioxin (TCDD)-treated rats. AB - Male Sprague-Dawley rats were administered i.p. various doses of 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) in corn oil. At several time points thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), reverse triiodothyronine (rT3) and insulin were determined in serum using radioimmunoassays, and glucose was measured by the glucose oxidase method. TSH and TT3 were not affected by any dose at any time point of measurement. TT4 and FT4 were decreased in a somewhat dose-dependent manner by days 2 to 4 after dosing. Return of TT4 and FT4 to normal values by day 32 after TCDD dosage also occurred in a dose-dependent manner, except in rats that died later. rT3 was also decreased at each dose level early and returned to normal levels in a somewhat dose-dependent fashion. Rats in the 2 highest dose groups became hypoinsulinemic and in the highest dose group also hypoglycemic by day 8 after dosing. Serum insulin and glucose remained suppressed in non survivors of TCDD until death ensued. In survivors, serum insulin returned to normal values by day 32 after dosing. The hypoinsulinemic state was further characterized by hypersensitivity towards insulin, i.e. injection of an otherwise non-toxic dose of insulin 3 days after administration of 125 micrograms/kg TCDD was lethal to 80% of the rats within 24 h. Insulin hypersensitivity preceded both hypoglycemia and hypoinsulinemia. These findings suggest that hypothyroxinemia and hypoinsulinemia may be part of an adaptive process whereby rats attempt to diminish the toxic insult of TCDD. PMID- 3554618 TI - Anterior aesthetic resins--an update. PMID- 3554619 TI - [Method of preparing combined knock-down models for porcelain and unit-cast crowns]. PMID- 3554620 TI - [Preparation of the teeth for different designs of fixed dentures]. PMID- 3554621 TI - [Preparation of caps made from thermoplastic materials for the long-term action of drugs in periodontal diseases and the consolidation of hard dental tissues]. PMID- 3554622 TI - [Contribution of N. V. Sklifosovskii to the development of surgery and dentistry (on the 150th anniversary of his birth)]. PMID- 3554623 TI - [The life and activities of N. N. Znamenskii]. PMID- 3554624 TI - [Transplantation in maxillofacial surgery]. PMID- 3554625 TI - [Chemical agents for preventing dental deposits]. PMID- 3554626 TI - Interaction between erythromycin and cyclosporine in a kidney and pancreas allograft recipient. PMID- 3554627 TI - Effect of charcoal and sorbitol-charcoal suspension on the elimination of intravenous phenobarbital. AB - The effects of two different oral charcoal suspensions on the elimination of a 200 mg/70 kg, 1 h intravenous (i.v.) infusion of phenobarbital and the tolerances of the two regimens were determined in a randomized crossover study in six healthy male volunteers. Phenobarbital was given i.v. alone or together with 105 g of oral activated charcoal suspension or with 105 g of a commercially available sorbitol-charcoal suspension over a 36-h period. A 13-34% decrease in the area under the serum concentration time curve (AUC) for 0-60 h occurred with the administration of the activated charcoal, and a 19-52% decrease occurred with the commercial sorbitol-charcoal regimen. The mean apparent systemic clearance of total phenobarbital increased from 0.089 +/- 0.019 ml/min/kg to 0.141 +/- 0.029 and 0.146 +/- 0.036 ml/min/kg with the charcoal and sorbitol-charcoal treatments, respectively. No significant change in the fraction of phenobarbital bound to protein was detected. The charcoal regimen caused constipation in one subject. All subjects taking the sorbitol-charcoal preparation experienced diarrhea; there were no changes in electrolytes with either charcoal suspension. All subjects preferred the sorbitol-charcoal preparation. PMID- 3554628 TI - Observed differences in amikacin pharmacokinetic parameters and dosage recommendations determined by enzyme immunoassay and fluorescence polarization immunoassay. AB - Enzyme immunoassay (EIA) and fluorescence polarization immunoassay (FPIA) methods are commercially available for quantitation of serum amikacin concentration. The purpose of this study was to determine if the two assay methods were comparable and would provide the same estimates for pharmacokinetic parameters and dosage recommendations. A total of 73 amikacin serum samples were used to evaluate the two assay techniques. Forty-four of these samples, obtained from 10 patients, were used to evaluate the comparability of pharmacokinetic parameters and dosage regimens. The correlation coefficient between the two assay methods was 0.98 (y = 1.03x + 0.64). There were substantial differences in assay performance noted in samples less than 10 mg/L, 10-20 mg/L, and greater than 20 mg/L, typical concentration ranges for serum sampling used in pharmacokinetic analysis. A difference of approximately 10% was observed in the determination of amikacin half-life, total body clearance, and dosage calculation. A 7% difference was noted in the volume of distribution. A significant difference (p less than 0.05) in volume of distribution and dosage recommendations was noted. Although the two methods for determining amikacin serum concentrations appear to be interchangeable on the basis of the in vitro comparison, significant differences were observed between the two assays in pharmacokinetic parameters and dosage recommendations. PMID- 3554629 TI - Early adventures in drug metabolism: 1. Role of the Bratton-Marshall reagent. AB - The Bratton-Marshall reagent is one of the real land-marks in the development of drug metabolism and pharmacokinetics, coming at a time when highly sensitive and specific analytical procedures were desperately needed for the measurement of drug concentrations in the body. Examples of its applications are taken from early work in the mid-40's and 50's in the Parke-Davis Research Laboratories, extending from primary aromatic amines (e.g., sulfonamides), to p-nitrophenyl compounds that must first be reduced to amines (e.g., chloramphenicol), and to phenyl derivatives that must be nitrated on a microgram scale and then reduced to aryl amines (e.g., phenytoin). The development and use of separation techniques such as liquid/liquid counter-current partition and paper chromatography is described. Emphasis is placed upon continued, progressive improvement in the basic assay procedures over long periods of time. PMID- 3554630 TI - The effect of hyperlipidemia on therapeutic drug assays. AB - Hyperlipidemia interferes with spectrophotometric assays of a number of analytes. No interference was found in the assay of gentamicin, phenytoin, or phenobarbital due to turbidity in levels of triglyceride less than or equal to 2,000 mg/dl with the Abbott TDx or Syva enzyme multiplied immunoassay (EMIT) methods. There is no evidence that lipophilic drugs partition into the lipid phase in severely hyperlipidemic serum. No assay errors due to turbidity or partitioning of phenobarbital in the lipid of serum with a triglyceride concentration of 10,000 mg/dl were found, nor were changes seen in free phenytoin distribution due to hyperlipidemia. PMID- 3554632 TI - Caffeine enzyme immunoassay in neonatal and pediatric drug monitoring. AB - An enzyme immunoassay technique (EMIT) for microdeterminations of caffeine was compared with high performance liquid chromatography (HPLC) and evaluated in 113 neonates and young infants, and in 18 asthmatic and 15 epileptic children. The EMIT assay was found reliable in therapeutic drug monitoring. It offers advantages over HPLC in its rapidity and simplicity. It is not affected by hemolysis, hyperbilirubinemia, or lipemia. In the neonate, greater accuracy is obtained with blood samples containing no heparin. PMID- 3554631 TI - Homogeneous enzyme immunoassay (EMIT) protocol for monitoring tricyclic antidepressants on the COBAS-BIO centrifugal analyzer. AB - EMIT tests are available for quantitative determination of the tricyclic antidepressants amitriptyline (AMI), nortriptyline (NORT), imipramine (IMI), and desipramine (DMI). An extraction step before analysis eliminates cross-reacting polar metabolites. Excellent correlation between EMIT and high-performance liquid chromatography (HPLC) has been previously established. Most published protocols for using EMIT reagents on COBAS-BIO centrifugal analyzers were designed for analytes present at 1-50 mg/L in serum. AMI, NORT, IMI, and DMI are usually present at far less than 1 mg/L. We describe a COBAS-BIO EMIT protocol for assaying these analytes. Patient sample correlation between COBAS-BIO EMIT and EMIT-AutoLab were greater than 0.99. Between-run precision for single-point determinations was comparable to SYVA AutoLab performance [less than or equal to 11% at 40 micrograms/L AMI, NORT, IMI (80 micrograms/L DMI), and less than or equal to 4% at 200 micrograms/L AMI, NORT, IMI (400 micrograms/L DMI)]. With stored-curve updating, working reagents were usable for at least 14 days (AMI) or 23 days (DMI). PMID- 3554633 TI - In vitro bone marrow cell migration to supernatants prepared from thymic epithelial cell cultures. AB - Thymic epithelial cell cultures were established from neonatal CBA/J mice by inhibition of fibroblast overgrowth. Epithelial cells were identified by their cobblestone appearance in culture, by the presence of keratin, and by ultrastructural analysis demonstrating desmosomes. Supernatants were prepared by incubation of confluent cultures of these cells in serum-free media. Using blind well chambers, these supernatants were chemoattractive to murine bone marrow cells, enriched for immature lymphoid cells, and decreased the myeloid to lymphoid ratio in the migrating cell population. Interleukin 2 had no effect as a modulator of this chemoattraction, nor did it possess chemoattractive properties. Supernatants prepared from epidermal growth factor stimulated thymic epithelial cells possessed significantly enhanced chemoattractive properties to bone marrow cells, and was found to be a thymic epithelial cell mitogen. Supernatants from serum-free cultures of thymocytes also induced a significant migration of bone marrow cells but were found to enrich for mature myeloid cells. PMID- 3554634 TI - On being two hundred 1787-1987. PMID- 3554635 TI - The well-placed and the misplaced philosophes, Benjamin Rush of Philadelphia and Benjamin Waterhouse of Boston. PMID- 3554636 TI - A selection of treasures from the Historical Collections of the Library of the College of Physicians of Philadelphia. PMID- 3554637 TI - A discourse delivered before the College of Physicians of Philadelphia, Feb. 6, 1787 on the objects of their institution. By Benjamin Rush. PMID- 3554638 TI - Successful 48-hour preservation of the rat liver by continuous hypothermic perfusion with haemaccel-isotonic citrate solution. AB - Eleven rat livers were stored at 7 degrees C for 24 or 48 hr using a continuous nonpulsatile perfusion method. The perfusate was based on the isotonic citrate preservation solution but contained, in addition, gelatin polypeptides (Haemaccel, Hoechst) and fluorocarbon emulsion (FC-43, Green Cross Corp.). Isologous livers were orthotopically transplanted after preservation, and long term survival was 3/6 following 24 hr preservation and 4/5 following 48 hr preservation. All the biopsies taken immediately after revascularization were histologically normal. The seven surviving animals were killed at two months and histology showed biliary obstruction, but in all cases the hepatocytes appeared to be well preserved. These late histological findings are common in any use of this transplantation model and are believed to be associated with the difficulty of obtaining a satisfactory anastomosis of the bile duct. The perfusate described here is capable of providing reliable 48 hr preservation of the rat liver. PMID- 3554639 TI - Cortical and vascular prostaglandin synthesis during renal allograft rejection in the rat. AB - Alterations in local prostacyclin and thromboxane synthesis could mediate the changes in vascular perfusion and platelet deposition in acutely rejecting renal allografts and prostaglandin E2 (PGE2) has been implicated in the regulation of the immune response. 6-Keto-prostaglandin F1 alpha (6 KetoPGF1 alpha), thromboxane B2 (TxB2) (the stable degradation products of prostacyclin and thromboxane A2 [TxA2], respectively) and PGE2 were measured in incubates of cortical slices taken from rat renal allografts or isografts one to seven days after transplantation. 6 KetoPGF1 alpha and TxB2 synthesis was also measured in incubates of blood vessels supplying and transplanted with the kidney in these animals. During the phase of cellular rejection (3-5 days), TxB2 synthesis was selectively elevated in allografted renal cortex, renal artery, renal vein, and abdominal aorta in comparison with isografted tissues. There was also a small but significant rise in cortical PGE2 synthesis at this time, but vascular and cortical 6 KetoPGF1 alpha production remained unchanged. Renal infarction, occurring 7 days after transplantation, was accompanied by a nonspecific rise in the synthesis of all three prostaglandins by renal cortical slices. Increased tissue TxA2 synthesis may contribute to local thrombosis and decreased graft perfusion during acute rejection, thereby potentiating graft destruction. PMID- 3554640 TI - Renal function after kidney transplantation in children. A comparison of conventional immunosuppression with cyclosporine. AB - Clearance studies were performed in 32 transplanted children treated with CsA in combination with low-dose prednisolone (CsA group), and the results were compared with those of 29 children transplanted earlier and treated with azathioprine and prednisolone (CIS group). Serum creatinine and urea levels 6 weeks and 1 year after transplantation (Tx) were significantly higher in the CsA than in the CIS group. Clearance studies 6 weeks after Tx exhibited significantly lower rates in the CsA group: Cin = 47 +/- 16.5 versus 83 +/- 25 ml/min/1.73 sqm, CPAH = 271 +/- 110 versus 503 +/- 181 ml/min/1.73 sqm (P less than 0.001). The filtration fractions were not different (19.1 versus 17.1%). The tubular phosphate reabsorption per ml GFR (Tp/Cin) was only slightly lower in the CsA group (0.76 +/- 0.23 mumol/ml versus 0.93 +/- 0.29; P = 0.09). The endogenous glucose clearance rates were equally elevated in both groups and returned to normal after 1 year. The creatinine clearance (Ccr) had dropped in both groups by a mean for 13 ml/min/1.73 sqm between 6 weeks and 1 year after Tx. No correlation was found between the Ccr and the CsA blood levels, but Ccr was inversely correlated with the number of rejection episodes (r = -0.72, P = 0.001). In conclusion, renal allografts in CsA-treated children exhibited a significantly lower function than in CIS-treated children. The effect was related to the global kidney function without any signs of additional tubular toxicity and was apparent within the first weeks after Tx. Thereafter, the decline in graft function was comparable in both groups and could not be related to CsA treatment. PMID- 3554641 TI - Evidence that cyclosporine does not affect the metabolism of prednisolone after renal transplantation. AB - The following investigation was performed to establish whether renal transplant patients treated with cyclosporine and prednisone have a decreased prednisolone catabolism and/or an increased systemic availability of oral prednisone when compared with patients treated with azathioprine and prednisone. Therefore we assessed, by HPLC and equilibrium dialysis, the total concentrations of prednisolone and prednisone and the unbound concentrations of prednisolone in plasma samples collected over 24 hr, and the 24-hr urinary excretion of prednisolone, prednisone, and 6 beta-hydroxyprednisolone after an i.v. dose of prednisolone and an equal oral dose of prednisone in 25 renal transplant patients on cyclosporine and in 25 patients on azathioprine and prednisone one month after transplantation. The metabolic clearance, the renal clearance, the volume of distribution, and the systemic availability of total and unbound prednisolone were identical in patients with and without cyclosporine. The apparent activities of the oxidoreductases involved in the biotransformation of prednisone into prednisolone and vice-versa were not affected by cyclosporine therapy. The fractional urinary excretions of 6 beta-hydroxyprednisolone increased with increasing metabolic clearance rate of prednisolone (r = 0.50, P less than 0.001). This relationship was not modulated by cyclosporine, indicating that cyclosporine does not affect the activity of the microsomal P-450-dependent 6 beta-hydroxylase. Thus, early after transplantation, patients on cyclosporine have a normal metabolism of prednisolone. PMID- 3554642 TI - Pretransplant transfusions in cardiac allograft recipients. AB - The role of pretransplant transfusion in cardiac allograft recipients was determined retrospectively in 68 patients. Three groups were studied: group 1 (n = 29) received no pretransplant transfusion, group 2 (n = 15) received transfusion over one year prior to transplantation, and Group 3 (n = 24) received 5 or 10 50-100 ml units of random donor red blood cells or buffy coat 2-4 weeks prior to transplantation. Data were analyzed for survival, number of rejection episodes, and number of infections. Immunosuppression included azathioprine, prednisone, and antithymocyte globulin. Survival in transfused patients (groups 2 and 3) was 68% and 51% at 1 and 5 years, respectively, while in the nontransfused population (group 1) it was 35% and 16%. The incidence of rejection episodes per year of survival was similar in the three groups (group 1: 1.3, group 2: 1.1, group 3: 1.3; P greater than 0.05). The number of infections per year of survival were greater in the transfused patients but this did not achieve statistical significance (group 1: 1.0, group 2: 1.2, group 3: 1.7; P greater than 0.05). Thus, we conclude that cardiac transplant recipients who have received blood transfusions prior to transplantation may have enhanced survival over patients who have not received preoperative transfusions. PMID- 3554643 TI - A controlled trial of steroids in cyclosporine-treated renal transplant recipients. AB - In a randomized controlled clinical trial, 117 recipients of a kidney transplant were treated with cyclosporine (15-17 mg/kg/day) either alone or with prednisolone 0.3 mg/kg/day in addition. There were no exclusions and all patients have been followed-up from 14 to 39 months. No differences in the survival of the patients or their transplants were seen between the two groups. Actual survival of first cadaver grafts was 73% at one year in the group receiving cyclosporine alone and 76% in the group with added steroids. Survival of second or third grafts in the steroid group was somewhat worse but not significantly so. All 6 recipients of living-donor grafts are currently alive with good function. Infective complications were significantly less common in the group not receiving routine steroids, and these patients were also at less risk of developing a changed facial appearance. However, half the patients in this group have subsequently required steroids because of previous rejections, and cyclosporine nephrotoxicity has been significantly more common. Nonetheless, we have found no overall advantage in combining cyclosporine with low-dose maintenance prednisolone, and we advise that patients undergoing renal transplantation receive cyclosporine alone in the first instance. PMID- 3554644 TI - Serum and cell-mediated responses in tolerance and hyperacute rejection of transplanted mouse hearts. AB - MHC-disparate recipients that have been sensitized intradermally or via a skin graft reject transplanted mouse hearts hyperacutely. However, transplant survival is prolonged after intraperitoneal or intravenous sensitization. These opposite in vivo events are not correlated with differences in serum antibody responses, but the correlation of hyperacute rejection with delayed-type hypersensitivity is fairly strong. Prolonged survival of heart transplants is probably related to suppressor cells, and adoptively transferable in MHC-compatible combinations. Intraperitoneal or intravenous sensitization, while prolonging survival of heart transplants, causes hyperacute rejection of skin grafts, indicating the importance of the target; it is probably related to differences in the establishment of a blood supply. PMID- 3554646 TI - Suture versus cuff technique for cardiac grafting in rats. A comparative study and description of a new abdominal approach. PMID- 3554645 TI - Evidence that cyclosporine does not inhibit allograft rejection by IL-2-treated sensitized splenocytes. AB - Splenocytes sensitized in vitro to the H-2 allotype of a skin allograft have been shown to cause accelerated rejection of the skin allograft after adoptive transfer of the splenocytes. Treatment of the host with splenectomy or sublethal radiation did not alter the accelerated rejection. In the present study, cyclosporine (CsA) given subcutaneously to mice bearing 1 day old skin grafts prevented the rejection of the graft despite the adoptive transfer of sensitized cells. If the CsA was given for 14 days at 50 mg/kg every other day, the grafts were rejected an average of 6 days after the cessation of CsA. If the CsA was given for 20 days 50 mg/kg every other day, the grafts were not rejected even after cessation of CsA. When no sensitized cells were given, the same pattern resulted; that is, when a 14 day course of CsA was given the grafts were rejected after cessation of the CsA but when a 20-d course was given, the grafts were not rejected even after the CsA was stopped. If splenocytes were sensitized in the presence of interleukin-2 (IL-2), they caused rejection of the skin allografts in animals even on treatment with CsA. We concluded that CsA can prevent skin allograft rejections in the murine system. Moreover, the dose of CsA was critical, in that a longer course of CsA was necessary for tolerance. CsA further prevented the accelerated rejection of skin allografts by adoptive transfer of specifically sensitized splenocytes. Donor irradiation did not alter the effect of the CsA or of the adoptively transferred cells. CsA could not prevent the rejection of skin allografts when the adoptively transferred cells were sensitized to antigen in the presence of IL-2. PMID- 3554647 TI - The importance of perfusate in 72-hour preservation of canine kidneys. PMID- 3554648 TI - Prolonged allograft survival in xenotransfused mice after graft and/or donor pretreatment with cyclosporine and/or concanavalin A. PMID- 3554649 TI - Renal toxicity following total-body irradiation and syngeneic bone marrow transplantation. PMID- 3554650 TI - Effect of hydergine on cyclosporine-induced nephrotoxicity in a rat kidney transplantation model. PMID- 3554651 TI - Reduction of susceptibility to lipid peroxidation by desferrioxamine in rabbit kidneys subjected to 24-hour cold ischemia and reperfusion. PMID- 3554652 TI - The relevance of pressure changes in transplanted hearts and kidneys in immunosuppressed rats. AB - The pressure within rat cardiac and renal allografts has been observed to rise during rejection. We wished to see if this pressure rise could be prevented or reversed with immunosuppression. Transplants were performed from Lewis or DA donors to Lewis recipients. The rats received either a heterotopic cardiac transplant or an orthotopic renal transplant and were then treated with different immunosuppressive protocols. Intramyocardial pressure was recorded using a fine gauge needle connected to an air pressure manometer. In the case of the renal transplants, a pressure transducer was used as well and the two methods compared. Intramyocardial and intrarenal pressures rose dramatically in unimmunosuppressed recipients of DA allografts. No such rise was seen in isografted organs, although the pressures recorded remained significantly higher than those found in untransplanted hearts and kidneys. Cyclosporine 20 mg/kg/day was effective in suppressing rejection in both models, and inhibited any rise in intraorgan pressure. Cyclosporine 10 mg/kg/day was less effective, and with 2 mg/kg/day allograft function was considerably impaired, one-third of the cardiac grafts being rejected by 16 days. In both models intraorgan pressures became raised. The addition of methylprednisolone 16 mg/kg i.p. on days 7 and 8 to this low dose regimen of cyclosporine 2 mg/kg/day rapidly reversed the rise in pressure and restored graft function to normal. Intraorgan pressure levels therefore accurately reflected the state of function of transplanted hearts and kidneys. When a manometer and a transducer were compared as a means of measuring the pressure in the renal transplants, the manometer method was found to be superior. PMID- 3554653 TI - Function of transplanted human pancreatic allografts after preservation in cold storage for 6 to 26 hours. AB - Preservation of cadaveric pancreas allografts has been a difficult problem in clinical pancreas transplantation; most institutions use Collins solution and limit preservation time to less than 6 hr. Longer preservation times have been used at the University of Minnesota. Between August 1983, and December 1985, 47 human cadaveric pancreas grafts were transplanted into Type I diabetic recipients after cold storage at 4 degrees C in a modified, hyperosmolar silica-gel filtered plasma (SGFP), a solution previously found to allow dog pancreas grafts to be successfully preserved for up to 48 hr. Ten grafts were preserved for 2-5 hr (group 1); 20 for 6-11 hr (group 2; 17 for 12-26 hr (group 3). Graft function and late outcome were compared between these groups and another group of 7 cadaveric grafts (group 4), which were transplanted immediately and without any preservation. Analysis of exocrine pancreatic function early after transplantation showed a maximum mean serum amylase (IU/L) of 557, 440, 429, and 307 in groups 1, 2, 3, and 4, respectively. Primary preservation failure rates of 0, 5%, 5.8%, and 0%, and endocrine graft function rates at 1 month of 80%, 80%, 76%, and 86% were obtained for groups 1, 2, 3, and 4, respectively (P = NS). Only patients who were insulin-independent were counted as having functioning grafts. Detailed functional studies at 1 month showed that mean plasma glucose levels during 24-hr metabolic profiles were in the normal range in 71%, 68%, 72%, and 50%, while oral glucose tolerance test results were within the normal range in 38%, 81%, 76%, and 66% of groups 1, 2, 3, and 4, respectively (P = NS). At 1 year, patient survival rates were 57%, 88%, 75%, and 100% (P = NS), and the graft functional survival rates were 0, 25%, 33%, and 29% (P = NS) in the respective groups. Five patients in group 2, and 6 in group 3 have currently functioning grafts at 4 to 37 months after transplantation. We conclude that cadaver pancreas grafts can be safely preserved for 12-24 hr in modified SGFP solution, thus making the sharing of these organs between different centers practical and the transplant operation less of an emergency procedure. PMID- 3554654 TI - The effect of zero HLA class I and II mismatching in cyclosporine-treated kidney transplant patients. AB - The effect of HLA matching on one-year first cadaver donor graft survival rates between best and worst matches was 6% (P less than 0.001) for A, B; 7% (P less than 0.001) for DR; 9% (P less than 0.001) for A, DR; 15% (P less than 0.001) for B, DR; and 17% (P less than 0.001) for A, B, DR. For second cadaver donor grafts, the differences were comparable. Analysis of the cyclosporine-treated patients separately yielded similar results: 5% (NS) for A, B; 7% (P less than 0.001) for DR; 13% (P less than 0.001) for A, DR; 16% (P less than 0.001) for B, DR; and 18% (P less than 0.001) for A, B, DR. The most significant effect of matching was achieved by zero mismatching B and DR antigens. The one-year graft survival for patients with zero A, B, DR mismatch was 88% with cyclosporine. Without cyclosporine, zero mismatched A, B, DR grafts survive at 84%; this difference is not statistically significant. Zero mismatching for class I and II antigens (that is, A, DR or B, DR with cyclosporine) gives one-year graft survivals of 84% and 87%, respectively. The zero mismatching HLA class I and II antigen effect is lost when even one antigen is mismatched. Transfusions improved the one-year graft survival 10% in cyclosporine-treated patients, but not in those who were not treated with cyclosporine. Seventy-one patients transfused with more than 4 units of blood, zero B, DR mismatched, and treated with cyclosporine had a 91% one-year graft survival. Recipient pool sizes for obtaining zero A, B, DR or B, DR mismatched donors are calculated. Zero A, B, DR mismatched patients can be transplanted at a 19% frequency with a 10,000 recipient pool. The success rate for zero mismatching of class I and class II antigens indicates that kidney sharing and large recipient pool sizes are a reasonable policy. PMID- 3554655 TI - Long-term effects of cyclosporine on renal function in liver transplant recipients. AB - The long-term effects of cyclosporine on renal function were evaluated in eleven liver transplant recipients over a 6-26-month follow-up period. Renal hemodynamic function (glomerular filtration rate [GFR], effective renal plasma flow [ERPF]) fell 60% postoperatively, subsequently improved, and stabilized at 45-60% of normal despite continued drug administration. Tubular sodium transport studies during water diuresis suggested that the proximal tubule is a major site of cyclosporine nephrotoxicity. In contrast to the acute effects of cyclosporine on renal function, the fraction of glomerular filtrate reabsorbed in the proximal tubule was less in the patient group while the fractional excretion of sodium, potassium, and phosphate was increased. When the fraction of filtered sodium reabsorbed in the diluting segment was examined as a function of sodium delivery, functional impairment occurred in the diluting segment as well. Eight renal biopsies performed in six patients 4-29 months posttransplantation showed only mild to moderate changes, predominantly vascular, which correlated poorly with corresponding renal function. These data showed that long-term cyclosporine administration produced early and persistent depression of both hemodynamic and tubular function. A functional rather than structural mechanism appears to be more significant during this period of observation. PMID- 3554656 TI - Postoperative deep venous thrombosis after renal transplantation. Effects of cyclosporine. AB - In this prospective study the frequency of deep venous thrombosis during the first three weeks after renal transplantation was determined using a combination of strain gauge plethysmography and thermography for objective diagnosis. Ninety seven consecutive patients were studied, 30 patients having juvenile diabetes mellitus. As immunosuppression cyclosporine and low-dose steroids were used. The series was compared with a similar group of 83 patients, 33 having juvenile diabetes mellitus treated with azathioprine and high-dose steroids as immunosuppression, in which the diagnosis of deep venous thrombosis was made with an identical technique. The overall frequency of thrombosis was 9.3% in the cyclosporine-treated group, which is a significant reduction in comparison with the azathioprine group (24.1%). It is concluded that the combination of cyclosporine and low-dose steroids does not increase the frequency of deep venous thrombosis in comparison with azathioprine and high-dose steroids in renal transplanted patients. PMID- 3554657 TI - Bone marrow transplantation for acute nonlymphoblastic leukemia during first complete remission. An analysis of prognostic factors. AB - Sixty-nine patients with acute nonlymphocytic leukemia in first remission received total-body irradiation and chemotherapy followed by allogeneic bone marrow transplantation from histocompatible sibling donors. Patient age was between 1 and 41 years: 20 patients 1-19 years (group 1); 27 patients 20-29 years (group 2); and 22 patients 30-41 years (group 3). Two pretransplant radiochemotherapy regimens were employed: The first 45 patients received total body irradiation (in a single dose) with cytosine arabinoside and cyclophosphamide; the next 24 patients received total-body irradiation (in a fractionated schedule) with cyclophosphamide alone. For all patients, actuarial disease-free survival is 51% (37 of 69 patients are alive and in continuous remission between 5 months and 9.3 years, median 3.7 years). For group 1 actuarial survival is 56%, group 2 48%, and group 3 48%. When analyzed for pretransplant factors that might predict disease-free survival after bone marrow transplantation neither patient age, white cell count at the time of diagnosis, FAB leukemic subtype, length of time before achieving remission, nor length of time between remission and bone marrow transplantation were established as prognostic. PMID- 3554659 TI - Substantial benefits of tissue matching in renal transplantation. AB - The purpose of this study was to perform a rigorous statistical analysis of the benefits of HLA-A,B and DR matching in renal transplantation. Graft survival in 2282 first cadaver kidney transplants, recorded and followed up by the United Kingdom Transplant Service (UKTS), was analyzed using the piecewise proportional hazards regression method. The results show that substantial improvements in graft survival are obtained when there is DR compatibility and at most one A or B mismatch, but that there is little advantage in tissue matching unless this degree of matching can be attained. So far, few graft recipients have benefited substantially through tissue matching (24% of kidneys exchanged through UKTS in 1984). This is partly attributable to unresolved technical problems in DR typing. However simulations show that under ideal conditions, with a pool of 3000 patients awaiting transplantation, considerable improvements in graft survival can be obtained in over 60% of recipients. PMID- 3554658 TI - Sequential intravenous and twice-daily oral acyclovir for extended prophylaxis of herpes simplex virus infection in marrow transplant patients. AB - To define an effective and convenient means for providing extended prophylaxis of herpes simplex virus (HSV) infection to chronically immunocompromised patients, we studied a two-part regimen of intravenous, followed by oral, acyclovir after marrow transplantation. Seropositive patients were first given intravenous acyclovir until day 30 after transplant. Intravenous acyclovir (250 mgm/m2) given twice daily to 34 patients during this period was 90% virologically effective among those completing the prophylactic course. A randomized, double-blind comparison of twice-daily oral acyclovir (800 mg) and placebo was then conducted from day 31 to day 75 after transplant in 51 patients. Oral acyclovir significantly delayed the median time to first excretion of HSV when compared with placebo (greater than 100 vs. 70 days after transplant, P = 0.0006) and was completely effective in all patients for the duration of drug administration. Patients receiving extended prophylaxis appeared to have less-severe HSV infection when later recurrences did occur. Sequential intravenous and oral acyclovir given twice daily is an effective and convenient regimen for extended prophylaxis of HSV infection following marrow transplantation, and should be useful in other transplant patients or other chronically immunosuppressed patients as well. PMID- 3554660 TI - Improved results in pancreatic transplantation by avoidance of nonimmunological graft failures. AB - Twenty eight consecutive combined renal and pancreatic transplantations with enteric exocrine diversion were performed between June 1984 and May 1986. The one year actuarial patient survival and renal and pancreatic graft survival were 90%, 67%, and 69%, respectively. Nineteen pancreatic grafts and eighteen renal grafts are currently functioning at 1-24 months. Of the pancreatic graft losses only 2 were attributable to nonimmunological complications. No pancreatic graft was lost due to pancreaticoenteric leakage or vascular thrombosis. This was achieved by reducing the cold ischemia time and by adopting an aggressive anticoagulant policy. In all patients with functioning grafts the fasting blood glucose, glycosylated hemoglobin level, and oral glucose tolerance test were normal. The intravenous glucose tolerance test was normal in most of the patients but subnormal in some. PMID- 3554661 TI - The role of cyclosporine dosage and plasma levels in efficacy and toxicity in bone marrow transplant recipients. AB - The efficacy and toxicity of cyclosporine (CsA) treatment for graft-versus-host disease (GVHD) was studied in 53 bone marrow transplant recipients. No correlation was found between acute or chronic GVHD and CsA dosage (daily or cumulative) or CsA plasma levels. Acute nephrotoxicity developed in 63% of the patients. Patients with nephrotoxicity had significantly higher CsA plasma levels during the first month after transplantation compared with patients without nephrotoxicity (P less than 0.05) although the cumulative CsA doses did not differ. Children had significantly fewer episodes of nephrotoxicity compared with adults (P less than 0.01). In spite of this, children received a significantly higher cumulative CsA dose (P less than 0.001). However, CsA plasma levels did not differ between children and adults, suggesting a difference in availability or elimination of the drug. Hypertension developed in 28% of the patients. Hypertensive patients tended to be younger compared with normotensive patients (P = 0.07). Nephrotoxicity tended to be less common in patients with hypertension (P = 0.06). No correlation existed between hypertension and CsA dose or CsA plasma levels. In conclusion, no correlation was found between CsA dose and GVHD or CsA toxicity, and in the single patient CsA plasma levels were of no value in predicting side effects of CsA treatment. PMID- 3554663 TI - Leukocyte subsets infiltrating into fully allogeneic, long-surviving rat liver allografts. AB - Leukocyte subsets that infiltrated into unmodified LEJ(RT1j)2 liver grafts from WKAH(RT1k) hosts were studied. This strain combination is fully allogeneic and yields acute rejections in skin and kidney transplantations. On days 3, 7, and 14, cellular infiltrates gradually increased, and many hepatocytes were degenerative and lost cellular glycogen. Blastoid lymphocytes were frequently seen, and mitotic features of hepatocytes were prominent (on day 14, 3 to 4/10 high-power fields). Later, on days 30, 50, and 300, the cellular infiltrates gradually subsided, and blastoid lymphocytes were rarely seen. Throughout the course, Ia+ cells (RT1.Dk+ and/or RT1.B+ cells) were the major cell populations infiltrating into the grafts. Most of the host RT1.D+ cells were histiocytoid in appearance on immunoelectron microscopy. Histiocytoid cells were the most numerous infiltrating cells, constituting 30-50% of the total infiltrating cells. There were different distributions of T cell subsets between the portal and sinusoidal areas, as we previously observed in acutely rejected rat renal allografts. Both RLyt-1+,2-(Th) and RLyt-1+,2+(Tc/s) cells were found almost equally in the portal area, while RLyt-1+,2+(Tc/s) cells predominated over RLyt 1+,2-(Th) cells in the sinusoidal area. However, a gradual replacement of RLyt 1+,2-(Th) cells by RLyt-1+,2+(Tc/s) cells, as seen in the perivascular area of renal grafts, was not found in the portal areas of the liver grafts. Except for the latter finding, the pattern of cellular infiltrates was similar to that of acute renal rejection, and the significance of these cellular infiltrates is discussed. PMID- 3554662 TI - An in vitro model for analyzing the nephrotoxicity of cyclosporine and preservation injury. AB - Renal damage caused by cyclosporine (CsA) has been documented. Clinical experiences have shown preservation injury further potentiates CsA nephrotoxicity. This study examined the mechanism of nephrotoxicity defined by changes in protein synthesis, DNA synthesis, and ornithine decarboxylase activity in an in vitro model. Initial results showed that CsA inhibited dog kidney epithelium cell (MDCK) replication at a dose of 200 ng after 24 hr (P less than .01) and 100 ng after 48 hr (P less than .01). Protein synthesis was inhibited with 100 ng after 24 and 48 hr (P less than .01). There was a reduction in ODC activity with 200 ng CsA (P less than .05). Methods for simulating transplant related injuries were then developed. Under ischemic conditions, 18 hr were required before a synergistic effect with CsA produced a reduction in replication (P less than .05). Incubation of MDCK cells in preservative solution at 4 degrees C under hypoxic conditions resulted in a time-dependent reduction in synthetic and replicative capacity that plateaued at 24 hr (P less than .01). The next step was to simulate the clinical situation by combining treatments. MDCK cells were incubated for 24 hr in preservative solution under hypoxic conditions at 4 degrees C, and then CsA was added at defined intervals. The addition of CsA before 24 hr resulted in a significant decrease in cell replication (P less than .05) compared with CsA addition after 48 hr. Similar results were obtained with cells incubated for 48 hr in preservative solution with hypoxia. These data suggest that renal injury from ischemia and cold storage requires a period of cellular repair and replication. Administration of CsA before this period results in further renal injury. Our analysis offers an explanation of CsA nephrotoxicity seen in the human situation and, therefore, may provide a model for studying human nephrotoxicity. PMID- 3554664 TI - Influence of endotoxin on graft-versus-host disease after bone marrow transplantation across major histocompatibility barriers in mice. AB - Much clinical and experimental data suggest that infection and graft-versus-host disease (GVHD) are intimately associated, and that bacterial endotoxin (ET), a potent immunostimulant, influences the severity of GVHD. We have used a cell-wall deficient mutant of Escherichia coli (E coli J5) to study the effect of active and passive immunization against ET in a murine model of GVHD induced by major histocompatibility antigens. CBA/Ca (H-2k) mice were irradiated and grafted with 1 X 10(7) bone marrow cells from C57BL/B6 (H-2b) donors. Groups of mice were immunized against J5: either actively immunized with killed J5 cells or pure J5 lipopolysaccharide, or passively immunized with rabbit anti-J5 antiserum (R alpha J5). Controls included irradiation controls, negative controls (syngeneic graft), positive controls (conventional mice receiving allogeneic graft), mice immunized with normal rabbit serum, Freund's adjuvant (FA), or human serum albumin (HSA) in FA. Active immunization with J5 exacerbated the effects of GVHD as indicated by increased weight loss (P = 0.002) and earlier death (P = 0.043). In contrast, immunization with HSA protected against weight loss (P = 0.028), and improved survival (P = 0.008). Passive immunization with J5 had no effect. These observations support the hypothesis that ET influences the pathogenesis of GVHD, and provide a useful model for studying the effects of ET in a well-defined immunological system. PMID- 3554665 TI - Immunogenicity of the non-MHC-encoded endothelial antigen Eag-1 in various tissues of the rat. AB - Immunizations of MAXX rats with spleen and lymph node cells from BN donors lead to the production of antibodies against the renal endothelial antigen Eag-1. In the present study we analyzed the ability of various tissues to induce a response against Eag-1. Lung homogenates, like spleen and lymph node cells, induced a strong and rapid antibody response. A weak and slow response was induced by cardiac allografts as well as kidneys transplanted into recipients in which unilateral or delayed bilateral nephrectomy was performed. Transplantation of kidney or skin allografts into intact recipients did not result in the formation of Eag-1 antibodies, nor did immunizations with kidney homogenates. A rapid response, however, was observed after transplantation of BN kidneys into MAXX rats previously sensitized by a single injection of BN lymphoid cells, whereas no secondary response was induced by BN kidney homogenates. With an indirect immunofluorescence technique, Eag-1 was detected on lung and kidney endothelium, but not on lymphoid cells or heart and skin tissue. It thus appears that the immunogenicity of Eag-1 does not correlate with the quantitative expression in different tissues and that lymphoid cells, rather than vascular endothelial cells, can induce a strong and rapid response against Eag-1. Because the immunogenicity of lymphoid cells was diminished by heat treatment and freeze-thaw lysis, it appears that intact donor cells are required for the stimulation of antibody production. PMID- 3554667 TI - Failure of donor-specific pretransplant blood transfusion to prolong heterotopic cardiac allograft survival in rats. PMID- 3554666 TI - The effect of the spleen on pancreatic rejection in the rat. PMID- 3554668 TI - Disappearance of pulmonary capillary leak syndrome when intravenous cyclosporine is replaced by oral cyclosporine. PMID- 3554669 TI - The Kell system and kidney transplantation. PMID- 3554670 TI - Immunomodulation of donor-specific transfusions. PMID- 3554671 TI - Adult respiratory distress syndrome associated with oral cyclosporine. PMID- 3554672 TI - Visual hallucinations and cyclosporine. PMID- 3554673 TI - Malignant external otitis in a diabetic renal transplant patient. Successful treatment without discontinuation of immunosuppressive therapy. PMID- 3554674 TI - Pseudoporphyria cutanea tarda associated with cyclosporine therapy. PMID- 3554676 TI - A thyroid metastasis revealing an occult renal clear-cell carcinoma. AB - A case of renal clear-cell carcinoma presenting as a nodular thyroid metastasis is reported. The possibility of a metastatic lesion from the kidney should be taken into account in each case of clear-cell thyroid lesion. Fine needle aspiration cytology may be unable to discriminate between the renal or thyroid origin of such lesions unless PAS staining is performed. PMID- 3554677 TI - [Effect of lipid peroxidation on the insulin receptor in rat adipocytes]. AB - Lipid peroxidation is studied for its effect on insulin receptors in isolated rat adipocytes. The results suggest that addition of two peroxidants (3 mM cumene hydroperoxide and 0.2 mM Fe2+) leads to malondialdehyde accumulation and binding inhibition through insulin receptors quantity and affinity decrease. PMID- 3554675 TI - [In memoriam Roman Beniaminovich Khesin (24 March 1922-16 July 1985) (on the 65th anniversary of his birth)]. PMID- 3554678 TI - [Allogenic bone marrow transplantation in acute leukemia and non-Hodgkin's malignant lymphoma]. PMID- 3554680 TI - [Preventive antibiotic treatment in hip fracture surgery]. PMID- 3554681 TI - [Calcium antagonists]. PMID- 3554679 TI - [Oral manifestations in chronic graft-versus-host disease]. PMID- 3554682 TI - [Chronic bacterial and abacterial prostatitis]. PMID- 3554683 TI - [The effect of natural medicine and vacuum therapy (Vacusac) in patients with stable intermittent claudication]. PMID- 3554684 TI - [Pertrochanteric fractures. Comparison between 2 surgical methods of internal fixation]. PMID- 3554685 TI - [Midazolam and diazepam in ketamine anesthesia]. PMID- 3554686 TI - [The value of ultrasonic scanning in patients with Crohn disease]. PMID- 3554687 TI - [Ultrasonic determination of the position of a coil when pregnancy has occurred]. PMID- 3554688 TI - [Toxic megacolon caused by Salmonella typhimurium infection]. PMID- 3554690 TI - Master index. Volumes 11-20. PMID- 3554689 TI - [Simultaneous intrauterine and extrauterine pregnancies]. PMID- 3554691 TI - A brief review: liquid ventilation. AB - The liquid-filled lung preparation has provided physiologists with a unique technique for varying the physical properties of respiratory media and studying their effect on basic pulmonary processes. More recently, liquid breathing, ventilation of the lungs with an oxygenated fluid, has extended the applicability of the liquid-filled lung to include a wide variety of environmental and clinical research areas. This article is an account of the history of liquid breathing based on a review of 60 publications dating back to 1920. The physiologic status of this experimental preparation has continuously advanced due to technical changes in experimental approach and improved understanding of the implications of fluid breathing on overall systemic physiology. In this regard, the evolution of the liquid breathing concept from the saline-filled lung to ventilation with inert liquids is presented. Emphasis is placed on how liquid breathing can be used as an effective research tool for expanding our understanding of normal respiratory physiology and how this technique may be of benefit to other areas of science. Finally, like most techniques in biological investigations, liquid ventilation has certain limitations. Therefore, this review summarizes the rationale behind various experimental approaches, the nature and tractability of limitations, and the results which can be safely drawn from experimental studies to date. PMID- 3554692 TI - Lower urinary tract function and pharmacologic management of lower urinary tract dysfunction. AB - Because of renewed interest in the neuropharmacology and neurophysiology of the urinary bladder and its outlet, drug therapy can now help manage many types of voiding dysfunction. This article summarizes the scientific foundations on which this type of therapy is based and the current drug usage in this area. PMID- 3554693 TI - Medical treatment of male infertility. AB - After an appropriate clinical and laboratory assessment of a patient's fertility status, the clinician must often decide whether specific and empiric treatment is indicated. Specific treatment may take the form of replacement therapy (exogenous gonadotropins or GnRH) for pituitary or hypothalamic failure, inhibition of prolactin secretion, antimicrobial therapy, or immunosuppressive therapy for demonstrable immunologic infertility. Finally, ejaculatory dysfunction often requires sympathomimetic agents. Alternatively, in the normogonadotropic oligospermic patient, the major form of empiric therapy relies on the enhancement of physiologic hormone levels that influence spermatogenesis. Such "stimulation" therapy may be achieved by GnRH analogues, antiestrogens, exogenous gonadotropins, or androgens. PMID- 3554695 TI - Intravesical therapy. A critical review. AB - In order to determine the effectiveness of intravesical therapy for superficial bladder cancer, the author critically reviews current data and the methodology upon which such data are based. Included is a discussion of prophylactic versus therapeutic intravesical therapy, the design of clinical trials for intravesical therapy and endpoints of response, biostatistical considerations, a review of randomized clinical trials, and selection of patients for intravesical therapy. PMID- 3554696 TI - [Percutaneous, perineal, ultrasound-controlled implantation of 125iodine in prostatic cancer: technics, report of initial experiences and comparison with the retropubic method of implantation]. AB - After a 4 years experience with the conventional retropubic operative free-hand technique the implantation procedure has been modified. For local therapy the volume of the prostate is measured endosonographically and biopsies are taken from defined areas of the prostate under transrectal ultrasonographic guidance using a puncture attachment (prostate mapping). According to the data of volumetry and pathology the brachytherapist calculates number and precise location of the seeds, which are inserted in a second procedure after diagnostic lymphadenectomy percutaneously and transperineally under ultrasonographic guidance with a afterloading technique. Since 1984 24 patients has been treated in this manner. Implantation procedure is described, preliminary clinical results are presented and the percutaneous technique is compared with the retropubic operative approach. The percutaneous, transperineal and ultrasonically guided 125Iodine implantation represents an alternative procedure to the radical prostatectomy and gives a good local tumor control in prostatic carcinoma with minimal side effects. PMID- 3554694 TI - Advances in the treatment of urothelial tract tumors. AB - Recently developed combination chemotherapy programs have now produced durable complete remissions in a significant percentage of patients with advanced urothelial tract malignancies. For advanced disease, efforts must still be directed at developing new agents but must also focus on understanding drug resistance. Some tumors appear to be resistant de novo; others respond for a period of time before a resistant population emerges. Clearly multiple factors come into play. In some cases, pharmacologic factors such as bioavailability metabolism, or toxicities predominate. In other cases, specific genes expressing surface proteins such as the p-glycoprotein identified in resistant ovarian tumors have been implicated. In the 1980s, it is no longer adequate to define tumors simply by pathologic inspection. As demonstrated by Russell and co-workers xenografts of phenotypically similar transitional cell tumors in nude mice demonstrated marked heterogeneity with respect to flow cytometric DNA analysis and immunocytochemistry. With the recent adoption of flow cytometric techniques, both from bladder washings and paraffin sections, insight into the biologic behavior of individual tumors may soon be possible. Blood group antigen expression and monoclonal antibodies to tumor-associated antigens may also help in this regard. For primary tumors, attention is now being focused on protocols aimed at bladder preservation. In some cases, radiation therapy alone can produce long-term survival, despite muscle infiltrating disease. Complete remissions have also been described with chemotherapy alone. The interaction of chemotherapy and radiation therapy has only recently begun to be investigated. In these trials, complete local control must still be the primary goal. Standard criteria for staging and response evaluation, including pathologic documentation of remission status, are crucial. To demonstrate a beneficial effect of therapy, long-term randomized trials will be required. The goal of individualized therapies may soon be possible, which will ideally translate into increased clinical benefit for patients with urothelial tract tumors. PMID- 3554697 TI - Breast carcinoma metastatic to bladder. AB - Breast carcinoma metastatic to the bladder and presenting initially with urinary tract symptoms has been reported only sporadically. Two cases, one unique in that the bladder was the sole site of metastasis, are reported herein, along with a review of the literature. PMID- 3554698 TI - Postpartum renal vein thrombosis with left retroaortic renal vein. AB - An unusual case of thrombosis in a left retroaortic renal vein is presented. Noninvasive radiologic diagnosis is reviewed. PMID- 3554699 TI - Primary lymphoma of prostate presenting as bladder outflow obstruction. AB - We report on a patient with prostatic lymphoma who presented with symptoms of bladder neck obstruction. Biopsy specimens from transurethral resection confirmed the diagnosis of prostatic lymphoma. There was no evidence of lymphoma spread. Treatment was by local x-ray therapy to the prostate gland. Since prostatic lymphoma is rare, the clinical literature is briefly reviewed. PMID- 3554701 TI - Prostatic biopsy guided by transrectal ultrasonography using real-time linear scanner. AB - Prostatic needle biopsy guided by transrectal ultrasonography using a real-time linear scanner was performed on 257 cases in our outpatient clinic and mass screening program for prostatic diseases. The success rate was 99.2 per cent, and complications occurred in only 2 cases (0.8%) after biopsy. This newly developed method is recommended as being safer and more accurate than conventional ones. PMID- 3554700 TI - Quantifying thread tension in Stamey vesical neck suspension procedure. Preliminary report. PMID- 3554702 TI - Clinical comparison of piperacillin and cefamandole in treatment of complicated urinary tract infections. AB - The efficacy and safety of piperacillin were compared with those of cefamandole in 72 patients (mean age: 63 years) with complicated urinary tract infections. Efficacy was evaluable in 25/34 piperacillin-treated patients (12 Gm/day) and in 23/38 cefamandole-treated patients (6 Gm/day). Clinical cure or improvement was noted in all patients who were given piperacillin and in 96 per cent (22/23) of those who received cefamandole. Seventy-one per cent (41/58) of the organisms cultured pretherapy were gram-negative aerobic bacteria. Escherichia coli was the most frequently isolated organism (15/58, or 26%), followed by Pseudomonas species (8/58, or 14%), and Proteus species (8/58, or 14%). Adverse clinical experiences were few, and none was directly attributed to therapy with either antibiotic. The changes noted in the results of laboratory tests were considered to be unrelated to the antibiotics administered. Thus, both piperacillin and cefamandole were safe and effective in the treatment of patients with complicated urinary tract infections. PMID- 3554703 TI - Focal salmonella enteritidis infection of urinary tract. AB - A case of upper urinary tract infection with Salmonella enteritidis is presented. The patient was diabetic which may have resulted in diminished immunocompetence, but no other predisposing factor was uncovered. Thorough search for an extraurinary primary source of this infection was unrevealing. The implications of this type of infection are reviewed. PMID- 3554704 TI - Exchange ureteral stent insertion using pullout suture after extracorporeal shock wave lithotripsy. PMID- 3554705 TI - Diagnostic ultrasound in the urologist's office. AB - The clinical value of diagnostic ultrasound in the management of urologic patients is now firmly established. The use of real time diagnostic ultrasound equipment in the solo office practice of a urologist was evaluated by retrospective office record review covering a period of at least one year. The appropriate use of this equipment in daily office practice is shown to be clinically useful, cost-effective, and easily performed by a urologist. The routine use of diagnostic ultrasound by urologists is recommended. PMID- 3554706 TI - Pleural effusions. AB - The key to effective evaluation of pleural effusions lies in an understanding of the dynamic nature of its formation and alteration. Trying to fit a specimen neatly into a distinct diagnostic category will not only lead to frustration, but is often unnecessary or incorrect. Combined etiologies are common, and although the possibilities are infinite, certain patterns often present themselves: inflammation frequently complicates congestive failure and neoplasms, hemorrhage is common in neoplastic and chylous effusions, neoplastic effusions may cause transudation from venous obstruction or pericardial stricture, and sepsis is frequently secondary to traumatic effusions. In the presence of atypical findings and the establishment of one cause of pleural effusion, one cannot rule out other operative conditions. PMID- 3554707 TI - Chylothorax in the dog and cat. AB - The etiology, pathogenesis, and treatment of chylothorax are discussed in this article. A detailed discussion of thoracic duct anatomy, physiology, and methods of lymphangiography is included. The information presented is a review of previous literature, an update on recently completed studies, and speculation about where future research is needed. PMID- 3554708 TI - Pneumothorax. AB - This article reviews the classification, etiopathogenesis, and treatment for the various forms of pneumothorax. Traumatic and nontraumatic pneumothoraces are discussed. New theories on the etiology and treatment of primary spontaneous and secondary pneumothorax are mentioned. PMID- 3554709 TI - Surgical diseases of the trachea. AB - Tracheal obstructions and disruptions can be successfully managed by using various tracheal reconstructive techniques provided that the principles of tracheal surgery are followed. Airflow to the lungs may also be improved by performing a tracheostomy distal to the obstructive lesion or surgical site in the nasopharynx, larynx, or proximal trachea. All patients having tracheal surgery should be monitored carefully after surgery and followed up closely for 1 to 2 months to evaluate the patient's ability to ventilate adequately. PMID- 3554710 TI - Non-neoplastic surgical diseases of the lung and pleura. AB - Non-neoplastic diseases of the bronchi, pulmonary parenchyma, mediastinum, and pleura that are amenable to surgical management represent a wide range of unrelated etiopathogenic conditions that usually have a focal distribution. The author discusses the presurgical clinical, radiographic, and laboratory assessment and prognoses, and addresses therapeutic recommendations. PMID- 3554711 TI - Neoplastic diseases of the thorax. AB - Thoracic neoplasia comprises a heterogeneous group of diseases, many of which are distinctly uncommon in veterinary medicine. These diseases often present the clinician with diagnostic and therapeutic challenges. Careful diagnostic work-up and staging are essential for consideration of therapeutic options and formulation of prognosis. Neoplastic diseases of the thorax are classified here as tracheal tumors, primary lung tumors, nonrespiratory intrathoracic tumors, and thoracic wall tumors. PMID- 3554712 TI - Diaphragmatic hernia. AB - This article describes the anatomy, etiology, and pathophysiology associated with congenital and traumatic diaphragmatic hernias. Suggestions on preoperative and post-operative maintenance are presented as are various techniques for surgical correction. PMID- 3554713 TI - Management of thoracic trauma and chest wall reconstruction. AB - This article reviews common causes and types of thoracic trauma in the dog. A triage approach for the diagnosis and immediate treatment of thoracic trauma is presented. Reconstructive procedures of the thoracic wall, which may be necessary following trauma or surgical resection of diseased tissue, are described. PMID- 3554714 TI - Surgical approaches and techniques for managing pulmonary disease. AB - Common pulmonary lesions that require partial or complete lobectomy include abscesses, cysts, bullae, neoplasms, lacerations, foreign bodies, and lung lobe torsions. This article discusses the instrumentation, surgical approaches and techniques, and postoperative management of partial and complete lung lobectomy. PMID- 3554715 TI - Anesthetic management of thoracotomy. AB - Successful anesthesia for thoracic surgery requires an understanding of the clinical disease and the physiologic changes accompanying the disease, as well as anesthetic agents available for use. The authors discuss selection of appropriate anesthetic drugs, perioperative management considerations, pharmacologic support, intraoperative monitoring and postoperative pain management. PMID- 3554716 TI - Lesions in dogs following renal transplantation and immunosuppression. AB - Renal allografts were transplanted into 20 dogs (12 beagles, eight mongrels) following a prescribed protocol for pre-transplantation blood transfusions and kidney exchange. Immunosuppressive therapy (azathioprine and prednisone) was modified as needed for each dog. Seven of the beagle dogs survived for 1 year and were then euthanized; all other dogs died or were euthanized prior to 1 year post transplantation. Graft rejection and renal failure were the greatest causes of mortality. Renal lesions which contributed to the death of some animals included renal vein thrombosis, nephrosis, and pyelonephritis. Inflammation of the lower respiratory tract (bronchitis, pneumonia, and pleuritis) was a contributory cause of death in some dogs. Cystitis and ureteritis occurred in almost half of the dogs. Prostatitis was seen in six of the 16 male dogs. Adrenal cortical atrophy, parathyroid gland hyperplasia, and bone marrow hypocellularity were seen in a majority of the dogs which survived 1 year. PMID- 3554717 TI - Diagnostic value of tissue biopsy in gastrointestinal and liver disease. AB - Methods are described for the endoscopic examination and biopsy of the gastrointestinal tract and liver of the dog, cat, ox and horse. The results of the examination of 41 biopsy samples are shown, followed by a discussion of the value of biopsy in the diagnosis of diseases of the digestive tract. PMID- 3554718 TI - Tuberculosis infection in cattle and badgers in an area of Staffordshire. AB - The recent history of tuberculosis infection in cattle in Staffordshire is described, showing how a problem area in the north of the county was identified. The subsequent culture of Mycobacterium bovis from badger faeces and a badger carcase is reported together with the operations to remove badgers from the area. PMID- 3554719 TI - Evaluation of an enzyme immunoassay for the qualitative assessment of progesterone in bovine blood. PMID- 3554720 TI - American Board of Veterinary Toxicology. 1987 directory of diplomates. PMID- 3554721 TI - [Computerized subtraction angiography--a new method of processing roentgenologic image]. PMID- 3554723 TI - [Digital ventriculography in evaluating the general and regional contractility of the right heart ventricle]. PMID- 3554722 TI - [Use of computerized subtraction angiography in the diagnosis of voluminous lesions of the liver]. PMID- 3554724 TI - [Complex radiologic diagnosis of pancreatic cysts]. PMID- 3554725 TI - [Use of ultrasonic examination in the diagnosis of pathologic lesions of the breasts]. PMID- 3554726 TI - [Ultrasonic semeiotics in diseases of the pancreas]. PMID- 3554727 TI - [Ultrasonic diagnosis of diseases of the gallbladder]. PMID- 3554728 TI - [Ultrasonic scanning in urology]. PMID- 3554729 TI - [Measurement of the volume of the gallbladder by ultrasonography in patients with hypotonic dyskinesia of the gallbladder]. PMID- 3554730 TI - Functional significance of histologic alterations induced by Escherichia coli pig specific, mouse-negative, heat-stable enterotoxin (STb). AB - In contrast to cholera enterotoxin and other Escherichia coli enterotoxins, a pig specific, heat-stable E. coli enterotoxin (STb) causes morphologic lesions (loss of villous epithelial cells and partial villous atrophy). These lesions reflect a loss of absorptive cells and thus suggest that STb causes impaired absorption as well as inducing net secretion. The present studies assess functional significance of morphologic changes induced by STb. Net fluid movement, mucosal surface area, sucrase activity and the electrical response induced by alanine were measured in swine jejunal loops exposed to E. coli culture filtrates with and without STb. Net fluid secretion (-11.1 +/- 1.1 ml) occurred in some STb loops (secretors) and net absorption (2.7 +/- 0.3 ml) in others (nonsecretors), but net absorption occurred in all control loops (4.9 +/- 0.2 ml). The mucosal surface area of STb loops was about 20% less than that of controls (P less than 0.01). Sucrase activity was also lower (about 15%) in STb loops than in control loops (P less than 0.01). The electrical response induced by alanine in mucosa from nonsecreting STb loops did not differ from that induced in mucosa from control loops. However, the response to alanine in mucosa from secreting STb loops was reduced about 70% from that in mucosa from nonsecreting STb loops or from control loops (P less than 0.05). It is concluded that reduced sucrase activity is a functional correlate to villous atrophy induced by STb, that STb impairs alanine absorption in some loops (secretors), and that the impaired alanine absorption is independent of the decreased surface area caused by STb. Because the impaired alanine absorption occurred independent of the decreases in surface area, it is suggested that the secretory response to STb is associated with an impairment of active absorption of alanine. PMID- 3554731 TI - Identification of histamine-receptor leukocytes in the bovine. AB - Subpopulations of leukocytes have been characterized by using cell surface membrane markers, and attempts have been made to correlate membrane receptors with cellular function. Histamine receptors on cell membranes have been identified in the mouse, man and rhesus monkey by numerous methods. In this study, an immunofluorescent technique was used to identify and enumerate histamine-receptor leukocytes in the peripheral blood of cattle. This report appears to be the first documenting these cells in the bovine. PMID- 3554732 TI - [Effects of treatment with Macronil on the viral population of the pharynx in 0- to 5-year-old children with acute respiratory infections]. AB - Macronil (a concentrated proteic extract from mackerel) associated to usual therapeutics (antibiotics, antipyretics, vitamins) in children aged 0-5 years, with acute respiratory infections led to a reduction of the viral pharyngeal population as detected by immunofluorescence (IF) technics. The IF positivity rate in children receiving Macronil was half as high as in controls receiving only the usual therapeutics. At the same time, the number of virus species detected in the pharynx of Macronil treated children was lower than in controls in which the viral pharyngeal population was not influenced in any way by the administered therapeutics without Macronil. PMID- 3554733 TI - Conservative mechanism of the in vitro transcription of killer virus of yeast. AB - A conservative mechanism of transcription has been proposed for the RNA polymerase activity of the killer virus of yeast, both in vivo and in vitro. This model is supported by the conservation of radioactivity in template double stranded RNA during transcription in vitro. PMID- 3554734 TI - Expression of the human immunodeficiency virus gag gene in insect cells. AB - Regions of the gag-pol gene of human immunodeficiency virus (HIV), the causative agent of AIDS, have been cloned into the polyhedrin gene of the baculovirus Autographa californica nuclear polyhedrosis virus. When these recombinant viruses were used to infect insect cells, the cells produced gag-related proteins which could be immunoprecipitated with serum from AIDS patients. The major proteins produced by Acgag1, which contained the entire gag gene and a small portion of the pol gene, had molecular weights of 55,000 and 40,000 Da. Acgag2, which contained a larger portion of the pol gene in addition to the gag coding sequences, produced a major protein of 24,000 Da and only minor amounts of the 55,000- and 40,000-Da proteins. The implications of these results with respect to proteolytic processing of HIV gag proteins as well as the potential diagnostic use of this system are discussed. PMID- 3554735 TI - Aging and human macular pigment density. Appended with translations from the work of Max Schultze and Ewald Hering. AB - The optical density of human macular pigment was measured for 50 observers ranging in age from 10 to 90 years. The psychophysical method required adjusting the radiance of a 1 degree, monochromatic light (400-550 nm) to minimize flicker (15 Hz) when presented in counterphase with a 460 nm standard. This test stimulus was presented superimposed on a broad-band, short-wave background. Macular pigment density was determined by comparing sensitivity under these conditions for the fovea, where macular pigment is maximal, and 5 degrees temporally. This difference spectrum, measured for 12 observers, matched Wyszecki and Stiles's standard density spectrum for macular pigment. To study variation in macular pigment density for a larger group of observers, measurements were made at only selected spectral points (460, 500 and 550 nm). The mean optical density at 460 nm for the complete sample of 50 subjects was 0.39. Substantial individual differences in density were found (ca. 0.10-0.80), but this variation was not systematically related to age. PMID- 3554736 TI - [Effect of stress during piloting of high performance aircraft (review of the literature)]. PMID- 3554737 TI - [Sombrevin anesthesia in clinical practice]. PMID- 3554738 TI - [Use of sodium mefenamine in the complex treatment of periodontosis]. PMID- 3554739 TI - [A method of surgical treatment of osteomyelitis caused by bone nails]. PMID- 3554740 TI - [Experience with the treatment of acute reactive conditions with hypophyseal cerebral neuropeptides]. PMID- 3554741 TI - [The personality of alcoholic military officers as assessed by projective methods of studying the personality]. PMID- 3554742 TI - [Advantages of using the semi-open method in the care of the donor region in partial thickness skin transplantation]. PMID- 3554743 TI - [The appearance of the C-peptide and immunoreactive insulin concentration curve in various phases of diabetes mellitus]. PMID- 3554744 TI - [Hemorheologic disorders and therapy concepts in cerebral infarct]. PMID- 3554745 TI - [Modern approach to the treatment of bronchogenic carcinoma]. PMID- 3554746 TI - [Genitourinary infections caused by Chlamydia trachomatis]. PMID- 3554747 TI - [Proportion of the psychotherapeutic component in the treatment of bronchial asthma patients using acupuncture]. PMID- 3554749 TI - [100th anniversary of the Poltava Regional Clinical Psychiatric Hospital]. PMID- 3554748 TI - [Apoproteins mediating the efferent transport of cholesterol in the blood (review of the literature)]. PMID- 3554750 TI - [Use of free skin grafts for additional strengthening of bronchial stumps]. PMID- 3554751 TI - [Treatment of gouty nephropathy (review of the literature)]. PMID- 3554752 TI - [Possibilities for correcting killer activity to protect the body against tumors (review of the literature)]. PMID- 3554753 TI - [Recording of bioelectric potentials of the spinal cord (review of the literature)]. PMID- 3554754 TI - [Isolation of strains of Negishi virus in Khabarovsk Territory]. AB - Two virus strains isolated from Aedes vexans nipponi and Aedes vexans vexans in 1976 and 1978, respectively, in Khabarovsk Territory were identified as Negishi virus. Among 176 human sera, 22.7% were found to contain complement-fixing antibodies to Negishi virus soluble antigen. PMID- 3554755 TI - [Isolation and study of the properties of IgG from antisera to influenza virus proteins]. AB - IgG to internal (NP, M) and external (HA, NA) proteins of influenza virus were isolated from immune rabbit sera using caprylic acid. The IgG retained their specificity and activity, worked in HI, lectin test, and enzyme-immunoassay. IgG migrated towards cathode in electrophoresis on acetate cellulose. Electrophoresis in polyacrylamide gel revealed a heavy chain (55,000) and a light chain (25,000) in IgG molecule. Different methods revealed changes in IgG structure after lyophilization. The possibility of recovering IgG from rat sera using caprylic acid was demonstrated. A comparative analysis of IgG recovered by means of caprylic acid as well as by polyethylene glycol or ammonium sulphate showed the IgG recovered with caprylic acid to contain less admixtures and to be suitable for use in immunological tests without additional purification. PMID- 3554756 TI - [Identification of insect cell lines]. AB - Identification of 10 cell lines of 6 insect species received by the cell culture collection of Molecular Biology Institute from different research institutions of the USSR was carried out by karyological analysis and determinations of the spectrum of isoforms of the following enzymes: glucose-6-phosphate dehydrogenase (G-6-PDH), lactate dehydrogenase (LDH), isocitrate dehydrogenase (ICDH), and superoxide dismutase (SOD). Nine out of the 10 cell lines examined were shown to be identical to those of gypsy moth. Possible ways of cell contamination with other cells in long-term cultivation and preparation of new lines were determined. PMID- 3554757 TI - [Purification and some properties of penicillin acylase from Escherichia coli As 1.76]. PMID- 3554760 TI - Pioneer transfusions of Los Angeles. PMID- 3554758 TI - Acromegaly update--etiology, diagnosis and management. AB - Acromegaly is a disease with unique clinical manifestations. Its confirmatory diagnosis, however, requires basal and dynamic tests of growth hormone secretion. The measurement of circulating levels of somatomedin C has been a valuable addition to the diagnostic armamentarium. We review the etiology of acromegaly, with particular reference to the different histochemical and ultrastructural forms of somatotropic adenomas and their respective clinical behaviors. Ectopic sources of growth hormone-releasing hormone and of growth hormone itself are now well-recognized, though unusual, causes of acromegaly. The treatment of acromegaly is often problematic and far from uniformly successful. Initial enthusiasm for the results of surgical treatment has now been tempered by reports of increasing rates of recurrence on long-term follow-up. The roles of irradiation and pharmacotherapy are reviewed with particular emphasis on the use of bromocriptine, which has added a new dimension to the control of the somatic and metabolic manifestations of hypersomatotropism. Studies have been done recently using a long-acting somatostatin analog with encouraging results. PMID- 3554759 TI - The role of immunotherapy in type I diabetes mellitus. AB - Type I diabetes mellitus appears to result from an insidious immunologic destruction of pancreatic beta-cells in genetically susceptible persons exposed to one or a series of environmental insults. This genetic susceptibility is related to alleles located on the sixth chromosome in the HLA-DR or an adjacent region. With superimposition of a viral or other environmental triggering event, cell-and antibody-mediated events are activated that lead to the specific autorejection of beta-cells and consequent insulin deficiency. Immunosuppressive strategies to impede or halt complete destruction of beta-cells, using cyclosporine, have already been initiated in both animals and humans with diabetes mellitus. Because of the potential toxicity of all current immunosuppressive regimens, such therapies cannot, at this time, be considered for wide-scale use in persons with type I diabetes. Reported inductions, however, of insulin independence in patients with newly diagnosed type I diabetes using cyclosporine or other agents underscore the role of the immune system in the pathogenesis of the disease and highlight the need to develop safer, more specific immunomodulation designed to avoid complete beta-cell destruction. PMID- 3554761 TI - Mitral valve prolapse syndrome--myth or reality? PMID- 3554763 TI - [Type A personality as a risk factor in coronary disease]. PMID- 3554764 TI - [Antoni Gluzinski--author of the first monograph on endocrine secretion]. PMID- 3554762 TI - Clinical evaluation and management of transient ischemic attacks. AB - Transient ischemic attack (TIA) is a common but poorly understood disorder. Although it rightfully has been classified as a major risk factor for stroke, the majority of patients with TIAs do not suffer subsequent stroke, and it is unclear whether aggressive evaluation and treatment of TIA will significantly lower stroke risk. To effectively treat this disorder, the implications of transient cerebral ischemia and the basic pathophysiologic process underlying this condition must be understood, as well as the myriad of specific clinical causes that must be considered in any patient. Any less sophisticated approach will only propagate the confusion that already exists and lead to the use of therapies that may be useless or even harmful. PMID- 3554765 TI - [Evaluation of the effect of the preparation Hemeran-gel in the treatment of superficial phlebitis]. PMID- 3554766 TI - [Cryotherapy of herpes zoster]. PMID- 3554767 TI - [Arrhythmogenic type of right ventricular hypoplasia]. PMID- 3554768 TI - [The achievements of Teodor Heryng in the field of inhalation therapy]. PMID- 3554769 TI - [Current views on the pathophysiology and treatment of chronic pulmonary heart disease]. PMID- 3554770 TI - [Ultrasonic location of arterial stenosis using the HSD-83 unit]. PMID- 3554771 TI - [Guillaume Dupuytren--an outline of a biography (on the 150th anniversary of his death)]. PMID- 3554772 TI - [Scrofula--today and in the past]. PMID- 3554774 TI - [Initial experience using routine hip sonography in newborn infants]. AB - 933 newborn infants were subjected to routine hip screening by means of ultrasound in the first week of life, along with usual clinical investigations. The sonographic examinations were performed according to the technique and classification laid down by Graf. 68.2% of the investigated hips were of type I, 30.6% of type IIa. 20 hips (1.1%) were classified as IIg and 3 hips as type IIIa. The results of the clinical investigation during the first week were compared with the ultrasonographic findings. It is remarkable that some of the type IIg and type IIIa hips displayed no clinical signs. These hips should be controlled or treated at an early date. PMID- 3554773 TI - [Use of autologous bone marrow transplantation in pediatric malignant diseases- results and conclusions]. AB - Ultrahigh-dose myeloablative antineoplastic therapy followed by autologous bone marrow transplantation (ABMT) has become an attractive therapeutic option for patients without HLA compatible bone marrow donors. Autologous bone marrow was harvested in 9 patients. In four cases the bone marrow was also treated ex vivo with a stable derivative of 4-hydroperoxycyclophosphamide, ASTA-Z 7654, to eliminate residual tumour cells. Altogether 5 patients, namely a patient with metastatic neuroblastoma, a patient with malignant histiocytosis, a patient with recurrent sacrococcygeal malignant teratoma and two patients with acute myelogenous leukaemia in first remission are in continuous remission so far from 125 + to 821 + days (median 657 + days). These patients were transplanted at the time of minimal tumour load (first remission) and in good clinical condition 3-7 months after diagnosis, while 3 of the four patients who died were transplanted in first or repeated relapse after one to several years of chemotherapy. It is concluded that the earliest possible recognition of a refractory therapeutic situation is of utmost importance for successful ABMT. Patients with an unfavourably responding neoplasm should, therefore, be already primary candidates for ABMT. PMID- 3554775 TI - [Etiology of erysipelas]. AB - Bacterial cultures were taken from 31 patients by scarification from the dermal compartment of recent erysipelas foci. Pathogenic organisms were isolated from the dermis while cultures from the skin surface remained sterile in 5 patients; Streptococcus pyogenes was cultured in 2 of these patients and Staphylococcus aureus in the other 3 patients. Our findings indicate that staphylococcal erysipelas does exist and we suppose that Staphylococcus aureus is able to induce erysipelas, above all in the presence of dysfunction of lymph vessels. When treatment with penicillin G is not successful, erysipelas caused by staphylococci has to be considered. In these cases treatment has to be changed to penicillinase resistant penicillin. PMID- 3554776 TI - [Detection of antibodies to HTLV-III: a comparison of various ELISA methods as screening tests and the Western Blot with immunofluorescence as confirmatory procedures]. AB - 386 sera were examined with three commercially available ELISAs for antibodies to HTLV-III. Western Blot and an indirect immunofluorescence assay were performed on sera showing a positive reaction in one or more ELISAs as confirmatory assay. 299 sera reacted negatively in all ELISAs, 48 were positive in all ELISAs and the confirmatory assays, whilst 33 ELISA positive sera reacted negatively in the confirmatory assays. In the case of 5 sera both Western Blot as well as the immunofluorescence assay had to be undertaken to obtain conclusive results. PMID- 3554777 TI - [High-dose busulfan with subsequent bone marrow transplantation in poor-risk forms of leukemia]. AB - The toxicity and potential late side effects of total body irradiation, especially in children, have caused the evaluation of alternative myeloablative agents. We report the results obtained in 4 patients with acute myelocytic leukaemia, 2 patients with acute lymphocytic leukaemia and 1 patient with chronic myelocytic leukaemia who received high-dose busulfan followed by bone marrow transplantation (4 times allogeneic, 3 times autologous), according to the protocol published by G. W. Santos. 4 patients have survived 708+, 413+, 313+ and 234+ days, respectively, to date, 3 patients died, two of whom had acute myelocytic leukaemia in relapse and died of cardiac and combined organ failure 9 and 10 days post transplantation, respectively, without evidence of leukaemic cells in the bone marrow. One patient with acute lymphocytic leukaemia (T-All) in second remission died of an extramedullary relapse 485 days after bone marrow transplantation. We report our experience in the use of busulfan before transplantation not only in patients with acute myelocytic leukaemia, but also in patients with acute lymphocytic leukaemia and chronic myelocytic leukaemia and discuss the effectiveness and toxicity of high-dose busulfan as alternative to total body irradiation. PMID- 3554778 TI - [Is sonography superior to enzyme diagnosis in the detection of hepatic steatosis?]. AB - In order to evaluate the diagnostic value of sonography in steatosis of the liver, liver biopsies were performed in 52 patients with sonographically diagnosed steatosis of the liver. 27 of 28 patients with normal serum enzymes showed an estimated steatosis of 10 to 40% on histological examination. In the other 24 patients with increased serum enzyme levels histological steatosis was found in 20 patients. 8 further patients with presumed systemic disorders had both normal sonographic findings and normal serum enzyme levels and when subjected to liver biopsy showed an estimated steatosis in the range of 5 to 10%. Reliable sonographic diagnosis of steatosis of the liver can be made only if the degree of steatosis exceeds 10% at least. Normal serum enzyme levels do not exclude steatosis of the liver. PMID- 3554779 TI - [Calculating the diameter of the anterior chamber before implanting an artificial lens]. AB - Anterior chamber lenses sized correctly and positioned properly yield excellent results. Problems reported with anterior chamber implants are related to improper length/or lens placement to the scleral spur. In clinical routine examinations the "white to white data plus one mm" determine the overall length of an anterior chamber lens. However, variability of limbal anatomy causes great variations in estimations of corneal diameter. Approximation of corneal profile can be achieved by using ellipsoid or paraboloid functions. These data together with ultrasound measurements and keratometer readings serve as prerequisites for computations. For biometry an Ocuscan DBR 400-ST unit is used; the corneal refraction (r0) is measured with an automatic keratometer (Humphrey). The peripheral measurements are performed 13.5 degrees nasally and temporally (r1, r2). Using Euler's formula the horizontal radius is calculated (R0, R1, R2). Taking the constant epsilon 2 (epsilon 2 = r2-r0(2)/r2sin2 phi) the diameter can be calculated with the formula h = square root of (2ap-p2)(1-epsilon 2). Model A: two asymmetric halves are computed, the addition gives the corneal diameter (H = h1 + h2). Model B and C: only one symmetric half is computed, the double distance gives the corneal diameter (H = 2 h). The distance p is taken from biometry data; the distance from the anterior corneal surface to the posterior lens surface (ACD + LE) should be multiplied with the factor 0.32: p = (ACD + LE) 0.32. 250 eyes were examined comparing the optical data with the calculated results of our corneal model; the mean value for p was 2.4811 millimeter. Based on a control system the computer eliminated 35 eyes (14%). In the rest group of 215 eyes (100%) the difference to the optical measurements was not greater than +/- 0.25 mm in 181 calculations (84.2%). We noticed a tendency to predict too short internal diameters with external methods. Using optical measurements 1.25 millimeters should be added assuring correct position of the haptics. Using our computer-program for calculations of corneal diameter new anatomic conditions in eyes with abnormal dimensions may be detected. PMID- 3554780 TI - Undernutrition and quality of life. PMID- 3554781 TI - Normal growth and nutrition. PMID- 3554782 TI - Physical work determinants and undernutrition. PMID- 3554783 TI - Crime and diet: is there a relationship? PMID- 3554784 TI - A fresh look at some perinatal growth and nutritional standards. PMID- 3554785 TI - Extrapolation from animals to man: predictions, pitfalls and perspectives. AB - Comparative drug disposition studies can be useful in extrapolating from animals to man provided that the criteria indicating interspecies similarity in disposition reflect similar exposure to the foreign compound. Interspecies variability, on the other hand, can often be related to physiological or biochemical differences, thereby providing a rationale for the unsuitability or limitations of a species as a model for human metabolism. Retrospective evaluation of the following examples illustrates the relevance of the indicated disposition characteristics to risk and efficacy assessment: (a) oxaprozin (route of excretion, enterohepatic circulation and exposure; plasma concentrations and efficacy prediction); (b) ciramadol (species differences in presystemic elimination and major metabolic pathway); (c) acebutolol (pharmacologically active human metabolite absent in one of the toxicology species); (d) esmolol (duration of pharmacologic effect controlled by species dependent nature of blood esterases). Stereochemical preferences in the disposition of racemic drugs often differ among species. Extrapolations from one species to another cannot be made in this situation. Pharmacokinetic parameters based on measurements of the sum of the isomers are meaningless and potentially misleading. Future improvements can come from: computer assisted predictions of metabolic pathways; increased use of human tissues; and use of animal species physiologically similar to humans, e.g. the miniature swine. PMID- 3554786 TI - Application of isolated hepatocytes to studies of drug metabolism in large food animals. AB - A definitive hazard assessment of xenobiotics translocated through food animals into edible products such as meat or milk requires a complete analysis of metabolism in food animals. However, large animal metabolism studies present many experimental difficulties. None of several in vitro alternatives such as subcellular fractions has been established as an acceptable predictor of in vivo metabolism. The feasibility of using isolated hepatocytes to predict the metabolism of xenobiotics, both quantitatively and qualitatively, in large ruminant animals (e.g. cattle) is being studied in our laboratory. A procedure was developed for isolating hepatocytes aseptically from the caudate process of the liver which was obtained surgically from 100-125 kg calves. A modified two step vascular perfusion procedure provides hepatocyte suspensions that are typically greater than or equal to 85% viable and greater than or equal to 1 X 10(7) viable hepatocytes/g of liver (wet wt). Xenobiotic metabolism has been evaluated in suspensions and primary cultures using aldrin epoxidation, ethoxycoumarin O-deethylation, and 7-hydroxycoumarin glucuronidation and sulfation. Metabolic activities are relatively short-lived in suspensions less than or equal to 4 h, but quite stable up to 10 h when cultured on collagen coated plates in chemically defined medium. Bovine hepatocytes behave similarly in culture to rodent hepatocytes. Although primary culturing of hepatocytes is more difficult than suspensions, primarily due to the asepsis requirements, it is the method of choice for xenobiotic metabolism determinations in isolated hepatocytes of cattle. PMID- 3554787 TI - Selected aspects of the development of methods for the analysis of drugs by high performance liquid chromatography. AB - The successful analysis of drugs in biological fluids and other matrices by reversed phase high performance liquid chromatography (h.p.l.c.) relies upon the optimization of the chromatographic separation, the sample preparation and the post-column detection. Recent advances in the detection and derivatisation of exogenous substances are described elsewhere in this volume (Sternson 1986). This paper deals with selected aspects of the optimization of the chromatographic separation, concentrating on the theoretical basis and practical application of mobile phase selectivity in reversed phase ion-pair systems. In addition, recent advances in sample preparation techniques which permit the direct injection of biological fluids are discussed. PMID- 3554788 TI - The application of chemical derivatization to clinical drug analysis. AB - The sensitivity and selectivity achievable in the analysis of drug substances from biological matrices is often limited by the physical and chemical properties of the analyte. These limitations are further exacerbated by the inherent reactivity of most drugs in biological systems (i.e., their propensity for undergoing biotransformation). One very powerful approach that has been taken to improve the quality of the analytical methodology is to alter the physico chemical properties of the drug through chemical modification (derivatization) during some stage of the analytical sequence. This approach has been successfully applied to situations and has resulted in improved chemical stability, analytical selectivity and sensitivity. In most cases, drug analysis from biological fluids involves a chromatographic step; the derivatization reaction can be carried out either prior or subsequent to chromatography. In this paper, examples of the advantages (and limitations) offered by the introduction of a chemical derivatization step in clinical drug analysis will be presented. Specifically, focus will be placed on analysis of chemically-reactive antineoplastic agents and peptides/proteins. The latter represent an emerging class of drugs which present significant analytical challenges. The use of o-phthalaldehyde analogues offering improved derivative stability and increased sensitivity will be described. PMID- 3554789 TI - Use of stable isotopes in the elucidation of drug biotransformation processes. AB - This article surveys the role of stable isotope labelling and mass spectrometric detection in the recognition and characterization of drug metabolites. Applications of the so-called isotope cluster technique, useful for both recognition of drug-related compounds and elucidation of their structures, are presented. The use of deuterium-labelled g.l.c./mass spectrometric derivatization reagents to facilitate the determination of drug metabolite structures via 'peak shifts' is illustrated. PMID- 3554790 TI - 'Metabolic mapping' of drugs: rapid screening techniques for xenobiotic metabolites with m.s./m.s. techniques. AB - The development of tandem mass spectrometry (m.s./m.s.) techniques for the rapid structural elucidation and quantification of metabolites is described. With these techniques the mass spectrometer serves as both a separation device as well as a tool for structure elucidation. Ion formation by desorption ionization techniques and mass analysis with an appropriate combination of neutral loss and precursor ion scans can then be used to classify the number and type of primary metabolites and polar drug conjugates that are present in a complex sample matrix. The resulting information can be used to assess the overall biotransformation routes that are available to a drug or other xenobiotic substance. PMID- 3554792 TI - The Gilbert H. Glaser symposium. May 17, 1986. Proceedings. PMID- 3554791 TI - Ganglioside changes associated with temporal lobe epilepsy in the human hippocampus. AB - To understand better the molecular and cellular events associated with status epilepticus, a multifaceted analysis has begun on hippocampal tissues therapeutically removed from patients with temporal lobe epilepsy. In this first study, quantitative changes in major ganglioside species are reported, as well as the immunocytochemical localization on the ganglioside GD3 in epileptic human hippocampus. Although significant variations were found between patients, the pattern of change was consistent when compared to normal values obtained from an autopsied specimen and the literature. Total ganglioside content was reduced in epileptic hippocampi, which was attributable, in part, to pyramidal cell loss found in CA1 and CA3. In each case, the percentage of ganglioside GD3 was increased significantly, while ganglioside GD1a decreased. The former change is probably associated with reactive astrocytosis and the latter with loss of neuronal dendrites. Immunocytochemical localization revealed GD3 in the stratum radiatum and the subgranular layer of the dentate gyrus. In these areas, GD3 was present in punctate structures and astrocytes. These findings indicate that GD3 increases in selected areas of the sclerotic hippocampus and is presumably related to localized accumulation of reactive glial cells. Since gangliosides have a high affinity for calcium and localized increase in extracellular calcium could disrupt normal neuronal function, the localized increase in GD3 may not only denote reactive glial cells but may contribute directly to the altered, hyperexcitable condition of epilepsy. PMID- 3554794 TI - [Medical education from a social democratic viewpoint at the end of the 19th century]. PMID- 3554793 TI - [Change in the renin-angiotensin-aldosterone system in aging. 1]. AB - Data are provided that testify to a changed reactivity of the RAAS in old age: Higher sensitivity of this system to the regulatory influences of the sympathico adrenal and of the hypothalamus-hypophysis system as well as restriction of the functional facilities and reduction of reactivity. The obtained results indicate an aging-dependent reduction of the degree of reliability of the RAAS in stress situations. PMID- 3554795 TI - [Immunologic studies using the leukocyte adherence inhibition test in the diagnosis and postoperative follow-up of breast cancer]. AB - 37 women with histologically proved carcinoma of the breast as well as 3 control groups (benign breast diseases, other carcinomas, benign surgical diseases) were investigated by means of the leucocyte adherence inhibition test. In the primary diagnostics of the carcinoma of the breast the specificity was 56%, the sensitivity 70%. Follow-up studies on the conditions of a district hospital over a period of 2 years showed a different reactivity which is suitable for the evaluation of recurrence and immunological tumour-host relations. PMID- 3554796 TI - [Vascular supply of the free fasciocutaneous forearm flap--an anatomical study]. AB - The vascular supply of the forearm skin--especially of the ventral antebrachial region--was investigated by means of selective angiographies and intravascular dye injections in 43 upper extremities of corpses. Besides the definition of the interesting supply regions assertions were made about the kind and the character of the angioarchitecture as well as recommendations for the flap planning and other clinical references. PMID- 3554797 TI - [Prenatal diagnosis of the sequelae of supravesical stenoses--hydronephrosis and hydroureter]. AB - In the introduction, the extrarenal and intrarenal pelvis are distinguished and morphologically recognizable reasons for the dilatation of the renal pelvis and the ureter are shown. With examples from twelve corresponding cases from an a.p. diameter of 10 mm upwards, contributions to the following problems are offered: Time of earliest possible prenatal diagnosis, relation between dilatation of the pyelon and thickness of the parenchyma, on the one hand, and the mean value of the abdominal diameter, on the other hand. In addition to the degree of the narrowing of the lumen the importance of the secretal function of the kidneys which begins in the course of the development is discussed. PMID- 3554798 TI - [Morphologic and biochemical aspects of prostaglandin-induced cervix ripening]. AB - For examination by electron microscopy tissue samples were taken from the posterior lip of the cervix of 8 patients having a termination of pregnancy at 9 12th week gestation and 16 patients of comparable gestational age who had an intracervical application of either 2 ml 5% tylose or 50 micrograms sulprostone tylose gel 8 hours before biopsy. The efficacy of cervical priming was demonstrated objectively by tonometric studies. In addition, collagenase and protease activities were determined in the cervical tissue extracts of the different treatment groups. For identification of typical collagen fragments SDS polyacrylamide-gel-electrophoresis were carried out on the acetic acid soluble extracts. The local application of sulprostone gel induced a marked multifocal loosening of the collagenous framework; there was no evidence for leucocyte infiltration or necrosis caused by the prostaglandin (PG) pretreatment. In the areas of disorganized collagen fibres cervical fibroblasts seemed to be activated characterized by fine granular loosening of the cytoplasma, dilated cisternae of rough endoplasmatic reticulum, vacuolized enlarged mitochondria and an increased number of cytoplasmatic vesicles close to the cell surface. Collagenase and protease activities were found in all extracts of the different treatment groups, however, PG-application led to no significant increase in enzymatic activities. There was no evidence for the presence of typical collagen cleavage products in the SDS-electrophoresis. Contradictory to the hitherto published literature enzymatic collagen degradation does not play an essential role in PG-induced cervical ripening. PMID- 3554799 TI - [Fetofetal transfusion syndrome in twin pregnancy with prune belly syndrome]. AB - The authors report on a twin pregnancy with one phenotypically normal twin and one with Prune-Belly-syndrome. Since a severe urethral obstruction-malformation complex was apparent, a premature vaginal delivery was aimed for. A pathologic CTG of the healthy twin, with silent and sinusoidal graph pattern, rendered a primary cesarean section necessary in the 36th + 0 week of pregnancy. The cause was established as a fetofetal transfusion syndrome with severe anemia of the phenotypically normal newborn. Following appropriate blood transfusion the subsequent development of this child was free of complications. The child with Prune-Belly-syndrome died on the second day of life. PMID- 3554800 TI - [Controlled study of increasing venous tone in primary varicose veins by oral administration of Ruscus aculeatus and trimethylhespiridinchalcone]. AB - In a randomized double blind study, 50 patients suffering from trunk or branch varicosis were orally treated with either a commercial preparation of Ruscus extract, trimethyl hesperidine chalcone and ascorbic acid (Phlebodril), or a placebo over 2 weeks. Changes of the venous tonus were measured by means of venous occlusion plethysmography in rest position (venous capacity, venous distensibility) as well as during (active) exercise (expelled blood volume). All parameters showed a tendency towards improvement in the verum group. The changes were partly significant (p less than 0.5). The course of the study suggests that the period of treatment possibly was too short to obtain the full pharmacologic effect. PMID- 3554801 TI - [Effect of dithranol therapy on membrane, basement membrane and nuclear markers in psoriasis lesions]. AB - We investigated the effects of anti-psoriatic therapy with dithranol (1/20-1%) in salicylic acid (0.5%) in white petrolatum on lesional skin. FITC-labeled lectins and pemphigus vulgaris antibodies (PV) served as analytical means to study the glycocalyx. Antibodies of bullous pemphigoid (BP) were used as basal membrane markers. Nuclear antigens were recorded according to the binding of speckled, anti-nuclear antibodies (ANA) as well as antibodies to dsDNA. With some lectins, dithranol therapy resulted in pronounced fluorescence of the lower parts of the basal cells. ConA was fixed by the basal cell layer. To a lesser degree, ANA were fixed by nuclei of keratinocytes. PV antibodies were not fixed at all. PMID- 3554802 TI - [Pityriasis versicolor pseudoatrophicans. A case description]. AB - We report on a pseudoatrophic manifestation of tinea versicolor. A 32-year-old female patient, who had suffered from typical spotty lesions of tinea versicolor for 12 years, now additionally developed pseudoatrophic lesions within a few weeks. Complete remission of these lesions after local antimycotic therapy as well as mycological and histopathological findings confirmed the diagnosis of pseudoatrophic tinea versicolor. PMID- 3554803 TI - [Systolic and diastolic blood flow velocities in the left coronary artery before and following i.v. dipyridamole. Comparative measurements using a digital image processing in 2 unstenosed vessel branches]. AB - The hemodynamic significance of coronary artery stenoses cannot be assessed by presently-used methods. Especially stenoses of small and moderate degree only reveal hemodynamic relevance during augmentation of coronary flow. It can be expected that the increase in flow is limited in a stenotic branch, compared with an unstenosed branch of the same vessel. The increase in coronary blood flow in two unstenosed branches of the same vessel, however, should be nearly identical. To prove this hypothesis, the relative increase in coronary flow was measured in two unstenosed branches of the left coronary artery by means of digital subtraction angiocardiography. Ten patients were examined before and after intravenous administration of 20 mg (on average 0.29 mg/kg body weight) dipyridamole. Dipyridamole resulted in an increase in the diameter of the left anterior descending branch (LAD) of 11% (p less than 0.005) and of the circumflex artery (RCx) of 13% (p less than 0.005). The increase in flow velocity during systole amounted to 49% in the LAD (p less than 0.001) and to 58% in the RCx (p less than 0.005); during diastole to 60% in the LAD (p less than 0.005) and 83% in the RCx (p less than 0.005). The increase in volume flow during systole amounted to 78% in the LAD (p less than 0.005) and to 89% in the RCx (p less than 0.005), during diastole to 84% in the LAD (p less than 0.005) and to 113% in the RCx (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3554805 TI - [Manfred von Ardenne and medical research--from the viewpoint of a clinician]. PMID- 3554804 TI - [Treatment of disorders of cerebral performance in the aged in ambulatory care using bencyclane. Results of a controlled double-blind phase III study versus placebo]. AB - A placebo-controlled, randomized double-blind study conducted at a general practitioner's surgery was designed to investigate the efficacy of bencyclane in 120 outpatients with cerebral dysfunctions based on organic brain syndrome. The study started with a 4-week placebo washout phase and then continued with a 12 week treatment phase. 200 mg Bencyclane-hydrogenfumarate was administered b.i.d. Efficacy was assessed by a doctor's symptom rating (SCAG) and a study nurse's rating (BGP) as well as by two performance tests (CFF and ZVT-G). Data from 106 patients (52 under bencyclane and 54 under placebo) were statistically analysed. More side effects were seen under bencyclane than under placebo, in particular insomnia, headache, akathisia, nausea and vomiting. As an a priori hypothesis, it was stated that after alpha-adjustment there should be a statistically significant difference in symptomatology (SCAG, BGP) and performance (CFF, ZVT G). With regard to performance, the zero hypothesis could be rejected on the 5% level, and on the 1% level with respect to symptomatology. The experimental error on both the performance and the symptom level was below 6%. The drug effects were significant on a confirmatory level and are considered to be also of clinical relevance. PMID- 3554806 TI - Distribution of L-fucose residues in the axon-myelin-Schwann cell complex. PMID- 3554807 TI - [3 dimensional acetabulum roof-plasty in children, adolescents and adults, methodology and results]. AB - The Salter innominate osteotomy is not indicated if there is a combination of hip dysplasia and hip deformity. The Chiari osteotomy seems to us not to be an adequate therapy not only because of a numerous disadvantages but also because it does not achieve a real enlargement or a congruent hip surface. We treat a hip deformity of children, youths and adults with a method we name three dimensional roof arthroplasty. This method realise a spheric enlarging of the roof and has achieved significant results. The method and results are presented. PMID- 3554808 TI - [Indications and results of intertrochanteric reconstructive osteotomy in coxa profunda and protrusio coxae]. AB - Coxa profunda often connected with coxa vara lead to an increasing stress on the medial part of the acetabulum. Secondary degenerative alterations with painful limited motion are the result. In 20 hip joints with coxa profunda a valgus intertrochanteric osteotomy was carried out in order to modify the direction of the resulting force from the depth to the roof of the acetabulum. A relief of pain was achieved in 18 of 20 cases. Therefore the valgus intertrochanteric osteotomy has to be considered an effective method in the treatment of coxarthrosis in coxa profunda. PMID- 3554809 TI - Recombinant vaccinia virus LC16m0 or LC16m8 that expresses hepatitis B surface antigen while preserving the attenuation of the parental virus strain. AB - Thymidine kinase-negative recombinant vaccinia virus LC16m0 or LC16m8 expressing hepatitis B surface antigen preserved almost the same pathogenicity as their parental thymidine kinase-positive attenuated virus strains. The results demonstrate the potential for using the LC16m0 or LC16m8 virus strain as a vector for recombinant vaccine. PMID- 3554810 TI - [Function and morphology of venovenous anastomoses following rotationplasty surgery]. PMID- 3554812 TI - [Principles for testing potential immunomodulators in the cancer clinic]. PMID- 3554811 TI - Ketanserin versus nifedipine in secondary Raynaud's phenomenon. PMID- 3554813 TI - [Determination of antibodies to Chlamydia trachomatis belonging to immunoglobulin classes G, M and A by immunoenzyme analysis in patients with inflammatory diseases of the urogenital tract]. PMID- 3554814 TI - [Immunologic aspects of the pathogenesis of psoriasis]. PMID- 3554815 TI - [Changes in the eye in skin diseases]. PMID- 3554816 TI - Correlation between presence of lactate dehydrogenase-elevating virus RNA and antigens in motor neurons and paralysis in infected C58 mice. AB - Lactate dehydrogenase-elevating virus (LDV) induces poliomyelitis in immunosuppressed C58 mice resulting in fatal paralysis. We have synthesized and cloned cDNA complementary to the LDV genome, and used the cDNA clones as in situ hybridization probes for the detection of LDV RNA in tissue sections. Direct fluorescent antibody staining using IgG from chronically infected mice was used for the detection of LDV antigens. Using these methods, we have detected LDV RNA and antigens in anterior horn neurons of paralyzed mice. The appearance of LDV RNA and antigen positive motor neurons and their location in the spinal cord correlated with the development of paralytic symptoms. No positive neurons were detected in LDV-infected, susceptible mice without signs of paralysis, but some glial cells of the white and gray matter in the spinal cords of these mice were found to contain LDV RNA. These analyses broaden the host cell range of LDV to include neuronal and other cells in the CNS and support the hypothesis of LDV replication in neurons as the cause of poliomyelitis and paralysis. PMID- 3554817 TI - Influence of insulin and 12-O-tetradecanoylphorbol-13-acetate (TPA) on influenza virus multiplication. AB - Insulin and 12-O-tetradecanoylphorbol-13-acetate (TPA) interfere with the multiplication of fowl plague virus, an influenza A virus, in primary chick embryo cells. Specifically the production of the viral glycoproteins hemagglutinin and neuraminidase are affected by the drugs. A decrease or omission of glucose from the culture medium enhances this effect, which is in agreement with the idea that these drugs act on virus replication via a shortage of glucose in the host cell. Virus replication in cells of different organs is affected to different extents by insulin and TPA. PMID- 3554818 TI - [Attention in hyperkinetic children: a signal detection analysis of the effect of methylphenidate]. AB - The effects of methylphenidate on sustained attention were investigated in a placebo-controlled double-blind trial with 20 hyperactive boys of normal intelligence with minimal brain dysfunction (MBD). Using signal detection theory methylphenidate significantly increased sensitivity (d) and did not change response bias (beta), independent of the dosage (5 to 20 mg/d). Responders and nonresponders to methylphenidate were differentiated by signal detection analysis: responders improved primarily in sensitivity, whereas nonresponders changed response bias. No response difference was found in physiological and biochemical measures (catecholamines), showing a general activation caused by methylphenidate. It is discussed that methylphenidate is improving information processing and arousal modulation in responders and is raising unspecific activation in nonresponders. PMID- 3554819 TI - Interleukin-3 regulation of the growth and differentiation of hematopoietic lymphoid stem cells. PMID- 3554820 TI - The role of regulatory factors in human antibody secretion. PMID- 3554821 TI - Structure and molecular genetics of complement proteins. An update. PMID- 3554822 TI - Evaluation of the structure function relationships of MHC class I antigens by molecular genetic techniques. AB - By combining the knowledge gained from several types of experiments we are beginning to understand the functional role of many structural features of the MHC class I antigens. Studies done by exon shuffling have defined the domains involved in recognition by T-cells and antibodies. As a result, we now know that the interaction between domains, as well as the structure of individual domains, is important for immune recognition. By in vitro mutagenesis we have shown that N linked carbohydrate moieties appear to function primarily in facilitation of intracellular processing, having seen little effect on immunologic function by their removal. Two other highly conserved structures, the disulfide bridges of the C-1 and C-2 domains, appear by this methodology to function in both intracellular processing and immune recognition. Finally, we are hopeful that extension of the method of in vitro mutagenesis to the evaluation of individual polymorphic amino acids in the MHC class I antigens will yield significant information regarding the relationship of their structure to their function. PMID- 3554823 TI - Natural cytotoxic activity in murine and human systems. A review. PMID- 3554824 TI - Cyclosporine action in blockade of cellular immune responses. PMID- 3554825 TI - Autoimmune endocrine diseases. PMID- 3554827 TI - Developments concerning the biochemical and molecular basis of IL-2 mediated T cell growth. PMID- 3554826 TI - Immunology of the eye--1985. PMID- 3554828 TI - [Immunoenzyme AB0 blood group determination using a single hair. I]. AB - The immunoenzyme technique was used to determine the ABO blood group of strands of human scalp hair. The hair was obtained from 168 individuals of known blood groups (A1: n = 58; A2: n = 11; B: n = 28; O: n = 46; A1B: n = 16; A2B: n = 9). Immunostaining was carried out by using monoclonal anti-A, anti-B and anti-H as primary antibodies. Group-specific staining was clearly observed within the medulla of the hair. The ABO blood group of all hair samples was determined correctly by the Sternberger (PAP) or APAAP (immunoalkaline phosphatase) technique. The present study indicates that immunoenzyme techniques can be regarded as practical methods for determining ABO blood group of hair. PMID- 3554829 TI - [Immunocytochemical identification of AB0 incompatible erythrocytes following fatal transfusion reaction]. AB - A patient with blood group O died 8 h after an accidental transfusion of one unit of A1 erythrocytes. The admixture of group A red cells was not detected during postmortem serology. Paraffin-embedded autopsy material was studied by the indirect immunoperoxidase technique using monoclonal antibodies. Group A red cells were easily identified as circulating agglutinates in the larger vessels, in the capillary vessels of all organs examined, and as closely packed cell aggregations in the sinuses of the spleen. However, there was no clear evidence of erythrophagocytosis in the spleen or in liver. PMID- 3554830 TI - [Ernst Furstenheim (1836-1904). On the 150th birthday of the pioneer of Berlin urology]. AB - On the occasion of his 150th birthday we make mention of the Berlin urologist Ernst Furstenheim born in Kothen in 1836 who in 1863 set up his practice as first "physician for diseases of the urinary tract" in Berlin and thus indicates the beginning of urology in Berlin. Emphasized are Furstenheim's efforts for the introduction and popularization of the urological endoscopy in Germany, the practical usability of which he detects as first physician. By his engaged advocacy of the performance of lithotripsy this versatile urological practitioner became a true pioneer of urology in Berlin. PMID- 3554831 TI - [Recommendations for the diagnosis and therapy of vesico-ureteral reflux (VUR) in childhood]. PMID- 3554832 TI - [Condition of the kidneys and upper urinary tract in patients with chronic prostatitis]. AB - The incidence of morphological and functional changes of the upper urinary passages and the kidneys obtains 78% in chronic prostatitis. The predominant localisation of the inflammation in the prostate and of the changes on the upper urinary passages and the kidneys on the same side confirms the importance of the chronic prostatitis in the pathogenesis of pathological conditions of the uropoetic system. Chronic pyelonephritis and nephrolithiasis can be proved in 24.5 and 78% of the patients with chronic prostatitis, respectively. Thus, the incidence of these diseases is significantly higher in patients with chronic prostatitis than in patients without such a disease. In 47% of the patients with chronic pyelonephritis and nephrolithiasis a latent chronic prostatitis can be proved, when an exact diagnosis was made. PMID- 3554833 TI - [Prevention of acute and recurrent pyelonephritis in pregnancy]. AB - In recent years the morbidity of the acute gestational pyelonephritis increased nearly double. From the anamnesis of 234 female patients who were hospitalised on account of chronic pyelonephritis or urolithiasis in 34.9% renal complications during pregnancy could be established. In these cases a sixfold increased coincidence of the lateral localisation of urological disease compared with the lateral localisation of the obstetrical complications. From the catamnestic data of 32 patients resulted a pathogenetic connection between chronic urological disease and acute gestational pyelonephritis. Pregnant women with contracted pelvis, megafetus, multigravidity and hydramnion fell ill from acute pyelonephritis 4 to 6 times more frequently than those in whom these risk factors which we intend to call compression factors were not existing. 72 pregnant women with compression factors and asymptomatic bacteriuria were given prophylactically antibiotics and carried out position exercises. In none of these pregnant women an acute pyelonephritis appeared during pregnancy. Apart from the primary prevention of the acute gestational pyelonephritis in 108 pregnant women also a prophylaxis of the recidivation of pyelonephritis has been performed. This consisted of a therapy with antibiotics for the persisting, asymptomatic bacteriuria as well as position exercises. Only in 2.7% of the metaphylactically cared patients a recidivation of the acute gestational pyelonephritis developed. Thus incomparison to other authors the number of recidivations of acute gestational pyelonephritides could bei reduced by the four- to sixfold. PMID- 3554834 TI - [Direct electrostimulation in the treatment plan of pseudarthroses]. AB - Direct electrostimulation with bipolar rectangular pulse currents was used as a complementary measure on 13 patients with pseudoarthrosis and delayed healing of fractures. In ten cases now completed, evidence was produced to accelerated ossification and transformation of autologous spongiosa, which cut consolidation periods by several months. Implantable mini-stimulators have yielded good clinical results. PMID- 3554835 TI - [Effect of the delivery procedure on perinatal mortality and neonatal morbidity of underweight infants in the breech position]. AB - The paper deals with the effect of the delivery technique used on perinatal mortality and neonatal morbidity rates. Overall mortality of 236 underweight breech babies (less than 2,500 g) and a number of morbidity parameters of 68 new born children of 1,000 to 2,000 g birth weight are studied collected over a period of comparable perinatological management. The results show that cesarean section is the most favourable technique for children of 1,000 to 2,000 g birth weight. To do so, it is necessary to exclude non-viable malformations prenatally and to ensure a reliable neonatological intensive care. Another major problem is to prevent premature birth. On the basis of the results obtained and taking into account anamnestic and obstetrical risks, we give preference to an adequate selective section to deliver underweight children from breech presentation, but do not rule out vaginal methods of delivery using good techniques and proceeding as carefully as possible. PMID- 3554836 TI - [A pregnancy without detectable human placental lactogen (hPL)]. AB - During a pregnancy of a 35 year old woman, we could not detect HPL in the peripheral serum, whereas other hormones showed normal values. Fetal growth ceased in the 36th week and a live neonate was delivered by caesarean section. The histological findings of the placenta and the perinatal record were not so unusual that they could account for the absence of HPL. This case illustrates that fetal growth is possible without HPL-production. PMID- 3554837 TI - Cultivation of Borrelia: a historical overview. PMID- 3554838 TI - Human fetal borreliosis, toxemia of pregnancy, and fetal death. PMID- 3554839 TI - Clinical manifestations of Lyme disease. AB - Lyme disease typically begins with a unique skin lesion, erythema chronicum migrans (ECM) (stage 1). Patients with this lesion may also have headache, meningeal irritation, mild encephalopathy, multiple annular secondary lesions, malar or urticarial rash, generalized lymphadenopathy and splenomegaly, migratory musculoskeletal pain, hepatitis, sore throat, non-productive cough, conjunctivitis, periorbital edema, or testicular swelling. After a few weeks to months (stage 2), about 15% of patients develop frank neurologic abnormalities, including meningitis, encephalitis, cranial neuritis (including bilateral facial palsy), motor or sensory radiculoneuritis, mononeuritis multiplex, or myelitis. At this time, about 8% of patients develop cardiac involvement--AV block, acute myopericarditis, cardiomegaly, or pancarditis. Throughout this stage, many patients continue to experience migratory musculoskeletal pain in joints, tendons, bursae, muscle, or bone. Months to years after disease onset (stage 3), about 60% of patients develop frank arthritis, which may be intermittent or chronic. Recently evidence suggests that Lyme disease may also be associated with chronic neurologic or skin involvement. Thus, Lyme disease occurs in stages with different clinical manifestations at each stage, but the course of the illness in each patient is highly variable. PMID- 3554840 TI - In vivo isolation and maintenance of some wild strains of European hard tick spirochetes in mammalian and arthropod hosts. A parasitologist's view. AB - Methods and results of isolation and experimental maintenance of Borrelia strains from indigenous Ixodes ricinus ticks are described. Out of 12 different proved rodent species and breeding variants the mongolian jird or gerbils (Meriones unguiculatus) offers most perfectly all the necessary qualities to produce a transitory not progressive microscopically apparent spirochetemia when splenectomized previously. Using a laboratory breed of Ixodes ricinus the occurrence of transstadial and transovarial transmission could be confirmed in the vector tick. Each developmental stage of ticks can be infected via blood ingestion on spirochetemic mammalian hosts but each stage can infect vice versa its blood donors equally well. Needle borne transmissions from gerbil to gerbil by i.p. administration of infected blood are particularly successful after previous deep-freezing and cryopreservation of the blood samples or tissue suspensions. Attempts are described to infect other tick species than I. ricinus, fleas and mites, respectively, via blood meal. The problem of the spirochetes perfect adaptation to the host will be discussed. PMID- 3554841 TI - Lyme arthritis in Germany. AB - Lyme arthritis appears not to be a rare manifestation of Borrelia burgdorferi infection in Germany. We report 20 cases of the illness occurring in South Germany. In eleven of our patients arthritis was the only clinical manifestation of the infection; the diagnosis in those cases has only been verified by the detection of specific antibodies to Borrelia burgdorferi with indirect immunofluorescence and IgG Western blot technique. In comparison with previous reports of Lyme arthritis the quota of chronic joint involvement in our patients was relatively high, 4 of the patients developed radiographic signs of erosive arthritis. We suggest that Lyme arthritis is still underrecognized in Germany, and that previously reported assertions concerning the relative frequency of the various disease manifestations of Borrelia burgdorferi infections reflect a patient-selection. PMID- 3554842 TI - Demonstration of Borrelia burgdorferi in a patient with chronic Lyme arthritis. PMID- 3554843 TI - Historical perspective of Lyme disease. PMID- 3554844 TI - Experimental inoculation of dogs with Borrelia burgdorferi. AB - To determine if dogs could serve as a reservoir for Borrelia burgdorferi, three beagles were inoculated subcutaneously (SQ) with 200 laboratory cultured spirochetes which were originally isolated from blood of a Peromyscus leucopus from Ft. McCoy, Wisc. One four month old beagle was inoculated SQ with 5 ground Ixodes dammini from Shelter Island, N.Y. which came from an area with a 50% B. burgdorferi tick infection rate; and another uninfected four month old beagle was housed loose on the floor with the tick inoculated dog. All three spirochete inoculated beagles developed IFA antibody titers to B. burgdorferi of (7 log2) to (8 log2) by day 28 post inoculation. All were apparently healthy and no spirochetes were cultured from the blood. In an attempt to exacerbate the disease two of the dogs were given 3 mg of dexamethasone on day 68 post inoculation. B. burgdorferi was isolated from blood of all these dogs on days 4 and 97 days post inoculation. The tick inoculated dog developed a B. burgdorferi IFA antibody titer of (10 log2) by day 14 post inoculation. The contact exposed dog also developed a B. burgdorferi IFA antibody titer of (7 log2) on post contact day 21 indicating contact infection. B. burgdorferi was not isolated from either of these dogs. These results indicate that, contact transmission of B. burgdorferi may occur between dogs, dogs can be subclinically infected with B. burgdorferi and have persistent infections. PMID- 3554845 TI - Potential role of native and exotic deer and their associated ticks (Acari: Ixodidae) in the ecology of Lyme disease in California, USA. AB - The relationship of native Columbian Black-tailed Deer, two species of exotic deer (Axis and Fallow), and their ticks to the Lyme disease spirochete, Borrelia burgdorferi, was studied in coastal and inland areas of northern California, USA. Spirochetemias were detected in 27% of Black-tailed Deer, 50% of Axis Deer, and 56% of Fallow Deer collected in late fall and winter. Antibody prevalence was 38% in Black-tailed Deer, 24% in Fallow Deer, and 6% in Axis Deer. One to 3 tick species were collected from each species of deer, and 2 tick species were flagged from vegetation; of these, only the Western Black-legged Tick, Ixodes pacificus, was found to contain spirochetes. These findings suggest that all 3 deer species may be important hosts of spirochetes, possibly B. burgdorferi, and reconfirm that I. pacificus is the primary vector of the latter in California. PMID- 3554846 TI - Discovery of the Lyme disease spirochete: a historical review. PMID- 3554847 TI - [Pathogenic properties of Yersinia and their role in yersiniosis pathology]. PMID- 3554848 TI - [A case of tularemia infection on Wrangel Island]. PMID- 3554849 TI - [Use of ganglioside-containing magnetic polyacrylamide sorbents for the immunoenzyme method of determining cholera enterotoxin]. AB - A variant of EIA techniques for the determination of cholera enterotoxin is proposed. This method is based on the selective sorption of the toxin on ganglioside-containing magnetic granules with its subsequent detection by means of immune serum and antispecific immunoperoxidase conjugate. The proposed method permits the detection of 0.052 +/- 0.02 ng of protein of the purified toxin. PMID- 3554850 TI - [Search for propionic acid bacteria in the human intestine]. AB - The possibility of detecting propionic acid-producing bacteria in the intestine of healthy humans with a view to obtaining a strain which is physiologically most suitable for therapeutic purposes has been studied. The selective conditions for the isolation of propionic acid-producing bacteria from the large intestine have been experimentally established. Analysis of 70 puncture biopsy specimens of parietal mucus and luminal contents from different sections of the intestine has not shown the presence of the representatives of propionic acid-producing bacteria. The strains isolated under the conditions selective for such bacteria have been found to belong to the family Enterobacteriaceae. These strains have proved capable of synthesizing vitamin B12, but the synthesis of propionic acid has not been observed. PMID- 3554851 TI - [Comparative study of the diagnostic value of Brucella allergens in a controlled epidemiological trial]. AB - The diagnostic value of 4 brucellar allergens used in Burnet's test has been studied in a controlled epidemiological trial. All these preparations have proved to be specific. According to the data of complex evaluation (taking into account reactogenicity, sensitivity, and specificity), the intradermal allergen consisting of the polysaccharide/protein complex extracted from acetone-dried cells of Brucella abortus vaccine strain 19 BA has shown the highest diagnostic effectiveness both in brucellosis patients and in persons immunized against brucellosis. PMID- 3554852 TI - [Antigenic structure of the causative agent and immunodiagnosis of erysipeloid]. PMID- 3554853 TI - [Complexities in the clinical interpretation of immunological tests]. PMID- 3554854 TI - [Bacteria of the genus Moraxella. Their ecology]. PMID- 3554856 TI - [65th anniversary of the Department of Nervous Diseases of the Perm Medical Institute]. PMID- 3554855 TI - [Diagnostic significance of detecting respiratory virus antigens in cerebrospinal fluid and brain cells]. AB - Cerebrospinal fluid (CSF) from 202 patients (114 children and 88 adults) was studied by immunofluorescent techniques. Antigens of respiratory viruses in the CSF were most frequently encountered (22%) in patients with the involvement of the central nervous system (usually meningoencephalitis) in the presence of acute respiratory disease. In lethal outcomes in the same group viral antigens in brain cells were also identified. Clinical and morphological findings suggest that these lesions are infectious-allergic in nature. In rare cases (4%) viral antigens in the CSF and brain cells may also be found in patients with acute respiratory diseases without central nervous system involvement which happens when patients' blood-brain barrier is especially permeable. PMID- 3554857 TI - [Tick-borne erythematous spirochetosis (tick-borne annular erythema. Bannwarth syndrome, Lyme disease)]. PMID- 3554858 TI - [Chromosome instability in diseases of the nervous system]. AB - The authors review both their own findings and literature data about chromosomal instability in neurologic diseases. The genetic mechanisms responsible for the development of chromosomal instability and its role in the pathogenesis of different diseases of the nervous system are discussed. PMID- 3554859 TI - [Potential role of endogenous ethanol as a predictor of alcoholism (review of the literature)]. PMID- 3554860 TI - [Transforming growth factor in F9 embryonal carcinoma cells and its immunocytochemical localization]. PMID- 3554861 TI - [Immunohistochemical study on the development of antibody-producing immunocytes in guinea pig popliteal lymph nodes]. PMID- 3554862 TI - [Scanning electron microscopic study of the surface of the epidermal grafts during the corneal induction in tadpoles of Bufo raddei]. PMID- 3554864 TI - Clinical lung transplantation: state of the art after 23 years of rational progress. PMID- 3554863 TI - [Value of automatic sutures in total gastrectomy for cancer: apropos of 81 patients]. AB - We reviewed the results of stapled circular (EEA) and linear (TA 30 or 55) anastomoses in a prospective study of 40 total gastrectomies for cancer, using an interposed jejunal limb (Henley technique). There were 63 circular anastomoses: 40 esophago-jejunal, 20 jejuno-duodenal and 3 jejuno-jejunal anastomoses. Forty patients were submitted to 41 linear stapled closures of the jejunal stump. Technical failure rate with stapled anastomoses was 5% (3 out of 63). Incidence of anastomotic leak was 6.3% for all the circular stapled anastomoses tried and 5% if the 3 technical failures were excluded. Anastomotic leakage is more often associated to splenopancreatectomy. One patient (1% of all the anastomoses) presented gastro-intestinal bleeding, related to the suture line. A conservative treatment was carried out successfully. The mean follow-up time of the surviving patients was 27 +/- 20 months: there was a 5.5% rate of late anastomotic stenosis; all the patients were cured by esophageal dilations. Late anastomotic stenosis is directly related to associated cobalt therapy. Analysis of an older retrospective series of 41 hand-sutured total gastrectomies allowed a comparison to be made between stapled and sutured anastomoses in total gastrectomy for cancer. PMID- 3554865 TI - Relationship between gastric acid secretion and clinical outcome after parietal cell vagotomy. AB - Results of insulin and pentagastrin tests 2 months after parietal cell vagotomy were compared with clinical outcome in six patients with subsequent duodenal recurrence of ulcer, ten with pyloric or gastric recurrence, 43 with dyspepsia and 75 persistently symptom-free controls. The insulin-stimulated peak acid output (IPAO) and the pentagastrin-stimulated peak acid output (PAO), but not the basal acid output (BAO), were significantly higher in the duodenal recurrence group than in the controls. In the pyloric/gastric recurrence and dyspepsia groups, BAO, IPAO and PAO were similar to the control values. In the duodenal group the postvagotomy reductions of IPAO and PAO were significantly less than in the controls, indicating incomplete vagotomy. In the pyloric/gastric recurrence and dyspepsia groups, the postvagotomy BAO fall was significantly less than in the controls, but IPAO and PAO fell similarly in all three groups, indicating that pyloric or gastric recurrence was related only to inadequately reduced BAO. PMID- 3554866 TI - An experimental model for studying reversible intestinal ischemia. AB - We have developed a simple experimental model for studying reversible intestinal ischemia. The model is based on tenting the mesenteric vessels (artery and vein) to a tied loop of the small bowel in rat and, after a certain time, lowering them down again. Total and partial ischemia (created by tenting 2 and 1 cm, respectively) were demonstrated by laser Doppler flowmetry, as was the revascularization obtained after bringing the vessels down again. Alterations in mucosal permeability after ischemia were determined by depositing fluorescent dextran 3000 in the tied loop and measuring its concentration in the portal blood, and mucosal damage due to ischemia was assessed by measuring the activity of N-acetyl-beta-glucosaminidase, a lysosomal enzyme, in the gut lumen. There was a significant increase in the intestinal permeability to dextran 3000 after total ischemia for 10 min or more, and the permeability was directly related to the duration of the ischemia. After the intestine had been subjected to total ischemia for 30 min or more, the activity of N-acetyl-beta-glucosaminidase in the luminal contents was significantly increased. The permeability after partial ischemia for 30 min was less than that after total ischemia for 30 min. After total ischemia for 10 min followed by revascularization for 30 or 60 min, the permeability did not differ from that in animals not subjected to ischemia. It is concluded that this simple model may be used to study reversible small intestinal ischemia and factors that influence mucosal permeability. PMID- 3554867 TI - Long-term efficacy of semi-synthetic human insulins (SHI) in newly-diagnosed insulin-dependent diabetic patients. A two year clinical study. PMID- 3554868 TI - Chemoprophylaxis for bacterial meningitis. PMID- 3554869 TI - Circulating serum phenylalanine concentrations and the effect of arginine infusion on plasma levels of growth hormone and insulin in treated phenylketonuric children. AB - According to desired phenylalanine (Phe) levels of 50-80 mg/l during treatment, three groups of patients with classical phenylketonuria (PKU) (5.3-17.1 years) were formed. They were investigated for their growth hormone (GH) and insulin response to arginine infusion: Group I (N = 5) had Phe levels below (22 +/- 4 mg/l), group II (N = 3) within (61 +/- 6 mg/l), and group III (N = 3) above therapeutic limits (156 +/- 3 mg/l). Nine children (5.2-14.5 years) with short stature served as controls. Whereas group I and II PKU children showed normal GH response to arginine infusion, group III children exhibited impaired GH response expressed as integrated GH response (218 +/- 38.6 micrograms X 1(-1) X 2 h vs 911 +/- 145 micrograms X 1(-1) X 2 h; P less than 0.01) or peak GH response (6.6 +/- 1.2 micrograms/l vs 18.7 +/- 2.3 micrograms/l; P less than 0.05). Integrated insulin responses did not differ between the three PKU groups but were significantly higher in all PKU patients compared with controls (4903 +/- 421 mU/l vs 2750 +/- 378 mU/l; P less than 0.01). However, this reflects impaired insulin secretion in children with constitutional delay of growth and adolescence rather than hyperinsulinism in PKU patients. PMID- 3554870 TI - Suppression by LRH of the stimulatory effect of oestradiol on the secretion of LH by the rat pituitary gland. AB - Ovariectomized rats were infused with varying doses of luteinizing hormone releasing-hormone (LRH). Some of the rats were also treated with oestradiol benzoate (EB). The effects of these pre-treatments on the in vitro release of luteinizing hormone (LH) were studied. The following parameters of in vitro LH release were measured: the autonomous secretion rate; the secretion rate following maximum stimulation with LRH, and the total quantity of LH released during the 6-hour experiment. The in vivo pre-treatments with LRH and EB dose dependently decreased the pituitary LH content as well as all three of the above parameters of in vitro LH secretion. There was a linear relationship between the pituitary LH content and the three parameters of in vitro LH release. These parameters were therefore expressed as percentage of the pituitary LH content to give the relative LH secretion rates. The three parameters were thereby corrected for LRH/EB-induced changes in the pituitary LH content. In this way we obtained information on the effects of LRH and EB on the state of the LH release mechanisms of the gonadotropes. EB potentiated the LRH-induced depletion of the pituitary LH stores at all in vivo LRH infusion rates. The effect of EB on the quantity of LH released during perifusion in vitro, however, varied with the previous LRH infusion rates. After LRH infusion rates lower than about 120 ng/h (which establishes plasma concentrations of about 70 ng/l) EB enhanced the stimulated quantity of LH released. After higher rates of LRH infusion, EB lowered the amount of LH released.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3554871 TI - Sonographic evaluation of uterine morphology: a new scanning technique. AB - Through sonographic sections with mid-empty bladder it is possible to evaluate all uterine biometric data. This technique was evaluated in thirty-four cases of uterine malformations and satisfactory results were obtained in thirty-two of them. If further studies on randomized patients confirm the specificity of this technique, it could become a basic non invasive investigation for the screening of uterine malformations. PMID- 3554872 TI - [Echotomography in hepatic hydatidosis]. AB - Ultrasonography, we found as a good diagnosis method for echinococcal hepatic cysts. We studied by U.S. 11 patient with a mass hepatic syndrome. Hepatomegaly was found in 4 patients. In all those cases, a liquid formation (echo-free mass with well walls defined) was seen. Ultrasonography (U.S.) give us an exactly localization topographically of the cysts. PMID- 3554873 TI - [Detection of pyloric Campylobacter in patients with gastroduodenal diseases]. AB - We report a study of 127 patients examined with esophago-gastroduodenoscopy and with a diagnosis of chronic gastritis (by biopsy), and gastric peptic ulcer and duodenal peptic ulcer (endoscopically). Brushing samples and biopsies were taken from the esophagus, stomach, and duodenum. Gram stains of brush-collected samples, culture of brush samples and biopsies were performed in order to detect the presence of PC. In cases of chronic active gastritis, PC was found in 91% of patients. It was found in 73% and 84%, respectively, of cases of gastric and duodenal ulcer. PC was found with equal frequency in the cardia and body as in the antrum of infected individuals, but no confirmed cases of colonization of the esophagus or duodenum were found. The most efficient methods for identifying PC colonization were (in descending order of efficiency), silver stain of biopsies, Gram stain of brushings, hematoxylin-eosin stain of biopsies, culture of biopsies, and culture of brushings. In some cases, we have identified PC in the esophagus and duodenum by gram stain and culture, but no not by silver stain or H&E stain of biopsies, suggesting that contamination from other areas of the stomach may be an occasional problem in sampling these areas for PC. PMID- 3554874 TI - [Carcinoid tumor of Vater's ampulla]. AB - We present the case of a patient with a Vater's papilla carcinoid tumor treated with total duodenopancreatectomy followed by re-gastrectomy because of a second localization of the tumor in the gastrojejunal anastomoses. The patient remains asymptomatic after 3 years and 6 months survival. Digestive carcinoid tumors are described, analyzing their physiopathologic, clinical and prognostic aspects, having done a bibliographic revision of the item. PMID- 3554875 TI - [Diagnosis of thyroid diseases using imaging procedures with reference to nuclear magnetic resonance tomography]. AB - Results of MR imaging performed in 74 patients with diseases of the thyroid gland and in normal persons are compared with nuclear medicine (99mTc 04 and 131J scans) and sonography (5 and 7.5 MHz transducers, linear scans) results. The MR signal intensity of hot nodules--Plummers' disease--is not specific. Therefore scintigraphy combined with sonography remain the methods of choice for the diagnosis of hyperfunctioning nodules. Morphologic alterations within the thyroid gland are detected by MRT as well as by ultrasound. But when lesions are not limited to the thyroid bed MRT will become the imaging examination of choice. Therefore MRT can be useful for scanning retrotracheal and superior mediastinal extent of thyroid lesions. Also clinically inapparent metastases to the cervical and mediastinal nodes may be detected. PMID- 3554876 TI - [Biological effects and risks of accidental radionuclide uptake]. AB - This review presents the actual state of knowledge about medical dangers of a radioactive fall-out. Concepts for the estimation of accidental incorporation, as well as effects and risks that are known to occur after incorporation of radionuclides are discussed. Special attention is paid to the following topics: effect of radioiodine on the thyroid gland, effect of radio-cesium on whole body burden, alpha-emitting particles (plutonium) with deposition in the airways, association of osteotrope radionuclides (strontium) with malignomas of the skeleton and finally prophylaxis with iodine to prevent damage of the thyroid. PMID- 3554877 TI - [The resected struma: diagnosis, prevention of recurrence, therapy]. PMID- 3554878 TI - Effects of dobutamine on haemodynamics and renal function in patients after major vascular surgery. AB - Eight mechanically ventilated patients were studied, before and during a dobutamine infusion the day after major vascular surgery. During infusion of three different doses of dobutamine (2.5, 5, 10 micrograms/kg/min) increases were found in heart rate of 13%, 21% and 47%, systolic blood pressure of 17%, 27% and 35%, and cardiac output of 11%, 22% and 45%, respectively. Right atrial pressure decreased by 20% at the highest dosage. Pulmonary arterial pressure and pulmonary capillary wedge pressure remained unchanged. There were no changes in plasma catecholamine concentrations and plasma renin activity. Fractional potassium excretion decreased by 23%, 33% and 43%, respectively, at the three dosages, while renal blood flow, glomerular filtration rate, urine flow, fractional sodium, chloride, osmolar and free water clearances were unchanged. PMID- 3554879 TI - The treatment of spasticity in multiple sclerosis: a double-blind clinical trial of a new anti-spastic drug tizanidine compared with baclofen. AB - The anti-spastic effect of a new drug, tizanidine, was compared with that of baclofen in a double-blind clinical trial; 40 seriously handicapped patients with multiple sclerosis (MS) were randomly allocated treatment with one or the other drug for a 6-week period. The antispastic effect was evaluated by clinical criteria. The optimal daily dose of both drugs varied considerably from patient to patient, and was on the average 23 mg for Tizanidin and 59 mg for baclofen. To the extent an antispastic effect was observed, the 2 drugs appeared to be equally effective when given at a 1:2 ratio (mg tizanidine: mg baclofen). Side effects of both drugs were sleepiness, muscular weakness and dry mouth. Tizanidine had a mild depressive effect on blood pressure. Sudden withdrawal of both drugs was accompanied by a transient relative increase of spasticity in approximately half the patients. There were no other changes suggesting physical or psychological dependence. The present study underscores that neither baclofen nor tizanidine are ideal antispastic drugs, and emphasize the need for further research. PMID- 3554881 TI - Fusidic acid in acute conjunctivitis. Single-blind, randomized comparison of fusidic acid and chloramphenicol viscous eye drops. AB - Fusidic acid 1% and chloramphenicol 0.5% eye drops were in a randomized, single blind manner given as a one-week treatment to out-patients with acute, purulent conjunctivitis. A clinical success was recorded in 84% (102/121) of patients receiving fusidic acid and in 81% (104/129) of patients receiving chloramphenicol. More patients (14%) receiving chloramphenicol complained of trivial side effects such as stinging and local discomfort, compared with fusidic acid (5%). No serious side effects were recorded. It is concluded that fusidic acid dispensed in a carbomer eye vehicle represents an effective and well tolerated new topical eye preparation with the advantage of being administered twice daily. PMID- 3554882 TI - Refractive change in diabetes mellitus around onset or when poorly controlled. A clinical study. AB - For generations it has been taught that myopic change is the principal response to hyperglycaemia in diabetes mellitus. Recently, however, a hyperopic concept has been advanced, to suggest that a change towards hypermetropia has possibly become the more frequent finding in diabetics with unstable refraction. The present sample comprises 32 cases of newly discovered diabetes and 40 cases of long duration, most cases being insulin-dependent. Of the former 47% showed a refractive change around the recognized onset of diabetes, in some cases prior to detection and admission, but mostly after institution of insulin therapy; in 14/15 the change was towards hypermetropia. Of the longstanding cases 20% showed refractive change (while 80% did not) in association with poor metabolic control, equally towards myopia/hypermetropia. It was not possible to point out an association with specific patterns of metabolic dysregulation. The results are further discussed in relation to previous refraction studies demonstrating an increased myopia prevalence in diabetics in general, as compared to non diabetics. Apparently this cannot be explained merely by a possibly overlooked transient refractive change under periods of poor metabolic control. PMID- 3554880 TI - On the biology of prions. AB - Prions cause scrapie and Creutzfeldt-Jakob disease (CJD); these infectious pathogens are composed largely, if not entirely, of protein molecules. No prion specific polynucleotide has been identified. Purified preparations of scrapie prions contain high titers (greater than or equal to 10(9.5) ID50/ml), one protein (PrP 27-30) and amyloid rods (10-20 nm in diameter X 100-200 nm in length). Considerable evidence indicates that PrP 27-30 is required for and inseparable from scrapie infectivity. PrP 27-30 is encoded by a cellular gene and is derived from a larger protein, denoted PrPSc or PrP 33-35Sc, by protease digestion. A cellular isoform, designated PrPC or PrP 33-35C, is encoded by the same gene as PrPSc and both proteins appear to be translated from the same 2.1 kb mRNA. Monoclonal antibodies to PrP 27-30, as well as antisera to PrP synthetic peptides, specifically react with both PrPC and PrPSc, establishing their relatedness. PrPC is digested by proteinase K, while PrPSc is converted to PrP 27 30 under the same conditions. Prion proteins are synthesized with signal peptides and are integrated into membranes. Detergent extraction of microsomal membranes isolated from scrapie-infected hamster brains solubilizes PrPC but induces PrPSc to polymerize into amyloid rods. This procedure allows separation of the two prion protein isoforms and the demonstration that PrPSc accumulates during scrapie infection, while the level of PrPC does not change. The prion amyloid rods generated by detergent extraction are identical morphologically, except for length, to extracellular collections of prion amyloid filaments which form plaques in scrapie- and CJD-infected brains. The prion amyloid plaques stain with antibodies to PrP 27-30 and PrP peptides. PrP 33-35C does not accumulate in the extracellular space. Prion rods composed of PrP 27-30 can be dissociated into phospholipid vesicles with full retention of scrapie infectivity. The murine PrP gene (Prn-p) is linked to the Prn-i gene which controls the length of the scrapie incubation period. Prolonged incubation times are a cardinal feature of scrapie and CJD. While the central role of PrPSc in scrapie pathogenesis is well established, the chemical as well as conformational differences between PrPC and PrPSc are unknown but probably arise from post-translational modifications. PMID- 3554883 TI - Bertil Stener. A portrait. PMID- 3554884 TI - Failures with the Judet noncemented total hip. AB - Primary failures with 36 noncemented Judet total hip arthroplasties are reported. Steep-cup inclination in 7 cases resulted in two dislocations, two migrations, one skew insertion, and two painful hips. Moreover, two migrations were encountered in patients with rheumatoid arthritis. Femoral shaft fractures occurred intraoperatively in 7 cases and postoperatively in another 2 cases. In addition, major fractures of the greater trochanter occurred in 3 cases. The reoperation rate was 11/36, due to primary failures 8-37 months postoperatively. Consequently, the Judet design cannot be recommended for noncemented use. PMID- 3554885 TI - Incorporation of nonviable bone grafts. Autoclaved autogeneic and frozen allogeneic bone grafts compared in the rabbit. AB - In 14 adult rabbits the middle third of the ulna was resected bilaterally followed by reimplantation of resected bone after autoclaving on one side and transplantation of allogeneic bone on the other. In 7 animals the bilateral implants were supplemented with allogeneic bone matrix. The reconstructions were studied in vivo by serial radiography, scintigraphy, and bone mineral determination. The animals were killed at 16 weeks, and the ulnar reconstructions further studied by high resolution radiography, 45Ca autoradiography, and histology. In both types of nonsupplemented reconstructions, new bone formation was poor; nonunion occurred in three out of seven autoclaved reimplants and in five out of seven allogeneic transplants. Supplemented with allogeneic bone matrix, both types of reconstructions exhibited abundant new bone formation and complete incorporation of all implants. Enhancement of new bone formation is probably more important than the type of nonviable bone graft chosen for reconstruction of large skeletal defects. PMID- 3554886 TI - Treatment of clavicular fractures. Figure-of-eight bandage versus a simple sling. AB - Seventy-nine out-patients with midclavicular fractures were included in a prospective, randomized trial comparing treatment with a figure-of-eight bandage and a simple sling. Sixty-one patients completed the study and were reevaluated clinically and radiographically after 3 months. We found that treatment with a simple sling caused less discomfort and perhaps fewer complications than with the figure-of-eight bandage. The functional and cosmetic results of the two methods of treatment were identical and alignment of the healed fractures was unchanged from the initial displacement. PMID- 3554887 TI - Theo J. G. van Rens 1931-1986. PMID- 3554888 TI - Systemic amyloidosis with a mesenteric mass which had the appearance of proteinaceous lymphadenopathy. AB - An autopsy case of systemic amyloidosis in a 46-year-old Japanese female who had M component in sera but no manifestations of myeloma is described. Autopsy revealed massive milky ascites and a large mesenteric mass, which showed histologically perivascular concentric deposition of eosinophilic materials with mixture of residual follicles and scattered plasma cells. These morphological findings closely resembled those seen in proteinaceous lymphadenopathy, and the material in the mesenteric mass proved to be an amyloid A lambda protein. Subsequent immunohistochemical observations strongly suggested that this mass lesion was a "burnt-out" plasmacytic dyscrasia. PMID- 3554889 TI - Systemic mastocytosis without cutaneous involvement. AB - An autopsy case of systemic mastocytosis without cutaneous involvement in a 76 year-old woman was described. The patient presented with general malaise, chest and epigastric discomfort, flushing of the face and progressive hepatosplenomegaly, and she terminated in hemorrhagic complications of DIC within 2 months. There was neither rash nor urticaria pigmentosa recognizable in the entire course. The diagnosis was made by the histologic identification of abnormal aggregates of mast cells in a bone marrow aspirate. These mast cell granules were chloroacetate esterase-positive, peroxidase-negative, and electronmicroscopically they were composed of fine granular materials containing variable numbers of lamellar structures. At autopsy, diffuse infiltration of the mast cells was found in the liver, spleen, bone marrow, lymph nodes, lungs, kidneys, stomach, and adrenal glands. PMID- 3554890 TI - Complete and incomplete pyloric gland metaplasia of human gallbladder. AB - The features of pyloric gland metaplasia in the gallbladder epithelium were studied by histochemical staining for mucin and the immunoperoxidase method for pepsinogens (Pg) I and II. Pyloric gland metaplasia was found in 48 of 72 gallbladders removed surgically. All the pyloric gland metaplastic cells contained class III mucin demonstrated by paradoxical concanavalin A (Con A) staining. Pyloric gland metaplasia was classified into complete and incomplete types on the basis of the immunohistochemical reactivities of Pgs I and II: The complete type of pyloric gland metaplasia contained neutral mucins and weak Pg I and strong Pg II activities, like normal pyloric gland cells. Almost all specimens of the incomplete type of pyloric gland metaplasia contained acid mucins and were further classified into two types: an incomplete type 1, which had Pg II but no Pg I activity, and an incomplete type 2, which had no Pg I or II activity. PMID- 3554891 TI - Pancreatoblastoma in Japan, with differential diagnosis from papillary cystic tumor (ductuloacinar adenoma) of the pancreas. AB - Twelve cases of pancreatoblastoma, 7 males and 5 females, were 5 years of age in average and showed an organoid structure consisting of acinar differentiation with squamoid corpuscles. Seven cases died, but 5 lived after surgery. On the contrary, 17 cases of papillary cystic tumor, ductuloacinar adenoma of the pancreas, one male and 16 females, were 21 years of age in average and disclosed a monomorphous pseudopapillary pattern of ductuloacinar type of tumor cells with some degenerative and granulomatous changes. All of the cases had suffered no recurrence after resection. Immunohistochemically, strong positivity for alpha 1 antitrypsin may be associated with the autodigestive process and limited growth of this tumor. Electron microscopically, both tumors showed centroacinar and acinar types of tumor cells. Both tumor cells frequently contained well-developed RER, zymogen-like granules, and annulate lamellae. The ductular or acinar lumina were clear in pancreatoblastoma, but not in ductuloacinar adenoma due to degeneration. Though both tumors disclosed contiguous histogenesis, pancreatoblastoma should be differentiated from ductuloacinar adenoma, based upon the young age, almost equal sex ratio, unfavorable prognosis, high serum AFP level in three measured cases, an organoid structure containing frequent mitotic figures, and the invasive growing margin. PMID- 3554892 TI - Effect of elevated temperature on human immunoglobulin synthesis, lymphokine production and lymphocyte proliferation in vitro. AB - Fever in infections is mediated by endogenous pyrogen, a protein inseparable from interleukin 1 (IL-1). It remains unclear what the role of fever in host defence is. We studied the effect of elevated temperature on mitogen-induced human lymphocyte stimulation in vitro. Lymphocyte proliferation, elaboration of leukocyte migration inhibiting factor (LIF) and immunoglobulin production were measured at normal and elevated temperatures. Pokeweed mitogen-(PWM) driven responses were quantitated with a plaque-forming cell assay and by measuring secreted immunoglobulins in culture medium. The responses at 38, 39 or 40 degrees C were, if anything, lower than those at 37 degrees C. The production of LIF after stimulation with PWM was not augmented at elevated temperatures. In contrast, the proliferative responses to PWM, phytohaemagglutinin (PHA) and concanavalin A (ConA) were increased at 38 degrees C. These results indicated that elevated temperature has diverse effects on mitogen-induced lymphocyte functions in vitro. PMID- 3554893 TI - Mouse peritoneal macrophages cultured serum-free deposit complement on IgM-coated sheep erythrocytes in vitro. AB - We conclude that the macrophages during cultivation produce the complement components of the classical pathway of complement, deposit complement components on EIgM and then phagocytose these cells via complement receptors. The conclusion is based on the following: EIgM, an activator of the classical pathway, are ingested when cultured serum-free with mouse peritoneal macrophages. We found a significantly higher binding of labelled protein to EIgM than to E kept in macrophage cultures in the presence of tritiated leucine, showing that de novo synthesis of macrophage-derived protein with affinity to EIgM takes place. A fraction of the bound protein is C3b and iC3b, since anti-mouse C3 antibodies bound to the co-cultured EIgM. Cycloheximide or anti-Mac-1 in the cultures inhibited macrophage attachment and uptake of EIgM. The phagocyte uptake of EIgM coated with complement by serum pretreatment was not inhibited by cycloheximide. This shows that the phagocytosis of the EIgM is dependent on erythrocyte-bound complement proteins made by the macrophage. PMID- 3554894 TI - Monoclonal antibodies reacting selectively with core and O-polysaccharide of Yersinia enterocolitica O:3 lipopolysaccharide. AB - In order to obtain specific tools for studying the alterations of the immunochemical structure of Yersinia enterocolitica lipopolysaccharide in various conditions, we have produced monoclonal antibodies reacting with core and O polysaccharide chains of Yersinia enterocolitica O:3 LPS. Immunizations were made with whole bacterial cells and outer membrane preparation, respectively. Monoclonal antibody 2B5 reacted in enzyme immunoassay with purified core-lipid A complex, and its binding was not inhibited by Polymyxin B, suggesting that the target determinant is in the outer core. 2B5 recognized 100% of all tested Y. enterocolitica O:3 strains (n = 152) and reacted to some extent also with many other gram-negative bacteria. In immunoblotting with 2B5, a band corresponding to core-lipid A complex was visualized both with Y. enterocolitica, Brucella abortus and Haemophilus influenzae. In immunofluorescence assay, the only positive reaction was seen with Y. enterocolitica. Monoclonal antibody A6 reacted in enzyme immunoassay with purified O-polysaccharide chains, recognized 100% of tested Y. enterocolitica O:3 strains, and showed no cross-reactions with other bacteria. A typical ladder pattern was not seen in the immunoblotting analysis with A6. This suggests that the O-chain of Y. enterocolitica O:3 may be different from those in other gram-negative bacteria. These two antibodies will make it possible to study the structural variations of Yersinia enterocolitica LPS more precisely than described before, because of their fine specificity against important immunogenic components of LPS. They will also be useful in serology measuring the immune response against the target determinants of these antibodies. PMID- 3554895 TI - Response ot insulin by thymocytes of adrenalectomized and adrenalectomized diabetic rats. AB - Insulin receptors and he hormone action "in vitro" and "in vivo" on alpha aminoisobutyric acid (AIB) uptake were studies on thymocytes from adrenalectomized and adrenalectomized-diabetic rats. The lack of insulin effect "in vitro" correlated with the absence of insulin receptors. Meanwhile the increase in AIB uptake produced by an injection of insulin suggest an indirect action of the hormone that could be the consequences of metabolic events. PMID- 3554896 TI - [Biochemistry of the development cycle of Triatoma infestans (vinchuca). X. Hemolymph lipoproteins of females]. AB - A lipoprotein of high density (HDL) and three of very high density (VHDL-I, VHDL f and VHDL-II) were separated by ultracentrifugation from T. infestans female hemolymph. Lipids were mainly transported by HDL, whereas VHDL-II presented the highest protein content. In all the lipoproteins, 1,2 and 1,3-diacylglycerols, triacylglycerols, free fatty acids, cholesterol, cholesterol esters and hydrocarbons, were present. Phosphatidylcholine and phosphatidylethanolamine were also identified. The main lipids were represented by phospholipids, 1,2 and 1,3 diacylglycerols and hydrocarbons. All lipoproteins were delipidated to study the corresponding apolipoproteins. They were examined by SDS-polyacrylamide gel electrophoresis in the presence of 2-mercaptoethanol. Apo-HDL was separated into four intense polypeptide bands of approximate MW 19,000; 45,000; 86,000 and 200,000. Apo-VHDL-I was fractionated into three polypeptide bands--a major one of MW 18,500 and two minor ones of 28,000 and 45,000. The apolipoproteins belonging to VHDL-f that only appeared in females, were separated into 10 bands; the major ones corresponded to MW of 58,000, 86,000 and 160,000. In these apolipoproteins, the specimens of 58,000 and 160,000 showed positive carbohydrate reaction. Yet, in the apo-VHDL-II the most intense protein subunits primarily corresponded to bands of MW 160,000 and 86,000. Apparently, the four lipoproteins would share two polypeptide chains. PMID- 3554897 TI - Plasma cholesterol levels in eviscerated rats. AB - Eviscerated rat models with a functional liver in which the kidneys or pancreas could be left in situ or removed were used. We found that removal of the gastrointestinal tract leaving the liver and kidneys intact resulted in a significant elevation above normal of the plasma cholesterol. In the absence of the liver, esterified cholesterol is decreased. The presence or absence of the kidneys plays no role here; esterification of cholesterol is primarily a liver function. The elevation in total cholesterol levels after removal of the gastrointestinal tract and pancreas is probably due to a lack of insulin action on peripheral tissues. This elevation in cholesterol is similar to that seen in genetic, surgical and chemical diabetes. Complete restoration of plasma cholesterol patterns to intact animal levels was seen only when the pancreas, liver and kidneys were left functional in the eviscerated rat. These data indicate that in this experimental model the absence of the intestinal tract per se does not significantly modify plasma cholesterol levels and that the critical regulators of cholesterol metabolism appear to be the liver and the endocrine pancreas. PMID- 3554898 TI - Changes in human cerebral blood flow due to step changes in PAO2 and PACO2. AB - The effect of moderate hypoxia on cerebral blood flow (CBF) in man has not been well described, and little is known about the interaction of changes in arterial PO2 and PCO2 as regards CBF. Using a non-invasive doppler ultrasound method we have measured the instantaneous mean blood velocity (which is proportional to CBF as long as the cross-section of the vessel is constant) in the carotid artery in four healthy unanaesthetized subjects. We found in all subjects that a reduction in alveolar PO2 from about 13 to about 8.7 kPa with maintained constant alveolar PCO2 (PA, CO2) caused CBF to increase gradually over 10 min (half-time about 4 min) to about 125% of control. The CBF decreased quickly (half-time about 45 s) towards control when alveolar PO2 was reset to 13 kPa. As measured 5 min after a step-change in PA, O2, the change in CBF was independent of PA, CO2 within the range 3.3-6.7 kPa. An increase in PA, O2 to about 33 kPa reduced CBF only if PA, CO2 was in the hypercapnic range. Unexpectedly we found that the CBF response showed 'adaptation' during both maintained increase and decrease in PA, CO2. The CBF started to return towards control level within 10 min after induction of hypo or hypercapnia. We conclude that also moderate hypoxia causes increased CBF in unanaesthetized man within a wide range of PA, CO2. PMID- 3554899 TI - IGF-I expression in blood vessels varies with vascular load. AB - The present study was designed to investigate if the immunoreactivity of insulin like growth factor I (IGF-I, somatomedin C) in blood vessels was changed in relation to the vascular load in adult rats. Occlusion of the right femoral artery resulted within 24 h in a strongly increased IGF-I immunoreactivity in the media of the contralateral, left, femoral artery and a significant decrease in the IGF-I expression in the right femoral artery distal to the occlusion. The increased labelling of the smooth muscle cells persisted for at least 21 days. Inactivity of the right hind limb, secondarily to an ischaemic insult, likewise induced a significant increase in IGF-I immunoreactivity, within 24 h, in the femoral vessels of the undamaged, contralateral left hind limb. It is concluded that IGF-I immunoreactivity varies with the dynamic load in the vascular walls. It is proposed that IGF-I may serve as a parahormone exerting its effect by paracrine and/or autocrine mechanisms, taking part in regulating the structural adaption of blood vessels in response to stress. PMID- 3554900 TI - Pre-infusion heart rates and laboratory-induced panic anxiety. AB - Resting and pre-infusion heart rates recorded in 66 panic disorder patients revealed no significant differences between panickers and nonpanickers. There was also no significant difference in pre-fusion heart rates between either lactate or isoproterenol panickers and placebo nonpanickers. There was neither a sensitizing nor a desensitizing effect of laboratory-induced panic attacks on subsequent pre-infusion heart rates. PMID- 3554901 TI - Hypnotics and actual driving performance. AB - Several related studies of the residual effects of hypnotic drugs on actual driving performance have been conducted using a standard approach and the most recent is described in detail. In it, 12 female formerly diagnosed insomniacs and hypnotic users acted as subjects. They were treated in two separate series with placebo for 2 nights, then hypnotic medication for 8 nights followed by placebo again for 3 nights. In one series, the medication was nitrazepam (10 mg nocte) and in the other, temazepam (20 mg nocte). Eleven subjects completed both series in a double-blind, cross-over (with respect to drugs) design. Their driving performance was repeatedly tested on a 100 km primary highway circuit, in normal traffic, during both the morning and afternoon (10-11 hours and 16-17 hours after drug and placebo ingestion, respectively). Nitrazepam but not temazepam significantly impaired driving performance, the difference lasting throughout the active medication period. These results along with those obtained in the earlier studies are compared to show degrees of driving impairment which follow the use of various hypnotics. PMID- 3554902 TI - The donor factor in hypertension after renal transplantation. PMID- 3554903 TI - Hemodynamic and humoral adaptation to weight stable chronic sodium restriction in comparison with weight reduction in moderately obese hypertensive men. PMID- 3554904 TI - Hormonal responses to treatment of high blood pressure with low-salt diet alone and combined with added potassium. AB - One week strict sodium depletion in essential hypertensive men (n = 17) decreased blood pressure and body weight. Plasma renin concentration increased four-fold (p less than 0.001), plasma noradrenaline with 38% (p less than 0.001), plasma dopamine with 58% while plasma adrenaline remained unchanged. The urinary excretion of vasopressin was reduced with 50% (p less than 0.001). Extra potassium induced only small changes when already sodium depleted. Thus, vasopressin was the only pressor hormone which varied directly with sodium intake, blood pressure and body weight during sodium depletion. PMID- 3554905 TI - [Value of intracavitary echography in the study of non-urologic pelvic pathology]. PMID- 3554906 TI - [Renal transplant. Ureteral fistula. Treatment by percutaneous nephrostomy]. PMID- 3554907 TI - [Renal malacoplakia]. PMID- 3554908 TI - [Kidney autotransplant apropos of a case]. PMID- 3554909 TI - Nutritional supplements in amyotrophic lateral sclerosis. PMID- 3554910 TI - Motor neuron disease: epidemiologic studies. AB - The etiology of motor neuron disease (MND) is unknown and treatment is limited to measures which sustain the patient. We review selected epidemiologic studies searching for a pattern in the clinical expression of MND which may reflect the operation of the underlying cause. Recognition of patterns of occurrence of MND might provide the basis for testable etiologic hypotheses for MND. In addition, recognition of the association of MND with diseases of known cause or the analogy of diseases of known cause with MND may provide further etiologic hypotheses. PMID- 3554911 TI - Auricular composite graft from the scapha and its repair using a retroauricular subcutaneous pedicle flap. AB - A technique to take an auricular composite graft from the scapha and its repair using a retroauricular subcutaneous pedicle flap is described. Not only can this procedure remove the composite graft without auricular deformity, but it is also useful for covering small auricular defects after trauma or tumor excision. PMID- 3554912 TI - The antialgesic drugs: human therapeutic correlates of their potency in laboratory animal models of hyperalgesia. AB - This survey discusses the correlation between the oral potency of antialgesic drugs in several pharmacology laboratories and their human oral dose in clinical practice. We also present a brief overview of a few biological assays that have been successfully used to direct the synthesis of newer antialgesic drugs. The laboratory assay that our analysis showed to be most predictive of the clinical analgesic dose is based upon the response of rats to flexion of an arthritic joint. Laboratory ED50 values from the ACh-induced abdominal constriction assay in mice are nearly as predictive while the predictive power of the yeast-induced hyperalgesia assay in rats is somewhat less. Probably because of the small number of experiments, the correlation between the efficacy of these agents in a canine model of synovitis and their clinical doses only reached borderline statistical significance (p = 0.0651). Regression equations are presented that permit calculations of single clinical analgesic doses from efficacy data in individual tests. Calculation of stepwise multiple regression showed that the clinical dose could be best predicted when efficacy data obtained in the joint flexion assay in rats and the ACh-induced constriction assay in mice are both taken into account. We have concluded that the effective doses are highly predictive of clinical efficacy because these animal assays have been designed to reflect the action of drugs upon prostanoid-induced hyperalgesia. PMID- 3554913 TI - The inhibition by morphine and D-aspartic acid of antibody production against Salmonella typhimurium antigen in rats: its antagonism by L-aspartic acid. AB - The changes in the production of antibody against Salmonella typhimurium antigen were investigated in rats by means of the agglutination test after chronic oral administration of the L-asparaginase inhibitors morphine (M) or D-aspartic acid (D-Asp) alone or together with L-aspartic acid (L-Asp) and food restriction, all of which had been started five days before the injections of antigen. The statistical evaluation, carried out after the titers had been defined as -log2 of the highest dilution giving a positive agglutination reaction, showed that M or D Asp significantly decreased antibody production in comparison with the immunized control or food restricted group. The concomitant administration of L-Asp appeared to significantly antagonize the inhibitory effect of both M and D-Asp. Therefore, the results were considered as further supporting evidence for the fact that the deleterious effect of M on the immune system and its functions might be related to the inhibitory effect of M on L-asparaginase activity. PMID- 3554914 TI - [Analytic index (1983-1986)]. PMID- 3554915 TI - Intraoperative sonography in spinal dysraphism and syringohydromyelia. AB - The use of intraoperative sonography was analyzed in 24 patients with spinal dysraphism and syringohydromyelia in order to determine the role of real-time sonography in the surgical management of these patients. Specific diagnoses included tethered cord (nine), syringohydromyelia (seven), congenital tumor unassociated with a tethered cord (four), diastematomyelia (three), and occult sacral meningocele (one). Intraoperative sonography determined the exact relationship of congenital tumors to the cord before opening the dura, which allowed a more precise approach to the mass. Intraoperative sonography identified the lower end of the syrinx cavities, which allowed optimal catheter placement. Fibroglial scar tissue, which may compartmentalize these syrinx cavities, was clearly shown, and the efficacy of shunt catheter placement was immediately determined. In diastematomyelia, intraoperative sonography identified the relationship of the hemicords to bony, cartilaginous, and/or fibrous septa and demonstrated the effect on the tethered hemicords of removing these septa and constructing a single dural sac from the two dural sacs that had enclosed the hemicords. Since significant surgical decisions are based on these sonographic observations, the authors urge widespread use of intraoperative sonography in patients with spinal dysraphism and syringohydromyelia. PMID- 3554916 TI - Intramedullary spinal cord metastases, mainly of nonneurogenic origin. AB - The clinical data and imaging studies of 12 patients with intramedullary metastases were reviewed retrospectively to see if these lesions had a typical radiographic appearance and to determine the sensitivity of the various radiologic examinations. The lesions were identified antemortem by either myelography, CT, MR, and/or intraoperative spinal sonography (IOSS). Final diagnosis was based on biopsy material from either the spinal cord lesion, another metastatic site, and/or the primary tumor. Ten patients had primary tumors located outside the central nervous system, while only two patients had primary brain tumors. Metrizamide myelography and CT demonstrated a definite intramedullary mass in nine of 11 patients. In five patients the mass was relatively small, well-defined, single, and resembled a primary spinal cord neoplasm. In the other four patients, longer and sometimes several segments of the cord were involved. These appeared irregular and nodular and were often associated with intradural lesions at separate sites. MR detected not only enlargement and abnormal signal in the cord but also clinically unsuspected brain lesions. IOSS localized lesions for biopsy and monitored tumor resection. These various imaging procedures showed that cord metastases were often more extensive than anticipated clinically. Spread of tumor into the spinal and intracranial subarachnoid space was common. Imaging of the entire spinal canal and brain, preferably with MR, is therefore recommended to aid in diagnosis, prognosis, and treatment. PMID- 3554917 TI - Breast calcifications in renal hyperparathyroidism. AB - A prospective mammographic study was performed on 151 women to determine the prevalence of breast calcifications in patients with chronic renal failure. Frequency, size, structure, and location of calcific lesions were assessed in 15 patients with compensated renal insufficiency, 22 on hemodialysis, 14 who had renal transplants, and 100 who had normal kidney function. Serum levels of calcium, phosphorus, alkaline phosphatase, and parathyroid hormone were determined for all 151 women. The calcific lesions occurred preponderantly in dialysis patients (arteries, 55%; parenchyma, 68%; and ducts, 36%). Next in order were those with renal transplants (43%, 64%, and 29%, respectively) and those with renal insufficiency (33%, 53%, and 20%, respectively). Patients with renal disease had significantly more calcifications (p less than .001) than the patients with normal kidney function: arteries, 45% vs 8%; parenchyma, 61% vs 27%; and ducts, 29% vs 9%. Frequencies of calcifications correlated with serum levels of parathyroid hormone. None of the calcifications induced by renal disease simulated those seen in carcinoma of the breast. PMID- 3554918 TI - Sonographic evaluation of resting gallbladder volume and postprandial emptying in patients with gallstones. AB - We investigated fasting gallbladder volume and gallbladder emptying in response to a fatty meal in 20 patients with asymptomatic gallstones and compared the results with findings from healthy controls. Compared with control subjects without gallstones, the majority of patients with gallstones exhibited a higher resting gallbladder volume, less fractional emptying after a fatty meal, and a higher postmeal residual volume. These abnormalities all appeared to stem from an abnormally high resting gallbladder volume. Whether the increased gallbladder volume and decreased postprandial fractional emptying in the gallstone patients represents a primary or secondary abnormality remains to be determined. The results suggest that in some patients decreased gallbladder contractility may contribute to gallstone development or proliferation. PMID- 3554919 TI - Torsion of the gallbladder: findings on CT and sonography and role of percutaneous cholecystostomy. PMID- 3554920 TI - 99mTc-glucoheptonate for quantitation of differential renal function. AB - Differential renal function was calculated by using 99mTc-glucoheptonate (Tc-GH) in 51 patients. Computer-acquired background-corrected individual renal function was calculated by using both the 1-3-min uptake counts and the 2-4-hr delayed static counts. The degree of correlation between the two was high (r = .96). An equally high correlation was noted in 16 children who were 12 years old or younger, in 15 patients with renal size disparity greater than 60/40%, and in six patients with abnormal creatinine clearances. Ten patients had a 30-min dynamic 99mTc-DTPA study followed immediately by the injection of Tc-GH and acquisition of delayed static images 2-4 hr later. A high degree of correlation (r = .99) was seen between the 1-3-min differential function obtained by using Tc-DTPA and the 2-4-hr delayed differential function obtained by using Tc-GH. This study shows that Tc-GH is a clinically useful and valid tool for calculation of differential renal function and that Tc-GH combines many of the best aspects of Tc-DTPA and Tc DMSA. PMID- 3554921 TI - Normal renal papillae simulating caliceal filling defects on sonography. PMID- 3554922 TI - Prostatic abscess: CT and sonographic findings. AB - The value of CT and sonography in the diagnosis and follow-up of abscesses of the prostate was studied in six patients with this disease. Five had CT alone, one had CT and sonography, and one had sonography only. CT findings included an enlarged gland with nonenhancing fluid-density collections that sometimes were multiseptated or had enhancing rims. Sonographic findings were similar, showing a hypoechoic mass with thick walls. Follow-up examinations after antibiotic therapy (one CT, one sonogram) showed improvement or resolution. In the patients studied, CT and sonography were useful methods to detect and follow the course of prostatic abscess. PMID- 3554923 TI - The spectrum of sonographic findings in hemorrhagic ovarian cysts. AB - The sonograms of 76 hemorrhagic ovarian cysts were reviewed to ascertain the full spectrum of sonographic findings. All cases were proved either by surgery or by documented resolution on sonography and/or clinical follow-up. The overwhelming majority (92%) had increased sound through-transmission, signifying the basic cystic nature of the lesion. The sonographic patterns were variable. The most common appearance was that of a heterogeneous mass (83%), almost half of which were predominantly anechoic with hypoechoic material. The other cases (17%) were completely homogeneous, either hypo- or hyperechoic. No masses were completely anechoic. Additional sonographic features included a thick rim, septations, and associated cul-de-sac fluid. A rounded hyperechoic mass, representing blood clot, was contained within 13 masses. In addition, some women appeared to have an increased tendency to form ovarian cysts, suggested by the fact that 26% of them had a past, concurrent, or future episode of simple or hemorrhagic ovarian cysts. Because hemorrhagic ovarian cysts have variable sonographic findings, they should be included in the differential diagnosis of any adnexal mass that has good sound through-transmission. PMID- 3554924 TI - Sonography for early diagnosis of enlarged parathyroid glands in patients with secondary hyperparathyroidism. AB - High-resolution sonography of the neck was performed in 207 patients undergoing renal dialysis to determine the usefulness of sonography in the evaluation of secondary hyperparathyroidism. The sonograms in 62 (30%) of the patients showed enlarged parathyroid glands, with an average of 2.3 glands per patient. Both the number and size of enlarged glands were increased in patients who had been receiving dialysis treatment for more than 6 years. Of the patients who had enlarged parathyroid glands on sonography, only 61% had bone pain, and only 63% had evidence of hyperparathyroidism on bone radiographs. Serum levels of amino terminal parathormone were within normal limits in 26% of these patients. In 14 patients who underwent total parathyroidectomy, the accuracy of sonography for the detection of enlarged parathyroid glands was 77% (40/52 lesions). Sonography is a valuable technique for the detection of enlarged parathyroid glands in patients with secondary hyperparathyroidism associated with renal dialysis. PMID- 3554925 TI - Primary adrenocortical carcinoma: sonographic evaluation with clinical and pathologic correlation in 26 patients. AB - The sonograms of 26 patients (19 adults and seven children) with pathologically proven diagnoses of primary adrenocortical carcinoma were evaluated. Clinical corroboration was obtained in all cases. The size of the lesions ranged from 3 to 22 cm. The five smaller lesions (3-6 cm) showed a homogeneous echo pattern, similar to renal cortical echogenicity. The 21 larger lesions varied in echo texture, having a heterogeneous appearance with focal or scattered echopenic or echogenic zones representing areas of tumor necrosis, hemorrhage, and/or, rarely (19%), calcification. Even the largest lesions were fairly well delineated, often with a lobulated border. Few (7/26 or 27%) showed a surrounding echogenic thin capsulelike rim. All five small lesions showed clinical evidence of endocrine activity. Larger lesions were hormonally active less often (9/21 or 43%). Twelve patients (46%) showed no sign of endocrine activity and presented with symptoms such as fever, weight loss, abdominal discomfort, abdominal mass, hematuria, and hypertension. In the pediatric and adolescent age group (0-16 years), all tumors were hormonally active, while only seven (37%) of tumors in the adult population (17-69 years) were hormonally active. Unfortunately no echo pattern was characteristic enough to allow differentiation of adrenal adenoma from carcinoma. Smaller lesions are more likely to be benign, and larger lesions with areas of necrosis, hemorrhage, and calcification are more likely to be malignant. PMID- 3554926 TI - Silicone-induced erosive arthritis: radiologic features in seven cases. AB - As silicone polymer implants are used more widely for arthroplasty of the wrist, hand, and foot, the complication of silicone-induced erosive arthritis in these areas is being recognized with increasing frequency. Pathologically, there is a chronic foreign-body type of inflammation with both intra- and extracellular silicone particulate debris. We report seven cases with this complication in various locations, showing distinctive radiographic findings. These include well defined marginal articular erosions and subchondral cysts with marginal sclerosis; normal mineralization; and deformity, dislocation, or decrease in the size of the silicone implant. Prompt recognition of this complication is important, because surgical removal of the silicone implant terminates the progressive and destructive process. PMID- 3554927 TI - Neuroblastoma: a specific sonographic tissue pattern. AB - Previous attempts to determine a sonographic appearance characteristic of neuroblastoma have had diverse results. Sonograms of 53 abdominal tumors, including 10 neuroblastomas, imaged during 1982-1986 were reviewed. Four of the patients with neuroblastoma had a distinctive sonographic "lobule" of increased echogenicity in a part of the larger tumor mass. This sonographic appearance was secondary to the growth pattern of the tumor and was not cell specific. Correlative CT scans in two of the four patients did not differentiate this lobule. Histologically, the lobule was an aggregate of uniform neuroblastoma cells (marginated by reticulin and collagen) without hemorrhage, necrosis, or calcification. This tissue pattern was not seen in any of the other 43 neoplasms, including 12 Wilms' tumors. When identified sonographically, the lobule identified in this study seems specific for neuroblastoma and is a valuable diagnostic sign in children with an abdominal mass. PMID- 3554928 TI - Sonographic detection of neonatal umbilical-artery thrombosis: clinical correlation. AB - Eighty-one neonates were prospectively studied by sonography of the abdomen to determine the frequency, risk factors, clinical symptoms, complications, and natural history of aortic thrombosis seen in conjunction with the use of umbilical-artery catheters. Twenty-six percent of neonates developed sonographically detectable thrombosis. Twenty-nine percent of the neonates with thrombosis were asymptomatic, and an additional 24% had hematuria (diagnosed by dipstick) as their only clinical finding. Significant risk factors associated with aortic thrombosis were calcium in the umbilical-artery-catheter infusate, placement of the catheter for any length of time above the renal arteries, and low birth weight. Physical examination did not reliably predict aortic thrombosis, and asymptomatic thrombosis was more frequent than previously recognized. PMID- 3554929 TI - Liver transplant rejection: angiographic findings in 35 patients. AB - Rejection, the leading cause of liver allograft dysfunction, is usually detected by liver biopsy. The purpose of this study was to determine if there are angiographic findings that correlate with this posttransplantation complication. In a retrospective study, the angiograms of 35 patients with histologically proven allograft rejection were reviewed. The examinations were done because of suspected posttransplantation vascular complications. Abnormal hepatic arteriograms were observed in 30 (86%). Eleven (37%) of the 30 had hepatic artery thrombosis (all had acute rejection). Nineteen (63%) of the 30 had varying degrees of intrahepatic arterial narrowing (14 had acute and five had chronic rejection). Additional findings in patients with acute rejection included stretching of the intrahepatic arterial tree (five cases) and slow flow, poor peripheral arterial filling, and a decrease in the number of intrahepatic arteries (10 cases total). Intrahepatic branch vessel stenoses and occlusions were seen in four patients with chronic rejection. We conclude that there is good correlations between the angiographic findings and histologic evidence of rejection. Although angiography is not advocated as a test for transplant rejection, detection of certain findings raises the possibility of rejection. PMID- 3554930 TI - Liver allograft transplantation: postoperative CT findings. AB - The CT findings in the abdomen after liver transplantation as seen on 72 examinations in 23 allograft recipients are described. CT was most useful in the evaluation of the gross structural integrity of the allograft and in the detection of extrahepatic fluid collections. Low-density foci within the allograft parenchyma were seen in 10 patients (43%) and were associated with infarction and necrosis, infection, malignancy, and rejection. Localized extrahepatic fluid collections (hematomas, bilomas, and seromas) were present in 16 patients (70%); four of the focal fluid collections detected by CT were infected. Since the nature of these fluid collections could not always be determined by CT characteristics, fine-needle aspiration was sometimes required for a specific diagnosis. Prominence of the portal structures was associated with previous or ongoing episodes of rejection in eight of nine patients, likely reflecting increased resistance to portal flow. CT occasionally showed low, dense, and calcified thrombi in the donor aorta and inferior vena cava. CT also showed biliary obstruction in four patients (17%) without identifying its cause. CT is a noninvasive means of imaging the hepatic allograft recipient; providing data on the hepatic parenchyma, vasculature, and biliary system; and identifying the presence of intraabdominal fluid. PMID- 3554931 TI - Thickness of the gallbladder wall in patients with hypoalbuminemia: a sonographic study of patients on peritoneal dialysis. AB - Thickening of the gallbladder wall in patients with ascites has been attributed not to the presence of ascites but to the associated hypoalbuminemia. The contribution of hypoalbuminemia was examined by sonographically measuring the thickness of the gallbladder wall in 12 patients with chronic renal failure who were on peritoneal dialysis. All patients had hypoalbuminemia, with serum albumin levels of 2.2-3.3 g/dl (normal range, 3.5-5.0 g/dl). In all patients, the thickness of the gallbladder wall was within the normal range of less than 3 mm. In the patients studied, hypoalbuminemia was not a cause of thickening of the gallbladder wall even when peritoneal fluid was present. PMID- 3554932 TI - Multiseptate gallbladder: incidental diagnosis on sonography. PMID- 3554933 TI - Imaging techniques: metastases and tumor extension in the abdomen. PMID- 3554934 TI - Papillary adenocarcinoma of the rete testis: sonographic findings. PMID- 3554935 TI - Comparative evaluation of the pulmonary arteries in patients with right ventricular outflow tract obstructive lesions. AB - The purpose of this prospective study was to assess and compare the roles of CT, sonography, and cineangiography in the evaluation of the central pulmonary arteries. Twenty patients with severe cyanotic congenital heart disease were evaluated. In six patients, cineangiography failed to identify pulmonary arteries (four right, two left) that were seen by CT. Narrowing within the right pulmonary artery was seen more clearly by CT and sonography than by cineangiography in one third of patients. By contrast, narrowing of the origin of the left pulmonary artery shown by cineangiography was not detected by either CT or sonography in four of four patients. CT has a complementary role and should be performed when the pulmonary arteries are not well seen by cineangiography or sonography, confirmation of the patency and adequacy of the pulmonary arteries is necessary before complete repair, or documentation of interval growth of the pulmonary arteries is desired after palliative surgery. PMID- 3554936 TI - Sonography of pelvic masses in children: diagnostic predictability. AB - The usefulness of sonography in determining the location and internal consistency of a pelvic mass and in predicting a specific diagnosis was assessed in 70 girls ranging in age from neonate to 19 years. Sonography was correct in determining the site of origin in 39 of 40 surgically proven cases. Among the various sonographic patterns observed, cystic uterine masses and cystic adnexal masses were the most specific, representing hydrometrocolpos or intrauterine pregnancy and benign ovarian cysts, respectively. A nonspecific sonographic pattern was encountered with complex or solid adnexal masses, which were proven to be ovarian teratomas, hemorrhagic ovarian cysts, and pelvic abscesses. Occasionally, a specific diagnosis of ovarian teratoma could be made when echogenic foci produced shadowing in a complex adnexal mass. Our results indicate that sonography in girls is reliable in determining the site of origin of a mass and can suggest a specific diagnosis of hydrometrocolpos, benign ovarian cyst, or intrauterine pregnancy. PMID- 3554937 TI - CT of cerebral abnormalities in precocious puberty. AB - True precocious puberty occurs as a result of the premature release of luteinizing hormone-releasing hormone from the hypothalamus, which stimulates the secretion of the pituitary gonadotropins, which in turn stimulate the gonadal sex steroids. The differential diagnosis of true precocious puberty includes cerebral and idiopathic categories. This differentiation, which cannot be made endocrinologically due to similarities in pituitary gonadotropin and sex steroid levels, may be facilitated by high-resolution CT. A CT study of 90 children (73 girls and 17 boys) with true precocious puberty was performed at the NIH to detect cerebral causes of their precocious puberty. Thirty-four cerebral abnormalities were demonstrated in 32 children, 16 boys and 16 girls. These included hypothalamic hamartomas (17), hypothalamic astrocytoma (one), optic chiasm lesions (six), ventricular abnormalities (eight), arachnoid cyst (one), and teratoma (one). The CT appearance of these cerebral abnormalities is discussed and related to the endocrinologic findings and natural history of true precocious puberty. A practical neuroradiologic approach to the evaluation of children with precocious puberty is presented. PMID- 3554938 TI - Mesenchymal hamartoma of the liver in childhood. PMID- 3554939 TI - Sonography of the hypertrophied column of Bertin. PMID- 3554940 TI - Priapism complicates pharmacological treatment of severe psychosis. PMID- 3554941 TI - Alienation and the mid-nineteenth century American deaf community: a response. PMID- 3554942 TI - Routine obstetric ultrasound. AB - Routine ultrasound may have a positive effect on obstetric outcome when determination of gestational age and placental localization are combined with evaluation for multiple gestation, congenital anomalies and growth retardation. The potential risk and benefit of obstetric ultrasound must be better understood before this procedure is used as a screening tool in large populations. PMID- 3554943 TI - Postoperative hypertension after repair of coarctation of aorta in children: protective effect of propranolol? AB - The effects of the nonselective beta blocker, propranolol, on coarctectomy induced hypertension were evaluated relative to changes in cardiac function, sympathetic tone, and plasma renin activity (PRA). A randomized, placebo controlled, double-blind, age-stratified design was employed. Propranolol (n = 11, mean age 9.4 years) or placebo (n = 12, mean age 10.2 years) was started 2 days before surgery and continued until 6 days after surgery. In patients on placebo, systolic and diastolic blood pressure, heart rate, and cardiac index increased rapidly and peaked within 1 day after surgery. Over the ensuing days these increases gradually abated. Plasma epinephrine and PRA increased markedly within 12 hours after surgery, but returned quickly toward preoperative levels. In contrast, plasma norepinephrine increased more gradually and remained elevated longer. In patients on propranolol, systolic blood pressure, heart rate, cardiac index and PRA showed only negligible increases. However, diastolic blood pressure, increased even faster with propranolol than with placebo but to the same extent. Plasma catecholamines showed similar increases on the two treatments. Only in the placebo group was the code broken in the intensive care unit because of hypertension uncontrolled by sodium nitroprusside; this occurred in 6 of 12 patients. We conclude that nonselective beta blockade ameliorates the hyperdynamic circulation and increase in systolic blood pressure following coarctectomy. The initial increase in diastolic blood pressure following surgery in the propranolol group may have been caused by vascular beta-2-receptor blockade resulting in unopposed alpha-receptor-mediated vasoconstriction. PMID- 3554944 TI - Reparative operations for mitral valve incompetence: an emerging treatment of choice. PMID- 3554945 TI - Diagnosis and classification of severity of mitral valve prolapse: methodologic, biologic, and prognostic considerations. PMID- 3554946 TI - Prevalence and clinical features of mitral valve prolapse. PMID- 3554947 TI - Arrhythmias and sudden death in mitral valve prolapse. PMID- 3554948 TI - Cerebral ischemia with mitral valve prolapse. PMID- 3554949 TI - Pharmacologic causes of arrhythmogenic actions of antiarrhythmic drugs. AB - All currently known antiarrhythmic agents can induce or worsen arrhythmias. Inappropriate dosage selection, mistakenly based on pharmacokinetic data from "normal" subjects, may result in adverse reactions when an antiarrhythmic drug is given to patients. Unexpected variations in drug clearance can increase plasma concentration of antiarrhythmic agents and aggravate arrhythmias. Changes in the rate of drug metabolism by the liver, e.g., due to cessation of alcohol or drugs that induce hepatic metabolism, can reduce drug clearance, making a previously well-tolerated dose toxic. Another possible explanation for adverse drug reactions is nonlinear protein binding. Recently, genetic determinants of drug metabolism have been identified as explanations of interindividual variations in drug responsiveness. Finally, the interactions of antiarrhythmic agents may also lead to aggravation of arrhythmias. A better understanding of the pharmacology of antiarrhythmic agents can reduce, if not prevent, the occurrence of potentially lethal proarrhythmic events. PMID- 3554951 TI - Transesophageal two-dimensional echocardiographic evaluation of biventricular dimension and function during positive end-expiratory pressure ventilation after coronary artery bypass grafting. AB - Transesophageal 2-dimensional echocardiography was performed in 21 patients soon after uncomplicated coronary artery bypass grafting to determine the mechanism of positive end-expiratory pressure (PEEP) ventilation-induced decreased cardiac output. End-diastolic and end-systolic short-axis area and percent area reduction of right and left ventricles were determined during 5-cm H2O stepwise increments of PEEP ventilation. Simultaneously, cardiac output and right- and left-sided hemodynamic values were determined. Cardiac output, mean arterial pressure and end-diastolic area of both ventricles gradually decreased, and right and left atrial and pulmonary arterial pressures (mainstem and capillary wedge) increased. Left ventricular end-systolic area did not change, whereas right ventricular area decreased. Percent area reduction of both ventricles decreased (p less than 0.01). Thus, decrease in cardiac output during PEEP ventilation is primarily caused by decrease of preload rather than compromised contractility. PMID- 3554950 TI - Clinical types of proarrhythmic response to antiarrhythmic drugs. AB - The problem of drug-induced or drug-aggravated cardiac arrhythmias has been recognized for many years. Digitalis glycosides and class I, II, III, or IV antiarrhythmic drugs can cause severe sinus node dysfunction or atrioventricular block. Digitalis can cause a variety of supraventricular arrhythmias; atrial tachycardia with block and nonparoxysmal atrioventricular junctional tachycardia are the most characteristic. Recognition that class IA and class III antiarrhythmic drugs can aggravate arrhythmias or cause new arrhythmias in patients being treated for potentially malignant or malignant ventricular arrhythmias has intensified the interest in proarrhythmia in recent years. Several characteristic types of proarrhythmic response have been described. Torsades de pointes (multiform) ventricular tachycardia (VT) accompanied by prolongation of the QT interval can be caused by class IA and class III antiarrhythmic drugs as well as other drugs that bind to the membrane sodium channels of ventricular cells, for example, tricyclic antidepressants. Uniform VT in patients with malignant ventricular arrhythmias and poor left ventricular function is a characteristic proarrhythmic response to class IC antiarrhythmic drugs. Bidirectional VT or accelerated idioventricular rhythm are characteristic of digitalis toxicity. More difficult to establish as proarrhythmic responses are increased frequency of ventricular premature depolarizations and increased ease of inducing VT with programmed ventricular stimulation. PMID- 3554952 TI - Central and renal hemodynamic effects and hormonal response to diltiazem in severe congestive heart failure. AB - The central and renal hemodynamic effects and the hormonal response to single doses of 60 mg and 90 mg of diltiazem were evaluated in 10 patients with severe chronic left ventricular (LV) systolic dysfunction (ejection fraction 0.22 +/- 0.08). Diltiazem administration resulted in only mild and mostly statistically insignificant changes. After 60 mg, only heart rate (from 86 +/- 10 beats/min at baseline to 79 +/- 14 beats/min at 4 hours) and pulmonary vascular resistance (from 231 +/- 108 to 165 +/- 74 dynes s cm-5 at 4 hours) changed significantly. Administration of 90 mg of diltiazem resulted in no significant change in any of the measured or calculated central hemodynamic variables. Individual data, however, revealed an increase stroke volume index in 3 patients but a decrease in 1 patient and a persistent increase in mean pulmonary artery wedge pressure in another patient. These hemodynamic changes were not associated with symptomatic deterioration in any of the patients. Both renal blood flow and glomerular filtration rate were impaired at baseline on both days and did not show a significant change 1, 2 and 4 hours after diltiazem administration. Similarly, no significant change was noted after either diltiazem dose in plasma catecholamine levels and renin concentration. In conclusion, administration of 60 to 90 mg of diltiazem in patients with severe chronic LV systolic dysfunction results in only mild and mostly insignificant acute effects on central and renal hemodynamics, plasma hormonal levels and patient clinical status. PMID- 3554954 TI - Arteritis in cardiac rejection after transplantation. AB - During a 4-year experience with cardiac transplantation, 33 hearts were obtained by autopsy or surgical resection for retransplantation. Arteritis was a feature common to all rejected hearts (14 of 14), but was absent in explanted hearts without rejection (0 of 19) (p = 0.001). Monitoring of acute cardiac rejection by endomyocardial biopsy (863 biopsies) was also reviewed, with special reference to the incidence of arteritis. Among the 16 patients with arteritis on 1 or more biopsies, 44% (7 patients, confidence limits 29 to 60%) suffered fatal rejection or underwent retransplantation because of irreversible rejection. Arteritis was seen in the small vessels obtained by endomyocardial biopsy in 4 of 5 persons who underwent biopsy within 3 days of death or retransplantation due to rejection and on none of the 6 persons who underwent biopsy within 3 days of death or retransplantation for causes other than rejection. Thus, arteritis is an important indicator for severe acute rejection, and although often reversible, may identify patients at higher risk for fatal rejection. Arteritis occurred in transplanted hearts subjected to varying combinations of cyclosporine, azathioprine and steroid therapy and could not be correlated with any drug regimen. PMID- 3554953 TI - Influence of recipient atrial contraction on left ventricular filling dynamics of the transplanted heart assessed by Doppler echocardiography. AB - Recipient atrial remnants retain electrical and mechanical activity after orthotopic cardiac transplantation. This study investigated the influence of recipient atrial contraction timing on Doppler ultrasound mitral flow velocity curves, isovolumic relaxation time, peak early mitral flow velocity (M1), mitral valve pressure half-time and peak mitral flow velocity due to atrial systole (M2). Clearly identifiable recipient atrial electrical activity (P waves) was present in 7 of 10 patients studied early postoperatively 2 to 6 months (mean 2.5) (early group) and in 20 of 24 patients seen 1 to 11 years (mean 3) after transplantation (late group). Median age and gender distribution were similar in both groups. For analysis of its influence on isovolumic relaxation time, pressure half-time and M1, recipient atrial contraction was classified by its position in the cardiac cycle as early systole, late systole or diastole. For analysis of M2, it was classified as early diastole, late diastole or systole. Compared with its occurrence in diastole, recipient atrial contraction in late systole was associated with a shorter isovolumic relaxation time, shorter pressure half-time and higher M1. In early systole it was associated with a longer pressure half-time and lower M1 than in diastole; isovolumic relaxation time was unchanged. Recipient atrial contraction in early diastole resulted in a lower M2 than in systole, whereas simultaneous contraction of recipient and donor atria in late diastole resulted in an increase in M2. These results indicate that the timing of recipient atrial contraction and relaxation significantly influences left ventricular filling dynamics. PMID- 3554955 TI - From irritable heart to mitral valve prolapse: World War I. The U.S. experience and the origin of neurocirculatory asthenia. PMID- 3554957 TI - Cyclosporine-induced pericardial effusion after cardiac transplantation. PMID- 3554956 TI - Rethinking sensitivity and specificity. PMID- 3554958 TI - Quantitative immunocytochemical analysis of the endocrine pancreas of the Nile crocodile. AB - Four major pancreatic hormones were immunolocalized at the light and electron microscopic levels in the pancreas of the Nile crocodile, Crocodilus niloticus. Immunogold was used for electron microscopy, and peroxidase-antiperoxidase was used for light microscopy. Somatostatin-positive D-cells and pancreatic polypeptide-containing F-cells accounted for about 60% of the immunoreactive cells in the ventral pancreas. Glucagon-positive A-cells were the least frequent cell type in the ventral pancreas, about 15%, but were the predominant cell type, about 40%, in the pancreas that was dorsal in character. An expanded population of D-cells (relative to mammals and other higher vertebrates) in association with two very different numbers of A-cells can be expected to have important consequences for the homotropic control of secretory activity of the endocrine pancreas as well as for the function of the acinar pancreas. F-cells were absent from the dorsal part of the pancreas, whereas insulin-containing B-cells were slightly more abundant in this portion of the pancreas. The regional character of the endocrine pancreas was related to the complex looping of the proximal small intestine. Without immunolabeling, only B-granules were morphognomonic in electron micrographs. The insulin-reactive B-granules were the smallest (370 nm) of the secretory granules and were followed in size by somatostatin-positive D granules (380 nm). The pancreatic polypeptide-containing secretory granules were the largest (580 nm). Glucagon-reactive A-granules (430 nm) sometimes exhibited a protuberance or extension of secretory granule matrix and limiting membrane. Such a morphological feature has previously been associated with secretion of glucagon and the initiation of insulin secretion. Taken together these studies indicate that protuberances have a significant, but as yet undefined, role in pancreatic endocrine cells. PMID- 3554959 TI - Characterization of filaments within Leydig cells of the rat testis. AB - Rat Leydig cells were permeabilized and the cytoplasm partially extracted to visualize, describe, and characterize filamentous elements of the cytoskeleton. It was demonstrated by immunofluorescence microscopy that vimentin is abundant within Leydig cells. Ultrastructurally, intermediate filaments in Leydig cells were concentrated at perinuclear sites and comprised bundles that coursed through the cytoplasm. Actin was identified in Leydig cells with the F actin probe, NBD phallacidin. Fluorescence was strongest at the cortex of the cell. With myosin S 1 subfragments, sparse actin was found positioned almost exclusively in cortical regions of the cell associated with coated pits and in Leydig cell processes. PMID- 3554960 TI - Micronutrient status in diabetes mellitus. AB - Diabetes mellitus is a chronic metabolic disorder, which can alter the nutritional status of the individual. Some micronutrients, in particular zinc and chromium, have been implicated in the pathogenesis of carbohydrate intolerance. This review evaluates the available published data on the status of 10 mineral elements and seven vitamins in diabetic patients and experimental animal models of diabetes. The role of these micronutrients in insulin secretion and carbohydrate metabolism is discussed in an attempt to determine whether the reported alterations in serum or tissue content of minerals or vitamins contribute to the carbohydrate intolerance of diabetic patients. It is concluded that both Type I and Type II diabetes mellitus can result in changes in certain micronutrients. However, adequately controlled studies to establish the role of trace elements in the pathogenesis of diabetes mellitus are not available. PMID- 3554961 TI - Atwater: a personal tribute from the United Kingdom. PMID- 3554962 TI - Intensive insulin therapy justifies simplification of the diabetes diet: a prospective study in insulin-dependent diabetic patients. AB - Dietary and metabolic variables were investigated in 48 unselected, nonobese Type 1 (insulin-dependent) diabetic patients before and 3 mo after changing from (a) traditional insulin and diet therapy to (b) intensified insulin plus simplified diet therapy. HbA1c levels declined significantly from 9.04 +/- 0.25% with therapy (a) to 8.34 +/- 0.16% with therapy (b) (p less than 0.005). During (a), 58% of all patients used a personal diet plan, but only 15% of them performed food exchange according to the traditional diet prescription. Their eating habits remained unchanged during (b). Since improved metabolic control in this study could be obtained without adherence to traditional diet schedules, a simplification of the traditional diabetes diet prescription seems justified for nonobese Type 1 diabetic patients on intensified insulin therapy. PMID- 3554963 TI - Concurrent ingestion of fat and reduction in starch content impairs carbohydrate tolerance to subsequent meals. AB - We examined the effect of breakfasts of different macronutrient compositions on blood glucose and insulin levels after a standard lunch fed 4 h later. Fat containing breakfasts were compared with a breakfast of equal carbohydrate and protein content and another with higher carbohydrate but equal calorie content. Concurrent ingestion of fat resulted in a large impairment of glucose tolerance following the standard lunch 4 h later. There was no significant difference in glucose and insulin if the fat eaten was butter or peanut butter. When the fat breakfast was compared with the isocaloric larger carbohydrate meal, the effect of fat on carbohydrate tolerance at lunch was even greater. Part of the reason for this additional difference is an improved glucose tolerance at lunch due to the higher carbohydrate content of the breakfast. Concurrent ingestion of fat and reduction of starch content have a persistent effect on carbohydrate tolerance to subsequent meals. PMID- 3554964 TI - Diet and health: scientific concepts and principles. Proceedings of a symposium. Alvor, Algarve, Portugal, October 19 through 22, 1986. Dedicated to Henry J. Heinz II. PMID- 3554965 TI - Evolution of dietary recommendations, goals, and guidelines. PMID- 3554966 TI - Transitions in health status: implications for dietary recommendations. PMID- 3554967 TI - Polyunsaturated fatty acids (n-3, n-6). PMID- 3554970 TI - Dietary carbohydrates and dental disorders. PMID- 3554969 TI - Dietary carbohydrates in the prevention and treatment of metabolic diseases of major public health importance. PMID- 3554968 TI - Complex carbohydrates: replacement energy for fat or useful in their own right? PMID- 3554971 TI - Protein intake and requirements with reference to diet and health. AB - We have reviewed, in brief, various aspects of human protein and amino-acid metabolism with particular reference to the assessment of protein and amino acid needs. The current requirements for protein and amino acids in various groups of healthy people were then summarized. Emerging from this discussion was the view that some plant protein foods, such as soy for example, are of much better nutritional value for humans than has been commonly appreciated. The figures for requirements were then compared with intakes characteristic of populations in the developed regions of the world. It is evident that these intakes greatly exceed the minimum physiologic need for most healthy individuals but little is known about the possible health benefit or otherwise of these intake levels of protein. Furthermore, also it was pointed out that consideration of different food proteins in relation to amino acid and nitrogen requirements constitutes an important, but only an initial, basis for evaluating the role of dietary protein and of various food protein sources in human nutrition and health. Different food protein sources influence, in various ways, the utilization of and possibly requirements for other nutrients. This complicates determination of requirements and the setting of rational and safe dietary allowances as well as of dietary guidelines for individuals and population groups. A further assessment of the role and impact of food proteins and their interrelationships with and interactions among other foods and essential nutrients, particularly with respect to the nutritional and metabolic status of free-living individuals and their long term health, presents a difficult but exciting research challenge to nutrition and other health professionals. PMID- 3554972 TI - Endothelial cell phenotypic diversity. In situ demonstration of immunologic and enzymatic heterogeneity that correlates with specific morphologic subtypes. AB - Some endothelial cells share functional and phenotypic properties with cells of monocyte/macrophage lineage. The authors have performed frozen-section immunologic stains and plastic section enzyme histochemical stains on various human tissues to examine endothelial cell phenotypic properties in situ. They found that endothelial cells express heterogeneous phenotypes that correlate with vessel type. Several endothelial cell subsets were identified. These included arterioles, capillaries, and venules (HLA-ABC+, HLA-DR+, Factor VIII RA+, monocyte-, alkaline phosphatase+, ATPase+); high endothelial venules of lymphoid tissues and hepatic sinusoidal lining cells (HLA-ABC+, HLA-DR+, Factor VIII RA+, monocyte+); lymphatics and glomerular capillaries (HLA-ABC+, HLA-DR+/-, Factor VIII RA-, monocyte-, 5'nucleotidase+); splenic sinusoidal lining cells (HLA-ABC+, Leu-2+, HLA-DR+, Factor VIII RAweak+, monocyte-, alpha naphthyl acetate esterase+); umbilical cord vessels (Factor VIII RA+, HLA-ABCweak+, HLA-DR-, monocyte-). The expression of monocyte-related antigens by some endothelial cells appears to be acquired in extranodal inflammatory infiltrates and is probably modulated by lymphokines. PMID- 3554973 TI - Protection of renal cells against free radical damage in vitro. A morphologic and functional study on human and rabbit kidney cells. AB - The morphologic and functional effects of free radicals on renal cells in vitro were investigated, as well as the possibility of avoiding them by pretreatment with scavenger enzymes or a xanthine oxidase inhibitor. Cultured human kidney cells, incubated together with a free radical-generating system, with and without protective agents, were examined by light and scanning electron microscopy. The vimentin filament structure of the incubated cells was visualized by immunofluorescence. The membrane function was studied in human kidney cells by using a dye exclusion test and in rabbit kidney slices by determination of the sodium-potassium pump activity. Exposure of the cells to free radicals caused rapid development of severe morphologic lesions, including extensive cytoskeletal disorganization. After pretreatment, only a few cells had similar, although less severe, lesions. The results of the dye exclusion test and indirect evaluation of the sodium-potassium pump activity did not indicate any major damage to the cell membranes after exposure to free radicals. PMID- 3554974 TI - The use of an expert system in the clinical laboratory as an aid in the diagnosis of anemia. AB - Experience with an expert system developed for the purpose of classification of anemias is presented. Input for this system consists of limited demographic information on each patient and the results of the complete blood count, with the incorporation of the results of further chemical testing (serum iron/total iron binding capacity/ferritin and serum B12/serum folate/red blood cell folate), if indicated. Performance of this system is demonstrated using data from 84 patients seen in the authors' laboratory selected either because of a request for evaluation by the attending physician or because of significant anemias. Using this limited input, the system was able to accurately classify 74 of 84 (88%) of cases according to previously established criteria. The output from the system is overread by a pathologist. Future directions are also discussed. PMID- 3554975 TI - Presence of HTLV-III antibodies in immune serum globulin preparations. AB - The authors tested 15 immune serum globulin pharmaceutical preparations for antibody reactivity to human T cell lymphotrophic virus type III (HTLV-III) by the Abbott immunoenzymometric assay (IEMA). Although no evidence of HTLV-III infectivity has appeared after injection of similar preparations into humans, the authors found all samples IEMA reactive. Upon dilution, the authors demonstrated parallel decreases of antibody reactivity among two samples of gamma globulin, the Abbott-positive control, and a markedly reactive patient specimen. Gamma globulin isolated from sera of six animal species was nonreactive in the Abbott assay. All samples were nonreactive with the H-9 cell line antigen. Antibody reactivity to HTLV-III was confirmed in 13 of 15 gamma globulin samples when tested by the Electro-Nucleonics IEMA, and 14 samples contained at least the p24 band on Western blot analysis. Although false positivity occurs in IEMA assays possibly because of elevated protein concentrations and nonspecific binding, the authors, results show that in most circumstances immune serum globulin preparations tested do contain true reactivity to HTLV-III. PMID- 3554977 TI - Are the discrepancies between urine dipstick testing and microscopic examinations clinically important? PMID- 3554976 TI - Lupus erythematosus cells in serum and pleural fluid of a patient with negative fluorescent antinuclear antibody test. AB - The authors report here a 61-year-old male with anemia, arthritis, and pleural effusions who had lupus erythematosus (LE) cells in the pleural fluid and a strongly positive LE cell test in the blood. However, the fluorescent antinuclear antibody (FANA) assay performed repeatedly with the serum always had negative results, despite the use of various technics. The patient was considered to have systemic LE and responded well to treatment with corticosteroids. Although the authors could not explain the LE cell-FANA incongruity, they suggest that the LE test not be deleted from the clinical laboratories' tests. PMID- 3554978 TI - Normal radiographic anatomy and common anomalies seen in cephalometric films. AB - Lateral and posteroanterior cephalometric radiographs are used routinely in the diagnosis and quantification of dentofacial anomalies that require orthodontic treatment. The anatomic information that these films contain is occasionally overlooked as the clinician prepares tracings and makes measurements. With the increase of the average age of the orthodontic patient population, there is greater likelihood of the presence of disease. This article describes some important features of normal radiologic anatomy of the head and neck so that a clinician can better recognize pathologic changes. Common pathologic findings and anatomic anomalies are also illustrated. PMID- 3554979 TI - Orthopedic/orthodontic treatment of a Class I malocclusion with a Class III skeletal pattern and maxillary deficiency. An American Board of Orthodontics case report. AB - A case report of a Class I dental malocclusion superimposed on a Class III skeletal pattern with normal mandible and underdeveloped maxilla is presented. The patient was a 15-year-old girl whose statural growth was complete. The maxilla was deficient in anteroposterior and transverse dimensions, causing a slightly concave profile, a crossbite relationship of most of the anterior and posterior teeth, and upper anterior crowding. Sutural expansion and orthopedic advancement of the maxilla was used to reduce the maxillary deficiency. A complete 0.018-inch slot straight-wire appliance was used to align the teeth, close lower spaces, and detail the occlusion. PMID- 3554980 TI - Somatic growth after kidney transplantation. Beneficial effect of cyclosporine in comparison with conventional immunosuppression. AB - Growth performance was evaluated in 69 children, aged 3 to 16 years, who had undergone kidney transplantation between 1974 and 1984. Forty children (21 boys, 19 girls) who received transplants before September 1982 were treated conventionally with azathioprine and high-dose prednisolone; 29 children (13 boys, 16 girls) who received transplants after September 1982 were treated with cyclosporine and low-dose prednisolone. The mean (+/- SD) survival times of grafts in the azathioprine and cyclosporine groups were 6.0 +/- 2.1 years and 1.4 +/- 0.5 years, respectively. Height and bone age were evaluated at the time of transplantation, one year after transplantation, and at reevaluation in December 1985. Growth rates expressed by standard deviation scores (SDS) declined in the azathioprine group for boys (mean, -2.2 at transplantation, -2.5 after one year, and -2.8 in December 1985) and girls (-2.1, -2.4, and -2.7) and improved in the cyclosporine group for boys (-2.5, -2.2, and -2.1) and girls (-2.2, -1.9, and 1.8). The difference between both groups one year after transplantation was significant. This trend continued beyond the first year after transplantation. Graft function was better in the azathioprine group than in the cyclosporine group. Bone age in December 1985 was less retarded in the cyclosporine group, but this could have been related to the shorter observation time. We conclude that somatic growth after kidney transplantation is below expected rates under azathioprine-prednisolone immunosuppression but is significantly better under cyclosporine-prednisolone immunosuppression. PMID- 3554982 TI - Surreptitious insulin administration. PMID- 3554981 TI - Linear growth following pediatric liver transplantation. AB - The linear growth of 29 patients was evaluated from two to 41/2 years after liver transplantation. All patients received cyclosporine and low-dose prednisone. Eight patients (28%) displayed acceleration of linear growth velocity and were above the fifth percentile at the end of the evaluation period. Four patients (14%) grew normally prior to transplantation and continued to grow normally after the surgical procedure. Only four patients (14%) dropped from higher levels to below the fifth percentile. Thirteen patients (45%) were less than the fifth percentile before and after surgery; ten of these 13 patients have attained normal or accelerated growth velocity. Good linear growth has been achieved in more than three fourths of patients who underwent liver transplantation. PMID- 3554983 TI - Sickle cell anemia. Report of two cases in children, with necropsy in one case. By V.P. Sydenstricked, W. A. Mulherin, and R. W. Houseal, 1923. PMID- 3554984 TI - Pathologic significance of nephromegaly in pediatric disease. AB - Ultrasonic renal volume and length measurements are easily performed in pediatric patients. Increases in volume over the normal level provide a potentially attractive method of assessing the severity and progression or regression of renal diseases. However, an analysis of data on 59 children with clinical renal disease and nephromegaly did not demonstrate any correlation with severity of the disease. We conclude that increases in renal length and volume in pediatric patients may indicate the presence of disease but not its severity. PMID- 3554986 TI - A history of forensic odontology in Canada. PMID- 3554985 TI - Medical management of chronic middle-ear effusion. Results of a clinical trial of prednisone combined with sulfamethoxazole and trimethoprim. AB - Prednisone for seven days plus the combination drug sulfamethoxazole and trimethoprim for 30 days was assessed in treating chronic middle-ear effusion present for at least eight weeks. Pneumatic otoscopy, tympanometry, and audiology at entry into the study, and one week and one month after therapy, documented the status of the middle-ear effusion. Clearing in both ears or in one when only one was involved was called complete resolution; clearing in one of two affected ears was called partial resolution. In the initial open trial, 13 of 24 patients experienced partial or complete resolution one month after therapy. Subsequently, 28 patients were enrolled in a randomized, double-blind, placebo-controlled clinical trial in which patients whose effusion failed to clear were crossed over to the alternative regimen. In this trial, ten treated children (71%) experienced partial or complete resolution one month after therapy compared with three (21%) in the control group. Patients enrolled in both trials whose effusion cleared were followed up monthly for six months. Seven of 29 patients required referral for ventilation tubes. PMID- 3554987 TI - Death associated with inadvertent hydrocodone overdose in a child with a respiratory tract infection. AB - A 3-year-old child died of the combined effects of a bacterial superinfection and a relative overdose of hydrocodone prescribed for a cough due to a presumed viral respiratory tract infection. This case illustrates the importance of evaluating the effects of prescribed medication in assessing the cause and mechanism of death in children dying suddenly of presumed natural disease. PMID- 3554988 TI - Tragedy at Tunnel 13. The d'Autremont brothers and "The Edison of Crime Detection". AB - Train robbery was frequent in the United States from the late 1800s through the 1920s. On October 11, 1923, the southbound Southern Pacific Express was halted by three men at Tunnel 13 in southern Oregon just north of the California line. The railway mail car carrying +40,000 was then blown apart by an explosive charge, killing the clerk and rendering the money unobtainable. The men shot three other train crew members before escaping into the mountains. The investigation was headed by Chief Agent Dan O'Connell, who soon asked that California criminalist, Edward Heinrich, examine soiled overalls found nearby. Using primarily botanical evidence, Heinrich identified them as those of a woodsman, leading to the identification of three Oregon d'Autremont brothers as suspects. After an intensive manhunt, one was captured 3 years later in the Philippines and was tried and found guilty. The twins, captured in Ohio, then pleaded guilty. This crime, typical of those in which unforeseen events lead the perpetrators to panic and to murder, helped to establish criminology and particularly botanical studies as valid scientific disciplines. Its investigation and solution also remain models of scientific crime detection. PMID- 3554989 TI - Anorectal physiology and pathophysiology. AB - The anatomy and physiology of the external anal sphincter, puborectalis muscle, internal anal sphincter, and rectum are described. Measurement techniques are reviewed emphasizing those which can be carried out by the gastroenterologist in independent office practice, and the range of normal values for each test is given. A protocol for diagnostic evaluation of anorectal disorders is recommended which includes testing for rectal prolapse and for descent of the perineum by having the patient strain while seated on a commode chair, evaluating the external and internal anal sphincters by recording EMG with an anal plug, or recording pressures with a perfused catheter or balloon probe, using a rectal balloon to evaluate the maximum tolerable volume of rectal distension and the minimum (threshold) volume of a bolus injection which can be subjectively perceived, and arranging with a radiologist to perform a proctogram--a radiograph of the rectum and anal canal during rest and when the patient strains to defecate -in order to evaluate the anorectal angle (puborectalis muscle) and to detect rectocele and intussusception. These objective tests should be supplemented by a careful clinical history and physical examination. PMID- 3554990 TI - Do endoscopic findings influence response to H2 antagonist therapy for gastroesophageal reflux disease? AB - As part of a multicenter trial evaluating ranitidine in the treatment of gastroesophageal reflux disease, the therapeutic responses of patients with and without abnormal endoscopic findings were evaluated. All patients were randomized to either placebo or ranitidine (150 mg bid) treatment groups. The treatment interval was 6 wk. Thirty-seven percent of 283 patients enrolled in the trial had normal baseline endoscopy. Compared to the placebo group, 147 evaluable ranitidine patients with abnormal endoscopy displayed a marked and rapid symptom reduction which was sustained throughout the last 4 wk of therapy. Despite randomization of endoscopically normal patients, those treated with ranitidine had significantly more heartburn at baseline. However, the 89 evaluable ranitidine-treated patients with normal endoscopy also experienced a marked and rapid reduction in heartburn at the end of 1 wk. The symptomatic improvement in the endoscopically abnormal ranitidine patients was significantly greater (p less than 0.05) than that observed in the endoscopically normal ranitidine group. Since both groups fared better on ranitidine than placebo, the results of this study indicate that ranitidine is an effective treatment for patients with heartburn symptoms and documented esophageal acid sensitivity whether or not endoscopic parameters for esophagitis are present. PMID- 3554991 TI - Levamisole in Crohn's disease: a randomized, double-blind, placebo-controlled clinical trial. AB - To evaluate the efficacy of levamisole in the treatment of Crohn's disease, 19 patients were entered into a long-term, randomized, double-blind, placebo controlled clinical trial. Seventeen patients (eight in the levamisole group and nine in the placebo group) completed the initial treatment arm of the study. Assessments made at 4- and 12-month intervals failed to show any statistically significant difference between the two groups. Sixteen patients embarked on the second segment of the study; six were continued on the same initial therapy while the remaining 10 were crossed over to the alternate treatment. Again, analysis of the clinical scores did not reveal any beneficial effect of levamisole; in fact, all three patients who remained on levamisole for a period of 12 months after cross-over showed deterioration. The overall dismal results have provided no basis for enthusiasm for levamisole in the treatment of Crohn's disease. PMID- 3554992 TI - Neoplasms of plasma cells: morphological diagnosis? PMID- 3554993 TI - Kidney function in pregnant women. AB - In pregnancy, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) increase to levels approximately 50% to 80% above nonpregnant levels. The increments occur shortly after conception and persist throughout the second trimester, with some reduction in late pregnancy. There is no accelerated growth akin to compensatory hypertrophy. The increased excretion of glucose and other nutrients in as well uric acid and protein is related in part to altered tubular function. These changes in renal physiology are so marked that nonpregnant norms cannot be used for the management of pregnant women. Cognizance of all these alterations is essential if kidney problems in pregnancy are to be suspected, detected, and managed correctly. PMID- 3554995 TI - The determinants of renal hemodynamics in pregnancy. AB - Studies in the rat have permitted a complete characterization of the glomerular hemodynamic changes that occur during a normal pregnancy. The rise in glomerular filtration rate (GFR) is the result of an evenly distributed increase in plasma flow to all nephrons due to vasodilation of both pre- and postglomerular resistance vessels. Pregnancy is not associated with any change in blood pressure in the glomerular capillaries; neither is there any detectable alteration in the glomerular water permeability or filtration surface area. Despite the chronically maintained renal vasodilation of pregnancy, gravid rats exhibit substantial renal reserve when challenged with an amino acid load, indicating that a residual renal vasodilatory capacity exists in the kidney of the normal pregnant animal. Despite the concomitant plasma volume expansion of pregnancy, the tubuloglomerular feedback system (a volume regulatory system that modulates GFR) remains fully active in the pregnant rat, suggesting that the plasma volume in pregnancy is not sensed as expanded by this system. The factor(s) that initiates the gestational rise in GFR is currently unknown, although since similar renal hemodynamic changes occur in the pseudopregnant rat, the stimulus is maternal rather than fetoplacental in origin. PMID- 3554996 TI - Renal tubular function in gestation. AB - During pregnancy, the filtered load of most ions and small-mol wt solutes increases. Overall, sodium, water, and potassium reabsorption increases, as does excretion of calcium and glucose. Many of the changes occur in the proximal tubule or the loop of Henle. The mechanisms underlying the changes are discussed. PMID- 3554994 TI - Possible mechanisms for changes in renal hemodynamics during pregnancy: studies from animal models. AB - Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) increase during gestation in humans, rats, rabbits, dogs, and sheep. Serial studies performed in chronically instrumented conscious pregnant rats show that the relative time course of changes in renal hemodynamics resembles that of human pregnancy. Because gestational alterations of renal hemodynamics in humans are similar to those in other mammalian species, animal models are being used to investigate possible mechanisms for these changes. In gravid rats and rabbits, vasodilatory prostaglandins most likely do not mediate the increase of GFR and ERPF. Chronic administration of prolactin has been tested in nonpregnant rats, and although some studies suggest that this hormone can augment renal hemodynamics, others do not. The decline in GFR and ERPF, which in rats occurs close to term despite ongoing increments of plasma volume, does not appear to be mediated by angiotensin II. Cyclic guanosine 3',5'-monophosphate (cGMP) is increased in the plasma of pregnant rats, and urinary excretion rates are also enhanced. Research is presently continuing to determine if intracellular and/or extracellular cGMP contribute to the vasodepressor phenomena observed during pregnancy. PMID- 3554997 TI - Water homeostasis and vasopressin release during rodent and human gestation. AB - Body tonicity decreases during both human and rodent gestation, manifested by a decrease in Posm of approximately 10 mosm/kg. In humans, the decrease in the osmotic threshold for thirst may precede decrements in the arginine vasopressin (AVP) secretory threshold by several weeks, whereas the metabolic clearance rate of AVP appears markedly increased in the third trimester. The cause of these osmoregulatory changes are unclear, since through 1986 we have been unable to implicate placental extracts, estrogens, progesterone, prolactin, angiotensin II, and certain endorphins in the decreased Posm observed during rat pregnancy. Changes also occur in volume-AVP secretory relationships in pregnancy. For instance, the volume-sensing AVP release mechanisms are altered during gestation in Sprague-Dawley rats in such a way that the increased intravascular volume is recognized as normal. PMID- 3554998 TI - Diabetes insipidus in pregnancy. AB - Diabetes insipidus (DI) and pregnancy may coexist and, when they do, present challenging diagnostic and therapeutic problems. Women with preexisting central DI usually experience increased thirst and require additional hormone replacement. Women with nephrogenic DI have an increased water turnover. Of interest is a group of women with transient DI of gestation. In some of these patients, central DI is brought to the fore by increases in water turnover during pregnancy as well as increments in the metabolic clearance of arginine vasopressin (AVP), especially near term. Others have a "vasopressin-resistant" form of the disease, which in one case followed by us appeared to be due to marked increments in circulating cystine-aminopeptidase (vasopressinase). This patient's DI was resistant to pitressin, but she concentrated her urine when given dDAVP. Her vasopressinase levels 2 weeks postpartum were still several-fold those of normal term gravidas. Her DI remitted, and she concentrated her urine appropriately 2 months postpartum. This article reviews the different forms of DI peculiar to pregnancy. PMID- 3554999 TI - Pregnancy: an overfill or underfill state. AB - With pregnancy, the expansion of plasma and extracellular fluid volume, increased cardiac output, and increased glomerular filtration rate (GFR) and renal blood flow (RBF) are compatible with primary renal sodium and water retention with secondary enlargement of the vascular compartment (overfill hypothesis). Alternatively, a primary enlargement of the vascular compartment (eg, prostaglandin-mediated vasodilation and placental arteriovenous shunting) with secondary renal sodium and water retention (underfill hypothesis) is supported by the activation of the renin-angiotensin-aldosterone (RAA) system, resetting of vasopressin release and thirst to a lower plasma osmolality, and a further stimulation of the RAA system and vasopressin when pregnant rats' water intake is maintained at a level of a virgin rat fluid intake, diminished BP and increased cardiac output in the first trimester, and worsening of hyponatremia with sodium restriction in the pregnant but not the virgin rat. With the underfill hypothesis, normal sodium and water excretion with mineralocorticoid escape could be mediated by hormonally induced increases in GFR and RBF associated with pregnancy. The nature of such a hormone effect of pregnancy to enhance renal hemodynamics remains to be defined. PMID- 3555000 TI - Control of sodium excretion in human pregnancy. AB - Sodium and water retention are normal accompaniments of pregnancy achieved by many significant and complex interrelated alterations in homeostatic forces. Furthermore, potentially harmful derangements in sodium and volume control are found in women with pregnancy-associated hypertension (P-AH, preeclampsia). None of these alterations is completely understood, and many of them appear paradoxical. Recent reviews examined some of the more closely investigated facets of sodium and volume control in normal and hypertensive pregnancy. This relatively brief discussion aims to summarize the known information, update it with more recent work, and speculate on the potential significance of abnormalities in sodium homeostasis in hypertensive pregnancy. PMID- 3555001 TI - Volume homeostasis during pregnancy in the rat. AB - This article reviews alterations in volume and sodium handling during rat pregnancy, noting similarities and contrasts to events in human gestation. Gravid rodents undergo extracellular and plasma volume increases of 50% to 70%, and these changes accompany a marked cumulative sodium retention shared by both dam and fetuses. Pregnancy alters several factors, with opposing effects on renal salt handling; however, mechanisms by which gestational sodium accumulation and volume expansion are achieved remain obscure. Furthermore, despite substantial increases in absolute blood volume, considerable uncertainty exists as to how this volume is sensed, particularly during the final gestational week when a rapid increase in volume is associated with decreases in peripheral resistance and BP. Attempts to assess "effective" intravascular volume by measuring responses to intravenous (IV) or oral sodium loading or to chronic mineralocorticoid administration indicate that pregnant and nonpregnant rats respond similarly, suggesting that such animals sense their volume as normal. In contrast, when salt-restricted, gravid rats fail to expand their plasma volume normally; this relative hypovolemia activates mechanisms leading to free water retention and pathologic hyponatremia, responses not observed in virgin animals. PMID- 3555002 TI - Control of vascular reactivity in pregnancy. AB - Human pregnancy is characterized by a blunted pressor responsiveness to vasopressor substances. This was first reported by Dieckmann and Michel in 1937 in experiments in which they measured vascular reactivity to the pressor effects of a crude preparation of vasopressin. Recently, this has been reported to occur in response to epinephrine, norepinephrine (NE), and angiotensin II (AII). Gant and associates reported that the increasing vascular sensitivity to infused AII not only was characteristic of women who developed pregnancy-induced hypertension, but in fact preceded the development of pregnancy-induced hypertension. Although a variety of factors may mediate this blunted pressor responsiveness, the most likely candidate appears to be the localized production within endothelium and/or vascular smooth muscle of prostaglandins. Indeed, administration of indomethacin or aspirin results in an increased sensitivity to infused AII in normotensive previously AII-refractory women. Administration of the steroid hormone 5 alpha-dihydroprogesterone reverses this apparent prostaglandin-mediated response. In addition, administration of the phosphodiesterase inhibitor, theophylline, results in a restoration of vascular refractoriness to infused AII in women with pregnancy-induced hypertension or in women destined to develop pregnancy-induced hypertension. Although a variety of known and possibly unknown compounds might also effect the control of vascular reactivity during human pregnancy, the prostinoids appear to play a pivotal role in mediation of control of vascular reactivity during human pregnancy. PMID- 3555003 TI - Decreased pressor responsiveness in pregnancy: studies in experimental animals. AB - Pregnant animals of several species are resistant to the pressor effects of vasoconstrictor substances. Although a blunted pressor response to angiotensin II (AII) has been most thoroughly documented, resistance to the pressor effects of norepinephrine (NE), and arginine vasopressin (AVP) has also been found. In this review, possible mechanisms for decreased pressor responsiveness are discussed. Although antagonism of vasoconstriction by vasodilatory prostaglandins is the most likely cause for decreased pressor responsiveness in pregnancy, other possibilities have been proposed. Reduced pressor responsiveness to AII occurs in many conditions other than pregnancy, and the mechanisms involved include down regulation of AII receptors, increased production of vasodilatory prostaglandins (as in pregnancy), and post-receptor defects in AII action. Several recent studies have also suggested a role of the sex hormones, particularly 17-beta estradiol and prolactin, in stimulating prostaglandin production and causing the decreased pressor response to AII in pregnancy. PMID- 3555004 TI - The clinical spectrum of preeclampsia. AB - Though classically a disease of the near term nullipara, the chameleonlike presentation of preeclampsia makes the diagnosis at times difficult and in most circumstances presumptive. A high index of suspicion is important. Early and frequent prenatal examinations coupled with laboratory parameters should reduce diagnostic error. PMID- 3555005 TI - Therapy of non-preeclamptic hypertension in pregnancy. AB - The poor perinatal outcome of pregnant women with chronic hypertension depends on their increased susceptibility to superimposed preeclampsia. There is no direct evidence that this is mediated by hypertension and reduced by antihypertensive treatment. In particular, the arterial lesions of the uteroplacental circulation in preeclampsia also occur in normotensive individuals and would be unusual types of pressure-induced injury. Thus, there is no compelling reason for treating hypertension below a threshold (170/110 mm Hg) above which maternal safety becomes the main concern. PMID- 3555006 TI - Pregnancy in IgA nephropathy, reflux nephropathy, and focal glomerular sclerosis. AB - Fetal outcome was retrospectively studied in 217 pregnancies observed during the past two decades in 93 patients, 34 suffering from IgA nephropathy (IgAGN, 69 pregnancies), 53 from reflux nephropathy (RN, 137 pregnancies), and six from focal glomerular sclerosis (FGS, 10 pregnancies). Overall incidence of live births was 175 in 217 (81%). Fetal loss, corrected for induced abortions, was 10 in 66 (15%) in IgAGN, 18 in 129 (14%) in RN, and 2 in 10 in FGS. Renal failure and hypertension preexisting prior to conception or developing early in pregnancy were the most important factors associated with unsuccessful fetal outcome whereas urinary tract infection had limited effects in RN patients. Influence of pregnancy on the course of maternal renal disease was evaluated in the same groups of patients. An abnormally rapid deterioration of renal function was observed in three of the women with IgAGN and in one of the RN patients (with an additional case among 46 further female RN patients) but in none in the FGS group. All five women experiencing functional deterioration had a serum creatinine (SCr) level of greater than or equal to 200 mumol/L (2.3 mg/dL) and hypertension at conception. Hypertension in pregnancy was highly predictive of recurrence of hypertension in subsequent pregnancy and of the remote development of permanent hypertension in IgAGN patients. We conclude that when renal function is preserved, pregnancy is usually successful and no deleterious effects on maternal renal disease are to be expected in patients with IgAN, RN, and probably FGS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555007 TI - Effect of diabetic nephropathy on pregnancy. AB - Because the metabolic changes in normal pregnancy are diabetogenic, pregnancy imposes a severe stress on the metabolic milieu of diabetic patients. Moreover, some patients with long-standing diabetes have vascular complications, including renal insufficiency and hypertension, that represent separate risk factors for optimal fetal development. During the past two to three decades, maternal mortality has been eliminated and perinatal deaths have been reduced in all classes of diabetic patients, including those with diabetic nephropathy, to a level approaching that of normal pregnant women. Fetal and neonatal morbidity have also been reduced, although rates of congenital abnormalities and respiratory disease syndrome remain high. In patients with significant vascular complications, such as nephropathy and retinopathy, pregnancy evidently does not alter the natural course of these complications. With meticulous metabolic control and fetal surveillance, however, women with diabetic nephropathy without severe renal insufficiency or severe hypertension can anticipate a pregnancy outcome similar to that of other insulin-dependent diabetic patients. PMID- 3555008 TI - Renal disease in gravid animal models. AB - Micropuncture studies in the rat have indicated that in the short term, the superimposition of pregnancy on an experimentally induced, advanced, autologous phase glomerulonephritis (GN) does not lead to any worsening of the functional or morphological changes characteristic of this disease. Indeed, pregnant rats with GN exhibit a tendency toward higher GFR and plasma flow rate than do virgin rats with this disease. In chronic studies to investigate the long-term effects on kidney function of pregnancy, normal rats undergoing five closely spaced pregnancies and lactations exhibit glomerular hemodynamics, 24-hour protein excretions, and morphology similar to those of age-matched virgins. When repetitive pregnancies are superimposed on rats with the long-term hyperfiltration stimuli of uninephrectomy plus high dietary protein feeding, no worsening of the proteinuria occurs in comparison to virgin rats subjected to the same degree of renal ablation plus high protein. Although filtration and plasma flow rates are lower in these repetitively pregnant rats as compared with virgin rats, amino acid infusion revealed substantial renal reserve in the repetitively pregnant rats. These studies show that gestational hyperfiltration does not, in and of itself, provide an adverse stimulus to the maternal kidney. PMID- 3555009 TI - Nephrolithiasis in pregnancy. AB - Despite anatomic and physiologic changes that predispose to stone formation, nephrolithiasis in pregnancy remains an uncommon occurrence. Stones occur more frequently in multiparas, during the later stages of gestation, and without a difference in laterality. Correct diagnosis can be confusing. Ultrasound has become a primary diagnostic tool and limited excretory urograms are only recommended for complicated cases. Conservative management can result in spontaneous passage of most stones. When necessary, cystoscopy or surgery can be done safely. Preexisting stone disease is associated with an increased incidence of urinary tract infections in pregnancy. Renal colic often precipitates premature labor. Most drugs used to treat stone disease are contraindicated in gestation. Increased quantities of known inhibitors of stone formation are present in gestation and may explain why the incidence of stones is not increased in this hypercalciuric state. PMID- 3555011 TI - Reproductive function in patients with renal insufficiency. AB - Hypogonadism is prevalent in patients with renal insufficiency and is manifested as sexual dysfunction and infertility in males and as anovulation and amenorrhea in females. Although many investigators believe that the defect represents primary gonadal damage by uremic toxins, we propose the coexistence of central neuroendocrine disorders in the regulation of gonadotropin secretion. Evidence supporting such a hypothesis is discussed. PMID- 3555010 TI - Acute renal failure in pregnancy: 1987. AB - Acute renal failure has become a rare complication of pregnancy due to the virtual disappearance of septic abortion and to better prenatal care, including prevention of blood volume contraction. The incidence of bilateral renal cortical necrosis also decreased in recent years. Severe preeclampsia-eclampsia may be accompanied by acute tubular necrosis. Acute fatty liver of pregnancy is often associated with renal failure. It is a medical emergency. The diagnosis should be made promptly, before liver failure becomes too severe. This should be followed by immediate delivery. In postpartum hemolytic uremic syndrome, plasma infusion, plasma exchange, and/or antiplatelet drug therapy may be of value. PMID- 3555012 TI - Pregnancy in women requiring dialysis for renal failure. AB - Pregnancy is an unusual occurrence in women with end-stage renal disease. When it occurs, spontaneous abortion, stillbirth, and neonatal death end 75% to 80% of the pregnancies. The mother is at risk for hypertension and abruptio placentae. The fetus is at risk for prematurity and growth retardation. Surviving infants appear to be normal. This report outlines the problems in 37 pregnancies (22 in the reported literature and 15 not yet reported). It outlines strategies for improving the chances of survival of the infant. PMID- 3555013 TI - Renal transplantation and pregnancy. AB - Renal transplantation is usually accompanied by an improvement in reproductive function. The possibility of conception in women of childbearing age emphasizes the need for counseling, and couples who want a child should be encouraged to discuss all implications, with the advice based on strict guidelines. If a recipient becomes pregnant, she must be monitored as a high-risk patient. Management requires particular attention to BP control, renal function, and all infection, as well as fetal surveillance. Just under 40% of conceptions do not go beyond the first trimester, but of those that do, greater than 90% end successfully. In most patients, renal hemodynamics improve during gestation, but permanent impairment occurs in 15% of pregnancies. Other patients may experience transient deterioration in late pregnancy (with or without proteinuria). Patients have a 30% chance of developing hypertension, preeclampsia, or both. Despite its pelvic location, the transplanted kidney rarely produces dystocia and experiences no apparent mechanical injury during vaginal delivery. Thus, cesarean section should be reserved for obstetric reasons only. Aseptic technique, bacterial prophylaxis even for trivial surgery, and steroid augmentation are necessary. Preterm deliveries occur in 45% to 60%, and intrauterine growth retardation in at least 20%, of gestations. Neonatal complications include respiratory distress syndrome, leukopenia, thrombocytopenia, adrenocortical insufficiency, and infection. No predominant or frequent developmental abnormalities have been described, and data on infancy and childhood are encouraging. Future goals should be to improve prepregnancy assessment criteria, to reassess the rationale and implications of immunosuppression during pregnancy, and to monitor the remote effects of pregnancy on both renal prognosis and the offspring. PMID- 3555014 TI - Neutrophil and monocyte alterations in chronic dialysis patients. AB - Chronic renal failure patients maintained on dialysis have an increased risk for infection. This article summarizes research that has been done on the function of neutrophils (PMNs) and monocytes from chronic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. The studies involving the HD patients showed that there is a decreased PMN in vitro chemotactic response, decreased C5a receptors on both PMNs and monocytes, and decreased oxidative metabolic responses of PMNs and monocytes to the chemotactic stimuli C5a and formyl-met-leu-phe (fMLP), but not to nonchemotactic factors. The results of studies involving phagocytosis have been conflicting and are discussed in this paper. Due to the basic principles of peritoneal dialysis, this treatment approach depletes the peritoneum of phagocytic cells, adversely affects the function of peritoneal WBCs, dilutes the existing opsonins, and alters the physiologic environment of the peritoneal cavity. Studies of peripheral PMN and monocyte function in CAPD patients have shown that, similar to HD patients, they also have decreased C5a receptors and decreased oxidative metabolic responses to the chemotactic factors C5a and fMLP. Although the factors contributing to the risk of infection in chronic dialysis patients are multifaceted, there are definitely alterations in PMN and monocyte function. PMID- 3555015 TI - Significance of IgA deposits on the glomerular capillary walls in IgA nephropathy. AB - Based on immunofluorescence findings, 232 patients with IgA nephropathy were classified into two groups; one consisted of 88 patients (38%) with IgA deposits in the glomerular capillary walls together with the mesangial deposits (capillary type), and the other consisted of 144 patients (62%) with deposits confined to the mesangium (mesangial type). Electron microscopic findings revealed dense deposits on the capillary walls (subepithelial, 50%; intramembranous, 65%; and subendothelial, 24%) in 37 of 46 patients with capillary type and six of 47 with mesangial type (P less than .001). Crescent formation observed in greater than or equal to 10% of glomeruli was more frequently found in patients with the capillary type (30/88, 34%) than those with the mesangial type (9/144, 6%) (P less than .01), especially higher in those with subepithelial deposits (15/26, 57%). The capillary type patients showed heavier proteinuria (1.7 +/- 0.2 g/d) than the mesangial type patients (0.6 +/- 0.1 g/d) (P less than .05). Thirteen of the 14 patients in an acute exacerbation phase, manifested by an abrupt increase in urinary protein and development of macroscopic hematuria, showed capillary type IgA deposits. The ratio of patients with normal renal function in the fifth year after apparent onset was lower in the capillary type (74.0%) than in the mesangial type patients (96.9%) (P less than .05). These findings suggest that capillary IgA deposition is closely related to clinical and histologic activities of IgA nephropathy and is considered to be an important factor responsible for the progression of the disease, possibly through crescent formation. PMID- 3555016 TI - Controlled trial of antiplatelet agents in mesangial IgA glomerulonephritis. AB - A trial of antiplatelet therapy (slow-release aspirin and dipyridamole) in mesangial IgA glomerulonephritis was conducted. Vitamin B was given to the control group. Altogether, 38 patients were observed for a mean of 33.2 months. Antiplatelet therapy did not favorably modify the course of mesangial IgA glomerulonephritis. The rate of progression of the disease, measured by the slope of reciprocals of serum creatinine v time plots, correlated significantly with the severity of tissue damage as assessed by an arbitrary morphologic score from renal biopsy specimens. PMID- 3555017 TI - Acquired cystic disease of the kidney in association with chronic ambulatory peritoneal dialysis. AB - A combined necropsy and ultrasound study in patients with end-stage renal disease treated exclusively by peritoneal dialysis revealed acquired cystic disease of the kidney (ACDK) in five of 15 necropsies and in one of seven sonograms from living patients. Two benign microscopic adenomas were also found in the first group of patients. No malignant renal tumors or hemorrhagic complications were detected. The cause of the cyst formation is clearly related to chronic renal failure rather than dialysis per se, as one patient had cysts prior to CAPD and seven of 41 patients with end-stage renal disease in the predialysis era were found to have renal cysts on postmortem examination. This study shows that ACDK is not uncommon in patients with chronic renal failure treated by chronic ambulatory peritoneal dialysis. PMID- 3555018 TI - Absence of anion gap metabolic acidosis in severe methanol poisoning: a case report and review of the literature. AB - Methanol poisoning in humans is characterized by a latent period with subsequent development of anion gap metabolic acidosis and blindness. We describe a patient with potentially lethal methanol ingestion as evidenced by an admission serum methanol level of 403 mg/dL and sustained serum methanol levels greater than 50 mg/dL for more than 18 hours after ingestion, despite hemodialysis therapy. That anion gap metabolic acidosis or visual impairment did not develop in this patient was attributed to documented prior ethanol ingestion (admission serum ethanol level of 158 mg/dL) and continued ethanol administration during hospitalization (sustained serum ethanol levels greater than 100 mg/dL). This case demonstrates the ability of ethanol to inhibit the metabolism of methanol to formic acid in humans. This inhibition was achieved without induction of lactic acidosis. Thus this case documents the efficacy of ethanol therapy in patients with methanol poisoning. PMID- 3555020 TI - Death certificate-based occupational mortality surveillance in the United States. AB - Surveillance of cause-specific mortality patterns by occupation and industry through the use of death certificate records is a simple and relatively inexpensive approach to the generation of leads as to potential occupational disease problems. Researchers from the National Institute for Occupational Safety and Health (NIOSH) have been working with the National Center for Health Statistics, other federal agencies, and state health departments on a number of programs to foster the development of standardized, routine coding of occupation and industry entries on death certificates by state health departments. Thirty one states and the District of Columbia are now doing such coding. These data are being analyzed currently by investigators at NIOSH and at individual state health departments for the purpose of hypothesis generation on occupation-disease relationships. The proportionate mortality ratio method is the predominant method being used, as appropriate denominator data are not generally available. This type of surveillance is particularly useful for the study of occupation and industry groups for which it is difficult to assemble cohorts, such as groups that are predominantly non-union and in small workplaces. Limitations of this surveillance include its inappropriateness for monitoring those occupational diseases which are not often fatal, and the limited scope and accuracy of death certificate information. PMID- 3555019 TI - Early detection of the nephrotoxic effects of industrial chemicals: state of the art and future prospects. AB - This paper discusses several tests that may permit the early detection of renal changes induced by long-term exposure to nephrotoxic industrial chemicals and may possibly serve as advance warning of pending renal damage. Some tests mainly attempt to assess the integrity of the glomerulus: high molecular weight proteinuria, glomerular basement membrane (GBM) antigens in blood and in urine, circulating anti-GBM antibodies, glomerular filtration rate after an acute oral load of proteins, and estimation of membrane negative charges (ie, glomerular polyanion). Others mainly attempt to identify functional and/or morphological changes at the tubular level: low molecular weight proteinuria, aminoaciduria, glucosuria, hyperphosphaturia, hypercalciuria, enzymuria, tubular antigen excretion, kallikrein, and prostaglandin excretion. Some of these tests are already routinely used, although controversy may still persist with regard to their clinical significance. Recently, new tests have been developed that may open new perspectives for assessing the significance of the early renal changes induced by chemicals. PMID- 3555021 TI - Historical perspective on asbestos: policies and protective measures in World War II shipbuilding. AB - Current public health consequences of poorly controlled utilization of asbestos in the past can be traced back, in part, to decisions made 45 or more years ago. This paper focuses on the extensive use of asbestos as a fireproofing and insulating material in shipbuilding in the 1940s, when World War II industrial expansion brought about a hitherto unprecedented rise in the amount of asbestos utilized. Twenty years after World War II, asbestos diseases began to manifest themselves, affecting thousands of shipyard workers as well as other workers who had been exposed in the 1940s and during the postwar period. By scrutinizing past actions, the paper argues that social forces, as well as science and technology, affect the setting of priorities and the determination of policy regarding needed but hazardous materials. PMID- 3555022 TI - Pharmacy practice in the Veterans Administration. AB - The current status of pharmaceutical services in the Veterans Administration (VA) is described. The mission of the VA Department of Medicine and Surgery is to ensure that quality medical care is provided on a timely basis to all eligible veterans. The VA operates 172 medical centers and 225 ambulatory-care clinics, which makes the VA Pharmacy Service the largest multiinstitutional pharmacy system in the United States. VA pharmacy staffs in VA hospitals range in size from four or five people to more than 100 employees. The VA Pharmacy Service programs are divided into inpatient programs and ambulatory-care programs. Clinical pharmaceutical services and education and research activities are integrated into these programs. A Regional Pharmacy Advisory Council composed of chiefs of pharmacy service from seven geographical regions coordinates the exchange of information between the Central Office and the regions. Current issues of priority for the VA Pharmacy Service include human resource management, material resource management, information resource management, public relations, program enhancement, and new technology. The VA health-care system is comprehensive and complex, and the Pharmacy Service programs reflect the VA mission to provide quality services and support programs that will generate new information or knowledge to improve the care of veterans. PMID- 3555023 TI - Frequency and appropriateness of drug prescribing for unlabeled uses in pediatric patients. AB - The incidence and appropriateness of drug prescribing for unlabeled indications in a pediatric hospital were examined. During a 19-day period, the medical record of each discharged patient was reviewed to obtain information about the drugs administered during hospitalization. The package insert of each drug was consulted to determine whether the drug had a labeled indication for pediatric use. Using a Delphi group-opinion technique, nine experts in pediatric pharmacology were asked to determine whether or not the use of the drugs with no labeled pediatric indications was supported by the medical literature. A total of 62 (7%) of the 951 drug orders were for unlabeled pediatric indications. A consensus of appropriate use was achieved in 24 (39%) cases, and a consensus of inappropriate use was achieved in 10 (16%) instances. No consensus was reached in 45% of cases. The number of drugs prescribed for unlabeled indications in pediatric patients appears to be small, and sufficient evidence exists in the medical literature to support at least some of those uses. PMID- 3555024 TI - Health care's safety net. PMID- 3555025 TI - Pharmacokinetics in the elderly. Studies on ciprofloxacin. AB - In many ways, the elderly are a more heterogeneous group than the young, yet most pharmacokinetic studies of a new drug are carried out in healthy young volunteers. Based on a variety of age-related alterations in the gastrointestinal tract, one could postulate an a priori diminished absorption with age. In fact, absorption in old age is unchanged or even increased, as is observed with ciprofloxacin. Two comparative pharmacokinetic studies of oral ciprofloxacin found greater areas under the concentration-time curves and maximal serum concentrations in elderly than in young volunteers, which suggests better absorption (Ball et al, LeBel et al). Comparable results were also observed by Guay et al in an open study of 13 elderly patients. Smaller apparent volumes of distribution of ciprofloxacin were also noted in older than in younger volunteers. Several age-related changes in body composition may significantly affect the distribution of ciprofloxacin; the decrease in total body water plays a predominant role for this drug. For a drug that is mostly eliminated unchanged in urine, as ciprofloxacin is, the diminished glomerular filtration rate related to normal aging is the most significant factor to alter drug pharmacokinetics. A diminution of 55 to 60 percent in the total clearance of ciprofloxacin was noted in both studies comparing elderly and young persons. The decline in glomerular filtration rate observed with aging is well illustrated by the smaller renal clearance of ciprofloxacin obtained in this population. To prevent accumulation and eventual toxicity, it would seem appropriate to avoid dosage intervals shorter than 12 hours, especially in view of the lack of data concerning the effect that reduced glomerular filtration rate has on the elimination of metabolites of ciprofloxacin. PMID- 3555026 TI - Drug interactions of ciprofloxacin with other non-antibiotic agents. AB - Interactions between ciprofloxacin and other non-antibiotic agents occur; some can be predicted from in vitro results and general pharmacodynamic rules, whereas other interactions appear to be unpredictable. In the absorptive phase, neither food nor ranitidine, a histamine (H2)-receptor blocker, alters the absorption of ciprofloxacin. Pirenzipine, a cholinergic agent, and N-butyl-scopolaminium bromide delay the absorption of ciprofloxacin, whereas metclopramide accelerates absorption. Both magnesium- and aluminum-containing antacids significantly decrease the absorption of ciprofloxacin, probably through formation of a chelate complex. Patients receiving ciprofloxacin and theophylline simultaneously have higher serum theophylline levels than do recipients of theophylline alone. The interaction is probably due to the inhibition by ciprofloxacin of hepatic microsomal enzymes that metabolize theophylline. Ciprofloxacin does not displace bilirubin from albumin; thus, interactions resulting from displacement of highly protein-bound agents by ciprofloxacin are unlikely. Ciprofloxacin and other quinolones inhibit gamma-aminobutyric acid receptors through reduction of their binding capacity and thus may potentiate convulsions induced by other agents. Cimetidine, a cytochrome P450 antagonist, affects metabolizable quinolones, and it is likely that it may affect ciprofloxacin's disposition after prolonged use. Currently, the only clinically significant interactions are the inactivation of ciprofloxacin by antacids and an increase in theophylline blood levels in the presence of ciprofloxacin. In the future, attention should be paid to other possible interactions. PMID- 3555027 TI - Penetration of ciprofloxacin into gynecologic tissues. AB - Penetration of ciprofloxacin into gynecologic tissues has been studied after administration of the following: a single oral dose of 500 mg; a single injection of 100 mg; single intravenous infusions of 200 mg and 300 mg, respectively; and repeated oral doses of 500 mg followed by an infusion of 200 mg. In general, tissue concentrations of ciprofloxacin exceeded the corresponding serum concentrations on average twofold to fivefold, irrespective of the route of administration or the size of the dose. For example, mean tissue and serum concentrations of ciprofloxacin determined 12 hours after administration of a single oral dose of 500 mg were as follows: serum, 0.09 mg/liter; ovary, 0.28 mg/kg; uterus, 0.49 mg/kg; endometrium, 0.23 mg/kg; myometrium, 0.34 mg/kg; and fallopian tube, 0.36 mg/kg. Repeated drug administration did not result in an accumulation of ciprofloxacin in either serum or the tissues studied. PMID- 3555028 TI - Pharmacokinetics of two dosage regimens of ciprofloxacin during a two-week therapeutic trial in patients with cystic fibrosis. AB - Twenty-nine adult patients with cystic fibrosis received 750 or 1,000 mg of ciprofloxacin orally every 12 hours for two weeks. Pharmacokinetic data were collected on Days 1, 7, and 14. Pharmacokinetic analyses revealed minor differences between the dosage regimens, and results were similar on the first, seventh, and last day of therapy. Means for peak serum concentration (3.1 to 5.0 micrograms/ml), elimination half-life (4.8 to 5.3 hours), area under the time concentration curve, and serum clearance (36.8 to 44.5 liter/hour) were similar to previously reported results for patients without cystic fibrosis. Sputum concentrations approximated serum values. PMID- 3555029 TI - Oral ciprofloxacin in the treatment of serious soft tissue and bone infections. Efficacy, safety, and pharmacokinetics. AB - Forty-eight patients were enrolled in a clinical study of oral ciprofloxacin for the treatment of soft tissue or bone infections. Patients received 500 to 750 mg of ciprofloxacin every 12 hours. In the predominantly older population studied, there were 13 patients with osteomyelitis, 24 diabetic patients with soft tissue infection and probable osteomyelitis, and 11 patients with other soft tissue infections. Infecting pathogens included Pseudomonas aeruginosa in 25 patients, Serratia species in nine patients, Staphylococcus aureus in 13 patients, and other aerobic gram-negative rods in 21 patients. Clinical response (defined as resolution or improvement) was noted in 84 percent of patients with non-diabetic osteomyelitis, in 79 percent of patients with diabetic infections, and in 91 percent of patients with soft tissue infections. Microbiologic outcome was very favorable in 75 percent of cases, and Pseudomonas responded as well as any other pathogen. Pharmacokinetic properties of ciprofloxacin were evaluated in 12 patients, and the data were analyzed using both compartmental and non compartmental analyses. Mean values for compartmental rate constants (hours-1) were as follows: absorption rate constant = 1.15; intercompartmental rate constants, k12 = 0.48, and k21 = 0.58; elimination rate constant = 0.46; distribution rate constant = 1.31; and terminal elimination rate constant = 0.19. The apparent volume of distribution at steady state/bioavailability was 196 liters and total body clearance/bioavailability was 45.9 liters/hour. The mean time to peak concentration was 1.3 hours. The mean peak concentration as determined by compartmental fitting (2.4 micrograms/ml) underestimated the observed peak (3.2 micrograms/ml) by 24.8 percent. Clearance of ciprofloxacin was similar regardless of the method used to fit the data, whereas the volume of distribution was significantly different when the two analysis techniques were compared. Ciprofloxacin was well tolerated, with the most frequent adverse reactions being rash, gastrointestinal intolerance, and increased levels of liver enzymes, each of which occurred in five patients. PMID- 3555031 TI - Clinical efficacy of ciprofloxacin in the treatment of patients with respiratory tract infections in Japan. AB - The clinical efficacy, safety, and optimal dosage of oral ciprofloxacin for the treatment of respiratory infections were studied in a multicenter, open trial in Japan. Five hundred seventy-one patients with respiratory infections received orally administered ciprofloxacin (the majority received 600 mg daily). Clinical efficacy was evaluated in 542 of these patients, and safety was analyzed in 568 patients. Clinical efficacy was excellent or good in 80.9 percent of patients with pneumonia, and in 71.3 percent of patients with chronic airway infections. The overall bacteriologic eradication rate was 68.5 percent. In infections caused by Hemophilus influenzae, the rate was 90.8 percent. Side effects were observed in 4.6 percent of patients, and abnormal laboratory findings were noted in 6.9 percent; however, there were no severe reactions. Ciprofloxacin may be a very useful agent for the treatment of respiratory infections. PMID- 3555030 TI - Controlled, comparative study of ciprofloxacin versus ampicillin in treatment of bacterial respiratory tract infections. AB - The efficacy and safety of ciprofloxacin in bacterial bronchitis were compared with those of ampicillin in a double-blind, prospective clinical trial. Eighty seven patients received either oral ciprofloxacin (750 mg twice daily) or oral ampicillin (500 mg four times daily). Ciprofloxacin was as effective as ampicillin and produced a 98 percent clinical cure rate. Significantly more pretreatment bacterial isolates were susceptible to ciprofloxacin (p less than 0.05), and ciprofloxacin had a significantly higher rate of sputum sterilization than did ampicillin (p less than 0.05). Ciprofloxacin showed broad in vitro antibacterial activity with particularly low minimal inhibitory concentrations for gram-negative organisms. Ciprofloxacin was well tolerated; there were few adverse effects, and patients had a significantly lower incidence of diarrhea with ciprofloxacin than with ampicillin (p less than 0.05). Ciprofloxacin was an effective and well-tolerated treatment for bacterial bronchitis that had the advantages of broad in vitro antibacterial activity and twice-daily dosing. PMID- 3555032 TI - Ciprofloxacin monotherapy for acute pulmonary exacerbations of cystic fibrosis. AB - Ciprofloxacin has potent in vitro activity against Pseudomonas aeruginosa and Pseudomonas cepacia strains isolated from cystic fibrosis patients. Our previous single-dose pharmacokinetic and pharmacodynamic studies identified important differences between cystic fibrosis patients and age- and sex-matched controls. Based on these data, 30 acutely ill cystic fibrosis patients (aged 18 to 44 years) received 750 mg of ciprofloxacin orally every eight hours for 21 days. Multiple timed serum, urine, and sputum samples for pharmacokinetic analysis were obtained on Days 3, 12, 14, and 21 of the study. Estimates of steady-state pharmacokinetic parameters averaged (+/- SD): t1/2 beta, 3.8 (1) hours; Vd/F, 4.4 (2) liters/kg; Cl/F, 772.9 (301) ml/minute/1.73 m2; Fe, 46 percent; peak, 5.4 (2) mg/liter; and trough, 1.8 (0.8) mg/liter. Serum ciprofloxacin concentrations and pharmacokinetic estimates remained unchanged throughout the study. Sputum ciprofloxacin concentrations exceeded those observed in serum. Sputum cultures revealed 43 P. aeruginosa (MIC90 = 2 micrograms/ml) and 15 P. cepacia (MIC90 = 16 micrograms/ml) strains. Sputum ciprofloxacin concentrations exceeded the MIC90 for P. aeruginosa approximately fivefold, yet only eight isolates were fully suppressed. Posttreatment sputum cultures revealed 35 P. aeruginosa (MIC90 = 16 micrograms/ml) and 15 P. cepacia (MIC90 = 16 micrograms/ml). All patients showed clinical improvement based upon the results of pulmonary function tests and an acute clinical efficacy score (median pre 49/post 60). No patients experienced drug-related toxicity. Ciprofloxacin monotherapy is effective for the acute treatment of cystic fibrosis patients. The development of pathogen resistance during oral therapy may limit its utility in ambulatory patients. PMID- 3555033 TI - Ciprofloxacin versus tobramycin plus azlocillin in pulmonary exacerbations in adult patients with cystic fibrosis. AB - Twenty adult patients with cystic fibrosis who were experiencing acute pulmonary exacerbations were enrolled in a randomized, controlled trial comparing oral ciprofloxacin with intravenous tobramycin plus azlocillin. Efficacy of the two treatments was compared based upon changes in clinical status, pulmonary function tests, white blood cell counts, and quantitative bacteriology of sputum. No statistically significant differences were detected in these parameters of response between the two treatment groups (p greater than 0.05). Ciprofloxacin appears to be therapeutically equivalent to intravenous antibiotics in the treatment of adult patients with cystic fibrosis who are experiencing pulmonary exacerbations associated with susceptible bacteria. PMID- 3555034 TI - Ciprofloxacin: comparative data in cystic fibrosis. AB - Ciprofloxacin, a 4-quinolone bactericidal antimicrobial, has a high activity against a broad spectrum of bacterial microorganisms, including Pseudomonas aeruginosa. The fact that ciprofloxacin can be administered orally would represent a cost-efficient advance in the management of patients with cystic fibrosis, most of whom must be treated frequently with anti-pseudomonal antibiotics. In this study, 11 adult patients received 26 therapeutic courses of ciprofloxacin at a dose of 750 mg orally every 12 hours. In addition, a 13-year old patient received 500 mg orally every 12 hours. The length of therapy was usually two weeks, but some patients received treatment for up to eight weeks. The mean serum concentration at two to three hours after administration of a dose was 3.68 micrograms/ml (range, 1.85 to 7.25 micrograms/ml). The mean trough level was 0.85 microgram/ml (range, 0.36 to 1.65 micrograms/ml). A comparable group of 11 patients matched by age and severity of disease were treated with conventional doses of tobramycin and azlocillin administered intravenously for at least two weeks. Sputum cultures from all the patients grew P. aeruginosa, except for one patient with Pseudomonas cepacia infection; the minimal inhibitory concentration of ciprofloxacin for these organisms ranged from 0.05 to 1.56 micrograms/ml. The clinical and microbiologic results obtained with these two antimicrobial regimens were similar. A therapeutic failure was noted in the patient infected with P. cepacia whose organism became resistant after one week of therapy (minimal inhibitory concentration greater than 4.58 micrograms/ml). Emergence of resistant strains was not observed in any of the other patients. PMID- 3555035 TI - Randomized study of two dosage regimens of ciprofloxacin for treating chronic bronchopulmonary infection in patients with cystic fibrosis. AB - Twenty-nine adult patients with cystic fibrosis who had chronic bronchopulmonary infection were randomly assigned to receive 750 or 1,000 mg of oral ciprofloxacin every 12 hours for two weeks. Assessments for efficacy and safety were made on treatment Days 7 and 14 and one week following completion of therapy, and pharmacokinetic data were collected on Days 1, 7, and 14. Fifteen of 28 evaluable patients showed clinical improvement, and none had clinical deterioration. The higher dosage of ciprofloxacin did not enhance the clinical response. Statistically significant, stepwise changes in clinical scores, pulmonary function, and sputum concentrations of Pseudomonas aeruginosa and Staphylococcus aureus were noted, but regression toward initial values occurred by one week after treatment. Although all P. aeruginosa isolates were initially inhibited by 2 mg/liter of ciprofloxacin or less, 45 and 35 percent of isolates were resistant after 14 days of therapy and one week later, respectively. Outpatient oral ciprofloxacin therapy was commonly associated with clinical improvement in adult patients with cystic fibrosis who have chronic bronchopulmonary infection, regardless of the emergence of resistant P. aeruginosa, and adverse reactions were infrequent. Further studies must delineate the long-term consequences of the frequent emergence of bacterial resistance. PMID- 3555036 TI - Ciprofloxacin therapy in cystic fibrosis. AB - There is great need for an oral agent that could be used to treat pulmonary exacerbations in patients with cystic fibrosis. In this study, the use of oral ciprofloxacin as sole therapy was evaluated in 18 patients with 39 infectious episodes; 13 episodes were classified as severe, 19 were classified as moderate, and seven were classified as mild. Patients ranged in age from eight to 36 years (mean, 23 years). Dosage varied according to severity of disease, body size, and the susceptibility of the Pseudomonas isolate to ciprofloxacin; the dose ranged from 750 to 2,250 mg daily (mean, 1,800 mg). Ten patients received one course of ciprofloxacin, and eight received repeated courses. The overall clinical response rate was 82 percent. There was a response to the initial treatment course in 96 percent of the patients. Those in whom therapy failed had been re-treated with ciprofloxacin and were severely ill. Failure to respond correlated poorly with pretreatment minimal inhibitory concentration (MIC) values (0.6 microgram/ml for failures versus 0.4 microgram/ml for responses). Pseudomonas could not be eradicated from the sputum of any of the patients, although there was a marked reduction in purulence and bacterial counts. In general, patients who did not require re-treatment for three months would again have susceptible organisms. When organisms became resistant to ciprofloxacin (MIC greater than 2 micrograms/ml), they showed no concomitant new aminoglycoside or beta-lactam resistance. No serious toxicity occurred in any of the 39 episodes of treatment. In seven patients treated with combination therapy (tobramycin or azlocillin), the infecting organisms were reduced in number, but eradication of Pseudomonas generally could not be achieved. Increases in MIC occurred during combination therapy. Ciprofloxacin is a major advance in the treatment of bronchopulmonary infection in patients with cystic fibrosis. PMID- 3555037 TI - Efficacy and safety of oral ciprofloxacin in the treatment of serious respiratory infections. AB - Fifty-two patients with serious respiratory infections were treated with orally administered ciprofloxacin; 42 patients were evaluable for the efficacy analysis and all were evaluable for determining adverse reactions. Cures were achieved in 24 patients with infections (14 with bronchitis, 10 with pneumonia) caused by Hemophilus influenzae, Streptococcus pneumoniae, or Branhamella catarrhalis, and pathogens were rapidly eradicated from respiratory secretions. Seventeen patients had infections (seven bronchitis, 10 pneumonia) caused by Enterobacteriaceae or Pseudomonas aeruginosa; many of these patients were critically ill and were enrolled in the study because their pathogens were resistant to multiple drugs or because their infections had not responded to alternate antimicrobial therapy. All patients had favorable clinical responses, and members of the Enterobacteriaceae were rapidly eradicated from respiratory secretions. However, five of 12 strains of P. aeruginosa persisted during treatment; minimal inhibitory concentrations for these strains increased 4- to 16-fold as infections continued to resolve. One patient with Staphylococcus aureus infection also showed a response. Ciprofloxacin probably caused nausea, vomiting, or both in three of the 52 patients and possibly contributed to similar symptoms in another three patients (6 to 12 percent). Other possible adverse reactions, including central nervous system symptoms, were also observed but were not clearly drug related. PMID- 3555038 TI - Efficacy and safety of oral ciprofloxacin in the treatment of respiratory tract infections associated with chronic hepatitis. AB - Twenty patients with lower respiratory tract infections presumably caused by ciprofloxacin-susceptible bacteria were admitted to a non-comparative, prospective clinical study. All patients were hospitalized for chronic hepatitis at various stages of the disease. Ciprofloxacin was given orally at a dose of 250 mg every 12 hours for five to 10 days. Patients had either acute bronchitis, chronic bronchitis in the acute phase, or acute tracheobronchitis. In 19 of 20 patients treated, there was a favorable outcome (15 cures and four improvements). In 17 patients, the presumably causative pathogen was eradicated. No side effect was observed except for oral candidiasis, which occurred in two patients. This study demonstrates the clinical and bacteriologic efficacy of ciprofloxacin in pulmonary infection in patients with severe impairment of liver function. PMID- 3555039 TI - Ciprofloxacin for eradication of methicillin-resistant Staphylococcus aureus colonization. AB - Ciprofloxacin (750 mg orally twice a day) was used to treat 22 episodes of methicillin-resistant Staphylococcus aureus (MRSA) colonization among 20 patients. Most patients had serious, progressive underlying medical diseases and had multiple sites of colonization. Eleven had previously received parenteral vancomycin therapy. Duration of ciprofloxacin therapy was from seven to 28 days. Therapy was discontinued in eight patients because of minor adverse reactions (two patients) or serious events attributed to underlying diseases (six patients). These serious events included seizures in two patients with known seizure disorders. Of the remaining 14 courses of therapy, 11 (79 percent) were associated with eradication of MRSA colonization. For the 18 patients who received at least two weeks of therapy, results of cultures from 47 of the 56 colonized sites became negative. Recolonization with MRSA occurred in four patients within one month. Increased resistance to ciprofloxacin was observed in seven of the 22 treatment episodes; this was associated with treatment failure in three patients and successful therapy in one patient; therapy was discontinued for other reasons in three patients. For comparison, medical records of 31 patients whose clinical specimens revealed MRSA but who did not receive ciprofloxacin were reviewed. MRSA colonization (as opposed to infection) was not eradicated in any patient who received only a single drug or no specific therapy directed against MRSA; four of seven patients given combination therapy had colonization eradicated. Although there is the potential for increased resistance, ciprofloxacin is an important new option that can be used as a single agent for eradication of MRSA colonization. Additional study is needed to define the optimum use of ciprofloxacin as a single agent and in combination therapy for MRSA colonization and infection. PMID- 3555040 TI - Comparative, double-blind study of oral ciprofloxacin and intravenous cefotaxime in skin and skin structure infections. AB - The effectiveness and safety of orally administered ciprofloxacin and intravenously administered cefotaxime were compared in a double-blind study of 60 men with infections of skin and soft tissue, including cellulitis, ulcers, abscesses, cellulitis with ulcers or abscesses, wound infections, and post traumatic infections. Patients in the ciprofloxacin group received 750 mg orally every 12 hours for a mean duration of 9.6 days (six to 18 days), and those in the cefotaxime group received 2.0 g intravenously every eight hours for a mean duration of 9.3 days (five to 14 days). Infection was documented bacteriologically in 78 percent of the patients in the ciprofloxacin group and in 83 percent of the patients in the cefotaxime group. Pathogens included Staphylococcus aureus, enterococci, group B streptococci, Escherichia coli, Proteus mirabilis, and Klebsiella and Pseudomonas species. Half of the infections were mixed infections. Ninety percent (19 of 21) of the infections were bacteriologically eradicated with ciprofloxacin, and 82 percent (18 of 22) were eradicated with cefotaxime. Treatment was completely successful in 79 percent (22 of 28) of the patients in the ciprofloxacin group and in 68 percent (19 of 28) in the cefotaxime group (p greater than 0.1). The side effects in both treatment groups were comparable. This study demonstrates that orally administered ciprofloxacin is comparable in effectiveness and safety to cefotaxime administered intravenously in the treatment of infections of skin and soft tissue, and that it can offer an alternative in the treatment of such infections. PMID- 3555041 TI - Systemic treatment of cutaneous infections. A comparative study of ciprofloxacin and cefotaxime. AB - A prospective, double-blind, randomized study of hospitalized patients with skin and skin structure infections was conducted to compare orally administered ciprofloxacin and conventional intravenous cefotaxime therapy. Fifty-six patients, predominantly elderly women, were randomly assigned to receive either ciprofloxacin (24 patients, 25 infected sites) or cefotaxime (32 patients, 36 sites). Patients in the ciprofloxacin group received 750 mg of orally administered ciprofloxacin every 12 hours plus a placebo infusion while the other group received 2.0 g of cefotaxime intravenously every eight hours plus a placebo tablet every 12 hours. The average duration of treatment was seven to 10 days, with a maximum of 21 days. Clinical response per infected site in the ciprofloxacin group was as follows: resolution in 88 percent, improvement in 8 percent, and failure in 4 percent. In the cefotaxime group, there was resolution in 69 percent, improvement in 25 percent and failure in 6 percent. Bacteriologic response per site in the ciprofloxacin group was eradication in 88 percent and persistence in 12 percent. With cefotaxime there was 69 percent eradication, 3 percent marked reduction, 6 percent recurrence, and 22 percent persistence. Clinical and bacteriologic responses were combined using an algorithm to derive a cure rate, which was 91 percent for ciprofloxacin and 61 percent for cefotaxime (p = 0.0214). PMID- 3555042 TI - Double-blind comparison of ciprofloxacin with cefotaxime in the treatment of skin and skin structure infections. AB - Oral ciprofloxacin (750 mg twice daily) was compared with intravenous cefotaxime (2 g three times daily) as therapy for 61 episodes of skin and skin structure infections occurring in adult patients. A variety of infections including cellulitis, infected ulcers, abscesses, and other miscellaneous infections were treated. Clinical cure was achieved in 77 percent (24 patients) of 31 patients treated with ciprofloxacin and in 76 percent (22 patients) of 28 patients treated with cefotaxime. The response was slower in infected diabetic patients than in non-diabetic patients in both groups. Side effects were minimal and appeared only in the cefotaxime group. Ciprofloxacin taken twice daily was as effective as cefotaxime administered intravenously three times daily in the treatment of skin and skin structure infections. PMID- 3555043 TI - Oral ciprofloxacin therapy for gram-negative bacillary osteomyelitis. AB - Gram-negative osteomyelitis frequently responds poorly to conventional therapy. Ciprofloxacin displays excellent in vitro activity against gram-negative bacilli and offers the potential for outpatient therapy. In this ongoing study, ciprofloxacin therapy is being evaluated for the treatment of gram-negative osteomyelitis. Twenty-three patients (16 men and seven women) have been treated under the protocol (750 mg orally twice daily for 1.5 to six months), and 14 patients have completed therapy. All patients had either growth on bone cultures from an open or percutaneous biopsy, or an arthrocentesis to confirm the diagnosis. Involved sites included ankle or tibia (seven patients), vertebra (four patients), hip (five patients), metatarsal (four patients), phalanx (two patients), and metacarpal (one patient); 16 patients had chronic disease, and seven patients had acute disease. Patients had a total of 28 gram-negative bacilli, 12 gram-positive cocci, and one anaerobic gram-negative rod, for an average of 1.8 pathogens per patient. Eighteen of the 28 gram-negative bacilli were Pseudomonas species. The geometric mean minimal inhibitory concentration for all the gram-negative bacilli was 0.15 microgram/ml. The geometric mean minimal inhibitory concentration for the gram-positive isolates was 0.41 microgram/ml. All patients who completed therapy experienced a cure, with a mean follow-up of 6.1 months. Infections in all patients, except for two who are still taking ciprofloxacin, are resolving, both clinically and radiologically. One patient who was not eligible for the protocol experienced a superinfection with methicillin resistant Staphylococcus aureus. Side effects have included urticaria, lethargy, nausea, and transient elevations of liver and renal function test results. Overall, ciprofloxacin therapy was well tolerated. This study suggests that ciprofloxacin holds promise for the outpatient treatment of gram-negative osteomyelitis. PMID- 3555044 TI - Oral ciprofloxacin therapy for chronic contiguous osteomyelitis caused by aerobic gram-negative bacilli. AB - Twenty adult patients with chronic contiguous osteomyelitis caused by aerobic gram-negative bacilli were enrolled in an open, prospective cooperative study to determine the effect of oral ciprofloxacin therapy in a dosage of 750 mg every 12 hours. There were 14 men and six women, with a mean age of 55 years. Fifteen of the 20 patients had undergone previous unsuccessful attempts at therapy; seven of the 20 patients had clinically important underlying diseases. Osteomyelitis involved the sternum in three patients and the bones of the lower extremity in 17 patients. Initial surgical debridement was performed in 15 of 20 patients. The predominant organism isolated was Pseudomonas aeruginosa, which was found as a single pathogen in 13 patients and as part of a polymicrobic flora in three patients. Based on posttreatment follow-up of seven to 21 months, clinical cure was achieved in 13 of 20 (65 percent) patients and bacteriologic cure was achieved in 14 of 20 (70 percent) patients. Minimal inhibitory concentrations of ciprofloxacin against P. aeruginosa increased during therapy in four of 16 (25 percent) patients. Minor gastrointestinal side effects occurred in five patients. Oral ciprofloxacin was an effective and safe therapy in patients with chronic contiguous osteomyelitis due to aerobic gram-negative bacilli. PMID- 3555045 TI - Clinical efficacy of ciprofloxacin therapy for gram-negative bacillary osteomyelitis. AB - The efficacy and toxicity of ciprofloxacin, an orally administered fluoroquinolone, were evaluated in 24 infections in 23 patients with osteomyelitis caused by aerobic gram-negative bacilli. The diagnosis was confirmed by surgical findings and the results of bone biopsy and culture of bone or deep soft tissue. The aerobic gram-negative bacilli were Pseudomonas aeruginosa (15 isolates), Serratia marcescens (five isolates), Escherichia coli (three isolates), Enterobacter species (three isolates), Proteus mirabilis (one isolate), Pseudomonas fluorescens (one isolate), and Klebsiella pneumoniae (one isolate). Minimal bactericidal concentrations (MBCs) were 1.56 micrograms/ml or less for all but one isolate. Nine infections were polymicrobial, involving aerobic gram-positive cocci or anaerobes in addition to aerobic gram-negative bacilli. Additional antibiotics to which the aerobic gram-negative bacilli were resistant were given when the additional organisms were resistant to ciprofloxacin. Patients received 750 mg of ciprofloxacin twice daily for a mean of 62 days. Peak serum levels of ciprofloxacin were at least threefold higher than the MBCs in 20 of 24 patients. Twenty of 22 infections in which a full course of therapy was completed were without evidence of active disease at one to 17 months posttreatment. A sternotomy wound infection relapsed after eight weeks of therapy with a newly resistant S. marcescens strain, and an infection of a compound fracture relapsed two months posttreatment with a still sensitive P. aeruginosa strain. Toxicity was minimal in most patients: eosinophilia (six patients), nausea (eight patients), mild elevation in transaminase levels (three patients), pruritus (one patient), diarrhea (two patients), thrush (two patients), rash (two patients), and mild leukopenia (one patient). Two additional patients had severe side effects (vertigo in one and acute renal failure in another) that required discontinuation of ciprofloxacin therapy. Overall, ciprofloxacin is a promising agent for the oral treatment of gram-negative bacillary osteomyelitis. PMID- 3555046 TI - Randomized trial of ciprofloxacin compared with other antimicrobial therapy in the treatment of osteomyelitis. AB - Thirty adults (mean age, 52 years) were enrolled in a randomized, comparative trial of oral ciprofloxacin (750 mg twice daily) and other antimicrobial therapies. Etiologic agents included Enterobacteriaceae (18 isolates), Pseudomonas aeruginosa (16 isolates), and Staphylococcus aureus (four isolates). Seven of 14 (50 percent) ciprofloxacin-treated infections are cured at up to 13 months follow-up and three infections appear improved. Treatment failure or relapse has occurred in four patients. Sixteen patients received other antimicrobial therapy and 11 patients (65 percent) remain without infection and have healed wounds, with follow-up from one to 13 months. One patient has had a relapse, while improvement is apparent in four patients. Complications that occurred in this group included drug-related neutropenia (two patients), diarrhea (two patients), drug allergy (one patient), and catheter-related staphylococcal cellulitis (one patient). Oral ciprofloxacin therapy for chronic osteomyelitis caused by susceptible organisms appears to be as effective as other antimicrobial therapies. PMID- 3555047 TI - New approaches to the treatment of urinary tract infection. AB - The term urinary tract infection encompasses a broad range of clinical entities, each with its own pathology and each requiring its own form of treatment. There are at least four different modes in which antimicrobial therapy may be prescribed for urinary tract infection: single-dose therapy aimed at patients with superficial mucosal infection; a conventional seven- to 14-day course of therapy; a prolonged four- to six-week course of therapy for patients with deep tissue infection; and low-dose prophylactic therapy. Increasingly, the response to single-dose therapy is being utilized to delineate the mode of therapy needed by a patient. Patients with underlying renal disease and/or structural abnormalities of the urinary tract are prone to the development of recurrent urinary tract infection, frequently with bacteria resistant to antimicrobial agents conventionally employed to treat the infection. There has been a steady increase, even among otherwise normal persons with urinary tract infection, in the level of antimicrobial resistance exhibited by bacterial uropathogens to the drugs commonly used to treat these infections. The quinolones in general, and ciprofloxacin in particular, appear to be very promising for the treatment of urinary tract infection. It will be important to evaluate the performance of this drug in the four different therapeutic modes and in patients with renal dysfunction or anatomic abnormalities of the urinary tract. PMID- 3555048 TI - Treatment of chronic bacterial prostatitis with ciprofloxacin. Results of a one year follow-up study. AB - In a one-year follow-up study, short-term therapy with ciprofloxacin proved to be beneficial in the treatment of chronic bacterial prostatitis, particularly in cases of Escherichia coli prostatitis. Ciprofloxacin therapy of E. coli prostatitis was a complete success in five of 12 patients, a probable success in two, and in one patient the outcome cannot be judged. Ciprofloxacin treatment failed in three men, and therapy was discontinued in one patient because of side effects. Enterobacter aerogenes prostatitis was cured. Ciprofloxacin treatment was insufficient in three patients with Streptococcus faecalis prostatitis and in one patient with Pseudomonas aeruginosa prostatitis. PMID- 3555049 TI - Ciprofloxacin versus cinoxacin in therapy of urinary tract infections. A randomized, double-blind trial. AB - In a prospective, randomized, double-blind trial, ciprofloxacin (250 mg orally, twice daily) was compared with cinoxacin (500 mg orally, twice daily) in 60 patients with urinary tract infections. Most patients were women with uncomplicated urinary tract infections. Escherichia coli was the most common isolate (36 patients). Clinical and microbiologic cure occurred in 20 of 24 (83 percent) evaluable patients treated with ciprofloxacin, compared with 15 of 21 (71 percent) evaluable patients treated with cinoxacin. Ciprofloxacin was well tolerated and had a low incidence of minor side effects that included Candida vaginitis, headache, and gastrointestinal intolerance. Relapse or failed therapy was not associated with the development of resistance. PMID- 3555050 TI - Comparison of ciprofloxacin and beta-lactam antibiotics in the treatment of urinary tract infections and alteration of fecal flora. AB - Ciprofloxacin treatment of urinary tract infections in 23 patients (16 with and seven without urorenal abnormalities) was compared with beta-lactam antibiotic therapy given orally to 10 comparable patients. The alteration of aerobic gram negative fecal flora was monitored. Ciprofloxacin eliminated bacteria from the urine of all patients; beta-lactam antibiotics failed in two of 10 patients. There were no relapses one week following ciprofloxacin treatment; six of nine patients experienced a relapse following beta-lactam treatment (p less than 0.01). By four to six weeks, all patients infected with gram-positive cocci had a relapse. Six of 14 patients with urorenal abnormalities in whom cures had been achieved acquired new infections. Before treatment, the bowel flora of 80 percent of the patients was resistant to amoxicillin, 20 percent was resistant to cefixime, and none was resistant to ciprofloxacin. Penicillin and cefixime increased the incidence of resistant flora to 93 and 36 percent, respectively. Ciprofloxacin suppressed aerobic bowel flora, and no resistant strains persisted after treatment. Ciprofloxacin promises effective short-term oral treatment of complicated urinary tract infections with minimal risk of drug-resistant recurrences. PMID- 3555051 TI - Oral ciprofloxacin in the treatment of elderly patients with complicated urinary tract infections due to trimethoprim/sulfamethoxazole-resistant bacteria. AB - The effectiveness and safety of ciprofloxacin, a new quinolone antibiotic, were prospectively evaluated in the treatment of patients with complicated urinary tract infections caused by gram-negative organisms resistant to trimethoprim/sulfamethoxazole. Twenty-five elderly (mean age, 70.4 years) patients (24 men and one woman) were enrolled. Initial pathogens included Pseudomonas aeruginosa (15 isolates), Escherichia coli (five isolates), Enterobacter aerogenes (one isolate), Citrobacter freundii (one isolate), Serratia species (two isolates), Proteus vulgaris (one isolate), and enterococcus (one isolate). Patients received 500 mg of ciprofloxacin orally twice daily for one week (mean, 6.98 days). Results of urine cultures obtained during therapy were negative in all cases, and at one week post-therapy, 21 of 25 (84 percent) infections were cured. Four patients experienced a relapse with P. aeruginosa. Repeat urine culture specimens were obtained at four to six weeks from 14 patients who had cures at one week post-therapy, and seven continued to have cures. Three patients had late relapses with P. aeruginosa, E. coli, or Serratia marcescens, and four were reinfected with new strains. Five patients who received concomitant oral antacids had lower mean peak and trough serum ciprofloxacin levels than did patients not receiving antacids (p less than 0.05, Wilcoxon rank sum test). Mild adverse effects were seen in seven patients: eosinophilia (one patient), eosinophilia and reduced white blood cell count (one patient), crystalluria (one patient), granular casts (one patient), elevation of serum creatinine and blood urea nitrogen levels (one patient), and nausea (two patients), but none warranted discontinuation of ciprofloxacin therapy. P. aeruginosa isolates from two patients who experienced a relapse showed increases in minimal inhibitory concentrations from 0.13 to 0.5 and 2.0 micrograms/ml, respectively, to ciprofloxacin and other antibiotics. Orally administered ciprofloxacin was a safe and effective therapy for complicated urinary tract infections in elderly patients. PMID- 3555052 TI - Oral ciprofloxacin in resistant urinary tract infections. AB - Thirty-two patients (18 men and 14 women), who ranged in age from 28 to 91 years (mean, 71.2 years), with urinary tract infections caused by Pseudomonas species or other organisms resistant to trimethoprim-sulfamethoxazole were treated with 500 mg of orally administered ciprofloxacin every 12 hours. Thirty patients completed at least five days of therapy and were evaluated for efficacy. Of these, the treatment of 28 (93 percent) patients was considered successful, with urine cultures yielding negative results five to nine days after cessation of therapy. Three of these patients were found to be reinfected with their primary pathogens when culture specimens were obtained again three to four weeks later. The two patients who received treatment that was classified as having failed had urine cultures that persistently grew Pseudomonas aeruginosa. Superinfections occurred in eight patients, four with diabetes and four with underlying central nervous system disease. Adverse reactions required discontinuation of therapy in two patients. Although the rates of reinfection and superinfection were somewhat high, these patients had a high frequency of underlying diseases that predisposed them to recurrent or difficult-to-treat infections. Despite these shortcomings, ciprofloxacin is a welcome addition to the oral antibiotic regimen for the treatment of antibiotic-resistant urinary infections. PMID- 3555053 TI - Problems in the treatment of bacterial sexually transmitted diseases. AB - Although most bacterial sexually transmitted diseases (STDs) can be effectively treated, currently available regimens are far from ideal. Increasingly widespread plasmid-mediated resistance to the penicillins limits the use of these agents in the treatment of Neisseria gonorrhoeae and Hemophilus ducreyi infections. Chromosomally mediated antimicrobial resistance to the tetracyclines, penicillins, erythromycins, and sulfonamides further limits therapeutic options in the treatment of gonorrhea, and plasmid-mediated resistance to sulfonamides and tetracyclines is frequent in H. ducreyi infections. In patients with Chlamydia trachomatis infections, effective regimens that can more easily be complied with (shorter duration, less frequent dosing) are needed, as are effective alternative regimens for use in pregnancy and in infants. In selected STDs that are polymicrobial (pelvic inflammatory disease and bacterial vaginosis, for example) or that often present simultaneously (gonorrhea-chlamydia, gonorrhea syphilis, chancroid-syphilis), single-drug regimens that are effective against several genital pathogens would be ideal. Only limited therapeutic alternatives are available for some STDs, especially in pregnant women or in patients with penicillin allergy. Thus, antimicrobial resistance, drug toxicity, poor compliance, limited alternatives in pregnancy or allergy, and the lack of single agents possessing a broad spectrum of activity against multiple genital pathogens limit currently available therapy. PMID- 3555054 TI - Treatment of nongonococcal urethritis with ciprofloxacin. AB - A randomized, double-blind study was performed in 225 men with nongonococcal urethritis or postgonococcal urethritis, in which the efficacy of ciprofloxacin (750 mg twice daily for seven days) was compared with that of doxycycline (100 mg twice daily for seven days). Of the 145 evaluable patients completing three weeks or more of follow-up or reaching an end point, 74 patients received doxycycline and 71 received ciprofloxacin. Chlamydia trachomatis and mixed infections with Ureaplasma urealyticum were more frequent in the cip, ofloxacin group, but the differences were not significant. The overall cure rates were similar for the two regimens (52.1 percent for ciprofloxacin and 60.8 percent for doxycycline; p greater than 0.3). However, in patients with chlamydial infections alone, ciprofloxacin was significantly less effective than doxycycline (45.5 percent versus 75 percent; p = 0.04). In patients with U. urealyticum infections alone, there was a more favorable trend in the ciprofloxacin group (69.2 percent versus 45 percent; p = 0.12). In patients whose culture results were negative, the responses were very similar (60.9 percent for ciprofloxacin and 64.3 percent for doxycycline). Both drugs were well tolerated; side effects, which were mostly gastrointestinal in nature, were mild. PMID- 3555055 TI - Treatment of chancroid with ciprofloxacin. A prospective, randomized clinical trial. AB - Chancroid is a major sexually transmitted disease in many developing countries. Although single-dose and short-course treatment of chancroid have been described, the increasing resistance of Hemophilus ducreyi to antimicrobial agents requires continuing evaluation of new therapies. Ciprofloxacin is a new quinolone antimicrobial agent with excellent in vitro efficacy against H. ducreyi. A double blind, randomized clinical trial was conducted comparing a single-dose ciprofloxacin regimen (500 mg) and a three-day regimen of ciprofloxacin (500 mg twice daily) with a three-day regimen of trimethoprim-sulfamethoxazole (160 and 800 mg, respectively, twice daily) for the treatment of chancroid. The three-day ciprofloxacin regimen successfully eradicated H. ducreyi, and resulted in rapid clinical improvement in all 40 patients followed, with no failures. The other two regimens were also effective, but bacteriologic and clinical failure occurred in two and three patients following treatment with single-dose ciprofloxacin and three days of trimethoprim-sulfamethoxazole, respectively. All patients with buboes had resolution of lesions. There were no significant adverse effects associated with ciprofloxacin or trimethoprim-sulfamethoxazole. All three regimens are effective therapy for chancroid and H. ducreyi infections. If resistance to trimethoprim-sulfamethoxazole becomes widespread, ciprofloxacin may become a first-line therapy for chancroid. This study also demonstrates the efficacy of ciprofloxacin in soft tissue infection. PMID- 3555056 TI - Current problems in antimicrobial therapy for bacterial enteric infection. AB - Trimethoprim/sulfamethoxazole is currently considered the treatment of choice for shigellosis and severe travelers' diarrhea. The problem with this combination regimen is inactivity against Campylobacter jejuni strains and other bacterial enteropathogens showing in vitro resistance to the drug. Resistance to trimethoprim/sulfamethoxazole among enteric pathogens has occurred frequently in certain areas of the world. A study of the in vitro susceptibility of enteric bacterial pathogens isolated from multiple countries was recently performed. The minimal inhibitory concentration of ciprofloxacin required to inhibit 90 percent of the 210 bacterial enteropathogens ranged from 0.25 micrograms/ml for C. jejuni to 0.016 micrograms/ml for enterotoxigenic Escherichia coli, Salmonella, and Shigella. In a clinical trial carried out in a United States student population that acquired diarrhea while in Mexico, it was shown that ciprofloxacin was as effective as trimethoprim/sulfamethoxazole and both were significantly (p less than 0.001) more effective than placebo. The average duration of diarrhea was 29 or 20 hours after initiation of treatment with ciprofloxacin or trimethoprim/sulfamethoxazole, respectively, compared with 81 hours in the placebo group. The antimicrobial agents were more efficacious than placebo in treating diarrhea caused by enterotoxigenic E. coli, invasive enteropathogens, and unknown pathogens. Ciprofloxacin and the quinolone derivatives are uniquely suited to the therapy of acute bacterial diarrhea in areas where C. jejuni is commonly found and where trimethoprim/sulfamethoxazole-resistant strains regularly occur. PMID- 3555057 TI - Clinical efficacy of ciprofloxacin compared with placebo in bacterial diarrhea. AB - In a double-blind, randomized trial, 85 adult patients with acute diarrhea (more than three watery stools per day) received either 500 mg of ciprofloxacin twice daily or placebo for five days. Seventy-six patients were evaluated, 38 patients in the ciprofloxacin group (16 with Salmonella species, 19 with Campylobacter jejuni, and three with Shigella species) and 38 patients in the placebo group (21 with Salmonella species, 11 with C. jejuni, and six with Shigella species). The duration of fever in patients treated with ciprofloxacin was 1.3 days versus 3.1 days in the placebo group (p less than 0.05). The mean duration of diarrhea in the ciprofloxacin group was 1.5 days versus 2.9 days in the placebo group (p less than 0.001). The corresponding numbers in patients with salmonellosis were 1.9 versus 3.4 days (p less than 0.01). In the ciprofloxacin group, all stool culture results became negative within 48 hours of treatment. Relapse occurred in four patients with salmonellosis within three weeks after the end of treatment. In the placebo group, only four of 38 patients had negative stool culture results during treatment and results were negative in only 13 at one week after the treatment period (p less than 0.001). Modest transient elevation of serum transaminase levels was detected in three patients in the ciprofloxacin group and in two patients in the placebo group. Epigastric pain occurred in one patient, and leukopenia occurred in one patient in the ciprofloxacin group. Gastrointestinal discomfort was recorded in two patients and rash was found in one patient in the placebo group. PMID- 3555058 TI - In vitro activity of ciprofloxacin against gram-positive bacteria. An overview. AB - A review of European data published before July 1986 and data from the authors' laboratory showed very similar activity of ciprofloxacin against gram-positive bacteria in all studies. Mean minimal inhibitory concentrations against 50 percent (MIC50) and 90 percent (MIC90) of staphylococcal strains were 0.32 and 0.59 mg/liter, respectively. The drug was equally active against staphylococcal strains resistant and susceptible to methicillin and/or gentamicin. The range of MIC50 and MIC90 values for Streptococcus faecalis and Streptococcus faecium was between 0.25 and 1 mg/liter and 1 to 8 mg/liter, respectively. Ciprofloxacin inhibited group A and group B streptococci at concentrations of 0.5 to 2 mg/liter. Group C and G strains were less susceptible (MICs, 2 to 16 mg/liter). Penicillin-resistant and penicillin-susceptible pneumococci and the Viridans streptococci were inhibited by 0.5 to 4 mg/liter. MIC50 and MIC90 values of ciprofloxacin against Corynebacterium, including group JK, and anaerobic gram positive cocci were 1 and 8 mg/liter, respectively, and against anaerobic gram positive rods, were 2 and 16 mg/liter, respectively. Listeria monocytogenes strains were inhibited by 0.12 to 2 mg/liter. Ciprofloxacin showed bactericidal activity against staphylococci and streptococci in minimal bactericidal concentration tests and in killing kinetic studies. The in vitro activity of the drug was influenced neither by the method employed, by the medium used, by the pH of the medium, nor by the size of the inoculum. Resistance to ciprofloxacin developed in staphylococci in a step-wise manner. First-step mutants usually showed a fourfold to eightfold decrease in susceptibility. Contrary to the situation in gram-negative organisms, resistant mutants did not show reduced growth. PMID- 3555059 TI - Use of intravenous ciprofloxacin in difficult-to-treat infections. AB - Intravenous ciprofloxacin was administered to 54 patients who were either critically ill or in whom oral administration was not possible. The 31 males and 23 females ranged in age from 20 to 89 years (mean, 53.2 +/- 17.8 years). Patients had "difficult-to-treat" infections, i.e., respiratory infections (15), abscesses (four intraabdominal, three lung, two soft tissue, and one intrahepatic), deep soft tissue infections (10), chronic post-traumatic osteomyelitis in exacerbation (nine), upper urinary tract infection (five), malignant external otitis (two), catheter-related bacteremia (two), and infectious endocarditis (one). Thirty patients (56 percent) had serious associated medical problems. Pathogens included Pseudomonas aeruginosa (38 isolates), Acinetobacter species (10 isolates), Enterobacter cloacae (eight isolates), Escherichia coli (two isolates), Proteus mirabilis (one isolate), Kingella kingae (one isolate), Bacteroides fragilis (eight isolates), and Peptostreptococcus species (five isolates). Minimal inhibitory concentrations of ciprofloxacin ranged from 0.003 to 2 micrograms/ml. In 39 patients, the isolated microorganisms were multi-resistant; resistance included ceftazidime and amikacin in 32 patients. In 24 patients, ciprofloxacin was given exclusively by the intravenous route at a dose of 200 mg every 12 hours; in 30 patients, treatment was completed after discontinuation of the parenteral drug with the oral preparation of ciprofloxacin at a dose of 750 mg every 12 hours. The duration of parenteral treatment ranged from six to 40 days (mean, 14.9 days). A successful clinical response was observed in 49 patients (91 percent), while five (9 percent) failed to show a response. Bacteriologic outcomes were as follows: eradication of pathogen in 33 patients (61.1 percent), persistence in 18 (33.3 percent), and relapse in three (5.6 percent), with development of resistance to ciprofloxacin in nine patients (16.7 percent) and superinfection in two patients (3.7 percent). Side effects included vein irritation at the site of the infusion (three patients), abnormal elevation in liver enzyme levels (two patients), reversible renal failure (one patient), and nausea (one patient). Parenteral ciprofloxacin is a safe, well-tolerated, and effective therapy for the critically ill patient, and can be replaced with the oral form when clinically appropriate. PMID- 3555060 TI - Dual individualization of intravenous ciprofloxacin in patients with nosocomial lower respiratory tract infections. AB - Dual individualization is the integration of patient-specific pharmacokinetic parameters with the pharmacodynamics (concentration versus response) of the infecting pathogen. This technique allows description of the time of in vivo bacterial eradication, and allows estimation of optimal dosages using small numbers of seriously ill patients. In an ongoing study, 11 patients with nosocomial lower respiratory tract infections were given 200 mg of intravenous ciprofloxacin every 12 hours. Ten blood samples were taken after the first dose, with additional peaks and troughs measured on Day 4 and at the end of treatment. Bacterial isolates had minimal inhibitory concentrations (MICs) determined by standard microdilution techniques. In the 11 patients, there were 14 bacterial isolates, of which seven were Pseudomonas aeruginosa and the remainder were other pathogens. Ciprofloxacin MICs ranged from 0.008 to 1.0 microgram/ml. The pharmacokinetics of ciprofloxacin in these patients varied with renal function, and average peak serum concentrations ranged from 1.7 to 4.9 micrograms/ml. Eradication of bacteria from tracheal aspirates occurred between Days 1 and 7, except in four patients in whom the organism persisted. Correlations were observed between the day of eradication and the length of time ciprofloxacin concentrations remained above the minimal inhibitory concentration (MIC). Essentially all bacteria with MICs of less than 0.25 were eradicated. Of the non eradicated bacteria, most had either MICs of more than 0.25, or less than 100 percent time above the MIC. The clinical response was satisfactory. It is concluded that 200 mg of intravenous ciprofloxacin every 12 hours is highly effective for bacteria with MICs less than 0.25 microgram/ml, but higher dosages may be required to eradicate organisms with higher MICs. PMID- 3555061 TI - Pharmacokinetics and pharmacodynamics of intravenous ciprofloxacin. Studies in vivo and in an in vitro dynamic model. AB - The pharmacokinetics and pharmacodynamics of a 200-mg intravenous dose of ciprofloxacin were studied in normal volunteers and in an in vitro dynamic model that exposes bacteria to changing concentrations of the drug in a neutropenic setting. Peak ciprofloxacin concentrations in vivo averaged 3.2 micrograms/ml. The terminal serum elimination half-life averaged 4.2 hours. The volume of distribution of ciprofloxacin was large and consistent with extensive extravascular distribution. Slightly less than half of the dose was recovered unchanged in urine by 48 hours after infusion. The median serum bactericidal titer against a strain of Escherichia coli was 1:16 or more for at least six hours after infusion, but was only 1:2 against a strain of Pseudomonas aeruginosa immediately after the end of the infusion. Pharmacodynamic studies in the in vitro model with a simulated regimen of 200 mg administered intravenously every 12 hours demonstrated rapid and complete killing of this strain of E. coli following the first 200-mg "dose." For the strain of P. aeruginosa, an initial bactericidal effect was observed due to the eradication of susceptible subpopulations of bacteria; however, regrowth of resistant organisms was observed. These data suggest that a regimen of 200 mg administered intravenously every 12 hours results in rapid killing of susceptible bacteria. Higher doses or combination therapy may be required to prevent the emergence of resistant P. aeruginosa in this model and in the setting of neutropenia. PMID- 3555062 TI - Treatment of serious infections with intravenous ciprofloxacin. AB - Thirty-four patients were treated with intravenous ciprofloxacin. Thirty infections occurring in 28 patients were assessable for the efficacy analysis. The drug dosage was 300 mg every 12 hours in 19 patients and 200 mg intravenously every 12 hours in nine patients. Twelve patients were also given ciprofloxacin orally after initial intravenous therapy. The mean duration of total therapy was 31 days. The overall clinical response rate was 87 percent, and the bacteriologic response rate was 70 percent. Favorable responses were observed in 10 of 12 patients with osteomyelitis/septic arthritis; seven of eight with soft tissue infection; four of four with pneumonitis; one of two with cystic fibrosis; and four of four with urinary tract infections. Resistance to ciprofloxacin developed in three Pseudomonas aeruginosa isolates. Toxicity was minor: phlebitis occurred in six patients, nausea in six, and rash in one. Intravenously administered ciprofloxacin or intravenous ciprofloxacin followed by oral ciprofloxacin is a safe and effective therapy for serious infections. PMID- 3555063 TI - Ciprofloxacin: an update on clinical experience. AB - This report presents the results of 146 clinical trials of the oral form of ciprofloxacin, a new quinolone antimicrobial agent active against a broad spectrum of gram-negative and gram-positive organisms, including Pseudomonas aeruginosa and methicillin-resistant strains of staphylococci. The safety of ciprofloxacin was assessed in 2,829 patients, most of whom were treated in the United States, and the analysis of efficacy was based on data from 3,981 patients evaluated through June 1986. In general, the patients received ciprofloxacin at a dosage of 250 to 750 mg every 12 hours; the median dose was 500 mg twice daily. Dose-ranging studies in male patients with urinary tract infections indicated that a regimen of 500 or 750 mg twice daily was not substantially more effective than a regimen of 250 mg twice daily. Forty-four double-blind, controlled trials were conducted to compare the efficacy and safety of oral ciprofloxacin with those of standard therapeutic agents in the treatment of infections of the urinary tract, skin and skin structure, respiratory tract, and bone. Ciprofloxacin at 250 mg twice daily was as effective as trimethoprim/sulfamethoxazole at 160/800 mg twice daily in the treatment of urinary tract infections. Orally administered ciprofloxacin in a regimen of 750 mg twice daily was shown to be as effective as cefotaxime administered intravenously at 2 g three times daily in the treatment of infections of the skin and skin structure. When compared with ampicillin for the treatment of respiratory tract infections, ciprofloxacin was as effective in resolving or improving markedly the signs and symptoms of infection and eradicated a higher percentage of causative organisms. Adverse reactions considered probably or possibly related to the drug were reported for 16.2 percent of the patients treated; most were of only mild or moderate intensity and resolved after therapy was completed. Emergence of resistant organisms associated with ciprofloxacin therapy has been reported infrequently. PMID- 3555064 TI - Efficacy of ciprofloxacin in animal models of infection. AB - The antibacterial efficacy of some of the newer quinolone antimicrobial agents in general, and ciprofloxacin in particular, in animal models of experimental septic arthritis, burn wound sepsis, empyema, chronic gastroenteritis, granuloma pouch infection, intraabdominal abscess, osteomyelitis, prostatis, sinusitis, urinary tract infection, and severe septicemia caused by Pseudomonas aeruginosa is reviewed. In addition, the efficacy of these newer quinolones has been studied in animal models of pneumonia, endocarditis, meningitis, skin and soft tissue infections, and a variety of other systemic infections. Although certain limitations are associated with animal models of infection, properly performed studies clearly have the potential to provide guidelines for evaluating the efficacy of antimicrobial agents in the treatment of some infections in humans. PMID- 3555065 TI - Hyporeninemic hypoaldosteronism associated with acquired immune deficiency syndrome. AB - Four patients with the acquired immune deficiency syndrome (AIDS) and persistent unexplained hyperkalemia were studied. Testing with cosyntropin (0.25 mg intravenously) revealed normal baseline and stimulated cortisol levels and adequate aldosterone stimulation. The baseline aldosterone level was low for the degree of hyperkalemia. Renin/aldosterone stimulation testing was performed by intravenous injection of 80 mg of furosemide followed by four hours of upright posture. This study showed low baseline renin and aldosterone levels and inadequate renin and aldosterone stimulation. Three patients were subsequently treated with fludrocortisone (0.1 to 0.2 mg per day), with normalization of serum potassium levels. It is concluded that hyporeninemic hypoaldosteronism is responsible for hyperkalemia in some patients with AIDS and that treatment with fludrocortisone is effective in these cases. PMID- 3555066 TI - Immune deficiency and expanded population of granular lymphocytes after bone marrow transplantation. PMID- 3555067 TI - Candida osteomyelitis. Report of five cases and review of the literature. AB - Candida species have emerged as important pathogens in human infection. Although a variety of deep-seated candidal infections have been reported, Candida osteomyelitis has rarely been described. Five patients with Candida osteomyelitis are presented, and the 32 adult cases previously reported are reviewed. Candida osteomyelitis is noted as a simultaneous occurrence or late manifestation of hematogenously disseminated candidiasis. Osteomyelitis may not be prevented by a course of amphotericin B adequate to control the acute episode of disseminated candidiasis, particularly in immunosuppressed patients. Less commonly, Candida osteomyelitis presents as a postoperative wound infection. Like bacterial osteomyelitis, the most common presenting symptom is local pain. The insidious progression of infection, the nonspecificity of laboratory data, and the failure to recognize Candida as a potential pathogen may lead to diagnostic delay. Diagnosis can be made by either open biopsy or closed needle aspiration. Successful therapeutic regimens have employed combinations of antifungal therapy (most often amphotericin B) with surgical debridement when indicated. It is anticipated that osteomyelitis will become a more commonly recognized manifestation of hematogenously disseminated candidiasis. PMID- 3555068 TI - Clinical spectrum of hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease). AB - Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is an autosomal dominant, systemic fibrovascular dysplasia in which telangiectases, arteriovenous malformations, and aneurysms may be widely distributed throughout the body vasculature. Major clinical manifestations include: recurrent bleeding from mucosal telangiectases and arteriovenous malformations; hypoxemia, cerebral embolism, and brain abscess due to pulmonary arteriovenous fistulas; high-output congestive heart failure and portosystemic encephalopathy from hepatic arteriovenous malformations; and a variety of neurologic symptoms due to central nervous system angiodysplasia. Therapy is primarily supportive, consisting of iron supplementation and blood transfusion. Septal dermoplasty and oral estrogens may allow prolonged remission of epistaxis, but permanent surgical cure of gastrointestinal bleeding is rarely feasible because of diffuse angiodysplasia of the alimentary tract. Ligation, resection, or embolization may be indicated for pulmonary arteriovenous fistulas. The prognosis and survival of patients with hereditary hemorrhagic telangiectasia are favorable, providing treatable complications are accurately diagnosed. PMID- 3555069 TI - Role of conventional chest radiography in diagnosis and exclusion of emphysema. AB - Although recognizing that the subject is controversial, most authors of textbooks about diagnostic radiology conclude that chest radiography is of little value for either confirmation or exclusion of the diagnosis of emphysema. Yet several reports in the literature show a high degree of accuracy in the interpretation of films for presence of this disease. Some of the controversy results from continuing confusion over the current definition of emphysema in terms of lung structure rather than symptoms or physiologic evidence relating to impaired ventilation. Many autopsy studies have shown that emphysema is often present at postmortem examination and can involve as much as 30 percent of the lung tissue, even in subjects with no respiratory symptoms or impairment during life. Since radiographs deal with structure rather than function, interpreters of chest films should have the intention to recognize the presence of structural emphysema. The correct recognition of emphysema is useful even in a patient without symptoms, and the ability to exclude this diagnosis in symptomatic patients is of equal, if not greater value. The degree of success reported in various studies depends upon the criteria used and the strictness applied by the authors in matching their interpretations to the presence or absence of structural emphysema. This review of existing literature deals solely with papers in which radiographic observations have been related to morphologic evidence of emphysema in inflation fixed autopsy lung specimens. It identifies reasons for discrepancies among reports and emphasizes the very high predictive value of validated radiographic criteria. Applications of radiographic interpretation both for diagnosis and for exclusion of emphysema in clinical situations are described. PMID- 3555071 TI - Early patent and proprietary medicines and the treatment of kidney and urinary tract diseases. PMID- 3555070 TI - Renal complications in patients with the acquired immune deficiency syndrome (AIDS). PMID- 3555072 TI - Kidney donation: reflections. AB - Living related kidney donors are still the donors of choice for renal transplantation at most US transplant centers. Nevertheless, many centers are strongly paternalistic and do not allow the potential donor at added risk to determine his own medical suitability. There are several reasons for this paternalism, yet all are flawed. Therefore, we suggest that it is generally ethically justified to allow the informed competent donor at small or unknown added risk to determine his own medical suitability. We offer guidelines to help determine how much added risk a potential donor should be allowed to accept. PMID- 3555073 TI - Computer-assisted patient ed. PMID- 3555075 TI - The American Board of Obstetrics and Gynecology, Inc. PMID- 3555074 TI - Conventional reanastomosis versus laser welding of rat uterine horns. AB - In this study we compared conventional surgical techniques with those of low power CO2 lasers (output 140 mW; spot size 0.4 mm) used to weld transected rat uterine horns. On one side a microanastomosis was made by standard surgical technique of 8-0 nylon; the other side was "welded" either after doing the anastomosis with 8-0 sutures or without any anastomotic sutures. Histologic sections obtained from rats' uteri treated with conventional and laser surgery showed that on the laser-treated sutured side there was less necrosis and inflammatory and giant cells. The animals that underwent laser welding without suturing had no necrosis, suppuration, or granulation; giant cells were not present. We conclude that in the tissue from the laser-treated animals, when compared with conventional and laser-with-suture surgery, histologic features indicate healing process by primary intention via an aseptic noninflammatory reaction. PMID- 3555076 TI - Limitations of fetal heart rate monitoring. PMID- 3555077 TI - Recurrent carcinoma in situ of vulva in skin graft. PMID- 3555078 TI - Dose-dependent effects of prostaglandin D2 on hemodynamics, renal function, and blood gas analyses. AB - Dose-response effects of prostaglandin D2 (0.125, 0.25, 0.5, and 0.75 micrograms/kg/min) infused intravenously in pentobarbital-anesthetized dogs were studied with particular reference to renal, pulmonary, and systemic effects. Another group receiving the vehicle alone served as controls. Prostaglandin D2 administration resulted in a significant dose-dependent increase in renal artery flow, urine output, creatinine clearance, plasma renin activity, sodium excretion, potassium excretion, and pulmonary artery pressure. A significant decrease occurred in renal resistance and arterial PO2. There were no appreciable changes in mean arterial pressure, heart rate, hematocrit, platelet count, arterial pH, and PCO2. In the vehicle control group, all other parameters remained relatively stable, except for some increase in the mean arterial pressure, plasma renin activity, and potassium excretion. The results of this study suggest that prostaglandin D2 administered intravenously at levels lower than those required to produce adverse pulmonary and systemic effects will improve the renal blood flow and function. PMID- 3555079 TI - Altered villus vessel fibronectin in preeclampsia. AB - Fibronectin is a high molecular-weight glycoprotein found in most tissues and body fluids. Maternal plasma fibronectin levels have been shown to be elevated in preeclampsia, but little is known about placental fibronectin in preeclampsia. Fibronectin tissue distribution in placental villi was "blindly" graded by two examiners using placentas from eight nonpreeclamptic and six preeclamptic pregnancies. Selected frozen sections of normal-appearing areas from each placenta were incubated with rabbit antihuman fibronectin antiserum and then stained with fluorescein isothiocyanate-conjugated goat antirabbit immunoglobulin G and examined by fluorescent microscopy. We found less intensity of fetal vessel fibronectin staining in villi from placentas from preeclamptic pregnancies than in those of normal pregnancies (p less than 0.02, Mann-Whitney U test). It is unclear why fetal villous vessels in preeclampsia have decreased tissue fibronectin, but this may reflect an additional vascular abnormality associated with the preeclampsia syndrome. PMID- 3555080 TI - Chorionic villus sampling by rigid forceps: experience with 300 cases at risk for thalassemia major. AB - In this article we report the results of chorionic villus sampling by a biopsy forceps inserted via the cervix under ultrasonic guidance in 300 pregnancies at risk for thalassemia major. A sufficient amount of chorionic villi for deoxyribonucleic acid analysis by oligonucleotide hybridization was obtained in all cases tested but one, with a success rate of 99.7%. The percentage of fetal loss, expressed as proportion of continuing pregnancies, was 4.8%. To verify the results, we carried out amniocyte deoxyribonucleic acid analysis in all the continuing pregnancies for the first 100 cases and in those in which trophoblast deoxyribonucleic acid analysis showed the heterozygous state for beta-thalassemia for the second 200 cases. At the beginning we had two cases of decidual contamination in such an amount to cause misdiagnosis. Successively more careful elimination of decidual tissue from villi avoided avoided this pitfall. These results indicate that chorionic villus sampling by a rigid forceps is a reliable and relatively safe method for fetal diagnosis of genetic diseases by deoxyribonucleic acid analysis. PMID- 3555081 TI - Low-dose digital urography in the pregnant patient. AB - In the pregnant patient when visualization of the ureters is requested, excretory urography is often ordered. We propose the use of digital radiography using single exposure as an alternative to conventional urography. This technique allows significant dose reduction while visualizing the entire urinary tract. It can be performed on most current-generation computerized tomographic scanners. In addition to dose reduction, the ability to manipulate, magnify, and avoid repeat exposures makes this an attractive alternative to the conventional film-screen technique. PMID- 3555082 TI - Clinical and microbiologic risk evaluation for post-cesarean section endometritis by multivariate discriminant analysis: role of intraoperative mycoplasma, aerobes, and anaerobes. AB - The clinical and microbiologic risk factors for postpartum endometritis were studied prospectively in 77 patients undergoing cesarean section without antibiotic prophylaxis at Harbor-University of California at Los Angeles Medical Center. Intraoperative cultures were obtained from the amniotic fluid, lower uterine segment, and abdominal wound for isolation of genital mycoplasmas, aerobes, and anaerobes. Postsection endometritis developed in 21 (27%) patients and was significantly associated with presence of either high-virulence bacteria (predominantly, coliforms, streptococci, anaerobic cocci, and bacteroides) (35% to 60% versus 10% to 24%; p less than 0.05) or Ureaplasma urealyticum (15% to 42% versus 0% to 10%; p less than 0.05) at any site compared with afebrile women. Multivariate analysis identified primary cesarean section, younger maternal age, presence of ruptured membranes, and presence of Ureaplasma as significant risk factors independent of other confounding variables (p less than 0.01). It is suggested that genital mycoplasmas could play a primary role in some cases of postsection endometritis or that they are cofactors or markers for the presence of other high-virulence aerobic and anaerobic bacteria. PMID- 3555084 TI - FMTUTOR: a computer-aided instructional system for teaching fetal monitor interpretation. AB - FMTUTOR is a computer program for instruction in the interpretation of fetal monitor recordings. The system runs on IBM-PC-compatible microcomputers and uses text and computer graphics to illustrate and reinforce important concepts. By means of a 2-hour introductory tutorial session and generation and guided interpretation of an unlimited variety of tracings, it simulates one-on-one instructor-student interactions and allows rapid accumulation of a store of information and experience in monitor tracing interpretation. FMTUTOR is currently used to teach third- and fourth-year medical students at the University of New Mexico. Acceptance has been enthusiastic, and development of more advanced instructional systems targeting nurses, residents, and obstetricians is underway. PMID- 3555083 TI - The effect of oxytocin injection into the umbilical vein for the management of the retained placenta. AB - In a single-blind study 51 patients with retention of the placenta were randomized into one of three groups: Group 1 was given 10 IU of oxytocin in 10 ml of sodium chloride into the umbilical vein; group 2 was given 10 ml of sodium chloride; group 3 was treated with manual removal of the placenta. No significant differences were recorded in groups 1 and 2, and no advantages were found in comparison with the procedure normally used. PMID- 3555085 TI - Computer applications in obstetrics. AB - The potential impact of the computer on the practice of obstetrics has long been recognized and is slowly being realized. Computers are already essential in many administrative aspects of obstetrics and indispensable in data storage and analysis for clinical research. Emerging applications include computer systems for taking the perinatal history, storage and on-line interpretation of fetal monitor tracings, information retrieval for case management and research purposes, and computer-assisted instruction. Future applications offer possibilities of computerized consulting for support of obstetric decisions and sophisticated case simulations for continuing education. PMID- 3555086 TI - Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development. AB - A prospective study of ultrasonography was conducted in 371 normal pregnant women, with gestational ages ranging from 13 weeks to 40 weeks. Several biometric measurements were obtained including the transverse cerebellar diameter, the biparietal diameter, the occipitofrontal diameter, and the calculated head circumference. Curvilinear relationships were found between the transverse diameter of the cerebellum (measured in millimeters), and the gestational age (R2 = 0.948; P = 0.001), the biparietal diameter (R2 = 0.956; P = 0.0001), and the head circumference (R2 = 0.969; P = 0.0001). A nomogram of cerebellar measurements estimating gestational age and predicting the biparietal diameter and head circumference was generated. Throughout pregnancy the establishment of normative cerebellar measurements allows for the estimation of gestational age that is independent of the shape of the fetal head and offers potential for evaluation of abnormal fetal growth and anomalous development of the central nervous system. PMID- 3555087 TI - Prenatal sonographic assessment of the fetal thorax: normal values. AB - Fetal thoracic circumference and thoracic length measurements were obtained by ultrasonographic examination on 576 women between 16 and 40 weeks gestation. Nomograms for thoracic circumference and thoracic length with respect to gestational age were developed. Growth of both thoracic parameters was observed to be linear throughout gestation. In normal pregnancy the ratios of thoracic circumference to abdominal circumference and thoracic length to humerus length remained virtually constant at 0.89 and 0.93, respectively. PMID- 3555088 TI - Single-dose antimicrobial therapy in the treatment of asymptomatic bacteriuria in pregnancy. AB - Fifty obstetric patients with asymptomatic bacteriuria were treated by single dose antimicrobial therapy. The immediate cure rate was 84% and the recurrence rate was 12%. Seven of the eight patients in whom single-dose treatment failed responded to subsequent 7-day therapy with the same drug, indicating renal involvement. A 50% recurrence rate in the group of patients in whom single-dose treatment failed was compared with a 5% recurrence rate in the group cured by single-dose therapy, which indicates that failure with single-dose antimicrobial therapy can serve as a therapeutic test to identify patients at high risk for recurrent bacteriuria and its sequelae during pregnancy. It is concluded that single-dose antimicrobial therapy is a safe and effective way to treat asymptomatic bacteriuria in pregnant patients without urologic problems in their history. PMID- 3555089 TI - Placental volume measurement by ultrasonography: evaluation of the method. AB - A method for placental volume measurement by parallel ultrasonographic section scans is presented. An interval of 2 cm between the scans proves most effective. During measurement the patient should lie in the lateral position to prevent caval vein compression. The precision of the method as estimated by the SE is between 10 and 50 ml. The volume measured reflects both placental cellular mass and placental circulating blood volume. Drainage of the latter after delivery causes a fairly large difference between antepartum placental volume and postpartum placental weight (volume/weight ratio 1:6). PMID- 3555090 TI - Single-dose cephalosporin for prevention of major pelvic infection after vaginal hysterectomy: cefazolin versus cefoxitin versus cefotaxime. AB - Antimicrobial overutilization accelerates the development of bacterial resistance. A prospective, randomized, blinded clinical trial of vaginal hysterectomy prophylaxis was designed to compare the efficacy, safety, and costs of cefazolin with those of cefoxitin and cefotaxime. Sixteen women (7.5%) developed febrile morbidity only, 10 (4.7%) developed major pelvic infection requiring parenteral antimicrobial therapy, and neither clinical nor laboratory adverse reactions of significance were observed. Anemia, diabetes, and additional surgical procedures were associated with a significantly increased incidence of postoperative infection; no regimen was more protective for women with or without these risk factors. Infections almost doubled hospital stay and the charges for health care. Diagnosis-related group reimbursement would have been more than $1,300 less than the mean hospital charge for women who developed infection. Utilizing cefazolin for prophylaxis and reserving cefoxitin and cefotaxime for therapy is cost and antimicrobial efficient. PMID- 3555092 TI - Diabetes and spontaneous abortion: a historical review. AB - The recent claims that there is an increased frequency of spontaneous abortion in diabetic pregnancies prompted a reexamination of this question. More than 50 articles published in 1950 to 1986 containing relevant information provided the data for this purpose. In 8041 American and European, otherwise uninterrupted diabetic pregnancies ascertained through hospital records, mostly not specified as to the time at first examination and the interval covered, there occurred 10.0% +/- 0.3% spontaneous abortions. The frequency was significantly greater (12.7% +/- 0.7%), however, in the 1890 pregnancies observed during specifically stated extended periods. The records are marred by the lack of control pregnancies and the great absence of information regarding the variables and confounding factors that influence the spontaneous abortion rate. Nevertheless, since the results are very similar to those found in general clinical material it is most probable that there is no excess of spontaneous abortion in diabetic pregnancy. The recent claims of such an increase may have been based on the pregnant women in these studies being seen earlier and being closely examined for longer periods than has usually been the case and to the enrollment in the studies of women with unrepresentatively great risk of reproductive mishap. PMID- 3555091 TI - Ovarian myxoma. AB - The clinical history, light microscopic, electron microscopic, and immunopathologic findings of an ovarian myxoma in a 32-year-old woman are described. We believe this to be only the fourth such case reported. PMID- 3555094 TI - Group B beta-hemolytic streptococcal sepsis. PMID- 3555093 TI - Controversies concerning the safety of estrogen replacement therapy. AB - Unopposed estrogen replacement is known to cause endometrial carcinoma in a small percentage of postmenopausal women, but the effects on ovarian and breast tissue remain uncertain. The increased risk of endometrial carcinoma seems to be related to both the dosage and duration of unopposed estrogen treatment. Until very recently, the morbidity and costs that result from the need for endometrial biopsy because of abnormal bleeding and from the need for hysterectomy due to hyperplasia have been ignored, but recent data suggest that they are likely to be considerable. Progestogens are known to protect against endometrial hyperstimulation, but the optimal duration of therapy each month and the maximally protective agent and dose remain to be determined. Estrogen replacement therapy may reduce the risk of arterial disease; however, the comparative effects of the various preparations, as well as their respective mechanisms of action, must be subjected to further study. PMID- 3555095 TI - Medical and surgical treatment of Acanthamoeba keratitis. AB - We examined seven patients with Acanthamoeba keratitis. All patients had a history of soft contact lens use. Predisposing factors included use of homemade saline, hydrogen peroxide disinfection, a history of improper lens care, and swimming with contact lenses. Currently recommended medical therapy, including topical propamidine isethionate and dibromopropamidine isethionate, miconazole, Neosporin, corticosteroids, and systemic ketoconazole, was used in all patients. Five patients have undergone penetrating keratoplasty for progressive primary Acanthamoeba keratitis (four patients) or recurrent infection (one patient) after maximal medical therapy. Two patients who began medical therapy less than three weeks after the onset of symptoms have done well. Early diagnosis of Acanthamoeba keratitis appears critical for successful medical therapy. Penetrating keratoplasty continues to have a central role in the management of more advanced cases that are unresponsive, or only transiently responsive, to medical therapy. PMID- 3555096 TI - Immunopathology and electron microscopy of Acanthamoeba keratitis. AB - In order to evaluate the local cellular immune response to Acanthamoeba infection we performed immunohistochemical examinations of the corneal buttons of two patients with Acanthamoeba keratitis. We found that the corneal stroma was infiltrated with polymorphonuclear leukocytes and HLA-DR positive macrophages that appeared to be stromal keratocytes by light microscopy. Despite the presence of chronic inflammation in both patients, no stromal lymphocytes were seen in one patient and a sparse lymphocytic infiltrate was seen in the other patient. Electron microscopy confirmed the presence of macrophages, neutrophils, and Acanthamoeba organisms in these two patients. PMID- 3555097 TI - Immunohistochemical characterization of human retinoblastomas in situ with multiple markers. AB - We studied paraffin-embedded specimens from 18 surgically enucleated eyes with retinoblastoma by peroxidase-antiperoxidase immunohistochemistry with antibodies against glial fibrillary acidic protein, S-100 protein, Leu 7 epitopes, neuron specific enolase, the 200-kilodalton subunit of the neurofilament triplet polypeptide, and retinal S-antigen. We found that (1) glial fibrillary acidic protein, S-100 protein, and Leu 7 epitopes were detected only in well differentiated glial cells that were interpreted as reactive and not neoplastic, (2) undifferentiated neoplastic cells expressed both neuron-specific enolase and retinal S-antigen immunoreactivity, and (3) differentiated cells forming Flexner Wintersteiner rosettes were found to express neuron-specific enolase, retinal S antigen, and, occasionally, neurofilament protein. These results support the view that retinoblastomas are composed of neuron-committed cells and favor the origin of these tumors from photoreceptor progenitor cells. We did not find any morphologic or immunohistochemical evidence of glial differentiation from tumor cells that would support the concept that retinoblastoma arises from a primitive neuroectodermal cell capable of divergent differentiation along neuronal and glial lines. PMID- 3555098 TI - Retinal vasculitis in Crohn's disease. AB - Although systemic vasculitis is a prominent part of the extraintestinal complications of Crohn's disease, the association of a retinal vasculitis with this chronic granulomatous disease of the gastrointestinal system is rare. We examined a 26-year-old woman with biopsy-proven Crohn's disease who developed a severe bilateral, obliterative retinal arteritis and phlebitis, leading to a marked loss of vision. Treatment with systemic corticosteroids and cyclophosphamide succeeded in halting progression of the disease. PMID- 3555099 TI - National Institutes of Health--100 years. PMID- 3555100 TI - A method for accurate centering of the Hessburg-Barron trephine. PMID- 3555101 TI - Modified placement of adjustable strabismus sutures. PMID- 3555102 TI - Phenotyping of proliferating lymphocytes in angioimmunoblastic lymphadenopathy and related lesions by the double immunoenzymatic staining technique. AB - Biopsy specimens of lymph nodes with the histologic characteristics of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) were obtained from 9 cases (4 cases of AILD and 5 cases of AILD-like T lymphoma [AILD-T]) and histologically analyzed by the use of a double immunoenzymatic staining technique with the combination of a monoclonal antibody against lymphocyte membrane antigen and that against human DNA polymerase alpha (pol alpha), which is detectable in the nucleus of the cells in G1, S, and G2 phases. In all 9 cases, the pol alpha + proliferating cells had a peripheral T-cell phenotype with T11 and Leu-4 antigens, whereas proliferating B cells with B1 antigen were rarely observed. As for T-cell subset antigens, the proliferating T cells had T4+ helper/inducer phenotype in 7 cases, while T8+ suppressor/killer T cells proliferated in 2 cases, although a significant number of T4+ proliferating cells were also recognized. The study on malignant lymphomas that evolved in the 2 cases showed that the T-subset antigens on major proliferating tumor cells were the same as those found in the preceding AILD lesions, suggesting that lymphoma T cells originate from the AILD lesion. The results suggested that AILD without histologic manifestations of malignancy and AILD-T may be a neoplastic disease derived from either subset of peripheral T cells. PMID- 3555103 TI - Antigenic differences between human platelets and megakaryocytes. AB - To investigate the apparent paradox in the observation that most patients with immune thrombocytopenias have normal or increased numbers of megakaryocytes (MKs), the extent of antigenic cross-reactivity between normal platelets and MK was examined. Indirect immunofluorescence and ultrastructural studies were carried out by means of four antisera specific for platelets: anti-GpIb, anti GpIIb/IIIa, anti-PLA1, and an antiserum from a patient with quinidine-induced thrombocytopenia. Following incubation of freshly collected marrow with these antisera, MK were first identified by phase-contrast microscopy and then inspected for fluorescence. Almost all MKs were found reactive with the last three antisera, albeit to a variable extent. In contrast, only 24% reacted with anti-GpIb. The pattern of fluorescence, ie, rim, partial or cytoplasmic, appeared to be related to the extent of MK fragmentation. Only rim fluorescence of living MKs could be interpreted to indicate that the platelet epitope was exposed on the surface of the precursor cell. The observations suggest that platelet antigens are variably expressed on the plasma membranes of MKs. In a clinical setting, the heterogeneity among platelet target antigens and the extent to which these are exposed on MKs at various stages of maturation may dictate the severity of the thrombocytopenia and degree of ineffective thrombocytopoiesis. PMID- 3555104 TI - Products of cells cultured from gliomas. VI. Immunofluorescent, morphometric, and ultrastructural characterization of two different cell types growing from explants of human gliomas. AB - Explants derived from human gliomas have been characterized with respect to their cellular outgrowth pattern after 1-22 weeks in culture. A mat of cells which were fibronectin (FN)-positive and glial fibrillary acidic protein (GFAP)-negative (hereafter designated FN+ cells) with a polygonal, flat morphology covered the growth substrate in a swirling pattern for a mean diameter of 9.2 mm around FN+ explants. FN+ cells showed ruffled plasmalemma, dilated rough endoplasmic reticulin (RDR), and extracellular filamentous strands. Rare desmosomes were compatible with at most minor leptomeningeal components or differentiation. FN+ cells predominated in six of seven cultures at passage 2, and their features were the same from various high-grade gliomas and gliosarcoma. Around other explants, elongated or stellate cells which were GFAP+ and FN- grew in a netlike pattern with little cell-to-cell contact. These GFAP+ cells surrounded explants at a mean diameter of 2 mm, substantially less than FN+ cells (P less than 0.005), and they grew more slowly than FN+ cells around explants. GFAP+ cells had an area/perimeter ratio which was less than that of FN+ cells. GFAP+ cells contained abundant intracellular filaments, rare desmosomes, and narrow RER cisternae. In mixed explants, GFAP+ cells often grew on top of FN+ cells. Individual cells which stained for both GFAP and FN were evident only from one glioma (8% doubly positive). Cells negative for both proteins resembled FN+ cells morphologically. Frozen sections of original glioma tissue showed FN+ vessel walls and GFAP+ parenchyma. Results are evidence for very early overgrowth of a preexistent FN+ cell type distinct from the GFAP+ parenchymal cell. The features of this distinct cell type are mesenchymal and resemble the proliferating vascular elements of gliomas in situ. The tendency for GFAP+ cells to grow on top of these FN+ cells suggests a feeder layer interaction. More knowledge of the origins and interactions of these two cell types may increase our understanding of the mechanism of antigenic changes in gliomas and may provide clues to improved therapeutic approaches. PMID- 3555105 TI - The effects of cyclophosphamide and irradiation singly and in combination upon SaI growth in A/J mice. AB - The effects of various doses of cyclophosphamide and low-dose (15 rads) radiation upon the size of tumors caused by 10(4) Sarcoma I (SaI) cells was determined. In intact A/Jax (A/J) recipients, the effect of the two agents singly and in combination was found to be dependent especially upon the dosage of cyclophosphamide and the time of its administration in relation to tumor inoculation. In cell transfer experiments to adult thymectomized, lethally irradiated, bone-marrow-restored (ATxXBM) mice, the effects of cyclophosphamide and irradiation appeared to be either overlapping (low dosages of cyclophosphamide) or additive (dosages of cyclophosphamide greater than or equal to 50 mg/kg), suggesting that the two agents exert their influence in dissimilar fashion, perhaps by injuring different cell types with the same basic function. The most pronounced conjoint effects are seen when low dosages of cyclophosphamide are given 3 days after the adoptive transfer of spleen cells from mice pretreated with low-dose irradiation. The implications of this observation with respect to immunotherapy are discussed. PMID- 3555107 TI - Obituary: William Walter Greulich, 1899-1986. PMID- 3555106 TI - HHF35, a muscle actin-specific monoclonal antibody. II. Reactivity in normal, reactive, and neoplastic human tissues. AB - Monoclonal antibody HHF35 has previously been characterized biochemically as recognizing isotypes of actin (alpha and gamma) which are specific to muscle cells. In this study, the authors have investigated the normal and pathologic tissue distribution of HHF35-positive cells using the avidin-biotin immunoperoxidase method on methacarn-fixed, paraffin-embedded sections of human tissue. In addition to muscle tissues (smooth, skeletal, and cardiac) the antibody localizes to myoepithelium, as well as most of the capsular cells of several parenchymal organs, including liver, kidney, and spleen, with extension of the latter cells into the splenic trabeculaes. In pathologic tissues, the antibody localizes to cells, identified by some investigators as "myofibroblasts," in the stroma of certain tumors, within hyperplastic fibrous tissue responses ("fibromatoses") such as Dupuytren's contracture, and within fibrotic lung tissue. HHF35 also localizes to cells that proliferate within the intima in lesions of atherosclerosis and to a unique population of reactive mesothelial and submesothelial cells. Among tumors, it is positive only on leiomyomas, leiomyosarcomas, and rhabdomyosarcomas, and negative on all nonmuscle sarcomas. This antibody thus shows great potential utility as a diagnostic reagent in various pathologic conditions, most especially in the diagnosis of tumors of muscle origin. PMID- 3555108 TI - Three cheers for cell physiology, everybody. PMID- 3555109 TI - Mutant isolation and gene transfer as tools in study of transport proteins. AB - Somatic cell and molecular genetic concepts, techniques, and approaches relevant to the analysis of a complex mechanism such as a mammalian ion transport system are reviewed and illustrated with examples taken from studies of K+ transport mutants. The reasons for undertaking a study of mutants and mutations are stated and followed by directly applicable approaches to transport mutant isolation. Examples of the types of information that can be extracted from a characterization of such mutants is then presented. The parasexual system of somatic cell hybridization is reviewed, again, followed by applicable approaches and examples of how data from such studies can be used. Finally, the technique of DNA-mediated gene transfer is presented as a method that allows the actual isolation of a transporter gene which has been characterized as above. PMID- 3555110 TI - Band 3 is the basolateral anion exchanger of dark epithelial cells of turtle urinary bladder. AB - The turtle urinary bladder serves as a model for collecting duct functions in the mammalian kidney. The epithelium of both the turtle bladder and the mammalian collecting duct can generate a steep gradient for H+ ions between blood and urine. Secretion of H+ into the urine is coupled to a basolateral efflux of HCO-3 that appears to be exchanged mainly against Cl-. Here we show that approximately 80% of the dark cells of the bladder contain a 110,000 relative molecular weight (Mr) analogue of the turtle erythrocyte anion exchanger, band 3. The band 3 analogue is confined to the basolateral cell surface and is absent from the apical membrane. A minor population of the dark cells (approximately 20%), which have been previously suggested to represent reverse cells that are involved in HCO-3 secretion rather than absorption, appears not to express a band 3-like anion exchanger, at either the apical or the basolateral membrane. The bladder band 3 protein is colocalized with actin and isoforms of ankyrin (200,000 Mr) and spectrin (230,000 Mr) along the basolateral membrane. Linkage of band 3 via ankyrin to the spectrin-actin lattice may restrict this anion exchanger to the basolateral membrane surface. In view of our previous observation of a band 3 like anion exchanger in the collecting duct epithelium of the rat kidney, these findings point to a common molecular basis for acid-base transport in the mammalian collecting duct and the reptilian urinary bladder. PMID- 3555111 TI - Regional blood flow and skeletal muscle energy status in endotoxemic rats. AB - Endotoxins induce muscle wasting in part as a result of depressed protein synthesis. To investigate whether these changes reflect impaired energy transduction, blood flow, O2 extraction, and high-energy phosphates in muscle and whole-body O2 consumption (VO2) have been measured. VO2 was measured for 6h after an initial sublethal dose of endotoxin (Escherichia coli lipopolysaccharide 0.3 mg/100 g body wt sc) or saline and during 6h after a second dose 24 h later. In fed or fasted rats, VO2 was either increased or better maintained after endotoxin. In anesthetized fed rats 3-4 after the second dose of endotoxin VO2 was increased, and this was accompanied by increased blood flow to liver (hepatic arterial supply), kidney, and perirenal brown adipose tissue and a 57 and 64% decrease in flow to back and hindlimb muscle, respectively, with no change in any other organ. Hindlimb arteriovenous O2 was unchanged, indicating markedly decreased aerobic metabolism in muscle, and the contribution of the hindlimb to whole-body VO2 decreased by 46%. Adenosine 5'-triphosphate levels in muscle were unchanged in endotoxin-treated rats, and this was confirmed by topical nuclear magnetic resonance spectroscopy, which also showed muscle pH to be unchanged. These results show that although there is decreased blood flow and aerobic oxidation in muscle, adenosine 5'-triphosphate availability does not appear to be compromised so that the endotoxin-induced muscle catabolism and decreased protein synthesis must reflex some other mechanism. PMID- 3555112 TI - Appraising the nature of luteinizing hormone secretory events in men. AB - We have appraised the nature of spontaneous luteinizing hormone (LH) secretory events in normal men by analyzing immunoactive LH concentrations in blood samples withdrawn at 5-min intervals for 24 h in eight healthy individuals. A novel discrete deconvolution algorithm was applied to determine apparent instantaneous LH secretory rates from these LH concentration series. These analyses unmasked unique attributes of spontaneous LH secretory events, which were represented as delimited momentary augmentations in endogenous LH secretory rates interspersed among intervals of relative secretory quiescence. For three different peak detection thresholds (P = 0.02, = 0.01, and = 0.005), the frequency of LH secretory episodes was significantly greater than that of LH "pulses" judged from concentration data alone. Moreover, the total mass of LH released within discrete secretory episodes could account for approximately 90% of LH secreted during the day. This model of distinct, short-lived, burst-like secretion of LH has important implications for further investigations of the neuroendocrine regulation of gonadotropin secretion in humans. PMID- 3555113 TI - Underestimation of hepatic glucose production by radioactive and stable tracers. AB - Although negative hepatic glucose production rates are physiologically impossible, they have been observed when hepatic glucose production is measured with the tracer-dilution technique during the hyperinsulinemic, euglycemic glucose clamp. Because hepatic glucose production is determined from the difference between tracer-derived glucose disposal and the known exogenous glucose infusion rate, the negative values for hepatic glucose production must result from an underestimation of glucose disposal by the tracer technique. In the current investigation, tracer-derived glucose disposal was measured in 25 subjects undergoing hyperinsulinemic, euglycemic clamps. Glucose disposal was measured with both radioactive and stable isotopes that utilize different methodologies, to determine whether discriminant metabolism of the isotopes versus methodological error leads to underestimation of tracer-derived glucose disposal. Both the radioactive and stable methodologies underestimated the exogenous glucose infusion rate during the hyperinsulinemic euglycemic clamp by 27 and 17%, respectively. Mean hepatic glucose production was -2.1 +/- 0.2 and 1.3 +/- 0.2 mg X kg-1 X min-1 as determined by the radioactive and stable isotope methodologies, respectively. Methodological error was an unlikely cause of this underestimation because it occurred with two different methodologies. The most likely explanation for underestimated rates of glucose disposal determined by the two types of isotope methodologies is discrepant metabolism of glucose tracers in comparison with unlabeled glucose. PMID- 3555114 TI - Characterization of mitochondrial-uncoupling protein in bovine fetus and newborn calf. AB - Development changes in the content of the mitochondrial-uncoupling protein (UCP) have been studied in adipose depots of bovine fetuses and a newborn calf as well as in adipose depots of newborn and aging lambs. The occurrence of UCP unique to brown adipose tissue (BAT) was investigated by GDP binding, photoaffinity labeling with 8-azidoadenosine 5'-triphosphate, and immunoblots using specific antibodies directed against rat UCP. A protein of 32,000 relative molecular weight was characterized in both species with properties similar to those of rodent UCP. In bovine, UCP became detectable in the perirenal adipose tissue at day -80 and its content increased until birth. Both in bovine (perirenal, subscapular, and retroperitoneal sites) and in ovine (perirenal, subscapular, retroperitoneal, and pericardiac sites), all adipose tissues except the subcutaneous adipose tissue contained at birth UCP and thus can be considered as BAT. The data indicate that the perirenal adipose depot should play in bovine and ovine a major thermogenic role at birth, whereas perirenal and pericardiac adipose tissues of lambs held under cold conditions for 45 days after birth did not show any immunoreactive UCP. PMID- 3555115 TI - Apolipoprotein A-IV synthesis in rat intestine: regulation by dietary triglyceride. AB - Apolipoprotein A-IV (apoA-IV) synthesis rates were measured in vivo in rat enterocytes by immunoprecipitation after administration of [3H]leucine into in situ loops of jejunum and ileum. Basal apoA-IV synthesis rates (percent total protein synthesis) were significantly higher in jejunal enterocytes (2.05 +/- 0.54%) compared with ileal enterocytes (0.48 +/- 0.32%) from the same fasted animals. After an acute triglyceride bolus, significant and sustained elevations of apoA-IV synthesis rates were seen in both jejunal and ileal enterocytes with maximal effects noted at 4-6 h. Animals fed diets containing 30% wt/wt triglyceride as saturated (SF) or polyunsaturated (UF) fats for 6 wk had similarly increased rates of apoA-IV synthesis in jejunal enterocytes with both SF (3.73 +/- 0.83%) and UF (3.33 +/- 0.64%) but no change in ileal enterocytes. By contrast, animals consuming a fat-free diet for 3 wk had jejunal apoA-IV synthesis rates indistinguishable from basal values (2.40 +/- 0.45%). Translatable intestinal mRNA levels for pre-apoA-IV after triglyceride increased in parallel to synthesis rates with a 50% increase in jejunum and a 350% increase in ileum observed at 4-6 h. These results suggest that apoA-IV synthesis by rat small intestine increases in response to acute and chronic dietary triglyceride, is maintained in the absence of dietary triglyceride, and may be under pretranslational control. PMID- 3555116 TI - Prostaglandin independence of kinin-stimulated renin release. AB - Bradykinin can increase prostaglandin synthesis and also stimulate renin release in vitro. Because prostaglandins also stimulate renin, studies were performed to determine whether bradykinin stimulation of renin is a function of prostaglandin synthesis. Isolated glomeruli with attendant arteriolar attachments were harvested from rat kidneys and superfused. The effluent was analyzed for renin, prostaglandins E2 and I2 (6-keto-PGF1 alpha). Bradykinin (10(-5) M) increased renin by 50% with a concomitant increase in prostacyclin (PGI2) but not in prostaglandin E2 (PGE2). The cyclooxygenase inhibitor meclofenamate (1.6 X 10(-5) M) inhibited bradykinin-induced PGI2 synthesis but not the concurrent increase in renin release. Additionally, neither the phospholipase inhibitor quinacrine (10( 2) M) nor the prostacyclin synthetase inhibitor 9,11-azoprosta-5,13-dienoic acid (Azo analogue-1) (5.67 X 10(-6) M) eliminated bradykinin-induced renin release. Superfusion with calcium-free media and EDTA increased basal renin release 2.5 fold, and bradykinin stimulated a twofold increase in renin release. Neither a high (10(-2) M) media calcium nor the calcium channel blocker nifedipine (10(-6) M) eliminated bradykinin stimulation of renin. These results suggest that bradykinin stimulation of renin is at least partially independent of prostaglandin synthesis and that bradykinin must act by some prostaglandin independent pathway to induce renin release from isolated glomeruli. PMID- 3555117 TI - Renin secretory effects of N6-cyclohexyladenosine: effects of dietary sodium. AB - Previous observations by others have shown that Na deprivation augments and Na loading attenuates the inhibitory effect of exogenous adenosine on renin secretion in vivo. The purpose of the present experiments was to test the hypothesis that Na deprivation and Na loading alter the sensitivity of the adenosine receptors (A1 subclass) that mediate the inhibitory effect. The rat renal cortical slice preparation was used. Na loading decreased and Na deprivation increased tissue renin content and the basal renin secretory rate; these two variables were directly related (r = 0.84, P less than 0.00005). N6 cyclohexyladenosine (CHA), an adenosine analogue that selectively activates the A1 subclass of adenosine receptors in the nanomolar to micromolar concentration range inhibited renin secretion over the same range of concentrations (nM-microM) and to approximately the same maximal extent (to 50% of the mean basal secretory rate) in cortical slices taken from Na-loaded, control, and Na-deprived rats. These results demonstrate that changes in the intrinsic sensitivity of adenosine receptors do not explain dietary Na-induced changes in the in vivo renin secretory response to exogenous adenosine. PMID- 3555118 TI - Subcellular distribution of renal tripeptide-releasing exopeptidases active on collagen-like sequences. AB - The rat kidney cortex was found to contain two N-terminal exopeptidases of the tripeptidyl peptidase (TPP) class. Each required a free N-terminus to catalyze the release of collagen-related (Gly-Pro-X) "triplets." In accordance with their apparent pH optima, activities were routinely determined fluorimetrically at pH 4.0 (TPP 4) and at pH 7.0 (TPP 7) on Gly-Pro-Met-2-naphthylamide. The specific activity in both the homogenate and the classical subfractions was much greater at pH 7 than at pH 4. Subfractionation of the microsomal fraction by equilibrium banding in sucrose did not separate the TPP 4 and TPP 7 activities. The banding density (1.18 g/ml) and the distribution patterns for TPP 7 in the microsomal subfractions, and also in the subfractions of the small lysosomes in the mitochondrial-lysosomal (ML) fraction, demonstrate that TPP 7 is associated with smooth membranes. The TPP 4 and TPP 7 activities were clearly separated during subfractionation of the ML fraction. Rate sedimentation demonstrated that TPP 4 was present in the large, fast-sedimenting lysosomes (protein droplets) and in a heterogeneous broad band of smaller lysosomes. Equilibrium banding of the small lysosomes gave two distinct TPP 4-containing populations at densities 1.20 and 1.235 g/ml. Notably, dipeptidyl peptidase II (DPP II) gave identical banding densities and showed distributions very similar to TPP 4.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555119 TI - Interleukin-1 decreases renal sodium reabsorption: possible mechanism of endotoxin-induced natriuresis. AB - Administration of pyrogen or endotoxins such as Escherichia coli lipopolysaccharide can elicit a marked increase in urinary sodium excretion. This response occurs without any elevation in the filtered load of sodium and it does not appear to be prostaglandin mediated. The various effects produced by endotoxins appear to have interleukin-1 as a common mediator. In the present work, we have studied whether human recombinant interleukin-1 beta (hrIL-1) could affect the renal handling of sodium and thus, could be implicated in natriuretic response to pyrogens or endotoxins. We observed that hrIL-1 intravenously injected into conscious rats provokes a marked increase in sodium excretion. This natriuretic response was not associated with any increase in glomerular filtration rate (clearance of [3H]inulin), nor was it accompanied by significant changes in the urinary excretion of potassium, calcium, or inorganic phosphate. The only concomitant alteration was a decrease in urinary pH. Pretreatment with indomethacin abolished the effect of hrIL-1 on urinary pH but did not modify the natriuretic response. In conclusion, hrIL-1 elicits a selective decrease in tubular sodium reabsorption, which does not appear to involve a change in prostaglandin synthesis. This observation strongly suggests that interleukin-1 could be a key mediator in endotoxin-induced natriuresis. PMID- 3555120 TI - Determination of plasma volume in swine by the enzyme-dilution method. AB - Plasma volume of six young swine was determined by simultaneous dilution in the plasma of two purified porcine enzymes, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and Evans blue dye. Ninety-minute time-activity and time-concentration curves were obtained, and the dilution spaces of each plasma indicator at the time of injection were estimated by extrapolation of data from the first 30 min after injection. Plasma volumes estimated using the two enzymes agreed closely with each other (AST, mean 50.2 ml/kg; ALT, mean 49.8 ml/kg) and were 11% smaller than those determined using Evans blue dye (mean 56.3 ml/kg). Plasma volumes calculated from the AST and ALT activities and Evans blue dye concentration in a sample drawn 5 min after injection very closely approximated those obtained by extrapolation. These values were comparable to previously published estimates of plasma volume for swine of equivalent weight. Endogenous plasma levels of AST and ALT activity were measured in samples drawn from five swine before and after a 40% blood loss. No significant change in AST or ALT activities occurred after hemorrhage. PMID- 3555121 TI - Ion transport in circulatory and/or septic shock. AB - This review surveys investigations of membrane ion transport in animals in hemorrhagic, endotoxic, or bacteremic shock. The focus of the review is on ion transport studies in the skeletal muscle and liver. Skeletal muscle Na+-K+ transport alterations have been shown during the induction of shock via hemorrhage, endotoxin, or live Gram-negative bacteria in the rodent, canine, and primate species. These alterations include impairment of active cellular K+ accumulation, increased permeability to Na+ and Cl-, and membrane depolarization. The ion transport alterations in the skeletal muscle are compatible with movement of extracellular fluid into the intracellular compartment. Such fluid movements can potentially lead to decreases in circulating plasma volume and thus to circulatory deficits in shock. Studies in the liver of rats subjected to hemorrhagic or endotoxic shock indicated the failure of electrogenic Na+ pump. Although the hepatic cellular membrane permeability to Na+ relative to permeability to K+ appeared unaltered in hemorrhagic shock, endotoxic shock caused an increase in permeability to Na+. Hepatic cellular Ca+ regulation also appeared to be adversely affected during endotoxic shock. Alterations in hepatic Na+-K+ transport and Ca+ regulation could contribute to impairment in hepatic glucose production during shock. Although mechanisms of altered membrane ion transport during shock states remain unknown, such changes could occur prior to any substantial loss of cellular metabolic energy. PMID- 3555122 TI - Intravenous insulin infusions in rats decrease gustatory-evoked responses to sugars. AB - Physiological factors that affect food intake have been shown to influence taste evoked activity in the rat's central nervous system. Insulin appears to have a bimodal effect on feeding, inhibiting intake when its rise is within the normal physiological range, but, with further increases, causing hyperphagia. We studied the effect of low intravenous doses (0.5 U/kg) of regular insulin on taste-evoked responses in the nucleus tractus solitarius. Taste activity was elicited by application to the tongue of glucose, fructose, NaCl, HCl, and quinine. We monitored responses before and after intrajugular injections of insulin or a control vehicle. Taste responsiveness to glucose and fructose was significantly reduced for the period 7-22 min following the injection. Activity representing NaCl, HCl, and quinine was unaffected. The suppression of responsiveness to sweet stimuli could decrease the hedonic appeal of tastants and so serve as a mechanism by which physiological doses of insulin could contribute to a reduction in feeding. PMID- 3555123 TI - Psychiatric aspects of AIDS. AB - Acquired immune deficiency syndrome (AIDS) has neuropsychiatric and psychopathological complications: anxiety, depressive symptoms, and suicidal ideation are common. Patients may express anger toward ineffective medical care and perceived public discrimination, guilt about sexual practices or drug abuse, reactions to social isolation, and uncertainty about the implications of an AIDS diagnosis. CNS dysfunction and subsequent neuropsychiatric impairment are common and are initially characterized by decreased acuity, slowed mentation, and psychomotor retardation that can resemble depression. Marked global cognitive deficits, disorientation, and delusions ensue. The author discusses case management and outlines future clinical and research activities. PMID- 3555124 TI - Differences in resource use and cost among facilities treating alcohol, drug abuse, and mental disorders: implications for design of a prospective payment system. AB - Specialized psychiatric facilities, including qualified distinct-part units in general hospitals, are exempt from Medicare's diagnosis-related group prospective payment system (PPS). One major reason for continuing the exemption is the redistribution of revenue that would probably occur if a single national price were established for care at the diverse facilities that treat patients with psychiatric and substance abuse disorders. This study investigated the extent of such potential redistribution in a private health insurance data base and found that a PPS would systematically underpay specialized facilities and systematically overpay general hospitals without specialized units. Alternatives for addressing this problem are discussed. PMID- 3555125 TI - Early identification of renal problems in patients receiving chronic lithium treatment. AB - Serum beta 2-microglobulin and creatinine values were compared with creatinine clearance in 20 lithium-treated patients. beta 2-microglobulin, but not creatinine, correlated significantly with creatinine clearance, indicating that beta 2-microglobulin is a more sensitive test than serum creatinine for monitoring glomerular filtration rate in chronic lithium therapy. PMID- 3555126 TI - ECG changes during haloperidol and pimozide treatment of Tourette's disorder. AB - The ECG QTc interval was significantly prolonged by pimozide but not haloperidol or placebo in a randomized clinical trial with 40 patients with Tourette's disorder. However, no adverse cardiac effects or differences in rate, rhythm, or waveform were found. PMID- 3555127 TI - Impact of growing numbers of the very old on Medicaid expenditures for nursing homes: a multi-state, population-based analysis. AB - We utilized Medicaid data from five states which account for 39 per cent of Medicaid expenditures to study the impact of the near-trebling of persons age 85 and older (the very old) projected to occur by the year 2012 upon Medicaid nursing home expenditures. We found a one-year prevalence of Medicaid-covered nursing home residence of 20 per 100 among the very old. If this rate continues, with no changes in current levels of Medicaid nursing home payments, and if population forecasts are accurate, increasing numbers of the very old will generate an additional +6.3 billion (1982 dollars) annually of Medicaid nursing home payments by 2012: an increase of 280 per cent from 1982 levels. The stress this trend will place upon societal ability to check growth in public expenditures for medical care while maintaining basic services for other low income populations will be an important force shaping public health policy in the next 25 years. PMID- 3555128 TI - Home health care: who's where? AB - Referrals to two home health agencies, one public and one private, were examined over a one-year period (n = 290). Clients in the public agency required greater frequency of visits, more nursing services, and care for a longer period of time than did those in the private agency. The public agency served a larger proportion of indigent and Medicaid clients. Increased service delivery with a decreased financial base may forebode an unhealthy future for traditional public home health agencies. PMID- 3555130 TI - The role of ultrasound in the early diagnosis of myositis ossificans. A case report. PMID- 3555129 TI - Early knee motion after open and arthroscopic anterior cruciate ligament reconstruction. AB - The hypothesis proposed in this study was that the initiation of active and passive knee motion within 48 hours of major intraarticular knee ligament surgery would not have the deleterious effects of increasing knee effusion, hemarthrosis, periarticular soft tissue edema, and swelling. We conducted a prospective study with randomized assignment of 18 patients into two groups: 9 patients in the "motion" group began 10 hours of daily continuous passive motion (CPM) on the 2nd postoperative day, while the remaining 9 in the "delayed motion" group used a soft hinged knee brace with knee hinges locked at 10 degrees of flexion and entered into the motion program on the 7th postoperative day. All knees were allowed full 0 degrees to 90 degrees of motion except for a total of seven knees with concomitant mensicus repairs and extraarticular reconstructions where 20 degrees to 90 degrees of motion was allowed, limiting the last 20 degrees of knee extension for the first 4 postoperative weeks to protect the repair. In all other respects, the rehabilitation program after surgery was the same for the two groups, including postoperative compression dressings, exercises, and weight bearing status. Ten of the eighteen patients had acute ACL disruptions and 8 had chronic ACL insufficiencies. There was an even distribution of acute and chronic knee cases and of open and arthroscopic ligament procedures in the early and delayed motion groups. Associated surgery included four meniscus repairs, three medial collateral ligament repairs, and one lateral collateral ligament repair. Special suturing and fixation techniques were used at surgery to maintain the integrity of ligament and meniscus structures, allowing the surgeon to feel safe in subjecting the joint to early postoperative motion. The objective parameters measured were KT-1000 arthrometer measurements, Cybex isokinetic testing, girth measurements at four lower limb locations, range of motion goniometer measurements, postoperative pain medications, and days of hospitalization. Starting intermittent passive motion on the 2nd postoperative day did not increase joint effusion, hemarthrosis, or soft tissue swelling. In both motion groups, postoperative joint effusions were absent after the 14th postoperative day. There was no statistically significant difference in knee extension or flexion limits, pain medication used, or hospital stay in comparing the two knee motion programs. An important finding of this study was the significant decreases in thigh circumference that occurred within the first few weeks of surgery, which progressed despite a closely supervised inpatient and outpatient rehabilitation program.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555131 TI - Malignant lymphoma presenting as a renal mass: four cases. AB - Primary lymphoma of the kidney is extremely rare; most lymphomatous renal masses represent extension from adjacent sites of disease or involvement by generalized disease (4,9,12). Three men and one woman, 45 to 71 years of age, presented with solitary renal masses clinically thought to be renal cell carcinoma. Each experienced abdominal pain, one with hematuria and one with "B" symptoms. Physical examination revealed no peripheral lymphadenopathy or hepatosplenomegaly. Lactic dehydrogenase (LDH) was elevated in three cases, and blood urea nitrogen (BUN) and creatinine were slightly increased in two. Two cases were diagnosed correctly from needle biopsy, with ultrastructural confirmation in one case and marker studies, DNA flow cytometry, and cytogenetics in the other. Because of a presumptive diagnosis of renal cell carcinoma, two patients underwent nephrectomy. Three cases were large-cell lymphoma, and one, small noncleaved cell lymphoma. PMID- 3555132 TI - Stromal tumors of the gastrointestinal tract: myogenic or neurogenic? AB - Because of the recent controversy over the histogenesis of gastrointestinal stromal tumors, 170 gastrointestinal tract tumors appearing to be of smooth muscle type with routine stains were studied immunohistochemically. Five percent were positive for S-100 ("neural") protein. These findings are compared with several recent studies. We conclude that only a small minority of gastrointestinal tract stromal tumors are neurogenic and that most are probably of smooth muscle type. PMID- 3555133 TI - Adenosquamous carcinoma of the prostate. AB - A case of the rare adenosquamous carcinoma of the prostate is herein presented. The divergent epithelial differentiation of the tumor was shown by conventional microscopy, immunohistochemistry, and ultrastructural studies. In previously described cases as well as in the present one, the tumor appeared several years following treatment of an ordinary prostatic adenocarcinoma by radiotherapy. It is proposed that adenosquamous carcinoma of the prostate arises from pluripotent stem-cells, with irradiation playing an etiopathogenetic role. PMID- 3555134 TI - Field evaluation of an enzyme-linked immunosorbent assay (ELISA) for Plasmodium falciparum sporozoite detection in anopheline mosquitoes from Kenya. AB - An enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody that recognizes a repetitive epitope on the circumsporozoite protein of Plasmodium falciparum was used in Kenya to assess malaria infections in Anopheles gambiae s.l. and An. funestus. The ELISA confirmed that 88% of 44 sporozoite-positive gland dissections were P. falciparum. The ELISA infection rate of 18.6% (n = 736) for individually tested mosquitoes for both species was significantly higher than the 10.4% (n = 537) salivary gland sporozoite rate determined by dissection. This difference was due to ELISA detection of medium and large sized oocysts on the midguts of infected mosquitoes which did not contain salivary gland sporozoites. From a series of 379 Anopheles that were cut at the thorax, ELISA tests on "head" and "body" portions showed that 29.5% of 95 positive mosquitoes contained circumsporozoite antigen in the body portion in the absence of salivary gland infections. This field evaluation demonstrates that the ELISA can most accurately be used to estimate sporozoite rates by cutting mosquitoes at the thorax and testing anterior portions. PMID- 3555135 TI - Single-dose chloroquine therapy for Plasmodium falciparum in children in Togo, West Africa. AB - Chloroquine, in a single dose of 10 mg of base/kg, was given orally to Togolese children less than 5 years of age as primary therapy for Plasmodium falciparum malaria. A simplified World Health Organization in vivo method was used, as was a sequential analysis procedure for determining if the drug trial was a success or failure. A total of 178 children in 3 regions were treated; 174 (98%) responded successfully, which required a greater than or equal to 75% reduction in parasites by day 2 and elimination of parasites by day 7. All 4 failures had low blood levels of chloroquine and desethylchloroquine at day 7. A single dose of chloroquine for treating malaria can be considered for those areas of Africa where the efficacy of such therapy is documented, and where an antimalarial drug sensitivity monitoring system is operating. PMID- 3555136 TI - Peripheral vascular pathophysiology of Plasmodium berghei infection: a comparative study in the cheek pouch and brain of the golden hamster. AB - Four- to six-week-old hamsters were infected with 1.5 X 10(7) Plasmodium berghei parasitized hamster red blood cells by intraperitoneal injection. Cheek pouch circulation was observed microscopically in the anesthetized animal; the brain and contralateral pouch were collected for histopathologic examination on days 3 12 post-challenge. Cheek pouch vascular lesions, observed in vivo, appear to involve three phenomena; early (beginning 3-4 days) adhesion of pigment-laden mononuclear cells to endothelium within venous vessels and loss of function of the small capillaries supplying the skeletal muscle fibers and, later (6-9 days), the apparent attraction of erythrocytes to venular and venous endothelium and to adherent monocytes. The aggregation of formed elements on endothelial walls leads to progressive occlusion of venules and small veins and contributes to the observed disruption of flow through capillary networks. Histopathology of the brain and pouch shows vascular changes similar to those seen in vivo; in addition, multifocal hemorrhages are seen commonly in the brain and occasionally in the pouch on postmortem. In severe disease, evidence of cerebral edema is seen in the brain. The data suggest that failure of capillary flow and disruption of venous outflow tracts by cell aggregates are central to vascular failure in both the cheek pouch and brain of the P. berghei infected hamster. This hamster model of human cerebral malaria allows the in vivo observation, still and video photomicrography, and manipulation of the peripheral vascular pathogenesis of a disease process similar to that seen in humans. PMID- 3555137 TI - Ultrastructural localization of the 150/130 Kd antigens in sexual and asexual blood stages of Plasmodium falciparum-infected human erythrocytes. AB - The subcellular localization of the 150/130 Kd antigen in Plasmodium falciparum infected erythrocytes was determined by electron microscopy using monoclonal antibody 9B11 and immuno-gold labeling. We now find that this antigen may be associated with the membrane of newly-infected human erythrocytes and the cytoplasm of ring stage parasites. During differentiation of the parasite to the trophozoite stage, the antigens are no longer detectable on the erythrocyte membrane, while gold particles become more numerous within the parasite and in the erythrocyte cytoplasm adjacent to the parasite. As the parasites develop into schizonts, more antigen appears within the parasites, and some of it appears in the erythrocyte cytoplasm. At the segmented schizont stage, many intraparasitic gold particles are associated with rhoptries and micronemes of developing merozoites. Likewise, gold particles are associated with elements of the rhoptry microneme complex in free merozoites. No gold particles are detected on the surface of merozoites. These antigens are found most abundantly in erythrocytes infected with gametocytes, revealing a localization pattern similar to that of mature trophozoite-infected erythrocytes. These subcellular localization patterns are similar to those described for the ring-infected erythrocyte surface antigen. PMID- 3555138 TI - Parasite antigens in sera and urine of patients with bancroftian and brugian filariasis detected by sandwich ELISA with monoclonal antibodies. AB - We developed a sandwich enzyme-linked immunosorbent assay to detect circulating parasite antigens in human lymphatic filariasis. The assay utilizes a polyclonal rabbit antifilarial antiserum to capture, and a monoclonal antibody to identify, circulating parasite antigen. Using this assay, we found that greater than 95% of sera from microfilaremic donors with bancroftian or brugian filariasis, approximately 60% of sera from microfilaremic patients with hydroceles, chyluria, or elephantiasis, and 15%-20% of sera from asymptomatic residents of filariasis endemic areas evidently contain filarial antigens. Antigen was also detected in the urine of some microfilaremic patients. Serum levels of antigen detected with one monoclonal antibody, ES34, correlated well with microfilarial density in night blood. In contrast, less than 5% of sera from residents of areas where lymphatic filariasis is not endemic reacted in the assay, even though approximately one-third of the donors whose sera were tested were known to be infected with intestinal nematodes. The assay was designed to be flexible enough to allow the parallel use of multiple monoclonal antibodies with different specificities and simple enough to be applicable in most areas where lymphatic filariasis is endemic. PMID- 3555139 TI - Effect of murine polymorphonuclear leukocytes on the yeast form of Paracoccidioides brasiliensis [corrected]. AB - The fungicidal activity of murine polymorphonuclear neutrophils from the peripheral blood or elicited intraperitoneally with thioglycollate or with antigen in Paracoccidioides brasiliensis-sensitized [corrected] or nonsensitized mice was studied. Although peripheral blood, thioglycollate-elicited, and antigen elicited neutrophils from normal mice or thioglycollate-elicited neutrophils from P. brasiliensis-sensitized [corrected] mice killed Candida albicans (57% to 84%), they failed to significantly reduce inoculum colony forming units of P. brasiliensis [corrected] (0% to 13%). In contrast, antigen-elicited neutrophils from sensitized mice reduced colony forming units of P. brasiliensis [corrected] by 40%, and exhibited significantly enhanced candidacidal activity compared to thioglycollate-elicited neutrophils from normal or sensitized mice but not peripheral blood neutrophils from normal mice. Fresh serum, but not specific antibody, was required for optimal killing of P. brasiliensis [corrected], presumably representing an essential role for complement. Killing of P. brasiliensis [corrected] by antigen-elicited neutrophils from sensitized mice correlated with their ability to produce an enhanced oxidative burst, as measured by luminol-assisted chemiluminescence, when interacting with killed P. brasiliensis [corrected] cells. These results indicate that in P. brasiliensis sensitized [corrected] hosts an inflammatory reaction to P. brasiliensis [corrected] results in activation of neutrophils for significant killing of the pathogen. PMID- 3555140 TI - Lyme disease and babesiosis: acaricide focused on potentially infected ticks. AB - Permethrin-treated cotton, intended as rodent nesting material, was distributed in wooded sites in which the agents of Lyme disease and babesiosis were enzootic, in order to kill immature Ixodes dammini, the ticks that transmit these human pathogens. Such ticks feed most abundantly on white-footed mice (Peromyscus leucopus), apparently the main reservoir hosts of these agents, and tend to concentrate in mouse burrows. Mice captured after permethrin-treated cotton was distributed, were infested by a tenth as many ticks as were those captured in adjacent nontreated sites, a difference that continued throughout the 4-month period of observation. On average, 72% of all mice captured in treated sites were free of ticks, while virtually all mice captured in nontreated sites were infested. Voles (Microtus pennsylvanicus), however, were tick-infested, regardless of site of capture. Laboratory-reared I. dammini failed to attach to mice captured in treated sites, and most such exposed ticks died. Distribution of permethrin-treated cotton appears to be a means for preventing transmission of the pathogens that cause human babesiosis and Lyme disease. PMID- 3555141 TI - DNA probe for P. falciparum. PMID- 3555142 TI - Transesophageal Doppler scanning versus thermodilution during general anesthesia. An initial comparison of cardiac output techniques. AB - Measurement of cardiac output has become an essential feature of anesthetic management of patients with cardiac disease requiring operation. Thermodilution by way of a Swan-Ganz catheter is the current popular technique for cardiac output determination. Unfortunately, this method is costly and has an associated irreducible morbidity rate and has, in rare instances, resulted in death. The suprasternal ultrasonographic Doppler technique has shown promise for measuring cardiac output noninvasively; however, it is too cumbersome for continuous intraoperative use. In an effort to overcome this limitation, the esophageal stethoscope was modified to accept a Doppler probe. Herein, we have reported an initial comparison of transesophageal Doppler scanning and thermodilution in 23 adult men during general anesthesia. The average difference between thermodilution and descending cardiac output was 0.16 +/- 0.81 liters/min. The correlation between thermodilution and descending cardiac output increased with operator experience. In the last 13 patients, there was an average correlation of 0.85. After the equipment was mastered and improvements in design were made, descending cardiac output had a high correlation with thermodilution and appeared to track the dynamic changes during general anesthesia. PMID- 3555143 TI - Early diagnosis and management of renovascular hypertension. AB - Renovascular hypertension is more common in hypertensive children than in hypertensive adults, and renal artery stenosis is second only to coarctation of the thoracic aorta as a cause of surgically correctable hypertension. Three infants presented with uncontrollable hypertension secondary to renal artery thrombosis due to umbilical artery catheterization for respiratory distress in the neonatal period. They all responded to nephrectomy. A fourth infant had stenosis of a polar vessel secondary to umbilical artery catheterization and was cured by partial nephrectomy. Two infants with renal artery stenosis secondary to fibromuscular dysplasia benefited from revascularization and, at last follow-up, were normotensive and off all blood pressure medication. Ultrasonography, isotope scanning, angiography and selective renal vein renin assays should be used to identify patients with surgically correctable lesions. The use of fine suture material and microvascular surgical techniques, including ex vivo revascularization and autotransplantation, can salvage renal parenchyma and relieve hypertension. Infants with less than 10 percent renal function on the involved side should have a nephrectomy. The infant with an umbilical arterial catheterization line needs blood pressure monitoring and aggressive evaluation and treatment of persistent hypertension. PMID- 3555144 TI - Techniques of aortic arch replacement: profound hypothermia versus moderate hypothermia with innominate artery perfusion. AB - Aortic arch resection remains a challenging problem. At present, the most reliable technique appears to be profound hypothermia and circulatory arrest, although long cardiopulmonary bypass times and coagulopathy remain significant problems. Interest in alternative procedures continues. Herein, we report our experience of aortic arch replacement in eight patients using profound hypothermia (12 to 17 degrees C) and circulatory arrest in six patients (Group I) and moderate (20 degrees C) hypothermia with low flow (200 ml/min), pressure monitored (100 mm Hg) innominate artery perfusion by way of a 14 Ga. cannula in 2 (Group II). Arch repair was by patch graft in two, and tube graft in six. Concomitant ascending aortic replacement was performed in five, aortic valve replacement in four, and coronary bypass in two. Circulatory arrest times ranged from 15 to 71 minutes in Group I and were 15 minutes and 35 minutes in Group II. All patients survived. One patient in Group I had a neurologic injury of moderate severity, probably due to a hypoxic postoperative cardiac arrest. We have found low flow pressure-monitored innominate artery perfusion and moderate hypothermia to be simple and expedient, and we will continue use of this technique. PMID- 3555145 TI - [Cesarean section in premature labor]. PMID- 3555146 TI - [Endocrine function of the pancreas in physiologic pregnancy]. PMID- 3555147 TI - The history of the discovery of iodine and its many uses. PMID- 3555148 TI - Sir Ivan Whiteside Magill. 23 July 1888-25 November 1986. PMID- 3555149 TI - Fluorocarbons. Current status and future applications. AB - This article presents information on medical applications of fluorocarbons. These inert chemicals have a high solubility for the respiratory gases and, in emulsified form, are present in the oxygen-transporting plasma substitutes now undergoing clinical trials. Oxygen content is directly related to arterial partial pressure of oxygen (PaO2). Thus, although oxygen transport of Fluosol-DA 20% (FDA) is only 0.75 ml per 100 ml per 10 kPa, oxygen delivery at the tissues will be adequate in the presence of a high PaO2. FDA has a low viscosity at low shear rates and this, together with a very small emulsion particle size of 0.1 micron, helps provide improved tissue oxygenation in conditions of ischaemic hypoxia. Fluorocarbon plasma substitutes may be employed as 'blood', but may also be used for a wide range of purposes in clinical practice. This review describes some current and potential future applications. PMID- 3555150 TI - [Future working conditions of anesthesiologists. Attempt at an analysis]. AB - The present conditions of the anaesthesiologist's workplace are characterized by completely unacceptable circumstances, incompatibilities, inflexibility and unsafeness. Like inadequate cockpit conditions in airplanes, these workplace conditions pose considerable risks to the safety of patients and personnel. Taking into consideration the literature and our own views, we have proposed some changes which are essential for improving the working conditions of anesthesiologists: Ergonomic improvements of the anaesthesiological workplace in order to facilitate the anesthetist's performance, to provide him with adequate space, and to automatize repeated and relatively unimportant activities. Vital information about the patient's condition must be located in a position where they will dominate the anesthetist's attention. Information about medications, infusions, transfusions, etc. can be located on the left-hand side of the anesthetist. All other devices can be located beside the anesthetist or even behind him, as they are of minor importance. The most useful alternative to the present conditions would be to locate the information panels of primary and secondary monitoring devices to the immediate right, or on the right- und left hand sides of the anesthetist at an angle of 15 degrees-30 degrees each. Furthermore, these information panels should be arranged so that they can be monitored using moving and slightly tilted screens. The most important of the patients, clinical parameters as well as the functions of the equipment should be monitored by alarms, warning devices, or simply indicators, which can easily be separated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555151 TI - [140 years of ether anesthesia in Germany]. PMID- 3555152 TI - Detection of pullulanase in polyacrylamide gels using pullulan-reactive red agar plates. AB - After electrophoresis, active pullulanase bands in acrylamide gels have been detected by overlaying and then incubating the gel on a replica gel containing 2.5% pullulan-reactive red conjugate and 2.1% agar. The enzyme activity is revealed as a clear band against a red background on the replica gel. The sensitivity of the replica plate is such that 0.0012 unit of Klebsiella aerogenes pullulanase can be detected easily. This procedure is effective in enzyme screening to distinguish pullulanase from other carbohydrases. PMID- 3555153 TI - Issue dedicated to Nathan O. Kaplan 1917-1986. PMID- 3555154 TI - On the impact on biochemical research of the discovery of stable isotopes: the outcome of the serendipic meeting of a refugee with the discoverer of heavy isotopes at Columbia University. AB - As late as the 1930s, approaches to biochemical research not only were rather primitive, but a certain amount of mysticism still surrounded the biochemical events that occur in the living cell. To a great extent, this was due to the lack of techniques needed to uncover the subtle reactions in the living cell. In the early 1930s, an accidental meeting of two scientists revolutionized approaches in biochemical studies and led to the scientific explosion in molecular biology that has occurred during the last few decades. The dark political storm in Germany deposited Dr. Rudolf Schoenheimer on the New York shore, where he met Professor Urey, who recently had discovered "heavy" hydrogen. Schoenheimer suggested that biological compounds tagged with heavy atoms of hydrogen would enable investigators to follow their metabolic pathways. This intellectual leap revolutionized the thinking and design of experiments and made it possible to uncover the myriad reactions that occur in the living cell. PMID- 3555155 TI - Enzymatic synthesis of novel glutathione analogs. AB - A strain of Escherichia coli enriched in its content of gamma-glutamylcysteine synthetase and glutathione synthetase by recombinant DNA techniques has been immobilized in a carrageenan matrix and used for the synthesis of various types of isotopically labeled glutathione (L-gamma-glutamyl-L-cysteinyl-glycine) (K. Murata, W. A. Abbott, R. J. Bridges, and A. Meister (1985) Anal. Biochem. 150, 235-237). In the present work, this E. coli matrix was used as the basis of a method for the synthesis of glutathione analogs. Thus, amino acid analogs were used in place of the corresponding amino acid constituents of glutathione (e.g., 4-fluoroglutamate was substituted for glutamate) in the reaction mixtures. Using this method we have synthesized several analogs of glutathione including L-gamma glutamyl-(beta-chloro)-L-alanyl-glycine, (R,S)-4-fluoro-DL-gamma-glutamyl-L cysteinyl-glycine, D-gamma-glutamyl-L-cysteinyl-glycine, and L-gamma-glutamyl-L homocysteinyl-glycine. This method may also be used for the synthesis of a number of L- and D-gamma-glutamyl amino acids. The analogs are purified by gel filtration and ion-exchange chromatography. The analogs are used to examine the substrate specificity and mechanisms of action of glutathione-utilizing enzymes and for studies on glutathione metabolism and function. Fluorine-containing analogs may be used for NMR studies. The enzymatically prepared compounds may also be used as intermediates in the chemical synthesis of other analogs of glutathione and glutathione disulfide. PMID- 3555156 TI - Photographic detection of luminescence in Escherichia coli containing the gene for firefly luciferase. AB - The gene for firefly luciferase (luc) can be used as a generalized genetic probe. A method that aids in the analysis of shuttle vectors containing luc by allowing verification in Escherichia coli of a functional coding sequence is presented here. Colonies containing a functional form of luc are detected on film after luciferin is added to initiate the luminescent reaction. Two conditions, lowering the pH of the environment and maintaining aerobic conditions, were found to greatly improve the sensitivity of the assay. This technique may be useful in the development of genetic constructs that alter the natural coding sequence of luc, such as in gene fusions. PMID- 3555157 TI - Enzymatic assays for 2-deoxyglucose and 2-deoxyglucose 6-phosphate. AB - Methods for 2-deoxyglucose (2-DG) and 2-deoxyglucose 6-phosphate (DG6P) are described which are based on the fact that DG6P is oxidized by glucose-6 phosphate dehydrogenase (G6PDH), but at a rate 1000-fold slower than for glucose 6-phosphate, whereas hexokinase phosphorylates 2DG and glucose at comparable rates. Therefore, by adding the two enzymes in a suitable order, and in appropriate concentrations, 2DG, glucose, DG6P, and glucose 6-P can all be separately measured. To avoid a side reaction from the use of a high level of G6PDH, when measuring DG6P, glucose is first removed with glucose oxidase plus aldose reductase. PMID- 3555159 TI - Immunohistochemical localization of the secretory products of rat Clara cells. AB - We used proteins in rat lung lavage fluid to successfully produce an antiserum against Clara cell secretory products. When used with the immunoperoxidase method, the antiserum specifically stained cells of the bronchiolar lining, which are morphologically consistent with Clara cells, as well as a few columnar cells in the bronchial and tracheal mucosa. B-5-fixed lung tissue furthermore demonstrated the immunoreactive layer over the bronchiolar epithelium. The alveolar and bronchial lining layers, on the other hand, were not immunoreactive, although a trace of granular immunoreactivity was seen in the latter. It was suggested that Clara cells produce and secrete some proteinaceous materials, which are mainly localized in the bronchiolar area after secretion and are seldom transferred into the alveolar lining layer. Our antibody cross-reacted with the Clara cells of mice, but not with those of hamsters, guinea pigs, rabbits, dogs, cats, monkeys, and man. The high degree of specificity of this antisera to Clara cells in formalin-fixed materials should make it a valuable tool for identifying Clara cell change in non-neoplastic lung pathology and in obtaining some insights into cell origin in neoplastic diseases. PMID- 3555158 TI - The current potential of plastination. AB - This review surveys the potential of plastination, a technique of tissue preservation introduced eight years ago. In this process, water and lipids in biological tissues are replaced by curable polymer which are subsequently hardened, resulting in dry, odorless and durable specimens. The procedure consists of the following steps - fixation, dehydration, forced impregnation in a vacuum, and hardening. The properties of the finished specimen are determined by the class of polymer used. Silicone yields flexible, resilient specimens, allows the broadest range of application, and provides satisfactory results with minimum equipment. Specimens plastinated with an epoxy-silicone copolymer are rigid enough to be polished, but are not unbreakable. This resin is used for thick, opaque body slices and showcase specimens. Epoxy resins are used for thin (2.5 mm), transparent body or organ slices. They are cast between polyester foils or glass plates and can be used for histological investigations. Polyester resin is used for the production of opaque brain slices, which gives excellent differentiation between grey and white matter. The application of plastination in research and the production of teaching specimens is discussed with special regard to the equipment required, cost, and feasibility of the processing. PMID- 3555160 TI - Hormonal regulation of epithelial cell proliferation in the fetal mouse duodenum in vitro. AB - In adult rodents, radioautographic studies have shown that cell proliferation in the small intestinal epithelium is confined to the crypts. However, before birth DNA synthesis occurs also on villi. The role of extrinsic factors in the establishment of the adult pattern of enterocyte proliferation was studied in 17 day fetal mouse duodenal explants cultured with a completely synthetic medium. The effect of dexamethasone (30 and 300 ng/ml), thyroxine (10 nM), and insulin (125 mU/ml) on labelling indices was determined after 48 hours of culture. At the onset of the culture period close to 60% of the cells located in the first five cell positions in the intervillous areas became labelled after 4 hours of culture in presence of 3H-thymidine; 8% of the other epithelial cells found higher in the intervillous areas and on villi were also labelled. After 48 hours of culture, well differentiated crypts have developed in all the explants cultured with or without the hormones. The addition of thyroxine or insulin did not modify the labelling indices. However, after 48 hours of culture, the presence of dexamethasone (both concentrations) significantly reduced the labelling index of the cells found over cell position 5 but had no effect on the labelling index of cells located at the bottom of the crypts. When labelling index was determined for each cell position in the crypts at the end of the culture period, it appeared that dexamethasone (300 ng/ml) had no effect thereon for the first five cell positions but had a significant influence on the transitional zone from cell position 6 through 15.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555161 TI - Immunoultrastructural studies of human NK cells: I. Ultracytochemistry and comparison with T cell subsets. AB - Human NK activity is known to be associated with a population of large granular lymphocytes (LGL) exhibiting several immunophenotypic surface markers including Leu-11a (NKP-15), Leu-7 (HNK-1), Leu-3a (T4), and Leu-2a (T8). Based upon correlation with cytolytic activity, Leu-11a is now considered the most specific antigenic marker for human NK cells. Present investigation compared the ultrastructure of cells expressing Leu-11a, Leu-7, Leu-3a, and Leu-2a, both in human peripheral blood lymphocytes (PBL) and the purified LGL fraction. Subcellular cytochemical reactions were investigated in Leu-7+ or Leu-11a+ PBL or LGL and in cells conjugated with K562 targets (indicating NK cytolytic potential). The surface markers, localized with monoclonal antibodies, were detected by immunoelectron microscopy by using direct or indirect avidin-biotin peroxidase (ABC) or colloidal gold methods. A peroxidase-colloidal gold double labeling system was used to identify subsets of Leu-7+ or Leu-11a+ cells. Previously described ultrastructural features of LGL including a villous surface, reniform nuclei, low nuclear/cytoplasm ratios, and abundant cytoplasm with vesicles, vacuoles, electron-dense granules, parallel tubular arrays (PTA), or paracrystalline inclusions were associated with Leu-7+, Leu-11a+, Leu-7+/Leu 11a+, Leu-7+/Leu-11a-, and Leu-7-/Leu-11a+ PBL or LGL. Results showed that the Leu-7+/Leu-11a+ cells were the most abundant NK cells in PBL. Lymphocyte subsets with Leu-3a or Leu-2a surface marker showed some ultrastructural features including PTA similar to Leu-7+ cells and Leu-11a+ cells, and their subsets. These T-cells appeared ultrastructurally more similar to the Leu-7+/Leu-11a- subset. Cytochemical studies showed that electron-dense cytoplasmic granules and PTA typical of the Leu-11a+ cells and Leu-7+ cells contained glycoprotein, acid phosphatase, and arylsulfatase. Large cytoplasmic vacuoles were heterogeneous and typically contained electron-dense material with DAB reactivity, membranous material, PTA, and/or paracrystalline inclusions. Glycoprotein, acid phosphatase, and arylsulfatase, and peroxidase reactive material were also found in these vacuoles. These features suggested that the vacuoles could be secondary lysosomes. The coexistence of intact PTA or degenerating PTA in the same vacuoles with paracrystalline inclusions suggested that the latter are possibly derived from PTA. PMID- 3555162 TI - Epinephrine improves the quality of spinal hyperbaric bupivacaine for cesarean section. AB - In a double-blind randomized study, the effects of the addition of epinephrine on hyperbaric spinal bupivacaine were studied in 63 patients having elective repeat cesarean sections. In the study group (32 patients), the addition of 0.2 mg epinephrine improved the quality of analgesia since fewer patients required supplementation of the spinal anesthetic; the motor block was more profound; and the times to two-segment regression, sensory recovery, and motor recovery were prolonged. PMID- 3555163 TI - Comparison of continuous epidural infusion of a local anesthetic and administration of systemic narcotics in the management of pain after total knee replacement surgery. AB - Continuous bupivacaine epidural analgesia was compared with conventional methods of systemic analgesic administration in the management of postoperative pain in 30 patients for 3 days following total knee replacement surgery. Patients given continuous epidural analgesia had significantly better pain relief (visual analogue scale, global evaluation), needed significantly fewer supplementary analgesics, and had significantly fewer side effects. In the epidural group, sensory block averaged six dermatomes on day 1 and four dermatomes on day 3. The number of patients with complete (or almost complete) motor block of the lower limbs decreased from eight on day 1 to five on day 3. The mean dosage of bupivacaine decreased from 21.0 +/- 5.7 (SD) mg/hr on day 1 to 15.1 +/- 8.5 mg/hr on day 3. No signs of accumulation of or toxic reactions to bupivacaine were seen. PMID- 3555164 TI - Prolongation of isobaric bupivacaine spinal anesthesia with epinephrine and clonidine for hip surgery in the elderly. AB - The effects of vasoconstrictors on the duration of isobaric bupivacaine spinal anesthesia are unknown. A prospective controlled study was conducted on 60 ASA class II or III patients aged 75 yr or more who were scheduled for spinal anesthesia for orthopedic hip surgery. The subjects were randomly allocated into three groups. All patients received 15 mg bupivacaine plain solution in 4 ml in the horizontal position. Group I patients received bupivacaine plus 1 ml normal saline; group II patients received bupivacaine plus 0.2 mg epinephrine; group III patients received bupivacaine plus 0.15 mg clonidine. The segmental level of sensory loss was tested using forceps. In one case in group III, anesthesia was unsatisfactory. The time course required for maximal spread of the sensory blockade did not differ in the three groups. No difference was observed between mean highest levels of sensory anesthesia. The mean time to two-segment regression from the highest level was significantly longer in group III than in groups I and II. Mean time for regression to the L2 segment was also significantly longer in groups II and III than in group I. This time tended to increase more with the bupivacaine plus clonidine solution than with the bupivacaine plus epinephrine solution. Significant prolongation of motor block was also associated with the addition of clonidine. PMID- 3555165 TI - Prior carotid surgery does not affect the reliability of landmarks for location of the internal jugular vein. AB - Twenty-one volunteer subjects who had undergone prior carotid endarterectomy (CEA) agreed to an ultrasound study of the neck. The transducer was held as one would hold a cannulating needle and ultrasound images were obtained of the great vessels in the neck. Each of two cannulating techniques was simulated on each side of every patient's neck. Photographs of the ultrasound images were analyzed to score "hit" or "miss" for the internal jugular vein (IJV) and the carotid artery (CA), and to measure both the angle between these vessels and the distance from the skin to the IJV. In 11 subjects, the effect of a Valsalva maneuver on IJV width was also determined. Owing to bilateral CEA in 9 of the 21 subjects, there were 12 studies of nonsurgical sides (NSS) and 30 studies of surgical sides (SS). SS and NSS hit frequencies were statistically indistinguishable both for the IJV and the CA. In no photograph did the IJV lie medial to the CA. A Valsalva maneuver did not change IJV width on either the SS or the NSS. These data show that prior CEA does not affect the location of the IJV. Tissue alterations or adhesions may render actual IJV cannulation more difficult or risky. The data suggest but do not prove that prior CEA may not increase the incidence of CA puncture under clinical conditions. PMID- 3555166 TI - Emergency one-lung high-frequency positive-pressure ventilation (HFPPV). PMID- 3555167 TI - High frequency ventilation. PMID- 3555168 TI - Dangers of using an improvised underwater seal for CPAP oxygenation during one lung ventilation. PMID- 3555169 TI - CPAP oxygenation during one-lung ventilation using a Bain circuit. PMID- 3555170 TI - [Changes in the pituitary-adrenal system and glucose-insulin homeostasis during ketamine anesthesia in children with malignant tumors]. PMID- 3555171 TI - [Prognosis and analysis of the dynamic process of development of the shock lung syndrome following terminal states using mathematical methods and a computer]. PMID- 3555172 TI - [Effect of fluothane, sodium hydroxybutyrate, ketamine, viadril and althesin on the insulin-producing function of the pancreas and insulin transport and utilization in children with congenital heart defects]. PMID- 3555173 TI - Prevention of venous complications from intravenous anesthesia. AB - Vascular complications following the use of intravenous sedative drugs continue to be a problem in dental anesthesia. Etiological factors associated with pain and thrombophlebitis are reviewed. From reports in the literature and clinical experience, venous complications from intravenous sedation may be reduced by utilizing large veins with the dilution of sedative agents in a fast running intravenous infusion. Intravenous lidocaine may be of use to block reflex venospasm and pain. PMID- 3555174 TI - Staphylococcus epidermidis: a significant nosocomial pathogen. AB - Staphylococcus epidermidis is an organism formerly believed to be nonpathogenic. It is now recognized as a pathogen, causing infections on implanted devices and among immunosuppressed patients. Further, it has been involved in the development of resistance to a number of antibiotics. The epidemiology of this organism, its pathogenesis, and its treatment are important to infection control practitioners. PMID- 3555175 TI - Nicardipine in the treatment of Raynaud's phenomenon: a randomized double-blind trial. AB - The efficacy of the calcium-channel blocker nicardipine in the treatment of Raynaud's phenomenon was assessed in a prospective, double-blind, randomized, crossover trial in 20 patients. Each patient received nicardipine 20 mg or placebo three times a day for two weeks and then was crossed over for two weeks. Nicardipine significantly decreased the frequency and severity of Raynaud's phenomenon as compared with placebo. The authors conclude that nicardipine is effective in the treatment of Raynaud's phenomenon. PMID- 3555176 TI - The role of food allergy in migraine: a review. PMID- 3555177 TI - Effect of nifedipine on hyperreactivity bronchial response to methacholine. PMID- 3555178 TI - [Recent aspects of blood culture technics]. PMID- 3555179 TI - [LDL receptors and correlations with atherogenesis]. PMID- 3555180 TI - [Identification of gram-negative aerobic and non-fastidious aero-anaerobic bacilli using the ATB 32 GN system]. AB - ATB 32 GN was tested with 279 gram negative non fastidious rods = 188 Enterobacteriaceae and 91 non-enterobacteriaceae. This micro-method included 32 carbon substrate's assimilation tests, read and interpreted automatically after incubation for one or two days at 30 degrees C. 93.5 p. cent of all bacteria are correctly identified (92.5 p. cent of Enterobacteriaceae and 95.6 p. cent of non enteric rods). 2.6 p. cent are misidentified and 3.9 p. cent are unidentified. The results these strains are analysed. This novel system of identification was possible utilised in a medical analysis laboratory. PMID- 3555181 TI - [Serum fructosamine in the monitoring of insulin therapy in the diabetic child]. PMID- 3555182 TI - [Pulmonary edema after laryngospasm]. AB - A case is reported of rapidly resolving pulmonary oedema following post extubation laryngospasm in a 23 year-old healthy man who underwent emergency resection of a rectal polyp. The laryngospasm occurred immediately after extubation and resolved after administration of curare. The patient was reintubated and auscultation disclosed bilateral coarse and moist rales. Chest X ray displayed a right pulmonary opacity. Because of the deteriorating respiratory status, mechanical ventilation was used with positive end-expiratory pressure for 18 h. Chest examination, chest X-ray and arterial blood gas levels improved steadily and the patient was discharged 24 h later. Pulmonary oedema associated with upper airway obstruction seems to be related to hypoxic pulmonary vasoconstriction and the largely subatmospheric transpulmonary pressure gradients generated while trying to breathe against a closed glottis. In addition, this increased negative intra-alveolar pressure was responsible for significant changes in cardiovascular function: right ventricular blood volume, right ventricular ejection fraction and left ventricular after-load increased, while left ventricular ejection fraction decreased. These changes favoured a rise in left atrial and pulmonary blood volumes, with transudation of fluid from the capillaries into the alveoli. Because of the severe consequences of respiratory failure, any patient who suffers acute upper airway obstruction should be observed in the recovery room for at least 3 h in order not to miss this rarely developing, but fortunately rapidly reversible, syndrome. PMID- 3555183 TI - Utility of a sensitive bedside serum pregnancy test. AB - We compared the performance characteristics of a rapid qualitative serum pregnancy test with a standardized quantitative assay for human chorionic gonadotropin in the evaluation of women with suspected ectopic pregnancy. At a threshold value of 25 mIU/mL, the rapid assay demonstrated a sensitivity of 100% and a specificity of 96%. PMID- 3555184 TI - The ectopic kidney in the emergency department. AB - Renal ectopia can present as abdominal pain and be a predisposing factor to several pathologies seen in the genitourinary system. We present the case of a 21 year-old man with intermittent right lower quadrant abdominal pain who was found to have a nonfunctioning pelvic kidney and underwent nephrectomy. Although specific findings on renal ectopia are often absent, associated congenital defects above the pelvic organs raise the suspicion for renal ectopia. Early detection and recognition of the ectopic kidney can prevent long-term complications. PMID- 3555185 TI - RNs meet growing need for home care. PMID- 3555186 TI - Airway responsiveness to methacholine during the natural menstrual cycle and the effect of oral contraceptives. AB - Exacerbations of symptoms have been reported in some women with asthma just prior to and during menstruation. We examined changes in airway responsiveness to methacholine during 2 consecutive menstrual cycles in 17 well-controlled asthmatics with a wide range of airway responsiveness. In 10 women with regular natural cycles, measurements were made 1 wk before and 1 wk after the start of menstruation to coincide with the highest and lowest progesterone levels. The mean concentration of methacholine to cause a fall in FEV1 of 20% (PC20) premenstruation was 1.49 mg/ml, which was not significantly different from the mean postmenstruation PC20 of 1.34 mg/ml (p = 0.45). Although there were only 10 subjects, the power was 96%, indicating little likelihood of any difference between the 2 phases. In 7 women taking oral contraceptives, the mean PC20, measured within 1 wk of completing a 21-day course, was 1.19 mg/ml, which was not different from the mean PC20 of 0.97 mg/ml measured after the start of menstruation but before restarting medication (p = 0.17). The power was 98%. In both groups, there was no difference in FEV1 or medication use during the cycle, but symptoms were worse during menstruation. The results suggest that the fluctuations in serum progesterone levels that occur during natural menstrual cycles are insufficient to alter airway responsiveness in an unselected sample of asthmatic women. They also demonstrate that changes in symptoms occur during the cycle both in women with natural cycles and those using contraceptives and that these changes are not related to serum progesterone levels or airway responsiveness. PMID- 3555188 TI - The serodiagnosis of tuberculosis and other mycobacterial diseases by enzyme linked immunosorbent assay. PMID- 3555187 TI - Distribution of airway contractile responses within the major diameter bronchi during exogenous bronchoconstriction. AB - The distribution of bronchoconstrictor responses within airway generations zero to 6 was studied by tantalum bronchography during exogenous bronchoconstriction with methacholine (MCh), prostaglandin F2 alpha (PGF2 alpha), norepinephrine (NE), and the thromboxane mimetic U-46619 [(15S)-hydroxyl-11 alpha,9 alpha (epoxymethano)prosta-5Z, 13E-dienoic acid] in 12 mongrel dogs undergoing vagotomy and beta-adrenergic blockade. Dose-response curves to each agonist were generated in random order, and tantalum bronchograms and simultaneous measurements of pulmonary resistance (RL) and dynamic pulmonary compliance (Cdyn) were obtained at the plateau of the response of each dose of agonist after intravenous (iv) infusion. At 5 X 10(-7) mol/kg, NE (after beta-adrenergic blockade) caused an increase to 254 +/- 27.3%, PGF2 alpha to 368 +/- 50.0%, U-46619 to 522 +/- 98.5%, and MCh to 1,204 +/- 173% of baseline in RL. However, airway diameter changes within the major diameter airways varied substantially for each agonist. Methacholine caused substantial contraction in all airways. Neither NE nor U 46619 caused significant airway narrowing in generations zero or 1, although both agonists caused greater than 30% narrowing in sixth generation airways. Prostaglandin F2 alpha (5 X 10(-7) mol/kg) cause an increase in RL of greater than 350%; however, this was accompanied by an approximately 10% increase (dilation) in airway diameter in generation 1 through generation 4 airways and an approximate 25% narrowing in generation 6 airways. We demonstrate that both alpha adrenergic agonists and thromboxane analog cause substantial bronchoconstriction in situ in the central air-ways of the lung.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555189 TI - Human mast cells and asthma. PMID- 3555190 TI - Histamine and asthma. PMID- 3555191 TI - The major enzymes of human mast cell secretory granules. PMID- 3555192 TI - Heterogeneity of mast cells in the tissues of the respiratory tract and other organ systems. AB - Heterogeneous cytochemical, morphologic, and functional properties have been shown to exist between populations of mast cells in a variety of tissues, or in different histologic subcompartments of the same tissue. This mast cell heterogeneity has important clinical implications for the understanding and treatment of allergic diseases and other conditions where the involvement of mast cells has been postulated. The evidence and implications of mast cell heterogeneity, particularly in the respiratory system, are the topics of this review. PMID- 3555193 TI - The pathophysiology of human mast cells. In vitro and in vivo function. PMID- 3555194 TI - Provoked asthma and mast cells. AB - There is now very substantial evidence to implicate mediators in the pathogenesis of asthma during both the early- and late-phase response. It seems likely that mast cells are activated since histamine was detected in early- and late-phase allergen- and exercise-induced asthma. On the other hand, the origin of NCA is still in some doubt, and the possibility exists that it may be derived from other cell types. Furthermore, there is no firm evidence that the mast cell is directly involved in pathogenesis and some evidence that it may have a secondary or amplifying role. There is an urgent need for further details of other mast-cell associated mediators such as prostaglandins and leukotrienes. Measurements in the blood have the obvious disadvantage of only indirectly reflecting events in the lung. It seems likely that more invasive procedures such as fiberoptic bronchoscopy will yield more critical information regarding mast cells and their mediators in early- and late-phase reactions, as well as the effects of selective drugs and the role of other cell types. PMID- 3555196 TI - Central sleep apnea reversed by continuous positive airway pressure. AB - Continuous positive airway pressure (CPAP) is an accepted and highly effective method used in the treatment of obstructive sleep apnea (OSA). We have explored the potential utility of CPAP in a patient with sleep apnea without a major contribution of airway obstruction as measured by the usual criteria. The patient showed dramatic clinical and laboratory improvement in central apnea when treated with CPAP. A low level of CPAP (7.5 cm H2O) resulted in the reduction of central apneas from 281 to 32 per night with no significant change in obstructive apneas, which increased from 43 to 59 per night. On a separate night, a higher level of CPAP (12.5 cm H2O) resulted in virtually complete removal of all apneas. Measurement of pharyngeal properties revealed pharyngeal cross-sectional area in the low normal range, but increased pharyngeal compliance. This case illustrates that pharyngeal abnormalities may be present in patients with central sleep apnea, and CPAP may be beneficial in the treatment of this disorder. Although the exact mechanism of action of CPAP in this disorder is unclear, we propose several possibilities that may account for the beneficial effect of CPAP in this patient. PMID- 3555195 TI - Bronchoalveolar lavage in allergic asthmatics. PMID- 3555197 TI - Short-course chemotherapy of pulmonary tuberculosis. PMID- 3555199 TI - The riddle of the sphincters. The morphophysiology of the anorectal mechanism reviewed. AB - Although easily taken for granted when functioning properly, malfunction of the anorectal mechanism presents profound inconvenience and embarrassment. The anal sphincters, internal and external, have been the subjects of extensive study yet much appears to remain unsettled. Each sphincter has been proposed, at one time or another, to be the sine qua non of fecal continence, and both clinical and nonclinical studies have often yielded contradictory results. For example, it has been established that the internal sphincter is actually relaxed during the moments of greatest need! On the other hand, the external sphincter can be fully contracted only for a matter of seconds before becoming fatigued. Anatomic studies of the external sphincter date from 1715, yet it has defied consistent and consensual description. A rather persistent theme has been the claimed existence of anatomic subdivisions (e.g., deep, superficial, and subcutaneous). Some form of this traditional description is found in all modern anatomic texts; however, when dissecting, the student is invariably disappointed in his or her efforts to discern the subdivisions. Further, the roles of other important, nonsphincteric mechanisms are often overlooked. This presentation will briefly review the controversial history of the anorectal mechanism and correlate the results of both clinical and anatomic/physiologic studies. By so doing, a functional concept of the structure of the anorectal mechanism emerges. PMID- 3555198 TI - The management of snake and spider bites in the southeastern United States. AB - Of all snake bites reported in the United States of America each year, 75 per cent occur in the states that form the Southeastern Surgical Congress. Pit vipers, coral snakes, and exotic imported snakes are all found in that area. Deaths from those snake bites are rare, but morbidity is high and it is often due to overtreatment rather than undertreatment. Treatment in the field is rarely necessary for the victim who is less than 1 hour away from definitive care. The type and size of the snake and the age, size, and health of the patient are important guides to therapy. Envenomation may not occur. When envenomation occurs from pit viper bites, antivenom is not always necessary, and its inherent dangers (serum sickness and possible hypersensitivity) must be weighed against the severity of systemic and local manifestations. All coral snake bites resulting in envenomation must be treated vigorously with coral snake antivenom. The Oklahoma City Poison Control Center can guide the treatment of bites from exotic snakes. The most frequently encountered toxic spider bites in the Southeast are those of the black widow and brown recluse spiders. The symptoms of black widow envenomation are best controlled with calcium gluconate or a muscle relaxant. Antivenom should be reserved for severe reactions. Brown recluse necrotic lesions are best controlled with dapsone. PMID- 3555200 TI - A new method for the take-down of Cimino-Brescia fistulas. AB - A new method for the take-down of Cimino-Brescia fistulas is described. Instead of ligating the venous runoff vessels individually, the fistula is opened over the area of the arteriovenous anastomosis and the connection between vein and artery is closed with a running Prolene suture. The advantages of this new method are described. PMID- 3555201 TI - Postexertional cardiac asystole in a young man without organic heart disease. PMID- 3555202 TI - A logical approach to screening for coronary artery disease. AB - Although changes in lifestyle may increase the life expectancy of persons at high risk for coronary disease, there is no cost-effective screening test that can select these persons from the general population. Exercise testing has been considered, but epidemiologic studies have not proved that it effectively identifies persons at risk for myocardial infarction or cardiac death. Theoretically, exercise testing should have limited sensitivity in predicting events because abnormal responses occur only when sufficient atherosclerotic plaque has accumulated to impede coronary flow. Abnormal test responses cannot occur before plaque has reached such dimensions. A test that indicates the presence of any atherosclerotic plaque in the coronary lumen would be more useful than one that indicates compromise of blood flow. Data show that sensitive detection of coronary calcific deposits accurately predicts the presence of atherosclerotic plaque. Sensitive radiographic techniques such as digital subtraction fluoroscopy need to be developed as screening tests. Screening studies should be blinded and include only hard endpoints, and follow-up periods should be no less than 10 years so that the detected disease can develop to its symptomatic endpoint. PMID- 3555203 TI - Immunologic mechanisms in intestinal diseases. AB - The intestine is a unique immunologic organ that comprises an afferent and efferent compartment and provides the host with the ability to respond through several different effector mechanisms against environmental factors. We discuss mechanisms in three intestinal diseases in this overview of the mucosal immune system. Genetic and immunologic factors are important in the pathogenesis of celiac disease, which is characterized by damage to the mucosa of the small intestine with resultant malabsorption. Pathogenic microbes are important environmental agents that interact with the intestinal mucosa and initiate local immune responses. Advances in the understanding of the mucosal immune response to these pathogenic microbes have produced a clear picture of the way in which this specialized immune system works in concert with systemic immunity. As to the autoimmune nature of inflammatory bowel disease, no specific antigen has been shown to incite the inflammatory reactions and neither the target cells nor the effector mechanism involved have been identified. Several factors exist, however, to suggest an autoimmune mechanism and the role of mucosal immunologic factors in this disease. PMID- 3555205 TI - Repetitive publication: a clinical trial of norfloxacin. PMID- 3555204 TI - Clinical trials in hairy cell leukemia. Current status and future directions. AB - During the past 5 years, clinical trials in hairy cell leukemia have shown dramatic activity for alpha-interferon and 2'-deoxycoformycin (pentostatin). Responses can be induced in more than 80% of patients using either agent, although a greater number of complete pathologic remissions may be achieved with deoxycoformycin. Despite interesting preliminary data, the optimal dose, schedule, treatment duration, and impact of therapy on survival are unknown. Clinical trials comparing efficacy and toxicity of alpha-interferon and deoxycoformycin, the extent of cross-resistance, and relationship of activity to previous splenectomy are in progress. Additional studies are testing combinations of these agents. Although interferon is commercially available for treating hairy cell leukemia, considering such therapy routine is counterproductive. Long-term clinical trials of interferon and deoxycoformycin are essential to advance our biologic knowledge of this rare disease, and to ensure optimal therapy for a potentially curable malignancy. PMID- 3555206 TI - [Dysmyelopoiesis and T lymphoma. 2 cases]. AB - The role played by T lymphocytes in myelopoiesis has been established in in vitro studies. Dysregulation of the lymphoid system results in quantitative and, more rarely, qualitative abnormalities of myelopoiesis. The authors report the clinical data of two cases of peripheral T cell lymphoma associated with an AREB type of dysmyelopoiesis. The fact that both conditions were diagnosed simultaneously and progressed in parallel is an indirect argument in favour of the regulation of myelopoiesis by the T lymphocytes. PMID- 3555207 TI - [Neurohormonal factors in congestive heart failure]. AB - Congestive heart failure is characterized by peripheral circulatory abnormalities including arterial and venous vasoconstriction and redistribution of regional blood flow. These peripheral factors are consecutive to a neurohumoral activation of sympathetic, renin-angiotensin-aldosterone and arginine-vasopressin systems. Clinical consequences of these neurohumoral changes are: excessive increase of aortic impedance and myocardial work, salt and water retention a processus which is angiotensin II-dependent, and eventually, hyponatremia. A growing body of evidences suggests that pharmacological blockade of this neurohumoral activation improves clinical and hemodynamic status in patients with congestive heart failure. PMID- 3555208 TI - [Use of injectable concentrates of purified fibronectin in an attack of malignant malaria]. PMID- 3555210 TI - [Violence in hospital psychiatric units]. AB - The present report is based on a review of literature and shows that violence is a rare manifestation, which results from the intrications of numerous factors and which is difficult to predict even in the short term. Preventive work should be based on the knowledge of some personal as well as relational risk factors. PMID- 3555209 TI - [Therapy and suggestion]. AB - Therapy and suggestion are closely related. That is clear for the ancient time: primitive medicine gives a good place to the Word. In plant, animal or mineral remedies, the suggestion is clearly preponderant. Towards the end of the 19th century, the "Ecole de Nancy" sets up a real theory of the suggestion, and Bernheim, its leader, bases hypnosis, then psychotherapy on this concept. Thereafter Coue will bring up the "conscious autosuggestion". Today, despite the progress of scientific medicine, the part of suggestion is still very important in medical therapy (with or without drugs), or in chirurgical therapy; this part is also very important in psychotherapies, whatever has been said in this field. This has to be known and used consciously in the doctor-patient relation, which is always essential in the therapeutic effectiveness. PMID- 3555212 TI - Interaction of species-typical environmental and hormonal factors in sexual differentiation of behavior. PMID- 3555213 TI - Prenatal stress disrupts reproductive behavior and physiology in offspring. AB - Prenatal maternal stress has been related to neonatal activity and irritability in both lower animals and humans in documented research for at least the past 30 years. Contemporary animal research demonstrates that prenatal stress feminizes and demasculinizes the sexual behavior of males and reduces fertility and fecundity in females, producing estrous cycle disorders, spontaneous abortions, or vaginal hemorrhaging and high neonatal mortality. Mechanisms of stress are being sought in the maternal-fetal blood exchange, hormonal alterations in the hypothalamus-pituitary-gonads and adrenals, and in brain catecholamines. Contemporary human research demonstrates that negative maternal attitudes toward pregnancy are related to high incidences of congenital abnormalities and infant deaths. Severe psychosocial stress is related to high incidences of neonatal deaths and neurological impairments in infants, and a high incidence of psychiatric disorders in adulthood. Data derived from both animal and human research may help explain the etiology and mechanisms of prenatal-stress-induced reproductive dysfunctions as well as some forms of human psychopathology. PMID- 3555214 TI - Hormonal and metabolic factors underlying intraspecific variation in reproductive social behavior. PMID- 3555215 TI - Social induction of the ovarian response in the female ring dove. PMID- 3555216 TI - Advantages to female rodents of male-induced pregnancy disruptions. AB - Several, not mutually exclusive, hypotheses have been discussed to account for the advantages of pregnancy disruptions for female rodents. Those hypotheses focusing on differential male behavior to related and unrelated pups may, with additional research, provide the most plausible explanation for the changes throughout pregnancy in the probability that a female will reabsorb a pregnancy when exposed to a new male. PMID- 3555218 TI - The role of the vomeronasal organ in behavioral control of reproduction. PMID- 3555217 TI - Reproductive behavior as a phenotypic correlate of T-locus genotype in wild house mice: implications for evolutionary models. PMID- 3555219 TI - Experiential influences on hormonally dependent ring dove parental care. PMID- 3555220 TI - The role of perception in habitat selection in colonial birds. PMID- 3555221 TI - Comparative behavioral endocrinology. PMID- 3555222 TI - Hormonal basis of maternal behavior in the rat. PMID- 3555223 TI - The effects of copulatory behavior on sperm transport and fertility in rats. PMID- 3555224 TI - Maternal responsiveness and nest defense during the prepartum period in laboratory rats. PMID- 3555225 TI - The role of the medial preoptic area in the regulation of maternal behavior in the rat. PMID- 3555226 TI - Psychobiology of rat maternal behavior: how and where hormones act to promote maternal behavior at parturition. PMID- 3555227 TI - Role of prolactin in avian incubation behavior and care of young: is there a causal relationship? PMID- 3555228 TI - A reevaluation of the concept of separable periods of organizational and activational actions of estrogens in development of brain and behavior. PMID- 3555229 TI - Extended organizational effects of estrogen at puberty. PMID- 3555230 TI - Reciprocity in neuroendocrine and evolutionary approaches to the study of reproductive behavior. PMID- 3555231 TI - The role of ultrasonic vocalizations in the regulation of reproduction in rats. PMID- 3555232 TI - A concept of physiological time: rhythms in behavior and reproductive physiology. AB - Biological clocks are self-sustained and endogenous. Animals have biological clocks in a variety of frequencies. Biological clocks provide temporal coordination among physiological, behavioral, and environmental events. One important function of steroid hormones may be to alter the temporal coordination among those events. Biological clocks provide a referent mechanism for the timing of both current and future endogenous and exogenous events. Physiological time is a unifying principle in biology. PMID- 3555233 TI - Hormonal control of behavior--a cautionary note. PMID- 3555235 TI - The role of androgen metabolism in the activation of male behavior. PMID- 3555234 TI - Heterotypical sexual behavior: implications from variations. PMID- 3555236 TI - Steroid hormone antagonists and behavior. PMID- 3555237 TI - Sex steroids and energy balance: sites and mechanisms of action. PMID- 3555238 TI - Individual behavioral response mediates endocrine changes induced by social interaction. PMID- 3555239 TI - Steroid receptors and hormone action in the brain. PMID- 3555240 TI - Noradrenergic regulation of progestin receptors: new findings, new questions. PMID- 3555241 TI - Reproductive neuroendocrine regulation in the female rat by central catecholamine neuropeptide interactions: a local control hypothesis. PMID- 3555242 TI - Hormone effects on serotonin-dependent behaviors. PMID- 3555243 TI - Female vocalizations and their role in the avian breeding cycle. PMID- 3555244 TI - Hormonal aspects of the morphological differentiation of neuronal clonal cell lines. PMID- 3555245 TI - Analysis of steroid action on gene expression in the brain. PMID- 3555246 TI - Genital stimulation as a trigger for neuroendocrine and behavioral control of reproduction. PMID- 3555247 TI - Neuroendocrinology of coitally and noncoitally induced pseudopregnancy. AB - In this paper, I have outlined our research perspective on coitally and noncoitally induced PSP. Coitally induced PSP requires a minimal threshold of vaginal stimulation to establish the repetitive nocturnal PRL surges which are essential for converting the corpora lutea from a nonfunctional to a functional state. The induction of PSP requires the activation of the adrenergic system and simultaneous inhibition of the cholinergic system. Reduction of neural activity in the medial preoptic area occurs at the time of coital stimulation, and is believed to be associated with the initiation of the nocturnal PRL surges. Apparently, cervical stimulation acts by inhibiting the nocturnal PRL surge inhibitory neurons at this brain site, thereby instituting PSP. It is proposed that the specific mating pattern of cervical stimulation activates a "mnemonic system" which retains information from vaginocervical stimulation permitting the expression of the repeated nightly PRL surges. In our view, each pregnancy originates as a direct continuation of the initial "hypothalamic PSP" triggered by the neural signal of mating. The mechanisms involved in the activation of the "mnemonic system" and the hypothalamically pseudopregnant state remain to be elucidated. Pseudopregnancy can be initiated by a number of socioenvironmental factors as well, such as cohabitation in all-female groups in mice or concaveation with foster pups in virgin rats. However, unlike coitally induced PSP which activates the "mnemonic system," noncoitally induced pseudopregnancies lack a "mnemonic system," and therefore require the continued presence of the initiating stimulus until progesterone levels become sufficiently elevated to provide positive feedback on PRL secretion. PMID- 3555248 TI - Licking, touching, and suckling: contact stimulation and maternal psychobiology in rats and women. PMID- 3555249 TI - Mitochondrial pathology: an overview. PMID- 3555250 TI - Inborn defects of the mitochondrial portion of the urea cycle. PMID- 3555251 TI - Transport and function of carnitine: relevance to carnitine-deficient diseases. PMID- 3555252 TI - Calcium and sodium in vascular smooth muscle. PMID- 3555253 TI - Membrane abnormalities in essential hypertension: physiologic and genetic links. PMID- 3555254 TI - Quantitative histochemical approaches are essential for investigating fundamental questions of diabetes research. PMID- 3555255 TI - The morphology of proinsulin processing. PMID- 3555256 TI - Cell biology of insulin's stimulatory action on glucose transport and its perturbation in altered metabolic states. PMID- 3555257 TI - The role of calcium and calmodulin in insulin receptor function in the adipocyte. PMID- 3555258 TI - Biological membranes and malignancy: an overview of pharmacological opportunities. PMID- 3555259 TI - The role of mitochondrial hexokinase binding in the abnormal energy metabolism of tumor cell lines. PMID- 3555260 TI - Membrane cholesterol and tumor bioenergetics. AB - We have established that a preferential export of pyruvate-generated citrate occurs from cholesterol-rich tumor mitochondria, with both isolated mitochondrial systems as well as with viable tumor tissue slices (i.e., with whole tumors cells). Furthermore, we have demonstrated that the more rapid citrate efflux kinetics (catalyzed by the tricarboxylate exchange carrier) of isolated tumor mitochondria is completely inhibited upon addition of 1,2,3-benzenetricarboxylate (BTC) and have shown that this inhibition is apparently also obtained in viable tumor tissue when the inhibitor is added to the tissue incubation. Upon BTC inhibition of tumor mitochondrial citrate export in viable tumor tissue incubations, the incorporation of [14C]pyruvate into newly synthesized cholesterol is severely inhibited as well. Among the most interesting conclusions drawn from our results, we catalog the following. The preferential export of citrate from isolated tumor mitochondria appears to be coupled, functionally, to a high linear rate of incorporation of 14C from pyruvate to cholesterol in viable tumor tissue slices, simultaneously supporting the postulate of a truncated Krebs cycle and corroborating the well-established deregulated and continuous cholesterogenesis pathway in tumors, especially hepatomas. The extent of [14C]pyruvate flux to newly generated cholesterol in either tumor or normal liver tissue is inversely related to the extent of 14CO2 production. Despite the evolution of some CO2 during cholesterogenesis, the predominant portion presumably arises via metabolic processing of pyruvate-generated citrate during Krebs cycle-linked respiration. Isolated tumor mitochondrial systems, as well as viable tumor tissue incubations, can manifest a reversal in the pattern of enhanced mitochondrial citrate efflux coupled to increased cholesterogenesis, when BTC is added to the system. This implies that BTC, a hydrophobic but negatively charged moiety at pH 7, can indeed penetrate the plasma membrane of cells. Upon entry into the cell, BTC apparently blocks the tricarboxylate carrier of tumor tissue mitochondria, thus forcing the mitochondrial citrate into Krebs cycle-linked respiration rather than permitting it to serve as the predominant provider of an increased supply of cytosolic acetyl CoA precursor required for deregulated cholesterogenesis during the development of the tumor. PMID- 3555261 TI - Membrane alterations in cancer cells: the role of oxy radicals. AB - Membranes isolated from tumor cells present profound alterations in their composition, structural organization, and functional properties. In this study we have reported some of these alterations in microsomal and plasma membranes of hepatomas with different growth rate and degree of differentiation. The chemical parameters studied were the phospholipid-to-protein, the cholesterol-to-protein, and the cholesterol-to-phospholipid ratios and the fatty acid composition of the phospholipids. The physical parameters were the molecular order (static) and the fluidity (dynamic), determined, respectively, as the order parameter [P2] and the correlation time tau R of the fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH). The functional property investigated was the ability of the membranes to undergo superoxide-induced lipid peroxidation, determined as byproduct (malondialdehyde and lipid hydroperoxides) formation and as changes in the fatty acid acyl residues. Changes in the physical state of the membrane, induced by oxy radicals, were also monitored during lipid peroxidation. A study of the antioxidant activity of the tumor cell, in terms of oxy radical enzymatic defenses (superoxide dismutase, glutathione peroxidase and catalase) was also performed. The main results obtained are the following: hepatoma membranes possess a lower phospholipid content and a lower degree of fatty acid unsaturation; on the other hand, the cholesterol-to-phospholipid ratio is increased; the physical state appears characterized by an increased rigidity (increased molecular order of the lipids and decreased fluidity); the membrane peroxidizability is markedly depressed and its order parameter, in contrast to liver membranes, does not increase with exposure to the action of O2- radicals; and the oxy radical enzymatic defense mechanisms are decreased. All these alterations increase with increasing growth rate and dedifferentiation of the tumor. Considering all of the data, we are inclined to think that tumor membranes are altered structurally and functionally in part as the result of an oxy radical induced damage that takes place in vivo under conditions of increased oxygen toxicity. PMID- 3555262 TI - Studies on giant mitochondria. PMID- 3555263 TI - Cystic fibrosis--a lethal exocrinopathy with altered mitochondrial calcium metabolism. PMID- 3555264 TI - [Why and how can we use fibroblast cultures in clinical practice?]. PMID- 3555265 TI - [Hereditary angioneurotic edema]. PMID- 3555266 TI - [Primary sporotrichoid cutaneous nocardiosis caused by Nocardia asteroides. Review of the literature apropos of 2 cases]. PMID- 3555267 TI - [Physiopathology and treatment of alopecia areata]. PMID- 3555268 TI - [Human cutaneous aspergillosis]. PMID- 3555269 TI - [Acquired bullous epidermolysis. The birth of a disease]. PMID- 3555270 TI - [Monoclonal antibodies applied to cutaneous lymphocytic infiltrates]. PMID- 3555271 TI - Milestones in modern plastic surgery. The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis: Crouzon's and Apert's diseases. By Paul Tessier 1971. PMID- 3555272 TI - Suction cannula assisted placement of traction sutures. AB - Many reconstructive techniques require placement of autogenous tissues or temporary implants into large subcutaneous cavities. This procedure may be facilitated by using traction sutures for their insertion. The blunt suction lipectomy cannula in turn can simplify this tedious step by providing a means to pass these sutures over long distances. The technique for this simple and time saving procedure is described. PMID- 3555273 TI - Carcinoma of the mucosa of the ethmoid in domestic animals. AB - The carcinoma of the mucosa of the ethmoid was reported in all domestic animals but specially in cattle and pigs in India. The tumour mass extended from the ethmoid to the nasal cavity and obturated the respiratory tract hence the clinical manifestation reported. Retropharyngeal and parotidal lymphnodes showed by metastases. The tumoral transformation was observed in the cells of the ethmoid mucosa. An early diagnosis could be done by sampling of cells in the nasal mucus. The disease was reproduced by instillation of cellular extracts. Several viruses have been isolated from the tumour tissue. In pigs there was a correlation between the incidence of tumour and the use of aflatoxin contaminated feed. This was an enzootical problem for the herd but neither genetics or microbial factors are determined. Various attempts were made to control the tumour growth. PMID- 3555274 TI - [Biological properties of Chlamydia]. PMID- 3555275 TI - Effect of soya bean oil on symptoms, gastric emptying and gut hormone release in patients with postvagotomy symptoms. AB - In a preliminary study the effect of an aperitif of a stable fat emulsion on symptoms, gastric emptying of a hypertonic glucose meal and associated release of insulin, neurotensin, enteroglucagon, gastric inhibitory polypeptide (GIP) and vasoactive intestinal polypeptide (VIP) was evaluated in 9 patients with postprandial gastrointestinal discomfort after vagotomy. In each patient gastric emptying of the glucose meal was measured twice: 20 min after intake of distilled water and after fat emulsion. On both occasions neurotensin, enteroglucagon and GIP rose significantly from fasting values. In contrast to distilled water, the fat emulsion was able to significantly activate the release of the hormones before ingestion of the glucose meal. All the patients had a rapid emptying of the glucose meal after distilled water and they experienced symptoms that corresponded with the nature of their spontaneous symptoms after ordinary meals. The fat emulsion reduced the early emptying of the meal and relieved the symptoms of the dumping patients, whereas gastric emptying and symptoms were variable in the patients with diarrhoea and other postvagotomy symptoms. The intake of an aperitif of soya bean oil seems to be an effective treatment only in patients with the dumping syndrome. PMID- 3555277 TI - Effect of bisacodyl on gut lavage cleansing for colonoscopy. AB - The effect of 10 mg oral bisacodyl (n = 19) or placebo (n = 26) on colon cleansing with polyethylene glycol electrolyte lavage solution was studied during colonoscopy. Patient tolerance was evaluated by questionnaire. During colonoscopy endoscopists graded adequacy of cleansing and subjective amounts of residual fluid and recorded the actual amount of fluid suctioned. Patient tolerance and adequacy of cleansing were not different between bisacodyl and placebo. There was no difference in subjective and measured residual fluid between the two groups. Compared to placebo, 10 mg oral bisacodyl does not influence adequacy of cleansing, patient tolerance, or residual fluid following polyethylene glycol electrolyte lavage solution for colonoscopy. This suggests that the beneficial cleansing effects with bisacodyl for barium enema may occur by mechanisms other than simple fluid evacuation. PMID- 3555276 TI - Efficacy of diclofenac in a single prophylactic dose in postoperative pain. AB - Prophylactic diclofenac (Voltaren) in postoperative pain was studied in 60 surgical patients who underwent either abdominal (30 patients) or superficial (30 patients) surgery. During anaesthesia, no analgesic or narcotic drugs were given. Immediately after surgery, an intravenous infusion of 100 ml normal saline or saline with 75 mg of diclofenac was administered over 10 minutes under double blind randomized conditions. The 2-hour study period was started when the patients complained of pain or half an hour after the end of anaesthesia. For pain relief during the study period, 4 mg of oxycodone was repeatedly given on demand. The initial mean pain intensity values were significantly higher after abdominal surgery than after superficial surgery but there were no statistically significant differences between diclofenac and placebo groups. The mean amount of oxycodone required after diclofenac was not significantly lower than after placebo (10.9 +/- 1.9 mg vs. 13.1 +/- 1.4 mg after abdominal surgery and 3.2 +/- 0.8 mg vs. 4.0 +/- 1.2 mg after superficial surgery). The pain relief obtained with oxycodone was similar after diclofenac and placebo. According to the present results, prophylactic use of diclofenac does not significantly reduce the need for narcotic analgesics in the immediate postoperative phase in general surgery. PMID- 3555278 TI - A practical approach to immunophenotyping of lymphomas. Comparison of immunohistologic and immunocytologic techniques. AB - Comparison of immunohistologic (IH) and immunocytologic (IC) techniques was conducted on 86 specimens. Forty-seven B-cell, five T-cell, and two null-cell lymphomas were identified by IH as well as 16 cases of lymphoid hyperplasia. The results of IC were generally identical to those of IH except for two T-cell and two B-cell lymphomas. The diagnosis of T-cell lymphoma was a major problem for IC because of the presence of normal T-cell count and/or normal helper/suppressor ratio in these cases. Twenty-one percent of the B-cell lymphomas failed to express surface immunoglobulin but did express B1 and HLA-DR antigens. Such a discrepancy was not demonstrated in cases of lymphoid hyperplasia, thus serving as a useful criterion in the diagnosis of B-cell lymphoma. While combined IH and IC should be used for immunophenotyping in large medical centers, IH is recommended for community hospitals. The identification of kappa, lambda, B1 and T11 (Leu 5) antigens in frozen sections with the immunoperoxidase technique should be sufficient to phenotype most lymphoproliferative diseases. The criteria for immunophenotyping of lymphomas are discussed. PMID- 3555279 TI - Heparin-induced thrombocytopenia: use of indirect immunofluorescence. AB - Sera from 14 patients who developed heparin-induced thrombocytopenia were tested by an indirect platelet immunofluorescent test in an attempt to characterize the serologic reactions between platelets, heparin, and the antibody. Positive results were observed in seven cases with variable patterns of reactions in the tests when performed in the presence or the absence of the offending drug. It was possible to absorb out the antibody in the presence of heparin and recover the antibody in the eluate. Neither complement nor the presence of immune complexes were found to play a role in the thrombocytopenia induced by heparin. PMID- 3555280 TI - Insulin or insulin-like peptides in the human pituitary. AB - Human pituitary cells and pancreatic islet beta cells from surgical and autopsy material showed positive immunoreactivity to anti-porcine insulin antisera demonstrating the presence in these tissues of insulin or insulin-like immunoreactive material. Glutaraldehyde-fixed, one micron epoxy sections were used and the polymerized resin was removed prior to staining with the peroxidase anti-peroxidase technique using guinea pig antisera to porcine insulin. Pancreatic beta cells served as the positive control, and appropriate negative controls were also utilized. PMID- 3555281 TI - [Importance of a loco-regional follow-up after curative operation in cancer of the rectum or sigmoid]. AB - After curative surgery for rectal or sigmoid cancer, loco-regional recurrence occurs in about 30% of the patients. Among them, one third presents no other tumor localization and a new curative surgical excision may, therefore be considered. A review of the literature shows that in these repeated procedures, the only good results, carcinologically, are observed when the original procedure consisted in a recto-colic anastomosis. Re-operations after abdomino-perineal resections have, until now, resulted in carcinologic failures. The location of the pelvic recurrence, after procedures which preserve the anal sphincter function, may be at the level of the anastomosis or most of the time around the anastomosis. If endoscopy is an easy mean of surveillance of the anastomosis, the screening of peri-anastomotic recurrences presents more of a problem. It seems necessary to use, in addition to rectal examination, other techniques which are more easily reproduced and compared with each other in the long run. This could be the case for endo-rectal sonography and pelvic tomodensitometry. As for re operation itself, it consists essentially in an abdomino-perineal resection possibly associated with radiotherapy. PMID- 3555282 TI - Class II antigen expression and inflammatory cells in the Guillain-Barre syndrome. AB - Monoclonal antibodies to T-lymphocyte subsets and Class II molecules (Ia) have been used to characterize the inflammatory infiltrate in nerve tissue biopsied from 2 patients in the acute phase of Guillain-Barre syndrome; the findings were compared with those in control nerve specimens. Normal control nerve was treated in the same way. In normal nerves, Class II molecules are expressed on endothelial cells and on occasional mononuclear and perineurial cells. In Guillain-Barre nerves the inflammatory infiltrate consisted mainly of Class II positive cells of the monocyte-macrophage lineage and of lesser numbers of T4 and T8 lymphoid cells. T4 cells predominated in perivascular collections. In the more severely affected patient, there was a marked increase of Class II molecules expressed on endothelial cells, perineurial cells, and most Schwann cells. Schwann cells associated with unmyelinated fibers and the Schwann cell processes of denervated Bungner bands all expressed Class II molecules. These histological changes were less marked in the more mildly affected patient. It is suggested that the expression of Class II molecules on the myelin forming cell, the Schwann cell, has important implications for the pathogenesis of the demyelination that occurs in Guillain-Barre syndrome. PMID- 3555283 TI - The Society for Physiological Neurology. PMID- 3555284 TI - Antiarrhythmic drug selection. AB - The selection of an effective and well-tolerated antiarrhythmic drug requires a systematic approach. Two methods for evaluating drug effect are routinely used- noninvasive techniques involving monitoring and exercise testing, and an invasive approach utilizing electrophysiologic testing. Each method has strengths and weaknesses and they must be applied to the appropriate patient. The evaluation of drug effect involves two types of testing. The acute drug test is a rapid screening of drug action, while a short-term maintenance period confirms drug efficacy and permits exposure of side effects. One of the most serious toxic effects is drug-induced aggravation of arrhythmia. An additional benefit of a systematized protocol is the identification of several effective agents that may be administered in combination to enhance antiarrhythmic drug effect. If an effective and well-tolerated drug is prescribed, recurrent malignant arrhythmia can be prevented. PMID- 3555285 TI - The use of "artificial skin" for burns. AB - An artificial skin composed of epidermal and dermal analogues has been successfully used in animal models and in severely burned patients. The development of skin substitutes, the clinical use of artificial skin, and future physiologic skin replacements are discussed. PMID- 3555286 TI - Mechanisms involved in gastric mucosal resistance to injury. AB - The healthy stomach resists the potentially devastating effects of its own secreted H+. Even though the resulting concentration gradient favors diffusion of luminal H+ into the mucosa, the actual amount of diffusion is limited in extent under normal conditions. Enhanced diffusion of H+ into the mucosa can be associated with the development of obvious injury, but this is not necessarily the case if the tissue effectively buffers H+. Conversely, in circumstances where the ability to dispose of H+ is impaired, what would be considered to be a usual amount of H+ diffusion can be troublesome. While several factors of mucosal defense have been identified, it is unlikely that alteration of a single mechanism accounts for gross damage. The interplay between defensive mechanisms may account for the variable endoscopic effects observed for damaging agents in man, especially in situations where the luminal concentrations of H+ and drug are variable. PMID- 3555287 TI - Normal and abnormal bone remodeling in man. AB - Remodeling is a continuous process of skeletal destruction and renewal, occurring throughout life in humans and some other mammals. Remodeling minimizes the damage of routine wear but, because of its fundamental inefficiency, also underlies normal age-related bone loss. Alterations in bone mass due to dietary and endocrine factors occur in response to changes in the birthrate of new remodeling units, increased remodeling imbalance within existing units, or a combination of both. Familiarity with remodeling is prerequisite to understanding the pathologic basis and rational therapy of metabolic bone disease. PMID- 3555288 TI - IgA nephropathy. AB - IgA nephropathy is a syndrome and probably the most important glomerular disease in terms of incidence and mortality. This review documents the clinical and pathological features and concentrates on the evolving thoughts regarding pathogenesis and treatment. PMID- 3555289 TI - Chronic lead nephropathy. AB - Chronic lead nephropathy remains a cause of morbidity and mortality in Queensland, Australia, and in other parts of the industrial world. It is underdiagnosed because it is not considered in the differential diagnosis of chronic renal disease and because the established methods for estimating the body burden of lead are cumbersome, time consuming, and sometimes inaccurate. PMID- 3555290 TI - Leukocyte adhesion deficiency: an inherited defect in the Mac-1, LFA-1, and p150,95 glycoproteins. AB - Leukocyte adhesion deficiency (LAD) is a recently recognized autosomal-recessive trait characterized by recurrent bacterial infections, impaired pus formation and wound healing, and abnormalities in a wide spectrum of adherence-dependent functions of granulocytes, monocytes, and lymphoid cells. Features of this disease are attributable to deficiency (or absence) of cell surface expression of a family of functionally and structurally related glycoproteins. These include Mac-1 (complement receptor type 3), lymphocyte function-associated antigen-1 (LFA 1), and p150,95. Defective biosynthesis of the beta chain shared by each molecule (comprised of alpha 1 beta 1 complexes) represents the fundamental molecular basis of this disease. Recognition of the molecular pathogenesis of this disorder has allowed rich insights into the role of cellular adherence reactions in inflammation and host defense. PMID- 3555291 TI - Clinical pharmacology of benzodiazepines. AB - The benzodiazepines are the most widely used anxiolytic drugs. Their pharmacokinetic properties differ widely. Side effects are usually mild but dependence can supervene after long-term administration, even if normal therapeutic doses are not exceeded. Careful monitoring of use is essential. PMID- 3555292 TI - Myocarditis and dilated cardiomyopathy. AB - The recent developments in the study of myocarditis and dilated cardiomyopathy are reviewed here, with the primary emphasis on the issue of myocarditis as a precursor to dilated cardiomyopathy. Advances in immunologic approaches have expanded our knowledge of the course of myocarditis, experimentally as well as clinically. Although further investigations are necessary to prove the direct link between acute myocarditis and some cases of dilated cardiomyopathy, clinical trials of immunosuppressive agents, virus-specific vaccine, and antiviral agents such as ribavirin and interferon appear warranted, with the hope of potential benefits in the treatment of myocarditis and, therefore, in some forms of dilated cardiomyopathy. PMID- 3555294 TI - Irritable bowel syndrome: classification and pathogenesis. AB - The irritable bowel syndrome (IBS), a chronic disorder of gut motility with a variable but continuous spectrum of clinical features, affects 15% of the population of developed countries. Its intestinal and extraintestinal symptoms arise principally from the global physiological changes that accompany emotional tension; but the advancing knowledge of neurohumoral control of gut motility has not yet revealed any features pathognomonic for IBS. Persons having IBS exhibit psychoneurotic traits in varying degree; and IBS patients (a minority of the whole) differ from nonpatients in having more severe life changes and in their learned illness behavior. PMID- 3555293 TI - Hypercalcemia of malignancy. AB - Malignancy-associated hypercalcemia is a common and important clinical problem. Two major pathogenic mechanisms appear to be operative in this disorder: local osteolytic hypercalcemia and humoral hypercalcemia of malignancy. The clinical and biochemical features that distinguish these two processes are reviewed. PMID- 3555295 TI - Endoscopic control of gastroduodenal hemorrhage. AB - Several methods of endoscopically controlling acute, nonvariceal upper gastrointestinal bleeding have been developed. Some, such as the laser, heater probe, and bipolar electrocoagulation, have been evaluated in controlled clinical trials. The purpose of this paper is to discuss endoscopic control of nonvariceal gastroduodenal hemorrhage and to consider whether improvement in outcome is likely with any of these devices. Techniques and results of controlled clinical trials are reviewed. PMID- 3555296 TI - The treatment of diabetic retinopathy. AB - Advances in our understanding of diabetic retinopathy have allowed the development of new treatments directed at the preservation of sight. This paper reviews the various clinical stages of this disorder with an emphasis on the underlying pathophysiologic mechanisms. A rational approach to the management of this disorder based upon pathogenesis is then presented. PMID- 3555297 TI - Controversies in the treatment of cancer of the breast. AB - There are many important controversial areas in the management of breast cancer. This chapter focuses on adjuvant hormonal and chemotherapy for early-stage breast cancer. Standard care for node-positive premenopausal women is chemotherapy. However, there are still unanswered questions revolving around the administration of the treatment such as optimal timing, treatment duration, specific drugs, and dose intensity. Also, the questions of adjuvant chemotherapy for postmenopausal women, adjuvant endocrine therapy, and therapy for node-negative women are reviewed. PMID- 3555298 TI - The treatment of infertility. AB - Combined management of infertile couples is optimal. The most common problems in men are low sperm concentration and motility of unknown cause. Although there are no specific effective treatments, factors correlated with subsequent fertility are emerging that should be useful for advising couples of their chances. In the woman, disorders of ovulation can usually be treated successfully, but results of tubal surgery for past inflammatory damage remain poor. In vitro fertilization may be useful for idiopathic infertility and semen disorders of mild to moderate severity, as well as for tubal obstruction. PMID- 3555299 TI - Lung inflammation: normal host defense or a complication of some diseases? AB - The inflammatory response in lung tissue is an important part of host defense that aids in removing microorganisms or particles that have reached the distal airways and alveolar surface. It augments the usual function of alveolar macrophages, immunoglobulins, and other defense mechanisms such as mucociliary clearance. However, excessive or poorly regulated inflammation can be destructive of tissue, thus contributing to many disease processes that can lead to fibrosis and impaired gas exchange. Several examples of diseases that feature inflammation as part of their pathophysiology have been selected for this review; i.e. asthma (especially examining the late-phase reaction that involves PMNs), chronic bronchitis (in which irritants and bacterial products may stimulate mucus secretion and inflammatory cells), interstitial lung diseases (IPF may disclose PMNs but sarcoidosis and hypersensitivity pneumonitis feature collections of activated lymphocytes), and acute lung injury leading to adult respiratory distress syndrome (PMNs and their breakdown products and enzymes incite local destruction of alveolar tissue). In preparation for these disease examples, a thorough review of the normal interactions between alveolar macrophages, various opsonins, complement and chemotactic factors, and the responsiveness of PMNs is given first. PMID- 3555301 TI - Reactive arthritis. AB - Inflammatory arthritis occurring days to weeks after a localized infection is known as reactive arthritis. Epidemiologic, genetic, and immunologic features have established this disease as a distinct clinicopathologic entity. Although reactive arthritis is often a transient disease, many individuals suffer a chronic relapsing course. Treatment is usually conservative except in a minority of cases in which patients require remittive therapy. PMID- 3555302 TI - Anorexia nervosa and bulimia. AB - This article is an update on the research and treatment of anorexia nervosa and bulimia. In the past five years, endocrine research has focused on neurotransmitters in anorexia nervosa and treatment research has centered on bulimia. PMID- 3555300 TI - IgG subclass deficiencies. AB - IgG subclasses represent distinct immunoglobulin types, each defined by unique primary structures of the constant region of the heavy-chain molecule, and each with characteristic biological and functional properties. New methods and reagents to measure serum concentrations have contributed to the study of the ontogeny, antigen restriction, and deficiencies of IgG subclasses. Distinct clinical entities of single or multiple IgG subclass deficiencies have been identified and the efficacy of immunoglobulin replacement therapy has been demonstrated in several instances. PMID- 3555304 TI - Endotoxins and disease mechanisms. AB - In this chapter, current concepts about the mechanisms of action of endotoxin are reviewed. Particular attention is focused upon endotoxin-induced production of soluble mediators from macrophages and mononuclear cells and on the potential contribution of these mediators to endotoxin shock. In many cases, the interrelationships between these mediators as primary and/or secondary consequences of endotoxin stimulation of mononuclear phagocytes are discussed. Final comments address the relevance of these mediators to the therapy of endotoxin shock. PMID- 3555303 TI - Prions causing degenerative neurological diseases. AB - Prions cause degenerative neurological diseases--scrapie in animals and Creutzfeldt-Jakob disease in humans. The novel properties and structure of the prion distinguish it from viruses. PMID- 3555305 TI - Affective disorders in the elderly. AB - Elderly patients, just as younger ones, may suffer from the two extremes of affective disturbance known as mania and depression. Either may be secondary to underlying organic causes often requiring specific treatment. For primary disorders, treatment typically consists of pharmacotherapy and/or psychotherapy. Pharmacologic treatment of nonorganic conditions is essentially similar to that used in younger patients, although medication dosages are generally lower and side effects more common. PMID- 3555306 TI - Results of coronary bypass surgery. PMID- 3555307 TI - Human lymphocyte and lymphoma homing receptors. AB - The migration of normal and malignant lymphocytes is controlled in part by selective lymphocyte recognition of high endothelial venules (HEV) at sites of lymphocyte exit from the blood. Recirculating lymphocytes appear to utilize structurally related, yet functionally distinct, 90-kD receptors to interact in an organ-specific manner with HEV in peripheral lymph nodes, in mucosa-associated lymphoid tissues (Peyer's patches, appendix), and in inflamed joint tissue (synovium). These lymphocyte "homing receptors" constitute a family of glycoprotein endothelial cell recognition elements that regulate the extravasation of circulating normal and neoplastic lymphocytes into different organs of the body, and thus play an important role in determining the characteristics of local immune responses and the patterns of dissemination of lymphoid neoplasms. PMID- 3555308 TI - Barrett's esophagus and adenocarcinoma. AB - Barrett's esophagus represents an epithelial metaplasia in which a columnar lining replaces normal squamous epithelium of the esophagus. It occurs in at least 10% of patients with chronic gastroesophageal reflux and is associated with an increased risk of adenocarcinoma of the esophagus. This review focuses on the criteria for the diagnosis of Barrett's esophagus, discusses its association with adenocarcinoma, and provides guidelines for surveillance for carcinoma. PMID- 3555309 TI - The biochemistry and pathophysiology of the prethrombotic state. AB - Several natural anticoagulant mechanisms oppose the procoagulant actions of the blood clotting cascade. Detailed biochemical analysis of some of these pathways have allowed us to develop an understanding of how the blood coagulation mechanism is normally regulated and to establish assays for evaluating the in vivo activity of these biological mechanisms. Clinical investigations of relatively simple inherited thrombophilic states have uncovered the regulatory defects that lead to overt thrombotic disorders and have also provided a new definition of the prethrombotic state that may have relevance to more complex multifactorial vascular disorders. PMID- 3555310 TI - Immune disregulation of hematopoiesis. AB - In vitro coculture studies of normal T lymphocytes, natural killer (NK) cells, or monocytes with human hematopoietic progenitor cells (HPC) suggest a potential role for immune cells in the regulation of hematopoiesis. In some patients with severe aplastic anemia or selective pure red cell, white cell, or megakaryocyte aplasia, activated T cells, NK cells, or monocytes mediate marrow failure by suppressing growth of HPC. Immunosuppressive agents such as corticosteroids, antithymocyte globulin, cyclophosphamide, or cyclosporin A may dramatically improve blood cell production in patients with marrow failure by removing or modulating immune suppressor cells. PMID- 3555311 TI - Platelet-derived growth factor. AB - Platelet-derived growth factor (PDGF) is emerging as a key mitogen in an increasing range of biological events, far more wide-reaching than initially suspected. Purification of the molecule and development of an antibody to PDGF have enhanced our ability to study its interactions with cells and the capacity of cells to express the gene for PDGF, secrete the molecule, and stimulate DNA synthesis and cell proliferation. The study of platelet-derived growth factor activity in normal biological processes and in disease processes has taken on many facets in a wide range of medical disciplines. PMID- 3555312 TI - The QT interval and cardiac arrhythmias. AB - The relation between the QT interval, ventricular arrhythmias, and dispersion of ventricular repolarization is reviewed. Conditions associated with prolonged QT interval in clinical practice are listed and discussed briefly. There is no conclusive evidence that prolonged QT is an independent prognostic marker in patients with coronary and other types of heart disease. PMID- 3555313 TI - Treatment of pulmonary embolism. AB - Most clinically important pulmonary emboli are associated with thrombosis of the proximal deep veins of the leg. Anticoagulant therapy is highly successful in reducing death and recurrence from pulmonary embolism and is the treatment of choice in the majority of these patients. Thrombolytic therapy is usually reserved for selected patients with clinically serious or massive pulmonary embolism. Vena caval interruption is limited to patients who have an absolute contraindication to anticoagulant therapy or who develop recurrent pulmonary embolism despite adequate anticoagulant therapy. Pulmonary embolectomy has a high mortality and should therefore be restricted to the most desperate cases. PMID- 3555314 TI - Inhibin. PMID- 3555315 TI - Computer-aided drug design. AB - Progress in genetic engineering has increased the need for, while advances in computational hardware have removed barriers impeding, the development of appropriate computational tools to assist in the understanding of molecular interactions. Advancements both in techniques and in broadening application have been clearly demonstrated. Further development requires progress in the fundamental aspects of theoretical chemistry as well as an increased base of experience in choosing the appropriate set of assumptions for a particular problem. Computer-aided drug design is a current reality, but one that, at its best, supplements an incomplete methodology with the traditional insight and wisdom of an experienced medicinal chemist. In the next few years progress in developing a sound theoretical foundation will make molecular design a realistic aid to the medicinal chemist and protein engineer. PMID- 3555316 TI - Molecular and cellular basis of chemically induced immunotoxicity. PMID- 3555317 TI - Platelet-activating factor antagonists. AB - Over the past decade platelet-activating factor has achieved the status of an important inflammatory mediator. The scientific enthusiasm and number of research investigators, publications, and meetings recently devoted to PAF suggest that this mediator will be the subject of continued study in the foreseeable future. The potential for the presence and involvement of PAF in human disease is easily concluded from the reports described in this review. Both the need for low concentrations for cellular response and the rapid biological clearance mechanisms have made the proof of the involvement of PAF in human disease difficult. The discovery of PAF receptor antagonists and structure-activity relationships of such antagonists (159) will make this determination possible in the near future. The current PAF antagonists may be considered as first generation agents, since the most potent antagonist is still less than 1/100th as potent as PAF is as an agonist. The wide diversity of clinical applications from asthma to septic shock may also require antagonists with selective attributes such as delivery route (oral vs intravenous vs topical) or biological half-life (prolonged vs short). PAF may prove to be the key mediator of several poorly understood disease syndromes such as hyperacute organ transplant rejection, ischemic bowel necrosis (160), and adult respiratory distress syndrome. We must wait for clinical results to draw further conclusions. PMID- 3555318 TI - The pharmacology of carnitine. PMID- 3555319 TI - Purine receptors in mammalian tissues: pharmacology and functional significance. PMID- 3555320 TI - Solvent toxicology: recent advances in the toxicology of benzene, the glycol ethers, and carbon tetrachloride. PMID- 3555321 TI - The promise of pharmacoepidemiology. PMID- 3555322 TI - [Normal human microflora and the problems of microecological toxicology]. PMID- 3555323 TI - [Gnotobiology of the host microflora and antibiotic therapy]. AB - Gnotobiological studies showed that under natural conditions normal microflora (microsymbiocenosis) is necessary for normal vital activity. In addition to autochthonous flora microsymbiocenosis includes an insignificant number of facultative pathogenic bacteria. In etiotropic antibiotic therapy it is important to preserve the autochthonous portion of the microsymbiocenonosis: bifidobacteria, lactobacilli, propionic bacteria and others. However, with respect to certain indications (diseases associated with suppression of resistance to infections) total decontamination with obligatory isolation of the patient under gnotobiological conditions is possible. In selective decontamination the facultative pathogenic portion of the intestinal microflora is the sole target of antibiotics. Selective decontamination is one of the methods for control of nosocomial infections, dysbacteriosis. It is indicated that establishment of departments in charge of investigation of intestinal microflora of patients and medical staff in hospitals is required for detecting risk groups which can be both the source of infection and the population most susceptible to hospital strains of antibiotic resistant facultative pathogenic bacteria. PMID- 3555324 TI - [Lactobacillus flora and colonization resistance]. AB - Lactobacillus flora of healthy persons and the properties influencing the protective function of lactobacilli are described. It was shown that the species and quantitative composition of the Lactobacillus flora in healthy persons was characterized by individual features and the Lactobacillus flora of separate microbiotopes was different. Furthermore, the properties defining the protective function of lactobacilli in the host: colonization capacity, direct antimicrobial activity and interference with other protective mechanisms were also different in separate species and even strains. PMID- 3555325 TI - [Human Bifidobacterium flora, its normalizing and protective functions]. AB - The paper is concerned with investigation of the normalizing and protective role of the Bifidobacterium flora in humans and its quantitative predomination in intestinal microbiocenosis of children and adults. The data on antagonistic properties of bifidobacteria with respect to pathogenic and facultative pathogenic bacteria, the Bifidobacterium flora influence on the host metabolism and efficiency of bifidobacterin in recovery of the Bifidobacterium flora optimal level are presented. PMID- 3555326 TI - [Dysbacteriosis--infectious processes of mixed etiology]. AB - At present dysbacteriosis or altered normal and sometimes very individual proportion of microorganisms in various macroorganism microbiotopes is considered as an infectious disease since it results from pathogenic action of microbes, is characterized by a set of features relating to pyoinflammatory processes and even can be contagious. PMID- 3555327 TI - [Metabolites of the intestinal microflora in the diagnosis of intestinal dysbacteriosis]. AB - The procedures most widely used in investigation of intestinal microflora activity are briefly reviewed. The original findings relating to investigation of intestinal microflora and isolation of certain bacterial metabolites from rats with self-filling jejunal loop are presented as an example. Marked correlation between isolation of certain bacterial metabolites and self-filling jejunal loop microflora was observed. The authors consider advisable that biochemical and bacteriological methods for investigation of intestinal microflora be combined. When there are shifts in the number and ratio of the produced metabolites, invasive diagnostic methods including intubation and bacteriological examination of the small intestine are recommended. PMID- 3555328 TI - [The adhesive capacity of representative intestinal microflora in the continuous and split oral administration of cephalexin and erythromycin]. AB - When cephalexin and erythromycin were administered intragastrically with intervals, adhesion of facultative pathogenic bacteria such as Klebsiella, Staphylococcus and E. coli to enterocytes of the small intestine in vitro was more pronounced than with their continuous administration with drinking water. The adhesive capacity of the staphylococcal strains resistant to the antibiotics was higher than that of the sensitive ones. PMID- 3555329 TI - [Sanitary microbiological aspects of the treatment of wastes from antibiotic manufacture in biological ponds]. AB - Efficiency of decreasing sewage contamination was estimated under laboratory conditions by the Coli index in additional treatment of antibiotic production sewage in bioponds with higher aquatic plants. It was shown that the sewage decontamination in summer was intensive due to vital activity of complex biocenosis of the higher aquatic plants and algae and reached the required levels. This allowed to use much lower quantities of the reagents in chlorination of water for circulating water supply. PMID- 3555330 TI - [Methods of determining the antibiotic sensitivity of obligately anaerobic pathogenic microorganisms]. PMID- 3555331 TI - Acyclovir prophylaxis for herpes simplex virus infection. AB - ACV is an effective agent for the treatment and prophylaxis of HSV infections in both IC and immunologically normal individuals. The drug is well tolerated in both populations and is not significantly associated with clinical or laboratory toxicities. Because of the great potential benefit and low risk, organ transplant recipients and patients with hematologic malignancies undergoing induction chemotherapy should be screened routinely for HSV antibodies; seropositive individuals should receive prophylactic ACV during the period of most profound immunosuppression. Immunologically normal individuals with frequently recurring genital HSV or serious complications associated with outbreaks are candidates for long-term suppression with ACV. PMID- 3555332 TI - Inactivation of clostridial ferredoxin and pyruvate-ferredoxin oxidoreductase by sodium nitrite. AB - Clostridial ferredoxin and pyruvate-ferredoxin oxidoreductase activity was investigated after in vitro or in vivo treatment with sodium nitrite. In vitro treatment of commercially available Clostridium pasteurianum ferredoxin with sodium nitrite inhibited ferredoxin activity. Inhibition of ferredoxin activity increased with increasing levels of sodium nitrite. Ferredoxin was isolated from normal C. pasteurianum and Clostridium botulinum cultures and from cultures incubated with 1,000 micrograms of sodium nitrite per ml for 45 min. The activity of in vivo nitrite-treated ferredoxin was decreased compared with that of control ferredoxin. Pyruvate-ferredoxin oxidoreductase isolated from C. botulinum cultures incubated with 1,000 micrograms of sodium nitrite per ml showed less activity than did control oxidoreductase. It is concluded that the antibotulinal activity of nitrite is due at least in part to inactivation of ferredoxin and pyruvate-ferredoxin oxidoreductase. PMID- 3555333 TI - Sensitivity of genetically engineered organisms to selective media. AB - Eighteen strains of Escherichia coli used in genetic studies were tested for their ability to grow on several selective media. Highest recoveries were obtained with m-T7 agar. The SOS system, particularly the recA gene, may play some role in the sensitivity of E. coli to selective agents. These results may be important in the selection of media used to detect genetically engineered organisms released into the environment. PMID- 3555334 TI - Antifungal activity of ajoene derived from garlic. AB - The antifungal activity of six fractions derived from garlic was investigated in an in vitro system. Ajoene had the strongest activity in these fractions. The growth of both Aspergillus niger and Candida albicans was inhibited by ajoene at less than 20 micrograms/ml. PMID- 3555335 TI - Mobilization of plasmid pHSV106 from Escherichia coli HB101 in a laboratory-scale waste treatment facility. AB - The mobilization of plasmid pHSV106 from Escherichia coli HB101, in a laboratory model waste treatment facility, by both laboratory and indigenous wastewater strains of E. coli was monitored by transfer of antibiotic resistance characteristics and by detection of pHSV106 DNA sequences in recipient cells. The mobilization was demonstrated to occur under several different treatment conditions, such as different media composition, microbial concentrations, and waste flow rates. The herpes simplex virus thymidine kinase gene was used as a hybridization marker to confirm the occurrence of the transfer. The use of the HB101 (recA mutant) host cell implies that recA functions are unnecessary for the gene transfer. PMID- 3555336 TI - Identification of major common extracellular proteins secreted by Aeromonas salmonicida strains isolated from diseased fish. AB - Ten different strains of Aeromonas salmonicida that were isolated from diseased fish were grown under identical conditions (24 h at 25 degree C) in 3% (wt/vol) tryptone soya broth medium supplemented with vitamins and inorganic ions. In each case the extracellular proteins that were formed were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and it was found that there were two significant common components, one with a molecular weight of 70,000 and the other with a weight of 56,000. Application of enzyme purification techniques to the supernatant fraction proteins of a culture of one of the strains resulted in the isolation of a 70-kilodalton (kDa) component, which was found to be a serine protease, and a 56-kDa component, which was hemolytic to trout erythrocytes. Rocket immunoelectrophoresis with rabbit antibodies to the isolated protease and hemolysin showed the same antigenic components in the supernatant fractions of all the cultures. These activities were assayed, and protease activity was found to vary by a factor of three, from 59 to 195 U/ml, while the range of hemolytic activity was over a narrow band, from 28 to 43 U/ml. There was an inconsistency between the immunoelectrophoretic and direct assay data in only one case. This indicated the presence of additional hemolytic activity, in addition to the 56 kDa component. The detection of large amounts of the same protease and hemolysin, two potent degradative activities, in a random series of strains of A. salmonicida suggests that they may be obligatory virulence factors in the development of furunculosis. PMID- 3555337 TI - Influence of immobilization on the stability of pTG201 recombinant plasmid in some strains of Escherichia coli. AB - The stability of pTG201 plasmid was examined by continuous culture in three genetically different Escherichia coli hosts. Two types of experiment were carried out, one with free cells and one with immobilized cells. When cells were cultivated in free continuous culture in the absence of antibiotic selection, the plasmid was maintained with various degrees of stability in the three host organisms. By contrast, in continuous culture with immobilized cells, plasmid pTG201 was stably maintained in the three strains. We showed that the increase in pTG201 stability in immobilized cells is due neither to plasmid transfer between immobilized cells nor to an increase of the plasmid copy number of immobilized cells. We also showed that plasmid-free cells, when coimmobilized and grown in competition with plasmid-containing cells, cannot overrun the culture. PMID- 3555338 TI - Tremorgenic mycotoxins from Aspergillus fumigatus as a possible occupational health problem in sawmills. AB - Wood-trimmers' disease, generally called extrinsic allergic alveolitis, which affects workers in sawmills, is thought to be caused by fungal diaspores. The importance of Aspergillus fumigatus on the surface of wood dried in kilns is accentuated by its ability to produce tremorgenic mycotoxins. Eight strains of A. fumigatus from five different sawmills were isolated and cultivated on liquid media, and one of the strains was also cultivated on wood blocks. Extracts were prepared, and the tremorgenic reactions were induced by oral administration of extracts to rats. Extracts of the strain grown in liquid medium and on wood blocks induced very strong tremorgenic reactions when administered orally to rats. Four other strains induced mild tremorgenic reactions. High-performance liquid chromatography analysis revealed two tremorgenic mycotoxins, verruculogen and fumitremorgen C, in the five toxic strains. One nontoxic strain produced detectable levels of verruculogen. These results, coupled with the known resemblance of the acutely toxic phase of wood-trimmers' disease to the symptoms produced by these tremorgens, imply that wood-trimmers' disease and similar occupational diseases are, at least in part, mycotoxicoses. PMID- 3555339 TI - Prevalence of Borrelia burgdorferi and Babesia microti in mice on islands inhabited by white-tailed deer. AB - Borrelia burgdorferi and Babesia microti were isolated from 35 of 51 white-footed mice (Peromyscus leucopus) and meadow voles (Microtus pennsylvanicus) captured on two Narragansett Bay, R.I., islands inhabited by deer, the principal host for the adult stages of the vector tick, Ixodes dammini. Immature ticks parasitized mice from both islands. From 105 mice captured on four other islands not inhabited by deer neither pathogen was isolated, nor were I. dammini found. PMID- 3555340 TI - Insulin-mimetic actions of wheat germ agglutinin and concanavalin A on specific mRNA levels. AB - Insulin has pleiotropic effects on sensitive cells, including the regulation of specific mRNA accumulation initiated by the binding of insulin to its plasma membrane receptor. Lectins, such as wheat germ agglutinin (WGA) and concanavalin A (Con A), are known to be insulin mimetic. It is thought that WGA and Con A interact with the insulin receptor or associated membrane glycoproteins which, when activated, lead to insulin-mimetic responses. We attempted to determine whether WGA and Con A could induce the accumulation of a specific messenger RNA (p33-mRNA). Insulin treatment of H4IIE (H4) hepatoma cells increased the concentration of p33-mRNA within 30 min after addition, with a maximum effect of 10- to 15-fold. WGA and Con A also exhibited time- and dose-dependent stimulatory effects on p33-mRNA accumulation with maximal effects of 30- to 40-fold. The effect of insulin was maximal by 1 h and plateaued thereafter, whereas lectins had maximal effects at 2 h after addition to cell cultures. Insulin, WGA, and Con A did not significantly alter the stability (half-life) of p33-mRNA. The addition of RNA synthesis inhibitors blocked the ability of insulin, WGA, and Con A to induce the amount of p33-mRNA. These data suggest that lectins, as well as insulin, induce the synthesis of p33-mRNA in acutely treated H4 hepatoma cells. PMID- 3555341 TI - Isolation and properties of a capillary injury-related protease from lung lymph. AB - Lung microvascular injury induced in sheep by intravenous infusion of Escherichia coli endotoxin, oleic acid, or air emboli caused the appearance in lung lymph of high levels of a protease with trypsin-like activity. The enzyme was isolated as an apparently homogeneous protein from pooled samples of active lung lymph, after an almost 9000-fold purification by affinity chromatography on columns of Reactive Blue 2-agarose, aprotinin-agarose, and p-aminobenzamidine-agarose, and chromatography on a column of Sephadex G-100. A molecular weight of about 70,000 to 75,000 was determined from mobility in polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The pH optimum was between 7.3 and 7.6. The isolated enzyme was quite labile, rapidly losing activity at both 37 and 25 degrees C. Addition of albumin to enzyme solutions protected against inactivation. Inhibition by diisopropylfluorophosphate and phenylmethanesulfonyl fluoride indicated that the enzyme belongs to the class of serine proteases. The enzyme cleaved peptide bonds on the carboxyl side of arginine residues and showed a relatively high affinity toward peptides containing several basic amino acid residues. Bonds involving the carboxyl group of lysine were cleaved at a much slower rate. The enzyme showed no plasminogen activator activity and its substrate specificity was quite different from that of several proteases of the clotting cascade. Its appearance in lymph was not influenced by lymph clotting and the isolated enzyme was not capable of correcting the clotting defect of plasmas deficient in factors XII, XI, IX, VII, and X. PMID- 3555342 TI - Insulin-degrading neutral cysteine proteinase activity of adipose tissue and liver of nondiabetic, streptozotocin-diabetic, and insulin-treated diabetic rats. AB - The activity of the insulin-degrading enzyme neutral cysteine proteinase (EC 3.4.22.11, insulinase) was studied in adipose tissue and in liver of nondiabetic, streptozotocin-diabetic, and insulin-treated diabetic rats. Proteinase activity was found to be significantly decreased during diabetes and was restored to near normal levels in both tissues following insulin treatment. The insulin-mediated increase of proteinase activity in both tissues was partially or completely blocked by actinomycin D (an inhibitor of RNA synthesis) and by cyclohexamide (an inhibitor of protein synthesis). Kinetic analysis showed that the changes in proteinase activity of both liver and adipose tissues were accompanied by a change in Vmax (i.e., maximal enzyme activity) without a change in Km (i.e., substrate affinity). These data indicate that insulin functions as an inducer for neutral cysteine proteinase in both tissues. These alterations in the proteinase activity paralleled the alterations in the activity of a second insulin-degrading enzyme, glutathione-insulin transhydrogenase in adipose tissue (this paper) and in liver (previously published papers) under the same physiological conditions. PMID- 3555343 TI - Chlorophyll antenna proteins of photosystem I: topology, synthesis, and regulation of the 20-kDa subunit of Chlamydomonas light-harvesting complex of photosystem I. AB - The light-harvesting complex of photosystem I (LHCI) was isolated from wild-type cells of Chlamydomonas reinhardtii; the Chl a/b-protein complex contains four major polypeptides of approximately 27, 26, 24, and 20 kDa (polypeptides 14, 15, 17.2, and 22, respectively, in the nomenclature for Chlamydomonas thylakoid proteins). Antiserum against the 20-kDa subunit of LHCI was prepared and used to determine the membrane topology, subcellular site of synthesis, and cell-cycle regulation of this polypeptide. The results indicate that the 20-kDa subunit as well as the other major LHCI polypeptides are integral membrane proteins. Moreover, protease digestion experiments reveal that the 20-kDa polypeptide is completely protected by the membrane bilayer but the 27- and 26-kDa LHCI polypeptides are exposed at the membrane surface. In vivo synthesis of the 20-kDa polypeptide is sensitive to cycloheximide but not to chloramphenicol; the form of the polypeptide recovered from in vitro translations of polyadenylated RNA is approximately 24 kDa, 4 kDa larger than the mature polypeptide. It is concluded that this LHCI polypeptide is nuclear encoded and synthesized in the cytoplasm as a higher molecular weight precursor. Synthesis of the 20-kDa polypeptide is restricted to the light period in light-dark synchronized cells. Translatable mRNA for this polypeptide accumulates during the light but levels are dramatically reduced during the dark period. Thus, synthesis of the 20-kDa subunit of LHCI appears to be transcriptionally regulated during the cell cycle. PMID- 3555344 TI - Photosystem I reaction center polypeptides of spinach are synthesized on thylakoid-bound ribosomes. AB - Purified chloroplasts were prepared from developing spinach leaves. The chloroplasts were separated into thylakoid and stroma fractions, and nucleic acids were prepared from them. Photosystem I reaction center polypeptide(s) (PS I RC) mRNA was associated with the thylakoid fraction when measured by hybridization using a probe for PS I RC polypeptide ps1A1, or when measured by translation assay. The ps1A1 polypeptide was coded for by a 5.5-kbp mRNA which others have shown also codes for PS IRC polypeptide ps1A2. This mRNA was in functional thylakoid-bound ribosomes because when thylakoids with bound ribosomes were translated in the absence of protein synthesis initiation, polypeptides that reacted with anti-PS I RC were formed. The results indicate that PS I RC polypeptides are synthesized exclusively by thylakoid-bound ribosomes. PMID- 3555345 TI - Two-dimensional polyacrylamide gel electrophoresis analysis of phosphorylated, membrane-localized ras p21 proteins. AB - The ras p21 oncogene product migrates as a heterogeneous series of polypeptides as resolved by both one- and two-dimensional polyacrylamide gel electrophoresis (PAGE). We have prepared polyclonal rat serum antibody to ras p21 and used this as well as monoclonal antibodies to immunoprecipitate forms of p21 synthesized in vivo in transformed NIH3T3 cells. Two-dimensional PAGE of p21 resolved two distinct groups of polypeptides, one acidic (pI 4.8-5.3) which we call the "A" forms, and one less acidic or more basic (pI 6.5-7.0) which we call the "B" forms. It is the membrane-localized, B forms of v-ras-Ha p21 that are predominantly phosphorylated in vivo. PMID- 3555346 TI - In situ behavior of the pyrimidine pathway enzymes in Saccharomyces cerevisiae. 2. Reaction mechanism of aspartate transcarbamylase dissociated from carbamylphosphate synthetase by genetic alteration. AB - The reaction mechanism of Saccharomyces cerevisiae aspartate transcarbamylase was studied in permeabilized cells of a mutant in which this enzyme is not associated to carbamylphosphate synthetase. The results obtained indicate an ordered mechanism in which carbamylphosphate binds first, followed by aspartate, with dissociation of the products in the order phosphate then carbamylaspartate. Interestingly, this clear-cut mechanism differs from the more complex behavior shown by aspartate transcarbamylase when this enzyme is associated to carbamylphosphate synthetase in wild-type S. cerevisiae (B. Penverne and G. Herve, Arch. Biochem. Biophys. (1983) 225, 562-575). This difference indicates that the association of the two enzymes within the multienzymatic complex alters the apparent kinetic properties of aspartate transcarbamylase. Such an enzyme enzyme interaction might be related to the channeling of carbamylphosphate from one catalytic site to the other one. PMID- 3555347 TI - Respective roles of the microsomal ethanol oxidizing system and catalase in ethanol metabolism by deermice lacking alcohol dehydrogenase. AB - To evaluate the roles of MEOS (microsomal ethanol oxidizing system) and catalase in non-alcohol dehydrogenase (ADH) ethanol metabolism, MEOS and catalase activities in vitro and ethanol oxidation rates in hepatocytes from ADH-negative deermice were measured after treatment with catalase inhibitors and/or a stimulator of H2O2 generation. Inhibition of ethanol peroxidation by 3-amino 1,2,4-triazole (aminotriazole) was found to be greater than 85% up to 3 h and 80% at 6 h in liver homogenates. Urate (1 mM) which stimulates H2O2 production in living systems, increased ethanol oxidation fourfold in control but not in cells from aminotriazole-treated animals, documenting effective inhibition of catalase mediated ethanol peroxidation by aminotriazole. While aminotriazole slightly depressed (15%) basal ethanol oxidation in hepatocytes, in vitro experiments showed a similar decrease in MEOS activity after aminotriazole pretreatment. Azide (0.1 mM), a potent inhibitor of catalase in vitro, also did not affect ethanol oxidation in control cells. By contrast, 1-butanol, a competitive inhibitor of MEOS, but neither a substrate nor an inhibitor of catalase, decreased ethanol oxidation rates in a dose-dependent manner. These results show that, in deermice lacking ADH, catalase plays little if any role in hepatic ethanol oxidation, and that MEOS mediates non-ADH metabolism. PMID- 3555348 TI - Sequence homology around the biotin-binding site of human propionyl-CoA carboxylase and pyruvate carboxylase. AB - Biotin-dependent carboxylases require covalently bound biotin for enzymatic activity. The biotin is attached through a lysine residue, which in a number of bacterial, avian, and mammalian carboxylases, is found within the conserved sequence Ala-Met-Lys-Met. We have determined the partial nucleotide sequence of cDNA clones for human propionyl-CoA carboxylase and pyruvate carboxylase. The predicted amino acid sequence of both these proteins contains the conserved tetrapeptide 35 residues from the carboxy terminus. In addition, both proteins contain the tripeptide, Pro-Met-Pro, 26 residues toward the amino terminus from the biotin attachment site. The overall amino acid homology through this region is 43%. Similar findings have been made for the biotin-containing polypeptides of transcarboxylase of Propionibacterium shermanii and acetyl-CoA carboxylase of Escherichia coli (W. L. Maloy, B. U. Bowien, G. K. Zwolinski, K. G. Kumar, and H. G. Wood (1979) J. Biol. Chem. 254, 11615-11622). The implications of this sequence conservation with regard to the function and evolution of biotin dependent carboxylases is discussed. We propose that the 60 amino acids surrounding the biotin site are bounded by a proline "hinge" and the carboxy terminus has remained conserved as a result of constraints imposed by biotinylation of the enzyme. PMID- 3555349 TI - Measuring lymphocytes. PMID- 3555350 TI - The anticardiolipin syndrome. A new way to slice an old pie, or a new pie to slice? AB - Students of systemic lupus erythematosus have long been confused by the paradoxical association of atypical clinical features such as recurrent thrombosis and spontaneous abortion with the lupus anticoagulant and biologic false-positive VDRL reaction. The recent development of sensitive, solid-phase immunoassays for quantitating the autoantibody response to phospholipids holds the promise of illuminating the basis for this seeming enigma. It is now apparent that antiphospholipids antibodies such as anticardiolipin might well play a role in mediating the elements of this paradox. In addition, other cutaneous vascular conditions as diverse as livedo reticularis and Degos' disease might also be related to this type of autoimmune response. PMID- 3555351 TI - Dermal pericapillary fibrin in venous disease and venous ulceration. AB - Pericapillary fibrin deposition is thought to contribute to the pathogenesis of venous ulceration. To our knowledge, however, there is no previous evidence that pericapillary fibrin is deposited in the tissue adjacent to venous ulcers. We prospectively studied patients with ulcers of the lower extremities for the presence of dermal pericapillary fibrin in the skin adjacent tot he ulcers. On direct immunofluorescence, pericapillary fibrin was found in 14 (93%) of the 15 patients with venous ulceration but in only one (7%) of the 14 subjects with ulcers due to other causes. We also confirmed the presence of dermal pericapillary fibrin in legs with venous disease without ulcerations. We conclude that the pericapillary fibrin is easily demonstrable in the dermis adjacent to venous ulcers. In the evaluation of ulcers due to uncertain causes, the presence of dermal pericapillary fibrin may provide additional diagnostic help. PMID- 3555352 TI - Syngeneic graft-vs-host disease. PMID- 3555353 TI - Acute graft-vs-host disease. Development following autologous and syngeneic bone marrow transplantation. AB - Graft-vs-host disease (GVHD) is a frequent complication of allogeneic bone marrow transplantation but has been infrequently reported following autologous or syngeneic bone marrow transplantation. Ninety-six autologous and 19 syngeneic marrow transplants were performed at our institution between July 1977 and March 1984. We report acute cutaneous GVHD occurring in seven patients who received autologous marrow and two patients who received marrow from an identical twin. All nine patients had clinically detectable eruptions and had skin biopsy specimens with histologic changes of grade 2 acute GVHD. Although most cases were mild and self-limiting, four patients required systemic corticosteroids to treat their disease. Thus, acute cutaneous GVHD was seen in approximately 8% of patients receiving autologous or syngeneic bone marrow transplants at our institution. PMID- 3555354 TI - Absence of estrogen receptor in human melanoma as evaluated by a monoclonal antiestrogen receptor antibody. AB - Controversy regarding the presence of estrogen receptor proteins in human melanomas persists despite extensive investigations on this subject. While apparent high-affinity binding has been observed using dextran-coated charcoal assays, several other characteristics of receptor protein have not been observed. The production of free water on incubation of tritiated estradiol (labeled in the C2 position) with melanoma cytosols suggests the possibility that the apparent binding observed is due to phenomena other than specific receptor-steroid interactions. Melanomas from 15 patients were evaluated for the presence of estrogen receptor using immunocytochemical techniques with a monoclonal antibody directed against the human estrogen receptor protein (H222 Sp gamma). Immunohistochemical evaluation included intensity and distribution of staining. None of the 15 cases demonstrated specific immunohistologic reactivity with the anti-receptor antibody. Control breast and uterine tissue confirmed the specificity and sensitivity of the methods. These results suggest that the apparent estrogen-binding capacity of human melanoma tissues is the result of interactions other than with estrogen receptor, and reaffirm the need to investigate alternate steroid protein interactions, such as catechol estrogen formation, in studying sex steroid influences on human melanoma. PMID- 3555355 TI - Improved pressure sore healing with hydrocolloid dressings. AB - We prospectively followed inpatients receiving treatment for pressure sores to identify the better of two local treatment regimens. Twenty-seven patients with 76 pressure sores received treatment with hydrocolloid dressings (HCDs) and 25 patients with 52 pressure sores received treatment with Dakin's solution (chloramine-T)-soaked wet-to-dry dressings. Thirty-eight (73%) patients initially had severe nutritional depletion. The mean serum albumin value of the pressure sore treatment groups was lower than that of an age-matched group without pressure sores. In the HCD group, 66 (86.8%) pressure sores improved compared with 36 (69.2%) pressure sores in the wet-to-dry dressings group. The HCD regimen was more efficacious even in a subgroup of patients who received inadequate nutritional support during treatment. Adequate nutritional intake during the study was associated with better healing in both local treatment groups. PMID- 3555356 TI - Childhood epidermolysis bullosa acquisita. Detection in a 5-year-old girl. AB - A 5 1/2-year-old girl with a blistering disease involving the skin and the oral, ocular, and anogenital mucosa is described. The initial clinical, histologic, and immunofluorescence findings suggested a diagnosis of cicatricial pemphigoid. However, immunoelectron microscopy demonstrated linear deposits of several immunoreactants within the sub-lamina densa region of the dermoepidermal junction, consistent with the diagnosis of epidermolysis bullosa acquisita. Although epidermolysis bullosa acquisita is considered a disease of adult onset, it should be included in the differential diagnosis of blistering diseases in children. PMID- 3555357 TI - Atypical neutrophilic dermatosis with subcorneal IgA deposits. AB - A 26-year-old woman had a chronic vesiculopustular and ulcerating skin disease associated with fever and arthritis. Cutaneous biopsy specimens showed an extensive infiltration of the dermis and epidermis by neutrophils. Direct immunofluorescence (IF) revealed linear subcorneal IgA deposits. Indirect IF showed IgA antibodies reactive with the subcorneal zone of normal epidermis. The disease responded to dapsone therapy. The association between neutrophilic dermatoses, including pyoderma gangrenosum, subcorneal pustular dermatosis, and related entities, and IgA involvement, either IgA gammopathies and/or intraepidermal IgA deposits, is emphasized. Intraepidermal IgA deposits are possibly involved in the pathogenesis of our patient's condition and of other cases of unusual neutrophilic dermatoses. PMID- 3555358 TI - Sjogren's syndrome. Association of cutaneous vasculitis with central nervous system disease. AB - We describe a group of patients with Sjogren's syndrome, who commonly present to dermatologists with cutaneous manifestations of vasculitis. Two specific clinically recognizable forms of cutaneous vasculitis predominate: palpable purpura of the lower extremities (Waldenstrom's benign hypergammaglobulinemic purpura) and urticarialike vasculitis. Two pathologic types of cutaneous vasculopathy are demonstrated, one leukocytoclastic and the other mononuclear. The leukocytoclastic vasculopathy is associated with high titers of Ro(SS-A) and La(SS-B) autoantibodies (detected by gel double-diffusion techniques) and general serohyperreactivity. In marked contrast, the mononuclear vasculopathy is associated with low titers of Ro(SS-A) and La(SS-B) autoantibodies (detected by enzyme-linked immunosorbent assay but not gel double-diffusion techniques) and general serohyporeactivity. Approximately 70% of patients with Sjogren's syndrome and cutaneous vasculitis have also developed peripheral and/or central nervous system disease. The pathogenesis of the nervous system disease is unknown, but preliminary data suggest a vasculopathy. PMID- 3555359 TI - A controlled trial of nandrolone decanoate in the treatment of rheumatoid arthritis in postmenopausal women. AB - To determine whether an anabolic steroid had any benefit in the treatment of rheumatoid arthritis 47 patients entered a parallel group study. Twenty four received nandrolone decanoate 50 mg intramuscularly every third week for two years and 23 patients received no anabolic steroids. Other therapy was unaltered. Patients attended for clinical and biochemical assessments as well as the objective assessments of elementary body composition by in vivo neutron activation analysis and measurement of the mineral content of the distal femur by single photon absorptiometry on five occasions. A modest clinical deterioration (except for grip strength) was seen in both groups. No significant changes in calcium or alkaline phosphatase were seen. There was no significant change in total body calcium, total body phosphorus, body weight, or bone index/bone width measurements in either group. Significant increases occurred in total body nitrogen, total body potassium, haemoglobin, and packed cell volume (by six months) in the group treated with nandrolone decanoate. Comparison of 10 patients in the group treated with nandrolone decanoate also receiving oral steroid therapy with 14 patients in this group not receiving oral steroid therapy showed no significant differences. The main side effect of nandrolone decanoate was hoarseness. No radiological changes were seen. Nandrolone decanoate, in a dose that produces a significant anabolic effect, has no demonstrable action on bone metabolism in rheumatoid arthritis but may improve the chronic anaemia by six months. PMID- 3555360 TI - Cavernous hemangioma of the liver. A single institution report of 16 resections. AB - Over the past 27 years cavernous hemangioma of the liver has been diagnosed in 12 nonoperated patients and in 16 patients who had resection of the lesion at Strong Memorial Hospital. In almost all patients the diagnosis was suggested by an imaging procedure. In the 12 nonoperated patients the average size of the tumor was 4.7 cm (range: 3-8 cm). No problems related to the tumor occurred during the follow-up period. The average size of the resected lesion was 10 cm (range: 4-32 cm). The usual indication for resection was pain, mass, or a combination of these manifestations. Five lobectomies, five left lateral segmentectomies, two trisegmentectomies, two segmentectomies, and two enucleations were performed. There were no postoperative deaths. Review of the literature indicates that although rapid growth of the lesion occurred during pregnancy in one patient, the effects of pregnancy or contraceptive drugs on growth are inconsistent. Spontaneous rupture occurs infrequently, and the potential for rupture should not constitute an indication for resection, which should be performed selectively. Intraoperative blood loss may be appreciable, but a mortality rate near 0% has been reported in all institutional series. PMID- 3555361 TI - Intraoperative ultrasound of the liver. An important adjunctive tool for decision making in the operating room. AB - Forty-nine patients operated on for liver or other pathologic processes were examined intraoperatively with special ultrasound transducers during surgical exploration of the abdomen. Subjects were evaluated because of known or suspected disease of the liver. All patients were examined using sterile technique. Prospective diagnosis and retrospective analysis of data were used. In 55% of subjects, no new information was obtained. In 19%, new information was gathered that changed the surgical approach. In 14% of patients, new information was obtained but it was such that no change in the therapeutic approach was needed. In 12% of patients, although no new information was gathered by the use of intraoperative ultrasound, a change in the surgical approach and management of the patient was still possible because of intraoperative ultrasound. These studies show that the routine use of ultrasound during intraoperative procedures, particularly when involving hepatic structures, is a clinically useful technique. In many instances, it will change the course of management. PMID- 3555363 TI - Airway obstruction by vascular anomalies. Importance of telescopic bronchoscopy. AB - This review of 28 cases of airway obstruction by vascular anomalies in the past 6 years emphasizes the importance of these anomalies as causes of obstruction, stridor, and apnea in infants as well as the important contribution of telescopic bronchoscopy to the recognition of these lesions, especially compression of the trachea by the innominate artery. There were 20 patients with compression by the innominate artery; four were surgically corrected. Seven vascular ring anomalies were all corrected by operation as was an enlarged left atrium and malformed mitral valve in one patient. Vascular anomalies caused 26% of the obstructive airway lesions in a series of infants who had bronchoscopy for obstruction, stridor, or apnea. Failure to diagnose and treat these entities may result in progressive respiratory embarrassment and even death. Barium esophagogram and aortic arch arteriogram, the traditional modalities for diagnosing vascular rings, may fail to identify tracheal compression by enlarged cardiac chambers or the more common "anomalous" innominate artery. Telescopic bronchoscopy will identify tracheal compression by the innominate artery; furthermore, it will identify the area of compression by the vascular ring. Observation of the compressed area during corrective surgery ensures that the operative manipulations are appropriate and successful in relieving the obstruction. This observation can be facilitated by televised monitoring and videotaping. PMID- 3555362 TI - Recent experience with choledochal cyst. AB - This report details an 11-year experience with 17 patients ranging from newborn to 17 years with choledochal cyst. Two distinct groups were noted: an infantile group (mean age: 3 months) with obstructive jaundice identical to biliary atresia and a late onset group (mean age: 9 years) with various combinations of pain, mass, and jaundice. Two patients had cystoduodenostomy performed and both required revision. One of six patients who had Roux-Y cystojejunostomy required revision. All seven patients who had primary cyst excision and two patients who had secondary cyst excision with Roux-Y hepaticojejunostomy have been followed prospectively and have done well. The follow-up period ranges from 1-11 years with an average of 5.8 years. Cyst excision should be performed as a primary or secondary procedure whenever feasible. The rare patients with intrahepatic ductal dilatation (Caroli's disease) are best approached by hepatic lobectomy when possible, and those with choledochocele should be treated by unroofing the cyst as indicated by the anatomy encountered. PMID- 3555365 TI - Concatenations. AB - Concatenations, linkings of events and ideas, are demonstrated to show the progress of thoracic surgery. The development of our knowledge of pulmonary anatomy, pleural drainage, and thoracic anesthesia, independently and collectively, has proven invaluable in the current successful surgical treatment of many pulmonary diseases. PMID- 3555366 TI - Important anatomical and physiological considerations in performance of complex mammary-coronary artery operations. AB - One or more internal mammary artery (IMA) anastomoses were performed in 87% of 692 consecutive coronary artery bypass operations performed over a 20-month period. One IMA was used in 68% (N = 469) and both IMAs were used in 19% (N = 130). Only saphenous vein grafts were used in 13% (N = 93). The mean number of anastomoses (all types) was 3.5. Fifty-seven patients were having a reoperation; bilateral IMA grafting was performed in 23% (N = 13). In 60 patients, 3 or more IMA anastomoses were performed: 3 IMA anastomoses, 50 patients; 4, 9 patients; and 5, 1 patient. In 27 patients, repeat coronary arteriography was performed within 30 days of operation to evaluate dynamics of IMA, saphenous vein, and native coronary artery flow. Major flow or all flow was through the graft (vs. the native coronary artery) in 62% of in situ IMA bypass grafts, 86% of free IMA grafts and 94% of saphenous vein grafts. Hospital mortality excluding patients having reoperation was 1.7% (11/635); it was less than 1% for patients having either single IMA grafting procedures (4/437) or bilateral IMA grafting procedures (1/117). Hospital mortality for patients receiving only saphenous vein grafts was surprisingly high, 7.4% (6/81). Major determinants of flow through the in situ IMA sequential graft are the size and flow of the IMA, the degree of proximal native coronary artery narrowing, the distally grafted to proximally grafted coronary artery size ratio, and probably the size of the side-to-side anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555364 TI - Should it be parietal cell vagotomy or selective vagotomy-antrectomy for treatment of duodenal ulcer? A progress report. AB - This is a progress report of a prospective, randomized study involving 200 consecutive patients treated electively with either parietal cell vagotomy (PCV) or selective vagotomy and antrectomy (SV-A). Both groups comprised patients with pyloric, prepyloric, or duodenal ulcers. There was no operative mortality in either group. Patients were examined at 2, 6, 12 months, and every 12 months thereafter for 8-10 years. The two operations produced no statistical difference in the frequency of diarrhea. Dumping (p less than 0.0005) and weight loss (p less than 0.0005-p less than 0.05) were statistically less after PCV than after SV-A. There were two recurrent ulcers (2.2%) after SV-A. One was treated successfully by medical therapy and one patient suspected of having gastrinoma had total vagotomy. Nine patients had recurrent ulcers in the PCV group for an accumulated recurrence rate of 10.1% at 10 years by life-table analysis. There was a significant difference (p less than 0.033) between the curves for recurrent ulcers in the two groups of patients. The recurrent ulcer rate after PCV was 21% for patients with pyloric and prepyloric ulcers and 6% for patients with duodenal ulcer. There was no significant difference between the recurrent ulcer rate for PCV and SV-A if the patients with pyloric and prepyloric ulcers were withdrawn from the study. Of the nine patients with recurrent ulcers in the PCV group, three had an inadequate vagotomy and four had a pyloric or prepyloric ulcer before operation. Three patients were successfully treated with antrectomy. Five patients were treated successfully by medical therapy and remained healed for long periods without recurrence. One patient had five recurrences. He declined operation and remained free of symptoms for 3 years after his last recurrence. Poor gastric emptying necessitated gastroenterostomy in five patients in the SV-A group and in one patient in the PCV group. Patients' clinical results were evaluated according to a simple Visick grading scale. A significantly (p less than 0.0005) greater number of patients were in Visick I category after PCV than after SV-A. The clinical results obtained with PCV make this the operation of choice for the elective surgical treatment of duodenal ulcers even though the results obtained with SV-A were good. PMID- 3555367 TI - Intermittent reperfusion extends myocardial preservation for transplantation. AB - A protocol was developed to compare prolonged heart preservation by hypothermic storage with prolonged hypothermic storage interrupted by a period of reperfusion. Hearts from adult mongrel dogs were excised after administration of 4 degrees C crystalloid cardioplegia. Group A hearts (N = 7) underwent 7.5 hours of ischemia at 4 degrees C followed by 1.5 hours of reperfusion and rewarming (A0). Group B hearts (N = 8) underwent 3 hours of ischemia at 4 degrees C, 1.5 hours of reperfusion and rewarming (B1), 3 additional hours of ischemia at 4 degrees C following repeat cardioplegia, and finally 1.5 hours of reperfusion and rewarming (B2). During reperfusion, hearts were defibrillated and left ventricular (LV) function was assessed by measuring isovolumic peak systolic pressure and maximum positive rate of rise of LV pressure (+dP/dtmax) with an intraventricular balloon. LV biopsy samples for adenosine triphosphate (ATP) assay were obtained before ischemia and after each rewarming period. One Group A heart could not be defibrillated and studied. All Group B hearts completed the protocol. LV function, as assessed by peak pressure and +dP/dtmax, at B1 and B2 exceeded values obtained at A0, but the differences were not statistically significant. The mean ATP level was 63.4 +/- 7.7% of baseline at B1 and 79.7 +/- 4.3% of baseline at B2 (p less than .03). The mean ATP level was 57.9 +/- 5.9% of baseline at A0 (p less than .007, B2 vs. A0). It is presumed that intermittent reperfusion allows repletion of substrate stores, which results in improved myocardial protection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555368 TI - Anatomical repair of transposition of the great arteries with intact ventricular septum in the neonate: guidelines to avoid complications. AB - Anatomical repair of transposition of the great arteries (TGA) seems more attractive than the more conventional atrial baffle procedures because of resultant left ventricular-aortic continuity. The results of anatomical repair in 16 consecutive neonates with TGA and intact ventricular septum were reviewed; special consideration was given to technique and guidelines to avoid complications. Infants underwent repair within 6 days of life (average weight, 3.3 kg). Survival was 88% (14 of 16 patients). One death occurred from pulmonary hypertension and atrial shunt reversal causing cyanosis after an uncomplicated procedure; the other was due to myocardial ischemia caused by kinking of an anomalous coronary artery after attempted repair. Complications of ventricular swelling and coronary tension or kinking were successfully treated by Silastic skin patches in 2 patients and pericardial aortic patches in 2, respectively. One patient had successful repair of supravalvular pulmonary stenosis. Because anatomical repair of TGA must be performed in the first week of life, special consideration must be given to meticulous anatomical dissection, careful coronary transfer, and optimal myocardial preservation. The excellent short-term results favor the continued application of anatomical repair of TGA with intact ventricular septum in infancy. PMID- 3555369 TI - Partial atrioventricular canal defect: the early and late results of operation. AB - Thirty-five patients underwent repair of a partial atrioventricular canal defect and have been followed for a mean of 8 years. Seventeen patients had either moderate or severe mitral incompetence prior to operation. The mitral valve was treated as a bileaflet structure. The cleft in its anterior leaflet was closed in each patient in whom the valve was incompetent. The septal defect was closed with pericardium, and the coronary sinus was left on the right atrium. Two patients required reoperation, 1 to close a recurrent septal defect and 1 to replace a mitral valve that had been competent for the first several years after the initial repair. All 33 survivors remain in New York Heart Association Functional Class I. Nineteen patients have no mitral incompetence, and the remaining 14 have only mild incompetence. These data demonstrate that excellent late results from repair of partial atrioventricular canal are possible when the mitral valve is managed as a bileaflet structure. PMID- 3555370 TI - Verapamil prophylaxis for postoperative atrial dysrhythmias: a prospective, randomized, double-blind study using drug level monitoring. AB - Orally administered verapamil hydrochloride (80 mg every 8 hours) or a placebo was given to 109 patients after coronary artery bypass grafting in a randomized, double-blind manner to test the efficacy of verapamil in preventing postoperative atrial dysrhythmias. The test drug was given through a nasogastric tube beginning 4 to 6 hours after operation until oral ingestion was possible. Serum levels of verapamil were measured at selected times after operation and when postoperative atrial dysrhythmias occurred. Postoperative atrial dysrhythmias occurred in 10 of the 53 verapamil-treated patients and in 20 of the 56 placebo-treated patients. Patients with verapamil drug levels higher than 150 ng/ml had fewer postoperative atrial dysrhythmias than those with lesser verapamil levels (p = .034) or than placebo-treated patients (p = .012). Only 2 of 31 patients with drug levels higher than 150 ng/ml experienced postoperative atrial dysrhythmias. Approximately 40% of verapamil-treated patients had drug levels lower than 150 ng/ml at 48 hours after operation. It is concluded that oral administration of verapamil prevents postoperative atrial dysrhythmias in a dose-dependent fashion. PMID- 3555371 TI - Prophylactic antibiotic treatment prevents infection after cardiopulmonary bypass: a study in dogs. AB - The effect of two prophylactic antibiotic regimens during cardiopulmonary bypass (CPB) was investigated in dogs. Airborne contamination was determined by spraying two different bacterial strains (Staphylococcus aureus and Serratia marcescens) into the air of the operating room. Dogs were operated on and underwent CPB with a bubble oxygenator. Pericardial suction, either conventional (blood-air) or selective (only blood), was used. Particularly in the first situation, an impaired humoral host defense is induced. In dogs given the regimen consisting of penicillin G (benzylpenicillin), gentamicin sulfate, and flucloxacillin, the number of contaminated sites for both bacteria was reduced (p less than .01) compared with those given cefuroxime. The effectiveness of the combined antibiotic regimen could be ascribed to increased serum bactericidal activity and polymorphonuclear leukocyte (PMN) killing capacity. Cefuroxime enhanced the PMN respiratory burst. As a result, two weeks postoperatively the rate of infection was small in both groups. We conclude that prior to CPB, antibiotics should be administered prophylactically to overcome a period of impaired humoral host defense during CPB. PMID- 3555372 TI - Occlusive coronary arteritis: a cause of early death in a cardiac transplant patient. AB - A patient died 5 months after undergoing cardiac transplantation. Endomyocardial biopsies performed prior to death showed no evidence of severe rejection. At autopsy, nonnecrotizing occlusive coronary arteritis was present. The intima of the coronary arteries contained numerous lymphocytes and plasma cells. Chronic rejection appeared to be responsible for the arteritis. The onset of coronary occlusive disease is insidious, and recognition depends on the performance of coronary arteriography, which is usually not done until the one-year follow-up. Early coronary arteriography is suggested to rule out occlusive coronary arteritis when cardiac allograft function is not satisfactory, even when the endomyocardial biopsy shows no evidence of rejection. PMID- 3555373 TI - Replacement of a degenerated porcine valve within a composite aortic valve graft. AB - A simple technique for replacing a valve prosthesis within a composite aortic root graft is described. This method allows isolated valve replacement without removing the Dacron tube graft or altering the original coronary artery repair. PMID- 3555374 TI - Mitral and tricuspid valve repair. PMID- 3555375 TI - The effect of interference in catecholamine biosynthesis on captivity-induced jumping stereotypy in bank voles (Clethrionomys glareolus). AB - The level of the captivity-induced jumping stereotypy in bank voles was significantly decreased by 150 and 200 mg/kg alpha-methyl-para-tyrosine and increased by 200 mg/kg L-DOPA while 20 and 40 mg/kg fusaric acid had no effect. None of the other movements were affected by these drugs (as measured by a general activity meter), except for a nonsignificant decrease after treatment with fusaric acid. These results suggest that cerebral dopaminergic neuronal systems and not noradrenergic neuronal systems are involved in the expression of that stereotypy in bank voles. PMID- 3555377 TI - Diagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures. AB - The results of a simplified quantitative broth dilution quantitative tip culture (QTC) of 331 central venous catheters were compared with clinical data prospectively recorded in critically III patients to diagnose bacteremic or nonbacteremic catheter-related sepsis (CRS) (36 catheters), as opposed to contamination (42 catheters) or simple colonization from a distant septic focus (seven catheters). Thirty-five of 36 catheters associated with CRS yielded 10(3) colony-forming units per milliliter (CFU/mL) or more, and 3.8 X 10(2) Candida organisms grew from one. In contrast, 5 X 10(2) CFU/mL or less grew from 37 of 42 contaminated catheters. A QTC of 10(3) CFU/mL or more was 97.5% sensitive and 88% specific for the diagnosis of CRS. The QTC appeared especially useful for the diagnosis of CRS secondary to blood-borne seeding of catheters, or associated with coagulase-negative staphylococci. PMID- 3555376 TI - The role of the renin-angiotensin system in normotensive and hypertensive rats with varying renin status. AB - We have investigated the relationship between the acute blood pressure lowering effect of captopril and renin status. Differences in renin status were induced by unilateral artery clipping combined with unilateral or bilateral nephrectomy in rats. The blood pressure lowering effect of captopril correlated very closely with plasma or aortic renin across a very wide range of renin levels. PMID- 3555378 TI - Quantitation of proteinuria by the use of protein-to-creatinine ratios in single urine samples. AB - Measurements of protein-to-creatinine ratios in single-voided urine samples were compared with 24-hour urinary protein excretions for quantitation of proteinuria in inpatients and outpatients. Patients included those representing a broad spectrum of renal diseases, a wide range of proteinuria, and various degrees of reduction in glomerular filtration rate. Protein-to-creatinine ratios in single voided urine samples correlated well with measurements of 24-hour urinary protein. This simple single-voided test is reliable and useful in the screening, assessment, and follow-up of proteinuria and avoids the problems associated with 24-hour urine collection. PMID- 3555379 TI - Energetics of glucose uptake in Salmonella typhimurium. AB - We have studied the energetics of glucose uptake in Salmonella typhimurium. Strain PP418 transports glucose via the phosphoenolpyruvate: glucose phosphotransferase system, while strain PP1705 lacks this system and can only use the galactose permease for glucose uptake. These two strains were cultured anaerobically in glucose-limited chemostats. Both strains produced ethanol and acetate in equimolar amounts but a significant difference was observed in the molar growth yield on glucose (YGlc). It is suggested that this difference is due to a difference in the energetics of the glucose uptake systems in the two strains. Assuming an equal YATP for both strains, we could calculate that uptake of 1 mole of glucose via the galactose permease consumes the equivalent of 0.5 mole of ATP. With the additional assumption that one proton is transported in symport with one glucose molecule, these results imply a stoichiometry of two protons per ATP hydrolysed. PMID- 3555380 TI - [Severe epithelio-exfoliative colitis in infants. Anatomical data]. AB - Amongst the uncommon forms of congenital severe colitis, we wish to draw attention to a peculiar and probably previously never described condition that we propose calling provisionally, epithelio-exfoliative colitis. This condition appears to be characterized by the following features: its early beginning within the first weeks of life; the smooth, glossy appearance of the mucosa, without ulcerations visible to the naked eye; the prevalent degenerative changes of the epithelial cells which become vacuolated, break away prematurely from the basement membrane and finally exfoliate within the glandular lumens; the distension and rupture of the glands, the mucous contents of which intrude into the lamina propria and induce a localized, mild and non suppurative inflammatory reaction; accessory reactive traits: intense mucus production actively regenerating epithelium (high mitotic activity, syncytial cells) and increase of the cholinergic fibers within the lamina propria. Although patchily distributed, these lesions involve the colon exclusively. The cause of epithelio-exfoliative colitis is unknown. However, the ultrastructural studies and immunocytochemical investigations using anti-collagen IV, antilaminin, anti-fibronectin antibodies disclose in some glands localized thinning and rupture of the basement membrane. These data suggest a primary disorder within the molecular arrangement of either the basement membrane itself or the proteins which anchor the glandular cells to the basement membrane. PMID- 3555381 TI - [Purpura fulminans in children. Current aspects]. PMID- 3555382 TI - [Trial of prevention of coronary aneurysm in Kawasaki's disease using plasma exchange or infusion of immunoglobulins]. AB - Coronary aneurysms are present in 15-25% of cases of Kawasaki disease and are responsible for the morbidity and rapid mortality in this disease. We treated 20 children aged 20 +/- 16 months, less than 15 days (8 +/- 3.2) after onset of the disease, either by plasma exchange (7 exchange transfusions and one plasmapheresis) or by high dose intravenous gammaglobulins. No coronary anomalies or cardiac dysfunction prior to or after therapy (mean follow-up 8.3 +/- 4 months) was found. Tolerance to therapy was good and the course of the disease was arrested by exchange transfusions or shortened by gammaglobulin infusion. We conclude as have the Japanese, that this therapy is efficacious and safe, and should be initiated early. PMID- 3555383 TI - Affective disorders and mortality. A general population study. AB - A 16-year prospective study of a general population sample indicates that those who had reported a depression and/or anxiety disorder at baseline experienced 1.5 times the number of deaths expected on the basis of rates for a large reference population. As part of the Stirling County Study (Canada), the information was gathered from 1003 adults through structured interviews and was analyzed by means of a diagnostic computer program. The risk for mortality was assessed using external and internal standards, controlling for the effects of age and sex as well as for the presence of self-reported physical disorders at baseline. Increased risk was found to be significantly associated with affective but not physical disorders and with depression but not generalized anxiety. When this evidence about mortality was combined with information about subsequent psychiatric morbidity among survivors, 82% of those who were depressed at baseline had a poor outcome. PMID- 3555384 TI - Exploitation of the insane in the New World. Benoni Buck, the first reported case of mental retardation in the American colonies. AB - Documenting the early history of mental illness in North America is complicated by the absence of colonial institutions specializing in the care or management of the insane. However, during the first half of the 17th century, a single authority existed in England, the Court of Wards and Liveries (1540-1660), with responsibility for appointing guardians for the mentally disabled. In 1637, Benoni Buck, a man with severe mental retardation, was referred to this court from Jamestown, Va. The ensuing conflict over Benoni's custody exposed a contradiction between the economic and political exigencies of a new order and the social obligation to protect the mentally ill. Benoni Buck is almost certainly the first case of mental disability reported from the English colonies. The case thereby represents a minor landmark in the history of mental illness in America; May 1987 marks the 350th anniversary of the first petition for guardianship. PMID- 3555385 TI - Low- and conventional-dose maintenance therapy with fluphenazine decanoate. Two year outcome. AB - We evaluated the effectiveness and the side effects of what we defined as low (5 mg) and conventional (25-mg) doses of fluphenazine decanoate administered every two weeks in a double-blind comparison. Subjects were 66 patients who fulfilled DSM-III criteria for schizophrenic disorder. Evaluation of the survival with each dose revealed no significant difference at one year, but significantly better survival was seen with the 25-mg dose (64%) than the 5-mg dose (31%) at two years. There was no significant difference in survival when the clinician was permitted to make a dosage adjustment up to 10 mg in the low-dose group and 50 mg in the higher-dose group when the patient demonstrated evidence of a symptomatic exacerbation. Patients assigned to the higher dose appeared to feel more uncomfortable during the early months of the study, as indicated by significantly higher scores on subscales of the Hopkins Symptom Checklist-90R and higher side effect scores for retardation and akathisia. Implications for clinical practice are discussed. PMID- 3555387 TI - [The 19th century--difficulties and achievements in medicine in Poland]. PMID- 3555386 TI - Adjunctive imipramine in the treatment of postpsychotic depression. A controlled trial. AB - The efficacy of adjunctive imipramine hydrochloride treatment for syndromally defined postpsychotic depression was assessed in a six-week, double-blind, placebo-controlled study. All patients had been diagnosed as having schizophrenia or schizoaffective disorder, all were receiving stable doses of fluphenazine decanoate, and all had received benztropine mesylate in an attempt to rule out neuroleptic-induced akinesia. Patients randomized to imipramine therapy fared significantly better in terms of their global improvement and in terms of individual symptoms that are components of the depression syndrome. There were no significant differences in outcome psychosis ratings or side effects. This study indicates the existence of an identifiable syndrome of secondary depression in this patient group that is likely to respond favorably to treatment with adjunctive imipramine. PMID- 3555388 TI - [Papers from the 14th Congress of the Polish Society of the History of Medicine and Pharmacy. Warsaw]. PMID- 3555389 TI - [Doctoral dissertations from the Wroclaw Women's Clinic in the second half of the 19th century]. PMID- 3555390 TI - [Medical and surgical practice in paintings, sculptures and caricatures. I]. PMID- 3555391 TI - [Marcin Rolinski (1776-1839), professor of anatomy at the Royal University of Warsaw (on the 210th anniversary of his birth]. PMID- 3555392 TI - [2 basic humors in the second half of the 19th century (the stages in studying blood and bile pigments: their importance in theory and practice)]. PMID- 3555393 TI - [Polish physicians--alumni of the University of Vienna. V (S-S)]. PMID- 3555394 TI - [The history of the "Polfa" pharmaceutical plants in Pabianice. III. Chemical plants in Pabianice as investment companies 1899-1918]. PMID- 3555395 TI - [Sources and materials regarding the history of the Medical Department of the University of Lwow]. PMID- 3555397 TI - [Development of social and ethical aspects of medical education in Germany in the 19th and 20th centuries]. PMID- 3555396 TI - [Efforts to create the Lublin Medical Department 1918-1939]. PMID- 3555398 TI - [Occupational medicine as the subject of graduate education in Germany up to 1945]. PMID- 3555399 TI - [De angore pectoris (angina pectoris). Doctoral dissertation. Cracow, July 1820]. PMID- 3555400 TI - [A bibliography of the scientific works of Prof. Stanislaw Konopka (1896-1982) published in Poland after 1975]. PMID- 3555401 TI - Recent progress in clinical quantitative cytology. AB - The last several years have seen changes in quantitative cytologic procedures that have significantly expanded the clinical research and diagnostic applications of quantitative cytologic analysis. Intact nuclei can be isolated from formalin-fixed paraffin-embedded tissue, and the DNA distribution of these nuclei can be analyzed either with flow cytometry or with slide-based image processing techniques. In addition, more informative DNA analysis has been achieved using antibodies to bromodeoxyuridine-modified DNA, proliferation associated nuclear antigens, or tissue-type-specific cytoplasmic antigens as second stains for two-parameter analysis. Improvements in both staining and instrumentation have also increased the usefulness of flow cytometry in analysis of "rare events," ie, cell types comprising less than 0.1% to 0.5% of a total cell suspension. Commercially available slide-based image-processing systems have been developed that provide sophisticated cell and tissue analysis functions using inexpensive personal-computer-based systems. PMID- 3555402 TI - Quality assurance in diagnostic surgical pathology. PMID- 3555403 TI - Accuracy of frozen-section diagnosis in a teaching hospital. AB - A retrospective quality assurance study of frozen-section diagnoses was performed to determine the source and nature of inaccuracies associated with this procedure over an 18-month period in a large teaching hospital. Of 30,278 surgical pathology specimens accessioned, 1414 (4.7%) had frozen-section examination. Of these, there were five false-positive diagnoses of malignancy (0.4%), 16 false negative diagnoses of malignancy (1.1%), and 53 deferrals of diagnosis (3.7%). Soft-tissue, breast, and lymph node sites accounted for 12 errors (57%), while central nervous system, breast, and soft-tissue sites were associated with 30 deferrals (57%). Erroneous frozen-section diagnoses were attributed to interpretation (57%), microscopic sampling (24%), gross sampling (9.5%), and lack of communication between pathologist and surgeon (9.5%). Some of these diagnostic errors might have been avoided by changes in procedure or technique. PMID- 3555404 TI - Activity against Trypanosoma cruzi of new analogues of nifurtimox. PMID- 3555405 TI - Exercise physiology and its role in disease prevention and in rehabilitation. AB - It is an impressive fact that many musicians can perform perfectly at an advanced age. Arthur Rubenstein played very demanding compositions of Chopin at the age of 88 and Andre Segovia at the age of 91 is still giving concerts on the classical guitar. Apparently, through practice very demanding neuromuscular activities can be maintained at advanced ages. Yet hours of daily "training" are behind these achievements. This review discusses some of the general aspects of training and their effects on function and health. As an overall goal it is more important to add life to years rather than add years to life. PMID- 3555406 TI - Aspiration of a tracheostomy plug. AB - A plastic truncated conical tracheostomy plug passed down the outer cannula of a Jackson tracheostomy tube and into the lungs of a respirator-dependent man during the monthly change of the inner cannula. Despite repeated flexible and rigid bronchoscopic visualization, attempts at dislodgement were unsuccessful. An exploratory thoracotomy was also unsuccessful in recovering the plug. Seventeen days postaspiration, with percussion and postural drainage, the patient expectorated the plug, even in the absence of the cough reflex. Such plugs have now been modified by passing a ring through the hole to prevent aspiration. PMID- 3555407 TI - A nineteenth-century transsexual. AB - An 1897 clinical case of transsexualism before the diagnostic category was established is described. It was reported by a Baltimore physician trying to introduce concepts of homosexuality to the psychiatric community. PMID- 3555408 TI - Presentation and perioperative management of arterioportal fistulas. AB - Arterioportal fistulas (APFs) are usually traumatic in origin and may result in portal hypertension and its complications. Over six years, six patients (aged 20 to 59 years) presented with APFs. Two APFs developed after percutaneous liver biopsy, but only one was complicated (hemobilia). Neither patient was treated operatively. Four APFs occurred two days to three years after gunshot wounds. Three patients presented with gastrointestinal tract hemorrhage. All patients had abdominal bruits. Two patients underwent primary repair. One patient underwent APF resection and replacement of the superior mesenteric artery with autogenous vein. Another patient underwent APF and bowel resection. Three patients survived. One patient died of liver failure. The development of an abdominal bruit in a patient with penetrating abdominal trauma suggests APF and should prompt angiography. Elective repair is recommended before complications of portal hypertension develop. PMID- 3555409 TI - Duplex B-mode imaging for the diagnosis of deep venous thrombosis. AB - Real-time B-mode venous imaging has numerous advantages for the diagnosis of acute deep venous thrombosis (DVT). During the 11 months ending Feb 1, 1986, we examined 431 patients for possible acute DVT using a 5-MHz hand-held continuous wave Doppler stethoscope and a duplex real-time B-mode imager. Clots were seen in 86 patients in multiple views and cross sections. Normal veins completely collapsed with probe pressure on the skin. Blood flow was seen and heard, and abnormal flow was detected. There were no false-negatives (100% sensitivity). Early in the study, two false-positives occurred (78% specificity), but these errors will not recur. These tests are accurate, noninvasive, and inexpensive. They differentiate acute from chronic thrombosis and are repeatable. Duplex imaging may become the "gold standard" for the diagnosis of DVT. PMID- 3555410 TI - Neonatal diaphragmatic hernia. An improving outlook with extracorporeal membrane oxygenation. AB - In a 15-year period, 89 newborns were treated for congenital diaphragmatic hernia. The patients were divided into three groups, depending on postoperative therapeutic support available: group 1, ventilator therapy only; group 2, ventilator therapy plus pulmonary vasodilators (tolazoline hydrochloride); and group 3, ventilators, tolazoline, and/or extracorporeal membrane oxygenation (ECMO). The three groups were identical for presenting symptoms, signs, and preoperative blood gas determinations. The survival for each group was as follows: group 1, 17 (40%) of 42; group 2, 14 (45%) of 31; and group 3, 12 (75%) of 16. Complications requiring further operations were identical. All survivors in groups 1 and 2 are normal developmentally, while one of five group 3 ECMO survivors has developmental delay and another has long-term ventilator dependence. These data suggest that ECMO, an invasive technique for newborn respiratory failure, improves survival in congenital diaphragmatic hernia. PMID- 3555411 TI - Noninvasive detection of gallstone acute pancreatitis. PMID- 3555412 TI - Repeated laparotomy for postoperative intra-abdominal sepsis. An analysis of outcome predictors. AB - To identify factors modifying the outcome of reoperation for intra-abdominal infection, we analyzed the management of 47 patients who underwent repeated laparotomy from July 1980 through July 1985. Overall mortality was 30% (14/47). Factors predictive of death were as follows: age greater than 60 years (86% mortality vs 21% mortality), preoperative vs no organ failure (57% vs 6%), multiple vs single abscess (53% vs 16%), and exploratory vs directed operative approach (39% vs 17%). Although the interval between the primary surgery and reoperation was similar between survivors (13 days) and nonsurvivors (14 days), five (36%) of 14 nonsurvivors were in septic shock and eight (57%) of 15 survivors showed evidence of organ failure prior to reoperation. The median survival period following reoperation in this group was only four days. Computed tomography (CT) and/or ultrasonography were performed to localize a source of infection in 24 patients. In nine (82%) of 11 patients, CT identified the abscess, while ultrasonography was positive in 15 (72%) of 21 patients. Neither the interval to operation nor the mortality was significantly different in patients diagnosed with CT and ultrasonography when compared with those who underwent exploration on the basis of clinical findings. To lower the mortality and to shorten the interval to reoperation in these high-risk patients, noninvasive diagnostic testing and confirmation by percutaneous sampling must be sought before the onset of clinical sepsis and organ failure. PMID- 3555413 TI - Liver lesions in B6C3F1 mice: the National Toxicology Program, experience and position. AB - The spectrum of hepatocellular proliferative lesions in B6C3F1 (C57BL/6N X C3H/HeN MTV-) mice used in National Toxicology Program (NTP) two-year carcinogenicity studies includes foci of cellular alteration, adenoma, carcinoma, and hepatoblastoma. The diagnosis of hepatocellular hyperplasia is reserved for those non-neoplastic proliferative lesions which are believed to occur secondary to necrosis or a degenerative process in the liver. Diagnostic criteria, similar to those previously published, are used during the NTP peer review of these lesions. Incidences of liver tumors in control mice have been established from the NTP database and the frequency of enhanced liver tumor responses in treated mice has been determined based on 278 two-year carcinogenicity studies. Although alternative rodent strains are being examined, at the present time there is no acceptable alternative to the B6C3F1 mouse for NTP carcinogenicity studies. Interim sacrifices and "stop" studies are incorporated into two-year studies to gain knowledge about the biological behavior of mouse liver neoplasia. Also, data are being gathered relative to the pattern of oncogene activation in spontaneous and chemically induced liver tumors in B6C3F1 mice. PMID- 3555415 TI - Anatomy, function and aging in the mouse liver. AB - A brief overview is given of the embryology, gross and microscopic anatomy and sinusoidal lining cells of the mouse liver. The handling of xenobiotics is also considered. So called phase I and II reactions are of major importance. Furthermore, heterogeneity of metabolism occurs in the different zones of the hepatic acinus. Finally, some of the manifest pathological changes are discussed. Despite the occurrence of these changes there is still no clearcut evidence that liver function declines with age. PMID- 3555414 TI - Pharmacokinetic factors and their implication in the induction of mouse liver tumors by halogenated hydrocarbons. AB - The presently available data on pharmacokinetics of halogenated solvents which produce hepatic tumors in B6C3F1 mice, but not in rats, are reviewed. Such compounds are trichloroethylene, perchloroethylene, 1,1,2-trichloroethane, 1,1,2,2-tetrachloroethane, and dichloromethane. It seems likely that higher metabolic rates in mice (compared with other species) may lead to a species selective toxicity of such compounds. Recurrent cytotoxicity which leads to stimulation of cell replication seems to be a contributing factor in the pathogenesis of mouse liver tumors. However, it is likely that more than one factor contributes to the unique tumor response of the B6C3F1 mouse. PMID- 3555416 TI - Sex hormones and neoplasia: liver tumors in rodents. AB - The association of liver tumors in women and men with the use of oral contraceptives and anabolics, respectively, has drawn attention to the hepatotumorigenic effects of sex hormones. The available evidence from long-term carcinogenicity studies in various strains of mice, rats and hamsters indicates that sex hormones are hepatotumorigenic agents, although the incidence of liver tumors is, in general, low even at doses exceeding human exposure by a factor of one hundred or more. Among the three rodent species, mice appear to be the least sensitive. Under certain modulating conditions, however, a 100% incidence of hepatocellular carcinomas can be obtained with some estrogens in male Syrian golden hamsters. The mechanism of the hepatotumorigenic effect of sex hormones is far from being clear. Whereas their tumor promoting activity is generally recognized, there is recent evidence suggesting that some sex hormones may also have initiating potential. Although the incomplete understanding of the mechanisms responsible for sex hormone induced liver neoplasia seriously hampers the assessment of the human risk, it appears to be clear that sex hormones are important modulating factors determining the incidence of hepatic tumors in rodents and possibly in humans. PMID- 3555417 TI - Sex hormones and neoplasia: genotoxic effects in short term assays. AB - The mechanism of the tumorigenic effects of sex hormones in the liver and in other organs is still unclear. Clues towards an understanding of this action of sex hormones can be gained from short-term assays suitable for revealing adverse effects at different molecular levels relevant to the process of neoplastic transformation. The available data on the effects of sex hormones indicating gene mutations, unscheduled DNA synthesis, sister chromatid exchange, chromosomal anomalies, induction of aneuploidy and cell transformation are reviewed. Although the data base is scant, in particular for androgens and progestins and in systems other than the mutational assays, it can be concluded that sex hormones, in general, fail to induce gene mutations. On the other hand, recent evidence shows that diethylstilbestrol and steroidal estrogens are capable of inducing neoplastic transformation in vitro. In this context, the induction of aneuploidy is discussed as non-mutational but genotoxic effect of estrogens responsible for the neoplastic transformation. Morphological transformation and scoring for chromosomal anomalies can provide useful endpoints for further evaluation of sex hormones with suspected carcinogenic properties. PMID- 3555418 TI - Pathogenesis of experimental liver cancer: comparison with humans. AB - The multi-step nature of cancer development in the liver with chemical carcinogens is very well developed in the rat and is highly probable in humans and in mice. Since this step-by-step analysis of hepatocarcinogenesis is much more advanced in the rat than in the other two species, the pathogenesis in the rat will be briefly reviewed. Initiation steps I and II, promotion steps III and IV and progression steps V and VI will be highlighted together with further unknown steps in progression to cancer. The focal proliferation of hepatocytes, as represented by hepatocyte nodules, appears to play a central and critical role as a precursor for cancer. In the rat, nodules have a very characteristic phenotype biologically, histologically and biochemically. Some of the options available to nodules and their significance will be discussed. The possible analogy between rat on the one hand and mice and humans on the other will be presented. A critical assessment of the relevance of pathological changes seen in rats and mice to the possible carcinogenicity of agents in humans will be discussed. The urgent need for more step-by-step studies of hepatocarcinogenesis in mice is very obvious and must be stressed. PMID- 3555420 TI - Relationship among histochemically distinguishable early lesions in multistep multistage hepatocarcinogenesis. AB - The evolution of liver cancer is discussed on the basis of the multistep multistage hypothesis. In rat liver the sequential generation of the tumor cell via intermediate precancerous cell populations is strongly supported by histopathological evidence (focus-in-focus lesions) indicating precursor-product relationships, inducibility of progression in an initiation-promotion-initiation type of experiment, and by the kinetics of focus and tumor induction. The formation of mouse liver tumors, either spontaneously in susceptible strains, or induced by a short initiating dose of carcinogen, may follow the same general pathway. The frequent observation of focus-in-focus patterns in mouse and the kinetic characteristics of that process favour the sequential development of cancer cell formation. The kinetic analysis suggested that (large) basophilic foci in mouse liver may be the result of spontaneous progression from an initiated cell population which is represented by either the small basophilic foci or by a cell population generally not recognized due to the lack of a suitable marker reaction. Furthermore, the basophilic foci may represent the precursor cell population leading by another step of spontaneous progression to hepatocellular carcinoma. PMID- 3555419 TI - Xenobiotic-induced peroxisome proliferation: role of tissue specificity and species differences in response in the evaluation of the implications for human health. AB - Significant increases in the number of peroxisomes and in the activity of H2O2 generating peroxisomal fatty acid beta-oxidation enzyme system occur in liver parenchymal cells of mice, rats and certain other species exposed to several structurally dissimilar hypolipidemic drugs and certain phthalate-ester plasticizers. These agents, referred to as peroxisome proliferators, are considered as novel hepatocarcinogenic agents in view of their non-mutagenic and non-genotoxic nature. The lack of mutagenicity of these agents combined with consistent coupling of proliferation of H2O2 generating peroxisomes led to the hypothesis that persistent proliferation of peroxisomes serves as an endogenous initiator of neoplastic transformation by inducing oxidative stress. The mechanism by which oxidative stress leads to neoplastic transformation is, however, not clear. This postulated link between peroxisome proliferation and carcinogenicity implies that tumors should develop only in organs displaying profound peroxisome proliferation. Current evidence indicates that maximal peroxisome proliferation is a tissue-specific phenomenon, restricted largely to the hepatocyte. This tissue-specific biological response suggests that interaction of these structurally dissimilar xenobiotics with a receptor(s) might be the mechanism responsible for peroxisome proliferation and the selective increase in the rate of transcription of peroxisomal fatty acid beta-oxidation enzyme genes without significantly affecting the transcriptional rate of peroxisomal marker enzyme catalase gene. Identification and molecular characterization of peroxisome proliferator specific receptor(s) and elucidation of the mechanisms responsible for the differences in interspecies responses will be necessary for the evaluation of the implications for human health, since the carcinogenicity is not directly attributable to the chemical but to the adaptive responses of the host. PMID- 3555421 TI - [Organizational principles and structural patterns of the organs of the human immune system]. PMID- 3555422 TI - [Scientific connections between the journal "Zeitschrift fur mikroskopische anatomische Forschung" and Soviet scientists (on the occasion of the publication of the 100th anniversary volume of the journal)]. PMID- 3555423 TI - [Bibliographical index of the articles in the journal Archives of Anatomy, Histology and Embryology (volumes LXXI-XC)]. PMID- 3555424 TI - [Historical evolution of cardiology in Brazil]. PMID- 3555425 TI - [Alphamethyldopa vs. atenolol in the treatment of arterial hypertension]. PMID- 3555426 TI - [Prazosin in the initial treatment of arterial hypertension]. PMID- 3555427 TI - Vascular casting and scanning electron microscopy in clinicopathologic correlations. PMID- 3555428 TI - Half-thickness sponges for retinal detachment surgery. PMID- 3555429 TI - Intraocular pressure following panretinal photocoagulation for diabetic retinopathy. Diabetic Retinopathy Report No. 11. AB - Data collected during the first five years after randomization in the Diabetic Retinopathy Study were analyzed to determine the effect of panretinal photocoagulation on intraocular pressure (IOP). At each follow-up visit, median IOP was identical for the treated and untreated eyes. Mean IOP rose slightly in each group. The proportion of untreated eyes with IOP above 30 mm Hg at two consecutive visits was twice that of the treated eyes (2% vs 1%). These data show that panretinal photocoagulation reduces the risk of subsequent intraocular hypertension, apparently by preventing the development of neovascular glaucoma. PMID- 3555430 TI - Treatment of partly accommodative esotropia with a high accommodative convergence accommodation ratio. AB - We conducted a prospective, randomized, masked comparison of two treatments for the nonaccommodative element in esotropic patients with a high accommodative convergence-accommodation ratio. One group received symmetric medial rectus recessions with posterior fixation sutures; the other received symmetric medial rectus recessions without posterior fixation sutures but augmented according to formula taking into account the near deviation. Previous experience had suggested that our surgical formula based solely on the distance deviation would lead to excessive undercorrections. A higher percentage of the augmented recession group achieved satisfactory alignment and were able to discontinue wearing bifocals postoperatively than the posterior fixation group. The data also showed a trend (though not statistically significant) suggesting that more members of the augmented recession group were able to discontinue wearing spectacles entirely. We concluded that the posterior fixation suture technique is not as effective as the augmented recession technique for the treatment of partly accommodative esotropia with a high accommodative convergence-accommodation ratio. PMID- 3555431 TI - Hydroxymethylglutaryl-coenzyme A reductase exhibits graded distribution in normal and mevinolin-treated ileum. AB - Because the small bowel is a site of significant cholesterol synthesis, we determined the ileal distribution of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase), the rate-limiting enzyme of the cholesterol biosynthetic pathway. Immunofluorescence microscopy on unfixed snap-frozen sections of ileum and jejunum from untreated rats or dogs showed HMG-CoA reductase in the absorptive villus epithelial cells and this appeared to be strikingly localized in their apical cytoplasm. This pattern of HMG-CoA reductase staining approximated a gradient along the villus-crypt axis with the distal villi labeling most intensely. Treatment of rats with mevinolin and/or cholestyramine for 12 days induced a 5- to 11-fold increase in ileal HMG-CoA reductase activity, and yielded a higher intensity of immunostaining without altering the pattern of enzyme distribution observed in control intestines. Also, rats with maximal induction of ileal HMG-CoA reductase exhibited a twofold increase in the number of epithelial villus cells containing prominent stacks of smooth-surfaced membranes in their apical cytoplasm as seen with electron microscopy. These observations suggest that the distal villus absorptive epithelial cells of the ileum contain high concentrations of HMG-CoA reductase, and therefore might be capable of contributing significant quantities of cholesterol to the circulation. PMID- 3555432 TI - Body mass, blood pressure, glucose, and lipids. Does plasma insulin explain their relationships? AB - Obesity, hypertension, a high plasma level of glucose, and some lipid abnormalities (high plasma levels of cholesterol and triglycerides) often occur in the same individuals. Some authors have postulated that the elevated levels of plasma insulin in obese individuals may explain this association. To explore this hypothesis further, the relationships between body mass index, fasting plasma glucose and insulin, blood pressure, serum lipids, and apoproteins were investigated in a group of 2144 healthy middle-aged men. Analysis of the data show that the associations between body mass index and blood pressure or lipid variables are largely independent of plasma glucose and insulin. Plasma glucose is strongly related to blood pressure in nonobese subjects. Plasma insulin is not associated with blood pressure independently of body mass index and plasma glucose; however, the simultaneous elevation of body mass index, plasma glucose, and insulin is strongly associated with blood pressure. The results also confirm that plasma insulin is positively related to triglycerides and negatively related to high density lipoprotein cholesterol independently of plasma glucose and body mass index. PMID- 3555433 TI - Quality assurance and clinical dietetics. AB - A comprehensive Quality Assurance Programme has been developed in the Department of Dietetic Services at Waikato Hospital. It involves the evaluation of personal performance and of the services provided by the Department. Performance Appraisal and Dietetic Record Audit. The programme has become an established aspect of the service. It has been modified from time to time, but always with the intent to improve performance. Significant gains have accrued to the Department and to the services it provides as a result of the Quality Assurance Programme. PMID- 3555434 TI - Energy and protein metabolism in sepsis and trauma. AB - Energy and protein metabolism in septic and trauma patients has been extensively studied over the past 30 years. Despite this, a number of inconsistencies are present in the literature and it is difficult to formulate a clear global picture of this complex series of metabolic events. Conclusions from human studies have often been hampered by the utilization of small numbers of patients, and data from animal models of sepsis or trauma are often difficult to interpret. Over the past 5 years, the authors have performed a series of isotopic infusions in normal volunteers, and in patients with either sepsis or trauma, in order to gain a clearer understanding of energy and protein metabolism in severely stressed patients. This review summarizes the findings. PMID- 3555435 TI - Skin necrosis secondary to meningococcal septicaemia in an adult. AB - A case of skin loss after meningococcal septicaemia is presented. This is a rare condition in adults and occurs after very severe infections. The skin loss is due to vasculitis, resulting from a combination of direct infection of the skin by Neisseria meningitidis, and an immunological reaction. Secondary infection frequently occurs under the eschar. Skin loss is treated by debridement and delayed split skin grafting. PMID- 3555436 TI - Use of an antigen detection assay to determine mortality of Dirofilaria immitis after thiacetarsamide therapy. AB - The use of an antigen detection enzyme immunoassay (EIA) to determine the post treatment infection status of 16 dogs naturally infected with Dirofilaria immitis was investigated. Dogs were treated with thiacetarsamide at a dose rate of 12mg/4.5kg twice daily for 2 days, bled at regular intervals and necropsied 9 weeks later. The infection status of all dogs at necropsy was compared to the ratios of optical density (OD) values from the EIA using fresh plasma samples (day 60/day 0 = R60) and dogs were divided into 2 groups. Using the R60 ratios, those dogs with fewer than 2 live adult worms or immature worms at necropsy ("cleared" dogs) could be differentiated with 95% confidence from those dogs with more than 1 live adult worm ("non-cleared" dogs). Changes in the average OD values from the plasma of "cleared" dogs and "non-cleared" dogs were similar up to 46 days after treatment but diverged significantly thereafter. The efficacy of thiacetarsamide was 50% if all worms were considered and 75% if the presence of immature worms was ignored. The benefits of antigen detection assays for diagnosis and improved patient assessment and the use of an R60 ratio to assess the efficacy of adulticides such as thiacetarsamide are discussed in relation to their practical significance for clinicians. PMID- 3555437 TI - Surface preparation for bonding to porcelain and gold. PMID- 3555438 TI - The 'functional matrix' hypothesis--current concepts and conflicts. PMID- 3555439 TI - Immunopathologic diagnosis of oral mucosal inflammatory diseases. PMID- 3555441 TI - Are immunosuppressed kidney transplant recipients photosensitive? PMID- 3555440 TI - Dapsone and sulfapyridine therapy of pemphigoid diseases. PMID- 3555442 TI - Dr. Arthur George Stening Cooper. PMID- 3555443 TI - The commonality and contrasts of agency law and relationships in sonography. PMID- 3555445 TI - Ultrasound in obstructive jaundice. PMID- 3555444 TI - A chiropractic X-ray service. PMID- 3555446 TI - Ultrasonic demonstration of anicteric biliary obstruction. PMID- 3555447 TI - Ultrasound demonstration of amoebic liver abscess causing obstructive jaundice. PMID- 3555448 TI - Primary hyperoxaluria in infancy. PMID- 3555450 TI - A method for the recovery of mishap related events lost to amnesia. AB - The author describes a non-hypnotic, non-pharmacologic method employed in the recovery of memories blocked by amnesia following an aircraft accident. A detailed account of the method used during the investigation of two mishaps is provided. Memories were fully recovered. In addition, a description of the use of this technique in enhancing the recall of a witness to a fatal aircraft accident is provided. PMID- 3555449 TI - Development and use of hybridoma antibodies directed against Eimeria acervulina merozoites for cross-reactive and ferritin-labeling studies. AB - Hybridoma antibodies (Hab) were produced against Eimeria acervulina merozoites that had been separated from extraneous intestinal material by a fiber column technique before injection into mice. The Hab demonstrated three different immunofluorescent-antibody (IFA) patterns of tip, surface, or surface-internal fluorescence in or on the merozoites. Some Hab reacted with round immature schizonts, which were also present in the fiber-cleaned merozoite material. Variations in cross-reactivity were seen with a number of Hab tested by IFA with merozoites, sporozoites, and immature schizonts of different coccidial species. Certain Hab were species- and stage-specific, whereas others cross-reacted with some or all stages or species tested. One Hab apparently reacted with only a small percentage of the E. acervulina merozoites in the fiber-cleaned material. The ferritin (Fe)-labeling technique showed that with one Hab, which gave a surface-internal IFA pattern, there was an irregular clumping of the Fe label along the surface of the immature schizont. A heavier deposit of Fe label was seen on the area of the schizont where the merozoite was beginning to form. A heavy uniform labeling of Fe was seen on the surface of the pellicle of the mature merozoites. These results demonstrate that stage-specific and cross reactive antigens are present in or on the merozoites of E. acervulina, and as shown with one Hab, surface antigens present on the immature schizont are incorporated onto the mature merozoite. PMID- 3555451 TI - A historical review of the fear of flying among aircrewmen. AB - The term fear of flying (FOF) has been applied to many sets of symptoms. Confusion has resulted from the use of the term FOF to describe problems arising from anxiety disorders, traumatic stress, exhaustion, psychosis, and motivational changes. This literature review describes the history and development of the term FOF, and suggests an approach to its evaluation by clinicians and administrators. Representative works from the last 65 years are reviewed in their historical contexts. PMID- 3555452 TI - Reported in-flight incapacitation: the early birds of 1911. AB - Numerous fatal accidents marred the early years of aviation, but not until 1911 was the first accident attributed to inflight incapacitation of the pilot. Two such accidents occurred in 1911 and were reported due to medical causes. Our review of the circumstances surrounding these two accidents lead to different conclusions. We believe them to have been caused by pilot error, and not by medical causes. So the first accident due to inflight incapacitation of the aircrew for medical reasons still remains unknown. PMID- 3555453 TI - The effects of cross-fostering on the development of social preferences in meadow voles (Microtus pennsylvanicus). AB - To determine the role of the parental environment in the formation of species attachments in the meadow vole (Microtus pennsylvanicus), young of this species were fostered to either meadow vole parents (in-fostered young) or to prairie vole parents (M. ochrogaster; cross-fostered young). At 50 to 60 days of age, subjects were tested for social preference in an environment that simulated the conditions of a runway system. The testing design assessed the reaction of fostered animals to a novel species (M. pinetorum) as well as to the parental and biological species. The proportion of total test time spent near stimulus animals did not vary as a function of rearing condition. However, when compared to in fostered controls, cross-fostered meadow voles displayed increased preference for prairie voles. Novelty did not appear to be a significant factor in test animal choice. These results suggest that in meadow voles, preference for the species of social partner is dependent on postnatal experience with parents. PMID- 3555454 TI - [Progressive spondylolisthesis following kidney transplantation]. PMID- 3555455 TI - [Comparison of sonographic findings and roentgen findings and pathologico anatomic changes in hip dysplasia]. PMID- 3555456 TI - Relaxation therapy in the control of blood pressure. PMID- 3555458 TI - Non-pharmacologic therapy of hypertension. Compliance with dietary changes. PMID- 3555457 TI - The role of exercise in preventing and moderating blood pressure elevation. PMID- 3555459 TI - Obesity and hypertension. PMID- 3555460 TI - The effects of sodium reduction on control of blood pressure elevation: a review. PMID- 3555462 TI - Optimal nutritional therapy in the treatment of hypertension. PMID- 3555461 TI - Potassium and its role in the etiology and therapy of hypertension. PMID- 3555463 TI - Complementary role of diet and drugs in the treatment of hypertension. PMID- 3555464 TI - Vegetarian diet and blood pressure. PMID- 3555465 TI - Intracellular protein catabolism VI. Proceedings of the 6th Symposium on Intracellular Protein Catabolism. April 21-25, 1986. Wernigerode, DDR. PMID- 3555466 TI - The cystatins: a diverse superfamily of cysteine peptidase inhibitors. AB - The cystatins comprise a homologous group of protein inhibitors of peptidases, of which the first to be studied in detail was chicken cystatin from egg-white. Three distinct protein families or "types" are recognized within the cystatin superfamily. The type 1 cystatins (also called "stefins") are the simplest in structure, being single chains of about 100 amino acids, with no disulphide bonds or carbohydrate. The Type 2 cystatins, which include the egg-white protein, have about 115 amino acids, and two disulphide loops, but still no carbohydrate. The Type 3 cystatins are the plasma kininogens in which each molecule contains three divergent copies of the typical cystatin sequence differing in activity as well as structure; these complex inhibitor molecules contain disulphide bonds and also carbohydrate groups. The cystatins inhibit most cysteine endopeptidases of the papain type, and also the exopeptidase dipeptidyl peptidase I. Each cystatin molecule has a single reactive site for all the peptidases it inhibits, but there are large differences in K(i) values for different combinations of cystatin and enzyme, and calpains are inhibited only by one of the segments of the kininogens. The cystatins have many important characteristics in common, but their differences in molecular structure imply different routes of biosynthesis, are associated with different in vivo distributions, and suggest a variety of physiological functions. PMID- 3555467 TI - mRNA levels of cathepsins B and D during myogenesis. AB - Muscle development is characterized by the fusion of myoblasts to form myotubes and the co-ordinate expression of muscle-specific proteins such as actin, myosin and creatine phosphokinase. Our laboratory has been involved in the study of the role of lysosomal proteinases, namely, cathepsins B, H and L and the endogenous cysteine proteinase inhibitor, cystatin, during muscle differentiation in vitro. Specific activities of the cysteine proteinase in chicken primary cultures and a number of rat myogenic lines increased with the degree of myotube formation. This has suggested that lysosomal proteinases play an important role in myogenesis. We have measured the mRNA levels of two of the lysosomal enzymes, cathepsins B and D. This is advantageous because the presence of the endogenous inhibitor, cystatin, masks the levels of the specific activities of the cysteine proteinases present in the cell. RNA was extracted from developing muscle at three stages of development: proliferating myoblasts, confluent cells, and myotubes. Hybridization of RNA extracted from the L6 myogenic cell line with cathepsin B cDNA showed an increase in the level of cathepsin B mRNA. However, in the L8 rat myogenic line the level decreased after fusion. Cathepsin D mRNA levels remained constant throughout differentiation of the L8 cells. This paper also reports on the characterization of lysosomal proteinases of a newly obtained mouse myogenic line, C2. PMID- 3555468 TI - Species variations amongst lysosomal cysteine proteinases. AB - Cathepsin B was purified from rabbit, human, ox and sheep liver. SDS polyacrylamide gel electrophoresis after reaction of the purified cathepsin B samples with the active site directed inhibitor, L-3-carboxy-trans-2,3 epoxypropionyl-leucylamido- ([3H]acetamido)-butane ([3H]Ac-Ep-459), showed that the enzyme exists as either a two-chain form (approx. Mr 25,000 and 4,000), a single-chain form (approx. Mr 30,000) or both. The active site was found in the light chain of the two-chain forms. The two-chain and single-chain forms of ox cathepsin B were separated by ion exchange chromatography and shown to have similar catalytic activities against the substrates Z-Phe-Arg-4-methyl-7 coumarylamide (Z-Phe-Arg-NHMec) and Z-Arg-Arg-NHMec and rates of inhibition by L 3-carboxy-trans-2,3-epoxypropionyl-leucylamido-(4- guanidino)butane (E-64). Cathepsin L was purified from the same four species, and compared with the enzyme from rat liver. SDS-polyacrylamide gel electrophoresis after reaction of the purified cathepsin L preparations with the active site directed inhibitor, [3H]Ac Ep-459, showed that cathepsin L from each species consists of two chains; a light chain of approx. Mr 5,000 and a heavy chain of approx. Mr 25,000, which contained the active site cysteine. All species variants of cathepsin L were recognized by the antibody to the human enzyme. With Z-Phe-Arg-NHMec as substrate, kinetic constants were found to be similar for all five species (Km 1-4 microM and and kcat 10-30 s-1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555469 TI - Are there species differences amongst the lysosomal cysteine proteinases? AB - Kinetic constants for the hydrolysis of synthetic substrates by cathepsin B, cathepsin L or cathepsin H show only small variations between various species. The species variants purified from human, beef and rabbit reacted with antisera raised against the enzymes from rat. With regard to these criteria we could show that cathepsin I from rabbit lung is a species variant of cathepsin H, whereas cathepsin S is a separate enzyme from cathepsin L. PMID- 3555470 TI - The azocasein-urea-pepstatin assay discriminates between lysosomal proteinases. PMID- 3555471 TI - Studies on the multicatalytic proteinase from rat skeletal muscle. AB - The multicatalytic proteinase purified from rat skeletal muscle was shown by electron microscopy to be a uniform cylinder-shaped protein particle. As the enzyme activities are enhanced by free fatty acids in vitro, we tested, by in vivo perfusion, whether high concentrations of free fatty acids increased the multicatalytic proteinase activities in skeletal muscle tissue. Perfusion of rat hindquarters with plasma containing 1.5 mM oleic acid bound to albumin led to a 30-40% increase of the proteinase activities in gastrocnemius muscle. This increase was statistically not significant when compared to control rats perfused with plasma containing fatty acid free albumin. These results are discussed under the following aspects: 1. the in vivo concentration of non-esterified fatty acids within the muscle cell is not known; 2. the uptake of free fatty acids by the muscle cell is too low, or the metabolism of free fatty acids taken up by the cell is too fast to allow activation of the multicatalytic proteinase; 3. the free fatty acids are bound to other proteins (e.g. fatty acid binding protein), which abolish their ability to activate the proteinase. PMID- 3555472 TI - Regulatory peptide metabolism at cell surfaces: the key role of endopeptidase 24.11. AB - This paper sets out to review some recent work on the role of endopeptidase 24.11. In renal brush borders, this enzyme is usually the only endopeptidase present among a host of exopeptidases, yet it appears to be the rate limiting step in the hydrolysis of a number of peptides, including bradykinin and the angiotensins. Endopeptidase-24.11 is widely, but not ubiquitously distributed- present not only in renal and intestinal brush borders, but also in lymph nodes, glandular tissues and the nervous system. All the last groups are rich in neuropeptides. The endopeptidase exhibits high specificity constants for a number of these potential substrates, including tachykinins, enkephalins and bradykinin. In the brain, immunocytochemical studies have shown colocalization of the enzyme and substance P. Thus, endopeptidase-24.11 has the appropriate topology, specificity, kinetic properties and localization to play a role in the metabolism of regulatory peptides. PMID- 3555473 TI - Metalloendopeptidases of the mouse kidney brush border: meprin and endopeptidase 24.11. AB - Two metalloendopeptidases, meprin and endopeptidase-24.11 ("24.11"), were isolated from mouse kidney membranes, and their structural and catalytic properties were investigated. The enzymes both cross-react with antibodies prepared in rabbits against purified preparations of meprin; thus they share some immunologic determinants. Meprin and 24.11 have similar subunit molecular weights of 85 000 and 90 000, respectively, as demonstrated after sodium dodecyl sulfate polyacrylamide gel electrophoresis in the presence of 2-mercaptoethanol. However, under non-reducing conditions, meprin migrates as an oligomer while 24.11 remains monomeric. This and other data indicate that meprin subunits are linked by disulfide bridges, whereas endopeptidase-24.11 subunits are not covalently linked. Both endopeptidases hydrolyze insulin B chain and are totally inhibited by EDTA and o-phenanthroline. The activity of 24.11 against insulin B chain was totally inhibited by low concentrations of phosphoramidon (less than 2 nM), whereas meprin was not inhibited by concentrations of this inhibitor as high as 20 microM. Large proteins are not substrates for endopeptidase-24.11, while meprin degrades proteins such as azocasein rapidly (apparent Km = 0.65 mg/ml). Meprin appears to require an extended polypeptide chain in substrates while 24.11 prefers smaller peptides as substrates. Both endopeptidases have a preference for peptide bonds that contain hydrophobic amino acids. With the octapeptide angiotensin II as substrate, both enzymes hydrolyze the central Tyr-Ile bond; 24.11 also cleaves at Arg-Val and Ile-His. The two endopeptidases show many similarities immunologically, structurally and catalytically, however, they display distinct characteristics which may be physiologically important. PMID- 3555474 TI - Proteinases of various Claviceps purpurea strains. AB - Extra- and intracellular proteinases from various Claviceps purpurea strains grown in submerged culture have been studied. A maximum level of intracellular proteinases was observed on the 6th day of culture growth, whereas extracellular activity continued to increase throughout the culture growth. Proteinases were purified and characterized. The ergotamine strain secreted one aspartic and two serine proteinases, whereas from the disrupted mycelium only the aspartic proteinase could be isolated. The ergocornine strain secreted the aspartic proteinase in two forms and the ergocristine strain produced an aspartic and a serine proteinase. PMID- 3555475 TI - Oxidation induced proteolysis and its possible restriction by some secondary protein modifications. AB - The hydroxyl radical (.OH) in the presence of molecular oxygen (O2) fragmented BSA and formed distinct peptides as did hydrogen peroxide catalysed by copper. .OH in the absence of O2 caused protein crosslinking. The selective fragmentation was ascribed to cleavage at proline residues, a mechanism consistent with an increase in the proline/glutamate ratio. Other radicals, such as peroxyl and superoxide radicals caused no change in molecular weight of the protein. Peroxyl radicals and .OH were, however, able to cause some change in conformation of the protein which increased its susceptibility to hydrolysis and oxidation might thus be implicated in protein turnover. Mitochondrial monoamine oxidase (MAO) was also susceptible to free radical cleavage but lipids were able to compete with the protein for radical species. Peroxides also seemed to be involved in the cleavage of MAO and this was evidenced by a "post irradiation effect" and the ability of the hydroperoxy radical to cause degradation; in contrast to the case with BSA. In whole cells, depletion of the antioxidant GSH and inhibition of catalase increased endogenous protein degradation. Lens protein autolysis was increased under conditions where thiol autoxidation was permitted but glycosylation of protein caused a decrease in breakdown by extrinsic hydrolases. These results indicate that free radicals, possibly also associated with lipids may play a role in the regulation of protein turnover but that secondary modifications may promote the accumulation of damaged protein. PMID- 3555476 TI - Regulatory mechanisms of intracellular proteolysis in mammalian cells. AB - Low molecular weight phosphoryl compounds, such as carbamoyl phosphate, 2,3 diphosphoglycerate and phytic acid protect, to different extents, mitochondrial and cytosolic proteins such as ornithine transcarbamoylase (OTC), carbamoyl phosphate synthetase (CPS), glutamate dehydrogenase (GDH) and glyceraldehyde 3 phosphate dehydrogenase (GAPDH), from proteolytic inactivation (rat liver lysosomal extracts, pronase, elastase). Given the wide variety and common occurrence of low molecular weight reagents such as typified here, it seems that this kind of inhibition may be important in the regulation of protein turnover. Regulation of intracellular proteolysis can also occur via the proteolytic systems. Immunocytochemical procedures for mitochondrial enzymes (CPS, GDH, OTC), show intracellular homogeneity, but intercellular heterogeneity in rat liver, compatible with a role of the autophagic-lysosomal system in degrading these proteins. However, degradation of short-lived proteins occurs by other mechanisms. Using centrifugation of cultured cells, we find that the Golgi apparatus takes part in the degradation of these proteins, probably by controlling the traffic of proteins or proteases to the degradation site. PMID- 3555477 TI - Perforated hepatocytes as a system for studying intracellular proteolysis. AB - Isolated rat hepatocytes were treated either by electroshock or enterotoxin in order to perforate the plasma membrane. Under appropriate conditions perforated cells could be incubated for a couple of hours without further disruption. The rate of proteolysis was higher in the perforated cells than in homogenized cells. ATP, a thiol reagent and Ca2+/Mg2+ stimulated proteolysis. By using inhibitors, it was shown that the proteolysis was partly lysosomal, and that all four classes of endoproteinases were involved. PMID- 3555478 TI - The influence of environmental temperature on the lymphocyte populations in carp (Cyprinus carpio L.). AB - The influence of environmental temperature upon the lymphocyte populations in carp (Cyprinus carpio L.) has been studied by immunoperoxidase labeling using different antisera. In carps kept in a warm and a cool environment, respectively, rabbit anti-carp IgM as well as rabbit anti-carp Fc antiserum showed different percentages of Ig-positive lymphocytes, whereas the percentage remained unaffected by temperature after the use of rabbit anti-carp Fab antiserum with a specificity against L-chains. It is clear from these observations that the "B" lymphocytes of carp are not temperature-dependent, while the "T" lymphocytes are extremely temperature-dependent, decreasing at low temperatures and increasing at elevated temperatures. The possible causes of the variation with temperature in the numerical ratios of lymphocyte populations and their importance for immunoreactivity are discussed. PMID- 3555479 TI - [Long-term stability of enzymes in solution]. AB - Two proteases (thermitase, a thermostable serine protease from Thermoactinomyces vulgaris and subtilisin Carlsberg) and one non-proteolytic enzyme (urate oxidase from Penicillium spp.) were used for revealing the main influences leading to the inactivation of enzyme preparations during their long-time storage at low temperatures. The temperature dependences (0 degree C-60 degrees C) of inactivation resulted in a linear Arrhenius-plot for each of the three native enzymes as well as in the presence of all stabilizing substances tested. Therefore, a method is available which shortens the time considerably needed for the experiments aimed at the discovery of substances stabilizing enzymes under storage conditions (i.e. long time at low temperatures). Because of the linear Arrhenius-plots potential stabilizers can be tested experimentally at suitable higher temperatures and one can extrapolate on their influence on the enzyme at storage temperatures (0 degree C-10 degrees C). By using this method effective combinations of stabilizers for urate oxidase were found, and possible reasons of their stabilizing influence on the enzyme are discussed. PMID- 3555481 TI - Tryptophan synthetase: its charmed history. PMID- 3555480 TI - [In vitro effects of E. coli endotoxin on the membrane permeability and substrate transport of isolated rat liver mitochondria]. AB - Incubation of freshly isolated rat liver mitochondria with E. coli endotoxin resulted in an increased inner membrane permeability for K+ and Cl- ions. This effect was not prevented by addition of the synthetic antioxidant butylated hydroxytoluene. The carrier-mediated transport rates of phosphate, pyruvate, citrate and reducing equivalents via the malate-aspartate shuttle were not altered significantly by endotoxin. Therefore, the endotoxin-mediated impairment of mitochondrial respiration and oxidative phosphorylation could not be attributed to a decrease in transport capacities through the inner mitochondrial membrane. PMID- 3555482 TI - The McArdle Laboratory for Cancer Research. PMID- 3555483 TI - Inhibition of tyrosine autophosphorylation of the solubilized insulin receptor by an insulin-stimulating peptide derived from bovine serum albumin. AB - A polypeptide from a tryptic digest of bovine serum albumin potentiates glucose oxidation stimulated by insulin in isolated rat adipocytes. We studied whether this effect is related to a modification of the insulin receptor kinase. In a solubilized rat adipocytes receptor system, the peptide caused dose-dependent inhibition of the stimulation by insulin of phosphorylation of the 95,000 dalton subunit of insulin receptor. The peptide also inhibited stimulation by vanadate of tyrosine autophosphorylation of the beta subunit of the receptor, though it enhanced vanadate-stimulated glucose oxidation. During the phosphorylation reaction, no phosphorylated forms of the peptide could be detected. The peptide had no effect on dephosphorylation of the phosphorylated beta subunit of the insulin receptor. These results strongly suggest that the inhibition of phosphorylation by the peptide is due not to either simple substrate competition or activation of phosphoprotein phosphatase, but to specific inhibition of tyrosine-specific protein kinase. PMID- 3555484 TI - Insulin stimulates the phosphorylation level of v-Ha-ras protein in membrane fraction. AB - Insulin was found to stimulate the phosphorylation of the 21,000-dalton protein encoded by the ras oncogene of Harvey murine sarcoma virus in membrane fraction both in vivo and in vitro. When the human ras proteins expressed in E. coli were reconstituted with purified human insulin receptor, GTPase activity of normal or its mutated oncogenic ras protein was not stimulated by the addition of insulin. Likewise, tyrosine kinase activity or insulin binding capacity of the receptor was not influenced when assayed in the presence of the ras proteins. These results suggest that ras proteins may be coupled with the insulin receptor system through some unidentified membrane factors. PMID- 3555485 TI - New chelator-sensitive proteases in matrix of yeast mitochondria. AB - Proteases in yeast mitochondria were studied using fluorogenic synthetic substrates containing methylcoumaryl amide (MCA). Among the eleven substrates which are commonly employed for several types of proteases, Leu-MCA, Arg-MCA, Boc Gln-Arg-Arg-MCA and Boc-Phe-Ser-Arg-MCA were found to be highly susceptible to proteases in mitochondria. All these proteases were localized in the matrix and sensitive to o-phenanthroline but not to phenylmethylsulfonyl fluoride or iodoacetate. The analysis of hydrolyzed products of Boc-Gln-Arg-Arg-MCA indicated that the peptide was cleaved at the site between Gln and Arg. These results demonstrate that there exist chelator-sensitive aminopeptidase(s) and endopeptidases in the matrix of yeast mitochondria. PMID- 3555486 TI - 3-13C-methionine-labelled E. coli alkaline phosphatase. AB - 3-13C-methionine has been biosynthetically incorporated into E. coli alkaline phosphatase using strain CW3747 which is auxotrophic for Met. 13C NMR of the dimeric native enzyme labelled at the eight methionine residues of the primary structure shows a dispersion of resonance signals permitting resolution of at least five methionine environments, none of which coincide with the chemical shift position of free methionine. At acid pH, 13C signal intensity is shifted to a chemical shift consistent with solvent exposure. However, three discrete resonances are observed, suggesting a retention of defined structure. The labelled protein thus can serve as a probe of conformational alterations of the enzyme. PMID- 3555487 TI - Methyl iodide, a potent inducer of the adaptive response without appreciable mutagenicity in E. coli. AB - Methyl iodide (MeI), a very weak mutagen, induced the adaptive response in E. coli to a similar extent to those induced by potently mutagenic methylating agents. MeI potentiated the mutagenicity of a methylating mutagen, N-methyl-N nitrosourea, by its co-treatment. These results might give indication that MeI directly methylates O6-methylguanine-DNA methyltransferase resulting in induction of the adaptive response and depletion of the repair capacity of enzyme. PMID- 3555488 TI - Covalent hybrids of ovomucoid third domains made from one synthetic and one natural peptide chain. AB - We have obtained two semisynthetic covalent hybrids (Wieczorek, M. & Laskowski, M., Jr., (1983) Biochemistry 22, 2630-2636) of turkey ovomucoid third domain by coupling the natural 19-56 peptide fragment with crude, synthetic peptides 1-18 and 6-18, respectively. We have reformed all of the disulfide bridges and then we have enzymatically synthesized the 18-19 peptide bond. The enzyme-inhibitor association constants for interaction with five different serine proteinases were the same for the semisynthetic proteins 1-56 and 6-56 and for natural proteins 1 56 and 4-56. Further, the semisynthetic 1-56 and natural 1-56 proteins were indistinguishable in analytical ion exchange and reverse-phase chromatography. This work shows that 1) making the covalent hybrids from synthetic and natural material is a facile and efficient method for preparing variants for highly quantitative sequence to reactivity studies, 2) the first five NH2-terminal residues of avian ovomucoid third domains have no effect on inhibitory activity, and 3) it is sufficient and convenient to prepare 6-56 proteins rather than 1-56 for inhibitory activity studies. PMID- 3555489 TI - Molecular cloning and amino acid sequence of rat enkephalinase. AB - cDNA clones encoding rat enkephalinase (neutral endopeptidase, EC 3.4.24.11) have been isolated in lambda gt10 libraries from both brain and kidney mRNAs and the complete 742 amino acid sequence of rat enkephalinase is presented. The enzyme possesses a single transmembrane spanning domain near the N-terminal of the molecule but lacks a signal sequence. Because enkephalinase has it active site located extracellularly and is thus an ectopeptidase, we suggest that the N terminal transmembrane region of the enzyme anchors the protein in membranes and that the majority of the protein, including the carboxy terminus, is extracellular. Enkephalinase, a zinc-containing metallo enzyme, displays homology with other zinc metallo enzymes such as carboxypeptidase A, B and E, suggesting enzymatic similarities in these enzymes. PMID- 3555490 TI - Neuron localization and neuroblastoma cell expression of brain-derived growth factor. AB - Bovine brain-derived growth factor (BDGF) is a approximately 16-17 kD polypeptide mitogen with a broad spectrum of cell specificity. Using a highly specific mouse polyclonal anti-BDGF antiserum for indirect immunoperoxidase and immunofluorescent stainings, BDGF was found to be specifically localized in the neurons of bovine brain cortex. The indirect immunofluorescent staining was blocked by the presence of excess purified BDGF. Human neuroblastoma cells showed cytoplasmic staining with anti-BDGF antiserum. The cell lysates of neuroblastoma cells elicited a BDGF-like activity which could be completely inhibited by preincubation with anti-BDGF antiserum. PMID- 3555491 TI - Isolation of hepatocyte stimulating factor from human monocytes. AB - Hepatocyte stimulating factor is a monocyte derived protein which regulates hepatic plasma protein synthesis. Human hepatocyte stimulating factor was purified to apparent homogeneity from adherent peripheral blood monocytes by using ion exchange, gel permeation and reversed phase chromatography. Electrophoretic analysis showed that it has a Mr of 28,000 daltons and an isoelectric point of 5.4. Biological assays specific for hepatocyte stimulating factor and interleukin-1 showed that they are distinct and have independent biological effects. PMID- 3555492 TI - The mouse homolog of the human amyloid beta protein (AD-AP) gene is located on the distal end of mouse chromosome 16: further extension of the homology between human chromosome 21 and mouse chromosome 16. AB - The human amyloid beta protein is the major constituent of the brain amyloid plaques found in Alzheimer disease. The gene that encodes this protein is located on chromosome 21, and individuals with Down syndrome (trisomy 21) also exhibit an early onset form of Alzheimer disease. We have used the cloned human amyloid beta protein gene and a panel of somatic cell hybrids to map the location of the mouse homolog of this gene. We report here that the mouse gene is located on chromosome 16 within the region 16C3----ter, in common with three other genes which map within the Down syndrome region of human chromosome 21. PMID- 3555493 TI - A novel yeast secretion vector utilizing secretion signal of killer toxin encoded on the yeast linear DNA plasmid pGKL1. AB - The NH2-terminal signal region comprising of approximately 70% length of the prepro-sequence of the pGKL killer precursor protein was found to direct an efficient secretion of the mouse alpha-amylase into the culture medium of Saccharomyces cerevisiae. The alpha-amylase molecule secreted into the culture medium was identified by both immuno-blotting and assay of the enzyme activity. The amount of alpha-amylase secreted via the killer toxin signal was comparable to that directed by the leader sequence of mating factor alpha. The secretion of alpha-amylase using the killer toxin signal was blocked at 37C but not at 25C in sec18-1 host, indicating that alpha-amylase is exported through the normal secretion pathway of S. cerevisiae. PMID- 3555494 TI - The effects of insulin-like growth factor-I and insulin on placental lactogen production by human term placental explants. AB - The effects of insulin-like growth factor (IGF)-I and insulin on placental lactogen production (hPL) by term human placental explants were studied. The hPL content in medium and explant decreased rapidly after first 24 hours of culture. The decrease thereafter was gradual and reached a plateau by day 4 of culture. The decrease of HPL content in placental culture has previously been suggested being due to the depletion of a rapidly secreting preformed pool of hPL. Addition of IGF-I (0.1-10 micrograms/ml) and insulin (1-20 micrograms/ml) stimulated the decreased level of hPL in tissue and medium after 24 hours in culture. IGF-I was 10 times more potent than insulin in stimulating hPL. These findings suggest that IGF-I and insulin effects the production of hPL by placenta. The lower potency of insulin may indicate that the effect of insulin on hPL production is via IGF-I receptor. PMID- 3555495 TI - Autodegradation of lysosomal cysteine proteinases. AB - Repeated injections of Ep-475, a potent cysteine proteinase inhibitor, into rats caused several-fold increase in the hepatic contents of the lysosomal cysteine proteinases cathepsin B, H and L and in the activities of other lysosomal hydrolases. The rates of degradation of these lysosomal enzymes, estimated by repeated injections of cycloheximide, were found to be retarded in Ep475-treated rats, indicating that lysosomal cysteine proteinases are involved in degradation of lysosomal enzymes including proteinases. PMID- 3555496 TI - A membrane-bound, calcium-dependent protease in yeast alpha-cell cleaving on the carboxyl side of paired basic residues. AB - Paired basic residues are known as a typical site for proteolytic processing of precursors of bioactive peptides. By using a fluorogenic substrate Boc-Gln-Arg Arg-MCA, a unique endoprotease exhibiting hydrolytic specificity toward the carboxyl side of paired basic residues was partially purified (about 4600-fold) from the membrane fraction of yeast Saccharomyces cerevisiae alpha-cells. The enzyme is a calcium-dependent thiol protease, with optimal pH at 7.0. It is a glycoprotein, with an apparent molecular weight of about 100,000-120,000. It cleaves fluorogenic substrates and a synthetic model peptide at the carboxyl side of paired basic residues. From its unique substrate specificity, this enzyme may be involved in precursor processing in vivo. PMID- 3555497 TI - A new enzymatic pathway of citrullinogenesis in murine hemopoietic cells. AB - Citrullinogenesis is demonstrated when murine bone marrow cells are incubated with dialyzed secondary mixed leukocyte culture supernatant. The identity of citrulline in bone marrow cell supernatants has been established by gas chromatographic mass spectrometric analysis. It is shown that, in our model, citrulline synthesis proceeds directly from arginine without intermediate ornithine production, ruling out the involvement of ornithine transcarbamylase (EC 2.1.3.3.). Moreover, none of the other enzymatic activities described for catalyzing citrullinogenesis, i.e. arginine deiminase or peptidyl arginine deiminase can be demonstrated. The generation of oxygen radicals is necessary for this enzymatic reaction. It is induced by a thermolabile protein produced during the antiallograft immune response with a molecular weight of about 150,000. PMID- 3555498 TI - M2 muscarinoceptor-associated ionophore at the cat adrenal medulla. AB - Atropine and pirenzepine displaced 3H-quinuclydinyl-benzylate binding and inhibited methacholine-evoked catecholamine release with a similar order of potencies, atropine being 200 fold more potent than pirenzepine. In contrast to high-K, methacholine-evoked 45Ca uptake or catecholamine release were not blocked by (+)PN200-110. Bay-K-8644 did not modify the secretory response to methacholine either in the presence of Ca or Sr but potentiated K-evoked secretion. In depolarized glands, methacholine still evoked its usual secretory response. The results suggest that muscarinic stimulation of cat adrenal chromaffin cells stimulates Ca entry though an ionophore other than voltage-dependent Ca channels; such ionophore seems to be chemically operated through a M2 muscarinoceptor. PMID- 3555499 TI - Potent GnRH agonists containing L-amino acid derivatives in the six position. AB - New agonists related to gonadotropin-releasing hormone (GnRH) have been synthesized that are comparable in potency to the GnRH and its superagonists for release of LH and estrus suppression without substitutions with D- or unnatural amino acids in position 6. We now report a series of L-beta-aspartyl-6 GnRH analogs containing only naturally occurring L-amino acids in the whole sequence, exhibiting considerable in vivo biological activity. Dose and time dependent LH release capability of the different analogs in adult male mice, estrus suppression comparisons and blockade of ovulation in female rats are given. The incorporation of L-Asp-OMe and L-Asp-OBzl in position 6 of GnRH resulted in the most potent GnRH agonists (to 12-20xGnRH potency) in this series inducing a biphasic biological response similar to the D-amino acid-6 substituted superactive GnRH analogs. A correlation between the LH releasing potencies of the analogs and their HPLC retention times was also investigated. Peptide synthesis were achieved using either solid phase or solution phase methodology. PMID- 3555500 TI - Glucose tolerance factor stimulates 3-O-methylglucose transport into isolated rat adipocytes. AB - Glucose tolerance factor partially purified from yeast extract powder stimulated [U-14C]-D-glucose uptake to a level 5.6 times greater than the basal level in the absence of insulin in isolated adipocytes prepared from rats fed with normal laboratory chow. The factor also stimulated 3-O-methylglucose transport 2.2-fold from the basal level in the absence of insulin, but not in the presence of 8 nM insulin. Kinetic analysis revealed that glucose tolerance factor increased 3-O methylglucose transport by decreasing the Ks value for 3-O-methylglucose with little change in the Vmax. PMID- 3555501 TI - Predominance of prostaglandin D2 and I2 in the rat gastric mucosa--analysis by high-performance liquid chromatography. AB - We have developed a method for measuring prostaglandins (PGs) in rat gastric mucosa by high-performance liquid chromatography (HPLC). The levels of PGD2 and 6 keto-PGF1 alpha, a degradation product of PGI2, were five times higher than those of PGE2 and PGF2 alpha. Oral administration of indomethacin (6 mg/kg body weight) completely abolished the synthesis of all detectable PGs uniformly. These results suggest that endogenous PGs, especially PGD2 and I2, play some roles in the function of the gastric mucosa. PMID- 3555502 TI - Decreased levels of prostaglandins I2 and E2 in acute gastric mucosal lesions induced by hypoxia. AB - We have observed that the contents of prostaglandin (PG) D2 and 6-keto-PGF1 alpha were five times higher than those of PGE2 and PGF2 alpha in rat gastric mucosa. In order to elucidate the role of PGs in the function of gastric mucosa, we studied the effect of hypoxia on the levels of PGs in relation to the degree of gastric mucosal lesions. 6-Keto-PGF1 alpha levels were significantly decreased only by severe and long-term hypoxia (10% O2, 18 hours) when severe ulcerative lesions were observed. PGE2 levels were significantly decreased even by mild and short-term hypoxia (13% O2, 4 hours) when slight ulcerative lesions were observed. PGF2 alpha and PGD2 levels were significantly decreased by mild and short-term hypoxia; however, there was no significant difference from the control group under severe and long-term hypoxia. These results suggest that each of the PGs plays a different role in the pathogenesis of acute gastric mucosal lesions induced by hypoxia. PMID- 3555503 TI - Glucocorticoid-biogenic amine interactions in relation to mood and behavior. PMID- 3555504 TI - The effect of carbon tetrachloride on the enzymatic hydrolysis of cellular triacylglycerol in adult rat hepatocytes in primary monolayer culture. AB - The effect of carbon tetrachloride on the intracellular hydrolysis of triacylglycerol and on the activity of acid triacylglycerol lipase was investigated with primary cultured rat hepatocytes. It was found that the concentration of the precursors in the medium did not affect the time course of the synthesis, secretion and the hydrolysis of triacylglycerol, and that carbon tetrachloride significantly suppressed the hydrolysis of intracellular triacylglycerol and the activity of acid triacylglycerol lipase with a concomitant accumulation of triacylglycerol. The results indicate a possibility that the triacylglycerol accumulation in the cultured rat hepatocytes caused by carbon tetrachloride might be mediated by the suppression of lysosomal acid triacylglycerol lipase activity in addition to the suppression of the secretion of triacylglycerol. PMID- 3555505 TI - 1,2-Dibromo compounds. Their mutagenicity in Salmonella strains differing in glutathione content and their alkylating potential. AB - The mutagenic activities of several structurally related dibromo compounds were compared in Salmonella strains sensitive to base substitution mutagenesis (TA1535 and/or TA100) and in the glutathione (GSH)-deficient derivative TA100/NG-57, using a preincubation procedure. The compounds tested were 1,2-dibromoethane (DBE), 1,2-dibromopropane (DBP), 1,2-dibromo-1-phenylethane (DBPE) and model compounds for the half-mustards resulting from their conjugation with GSH, i.e. the N-acetyl-S-2-bromoalkyl-L-cysteine methyl esters SBE, SBP, and SBPE, respectively. The alkylating potential of all compounds was assayed with the 4-(p nitrobenzyl)pyridine (NBP) alkylation test. Five of the compounds showed a good correlation between relative mutagenic activity in TA100 and electrophilic reactivity in the NBP-test, the order of decreasing potency being SBE greater than SBP greater than DBPE greater than DBP. SBPE displayed the highest reactivity in the NBP-test, but was devoid of mutagenic activity. The mutagenic activity of DBE was substantially decreased in the GSH-deficient strain TA100/NG 57 and could be restored by pretreating the cells with GSH. None of the other chemicals showed different mutagenic activities in TA100 and TA100/NG-57. From the results it can be concluded that 2-bromothioethers possess higher alkylating activities than the 1,2-dibromo compounds. Methyl substitution has a deactivating effect on the mutagenic activity. The results with the phenyl-substituted analogue, DBPE, show that a higher alkylating activity does not always lead to a higher mutagenic activity. PMID- 3555506 TI - Role of protease inhibition in cellular migration and neuritic growth. PMID- 3555507 TI - Influence of the antileukemic and anti-human immunodeficiency virus agent avarol on selected immune responses in vitro and in vivo. AB - The effect of the antileukemic and anti-HIV agent avarol on the lymphoid system was studied both in vitro and in vivo. Radioactively labelled avarol ([3H] dihydroavarol) was found to accumulate in vitro in the cytoplasmic compartment primarily of T-lymphocytes and not of B-lymphocytes. Avarol increased significantly the IgG and IgM production by cultures of human lymphoid cells (unseparated) in vitro and slightly the number of plaque forming cells in vivo in spleen of mice. Moreover, a pretreatment of mice with avarol resulted in a higher [3H]-dThd incorporation rate in both macrophage-containing and macrophage depleted lymphocyte cultures in vitro. The stimulatory influence of avarol on humoral immune responses is not accompanied by a change of the antibody-mediated hypersensitivity reaction, as measured by the Arthus reaction. No significant influence of avarol on the cellular immune system in vivo (rats or mice) was found, as taken from studies on delayed-type hypersensitivity reactions to sheep red blood cells and to oxazolone. The in vitro and animal data indicate that avarol combines useful properties (anti-HIV efficiency in vitro and augmentation of humoral immune responses) to consider it as a potential anti-AIDS agent. PMID- 3555508 TI - Comparison of results obtained with different methods for estimating GABA turnover in rat neostriatum. AB - Different methods for measuring GABA turnover in rat brain were compared. One method was based on the irreversible inhibition of GABA transaminase (EC 2.6.1.19) by microinjection of gamma-vinyl-GABA into neostriatum of rat. The accumulation of GABA was almost linear for 4 hr. The GABA turnover in control animals was estimated to be 25.8 +/- 1.1 nmole/mg protein/hr. Another method was based on the post mortal increase in GABA level in an 8 min interval after decapitation. This method gave a GABA turnover of 54.3 +/- 4.8 nmole/mg protein/hr in neostriatum. The methods were compared with respect to their ability to detect the effect of high doses of diazepam and morphine on the turnover rate of GABA. The GABA transaminase inhibition method resulted in a 27% and a 17% decrease in GABA turnover for diazepam and morphine respectively. The post mortem method did not detect any change in GABA turnover after administration of these drugs. Hypoglycemia leads to a decrease in GABA turnover of 17% with the GABA transaminase inhibition method and a 43% decrease in GABA turnover with the post mortem method. The advantages and limitations of the methods for estimating GABA turnover changes during drug exposure is discussed, and are compared with results from a third method based on steady state kinetics extracted from the literature. PMID- 3555509 TI - [Antiviral activity of mutant interferons. A new approach to the study of structural-functional organization of interferons]. AB - The developed approach to investing the structure-functional organization of interferon has been developed consisting in: 1) fusing genes of interferon and alpha-peptide of beta-galactosidase, the resultant protein having the interferon properties and being determined by the beta-galactosidase alpha-complementation test; 2) constructing mutant genes of interferon by the localized mutagenesis; 3) determining the mutant interferon activity; 4) deducing the amino acid sequence of mutant interferon by sequencing mutant genes; 5) analyzing structure functional organization of interferon. In accordance with this approach, ten mutant interferons with up to 15 changes of amino acid substitutions are obtained and their antiviral activity is determined. The role of some amino acid residues in antiviral activity of interferon alpha 2 is revealed. PMID- 3555510 TI - Low-dose methotrexate compared with azathioprine in the treatment of rheumatoid arthritis. A twenty-four-week controlled clinical trial. AB - Forty-two patients with definite or classic rheumatoid arthritis entered a prospective 24-week, double-blind, parallel clinical trial, followed by an 18 month open phase. All subjects had active synovitis that was unresponsive to nonsteroidal antiinflammatory medications and conventional slow-acting antirheumatic drugs. Initial treatment with azathioprine (AZA), 100 mg/day, or methotrexate (MTX), 10 mg/week, orally, was adjusted at predefined intervals. Both treatment groups showed statistically significant improvement at week 24, compared with baseline status, in all 9 clinical outcome variables. There were no apparent statistically significant differences in these outcome variables between the 2 treatment groups. There was a trend toward a more marked and rapid improvement in the MTX-treated group. Radiologic evidence of progression of joint damage was similar in both treatment groups at 24 and 52 weeks. Four of the 42 patients (2 receiving MTX and 2 receiving AZA) discontinued the study because of side effects, and 1 MTX-treated patient withdrew because of personal reasons. Outcome measures at week 52 (open phase) were not statistically different from those at week 24. Twenty-three patients were still taking the medication at week 104. We found that AZA and MTX were similarly effective in the treatment of rheumatoid arthritis, and that this beneficial effect was maintained for up to 2 years in most patients. PMID- 3555512 TI - Antibacterial activity of the metabolites of ciprofloxacin and its significance in the bioassay. AB - The antibacterial activity of the metabolites of ciprofloxacin (1-cyclopropyl-6 fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3- quinolinecarboxylic acid, Bay o 9867; designated tradename: Ciprobay) M1, M2, M3 and M4 was tested with the agar dilution method against various Gram-positive and Gram-negative bacteria in comparison to ciprofloxacin, norfloxacin and nalidixic acid. The results show that M1 had only a weak antibacterial activity comparable to nalidixic acid, whereas M2 was significantly less active. M3, which is one of the main metabolites in urine has a broad antibacterial activity but was less active than ciprofloxacin or norfloxacin. M4 which is a very minor metabolite of ciprofloxacin was the most active compound with minimal inhibitory concentrations for strains of Escherichia coli or Klebsiella pneumoniae in the range of norfloxacin, whereas with staphylococci the antibacterial activity was comparable to ciprofloxacin. Possible interactions between ciprofloxacin and the metabolites in the bioassay system, using Escherichia coli (ICB 4004) were studied, to explain discrepancies between the microbiological assay and the HPLC-method reported in the literature. It could be demonstrated that under conditions where the concentration of ciprofloxacin exceeds or equals the concentration of the metabolites or mixtures of them no increase in the inhibition zones for ciprofloxacin could be observed, which would have led to false high values for ciprofloxacin in the bioassay system. From these data we conclude that the antibacterial activity of the metabolites in biological specimens, e.g. urine, does not influence the bioassay results. PMID- 3555514 TI - Support for those who stutter needs support. PMID- 3555511 TI - An immunoassay differentiating sera with antibodies to Sm alone, antibodies to Sm/RNP complex, and antibodies to RNP alone. AB - Combined DEAE-Sephacel and hydroxyapatite chromatography resulted in a separation of free Sm antigen from the Sm/RNP complex in rabbit thymus extracts. In Western blots, the free Sm preparation contained an immunoreactive 14-kd (D) protein, whereas the Sm/RNP complex contained, in addition to the 14-kd protein, a 68-kd reactive protein and its putative degradation fragments. Ethidium bromide staining of these preparations separated by agarose gel electrophoresis showed that the Sm/RNP preparation contained RNA, but the free Sm preparation did not. These preparations were used as antigens in an enzyme-linked immunosorbent assay (ELISA). Sera characterized as anti-Sm only, anti-Sm/RNP, and anti-RNP only were assayed. A quotient (Q) was derived from the ELISA optical density obtained with Sm/RNP as antigen divided by the optical density obtained with free Sm as antigen. Q values less than 4.0 characterized sera with anti-Sm only, values of 4.0-12.0 were observed in sera with anti-Sm plus anti-RNP, and values greater than 12.0 in sera with anti-RNP only. Sera with antibodies to other nuclear antigens were not reactive in this system. It has traditionally been difficult to identify sera with anti-RNP when this is present simultaneously with, and in lower concentration than, anti-Sm. With this method, such sera can be identified by their Q value, which falls in an intermediate region between a lower Q for anti-Sm and a higher Q for anti-RNP. PMID- 3555513 TI - [Treatment of impetiginized eczema with prednicarbate in combination with a quarternary ammonium salt]. AB - After a brief account of the therapeutic problems with microbially superinfected eczemas, the results of a double-blind study of hospitalized patients are reported. Two concentrations of the antibacterial agent Bardac-22 (didecyl dimethyl-ammonium chloride. Hoe S 2922) in combination with the steroid prednicarbate (prednisolone 17-(ethylcarbonate)-21-propionate, Hoe 777) were used. The quantitative determination of cutaneous bacteria was performed by a modified method of Faergemann. The double blind study did not reveal any significant differences in effectiveness, although a trend in favour of the higher concentration was apparent. PMID- 3555515 TI - Pediatric emergency care: an annotated bibliography of the recent literature. PMID- 3555516 TI - EMT-defibrillation: national guidelines for implementation. PMID- 3555517 TI - International mobility of hazardous products, industries, and wastes. PMID- 3555518 TI - Social/economic status and disease. PMID- 3555519 TI - Managed care in Medicaid: selected issues in program origins, design, and research. PMID- 3555520 TI - Evaluating a new technology: the effectiveness of electronic fetal heart rate monitoring. PMID- 3555521 TI - Health status measures: an overview and guide for selection. PMID- 3555522 TI - Injury: conceptual shifts and preventive implications. PMID- 3555523 TI - Trends in the health of the elderly population. PMID- 3555524 TI - Women, work, and health. PMID- 3555525 TI - Physical activity and the incidence of coronary heart disease. AB - Our review focuses on all articles in the English language that provide sufficient data to calculate a relative risk or odds ratio for CHD at different levels of physical activity. The inverse association between physical activity and incidence of CHD is consistently observed, especially in the better designed studies; this association is appropriately sequenced, biologically graded, plausible, and coherent with existing knowledge. Therefore, the observations reported in the literature support the inference that physical activity is inversely and causally related to the incidence of CHD. The two most important observations in this review are, first, better studies have been more likely than poorer studies to report an inverse association between physical activity and the incidence of CHD and, second, the relative risk of inactivity appears to be similar in magnitude to that of hypertension, hypercholesterolemia, and smoking. These observations suggest that in CHD prevention programs, regular physical activity should be promoted as vigorously as blood pressure control, dietary modification to lower serum cholesterol, and smoking cessation. Given the large proportion of sedentary persons in the United States (91), the incidence of CHD attributable to insufficient physical activity is likely to be surprisingly large. Therefore, public policy that encourages regular physical activity should be pursued. PMID- 3555526 TI - Setting objectives for public health. PMID- 3555527 TI - Alternatives to using human experience in assessing health risks. PMID- 3555528 TI - Computer-based health promotion: combining technological advances with problem solving techniques to effect successful health behavior changes. PMID- 3555529 TI - Tobacco and health: trends in smoking and smokeless tobacco consumption in the United States. PMID- 3555530 TI - The use of large data bases in health care studies. AB - The growing number of large health data bases available represents a valuable resource for health care research. Many available data bases, however, have subtle and/or complex defects in their design as well as in the quality of the data themselves. The apparent ease and economy of using pre-collected data cannot eliminate the need for careful selection, examination, and analysis of these data. Existing documentation should be critically reviewed to assess the appropriateness of the data base for its intended use. Once in hand, the completeness and coding of the data should be examined in detail before attempting to test hypotheses. In conducting data analysis, the investigator must be aware of the potential problems related to the size of the data base, the unit of analysis, and the sampling strategy--particularly if sampling involved stratification or clustering. Awareness of the potential pitfalls inherent in the use of large health data bases can help prevent many problems and disappointments, as well as improve the validity and efficiency of statistical analysis. PMID- 3555531 TI - Malaria and its control: present situation and future prospects. AB - The global program of malaria eradication coordinated and supported by the World Health Organization (WHO) since 1957 has been successful in most of the countries in the temperate climate zones of the globe. However, by the end of the 1960s it became evident that technical problems, such as resistance of mosquito vectors to insecticides and resistance of malaria parasites to drugs, presented serious obstacles to the pursuit of eradication programs in many tropical countries. Moreover, the administrative and financial difficulties of the developing countries were such that a revised strategy of antimalaria campaigns became necessary. In 1969 the World Health Organization recommended that although eradication of malaria should remain an ultimate goal, in countries where eradication does not appear to be feasible, malaria control operations may form a transitional stage. All effective methods of attack on the parasite and on the Anopheles vector should be employed according to epidemiological conditions of the area involved and in relation to their technical and logistic feasibility. Nevertheless, during the past decade the malaria situation has deteriorated in several countries, especially in southern and southeast Asia and some parts of Latin America. There has been no improvement in the highly endemic countries of tropical Africa. Since 1978 the concept of primary health care has been widely adopted, and antimalaria activities have become essential components of national health systems in many developing tropical countries. Malaria control within the orbit of primary health care aims first at the reduction of morbidity and mortality from malaria, although the decrease of the prevalence of this infection should also be an objective, whenever possible. This selective approach, based largely on chemotherapy, has been successful in a few countries, but in other areas the degree of integration of antimalaria activities with the primary health care system is less effective. Patterns of such integration depend on different epidemiological, socioeconomic, cultural, and other factors. Malaria control within the framework of primary health care demands full commitment by the government concerned, constant support of the community, and a close cooperation with all other sectors of the health system. Training of national professional and auxiliary staff and health education of the community are equally important.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555532 TI - Work in the north: physiological aspects. PMID- 3555533 TI - History of the development of cytophotometry from 1935 to the present. PMID- 3555534 TI - Statistical methods for the practical clinical application of morphometric measurements. AB - Four statistical methods are presented to determine the practical clinical value of measurements made from malignant tumors and to translate these measurements into a prediction of survival for each patient: the Cox statistical model, which must be derived from a data base of cases with known outcome; the null-rank test, a modified rank-sum test that provides an overall measure of the effectiveness of the Cox model; the predicted survival curve, an estimate of survival derived for each new patient from measurements of the primary tumor; and the standard error of measurement, an empirical method for estimating the variability introduced into predicted survival by errors in measurement. The value of these statistical methods was demonstrated by application to 200 cases of human intraocular melanoma, with the two predictive morphometric measurements used being the standard deviation of nucleolar area (SDNA) and the largest tumor dimension (LTD) derived from a single histologic slide of each tumor. Sufficient references and mathematical details are provided to allow anyone with moderate skills as a computer programmer to construct or obtain all of the relevant algorithms. PMID- 3555535 TI - The use of morphometry in the study of nodular and vascular lesions of the liver. AB - This paper summarizes the use of morphometry on human autopsy livers to investigate three conditions characterized by the presence of hepatocellular nodules: nodular regenerative hyperplasia (NRH), partial nodular transformation (PNT) and focal nodular hyperplasia (FNH). Vascular abnormalities were seen in all cases. The nodules can be explained in all three conditions as a response to a greater blood supply in the nodules as compared to the surrounding parenchyma. In NRH, there appears to be ischemia caused by arteritis and secondary oblitertion of small portal veins. In PNT, ischemia may be caused by portal vein thrombosis. In FNH, there appears to be hyperemia caused by a spiderlike arterial anomaly. PMID- 3555536 TI - Electron microscopic morphometry. AB - The fundamental concepts of morphometry, the principal correction factors for systematic errors and the basic principles of efficient sampling are outlined for quantitative morphology at the electron microscopic level of resolution. The important usefulness of correlating electron microscopic morphometry with complementary light microscopic morphometry is emphasized. PMID- 3555537 TI - MPOA and BNST lesions in male Syrian hamsters: differential effects on copulatory and chemoinvestigatory behaviors. AB - Electrolytic lesions were made in the medial preoptic area (MPOA) and bed nucleus of the stria terminalis (BNST) to evaluate their participation in the neural regulation of copulatory and chemoinvestigatory behaviors in male hamsters. Damage to either the MPOA or the BNST caused severe deficits in copulatory performance in a subset of the animals in each group. In the MPOA group all males displaying severe deficits had lesions which included a small central region of the caudal MPOA. In the BNST group, animals with severe copulatory deficits all had large lesions which covered most of both the medial and lateral parts of the nucleus. In contrast, MPOA and BNST lesions differentially affected chemoinvestigatory behaviors. MPOA lesions did not affect any of the males' anogenital investigation rates or attraction to female odors, even though some of these hamsters had stopped mating completely. Males with BNST lesions, on the other hand, all displayed significant reductions in their chemoinvestigatory responding even though the majority of them continued to mate normally. We suggest that the MPOA and BNST may in part regulate male sexual behavior by differentially responding to 'attractant' and 'mounting' substances within female hamster vaginal secretion. PMID- 3555538 TI - On the pathogenesis of human type I diabetes: where do we stand? PMID- 3555539 TI - Enzyme immunoassay of 2'-5'-oligoadenylates at the femtomole level. AB - We have developed a competition enzyme immunoassay (EIA) for 2'-5' oligoadenylates [p kappa(A2'p5')nA; 0 less than or equal to kappa less than or equal to 3; 1 less than or equal to n] based on an anti-A2'p5' A monoclonal antibody coated onto 96-well polystyrene plates and A2'p5' A peroxidase as a marker. It permits measurement of 5'OH(A2'p5')nA as such and p kappa(A2'p5')nA after alkaline phosphatase hydrolysis, with a detection threshold of 5 X 10(-12) M. All 2'-5'-oligomers were assayed with similar sensitivity. ATP and adenosine did not interfere at concentrations up to 10(6)-fold higher than those of 2'-5' oligoadenylates. Reproducibility, stability of reagents and correlation with the radioimmunoassay were good. As such, this EIA is a suitable tool for studying the 2-5A system, particularly, in clinical investigations: the initial velocity of 2 5A synthetase can be determined on 10,000 cells without purification and the level of 2'-5'-oligoadenylates can be assayed on less than 1 ml of blood. PMID- 3555540 TI - The identification of Gardnerella vaginalis. AB - In an attempt to develop a rapid identification system for Gardnerella vaginalis that could be used in a clinical microbiologic laboratory, we examined 102 samples of vaginal discharge from women with symptoms of vaginitis. Gardnerella vaginalis was obtained from 77 of 102 cases. We found a combination of six tests of particular value for distinguishing G. vaginalis from other catalase-negative coryneforms isolated from vagina. PMID- 3555541 TI - Cranial bone grafting in facial aesthetic and reconstructive contouring. AB - Harvesting of outer-table cranial bone for major craniofacial surgery can be an extensive surgical undertaking. However, when it is used for facial cosmetic and reconstructive contouring, it can be a relatively minor procedure. Our experience with harvesting outer-table calvarial bone and its placement in the face will support a more liberal use of this material. Over a period of 24 months, we have performed outer-table calvarial bone grafts on 62 patients, totaling 367 individual grafts, which were placed in an average of three separate facial sites per patient. The grafts have been easily taken in a prompt fashion with little postoperative discomfort or graft-site deformity. We have not experienced significant complications in harvesting or in placement of cranial bone. The contour provided in the face is quite natural and predictable. PMID- 3555542 TI - Purification and properties of two phospholipid transfer proteins from yeast. AB - Several intracellular proteins of low and intermediate molecular weights have been isolated from a variety of mammalian and plant tissues that possess an ability to catalyze the transfer or exchange of intact phospholipid molecules between different membrane systems. The soluble cytosolic fraction of the yeast Saccharomyces cerevisiae also contains phospholipid transfer activity that varies with both the state of cellular growth and the type of metabolic carbon source. This activity is protein in nature and very unstable, and requires powerful separation techniques for its purification. Here we report the isolation and characterization of two phospholipid transfer proteins from yeast, one of which we believe represents a partial proteolytic product of the other. The two proteins were purified to near homogeneity through a combination of dye-ligand and high performance ion-exchange chromatographic techniques. Transfer protein I (TP-I) is eluted at a lower ionic strength from an anion-exchange column than transfer protein II (TP-II), which reflects the difference in their isoelectric points; TP-I has a pI of 6.3, while that for TP-II is 6.1. Both species have the same apparent molecular weight of 33,400 and virtually identical substrate specificities. The order of the relative rates of phospholipid transfer are phosphatidylcholine greater than phosphatidylethanolamine greater than phosphatidylinositol greater than phosphatidylserine. PMID- 3555543 TI - Catalytic properties of the yeast phospholipid transfer protein. AB - The properties of the phosphatidylcholine (PC) transfer reaction catalyzed by the yeast phospholipid transfer protein (TP-I) were examined in vitro. Donor and acceptor membranes consisted of unilamellar (ULV) and multilamellar (MLV) vesicles, respectively. The phospholipid composition of the membranes participating in the transfer reaction, and in particular that of the MLV acceptors, have a tremendous effect upon the rate of PC-catalyzed transfer. Phosphatidylethanolamine (PE) is an essential component of the acceptor membrane, but it alone is not sufficient to sustain appreciable transfer rates. If combined in an equimolar ratio with PC, there is only a modest increase in transfer rates. On the other hand, when combined with alternate substrates such as phosphatidylinositol (PI) or phosphatidylserine (PS), very high rates of PC transfer occur. The measurement of transfer rates is not affected by the molecular species of PC used as the radioactive tracer. Evidence is also presented to indicate that the two forms of the transfer protein (TP-I and TP-II) are not identical in terms of their interactions with a membrane surface: differences occur in the levels of transfer of PC, PE, PI, and PS at equilibrium. Finally, by kinetic analysis, the mechanism of the protein-catalyzed transfer of PC is shown to conform to a ping-pong bibi model with excess substrate inhibition, analogous to ordinary two-substrate enzyme-catalyzed reactions. Both the rates of desorption and adsorption of the protein from the surface of the ULV are much greater than those describing the similar interactions of the protein with MLV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555544 TI - [Importance of exocellular polysaccharides in biological purification of water]. PMID- 3555545 TI - [Medium-term effects of human biosynthetic insulin on platelet function and gluco lipidic metabolism]. PMID- 3555547 TI - Multivariate classifications of transitional cell tumors of the bladder: nuclear abnormality index and pattern recognition analysis. AB - The authors report their experiences in applying two types of computer-aided multivariate classification systems in transitional cell tumors of the bladder. The systems are based on nuclear changes in urothelial papillary lesions. 19 out of 54 parameters, selected on the basis of the overlapping area between contiguous grades and the monotonic function, were combined mathematically to obtain the nuclear abnormality index. This index expresses the progressive nuclear abnormalities as a single number on a continuous scale from 0.5 to 2.6. The standard deviation (SD) of the 10 largest nuclear area values in the lower half of epithelial thickness (L), the mean perimeter (L), the SD of the roundness factor in the upper half of epithelial thickness (U), the SD of the logarithm of area (L) and the percentage of round nuclei (U) represent the smallest, the most discriminant and the least correlated set of features for the pattern recognition analysis. The latter shows an agreement of 92% between computer and histologic classifications-estimated by applying Bayes theorem. A good correlation exists between nuclear abnormality index and computer grading by pattern recognition analysis. PMID- 3555546 TI - Computer-aided morphometric analysis of lymph nodes draining laryngeal carcinomas. AB - A new method of morphometric evaluation of nodal patterns in patients with laryngeal cancer was developed. In 8 selected cases with median tumor and unilateral metastasis, the morphometric data about the perimetastatic nodal tissue and contralateral node in the same patient were compared. The results showed the paracortical area to be consistently larger in lymph nodes without metastasis than in those containing metastases. The mean number of blasts, mitoses and postcapillary venules was also increased in the paracortical area in the non-metastasis-containing nodes. These data support the idea that delayed immunity may inhibit development of metastases. The need for objective morphometric methods in lymph node examination is emphasized. PMID- 3555548 TI - Quantitative microscopy today. PMID- 3555549 TI - [Static B-scan ultrasound imaging in the diagnosis of neuromuscular diseases in children]. PMID- 3555550 TI - Critical care nursing. AB - The research pertaining to the delivery of nursing care in the ICU was reviewed to describe: the impact of the unit structure and organization, including policies and procedures, on patients, nurses, and families; the process of critical care nursing; the outcomes of critical care nursing; some of the ethical issues germane to the care of the critically ill patient. Although these areas of inquiry are quite diverse, a number of similarities can be identified. The most obvious of the similarities was that, with few exceptions, the studies pertaining to delivery of nursing care were performed by researchers from a variety of disciplines other than nursing, including medicine, psychology, public health, and economics. In many instances, such as the studies of patients' stress experiences in ICUs, these efforts enhanced our knowledge of the phenomena and complemented or replicated the efforts of nurse researchers. Unfortunately, in some areas nurse researchers were quite absent, with the result that the studies lacked a nursing perspective. For example, the large body of knowledge related to the effects of critical care on patient outcome reflected medicine's orientation toward cure. While it is important to measure the effect of nursing care in the ICU on patient survival, the effect of nursing efforts on short- and long-term quality of life, functional status, and health maintenance is also critical and remains unknown. Nurse researchers need to build on the data base already acquired about critical care. Even more important, they need to fashion programs of research focused on the concepts central to the discipline of nursing. A second similarity relates to the increasing quality of the reported research over the past decade. In general, early descriptive studies were conducted in a single critical care unit with a small and often biased sample. These gave way to more carefully designed, multicenter studies, although lack of randomization procedures continued to be a significant problem. Increasing attention was paid to the psychometric properties of instruments, and the validity and reliability of these instruments were appropriately discussed by the researchers using them. However, the area of family stress is a remarkable exception to this positive trend. Investigators also began to address the problem of sample homogeneity in some of the areas of inquiry by replicating their work outside the often favored CCU. The third and final similarity lies with the preponderance of descriptive studies in all areas reviewed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555551 TI - Faculty practice. PMID- 3555552 TI - Teaching clinical judgement. PMID- 3555553 TI - Leadership in nursing. PMID- 3555555 TI - Conceptual models of nursing. PMID- 3555554 TI - International nursing research. PMID- 3555556 TI - Research on nursing practice. Pain. PMID- 3555557 TI - Research on nursing practice. Stress. AB - Clearly, there is not agreement among nurse researchers regarding a definitional orientation to stress that best fits nursing's orientation to human experiences. Varying theoretical orientations are used to explain stress or stress-related phenomena, for example, stress as a stimulus, stress as a response, and stress as a transaction. The studies are fairly evenly distributed among the four definitional categories. The various approaches do not represent expanding theoretical explanations of stress, but rather are incompatible approaches to explaining stress. More disconcerting than the lack of direction in research efforts, however, is that all too commonly the measurement of the variables and the methodology were not "linked" or consistent with the theoretical framework. For the most part the research efforts reviewed fell short of theory testing. Even for those studies that were designed to contribute to theory development, it was rare to find research reports that included implications regarding theory in the discussion sections. Additionally, discussion sections of the reports typically did not identify alternative explanations for the findings. Quasi experimental, ex post facto, and causal comparative studies typically were flawed with validity problems. If nursing is to strengthen its contribution to knowledge in the area of stress, more emphasis will need to be placed on congruence between design and measurement, and on issues of statistical rigor, validity, and reliability. Although some might argue that it is too early to expect a coalescing of definitional orientations, it is important to point out that considerable confusion regarding stress phenomena results from a nonsystematic or nondeliberative mixture of incompatible orientations to or definitions of stress. It is little wonder that the vast number of opinion articles that appear in the nursing literature include varied definitions of stress, often making conflicting recommendations regarding the nursing assessment of stress and nursing intervention strategies to assist a person in stress management efforts. PMID- 3555558 TI - Human biologic rhythms. PMID- 3555559 TI - Physiologic responses in health and illness: an overview. PMID- 3555560 TI - Unbiased stereologic estimation of surface density in bone using vertical sections. AB - The conventional stereologic procedure for estimating bone surface densities in iliac crest biopsies gives biased estimates because bone substructure is anisotropic and the sectioning of the biopsies is intended to be parallel to the cylindrical axis of the iliac crest biopsy. It has recently been shown that random anisotropic sections with an identifiable axis or direction that is arbitrary but fixed can be used for unbiased estimates of surface areas. The arbitrary axis is called "vertical," which does not imply anything about its relation to direction of gravity. To describe the methodology and the practical sampling procedure for vertical sections, surface density of trabecular bone was estimated in 16 bone samples obtained at autopsy from eight persons (mean age 64 years) using an anisotropic cycloid test system designed for vertical sections. In addition, variation in the estimation procedure was quantitated. The average surface density of trabecular bone was 2.8 +/- 0.4 mm-1 (+/- SD). No systematic difference was observed between the two bone specimens from each of the eight persons. Estimation of the variance at each level of sampling showed that the majority of the total observed variance was due to true variance between individuals. Vertical section is, in general, the method of choice when dealing with surfaces not known to have an isotropic orientation distribution. The cycloid test system is easy and fast to use, and the estimate is truely unbiased. The requirements are all sections must be parallel to the vertical axis, the rotation around this axis must be random, the position of the section or of the biopsy must be random, and the vertical axis must be identified in the section. PMID- 3555561 TI - Bone appositional rate and percentage of doubly and singly labeled surfaces: comparison of data from 5 and 20 microns sections. AB - On theoretical grounds, it seemed plausible that the apparent distance between two fluorescent labels can surpass the actual distance between them by a percentage that is related to the true distance: section thickness ratio. For similar reasons, the percentage of double labels discernible as such would be influenced by the same ratio. These assumptions were tested in a series of doubly labeled biopsies in which a large variation of appositional rates had been found. The apparent mean distance between labels and, hence, the appositional rate as measured in 20 microns sections was significantly lower than in the 5 microns sections from the same biopsies. Yet, 20 microns sections cannot be used to counteract distortion by oblique sectioning because of the bias obscuring the lower range of true interlabel distances. The percentage of doubly labeled surfaces was from 13 to over 50% lower in the 20 microns sections. Thus, overlap of double labels by geometrical projection in 20 microns sections causes a considerable reduction of formation rates derived from the parameters investigated. The problem is resolved, to a large extent, by using sections as thin as possible. PMID- 3555563 TI - 'The potential clinical consequences of the new dentine-bonding resins'. PMID- 3555562 TI - Linear firing shrinkage of metal-ceramic restorations. PMID- 3555564 TI - Badges of the dental profession. Association of Industrial Dental Surgeons. PMID- 3555565 TI - Coronary thrombolysis. PMID- 3555566 TI - A double blind placebo controlled comparison of verapamil, atenolol, and their combination in patients with chronic stable angina pectoris. AB - The efficacy and effect on cardiac function of verapamil 120 mg three times a day and atenolol 100 mg once a day, singly and in combination, were evaluated in 15 patients with angina pectoris. While they were on the combination treatment four patients withdrew from the study. Episodes of angina pectoris and glyceryl trinitrate consumption were significantly reduced only on the combination. On the combination only four patients developed evidence of ischaemia during exercise compared with seven on verapamil and ten on atenolol. ST segment depression at peak exercise, assessed by 16 point precordial mapping, was reduced by all active treatments from 7.1 on placebo to 2.7, 0.9, and 0.6 mm on atenolol, verapamil, and the combination respectively. Mean left ventricular ejection fraction fell significantly from 60% on placebo to 53% on the combination but was unchanged on verapamil and atenolol. Verapamil was an effective alternative to atenolol; the combination was the most effective treatment but was associated with a significant morbidity. PMID- 3555568 TI - The cause of rheumatic heart disease. PMID- 3555567 TI - Nocardial endocarditis of an aortic valve prosthesis. AB - The organism responsible for endocarditis of a prosthetic aortic valve was identified as Nocardia asteroides. The patient was treated with intravenous amikacin (250 mg four times a day) and intravenous imipenem (1.5 g four times a day). The valve was replaced under this new antibiotic regimen. This is the first report of survival after prosthetic valve nocardiosis. PMID- 3555569 TI - Comparison of nalbuphine, pethidine and placebo as premedication for minor gynaecological surgery. AB - In a randomized double-blind placebo-controlled trial involving 80 patients nalbuphine 10 mg and 20 mg were compared with pethidine 100 mg and a placebo given i.m. at least 90 min before minor gynaecological surgery. Nalbuphine proved a suitable alternative to pethidine, producing beneficial sedation which was maximum at 60 min after injection. Both nalbuphine and pethidine reduced the excitatory sequelae of methohexitone induction. Increasing the dose of nalbuphine from 10 mg to 20 mg produced no significant additional sedation or intraoperative benefit. Short-lived pain at the injection site was a feature of the use of nalbuphine in either dose. The main disadvantage of nalbuphine was nausea and vomiting of delayed onset, the frequency of which was similar after either dose. PMID- 3555570 TI - Influence of bolus doses of phenoperidine on intracranial pressure and systemic arterial pressure in traumatic coma. AB - The effects of bolus doses of phenoperidine 1-2 mg i.v. either alone, or combined with pancuronium 2-4 mg, were investigated in seven patients in traumatic coma. Phenoperidine alone significantly reduced mean arterial pressure (MAP) by a mean (+/- SEM) of 13.2 (+/- 2.8) mm Hg. Overall there was no significant change in intracranial pressure (ICP) despite the decreases in MAP and, consequently, cerebral perfusion pressure (CPP) decreased (14.0 +/- 2.4 mm Hg) on all but one occasion. In some instances these decreases were considerable (maximum 38 mm Hg). Similar results were obtained when phenoperidine was combined with pancuronium. These findings suggest that the bolus administration of phenoperidine and probably other opiates should be avoided in traumatic coma. PMID- 3555572 TI - Cognitive processes in addiction. PMID- 3555571 TI - Effect of salbutamol and suxamethonium on the plasma potassium concentration. AB - In a double-blind randomized study, patients received premedication with lorazepam 0.04 mg kg-1 and salbutamol 0.1 mg kg-1 or lorazepam 0.04 mg kg-1 and placebo given orally 2.5-3 h before anaesthesia. The plasma potassium concentration was measured at the time of premedication, before the induction of anaesthesia and at selected intervals after suxamethonium 1 mg kg-1 i.v. The plasma potassium concentration was lower in those patients who received salbutamol than in those given placebo, and remained lower at all the subsequent sample times. Oral salbutamol did not appear to affect the incidence of suxamethonium related muscle pain. PMID- 3555573 TI - The contribution of Pavlovian conditioning to drug tolerance and dependence. PMID- 3555574 TI - Uncontrollable events and alcohol drinking. PMID- 3555575 TI - Craving for cigarettes. PMID- 3555576 TI - Relapse: a psychological perspective. PMID- 3555577 TI - Change processes in psychotherapy. PMID- 3555578 TI - Effect of guanfacine on ambulatory blood pressure and its variability in elderly patients with essential hypertension. AB - The effect of guanfacine (2 mg once daily) on ambulatory blood pressure was studied with the Remler M 2000 recorder in 16 elderly hypertensive patients during a randomized, double-blind, placebo-controlled, balanced, cross-over study. Guanfacine significantly reduced heart rate and systolic and diastolic ambulatory blood pressure. The antihypertensive effect was maintained over the whole recording period. Systolic and diastolic blood pressure variability was not changed by guanfacine, neither when defined as standard deviation or variation coefficient of the mean, nor when defined as the range between the highest and lowest ambulatory blood pressure, suggesting that blood pressure variability is unrelated to sympathetic nervous system activity. PMID- 3555580 TI - A quinine a day keeps the leg cramps away? AB - A double-blind, placebo-controlled, cross-over trial of quinine in leg cramps occurring at rest was conducted in 22 elderly cramp sufferers. Despite demonstration of impaired quinine elimination in the elderly, prescription of the traditional dose of 300 mg quinine bisulphate at night failed to produce a significant (P = 0.1) reduction in the number or severity of cramps. There was a significant relationship between serum quinine concentration and attenuation of cramps. However, the simple expedient of increasing the nightly dose of quinine may carry the concomitant risk of cinchonism. PMID- 3555579 TI - The metabolism of 17 alpha-ethinyloestradiol by human liver microsomes: formation of catechol and chemically reactive metabolites. AB - The metabolism of 17 alpha-ethinyloestradiol (EE2) to catechol and reactive metabolites by human liver microsomes was investigated. 2 Hydroxyethinyloestradiol (2-OHEE2) was either the sole or principal metabolite. Small amounts of 6-hydroxyethinyloestradiol and 16-hydroxyethinyloestradiol were produced by some of the livers. EE2 (10 microM) underwent substantial (5-20% of incubated drug), though highly variable, NADPH-dependent metabolism to material irreversibly bound to microsomal protein. 2-OHEE2 appeared to be the pro-reactive metabolite. The maximum EE2 2-hydroxylase activity was 0.67 nmol min-1 mg-1 microsomal protein, with a Km value of 8.6 microM. Oestradiol, which is mainly hydroxylated to 2-hydroxyoestradiol, was the most potent inhibitor of hydroxylase activity and exhibited competitive inhibition. Progesterone, which undergoes 2 hydroxylation to a minor extent was also a competitive inhibitor, whereas cholesterol and cortisol did not have any appreciable inhibitory effect. Primaquine was the most potent non-steroidal inhibitor but was non-competitive. Other non-steroidal compounds investigated, e.g. antipyrine, did not show any significant effect on EE2 2-hydroxylation. The results of this study suggest that EE2 2-hydroxylation is metabolised by a form(s) of cytochrome P-450 which has affinity for endogenous steroids. PMID- 3555581 TI - Plasma and whole blood mefloquine concentrations during treatment of chloroquine resistant falciparum malaria with the combination mefloquine-sulphadoxine pyrimethamine. AB - Mefloquine-sulphadoxine-pyrimethamine (MSP) in combination has proved effective against multiple-drug-resistant falciparum malaria, but nothing is known about mefloquine absorption when it is given in this formulation. Nine Thai patients, aged 15-51 years with uncomplicated chloroquine-resistant falciparum malaria, took 11.2-16.7 mg of mefloquine base per kilogram bodyweight as MSP tablets. All patients responded to treatment with fever and parasite clearance times of 61 +/- 29 h (mean +/- s.d.) and 52 +/- 24 h, respectively. The mean apparent absorption half-time (t1/2abs) of mefloquine was 4.89 h (range 2.25-9.72) and mean peak plasma concentration was 1815 ng ml-1 (range 725-3368). Peak plasma mefloquine concentrations in three patients who vomited within 2 h of treatment were 725, 956 and 1972 ng ml-1. There was no significant difference between plasma and whole blood mefloquine concentrations during the first 48 h of treatment. Based on the elimination of parasitaemia, the plasma mefloquine concentrations are adequate for therapy of uncomplicated falciparum malaria although the relationship between plasma concentrations and therapeutic efficacy of mefloquine requires further study. PMID- 3555582 TI - Rationale for combination therapy. AB - Cardiovascular morbidity and mortality is higher in treated hypertensive patients than in normotensive subjects of the same age, sex and from the same populations. A possible and logical explanation for this could be that arterial pressure in treated hypertensive patients usually is significantly higher than in matched normotensive subjects. For these reasons it would appear logical to identify a therapeutic goal in the treatment of hypertension: to obtain normotensive blood pressure levels. In order to obtain this goal, combined treatment with more than one antihypertensive drug would appear to be required. Therapeutic combinations consisting of an ACE-inhibitor plus a diuretic or an ACE-inhibitor plus a calcium antagonist constitute two examples of antihypertensive drug combinations that would appear to offer potent antihypertensive efficacy and good tolerability. PMID- 3555583 TI - Captopril and hydrochlorothiazide: rationale for their combination. AB - The results of controlled clinical studies have shown that about 80% of hypertensive patients have a satisfactory blood pressure reduction when treated with a combination of captopril and thiazide diuretics. The high response rate to this treatment can be explained on the basis of the mechanism of action of these drugs. In the long term, diuretics act by reducing peripheral vascular resistance. The mechanism by which they reduce peripheral vascular resistance is the subject of debate, but could be explained on the basis of cellular ionic changes. From our studies, it was observed that thiazides cause a reduction in intracellular Na+ (Nai) and in intra- and extracellular K+ (Ki, Ke). Since in many patients Ke losses are greater than Ki losses, the Ki/Ke ratio (which is directly related to membrane potential and thus to vascular tone) increases. Captopril also reduces Nai, but its effects on Ke and Ki are quite different from those of thiazides. Captopril in fact causes an increase in Ki inducing a net increase in Ki/Ke. This increase can also be observed when captopril is given in combination with thiazides. Therefore the combination of captopril and thiazides has an additive effect on Nai, and increases Ki/Ke in the vast majority of patients. The decrease in Nai probably acts by reducing membrane sensitivity to catecholamines and angiotensin, whereas the increase in Ki/Ke acts by hyperpolarizing vascular smooth muscle membrane. The combination of captopril an thiazides also has favourable metabolic effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555584 TI - Determination of the optimal dosage regimen of captopril + hydrochlorothiazide in the treatment of moderate arterial hypertension. AB - A multicentre controlled trial was carried out to determine the optimal dosage of a 2/1 combination of captopril plus hydrochlorothiazide (HCTZ) in mild hypertension at three doses against placebo in a 6 week double-blind trial. The number of patients was 111:27 received placebo; 26 were treated with captopril 25 mg plus HCTZ 12.5 mg (25/12.5); 25 with captopril 50 mg plus HCTZ 25 mg (50/25); and 33 with captopril 100 mg plus HCTZ 50 mg (100/50). A significant fall in blood pressure was seen in all four groups, but was greater with the active treatments. The percentage of patients who were normalized [diastolic blood pressure (DBP) less than or equal to 90 mm Hg] or good responders (10% fall in DBP) increased as a function of the dose. At Day 21, the antihypertensive effect of 50/25 was similar to that of 100/50, but greater than that of captopril 25 HCTZ 12.5. At Day 42, the antihypertensive effects of the three doses were similar. Tolerance data showed a higher incidence of side-effects with 100/50 than with the other dosages. Thus, 50/25 appeared to be the optimal dosage for the control of mild hypertension. PMID- 3555585 TI - Comparison of once and twice daily administration of captopril plus hydrochlorothiazide on 24 h blood pressure levels. AB - The anti-hypertensive effect of captopril 50 mg plus hydrochlorothiazide 25 mg, given once or twice daily, was investigated by 24 h monitoring in hypertensive patients in a controlled, randomized, double-blind, cross-over trial. Ten patients with blood pressure (BP) greater than 160 and/or 95 mm Hg after a 15 day placebo period, were randomly assigned to one of two treatments, in which they either received the combination once daily in the first month, twice daily in the second and once daily in the third (Treatment Group A) or twice daily in the first month, once daily in the second month and twice daily in the third month (Treatment Group B). The anti-hypertensive effect of the drug combination was assessed by 24 h monitoring using a Dinamap 845 to establish mean BP levels and circadian curves. After 1 month the twice daily administration was more effective than the once daily, but after 2 months, and throughout the third month, there was no difference in the anti-hypertensive efficacy of the combination given either once or twice daily. PMID- 3555586 TI - Captopril + hydrochlorothiazide 24 h ambulatory monitoring effects. AB - The purpose of this study was to evaluate over a 24 h period the antihypertensive effect of captopril 50 mg + hydrochlorothiazide (HCTZ) 25 mg once a day in mild to moderate hypertension. Ambulatory recordings over 24 h of the blood pressure using the Spacelabs system were performed, at the end of a 15-day placebo period and after giving captopril + HCTZ for 45 days. Captopril + HCTZ significantly decreased (P less than 0.001) systolic and diastolic blood pressures for both the diurnal period (8 h to 22 h) and the nocturnal period (22 h to 8 h). No change in heart rate was observed. For further analysis, the mean hour values of blood pressure and heart rate were calculated. A constant decrease of the systolic and diastolic blood pressure throughout the 24 h was obtained after captopril + HCTZ without any change in heart rate and in nyctohemeral variations. The study provided evidence that, in patients with mild to moderate essential hypertension, captopril + HCTZ once a day decreased systolic and diastolic blood pressure all day long without any change in the heart rate and the blood pressure nyctohemeral cycle. PMID- 3555587 TI - Captopril plus hydrochlorothiazide once daily normalizes 24 h blood pressure in patients with essential hypertension. AB - The hypotensive effect of captopril 50 mg twice daily and of captopril 50 mg + hydrochlorothiazide (HCTZ) 25 mg once daily was studied in 12 patients with mild to moderate essential hypertension, whose blood pressure was not normalized by captopril 25 mg twice daily alone. Both captopril 50 mg twice daily and captopril 50 mg + HCTZ 25 mg once daily caused a significant reduction of outpatient blood pressures as compared with placebo (P less than 0.001). Captopril 50 mg + HCTZ 25 mg once daily also reduced outpatient blood pressures significantly when compared with captopril 25 mg twice daily (P less than 0.01). Both captopril 50 mg twice daily and captopril 50 mg + HCTZ 25 mg once daily significantly reduced 24 h blood pressure (P less than 0.001) without disturbance of its normal circadian rhythm. This effect was more pronounced while on captopril + HCTZ. Captopril 50 mg + HCTZ 25 mg once daily normalizes 24 h blood pressure in most patients with mild to moderate essential hypertension, whose blood pressure is not controlled by captopril 25 mg twice daily alone. PMID- 3555588 TI - Comparative study of once-daily administration of captopril 50 mg, hydrochlorothiazide 25 mg and their combination in mild to moderate hypertension. AB - Two hundred and eleven patients with mild or moderate hypertension, mean age 53.5 +/- 9.5 years (range 24-70) were randomised double-blind to treatment with either captopril 50 mg (C50), hydrochlorothiazide 25 mg (HCTZ 25), the fixed combination of captopril 50 mg and hydrochlorothiazide 25 mg (C50/HCTZ 25) or placebo. Blood pressure, heart rate, body weight and side effects were assessed at the end of the run-in period on placebo and after 4, 6, 8 weeks treatment at the same time, 20-24 h after the last dosing. Routine biochemical examinations were carried out on all patients after the placebo period as well as after 4 and 8 weeks. Blood pressure significantly decreased in all groups, but the mean percentage change from baseline was highly statistically significant at 8 weeks, for C50 and C50/HCTZ 25 groups. The incidence of clinical side effects was low and not statistically different for the four groups with few specific adverse effects (one transient alteration of taste in captopril group). No patient was withdrawn from the study due to side effects. A better anti-hypertensive efficacy was obtained with the fixed combination captopril 50 mg/hydrochlorothiazide 25 mg once daily compared to placebo or each component alone, and without any difference in side effects. PMID- 3555589 TI - Captopril in combination with hydrochlorothiazide: comparative efficacy vs perceived best therapy. AB - An open, randomized, multicentre, comparative trial on 2128 patients with mild-to moderate hypertension, treated with so-called perceived best therapy or a combination of captopril plus hydrochlorothiazide (HCTZ), was conducted over a period of 10 weeks. Both regimens lead to significant blood pressure reductions within the initial 6 weeks, with a difference of 3 mmHg systolic and 2 mmHg diastolic in favour of the captopril plus HCTZ regimen as compared to the perceived best therapy. Both an increase in the daily dose of captopril in uncontrolled patients receiving initial treatment with captopril plus HCTZ and treatment with captopril plus HCTZ in uncontrolled patients receiving the perceived best therapy was followed by improved blood pressure control. There were more withdrawals mainly due to side effects and non-compliance in the captopril plus HCTZ group as compared to the perceived best therapy group. By contrast, there were fewer side effects and a tendency towards a more pronounced improvement of complaints and general well-being in the captopril plus HCTZ group. The study has yielded no clear evidence of an increased number of side effects known to be associated with captopril. Changes of the treatment regimen and dosages according to diastolic blood pressure during the study are difficult to achieve in a study of this type and size. PMID- 3555591 TI - Characterization of factor XIII containing-macrophages in lymph nodes with Hodgkin's disease. AB - A large number of cells containing subunit a of blood coagulation Factor XIII (FXIII) was detected by immunoperoxidase staining in lymph nodes with Hodgkin's disease. These relatively large, multipolar, mononuclear cells were often found in the immediate vicinity of malignant Hodgkin's cells. Intensive characterization of these cells carried out by immunofluorescent and enzymecytochemical techniques in double- and triple-labelling systems on the same sections clearly demonstrated that they represent tumour-associated macrophages (TAMs). FXIII containing-cells showed alpha-naphtyl acetate esterase (ANAE) positivity, and were labelled by monoclonal anti-Leu M3 antibody, a monocyte/macrophage marker, but not at all or only very weakly by anti-HLA-DR. Neither alkaline phosphatase (ALP) nor adenosine triphosphatase (ATPase) activity could be detected in these cells and surprisingly, they were consistently negative for acid phosphatase (AcP) as well. The presence of FXIII subunit a in tumour-associated macrophages suggests that this cell type might have an important role in the stabilization of fibrin deposits around tumour cells. PMID- 3555590 TI - Haematological toxicity of carboplatin in rats. AB - In rats a maximal tolerated dose of carboplatin (60 mg kg-1, i.v.) caused severe anaemia, leucopenia and thrombocytopenia. These indices of haematological toxicity were also observed with a maximal tolerated dose of cis-platin (6.5 mg kg-1, i.v.), but reductions in blood cell counts were less than those observed with carboplatin. Anaemia was deduced to be the dose-limiting toxicity of carboplatin, since red cell transfusions afforded protection to rats receiving a lethal dose of this compound (80 mg kg-1, i.v.). Anaemia did not appear to be due to an increase in the susceptibility of cis-platin- or carboplatin-exposed red cells to lysis, as concluded from results of osmotic fragility tests. These red cells, when tagged with 51Cr, also did not exhibit reductions in survival time. Administration of 51Cr-labelled control red cells to rats, which had been treated with carboplatin 3 days earlier, resulted in substantial loss of the radiolabel from the circulation, indicating that internal haemorrhaging, as a result of thrombocytopenia, is probably the principle cause of drug-induced anaemia. PMID- 3555592 TI - Preparation of viable single cell suspensions of tracheal epithelial cells. AB - This paper reports a procedure used for isolating the entire epithelial lining of the rat trachea. Isolated trachea was initially filled with 0.2% hyaluronidase and incubated at 37 degrees C for 30 min. Tracheas were flushed with medium and then reinflated with 0.5 microgram/ml cytochalasin B and re-incubated for 60 min. The tracheal lumens were again flushed and reinstilled with 24 iu/ml pronase and incubated for a further 30 min. The tracheas were flushed again and the cells removed enumerated and viability assessed by trypan blue dye exclusion. Cell yields (X 10(6)) from 30 consecutive Fischer 344 rats were 5.06 +/- 0.16 (s.e.m.) and the mean percentage of viable cells was 83.13 +/- 1.10 (s.e.m.). This cell yield was close to the estimated tracheal cell population (5.3 X 10(6)). The suspensions were predominantly single cells which apparently retained a normal ultrastructural appearance. PMID- 3555593 TI - Relationship between blood pressure level, renal histopathological lesions and plasma renin activity in fawn-hooded rats. AB - The fawn-hooded rat (FH rat) develops hypertension accompanied with focal and segmental glomerulosclerosis and proteinuria, resulting in premature death. In a first experiment the relationship between renal lesions and blood pressure at various ages was investigated. In a second experiment blood pressure was measured weekly from 10 to 38 weeks of age in a number of male FH rats, followed by examination of renal tissues at 40 weeks of age. Plasma renin activity (PRA) had also been determined in individual FH rats. FH rats aged 4.5 weeks had no renal morphological abnormalities. The severity of the glomerulosclerosis increased with age and showed a positive relationship with blood pressure. The scores of the proteinaceous tubular casts also increased with age and they, too, showed a positive correlation with blood pressure. The severity of glomerulosclerosis and proteinaceous casts at 40 weeks of age was related positively to the course of blood pressure throughout life. The final blood pressure level showed a positive correlation with final PRA values. Only FH rats with malignant nephrosclerosis had high PRA values. The renal glomerular and vascular lesions in the FH rat, most likely caused by the hypertension, progressively deteriorate to malignant nephrosclerosis. At that stage PRA values are increased and may be contributing to the development of renal vascular lesions and acceleration of the hypertension. PMID- 3555594 TI - Delayed toxicity of cyclophosphamide in normal mice. AB - Delayed toxicity of a single dose of 300 mg/kg cyclophosphamide (CP) was investigated in female DBA/2 mice. Lethality was low up to 30 days but increased markedly afterwards reaching a peak of 50% between 50-70 days with a total mortality of more than 80% by day 120 after CP. One week before death, the mice suffered a sharp loss of weight and showed typical signs of wasting disease. There was a decrease in the white cell count and lymphocyte neutrophil ratio was reversed as a result of lymphocyte depletion whereas neutrophil count remained similar to the controls. Profound lymphocyte depletion was also observed in light and electron microscopy preparations of thymus from mice with CP-induced wasting disease. Histochemical methods demonstrated increased activity of four lysosomal enzymes, acid phosphatase, beta-glucuronidase, E600 resistant esterase and n acetyl-beta-glucosaminidase, in the thymus of treated mice. Acid phosphatase was notably active in thymus epithelial cells; the reaction product was localized in multiple primary Golgi lysosomes, Golgi cisternae, cisternae of the endoplasmic reticulum, and secondary lysosomes. The appearance of numerous cystic formations, as well as the activation of the lysosomal system and the presence of large areas of degradation support the assumption that CP-delayed toxicity is accompanied by thymus involution. Delayed mortality was partially prevented when syngenic bone marrow cells were injected as early as 24 h after CP injection. On the other hand thymus transplants were incapable of reducing delayed lethality. It is suggested that CP provokes a delayed wasting syndrome with thymic involution that is not caused by a direct effect on specific thymus structures but rather secondary to a primary injury to pre T cells in bone marrow. PMID- 3555595 TI - A comparison of liver ultrasound with liver biopsy histology in psoriatics receiving long-term methotrexate therapy. AB - A comparison of liver ultrasound and liver biopsy histology was made on 54 paired investigations from 28 patients about to receive or already receiving methotrexate for severe psoriasis. Ultrasound scans were reported as normal, or abnormal showing either fatty change or fibrosis. Eighteen of the scans were reported as normal and in no instance did the simultaneously-obtained liver biopsy show significant fibrosis. Thirty-one of the scans were reported as showing fatty change without fibrosis; in 12 cases the liver histology showed mild but significant fibrosis and in four cases fibrosis was of sufficient severity to necessitate methotrexate withdrawal. Five of the scans were reported as showing fibrosis and in all the biopsy showed significant fibrosis. This was of sufficient degree to necessitate methotrexate withdrawal in two cases. No patient with a normal ultrasound scan showed significant fibrosis and thus we concluded that such patients may be spared liver biopsy and safely continue with methotrexate therapy. Ultrasound cannot reliably distinguish between fatty change and fibrosis, so all patients with abnormal scans require liver biopsy. PMID- 3555596 TI - Prophylactic PUVA and UVB therapy in polymorphic light eruption--a controlled trial. AB - A double-blind controlled trial of low-dose prophylactic oral psoralen photochemotherapy (PUVA) and ultraviolet-B (UVB) irradiation therapy was undertaken from April to September 1983 in 42 patients with polymorphic light eruption (PLE). Patients were randomly allocated to three groups, PUVA with oral 8-methoxypsoralen (8-MOP), UVB with oral placebo, and control low-dose UVA with oral placebo. The initial dose given to each active treatment group was a third of the predetermined minimal phototoxic or erythema dose, followed three times weekly for 6 weeks by doses incremented by an eighth on each occasion in the PUVA group and by a seventh in the UVB group. Ultraviolet radiation exposure was monitored throughout with polysulphone film lapel badges. Patients recorded their symptoms on a visual analogue scale. Symptoms of rash and itch in patients treated with PUVA and UVB were significantly less affected by increasing exposure to ultraviolet radiation than were these symptoms in control patients. PMID- 3555597 TI - Topical chemotherapy of actinic keratoses of the upper extremity with tretinoin and 5-fluorouracil: a double-blind controlled study. AB - In a randomized double-blind controlled study, 19 patients applied 5% 5 fluorouracil (5-FU) cream to actinic keratoses (AK) on each arm twice daily, followed by nightly application of 0.05% tretinoin cream to one arm, and a control cream to the other arm until discomfort precluded further applications. After 3 months, the number of residual AK was compared to pre-treatment values. The tretinoin-treated arms had 15.7 +/- 6.1 AK before treatment and 3.4 +/- 2.6 AK following therapy. The control arms had 15.3 +/- 6.9 AK before therapy and 4.2 +/- 2.5 lesions afterwards. Using a one-tailed paired t-test, the difference in response was statistically significant (0.03 less than P less than 0.04). It was concluded that daily application of 0.05% tretinoin cream appeared to enhance the efficacy of topical 5-FU in destruction of AK of the arms and may represent a useful treatment modality. PMID- 3555598 TI - Beneficial effects of danazol on symptoms and laboratory changes in cholinergic urticaria. AB - In a double-blind placebo-controlled study, danazol, an attenuated androgen, was effective in reducing exercise-induced weals in cholinergic urticaria. Danazol treatment also caused significant elevations of several protease inhibitors, particularly antichymotrypsin which has been reported previously to be low in cholinergic urticaria. PMID- 3555599 TI - Adult linear IgA bullous dermatosis with bronchial involvement. AB - A 54-year-old man is described, suffering from adult linear IgA bullous dermatosis with involvement of the bronchial mucosa. The main respiratory symptoms were recurring haemoptysis, episodic narrowing of the airways and persistent non-specific bronchial hyperreactivity. On CT scan the trachea had a saber-sheath shape with tracheal ring calcification. Endoscopically the tracheo bronchial mucosa was diffusely purpuric and hyperaemic and also showed pale elevated plaques, bullous lesions and ulceration. Histological examination of biopsies of skin and nasal and tracheo-bronchial mucosa showed subepithelial blister formation associated with an accumulation of polymorphonuclear cells at the epithelial-subepithelial junction, and linear IgA deposits on direct immunofluorescence. PMID- 3555600 TI - Graft rejection after T-cell depleted marrow transplantation: role of fractionated irradiation. PMID- 3555601 TI - Haemopoietic recovery from Ph1 positive chronic granulocytic leukemia. PMID- 3555602 TI - Circulatory changes in the fetal aorta after maternal smoking. AB - The acute cardiovascular responses of the human fetus to maternal smoking of one cigarette were studied in 10 healthy pregnant women. Following maternal smoking, a significant increase was found in the nicotine concentration in maternal plasma accompanied by a significant increase in the fetal heart rate. The flow velocity was recorded in the fetal descending aorta by combining real-time ultrasonography and the 2 MHz pulsed Doppler technique and the waveform of the maximum blood velocity was analysed. The duration of the acceleration part of the pulse cycle (start-to-peak time) remained unchanged during the study period. The least diastolic blood velocity increased significantly after smoking. The pulsatility index fell significantly during the first 5 min after smoking, probably as the consequence of fetal tachycardia, but was normal again at 10 min. The rising slope rose significantly within the first 10 to 20 min after the onset of smoking. The results indicate, that, following maternal smoking of one cigarette, fetal central circulation increases but peripheral resistance is unchanged. PMID- 3555603 TI - Obstetric analgesia and fetal aortic blood flow during labour. AB - Fetal aortic blood flow was studied in 50 women during labour, using a method combining real-time ultrasonography and a pulsed Doppler technique. Eleven women had no analgesia, 24 women received 75-100 mg pethidine intramuscularly, 12 epidural analgesia with 0.25% bupivacaine and three paracervical block with 0.125% bupivacaine. Fetal aortic blood flow increased during labour from 200 to 245 ml/min/kg in the group without analgesia (P less than 0.05) and from 211 to 236 ml/min/kg in the group with epidural analgesia (P less than 0.05) but decreased insignificantly from 216 to 204 ml/min/kg after pethidine. After paracervical block the aortic blood flow fell in two out of three fetuses. Not only is epidural analgesia the most effective means of pain relief during labour, it is also the type of obstetric analgesia that interferes least with the physiological response to labour in terms of its effect on the fetal blood flow. PMID- 3555604 TI - Treatment of hirsutism in polycystic ovary syndrome with bromocriptine. AB - The value of bromocriptine in the treatment of hirsutism in polycystic ovary syndrome (PCO) was assessed subjectively and photographically in a double-blind trial in 22 women studied for 1 year. Menstrual frequency was recorded. Circulating concentrations of oestradiol, oestrone, testosterone, androstenedione, and sex hormone binding globulin (SHBG) were determined before treatment and after 6 and 12 months therapy. On the same occasions gonadotrophin concentrations (mean of 24 samples) and their response to 100 micrograms LHRH were determined. No evidence was found to support a therapeutic role for bromocriptine in the treatment of hirsutism or menstrual regulation in PCO. No biochemical changes were seen specific to bromocriptine therapy. PMID- 3555605 TI - A trial of topical idoxuridine for vulvar condyloma acuminatum. AB - The effect of 0.25% idoxuridine ointment on condyloma acuminatum of the vulva was investigated in a randomized, double-blind, placebo-controlled trial in 24 women. Idoxuridine inhibits DNA synthesis in mammalian cells and is a specific inhibitor of DNA viruses. Of the 24 women with vulvar condyloma acuminatum, 14 applied idoxuridine ointment and 10 a placebo ointment to the lesions twice daily for 2 weeks. In 11 out of 14 patients treated with idoxuridine the condylomata regressed completely. The treatment did not cause any side-effects. None of the women in the placebo group showed regression of the condylomata. Topical idoxuridine therapy is effective and non-toxic; it appears to be most effective for new condylomata. PMID- 3555606 TI - Obstetric and perinatal consequences of human immunodeficiency virus (HIV) infection: a review. PMID- 3555607 TI - Use of soft contact lenses in an eye casualty department for the primary treatment of traumatic corneal abrasions. AB - We have assessed the role of bandage contact lenses in the primary treatment of traumatic corneal abrasions. Patients treated with bandage lenses healed more quickly (0.05 greater than p greater than 0.02) and with less discomfort (0.05 greater than p greater than 0.02) than those treated traditionally, with the added advantage of maintaining vision during treatment. Resterilisation of contact lenses reduces the cost and makes the treatment economically viable. Large diameter lenses were fitted satisfactorily without the use of keratometry. PMID- 3555608 TI - Traumatic myopia; an ultrasonographic and clinical study. AB - Three patients with transient myopia following blunt injury are described with the aid of serial ultrasonography. The cause of refractive change is an increase in the anteroposterior thickness of the crystalline lens, which probably results from oedema of the ciliary body. PMID- 3555609 TI - Microbiological diagnosis of suppurative keratitis in Bangladesh. AB - Experience in setting up an inexpensive microbiology laboratory in the Bangladesh National Society for the Blind Eye Hospital and Training Complex at Chittagong is presented, together with the results of a pilot study to identify organisms responsible in 33 consecutive cases of suppurative keratitis in the Chittagong area of Bangladesh. Of the 33 cases 21 were positively identified by means of Gram stain and/or culture. Two-thirds of the responsible organisms were bacteria, and one-third were fungi. The bacterial causes included Streptococcus pneumoniae and Pseudomonas aeruginosa. The fungi isolated were Aspergillus fumigatus, Aspergillus ochraceus, and Fusarium solani. Among the causes of failure to diagnose the organism was chronicity of infection and previous treatment. The value of the study in the planning of future treatment regimens, and the implications of setting up similar relatively cheap microbiology laboratory facilities in developing countries, are discussed. PMID- 3555610 TI - T lymphocytes of the normal human cornea. AB - Lymphocytes in the periphery of the normal human cornea are identified as being only T lymphocytes by immunohistochemical methods. OKT-4 positive cells (T helper/inducer lymphocytes) and OKT-8 positive cells (T-suppressor/cytotoxic lymphocytes) are found in similar numbers in most of the corneas examined. OKT-4 positive cells in the cornea present a risk of transferring HTLV-III (HIV) by corneal grafting. PMID- 3555611 TI - Biological reconstruction of the mandibular condyle. AB - It is proposed in the scientific literature that the costochondral graft is the most suitable method for reconstruction of the mandibular condyle. Success is demonstrated by function and continued growth. Creeping substitution of osteoid does not compromise the osteochondral graft. In many species cartilage autografts survive and grow despite the absence of perichondrium and synovial membrane. These studies emphasise the importance of transferring only a thin cartilage cap on an osteochondral graft for optimum survival of cartilage cells. Many experiments involving metatarsals or ephiphyseal heads have failed to reproduce the cartilaginous cap found in the normal condyle. Despite evidence from animal studies, there is human experience of the unpredictability of costochondral grafts. Much remains to be evaluated, in animal model systems comparable with man, before optimum joint replacement can be assured in the treatment of those with congenital and acquired deformities of the condyle. PMID- 3555612 TI - Medical versus surgical management of temporomandibular joint pain and dysfunction. AB - Most patients with temporomandibular joint pain and dysfunction have a history of stress and pains elsewhere in the body. These patients become symptom free in response to reassurance and a course of tricyclic antidepressant drug therapy when used as a muscle relaxant and central analgesic. Some however, will benefit from psychiatric help. A smaller proportion have secondary joint disturbances requiring surgery. PMID- 3555613 TI - Surgery of the non-ankylosed temporomandibular joint. AB - Apart form the sequelae of acute trauma and ankylosis, the principal conditions affecting the temporomandibular joint for which surgery may be required are condylar hyperplasia, recurrent dislocation, internal derangement and degenerative joint disease. The indications for and techniques of surgery for these conditions are reviewed, and the results of a small survey conducted in the West Midlands are presented. PMID- 3555614 TI - The effects of differing etch times on the etch pattern on enamel of unerupted and erupted human teeth examined using the scanning electron microscope. AB - The etch pattern produced on enamel from unerupted and erupted human teeth with varying periods of acid etching using 37 per cent phosphoric acid was examined using a scanning electron microscope. For erupted enamel etch scores were fairly consistent above 10 seconds etching, for unerupted enamel etch scores matched those for erupted enamel for etch times above 30 seconds. The etch type was more consistent on unerupted enamel. PMID- 3555615 TI - Iatrogenic root resorption of upper first permanent molars associated with orthodontic treatment. Report of a case. AB - A case of severe resorption of the roots of upper first molars, associated with second molar impaction, is reported. The possible causes of this condition, which occurred as a complication of rapid maxillary expansion and distal movement of the first molars, are discussed. PMID- 3555616 TI - A solution to the orthodontic and surgical management of unerupted teeth. PMID- 3555617 TI - Cytochrome pools in membranes of Escherichia coli grown aerobically on L-proline. AB - The cytochromes of membranes of the cydA mutant Escherichia coli GR19N grown on a proline-amino acid medium were examined. Reduced minus oxidized difference spectra (including fourth-order finite difference spectra) showed that cytochromes with absorption maxima at 554-555, 556-557, 560-561.5 and 563.5-564.5 nm were present. In addition, there were two components with absorption maxima at 548.5 and 551.5 nm which made a minor contribution to the alpha-band absorbance. These were not examined further. Two pools within the cytochromes were detected. One pool, which was reduced rapidly by the substrates NADH, formate and succinate, consisted of cytochromes of the cytochrome o complex. These cytochromes had absorption maxima at 555, 557 and 563.5 nm. In addition, the low potential cytochrome associated with formate dehydrogenase was reduced rapidly by formate, and a component absorbing at 560-561.5 nm was also present in this pool. The second pool of cytochromes was reduced more slowly by substrate, although the rate was accelerated greatly in the presence of the electron mediator phenazine methosulfate. These cytochromes absorbed maximally at about 556.5 nm. A portion of the cytochrome in this pool was reoxidized by fumarate. This cytochrome may be a component of the fumarate reductase pathway, since the membranes showed high NADH-fumarate reductase activity. The respiratory chain inhibitor 2-n-heptyl-4 hydroxyquinoline N-oxide appeared to act at two sites. One site of inhibition was between the dehydrogenases and the cytochromes. A second site of inhibition was located in the cytochrome o complex between cytochrome b-564 and oxygen. PMID- 3555618 TI - The plasma membrane of yeast protoplasts exposed to hypotonicity becomes porous but does not disintegrate in the presence of protons or polyvalent cations. AB - Protoplasts of Saccharomyces cerevisiae swelled, lysed and disintegrated when exposed to hypotonic solutions at neutral pH. At pH 4.5 or lower the hypotonically treated protoplasts did not disintegrate and they retained their intracellular proteins, nucleic acids and nucleotides. However, they became leaky for K+ and Ca2+, indicating that pores had been created in the surface membrane, relaxing the osmotic stress. Upon readjustment of pH to neutral, the hypotonically treated protoplasts released the intracellular content and disintegrated. Also, at low pH, protoplasts did not swell in isotonic ammonium acetate and were refractory to the permeabilizing effect of nystatin and to lysis with low concentrations of detergents. Protoplasts were similarly protected against lysis and disintegration by hypotonic treatment or by detergents, even at neutral pH, if the incubation media contained polyvalent cations, especially Zn2+, La3+, spermine, and Ca2+ chelated with EDTA. The protoplasts exposed to hypotonic stress at low pH did not respire and could not regenerate into viable cells. Effects of H+ and polyvalent cations on intramembrane forces acting between molecules of membrane phospholipids are considered along with possible changes in interactions between membrane proteins. PMID- 3555620 TI - Conformational changes of F-actin in myosin-free ghost single fibre induced by either phosphorylated or dephosphorylated heavy meromyosin. AB - The changes in F-actin conformation of myosin-free single ghost fibre induced by binding of phosphorylated or dephosphorylated heavy meromyosin have been studied by measuring polarized fluorescence of F-actin intrinsic tryptophan and of phalloidin-rhodamine bound to F-actin. The changes of polarization of both fluorescences were found to be dependent on low or high Ca2+ concentration and on the phosphorylated or dephosphorylated form of heavy meromyosin. Computer analysis of polarized fluorescence has shown that binding of phosphorylated heavy meromyosin with divalent ion binding sites saturated with Mg2 (in the presence of 1 mM MgCl2 and 1 mM EGTA) and dephosphorylated heavy meromyosin with divalent ion binding sites saturated with Ca2+ (in the presence of 1 mM MgCl2 and 0.1 mM Ca2+) decreases the angles of emission and absorption dipoles and the angle between the F-actin axis and the fibre axis, thus suggesting that F-actin in ghost fibre becomes more flexible. On the other hand, the above-mentioned angles increase when phosphorylated heavy meromyosin at high and dephosphorylated heavy meromyosin at low Ca2+ concentration were bound to thin filaments, thus showing the decrease of F-actin flexibility under these conditions. PMID- 3555619 TI - The interaction of the trp repressor from Escherichia coli with the trp operator. AB - We have examined the interaction of the trp repressor from Escherichia coli with a 20 base-pair synthetic operator. Nonspecific binding was relatively strong (Kd = 2 microM), but only weakly sensitive to the concentration of added salt [d log Kd)/(d log [Na]) = -1). 1H-NMR studies indicate that the structure of the repressor is not greatly altered on forming the complex, and that few if any of the lysine and arginine residues make direct contact with the DNA. However, the mobility of one of the two tyrosine residues is significantly decreased in the complex. The repressor makes close contact with the major grooves of the operator such that the base protons are broadened much more than expected on the basis of increased correlation time. There are large, differential changes in chemical shifts of the imino protons on forming the complex, as well as changes in the rate constants for exchange. The fraying of the ends is greatly diminished, consistent with a target size of about 20 base-pairs. The effects of the repressor on the NMR spectra and relaxation rate constants can be interpreted as a change in the conformation of the operator, possibly a kinking in the centre of the molecule. PMID- 3555621 TI - Comparative enzymatic studies of human renin acting on pure natural or synthetic substrates. AB - Some of the essential structural requirements for the enzymatic reaction of pure human renin acting on pure human and rat angiotensinogen and on their synthetic tetradecapeptide substrates were investigated. The five carboxy terminal amino acids of synthetic tetradecapeptides played a significant role in substrate recognition and/or hydrolysis by human renin. Kinetic constants Km, Kcat and kcat/Km of the various human renin assays were different according to the substrate used. The presence of either an asparagine or a threonine residue in the S'4 renin subsite did not affect significantly the kinetic constant values. A tyrosine residue, rather than a histidine residue, in the S'3 renin subsite gave the best synthetic substrate studied. When tyrosine residue was present in the S'2 renin subsite an important decrease in kcat was observed. Human angiotensinogen was hydrolysed by human renin with lower Km and kcat values than those measured with human and porcine synthetic substrates, suggesting that the 3 dimensional structure of human angiotensinogen plays a key role in the hydrolysis. This finding was supported by assays performed with rat angiotensinogen, which was cleared by human renin with the same kcat value as rat tetradecapeptide, but with a 49-fold lower Km. Between human and rat angiotensinogen a kcat/Km value of only 2-fold higher has been found in the renin assay using human substrate. PMID- 3555622 TI - Isolation and sequencing of alpha-tubulin peptides from myxamoebae of the slime mould Physarum polycephalum. AB - Starting from only 5.9 mg of alpha-tubulin from myxamoebae of the slime mould Physarum polycephalum, we have isolated and sequenced peptides that account for 96% of the complete sequence. The peptides were generated by digestion of alpha tubulin with trypsin, Staphylococcus aureus protease and cyanogen bromide. They were then separated according to size on a TSK G2000 SW column using a 10 mM ammonium acetate buffer at pH 6.8. In addition to good peptide separations, a time-consuming desalting step with subsequent loss of material was unnecessary because the relatively small amount of ammonium acetate could be removed by lyophilization. High resolution of peptides from the TSK fractions was achieved on C4 or C18 reverse-phase columns by eluting with a gradient of acetonitrile in 50 mM ammonium acetate (pH 6.8) and in 0.1% trifluoroacetic acid, respectively. The peptides were then sequenced using a gas phase sequencer. PMID- 3555623 TI - Reevaluation of citrate lyase from Escherichia coli. AB - The subunit structure of citrate lyase from Escherichia coli was shown to be similar to that of all other lyases investigated so far. The three different subunits with molecular masses of 55.5 kDa, (large subunit) 35 kDa (medium-sized subunit) and 12.5 kDa (small subunit, acyl carrier protein) occurred in a ratio of 1:1:1. Using high-pressure liquid chromatography, it was possible to demonstrate that the reported large acyl carrier protein, with a molecular mass of 85 kDa was a contaminating protein associated with citrate lyase multienzyme complex; it could be removed by anion-exchange chromatography with Q-Sepharose. The typical two configurations of citrate lyase, the 'star' form and the 'ring' form with a diameter of 14.3 nm and 15.4 nm, respectively, could be detected by electron microscopy. PMID- 3555625 TI - [Detection of a system of microsomal monooxygenases in the rodent malaria parasite Plasmodium berghei]. AB - A microsomal fraction from the cells of the malaria parasite of rodent Plasmodium berghei was obtained. The spectral properties of microsomal preparations suggest that P. berghei microsomes contain cytochromes b5 and P-420. Electrophoretic separation of microsomal proteins revealed the presence of proteins whose molecular mass corresponds to NADPH-cytochrome c reductase, cytochrome P-450 and epoxide hydratase. The activities of NADPH-cytochrome c reductase and benzpyrene hydroxylase were determined. The spectral parameters, electrophoretic data and enzymatic activities of microsomal proteins indicate that P. berghei cells contain a cytochrome P-450 monooxygenase system. The interrelationship between the activity of the microsomal monooxygenase system and the resistance of P. berghei cells to the antimalaria preparation chloroquine is discussed. PMID- 3555624 TI - Purification of nonspecific lipid transfer protein (sterol carrier protein 2) from human liver and its deficiency in livers from patients with cerebro-hepato renal (Zellweger) syndrome. AB - The nonspecific lipid transfer protein (i.e., sterol carrier protein 2) from human liver was purified to homogeneity using ammonium sulfate precipitation, CM cellulose chromatography, molecular sieve chromatography and fast protein liquid chromatography. Its amino acid composition was determined and found to be very similar to that of the nonspecific lipid transfer protein from bovine and rat liver with, as main feature, the absence of arginine, histidine and tyrosine. By way of a specific enzyme immunoassay using affinity-purified antibodies, the levels of nonspecific lipid transfer protein were determined in human livers. Levels varied from approximately 150 ng nonspecific lipid transfer protein per mg 105,000 X g supernatant protein for juvenile and adult humans to 40 ng per mg supernatant protein for a young infant. Levels of nonspecific lipid transfer protein in livers of infants with cerebro-hepato-renal (Zellweger) syndrome were extremely low (i.e., 2 ng per mg supernatant protein). Immunoblotting revealed the presence of crossreactive proteins of molecular masses of 40,000 and 58,000. The 40 kDa and 58 kDa proteins occurred in control livers, whereas only the 40 kDa protein was present in Zellweger livers. As in rat the 58 kDa protein could be demonstrated in a peroxisomal preparation isolated from an adult liver. A possible link between the occurrence of nonspecific lipid transfer protein and the presence of peroxisomes is discussed. PMID- 3555626 TI - [Allergenic mites (Acariformes, Pyroglyphidae) in house dust]. AB - Paper is the second part of the literature review on house dust mites (including 1985). It deals with the diagnosis of the dust mite allergy, the nature of the mite allergens, distribution and population density of the mites in various premises, seasonal population dynamics and population age structure of the dermatophagoid mites, life cycle and breeding of Dermatophagoides pteronyssinus and D. farinae on different food substrates. The methods of the house dust mite control are discussed. The original data on the house dust mite distribution in Moscow is shown. A comparative estimation of the results of mite antigens in the house dust discovering by the acarological and three immunological methods are given. PMID- 3555627 TI - A controlled trial of methylene blue in severe depressive illness. AB - Methylene blue, 15 mg/day, was compared with placebo in treatment of severe depressive illness. The 3-week trial was designed to avoid bias by placebo response and also to avoid observer bias. Improvement in patients receiving methylene blue was significantly greater than in those receiving placebo. Methylene blue at a dose of 15 mg/day appears to be a potent antidepressant, and further clinical evaluation is essential. PMID- 3555628 TI - Peripherally detectable hormones--their relation to the increased uterine activity during standing in pregnant women. AB - Two-thirds of women in late pregnancy in standing position show marked cyclic accelerations in heart rate with concomitant increase in the uterine activity. As the regulating mechanism of these contractions has not been investigated the aim of the present study is to see if variations in the concentrations of peripheral venous circulating hormones could account for the accelerations of the heart rate and the uterine contractions. In four healthy pregnant women, 25 to 27 years old and in the 33rd-38th weeks of gestation, and in three healthy nonpregnant women, 29 to 30 years old, venous blood was intermittently collected from a cubital vein. The women were investigated in the left lateral as well as in the standing postures. The plasma concentrations of norepinephrine (NE), prostaglandin E2(PGE2), prostaglandin F2 alpha (PGF2 alpha), 6-k-prostaglandin F1 alpha (6-k PGF1 alpha) thromboxane B2 (TxB2), aldosterone (A), and the plasma renin activity (PRA) were measured by specific and sensitive assays. Significant differences in level and dynamics of the various substances were found between pregnant and nonpregnant subjects. However, no correlation could be found between the fluctuations in the concentration of hormones and heart rate accelerations and the occurrence of uterine contractions, respectively. Local changes of these substances in the uterus may not be reflected in the peripheral venous blood. Therefore our measurements can neither prove nor disprove the hypothesis that these hormonal substances are involved in the regulatory mechanism of uterine contractions occurring in standing. PMID- 3555629 TI - Effect of 6-methoxybenzoxazolinone on sex ratio and breeding performance in Microtus montanus. AB - The plant derivative, 6-mathoxybenzoxazolinone (6-MBOA), which has been demonstrated to initiate reproduction in field populations of the montane meadow vole (Microtus montanus), was administered via feeding or Silastic capsule implants to mated pairs of laboratory bred M. montanus. The animals remained paired for 120 days, and the number, size, and sex ratios of the resulting litters were recorded. Both the size and frequency of litters were significantly greater in 6-MBOA-treated pairs than in controls. By using implants, it was possible to treat one or both sexes in a mated pair. The positive effects of this compound on litter size and number of litters occurred when the females received implants, which indicates that the male has no influence on these parameters. The most unusual result of these experiments was that 6-MBOA has a significant effect on the sex ratio of the litters. Animals receiving 6-MBOA produced significantly more females than did control pairs. This result occurred regardless of the method of administration, and in the case of the implant studies, regardless of which sex received the active implants. These findings are discussed in relation to the ecology and life history strategy of Microtus montanus. PMID- 3555630 TI - Ultrasonographic assessment of the endometrium in rhesus monkeys during the normal menstrual cycle. AB - This study was undertaken to determine whether cyclical changes in the endometrium of the rhesus monkey could be observed by using ultrasound. Three indices of endometrial size were examined: the antero-posterior (or ventro dorsal), longitudinal, and transverse diameters. Changes in the ultrasonic reflectivity of the endometrium were also assessed. We have attempted to correlate these endometrial parameters with the hormonal status of the animal. Ultrasonography was performed for an average of 12 consecutive days during 19 menstrual cycles. All ultrasonic recordings were normalized to the day of the estradiol (E2) peak (Day 0). We found that the reflectivity of the endometrium was dependent on the stage of the cycle: during the follicular phase, the endometrium appeared less echogenic (darker) compared to the myometrium; in the luteal phase, the endometrium was more echogenic (lighter). During the follicular phase (Days -9 to 0), there was a linear increase in the antero-posterior (p less than 0.001), longitudinal (p less than 0.05), and transverse (p less than 0.001) diameters. In the luteal phase (Days 1-15), no significant changes were observed in these diameters. An estimated endometrial volume (EEV) was obtained by the product of the antero-posterior, longitudinal, and transverse diameters. Each animal observed during the follicular phase (n = 14) exhibited a peak in the EEV, which correlated with the day of the E2 peak (p less than 0.01). From this study, we conclude that the sonographic appearance of the endometrium of the rhesus monkey reflects the cyclical changes that occur during the menstrual cycle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555631 TI - A protease activity is associated with testicular chromatin of the mouse. AB - A protease activity associated with the micrococcal nuclease-solubilized chromatin from mouse seminiferous tubules has been characterized. Proteolysis of histone H1 and core histones is stimulated in the presence of 3 M urea. The pH optimum of this protease is between pH 8 and 9, and the activity is not inhibited by trypsin or chymotrypsin-active site inhibitors. Leupeptin is an effective inhibitor of the protease at low concentrations. Soluble chromatin from neonatal and prepubertal mice lacks this proteolytic activity until three to four weeks after birth. That the protease activity is localized in the dinucleosomes and higher oligomers but is lacking in mononucleosome populations suggests its association with the linker DNA. Rat testis-soluble chromatin apparently lacks such a protease activity. The developmental expression of this protease and its in situ localization are consistent with a role in histone displacement during mouse spermiogenesis. PMID- 3555632 TI - Tissue response to potential neuroprosthetic materials implanted subdurally. AB - A histologic study was made of the response of the leptomeninges and underlying cerebral cortex of the cat to subdural implantation of 3 insulating materials (HR605-P, Parylene-C and PI-2555) and a polymeric electrode component (MMA/MAPTAC) for periods of 8 and 16 wk. The tissue reactions were compared with those elicited by the arrays of Dacron mesh matrices, pure platinum controls and by positive controls (Ag-AgCl) known to cause reactions in the brain. Sites beneath the Dacron mesh matrix, pure platinum control implants and beneath all insulating materials implanted for 8 and 16 wk appeared indistinguishable, exhibiting little tissue reaction. All neurons appeared normal. The leptomeninges and cortex beneath the Ag-AgCl implants showed a chronic inflammatory reaction after 8 and 16 wk. Despite varying amounts of oedema, gliosis and ingrowth of connective tissue in the molecular layer, virtually all underlying neurons appeared normal. PMID- 3555633 TI - Studies of the ocular compatibility of hydrogels. A review of the clinical manifestations of spoilation. AB - The range and nature of the various clinical manifestations of hydrogel contact lens spoilations are considered. An indication of the present view of the occurrence, chemical composition and potential aetiology for discrete elevated deposits, organic and inorganic surface films, plaques and granular deposits, microbial spoilation, lens discoloration and other extrinsic factors is provided. The literature is principally concerned with the clinical manifestations of spoilation and most observations have been made on lenses that have become so severely spoiled as to be unwearable. No serious attempt has yet been made to identify those tear species responsible for the development of the various types of deposits or of the effects of variations in the bulk and lens chemistry, and also wear protocols on the formation of deposits. PMID- 3555634 TI - Age-related alterations in human chromosome composition and DNA content in vitro during senescence. PMID- 3555635 TI - Biopolymers and biotechnology. A symposium in honor of Professor Ephraim Katzir's 70th birthday. May 18-22, 1986, Ramat Aviv, Israel. Proceedings. PMID- 3555636 TI - Posttranslational modification as a means of anchoring acetylcholinesterase to the cell surface. PMID- 3555637 TI - [Hamao Umezawa]. PMID- 3555638 TI - Simultaneous detection in the bone marrow of mammary cancer metastatic cells and of their labelling index as respective markers of the residual minimum submacroscopic disease and its proliferative condition (preliminary results). AB - A study of 200 patients with breast cancer carcinoma at different stages of the disease, was carried out for detecting in their bone marrow, mammary cells and their proliferative condition using a double labelling method with two types of monoclonal antibodies. The mammary cells were visualised with monoclonal antibodies raised against human breast epithelium and/or carcinoma. DNA synthetising cells (in S phase) were detected on the same slide, using a monoclonal antibody directed against an antigen associated with bromodeoxyuridine (BrdU) after cell incubation with BrdU. Mammary cells could be detected in the bone marrow of 13 out of 20 cases presenting macroscopically visible metastasis, 12 out of 20 patients at diagnosis of their disease, 90 out of 160 patients in apparent disease free condition. The labelling index was 6/13, 6/12 and 45/90 in those respective three groups of patients. The similarity of these three groups for both parameters suggests that the fate of breast carcinoma patients and their prognosis in three types (++, +-, --) is carried from the beginning of the disease. We have, with Eriguchi shown that the mammary (and other) cancer patients survival exponential curves do not express homogeneous populations but are in fact composed of three segments, the first with a rapid slope represents the acute type patients, at high risk of early relapse, the second, with a slow slope, represents the chronic type patients at risk of late relapse and the third, the slope of which is parallel to the general population life expectancy, represents the so called "cured patient".(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555639 TI - The AIDS combat: a survey. AB - The Acquired Immune Deficiency Syndrome is one of the most challenging problems of medical sciences in the last decade, because it is a completely new disease, which appears to be inevitably fatal. Although much effort has been put in the development of therapeutic and prophylactic methods ever since the recognition of this new disease, efficient methods are still lacking, causing the number of victims to rise continuously. In this article I review the progress that has been made in the development of various prophylactic and therapeutic approaches by which science is trying to defeat AIDS. It includes anti-viral drug therapy, reconstitution of the immune system, vaccine development and a few alternative approaches to AIDS therapy. PMID- 3555640 TI - Glucose-induced reduction of the sodium content in beta-cell-rich pancreatic islets. AB - The sodium contents of beta-cell-rich pancreatic islets from ob/ob-mice were measured with an integrating flame photometer. After washing to an apparent steady state with different types of ice-cold media, islets incubated in the absence of glucose contained 79-108 mmol sodium kg-1 dry weight. Exposure to glucose resulted in 25% reduction of the islet content of sodium. This effect became manifest in the presence of 5 mM glucose, there being no additional reduction with a further increase of glucose to 20 mM. Depression of Na+ activity may partially explain why glucose, under certain conditions, can lower cytoplasmic Ca2+ and even inhibit insulin release. PMID- 3555641 TI - Nobel lecture. Epidermal growth factor. PMID- 3555642 TI - Discrimination between M2 and M4 antimitochondrial antibodies in primary biliary cirrhosis. AB - 10 sera were studied from patients with primary biliary cirrhosis (PBC), that were anomalous in their reactivity against mitochondrial antigens as detected by Western blotting. They had low reactivity against the major, M2 reactive antigen (Mr for beef heart mitochondria, 74 Kd) but reacted against an antigen of Mr 52 Kd (species independent) which was apparently inaccessible in submitochondrial particles (SMP) on ELISA and which was not present in chloroform-released ATPase preparations. In all respects this differed from the characteristics of the M2 antigens and it is concluded that these sera are detecting predominantly the M4 reactive antigen. PMID- 3555643 TI - A multidisciplinary committee approach to prenatal diagnosis and management of fetuses with congenital anomalies. PMID- 3555644 TI - Antenatal diagnosis of skeletal dysplasia using ultrasound. PMID- 3555645 TI - Management of the fetus with urinary tract dilatation. AB - This report describes our experience with 18 pregnant women who presented to our center with suspected fetal urinary tract dilatation. The patients were divided into 4 groups: group I had unilateral fetal urinary tract dilatation and normal amniotic fluid volume, group II had bilateral dilatation and normal amniotic fluid volume, group III had bilateral dilatation and oligohydramnios, group IV had nonurinary tract malformations in addition to urinary tract dilatation. Patients with normal amniotic fluid volume and either unilateral or bilateral fetal dilatation (groups I and II) had a good pregnancy outcome. Patients with oligohydramnios and bilateral dilatation had a poor pregnancy outcome. No intrauterine surgery or shunting was performed in any of the patients. The initial diagnosis of urinary tract dilatation led to the prenatal diagnosis of major nonurologic malformations (group IV) in 3 patients who also had a poor outcome. An algorithm is presented that reflects our experience with the management of these patients and could serve as a guide for others caring for similar patients. PMID- 3555646 TI - Nonimmunologic hydrops fetalis due to intrauterine closure of fetal foramen ovale. PMID- 3555647 TI - Acute myelogenous leukemia: recent advances in therapy. AB - Results of treatment of AML have improved over the last decade. With modern remission induction chemotherapy, most patients achieve complete remission. The median remission duration is now 1 to 2 years, and a substantial fraction of patients achieve long-term disease-free survival. Bone marrow transplantation provides an improved antileukemic effect compared with chemotherapy alone, and it is the treatment of choice for selected groups of patients. The major limitation is the risk of transplant-related mortality. Most patients are not currently eligible for bone marrow transplants because of advanced age or lack of a histocompatible donor. Autologous marrow transplantation may be effective in selected setting, but this remains investigational at present. Substantial improvement in results of treatment of AML requires the development of new and effective chemotherapeutic agents that are non-cross-resistant with available drugs. Results of bone marrow transplantation may substantially improve if innovative measures to prevent major complications are successful. PMID- 3555648 TI - Intermediate lymphocytic lymphoma: immunophenotypic and cytogenetic findings. AB - A detailed immunohistologic and cytogenetic analysis of 12 cases of intermediate lymphocytic lymphoma was performed. The characteristic immunophenotype of intermediate lymphocytic lymphoma was: surface IgM and IgD+, BA1+, B1+, BA2-, B2 , B4+, Leu 14+, Leu 1+, HLA-DR+, and common acute lymphocytic leukemia associated (CALLA) antigen negative. Clonal chromosome abnormalities were identified in ten cases, with structural or numerical abnormalities of chromosomes 11 or 12 in nine cases. Five cases had structural abnormalities involving the long arm of chromosome 11; three of these had translocations with chromosome 14 at band q32. Three cases had trisomy 12, and one case had a translocation involving the long arm of chromosome 12. The tenth case had a translocation involving the long arms of chromosomes 7 and 9. These characteristic immunophenotypic and cytogenetic findings suggest a close lineage relationship between intermediate lymphocytic lymphoma and small lymphocytic (well differentiated) lymphoma/chronic lymphocytic leukemia. Their differing clinical, cytologic, and architectural features suggest, however, that intermediate lymphocytic lymphoma should be considered a separate category of lymphocytic lymphoma in the International Working Formulation. PMID- 3555649 TI - Deficiency of leukocyte surface glycoproteins Mo1, LFA-1, and Leu M5 in a dog with recurrent bacterial infections: an animal model. AB - A dog with severe recurrent bacterial infections, impaired pus formation, delayed wound healing, and severe persistent leukocytosis was the result of a mother-son mating. Assessment of leukocyte function revealed profound abnormalities in adherence-dependent activities including impaired granulocyte adhesion to glass/plastic surfaces or nylon wool, decreased granulocyte aggregation and chemotaxis, and diminished lymphocyte blastogenesis, but normal neutrophil oxidative activity, serum immunoglobulin, and complement levels. By immunofluorescence analysis, CD11b and CD18 monoclonal antibodies specific for the 155-kd alpha polypeptide of Mo1 (gp 155, 94) and the 94 kd beta peptide common to Mo1, LFA-1 (gp 170, 94), and Leu M5 (p 150, 94) (surface molecules that promote leukocyte adhesion) failed to bind to unstimulated and A23187 calcium ionophore-stimulated granulocytes or mononuclear cells of the affected dog as compared with strong specific binding to canine control cells. The Mo1 glycoproteins were only barely detectable by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of immunoprecipitates from lysates of 125I surface-labeled neutrophils from the affected dog as compared with intense bands seen with canine control cell precipitates. We conclude that this dog has a severe leukocyte surface glycoprotein deficiency syndrome that is similar, if not identical, to that recently recognized in humans. Dogs with deficiency of leukocyte Mo1, LFA-1, and Leu M5 expression may represent a useful animal model to characterize further the molecular basis for an inherited disorder in leukocyte effector function. PMID- 3555650 TI - A randomized prospective comparison of chemotherapy to total body irradiation as initial treatment for the indolent lymphoproliferative diseases. AB - One hundred eight consecutive patients with indolent lymphoproliferative diseases were stratified into chronic lymphocytic leukemia (CLL), stage III and IV well differentiated lymphocytic lymphoma (WDLL), and stage III and IV follicular lymphoma (FL). Within each stratum, patients were prospectively and randomly assigned to receive chemotherapy with chlorambucil and prednisone (CP) or fractionated total body irradiation (TBI). Morbidity from both regimens was negligible. Complete response (CR) was defined as the resolution of organ enlargement and the return of blood count to normal. The CR rate for the entire CP group (n = 54) was 59% and that for the TBI group (n = 54), 52%; median survivals were 53 and 57 months respectively. In the 41 patients with CLL the CR rate for CP (n = 17) was 47% and that for TBI (n = 24), 50%; the median survival for CP was 48 months, and for TBI it was 51 months. In the 21 patients with WDLL the CR rate for CP (n = 15) was 53% and that for TBI (n = 6), 67%; the median survival for CP was 42 months and has not yet been reached for TBI. For the 46 patients with FL the CR rate for CP (n = 22) was 72% and that for TBI (n = 24), 50%; the median survival was 55 months, and for TBI it was 56 months. None of the differences in CR or survival are statistically significant (P greater than .05). In these indolent lymphoproliferative diseases, CP and TBI are equally effective forms of initial treatment irrespective of the end point being defined as CR or survival. PMID- 3555651 TI - Differences in cell cycle characteristics among patients with acute nonlymphocytic leukemia. AB - The proliferative characteristics of myeloid leukemias were defined in vivo after intravenous infusions of bromodeoxyuridine (BrdU) in 40 patients. The percentage of S-phase cells obtained from the biopsies (mean, 20%) were significantly higher (P = .00003) than those determined from the bone marrow (BM) aspirates (mean, 9%). The post-BrdU infusion BM aspirates from 40 patients were incubated with tritiated thymidine in vitro. These double-labeled slides were utilized to determine the duration of S-phase (Ts) in myeloblasts and their total cell cycle time (Tc). The Ts varied from four to 49 hours (mean, 19 hours; median, 17 hours). Similarly, there were wide variations in Tc of individual patients ranging from 16 to 292 hours (mean, 93 hours; median, 76 hours). There was no relationship between Tc and the percentage of S-phase cells, but there was a good correlation between Tc and Ts (r = .8). Patients with relapsed acute nonlymphocytic leukemia (ANLL) appeared to have a longer Ts and Tc than those studied at initial diagnosis. A subgroup of patients at either extreme of Tc were identified who demonstrated clinically documented resistance in response to multiple courses of chemotherapy. We conclude that Ts and Tc provide additional biologic information that may be valuable in understanding the variations observed in the natural history of ANLL. PMID- 3555652 TI - Myeloablation with diaziquone: in vitro assessment. AB - The promising antineoplastic agent diaziquone is associated with prolonged aplasia and rare instances of bone marrow necrosis, but only mild extramedullary toxicity. To explore the drug's potential as a myeloablative agent prior to bone marrow transplantation, we compared its effects on hematopoietic versus marrow stromal cells. After short-term (one to six hours) or prolonged (three to seven days) exposure to the drug, marrow was assayed for hematopoietic (CFU-Mix, BFU-E, CFU-GM) and stromal (CFU-F) colony-forming cells and studied in long-term marrow culture (LTMC). One- and three-hour treatments produced little cytotoxicity, even at 5000 ng/mL. After six-hour treatments with this dose, marrow was depleted of CFU-Mix, BFU-E, and CFU-GM, but produced CFU-GM in LTMCs, indicating an ongoing input of CFU-GM from a surviving pre-CFU-Mix population. In contrast, elimination of the latter may be inferred from the absence of CFU-GM in LTMCs exposed for three to seven days to diaziquone at only 150 ng/mL. Under these conditions, CFU F recovery was 40% and adherent stromal layers in LTMCs were similar to untreated controls regarding rate of development and cellular composition. Our in vitro pre CFU-Mix-ablative regimen correlates with clinical data that show prolonged but reversible myelosuppression at steady-state diaziquone plasma levels of 101 +/- 10 ng/mL (mean +/- standard error of mean) during 7-day constant infusions. IN CONCLUSION: hematopoietic cells are more sensitive than marrow stromal cells to the dose- and highly time-dependent cytotoxicity of diaziquone, a direct drug induced noxious effect on the marrow microenvironment is an unlikely cause of the isolated episodes of marrow necrosis after the use of diaziquone in vivo, and prolonged infusion of diaziquone represents an attractive means for achieving myeloablation in selected clinical situations. PMID- 3555653 TI - Experimental liver tumours in animals. PMID- 3555654 TI - Mutagenic activity of incense smoke in Salmonella typhimurium. PMID- 3555655 TI - Chlorinated phenol toxicity by bacterial and biochemical tests. PMID- 3555656 TI - Genetic and biochemical effects of dry residue of Arno river in vitro and in vivo. PMID- 3555657 TI - Bioaccumulation potential of heterotrophic bacteria for lead, selenium, and arsenic. PMID- 3555659 TI - Tetanus prevention in seafarers. PMID- 3555660 TI - The activity of Genoa health authorities at the turn of the 17th century as an example of work of antiepidemic service. PMID- 3555658 TI - Evaluation of mutagenic activities of endosulfan, phosalone, malathion, and permethrin, before and after metabolic activation, in the Ames Salmonella test. PMID- 3555661 TI - On the possibility of hyperbaric oxygen therapy in some pathological reactions of immunological hypersensitivity. PMID- 3555662 TI - Interventions for amnesics: a review. AB - Research on interventions for amnesics is reviewed which suggests that it is possible to teach amnesics specific information or memory skills but that these are not likely to generalize or to be maintained spontaneously. It is suggested that interventions with clearly defined behavioural goals and which have programmed for generalization and maintenance of treatment gains may prove to be most effective. The purpose of interventions for chronically hospitalized cognitively impaired patients does not appear to have been considered adequately, and it is concluded that future research will be hampered unless greater consideration is given to information processing theory relating to amnesia. Possible directions for future research are discussed. PMID- 3555663 TI - Reminiscence: a critical review of the empirical literature. AB - The empirical evidence concerning the prevalence and function of reminiscence among the elderly is reviewed and the relevance of such activity for clinical populations is evaluated. Variations in the ways in which reminiscence is defined and methods of eliciting reminiscence activity are described. Data on frequency of reminiscence and its relationship to age are discussed. Studies investigating the functions of reminiscence are divided into three groups according to experimental design and their findings critically reviewed. It is concluded that there is little evidence of an age-specific process of reminiscence, that the functions of such a process are unclear and that the role of reminiscence as a therapeutic activity is in doubt. PMID- 3555664 TI - [Academic eulogy of Professor Paul Bastenie (1906-1985). Titular member and former president]. PMID- 3555665 TI - Why expert systems for medical diagnosis are not being generally used: a valedictory opinion. PMID- 3555666 TI - [Emergency corneal transplants]. PMID- 3555667 TI - [Emergencies in the follow-up of corneal transplants]. PMID- 3555668 TI - Pyoderma gangrenosum. PMID- 3555669 TI - Practical aspects of pulsatile LHRH therapy. AB - The availability of miniaturized portable infusion devices has enabled the development of another important method of inducing ovulation in women with clomiphene-resistant anovulatory infertility (Labrie et al, 1984; Mason et al, 1984; Armar et al, 1986a). When cases are carefully selected and accurate ultrasound monitoring is used, very impressive conception rates are achieved (Armar et al, 1986a). The treatment is simple, effective and safe. PMID- 3555670 TI - Transplantation of the lungs. AB - After years of disrepute, single-lung transplant now seems to be a suitable form of treatment for a carefully selected group of patients with end-stage pulmonary fibrosis. In addition, there is the prospect of treating a wider range of pulmonary diseases in the near future, with the appropriate use of double-lung and heart-lung transplants. PMID- 3555671 TI - Comparison of immunofluorescence and immunoperoxidase for demonstration of antinuclear antibodies on HEp-2 substrate. AB - A comparison of antinuclear antibody (ANA) detection on HEp-2 cell substrate, using immunofluorescence (IF) and immunoperoxidase (IP) techniques, was performed on 183 sera from 178 individuals, with and without connective tissue diseases. All sera were number coded and scored blindly by two independent observers. ANA was detected in 61% of sera by IF and 62% of sera by IP. Positive and negative results corresponded between the two techniques in 97% of sera. Patterns and titres corresponded in 85% of positive sera. The two independent observers scored ANA more consistently with IP than with IF. Both methods were technically simple to perform and produced consistent results with control sera. These data show that IP provides results equivalent to the traditional IF technique for demonstrating ANA on HEp-2 substrate. Fewer discordant results between two independent observers using IP suggests that this technique has technical advantages for interpretation of ANA on HEp-2 substrate. PMID- 3555672 TI - Low-dose total body irradiation in rheumatoid arthritis. PMID- 3555673 TI - Surgical aid for intractable rheumatoid ulcers. PMID- 3555674 TI - Intravenous digital subtraction angiography in intracranial aneurysms. AB - Intravenous digital subtraction angiography was undertaken in 121 patients with known intracranial aneurysms. Its role in the management of these patients and its diagnostic accuracy have been assessed. PMID- 3555676 TI - Barium embolisation during barium enema examination: a report of a case and a review of the literature. PMID- 3555675 TI - Noise reduction in ultrasonic images by digital filtering. PMID- 3555677 TI - Unilateral breast hyperplasia in pregnancy simulating neoplasm. PMID- 3555678 TI - Rounded opacity in a young man's chest. PMID- 3555679 TI - Ultrasound examination of the paediatric "acute abdomen": preliminary findings. PMID- 3555680 TI - Upper gastrointestinal endoscopic ultrasonography in gastroenterology. AB - Endoscopic ultrasound is a new technique in which high-frequency, high-resolution real-time ultrasound images are obtained from within the gastrointestinal tract by use of an ultrasound probe incorporated into the tip of a fibreoptic endoscope. Forty patients were scanned for gastrointestinal indications. In six patients the scans were technically unsuccessful, in three of these because of difficulties with the prototype instrument. New information was obtained in 20 patients, later confirmed by other means in 12. Endoscopic ultrasound did not provide any new information in 14 patients. The technique shows considerable promise in patients with pancreatic disorders and gut-wall malignancies. It has the ability to provide images with a spatial resolution unobtainable by other imaging methods. PMID- 3555681 TI - Parathyroid sonography: diagnostic accuracy related to shape, location, and texture of the gland. AB - The sonographic features of 51 pathological parathyroid glands detected pre operatively were analysed. Atypical texture was found in 23.5% and variation in shape in 15.6% of the cases. Cystic parathyroid glands are difficult to differentiate from thyroid cysts, and may be the cause of false positive diagnosis, as in three cases in this series. Topographic assessment showed a relatively low sensitivity in detecting disease in the right upper gland (50%) and in the upper mediastinum (70%). The decreased accuracy in these regions is probably because of the particular anatomical location of the right upper gland and sonographic limitations in screening the mediastinal region. Awareness by the radiologist and surgeon of the variations in texture and location may influence both diagnosis and intraoperative detection of the abnormal parathyroid gland. PMID- 3555682 TI - Brachytherapy of tumour recurrences in the region of the pharynx and oral cavity by means of a remote-controlled afterloading technique. AB - In the period 1981-86, 22 patients with local inoperable tumour recurrences in the mouth and pharynx area had endocavitary contact therapy using a remote controlled afterloading system at the Radiotherapy Centre of the University of Heidelberg. All patients had had previous surgery and external-beam radiation; some had also received chemotherapy. The technique is described and preliminary results are discussed. PMID- 3555683 TI - Ultrasound diagnosis of profunda femoris pseudo-aneurysm following nail-plate fixation of a transcervical femoral fracture. PMID- 3555684 TI - Demonstration of a lactobezoar by ultrasound. PMID- 3555685 TI - The radiological findings in torsion of an appendix epiploica. PMID- 3555686 TI - Fetal ureteric reflux. AB - Seven babies (six male, one female) with ureteric reflux, all of whom had antenatal renal dilatation, are described together with one other baby who was found to have gross ureteric reflux when investigated following an acute urinary infection at the age of 9 days. There was a strong probability that all of the babies had fetal ureteric reflux (FUR). Radioisotope studies demonstrated parenchymal damage in three of seven and reduced function in four of 10 refluxing kidneys. Subsequent investigation showed no increase in the areas of parenchymal damage but there was evidence that function in some kidneys had deteriorated. It was thought that this was due to disturbances in inter-renal or renal-child related growth velocities. A plea is put forward for more detailed postnatal examination of babies whose urinary tracts show evidence of dilatation antenatally. PMID- 3555687 TI - Antibiotic prophylaxis for prostatic surgery. Single-dose cephradine compared with single-dose cefotaxime. AB - Several previous studies have attested to the value of antibiotic prophylaxis for prostatic surgery. We report a prospective randomised study which compared a single dose of cefotaxime with a single dose of cephradine given with the induction of anaesthesia. There was little difference between these regimens and it was concluded that either may be used, depending on availability and cost of the antibiotic. We have now completed a 5-year study of antibiotic prophylaxis for prostatic surgery and we also report the results of a long-term survey of the ward flora. There has been no significant change and there is no evidence for the emergence of resistant strains. PMID- 3555688 TI - Aminoglutethimide in advanced prostatic carcinoma. AB - We have treated 34 patients with advanced prostate cancer, resistant to orchiectomy or oestrogen therapy, with aminoglutethimide. Seven patients (21%) showed improvement in pain and performance status for prolonged periods. By NPCP criteria six patients had stable disease and one had partial tumour response. Six of these patients remained on oestrogen therapy. Suppressed gonadotrophin levels (FSH and LH), despite orchiectomy, correlated strongly with benefit from aminoglutethimide. No relationships between response to treatment and changes in serum testosterone, dehydroepiandrosterone, oestradiol or prolactin were found. Six patients had side effects requiring cessation of therapy. A further 27 patients developed less severe toxicity. Despite its toxicity, these results show that aminoglutethimide has a role in the management of advanced prostatic cancer resistant to primary hormonal manipulation. PMID- 3555689 TI - Non-specific abdominal pain as a cause of acute admission to hospital. PMID- 3555690 TI - Random control trial of a short course of aspirin and dipyridamole (Persantin) for femorodistal grafts. AB - The effect of a short course of anti-platelet agents, started preoperatively, on the patency of femorodistal bypass grafts is unknown. One hundred and forty-eight such grafts were randomized to act as controls or to receive dipyridamole 200 mg b.d. for 48 h pre-operatively and dipyridamole 200 mg b.d. with aspirin 300 mg daily for 6 weeks after surgery. Patients were well-matched and the mean pre operative pressure index of 0.37 rose to 0.78 during the first postoperative week. No deaths were attributable to the treatment. Ninety-three grafts were autogenous vein and the remainder were prosthetic (GORE-TEX (PTFE), human umbilical vein or externally supported Dacron). At 1 year autogenous vein cumulative patency was 75 per cent. Overall results showed higher patency in the treated group (P = 0.012) which was entirely accounted for by the difference between prosthetic dipyridamole and aspirin group (85 per cent patency) and prosthetic control groups (53 per cent patency, P = 0.005) and arose during the first postoperative month. There were 11 deaths and 8 amputations in the dipyridamole and aspirin group and 8 deaths and 12 amputations in the control group. It is concluded that a six week perioperative course of dipyridamole and aspirin allows the patency of prosthetic femorodistal bypass to approach that of autogenous vein, and the regimen therefore is recommended for patients who may require a prosthetic graft. PMID- 3555691 TI - Prospectively randomized clinical trial to compare in situ and reversed saphenous vein grafts for femoropopliteal bypass. AB - Two hundred and fifteen femoropopliteal bypass procedures using autologous saphenous vein grafts were randomly allocated to either the reversed or in situ technique. Eleven veins (5 per cent) were rejected at operation on the basis of their small size, nine in the reversed group and two in the in situ group, and there were two (2 per cent) perioperative deaths in each group, leaving 102 reversed and 98 in situ grafts for further study. The cumulative patency at 3 years of the reversed grafts was 77 per cent and that of the in situ grafts was 68 per cent (n.s.). The patency of all grafts was affected adversely by small veins (P less than 0.005), long grafts (P less than 0.05), low volume of blood flow in the grafts (P less than 0.001) and poor run-off (P less than 0.05). These factors influenced the outcome of the in situ and reversed operations to a similar degree and there was no statistically significant difference between them within any subgroup. The mean compliance of the in situ grafts measured 3 months or more after operation with an ultrasonic echo-tracking system was 0.024 +/- 0.01 per cent/mmHg (+/- s.d.) compared with 0.017 +/- 0.01 per cent/mmHg for the reversed grafts (t = 2.43, P less than 0.02). The incidence of fibrous stricture formation as shown by intravenous digital subtraction angiography was 29 per cent in both the reversed and the in situ grafts. The results of the study to date indicate that reversed and in situ vein grafts are equally effective for femoropopliteal bypass. PMID- 3555692 TI - Perforated duodenal ulcer managed by simple closure versus closure and proximal gastric vagotomy. AB - A prospective randomized trial of simple closure versus closure and proximal gastric vagotomy was conducted in 50 consecutive patients with perforated duodenal ulcer. There was one postoperative death in each group and no difference in postoperative morbidity. After a median follow-up of 54 months (24-96) the cumulative recurrence rate after simple suture was 52 per cent against 16 per cent after proximal gastric vagotomy and closure (P less than 0.01). The recurrence rate after proximal gastric vagotomy for perforated duodenal ulcer was comparable to the recurrence rate seen after the electively performed operation. PMID- 3555693 TI - Combination fine-needle aspiration cytology and intrarenal manometry at the onset of renal dysfunction. AB - Twenty-three consecutive cadaveric renal allograft recipients immunosuppressed with cyclosporin have been monitored three times a week by fine-needle aspiration cytology and intrarenal manometry until discharge from hospital or until 30 days post-transplant. Standard criteria were used to determine the cause of allograft dysfunction. The onset of allograft rejection was marked by an elevation of the total corrected increment score by fine-needle aspiration cytology in 80 per cent of rejection episodes whereas intrarenal pressure was raised in only 46.6 per cent. However, intrarenal pressure was greater than 40 mmHg on a single occasion in 16 measurements performed on allografts showing evidence of cyclosporin nephrotoxicity. By combining fine-needle aspiration cytology and intrarenal manometry the sensitivity of these tests for allograft rejection was increased to 93.3 per cent at the onset of renal dysfunction. Our results demonstrate that fine-needle aspiration cytology is more sensitive than intrarenal manometry as a single investigation. However, the combined test may have an important role in the differentiation of allograft rejection and cyclosporin nephrotoxicity in the early management of renal allograft recipients. PMID- 3555694 TI - An overview of bacterial skin disease in the dog. PMID- 3555695 TI - The epidemiology of ovine toxoplasmosis with especial respect to control. PMID- 3555696 TI - Recommended techniques in small animal anaesthesia. II. Intraoperative cardiac dysrhythmias and their treatment. PMID- 3555697 TI - Calcitonin gene-related peptide-like immunoreactive sensory fibers form synaptic contact with sympathetic neurons in the rat celiac ganglion. AB - The present study demonstrates synaptic contact between calcitonin gene-related peptide (CGRP)-like immunoreactive axon terminals and sympathetic neurons in the rat celiac ganglion. Our observations suggest that sensory ganglion neurons directly regulate the sympathetic activity via synapses, because CGRP immunoreactive (CGRPI) fibers in this ganglion are supplied by the sensory ganglia. PMID- 3555698 TI - Immunohistochemical localization of choline acetyltransferase in the central nervous system of the locust. AB - Immunohistochemistry of the locust central nervous system with antibody to choline acetyltransferase (ChAT) purified from the same species shows: first, there are relatively few immunoreactive cell bodies in the CNS; and second, sensory neuropiles, such as the ventral association centre and the ventral VAC (vVAC), the anterior ring tract, the tritocerebrum and the antennal lobe, are immunoreactive. That ChAT is contained in sensory neurones is suggested by immunoreactivity found in peripheral neurone cell bodies. These results indicate that acetylcholine serves primarily as a sensory transmitter in the locust. PMID- 3555699 TI - Non-phosphorylated and phosphorylated neurofilaments in hypothyroid rat cerebellum. AB - Purkinje cell baskets in hypothyroid rat cerebellum were studied with antibodies reacting with phosphorylated or non-phosphorylated neurofilament epitopes. Compared to normal rats, Purkinje cell baskets were fewer in number and less developed in hypothyroid rat cerebellum. However, no differences were observed as to their immunoreactivity with monoclonal antibodies reacting with phosphorylated or non-phosphorylated neurofilament epitopes. PMID- 3555700 TI - Hippocampofugal gamma-aminobutyric acid (GABA)-containing neuron system in the rat: a study using a double-labeling method that combines retrograde tracing and immunocytochemistry. AB - Using a double-labeling method that combines retrograde tracing and immunocytochemistry, we demonstrated the presence of a hippocampofugal gamma aminobutyric acid (GABA)-like immunoreactive (GABA-LI) neuron system in the rat. As a preliminary experiment, knife-cut of the dorsal fornix was made and it resulted in a remarkable accumulation of GABA-LI fibers caudal to the section. This suggested the presence of a hippocampofugal GABAergic projection. The hypothesis was confirmed by the double-labeling method: injection of the biotinylated wheat germ agglutinin (B-WGA) into the septum resulted in labeling numerous neurons in the hippocampus and some of them also showed GABA-like immunoreactivity by the simultaneous immunostaining with the antiserum against GABA. PMID- 3555701 TI - Enkephalin-like immunoreactive axon terminals make synapses with alpha motoneurons in the chicken. AB - Methionine (Met)-enkephalin (Enk)-like immunoreactive axon terminals on HRP labeled alpha-motoneurons were studied using the indirect antibody peroxidase- anti-peroxidase technique in the chicken. Electron microscopically, Met-Enk-like immunoreactive axon terminals containing dense-cored vesicles and clear vesicles made axosomatic and axodendritic synapses with PLD alpha-motoneurons. Dense-cored vesicles were sometimes observed to be adjacent to the presynaptic membrane accompanied by the postsynaptic density. These results suggest morphologically that alpha-motoneurons may be directly modulated by enkephalins. PMID- 3555702 TI - Astrocytes in rat fetal cerebral cortical homografts following implantation into adult rat spinal cord. AB - The present experiment examines astrocytes in fetal cerebral cortical homografts to adult rat spinal cords. The purpose of this study is to determine if astrocytes are structurally organized within the graft. Also, the presence or absence of astrogliosis may be an indicator of the metabolic status of the graft. Embryonic cerebral cortex was taken at 14 days gestational age and transplanted into adult spinal cord at the level of the sixth thoracic vertebra. The homografts were examined at the light and electron microscopic levels from 7 days postimplantation (PI) to 6 months PI with glial fibrillary acidic protein antiserum which is a specific immunohistochemical marker for astrocytes. At 7 days PI, immunoreactive astrocytes were present only at the periphery of the graft and appeared to be associated with blood vessels. By 30 days PI, normal protoplasmic astrocytes were present throughout the graft. No hypertrophied astrocytes are present at 30 days PI, but the numerical density of astrocytes is greater than that of normal cerebral cortical gray matter. Fibrous astrocytes are present in the periphery of the implant and many of these astrocytes extended their processes between the host and the graft. Occasional glial scarring is observed between the gray matter of the host and graft, but generally no glial scar occurred in the interface between the graft and the host gray matter. By 45 days PI, hypertrophied astrocytes can be seen in the graft, but are confined in this age group to perivascular regions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555704 TI - Changes in vasopressin cells of the rat suprachiasmatic nucleus with aging. AB - The suprachiasmatic nucleus (SCN) of the hypothalamus is considered to be the endogenous clock of the mammalian brain, regulating circadian rhythmicity of a great number of physiological and behavioural parameters. Numerous studies have shown that the circadian organization in the rat is progressively disturbed in senescence. However, a recent study by Peng et al.17 using conventionally stained material, revealed no decrease in overall SCN cell number of senescent rats. Their results have now been confirmed in this study. In addition, an increase in SCN volume (P = 0.02) and nucleus diameter (P = 0.001) and an overall decrease in cell density (P = 0.006) was observed. All these parameters seem to confirm the absence of a general degeneration in the senescent SCN. However, the major aim of the present study was to determine whether a well-defined population of neurons, i.e. the vasopressinergic (AVP) cells of the SCN, shows changes with aging. Immunocytochemical staining with antivasopressin and morphometry revealed a decrease of 31% (P = 0.007) in the number of these SCN neurons, whereas the remaining vasopressin cells became larger (P = 0.001). There were no statistical significant differences between rats housed in standard cages and those housed in an enriched environment in either age group, but the groups were relative small. Changes in either the number or stainability of SCN vasopressin neurons may be a morphological correlate of changed circadian rhythms in senescence. PMID- 3555703 TI - Insulin receptors in the peripheral nervous system: a structural and functional analysis. AB - Although the brain is known to contain specific insulin receptors, there is no information on whether these receptors are also present in the peripheral nervous system (PNS). The present studies sought to provide this information by characterizing insulin binding in bovine autonomic (superior cervical) and sensory (trigeminal) ganglia. It was found that both ganglia contain specific, high-affinity receptors for insulin. Like insulin receptors in other tissue, these receptors could be solubilized and purified on wheat germ agarose columns and were found to have tyrosine-specific kinase activity. SDS-PAGE and autoradiography revealed that the apparent molecular weight (Mr) of the PNS insulin receptor was approximately 133 kDa which is similar to the Mr of hepatic receptors, but is approximately 10 kDa larger than the insulin receptor found in the brain. Because the vasculature of autonomic and sensory ganglia is fenestrated, it is possible that PNS insulin receptors are exposed to blood-borne insulin. PMID- 3555705 TI - Long day lengths increase brain weight and DNA content in the meadow vole, Microtus pennsylvanicus. AB - Male voles reared in long (spring) day lengths had heavier brains with greater total DNA content than did males housed in short (fall) day lengths; these effects were not observed in female littermates kept in the two photoperiods. Male brains were heavier than female brains in long but not in short photoperiods. Day length affected brain mass during early postnatal development, but not when treatments were initiated in adulthood. Seasonal differences in brain development, including the numbers of neurons and glia, may reflect different metabolic and behavioral demands faced by males born in spring and fall, respectively. PMID- 3555706 TI - Immunohistochemical evidence for the coexistence of calcitonin gene-related peptide and glutamate decarboxylase-like immunoreactivities in the Purkinje cells of the rat cerebellum. PMID- 3555707 TI - Immunohistochemical evidence for colocalization of gamma-aminobutyric acid and serotonin in neurons of the ventral medulla oblongata projecting to the spinal cord. AB - Fluorescence immunohistochemistry was used to analyze the medulla oblongata of colchicine-treated rats that had been incubated with guinea pig antibodies to serotonin (5-HT) and either rabbit or sheep antibodies to glutamic acid decarboxylase (GAD). Numerous cells in the rostral ventrolateral medulla in the region of nucleus raphe magnus were immunostained for either 5-HT or GAD. A substantial number of neurons showed positive immunoreactivity for both substances, and were most frequently observed in the lateral aspect of nucleus raphe magnus. In addition, a number of the 5-HT/GAD-containing neurons were retrogradely labelled with Fast blue dye that had been injected into the thoracic spinal cord. This work provides evidence for colocalization of the classical neurotransmitters 5-HT and GABA in single cells of the ventral medulla oblongata, some of which project to the spinal cord. PMID- 3555708 TI - Localization of angiotensinogen in multiple cell types of rat brain. AB - Angiotensinogen was localized in 3 cell types in brain using immunohistochemical methods. These locations included subpopulations of neurons in nuclei that co stain for angiotensin II, subpopulations of astrocytes that make putative contacts with brain microvessels, and cells of the choroid plexus. These findings are consistent with multiple functions for brain angiotensinogen as a precursor for neuronal angiotensin II and as a potential source for angiotensin II that is locally produced in the brain. PMID- 3555709 TI - Sympathetic sprouting in the central nervous system: a model for studies of axonal growth in the mature mammalian brain. AB - Sympathetic fibers innervate many peripheral tissues but are normally confined to extracerebral structures within the cranial cavity, e.g. blood vessels. The invasion of the central nervous system by vascular sympathetic axons is a unique example of neuronal plasticity which provides new information concerning the regulation and mechanisms of neuronal sprouting in both the peripheral and central nervous systems. In this paper, the principal findings concerning the conditions under which such sprouting occurs, the mechanisms which may be involved, and the question of its possible function are reviewed. Of special interest is the fact that a nerve growth factor-like brain factor may be involved in this growth response. The principles gleaned from studies of this sprouting phenomenon may be applicable to other models of neuronal plasticity and may have clinical relevance. PMID- 3555710 TI - Sex differences in the rat forebrain. AB - In the first postnatal month, the thickness of the cerebral cortex has different patterns of development in the male and female Long-Evans rat. All areas of the male cortex appear to develop at similar rates, very rapidly for the first 10 days, then more gradually reaching a peak somewhere between 30 and 40 days of age before beginning to decrease in thickness. The same is not true for the female; for example, at birth her medial frontal cortex is further developed than her lateral posterior parietal cortex and the rate of growth in the first weeks varies immensely. The male right cortex is thicker than the left from birth to 904 days of age, but the differences become less significant with age. The female cortex is thicker on the left side in the majority of the cases, from 7 to 400 days of age, but the differences are not in general statistically significant. Estrogen receptors are found in both male and female rat cerebral cortices at birth and apparently disappear after one month. In the male the greatest concentration of receptors is in the left cortex, and in the female, in the right. The number of neurons and glia per unit area is greater in the right cortex (area 39) in the male; and in the female, in the left cortex. Ninety days after ovariectomy at birth, the female right cortex is thicker than her left, establishing a pattern similar to that of the male. In the male gonadectomized at birth, the left cortex is thicker 90 days later in the frontal and somatosensory regions but not in the occipital or posterior region.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555711 TI - Central control of gastric acid secretion by extralateralhypothalamic nuclei. AB - Whether secretion of gastric acid (GAS) is in response to peripheral and/or central administration of chemical or electrical stimuli can be differentiated by vagotomy. GAS has been shown to be controlled by specific lateral hypothalamic (LHA) neurons. Application of 2-deoxy-D-glucose (2-DG) or insulin to the LHA by microinjection or iontophoresis has experimentally induced GAS. The paraventricular nucleus (PVN) has now been found to also affect GAS. GAS was produced more copiously and more quickly by rostral PVN lesion than by lesion of the ventromedial (VMH) or dorsomedial (DMH) nucleus, and nearly as much by caudal PVN lesion. Microinjection of 2-DG into the LHA induced GAS more potently in animals with rostral PVN lesions than in those with caudal PVN, VMH or DMH lesions, or in intact animals. Results indicate that the PVN may be an additional central site from which GAS is affected. PMID- 3555712 TI - The immunohistochemical localization of choline acetyltransferase in the cat brain. AB - The distribution of neurons displaying choline acetyltransferase (ChAT) immunoreactivity was examined in the feline brain using a monoclonal antibody. Groups of ChAT-immunoreactive neurons were detected that have not been identified previously in the cat or in any other species. These included small, weakly stained cells found in the lateral hypothalamus, distinct from the magnocellular rostral column cholinergic neurons. Other small, lightly stained cells were also detected in the parabrachial nuclei, distinct from the caudal cholinergic column. Many small ChAT-positive cells were also found in the superficial layers of the superior colliculus. Other ChAT-immunoreactive neurons previously detected in rodent and primate, but not in cat, were observed in the present study. These included a dense cluster of cells in the medial habenula, together with outlying cells in the lateral habenula. Essentially all of the cells in the parabigeminal nucleus were found to be ChAT-positive. Additional ChAT-positive neurons were detected in the periolivary portion of the superior olivary complex, and scattered in the medullary reticular formation. In addition to these new observations, many of the cholinergic cell groups that have been previously identified in the cat as well as in rodent and primate brain such as motoneurons, striatal interneurons, the magnocellular rostral cholinergic column in the basal forebrain and the caudal cholinergic column in the midbrain and pontine tegmentum were confirmed. Together, these observations suggest that the feline central cholinergic system may be much more extensive than previous studies have indicated. PMID- 3555713 TI - [Ultrastructural localization of succinate dehydrogenase in the myocardium. Functional heterogeneity of the mitochondria is probably an artifact dependent on the method of preparation]. PMID- 3555714 TI - [The scientific and technical development of pathology at the Institute of Pathology at Comenius University Medical School and the Medical Hospital in Bratislava. I. Computer documentation, clinicopathologic analysis of the causes of death, new methods in histologic practice]. PMID- 3555715 TI - [The effect of iodophors with an amino-oxide base on mammalian chromosomes]. PMID- 3555716 TI - [Regeneration of implants after autotransplantation of the spleen]. PMID- 3555717 TI - [Scientific and technical developments in pathology within the framework of the Institute of Pathology at the Medical School of Comenius University and Medical School Hospital in Bratislava. II. Electron microscopy, enzymohistochemistry]. PMID- 3555719 TI - Endogenous lectins in tumors and the immune system. PMID- 3555720 TI - Delayed node dissection in stage one malignant melanoma: justification and advantages. PMID- 3555718 TI - Interplay between the toxic effects of anticancer drugs and host antitumor immunity in cancer therapy. AB - The results accumulated thus far illustrate that the therapeutic efficacy of many anticancer drugs depends not only on the direct tumoricidal/tumoristatic activity of the drug but also on the contribution to tumor eradication of antitumor immunity which emerges after the chemotherapy. When a low dose of anticancer drug is employed, it reduces the tumor burden to a lesser extent than a high dose of drug. Consequently, in order for the low dose of drug to be as effective as a high dose of drug, antitumor immunity has to control a larger tumor burden than that controlled by the immune system following high-dose chemotherapy. This was shown to happen in several experimental tumor models wherein the low dose of drug greatly potentiated host antitumor immunity while the high dose of drug either potentiated host antitumor immunity to a lesser extent, did not potentiate it at all, or actually exerted a suppressive effect on host antitumor immunity. As a result of the immunopotentiating activity of the low dose of drug, tumor-bearing animals which did not exhibit concomitant antitumor immunity due to the inhibitory activity of suppressor cells, developed a very potent antitumor immunity shortly after the chemotherapy. The immunopotentiating effect of the low dose of drug was attributed in these situations to drug-mediated selective elimination of suppressor cell activity and possibly also to drug-mediated enhancement in the activity of T cells of the helper phenotype through elevation in IL-2 production. Antitumor immunity can also facilitate the therapeutic effectiveness of high-dose chemotherapy. Therefore, it is important to determine the conditions under which high-dose chemotherapy can also potentiate host antitumor immunity. From the rodent data available, the picture emerges that the maturity of antitumor immunity at the time of the chemotherapy is an important factor in determining if the high dose of drug leads to immunosuppression or immunopotentiation. When a high dose of drug is administered to tumor bearers with a fully developed antitumor immune response, it is more likely to lead to potentiation of host antitumor immunity than when the high dose of drug is administered to tumor bearers that have not yet achieved the full maturity of their antitumor immune response. In order to achieve the maximal enhancement of antitumor immunity in hitherto immunosuppressed tumor bearers, the suppressor cell pool should be more sensitive to the toxic effects of the anticancer drugs than are cells involved in immune-tumor eradication.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555721 TI - Anthelmintics used in treatment of parasitic infections of horses. AB - The common anthelmintics used to treat parasitic infections of horses are described. Dosage, anthelmintic spectrum, formulation and administration, mode of action, toxicity contraindications, and resistance of parasites to anthelmintics are included. PMID- 3555722 TI - Clinical pharmacology of the gastrointestinal tract. AB - This article discusses the various drugs that affect the equine gastrointestinal tract. Drugs that alter intestinal motility, that protect the gastrointestinal tract, and that alter secretions, as well as analgesics, appetite stimulants, and orally administered antimicrobial agents are reviewed. PMID- 3555724 TI - Drug interactions and incompatibilities. AB - The clinical significance of drug interactions in animals is often minor, but, in some cases, they may result in a fatal outcome. In the critically ill patient, the temptation to employ relatively large doses, particularly of antimicrobials or corticosteroids, or to use multiple-drug therapy is enhanced. These two factors, combined with a debilitated state of the patient, increase the probability of severe drug interactions that could mean the difference between recovery or death. It would be prudent to consider the possibility of drug interactions when selecting drugs for concomitant use, evaluating adverse reactions, evaluating laboratory test results, or mixing drugs in vitro. PMID- 3555723 TI - Pharmacologic considerations in drug therapy in foals. AB - Rational drug therapy in the foal requires a sound knowledge of the pharmacodynamics and pharmacokinetics of various drugs as well as a thorough understanding of the physiologic differences that exist between the neonate and the adult and that may serve to alter drug disposition and, therefore, drug response. A summary of these physiologic factors with emphasis on the foal is presented and is followed by recommendations regarding the applied therapeutics of various antimicrobial agents. PMID- 3555725 TI - Injectable anesthetics and anesthetic adjuncts. AB - The purpose of this article is to review the use of selected anesthetics and anesthetic adjuncts in horses. Emphasis is placed on the pharmacologic bases of their use. PMID- 3555726 TI - Adverse drug reactions in the horse. AB - Adverse drug reactions occasionally occur in the horse. The majority can be anticipated and avoided. The practicing veterinarian should understand the various types of adverse reactions as well as their mechanisms so that should such a reaction occur, the practitioner can promptly recognize the problem and institute corrective measures. PMID- 3555727 TI - Antimicrobic susceptibility of bacterial pathogens from horses. AB - Rational choice of an antimicrobial agent requires that the condition for which the drug is prescribed contain an infectious agent and, if so, knowledge of the susceptibility of the microorganism to antimicrobial drugs. Unfortunately, most infectious conditions necessitate the use of an antimicrobic drug before data from the microbiology laboratory are available. The data presented are meant to serve as a guide in the choice of antimicrobic drugs for treatment of infectious processes of the horse before knowledge of the nature of the microorganism isolated as well as its susceptibility to antimicrobic agents. What has been presented are the most commonly isolated microorganisms together with their susceptibility to antimicrobic drugs. PMID- 3555728 TI - Rational selection of antimicrobial drugs for treatment of infections of horses. AB - The goal of antimicrobial drug use is quite specific. Consideration of many microbe-related, host-related, and drug-related factors is necessary for appropriate selection and use of antimicrobial drugs in equine patients. The concepts and data presented in this article demonstrate that fact. At the risk of oversimplification, "The bug denotes the drug, and the horse directs the course." PMID- 3555729 TI - Principles of drug disposition in the horse. AB - This article is intended to give the reader an understanding of the mathematic and conceptual framework underlying equine pharmacology. The methods by which the veterinary practitioner determines drug concentrations, disposition, and bioavailability are discussed. PMID- 3555730 TI - Cardiovascular drugs. Their pharmacology and use in horses. AB - Knowledge of the dosage, rate and route of administration, and potential side effects of drugs used to treat cardiac disease in horses has been refined. The judicious use of these drugs can increase exercise capacity, improve health, and potentially prolong life. Currently, antiarrhythmics (quinidine, lidocaine), positive inotropies (digoxin), and diuretics (furosemide) are the primary agents used to treat cardiovascular disease in horses. The development of newer drugs (verapamil, milrinone, bumetanide) and their usefulness in therapy for horses with cardiovascular disease require further investigation. PMID- 3555731 TI - Drug therapy of respiratory disorders. AB - The emphasis of this article is on the clinical application of drugs in therapy for treatment of disorders of the lower respiratory tract. Medications discussed include those used to enhance clearance of secretions and those employed to prevent and/or alleviate bronchoconstriction. Antimicrobial agents and respiratory stimulants are briefly mentioned. PMID- 3555732 TI - Hormone therapy for control of reproduction in mares and stallions. AB - Because the reproductive performance of mares is lower than that of any other domesticated species, hormone therapy is important in ensuring fertility and proper management of pregnancy. Current techniques of hormone therapy are discussed. PMID- 3555733 TI - Time to reconsider the use of aldehydes in children's dentistry. PMID- 3555734 TI - The Association of Canadian Faculties of Dentistry. Twenty years of achievement. PMID- 3555735 TI - Periodontics and the dental curriculum. Curriculum changes based on changing disease patterns. PMID- 3555736 TI - Curriculum changes based on changing disease patterns (reactor paper). PMID- 3555737 TI - Oral submucous fibrosis. A review with case reports. PMID- 3555738 TI - Citric acid burnishing of dentinal root surfaces. A preliminary scanning electron microscopy report. PMID- 3555739 TI - Formocresol concerns. A review. PMID- 3555740 TI - [Principles of infection control in dental practice]. PMID- 3555741 TI - Epidemiologic aspects of congenital oral clefts: with implications and strategies for dental public health specialists. PMID- 3555743 TI - Implementing nursing inservice sessions using a personal home computer. PMID- 3555742 TI - [A comparative study of fracture resistance of pulpless teeth]. PMID- 3555744 TI - Preparing faculty to use and develop computer-based instructional materials in nursing. PMID- 3555745 TI - Membrane controls of epithelial phosphate transport. AB - Phosphate homeostasis involves efficient intestinal absorption of dietary phosphate and sensitive renal conservation of filtered phosphate. Phosphate transport occurs by similar mechanisms across the intestinal and renal epithelium. This includes secondary active uptake across the brush-border membrane, movement of phosphate across the cytosol or into the metabolic phosphate pool, and finally the passive exit from the basolateral membrane. Active transport across the brush-border membrane involves cotransport of phosphate with sodium, which moves down its electrochemical gradient. As this process is the rate-limiting step, it is thought to be the controlling event in intestinal and renal absorption. The interaction of phosphate, sodium, and hydrogen ions with the recognition proteins involved with sodium-dependent phosphate transport is complex and not fully understood. Furthermore, the lipid bilayer structure may play a significant role in controlling the sequence of events in the movement across the brush-border membrane. Transfer of phosphate through the cytosol and exit across the basolateral membrane is less well understood, although the latter transmembrane flux is thought to be carrier mediated. Intestinal phosphate absorption is determined principally by plasma calcium and phosphate concentrations (1,25(OH)2 D3) and dietary availability of phosphate (intrinsic adaptation). On the other hand, renal conservation is determined by the available calcium (PTH), phosphate (intrinsic adaptation), and acid-base balance (hydrogen ions). These controls alter sodium-dependent phosphate cotransport across the brush-border membrane of the epithelial cell. The chemical alterations of the brush-border membrane and the metabolic events leading to changes in the brush-border membrane are not understood. The use of isolated, purified membranes and innovations of current techniques will enhance our understanding of these events and allow us to explain the mechanisms controlling epithelial phosphate absorption. PMID- 3555746 TI - Basal, oxytocin-, and insulin-stimulated glucose oxidation in human endometrium. AB - Samples of endometrium from regularly cycling women (28 +/- 2 days cycle) were assayed for [U-14C]glucose oxidation activity in the presence or absence of 100 nM oxytocin or 1.7 nM insulin. The basal rate of glucose oxidation in the tissues obtained from women in early and midfollicular phase and late luteal phase was approximately 125 pmol/(h X mg tissue). Late follicular and midluteal phases had higher basal rates, up to 400 pmol/(h X mg tissue). Oxytocin increased glucose oxidation by 50-100 pmol X h-1 X mg-1 in early and midfollicular phase and in early luteal phase endometrial fragments. Insulin did not stimulate glucose oxidation in these tissues. In samples of late luteal phase, glucose oxidation was stimulated by both oxytocin and insulin. High and low basal glucose oxidation activity in the endometrium corresponded, respectively, to reported periods of high and low plasma estradiol in normal menstruating women. In contrast, oxytocin stimulated glucose oxidation in endometria from women with anticipated low plasma estradiol. PMID- 3555747 TI - Transfer of newly made triglyceride from hepatocytes to preexisting extracellular very low density lipoproteins. AB - Previous in vivo studies suggested a new model to describe the metabolism of very low density lipoproteins (VLDL). It was hypothesized that some of the lipoprotein triglyceride was transferred directly from hepatocytes and intestinal mucosal cells into preexisting extracellular VLDL particles. These studies employ an in vitro system to test this hypothesis. Isolated rat liver cells containing newly made radioactive triglyceride were prepared. These cells were incubated in medium to which exogenous VLDL had or had not been added. The presence of extracellular VLDL (rat or human) stimulated the transfer of labeled triglyceride out of the liver cells. This triglyceride was recovered in the medium's VLDL (as determined by its density and its precipitability by MnCl2-heparin or by anti-apoprotein B). Although these studies focussed on VLDL, preliminary data showed that similar triglyceride transfer occurred in the presence of the other apoprotein B containing lipoprotein, low density lipoprotein (LDL). However, in the presence of equivalent amounts of LDL, this triglyceride transfer was less than that seen in the presence of exogenous VLDL. Furthermore, the increased triglyceride released in the presence of LDL occurred entirely in the d less than 1.006 fraction of the medium. That released in the presence of VLDL was recovered in the d greater than 1.006 fraction. Hence, we conclude that the transfer of the newly made triglyceride was from the cell to the extracellular lipoprotein that had been added to the medium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555748 TI - A biophysical and histological analysis of factors that lead to aortic rupture in normal and lathyritic turkeys. AB - These experiments were designed to determine if local differences in elastic properties or wall structure contributed to the development of aortic rupture in turkeys. Static elastic properties were measured from pressure-volume curves of cylindrical segments of upper and lower thoracic aorta and innominate artery in two groups of lathyritic birds and two age-matched control groups. The biggest changes were in the young lathyritic group that was on 0.04% beta aminoproprionitrile at 3 weeks of age and continued for 2, 3, or 4 weeks. Much smaller changes were seen in the older group that started on 0.05% beta aminoproprionitrile at 6 weeks of age for 10 days and then 0.02% beta aminoproprionitrile for the next 9-12 weeks. The biggest changes were seen in the abdominal aorta, which ruptured spontaneously in 50% of the young lathyritic group. The birds had a marked decrease in the number of elastin layers per unit wall thickness. Analysis of the elastic diagrams showed that the elastance of both elastin and collagen were altered in the young lathyritic group. Rupture appeared to follow partial dissection of plaques, but true longitudinal dissection did not occur. PMID- 3555749 TI - The role of the mast cell in allergic bronchospasm. AB - In allergic bronchospasm inhaled allergen interacts with specific IgE antibody on the surface of mast cells, inducing the release of mediators, particularly histamine and leukotrienes, which induce bronchoconstriction. Disodium cromoglycate, previously considered to be predominantly a mast cell stabilizing agent, is effective prophylactically in inhibition of early and late phase asthmatic reactions. However, the microenvironment of the airways contains many cell types and the precise role of mast cells is not clear. Lymphocytes, alveolar macrophages, eosinophils, platelets, and neutrophils possess low affinity surface receptors for IgE and can respond to allergen, releasing mediators that have diverse functions. These observations compound the problem of which mediator(s) is most important in pathogenesis of asthma. Moreover, mast cell products modulate the functions of many cells, and thus whether mast cells act directly or indirectly on bronchial smooth muscle requires clarification. Neuropeptides activate or modulate mast cells, and together with evidence of the close association of mast cells and nerves, these observations provide exciting new directions for investigation. Evidence that mast cells from different sites are heterogeneous in their response to stimuli and antiallergic drugs and differ in mediator production and function amplifies the problems identified above. In summary, the role of mast cells in bronchoconstriction is complex and systematic analysis of interactions between mast cells and other cells of the airways is essential. PMID- 3555750 TI - The role of histamine and other mediators in microvascular changes in acute inflammation. AB - In addition to bronchial smooth muscle, histamine and other mediators act in bronchial asthma on the microcirculation of pulmonary connective tissue. The mediators induce enhanced blood flow, and by acting on the blood-tissue barrier, they induce increase in vasopermeability with edema and in more severe injury microhemorrhage and microthrombosis and infiltration of the connective tissue by leukocytes, predominantly neutrophils. The scheme proposed 10 years ago by K. F. Austen and co-workers in 1976 still holds true: a short-acting humoral-cellular phase is followed by a longer-acting pathopharmacologic or inflammatory phase. Some mediators, including histamine, serotonin, bradykinin, the sulfido leukotrienes and platelet activating factor, have a direct effect on endothelium and smooth muscle cells and more severe injury is due to mediators that exert their effect via neutrophils, which release lysosomal constituents. The intact complement-derived fragments C3a and C5a act directly and for a short period, as do histamine and the other direct-action mediators. The accumulation of neutrophils is brought about by C5a and its stable derivative C5ades Arg, leukotriene B4, PAF, and interleukin-1. Unlike the direct-action mediators, whose effect on the microcirculation does not extend beyond 20-25 min, those mediating via neutrophils have a delayed effect (peak 1-2 h), which parallels the neutrophil influx. The direct action mediators exert their effects on the microcirculation also in neutropenic animals. The most potent agents causing enhanced blood flow are the prostaglandins of the E class. Through the enhanced blood flow increase in vasopermeability, neutrophil emigration and hemorrhage are enhanced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555751 TI - Plant phenolics as inhibitors of mutational and precarcinogenic events. AB - Initiation of chemical carcinogenesis involves the intracellular formation of a highly reactive electrophile that can attack many chemical nucleophiles in the cell, including DNA, a process that seems to be a central mechanism of initiation. Competing chemical nucleophiles in the cell, such as endogenous glutathione, can act as protecting or blocking agents against the attack on DNA. There are chemical substances in our food supply that may act as anticarcinogens or antimutagens by blocking or trapping ultimate carcinogen electrophiles in a nucleophilic chemical reaction, to form innocuous products. A continuous input of these substances could serve as an additional buffer against DNA damage, supplementing the endogenous systems qualitatively and quantitatively. Certain plant phenolics can be effective inhibitors of chemical mutagens and (or) carcinogens. Tetrapyrroles and porphyrins, both plant and animal, can also act as blocking agents. Both plant phenolics and porphyrins are primarily active against aromatic carcinogens as inhibitors of mutagenesis in in vitro systems. Plant phenolics have also demonstrated inhibiting activity against aromatic chemically induced carcinogenesis. PMID- 3555752 TI - Calcium and vitamin D modulate mouse colon epithelial proliferation and growth characteristics of a human colon tumor cell line. AB - The role of calcium and vitamin D in the prevention of colorectal cancer is only now being investigated at the organismal, cellular, and molecular biologic levels. Recent epidemiologic studies have supported the hypothesis that dietary calcium and vitamin D may be related to a reduced risk for colon cancer. The evidence from laboratory investigations in animals and in cell culture also indicate a possible preventative effect. Addition of calcium and vitamin D to the roster of developmental cancer chemopreventative agents for further research is warranted. PMID- 3555753 TI - Use of intermediate endpoints in quantitating the response of precancerous lesions to chemopreventive agents. AB - A current area of emphasis in cancer research is the determination of whether cancer can be prevented through the use of naturally occurring chemopreventive agents such as beta-carotene. A major area of concern in the design of long-term, large-scale population studies to ascertain the efficacy of such chemopreventive agents lies in the paucity of biological data on the activity of these agents in man. The studies described in this paper were performed to determine whether a series of short-term markers could be used in chemopreventive trials as indicators of the possible success of a chemopreventive regime. Three such markers are described. The first involves the measurement of genotoxic damage in the target tissues of carcinogen-exposed individuals by using the micronucleus test on exfoliated cells. This end point has been successfully used to demonstrate a reduction in carcinogen damage (micronuclei production) in the oral cavity of individuals in population groups at elevated risk for oral cancer (tobacco and betel quid users in the Philippines, snuff users in the Northwest Territories). The second marker involves the determination of DNA adducts in exfoliated cells of carcinogen-exposed individuals by the use of DNA postlabelling procedure. The final marker discussed involves a chemical determination of the levels of a chemopreventive agent in target tissues of individuals receiving a supplement in the diet. In this case, the example described is beta-carotene in exfoliated cells of carcinogen-exposed individuals. These three markers may be combined to determine whether a chemopreventive agent reaches a target tissue, affects DNA adduct formation, and prevents genotoxic damage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555754 TI - Inhibition of yeast respiration and fermentation by benomyl, carbendazim, isocyanates, and other fungicidal chemicals. AB - The inhibition of yeast (Saccharomyces cerevesiae) metabolism by fungicidal chemicals was investigated. Glucose- or ethanol-dependent yeast respiration was measured with an oxygen electrode, and manometric determination of carbon dioxide release was used to measure fermentation. Both respiration and fermentation were inhibited more by benomyl than by identical molar concentrations of its breakdown product, carbendazim. Butyl isocyanate, another benomyl breakdown product, inhibited respiration more but inhibited fermentation less than the parent compound. Of the isocyanates tested, hexyl isocyanate was the most inhibitory towards both activities. Captan was more active and iprodione less active than benomyl. Because benomyl rapidly broke down to carbendazim when it was prepared in 80% ethanol, only 59% of the dissolved benomyl was intact when it was added to yeast to determine its effect on respiration or fermentation. PMID- 3555755 TI - ICMSF methods study. XVII. An international comparative study of the direct plate and hydrophobic grid-membrane filter methods for enumeration of Escherichia coli in foods. International Commission on Microbiological Specifications for Foods. AB - Eight laboratories compared counts of Escherichia coli from naturally or artificially contaminated ground beef, other meats and poultry, vegetables, fish and shellfish, cheese, and diverse sources such as swabs, by the Anderson-Baird Parker direct plate (DP) and a hydrophobic grid-membrane filter (HGMF) method. For five of the eight laboratories overall counts by HGMF were significantly low (51-83%) compared with those by DP. Counts by HGMF tended to be lower for naturally contaminated samples; several possible causes were investigated. In a subsidiary study, analyst variation in counting HGMF ranged from 0.8-7.3%, with little evidence of effects from counting positive versus negative grid cells or from the fullness of growth or staining intensity. PMID- 3555756 TI - New hope in cancer of the breast. PMID- 3555757 TI - Repair and survival of the innominate artery late after transection. AB - Survival of major thoracic arteries transected by blunt trauma usually depends on immediate surgical repair. However, the authors report a case in which a 54-year old man had survived an untreated complete transection of the innominate artery 20 years before. He presented with subclavian steal syndrome and transient ischemic attacks. There was wide separation between the proximal and distal stumps of the artery with no apparent continuity of tissue between them. A 10-mm Gore-Tex graft was successfully used as a bypass from the ascending aorta to the distal carotid bifurcation. Survival of the innominate artery transection without treatment and late onset of symptoms has not previously been described. PMID- 3555758 TI - Sporadic hemorrhagic colitis associated with Escherichia coli, type O157:H7: unusual presentation mimicking ischemic colitis. AB - Hemorrhagic colitis is a bacterial infection of the colon, associated with a verotoxigenic strain of Escherichia coli, commonly serotype O157:H7. This recently described disease is usually self-limiting. Because fecal cultures are negative for the usual pathogens and the clinicopathologic features closely mimic ischemic colitis, the patient is exposed to the risk of unnecessary surgery. One such situation is described and differentiation between hemorrhagic and ischemic colitis is discussed. PMID- 3555759 TI - William Harvey, 2. Harvey and the Royal College versus the "empirics". AB - Harvey, in solitary fashion, conducted the research that led to the publication in 1628 of his famous treatise De Motu Cordis. Later he joined other anatomists in scientific research and, after becoming a fellow and office holder, assumed a position of prominence in the Royal College of Physicians. There he was an active member, attending meetings, carrying out his duties as an Elect, as Lumleian Lecturer, as censor and frequently as a member of special committees. Harvey the scientist cannot be separated from Harvey the physician. His work in London both as Physician-in-Ordinary to King Charles I and as Physician to St. Bartholomew's Hospital is outlined. His fate however, was, irrevocably tied to the Royalist cause and the Parliamentary Party was instrumental in having him dismissed from the hospital in 1643. After 1650 his reputation was again on the rise. Apothecaries were practising medicine with increasing boldness, and Harvey devoted considerable effort to defending the monopoly of physicians through the offices of the Royal College of Physicians. He fought the "empirics" with every available weapon and in the process introduced a number of needed reforms. In his work as scientist and physician, Harvey epitomized the close links that bound together classically educated physicians, experimental inquiry and anatomical innovation. He made it understood that learned men, not "empirics" were responsible for the great improvements under way in what was to become modern medicine. PMID- 3555760 TI - Adaptation of children to a chronically ill or mentally handicapped sibling. AB - The presence of a chronically ill or mentally handicapped child in a family can be a stress for the child's siblings, who often are ill informed about the nature and prognosis of the illness, may be uncertain what is expected of them in the caregiving role, may feel their own identities threatened, and may experience ostracism by their friends and misunderstanding at school. Although individual reactions vary widely, feelings of anger, guilt, resentment and shame are commonly reported. Excessive responsibility and concern about one's identity may add to these feelings and culminate in psychologic problems in the sibling. The physician caring for the family must be alert for symptoms of emotional disturbance or social maladjustment among the siblings of chronically ill or mentally handicapped children and should be prepared to counsel the family or refer them to a counsellor experienced in this area. In general, the first step is to be sure that the sibling is fully informed about the condition and to encourage frank discussion between the parents and the handicapped child's siblings. PMID- 3555761 TI - Health, aging, and nutrition. An overview. AB - The field of geriatric nutrition consists of a complex combination of physical, emotional, and environmental conditions. In order to properly assess the nutritional status of an elderly individual, all of these conditions must be considered. Because of the complex nature of geriatric life, old age may be the most difficult time in life to assure nutritional adequacy. PMID- 3555762 TI - Nutrient-drug interactions. AB - The full range of drug-nutrient interactions is discussed, with emphasis on metabolic mechanisms. The effects of nutrition on drug oxidation and drug conjugations are discussed separately. Chemical interactions of drugs and nutrients in the stomach and intestine are evaluated. PMID- 3555763 TI - Therapy-related acute nonlymphocytic leukemia with inversion of chromosome 16 and a sustained remission. AB - Acute nonlymphocytic leukemia, apparently without a preleukemic phase, developed in a 48-year-old male who had received oral cyclophosphamide and razoxane in succession. Inversion of chromosome #16 was present in association with the morphologic features typically seen with this abnormality in de novo acute leukemia. Conventional chemotherapy resulted in complete remission, which lasted for 13 months. The importance of performing cytogenetic studies in cases of secondary leukemia is emphasized. PMID- 3555764 TI - Inhibin-like material--an immunohistologic marker for prostatic origin of metastases. AB - Immunocytochemical localization of inhibin-like material (ILM) using a specific antiserum generated against ILM of prostatic origin was carried out in metastatic lymph nodes of known primary prostatic tumours and in rectal biopsies showing direct invasion with known prostatic carcinoma. Nine of the 11 metastatic lymph nodes gave positive reaction, which was readily apparent in differentiated tumours showing micro-acinar formation. In poorly differentiated tumours it was often focal and indicated intracytoplasmic staining within randomly scattered cells. Rectal biopsies showing invasion of prostatic carcinoma (4 cases) also showed positive reaction for ILM. Using this experimental protocol, the reaction for metastatic lesions from patients with non-prostatic carcinomas was completely negative indicating the specificity of the test for prostatic origin of metastasis. In conclusion, the present investigation indicates the potential application of ILM in confirming or excluding the prostatic origin of invasive tumour in metastatic lesions. PMID- 3555765 TI - Preparation of sibling donor for bone marrow transplant harvest procedure. PMID- 3555766 TI - Skin changes following bone marrow transplantation. PMID- 3555767 TI - Transport of molecules in the tumor interstitium: a review. AB - The transport of fluid and solute molecules in the interstitium is governed by the biological and physicochemical properties of the interstitial compartment as well as the physicochemical properties of the test molecule. The composition of the interstitial compartment of neoplastic tissues is significantly different from that of most normal tissues. In general the tumor interstitial compartment is characterized by large interstitial space, high collagen concentration, low proteoglycan and hyaluronate concentrations, high interstitial fluid pressure and flow, absence of anatomically well-defined functioning lymphatic network, high effective interstitial diffusion coefficient of macromolecules, as well as large hydraulic conductivity and interstitial convection compared to most normal tissues. While these factors favor movement of macromolecules in the tumor interstitium, high interstitial pressure and low microvascular pressure may retard extravasation of molecules and cells, especially in large tumors. These differences in transport parameters have major implications in tumor growth and metastases, as well as in tumor detection and treatment. PMID- 3555768 TI - Changes in the cell surface protein composition of human alveolar macrophages induced by smoking. AB - The cell surface proteins of human alveolar macrophages obtained from nonsmokers have been compared to those of alveolar macrophages obtained from smokers. Proteins of nonsmokers' alveolar macrophages surface labeled with 125I differed from those of smokers' alveolar macrophages, as shown by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Three major radiolabeled proteins with molecular weights of 183,000, 80,000, and 30,000 were identified in fresh smokers' cells. The major radiolabeled protein of nonsmokers' macrophages had an apparent molecular weight of approximately 183,000. Affinity chromatography suggested the Mr 183,000 protein is a mannose receptor. In contrast, the molecular weight of the major radiolabeled protein of smokers' alveolar macrophages was approximately 30,000; the Mr 183,000 protein was less prominent. When nonsmokers' alveolar macrophages were cultured in vitro before 125I labeling, the cell surface protein pattern changed to resemble that of smokers' alveolar macrophages; the Mr 183,000 protein could no longer be detected on the cell surface, whereas a Mr 80,000 protein was increased in quantity and a new Mr 30,000 protein was detected. Nonadherent macrophages showed similar changes in their surface-labeled proteins but also contained a new prominently labeled Mr 70,000 protein. Limited proteolysis peptide mapping with five different enzymes did not reveal any evidence of homology among the Mr 183,000, 80,000, 70,000, and 30,000 proteins. The differences in cell surface protein composition between alveolar macrophages of smokers and nonsmokers may reflect their functional capabilities or their state of "activation" and may be mechanistically important in the development of various pulmonary diseases seen in smokers including cancer. These results also demonstrate that major changes in the surface proteins of the human alveolar macrophage plasma membrane can occur rapidly following manipulation. PMID- 3555769 TI - Growth inhibition of murine melanoma cells by antibodies to a cell surface glycoprotein implicated in retinoic acid action. AB - Previous studies have shown that treatment of S91-C2 murine melanoma cells with beta-all-trans-retinoic acid (RA) results in growth inhibition, enhanced activity of sialyltransferase, and increased glycosylation of a Mr 160,000 cell surface sialoglycoprotein (gp160). None of these effects could be detected in mutant clones (e.g., S91-C154) selected from the S91-C2 cells for resistance to RA induced growth inhibition. These findings suggest that modulation by RA of gp160 might be related causally to growth inhibition. In this study we examined the possible role of gp160 in growth regulation using specific antibodies to this glycoprotein. Metabolic labeling of S91-C2 cells with either [3H]glucosamine or [35S]methionine revealed that the cells shed into the growth medium a gp160-like glycoprotein, in addition to several other macromolecules. The gp160-like glycoprotein was isolated from concentrated conditioned medium after preparative polyacrylamide slab gel electrophoresis in the presence of sodium dodecylsulfate by excision of the corresponding protein band. Rabbits were immunized with this material and immunoblotting revealed that their sera contained antibodies that bound specifically to gp160 in extracts of untreated or RA-treated S91-C2 cells. Indirect immunofluorescence staining followed by fluorescence-activated cell sorter analysis demonstrated that the anti-gp160 antibodies bound to the surface of both untreated and RA-treated S91-C2 cells and that the treated cells bound more of the antibodies than untreated ones. In contrast, these antibodies bound to the same extent to untreated and RA-treated resistant S91-C154 cells. The growth of S91-C2 cells in the presence of anti-gp160 antibodies in semisolid medium as well as in monolayer cultures was inhibited in a dose-dependent fashion. Fifty % growth inhibition was obtained at an immunoglobulin concentration of 10 micrograms/ml. The growth of cells exposed concurrently to RA and anti-gp160 antibodies was also inhibited strongly in semisolid medium, but the antibodies caused only a small increase in the inhibitory effect of RA in monolayer cultures. No inhibition by the antibodies of either anchorage independent growth or anchorage-dependent growth of S91-C154 cells, grown in the absence or presence of RA, was observed. These results support the suggestion that cell surface gp160 might be involved in growth regulation in the S91-C2 cells. PMID- 3555770 TI - Characterization of a human malignant mesothelioma cell line (H-MESO-1): a biphasic solid and ascitic tumor model. AB - Human malignant mesothelioma of the pleura was successfully transplanted s.c. into athymic nude mice and grew as a solid neoplastic mass. Tumor growth resulted in death of the animals between 98 and 161 days after implantation. Minced samples of the growing tumor were propagated as a malignant peritoneal effusion. Animals with malignant ascites died predictably at 32 to 33 days. Light and electron microscopy, and immunocytochemistry demonstrated a similarity of the transplanted solid and fluid malignancies with the human primary mesothelioma. Cytogenetic analysis demonstrated a predominance of cells with a triploid number of identifiable but abnormal human chromosomes. This model, which mimics the clinical behavior of malignant mesothelioma in the human, may be of value in animal trials of chemotherapy and immunotherapy. PMID- 3555771 TI - Novel cell cycle-related nuclear proteins found in rat and human cells with monoclonal antibodies. AB - Monoclonal antibodies which react specifically with the nuclei of interphase cells recognized three nuclear antigens with molecular weights of 110,000 (p110), 85,000 (p85), and 18,000 (p18). p110 and p85 were found in eight tumor cell lines but were not found in resting lymphocytes. p18 was found in resting lymphocytes as well as the tumor cell lines. Protein p85 appeared in phytohemagglutinin stimulated lymphocytes in the G1 phase and protein p110 appeared in the S phase. p110 and p85 were localized to the extranucleolar chromatin while p18 was distributed throughout the nucleus and was determined by microscopic and DNase digestion studies to be DNA associated. The anti-p110 antibody recognized a component of the DNA polymerase alpha 2 complex. Three novel nuclear proteins were identified using monoclonal antibodies. Two of these proteins (p110 and p85) are proliferating cell nuclear and nucleolar antigen-like while the third (p18) is not cell cycle dependent. PMID- 3555772 TI - Expression of retroviral sequences and oncogenes in rat liver tumors induced by diethylnitrosamine. AB - The expression of three cellular oncogenes (c-myc, c-Ha-ras, and c-delta-raf), the epidermal growth factor receptor gene, and two endogenous retrovirus-like sequences [rat leukemia virus (RaLV) and 30S] was examined in control rat livers and in 16 liver tumors. The tumors were induced in Sprague-Dawley male and female rats by a single i.p. injection of diethylnitrosamine at 1 or 2 days after birth, followed by dietary exposure to phenobarbital beginning at weaning. Increased expression of c-myc was seen in most of the tumors, but there was no consistent increase or decrease in expression of c-Ha-ras or c-delta-raf. It is of interest that a number of the tumor samples showed a decrease in epidermal growth factor receptor RNA. In all of the tumors, including both hepatocellular adenomas and carcinomas, there was a marked increase in expression of the endogenous RaLV sequence, and over 90% of the tumors displayed increased expression of the 30S endogenous retroviral-like sequence. No or a very low level of expression of the RaLV and 30S sequences was found in the control livers. The extent of expression of the RaLV and 30S sequences in individual tumors did not correlate with the extent of expression of c-myc or c-Ha-ras. Although increased expression of certain endogenous retrovirus-related sequences appears to be a common finding during rat liver carcinogenesis, the significance of this finding remains to be determined. PMID- 3555773 TI - Inhibition of growth and induction of differentiation in a malignant human glioma cell line by normal leptomeningeal extracellular matrix proteins. AB - We devised a model system to study the effects of extracellular matrix proteins on the malignant phenotype of an anaplastic glioma cell line, U 343 MG-A. Well characterized cultures derived from normal human leptomeninges were grown to confluence and maintained for 2 weeks. The leptomeningeal cells were then removed with base and detergent, leaving behind an extracellular matrix enriched in laminin, fibronectin, type I and IV collagen, and procollagen III. U 343 MG-A tumor cells planted on top of this normal extracellular matrix were profoundly growth inhibited compared with glioma cells grown on plastic alone. Glioma cells grown on the extracellular matrix developed multiple, slender processes and assumed a more differentiated astrocytic phenotype; immunostains for glial fibrillary acidic protein revealed a more extensive intracytoplasmic network of intensely staining filaments than in control glioma cells. When glioma cells grown on the extracellular matrix were analyzed by an enzyme-linked immunosorbent assay for glial fibrillary acidic protein, the amount of this intermediate filament per cell was increased 20-fold compared with glioma cells growing on plastic. The growth and differentiation of U 343 MG-A glioma cells in flasks coated with purified fibronectin or laminin was not significantly perturbed; however, glioma cell cultures grown in flasks coated with purified type I or IV collagen showed decreased cellular proliferation, stellate cell formation, and increased levels of glial fibrillary acidic protein per cell compared with glioma cells growing on plastic. Gelatin gel analysis showed that U 343 MG-A glioma cells growing on plastic secreted a 65,000-D metalloproteinase that was not secreted by glioma cells grown on the leptomeningeal extracellular matrix. We conclude that in this system, the extracellular matrix of a normal human leptomeningeal culture substantially inhibited the proliferation of and induced differentiation in an anaplastic glioma cell line. Our analysis of single components of the extracellular matrix suggests that these effects may be mediated in part by type I and IV collagen. The mechanism by which the leptomeningeal extracellular matrix inhibits glioma cell proliferation may be by diminishing tumor-associated protease secretion so that the degradation of extracellular matrix macromolecules in the tumor cell microenvironment is prevented and tumor cell migration becomes less likely. PMID- 3555774 TI - Differential expression of carcinoembryonic antigen in early gastric adenocarcinomas versus benign gastric lesions defined by monoclonal antibodies reactive with restricted antigen epitopes. AB - Murine monoclonal antibodies (MAbs) reactive with distinct epitopes on carcinoembryonic antigen (CEA) have been analyzed systematically by radioimmunoassays, Western blotting, and immunohistochemical assays to define CEA expression in adenocarcinomas, benign lesions, and normal tissues of the stomach. Each of four COL-MAbs (COL-1, COL-4, COL-6, and COL-12) reacted preferentially with cell extracts of adenocarcinomas versus those of normal mucosae in solid phase radioimmunoassays. Using Western blotting analyses MAbs COL-1, COL-4, COL 6, and COL-12 detected only the Mr 180,000 molecule characteristic of CEA in adenocarcinoma of the stomach; no reactivity was observed in an extract of normal gastric mucosa. Antibody competition radioimmunoassays were then carried out to define relations among COL-MAbs using 125I-radiolabeled MAbs, and nonradiolabeled MAbs as competitors. A spectrum of formalin-fixed, paraffin-embedded normal, benign, and malignant tissue sections of the stomach were examined for immunoreactivities with COL-MAbs using immunohistochemical assays to define whether the COL-MAbs were able to detect CEA expression in early foci of gastric carcinomas. All of the COL-MAbs generally demonstrated selective reactivities to adenocarcinomas (n = 40) versus benign lesions (n = 15) and normal mucosae (n = 6) of the stomach. From 72 to 100% of adenocarcinomas at early stage (n = 18) were reactive with the COL-MAbs, suggesting that these MAbs might serve as immunohistochemical diagnostic tools to detect early foci of gastric carcinoma. The data reported here indicate that the COL-MAbs can potentially be utilized as radioimmunological and immunohistochemical adjuncts to differentiate early adenocarcinomas from normal mucosae or benign lesions of the stomach on the basis of differential CEA expression. PMID- 3555776 TI - Endocrine aspects of breast and prostatic cancer: an overview. PMID- 3555775 TI - Tumor-specific genetically engineered murine/human chimeric monoclonal antibody. AB - Murine variable and human constant region exons were fused to produce "chimeric" immunoglobulin gamma and kappa genes. These constructs were cotransfected into murine myeloma cells which then produced and secreted intact, functional antibody. Cells secreting the chimeric antibody were introduced into mice. The engineered immunoglobulin was subsequently harvested from ascites fluid and was purified by affinity chromatography. Its immunological properties were compared to those of the parental murine monoclonal (B6.2), which exhibits specificity for human breast, lung, and colon carcinoma cells. Competitive binding, immunofluorescent cell staining, and analysis of immunoprecipitated antigen gave similar results for the chimeric and murine B6.2. The biodistribution of chimeric and murine B6.2 after injection into mice bearing human tumors was found to be identical. These results suggest that murine/human chimeric antibodies may be viable clinical replacements for murine monoclonals with the potential for better immunological tolerance and pharmacological efficacy. PMID- 3555777 TI - Comments on the treatment of breast cancer. PMID- 3555778 TI - Hormone agonists and antagonists in the treatment of hormone sensitive breast and prostate cancer. PMID- 3555779 TI - Biology and therapy of prostatic cancer. AB - There is no effective therapy for increasing the survival of metastatic prostatic cancer. New approaches to this major disease are urgently needed. One approach is to study the biology of prostatic carcinogenesis in order to develop a treatment that prevents the initial development of clinically manifest prostatic cancer. International epidemiological data on the incidence of prostatic cancer and the data on migrant populations make this both possible and practical. For example, it should be possible to lower the incidence of clinical prostatic cancer by more than ten-fold among men in the United States. An alternative approach is to study the tumour biology of prostatic cancer to identify better methods for treating established clinical prostatic cancer. Such studies have already demonstrated that individual prostatic cancers are composed of clones of cancer cells that are phenotypically heterogeneous even before therapy is initiated. Because of this tumour cell heterogeneity, future studies should be directed towards combining androgen ablation plus chemotherapy and/or radiation early in the disease in order to affect both the androgen-dependent and the androgen-independent cancer cells present in individual prostatic cancers. PMID- 3555780 TI - Oestrogen and progesterone receptor determinations in breast cancer: technology and biology. AB - Our present state of knowledge regarding oestrogen and progesterone receptors (ER and PgR, respectively) has led to changes in treatment strategies: patients without receptors in their tumour tissues cannot be expected to respond to endocrine therapy; furthermore, groups of patients with specifically good or poor prognoses can be selected. Treatment of the disease is now starting to be rational rather than empirical. However, it is imperative that we achieve a greater level of understanding before we can predict with high probabilities which patients will benefit from endocrine therapy. Only through a coordinated effort by many centres can we hope to attain this goal. In such collaboration several factors must be considered if reproducible conclusions with respect to results from receptor assays are to be reached: sampling of the tumour biopsy for analysis, potential differences in assay procedures which may affect results and the composition of the population studied. Differences between centres in any of these aspects may affect the study conclusions. The causes of and direction of possible biases due to these factors will be discussed here. Approximately 90% of all patients with primary breast cancer have been registered in the national Danish Breast Cancer Cooperative Group (DBCG) project. ER and PgR determinations have been performed on tumour tissue from approximately 30% of these patients in a single laboratory. The results of these analyses are presented here for 3735 patients in relation to age, menopausal status, tumour size, grade of anaplasia, lymph node involvement and parity. Approximately 30% of these patients have been in DBCG protocols in which no adjuvant systemic therapy has been administered. Because of this large number of cases, the recurrence-free survival of the untreated disease in relation to receptor status can be reliably analysed. Both ER status and PgR status were found to be significant prognostic variables for premenopausal women under 50 years of age. In contrast, in the postmenopausal women neither ER nor PgR status was a significant prognostic factor in the low risk group (tumour less than 5 cm, no lymph node involvement). In high risk, postmenopausal women, however, ER status is a significant prognostic factor for recurrence-free survival and it appears to be independent of lymph node status. PMID- 3555781 TI - Prognostic factors in primary breast cancer. AB - A review and update of published studies on oestrogen receptor and progesterone receptor as prognostic factors in breast cancer supports the following conclusions. In stage I breast cancer the lack of oestrogen receptor seems to be the most important factor for predicting earlier recurrence and poorer survival. In stage II breast cancer, measurement of progesterone receptor appears to be better than measurement of oestrogen receptor for predicting disease-free survival, and is as important as the oestrogen receptor in predicting overall survival. The benefits of adjuvant endocrine therapy are better predicted by the presence or absence of progesterone receptor rather than by oestrogen receptor. Measurement of proliferative activity (DNA S-phase) by thymidine labelling or flow cytometry, and of aneuploidy by flow cytometry, also provides prognostic information. The strong correlations between tumour receptor content, per cent S phase and aneuploidy suggest that these measurements in concert might identify a subset of stage I breast cancer patients at increased risk for recurrence, who would thus be potential candidates for adjuvant therapy. PMID- 3555782 TI - Endocrine status and the epidemiology and clinical course of breast cancer. PMID- 3555783 TI - The epidemiology and endocrinology of the menarche in relation to breast cancer. AB - The search for major endocrine abnormalities as causes for breast cancer has not been successful, whether it has been directed to patients with this disease, or to different groups or populations at risk, such as women who have had an early menarche. There were, however, clear-cut differences in a number of variables when the pubertal development of girls with an early menarche was compared with that in other girls. The girls with an early menarche, compared to those with a late menarche, had an early increase in serum concentrations of follicle stimulating hormone, higher circulating oestradiol concentrations before and for several years after menarche and lower serum sex hormone-binding globulin concentrations for several years after menarche, the last two leading to higher 'free oestradiol indices' in the serum. Early menarche was characterized by early onset of ovulatory cycles. We found that the times from menarche until 50% of the cycles were ovulatory were about 1, 3 and 4.5 years, when the ages at menarche were less than 12, 12-12.9 and more than or equal to 13 years, respectively. In addition, the luteal phase of the menstrual cycles of subjects with an early menarche was adequate more frequently than that of subjects with a later menarche. These findings are compatible with the view that girls with an early menarche have a more profound decrease in the sensitivity of the hypothalamic pituitary axis to the negative feedback of circulating steroids. The associations between endocrine variables and body weight and percentage of fat seem to be primarily determined by the endocrine variables. Altogether the data on early menarche suggest that early-onset regular cyclic ovarian function is related to the increased risk of breast cancer that is associated with this category of women. Athletic activities may delay menarche, which may have relevance for reducing the risk of breast cancer. PMID- 3555784 TI - Human mammary cancer as a site of sex steroid metabolism. AB - Oestrogen-progesterone imbalance in favour of the oestrogens is considered to be an important factor in the development of mammary cancer, although oestrogens are not directly mitogenic. Moreover, this promoter effect of carcinogenesis may be limited in time. Except for increased plasma (free) oestradiol levels, plasma sex hormone levels in breast cancer patients are comparable to those in normal women, matched for age and weight. In both benign and malignant breast tissue, sex hormone concentrations (ng/g) are significantly higher than in plasma (ng/mg), except for dehydroepiandrosterone sulphate, oestrone sulphate and testosterone, but in breast cancer tissues, dehydroepiandrosterone sulphate (DHEAS), 5 alpha androstane-3 alpha-17 beta-diol and progesterone concentrations are lower than in normal breast tissue. As to the origin of these sex hormones in breast tissue, a positive arteriovenous gradient across the breast tissue has been observed for androstenedione and oestradiol, suggesting uptake from plasma by the tissues. Aromatization of androstenedione, on the other hand, is probably only a minor source of oestrogens in breast tissue. Hydrolysis of oestrone sulphate taken up from the blood, or oestradiol-17 beta fatty acid esters may be another source, but data are too scarce at present to draw a final conclusion as to their role as source of tissue oestrogens. 17 beta-hydroxysteroid dehydrogenase activity, inactivating oestradiol into oestrone, may be an important determinant of tissue oestradiol concentration. This enzyme activity was found to be higher in oestrogen receptor positive than in oestrogen receptor negative tissues and was negatively correlated with DHEA and DHEAS concentrations. As it was shown that the latter two steroids are non-competitive inhibitors of the 17 beta hydroxysteroid dehydrogenase as well as of the oestrogen-sulphotransferase, it appears that DHEA may be an important modulator of tissue oestradiol concentration, whereas the 17 beta-hydroxysteroid dehydrogenase might constitute an additional marker of hormone dependency of breast cancer. PMID- 3555785 TI - Determinants of tissue oestradiol levels in human breast cancer. AB - A variety of clinical and experimental evidence indicates that the oestrogens are the major hormones affecting human breast cancer growth. The goal of recent treatment strategies is to reduce the amount of oestradiol acting locally on the tumour. For this reason, it is relevant to examine what determines tumour tissue oestradiol concentrations. Various steps are potentially important and include glandular or extraglandular production of oestradiol, tissue uptake, binding to receptors and the rate of local tissue oestradiol synthesis. In premenopausal women, glandular secretion of oestradiol by the ovary provides the major source of tissue oestradiol. In postmenopausal women, the extraglandular conversion of androstenedione to oestrone and then oestradiol in peripheral tissues accounts for 90% of circulating oestradiol. However, plasma levels of oestradiol in postmenopausal women are only 4 to 40% of those found in premenopausal patients and yet breast cancer tissue levels are similar. This observation suggests the possibility of local oestradiol synthesis by breast tumours in postmenopausal women. We examined two pathways which could be involved in local oestradiol synthesis: the androstenedione to oestrone (aromatase) pathway and the oestrone sulphate to oestrone (sulphatase) system. Seventy-nine of 128 tumours contained aromatase with activity ranging from 5-80 pmol/g protein/hr. This enzyme was of high affinity with a Km of 0.027 microM. Sulphatase, on the other hand, was present in all tumours with activity ranging from 0.8-125 microM. Its affinity was appreciably lower with a Km of 27 microM. Comparing both activities at substrate concentrations approaching physiological levels, we detected 10-fold higher activity with sulphatase than with aromatase. Further studies revealed the presence of 17 beta-hydroxysteroid dehydrogenase in all tumors studied. Whereas 50% of tissues contained both a high and a low affinity type of activity, the remainder had only the low activity form. Since our data favoured the oestrone sulphate to oestrone to oestradiol pathway as biologically relevant, we sought to determine whether oestrone-sulphate could act as an oestrogen after conversion to oestradiol. Using an NMU rat mammary tumour soft agar colony forming assay, we found that oestrone-sulphate stimulated colony growth in a manner consistent with its 1% conversion to oestradiol by cells in the agar dishes. Furthermore, preliminary data indicate that oestrone-sulphate can stimulate NMU tumour growth in vivo in rats. The metabolism of oestradiol in tissue can also determine its biological effects and its tissue levels.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555786 TI - Hormonal control of human breast cancer cell lines. AB - The most widely studied steroid hormone responsive cancers are those of the prostate, endometrium and mammary endothelium and the leukaemias. Steroids may in some cases be involved in tumour initiation, and they induce critical events in the malignant 'progression' of these cancers once they develop (after exposure to carcinogens, for example). This paper focuses on the role of the oestrogen receptor as a trigger of cellular growth and invasiveness and as modulator of growth factor secretion in human breast cancer. Growth factor secretion may be a common final pathway of diverse tumorigenic stimuli in a variety of cancers. The finding of external growth control mechanisms suggests possible new ways of therapeutic intervention in breast cancer. PMID- 3555787 TI - Mechanism of steroid hormone action. AB - Steroid hormones regulate growth and development in certain types of cells and are involved in a wide variety of physiological responses in most tissues. These responses depend on the association of a hormone with a receptor protein and the subsequent activation of different genes at precise stages during embryonic development and cell differentiation. The primary role of the steroid receptor complex is to bind to specific loci in the genome and regulate rates of gene transcription, but in addition steroids can also modulate the expression of some genes posttranscriptionally. The nuclear binding sites are specific DNA sequences termed steroid response elements that, upon steroid binding, function as transcriptional enhancers. After this interaction there are specific changes in the structure of chromatin which correlate with transcription of the gene and may mediate the action of the steroid. There are a variety of transcriptional enhancers associated with certain genes which interact with activating proteins and these could account for the expression of different networks of genes in individual cells that respond to different physiological stimuli. PMID- 3555788 TI - Influence of daunorubicin and cytarabine sequencing on the outcome of therapy in acute myelogenous leukemia: a randomized trial. AB - Ninety-seven patients less than or equal to 70 years of age with previously untreated primary acute myeloblastic leukemia were randomly treated with either the DAT or TAD regimen: daunorubicin (70 mg/m2/day) administered on Days 1-3 (DAT) or 5-7 (TAD) of a 7-day sequence consisting of cytarabine (200 mg/m2/day) and 6-thioguanine (200 mg/m2/day). Complete responders received consolidation, maintenance, and final intensification over 14 months using mostly the same drugs as during induction and administered in the same sequence. The regimens did not significantly differ from each other with regard to toxicity or efficacy. Complete remission rate was 80% in the two groups, and median duration of complete remission was 549 days with DAT and 518 days with TAD. PMID- 3555789 TI - Pilot trial of prolonged continuous-infusion 5-fluorouracil and weekly cisplatin in advanced colorectal cancer. AB - Thirty-five patients with previously untreated, advanced, measurable metastatic colorectal carcinoma were treated with a 12-week course of continuous 5 fluorouracil (5-FU) and weekly cisplatin. Twenty of 32 evaluable patients responded (five complete and 15 partial responses), for an overall response rate of 63% (90% confidence limits, 43%-75%). Toxicity was generally mild and reversible and included mucositis (40%), painful erythema of the palmar and plantar skin (30%), diarrhea (21%), nausea and vomiting (15%), and leukopenia (6%). One patient died of sepsis secondary to mucositis and myelosuppression. This program is a well-tolerated outpatient regimen for metastatic colorectal carcinoma. The response rate is higher than expected for 5-FU and cisplatin and suggests clinical therapeutic synergism at this dose rate and schedule. PMID- 3555790 TI - Total-body irradiation and high-dose teniposide: a pilot study in bone marrow transplantation for patients with relapsed acute lymphoblastic leukemia. AB - Inadequate leukemic ablative therapy ending in leukemic relapse is the source of most failures following bone marrow transplantation. Attempting to improve pretransplant leukemic ablative therapy, we report on a pilot regimen that includes teniposide, the principal chemotherapy, and total-body irradiation. Ten patients with acute lymphoblastic leukemia in relapse underwent allogeneic bone marrow transplantation. All patients engrafted. Toxicity, primarily mucositis, was manageable. Two patients have survived for 1547 and 1988 days in continued remission. Eight patients have died: three from sepsis in the immediate posttransplant period, four with recurrent leukemia, and one with chronic graft versus-host disease and pneumonia. We believe that these results support further trials with teniposide in pretransplant leukemic ablative therapies. PMID- 3555791 TI - Phase II trial of aminothiadiazole in previously treated and untreated patients with advanced colorectal carcinoma: an Illinois Cancer Council Trial. AB - Eighty-three patients with advanced colorectal carcinoma were entered on a phase II trial of weekly iv aminothiadiazole (125 mg/m2) plus daily oral allopurinol (300 mg). There were five partial responses. Median survival of all patients on study was 36 weeks from entry (48 weeks for those without prior therapy and 34 weeks for those with previous chemotherapy). Toxicity was generally mild and consisted predominantly of stomatitis. In the dose given, aminothiadiazole has limited activity against metastatic colorectal cancer. PMID- 3555792 TI - Structural studies of the O-specific side-chains of the Escherichia coli O2 lipopolysaccharide. AB - The structure of the O-specific side-chains of the Escherichia coli O2 lipopolysaccharide has been investigated, different 1H- and 13C-n.m.r. techniques being the main methods used. It is concluded that they are composed of pentasaccharide repeating-units having the following structure, in which D Fuc3NAc is 3-acetamido-3,6-dideoxy-D-galactose. ----4)-beta-D-GlcpNAc-(1----3) alpha-L-Rhap-(1----2)-alpha-L-Rh ap-(1----3)-beta-L-Rhap-(1----2 increases 1 alpha-D-Fucp3NAc. PMID- 3555793 TI - [Results of a multicenter trial of antihypertensive treatment with atenolol, alone or in combination with chlorthalidone, of patients with mild, moderate and severe hypertension]. PMID- 3555794 TI - Cardiovascular responses to dynamic exercise. AB - Dynamic exercise results in a marked increase in oxygen consumption. This increase is accomplished by a significant increase in heart rate and peripheral oxygen extraction and, to a lesser extent, by an increase in stroke volume. There is a small increase in mean systemic and pulmonary artery pressures and marked decrease in systemic and pulmonary resistances with exercise. The result of changes in focal vasomotor tone is that a greater percentage of the cardiac output is directed to the working muscles. PMID- 3555795 TI - Exercise and the failing heart. AB - In summary, patients with chronic heart failure are frequently limited during exercise, even if they are asymptomatic at rest. Maximal exercise testing, preferably coupled with respiratory gas analysis, provides an objective method of assessing this functional limitation. Exercise testing also offers an objective method of noninvasively evaluating circulatory function in patients and, potentially, of monitoring responses to therapeutic interventions. PMID- 3555797 TI - Cardiovascular drugs and exercise interactions. AB - An appreciation of the hemodynamic and biochemical changes induced by drugs is critical for a logical diagnostic interpretation of graded stress tests and the evaluation of the projected exercise prescription and exercise programs that a patient is asked to follow. Drug therapy is clearly not a contraindication to acute or chronic exercise as long as the potential benefits and complications of exercise and drug interaction are considered. PMID- 3555796 TI - Exercise testing for sports and the exercise prescription. AB - The uses of the exercise test continue to grow and diversify. Familiarity with the mechanics, logistics, and interpretation of these tests leads to their optimal use. The application of exercise testing for competitive or recreational sports, cardiovascular fitness exercise training, and cardiac rehabilitation is the focus of this review. Many test protocols are available, but treadmill testing is the most widely used. The inclusion of thallium scintigraphy in the exercise protocol requires additional time and expense and is best reserved for those in whom the exercise electrocardiographic response cannot be adequately interpreted. Exercise testing is a relatively safe procedure, providing that adequate screening of individuals for unstable cardiac or medical conditions has been performed. The test must be administered by experienced personnel in a setting where the necessary emergency resuscitative equipment is available. Adequate interpretation of the exercise test requires knowledge of the individual being tested and of the reason the test is being performed. Complete analysis of the exercise test includes electrocardiographic response (ST segment changes and rhythm disturbances), hemodynamic response (heart rate and blood pressure before, during, and after exercise), and functional capacity (exercise duration, symptoms, conversion to MET's). When exercise tests are employed to establish a diagnosis of coronary artery disease, an assessment of the pretest likelihood (prevalence) of disease is essential in deriving a reasonable assessment of the probability of disease after the test has been performed and reviewed. This information is particularly important when screening asymptomatic subjects for underlying coronary disease before they engage in an exercise program. Exercise testing of individuals with known cardiac disease prior to engaging in competitive or recreational sports can yield much useful information. In addition to a knowledge of the underlying cardiac condition, the type and intensity of the sport being performed must be taken into account when exercise testing is performed for athletic screening. Individuals with congenital or acquired valvular heart disease, coronary artery disease, and rhythm disturbances should undergo an exercise test as part of the pretraining evaluation. Patients with ischemic heart disease, especially those who have had a recent myocardial infarction or have undergone coronary artery bypass surgery, require counseling regarding their ability to perform certain activities of daily living and to return to work. Exercise testing can be a useful tool in establishing activity guidelines for these individuals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555798 TI - Environmental considerations for exercise. AB - Physical activity, whether at a competitive or a recreational level, is frequently affected by environmental conditions. With changes in the natural environment, the exercising individual invokes a series of complex physiologic responses that are directed at maintaining homeostasis. This article will focus on the nature of these responses, with special reference to their influence on cardiorespiratory function. Because alterations in ambient temperature and ascent to altitude are the most common and are the most extensively studied of man's adaptational abilities, these will provide the basis for this discussion. PMID- 3555799 TI - Epidemiologic analysis of coronary heart disease and exercise. AB - The association between sedentary lifestyle and cardiovascular disease is reviewed. Hazards of exercise are discussed, and clearance procedures for participation in exercise testing are described. There is a brief section on the epidemiology of exercise participation in the United States. Implications for the practitioner are presented. PMID- 3555800 TI - The role of exercise training in the therapy of hyperlipoproteinemia. AB - Exercise therapy is a valid therapeutic modality in patients with hyperlipoproteinemia (HLP). In combination with appropriate dietary modification, it can be a powerful therapeutic tool and may allow a reduction in hyperlipidemic medication doses. Improved triglyceride values and lipoprotein profiles can be obtained. The dose of therapy is an important aspect of exercise prescription, as it is in any medical therapy. The amount and type of exercise required to achieve therapeutic lipid changes in patients with HLPs deserves further attention. PMID- 3555801 TI - Exercise and hypertension. AB - The cardiovascular response to dynamic exercise is generally normal in patients with mild hypertension, but the response to isometric exercise may be increased, with a greater degree of vasoconstriction. The exercise-induced rise of pressure is affected little by most antihypertensive medications; with beta blockers, the response to dynamic exercise may be diminished, but to isometric exercise it may be enhanced. There is increasing evidence that regular dynamic exercise may attenuate the development of hypertension and lower blood pressure in patients with mild hypertension. For patients with mild, uncomplicated hypertension, the benefits of exercise appear to out-weigh the risks. PMID- 3555803 TI - Exercise and the aging heart. AB - Studies of the effect of age on cardiac function during exercise are confounded by the increasing prevalence of disease and sedentary lifestyle that accompany aging and by the lack of techniques to clearly distinguish between the contribution of changes in central circulatory and peripheral factors to the age related alterations in cardiovascular physiology. Although diastolic filling is delayed at rest, end diastolic volume is not compromised either at rest or during exercise. Exercise heart rate is invariably reported to decrease with increasing age, whereas stroke volume has been reported to be both increased and decreased in studies of different populations. Most investigators report an increase in end systolic volume and a diminished ejection fraction in older individuals as well. These changes are mediated, in part, by an age-associated diminished responsiveness to beta-adrenergic stimulation. PMID- 3555802 TI - The athletic heart. AB - The clinical features of athletic hearts are confusing to physicians who are unfamiliar with them. In particular, the diagnosis of hypertrophic cardiomyopathy may be suggested. The clinical signs of athletes' hearts are discussed with special reference to this difficult diagnosis. Emphasis is placed on the results of special investigations including the electrocardiogram and echocardiogram. The changes seen in athletic hearts are physiologic adaptations that do not appear to cause significant problems. Long-term follow up of the more extreme examples, however, is very limited, and this is an area where further information is needed. Resting bradycardia is a common feature in athletes, but abnormal tachyarrhythmias on exertion signify cardiac disease and are not a part of the athlete heart syndrome. PMID- 3555804 TI - Exercise and sudden death. AB - Sudden death during exercise is rare, but limited data suggest that vigorous physical activity is associated with an increased risk for this event, particularly in individuals with overt cardiac disease or a high coronary risk profile. The mechanism of exercise-associated sudden death is usually a lethal arrhythmia; however, this may vary depending on the underlying cardiovascular disease. In the great majority of cases, cardiovascular disease is present in persons who die during exercise. In young individuals (less than 35 years old) hypertrophic cardiomyopathy and congenital coronary anomalies are the most common conditions, whereas older victims usually have coronary artery disease. Cardiac disease is typically unrecognized prior to death in young persons; in the older population, most have overt coronary disease or recognizable coronary risk factors. Screening asymptomatic individuals to identify increased risk of a cardiac event during exercise presents major problems in terms of logistics, expense, and accuracy, but careful evaluation, including exercise testing, is mandatory before a program of increased activity in patients with overt cardiac disease. In other cases, the extent of any evaluation must be determined on an individual basis. PMID- 3555805 TI - Cardiac surgery. Prologue: from whence? PMID- 3555806 TI - Basis for selecting a valve prosthesis. PMID- 3555807 TI - Mitral valve reconstruction versus prosthetic valve replacement. PMID- 3555809 TI - Advances in the surgical management of congenital heart disease in infants and children. AB - This chapter is not meant to be an exhaustive review; it is meant only to highlight the clinical developments over the past decade in selected areas. Much remains to be learned about the management of many congenital cardiac defects, and only through further experience, curiosity, and imagination, coupled with careful and complete analysis of our activities, will we further refine and improve surgical management programs that are so critical to the patients we treat. PMID- 3555808 TI - Role of surgery in infective endocarditis. AB - The thrust of the surgical literature at present and over the past 10 years has emphasized that early operation based on hemodynamic considerations and to some extent on the infecting organism offer a very reasonable outlook to the patient for hospital survival and long-term survival. However, as in all valvular heart disease, consideration of the risk of an indwelling prosthetic device and all its attendant complications must enter into decision making as to appropriateness and timing of operation. PMID- 3555810 TI - Advances in surgical management of congenital heart disease in adults. AB - The spectrum of congenital heart anomalies presenting in adults varies somewhat from that in children. Prolonged exposure to hypoxemia coupled with volume overload or pressure overload can produce myocardial fibrosis and ventricular dysfunction, which complicates surgical correction. Despite these difficulties, surgical correction is possible for most congenital heart lesions in adults, with subsequent improvement in symptoms and survival paralleling that achieved after repair in childhood. In the future, cardiologists and cardiac surgeons will encounter an additional subgroup of adults with congenital heart problems. These are patients who have survived initial correction or palliation of complex heart diseases and later develop complications owing to failure of abnormal native valves or prosthetic valves, narrowing of surgically created conduits, or intrinsic ventricular failure. Such patients will add to the challenge of evaluation and treatment of adults with congenital heart disease. PMID- 3555811 TI - Acute dissection of the aorta. PMID- 3555813 TI - Recent progress in myocardial protection during cardiac operations. PMID- 3555812 TI - Aneurysms of ascending thoracic aorta and transverse aortic arch. AB - Recent chapters in the relatively brief history of surgical treatment of patients with ascending aortic aneurysms and aortic arch aneurysms continue to be punctuated by substantial clinical improvements. More precise diagnostic methods, increased awareness of the dismal natural history of patients with these aneurysms, improved methods of myocardial and cerebral protection, refined vascular grafts and prosthetic valves, widespread availability of specific coagulation components, more sophisticated anesthetic and postoperative management, and more timely referral of patients (prior to rupture or irreversible deterioration of left ventricular function, or both) have all been instrumental in promoting these improving results. The thrust of future efforts should be directed to the appropriate identification, diagnosis, and treatment of remote aneurysms and atherosclerotic disease in the cerebral and coronary circulation, detection of patients predisposed to aortic dissection, and ultimately to the development of pharmacologic methods to prevent aortic dissection and atherosclerotic aneurysm development. Eventually, it is hoped, more complete understanding of the genetics, molecular biology, and biochemistry of both acquired and congenital degenerative thoracic aortic aneurysms will also lead to preventive measures for these patients. PMID- 3555814 TI - Elective coronary surgery. AB - The goal of providing patent grafts distal to important coronary stenoses remains unchanged. Results of bypass grafting show the influence of refined technique, improved technology, and the longer followup now available. Coronary artery bypass is now routinely performed with low morbidity and mortality. Late attrition of saphenous vein grafts with concomitant deterioration of patients' clinical status has been increasingly recognized. The internal mammary graft, with its superior patency and impact on length and quality of survival, is gaining wider acceptance. Increased use of the mammary artery graft and extension of its use with bilateral and sequential grafting patterns are an important trend in the current practice of coronary surgery. PMID- 3555815 TI - Early complications following cardiac surgery. PMID- 3555816 TI - Cardiac and cardiopulmonary transplantation. PMID- 3555817 TI - Mechanical support or replacement of the heart. PMID- 3555818 TI - Surgical management of cardiac arrhythmias. PMID- 3555819 TI - Left ventricular aneurysm: natural history and surgical treatment. PMID- 3555820 TI - Controlling color in the porcelain laminate. PMID- 3555821 TI - Local anesthetics: a review of their pharmacology and clinical use. PMID- 3555822 TI - Dentistry in ancient Egypt. PMID- 3555823 TI - The Ross osteounification tooth replacement system: a clinical case report of an immediate extraction site. PMID- 3555824 TI - Posterior porcelain bonded inlays. PMID- 3555825 TI - A brief history of dental prophylaxis. PMID- 3555826 TI - [Diabetes after transplantation of the pancreas and kidney]. PMID- 3555827 TI - [Comparison of the effect of methyltestosterone and testosterone undecanoate in substitution therapy of hypogonadism]. PMID- 3555828 TI - [Lomonosov and the Prague Medical School in the 18th century]. PMID- 3555829 TI - [The effect of ionizing radiation on prostanoid metabolism]. PMID- 3555830 TI - [Prof. Kamil Lhotak. 20 December 1876-27 January 1926]. PMID- 3555831 TI - Catecholamine distribution and relationship to magnocellular neurons in the paraventricular nucleus of the rat. AB - The distribution of catecholamine synthesizing enzymes within the paraventricular nucleus of the rat hypothalamus is elucidated immunocytochemically by use of antibodies to tyrosine hydroxylase, dopamine beta-hydroxylase, and phenylethanolamine-N-methyltransferase. Tyrosine hydroxylase-immunostained cell bodies are localized in the periventricular stratum and adjacent parvocellular regions, but rarely in magnocellular subnuclei of the paraventricular nucleus. Tyrosine hydroxylase-immunostained fibers are present in greatest density in the periventricular zone, and moderate density in the parvocellular and magnocellular subnuclei. Dopamine beta-hydroxylase-immunostained fibers are remarkably dense in the posterior magnocellular division of the paraventricular nucleus, especially in the dorso-lateral portion where vasopressin-containing cells predominate. Noradrenergic fiber input to these magnocellular neurons is likely since phenylethanolamine-N-methyltransferase-immunostained fibers are sparse in magnocellular subnuclei of the paraventricular nucleus. Dual immunocytochemical staining of thick and thin tissue sections demonstrates with clarity an anatomical association of dopamine beta-hydroxylase-immunostained fibers and magnocellular neurons. Dopamine beta-hydroxylase-immunostained and phenylethanolamine-N-methyltransferase-immunostained fibers are dense in the medial parvocellular component of the paraventricular nucleus; distinct features of both antisera are presented. PMID- 3555832 TI - Effects of aging and life-long physical training on collagen in slow and fast skeletal muscle in rats. A morphometric and immuno-histochemical study. AB - Intramuscular collagen in a slow (m. soleus) and a fast (m. rectus femoris) skeletal muscle was studied by biochemical, morphometric, and immunohistochemical methods. Wistar white rats of 1, 4, 10, and 24 months were used as experimental animals. Our aim was to evaluate the effects of life-long physical training (treadmill running, 5 days a week for 1, 3, 9, and 23 months depending on the age attained). The biochemical concentration of collagen was higher in m. soleus than in m. rectus femoris and it increased in youth and in old age in m. soleus. The trained rats had higher concentrations of collagen than the untrained rats at 10 and 24 months. The morphometrically measured area-fractions of both the endomysium and perimysium were higher in m. soleus than in m. rectus femoris. The age-related increase in intramuscular connective tissue was of endomysial origin. The immunohistochemical staining of type-I, -III, and -IV collagens indicated the more collagenous nature of m. soleus as compared with m. rectus femoris for all major collagen types; this was most marked for type-IV collagen of basement membrane. The results indicate that both age and endurance-type physical training further distinguish the slow and fast muscles with respect to their connective tissue. PMID- 3555833 TI - Nerve growth factor-like immunoreactivities in rodent salivary glands and testis. AB - A series of polyclonal affinity-purified antibodies against mouse submandibular gland nerve growth factor (NGF) are described. Using the submandibular gland of the male mouse and indirect immunofluorescence, the specificity and sensitivity of affinity-purified immunoglobulins and various other fractions from the immunized animals have been tested. It will be shown that affinity-purification schemes, including pre-purification of protein A-fractionated immunoglobulins to remove antibodies that bind to unrelated hydrophilic and hydrophobic proteins, significantly enhance the signal-to-noise ratio and specificity of the antibodies. The antibodies effectively detect NGF-like immunoreactivity in both fresh and fixed glandular tissue. Optimal fixation procedures are described. Fluorescence intensities are linearly correlated to log antibody concentration. By use of the best antibody fractions and optimal fixation protocols, the distribution of NGF-like immunoreactivity is described in eight different salivary glands (rat and mouse, male and female, submandibular and sublingual glands). In addition to the well-known large numbers of immunoreactive cells in the submandibular gland of the male mouse, immunoreactive cells were found in the sublingual gland of male mice and in the submandibular and sublingual glands of female mice. One antibody revealed a weak specific fluorescence also in the submandibular gland of the male mouse. In a survey of genital organs of male mice, one antibody revealed fluorescence in the germ cell line. We conclude that several polyclonal affinity-purified antibodies have been characterized that show a strong NGF-dependent binding to the secretory granules of tubular cells in the submandibular gland of male mice. These antibodies should make it possible to locate endogenous and perturbed NGF levels immunocytochemically, e.g., in the peripheral and central nervous system, where NGF concentrations may be several orders of magnitude lower than in the salivary glands. PMID- 3555835 TI - Electron-microscopic characterization of adrenergic axon terminals in the diencephalon of the rat. AB - The fine structure of adrenergic axon terminals was examined in the paraventricular nucleus of the thalamus (PNT) and in the hypothalamic arcuate nucleus-median eminence (ARC-ME) complex by use of phenylethanolamine-N-methyl transferase (PNMT) immunocytochemistry. In the PNT, immunoreactive terminals formed a dense and well-circumscribed plexus. In the ARC, labeled varicosities were less numerous and more evenly distributed. In the ME, they were scarce and confined to the inner zone. In all these areas, the diameter of immunoreactive varicosities ranged between 0.2 and 1.3 micron; in the ME and in the transitional zone between the ARC and the ME, a population of larger boutons (greater than 2 microns) was also visible. All immunoreactive varicosities exhibited densely packed small, clear vesicles associated with a few large granular vesicles. In the PNT and the ARC, but not in the ME, they formed synaptic contacts with dendritic elements and were occasionally apposed to neuronal cell bodies. These axo-somatic appositions showed no junctional specializations. In the ME and transitional zone, immunoreactive terminals were frequently juxtaposed to, and occasionally established differentiated synaptic contacts with, tanycytes. These data support a transmitter role for adrenaline in the diencephalon and suggest that adrenaline plays a role in hypothalamo-hypophysiotropic regulation through interactions with neural and glial elements. PMID- 3555834 TI - Immunohistochemical demonstration of serotonergic and peptidergic nerve fibers in the subcommissural organ of the dog. AB - The distributional patterns of serotonin-, luteinizing hormone-releasing hormone (LHRH)-, oxytocin (OXT)- and vasopressin (VP)-immunoreactive nerve fibers were studied in the subcommissural organ (SCO) of the dog by use of the peroxidase antiperoxidase technique. Abundant serotonergic and moderate numbers of peptidergic nerve fibers running toward the ventricular surface were observed among the cylindrical ependymal cells in the SCO of the dog. Concerning the distributional density of the peptidergic nerve fibers, VP-immunoreactive fibers displayed the highest and LHRH-immunoreactive fibers the lowest values. Most serotonergic and peptidergic fibers returned to the basal portion of the SCO after forming loops immediately beneath the ventricular surface of the ependymal layer. Serotonin-immunoreactive fibers often established a perivascular plexus around the blood vessels in the SCO. At the electron-microscopic level, after use of antiserum to serotonin dark immunoprecipitate was observed in large granular vesicles and the matrix surrounding small and large, clear vesicles and mitochondria; VP immunoreactivity was localized in the large granular vesicles. Serotonergic nerve fibers could be detected in the SCO of the newborn dog. Although the distributional density was in principle not different from that in the adult animal, individual fibers showed immature features such as growth cones and insufficiently swollen varicosities. After penetrating into the ventricle, in the newborn dog, a few serotonin-immunoreactive fibers ran for a relatively long distance on the ependymal surface. PMID- 3555836 TI - Determination of the numerical density of perforated synapses in rat neocortex. AB - The numerical density and frequency of perforated synapses in the molecular layer of rat parietal cortex have been determined using 4 procedures in an attempt to overcome problems associated with the size and complex three-dimensional shape of perforated synapses. The following procedures were compared: A, single-section analysis; B, adjacent-section analysis; C, semi-serial-section analysis; and D, complete serial-section analysis. All procedures made use of an unbiased counting rule. Estimates of the numerical density of perforated synapses ranged from 0.06 to 0.27 X 10(9) mm-3, and that of all synapses (non-perforated and perforated) from 1.88 to 2.50 X 10(9) mm-3. The frequency of perforated synapses varied from 4.5 to 18.0%. Procedures B (adjacent-section analysis) and D (complete serial section analysis), neither of which utilize assumptions regarding the shape of synapses, produced comparable results (numerical density of perforated synapses 0.19-0.27 X 10(9) mm-3, and of all synapses 2.24-2.45 X 10(9) mm-3; frequency of perforated synapses 8.6-10.9%). The frequency of perforated synapses appeared to be underestimated by procedure A (single section analysis; 4.5%) and overestimated by C (semi-serial section analysis; 18%). It is concluded that adjacent-section analysis is the most efficient and effective procedure for determining the numerical density and frequency of complex particles, such as perforated synapses. There is, however, no significant difference in the performance of this procedure compared with that of single-section analysis, for determining the numerical density of synapses in general. Nevertheless, inherent problems of bias within the single-section procedure make the adjacent section method the procedure of choice. PMID- 3555838 TI - Efficacy of nimodipine in comparison with pizotifen in the prophylaxis of migraine. AB - The efficacy of nimodipine in comparison with that of pizotifen was assessed in the prophylaxis of migraine in a double-blind cross-over study, in which a double dummy technique was also utilized. The study was carried out on 43 migraine patients, of whom 15 had classic and 28 had common migraine. A 4-week run-in placebo period preceded the drug treatments, the drug treatments lasted 12 weeks, and there was a washout placebo period of 4 weeks between nimodipine and pizotifen treatments. The dosages used were 40 mg three times daily for nimodipine and 0.5 mg three times daily for pizotifen. Both nimodipine and pizotifen proved to be better than placebo, the number of migraine attacks showing a significant reduction. There was no difference between nimodipine and pizotifen in antimigrainous efficacy, but there were fewer side effects during the nimodipine period. The results suggest that nimodipine is an effective drug for the prophylaxis of migraine, with few side effects and therapeutic efficacy equal to that of pizotifen. PMID- 3555837 TI - Binding sites of Ulex europaeus-lectin I in human parotid gland. A light microscopic and ultrastructural study using the immunoperoxidase technique and immunocryoultramicrotomy. AB - Twenty non-neoplastic parotid glands (removed during neck dissection for regional tumours) were examined for cellular and subcellular binding sites of Ulex europaeus-lectin I (UEA-I), a lectin reported to be specific for alpha-L-fucose. For light microscopy, an extended peroxidase-antiperoxidase method was applied; for the evaluation of the subcellular localization of bound lectin, three of these glands were examined following immunocryoultramicrotomy and staining by the protein A-gold technique. In addition to the known cytoplasmic affinity of UEA-I for capillary endothelium, acinar cells bound the lectin within the cytoplasmic compartment; the number and distribution of stained acinar cells varied among individuals. Furthermore, cytomembrane-bound labelling that occurred most markedly at the luminar surface was observed in striated-duct epithelium. Using the electron microscope, protein A-gold particles were seen in zymogen granules and in Golgi cisternae of serous acinar cells; primary saliva secreted in the lumina exhibited strong labelling; serous acinar cells had binding sites on their cell membranes, striated-duct epithelium had binding sites on its surface membrane and in the vicinity of apical vesicles. Our results show that UEA-I is a useful tool for the study of the structure and functional states of the parotid gland epithelium and its associated pathological alterations. PMID- 3555839 TI - George Khoury (1943-1987). PMID- 3555840 TI - Conserved domains in bacterial regulatory proteins that respond to environmental stimuli. PMID- 3555841 TI - An essential yeast snRNA with a U5-like domain is required for splicing in vivo. AB - Yeast contains at least 24 snRNAs, many of which are dispensable for viability. We recently demonstrated that a small subset of these RNAs has a functional binding site for the Sm antigen, a hallmark of metazoan snRNAs involved in mRNA processing. Here we show that one of these snRNAs, snR7, is required for growth. To determine the biochemical basis of lethality in cells lacking snR7, we engineered the conditional synthesis of snR7 by fusing the snRNA coding sequences to the yeast GAL1 control region. Cells depleted for the SNR7 gene product by growth on glucose for five generations show marked accumulation of unspliced mRNA precursors from the four intron-containing genes tested. In some cases, intron exon 2 lariats also accumulate. We have identified a 70 nucleotide domain within snR7 with limited sequence-specific but striking structural homology to the mammalian snRNA U5. We conclude that mRNA splicing in yeast requires the function of a U5-like snRNA. PMID- 3555842 TI - A family of serine esterases in lytic granules of cytolytic T lymphocytes. AB - Cytoplasmic granules of cytolytic T lymphocytes (CTLs) contain, in addition to the pore-forming protein perforin, a family of highly homologous serine esterases, granzymes A-H. The serine esterase affinity label diisopropyl fluorophosphate reacts strongly with granzymes A and D, to a lesser extent with B, E, F, G, and H, and not at all with C and F. For granzymes A and D, synthetic substrates have been found. Antibodies raised against granzyme B strongly cross react with A, G, and H, and antibodies to granzyme D recognize C, E, and F. These antigenic relationships correlate with similarities in the N-terminal amino acid sequences. At least 60% homology is observed between the eight proteins, and all are similar to rat mast cell protease 2. Sequence analysis suggests the identity of granzyme A with a protease predicted from a CTL-specific cDNA clone (H factor) and of granzyme B, G, or H with a protein encoded by the CTL-specific cDNA clone CTLA 1/CCP 1. PMID- 3555843 TI - The integration host factor of Escherichia coli binds to bent DNA at the origin of replication of the plasmid pSC101. AB - The integration host factor (IHF) of Escherichia coli is necessary for maintenance of pSC101. The protein binds specifically to the replication origin of the plasmid, in the AT-rich region located immediately adjacent to the left, weak binding site for the plasmid-encoded initiator protein. DNAase I and OH- radical footprinting experiments showed that IHF protects 49 bp of the DNA at the origin region. Methylation protection analyses revealed that IHF contacts purine residues in both the major and minor grooves of the DNA. Electrophoretic analyses showed that IHF binds to bent DNA, and the protein binding further enhances the degree of DNA bending. Site-directed mutagenesis of three of the contact points not only abolished binding of the protein to the DNA but also inactivated the replication origin. Therefore, binding of IHF to the ori sequence most probably is necessary for initiation of plasmid replication. PMID- 3555844 TI - The leader peptide of yeast gene CPA1 is essential for the translational repression of its expression. AB - The expression of gene CPA1, encoding the glutaminase subunit of the arginine pathway carbamoyl-phosphate synthetase, is repressed by arginine at a posttranscriptional level. The 5' region of CPA1 mRNA contains a 25 codon upstream open reading frame. The importance of this feature for the repression of CPA1 expression has been analyzed by oligonucleotide-directed mutagenesis and by sequencing of constitutive cis-dominant mutations obtained in vivo. The results show that the leader peptide, the product of the upstream open reading frame, plays an essential, negative role in the specific repression of CPA1 by arginine. A model of translational regulation of CPA1 is proposed that takes into account the cis-dominance of the mutations affecting the leader peptide. PMID- 3555846 TI - Proteolytic maturation of insulin is a post-Golgi event which occurs in acidifying clathrin-coated secretory vesicles. AB - The direct identification of the intracellular site where proinsulin is proteolytically processed into insulin has been achieved by immunocytochemistry using an insulin-specific monoclonal antibody. Insulin immunoreactivity is absent from the Golgi stack of pancreatic B-cells and first becomes detectable in clathrin-coated secretory vesicles released from the trans Golgi pole. Clathrin coated secretory vesicles transform into mature noncoated secretory granules which contain the highest concentration of insulin immunoreactive sites. Maturation of clathrin-coated secretory vesicles is accompanied by a progressive acidification of the vesicular milieu, as evidenced by a cytochemical probe that accumulates in acidic compartments whereupon it can be revealed by immunocytochemistry. Thus packaging of the prohormone in secretory vesicles, and acidification of this compartment, are critical steps in the proper proteolytic maturation of insulin. PMID- 3555847 TI - Structured ceramics for laminate veneers. PMID- 3555845 TI - Nucleoprotein complexes that regulate gene expression in adipocyte differentiation: direct participation of c-fos. AB - Adipocyte differentiation is accompanied by the transcriptional activation of many new genes, including a putative lipid-binding protein termed adipocyte P2 (aP2). The aP2 gene contains a regulatory element (FSE2) 124 bases 5' to its start of transcription. This element binds nuclear factors in sequence-specific and differentiation-dependent fashion as determined by altered mobility in gel retardation assays. Deletion analysis of promoter-linked transfection assays and competition of these constructions in cells with a synthetic FSE2 element suggest that trans-acting factors bind to this region and act as negative regulators of aP2 gene activity in preadipocytes. c-fos appears to participate directly in this nucleoprotein complex, as demonstrated by the ability of antibodies to c-fos to disrupt specific binding of factors to the FSE2 sequence but not to factor binding sequences from several other genes. Antibodies to c-fos specifically immunoprecipitate protein complexes covalently bound to FSE2 DNA via UV cross linking. PMID- 3555848 TI - Effect of xid on autoimmune C3H-gld/gld mice. AB - The xid gene was introduced into C3H-gld/gld mice to determine its effects on the development of autoimmune disease. C3H-gld/gld.xid mice were compared with C3H gld/gld mice for the development of lymphadenopathy, surface phenotype of lymph node (LN) cells, c-myb oncogene RNA production, serum immunoglobulin (Ig) levels, and autoantibody production. In addition, C3H-gld/gld and C3H-lpr/lpr mice were examined for serum Ig and autoantibody levels. The results showed that the xid gene had no effect on either the development of the severe lymphadenopathy characteristic of C3H-gld/gld mice or the phenotype of the Ly-2-, L3T4-, Ly 5(B220)+ T-cell subset that is expanded in the LN and spleens of these mice. Similarly, xid did not affect the high levels of c-myb oncogene RNA expression by C3H-gld/gld LN and spleen cells. By contrast, the xid gene caused a significant reduction in serum IgM but not IgA levels and almost completely ablated the generation of both IgM and IgG anti-ssDNA antibodies and anti-dsDNA antibodies. These data suggest that the xid gene can dramatically decrease the B-cell manifestations of autoimmunity in gld homozygotes without affecting their abnormal T-cell expansion. Comparisons of age-matched C3H-gld/gld and C3H-lpr/lpr mice showed that they had similarly elevated serum IgM and IgA levels and anti ssDNA and anti-dsDNA antibody levels providing further evidence that gld and lpr produce parallel defects in C3H mice. PMID- 3555849 TI - Caenorhabditis elegans spermatozoa assemble membrane proteins onto the surface at the tips of pseudopodial projections. AB - The crawling movement of nematode sperm, like that of many other crawling metazoan cells, is accompanied by movement of membrane components from the leading edge of the cell rearward. We used colloidal gold conjugates of monoclonal antibodies (CGP-ABY) to membrane proteins on Caenorhabditis elegans sperm to examine this surface movement by electron microscopy. Antibody binding sites on fixed sperm are distributed uniformly over the cell surface. However, blocking these sites on live sperm with unlabelled antibody or removing them with protease and then pulse-labelling the cell with CGP-ABY revealed that new antigen is assembled onto the surface at the tips of the stubby projections that stud the pseudopod surface. These proteins then move rearward rapidly so that the pseudopod surface pool of antigen is replaced within 2 min. The same pattern of surface movement was observed when live cells were labelled with CGP-ABY and then washed with buffer before fixation. Bound CGP-ABY was cleared first from the tips of the projections and subsequently from the entire pseudopod surface. These gold particles accumulated at the base of the pseudopod without moving onto the cell body or being internalized. We did, however, detect a pool of antigen in the pseudopod cytoplasm that may be available for assembly onto the pseudopod surface. We propose that the localized assembly of new membrane and its subsequent rearward movement may play an important role in sperm locomotion. PMID- 3555850 TI - Role of lipid peroxidation in post-traumatic spinal cord degeneration: a review. AB - A large amount of biochemical, physiological, and pharmacological data has been obtained which supports a mechanistic role of oxygen free radical-induced lipid peroxidation (LP) in post-traumatic spinal cord degeneration. Biochemical evidence of early and progressive lipid peroxidative reactions occurring in the injured spinal cord includes: an increase in polyunsaturated fatty acid peroxidation products (e.g., malonyldialdehyde), a decrease in cholesterol and the appearance of cholesterol oxidation products, an increase in cyclic GMP presumably due to free radical activation of guanylate cyclase, a decrease in tissue anti-oxidant levels (e.g., alpha tocopherol, reduced ascorbate), and inhibition of membrane-bound enzymes such as Na+ + K+-ATPase. In vitro CNS tissue studies have provided support for the possibility that LP may contribute to other early post-traumatic events including intracellular calcium accumulation and arachidonic acid release. Moreover, spinal tissue lactic acidosis, which occurs early after injury, can exacerbate LP reactions. The involvement of LP in the development of progressive post-traumatic spinal white matter ischemia has been strongly inferred from pharmacological studies in cats with known inhibitors of LP. For example, the dose-response curves for the ability of the glucocorticoid methylprednisolone (MP) to inhibit post-traumatic LP and to retard ischemia development are identical. This relationship between LP and post-traumatic ischemia is more directly implied from studies showing that pretreatment of cats with high doses of anti-oxidants (e.g., d-alpha tocopherol plus selenium p.o. or 1-ascorbic acid i.v.) can also significantly antagonize the progressive decrease in spinal cord blood flow that follows severe blunt injury. However, a similar efficacy of certain calcium and prostaglandin antagonists suggests an interrelationship between aberrant calcium fluxes, vasoconstrictor/platelet aggregating prostanoids, and LP in the post-traumatic ischemic phenomenon. In addition to a role of LP in ischemia development, the action of intensive d-alpha tocopherol and selenium pretreatment to retard anterograde cat motor nerve fiber degeneration after nerve section suggests that LP may also be a fundamental mechanism of "Wallerian" axonal degeneration after neural injury. Finally, a critical role of LP in the acute pathophysiology of CNS injury in general has been supported by the finding of an excellent correlation, in terms of efficacy and potency, between the action of glucocorticoid and nonglucocorticoid steroids to inhibit neural tissue LP in vitro and to promote early neurological recovery in severely head-injured mice. PMID- 3555851 TI - The spinal cord injury problem--a review. AB - The incidence of spinal cord injury in the United States is between 50 and 55 million per year. The personal and societal costs have been an impetus for experimental studies that defined the posttraumatic pathological and biochemical changes from which the hypothesis has arisen that a portion of the resulting neurological deficit is caused by the response of the spinal cord to the injury. Alteration in this response has been a therapeutic goal. Clinical series over a number of years with varied treatment regimens have failed to show any significant difference in neurological outcome. A single randomized clinical trial of 'high dose' 'low dose' steroid treatment failed to support the secondary injury response hypothesis. The experimental studies and lack of therapeutic effectiveness of present treatment both support the concept of further experimental studies and further randomized clinical trials. It is important to test the hypothesis of secondary injury since, if it is a cause of a portion of the resultant loss of neurological function, the benefit of its control would extend beyond spinal cord injury to other central nervous system injuries. PMID- 3555853 TI - [Interrelation of selected factors in insulin use in juvenile diabetics]. PMID- 3555852 TI - Effects of oral physostigmine and lecithin on memory and attention in closed head injured patients. AB - In view of the evidence for the role of the central cholinergic pathways in memory and preliminary studies suggesting alteration of neurotransmitters after severe head injury, we completed a double-blind, placebo-controlled study of combined oral physostigmine and lecithin. Sixteen survivors of moderate to severe closed head injury who had unequivocal memory deficit were studied during the course of inpatient rehabilitation. Although the results generally indicated no difference in the effects of the physostigmine-lecithin combination as compared to lecithin alone, sustained attention on the continuous performance test was more efficient under physostigmine than placebo when the drug condition occurred first in the crossover design. Further investigation of neurotransmitter manipulation is warranted in patients with traumatic brain injury. PMID- 3555854 TI - [Use of ultrasound in the diagnosis of inflammatory adnexal tumors]. PMID- 3555855 TI - [History of gynecology and obstetrics in Prague]. PMID- 3555856 TI - [Jan Melic--obstetrician and reformer]. PMID- 3555857 TI - [Prof. Antonin Jan Jungmann--obstetrician and teacher]. PMID- 3555858 TI - [Report of the International Federation of Gynecology and Obstetrics Subcommittee on Perinatal Epidemiology and Statistics on "Methods of measuring and registering the growth of the fetus and neonate in the perinatal period"]. PMID- 3555859 TI - [The reticulo-spinal system. Its role in the regulation of motor reactions in the segmental circuit (long-loop reflexes)]. PMID- 3555860 TI - [Regulation of sodium transport in the colon]. PMID- 3555861 TI - [In memoriam. Academician Zdenek Servit]. PMID- 3555862 TI - [Czech and Slovak professors of ophthalmology]. PMID- 3555863 TI - [Endomyocardial biopsy of the transplanted heart (with cyclosporin immunosuppression)]. PMID- 3555864 TI - [Suggestions for improving histo-oncologic diagnosis (an overview of problems]. PMID- 3555865 TI - [Changes in experimentally allotransplanted kidneys in pigs]. PMID- 3555866 TI - [Plastic surgery of the dura mater--physical properties of certain materials in an experiment]. PMID- 3555868 TI - [Notes on the founding of the independent Czech Charles University and the Czech Psychiatric Clinic]. PMID- 3555867 TI - [Centenary of the first Czech Psychiatric Clinic at Charles University in Prague]. PMID- 3555869 TI - [2 anniversaries of Dr. Jan Simsa (1865-1945)]. PMID- 3555871 TI - [Clinical evaluation of results in the therapy of gastrointestinal diseases with colostrum antibodies in premature infants and infants]. PMID- 3555870 TI - [Freud vs Wagner-Jauregg (on the so-called "Wagner-Jauregg process")]. PMID- 3555872 TI - [Insulin resistance]. PMID- 3555873 TI - [Radiotoxicity of intracellularly incorporated Auger emitters]. PMID- 3555874 TI - A delayed onset cerebellar syndrome complicating falciparum malaria. PMID- 3555875 TI - Cerebroside of the dimorphic human pathogen, Candida albicans. AB - Structural studies on the cerebroside isolated from the yeast form of a dimorphic pathogen, Candida albicans were carried out using fast atom bombardment mass spectrometry (FAB/MS), proton magnetic resonance spectrometry, gas chromatography mass spectrometry and usual chemical methods. The component sugar was only glucose attached to ceramide in a beta-configuration. The major fatty acid was 2 hydroxystearic acid (62%). The predominant long chain base was identified as 9 methyl-C18-sphinga-4,8-dienine which is widely distributed in fungi and reported to be essential to the fruit-inducing activity of fungi. Therefore, the structure of the main molecular species of the cerebroside was determined to be N-2 hydroxystearoyl-1-O-beta-glucosyl-9-methyl-C18-sphinga-4 ,8-dienine. Cerebroside prepared from the mycelial form of C. albicans has the same structure. PMID- 3555876 TI - [Trial treatment of degenerative lesions of the retinal periphery using argon laser squaring]. PMID- 3555877 TI - Decreasing post-succinylcholine myalgia in outpatients. AB - The effectiveness of four pretreatment regimens in decreasing succinylcholine induced myalgias was studied in healthy outpatients undergoing general anaesthesia for ambulatory surgery. Four hundred and forty adult females were randomly assigned to one of four pretreatment groups. Three hundred and ninety five patients completed the study. One of the following pretreatments was given prior to injection of 1.5 mg X kg-1 of succinylcholine: normal saline IV three minutes and again immediately prior to succinylcholine; 0.06 mg X kg-1 d-tubo curarine (dTc) IV three minutes prior and normal saline IV immediately prior; normal saline IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior; 0.06 mg X kg-1 dTc IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior. Fasciculations after injection of succinylcholine were observed and recorded. Patients were contacted by telephone 40-48 hours postoperatively and questioned about the presence of muscle pains. These pains, if present, were graded either mild or moderate to severe. The patients in the two dTc-containing groups exhibited less fasciculations than patients in the other two experimental groups. The dTc-lidocaine group had a lower incidence of moderate to severe fasciculations than in any of the other three groups. Patients in the dTc, lidocaine, and dTc-lidocaine experimental groups reported a higher incidence of absence of muscle pain and a lower incidence of moderate-severe pain than did patients in the saline group. The dTc-lidocaine group had more patients without myalgia and less patients with moderate to severe myalgias than any of the other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555878 TI - Screening for colorectal cancer. AB - Colorectal cancer is a good candidate for secondary prevention strategies. It appears to have a long lead time since most, if not all, of these cancers arise from premalignant adenomas, and several screening methods are available that might detect the cancer in a very early stage. However, there is little evidence at present to show that the available methods of early detection will actually decrease the mortality from colorectal cancer of a screened population as compared to a non-screened population. Studies that might convincingly provide this evidence are still in progress. This paper critically reviews the natural history of colorectal cancer, risk factors, screening trials and treatment. PMID- 3555879 TI - Comparative testing of monoclonal antibodies against Plasmodium falciparum sporozoites for ELISA development. AB - Ten monoclonal antibodies developed against Plasmodium falciparum sporozoites at four institutions were evaluated for use in an enzyme-linked immunosorbent assay (ELISA). Four of the antibodies were eliminated because of their low sensitivity or requirement for high concentrations of capture antibody, while an additional four were rejected because they exhibited cross-reactivity with P. berghei sporozoites. Of the two remaining monoclonal antibodies, that designated 2A10 had the highest sensitivity, a requirement for lower concentrations of capture antibody, and had been tested successfully against sporozoites from a wider range of geographical areas than the others. Use of this monoclonal antibody in a standardized ELISA method gave a test ten times more sensitive than previously reported for P. falciparum sporozoites and its detection limit was less than 100 sporozoites per mosquito. PMID- 3555880 TI - Peroxisome proliferation and hepatocarcinogenesis. PMID- 3555882 TI - The early history of health visiting: a review of the role of central government (1830-1914). AB - The emergence of health visiting is traced through available historical material. It is argued that the evidence supports the view that the role of central government was limited and that health visiting owes its emergence to the pioneer work of able medical officers of health. PMID- 3555881 TI - Competent kids: children and adolescents with a chronic illness. AB - The social and personal competence of children and adolescents with a seizure disorder or an orthopaedic condition was assessed by parents and teachers. The contributions to these assessments of characteristics of the child, the intensity of the illness, and the child's temperament were explored using a hierarchical regression model. Parents and teachers rated all children as functioning fairly well. Children with a seizure disorder were perceived as significantly less competent than were their healthy peers (P less than 0.05). Across health status groups, children received higher competence scores from their parents than they did from their teachers (P less than 0.05). Competence scores did not differ according to the age of the child. The patterns of variables that predicted ratings of competence differed according to illness type and rater. Indicators of illness intensity explained a larger share of the variance in competence ratings for children with a seizure disorder (25%) than for children with an orthopaedic condition (5%). For children in this latter group, temperament explained a much larger proportion of the variance in both parents' (29%) and teachers' (42%) ratings of competence than did the illness intensity variables. PMID- 3555883 TI - Endothelial renin-angiotensin pathway: evidence for intracellular synthesis and secretion of angiotensins. AB - Cultured bovine aortic endothelial cells (BAEC) contain renin and angiotensinogen. To examine whether angiotensins are synthesized intracellularly and secreted by these cells, we assayed cell extracts as well as serum-free media of intact confluent BAEC. Angiotensins were identified by their retention time on reverse phase high performance liquid chromatography and direct radioimmunoassay. BAEC and their media contain angiotensin II and angiotensin III. The rate of angiotensin accumulation in the media was a nonlinear function of time; the highest rate occurred in the first 15 minutes. The amount of angiotensin II accumulated in 30 minutes exceeded 200% of the intracellular concentration and that of angiotensin III exceeded 500% of the initial intracellular content. Neither renin nor angiotensinogen could be detected in the media. The viability of these cells was supported by low lactic dehydrogenase activity in the media (less than 0.5% of cellular level). These data suggest that BAEC is capable of synthesizing and secreting angiotensins. We postulate that this endothelial derived angiotensin system may play an important paracrine or autocrine role in influencing local vascular tone. PMID- 3555884 TI - Quantitative ultrasonic characterization of the nature of atherosclerotic plaques in human aorta. AB - To determine the feasibility of quantitative ultrasonic techniques to define the composition of atherosclerotic plaques, samples of freshly excised human aortas were sewn to a sample holder and immersed in a saline bath for ultrasonic interrogation. Integrated backscatter of a 2-microsecond portion of the backscattered radiofrequency signal was measured with a 10 MHz focused transducer. Integrated backscatter was calculated by normalizing the root-mean square voltage of the gated signal to the root-mean-square voltage obtained by replacing the tissue sample with a nearly perfect reflector. Microscopic examination of the 124 interrogated sites allowed differentiation of normal, fibrous, fibrofatty, and calcified regions. A site was considered calcified if it contained any histochemically detectable calcium. Values of integrated backscatter were markedly elevated from calcified regions (-30.0 +/- 6.4 dB, n = 25; mean +/- SD; p less than 0.001) compared to normal (-43.2 +/- 2.4 dB, n = 20) and fibrofatty (-43.9 +/- 3.4 dB, n = 43) sites. Values from fibrous regions ( 40.7 +/- 3.8 dB, n = 36) were also significantly different compared with the calcified and fibrofatty regions (p less than 0.001). Thus, we have demonstrated that quantitative ultrasonic backscatter identifies and differentiates calcification and fibrosis in atherosclerotic sites offering promise for the noninvasive assessment of the pathologic status of the arterial wall. PMID- 3555885 TI - Liver transplantation at the Cleveland Clinic. Early results. PMID- 3555886 TI - Chymotrypsin: molecular and catalytic properties. AB - A review on the peptide hydrolase chymotrypsin gives some characteristics concerning the structure, specificity, mechanism of activation from its precursor and catalytic activity. Problems of the active sites, allosteric alterations, changes of conformation, different behaviour against types of substrates, and suggested kinetics are shown in some detail. Finally, the diagnostic role of this serine proteinase is mentioned. PMID- 3555887 TI - Bisphosphorylated metabolites of glycerate, glucose, and fructose: functions, metabolism and molecular pathology. AB - 2,3-Bisphosphoglycerate, glucose 1,6-P2 and fructose 2,6-P2 have been recognized as regulatory signals implicated in the control of metabolism, oxygen affinity of red cells and other cellular functions. The alterations of their metabolism constitute a novel area in molecular pathology. The concentration of 2,3 bisphosphoglycerate in erythrocytes changes in a number of pathological conditions. An inherited deficiency of the multifunctional enzyme involved in the synthesis and breakdown of 2,3-bisphosphoglycerate in erythrocytes has been reported. The levels of glucose 1,6-P2 are reduced in the liver and in the muscle of rats with experimentally induced diabetes. In muscle of genetically dystrophic mice a decrease in the levels of glucose 1,6-P2 has been found, probably resulting from enhancement of glucose 1,6-P2 phosphatase activity. Fructose 2,6 P2 levels are decreased in the liver of experimental diabetic mice and rats, and elevated in the liver of genetically obese animals. PMID- 3555889 TI - Evidence for endotoxin binding capacity of human Gc-globulin and transferrin. AB - In the present paper the ability of Gc-globulin and transferrin to bind endotoxin of Escherichia coli 0 111: B 4 is demonstrated. This conclusion is based on four lines of evidence. By affinity chromatography using lipopolysaccharide of E. coli 0 111: B 4 two endotoxin-binding proteins of serum were identified, showing an apparent molecular weight of 77,000 and 51,000, respectively. If serum samples preincubated with the tritiated endotoxin form have undergone isoelectric focusing under non-denaturing conditions one radioactive peak appears which coincides with the precipitate obtained by immunoelectrophoresis against anti human Gc-globulin and anti-human transferrin. Radioimmunoprecipitation experiments of serum showed that tritiated endotoxin of E. coli 0 111: B 4 was only found in the precipitate obtained with anti-Gc-globulin, antitransferrin, and polyvalent antiserum against human serum. By isoelectric focusing of purified proteins 3H-lipopolysaccharide of E. coli 0 111: B 4 was only found associated with human Gc-globulin and transferrin. PMID- 3555888 TI - Tooth transplantation to bone graft in cleft alveolus. AB - Autotransplantation of teeth has developed from a last resort operation into a well tested and relatively predictable clinical procedure. This article documents four cases where autologous teeth were successfully transplanted into bone from the iliac crest grafted to an alveolar cleft. The possibility of tooth transplantation should be considered when planning dental rehabilitation for patients with cleft. PMID- 3555890 TI - Effects of high-dose glucocorticoid on serum lipid-peroxide levels in acute renal allograft rejection. PMID- 3555892 TI - The effectiveness of adenoidectomy in the treatment of glue ear: a randomized controlled trial. PMID- 3555891 TI - The significance of autonomic neuropathy in the elevation of inactive renin in diabetes mellitus. AB - Plasma renin activity (PRA) and inactive renin(IR, activated by trypsin) were measured in the plasma of 15 type II diabetics with autonomic neuropathy (group 3), 15 type II diabetics without (group 2), and 14 nondiabetic control subjects (group 1) in the recumbent position. There were no significant differences between the 3 groups with respect to age, ideal body weight, supine resting mean blood pressure, serum creatinine, daily urinary excretion of sodium, or renin substrate at the time of study. Autonomic neuropathy (AN) was assessed by measurement of the ratio of the longest to the shortest R-R interval during deep breathing (E/I-ratio) and by postural hypotension. PRA was significantly lower in group 3 than in group 1 (p less than 0.05). The IR level was significantly higher in group 3 than in groups 2 and 1 (p less than 0.005 for both comparisons). The ratio of active renin to total renin (TR) (PRA/(IR + PRA)) was significantly lower in group 3 than in groups 2 and 1 (p less than 0.001 for both comparisons). The IR level and PRA/(IR + PRA) were significantly correlated with E/I-ratio (r = -0.498, p less than 0.01 and r = 0.588, p less than 0.001, respectively) and with the severity of postural hypotension (r = 0.383, p less than 0.05 and r = 0.401, p less than 0.05, respectively), but not with the daily urinary excretion of protein or 24 h-creatinine clearance (24 h-Ccr) in the whole diabetics. From these results, we conclude that autonomic neuropathy might be a more important factor than nephropathy in the lower PRA and higher IR level in type II diabetics with AN. PMID- 3555893 TI - High dose chemotherapy with autologous marrow transplantation for advanced gastrointestinal adenocarcinomas. PMID- 3555894 TI - Diagnosis in jaundice: a contemporary approach. AB - In jaundiced patients, the most important diagnostic problem is to achieve a correct differentiation between nonobstructive and obstructive causes of jaundice. Several new diagnostic tests are available to the clinician. Noninvasive tests include: US, CT and CS, invasive tests are: PTC and ERC. The latter also have therapeutic potentials to be considered. For a proper selection of diagnostic tests in a particular case, clinical evaluation as to the most probable cause of jaundice is mandatory, because the new tests all have their limited field of application. The accuracies of clinical evaluation, noninvasive and invasive tests are therefore reviewed and a flow chart for the differential diagnosis in jaundice is suggested. The clinical evaluation, which may be assisted by a diagnostic chart presented, should sort out patients with probable obstructive or nonobstructive jaundice in whom direct cholangiography or liver biopsy, respectively, is the most appropriate diagnostic test. In the remaining group of patients with clinically doubtful causes of jaundice, or if liver metastases are the most likely diagnosis, US seems to be the test best suited for further differentiation before direct cholangiography or liver biopsy are used as confirmatory tests. PMID- 3555895 TI - Focus on duodenitis. PMID- 3555896 TI - Gastrointestinal manifestations of collagen diseases. PMID- 3555897 TI - Lumbosacral nerve plexus compression by ovarian-fallopian cysts. AB - A 43 year old woman presented with a 10 month history of pain, progressive weakness and wasting of the left calf. Electromyography demonstrated denervation at the level of the lumbosacral plexus, particularly of its sciatic component. CT and ultrasound examination revealed intrapelvic cysts which were confirmed on surgical exploration to be fallopian and ovarian cysts. PMID- 3555898 TI - Transfer factor as a therapy for multiple sclerosis: a follow-up study. AB - The result of a two year, double blind, controlled trial of Transfer Factor (TF) in the treatment of multiple sclerosis (MS) were reported in 1980. It was demonstrated that TF significantly reduced the rate of progression of the disability but the benefit of therapy was not apparent until 18 months after its commencement. After the completion of the trial, TF treatment was offered to all the trial participants. Forty-five of these people accepted TF as treatment and have been followed for the subsequent three years. The twenty-three people who had received TF during the trial, and continued on TF after the trial, consistently had a slower rate of progression of their MS. Although the twenty two patients initially on placebo had a significantly faster rate of progression during the trial, this slowed with commencement of TF treatment. After 3 years of TF, the rate of progression of disease was similar to that of the group receiving TF continuously for 5 years. In addition, 470 patients with clinically definite MS are being treated in New South Wales in an open study of TF. The rate of progression of the disease is being monitored by neurological assessments and appears to be similar to that of patients who had received TF in the original trial. The follow-up study of the 1980 TF trial patients and the open study of 470 MS patients confirm the original observation that TF has some effect on slowing the course of MS. PMID- 3555901 TI - Repair of surgical defects. AB - Basic skills in elliptical excision are essential for success in dermatologic surgery. Once the elliptical excision has been mastered, the practitioner should progress to variations on the ellipse. These include "curving" the incision, M plasty, A-to-T closure, O-to-Z closure, and subcutaneous island pedicle flaps. When one of these methods will not suffice, a local flap or a full-thickness skin graft is often a good alternative. PMID- 3555899 TI - The effect of dietary zinc and prothymosin alpha on cellular immune responses of RF/J mice. AB - Mice of the RF/J strain on a normal diet are defective in some aspects of cellular immunity, as evidenced by their susceptibility to infection with Candida albicans, their failure to release detectable quantities of circulating migration inhibitory factor (MIF) in vivo, and the presence of a low rate of phagocytosis and killing by peritoneal macrophages. When the mice were fed a high-zinc diet (300 ppm) for 4 weeks and then treated daily with 160 ng prothymosin alpha, an increase occurred in resistance to infection with C. albicans, in the capacity to release MIF in vivo into the circulation and in the capacity of peritoneal macrophages to engulf (phagocytose) and kill cells of C. krusei. In addition, the number of spleen lymphocytes producing antibody to a T-dependent antigen was significantly increased in the mice fed a high-zinc diet and inoculated daily with prothymosin alpha. PMID- 3555900 TI - The proliferative response of human peripheral blood lymphocytes to group A streptococcal vaccine. AB - The proliferative response of human peripheral blood mononuclear cells to group A streptococcal vaccine (strain J17A4) was assessed by measurement of [3H]thymidine incorporation. This was maximal after 7 days in cultures containing 1 X 10(5) lymphocytes. Cells from 33 out of 38 adult donors (87%) yielded stimulation indices between 2.0 and 81. Responding cells were predominantly of the OKT4+, Ia+, Tac+ phenotype expressed by activated helper T lymphocytes. In contrast, no response was observed in 10 out of 12 samples of cord blood lymphocytes. Addition of conventional rabbit or monoclonal murine anti-Ia (HLA-DR) antibodies to the culture medium abrogated the vaccine-induced proliferative response. Frequencies of responding cells estimated by limiting dilution analysis were between 1 in 2370 and 1 in 4580 lymphocytes. The results suggest that lymphocyte stimulations induced with streptococcal group A vaccine represented an in vitro anamnestic cellular immune response. PMID- 3555902 TI - Surgical management of leg ulcers. AB - Before an ulcer is treated, a systemic work-up should be pursued to find the etiology. Treatment should be instituted to prevent more ulcers from occurring. However, once an ulcer has formed, good medical management is usually sufficient to heal an ulcer and prevent others from occurring. If the ulcer persists despite adequate medical treatment, then pinch grafting or split-thickness grafting are relatively simple techniques with good success rates. PMID- 3555904 TI - Tattoo removal. AB - The reasons for tattoo removal can be personal, social, cultural, and medical. Removal methods have been many and varied, and all of the past methods are summarized. Details of modern tattoo removal methods by physicians, ranging from dermabrasion to laser therapy, are described. Included are descriptions of excision and closure techniques, and split-thickness tangential excision. PMID- 3555903 TI - Liposuction. History, techniques, and complications. AB - Liposuction is a very safe and predictable means of contouring the body's adiposities. It is an effective surgical method for aesthetic sculpturing with minimal complications. Complications are rare and most commonly include waviness or irregularities of the skin from poor patient selection. We have had in the last 1200 patients one case of a hematoma that was attributed to preoperative ingestion of aspirin. No seromas have occurred in this group of patients. The procedure is relatively pain free, and propoxyphene is usually adequate for pain control. The results have been rewarding for both the surgeon and the patient. Liposuction surgery has arrived as a well-accepted, reliable, and safe procedure for treating unwanted adiposities and contouring the face, neck, and body. PMID- 3555905 TI - Acne scar revision update. AB - The typical patient with acne scarring has a variety of scar types. This article covers the choice and implementation of the several different techniques usually required to achieve optimal reconstruction. PMID- 3555906 TI - The newer surgical dressings and wound healing. AB - In summary, there are a variety of new synthetic surgical dressing materials available today. Although individual physician preferences and differences in the type of injury may determine which of these membranes is utilized in a given clinical situation, they all serve to speed the rate of epithelialization, to decrease motion within the healing wound, to decrease postoperative pain, and to minimize the potential for bleeding and infection. For all of these reasons, a complete knowledge of these dressings and their uses will greatly enhance the surgeon's ability to care more satisfactorily for the patient with a cutaneous wound. PMID- 3555907 TI - Tissue expansion in dermatologic surgery. AB - Reconstructive scar revision as a result of cutaneous malignancy, trauma, or cicatricial inflammatory disease can be augmented by tissue expansion. This more complicated, two-staged procedure provides expansion of adjacent, normal skin that is advanced as a flap to reconstruct defects with tissue of good color and texture match. Its adaptation in dermatology to scalp reduction for cicatricial alopecia and other cutaneous disease is described. PMID- 3555908 TI - Normalization of lipoprotein lipase and hepatic lipase by gemfibrozil results in correction of lipoprotein abnormalities in chronic renal failure. AB - Eighteen patients with chronic renal failure (serum creatinine 173-756 mumol/l) and hyperlipidemia were treated with gemfibrozil (1200 mg/day). The drug caused a significant improvement of the dyslipidemia within one week and the effect was progressive during the 28 weeks of treatment. Very-low-density lipoprotein triglycerides and very-low-density lipoprotein cholesterol decreased by about 50% and high-density lipoprotein cholesterol increased by 30%. The lipoprotein changes occurred simultaneously with a significant activation to normal levels of postheparin plasma lipoprotein and hepatic lipases. Opposite effects were observed when gemfibrozil was discontinued and the patients were given placebo. No major harmful effects were observed. PMID- 3555909 TI - Tissue distribution of dialysis amyloidosis. AB - Twenty-three uremic patients on intermittent hemodialysis for eight to eighteen years provided the material for the present pathological study. In all of them, there was evidence for dialysis related amyloidosis based on previous clinical or histological findings or both. The material examined consisted of nine skin biopsies, five abdominal fat aspirates, eight trans-iliac bone biopsies and numerous post-mortem specimens of various visceral organs from eight cases. None of the skin biopsies or fat aspirates showed amyloid deposits. In only one bone biopsy could a small Congo red positive area be recognized that showed characteristic birefringence under polarizing light. Autopsy material findings were negative except for one case: this patient had been dialyzed for 18 years. Very minute amyloid deposits with a positive immunofluorescence staining for beta 2-microglobulin (beta 2-M) were found in the walls of small vessels from her lung, heart, liver and intestine. Thus, in chronic hemodialysis patients the accumulation of beta 2-M amyloid fibrils in tissues other than joints and juxta articular structures appears to have a low incidence, to occur lately and to be of limited size. Although extra-articular amyloid deposits may progressively occur and extend with increasing survival time on dialysis, tiny deposits such as those observed in only two of our patients will hardly lead to serious complications. PMID- 3555910 TI - HIV infection in patients on dialysis and after renal transplantation. PMID- 3555911 TI - Robert Purves Grant. PMID- 3555913 TI - The value of ultrasound in ectopic pregnancy. PMID- 3555912 TI - Hormonal correlates of the inadequate natriuretic response to salt loading in idiopathic edema. AB - The purpose of this study was to evaluate the body fluid and hormonal responses to salt loading in patients with idiopathic edema. In response to a combined intravenous and oral salt loading, patients with idiopathic edema were found, compared to control women, to have more weight gain, an increase in systolic and diastolic blood pressure, lower excretion of sodium and free dopamine (both the latter being partially accounted for by a diminished salt loading-induced increase in the creatinine clearance), and less plasma dopamine-beta-hydroxylase suppression. There were, between the groups, no differences in plasma and urinary concentrations of the dopamine precursor (dihydroxyphenylalanine), metabolites (dihydroxyphenyl-acetic and homovanillic acid, methoxytyramine and dopamine sulfate), or suppressibility of hormones which are under a partial dopaminergic inhibitory control (plasma renin activity, aldosterone and norepinephrine) by high salt. The inappropriate sodium retention, weight gain, and blood pressure increase following salt loading in idiopathic edema is thus associated with a blunted increase in the glomerular filtration and urinary dopamine excretion rates, as well as plasma dopamine-beta-hydroxylase non-suppressibility by saline. Some circumstantial evidence suggests that the dopamine deficiency is part of a wider disturbance within the cascade of natriuretic hormones. PMID- 3555914 TI - Tubal physiologic consideration in ectopic pregnancy. PMID- 3555915 TI - Epidemiology of ectopic pregnancy. PMID- 3555916 TI - The hormonal basis of ectopic pregnancy. AB - The endocrine origin of EP revolves around certain endocrine events that modify reproductive tract function. The reproductive tract and the embryo are highly dependent on the proper function. Changes in this environment from either external or internal origin can lead to abnormalities in implantation including EP. Based on the examples presented above, it seems that both a high estrogenic or a high progestogenic environment can contribute to an increased risk of EP. This observation stresses the importance of the proper hormonal balance rather than an absolute value of a single hormone in the normal implantation process. PMID- 3555917 TI - The nonsurgical management of ectopic pregnancy. AB - The nonoperative management of unruptured tubal ectopic pregnancy by either chemotherapy or expectant observation may be appropriate in a select group of patients, as outlined above. The routine use of these management modalities as a replacement for conservative surgery is not yet justified. PMID- 3555918 TI - Fetal dystocia. AB - Fetal dystocia is the result of an unfortunate relationship between fetal anatomy and maternal pelvic capacity. Most commonly, arrest of labor progress occurs at a point at which the problem is solved without significant risk to maternal-fetal welfare by abdominal delivery. This article has, in part, focused upon some rare exceptions and on how to anticipate and deal with them as well as possible. PMID- 3555919 TI - Soft tissue and pelvic dystocia. AB - This article has considered the subject of bony pelvic dystocia and soft tissue dystocia. Dystocia most often results from a combination of fetal and pelvic factors. However, on many occasions the size and shape of the pelvis is the initial problem, which encourages the fetus to take up a malposition such as occiput-posterior, and this in turn results in a dysfunctional contraction pattern that may or may not be corrected by oxytocin augmentation--a vicious circle that can only be broken by performance of a cesarean section. With minor degrees of pelvic dystocia, asynclitism and molding of the fetal head can often make a safe vaginal delivery possible. Clinically all pelvises can be categorized into adequate, questionable, and too small. The latter group is the least common and generally includes the congenitally or developmentally abnormal pelvises, and in most cases primary cesarean section should be the mode of delivery. In all other pelvises with a vertex presentation, a trial of labor is indicated because the fetal head is an excellent pelvimeter. With proper fetal monitoring with an intrauterine pressure catheter, with the use of a partograph to assist in the diagnosis of an active-phase arrest, followed by a cesarean section at the appropriate time, there is no increase in fetal or maternal morbidity. If the breech is the presenting part, then there are only two types of pelvis--very adequate and inadequate--and x-ray pelvimetry should be used to help in the classification.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555920 TI - Shoulder dystocia. PMID- 3555921 TI - Maternal positioning to prevent or alleviate dystocia in labor. AB - Women have always used different positions to make labor more comfortable and, when allowed, spontaneously change position numerous times during labor and birth. The positions they choose, while dictated by comfort, frequently prove to be beneficial in promoting labor progress. For 50 years, the value of mobility and position change received little attention, but recent research and advances in the design of birthing equipment indicate that maternal positioning provides a valuable, noninvasive, and acceptable intervention. This paper reviewed six mechanisms by which dystocia may be prevented or corrected through the use of maternal positioning. PMID- 3555922 TI - Midforceps delivery: yes? PMID- 3555923 TI - Midforceps delivery: no? PMID- 3555924 TI - Intracapsular pressure and caput circulation in nondisplaced femoral neck fractures. AB - Nine patients with nondisplaced femoral neck fracture were evaluated with preoperative Tc-MDP-scintimetry, ultrasonography, and measurement of the intracapsular pressure. The intracapsular pressure in straight neutral position of the hip exceeded normal hip pressure in all cases. Patients with an intracapsular pressure greater than 80 mm Hg had a low scintimetric rate, indicating a risk for segmental collapse of the femoral head. Intracapsular tamponade may contribute to the development of segmental collapse in some patients with nondisplaced femoral neck fracture, but further investigations are needed to determine whether evacuation of the hemarthrosis should be recommended. PMID- 3555925 TI - Nonunion of the humeral shaft. AB - Retrospective review of records of 26 patients with nonunion of the humeral shaft revealed several factors frequently associated with the development of nonunion. The fractures were transverse and short oblique and treated per primam with hanging casts or open reduction. Surgical fixation was unstable. The types of nonunion were atrophic in 19 patients, hypertrophic in five patients, and synovial pseudarthrosis in two patients. Twenty-four of 26 nonunions (92%) treated with bone grafts and rigid internal fixation healed in an average of 5.6 months. Overall, 47 surgical procedures, including prior procedures, were performed on these 26 nonunions. The average number of operations per patient was 1.8. Successful platings produced immobilization, consisting of an average of 6.8 points of cortical fixation above the nonunion and 7.1 cortices below. Rigid fixation was not obtained in the unsuccessful procedures. Unsuccessful platings were noted to have unstable fixation, with an average of 2.7 points of cortical fixation above the nonunion and 3.0 cortices below. Bone grafting was performed in only 55% of the unsuccessful platings. Optimal treatment of nonunions of the humeral shaft consists of resecting atrophic nonunions, shortening the bones, drilling sclerotic areas, and apposing bleeding diaphyseal surfaces; open reduction with internal fixation with a broad compression plate, including at least six points of cortical fixation above and below the nonunion; compression of the nonunion by means of interfragmentary lag screws, prestressing of the plate, dynamic compression by the plate, or direct compression by the external compression device; and autogeneic cancellous iliac bone grafts. PMID- 3555927 TI - The classic. Back strain and sciatica. By Frank R. Ober, 1935. PMID- 3555926 TI - Replacement of the anterior cruciate ligament with a bone-ligament-bone anterior cruciate ligament allograft in dogs. AB - Acute replacement of the canine anterior cruciate ligament (ACL) with a frozen, bone-ligament-bone anterior cruciate ligament preparation was studied using biochemical, immunologic, and biomechanical testing methods. Nine dogs were used for the study, six dogs received allografts and three received autografts. No tissue antigen matching was performed. All nine dogs were killed nine months after surgery. Necropsy examination revealed that the ACL was not present in three joints (one autograft, two allografts). The two autograft and four allograft ligaments available for mechanical testing sustained mean maximum loads that were 10% and 14%, respectively, of the mean maximum loads sustained by the contralateral ACL. Autoradiography indicated that cellular activity was more pronounced in the autograft specimens. Hydroxyproline uptake was 200% and 45% of normal in the autograft and allograft ligaments, respectively. Both autograft and allograft specimens were producing Type I collagen at the time of killing. Antidonor dog leukocyte antigen (DLA) antibody was detected in the synovial fluid taken at the time of killing from six of six dogs that received allografts and in zero of three dogs that received autografts. PMID- 3555928 TI - Contractures. A historical perspective. AB - Orthopedic history vividly documents the continuing battle between restoring tissue stability and preserving functional mobility. Prolonged and uninterrupted rest, popularized by Hilton and Thomas, but promoted by many before them and subsequently continued by Jones, Orr, and others, assures healing. Contractures that permanently limit function are not an uncommon consequence. Hippocrates, Hunter, Lucas-Championniere, and David advocated judicious motion. Timing and the interpretation of the patient's pathologic state have proved to be the critical criteria. Modern antibiotics, antiinflammatory medications, acute surgical repair, and techniques that combine stability and early motion provide today's orthopedic surgeons' great versatility and capability. Despite these advantages the threat of contractures remains. The dictum "rest until healed" persists. Physiologic posturing of inflamed or swollen joints to minimize tissue strain introduces resting positions of 15 degrees plantar flexion at the ankle, and 30 degrees flexion at the knee and hip. These will be perpetuated by contractures if not actively counteracted by timely mobilizing procedures. Each of these joint positions is a serious deterrent to walking without stressful substitutive posturing, and the patient's ability to function is impaired. PMID- 3555929 TI - [Radiological studies on the portosystemic shunts in portal-systemic encephalopathy]. PMID- 3555930 TI - Urinoma detected by dual isotope renogram-cystogram. AB - A case is reported in which a urinoma developed following a renal transplant. Dual isotope renography-cystography using Tc-99m DTPA and Ga-67 citrate revealed the diagnosis after ultrasonography and radiographic cystography were nondiagnostic. PMID- 3555931 TI - Quantitative evaluation of postembolized splenic tissue using technetium-99m sulfur colloid. AB - Tc-99m sulfur colloid scans were used to quantitate the percent of residual splenic tissue after partial splenic embolization (PSE) performed for the treatment of hypersplenism in 17 renal transplant patients. A liver-spleen phantom was designed which simulated the human liver and spleen configuration to evaluate the technique. This phantom contained a solution of tc-99m sulfur colloid, which allowed precise quantities of the spleen phantom volume to be displaced using lucite pseudo-emboli. After each lucite embolus, computer images of the spleen phantom were collected and analyzed in the same manner used for the transplant patients. Correlation of the actual volume displaced or embolized with the computer estimated values was 0.996 (P less than 0.001). This technique was superior to both CT and MRI, which were more difficult to perform and less precise in measuring a decrease in postinfarction functioning splenic tissue. PMID- 3555932 TI - Radionuclide scintigraphy of the brain and ultrasound studies in tubercular meningitis. AB - The present study was undertaken to assess the usefulness of brain scintigraphy and ultrasound evaluation of changes described in tuberculous meningitis. Brain scans were done with Tc-99m DTPA in 127 cases of tuberculous meningitis (TBM) and ultrasound studies in 41 cases with open anterior fontanelles. The data show that 54/127 (42.5%) of cases had abnormal brain scans, of which 33/54 had cerebrovascular infarcts and 14/54 had tuberculomas, while the remaining cases had either subdural effusions or generalized increased activity. The cerebrovascular infarcts were more frequent in patients with acute onset of TBM with associated hemiplegias. The ultrasound studies indicated that 80% of all cases of TBM had a mild to severe dilatation of the ventricles. About 55% of cases had a dilatation of only the lateral ventricles while the remaining cases had a block of aqueduct or beyond the fourth ventricles. Increased intracranial pressure changes were associated with a higher incidence of severe ventricular dilatation. Noninvasive detection methods in the study of TBM are important not only from the point of view of diagnosis but also to understand and evaluate the pathological changes occurring in vivo during the disease process and to judge the progress and response to treatment. A combination of ultrasound and brain scans offers diagnostic accuracy comparable to CT. Apart from cost, the larger radiation doses resulting from CT studies preclude its routine use in pediatric subjects. PMID- 3555933 TI - Falsely positive radionuclide venogram following DTPA aerosol ventilation scan. PMID- 3555934 TI - Abdominal crisis with "absent" spleen. PMID- 3555935 TI - Postpneumonectomy bronchopleural fistula imaged by ventilation lung scanning. PMID- 3555936 TI - Intrathecal administration of radiopharmaceuticals for cisternography. PMID- 3555937 TI - Comparison of a radionuclide method and catheterization for the measurement of residual volume of urine in the bladder. AB - Residual urine volume in the bladder was measured using a gamma camera and Tc-99m DTPA labeling of the urine and was compared to urethral catheterization in 21 male patients. The results of the radionuclide method did not differ significantly from the catheterization (P less than 0.001) and a good correlation was found between the two methods (r = 0.98). The results suggest that the simple, safe radionuclide method may be used instead of catheterization to measure residual urine volume in the bladder. PMID- 3555938 TI - An intravenous radionuclide method for repeated shunt determinations. AB - Using a subtraction technique, repeated shunt determinations were successfully performed on 25 patients with a high degree of correlation. PMID- 3555941 TI - Relationship of body fat distribution to metabolic complications in obese prepubertal girls. AB - The purpose of this study is to assess the relative effects of body fat distribution and obesity "per se" on serum glucose, insulin, and insulin resistance. Seventeen obese and nine nonobese control prepubertal girls were studied. Biceps, triceps, subscapular, and suprailiac skinfold thickness were measured. Percentage of body fat (% BF) and total body fat (TBF) were calculated. Body fat distribution was assessed by analyzing the central (suprailiac, subscapular)/peripheral (biceps, triceps) ratios. Oral glucose tolerance test was performed. Serum glucose and insulin were measured and insulinogenic index (insulin/glucose) was calculated. Body fat anthropometric data and body fat distribution indexes were significantly higher (p less than 0.001) in the obese group. The obese population presented significantly elevated values of glucose, insulin, and insulinogenic indexes (p less than 0.01-p less than 0.001). In the obese group, insulin showed significant positive correlations (p less than 0.05-p less than 0.001) with biceps, subscapular, and suprailiac skinfolds, % BF and TBF, whereas the insulinogenic index had positive correlations with suprailiac skinfold and TBF (p less than 0.05). Obese girls showed positive correlations between the body fat distribution indexes and insulin or insulinogenic indexes (p less than 0.05-p less than 0.001). In prepubertal girls obesity is of the centripetal (central) type. This pattern has an important role in determining the alterations in the glucose-insulin homeostasis that characterize the childhood nutritional obesity. PMID- 3555942 TI - Survival analysis of adverse effects data in the Beta-Blocker Heart Attack Trial. AB - Monitoring for adverse effects in an integral part of controlled clinical trials. Traditionally the results of monitoring are reported as either cumulative percentages at the end of the study or cross-sectional percentages at a given time in the study. These results are likely to underestimate the true number of complaints because participants may be withdrawn (e.g., deaths, losses to follow up, and refusals) before they ever complain of an adverse effect. However, survival analysis methods can be used to compare the distributions of "time to first complaint" in the active and placebo treatment groups, taking into account withdrawals. Participants in the Beta-Blocker Heart Attack Trial were monitored for possible adverse effects. On each follow-up visit they were asked whether they had had any of four conditions (blacking out, fatigue, depression, and bronchospasm) since their previous visit about 3 months earlier. The patients were followed for up to 30 months. For fatigue and bronchospasm, the complaint free time was significantly longer in the placebo vs. active (propranolol) treatment group (P less than 0.005). PMID- 3555939 TI - Clinical pharmacokinetics of the inhalational anaesthetics. AB - At present, the most widely used inhalational anaesthetics are the halogenated, inflammable vapours halothane, enflurane, isoflurane and the gas nitrous oxide. The anaesthetic effect of these agents is related to their tension or partial pressure in the brain, represented at equilibrium by the alveolar concentration. The minimum alveolar concentration for a specific agent is remarkably constant between individuals. The uptake and distribution of inhalational anaesthetics depends on inhaled concentration, pulmonary ventilation, solubility in blood, cardiac output and tissue uptake. Inhalational anaesthetics are mainly eliminated by pulmonary exhalation, but significant amounts of halothane are removed by hepatic metabolism. Inhalational agents currently in use have acceptable pharmacokinetic characteristics, and clinical acceptance depends on their potential for adverse effects. Induction of anaesthesia with halothane is rapid and relatively pleasant and it is the agent of choice for paediatric anaesthesia. Between 20 and 50% is metabolised, and the parent drug is a potent inhibitor of drug metabolism. Post-operatively enzyme induction may follow. The major disadvantages of halothane are myocardial depression, propensity to evoke cardiac arrhythmias and the rare but serious halothane hepatitis. Induction and recovery from enflurane anaesthesia is rapid. Metabolism accounts for 5 to 9% of the elimination. The metabolic product inorganic fluoride may in rare cases cause renal toxicity. Enflurane is a weak inhibitor of drug metabolism at anaesthetic concentrations. Enflurane depresses circulation more than halothane by reducing both myocardial contractility and systemic vascular resistance, but cardiac rhythm is stable. Enflurane anaesthesia may, unlike the other agents, induce epileptic activity. Enflurane is widely used as replacement for halothane in adults. Despite its low blood-gas solubility, the airway irritability of isoflurane precludes a faster induction of anaesthesia than with halothane. Isoflurane is almost resistant to biodegradation. Myocardial contractility is maintained during isoflurane anaesthesia and cardiac rhythm is stable except for the occurrence of tachycardia in some patients. Isoflurane is the inhalational agent of choice for neurosurgical operations. Sevoflurane is an experimental ether vapour: induction and recovery is fast and pleasant. It is metabolised to the same extent as enflurane and subnephrotoxic concentrations of inorganic fluoride may result. Sevoflurane has fewer respiratory and cardiovascular depressant effects than halothane and may be a future alternative for paediatric anaesthesia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3555945 TI - Clinical and histologic features of nevi with emphasis on treatment approaches. AB - A nevus is a cutaneous lesion characterized histologically by clustering and disorganization of a variety of cell types in the skin including the epidermis, appendages, melanocytes, and their precursor cells. Commonly, a nevus is congenital but it may be acquired. Owing to the prevalence and variations of melanocytic nevi and their association with malignancy, this article discusses the development, classification, histology, and clinical characteristics of nevi with an emphasis on the relationship to malignancy. Recommendations are provided for treatment of these benign lesions. PMID- 3555943 TI - Effect on the endocrine system of a new dopaminergic agent, ibopamine. AB - Ibopamine, an oral dopaminergic and adrenergic agent, was given to 19 healthy men to investigate the effect of this dopamine analogue on carbohydrate metabolism. In a three-part study six subjects received ibopamine alone, seven subjects were pretreated with metoclopramide (a dopamine antagonist), and six subjects received phentolamine (an alpha-receptor antagonist) and propranolol (a beta-receptor antagonist) to study the specific mechanisms involved. In these single-blind, controlled, randomized studies, effects on fasting glucose, insulin, glucagon, and prolactin were evaluated. Ibopamine, 300 mg, produced a statistically significant increase in fasting glucose and insulin levels but had no effect on glucagon or prolactin levels. Pretreatment with metoclopramide or phentolamine did not block these effects, but pretreatment with propranolol significantly (P less than 0.05) blunted the increase in fasting glucose and insulin levels. These findings indicate that, unlike other dopaminergic agonists, administration of ibopamine results in increased glucose levels without affecting glucagon. The effect on glucose is mediated through stimulation of beta-adrenergic receptors. PMID- 3555944 TI - Lack of effect of hepatic enzyme induction on metabolic control in patients with type 2 (non-insulin-dependent) diabetes. AB - A placebo-controlled, double-blind crossover study was carried out in 11 non insulin-dependent (type 2) diabetic patients to find out the effects of a hepatic enzyme inducer (phenobarbital, 100 mg/day for 2 months) on the metabolic control, plasma C-peptide, insulin, serum, and lipoprotein lipid levels. Phenobarbital induced a significant increase in hepatic antipyrine metabolizing activity, but no significant changes were found in fasting or postload blood glucose, plasma C peptide, or insulin levels during the study. There was a significant increase in serum total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, as well as in serum total and very low-density lipoprotein triglycerides, during phenobarbital treatment as compared with placebo. PMID- 3555946 TI - Lymphedema. AB - Despite our improved knowledge of the lymphatic system, lymphedema remains an incurable disease. Its pathogenesis is still poorly understood, but fortunately the majority of patients can be satisfactorily managed by conservative means. Surgical intervention is offered only in cases of refractory disease and does not offer a surgical cure. At the present time, there are five major surgical options: lymphangioplasty, buried dermal flap, lymphaticovenous shunts, the Charles procedure, and the staged subcutaneous excision beneath flaps. Lymphangioplasty is usually limited to those patients with limited life expectancy, because the beneficial effects are transient. The most frequently used procedures--the buried dermal flap, the Charles procedure, and the subcutaneous excision beneath flaps--offer patients symptomatic improvement, primarily through the excision of lymphedematous subcutaneous tissue. Much controversy still exists as to the efficacy and future applicability of both the enteromesenteric bridge and microlymphatic surgery, which are currently under investigation. Long-term follow-up will be necessary. The discouraging fact remains that no procedure cures lymphedemia; however, we believe that, at this time, the subcutaneous excision beneath skin flaps offers the most reliable and consistently beneficial means of surgically managing the symptoms of lymphedema. PMID- 3555947 TI - Cysts and cyst-like lesions of the skin and subcutaneous tissue. AB - Cysts and cyst-like lesions are common occurrences seen in a busy plastic surgical practice. Although many can be treated by surgical excision, they still represent an interesting histologic, etiologic, embryologic, and clinical spectrum. In a number of instances, they require detailed multidiagnostic evaluation and complex surgical approaches to excision. By classifying these cystic masses by age group and anatomic location, the clinician can simplify his or her approach to this group of cutaneous masses. PMID- 3555948 TI - Cutaneous hemangiomas and lymphangiomas. AB - This article describes but the tip of the congenital vasoformative iceberg. Much has been left unsaid. The problem is very common, and it is hoped that with continued clinical prudence we can advance and improve our treatment modalities, particularly in those areas in which we fall so short! PMID- 3555949 TI - Hidradenitis suppurativa. AB - Hidradenitis suppurativa is a chronic, relapsing, inflammatory disease process that primarily involves the axilla and/or inguinal region and does not manifest itself until after puberty. Typically, the process begins as a local occlusive disease of a sweat gland; secondary bacterial infection then occurs. The early stages of hidradenitis suppurativa are usually managed by the dermatologist. Once the disease becomes extensive and chronic, surgical excision of all the involved tissue is indicated. PMID- 3555940 TI - Pharmacokinetics of anticancer drugs in children. AB - Interpatient pharmacokinetic variability normally observed in adults is often of even greater magnitude in paediatric patients because of age-related maturation of physiological processes responsible for drug disposition. Several antineoplastic agents have shown age-related changes, including alterations in volume of distribution, hepatic (doxorubicin, cyclophosphamide), and renal (bleomycin, methotrexate) clearances. These differences in pharmacokinetics as a function of age alter systemic exposure to chemotherapy, and may alter the efficacy and toxicity profile for standard doses of antineoplastic drugs. The relationship of systemic exposure to toxicity has been most clearly defined for methotrexate. Clinical monitoring of methotrexate serum concentrations, and adjustment of folinic acid dosages and duration of rescue based on methotrexate disposition is now routine. More recently, pharmacodynamic data have been published for high-dose methotrexate, epipodophyllotoxins, cisplatin, and cytarabine (cytosine arabinoside), indicating a relation between drug disposition and toxicity or efficacy. Collectively, these data suggest that the pharmacokinetics of many anticancer drugs in children is different from adults, and that variability in drug disposition may have an important influence on toxicity or efficacy. PMID- 3555950 TI - Nonpigmented premalignant lesions of the skin. AB - This article presents a survey of some of the nonpigmented cutaneous lesions that have the propensity or possibility to progress or transform into malignancies. For each lesion, the author discusses clinical appearance and course, histologic features, and general recommendations for treatment. PMID- 3555951 TI - The wax try-in and characterization of the complete denture set-up. PMID- 3555952 TI - Atypical response after a single episode of scaling and root planing therapy. A case report. PMID- 3555953 TI - Hormonal and metabolic response to physical exercise in hyperinsulinemic and non hyperinsulinemic type 2 diabetics. AB - In order to find out the influence of hyperinsulinaemia and initial blood glucose levels on glucose homeostasis during physical exercise, 6 Type 2 diabetic patients with basal hyperinsulinemia (0.209 nmol/l) (group A) and 10 Type 2 diabetics without basal hyperinsulinemia (0.046 nmol/l) (group B) took part in a study on metabolic effects of exercise. Mean bodymass was higher in group A (101 kg) than in group B (71.7 kg). Exercise was performed on a bicycle-ergometer for 1 hr. Work load was adjusted to a pulse-rate of 120/min with a mean of 48 watt (W) in group A and 52 W in group B. Blood glucose (BG), insulin (IRI), glucagon (G), growth hormone (HGH), cortisol (C), epinephrine (E), norepinephrine (NE), lactate (L), pyruvate (P) and free fatty acids (NEFA) were measured during 3 hr. BG and IRI were also documented for the following 7 hr. Both groups showed a small but significant decrease of BG during exercise (group A from 11.54-10.38 mmol/l, p less than 0.01, and group B from 8.71-7.22 mmol/l, p less than 0.005). IRI decreased insignificantly in group A (from 0.209-0.174 nmol/l, p less than 0.15) and significantly in group B (from 0.046-0.032 nmol/l, p less than 0.01). G increased significantly in both groups (from 62.4-75.2 pmol/l in A, p less than 0.05, and from 38.8-47.1 pmol/l in B, p less than 0.01). HGH rose from 0.018 0.149 nmol/l in A, p less than 0.01, and from 0.077-0.320 nmol/l in B, p less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555954 TI - Cytotoxic activity of sera from diabetic BB rats against BB rat islet--a functional study. AB - [3H] leucine incorporation into islet proteins, insulin secretion, hormone content (insulin, glucagon) and DNA synthesis were measured in cultured BB rat islets in a study to compare the effect of freshly prepared BB rat serum obtained from non-diabetic and newly diagnosed diabetic BB rats on islet functions. After exposure of isolated BB rat islet to a mixture of tissue culture medium and BB rat serum (1:1) for 24 hr, islet lysis was induced by 40% of the diabetic BB rat sera whereas the remaining 60% of diabetic BB rat sera tested did not influence islet functions as evidenced by insulin net production, glucose-induced insulin release and DNA synthesis measured in a subsequent culture period in TCM 199, 10 mmol/l glucose supplemented with 10% neonatal calf serum or short-term incubations. After exposure of islets to sera with anti-islet cytotoxicity the majority of islet cells were destroyed as indicated by a drastically reduced [3H] leucine incorporation into islet proteins and by a diminution of hormone and DNA content of islets. This toxicity against islets was overcome by heat treatment (58 degrees C, 30 min) of sera. The results indicate that heat-labile components in certain diabetic sera of BB rats can lyse the majority of islet cells in BB rat islets within 24 hr. Our assay may help to dissociate humoral and cellular components which cause the injury of beta cells and the onset of diabetes in BB rats. PMID- 3555955 TI - Insulin binding and action in isolated cardiocytes from spontaneously diabetic BB rats. AB - Isolated cardiac myocytes from control and insulin treated diabetic BB rats were used to study cellular alterations related to partly controlled diabetes. Scatchard analysis of equilibrium binding data showed an unaltered affinity and number of insulin receptors in cardiocytes from both groups of animals. Moreover, insulin internalization was found to be identical under these conditions. Insulin action was determined by measuring the effect of the hormone on initial velocities of 3-0-methylglucose influx. Basal activity of the glucose transporter and maximal transport stimulation by insulin remained unaffected. In contrast, the sensitivity of the carrier towards stimulation by insulin was markedly reduced in cardiocytes from diabetic rats with a half-maximal action occurring at an insulin concentration of 3 X 10(-10) mol/l and 9 X 10(-9) mol/l in control and diabetic animals, respectively. The onset of insulin action was much slower in cells from diabetic BB rats exhibiting an increase in the coupling time by 400% from 5 to 20 min, respectively. The data suggest an association of partly controlled diabetes with myocardial alterations located at the postreceptor level. PMID- 3555956 TI - A within patient cross over trial of 4 insulin regimens in antibody-negative, C peptide negative patients. AB - 12 patients entered a within patient cross over trial of 4 insulin regimens:- twice daily semi-synthetic human soluble and insulin zinc suspension (Actrapid/Monotard HM), twice daily porcine soluble and insulin zinc suspension (Actrapid/Monotard), twice daily porcine soluble and isophane insulin (Velosulin/Insulatard), and thrice daily porcine soluble insulin (Actrapid) supplementing once daily bovine ultralente insulin (Ultratard). Each insulin regimen lasted 10 weeks, the order of allocation being determined on a random basis. Patients were encouraged to improve glycaemic control throughout the study by self adjustment of insulin dosage guided by standard algorithms. Metabolic control was assessed by capillary blood glucose series, M-values, HbA1c, and fasting lipids. No significant differences in M-values, mean HbA1c or fasting lipids were found at the end of any of the regimens. Patients achieved significantly (p less than 0.01) lower pre-lunch blood glucose on Velosulin/Insulatard than on any other regimen, but severe hypoglycaemic events were more common (p less than 0.05) on this regimen. A significant fall in HbA1c values from that at recruitment could be demonstrated only by analysing treatment periods in chronological order. Thus at the end of the second study period, mean HbA1c was significantly less than that at recruitment (p less than 0.01), but by the end of the 4 treatment periods of our study, had returned to levels similar to those at recruitment. Similar control is achieved on semi-synthetic human insulin as on other conventional regimens. Day-to-day variability of blood glucose, expressed as a standard deviation, is approximately twice the maximum difference between any 2 regimens at any time point.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3555957 TI - The ultrasound appearances of prostatic cancer with histological correlation. AB - An analysis of the ultrasound appearances of the prostate with its capsule and periprostatic structures was performed in 221 patients with a histologically confirmed diagnosis of prostatic cancer. The cancers were histologically graded into well, moderate and poorly differentiated adenocarcinoma and transitional cell carcinoma. The results of this study indicate that an ill-defined hypoechoic area is the commonest appearance of prostatic cancer; this was seen in 96% of our 221 patients. The cancers were staged by ultrasound into confined (T0, T1, T2) and unconfined (T3) cancers. A breach of the capsule was seen in 55% of cases. In this unconfined group all cancers were hypoechoic in comparison with 92% in the confined group. In the confined cancer group the areas of abnormal echogenicity were present in more than one prostatic quadrant in 76%. Mostly commonly two prostatic quadrants were affected. The abnormal echogenicity was noted in the posterior quadrants of the prostate more commonly (58%) than in the anterior quadrants. The prostate gland appeared round in 67%, semicircular in 25% and crescentic in 8%. The gland was symmetrical in 68%. The prostatic capsule appeared regular in 86% of patients with a confined cancer. In 70% of cases of extensive but confined cancer there was loss of demarcation between the central and peripheral zones of the gland. The unconfined cancer group all had a breach of the capsule and all glands were heterogeneous due to hypoechoic areas. The breach affected more than one quadrant in 81% and most commonly the capsular breach involved two prostatic quadrants. An anterior breach of the capsule was noted much more frequently than a posterior breach. Forty-four per cent of cases had three or four quadrants of the gland involved. In 3% of cases of proven prostatic cancer no definite ultrasound abnormality could be detected. Calcification was seen within the gland in association with the cancer in 63% with approximately equal frequency in confined and unconfined disease. The seminal vesicles showed definite evidence of infiltration in 10%. Both seminal vesicles were seen in 61% and thought to be normal. In 8% only one was seen. Failure to demonstrate either seminal vesicle occurred in 21%. There was no correlation between the ultrasound appearances of prostatic cancer and the histological grading of the tumour. PMID- 3555958 TI - Duplex ultrasound in the assessment of renal transplant complications. AB - Duplex ultrasound was performed on 21 patients with renal transplants to assess the feasibility of detection of complications and, in particular, acute rejection and vascular abnormalities. A comparison of the results of Doppler waveform analysis in the transplant renal artery and morphological features on real time scanning in the detection and follow up of acute rejection was made. It was noted that there were characteristic alterations of Doppler shift spectral pattern in acute rejection, and these characteristics were more accurate, appeared earlier and showed a more consistent response to anti-rejection treatment than morphological changes demonstrated by real time ultrasound. Three patients had vascular abnormalities correctly predicted by duplex ultrasound and confirmed by angiography. These findings suggest that duplex ultrasound should be the investigation of choice in the initial assessment and follow up of renal transplant. PMID- 3555959 TI - Percutaneous nephrostomy in paediatrics. AB - Percutaneous nephrostomy has been performed on 18 kidneys in 16 children with an age range of 1 day old to 14 years. The indications and techniques for percutaneous nephrostomy are described, the results are documented, and the effects of the procedure on the management of these patients are discussed. It is shown that percutaneous nephrostomy in paediatrics is a safe and reliable method for draining renal collecting systems in order to relieve obstruction, to assess renal function and to drain pyonephroses. PMID- 3555960 TI - The radiology of sarcomas and sarcomatoid carcinomas of the kidney. AB - Tumours of the kidney with sarcomatoid elements are uncommon. The radiological findings in 11 patients with such lesions are presented. It is important to separate pure sarcomas from lesions with sarcomatous and carcinomatous elements since they have different radiological appearances and prognosis. These tumours often show calcification on radiographs and on angiography appear predominantly avascular with a blood supply from capsular vessels. Because of their rarity and the overlap of radiographic findings with more common tumours the diagnosis cannot be made by current imaging methods alone. PMID- 3555961 TI - Vomiting associated with whole body irradiation. AB - A study has been made of the patterns of vomiting in 305 patients undergoing total body irradiation before bone marrow transplantation. Vomiting usually begins after a dose of 2 to 3 Gy has been given to the whole body and may persist for up to 12 hours from the start of treatment. There is a recurrence of vomiting after 2 to 5 days. It is infrequent in patients receiving fractionated radiation with fraction sizes of less than 2 Gy, and appears unrelated to cumulative dose after the threshold has been reached. The incidence of vomiting is reduced by limitation of patient movement during radiation and by sedation adequate to keep the patient asleep. It is increased by anxiety and there is a higher incidence in patients aged 10 to 40 than in those aged less than 10 years. Other drugs administered before total body irradiation may affect the incidence. Vomiting can be prevented completely in 50% of patients. PMID- 3555962 TI - Real-time ultrasound diagnosis of deep vein thrombosis: a comparison with venography. AB - A prospective study comparing real-time ultrasound scanning with contrast venography in the diagnosis of deep venous thrombosis of the lower limb was performed in a group of 46 patients. The sensitivity of ultrasound scanning for thrombus within the iliofemoral segment, femoral vein, and popliteal vein was 94% with a specificity of 100%. Additional information obtained by ultrasound included the diagnosis of popliteal cysts, pelvic and inguinal lymphadenopathy, popliteal haematoma, and traumatic arterial aneurysm. Real-time ultrasound scanning is a rapid and non-invasive alternative to contrast venography in the diagnosis of lower limb deep venous thrombosis. PMID- 3555963 TI - Computed tomography and ultrasound diagnosis of mycotic aneurysm of the abdominal aorta due to Salmonella. AB - The case of a 56 year old diabetic Chinese male, with a Salmonella bovismorbificans (serogroup C) mycotic aneurysm of the abdominal aorta is presented. The lesion was seen by computed tomography and ultrasound and the patient was successfully treated by primary resection, debridement and grafting. Computed tomography criteria for the diagnosis of mycotic aneurysms of the abdominal aorta are discussed. Ultrasound identified the aortic aneurysm correctly but was unable to demonstrate the associated psoas abscess in this case. PMID- 3555964 TI - Angiomyolipoma of the liver. AB - The radiological features of a case of angiomyolipoma of the liver are reported. A review of the literature has shown this to be a rare benign tumour. The lesion falls within the broad spectrum of lipomatous liver tumours. The angiomyolipoma was shown to be a well defined, fat-density mass on computed tomography. The mass was echogenic, with a sharp margin, on ultrasound. Angiography showed the lesion to be vascular. The preoperative diagnosis of a lipomatous tumour was therefore possible. PMID- 3555965 TI - Special features, pathogenesis and aetiology of glomerular diseases in the tropics. PMID- 3555967 TI - Colorado Medical Society, Physician's directory 1987. PMID- 3555966 TI - The effect of sodium intake on rabbit renal prostaglandin E2 and thromboxane A2: dissociation from the renin-angiotensin system. AB - The effects of chronic alterations in dietary sodium intake on urinary prostaglandin (PG) E2 and thromboxane (TX) B2 was investigated in the rabbit. Sodium restriction, over a 15-day period, reduced daily urinary PGE2 and TXB2 in concordance with urinary flow (V) and sodium excretion (UNa+V), but increased plasma renin activity (PRA) and plasma aldosterone concentration (PAC). Sodium repletion, on the other hand, increased urinary PGE2 and TXB2 in proportion to the rise in V, but reduced PRA and PAC. During both sodium diets PGE2 and TXB2 correlated positively with V and negatively with PRA. It is concluded that chronic sodium intake produces opposite changes in the renal prostaglandin and the renin-angiotensin systems. PMID- 3555969 TI - A survey of the acoustic output of ultrasonic Doppler equipment. AB - Measurements of the acoustic output generated by a variety of clinical ultrasonic Doppler instruments have been carried out. The instruments surveyed include continuous wave Doppler units for cardiovascular investigations, fetal monitors, stand-alone pulsed Doppler equipment and 'duplex' scanners working in Doppler mode. Acoustic measurements have been made using a calibrated PVDF membrane hydrophone, and a milliwatt radiation force balance. Almost all the pulsed Doppler and duplex systems investigated could generate spatial-peak, temporal average intensities in water which exceeded 100 mW cm-2, with a maximum of 825 mW cm-2 measured. These intensities were also reached by some continuous-wave Doppler systems, particularly those incorporated into duplex scanning systems. Fetal monitoring equipment was found to operate typically at lower intensities. Doppler units have been found to show a very wide variation in pulse length, repetition frequency and spatial peak pressure, and a wider range of pulse average intensities than previously reported. Units were found to vary considerably in their control of total acoustic power whilst operating parameters such as gate width and range were altered. PMID- 3555968 TI - Intra-articular treatment of inflammatory arthritis: double-blind trial comparing bufexamac with methylprednisolone acetate. AB - A double-blind trial was carried out to weigh the effectiveness and tolerance of intraarticular injections of bufexamac (20 mg) against methylprednisolone (40 mg) in 40 patients with an acute bout of inflammatory arthritis. Leucocyte and polymorphonuclear counts and viscosity measurement of the synovial fluid were performed before and 14 days after injection, which showed methylprednisolone to be significantly superior to bufexamac in suppressing inflammation. In both groups a statistically significant improvement of pain on mobilisation and pain index was noted, but the number of clinical remissions was significantly higher in the methylprednisolone group. The blind investigator found a statistically significantly greater improvement with methylprednisolone than with bufexamac, and patients' opinion on effectiveness did not differ significantly. Important local or general side-effects were not observed. It was concluded that, although both drugs appeared to exert a considerable anti-inflammatory effect in inflammatory arthritis, methylprednisolone was more effective. PMID- 3555970 TI - Management of idiopathic myelofibrosis. PMID- 3555971 TI - Anti-platelet opsonic activity in alloimmune and autoimmune thrombocytopenia. AB - A chemiluminescence technique (CLT) has been developed which measures the interaction between human monocytes and antibody-coated (opsonized) platelets. This technique has an objective end-point, is simple to perform and is of comparable sensitivity to the platelet suspension immunofluorescence test (PSIFT) when used to detect anti-platelet allo-antibodies. In contrast, only 4/20 sera from patients with clinically diagnosed autoimmune thrombocytopenia were opsonic in the CLT, while 8/20 of these same sera bound IgG to platelets in the PSIFT. Only one serum gave positive results in both tests. PMID- 3555972 TI - Microbial nomenclature: a list of names and origins. AB - Microbial nomenclature underwent a large number of changes in the 1970s. Many species of pathogens were added and many others experienced name changes. These modifications primarily were due to two unrelated factors: the use of new DNA hybridization techniques and the advent of computerized literature searches to establish historical precedence. In 1980 an approved list of microbial names was published. This list fixed and legitimized bacterial nomenclature. All future additions or alterations to it had to pass international scientific committees. This list has now been accepted by the scientific community. The derivation of these names are presented in this review. PMID- 3555973 TI - Structural features of the proteins participating in blood coagulation and fibrinolysis. PMID- 3555974 TI - Tandem arrangement of genes coding for tumor necrosis factor (TNF-alpha) and lymphotoxin (TNF-beta) in the human genome. PMID- 3555975 TI - Human growth hormone: from clone to clinic. PMID- 3555976 TI - Marrow transplantation and gene transfer as therapy for hematopoietic diseases. PMID- 3555978 TI - Human fos gene. PMID- 3555977 TI - Gene replacement therapy for inborn errors of purine metabolism. AB - Effective retroviral vectors carrying the human HPRT and ADA genes have been described. Initial characterization of the retroviral gene transfer system using the HPRT vector allowed the delineation of several parameters important in viral titer, expression, and stability. Using the HPRT and ADA vectors, we have initiated experiments designed to insert these human genes into various tissues of the mouse and have demonstrated expression of both transduced genes in mouse bone marrow cells. Further work with these and other vector constructions is underway in the hope that this technique may allow safe and effective treatment of ADA and HPRT deficiencies, paving the way for treatments of other inborn errors of metabolism through somatic gene replacement therapy. PMID- 3555979 TI - New thinking on hypertension in the elderly. AB - Most patients over the age of 60 with sitting casual systolic blood pressure averaging greater than 160 mm Hg and diastolic pressure greater than 90 mm Hg and those with isolated systolic hypertension with elevated mean arterial pressure should be treated to reduce their blood pressure to less than 160/90 mm Hg or the mean arterial pressure below 110 mm Hg without producing adverse effects. The treatment should be individualized when other patient characteristics indicate a preferred drug. When this is not the case, then a thiazide diuretic combined with a potassium-sparing diuretic, with the addition of a centrally acting alpha agonist when needed to control blood pressure has been demonstrated to be effective. If the patient does not tolerate this, or if his blood pressure reduction is not satisfactory, then other drugs can be used effectively. PMID- 3555980 TI - Gastrointestinal bleeding in elderly patients. PMID- 3555981 TI - Current concepts of anemia in elderly patients. PMID- 3555982 TI - Drug treatment for elderly patients. PMID- 3555983 TI - Recent developments in radiotherapy for malignancies. PMID- 3555984 TI - Diurnal rhythms in liver carbohydrate metabolism. Comparative aspects and critical review. AB - Literature data on the diurnal rhythms of blood glucose, liver glycogen levels and key hepatic enzyme activities of glycolysis, gluconeogenesis, glycogen metabolism and lipogenesis in animals are reviewed. Materials on the diurnal rhythms of the activities of other enzymes involved in carbohydrate metabolism and related pathways such as the equilibrium glycolytic enzymes are also given. Interspecies comparison and analysis of the results and their interpretation are given. PMID- 3555985 TI - CT and ultrasound in abscess detection at specific anatomic sites: a study of 198 patients. AB - Records of 902 patients with possible abdominal abscess were reviewed and of these 198 had abscesses on at least one occasion imaged either with ultrasound (US) or computed tomography (CT). There were 235 episodes of either one or simultaneous multiple abscesses. Sensitivities of CT and US were analyzed according to anatomic site. The nature of errors made was tabulated. CT was significantly more sensitive than US for the detection of abdominal abscess. Causes of CT and US error in abscess detection are discussed, and recommendations regarding choice of exam and means of improving performance are made. PMID- 3555986 TI - ["Remarks on a register for nurses" by Florence Nightingale (1892)]. PMID- 3555987 TI - [Description of the "Notes on Nursing" by Florence Nightingale]. PMID- 3555988 TI - [Visit to the birthplace of Hildegard von Bingen: on medicine by a nun in the Middle Ages]. PMID- 3555989 TI - Acetylsalicylic acid inhibits non-immunologic contact urticaria. AB - To investigate the mechanisms of non-immunologic contact urticaria (NICU), the effects of 1g + 1g of acetylsalicylic acid (ASA) on contact reactions to methyl nicotinate, diethyl fumarate, benzoic acid, cinnamic acid, cinnamic aldehyde and dimethyl sulfoxide were studied in 21 test subjects. Erythema and edema reactions were observed visually, and the changes in the skin blood flow were monitored using laser-Doppler flowmetry. ASA had a significant inhibitory effect on erythema from all 6 agents and also on edema from all substances except dimethyl sulfoxide. The mechanism of the effect may be a result of the inhibitory influence of ASA on prostaglandin bioformation. Thus, to avoid false negative test results, non-steroidal anti-inflammatory drugs should not be used during NICU tests. PMID- 3555990 TI - Buspirone: a non-benzodiazepine for anxiety. The Medical Letter. PMID- 3555991 TI - Concerning multiple fibromas of the skin. PMID- 3555992 TI - Anesthesia and transplantation surgery. PMID- 3555993 TI - Forensic and medicolegal aspects of transplantation. PMID- 3555994 TI - The total artificial heart. PMID- 3555995 TI - Anesthesia considerations for orthotopic liver transplantation. AB - An institutionwide commitment is necessary for the success of a liver transplantation program. Although the number of people available to manage anesthesia for such surgery may vary, a minimally staffed transplantation team must include a staff anesthesiologist, an anesthesia resident, one or two certified nurse-anesthetists, and a nonprofessional to obtain and run specimens to the laboratory and blood bank; the operating room must be connected by intercom and telephone to support services. Another technician may be present to collect specimens and data for research purposes. Additional staff anesthesiologists, certified nurse-anesthetists, and anesthesia residents should be on call for other emergency surgery. The staff of laboratory and blood bank facilities must participate wholeheartedly to meet ongoing requirements during a liver transplantation. Enormous quantities of packed red cells (up to 250 units), fresh-frozen plasma, platelets, and occasionally cryoprecipitate must be immediately available. In addition, the donor pool and the supply of on-hand blood must be large enough to prevent shortages of blood for other emergency or routine surgery. Liver transplantation procedures last an average of 12 hours and cannot easily be accommodated in a busy operating room schedule. It is not reasonable to expect other patients, other surgeons, the anesthesiology department, and the hospital to postpone routine or other emergency surgery while a liver transplantation is being performed. Thus, the hospital must provide facilities to accommodate such a program either by new construction or by remodeling or reassigning operating space. PMID- 3555996 TI - Anesthesia considerations for renal transplantation. PMID- 3555997 TI - Immunosuppression following cardiac transplantation. PMID- 3555998 TI - The organ donor: physiology, maintenance, and procurement considerations. PMID- 3555999 TI - Cardiac transplantation: recipient selection criteria and pathophysiology and management of advanced heart failure. PMID- 3556000 TI - Managing the cardiac transplant patient. PMID- 3556001 TI - Anesthesia for cardiac transplantation. AB - As the number of cardiac transplantation recipients grows, more centers will be performing cardiac transplantations and more anesthesiologists will be confronted with such patients. This chapter is intended to impart to the reader the basic knowledge necessary to manage both the donor and recipient intraoperatively. It is not intended to provide a complete description of the entire field including such areas as the surgical procedure or the immunologic theories involved. Rather, it is hoped that with the information provided, the anesthesiologist may optimally care for this patient group and perhaps become stimulated to investigate this area of medical science in more detailed sources. PMID- 3556003 TI - Biochemistry of hospital nutrition. Energy and nitrogen requirements. PMID- 3556002 TI - Biochemistry of hospital nutrition. Nutritional assessment. PMID- 3556004 TI - Biochemistry of hospital nutrition. Special cases. PMID- 3556005 TI - Biochemistry of hospital nutrition. Infancy and childhood. PMID- 3556006 TI - Nutrition in old age. PMID- 3556007 TI - Biochemistry of hospital nutrition. Monitoring treatment. PMID- 3556008 TI - Biochemistry of hospital nutrition. Laboratory aspects. PMID- 3556009 TI - Biochemistry of hospital nutrition. Micronutrients. PMID- 3556010 TI - Ultrastructural evidences of direct endotoxin action on the heart. AB - In experiments on 13 rabbits, the authors performed heart perfusion according to Langendorf with endotoxin (9 experiments) or with Ringer's solution (4 experiments), and subsequently analysed the myocardial ultrastructure. They found that 30-minute endotoxin perfusion produces contracture changes, intracellular myocytolysis and desquamation of endothelial cells with destruction of the capillary basal membrane. The findings attested to myocardial dysfunction caused by direct endotoxin action on the heart. PMID- 3556011 TI - Acanthamoeba keratitis. A review of the literature. AB - Acanthamoeba is a free-living ubiquitous ameba that is responsible for a small but increasing number of cases of keratitis. The infection is associated with minimal corneal trauma and soft contact lens wear. It typically presents as a unilateral central or paracentral corneal infiltrate, often with a ring-shaped peripheral infiltrate. The lesion is often confused with fungal, bacterial, or herpetic keratitis. Successful therapy hinges on early recognition and aggressive therapy with appropriate topical antiamebic medication often in conjunction with penetrating keratoplasty. Thirty-five cases from the world literature are reviewed. PMID- 3556013 TI - Abstracts from World Congress on the Cornea III. April 27 to May l, 1987, Washington, D. C. PMID- 3556012 TI - Posterior chamber lens implantation during keratoplasty without posterior lens capsule support. AB - An easy and successful technique is described for implanting a posterior chamber lens at the time of corneal grafting in patients who have no posterior lens capsule for support. Using the principle of pupil entrapment with the lens optic in the anterior chamber, the lens loops are placed behind the iris and secured with McCannel sutures one at a time. Finally, the lens body is placed behind the pupil and covered with Healon, and then the grafting is completed. PMID- 3556014 TI - Imaging techniques and guidelines for evaluation and follow-up of breast cancer patients. AB - The use of imaging procedures for breast cancer staging and follow-up should be based on the natural history of the disease as well as the accuracy, cost, and availability of the studies themselves. Early detection of metastases may provide palliation but probably does not affect survival. For staging, chest X-ray and mammogram are both recommended on all patients; radionuclide bone scan is advised in the presence of either an elevated alkaline phosphatase, axillary metastases, or a primary tumor measuring more than 2 cm; abdominal CT should be performed if liver chemistries are abnormal; CT brain scan is the procedure of choice for neurological symptoms. Chest CT should be reserved for selected patients with an abnormal chest X-ray. Follow-up recommendations include annual chest X-rays and mammogram, bone scans every 5 years when a staging scan was indicated, and CT of the liver and/or brain in the presence of appropriate symptoms or laboratory values. PMID- 3556015 TI - The architecture of the proximal femur: an imaging analysis. AB - The proximal femur is a dynamic region whose internal architecture reflects the biomechanical demands of weight-bearing. It is composed of two major trabecular systems arranged along the lines of compressive and tensile stresses. Adaptive alterations in these trabeculae occur in a variety of disorders, including osteoporosis, osteoarthritis, and ischemic necrosis. Plain film radiography and computed tomography (CT) have been utilized to study these changes and provide insight into the pathophysiology of these disorders. Analysis of the order of resorption of trabeculae in osteoporosis, the proliferation of trabeculae in osteoarthritis, and the reparative changes in ischemic necrosis often allows accurate assessment of the severity of involvement and can give valuable information to aid treatment planning. PMID- 3556016 TI - Hepatic encephalopathy: experimental approaches to human metabolic encephalopathy. AB - Derangements in systemic metabolism are probably the most frequent cause of coma of unknown etiology. Within this group, coma due to liver failure is common. Systematic research into the mechanisms that underlie the development of hepatic coma is a topic that has interested investigators of as many backgrounds as there are theories that seek to explain the development of the disorder. This review seeks to summarize relevant basic science and clinical literature that focuses on potential etiological mechanisms. In the sections on actions of toxins including ammonia, mercaptans, and fatty acids, and descriptions of altered levels of plasma amino acid levels and abnormalities of neurotransmitter pharmacology, a complex pattern of interrelationships emerges. Discussions of ammonia inevitably require analysis of other seemingly unrelated topics, suggesting strongly that hepatic encephalopathy is indeed the multidimensional problem that might be suspected to follow disorders of this central organ of intermediary metabolism and digestion. The recent development of new technical and statistical methodology has started to make it possible to consider the impact of multiple isolated and seemingly unrelated abnormalities on patterns of functional interaction within the brain. These global aspects of brain function form the essential basis for the understanding of this fascinating disorder. PMID- 3556017 TI - Pancreatitis presenting as pleural effusions: computed tomography demonstration of pleural space extension of pancreatitis exudate. AB - Reported are two cases of acute pancreatitis that presented as large pleural effusions in which the route of communication of the pancreatic fossa with the chest was demonstrated on computed tomography. The bloody effusions were right sided in one case and bilateral in the other. Pleuropulmonary complications of pancreatitis and possible mechanisms for pulmonary involvement are presented. PMID- 3556019 TI - Vaccines against fungal infections. AB - The state-of-the-art reached in developing protective immunity against fungal infections through vaccination makes a survey of methodologies and results timely. This review describes experimental vaccinations against dermatophytes, pathogenic yeasts, and dimorphic fungi with special attention to the anti Coccidioides immitis vaccine, which has reached clinical trials, and to the anti Candida albicans and anti-Histoplasma capsulatum ribosomal vaccines. Also covered are vaccination experiments in compromised hosts aimed at eliciting acquired resistance to opportunistic fungal infections which constitute risk factors for these hosts. Immunization procedures include live, killed, and attenuated organisms, as well as different subcellular fractions such as cytoplasmic extracts, fungal culture filtrates, cell walls, or ribosomal fractions. A variety of experimental animal models and isolated human trials constitute the subjects in these studies. Acquired immunity has been evaluated through assessment of resistance to infection and determination of specific immune responses. It has been demonstrated that fungal vaccines do elicit both humoral and cell-mediated immunity in the immunized host. For some vaccines (e.g., H. capsulatum), a correlation between the induced immunity and protection was observed and the immunity could be adoptively transferred. In view of the potential of vaccines against fungal infections, a perspective on their applicability, significance, and value for human use is discussed. PMID- 3556020 TI - Sulfite hypersensitivity. A critical review. AB - Sulfiting agents (sulfur dioxide and the sodium and potassium salts of bisulfite, sulfite, and metabisulfite) are widely used as preservatives in foods, beverages, and pharmaceuticals. Within the past 5 years, there have been numerous reports of adverse reactions to sulfiting agents. This review presents a comprehensive compilation and discussion of reports describing reactions to ingested, inhaled, and parenterally administered sulfite. Sulfite hypersensitivity is usually, but not exclusively, found within the chronic asthmatic population. Although there is some disagreement on its prevalence, a number of studies have indicated that 5 to 10% of all chronic asthmatics are sulfite hypersensitive. This review also describes respiratory sulfur dioxide sensitivity which essentially all asthmatics experience. Possible mechanisms of sulfite hypersensitivity and sulfur dioxide sensitivity are discussed in detail. Sulfite metabolism and the role of sulfite oxidase in the detoxification of exogenous sulfite are reviewed in relationship to the etiology of sulfite hypersensitivity. PMID- 3556018 TI - Role of encapsulated anaerobic bacteria in synergistic infections. AB - The effect of encapsulation on the virulence, survival, and protection of anaerobic bacteria from phagocytosis is reviewed. Support for the importance of encapsulated Bacteroides sp. and anaerobic and facultative Gram-positive cocci (AFGPC) was provided by their higher recovery rate in oropharyngeal infections, compared to their number in the normal oral flora. Studies of the pathogenicity of anaerobic bacteria of the Bacteroides, Fusobacterium, and Clostridium genera and AFGPC are also presented. The organisms were inoculated into mice and their ability to induce subcutaneous abscesses was determined. Encapsulated Bacteroides, Fusobacteria, and AFGPC generally induced abscesses, whereas unencapsulated organisms did not. However, many of the strains that had only a minimal number of encapsulated organisms (less than 1%) survived in the abscess, and became heavily encapsulated when inoculated with other viable or nonviable encapsulated bacteria. These strains were thereafter able to induce abscesses when injected alone. Encapsulated Bacteroides sp. and anaerobic cocci induced bacteremia and translocation, and increased the mortality of the infected animals more often than did the unencapsulated form of the same strains. The relative importance of encapsulated anaerobes in relation to their aerobic and facultative counterparts in mixed infection was studied, using selective antimicrobial therapy and quantitative cultures of abscesses induced in mice. With few exceptions, possession of a capsule made Bacteroides sp. more important than their aerobic counterparts. Synergistic potentials were seen between encapsulated Bacteroides sp. and all tested aerobic bacteria and most AFGPC, and between most AFGPC and Pseudomonas aeruginosa or Staphylococcus aureus. These studies demonstrated the importance of encapsulated anaerobes in mixed infections. PMID- 3556022 TI - Co-culture of rat trigeminal ganglion neurons and corneal epithelium. AB - Corneal epithelium and the trigeminal ganglion neurons which normally innervate the epithelium have been grown in adjacent chambers of a 35 mm tissue culture plate. Dissociated nerve cells from late embryonic rats were plated inside an 8 mm cloning cylinder attached to the center of the culture plate by silicone grease. In 7-10 days neurites extended out of this inner chamber by growing through the grease seal and along parallel scratches in the collagen coating of the tissue culture plate. Once this occurred, pure corneal epithelial explants were isolated from young adult rats and plated in the area surrounding the cloning cylinder, i.e. in the outer chamber. Cultures were monitored regularly with phase microscopy and, at various times, were fixed for ultrastructural examination. Within 24-48 hours of the epithelial plating, there were both individual neurites and bundles of neurites in contact with the epithelium. This interaction increased substantially over the next few days. Growth cones of the neurites could be seen to approach the microvilli-covered surface of the epithelium, travel over the surface and penetrate between the epithelial cells. This tissue culture model of the innervated ocular surface may prove valuable in the study of a variety of ocular conditions or diseases, as well as provide a means to study functional relationships and mechanisms of cellular interaction between neurons and their target cells. PMID- 3556023 TI - Ovarian cancer. AB - A comprehensive research effort has been focused on ovarian cancer during the past decade and this research focus has resulted in substantial improvements in accurate staging and effective treatment. On the basis of prospectively performed clinical trials in well-staged early ovarian cancer patients, a subset can be identified in whom no further therapy is necessary. Consequently, these patients can be spared the toxicities associated with long-term use of adjuvant chemotherapy. For patients with advanced disease, cisplatin-based combination chemotherapy regimens have produced higher complete response rates, prolongation of disease-free survival, and, in several large studies, a statistically significant prolongation of overall survival. In addition, recent clinical and laboratory data has confirmed the importance of dose and dose intensity in the optimum management of patients with ovarian cancer, and preliminary results of high-dose regimens are encouraging. Unfortunately, high-dose cisplatin-based chemotherapy regimens are associated with increased toxicity. However, pharmacologic techniques to decrease toxicity have been proven effective in murine models and clinical trials in patients have recently been initiated. Furthermore, the development of new cisplatin analogs may also permit further dose escalations with decreased long-term toxicities. There are also new promising clinical approaches that may be useful in treatment of patients who are left with small volume residual disease. It seems that approximately 30% of these patients can achieve disease-free status with intraperitoneal cisplatin therapy. While these results need to be confirmed in larger prospective trials, they do suggest that some patients with residual disease can be salvaged with intraperitoneal chemotherapy. Our understanding of the biology of ovarian cancer has been greatly facilitated by the development of relevant experimental model systems. These model systems have been used to help unravel the mechanisms associated with broad cross-resistance that currently limits the effectiveness of combination chemotherapy. In addition, pharmacologic techniques have already been shown to be capable of reversing resistance both in vitro and in vivo and these exciting new approaches will be entering clinical trial in the not too distant future. Finally, biological agents have also shown marked efficacy in these model systems of human ovarian cancer.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556021 TI - Use of in vivo/in vitro unscheduled DNA synthesis for identification of organ specific carcinogens. AB - There are still only a few in vivo short-term assay methods for predicting potential organ-specific carcinogens and mutagens in mammals, although such methods are required for evaluating the in vivo effects of in vitro mutagens. In the in vivo/in vitro UDS assay methods described here, chemicals are given to experimental animals and induction of UDS in target organs is determined by in vitro organ culture or primary cell culture in the presence of [3H]dThd. Incorporation of [3H]dThd into DNA is measured with a liquid scintillation counter or by autoradiography. These methods have now been applied to the glandular stomach, forestomach, colon, liver, kidney, pancreas, tracheal epithelium, nasal epithelium, and spermatocytes. With minor modifications, they may also be applied to other organs. The present review shows that induction of UDS in various organs correlated well with the induction of cancer in these organs. The present authors have used the present methods to identify some potential organ-specific mutagens and carcinogens in mammals. The present authors found that three dicarbonyl compounds, glyoxal, methylglyoxal, and diacetyl, induced apparent UDS and TDS in the glandular stomach, and other groups found that 2-NT, MA6BT, and CNEt6BT induced UDS in the liver. These in vivo/in vitro UDS assays are better than in vitro UDS assay for identification of potential organ-specific mutagens and carcinogens in mammals and are especially useful for identifying potential mutagens and carcinogens that are specific for certain organs, such as the stomach, liver, and kidney. They are also useful for examining the potential mutagenicities and carcinogenicities of carcinogen analogs. However, these methods are not suitable for general in vivo screening because they are not yet available for all organs. A further advantage of the methods is that they can be used to examine larger numbers of animals at one time than other methods for detecting DNA damage, such as alkaline elution or alkaline sucrose density gradient centrifugation. Glyoxal enhanced cancer induction in the glandular stomach by the administration of a limited amount of MNNG and then glyoxal afterward in the two-stage stomach carcinogenesis. PMID- 3556024 TI - Use of fetoscopy for the prenatal diagnosis of hereditary skin disorders. PMID- 3556025 TI - Use of morphological markers in carriers as an aid in genetic counselling and prenatal diagnosis. PMID- 3556026 TI - Prenatal diagnosis of epidermal disorders. PMID- 3556027 TI - Early prenatal diagnosis by chorionic villi sampling. PMID- 3556028 TI - Prenatal diagnosis of inherited epidermolyses. PMID- 3556029 TI - Molecular basis of inherited disorders of collagen biosynthesis: implications for prenatal diagnosis. PMID- 3556030 TI - Prenatal diagnosis of immunodeficiency diseases. PMID- 3556031 TI - Prenatal diagnosis of mutagen-hypersensitivity syndromes. PMID- 3556032 TI - Chorionic villus sampling in first trimester and fetoscopy in second trimester. PMID- 3556033 TI - Recombinant DNA, chromosomes and prenatal diagnosis. PMID- 3556034 TI - The human gene map and genes expressed in the skin. PMID- 3556035 TI - Prenatal diagnosis of genodermatoses using amniotic fluid cells and DNA analysis. PMID- 3556036 TI - Human periderm: a monoclonal antibody marker. PMID- 3556037 TI - Markers of adult skin expressed in the skin of the first trimester fetus. PMID- 3556038 TI - Neonatal necrotizing enterocolitis: pathogenesis, classification, and spectrum of illness. PMID- 3556039 TI - The syndromes of intestinal polyposis. PMID- 3556041 TI - A century of dermatology: the Department of Dermatology at Northwestern University Medical School. PMID- 3556040 TI - Stromal cell and factor-dependent B lymphopoiesis in culture. PMID- 3556042 TI - Topical minoxidil therapy for hereditary male pattern alopecia. AB - Minoxidil solution 2.8 percent applied topically produced new hair growth in patients with male pattern alopecia. An open trial involving 777 male patients was conducted over thirty-two months. Of these patients, 133 were followed for six months or longer. Forty-five percent noted growth that varied from a few vellus hairs to terminal hair. Better response was seen in patients who underwent longer treatment and who had type I or type II alopecia. Subjective evaluations by the patients were better than objective evaluations. No serious systemic effects of minoxidil were encountered; however, in one patient allergic contact dermatitis occurred. The mechanism of this growth is presently unknown but may be related to a vasodilatory effect or direct cell stimulation. PMID- 3556043 TI - Triatoma: the "kissing bug". PMID- 3556044 TI - Local necrosis and interstitial nephritis due to topical methyl salicylate and menthol. AB - Excessive percutaneous absorption of potentially toxic substances such as menthol and methyl salicylate may occur through local application of heat, such as the use of a heating pad. Menthol and methyl salicylate are found in nonprescription items and used for muscular and arthritic pains. This patient experienced full thickness skin and muscle necrosis as well as persistent interstitial nephritis as a result of topical application of methyl salicylate and menthol followed by use of a heating pad, despite the manufacturer's warning against the use of heating pads. PMID- 3556045 TI - Thyroid size and goitre frequency in hyperthyroidism. AB - Thyroid function, the clinical occurrence of goitre and thyroid gland volume, ultrasonically determined, were investigated in 310 consecutive untreated patients with hyperthyroidism. Of 173 patients with Graves' disease (39%), 67 had no goitre, while 53 patients (31%) had a normal thyroid volume. Twenty-three of 91 patients with multinodular glands (25%) had no goitre and ten patients (11%) had a normal thyroid volume. Of 46 patients with solitary autonomous nodules (7%), three had no goitre while six (13%) had a normal thyroid volume. Out of all the hyperthyroid patients (30%), 93 had no clinically detectable goitre, and 69 (22%) had a normal thyroid volume. The lack of a goitre in a large portion of patients with hyperthyroidism could be responsible for delayed diagnosis and subsequent treatment of these patients. PMID- 3556046 TI - Interactions between human plasma proteins and cell wall components of Staphylococcus aureus. AB - Staphylococcus aureus has surface structures with affinity to human IgG, fibrinogen, and fibronectin. Besides the binding of the Fc-terminal part of IgG from a range of mammalian species, S. aureus protein A binds some IgM, IgA, and IgE molecules. Furthermore, it seems also able to bind immunoglobulins via their Fab-terminal parts. Protein A (Mr 42,000) is the only well-characterized S. aureus cell wall protein, and its structure is known in detail. A considerable number of biological properties of protein A has been demonstrated. Most of these properties seem to be a consequence of the complement activation induced by protein A-IgG complexes. The role of protein A in the phagocytosis of S. aureus is complex. By complement consumption protein A has been found to inhibit the phagocytosis of staphylococci by polymorphonuclear leucocytes. However, it has been demonstrated that protein A-containing staphylococci bind to surface IgG on human alveolar and peritoneal macrophages and thereby promote phagocytosis by these cells. This phenomenon might explain the increased virulence of S. aureus in the presence of human IgG in experimental peritonitis in mice. Fibrinogen binds to a surface structure on S. aureus, designated clumping factor as the binding results in clumping of whole bacteria. Recently, a glycoprotein (Mr of about 400,000) has been isolated from S. aureus. This glycoprotein seems to be the clumping factor. It binds to fibrinogen, inhibits the fibrinogen induced clumping, and seems to be a S. aureus specific, surface component. The isolated component activates human complement in vitro. Also, it induces protection against S. aureus peritonitis in immunized mice. The presence of fibrinogen and an unknown human plasma component increases the virulence of S. aureus in experimental peritonitis in mice, but the role of fibrinogen in human S. aureus infection is unknown. Fibronectin binds to a surface protein on S. aureus, and this binding also results in the clumping of the bacteria. The binding site(s) for fibronectin is different from the binding sites for fibrinogen and IgG. A fibronectin-binding protein (Mr 197,000) has been isolated from S. aureus by affinity chromatography. This protein binds fibronectin and inhibits the fibronectin induced S. aureus clumping. No other biological properties of this protein have yet been demonstrated. The binding of fibronectin to S. aureus opsonize the bacteria for polymorphonuclear leucocytes. The opsonic capacity is, however, low compared to other serum opsonins. It has been suggested that fibronectin plays a role in the attachment of S. aureus, but further studies are needed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556047 TI - Human steroid sulphatase deficiency. PMID- 3556048 TI - Coagulase-negative staphylococci and micrococci in clinical microbiology. PMID- 3556049 TI - [The problems of limits of education and availability of dental health services in the former province of Galicja (1772-1918)]. PMID- 3556050 TI - [The use of methods of relaxation psychotherapy during treatment of deep carious defects]. PMID- 3556051 TI - Comparison of domiciliary nebulized salbutamol and salbutamol from a metered-dose inhaler in stable chronic airflow limitation. AB - Nineteen patients (12 men) mean age, 63.4 years (range, 32 to 78), with stable chronic airflow limitation, mean FEV, 0.55 L (range, 0.3 to 1.05 L), completed an eight-week, double-blind, double cross-over study comparing nebulized salbutamol and salbutamol from a metered-dose inhaler (MDI). Salbutamol from both delivery systems produced bronchodilation. The doses of salbutamol inhaled via the nebulizer and MDI producing maximal bronchodilation were established by cumulative dose-response curves. The contents of the nebulizer and MDI were inhaled four times a day, one system containing salbutamol and the other a placebo. Cross-over of salbutamol from one system to the other occurred every two weeks. There was no significant difference between the two delivery methods in daily peak expiratory flow rate (PEFR), severity of symptoms, or extra bronchodilator usage. Two weekly laboratory assessments of spirometry, PEFR, and exercise tolerance also showed no significant differences. Careful assessment is recommended before the provision of domiciliary nebulizers. PMID- 3556052 TI - Ultrasound-guided tissue-core biopsy of thoracic lesions with Trucut and Surecut needles. AB - The value of ultrasound-guided tissue-core needle biopsy was assessed in 54 patients with thoracic lesions adjacent to the chest wall. Of these, six were apical and two mediastinal. Biopsy was performed with Trucut or Surecut (modified Menghini) needles in 22 patients, and with both in 32 patients in order to compare the two types of needle. Definitive diagnosis was made in 46 patients (85 percent), of whom 41 had malignancy of various cell types, and five had benign lesions. Of the remaining eight, three had apical lesions, and two had consolidation distal to a proximal tumor. There was complete histologic agreement in 25 of 32 patients where biopsy was performed with both needles. Roentgenographic size of the lesion had relatively little influence on the diagnostic yield. Complications comprise moderate hemoptysis in one patient (2 percent), trivial hemoptysis or hemothorax in three, and symptomless pneumothorax in two which resolved spontaneously. We conclude that tissue core needle biopsy of thoracic lesions under ultrasound guidance is an accurate and safe technique which provides specimens adequate for routine histologic examination. The diagnostic yield from Trucut and Surecut biopsies is comparable. PMID- 3556053 TI - A comparative study of intravenous digital subtraction angiography and ventilation-perfusion scans in suspected pulmonary embolism. AB - We observed 102 patients suspected of having pulmonary emboli (PE) who underwent ventilation-perfusion (V/Q) lung scintigraphy and IV digital subtraction angiography (DSA). Only five DSA studies were inadequate for interpretation. In 81 of the remaining 97 patients (83.5 percent) the results of both studies correlated regarding the probability of PE. In 50 patients the results of both studies were highly suggestive of PE; in 31 patients DSA and V/Q were normal or classified as low probability of PE. There was disagreement in 3/97; in 13/97 one or both studies were nondiagnostic. The clinical data of these 16 patients are given. Conventional catheter pulmonary angiography was indicated in 11/102 patients to establish a firm diagnosis of PE. The results of V/Q and DSA correlated in 83 percent (49/59) of patients without chronic obstructive pulmonary disease (COPD) and in 84 percent (32/38) of the patients with COPD. PMID- 3556054 TI - Complement activation and corticosteroid therapy in the development of the adult respiratory distress syndrome. AB - Fifty-nine patients in septic shock were observed for the development of the adult respiratory distress syndrome (ARDS) prior to and after receiving either 30 mg/kg methylprednisolone sodium succinate, 6 mg/kg dexamethasone sodium phosphate or no steroid. Serum levels of C3, C4 and Factor B allowed classification of 42 patients by activation of complement pathways. Despite a trend toward patients with severe septic shock who activate the alternative pathway being protected from the development of ARDS, complement pathway determination did not allow prediction of the development of ARDS and steroid pretreatment did not influence complement levels or prevent ARDS. PMID- 3556055 TI - Mouth intermittent positive pressure ventilation in the management of postpolio respiratory insufficiency. AB - The use of mouth intermittent positive pressure ventilation alone or in combination with other noninvasive respiratory techniques as an alternative to tracheostomy in the home management of respirator-dependent postpolio persons was studied in 75 patients. The onset of polio was at an average age of 15 years. At that time, all were dependent on some form of respiratory assistance, most frequently, the iron lung. Fifty-nine percent of them remained respirator dependent from the onset. Forty-one percent became respirator-dependent at an average of 18 years after onset of polio. Overall, they lost an average of 1.9 percent of vital capacity per year. All used mouth intermittent positive pressure ventilation as their predominant mode of respiratory assistance for an average of 14.5 years. Four of them who had no measurable vital capacity used only mouth intermittent positive pressure ventilation 24 hours per day. Of the 66 who had no significant tolerance off 24 hours per day respiratory assistance, only six had tracheostomies. Despite severe physical disability and dependence on artificial ventilation, the majority of these persons have married, have been gainfully employed, and lead useful lives in society. PMID- 3556056 TI - Pathogenesis and management of septic shock. PMID- 3556057 TI - Immune alveolar hemorrhage. PMID- 3556058 TI - Anaerobic bacterial infections of the lung. PMID- 3556059 TI - Percutaneous drainage of an infected lung bulla in a patient receiving positive pressure ventilation. AB - Percutaneous drainage of an infected bulla was performed under fluoroscopy in a patient who was receiving positive pressure ventilation. The procedure was without complications, and the patient was later weaned from mechanical ventilation. PMID- 3556060 TI - Occurrence of asthma, nonspecific bronchial hyperresponsiveness and atopy. Insights from cross-sectional epidemiologic studies. AB - Data from various different types of cross-sectional studies are reviewed in order to examine hypotheses about the etiology of asthma and to more precisely define its relationship with nonspecific bronchial hyperreactivity (NSBH). Although cross-sectional studies have not clarified the precise etiologic links, they have established that NSBH and atopy are linked to the occurrence of asthma and to each other. In children, evidence supports the hypothesis both that atopy is a cause of asthma and that atopic diathesis is the most frequent trigger for NSHB. In adults, the associations are more complex, although in a small subset findings are similar to those in children. It is concluded that further general population-based or clinical epidemiologic cross-sectional studies based on questionnaires will contribute little more to explaining these associations. Criteria are presented for the further application of case-control studies to maximize their use in examining hypotheses of asthma etiology. PMID- 3556061 TI - Prospective investigations in asthma. What have we learned from longitudinal studies about lung growth and senescence in asthma? AB - The natural history of lung growth and senescence in individuals with variable air flow obstruction or clinical asthma has been given less attention than the natural history of chronic airflow obstruction. This article reviews the information available on lung growth during childhood in persons with asthma and on the rate of decline of lung function during adult life in individuals with asthma or bronchial hyperresponsiveness. Lung growth appears to be relatively normal in most children with asthma but is reduced throughout childhood and adolescence in those with severe and persistent symptoms. It is not known if this reflects a failure to reach full growth or reversible bronchoconstriction. During adult life, clinical asthma is associated with a slight increase in the rate of decline in FEV1. In the middle-aged and elderly smoker it is virtually impossible to separate chronic bronchitis and asthma. Bronchial hyperresponsiveness appears to be associated with an increase in the rate of decline of lung function but it is not clear if this is a result of airway disease due to smoking or a true risk factor. Further research needs are identified. PMID- 3556062 TI - Occupational asthma. AB - This article review recent developments in the study of occupational asthma and implications for the overall understanding of asthma. Occupational asthma is a clinical syndrome caused by many different agents. Contribution of studies of experimental inhalation challenge using occupational agents to the knowledge of asthmatic reactions and their mechanisms is discussed. Investigations in the occupational environment into predisposing factors and persistence or recovery after exposure to an allergic agent or nonspecific irritant are reviewed. Approaches to diagnosing asthma in the occupational environment and to assessing functional impairment and disability are outlined. Directions for future research are identified. PMID- 3556063 TI - Metabolic basis of asthma. A united hypothesis. AB - Asthma is a heterogenous disease triggered by a large number of different stimuli. This article presents a theory of the metabolic mechanisms of asthma. The theory is based on the growing understanding of the activity of lysophosphatidylcholine (LPC). Since the effect of LPC on cell membranes, membrane bound enzymes and the various types of cells involved in the pathogenesis of asthma, this may represent a unifying link between the various types of asthma. PMID- 3556064 TI - Exercise-induced asthma. Assessment of current etiologic concepts. AB - Airflow limitation in exercise-induced asthma is related to the thermal events in the intrathoracic airways. This article reviews the present knowledge about the exchange of respiratory heat and water. The evidence for the various theories proposed for the basic mechanisms involved in exercise-induced asthma are discussed. The evidence suggests that exercise-induced airways obstruction may be a vascular phenomenon dependent on the rapidity and magnitude of airway rewarming. Obstruction is induced if a thermal gradient exists at the end of exercise and the greater the gradient the greater the resultant hyperemia and edema. The basic mechanism of control of reactivity is still not known and directions for future research are outlined. PMID- 3556065 TI - The role of infection in asthma. AB - The possible role of bacterial, viral and fungal infections in the development, exacerbation and treatment of asthma are discussed. Although bacterial allergy has in the past been advocated as an important etiologic factor for asthma, the evidence is inconclusive. Hyposensitization with bacterial antigens is no longer an accepted treatment. Bacterial infection of the nasal sinuses and bronchi may exacerbate an asthmatic attack and in some cases patients benefit from antibiotic therapy. However, bacterial infections in asthma and allergic rhinitis do not always require treatment and if treated this is not sufficient alone to reverse symptoms. Opinions vary as to the importance of viral infections. There is evidence that the immunologic consequences of intrabronchial infection with Aspergillus fumigatus may cause exacerbations of asthma. PMID- 3556066 TI - Allergic bronchopulmonary aspergillosis. Model of bronchopulmonary disease with defined serologic, radiologic, pathologic and clinical findings from asthma to fatal destructive lung disease. AB - Allergic bronchopulmonary aspergillosis (ABPA) complicates asthma and results in immunologic lung destruction. Respiratory failure or fatalities from end-stage fibrotic lung disease have occurred in patients in the third and fourth decades of life. Allergic bronchopulmonary aspergillosis may be confirmed in patients with varying severity of asthma from minimal to corticosteroid-dependent and has been reported to occur in approximately 10 percent of patients with cystic fibrosis. It has been documented in infants and children, the geriatric patient with asthma, in the presence of a normal chest roentgenogram, in the corticosteroid-dependent asthmatic patient, and on a familial basis. The pathogenesis of ABPA is unclear, but may be related to the array of immunologic abnormalities including: elevation of total serum IgE, not all of which is directed to Aspergillus fumigatus (Af); elevated serum IgE-Af, IgG-Af and IgA-Af; precipitating antibodies to Af; hyperreactivity of peripheral blood basophils to Af and other molds; and sensitized lymphocytes. Research in ABPA should be multidisciplinary and initially should include investigators in allergy immunology, mycology, pulmonary, and epidemiology. PMID- 3556067 TI - Genetic and immunologic basis of atopic responses. AB - We summarize current understanding of the genetics of human diseases and of the major histocompatibility complex related factors regulating immune responsiveness. Special factors are involved in atopic diseases as a result of the intersection between the immune system, the targets in the tracheobronchial tree and the endocrine, neurologic and genetic mechanisms affecting both the effectors and the targets. The evidence from investigations of human subjects and their families and from laboratory animals for the underlying genetic and immunologic mechanisms of asthma are reviewed. The genetic control of asthma is complex. The evidence suggests a gene or genes associated with and linked to HLA. The disease phenotype may also be regulated by genetically determined levels of IgE and the outcome of the balance between immune response and immunosuppression. PMID- 3556069 TI - Reproducibility of challenge tests at different times. AB - Bronchial challenge for determination of bronchial reactivity is widely used in the diagnosis of asthma, the grading of severity, and evaluation of effect of treatment with new antiasthmatic drugs. Allergen challenge is also used for diagnosis of specific IgE-mediated asthma and evaluation of the effect of immunotherapy. A number of factors influence the result of the challenge test including the selection of patients, criteria for carrying out the challenge test, a number of technical factors concerning the challenge, the dosing schedule, pulmonary function tests carried out and analysis of the data. All these factors have to be taken into consideration before reproducible challenge tests can be performed. Detailed description of the equipment and procedures used and inclusion criteria for the patients should be included in all publications concerning challenge tests in order to be able to compare results from different laboratories. Each clinic or laboratory needs to perform reproducibility studies on bronchial challenge testing procedures and equipment used in their clinic. PMID- 3556068 TI - Epidemiologic approaches for the identification of asthma. AB - Clinical, physiologic, and questionnaire approaches can be used to identify subjects with asthma in an epidemiologic investigation. Each method, however, may select differing subsets of the population. At present, a comprehensive asthma questionnaire is unavailable; the difficulty of defining asthma in operational terms has been a major obstacle in the development of such a questionnaire. This review describes the questionnaires prepared by the British Medical Research Council and the American Thoracic Society and suggests modifications. PMID- 3556070 TI - A biobehavioral approach to managing childhood asthma. PMID- 3556071 TI - Studies on resistance to breathing. AB - Some aspects of resistance to breathing are reviewed in this article. The importance in medicine of the determination of resistance to breathing is emphasized. Estimation of respiratory resistance in clinical practice by spirometry is mentioned. Clinically useful methods for determination of resistance to breathing reported in the literature are reviewed. The body plethysmograph, an instrument specially designed to measure airway resistance and currently used in clinical medicine, is complicated and expensive. A newly designed instrument for measuring total respiratory resistance by partial airway occlusion is strongly recommended. A comparison of the two methods, body plethysmography and partial airway occlusion, has been made. The theory of the partial airway occlusion method is also briefly described. Factors affecting respiratory resistance are analyzed. The relationship between the size of dead space and the magnitude of respiratory resistance is also discussed. PMID- 3556073 TI - Several implant systems enhance overall success rate. Manufacturers note 'distinctive' qualities of their systems. PMID- 3556072 TI - [Reconstruction of noncircumferential bile duct defects by omentumplasty and temporary stenting]. AB - In a case of bile duct stricture associated with biliary peritonitis, longitudinal incision and duct repair using omental patch and T-tube stenting was performed. Functional and anatomic success was proven at 4-years follow-up. The simple procedure offers an option worthy of consideration even in adverse conditions. PMID- 3556074 TI - Bur design evolves to match technology. Increased handpiece speeds shape growth of bur market. PMID- 3556075 TI - [Role of the temporary exclusion of the pylorus in the treatment of injuries of the duodenum]. PMID- 3556077 TI - [Preliminary clinical uses of removable partial dentures with rotational path of insertion]. PMID- 3556078 TI - [Strengthening the removable partial denture in a reduced vertical space by casting metal net]. PMID- 3556076 TI - Chromosome organisation in polyploid mouse trophoblast nuclei. AB - At least one-third of mouse trophoblast cells undergo endoreduplication during the first half of gestation. It has been suggested that the endoreduplicated chromosomes may be polytenised. Here it is shown, using in situ hybridisation to the alpha-1 antitrypsin genes, which map at a unique site, that while there is a tendency for duplicated chromosomes to cluster, this does not involve the complete fusion of replicated chromatids found in fully polytene chromosomes, and in a substantial proportion of homologues the sites on the chromosome arms corresponding to these genes are widely separated. The centromeres do not fuse into a single chromocentre but the possibility is not ruled out that individual chromosomes may be polytenised in the centromeric region. Evidence is also presented showing that endoreduplication in trophoblast nuclei is not accompanied by the formation of new prekinetochore structures, in contrast to the situation in polyploid mouse liver and C127 cells. PMID- 3556079 TI - [Prosthetic designs for reduced vertical space in posterior teeth with deep overbite in anterior teeth]. PMID- 3556080 TI - [Restoration of partial maxillary defect with removable partial denture]. PMID- 3556081 TI - [Properties of the coupling agent NBGGMA for dental adhesion and its use in clinical practice]. PMID- 3556082 TI - [Determination of autoantibody in patients with recurrent aphthae ulcer]. PMID- 3556083 TI - Trophic and growth-regulating mechanisms in the central nervous system monitored by intracerebral neural transplants. AB - In vitro studies have demonstrated the presence of nerve growth factor (NGF) and other neurotrophic factors in the mammalian central nervous system (CNS). This paper reviews a series of experiments in which the intracerebral neural grafting technique was used to monitor the in vivo expression of such neurotrophic factors and the changes induced by denervating lesions, with the hippocampal formation as a model. Neonatal or adult sympathetic ganglionic neurons, and fetal septal cholinergic neurons, were grafted into or adjacent to the hippocampal formation in adult rats, and the effect of removal of the major afferent inputs (i.e. the septal, commissural or entorhinal inputs) on neuronal survival and fibre outgrowth was assessed histochemically or biochemically. Damage to the septohippocampal (partly cholinergic) pathway had a dramatic effect on survival and fibre outgrowth from neonatal and adult sympathetic ganglionic neurons, and increased the survival of both cholinergic and noncholinergic neurons in the fetal septal grafts. These effects were specific for lesions of the septohippocampal system (fimbria-fornix transection or medial septal lesions), and were not seen after transection of the entorhinal perforant path or the commissural system. It is proposed that neurotrophic factors in the hippocampal formation are under some type of regulation from the afferent inputs, and that removal of the septal afferents, in particular, will increase the availability of NGF or an NGF-like factor from the denervated target. This mechanism may play a normal role in the induction and regulation or regeneration and compensatory collateral sprouting from the remaining afferents in partially denervated brain regions. PMID- 3556084 TI - Cytoskeletal abnormalities in long-term embryonic CNS transplants isolated within peripheral nerve. AB - Cells from the fetal central nervous system (CNS) of rat embryos survive and differentiate when transplanted into the peripheral nervous system (PNS) of adult rats. The experiments described here were aimed at investigating selected molecular and ultrastructural features of dissociated CNS cells from the telencephalon of 12-day-old embryos isolated for long periods of time within PNS segments. Neurons and glia of grafts examined 6-12 months after transplantation into the PNS developed several cytoskeletal abnormalities. In neurons, these changes included Hirano bodies within dendrites and a marked perikaryal immunoreactivity to RT97, a monoclonal antibody that normally recognizes in neuronal processes the phosphorylated 200 kDa protein subunit of neurofilaments. Rosenthal fibres were seen within the glial cells. Similar-looking abnormalities have been described in certain human and animal neurodegenerative diseases and in ageing. Although a relationship between the changes in these long-term neural transplants and such diseases is unknown, these observations provide an opportunity for studying their pathogenesis within laboratory conditions. PMID- 3556085 TI - Hormonal control of cell death in a sexually dimorphic song nucleus in the zebra finch. AB - The song control nuclei of the brain of the male zebra finch (Poephila guttata) contain more neurons of larger cross-sectional area and more extensive innervation than those in the female. The sexual dimorphism of nucleus robustus archistriatalis (RA), one of the song nuclei, arises from neuronal atrophy and death in the female brain as well as from an increase in cell-body size and afferent terminals from other forebrain nuclei in the male. Subcutaneous implantation of a slow-release pellet of oestrogen in a female chick not only prevents her RA neurons from dying but also promotes their growth and innervation. The masculinizing effects of oestrogen on RA appear to be limited to a period of 35-40 days after hatching. Oestrogen may act on RA neurons indirectly by promoting their innervation from other forebrain song nuclei. PMID- 3556086 TI - The significance of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. AB - The chance occurrence of an outbreak of persistent parkinsonism amongst young drug addicts abusing a synthetic pethidine derivative has aroused considerable interest. The offending agent, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), has to be converted by monoamine oxidase B perhaps in glia, into the neurotoxin, 1-methyl-4-phenylpyridinium (MPP+). MPP+ is then taken up into dopaminergic neurons by the normal dopamine re-uptake system. Once within dopaminergic neurons it binds to neuromelanin, so is retained to kill nerve cells, perhaps by generation of free radicals and other toxic species. MPTP produces parkinsonism in primates (but not in many lower species, probably because they possess little or no neuromelanin). MPTP toxicity in primates can be prevented by treatment with monoamine oxidase inhibitors, or by inhibitors of dopamine re-uptake, and to some extent by antioxidants. Toxicity of MPTP is remarkably selective. It preferentially destroys the substantia nigra pars compacta, but may spare the adjacent pigmented ventral tegmental areas, as well as other neuronal systems. However, selectivity decreases with age: MPTP causes more widespread damage in older animals. Affected individuals exhibit all symptoms and signs of Parkinson's disease. As well as providing an accurate animal model of the illness, MPTP is one of the first environmental neurotoxins known to cause parkinsonism in humans. This observation has led to reappraisal of the epidemiology of the illness and a search for similar environmental agents. Understanding the mechanism of MPTP toxicity has also provided suggestions on how to treat the cause of Parkinson's disease. PMID- 3556087 TI - Nerve cell death in degenerative diseases of the central nervous system: clinical aspects. AB - The origin of degenerative diseases of the central nervous system lies in genetic and acquired disorders. Analysis of the clinical characteristics of diseases affecting specific neuronal systems may help us to understand their pathogenesis. The stereotyped symptomatology characteristic of most degenerative diseases results from neuronal death in specific pathways: pyramidal tract and motor neurons in amyotrophic lateral sclerosis, nigrostriatal dopamine system in Parkinson's disease, posterior and lateral columns of the spinal cord in Friedreich's ataxia, etc. This suggests that these neurons are sensitive to pathological processes that are still unknown. Progression of the disease, whether linear or not, is slow, but it is more rapid than similar effects due to ageing. This indicates either that the environmental cause of degeneration (if it exists) is continuously present or that a vital process has been once and for all disrupted, perhaps at the level of the genome, causing insufficient production of essential proteins, or accumulation of eventually toxic metabolites. Symptoms generally appear during adulthood, i.e. after normal differentiation has taken place, and after a considerable number of neurons have already been damaged. The initiation of neuronal death precedes the appearance of the first symptoms. PMID- 3556088 TI - Dysfunction and death of neurons in human degenerative neurological diseases and in animal models. AB - The human neurological disorders--amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), and Alzheimer's disease (AD)--share certain features: they occur in later stages of adult life; are slowly progressive; and involve specific groups of nerve cells. Different clinical syndromes result from dysfunction and death of these specific groups of neurons. In ALS, patients are weak due to disease of motor neurons in the spinal cord. The clinical features of PD, e.g. slow movements, tremor and rigidity, are attributed, in part, to degeneration of dopaminergic neurons of the substantia nigra. Impairments of cognition and memory in AD result from disease of neurons in a number of regions, including brainstem, basal forebrain, amygdala, hippocampus, and neocortex. In each of these diseases, affected neurons exhibit abnormalities of the neuronal cytoskeleton: in ALS, neurofilaments accumulate and distend proximal motor axons; in PD, nigral perikarya show Lewy bodies-intracytoplasmic inclusions containing neurofilament antigens; in AD, neurons develop neurofibrillary tangles, Hirano bodies, granulovacuolar degeneration and filament-filled neurites in plaques. Certain features of ALS, PD and AD are recapitulated in animal models, three of which are described in this review. Hereditary canine spinal muscular atrophy (HCSMA), a dominantly inherited motor neuron disease, shows many clinical and pathological features in common with ALS, including weakness, muscle atrophy, neurofilamentous swellings of proximal axons, impaired transport of neurofilament proteins, and degeneration of motor neurons. In primates, intoxication with 1 methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) produces a parkinsonian syndrome due to injury of nigral dopaminergic neurons and associated denervation of the striatum. Finally, aged macaques exhibit memory deficits, and their cerebral cortices show senile plaques and filament-filled neurites derived from a variety of transmitter-specific populations of nerve cells. In human diseases, the causes and mechanisms leading to dysfunction and death of nerve cells are unknown. Investigators have begun using a variety of techniques derived from neurobiology to study animal models in an effort to clarify the mechanisms, evolutions, and consequences of structural-chemical abnormalities occurring in different neuronal systems implicated in human disease. Understanding such processes in these models should provide important new insights into the pathogeneses of similar processes occurring in ALS, PD and AD. PMID- 3556089 TI - Neuronal origin of cerebral amyloidogenic proteins: their role in Alzheimer's disease and unconventional virus diseases of the nervous system. AB - The protein component of Alzheimer's disease amyloid (neurofibrillary tangles, amyloid plaque cores and congophilic angiopathy) is an aggregated polypeptide with a subunit mass of approximately 4 kDa (the A4 monomer). The aggregational properties of this monomer may explain the amyloidogenic nature of the protein: the native monomer forms dimers, tetramers and higher oligomeric species which are dependent on pH, ionic strength and concentration; the synthetic peptide corresponding to residues 1-28 spontaneously forms fibrils in vitro. Based on the degree of N-terminal heterogeneity, the A4 monomer aggregates first in neurons and later in the extracellular space. Using antisera raised against synthetic peptides, we can demonstrate that the N-terminus contains an epitope for neurofibrillary tangles, and the inner region of the molecule contains an epitope for the extracellular amyloid fibrils. There is a non-protein component of the amyloid (inorganic residues of aluminium silicate) which may be important in the deposition of the amyloid fibrils. There are several intriguing similarities between the amyloid fibrils and proteins of Alzheimer's disease when compared to the scrapie-associated filaments and proteins of the unconventional virus diseases (scrapie, kuru, Creutzfeldt-Jakob disease). Although there is no sequence homology between the proteins, we suspect they are formed as a result of similar biochemical processes. If the scrapie proteins and filaments are an integral part of the infectious agent, it follows that Alzheimer's disease is also an infectious process similar to scrapie. As they are host-encoded proteins, it is still feasible that both types are pathological by-products of independent diseases. PMID- 3556090 TI - Mechanisms for programmed cell death in the nervous system of a moth. AB - In the moth Manduca sexta 50% of the abdominal motor neurons and interneurons die during the first days after the adult emerges. Although the dying motor neurons innervate larval muscles that also die at this time, the death of the neurons has been shown to be a direct response to an endocrine signal, the decline in ecdysteroids that occurs at the end of metamorphosis. The response to the withdrawal of the hormone apparently requires new synthesis of RNA and protein, as actinomycin-D and cycloheximide can prevent neuronal death. This selective neuronal death probably results from changes in gene activation. The fixed spatial and temporal pattern of neuronal death, however, suggests that trophic interactions among neurons may also be involved. Current work is focused on the fate of a pair of motor neurons, the MN-12 cells, in the third abdominal ganglion. Isolation of this ganglion from the thoracic ganglia can prevent the death of these cells at the time when they would normally die in response to removal of ecdysteroids. The factors mediating this effect may act in concert with the ecdysteroid decline to specify the exact time of death for individual neurons. PMID- 3556091 TI - Neurotrophic factors and neuronal death. AB - The well-documented physiological role of nerve growth factor (NGF) in peripheral sympathetic and neural-crest-derived sensory neurons in vivo has its exact counterpart in vitro. This provided the conceptual basis for developing in vitro analytical procedures for the purification of new neurotrophic molecules. The experimental approaches used are discussed in the context of the purification of new neurotrophic factors, brain-derived neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF). The importance of the modulatory role played by extracellular matrix molecules, in particular laminin, on both NGF-mediated and BDNF-mediated survival effects is also delineated. BDNF is a very basic (pI approximately 10) molecule of about 12 kDa, having physico-chemical characteristics close to those of the monomer of NGF. However, the spectrum of its biological actions is distinctly different from that of NGF. In particular, BDNF supports the survival of retinal ganglion cells and placode-derived peripheral sensory neurons which are not supported by NGF. The trophic supply of primary sensory neurons projecting to both the central nervous system and the periphery is discussed. It is hypothesized that sensory neurons receive limited quantities of neurotrophic molecules from both peripheral and central axons, a mechanism ensuring the survival of neurons adequately connected with both peripheral and central targets. PMID- 3556092 TI - Muscle activity and motor neuron death in the spinal cord of the chick embryo. AB - During embryonic development in vertebrates about half the spinal motor neurons degenerate naturally after an initial period of normal differentiation. Motor neuron survival during this period is regulated by influences associated with both afferent and target contacts. Target-associated influences are regulated, at least in part, by activity (i.e. neuromuscular transmission or muscle contraction). Pharmacological blockade of neuromuscular activity reduces or prevents normal cell death whereas induced hyperactivity of targets enhances the death of motor neurons. Information supporting these assertions is reviewed and evidence is presented from studies which attempt to elucidate the major site at which neuromuscular activity affects motor neuron survival and degeneration in the chick embryo. Finally, a model and some supporting evidence are described in which activity is thought to regulate the production or availability of a target derived trophic factor required by motor neurons for their survival during certain critical phases of early development. PMID- 3556093 TI - [A cross-over treatment of obsessive-compulsive neurosis with imipramine and chlorimipramine]. PMID- 3556094 TI - [A double-blind trial of chlorimipramine and doxepin in obsessive-compulsive neurosis]. PMID- 3556095 TI - [Some issues on neurosis]. PMID- 3556096 TI - [CT enhancement in cerebral infarction]. PMID- 3556097 TI - [Use of the laser in cardiovascular diseases]. PMID- 3556098 TI - [Tendon healing and adhesion]. PMID- 3556099 TI - [Current status of treatments of massive hemoptysis]. PMID- 3556100 TI - A single laser method for subtraction of cell autofluorescence in flow cytometry. AB - In flow cytometry cell autofluorescence often interferes with efforts to measure low levels of bound fluorescent antibody. We have developed a way to correct for autofluorescence on a cell-by-cell basis. This results in improved estimates of real staining and better separation of the fluorescence histograms of stained and non-stained cells. Using a single laser, two-color fluorescence measurement system and two-color compensation electronics, autofluorescence and one fluorescent reagent are measured (rather than two fluorescent reagents). With fluorescein-conjugated antibodies the signal in the 515 to 555 nm range (green fluorescence) includes both fluorescein emission and part of the cellular autofluorescence. In the cases we have investigated, autofluorescence collected at wavelengths above 580 nm ("red") is well correlated with the green autofluorescence of the cells. A fraction of this red fluorescence is subtracted from the green fluorescence to produce an adjusted fluorescein output on which unstained cells have zero average signal. Use of this method facilitates the selection of rare cells transfected with surface antigen genes. Culture conditions affect the level of autofluorescence and the balance between red and green autofluorescence. When applied with fluorescein-conjugated reagents, the technique is compatible with the use of propidium iodide for live/dead cell discrimination. PMID- 3556101 TI - Evaluation of contextual analysis for computer classification of cervical smears. AB - A procedure for automated analysis of cervical smears has been implemented in an image cytometry system. Smears are described exclusively in terms of global and contextual information extracted by pattern-recognition algorithms and represented by a vector of proportions of cellular object types. Linear discriminant functions, based on a Fisher criterion, are derived to classify smears with a cross-section of diagnoses into two broad categories, normal and abnormal. Results obtained from 83 smears indicate 78% correct classification. In contrast to most automated systems, good classification results were obtained in normal smears with benign changes caused by inflammation and with postmenopausal atrophia and in abnormals with mild dysplasia. These findings suggest that contextual analysis may be sensitive to subtle changes in cellular morphology and to progressive patterns of dysplasia. When used with standard isolated cell analysis, contextual analysis may provide additional complementary information for automated cervical prescreening. PMID- 3556102 TI - Nocturnal insulin and C-peptide rhythms in normal subjects. AB - Immunoreactive insulin and C-peptide reactive plasma levels in venous blood were studied between 0100 and 0820 h in 10 healthy volunteers to assess nocturnal endogenous insulin secretion and its peripheral extraction. Insulin secretion appeared significantly reduced after 0600 h. No correlations were observed between counterregulatory hormones and insulin secretion during this period. Plasma glucose remained stable throughout the study. An increased peripheral sensitivity to insulin after 0600 h is suggested to explain reduced secretion of insulin. PMID- 3556103 TI - Spontaneous hypoglycemia associated with autoimmunity specific to human insulin. AB - A 55-yr-old woman with a history of Graves' disease experienced attacks of postprandial hypoglycemia for 6 yr. An insulinoma could not be confirmed by repeated fasting tests and by surgical pancreas revision. Extracted pancreatic insulin was chemically normal. Fasting plasma total insulin (1.22 nM = 183 microU/ml) and proinsulin (0.48 nM) were elevated and greatly increased after oral glucose. Glucose-clamp studies revealed delayed insulin clearance. Plasma free-insulin levels were normal. Insulin-binding antibodies were detected by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay with human insulin as ligand but not with pork or beef insulins. Analysis with a modified ELISA suggested a monotypic and monoclonal human insulin autoantibody, which showed a restriction to the lambda-light chain. T-lymphocytes (predominantly helper) demonstrated increased responsiveness to beef, pork, and human insulins by proliferation assay. A T-lymphocyte line showed exclusively human insulin specificity. All this indicated cellular and humoral anti-human insulin autoimmunities. Clinically, the cause of hypoglycemia associated with elevated total insulin and proinsulin was misdiagnosed as atypical insulinoma. The study of total and free plasma insulin levels and sensitive antibody assays specific to human insulin were necessary to correctly diagnose autoimmune hypoglycemia. PMID- 3556104 TI - Remission in IDDM: prospective study of basal C-peptide and insulin dose in 268 consecutive patients. AB - To elucidate beta-cell function, insulin requirement, and remission period in insulin-dependent diabetes mellitus (IDDM), a study was undertaken comprising 268 patients consecutively admitted to Steno Memorial Hospital with newly diagnosed IDDM. The patients were characterized by sex, age, and seasonal variation at onset of diabetes mellitus. During the first 36 mo of the disease, an evaluation was performed for basal C-peptide, HbA1c, and insulin dose per kilogram. Total remission was interpreted as complete discontinuation of insulin therapy for at least 1 wk while still metabolically well controlled, and partial remission was interpreted as an insulin need that was less than or equal to 50% of the insulin dose at discharge from the hospital. During the first 18 mo of the disease, 12.3% of the patients entered total remission (median 6 mo), and 18.3% of the patients entered partial remission (median 6 mo). Patients entering remission had significantly higher basal C-peptide levels than those who did not. Sex, age, and initial HbA1c levels did not influence the frequency of remission. PMID- 3556105 TI - Proteinuria in newly diagnosed type II diabetic patients. AB - Urinary excretion of albumin, IgG, and beta 2-microglobulin was examined in 132 (69 men, 63 women) newly diagnosed, middle-aged type II diabetic patients and in 144 (62 men, 82 women) nondiabetic control subjects. Both male (N = 57) and female (N = 29) diabetic patients with normal urinary sediment showed an increased excretion of albumin compared with the respective nondiabetic subjects, and male diabetic patients also had an increased IgG excretion. No consistent difference was found in urinary beta 2-microglobulin concentration between the diabetic and nondiabetic subjects. In all, 19.5% of the diabetic subjects with normal urinary sediment (12 men, 5 women) showed urinary albumin concentration exceeding the highest value (35 mg/24 h) found in nondiabetic subjects without renal disease. The urinary excretion of albumin in the diabetic subjects was not associated with the presence of hypertension or coronary heart disease or with the fasting blood glucose or serum insulin levels measured at diagnosis of diabetes. In male diabetic subjects with urinary albumin excretion greater than 35 mg/24 h, a reduced creatinine clearance was found, suggesting the presence of structural damage associated with diabetic nephropathy. The early increase of urinary albumin excretion in type II diabetic patients may be mostly functional in nature. However, some patients may have structural renal damage associated with diabetic nephropathy present at diagnosis. PMID- 3556106 TI - Insulin and glucose responses to various starch-containing foods in type II diabetic subjects. AB - The circulating insulin and glucose responses in type II diabetic subjects were determined for 5 h after ingestion of various meals, each containing 50 g carbohydrate. The purpose of the study was to 1) systematically study the insulin response to several different high-starch foods, 2) determine whether this insulin response could be predicted by the glucose response, and 3) determine whether the glucose response could be predicted by the physical structure and digestibility of the ingested carbohydrate. Each subject served as his own control. Carbohydrate was given in the form of potatoes, bread, oatmeal, rice, lentils, kidney beans, cornflakes, high-amylose corn muffins, and low-amylose corn muffins. Bread, oatmeal, rice, lentils, kidney beans, and high-amylose corn muffins resulted in a significantly lower glucose area than 50 g glucose, and the glucose response generally could be predicted by the physical structure and the known digestibility of the ingested carbohydrate. The insulin rise was statistically significantly greater than would be predicted from the glucose response for oatmeal, lentils, kidney beans, and high-amylose corn muffins. Although not statistically significant, the mean was greater than predicted for every other food except potatoes when the insulin response to 50 g glucose was used as a standard. These results indicate that the insulin response cannot be predicted by the glucose response. PMID- 3556107 TI - Primary prevention of diabetes mellitus. AB - Diabetes mellitus is one of the chronic noncommunicable diseases that have increased markedly in this century. The discovery of insulin and other drugs for lowering hyperglycemia have certainly reduced mortality from acute complications of diabetes and improved the quality of life of many diabetic patients. Recent advances in research into the etiology and natural history of diabetes have increased our knowledge about different types of diabetes to such an extent that primary prevention of diabetes mellitus is becoming a reality. Until now, few studies have attempted to test measures for primary prevention of diabetes. Therefore, the data supporting the possibility for primary prevention are largely indirect and need to be tested in preventive trials or in community-based prevention programs. We believe, however, that the time is right to start action in populations in which the prevalence of diabetes is known to have clearly increased recently. We summarize the evidence that can be used as the scientific basis of primary prevention of diabetes mellitus. PMID- 3556108 TI - Pancreatic polypeptide: marker for autonomic neuropathy but not for lean NIDDM. PMID- 3556109 TI - Reduced awareness of hypoglycemia after changing from porcine to human insulin in IDDM. PMID- 3556110 TI - Dermatomyositis. AB - Dermatomyositis and polymyositis are related disorders of unknown cause in which immunologic changes may be important. They sometimes overlap with other collagen vascular diseases, and not infrequently are associated with malignancy. The clinical features of the adult and juvenile forms of the disorder and the visceral manifestations of DM-PM are outlined, along with enzymatic, electromyographic, and histologic aids to diagnosis. While the cutaneous lesions often are resistant to treatment, systemic involvement may respond to corticosteroids or to immunosuppressive drugs. Treatment definitely alters the prognosis in cases not associated with malignancy. PMID- 3556111 TI - Chemical mutagenesis of human interferon-beta: construction, expression in E. coli, and biological activity of sodium bisulfite-induced mutations. AB - A series of modified human interferon-beta (IFN-beta) genes was produced by sodium bisulfite treatment of the IFN-beta gene cloned in M13. A library of mutated sequences was generated from which subgenomic fragments containing one or a small number of coding alterations were isolated and substituted into the IFN beta gene in an E. coli expression vector. A number of modified genes and their expression products were evaluated. In several instances levels of expression and biological activity profiles are altered compared to the parental gene product. A number of key amino acids can be identified, whose substitutions have marked effects on biological activity of IFN-beta. PMID- 3556112 TI - Comparison of the DNA sequences involved in replication and packaging of the filamentous phages IKe and Ff (M13, fd, and f1). AB - The product of gene II of the distantly related, filamentous, single-stranded DNA phages IKe and Ff (M13, fd, and f1) is the only phage-encoded protein that is required for the replication of their double-stranded replicative form DNA. With the aid of recombinant plasmids containing the origins of viral strand replication [(+)-origins] of both IKe and Ff, we demonstrated that initiation but not termination of viral strand replication by gene II protein is restricted to its cognate (+)-origin. If the (+)-origins of IKe and Ff are present in the same orientation, fusion origins are generated upon gene II protein-instructed replication as a result of initiation at one origin and termination at the other. These fusion origins are only functional in the presence of the gene II protein encoded by the phage from which the sequence lying at the 3' side of the gene II protein cleavage site is derived. The nucleotides that determine the specificity of the replication initiation process are located between positions +17 and +49, or +17 and +40, with respect to the gene II protein cleavage site of IKe and Ff, respectively. The DNA sequence that forms the recognition signal for cleavage by gene II protein is probably located within the sequence that starts 3 nucleotides before and terminates 17 nucleotides after the cleavage site. Efficient packaging by phage IKe of plasmid DNA strands that contain the morphogenetic signal of Ff, or vice versa, indicates that, despite their only partial homology, the morphogenetic signals of IKe and Ff are interchangeable. PMID- 3556113 TI - Radial corneal sutures for the correction of myopia: a laboratory experiment. AB - Radial interrupted nylon sutures were placed in the corneas of fourteen human donor eyes, in a laboratory setting, to produce a reversible surgical correction of myopia. Significant corneal flattening was achieved when a small optical zone (4-5 mm) was left free but not with a larger optical zone. It may be possible that radial sutures have a permanent flattening effect when the sutures are left in place and keep their tensile strength. PMID- 3556114 TI - Clinical and experimental studies concerning circulating antibodies to corneal epithelium antigens. AB - Corneal epithelium antibodies were detected in patients with corneal melting disease (55%), uveitis (42%), corneal transplantation (42%) and marginal furrow disease (20%). These antibodies were not found in herpetic keratitis patients. In control groups, consisting of ocular surgery patients (glaucoma, retinal detachment and cataract) and persons without a history of ocular disease, approximately 4% of the subjects had these antibodies. To investigate the possible role of trauma to the cornea as an initiator of corneal epithelium antibodies, these antibodies were determined in rabbits after alkaline burns were made on the cornea. These antibodies were detected one week later and disappeared after six weeks. Serum from three patients with corneal melting disease and corneal transplantation containing a high antibody titre against corneal epithelium were used to isolate corneal epithelium antigens. A 54 kD and a 17 kD corneal epithelium antigen were isolated. The incidence of autoantibodies directed against these antigens was investigated in patients with corneal melting disease, uveitis and corneal transplantation using an ELISA. 50% of the sera positive in the immunofluorescence test were positive in the ELISA. PMID- 3556115 TI - Expression of HLA antigens in paraffin sections of uveal melanomas. AB - Expression of histocompatibility (HLA) antigens on tumor cells may influence the recognition of these tumor cells by the immune system. Immunological recognition may influence tumor growth and patient survival. Although HLA class I and II antigens are known to be present on several tissues in the eye, their presence on ocular tumors had not yet been demonstrated. We studied the expression of these antigens on paraffin preparations of uveal melanomas. Most tumors carried class I and beta 2m antigens on most of their cells while class II antigens were less often expressed. No association with tumor cell type or tumor size was observed. Further studies will be necessary to determine the relevance of different levels of antigen expression with regard to patient survival. PMID- 3556116 TI - Xeroderma pigmentosum and keratoconus. AB - Two XP patients are presented. A corneal perforation in the left eye of the first patient necessitated an at-random transplantation a chaud. The graft was remarkably well tolerated, which is possibly explained by UV-light-induced suppression of the cellular immune response in the patient. The right eye of this patient and both eyes of the second patient had a keratoconus. Keratoconus in XP may be the result of disturbances in the cell differentiation and the function of epithelial cells and keratocytes, due to UV-light-induced deficient DNA repair synthesis. PMID- 3556117 TI - Evaluating computer nutrition education software for clients. PMID- 3556118 TI - Energy metabolism in diabetes: computer-assisted instruction for persons with diabetes. PMID- 3556119 TI - Computers in diabetes nutrition education: a perspective. PMID- 3556120 TI - [Fluorimetric study of immobilized yeast D-glyceraldehyde-3-phosphatase and its subunits. Binding of NAD+]. PMID- 3556121 TI - Ceftazidime: experimental and clinical evaluation of biliary elimination. AB - During a 3-h perfusion of five isolated rabbit liver preparations, 1.4% of 10 mg of ceftazidime added to the circulating blood was eliminated in the bile and 0.9% was metabolized or inactivated in the liver. Five normal subjects were given 2 g of ceftazidime intravenously; antibiotic concentration in the aspirated duodenal fluid rose progressively during the 4 h of the investigational period to a maximal mean level of 21.3 +/- s.e.m. 9.2 micrograms/ml and 0.05% of the dose given was recovered during this period. The same dose was given to 12 cholecystectomized patients fitted with a Kehr drain. An average peak value of 36.3 +/- 4.0 micrograms/ml was reached in the collected bile during the second hour after drug administration. The 12-h biliary recovery was 0.21% of the dose given. Ceftazidime concentrations in choledochal and gallbladder bile sampled peroperatively in 10 patients 1 h after intravenous administration of 2 g of ceftazidime were 78.3 +/- 12.0 and 17.9 +/- 7.5 micrograms/ml respectively. These data compare favourably with the results of the authors' studies on the biliary elimination of 15 other beta-lactams and are consistent with a possible beneficial effect of ceftazidime in the treatment of biliary tract infections. PMID- 3556122 TI - Effects of changes in pH, medium and inoculum size on the in vitro activity of different quinolone and fluoroquinolone antibiotics against urinary pathogens. AB - The antibacterial activity of quinolones and fluoroquinolones was evaluated against several strains of enterobacteria growing in Mueller-Hinton broth and in urine at different pH. The data obtained in alkaline urine and in Mueller-Hinton broth indicate that the MIC values of the fluoroquinolones are about 16-32 times inferior to those found in urine at pH 6. On the other hand, the activity of nalidixic acid and more particularly that of cinoxacin in urine appears to be optimum at this lower pH, showing MIC values only 2-4 times higher than those obtained in Mueller-Hinton media. Although the fluoroquinolones appear to have the highest degree of activity, a better MBC/MIC ratio was observed for cinoxacin and for nalidixic and oxolinic acids. PMID- 3556124 TI - [Effects of gamma-oryzanol on experimental coronary atherosclerosis in rats]. PMID- 3556123 TI - Cefuroxime axetil in the treatment of uncomplicated UTI: a comparison with cefaclor and augmentin. AB - Cefuroxime axetil (CAE) is an acetoxyethyl ester prodrug of cefuroxime. The efficacy and safety of cefuroxime axetil was studied in a randomized general practice trial in urological infections where cefuroxime axetil 250 mg b.d. was compared with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. A randomized trial was then performed in hospital outpatients, who received cefuroxime axetil 250 mg b.d. or cefaclor (CCL) 250 mg t.d.s. Of 140 clinically assessable patients, 108 were cured and 28 improved on cefuroxime axetil (97% success) compared with 75 cured and 13 improved out of 89 on Augmentin (99% success) and 31 cured and 7 improved out of 38 patients treated with cefaclor (97% success). Bacteriology was assessable in 101 patients given cefuroxime axetil (72% cleared), 61 of those given Augmentin (70% cleared) and 27 out of 28 (96%) given cefaclor. As expected, the predominant pathogen was E. coli, accounting for 61% of isolates overall. Drug-related adverse events occurred in 10% of patients given cefuroxime axetil, including diarrhoea in 4%. Eleven percent of patients given Augmentin suffered adverse events (5% diarrhoea) and 5% of those given cefaclor. Superinfections occurred in 4 cefaclor patients (2 Pseudomonas aeruginosa, 1 Candida, 1 E. coli) compared with 2 on cefuroxime axetil (1 Candida, 1 E. coli). Uncomplicated UTI accounted for 92% of cases in the G.P. trial and 82% of cases in the hospital trial. Cefuroxime axetil may be used safely and effectively to treat uncomplicated UTI at a dose of 250 mg b.d. PMID- 3556125 TI - Factors affecting the drinking driver. AB - Although the relationship between alcohol and traffic safety has been the subject of numerous studies, much remains unknown about the mechanisms by which alcohol contributes to traffic accidents. A number of other factors, which are reviewed in this paper, also can contribute to car accidents. They may also interact with alcohol, perhaps in a complex manner. Therefore, multiple factors rather than one single factor may contribute to automobile accidents for those who drink and drive. PMID- 3556126 TI - Clinical use of antiviral drugs. AB - Remarkable progress has been made in antiviral chemotherapy. Six approved antiviral drugs are now available for the treatment of various viral infections. Trifluridine, idoxuridine and vidarabine are all effective in patients with herpes keratitis; trifluridine is preferred due to its low toxicity. Acyclovir is the drug of choice in patients with infections due to herpes simplex viruses, including genital herpes, herpes encephalitis, and neonatal herpes, and infections due to varicella-zoster virus. Amantadine is the only drug currently available for prophylaxis and treatment of influenza A, but an investigational drug, rimantadine, appears to be equally effective and less toxic than amantadine. Ribavirin is the most recently approved antiviral agent for the treatment of respiratory syncytial virus infections. Numerous antiviral drugs are being studied in patients with acquired immunodeficiency syndrome. Although currently available drugs have improved our ability to manage a variety of viral illnesses, much needs to be learned about specific dosage guidelines based on the studies of pharmacokinetics, pharmacodynamics, potential adverse effects and viral resistance, and the role of combination therapy to optimize therapy. PMID- 3556127 TI - Antimicrobial prophylaxis of gastrointestinal surgical procedures and treatment of intraabdominal infections. AB - Antibiotic prophylaxis and treatment regimens ideally are selected on the basis of efficacy, safety, and cost. This review evaluates current, selected literature on antibiotic prophylaxis for colorectal surgery, presumptive antibiotic administration following penetrating abdominal trauma, and treatment of intraabdominal infections. Single-drug regimens with the newer, broad-spectrum agents are assessed and compared with combination regimens; specific regimens are recommended. Colorectal procedures require an antimicrobial agent with activity against both aerobes and anaerobes. Patients undergoing elective colorectal procedures can be adequately protected with an orally administered three-dose regimen of neomycin/erythromycin. Parenteral antibiotic administration is generally not necessary, but, cefoxitin is recommended for nonelective colorectal surgery. The risk of potential infectious complications following penetrating abdominal trauma without colonic perforation is less than with colonic perforation; however, antibiotic therapy that includes activity against aerobes and anaerobes is recommended for all types of penetrating abdominal trauma. Although cephalothin, cefamandole, or cefoxitin alone may be used in abdominal trauma without perforation of the colon, only cefoxitin is recommended as a single-drug alternative to the standard clindamycin/gentamicin regimen in trauma with colonic perforation. Single-drug therapy with cefoxitin or moxalactam can be used successfully as alternatives to the standard regimens of clindamycin/gentamicin or metronidazole/gentamicin in many patients with intraabdominal sepsis. Single-drug regimens reduce the risk of developing adverse effects and are cost-effective. However, if resistant organisms are suspected, or if the patient has been hospitalized for a prolonged period or has multiple organ failure, it may be necessary to supplement cefoxitin therapy with an antibiotic that will enhance coverage against gram-negative aerobes. PMID- 3556128 TI - Almitrine bismesylate. AB - Almitrine bismesylate is a pharmacologically unique respiratory stimulant. It enhances respiration after both acute and chronic administration by acting as an agonist of peripheral chemoreceptors located on the carotid bodies. In comparison with traditional central-acting respiratory stimulants, almitrine has advantages of oral activity, prolonged duration of effect, and an improved adverse effect profile. Almitrine is generally well tolerated, with headache and minor gastrointestinal disturbances being the most frequently observed side effects. This investigational agent has been shown to increase arterial oxygen tension while decreasing arterial carbon dioxide tension in patients with chronic obstructive pulmonary disease both at rest and during exercise through increased ventilation and improved ventilation/perfusion matching. It may also prove useful in the treatment of nocturnal oxygen desaturation because of its ability to reduce the frequency and severity of nocturnal hypoxemia without impairing the quality of sleep. Additional research is needed to further define the role of almitrine in the relief of hypoxemia. PMID- 3556129 TI - Therapeutic assessment of Slow-K and K-tab potassium chloride formulations in hypertensive patients treated with thiazide diuretics. AB - Therapeutic equivalency among different drug products is one of the major issues confronting many clinicians today who are functioning as members of pharmacy and therapeutic committees and state Medicaid programs (SMP). Selection of one of the available slow-release potassium chloride formulations for inclusion in a hospital formulary or SMP exemplifies one of these therapeutic equivalency issues. To evaluate this issue, we studied 20 hypertensive adult patients receiving hydrochlorothiazide 50 mg/d to determine if there are significant differences between the administration of 24 mEq of Slow-K given as 8 mEq/tablet tid, and 30 mEq of K-Tab given as a 10 mEq/tablet tid. The study was conducted in a randomized, open-label, crossover design in which the two drug formulations of potassium chloride were compared over two four-week treatment periods. Results from this study indicate that 24 mEq of Slow-K and 30 mEq of K-Tab were equally effective in maintaining serum electrolyte concentrations, blood pressure measurements, and electrocardiogram evaluations within normal limits in all 20 hypertensive patients studied. Furthermore, no adverse effects were noted with either potassium chloride formulation, and patient acceptance, tolerability, and compliance to prescribed dosing regimens were similar for both products. Based on our findings, therefore, we conclude that 24 mEq of Slow-K and 30 mEq of K-Tab given three times daily as 8 mEq and 10 mEq tablets, respectively, are therapeutically equivalent. PMID- 3556130 TI - [Rapid test for Campylobacter pylori]. PMID- 3556131 TI - [Congenital toxoplasmosis with delayed immune response in children. Diagnostic problems]. AB - A newborn, delivered at term, developed a rapidly increasing hydrocephalus with intracranial calcifications and seizures during the first week of life. Clinical suspicion of congenital toxoplasmosis was at first not confirmed serologically (serum titer in the immunofluorescence test [IFT] of 1:1024 and complement fixation reaction [CFR] of 1:40 equalling those of the mother; IgM-IFT being negative and the IFT and CFR titers significantly falling within two weeks). But in the further course of the disease the diagnosis of congenital toxoplasmosis was confirmed: 1. Microscopic tachyzoits in CSF when aged six weeks; 2. positive IgM-IFT in serum and CSF from the seventh weeks onwards; 3. steep IFT titer rise in serum and CSF from the 16th week onwards. This case demonstrates that with delayed immune response in the infected child only serial serological tests will exclude or confirm the diagnosis of congenital toxoplasmosis. PMID- 3556132 TI - [Toxicity of coffee and caffeine]. PMID- 3556134 TI - [Early sonographic recognition of renal cell carcinoma]. AB - Of 19 patients with renal cell carcinoma diagnosed by ultrasound, nine already had symptoms of the tumor at the time; in the other ten it was discovered by chance during an upper-abdominal ultrasound screening. The latter group differed from the former by a lower average age (52.7 compared with 63.1 years), lower mean tumor size (4.5 and 7.0 cm, respectively), less advanced tumor stage, further course with fewer complications, and higher survival rate. The findings underline the great importance of routine abdominal ultrasound screening in the early diagnosis of tumors. PMID- 3556133 TI - [Walk training and drug therapy in peripheral arterial occlusive disease. A randomized, prospective, placebo-controlled double-blind study]. AB - It was demonstrated in a prospective, randomized and placebo-controlled double blind study of two groups of 15 patients each with peripheral arterial occlusive disease in stage IIb of Fontaine that the combination of intravenous and oral administration of Pentoxifylline with walk training was superior to walk training alone. Comparison of the two groups revealed a significant increase in pain-free walking capacity, as well as reduction in plasma viscosity and platelet aggregation in the patients of the combination group. A significant reduction in platelet aggregation and rigidity occurred with time in this group only, while there was no significant difference between the groups with regard to these two parameters at the end of the treatment period. PMID- 3556135 TI - [CLO-Tests for the demonstration of Campylobacter pylori]. PMID- 3556136 TI - What is past is prologue: a short history of the development of tracheostomy. PMID- 3556137 TI - Ultrasonic evaluation of antibiotic therapy. PMID- 3556138 TI - Epidemiology of Campylobacter infection: a review. PMID- 3556139 TI - The acute leukaemias. PMID- 3556140 TI - A two year longitudinal study on the effect of removable partial denture design on the health of the remaining teeth. PMID- 3556141 TI - Influence of antisera to pancreatic acinar cells on rat pancreas in situ. AB - For investigations of cell injury during pathogenesis of acute pancreatitis antisera to pancreatic acinar cells were used as experimental tool. Within one hour after intraductal injection of antiserum a strong pancreatic edema was developed. Within 24 h this edema receded to a large extent but at this time there were inflammatory cells scattered in the intra- and periductal region. As a sequel of application of antiserum pancreatic enzymes were released. At 24 h after this application serum activities of alpha-amylase and lipase were significantly increased in comparison to the control and reached that level which was found in a model of acute pancreatitis provoked by pancreatic edema plus short-term ischemia. PMID- 3556142 TI - [Anti-leukemia resistance and growth-regulating molecules in hematopoietic tissue]. AB - The analyzed data from literature suggest that the growth-regulating molecules of the hematopoietic tissue are a part of the antileukemic defence system of the body. This component of the antitumour resistance is the first one formed during the multicellular organism evolution. It is of special significance in the tissue stimulated to proliferation in which the number of antiblastic defence cell effectors diminishes in the regenerating tissue while the number of progenitor cells having the oncogenic potential increases. PMID- 3556144 TI - Evaluation of the somatosensory evoked potentials in brain death. PMID- 3556143 TI - [Micronucleus test as a short-term assay for detecting the potential carcinogenicity of different groups of chemical compounds]. AB - Certain theoretical aspects of the method, the normal level of micronuclei in polychromatic erythrocytes of bone marrow cells in different animals species, the data obtained for the different types of chemical compounds are analyzed as well as the possibility of obtaining false-negative and false-positive results. This method is found to be very promising and needs further development in the near future. PMID- 3556145 TI - [Tryptophan in the treatment of insomnia in hospitalized psychiatric patients]. AB - In 21 psychiatric in-patients, the efficacy of tryptophan at the dose of 250 and 500 mgr, with or without sodium salicylate, has been evaluated with respect to placebo, according to a double-blind randomized design. The results show that none of the treatment conditions induced significant shortening of sleep latency. PMID- 3556146 TI - Immunohistochemical evidence of progestin target cells in the pituitary gland of ovariectomized rat. AB - Progestin (P) target cells were identified in the pituitary gland of gonadectomized female rats which had been primed with estrogen (E). P staining was localized using the immunohistochemical avidin-biotin-peroxidase (ABP) complex method. Dark brown precipitates were primarily found over the cytoplasm of cells in the pars distalis, but not in the pars intermedia nor in the pars nervosa. The majority of P-sensitive cells in the pars distalis were identical with luteotrophs, a few being lactotrophs. These observations suggest a role of P in the regulation of production and secretion of gonadotrophins in the pituitary glands of female rats. PMID- 3556147 TI - Time course of ketone body production in the isolated perfused rat liver in response to various stimuli. AB - Using a non-recirculating perfusion system, we studied the time course of ketone body output from the isolated rat liver in response to various hormones and changes in pH and redox state. The release of 3-hydroxybutyrate (3-OHB) started to be suppressed within 1 min after the addition of insulin (50 mU/ml) and kept half of the basal level even 10 min after its cessation. The addition of glucagon (0.2 microM) caused an increase in both 3-OHB and acetoacetate (AcAc) outputs from fed livers within 5 min, which reached about 150% of the basal level 10 min after the infusion and maintained a constant level through out the experiment. Growth hormone (2 mu/ml) elicited a slight but significant increase in AcAc output soon after the infusion. Epinephrine (10 microM) also caused a slight increase in both AcAc and 3-OHB outputs 9 min after the infusion and maintained a significant increase even 10 min after stopping infusion. The decrease in pH of the perfusate or the addition of ascorbic acid abruptly suppressed the AcAc production. In summary, the present study clearly demonstrated the direct effects of various hormones on ketogenesis in the liver and the usefulness of a non recirculating liver perfusion system as a tool for the study of ketogenesis. PMID- 3556148 TI - Effects of thyroidectomy and administration of propylthiouracil (PTU) or thyrotropin (TSH) to pregnant rats on the functional development of the fetal thyroid gland an immunohistochemical study. AB - In order to elucidate the maternal factors influencing the functional development of the fetal rat thyroid gland, pregnant rats were subjected to either thyroidectomy or administration of PTU or TSH and the thyroid glands of the fetuses were examined chronologically by immunohistochemistry to detect thyroglobulin (Tg), T4 and T3. In the group undergoing thyroidectomy, the occurrence of immunoreactive Tg, T4 and T3 was the same as in the control group in spite of slight retardation of the development of the thyroid gland. On the other hand, PTU administration caused remarkable degeneration of the hyperplastic epithelium of the follicles, where immunoreactivity of T4 and T3 was barely detectable, suggesting a transplacental effect of PTU on the fetal thyroid gland. However, Tg remained unaffected and was stained as well as in the controls. Injection of TSH led to a delay in the occurrence of T4 and T3 by one day, probably due to increased levels of thyroid hormone from the stimulated thyroid gland of the mother rats. PMID- 3556150 TI - Obturation of root canals by the standardized and step back techniques. PMID- 3556149 TI - Spontaneous autoimmune thyroiditis in Bio Breeding/Worcester (BB/W) rat. AB - We investigated the serial changes in the plasma levels of anti-thyroglobulin antibody (ATA) by solid-phase enzyme immunoassay, thyroid hormones and blood glucose, since spontaneous occurring lymphocytic thyroiditis (LT) has been found in spontaneously diabetic Bio Breeding/Worcester (BB/W) rat. We also observed the correlation between these levels and histological findings in the thyroid gland. The incidence of diabetes was 0% in 5 week old rats (group A), 70% in 11 week old rats (group B), and 86% in 20 week old rats (group C), while LT was observed in 0% in group A, 20% in group B and 48% in group C. Although the incidence of both increased with age, there was no link between LT and diabetes. Plasma ATA levels were 91.4 +/- 28.5 (OD492 X 1,000, mean +/- SEM) in the control (14 week old Wistar Furth) rats. 49.5 +/- 15.4 in group A, 197.8 +/- 41.5 in group B, and 376.7 +/- 48.7 in group C, again showing a clear increase with age. In group C, the plasma levels of ATA in rats with LT were significantly higher than those without LT. In addition, 6 out of 11 rats without LT had abnormaly high ATA levels. In group C, the plasma levels of free 3,5,3'-triiodothyronine (FT3) and total thyroxine (TT4), and also the FT3/TT4 ratio were significantly lower and the plasma levels of blood glucose were higher than in the other groups. There was no difference between the plasma thyroid hormone levels in rats with LT and those without LT. These studies suggest that LT may occur independently of insulitis, namely diabetes, ATA levels and the incidence of LT increase with age, the site of ATA production may not be confined to the thyroid gland, and the derangement of glucose metabolism may be one of the factors in the decrease in plasma thyroid hormone. The BB/W rat is not only a useful animal model to use in exploring the pathogenesis of human insulin-dependent diabetes mellitus, but also spontaneous autoimmune thyroiditis. PMID- 3556151 TI - Effect of pulpal inflammation on bacterial penetration of acid-etched and non etched dentin. PMID- 3556152 TI - Effect of insulin-induced hypoglycemia on plasma renin activity and aldosterone and cortisol concentration in humans. PMID- 3556153 TI - [Effect of sudden changes in blood calcium level on the process of glucose assimilation and the early phase of insulin secretion in healthy persons and in patients with diabetes mellitus type 2]. PMID- 3556154 TI - Location of parathyroid adenomas by ultrasonography. PMID- 3556155 TI - Increase in insulin binding affinity by chloroquine in cultured rat hepatoma cells. AB - Chloroquine increased the binding of 125I-labeled insulin to rat hepatoma cells (R-Y121B) at 4 degrees C. The effect of chloroquine on insulin binding was amplified at 23 degrees C, and a large increase in cell-associated radioactivity was observed. Scatchard analysis showed that chloroquine increased the affinity of insulin for cells at both 4 degrees C and 23 degrees C, and that this increase eventually caused the accumulation of insulin internalized by cells at 23 degrees C. PMID- 3556156 TI - Plasmid pKM101 muc(-)- and muc(+)-mediated anthracycline mutagenicity and cytotoxicity in Salmonella typhimurium. AB - Muc (mutagenesis: UV: chemical) genes of plasmid pKM101, along with the chromosomal gene recA are known to be important constituents for full expression of inducible error-prone DNA repair in Salmonella typhimurium. This study investigates the affects of muc+ pKM101 and three of its derivatives bearing muc- point mutations (pGW1, pGW16, and pGW21) on spontaneous as well as anthracycline induced back mutation to histidine independence. Different base-substitution and frameshift his- tester strains of S typhimurium were treated with the anthracyclines daunomycin, Adriamycin, carminomycin, and 4-demethoxy-doxorubicin. In many cases the muc- plasmids did mediate dose-dependent anthracycline mutagenicity as measured by His+ reversion. In many of the his- strains, the presence of muc+ pKM101 or muc- plasmids also resulted in a concomitant elevation of spontaneous reversion patterns over those seen with the plasmid-free parent strains. As a result, the sensitivity of most strains to anthracycline mutagenicity (based on His+ revertants/spontaneous background/microgram anthracycline) was not enhanced by muc+ pKM101 or its muc- mutant derivatives. In contrast, the low incidence of spontaneous His+ reversion in strains of the hisD3052 series, along with the inherently greater sensitivities of these strains to anthracycline-induced reversion, demonstrate most dramatically the mutagenesis enhancing effects of muc+ pKM101 and muc- plasmids. In these and other cases in which muc- plasmid effects on enhancement of strain sensitivity to mutagenesis or cytotoxicity are observed, the overall spectrum of enhancement is the following, in decreasing order: pKM101 greater than pGW16 greater than pGW1 greater than no plasmid approximately equal to pGW21. Possible correlations are drawn between muc plasmid effects on anthracycline-induced mutagenesis and cytotoxicity. PMID- 3556157 TI - Vaporization technique to measure mutagenic activity of volatiles organic chemicals in the Ames/Salmonella assay. AB - The purpose of this research was to develop and characterize a sensitive test method to detect mutagenic activity of volatile liquid organic chemicals (i.e, volatiles) in the Ames/Salmonella assay. A Tedlar bag vaporization technique was developed, which increased contact time between the volatiles and bacterial test system, circumvented volatilization limitations in the standard plate incorporation and preincubation methods, allowed chemical analysis during incubation, and was flexible in design. The vaporization technique was evaluated concurrently against the plate incorporation and preincubation techniques with eight liquid volatile mutagens in the Ames/Salmonella mutagenicity assay with Salmonella typhimurium strains TA100 and TA102. Results suggested that when volatile organic chemicals with boiling points below 63 degrees C were tested for mutagenic activity, the most sensitive test conditions were the vaporization technique with TA100. GC analysis of epichlorohydrin and butylene oxide concentrations within Tedlar bags suggested that these two chemicals volatilized and were contained in the media after 1 hr of incubation at 37 degrees C. The mutagenic activity of six volatile liquid mutagens was similar in single and triple plate Tedlar bags. Three general test groups of volatile organic chemicals were identified by test data: chemicals which had boiling points below 63 degrees C, for which the vaporization technique was the most sensitive test procedure (ethylene, propylene, and butylene oxides and methylene chloride); chemicals which had boiling points from 107 degrees to 132 degrees C, for which the vaporization technique was still useful, but where sensitivity was only slightly increased over the preincubation technique (1-bromo-2-chloroethane, epichlorohydrin, and ethylene dibromide); and 3) a chemical which had a boiling point at 194 degrees C, where the preincubation technique was the most appropriate test method (styrene oxide). PMID- 3556158 TI - Ecotoxicity of copper to aquatic biota: a review. AB - The toxic effects of copper on numerous aquatic flora and fauna has been studied intensely over the past 10 years. In general, there is a consensus that free cupric ions are more toxic if compared with other chemical forms such as organically complexed copper. Biological indicators exhibit a tremendously wide range of sensitivity to copper with toxic effects noted at pCu as low as 10 for some algae, while aquatic macrophytes appear to have a much higher tolerance for copper (pCu less than 5.0). The sensitivity of various groups of organisms seems discrepant and anomalous with accepted standards for drinking water and industrial discharges, and recommended rates of copper sulfate application to water bodies. The toxicity of copper, however, is mitigated by the presence of naturally occurring organic compounds in waters through complexation. The regulatory function of dissolved humic matter will continue to be a vital one for as long as copper is discharged into aquatic environments. PMID- 3556159 TI - Promotion of radioresistance by metallothionein induction prior to irradiation. AB - A striking radioresistance has been found in mice which were subjected to various pretreatments to induce metallothionein synthesis in the liver prior to irradiation. The tolerance to lethal damage from an LD50 level of radiation during a 30-day postirradiation period was demonstrated by a highly significant difference (P less than 0.01) in mortality rate between mice given subcutaneously manganese, cadmium, or zinc injection or surgical skin excision of mice and the control mice (no pretreatment). A typical loss in body weight that generally reached a peak 2 weeks after irradiation was observed in the control mice, but mice given a dose of 10 mg manganese per kilogram body weight showed a steady weight increase even a few days after irradiation. The normal level of metallothionein in mouse liver is 20 micrograms/g tissue. This level increased up to 70 micrograms/g tissue following irradiation at 6.3 Gy. Among irradiated mice, metallothionein levels in the liver increased approximately 200-800% after cadmium, manganese, or zinc injection compared to levels of irradiated mice without pretreatment. Mice undergoing 2 X 2-cm2 dermal excision also demonstrated a similar reduction of mortality and high metallothionein contents in liver, i.e., 150-400 micrograms/g. The present results, together with our previous findings (Matsubara et al., 1982, 1983, 1984; Matsubara, 1986), suggest that the body's protective mechanism against radiation strongly correlates with the biosynthesis of metallothionein or metallothionein itself acting as a scavenger of radiation-induced peroxides. PMID- 3556160 TI - Liver and muscle proteolytic activity in male growing rats fed a field bean (Vicia faba L.) diet. AB - Total liver cathepsin A and D and gastrocnemius acid proteolytic activities have been evaluated in male growing rats fed ad libitum over periods of 15 and 30 days on 20%-protein diets containing either casein or raw field bean (Vicia faba L.) as protein sources. It has been found that, compared to the control casein-fed rats, those fed the legume diet exhibited a marked reduction (p less than 0.05) in the rate of growth and protein efficiency rate; liver proteolytic activity increased with ageing in the two dietary treatments and was found to be significantly higher (p less than 0.05) in the legume-fed rats. However, muscle proteolytic activity decreased with ageing and proved significantly increased (p less than 0.05) in the legume-fed rats. PMID- 3556161 TI - A novel yeast mutant defective in the processing of ras proteins: assessment of the effect of the mutation on processing steps. AB - Biosynthesis of RAS1 and RAS2 proteins of Saccharomyces cerevisiae involves processing, fatty acid acylation and transport to plasma membranes. We now report the isolation of a mutant, termed dpr1, defective in these biosynthetic events. The dpr1 cells are temperature sensitive for growth and display sterile phenotype specific to a cells. The following observations were made using cells overproducing the RAS2 protein. (i) In the dpr1 cells, the RAS2 proteins remain as precursors and accumulate in the cytoplasm. (ii) The level of the RAS2 proteins in the plasma membrane of the dpr1 cells is much lower than that in the plasma membrane of wild-type cells. (iii) Fatty acid acylation appears to take place in the dpr1 cells. These results suggest that the major effect of the dpr1 mutation is in the processing of the precursor proteins, but not in their fatty acid acylation. Mutants such as dpr1 should be invaluable for further elucidation of the mechanisms of biosynthesis and transport of the RAS proteins, and presumably also a factor. PMID- 3556162 TI - Selection of AUG initiation codons differs in plants and animals. AB - The influence of the nucleotide at position -3 relative to the AUG initiation codon on the initiation of protein synthesis was studied in two different in vitro translation systems using synthetic mRNAs. The four mRNAs, transcribed from cDNAs directed by an SP6 promoter, were identical except for mutations at nucleotide -3. In each case, translation of mRNAs produced a single protein of Mr = 12,600. Relative translational efficiencies showed a hierarchy in the reticulocyte lysate system (100, 85, 61 and 38% for A, G, U and C in position -3, respectively) but no differences in the wheat germ system. Differential mRNA degradation or polypeptide chain elongation were excluded as causes of the differences observed in translation in the reticulocyte lysate. mRNA competition increased the differences observed in translational efficiencies in reticulocyte lysate but showed no effect in wheat germ. Analysis of 61 plant and 209 animal mRNA sequences revealed qualitative and quantitative differences between the consensus sequences surrounding AUG initiation codons. Whereas the consensus sequence for animals was CACCAUG that for plants was AACAAUGGC. Both the structural and functional findings suggest that the factors which select AUG initiation codons in plants and animals differ significantly. PMID- 3556163 TI - Expression of the nuclear encoded OEE1 protein is required for oxygen evolution and stability of photosystem II particles in Chlamydomonas reinhardtii. AB - In Chlamydomonas reinhardtii the oxygen evolving enhancer protein 1 (OEE1), which is part of the oxygen evolving complex of photosystem II (PS II), is coded for by a single nuclear gene (psb1). The nuclear mutant FuD44 specifically lacks the OEE1 polypeptide and is completely deficient in photosynthetic oxygen evolution. In this mutant a 5 kb DNA insertion into the 5' region of the psb1 gene results in the complete absence of OEE1 mRNA and protein. A revertant, FuD44-R 2, which is capable of 30% of the photosynthetic oxygen evolution of wild-type cells, has lost 4 kb of the 5 kb DNA insert, and accumulates both OEE1 mRNA and protein, although at levels somewhat less than those of wild-type cells. Absence of the OEE1 protein in the FuD44 mutant does not affect the accumulation of other nuclear encoded PS II peripheral polypeptides. OEE1 absence does, however, result in a more rapid turnover of the chloroplast encoded PS II core polypeptides, thus resulting in a substantial deficiency of PS II core polypeptides in FuD44 cells. These PS II core proteins again accumulate in revertant FuD44-R2 cells. PMID- 3556164 TI - Evidence suggesting that PrP is not the infectious agent in Creutzfeldt-Jakob disease. AB - It has been suggested that the infectious agents of scrapie and Creutzfeldt-Jakob disease (CJD) are 'prions' constituted by a protease resistant glycopeptide, PrP. To analyze the role of PrP in CJD infectivity we re-evaluated the biochemical characteristics of infectivity. First, when the infectious agent is not aggregated, infectivity is exquisitely sensitive to proteinase K treatment, and therefore a proteinase-K-resistant molecule (e.g. PrP) is unlikely to contain information essential for agent replication. Second, removal of sugar residues from Gp34 (the major precursor of the proteolyzed PrP band) failed to reduce infectivity. Third, one-half of the PrP peptides could be separated from significant infectivity using nondenaturing conditions with practical quantitative recovery of infectivity. These studies suggest that PrP in itself is unlikely to be the replicating component of the infectious agent. We suggest that these as yet undefined agents may consist of core protein and nucleic acid that are incompletely assembled in, and protected by, cell membranes. This hypothesis would explain the absence of conventional viral particles in these diseases, account for observed membrane pathology including altered behavior of endogenous membrane proteins, and would be consistent with the replication and transforming properties of CJD that indicate there is an agent specific nucleic acid. PMID- 3556165 TI - Enzymatic conversion of guanosine 3' adjacent to the anticodon of yeast tRNAPhe to N1-methylguanosine and the wye nucleoside: dependence on the anticodon sequence. AB - N1-Methylguanosine (m1G) or wye nucleoside (Y) are found 3' adjacent to the anticodon (position 37) of eukaryotic tRNAPhe. The biosynthesis of these two modified nucleosides has been investigated. The importance of the type of nucleosides in the anticodon of yeast tRNAPhe on the potentiality of this tRNA to be a substrate for the corresponding maturation enzyme has also been studied. This involved microinjection into Xenopus laevis oocytes and incubation in a yeast extract of restructured yeast tRNAPhe in which the anticodon GmAA and the 3' adjacent Y nucleoside were substituted by various tetranucleotides ending with a guanosine. The results obtained by oocyte microinjection indicate: that all the restructured yeast tRNAsPhe are efficient substrates for the tRNA (guanosine-37 N1)methyltransferase. This means that the anticodon sequence is not critical for the tRNA recognition by this enzyme; in contrast, for Y nucleoside biosynthesis, the anticodon sequence GAA is an absolute requirement; the conversion of G-37 into Y-37 nucleoside is a multienzymatic process in which m1G-37 is the first obligatory intermediate; all the corresponding enzymes are cytoplasmic. In a crude yeast extract, restructured yeast tRNAPhe with G-37 is efficiently modified only into m1G-37; the corresponding enzyme is a S-adenosyl-L-methionine-dependent tRNA methyltransferase. The pure Escherichia coli tRNA (guanosine-37 N1) methyltransferase is unable to modify the guanosine-37 of yeast tRNAPhe. PMID- 3556166 TI - A 75 kd merozoite surface protein of Plasmodium falciparum which is related to the 70 kd heat-shock proteins. AB - Proteins on the merozoite surface of the human malarial parasite Plasmodium falciparum are targets of the host's immune response. The merozoite surface location of p75, a 75 kd P. falciparum protein, was established by immunoelectron microscopy using antisera raised to the expressed product of a cDNA clone. Immunoprecipitation from protein extracts biosynthetically labeled during different periods of the asexual cycle showed that p75 is made continuously, although ring-stage parasites appear to synthesize larger quantities. p75 is conserved and invariant in size in eight isolates of P. falciparum. The 880 bp cDNA sequence encoding part of p75 reveals one open reading frame containing a repetitive sequence unit of four amino acids. The predicted reading frame is correct since antisera to a synthetic peptide corresponding to the repetitive region recognize p75 in immunoblots. The sequence of p75 is homologous with the sequences of proteins from the ubiquitous, highly conserved family of 70 kd heat shock proteins, suggesting an important physiological function for p75. The cDNA fragment encoding part of p75 hybridizes with multiple genomic fragments, whose sizes are identical in DNA from nine P. falciparum strains, suggesting that the gene for p75 is well conserved and may be part of a gene family. PMID- 3556167 TI - Control of replication of plasmid R1: translation of the 7k reading frame in the RepA mRNA leader region counteracts the interaction between CopA RNA and CopT RNA. AB - Replication of IncFII plasmids is regulated through the expression of a gene, repA. The RepA protein is rate-limiting for initiation of replication. The main negative control is exerted by a countertranscript, CopA RNA, that binds to the complementary region of the RepA mRNA, thereby inhibiting the formation of the RepA protein. The target region for CopA RNA, CopT, is located upstream of the RepA coding region. An open reading frame for a putative 7k protein overlaps the CopT sequence. Here we show by using lacZ fusions that the 7k gene is expressed. We constructed a translation start mutation in order to abolish formation of the 7k protein. This resulted in a 10-fold decrease in repA expression. The 7k protein produced in trans did not reverse this effect, so the 7k protein per se does not control expression of repA. However, translation of the 7k coding sequence must influence CopA/CopT RNA recognition, since ribosomes will transiently disrupt the target hairpin. We propose here a novel mechanism that affects the level of gene expression: the 7k region of the RepA mRNA is a leader sequence that is involved in expression of the downstream gene; translation of the 7k region competes with a negative control system involving RNA-RNA interaction. PMID- 3556169 TI - Mechanism of hypotensive action of ketanserin in men. AB - The mechanism of the hypotensive action produced by ketanserin during chronic treatment in humans remains unknown. In contrast to previous reports, recent data show that ex vivo inhibition of the serotonin-induced platelet aggregation can be demonstrated in men during chronic ketanserin administration, provided that the pH is controlled in the in vitro assay. This test could be used as a tool to measure the degree of serotonin inhibition, at least at the platelet level. PMID- 3556168 TI - Signal peptide amino acid sequences in Escherichia coli contain information related to final protein localization. A multivariate data analysis. AB - With few exceptions, the signal peptides from proteins inserted into, or translocated through, the membranes of gram-negative bacteria or the endoplasmic reticulum of eukaryotes have no sequence homologies. Therefore these signal peptides have not been considered to contain information related to the different final localizations of the proteins. In this study, 43 signal peptide amino acid sequences from proteins with different final localizations in Escherichia coli have been subjected to a multivariate data analysis. Each amino acid residue was characterized by 20 physico-chemical properties, yielding a multivariate property profile for each peptide. The similarities/dissimilarities in the property profiles for the signal peptides from different classes were compared with each other by generating few-dimensional partial least squares (PLS) discriminant plots. With this approach, signal peptides from proteins localized to the periplasmic space (PS), the outer membrane (OM), and the extracellular surroundings (excreted proteins), were separated into distinct groups. Signal peptides from pili proteins were not separated from the OM signal peptides and only partly from the PS signal peptides, but were clearly different from the signal peptides of the excreted proteins. Signal peptides from inner membrane proteins were similar to those of the PS peptides. The size and the hydrophobicity of different peptide segments were responsible for the separation of the signal peptide classes. For example, the hydrophobicity of the N-terminal segment of the signal peptides increased with an increased distance from the cytoplasm of the final localization for the corresponding proteins. Thus, many signal peptides from proteins with different final localizations in E. coli have different discernible physico-chemical profiles. PMID- 3556170 TI - Necrotising vasculitis associated with captopril therapy. PMID- 3556171 TI - The clinical usefulness of the antiarrhythmic drug quinidine. PMID- 3556172 TI - Antiarrhythmic drug effects on left ventricular performance. PMID- 3556173 TI - Procainamide and disopyramide. PMID- 3556174 TI - Prognostic value of QT interval prolongation in post myocardial infarction patients. PMID- 3556175 TI - Antiarrhythmic drug interactions: are they important? AB - Most cardiac patients who have cardiac arrhythmias and are treated by antiarrhythmic agents will receive other cardiovascular drugs to treat coexistent problems, for example heart failure, angina or hypertension. Also, two antiarrhythmic drugs may be simultaneously prescribed to these patients in the search for better efficacy and fewer side effects. Finally these patients may well take noncardiovascular drugs such as cimetidine for the treatment of peptic ulcer disease or other hypersecretory disorders. In all cases, complex pharmacodynamic and pharmacokinetic drug interactions are likely to occur. These interactions have been extensively reviewed by Bigger and Giardina. The purpose of this work is to focus on the potentially important interactions with antiarrhythmic drugs. It is of interest for the cardiologist to be aware of the most common and meaningful drug interactions in order to prevent lack of efficacy or a risk of drug toxicity that could result from the simultaneous administration of different drugs to a patient. In this regard the interactions of antiarrhythmic drugs with digitalis, cimetidine, beta-blocking agents and other antiarrhythmic drugs will be briefly reviewed. PMID- 3556176 TI - Propafenone, a review of its profile. PMID- 3556177 TI - Class III drugs: amiodarone. PMID- 3556178 TI - Antiarrhythmic drugs--class IV. PMID- 3556179 TI - Clinical usefulness of the Vaughan Williams classification system. AB - The clinical usefulness of the Vaughan Williams classification scheme is limited by the complexity of the mechanisms of arrhythmia formation in man, which offer multiple potential sites for intervention. The properties of antiarrhythmic drugs may be considerably altered in abnormal myocardium. Despite these limitations, however, the classification provides a valuable conceptual framework for the understanding of the clinical electrophysiological properties of antiarrhythmic drugs and for their use. PMID- 3556180 TI - Clinical value of plasma concentrations of antiarrhythmic drugs. AB - The clinical use of plasma concentrations of antiarrhythmic agents suffers from important limitations. Any factor changing the protein binding capacity affects the free, clinically active, fraction of the drug. Most antiarrhythmic agents attach to the acute phase alpha-1-acid glycoprotein, varying during conditions such as acute myocardial infarction, leading to changes in the plasma binding capacity for e.g. lidocaine. Several pharmacodynamic factors may counteract or potentiate the electrophysiological or haemodynamic action of antiarrhythmic agents. Active metabolites contribute to the clinical efficacy or to the side effects. The induction of metabolizing enzymes of some drugs and the inhibition of hepatic metabolism of others may change the free drug fraction in plasma. While many studies show a good correlation between plasma levels and antiarrhythmic effect, few imply a correlation between plasma levels and a decrease in mortality. However, in spite of these limitations, plasma levels may be useful in guiding treatment with high dosages, with drugs with long elimination half-lives, in treatment failures due to true failure of the drug, changes in pharmacokinetics or because of poor patient compliance, and may be of particular interest when side-effects and/or intoxication are suspected. PMID- 3556181 TI - Programmed electrical stimulation of the heart to select antiarrhythmic drug treatment in patients with recurrent ventricular arrhythmias. PMID- 3556182 TI - Effects of pharmacological and non-pharmacological interventions on ventricular late potentials. AB - The purpose of this paper is to review the presently available information on the effect of antiarrhythmic drugs and of map-guided antitachycardia surgery on ventricular late potentials. Studies in experimental myocardial infarction have shown that antiarrhythmic drugs are able to prolong regional low-amplitude fractionated electrical activity. However, no correlation between changes in duration of low-amplitude electrical activity and antiarrhythmic drug efficacy could be demonstrated. A similar lack of correlation between changes in duration of late potentials as recorded by the signal averaging technique from the body surface and inducibility or suppression of ventricular tachycardia were observed. Neither changes in duration or amplitude nor in the frequency content of ventricular late potentials showed an unequivocal correlation with drug efficacy. By contrast, there is convincing evidence that exclusion of arrhythmogenic tissue by map-guided antitachycardia surgery correlates with the loss of late potentials postoperatively in a high percentage of cases. If, however, late potentials persist after surgery, there is a high chance of ventricular tachycardia being still inducible postoperatively. A loss of ventricular late potentials by surgery may be the result of isolation of the arrhythmogenic tissue, devitalization and/or removal. In conclusion, there is presently no convincing evidence that any of the parameters for characterization of ventricular late potentials is clinically useful to predict the efficacy of antiarrhythmic drug therapy. On the other hand, ventricular late potentials have proved useful for prediction of the success of map-guided antitachycardia surgery. PMID- 3556183 TI - Echocardiography in neurological disorders. AB - Numerous neurological disorders are associated with myocardial disease or involve the cardiovascular system. Echocardiography thus proves quite helpful in the evaluation and management of patients with problems such as hydrocephalus, tuberous sclerosis, Friedreich ataxia, mitochondrial encephalo-myopathies, Werdnig-Hoffmann disease, convulsive disorders, syncope, central nervous system infections, etc. PMID- 3556184 TI - Differential effects of prostaglandins on mesenteric and cerebral arteries isolated from premature newborn baboons. AB - Responses to prostaglandins (PGs) E1, E2, F2 alpha and I2 at a wide range of concentrations were compared in the cerebral and mesenteric arteries isolated from premature newborn baboons. PGE1 at low concentrations relaxed the cerebral artery but not the mesenteric artery. PGI2 produced a relaxation of similar magnitude in both arteries. PGF2 alpha in high concentrations produced a much greater contraction in the mesenteric artery than in the cerebral artery. Thus, during the perinatal stage, the baboon cerebral artery has distinctive PG reactivity compared to the extracerebral artery. Clinical use of PGE1 or indomethacin may result in circulatory derangement or redistribution of blood flow in the cerebral and mesenteric circulations, and may produce side effects of these drugs. PMID- 3556185 TI - Growth failure associated with medullary sponge kidney, due to incomplete renal tubular acidosis type 1. AB - A girl, 12 years of age, was referred for short stature. Clinical examination and laboratory investigations currently performed in a case of growth failure gave normal results. Renal echography revealed a hyper-echogenic renal medulla. An excretory urogram showed medullary sponge kidney with bilateral renal calculi. An ammonium chloride loading test revealed a defect in acid excretion and led to the diagnosis of incomplete renal tubular acidosis. Treatment with oral bicarbonate was associated with an increase in growth velocity. PMID- 3556186 TI - Arteriovenous malformation of the great cerebral vein (of Galen) in a newborn. Diagnosis by ultrasound and digital subtraction angiography. AB - This is a report of a case with an arteriovenous (a.v.) malformation of the great cerebral vein. Applicable diagnostic procedures are reviewed. The initial diagnostic procedure in the approach to an a.v. malformation of the great vein of Galen is cerebral ultrasound. The findings in our patient are compared with those reported in the literature. PMID- 3556187 TI - MPTP: insights into the etiology of Parkinson's disease. AB - MPTP-induced parkinsonism in humans faithfully replicates the clinical features of Parkinson's disease, including physical findings, response to therapy and even complications of therapy. Further, the neuropathological picture in experimental animals appears to be drawing much closer to that seen in the idiopathic disease, particularly in the light of recent findings showing involvement of the locus ceruleus as well as the substantia nigra, and the presence of eosinophilic inclusion bodies. It is suggested that the more closely the MPTP model comes to reproducing Parkinson's disease, the more valuable it may be in exploring the etiology of the disease. MPTP could provide insights into mechanisms underlying neuronal degeneration in the substantia nigra and other areas of the brain in Parkinson's disease, and has already set in motion a renewed search for possible environmental causes of the disease. PMID- 3556188 TI - Pathophysiology of involuntary movements in Parkinson's disease. AB - Tremor and drug-induced dyskinesia are major involuntary movements in Parkinson's disease. The rhythm of resting tremor is 4-6 cycles/s, driven by generators in the brain, and stabilized by reflex arcs involving the spinal cord, nerves and muscles. Its frequency is fixed: it is the same in proximal and distal muscles in each case and does not change in the course of amplitude reduction of tremor by levodopa injection. An approximate doubling of frequency occurs in action tremor which suggests a central mechanism liable to produce harmonics. In postural tremor as observed in the lower limbs while on standing, the frequency of grouped discharges falls into ranges of rhythm with either resting or action tremor. Levodopa-induced dyskinesia has a similar nature to chorea in both clinical observation and EMG. With EMG choreic discharges may appear concomitant with regular parkinsonian tremors in the same muscle, suggesting that the two are not opposites as expressions of dysfunction of the dopaminergic system. PMID- 3556189 TI - Posterior urethroplasty in children. AB - A series of 33 posterior urethral strictures in children is presented. The etiology was traumatic in 31 cases and iatrogenic in 2. Complex strictures were treated by a transpubic approach (20 cases) or by a posterior scroto-urethral inlay (1 case). Simple strictures were directly treated via the perineum: by a push-in technique (6 cases); by end-to-end anastomosis (3 cases); by a skin pedicled tube urethroplasty (1 case); by free skin graft (1 case), and by endoscopic urethrotomy (1 case). The use of omentum, employed in 19 cases, is considered a necessary step in transpubic urethroplasty. Favorable results were observed in 18 out of 20 transpubic procedures, in 8 out of 9 perineal urethroplasties and in 3 out of 4 other techniques, with an overall success rate of 87.8%. PMID- 3556190 TI - Value of computerized tomography and ultrasonography in the preoperative diagnosis of renal cell carcinoma extending into the inferior vena cava. AB - During a 15-year period, 34 patients with renal cell carcinoma extending into the inferior vena cava were submitted to radical ablative surgery at our institution. 8 patients had caval tumor thrombus (TT) extension at the level of the renal veins, 17 had infrahepatic, 8 retrohepatic and 1 atrial TT extension. Cavography, computerized tomography (CT) and ultrasonography (US) were performed preoperatively on 34, 24 and 16 of these 34 patients, respectively. The sensitivity of the techniques used in diagnosing caval involvement was 100, 97 and 87.5% for US, cavography and CT, respectively. The upper limits of TT were clearly detected by US, CT and cavography in 100, 95 and 76% of diagnosed cases, respectively. From this study it appears that US and CT have a sensitivity comparable to cavography in the detection of caval TT. However, US and CT allow a more precise delineation of the upper limits of TT if compared to cavography. This implies that the role of cavography in diagnosing caval TT and its upper limits must be reappraised in light of the progress of noninvasive outpatient procedures. PMID- 3556191 TI - Ultrasonographic diagnosis of infected lymphocele after kidney transplantation. AB - Lymphoceles after kidney transplantation are usually not infected and are drained into the peritoneal cavity, if their size requires treatment. Infected lymphoceles should be drained externally rather intraperitoneally, to avoid peritonitis. Ultrasonographic examinations of 2 febrile patients identified complex echoes that were correctly interpreted as infection within lymphoceles. The ultrasonographic diagnosis of infected lymphocele facilitates early and appropriate operative treatment. PMID- 3556192 TI - Acute natriuretic effect of nifedipine in hypertensive patients and normotensive controls--a proximal tubular effect? AB - The acute effects of buccal nifedipine 20 mg on blood pressure, renal haemodynamics and electrolyte excretion were compared in 16 untreated patients (HT) with uncomplicated arterial hypertension (WHO I-II), 11 normotensives (NT) and 6 normotensives given a placebo. Nifedipine caused a significant fall in the systolic and diastolic blood pressures (BP) of 25.7 +/- 12/26.5 +/- 10 mmHg in the hypertensives, and a minor but significant fall in diastolic BP in the normotensives. Renal vascular resistance fell significantly and renal plasma flow was increased non-significantly in the hypertensives. No changes in these parameters were seen in NT. Glomerular filtration rate remained constant in all groups, also in HT despite the marked haemodynamic changes. Natriuresis was significantly increased to the same degree in the HT and NT groups, in spite of their different haemodynamic responses. Uric acid excretion showed a parallel acute increase in both groups. The significant and close relationship between the acute changes in the excretion of sodium and uric acid provides evidence for a proximal tubular natriuretic effect of nifedipine. PMID- 3556194 TI - Isotypic pattern of the polyclonal B cell response during primary infection by Plasmodium chabaudi and in immune-protected mice. AB - The primary infection by P. chabaudi induces an increase of the numbers of splenic immunoglobulin (Ig)-secreting B cells in both athymic and euthymic BALB/c mice. The isotypic pattern of the polyclonal response is restricted only in euthymic mice where IgG2a, IgG2b and IgM plaque-forming cells (PFC) predominate. In immunized animals, protected against a parasite challenge, the isotypic pattern of splenic PFC is completely different, the IgG1 and IgM isotypes constituting the main part of the response. Reinoculation of immune-protected animals induces a PFC response which is dose dependent and accentuates the characteristic isotypic profile of the immune-protected mice. PMID- 3556193 TI - Evaluation of oxprenolol slow release and osmotic release by exercise testing and ambulatory electrocardiographic monitoring in patients with chronic stable angina pectoris. AB - We have treated eleven patients with chronic stable angina pectoris with slow release oxprenolol (160 mg and 320 mg) in a double-blind crossover study and evaluated its efficacy objectively by exercise testing between 180 and 240 min after dosing. The mean exercise time increased significantly from 6.2 min on placebo to 7.2 min and 7.3 min on oxprenolol 160 mg and 320 mg respectively. No overall beneficial effects could be demonstrated for the higher dose. A further 20 patients received slow release oxprenolol 160 mg and 10/170 mg "Oros" (osmotic release) oxprenolol in a double-blind crossover study using exercise testing and ambulatory electrocardiographic monitoring at 21-23 h after dosing. The mean exercise time increased significantly from 7.0 min on placebo to 8.3 min on slow release oxprenolol and to 8.1 min on "Oros" oxprenolol. The effects of the 2 treatments on exercise and ambulatory heart rates were comparable. Two patients were withdrawn during the double-blind treatment period while receiving oxprenolol slow-release, one because of unstable angina and another because of throbbing headache. These findings confirm that slow-release oxprenolol is effective in treating chronic stable angina pectoris at the 160-mg dose. "Oros" oxprenolol 10/170 mg has a profile of action closely similar to but without any additional benefit over slow-release oxprenolol 160 mg. PMID- 3556195 TI - The T cell-specific serine proteinase TSP-1 is associated with cytoplasmic granules of cytolytic T lymphocytes. AB - This study describes the localization of the previously purified T cell-specific serine proteinase, termed TSP-1 (M. M. Simon et al., EMBO J. 1986. 5: 3267), within cytoplasmic granules of cytolytic T cell lines (CTLL). Subcellular fractionation of disintegrated CTLL (ruptured by nitrogen cavitation) was accomplished by Percoll density gradient centrifugation of cell lysates (postnuclear supernatant). Individual fractions were tested for proteinase activity on chromogenic peptide substrates and for the presence of TSP-1 by Western blot analysis. In addition, each fraction was assayed for cytolytic activity against sheep red blood cells (SRBC), for protein and for additional marker enzymes to assess the enrichment for cellular organells. All serine enzyme type molecules including TSP-1 expressed by CTLL were identified by labeling cell lysates or gradient fractions with the serine proteinase-specific affinity ligand tritiated diisopropyl fluorophosphate [( 3H]DFP) in the presence or in the absence of class-specific or enzyme-specific proteinase inhibitors and subsequent sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The data demonstrate that the Percoll gradient fraction, which was shown by morphological examination in the electron microscope to be highly enriched for cytoplasmic granules, also contained greater than 80% of proteinase activity in addition to the granule associated structures cytolysin and arylsulfatase. The identity of the granule associated proteinase in two independent cell lines, CTLL HY3-Ag3 and CTLL 1.D.9, with the serine proteinase TSP-1 is indicated by its specificity for the chromogenic substrate H-D-Pro-Phe-Arg-p-nitroanilide, its sensitivity to class specific as well as TSP-1-specific enzyme inhibitors and by its reactivity with a polyvalent TSP-1-specific rabbit antiserum. Both CTLL contain a [3H]DFP-labeled protein that migrates with a molecular mass of 60 kDa under nonreducing conditions and with 30 kDa under reducing conditions and which can be inactivated by the TSP-1-specific inhibitor H-D-Pro-Phe-Arg-chloromethylketone. CTLL HY3-Ag3 (a long-term culture CTLL with natural killer-like activity) but not CTLL 1.D.9 (an antigen-specific short-term cultured CTLL) express in addition a further [3H]DFP-binding protein which migrates with 27 kDa under nonreducing or reducing conditions. No substrate specificity was found for this molecule. The possible function of the granule-associated serine proteinase TSP-1 is discussed. PMID- 3556196 TI - Kinetics of cellular oncogene expression in mouse lymphocytes. II. Regulation of c-fos and c-myc gene expression. AB - Newly isolated lymphocytes from mouse spleens express the c-fos oncogene even in the absence of mitogen with maximal mRNA levels 60 min post preparation of single cell suspension, whereas c-myc mRNA levels increase only after mitogenic stimulation with maximal mRNA levels 6 h post stimulation. The half-lives of c fos mRNA are generally very short; they increase from 14 min (after 30 min of culture) to 70 min (after 2 h of culture). The half-lives of c-myc mRNA decrease from 50 min (at 2 and 6 h post stimulation with concanavalin A) to 12 min (at 48 h post stimulation). The c-fos gene transcription is already turned on in time-0 lymphocytes 10 min after disruption of the organ structure of the spleens and is down-regulated after 2 h and later. In nuclear run-on experiments with nonstimulated lymphocytes there is already significant transcription of the first exon of c-myc, but almost no elongation of the transcript to exon 2 and 3. In concanavalin A-treated lymphocytes elongation is stimulated about 5-fold within 6 h and returns to background levels at 48 h post stimulation. The nuclear run-on analyses of nonactivated lymphocytes showed a signal for RNA complementary to c myc mRNA detected with a probe specific for the exon 1/intron 1 boundary of c myc, which disappeared with increasing time of concanavalin A stimulation. This anti-sense transcription may play a role in regulating the elongation of c-myc transcripts. PMID- 3556197 TI - Absence of [3H]SCH 23390 specific binding sites in anterior pituitary: dissociation from effects on prolactin secretion. AB - We extended a previous study that had shown the selective D1 receptor antagonist SCH 23390, at relatively high doses, to stimulate prolactin (PRL) secretion in the rat and weakly inhibit [3H]spiperone binding to striatum and anterior pituitary (AP) membranes. No specific [3H]SCH 23390 binding sites, up to the micromolar range, were detected in rat AP while specific, saturable [3H]SCH 23390 binding sites (low nanomolar range) were observed in the striatum. In vivo SCH 23390 (1 mg/kg s.c.) induced higher plasma PRL levels, not reversible by the D1 agonist SKF 38393. Similarly the postsynaptic serotonin (5-HT) antagonists metergoline and cyproheptadine did not influence the SCH 23390 effect on PRL. SCH 23390 was also unable to antagonize the decrease of PRL secretion induced by the selective D2 agonist LY 171555. However this latter compound prevented SCH 23390 as well as sulpiride from increasing the PRL concentrations above the control values. These data rule out the possibility that D1 or 5-HT receptors mediate the stimulation of PRL release by SCH 23390. This effect is more likely to be due to a weak indirect interaction with AP-D2 receptors, as indicated by the non competitive inhibition of [3H]spiperone binding to AP exerted by SCH 23390. Alternatively, non-specific mechanisms triggered by the multiple behavioral changes elicited by such high doses of SCH 23390 may be involved. PMID- 3556198 TI - Blockade of D-1 receptors by SCH 23390 antagonizes morphine- and amphetamine induced place preference conditioning. AB - Morphine (0.5 mg/kg s.c.) and amphetamine (1 mg/kg s.c.) used in a two compartment place preference test induced strong place preference when paired to the non-preferred environments. They did not modify preference under basal conditions but completely reversed morphine- and amphetamine-induced place preference. Pairing of haloperidol (0.2 mg/kg s.c.) to both environments also abolished the morphine-induced place preference. PMID- 3556199 TI - Heterogeneity in mechanisms of bradykinin action in canine isolated blood vessels. AB - The relaxation induced by bradykinin in helical strips of coronary arteries contracted with prostaglandin (PG) F2 alpha was abolished by removal of the endothelium and was markedly suppressed by treatment with methylene blue or AA861, a lipoxygenase inhibitor. Indomethacin did not alter the response. Renal arterial relaxation by bradykinin was partially reduced by removal of the endothelium. Indomethacin moderately attenuated the response in the strips with endothelium and additional treatment with methylene blue or AA861 suppressed the response further. Tranylcypromine or diphloretin phosphate, an antagonist of PGI2, attenuated the peptide-induced relaxation. In mesenteric veins, the relaxation induced by bradykinin was slightly reduced by removal of the endothelium; indomethacin reversed the relaxation to a contraction in the strips with or without endothelium. Des-Arg9-[Leu8]bradykinin, a bradykinin B1 antagonist, did not alter the relaxation due to bradykinin in coronary arteries but reduced the response of mesenteric veins. It appears that bradykinin-induced relaxation is associated exclusively with EDRF in dog coronary arteries, with both PGI2 and EDRF in the renal arteries, and only with PGI2 liberated from endothelial and subendothelial tissues in the mesenteric veins. The release of PGI2 and EDRF may be mediated by activation of B1 and B2 receptor subtypes, respectively. PMID- 3556200 TI - Defibrotide, an antithrombotic substance which prevents myocardial contracture in ischemic rabbit heart. AB - Defibrotide, a polydeoxyribonucleotide obtained from mammalian lungs, reduced in a dose-dependent fashion the ischemic contracture due to low perfusion (0.2 ml/min) of isovolumic left heart of rabbit and abolished the irregular rhythm of the heart, thereby restoring the cardiomechanical activity upon reperfusion (20 ml/min). Defibrotide stimulated the release of PG-like material from the heart in a dose-dependent manner without modifying the basal contractility. Both PGE2 and PGI2 (10 ng/ml) have an antiischemic activity on this preparation as shown by the partial reduction of the ischemic contracture and by the improvement of heart contractility upon reperfusion. Indomethacin infusion (1 microgram/ml) completely removed both the antiischemic activity of Defibrotide (400 micrograms/ml) and its ability to increase the generation of prostaglandins in the rabbit heart. These results suggest that Defibrotide has a beneficial influence on ischemic rabbit heart through an increase in prostaglandin synthesis. However other mechanisms not necessarily related to prostaglandin generation, such as a direct effect on membrane function deactivation and mitochondrial Ca2+ overload, should be considered in explaining the antiischemic activity of Defibrotide in the rabbit heart. PMID- 3556201 TI - Synthesis of enkephalinase B inhibitors, and their activity on isolated enkephalin-degrading enzymes. AB - Compounds in which a dipeptide moiety is linked to a metal chelating mercapto group were synthesized to obtain effective enkephalinase B inhibitors. Inhibitors containing two hydrophobic amino acid side-chains decrease enkephalinase B activity with a potency depending on the length of the spacer connecting the mercapto group and the dipeptide (IC50 values vary between 0.35 and 14 microM) and they also inhibit enkephalinase A and aminopeptidase activity. Compounds lacking the carboxy terminal side-chain are not recognized by enkephalinase B or aminopeptidase but are potent inhibitors of enkephalinase A. Our most potent enkephalinase B inhibitor is mercaptoacetyl-Phe-Phe (designated phelorphan), having an IC50 value of 0.35 microM for enkephalinase B. This compound also effectively inhibits enkephalinase A (IC50 = 0.02 microM) and aminopeptidase activity (IC50 = 13 microM). Phelorphan can therefore be considered as a complete inhibitor of enkephalin biodegradation. PMID- 3556202 TI - Effect of inhaled budesonide on severe steroid-dependent asthma. AB - Twenty-four patients with severe steroid-dependent asthma participated in a double-blind cross-over study performed in two centers. After a run-in period of 2 weeks when beclomethasone dipropionate (BDP) (400 micrograms/day) was used, the patients were treated for 4 weeks with either a high-dose (1600 micrograms/day) or a low-dose (400 micrograms/day) of budesonide (Pulmicort). Thereafter the doses of budesonide were switched and the treatment continued for a further 4 week period. Patients treated with high-dose budesonide displayed significant improvements in airway functions. In addition, subjective scores for cough, sputum production and dyspnoea were more improved in the high-dose group than in the low-dose group. The need for concomitant beta 2-agonist therapy was also significantly reduced during the high-dose treatment. No significant changes in plasma cortisol levels were detected and no adverse effects of importance were registered. The results indicate that high-dose budesonide treatment improves the clinical status of patients with severe steroid-dependent asthma more than a low dose therapy but without causing systemic side-effects. PMID- 3556203 TI - Inhibition of gastric acid secretion evoked by activation of the hypothalamic paraventricular nucleus. AB - Electrical stimulation of the paraventricular nucleus depressed the gastric acid output of adrenalectomized male rats of which gastric acid output had been induced by insulin hypoglycemia. Electrical stimulation of the pituitary stalk produced a similar secretory response, but the response was abolished by bilateral lesion of the paraventricular nucleus. These findings allow us to speculate that the paraventricular nucleus is capable of modulating gastric acid secretion, and suggest that the nucleus has a neural connection between the neurohypophysis and the system relevant to gastric acid secretion. PMID- 3556204 TI - Repair of severed peripheral nerves: comparison of the "de Medinaceli" and standard microsuture methods. AB - The return of function following transection of the rat sciatic nerve has been assessed after repair by either standard microsurgical techniques (i.e., the use of microsutures to coapt the severed ends) or the new repair technique introduced by de Medinaceli and coworkers. The regeneration after transection was compared with that following sciatic nerve crush, i.e., a lesion in which the return of function is near optimal. Return of function was monitored serially using walking track analysis (i.e., the sciatic functional index, which indicates overall functional performance), the ability to spread the toes (which indicates intrinsic function in the foot), and the determination of muscle twitch tension of the middle digit. Function in the nerve crush group returned to within the normal range by 53 days, but function in the transection and repair groups did not return to normal before the rats were perfused at 85 postoperative days. However, the function regained when nerves were repaired with the de Medinaceli technique was significantly superior to that regained after repair with microsutures. Histological examination of the repair site (at 85 days) revealed that the regenerated nerve fibers in the de Medinaceli group crossed the site of anastomosis in a relatively orderly fashion, whereas they were more randomly arranged when microsutures were used. However, there was no statistical difference between the two groups in the number of regenerated fibers present in the distal stump. The increase in function in the de Medinaceli group may therefore arise primarily from an increase in the proportion of regenerating fibers which reach appropriate targets.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556205 TI - Fetal-type creatine kinase in rat fast and slow muscles during denervation and reinnervation. AB - Creatine kinase (CK) has three forms of isozymes; CK-BB, CK-MB, and CK-MM. In adult rats they show a specific tissue distribution: the BB form in the brain, the MB form in the heart, and the MM form in skeletal muscle. In embryonic skeletal muscles only the BB and MB forms are found. Adult slow-twitch muscles contain more fetal type creatine kinase (CK-B) than do fast-twitch muscles. In the present experiment the effect of denervation and reinnervation on the CK-B concentration was investigated in rat fast (extensor digitorum longus)- and slow (soleus)-twitch muscles by a highly sensitive immunoassay. Denervation of these muscles produced a progressive increase in CK-B concentration in both muscles. When the sciatic nerve was cut and immediately sutured, the CK-B concentration in both muscles showed a gradual reduction after an initial increase. By the 34th postoperative week the CK-B concentration in the soleus was about one-half that of the contralateral control, whereas that in the extensor digitorum longus was nearly normal. After cross union of the nerves innervating the muscles, the CK-B concentration in the soleus was reduced at 35 weeks to about one-half normal, but that in the extensor digitorum longus was always higher than the control value. After self-reunion of the nerves, the CK-B concentration at the 20th week was approximately normal in the extensor digitorum longus and significantly increased in the soleus. We suggest that the motoneurons normally innervating the extensor digitorum longus have a greater capability in suppressing the production of CK-B than do the soleus motoneurons. PMID- 3556206 TI - Trypanosoma lewisi: restriction of alternative complement pathway C3/C5 convertase activity. AB - The rat parasite Trypanosoma lewisi was incubated in vitro with rat or human serum, washed, and extracted in detergent. Extracts were fractionated by electrophoresis in denaturing gels, transferred to nitrocellulose, allowed to renature, then immunoblotted with polyclonal antibodies to rat complement component C3 and human complement components C3, C5, and factor B. Molecules that reacted with these antibodies were detected in the extracts. Fragments of rat C3 were detected in extracts of parasites that had not been exposed to serum in vitro. Additional complement deposition occurred during in vitro incubations; human complement components deposited in vitro could be distinguished from rat components deposited in vivo. Complement deposition in vitro required magnesium ions and did not occur when heat inactivated serum was used. Components reacting with antibodies to human C3 included a group of bands with molecular weights higher than C3 alpha or beta chains. Blotting with affinity purified, chain specific antibodies demonstrated that a 68 kDa component on parasites is C3 beta and that a 44 kDa molecule is derived from C3 alpha. A 73 kDa component that was difficult to resolve from C3 beta is probably also a C3 alpha fragment. This suggests that an inactive iC3b-like molecule is present on parasites. Kinetic studies showed that cleavage of C3 alpha is rapid and that the amount of C3 alpha fragments and C3 beta on intact parasites reached a steady state after 15 min. When parasites were trypsinized prior to incubation in C5 or C6 deficient serum, the rate and extent of C3 and C5 deposition increased. Unprocessed C3 alpha' and C5 alpha' chains were detected. Trypsinized parasites were lysed by the alternative complement pathway in normal serum. Intact parasites could be lysed by complement in the presence of antibody. The data support our previous suggestion that trypsin sensitive surface proteins on intact T. lewisi limit alternative pathway activity by restricting C3/C5 convertase activity. PMID- 3556207 TI - Plasmodium berghei: cloning of the circumsporozoite protein gene. AB - A DNA fragment encoding the carboxy terminal 80% of the Plasmodium berghei circumsporozoite protein was selected from a genomic DNA expression library. Sequencing revealed that the P. berghei circumsporozoite protein was similar in overall structure to circumsporozoite proteins from other malaria species, although the central repeat region was unique in comprising two different blocks of tandem peptide repeats: 11 eight amino acid repeats with predominant sequence DPAPPNAN were followed by 16 two amino repeats, predominantly PQ. The P. berghei circumsporozoite protein exhibited limited, but about equal amino acid homology to circumsporozoite proteins from P. knowlesi, P. vivax, and P. falciparum, indicating that P. berghei is not closely related to any of these other malaria species. Cloning of the P. berghei circumsporozoite protein gene will allow direct testing of sporozoite vaccines in mice. PMID- 3556208 TI - Pneumocystis carinii: immunoblotting and immunofluorescent analyses of serum antibodies during experimental rat infection and recovery. AB - Serum antibodies to Pneumocystis carinii were measured in rats by the indirect fluorescent antibody and immunoblotting techniques. Serum IgG and IgM antibodies developed with environmental exposure to P. carinii, were low or absent during immunosuppression to induce P. carinii pneumonia, and rose when immunosuppression was withdrawn. The IgG and IgM antibodies formed at the same time, but the titers of each antibody varied in individual rats. Serum IgG antibodies by immunoblotting recognized bands of 45, 50, and 116 kDa as the major reactive moieties of P. carinii. The bands were detected with sera from all rat groups in a temporal pattern which closely paralleled antibody formation by indirect immunofluorescence. The pattern of immunoblotting reactivity varied among individual rats, particularly with immunosuppression. Additional bands were detected with prolonged exposure to P. carinii. Thus, the rat makes both IgG and IgM antibodies to P. carinii, and specific P. carinii antigens identified in this immune response might be targeted for future serologic studies. PMID- 3556209 TI - Transformations of arsenic in the marine environment. AB - It is ten years since arsenobetaine was first isolated from the western rock lobster Palinurus cygnus. Subsequently this naturally-occurring arsenical has been found in many species of marine animals contributing to the human diet. The identification of arsenic-containing ribofuranosides in algae and the production of dimethylarsinoylethanol from their anaerobic decomposition has allowed speculation on arsenic metabolism in marine organisms and has suggested a possible route to arsenobetaine from oceanic arsenate. PMID- 3556210 TI - Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection. AB - A seroepidemiological study was performed on HTLV-III, T. pallidum, C. trachomatis and Hepatitis B virus (HBV), in Butare, Rwanda, among 33 female prostitutes, 25 male customers of prostitutes, and 60 male and female controls. As compared with female controls the prostitutes had a higher prevalence of antibodies to HTLV-III (29/33 versus 4/33, p less than 0.001), T. pallidum (TPHA: 27/33 versus 6/33, p less than 0.001; RPR: 19/33 versus 2/33, p less than 0.001; FTA-Abs: 27/33 versus 5/33, p less than 0.001) and C. trachomatis (IgG IF: 31/33 versus 13/33, p less than 0.001). HBV serological markers were more often detected in the prostitutes than in the female controls (31/33 versus 18/33, p less than 0.001) although HBs antigen carriage rate was similar in both groups. As compared with male controls, the male customers of prostitutes had more frequently detectable antibodies to HTLV-III (7/25 versus 2/27, p = 0.05), and a positive RPR (10/25 versus 1/27, p less than 0.01). Among the 118 individuals studied, odds ratios and trend analysis disclosed a significant association between HTLV-III seropositivity and a positive TPHA, RPR, FTA-Abs, Chlamydia IgG IF test and serological markers to HBV. No association was found between HTLV-III seropositivity and HBs Ag carriage. This study suggests that HTLV-III has to be considered as an infectious agent transmitted among promiscuous Central African heterosexuals by sexual contact and/or parenteral contact with unsterile needles used for STD treatments. PMID- 3556211 TI - A review of statistical methods for continuous monitoring of malformation frequencies. AB - Six statistical methods for monitoring of populations are reviewed with special reference to surveillance of congenital malformations. Their characteristics are compared; their relative efficiencies are assessed through both analytical and numerical comparisons. The cumulative sum technique appears to be convenient from most points of view; particular cases in which other methods may be preferred are discussed. PMID- 3556212 TI - [Effect of haloperidol, diazepam and sodium oxybutyrate on the antinociceptive activity of opioid agonists administered via the theca medullaris spinalis]. AB - At intrathecal administration the antinociceptive effect of morphine and DADL significantly exceeds the antinociceptive effect of pentazocine (ED50 in tail flick test were 1.1, 1.64, 75.0 nmol per mouse and in "writhing" test 0.0064, 0.0047, 24.53 nmol per mouse, respectively). All the agonists tested exhibited significantly higher activity at chemical stimulation than at thermal one. During the analysis of pA2 of naloxone during the interaction with morphine, DADL and pentazocine under thermal and chemical stimulation a pronounced mu-receptor component in the effect of DADL and pentazocine was suggested. A preliminary subcutaneous injection of sodium oxybutyrate (150 mg/kg) fails to change the activity of opioids administered intrathecally. Diazepam (5 mg/kg, subcutaneously) enhances the antinociceptive activity of DADL only at chemical stimulation. Haloperidol (2 mg/kg) increases the antinociceptive effect of morphine and DADL at pain stimulation of both types but exerts no influence on the analgesic effect of pentazocine. Haloperidol produces the most pronounced enhancement of the spinal component of delta-agonist DADL antinociceptive action. The enhancing effect of haloperidol is realized at the supraspinal level. PMID- 3556213 TI - [Means for enhancing the effectiveness of immunostimulants]. PMID- 3556215 TI - Localization of possible functional domains in sup2 gene product of the yeast Saccharomyces cerevisiae. AB - Primary structures of yeast sup2 gene and polypeptide product coded by the gene are compared with the current nucleotide and amino acid sequence data base. The amino acid sequence of the sup2 product shows homology to elongation factors from different sources. Especially high homology is found in the regions, corresponding to conservative aminoacyl-tRNA- and GTP-binding domains, described in elongation factors and other proteins. The data obtained are discussed in relation to the functions of sup2 polypeptide product in protein synthesis. PMID- 3556214 TI - [Influence of prostaglandin synthesis blockade on the immunosuppressive effect of serotonin and haloperidol]. AB - Administration of indomethacin (1.5 and 10 mg/kg) to CBA mice was found to produce a considerable increase of the number of plaque- and rosette-forming cells irrespective of the dose and the interval between its injection and immunization of the mice with ram erythrocytes (5 X 10(6)). The immunogenesis stimulation preserved in the mice after a lesion of the pituitary peduncle. Indomethacin was shown to prevent a decrease of the immune response produced by administration of serotonin (50 mg/kg) and haloperidol (1 mg/kg). PMID- 3556216 TI - The amphiphilicity of ACP helices: a means of macromolecular interaction? AB - ACP interacts with diverse proteins in an unknown way. Possibly there is a similar mode of interaction between ACP and all ACP-binding proteins, the amphiphilic helix. The hydrophobicities of helices from 4 different ACPs were compared. Hydrophobic moment plots were prepared for ACP helices and those of many EF hand calcium-binding proteins. Both groups of proteins occupied the same region of the plot. PMID- 3556217 TI - The prephenate dehydrogenase component of the bifunctional T-protein in enteric bacteria can utilize L-arogenate. AB - The prephenate dehydrogenase component of the bifunctional T-protein (chorismate mutase:prephenate dehydrogenase) has been shown to utilize L-arogenate, a common precursor of phenylalanine and tyrosine in nature, as a substrate. Partially purified T-protein from Klebsiella pneumoniae and from Escherichia coli strains K 12, B, C and W was used to demonstrate the utilization of L-arogenate as an alternative substrate for prephenate in the presence of nicotinamide adenine dinucleotide as cofactor. The formation of L-tyrosine from L-arogenate by the T protein dehydrogenase was confirmed by high-performance liquid chromatography. As expected of a common catalytic site, dehydrogenase activity with either prephenate or L-arogenate was highly sensitive to inhibition by L-tyrosine. PMID- 3556218 TI - Expression of ricin A chain in Escherichia coli. AB - DNA encoding ricin A chain was derived from preproricin cDNA and ligated into the expression vector pDS5/3. Transcription is controlled from the coliphage promoter PN25 fused with the lac operator of E.coli. When induced, E.coli 71.18 cells transformed with the recombinant plasmid express ricin A chain which is soluble and has full biological activity. PMID- 3556219 TI - Immunoblotting and ligand blotting of the low-density lipoprotein receptor of human liver, HepG2 cells and HeLa cells. AB - Low-density lipoprotein receptors from adult human liver and the human hepatoblastoma cell line HepG2 were analyzed by polyacrylamide electrophoresis in SDS followed by immuno- and ligand blotting. In both liver and HepG2 we detected a protein band with apparent relative molecular mass of 130 kDa, which is similar to that of the LDL receptor in fibroblasts. In addition we showed that HeLa cells also possess this LDL-receptor protein. PMID- 3556220 TI - [The 1st Russian pediatrician S. F. Khotovitskii]. PMID- 3556221 TI - [Permeability of the hemato-encephalic barrier and the sciatic nerve hemato neuronal barrier to serum proteins in the guinea pig]. PMID- 3556222 TI - [Role of biogenic amines and acetylcholine in regulating hypothalamo-thyroid interaction]. PMID- 3556223 TI - [Condition of the periodontium of teeth supporting single-abutment free-end prostheses]. PMID- 3556224 TI - [Free-end prostheses in the light of the literature]. PMID- 3556225 TI - [Survey of the contents of volumes II, XXV, L and LXXV of the journal Fogorvosi Szemle]. PMID- 3556226 TI - [Experience with the use of the metronidazole-containing paste (Grinazole) in root canal therapy of gangrenous teeth]. PMID- 3556228 TI - [Changes in the efficiency coefficient of muscles and regulation of body heat production]. PMID- 3556227 TI - [Experience with anchoring of the subtotal prosthesis using the Ceka anchoring system]. PMID- 3556229 TI - [Efficacy of regulation of the vascular tone of the lungs]. AB - Vasomotor responses to activation of sympathetic and parasympathetic lung nerves were studied in the minor circulation, as well as the effect of some vasoactive substances upon vessels and changes in the alveolar air composition. The efficacy of neurohumoral and physical stimuli influence upon the lung resistance function seems to be more obvious at the local level rather than at organic one. This is reflected in actualization of the lung vasomotor control mainly through regional redistribution of the lung blood flow at minimal shifts of the integral vascular resistance. Active changes of the tone of the minor circulation vessels may participate in formation of the lung blood volume shifts in transitory states of the circulation system. Physiological significance of changes in the resistance and capacitance functions of the lung vessels, is discussed. PMID- 3556230 TI - Extracoronal clasp design for the distal extension removable partial denture. PMID- 3556231 TI - Neonatal shigellosis: a case report. PMID- 3556232 TI - [Comparison of castings obtained using 2 impression materials. Van-R reversible hydrocolloid and vinyl polysiloxane 3M Express]. PMID- 3556233 TI - [A prosthesis for the severe loss of maxillofacial substance. I]. PMID- 3556234 TI - [Artificial gingiva in fixed dentures]. PMID- 3556235 TI - [A prosthesis for the severe loss of maxillofacial substance. II. Loss of mandibular substance]. PMID- 3556236 TI - [Evaluation of the margin edge. Factors to improve the fit]. PMID- 3556237 TI - [Controlled application of a retention agent--no penetration into the adhesive. Light polymerization makes it possible. Experiences with a new retention system]. PMID- 3556238 TI - [Induction heated vacuum pressure casting. A prospective reliable casting technic]. PMID- 3556241 TI - [A modified double flask. A simplified method with greater precision]. PMID- 3556240 TI - [Problems in the precision fit of the margin edges of cast crowns]. PMID- 3556239 TI - [Structural change in the field of alloys? Experiences with a cobalt-chromium alloy]. PMID- 3556242 TI - [The non-reduction treatment--age-specific dentures. Likewise the tooth finds its groove. Phantom models for 3 age groups]. PMID- 3556244 TI - [Masterful dental technic. The way to the "Golden Parallelometer"]. PMID- 3556243 TI - [Principles of construction for implant-borne dentures. Use of the J.B. crossbar block. Practical retention of the superstructure]. PMID- 3556245 TI - [Development of synthetic resin veneering method. Tips and strategies for the clinician]. PMID- 3556246 TI - [Skillful dental technic. The method with the "Golden Parallelometer"]. PMID- 3556247 TI - [Parallel milling tool with a beveled surface on the cutting angle]. PMID- 3556248 TI - [Good ideas help spare a set screw that undergoes friction]. PMID- 3556250 TI - [Unipress-injection method. No current--no compressed air--no hydraulics]. PMID- 3556251 TI - [Casting jackets for overlay constructions. A method to improve friction]. PMID- 3556249 TI - [Use of a modified telescope. An answer for chronic shortage of space]. PMID- 3556252 TI - [Skillful dental technic. A method with the "Golden Parallelometer"]. PMID- 3556253 TI - The new implant systems: a comparative analysis. PMID- 3556254 TI - The diagnostic value of ultrasonography and sialography in salivary gland masses. PMID- 3556255 TI - The wastage of microbial samples in clinical practice. PMID- 3556256 TI - Chlorhexidine for prevention of neonatal colonization with group B streptococci. IV. Depressed puerperal carriage following vaginal washing with chlorhexidine during labour. AB - The effect of vaginal washing with chlorhexidine acetate, 2 g/l at delivery, on the colonization of the urogenital tract with group B streptococci (GBS) 4 days later was investigated. Patients who were culture-positive for GBS in urethra and/or cervix in pregnancy weeks 32 and 36 as well as at delivery were included in a prospective study. The washing procedure was performed in 31 parturients, and 10 (32%) were culture-negative at day 4 after delivery. In contrast, only 7/47 (15%) non-washed controls were negative at day 4 (p = 0.044). The results demonstrate a prolonged suppressive effect of vaginal washing with chlorhexidine on the recovery of GBS from the urogenital tract in this highly selected patient group. PMID- 3556258 TI - Compartmentalization of cholesterol in hepatic and intestinal cells: implications for bile and lipoprotein secretion. PMID- 3556257 TI - Treatment of clue cell-positive discharge with 200 mg povidone-iodine pessaries. A double-blind and placebo-controlled trial. AB - In a double-blind randomized study we evaluated the efficacy of povidone-iodine in the treatment of clue cell-positive discharge (CCPD). Vaginal pessaries (200 mg povidone-iodine or placebo) were taken twice daily for five consecutive days. Although the regimen was reasonably well accepted, 'messiness' was reported by 13 of 33 women (39%). Of 44 women enrolled, treatment efficacy was evaluated in 28 women who had both follow-up visits. There was no significant difference in the efficacy of povidone-iodine and placebo pessaries, at either the first or the second follow-up visit (p values 0.46 and 1 respectively). It is concluded that the use of povidone-iodine pessaries, at least in the regimen described, cannot be regarded as an effective therapy for CCPD. PMID- 3556259 TI - Human apolipoprotein B: complete cDNA sequence and identification of structural domains of the protein. PMID- 3556260 TI - Pharmacological modification of lipoprotein metabolism. PMID- 3556261 TI - A comparison of pivmecillinam/pivampicillin and amoxycillin in acute exacerbations of chronic bronchitis. AB - Courses of 7 days on either 200 mg pivmecillinam/250 mg pivampicillin given twice daily or 250 mg amoxycillin given three times daily were compared in 3783 general practice patients with acute exacerbations of chronic bronchitis in a single blind parallel group study. Patients on pivmecillinam/pivampicillin had significantly more 'excellent' responses, although there was no difference in overall response between treatments. Post-treatment sputum colour and consistency and peak expiratory flow rates were significantly better with pivmecillinam/pivampicillin. The incidence of side-effects was the same for both groups (approximately 10%), although significantly more patients reported lower gastro-intestinal problems with amoxycillin. Treatment was withdrawn due to side effects in 47 (2.5%) patients on pivmecillinam/pivampicillin and 51 (2.7%) patients on amoxycillin. Amoxycillin is a standard therapy in the treatment of patients with acute exacerbations of chronic bronchitis. In this study, however, it was shown that pivmecillinam/pivampicillin offers benefits over amoxycillin in these patients. PMID- 3556262 TI - A treatment for the acute migraine attack. AB - A compound analgesic/anti-emetic formulation was significantly effective in reducing the severity of acute attacks of migraine, in a double-blind, randomized, crossover trial of 34 patients referred to a migraine clinic. The preparation contained paracetamol (acetaminophen) 500 mg, codeine phosphate 8 mg, buclizine hydrochloride 6.25 mg and dioctyl sodium sulphosuccinate 10 mg. The dosage was two tablets taken as early as possible in the acute attack. No specific factors could be identified which influenced response to treatment. Patients with a long history of migraine (more than 10 years) responded as well as those with a recent onset of the condition. PMID- 3556263 TI - Analgesic efficacy and side-effect profile of paracetamol/codeine and paracetamol/dextropropoxyphene after surgical removal of a lower wisdom tooth. AB - A double-blind randomized analgesic trial was carried out on 180 patients undergoing surgical removal of an impacted lower wisdom tooth. The patients took their first dose of either 1000 mg paracetamol plus 60 mg codeine or 650 mg paracetamol plus 65 mg dextropropoxyphene when pain appeared after the decline of the local anaesthesia. If needed, another two doses were available during the observation period (less than or equal to 10 h). The analgesic efficacy of paracetamol/codeine was overall superior to paracetamol/dextropropoxyphene in all variables. Sufficient pain relief was obtained in most patients. The pain reduction after the first dose was 64% in the group receiving paracetamol/codeine compared with 53% in the group receiving paracetamol/dextropropoxyphene and the mean durations of effect of the first dose were 6.6 and 5.8 h, respectively. Side effects appeared in all patient groups but were most frequent in women taking paracetamol/codeine. PMID- 3556264 TI - Analgesic efficacy of paracetamol/codeine and paracetamol/dextropropoxyphene in pain after episiotomy and ruptures in connection with childbirth. AB - Pain after episiotomy and/or perineal/vaginal rupture in childbirth is severe in many patients and in most cases it can be treated with oral analgesics. In this trial the efficacy and side-effect profile of two combination analgesics, paracetamol/codeine and paracetamol/dextropropoxyphene hydrochloride, were compared in post-partum pain after episiotomy and/or rupture of the perineum. Eighty-five patients were analysed for efficacy and 96 were included in an analysis of side-effects. Paracetamol/codeine was shown to give faster and more efficient pain relief while not causing constipation or other troublesome side effects. PMID- 3556265 TI - Studies on the role of insulin in N metabolism changes in cafeteria-fed rats. AB - The present work studies the serum insulin response to cafeteria feeding and the possible role of this hormone in the marked N retention induced by cafeteria feeding. Rats fed a cafeteria diet for periods of 10, 20 and 30 days showed a significant and progressive increase in serum insulin levels. In order to elucidate the possible intervention of this hormone in the marked N retention induced by cafeteria feeding we studied the changes in N metabolism in non diabetic and streptozotocin-diabetic rats fed a cafeteria diet for 10 days. The amount of N ingested was the same in all experimental groups. Our results suggest that insulin is not absolutely indispensible in the N retention exhibited by cafeteria-fed rats, inasmuch as cafeteria feeding also promotes a decrease in N excretion in streptozotocin-diabetic rats. This is in accordance with the reduction in urea excretion and the activities (U/g liver) of the ureogenic enzymes in streptozotocin-diabetic rats fed a cafeteria diet. PMID- 3556266 TI - Down-regulation of insulin receptors in Propionibacterium acnes-activated macrophages in the mouse. AB - Intraperitoneal administration of Propionibacterium acnes in CD-1 mice was associated with the reduction in number of insulin receptors in peritoneal macrophages (M phi), and with elevated levels of insulin in plasma and the peritoneal cavity. When insulin levels returned to normal, insulin receptors in P. acnes-M phi were still reduced. Insulin appears to contribute significantly to the down-regulation of the M phi-insulin receptors during the early stage of activation. Other biologically active substances released during M phi activation might assume greater influence on insulin resistance in activated M phi at a later stage. The induction of transient hyperinsulinemia in P. acnes-treated mice might be attributed to the effect of concurrently elevated interleukin-1 (IL-1) released in the early course of M phi activation. PMID- 3556267 TI - The migration of myogenic cells from the somites at the wing level in avian embryos. AB - This study is concerned with establishing a morphological basis for the initiation of migration of putative myogenic cells from the somites into the presumptive wing bud in avian embryos. At the 22 somite stage (stage 14) vasculogenesis is a prevalent activity. By use of a quail specific monoclonal antibody to vascular endothelial cells, vascular cells are recognized in the lateral plate, on the intermediate mesoderm, and on somite surfaces. Cells that are found between the lateral plate mesoderm and somites are shown to be vascular endothelial cells. The lateral body folds progressively bring the lateral plate mesoderm close to the lateral margin of the somites and vascular elements disappear from surface view. It is not until the 24 somite stage (stage 15) that some cells in the ventral lateral margin of somites at the wing level can be seen in scanning electron micrographs to extend basal cell processes toward adjacent vascular tubes. These results provide a morphological basis for the early migratory behavior of myogenic cells and demonstrate their close proximity to the prepatterned vascular network. PMID- 3556268 TI - Epigenesis in developing avian scales. III. Stage-specific alterations of the developmental program caused by 5-bromodeoxyuridine. AB - As an approach to the study of a developmental program, 5-bromodeoxyuridine (BrdU) was administered to chick embryos in ovo at various stages of avian scale formation. This brought about stage-specific alterations in morphogenesis in the anterior tarsometatarsus such as feathered scales, from Day 6 through Day 6 1/2; feathers only, from Day 6 3/4 through Day 7 1/4; scalelessness and rudimentary scales, from Day 7 7/8 through Day 8 1/8; and partial ridge scales, from Day 8 1/8 through Day 10. The effects of BrdU were completely nullified by an excess dose of thymidine which instantly suppressed BrdU incorporation into nuclear DNA. Effects of BrdU causing scalelessness were further examined. The percentage of BrdU labeled cells was immunohistochemically detected. It increased linearly in both the epidermis and dermis, reaching nearly 100% 24 hr following its injection on Day 8. However, scale forming potency, as assayed by the area of scale epidermis on Day 11, decreased with the duration of BrdU incorporation into the cells and disproportionately dropped at 15 hr when about 50% of the cells had incorporated BrdU. Scalelessness was also produced when the period of the incorporation of BrdU exceeded 15 hr. Time sequence observations demonstrated epidermal cell shape, polarity, alignment, and packing density to be remarkably disordered so that the placode and interplacode failed to develop on Day 9 1/4. Epidermal-dermal recombinations were carried out by exchanging normal tissues with those treated with BrdU in the anterior tarsometatarsus. The results clearly showed defects in the dermis at the time of reassociation, giving rise to scalelessness. PMID- 3556270 TI - Application of sensors for the determination of physical and biochemical parameters in the fermentation of animal cells. AB - Biosensors, sondes, and transducer elements are reviewed with respect to the application for fermentation processes of animal cells. Hereby, the possible connection of these elements to the fermentor is shown. Specially, the (possible) online determinations of the viable and total cell count, of the glucose, the lactate, the pyruvate, and the ammonia concentration in the medium of fermentors are presented. Finally, some sensors for the on-line estimation of the product concentration are described. PMID- 3556269 TI - On the macromolecular composition of the zona pellucida from porcine oocytes. AB - The chemical and immunological relation between the glycoprotein components of the pig oocyte zona pellucida resolved by two-dimensional polyacrylamide gel electrophoresis was investigated. After disulfide bond reduction, four microheterogeneous glycoprotein components with apparent molecular weights of 25K, 55K, 65K, and 90K were resolved. When disulfide bonds were left unreduced, two microheterogeneous glycoprotein components were resolved with apparent molecular weights of 55K and 90K. Actin was present, but as a contaminant of the zona pellucida rather than as a true component. The structural relation of these components was investigated using deglycosylation with trifluoromethane-sulfonic acid, limited proteolysis with Staphylococcus aureus V8 protease, amino acid and carbohydrate composition analyses, sequence analysis, and monoclonal antibodies. The 25K and 65K components comigrated with the 90K component when disulfide bonds were not reduced. When the intermolecular disulfide bonds crosslinking the two components were reduced, the 25K and 65K components behaved independently. The 25K and 65K components were derived from the 90K glycoprotein family by proteolysis. The 25K component originated from the C-terminal end, and the 65K component from the N-terminal end of the 90K glycoprotein. The 55K component was composed of two chemically and antigenically distinct glycoproteins, termed 55K alpha and 55K beta, that electrophoretically comigrated. The N-terminal amino acid of the 55K alpha family was blocked. The 55K beta family had an N-terminal amino acid sequence of Asp-Val-Pro-Thr-Ile-Gly-Leu-Ser-X-Ala-Pro-Thr. Thus, the two to four electrophoretic components of the zona pellucida observed on gel electrophoresis are derived from three glycoprotein families. PMID- 3556271 TI - Proteolytic activity in the culture supernatants of mouse hybridoma cells. AB - When serum-reduced or serum-free culture supernatants were incubated for 16 hours at 37 degrees C, more than 70-80% of original proteins were digested as measured by gel electrophoretic analysis. The proteolytic activity, which was only observed at pH values lower than 4.5, was reduced in conditioned medium containing higher concentrations of fetal calf serum. During incubation large amounts of the monoclonal antibody (IgG1) were cleaved giving F(ab')2 fragments. The results reported here strongly suggest that the conditioned medium of mouse hybridoma cultures contain probably two cellular (acid) proteases with apparent MW of 45-50 K and 90-95 K, respectively. The similarities with the lysosomal cathepsin D are discussed. PMID- 3556273 TI - Purification of monoclonal antibodies produced in vitro by using Ultroser HY as culture medium. PMID- 3556272 TI - Production of carcinoembryonic antigen from a human colon adenocarcinoma cell line. II. Use of monoclonal antibodies to carcinoembryonic antigen for antigen purification and characterization. AB - Monoclonal antibodies (McAbs) were prepared against carcinoembryonic antigen (CEA), derived from human metastases to the liver of primary colon adenocarcinoma. A stable clone, secreting monoclonal anti-CEA antibody (Ab), was selected. The hybridoma cells were grown in BALB/C mice, forming ascites fluids containing 2-5 mg/ml of the relevant McAbs. Ascites fluids were purified using a DEAE-Sephacel column. The purified immunoglobulin fraction was characterized as IgG2b, having a dissociation constant of 2 X 10(-9)M. The potential use of these McAbs for CEA diagnosis and purification was evaluated: the IgG2b fraction, when bound to Sepharose 4B, facilitated the purification of CEA from spent media of a human colon adenocarcinoma cell line, resulting in iodination grade CEA; the anti CEA McAbs demonstrated differential histochemical staining of various sections, both fresh and fixed; the McAbs were also found to be suitable as tagging Abs in a CEA RIA. PMID- 3556274 TI - Production of human alpha-inteferon in silkworm using a Bombyx mori nuclear polyhedrosis virus vector. PMID- 3556275 TI - S-phase cell detection with a monoclonal antibody. AB - The use of a newly developed monoclonal antibody against Bromodeoxyuridine is demonstrated in a study with V79 Chinese hamster cells. It can replace radioactive material in cell cycle analysis studies in the way that BrdU incorporated into the DNA during S-phase is detected by immunofluorescence. By this technique the proportion of actively synthesizing S-phase cells can be determined. The proportion of such cells is a good measure with regard to the quality of a culture and/or medium in question. The method is fast and offers within 3-5 hours the possibility to analyse growth conditions in monolayers and suspension cultures. PMID- 3556276 TI - D. O. Hebb and the developmental organization of behavior. PMID- 3556277 TI - Spontaneous reassociation of dispersed adult rat pancreatic islet cells into aggregates with three-dimensional architecture typical of native islets. AB - Islets of Langerhans consist of four major endocrine cell types assembled in a highly organized manner critical for their function. The molecular forces governing islet cellular architecture are not understood. We determined whether adult rat islet cells carry information necessary for orderly assembly. Dispersed cells from adult rat islets were maintained in static suspension culture for 6 days. During this time the cells reassociated to form numerous aggregates. These aggregates were approximately half the size of native islets with a commensurate reduction in DNA and insulin content. However, both cellular composition and organization were remarkably similar to that of adult rat islets, in which the beta-cells form a central core surrounded by a discontinuous mantle of non-beta cells. Thus, immunoperoxidase staining showed that in the aggregates, just as in intact islets cultured in parallel, 26% of the cells were non-beta-cells and of these, 94% were clearly peripheral. Non-beta-cells were similarly found to be peripheral, with beta-cells located centrally, even when the ratio of non-beta cells to beta-cells had been altered. This was achieved by sorting the two cell populations by fluorescence-activated flow cytometry, resulting in aggregates with 79% non-beta-cells and 21% beta-cells. Insulin release from the aggregates was stimulated approximately ninefold by raising glucose from 50 to 300 mg/dl, which was comparable to that found for intact islets. The spontaneous formation of isletlike aggregates displaying appropriate cellular architecture indicates that the signals (molecules) needed for such organization are intrinsic to islet cells and are still expressed by them in adult life. PMID- 3556278 TI - Role of the oropharynx in regulation of glycemia. AB - Previous studies have demonstrated that reflexes originating from the oral cavity at the start of food intake are necessary to ensure a normal glucose tolerance. In our experiment, the underlying mechanisms of these reflexes were studied in conscious, freely moving rats bearing chronic catheters. A double-isotope technique was used to measure, under non-steady-state conditions, rates of total glucose appearance (total Ra), total glucose disappearance (Rd), gut glucose absorption (gut Ra), hepatic glucose production (HGP), and the metabolic clearance rate of glucose (MCRg). In random order, 1 wk apart, rats either spontaneously drank 1 ml of a 60% glucose solution or were given the same dose into the stomach via a chronic gastric catheter. Glycemia and insulinemia were lower when glucose was taken orally than when the same amount of the substrate was administered intragastrically. Total Ra after glucose administration was the same in both groups throughout the experiment. Despite lower insulin and glucose values, the increase in Rd was initially higher in the oral group than in the intragastric group. This was accompanied by initial higher MCRg values in the oral group than in animals that received the glucose load directly into their stomachs. We conclude that a series of reflexes elicited by oral glucose ingestion improve glucose tolerance by increasing the efficiency of glucose disposal in the early stages after a glucose load, with a smaller amount of insulin released. PMID- 3556279 TI - Treatment with anti-T-lymphocyte antibodies prevents induction of insulitis in mice given multiple doses of streptozocin. AB - The importance of T-lymphocytes in the induction of insulitis and hyperglycemia in certain strains of mice treated with multiple subdiabetogenic doses of streptozocin has been a matter of controversy. To understand the role of T lymphocytes, we treated thymectomized BALB/c ByJ mice with five daily doses of streptozocin (45 mg/kg) and determined the effect of treatment with monoclonal antibodies against T-lymphocyte subsets on the development of diabetes and insulitis. Hyperglycemia (mean glucose of 321 +/- 29 vs. 167 +/- 15 mg/dl in controls) and insulitis were induced in BALB/c ByJ mice given streptozocin. Thy1.2+, L3T4, and Lyt2+ cells were all identified within the islets of diabetic mice. There was a relative paucity of L3T4+ cells and an overabundance of Lyt2+ cells compared with the frequency of these cells found in lymphatic tissues or peripheral blood. Treatment with anti-L3T4 or anti-Lyt2 monoclonal antibodies caused a reduction in splenic T-lymphocyte subsets and attenuated the hyperglycemia to 212 +/- 14 and 197 +/- 16 mg/dl (P less than .001 and .01), respectively, compared with controls and prevented the insulitis induced by streptozocin. Our studies support the hypothesis that an immune response is important to the development of multi-low-dose streptozocin diabetes and indicate that treatment with monoclonal antibodies against the L3T4+ or Lyt2+ T-lymphocyte subsets can attenuate this process. PMID- 3556280 TI - Progression of incipient diabetic retinopathy during good glycemic control. AB - To assess the extent to which the progression of diabetic retinopathy can be arrested by improved glycemic control, 35 normal dogs were randomly divided into a nondiabetic and three alloxan-induced diabetic groups prospectively identified according to glycemic control: poor control for 5 yr (PC), good control for 5 yr (GC), and poor control for 2.5 yr followed by good control for 2.5 yr (PGC). To achieve good control, insulin was given twice daily together with a measured diet so that hyperglycemia and glucosuria were mild and infrequent, and HbA1 was comparable to normal. Retinal capillary aneurysms and other lesions developed during 60 mo of poor control (group PC) and were inhibited if good control was begun promptly within 2 mo (group GC). In group PGC, retinopathy was absent or equivocal at 2.5 yr of poor control and, surprisingly, was found to develop subsequently despite good glycemic control. Retinopathy in group PGC was greater at autopsy than at 2.5 yr and was greater than in group GC. The results indicate that retinopathy may be preventable but tends to resist arrest even in its incipient stages, before more than the first few aneurysms have appeared. PMID- 3556281 TI - Beta-cell function and insulin sensitivity in nondiabetic HLA-identical siblings of insulin-dependent diabetics. AB - Insulin secretion and insulin sensitivity were compared in 12 HLA-identical siblings of insulin-dependent diabetics and nondiabetic controls. Only the maximum acute insulin response to intravenous arginine was lower in the siblings than in the matched controls (P less than .05); other measures of insulin secretion, including the acute insulin response to glucose or arginine, the second-phase insulin response to glucose, and the slope of glucose potentiation, were not significantly different. Insulin sensitivity, derived from an intravenous glucose tolerance test with a minimal-modeling technique, was lower in the siblings (P less than .01). In a large group of nondiabetic controls of various adiposity, insulin secretion and insulin sensitivity were inversely related. In view of the difference in insulin sensitivity between siblings and matched controls, a direct comparison of beta-cell function tests may be inappropriate, and the measures of insulin secretion were compared with those of nondiabetics when adjusted for differences in insulin sensitivity. This analysis revealed that all measures of insulin secretion were significantly lower in the siblings. We conclude that HLA-identical siblings of insulin-dependent diabetics show evidence of both insulin resistance and impaired beta-cell function and that analysis of beta-cell function in relation to insulin sensitivity shows a greater frequency of beta-cell secretory abnormalities than previously appreciated. PMID- 3556282 TI - Anterograde fast component of axonal transport during insulin-induced hypoglycemia in nondiabetic and diabetic rats. AB - To elucidate the pathogenesis of the peripheral neuropathy associated with hypoglycemia the anterograde fast component (aFC) of axonal transport was studied in nondiabetic rats during acute and prolonged insulin-induced hypoglycemia and in streptozocin-diabetic (STZ-D) rats with acute hypoglycemia. [35S]methionine and [3H]fucose were injected into the dorsal root ganglion (L5) to label protein and glycoprotein, respectively. During the 4 h of transport, thigh temperature was maintained constant. Acute severe hypoglycemia (1.5 +/- 0.2 mM) was associated with a 36% decrease in the amount of aFC (2.3 +/- 0.7% in the test group vs. 3.6 +/- 0.8% in the controls), whereas transport velocity was unaffected. Prolonged hypoglycemia, obtained by pretreatment with insulin for 3 days, prevented the decrease in amount of aFC. In STZ-D rats, acute severe hypoglycemia (1.5 +/- 0.6 mM) produced a similar but less-pronounced decrease of aFC. We conclude that hypoglycemia is associated with alterations in axonal transport that could play a role in development of neuropathy. Prolonged hypoglycemia protects axonal transport against the effects of glucopenia, and an untreated diabetic state maintained for several days has a partially protective effect against episodes of hypoglycemia. PMID- 3556283 TI - Genetic, immunologic, and environmental heterogeneity of IDDM. Incidence and 12 mo follow-up of an Italian population. AB - The 1-yr incidence of insulin-dependent diabetes mellitus (IDDM) in a population of the Piedmont and Aosta Valley area of Italy was recorded. Anti-virus antibodies (e.g., Coxsackie B1-6, mumps, cytomegalovirus), islet cell antibodies (ICAs), and HLA-A, -B, -C, and -DR were determined in 74 IDDM patients (38 males, 36 females) and in controls. Total IDDM incidence was 5.0/100,000, and the incidence for those less than 20 yr of age was 11.6/100,000. Anti-virus antibody frequency was not different in IDDM patients and controls. ICAs were present in 58% of IDDM patients at onset and in 30% after 12 mo, and complement-fixing ICAs were found in 39 and 17%, respectively. IDDM was significantly and positively associated with DR3/DR4 and negatively associated with DR2 and DR5. ICA frequency was significantly higher in DR3/DR4 heterozygote patients than in patients without DR3 and DR4. These results suggest that in this IDDM population viral etiology is not evident, ICAs offer only a partial pathogenetic explanation, and genetic and immunologic heterogeneity is evident. PMID- 3556284 TI - High K+ rapidly stimulates Ca2+-dependent phosphorylation of three proteins concomitant with insulin secretion from HIT cells. AB - We have previously shown in a glucose-responsive insulin-secreting beta-cell line (HIT cells) that a cell membrane-depolarizing concentration of K+ causes an influx of extracellular Ca2+ that elevates the free cytosolic Ca2+ concentration ([Ca2+]i) and activates insulin secretion. To identify the cellular mechanisms that couple Ca2+ influx to exocytosis, studies of protein phosphorylation were conducted. HIT cells were loaded with 32P and stimulated with either 40 mM K+ or 19.4 mM glucose, both of which trigger the immediate release of insulin. Phosphoproteins were examined with two-dimensional polyacrylamide gel electrophoresis and autoradiography. With addition of 40 mM K+, after the rise in [Ca2+]i, proteins of Mr 17,500, 20,000, and 24,000 were rapidly and specifically phosphorylated. The 17,000-Mr protein showed maximum phosphorylation by 1 min, whereas phosphorylation of the 24,000- and 20,000-Mr proteins continued to increase at 5 min. Despite stimulating the immediate release of insulin, high glucose did not result in a change in [Ca2+]i or the phosphorylation of the three Ca2+-dependent phosphoproteins. Insulin secretion, the increase in [Ca2+]i, and phosphorylation of the proteins by 40 mM K+ was inhibited by 100 microM verapamil, an organic Ca2+-channel-blocking drug. The rapid phosphorylation of three proteins, after a rise in [Ca2+]i and the coordinate inhibition of insulin secretion and phosphorylation, are consistent with the hypothesis that Ca2+ enters the beta-cell through voltage-dependent Ca2+ channels, regulating insulin release by effects on protein phosphorylation. However, glucose activates the immediate release of insulin by another, as yet undefined, mechanism. PMID- 3556285 TI - Presence of pancreatic hormones in islet cells with MHC-class II antigen expression. AB - In the normal rat pancreas, only few islet cells express MHC-class II antigens. Their nature and function has not yet been elucidated. We report a method for the purification of Ia-positive islet cells by fluorescence-activated cell sorting. The isolated mononuclear cells appear of nonendocrine origin but contain vacuoles with partially digested secretory vesicles. Both insulin- and glucagon immunoreactive granules were identified in these vacuoles of varying size and composition. It is suggested that at least part of the rat islet cells with class II antigen expression can exhibit phagocytotic properties leading to the uptake of fragments from damaged endocrine cells. This functional characteristic may implicate this particular islet cell type in the pathology of the endocrine pancreas in type I diabetes. PMID- 3556286 TI - The dilemma in prenatal diagnosis of idiopathic microcephaly. AB - It is estimated that 20 to 35 per cent of idiopathic microcephaly is hereditary. Common practice dictates that after the birth of such a case, subsequent pregnancies should be monitored ultrasonographically in order to facilitate early antenatal diagnosis, and thus genetic counselling. Two cases are reported to indicate the difficulties encountered. In case 1 head growth appeared to be normal until the 20th week of gestation and then slowed down to 31 cm at birth. In case 2 head growth proceeded normally until the 28th week of gestation; at birth it was 32 cm and over the succeeding months became markedly microcephalic. The accuracy of various ultrasonographic techniques is reviewed, and the limitations are discussed. In the light of these findings it is concluded that reliable prenatal diagnosis of hereditary microcephaly is not available as yet. PMID- 3556287 TI - Mortality and survival in type 2 (non-insulin-dependent) diabetes mellitus. PMID- 3556290 TI - Dihydroergotamine, but not naloxone, counteracts lithium as an inhibitor of glucose-induced insulin release in isolated rat islets in vitro. AB - Lithium exerts an inhibitory effect on glucose-induced insulin release. Lithium (5 mmol/l) added 30 min prior to glucose stimulation or together with glucose (16.7 mmol/l) failed to affect first phase, but reduced second phase glucose induced insulin release by 35%. Similar results were obtained when islets isolated from rats following long-term oral lithium treatment were perifused with glucose (16.7 mmol/l). The inhibitory effect of lithium was counteracted by pretreatment of the rats with the alpha-adrenergic blocking agent dihydroergotamine, whereas the opiate antagonist naloxone had no apparent effect on lithium-induced inhibition of glucose-stimulated insulin release. PMID- 3556289 TI - The relationship of acute insulin sensitivity to the progression of vascular disease in long-term type 1 (insulin-dependent) diabetes mellitus. AB - In 51 individuals with Type 1 (insulin-dependent) diabetes mellitus initially of more than 15 years' duration, the acute hypoglycaemic effect of intravenous insulin (0.11 IU/kg) was related to outcome over 18 years. This acute insulin sensitivity, or glucose assimilation index, was reproducible over the period of study. At 18-year follow-up, initial low glucose assimilation index (less than 0.082 mmol X l-1 X min-1 was significantly (p less than 0.01) associated with death from vascular disease. Low glucose assimilation index was similarly significantly (p less than 0.01) associated with progression of atherosclerotic disease, but not with microangiopathy alone. Hypertension (systolic blood pressure greater than 150 mmHg and/or diastolic blood pressure greater than 95 mmHg) was the only other parameter significantly (p less than 0.01) related to outcome, but this relationship was no longer significant once glucose assimilation index had been taken into account. A linear logistic analysis confirmed that acute insulin sensitivity was independently associated with outcome. Neither initial clinical control of diabetes nor glycosylated haemoglobin level in the 26 survivors was related to vascular prognosis. PMID- 3556288 TI - Multiple immunological abnormalities in patients with type 1 (insulin-dependent) diabetes mellitus. PMID- 3556292 TI - A soft tissue mass in an edentulous patient. PMID- 3556291 TI - Chronic administration of theophylline to rats induces a post-insulin binding defect in adipocyte glucose transport. AB - To determine whether adenosine is involved in long-term regulation of glucose transport in adipose tissue, we have investigated effects of administration of an adenosine receptor antagonist (theophylline) on adipocyte glucose transport. Rats were injected with theophylline (30 mg/kg, dissolved in 0.9% NaCl) daily for 7 days. Controls were injected with saline. The rats were then killed, and epididymal adipocytes were isolated. Insulin-stimulated glucose transport rates were decreased by about 25%-30% in the cells from theophylline-treated rats at all insulin concentrations tested. The half-maximally effective concentration of insulin was not altered (6.5 +/- 0.5 and 6.7 +/- 0.5 mU/l in control and treated cells respectively), suggesting a post-insulin binding defect. This was confirmed by the finding that 125I-insulin binding to the cells was not altered. Adenosine receptor number and affinity (measured on detergent-solubilized adipocyte extracts using 125I-hydroxyphenylisopropyl adenosine) was also not changed by theophylline treatment. We conclude that theophylline administration causes decreased glucose transport rates in rat adipocytes at a post-insulin binding level. Thus, chronic adenosine receptor blockade impairs adipocyte glucose transport, suggesting that adenosine is involved in long-term regulation of glucose metabolism in adipose tissue. PMID- 3556293 TI - Sir James Mackenzie and the spectre of medical technology. PMID- 3556295 TI - [Metabolism of the adipose tissue in experimental hyperthyroidism and in humans]. PMID- 3556294 TI - [A scientific discovery truncated in 1912, that of yellow fever in the jungles of Yucatan]. PMID- 3556296 TI - [Of sirens and centaurs (a fantastic morphology)]. PMID- 3556297 TI - [Homage to the memory of Dr. Raoul Fournier]. PMID- 3556298 TI - [Dynamics of pulmonary tuberculosis]. PMID- 3556300 TI - [Alcoholic acidoketosis]. PMID- 3556299 TI - [Evaluation of an immunological test for detecting occult fecal blood for case finding in colorectal tumors]. AB - Screening for colorectal tumours (cancers and polyps) by searching for blood in stools using the gaiac test is a well-known method. We evaluated a new gaiac test, the originality of which from its coupling with an enzyme immuno-assay specifically measuring human hemoglobin (Fecatest). The objectives of this new test were to decrease false positives and thus to improve the positive predictive value of screening. Subjects over 45 years of age attending health examinations at a Center of Preventive Medicine were studied. Of the 5,185 subjects who received the test, 4,376 (84 p. 100) performed it correctly, demonstrating good compliance in this population. For 664 (15 p. 100), the results of the gaiac test were positive. This positivity rate was higher for men than for women (20 p. 100 vs. 10 p. 100) but was not influenced by age. After positive results, 471 (70 p. 100) patients completed investigations decreasing the overall compliance to 80 p. 100. Fifteen cases of cancer and 78 cases of adenomas were found. The positive predictive value of the test was 20 p. 100 for tumours. A benign cause was found in 44 p. 100 of 471 patients, and investigations were negative in 36 p. 100. When the gaiac test was positive, the immunoenzymatic method significantly improved the positive predictive value for cancer (6 p. 100 vs. 3 p. 100) but not for polyps (20 p. 100 vs. 17 p. 100). Three of the 15 cancers and half of the 78 adenomas would not have been discovered with the immunoenzymatic method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556301 TI - [Endorectal ultrasonography: a new method for studying cancer of rectum]. PMID- 3556302 TI - [Endorectal ultrasonography: evaluation of locoregional extension of cancers of the rectum]. AB - The treatment of rectal carcinoma is mainly determined by its local extension, which is difficult to assess before surgery. Our purpose was to determine the reliability of endorectal echography (ERE) in order to provide preoperative assessment of local extension of rectal tumors. Twenty-five patients with rectal adenocarcinoma were included in this study. Seventeen tumors could be felt by rectal examination. ERE was impossible in one case. Echographic data were compared with anatomic findings in 24 patients. ERE provided an accurate assessment of the parietal involvement in 22 cases. The sensitivity and specificity of ERE in determining the spread of the tumor to the rectum alone were 1 and 0.89, respectively, superior to the results provided by clinical examination alone (sensitivity 0.84-specificity 0.76). When the results of the two investigations were identical, all patients were well classified. For lymph node involvement, the sensitivity and specificity of ERE were 0.71 and 0.76 respectively. These results show that ERE is one of the best investigations currently available for assessing parietal involvement of rectal tumors. ERE might be able to determine the appropriate place of radiation therapy, local excision or anal sphincter preservation. PMID- 3556303 TI - Effects of renal impairment on liver transplantation. AB - To determine the incidence, prevalence, and prognostic value of preoperative and postoperative renal dysfunction occurring in adults undergoing orthotopic liver transplantation, the records of 102 consecutive adults who underwent orthotopic liver transplantation using cyclosporin A were reviewed. Renal dysfunction was defined arbitrarily as an increase in creatinine or blood urea nitrogen, or both, to 1.5 and 50 mg/dl, respectively, in patients previously having normal renal function or a 50% increase in either creatinine or blood urea nitrogen in patients with preexisting renal dysfunction. Twenty-six of the 102 patients had renal dysfunction before orthotopic liver transplantation. Sixty-eight of the 102 patients studied experienced an episode of renal impairment after orthotopic liver transplantation. Forty-nine of these episodes developed early, having occurred within the first 6 days. Late renal impairment occurred in 36 cases at 32 +/- 6 days after orthotopic liver transplantation. Using multivariate analysis, cirrhosis of a noncholestatic nature was found to be an independent predictor of early renal impairment. Trough blood cyclosporin A levels measured by radioimmunoassay were higher in those who experienced early renal impairment or late renal impairment than in those who did not (p less than 0.05). Several factors capable of adversely influencing renal function (nephrotoxic drugs, shock, and graft failure) other than cyclosporin A were present also in half of the patients who developed late renal impairment. Overall, 25 patients died. Multivariate analyses identified serious postoperative infection, graft failure, and preoperative renal dysfunction to be independent predictors of mortality. PMID- 3556304 TI - Corticosteroids and intestinal ion transport. PMID- 3556305 TI - Antigen reversion of glycogen phosphorylase isoenzyme in carcinoma and proliferative zone of intestinal metaplasia of the human stomach. An immunohistochemical study. AB - Specific antibodies to three purified glycogen phosphorylase isoenzymes, i.e., brain (or fetal), muscle, and liver types, were used to study the localization of these isoenzymes in carcinoma and the proliferative zone of intestinal metaplasia of the human stomach. Both the malignant cells of well-differentiated adenocarcinoma and the proliferative zone of some intestinal metaplasia of the stomach were stained when the antibrain-type phosphorylase isoenzyme antibody was used, but not when the other two types were used. The results suggest that brain type phosphorylase in gastric carcinoma could be one example of fetal protein expression in cancer, and that the proliferative zone of some intestinal metaplasia having brain-type phosphorylase may histogenetically relate to well differentiated adenocarcinoma. PMID- 3556306 TI - Slow moving proteinase. Isolation, characterization, and immunohistochemical localization in gastric mucosa. AB - Human gastric mucosa contains three immunochemically distinguishable aspartic proteinases, pepsinogen I (pepsinogen A), pepsinogen II (pepsinogen C, progastricsin), and a nonpepsinogen proteinase also termed slow moving proteinase (SMP). The properties of SMP, and in particular its relationship to another aspartic proteinase, cathepsin D, were examined in this study. Slow moving proteinase and cathepsin D were isolated, respectively, from gastric mucosa and human spleen. Antiserum specific to each proteinase was prepared in rabbits. Rabbit anti-SMP did not recognize cathepsin D, and conversely, anticathepsin D did not react with SMP. Immunohistochemical studies localized SMP to surface epithelial cells in both the fundic and pyloric gland areas of the stomach. In contrast, cathepsin D was found mainly in mononuclear cells in the lamina propria and in parietal cells. Slow moving proteinase exhibited considerably lower Km values for its interaction with two chromogenic substrates than did cathepsin D. An even greater distinction between the two enzymes was found with the protein inhibitor from Ascaris lumbricoides; the activity of SMP was inhibited very strongly, whereas that of cathepsin D was not affected. By sodium dodecyl sulfate polyacrylamide gel electrophoresis under denaturing conditions, SMP consisted of two subunits with apparent molecular weights of 42,500 and 41,000. The last two properties characterize a less-well-known aspartic proteinase, cathepsin E. We conclude that SMP is not cathepsin D, but that it may be cathepsin E. PMID- 3556307 TI - [Therapeutic and prognostic results of a prospective multicenter ovarian cancer study of FIGO stages I and II]. AB - Between April 1980 and December 1985 a prospective controlled and randomized multicenter study of 124 assessable patients with stage I and II epithelial ovarian carcinomas was carried out. The aims of this study were first to verify the value of adjuvant irradiation therapy or combined chemo-irradiation therapy, and second to evaluate the importance of different prognostic factors such as age, histology, tumor grading, and tumor stage. Patients with well-differentiated stage IA tumors did not receive any therapy; patients with undifferentiated stage IA tumors were randomized to "no therapy" or irradiation therapy; patients with stage IB, IIA, and IIB tumors were treated by either irradiation or a combined chemo-irradiation therapy consisting of Adriamycin/Cyclophosphamide. In patients with stage IC and IIC ovarian carcinomas a combined irradiation-polychemotherapy was instituted, consisting either of Adriamycin/Cyclophosphamide or of Adriamycin/Cisplatin. Because of the low number of patients and the relatively good prognosis no definite evaluation of the individual therapeutic modalities could be done. An analysis of all patients showed that differentiation between stage I and stage II ovarian carcinomas is the single most important prognostic factor. After a mean observation time of 42 months (8-71 months) for stage I tumors a 91% probability of three-year survival was attained, in comparison with 57% for stage II tumors. It has not been definitely established that there is a need for adjuvant therapy for stage I tumors and this should be confirmed by further studies. Because of the unfavorable prognosis for patients with stage II ovarian cancer, these patients should be given the same polychemotherapy, including Cisplatin, as patients with advanced ovarian carcinomas. PMID- 3556309 TI - [Functional role of proteolysis in erythroid cells in hemoglobinopathies]. PMID- 3556308 TI - [Cervix ripening using drugs before oxytocin labor induction. Clinical study of a new prostaglandin E2 triacetin gel]. AB - In an open randomized clinical study, 50 of 100 gravidae with a low Bishop score (less than or equal to 5) at term were treated with prostaglandin E2 (0.5 mg PGE2 in 2.5 ml Triacetin gel. Prepidil, intracervically) 12 hours before the indicated i.v. oxytocin induction. In 50 patients labor was induced intravenously without any pretreatment. In 46 of 50 pretreated women (92%) there was an increase in the Bishop score of at least three points, and of only two points in the remaining four. In the control group no significant increase in the Bishop score was measurable. Sixteen patients delivered within the first 12 hours after PGE2 gel administration, before oxytocin induction. Three women in the untreated control group also delivered during this pre-observation period. In 14 (64%) of 22 women in whom cervical priming with PGE2 was performed and 26 (57%) of 47 patients in whom it was not the first intravenous oxytocin induction was successful. The frequency of cesarean sections was 10% (n = 5) in the PGE2 gel group and 12% (n = 6) in the oxytocin group. The oxytocin dose needed to induce labor was significantly lower after cervical priming. No severe side effects were observed during and after PGE2 treatment, in either the mothers or the children. PMID- 3556310 TI - [Transferrin: its role in iron metabolism and various clinical aspects]. PMID- 3556311 TI - [Study of the immune antibody spectrum in blood and plasma donors]. PMID- 3556312 TI - A hypoglycemic factor from the corpus cardiacum of the American cockroach Periplaneta americana. AB - Thin-layer chromatography of cockroach corpora cardiaca (cc) extracts revealed a fraction (F1 in solvent system 1) which had hyperlipemic activity in locusts and which differed in mobility from synthetic locust adipokinetic hormone I (AKH I). Fractions 4 and 5 exhibited hypolipemic activity when injected into locusts. Pooled samples of these fractions caused a diminution of carbohydrate levels in the cockroach. Bovine insulin mimicked both these effects. No change in hemolymph lipid was evident in the cockroach after injection of either CC fractions 4 and 5 or bovine insulin. Both the active fraction from the cockroach CC and bovine insulin caused a decrease in hemolymph carbohydrate in neck-ligated locusts. Injection of locust hypolipemic hormone, separated from locust CC storage lobes by TLC, into neck-ligated locusts also caused a decrease in hemolymph carbohydrate concentration. Normal locusts showed no change in hemolymph carbohydrate. PMID- 3556313 TI - Primary structure of insulin and glucagon from the flounder (Platichthys flesus). AB - Insulin and glucagon have been isolated from the Brockmann bodies of the flounder, a teleostean fish, and their primary structures established by automated Edman degradation. The A-chain of flounder insulin shows strong homology to the A-chains from the coho salmon (Oncorhynchus kisutch; 100%) and the anglerfish (Lophius americanus; 95%) but homologies in the B-chain region are weaker (salmon 79%, anglerfish 83%). Flounder insulin B-chain contains the novel sequence Val-Val-Pro-Pro at the NH2 terminus and the highly conserved seryl residue at position 10 (B 9 in mammals) is replaced by an alanyl residue. Flounder glucagon is identical to anglerfish glucagon II but shows four amino acid substitutions compared with salmon glucagon. PMID- 3556314 TI - Specificity of amphibian and reptilian pituitaries for various forms of gonadotropin-releasing hormones in vitro. AB - In vitro perifusion was employed to compare the potencies of mammalian, avian, salmon, and lamprey gonadotropin-releasing hormones (GnRHs) on the release of luteinizing hormone (LH) from the pituitaries of an amphibian (Rana pipiens) and a reptile (Chrysemys picta). The chicken-I and salmon GnRH variants were equipotent with mammalian GnRH in both the frog and the turtle glands. By contrast, the lamprey GnRH was inactive (less than 1% as potent as the others). Lamprey GnRH also failed to stimulate LH release or to induce GnRH priming when administered chronically to the frog gland. These results support the hypothesis that the GnRH receptors on nonmammalian pituitary cells are much less specific than those of the mammal with regard to the amino acid at position 8 of the GnRH molecule. These data suggest that the native GnRH variant or the one most like that found in the brain of a species is not necessarily the most potent biologically in that species. However, the nonmammalian pituitary does show some specificity with regard to the structure of natural GnRHs in that none of the tetrapod species studied is responsive to lamprey GnRH. PMID- 3556315 TI - Immunocytochemical evidence for vasopressin and oxytocin pathways in the hypothalamo-hypophyseal axis of the camel (Camelus dromedarius). AB - Immunoperoxidase staining was applied to the hypothalamus and posterior pituitary of the camel. Vasopressin and oxytocin cells and fibers were identified in different nuclei of the hypothalamus. Immunoreactive fiber tracts were followed to the median eminence and the posterior pituitary. In the median eminence, two different pathways were found for vasopressin, one passing to the posterior lobe and the other contacting capillaries of the portal system. The oxytocin antiserum stained one unique pathway in the internal zone on its way to the posterior pituitary. The two immunoreactivities were shown in the posterior lobe of the pituitary, vasopressin staining being the more intense. Relations between these data and the physiology of the camel are discussed. PMID- 3556316 TI - Sally Beauchamp's career: a psychoarchaeological key to Morton Prince's classic case of multiple personality. AB - By the methods of psychoarchaeology, the identity of Sally Beauchamp, Morton Prince's classic case of multiple personality, has been established. The reconstructed life history has for the first time revealed the roots of the dissociative process. This goal was actually obscured by the tangled web of Prince's rambling 1906 book and his other publications on the case. The determinative events included two instances of sudden infant death during the childhood period of the patient, the earlier of which was apparently never even known to Dr. Prince. Though not mentioned in the patient's autobiography, it probably induced the initial dissociation to defend the integration of the personality. The relevance of the new concept of SIDS (since 1969) is considered. Other disturbing influences were the constant rejection of the patient by her mother, who died at an early age, and probable severe abuse by the widowed father which led her to run away from home (permanently) at age 16. Nine years afterward, therapy with Dr. Prince began and lasted seven years. It is suggested that this case and the parallel one of Breuer and Freud (Anna O.) be comparatively reexamined from the standpoint of modern feminism. The role of the conventional 19th-century woman was not acceptable to either of them, and both probably had an unusually large innate, bisexual endowment. Endogenous conflict, intensified by social demands, produced dissociation as a pseudo-solution until, through opportune therapy and other environmental opportunities, each was able to achieve a productive modus vivendi. The relation of bisexuality to the etiology of personality dissociation in general is considered. An incidental but instructive discovery made in the course of the Prince research was an unknown letter from William James to Morton Prince about The Dissociation of a Personality. This find points up the fact that James's final metaphysic was a form of pluralistic panpsychism derived from both psychical research and the contemporary knowledge about dissociated personality. James postulated a cosmic multiple personality. PMID- 3556317 TI - Temperature-sensitive lethal pseudorevertants of ste mutations in Saccharomyces cerevisiae. AB - A procedure was devised to isolate mutations that could restore conjugational competence to temperature sensitive ste mutants and simultaneously confer temperature-sensitive lethal growth phenotypes. Three such mutations, falling into two complementation groups, were identified on the basis of suppression of ste5 alleles. These same mutations were later shown to be capable of suppressing ste4 and ste7 alleles. Five mutations in a single complementation group were isolated as suppressors of ste2 alleles. None of the mutations described in this study conferred a homogeneous cell cycle arrest phenotype, and all were shown to define complementation groups distinct from those previously identified in studies of cell division cycle (cdc) mutations. In no instance did pseudoreversion appear to be achieved by mutational G1 arrest of ste mutant cells. Instead, it is proposed that the mutations restore conjugation by reestablishing the normal pheromone response. PMID- 3556318 TI - MMS sensitivity of all amino acid-requiring mutants in aspergillus and its suppression by mutations in a single gene. AB - All available amino acid-requiring mutants of Aspergillus nidulans were found to be hypersensitive to MMS (methyl methanesulfonate) to various degrees. On MMS media, secondary mutations could be selected which suppress this MMS sensitivity but do not affect the requirement. Many such mutations were analyzed and found to be alleles of one gene, smsA (= suppressor of MMS sensitivity), which mapped distal on the right arm of chromosome V. This gene is more likely to be involved in general regulation of amino acid biosynthesis than MMS uptake, since a variety of pathway interactions were clearly modified by smsA suppressors in the absence of MMS. PMID- 3556319 TI - [The proof of real increase in the frequency of reverse mutations in haploid yeasts in media with decreased adenine content]. AB - It has been shown by the direct experiment in the haploid yeast Saccharomyces cerevisiae, strain p192 (a ade2-192), that, if cultivated in the solid media containing 1 and 10 mg/l of adenine, the reversion frequencies (5.6 X 10(-8) and 0.82 X 10(-8), respectively) do not depend on the number of cells (from 10(2) to 10(7)) in colonies growing on either medium. This means that the difference in the reversion frequencies mentioned is not connected with the "selection effect" and is only caused by the varying initial content of adenine in the medium. A method combining the technique of ordered plating and the use of nuclear filters is recommended for the study of mutagenesis in microorganisms. PMID- 3556320 TI - [Relation between the frequency of various types of reverse mutations in yeasts auxotrophic for adenine and the adenine content of the medium]. AB - As shown in the haploid yeast Saccharomyces cerevisiae, the strain 769-p192-15B n4 (a ade2-192 lys5-3), the rates of reversion to adenine prototrophy are 0.36 X 10(-8), 1.7 X 10(-8) and 2.7 X 10(-8), when the medium contains 100, 10 and 1 mg/l adenine, respectively. Two types of revertants were taken into account: those prototrophic both for adenine and lysine, i. e. suppressors, and those prototrophic for adenine only, most of them being locus revertants. The proportion of locus revertants at 100, 10 and 1 mg/l adenine does not exceed 2, 25 and 41%, respectively. It is assumed that excess adenine (100 mg/l) suppresses the activity of the genes controlling its synthesis, including the mutant ade2 gene. A hypothesis is forwarded, according to which the genes being in the "active" state mutate significantly more frequently than "not working" genes. PMID- 3556322 TI - Base substitution mutants of the lac operator: in vivo and in vitro affinities for lac repressor. AB - 16 single-site mutations and a 1-bp deletion in the lac operator have been cloned and examined with regard to repressor binding. A 13-bp, central 'core' operator sequence, bp 5-17 of the natural operator, was also synthesized and cloned. Repressor affinity was assessed in vivo by quantitating the level of beta galactosidase activity resulting from chromosomal operon derepression and in vitro by measuring the stability of repressor-operator complexes. Our results support the general conclusion that the repressor-operator interaction is asymmetric, particularly across the center of the operator sequence, with little or no specific contact at position 12. Some sequence changes in the right side of the operator markedly reduced repressor affinity, indicating that although binding to this half of the sequence has been suggested to be less important than the left half, it still significantly contributes to the binding affinity. PMID- 3556321 TI - Characterization of the regulatory region of the Escherichia coli penicillin acylase structural gene. AB - Penicillin acylase is utilized in the enzymatic production of semisynthetic penicillins. The enzyme is composed of two different subunits that originate from a common precursor. The partial nucleotide (nt) sequence of the structural gene has been published. This paper reports the nt sequence of the regulatory region of this gene, the identification of a functional promoter, the transcriptional start point, and the description of possible regulatory regions. PMID- 3556323 TI - Construction of stable laboratory and industrial yeast strains expressing a foreign gene by integrative transformation using a dominant selection system. AB - An expression cassette of mouse dihydrofolate reductase (Mdhfr) cDNA under control of the yeast cytochrome c promoter was inserted in a yeast plasmid containing the ARS1 sequence. The ARS replicating function was destroyed by BglII treatment prior to yeast transformation. Using this linearized plasmid, genomic transformants could be obtained from either laboratory or industrial strains of bakers' yeast based on direct methotrexate (MTX)-resistance selection. The entire sequence of the linearized plasmid was integrated by homologous recombination at the ARS region of the host chromosome. The results indicate that repetitive and homologous recombination occurs readily in such transformations. The stability of the constructed integrants was more than 99.95% per generation in non-selective medium, and tandem repeats of up to six copies (i.e., about 44 kb) were not changed even after 30 generations in rich medium. Expression in rich medium of cointegrated, human interleukin 2 cDNA under control of the triose phosphate isomerase promoter was shown by Western blot experiments in both laboratory and industrial yeast strains. Furthermore, a comparison of the transcription efficiency of the Mdhfr gene in the chromosome with that in the plasmid revealed that the efficiency was almost proportional to the number of gene copies, irrespective of the location of the transcription unit. These results show that by using the MTX/Mdhfr dominant selection-amplification system one can construct stable recombinant yeast strains suitable for heterologous gene expression in laboratory as well as in industrial fermentation conditions. PMID- 3556324 TI - Expression of human salivary alpha-amylase gene in Saccharomyces cerevisiae and its secretion using the mammalian signal sequence. AB - A cDNA fragment coding for human salivary alpha-amylase precursor was joined to the promoter of the Saccharomyces cerevisiae PHO5 gene, and the recombinant gene was inserted into a vector plasmid capable of autonomous replication in yeast. Yeast cells transformed with this recombinant plasmid synthesized about 5 X 10(5) molecules of the enzyme per cell when synthesis was induced by deprivation of inorganic phosphate and released about half of the synthesized enzyme into the medium. The enzyme is stable, and exhibited the same specific activity as alpha amylase in human saliva. The amylase-producing yeast grew on starch and produced alcohol. PMID- 3556325 TI - Expression of the human salivary alpha-amylase gene in yeast and characterization of the secreted protein. AB - Recombinant plasmids were constructed in which the human salivary alpha-amylase gene, with or without the N-terminal signal sequence for secretion, was placed under control of the APase (PHO5) promoter of Saccharomyces cerevisiae. In yeast cells transformed with the alpha-amylase gene having the human signal sequence for secretion, the gene was expressed and the enzyme was secreted into the medium in three different glycosylated forms. The amylase gene without the signal sequence was also expressed in yeast, but the products were neither secreted nor glycosylated. Determination of the N-terminal amino acid (aa) sequence revealed that the 15-aa signal sequence had been cleaved from the secreted enzyme, and that the N-terminal residue, glutamine, had been modified into pyroglutamate, as is commonly observed with the mammalian salivary alpha-amylase. Thus, the human salivary alpha-amylase signal sequence for secretion was correctly recognized and processed by the yeast secretory pathway. The C-terminal residue was identified as leucine, which is predicted from the nucleotide sequence data to be located at position 511 in front of the termination codon. Therefore, there is no post translational processing in formation of the C terminus. PMID- 3556326 TI - Overproduction of the Bacillus sphaericus R modification methylase in Escherichia coli and its purification to homogeneity. AB - A DNA fragment containing the information coding for the GGCC-specific Bacillus sphaericus R modification methylase, BspR, was inserted into plasmid vector pKK223-3 under the control of the strong and inducible tac promoter, and transformed into Escherichia coli HB101. Upon induction this strain accumulated the methylase enzyme (while cell growth was inhibited) up to several percent of total cellular protein. Homogeneous methylase could be prepared in three purification steps. PMID- 3556327 TI - Fritz Verzar, 1886-1979. PMID- 3556328 TI - Serum C-peptide concentrations and their value in evaluating the usefulness of insulin therapy in elderly diabetics. AB - Serum C-peptide concentrations were determined in 121 elderly subjects: 25 nondiabetic controls aged 69-86 years, and 96 type 2 (noninsulin-dependent diabetes mellitus) diabetics aged 64-96 years. Forty-seven of the diabetics were treated with tablets, 35 with insulin, and 14 with diet alone. Fasting serum C peptide concentrations (nmol/l; mean +/- SD) were 0.51 +/- 0.20 for controls; 0.60 +/- 0.16 for diabetics on diet alone; 0.72 +/- 0.33 for diabetics on tablets and 0.46 +/- 0.23 for diabetics on insulin (p less than 0.001 for diabetics on tablets vs. controls and diabetics on tablets vs. diabetics on insulin). The glucagon-stimulated C-peptide concentrations were similar in all groups; the increment after glucagon was less in the diabetic patients on tablets or on insulin than in the nondiabetics. In 10 patients on insulin treatment and with fasting C-peptide of 0.24-1.46 nmol/l an attempt was made to withdraw insulin. In 4 subjects the transfer to tablets was possible. Serum C-peptide level did not predict the outcome of the attempt to change the therapy, but the possibility of an adequate dietary regimen seemed to be important. The results demonstrate a wide range of basal C-peptide concentrations in elderly diabetics on different treatments, which may indicate varying pathogenetic contributions of insulin deficiency and resistance in these patients. Our observations emphasize the necessity for regular re-evaluation of the therapeutic management of elderly diabetic patients. PMID- 3556329 TI - Differentiation of regulatory cell interactions in aging. AB - Age-related changes in different regulatory processes are polymorphic and differ in different strains and organs in terms of onset and progression. Membrane changes have been observed in terms of the association between receptors and class I major-histocompatibility-complex molecules as well as in terms of structural modification of membrane molecules. Various nutritional strategies can differentially affect age of onset and rate of progression. Tumor incidence and progression increase with age; and interesting exception has been described. Principles of experimental design for the exploration of aging processes and evolutionary aspects of aging processes are being discussed. Identification of alleles, which affect initiation and progression of deleterious aging processes, are being considered for their potential in strategies for preventive medicine. PMID- 3556330 TI - Defective superoxide-dismutase molecules accumulate with age in human lenses. AB - The specific activity of superoxide dismutase (SOD) in human transparent lenses declines as a function of age. Immunotitration using monospecific antibodies showed that, with increasing age, lenses exhibit an accumulation of catalytically inactive, but antigenically reactive, enzyme molecules. Antiserum produced against denatured enzyme removed the inactive molecules from the lens homogenates without affecting the enzyme activity. These aberrant molecules are at least partially denatured and are totally devoid of catalytic activity. PMID- 3556331 TI - Andre Du Laurens (1558-1609): an early French writer on the aged. PMID- 3556332 TI - [Successful treatment of female infertility of hypothalamic origin using pulsed administration of gonadotropin-releasing hormone (LHRH)]. PMID- 3556333 TI - [Simultaneous translumbar coronaro-, ventriculo- and panaortoarteriography in patients with ischemic heart disease associated with lesions of the aorta and its branches]. PMID- 3556334 TI - [Radical correction of tetralogy of Fallot after Culie-Edwards anastomosis and cavapulmonary fistula of septic etiology]. PMID- 3556335 TI - Back to the future; or forward to the past? PMID- 3556336 TI - Cellular hypersensitivity to gluten derived peptides in coeliac disease. AB - Wheat gluten derived antigens have been tested for their ability to inhibit the migration of leucocytes from healthy subjects and patients with coeliac disease. Three preparations of a water soluble fraction (Frazer's fraction III, FIII) of partial peptic tryptic digests of wheat gluten had different effects in a direct (one stage) assay. Subfractions B and B2 caused migration inhibition of leucocytes from patients with treated coeliac disease but not of leucocytes from healthy volunteers or patients with Crohn's disease or ulcerative colitis. This migration inhibition seems to be specific for gluten fractions because maize zein fraction B, beta-lactoglobulin and ovalbumin did not cause it. The sensitivity of coeliac leucocytes to fraction B is not related to factors present in coeliac serum as the migration of leucocytes from healthy individuals preincubated with coeliac sera was not inhibited. Puromycin diminished inhibition by fraction B, which was active at 1.2 micrograms/ml in an indirect (two stage) migration inhibition assay; this is consistent with a process involving elaboration of lymphokine(s). More highly purified fractions of B2, P1-P4 were prepared by reverse phase high performance liquid chromatography (HPLC) and showed differing potency in direct and indirect assays, with P4 being the most active fraction. Inhibition of migration by gluten derived peptides appears to result from the release of lymphokine by leucocytes specifically from coeliac patients. PMID- 3556337 TI - Effects of nifedipine on gastric acid secretion and gastrin release in man. AB - As calcium is important in the regulation of gastric acid secretion and gastrin release, we have examined the effect of the calcium antagonist nifedipine on these processes in man. Nifedipine 30 mg orally inhibited basal acid output by 37% (p less than 0.025) and that stimulated by low infusion rates of pentagastrin -that is, 0.031 and 0.062 microgram/kg/h by 44% (p = 0.05) and 39% (p less than 0.02) respectively. On increasing the pentagastrin infusion rate the inhibition was surmounted suggesting it was competitive in type. Nifedipine did not affect basal or Oxo meal stimulated gastrin concentrations in normal volunteers nor did it affect resting serum gastrin or calcium stimulated increase in gastrin in a single patient with Zollinger-Ellison syndrome. These findings are consistent with the transmembrane flux of calcium ions being involved in basal and pentagastrin stimulated acid secretion in man. PMID- 3556338 TI - Ranitidine 150 mg at night in the prevention of gastric ulcer relapse. AB - After healing of a gastric ulcer, 53 patients were randomly allocated to either 12 months maintenance treatment with ranitidine 150 mg at night or an identical placebo. Fifty patients completed the trial. The patients were interviewed every third month. If symptoms indicated a relapse, endoscopy was done; and if an ulcer was found the maintenance trial was terminated. All remaining patients were endoscoped after one year. The accumulated relapse rate in the ranitidine group (36%) was significantly lower (p less than 0.01) than in the placebo group (76%), as also was the antacid consumption (p less than 0.01). Four of the six ulcers found at the final one year endoscopy were asymptomatic. In all but two of the 26 patients with relapse of symptoms an ulcer was found at endoscopy. The patients that suffered a recurrence had significantly (p less than 0.05) higher maximal acid output than those without ulcer recurrence. The time needed for healing of the relapse ulcers (four or eight weeks) corresponded to that needed for healing of the preinclusion ulcers. It is concluded that ranitidine 150 mg at night significantly reduces the gastric ulcer recurrence rate, and that relapsing ulcers are similar to the initial ones in healing response. PMID- 3556340 TI - Fetal kidney size related to gestational age. AB - Fetal renal anatomy was assessed in 660 apparently normal fetuses. The problems of technique of visualization of the kidneys are outlined. A correlation of fetal kidney length and gestational age is presented. The results are presented to be used as an adjunct in establishing fetal gestational age, as well as the assessment of normal renal morphology in routine obstetric ultrasound assessment. PMID- 3556341 TI - Ultrasonographical evaluation of the incidence of simultaneous and independent movements in twin fetuses. AB - Fetal movements (FM) may be spontaneous, originating in the fetus itself, or evoked by external stimuli. The relative rate of spontaneous and evoked FM has not yet been documented. As it is impossible to differentiate in a singleton pregnancy between these types of movements - the natural model of twin pregnancy was used. The FM of 10 normal twin pregnancies between 33 and 39 weeks of gestation were studied by two realtime ultrasounds, and were operated by two ultrasonographers over a period of 10 min. The mean number of independent FM of each fetus which occurred while the other fetus was resting was 7.9 FM and 7.7 FM, respectively (average 7.8 FM). A mean of 2.5 FM occurred simultaneously. The rate of independent FM was 75.7% and that of simultaneous FM was 24.3%. Vibroacoustic stimulation applied to the maternal abdomen evoked simultaneous movements of both fetuses in all cases. It is suggested that the independent FM may represent spontaneous FM and that the simultaneous FM may indicate the presence of an external stimuli and are therefore evoked responses. PMID- 3556342 TI - Ultrasound detection of antenatal meconium. AB - A new method for antenatal diagnosis of the presence of meconium in the amniotic cavity is reported. Ultrasonographic placental grading is a routine procedure in the monitoring of high-risk pregnancy. During serial scans of 58 patients, it was noted that in 11 cases placental grading was impossible after a certain period. At delivery, thick meconium was noted in all these cases. PMID- 3556343 TI - Characteristic pattern of Doppler umbilical arterial velocity waveform in conjoint twins. AB - Doppler blood flow studies in a pair of conjoint twins at 18 weeks gestation revealed a characteristic 'double layer' spectral velocity waveform from the umbilical arteries. This is the result of signals originating from 2 separate arterial supplies adjacent to each other in a single umbilical cord. Such a characteristic feature provides an additional sonographic sign in the diagnosis of conjoint twins. PMID- 3556344 TI - Ultrasonographic in utero identification and measurement of the normal fetal spleen. AB - Sixty-nine ultrasonographic examinations were performed to identify and measure the fetal spleen in utero on 49 women with regular menstrual cycles, at 18-41 weeks of gestation. The length (FS-L), width (FS-W), area (FS-A), and sectional area (length X width; FS-LW) of the fetal spleen correlated well with the gestational age. A very high correlation of FS-LW with FS-A was noted (r = 0.98; p less than 0.001). Ultrasonographic identification and measurement of the fetal spleen in utero is thus a useful indicator of fetal spleen growth and should facilitate detection of in utero splenomegaly, asplenia and other abnormalities. PMID- 3556339 TI - Achlorhydria: hypergastrinaemia: carcinoids--a flawed hypothesis? PMID- 3556345 TI - Ultrasonographic identification of the human fetal gallbladder in utero. AB - Ultrasonographic studies of the human fetal gallbladder were performed in utero on 149 fetuses ranging from 20 to 39 weeks of gestation. The gallbladder could be identified in 37.5% (20-23 weeks) to 64.7% (24-27 weeks) after 20 weeks of gestation. The normal sonographic characteristics of the fetal gallbladder were described and the area of fetal gallbladder, the length and the width were measured, respectively. The ultrasonographic identification of the fetal gallbladder is a first step in antenatal detection of congenital anomalies affecting the gallbladder. PMID- 3556346 TI - Factors of the hemostatic system in diabetic patients. A survey of controlled studies. AB - Diabetes mellitus is associated with a variety of vascular complications like diabetic retinopathy, myocardial infarction, stroke and peripheral vessel disease. These complications are of utmost importance because they lead to disability and premature death of the patients. The pathogenesis of these lesions has been thought to depend at least partly on defects in the hemostatic system. Many alterations of the coagulation and the fibrinolytic system as well as of the reaction of platelets have been found in diabetics. In general these tend to suggest a state of slightly activated coagulation, of increased platelet reactivity and of decreased fibrinolysis. However, no conclusive picture of the role of hemostasis in the development of vascular lesions in diabetics has emerged yet, as contradictive results have been found by many investigators. The aim of this review article is to sum up the knowledge that has accumulated in the last years in controlled clinical trials concerning the state of the diabetic hemostatic system. PMID- 3556347 TI - VA cooperative study on antiplatelet agents in diabetic patients after amputation for gangrene. IV. Issues in design, interpretation, and analysis. AB - This paper review some of the issues faced by the investigators involved in a VA Cooperative Study on Antiplatelet Agents in Diabetic Patients after Amputation for Gangrene. The study was a negative one, and some of the reasons for this are considered. In addition, suggestive results in two subgroups, cerebrovascular disease and unexpected, sudden, or unobserved deaths, were found. The implications and interpretation of these findings are discussed. PMID- 3556348 TI - Reduced serum-stimulatory activity on prostacyclin production by cultured aortic endothelial cells in diabetes mellitus. AB - Reduced prostacyclin (PGI2) production by the vascular wall has been proposed as a possible cause of macro- or microangiopathy in diabetes mellitus. In the present study, we confirmed the stimulatory activity on PGI2 (PSA) production in plasma-derived serum (PDS) by cultured aortic endothelial cells. Furthermore, the abnormality of PSA was examined in diabetic PDS. PSA in PDS from non-insulin dependent diabetics significantly decreased as compared with that in PDS from age matched control subjects. There was no difference in PSA in PDS between diabetic patients with and without vascular complications such as retinopathy and nephropathy. In addition, after treatment with dialysis, PSA in diabetic PDS was still not restored to that in normal PDS. These findings suggest that relatively heat-stable (56 degrees C, 30 min) and nondialyzable PGI2 stimulatory substance(s) may decrease in diabetic PDS. It is concluded that a reduction in PDS-stimulated PGI2 production by the vascular wall can play an important role in the pathogenesis of vascular lesions in diabetes mellitus. PMID- 3556349 TI - National health line. PMID- 3556350 TI - Malaria in Kampuchea: clinical course of falciparum malaria in Chemin de Fer Hospital, Phnom Penh. AB - To receive actual information about the clinical course of falciparum malaria case history of 373 patients hospitalized in Chemin de Fer Hospital in Phnom Penh from May 1 till October 1, 1985 were evaluated. No patients were infected in Phnom Penh. We estimated that only 8.3% of patients had higher parasitaemia than 100,000 or more asexual parasites in microliter of peripheral blood which is considered as a heavy infection. Complicated malaria was found in 39 patients (10.4%). The most frequent complications were cerebral complications (80.0%), renal failure (23.3%), and liver failure (16.6%). Ten patients had multiple organ complications and they represented 25.6% of patients with complications. The 100% mortality was observed in those in coma stage III; with haemoglobinuria, epistaxis and melena. Only coma stage III as a single symptom caused the death. In other cases death resulted from multiple organ complications. PMID- 3556351 TI - Correlation of the results of IFAT-DASS and ELISA tests in experimental cysticercosis of mice. AB - The sera of mice experimentally infected with Taenia crassiceps were tested for the occurrence of the antibodies by the enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence using defined antigen substrate spheres (IFAT DASS). Results of both tests were compared. From day 11 p.i. until the end of the experiment (day 108 p.i.) antibodies were detected by both tests. The maximal intensity of the ELISA and IFAT-DASS reactions was observed between days 63 and 94 and days 14 and 46 p.i., respectively. ELISA is an easy-to-do and objectively appraisable method, IFAT-DASS is more suitable for testing antigens weakly adsorbing to polystyrene plates. PMID- 3556354 TI - Localization of protease activities in rat brain. PMID- 3556352 TI - [Mechanism of the inhibitory effect of pranoprofen on sodium urate crystal induced inflammation]. AB - The mechanism of the inhibitory effect of pranoprofen on sodium urate crystal induced inflammation was investigated with several inflammatory parameters using leucocytes stimulated with sodium urate crystals in vitro. At 10(-5) M, pranoprofen tended to inhibit the production of chemotactic factor in guinea pig polymorphonuclear leucocytes (PMNL) stimulated with sodium urate crystals and at 10(-4) M, significantly inhibited it. At 10(-3) M and 10(-4) M, it potentiated the chemotaxis of guinea pig PMNL. Furthermore, it inhibited the production of superoxide anion (O2-) in guinea pig PMNL stimulated with sodium urate crystals, with an IC50 value of 5.0 X 10(-4) M, comparable to that of indomethacin. At 10( 3) M, it inhibited the release of beta-glucuronidase stimulated by sodium urate crystals. From doses as low as 10(-6) M, it inhibited dose-dependently the production of PGE2-like substance by the phagocytosis of sodium urate crystals by rat peritoneal leucocytes, with an IC50 value of 7.5 X 10(-6) M. These results suggest that in inhibiting the production of PGE2 stimulated by sodium urate crystals, pranoprofen shows an inhibitory effect on sodium urate crystal-induced inflammation. PMID- 3556355 TI - Screening of the food additive propionic acid for genotoxic properties. AB - Genotoxic properties of the food additive propionic acid were analysed using the Escherichia coli DNA repair assay, the SOS chromotest, the Salmonella/microsome mutagenicity test, the sister chromatid exchange test in vitro and the micronucleus test in vivo. All tests except the DNA repair assay with E. coli yielded negative results. These data support other evidence that propionic acid is not mutagenic and that genotoxic events are unlikely to be the cause of forestomach lesions in rats fed propionic acid in the diet (Griem, Bundesgesundheitsblatt 1985, 28, 322). PMID- 3556356 TI - Commercial hickory-smoke flavouring is a human lymphoblast mutagen but does not induce lung adenomas in newborn mice. AB - Commercial aqueous wood-smoke flavouring induced significant increases in the 6 thioguanine resistance mutation frequency of TK6 human lymphoblasts at 0.1 microliter flavouring/ml of cell suspension. This corresponds to 6 micrograms/ml of dissolved 'solids' as determined by fully drying the aqueous flavouring in a vacuum desiccator. In AHH-1 human lymphoblasts, which contain a cytochrome P-450 monooxygenase system, mutations were induced at 0.3 microliter/ml, corresponding to 18 microliters/ml of dissolved 'solids'. The flavouring did not induce 8 azaguanine resistant mutations in Salmonella typhimurium at concentrations up to 1.5 microliter/ml. At higher concentrations the flavouring was toxic to bacteria. The flavouring did not induce lung adenomas or other tumours in newborn mice when injected ip with total doses of up to 26 microliters over a 3-wk period. Toxicity to the kidney, colon and rectum was observed in some mice at 15 wk of age. PMID- 3556357 TI - Corneal perforation in dry eye patients. PMID- 3556353 TI - Very-long-chain fatty acids from lower organism. AB - The qualitative occurrence and quantitative proportion of very-long-chain fatty acids (above C22), mainly in lower organisms and briefly in higher plants and animals is described. PMID- 3556358 TI - [Results of HLA-typing in corneal transplantation]. PMID- 3556359 TI - [Bacterial conjunctivitis]. PMID- 3556360 TI - [Computer-assisted calculation of medical data--review of development and example of ultrasound implant biometry]. PMID- 3556361 TI - [Immunoglobulin therapy in pollinoses]. PMID- 3556362 TI - [Studies on kinetics of insulin secretion in perifused pancreatic islets of hamster. I. Characteristics of insulin secretory response to various secretagogues]. PMID- 3556363 TI - [Studies on kinetics of insulin secretion in perifused pancreatic islets of hamster. II. An inhibitory effect of sulfonylureas on a subsequent glucose stimulated insulin secretion]. PMID- 3556364 TI - [Exercise hypertension: historical, physiologic and clinical aspects of ergometry]. AB - More than a decade before Riva Rocci in 1896 described the principles of blood pressure measurement as still employed today, in 1881 Zadek reported that there is an increase in blood pressure during physical work. The blood pressure increase during physical exercise as well as its extent as a relatively constant physiological response to a given workload were delineated accurately for the first time, however, in the 1950s. There is no significant difference between the blood pressure increase seen in conditioned athletes and untrained individuals at comparable workloads. In healthy male subjects, a comparison was carried out of the reactions of cardiopulmonary and metabolic parameters during five different modes of exercise. The highest values for oxygen uptake as well as the highest heart rates can be observed during treadmill ergometry; with this method, the largest muscle mass is activated. During both treadmill ergometry as well as during step climbing, the blood pressure can be measured only invasively. As compared with bicycle ergometry in the seated position, the stroke volume increase is only relatively small during supine pedaling. Accordingly, to reproduce situations similar to that of everyday activity exercise testing should be carried out in an upright position. Vascular and cardiac catheterization, however, can be performed more easily in the supine than in the seated position. With these facts in mind, the appropriate methods should be chosen according to the needs of the study and the condition of the patient. During continuously increasing workloads, the systolic pressure increases proportionately. Immediately after termination of exercise, this pressure decreases rapidly over two to three minutes. The diastolic pressure measured noninvasively during seated bicycle ergometry is not particularly accurate and should be interpreted with caution. In general, exercise blood pressure should be determined during a standardized test beginning with a workload of 30 watts for three minutes and subsequent workloads incremented 40 watts for three minutes each. The normal ranges for younger and older patients differ substantially. Additionally, body weight exerts an influence on exercise blood pressure. During exercise, patients with hypertension may show one of three different reactions: the increased pressure can be maintained relative to the normal values during the specified workloads, the blood pressure can show normalization and the systolic blood pressure can remain constant or even decrease at higher workloads.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556365 TI - Lessons from a fourteen-state study of Medicaid. PMID- 3556366 TI - Health care for native Americans: who will pay? PMID- 3556367 TI - Nonphysician providers for Medicare patients. PMID- 3556368 TI - Financing charity care in an era of competition. PMID- 3556369 TI - A national survey of Medicaid case-management programs. PMID- 3556370 TI - Lessons learned from Medicaid managed care approaches. PMID- 3556371 TI - Mandatory HMO care for Milwaukee's poor. PMID- 3556372 TI - Diverse effects of insulin-induced hyperpolarization on 3-O-methyl-D-glucose (3-O MG) transport in frog skeletal muscles. AB - It has been suggested that the insulin-induced hyperpolarization might be a mediator of the stimulatory action of insulin on glucose transport. The purpose of the present study was to investigate the relationship between the insulin induced hyperpolarization and the stimulatory action of insulin on glucose transport in skeletal muscle. Satorius muscles dissected from bullfrogs (Rana catesbeiana) were used. Insulin induced a hyperpolarization of the membrane and an increase in the 3-O-Methyl-D-glucose (3-O-MG) uptake and extrusion. In the presence of valinomycin, insulin had no significant effect on the membrane potential. Insulin still had the stimulatory action on both the 3-O-MG uptake and extrusion even in the presence of valinomycin, under whose condition insulin had no significant effect on the membrane potential. The magnitude of the stimulatory action of insulin on the 3-O-MG uptake in the presence of valinomycin was smaller than that in the absence of valinomycin. The magnitude of the stimulatory action of insulin on the 3-O-MG extrusion was, on the contrary, larger than that in the absence of valinomycin. The abolishment of the insulin-induced hyperpolarization decreased the 3-O-MG uptake and increased the 3-O-MG extrusion. The observation in the present study concludes that insulin has two different actions on glucose transport. One of them is developed through the insulin-induced hyperpolarization, which increases the 3-O-MG uptake and decreases the 3-O-MG extrusion. The other action is irrelevant of the insulin-induced hyperpolarization and stimulates both the 3-O-MG uptake and extrusion. PMID- 3556373 TI - Three months energy restricted diet does not reduce peripheral insulin resistance in newly diagnosed non insulin dependent diabetics. AB - Sixteen newly diagnosed non insulin dependent diabetic patients were treated for 3 months with an individual energy restricted diet. The effect on weight, hyperglycaemia and insulin response to oral glucose was measured in all subjects, and in 7, peripheral insulin resistance was estimated using a hyperinsulinaemic glucose clamp at two insulin infusion rates (40 and 400 mU m-2 X min-1). After diet, fasting plasma glucose fell from 12.0 +/- 0.7 mmol/l (mean +/- SEM) to 7.4 +/- 0.5 mmol/l (P less than 0.001) and weight fell from 92.9 +/- 4.2 kg to 85.0 +/- 3.1 kg (P less than 0.001). The plasma insulin response to oral glucose was unchanged after diet therapy. Insulin induced glucose disposal (M) was also unaffected by diet at insulin infusion rates of 40 mU m-2 X min-1 (12.5 +/- 1.5 mumol X kg-1 X min-1 vs 15.7 +/- 1.6 mumol X kg-1 X min-1) and 400 mU m-2 X min-1 (49.5 +/- 2.7 mumol X kg-1 X min-1 vs 55.1 +/- 2.5 mumol X kg-1 X min-1). These results show that 3 months reduction of energy consumption with weight loss in newly diagnosed non insulin dependent diabetics improves B-cell responsiveness to glucose but has no effect on liver glucose output or on peripheral insulin action. PMID- 3556374 TI - Simple devices in differentiating the effects of buprenorphine and fentanyl in healthy volunteers. AB - We have tested the usefulness of the critical flicker fusion threshold-test (CFF), Maddox wing readings (MW), and visual analogue scale scores (VAS) in a double-blind, random-order study designed to evaluate the clinical effects of two different kinds of opiates, buprenorphine and fentanyl in comparison with those of placebo. The results were compared with the so-called postanaesthetic recovery score (PARS). In 7 healthy volunteers MW and VAS differentiated the effects of buprenorphine 7.5 micrograms/kg i.v. from those of fentanyl 2.5 micrograms/kg i.v. and placebo. CFF was very insensitive in this respect and PARS completely useless. Our results show that, in addition to the known usefulness of VAS, MW is also able to differentiate the effects of these opiates. PMID- 3556375 TI - Paracetamol as a test drug to determine glucuronide formation in man. Effects of inducers and of smoking. AB - A simple, noninvasive procedure was developed to monitor glucuronidation and sulphation in patients using paracetamol as the test drug. Urinary paracetamol and its metabolites were determined by UV absorption and electrochemical detection after separation by HPLC. The metabolite to paracetamol ratio (M/P) was used as an approximation of the partial clearance due to metabolite formation. In 14 healthy volunteers, all nonsmokers without medication, M/P was 18 +/- 5 for glucuronides and 12 +/- 4 for sulphate esters. The test was validated in patients treated with enzyme inducers. In 10 patients with epilepsy given phenytoin 0.3 g/day, and in 10 patients with tuberculosis treated with rifampicin 0.6 g/day, the M/P value for glucuronidation was significantly increased to 41 +/- 11 and 35 +/- 7, respectively. In contrast, M/P values for sulphation were not significantly different from untreated controls. In 9 heavy smokers (about 40 cigarettes/day) M/P values for glucuronidation were also significantly increased to 33 +/- 11. However, in 4 moderate smokers (about 10 cigarettes/day) no significant increase was found. The results suggest that in man glucuronidation of paracetamol is inducible both by phenobarbital- and 3-methylcholanthrene-type inducers. Monitoring the ratios of various urinary paracetamol conjugates/paracetamol may be useful as a new tool for the evaluation of factors determining glucuronide and sulphate ester formation in man. PMID- 3556376 TI - Pharmacokinetics of doxorubicin in sarcoma patients. AB - The pharmacokinetics of doxorubicin has been studied in 26 sarcoma patients receiving polychemotherapy. Mean elimination half-life was 34.7 +/- 16.6 h and the total plasma clearance was 29.5 +/- 9.31 X h-1 X m-2. No relationship was found between the pharmacokinetic parameters and the response to treatment, or its toxicity. Special attention was paid to the early-phase kinetics of the drug (3-20 min after injection). A correlation between the early clearance and the ages of the patients was observed. The early clearance was clearly correlated with the total plasma clearance measured over 48 h after injection, indicating the importance of the distribution phase in the overall kinetics of the drug. PMID- 3556377 TI - Ventilatory effects of inhaled capsaicin in man. AB - Nebulised capsaicin (10(-7) M) was inhaled by 8 normal subjects to study its effects on the pattern of breathing. When compared to the diluent alone capsaicin increased mean inspiratory flow, a reflection of central inspiratory drive (mean increase: 25 +/- 6%, SEM, p less than 0.01), with a trend to increasing ventilation through more rapid but not more shallow breathing. If capsaicin selectively stimulates non-myelinated fibres in the lung in man as it does in dogs, these results suggest that such stimulation in man can alter the pattern of breathing. PMID- 3556378 TI - Lidocaine protein binding in preeclampsia. AB - The effect of preeclampsia on the binding of lidocaine to serum proteins was studied in 25 term parturients with severe preeclampsia and in 21 normal parturients serving as controls. There were no statistically significant differences in mean lidocaine free fraction, binding ratio, or serum AAG levels in the control vs preeclamptic patients, respectively. Binding ratio was strongly correlated with AAG concentration for the control (r = 0.91) and preeclamptic (r = 0.85) patients. A statistically significant difference was observed in the slopes of the lines relating binding ratio to AAG. Preeclampsia had little affect on serum AAG concentrations and lidocaine binding ratio. Preeclampsia may alter the interaction of lidocaine with binding sites on AAG without a significant change in lidocaine free fraction. PMID- 3556379 TI - Correction by pentoxifylline of the abnormal fluorescence polarization of erythrocyte membranes from diabetic patients. AB - Erythrocytes from diabetic patients show abnormal rheology. Pentoxifylline, a methylxanthine, improves the abnormal deformability of diabetic erythrocytes, but its mechanism of action remains unclear. We have studied the effect of pentoxifylline on the lipid order of erythrocyte membranes from controls and patients with Type I diabetes. We studied the structural organization of membrane lipids in individual erythrocyte ghosts by fluorescence polarization using a cell sorter. Fluorescence polarization values (P) for 17 controls (P = 0.244) and 20 diabetic patients (P = 0.215) were significantly different. Pentoxifylline added in vitro had no effect on normal membranes, but significantly increased at 10(-5) mol X l-1 (P = 0.233), and normalized at 10(-4) mol X l-1 (P = 0.243), the P value of membrane ghosts from diabetics. PMID- 3556380 TI - Apparent dose-dependence of chloroquine pharmacokinetics due to limited assay sensitivity and short sampling times. AB - We have shown that apparent nonlinearities in the pharmacokinetics of chloroquine and wide variability in reported kinetic values are possibly artefacts of experimental design. We have used simulated data based on linear equations to demonstrate that chloroquine kinetics may appear to be dose-dependent if samples are collected over a short period or if they are assayed with a method of low sensitivity. PMID- 3556382 TI - Drug interaction between lorcainide and rifampicin. PMID- 3556381 TI - Pharmacokinetics of meptazinol after parenteral administration in the elderly. AB - We have determined the pharmacokinetics of meptazinol after its intravenous and intramuscular administration in a crossover study in 7 elderly hospital in patients (greater than 70 years), and have compared with the results from 14 healthy, young volunteers (ages 20-40 years). The systemic availability after i.m. administration was comparable to that after i.v. administration, a result consistent with the physicochemical properties of the drug. There was a slight, but statistically significant (p less than 0.01) prolongation in t1/2Z in the elderly (mean 2.93 h) compared with the young (mean 2.06 h). This was associated with a 25% lower clearance in the elderly rather than with any alteration in volume of distribution. However, these changes would not appear to be substantial enough to require a revised dosage recommendation for meptazinol for this age group. PMID- 3556383 TI - Evaluation of the negative inotropic effect. PMID- 3556384 TI - Cadralazine did not produce the SLE-syndrome when hydralazine did. PMID- 3556385 TI - Variation in chloroquine pharmacokinetics due to assay sensitivity and duration of sampling. PMID- 3556386 TI - Stimulatory effects of cyclosporin A on human and mouse thymic epithelial cells. AB - When injected daily into normal young or aging mice, cyclosporin A (CsA) induces a significant stimulation of thymic hormone (thymulin) secretion, as measured by the peripheral level of the hormone and the number of thymulin-producing cells in the thymus. This stimulation is dose dependent and reversible after the end of treatment. Similar findings have been made in primary cultures of human thymic epithelial cells in which CsA increases the percentage of thymulin-producing cells evaluated by immunofluorescence, as well as the amount of hormone released into the supernatants. No effect of CsA is observed on the expression of class II major histocompatibility complex antigens. CsA also increases the proliferation of cultured human thymic epithelial cells, as assessed by bromodeoxyuridine and [3H]thymidine incorporation. The present study strongly suggests that CsA can stimulate the proliferation and endocrine function of thymic epithelial cells. Its action on the immune system is thus not restricted to lymphoid cells and might be partially mediated by its effect on the thymic epithelium. PMID- 3556387 TI - Differential calcium movements induced by agonists in guinea pig tracheal muscle. AB - The effects of high potassium, carbachol and histamine on tension responses and 45Ca fluxes in tracheal smooth muscle were examined. Calcium depletion or nitrendipine (10(-8) M) inhibited potassium-induced contractile responses more than those obtained with either histamine or carbachol, whereas Sr2+ inhibited mainly responses to histamine or carbachol. The Ca2+ entry facilitator, CGP 28392 (3 X 10(-6) M), potentiated contractions induced only by potassium. Uptake of 45Ca in guinea pig tracheal muscle can be separated into high and low affinity components. The 45Ca efflux rate from tracheal muscle into a La3+-substituted solution was over four-fold higher than in other smooth muscles. Potassium, carbachol and histamine induced sustained increases in 45Ca efflux into solutions containing 1.5 mM Ca2+; only transient increases in 45Ca efflux with carbachol and histamine were obtained after Ca2+ depletion. These agonists elicit contractile responses in tracheal muscle by selectively mobilizing different cellular and extracellular Ca2+ components. PMID- 3556388 TI - Sulpiride injection into the dorsal striatum increases methamphetamine-induced gnawing in rats. AB - Sulpiride injected into the dorsal striatum enhanced both methamphetamine- and apomorphine-induced gnawing but blocked both when injected into the ventral striatum. The hyperlocomotion produced by methamphetamine was reduced by sulpiride injected into the dorsal striatum. The DA, DOPAC and HVA concentrations in the ventral striatum were increased 60 min after the injection of sulpiride into the dorsal striatum. Possible reasons for the enhancement of methamphetamine induced gnawing by sulpiride injected into the dorsal striatum are discussed. PMID- 3556389 TI - A muscarinic receptor with high affinity for pirenzepine mediates vagally induced bronchoconstriction. AB - The nature of the putative muscarinic receptor subtypes involved in vagally mediated bronchoconstriction was examined in the rabbit model utilizing the classical muscarinic antagonist atropine and the selective antagonist pirenzepine. In vivo electrical stimulation of the cervical vagus nerves in anesthetized rabbits resulted in a reproducible increase in pulmonary resistance indicative of bronchoconstriction and a marked negative chronotropic effect on the heart. Both atropine and pirenzepine produced dose-related inhibition of these two vagal effects. Fifty percent inhibition of the vagally induced increase in pulmonary resistance was achieved with an infusion of pirenzepine that was only 8-fold greater than the equi-effective dose of atropine. In contrast, the dose of pirenzepine required to inhibit the vagally induced decrease in heart rate by 50% was 100-fold greater than the atropine dose. Thus, pirenzepine is markedly more potent in inhibiting vagally mediated bronchoconstriction than bradycardia. In vitro inhibition of methacholine-induced contraction of bronchial rings with atropine and pirenzepine yielded pA2 values of 8.86 and 6.88 respectively (95-fold potency ratio), demonstrating that the muscarinic receptors on airway smooth muscle cells that mediate contraction are not of the pirenzepine sensitive subtype. PMID- 3556390 TI - Comparison in vitro of the electrophysiological effects of lorcainide and its metabolite norlorcainide. AB - The effects of lorcainide and its metabolite norlorcainide on the maximal rate of depolarization (Vmax) were compared at different rates of stimulation and at various membrane potentials in ventricular muscle preparations of guinea-pig heart. A standard microelectrode technique was used. The results show that lorcainide and norlorcainide exerted qualitatively similar effects; they both depressed Vmax in a frequency- and potential-dependent way. The following quantitative differences were found: lorcainide was about 50% more potent in depressing Vmax; this difference in potency was observed at 1 and 2 Hz stimulation rates; the block by lorcainide was clearly potential-dependent; in the case of norlorcainide this effect was weak; the onset and removal of block were about twice as fast with lorcainide; the block per action potential was greater with lorcainide. The electrophysiological effects were decreased in the presence of alpha 1-acid glycoprotein, though to a similar extent with both drugs. Taking into account the difference in potency found in the present experiments and the difference in plasma concentration described in the literature, it is concluded that the parent drug and its metabolite both contribute to about the same extent to the in vivo effect of oral treatment with lorcainide. PMID- 3556391 TI - Effects of alpha,beta-methylene ATP on biphasic responses of rat vas deferens. AB - The epididymal region of isolated vas deferens of the rat was stimulated locally with field electrodes. Continuous perfusion with alpha,beta-methylene-adenosine 5'-triphosphate (mATP, 10(-5) M) desensitized the P2-purinoceptors and the effect of this on the two components of tetanic responses and the 'non-adrenergic' and adrenergic phases of single shock responses were examined. Exposure to mATP selectively prevented the contractions to adenosine-5'-triphosphate (ATP, 10(-4) 5 X 10(-4) M) but not noradrenaline (NA, 10(-5) M) and preferentially blocked the secondary but not the primary tetanic component. It also depressed markedly the non-adrenergic phase of single shocks and either reduced or abolished the adrenergic phase. Thus the secondary tension development depends in the rat vas deferens on both the activation of alpha 1-adrenoceptors and the non-adrenergic twitch mechanism. The action of mATP involves more processes than the desensitization of the P2-purinoceptors so does not positively identify purinergic transmission. Direct NA-induced contraction contributes more to the primary than to the secondary tetanic component. PMID- 3556392 TI - Chloroquine is a muscarinic antagonist. Binding and dose-response studies with chick embryo cells. AB - A muscarinic acetylcholine receptor is present on undifferentiated cells of the chick embryo. We show that, in the chick embryo, chloroquine binds to the muscarinic receptor site and behaves as a muscarinic antagonist. In competition studies performed with cell suspensions, chloroquine displaced the specific muscarinic ligand [3H]quinuclidinylbenzilate ([3H]QNB) from the receptor. The dissociation constant (KD) of chloroquine was calculated to be 6.0 X 10(-6) M. In saturation studies performed in chick embryo homogenate, chloroquine shifted the binding curve of [3H]QNB to the right (KD = 4.8 X 10(-6) M). Dose-response curves were established by measuring the acetylcholine-triggered Ca2+ mobilization in cell suspensions by means of a fluorometric assay with chlorotetracycline. Chloroquine shifted the dose-response curve to the right. The inhibitory constant (KI) of chloroquine calculated from the dose-response curve was 1.5 X 1 10(-5) M. Our observations provide an explanation for the known interference of chloroquine with the muscarinic cholinergic systems in a variety of adult organs. PMID- 3556393 TI - A comparison of muscarinic acetylcholine receptors coupled to phosphatidylinositol turnover and to adenylate cyclase in guinea-pig atria and ventricles. AB - The affinities of muscarinic acetylcholine receptor agonist and antagonist compounds have been measured in studies of adenylate cyclase inhibition and phosphatidylinositol turnover in guinea-pig atria and ventricles. The affinities of all compounds tested were similar in atrial and ventricular preparations. However, three antagonists, atropine, pirenzepine and gallamine had different affinities at receptors coupled to adenylate cyclase inhibition compared with those which stimulated turnover of phosphatidylinositols. The neuromuscular blocking agents gallamine and pancuronium, which demonstrate cardioselective acetylcholine receptor antagonist activity, were competitive antagonists at receptors coupled to both second messenger systems. However, their affinities measured in both systems were lower than expected from tissue-response studies. Therefore, the cardioselectivity of these compounds cannot be explained by a simple competitive interaction with receptors coupled to either adenylate cyclase inhibition or phosphatidylinositol turnover. PMID- 3556394 TI - Phencyclidine-induced head-twitch response in rats treated chronically with methysergide. AB - This study was designed to assess whether phencyclidine (PCP)-induced behaviors in rats were potentiated after two days' withdrawal from chronic methysergide (a 5-HT2 receptor blocker) treatment (10 mg/kg per day i.p. for 12 days), in order to confirm the involvement of 5-hydroxytryptamine (5-HT) neurons in PCP actions. The PCP (10 mg/kg)-induced behaviors (head-twitch, head-weaving, turning and backpedalling) were attenuated by successive pretreatment with PCP (10 mg/kg per day i.p. for 12 days), while PCP- and 5-methoxy-N,N-dimethyltryptamine (2 mg/kg) induced head-twitch increased significantly after the repeated methysergide treatment was stopped. The development of tolerance to PCP-induced head-twitch was antagonized by pretreatment with methysergide. Furthermore, Scatchard plots of specific [3H]ketanserin binding at the 5-HT2 receptors and [3H]PCP binding at the PCP receptors in the methysergide group revealed significant increases in binding capacity (Bmax) with no change in affinity (Kd). On the contrary, after development of tolerance to PCP, there were significant decreases in Bmax of [3H]ketanserin binding with no change in affinity. PCP can thus displace [3H]ketanserin at the 5-HT2 receptor site, but not [3H]5-HT at the 5-HT1 receptor site. These facts indicate that PCP may produce head-twitch via an agonistic interaction with 5-HT2 receptor sites. PMID- 3556395 TI - Repeated administration of adenosine increases its cardiovascular effects in rats. AB - Hypotensive and negative chronotropic responses to adenosine in anesthetized rats increased after previous administration of the nucleoside. Bradycardia after adenosine in the isolated perfused rat heart was also potentiated after repeated administration at short intervals. This self-potentiation could be due to extracellular accumulation of adenosine and persistent stimulation of receptors caused by saturation or inhibition of cellular uptake of adenosine. PMID- 3556396 TI - Phencyclidine suppresses the activity of midbrain dopamine-containing neurons recorded from mouse brain slices in vitro. AB - Phencyclidine produced a dose-dependent decrease in the activity of dopamine containing neurons in the substantia nigra and ventral tegmental area recorded from mouse brain slices in vitro. The suppression of dopamine neuronal activity by phencyclidine was blocked by pretreatment of the animals with alpha-methyl para-tyrosine or haloperidol. These data are in contrast with previous studies which reported that the activity of many midbrain dopamine neurons is increased by phencyclidine, while others are decreased and yet others showed no change. PMID- 3556397 TI - Reduced apomorphine-induced sedation following chronic stress. AB - In agreement with previous reports, low doses of apomorphine (10-50 micrograms/kg, 5 min before test) produced a dose-dependent decrease in motor activity of control rats. This effect was markedly attenuated 24 h after a prolonged immobilization stress (2 h daily during 7 days). A single stress session had no effect on motor activity. These behavioral observations suggest a reduced sensitivity of presynaptic dopamine receptors after chronic stress. PMID- 3556398 TI - Effects of diethyl ether, halothane, ketamine and urethane on sympathetic activity in the rat. AB - The present paper describes the effects of different general anaesthetics on plasma catecholamine (CA) concentrations taken as biochemical index of peripheral sympathetic activity. In chronically catheterized rats, diethyl ether, ketamine and urethane increased plasma adrenaline (A) and noradrenaline (NA) concentrations, indicating that these drugs stimulate both neurosympathetic and adrenomedullary functions. These effects appear to be centrally mediated, since ganglionic blockade or spinal transection completely counteracted the diethyl ether- and ketamine-induced increases in plasma CA levels. Halothane induced a transient decrease in circulating A and an increase in NA. These results support the concept that general anaesthetics may have different effects on sympathetic function. Arterial blood pressure and heart rate were also measured to look for possible correlations with peripheral sympathetic activity. The enhanced release of peripheral CAs seemed to be the determining factor for increasing blood pressure and heart rate with ketamine only. In the other instances the activation of the peripheral sympathetic system appeared to maintain homeostasis by counterbalancing the various depressive effects of anaesthetics on the cardiovascular system. PMID- 3556399 TI - Stimulation of ganglionic muscarinic M1 receptors by a series of tertiary arecaidine and isoarecaidine esters in the pithed rat. AB - The cardiovascular effects of a series of tertiary esters of arecaidine (1-methyl 1,2,5,6-tetrahydro-3-carboxy-pyridine) and isoarecaidine (1-methyl-1,2,5,6 tetrahydro-4-carboxy-pyridine) were investigated in the pithed rat. For some esters (e.g. arecoline, arecaidine propargyl ester, isoarecoline) a prominent elevation in mean arterial pressure and heart rate was observed following an initial short-lasting and atropine-sensitive depressor response and bradycardia (dose range: 0.1-10 mumol/kg i.v.). The increase in blood pressure and heart rate was not affected by pretreatment with mecamylamine (0.5 and 5 mg/kg i.v.), but could be totally blocked by N-methylatropine (500 micrograms/kg i.v.). Furthermore, the M1 receptor antagonist pirenzepine (300 micrograms/kg i.v.) selectively antagonized these stimulatory cardiovascular responses, indicating that these effects are due to an activation of muscarinic M1 receptors in sympathetic ganglia. As tertiary arecaidine and isoarecaidine esters easily penetrate the blood-brain barrier, they might also stimulate central M1 receptors and thus become lead compounds in the search for an effective drug treatment of Alzheimer's disease. PMID- 3556400 TI - Adenosine 5'-triphosphate release evoked by electrical nerve stimulation from the guinea-pig gallbladder. AB - The endogenous release of adenosine 5'-triphosphate (ATP) from strips of guinea pig gallbladder during transmural stimulation (TS) was measured with a firefly luciferine-luciferase reaction. TS (15V, 1 ms, 0.5-5 Hz, for 1 min) caused a rapid and marked increase of ATP release in a frequency-dependent manner. Both ATP release and contractions evoked by TS (15 V, 5 Hz, 1 ms) were completely abolished in Ca-free medium. BaCl2 (3 X 10(-3) M), a direct muscle stimulant, produced almost the same degree of contractile tension as TS (15 V, 5 Hz, 1 ms) while the ATP release induced by BaCl2 was significantly reduced to about 60 percent of that induced by TS. Atropine (10(-6) M) significantly reduced TS evoked contraction without affecting ATP release. It was suggested, therefore, that some of the ATP release induced by TS was of neural origin. Theophylline (a P1-purinoreceptor antagonist) 10(-6) M, quinidine (a non-specific P2 purinoreceptor antagonist) 10(-6) M and apamin (a potassium channel blocking agent) 10(-8) M had no effects on TS-evoked contraction and ATP release, suggesting the absence of a presynaptic autoregulatory mechanism of ATP release in the guinea-pig gallbladder. PMID- 3556401 TI - The effects of two types of pyrethroid on rat skeletal muscle. AB - The mechanical and electrophysiological effects of two synthetic pyrethroids, cismethrin (Type I) and deltamethrin (Type II) have been studied in whole rat gastrocnemius muscle and in isolated perfused rat diaphragm. In both directly or indirectly stimulated preparations deltamethrin but not cismethrin had a positive inotropic effect which in the case of the whole animal could be reversed by increasing the stimulation frequency. In the isolated diaphragm the deltamethrin effect could be prevented by TTX suggesting it is primarily the result of an increased sodium conductance. Deltamethrin also reversed a partial curare blockade in the diaphragm. Electrophysiological studies showed that the inotropic effect of deltamethrin is accompanied by repetitive muscle action potentials. In addition deltamethrin significantly increased muscle fibre input resistance, a novel finding which may underlie the curare reversal effect. It is concluded that the effectiveness of deltamethrin compared with cismethrin in causing repetitive firing in the muscle membrane is attributable to the greater duration of the after-depolarization produced by deltamethrin. PMID- 3556402 TI - Correlation between anorectic potency and affinity for hypothalamic (+) amphetamine binding sites of phenylethylamines. AB - The potencies of a number of phenylethylamines and related compounds to inhibit food intake were compared with their relative affinities for hypothalamic (+) amphetamine binding sites in vitro. There was a positive correlation (r = 0.78, P less than 0.001, n = 19) between potencies of these compounds to inhibit food intake and their potencies to inhibit [3H](+)-amphetamine binding. Individual enantiomers of amphetamine, ephedrine, norephedrine, pseudoephedrine and norpseudoephedrine all inhibited food intake with a two- to five-fold greater potency than that of their respective optical isomers. However, they did not exhibit a comparable stereospecificity to inhibit [3H](+)-amphetamine binding. Further, several compounds including imipramine and propranolol, without known anorectic properties were among the most potent agents to inhibit [3H](+) amphetamine binding. Thus, although a positive correlation exists between relative binding affinity and potencies to inhibit food intake, the functional interrelationship is uncertain. PMID- 3556403 TI - Behavioural changes in adult rats produced by early postnatal maternal deprivation and treatment with choline chloride. AB - Rats deprived temporarily of maternal contact and nutrition from the 3rd to 14th day of life showed decreased emotionality and poor memory capacity when tested in adulthood. Simultaneous administration of choline chloride, an acetylcholine precursor, in neonatal life permanently increased the emotionality and restored memory capacity to levels of control animals. However, no effect was demonstrated when choline chloride administration occurred after the deprivation period. The results of this study reveal that the effects on later behaviour appear to be dependent on the timing of choline chloride exposure in early life. Profound and long-lasting abnormalities in brain function produced by early postnatal maternal deprivation can be attenuated by correcting abnormal acetylcholine levels during brain development. Hence, acetylcholine can be considered as an important, environment-dependent local organizer of the brain. PMID- 3556404 TI - Differential behavioural and hormonal responses to two different stressors (footshocking and immobilization) in sheep. AB - Two different stressors footshocking and immobilization applied for 3 days induced in sheep differential behavioural and hormonal responses in cortisol and prolactin secretion. Immobilization drastically disturbed rumen motoric activity (significantly attenuated its contractions), caused loss of appetite and severe general depression. Footshocking did not induce any of these symptoms. Immobilization induced 2-3 fold higher rise of plasma cortisol mesors on the days of stressing as compared to footshocking. On the poststressing days after footshocking as well as after immobilization plasma cortisol mesors fell to 50% of the prestimulatory values. The rise of plasma prolactin mesors in footshocked and in immobilized animals on the days of stressing was nearly of the same magnitude. However, a significant difference in the response of prolactin secretion between footshocked and immobilized animals occurred in the circadian rhythmicity of the hormone secretion. Footshocking induced circadian rhythmicity with characteristic acrophases, while immobilization did not induce the circadian pattern of prolactin secretion. An attempt of interpretation of the described phenomena has been undertaken. PMID- 3556405 TI - Testosterone-induced oestrous cycle blockade in the rat: no evidence for prolactin involvement. AB - The relation between testosterone-induced oestrous cycle disruption and prolactin (Prl) secretion was studied in the female rat. Testosterone propionate (TP) injection on dioestrus 2 (day 0) of 4-day cycles induced cycle interruption for 12 days. A diurnal pattern of Prl secretion was observed from day 1 to day 6 with high levels in the afternoon and low levels in the morning. Cycle interruption also occurred in TP treated females given a dose of bromocriptine (BRC) known to completely block Prl secretion. Impairment of follicular growth resulted from TP treatment and from TP and BRC treatment as well. Until resumption of prooestrous, the follicular size did not exceed that noted during the dioestrous period of the cycle. Despite resumption of follicular growth from day 9 until day 14, ovulation only took place in a small number of animals. These results indicate that the antigonadotropic effects of Prl were not responsible for cycle disruption in our experimental model and that other mechanisms were in itself sufficient for the disruption. This was discussed in the light of previous findings in our laboratory. PMID- 3556406 TI - Effect of estradiol benzoate on rat testis and adrenal. AB - The effects of in vivo administration of estradiol benzoate at a dose of 50 micrograms/rat/day for 15 days on testosterone production of testis and adrenal in vitro were investigated in rats. The data revealed that the androgen synthesis of both the steroidogenic organs were reduced by the treatment. The decrease in androgen production by testis was related to its reduced sperm count and weight. On the contrary, accumulation of cholesterol occurred in treated rat testis indicating inhibition of its steroidogenesis. This data confirm our earlier reports on the direct effect of estrogen on testis. PMID- 3556407 TI - Molecular interaction of nonsteroidal compounds with uterine progesterone receptor (Part I). AB - Progesterone-receptor binding affinity of some nonsteroidal molecules was assessed by competitive protein binding assay in rabbit as well as human uterine cytosol in vitro. Of 40 compounds belonging to 5 different series tested, 3-(p anisoyl)-2-chloro-6, 7-dimethoxy-quinoline exhibited around 50% inhibition whereas 2-(p-anisoyl) naphthalene and 3-substituted phenyl-1-(3-(2-chloro-6, 7 dialkoxy) quinolinyl)prop-2-en-1-one showed around 20% inhibition in 3H progesterone binding for rabbit and human uterine progesterone receptor. PMID- 3556408 TI - The effect of oxytocin and vasotocin upon progesterone, testosterone and estradiol 17 beta-secretion by the luteal cells from cyclic pigs. AB - Porcine luteal cells were obtained from the corpora lutea on the 13th day of the estrous cycle. The cells were digested with 0.25% trypsin and suspended in the Medium 199 with an addition of 10% calf serum, at a concentration of 5 X 10(4) cells/ml. The cells were incubated with or without 4 and 40 mi.u./ml of oxytocin, 10 and 100 ng/ml of arginine-vasotocin, 1 microgram LH and 50 U/ml hCG. Levels of progesterone, testosterone and estradiol 17 beta were determined with the radioimmunological method, following 6 h incubation. It was found that progesterone secretion under the influence of oxytocine (4 mi.u./ml) was less than in the control group and in the group with LH. Similarly, arginine-vasotocin at a dose of 10 ng/ml inhibited progesterone secretion (P less than 0.05). Higher doses of these peptides had no suppressive effect on the luteal cells. Oxytocin and arginine-vasotocin had no influence on testosterone secretion by luteal cells. However, these cells produced less (P less than 0.05) estradiol 17 beta under the influence of oxytocine than of hCG. The results point to a direct effect of oxytocin and arginine-vasotocin on steroidogenesis in the corpora lutea of cyclic pigs. PMID- 3556409 TI - Cholecystokinin affects water intake as well as neurohypophysial storage of vasopressin and oxytocin in the rat. AB - Intracerebroventricular injections of CCK were followed by a decrease of vasopressin and oxytocin content in the neurohypophysis. Water intake and body weight were diminished: serum osmolality and haematocrit index increased. These results suggest a possible regulatory role of CCK in water metabolism and release of neurohypophysial hormones. PMID- 3556410 TI - Does cyclosporin A influence sex hormone level? AB - Cyclosporin A is an effective immunosuppressive substance which is extensively applied in various conditions. A well known side effect of high dose Cyclosporin A treatment is the occurrence of hypertrichosis, often referred to as hirsutism. The purpose of the study was therefore to investigate ovarian, adrenal and pituitary hormones as possible mediators of increased hair growth. In 5 female and 11 male patients who had developed hair overgrowth during Cyclosporin A treatment serum androgens (testosterone, dehydroepiandrosterone-sulfate, androstendione), sex hormone binding globuline (SHBG), prolactin (HPRL), 17 hydroxyprogesterone (17-OHP), 17 beta-estradiol (17 beta-E) and cortisol (F) were determined by standard radioimmunoassay methods. The same number of age matched patients with Azathioprine treatment served as control. Both patient groups received additive cortisone treatment of the same dosage. No significant differences of serum androgens were noted between Cyclosporin A treated patients and controls. In addition, normal prolactin levels were defected. 17-OHP was in the low normal range and cortisol below normal due to the additive cortisone treatment. SHBG was within normal range. The findings thus indicate that increased hair growth caused by Cyclosporin A seems not to be caused by an action of the substance on the hormonal level. PMID- 3556411 TI - The effect of ovariectomy on lipoprotein metabolism during a period of one year. AB - In a follow-up study over one year the influence of sex hormones on lipoprotein metabolism in women after ovariectomy was investigated. During this relatively long period we could observe several changes of lipid and apolipoprotein levels in serum which may be caused by adaptive processes after withdrawal of sex hormones. The first phase of variation of lipids and apolipoproteins (2 weeks after ovariectomy) is strongly influenced by the operation trauma and characterized by a decrease of apo A-I, apo A-II, TC levels and an increase of the triglyceride level. The second phase (6-18 weeks after operation) shows an increase of the levels of apolipoprotein of HDL (apo A-I and apo A-II) and also apo C-II and apo C-III. The pattern in the third phase (one year after operation) differs from that of the two earlier phases and is similar to that in the natural postmenopausal state (elevation of apo B, TC, nonsignificant elevation of apo A-I and significant elevation of apo A-II). It seems that ovariectomy causes permanent changes of the LDL-level whereas the fluctuation of HDL is temporary. The late changes in the lipoprotein spectrum following ovariectomy in the reported direction may be important for the increase of ischemic heart disease observed by many investigators. PMID- 3556412 TI - Androgen administration to transsexual women. II. Hormonal changes. AB - The authors administered to six transsexual women at three-month intervals androgenic depot preparations: testosterone undecanoate (Andriol-Organon) by the oral route and testosterone isobutyrate (Agovirin depot-Spofa) in injections. The achieved changes were evaluated by clinical and laboratory examinations, i.e. somatic changes as well as changes of hormonal indicators in plasma, urine and saliva, changes in the TeBG binding capacity, the effect of the administered hormones on liver functions, glucose metabolism and secretory insulin response. The high plasma androgen level did not vary substantially. After Andriol administration, a significant decrease of plasma TeBG was achieved, and an increase of the free testosterone fraction in saliva which was retained three months after discontinuation of the treatment. Both preparations caused the required virilization, whereby the action of Agovirin depot-Spofa in the selected dose was, as regards the speed of onset and intensity of the androgenization symptoms, more effective. The gonadotropin levels were not changed significantly during short-term administration. No interference with liver functions and glucose metabolism was observed. The patients tolerated both preparations well. PMID- 3556413 TI - Effect of chronic dietary nitrate and different iodine supply on porcine thyroid function, somatomedin-C-level and growth. AB - Due to the lately increased oral nitrate intake of humans and animals the influence of 3% KNO3 in the diet on growth and the thyroid hormone and somatomedin-C-concentration in the serum was to be tested in an experiment with growing pigs in case of different iodine supply. The investigations were undertaken in 3 groups with 9 piglets each. The animals were 6 weeks old: 1. nitrate-exposed, 2. pair-fed to group 1 (without nitrate), 3. ad libitum without nitrate. The mean daily weight gains amounted to 242, 274 and 393 g respectively, after a five-week test period. Compared to the ad libitum control group, the T4-, T3-, rT3- and Sm-C-level of nitrate-exposed animals was significantly lower after 5 weeks. There were no statistically relevant differences between nitrate-exposed and pair-fed animals with regard to the T3- and Sm-C-level. After the 5-week test period with an iodine supply covering the requirement the rations of all 3 groups were supplemented with further 0.8 mg iodine/kg. The T4-, T3- and rT3-levels of the animals of group 1 normalized within one week. The Sm-C-levels of the nitrate exposed and pair-fed group were still decreased. The investigations show that an increased nitrate intake via food and drinking water influences the thyroid hormone metabolism. It should be taken into consideration in the etiology of endemic struma. Furthermore, excessive nitrate intakes influence the Sm-C concentration and thus growth due to food intake depression. PMID- 3556415 TI - Stimulatory effect of intracerebroventricularly administered dopamine on vasopressin release in rats. AB - Experiments were designed to investigate the effects of the intracerebroventricular administration of dopamine (DA) and a DA antagonist (pimozide) on the immunoreactive-vasopressin (IR-VP) contents of the rat magnocellular nuclei (MCN), neurohypophysis (NH) and plasma. The IR-VP levels in the MCN and NH were decreased 5 min after administration of DA in a dose of 20 nmol, but that in the plasma was increased. This effect was not observed after pretreatment with pimozide. Administration of pimozide alone did not affect the IR-VP contents of the MCN, NH or plasma. The results suggest that DA given icv. has a stimulatory effect on VP release from the neurohypophysial system. PMID- 3556414 TI - Influence of lesions of the limbic-hypothalamic system on metabolic response of pyruvate to daily repeated immobilization stress in rabbits. AB - The pyruvate metabolic response to the 1st exposure (exposure on the 1st day) to immobilization stress (IMO) were considerably altered by lesions of the periventricular arcuate nucleus (ARC), ventromedial hypothalamus (VMH), stria terminalis (ST) and dorsal fornix (FX). The pyruvate metabolic responses to IMO were completely abolished by seven times repetition of exposure to IMO in the rabbits with lesions of ARC and VMH; they were similar to sham-operated groups. In rabbits with lesions of ST and FX, the pyruvate metabolic responses to the 7th exposure (exposure on the 7th day) to IMO were almost the same as those after the 1st exposure to IMO, but these metabolic responses were completely abolished by the seven times repetition of exposure to IMO in the sham-operated animals. These results suggest that firstly the ARC, VMH, amygdala (AMYG)-ST system and dorsal hippocampus (HPC)-FX system are involved in the pyruvate metabolic responses to the 1st exposure to IMO, and secondly, that the AMYG-ST system and the HPC-FX system are involved in the disappearance process of pyruvate metabolic responses to IMO by the daily repetition of exposure to IMO. PMID- 3556417 TI - Serum somatomedin activity and growth hormone level in obese men: dependence on degree of obesity and hyperlipidemia. AB - The effect of body weight excess and hyperlipidemia on stimulated growth hormone (GH) secretion and serum somatomedin activity (SSA) has been investigated. Among 40 obese men gradually impairment of GH secretory response during the insulin hypoglycemia test was shown. Propranolol-L-DOPA administration elicited satisfactory GH secretory response only in the subgroup of patients with the mild weight excess. SSA was found to be in the normal range among the whole group of obese patients, however, it was significantly depressed in subjects with average weight excess higher than 100%. Obese men with hypertriglyceridemia and hypercholesterolemia presented low SSA even when their weight excess was relatively moderate, i.e., 52% and 57%, respectively. PMID- 3556416 TI - Lipid metabolism indices and plasma corticosterone concentration in chickens treated with prolactin at different time points. AB - The effect of exogenous prolactin (PRL) on the weight and lipid content of the liver and abdominal adipose tissue as well as on the concentrations of total lipids and lipoprotein fractions (portomicrons, VLDL, LDL, HDL) in plasma was investigated in chickens. PRL or its solvent were administered at different time points (0, 4, 8, and 12 hours after light onset = HALO) during 5 consecutive days. The birds were exsanguinated at the same time of the day when they received the injections, 24 hours after the last one. At the same time plasma corticosterone (CS) concentration was determined in these chickens and also during 24 hours in intact chickens matched for age. PRL affected fat accumulation in the experimental birds and the intensity of this effect depends on the time of the day at which it was administered. PRL caused rise of the weight of the fat tissue and its lipid content when it was injected at 8 or 12 HALO. This was associated with a significant increase of total plasma lipids and with an insignificant increase in the level of lipoprotein fractions excluding portomicrons. PRL increased also (at 4 HALO) or decreased (at 8 HALO) the liver weight. Handling of the birds during vehicle injections decreased the corticosterone level in the control chickens as compared with the intact ones; PRL raised the level of CS at 0 HALO significantly. The role of PRL in the intensification of fat transport is discussed. PMID- 3556418 TI - Stimulatory effect of pentagastrin on growth hormone and prolactin secretion in normal subjects. AB - Gastrin-like immunoreactive substances have been reported as occurring in both digestive tract tissues and nervous system, including the hypothalamus and the anterior and posterior pituitary. The carboxyterminal tetrapeptide shared by gastrin and cholecystokinin, which represents the bioactive site of both hormones, has been shown to be a secretagogue for insulin and glucagon and it might have a neurotrasmitter function. As small gastrin-like peptides may also play a role in the regulation of anterior pituitary hormones, the present study deals with the in vivo effect of pentagastrin on the release of growth hormone (GH) and prolactin (PRL). Six healthy volunteer males and six healthy volunteer females were studied. All females subjects were in the early follicular phase of the normal menstrual cycle and all subjects were not taking or had been taking any drug known to affect GH or PRL secretion. A continuous intravenous infusion of pentagastrin (1.5 micrograms/kg/h) was administered to all the subjects for a time of 3 hours. In males pentagastrin infusion resulted in a significant increase in GH concentration from basal values (P less than 0.01 at 60 min). In females pentagastrin infusion did not affect GH levels. PRL levels were not affected at all by intravenous pentagastrin infusion both in males and females. The exact understanding of pentagastrin action on GH release awaits further investigation. The different pattern between male and female subjects suggests a sexual hormone influence on the hypothalamic-pituitary sites of action of pentagastrin in vivo. Our data did not confirm a stimulatory effect of pentagastrin on PRL secretion in normal subjects. PMID- 3556419 TI - Correlation between mass of parathyroid adenoma and biochemical indicators of bone turnover in patients with primary hyperparathyroidism. AB - We related the weight of the parathyroid adenoma to biochemical variables of bone turnover in 53 patients submitted to parathyroidectomy for primary hyperparathyroidism. There was a positive correlation (r = 0.61, p less than 0.01) between iPTH (c-assay) and adenoma weight. No correlations were found between either concentration of circulating iPTH or weight of parathyroid adenoma and severity of skeletal change expressed by total activity of serum alkaline phosphatase and its bone isoenzyme and urinary excretion of hydroxyproline. We conclude that the severity of bone changes in individual patients with primary hyperparathyroidism does not result from the direct tissue effect of a single hormone (parathyroid hormone). PMID- 3556420 TI - PC13 embryonal carcinoma cells produce a heparin-binding growth factor. AB - A polypeptide growth factor has been isolated from serum-free medium conditioned by mouse PC13 embryonal carcinoma cells, which is strongly mitogenic for Swiss 3T3 fibroblasts. On a CM-2-SW high-performance liquid chromatography cation exchange column at low pH, this growth factor elutes at a salt concentration very close to that of basic fibroblast growth factor (FGF). The growth factor is mitogenic for a mesodermal derivative of embryonal carcinoma (EC) cells, but not for differentiated derivatives with endodermal or ectodermal characteristics, again similar to FGF. The PC13-derived growth factor binds to heparin-Sepharose, and elutes from this column at similar salt concentrations as FGF. These data demonstrate that PC13 embryonal carcinoma cells produce a basic heparin-binding growth factor (HBGF). Since the initial purification steps are similar to those used by Heath & Isacke (EMBO j 3 (1984) 2957 [7]) for isolation of a PC13 embryonal carcinoma-derived growth factor (ECDGF), which is cationic with a molecular weight (MW) close to that of FGF, the present heparin-binding growth factor (HBGF) is most likely identical with ECDGF. PMID- 3556421 TI - A nuclease-derived fragment of metaphase DNA and its relationship to the replicon. AB - When isolated Chinese hamster cells (CHO) metaphase chromosomes are treated with nuclease Bal-31, the DNA is reduced to a size class that is resistant to further degradation. This size class resembles the distribution of replicon sizes in this particular cell line in both average size and size range. Tests based on molecular weight (MW) analysis were devised to locate the origin of replication within the Bal-31 segments. The evidence indicates that replication origins are positioned at or near the center of these segments. The tests were made possible by the additional discovery that BrdU-substituted DNA is highly susceptible to Bal-31 nuclease attack while still contained in the isolated metaphase chromosome. PMID- 3556422 TI - Level of ribosomal RNA required for stimulation from quiescence increases during cellular aging in vitro of mammalian fibroblasts. AB - We have investigated the relation between cell size in terms of cellular ribosomal RNA (rRNA) content and proliferation of diploid human and rat embryo fibroblasts during their aging in vitro. During phase III of the proliferative lifespan in vitro, cellular rRNA content increases by a factor of nearly 3. For very different regimes of stimulation of quiescent cells, a strict correlation was observed, between the proportion of cells stimulated and cellular rRNA content, resembling a steep threshold curve. During aging in vitro, these characteristic curves exhibit an essentially parallel shift to higher values of cellular rRNA content (to higher 'thresholds'). Upon establishment as a permanent cell line, the relation between proliferation stimulation and cellular rRNA ceases to change with further subculturing. It is suggested that the essence of transformation of fibroblasts with a myc-type of oncogenes is a reduction and stabilizing of the critical rRNA content required for proliferation. PMID- 3556423 TI - Respiration capacity of mitochondria isolated from unfertilized and fertilized sea urchin eggs. AB - Mitochondria were isolated from unfertilized and fertilized eggs of the sea urchin, Strongylocentrotus purpuratus. Both preparations exhibited coupled adenosine 5'-diphosphate (ADP)-dependent) oxidation of flavin and pyridine-linked substrates and both yielded the expected P:O ratios with these substrates. Highest respiratory control indices (greater than 4.0) were observed when succinate or pyruvate + malate were used as substrates. Mitochondria from unfertilized and fertilized eggs exhibited sensitivity to respiratory and phosphorylation inhibitors and uncouplers and both preparations exhibited cross over points at sites I, II and III of the respiratory chain. Low-temperature difference spectra revealed a normal complement of cytochromes c, b and aa3, although cytochrome c from unfertilized eggs appears to be more subject to extraction during the course of mitochondrial isolation than does cytochrome c from fertilized eggs. An unidentified pigment absorbing at approx. 570 nm was visible in low-temperature spectra of unfertilized eggs and unfertilized egg mitochondria. PMID- 3556424 TI - Isolation of a human X chromosome-linked gene essential for progression from G1 to S phase of the cell cycle. AB - The tsBN462 cell line, a temperature-sensitive (ts) mutant isolated from the hamster cell line, BHK21/13, cannot progress into S phase at 39.5 degrees C, following the release from isoleucine deprivation. The mutant cells were transfected with high molecular weight (HMW) DNA from human KB cells, and several human DNA bands were found to be conserved through three cycles of ts+ transformation. Conserved human DNA was isolated from the cosmid library of the secondary ts+ transformant (K-1-1), using 32P-labelled total human DNA as a probe. The isolated human DNA covers about 70 kb of human DNA flanked with hamster DNA, and originates from the human X chromosome. The middle part (56 kb) of the isolated human DNA was conserved through the primary, secondary and tertiary ts+ transformation, without gross rearrangement. PMID- 3556425 TI - Inhibition of the phagocytosis-induced respiratory burst by the fungal metabolite wortmannin and some analogues. AB - The sterol-like fungal metabolite wortmannin and a number of natural and chemically-derived analogues were found to block the induction of the respiratory burst during phagocytosis. 17-Hydroxy wortmannin, the most active compound tested, showed a 50% inhibition of the burst in neutrophils and mononuclear phagocytes at concentrations ranging between 0.8 and 17 nM, while wortmannin itself was about half as potent. Chemical derivation showed that a furane structure between ring A and B with adjacent carbonyl functions is essential for activity. At concentrations that entirely prevented superoxide or hydrogen peroxide production, the wortmannins were not cytotoxic and did not inhibit phagocytosis. At even higher concentrations (10 microM), 17-hydroxy wortmannin had no effect on the NADPH oxidase, once activated. This suggests that the wortmannins interfere with the signal transduction sequence initiated by the particulate stimulus and leading to the activation of the respiratory burst oxidase. PMID- 3556426 TI - Ribosomal protein, histone and calmodulin mRNAs are differently regulated at the translational level during oogenesis of Xenopus laevis. AB - The localization of r-protein mRNA in subcellular compartments has been analysed. It was observed that the mRNA for a representative r-protein (L1) is diffuse in the cytoplasm, as shown by in situ hybridization experiments and that the distribution of rp-mRNA between polysomes and light mRNPs changes during oogenesis. In early oogenesis this mRNA is found mostly in subpolysomal fractions, whereas at the beginning of vitellogenesis (stage II) it becomes associated with polysomes where it remains in a constant amount at later stages. Histone and calmodulin mRNA, on the contrary, are mostly associated with non polysomal fast-sedimenting particles throughout oogenesis. This suggests that the partition of different classes of mRNA between polysomes, light mRNP and heavy particles depends on their nature and might be determined by different requirements for these mRNAs during oogenesis. PMID- 3556427 TI - Changes in chromatin structure during aging of human skin fibroblasts. AB - Human skin fibroblasts from embryo, 16-, 30- and 60-year-old adults were cultivated and passaged in vitro. Their chromatin structures were examined by the sensitivity to micrococcal nuclease and by electron microscopy. When the mode of DNA degradation by the nuclease was analysed during in vitro aging of the embryo skin fibroblasts, the discrete ladder of nucleosomal DNA became obscure in old cells. Analogous change of chromatin structure was also observed even in young cells as their donor ages increased. From the observation with electron microscopy, it became clear that chromatin of fibroblasts from 30-year-old adults does not have regularly spaced nucleosomes, compared with chromatin from embryo. These results suggest that the length of the linker DNA which connects core particles becomes to be heterogeneous by aging, both in vivo and in vitro in human skin fibroblasts. PMID- 3556428 TI - Replication of injected DNA templates in Xenopus embryos. AB - We have analysed the replication of both exogenous frog DNAs and heterologous DNAs during development from the first cleavage through the blastula stage, by their microinjection into fertilized eggs of Xenopus laevis. The data show that various plasmids increase to different extents and that the differences cannot be attributed to size alone. Plasmids containing the Xenopus ribosomal gene repeat unit do not replicate efficiently, and they also inhibit the replication of co injected DNA templates. This inhibitory effect may be due to DNA sequences contained in the intergenic ribosomal gene spacers. PMID- 3556429 TI - Evidence for a dual mechanism of chick embryo fibroblast adhesion on fibronectin and laminin substrata. AB - Eight-day-old chick embryo fibroblasts were shown to adhere specifically to fibronectin and laminin substrata. Moreover, the Scatchard analysis reveals 540,000 binding sites per cell for the fibronectin with a dissociation constant (Kd) of 1.35 microM and 5,500 binding sites per cell for laminin with a Kd of 1.5 nM. Furthermore, cell-fibronectin interactions are mediated by plasma membrane proteins of high molecular weight (HMW) (150K and 125K) insensitive to trypsin treatment and low molecular weight (LMW) proteins (95K, 80K, 65K and 45K) sensitive to trypsin treatment. Adhesion of 8-day-old chick embryo fibroblasts on laminin is mediated by plasma membrane proteins highly sensitive to trypsin treatment. Regarding the paucity of laminin-binding sites, the identification of laminin receptor could not be achieved. Nevertheless, this study provides quantitative and qualitative evidences for different mechanisms of 8-day-old chick embryo fibroblasts on laminin and fibronectin. PMID- 3556430 TI - Localization of a gene involved in complementation of the defect in xeroderma pigmentosum group A cells on human chromosome 1. AB - Human, Chinese hamster or Chinese hamster/human hybrid cytoplasts were fused with UV-irradiated xeroderma pigmentosum group A (XP-A) cells. Unscheduled DNA synthesis (UDS) of the XP-A nucleus was measured 0-2 and 2-4 h after seeding of the fused population. Human cytoplasts did correct the defect in the XP-A nucleus immediately after fusion, whereas the chinese hamster cytoplasts did not show this rapid increase in excision repair. The results obtained after fusion of cytoplasts isolated from a panel of 26 Chinese hamster-human hybrids showed that chromosome 1 bears genetic information that is necessary for the rapid correction of the XP-A defect. Furthermore, this genetic information was regionally assigned to 1q42-qter by analysing hybrid cell lines having retained various segments of chromosome 1. Cytoplasts from a Chinese hamster/XP-A hybrid containing chromosome 1 of XP-A origin corrected also the defect with fast kinetics. This result indicate that the correcting factor consists of human and Chinese hamster components. As a consequence, the gene mapped on chromosome 1 may not be the gene which is mutated in XP-A cells. PMID- 3556431 TI - Alterations in lateral lipid mobility in the plasma membrane of urodelean ectodermal cells during gastrulation. AB - The mobility characteristics of lipids were studied in the plasmalemma of dissociated presumptive ectodermal cells from embryos of Pleurodeles Waltl at different stages of development, from early blastula to early neurula, using a Fluorescence Recovery After Photobleaching technique (FRAP), after incorporation of the lipophilic fluorescent probe 5N-(hexadecanoyl)-aminofluoresceine (HEDAF) into the cell plasma membrane. At all stages of development, fluorescence recovery was found to extrapolate to 100%, which suggested that the lipid phase in these plasma membranes can be regarded as dynamically homogeneous (no immobilized fraction). It appears as a continuum over a wide cell surface area, in which lipids are free to move laterally. The lateral diffusion coefficient of the probe, obtained from statistical analysis of the fluorescence recovery data, was found to decrease significantly from blastula to gastrula, slightly increasing at the neurula stage. These changes in the dynamic properties of the lipid probe HEDAF during gastrulation suggest that the lipid phase of the plasma membrane of these ectodermal cells undergo structural changes. The results lend support to the idea that the plasma membrane of these cells is actively involved in the morphogenetic movements which characterize the development of the embryo. PMID- 3556432 TI - Control of membrane permeability in animal cells by divalent cations. AB - The permeability of several cell lines, including HeLa, L929, 3T6 and 3T3, to various compounds is affected by the concentration of divalent cations in the culture medium. In the absence of Mg2+ ions but with 4-8 mM CaCl2 in the medium, HeLa and L929 cells become permeabilized, as measured by the entry of the aminoglycoside antibiotic hygromycin B. However, 3T3 and 3T6 cells become much more permeable when calcium and magnesium are both absent from the medium. Addition of Mg2+ above 2 mM abolishes the permeabilization induced by Ca2+. Basic pH favors permeabilization, whereas acidic pH inhibits the entry of hygromycin B. Increased entry of macromolecules, such as the toxin alpha-sarcin, horseradish peroxidase (HRP) and luciferase, is also observed under permeabilization conditions, suggesting that this method could be of general use, since it is not harmful to cells and is fully reversible. Exit of 86Rb+ ions and [3H]uridine labelled nucleotides was also assayed. We did not observe increased release of these compounds from preloaded cells under various calcium concentrations. Finally, the effects of several inhibitors of endocytosis and other membrane functions on the permeabilization inhibitors of endocytosis and other membrane functions on the permeabilization process were also analysed. The entry of alpha sarcin was not affected by nifedipine, dibucaine or mepacrine, but was partially inhibited by NH4Cl, amantadine and chloroquine. PMID- 3556434 TI - Changes in the virulence of myxoma virus strains in Britain. AB - National surveys of the virulence of field strains of myxoma virus were carried out in 1975 (128 virus strains) and in 1981 (123 strains), using the virulence testing method employed in a similar survey in 1962. Results showed that the virulence of field strains had increased between 1962 and 1975, and again between 1975 and 1981. The increases in virulence are thought to be a result of the development of resistance to myxomatosis in wild rabbit populations. The effects of the changes in virulence and resistance are discussed. PMID- 3556433 TI - Clinical conditions associated with positive complement fixation serology for Chlamydiae. AB - The hospital records of 242 patients with diagnostic chlamydial complement fixation (CF) titres (seroconversion and/or titre greater than or equal to 64) found among 60,000 patients screened for suspected viral illnesses were reviewed to study the clinical conditions associated with positive CF serology for Chlamydiae. After excluding typical genital C. trachomatis infections, the majority of the remainder were considered to represent C. psittaci infections. Respiratory symptoms were the most common clinical manifestations of chlamydial infections detectable by CF, but the majority (58%) of the patients did not have pneumonia. Abdominal, neurological as well as urinary tract symptoms were common. Cutaneous, joint, cardiac, genital and ocular manifestations were also noted. Fever (greater than or equal to 38.5 degrees C) was present in 62% of the patients. The ESR was raised (greater than or equal to 20 mm/h) in the majority of the patients (83%), but the leucocyte count was usually (86%) within normal limits. Because the clinical spectrum of C. psittaci infections is apparently broad, serological tests for detecting antibodies to C. psittaci (e.g. CF) should be used widely in various clinical conditions and not for patients with pneumonia alone. PMID- 3556435 TI - Mite fauna of dust from passenger trains in Glasgow. AB - The mite fauna of dust from cloth-covered seats of four passenger trains and bedding from a British Rail linen store in Glasgow was investigated; 22 samples containing 4488 mg of dust from a total surface area of 5.5 m2 were taken. Sixteen samples were positive for mites and 33 specimens belonging to 10 species were found. The most common species were Dermatophagoides pteronyssinus (Trouessart), Glycyphagus domesticus (De Geer), G. destructor (Schrank) and Euroglyphus maynei (Cooreman). The species composition bore considerable resemblance to that of house dust (although the density of mites was far lower) and the mites have probably been transported from homes via clothing and pets. Only five intact specimens, which may have been alive at the time of sampling, were found. The dust from trains consisted mostly of particles of soot. Very few skin scales, the food source of house dust mites, were detected. The small numbers of intact mites found and the absence of an identifiable food source make it unlikely that permanent populations of mites survive in upholstered seats on trains. PMID- 3556436 TI - Common respiratory and gastrointestinal illness in paediatric student nurses and medical technology students. AB - The aim of this study was to establish the risk of acquiring common respiratory and gastrointestinal illness for paediatric nurses. Using self-administered questionnaires, student nurses at two children's hospitals and students at one school of medical technology reported biweekly the number of minor illnesses, symptoms, and indicators of severity of infection over a 3-year period (1975-8). Although a systematic bias was evident with some symptoms, others appeared to be quite reliable. The following four syndromes were defined to estimate the risk: upper respiratory syndrome (URS), lower respiratory syndrome (LRS), respiratory and gastrointestinal syndrome (RGS), and gastrointestinal syndrome (GS). Surveillance days were allocated to groups with high- or low-intensity contact with children. The incidence of all illnesses was 2.9 per person-year in the low intensity contact group and 4.4 per person-year in the high-intensity contact group. The reported incidence of LRS and RGS in the high-intensity contact group was 1.55 times higher than in the low-intensity group (P less than 0.001). LRS and RGS incidence was similar in nurses at both schools. During low contact periods it corresponded to that of the medical technologists. PMID- 3556437 TI - Epidemiological complexity of hospital aeromonas infections revealed by electrophoretic typing of esterases. AB - An epidemiology analysis of a series of 12 Aeromonas hydrophila infections, including six of septicaemia, which occurred on several wards of one hospital during the summer of 1982 is presented. The hypothesis that the hospital water could be the source of these infections was supported by the isolation of 1-10 motile aeromonads per ml in most of the water samples collected from various points on the hospital water system. Electrophoretic esterase typing was used as an epidemiological screening method to determine the relationship between bacterial strains isolated from the patients and those from water samples. The epidemiology of A. hydrophila infection in the hospital was found to be complex. Amongst the 15 strains of A. hydrophila isolated from patients were 8 zymotypes, while amongst the 126 strains from the water samples there were 37. In some cases, several zymotypes were isolated simultaneously from the same tap water. On one ward, the same zymotype was found in 2 patients and in 2 water samples. The prophylactic measures taken in 1982-5 to avoid oral contamination of immuno compromised patients with infected hospital water have significantly reduced the number of cases of septicaemia. This success has constituted additional retrospective evidence for the water-borne origin of these infections. PMID- 3556438 TI - Predisposition to Trichuris trichiura infection in humans. AB - The study examines the distribution of Trichuris trichiura infection in a village community in St Lucia, West Indies. The infection intensity of the same age stratified population was assessed (by drug expelled worm burden and faecal egg count) at the initiation of the study, and after 17 months of reinfection following treatment. The frequency distribution of worm numbers per person was similar at both periods of sampling. There was a significant correlation between the initial infection intensity of an individual, and the intensity acquired by the same individual following the 17 month period of reinfection. This relationship was observed in a broad range of host age classes. The study provides firm evidence that individuals are predisposed to heavy (or light) T. trichiura infection. PMID- 3556439 TI - Bacteriological status of beef carcasses at a commercial abattoir before and after slaughterline improvements. AB - The bacteriological status of beef carcasses was monitored at a commercial abattoir before and after two stages of modernization to the beef slaughterline which included changing from cradle dressing to dressing on an overhead rail, and the introduction of hot water spray cleaning of carcasses. Although small significant (P less than 0.05) differences in bacterial count occurred among carcass sites within modernization stages, significant visit within stage variation and stage X site interactions prevented any significant change in overall count being observed among stages and carcass sites. Principal components analysis revealed small changes in the distribution of bacterial numbers on the sites sampled. PMID- 3556440 TI - Trimethoprim resistance in commensal bacteria isolated from farm animals. AB - Trimethoprim resistance was examined in faecal bacteria obtained from chickens, sheep, cattle and pigs. The incidence of trimethoprim resistance in porcine strains was 17% (157/922) and, whereas 15.8% (146/922) of these bacteria were highly resistant, only 4% (37/922) of the isolates possessed trimethoprim resistance plasmids. Highly resistant porcine strains were obtained from 44% of the pig farms (41/93) but transferable trimethoprim resistance was found in isolates from 11% (10/93) of the farms. There was an association between the carriage of trimethoprim resistance plasmids and certain farms. Most of the resistance plasmids were not identical with those found in human clinical bacteria but one porcine plasmid was the same as the most ubiquitous trimethoprim resistance plasmid in Edinburgh. PMID- 3556441 TI - Epidemiological studies on leptospirosis in Chiang Mai (Thailand). AB - A total of 270 serum samples collected in Chiang Mai province were examined for antibodies against leptospira using the microscopic agglutination test (MAT). Four of 40 serum specimens from patients who visited the hospital with the common cold, were positive with a titre of 20. Twelve (10.4%) of the 115 samples in the Doi Saket district showed a positive reaction. Only 2 of 115 sera of school children in Chiang Mai city had antibodies. Specific serovars detected were Leptospira hebdomadis (5), L. australis (3), L. icterohaemorrhagiae (2), L. bataviae (2), and one each of L. canicola, L. javanica and L. pyrogenes. One case of mixed infection with L. hebdomadis and L. javanica, and L. autumnalis and L. australis were observed. PMID- 3556442 TI - Application of three typing schemes (Penner, Lior, Preston) to strains of Campylobacter spp. isolated from three outbreaks. AB - Campylobacters isolated from human, animal and environmental sources during the investigation of a milk-borne outbreak, an incident involving goats' milk and an outbreak associated with puppies were serotyped using the Penner and Lior schemes and biotyped using the Preston scheme. Application of these three methods to the incident strains demonstrated that heterogenicity amongst similar strains exists. This study has confirmed the need to use at least two typing methods when investigating epidemiologically-related strains and we suggest that a combination of a serotyping scheme and an extended biotyping scheme is the most useful. PMID- 3556443 TI - Shigellosis in the south-western Cape of Good Hope 1968-85. AB - During the period 1968-85 shigella organisms were isolated from stool specimens of 1562 patients attending Tygerberg Hospital, situated in the south-western province of the Cape of Good Hope of the Republic of South Africa. Shigella flexneri (72% of patients) was the commonest subgroup identified. Sh. sonnei was the second-commonest isolate (20%), with smaller numbers of Sh. boydii (5%) and Sh. dysenteriae (3%). Sh. dysenteriae has not been isolated since 1979. In 1985 30% of isolates were resistant to ampicillin and 52% to trimethoprim sulphamethoxazole. During this period 12 cases of shigellaemia were seen, 11 in young infants less than 13 months of age who were malnourished in 6 cases. The single adult had had a previous gastrectomy and splenectomy. PMID- 3556444 TI - Characterization of Streptococcus zooepidemicus (Lancefield group C) from human and selected animal infections. AB - We assembled an international collection of strains from sporadic and epidemic human infection with Streptococcus zooepidemicus (Lancefield group C) for laboratory study. Cultural and physiological characteristics of the isolates were determined, including biotyping with the API 20 STREP test kit and susceptibility testing with penicillin, erythromycin and tetracycline. The strains were examined for bacteriocin production and sensitivity and typed with a specially developed group-C streptococcal bacteriophage system incorporating a panel of 14 phages. Results of these tests gave useful discrimination between many of the strains: differences were shown between each of the major outbreak strains, including those complicated by post-streptococcal glomerulonephritis. Serious group C streptococcal infection may be caused by S. zooepidemicus and isolates should be identified to species level; the application of a typing scheme such as this may help to distinguish epidemiological patterns of infection. PMID- 3556445 TI - Human infection with Streptococcus zooepidemicus (Lancefield group C): three case reports. AB - Three unrelated severe infections with Streptococcus zooepidemicus occurred in England in 1985. The first patient developed septic arthritis, which has not been recorded before with this organism. The second died with septicaemia, pneumonia and post-streptococcal glomerulonephritis, the only record so far of nephritis following sporadic S. zooepidemicus infection and of nephritis and systemic sepsis in the same patient. The third patient experienced septicaemia during pregnancy but recovered without complications. A likely animal source of infection was found in only one case. PMID- 3556446 TI - Detection of tetanus toxoid antibodies in human sera in New Zealand by ELISA. AB - An enzyme-linked immunosorbent assay (ELISA) incorporating the sensitive biotin streptavidin system was developed to detect IgG antibodies to tetanus toxoid in human serum. Serum samples obtained from 557 normal persons aged 1-65 years from different areas in New Zealand were tested. The proportion of those immune ranged from 60-93% in males, and from 46-86% in females. In the 1-9 years age group 85% were immune. The indirect ELISA is suitable for serological surveys as it is simple to perform, economical and reproducible. PMID- 3556447 TI - A comparison of the distribution of pneumococcal types in systemic disease and the upper respiratory tract in adults and children. AB - The serotype distribution of 874 strains of Streptococcus pneumoniae was determined in relation to patients' age and to frequency of isolation from systemic disease. Types 14 and 18, in pre-school children, and types 1, 4, 7, 8 and 12 in patients over 5 years of age were significantly associated with systemic disease whereas type 23 in pre-school children, and type 6 in older patients was associated with upper respiratory tract carriage. No significant difference was found in the incidence of other types in systemic disease compared to upper respiratory tract carriage. Fifteen diagnostic pneumococcal antisera (to types 1, 3, 4, 6, 7, 8, 9, 11, 12, 14, 17, 18, 19, 22 and 23) sufficed for typing 87% of strains. PMID- 3556448 TI - The influence of carbohydrates on the binding of rod outer-segment (ROS) disc membranes and intact ROS by the cells of the retinal pigment epithelium of the embryonic chick. AB - The role of carbohydrates in mediating the interaction of rhodopsin-containing membranes with retinal pigment epithelium (RPE) cells was investigated by studying the influence of various monosaccharides on their binding by RPE cells of the embryonic chick maintained in cell culture. Rod outer-segment (ROS) disc membranes were selected as a model rhodopsin-containing membrane system for these studies in view of their high concentration of rhodopsin and the relative purity with which they can be isolated. Disc membranes, frozen and thawed in order to expose the carbohydrate groups of rhodopsin which are oriented intraluminally in situ, were incubated with monolayers of RPE cells under various conditions, and the binding of the membranes by the cells was quantitated by radioimmunoassay for rhodopsin. Cell-membrane association was also verified by indirect immunofluorescence microscopy. The surface accessibility of the sugars in frozen thawed discs was verified by succinyl concanavalin A-binding studies. From 15- to 20-fold increase in carbohydrate-reactive sites was obtained after freezing and thawing the discs. The RPE cell-membrane binding process was saturable, and time- and temperature-dependent. By means of competition studies carried out in the presence of high concentrations of various monosaccharides, and also by comparing the binding of disc membranes whose carbohydrate groups were either exposed (frozen-thawed) on the surface or inaccessible (native), it was concluded that the carbohydrates of rhodopsin, mannose and N-acetylglucosamine, were not involved in the interaction with the RPE. The possibility was also examined that enzymatically galactosylated rhodopsin might serve as a site for recognition by the RPE cell. The binding of ROS disc membranes modified in this manner was not enhanced, indicating that the presence of galactose groups on rhodopsin did not serve as a site for recognition by the RPE. The influence of monosaccharides on the binding of intact ROS by the RPE cells was also investigated. Similar to the results with the disc membranes, the process was not blocked by the presence in the incubation medium of high concentrations (up to 30,000-fold higher than that of rhodopsin) of mannose or GlcNAc, as with the disc membranes, or by glucose or galactose. Thus, from these studies it is concluded that a lectin-like carbohydrate-recognition process may not be involved in the interaction between rhodopsin-containing membranes and the RPE cells. PMID- 3556449 TI - Diffusion of lactate and its role in determining intracellular pH in the lens of the eye. PMID- 3556450 TI - Mercury accumulation in the eye following administration of methylmercury. PMID- 3556452 TI - Effect of experimentally-prolonged life span on flight performance of houseflies. AB - Reduction of metabolic rate by the elimination of flying activity extends the life span of male houseflies about two-fold as compared to those permitted to engage in flying activity. Flying performance of flies is known to undergo an age associated decline. The objective of this study was to determine if such an age related decline in flight performance is delayed by the reduction of metabolic rate. Flight performance was measured, by cross-sectional sampling at different ages, by the "stationary flight" method, as the total time spent in flight and the number and duration of individual flights and rest stops during a one hour observation period. Flies kept under conditions of low physical activity exhibited a superior flight performance at all ages as compared to those kept under high activity conditions. The decline in flight performance observed in old flies was delayed in the longer-lived low activity flies as compared to the shorter-lived high activity flies. Results support the concept that the rate of aging in houseflies is modified by variations in the level of physical activity. PMID- 3556451 TI - The rate of diffusion of fluorophores through the corneal epithelium and stroma. AB - The time taken to cross the rabbit corneal epithelium and stroma was estimated for fluorescein (F), carboxyfluorescein (CF), rhodamine B (RB), and sulforhodamine B (SRB). Paired corneas were mounted in vitro; one was intact and the dye solution was kept in continuous contact with its epithelial surface; the epithelium was scraped from the other and the dye was applied as a pulse to the bare stroma. The time course of the dye appearing in a solution rapidly passing over the endothelial surface was determined by fluorometry. This rate of appearance was compared in the two cases and used to estimate the diffusional lag time introduced by the epithelium. For the very hydrophilic CF and SRB, the delay was too short to measure; this is compatible with the passage of these dyes taking place through the paracellular spaces. For the very lipophilic RB, the delay was about 2 min; this was rather too slow for it to be explained as being controlled entirely by diffusion in the cytosol. For the intermediate F, the delay was 5 min; it is suggested that this is a result of it partitioning between the spaces and the cytosol during its passage. The experiments also led to determinations of the permeability of the epithelial and endothelial layers to the dyes. In both cases lipophilicity was a strong determinant of penetration, but not the only one. The permeability of the endothelium to F was unchanged from its in vivo value in these experiments, but that of the epithelium was increased four-fold. The diffusion rate of the dyes across the stroma could also be determined. There was no clear relationship with molecular size or partition coefficient. The rate of diffusion of F across the tissue was about half that in its plane, as determined in previous experiments. This is possibly a result of the anisotropic structure of the tissue. PMID- 3556453 TI - Aging affects the drug metabolism systems of rat liver, kidney, colon and lung in a differential fashion. AB - Microsomes prepared from the liver, lungs, colon and kidney cortex of Sprague Dawley rats of ages 2, 4, 10, 24 and 78 weeks were assessed for hydroxylation activity with the substrate benzo[alpha]pyrene. Liver microsomal activity declined after reaching a peak of activity at 10 weeks. The hydroxylation of benzo[alpha]pyrene by colon, kidney and lung microsomes, however, either remained the same or decreased only slightly. During the age range examined inducibility of hydroxylation activity by beta-naphthoflavone decreased with age in liver but actually increased with age in the extrahepatic tissues. Although phenobarbital did not elicit any increases in liver, kidney or lung, it increased substantially benzo[alpha]pyrene hydroxylation activity in colon microsomes of 78 week old rats. Total cytochrome P-450 content was induced at all age groups in all tissues by beta-naphthoflavone and in all tissues except lung by phenobarbital. Induction of cytochrome P-450 in kidney by phenobarbital was only observed in 24 and 78 week old rats. These data suggest an increased role for extrahepatic activation of benzo[alpha]pyrene with aging. In contrast to total content of cytochrome P 450, the beta-naphthoflavone inducible amount of Form 5 which has a high turnover number for benzo[alpha]pyrene, declined by 55% in liver between 2 weeks and 78 weeks while it increases dramatically in all extrahepatic tissues (from 80 to 138%). PMID- 3556454 TI - An electron microscopic examination of age-related changes in the rat kidney: the influence of diet. AB - The changes with age in the ultrastructure of the kidneys were explored in ad libitum fed rats with restricted food intake started soon after weaning or started in young adult life or limited to early life and in rats restricted in protein but not caloric intake. Many ultrastructural changes occurred with age both in the glomeruli and the tubules. Food restriction started soon after weaning or in adult life modulated most of these age changes. By providing detailed information on basement membrane and tubular cell structure, these findings complement previous light microscopic and functional studies in regard to the effects of food restriction on progressive kidney disease in the rat. Food restriction limited to early life and protein restriction without caloric restriction were less effective in modulating these age changes in kidney ultrastructure than food restriction initiated at 6 weeks or 6 months of age and continued for the rest of the life span. PMID- 3556455 TI - Age-estimations of rats based on the average lateral diffusion constant of hepatocyte membrane proteins as revealed by fluorescence recovery after photobleaching. AB - A method has been developed recently for measuring the average lateral diffusion constant of the proteins (D) in the cell membrane of hepatocytes in liver smears by fluorescence recovery after photobleaching (FRAP). A peroxide-induced autofluorescence (PIAF) of the membrane proteins was used as a fluorescent label. It has been established that D displays a significant negative linear correlation with age. The present paper describes age-estimations carried out on 12 male Fischer 344 rats (7-29 months of age) in so-called "blind experiments": the operator knew only the sex of the rat, determined D from a small piece of the freshly removed liver, and estimated the age of the rat from the age-dependent regression line for D established previously on 16 other Fischer 344 male rats of various ages. There was a strong correlation of the estimated age with the actual one (r = 0.92), the slope of the regression line was 0.98 and its intercept differed from 0 by only 0.5 months. These results indicate that D may play a decisive role in the determination of membrane functions as predicted by the membrane hypothesis of aging. PMID- 3556456 TI - Reorganization of rat vibrissa barrelfield as studied by cortical lesioning on different postnatal days. AB - A small lesion was placed in the rat somatosensory vibrissa cortex on postnatal days (PND) 0, 5, 10, 14 or 20. At the age of three months, the animals were sacrificed and tangential sections of the somatosensory cortex were reacted for detection of succinic dehydrogenase or cytochrome oxidase activity to see if the lesion had produced a defect in the barrelfield. In animals of the groups of PND 0, 5 and 10, the entire barrelfield formed normally, but avoided the lesioned cortex. In a few cases, however, the lesion was found between rows of barrels but never between arcs of barrels. This latter type of result was seen only in the PND-0 group. In animals of the groups of PND 14 and 20, the lesion typically resulted in a defect in the barrelfield. It is concluded that the vibrissa cortex attains its final topographic specificity between day 10 and 14 postnatally. In view of the date of barrelfield formation in normal animals (postnatal day 5), it is thought that the barrelfield is subject to plastic reorganization for some days after its formation; at least for the period between postnatal days 5 and 10. PMID- 3556457 TI - Reflex pathways from group II muscle afferents. 1. Distribution and linkage of reflex actions to alpha-motoneurones. AB - The interneuronally mediated reflex actions evoked by electrical stimulation of group II muscle afferents in low spinal cats have been reinvestigated with intracellular recording with motoneurones to knee flexors and ankle extensors. The results of Eccles and Lundberg (1959) have been confirmed and extended. There was wide convergence from flexors and extensors of group II excitation to flexor and group II inhibition to extensor motoneurones. Some quantitative differences in the effect from the different nerves are described. Latency measurements suggest that the minimal linkage is disynaptic in the excitatory interneuronal pathways and trisynaptic in the inhibitory pathways. Disynaptic group II EPSPs were found in 14% of the ankle extensor motoneurones but were much more common in unanaesthetized high spinal cats (Wilson and Kato 1965). From these results and corresponding ones on flexors (Holmqvist and Lundberg 1961) it is postulated that secondary afferents in addition to the weak monosynaptic connexions (Kirkwood and Sears 1975) have disynaptic excitatory pathways and trisynaptic inhibitory pathways to both flexor and extensor motoneurones. It is proposed that the group II actions of the flexor reflex pattern characterizing the anaesthetized low spinal cat are due to suppression of the inhibitory pathway to flexor motoneurones and the excitatory pathway to extensor motoneurones. In some ankle extensor motoneurones the disynaptic group II EPSPs occurred in combination with IPSPs from the FRA (including group II and III muscle afferents). The possibility is considered that these group II EPSPs are mediated by an interneuronal group II pathway with little or no input from group III muscle afferents but probably from extramuscular receptors. In other ankle extensor motoneurones group II EPSPs were combined with EPSPs from group III muscle afferents, cutaneous afferents and joint afferents. It is postulated that these group II EPSPs are mediated by an interneuronal pathway from the FRA which also supply interneuronal pathways giving inhibition to extensor or/and flexor motoneurones and excitation to flexors as postulated by Eccles and Lundberg (1959) and Holmqvist and Lundberg (1961). PMID- 3556458 TI - Reflex pathways from group II muscle afferents. 3. Secondary spindle afferents and the FRA: a new hypothesis. AB - A hypothesis is forwarded regarding the role of secondary spindle afferents and the FRA (flexor reflex afferents) in motor control. The hypothesis is based on evidence (cf. Lundberg et al. 1987a, b) summarized in 9 introductory paragraphs. Group II excitation. It is postulated that subsets of excitatory group II interneurones (transmitting disynaptic group II excitation to motoneurones) may be used by the brain to mediate motor commands. It is assumed that the brain selects subsets of interneurones with convergence of secondary afferents from muscles whose activity is required for the movement. During movements depending on coactivation of static gamma-motoneurones impulses in secondary afferents may servo-control transmission to alpha-motoneurones at an interneuronal level. The large group II unitary EPSPs in interneurones are taken to indicate that, given an adequate interneuronal excitability, impulses in single secondary afferents may fire the interneurone and produce EPSPs in motoneurones; interneuronal transmission would then be equivalent to that in a monosynaptic pathway but with impulses from different muscles combining into one line. It is postulated that impulses in the FRA are evoked by the active movements and that the role of the multisensory convergence from the FRA onto the group II interneurones is to provide the high background excitability which allows the secondary spindle afferents to operate as outlined above. The working hypothesis is put forward that a movement governed by the excitatory group II interneurones is initiated by descending activation of these interneurones, but is maintained in a later phase by the combined effect of FRA activity evoked by the movement and by spindle secondaries activated by descending activation of static gamma-motoneurones. As in the original "follow up length servo" hypothesis (Rossi 1927; Merton 1953), we assume that a movement at least in a certain phase can be governed from the brain solely or mainly via static gamma-motoneurones. However, our hypothesis implies that the excitatory group II reflex connexions have a strength which does not allow transmission to motoneurones at rest and that the increase in the gain of transmission during an active movement is supplied by the movement itself. Group II inhibition. It is suggested that the inhibitory reflex pathways like the excitatory ones have subsets of interneurones with limited group II convergence. When higher centres utilize a subset of excitatory group II interneurones to evoke a given movement, there may mobilize inhibitory subsets to inhibit muscles not required in the movement.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556459 TI - Limbic oxytocin and arginine 8-vasopressin in morphine tolerance and dependence. AB - Immunoreactive oxytocin (OXT) and arginine8-vasopressin (AVP) levels were measured in limbic areas of the mouse brain (hippocampus, amygdala and basal forebrain). Peptides were measured by radioimmunoassay (RIA). Acute morphine treatment caused a naloxone-reversible increase in OXT content in all three brain regions. The AVP contents of the same brain areas, on the other hand, were not affected by acute morphine treatment. In mice rendered tolerant to/dependent on morphine with subcutaneous morphine pellets, the OXT levels in the limbic brain structures were in the control range (basal forebrain and amygdala) or even decreased (hippocampus). In the latter brain structure of the tolerant animals, the AVP content was also decreased. Naloxone-precipitated withdrawal syndrome in the tolerant/dependent animals resulted in abrupt increases in the OXT and AVP levels of the hippocampus and in the OXT content of the basal forebrain structures. PMID- 3556460 TI - Morphological and electrophysiological characteristics of somatosensory thalamocortical axons studied with intra-axonal staining and recording in the cat. AB - The intracortical arborizations of thalamocortical fibers arising from the ventroposterolateral (VPL) nucleus in the cat were studied following intra-axonal injections of horseradish peroxidase (HRP). The axons were impaled 1.5 to 3 mm below the surface of the cortex, identified electrophysiologically by stimulating the VPL nucleus and functionally by stimulating the somatic receptive field with natural stimuli. Many of the results obtained in a previous study using similar techniques (Landry and Deschenes 1981) were confirmed by the present experiments. Fibers activated by cutaneous stimulation arborized either in area 3b or 1 but some did send branches to both areas. Also, the intracortical arborization of a rapidly adapting cutaneous afferent fiber in area 2 is described. The size and tangential extent of the fiber in area 2 are similar to those arborizing in other areas of the primary somatosensory cortex and consist of multiple patches separated by uninvaded gaps. One fiber activated by stimulation of deep tissue receptors gave rise to two bushes that arborized along a rostrocaudal axis exclusively in area 3b. Terminal boutons and varicosities were found mostly in layers VI, IV, the bottom third of III and the upper portion of V, but some fibers did send a few collateral branches to layer II and the bottom part of layer I. The results suggest that in the forebrain representation, the same modality and submodality can be recorded in more that one cytoarchitectonic area but that areas 3b, 1 and 2 should not be considered as a single functionally homogeneous area. Counts of terminals suggest that a single fiber arborizing in area 1 makes as many as 3 times the number of synapses made in area 2 or 3b. Since fibers appear to be modality and submodality specific, if convergence of modality, submodality and/or body areas occur in the cortex, then this must be preferentially, but not exclusively, done by thalamic fibers of different functions which arborize in the same cytoarchitectonic area and synapse upon a shared postsynaptic target. In the same experiments intra-axonal recordings revealed the presence of two hyperpolarizing after potentials elicited by a preceding action potential. The first after potential was associated with a decrease in excitability of the fiber and an increase in membrane resistance.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556461 TI - Reflex responses of motor units in human masseter muscle to electrical stimulation of the lip. AB - The reflex responses of single motor units in human masseter muscle to electrical stimulation of the lip were recorded. The subject maintained a content mean level of pre-stimulus excitation of the parent motor neurone by biting in such a way that the unit fired at either 10 or 15 Hz during each trial. When firing at 10 Hz, most units were reflexly inhibited for up to 90 ms by electrical stimuli at intensities that were perceived to be mildly uncomfortable. In many units, the inhibition consisted of 2 phases which were separated from each other by a few spikes occurring about 30 ms after the stimulus. It was occasionally possible to evoke only the latter phase (latency about 40 ms) with stimulus at intensities near the response threshold. In these instances, the inhibitory response became biphasic at higher stimulus intensities with the emergence of a shorter (10-15 ms) component. Still higher intensities caused the 2 phases of inhibition to merge, giving the appearance of a single, prolonged, inhibitory response. When the pre-stimulus firing frequency of the unit was changed from 10 Hz to 15 Hz, the inhibitory responses to the same stimuli were decreased, with the longer latency component usually surviving beyond the shorter-latency phase. The pattern of reflex responses observed can be explained by a model based on information derived from intracellular recordings in animal experiments. PMID- 3556462 TI - Decomposition of the human electromyogramme in an inhibitory reflex. AB - The activity of up to 4 motor units was recorded simultaneously with electrodes placed in the masseter muscle in human subjects. Mildly noxious electrical shocks were applied to the ipsilateral lip while one of the units was kept firing at a steady frequency by voluntary control. The pattern of reflex responses of each of the units was determined, and spike-triggered averaging was used to measure the potential that each action potential contributed to the rectified surface electromyogramme (EMG). Finally, the average contribution made to the surface EMG by each unit throughout the whole course of the reflex was determined. The contribution of each unit to the reflex response in the surface EMG was found to depend on its firing frequency throughout the course of the response, and on its amplitude measured at the surface. The timing of the various phases of inhibition and activation of different units depended on their pre-stimulus firing frequency. In a given bite, the lowest-threshold units were more likely to be firing most rapidly, and these were least susceptible to the inhibitory stimulus. Higher-threshold units tended to produce larger potentials at the muscle surface but, because they fired more slowly in a given bite, they were more powerfully inhibited by the stimulus. Most units showed the same general pattern of inhibitory and excitatory activity that can be seen in the surface EMG. However, the timing of these various phases in the surface EMG did not necessarily correspond with the timing of inhibition and activation in the records of individual units.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556463 TI - Activity-related changes in electrical thresholds of pyramidal tract axons in the behaving monkey. AB - In monkeys generating torques about the wrist we investigated changes in the excitability of pyramidal tract (PT) axons, measured as the probability of evoked antidromic responses in motor cortex with constant juxtathreshold stimuli delivered in the brain stem. When PT stimuli were delivered 2-20 ms after an orthodromic action potential in the PT neuron, the excitability of axons was elevated, with a characteristic post-spike time course. Excitability peaked at a post-pike delay of 7.0 +/- 2.7 ms (n = 33). Axonal thresholds typically dropped to 80-90% of the unconditioned values (obtained for stimuli with no preceding spike). Controlling for such post-spike threshold changes by delivering stimuli at fixed post-spike delays, we found that excitability of many PT axons also fluctuated with the wrist responses, being slightly higher during flexion or extension. The place of movement in which excitability increased had no consistent relation to the phase of movement in which the PTN fired. Task-related threshold changes were also seen in PTNs whose discharge was not modulated with the wrist response. Delivering a subthreshold conditioning stimulus also increased the excitability of most PT axons to a subsequent test stimulus. Such post-stimulus changes may be mediated by the effects of adjacent fibers activated by the conditioning stimuli. The post-spike and post-stimulus changed added in a nonlinear way. All three types of threshold change may be mediated by a common mechanism: changes in the ionic environment of the axon produced by activity of the axon itself or its neighbors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556464 TI - Cognitive spatial-motor processes. 1. The making of movements at various angles from a stimulus direction. AB - Naive human subjects (N = 18) were asked to move a manipulandum on a phase in directions other than going straight towards a visual stimulus. They were instructed verbally to generate a movement at an angle from a stimulus direction which varied in 2-dimensional (2-D) space from trial to trial in a pseudorandom fashion. Each subject performed eight sets of twenty consecutive trials: one for moving in the stimulus direction and seven for moving in directions at an angle from it. The angles were 5, 10, 15, 35, 70, 105 and 140 degrees. Nine subjects were instructed to move in the clockwise (CW) departure and 9 to move in either (EI) the clockwise or the counterclockwise (CCW) departure, as they wished. The direction of the movement in 2-D space and the reaction time (RT) were measured. The mean angle achieved in a given set overshot the instruction angle, especially in the lower range (5-35 degrees). The reaction time, RT phi, of movements made at an angle from the stimulus direction showed two kinds of change; first, a step increase from the reaction time, RT0, of movements in the stimulus direction, and second, superimposed upon it, a linear increase with the amplitude of the angle. The slope of the line was similar for the CW (2.37 ms/degree) and the EI case (2.28 ms/degree), but the step increase (y-intercept) for the EI case (84 ms) was substantially less than that of the CW case (155 ms). The linear increase of the RT with angle is compatible with the idea that performance in the task may involve a mental rotation of the imagined movement vector about its origin. The rotation would begin from the stimulus direction and end when the required angle is judged to have been reached; in addition, corrections of this angle at the end of the rotation could be made. The slope of 2.37 ms/degree observed in the CW case would correspond to a rotation rate of 422 degrees/s. The finding of a similar rate for the EI case indicates a similarity in strategy with regard to achieving a desired angle. In contrast, the lower intercept observed for the EI case suggests significant savings in processing information which is unconstrained with regard to angular departure. Assuming this model of internal motion, we analyzed the amplitude-accuracy relations using Fitts' (1954) approach to real movements.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556465 TI - Eye movement responses to combined linear and angular head movement. AB - Lateral eye movements evoked by linear head motion were evaluated in human subjects by subtracting the eye movement responses to head-centred angular oscillation in the dark, about a vertical axis, from the responses evoked by similar oscillation with the head displaced 30 cm eccentrically from the axis. The centred oscillation gave a purely angular stimulus whereas the eccentric oscillation gave an additional tangential linear acceleration acting laterally to the head. The stimuli used were relatively unpredictable, enveloped sinewaves at 0.02 to 1.2 Hz, 60 degrees/s peak angular velocity, 0.004 to 0.24 g peak tangential acceleration, and subjects were either given no instructions or were told to imagine fixating on targets at 60 cm or 5 m distance. Eye movements of significantly higher velocity were evoked in the eccentric position, particularly at the higher frequencies and when subjects imagined near targets. The increase in velocity of eye movement was attributed to the linear stimulus and probably derives from stimulation of the otolith organs. The frequency response of the gain (degree/s/g) of these movements gave an approximate slope of -1, indicating that the eye velocity bears a constant proportionality to linear head velocity. The findings are in accord with the theoretical prediction that eye movements compensating for linear head motion should only be required for viewing near targets. These otolithic influences on eye movements could either the mediated by a direct "otolith-ocular reflex" which is subservient to viewing conditions, or, alternatively, the otolith signals may modify the activity of other oculomotor mechanisms. PMID- 3556466 TI - Difference in projections to the lateral and medial facial nucleus: anatomically separate pathways for rhythmical vibrissa movement in rats. AB - The present paper demonstrates that the lateral and medial subdivisions of the rat facial motor nucleus (NVII) receive differing mesencephalic and metencephalic projections. In order to study brain projections to facial nucleus, horseradish peroxidase (HRP) was injected iontophoretically into the entire facial nucleus or the following subdivisions: lateral, dorsolateral, medial, intermediate, and ventral. In the mesencephalic region, the retrorubral nucleus was found to project to the contralateral medial subdivision of NVII, while the red nucleus was found to project to the contralateral lateral subdivision of NVII. Other mesencephalic projections to the facial nucleus arose from the deep mesencephalic nucleus, oculomotor nucleus, central gray including interstitial nucleus of Cajal and nucleus Darkschewitsch, superior colliculus and substantia nigra (reticular). In the mesencephalic region, the Kolliker-Fuse nucleus, parabrachial nucleus, and the ventral nucleus of the lateral lemniscus projected mainly to the ipsilateral lateral subdivision of NVII. In addition, the trapezoid, pontine reticular, vestibular, and motor trigeminal nuclei were observed to have predominantly ipsilateral connections to the facial nucleus. In contrast, projections from the myelencephalic region were to both the lateral and medial subdivision of NVII. The medullary reticular nucleus, ambiguus nucleus, spinal trigeminal nucleus and parvocellular reticular nucleus projected to both lateral and medial subdivisions of NVII with an ipsilateral predominance. The gigantocellular and paragigantocellular reticular nuclei, raphe magnus, external cuneate nucleus and the nucleus of the solitary tract also projected to the facial motor nucleus. Surprisingly, no direct projections to the NVII were observed from diencephalic and telencephalic regions. Our findings that the lateral subdivision of NVII which innervates vibrissa-pad-muscles (Dom et al. 1973; Martin and Lodge 1977; Watson et al. 1982) receives different metencephalic and mesencephalic projections than medial subdivision which controls pinna movement (Henkel and Edwards 1978), suggest that the functional difference between these subdivisions is mediated by the anatomically separate pathways. We confirmed our anatomical findings by eliciting exclusively vibrissa responses by electrical stimulation of the nuclei which project to the lateral subdivision of NVII. PMID- 3556467 TI - The role of visual reafferents during a pointing movement: comparative study between open-loop and closed-loop performances in monkeys before and after unilateral electrolytic lesion of the substantia nigra. AB - In order to elucidate the compensatory role of visual feedback during movement, two experiments were designed to compare the motor performances of Papio papio baboons depending on whether the animals were able to visually control the limb trajectory (visual closed-loop condition) or not (visual open-loop condition). The visuomotor task used consisted of making trained pointing movements towards a stationary target. In experiment A, the baboons were successively presented with these two experimental conditions. The abolition of visual control was found to cause no change in either reaction time (RT) or movement time (MT), but brought about extensive pointing errors. It was also associated with a conspicuous increase in the mean velocity and the mean length of the trajectories. In experiment B, two groups of baboons were used. The monkeys in the first group were required to perform under closed loop conditions. The second group performed the pointing movement under open loop conditions. Once criterion was reached by each animal, a unilateral electrolytic lesion of the substantia nigra (SN) was performed. A comparison between the post operative performances of the animals in the two groups showed that suppression of visual cues resulted in a lengthening of the RT and a slowing of the movement speed. Moreover when visual feedback was lacking, the amplitude of the movement decreased and the finger fell short of the target. During the last post operative period, suppression of visual feedback brought about a more rapid return of RTs to their preoperative level and a more durable slowing of movement speed than with normal vision. The discussion deals with the role of visual feed-back in the control of movement preparation and execution, and with the change in mode of motor control caused by lesion of the SN. Partial exclusion of the SN might bring about a shift from the feedforward to a feedback mode relying more heavily on visual cues. PMID- 3556468 TI - Anatomical and electrophysiological evidence for a direct projection from Ammon's horn to the medial prefrontal cortex in the rat. AB - Following microinjection of wheat germ agglutinin-horseradish peroxidase (WGA HRP) into the medial prefrontal cortex (defined as the neocortical area innervated by the thalamic mediodorsal nucleus) labelled cells were observed in the pyramidal layer of the CA1 field of Ammon's horn. Observations made using antidromic stimulation confirmed these results, and revealed that slow conduction velocity of the fibers of the hippocampal cells innervating the prefrontal cortex. Taken together, these data provide evidence for a direct projection of CA1 cells to the medial prefrontal cortex. PMID- 3556469 TI - Hypothalamic control of nocireceptive and other neurons in the marginal layer of the dorsal horn of the medulla (trigeminal nucleus caudalis) in the rat. AB - The effect of electrical stimulation of the preoptic area of the hypothalamus on the discharge of neurones in the marginal layer (lamina I) of the trigeminal nucleus caudalis was studied in the anaesthetised rat. There was a powerful suppression of the discharge evoked by noxious thermal stimuli in 49/49 specific nociceptor driven (nocireceptive) neurones. The inhibitory effect increased with graded increases in the intensity of preoptic stimulation. Stimulation, however, produced only a small reduction in the discharge of 14/17 cold receptive neurones. Thresholds for producing suppression of cold receptive neurones were generally higher than those for nocireceptive neurones. There was no effect on the activity of 12/12 low threshold mechanoreceptive neurones. The inhibitory action generated on the activity of nocireceptive neurones was reduced by electrolytic lesions in the nucleus raphe magnus (NRM) or the nucleus paragigantocellularis lateralis (PGCL) or the dorsolateral and ventrolateral periaqueductal gray matter (PAG). Lesions made in the ventral or dorsal aspect of PAG were, however, ineffective in reducing the suppression. It is suggested that the powerful descending inhibitory control of nociceptive transmission in the trigeminal nucleus caudalis is one of the neuronal mechanisms mediating analgesia from the preoptic area of the hypothalamus. PMID- 3556471 TI - Visuo-motor tracking during reversible inactivation of the cerebellum. AB - Two monkeys were trained to track a continuously moving target using a joystick. One then had a cooling probe implanted in nucleus interpositus of the cerebellum ipsilateral to his tracking arm. The other had a cannula implanted in the ipsilateral cortex of the lateral cerebellum through which local anaesthetic could be infused. Both monkeys showed similar tracking deficits during temporary inactivation of the cerebellum. The main effects seen were an increase in the peak velocity of their intermittent corrective tracking movements, and a decrease in the accuracy of these movements. Linear regression analyses were undertaken of the peak velocity and amplitude of each corrective movement against a number of possible control signals (target velocity, target position, error, error velocity etc.). The initially strong correlation of the amplitude of each movement made with target velocity was severely reduced during cerebellar inactivation, and movement amplitude became better predicted by the error between target and joystick positions. The peak velocity of movements became more strongly correlated with movement amplitude and less correlated with target velocity than in the intact animal. These results are consistent with the hypothesis that intermittent tracking is achieved by the production of 'primitive' movements, that are then adjusted to the correct amplitude and velocity required to catch up with the moving target. Our findings suggest that the cerebellum may normally be responsible for these adjustments, using visual and memorised cues about the target. The velocity of each movement may be reduced, and its amplitude adjusted, by combining measures of the current error with estimates of target speed and direction. We conclude that the cerebellum has an inhibitory role in tuning movements during visuo-motor tasks and that optimal tuning using feedforward measurements of target motion cannot be made without it. PMID- 3556472 TI - Effects on visual search of lesions of the superior colliculus in infant or adult rats. AB - The superior colliculus was removed from rats at either one or five days of age or in maturity. Four months later they were tested on two versions of a visual search task. Experiment 1 required animals to retrieve food pellets concealed in a depression in the top of identical narrow pillars arranged in an arena. Rats with lesions of the superior colliculus, regardless of the age at operation, showed a large number of 'return' errors compared with sham-operated controls. Return errors were defined as occasions on which the animal returned to pillars that had previously been visited on that trial, before every pillar had been visited at least once. Experiment 2 compared the ability of infant- and adult operated animals to detect and locate a single, baited white pillar in an array of black ones. There were no group differences in response latencies to targets presented in the rostral visual field (within 40 degrees of the midline). However, animals operated on in adulthood or at 5 days of age were slower than both sham-operated animals and animals operated on at one day of age in their responses to more peripheral targets. The latter two groups were indistinguishable. PMID- 3556470 TI - Retrograde labeling of neurones in the brain stem following injections of [3H]choline into the forebrain of the rat. AB - In an attempt to identify cholinergic neurons of the brain stem which project to the forebrain, retrograde labeling of neurons in the brain stem was examined by autoradiography following injections of 20 microCi [3H]choline into the thalamus, hypothalamus, basal forebrain and frontal cortex. After injections into the thalamus, retrogradely labeled neurons were evident within the lateral caudal mesencephalic and dorsolateral oral pontine tegmentum (particularly in the laterodorsal and pedunculopontine tegmental nuclei) and in smaller number within the latero-medial caudal pontine (Reticularis pontis caudalis, Rpc) and medullary (Reticularis gigantocellularis, Rgc) reticular formation. Following [3H]choline injections into the lateral hypothalamus and into the basal forebrain, retrogradely labeled neurons were localized in the dorsolateral caudal midbrain and oral pontine tegmentum and in smaller number in the medial medullary reticular formation (Rgc), as well as in the midbrain, pontine and medullary raphe nuclei. After injections into the anterior medial frontal cortex, a small number of retrogradely labeled cells were found in the brain stem within the laterodorsal tegmental nucleus and the dorsal raphe nucleus. In a parallel immunohistochemical study, choline acetyltransferase (ChAT)-positive neurons were found to be located in most of the regions of the reticular formation where cells were retrogradely labeled from the forebrain following [3H]choline injections. These results suggest that multiple cholinergic neurons within the lateral caudal midbrain and dorsolateral oral pontine tegmentum and a few within the caudal pontine and medullary reticular formation project to the thalamus, hypothalamus and basal forebrain and that a limited number of pontine cholinergic neurons project to the frontal cortex. PMID- 3556473 TI - Accuracy of voluntary movements at the thumb and elbow joints. AB - Subjects made simultaneously movements from a common rest position and attempted to align corresponding joints (elbow joints, or distal joints of thumb), on opposite sides of the body. When misalignments were expressed in angular terms, variability of performance within and between subjects was greater for thumb than for elbow joints. When the misalignments were expressed in terms of linear misalignment at the end of the moved lever arms, variability of performance within and between subjects was less for thumb than elbow joints. However, when the misalignments were expressed in terms of mean proportional changes in the lengths of fascicles in muscles operating at the joints, variabilities of performances at both joints were similar. In another test, subjects made small unloaded movements at either the elbow joint or the distal thumb joint to guide a cursor along a narrow path. When the movement task was made similar for the elbow and thumb joints in terms of either the angular excursion required, or the required linear excursion of the moved lever tip, accuracy of performances at the two joints varied greatly. Only when the tasks were similar in terms of the mean proportional changes of length in fascicles of muscles operating at the joints, were performances at the two joints of similar accuracy. The results suggest that proportional change in muscle fascicle length is a significant variable for the CNS in proprioception and the control of voluntary movement. PMID- 3556474 TI - Motor abnormalities in weaver mutant mice. AB - Weaver mutant mice lose mainly cerebellar granule cells. Motor abnormalities included less activity in a hole-board test and a loss of balance in two equilibrium tests. It was noted that the weaver mutants also displayed paw clasping responses when held by the tail of a sort never seen in normal mice. The role of the cerebellum in these abnormalities is discussed. PMID- 3556475 TI - Action of dopamine and serotonin on the membrane potential of cultured astrocytes. AB - The actions of dopamine, apomorphine and serotonin on the membrane potential of cultured astrocytes from rat spinal cord and striatum were examined. All three compounds caused a hyperpolarization of the majority of astrocytes tested. A small number of cells was depolarized and on a relatively large number of cells the amines had no effect. The dopamine antagonists cis-flupenthixol and domperidone reversibly blocked the effects of dopamine whereas the action of serotonin was antagonized by ketanserin. It is therefore concluded that the effect of both amines are due to activation of specific dopamine and serotonin receptors, respectively. Our electrophysiological data together with autoradiographic binding studies provide evidence that astrocytes possess receptors for dopamine and serotonin in addition to adrenoceptors and histamine receptors. PMID- 3556476 TI - Autoradiographic localization of binding sites for 3H-serotonin and 3H-ketanserin on neurones and astrocytes of cultured rat brain stem and spinal cord. AB - By means of lightmicroscopic autoradiography we have studied the cellular localization of binding sites for 3H-serotonin and 3H-ketanserin in organotypic cultures of rat brain stem and spinal cord. In both types of cultures, a relatively great number of neurones revealed binding sites for 3H-serotonin which predominantly labels S1-receptors. 3H-ketanserin, an S2-antagonist was also bound to many neurones although to a lesser extent than 3H-serotonin. Binding sites for both radio-ligands were also observed on astrocytes. These findings together with electrophysiological investigations indicate that astrocytes possess serotonin receptors. PMID- 3556477 TI - Discharge patterns of afferent cutaneous nerve fibers from the rat's tail during prolonged noxious mechanical stimulation. AB - Feedback controlled constant force stimuli of 4, 6 and 8 N intensities and of 120 s duration were applied to the receptive fields of cutaneous afferent fibers in the rat's tail. Two types of nociceptive units showed sustained discharges during these stimuli: "polymodal" unmyelinated C-units (MH-C units, N = 18, c.v. 0.5-0.9 m/s) and high-threshold mechanoreceptive A-delta-units (HTM-units, N = 10, c.v. 1.9-11.2 m/s). In addition two classes of sensitive low threshold mechanoreceptors, SA I (N = 6) and SA II (N = 5) units, responded to the prolonged mechanical stimuli. At the onset of a noxious pressure, 11 of the 18 polymodal nociceptors exhibited dynamic responses (lasting about 10 s) which were followed by slowly adapting tonic discharges that lasted for the duration of the stimuli. The remaining polymodal C-fiber units (8/18) did not show dynamic discharges at 4 and 6 N. Phasic and tonic discharges were positively correlated with stimulus strength. The HTM-units encoded stimulation intensity mainly by their dynamic discharges. The tonic discharges of these units displayed faster adaptation rates with stronger mechanical stimuli, i.e. encoding of stimulation intensity became progressively weaker during the tonic phase. The discharges of sensitive SA I and SA II units with A beta axons were not positively correlated with the strength of noxious pressure stimuli. Tonic discharge rates of SA I units were negatively correlated to stimulus strength, whereas SA II units usually stopped firing in the course of a stimulus and became reversibly irresponsive to mechanical stimulation. Possible afferent mechanisms underlying the induction of pain by sustained noxious mechanical stimulation are discussed. PMID- 3556478 TI - Sensitization of nociceptive cutaneous nerve fibers from the rat's tail by noxious mechanical stimulation. AB - This single fiber study on rat tail nerve afferents attempts to establish a peripheral neural correlate for the hyperalgesia to mechanical stimulation which follows injury to the skin. Mechano-heat sensitive C fibers (MH-C or "polymodal" nociceptors) and high-threshold mechanoreceptive A delta fibers (HTM-A delta) were examined with a series of constant noxious pressure stimulations (4-6-8-4 N on 25 mm2, 120 s each, 5 min intervals). These injurious stimuli were either directed to the most sensitive spot of the receptive fields (central stimulation) or closely outside their borders (1-5 mm). With this protocol no clear sensitization was seen in MH-C fibers apart from a stronger dynamic response to central stimulation in some of them. In contrast, most HTM-A delta units, irrespective of the site of noxious stimulation, developed spontaneous activity, lowering of their von Frey thresholds and expansion of their receptive fields. All HTM-A delta units responded to outside stimulation: upon the first stimulus (4 N) there was a delayed discharge of continuously increasing frequency ("recruited response"), but the onset of the last stimulation (4 N repeated) evoked vigorous dynamic responses in many fibers. The recruitment of HTM-A delta nociceptor activity may contribute to post-injury hyperalgesia to mechanical stimulation and it may counteract adaptation of the single afferent fiber during prolonged noxious influence. PMID- 3556480 TI - Intracellular calcium in mammalian brain cells: fluorescence measurements with quin2. AB - Dispersed brain cells from 12-14 day old mouse embryos were loaded with the Ca2+ sensitive fluorescent probe, quin2 and shown to have a resting intracellular Ca2+ concentration ([Ca2+]i) of 158 nM (SE +/- 5) in the presence of 1 mM [Ca2+]o. When external [Ca2+] was raised from 0 to 1 mM there was an increase of [Ca2+]i of 70 nM; with further additions of Ca to greater than or equal to 10 mM [Ca2+]o the level of [Ca2+]i increased by less than or equal to 25 nM. Releasable intracellular Ca2+ stores, estimated from the increase in [Ca2+] produced by 4-Br A23187 in the absence of extracellular Ca2+, were 24 fmol/10(6) cells. A small increase in [Ca2+]i could be produced by the mitochondrial inhibitor, carbonyl cyanide m-chlorophenylhydrazone (CCCP). When extracellular K+ was raised by 10-20 mM, intracellular Ca2+ levels increased from 152 (SE +/- 7) to 204 nM (SE +/- 10). These K+-induced increases in [Ca2+]i were blocked by verapamil, did not occur in the absence of extracellular Ca2+, and presumably reflect the activation of voltage-dependent Ca2+ channels. N-methyl-D-aspartic acid (NMDA) evoked an increase in [Ca2+]i, while the kainate-like lathyrus sativus neurotoxin, L-3 oxalyl-amino-2-aminopropionic acid (L-3,2-OAP) did not; this is consistent with previous observations of different and respectively Ca2+-dependent and independent mechanisms of action of these excitatory amino acids. PMID- 3556479 TI - Evoked potential changes in rat hippocampal slices under helium pressure. AB - High pressures of helium affect the physiology of the central nervous system in animals and humans. We examined these effects in rat hippocampal slices. The in vitro preparation displayed a reversible reduction in postsynaptic and antidromic field potentials of CA1 pyramidal cells, but no significant change in the amplitude of the afferent volley. Although the subliminal synaptic response of CA1 neurons was depressed, the ability of these cells to produce population spikes was enhanced. These changes resembled those previously found in vivo in the rat hippocampus. The present results support the hypothesis of a helium pressure-induced depolarization of hippocampal neurons. Other possible mechanisms are discussed. PMID- 3556481 TI - Automatic postural responses in the cat: responses of proximal and distal hindlimb muscles to drop of support from a single hind- or forelimb. AB - Cats respond to drop of the support from beneath a single limb with the "diagonal stance response" (Coulmance et al. 1979). They load the limbs on the diagonal opposite to the one containing the dropped limb and unload the third supporting limb in the diagonal containing the dropped limb. Characteristic biomechanical delays in limb motion and in vertical force changes imposed upon the limbs are observed. These delays range from 30 to 45 ms, depending upon the location of the dropped limb. This study describes the kinematics of the "diagonal stance response" and the activation of selected agonist-antagonist muscle pairs acting on the joints of the hindlimb during the response. Proximal and distal hindlimb muscles respond to perturbations in groups that are appropriate to the vertical forces imposed upon the limb. When the hindlimb containing the recording electrodes is loaded by drop of the contralateral hindlimb or the ipsilateral forelimb medium latency (25-45 ms) EMG responses occur in the extensors. This response serves to stiffen the limb against the increased vertical force of loading. A similar response is observed when the hindlimb is reloaded after being dropped. In this case, however, short latency responses precede the medium latency responses in muscles that are passively stretched by the limb drop. When drop of the diagonal forelimb unloads the hindlimb containing the electrodes, medium latency responses are observed in the distal hindlimb flexors, which indicates that the unloading is evoked in part by active lifting of the limb. In most cases, the medium latency responses precede or are coincident with the changes in force imposed on the limb, suggesting that the observed responses are centrally programmed. PMID- 3556482 TI - Forward and backward axial synergies in man. AB - Upper trunk and head forward and backward movements were analyzed in human subjects standing on a force platform. EMG of several flexor and extensor muscles was recorded together with the kinematics of the movement (EL.I.TE. system). It was found that upper trunk movements are accompanied by movements of hip and knees in the opposite direction, resulting in a slight displacement of the center of gravity projection on the ground. In fast movements, all the body segments were displaced at the same time, which suggests a feedforward control, whereas in slow movements, onset of displacement of the body segments was found to take place sequentially in a cranio-caudal direction. EMG analysis during fast movements revealed two different types of control, utilized in forward and backward movements. With forward bending movements the action of two sets of muscles could be recognized: the prime mover (R. Abd.), the activation of which was not correlated with that of the other muscles and preceded the onset of movement with a fairly constant lead, and a group of postural muscles, the activation (VM, TA) and inhibition (Sol) of which were closely correlated. By contrast, with backward movements, the prime mover (Er.S.) and the postural leg muscles (Hamstrings, Sol) were activated simultaneously. In both cases, a feedforward type of control is evident. Performance of the fast forward movements was accompanied by an initial forward displacement of the knee. The function of this phenomenon is discussed in term of a destabilizing action favouring the forward bending of the body or a prestretching of the knee extensor muscles increasing the strength of their subsequent contraction. PMID- 3556483 TI - Receptive field properties of cells in area 19 of the cat. AB - We have recorded extracellularly from single cells in area 19 of the cat for the purpose of providing a quantitative description of response characteristics. A prominent feature of this area is a high incidence of cells that are end-stopped. Drifting sinusoidal gratings were used to determine spatial and temporal characteristics of the discharge region. In addition, we have conducted independent tests to characterize end zones of receptive fields. When a grating patch was used to stimulate the discharge region alone, all of the cells showed a band-pass spatial frequency tuning characteristic. The optimal spatial frequency ranged from 0.1 to 1.13 cycles/deg, and the distribution had a peak at 0.4 cycles/deg. The bandwidth at half peak amplitude ranged widely from 0.7 to 3.3 octaves (mean 2.0 octaves). When gratings were also presented to the end zones, responses to stimulation of the central region were suppressed. The surround was phase-insensitive in that the relative phase between the grating in the two regions generally did not affect the strength of the suppression. To determine spatial characteristics of the end-zone inhibition, the spatial frequency of the end-zone grating was changed while that for the central pattern was fixed. All cells showed a band-pass characteristic for end-zone inhibition, but in each case, the tuning width was broader than that for excitation. The mean spatial frequency bandwidth of end-zone inhibition was 2.7 octaves. The peak of the inhibition generally coincided with the peak of the excitatory spatial frequency tuning of the discharge center. Considered together, these results show that neurons in area 19 share common properties with those in areas 17 and 18, but they exhibit phase-insensitive end-zone inhibition more frequently. PMID- 3556484 TI - Dynamic properties of the vertical otolith neck reflexes in the alert cat. AB - Electromyographic activity of dorsal neck muscles elicited by sinusoidal vertical linear accelerations was studied in alert cats over a wide range of frequencies. Experiments were performed in head-fixed cats and total darkness in order to activate selectively the otolith system. The polyunitary EMG activity was recorded from splenius capitis muscles in normal and labyrinthectomized cats during vertical translations varying from 0.05-1 Hz with a fixed 290 mm peak-to peak amplitude. The corresponding accelerations ranged from 0.003-1.2 g. In normal cats, the results showed a bilateral and sinusoidal modulation of the EMG activity characterized by two typical EMG patterns depending on the stimulus frequency. In the low-frequency range (0.05-0.25 Hz), the neck muscles responses were composed of a second harmonic (frequency double that of the input signal: H2 responses). The H2 pattern was characterized by an increase in EMG activity during both the upward and downward parts of translation. These two components of the H2 response were closely related to the two peak velocities (+90 degrees and 90 degrees) of the animal motion. Only slight decreases in amplitude and shifts in phase were observed when increasing the frequency. In the higher frequency range (0.25-1 Hz), the neck muscles response was composed of a fundamental frequency corresponding to the input signal (H1 response). The H1 pattern was in phase with the peak of downward acceleration at 0.25 Hz. A phase lag (up to 45 degrees) and a gain attenuation (16.5 dB) were observed when increasing the frequency. The two H1 and H2 EMG patterns were totally absent in bilateral vestibular neurectomized cats. In unilateral vestibular neurectomized cats, a strong drop in gain and phase advance was noted, which mainly affected the H1 pattern. The present results describe some characteristics of otolith-spinal reflexes acting on the head musculature during vertical motion. They are compared with the neuronal responses that we have recorded within the vestibular nuclei complex in the same experimental conditions. The functional role of the vertical otolith-neck reflexes in stabilizing the head in space during many real-life situations is discussed. PMID- 3556485 TI - Neuronal coding of linear motion in the vestibular nuclei of the alert cat. I. Response characteristics to vertical otolith stimulation. AB - The aim of the present study was to investigate some aspects of the central processing of otolith information during linear motion. For this purpose, the response characteristics of 69 vestibular nuclei units to sinusoidal otolith stimulation in the vertical Z axis were analysed in the alert cat. Among this population of neurons which responded to a 0.05 Hz, 290 mm translation, 47 units (70%) displayed a firing rate modulation which followed the input frequency (H1 units). The majority of these neurons exhibited an increase in discharge rate during upward displacement, with a response phase close to the motion velocity or slightly leading downward acceleration. The acceleration related units were divided into two groups according to whether they showed clear increases or only a slight change in discharge rate when the stimulus frequency was increased. The former group was characterized by an average -16.3 dB drop in gain (from 43.9 +/- 1.8 dB, S.D. to 27.6 +/- 7 dB, S.D.) within the 0.05 Hz-0.5 Hz frequency range, while the latter group displayed an average -31.2 dB gain attenuation (from 45.1 +/- 1.1 dB, S.D. to 13.9 +/- 0 dB) within the same decade. In contrast to differences in response gain, all the units tested exhibited a relatively stable phase lead of about 20 degrees with respect to downward peak acceleration. Conversely, units whose response was close to motion velocity in the lower frequency range (0.05 Hz-0.10 Hz) displayed a strong phase lead of about 100 degrees when the stimulus frequency was increased (up to 0.50 Hz). These neurons were thus characterized by an acceleration related response in the higher frequency range. At the same time, an average -24.8 dB gain attenuation (from 47.7 +/- 3.4 dB to 22.9 +/- 3.7 dB) was found in the 0.05 Hz-0.5 Hz decade. The remaining 22 neurons (30%) were called H2 units since they displayed a response waveform double that of the input frequency, a response already described during sinusoidal rotation. Unit discharge reached a peak approximately in phase with maximum upward and downward velocity. Asymmetrical change in unit firing rate about the resting discharge level and different dynamic behavior of the upward and downward response components were usually found. These response characteristics suggest that the H2 patterns are centrally constructed and could result from convergence of otolith afferents having opposite polarization vectors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556486 TI - Local precision of visuotopic organization in the middle temporal area (MT) of the macaque. AB - The representation of the visual field in the middle temporal area (MT) was examined by recording from single neurons in anesthetized, immobilized macaques. Measurements of receptive field size, variability of receptive field position (scatter) and magnification factor were obtained within the representation of the central 25 degree. Over at least short distances (less than 3 mm), the visual field representation in MT is surprisingly orderly. Receptive field size increases as a linear function of eccentricity and is about ten times larger than in V1 at all eccentricities. Scatter in receptive field position at any point in the visual field representation is equal to about one-third of the receptive field size at that location, the same relationship that has been found in V1. Magnification factor in MT is only about one-fifth that reported in V1 within the central 5 degree but appears to decline somewhat less steeply than in V1 with increasing eccentricity. Because the smaller magnification factor in MT relative to V1 is complemented by larger receptive field size and scatter, the point-image size (the diameter of the region of cortex activated by a single point in the visual field) is roughly comparable in the two areas. On the basis of these results, as well as on our previous finding that 180 degrees of axis of stimulus motion in MT are represented in about the same amount of tissue as 180 degrees of stimulus orientation in V1, we suggest that a stimulus at one point in the visual field activates at least as many functional "modules" in MT as in V1. PMID- 3556487 TI - Head movements during optokinetic stimulation in the alert rabbit. AB - Pigmented rabbits with their heads free to move about the vertical axis were seated inside a rotating optokinetic drum in order to evoke the optocollic reflex (OCR). At drum velocities below 5 degrees/s, head movements were inconsequential, and eye velocity generally matched drum velocity. At velocities between 5-15 degrees/s head movements were irregular and slight; head velocity was less than 20% of drum velocity, and gaze was undercompensatory by 1-3 degrees/s (retinal image motion of 1-3 degrees/s). At drum velocities above 15 degrees/s, and especially above 30 degrees/s, head movements were substantial (more than 20% of the drum velocity), but gaze was undercompensatory by 60-70% of the stimulus velocity. In the same rabbits in the same test periods and conditions, the vestibulo-collic reflex (VCR) was evoked with vision with minimal gaze undercompensation relative to a stationary surround; however, when deprived of vision the VCR gain dropped. The present results support the notion that with vision, the OCR does not contribute significantly to the improvement of the VCR response, since massive undercompensation of the gaze relative to the rotating drum was required in OCR testing to evoke head movements similar to those seen in VCR tests. Due to many differences in operating characteristics of the vestibular and optokinetic systems, and due to the nature of OCR testing, there were several unexpected results: in some cases head movements did not result in summation of vestibular and optokinetic reflexes, and with sinusoidal drum rotations of about 2 degrees/s2 peak acceleration there was overcompensation (gaze moves faster than the drum) for intervals up to 20 s. Thus, optokinetically generated active head movements could produce behavior strongly contrasting with passively induced head movements in visual-vestibular tests. It is tentatively concluded that in mammals there is a vestigial and specific optokinetic control of gaze and that the optokinetic control of the head is weak (relative to the eyes). However, other non-reflex mechanisms controlling head movements-such as stimulus entrainment and temporal asymmetries in the vestibular and optokinetic reflexes-must also be considered to explain all facets of the data. PMID- 3556488 TI - Responses of neurons in the inferior temporal cortex in short term and serial recognition memory tasks. AB - Gaffan and Weiskrantz (1980) and Mishkin (1982) have shown that lesions to the inferior temporal visual cortex can impair the performance of serial visual recognition memory tasks. In order to provide evidence on whether the inferior temporal visual cortex contains a mechanism which enables memory to span the intervening items in a serial recognition task, or whether the inferior temporal cortex is merely afferent to such recent memory mechanisms, we analysed the activity of single neurons in the inferior temporal visual cortex and the adjacent cortex in the superior temporal sulcus in both delayed match to sample and serial recognition memory tasks. In the serial recognition task, various numbers of stimuli intervened between the first and second presentations of a stimulus. A considerable proportion (64/264 or 26%) of visually responsive inferotemporal neurons showed a different response to the "novel" and "familiar" presentations of a stimulus in the serial recognition memory task, and often a corresponding difference in response between the sample and match presentations of a stimulus in the delayed match to sample task. For the majority of neurons this difference was not sustained across even one intervening stimulus in the serial recognition task, and no neurons bridged more than 2 intervening stimuli. These results show that neurons in the inferior temporal cortex have responses which would be useful for a short term visual memory for stimuli, but would not be useful in recency memory tasks in which more than one stimulus intervenes between the first and second presentations of a stimulus. In this investigation, neurons were recorded both in the cortex on the inferior temporal gyrus (commonly called inferior temporal visual cortex, and consisting of areas TE3, TE2 and TE1 of Seltzer and Pandya 1978), and in the cortex in the adjacent anterior part of the superior temporal sulcus, in which a number of different temporal cortical visual areas have now been described. PMID- 3556489 TI - A centrifugal respiratory modulation of olfactory bulb unit activity: a study on acute rat preparation. AB - In behaving rats, unit activity in the mitral and granule cell layers of the olfactory bulb (OB) can be modulated by respiration. In order to determine whether central influences could take part in this phenomenon, respiratory rhythm and the activity of OB units were recorded in the present experiment and analyzed temporally in 18 anaesthetized tracheotomized rats. In spite of the interrupted nasal airflow, 30 of the 80 cells recorded in the mitral and granule cell layers, still displayed a significant respiratory patterning of their activity. Maximal neuronal discharges were time-locked with different phases of the respiratory cycle, most often synchronized with the end of expiration. This is in contrast with previous observations in intact animals. Possible underlying mechanisms are discussed. PMID- 3556490 TI - Monoclonal anti-vasopressin (VP) antibodies penetrate into VP neurons, in vivo. AB - The fate of monoclonal anti-vasopressin antibodies (VP-MAbs) injected in vivo into the paraventricular nucleus (PVN) of the rat brain was studied by immunocytochemistry. Depending on the post survival time, VP-MAbs contained in an ascites fluid were stained at different levels of the VP neurons: the cytoplasm of the PVN neurons, the fibres of the median eminence and the granular layer of the Gyrus Dentatus. The identification of endogenous peptides synthesized by PVN neurons showed that the VP-MAbs uptake was specific: it did not appear either in the oxytocinergic neurons or in the non immunoreactive neurons of the Brattleboro rat brain, this rat being genetically incapable of synthesizing central VP. Conversely, VP-MAbs only penetrated into the VP neurons: ascites fluid containing monoclonal antibodies prepared against bovine thyroglobulin (the carrier conjugated to VP in our immunizations) was neither stained in magnocellular neurons nor carried in nerve fibres. The neuronal uptake and transport of VP-MAbs occurred in vivo: they were totally inhibited by heating of the ascites fluid at 56 degrees C for 30 min; this treatment did not alter the VP-MAbs themselves but probably destroyed some thermic sensitive component essential to the macromolecule internalization. The biological effects of antibodies injected in vivo have been reported. The results described here suggest that some specific antibodies passively transferred into the brain could act directly on the peptide synthesis recognized by the antibodies. PMID- 3556491 TI - Cortical field potentials associated with audio-initiated hand movements in the monkey. AB - Monkeys were trained to respond to auditory stimulus by lifting a lever (audio initiated hand movement), and field potentials were recorded from various cortical areas with electrodes implanted on the surface and at a depth of 2.0-3.0 mm, depending on the area. Tones of 500, 1000 and 2000 Hz were given to the monkey for about 500 or 10 ms, as auditory stimuli. In association with the movement, potentials of different configurations were recorded respectively in the primary auditory, auditory association, prefrontal, premotor, motor and somatosensory cortices. Initial surface-positive (s-P), depth-negative (d-N) potentials appeared in the primary auditory and auditory association cortices about 20 ms after the onset of the auditory stimulus, and they were often followed by s-N, d-P potentials. In the forelimb area of the motor cortex contralateral to the moving hand, s-N, d-P potentials appeared at a latency of about 100 ms. Following cerebellar hemispherectomy ipsilateral to the moving hand, the s-N, d-P potentials in the forelimb motor cortex were eliminated and reaction times prolonged. The same monkeys were also trained to perform a visuo initiated movement, and results were compared with each other. Primary sensory and sensory association areas activated during such movements were certainly different, and the prefrontal association cortex appeared to participate much less predominantly in the audio- than in the visuo-initiated movement. Reaction times were generally longer and more variable for the audio- than for the visuo initiated movement. Nevertheless the cerebello-thalamo-motor cortical projection was found to be recruited in the same manner prior to both movements. PMID- 3556492 TI - Dark-reared cats: unresponsive cells become visually responsive with microiontophoresis of an excitatory amino acid. AB - The visual system of kittens reared in total darkness is grossly abnormal. Although estimates vary, substantial proportions of cells in the visual cortex of these animals are unresponsive to visual stimulation. Additional cells are weakly responsive or erratic. We have considered the possibility that these neurons receive subthreshold input which might be evident if an excitatory neurochemical agent is applied during extracellular recording with a microelectrode. To test this notion, we have recorded from cells in the striate cortex of dark-reared kittens during microiontophoretic application of an excitatory amino acid, DL homocysteate (DLH). Using this technique, we find that virtually all cells in the visual cortex of dark-reared kittens are responsive to visual stimulation. Prior to application of DLH, 27% of the cells were unresponsive to visual stimuli. Following iontophoresis of DLH, half of these cells responded with excitatory discharge to visual stimuli and the other half exhibited an inhibitory response in that the elevated maintained activity was suppressed during presentation of a visual stimulus. Additional cells from these animals, which were initially visually responsive, were also studied. For some of these units, responses were weak prior to administration of DLH and we were able to obtain a more clear estimate of selectivity for stimulus orientation during microiontophoresis of the drug. In these cases, and for the few cells which were initially responsive and orientation selective, we observed no major differences in selectivity before and after DLH application. PMID- 3556493 TI - Dark-reared cats: responsitivity of cortical cells influenced pharmacologically by an inhibitory antagonist. AB - When studied physiologically, dark-reared kittens exhibit abnormal responses. Specifically, cortical cells respond poorly, if at all, to visual stimulation. In the preceding paper (Ramoa et al. 1986) we showed that iontophoretic application of an excitatory amino acid allows all cells in this preparation to be excited or suppressed by visual stimuli. In the current study, we have pursued this finding by studying additional dark-reared kittens using iontophoretic application of an inhibitory antagonist, bicuculline methiodide (BIC). Responses of most cells studied were affected by application of BIC. Of cells which were originally weak or unresponsive, 76% became clearly responsive with application of BIC. Of cells which responded without BIC and were orientation-selective, only 33% lost selectivity during application of BIC. Considered together, these findings suggest functional inhibitory input in dark-reared animals which appears to differ from that in normal kittens with respect to its role in selectivity for stimulus orientation. PMID- 3556494 TI - Dark-reared kittens: GABA sensitivity of cells in the visual cortex. AB - Most cells in the visual cortex of dark-reared kittens are unselective for stimulus orientation and we examined the notion that this might be due to insufficiently developed gamma-aminobutyric acid (GABA) receptors. We recorded from cortical neurons and examined their sensitivity to iontophoretically applied GABA. As expected, most units were non-selective for orientation, but application of GABA suppressed impulse activity of these cells just as for orientation selective neurons. This result suggests that the development or maintenance of GABA receptors is not critically dependent on visual experience. PMID- 3556495 TI - Abolition of the orthodromically evoked IPSP of CA1 pyramidal cells before the EPSP during washout of calcium from hippocampal slices. AB - The complex EPSP-IPSP response of CA1 pyramidal cells to orthodromic activation of Schaffer collaterals-commissural afferent fibres was monitored during washout of Ca from hippocampal slices. The IPSP was clearly abolished before the EPSP and this occurred when the extracellular Ca([Ca2+]o) had fallen to between 1.03 and 0.7 mM. The loss of the IPSP was usually associated with a temporary increase in size of the EPSP and sometimes a membrane depolarization and the appearance of spontaneous activity. As [Ca2+]o fell further these effects were reversed and eventually the EPSP was abolished when [Ca2+]o had reached between 0.78 and 0.26 mM. PMID- 3556496 TI - Glial fibrillary acidic protein (GFAP)-like immunoreactivity in normal and transected rat olfactory nerve. AB - Normal and transected rat olfactory nerves were stained immunohistochemically using a monoclonal antibody previously shown to selectively detect GFAP-like immunoreactivity in central astrocytes but not in peripheral Schwann cells. Low levels of "central" type GFAP were found in the olfactory nerves, presumably in ensheathing cells. The levels of GFAP increased dramatically after nerve transection. A population of strongly GFAP-positive cells was detected at the junction between the olfactory epithelium and initial part of the nerves, of possible relevance to the regenerative abilities of this pathway. PMID- 3556497 TI - Effects of low pass filtering on the brainstem auditory evoked potential in the rat. AB - The effects of low pass filtering on the brainstem auditory evoked potential (BAEP) were studied in the adult male rat. The bandpass of the recording system was progressively widened while the cut-off frequency of the high pass filter remained constant at 3.2 Hz. When the high frequency cut-off was 320 Hz or less, the principal waveform recorded in response to a click stimulus was a slow positive-negative complex. As the high frequency setting was raised from 800 Hz to 3.2 kHz, the slow components of the brainstem were replaced by four fast BAEP waves (I, II, III and IV). As the bandpass widened there was an increase in amplitude and a decrease in the absolute latency of all four fast waves in the order of 0.1 ms although the wave I-IV interpeak latency remained unaffected. The results confirm that the high frequency components of the BAEP are underlain by a slow positivity of uncertain origin followed by a slow negativity which probably arises within the inferior colliculus. PMID- 3556498 TI - On the role of posterior parietal and prefrontal cortex in visuo-spatial perception and attention. AB - Monkeys with bilateral removal of caudal prefrontal cortex (area 8) or dorso lateral parietal cortex (areas 5 and 7) or the inferior temporal cortex (area TE) were presented with two versions of a go-left/go-right visuo-spatial discrimination. In the first task they had to displace either the left or right of two identical plaques according to whether both plaques were black or white respectively. There were no performance differences among groups. In the second task, the two plaques were always red and the appropriate response was indicated by whether a spatially remote third plaque was black or white. Both the prefrontal and parietal groups were impaired relative to the inferotemporal group on this task. The results indicate that whether an impairment occurs on a task that is thought to test the perception of egocentric space may depend on whether the animal has to notice and attend to a remote cue, and that an attentional disorder may also explain impairments reported on tests of allocentric perception where the critical cue is spatially remote from the response site. PMID- 3556499 TI - Selective mediation of kappa-opioid central cardiovascular effects by ascending noradrenergic pathways. AB - The role of ascending noradrenergic pathways in the mediation of central opiate induced cardiovascular effects has been investigated. The effects of selective kappa- and delta-opiate agonists microinjected into the nucleus tractus solitarius (NTS) of urethane anaesthetized rats were compared following 6 hydroxydopamine lesions of either the dorsal (DNAB) or ventral (VNAB) noradrenergic bundles. In sham lesioned animals both opiates elicited a significant pressor effect and a variable but consistent bradycardia. The delta agonist responses were not modified in lesioned rats. In marked contrast the pressor effect of the kappa-agonist was abolished in both DNAB and VNAB lesioned rats. The bradycardic response was not significantly modified. These findings are consistent with previous observations that the cardiovascular effects of kappa- and delta-opiates in the NTS are mediated via different mechanisms, and provide evidence for selective functional actions of endogenous opioids within brain nuclei. PMID- 3556500 TI - Detection latencies of X and Y type cells of the cat's dorsal lateral geniculate nucleus. AB - The latencies of visually-evoked responses from X- and Y-type neurons of the cat's dorsal lateral geniculate nucleus were measured in a manner that takes account of the inherent variability of discharge in these cells. Latencies measured in this way vary from trial to trial in one cell (and also between cells) by tens to as much as hundreds of milliseconds. This variability in the time for generation of reliable responses suggests that the much emphasized conduction advantage of the Y pathway plays a minor role in the detection of visual stimuli by the cat. PMID- 3556501 TI - Ontogeny of 3H-muscimol binding to membranes of chick forebrain. AB - A potent GABA agonist, 3H-muscimol, was used to investigate the development of GABA receptors in left and right hemispheres of chick forebrain from day 12 in ovo to day 21 post-hatch. Total specific 3H-muscimol binding (p mol mg-1 protein) increases rapidly in ovo, reaching a peak at around day one post-hatch and then showing a slow decline to approximately 50% of the maximal level at day 21 post hatch. Despite the considerable evidence from previous studies of lateralization of avian brain function, no significant hemispheric differences were found in 3H muscimol binding (either of p mol hemisphere-1 or p mol mg protein-1) at any of the developmental ages examined. PMID- 3556502 TI - Ventral root potentials of the cat's sacrococcygeal segments evoked by stimulation of intact and transected dorsal roots. AB - The latency and amplitude of reflex-evoked potentials in the sacrococcygeal ventral roots of acute spinalized cats were investigated. The characteristics of the potentials were examined in response to electrical stimulation of intact and acutely transected dorsal roots. We found that: the last sacral and caudal (coccygeal) segments of the cat's spinal cord are endowed with electrophysiologic characteristics that distinguish them from other spinal segments (e.g., L7-S1); afferent stimulation of the corresponding intact dorsal roots evokes in the ventral root of segment S2 a small monosynaptic response, whereas no monosynaptic response is seen in segment Ca6; acute transection of the dorsal roots provokes an increment of the monosynaptic response in all segments studied except for Ca6; rhizotomy provokes in Ca5 the appearance of polysynaptic responses to electrical stimulation of the corresponding dorsal root; and transection of the cutaneous afferent fibers of the coccygeal motoneurons resulted in an increment of monosynaptic and polysynaptic responses, indicating the removal of inhibitory effects. PMID- 3556503 TI - Effect of experimentally elicited rhythmic oral activity on the linguodigastric reflex in the lightly anesthetized rabbit. AB - The digastric reflex was elicited in lightly anesthetized juvenile rabbits by electrical stimulation of the tongue. The reflex was depressed by maintained intraoral mechanical stimuli and facilitated by transient intraoral mechanical stimuli applied using a vinyl tube in the buccal sulcus. Intraoral mechanical stimuli were also used to elicit rhythmic oral activities; these were of four types but only the two most easily distinguished types were studied further. One type, elicited by agitating a soft vinyl tube in the buccal sulcus (the tube was then taken further into the mouth by the animal and chewed), was categorized as "transport/chew"; another type, most easily elicited by fluid passed down the stationary tube (which was then removed), was categorized as "liquid." When initiated, the two rhythmic activities continued with no further external stimulation although the intraoral self-stimulation differed. When the digastric reflex was elicited during rhythmic movements, the response was phasically modulated. More than 80% of the digastric reflex responses elicited during jaw closure in "liquid" cycles were less than control values but less than 60% of responses elicited in the same phase of "transport/chew" cycles were less than control values; the difference was significant (P less than 0.001; chi 2). The findings were consistent with two hypotheses: that sensory input, generated by the animal during the rhythmic oral movements, modulates the reflex; and that stimuli initiating particular rhythmic oral movements select one of a number of potential modes of operation of the pattern generator, each with its characteristic pattern of modulation of the digastric reflex. PMID- 3556504 TI - Reflex responses evoked from cats' coccygeal ventral roots by electrical stimulation of the tail nerves. AB - In the terminal cone of the cat spinal cord, the coccygeal segments give rise to the ventrolateral and dorsomedial nerves of the tail. Extracellular recording was made from the ventral root of the coccygeal segments after stimulation of each or both ventrolateral and dorsomedial nerves. Stimulation of either nerve caused a polysynaptic response of 5- or 10-ms latency. A monosynaptic response was not seen unless posttetanic potentiation was carried out, or both nerves were stimulated simultaneously. It is suggested that the ventrolateral and dorsomedial nerves are linked by a common pathway, allowing spatial summation to take place, thus facilitating the elicitation of a monosynaptic response. The neural organization underlying the muscle movements of the cat's tail is discussed. PMID- 3556505 TI - Greater disturbance of water and ion homeostasis in the periphery of experimental focal cerebral ischemia. AB - Differences in disturbed water and ion homeostasis in the periphery and the center of focal cerebral ischemia were investigated. Focal cerebral ischemia was induced by occlusion of the right common carotid artery in gerbils. Water and electrolyte content were determined using punched-out samples. In 2 h of ischemia, water content of the cerebral cortex was 79.0 +/- 0.3, 82.0 +/- 0.4, and 80.7 +/- 0.4% (means +/- SE) for the nonischemic region, the periphery, and the center of the ischemic region, respectively (significantly different). Na+ content was increased and K+ content was decreased most prominently in the periphery of the ischemic region. K+ depletion and exogenous Ca2+ accumulation in the peripheral region were visualized by K+ staining and 45Ca autoradiography, respectively. Thus, water and electrolyte changes in the periphery of ischemia were different from those in the center. Brain edema was developed initially in the marginal region of the focal cerebral ischemia. PMID- 3556506 TI - Amygdala kindling modifies interhemispheric dopaminergic asymmetry. AB - Brain dopamine is known to retard the development of kindled seizures, but it is uncertain whether kindling affects dopamine function. In the present study, rats were screened for cerebral dominance by recording their preferred direction of rotation when injected with d-amphetamine. Bipolar stimulating electrodes were then implanted in the amygdaloid complex of either the dominant or nondominant hemisphere (i.e., respectively, contra- and ipsilateral to the preferred direction of rotation; the dominant hemisphere identified in this way has been shown to contain higher concentrations of dopamine than the nondominant hemisphere). Kindling stimulation (or sham-kindling, in control rats) was applied through the electrodes two or three times daily for 21 days, and the rats were reassessed for amphetamine- and apomorphine-induced rotation, during and after the course of treatment. Kindling of the originally dominant hemisphere caused a diminution of rotational asymmetry as measured in tests 2 to 3 h after stimulation sessions, and in some rats led to a reversal in the preferred direction of amphetamine-induced rotation. Kindling of the nondominant hemisphere tended to accentuate the original amphetamine-induced asymmetry. The direction of rotation induced by a direct postsynaptic DA-receptor agonist (apomorphine) was not significantly affected by kindling of either hemisphere. It appears that kindling stimulation brings about a relatively inferior level of DA function on the stimulated vs. the nonstimulated side of the brain, and that this process depends mainly on changes occurring at a presynaptic level. PMID- 3556507 TI - Responses of neurons in nucleus supratrigeminalis to sinusoidal jaw movements in the cat. AB - Single neurons in the mesencephalic nucleus of the fifth nerve and in the rostral brain stem of barbiturate-anesthetized cats were studied in terms of their response to sinusoidal jaw movements at different frequencies and amplitudes. Units were quantitatively characterized by magnitude and phase of their firing rate modulation as a function of frequency, the linearity of their response at 5 Hz, and the variability of the interpsike intervals. Units were qualitatively characterized in terms of their response to gentle palpation of jaw muscles. Neurons were found in the nucleus supratrigeminalis that were selectively driven by jaw movement and that responded to gentle palpation to one or more ipsilateral jaw muscles. The magnitude of the sensitivity of these neurons as a function of frequency was not significantly different from cells of the mesencephalic nucleus of the fifth nerve. The phase of the sensitivity was, however, significantly more advanced than were those cells at all but the highest frequencies. The typical interspike interval variability of cells in nucleus supratrigeminalis was about 40% of the mean interval, whereas that variability of neurons of the mesencephalic nucleus of the fifth nerve was only about 10% of the mean interval. Supratrigeminal cells could relay jaw proprioceptive information to the cerebellum or thalamus. PMID- 3556508 TI - Sleep disorders in kindled cats differ according to the timing of polygraphic recordings and of seizures in the sleep-wake cycle. AB - Sleep disorders in amygdala-kindled cats differ according to the sleep or waking state in which seizures occur and the time lapse between seizures and polygraphic recordings. Twelve-hour polygraphic recordings were initiated at the following times: (i) before kindling (N = 8 cats); (ii) just after kindled convulsions during waking, slow-wave sleep (SWS), rapid-eye-movement sleep (REMS), or in transition from SWS to REMS (N = 8 cats per state), and (iii) 24 h after state specific seizures (N = 8 cats per state). Rapid onset SWS and delayed REMS occurred in records started immediately after seizures in waking, SWS, or REMS; in contrast, seizures during transitions from SWS to REMS produced early onset REMS and SWS. Finally, records begun 24 h after seizures always revealed prolonged sleep onset and generalized sleep suppression regardless of the state in which seizures occurred. The timing of seizures and of polygraphic recordings may explain discrepancies in the literature on the type of sleep disorders seen in secondary generalized temporal lobe epilepsy. PMID- 3556509 TI - Cat triceps surae motor nuclei are organized topologically. AB - A "compartment nucleus" consists of a group of spinal motoneurons that supply the individual primary branches of a muscle nerve. Each primary muscle nerve branch innervates a specific subvolume or compartment of a muscle. The spatial and size distributions of motoneurons supplying primary nerve branches of the cat medial gastrocnemius muscle were examined to: determine whether or not the medial gastrocnemius motor nucleus is organized in the same manner as that of the lateral gastrocnemius; determine the type of organization which collectively governs the triceps surae (lateral and medial gastrocnemius, soleus) motor nuclei. Individual primary branches of the medial gastrocnemius nerve were exposed to a horseradish peroxidase solution to retrogradely label their cells of origin. Each compartment nucleus was compared with the distribution of the entire medial gastrocnemius motor nucleus. These data were also compared with data on the spatial and size distribution of motoneurons in the lateral gastrocnemius motor nucleus. Results indicate rostrocaudal overlap in the distribution of motoneurons in each compartment nucleus. However, a rostral to caudal topographic arrangement and preferential size distribution for each compartment nucleus exist for proximal to distal muscle compartments. These and other results indicate that the motor nuclei of the entire triceps surae muscle group are organized by a topologic type map. PMID- 3556510 TI - Effect of inhibitory amino acid antagonists on masseteric reflex suppression during active sleep. AB - We examined the pharmacological basis for the suppression of the masseteric (jaw closer) reflex which occurs during the behavioral state of active sleep. Accordingly, the masseteric reflex was recorded in intact, unanesthetized, normally respiring cats during naturally occurring states of wakefulness and active sleep. The amplitude of the reflex during these states was determined before and after strychnine, picrotoxin, and bicuculline methiodide were applied, by microinjection, to the trigeminal motor nucleus. The effectiveness of each drug in blocking the active sleep-related suppression of the masseteric reflex was examined and compared with the degree of suppression evoked, during wakefulness, by stimulation of the inferior alveolar nerve. Microinjection of strychnine (50 microM to 20 mM) reduced the degree of suppression of the masseteric reflex during active sleep, but was markedly more effective in blocking reflex suppression that was induced by stimulating the inferior alveolar nerve. Picrotoxin and bicuculline methiodide (10 microM to 5 mM) produced a nonspecific increase in the amplitude of the masseteric reflex during both states. Thus, these substances did not appear to reduce the degree of reflex suppression induced by inferior alveolar nerve stimulation or that occurring spontaneously during active sleep. We concluded that strychnine-sensitive postsynaptic inhibition does participate in the suppression of masseter motor activity during active sleep, but that it is not the exclusive factor responsible for atonia of the masseter musculature during this state. PMID- 3556511 TI - Alteration in dentate neuronal activities associated with perforant path kindling. I. Long-term potentiation of excitatory synaptic transmission. AB - One candidate for the neuronal mechanism of kindling is the facilitation of excitatory synaptic transmission. The population EPSP component of the perforant path-dentate field potential is strongly potentiated by the first few kindling stimulations applied to the perforant path. As kindling proceeds further, however, subsequent changes in transmission efficacy have been a source of controversy. The present study reexamines these changes in transmission efficacy of the perforant path-dentate granule cell synapses during and after perforant path kindling using improved methods of analysis of the field potentials recorded in freely moving rats. The slope of the regression line of the population EPSPs on a range of stimulus strength values was found to be enhanced by the first kindling stimulation and then continued to increase gradually with subsequent kindling stimulations, indicating a cumulative increase in synaptic transmission efficacy throughout the period of kindling. The potentiated excitatory synaptic transmission lasted for at least 1 month after the cessation of kindling. On the other hand, the kindling stimulations produced a progressive increase in the x intercept of the regression line, indicating an increase in the minimal EPSP threshold. These two effects seem to account for the apparent discrepancy between previous studies, each of which measured the population EPSP at a fixed stimulus strength. PMID- 3556512 TI - Supernormal excitability of fibers of the dorsal hippocampal commissure. AB - The excitability modifications induced by a conditioning stimulus were studied in the three groups of fibers coursing in the dorsal hippocampal commissure of the guinea pig. The response of all fibers was potentiated after a conditioning stimulus greater than and equal to the test stimulus. The potentiation lasted 120 to 600 ms, 180 to 1000 ms, and 120 to 700 ms, respectively, in the three fiber groups. The data indicate that the fibers of the dorsal hippocampal commissure exhibit a prolonged supernormal period during which threshold is reduced for both previously discharged and previously inactive fibers. PMID- 3556513 TI - Collagen synthesis in axotomized peripheral nerve: evidence against Schwann cell involvement. AB - To explore the role of Schwann cells in nerve collagen formation, fascicular collagen was measured in axotomized rat sciatic nerve after regeneration or permanent axotomy. The same increase in fascicular collagen was seen in both paradigms. Thus there is no evidence that Schwann cells unassociated with axons make an important contribution to nerve collagen synthesis after transection. PMID- 3556514 TI - Colloidal gold fluorescent microspheres: a new retrograde marker visualized by light and electron microscopy. AB - A new retrograde tracer, rhodamine latex microspheres, permits labeled neurons to be visualized with fluorescence light microscopy. However, their use has been limited to the light microscope. We now have developed colloidal gold fluorescent microspheres which identify retrogradely labeled neurons first by fluorescence microscopy and then by electron microscopy. This new fluorescent/EM tracer will find widespread use in the field of neuroscience to elucidate the ultrastructural integrity of neuronal networks. PMID- 3556515 TI - Effect of housing in an enriched environment on the size of the cerebral cortex in young and old rats. AB - To assess whether or not environmental changes may continue to affect measures relating to cortical size, the size of the cerebral cortex of young adult (7 to 8 months) and old (32 to 33 months) "standard" and "enriched" rats were compared. Enriched rats were housed in large cages during 10 weeks and had access to many different objects; age-matched controls remained in standard laboratory cages. Effects on the cerebral cortex were small; a significant increase in cortical thickness at one, albeit different, site in both age groups was observed. Significant correlations were not present between environmentally induced changes in sleep parameters (recorded in the same rats prior to the present experiment) and the small change in cortical size. The results do, however, support the hypothesis that a certain amount of plasticity of the cerebral cortex is preserved in old age. PMID- 3556516 TI - Interactions between guanabenz and clonidine in their antinociceptive effects in the rat. AB - Based on the hot-plate algesiometric assay in conscious Sprague-Dawley rats, we observed that both guanabenz and clonidine, at a subcutaneous dose of 5 and 1 mg/kg, respectively, exhibited significant antinociceptive potencies. Paradoxical actions on the hot-plate responses, however, were exerted by guanabenz at lower doses, varying from hyperalgesia (1 mg/kg) to no effect (2 mg/kg). A pretreatment of clonidine (1 mg/kg) substantially potentiated the antinociceptive efficacy of the two latter doses, but failed to further augment the pain-suppressive action of guanabenz at 5 mg/kg. These interactive effects of the two alpha-adrenoceptor agonists suggest that they may share a common mechanism(s) in their analgesic actions. PMID- 3556517 TI - Alteration in dentate neuronal activities associated with perforant path kindling. II. Decrease in granule cell excitability. AB - Changes in the excitability of the dentate granule cells after perforant path kindling were examined by the analysis of perforant path-dentate gyrus field potentials recorded in freely moving rats. Using a range of test pulse intensities, the population spike heights (cellular output) were plotted against the magnitudes of the associated population EPSPs (synaptic input), and a linear regression (input/output) was estimated from the relative linear portion of the plot. The x-intercept of this regression defines the population spike threshold. With kindling, the overall amplitude of the population spikes decreased, in spite of an increase in the population EPSPs resulting in a flatter input/output regression. The x-intercept of the regression was unaffected by the first kindling stimulation, but consistently and significantly increased with subsequent kindling. These changes gradually reverted to near the prekindling control values during a postkindling rest period of 1 month, and were reinstated by rekindling after the period of rest. Similarly, the onset and peak latencies of the population spike were significantly retarded during the period of kindling. These results suggest that seizure activity causes a significant but temporary reduction in the excitability of dentate granule cells. This effect would tend to counteract the process of kindling and provide an explanation for some of the phenomena of postictal depression. PMID- 3556518 TI - Alteration in dentate neuronal activities associated with perforant path kindling. III. Enhancement of synaptic inhibition. AB - Changes in the hippocampal commissural inhibition of dentate granule cell firing following perforant path kindling were examined by analysis of field potentials recorded in freely moving rats. Prior stimulation of the contralateral dentate hilus inhibits the dentate population spike response to perforant path stimulation at interpulse intervals of less than 11 ms via GABAergic control. This measure of inhibition was gradually enhanced from 26.6% to 76.9% by kindling stimulations delivered to the perforant path once a day for 3 weeks. It then decreased from 76.9% to 54.6% within 2 weeks after the last kindling trial, and remained at approximately this value for another 18 days of observation. Similarly, the mean maximum duration of commissural inhibition significantly increased from 7.43 ms to 10.6 ms during the kindling period, and decreased to 8.29 ms 2 weeks later. These results indicate that perforant path kindling temporarily increased the synaptic inhibition of granule cells, in a close temporal relationship to the temporary decrease in the granule cell excitability observed in our preceding study. PMID- 3556519 TI - Functional analysis of an electromechanical spinal cord injury device. AB - Feedback control in our injury device allowed the impactor to be sensitive to the biomechanical characteristics of the spinal cord and produce mechanically predictable injuries. We tested the hypotheses that (i) extracellular calcium [( Ca2+]e) in the rat spinal cord recovers with a time course dependent on the magnitude of injury intensity, (ii) [Ca2+]e is initially depressed at the injury epicenter to the same degree independent of injury severity, and (iii) acute (less than 3.0 h) recovery of [Ca2+]e to normal values occurs in that group of animals that shows only transient neurologic deficits in the postinjury period. Three levels of injury (light, intermediate, and heavy) were produced by controlling spinal displacement during the injury process. After injury, [Ca2+]e at the injury site decreased to values less than 0.1 mM and then recovered during the next 3 h. Incomplete recoveries occurred in the intermediate- and heavy injury groups (0.72 +/- 0.01 and 0.58 +/- 0.01 mM, respectively). [Ca2+]e activity in the lightly injured group recovered to normal values by 3 h. Specific injury protocols therefore resulted in reproducible responses in the cellular microenvironment. Behavioral recovery could be predicted from mechanical impact parameters. Animals in the light-injury group had transient neurologic deficits in some behavioral tests (open-field walking) with no alteration in others (inclined-plane analysis). Neurologic tests that required coordination between fore and hind limbs (grid walking) did not reveal significant deficiencies until 14 days postinjury. Those animals in the intermediate and heavy groups showed initial and continuing neurological effects in all behavioral measures. It is therefore probable that acute mechanical descriptors and hypocalcia transients are predictive of the ongoing and subsequent pathology of spinal cord injury. PMID- 3556520 TI - Effects of treatment with scopolamine and naloxone, singly and in combination, on amygdala kindling. AB - Scopolamine and naloxone were administered singly and in combination to different groups of rats undergoing electrical kindling of the amygdala. Scopolamine significantly reduced the maximal seizure stage attained during 15 drug sessions and increased the total number of afterdischarges required to kindle a generalized convulsion. Naloxone had a similar but weaker and nonsignificant effect. The results confirm that antagonism of muscarinic receptors by scopolamine retards amygdala kindling. PMID- 3556521 TI - Prey localization by surface wave ray-tracing: fish track bugs like oceanographers track storms. AB - Surface-feeding fish accurately determine direction and distance to the center of a concentric wave stimulus, even if only a single, short lasting wave train is presented. It has been suggested that one cue used by these fish to localize the wave center is the distance dependent frequency modulation of the initial part of a wave stimulus. Here we show how the distance information contained in the fractional frequency change of a capillary wave group can be decoded. We suggest that wave source localization in surface-feeding fish in part is based on a principal similar to that used by oceanographers to track storms by the frequency change of forerunners of swell. PMID- 3556522 TI - Circadian pacemaker does not arrest in deep hibernation. Evidence for desynchronization from the light cycle. AB - A freerunning rhythm of locomotor activity was observed between hibernation bouts in Turkish hamsters (mesocricetus brandti) kept in 10L:14D light-dark cycles at 10 +/- 1 degree C. The data further indicate an influence of natural hypothermia upon the circadian system and its ability to entrain to light-dark cycles. PMID- 3556523 TI - Seasonal changes of circadian pattern in human rectal temperature rhythm under semi-natural conditions. AB - A phase delay of the circadian rectal temperature rhythm existed in three human subjects leading normal lives under semi-natural conditions: the rectal temperature began to increase later in summer than in the other three seasons. PMID- 3556524 TI - Morphological evidence for a direct neuroendocrine GABAergic control of the anterior pituitary in teleosts. AB - The anterior pituitary of teleosts is unique among vertebrates in receiving a direct innervation which represents the morphological support of the neuroendocrine control of pars distalis functions. The participation of GABAergic fibers in this innervation was studied by means of immunocytochemistry at the light and electron microscopic levels, using antibodies against GABA. Immunoreactive fibers, characterized by the presence of small clear and dense cored vesicles, were detected in all parts of the gland. Immunopositive terminals were found in close, sometimes synaptic-like, contact with most glandular cell types in the anterior lobe. The data strongly suggest that in teleosts, as in mammals, GABA is involved in the neuroendocrine control of anterior pituitary functions. PMID- 3556525 TI - Differential displacement of cells from the median eminence into the arcuate nucleus during puberty. Effects of melatonin administration. AB - A displacement of catecholaminergic-positive and catalase-containing cells from the median eminence into the arcuate nucleus at puberty has been described previously. This study reports on the displacement phenomena after postnatal administration of melatonin. Catalase-positive cells undergo a delayed displacement from the median eminence into the arcuate nucleus. However, part of this cell population lags behind within the median eminence. This differential reaction of cell displacement by catalase-positive cells is considered as a special reaction of these cells to melatonin administration. PMID- 3556526 TI - Crowding during pregnancy delays puberty and alters estrous cycles of female offspring in mice. AB - Chronic crowding of mice during late pregnancy resulted in offspring of lowered birthweights and, in the females, delayed puberty and altered estrous cycles. Plasma corticosterone in the crowded dams was elevated acutely, lending some support to the hypothesis of adrenocortical mediation of prenatal stress effects. PMID- 3556527 TI - Chronic maintenance of rat sperm reserves into old age by previous sexual contact. AB - Extensive copulatory experiences at a younger age provoked chronic changes in the reproductive physiology of old male rats. Continuous access to females was not necessary, sperm numbers were elevated in the 22-month-old males 7 months after a final sexual interaction. PMID- 3556528 TI - Lysosomal membrane fragility and catabolism of cytosolic proteins: evidence for a direct relationship. AB - A direct relationship was established between the stability of the lysosomal membrane and an estimate of cytosolic protein catabolism, based on loss of radiolabel from prelabeled protein. Lysosomes in the lysosomally-rich digestive cells of the midgut gland of the marine mussel (Mytilus edulis) were destabilized by experimental treatment with phenanthrene. PMID- 3556530 TI - Influence of pulsing electromagnetic field on the frequency of sister-chromatid exchanges in cultured mammalian cells. AB - Exposures of Chinese hamster cells to pulsing electromagnetic field (PEMF) with 0.18-2.5 mT did not influence the baseline frequency of sister-chromatid exchanges (SCE). The results suggest that PEMF with the magnetic intensity examined does not interfere with DNA replication nor produce DNA lesions, thereby leading to an increased frequency of SCE. PMID- 3556529 TI - Carbohydrate interference of complement-dependent cell lysis. AB - The antibody-mediated cytotoxicity of three autoreactive sera, an allogeneic hyperimmune serum and a xenogeneic hyperimmune serum was abrogated by the presence of either glucosamine, galactosamine, lactulose or lactose. This inhibition could be overcome in a dose-dependent fashion by increasing the amount of complement in the cytotoxicity assay, but not by increasing the amount of antibody. Furthermore, the inhibition was specific for these sugars in that isomers and N-acetylated derivatives were not inhibitory. The results suggest that these sugars directly blocked events of the complement cascade. PMID- 3556531 TI - Protection against carbon tetrachloride hepatotoxicity by pretreatment with indole-3-carbinol. AB - The effects of administering indole-3-carbinol (I-3-C) on carbon tetrachloride (CCl4)-induced hepatotoxicity were examined. Mice received by gavage 0-150 mg I-3 C/kg body wt in methanol-extracted corn oil, followed 1 h later by 15 microliters CCl4/kg body wt in corn oil. Animals were sacrificed 24 h after receiving CCl4. Pretreatment with I-3-C reduced the degree of centrolobular necrosis, as observed histologically. Additionally, CCl4-mediated elevated serum enzymes were reduced by I-3-C. Although I-3-C induced elevated levels of cytochrome P-450 and associated mixed-function oxidase activity, the CCl4 depression of these parameters was not clearly reversed by I-3-C. However, CCl4 produced decreases in hepatic levels of glutathione (GSH), total reducing equivalents, and protein sulfhydryls, all of which were restored to control levels by I-3-C. Using mouse liver microsomes in an NADPH-fortified reaction mixture, I-3-C inhibited, in a concentration-dependent manner, CCl4-initiated lipid peroxidation, with 50% inhibition at 35-40 microM I-3-C. When mice were treated by gavage with 50 mg [14C]I-3-C/kg body wt, concentrations of radiolabel in the liver were greater than 100 microM after 1 hr. This was five times the level of radioactivity measured in blood and three times the concentration of I-3-C necessary for 50% inhibition of CCl4-mediated lipid peroxidation in vitro. The data are consistent with the hypothesis that I-3-C intervenes in CCl4-mediated hepatic necrosis by combining with reactive free radical metabolites of CCl4, thereby protecting critical cellular target sites. PMID- 3556533 TI - Effects of respiratory treatment with N-hexane on rat testis morphology. I. A light microscopic study. AB - Testicular damage was induced in rats by respiratory treatment with n-hexane at a concentration of 5000 ppm. The earliest lesions were observed immediately after 24 hr of continuous treatment, and involved primary spermatocytes from the leptotene to the middle pachitene stages and spermatids at late stages of maturation; at the same time numerous exfoliated, injured germ cells reached the epididymis. After the 24-hr treatment was suspended, damage to the seminiferous epithelium increased for the first 7 days, while the epididymis showed also focal infiltration by inflammatory cells; recovery was completed from Days 14 to 30. Intermittent treatment (16 hr/day, 6 days/week) at the same concentration of 5000 ppm for up to 6 weeks induced progressive increases in testicular and epididymal lesions, which, after 5 weeks (when most animals began to show clinical symptoms of polyneuropathy), reached aplasia of the germinal epithelium involving also the spermatogonia. Recovery from clinical symptoms was not paralleled by a regression of testicular pathology. On the contrary, after interruption of the treatment, the testicular lesions became increasingly severe, up to complete atrophy of the seminiferous tubules, suggesting an irreversible sterility of the treated animals. Pair-fed controls did not show histological alterations of the testis or epididymis. PMID- 3556532 TI - Dissemination of beads coated with trehalose 6,6'-dimycolate: a possible role for coagulation in the dissemination process. AB - When spread as a monolayer on the surface of hydrophobic beads and injected into mice, the mycobacterial glycolipid, trehalose 6,6'-dimycolate, reproduces the biologic effects traditionally associated with virulent mycobacteria, including acute inflammation, granuloma formation, and immune adjuvancy. Repeated intraperitoneal injection of glycolipid-coated beads into young C57Bl/6 mice elicits a granulomatous peritonitis, with concomitant dissemination of beads from the peritoneum to distant organs. Glycolipid-coated beads which disseminate from the peritoneum to other sites elicit neither acute inflammation nor granulomata. The coagulation system may be involved in the dissemination of glycolipid-coated beads as evidenced by the following: fibrinogen is a necessary cofactor of the trehalose dimycolate monolayer; diffuse peritoneal and pulmonary hemorrhage accompanies bead dissemination; peritoneal exudate collected shortly after intraperitoneal injection of glycolipid-coated beads is enriched in coagulant activity; coagulability of blood from trehalose dimycolate-treated animals is reduced; and anticoagulation inhibits the inflammatory response to glycolipid coated beads. In this report, the dissemination of trehalose dimycolate-coated beads is characterized, and a role for the coagulation system in this process is proposed. PMID- 3556534 TI - Contraception and the status of women: what is the link? PMID- 3556535 TI - Sex education and family planning services for adolescents in foster care. AB - Representatives of public child-welfare agencies in 48 states were surveyed to determine their states' policies for meeting the sexual development and family planning needs of teenagers served by the agencies. Only nine states have a formal written policy dealing with this area of child welfare, and just two of the states have a comprehensive policy. A handful of states have deliberately avoided addressing the issue. Officials in other states believe that a formal policy would be counterproductive, arguing that a low-key approach is the best way to deal with the needs of the teenagers they serve. Finally, some state child welfare officials admit that they have not given the issue much thought. Twenty nine states offer foster parents special training in adolescent sexuality, and 19 offer such training to caseworkers; however, only five states mandate such training for foster parents and only four do so for caseworkers. Southern states are the most likely to have written policies, while western states are the least likely; western states also are the least likely to offer or mandate special training for caseworkers in contact with teenagers. The officials surveyed also identified a number of institutional barriers that prevent their agencies from developing and implementing policies to deal with the sexual development needs of children in state care. PMID- 3556536 TI - Contraception for american women 40 and over. PMID- 3556537 TI - A technical knockout for parental notification. PMID- 3556538 TI - Characteristics of U.S. women having abortions, 1982-1983. AB - In 1982 and 1983, as in previous years, the majority of abortions in the United States were obtained by young women (62 percent), white women (70 percent) and unmarried women (81 percent). Half of all abortions were performed eight or fewer weeks after the last menstrual period, and 91 percent, at 12 weeks or earlier. The proportion of abortions that were repeat procedures continued to rise, to 37 percent in 1982 and 39 percent in 1983. The rate of abortion, 29 per 1,000, has remained essentially the same since 1981. Women aged 18-19 continue to have the highest abortion rate of any age-group (60 per 1,000). While most abortions are obtained by white women, the nonwhite abortion rate is more than twice that of whites. Thirty percent of all pregnancies were terminated by abortion in 1983, the same proportion as in 1982 and 1981. The highest abortion ratios are found among unmarried women (63 percent), women 40 and older (51 percent), teenagers (42 percent) and nonwhites (40 percent). Teenage nonwhites and whites have about the same abortion ratios. After rising during the 1970s, the adolescent pregnancy rate peaked around 1980-1981 and fell slightly in 1982-1983. The relative differentials between the pregnancy, birth and abortion rates of nonwhite and white teenagers narrowed somewhat between 1978 and 1981, but then widened slightly between 1981 and 1983. PMID- 3556539 TI - The harassment of U.S. abortion providers. AB - In 1985, 47 percent of abortion providers experienced antiabortion harassment. The approximately 1,250 facilities that were affected served 83 percent of all abortion patients. Nonhospital facilities performing 400 or more abortions a year were the most likely targets of antiabortion activity; 88 percent reported at least one type of harassment during the year. Picketing occurred at 80 percent of these facilities. Only six percent experienced picketing alone; the average facility was subjected to five different types of activity. Seventy-three percent of the facilities were the target of at least one illegal activity. A number of problems that made abortions more difficult or costly to provide were significantly related to the occurrence of antiabortion activity: increased expenditures for security and for legal services, loss of fire and casualty insurance, new licensing requirements and problems hiring staff. However, harassment did not appear to have affected the average number of abortions performed at large nonhospital facilities or the fee charged. PMID- 3556540 TI - Microbiological analysis of pharmaceutical purified cotton. PMID- 3556541 TI - [Effect of psychotropic substances and gamma-aminobutyric acid analogs and derivatives on the release of 3H-D-aspartic acid from perfused synaptosomes of the rat cerebral cortex]. AB - It was shown in experiments in vitro that neuroleptics haloperidol and sulpiride, antidepressants desipramine and amitriptyline, nootropic agent piracetam, benzodiazepine tranquillizer phenazepam, psychostimulant phenamine and agonist of GABA A-receptors tetrahydroisoxazolopyridinol depending on the concentration in the micromolar range decrease K+-stimulated release of 3H-D-aspartic acid from rat brain cortex synaptosomes. Agonists of GABA B-receptors phenibut and baclofen as well as valproate and sodium oxybutyrate failed to exert a noticeable effect on the process under study. PMID- 3556543 TI - [Mechanism of the anti-alcohol action of fenazepam]. AB - Experiments were performed on 64 albino male rats selected according to their ethanol preference. A long-term administration of ethanol produced a number of specific changes in the activity of the enzymes involved in metabolism of ethanol, lipid peroxidation, enzymes of metabolism of xenobiotics. At the continuous ethanol administration, phenazepam was found to normalize the activity of ethanol-metabolizing enzymes, both in vivo and in vitro. Phenazepam also normalized reaction of lipid peroxidation both in vivo and in vitro. The drug was shown to be an inductor with respect to enzymes of xenobiotic metabolism. PMID- 3556542 TI - [Excretory function of the liver with an allyl alcohol lesion and the antioxidant correction of the disorders]. AB - In experiments on 33 albino male rats it was established that during allyl alcohol-induced damage of the liver its excretory function is impaired that was judged by the biliary excretion of intravenously injected Bengal pink-131I. Antioxidants (tocopherol acetate, sodium selenite, unithiol) reduced the toxic effect of allyl alcohol on the liver. PMID- 3556545 TI - [Pharmacological analysis of the anticonvulsant action of kavinton]. AB - In experiments on rats it was found that cavinton administered in doses of 1-30 mg/kg exerted a distinct dose-dependent anticonvulsant effect, according to the test of maximal electroshock, not less than that of phenobarbital, difenin and carbamazepine. Combined use of cavinton and these drugs potentiated its anticonvulsant action. The involvement of noradrenergic systems, in particular, alpha 1-adrenoceptors, in the anticonvulsant effect of cavinton is suggested. PMID- 3556544 TI - [Effect of alcohol on the calcium and protein content of the subcellular fractions of the human myocardium]. AB - It was established that in the persons who had died from acute ethanol intoxication the processes of calcium compartmentalization in myocardiocytes are disordered and characterized by a decrease of calcium content in mitochondria and sarcoplasmic reticulum and an increase of its concentration in the supernatant fluid. Alcohol-induced changes of calcium compartmentalization in myocardiocytes may cause cardiac disorders and be, in particular, one of the possible links in the thanatogenesis of sudden death. PMID- 3556546 TI - [Role of cholinergic and adrenergic mechanisms in the action of ketamine and thiopental sodium on the structures of the hippocampal-reticular complex and the neocortex]. AB - Under conditions of free behaviour of rabbits with electrodes implanted into the brain structures it was found that ketamine and sodium thiopental decrease the excitability in the dorsal hippocamp, reticular formation and periaqueductal gray matter of the midbrain. Excitability of the frontal neocortex increases during general anesthesia with ketamine and decreases during thiopental narcosis. Changes in excitability of the studied cerebral structures during general anesthesia can be determined by common N-cholinoblocking and alpha-adrenomimetic properties of ketamine and thiopental at the level of the dorsal hippocamp, cholinoblocking and adrenoblocking properties at the level of the reticular formation and central gray matter. In the frontal cortex ketamine presented properties of an M-cholinomimetic and adrenomimetic agent, sodium thiopental- those of a M-cholinoblocker and beta-adrenoblocker. PMID- 3556547 TI - [The spectrum of analgesic activity of baclofen and tolibut]. AB - Spectrum of the analgetic activity of GABA derivatives baclofen (2.5-10.0 mg/kg) and tolibut (12.5-100.0 mg/kg) was studied in experiments on albino mice and rats. Baclofen and especially tolibut showed a dose-dependent inhibition of perceptive, emotional and autonomic manifestations of nociceptive reactions at the tail's thermal and electrical stimulation and enhancement of the analgetic effect of promedol. The regressive analysis made it possible to show dependence of the analgetic effect on the level of pain sensitivity and emotional reactivity of the animals. Tolibut deepens and prolongs sombrevin anesthesia, baclofen fails to alter it. PMID- 3556548 TI - [Effect of morphine and pentazocine on emotional-behavioral and hemodynamic nociceptive reactions]. AB - Pentazocine (5-15 mg/kg) fails to change the period of latency in the rat tail flick reaction at thermic stimulation but suppresses to the same extent as morphine (5 mg/kg) the emotional-pain response and enhances the reactions of arterial blood pressure during mechanical stimulation. Both prazosin and naloxone (1 mg/kg) abolished the activating effect of pentazocine on the arterial blood pressure changes produced by nociceptive stimulation. PMID- 3556549 TI - [Effect of disulfiram on the free amino acid pool of the brain tissue of rats]. AB - Disulfiram (DS) (200 mg/kg for 3 days) decreases contents of GABA, phenylalanine, histidine, cystathionine, methionine, ornithine, leucine and lysine. The effect of DS is potentiated by ethanol (1 g/kg). In this case concentrations of alanine, valine, isoleucine and tyrosine additionally fall. Probable roles of GABA-ergic system and amino acids--precursors, neurotransmitters in the realization of therapeutic and, perhaps, side effects of DS are discussed. Additive effects of DS and its combination with ethanol indicates a significant contribution of acetaldehyde to the mentioned changes. PMID- 3556550 TI - [Mechanism of action of piracetam on cerebral circulation]. AB - The experimental data show that piracetam exerts a marked effect on cerebral hemodynamics producing a lowering of cerebral artery tonus and an increase of local blood flow. In addition, an increase of GABA content is noted, particularly following an experimentally-induced disorder of cerebral blood circulation. A stable dilatation of the mean capillary diameter, a decrease of the number of non functioning capillaries in the brain cortex after piracetam administration indicate an important role of piracetam as a cyclic analogue of GABA in regulation and compensation of disordered cerebral hemodynamics. PMID- 3556551 TI - [Age-related characteristics of the effect of adrenomimetics and adrenoblockaders on the calcium and magnesium content of the rat myocardium]. AB - The effects of noradrenaline (0.025 mg/kg), izadrin (0.1 mg/kg), adrenaline (0.025 mg/kg), ephedrine (5 mg/kg) phentolamine (5 mg/kg), dibenamine (5 mg/kg), anaprilin (1 mg/kg), alpheprol (1 mg/kg) on calcium and magnesium contents in the myocardium of growing rats (7 and 30 days, 3-5 months) were studied. During the animal development and growth the effects of adrenomimetics on calcium and magnesium metabolism decrease to a lesser degree than those of adrenoblockers. The data obtained indicate the enhancement of the regulatory factors and attenuation of the metabolic factors of the mechanism of adrenergic agents' action in the process of the postnatal development. PMID- 3556552 TI - [Effect of obzidan on the adenine nucleotide content of various areas of the heart in experimental myocardial infarct]. AB - Obzidan was demonstrated to increase the total adenine nucleotide pool content in all zones of the hearts of male rabbits with experimental myocardial infarction. The total adenine nucleotide pool in the remote from affected zone site of the left ventricle kept exceeding the values of control ones within 7 days of obzidan treatment. PMID- 3556553 TI - [Action of dibunol, isoptin and their combination in transitory myocardial ischemia in waking rabbits]. AB - Effects of dibunol, isoptin and their combination were studied on 80 conscious rabbits with transient myocardial ischemia. Prophylactic (for 4 days before experiment in a dose of 20 mg/kg) and therapeutic (2 days, 40 mg/kg) intraperitoneal administration of dibunol resulted in a diminution of necrosis size and a decrease of the number of ventricular fibrillations in the period of the coronary artery occlusion. Administration of isoptin (0.4 mg/kg intravenously during transient ischemia) was followed by a restriction of necrotic focus. A combined therapeutic administration of dibunol and isoptin provided a significant diminution of myocardial necrosis size, the number of ventricular fibrillations and stabilized the level of malondialdehyde in the blood plasma. The role of peroxide destruction of membranes and calcium overload of cardiomyocytes in the pathogenesis of irreversible ischemic damage of the myocardium is discussed. PMID- 3556554 TI - [Effect of kaleflon on the course of experimental hepatitis]. AB - A pronounced cholagogic effect of kaleflon was found in the experiment on albino rats. The course administration of kaleflon in a dose of 0.05 g/kg exerts a marked pharmacotherapeutic action on the course of experimental hepatitis. PMID- 3556555 TI - [Changes in the pharmacodynamic properties of promedol, droperidol and dimedrol in burn shock and combined radiation-thermal injury]. AB - Toxic and pharmacological properties of promedol, droperidol and dimedrol were studied during burn shock and combined radiation and thermal injury (CRTI). Acute toxicity and analgesic effect of promedol were shown to increase in the given period Droperidol analgesic effect enhanced in burn and CRTI, cataleptic action enhanced only in CRTI. A decrease of antihistaminic activity of dimedrol was more pronounced in CRTI. PMID- 3556556 TI - [Characteristics of the antihypoxic properties of 3-hydroxypyridine-class antioxidants]. AB - It was found during experiments using three models of hypoxia (hypobaric, normobaric, hemic) in mice that derivatives of 3-hydroxypyridine possess an antihypoxic effect. They are as active as sodium hydroxybutyrate but less active than gutimine. A clear-cut dependence of the antihypoxic activity on the radical character in the 2nd position of 3 hydroxypyridine was revealed. The presence of a hydroxy group in the 3rd position of pyridine ring was shown to be very important for the antihypoxic properties. The data suggesting different degrees of involvement of GABA and benzodiazepine receptors in realization of the antihypoxic effect were obtained. PMID- 3556558 TI - [Pharmacological effects of combinations of psychotropic preparations used in combined pharmacotherapy]. AB - It was shown in experiments on mice that inhibition of the exploratory activity by ftoracizin, phenazepam, scopolamine hydrobromide and their combinations predominates in comparison with muscle relaxation. Phenazepam administered at the low dose (0.025 mg/kg) by its depressive effect on the central nervous system was an antagonist of ftoracizin and a synergist of scopolamine. Ftoracizin and scopolamine show a mutual dose-effects-dependent antagonism in the inhibitory action and acute toxicity (LD50). PMID- 3556557 TI - [The serotoninergic component in the mechanism of the development of neurogenic damage to the stomach]. AB - The involvement of the serotoninergic system in the development of neurogenic gastric lesions induced by the three-hour electrical stimulation of the immobilized rats was shown. Serotonin (0.4 mg/kg) and d,1-5-hydroxytryptophan (50 mg/kg) failed to prevent the development of neurogenic gastric lesions. Deseril (0.5 mg/kg) and BC-105 (1 mg/kg) significantly decreased the formation of hemorrhagic erosions and prevented a decrease of serotonin and norepinephrine levels as well as creatine phosphate content in the stomach tissue. PMID- 3556559 TI - [Correlations between the pharmacokinetic indices of the tranquilizer fenazepam in single and long-term administration to patients]. AB - A high degree of correlation between experimentally established and theoretically calculated constant concentrations of phenazepam was revealed in blood plasma of patients. Due to experimental findings the employment of a single-dose drug administration with regard to previously stated effective-dose interval during dosage build-up made possible estimating the maximum allowable individual dosage which should yield a good therapeutic result without side effects. PMID- 3556560 TI - [Comparison of the verapamil concentration of human blood serum and saliva]. AB - Verapamil concentrations were measured in the samples of blood serum and saliva taken at the same time in patients with angina of effort within 0.5-24 hr after administration of a single dose of the drug (14 persons) or the last dose of the course (10 persons). A mean ratio of saliva verapamil concentration to blood serum concentration was 0.85 +/- 0.09 (from 0.19 to 2.69) after a single administration and 0.77 +/- 0.04 (from 0.29 to 1.09) after the course treatment. A statistically significant (p less than 0.001) positive correlation was revealed between verapamil concentrations in blood serum and saliva after a single administration (r = 0.69) and course treatment (r = 0.80). It is suggested that determination of verapamil concentration in the saliva of patients on long-term verapamil medication should be used for a reference estimation of its level in the blood. PMID- 3556561 TI - [Pharmacokinetic research on theophylline]. AB - Blood serum theophylline concentrations were studied in 6 volunteers and 8 patients with bronchospastic syndrome by using an enzyme immunological assay with a commercial kit "Fedesim" (USA) at intravenous and oral administration of euphylline in a dose of 5 mg/kg. The maximal concentration at intravenous injection of euphylline was reached in volunteers in 15 minutes, at oral administration--in 90 minutes, and in patients--somewhat later. PMID- 3556562 TI - [Participation of the baroreceptor reflex in the hypotensive effect of clofelin in hypertensive patients]. AB - Involvement of the baroreceptor reflex in a hypotensive effect of clofelin was studied in 12 patients with hypertension. A close relationship of changes in the parameters of central hemodynamics with the baroreflex levels and alteration during hypotensive therapy was established. PMID- 3556563 TI - [Search for anti-inflammatory preparations among the derivatives of succinic acid heteryl amides]. AB - The antiinflammatory activity and acute toxicity of 44 derivatives of heteryl amides of succinic acid (acids, esters, amides) were studied. This series of compounds was found to be promising for the search of nonsteroidal, practically nontoxic antiphlogistics. The structural-pharmacological analysis was performed and the dependence of the biological effect on the compound structure was revealed. PMID- 3556565 TI - Synthesis and pharmacological investigation of beta-substituted pyrrolo derivatives. AB - A series of pyrroles bearing an ethanol- or an iso-propanolamine side-chain in the beta-position was prepared and their adrenergic activity evaluated. The absence of any appreciable activity suggests that the pyrrole ring is not suitable for replacing the phenol nucleus in derivatives possessing an adrenergic activity. Noteworthy is the amphetamine-like activity observed in amino-ketone (XXIII). PMID- 3556564 TI - [Clinico-laboratory research on the pharmacodynamic characteristics of Rigevidon]. AB - A contraceptive effect of Rigevidon depends on the drug influence on cyclic secretion of gonadotropic hormones. Rigevidon fails to exert a significant effect on prolactin secretion. The drug withdrawal results in a comparatively rapid restoration (within the first three months) of the generative function. PMID- 3556566 TI - Synthesis of pyrido[1,2-a]pyrimidin-4-ones. Potential antihypertensive agents. III. AB - Several 4H-pyrido[1,2-a]pyrimidine derivatives with a basic substituent in the 2 position have been synthesized. All the compounds tested showed no appreciable antihypertensive activity. PMID- 3556567 TI - Acetoxy benzene derivatives: in vitro antiaggregant activity. AB - A dozen acetoxy benzene derivatives (mono- or diacetylated diphenols) were tested for inhibitory activity on platelet aggregation in human platelet rich plasma induced with collagen, ADP and arachidonic acid. All the compounds tested showed an activity, and the results emphasize the antiaggregant properties of diacetylated derivatives which are more potent than aspirin. Unlike aspirin, their action is not prevented by salicylate. However, the large inhibition of serotonin release and thromboxane synthesis localizes their activity in arachidonic acid metabolism. PMID- 3556568 TI - [3-Dialkylamino-substituted 2H-1,4-benzoxazines]. AB - N,N,N',N'-Tetrasubstituted 2-(2-aminophenoxy)malonamides (IX) in the presence of phosphorus oxychloride led to the formation of N,N-dialkyl-3-(dialkylamino)-2H 1,4-benzoxazine-2-carboxamides (XII). In the same way 2-(2-amino-3-pyridyloxy) N,N,N',N'-tetraethylmalonamide (X) yielded 3-(diethylamino)-N,N-diethyl-2H pyrido[3,2-b] [1,4]oxazine-2-carboxamide (XIII). Also N,N-dialkyl-2-(2 aminophenoxy)acetamides (XIV) by the action of phosphorus oxychloride afforded 3 (dialkylamino)-2H-1,4-benzoxazines (XV). Some compounds when submitted to pharmacological screening showed a weak depressant activity in the Irwin test. PMID- 3556569 TI - Synthesis and properties of amides of 1-benzyl-3-methyl- and 1-butyl-3-phenyl-7 methyl-4-oxo-2-thioxo (2,4-dioxo)-1,2,3,4-tetrahydropyrido-[2,3-d]pyrimidine-6 carboxy lic acids. AB - Amides of 1-benzyl-3,7-dimethyl-4-oxo-2-thioxo-1,2,3,4- tetrahydropyrido[2,3]pyrimidine-6-carboxylic acid were obtained by the condensation of ammonia, primary and secondary cyclic amines with the corresponding acid chloride. As by - products amides of 1-benzyl-3,7-dimethyl-2,4 dioxo-1,2,3,4-tetrahydropyrido[2,3-d]pyr imidine-6- carboxylic acid were isolated as a result of desulfuration. The same reaction performed with chloride of 1 butyl-7-methyl-3-phenyl-4-oxo-2-thioxo-1,2,3,4-tetrahydropyri do[2,3- d]pyrimidine-6-carboxylic acid gave mainly the corresponding 2,4-dioxo-amides. PMID- 3556570 TI - Synthesis and properties of new 3-acyl- and 3-carbamoyl derivatives of esters of 3H-2-imino-7-methyl-4-oxopyrido[3,2-e]-1,3-thiazine-5- and -6-carboxylic acids. AB - It was stated that esters of 3H-2-imino-7-methyl-4-oxopyrido[3,2-e]-1,3-thiazine 5- and -6-carboxylic acids react with acyl anhydrides and chlorides giving 3-acyl derivatives. Reaction of the above mentioned esters with isocyanates affords the corresponding 3-carbamoyl derivatives. PMID- 3556571 TI - [New heterocyclic derivatives of benzimidazole with germicidal activity. III. Synthesis and activity of derivatives of (formyl-5'-furyl-2')-2-benzimidazole with different substitutions at position 5]. AB - The synthesis and germicidal properties of 28 new derivatives of furyl-2 benzimidazole are described. The compounds are substituted both in position 5 of the benzene moiety and in position 5' of the heterocycle moiety. The germicidal properties of the new molecules were tested using 9 strains of bacteria and Candida albicans. Some of them exhibited germicidal properties versus Gram + bacteria and versus Candida. Some derivatives were also tested using Mycobacterium aurum: two isonicotinoylhydrazones derivatives exhibited tubercolostatic activity comparable to that of streptomycin and not much lower than that of isoniazide. PMID- 3556572 TI - [Derivatives of 4-(p.ter. butylbenzoyl)phenol with phytoiatric antifungal activity]. AB - Some derivatives of 4-(p.ter.butylbenzoyl)phenol were prepared and tested for phytoiatric antimycotic activity. The substances, all new to the literature, were subjected to in vitro and in vivo tests (in preventive phase). The compounds studied proved to have interesting in vitro activity. PMID- 3556573 TI - Brain spectrin fragments and crosslinks actin filaments. AB - The effect of brain spectrin (fodrin) on actin has been studied using viscometry and fluorimetry. Brain spectrin resembles erythrocyte spectrin tetramer in its action on actin. Both proteins crosslink actin filaments giving rise to a large increase in the viscosity but fluorimetry shows that neither affects actin polymerization significantly. In addition, brain spectrin as well as erythrocyte spectrin fragments preformed actin filaments. Actin filaments incubated in the presence of either of the two proteins incorporate actin monomers at a much higher rate showing that more filament ends are generated. PMID- 3556574 TI - Retinal Schiff base position relative to the surfaces of photoreceptor disk. AB - Surface-enhanced Raman spectra of native and photobleached bovine rod outer segment disks as well as inside-out (inverted) photoreceptor disks adsorbed on silver hydrosol have been analyzed. Surface-enhanced spectra of inverted disks and disk-monoclonal antibody complexes reveal the short-range mechanism of enhancement. The distance between retinal Schiff base and the cytoplasmic side of native disk has been shown to be 5-10 A. PMID- 3556575 TI - Co-solubilization of asymmetric acetylcholinesterase and dermatan sulfate proteoglycan from the extracellular matrix of rat skeletal muscles. AB - We have previously communicated that heparin released asymmetric acetylcholinesterase (AChE) from cholinergic synapses. Here we report studies showing that heparin, besides releasing asymmetric AChE from the skeletal muscle extracellular matrix (ECM), specifically solubilizes a dermatan sulfate proteoglycan (DSPG) which accounts for more than 95% of the 35S-released material. The co-solubilization of AChE and the proteoglycan opens up the possibility that both macromolecules could be involved in the formation of the soluble AChE complex observed after incubation of muscle homogenate with heparin. Our results suggest a possible association between asymmetric AChE and DSPG at the muscle ECM, moreover this work is the first report of the existence of DSPG at the skeletal muscle cell surface. PMID- 3556576 TI - Synthesis of 11,12-leukotriene A4, 11S,12S-oxido-5Z,7E,9E,14Z-eicosatetraenoic acid, a novel leukotriene of the 12-lipoxygenase pathway. AB - A simple and efficient method for preparing 11,12-leukotriene A4 has been established by the stereospecific biomimetic route from arachidonic acid. 12S Hydroperoxy-5Z,8Z,10E,14Z-eicosatetraenoic acid was synthesized using a partially purified 12-lipoxygenase of porcine leukocytes. The methyl ester of the compound was then chemically converted to two labile epoxides with a conjugated triene structure. These compounds were identified by proton NMR and mass spectrometry to be 11S,12S-oxido-5Z,7E,9E,14Z-eicosatetraenoic acid (11,12-leukotriene A4) and its geometric isomer. PMID- 3556578 TI - Separation of damage specific DNA endonuclease activities present in calf thymus. AB - A DNA endonuclease activity present in calf thymus specific for incision on DNA damaged by ultraviolet light, osmium tetroxide, potassium permanganate, hydrogen peroxide and acid has been purified from whole cell extracts. The enzymatic activity was heterogeneous both with regard to molecular mass and charge. The molecular mass of the enzyme varied from 25 to 35 kDa, but the different enzymatic species appeared to possess similar activities. The enzymes acted equally well on damage in supercoiled and relaxed forms of DNA. It further had a narrow optimum with regard to salt concentrations, the optimum activity being observed at a concentration of KCl from 40 to 65 mM. PMID- 3556577 TI - Inhibition of terminal deoxynucleotidyl transferase by adenine dinucleotides. Unique inhibitory action of Ap5A. AB - Terminal deoxynucleotidyltransferase (TdT) exhibits strong sensitivity to ATP and its dinucleotide analogues, Ap2A, Ap3A, Ap4A, Ap5A and Ap6A. Similar to ATP, all of the dinucleotides appear to be competitive inhibitors of TdT catalysis with respect to substrate deoxynucleoside triphosphates and effectively block the UV mediated substrate cross-linking to TdT. Among the various dinucleotides, Ap5A and Ap6A (diadenosine 5'-5' penta- and hexaphosphate, respectively) are significantly more effective than dinucleotides containing 2, 3 or 4 phosphate backbones. Furthermore, Ap5A is found to be the only dinucleotide which has reactivity at both substrate- and primer-binding domains in TdT. PMID- 3556579 TI - Inhibition of taurocholate efflux from rat hepatic canalicular membrane vesicles by glutathione disulfide. AB - In right-side out rat hepatic canalicular membrane vesicles glutathione disulfide (GSSG) inhibited the efflux of taurocholate approx. 70% in the presence or approx. 55% in the absence of a valinomycin-mediated K+ diffusion potential; maximal inhibition occurred at 5 mM GSSG. The inhibition by GSSG was abolished by dithioerythritol. Neither dithioerythritol alone nor GSH inhibited taurocholate efflux. S-(2,4-Dinitrophenyl)glutathione and N-ethylmaleimide showed intermediate inhibitory effects. PMID- 3556580 TI - Electrochemical characteristics of platinum electrodes coated with cytochrome b5 phospholipid monolayers. AB - Platinum electrodes can be coated with cytochrome b5-phospholipid monolayers by the Langmuir-Blodgett technique. Cyclic voltammetry of a series of dyes shows that the coated electrodes become selective for certain electroactive species. The electron transfer reactions of negatively charged species are inhibited at the modified electrode, whereas positively charged species show enhanced reactivity compared with that at a bare metal electrode. PMID- 3556581 TI - Counteraction by 20-hydroxyecdysone of the effect of juvenile hormone on phosphorylation of ribosomal protein S6. AB - Phosphorylation of ribosomal protein S6, induced when the fat body of Sarcophaga peregrina (flesh-fly) larvae was incubated in vitro in the presence of 32P, was found to be suppressed by juvenile hormone. This suppressive effect of juvenile hormone was counteracted by a physiological concentration of 20-hydroxyecdysone. Since 20-hydroxyecdysone is known to induce phosphorylation of S6 in vivo, this reaction was suggested to be regulated by the balance of the effects of ecdysone and juvenile hormone. PMID- 3556582 TI - The leader peptides from bacteriorhodopsin and halorhodopsin are potential membrane-spanning amphipathic helices. AB - We show that the N-terminal leader peptides from the bacterial membrane proteins bacteriorhodopsin and halorhodopsin can be expected to form amphipathic alpha helics with a highly hydrophobic nonpolar face and a narrow, negatively charged polar face. This finding is discussed in terms of a model for the integration of these proteins into the bacterial membrane. PMID- 3556583 TI - 1H resonances of proximal histidine in CO complexes of hemoglobins provide a sensitive probe of coordination geometry. AB - A straightforward strategy for assignment of the C epsilon H, C delta H and N delta H proton resonances of the proximal histidine ligand in diamagnetic complexes of monomeric hemoglobins and myoglobins is reported. These resonances are subject to large ring current shifts and are highly sensitive to coordination geometry. There are no significant differences between the CO complexes of myoglobin, leghemoglobin or hemoglobin alpha-subunits in proximal His coordination geometry or hydrogen bonding to the backbone at Leu F4. Ring current calculations show that the His F8 coordination geometry in the CO complexes of myoglobin and hemoglobin alpha-subunits is very similar in crystal and solution. PMID- 3556584 TI - Inhibition of actin polymerization by latrunculin A. AB - Latrunculin A, a toxin purified from the red sea sponge Latrunculia magnifica, was found previously to induce striking reversible changes in the morphology of mammalian cells in culture and to disrupt the organization of their microfilaments. We now provide evidence that latrunculin A affects the polymerization of pure actin in vitro in a manner consistent with the formation of a 1:1 molar complex between latrunculin A and G-actin. The equilibrium dissociation constant (Kd) for the reaction in vitro is about 0.2 microM whereas the effects of the drug on cultured cells are detectable at concentrations in the medium of 0.1-1 microM. PMID- 3556585 TI - ATP release from pure cholinergic synaptosomes is not blocked by tetanus toxin. AB - Tetanus toxin (TeTx) is a neurotransmission impairing toxin that acts on several neurotransmitter systems. TeTx also inhibits the K+-induced release of acetylcholine (ACh) from synaptosomes isolated from the electric organ of Torpedo. Neither the membrane potential and depolarization, nor the depolarization-induced calcium uptake into cholinergic nerve terminals is modified after TeTx poisoning. On the other hand, it is known that, when cholinergic nerve terminals are stimulated, there is a release of ATP associated with the release of ACh. We have explored the action of TeTx on this co-release, and have found that there is no action of TeTx on the nucleotide release. Thus, TeTx blocks ACh release without modifying ATP release. PMID- 3556586 TI - B-Z DNA conformational transition in 1:1 electrolytes: dependence upon counterion size. AB - We have studied the B-Z transition of poly[d(G-C)] in the presence of alkali metal, tetramethylammonium and tetraethylammonium chlorides at room temperature. The measured critical salt concentrations increase in the order Na, K, Rb, TMA, Cs and are in good agreement with the theoretical values predicted from a statistical-mechanical treatment of the transition. PMID- 3556587 TI - Identification of the serotonin-S2 receptor ligand binding site by photoaffinity labelling with 7-azido-8-[125I]ketanserin ([125I]AZIK). AB - 7-Azido-8-[125I]ketanserin ([125I]AZIK) was characterized as a potent photoaffinity probe for serotonin-S2 receptors. In reversible binding experiments, [125I]AZIK bound with high affinity (Kd = 0.69 nM) to rat frontal cortex membranes. When incubation with [125I]AZIK was followed by UV irradiation, the binding was found to be irreversible. Protection experiments with various drugs demonstrated the serotonin-S2 nature of the photoaffinity labelling. SDS polyacrylamide gel electrophoresis of the photolabelled membranes allowed one to identify the serotonin-S2 receptor ligand binding site as a single polypeptide with a molecular mass of approx. 67,500 Da. [125I]AZIK will be a valuable tool for the elucidation of the serotonin-S2 receptor structure. PMID- 3556588 TI - Neurotrophic effect of naturally occurring long-chain fatty alcohols on cultured CNS neurons. AB - A long-chain fatty alcohol,n-hexacosanol, that we have isolated from the Far Eastern traditional medicinal plant, Hygrophila erecta, Hochr., is shown to promote the maturation of central neurons. Added at 500 nM to fetal rat brain neurons in culture, it increased both neurite outgrowth by a factor of 4-6 and the number of collaterals, especially in multipolar neurons. The biochemical differentiation of cultured neurons was also strikingly enhanced by this compound: it increased the protein content and almost doubled the activities of two neuron-specific enzymes, phosphate-activated glutaminase and neuron-specific enolase, by 92 and 78%, respectively. Extensive studies with several synthetic long-chain fatty alcohols showed that the neurotrophic activity was maximal for n hexacosanol. It is suggested that some long-chain fatty alcohols with an appropriate length of hydrocarbon chain might play an important role in central neuron development. PMID- 3556589 TI - The hydration of protein secondary structures. AB - The hydration of the main-chain carbonyl (CO) groups in proteins have been studied using infra-red spectroscopy, and computer-graphics analysis of high resolution protein crystal structures. The IR measurements indicate that the strength of water binding to the CO groups is lower in beta-sheet proteins compared with alpha-helical ones. Analysis of the protein crystal structures shows that this is due primarily to differences in the geometry of water-CO group interactions in the two types of secondary structure. PMID- 3556590 TI - Indoor air quality research. Report on a WHO meeting. Stockholm 27-31 August 1984. PMID- 3556591 TI - Adjuvant androgen treatment of operable breast cancer--a 20 year analysis. AB - One hundred and fifty-five patients with carcinoma of the breast treated by mastectomy were randomised to receive no additional treatment or to receive adjuvant testosterone. After a minimum follow up of 15 years there is no difference in either relapse free survival or overall survival between the treated and control groups. Stratification by pathological nodal status showed no benefit either for those with negative or positive axillary lymph node involvement. PMID- 3556592 TI - The effect of familiality on clinical presentation and survival in mammary carcinoma. AB - In a series of 467 patients treated for mammary carcinoma 96 (20%) had a family history for this tumour. Sixty-eight (71%) had at least one first degree, 28 (29%) a second or third degree family member. Only the mean age of the second degree relative group differed significantly from that of the non-familial group. The size of the primary tumour at first presentation did not differ significantly in the familial and non-familial group, as the estimated survival. So patients with a family history for mammary carcinoma did not present themselves in an earlier stage of disease. Because of the higher risk of developing this type of tumour in female relatives we have to instruct this potential patient group more explicitly. PMID- 3556594 TI - Vocal cord paralysis and tumour length in staging postcricoid cancer. AB - The present UICC classification of postcricoid cancer is based on directions of tumour spread which are uncommon and difficult to assess clinically. The classification takes no note of spread into the cervical oesophagus and fails to correlate staging with survival. The aim of this study was to assess the value of other criteria, including vocal cord paralysis and tumour length, in staging 157 patients with postcricoid cancer. Both vocal cord paralysis and tumour length could be assessed in most patients, and correlated with the mode of treatment. Generalized Linear Interactive Modelling (GLIM) identified vocal cord paralysis (P less than 0.001), performance status (P less than 0.025) and the interaction of length and histological grade (P less than 0.05) as significant predictors of survival. None of these variables is included in the current UICC classification. PMID- 3556593 TI - Hyperthermic antiblastic perfusion with DTIC in stage IIIA-IIIAB melanoma of the extremities. AB - The aim of this paper is to evaluate the effectiveness of DTIC when employed at a local level in hyperthermic antiblastic perfusion (HAP) for stage IIIA-IIIAB melanoma patients. Twenty-seven consecutive patients have been treated at the National Cancer Institute of Milan from October 1983 to June 1985. All the patients were submitted to HAP at 40 degrees for 60' with DTIC at the dosage of 2.5 g/m2 [corrected] for lower extremities and 1.5 g/m2 [corrected] for upper extremities. We observed a complete local response in three patients and a partial local response 50% in seven patients, 10 patients has a response less than 50% and 4 patients did not show any response. After surgical removal of the residual tumor when possible, 14 patients are alive without detectable disease while 11 are alive with disease and two dead for progression. No serious complications were observed. These data indicate that DTIC seems able to obtain in HAP, results superimposable to L-PAM without any significant toxicity. PMID- 3556595 TI - Dysplasia-carcinoma sequence, types of adenomas and early colo-rectal carcinoma. PMID- 3556596 TI - Methods for and results from colo-rectal cancer screening: the Minnesota experience. PMID- 3556597 TI - Diagnostic procedures in colo-rectal cancer: barium enema or colonoscopy? Or both? PMID- 3556598 TI - Colo-rectal cancer, the prophylactic effect of polypectomy. PMID- 3556599 TI - Colo-rectal cancer: intraoperative colonoscopy. PMID- 3556600 TI - Local therapy of early malignant lesions in the rectum. PMID- 3556601 TI - Extraskeletal Ewing's sarcoma in a pregnant woman: a case report. AB - Extraskeletal Ewing's sarcoma is an unusual form of soft-tissue sarcoma. We report a case of a pregnant woman with a rapidly growing tumour of the left thigh, who went into complete remission with combination chemotherapy. Aggressive therapy is justified in this kind of tumour even in cases with advanced disease. PMID- 3556602 TI - The relationship between surgeons and pathologists in treating cancer. PMID- 3556603 TI - Effect of training on the decline of VO2max with aging. AB - It has been proposed that continued exercise training may slow the rate of decline of VO2max that occurs as a person ages. Although little evidence has been available in the past to support this belief, recently published data appear to indicate that older persons who maintain their activity levels decrease their VO2max at a rate of 5% per decade rather than the 10% per decade decline found in sedentary persons. It was also believed that men and women over the age of 60 either showed minimal or no increase in VO2max as a result of exercise training. Recent data from our laboratory and others indicate that individuals in this age range can increase their VO2max in response to training and that their adaptive capacity, at least on a relative basis, is similar to that of younger persons. It also appears that older persons may require a lower relative training intensity to elicit increases in VO2max. Thus it appears that older persons can minimize the reduction in VO2max that occurs as they age if they maintain high levels of physical activity and that they retain the ability to adapt to exercise training. PMID- 3556604 TI - Cardiovascular response to exercise in younger and older men. AB - Measurements of cardiac performance for humans at various ages is influenced by the variable examined, the population and techniques employed, and the factors that co-vary with age, including the presence of disease and physical conditioning. Interstudy differences in the extent to which occult coronary disease is present in older subjects and in the level of physical conditioning among subjects may underlie the variable perspectives contained in the literature of how aging affects cardiovascular function. In carefully screened, highly motivated but not athletically trained community-dwelling subjects, resting cardiovascular parameters are not age related except for systolic blood pressure, which increases with age. During vigorous exercise the mechanisms used to achieve a high level of cardiac output shift from a dependence on a catecholamine mediated increase in heart rate and inotropy to a dependence on the Frank Starling mechanism. One reason for the age difference in cardiovascular response to exercise may be a diminished responsiveness to beta-adrenergic stimulation in these subjects. In other elderly subjects who cannot exercise to high work loads, a decline in stroke volume as well as heart rate at peak exercise has been observed. Whether the inability of these individuals to augment stroke volume is caused by a decrease in the ability of the heart to increase diastolic filling, by a decrease in systolic pump function caused by an increased afterload, by intrinsic myocardial contractile defects, or by a greater diminution of the cardiovascular response to beta-adrenergic stimuli is presently unknown. PMID- 3556605 TI - Cardiovascular adaptations to exercise training in the elderly. AB - Maximal O2 uptake (VO2max) and left ventricular function decrease with age. Endurance exercise training of sufficient intensity, frequency, and duration increases VO2max in the elderly. The mechanisms underlying the increased VO2max in the elderly are enhanced O2 extraction of trained muscle during maximal exercise leading to a wider arteriovenous O2 difference, and higher cardiac output in the trained state. However, increased cardiac output during true maximal exercise has not been documented in elderly subjects. Endurance exercise training results in a lower heart rate and rate pressure product during submaximal exercise at a given intensity. However, no improvement in left ventricular function has been reported in the elderly after exercise training. Highly trained master athletes exhibit proportional increases in the left ventricular end-diastolic dimension and wall thickness suggestive of volume overload hypertrophy compared with age-matched sedentary controls. The magnitude of left ventricular enlargement is similar to that in young athletes. The failure of exercise training to alter the age-related deterioration of left ventricular function in the elderly may reflect an insufficient training stimulus rather than the inability of the heart to adapt to training in elderly subjects. PMID- 3556606 TI - Effect of exercise on cardiac muscle performance in aged rats. AB - Most investigations of a direct impact of chronic physical conditioning on cardiac muscle physiology and biochemistry have utilized relatively young animal models. Some, but not all, of these studies have demonstrated beneficial effect of relatively modest magnitude. With advancing age, i.e., with the onset of senescence, characteristic changes in many aspects of cardiac physiology and biochemistry in rodent models have been noted to occur. In general, these consist of a reduction in the kinetics of events that determine myocardial excitation contraction relaxation and energetics. Recently it has been shown that several of these apparent age-related functional declines can be reversed by chronic physical conditioning, which in some instances have no effect on cardiac muscle of younger animals. This suggests that the relative efficacy of chronic exercise to modulate myocardial performance may, in part, be determined by the level of function present before the intervention, as is the case for other modulators of cardiac muscle function. In addition, that apparent age-related deficits in myocardial function can be reversed by conditioning suggests an interaction between life-style and aging. PMID- 3556607 TI - Effects of exercise on longevity of rats. AB - It has been postulated that life span is inversely related to energy expenditure. If this is correct, regularly performed exercise could accelerate the aging process. In two early studies, exercise shortened the life span of rats; the results of these studies have been cited as evidence for the concept that an increase in energy expenditure accelerates aging. However, subsequent studies have not confirmed this finding. Instead, the weight of evidence now indicates that rats that exercise regularly have a longer average life span than sedentary, ad libitum-fed controls. Freely eating sedentary rats become obese, indicating that their food intake is in excess of their energy requirements. Available evidence seems compatible with the interpretation that exercise results in improved survival in rats by countering deleterious effects of a sedentary life combined with overeating. PMID- 3556608 TI - Metabolic activation of xenobiotic stilbene estrogens. AB - Certain stilbene estrogens, in particular diethylstilbestrol, are established carcinogens in animals and in humans. The question is raised whether the formation of reactive metabolites is part of the carcinogenic mechanism of these compounds. Some aspects of the oxidative metabolism are briefly reviewed, with special emphasis on peroxidase-mediated metabolic activation. The interaction of the reactive intermediates with nucleic acids and proteins is described and examples of the induction of genetic damage in several short-term assays are given. From the available data it is concluded that metabolic activation may play a role in the process of neoplastic cell transformation induced by stilbene estrogens. PMID- 3556609 TI - Metabolic activation of pesticides with proestrogenic activity. AB - The role of metabolism in the estrogenic activity of chlorinated hydrocarbon pesticides was examined. Whether the estrogenic activity in technical grade preparations of the pesticide methoxychlor is due to methoxychlor or to contaminants was also investigated. Identified compounds in technical methoxychlor were examined by an in vitro method to determine whether they are estrogens or proestrogens. This method showed that purified methoxychlor and MDDE, an olefinic derivative of methoxychlor, are proestrogens and that monohydroxymethoxychlor and monohydroxy-MDDE are estrogens. Thus, the estrogenic activity in technical methoxychlor is due to both methoxychlor and contaminants. MDDE is an in vivo metabolite of methoxychlor, and the mono- and bishydroxy derivatives of methoxychlor and MDDE are metabolites of methoxychlor and MDDE, respectively. These metabolites exhibited in vitro estrogenic activity in the following order of potency: bis-OH-MDDE greater than bis-OH-methoxychlor greater than mono-OH-MDDE greater than mono-OH-methoxychlor. A similar order of potency was observed in vivo, demonstrating that metabolites of methoxychlor are potent estrogens. In addition to phenolic products, hepatic monooxygenases metabolize methoxychlor and MDDE to reactive intermediates that bind covalently to microsomal proteins. Further studies are needed to determine the factors controlling the two pathways of methoxychlor metabolism and determine whether covalent binding is associated with cellular and organ toxicity. PMID- 3556610 TI - Species-specific pharmacology of antiestrogens: role of metabolism. AB - The nonsteroidal antiestrogen tamoxifen exhibits a paradoxical species-specific pharmacology. The drug is a full estrogen in the mouse, a partial estrogen/antiestrogen in humans and the rat, and an antiestrogen in the chick oviduct. Inasmuch as tamoxifen has antiestrogenic effects in vitro, differential metabolism of tamoxifen to estrogens might occur in the species in which it has an estrogenic pharmacology. Tamoxifen or its metabolite 4-hydroxytamoxifen could lose the alkylaminoethane side chain to form the estrogenic compound metabolite E or bisphenol. Sensitive metabolic studies with [3H]tamoxifen in chicks, rats, and mice identified 4-hydroxytamoxifen as the major metabolite, but no potentially estrogenic metabolites were observed. Athymic mice with transplanted human breast tumors can be used to study the ability of tamoxifen to stimulate target tissue or tumor growth. Estradiol caused the growth of transplanted MCF-7 breast cancer cells into solid tumors and a uterotrophic response. However, tamoxifen does not support tumor growth when administered alone, although it stimulates uterine growth. Since a similar profile of metabolites is sequestered in human and mouse tissues, these studies strongly support the concept that the drug can selectively stimulate or inhibit events in the target tissues of different species without metabolic intervention. PMID- 3556612 TI - Photodegradation of carotenoids in human subjects. AB - Photodegradation of vitamins in vitro is responsible for large losses of these nutrients in foods, beverages, and semisynthetic liquid formula diets. In vivo photodegradation of vitamins has been reported for riboflavin in jaundiced infants exposed to blue light and for folate in patients with chronic psoriasis given photochemotherapy. Two recent studies of normal subjects have also shown that photodegradation of carotenoids in plasma occurs with cumulative exposure of the skin to an artificial light source having maximal spectral emission in the UVA range. Females showed a larger effect of the UV light on their plasma carotenoid levels than males. These observations have identified a need for further investigation of the role of sunlight exposure as a determinant of plasma carotenoid levels and vitamin A status in human subjects. PMID- 3556611 TI - Photodegradation of riboflavin in neonates. AB - The biologically most important flavins are riboflavin and its related nucleotides, all highly sensitive to light. It is because of its photoreactivity and its presence in almost all body fluids and tissues that riboflavin assumes importance in phototherapy of neonatal jaundice. The absorption maxima of both bilirubin and riboflavin in the body are nearly identical: 445-450 (447) nm. In consequence, blue visible light will cause photoisomerization of bilirubin accompanied by photodegradation of riboflavin. This results in diminished erythrocyte glutathione reductase, which indicates generalized tissue riboflavin deficiency and red cell lysis. Single- and double-strand breaks in intracellular DNA have occurred with phototherapy. This light exposure of neonates may result also in alterations of bilirubin-albumin binding in the presence of both riboflavin and theophylline (the latter frequently given to prevent neonatal apnea). Many newborns, especially if premature, have low stores of riboflavin at birth. The absorptive capacity of premature infants for enteral riboflavin is likewise reduced. Consequently, inherently low stores and low intake of riboflavin plus phototherapy for neonatal jaundice will cause a deficiency of riboflavin at a critical period for the newborn. Supplementation to those infants most likely to develop riboflavin deficiency is useful, but dosage, time, and mode of administration to infants undergoing phototherapy must be carefully adjusted to avoid unwanted side effects. PMID- 3556613 TI - Photoprotection by carotenoids. AB - Carotenoid pigments have been found to have a protective function against photosensitization in green plants. This protective ability has been exploited in the administration of high doses of beta-carotene to patients with erythropoietic protoporphyria to ameliorate the photosensitivity associated with this disease. The carotenoids seem to exert their light-protective function by quenching excited species such as singlet oxygen and free radicals. PMID- 3556614 TI - Diet and alcohol effects on the manifestation of hepatic porphyrias. AB - Porphyria cutanea tarda (PCT) is the most frequently reported type of porphyria. The average patient is male more than 40 years old with a history of alcohol consumption. In women the incidence of PCT has increased with use of estrogens for birth control. The cutaneous features are those of chronic porphyrin photosensitivity on the light-exposed area of the skin: pigmentation, hirsuitism and fragility, and vesiculobullae, which has prompted the expression bullosa actinica et mechanica. One-third of the patients have glucose intolerance. PCT has been reported frequently among the Bantu people in South Africa as resulting from combinations of alcohol and cooking in ironware. The average patient has a higher than normal hematocrit, which is used as a guide to treatment by phlebotomy ranging from 8 to 14 units removed every 2-4 wk. Chemically induced PCT has been reported with chlorinated hydrocarbons, the best-known of which is hexachlorobenzene (HCB). Porphyria was noted in more than 3,000 patients in southeast Turkey between 1955 and 1961, because of consumption of seed wheat treated with HCB. In addition, more than 1,000 children under the age of 1 year died because HCB was transferred from the mother, either via the placenta or through breast milk. PMID- 3556615 TI - Photocarcinogenesis and diet. AB - Nearly 50 years ago the first reports appeared that cast suspicion on lipids, or peroxidative products thereof, as being involved in the expression of actinically induced cancer. Whereas numerous studies have implicated lipids as potentiators of specific chemical-induced carcinogenesis, only recently has the involvement of these dietary constituents in photocarcinogenesis been substantiated. It has now been demonstrated that both level of dietary lipid intake and degree of lipid saturation have pronounced effects on photoinduced skin cancer, with increasing levels of unsaturated fat intake enhancing cancer expression. The level of intake of these lipids is also manifested in the level of epidermal lipid peroxidation. Conversely, dietary antioxidants inhibit both lipid peroxidation and photocarcinogenesis, the degree of inhibition of the latter being roughly equivalent to the degree of cancer enhancement evoked by the respective level of dietary lipid. The apparent similarities of lipid effects on both chemical and photoinduced carcinogenesis suggest a common underlying role for these dietary constituents in the carcinogenic process. This role may involve free radical mediated lipid peroxidative reactions. Regardless of the mechanism, it is obvious that both dietary lipid and antioxidants can modify the photocarcinogenic response of skin. PMID- 3556616 TI - Genetically mast cell-deficient W/Wv mice as a tool for studies of differentiation and function of mast cells. AB - Genetically mast cell-deficient W/Wv mice are useful for the analysis of mast cell biology, especially as recipients of bone marrow cells and skin pieces. Inasmuch as suspension and clonal cultures of mast cells have been developed, we combined these in vivo and in vitro systems. Suspension-cultured mast cells had morphological and biochemical characteristics similar to those of mucosal mast cells (MMC). However, i.p. injection of such cultured mast cells gave rise to development of cells with characteristics similar to those of connective tissue mast cells (CTMC). When peritoneal cells of normal +/+ mice were cultured in methylcellulose, pure mast cell colonies appeared. Cells from individual mast cell colonies were divided and injected into the skin and stomach wall of W/Wv mice; CTMC developed in the skin and MMC in the stomach mucosa. This indicates the presence of a common precursor for CTMC and MMC. Morphology of such bipotent mast cell precursors was studied by using micromanipulation. About 4% of morphologically identifiable peritoneal mast cells may function as the bipotent precursors. Although W/Wv mice showed a defect in resistance against ixodid ticks, injection of suspension-cultured mast cells normalized the defect. The four examples mentioned above indicate that combinations of in vivo and in vitro systems increase the usefulness of W/Wv mice. PMID- 3556617 TI - Ethical and legal issues in cryopreservation of human embryos. PMID- 3556618 TI - Visual assessment of peritoneal implants for staging endometriosis: do number and cumulative size of lesions reflect the severity of a systemic disease? PMID- 3556619 TI - Prediction of ovulation with the use of oral and vaginal electrical measurements during treatment with clomiphene citrate. AB - This study was undertaken to evaluate the usefulness of measuring salivary and vaginal electrical resistance in monitoring ovulation induced by clomiphene citrate (CC). Data from 28 cycles of 12 women treated with CC were compared with those of 18 cycles of 13 women who were ovulating spontaneously. Patterns of salivary readings in CC and spontaneous cycles were similar and showed a preovulatory peak 6.2 (mean) days before the luteinizing hormone peak. The trend in vaginal readings for CC cycles differed from that of spontaneous ovulations in that the values were depressed during and shortly after CC therapy. Occurrence of the periovulatory nadir and subsequent rise was common to both groups. The rise in vaginal readings CC cycles occurred within 24 hours of the luteinizing hormone peak in 88% of cases. Retrospective analysis showed that, based on this method, artificial insemination would have been timed appropriately in 25 of 27 cycles or in every cycle, depending on the protocol used. The results indicate that the method is equally useful for predicting and confirming ovulation in cycles in which CC was used to induce ovulation as it is in spontaneous cycles. PMID- 3556620 TI - Reproductive performance of women with unicornuate uterus. AB - The reproductive history of 19 women with a diagnosis of unicornuate uterus confirmed by laparoscopy or laparotomy is analyzed. The patients were followed for 2 to 10 years. One patient had a cavitary communicating rudimentary horn, four a cavitary noncommunicating rudimentary horn, seven a noncavitary rudimentary horn, and seven no rudimentary horn. Six of the patients presented with primary infertility. The other 13 women had a total of 29 pregnancies, 1 (3.4%) in a rudimentary horn determining rupture; abortions occurred in 17 (58.6%), premature labor in 3 (10.3%), and term births in 8 (27.6%), with a live birth rate of 38%. Of the 11 births, 6 (54.5%) were breech presentations, and 9 (81.8%) were cesarean sections. In five cases the rudimentary horn was removed, with associated salpingooophorectomy in three patients. Cervical cerclage was not performed in any of the patients. PMID- 3556621 TI - Reproductive outcome after fimbrial evacuation of tubal pregnancy. AB - Thirty-one ectopic pregnancies were manually expressed (i.e., "milked out") by the tubal fimbria during a 13-year period. Reproductive histories and operative findings were unremarkable when compared with the general population with ectopic gestation. The subsequent reproductive performance was evaluated in 27 patients who attempted conception. Twenty-five (92%) of the 27 patients subsequently conceived, 23 (85%) had at least one successful term pregnancy, and the remaining 2 (7%) had abortions only. There was no repeat ectopic pregnancy. Average follow up time was 38.5 months. Previous experience with this technique has been disappointing with low postoperative rates of successful term pregnancies. Favorable outcomes after fimbrial expression have been reported only in small numbers of patients. It is suggested that the procedure is appropriate for distal tubal gestations that are loosely adherent within the tubal lumen; these are usually expressed with minimal efforts. However, if the gestational mass does not yield to gentle milking of the tube or evacuation has been incomplete, the surgeon can always use a linear salpingotomy. More experience is obviously needed to verify these preliminary results, suggesting that fimbrial evacuation is simple, safe, and advantageous in properly selected cases. PMID- 3556622 TI - A low-dose triphasic oral contraceptive. AB - Controlled clinical investigations of a three-phase, low-dose oral contraceptive combination of levonorgestrel and ethinyl estradiol were conducted at 17 sites in the United States and 60 sites in the United Kingdom. A day 1 start in cycle one with no backup contraception was used. A total of 3546 female volunteers participated in 35,036 cycles. Medication was missed in 2688 (7.7%) cycles. Nine pregnancies were reported for an uncorrected use-effectiveness rate of 0.33 per 100 woman-years. Cycle control was excellent, bleeding irregularities were minimal, and the incidence of side effects was very low. No clinically significant variations in blood pressure means or weight means were observed. Carbohydrate and lipid metabolism studies were limited to 6 months and showed minimal alterations. Subject compliance with the preparation was excellent. It is concluded that this triphasic oral contraceptive with its varying ratios of levonorgestrel and ethinyl estradiol is an effective, predictable, and well tolerated combination oral contraceptive. PMID- 3556623 TI - Performance of patients with a "frozen pelvis" in an in vitro fertilization program. AB - It is now possible to identify and study the performance of different subgroups of patients in in vitro fertilization (IVF) programs. Patients with severe pelvic adhesions due to pelvic inflammatory disease (PID) or endometriosis were classed as having a frozen pelvis if less than or equal to 20% of total ovarian surface was visible and if the rest of the ovary was bound down with significant adhesions. IVF offers the only hope of pregnancy for these patients. Fifty-one treatment cycles in 23 such patients were matched against 51 cycles in 48 patients with adhesion-free ovaries. The study group had a significantly higher number of cancelled oocyte retrievals because of poor estradiol (E2) response. They also had a significantly lower rate of E2 rise and a lower peak value of E2 before and after the administration of human chorionic gonadotropin. These patients took longer to respond to a hyperstimulation regime, and when a response occurred they formed fewer follicles, as measured with the use of ultrasound. Lower numbers of oocytes were obtained from this group, but the fertilization rate of oocytes was the same for both groups. One pregnancy occurred in the study group and 11 in the control group. It is possible that disruption of ovarian blood supply or mechanical factors due to the pressure of significant adhesions prevent a good follicular response in patients with a frozen pelvis. PMID- 3556624 TI - Importance of sperm motility after capacitation in interpreting the hamster ovum sperm penetration assay. AB - Routine semen analysis and a zona-free hamster ovum sperm penetration assay (SPA) were carried out for 220 men from a group of infertile couples. The grade of sperm motility was determined after a preincubation period. For both the normal and abnormal semen samples, the number of positive SPAs was significantly higher when the postcapacitation motility was normal. This difference was observed also when the routine semen characteristics of density, motility, and morphologic features were considered separately regarding their relationship with the SPA. Motility after preincubation showed the most significant positive correlation with the SPA result. Therefore, the SPA score should be limited to semen samples showing adequate postincubation motility. PMID- 3556625 TI - Influence of temperature on the function of Sertoli and Leydig cells of human testes. AB - The influence of temperature on Leydig and Sertoli cell functions was investigated in two experiments. One experiment was performed with testes of men with or without varicocele, because the temperature differs between right and left testes of men with left varicocele and right testes of men without varicocele. There were no significant differences in follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG) receptors, and testosterone (T) concentrations among the testes. The other experiment was performed with the use of testicular organ culture. Specific binding sites for FSH, hCG, and T production were similar in cultured testes maintained at 33 degrees and 37 degrees C for 7 days. It is concluded that high temperature may not disturb Leydig and Sertoli cell functions in the short term. PMID- 3556626 TI - Interrelationships of cigarette smoking, testicular varicoceles, and seminal fluid indexes. AB - Data on cigarette smoking, testicular varicoceles, seminal fluid indexes, and oligospermia were examined in 160 young men without known disease and in 94 husbands in infertile couples. The combination of smoking and testicular varicoceles is strongly related to the incidence of oligospermia, defined as sperm count less than or equal to 20 X 10(6)/ml, in each sample. Smokers with testicular varicoceles, in each sample, had a disproportionately high incidence of oligospermia. In the combined sample of 254 men, the smokers with testicular varicoceles had an incidence of oligospermia approximately ten times greater than that in nonsmokers with testicular varicoceles and approximately five times greater than that in men who smoked but were without testicular varicoceles. This relationship of cigarette smoking and testicular varicoceles to oligospermia has not been previously reported. The pathophysiologic basis of the interaction between smoking and varicoceles was theorized to be due to an increased secretion of catecholamines from the adrenal medulla, induced by cigarette smoking. The elevated catecholamine concentrations in the renal vein would then reach the testes via retrograde flow down the internal spermatic vein in men with testicular varicoceles, resulting in seminiferous tubule damage. PMID- 3556627 TI - A 20-year experience with epididymovasostomy for pathologic epididymal obstruction. AB - A total of 255 patients of 281 patients with side-to-side epididymovasostomy for postpathologic epididymal obstruction were followed from 1964 to 1983. The success rates were higher in patients with nontuberculous epididymitis than in those with tuberculous epididymitis. There were no significant differences among anastomotic levels of the epididymal incision. The success rates were 31% for patency and 12% for pregnancy in the 97 patients with macrosurgery and 37% for patency and 20% for pregnancy in the 158 with microsurgery. The causes of anatomic failure were scar formation at the anastomotic site and blockage of opening of the original epididymal tubule. The cause of functional failure was poor semen quality after epididymovasostomy. PMID- 3556628 TI - Superfetation secondary to ovulation induction with clomiphene citrate: a case report. AB - In conclusion, CC has been associated with an increased rate of multifetal pregnancy; however, after each induction cycle, pregnancy should be ruled out before start of a new induction cycle. This would prevent misinterpretations of the gestational age at delivery, and hence of maturity, and would also help prevent any potential malformation that may be caused by a yet undetected teratogenic effect of CC. PMID- 3556629 TI - The "forgotten" intrauterine device. AB - It is essential to ascertain that women who had an IUD inserted at some time have indeed had the device removed. It is also important to ensure that the whole IUD was removed and that no parts were left in the uterine cavity. This is especially true in cases of infertility and should be ascertained before invasive investigations such as hysterosalpingography or laparoscopy commence. An accurate history and ultrasonography can easily rule out a forgotten or fragmented IUD, thereby preventing considerable unnecessary suffering and expense. PMID- 3556630 TI - Ectopic pregnancy in unrepaired distal tubal remnant after contralateral tubal anastomosis. AB - A case is described in which, after a tubal sterilization procedure and subsequent unilateral tubal anastomosis, an ectopic gestation occurred in the contralateral, unrepaired, distal tubal segment. On the basis of this case and related evidence, the authors suggest that in cases in which only a unilateral tubal anastomosis is possible, strong consideration should be given to removal of the contralateral, unrepaired, distal tubal remnant. PMID- 3556631 TI - Adult respiratory distress syndrome complicating ovarian hyperstimulation syndrome. AB - A rare case of OHSS complicated by an ARDS from which the patient recovered after appropriate treatment is presented. Pulmonary capillary leakage induced by prostaglandin release, hypoalbuminemia, and shift of dextran 40 macromolecules to the intraalveolar space is considered the most probable reason for this complication. PMID- 3556632 TI - Importance of semen preparation in avoidance of reduced in vitro fertilization results attributable to bacteria. AB - Although the physical treatment of semen for IVF and related procedures is sufficient to remove most organisms present in semen, the pathogenic varieties tend to be more resistant. The supplementation of oocyte culture medium with both penicillin and streptomycin was associated with the eradication of 100% of organisms in the current study. In these circumstances, the presence of pathogenic organisms in the untreated semen is not associated with reduced oocyte fertilization in vitro. PMID- 3556633 TI - Sex chromosome ratios in human sperm. PMID- 3556634 TI - Sperm separation. PMID- 3556635 TI - [Basic principles of the functional organization of neuronal systems of the brain stem]. PMID- 3556636 TI - [Differentiation of 2 alimentary conditioned reflexes according to the site of the instrumental response in the rabbit with a lesion of the dorsal hippocampus]. PMID- 3556637 TI - [Responses of neurons of the motor cortex of the cat to stimulation of the parietal association area]. PMID- 3556638 TI - [Effect of des-9-glycine-(8-arginine)vasopressin on the evoked primary response of different structures of the rabbit brain]. PMID- 3556639 TI - [Functional interaction of neurons in the cerebral cortex]. PMID- 3556640 TI - [Age and the metabolism of parenterally administered labeled thiamine, pantothenate, nicotinate and lipoate in the digestive system of the rat]. PMID- 3556641 TI - [Strength of the left ventricular wall of mammals]. PMID- 3556642 TI - [Effect of alpha-tocopherol acetate on the response of the lysosomal system of neutrophil leukocytes during exposure to immobilization stress]. PMID- 3556643 TI - [Participation of inhibitory brain systems in learning]. PMID- 3556644 TI - [Action potentials of cardiomyocytes and spike activity of the neural components of the vagosympathetic reflex after immune damage to the heart]. PMID- 3556645 TI - [Effect of antihistone serum on the fractional composition of histones during an immune response]. PMID- 3556646 TI - [Effect of starvation at an early age on the intensity of oxidation of energy substrates in the small intestine]. PMID- 3556647 TI - [Changes in the microcirculation, morphologic structure and activity of redox enzymes of the kidney during constriction of the renal artery]. PMID- 3556648 TI - [Neurogenic nature of ovarian cysts in cows]. PMID- 3556650 TI - [Device for measuring intramembrane potential jumps by the electrostriction method]. PMID- 3556649 TI - [Effect of insulin deficiency on the periodontal response to stress]. PMID- 3556651 TI - Retinal dysfunction in central serous retinopathy. AB - Patients with acute and chronic central serous retinopathy (CSR) were studied by psychophysical and photochemical means to establish the extent of visual depression and to investigate the basis of rod dysfunction in this disorder. In acute disease with serous detachment of the retina, the loss of sensitivity attains 3 log units and parallels the height of retinal elevation as does its recovery with resolution of the episode. Immediately after resolution, there is a residual 0.5 log unit threshold elevation. In chronic disease, marked loss of function exists over areas of abnormal retinal pigment epithelium in the absence of clinically detectable serous detachment. Although rhodopsin levels are low in both acute and chronic CSR, this relative lack of visual pigment does not totally account for the functional deficits in either situation. PMID- 3556652 TI - An in-vitro study of irradiated vitreo-retinal membranes. AB - Standard perforating injuries were created in the right eye of 30 rabbits. Twenty of these had the site of injury irradiated using the radioactive ophthalmic 60Cobalt applicator. Vitreo-retinal membranes obtained from non-irradiated and irradiated eyes were propagated in vitro. The morphology and viability of the cells that grew as a monolayer was studied using phase, light and electron microscopy. The proportions of the different cell types that constituted the monolayer was determined using immunofluorescent staining techniques. Non irradiated membranes elaborated an abundant outgrowth of healthy cells that were predominantly fibroblasts. Irradiated membranes developed a sparse outgrowth of cells with vacuolated cytoplasm and pyknotic nuclei indicating cell destruction. The majority of the surviving cells were glial, with fibroblasts and retinal pigment epithelial cells forming the remainder. PMID- 3556653 TI - Bilateral Coats' disease in an infant (a clinical, angiographic, light and electron microscopic study). AB - The clinical, angiographic, ultrastructural and immunohistochemical features of a bilateral and asymmetrical case of Coats' disease in a three year old girl are described. The left eye showed advanced disease and was enucleated. Pathological examination revealed an exudative vasculopathy with ultrastructural evidence of interendothelial cell separation and formation of fenestrations. An isolated vascular malformation was discovered in the right eye. This was successfully treated with Argon laser under general anaesthesia. PMID- 3556654 TI - Ocular signs in Alport's syndrome. AB - The eyes of sixty one patients with Alport's syndrome or its variant, and of 25 unaffected relatives, were examined. Details of ocular signs associated with Alport's syndrome are presented and related to renal prognosis and family history. PMID- 3556655 TI - What is open angle glaucoma? PMID- 3556656 TI - Eye pathology scheme. PMID- 3556657 TI - The organisation of the glaucoma clinic. AB - The diagnosis and accurate assessment of progress of patients with glaucoma is more complex and time consuming than for most other ophthalmic disorders. Glaucoma patients in an overcrowded general clinic are therefore seldom given time for adequate visual field examination and all too often silent deterioration goes unnoticed until irreversible loss of central vision occurs. The introduction of a clinic specifically for glaucoma patients provides the opportunity for detailed assessment so that effective modern treatment can be applied and unnecessary blindness avoided. This paper describes the simple and practical plan for the organisation of a glaucoma clinic which has worked well for many years in the Tennent Institute of Ophthalmology. PMID- 3556658 TI - When to advise medical treatment for open-angle glaucoma. PMID- 3556659 TI - Ten year results of laser trabeculoplasty. Does the laser avoid glaucoma surgery or merely defer it? AB - The first 150 consecutive phakic eyes from 113 patients aged 40 years or more treated with laser trabeculoplasty were evaluated. Twenty-four patients (37 eyes) have died, two eyes developed spontaneous rubeosis, and one patient (one eye) was not available, leaving 110 eyes with a 6 to 10 years follow-up. Of the 37 eyes of dead patients (average age 80 years), only one eye had filtering surgery, and 33 of the other 36 eyes had a last recorded intraocular pressure of less than 21 mm Hg. Of the 110 eyes of living patients followed for 6 years, 33 had filtering surgery and 62 eyes (56 per cent) had an intraocular pressure of less than 21 mm Hg. Of 10 eyes followed for 10 years, eight had intraocular pressures less than 23 mm Hg, seven had pressures less than 21 mm Hg, and two had had filtering surgery. Eyes with advanced disc damage at the time of trabeculoplasty had a 51 per cent rate of later glaucoma surgery, while eyes with a cup/disc ratio less than 0.9 at trabeculoplasty had a glaucoma surgery rate of 16 per cent. Eyes of non-white patients did as well as eyes of white patients. Computer analysis of over 1,700 eyes with two-year follow-up indicated better long-term control when 100 or more laser burns were used for trabeculoplasty. Laser trabeculoplasty can defer surgery for the remaining lifespan in elderly patients, and has controlled primary open-angle glaucoma for over 10 years, but later glaucoma surgery is often required in eyes with far advanced glaucoma damage. PMID- 3556660 TI - How to manage the unresponsive patient. PMID- 3556661 TI - Ophthalmological status of school children with dyslexia. PMID- 3556662 TI - Retinal vasculitis: correlation of animal and human disease. AB - A form of experimental retinal vasculitis was induced in black hooded Lister rats by the inoculation of retinal S-antigen. Comparison of this disease with retinal vasculitis in man showed striking clinical, angiographic and pathological similarities. Clinically disc oedema, periphlebitis and retinal infiltrates were observed with corresponding leakage of dye on fluorescein angiography. Pathologically the disease showed perivascular lymphocytic infiltrates with focal photoreceptor necrosis. These characteristic features make this an ideal model for the study of the pathogenesis of retinal vasculitis in man. PMID- 3556663 TI - The diagnosis and surgical management of acquired bilateral superior oblique palsy. AB - Thirty-four patients with surgically treated bilateral superior oblique palsy are presented. The patients are divided into three groups: Symmetrical palsies, Asymmetrical palsies, A group in whom the bilaterality was initially masked. Bilaterality should be suspected in all cases of traumatic IVth nerve paresis, and particularly in cases with a large 'V' pattern, excyclo deviation of more than 10 degrees on down-gaze and when right hypertropia switches to left hypertropia on lateral down-gaze. Bilateral Harada-Ito procedures alone 'cured' 11 of 17 patients (65 per cent) in groups 1 and 2, and is the operation of choice in acute bilateral superior oblique palsy. Cyclo deviation was reduced by a mean of 5.5 degrees in the primary position and by 6-10 degrees in down-gaze. Patients initially managed with other surgery had a more complicated surgical course and required more operations. Seven patients who initially demonstrated only gross fusion recovered good fusion after Harada-Ito surgery. PMID- 3556664 TI - Retinal detachment following Nd:YAG posterior capsulotomy. AB - Five hundred and eighty-two patients who underwent Nd:YAG laser posterior capsulotomy at Moorfields Eye Hospital were reviewed retrospectively. Twelve patients (2 per cent), nine of whom were previously myopic, subsequently developed rhegmatogenous retinal detachment. Comparison with other studies suggests there is no greater risk of retinal detachment associated with Nd:YAG laser capsulotomy than with surgical discission. The relevance of the damage mechanisms of Nd:YAG lasers are discussed. PMID- 3556665 TI - Ocular morbidity after radiotherapy of orbital and conjunctival lymphoma. AB - One hundred and fifteen patients were treated for lymphoma of the conjunctiva and orbit between 1970 and 1984. One hundred and twelve patients received radiotherapy to the orbit, of whom 73 (65 per cent) had at least one year of follow-up by an ophthalmic surgeon. Patients with low-grade lymphomas (97) mostly received 30 Gy in 15 fractions to the orbit over a period of 3 weeks. Those with high-grade lymphomas (18) mostly received 40 Gy in 20 fractions over 4 weeks. Most were treated using anterior and lateral radiation fields to the orbit with shielding of the cornea and lens. This technique delivered a mean lens dose of 15 Gy. The early and late ocular and orbital morbidity in these patients was low. Eight radiation-induced cataracts developed of which only six interfered with vision. None has needed cataract surgery. No patients developed radiation retinopathy and only 5 had disorders of ocular lubrication. PMID- 3556666 TI - Ultrastructural differentiation of glandular stomach (proventriculus) in chick embryo. AB - Cytochemical characterization of mucosubstances of chick glanular stomach (proventriculus) changes from 15 days of development to postnatal and adult stages was studied. To corroborate these data cytochemical, ultrastructural and ultracytochemical study of chick embryo proventriculus from 7 to 20 days of development was performed. At the 7th day several layers of undifferentiated cells formed an epithelium which covered the walls of the glandular stomach. Mocosubstances were not found. Between the 9th and 5th day a single layer of cylindrical cells was encountered forming invaginations which originated deep glands. Three types of cells were separated from the above mentioned layer, dark, clear and undifferentiated. The dark cells had organelles which are involved in protein synthesis and the clear ones were rich in mitochondria. Argentaffine cells appeared at 15th day instead mucosubstances formed a thin coat on the epithelium at 9th day which increased at the end of development in the apical cytoplasm and gland cells. These observations demonstrate that proventriculus of chick embryo has ultrastructurally differentiated cells involved with enzymatic and hydrochloric acid secretion after the 9th day. These progressive events are correlated with the digestion process of yolk during embryogenesis. At the end of development the proventriculus has completely organized the glandular layer. PMID- 3556667 TI - Stereological studies of mitochondria during the implantation of mouse blastocytes. AB - The following stereological parameters of mitochondria were compared in trophoblast of 5 and 6 day blastocysts: volume density of inner membrane (Vim), outer membrane (Vom), matrix (Vmat), outer compartment (Voc), surface density of outer membrane (Som) and inner membrane (Sim). They were the basis to calculate the partition coefficient of matrix (Emm) and the partition coefficient of outer compartment (Eocm). On 6 day after fertilization we found statistically significant volume increase of Vim, Voc, Sim, Som, Eocm and volume decrease of Vom, Vmat and Emm. Mitochondria visual evaluation and stereological analysis made for both groups allow to classify them to metabolic transitional state. PMID- 3556668 TI - A simple procedure for isolation of microsomes from human placenta. AB - A method for rapid isolation of human placenta microsomes, which does not require facilities for ultracentrifugation was described. Such microsomes were compared with microsomes prepared by conventional ultracentrifugation technique. Both microsomal preparations were tested for protein, RNA and phospholipid content as well as for sulphohydrolase activities and glucose-6-phosphatase activity. The degree of contamination with other subcellular particles were tested as well. The data presented showed that microsomal proteins precipitated at pH 5.3 may be conveniently used for preparative separation of microsomal enzymes. PMID- 3556669 TI - Morphology and microanalysis of teeth in scleroderma. AB - The studies were carried out on teeth extracted for stomatological reasons in the persons with generalized scleroderma. The studies included: morphologic examination of the longitudinal and cross-ground sections in the light and scanning microscope, and microanalytic examination of the longitudinal halves of the teeth in the X-ray microprobe. In the course of scleroderma morphological changes of the mesenchymal origin occurred in the teeth hard tissues. The deviation in the calcium and phosphorus contents was relatively significant and an absence of magnesium in the dentine and distinct decrease in the calcium phosphorus ratio were observed. PMID- 3556670 TI - 17th meeting of Polish cell biologists with proceedings of the Electron Microscopy Conference. Krakow, 13-14 September 1985. PMID- 3556671 TI - [Evaluation of plasma 6-keto-prostaglandin F1 alpha and thromboxane B2 in diabetic neuropathy]. AB - The relationship between diabetic neuropathy on the one hand and microangiopathy and arteriosclerosis on the other was studied by determining plasma 6-keto prostaglandin F1 alpha (PGF1 alpha) and plasma thromboxane B2 (TXB2) in diabetics with neuropathy. The subjects were 13 patients with insulin independent diabetes mellitus with polyneuropathy (DN+ group), 9 cases which had no neuropathy (DN- group) and 6 control cases. The patients with severe retinopathy, nephropathy and hypertension were excluded. Plasma 6-keto-PGF1 alpha and plasma TXB2 concentration were determined by radioimmunoassay. The motor neuron conduction velocity (M.C.V.) was measured through the tibial nerve in all diabetics. Plasma 6-keto-PGF1 alpha was 116.3 +/- 4.2 pg/ml (mean +/- SE) in the DN+ group and 139.9 +/- 3.0 in the DN- group, each group showing a significant fall over the control with 150.8 +/- 4.5. Plasma 6-keto-PGF1 alpha in the DN+ group showed a significant decrease in comparison with that in the DN- group. As to plasma TXB2, there was no significant difference among the three groups. The M.C.V. fell off significantly in the DN+ group with 52.9 +/- 3.2 m/sec. Furthermore, a significant positive correlation was observed between M.C.V. and plasma 6-keto PGF1 alpha. The following is the summary of these results. A decrease in plasma 6 keto-PGF1 alpha was observed in diabetics with polyneuropathy. A decrease in the production of prostacyclin (PGI2) due to impairment of vascular endothelium in the nerve tissue was surmised. The decrease in plasma 6-keto-PGF1 alpha presumably stimulates the activity of platelet agglutination and causes an ischemic change in the nerve tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556672 TI - [Hyperthyroidism due to a TSH-secreting pituitary tumor]. AB - A 28-year-old female with a 12-year history of goiter is presented. She had both clinical and laboratory evidence of hyperthyroidism, and her serum TSH was persistently and markedly elevated after treatment with antithyroid drugs. A TRH stimulation test resulted in no further rise in serum TSH after cessation of medication. Menses were regular and serum prolactin levels were normal. Serum LH and FSH responses to LHRH stimulation test were normal. No other evidence of pituitary or peripheral endocrine deficiencies existed. She underwent a subtotal thyroidectomy followed by 131I therapy three years later. A pituitary adenoma with sphenoidal and suprasellar extension was completely removed by transphenoidal approach. On light microscopy, it was mostly composed of chromophobic cells with occasional calcification showing sinusoidal pattern. On electron microscopy, most of the cells contained fine granules, which suggested thyrotroph. The immunoperoxidase technique revealed TSH beta in the cytoplasm of some adenoma cells. Three days postoperatively the patient's serum TSH levels returned to normal. TRH stimulation test produced a normal response in serum TSH. The patient was diagnosed hypothyroid by laboratory findings and is currently on thyroid replacement therapy. The patient became pregnant and delivered twice prior to the operation for pituitary adenoma. The previously reported TSH secreting adenomas associated with hyperthyroidism were reviewed. PMID- 3556673 TI - Relationships between elemental intakes within the United Kingdom total diet study and other adult dietary studies. AB - Elemental concentrations from the UK total diet study reflecting the contents of foodstuffs of the diet and their preparation have been compared with the elemental concentration of the study reflecting the contents of the foodstuffs alone. A relationship is defined for a group of elements for which intake concentrations are constant from both studies. A second group is composed of elements for which there are sources other than foods, eg., from food processing, food preparation or from adventitious contact. The defined relationship enables the results from any subsequent adult dietary study to be assessed in terms of the dietary concentration of elements and this is exemplified by a control duplicate diet study. PMID- 3556674 TI - The collaborative evaluation of a procedure for the determination of N-nitroso compounds as a group. AB - Two collaborative studies have been made of the method devized for the determination of N-nitroso compounds as a group, which involves their selective denitrosation with hydrogen bromide in glacial acetic acid, followed by the measurement of the nitric oxide liberated using a chemiluminescence analyzer, such as the TEA. Considerable variation was evident between the results in the first study, most of the values reported being low. This situation undoubtedly arose from the carry-over of traces of hydrogen bromide from one determination to the next, which resulted in premature denitrosation. The precision and consistency of the results were greatly improved in the second study, for which additional precautions had been recommended. All of the six participating laboratories reported reasonably consistent values, the coefficients of variation being 27.9% and 21.1% respectively, at the levels of spiking of N nitrososarcosine equivalent to 32.9 ng and 146.4 ng of nitric oxide. PMID- 3556675 TI - Synthesis of N1-nitroso-3-nitromethylindole: a nonvolatile N-nitroso compound isolated from the nitrosation of the alkaloid gramine. AB - An approach to the synthesis of N1-nitroso-3-nitromethylindole, a nitrosation product of the alkaloid gramine, is described. The method involves a few reaction steps starting from indole-3-carbinol. PMID- 3556676 TI - Protein synthesis inhibition and cardiac lesions associated with deoxynivalenol ingestion in mice. AB - Deoxynivalenol (DON), an occasional contaminant of foodstuffs, has been implicated in outbreaks of mycotoxicosis. Balb-c mice that had ingested 0.35 mg/kg of DON showed a drastic decrease in food intake and concomitant loss of weight. Severe depletion of the lymphoid organs and liver were also observed. Cardiac lesions, appeared as calcified pericarditis foci in young animals fed a diet contaminated by 10 to 20 ppm of DON for a period of a few weeks. DON inhibited protein synthesis. This inhibition occurred at lower doses for the heart than for the other organs. This preferential effect on cardiac tissue correlated with the cardiotoxicity observed. PMID- 3556677 TI - Nickel in foods and the diet. AB - Food has been found to be the main source of nickel intake by man. Nickel was fairly evenly distributed throughout the various food groups examined but highest concentrations of nickel were found in the canned vegetables, sugars and preserves, and bread and cereals food groups, suggesting a contribution from food processing equipment and, possibly, food cans. Mean dietary nickel intakes in the UK (1981-4) were between 0.14 and 0.15 mg/day. The contribution made to dietary nickel intakes by nickel from food utensils and cookware is discussed. PMID- 3556678 TI - Arsenic, cadmium, lead and mercury in meat, livers and kidneys of cattle slaughtered in The Netherlands during 1980-1985. AB - The results obtained between 1980 and 1985 in a Dutch monitoring programme investigating the presence of cadmium, lead, mercury and arsenic in meat, livers and kidneys of cattle are presented. During the period of investigation no clear trends were observed in the metal concentrations, except for lead in kidneys, for which the average concentration decreased from 0.48 mg/kg in 1980 to 0.24 mg/kg in 1985. The average cadmium and lead concentrations found in livers and kidneys in the present study were lower than those obtained for Dutch cattle investigated between 1970 and 1980. In general the metal concentrations found were in good agreement with data reported for other countries. The provisional Dutch legal limits for heavy metals in foods were exceeded only for cadmium in 2 kidney samples. Significant linear relations were found between the concentrations in livers and kidneys for arsenic, cadmium and lead. Significant relations were found also between the cadmium and lead concentrations in livers and between the cadmium levels in livers and kidneys and the age of the animals investigated. PMID- 3556679 TI - Dietary intakes of lead, cadmium, arsenic and fluoride by Canadian adults: a 24 hour duplicate diet study. AB - Twenty-four hour duplicate diets, including drinking water and snacks, were collected from 24 adults living in five Canadian cities. Each diet was separated by the participants into 10 food categories, and each of the samples was analyzed in duplicate for lead, cadmium, arsenic and fluoride. Minimum detection limits for the respective elements in foods were about 0.1, 0.01, 0.3 and 5 ng/g. Mean dietary intakes were 53.8 micrograms/day or 0.80 micrograms/kg/day for lead, 13.8 micrograms/day or 0.21 micrograms/kg/day for cadmium, and 16.7 micrograms/day or 0.26 micrograms/kg/day for arsenic. The median intakes were 42.7 micrograms/day or 0.57 mu/kg/day for lead, 11.9 micrograms/day or 0.17 micrograms/kg/day for cadmium, and 9.79 micrograms/day or 0.139 micrograms/kg/day for arsenic. Half of the participants lived in communities with 1 microgram/g fluoride in the drinking water, and half lived in cities with less than 0.2 microgram/g fluoride in the water. The dietary intake of fluoride for the former was 2802 micrograms/day or 39.7 micrograms/kg/day; while that of the latter was 563 micrograms/day or 8.5 micrograms/kg/day. The respective median intakes of fluoride were 2090 micrograms/day or 30.3 micrograms/kg/day, and 414 micrograms/day or 7.0 micrograms/kg/day. Contribution of individual foods and food categories to the dietary intakes is discussed. PMID- 3556681 TI - The prevention of thromboembolic disease: the NIH report. PMID- 3556680 TI - Trisomy 13 update. PMID- 3556682 TI - A new challenge--charitable medical services. PMID- 3556683 TI - Snoring: a case report and some psychiatric implications. PMID- 3556684 TI - Management of hemoptysis in cystic fibrosis. PMID- 3556685 TI - The influence of individual and historical time on marital dissolution. PMID- 3556686 TI - Analyzing fertility histories: do restrictions bias results? AB - The straightforward tests we have conducted lead to two major conclusions. First, parameter estimates, such as the proportions that practice contraception or that breastfeed, can be biased in data restricted to the last closed and open interval. This is particularly true the further back in time one goes. However, the second conclusion is that these restrictions do not bias estimates of the structure of the relationships predicting fertility. This may seem surprising, and perhaps even magical. The reason is that multivariate life table techniques allow one to reach the same conclusion even if the proportions in various categories are altered by a criterion such as limiting the analysis to intervals begun by the last and next-to-last live births. Limiting the analysis in this way means that there are fewer short intervals and thus fewer cases of intervals with characteristics associated with short intervals (e.g., no contraceptive use, no breastfeeding, or infant mortality). As long as the model specified in the multivariate life table is an appropriate one, that is, it is not misspecified, and as long as the skew produced by the WFS restriction is not too extreme, then the multivariate life table procedures can produce unbiased estimates of the structure of the relationships predicting birth interval dynamics. Thus even though the WFS data are in fact inappropriate for some simple parameter estimation procedures, they appear to be adequate for the more complex multivariate procedures of the sort used here. Several caveats must be added to the foregoing results. First, we have performed this test in only one country, Korea; it is possible that the same results might not be obtained in other countries. We expect, however, that they would. Second, our procedure only looks at the first 40 months of experience in the birth interval. A procedure that incorporates the long tails of the birth interval distribution may obtain different results. In fact, we caution against analyzing the tail of the distributions using data from the normal WFS sample, since these would be most affected by the restriction to last closed and open intervals. Third, the extent to which these results are generalizable to other types of substantive problems is unknown at present. We suspect, however, that examining the determinants of lengths of breastfeeding will produce similar results. Finally, even with multivariate procedures, it would be highly misleading to impose the WFS restrictions and then examine trends in the length of birth intervals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556687 TI - Repeated resuscitation: how lifesaving alters life tables. PMID- 3556688 TI - Fertility change in five Latin American countries: a covariance analysis of birth intervals. PMID- 3556689 TI - Reproductive patterns and child mortality in Guatemala. PMID- 3556690 TI - Constraints to the fulfillment of residential preferences among Texas homebuyers. PMID- 3556691 TI - Changing living arrangements: a hazard model of transitions among household types. PMID- 3556692 TI - Work shifts of full-time dual-earner couples: patterns and contrasts by sex of spouse. PMID- 3556693 TI - [Experimental studies of the effect of Dehisan on wound healing]. PMID- 3556694 TI - [The terminology of human mycoses]. PMID- 3556695 TI - [Case report of an atypical course of chancroid]. PMID- 3556696 TI - [Light-protective properties of n-propylgallate]. PMID- 3556697 TI - Lack of effect of a spironolactone-containing cream on hair growth in hirsute women. PMID- 3556698 TI - Eosinophilic pustular folliculitis. PMID- 3556699 TI - Necrobiosis-lipoidica-like skin manifestation in lymphomatoid granulomatosis (Liebow). AB - A 58-year-old man developed 3 indurative erythematous lesions like necrobiosis lipoidica on the right lower leg. He had had similar cutaneous lesions 1.5 years previously. These had been surgically excised, and a histologic diagnosis of necrobiosis lipoidica was made at another hospital. He was diagnosed as having lymphomatoid granulomatosis by lung biopsy in our hospital. Nasal involvement was confirmed in later examinations and the skin lesions were also considered to be the cutaneous manifestation of lymphomatoid granulomatosis. This outlines that cutaneous manifestations may allow early diagnosis of lymphomatoid granulomatosis. PMID- 3556700 TI - Eosinophilic fasciitis (Shulman syndrome) in association with morphea, immunological disturbance and profuse achromia. AB - A case of localized eosinophilic fasciitis (EF) is reported. Profuse hypopigmentation, guttate morphea and immunological disturbances accompanied the subcutaneous changes. The case links Shulman's syndrome with classical localized cutaneous scleroderma. PMID- 3556701 TI - Hyperkeratosis lenticularis perstans (Flegel's disease). A light and electron microscopic study of involved and uninvolved epidermis. AB - Lesional as well as uninvolved skin were studied by light and electron microscopy in 1 case of hyperkeratosis lenticularis perstans (Flegel's disease). The main ultrastructural finding was a morphological alteration of lamellar (Odland) bodies. A review of the literature on the ultrastructure of Flegel's disease is made, and the significance of the ultrastructural findings is briefly discussed. PMID- 3556702 TI - Cell kinetics of the human anagen hair follicle. Flow cytometric studies in healthy and psoriatic subjects. AB - Anagen hair follicles obtained from both healthy (n = 7) and uninvolved psoriatic (n = 4) scalps were segmentally analyzed for proliferative activity using DNA flow cytometry. Hair follicle kinetics were almost equal in either group except for the infundibular portion which exhibited significant increase of S-phase values in psoriatic patients. Maximum proliferation was disclosed within the bulbar segment. This study confirms that cell kinetics behavior of hair follicles from uninvolved scalp of psoriatics compared with those from healthy scalps is altered in the infundibular portion only. PMID- 3556703 TI - X-ray microanalysis of the fingernails in cirrhotic patients. AB - The element content of clipped nails of 13 patients with liver cirrhosis was examined by X-ray microanalysis, and compared with that of 50 healthy subjects. The results showed a statistically significant increase in the percentage of Na, Mg and P and a slight, but statistically significant decrease in S and Cl. The percentage of K, Ca, Fe, Cu and Zn did not show any difference from that of the controls. The findings indicate that X-ray microanalysis may be a valuable tool for the simultaneous examination of a large number of elements in the fingernails. PMID- 3556704 TI - Metastatic basal cell carcinoma. AB - A case of metastasizing basal cell carcinoma is presented. Although primary surgical excision appeared complete, local recurrence continued over the following 5 years terminating in metastases to lungs, kidneys, bones and lymph nodes. PMID- 3556705 TI - Sarcoidosis with extensive cutaneous ulceration. Unusual clinical presentation. AB - A 70-year-old white woman with sarcoidosis and insulin-resistant diabetes mellitus presented with extensive cutaneous ulcerations. Both the cutaneous lesions and the systemic features of sarcoidosis showed a dramatic improvement during oral corticosteroid therapy. When extensive cutaneous ulcerations are present, it is important to consider sarcoidosis, as these may be the only presenting sign of the disease. Unlike ulcerated necrobiosis lipoidica diabeticorum, sarcoidal ulcerations may respond well to treatment with oral corticosteroids. PMID- 3556706 TI - Nevus comedonicus with epidermolytic hyperkeratosis. AB - A 7-year-old girl had a linear nevus comedonicus affecting the right upper limb. Histologic examination of two biopsies specimens showed both the common changes of nevus comedonicus and the presence of epidermolytic hyperkeratosis. Therefore, nevus comedonicus should be included in the list of dermatoses having the distinctive histologic pattern of epidermolytic hyperkeratosis. PMID- 3556707 TI - Treatment of oral 'hairy' leukoplakia in AIDS patients with vitamin A acid (topically) or acyclovir (systemically) PMID- 3556708 TI - Is eyelid involvement a sign of severe psoriasis? PMID- 3556709 TI - Papulonecrotic tuberculides on glans penis. PMID- 3556710 TI - Indentation study of the biochemical properties of articular cartilage in the canine knee. PMID- 3556711 TI - Some experimental results concerning the mechanical coupling in endoprosthetics. PMID- 3556712 TI - Curve and surface representation by iterative B-spine fit to a data point set. PMID- 3556713 TI - Body surface measurement and replication by photogrammetry and computer aided design. PMID- 3556714 TI - An automated technique for in vitro assessment of the susceptibility of urinary catheter materials to encrustation. PMID- 3556715 TI - Perspectives in non-traditional biofluid mechanics. PMID- 3556716 TI - Ambulance transport: a question of patient comfort. PMID- 3556717 TI - Quantitative approach to osteoarthritic gait assessment. PMID- 3556718 TI - Fetal monitoring, present and future. PMID- 3556719 TI - Problems of early pregnancy. PMID- 3556720 TI - Magnetic resonance imaging. PMID- 3556721 TI - Obstetric practice and perinatal outcome. PMID- 3556722 TI - European Association of Gynaecologists and Obstetricians: 1st meeting. London, 12 13 June 1986. Proceedings. PMID- 3556723 TI - Management of breech delivery. PMID- 3556724 TI - Change of serum HPL level in maternal vein, umbilical cord vein and artery in mature and premature labour. AB - The authors examined the possible role of HPL in the onset of labour. The HPL level of the maternal vein, the umbilical cord vein and artery was compared in vaginal mature (n = 16) and premature (n = 52) deliveries. The HPL concentration was also examined in mature (n = 18) and premature (n = 18) deliveries performed by caesarean section prior to the onset of labour. The results showed that: the serum HPL level in the maternal vein, the umbilical cord vein and artery was lower during the 33rd-36th and the 40th weeks in cases of vaginal delivery compared to elective caesarean section; The artery/vein ratio decreases during labour (A/V X 100 value), indicating that HPL metabolism in the fetus decreases during regular labour pains; The onset of premature labour and delivery was associated with lower HPL levels compared to normal pregnancy. The authors assume that the lower HPL level found in cases of vaginal delivery may be due to reduced placental perfusion, but they do not exclude the possible association of lower HPL concentrations in cases of premature delivery. PMID- 3556725 TI - Haemoglobin A1c levels in normal and diabetic pregnancies. AB - Serial measurements of the HbA1c levels were performed during pregnancy in 4 groups of patients attending Antenatal Clinics: 36 normal pregnancies; 16 pregnancies in established insulin-dependent diabetic patients; 9 patients with gestational diabetes diagnosed during that pregnancy; and 21 patients who had been diagnosed as having gestational diabetes in at least one previous pregnancy. In the normal pregnancy HbA1c levels showed a small but significant increase from the end of the first trimester to delivery despite blood glucose levels remaining constant throughout. In the insulin-dependent and gestational diabetic patients, blood glucose levels remained significantly higher than in the normal throughout pregnancy but only in insulin-dependent diabetic patients and the newly diagnosed untreated gestational diabetic patients were the HbA1c levels significantly higher than in the normal. In those patients who had previous pregnancies complicated by gestational diabetes, blood glucose levels were significantly higher than in the normal but HbA1c levels were not. This dissociation between blood glucose and HbA1c levels in gestational diabetic pregnancies in particular limits the value of HbA1c levels in monitoring antidiabetic treatment in such pregnancies. PMID- 3556726 TI - Steroidal binding sites in the ampulla of the human fallopian tube- autoradiographic and biochemical study. AB - Most of the morphological changes which occur during the different phases of the reproductive cycle are hormone-dependent. Thus, the aim of this work was to demonstrate the fluctuations in the availability of steroid binding sites in the ampullary segment of the tube during the menstrual cycle. Specimens were obtained during routine gynecological operations and were prepared for histological examination. In addition, determinations of specific binding of estradiol and progesterone (specific activity was about 100 Ci/mmol) were made in soluene dissolved tissue of ampullary mucosa. Autoradiographic grain counts of tissues which were incubated with [3H]estradiol and [3H]progesterone were performed on histological sections. The epithelial cell binding capacity was higher than that of the cells in the underlying lamina propria and this was found throughout the cycle. Estrogen and progesterone binding capacity was higher during the proliferative phase and decreased markedly during the secretory phase. Tissue binding of steroids appears to be inversely related to serum levels, which are lower in the proliferative phase and rise during the secretory phase. PMID- 3556727 TI - Confusing presentation in a retroflexed septate uterus at term. AB - This case report presents a full-term pregnancy in a retroflexed uterus. Although the fetus presented at first as a cephalic presentation, the longitudinal lie appeared to be breech. Further diagnostic procedures revealed a uterus subseptus. No explanation could be found for this persisting retroflexion during pregnancy. PMID- 3556728 TI - Renal failure in pregnancy, treated by hemodialysis. AB - A patient with renal failure in pregnancy is presented. Prior to pregnancy she was known to have impaired renal function due to chronic pyelonephritis. Renal insufficiency was successfully treated by hemodialysis. The literature concerning etiology and proper management of renal failure in pregnancy and the results and complications of its treatment with hemodialysis are reviewed. A multidisciplinary approach is important for the successful outcome of these pregnancies. PMID- 3556729 TI - The molecular pathology of haemophilia B. Fourth Wellcome Trust lecture. AB - Haemophilia is a rare inherited disease of blood clotting known since biblical times. The rarer form (haemophilia B) occurs in about 1 in 30,000 males and there are about 900 patients in the U.K. at present. Biochemically, patients either lack or have a defective protein (called factor IX) which is needed for the clotting of blood in response to injury. Only males get the disease. However, females can carry the trait in a latent form and transmit the disease to their offspring. Untreated, the disease leads to internal bleeding into muscles and joints and is life-threatening. In the U.K. and in countries with effective health care programmes, patients are treated by periodic injection of factor IX concentrate, a drug isolated from the pooled plasma derived from many blood donors. This drug replaces their own absent or defective factor IX and allow them to enjoy a relatively normal lifestyle. I have reviewed recent studies on the molecular genetics of haemophilia B which started with the isolation of the gene coding the factor IX protein from normal individuals in 1984. Following this, it has been possible firstly to produce factor IX artificially in the laboratory from cloned copies of the messenger RNA of the factor IX gene. Secondly, it has been possible to improve the diagnosis of 'carriers'. Carrier females often wish to know whether they are carriers or not before they have children. If they are positively identified as carriers, the risk and implications of having a haemophiliac son can be discussed and therapeutic abortion considered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556730 TI - Allosteric interactions between distinct structural domains at the nicotinic acetylcholine receptor. PMID- 3556732 TI - Characterization of developmentally and environmentally regulated genes in potato. PMID- 3556731 TI - The structure and properties of the purified muscarinic acetylcholine receptor from rat forebrain. PMID- 3556733 TI - Inositol phospholipid turnover and protein kinase C in stimulus-response coupling. PMID- 3556734 TI - Molecular biological approaches to the relationship between short-term and long term memory in Aplysia. PMID- 3556735 TI - The structure-function relationship of the nerve growth factor molecule and the regulation of its synthesis. PMID- 3556736 TI - The cellular localization of mRNA in neurobiology. PMID- 3556737 TI - Brain messenger RNA levels and ribonuclease activity in Alzheimer's disease. PMID- 3556739 TI - Structure and membrane topography of the lutropin receptor. PMID- 3556738 TI - The subunit structure of the thyrotropin receptor. PMID- 3556740 TI - Microtubules as target organelles for benzimidazole anthelmintic chemotherapy. PMID- 3556741 TI - Levamisole: mode of action. PMID- 3556742 TI - Schistosomicides and DNA functioning. PMID- 3556743 TI - Modelling the biological membrane. PMID- 3556744 TI - Nuclear magnetic resonance studies of a model membrane protein (M13 coat protein) reconstituted in detergent micelles and phospholipid vesicles. PMID- 3556745 TI - Lipid phase behaviour and lipid-protein interactions in the chloroplast photosynthetic membrane. PMID- 3556746 TI - Hormonal and development control of gene expression in wheat. PMID- 3556747 TI - Modulation of protein-protein interactions in membranes. PMID- 3556748 TI - Specific binding sites for prolactin and growth hormone in the adult rabbit lung. AB - Specific prolactin (PRL) and growth hormone (GH) binding sites were identified and characterized in lung membranes from male and female adult rabbits. The binding of iodinated human GH ([125I]iodo-hGH) and iodinated ovine PRL ([125I]iodo-oPRL) was time, temperature and protein dependent and was found to conform to the requirements defining a physiological receptor, in terms of hormonal and immunological specificities as well as kinetic properties. [125I]Iodo-hGH was displaced from lung membranes by hGH, oPRL, ovine GH and rat GH, while [125I]iodo-oPRL was effectively displaced only by oPRL and hGH. Scatchard plots of the competition curves of [125I]iodo-hGH and [125I]iodo-oPRL were both linear, suggesting, in each case, a single class of binding sites with affinity constants (Ka) of 1.74 +/- 0.64 X 10(9) M-1 and 0.78 +/- 0.28 X 10(9) M 1 and binding capacities of 6.43 +/- 0.53 and 4.16 +/- 0.69 fmol/mg protein, respectively. Anti-PRL-receptor antiserum significantly inhibited the binding of the [125I]iodo-oPRL to rabbit lung membranes, while it was less potent in preventing the binding of [125I]iodo-hGH, which has both lactogenic and somatogenic activity. Removal of endogenous ligand by treating lung membranes with 4 M MgCl2 increased specific binding of hGH about 2.5-fold, exposing additional specific binding sites without significantly changing the binding affinity. The level of binding of hGH and oPRL to rabbit lung did not show a pronounced sex differentiation. In summary, PRL and GH binding sites have been demonstrated for the first time in adult rabbit lung membranes, and they support the possibility of a physiological role for PRL and GH in the lung. PMID- 3556749 TI - Visualization of the rat ovarian lutropin receptor by ligand blotting. AB - A ligand blotting technique was developed to identify the lutropin receptor after size separation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions. The separated proteins were transferred to a nitrocellulose sheet, which was subsequently incubated with 125I-labeled human choriogonadotropin (125I-hCG), and subjected to autoradiography. An Mr 90,000 band was specifically and intensely labeled with 125I-hCG. The band was not observed, when the hormone incubation was performed in the presence of an excess of unlabeled hCG or human lutropin. The presence of rat follitropin or rat prolactin did not, however, abolish the labeling. No specific labeling was found when down-regulated ovarian tissue or rat liver was used as starting material. The Mr 90,000 band disappeared when the protein samples were treated with reducing agent, showing that integrity of receptor disulfide bonds is essential for the hormone-receptor interaction. In addition, a receptor-positive murine Leydig tumor cell line produced an Mr 90,000-92,000 band in ligand blotting, thus demonstrating the similarity between rat and murine lutropin receptors. These results provide strong evidence that the lutropin receptor is an Mr 90,000 protein. PMID- 3556751 TI - Molybdate inhibits glucocorticoid-receptor complex binding to RNA. AB - The binding of dexamethasone-receptor complexes to RNA was investigated by an assay system under cell-free conditions. By this gradient centrifugation assay, we found that, under low salt concentrations, dexamethasone-receptor complexes can bind to 18S RNA from HeLa cells. Molybdate, tungstate and methavanadate were able to inhibit dexamethasone-receptor complex binding to 18S RNA, whereas this was not the case when chloride, fluoride, or sulfate ions were present in our binding assays. Molybdate was also found to disrupt dexamethasone-receptor-18S RNA complexes once they were already formed. We concluded that interaction between dexamethasone-receptor complexes and RNA under cell-free conditions is affected by ions present in the medium. PMID- 3556750 TI - Estrogen induction of a 45 kDa secreted protein coordinately with vitellogenin in Xenopus liver. AB - In the frog Xenopus laevis, vitellogenin is the major estrogen-induced protein in the liver. We have characterized an additional secreted protein, of 45,000 Da and designated Ep45, which is also responsive to estrogen treatment. Like vitellogenin, Ep45 is not normally found in the plasma nor synthesized by the liver of the male frog. Its synthesis increases 6-fold between days 2 and 8 following a single 2 mg injection of estradiol-17 beta. For comparison, we have also studied a third estrogen-regulated protein, Ep20, with a molecular weight of approximately 20,000. This protein exhibits a different set of characteristics with regard to hormone responsiveness. Ep20 is synthesized in the liver of normal males and therefore is not absolutely hormone-dependent. Its level increases only about 4-fold following estrogen stimulation. The messenger RNAs for both Ep45 and Ep20 have been identified and purified, using a high-resolution RNA fractionation technique. By this procedure, it was possible to demonstrate that following high doses of estrogen the predominant mRNAs in the liver are those coding for vitellogenin, Ep45 and Ep20. Thus estrogen suppression of virtually all other liver proteins appears to act at the messenger RNA level for intracellular as well as secreted proteins. PMID- 3556752 TI - The structure of tissue on cell culture-extracted thyroglobulin is independent of its iodine content. AB - The major protein synthesized in vitro by the ovine thyroid cell line OVNIS 6H is the prothyroid hormone thyroglobulin. Purified from serum-free cell culture media using sucrose gradient centrifugation, the thyroglobulin dimer was analysed for iodine content and observed by electron microscopy. In their usual medium, the OVNIS 6H cells produce a very poorly iodinated thyroglobulin containing 0.05 I atom per molecule. When cultured with methimazole or propylthiouracil, two inhibitors of iodide organification, less than 0.007 I atom/molecules was found. These molecules purified from cell cultures were compared to those purified from ovine thyroid tissue containing 26 I atoms/mol. Despite large differences in iodine content, the three preparations all consist of 19 S thyroglobulin dimers with the classical ovoidal shape. The variability in size measurements remains in a 2% range for all thyroglobulin types. Consequently, no real significant variation can be found between the highly iodinated thyroglobulin isolated from tissue, and the poorly or non-iodinated thyroglobulins isolated from cells cultured with or without methimazole or propylthiouracil. PMID- 3556753 TI - Photolabeling of the adipocyte hexose carrier with an aryl azide derivative of maltose. AB - A nitrophenyl azide derivative of maltose, N-(4-azido-2-nitrophenyl) maltosylamine (NAP-maltosylamine), was synthesized as a potential photoaffinity label for the hexose carrier of the rat adipocyte. This derivative inhibited 3-O methylglucose uptake with a Ki of 1.3 mM in the dark, while that of maltose was 10.0 mM. Carbon-14-labeled maltose and NAP-maltosylamine entered adipocytes via the hexose carrier, the latter in a concentrative fashion. Photolysis of NAP [14C]maltosylamine in the presence of an adipocyte low density microsomal membrane fraction labeled several electrophoretic bands. Among these are a 45 kDa band which showed features expected of the hexose carrier: its labeling was decreased 40% by D- but not L-glucose and pretreatment of intact adipocytes with insulin decreased labeling of the 45 kDa band by 10-40%, as predicted by the translocation theory of insulin-stimulated transport activation. These studies show the suitability of using carbon-1-modified sugar photoaffinity labels as probes for the hexose carrier and possibly of its regulation in rat adipocytes. PMID- 3556754 TI - Isolation and partial characterization of basic fibroblast growth factor from bovine testis. AB - A basic fibroblast growth factor (FGF) has been purified to homogeneity from bovine testis, using ammonium sulfate precipitation of the crude extract followed by three chromatographic steps, involving cation-exchange, heparin-Sepharose, and reversed-phase HPLC. Gas-phase sequence analysis showed the amino-terminal amino acid sequence of the isolated polypeptide as His-Phe-Lys-Asp-Pro-Lys-Arg-Leu-Tyr , which is identical to the amino-terminal of the (16-146) fragment of basic FGF previously characterized from corpus luteum, adrenal, and kidney. The purified FGF was shown to have the same biological activity as that of basic FGF (1-146). This finding suggests that basic FGF is present in testis and may act as a local regulator of testicular function. In addition, testicular FGF might play an important role in spermatogenesis and/or the development of testis. PMID- 3556755 TI - Inhibition of Manduca sexta corpora allata in vitro by a cerebral allatostatic neuropeptide. AB - When an in vitro assay system and radioimmunoassays specific for juvenile hormones (JH) I and III were used to probe the effect of day 4 last instar larval brains on JH synthesis by day 0 last instar larval corpora allata (CA) of the tobacco hornworm, Manduca sexta, a selective inhibition of JH I synthesis by the CA was observed. The nature of this inhibition suggested the presence of an allatostatin specific for the synthesis of JH I. Its occurrence in the day 4 brain was demonstrated by the ability of a crude brain extract to inhibit the CA in a dose-dependent manner. The allatostatic factor (ASF) appears to be a protein, based on its heat lability and pronase sensitivity, and it has apparent molecular weights of 6.8 and 13 kDa. Inhibition of JH I synthesis occurs within 1 min of exposure of the CA to the factor and is reversible by 6 h after this exposure. Thus it appears that a cerebral neuropeptide specifically inhibiting JH I synthesis by the CA is present in Manduca on day 4 of the last larval instar, a time when the hemolymph titer of JH must drop to ensure the occurrence of pupal commitment. PMID- 3556756 TI - Down-regulation of thyroid hormone nuclear receptor levels by L-triiodothyronine in cultured glial C6 cells. AB - L-Triiodothyronine (T3) produced a time- and dose-dependent depletion of nuclear thyroid hormone receptor levels in C6 cells, a rat glioma cell line. Receptor number diminished by 30-40% after a 48 h incubation with concentrations of T3 that saturate the nuclear receptor. The nuclear binding curve obtained in cells incubated for 48 h with T3 was shifted leftward of the curve obtained after a 3 h incubation, which indicates an apparent increase in receptor affinity after long term incubation with T3. However, this change probably represents a further equilibration of the hormone, since the dissociation rate from the nuclei was similar in C6 cells after long- and short-term incubation with T3. The effect of T3 was further demonstrated in C6 cells incubated with short-chain fatty acids. Butyrate and isobutyrate increased receptor levels, and T3 partially decreased the response to these compounds. These findings suggest the existence of a desensitization process by which C6 glial cells would be protected against an excess of thyroid hormone. PMID- 3556757 TI - The intrinsic synthesis of juvenile hormone-III diol by locust corpora allata in vitro. AB - Juvenile hormone (JH)-III 10-11-diol is intrinsically synthesized and released from the corpora allata (CA) of adult locust females in vitro, together with JH III. JH-III synthesis is preferentially stimulated and diol production only slightly enhanced, by cerebral locust allatotropin. The identification of JH-III diol is based on: similar ratio of incorporation of 14C/3H from radiolabelled [2 14C]acetate and [methyl-3H]methionine, to that of JH-III; similar chromatographic properties to those of synthetic diol on an RP-18 column eluted with acetonitrile, and similar chromatographic properties of acetylated derivatives; mass spectrometric analysis of derivatives and fragmentation products. Exogenous radiolabelled JH-III is not degraded during incubation with locust CA in vitro, corroborating the endogenous production of JH-III diol. Allatal diol formation may be an additional mechanism for the control of JH-III levels in locusts, preceding release into the hemolymph. PMID- 3556758 TI - Extracellular matrix from embryonic myocardium elicits an early morphogenetic event in cardiac endothelial differentiation. AB - A critical step in early cardiac morphogenesis can be faithfully duplicated in culture using a hydrated collagen substratum, and thereby serves as a useful model system for studying the molecular mechanisms of cell differentiation. Results from previous work suggested that the myocardium in the atrioventricular canal (AV) region of the developing chick heart secretes extracellular proteins into its associated basement membrane, which may function to promote an epithelial-mesenchymal transition of endothelium to form prevalvular fibroblasts (E. L. Krug, R. B. Runyan, and R. R. Markwald, 1985, Dev. Biol. 112, 414-426; C. H. Mjaatvedt, R. C. Lepera, and R. R. Markwald, 1987, Dev. Biol., in press). In the present study we show that an EDTA-soluble extract of embryonic chick hearts can substitute for the presence of myocardium, the presumptive stimulator tissue, in initiating mesenchyme formation from AV endothelium in culture. Ventricular endothelium was unresponsive to this material in keeping with observed in situ behavior. AV endothelial cells did not survive beyond 4-5 days when cultured in the absence of either the EDTA-soluble heart extract, myocardial conditioned medium, or the myocardium itself. Antibody prepared against a particulate fraction of the EDTA-solubilized heart extract immunohistochemically localized this material to the myocardial basement membrane. In addition, conditioned medium from embryonic myocardial cultures effectively induced mesenchyme formation. Neither a variety of growth factors nor a sarcoma basement membrane preparation were effective in promoting mesenchyme formation indicating a selectivity of the responding embryonic AV endothelial cells to myocardial basement membrane. These observations reflect a truly inductive phenomenon as there was an absolute dependence on the presence of the stimulating substance/tissue and retention, in culture, of both the temporal and regional characteristics observed in situ. This is in contrast to the results of others investigating the cytodifferentiation of committed cells whose phenotypic expression can be either accelerated or diminished but not obligatorily regulated by a specific agent, thus making the interpretation of data difficult, if not irrelevant, to the study of differentiation. The results of this study provide direct experimental support for the hypothesis that extracellular matrix can indeed serve as a direct stimulator or "secondary inducer" of cytodifferentiation. PMID- 3556759 TI - The detection of a precartilage, blastema-specific marker. AB - Mesenchymal cell aggregates, termed blastema in vivo, precede cartilage differentiation in vivo and in high-density cell cultures. The galactose specific lectin, peanut agglutinin (PNA), has been shown to be blastema specific (B. Zimmermann and M. Thies, 1984, Histochemistry 81, 353-361). PNA appears to be a marker for precartilage cellular aggregates both in vivo and in vitro. Frozen sections of stage 24 chick wing buds were double stained with PNA-rhodamine and by indirect immunofluorescence with antibody directed against type II collagen. The PNA stained the humeral blastema intensely and extended distal to the level of type II collagen. High-density cultures of stage 24 chick wing buds were also evaluated for the distribution of PNA binding. Sixteen-hour cultures showed the earliest consistent appearance of PNA binding. The PNA-stained areas coincided with hematoxylin-stained cell aggregates. PNA staining was inhibited by 50 mM D(+)-galactose and was not sensitive to 1% testicular hyaluronidase pretreatment. No Alcian blue-staining nodules were present yet at 16 hr. The presence of a precartilage, blastema-specific marker in situ, as well as in precartilage aggregates in cultures, suggests the similarities in chondrogenesis between these two conditions. Stage 19 limb bud cultures did not form nodules but did form aggregates that were PNA positive. Furthermore, single cells that differentiated into chondrocytes on collagen gels or after cytochalasin D treatment lacked PNA binding material. These results suggest that this material is specific to precartilage aggregates. The PNA-positive material was extracellular in distribution and was removed after brief extraction with 0.5 M guanidine hydrochloride. PMID- 3556760 TI - Fertilization of rabbit ova and the role of ovum investments in the block to polyspermy. AB - The rabbit ovum seldom becomes polyspermic despite the presence of supernumerary sperm with easy access to the ovum plasma membrane. The purpose of this study was to characterize the role of ovum investments in blocking polyspermy. Ova were inseminated with capacitated sperm in vitro and were fertilized. Early stages of development were normal. The incidence of polyspermy was determined by cytological examination of fixed ova. The incidence of polyspermy increased following removal of both the zona pellucida and corona radiata but not following removal of only the corona radiata. These results suggest that the failure of supernumerary sperm to penetrate the ovum plasma membrane is at least in part due to the presence of the zona pellucida. PMID- 3556761 TI - The ability of the chick wing bud to regulate positional disparity along the anterior-posterior axis. AB - When wedges of wing bud tissue are added to a host wing bud so there is positional disparity between graft and host, skeletal duplications result (L. E. Iten and D. J. Murphy 1980) Dev Biol. 75, 373-385. The polarity of the duplications is predictable by the polar coordinate model, leading to the interpretation that the positional disparity caused the duplications. To determine whether positional disparity alone causes duplications, without the complication of added tissue, we rotated wedges of ectoderm and mesoderm around the proximodistal axis within the wing bud. Wedges measuring 200-800 micron along the distal edge were rotated 180 degrees at stages 20-22, reversing the anteroposterior and dorsoventral axes relative to the bud. This caused positional disparity, similar to that achieved by Iten and Murphy (1980), without the addition of tissue. We found that rotations involving no polarizing zone tissue produced normal wings or wings lacking some distal parts, as did rotations of tissue lying entirely within the polarizing zone. However, when polarizing zone mesoderm was displaced, so that polarizing and nonpolarizing tissues were juxtaposed, a majority of the operations produced polarized skeletal duplications. Our data demonstrate that positional disparity alone does not cause skeletal duplications in the chick wing bud, unless polarizing zone tissue is displaced. Further, these data demonstrate that the chick wing bud can regulate to form a normal wing skeleton in the face of large positional disparity, provided that the polarizing zone is not moved. Finally, our results may be explained by the action of the proposed polarizing morphogen on the displaced cells causing repolarization. PMID- 3556762 TI - Decrease in triiodothyronine binding sites in chick embryo erythrocytes during early development. AB - Specific thyroid hormone (TH) binding sites have been detected in nuclei of erythrocytes obtained from developing chick embryos. The binding characteristics and relative affinities for TH analogs were those expected of TH receptors. Nuclear triiodothyronine (T3) saturation analysis was carried out in vitro by incubating intact erythrocytes in M199 medium with 3-200 pM [125I]T3 for 1 hr at 37 degrees C or 20-24 hr at 21 degrees C. Nuclei were obtained by centrifugation after lysing the erythrocytes in a stabilizing buffer containing 0.3% saponin, followed by addition of Triton X-100 (final concentration 0.2%) to minimize the nonspecific binding. Scatchard analysis of equilibrium binding data suggested that the nuclei possess a single class of binding sites. The binding is reversible and the rate of dissociation is temperature dependent. T3 and T4 appear to bind to the same sites, but the affinity of T3 was 16 times greater. Among TH analogs tested, Triac had the highest affinity followed by L-T3, D-T3, Tetrac, L-T4, D-T4, T2, and rT3. Serial studies performed on different days of chick embryogenesis demonstrated a rapid and significant decrease of the erythrocyte nuclear T3 receptor. On Day 5, the number of T3 binding sites was maximal at 1600 +/- 100 per nucleus. The number declined steadily until, by Day 20, it had reached about 60 +/- 10 sites/nucleus. RBC from adult and baby chickens had less than 1% as many binding sites as those from Day 5 embryos. There was no significant change in the affinity of the sites (Kd approximately equal to 20 pM at 37 degrees C). The reason for the loss of T3 binding sites during embryogenesis is not known. Since the plasma level of the TH increases during embryogenesis, this may reflect down regulation. Another possibility is that the change in erythrocyte population which occurs during this period involves production of erythrocytes which contain fewer T3 binding sites. PMID- 3556763 TI - Loss of functional sperm entry into Xenopus eggs after activation correlates with a reduction in surface adhesivity. AB - In Xenopus, the plasma membrane of the unactivated egg is receptive to sperm only in the animal hemisphere (R. Grey, M. Bastiani, D. Webb, and E. Schertel, 1982, Dev. Biol. 89, 475-487). The reinsemination experiments of investment-free eggs reported in this paper demonstrate that functional sperm entry is lost after activation. Supernumerary sperm were excluded even though the fertilization envelope was absent and the membrane potential had returned to the level found in the unfertilized egg. Even when the electrical block to polyspermy was suppressed by 40 mM NaI (which reduces the membrane potential), polyspermy could be induced only if denuded eggs were initially inseminated in this medium. We estimate that the loss of functional sperm entry, independent of the electrical block, occurs during the first 10 min following fertilization. Sperm readily adhere to the surface of the animal hemisphere of unactivated eggs divested of their extracellular coats, but they do not adhere to the surface of activated eggs. Denuded eggs also adhere to each other, with the surface of the animal hemisphere of unactivated eggs exhibiting the greatest degree of adhesivity. We used electric field-induced fusion (EFIF), without prior dielectrophoresis, to quantify the regional and temporal adhesiveness of eggs. At electric field strengths greater than 8 V/cm, the probability of fusion during EFIF is highest with the animal hemisphere of unactivated eggs, moderate with both the vegetal hemisphere of unactivated eggs and the animal hemisphere of activated eggs, and lowest with the vegetal hemisphere of activated eggs. When pairs of eggs are constructed with different hemispheres in contact, the fusion characteristics of the pair are similar to the more adhesive member of the pair. The regional and temporal differences in the adhesiveness of the Xenopus egg surface correlate with its receptivity to sperm and could possibly account for the plasma membrane's activation-induced loss of functional sperm entry. PMID- 3556764 TI - Growth and differentiation during myogenesis in the chick embryo. AB - A general method for describing the complex dynamics of cell populations over an extended period of growth and differentiation in a developing tissue is presented. The measurements required to produce a unique description are defined. Skeletal muscle development in the thigh and breast of the chick embryo is analyzed, using this method, during the period of embryonic development between Day 7 and Day 17. A unique quantitation of growth and differentiation for the period from Day 11 to Day 17 is developed. The pectoralis major is compared with the averaged behavior of the thigh musculature. In each case, a single partitioning rule holds for more than 10 generations during the main myogenic period. In the pectoralis, approximately 51% of the cells entering G1 in each generation continue in the cell cycle; in the thigh, which experiences substantially greater overall growth, approximately 58% of the cells entering G1 in each generation continue in the cell cycle. No significant cell death is detected. Thus, in each case, the absolute number of myoblasts is increasing while the fractional value of myoblasts in the population is decreasing over a fivefold range. These results are discussed in terms of several quantitative models for the possible basis of the observed population dynamics. PMID- 3556765 TI - Determination of cleavage pattern in embryonic blast cells of the leech. AB - The o blast cells of the leech embryo become committed to one of two alternative cleavage geometries shortly before they divide. Cleavage geometry depends upon the presence or absence of the adjoining p bandlet, and if that bandlet is ablated, the pattern of o blast cell cleavages will undergo an abrupt transition several hours later. Previous work has shown that the oblast cell becomes committed to the formation of a particular complement of postmitotic descendants early in its differentiation, but the present findings suggest that cleavage pattern and descendant fate are determined at separate commitment events. PMID- 3556766 TI - A lineage-specific gene encoding a major matrix protein of the sea urchin embryo spicule. I. Authentication of the cloned gene and its developmental expression. AB - The developing sea urchin embryo forms endoskeletal CaCO3 containing spicules which are elaborated by the primary mesenchyme cells, descendants of the micromeres, beginning at gastrulation. In this and the accompanying paper [H. M. Sucov, S. Benson, J. J. Robinson, R. J. Britten, F. Wilt, and E. H. Davidson (1987) Dev. Biol. 120, 507-519] the isolation and characterization of a gene that encodes a 50-kDa spicule matrix glycoprotein that we call SM50 are described. A cloned cDNA isolated from a lambda gt11 library was used in hybrid-selected translation and hybrid arrest of translation experiments to verify that the cDNA encodes a spicule matrix protein. The cognate RNA transcript encodes a 50-kDa protein which is precipitated by polyclonal antisera against spicule matrix proteins and is present only in polyadenylated RNA at stages known to be making a spicule. The cloned cDNA sequence described in the accompanying paper was used to follow the time of expression of the cognate gene by RNA blotting analysis. The 2.2-kb mRNA is first detected at late cleavage stages and rapidly accumulates as the primary mesenchyme forms, reaching an apparent maximum concentration in the late gastrula and pluteus stages. The cDNA was also used to identify the cells that contain the transcripts by hybridization in situ. Hybridization to cellular transcripts is first detected in primary mesenchyme cells as they enter the blastocoel, and transcripts are confined to these cells during spicule formation and subsequent development. PMID- 3556767 TI - Temporal and spatial analysis of hyaluronidase activity during development of the embryonic chick limb bud. AB - The glycosaminoglycan hyaluronate (HA) appears to play an important role in limb cartilage differentiation. The large amount of extracellular HA accumulated by prechondrogenic mesenchymal cells may prevent the cell-cell and/or cell-matrix interactions necessary to trigger chondrogenesis, and the removal of extracellular HA may be essential to initiate the crucial cellular condensation process that triggers cartilage differentiation. It has generally been assumed that HA turnover during chondrogenesis is controlled by the activity of the enzyme hyaluronidase (HAase). In the present study we have performed a temporal and spatial analysis of HAase activity during the progression of limb development and cartilage differentiation in vivo. We have separated embryonic chick wing buds at several stages of development into well-defined regions along the proximodistal axis in which cells are in different phases of differentiation, and we have examined HAase activity in each region. We have found that HAase activity is clearly detectable in undifferentiated wing buds at stage 18/19, which is shortly following the formation of a morphologically distinct limb bud rudiment, and remains relatively constant throughout subsequent stages of development through stage 27/28, at which time well-differentiated cartilage rudiments are present. Moreover, HAase activity in the prechondrogenic distal subridge regions of the limb at stages 22/23 and 25 is just as high as, or even slightly higher than, it is in proximal central core regions where condensation and cartilage differentiation are progressing. We have also found that limb bud HAase is active between pH 2.2 and 4.5 and is inactive above pH 5.0. This suggests that limb HAase is a lysosomal enzyme and that extracellular HA would have to be internalized to be degraded. These results indicate that the onset of chondrogenesis is not associated with the appearance or increase in activity of HAase. We suggest that possibility that HA turnover may be regulated by the binding and endocytosis of extracellular HA in preparation for its intracellular degradation by lysosomal HAase. Finally, we have found that the apical ectodermal ridge (AER)-containing distal limb bud ectoderm possesses a relatively high HAase activity. We suggest the possibility that a high HAase activity in the AER may ensure a rapid turnover and remodeling of the disorganized HA-rich basal lamina of the AER that might be essential for limb outgrowth. PMID- 3556768 TI - Partial differentiation of rat egg cylinders in serum-free and protein-free medium. AB - Modified organ cultures of rat egg cylinders were grown for 2 weeks in Eagle's MEM without serum or with serum added at different times. Explant survival was decreased only in cultures grown for the entire 2 weeks in serum-free medium, whereas the explant growth was impeded in all but the cultures grown for 2 weeks in 50% MEM plus 50% serum. Differentiation of epidermis and cartilage in the cultures deprived of serum for the entire 2-week period was comparable to that in fully serum-supplemented medium, whereas other differentiated tissues were rare or absent. In explants cultivated without serum for only the first week, neuroblasts were scarce. PMID- 3556769 TI - Use and standardization of combined vaccines. Proceedings of a symposium. Amsterdam, The Netherlands, 10-13 December, 1985. PMID- 3556770 TI - Effect of simultaneous administration of live measles vaccine on the "take rate" of live mumps vaccine. AB - During the course of clinical studies to develop a new bivalent measles-mumps vaccine, it was established that simultaneous administration of live measles and mumps vaccines at doses contained in the monovalent vaccines resulted in a reduced seroconversion rate against mumps but not against measles. This one-way interference was resolved by increasing the dose of the mumps component in the bivalent measles-mumps and the trivalent measles-mumps-rubella vaccines above that in the monovalent mumps vaccine. On the other hand, it was not necessary to adjust the doses of the measles and rubella components in the combined vaccines. This observation requires that not only the titres of vaccine viruses must be carefully adjusted in combined live mumps vaccines but also that the heat stability of each component in such vaccines be carefully determined to ensure that interference is not a problem during the complete shelf-life of the product. The relative doses at release of combined mumps vaccines using the Urabe Am 9 strain and the heat-stability characteristics of these products will be presented and discussed. PMID- 3556771 TI - Combined live and inactivated poliovirus vaccine to control poliomyelitis in a developing country--five years after. AB - The Gaza Strip is an area in transition which in the 1960's had a high prevalence of malnutrition and infectious diseases. The infant mortality was approximatively 140 per 1000 live births. Pediatric Services were almost non-existant. Trivalent oral poliovaccine (TOPV) has been used since 1967. Coverage however did not exceed 70%. From 1973 a network of comprehensive Child Health Centers was spread throughout the area, a set of laws was passed which made vaccination obligatory and the community became heavily involved in health education. These measures resulted in a vaccination coverage, from fixed centers, of over 90% of the susceptible infant population. Though infant mortality decreased rapidly, poliomyelitis was less affected and the mean annual incidence of the paralytic disease until 1977 continued to be 10 per 100,000 inhabitants. Two outbreaks caused by poliovirus Type 1 were registered in 1974 and 1976 with an incidence of 18 per 100,000 inhabitants. In these outbreaks 34% and 50% of the affected children, respectively, had received 3-4 doses of (TOPV). A new vaccination schedule was implemented in 1978 combining TOPV and inactivated polio vaccine in the form of an injectable quadruple vaccine. In the first three years following this change the annual incidence of the paralytic disease dropped from 10 to 2.2 per 100,000 inhabitants. In the following 5 years (1981-1985) only 4 cases of paralytic poliomyelitis were discovered, an annual incidence of 0.16 per 100,000 inhabitants. A serosurvey was done in 1980 on 117 immunized children age 6 months to three years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556772 TI - Combined tetanus-rabies vaccination. AB - Studies in mice have shown that Calcium Phosphate adsorbed tetanus toxoid (IPADT) can be used as a vehicle for freezedried rabies vaccine. Trials were undertaken in human volunteers and patients receiving a post-exposure treatment using the same vaccines to evaluate tolerance and antibody response to both vaccines. PMID- 3556773 TI - Reduction in animal usage for potency testing of diphtheria and tetanus toxoids. PMID- 3556774 TI - Rubini, a new live attenuated mumps vaccine virus strain for human diploid cells. AB - A new, live attenuated mumps vaccine virus strain for human diploid cells has been developed at the Swiss Serum and Vaccine Institute, Berne. The Rubini virus was derived from a child of the same name possessing typical clinical signs and symptoms of mumps infection. Attenuation of the wild virus was performed by isolation and serial passage in WI-38 human diploid cells, specific pathogen-free hens' eggs and MRC-5 human diploid cells. The attenuated virus has been examined in respect of identity, freedom from adventitious agents and growth potential in MRC-5 cells. Furthermore, it does not evoke any clinical reactions in either baby or adult monkeys. It is characterized by the production in Vero cells of smaller plaques than are elicited by either the Jeryl Lynn or Urabe mumps virus strains. The reactogenicity and immunogenicity of the Rubini virus for man was studied by administering a monovalent vaccine to 13 adult male volunteers and a trivalent human diploid cell Rubini, measles (Edmonston-Zagreb-19 virus strain) and rubella (RA 27/3 virus strain) vaccine to 60 children ranging in age from 15 to 24 months. No reactions were observed. Seroconversion was obtained in 95% of the vaccinees, who developed a mean 50% neutralizing antibody titre of 1:64 after 6-8 weeks. Sensitization to avian and other animal proteins and antibiotics which may follow the use of most of the currently available measles-mumps-rubella vaccines, either single or combined, may be expected to be eliminated when this new vaccine is used. Its use in persons already sensitized to such products should furthermore induce no anaphylactic reactions. PMID- 3556775 TI - Elimination of diseases from Europe through use of vaccines. AB - A target has been set to eliminate measles, poliomyelitis, congenital rubella (as well as diphtheria and neonatal tetanus) from the 32 countries of the European Region of WHO by the year 2000. Achievement of this target will require achievement and maintenance of high levels of immunization coverage as well as strengthened surveillance and outbreak control. Use of combined vaccines and simultaneous administration of vaccines is a key component of achieving the goal. PMID- 3556776 TI - Vaccination with a combined vaccine against measles, mumps and rubella aiming at elimination of the three diseases. AB - General vaccination with a combined measles, mumps and rubella vaccine was introduced in Sweden in 1982. The vaccination is performed at the age of 18 months and 12 years. The coverage in the former age was about 90% and in the latter between 80 and 90%. Seroconversion against measles was 96% in 18 months old and 82% in the 12 year old. The corresponding figures concerning mumps were 93 and 80% and concerning rubella 99 and 100%. Before this vaccination was introduced preschool children were partly vaccinated against measles and teen-age girls against rubella. The measles morbidity is low since the beginning of the 1980's, the morbidity of mumps is unchanged while rubella was epidemic in 1985. Mainly unvaccinated age groups were affected. PMID- 3556777 TI - Measles, mumps and rubella: control by vaccination. AB - In 1984, the Health Council of the Netherlands advised that a new vaccination strategy against measles, mumps and rubella (MMR) should be initiated. The use of a combined MMR vaccine, to be given at 14 months and 9 years of age was recommended. An analysis of this strategy based on mathematical models, predicted that rubella and mumps and very probably measles will be eliminated in The Netherlands before 1990. The use of a combined MMR vaccine has a number of logistical and financial advantages over immunization with separate vaccines. Another factor to be considered is of course the mutual interference regarding immune response or immunization reactions. Less obviously, and often not recognised as an important factor, is the possibility of an adverse effect on the incidence of the congenital rubella syndrome (CRS), when vaccine coverage is low or the natural force of infection of rubella is high. Vaccine induced herd immunity can act to the disadvantage of the unvaccinated individuals. Following earlier work we show that certain vaccination programmes could actually increase the incidence of serious cases. At first sight, this may seem inconceivable. Mathematical analysis, however, reveals that this is indeed a real possibility. Implementing a vaccination programme that is not sufficiently intensive to eradicate the infection in the population will ultimately lead to a new steady state in which the force of infection is lower than in the period before the start of the programme. As a consequence those who are not (effectively) vaccinated have a higher chance of contracting the infection at an older age. For many viral infections, the chance of serious complications is greater if the infection is acquired at an older age. Congenital rubella and measles encephalitis are striking examples (with respect to mumps the situation is less clear). When boys and girls are vaccinated around one year of age and MMR vaccine coverage is lower than approximately 50%, the total number of cases with the congenital rubella syndrome can increase in the long term. When the force of infection of rubella before implementing the vaccination programme is high - which may be the case in developing countries - the effect is more pronounced and even a relatively high vaccine uptake of 80-90% may not be sufficient to keep CRS incidence below the level prior to control.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3556778 TI - Comparative study and evaluation of further attenuated, live measles vaccines alone and in combination with mumps and rubella vaccines. AB - The further attenuated Enders (FAE) measles vaccine strain and the Edmonston B Zagreb (EZ) measles vaccine strain were compared. In VERO-cells plaque sizes of FAE varied between 0.5 and 1 mm, those of EZ between 1 and 2 mm in diameter. The lots available in Switzerland during a 2 year period showed virus titers of 10(3.1) to 10(4.0) TCID50 per dose in the one vaccine (FAE) and of 10(3.1) to 10(4.5) TCID50 per dose in the other (EZ). Clinical investigations were performed with FAE and EZ monovalent and trivalent (measles + mumps + rubella) vaccine preparations. The virus titers of the vaccine lots used were 10(3.1) to 10(4.0) TCID50 per dose. The overall seroconversion rates of 96% to 100% indicate that both types of vaccine have comparable immunization properties. Stability tests demonstrated good stability of both the FAE and the EZ vaccines. Thus conservation at 37 degrees C was possible for 2 and 4 weeks, respectively, and at 41 degrees C for 6 and 6 days, respectively, without undue loss of live virus content (less than 1 log 10). Since the EZ vaccine is derived from human diploid cells, it is particularly suitable for the vaccination of persons with a history of allergy to avian proteins. PMID- 3556779 TI - Immunity against measles and rubella in Massachusetts schoolchildren. AB - A statewide serosurvey was conducted among 6th, 10th and 12th grade Massachusetts schoolchildren in 1982. Sera were screened using a standard measles hemagglutination inhibition (HI) assay, a sensitive measles plaque neutralization assay, and four rubella assays with corresponding sensitivity limits of approximately 15, 10, 7.5, and 5 international units (IU) of rubella antibody/ml respectively. Using the most sensitive assays, seroprevalence was 98.6% for measles antibodies and 93.1% for any rubella antibodies. For persons who received single doses of either combined measles and rubella vaccines or separate single vaccinations at different times, there were no significant differences in seroprevalence using sensitive assays. Of persons who received combined vaccines, 99.3% had antibody against measles compared to 98.4% of single antigen recipients. For rubella, 98.6% of combined vaccine recipients had antibody compared to 95.7% of single antigen recipients. These seroprevalence data indicate the effectiveness of a combined vaccination program and support epidemiologic data indicating virtual elimination of these diseases in Massachusetts schoolchildren. PMID- 3556780 TI - Immune response to Edmonston-Zagreb measles virus strain in monovalent and combined MMR vaccine. AB - The live Edmonston-Zagreb measles vaccine is currently produced either on chick embryo fibroblasts (CEF) or on human diploid cells (HDC). Its stability meets the WHO requirements. Since the vaccine licensure in 1967 the Edmonston-Zagreb measles virus strain has been administered to over 20 million vaccinees either as a monovalent vaccine or as a component of the combined MR, MMR and MM vaccines. Immunogenicity studies have shown the persistence of the elicited HI antibody for a minimum of 16 years. In children aged 13-17 months a greater than 95% seroconversion was recorded after subcutaneous administration both CEF and HDC vaccines. The vaccine has also been shown to be highly immunogenic when administered intranasally. In 6-12 month old infants the Edmonston-Zagreb monovalent vaccine elicited a 100% HI antibody response after both s.c. and i.n. administration. The GMT of antibody 42 days after vaccination was significantly higher in those given HDC vaccine, regardless of the age of the vaccinees or the route of immunization. PMID- 3556781 TI - The golden-mantled ground squirrel (Spermophilus lateralis) as a model for the effects of environmental enrichment in solitary animals. AB - It has been proposed that the brain effects induced by laboratory environmental enrichment may be a product of the social stimulation inherent in the standard enriched environment. This experiment was conducted in order to study the suitability of the golden-mantled ground squirrel Spermophilus lateralis (a solitary-living species) for studies attempting to dissociate social factors from other effects in brain and behavioral effects of environmental enrichment. Juvenile Spermophilus lateralis, born in the laboratory of mothers wild-caught while pregnant, were assigned singly to individual enriched conditions (I-EC) or impoverished (IC) conditions at 55-62 days (an age at which wild individuals would disperse from the natal burrow and live alone). After 30 days, the subjects were videotaped in two 10-min opportunities for exploration; following this, they were sacrificed and their brains dissected. Multiple indications of isolation stress were observed, including unusual difficulty in handling, stereotyped pacing behavior, and escape behaviors in the exploration arena. Comparisons between I-EC and IC showed no differences in whole-brain weight or weights of several brain regions. These results indicate that S. lateralis is not suitable for this type of study; in addition, this species' reported nonsociality is questioned, based on these subjects' reactions to isolation housing and field observations of social interactions in this species. PMID- 3556783 TI - Sensory modulation of juvenile play in rats. AB - A series of experiments was conducted to determine the extent to which somatosensory stimulation is necessary for the elaboration of juvenile play in rats. Anesthetization of the dorsal body surface of juvenile rats with xylocaine reduced the frequency of pinning, an indicator variable for play, by 35% to 70%, while motivation to play, as measured by dorsal contacts, an index of play solicitation, remained largely intact. These data suggest that dorsal body surface anesthetization impairs the ability of juvenile rats to perceive and/or respond to playful gestures. When untreated animals were paired with xylocaine treated animals, the xylocaine-treated animals consistently pinned the untreated pups more than vice versa, further suggesting that somatosensation may be involved in the establishment and/or maintenance of play dominance relations. A preliminary examination assessing potential involvement of other modalities in the play of rats was also conducted, with the data suggesting a possible role for audition in the play of this species. PMID- 3556782 TI - Behavioral states of premature infants: implications for neural and behavioral development. AB - Nine premature and 28 full-term infants were observed in their homes for 7 hr when they were 2, 3, 4, and 5 weeks post-term, and the sleeping and waking states displayed by these infants were compared. For these comparisons, the observation day was divided into two mutually exclusive contexts: times when the baby was alone and times when the baby was with the mother. The premature infants spent more time alone (mean of 5.4 hr a day) than the full-terms (4.6 hr). Over the total 7-hr day, the premature infants spent more time in alert, nonalert waking activity, and sleep-wake transition than the full-terms, and they spent less time in drowse and total sleep. These results clearly indicate that, at the same post term ages, the sleep-wake states of premature infants differ markedly from those of full-terms. Four states showed significant Group X Context interactions indicating that state differences between premature and full-term infants were also a function of the context in which the infants were observed. For example, the prematures exhibited more fuss or cry and more drowse when alone; whereas the full-terms exhibited more of these states when with their mothers. This finding of context-related differences between prematures and full-terms has implications for the conflicting reports in the literature, as heretofore the states of prematures and full-terms have been compared from observations made in a single situation. The results indicate that prematures exhibit significant commonality in their neurobehavioral development through the early post-term period despite heterogeneity among them in their exposure to prenatal, perinatal, and early postnatal stresses. PMID- 3556784 TI - Preweanling behavioral development in spontaneously hypertensive, borderline hypertensive, and Wistar-Kyoto normotensive rats. AB - Preweanling physical and behavioral development was studied in spontaneously hypertensive (SHR), borderline hypertensive (BHR), and Wistar-Kyoto normotensive (WKY) rat pups. Measures of physical development included body weight, onset of various morphological landmarks, and speed of surface righting. Behavioral tests assessed locomotor development, exploratory behavior, and cliff avoidance in pups of the 3 groups. On all measures employed, SHR pups exhibited a delay in physical maturation compared to age-matched BHR and WKY pups. Results from the locomotor development test revealed that young WKY pups (ages 1-7 days) spent more time locomoting than SHR pups, with BHR times being intermediate. In contrast, older SHR pups (ages 17-30 days) displayed greater activity in an exploratory maze than WKY pups, with BHR values again intermediate. Finally, SHR pups were more behaviorally reactive in the cliff avoidance task compared to BHR and WKY pups. These group differences may be useful in understanding the development of genetic hypertension and may serve as early behavioral markers of a predisposition to cardiovascular disease. PMID- 3556785 TI - Preferences of female rhesus monkeys (Macaca mulatta) for infantile coloration. AB - While developmental researchers have long noted that infants of many mammalian species, including primates, have characteristic physical features, such as a distinctive coat or skin color, and some authors have further suggested that these features serve to elicit caretaking and solicitous behavior, few systematic investigations of the actual salience of such features for adult conspecifics have been carried out to date. The present series of 3 studies sought to determine whether natal coat and/or facial skin coloration might provide desirable visual stimulation for rhesus monkey adult females. In these studies the faces and/or fur of 6-month-old rhesus monkeys were dyed to simulate the normal coloration of rhesus monkey neonates. Adult females varying in parity and rearing history were then tested for their relative preference between these infantile-colored 6-month-olds and both normally colored 6-month-olds and other differentially colored control stimulus monkeys. Results indicated that regardless of parity or rearing history the adult female subjects exhibited consistent preferences for the stimulus animals with neonatal-like reddish-pink facial skin coloration. PMID- 3556786 TI - Regulation of nursing in chimpanzees. AB - The regulation of nursing was studied in captive chimpanzees from birth to 6 months of age. It was asked whether regulation was predictable or timing was irregular. A search for unimodal frequency distributions resulted in a distinction among nursing bouts, nursing episodes (bouts with brief interruptions) and nursing pauses. The frequency distributions of these types were either normal with very large standard deviations or exponential (i.e., randomly terminated). This implies a very irregular timing. Longer nursing episodes were followed by somewhat longer pauses; pauses with daytime sleep (that were relatively long) were followed by longer nursing. However, these regulatory effects were only slight. Most of this loose regulation of nursing was due to the infant, as the mothers did not put the infant on the breast and usually were permissive. Comparisons with humans suggest a similarly loose organization as well as frequent feeding in societies that provide relatively unlimited access to the breast. The regular 4-hr, meal-like schedule in industrial countries seems mainly to be due to human mothers and their advisors. PMID- 3556787 TI - Differences in maternal behavior of rats and the sociosexual development of the offspring. AB - This paper describes experiments designed to investigate long-term behavioral consequences for offspring of changes in maternal behavior directed toward them as pups. Specifically, the hypothesis was considered that experimentally induced alterations in maternal behavior would result in general and wide-ranging effects on offspring development, including effects on later social and sexual behavior. The first experiment looked at the effects of changing pup odors on maternal responsiveness toward the pups, and showed that the application of perfume, particularly to the anogenital region, resulted in significant lowering of maternal anogenital licking of pups. Non-pup-directed behavior did not differ between groups. The behavior of those pups that had thus differed in infant experience was then followed in three subsequent experiments. In Experiment 2, social behavior during the juvenile period was investigated, focusing particularly on the expression of social play. The most noticeable difference to emerge in this experiment was that male pups that had been anogenitally perfumed as infants showed much higher levels of social play than male or female pups from other treatment groups. The last two experiments considered adult behavior. Experiment 3 showed that there are no lasting effects of the neonatal treatment on the attractiveness an animal has for its conspecifics. In the final experiment, "masculine" sexual behavior of males (mounts with intromission), and "feminine" sexual behavior of females (i.e., lordosis and proceptive behavior) were investigated. This confirmed previous reports by Moore (1984) (Moore, C. L. (1984). Maternal contributions to the development of masculine sexual behavior in laboratory rats. Dev. Psychobiol., 17:347-363) that those male pups that had received lower rates of anogenital licking as pups showed longer intermount intervals, when tested as adults. The results are discussed in relation to the development of sexually differentiated behavior. PMID- 3556788 TI - Forward from neonatology. PMID- 3556790 TI - Differential diagnosis of Reye's syndrome. PMID- 3556789 TI - Non-progressive central core disease with severe congenital scoliosis: a case report. AB - An extremely unusual case of central core disease combined with a congenital spine deformity is described. The congenital myopathy was non-progressive, but the scoliotic curve worsened markedly. This case was characterised also by the type of squatting ambulation the child used until the age of 12, when the limb contractures were corrected surgically and with casting, permitting her to walk in an upright position. It was not feasible to perform spinal surgery. PMID- 3556791 TI - Central visual disturbances. PMID- 3556792 TI - Preliminary survey of family abuse of children served by United Cerebral Palsy centers. AB - Two preliminary surveys were performed of children under six years of age to determine: whether handicapping conditions may have occurred as a result of abuse, and the incidence of abuse among children who already had disabilities. The first group of children were in preschool programs operated by United Cerebral Palsy affiliates and the second group were in respite care programs operated by such affiliates. 42 preschool programs with 2771 children and 14 respite care programs with 435 children responded to the survey questionnaire. The results suggest a high incidence of abuse among handicapped children in preschool programs, but a lower incidence in respite care programs. There is a need for greater awareness and reporting of abuse in programs for young handicapped children. PMID- 3556793 TI - Spinal curvature and hand dominance. PMID- 3556794 TI - Family communication about muscular dystrophy. PMID- 3556795 TI - Inhibitive casting for cerebral palsied children. PMID- 3556796 TI - Birth asphyxia in the fullterm newborn. PMID- 3556797 TI - Biofeedback techniques and behaviour modification in the conservative remediation of drooling by children with cerebral palsy. AB - In an attempt to decrease the rates of drooling of 12 children with cerebral palsy, the authors investigated the effectiveness of EMG auditory feedback training of the orbicularis oris, of making the act of swallowing a conscious one, and of providing an auditory signal to cue swallowing by means of an Accularm interval timer. After biofeedback training there was a significant decrease in drooling rates and a small increase in swallowing rates. After the Accularm was used the children maintained the decreased drooling rates and there was a further small improvement in swallowing rates. One month after treatment stopped there was a non-significant regression in the rates of both drooling and swallowing. The marked decrease in drooling after biofeedback training must be attributed to more effective swallowing as a result of improved oral motor control, rather than to increased rates of swallowing. PMID- 3556799 TI - Saccadic eye-movements of children with cerebral palsy. AB - Oculomotor disorders are frequently observed in cerebral-palsied children, and are thought to contribute to impairment of verbal as well as non-verbal skills. The authors present the first quantitative analysis of saccadic eye-movements of these children, choosing those with normal verbal IQ but evidence of a learning disability. A majority showed various abnormalities of saccadic eye-movements and these should be taken into account when evaluating and treating children with cerebral palsy. PMID- 3556798 TI - Factors affecting cognitive functioning of hemiplegic children. AB - The results of psychological testing, EEGs and CT scans were examined for 41 children with congenital or early acquired hemiplegia. On average, IQ was depressed and the magnitude of this depression was highly correlated with lesion size, degree of hemiparesis and EEG abnormality, but not with location of lesion. There were no significant effects of lesion laterality on Verbal vs. Performance IQ on Wechsler tests. However, receptive vocabulary, as measured by the Peabody Picture Vocabulary Test, was differentially depressed by left-hemisphere damage. Further, on a variety of verbal tasks, patients with congenital lesions performed better than those with acquired lesions. In contrast, no significant differences were found between the two groups on spatial tasks. PMID- 3556800 TI - The medical examination of children on entry to school. The results and use of neurodevelopmental assessment. AB - In the North Paddington Primary School Study 350 children were identified at five and studied over a five-year period. The children were given a comprehensive examination on entry to school, the findings from which are briefly described. Here the results of the neurodevelopmental assessment are reviewed. Children with a high (abnormal) neurodevelopmental score (NDS) are shown to be a very vulnerable group with significantly higher rates of learning difficulty by the age of 10. The NDS alone does not give as good a prediction of such difficulty as the school doctor's clinical judgment. It is emphasised that prediction of difficulties is not an objective of the school entrant examination but clearly the clinical tests from which a NDS can be calculated provide a sound basis for clinical practice. Attention is drawn to the need for the school doctor with discretion to pass on to teachers the results of their examination that may increase the teachers' insight into their pupils and help them in their methods of teaching and care. PMID- 3556801 TI - Remediation for subgroups of retarded readers using a modified oral spelling procedure. AB - The effectiveness of Bradley's modification of the method of Simultaneous Oral Spelling (SOS) remedial training for both spelling and reading was assessed in this study. Subgroups of disabled readers, 'Chinese' (dysphonetic) and 'Phonecians' (dyseidetic), received six remedial sessions and were assessed immediately after treatment and then two months later on spelling of the training words and on general reading measures. Compared with a non-treated group, the two experimental groups showed significant but different general gains in reading. SOS training appears to be more effective for the teaching of regular words, as opposed to exceptional ones. PMID- 3556802 TI - Factors associated with reading-plus-spelling retardation and specific spelling retardation. AB - Factors associated with reading-plus-spelling retardation and specific spelling retardation were investigated in a large sample of Dunedin children who were studied longitudinally between the ages of three and 11 years. Those with reading plus-spelling retardation showed poor performance on WISC-R Verbal subtests relative to non-retarded children, but superior performance on Picture Completion and Object Assembly subtests. The group with reading-plus-spelling retardation also had poor speech articulation but no significant language, motor or neurological dysfunction. Their educational attainment in reading, writing and mathematics was consistently poor. Specific spelling retardation was associated with deficits on WISC-R Arithmetic and Coding subtests, teacher ratings of low attentiveness and poor achievement in writing and mathematics. No language, motor or neurological deficits were apparent in this group. PMID- 3556803 TI - The pattern of congenital renal anomalies associated with neural-tube defects. AB - This is a retrospective study of 190 patients with neural-tube defects for whom there were precise data, both on sensory levels (to pin-prick) and on the presence or absence of congenital renal anomalies. There were 17 renal anomalies, of which three were renal agenesis, five horseshoe kidneys, eight ureteral duplications and one simple ureterocele. There was a consistent pattern of congenital renal anomalies in relation to the extent of the neurological lesion, as measured by the sensory level. Renal agenesis was associated with a sensory level in the dermatomes T5 to T8, horseshoe kidneys with a T9 to L1 level and ureteral duplications predominantly with a sensory level in the sacral dermatomes. PMID- 3556804 TI - Discontinuation of immunosuppressive therapy in hepatitis B surface antigen positive chronic hepatitis: effect on viral replication and on liver cell damage. AB - Immunosuppressive therapy was stopped in 12 individuals positive for hepatitis Be antigen (HBeAg) and hepatitis B surface antigen (HBsAg) and in 4 individuals positive for HBsAg but negative for HBeAg. Discontinuation of immunosuppressive therapy in HBeAg-positive patients was always associated with a bout of hepatitis and elimination of HBeAg in 8/12 patients. One patient died from liver failure and 2 patients experienced a decompensation of their liver disease indicating that this approach might be harmful if used therapeutically. A bout of hepatitis was not noted in any of the individuals negative for HBeAg when the immunosuppressive therapy was stopped, implying that this event is not potentially harmful to the patient. PMID- 3556806 TI - Accuracy of twelve methods for estimating the real ear gain of hearing aids. AB - The gain of a hearing aid was measured on each of eight subjects using a variety of functional (subjective) and insertion (objective) gain methods. Each measurement was repeated on subsequent days and the hearing aid gain was also determined in several couplers and on KEMAR. The multiple measurements enabled an accurate estimate of the "true" gain of the aid on each subject to be determined. The real ear gain measured by each of the individual methods was then compared with this true gain estimate and the relative accuracy of each method was quantified. Of the clinically feasible methods, probe microphone measurement of insertion gain proved to be the most accurate. Few significant differences were found between functional gain and insertion gain. Estimation of real ear gain on the basis of coupler gain appeared to be a reasonable, though not recommended approach. PMID- 3556805 TI - Simultaneous occurrence of collagenous colitis and Crohn's disease. AB - A 59-year-old woman who presented initially with clinical and histological features of collagenous colitis subsequently developed Crohn's disease of the small and large bowel. PMID- 3556807 TI - Hearing screening of high risk newborns. AB - Prospective screening of an extremely high risk group of 137 infants cared for in the Newborn Intensive Care Unit of the James Whitcomb Riley Hospital for Children was undertaken during 1983. Auditory brain stem responses (ABR) were obtained utilizing a clinical evoked potential system (Madsen 2250). Patients were selected for screening prior to discharge or transfer to the referring hospital on the basis of one or more of the following criteria: birth weight less than 1250 grams; birth weight less than 1500 grams and ventilatory support; significant depression at birth (Apgars less than 3 and 6 at 1 and 5 minutes, respectively); seizures, meningitis, and/or sepsis. Of the original 137 infants tested, 82 passed the initial ABR, 22 conditionally passed, and 34 failed. Eighty two infants had follow-up behavioral and audiometric testing while 20 infants died and 35 were lost to follow-up. Four infants had severe sensorineural hearing loss, each of whom had failed the initial ABR. None of the infants who initially passed or conditionally passed the ABR had sensorineural hearing loss on follow up testing. High risk factors for sensorineural hearing loss in the neonatal period included: intraventricular/periventricular hemorrhage, apnea, family history, major malformations of the head and neck, and possibly hyperbilirubinemia and congenital infection. No relationship of sensorineural hearing loss with very low birth weight, hyponatremia, infection, seizures, or medications was found. On the basis of these data, it is suggested that electrophysiologic hearing screening of a high risk population may be delayed until 3 to 6 months of age to improve specificity of testing. PMID- 3556808 TI - Use of connected discourse tracking to train functional speech skills. AB - The connected discourse tracking procedure was adopted for use as a production training task for profoundly hearing-impaired children. A clinician served as the receiver and 5 children with profound hearing losses each served as the sender for 16 tracking sessions. There were individual differences among the children in their ability to convey the connected discourse to the clinician over time. The increase in comprehension of each subject's speech during the last session relative to the amount of information understood during the first session ranged from 0 to 48%. Two independent observers were used during the first and last sessions to verify the tracking results obtained by the clinician (the primary receiver). There were differences in words tracked per minute among the three receivers with the primary clinician achieving higher tracking rates than the other two. The children learned how to use discourse strategies when they were not understood and they were highly motivated by the task. The results indicate that it is feasible to incorporate the procedure in a speech training program for hearing-impaired children. PMID- 3556810 TI - Nonsense syllable test (NST) results and hearing loss. AB - Errors on a nonsense syllable test (NST) were compared to pure-tone thresholds and ages of 109 subjects with normal or sensorineural hearing loss. A strong correlation was found between the number of NST errors and hearing loss at 2000 and 250 Hz. NST errors do not appear to be related to the age of subjects. Excellent predictive relationships were found between total NST errors and a weighted pure-tone average for slight to marked sensorineural hearing loss. Implications for counseling, site of lesion, and amplification evaluation are discussed. PMID- 3556809 TI - Relationships among selected measures of single-channel cochlear implant performance. AB - Relationships among a number of pre- and postimplant variables measured in 20 adults implanted with a single-channel cochlear implant were examined through a variety of univariate and multivariate statistical techniques. A large number of variables were analyzed to yield information on the relationships between pre- and postimplant performance, and among a variety of postimplant measures. Variables included: age; etiology and nature of deafness; type of implant worn; pre- and postimplant warble tone and speech detection thresholds; postimplant performance on the Monosyllable-Trochee-Spondee (MTS) and Environmental Sounds tests; postimplant electrical thresholds, uncomfortable loudness levels, and dynamic range; I.Q. scores; and postimplant discourse tracking performance with and without the implant. The difference score on the discourse tracking task, representing the auditory advantage over performance with lipreading alone, related substantively to a combination of variables including type of unit worn (Sigma versus Alpha), nature of deafness (progressive versus sudden), and etiology (meningitis versus nonmeningitis). Additionally, MTS and Environmental Sounds test scores were found to relate to one another and to etiology and nature of deafness. PMID- 3556811 TI - Effects of audiometric configuration on the auditory brain stem response. AB - Evidence reported in the literature indicates that wave I of the auditory brain stem response is influenced by cochlear contributions from a more basal area of the cochlea than is wave V. This phenomenon is invoked to explain different latency-intensity function patterns of waves I and V and the I-V interval for four types of cochlear hearing loss. In high frequency hearing losses wave V is delayed at low intensities. Wave I tends to be delayed at all intensities and by a greater amount than wave V. The I-V interval is often reduced with the effect maximal at higher intensities. Low frequency hearing losses tend to cause early wave V latencies at low intensities. Wave I latencies are normal. The I-V interval is therefore reduced at lower intensities. Flat hearing losses produce normal latency-intensity functions. High frequency notched audiograms are almost always associated with delayed wave V but early wave I latencies. The I-V interval is therefore significantly prolonged with the effect maximal at low intensities. The variability of the I-V interval as a function of audiometric configuration indicates that it is not a pure measure of central conduction time. PMID- 3556812 TI - Auditory brain stem response laboratory norms: when is the data base sufficient? AB - This note proposes that a statistical index, the standard error of the mean, be used in determining a posteriori whether an adequate subject sample has been selected for auditory brain stem response laboratory norms. When the standard error calculated is within the laboratory's resolution of measurement, the data set obtained provides a good estimate of the true population mean, obviating the need for sampling additional subjects. PMID- 3556813 TI - The effects of alerting tasks on caloric induced vestibular nystagmus. AB - The present study compared the effects of four different mental altering tasks on the speed of the nystagmic slow component during caloric testing in 40 young adults. Subjects were randomly divided into four groups (10/group) and stimulated twice in each ear in a counterbalanced manner according to test ear, irrigating temperature, and alerting task. Analysis of the data revealed significant differences between treatment effects on the magnitude of the slow phase velocity of nystagmus. Results suggest that passive listening does not sufficiently alert subjects to ensure the adequate release of nystagmus suppression during vestibular testing. PMID- 3556814 TI - Are there local room effects on hepatic tumors in male mice? An examination of the NTP eugenol study. AB - The NTP mouse bioassay on eugenol shows an increase in proliferative hepatic tumors, primarily carcinoma, in the low-dose males, but not the high dose. Examination of the data indicates that the increase in hepatic tumors is concentrated in the first 5 of the 10 contiguous cages on this low dose. Since cages were located systematically, the increase in tumors at the low dose appears to be due to some local room effect and not eugenol treatment. PMID- 3556815 TI - Acute inhalation toxicity of aliphatic (C1-C5) nitrites in rats. AB - The 4-hr inhalation LC50 was determined for methyl-, ethyl-, n-propyl-, n-butyl-, isobutyl-, and isopentyl nitrite in Sprague-Dawley rats. LC50 values were 176, 160, 300, 420, 777, and 716 ppm, respectively. The dose-mortality curves were characterized by extremely steep slopes. Toxic signs observed during exposure included cyanosis, prostration, and rarely, convulsions. There were no effects of exposure on body weight gain during a 14-day postexposure observation period. Signs of pulmonary hemorrhage were apparent in rats which died during exposure but were much less prominent in rats sacrificed at study termination. No animals died after cessation of exposure, and rapid recovery was apparent after exposure. Concentration X Time (CT) relationships suggested that the actual concentration was more important than the "dose" in determining the lethal effects of inhalation exposure to nitrites. Because of the extremely steep dose-mortality curves, the aliphatic nitrites are more hazardous than the LC50 values would indicate. PMID- 3556816 TI - Pulmonary alterations in rats due to acute phosgene inhalation. AB - This study evaluated the relationship between low-level phosgene (COCl2) exposure and pulmonary change or damage. Male Sprague-Dawley rats were exposed to phosgene for 4 hr at concentrations of 0.125 to 1.0 ppm (30, 60, 120, and 240 ppm X min). We examined the dose-related changes in body weight, lung wet and dry weights, lavage fluid protein concentrations (LFP), total cell count, and cell differential in rats exposed to phosgene under carefully controlled conditions. These parameters were measured at the conclusion of single acute exposures and for 3 days postexposure. Significant changes in lung weights (wet and dry) were observed following exposure to 120 and 240 ppm X min phosgene and the LFP was significantly altered at 60 ppm X min. The changes in lung wet and dry weights pooled over all times and phosgene concentrations each correlated significantly with the change in LFP induced by phosgene. The total number of cells in the lavage fluid of phosgene-exposed rats was increased, and the most sensitive cellular indicator of phosgene inhalation was the increase in the percentage of polymorphonuclear leukocytes (PMNs). These results confirm that LFP concentration and cellular differentials can be used as an index of lung damage due to phosgene. A dose-response relationship for the measured parameters was observed. Over the dosage range studied, the return of all measured parameters to near control levels within 3 days following exposure showed that the pulmonary damage was reversible or rapidly reparable. Although the acute effects were shown to be reversible, studies on chronic, low-level phosgene exposures are necessary to determine safe levels for industrial employees. PMID- 3556817 TI - The developmental toxicity of diethylene glycol dimethyl ether in mice. AB - Diethylene glycol dimethyl ether (diEGdiME) is structurally related to several compounds which produce reproductive and developmental toxicity, including teratogenicity in laboratory animals. In the present study, diEGdiME (0, 62.5, 125, 250, or 500 mg/kg/day) was administered by gavage in distilled water to timed-pregnant CD-1 mice during major organogenesis [gestational days (gd) 6-15]. Clinical status of treated females was monitored daily during treatment and on gd 17. At sacrifice (gd 17), pregnancy was confirmed by uterine examination for 20 24 dams per group; each live fetus was examined for external, visceral, and skeletal malformations. No maternal deaths, morbidity, or treatment-related clinical signs were observed. Reduced maternal weight gain during treatment at greater than or equal to 250 mg/kg/day was primarily attributed to compromised pregnancy status resulting in reduced gravid uterine weight. Maternal weight gain during gestation corrected for gravid uterine weight, and relative liver weight (% body weight) were not affected. Average fetal body weight/litter was significantly reduced at greater than or equal to 125 mg/kg/day. The percentage of postimplantation loss/litter (5, 8, 7, 12, and 50% for control through high dose) and the percentage of malformed live fetuses/litter (0.4, 0, 2, 24, and 96%) were significantly increased at greater than or equal to 250 mg/kg/day. Developmental defects involved primarily the neural tube, limbs and digits, craniofacial structures, abdominal wall, cardiovascular system, urogenital organs, and both the axial and appendicular skeleton. In summary, oral administration of diEGdiME during major organogenesis did not produce any distinctive signs of maternal toxicity, but did produce selective and profound adverse effects upon fetal growth, viability, and morphological development at greater than or equal to 125 mg/kg/day. PMID- 3556818 TI - A framework for evaluating Ames' test data submitted to a regulatory agency. PMID- 3556819 TI - Long term toxicity tests in non-rodents. PMID- 3556820 TI - Morphological evidence for increased protein synthesis in CNS neurons after soman exposure. AB - Fine structural changes in neurons of the dorsal hippocampus, caudate nucleus, supraoptic nucleus (SON), and ventral horn of the spinal cord of adult male or spayed female cats were studied after single and multiple doses (dose range 1.0 20.0 micrograms/kg sc) of the organophosphonate, pinacolyl methylphosphonofluoridate (soman). Increases in amounts of rough endoplasmic reticulum (rER) and polyribosomes, proliferation of Golgi complexes, as well as indentations of nuclear membranes occur after single and multiple exposures. The degree of change is dependent on dose, duration of exposure, and time of survival after exposure. The cell organelles affected are essential for protein synthesis and changes in their quantities are morphological indicators for changes in protein synthesis. The data presented in this study suggest an initial increase in protein synthesis after soman exposure, followed by early signs of degeneration. Soman (10 micrograms/kg iv) inhibition of cholinesterases of whole blood, spinal cord, and caudate nucleus of control and cats from which electrophysiological recordings of Renshaw cell field potentials were taken show significant differences. Moreover, while blood values are unmeasurable, spinal cord and caudate nucleus values are 42.21 and 53.6% those of controls at 30 min after injection and 63.41 and 50.75% those of controls after 240 min, respectively. No differences are noted between Renshaw cell field potentials after treatment and controls. Similarly, no changes in gross behavior are noted after 10 micrograms/kg sc. Yet, morphological signs of increases in protein synthesis are present. It is concluded that soman induces increased protein synthesis in many areas studied and that this increase is not dependent on inhibition of cholinesterase to a degree that affects gross behavior of evoked potentials from a CNS cholinergic-transmitting synapse--the motoneuron axon collateral and Renshaw cell (J. C. Eccles, P. Fatt, and K. Koketsu (1954), J. Physiol, 126, 524-562). PMID- 3556822 TI - Evaluation of the teratogenicity and pharmacokinetics of diflunisal in cynomolgus monkeys. AB - This study examined the pharmacokinetics and potential teratogenicity of the nonsteroidal antiinflammatory drug, diflunisal, in cynomolgus monkeys. Pregnant cynomolgus monkeys were administered 0.5% methyl cellulose, 20 mg/kg/day diflunisal, or 80 mg/kg/day diflunisal on Days 25 to 48 of gestation. There was no evidence of maternal toxicity, increased abortion rate, fetal growth retardation, or malformation. These data demonstrate that diflunisal is not teratogenic in cynomolgus monkeys over a dosage range of 20 to 80 mg/kg/day. Peak plasma levels of diflunisal were found 1 hr after oral administration of [14C]diflunisal at a dosage of 60 mg/kg and declined to low levels by 24 hr. The plasma elimination half-life was calculated to be 10.2 hr over the period of 1 to 8 hr postadministration. Intact diflunisal accounted for 96.4% of total plasma radioactivity at 0.5 hr and declined to a value of 74% at 8 hr. Plasma protein binding averaged greater than 99% over a concentration range of 62.5 to 250 micrograms/ml. Urinary excretion of diflunisal and metabolites averaged 66.5% of the dosage over the first 4 days postadministration, compared with 0.8% in the feces. The majority of activity represented conjugates of diflunisal. Embryo concentrations of diflunisal on Days 35 to 37 of gestation were 0.7 and 1.1% of maternal plasma level at 4 hr postadministration of 20 or 60 mg/kg, respectively. PMID- 3556823 TI - Percutaneous absorption, metabolism, and hemolytic activity of n-butoxyethanol. AB - A series of studies was conducted to examine the percutaneous absorption, distribution, excretion, and hemolytic activity of n-butoxyethanol (BE). Rats receiving a subcutaneous dose of 14C-labeled BE excreted the radioactivity in the urine (79%), expired air (10%), and feces (0.5%) within 72 hr. Of the organs analyzed, thymus and spleen showed elevated specific radioactivities as compared with blood. A percutaneous application of BE on rats, under nonocclusive conditions, showed 25-29% absorption within 48 hr. Peak blood levels of BE occurred at 2 hr after application; butoxyacetic acid (BAA) was found to be the major metabolite. Comparison of in vitro skin penetration data showed the following absorption pattern of BE: hairless rat much greater than pig greater than human skin. Hemolysis and associated hematological changes were noted in the rats which received single dermal applications of 260-500 mg/kg of BE. In vitro, BAA showed markedly greater hemolytic ability on rat erythrocytes than did BE. Human erythrocytes showed no hemolysis when incubated with BE or BAA at concentrations that are hemolytic to rat erythrocytes. An intravenous dose of 62.5 mg/kg of BE does not result in hemolysis or hemoglobinuria in the rat. The rat may be an animal model with increased susceptibility to the effects of BE compared with humans because of its rapid percutaneous absorptive ability and its greater hemolytic sensitivity. PMID- 3556821 TI - Effects of toxic agents at the protein level: quantitative measurement of 213 mouse liver proteins following xenobiotic treatment. AB - By analyzing two-dimensional electrophoretic patterns of mouse liver proteins with a computerized image analysis system, we have observed quantitative changes in the abundance of more than 70 proteins in mice treated with various agents. Aroclor 1254, a mixture of polychlorinated biphenyls known to induce a broad spectrum of microsomal activity, induces the largest group of changes (60 proteins altered at p less than 0.001 significance). Phenobarbital produces a small set of characteristic changes that forms part of the much larger Aroclor 1254 effect. Ibuprofen treatment produces a phenobarbital-like pattern of change, with the addition of at least one protein change not observed with any of the other treatments. Cycloheximide and carbon tetrachloride each induces a different characteristic pattern of protein alteration. We have assigned most of the mouse liver proteins to a specific subcellular fraction, and it appears that the predominant class of proteins altered by each compound is present in the soluble phase, rather than in the microsomal fraction. The ability to survey large numbers of tissue proteins for involvement in pharmacologic and toxic effects may allow a more comprehensive understanding of the mechanisms of action in vivo and provide new markers of tissue damage. PMID- 3556824 TI - Prenatal toxicity of 2-methoxypropylacetate-1 in rats and rabbits. AB - 2-Methoxypropylacetate-1 was investigated in Wistar rats and Himalayan rabbits for embryotoxic potential. Rats after inhalation exposure to 0, 0.6, 3.0, or 14.9 mg/liter (approximately 0, 110, 550, or 2700 ppm, respectively) for 6 hr per day from gestation Days 6 through 15 exhibited some degree of maternal toxicity at 2700 and 550 ppm. At 2700 ppm an increase of skeletal anomalies of the thoracic vertebrae among the fetuses was observed and interpreted as an exposure-related slight teratogenic effect. In Himalayan rabbits exposed via inhalation to 0, 0.2, 0.8, or 3.0 mg/liter (approximately 0, 36, 145, or 550 ppm, respectively) for 6 hr per day from gestation Days 6 through 18 teratogenicity was much more pronounced: at 550 ppm, in the absence of clear maternal toxicity, the fetuses of all litters showed severe malformations. No maternal or fetal effects were observed at 145 and 36 ppm. Dermal application of 1000 and 2000 mg/kg to Himalayan rabbits from gestation Days 6 through 18 failed to produce maternal or fetal toxicity. PMID- 3556825 TI - Age-related changes in serum chemistry and hematology values in normal Sprague Dawley rats. AB - Age-related changes in serum chemistry and hematology values in male and female Sprague-Dawley rats 2 to 29 months of age are described. The number of values per determination (N) ranged from 554 to 1126. Serum chemistry parameters demonstrating changes with time included inorganic phosphorus, total protein, cholesterol, triglycerides, and alkaline phosphatase. There was little or no sex difference among these parameters. Hematologic parameters demonstrating changes with time included leukocyte elements (lymphocytes, neutrophils, eosinophils, monocytes), erythrocyte parameters (red blood cell count, hematocrit, hemoglobin, mean cell volume, mean cell hemoglobin), and platelet count. Most trends in erythrocyte parameters were more marked in males than in females. To visualize the effect of age of these parameters, the data were plotted vs time, and fitted models were superimposed on the graphs. Comparisons with available literature values are made, and the value of an age-related data base when conducting long term toxicity studies is discussed. PMID- 3556826 TI - A confirmatory study of the up-and-down method for acute oral toxicity testing. AB - Ten materials have been tested in parallel both by the "classical" method for acute oral toxicity (LD50) and by the up-and-down method. Materials tested included laundry and dishwashing detergents, a shampoo, a flavor, potassium hydroxide, and caffeine. All testing was done in Sprague-Dawley rats. Excellent agreement was seen between the two methods. The classical method typically used 40 to 50 animals while the up-and-down method required only six to nine animals per material. PMID- 3556827 TI - The pathogenesis of trimethyltin chloride-induced nephrotoxicity. AB - In exploratory studies aimed at elucidating CNS effects due to heavy metal toxicity, signs of compromised renal function were seen in rats. The studies reported here describe the sequential steps of the development of nephrotoxicity by trimethyltin chloride (TMT) in rats. Single doses of 12.25 mg/kg TMT administered orally to 150- to 175-g Long-Evans rats elicited overt signs of toxicity including behavioral abnormalities and marked weight loss. Concurrent with the development of these signs, nephrotoxicity was manifested as functional kidney compromise and associated histopathologic evidence of tubular damage. Pathological changes in the kidneys from treated rats were hyaline droplet inclusions, attenuated brush border, basolateral vacuolization, and eosinophilic granular casts in the proximal tubule cells. These lesions were detected as early as 2 days post-treatment and progressed with time in an orderly and sequential fashion. Renal lesions between 5 and 8 days were mild to severe cortical tubular dilatation, hydropic degeneration, and diffuse hyaline droplet deposition in the lower nephron tubules. Medullary edema and exfoliation of degenerated tubular epithelial cells with cast formation followed from 8 to 11 days. The morphological changes were accompanied by marked elevation of blood urea nitrogen, parallel with polyuria at Day 2 and oliguria by Day 14. Behavioral abnormalities as well as weight loss correlated well with the time course and severity of renal dysfunction and progression of morphological changes. A second experiment compared the effects of TMT in rats of different weights. Heavier rats were more sensitive than lighter rats to the nephrotoxic effects of TMT. These effects were independent of recognizable neurotoxic effects of TMT in the hippocampus. PMID- 3556828 TI - Analysis of longitudinal "time series" data in toxicology. AB - Studies focusing on chronic toxicity or on the time course of toxicant effect often involve repeated measurements or longitudinal observations of endpoints of interest. Experimental design considerations frequently necessitate between-group comparisons of the resulting trends. Typically, procedures such as the repeated measures analysis of variance have been used for statistical analysis, even though the required assumptions may not be satisfied in some circumstances. This paper describes an alternative analytical approach which summarizes curvilinear trends by fitting cubic orthogonal polynomials to individual profiles of effect. The resulting regression coefficients serve as quantitative descriptors which can be subjected to group significance testing. Randomization tests based on medians are proposed to provide a comparison of treatment and control groups. Examples from the behavioral toxicology literature are considered, and the results are compared to more traditional approaches, such as repeated-measures analysis of variance. PMID- 3556829 TI - Inhalation teratology studies of n-butyl mercaptan in rats and mice. AB - n-Butyl mercaptan (n-BM) is used as a solvent and a chemical intermediate. Pregnant Charles River CD-1 mice and COBS CD rats were randomly assigned to a control group and to three n-BM-exposed groups of 25 rats and 25 mice each. The animals were exposed by whole-body inhalation to mean n-BM concentrations of 10, 68, or 152 ppm on a 6-hr daily exposure schedule. Rats were exposed on Gestation Days 6-19 and mice on Gestation Days 6-16. The control group was exposed to filtered air only on a comparable regimen. Cesarean sections were performed on all surviving mice on Gestation Day 17 and on all rats on Gestation Day 20. Seventeen of the n-BM-treated mice died: 8 at the 68-ppm level and 9 at the 152 ppm level; none of the n-BM-treated rats died. An increased postimplantation loss and increased early resorption occurred in mice exposed at 68 and 152 ppm, indicating embryotoxicity. An increased incidence of cleft palate was observed in mice exposed to 10 or 68 ppm which was not statistically significant. Total fetal abnormalities were statistically significantly different from controls at 68 ppm where maternal lethality was observed when based on the fetal unit although not when based on the litter unit. Rats exposed to 152 ppm or less demonstrated no terata. PMID- 3556830 TI - Embryotoxicity and fetotoxicity of orally administered tridiphane in mice and rats. AB - Tridiphane [2-(3,5-dichlorophenyl)-2-(2,2,2-trichloroethyl)oxirane], a broad-leaf herbicide, was evaluated for its potential effects on mouse and rat embryonal and fetal development. Pregnant CF-1 mice were given 0, 25, 75, or 250 mg tridiphane/kg/day on Days 6 through 15 of gestation. Significant maternal toxicity was observed in both the 75- and 250-mg/kg/day dose groups. An increased percentage of females given 250 mg/kg/day showed implantation sites only after staining of the uterus, suggesting a toxic effect on the embryo during the early stages of development, possibly secondary to maternal toxicity. Increases in some skeletal variants were noted at the 75-mg/kg dose level; however, a teratogenic effect was not observed. An additional group of mice was given 250 mg/kg/day on Days 8 through 15 of gestation. Maternal toxicity was also observed among these mice as manifested by significantly elevated (+50%) liver weight; however, there was a substantial increase in the number of females with full-term litters following this shorter dosing period. An increase in the occurrence of cleft palate in these offspring associated with low fetal body weights was also observed. Pregnant Sprague-Dawley rats were given 0, 30, 100, or 200 mg/kg/day of tridiphane on Days 6 through 15 of gestation. Maternal toxicity was observed among rats given 200 mg/kg. Increased incidences of two minor skeletal variants, lumbar spurs and extra ribs, were observed in the 200-mg/kg/day dose group, and an increase in lumbar spurs was observed at 100 mg/kg/day. Thus, tridiphane was embryotoxic and induced cleft palate in mice only at the maternally toxic dose level of 250 mg/kg/day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556831 TI - Cimetidine does not demasculinize male rat offspring exposed in utero. AB - Cimetidine has weak antiandrogenic activity in rats, but does not affect fertility in male rats at daily doses up to 950 mg/kg. Literature reports have claimed that giving cimetidine to pregnant rats in the drinking water caused feminization of male pups, small sex organs, low libido, and low serum testosterone. In the present study these effects were tested by giving large groups of pregnant rats 180 mg/kg/day cimetidine in the drinking water from Day 12 of pregnancy until the end of lactation, or a combination of drinking water and gavage treatment. Estimations included anogenital distance exactly 24 and 120 h after birth; serum testosterone at 55 and 110 days of age; mating performance at 110 days and (after castration and testosterone implantation) at 143 days; and testis, prostate, and seminal vesicle weights at 55 and 147-148 days. Maternally administered cimetidine was completely without effect on all the parameters measured in the male offspring. Thus, giving cimetidine to pregnant rats did not affect the masculinity of their male offspring. PMID- 3556832 TI - Acute, 9-day, and 13-week vapor inhalation studies on ethylene glycol monohexyl ether. AB - At ambient conditions, the low vapor pressure of ethylene glycol monohexyl ether (EGHE) allows for a maximum vapor concentration of approximately 85 ppm. In an acute inhalation study on Wistar albino rats, a 4-hr exposure to 83 ppm EGHE produced no clinical signs, body weight effects, mortality, or macroscopic lesions in thoracic or abdominal organs. Fischer 344 rats exposed for 9 days (6 hr/day) over an 11-day period, to 0 (control), 19, 41, or 84 ppm EGHE had decreased body weight gains and increased liver to body weight values at 84 ppm EGHE. No alterations of the hematology parameters or the morphology of the testes or liver were observed. In a subsequent study, rats were exposed to mean EGHE concentrations of 0 (control), 20, 41, or 71 ppm for 6 hr/day, 5 days/week, for 13 weeks. Urogenital wetness was observed in all EGHE-exposed groups of females and in males of the 71-ppm group. Decreased body weight gains were observed in both sexes of the 71-ppm group, and a slight decrease was also observed in females of the 41-ppm group. Increased absolute and/or relative liver weights were observed in both sexes of the 71-ppm group and to a lesser extent in the 41 ppm group. Possibly related to these findings in the liver were decreases in serum transaminases (aspartate and alanine aminotransferase) and sorbitol dehydrogenase, with an increase in alkaline phosphatase observed in the 71-ppm group of female rats. However, there were no gross or histopathologic lesions found to indicate impairment of the liver.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556833 TI - Toxic effects of N-nitrosodiethylamine on nasal tissues of Sprague-Dawley rats and golden Syrian hamsters. AB - The acute necrogenic effects of N-nitrosodiethylamine (NDEA) on nasal tissues of female Sprague-Dawley rats and golden Syrian hamsters were determined. Rats and hamsters were given a single ip dose of 0, 10, 20, 40, or 80 mg NDEA/kg body wt. After 24 hr, the rats and hamsters were killed and tissues were collected. Sections of nasal cavity and liver were evaluated histologically. All doses of NDEA caused inhibition of glycoprotein synthesis in cells of Bowman's glands in the olfactory region of rats and hamsters as determined by the loss of Alcian blue-periodic acid-Schiff staining material. Glycoprotein synthesis in other glands including the lateral nasal glands, maxillary glands, medial nasal glands, and the acinous glands near the vomeronasal organ was not affected by NDEA. Necrosis of Bowman's glands in the olfactory region of the nasal cavity occurred in rats given 20, 40, or 80 mg NDEA/kg body wt whereas the same cells were not necrotic in hamsters given NDEA. The results demonstrate the unique susceptibility of cells of the Bowman's glands to the toxic effects of NDEA given ip and indicate that nasal tissues of the rat are more susceptible to the necrogenic effects of NDEA than those of the hamster. PMID- 3556834 TI - Acute inhalation toxicity of T-2 mycotoxin in mice. AB - Experiments were conducted to study the acute inhalation toxicity of T-2 mycotoxin in both young adult and mature mice. For a 10-min aerosol exposure, the 24-hr LC50 of T-2 mycotoxin in young adult mice was 0.08 +/- 0.04 mg T-2/liter air and that for mature mice was 0.325 +/- 0.1 mg T-2/liter air. Deaths among mice exposed to the higher aerosol concentrations used in this study (i.e., 1.5 to 2.4 mg T-2/liter air) occurred in less than 5 hr. General clinical symptoms in these animals immediately postexposure were tremors, lethargy, stilted gait, and, in some animals, prostration. In experiments separate from the concentration response studies, total deposition of T-2 aerosol and selective retention of T-2 in the respiratory tract and nasal turbinates were determined analytically from 3H-labeled T-2. When total deposition of T-2 was quantitated, there was excellent agreement between that amount of T-2 deposited and that amount of T-2 predicted from calculations based on aerosol size and animal minute volume. Based on the aerosol deposition data, the LD50 values of T-2 mycotoxins was 0.24 mg/kg for young adult mice and 0.94 mg/kg for mature mice. For mice, inhalation of T-2 mycotoxin is at least 10 times more toxic than systemic administration (LD50 approximately 4.5 mg/kg) and at least 20 times more toxic than dermal administration (LD50 greater than 10 mg/kg). PMID- 3556835 TI - Five-month oral (diet) toxicity/infectivity study of Bacillus thuringiensis insecticides in sheep. AB - Bacillus thuringiensis insecticides (Bt) [Dipel (test substance D or Thuricide-HP (test substance T)] were administered in the diet for 5 months to castrated mixed rambouillet/merino sheep (24-34 kg at the beginning of the study) at a dose of 500 mg/kg/day (approximately 10(12) spores per day). No treatment-related effect was seen on weight gain or clinical chemistry parameters nor were significant gross clinical changes observed. Several blood and tissue samples taken just prior to the time the animals were killed or at necropsy were found to be positive for Bt when cultured. Detailed gross and microscopic pathologic examination of the sheep revealed several incidental lesions. However, the only lesion that may have been associated with the treatment was lymphocytic hyperplasia in Peyer's patches seen in the cecum of three sheep and it was not considered to be clinically significant. PMID- 3556836 TI - Pulmonary toxicity of cytostatic drugs: cell kinetics. AB - Mice were treated with three cytostatic drugs: cyclophosphamide, busulfan, or 1,3 bis(2-chloroethyl)-1-nitrosourea (BCNU). The alveolar labeling index was measured following drug administration with a pulse of 3H-labeled thymidine and autoradiography. In cyclophosphamide-treated animals, peak alveolar cell proliferation was seen 5 days after injection of the drug. In animals treated with busulfan or BCNU, proliferation was even more delayed (occurring 2-3 weeks after administration). In contrast, with oleic acid, the highest alveolar cell labeling was found 2 days after intravenous administration. In animals exposed to a cytostatic drug, proliferation of type II alveolar cells was never a prominent feature whereas in animals treated with oleic acid there was an initial burst of type II cell proliferation. It is concluded that the patterns of pulmonary repair vary between chemicals designed to interfere with DNA replication as compared to agents which produce acute lung damage such as oleic acid. PMID- 3556838 TI - Teratologic evaluation of 2-phenoxyethanol in New Zealand White rabbits following dermal exposure. AB - 2-Phenoxyethanol was applied to the clipped skin of pregnant rabbits on Days 6 through 18 of gestation in order to assess the fetotoxic and teratogenic potential by the dermal route. Rabbits were treated with 0, 300, 600, or 1000 mg/kg/day of 2-phenoxyethanol, and fetuses were examined for external, visceral, and skeletal alterations. Dermal application of 1000 mg/kg/day produced maternal toxicity as evidenced by intravascular hemolysis of red blood cells and death in some animals. Maternal toxicity was observed in rabbits treated with 600 mg 2 phenoxyethanol/kg/day but at a lower incidence than that observed at 1000 mg/kg/day. Nine rabbits in the 1000 mg/kg/day dose group and five rabbits at 600 mg/kg/day died or were sacrificed in extremis. Rabbits in the two highest dose groups which survived until Day 28 of gestation showed no evidence of treatment related effects. No signs of maternal toxicity were seen at 300 mg/kg/day. Examination of rabbit fetuses indicated that, at the dosages tested, 2 phenoxyethanol was not embryotoxic, fetotoxic, or teratogenic. PMID- 3556837 TI - The metabolism of acetonitrile to cyanide by isolated rat hepatocytes. AB - The metabolism of saturated nitriles, including acetonitrile, has been assumed to occur by a cytochrome P-450-dependent oxidation at the alpha-carbon, yielding a cyanohydrin intermediate which may spontaneously degrade to hydrogen cyanide and an aldehyde. However, results of studies in our laboratory suggest that formaldehyde is not a metabolite of acetonitrile. Since acetonitrile is structurally similar to iodomethane, a substrate for glutathione (GSH) S transferases, we hypothesized that the metabolism of acetonitrile to cyanide might also occur by a nucleophilic substitution reaction involving GSH. The present studies were conducted to investigate these hypotheses and to further our study of the effects of acetone on acetonitrile metabolism. Female Sprague-Dawley rats were pretreated with buthionine sulfoximine BSO (4 mmol/kg ip, at -4 and -2 hr), cobalt heme (90 mumol/kg sc, at -48 hr), acetone (1960 mg/kg po, at -24 hr), or vehicle, and hepatocytes were isolated after collagenase perfusion of the liver. BSO reduced the cellular GSH content by greater than 80%, but did not appear to affect the metabolism of acetonitrile: the liberation of cyanide correlated with cytochrome P-450, and not GSH, concentrations. Cobalt heme depleted hepatocellular cytochrome P-450 (-45%) content, decreased cell yield and viability, and resulted in a marked reduction in the metabolism of acetonitrile to cyanide. Cobalt heme did not affect the recovery of sodium cyanide from hepatocyte suspensions. Pretreatment of rats with acetone resulted in a twofold increase in the metabolism of acetonitrile to cyanide. Addition of acetone in vitro inhibited acetonitrile metabolism, with an IC50 of 319 microM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556839 TI - Testicular toxicity of N-methyltetrazolethiol cephalosporin analogs in the juvenile rat. AB - The testicular toxicity of 10 antibiotics was evaluated in juvenile rats. Three of the antibiotics, cefbuperazone, cefamandole, and cefoperazone, contain the N methyltetrazolethiol group as the 3-substituent; ampicillin, cefazolin, cephalothin, cefoxitin, piperacillin, and ceforanide do not contain this moiety. Testicular degeneration, partially irreversible in nature, was observed with those antibiotics which contain the N-methyltetrazolethiol substituent. Further, free N-methyltetrazolethiol also produced testicular degeneration in the juvenile rat. This substituent is most likely responsible for the testicular toxicity observed with cefbuperazone, cefamandole, and cefoperazone in the juvenile rat. The implications of these findings to man are undetermined. PMID- 3556840 TI - Behavioral medicine rounds: using a biopsychosocial approach for inpatient teaching. AB - The inpatient setting is commonly used to teach residents various aspects of the practice of medicine. This paper describes how inpatient teaching rounds can be expanded to teach the biopsychosocial approach to patient care. The background and early development, the structure of the teaching, and specific case examples of behavioral medicine rounds are described. PMID- 3556841 TI - Interviewing style and response to family information by family practice residents. AB - The visits of 50 new patients seeing 20 family practice residents were audiotaped. Analysis of transcripts of all conversation involving family-related content showed that the resident physicians used a high control interviewing style consisting mostly of closed-end questions and declarative statements. They rarely asked open-end questions. After eliciting family information, the residents missed numerous opportunities to express empathy or concern verbally. The physicians seldom connected family information obtained during the visit with the patient's ongoing or potential health problems. Of 12 patients reporting a life-threatening familial illness in a close relative, only one received any relevant patient education. The closed style of interviewing appeared to interfere with the physicians' gathering and responding to family information. PMID- 3556842 TI - Improving consistency in student evaluation at affiliated family practice centers. AB - The Department of Family Medicine at Jefferson Medical College has since 1974 been successful in administering a required third-year family medicine clerkship, providing students with a structured, didactic, and experiential curriculum in six affiliated family practice centers. Prior analysis (1976-1981) had indicated, however, that variation existed in evaluating similar students, depending on the clerkship training site, i.e., three sites graded students in a significantly different fashion than the three other sites. Utilizing these data to focus on the evaluation process, a comprehensive and specific six-point plan was developed to improve consistency in evaluations at the different training sites. This plan consisted of a yearly meeting of affiliate faculty, assigning predoctoral training administrative responsibility to one faculty member at each training site, increased telephone communication, affiliate-faculty attendance at the university site evaluation session, faculty rotation to spend time at other training sites, and financial reimbursement to the affiliate training sites. After intervention, analysis (1981-1983) indicated that five of the six clerkship sites now grade students in a consistent fashion, with only one affiliate using different grading standards. The intervention was therefore judged to be successful for five of the six training sites, allowing for better communication and more critical and consistent evaluation of medical students. PMID- 3556843 TI - A curriculum in sport psychology in a family medicine residency program. AB - A model curriculum for a sport psychology component to sports medicine training in a family practice residency program is presented. A rationale for its inclusion and examples of content are provided. It is suggested that such an emphasis helps fulfill the goals of family medicine within sports medicine. PMID- 3556845 TI - Family practice resident selection using a videotaped interview. AB - The selection interview is by its nature unstructured and likely to yield inconsistent information about candidates, whether for a job or a residency program. The selection interview is seen by some to be an unreliable tool for evaluation of residency candidates. This paper describes a structured, videotaped interview that was designed to increase the reliability of resident selection. The format was well received by faculty members and was found to contribute to highly accurate discrimination among residency candidates. The implications of using this type of interview for selection of family practice residents are discussed. PMID- 3556844 TI - Strategies for overcoming problems in implementing the obstetrics curriculum. AB - This paper describes several recurring problems in implementing the obstetrics curriculum for residents in family medicine. Four broad remedial goals are proposed: to reduce tension between departments of family medicine and of obstetrics-gynecology; to maintain a curriculum that has a balance between family centered obstetrics and high-risk obstetrics; to help residents make an informed decision about whether to practice obstetrics; and to train residents to do practice evaluation. Multiple strategies are proposed for accomplishing these goals. The paper concludes with the recommendation that a successful curriculum needs to be promoted by at least one enthusiastic faculty member. This person's role should include evaluating and updating the curriculum as well as anticipating and solving problems that interfere with the implementation of the curriculum. PMID- 3556846 TI - Sex differences in student preference for family medicine. AB - Differences between male and female students at the University of Washington School of Medicine in their choices of family medicine specialization were examined over a ten-year period. Specialty choices during the second year of medical school were compared to later residency selections. Women showed a significantly stronger early preference for family practice but were less likely to select a family medicine residency than their male counterparts. Although the magnitude of the differences was modest, the possible decline in interest among a group of students who intuitively seem particularly suited to this specialty appears worthy of note. Possible implications of these findings are discussed. PMID- 3556848 TI - Community based family medicine fellowships: a four-year experience. PMID- 3556847 TI - A model for evaluating the stressed patient in the family practice setting. AB - Family physicians frequently encounter patients with stress-induced medical and psychological problems. When the symptoms are severe, or the mechanisms are vague, it is often useful to perform a detailed medical, behavioral, and psychological evaluation in order to initiate effective therapy. This paper illustrates a model for evaluating stress-related and other psychosomatic problems in a family practice. PMID- 3556849 TI - Continuing education in nutrition for rural physicians. PMID- 3556851 TI - The art of straddling a three-sided fence. PMID- 3556850 TI - Our students need most what we do best. PMID- 3556852 TI - Focusing on differences makes identity fuzzy. PMID- 3556854 TI - Career guidance for medical students with an interest in family practice. PMID- 3556855 TI - Questionnaire instructions--does anybody read them? AB - In the absence of data useful to the design of instructions for self-administered questionnaires, a study was performed in a family practice clinic on people having their first complete physical there. Although 1,303 persons filled out a health questionnaire prior to their examination, only 36.5% gave evidence of having carefully read the brief instructions. Women did better than men and some occupational or educational subcategories were above this average, but no subgroup had a high enough response rate to warrant relying on the instructions for important information. In particular, there was no evidence that either those in poorer health or those completing a questionnaire for their young children were any more careful in reading the instructions. Those who design such self administered questionnaires are advised to make the form completion self-evident, rather than to rely upon introductory instructions to convey this information. PMID- 3556853 TI - Does the family physician's role correspond to the patient's expectations? AB - A telephone survey of Ohio residents was undertaken to measure how respondents rate 12 selected characteristics of physicians and medical practices when choosing a doctor. All parameters were found to be important, some more than others. "The doctor being able to explain things in an easily understood way" ranked first, followed closely by "being able to reach the doctor easily for emergencies," and "the doctor's fees being reasonable." The effect of several demographic characteristics of the 12 parameters was tested; only age of the respondent had a consistent impact. Factor analysis showed that the interests of potential patients centered primarily in the areas of interpersonal relations, continuity of care, access to services, and activities such as preventive care, all of which are highly valued by family medicine. PMID- 3556857 TI - Family practice in the tropics. AB - A one-week practice experience in a remote tropical rain forest area of Colombia is described. Frequency of diagnoses by ICD-9 category are compared between this practice setting and the author's university family medicine residency-based practice in Oklahoma. Implications of the similarities between the practices, as well as the differences, are discussed. PMID- 3556856 TI - Effects of training in patient education on attitudes and behaviors of family practice residents. AB - The attitudes of 24 family practice residents toward patient education and perceptions of their own efficacy as patient educators were measured before and after they underwent a special patient education training program. Their scores were compared to those of 34 family practice residents who did not have access to the program. Study group residents showed positive changes in attitudes, reported behaviors, and problems, while the comparison group showed no changes in any of the categories. The differences were statistically significant for the behaviors and problems but not for the attitudes data. PMID- 3556858 TI - Medical anthropology and the family physician. AB - As family physicians increasingly begin to practice in a variety of settings both in the U.S. and abroad, they are faced with the challenge of caring for patients from different ethnic and socioeconomic backgrounds. In particular it has been suggested that delivering effective and acceptable community oriented primary care requires a deeper understanding of the cultural background of patients, their families, and the social contexts in which they live. In this paper, the authors provide an introduction to the field of medical anthropology--the discipline which studies the cultural dimensions of health, illness, and the medical care system. The "anthropology of family medicine" (the theoretical focus) is distinguished from the "anthropology of family practice" (the applied focus), and contributions from medical anthropological research at the micro (practitioner-patient relationship), intermediate (family), and macro (community) levels of analysis are examined. In particular, three clinical case vignettes are presented which illustrate the ways in which cultural issues can become critical in the care of patients and their families. Finally, the activities of the STFM Task Force on Skills and Curriculum Development in Cross-Cultural Experiences are described, and future directions for research and teaching efforts are proposed. PMID- 3556859 TI - Working with one's own family: another path for professional development. AB - Unresolved issues related to the clinician-teacher's family of origin can interfere with working with families and teaching about family systems. For the past three years the author has been working on his own family issues through family therapy training, which challenged him to better differentiate from his family of origin. The therapy model, Bowen Family Systems Theory, asserts that personal changes are best made by altering emotion-based behavior patterns derived from prior generations of the family. Beginning to deal with personal family issues has helped the author teach residents and medical students more effectively and work better with patients and their families. PMID- 3556861 TI - Is there a public need? PMID- 3556860 TI - Physician-patient power struggles: their role in noncompliance. AB - Physicians have tended to label the patient who doesn't follow their advice as resistant and noncompliant. However, compliance studies have not identified the physician's sometimes unwitting complicity in the noncompliance. Some physician patient partnerships are marked by an intensifying power struggle which may have more to do with the emotional needs of each party than with the specific content around which the struggle is focused. This article discusses how these power struggles can be activated and what the physician can do to defuse the struggle and work effectively with noncompliant patients. PMID- 3556862 TI - Influenza vaccine--resident and faculty use. PMID- 3556864 TI - The family therapist and the family physician: a cooperative model. AB - This study discusses the current lack of cooperation between family physicians and family therapists and its roots in the different belief systems that influence each profession. Family medicine and family therapy have each, in different ways, espoused a reductionistic view of the systems model they each formally espouse. A model is proposed that enables each profession to work cooperatively with the other by recognizing the particular dysfunction present within the family. This model is explained and clarified in terms of the interaction of biomedical and developmental crises in the course of the normal family life cycle. The purpose of this model is to provide a framework through which the two professions of family medicine and family therapy can cooperate to treat the various kinds of levels of dysfunction that occur within families. PMID- 3556863 TI - Where is family medicine in medical education? PMID- 3556865 TI - A technique for measuring family physician priorities for patient care. AB - Family physicians frequently choose which elements of patient care to emphasize in order to balance the idealized principles of medical care with the real constraints of medical practice. Colleagues at several residency programs agreed to help us to find out if these choices can be quantified and whether personal characteristics of respondents or the acuteness or chronicity of the patient's illness influence these priorities. Two sets of 15 forced-choice item pairs, one set in reference to chronic illness and one set in reference to acute illness, were used in the study. Responses from 346 family physicians and non-physician colleagues ranked six hypothetical elements of patient care for acute and chronic illness: continuity, comprehensiveness, family orientation, community orientation, coordination and prevention. The data were analyzed using the psychometric scaling technique of paired comparisons. The analysis yielded a set of rankings which showed that these choices were quantifiable and made with a high degree of individual consistency and greater intragroup agreement than would result from chance. Patterns of choice differed for acute and chronic illness in a manner consistent with observed clinical practice. PMID- 3556866 TI - Integrating community oriented primary care into training and practice: a view from the Bronx. AB - Community oriented primary care (COPC) brings together the pragmatics of clinical practice with the population principles of epidemiology and public health. This article describes the efforts of the residency program in social medicine at Montefiore Medical Center to integrate COPC into the training of residents and medical students. There are four formal COPC curriculum components: the first year orientation, the core curriculum in social medicine, social medicine projects, and faculty and health center service projects. The obstacles to COPC training and practice and the lessons learned from implementation are described. PMID- 3556867 TI - Educational impact of a Family Practice Clinic Patient Medical Advisor Booklet. AB - The present study was conducted to test the efficacy of a new "Family Practice Clinic Patient Medical Advisor Booklet" developed by the author for patient education. Experimental group patients were given the booklet with a prepared 25 minute talk describing it. Two to four weeks later they were seen again to answer a health knowledge questionnaire. Control group patients were seen only once. At that time, the questionnaire was given without the preceding presentation. The interviewer then discussed incorrect answers with control group patients and distributed the booklet. Both groups were asked to evaluate the booklet by mail approximately one month after administration of the health knowledge questionnaire. The experimental group showed a statistically significant higher mean score on the health knowledge questionnaire. The experimental group answered 96.8% correctly, compared to 71.6% for the control group. In their responses to the mailed evaluation forms, both experimental and control groups thought the booklet was well written and useful in understanding and treating the illnesses described. PMID- 3556868 TI - Determinants of no-show appointment behavior: the utility of multivariate analysis. AB - A multitude of determinants have been identified as predictive of broken appointments. The majority of prior studies have been limited to univariate analysis of the relationship between predictors and appointment keeping behavior. The present report studied 25 independent predictors of no-show behavior using both univariate and multivariate analyses. A total of 579 kept appointments and 84 failed appointments were analyzed. Results of univariate analysis indicated the following significant relationships with appointment behavior: age, ethnicity, marital status, mode of payment, chronic illness, telephone in house, type of care, prior visits to center, cost of care, transportation to center, physician ethnicity, and linguistic capability. However, multiple logistic function analysis revealed only six significant associations: type of care, chronic illness, linguistic capability, mode of payment, physician-patient sex differences, and marital status of the patient. Multivariate analysis may yield a more accurate and clinically useful model of no-show behavior. For example, language barrier may be more of a problem than the race of the patient. Prospective studies might benefit from these considerations. PMID- 3556870 TI - "Routine" chemistry testing. AB - This study examines the use and results of a multichannel chemistry test (SMAC) in asymptomatic patients attending a family practice center. Of 288 patients, 71 (25%) presenting for complete physical examinations had apparently "routine" or baseline SMACs. Forty-three (61%) had at least one abnormal value in their chemistry profiles. Most abnormal results appeared to be of little clinical significance, but few were repeated or otherwise evaluated. Screening or baseline chemistry testing is a common feature of general health evaluations, but the efficacy of such studies is not clear. PMID- 3556869 TI - Primary care epidemiology: new uses of old tools. AB - The emergence of interest in community oriented primary care (COPC) has emphasized the need for applications of epidemiologic principles to the practice of primary health care. A recent report from the Institute of Medicine has demonstrated the feasibility of COPC in a variety of practice settings, and has recommended the development of simple and easily applied quantitative techniques to support this form of primary care. The purposes of primary care practice, research, and education would be well served by techniques that improve the physician's knowledge of the patient population. Epidemiology offers the fundamental principles and methods to support primary care, but these have been neither appropriately modified nor integrated into primary care practice. The potential benefits of and the requirements for an epidemiology for primary care are presented and discussed. PMID- 3556871 TI - Back to basics: a psychosocial primer. PMID- 3556872 TI - Medical student perceptions of family practice opportunities. AB - This study was conducted to obtain information concerning family practice opportunities in Chicago and to compare the actual availability with students' perceptions of such opportunities. Questionnaires received from 85 hospital administrators (98% response rate) indicated that 93% of the Chicago-area hospitals had open staff positions for family physicians. Comparison data were obtained from another questionnaire completed by 201 medical students (39%). The students' average estimate of the percentage of hospitals having positions available for family physicians was 45%. This suggested that the students greatly underestimated the availability of staff positions for family physicians. PMID- 3556873 TI - Physician teachers--present and future. PMID- 3556874 TI - Applying family medicine concepts to prescribing. PMID- 3556875 TI - Career guidance and promoting family practice. PMID- 3556876 TI - Characteristics and job satisfaction of family physicians in full-time teaching. AB - In January 1985, a questionnaire was sent to 986 family physicians teaching full time in 214 family medicine residency programs. The questionnaire was designed to explore the relationship between job satisfaction and specific demographic characteristics of respondents. This paper presents the analysis of the survey data and identifies areas that would benefit from further research. PMID- 3556877 TI - An anthropological approach to community diagnosis in family practice. AB - Developing a community oriented family practice requires gathering information about the community, its health problems and resources, and organizing these data into a community diagnosis. Viewing the community from both the insider and outsider perspectives allows the clinician to use social indicator data as well as subjective data from residents in the community. This paper describes the application of anthropological concepts in the process of community diagnosis within an urban teaching family practice. PMID- 3556878 TI - A model of computer documentation of hospital specialty rotations. AB - The importance of a comprehensive documentation system for assisting residents in securing hospital privileges has been widely asserted. Other applications of a documentation system such as encouraging research, providing individual resident evaluations, and providing program evaluation are also worthy reasons for developing a system. This paper describes a computerized system for documenting the inpatient rotation experiences of family practice residents and discusses its potential applications. An example of curriculum evaluation as a use of a documentation system is detailed. PMID- 3556879 TI - The effect of a required residency based student clerkship on resident selection. AB - Over the past decade, the Department of Family Medicine at Jefferson Medical College has used a network of seven residency-based family practice centers each year to teach 223 third-year medical students in their required family medicine clerkship. A comparison of these affiliated residency programs with a control group of the other family medicine residency programs in Pennsylvania and Delaware (with minimal third-year teaching responsibilities) from 1976 to 1984 has shown that the affiliated programs had a significantly higher National Residency Matching Program (NRMP) fill rate (92% v. 77%), had a higher percentage of programs with fill rates above the national average (71% v. 41%), and filled their full complement of residents more often (82% v. 52%) than the control programs. This success in residency recruitment was due in part to the fact that the affiliated programs filled one-third of their positions with Jefferson graduates, three times the percentage found in the control programs. For family medicine residency programs, teaching third-year medical students in a required clerkship offers a major opportunity to improve their residency selection results in the NRMP. PMID- 3556880 TI - The impact of a health screening flow sheet on the performance and documentation of health screening procedures. AB - We monitored physician performance of stool occult blood testing and breast exams during health maintenance visits of patients aged 50 or greater, to assess the impact of a physician education program and the use of a health screening flow sheet on performance of these health screening procedures. During the baseline study period, use of these procedures was documented for only about 40% of patients. A physician education program (conferences reviewing appropriate health maintenance screening procedures, and information on the use of a specific health screening flow sheet) did not significantly change the rate of documented physician performance of these procedures. After a health screening flow sheet was introduced into the medical record, the rate of documented performance of these screening tests increased. However, despite the presence of the screening flow sheet in the patient record, most screening evaluations were documented only in the progress notes. These results suggest that the screening flow sheet serves primarily as a memory prompting device. The usefulness of the flow sheet as a patient data storage device appears questionable. PMID- 3556881 TI - The effect of taking a sexual history on the notation of sexually related diagnoses. AB - Many patients have questions or concerns about sex, but few talk directly about the subject with their physician. Including a sexual history during the physician patient encounter is one way to indicate to the patient that discussing sexual concerns is appropriate. We observed that physicians at the University of Iowa Family Practice Center were divided into two groups: those who routinely include a sexual history with a new patient and those who do not. Those physicians who claimed to routinely take a sexual history reported 33.3% of their patients had some type of sexual question, concern, or problem; those who claimed they do not include such a history reported only 9.5% had a sexual concern (P less than 0.05). Female physicians were less apt to take a sexual history than male physicians (11.8% v. 60%; P less than 0.001). We conclude that education in sexual history taking is an important part of the family practice curriculum for resident training. PMID- 3556882 TI - Entry of U.S. medical school graduates into family practice residencies: 1983-84. AB - This study is the third of a series from the American Academy of Family Physicians to report on the percentage of each medical school's graduates who enter family practice residency programs. Approximately 12.5% of the 15,739 graduates of United States medical schools between July 1982 and June 1983 were residents in family practice in December 1983. The Mountain and Pacific regions report the highest percentage of medical school graduates who were residents in family practice programs in December 1983; the New England and Middle Atlantic regions had the lowest percentages. Medical school graduates from publicly funded medical schools were twice as likely to be residents in family practice in December 1983 as were graduates from privately funded schools. The independent variable indicated by the presence of a family practice department in the medical school is the only variable which entered into a step-wise linear regression on a transformation of the dependent variable, percentage of graduates entering an FP residency program. PMID- 3556883 TI - Family mediation: clinical strategies in mediating child custody. AB - Family medicine has only begun to explore the extent of its contribution to the process of family mediation--the clinical application of conflict resolution theory to the divorce process. This article reviews the literature on the impact of separation and divorce on families and recommends the use of family mediation as a clinical strategy to sensitize parents to the needs of the children during the divorcing process. Goals of family mediation include the assurance that the children have frequent and continuing contact with natural parents to the extent that this is to the benefit of the child. A specific model of family mediation is presented and the role of family physicians in the mediation is explored. PMID- 3556884 TI - Documenting resident experience. PMID- 3556885 TI - Temperament and stress factors predictive of choosing to leave after one year of residency. AB - First-year residents in two affiliated Southern California three-year family practice residency programs were studied prospectively. Those who chose to leave their program following completion of the first year were compared to those who stayed for the second year of residency on the basis of stress and personality factors. Results indicate that those who left their programs were more impulsive at baseline measures and increased their self-discipline during the year, while those who stayed were more self-disciplined at baseline and increased their impulsiveness during the year. Those who left were more socially active at the end of the year than those who stayed, and they experienced a significantly greater increase in acute anxiety by the end of the year. PMID- 3556886 TI - A profile of the urban family. AB - Very little research work has detailed the structure and function of inner city families. A retrospective demographic analysis of three distinct New York City community districts shows a broad spectrum of living arrangements within the city as well as within separate census tracts. Urban family physicians should be aware of these trends in order to improve their delivery of care and their understanding of family dynamics. PMID- 3556887 TI - A family practice learning resource center. PMID- 3556888 TI - Using graduate surveys to guide curricular reform. PMID- 3556889 TI - Creating geriatric fellowships. PMID- 3556890 TI - Diversity is needed in faculty structure. PMID- 3556891 TI - The subspecialization of family medicine. PMID- 3556892 TI - An application of the health belief model to patient education and compliance: acute otitis media. AB - This study made use of concepts from the health belief model to test the influence of educational intervention on patient attitude and subsequent sick role behavior. The hypothesis tested was as follows: Mothers of pediatric patients in an experimental group (N-29) receiving specially designed education about otitis media, would consequently acquire greater awareness of their children's susceptibility to the disease, the possibility of its serious effects, and the benefits of treatment than a comparable control group (N-30) not receiving the educational intervention. It was further hypothesized that patient compliance would be higher in the experimental group. Experimental group health beliefs changed in a significant, positive direction with respect to illness susceptibility and severity, the benefits of treatment, and patient modifying factors. Control group attitudes did not significantly change. Compliance rates for both groups were very high; 91.8% compliance was noted for experimental subjects and 85.6% for controls. This may reflect the additional time and attention given all those participating in the study. PMID- 3556893 TI - Assessing the impact of psychological intervention on family practice clinic visits. AB - The effects of brief psychological intervention on rates of medical utilization were investigated in a family practice clinic. Patients referred to the psychology service served as experimental subjects. These subjects underwent psychological assessment and treatment from supervised clinical psychology externs in joint working arrangements with family practice residents. Control subjects were other family practice patients, matching the experimental group in age, sex, and race. The number of medical visits to the family practice clinic, specialty clinics, and the emergency room were the dependent measures. The study period was two years. Results indicated that the experimental subjects were more likely than control subjects to decrease medical utilization of the family practice clinic. The findings are consistent with earlier work showing an association between brief psychosocial intervention and decreases in the frequency of clinic visits. However, this study suggests that preinternship-level clinical psychology trainees can be equally as effective in providing this intervention as mental health professionals who have completed their training. PMID- 3556894 TI - Simulated versus actual patients in teaching medical interviewing. AB - This research project investigates the value of using simulated v. real patients in teaching interviewing skills to third- and fourth-year medical students on a clerkship in family and community medicine. Sixty-four medical students (38 males, 28 females) were asked to make a videotaped patient interview at the beginning of the clerkship. Forty-one of the students interviewed trained, simulated patients and 22 interviewed real patients at their clerkship site. Students received feedback and faculty teaching of interviewing skills after the first interview. All students made another videotaped interview with a simulated patient at the conclusion of the clerkship. All interviews, pre- and post clerkship, were scored for interviewing skills, focal areas, and nonverbal language. Multivariate and univariate analyses of pre- and post-interviews found simulated patients to be of most value in teaching medical students verbal interviewing skills and real patients to be of most value in teaching the focal content areas of the interview. Recommendations were made to include use of both simulated and real patients in the teaching of medical interviewing. PMID- 3556895 TI - Structuring a home visit program for residents. AB - Home assessment visits in which a family practice resident accompanied by a social worker and a specially trained nurse go to a patient's home have been a part of the curriculum for three years. A specific format has been developed for these visits. The trainees' initial positive views about home assessment visits were maintained after the visits with improved understanding of the impact of environmental, familial, and social factors on patient health. The efforts and effects of the nonphysician health care providers in home visits were clarified. Clearly, residents can appreciate and benefit from a well-structured home visit program. PMID- 3556896 TI - Research funding for family medicine: dilemmas and options. PMID- 3556897 TI - Naturalistic inquiry: an appropriate model for family medicine. AB - Family medicine's stated philosophy is consistent with the philosophical basis of naturalistic inquiry, a research paradigm from the social sciences. However, the majority of published family medicine research more nearly resembles traditional biomedical research, here termed rationalistic inquiry. Adding naturalistic inquiry to family medicine's research armamentarium would be consistent with the specialty's stated philosophy and would foster investigation in areas not well addressed by the traditional biomedical approach. PMID- 3556898 TI - Patient, family, physician: agreement, disagreement, and resolution. AB - This paper examines the role of the family in moral decision making with critically ill patients. It offers a case for consideration and examines the issues concentrating on questions of autonomy, the family's role in decision making with autonomous patients, the special duty which patient helplessness confers on the physician, the role of empathy and courage in the physician's moral agency. It uses these issues to offer a possible resolution. PMID- 3556899 TI - Academic departments of family medicine: a retrospective and a prospective view. PMID- 3556901 TI - A pharmacy fellowship in a family practice training program. AB - An evaluation of the two-year experience since the institution of the postdoctoral pharmacy fellowship in family practice has revealed the program to be a valuable one not only for the fellows completing the program but to the departments cosponsoring this experimental training program. The two individuals who have completed the program have gone to clinical practice positions. In both academic and hospital settings, the fellow gains an understanding of the philosophical basis of family medicine while at the same time gaining specialized experience in an area of interest as well as research design and implementation. The department of family practice has benefited by the provision of additional clinical pharmacy services and education. It has also enabled the department to expand its involvement in research activities. PMID- 3556900 TI - Rites of spring for medicine: discontent, discontinuity, and discovery. PMID- 3556902 TI - Teaching practice management: a simulated production report. PMID- 3556903 TI - [Heat transfer by the blood]. PMID- 3556904 TI - [Reference values for the blood lipids of healthy subjects]. PMID- 3556905 TI - [Autonomic reactions of humans to different exposures to hot and cold in a sauna]. PMID- 3556907 TI - [Interaction of mechanisms facilitating and limiting voluntary reduction of pulmonary ventilation during muscular work]. PMID- 3556906 TI - [Factor structure of the basic parameters of the EEG during intellectual activity. II. Topography of functional states]. PMID- 3556908 TI - [Mobilization of physiologic reserves during intense muscular activity]. PMID- 3556909 TI - [Energy expenditure during human walking and running (meta-analysis)]. PMID- 3556910 TI - [Dynamics of bioenergetic indices during hypercapnia]. PMID- 3556911 TI - [Development of hemodynamic shifts during arterial hypertension]. PMID- 3556912 TI - [Concentration of cortisol, somatotropin, urea and triglycerides in the blood during extremely long competitive stress]. PMID- 3556913 TI - [Concentration of calcium ions in the blood and temperature sensitivity in normal circumstances and during the body's adaptation to cold]. PMID- 3556914 TI - [Changes in various indices of physical work capacity on a low-calorie diet]. PMID- 3556915 TI - [A 2-compartment model of the regulation of pain sensitivity during stimulation of sensory structures]. PMID- 3556916 TI - [Psychological characteristics of perception during polarization of the occipital and frontal areas of the cortex]. PMID- 3556917 TI - [Temporal characteristics of visual perception]. PMID- 3556918 TI - [Frequency resolving capacity of human hearing]. PMID- 3556919 TI - [Effect of different frequencies of photostimulation on the dynamics of interhemispheric relations]. PMID- 3556920 TI - [Rhythmic activity of neuronal populations of the human brain]. PMID- 3556921 TI - [Experience with the use of a complex method of correcting the psychophysiologic state of humans working with constant visual strain]. PMID- 3556922 TI - [Role of active rest in accelerating restoration of acid-base balance and external respiratory functions in fatigue]. PMID- 3556923 TI - [Responses of the respiratory system to hypoxic and hypercapnic stimuli during human adaptation to high altitude conditions]. PMID- 3556924 TI - [Age and features of the inotropic function of the myocardium of healthy 30-59 year-old men with different subendocardial blood flow efficiencies]. PMID- 3556925 TI - [Age and changes in the regional blood flow of the gastric and duodenal mucosae]. PMID- 3556926 TI - [Age and features of the interaction of mechanisms regulating heart rate and external respiration in coal miners]. PMID- 3556927 TI - [Relation between changes in arterial pressure and the character of mental activity during emotional stress]. PMID- 3556929 TI - [Role of the original state of physiologic functions in reactions to a physical load]. PMID- 3556928 TI - [Mechanism of voluntary and involuntary human activity in extreme circumstances]. PMID- 3556931 TI - [Clinical applicability of myocardial scintigraphy with gallium-67 in the study of dilated cardiomyopathy]. AB - Gallium-67-citrate imaging has been recently proposed, in addition to endocardial biopsy, to detect myocardial inflammation in idiopathic dilated cardiomyopathy (IDCM). In order to evaluate the clinical usefulness of this method, 33 patients (pts) suffering from IDCM, 24 pts with various other cardiac diseases (inflammatory etiology in 7), and 11 controls underwent Gallium-67 scintigraphy (anterior and 30 degrees left anterior oblique projections; acquisition at 48 and 72 hrs). In 31 pts repeated scintigraphic examinations (at least two) were obtained. Scans were interpreted by two independent observers. Positivity of scintigrams was based on three different criteria: 1) myocardial activity greater than that of the sternum; 2) presence of focal myocardial activity; 3) semiquantitative index (index = activity of sternum/myocardial activity). Significant differences, either in the percentage of positive scans or in the values of the semiquantitative index, were found between controls and all pts with cardiac diseases. However, no difference was observed when comparing pts with IDCM to pts with other cardiac diseases. Finally, among the pts with cardiac disorders other than IDCM, the qualitative and semiquantitative results of the 7 pts with inflammatory etiology of the disease were similar to those obtained in the remaining 17. Of those pts who underwent longitudinal study, about a third showed modified scintigraphic results later on. No significant difference in behaviour was observed between IDCM and other cardiac disorders. Therefore, we conclude that Gallium 67-citrate imaging does not appear to be a suitable method for the identification of pts. with IDCM. The usefulness of this technique should be tested in samples of pts should previously selected with other more specific methods. PMID- 3556930 TI - [Functional evaluation of the autonomic regulation in mitral valve prolapse]. AB - We examined fifty patients aged from 15 to 35 years, mean 23 +/- 5, with mitral valve prolapse (MVP) documented by two-dimensional echocardiography in the apical 4-chamber view as well as in the parasternal-long axis. The patients have been submitted to 4 tests: Valsalva maneuver, standing and exercise test and 24 hours ambulatory ECG monitoring. Fourty-five healthy subjects of similar age and sex served as controls. During the standing test the patients with MVP showed a significantly faster heart rate than the control subjects both in resting and in the standing position; during the exercise test they exhibited higher prevalence of ST segment and T wave abnormalities disappearing at the peak of the exercise. These observations support the hypothesis of a hyperadrenergic state. The greater bradycardia showed during the Valsalva maneuver, the lower heart rate and the higher incidence of bradyarrhythmias and A-V blocks during the sleeping period suggest an increased vagal tone. Our results suggest therefore that in subjects with MVP a dysfunction of both, sympathetic and parasympathetic nervous system is present. PMID- 3556932 TI - [Specific extranodal sinoatrial muscle cells in the crista terminalis. Cyto morphometric study and anatomoclinical considerations]. AB - To assess the occurrence, location and structure of specialized pacemaker slender cells, beyond the conventional anatomic boundaries of the sinoatrial node, cyto morphometric evaluations were made in specimens from 10 human hearts. The morphometric analysis showed significant histocytological peculiarities of extranodal slender cells, which presented 60% to 70% smaller than those of the ordinary atrial muscle; their preferential location was at a mean distance of 12 to 14 mm from the posterior tip of the sinoatrial node, beneath the crista terminalis. These morphologic data were taken into consideration with regard to electrophysiologic recording of shifts in pacemaking, within and around the sinoatrial node. It was also remarked that the presence and action of extranodal specialized cells along the crista terminalis are consistent with clinical and pathologic evidence obtained from human cases of sick sinus syndrome, as well as from animal experiments at sinoatrial node damage. PMID- 3556933 TI - [Electrocardiographic diagnosis of supraventricular paroxysmal tachyarrhythmias with short QRS complexes. Recent findings]. PMID- 3556934 TI - [Primary heart arrest during dynamic ECG in the myocardial infarct patient during convalescence. Contribution of 4 cases]. AB - Four cases of cardiac arrest occurred during Holter monitoring are described. All patients had sustained an acute myocardial infarction thirteen-fourteen days prior to recording and were fully mobilized. In all of them the fatal arrhythmic event was ventricular fibrillation (VF). ECG analysis revealed an increase in heart rate before initiation of VF in one patient only. Warning ventricular arrhythmias were present in two patients. Transient ST segment changes during monitoring were noted in all patients. In three cases the arrhythmia was initiated by an ectopic ventricular beat (EVB) with R-on-T phenomenon; in two of them the EVB occurred after a sinus beat following a long post-ectopic pause. The different electrical events able to induce VF showed a variable and unpredictable pattern of occurrence and association in different patients and at different times in the same patient. Therefore, no specific "trigger" of the fatal arrhythmia could be identified. PMID- 3556935 TI - [Possible danger of rapid intravenous amiodarone in re-entry tachycardia in subjects with Wolff-Parkinson-White syndrome]. AB - In order to control a re-entrant tachycardia in a patient with Wolff-Parkinson White syndrome, intravenous Amiodarone (5 mg/Kg per min.) was administered. The drug caused a blood pressure fall, a sympathetic drive and an increase of frequency up to a value of 187/min. An atrial fibrillation with rapid ventricular response in pattern of pseudo-ventricular tachycardia intervened by conduction on accessory pathway. In order to avoid the risk of ventricular fibrillation it is suggested to be wary in the use of rapid intravenous Amiodarone when associated with Wolff-Parkinson-White syndrome. PMID- 3556936 TI - [Hypertrophic cardiomyopathy and juvenile sudden death. A clinical case and re evaluation of the problem]. AB - A 29-year-old man with non-familiar hypertrophic cardiomyopathy died suddenly. The patient experienced recurrent episodes of palpitation both at rest and during exercise. M-mode and 2-D echocardiograms showed severe asymmetric septal hypertrophy (IVS/LVPW ratio 3:1) and systolic anterior motion of anterior leaflet of the mitral valve. The ECG demonstrated deep "Q" waves from the inferior leads and inverted "T" waves in V1 to V6, but failed to register arrhythmias. Holter monitoring had been planned in order to achieve information for pharmacologic therapy, but unfortunately the patient died during the stand-by. Postmortem examination showed severe asymmetric septal hypertrophy with fibrosis and wide spread "myocardial disarray". PMID- 3556937 TI - [The electrocardiogram in dilated cardiomyopathy]. AB - The electrocardiogram (ECG) of 80 patients with dilated cardiomyopathy was studied. An abnormal ECG was present in 100% of our patients, and in 25% it was the first sign of the disease. Thirty-eight cases (47.5%) showed left atrial enlargement, 22 (27.5%) prolonged PR interval, 33 (41.2%) left bundle branch block, 15 (18.7%) abnormal Q waves, 9 (11.2%) primary S-T and T changes. There were significant differences in ejection fraction and in left ventricular end diastolic volume between patients with right bundle branch block (p less than 0.05 and p = 0.05 respectively). Patients were followed for a period of 29.5 +/- 28.8 months (min. 2 days, max. 10 years): during the observation period the ECG showed in 28 cases an increasing left ventricular conduction delay and a leftward shifting of mean QRS axis. Patients with left ventricular conduction delays showed a worse prognosis. ECG in dilated cardiomyopathy is a nonspecific but sensitive tool, which may be related to different degrees of myocardial impairment and may be useful in the definition of a prognostic profile. PMID- 3556938 TI - [Behavior of blood ferritin in acute myocardial infarct]. AB - Ferritin (F) is an iron-protein (molecular weight 445.000) present in various organs including the heart. Using the immunoenzymatic method (Ferrizyme Abbott), ferritinemia (Fe) was determined daily in 28 patients with acute myocardial infarction (AMI). A significant rise was revealed, already evident in the first few days 8-9 after with Fe gradually returns to baseline levels. The results have shown that this pattern is not evident in patients with angina, heart failure, valve defects, pericarditis or cor pulmonale and may thus be considered a reliable, if not early, marker of myocardial cytolysis. In those cases studied no correlations were observed between CPK and Fe peak or between these and clinical intensity of AMI. PMID- 3556940 TI - [Clinical and angiocardiographic observations on the so-called absence of a branch of the pulmonary artery]. AB - We present 5 cases with angiographically absent pulmonary artery: 4 with absence of right pulmonary artery and 1 with absence of the left. We excluded cases of atresia of pulmonary artery, ventricular septal defect and major aorto-pulmonary collaterals. We excluded also cases of anomalous origin of a pulmonary artery from the aorta. Surgical inspection in 3 patients demonstrated total absence of pulmonary main branch (1 case), with intraoperative death, and presence of the hilar portion of the pulmonary artery (2 cases), with successful palliative procedure. It is supportive of efforts to identify as early in life as is feasible the absent vessel, for surgical purposes. In fact the early surgical procedure will ensure development of the vessel and normal lung growth, and will decrease the risk of the following intracardiac repair, when needful. PMID- 3556939 TI - [Circadian and ultradian rhythms of the heart rate in the neonate]. AB - Few papers deal with the chronobiologic characteristics of heart rate in neonates. A better knowledge of this topic could be useful under both clinical and therapeutical point of view. We studied the circadian and ultradian rhythms of heart rate in 10 healthy neonates (5 males and 5 females). Six of them (60%) show a well defined circadian rhythm of heart rate such as adult subjects even if with an obviously higher mesor and with acrophases dispersed throughout the 24 hours. We also demonstrated one or more ultradian rhythms of heart rate for each neonate. The most frequent have a period between 4 hours and 6 minutes and 4 hours and 36 minutes. These rhythms are out of phase with the world outside which is the best evidence that they are not imposed by some undetected external factors. PMID- 3556941 TI - [Beneficial effects of diltiazem in exertion stable angina. Evaluation of coronary hemodynamics during cardiac pacing]. AB - We evaluated the protective effect of Diltiazem from pacing-induced myocardial ischemia in 9 patients (pts) with coronary heart disease (CAD) and stable effort angina by studying the changes in systemic and coronary hemodynamics during pacing. Hemodynamic parameters were evaluated at baseline and at peak pacing before and after Diltiazem, 25 mg i.v. Diltiazem prevented angina in 6 of 7 pts who presented angina in the control pacing. This beneficial effect was accompanied at peak pacing rate by a significant fall in ST depression, arterial pressure, rate-pressure product and left ventricular (LV) end-diastolic pressure, while no significant changes were observed in LV dp/dt max, coronary blood flow and coronary vascular resistance. Therefore, Diltiazem exerts a protective effect from pacing-induced myocardial ischemia in pts with CAD and stable effort angina, without impairing LV function. This beneficial effect is due to a reduction in myocardial metabolic requirements, rather than to an improvement of blood supply to the ischemic myocardium. PMID- 3556942 TI - [Tolerance to nitrates]. PMID- 3556943 TI - [New criteria of positivity of the ergometry test in coronary insufficiency (round table)]. PMID- 3556944 TI - [Torsade de pointes caused by tricyclic antidepressive agents. Description of a clinical case]. AB - Tricyclic antidepressant drugs are known to cause often electrocardiographic abnormalities and to induce sometimes cardiac rhythm disturbances. We report a case of a patient on antidepressant therapy (Desipramine Hydrochloride, 50 mg/die, and Dothiepin Hydrochloride, 150 mg/die), without any underlaying heart disease, admitted to our Coronary Care Unit for recurrent syncopal episodes. An ECG on admission showed Sinus Tachycardia with Ectopic Ventricular Beats and recurrent runs of Torsade de Pointes, a distinctive form of Ventricular Tachycardia. Lignocaine i.v. was only transiently effective. Both Isoprenaline and Atropine Sulphate i.v. were uneffective. Ventricular Fibrillation occurred and cardioversion was achieved by a single DC shock. Amiodarone i.v. and electrical overdrive only temporarily suppressed ventricular arrhythmias. Magnesium Sulphate i.v. (bolus + infusion) induced a definitive suppression of Torsades de Pointes. One day later no more arrhythmias were present. PMID- 3556945 TI - [A case of torsade de pointes caused by hypomagnesemia]. AB - The author reports a case of a patient who had serious arrhythmia of the kind Torsade de pointes with hypomagnesemia as the only a abnormal parameter. This confirms previous reports and propose again a ion often forgotten in medical practice. PMID- 3556947 TI - [The physician confronting the risks of nuclear war]. PMID- 3556946 TI - [Normal behavior during the exercise test of the left ventricular ejection fraction determined by an angioscintigraphic method]. AB - The correct definition of left ventricular ejection fraction (LVEF) normal response to exercise is still debated. The lack of unanimous agreement firstly depends on the different normality criteria adopted in literature. In order to make ligh, we carefully reviewed several papers on this matter, and performed exercise radionuclide angiography (RNA), by multiple gated blood pool, in 2 different populations. I group: 39 normal subjects, selected on the basis of normal clinical examinations, ECG, X-ray film, exercise test, at rest LVEF greater than 50%: 20 males, mean age 43 +/- 13%. II group: 22 patients, abnormal from the clinical point of view, but elsewhere included in control groups: 13 males, mean age 54 +/- 9%. 14 of them refer only atypical chest pain, in 5 the sole abnormal finding is an exercise-induced ST depression greater than 1 mm, in 2 a left bundle branch block at rest, 1 patient suffers from X syndrome. Symptom limited exercise RNA was carried out by adopting a semi supine (40 degrees) cycloergometer, with a 25 watt initial workload and 25 watt subsequent increases every 3 minutes; count acquisition lasted 2 minutes, from the end of the 1st to the end of the 3rd, during each stage of the test. RESULTS: I group: constant LVEF increment during exercise in all subjects: mean LVEF at rest was 65 +/- 8%, at maximum workload 80 +/- 8%: mean increase was 15 +/- 7%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556948 TI - [Sources of infection in dermatophytosis. Study of soils, animals and man]. PMID- 3556949 TI - [Levels of cerebral dopamine during the climacteric in the rat]. PMID- 3556952 TI - [The horizon of the new cancer therapy]. PMID- 3556950 TI - [Scientific bases for multidiscipline cancer treatment]. PMID- 3556953 TI - [Do Mallory bodies have a prognostic value in patients with alcoholic cirrhosis treated by portal disconnection of the esophagus with a clip for rupture of esophageal varices?]. PMID- 3556954 TI - [Diffuse nodular regenerative hyperplasia of the liver and disseminated lupus erythematosus]. PMID- 3556955 TI - [Focal nodular hyperplasia of the liver and testicular choriocarcinoma]. PMID- 3556956 TI - [Ambulatory recording of esophageal pH over a 24-hour period in a population of 27 control subjects: analysis of technical and methodological factors influencing results]. AB - Twenty-four hour pH monitoring is used increasingly as a technique for diagnosis of gastro-esophageal reflux (GER). The Synectics recording apparatus (Stockholm, Sweden) was used in 27 ambulatory control subjects in order to: identify the variations of the data-dependent factors (electrodes, buffer solutions, calibration, placement of esophageal electrode). The consequences of these variations were evaluated by studying the measurement deflection after 24 h, baseline variations, and a comparative double pH esophageal recording with reference equipment for 3 h postprandial; to provide normal values for several parameters of GER measurement under the conditions of this study (total number of reflux, number of reflux episodes longer than 5 min, duration of the longest reflux, percentage of time during which pH was less than 4.0). Important interindividual variations were observed. When interpreting the results provided by this type of apparatus, one should take into account these large variations due, first, to the technique used and second, to the conditions of ambulatory recording. PMID- 3556957 TI - [Attempt at preventive treatment of esophagitis caused by intubation during intensive care]. AB - A randomized prospective trial was designed to evaluate the preventive treatment of esophagitis in 31 intensive care patients who had a nasogastric feeding tube for at least 10 days. Fourteen patients (group B) received no preventive treatment while 17 patients (group A) received 300 mg of cimetidine every 6 h intravenously and 11 g of colloidal aluminium phosphate every 4 h per os. All patients were fed a standard diet through their nasogastric tube at a constant rate of 30 Kcal/kg/day. Endoscopic controls at day 1 and 10 showed that the number of initial and final esophagitis was not different in groups B and A: 7 and 8 at day 1, 11 and 10 at day 10, respectively. The inefficiency of this preventive treatment suggested that acid gastroesophageal reflux is not a major factor in the occurrence of nasogastric feeding tube-induced esophagitis. However as esophagitis is associated with a more severe Knaus index and a greater number of gastric stress ulcer risk factors, it is suggested that decreased defense of the mucosa may be a key factor in the occurrence of this type of esophagitis. PMID- 3556958 TI - [Cancer of the rectum: surgical alternatives to abdominoperineal amputation]. PMID- 3556959 TI - [Morphology and function of the esophagus after sclerotherapy of esophageal varices in cirrhotic patients]. AB - To assess the effects of endoscopic variceal sclerotherapy on esophageal symptoms and function, we prospectively studied 24 consecutive cirrhotic patients (group I), 60 days after variceal eradication had been achieved. Nine cirrhotics with varices (group II) and 16 normal volunteers (group III) were control groups. After sclerotherapy, 9 patients had persistent dysphagia and two others had heartburn. Nine patients developed an esophageal stricture, without dysphagia in 2 cases. Distal esophageal scars were observed in 8 out of 9 patients with stricture and 2 out of 15 patients without stricture. The percentage of patients with abnormal peristaltic waves (abnormal pattern, non propulsive contractions, respectively) was significantly (p less than 0.01) more important in group I (83 p. 100, 96 p. 100) than in group II (22 p. 100, 22 p. 100). A very particular manometric "en plateau" waveform pattern, never seen before, was observed in 75 p. 100 of patients in group I. Relaxation of lower esophageal sphincter (LES) was significantly (p less than 0.01) lower in patients with stricture (38 p. 100 median) than in the others (71 p. 100 median). Motility disturbances were observed in the 6 +/- 3 last centimeters of the esophagus, and were unchanged 9 months later in 5 patients who had further examination. The percentage of time below pH 4 and the Kaye's score did not differ between group I (n = 17) and group III on 3 hours postprandial esophageal pH monitoring. The percentage of time at pH less than 4 was more than 9 p. 100 in 31 p. 100 of group I patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556960 TI - [Hepatotoxicity of drugs. A data bank of hepatic involvement and responsible drugs]. PMID- 3556962 TI - [21st meeting of the French Association for the Study of the Liver. Paris, France, 28 November 1986. Abstracts]. PMID- 3556961 TI - [Evaluation by endoscopic biopsies, of the histological criteria of reflux esophagitis]. AB - Histologic criteria of esophagitis and/or gastroesophageal reflux have been described in suction biopsy specimens which are easy to orient for perpendicular section of the mucosal surface. The aim of this study was to reassess the currently accepted criteria in guided endoscopic pinch biopsy specimens obtained from esophageal erosions. Epithelium of each sample was stained by Lugol's solution in order to be able to spread the specimen out flat and orient it before fixation. Of 92 biopsies nine were composed of granulation tissue and were excluded from the study. Of the remaining 83 biopsy specimens, 74 (89.2 p. 100) from 66 patients were properly oriented. Of these 74.65 (87.8 p. 100) from 57 patients contained lamina propria. Combination of the 2 epithelial criteria, i.e. papillary height and basal cell zone thickness greater than 50 p. 100 and 14 p. 100 of total epithelial thickness, respectively, were recorded in only 58 p. 100 of 66 patients. Nevertheless, the mean papillary height and the mean basal cell layer thickness were 64 p. 100 and 19 p. 100 of total epithelial thickness, respectively. Infiltration of the lamina propria by neutrophilic and/or eosinophilic granulocytes were recorded in 32 of 57 patients (56 p. 100) and only in 48 p. 100 of biopsy specimens which did not display any epithelial defect. Combination of pathologic changes in epithelium and lamina propria were observed in only 32 p. 100 of the patients and were not more frequent than expected on the basis of a chance association. We conclude that histologic criteria have a low sensitivity even in patients with erosive esophagitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3556963 TI - [Response to hepatic intra-arterial chemotherapy for metastases of colorectal cancer. Anatomo-pathological evaluation apropos of 3 cases of secondary hepatic excision]. AB - Following intra-arterial chemotherapy (5-fluorouracil), wide hepatic resection was performed in three patients with metastases from colorectal cancer. These surgical procedures had been considered to be unfeasible before chemotherapy in two of the three cases because of the extension of the metastases. In contrast to the results of preoperative imaging techniques (CT scan, ultrasonography), the histologic response of tumors to chemotherapy was found to be significant (1/3) or complete (2/3). Since after chemotherapy these imaging procedures are unable to determine whether the observed lesions are tumoral, fibrotic or necrotic, a laparotomy after hepatic intra-arterial chemotherapy is proposed to obtain specimens for histopathologic examination and an assessment of resectability. This procedure should be reserved for patients in whom substantial benefit can be expected considering the extension of primary and metastatic disease. PMID- 3556964 TI - [Hepatic involvement in secondary syphilis]. AB - A case of secondary syphilitic hepatitis is reported. A 49-year old woman was admitted for weight-loss, fever, hepatomegaly and splenomegaly. Diagnosis of syphilitic hepatitis was based on cholestasis associated with positive serologic tests for syphilis without other immunological disturbances. Biopsy of the liver showed a moderate infiltration in and around the portal tracts. Immunofluorescence study for treponema was negative. Rapid improvement was obtained with penicillin initially associated with steroid therapy. Liver involvement in secondary syphilis is characterized by anicteric cholestasis, an inflammatory syndrome, and periportal infiltrate inconstantly associated with centrilobular necrosis, granulomatous reaction and presence of treponemas in the lesions. Due to the increasing frequency of sexually transmitted diseases, this diagnosis could become more frequent. PMID- 3556965 TI - Rectovaginal fistula following fecal impaction. PMID- 3556967 TI - [22d forum on hepato-gastroenterology research. 11th French-language seminar on hepatology and gastroenterology. 5th national continuing education seminar on hepato-gastroenterology. Paris, 28 February-4 March 1987. Abstracts]. PMID- 3556966 TI - [Ingestion of tiaprofenic acid (Surgam) associated with an outbreak of acute pancreatitis]. PMID- 3556969 TI - Base line tenting: a sign of duodenal ulcer disease. AB - Indirect signs such as clover-leaf deformity, pseudodiverticulum formation, eccentric location of pyloric channel, and flattening of the fornix are of considerable value in the radiologic detection of an ulcer crater. We have found another indirect sign, base line tenting (BLT) to be very useful in the detection and diagnosis of duodenal ulcer disease. This is characterized by interruption of the base line of the bulb, with 2 associated perpendicular lines extending from the base and converging to a point in the duodenal bulb. After we observed this sign in various patients with peptic ulcer disease, a prospective investigation was performed involving 62 patients with duodenal ulcer disease over a period of 2 years. We found the BLT sign in 52 (83.8%). To date, no false-positive incidence has been identified. We concluded that BLT is a most valuable sign in the radiologic identification of duodenal ulcer disease. PMID- 3556968 TI - Gastric duplication cyst: GI series and CT correlation. AB - The radiographic and computed tomographic findings of a communicating gastric duplication first diagnosed in a 55-year-old man are presented and the pertinent literature is reviewed. PMID- 3556970 TI - Perirenal fluid collection complicating chronic pancreatitis: CT demonstration. AB - Extrapancreatic fluid collections are a well-known complication of pancreatitis and may occur in unusual locations. Involvement of the left perirenal space is uncommon and has not yet been documented by computed tomography. One surgically proven case is described and pertinent radiologic findings are described. PMID- 3556972 TI - Pararenal pseudotumors of the diaphragm: computed tomographic features. AB - Two cases of diaphragmatic pseudotumors in the right posterolateral pararenal space are reported to highlight their unusual location and their confusing computed tomographic pattern. PMID- 3556971 TI - Pancreatic lesions and transfascial perirenal spread: computed tomographic demonstration. AB - Computed tomographic (CT) findings in 105 cases of pancreatitis and 107 cases of pancreatic carcinoma were analyzed retrospectively to determine the occurrence and roentgenologic signs of penetration of the anterior renal fascial planes in relation to clinical symptoms. In pancreatitis, the perirenal fat was infiltrated in 7% to variable extents by extrapancreatic fluid collections, either as asymptomatic fluid lying alongside renal fascial planes and perirenal septa (5 cases) or as well-circumscribed fluid collections causing clinical symptoms (2 cases). In pancreatic carcinoma the occurrence of retropancreatic extension to a perirenal space was rarer (3%). Distinction on CT between perirenal involvement from the pancreas and primary adrenal or renal lesions with anterior spread can prevent unnecessary surgery. PMID- 3556973 TI - Interhepatic duct: a new biliary anomaly. AB - True accessory bile ducts occur in only 1% of patients. An accessory bile duct connecting the right and left hepatic ducts at the porta hepatis is described. This anomaly has never been reported previously, and was clinically significant in the presence of partial obstruction of an anomalous right hepatic duct by stones. The embryologic origin of this duct, which we term an "interhepatic duct," is uncertain. PMID- 3556974 TI - Percutaneous transhepatic biliary endoscopic procedures. AB - Two cases are presented to demonstrate the acceptability of the percutaneous route for performing endoscopic procedures in the biliary tree. They involved debridement of an atypical villoglandular polyp and ultrasonic lithotripsy of intrahepatic stones. Both cases serve to introduce percutaneous biliary endoscopy as a viable alternative for diagnosis and therapy in selected cases. PMID- 3556975 TI - Calcified gallstone fissures: the reversed Mercedes Benz sign. AB - This article describes the occurrence of an unusual radiating pattern of calcification in the center of large radiolucent gallstones. The radiographic findings are attributed to calcium deposition within the fissures of biliary calculi. PMID- 3556976 TI - Computed tomography of xanthogranulomatous cholecystitis. AB - A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallbladder on computed tomography. The large, infiltrating mass satisfied the criteria for massive carcinoma of the gallbladder. PMID- 3556977 TI - CT abnormalities in right lower quadrant inflammatory disease: review of findings in 26 adults. AB - Abnormal abdominal computed tomographic (CT) examinations, performed on 26 adults who presented with clinical evidence of right lower quadrant inflammatory disease, were retrospectively studied. Final diagnoses, established surgically in each case, included complicated appendicitis (15 patients), diverticulitis of the ileum or right colon (4), previously undiagnosed Crohn's disease (3), perforated cecal neoplasm (2), right tuboovarian abscess (1), and paracolic abscess of unknown cause (1). The CT features in each diagnostic group are presented in detail. Solid or ring calcification within a pericecal inflammatory mass was specific for appendicitis, occurring in 40% of the 15 patients. Without calcification, the differentiation of complicated appendicitis from Crohn's disease or diverticulitis, based on CT features alone, may be difficult in some cases. PMID- 3556978 TI - CT-guided percutaneous catheter cecostomy. AB - A patient with pseudomembranous colitis is described in whom a percutaneous cecostomy was performed using computed tomographic guidance. Several lines of evidence indicate the safety of this approach, and clinical circumstances are suggested in which the procedure may have potential therapeutic benefit. PMID- 3556979 TI - Computed tomographic demonstration of intramural colonic air (pneumatosis coli) as a feature of severe ulcerative colitis. AB - Fast rotational computed tomographic scanning techniques allow an accurate appreciation of the diameter of the colon, the presence of severe necrotizing mucosal change, and the detection of unsuspected intramural colonic air (pneumatosis coli) in cases of severe necrotizing ulcerative colitis. PMID- 3556981 TI - Limiting overhead views in double-contrast colon examinations does not affect diagnostic accuracy. AB - A prospective study was undertaken to evaluate whether reducing overhead (technician-performed) films in double-contrast colon examinations had any effect on diagnostic accuracy. Only 4 overhead films were obtained routinely: supine, both decubitus, and prone cross-table rectal views. A high detect rate was maintained, comparable to our accuracy when 7 or 8 overhead films were obtained. Our study confirms that with double-contrast colon examinations, the need for overhead films is diminished. A significant decrease in cost, radiation exposure, and examination time can be obtained. We continued to use this method without any noticeable decrease in diagnostic accuracy. PMID- 3556980 TI - Complications of endoscopic gastrostomy: pneumoperitoneum and volvulus of the colon. AB - Pneumoperitoneum caused by percutaneous gastrostomy usually follows a benign clinical course, but led to progressive volvulus of the ileocolic segment in the patient described here. This article explains relationships between pneumoperitoneum after surgical or endoscopic procedures and volvulus involving the intraperitoneally mobile intestinal loops. PMID- 3556982 TI - Natural progression of the lower esophageal mucosal ring. AB - Among 390 patients with endoscopically verified lower esophageal mucosal ring (LEMR), 22 cases were identified with previous or subsequent radiologic examinations of the esophagogastric region. Among these, it was found that 2 cases of LEMR had developed from a normal esophagus. In 3 patients, there was increasing stenosis of the LEMR. In 8 cases, the LEMR was transformed into an esophageal stricture. In 10 of the 13 cases, esophagitis of varying degree was present endoscopically. In the 9 patients exhibiting no change in the LEMR, only 1 patient had esophagitis. The data suggest that there is a potential progression from normal esophagus to lower esophageal ring to esophageal stricture that occurs in association with reflux esophagitis. PMID- 3556983 TI - Intravenous cisapride accelerates delayed gastric emptying and increases antral contraction amplitude in patients with primary anorexia nervosa. AB - Delayed gastric emptying is common in primary anorexia nervosa. We investigated in 12 patients whether gastric emptying could be accelerated by the prokinetic drug cisapride. Patients were studied on two occasions 1 wk apart and received, under random double-blind conditions, 8 mg of cisapride and placebo intravenously. Gastric emptying of an isotopically labeled semisolid meal and antral motor activity were measured using a dual-headed gamma-camera for 50 min. Emptying was significantly slower (half-emptying time, 50-191 min; median, 121 min) than in 24 healthy volunteers (half-emptying times, 21-119 min; median, 47 min). Cisapride accelerated emptying significantly (p less than 0.001; half emptying time after cisapride, 22-80 min; median, 42 min). Antral contraction amplitude increased and contraction frequency decreased significantly (p less than 0.001), whereas the propagation velocity of contractions remained unchanged. We concluded that intravenous cisapride accelerates gastric emptying and increases antral contraction amplitude in patients with anorexia nervosa. Whether or not these effects can prove beneficial in diminishing the patients' symptoms and in helping them to gain weight can only be answered from studies involving long-term treatment with cisapride. PMID- 3556984 TI - Coating of oral beclomethasone dipropionate capsules with cellulose acetate phthalate enhances delivery of topically active antiinflammatory drug to the terminal ileum. AB - Selective delivery of orally administered topically active antiinflammatory drugs to the terminal ileum and ascending colon could be potentially useful for patients with inflammatory bowel disease involving these sites. Because topical beclomethasone dipropionate (BDP) enemas have been used successfully in the treatment of distal idiopathic colitis, oral formulations of this drug were studied. Enteric-coated or uncoated capsules containing BDP were administered in a single-dose protocol on separate days to 6 healthy volunteers with postcolectomy ileostomies. Ileostomy effluent was collected for a minimum of 8 h and analyzed by high-performance liquid chromatography for BDP, its pharmacologically active derivative beclomethasone monopropionate (BMP), and inactive beclomethasone alcohol. Cellulose acetate phthalate coating of oral BDP capsules significantly increased the mean percentage recovery of BDP + BMP in ileal effluent (43.0% +/- 24.1%) compared to uncoated BDP capsules (13.5% +/- 8.5%, p less than 0.05, Student's paired t-test). We conclude that oral cellulose acetate phthalate-coated BDP capsules may merit clinical trial in Crohn's ileitis and ileocolitis or in conjunction with BDP enemas for topical treatment of ulcerative colitis involving the whole colon. PMID- 3556985 TI - Endoscopic measurements of canine colonic mucosal blood flow using hydrogen gas clearance. AB - We have examined the feasibility of hydrogen (H2) clearance for endoscopic measurements of colonic mucosal blood flow in anesthetized dogs. In 6 animals, measurements of H2 clearance did not differ significantly in different regions of the sigmoid colon and they were highly reproducible (p less than 0.001) on different days. In a total of 12 dogs, measurements of H2 clearance correlated closely with those obtained using radioactive microspheres under resting conditions and, in 4 dogs, during infusion of vasopressin (slope = 0.94, p less than 0.001). In 8 dogs, ligation of the major arteries supplying the sigmoid colon resulted in an acute 60% decrease in sigmoid mucosal blood flow (p less than 0.001); however, in 5 animals that survived the procedure, mucosal blood flow returned nearly to control levels as early as 3 days after operation. Endoscopic H2 clearance thus appears to be feasible for measuring mucosal blood flow in the colon. Serial measurements of H2 clearance may prove useful in characterizing the role of mucosal blood flow in the pathogenesis of various forms of human colonic disease. PMID- 3556986 TI - Effects of a protein-free diet on the rat stomach. AB - The effects of a protein-free diet containing a mixture of free amino acids on the stomach were studied using male Wistar strain rats. In the forestomach, thickening of mucosa and hyperkeratosis appeared and papillomas frequently developed, but they did not occur in the control rats fed a semipurified diet. Mucous neck cells increased and parietal cells and chief cells decreased in the fundus. Goblet cells occurred in the antral glands, and intestinal metaplastic glands developed in the late stage of the experiment. The number of deoxyribonucleic acid-synthesizing cells in the glandular stomach was significantly higher than that of the control. Moreover, in the antrum, somatostatin-producing cells increased in the early stage and gastrin-producing cells decreased in the late stage. These results suggest that dietary protein might play a crucial role in the differentiation of gastric epithelium and the development of intestinal metaplasia in the stomach. PMID- 3556987 TI - Prognosis of chronic unexplained dyspepsia. A prospective study of potential predictor variables in patients with endoscopically diagnosed nonulcer dyspepsia. AB - The aim of this study was to determine if there were predictors of the symptomatic course of patients with chronic unexplained (essential) dyspepsia. After endoscopic assessment, 111 patients with essential dyspepsia were followed up by telephone interview every second month. Data were gathered, for a mean of 17 mo per patient, on the number of days of upper abdominal pain (the response variable) each month. In the 6-mo period before entry to the study the following predetermined predictor variables were collected: demographic factors (age, sex, social grade), number of pain days in the 6 mo before diagnosis, environmental factors (analgesics, nonsalicylate nonsteroidal antiinflammatory drugs, alcohol, smoking, coffee, tea), length of dyspepsia history, and past history of peptic ulcer. Prospectively for each month of follow-up, the following additional variables were recorded: environmental factors, treatment, and development of gastroesophageal reflux symptoms. It was found that patients with more pain before diagnosis were significantly more likely to have pain over the follow-up, and the taking of medications for dyspepsia and development of gastroesophageal reflux were associated with more days of pain over the follow-up (all p less than 0.001). Demographic and environmental factors, length of dyspepsia history, and a past history of ulcer were of no significant predictive value. There was a decrease in pain over the follow-up period (p = 0.002), but this effect was limited to the first two periods after endoscopic diagnosis. PMID- 3556988 TI - Adenosquamous carcinoma of the stomach. Histogenetic and ultrastructural studies. AB - Adenosquamous carcinoma of the stomach in a 45-yr-old Japanese woman was studied ultrastructurally and light microscopically. The tumor consisted of combined areas of poorly and moderately differentiated adenocarcinoma and squamous cell carcinoma, with keratinization. Noteworthy was the demonstration of individual cells containing both tonofibrils and mucous vacuoles. The frequencies of this type of tumor in early and advanced gastric carcinomas are given attention and the pathogenesis is discussed with respect to our own observations and to data in the literature. PMID- 3556989 TI - Endothelial lamina in intestinal lymphangiectasia. PMID- 3556990 TI - Role of albumin in liver uptake. PMID- 3556991 TI - Motility in Roux-en-Y patients. PMID- 3556992 TI - Erythrocyte porphobilinogen deaminase activity in liver disease. AB - The activities of erythrocyte porphobilinogen deaminase were studied in patients with various liver diseases and in control groups. The lowest enzyme activities were found in patients with acute intermittent porphyria, and the highest ones in those with increased hemopoietic activity. Patients with liver cirrhosis or chronic active hepatitis had porphobilinogen deaminase activities that were significantly higher than in normal subjects and did not depend on disease activity. In patients with acute hepatitis, porphobilinogen deaminase activities varied depending on the phase of disease, being normal at onset and after 3-4 mo, and elevated to the values observed in chronic liver disease between 2 and 4 wk of hospitalization. The differences in porphobilinogen deaminase activities between patients with liver disease and controls did not relate to red cell age as determined by density gradient centrifugation. Therefore, although the mechanism responsible for the increase in porphobilinogen deaminase activities in liver disease is not clear, the results of this study suggest that it is independent of the presence of immature red cells in the circulation. PMID- 3556993 TI - Persistence of serum hepatitis B virus deoxyribonucleic acid in hepatitis B surface antigen-positive patients with chronic persistent hepatitis treated with prednisone. AB - The effect of a short course of prednisone therapy was evaluated in 8 patients with liver biopsy-verified chronic persistent hepatitis B. In 6 of the 8 (75%) patients, an abrupt fall in serum alanine aminotransferase levels after the initiation of prednisone was noted, and in 4 patients, there was an increase in serum alanine aminotransferase values after prednisone was discontinued. However, the serum levels of hepatitis B virus deoxyribonucleic acid were consistently greater than or equal to 200 pg before, during, and after the course of treatment in 7 of the 8 (87.5%) patients. All patients were initially hepatitis B e antigen positive and remained so during the study period. These findings indicate that, unlike some patients with chronic active hepatitis B, immunosuppression with prednisone had no effect in altering hepatitis B viral replication in patients with chronic persistent hepatitis. PMID- 3556994 TI - Biliary proteins and the nucleation defect in cholesterol cholelithiasis. AB - A study was performed to determine whether differences in gallbladder proteins might be present in patients with rapidly nucleating bile. Gallbladder and hepatic bile protein concentrations were measured using a fluorometric assay. The method was validated by an independent technique, i.e., hydrolysis and amino acid analysis. Persons with cholesterol gallstones had significantly higher gallbladder bile protein concentrations than patients without gallbladder disease or patients with pigment stones. The protein concentration correlated with the in vitro nucleation time in the cholesterol stone group. Gallbladder bile proteins were also purified by chromatography and gradient ultracentrifugation. Proteins from patients with cholesterol gallstones accelerated the nucleation time of control bile, whereas protein from controls had little effect. Hepatic bile protein concentrations were similar in persons with and without cholesterol gallstones. The gallbladder-to-hepatic bile ratios of a variety of solutes were examined. The ratio for protein in the cholesterol gallstone group can be explained straightforwardly by water reabsorption in the gallbladder, whereas the very low ratio in patients without cholesterol gallstones suggests that their gallbladders reduce protein mass by a process such as protein absorption or degradation during water absorption in the gallbladder. PMID- 3556996 TI - Prospective study of the ability of computed axial tomography to localize gastrinomas in patients with Zollinger-Ellison syndrome. AB - The ability of routine computed tomography (CT) performed with oral and intravenous contrast to localize gastrinomas in 61 consecutive patients with Zollinger-Ellison syndrome was evaluated prospectively. The results of CT scanning were subsequently evaluated in all patients by either surgery, autopsy, or percutaneous biopsy. Thirteen of 14 patients with CT scans positive for hepatic metastases and 5 of 13 patients with CT scans negative for hepatic metastases were found to have gastrinoma in the liver. For gastrinoma metastatic to the liver, CT scanning had a specificity of 98%, a sensitivity of 72%, a positive predictive value of 93%, and a negative predictive value of 90%. Twenty two of 23 patients with positive extrahepatic CT scans and 15 of 33 patients with negative extrahepatic CT scans were found to have extrahepatic gastrinomas. For extrahepatic gastrinoma, CT scanning had a specificity of 95%, a sensitivity of 59%, a positive predictive value of 96%, and a negative predictive value of 54%. The ability of CT scan to detect gastrinomas both in the liver and extrahepatically was directly related to tumor size, detecting 0% of tumors less than 1 cm and 83%-95% of tumors greater than 3 cm. The location of the extrahepatic gastrinoma was also an important determinant in that approximately 80% of pancreatic gastrinomas but only 35% of extrapancreatic gastrinomas were detected. The present results indicate that because of its convenience and accuracy, CT scanning with oral and intravenous contrast material should be the initial procedure to evaluate the extent of gastrinoma. A positive CT scan is almost always correct; therefore, a CT scan detecting metastatic gastrinoma to the liver would avoid unnecessary surgery and, if positive for extrahepatic gastrinoma, would assist the surgeon in finding the gastrinoma. A negative CT is less reliable; therefore, patients should undergo other localizing studies before exploratory laparotomy. PMID- 3556995 TI - Metabolism of the bile acid analogues 7 beta-methyl-cholic acid and 7 alpha methyl-ursocholic acid. AB - The metabolism of two new bile acid analogues, 7 beta-methyl-cholate and 7 alpha methyl-ursocholate, was compared with that of cholate in the hamster. After intraduodenal administration of 14C-labeled compounds into bile fistula hamsters, radioactivity was exclusively recovered in bile; the more hydrophobic bile acid was absorbed more rapidly. Hepatic extraction of intravenously infused compounds was efficient and administered analogues became major biliary bile acids. Amidation of cholate was essentially complete, whereas 39% of 7 beta-methyl cholate and 65% of 7 alpha-methyl-ursocholate were secreted in unconjugated form. After intragastric administration of the compounds, radioactivity was quantitatively recovered in feces. Cholate was 7-dehydroxylated to deoxycholate, whereas 31% of 7 beta-methyl-cholate and 78% of 7 alpha-methyl-ursocholate were recovered unchanged. Fifty percent of 7 beta-methyl-cholate and 15% of 7 alpha methyl-ursocholate were transformed into ketonic derivatives, without loss of the 7-hydroxyl group. It is concluded that the introduction of the 7-methyl group did not interfere with intestinal absorption, hepatic extraction, and biliary secretion but did affect enzymatic amidation and bacterial 7-dehydroxylation of the analogues. PMID- 3556997 TI - Role of selective angiography in the management of patients with Zollinger Ellison syndrome. AB - To determine the ability of selective abdominal angiography to localize gastrinoma in patients with Zollinger-Ellison syndrome, selective angiography was performed in 70 consecutive patients and the results were assessed prospectively by either surgery, autopsy, or percutaneous biopsy. In addition, to define the role of angiography in the management of patients with gastrinoma, we compared the results of angiography with those of computed tomography (CT) scanning in 58 patients who underwent both tests. For gastrinoma in the liver, angiography had a specificity of 100% and a sensitivity of 86% with a positive predictive value of 100% and a negative predictive value of 94%. For extrahepatic gastrinoma, angiography had a specificity of 94% and a sensitivity of 68%, a positive predictive value of 97% and a negative predictive value of 53%. Comparison of CT scanning and angiography demonstrated that for hepatic tumor CT demonstrated 72% and angiography 89% of tumors, and the combination detected all tumors with no false-positive results. Outside the liver, CT scanning detected 57%, angiography 70%, and the combination 73% of tumors with a false-positive rate of 7%. These results indicate that if a CT scan is performed first, then the addition of selective angiography will detect a further 28% of hepatic tumors and a further 16% of extrahepatic tumors, but that 24% of extrahepatic tumors will still be missed. Angiography is a useful adjunct to CT particularly in patients in whom surgery is contemplated. PMID- 3556998 TI - Giant migrating contractions during defecation in the dog colon. AB - The colonic motor correlates of defecation were studied in 5 conscious dogs. A set of six strain-gauge transducers were implanted on the colon of each dog. An implanted cannula gave access to the terminal ileum. During a total control recording period of 230 h we observed 12 large-amplitude contractions that occurred spontaneously in the proximal colon and migrated caudad. We called them giant migrating contractions. The mean amplitude of these contractions was 2.8 times larger than the mean peak amplitude of phasic contractions during colonic motor complexes. The following stimuli were applied to induce defecation: 2 mg/kg guanethidine (i.v.), 30 micrograms/kg neostigmine (i.v.), 1-4 ml/kg castor oil (p.o.), 200 ml of 25% glucose (into ileum), and rectal distention by a balloon (120 ml). In 85% of experiments with guanethidine, neostigmine, glucose, and castor oil, giant migrating contractions occurred before defecation. The giant migrating contractions migrated over the entire colon or a part of its length. The migration velocity varied from 0.2 to 3.2 cm/s (mean +/- SE, 0.82 +/- 0.1 cm/s). In 11% of the experiments, giant contractions occurred almost simultaneously at different recording sites at the time of defecation. In 4% of the experiments giant contractions occurred only at a single site. Balloon expulsion was only rarely accompanied by giant contractions in the colon, and then occurred only at a distal site and did not migrate. We conclude that the colon has spontaneous but infrequent large-amplitude caudad-migrating contractions. These contractions may be the motor equivalent of mass movements. Defecation is usually preceded by colonic giant migrating contractions. The giant migrating contractions may provide a major force for defecation and be partially responsible for the evacuation of the colon during defecation. However, evacuation of contents such as a balloon seems to be possible without giant migrating contractions. PMID- 3556999 TI - Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis. AB - Using a gastric barostat we have studied interdigestive variations in gastric tone and its response to gastric distention in 17 healthy volunteers and 5 patients with postsurgical gastroparesis. The barostat measures tone by monitoring the volume of air within a flaccid intragastric bag, maintained at a constant, preselected pressure level by an electronic feedback mechanism. In healthy individuals, inter-digestive variations in gastric tone were phase-locked in advance of duodenal interdigestive motor activity and consisted of three sequential periods; a quiescence period, an intermediate period, and a period of activity. In contrast to controls, gastroparetic patients presented significantly larger intragastric volume at low intragastric pressure (6 mmHg). Gastric distention (14 mmHg) resulted in significantly reduced extension ratio and phasic motor response in the gastric remnant. Furthermore, distention elicited a symptomatic response that resembled their postcibal syndrome (epigastric fullness, pain, nausea). These data suggest that postsurgical gastroparesis is associated with impaired tone of the residual gastric pouch. PMID- 3557000 TI - Variable contribution of gastrin to gastric acid secretion after a meal in humans. AB - The purpose of these experiments was to determine the contribution of gastrin to the acid secretory response to eating in healthy human subjects. To simulate the gastric and intestinal phases of eating, a meal was homogenized and then infused into the stomach through a nasogastric tube. At the same time, the cephalic phase of acid secretion was activated by sham feeding. With this simulated meal, mean serum gastrin concentration increased from a basal value of 43 +/- 9 pg/ml to an average postprandial gastrin concentration over 2 h of 121 +/- 25 pg/ml. Gastrin release after this simulated meal was similar to gastrin release after a normally eaten meal in the same 12 subjects. Gastric acid secretion in response to the simulated meal, which was measured by in vivo intragastric titration, averaged 24.2 +/- 2.4 mmol/h. To determine how much of this postprandial acid secretion could be attributed to gastrin, gastrin 17 I was infused intravenously in the same subjects on a separate day and acid secretion and serum gastrin concentrations were measured. By relating serum gastrin concentration during gastrin 17 infusion to concomitant acid secretion, we determined that an average postprandial serum gastrin concentration of 121 pg/ml could result in an acid secretion rate of 21.5 mmol/h, 89% of the actual acid secreted after the simulated meal in these subjects. However, in individual subjects, the amount of gastrin released after a meal could produce as little as 51% or as much as 162% of actual postprandial acid secretion. Thus, in individual human subjects the contribution of gastrin to acid secretion after a meal is variable. PMID- 3557001 TI - Gastric mucosal injury in the rat. Role of iron and xanthine oxidase. AB - Recent studies have implicated oxygen free radicals in ischemia-reperfusion injury to the gastric mucosa. The aims of the present study were to test the hypothesis that the enzyme xanthine oxidase is the source of the oxygen radicals in the ischemic stomach and determine the importance of the iron-catalyzed Haber Weiss reaction in generating the cytotoxic oxygen radicals. Gastric mucosal clearance of 51Cr-labeled red blood cells was measured during a 30-min control period, a 30-min ischemic period (hemorrhage to 25 mmHg arterial pressure), and a 60-80-min reperfusion period (reinfusion of shed blood). In untreated (control) rats, a dramatic rise (100-fold) in the leakage of 51Cr-labeled red blood cells into the gastric lumen was observed only during the reperfusion period. After the reperfusion period, gastric mucosal damage was further assessed using gross lesion area and histology. Rats were placed on a sodium tungstate diet (to inactivate xanthine oxidase), or treated with either deferoxamine (an iron chelating agent) or superoxide dismutase (a superoxide scavenger). All three interventions substantially reduced 51Cr-labeled red blood cell clearance and gross lesion area relative to untreated rats. However, tissue injury assessed histologically was similar in both treated and untreated animals. The results of this study support the hypothesis that oxygen free radicals mediate the hemorrhagic shock-induced extravasation of red blood cells. The data also indicate that xanthine oxidase is the source of the oxy-radicals and that the iron-catalyzed Haber-Weiss reaction is largely responsible for hydroxyl radical generation in this model. PMID- 3557002 TI - Spinal cord injury is a risk factor for gallstone disease. AB - The purpose of this study was to determine the prevalence of gallstone disease among patients with a spinal cord injury. We identified all patients with a spinal cord injury of greater than 2 weeks' duration who died and underwent an autopsy between 1975 and 1985. These 38 patients with spinal cord injury were age , sex-, and race-matched with 38 patients without spinal cord injury who underwent an autopsy during the same period. Gallstone disease was significantly more prevalent in patients with spinal cord injury (11 of 38 or 29%) compared to the control population (4 of 38 or 11%) (p less than 0.05; odds ratio of 3.46 with 95% confidence interval of 1.08-11.24). A significant difference in age or level or duration of spinal cord injury was not found between patients with spinal cord injury who had gallstone disease and those who did not. Possible explanations for this threefold increase in risk of gallstone disease among patients with spinal cord injury include abnormal gallbladder motility resulting in stasis, decreased intestinal transit leading to an abnormal enterohepatic circulation, and metabolic changes leading to abnormal biliary lipid secretion. PMID- 3557003 TI - Effect of indomethacin on gastric mucosal prostaglandins in humans. Correlation with mucosal damage. AB - We evaluated in healthy human beings the effect of indomethacin on gastric mucosal prostaglandin concentration and on gastric mucosal damage in a placebo controlled study. Prostaglandin E2, prostaglandin F2 alpha, and 6-keto prostaglandin F1 alpha concentrations of gastric mucosal biopsy specimens, obtained endoscopically, were measured by radioimmunoassay. Mean prostaglandin concentration of the antrum and fundus was similar. In both regions there was considerable intersubject variability in prostaglandin concentration. Repeated 50 mg oral doses of indomethacin for 4 days reduced mean prostaglandin F2 alpha and E2 concentration by 50.2% and 69.4%, respectively, in the fundus and by 40.0% and 49.7% in the antrum, but this led to no significant mucosal damage when assessed endoscopically or histologically. A single 100-mg oral dose of indomethacin reduced mean prostaglandin F2 alpha and prostaglandin E2 concentration by 81.4% and 60.9% in the fundus and by 64.2% and 57.5% in the antrum and also induced significant mucosal injury in both regions when assessed endoscopically. However, there was no correlation between degree of suppression of prostaglandin concentration by indomethacin and endoscopic evidence of mucosal damage. PMID- 3557005 TI - Intracellular studies of electrical membrane properties of opossum esophageal circular smooth muscle. AB - It has been suggested that regional differences in membrane properties of circular esophageal smooth muscle play an important role in the mechanism of esophageal peristalsis. The purpose of this study was to examine both the passive and active membrane properties of circular smooth muscle at proximal and distal esophageal sites so as to delineate the role of myogenic properties in the intramural mechanism of peristalsis. Intracellular recordings were made in circular muscle strips taken from proximal (8 cm above the gastroesophageal junction) and distal (2 cm above the gastroesophageal junction) sites in 10 opossums using the partition method of Abe and Tomita. At both esophageal sites, determinations were made of resting membrane potentials, time constants, space constants, thresholds for action potentials, action potential amplitudes, rates of rise of action potentials, and action potential durations at half-amplitude. The values for these parameters at the proximal and distal sites, respectively, were as follows: mean resting membrane potential, 49.7 +/- 0.24 and 49.5 +/- 0.3 mV; length constant, 4.0 +/- 0.4 and 3.8 +/- 0.4 mm; time constant, 513 +/- 49 and 456 +/- 53 ms; threshold for action potentials, 9.3 +/- 0.4 and 8.8 +/- 0.3 mV; amplitude of action potentials, 36.0 +/- 5.2 and 35.3 +/- 1.7 mV; rate of rise of action potentials, 2.3 +/- 0.3 and 2.6 +/- 0.4 mV/ms; duration of action potentials at half-amplitude, 5.0 +/- 1.2 and 4.1 +/- 0.4 ms; and the conduction velocity for evoked potentials, 3.9 +/- 0.3 and 3.8 +/- 0.4 cm/s. Our studies show that there are no differences between proximal and distal esophageal sites in any of these determinations. These studies also show that regional differences in the electrical membrane properties of circular smooth muscle do not account for esophageal peristalsis. PMID- 3557004 TI - Effect of total sympathectomy and of decentralization on migrating complexes in dogs. AB - The effect of total sympathectomy and of decentralization on interdigestive myoelectric activity of the stomach and small intestine and on cycling levels of plasma motilin were studied in conscious dogs. In controls, 98.3% +/- 7.9% of the migrating myoelectric complexes (mean +/- SD) originated in the stomach. In sympathectomized dogs, 38.17% +/- 16.7% originated in the stomach, 35.8% +/- 12.3% in the duodenum, and 26.3% +/- 4.3% in the jejunum. In decentralized dogs, 5.3% +/- 1.4% of the migrating myoelectric complexes originated in the stomach, 71.0% +/- 16.5% in the duodenum, and 23.9% +/- 17.4% in the jejunum. Cycling of plasma motilin was not affected by long-term sympathectomy but coordination of peak levels of plasma motilin and initiation of gastric migrating myoelectric complexes was disrupted in decentralized dogs. These data suggest that central nervous input is required for initiation of migrating myoelectric complexes in the stomach and that central vagal but not central sympathectic input is essential for cycling of plasma motilin. PMID- 3557006 TI - Mechanisms of canine gastric dysrhythmia. AB - We postulated that local synthesis and release of prostaglandins might be the paracrine pathway that triggers gastric dysrhythmia when exogenously activated. The study was divided into three parts. In part 1, a dose-response study was performed in 7 dogs to estimate the 95% effective dose for four pharmacologic agents known to cause gastric dysrhythmia. In part 2, we determined the relative efficacy of three putative blockers in preventing pharmacologic induction of gastric dysrhythmia. In part 3, several ancillary experiments were performed. The results show that an intraarterial bolus of epinephrine, met-enkephalin, prostaglandin E2, and glucagon each induced episodes of gastric dysrhythmia, whereas saline injections did not. The 95% effective dose of these dysrhythmic drugs were 10.5, 77.0, 35.0, and 407.0 micrograms/kg, respectively. The dysrhythmic action of epinephrine was blocked by phentolamine and indomethacin but not by naloxone. The dysrhythmic action of met-enkephalin was blocked by naloxone and indomethacin but not by phentolamine. The dysrhythmic action of glucagon was not blocked by phentolamine, naloxone, or indomethacin. The inhibitory effect of indomethacin on epinephrine-induced gastric dysrhythmia was shared by meclofenamate. Thus, we conclude that local prostaglandins mediate the production of gastric dysrhythmias by epinephrine and met-enkephalin; however, glucagon causes gastric dysrhythmias by a non-prostaglandin-mediated mechanism. PMID- 3557007 TI - Critical evaluation of a pressure-sensitive capsule for measurement of esophageal varix pressure. Studies in vitro and in canine mesenteric vessels. AB - The accuracy and reliability of a noninvasive pressure-sensitive capsule for the endoscopic measurement of esophageal varix pressure was evaluated. Capsule pressure was correlated with direct intraluminal pressure measurements. The influence of vessel wall tension on capsule pressure was also assessed. In vitro studies demonstrated an excellent correlation (r greater than or equal to 0.94; p less than 0.001) between the pressure obtained with the capsule and intraluminal pressure over a range of vessel diameters and wall thicknesses. In vivo correlation of pressures obtained with the capsule with direct venous pressure measurements was excellent (r = 0.85). However, this correlation decreased with a decrease in vessel diameter (group 1 diameter greater than or equal to 10 mm, r = 0.95; group 2 diameter greater than or equal to 5 mm but less than 10 mm, r = 0.75; group 3 diameter greater than or equal to 3 mm but less than 5 mm, r = 0.81). This decrease in accuracy was significant (p less than 0.001) between group 1 and groups 2 and 3. In vitro and in vivo, capsule pressure variability was significantly greater (p less than 0.001) in vessels of smaller diameter. Wall tension significantly influenced capsule pressure (p less than 0.05), although this effect was only seen in large "vessels" with a diameter beyond a clinically relevant range. Therefore, despite obtaining technically acceptable capsule pressure measurements in ideal experimental conditions, the accuracy and variability of these measurements are limited by vessel size. PMID- 3557008 TI - Lectin binding patterns in developing rat colon. AB - To evaluate qualitative changes in brush-border and goblet cell glycoconjugates during colonic development, rhodamine-conjugated lectins were applied to tissue from fetal (18-22 day), suckling (1-20 day), and weanling (22-26 day) rats. Tissue from the proximal and distal colon of each animal was incubated with Triticum vulgaris, Arachis hypogaea, Glycine max, or Ulex europeus agglutinin I. Formalin-fixed paraffin sections and unfixed frozen sections were coded, read blindly, and graded from negative (-) or weak (+) to intensely positive (4+). The results showed a unique developmental pattern for each lectin, although in all cases the adult binding pattern was established by weaning. Alterations in the binding pattern between paraffin and frozen sections were noted only for Arachis hypogaea and Glycine max. Minimal Glycine max binding was seen at any age in paraffin sections, although in frozen sections a weak but consistent supranuclear binding was seen in goblet cells of postnatal animals. In contrast, both the brush-border and goblet cells were intensely fluorescent after exposure to Triticum vulgaris. This fluorescence was present in both regions at all ages studied. Ulex europeus agglutinin I also labeled goblet cells in the fetal and neonatal colon, but late in the suckling period regional differences appeared. This resulted in a significant loss of labeled goblet cells distally and a restriction of Ulex europeus agglutinin I-positive cells to the base of the crypts proximally. Finally, Arachis hypogaea showed a transient brush-border binding in paraffin sections of the proximal colon before weaning, whereas frozen sections revealed a supranuclear localization in goblet cells in both regions after birth. These studies indicate significant changes in membrane-associated and goblet cell secretory glycoconjugates in the developing rat colon. PMID- 3557009 TI - Terminal ileitis associated with Mycobacterium avium-intracellulare infection in a homosexual man with acquired immune deficiency syndrome. AB - A 38-yr-old homosexual man developed fever, diarrhea, and weight loss. An upper gastrointestinal examination revealed terminal ileitis, and stains of stool revealed acid-fast bacilli that were subsequently identified as Mycobacterium avium-intracellulare. Antimycobacterial therapy was associated with weight gain and loss of fever and diarrhea. Several months later, cutaneous Kaposi's sarcoma was observed. When the patient developed strictures in the terminal ileum, a surgical resection was performed. Numerous granulomas and acid-fast bacilli, later identified as M. avium-intracellulare, were present in the resected terminal ileum. This report demonstrates that infection of the terminal ileum with M. avium-intracellulare in a patient with acquired immune deficiency syndrome can present with a clinical and radiologic picture resembling Crohn's disease. It also demonstrates symptomatic improvement of this infection temporally related to the administration of antimycobacterial therapy and the ability of an acquired immune deficiency syndrome patient to tolerate major abdominal surgery. PMID- 3557010 TI - Structural analysis of a human intestinal epithelial cell line. AB - Confluent monolayers of epithelial cell lines of intestinal derivation may serve as useful models for studies of intestinal epithelial structure and function. Cells of the T84 line appear to be a useful model for studies of Cl- secretion. We now define the fine structure of this cell line, the structural events that occur during monolayer formation, and the influence of plastic versus collagen substrates and permeable versus impermeable substrates on the structural development of these monolayers. When plated on collagen-coated filters at confluency, T84 cells cover the filter surface and lay down basement membrane like material within 18 h. Such "monolayers" multifocally display areas with many cell layers alternating with areas composed of a single layer of cells. During this stage of development cell polarization is minimal, ultrastructural discontinuities exist that impart low transepithelial resistance, and morphologic features reminiscent of stratified intestinal epithelium during fetal development are present. Within 5 days of plating on collagen-coated filters, true monolayers form. These monolayers have high transepithelial resistance and consist of highly polarized columnar cells with structural similarity to intestinal crypt cells. Cells plated on a plastic substrate are also capable of rapidly producing basement membrane-like material but, unlike those plated on collagen-coated filters, under these conditions the rapid initial spreading of cells over the substrate surface does not occur. As a result, at 5 days monolayers plated on plastic are less uniform than those plated on collagen-coated filters, exhibit areas in which unpolarized flattened cells abound, and multifocally leak macromolecules. Studies using collagen-coated filters made impermeant with glass backing suggest that the enhancing effect of this substrate on monolayer structural development is not simply due to the greater access that basolateral membranes have to nutrient media when grown on permeable supports. This study defines the structure and structural development of this useful model epithelium, and demonstrates the importance of substrate selection. PMID- 3557011 TI - Early invasive cancer in adenomatous colonic polyps ("malignant polyps"). Evaluation of the therapeutic options by decision analysis. AB - The management alternatives of segmental colonic resection versus follow-up alone for colonic adenomas containing early invasive carcinoma (i.e., polypectomy resection margin free of tumor) were evaluated by decision tree analysis. Using data from the literature, the major variables influencing the decision were as follows: probability of residual disease after polypectomy, operative efficacy (defined as the chance of curing a tumor that would otherwise recur without surgery), and operative mortality. For a hypothetical patient with low operative risk (operative mortality of 0.2%), resection would yield the best outcome in terms of life expectancy as long as the probability of residual disease was greater than 0.5%. Extensive analysis of the impact of changes in assumptions about the parameters characterizing the problem showed this conclusion to be unchanging over wide ranges of operative efficacy and probability of residual disease. However, the decision to do a secondary resection in this situation was still close because surgery was only marginally justifiable on economic grounds. Observation would be preferred in patients with higher operative risk (operative mortality greater than 2%). PMID- 3557012 TI - Effects of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. AB - The present investigation was undertaken to evaluate what fraction of alcohol ingested in amounts during usual "social drinking" does not enter the systemic circulation. To that effect, on consecutive days, either peroral or intravenous ethanol was administered in both fed and fasted states to 7 nonalcoholic and 18 alcoholic subjects. In nonalcoholics consuming 0.15 g/kg body wt ethanol, the magnitude of first-pass metabolism of ethanol was 3.94 +/- 0.15 mmol/L X h, calculated as the difference of the areas under the curve obtained after oral and intravenous alcohol administration. The first-pass metabolism accounted for 73% of the latter. When the administered dose was increased to 0.3 g/kg body wt ethanol, the corresponding values were 6.46 +/- 0.50 mmol/L X h and 44%. Fasting decreased this effect. When alcoholics consumed 0.15 g/kg body wt ethanol, the corresponding values were 0.92 +/- 0.65 mmol/L X h and 23%. When these alcoholics were fasted, the first-pass metabolism again decreased and it was significantly lower than in the nonalcoholics tested under the same conditions. We conclude that in humans a significant fraction of ingested alcohol undergoes first-pass metabolism but that this effect is reduced in alcoholics and by fasting. The magnitude of this process determines the bioavailability of alcohol and thus modulates its potential toxicity. PMID- 3557013 TI - Protooncogene abnormalities in colon cancers and adenomatous polyps. AB - To determine the frequency and clinical significance of oncogene abnormalities in colon cancer, deoxyribonucleic acids from 45 colon carcinomas and 15 benign adenomas were hybridized with 14 different protooncogene probes. Abnormalities of oncogenes were found in 22% of cancers at the time of resection. Amplification of c-myc or c-erbB-2 and allelic deletion of c-ras-Ha or c-myb were the most frequent abnormalities. The presence of altered oncogenes did not correlate with Dukes' stage, tumor progression, or patient survival after resection. One adenoma had an allelic deletion of the c-myb oncogene which was not seen in either the normal colon or an adjacent carcinoma. These data indicate that the spectrum of altered protooncogenes in colon carcinoma is similar to that of other adenocarcinomas, and that unstable oncogenes can be found before overt malignancy develops. PMID- 3557014 TI - Sucralfate overcomes adverse effect of cigarette smoking on duodenal ulcer healing and prolongs subsequent remission. AB - A unicenter, single-blind, randomized study was conducted on 283 patients with active duodenal ulcer to compare possible factors that may affect healing and relapse in patients treated with a potent antisecretory agent, cimetidine, or a site-protective and cytoprotective agent, sucralfate. The endoscopic healing rates at 4 wk were 76% and 79%, respectively, and cross-over treatment of the failures for a further 4 wk resulted in 68% healing with cimetidine and 69% healing with sucralfate, both differences being not statistically different. Unlike cimetidine, healing by sucralfate was unaffected by cigarette smoking, reluctance to give up smoking, habitual use of alcohol, high maximal acid output, and large ulcer diameter. In particular, the healing rate of smokers treated with sucralfate (82%) was significantly greater than that of smokers treated with cimetidine (63%). Duodenal bulb deformity significantly affected healing in both groups, and was the only offsetting factor identifiable for sucralfate out of 46 factors examined. Of the patients with healed ulcers, 238 participated in a 24-mo follow-up study consisting of interviews at 2-mo intervals and endoscopy at 4-mo intervals or whenever symptoms recurred. The cumulative relapse rate was significantly (p less than 0.007) greater in patients healed with cimetidine than with sucralfate, 50% relapse occurring at 6 and 12 mo, respectively. In both, the cumulative relapse rate was significantly greater in cigarette smokers than in nonsmokers, but smokers and nonsmokers treated with cimetidine relapsed (50% at 4 and 8 mo, respectively) faster than the corresponding smokers and nonsmokers treated with sucralfate (50% at 8 and 18 mo, respectively). Furthermore, in cimetidine- but not sucralfate-healed patients, early ulcer relapse (within 6 mo) was associated with short duration of illness, short remission period, long symptomatic spell, and reluctance to give up smoking. We conclude that smoking adversely affects duodenal ulcer healing by cimetidine and hastens subsequent relapse, and that sucralfate overcomes the adverse effect of smoking on healing as encountered with cimetidine, and results in a subsequent remission period double that of cimetidine. PMID- 3557015 TI - Effect of peptide YY on cephalic, gastric, and intestinal phases of gastric acid secretion and on the release of gastrointestinal hormones. AB - The objective of this study was to investigate the effects of a novel gut peptide, peptide YY (PYY), on the cephalic, gastric, and intestinal phases of gastric acid secretion and to explore the mechanisms involved. The cephalic phase of gastric acid secretion, stimulated by the intravenous injection of 2 deoxyglucose (75 mg/kg), was found to be inhibited by intravenous PYY (100, 200, 400 pmol/kg X h) in a dose-related fashion. Peptide YY (200 and 400 pmol/kg X h) also resulted in a significant dose-dependent inhibition of the gastric phase of acid secretion. On the other hand, PYY (400 pmol/kg X h) failed to affect the intestinal phase of gastric acid output. Serum gastrin levels were increased on infusion of 10% liver extract into stomach, but were unaffected on instillation of liver extract into duodenum. Peptide YY did not inhibit the release of gastrin in either the gastric or intestinal phase studies. Furthermore, PYY had no significant effect on either the basal release of secretin, gastric inhibitory polypeptide, pancreatic polypeptide, or neurotensin, or on the stimulated release of pancreatic polypeptide by 2-deoxyglucose. The specific binding of gastrin to its receptors on the fundic mucosa was also unaffected by PYY. These results indicate that PYY inhibits the cephalic and gastric phases of acid secretion independently, and that its actions are not mediated by either a negative effect on gastrin release or a positive effect on the release of some of the known acid inhibitors, or by an inhibition of gastrin binding to its receptors on the fundic cells. Our present findings (in combination with our previous findings of inhibition of pentagastrin- and bethanechol-stimulated gastric acid secretion by PYY, independent of the vagal cholinergic mechanism) indicate that the action of PYY is either direct on the parietal cells or is mediated by yet another, unidentified, inhibitor. PMID- 3557016 TI - Importance of collateral circulation in the vascularly occluded feline intestine. AB - The aim of this study was to assess the extent of collateral blood flow provided by the celiac and inferior mesenteric arteries to the intestines during total occlusion of the superior mesenteric artery (SMA). In anesthetized cats, blood flow to the pancreas, duodenum, jejunum, ileum, and colon was measured with radioactive micropheres (15 microns in diameter) before and during occlusion of the SMA. Superior mesenteric artery occlusion significantly decreased (by 63%) blood flow to the head of the pancreas. Flow to the neck and tail of the pancreas was not altered. Blood flow to the proximal and distal duodenum was significantly reduced by 35% and 61%, respectively. Along the entire jejunum and ileum, SMA occlusion markedly decreased blood flow by an average of 71%. In the proximal colon, blood flow decreased by 63%, whereas flow to the middle and distal colon was not affected by SMA occlusion. Reduction in total wall blood flow to the small and large intestines was largely due to a marked reduction in mucosa/submucosa blood flow; muscularis/serosa flow was not affected. The results of this study suggest that total occlusion of the SMA does not compromise blood flow to the neck and tail of the pancreas and middle and distal colon (tissues that are normally perfused with blood from either the celiac or inferior mesenteric arteries). Perfusion through collaterals maintains flow to the head of the pancreas and gut (from duodenum to proximal colon) to within 30%-65% of control (preocclusion) flow. An important new observation of this study is that collateral blood vessels are much more effective in preventing ischemia in the muscularis/serosa than in the mucosa/submucosa after SMA occlusion. PMID- 3557017 TI - Comparison of the metabolism of sulfated and unsulfated heptadecapeptide gastrin in humans. AB - The metabolism of synthetic human sulfated heptadecapeptide gastrin (G-17) was studied in normal human volunteers. Plasma concentrations were measured by radioimmunoassay using antibodies specific for intact G-17, and for the C- and N- terminus of G-17, during and after infusion of both sulfated and unsulfated G-17. With all three antibodies, plasma concentrations at a steady state were higher during infusion of sulfated compared with unsulfated G-17. In addition, the half life in plasma measured by the three antibodies was two to five times higher for sulfated G-17 compared with unsulfated G-17. The half-life measured by N-terminal specific antibodies was greater than that with antibodies specific for C-terminal or intact G-17. The difference was accounted for by the production during infusion of N-terminal fragments of relatively long half-life. The pattern of fragments generated during infusion of sulfated G-17 resembled that during unsulfated G-17 infusion, but there was no evidence of desulfation in the systemic circulation. The results indicate that in humans, sulfation protects G 17 from metabolism. PMID- 3557018 TI - Cytopathic liver injury in acute delta virus hepatitis. AB - Hepatitis delta-virus (the delta-agent) is now recognized as a cause of acute hepatitis, fulminant hepatitis, chronic hepatitis, and cirrhosis in hepatitis B surface antigen-positive hosts. This report describes the clinical course and liver biopsy histopathology of acute delta-hepatitis in a young American woman with presumed chronic hepatitis B infection. The liver biopsy specimen features included severe cytotoxic and cytopathic hepatocellular damage, small droplet vacuolar liver cell degeneration, and few parenchymal inflammatory cells, lesions resembling epidemic delta-hepatitis in Venezuelan Indians and experimental chimpanzee delta-superinfection. This case suggests that this form of cytopathic liver injury is an important morphologic expression of delta-virus hepatitis that deserves wider diagnostic recognition. PMID- 3557020 TI - Anemic halos around telangiectasias. PMID- 3557019 TI - Clinical research in the functional digestive disorders. PMID- 3557022 TI - Digestive Disease Week and the 88th annual meeting of the American Gastroenterological Association. May 9-15, 1987, Chicago, Illinois. Program and abstracts. PMID- 3557021 TI - Survey of the AGA membership relating to patients with functional gastrointestinal disorders. PMID- 3557023 TI - Abstracts of papers submitted to the American Gastroenterological Association. PMID- 3557024 TI - Abstracts of papers submitted to the American Association for the Study of Liver Disease. PMID- 3557025 TI - Primary panendoscopy. AB - Primary panendoscopy is defined as a limited-consultative, diagnostic, UGI endoscopic examination that provides, in non-critically ill patients with dyspeptic symptoms, an accurate and cost-effective alternative to the standard UGI x-ray examination. The procedure was instituted at St. Mary's Medical Center's hospital in February 1985. During the first 12 months, a total of 321 patients were examined: 212 inpatients and 109 outpatients. In those patients with complete information, primary panendoscopy changed the diagnosis in 67% and the treatment in 52%. As expected, the number of esophagogastroduodenoscopies decreased during this time, but the combined numbers of primary panendoscopies and esophagogastroduodenoscopies exceeded the projected increase of esophagogastroduodenoscopies. Similarly, the number of UGI x-ray examinations fell sharply. With a physician fee of $150.00 and a facility fee of $50.00, theoretical savings of some $117,000.00 to the patients were estimated. The authors conclude that primary panendoscopy provides a cost-effective and beneficial patient service that warrants broad consideration by gastroenterologists as they face the cost constraints being imposed within the health care system of the 1980s. PMID- 3557026 TI - A comparison between peroral choledochoscopy and endoscopic retrograde cholangiopancreatography. AB - Nonoperative direct examination of the pancreaticobiliary system with an ultrathin fiberoptic endoscope was compared to endoscopic retrograde cholangiopancreatography (ERCP). Thirty-one patients were examined by both techniques. Direct examination of the biliary system was successful in 12 patients, seven of whom had had previous endoscopic sphincterotomy. In two patients it revealed stones missed on ERCP. In none of the patients was an examination of the pancreatic duct possible. ERCP visualized the biliary system in 28 patients and the pancreatic duct in 30 patients. In one patient the ERCP revealed a stone missed by the peroral choledochoscopy. Peroral choledochoscopy is complementary to ERCP and should be reserved for patients with probable pathology of the biliary tract and normal ERCP. PMID- 3557027 TI - Depth of colorectal biopsies with proctoscopic forceps. AB - It has been suggested that a barium enema may safely follow a colorectal biopsy superficial to the muscularis propria within 24 hours, but that the colon radiograph should be postponed 3 to 7 days following a biopsy including this layer. The authors prospectively studied 67 colorectal biopsies obtained with the Wolf 3-mm (grasping) and 5-mm (cutting) proctoscopic forceps from 49 patients to determine the depth of the biopsies. The 5-mm biopsies were not significantly deeper than the 3-mm biopsies (p greater than 0.5). In 18 patients biopsied with each instrument, the 3-mm biopsy was deeper in two cases (11%), the 5-mm biopsy was deeper in three cases (17%), and the biopsies were of equal depth in 13 cases (72%). None of the biopsies with either forceps reached the muscularis propria. The authors concluded that it may be unnecessary to wait longer than 24 hours before performing a barium enema after colorectal biopsy with these forceps. PMID- 3557028 TI - Endoscopic dilation of anastomotic colonic stenosis by different techniques: an alternative to surgery? PMID- 3557029 TI - Endoscopic management of anastomotic colon strictures with electrocautery and balloon dilation. PMID- 3557030 TI - A double endoscope method for multiple colonic polypectomy. PMID- 3557031 TI - Fiberoptic esophagogastroscopy via nasal intubation. PMID- 3557032 TI - Acyclovir in endoscopically presumed viral esophagitis. PMID- 3557033 TI - Primary malignant melanoma of the esophagus. PMID- 3557034 TI - Double channel pylorus as a complication of carcinoma of the stomach. PMID- 3557035 TI - Endoscopic cholangiopancreatography in the infant: evaluation of a new prototype pediatric duodenoscope. AB - The usefulness of a new pediatric duodenoscope PJF in the diagnosis of neonatal cholestasis was studied in 23 infants with ages ranging from 19 to 150 days. In 22 of 23 infants the papilla was cannulated. In 13 of 14 neonates (93%) with neonatal hepatitis, the common bile duct was opacified and biliary atresia was excluded. In one of two neonates with choledochal cyst, the common bile duct was demonstrated. In six of seven neonates (86%) with biliary atresia, only the pancreatic duct was demonstrated and the diagnosis was suspected. Although absence of a common bile duct opacification does not rule out biliary atresia, ERCP with the new duodenoscope proved to be most useful in the diagnosis of normal biliary tree and served to avoid unnecessary surgery in most infants with neonatal cholestasis. PMID- 3557037 TI - Radiologists look at primary panendoscopy. PMID- 3557036 TI - Colonoscopy as an aid in the diagnosis of nonspecific ulcers of the colon. PMID- 3557038 TI - Is endoscopic cholangiopancreatography needed for the jaundiced infant? PMID- 3557039 TI - Benign subcutaneous emphysema after percutaneous endoscopic gastrostomy. PMID- 3557040 TI - Reducing PEG wound problems. PMID- 3557041 TI - Complications of routine diagnostic upper endoscopy. PMID- 3557042 TI - Intraperitoneal hemorrhage following upper gastrointestinal endoscopy. PMID- 3557043 TI - The use of frozen sections during gastrointestinal endoscopy. PMID- 3557044 TI - Massive dilation of the pancreatic duct associated with large calculi. PMID- 3557045 TI - ERCP in the diagnosis of obstructive jaundice following cholecystectomy. PMID- 3557046 TI - Endoscopic treatment of biliary duct strictures in sclerosing cholangitis: follow up assessment of a new therapeutic approach. AB - Endoscopic sphincterotomy was performed on 10 patients with sclerosing cholangitis to improve biliary tract drainage and to remove bile duct sludge and stones. In addition, Gruentzig-type balloons were placed endoscopically to dilate severe biliary duct strictures in eight of these patients, and endoprostheses were inserted to bridge high grade strictures in three patients. In order to assess the effectiveness of endoscopic treatment, we compared the number of hospitalizations for clinical episodes of cholangitis in this patient group for similar periods of time before and after therapy. Episodes of cholangitis requiring hospitalization decreased from 2.5 +/- 0.4 per patient in the 12 months prior to endoscopic therapy to 0.2 +/- 0.2 episodes per patient in the year following treatment and to 0.33 +/- 0.2 episodes per patient in the additional follow-up period during the second year. Liver function tests have improved significantly over the follow-up period of 19.1 +/- 2.6 months from the time of endoscopic treatment. The serum bilirubin decreased from 6.9 +/- 2.0 mg/dl to 2.7 +/- 1.4 mg/dl; serum alkaline phosphatase decreased from 959 +/- 214 IU to 385 +/ 89 IU; and serum transaminase decreased from 117 +/- 17 IU to 77 +/- 12 IU. Endoscopic treatment appears to be effective in patients with severe sclerosing cholangitis. PMID- 3557047 TI - [Diagnostic and prognostic significance of chromosomal changes in acute leukemia in children]. PMID- 3557048 TI - [Clonogenic precursors of granulocytes and macrophages in the bone marrow of children]. PMID- 3557049 TI - [Neutrophil granulocytopathies in various pediatric diseases]. PMID- 3557050 TI - [Colony-stimulating activity of the adhering fraction of bone marrow cells in children]. PMID- 3557051 TI - Increased adenylate energy charges in rat liver or primary cultured rat hepatocytes by diisopropyl 1,3-dithiol-2-ylidenemalonate. AB - Six hours after oral administration in rat liver, diisopropyl 1,3-dithiol-2 ylidenemalonate (malotilate) decreased AMP concentrations by 60% with unchanged total adenine nucleotide concentrations and significantly increased adenylate energy charges of 0.87 in comparison to those of 0.81 in vehicle administered control animals. Twelve hours after incubation in primary cultured rat hepatocytes, malotilate decreased AMP concentrations by 18% and increased ATP and GTP concentrations by 13 and 18% respectively with significantly increased adenylate energy charges of 0.89 in comparison to 0.87 in vehicle control. Increased adenylate energy charges by malotilate coincided with the initiation of increases in protein and de novo purine synthesis in vivo, and are associated with the increased rate of de novo purine synthesis in vitro. PMID- 3557052 TI - Inhibition of rat brain and liver protein synthesis by amphetamine. AB - Dose-dependent, amphetamine-induced reductions in protein synthesis were determined in vivo by measuring [3H]lysine incorporation into trichloroacetic acid precipitated protein in homogenates prepared from different regions of the brain or liver. Low-to-moderate doses of amphetamine (1-5 mg/kg) decreased striatal protein synthesis whereas higher doses (10 mg/kg) reduced it in the cerebral cortices, cerebellum, and remaining portions of the cerebrum, as well as in the striatum and liver. Reductions in regional brain protein synthesis occur following amphetamine treatment in relatively low doses known to change various aspects of physiology and behavior. PMID- 3557053 TI - Rigidity in rats due to radio frequency decerebration and effects of chlorpromazine and mephenesin. AB - Bilateral radio frequency (RF) lesions of the midbrain were produced in an attempt to establish a non-bleeding method of producing decerebrate rigidity in rats. Marked extensor rigidity occurred with a high reproducibility in hindlimbs without the appearance of voluntary movement. Stretch reflex tension induced by repetitive dorsiflexion of the hindfeet was employed as a measure of the intensity of rigidity. Chlorpromazine-HCl (0.1-1 mg/kg, i.v.) and mephenesin (10 50 mg/kg, i.v.) which depress intercollicular decerebrate rigidity, reduced the RF decerebrate rigidity. These results suggest that RF decerebrate rigidity can be used instead of intercollicular transection rigidity in the pharmacological and physiological studies. PMID- 3557054 TI - The role of acetylcholine in tetraethylammonium induced contractures of the chick biventer cervicis muscle in the presence of lidocaine. AB - Lidocaine (0.92 mM) potentiated tetraethylammonium (TEA, 0.6-6 mM) induced contractures of the chick biventer cervicis muscle (BVC) in vitro. The dose ratio for TEA (EC50 in lidocaine/EC50 control) was 1.16 X 10(-3). Lidocaine (0.92 mM) blocked nerve and muscle action potentials in the BVC preparation, blocked slow fibre MEPPS, and blocked indirectly elicited muscle contraction. Lidocaine (0.92 mM) non-competitively blocked acetylcholine (ACh) induced contractures of the chick BVC. Gallamine competitively blocked ACh contractures (pA2 6.53) but produced only a relatively weak non-competitive block of TEA induced contractures in lidocaine. TEA induced contractures of the chick BVC in the presence of lidocaine probably do not involve ACh. PMID- 3557055 TI - Cholinergic agonist and antagonist interactions on motor nerve endings of the rat -evidence for the involvement of presynaptic receptors in the regulation of acetylcholine release. AB - The effects of atropine and oxotremorine on the amplitude of contraction and on the release of Ach from rat isolated diaphragm were examined. Atropine (14-112 microM) induced a dose-related increase in the amplitude of contractions, the effect being potentiated by neostigmine (10 and 100 nM) or by increasing the rate of nerve stimulation and was accompanied by no change in the twitch evoked by retrograde injection of Ach. Atropine (112 microM) depressed the post-tetanic twitch response in muscles incubated in nutrient solution containing or not non paralyzing concentration of d-tubocurarine (1 nM). Atropine (28 and 56 microM) enhanced and d-tubocurarine (1 nM) reduced the carbachol-induced neuromuscular facilitation. Atropine (28 and 56 microM) enhanced the evoked release of Ach, the effect being potentiated by increasing the rate of nerve stimulation. Oxotremorine (5-20 microM) inhibited the muscle contraction and depressed the evoked release of Ach. The effects were both prevented by atropine. The oxotremorine-induced blockade was potentiated by d-tubocurarine (1 nM), the effect being accompanied by no change in the twitch induced by retrograde injection of Ach. These results suggest the presence of muscarinic and nicotinic presynaptic receptors participating in a mechanism which might regulate the release of Ach. PMID- 3557056 TI - cis(-)-2,3-Dihydro-3-(4-methylpiperazinylmethyl)-2-phenyl-1,5- benzothiazepin 4(5H)-one monohydrochloride and its butylbromide as M1-receptor antagonists. AB - Selectivity of cis(-)-2,3-dihydro-3-(4-methylpiperazinylmethyl)-2-phenyl-1,5-b enzothiazepin-4 (5H)-one monohydrochloride (BTM-1086) and its butylbromide (BTM 1073) to subtypes of muscarinic receptor, M1-and M2-receptors were tested, using pirenzepine, a M1-selective antagonist and atropine, a nonselective antagonist as reference drugs. Like pirenzepine, BTM-1086 and BTM-1073 were M1-selective antagonists. BTM-1086 was most selective among the test drugs. BTM-1073, a butylbromide of BTM-1086 was more potent than BTM-1086 in antimuscarinic activity tested on the isolated ileal longitudinal muscle, suggesting that quarternarization increased selectivity to M2-receptor but not to M1-receptor. PMID- 3557057 TI - The thyroxine-stimulating activity is only present in the glycoprotein and not in the protein fraction of a carp hypophyseal homogenate. AB - The in vivo release of thyroxine (T4) in the carp (Cyprinus carpio) and the in vitro release of T4 in the frog (Rana ridibunda) from isolated thyroids were used as a bioassay to study the thyrotropic activity of carp hypophyses. The addition of up to 1 hypophyseal equivalent to the medium did not increase the in vitro release of T4 from isolated frog thyroids in November whereas 3 mU of bovine thyrotropin (b-TSH) was effective. However, when this experiment was repeated at the end of February, the responsiveness of frog thyroids was increased since the addition of 0.5 carp hypophyseal equivalent did stimulate the release of T4. When Winter carp alone were used in an in vivo bioassay, an intracardial injection of up to a dilution of 1/64 hypophyseal equivalent increased plasma concentrations of T4 after 2 and 4 hr. However, 3 mU of b-TSH was ineffective in this regard. Affinity chromatography of b-TSH indicated that all thyrotropic activity as tested in the frog bioassay was retained on a concanavalin (Con A)-Sepharose column. Following Con A separation of a carp hypophyseal homogenate it was finally demonstrated that the unadsorbed protein fractions did not increase plasma concentrations of T4, whereas the adsorbed glycoprotein fraction did. No influence on circulating triiodothyronine (T3) levels was noted with both fractions. These results indicate that the thyrotropic activity of a carp hypophysis is of a glycoprotein nature. PMID- 3557058 TI - Thyroxine 5'-monodeiodinase activity in hepatocytes of rainbow trout, Salmo gairdneri: distribution, effects of starvation, and exogenous inhibitors. AB - L-Thyroxine (T4) 5'-monodeiodinase activity (MDA) of hepatocyte cell fractions of rainbow trout was evaluated by 125I- generation following incubation with [125I 3' or 125I-5']T4 at 12 degrees. Produced in approximately equal proportions, 3,5,[125I-3'] triiodo-L-thyronine and 125I- were the sole labeled products detected by gel permeation on G-25 Sephadex columns, confirming restriction of T4 deiodination in trout to removal of a single outer-ring iodine atom. T3 underwent no significant outer-ring deiodination. MDA activity, located mainly in the microsome fraction, was optimal at a pH of approximately 7.0 and was enhanced by dithiothreitol but not by reduced glutathione. Azide, thiocyanate, thiourea, and KCl exerted no significant influence on MDA, but MDA was inhibited by: 8-anilino 1-naphthalene sulfonic acid greater than N-ethyl maleimide greater than propylthiouracil greater than sodium salicylate greater than KI. Starvation for 2 weeks depressed MDA to 46% of the level of trout fed 1% of body wt once per day. This was due to a decreased Vmax of MDA. In conclusion, trout hepatic microsomal MDA is acutely and chronically susceptible to both exogenous and endogenous factors; as an enzyme responsible for extrathyroidal T3 generation, it may exert a key role in regulating peripheral thyroidal status under both natural and experimental conditions. PMID- 3557059 TI - Neurohormonal control of Na+ and Cl- metabolism in the pulmonate freshwater snail Lymnaea stagnalis. AB - In Lymnaea stagnalis, extirpation of the cerebral ganglia resulted in a significant decrease of the Na+ and Cl- concentrations in the haemolymph. In intact snails, injection of an extract of the cerebral ganglia stimulated the Na+ influx from the external medium in a dose-dependent way. No effect on the Cl- influx was found. Extract injections did not affect the Na+ efflux. The Na+ influx stimulating activity, in relatively high concentrations, was also present in extracts of the median lip nerve (an important neurohaemal area, originating from the cerebral ganglia). The influx-stimulating activity was heat-stable and destroyed by Pronase treatment. It is suggested that in L. stagnalis, Na+ uptake from the medium is controlled by a neurohormone produced by the cerebral ganglia. PMID- 3557060 TI - Induction of rhythmic modulation of haemolymph ecdysteroids in the insect Rhodnius prolixus by treatments which elicit rhythmic ecdysis. AB - The titer of moulting hormones (ecdysteroids) in fifth instar male Rhodnius displays a gradual decline throughout the week preceding ecdysis when animals are maintained in constant light (LL). Multiple sampling of haemolymph from the same animal reveals a constant rate of decline with no increases in titer observed. However, 20-hydroxyecdysone (20HE) provokes increases in the titer of ecdysteroids which occur between 18 and 27 hr after injection. Multiple injections of 20HE provoke regular changes in the rate of decline of the titer. When 20HE is injected into animals reared in LL, a rhythm in the titer of ecdysteroids with an initial periodicity of approximately 28 hr is provoked which is reduced to 24 hr by 72-96 hr after injection. Injection of antiserum to ecdysteroids elicits an immediate rapid oscillation in titer similar to that observed in light/dark (L/D) cycles. Therefore injections of 20HE or antiserum to ecdysteroids can provoke a rhythm in the titer of ecdysteroids in animals reared in LL. Rhythms in ecdysteroid titer would appear to result from the interactions of synthetic and catabolic systems, both of which would appear to be able to act in a timed fashion. Such rhythmic modulation of ecdysteroid titer may provide time cues to the circadian system timing ecdysis. Thus the gated ecdysis rhythm observed after 20HE or antiserum injections may be a response to induced modulation of the ecdysteroid titer. PMID- 3557061 TI - Ecdysteroid titers and Y-organ activity during late anecdysis and proecdysis in the fiddler crab, Uca pugilator. AB - The titer of ecdysone in hemolymph and the ratio of ecdysone to other radioimmunoassay(RIA)-active hemolymph ecdysteroids were compared to in vitro secretion of ecdysone in Y-organs removed from eyestalkless fiddler crabs at various times following eyestalk ablation. Using high-pressure liquid chromatography (HPLC) and RIA it was established that ecdysone, 20 hydroxyecdysone, and RIA-active metabolites are present in the hemolymph at the end of anecdysis and throughout proecdysis. There was little correlation between in vitro secretory activity and total ecdysone in circulation. Ratios of ecdysone and 20-hydroxyecdysone changed during proecdysis as did the percentage of total RIA activity attributable to both. Positive correlations were observed between in vitro Y-organ secretion rates and amounts of ecdysteroids extracted from hemolymph and added to incubation media. PMID- 3557062 TI - Immunocytochemical and ultrastructural evidence for supra- and subesophageal localization of the dorsal-body cells of the snail Helix aspersa. AB - Dorsal-body endocrine cells (DBEC) of the snail were studied by means of immunocytochemical and electron microscopic methods at different times of the reproductive cycle. They specifically bind the anti-methionine-enkephalin (vertebrate--opioid-pentapeptide) antibody and are located not only near the cerebral ganglia but also in the connective tissue surrounding the subesophageal ganglia. Ultrastructural characteristics of these subesophageal cells, however, confirm their clear identity with the previously described supraesophageal cells. The quantitative variations of their immunoreactive content allow us to postulate a likely involvement in reproductive physiology (mating and egg laying). These observations prove that the distribution of the classical "dorsal-body cells" is more extensive than has been admitted until now and that they synthesize methionine-enkephalin-like substance(s). PMID- 3557063 TI - Reproduction in the Mexican leaf frog, Pachymedusa dacnicolor. III. The female. AB - The female of the Mexican leaf frog, Pachymedusa dacnicolor, displays a marked annual ovarian cycle. This consists of a long period of vitellogenic stasis, starting in early fall, soon after the breeding season, and ending in early spring. Oogonial proliferation continues throughout the year and new previtellogenic follicles are formed continuously. During the period of vitellogenesis, from spring to early summer, early, advanced, and postvitellogenic follicles are all found together, a situation that continues through the breeding season. This is correlated with the fact that a breeding female can lay three or more clutches per season. Breeding can begin as early as June and end as late as early September, with peak spawning activity taking place during July and August. An examination of the ovarian hormone secretion pattern in P. dacnicolor during the year revealed that plasma levels of testosterone and estradiol correlated with ovarian growth and attained highest levels in amplectant and ovulating females. Both hormones showed quite similar plasma levels and patterns of change during the annual reproductive cycle. Lowest plasma levels of testosterone and estradiol were found during fall and winter, in females possessing exclusively previtellogenic ovarian follicles. Plasma progesterone levels were maintained at a very low level throughout the year, except for the ovulatory surge, when amplectant and ovulating females may show a three- to sixfold increase. Plasma androstenedione showed a low peak during this phase of the reproductive cycle. Plasma levels of 5 alpha-dihydrotestosterone were 13 to 30 times lower than plasma testosterone levels. The potential roles of these gonadal steroids in controlling ovarian activity and reproduction are discussed briefly. PMID- 3557065 TI - Comparison of type I 5'-deiodination of thyroxine and of reverse-triiodothyronine in rat and chicken liver homogenates. AB - The characteristics of 5'-deiodination in the chicken liver have been compared to those in the rat. Using 6-n-propyl-2-thiouracil (PTU) at 1 mM in vitro, it was shown that, in accordance with former in vivo studies, only type I 5'-deiodinase exists in the liver of the chicken. When PTU was used in a concentration (10 microM) close to its Ki species differences could be demonstrated as for PTU sensitivity. 5'-Deiodinase in the chicken liver was more susceptible against the inhibitor. The early thiol-independent phase of deiodination was longer in the chicken than in the rat. Reverse-triiodothyronine (r-T3) seemed to be a more suitable substrate for this enzyme in the chicken when compared to either T4 degradation or r-T3 degradation in the rat. It is concluded that major characteristics of 5'-deiodination in the chicken are similar to those in the rat; however, the slight variances observed might explain some species differences found earlier. PMID- 3557064 TI - Effects of catecholamines on plasma thyroid hormone levels in arctic charr, Salvelinus alpinus. AB - Plasma levels of L-thyroxine (T4) and 3,5,3'-triiodo-L-thyronine (T3) were measured in arctic charr at 2, 6, or 24 hr after single intraperitoneal injection of epinephrine (E) or norepinephrine (NE). At a dose of approximately 1 microgram/g body wt (sufficient to cause a submaximal dermal melanophore pallor response) plasma T4 was usually elevated at 2 hr, consistently depressed at 6 hr, and unaffected at 24 hr. There was no effect of E on plasma [125I]T4 kinetics or [125I]T4 5'-monodeiodination to [125I]T3. Plasma T3 showed no consistent response to E or NE at any sampling time. At an E dose of 4 ng/g body wt (probably sufficient to cause a physiological elevation in plasma E level), neither plasma T4 nor T3 levels were altered at 6 hr. Acute depression in plasma T4 by the high doses of E and NE may reflect a local neurotransmitter role of catecholamines in inhibiting thyroidal T4 release through action at thyroidal, hypophysial, or hypothalamic levels. PMID- 3557066 TI - Acute changes of the conversion of thyroxine to triiodothyronine in hypophysectomized and thyroidectomized chickens exposed to mild cold (10 degrees). AB - The effect of acute cold (10 degrees) exposure on the tissue level of triiodothyronine (T3) and on the conversion of thyroxine (T4) to triiodothyronine, both in vitro and in vivo, has been investigated in young chickens previously thyroidectomized or hypophysectomized. It was found that cold exposure stimulates T4 to T3 conversion both in vivo and in vitro not only in intact animals but also in hypophysectomized and thyroidectomized ones. It is concluded that peripheral metabolism of thyroid hormones represents a self standing but not sole route of adaptation to changes in environmental temperature. PMID- 3557067 TI - Sex steroid hormones in natural populations of a sexual whiptail lizard Cnemidophorus inornatus, a direct evolutionary ancestor of a unisexual parthenogen. AB - The lizard genus Cnemidophorus consists of both sexual species and unisexual, all female species. We characterized changes in circulating levels of gonadal sex steroid hormones in males and females in one of the sexual species, C. inornatus, to compare them to previously measured levels in a unisexual, parthenogenetic species, C. uniparens. Reproductively active male C. inornatus have high levels of dihydrotestosterone and somewhat lower levels of testosterone. These levels are highest immediately after females become sexually receptive and decrease later at the onset of testicular regression. Female C. inornatus have high levels of estradiol and low levels of progesterone during the previtellogenic and vitellogenic phases of the ovarian cycle. During the postovulatory phase, they have low levels of estradiol and high levels of progesterone. We could not detect circulating levels of androgen at any phase of the ovarian cycle. The patterns of hormone secretion in the female C. inornatus are virtually identical to those of its direct evolutionary descendant, C. uniparens. This confirms our previous conclusion that the evolution of the parthenogenetic mode of reproduction and expression of male-like pseudosexual behavior that are characteristic of the unisexual C. uniparens has not been accomplished by evolutionary modifications in the pattern of sex steroid hormone secretion. Rather it is the response to this pattern of secretion that has been modified. PMID- 3557068 TI - Pheromone from ovulatory female goldfish induces gonadotropin surge in males. AB - Characterization was made of the female stimuli which induce male gonadotropin (GtH) surge during spawning in the goldfish. In the presence of ovulatory females, olfactory tract sectioned (OTX) males failed to show sexual behavior or the GtH surge, while sham-operated (sham) males spawned and showed a GtH surge. When OTX and sham males were separated from ovulatory females with an opaque partition but with water circulating between male and female compartments, the GtH surge occurred only in sham males, although they could not court with the females. These results indicate that an olfactory stimulus (pheromone) from ovulatory females is essential to the occurrence of male GtH surge. Pheromone(s) from ovulatory female goldfish thus functions both as a releaser stimulating sexual behavior and as a primer inducing GtH surge in males. PMID- 3557069 TI - Development of interstitial cells in experimentally sex-reversed gonads of genetically female chick embryos. AB - A testis graft implanted in young genetically female embryos induced a male gonadal differentiation. The interstitial cell percentage and actual content were strongly lowered in masculinized gonads compared to normal female embryos and became similar to those observed in the normal developing embryonic testis. This effect was enhanced by the association of a graft and an antiestrogenic drug, and was not observed after administration of the drug alone. This inhibiting influence of the graft on interstitial cell formation may be considered as resulting in an inhibition of estrogen production. Its possible causative role in gonadal masculinization is discussed in the light of previous and present results. PMID- 3557070 TI - Regulation of melanotropin release from the pars intermedia of the amphibian Xenopus laevis: evaluation of the involvement of serotonergic, cholinergic, or adrenergic receptor mechanisms. AB - Melanophore-stimulating hormone (MSH) release from the pars intermedia of the pituitary gland is probably regulated by multiple factors of hypothalamic origin. We have examined a number of potential regulatory factors for their effects on MSH release from the amphibian Xenopus laevis. Serotonin and acetylcholine have no effect on MSH release. Both adrenaline and noradrenaline inhibit release of MSH in a dose-dependent manner. Studies with specific receptor agonists and antagonists reveal that these neurotransmitters exert their in vitro effects primarily through a dopamine D-2 receptor, although an alpha-adrenergic receptor could not be excluded. We further conclude that the pars intermedia of X. laevis lacks a beta-adrenergic receptor for the regulation of MSH secretion from the pars intermedia. In mammals, this receptor activates the adenylate cyclase system. Our studies reveal that despite the lack of beta-adrenergic receptors, cyclic-AMP is likely an intracellular factor involved in the stimulation of MSH release. PMID- 3557071 TI - Purification, characterization, and bioassay of teleocalcin, a glycoprotein from salmon corpuscles of Stannius. AB - This report describes the isolation of teleocalcin, a glycoprotein hormone from the corpuscles of Stannius (CS) of sockeye salmon (Oncorhynchus nerka), using affinity, gel exclusion, and ion exchange chromatography. In discontinuous, gradient (10-20%) SDS gels under nonreducing conditions, teleocalcin had an estimated molecular weight of of 39,300 and migrated as a single band. Two bands with estimated molecular weights of 28,000 and 32,000 were obtained upon reduction and carboxymethylation of the molecule. In acid-urea gels, teleocalcin migrated as one band with an Rf of 0.17. Amino acid sequence analysis revealed single residues for the first 19 amino acids, with phenylalanine as the N terminal residue. Teleocalcin did not resemble parathyroid hormone (PTH) with respect to amino acid composition and exhibited no cross-reactivity in two PTH radioimmunoassays. Gas-liquid chromatographic analysis of teleocalcin demonstrated that mannose was the principal sugar present (1.86%) and glucosamine was the only hexosamine identified (2.49%). Smaller quantities of galactose (0.49%), fucose (0.44%), and sialic acid (1.6%) were also found. In bioassays using juvenile rainbow trout (Salmo gairdneri), teleocalcin significantly reduced the rate of net branchial 45Ca uptake at dosages as low as 0.02 microgram/g body wt. This inhibitory effect was dependent upon the branchial calcium uptake cycle that has been identified in this species. Pronounced inhibition was observed during periods of high uptake whereas little or no effect was obtained during the low uptake phase. The results are discussed in relation to a possible role of teleocalcin in regulating this cycle. PMID- 3557072 TI - Plasma concentrations of prolactin during the breeding cycle in the Cape gannet (Sula capensis): a foot incubator. AB - Plasma prolactin was measured in the Cape gannet (Sula capensis) which differs from most other avian species in that although both sexes share equally in incubation duties, neither sex possesses an incubation patch but rather incubates a single egg with its foot webbing. Five main categories of birds were studied: nonbreeders, unmated birds which were nevertheless defending a nest site, recently mated birds, incubators, and brooders with nestlings. Prolactin titers in the plasma were 8-9 ng/ml in nonbreeding gannets, increasing to 17.7 +/- 1.6 and 16.7 +/- 1.2 ng/ml in incubating females and males, respectively. Plasma concentrations of prolactin progressively increased in nonbreeding gannets from 5.5 +/- 0.4 ng/ml in 1-year-old birds to 8.7 +/- 1.6 ng/ml in birds defending a nest site but without an egg. Blood samples taken from both incubators and nonincubators every 3 hr over 27 hr did not reveal any significant daily cycling in prolactin titers. Plasma osmolarity did not vary significantly between nonincubators and incubators, being 300.1 +/- 3.2 and 298.2 +/- 3.0 mOsm/kg, respectively. No positive correlation was found between possible osmotic stress during incubating and plasma concentrations of prolactin. Plasma concentrations of luteinizing hormone and testosterone increased while prolactin decreased, significantly, 24 hr after clutch loss. The putative inhibition of the pituitary gonadal axis by prolactin is discussed together with other possible roles of prolactin during the breeding season in gannets. PMID- 3557073 TI - Ecdysteroid levels during the larval development of the spider crab Hyas araneus. AB - Ecdysteroid levels were determined by radioimmunoassay during the larval development of the spider crab Hyas araneus L. In each of the three larval instars (zoea I, zoea II, megalopa) a minimum in ecdysteroid levels was found during early postmoult and a maximum during premoult. The amounts of ecdysteroids increased during development and reached maxima of 93, 137, and 165 pg ecdysone equivalents per larva in zoea I, zoea II, and megalopa, respectively. Ecdysteroid concentrations per unit of body dry weight or carbon increased during each moulting cycle, but the average values showed decreasing tendency from the first to the last instar. The main ecdysteroid in all larval instars and during the moulting cycle was 20-OH-ecdysone, and practically no ecdysone could be detected by HPLC-RIA. PMID- 3557074 TI - [Evidence of apparent vasopressin and oxytocin peptides in the brain of the leech Rhynchobdelle Theromyzon tessulatum (O.F.M.)]. AB - Vasopressin- and oxytocin-immunoreactive cells have been demonstrated in the brain of the leech Theromyzon tessulatum. A mapping of their localization in the different compartments of the brain has been undertaken. The cells immunohistochemically identified have been compared to previously described cell types defined by classical staining methods for neurosecretory material. Preliminary results obtained with high performance liquid chromatography confirm the presence in brain homogenates of substances with chromatographic properties similar to that of vertebrate nonapeptides. The possible role of these vasopressin- and oxytocin-like substances in osmoregulation is discussed. PMID- 3557075 TI - Hormonal control of fat-body glycogen mobilization for locust flight. AB - Fat-body phosphorylase in locusts injected with adipokinetic hormone (AKH I) is highly activated, as revealed by the relative proportions of the three forms present. Activation of phosphorylase during flight is strongly reduced when locusts are ligated at the neck, indicating that this activation is due to a factor from the head, which upon flight is released into the hemolymph. Flight induced activation of phosphorylase is prevented when the release of AKH from the corpus cardiacum is blocked by the presence of high trehalose levels in the hemolymph, and also when the production of AKH is made impossible by prior removal of the corpus cardiacum glandular lobe. These results are discussed in relation to the possible involvement of AKH in the control of fat-body phosphorylase activity during flight. PMID- 3557076 TI - Metabolism of 25-hydroxycholecalciferol in a teleost fish, the rainbow trout (Salmo gairdneri). AB - Plasma concentrations of vitamin D3 (cholecalciferol) metabolites have been studied in rainbow trout (Salmo gairdneri) adapted to varying environmental calcium concentrations in both fresh water and artificial seawater, and in natural seawater. In vivo, intraarterial injection of tritiated 25 hydroxycholecalciferol was followed by its transformation to a number of metabolites including compounds that cochromatographed on high performance liquid chromatography (HPLC) with 1,25-dihydroxycholecalciferol and 25,26 dihydroxycholecalciferol. Hypercalcaemia and increased environmental calcium were associated with a greater transformation to the compound cochromatographing with 25,26-dihydroxycholecalciferol, while hypocalcaemia and reduced environmental calcium concentrations induced more conversion to the 1,25 dihydroxycholecalciferol-like compound. In vitro, both metabolites were produced by liver but not by kidney preparations, and the difference in conversion ratios observed in vivo associated with changes in plasma calcium were also seen in vitro. It is concluded that the metabolism of 25-hydroxycholecalciferol in the trout can be influenced by calcium status, but at present the physiological importance of this metabolism and the mechanisms and site(s) of action of the metabolites are unknown. PMID- 3557077 TI - Autoradiographic localization of gonadotrophin receptors in ovaries of the common carp, Cyprinus carpio L. AB - Binding sites for carp gonadotrophin have been located in carp ovaries using [125I]labeled gonadotrophin and autoradiography. The radioactive gonadotrophin was displaced from tissue by unlabeled gonadotrophin or carp hypophysial homogenate in a dose-dependent fashion. No binding of gonadotrophin was found in previtellogenic oocytes but binding appeared with the first indications of vitellogenesis. In the smaller vitellogenic oocytes binding was uniformly distributed in the follicular envelope, but in the largest oocytes binding was restricted to the interstitial tissue. In these more mature oocytes gonadotrophin was also found within the oocyte and appeared to migrate toward the nucleus. The relationship between binding location, steroidogenesis, and oocyte maturation is discussed. We found no evidence for specific binding of [125I]thyroxine under comparable conditions. PMID- 3557078 TI - Effect of GABAergic treatment on resting and stress-induced adrenocortical activities in the thalamic pigeon. AB - Muscimol was injected (0.5 mg kg-1) intravenously to either intact or thalamic lesioned animals through a chronic catheter. Plasma samples were obtained at 7 min intervals and exhibited a moderate and transient increase in corticosterone levels in both groups, together with some symptoms of light discomfort (e.g., ptiloerection or panting). All these signs disappeared within 45 to 60 min. Intraventricular injection of bicuculline (3.5 micrograms) provoked a corticosterone profile quite similar to a stress-induced polyphasic pattern. Acute stress (electrical footshocks for 30 sec) was applied 2 hr after drug treatment. In controls, the stress-induced adrenocortical response appeared to be markedly modified after muscimol injection. The usual polyphasic rebounding profile was replaced by a monophasic one. This effect of muscimol did not occur when bicuculline had been injected in the 3rd ventricle. Bicuculline alone did not alter the stress-induced profile. GABAergic treatment had no effect on the monophasic response of thalamic-lesioned birds. PMID- 3557079 TI - A possible hormone controlling O2 consumption in the nematode Phocanema decipiens. AB - The third-stage larva of Phocanema decipiens, which initiates development upon transfer from 5 to 37 degrees, has been used in these experiments. Larvae ligatured at both the head and tail ends lose weight more rapidly during the first 4 hr after transfer to 37 degrees than do normal worms or those ligatured at the front end alone. Larvae ligatured at the tail end exhibit a higher rate of O2 consumption as determined manometrically than do normal larvae. The O2 consumption of strips of body wall is depressed by the addition of an homogenate of the posterior ends of worms, but unaffected by the addition of an homogenate of the anterior ends. These facts are consistent with the release from the tail end of the worm of a hormone which depresses the O2 consumption of the worm. PMID- 3557080 TI - The effects of neurohypophysial hormones on the vascular resistance of the isolated perfused gill of the European eel, Anguilla anguilla L. AB - Arginine vasotocin (AVT) and oxytocin (OXY), in the dose range of 2 X 10(-13)-2 X 10(-8) mol, were found to be potent vasoconstrictors of the arterioarterial pathway of isolated perfused eel gills. AVT was significantly (P less than 0.05) more potent than OXY, as indicated by the results of both dose- and concentration response curves. Isotocin (IT) and arginine vasopressin (AVP) were unable to elicit a vascular response at doses of up to 2 X 10(-8) mol. The arteriovenous component of branchial flow was not affected by these four peptides. Results from constant-pressure head and constant-flow preparations yielded similar results. PMID- 3557081 TI - Corticosterone-binding proteins and behavioral effects of high plasma levels of corticosterone during the breeding period in the pied flycatcher. AB - In the pied flycatcher there exists an anomaly in the relationship between cortical histology and plasma levels of corticosterone during the breeding period. In an attempt to study this anomaly, binding capacity and binding affinity of plasma corticosterone-binding proteins (CBP) were studied in free living pied flycatchers during the early and late parts of the breeding period. Binding capacity of CBP showed a significant decrease with the progress of the breeding season in both males and females. During the early parts of the breeding season binding capacity was significantly higher in males than in females. No difference between sexes was observed during the nestling period. In males there also was a seasonal decrease in the binding affinity of CBP. The results show that there is a good relationship between periods with high plasma levels of corticosterone and its binding capacity in the blood. A second study showed that an experimentally increased plasma level of corticosterone during the nestling period drastically reduced reproductive success. Parents given silastic implants containing corticosterone fed their nestlings less frequently and produced significantly fewer fledglings than did controls. Unlike the control birds, the body weight of the corticosterone-implanted birds did not decrease during the nestling period. Birds given corticosterone implants in which one small hole had been punched, in order to facilitate diffusion of corticosterone, all abandoned their territories and, consequently, these parents produced no fledglings. Thus, the results show that an elevation of plasma levels of corticosterone in adult pied flycatchers during the nestling period affects parental as well as territorial behavior. PMID- 3557082 TI - Seasonal variation of plasma testosterone in a wild population of male Eastern quoll, Dasyurus viverrinus (Marsupialia: Dasyuridae), from Tasmania. AB - In the wild, male Eastern quoll, Dasyurus viverrinus, exhibit a synchronized sequence of increase and decrease in plasma testosterone concentration, body weight, and scrotal size in response to the breeding season. Basal concentrations of peripheral testosterone between 0.5 and 0.7 ng/ml circulate during the nonbreeding period. By April, 2 months prior to breeding, testosterone concentrations increased to around 1.6 ng/ml. This increase may reflect a resurgence in testicular activity, as scrotal size is maximal at this time. A synchronized testosterone peak of 5.0 ng/ml was observed during the mating period in early June. With the cessation of breeding, testosterone concentrations in resident males returned to basal levels by July; however, transient males maintained elevated levels for slightly longer. The timing of breeding and the short duration of the testosterone breeding peak enable the quoll to intensify its reproductive effort. PMID- 3557083 TI - Induction of egg spawning in Gibbula umbilicalis (da Costa) by an homogenate of the cerebral ganglia. AB - A putative egg-spawning neurohormone (ESH) has been demonstrated in extracts of the cerebral ganglia from the prosobranch gastropod, Gibbula umbilicalis, using an in vivo bioassay. The active principle is not sex-specific, although spawning in males cannot be induced with injections of ganglion extracts. A partial characterization of the ESH indicates that it is a stable peptide. ESH activity could be detected in the bioassay at a level of 0.625 cerebral ganglion equivalent in a dilution series ranging down from 5.0 ganglion equivalents, with 1.25 ganglion equivalents being the most potent dose. Egg release could be induced for only a short period of the year in vivo, but this period corresponded well with that of natural spawning in the field. PMID- 3557084 TI - Seasonal changes in pineal melatonin content and hydroxyindole-O methyltransferase activity in juvenile chinook salmon, Oncorhynchus tshawytscha. AB - Juvenile fall and spring chinook salmon were examined for seasonal changes in pineal hydroxyindole-O-methyltransferase (HIOMT) activity. Numerous small peaks in pineal HIOMT specific activity were found in fall chinook salmon and HIOMT activity per pineal gland increased linearly with age and/or size. In spring chinook salmon, cyclic changes in pineal HIOMT specific activity occurred in midsummer and midwinter, independent of the photoperiod under which the fish were reared. HIOMT activity per pineal gland showed a peak in midwinter. Activity increased with age and/or size of the fish during the following spring. Melatonin content of the pineal gland of spring chinook salmon did not change seasonally in fish reared under a normal photoperiod. Fish reared under constant illumination had about 50% higher pineal melatonin content than those under a normal photoperiod until November. At that time, pineal melatonin content decreased to the same level as that of fish reared under a normal photoperiod. PMID- 3557085 TI - Preparation and culture of dispersed avian pituitary cells, and age-related changes in donor pituitary weight and growth hormone content. AB - Techniques were perfected for the enzymatic dissociation of chicken pituitary glands and a number of factors evaluated for their effects upon growth hormone (GH) production by dispersed chicken pituitary cells in culture. Age-related changes in donor pituitary weight and GH content were also determined. A procedure involving digestion of minced glands with a solution of 0.1% trypsin in S-MEM tissue culture medium (0.1% BSA) for 1 hr at 37 degrees under an atmosphere of 5% CO2-95% air yielded greater than 2.0 X 10(6) cells per gland with 80-90% viability. Five tissue culture media (D-MEM, alpha-MEM, RPMI 1640, Med-199, Earle's salts), two serum sources (calf serum (CS), horse serum (HS), and two levels of serum (5, 20%) were tested for their ability to support GH synthesis over 4 days in culture. Additionally, two culture regimes (continuous culture vs daily media changes) were evaluated for their effects on GH production. alpha-MEM resulted in the numerically highest net GH synthesis (over starting cell content), although not statistically different from RPMI 1640 or Earle's salts. Neither serum type nor percentage was significant; therefore the lower serum percentage (5) was adopted for future studies. Culture regime significantly altered the proportion of secreted vs stored hormone harvested at the end of the culture period. Changing media daily resulted in a 40% reduction in final cell GH content compared to continuous culture, whereas total cumulative media GH was approximately 39% greater (P less than 0.01). Pituitary weight increased with age until approximately 9 weeks, whereas GH content plateaued earlier, at 5 weeks of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557086 TI - Gonadotropin hormone (GtH) receptors in the ovary of the brown trout Salmo trutta L. in vitro studies. AB - A method has been developed suitable for the study of the binding of salmon (Oncorhynchus tsawytscha) gonadotropic hormone (GtH) to brown trout (Salmo trutta) ovarian particulate fractions. Several proteolytic enzyme inhibitors were tested to preserve the binding capacity of particulate fractions (1000, 20,000, and 110,000g) from yolky oocytes. The best preservation was obtained with trypsin inhibitor. The effects on binding of the pH, time, and temperature of the incubation were investigated. Binding increased linearly with amount of particulate fraction, and is saturable. In both the 20,000 and 110,000g fractions, there are two classes of receptors: one with a high-affinity constant (3.14 and 0.95 10(10) M-1 for the 20,000 and 110,000g fractions, respectively) and a low capacity (1.76 and 0.63 fmol/g of ovary), the other with a higher affinity constant (3.44 and 1.78 10(9) M-1) but a higher capacity (7.37 and 7.42 fmol/g of ovary). GtH binding was not affected by ovine luteinizing hormone (oHL), ovine follice-stimulating hormone (oFSH), and human chorionic gonadotropin (hCG), but was partially inhibited by 1 micrograms of bovine thyroid-stimulating hormone (bTSH) and salmon prolactin (sPRL). The results are discussed in relation to the biological specificity of fish GtH and to the unsolved problem concerning the number of gonadotropins in fish. PMID- 3557087 TI - Short-term profiles of plasma gonadotropin and estradiol-17 beta levels in the female rainbow trout, from early ovarian recrudescence and throughout vitellogenesis. AB - At various stages throughout the annual reproductive cycle, female rainbow trout (Salmo gairdneri) were fitted with a catheter in the dorsal aorta. They were bled via the catheter at frequencies of once every 30, 60, or 240 min over periods of 5 to 24 hr. Gonadotropin (GtH), estradiol-17 beta (E(2)17 beta). and estrone levels were measured in the plasma samples. At early ovarian recrudescence (March), short-term (1-2 hr), high-amplitude (delta GtH = up to 100 ng/ml), episodic pulses of GtH were recorded in the plasma of 12 of the 26 studied fish. In the others, GtH levels remained low and constant. No synchronization was found among the individual GtH profiles. E(2)17 beta levels in the same fish were low and constant while estrone was not detectable. At early stages of exogenous vitellogenesis (June), plasma GtH (1-3 ng/ml) and E(2)17 beta (0.5-1.5 ng/ml) levels were low and constant. At advanced stages of exogenous vitellogenesis (September-October), fluctuating GtH levels were found again in most of the females; basal GtH concentrations were only slightly higher than those recorded in June. The fluctuations consisted of short-term (1-3 hr) random GtH pulses of moderate amplitude (delta GtH = up to 5 ng/ml), occurring at a relatively high frequency (up to 5 per 12 hr). Although no regular synchronous daily pattern of GtH was noted, most of the GtH pulses were observed during the photophase and early scotophase. The appearance of GtH pulsatility during exogenous vitellogenesis was accompanied by a large increase in plasma E(2)17 beta up to levels ranging from 6 to 30 ng/ml. In contrast to the GtH profiles, the E(2)17 beta profiles showed continuous and progressive variations, superimposed the abrupt GtH pulses, and a high degree of synchronization. E(2)17 beta levels increased during the photophase and reached maxima toward and during early scotophase. PMID- 3557088 TI - Short-term profiles of plasma gonadotropin and 17 alpha-hydroxy, 20 beta dihydroprogesterone levels in the female rainbow trout at the periovulatory period. AB - Individual free-swimming female rainbow trout in which oocytes underwent final stages of germinal vesicle migration, maturation, or ovulation were bled via a dorsal-aortic catheter at frequencies of once every 1, 3, or 4 hr over periods of 9 to 36 hr. Gonadotropin (GtH) and 17 alpha-hydroxy,20 beta-dihydroprogesterone (17 alpha,20 beta-OHP) levels were measured in the plasma samples. GtH levels were elevated and showed wide and progressive daily variations. A high degree of synchronization appeared among the GtH profiles of individual fish. Two distinct daily GtH surges were observed, one at early photophase and the other during the mid-scotophase. The onset of the GtH increases was closely related to the beginning of the photophase and the scotophase, respectively. In females undergoing oocyte maturation or in ovulated females, 17 alpha,20 beta-OHP levels were increasing or high, showing progressive daily fluctuations that were either synchronized with the GtH changes or somewhat phase-shifted in relation to them. These data are discussed in relation to the seasonal changes in the short-term profiles of reproductive hormones in the trout. PMID- 3557089 TI - Endocrine profiles in the males of a twice-annually spawning strain of rainbow trout, Salmo gairdneri. AB - The male reproductive cycles of a twice-annually spawning strain of rainbow trout were studied by monitoring the plasma gonadotropin (GtH) and steroid hormone levels in individual fish for more than a year using thirty-five 2.5-year-old mature males. Twenty-five males survived the whole experimental period and were divided into four groups according to the amount of milt and endocrine profiles. In the summer breeding season, milt amount was negligible in Group I and small in Group II with low plasma testosterone, 11-ketotestosterone (11-KT), and 17 alpha,20 beta-dihydroxy-4-pregnen-3-one (17 alpha,20 beta-diOH-P) levels, whereas both groups showed a large amount of milt and a distinct increase in steroid levels in the winter breeding season (November-January). Group III expelled a large amount of milt in both the summer and winter breeding seasons, and plasma testosterone, 11-KT, and 17 alpha,20 beta-diOH-P showed a clear peak in each breeding season. In Group IV, milt was expelled from December to July, and plasma steroid levels remained high until June before declining to the basal levels; however, these fish failed to mature in the ensuing winter breeding season. Plasma GtH levels in Groups III and IV were significantly higher than those in Groups I and II in the summer breeding season. These results clearly indicate that fish in Group III are twice-annual spawners. PMID- 3557090 TI - Effects of thyroxin, cortisol, growth hormone, and prolactin on lipid metabolism of coho salmon, Oncorhynchus kisutch, during smoltification. AB - Juvenile coho salmon, Oncorhynchus kisutch, were either immersed in thyroxin containing water (T4; 20 micrograms/ml) or implanted with cortisol (5 mg), bovine growth hormone (GH; 1.5 microgram/g body wt), or ovine prolactin (PRL; 1.5 microgram/g body wt), both early and late in smoltification. T4 and cortisol treatment stimulated lipid mobilization in parr. T4-stimulated lipid mobilization was indicated by decreased total lipids, primarily as triacylglycerols, and increased lipolytic enzyme (triacylglycerol lipase) activity in the liver and dark muscle. T4-stimulated lipid mobilization from mesenteric fat was indicated by decreased total tissue mass and by increased lipase activity. Cortisol caused significant reductions in total lipid concentration and triacylglycerol content of the liver and dark muscle; these effects were accompanied by increased lipase activity. Cortisol treatment did not affect mesenteric fat total lipid concentration, total tissue mass, or triacylglycerol content. However, cortisol implantation did enhance mesenteric fat lipase activity. Thyroxin and cortisol treatment failed to elicit alterations in the pattern of tissue lipid mobilization of smolts. GH stimulated lipid mobilization from coho salmon parr. Depletion of liver total lipids was accompanied by increased lipolytic enzyme (triacylglycerol lipase) activity. GH had limited effects on dark muscle and mesenteric fat. In smolts, GH had virtually no effect on lipid mobilization. PRL strongly stimulated lipid mobilization in parr; this effect was evident in all depots studied (liver, dark muscle, mesenteric fat). Decreases in total lipid concentration, or in total tissue mass (mesenteric fat), were accompanied by increased lipase activity and generally resulted in reduced tissue triacylglycerol content. Smolts appeared refractory to PRL treatment. Smolts (characteristically possessing elevated liver lipase activity) that were hypophysectomized exhibited low levels of liver lipase activity. Cortisol replacement restored enzyme activity to approximately the same levels as those observed in sham-operated controls. GH replacement restored lipase activity, but not to the levels observed in sham-operated controls. These results indicate that T4, cortisol, GH, and PRL all stimulate lipid mobilization in developing salmon by enhancement of lipolysis and suggest that T4, cortisol, GH, and PRL are among the factors which contribute to smoltification-associated lipid depletion. PMID- 3557091 TI - Circadian rhythms in serotonin, norepinephrine, and epinephrine contents of the pineal-paraphyseal complex of the soft-shelled turtle (Lissemys punctata punctata). AB - Diurnal variations in pineal serotonin, norepinephrine, and epinephrine levels were measured at four different time intervals (06:00, 12:00, 18:00, and 24:00 hr) in adult male soft-shelled turtles. The serotonin level increased during day and decreased during night. But the norepinephrine and epinephrine levels showed reverse changes. The findings reveal that there is a distinct circadian rhythm in serotonin, norepinephrine, and epinephrine contents of the pineal-paraphyseal complex in adult male soft-shelled turtles. PMID- 3557092 TI - Calcium-dependent chronotropic action of bovine parathyroid hormone (1-34) in isolated atria of Japanese quail, Coturnix coturnix japonica. AB - The involvement of extracellular calcium in the chronotropic action of parathyroid hormone (PTH) in isolated quail atria was studied. Bovine (b) PTH-(1 34) caused dose-dependent increases in the atrial beating rate. The PTH-induced positive chronotropism was significantly attenuated by lowering the extracellular calcium concentration or by using the calcium channel antagonists verapamil and D600. This suggests the importance of calcium influx in the cardiac action of PTH. beta-Adrenergic blockade with propranolol did not affect the responses to bPTH-(1-34). This further substantiates the previous findings that the PTH action is independent of cardiac beta-adrenoceptor stimulation. PMID- 3557093 TI - The effect of prolactin on fanning behavior in the male three-spined stickleback, Gasterosteus aculeatus L. AB - The effect of administration of homologous prolactin on fanning behavior, an important aspect of parental care in sticklebacks and many other teleost fish, was studied. Prolactin was administered by implantation of an additional pituitary prolactin lobe in the dorsal body musculature of males with a nest without eggs. The low but rather constant level of fanning behavior is significantly increased from Day 6 to Day 12 after administration of the prolactin lobe. The implantation has no noticeable effects on cell and nuclear size or on the ultrastructure of the in situ prolactin cells of the recipient fish. Recovered prolactin lobe implants show two categories of prolactin cells. The major category consists of cells that are well developed and, similar to in situ prolactin cells, show structural signs of high secretory activity. The other prolactin cell category in the implants shows signs of cellular involution. Ten days after implantation, the first category predominates, and 16 days after implantation the second category. Prolactin lobe implantation increases the number of mucocytes in the epithelium of the skin, in particular at Day 10, and to a lesser extent at Day 16. This is considered evidence for a transient rise in blood prolactin levels in the recipient fish. We conclude that prolactin stimulates fanning behavior in male sticklebacks. PMID- 3557094 TI - Effect of melatonin on oocyte growth and recruitment, hypophyseal gonadotrophs, and oviduct of the frog Rana cyanophlyctis maintained under natural photoperiod during the prebreeding phase. AB - The effect of 25 and 50 micrograms melatonin on oocyte growth and recruitment, hypophyseal gonadotrophs, and oviduct was studied in Rana cyanophlyctis maintained under natural photoperiod (12.36 L/11.24 D) during the prebreeding phase (April). During the experiment minimum and maximum temperature was 20 +/- 0.2 degrees and 37.2 +/- 0.3 degrees, respectively; the daily fluctuation between these was 17 +/- 0.4 degrees. Melatonin was injected (ip) 6 days a week for 31 days and frogs were killed on the 32nd day. Treatment with 25 or 50 micrograms melatonin 2 hr after the beginning of natural photophase had no effect on the gonadosomatic index (GSI) or on the percentage and number of oocytes at each stage of development. Injections 7 hr after the beginning of the natural photophase caused a marked decrease in the percentage of medium second growth phase (MSGP) and large second growth phase (LSGP) oocytes, while the percentage of the first growth phase (FGP) oocytes increased. However, in 50% of the 25 micrograms and 62.5% of the 50 micrograms melatonin-injected frogs, there was significant reduction in the number of both MSGP and LSGP oocytes. Frogs which received melatonin (25 and 50 micrograms) 11 hr after the onset of natural photophase exhibited a significant (P less than 0.05) decrease in the number of MSGP and LSGP oocytes and GSI. Atretic follicles (AF) increased in all the melatonin-treated groups, but a significant increase was seen only in evening injected frogs receiving 50 micrograms melatonin. The mean diameter of the largest oocytes decreased significantly in 50 micrograms melatonin-injected frogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557095 TI - Neuroendocrine control of physiological color change in Chameleo gracilis. AB - Color changes in Chameleo gracilis are under neuroendocrine control. Denervation of the limbs, by removal of the sciatic or brachial nerves, does not interfere with the normal color changes in the affected limbs. Denervated skins, placed back onto C. gracilis, show color changes in synchrony with the rest of the animal. Pieces of isolated skin turn very dark or black in alpha-melanophore stimulating hormone (alpha-MSH) and green in adrenaline, but do not show any color changes in physiological saline. Hypophysectomized animals turn green but never turn dark. Injections of alpha-MSH cause intact or hypophysectomized animals to turn dark or black, while injections of adrenaline cause them to turn light green. Injections of physiological saline have no effect. Crude pituitary extracts cause darkening of isolated skins or of intact animals injected with such extracts. Similar treatment with crude extracts of adrenal glands causes the skins to become light green. Electrical stimulation of transected spinal cord leads to localized lightening of the skin but never to darkening of the same. Light, temperature, darkness, and color of the surroundings influence color change. Color change to green at night and to darker colors in the daytime suggests a possible circadian rhythm in the phenomenon. PMID- 3557096 TI - In vitro metabolism of steroid hormones in the liver and in blood cells of male rainbow trout (Salmo gairdneri Richardson). AB - Male rainbow trout show high plasma androgen levels beginning with the period of full spermatogenesis until the end of spermiation. The difficulties in explaining the steroid levels in regard to the concomitant changes of the plasma GTH concentrations prompted investigations into whether the steroid demand may be met in part by extragonadal steroid metabolism. The results of in vitro experiments with liver tissue fit into the concept of an interrenal-liver-gonad axis of androgen production, since increased amounts of C-19 steroids were detected in the media after incubation of hepatic tissue with cortisol. 17 beta Hydroxysteroid dehydrogenase and hydroxysteroid glucuronyltransferase activities were shown to be associated with blood cells of mature males. The fact that unidentified products from incubations with 17 beta-estradiol, testosterone, and 17 alpha-hydroxyprogesterone were also found suggests that other steroid metabolizing enzymes are also associated with blood cells. The possibility is discussed that, assuming the blood cell activities are relevant in vivo, a production of potent androgens or the formation of water soluble steroid derivatives could proceed in the blood (e.g., 11-ketoandrostenedione----11 ketotestosterone; testosterone----testosterone glucuronide), possibly affecting the organism's steroid balance. PMID- 3557097 TI - The effect of age on egg production in the domestic hen. AB - The effect of age on egg production was investigated in the domestic fowl. The rate of egg production was reduced with increasing age and the incidence of thin shelled and cracked eggs was markedly increased. Older hens which remained in lay produced fewer but larger eggs than the younger birds. The ovaries of these two groups of hens were of similar appearance but the largest preovulatory follicle and the oviduct were significantly heavier in the older birds. No differences in the circulating levels of progesterone or estradiol were apparent between the young and old birds but the activity of the renal 25-hydroxycholecalciferol 1 alpha-hydroxylase was found to be significantly reduced with age. Circulating levels of total and ionized calcium were very similar in the young and old laying birds, plasma ionized calcium levels being markedly depressed during egg shell calcification in both groups. The decreased rate of ovulation in the older birds and the increase with age in the size of the follicles ovulated is thought to be associated with a reduced rate of recruitment of follicles for rapid growth followed by a prolonged period of follicular growth and development. The poor calcification of egg shell in old birds would appear to be due to some dysfunction of the shell gland, possibly associated with reduced synthesis of 1,25-dihydroxycholecalciferol by the kidney. The maintenance of plasma ionized calcium concentrations does not appear to be of primary importance in this respect. PMID- 3557098 TI - Thyroid hormones in blood plasma of developing salmon embryos. AB - Blood plasma thyroxine (T4) and 3,5,3'-triiodo-L-thyronine (T3) concentrations in developing embryos of chum (Oncorhynchus keta), coho (Oncorhynchus kisutch), chinook (Oncorhynchus tschawytscha), and Atlantic salmon (Salmo salar) were measured by radioimmunoassay between hatching and completion of yolk-sac absorption. Blood sampling was initiated when approximately 50% of the yolk that was present at hatching had been absorbed. At this time blood plasma levels of T4 (7-9 ng/ml) and T3 (1-5 ng/ml) were similar in all species. In embryos of each salmon species blood plasma levels of T4 increased to maximal values (9-16 ng/ml) when both differentiation of the abdominal body wall and absorption of the yolk sac were completed. Blood plasma levels of T3 generally decreased to low or nondetectable values during this time. There was either a trend toward a decrease or a stasis of levels of T4 and at the same time in some species an increase in levels of T3 in the blood plasma following the completion of yolk-sac absorption and the onset of exogenous feeding. These results demonstrate that thyroid hormones are present in the blood of developing teleost embryos. This finding is discussed in light of the possible role of thyroid hormones in control of the embryonic and larval development of fishes. PMID- 3557099 TI - Constant photoperiod regimes and the entrainment of the annual cycle of reproduction in the female rainbow trout (Salmo gairdneri). AB - The effect of constant photoperiod regimes on the timing of maturation and the associated changes in serum oestradiol-17 beta (E2), testosterone (T), and total calcium (Ca2+, as an index of vitellogenin) were investigated in virgin female rainbow trout (Salmo gairdneri). From mid-January four groups of fish were maintained on constant long days (18L:6D) and one group on constant short days (6L:18D; group A). On May 8 the photoperiod of three of the groups on long days was abruptly reduced from 18L:6D to 6L:18D (group B), to 10L:14D (group C), or to 14L:10D (group D); Group E remained on 18L:6D throughout the experiment. The reduction in photoperiod per se appeared more important than the magnitude of the reduction in the advancement of the time of spawning with the first fish in groups B, C, and D spawning on September 3, 13, and 24, respectively; spawning of the remaining fish in each group was spread over 6-week periods. In contrast, spawning in group E began on October 24 and was spread over a period of 12 weeks. Spawning in group A was delayed until the following March. Although a long photoperiod earlier in the year was clearly necessary for the advancement of spawning, as evidenced by the delay in maturation under constant short days, no clear increases in E2, T, and Ca2+ were detected until after the reduction in photoperiod. Thereafter, the sequence of changes in serum E2, T, and Ca2+ levels was similar in all groups although the timings of these alterations were modified in relation to the time of spawning. Thus, peak levels of the three serum parameters were attained earliest in the year by fish in group B followed by those in groups C, D, E, and A, respectively. Collectively, these data support the hypothesis that photoperiod entrains an endogenous rhythm of maturation rather than having a direct, driving influence on the control of reproduction. PMID- 3557100 TI - The neuroendocrine mechanism responsible for sexual inversion of the gonad in the protandrous hermaphroditic mollusc, Crepidula fornicata L. AB - An in vitro investigation has clarified the neuroendocrine mechanism responsible for the differentiation of the female gonad in the protandrous hermaphrodite Crepidula fornicata. The male gonads were used as target organs; in some experiments they were brought to a uniform resting state by prior decerebration of donor animals. When isolated in culture, most of the male gonad degenerates, leaving only the stem cells lining the wall of the acini. No ovarian autodifferentiation has been observed. A masculinizing factor, released by the nervous ganglia during the male phase, controls spermatogonial mitosis and maintenance of male differentiation. A feminizing factor, secreted by the nervous ganglia during sex inversion and the female phase and present in the hemolymph, initiates oogonial mitosis and female differentiation in the male phase gonad. PMID- 3557101 TI - A neuropeptide (Calfluxin) is involved in the influx of calcium into mitochondria of the albumen gland of the freshwater snail Lymnaea stagnalis. AB - In the course of a study on the role of Ca2+ in the regulation of the secretion process in a female accessory sex gland, the albumen gland of the freshwater snail Lymnaea stagnalis, it appeared that the percentage of mitochondria containing Ca2+ deposits varied significantly in the successive stages of the egg laying process. Ca2+ was demonstrated at the ultrastructural level with the pyroantimonate precipitation technique. A significant increase of the percentage can be correlated with the onset of synthetic activity. Two gonadotropic (neuro) hormones are known to stimulate synthetic activity, viz. the cerebral caudo dorsal cell hormone (CDCH) and the dorsal body hormone (DBH). In vitro experiments involving addition of extracts of various parts of the cerebral ganglion-dorsal body (DB) complex to albumen glands showed that neither CDCH nor DBH causes the influx of Ca2+ into the mitochondria of the gland cells, but that another factor is responsible. The factor is present in the cerebral commissure. It is pronase sensitive and heat stable. The factor is released from isolated cerebral ganglia-DB complexes upon stimulation with 8-chlorophenylthio-cAMP. Probably the factor is a CDC peptide. It is called Calfluxin. PMID- 3557102 TI - Effect of melatonin on gonads, body weight, and luteinizing hormone (LH) dependent coloration of the Indian finch, Lal munia (Estrilda amandava). AB - Four doses of melatonin were administered intramuscularly over 30 days in separate groups of intact adult male Lal munia, Estrilda amandava, during mid-day (1300 hr) and mid-night (0100 hr) in separate sets during the month of August (late progressive phase), and their effects were studied on the body weight, gonadal and thyroidal activities, and luteinizing hormone (LH)-dependent plumage and beak pigmentation. Melatonin, irrespective of its dose and the time of administration, invariably induced complete inhibition of seasonal gonadal growth and activity, and also the LH-dependent plumage pigmentation. Melatonin had no effect on LH-dependent beak coloration. The inhibitory effect of melatonin on the body weight growth was found to be dependent on the time of administration and the dose of the hormone. Melatonin inhibited the thyroid activity in all the groups. These findings seem to suggest that while melatonin influences gonadal activity, body weight growth, and thyroid activity by acting directly at the hypothalamo-hypophyseal complex, it counteracts the effect of LH at the feather papillae level. Further, synthesis and/or release of FSH seems to be more sensitive to melatonin than that of LH. However, the metabolic action of melatonin might be species specific. PMID- 3557103 TI - 20 (OH) ecdysone-induced transition from intermolt to premolt protein biosynthesis patterns in the hypodermis of the crayfish, Astacus leptodactylus, in vitro. AB - 20 (OH) Ecdysone-induced alteration of protein biosynthesis and secretion by the hypodermis of the crayfish Astacus leptodactylus was studied using isolated tissues in vitro. Characteristic quantitative and qualitative changes of late intermolt tissues are governed by the hormone in a dose- and time-dependent manner. The greatest response to the hormone was observed in tissues which were exposed for 48 hr to 10(-8) M 20 (OH) ecdysone, followed by 1 day of hormone withdrawal. The observed differences correspond to the reprogramming in protein biosynthesis after transition from intermolt to the premolt stage. PMID- 3557104 TI - Effect of lysophosphatidylcholine on salt permeability through the erythrocyte membrane under haemolytic conditions. AB - Human erythrocytes were incubated in haemolytic salt or sucrose media and the amount of potassium and haemoglobin released were monitored. In hypotonic NaCl and KCl solutions potassium release and haemolysis increased with time showing that the cell membrane had been injured and became permeable to intra- and extracellular cations which, due to intracellular haemoglobin, causes water influx and continuous haemolysis. Both potassium release and haemolysis remained, however, at their 2-minute level in the presence of LPC. Thus, LPC could reseal the membrane and prevent continuous salt fluxes. It protected erythrocytes from hypotonic haemolysis and the protection was more efficient in NaCl than in sucrose media. This suggests that the increase in the critical volume of erythrocytes caused by LPC occurs both in electrolyte and sucrose media, and the additional protection observed in electrolyte media is due to the resealing of the injured cell membrane by LPC. The repairing mechanism was mediated via the membrane lipids or integral proteins, since the time-course of haemolysis of erythrocytes swollen in NaCl media at the spectrin-denaturing temperature of 49.5 degrees C was similar to that at room temperature with and without LPC. LPC did not protect erythrocytes from colloid osmotic haemolysis caused by ammonia influx in an isotonic NH4Cl medium, but protected the cells from colloid osmotic haemolysis caused by sodium influx through nystatin-channels in NaCl media without any area or volume increase. Hence, LPC could not prevent ammonia influx through the lipid bilayer, but suppressed sodium influx through nystatin-channels presumably via LPC interference with cholesterol. PMID- 3557105 TI - Effect of activated oxygen species on mitochondria isolated from myocardium after reperfusion injury. PMID- 3557106 TI - Recessive lethal mutations and the maintenance of duplication-bearing strains of Dictyostelium discoideum. AB - Recessive lethal mutations have been isolated and used to maintain n + 1 aneuploid strains of Dictyostelium discoideum carrying a duplication of part or all of linkage group VII. The recessive lethal mutations, relA351 and relB352, arose spontaneously in diploids; no mutagenic treatment was used in the isolation of these mutations. The probable gene order on linkage group VII is: centromere, relB couA, bsgB, cobA, relA. Maintenance of aneuploids disomic for linkage group VII was made possible by complementation of a rel mutation on each linkage group VII homologue by the corresponding wild-type allele on the other linkage group VII homologue. The duplication-bearing disomic strains were slow-growing and produced faster-growing sectors on the colony edge. Haploid sectors probably arise by a combination of mitotic recombination and subsequent loss of one homologue, diploid sectors may be formed by chromosome doubling to 2n + 2, followed by chromosome loss to return to 2n, and aneuploid sectors may arise by deletion or new mutation. PMID- 3557107 TI - Gain-of-function mutations of fem-3, a sex-determination gene in Caenorhabditis elegans. AB - We have isolated nine gain-of-function (gf) alleles of the sex-determination gene fem-3 as suppressors of feminizing mutations in fem-1 and fem-2. The wild-type fem-3 gene is needed for spermatogenesis in XX self-fertilizing hermaphrodites and for male development in both soma and germ line of XO animals. Loss-of function alleles of fem-3 transform XX and XO animals into females (spermless hermaphrodites). In contrast, fem-3(gf) alleles masculinize only one tissue, the hermaphrodite germ line. Thus, XX fem-3(gf) mutant animals have a normal hermaphrodite soma, but the germ line produces a vast excess of sperm and no oocytes. All nine fem-3(gf) alleles are temperature sensitive. The temperature sensitive period is from late L4 to early adult, a period just preceding the first signs of oogenesis. The finding of gain-of-function alleles which confer a phenotype opposite to that of loss-of-function alleles supports the idea that fem 3 plays a critical role in germ-line sex determination. Furthermore, the germ line specificity of the fem-3(gf) mutant phenotype and the late temperature sensitive period suggest that, in the wild-type XX hermaphrodite, fem-3 is negatively regulated so that the hermaphrodite stops making sperm and starts making oocytes. Temperature shift experiments also show that, in the germ line, sexual commitment appears to be a continuing process. Spermatogenesis can resume even after oogenesis has begun, and oogenesis can be initiated much later than normal. PMID- 3557108 TI - Homology requirement for efficient gene conversion between duplicated chromosomal sequences in mammalian cells. AB - We report experiments designed to test homology dependence for gene conversion between duplicated chromosomal sequences in cultured mammalian cells. The experimental system is such that gene conversion events not associated with reciprocal exchange are recoverable. For this study four plasmids were constructed. Each contains a different duplication of the herpes simplex virus thymidine kinase (HSV tk) gene sequence. In particular, the interacting sequences share different lengths of homology. Our results indicate that for shared homologies between 295 base pairs (bp) and 1.8 kilobase pairs (kbp) in length, conversion is efficient with the rate being directly proportional to the extent of homology. In contrast, conversion with either 200 bp or 95 bp of homology is inefficient, and the rate is reduced at least seven- or 100-fold, respectively, relative to that observed with 295 bp of homology. These results are consistent with the notion that greater than 200 bp of homology are required for efficient gene conversion between repeated chromosomal sequences in mammalian cells. PMID- 3557109 TI - Patterns of somatic mutations in immunoglobulin variable genes. AB - The mechanism responsible for somatic mutation in the variable genes of antibodies is unknown and may differ from previously described mechanisms that produce mutation in DNA. We have analyzed 421 somatic mutations from the rearranged immunoglobulin variable genes of mice to determine if the nucleotide substitutions differ from those generated during meiosis and if the presence of nearby direct and inverted repeated sequences could template mutations around the variable gene. The results reveal a difference in the pattern of substitutions obtained from somatic mutations vs. meiotic mutations. An increased frequency of T:A to C:G transitions and a decreased frequency of mutations involving a G in the somatic mutants compared to the meiotic mutants is indicated. This suggests that the mutational processes responsible for somatic mutations in antibody genes differs from that responsible for mutation during meiosis. An analysis of the local DNA sequences revealed many direct repeats and palindromic sequences that were capable of templating some of the known mutations. Although additional factors may be involved in targeting mutations to the variable gene, mistemplating by nearby repeats may provide a mechanism for the enhancement of somatic mutation. PMID- 3557113 TI - Simulating evolution by gene duplication. AB - By considering the recent finding that unequal crossing over and other molecular interactions are contributing to the evolution of multigene families, a model of the origin of repetitive genes was studied by Monte Carlo simulations. Starting from a single gene copy, how genetic systems evolve was examined under unequal crossing over, random drift and natural selection. Both beneficial and deteriorating mutations were incorporated, and the latter were assumed to occur ten times more frequently than the former. Positive natural selection favors those chromosomes with more beneficial mutations in redundant copies than others in the population, but accumulation of deteriorating mutations (pseudogenes) have no effect on fitness so long as there remains a functional gene. The results imply the following: Positive natural selection is needed in order to acquire gene families with new functions. Without it, too many pseudogenes accumulate before attaining a functional gene family. There is a large fluctuation in the outcome even if parameters are the same. When unequal crossing over occurs more frequently, the system evolves more rapidly. It was also shown, under realistic values of parameters, that the genetic load for acquiring a new gene is not as large as J.B.S. Haldane suggested, but not so small as in a model in which a system for selection started from already redundant genes. PMID- 3557110 TI - Molecular nature of spontaneous mutations in mouse lactate dehydrogenase-A processed pseudogenes. AB - The presence of at least ten mouse LDH-A pseudogenes was demonstrated in the genomic blot analysis, and four different processed pseudogenes have thus far been isolated and characterized. In this report, the nucleotide sequences to two different mouse lactate dehydrogenase-A processed pseudogenes, M11 and M14, were determined and compared with the protein-coding sequences of the mouse and rat LDH-A functional genes. In the pseudogene M11, the sequence of 64 nucleotides from codon no. 257 to 278 was tandemly duplicated. In the pseudogene M14, the sequence of 22 nucleotides from codon no. 68 to 75 was replaced by an inserted repetitive sequence of 242 nucleotides homologous to a mouse truncated R element. The pattern of nucleotide substitutions accumulated in mouse LDH-A pseudogenes M11 and M14, as well as that of pseudogene M10 identified previously, was analyzed, and the substitution frequencies of the C or G at the CG dinucleotide were found to be high. PMID- 3557112 TI - Factors determining the frequency of the killer trait within populations of the Paramecium aurelia complex. AB - The factors maintaining the cytoplasmically inherited killer trait in populations of Paramecium tetraurelia and Paramecium biaurelia were examined using, in part, computer simulation. Frequency of the K and k alleles, infection and loss of the endosymbionts, recombination during conjugation and autogamy, cytoplasmic exchange and natural selection were incorporated in a model. Infection during cytoplasmic exchange at conjugation and natural selection were factors that would increase the proportion of killers in a population. Conversely, k alleles reduced the proportion of killers in a population, acting through conjugation and autogamy. Field studies indicate that the odd mating type is prevalent in P. tetraurelia isolated from nature. Conjugation and therefore transmission by cytoplasmic transfer would be rare. Competition studies indicate a strong selective disadvantage for sensitives at concentrations found in nature. Natural selection must therefore be the factor maintaining the killer trait in P. tetraurelia. PMID- 3557111 TI - X-linked gene expression in the Virginia opossum: differences between the paternally derived Gpd and Pgk-A loci. AB - Expression of X-linked glucose-6-phosphate dehydrogenase (G6PD) and phosphoglycerate kinase-A (PGK-A) in the Virginia opossum (Didelphis virginiana) was studied electrophoretically in animals from natural populations and those produced through controlled laboratory crosses. Blood from most of the wild animals exhibited a common single-banded phenotype for both enzymes. Rare variant animals, regardless of sex, exhibited single-banded phenotypes different in mobility from the common mobility class of the respective enzyme. The laboratory crosses confirmed the allelic basis for the common and rare phenotypes. Transmission of PGK-A phenotypes followed the pattern of determinate (nonrandom) inactivation of the paternally derived Pgk-A allele, and transmission of G6PD also was consistent with this pattern. A survey of tissue-specific expression of G6PD phenotypes of heterozygous females revealed, in almost all tissues, three banded patterns skewed in favor of the allele that was expressed in blood cells. Three-banded patterns were never observed in males or in putatively homozygous females. These patterns suggest simultaneous, but unequal, expression of the maternally and paternally derived Gpd alleles within individual cells (i.e., partial paternal allele expression). The absence of such partial expression was noted in a parallel survey of females heterozygous at the Pgk-A locus. Thus, it appears that Gpd and Pgk-A are X-linked in D. virginiana and subject to preferential paternal allele inactivation, but that dosage compensation may not be complete for all paternally derived X-linked genes. The data establish the similarity between the American and Australian marsupial patterns of X-linked gene regulation and, thus, support the hypothesis that this form of dosage compensation was present in the early marsupial lineage that gave rise to these modern marsupial divisions. In addition, the data provide the first documentation of the differential expression of two X-linked genes in a single marsupial species. Because of its combination of X-linked variation, high fecundity, and short generation time, D. virginiana is a unique model for pursuing questions about marsupial gene regulation that have been difficult to approach through studies of Australian species. PMID- 3557114 TI - Mating-type switching in filamentous ascomycetes. PMID- 3557115 TI - Use of the multinomial Dirichlet model for analysis of subdivided genetic populations. AB - The distribution found by compounding the multinomial distribution with the Dirichlet distribution has been suggested as a basis for the estimation of parameters in subdivided populations, in particular of the "correlation between genotypes" within subpopulations. It is shown that the estimators deriving from these procedures perform poorly when the data are generated by the classical Wright drift model of subdivided populations. This conclusion suggests that the compound distribution estimation approach does not provide a good estimation procedure for real populations which are reasonably described by the Wright model. PMID- 3557116 TI - Evolution under fertility and viability selection. AB - Evolution at a single multiallelic locus under arbitrary weak selection on both fertility and viability is investigated. Discrete, nonoverlapping generations are posited for autosomal and X-linked loci in dioecious populations, but monoecious populations are studied in both discrete and continuous time. Mating is random. The results hold after several generations have elapsed. With an error of order s [i.e., O(s)], where s represents the selection intensity, the population evolves in Hardy-Weinberg proportions. Provided the change per generation of the fertilities and viabilities due to their explicit time dependence (if any) is O(s2), the rate of change of the deviation from Hardy-Weinberg proportions is O(s2). If the change per generation of the viabilities and genotypic fertilities is smaller than second order [i.e., o(s2)], then to O(s2) the rate of change of the mean fitness is equal to the genic variance. The mean fitness is the product of the mean fertility and the mean viability; in dioecious populations, the latter is the unweighted geometric mean of the mean viabilities of the two sexes. Hence, as long as there is significant gene frequency change, the mean fitness increases. If it is the fertilities of matings that change slowly [at rate o(s2)], the above conclusions apply to a modified mean fitness, defined as the product of the mean viability and the square root of the mean fertility. PMID- 3557117 TI - Optimal recombination rate in fluctuating environments. AB - The optimal recombination rate which maximizes the long-term geometric average of the population fitness is studied for a two-locus haploid model, assuming that the fitnesses of genotypes AB, Ab, aB and ab are 1 + s(t), 1 - s(t), 1 - s(t), and 1 + s(t), respectively, where s(t) follows various stationary stochastic processes with the average zero. With positive recombination, the polymorphism is stably maintained at both loci. After an initial transient phase, the dynamics are reduced to one dimension, and are analyzed for weak selection limit, strong selection limit, and selection with two state Markovian jump. Results are: (1) If the environmental fluctuation has a predominant periodic component, ropt is approximately inversely proportional to the period irrespective of selection intensity. (2) If the fluctuation is a superposition of many periodic components, the one with the longest period is the most effective in determining ropt because the genetic dynamics cannot track very quick fluctuations (low pass filter effect). (3) If the power spectrum density is decreasing with the frequency, as in pink, or 1/f noises, ropt is small when selection is weak, and increases with the selection intensity. Numerical calculation of the genetic dynamics of a recombination modifier supports all these predictions for the evolutionarily stable recombination rate. PMID- 3557118 TI - [The system for Mendelian analysis of alternative traits (MAH-A1)]. AB - The principle means of the system of applied programs are described. The system is assigned for checking up monogenic diallele hypotheses of inheritance of an alternative trait, on the basis of a population sample of free structured and sized pedigrees, through probands. PMID- 3557119 TI - [Interpretation of various ratios of genetic parameters in Hayman's diallelic analysis]. AB - The genetical algebra of diallele analysis was used to interpret some relations of genetic parameters which were not earlier applied in research of genetic control (GC). It was discovered that in the case of gene correlation, the relation H2 greater than H1 is possible, meaning the regression among frequencies of alleles in loci. We demonstrated, in what way to distinguish two reasons for changes in H1, H2 and h2, when an external treatment is applied: Due to frequency changes of dominant and recessive alleles in the majority of loci, in case new loci are involved in GC; Due to changes in dominance contributions. The latter could provide new information about a situation in loci by analysing the changes in h2 and the correlation coefficient of parental trait levels with their dominant properties as well as changes in D. A few experimental examples illustrate the theory implication. PMID- 3557120 TI - [A complex medico-genetic study of West Siberian populations. I. Formulation of a problem. Goals and objectives of the study. Population genetic characteristics of Northern Khanty]. AB - Purposes and tasks of the complex medical and genetic study of West-Siberian inhabitants were formulated. Demographic parameters for the North Khanty inhabitants, such as size, dynamics of the tertiary sex ratio, marriage structure and migration processes were presented. Mating and intrapopulation migration patterns are determined by spatial subdivision, because of the vast territory and the traditional way of life, and by isolation by distance. Index of the isolocal endogamy equals to 0.364. The portion of mixed marriages is 22.7% and that of the gametic contribution of immigrants - 7.3%. Inbreeding coefficient by isonymy is 0.00097. Effective population size of the five subpopulations studied as a whole is 25% of their total number. PMID- 3557121 TI - [Analysis of the diallelic model for the prevalence of epilepsy in families and populations]. AB - The initial data for the analysis have resulted in epidemiologic (547 patients) and genetic-epidemiologic (365 patients) study of patients with diagnosis of epilepsy living in five districts of the Khabarovsk Territory. The population frequency of epilepsy was equal to 0.288%. With the use of data on numbers of sick and healthy first-third-degree relatives, and the method of maximum likelihood, the monolocus diallelic model (MDM) parameters of the family and population epilepsy prevalence were estimated. For each of 9 MDM variants two decisions were obtained, depending on the use of population probability of the feature. The analysis of 8 sets of initial data allowed to ascertain the influence of information about the first-third-degree relatives on parameter estimates. The calculation results are presented for one of initial data sets (set A). Three MDM variants were shown to predict the values of the relative affection probability, these being rather close to frequencies observed. The arguments are presented in favour of quasi-dominant variant with following parameters: frequency of mutant allele in a population - 5.28%, homozygote penetrance - 21.5% and that for heterozygote - 2.6%. According to parameter estimates within this model, the probability of offspring disease in the family with the known number of sick and healthy parents was calculated. PMID- 3557122 TI - Nucleotide sequence of the 1.2-kb 3'-region and genotype distribution of two common c-myc alleles of the domestic cat. AB - Nucleotide (nt) sequence analyses of the 1.2-kb BamHI-EcoRI cloned 3'-fragment encompassing the polymorphic SmaI restriction site of the feline c-myc gene reveal that the SmaI site, present in CM2 allele but absent from CM3 allele, is located in intron 2, 134 nt 5' of the exon 3. A G-to-C transversion in CM2 results in the creation of the SmaI site. Additionally, the alleles differ at four other nt positions in intron 2, three of these changes being in a region of the intron which exhibits 80% homology between the feline and human c-myc. The alleles also differ in two nt positions in exon 3 in the third position of the codon resulting, however, in no amino acid alteration. Genotype distribution analysis based on the SmaI polymorphism shows that CM2 homozygosity is rare and its frequency deviates significantly from the expected distribution patterns for independently segregating alleles. PMID- 3557123 TI - Nucleotide and amino acid sequence of a Cucurbita phytochrome cDNA clone: identification of conserved features by comparison with Avena phytochrome. AB - The amino acid (aa) sequence of Cucurbita phytochrome has been deduced from the nucleotide (nt) sequence of a cDNA clone which was initially identified by hybridization to an Avena phytochrome cDNA clone. Cucurbita, a dicot, and Avena, a monocot, represent evolutionarily divergent groups of plants. The Cucurbita phytochrome polypeptide is 1123 aa in length, corresponding to 125 kDa. Overall, the Cucurbita and Avena phytochrome sequences are 65% homologous at both the nt and aa levels but this sequence conservation is not evenly distributed. Most of the N-terminal two-thirds of the aligned polypeptide chains exhibits localized regions of high conservation, while the extreme N terminus and the C-terminal one third are less homologous. Comparison of the predicted hydropathic properties of these polypeptides also indicates conservation of domains of phytochrome structure. The possible correlation of these conserved structural features with previously identified functional domains of phytochrome is discussed. PMID- 3557124 TI - The hypervariable region in the genes coding for entomopathogenic crystal proteins of Bacillus thuringiensis: nucleotide sequence of the kurhd1 gene of subsp. kurstaki HD1. AB - One of the genes for the entomophatogenic crystal protein of Bacillus thuringiensis (subsp. kurstaki strain HD1) has been cloned in Escherichia coli, and its nucleotide sequence determined completely. The gene is contained within a 4360-bp-long HpaI-PstI DNA restriction fragment and codes for a polypeptide of 1,155 amino acid residues. The protoxin protein has a predicted Mr of 130,625. The E. coli-derived protoxin gene product is biologically active against Heliothis virescens larvae in a biotest assay. Extensive computer comparisons with other published B. thuringiensis subsp. kurstaki strains HD1, HD73, and B. thuringiensis subsp. sotto gene sequences reveal hypervariable regions in the first half of the protoxin coding sequence. These regions are responsible for the biological activity of the protein product of the cloned gene, and may explain the different biological activities of these different protoxins. PMID- 3557125 TI - Nucleotide sequence and transcription of a human tRNA gene cluster with four genes. AB - A bacteriophage lambda clone containing a 20-kb human DNA segment was isolated and found to harbor a cluster of four tRNA genes. An 8.2-kb HindIII subfragment encompassing the genes was cloned into pBR322 for restriction mapping and DNA sequence analysis. The genes were found to be arranged as two tandem pairs, separated by 3 kb. A proline tRNAAGG gene is separated from a leucine tRNAAAG gene by a 724-bp intergenic region in the first pair, and a second proline tRNAAGG gene is 316 bp from a threonine tRNAUGU gene in the second pair, with the leucine tRNA gene being of opposite polarity to the other three genes. A putative Alu-like element was found to occur within a 2.0-kb DNA fragment, at least 0.7 kb from the tRNA gene cluster. The coding sequences of the two proline tRNAAGG genes are identical. The coding regions of all four tRNA genes contain consensus internal split promoter sequences and do not have intervening sequences nor the CCA trinucleotide found in mature tRNAs. The 3'-flanking regions of these four tRNA genes have normal RNA polymerase III termination sites of at least four consecutive T nucleotides. No apparent homologies occur between the 5'-flanking regions of these genes. All four tRNA genes are accurately transcribed in an in vitro HeLa cell-free system, and the RNase T1 fingerprints of the mature-sized tRNA transcripts were found to be consistent with the DNA sequences of the genes. PMID- 3557126 TI - Characterization of two types of rRNA gene repeat units from the crustacean Artemia. AB - We have previously described that Artemia rRNA genes are organized with a basic repeat unit of 16.5 kb [Cruces et al., Biochem. Biophys. Res. Commun. 98 (1981) 404-409]. Here we describe the organization of the DNA coding for rRNA of a different population of this crustacean that has a repeat unit of 12.2 kb. Both types of repeat units have been cloned and the organization of the external spacers studied by restriction analysis. Both external spacers contain repeated sequences, but they are not homologous to each other. Sequences from the external spacer of the 16.5 kb repeat are also found elsewhere in the genome, within sequences not related to rRNA genes. PMID- 3557127 TI - Nucleotide sequence and molecular evolution of two tomato genes encoding the small subunit of ribulose-1,5-bisphosphate carboxylase. AB - We have isolated and sequenced two cDNA clones (LESS5 and LESS17) encoding the small subunit of ribulose-1,5-bisphosphate carboxylase of tomato (Lycopersicon esculentum). At the nucleotide level, the protein-coding regions of these genes are 85% conserved, while the untranslated 3' regions are only 55% conserved. Comparison with rbcS genes from other species of Solanaceae suggests that the tomato LESS5 gene, the Nicotiana tabacum NTSS23 gene and the Petunia hybrida SSU8 gene are orthologous members of the rbcS gene family. In addition, the tomato gene LESS17, and the Petunia hybrida gene SSU611, may also be orthologous, since their untranslated 3' regions are related. There is a large difference between the two tomato rbcS genes in the frequency of the CG dinucleotide. This difference may reflect different levels of methylation, and therefore expression, of the tomato genes. Many of the differences involving the CG dinucleotide can be represented as transitions between C and T on the noncoding strand. Such changes are consistent with observations that methylated cytosines are hot-spots for transitions. PMID- 3557129 TI - Characterization of a human orphon 28 S ribosomal DNA. AB - We have isolated clones in which two regions of the human genome are represented, each containing an orphon: a dispersed copy of 28S rDNA. Nucleotide (nt) sequence analysis established that one of these, H28S-O1, corresponds to nt 3627-4105 of human 28S rDNA, but in a mutated form. The orphon was flanked on one side by a portion of the L1Hs long interspersed repeat family of the human genome. Although H25S-O1 is not flanked by the terminal direct repeats characteristic of transposed DNA, it is possible that it is a processed pseudogene. PMID- 3557128 TI - Nucleotide sequence of mouse 5-aminolevulinic acid synthase cDNA and expression of its gene in hepatic and erythroid tissues. AB - The cDNA coding for 5-aminolevulinic acid (ALA) synthase (EC 2.3.1.37) in both liver and anemic spleen of the mouse has been cloned. The liver clone was selected by complementation of an Escherichia coli hemA mutant. Erythroid clones were obtained by screening a cDNA library made from mouse anemic spleen RNA, using the liver cDNA as a probe. The sequences of the spleen-derived and liver derived cDNAs are identical. The nucleotide sequence and predicted amino acid (aa) sequence of a 1.85-kb spleen-derived cDNA is presented. The mouse ALA synthase as sequence displays extensive homology to ALA synthase of chick embryonic liver. The ALA synthase mRNA, detected by Northern blot analysis, was the same size, approx. 2.3 kb, in mouse liver, anemic spleen, and mouse erythroleukemia cells. It is therefore unlikely that different isozymic forms of ALA synthase are present in mouse erythroid and hepatic tissue and this is not the basis for the different effects of heme and porphyrinogenic compounds on the expression of liver and erythroid ALA synthase. PMID- 3557130 TI - A DNA fragment hybridizing to a nif probe in Rhodobacter capsulatus is homologous to a 16S rRNA gene. AB - We have sequenced the Rhodobacter capsulatus nifH and nifD genes. The nifH gene, which codes for the dinitrogenase reductase protein, is 894 bp long and codes for a polypeptide of predicted Mr 32,412. The nifD gene, which codes for the alpha subunit of dinitrogenase, is 1,500 bp long and codes for a protein of predicted Mr 56,113. A 776-bp BglII-XhoI fragment containing only nif sequences was used as a hybridization probe against R. capsulatus genomic DNA. Two HindIII fragments, 11.8 kb and 4.7 kb in length, hybridize to this probe. Both fragments have been cloned from a cosmid library. The 11.8-kb fragment contains the nifH, D and K genes, as previously demonstrated (Scolnik and Haselkorn, 1984). In this paper we present evidence that suggests that the 4.7-kb HindIII fragment contains a gene coding for 16S rRNA, and that although homology between nif and this fragment can be observed in filter hybridization experiments, a second copy of the nif structural genes seems not to be present in this region. PMID- 3557131 TI - In vivo dimerization of cauliflower mosaic virus DNA can explain recombination. AB - Pairs of heterologous cauliflower mosaic virus (CaMV) genomes cloned in pBR322, one having a defective genome and both restricted at the same pBR322 cloning site, generate recombinant molecules in infected cells when co-inoculated on plants. Analysis of the restriction pattern of the isolated recombinant CaMV DNAs indicated that the intergenomic recombination may be explained by dimerization of two heterologous CaMV molecules and transcription into a hybrid 35S RNA responsible for replication of the recombinant genomes. PMID- 3557132 TI - Syncope in the elderly: a clinical approach. AB - In the elderly, syncope is a common and potentially hazardous event. The traditional diagnostic approach, which involves extensive procedural testing and hospitalization, will establish the diagnosis in only 40 to 50% of patients, but is associated with significant risk for iatrogenesis in older individuals. A focused approach based on clues from a detailed history and physical exam and knowledge of how age-related physiologic changes can affect presentation of illness in the elderly is emphasized. Treatment should focus on preventing recurrence, and the physician should take into consideration associated age and disease-related changes that may lead to iatrogenic complications. However, therapy should not be denied purely because of the patient's age. PMID- 3557133 TI - Geriatric depression: avoiding the pitfalls of primary care. AB - Depression in the elderly should be viewed as a biological disorder, with multifactorial etiology, and not as a consequence of increasing social, physical, and material losses. Diagnosis is made basically on somatic symptoms, the most important ones being chronic fatigue, chronic pain, chronic sleep disorder, chronic gastrointestinal disturbance, and dysphoria. Other illnesses that might be present instead of or in addition to depression should be sought, both before depression therapy is started and also in the face of persistent symptoms after treatment is started. Basic treatment is with antidepressant medications, with careful attention to selection of drug and dosage, and careful monitoring for adverse effects. Antidepressant therapy and any other applicable forms of therapy are not mutually exclusive, and any other means of improving the patient's overall situation should be vigorously sought. PMID- 3557134 TI - Primary care evaluation of the elderly for elective surgery. AB - The role of the primary physician in the preoperative evaluation of the elderly patient is critical. Due to the many associated changes of aging, careful assessment is required to reduce morbidity and mortality, and to identify treatable medical conditions which increase operative risk. Although increasing age is a major risk factor for surgery, the increased incidence of major diseases may be more important than age alone. Emergency surgery also involves considerably greater risk. It is important that the patient be involved in the decision-making process to the extent possible, and also that adequate postoperative and discharge planning be part of the preoperative management of the elderly person. PMID- 3557135 TI - Evaluating a new approach to the 'osteoporosis-prone' woman. PMID- 3557136 TI - Behavioral dimensions of patients at risk of wandering. PMID- 3557138 TI - The professional socialization of undergraduate gerontology students. PMID- 3557137 TI - Never married elderly as a social type: re-evaluating some images. PMID- 3557139 TI - On the Steinberg, Fitten and Kachuk article. PMID- 3557140 TI - The effects of assertiveness training on older adults. PMID- 3557141 TI - Helping network: seniors to seniors. PMID- 3557142 TI - Reconstructing GSA's history. PMID- 3557143 TI - Careers in gerontology: occupational fact or academic fancy? PMID- 3557144 TI - Job placement and career advancement of gerontology master's degree graduates. PMID- 3557146 TI - Predictors of early retirement among university faculty. PMID- 3557145 TI - Linking research and practice: the Fellowship Program in Applied Gerontology. PMID- 3557147 TI - The American idealization of old age in Japan. PMID- 3557148 TI - Sex-typed age norms among older Hispanics. PMID- 3557149 TI - Korean elders in the United States: intergenerational relations and living arrangements. PMID- 3557150 TI - Stress in racial differences in self-reported health among the elderly. PMID- 3557151 TI - Congressional perceptions of the elderly: the use of stereotypes in the legislative process. PMID- 3557152 TI - Differences in psychologists' ratings of older and younger clients. PMID- 3557153 TI - Home equity conversion: a counseling model. PMID- 3557154 TI - Rural-urban differences in senior center activities and services. PMID- 3557155 TI - Early prediction of discharge disposition after hospitalization. PMID- 3557156 TI - [Prostaglandins in reproductive processes]. PMID- 3557157 TI - [Procoagulant properties of the amniotic fluid III. Thromboplastin acceleration time of the amniotic fluid as an index of fetal maturity in normal pregnancy]. PMID- 3557158 TI - [Retropubic cystourethropexy in urinary stress incontinence. II. Modified Pereyra procedure]. PMID- 3557159 TI - [Artificial insemination with donor semen]. PMID- 3557160 TI - [Postoperative course after cesarean section conducted before and after rupture of the fetal membranes]. PMID- 3557161 TI - [Pregnancy complicated by appendicitis]. PMID- 3557162 TI - [Polygraphic evaluation of sleep in prolonged pregnancy]. PMID- 3557164 TI - [Obstetric aspects of pregnancy complicated by diabetes mellitus in the perinatal period]. PMID- 3557163 TI - [Results of treating fetal hemolytic disease using intrauterine transfusions]. PMID- 3557165 TI - [Importance of the first contact with the mother for the normal development of premature infants]. PMID- 3557166 TI - [Male infertility and the result of pelvic presentation]. PMID- 3557167 TI - [Diagnostic and prognostic value of determining 17-beta-estradiol in the sera of women between the 6th and 20th weeks of pregnancy. III. 17-beta-estradiol level in the sera of women with threatened abortion whose pregnancies were terminated before the 18th week of gestation]. PMID- 3557168 TI - [Sexually transmitted infections in obstetrics and gynecology]. PMID- 3557169 TI - [Experience using a differentiated approach to the surgical correction of Ebstein's anomaly]. PMID- 3557170 TI - [Repeat operations in congenital aortic valve stenosis]. PMID- 3557171 TI - [Transthoracic aspiration biopsy of the lung using a fine needle]. PMID- 3557172 TI - [Clinical evaluation of the data of roentgenobronchologic examinations in patients with chronic pneumonia]. PMID- 3557173 TI - [Rupture of a congenital aneurysm of the sinus of Valsalva (clinical picture, diagnosis and treatment)]. PMID- 3557174 TI - [Various problems of the diagnosis and therapeutic tactics in thoracoabdominal injuries]. PMID- 3557175 TI - [Value of respiratory function tests in surgery of the lungs in children]. PMID- 3557176 TI - [External respiratory function and the condition of the surfactant in experimental contusion of the lung]. PMID- 3557177 TI - [Surgical aspects of the treatment of gastroesophageal reflux in children]. PMID- 3557178 TI - [Correction of aortic subvalvular stenosis, interventricular septal defect and pulmonary valve stenosis combined with the correction of transposition of the great vessels]. PMID- 3557179 TI - [Hemodynamic correction of double origin of the major vessels from the arterial ventricle in "crisscross" heart]. PMID- 3557180 TI - [Successful correction of a defect of the interatrial septum of the heart in a patient with aplasia of the left lung]. PMID- 3557181 TI - [Resection of a tracheal bifurcation with exclusion of the left lung from ventilation and circulation]. PMID- 3557182 TI - [Accessory right-side "tracheal" bronchus inducing attacks of bronchial asthma]. PMID- 3557183 TI - [Combined operation to remove a thoraco-intravertebral neurinoma of the hourglass type]. PMID- 3557184 TI - Porphyrin metabolism and haem biosynthesis in Gilbert's syndrome. AB - Studies in 14 patients with unconjugated hyperbilirubinaemia caused by Gilbert's syndrome have revealed abnormalities of the enzymes of haem biosynthesis measured in peripheral blood cells. The activity of the penultimate enzyme of haem biosynthesis protoporphyrinogen (PROTO) oxidase was reduced at 3.1 +/- 2.6 nmol PROTO/g protein/h (mean +/- ISD) compared with 8.2 +/- 5.1 in controls (p less than 0.005). This was associated with a compensatory increase in the activity of the initial and rate controlling enzyme of the pathway delta-aminolaevulinic acid (ALA) synthase at 866 +/- 636 nmol ALA/g/protein/h compared with 156 +/- 63 in controls (p less than 0.001). Unlike variegate porphyria in which there is a genetic deficiency of PROTO oxidase there was no increased excretion of porphyrins or their precursors in Gilbert's syndrome. Accentuation and subsequent correction of the unconjugated hyperbilirubinaemia with rifampicin produced reciprocal changes in PROTO oxidase activity indicating that bilirubin may be inhibiting the activity of this enzyme. PMID- 3557185 TI - Intragastric bile acid concentrations are unrelated to symptoms of flatulent dyspepsia in patients with and without gallbladder disease and postcholecystectomy. AB - It has been proposed that duodenogastric reflux may be the basic underlying mechanism which gives rise to symptoms of flatulent dyspepsia. Fasting and postprandial gastric juice bile acid concentrations were measured in patients with flatulent dyspepsia with and without gall bladder disease and postcholecystectomy. There were 13 patients with gall bladder disease, 12 with normal gall bladders and 13 postcholecystectomy. Gastric juice was obtained by intubation. Bile acid concentrations were compared with 21 controls and 15 asymptomatic subjects with gall bladder disease. For 21 patients with gall bladder disease who underwent cholecystectomy, levels were again assessed postoperatively to allow correlation with outcome. The occurrence of reflux and the resultant gastric juice bile acids did not correlate with symptoms. Concentrations postcholecystectomy, including asymptomatic subjects were significantly higher than controls (p less than 0.01). It is concluded that limited duodenogastric reflux is common and need not be associated with symptoms even when the resultant intra-gastric concentrations are higher than normal. PMID- 3557187 TI - Is there a relationship between symptoms of the irritable bowel syndrome and objective measurements of large bowel function? A longitudinal study. AB - Four patients with the irritable bowel syndrome completed 28 day continuous stool collections and concurrent symptom diaries. The diaries revealed that three patients had multiple pains. When the diaries were compared with objective measurements, no relationship could be detected between the occurrence of pain or any other symptom on the one hand and stool weight, stool form or consistency, mean whole gut transit time, or interdefecatory transit on the other. Patients' descriptions of urgency, looseness and frequency of defecation give little guide to intestinal events, at least using currently available techniques. PMID- 3557186 TI - Endoscopic sphincterotomy and surgical approaches in the treatment of the 'sump syndrome'. AB - The 'sump syndrome' is a rare, late complication of choledochoenterostomies. We observed 13 patients with this syndrome. The clinical features included recurrent cholangitis, liver abscesses, and recurrent pancreatitis. Five patients were treated by surgery, eight patients endoscopically. Reviewing an average follow up period of 22 months (range 6-60) after therapeutic endoscopy and 57 months (range 1-126) after different surgical procedures, we conclude that endoscopic sphincterotomy with removal of the debris is as efficient a therapy of the 'sump syndrome' as surgical sphincteroplasty and entails a smaller risk for the patient. We therefore advocate that endoscopic papillotomy should first be tried in all cases of 'sump syndrome' in the absence of suprapapillary stricture of the bile ducts. PMID- 3557188 TI - Life events, psychiatric illness and the irritable bowel syndrome. AB - The frequency, severity, and characteristics of psychiatric illness and stressful life situations were assessed in 134 patients aged 18-60 years referred to a gastrointestinal clinic by their general practitioner. A functional disorder of the gastrointestinal tract was established in 72%. A formal psychiatric assessment in 64 randomly selected patients revealed a previous or current psychiatric disorder in 54% of the functional group and 12.5% of the organic group. Stressful life events before referral were assessed by a modification of the Bedford College methodology. Anxiety provoking life situations were found in 30%, a proportion which was not significantly different in the two groups. Psychiatric illness episodes and/or anxiety provoking situations, preceded the onset of bowel symptoms in two-thirds of the functional group, however, but in none of the organic group. Life situations alone did not appear to be associated with functional disorders unless they provoked an anxiety state. PMID- 3557189 TI - Effects of peptide YY (PYY) on mouth to caecum intestinal transit time and on the rate of gastric emptying in healthy volunteers. AB - The effect of an infusion of two doses of peptide YY (PYY), a novel putative gastrointestinal hormone, has been assessed on mouth to caecum intestinal transit time and on the rate of gastric emptying after ingestion of an inert 200 ml liquid meal thought unlikely to interrupt fasting gastrointestinal motility patterns. A low dose of PYY was chosen to give plasma concentrations within the range seen postprandially in healthy subjects, while the high dose mimicked the raised levels seen in several malabsorptive conditions. During infusion of PYY at 0.18 pmol/kg/min plasma concentrations rose from a basal of 8 +/- 2 pmol/l to 38 +/- 5 pmol/l and at 0.51 pmol/kg/min to 87 +/- 10 pmol/l. Mouth to caecum transit time was delayed from 67 +/- 4 mins on the saline infusion day to 94 +/- 7 mins (p less than 0.01) on the low dose and 192 +/- 9 mins (p less than 0.001) on the high dose infusion day. Time to 50% gastric emptying was prolonged from 37 +/- 8 mins during saline infusion to 63 +/- 10 mins (p less than 0.05) during low and 130 +/- 12 mins (p less than 0.001) during high dose infusion. Thus the infusion of PYY shows a dose related inhibition of mouth to caecum intestinal transit time and of the rate of gastric emptying and suggests this novel hormonal peptide to be of importance in gastrointestinal physiology. PMID- 3557190 TI - Metabolism and urinary excretion of 5-amino salicylic acid in healthy volunteers when given intravenously or released for absorption at different sites in the gastrointestinal tract. AB - In six healthy subjects serum concentrations of 5 amino salicylic acid (5ASA) and acetyl 5ASA were measured for up to 24 hours, and urinary excretion over 48 hours. After an intravenous injection of 3.26 mmol 5ASA serum concentrations fell rapidly with a distribution half-life of 17 +/- 2 min and an elimination half life of 42 +/- 5 min. After 45 minutes acetyl 5ASA became the dominant compound and after seven hours serum concentrations of both components were almost unrecordable. Orally ingested 5ASA in three preparations to ensure its release in the stomach, small intestine and ileocaecal region respectively gave lower serum concentrations and urinary excretion than those obtained after an intravenous infusion. Bioavailabilities which ranged from 19% for ileocaecal release to 75% for release in the upper gastrointestinal tract, were calculated from areas under the serum concentration curves. Urinary excretion of 5ASA and its acetyl metabolite over 48 hours was 78%, 52%, 55%, and 21% respectively of the dose given intravenously and orally for gastric, small intestinal and ileocaecal release. PMID- 3557191 TI - Clinical markers of slow healing and relapsing gastric ulcer. AB - The aim of the study was to identify the clinical markers useful in characterising slow healing and relapsing gastric ulcer patients. Ninety nine subjects entered the short term and 79 the long term study (12 months). The following parameters were taken into account: therapy, sex, age, smoking habit, alcohol consumption, analgesic intake, peptic ulcer family history and onset of the disease. Results of the studies were analysed by means of chi 2 test and logistic regression, both in stepwise and in specifying models. Cigarette smoking was found to be the most important risk factor of non-healing (p = 0.04). In women with late onset of the disease, cigarette smoking identified the gastric ulcer subjects at higher risk of non-healing with a predictive probability of 0.4679. Age under 50 years was found to be the most important risk factor of relapsing throughout the entire 12 month follow up period (p = 0.025). In those under 50 years, cigarette smoking and negative peptic ulcer family history in combination, identified the gastric ulcer subjects at higher risk of relapsing, the predicted probability being 0.6027. It is concluded that cigarette smoking is the most important risk factor for non-healing and those who relapse under the age of 50. The possibility of singling out categories of patients more prone not to heal and to relapse suggests new strategies in the management of gastric ulcer disease. PMID- 3557192 TI - Urinary N-nitrosoproline excretion: a further evaluation of the nitrosamine hypothesis of gastric carcinogenesis in precancerous conditions. AB - Measurement of N-nitroso compounds in gastric juice by different methods has given conflicting results. In order to resolve this controversy, we have assessed endogenous nitrosation by the independent N-nitrosoproline excretion test in subjects who had previously undergone gastric juice analysis by one of these methods. Ten Polya gastrectomy, 10 pernicious anaemia and nine matched control subjects were fed 380 mg of nitrate in beetroot juice and 500 mg proline. N nitrosoproline (N-Pro) synthesised intragastrically from these precursors, and quantitatively excreted by the kidneys, was measured in 24 hour urine samples (collection checked by creatinine clearance). N-Pro excretion (mean +/- SEM) was reduced (p less than 0.01) in pernicious anaemia (1.1 +/- 0.8 ng/day) compared with matched control (18.0 +/- 7.2 ng/day), and also tended to be lower (NS) in polya gastrectomy (3.2 +/- 2.3 ng/day). Twenty four hour intragastric pH was monitored on a separate occasion in 23 of the 29 subjects; 13 were hypoacidic (pH greater than 4 greater than 50% of 24 hours) and 10 were acidic. N-Pro yields were reduced (p less than 0.01) in the hypoacidic group (0.9 +/- 0.6 ng/day) compared with the acidic group (17.9 +/- 6.6 ng/day), and N-Pro was negatively associated with mean intragastric pH (tau = -0.53, p = 0.001). We conclude that endogenous synthesis of this specific N-nitroso compound is favoured by low rather than high pH. These results are concordant with those previously reported in gastric juice from the same subjects and suggest that nitrosation is chemically rather than bacterially mediated, contrary to the nitrosamine hypothesis of gastric carcinogenesis. PMID- 3557193 TI - Collagenous colitis in Greece. PMID- 3557194 TI - Second-look laparotomy--clinical correlations. PMID- 3557195 TI - A simplified technique of Hickman catheter insertion at bedside in gynecologic oncology patients. PMID- 3557196 TI - Primary carcinoma of the fallopian tube: evidence for activity of cisplatin combination therapy. AB - The records of 23 patients with confirmed carcinoma of the fallopian tube, treated between 1966 and 1983, were reviewed. Patients ranged in age from 41 to 88 years. A pelvic mass was the most common preoperative finding (61%), followed by abnormal bleeding (43%), and pain (39%). Fifteen patients had stage I or II disease, 8 had Stage III or IV disease. In patients with metastatic disease, involvement of the peritoneal surfaces, bowel, and omentum were noted most often. Lymph nodes were the most common site(s) of recurrent disease. Twelve evaluable patients with measurable disease were treated with cisplatin and cyclophosphamide (PC) +/- doxorubicin (PAC). There were 9 complete and 2 partial responses, a 92% response rate. Incorporation of cisplatin therapy appears to have resulted in improved short-term survival. PMID- 3557197 TI - The outcome of the patients with recurrent cervical carcinoma in terms of lymph node metastasis and treatment. AB - Of the 908 patients who underwent radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer from 1973 to 1983, 139 (or 15.30%) had recurrences. The recurrent rate in the 175 patients with positive pelvic lymph nodes was 32.6%, compared with a 11.2% in the 733 patients with negative nodes (P less than 0.001). This suggests that cervical cancer patients with negative nodes acquire better prognosis after surgical treatments. Not only is recurrence much less frequent in patients with negative nodes, but also the outcome of treatments is significantly in favor of such patients: (A) 51 recurrent patients refused further treatments owing to personal reasons. None survived over 3 years; (B) The survival rate is far higher for treated patients formerly with negative nodes. Sixty of the 82 patients achieved a 5-year survival of 17.74% compared with a 2 year survival of 21.64% only in 28 patients with positive nodes. This suggests that our treatments on patients with recurrent cervical cancer are more effective when the patients have previously had negative nodes, and that refusal of treatment results in quick death. PMID- 3557198 TI - Simultaneous radiation and chemotherapy for advanced carcinoma of the cervix. AB - Six patients with poor prognosis carcinoma of the cervix were treated with external radiation therapy simultaneously with cisplatin, bleomycin, and vincristine. Toxicity was very mild with nausea and vomiting and mild myelosuppression being the major toxicities. At a median of 36 months follow-up, four of six patients are alive, three with no evidence of disease. The median survival after diagnosis is 25+ months. The data suggest that radiation therapy and cytotoxic therapy administered together in patients with advanced cervix carcinoma is well tolerated. Further study to determine therapeutic efficacy is warranted. PMID- 3557199 TI - Sebaceous gland tumor of the ovary. AB - A sebaceous gland tumor of the ovary was detected in a 60-year-old woman who underwent right salpingo-oophorectomy for a right ovarian cyst. The cyst was unilocular, weighed 820 g, and was filled with sebaceous material containing a few hair shafts. There was a protruded mass composed of lobules of mature or immature sebaceous cells over the inner surface of the cyst wall. She has been well for 4 years and 2 months after the surgery. This is the second well documented case of this extremely rare type of tumor. This lesion is teratogenic with unilateral development of the sebaceous glands and malignant characteristics are nil. PMID- 3557200 TI - Toxicity of whole abdominal irradiation after operation, combination chemotherapy, and reoperation in advanced epithelial ovarian cancer. PMID- 3557202 TI - [Anatomy and clinical aspects of sartoriusplasty]. AB - According to Mathes and Nahai (1982) the sartorius muscle is supplied in a segmental fashion (Type IV) from six to ten branches arising from the superficial femoral artery. They state that the use of this flap is limited because of the segmental blood supply. In contrast, dissecting 40 cadaver specimens at the Anatomy Department of Munich University a different vascular anatomy was revealed in which only two to four branches from the femoral artery supply the whole muscle. Based on this pattern of intramuscular vascular connections, the most proximal arterial branch provides the blood supply to the whole muscle. Elevated on the proximal vascular pedicle the muscle can cover defects of symphysis, fill the acetabulum following disarticulation of the septic hip joint and osteomyelitic defects of femur. PMID- 3557201 TI - [Primary immediate coverage of decubitus ulcers by musculocutaneous flaps and gentamicin PMMA beads]. AB - Myo- or fasciocutaneous flaps for coverage of longstanding pressure sores in para or quadriplegic patients have been proved superior to cutaneous flaps. Pretreatment with ulcer-debridement and systemic antibiotics for urinary-tract infection and septicaemia was thought to be necessary for successful closure of these difficult defects. In a prospective, clinical trial 17 patients with 20 pressure sores were treated this way during 1980-1983. From 1983-1985 no local or antibiotic treatment was given to a second group of 20 patients with 28 decubitus ulcers prior to a one-stage-closure of the pressure sores. Only five patients with septicaemia above 39 degrees C received antibiotics intraoperatively. Gentamicin-PMMA-beads were temporarily inserted under the myo- or fasciocutaneous flaps during the procedure. If necessary, urinary-tract-infection was treated after successful coverage. Both groups have been compared historically. There were less wound complications in the second group while a median time-saving of 2 1/2 weeks per patient could be gained, even though they had larger pressure sores, frequent bone involvement, and multiple ulcers in this group. PMID- 3557203 TI - [What demands does playing an instrument make on the hand?]. AB - The frequency of occupational diseases of the locomotor system in musicians, illustrated by an investigation of 160 orchestral string players, leads to the question of whether manual preconditions might play a role in this respect. At first, the special manual demands in instrumental playing are explained by means of an example of piano literature. They are different from any other manual task in daily life or profession, qualitatively and quantitatively: isolation of the fingers as far as possible instead of the normal "co-operation"; unequal fingers have to perform equivalent tasks in respect to complexity, speed, and force; simultaneous movements in contrary directions with any combination of fingers and joints instead of the regularly used simultaneous movements in the same direction; equivalence of flexion and extension with conscious control of either action; each activity of posture and movement is committed to the timing preset by the music; extremely high frequencies of movement in many cases; to compensate for organic defects may be difficult in a professional level of performance. A method is presented for the examination of manual preconditions with regard to specific instruments. It considers a series of biomechanical characteristics (hand-size and joint mobility) which are able in principle to influence the dexterity of the hand. Results of investigations with about 600 professional musicians are briefly summarized. According to the data available the characteristics investigated seem to be influenced rather by heredity than by training. Musicians who had serious difficulties with the instrument or who suffered from functional or organic disorders in the area of the upper extremities showed, as a rule, more disadvantageous manual prerequisites. The individual result of an examination can be displayed as a "Biomechanical Handprofile" showing deviations from the data of a corresponding reference group. Practical conclusions can be drawn, as with an aptitude test. PMID- 3557204 TI - [Proximal ulnar nerve compression syndrome with special reference to the m. epitrochleo-anconaeus]. AB - Subluxation and luxation of the ulnar nerve are normally congenital and can result in not only an irritation of the nerve but also sensory loss and motor weakness. The structures overlying the ulnar groove are responsible for the extent of nerve dislocation. In the case of subluxation, the ulnar nerve is compressed near the medial epicondyle by the edge of the ligamentous or muscular roof of the ulnar groove. In the case of luxation, ulnar nerve compression is located more distally under the aponeurotic arch of the M. flexor carpi ulnaris. We, therefore, distinguish between a proximal and a distal mechanism of nerve compression. In the years from 1970 to 1984 216 ulnar nerve compression syndromes in the elbow area have been treated and 208 cases have been evaluated. The authors found 77 proximal mechanisms (37%) and 54 distal mechanisms (26%). In 43 cases the proximal pressure was due to the ligamentum epitrochleo-anconaeum (20.7%) and in 34 cases to the epitrochleo-anconeal muscle. PMID- 3557205 TI - [M. abductor digiti minimi longus: anatomical rarity?]. AB - Within a period of five months, in eleven of all the cases examined, the author found the M. abductor digiti minimi longus as was described by Frohse and Frankel in 1908. It ran from the fascia antebrachii through the Canal de Guyon to the hypothenar muscle mass. Vascularization and innervation were by the ulnar artery and nerve. This muscle must be assigned to the hypothenar muscular system, while a variation of the palmaris longus muscle, which is found in the same region and frequently described in the literature is supplied by the median nerve. Further, the literature has held this muscle to be the cause of compression of the ulnar nerve. In the author's view, the compression of the nerve is caused by the distal transverse ligament of the fascia antebrachii. By severing this transverse ligament, regeneration of the nerve is made possible. PMID- 3557206 TI - [Stonefish stab injury of the hand]. AB - The authors report a sting injury by a stonefish in the hand. First aid and surgical treatment are discussed. The biology of the stonefish is reviewed. PMID- 3557208 TI - Choice of techniques in nasal repairs. AB - The authors after classifying skin loss of the nose according to their size and site, resume the techniques they normally use in every kind of loss. They suggest those most reliable and easy to perform. PMID- 3557207 TI - [Arthrodesis of the wrist joint in patients with polyarthritis]. AB - In rheumatoid arthritis, extreme damage to the wrist joint with rupture of the wrist extensor tendons can only be treated effectively by arthrodesis. The authors describe the technique of wrist fusion by an AO-plate. Twenty-two arthrodeses have been performed between July 1974 and June 1984, representing 7.4% of all surgical procedures on rheumatoid wrists (n = 294). Radial deviation and dorsiflexion of the hand must be avoided. Follow-up was possible in nine patients (eleven wrist-fusions). All these patients were satisfied with the result. PMID- 3557209 TI - [L cells: a separate mononuclear cell population?]. PMID- 3557210 TI - [Effect of low-dose heparin on the peripheral platelet count]. PMID- 3557211 TI - [Cutaneous leishmaniasis in Ethiopian immigrants in Israel]. PMID- 3557212 TI - [Tetralogy of Fallot with absence of the pulmonary valve]. PMID- 3557213 TI - [Ascending myelitis and urinary retention due to herpes simplex virus]. PMID- 3557214 TI - [Methyl-prednisolone pulse therapy of recurrent peritonitis and cerebritis in systemic lupus erythematosus]. PMID- 3557215 TI - [Congenital polyp of the prostatic urethra with hydro-ureter in an infant]. PMID- 3557216 TI - [Polyagglutination]. PMID- 3557217 TI - [Pediculosis capitis--biological, clinical and therapeutic aspects]. PMID- 3557218 TI - [Organ transplantation]. PMID- 3557219 TI - [Internal medicine in a state of crisis: the view from a subspeciality]. PMID- 3557220 TI - [Biopsy of the prostate--when and how]. PMID- 3557221 TI - [Scabies--prevention and treatment]. PMID- 3557222 TI - [The mode of cardiac action of cardiotonic steroids isolated from Toad Cake in perfused working guinea-pig heart and effect of cinobufagin on experimental heart failure]. AB - The effects of bufadienolides (bufalin, bufotalin, cinobufagin, cinobufotalin, gamabufotalin and resibufogenin) isolated from Toad Cake was compared to that of cardenolides (digitoxin and ouabain) on cardiac function in a guinea-pig working heart preparation. All the steroids showed the cardiotonic effect in a concentration-dependent manner, and the minimum threshold concentration was 10( 8) M for bufalin, cinobufagin, gamabufotalin and digitoxin and 10(-7) M for bufotalin, cinobufotalin and ouabain. In addition, the order of maximum efficacy of cardiotonic action was as follows: cinobufagin (3 X 10(-7) M) = ouabain (3 X 10(-7) M) greater than digitoxin (1 X 10(-7) M) = gamabufotalin (3 X 10(-7) M) greater than cinobufotalin (3 X 10(-7) M) greater than bufotalin (1 X 10(-7) M). The effect of cinobufagin was examined on experimentally induced heart failure caused by acute local ischemia through ligation of the left anterior descending coronary artery in perfused guinea-pig heart. Cinobufagin (3 X 10(-7) M) and digitoxin (1 X 10(-7) M) reestablished the coronary flow of perfused guinea-pig heart to 90% and 98% of the level prior to the coronary artery ligation. The cardiac output and left ventricular pressure of perfused heart were increased to the level prior to the acute local ischemia, and the left ventricular work was increased by cinobufagin (3 X 10(-7) M) and digitoxin (1 X 10(-7) M) to 108% and 106%, respectively, of the pre-ligation level. These results indicate that cinobufagin possesses strong cardiotonic action, similar, to digitoxin, in experimentally induced heart failure due to acute local ischemia. PMID- 3557223 TI - [Properties of ATP-dependent H+-transport in rat brain synaptosomes]. AB - Properties of the ATP-dependent H+-transport system in rat brain synaptosomes were examined using the acridine orange fluorescence quenching method. ATP dependent H+-accumulation assessed by the quenching of acridine orange fluorescence was observed with the synaptosomes treated with hypotonic solution (hypotonic shock-synaptosomes), but not with the intact synaptosomes. With hypotonic shock-synaptosomes, H+-transport was activated in the presence of Cl- or Br-. However, this transport activity was markedly reduced in the presence of Mes-, NO3-, I- or SCN-. On the other hand, H+-transport activity was less effective with cations other than K+ in the following decreasing order of potency: K+ greater than Cs+ greater than Na+ greater than Li+. The H+-transport activity was inhibited by 0.3 mM ethacrynic acid, 10 microM 4-acetamide-4' isothiocyanostilbene-2,2'-disulfonic acid or 1 mM 4-aminopyridine to 39.2%, 36.3%, or 33.1% of the control, respectively, but was not inhibited by 1 mM ouabain, 500 microM vanadate, 10 microM picrotoxin and 100 microM gamma aminobutyric acid. These results suggest that the ATP binding site of the synaptosomal ATP-dependent H+-transport system exists on the internal surface of synaptosomal plasma membranes and that the H+-transport system is stimulated by the presence of Cl- or Br- and by K+ movement through the K+ channel. PMID- 3557224 TI - Census and survey of wild black-crested gibbons (Hylobates concolor concolor) in Yunnan Province, People's Republic of China. AB - Black-crested gibbons (Hylobates concolor concolor) inhabit the subtropical forests of Southern China and Northern Vietnam, and have never previously been the subject of any systematic behavioral or ecological study. This report presents the findings of a three-month census and survey of black-crested gibbons in the Wuliang and Ailao Mountain Game Reserves in Yunnan province, China. The censusing methods used here were similar to those techniques used during other census studies of gibbons. The sites visited were subtropical broadleaf evergreen forests, with trees belonging to the families Fagaceae, Theaceae, Magnoliaceae, Lauraceae and Elaeocarpaceae. A total of 23-25 groups of black-crested gibbons were documented from 4 sites visited, and a group density estimate from all sites averaged 0.82 groups/km2. These gibbons were found to be polygynous with an average family group size of 7-8 animals, comprising 1 adult male, 1-4 adult females and numerous offspring of various ages. Some of the ecological and evolutionary implications of these findings are also presented. PMID- 3557225 TI - The similarity principle underlying social bonding among female rhesus monkeys. AB - Twenty adult female rhesus monkeys (Macaca mulatta) were observed over a three year period. They lived in a mixed captive group with kinship relations known for three generations. The study's aim was to test Seyfarth's [J. theor. Biol. 65: 671-698, 1977] model of rank-related grooming and to investigate two other possible determinants of social bonding, i.e. relative age and the group's stratification into two social classes. Data on affiliation, coalitions, and social competition were collected by means of both focal observation and instantaneous time sampling. Whereas certain elements of the existing model were confirmed, its explanatory principles were not. Social competition did not result in more contact among close-ranking females (the opposite effect was found), and the relation between affiliative behavior and coalitions was more complex than predicted. Based on multivariate analyses and a comparison of theoretical models, we propose a simpler, more encompassing principle underlying interfemale attraction. According to this 'similarity principle', rhesus females establish bonds with females whom they most resemble. The similarity may concern genetical and social background, age, hierarchical position and social class. Effects of these four factors were independently demonstrated. The most successful model assumed that similarity factors influence female bonding in a cumulative fashion. PMID- 3557226 TI - [Dental enamel prisms of Mesopithecus pentelicus Wagner, 1839, compared with recent cercopithecids (Primates: Cercopithecidae)]. AB - The dental enamel prisms of Cercopithecidae were examined by scanning electron microscopy. The main task of this study was to show the prism morphology representatives of different genera as well as their comparison with the fossil Mesopithecus pentelicus Wagner, 1839. The method used to show the enamel prisms was to etch the tooth surface with hydrochloric acid. In this way the outlines of the prisms were better contrasted for the descriptive morphology of the prisms than in etching with phosphoric acid. Two types were determined, in accord with the systematic division into subfamilies. In the subfamily Cercopithecinae elongated slender prisms were dominating, some with pointed, others with truncated tops. Most characteristic of this type were Macaca and Cercopithecus. An exception was Papio hamadryas which had broader, rounded prisms. In this way it differed largely from P. anubis whose prisms were short and mostly triangular. A very interesting fact was that very different patterns were found in P. anubis and P. hamadryas, although these two species are regarded as only one species by many authors. The second subfamily, the Colobinae, was characterized by broader prisms with a rounded shape, nearly as long as wide. Exceptions of the 'Colobine type' were at first Colobus with prisms little longer than wide and secondly Nasalis, with mostly parallel sides and truncated tops of the prisms. The prism outlines of Mesopithecus showed the greatest similarity to those of Presbytis which represents the characteristic 'Colobine type'. This fact confirmed the actual systematic position of the fossil Mesopithecus within the subfamily Colobinae. In addition to previously known primitive features of Mesopithecus within the subfamily of Colobinae, we present here a further concrete, common feature with asiatic Colobines. PMID- 3557227 TI - Age-sex class differences in the positional behaviour of the Sumatran orang-utan (Pongo pygmaeus abelii) in the Gunung Leuser National Park, Indonesia. AB - During a three-year field study of the socio-ecology of Sumatran orang-utans, their use of the canopy was investigated in the Gunung Leuser National Park, Indonesia. This paper concerns the positional behaviour of different age-sex classes of orang-utans. Adolescents and females with infants differed significantly from an adult male in the following respects: the use of locomotion types (more 'quadrumanous scrambling' and perhaps also 'quadrupedal walking' and less 'tree swaying'); substrate use during resting, and travelling and resting heights. We suggest that large body size restricts the travel route options in higher forest strata and necessitates the use of the lower stratum. Here, 'tree swaying' is an efficient method of progression, particularly for heavy animals. Mothers with infants are forced to travel in the lower zones as well. The fact that they return to a greater heights when they go to rest might suggest that they travel lower in spite of a greater predation risk. PMID- 3557228 TI - Environmental correlates of ranging behaviour in the banded langur, Presbytis melalophos. AB - Data are presented from a long-term study of banded langurs in three contrasting rain forest habitats in Peninsular Malaysia. Results from different sites and months are used to correlate ranging patterns with food availability and other environmental variables. Day range lengths are correlated with availability of preferred foods; the degree of territoriality is related to the distribution and size of food sources and length of time for which any one of these produces favoured food items. PMID- 3557229 TI - Population ecology of the ring-tailed lemur, Lemur catta, and the white sifaka, Propithecus verreauxi verreauxi, at Berenty, Madagascar, 1981. AB - The diurnal lemurs Propithecus verreauxi verreauxi and Lemur catta at Berenty in southern Madagascar, have been studied for the last 30 years. The August 1981 census indicates that the population size of L. catta remains stable at 150 adults but that P. v. verreauxi troops have become fragmented and scattered and the population is apparently increasing. Eight different vegetation types were classified within the reserve and their influence on the distribution of L. catta and P. v. verreauxi investigated. Behavioural data obtained shows the niche separation between these two, potentially competitive, sympatric lemurs. PMID- 3557230 TI - Evidence for social referencing in young chimpanzees (Pan troglodytes). AB - A captive chimpanzee group was observed in order to determine the extent to which the social interactions of the infants and juveniles (18-50 months) were affected by their mothers' relationships with other adult group members. It was found that the young chimpanzees initiated more interactions with adults who interacted more with their mothers. A vast majority of those interactions occurred at significant distances from the mother. It is argued that these data imply a social-cognitive ability in young chimpanzees closely related to the human infant's ability to use its mother in 'social referencing'. PMID- 3557231 TI - Does intermale mounting function as a dominance demonstration in rhesus monkeys? AB - The relationship between dominance and intermale mounting was analyzed in two troops of captive rhesus monkeys (Macaca mulatta). The data did not support the assumption that mounting among males functions as a dominance demonstration as described in the literature because mounting commonly (63% of 65 dyads) occurred in a bidirectional fashion, and mounting not only was performed by dominant males but also was shown with regularity (36% of 521 cases) by subordinate males. Intermale mounting was often (37% of 521 cases) associated with amicable interactions--commonly preceding them--but it was only rarely (2%) associated with dominance-subordination behaviors. It was concluded that intermale mounting may serve as a socially cohesive behavior in rhesus monkeys by promoting nonagonistic contact. PMID- 3557232 TI - Aggression toward large carnivores by wild chimpanzees of Mahale Mountains National Park, Tanzania. AB - In the Mahale Mountains National Park of Tanzania, a group of about 33 chimpanzees were observed to surround a leopard den containing a mother and at least one cub and to drag out and kill the cub. This is the first report of chimpanzees or any other primate species killing their potential predator's offspring. The incident suggests that chimpanzees, without any weapons, can manage to defend themselves against a carnivore of at least up to leopard size, and implicates how the early hominids may have reacted against their potential predators. PMID- 3557233 TI - Effects of pretreatment with SKF-525A or sodium phenobarbital on thiabendazole induced teratogenicity in ICR mice. AB - To study the effects of SKF-525A, an inhibitor of cytochrome P-450, and of sodium phenobarbital (PB), a drug-metabolizing enzyme inducer, on the teratogenicity of thiabendazole (TBZ), pregnant mice were given ip either a single dose of 40 mg SKF-525A/kg 1 hr before oral dosing with 250 or 500 mg TBZ/kg or a dose of 75 mg PB/kg/day on three consecutive days before oral administration of a dose of 500 or 1000 mg TBZ/kg. In either case the TBZ dose was given on day 9 of gestation. All foetuses were removed from the uterus on day 18 of gestation, and were examined for external and skeletal anomalies. The spectrum of malformations in the groups of mice pretreated with SKF-525A or PB was similar to that in mice treated only with TBZ. In the group pretreated with SKF-525A, however, the incidence of resorbed foetuses was higher than in the group treated with TBZ alone and there was a tendency towards an increase in the number of foetuses with skeletal fusion and reduction deformity of the limbs, an anomaly characteristically induced by TBZ. On the other hand, in mice pretreated with PB, the incidence of resorbed foetuses tended to be lower, the numbers and body weights of live foetuses were higher and the incidence of external and skeletal malformations was lower than in the groups treated with TBZ only. No reduction deformity of the limbs was observed in the groups pretreated with PB. These results suggest that with TBZ the ultimate teratogen may be the parent compound rather than its metabolites. PMID- 3557234 TI - Effects of administering caffeine to pregnant rats either as a single daily dose or as divided doses four times a day. AB - From day 6 to day 20 of pregnancy, rats were treated with caffeine in a total daily dose of 10 or 100 mg/kg by gavage, either as a single bolus dose or as four divided doses given at 3-hr intervals throughout the day. Controls were given distilled water at the same times. Maternal body weight and food and water consumption were reduced in the two groups receiving a total of 100 mg caffeine/kg/day and in the group given 2.5 mg/kg four times daily. Dose-related decreases in foetal weight, placental weight and crown-rump length and dose related retardation of skeletal ossification were observed. Major foetal abnormalities, mainly ectrodactyly, were seen only in the group given 100 mg caffeine/kg in a single daily dose. PMID- 3557235 TI - Mutagenicity of proanthocyanidins. AB - Several procyanidins with different degrees of polymerization (dimers, a trimer and a polymer) and extracted from different natural sources were found to be non mutagenic in the Salmonella mutagenesis assay system. A mutagenic impurity in procyanidin B-4 was isolated by means of reversed-phase high-performance liquid chromatography (HPLC) and identified as rutin with UV spectrometry, co chromatography on reversed-phase HPLC and gas chromatography-mass spectrometry. PMID- 3557236 TI - Inhibitory effect of cheese and some food constituents on mutagenicity generated in Vicia faba after treatment with nitrite. AB - The inhibitory potential of various food constituents on the mutagenicity generated in fava beans after treatment with nitrite has been investigated. Cheese was able to inhibit this direct-acting mutagenicity. The antimutagenic factor was not extractable from cheese; solvents of different polarity were used for the extraction. Casein, pectin, gelatin, Vicia faba protein and, to a lesser extent, whey protein and starch could also inhibit mutagenicity. A decrease in mutagenicity was always accompanied by a decrease in total N-nitroso content, as measured analytically. The mutagenic principles appeared to bind more strongly onto cheese than onto V. faba. The implications of this finding are discussed. PMID- 3557237 TI - Mutagenicity of human urine after the consumption of fried salted salmon. AB - Mutagenicity in the urine of four non-smoking individuals who had eaten salted salmon cooked at home for both lunch and supper was monitored by means of Salmonella/microsome mutagenicity tests. Extracts from fresh and salted salmon had the same level of mutagenicity after being cooked for 10 min at 200 degrees C, but no activity was detected before cooking. Salmonella strains TA98 and TA1538 were equally sensitive to the mutagens and required metabolic activation. No mutagenicity was shown with TA100 and TA1535. Urine samples were tested using a concentrate prepared by means of an XAD-2 resin column. Mutagenicity was detected mainly in urine excreted during 4-5 hr after the ingestion of cooked salmon, but only weak mutagenicity, or none at all, was detected in the urine after the ingestion of vegetables. The levels of urinary mutagenicity due to salmon consumption were not affected when cabbage was eaten simultaneously. The excretion of mutagenic substances was completed within about 20 hr, and there were almost no mutagens in the urine 24 hr after the ingestion of cooked salmon. PMID- 3557238 TI - Comparison of acute toxicities of deoxynivalenol (vomitoxin) and 15 acetyldeoxynivalenol in the B6C3F1 mouse. AB - The acute toxic effects of deoxynivalenol (DON) and 15-acetyldeoxynivalenol (15 ADON) were compared in the B6C3F1 female mouse after oral and intraperitoneal exposure. Using the abbreviated procedure of Lorke (Archs Toxicol. 1983, 54, 275), LD50 values for DON were estimated to be 78 mg/kg (oral) and 49 mg/kg (ip) whereas the LD50 values for 15-ADON were 34 mg/kg (oral) and 113 mg/kg (ip). Acute doses of these toxins resulted in extensive necrosis of the gastro intestinal tract, bone marrow and lymphoid tissues, and focal lesions in kidney and cardiac tissue. The minimum doses required for these histopathological effects were consistent with LD50 estimations. The results indicate that 15-ADON was more or less toxic than DON depending on the route of administration. Risk assessments for DON should therefore consider the potential for 15-ADON occurrence and toxicity in food and feed. PMID- 3557239 TI - Teratogenic potential of purified pentachlorophenol and pentachloroanisole in subchronically exposed Sprague-Dawley rats. AB - Male and female Sprague-Dawley (Spartan) rats were exposed to dietary levels of 0, 60, 200 or 600 ppm purified pentachlorophenol (PCP) or pentachloroanisole (PCA) for 181 days, through mating and pregnancy. The daily intakes of PCP were 0, 4, 13 or 43 mg/kg body weight and of PCA were 0, 4, 12 or 41 mg/kg body weight. Animals exposed to PCP generally consumed more food than control animals during pregnancy. Dams at the high-dose level of both compounds showed evidence of toxicity, weighing less on day 0 of gestation and gaining less throughout pregnancy than did the controls. Dams exposed to the high dose of PCP gained less weight during pregnancy (exclusive of the gravid uterus) than control dams. At the 43 mg/kg/day dose level PCP was embryolethal. Foetuses at the lower dose levels of PCP exhibited dose-related decreases in body weights. A reduction in crown-rump length and an increase in foetal skeletal variations were seen at 13 mg/kg/day in PCP animals only. An intake of 41 mg PCA/kg/day was associated with a decrease in the number of corpora lutea and in embryolethality. PCA exposure also resulted in reductions in foetal body weight and crown-rump lengths of males at 4 and 41 mg/kg/day. Female foetuses were unaffected. PMID- 3557240 TI - Teratogenic evaluation of 1,1,3,3-tetrabutylurea in the rat following dermal exposure. AB - The teratogenic potential of 1,1,3,3-tetrabutylurea (TBU) was evaluated in the Crl:CD(SD)BR rat. Doses of 25, 50 or 100 mg TBU/rat/day in 0.5 ml dimethyl phthalate were applied to the shaven dorsal skin on days 6-15 of gestation, the day on which a sperm-positive vaginal smear was present being designated day 1. The rats were killed 1 day before natural delivery and the foetuses were examined for external development, structure and integrity of internal tissues and organs, and skeletal development. No maternal effects were seen in rats exposed to 25 mg TBU, but skin irritation and a reduction in maternal body-weight gains were seen in rats treated with either 50 or 100 mg/day, the effects being more pronounced in the 100-mg/day group. In the latter group, the number of pregnancies maintained was reduced and the number of resorptions per litter, calculated only on the litters with resorptions, was increased. Foetuses derived from the females treated with 100 mg/day were slightly smaller than the controls but were structurally normal. The outcome of pregnancy was unaltered in rats given either 25 or 50 mg TBU/day. No increase in malformed foetuses was observed in any of the test groups. Under the conditions of this study, TBU was not teratogenic when applied dermally to rats at doses up to 100 mg/day. PMID- 3557241 TI - Formation of acute pulmonary toxicants following thermal degradation of perfluorinated polymers: evidence for a critical atmospheric reaction. AB - In some small-scale tests of combustion-product toxicity, perfluorinated polymers (FP) have been shown to be much more toxic than other common materials. These studies were conducted to determine the conditions under which highly toxic decomposition products of FP are formed. A modification of the National Bureau of Standards exposure system (Levin et al. National Bureau of Standards 1982, NBS IR 82-2532) was used, in which materials could be heated either in a cup furnace or above a small methane flame. At 700 degrees C, the approximate lethal concentrations (ALCs) of the products formed from polytetrafluoroethylene (pTFE) and from hexafluoropropylene/tetrafluoroethylene copolymer (FEP) in the CH4 flame (applied for 1 min) are approximately 850 times higher than the ALCs of the products formed in the cup furnace. Analytically, the major products formed initially from pTFE at 700 degrees C under either condition (flame or cup furnace) are similar but they disappear rapidly in the presence of continuous heat. When the cup furnace is removed 1 min after pTFE is added (a procedure temporally similar to the use of the flame) the toxicity of the products is again low. However, when heat from either the cup furnace or from a small secondary flame is applied continuously (for up to 30 min) to the initial products formed from pTFE in the flame, high toxicity is observed. These observations are supported by pathological evaluation of the respiratory tracts of exposed rats. Thus, the inhalation toxicity of FP thermal decomposition products is related to a heat- and time-dependent atmospheric reaction. Such mechanisms should be considered in estimating the fire hazard of these materials in use. PMID- 3557242 TI - Evaluation of the 190H analogues of prostaglandins E1, E2, F1 alpha and F2 alpha as specific markers for the identification of human semen in body fluid mixtures. AB - The specificity of antisera raised against each of the prostaglandin series 190H E1/E2 and 190H F1 alpha/F2 alpha, produced in males, was evaluated by radioimmunoassay. Further, the ability of these antisera to detect semen specific prostaglandins in mixtures of body fluids was examined. Antisera directed against the 190H E1/E2 series cross-reacted with prostaglandin E1 and marginally with E2. Antisera raised to the 190H F1 alpha/F2 alpha series were, however, highly specific to the semen specific prostaglandins 190H F1 alpha/F2 alpha and 190H E1/E2. It was possible to detect picogramme quantities of contaminating 190H F1 alpha/F2 alpha on vaginal swabs taken up to 72 h after intercourse and on vaginal swabs stored at room temperature for up to 2 years. These prostaglandins were not detected on semen free vaginal swabs, in faecal material, saliva, urine or in a sample of human milk (stain). A limited study of casework material is also described. Detection of the 190H F series, as a group, has considerable potential in the identification of human semen at picogramme levels, eliminating the need for alternative chemical tests and extensive microscopic examination. PMID- 3557243 TI - Tissue disposition of cocaine in man: a report of five fatal poisonings. AB - The disposition of cocaine in five cases of fatal poisoning are presented. The highest concentrations of cocaine were found in urine, kidney, spleen, brain, lung and skeletal muscle. Cocaine concentrations in these organs far exceeded those in blood. Cocaine was detected in all other specimens tested including: bile, heart, liver, vitreous and adipose tissue. These results are in agreement with limited, previously reported, tissue data, and indicate that when urine is not available, kidney, spleen, brain and/or lung should be the specimen of choice for cocaine detection. PMID- 3557244 TI - Identification of propellants of small arms ammunition. AB - Existing methods seem inadequate to identify propellants of small arms ammunition. The present article describes that viscosity may be effectively used to differentiate and identify those. The temperature dependence, intra- and inter batch variation and storage effect of propellants were studied. PMID- 3557245 TI - Two tricyclic antidepressant poisonings: levels of amitriptyline, nortriptyline and desipramine in post-mortem biological samples. AB - Two deaths due to amitriptyline and desipramine overdoses are reported. The first case deals with a 20-year-old Caucasian male who was found dead at his residence. Toxicological analysis of the blood, urine, liver and kidney revealed the presence of amitriptyline (1.7 mg/l, 0.13 mg/l, 36.0 mg/kg and 98.0 mg/kg) and nortriptyline (0.66 mg/l, 0.74 mg/l, 12.0 mg/kg and 37.0 mg/kg). The gastric content contained only 220 mg of amitriptyline. The urine also contained norverapamil, which was consistent with previous verapamil therapy. The second case involved a 19-year-old Caucasian male who attempted suicide earlier and was on desipramine medication. The blood, urine, liver and gastric content disclosed the presence of desipramine in the concentrations of 14.2 mg/l, 33.7 mg/l, 112.5 mg/kg and 180 mg, respectively. The levels of these tricyclics analyzed by high pressure liquid chromatography were in agreement with the levels reported in the literature. Though with the amitriptyline poisoning no significant anatomic changes were noted, the desipramine-caused death was further supported by the multisystem vascular congestion and ischemic changes consistent with cardiopulmonary failure. PMID- 3557246 TI - [Pediatrics 1986]. PMID- 3557247 TI - [Polymyalgia rheumatica]. PMID- 3557248 TI - [Epidemiologic research--is it still possible for us today?]. PMID- 3557249 TI - [Prevention of affective and schizoaffective psychoses]. PMID- 3557250 TI - [Proctology--highlights 1986]. PMID- 3557251 TI - [What does family anamnesis contribute in routine medical practice?]. PMID- 3557252 TI - [Do we need naturopathy?]. PMID- 3557253 TI - [Significance of Chlamydia trachomatis in urology]. PMID- 3557254 TI - [Omeprazole and peptic ulcer. Profile of a new active agent]. PMID- 3557255 TI - [Ulcerative colitis. Evaluation of a newly developed activity index within the scope of a therapeutic study of mesalazin]. PMID- 3557256 TI - [A surrogate mother contract on the witness stand]. PMID- 3557257 TI - [Stenosing laryngotracheitis (pseudocroup). Current review of etiology, pathophysiology, differential diagnosis and therapy--air pollutants: an etiologic factor?]. PMID- 3557258 TI - [Iodine-induced hyperthyroid crises]. PMID- 3557259 TI - [Effects of an anti-androgen combination preparation on the hemostatic system]. PMID- 3557260 TI - [Artefacts on the skin. 3 case reports]. PMID- 3557261 TI - [Bacteremia following endoscopic laser therapy. Incidence of bacteremia and infection following laser coagulation of stenosing processes of the gastrointestinal tract]. PMID- 3557262 TI - [Secondary failure of oral diabetes therapy]. PMID- 3557263 TI - [Therapy with hemorheologic considerations. 2: Rheologic agents]. PMID- 3557264 TI - [Prevention of kinetosis in children. Transdermal therapy with scopolamine]. PMID- 3557265 TI - [Comparison of the diagnostic categories of ICD-9 and DSM-III]. AB - To support the discussion of the DSM-III as well as to facilitate its clinical use, its diagnostic categories are contrasted with the diagnostic categories of the ICD-9. PMID- 3557267 TI - Electron microscopic studies on the Auerbach's plexus in the rat small intestine. I. Vagal nerve elements. PMID- 3557266 TI - Morphological characteristics of the motor endplate myopathy observed in the soleplate sarcoplasm after chronic neostigmine treatment. PMID- 3557268 TI - Electron microscopic studies on the Auerbach's plexus in the rat small intestine. II. Sympathetic nerve elements. PMID- 3557269 TI - Catalytic and immunochemical properties of purified human liver lipoamide dehydrogenase. PMID- 3557270 TI - [Comparison of triggered movement-related and self paced movement-related neuronal activities in the frontal agranular cortex]. AB - To examine the functional differences in primate motor cortex (MC), premotor cortex (PM) and supplementary motor area (SMA), single cell activities in these areas were recorded from monkeys performing either visually triggered or self paced key press movement. EMG recordings made clear that activities in finger and hand flexor muscles preceding the triggered or self paced movement were identical and no limb and body muscles were active during performing the task. Neuronal activity changes preceding movement onsets were classified into two categories; a short lead type with the preceding time of less than 300 ms, a long lead type with longer preceding times. In MC, a majority of movement-related neurons (86%) was active phasically and therefore belonged to a short lead type. They exhibited similar activity changes regardless of whether triggered or self paced. In PM, 87% of movement-related neurons were of short lead type. About one third of them were triggered movement specific and another one third were triggered movement predominant. These preferential relation to triggered movement were characteristic in PM. Neurons of SMA were different from MC and PM cells in that as much as a half of them showed the long lead type of activity changes and almost all of these cells were classified into self paced movement dominant or specific. These results suggest that each of these areas have different functional characteristics. PM has more preferential relation to the triggered movement and SMA has more preferential relation to the self paced movement, whereas MC is involved equally in both. PMID- 3557271 TI - [Experimental teratological studies on facial anomalies induced in mice by bis (dichloroacetyl) diamine. I. Establishment of an animal model of the median cleft face syndrome by the administration of bis (dichloroacetyl) diamine to mice]. AB - Bis (dichloroacetyl) diamine (abbreviated as bisdiamine hereafter) was administered by oral intubation to pregnant Jcl: ICR and A/J mice at a dosage of 3,200 mg/kg/day at days 7.5 and 8.5, 8.5 and 9.5, 9.5 and 10.5 or 10.5 and 11.5 of gestation (VP = day 0). Fetuses were recovered at day 17.5 of gestation following maternal sacrifice. The numbers of resorptions, live fetuses and malformed fetuses were counted in the two strains of mice and the induced craniofacial anomalies were examined macroscopically and histopathologically. In both strains, median facial cleft, cleft palate, exencephalocele and open eyelids were commonly induced craniofacial anomalies. Bisdiamine-induced median facial cleft ranging in severity from minor midfacial disorganization to completely divided nose with a median cleft lip in Jcl: ICR and A/J was strikingly similar to a spectrum of midline defects of the median cleft face syndrome in humans. Histopathological examinations of severe median facial cleft in the two strains revealed that the bifurcated nasal septal cartilage showed irregular hypoplasia and that it was partly disorganized into several nodules of various shapes and sizes. These results indicate that bisdiamine treatment in mice provides a useful animal model of the median cleft face syndrome. Furthermore, higher frequency of median facial cleft and lower mortality in bisdiamine-treated Jcl: ICR indicate that bisdiamine treatment in Jcl: ICR is more effective than that in A/J to make an animal model of this syndrome. PMID- 3557272 TI - [Experimental teratological studies on facial anomalies induced in mice by bis(dichloroacetyl)diamine. II. Pathogenesis of bis(dichloroacetyl)diamine induced median cleft face syndrome in mice]. AB - The present study was performed to clarify the pathogenesis of bis(dichloroacetyl)diamine (abbreviated as bisdiamine hereafter)-induced median cleft face syndrome in mice. Bisdiamine was administered by oral intubation to pregnant Jcl: ICR mice at a dosage of 3,200 mg/kg/day at days 7.5 and 8.5 of gestation (VP = day 0). Embryos were recovered at 4, 12, 24, 48, 72 and 96 hr after bisdiamine treatment at day 8.5 of gestation and morphological differences between the bisdiamine-treated and control embryos at the specific time intervals were quantitatively examined by the light and scanning electron microscopy. First, bisdiamine caused extensive death of cranial, mainly prosencephalic and mesencephalic, neural crest cells and neuroepithelial cells. Second, the former damage resulted in reduced numbers of mesenchymal cells in the frontonasal prominences and the latter resulted in dorsolateral deviation of the nasal placodes. Consequently, the medial nasal prominences were abnormally widely spaced and then, the median cleft face syndrome was induced. In addition, the findings suggesting that bisdiamine might cause aberrant movement of neural crest cells and/or mesenchymal cells were observed. PMID- 3557273 TI - [Purification and characterization of lathosterol 5-desaturase from rat liver microsomes by cytochrome b5-sepharose affinity column chromatography: evidence for the non-heme iron protein]. AB - Lathosterol 5-desaturase, which catalyzes introduction of a delta 5 bond into lathosterol to form 7-dehydrocholesterol, was purified up to 2000-4000-fold with a 13-18% yield from rat liver microsomes by cytochrome b5-Sepharose affinity chromatography followed by isoelectric focusing. The final enzyme preparation was homogenous as judged by SDS-polyacrylamide gel electrophoresis and a single polypeptide of 65,000 daltons. Furthermore, the two molecular forms with isoelectric points of 6.3 and 9.5 were demonstrated by electrofocusing, though they did not show any significant difference with respect to their enzymatic properties. The desaturase was found to be a non-heme iron protein containing one atom of iron per one molecule of the enzyme. The enzyme activity was inhibited strikingly by iron chelators and cyanide. The decreased enzymatic activity, however, was recovered completely by Fe-ion to the original level, suggesting that the iron was essential for the catalytic activity. PMID- 3557274 TI - [Chemiluminescence of whole blood--analysis of the kinetics and application of clinical examination of phagocytic functions of whole blood from various type of diseases]. AB - Luminol-dependent chemiluminescence of whole blood (whole blood CL) was developed to estimate the phagocytic function of granulocytes and the serum opsonin activity simultaneously. Whole blood (0.1 ml) was examined directly and results were obtained within 20 minutes. Phagocytic function of granulocytes can be estimated from the peak CL of whole blood and the number of granulocytes in a specimen, and the opsonin activity from the amount of time the peak CL is shown after the addition of nonopsonized CL inducer (nonopsonized zymosan). Subsequently, whole blood CL was measured to evaluate phagocytic functions in children with disease. Patients with chronic granulomatous disease showed no CL, and one of their mothers (1/3) showed low CL, suggesting she is a carrier. Two patients with hypocomplementemia (SLE and chronic nephritis) showed low serum opsonin activity, and phagocytic function of their granulocytes was enhanced. In cord blood and newborn infants serum opsonin activity was low, and phagocytic function of granulocytes was slightly decreased in cord blood but not in newborn infants. Patients with systemic bacterial infections showed an increased phagocytic function of granulocytes. Anti-cancer drugs decreased serum opsonin activity in children with leukemia or lymphoma. The children treated with L asparaginase had very low opsonin activity, suggesting the drug inhibits complement synthesis. The measurement of whole blood CL was useful for monitering the phagocytic functions of blood after granulocyte transfusion. PMID- 3557275 TI - [Statistical analyses on over ten years survivals in Hokkaido under chronic dialysis therapy]. AB - In Hokkaido, there were 305 chronic dialysis patients surviving more than ten years as of July 31, 1985. All patients except for one (CAPD) have been placed under hemodialysis. About 73% of them were introduced into a dialysis therapy in their thirties and chronic glomerulonephritis was extremely predominant as for the underlying disease. 93.2% of the cases possessed internal AV-fistulae using own vessels and other types of blood access remained only 6.8%. Hematocrit (Hct) was 27.5% on average of 305 cases. The value was fairly satisfactory but it must be noted that Hct of 33 patients (10.8% of all) was less than 20%. Severe anemia is still one of major complication in chronic dialysis patients. Characteristic complications, which have been increasing in frequency in parallel with prolonged dialysis length, became clarified: renal osteodystrophy, secondary hyperparathyroidism, carpal tunnel syndrome, persistent hypotension and so on. The former two are strongly related to Ca & P metabolism and some of the long term survivals require parathyroidectomy. It is now estimated that carpal tunnel syndrome is induced by accumulation and deposition of beta 2-microglobulin, which increases in blood progressively if used Cuprophane membrane dialyser. Patients with CTS must be placed under surgical intervention, which relieves the symptoms effectively and the prophylaxis might require protein-permeating dialyser. PMID- 3557276 TI - [CT findings of ongoing intracerebral hematoma]. AB - Three cases of ongoing intracerebral hematoma are reported. In all cases, a very small hematoma on the initial CT taken within 2 hours after onset increased in size to such an extent that surgical intervention was necessary. A round radiolucent zone in high density clots was seen on the initial CT of all cases. The attenuation values of each pixels in hematoma formed V-figure in profile display, vfrying from minimum density (40-60) in the center of radiolucent zone to the maximum density (80-90) in peripheral clots. Experimental data have established that the density of blood in circulation and, therefore, one immediately after extravasation is directly related to the patient's hemoglobin and hematocrit levels. Hemoconcentration following clot formation and serum absorption in the brain tissue results in further increase of hematoma density. The radiolucent zone in a intracerebral hematoma suggests extravasated fresh blood. Therefore, we conclud that this is an evidence of active bleeding which calls for immediate surgery. PMID- 3557277 TI - Isozyme compositions and subunit structures of subcellular glutathione S transferases in rat brain. PMID- 3557278 TI - Phenobarbital treatment increased the astroglia-specific enzyme, glutathione S transferase in rat brain. PMID- 3557279 TI - Lipoproteins status in professional football players after period of vacation and one month after a new intensive training program. AB - Plasmatic lipoproteins were evaluated in a group of 11 professional football players after a 3-week rest, and one month later, after an intensive training (characterized by a succession of aerobic and anaerobic efforts), for engaging a new competition. At day 0, total cholesterol (TC = 4.4 +/- .04 mmol/l), triglycerides (TG = .6 +/- .04 mmol/l), and LDL-TC (2.54 +/- .18 mmol/l) were significantly decreased versus sex and age matched sedentary subjects (TC = 5.13 +/- .2 mmol/l, P less than .02; TG = .99 +/- . mmol/l, P less than .01; LDL-CT = 3.26 +/- .2 mmol/l, P less than .02). HDL-TC was increased (1.50 +/- .06 vs 1.30 +/- .05 mmol/l, P less than .05). The apoprotein A1 (apoA1) was higher in football-players (1.5 +/- .06 vs 1.16 g/l, P less than .001), while the apoprotein B (apoB) was lower (.6 +/- .03 vs .88 +/- .04 g/l, P less than .001). Even after 3 weeks of rest, the football-players lipoproteins were still identical to aerobic elite-athletes. At day +30, after a daily training involving 2 anaerobic sequences, the maximal aerobic capacity was increased by 21%, without any change in nutritional, plasmatic and hepatic status. Weight was diminished ( 0.8 kg, P less than 0.05). TC (4.14 +/- .2 mmol/l), TG less than .64 +/- .08 mmol/l), LDL-TC (3.37 +/- .17 mmol/l), apo B (.64 +/- .05 g/l) were unchanged. HDL-CT fell to controls values while apoA1 increased (1.66 +/- .06 mmol/l, P less than .001). Thus, HDL-CT/apoA1 ratio (indicating the TC content of HDL) was decreased, whereas apoB/apoA1 ratio was unchanged. The decrease of TC content of HDL was not related to dietary change nor to weight decrease. As TG were stable, the lipoprotein lipase activity could not be modified.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557280 TI - Hepatic lipase and the clearing reaction: studies in euthyroid and hypothyroid subjects. AB - Eight patients with primary hypothyroidism were compared to eleven euthyroid subjects with regard to the effects of a single i.v. dose of heparin on plasma lipoprotein concentrations (the "clearing reaction"). The hypothyroid patients were moderately hypercholesterolemic but had normal plasma triglyceride levels. Maximal activities of hepatic lipase (HL) and lipoprotein lipase (LPL) were lower in the hypothyroid than in the normal subjects. The hypothyroid patients demonstrated a significant decrease in total plasma cholesterol levels after heparin injection (from 8.36 +/- 0.70 mmol/l to 7.55 +/- 0.62 mmol/l, P less than 0.02). The maximal activity of HL after heparin was significantly correlated to the decrease in plasma cholesterol levels (P less than 0.05) and in LDL cholesterol levels (P less than 0.01). The euthyroid subjects demonstrated a smaller decrease in total plasma cholesterol concentrations (from 5.53 +/- 0.31 to 5.08 +/- 0.28 mmol/l, P less than 0.05). In this group, the fall in cholesterol levels was not correlated to maximal HL activity. The reduction in plasma triglyceride levels after heparin was similar and significant (P less than 0.01) in both groups. These data support the view that decreased activity of HL contributes to the dyslipoproteinemia seen in hypothyroidism. They are also in accordance with the notion that HL is involved in the elimination of cholesterol from plasma. PMID- 3557281 TI - Effect of three days nifedipine administration on thyroid response to TSH. PMID- 3557282 TI - The nonsuppressibility of plasma cortisol persists after pregnancy. AB - To determine if normal balance is restored to the hypothalamic-pituitary-adrenal axis after pregnancy, we compared the dexamethasone suppressibility of plasma cortisol in women four days after delivery of their infant, with that of nonpregnant women. Plasma concentrations of cortisol before dexamethasone administration were similar in the post-partum women and in women taking oestrogen contraceptives, but both were higher than in normally cycling women. After dexamethasone, plasma cortisol in the post-partum women was significantly higher than in both oestrogen-taking and normally cycling nonpregnant women. The reduced dexamethasone-suppressibility of plasma cortisol, which is characteristic of pregnancy, extends into the post-partum period. PMID- 3557283 TI - DNA-synthesis under the effect of a placental protein in mammary gland in culture. PMID- 3557284 TI - Time dependent stimulating effect of glucagon on the capacity of urea-N synthesis in rats. AB - The effect of glucagon on the capacity of urea-N synthesis was examined in 24 rats as a function of time. First, the conditions for saturation of urea synthesis under glucagon influence were studied by the kinetics of urea-N synthesis rate in relation to arterial blood alpha-amino-N concentration between 5 and 17 mmol/l in 21 nephrectomized rats given zinc-glucagon (20 micrograms s.c. per day) for 14 days. Alanine was infused so that steady state concentrations of total alpha-amino-N was attained in each rat. The urea-N synthesis rate was calculated as accumulation in total body water corrected for intestinal hydrolysis. The relationship suggested a barrier limited substrate inhibition kinetics, as earlier found in control rats, and data were examined accordingly by non-linear regression analysis. The estimated kinetic constants were: Vmax = 71 mumol/(min X 100 g body wt), Km = 5.4 mmol/l, Ki = 2.4 mmol/l, and the barrier = 4.4 mmol/l. Vmax was increased three times compared with controls. The capacity of urea-N synthesis, i.e. the zenith of the relation, was attained in the concentration interval 7.5 to 12.0 mmol/l, as in controls. The capacity of urea-N synthesis was determined during i.v. infusion of zinc-glucagon (0.15 microgram per min) and after 2, 8, and 14 days of daily s.c. injections of 20 micrograms zinc-glucagon. Rats given zinc-protamine solution were controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557285 TI - Effects of streptozotocin-induced diabetes in pregnant rats on placental transport and tissue uptake of alpha-amino-isobutyric acid. AB - Placental transport and tissue uptake of amino acids were studied in streptozotocin (STZ)-induced diabetic rats by using the non-metabolizable amino acid [U-14C]-alpha-amino-isobutyric acid (AIB). Fifteen minutes prior to autopsy, animals of each group, control (C), diabetic (D), diabetic-insulin treated (DI) and diabetic-T4 followed by 3-5-Dimethyl-3'-isopropyl-L-thyronine (DIMIT) treated (DTD), received an injection of the [U-14C]-AIB SC. Disintegrations per minute (DPM) were measured in serum and tissues subsequent to autopsy. There were no differences in maternal serum DPM/ml among groups. Fetal serum DPM, however, were lower in D and DTD groups than in the C group. The whole fetal tissue homogenate radioactivity was lower in the D, DTD, and DI groups than in the C group. In general, more AIB was taken up by fetal tissues of C than D animals. Maternal liver AIB uptake was reduced in D, DI, and DTD from C animals and net placental transport of AIB was less in D and DTD than C animals. Fetal liver protein concentrations were depressed in D and DTD animals from C and DI, but fetal brain protein concentrations showed no significant differences. Furthermore, the lower organ and fetal body weights of the D and DTD groups compared with the C and DI groups support the proposal that fetal anabolism is impaired. Maternal and fetal serum T4 concentrations were lower in D and DTD than in C and DI animals. Insulin therapy improved serum T4 levels in both mother and fetuses. It did not, however, correct all other measured parameters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557286 TI - Secretion of glicentin in response to hypoglycemia in pigs. PMID- 3557287 TI - Erythrocyte lipid peroxidation and glutathione peroxidase activities in patients with diabetes mellitus. PMID- 3557288 TI - Core criteria for diagnosing borderline patients. AB - This study compares 17 hospitalized borderline personality disorder (BPD) patients with 20 normal control subjects. Four criteria sets--DSM III, Grinker, Gunderson, and Kernberg--were combined and used with the semistructured DIAGNOSTIC INTERVIEW BORDERLINES (DIB) Scale. Findings indicate that among BPD patients the following were most prominent: 1) impulsive episodes 2) unstable relationships 3) chronic feelings of depressive emptiness/loneliness 4) acting out behavior and, somewhat less prevalent, 5) identity disturbance. BPD patients can be discriminated by different patterns of disturbance while sharing other features in common with them. While DSM III requires five of eight items for BPD diagnosis, from the above group significantly less than five adequately made a positive diagnosis in this study. BPD seems to identify a heterogeneous group of patients with behavioral disturbances without particular personality specificity which share certain core characteristics among which additional features may further subtype component members. PMID- 3557289 TI - Right on the money: disability forms and the hospitalized borderline patient. AB - Handling of the hospitalized borderline patient's request for disability compensation reflects the therapists's success or failure in keeping a sustained focus on splitting. This focus is crucial to the subacute hospital treatment of borderline psychopathology. Overprotectiveness or withholding of appropriate support results from countertransference reactions. Splitting is reinforced rather than minimized if the therapist fails to focus both on the damaged and overwhelmed aspect of the personality (how the patient feels) and on the irresponsible and manipulative aspect (what the patient does). The therapist who fails to respond to the disparate aspects in an integrated way risks acting out key aspects of the clinical picture to the detriment of successful subacute hospital treatment. The therapist's awareness of typical patterns of splitting can be enhanced by considering the patient's developmental history; current familial and vocational relations (or lack of them); and the patient's relation to the hospital staff. PMID- 3557290 TI - Anorexia nervosa in later life. AB - Anorexia nervosa is generally considered a disease of adolescence. However, recently there has been a growing number of case reports of anorexia nervosa occurring in later life. Physicians must be aware of the fact that anorexia nervosa can occur well into the fifth, sixth, and seventh decades of life. Three cases of probable anorexia nervosa in later life are presented. When confronted with cases of unexplained weight loss, physicians should include anorexia nervosa in their differential diagnosis and pursue the answers to questions that will help make the diagnosis. PMID- 3557291 TI - Serum salivary isoamylase levels in patients with anorexia nervosa, bulimia or bulimia nervosa. AB - Salivary isoamylase levels were studied in a sample of 35 women with bulimia, anorexia nervosa, or bulimia nervosa. Salivary isoamylase elevation was related to the presence of sham eating, evidenced by elevated isoamylase values in patients with bulimia nervosa or bulimia, and depressed isoamylase values in patients with anorexia nervosa. Salivary isoamylase levels may provide insight and have bearing on the functional interrelationship between appetite regulation and ingestive behavior in patients with eating disorders, as abnormalities may occur during both the cephalic as well as the oral phase of eating. PMID- 3557292 TI - The relationship between early life events and DSM III personality disorders. AB - The relationship between early childhood events and DSM III personality disorders was examined in 82 non-psychotic psychiatric outpatients. Early loss of a parent or living in a family where there was overt marital discord was associated with having a greater chance of developing DSM III Cluster B personality disorders (narcissistic, antisocial, borderline, histrionic) as adults. It was also related to an increased number suicide attempts as adults. Those patients who suffered an early loss of a parent through death had a significantly higher percentage of antisocial personality and suicide attempts as adults. Patients who as adults had a DSM III Cluster B personality disorder were significantly less likely than comparison patients to have had an early loss of a parent. This finding of a lower chance of a personality disorder if there were a loss of a parent was also significant for histrionic personality disorder when it was analyzed separately. Some theoretical implications of these findings are discussed. PMID- 3557293 TI - Regional cerebral blood flow and neuropsychological functioning among adolescent psychiatric inpatients. AB - Relationships between regional cerebral blood flow (rCBF) and the Luria-Nebraska Neuropsychological Battery (LNNB) were examined utilizing 15 adolescent psychiatric inpatients. Significant correlations were obtained between the gray matter measure on the rCBF and those scales on the LNNB more related to nonverbal function. PMID- 3557294 TI - Cross-cultural studies of sex differences in normal adolescents' self-image. AB - One context for understanding an adolescent's (or any other individual's) abnormal functioning is an appreciation of normal or modal functioning in the culture to which that adolescent belongs. After decades of research and clinical observation there is no consensus about what constitutes modal adolescent functioning in the United States. Much less is known about adolescent functioning in other cultures. Results were suggestive of large, cross-cultural differences in self-image among normal adolescents. In most areas American teenagers reported the best functioning while Bengali teenagers reported the worst. There were consistent gender differences in self-image across cultures, with adolescent girls showing poorer self-image than adolescent boys in many areas. Results are discussed from the point of view of difficulties in doing cross-cultural psychiatric research and the need for further research in this field. PMID- 3557295 TI - A supportive care clinic: maintaining the chronic psychiatric patient. AB - A comprehensive investigation into the social support networks of a group of chronic psychiatric patients attending a Supportive Care Clinic was conducted. The results suggest that these patients, while exhibiting weaker support systems than the general population, do have a significant amount of personal support in addition to that received from the treatment center. Furthermore, they perceive the "support" aspect of the Clinic as the most helpful feature as compared to personal growth or medication. The results of these findings are discussed in terms of their practical utility for the ambulatory care of chronic psychiatric patients. PMID- 3557296 TI - Persistent tardive dyskinesia associated with amoxapine therapy--two case reports. AB - Two patients with depression were treated with amoxapine for 3 to 5 years and subsequently developed persistent tardive dyskinesia. The author stresses caution in regard to the long term use of amoxapine. PMID- 3557297 TI - Possible efficacy of alprazolam in restless leg syndrome. AB - Restless leg syndrome is a frequently misdiagnosed and often misunderstood condition contributing to a complaint of insomnia in geriatric patients. Various pharmacologic agents used to treat the condition are often ineffective and have not consistently provided relief for the majority of patients with this condition. Our recent experience with Xanax suggests its possible effectiveness in controlling symptoms of the restless leg syndrome. Further, more controlled double blind studies--especially comparing other benzodiazepines at appropriate dosages--are called for. PMID- 3557298 TI - Factitious rape: a case report. AB - The author reports a case of factitious rape in a psychiatric inpatient. To his knowledge, this is the first case report of this syndrome in the medical literature. This case is related to the signs and symptoms commonly found in Munchausen Syndrome. The question of the relationship of factitious rape to borderline personality disorder and to disturbed sexual identity is raised. Physicians are urged to develop an index of suspicion for factitious disorder. PMID- 3557299 TI - The American Association for the Study of Liver Diseases. Presentation of the Distinguished Achievement Award to Hyman J. Zimmerman, M.D. PMID- 3557300 TI - Isolated rat hepatocyte couplets in short-term culture: structural characteristics and plasma membrane reorganization. AB - Studies of canalicular bile secretion have been limited due to lack of direct access to the canalicular lumen. Isolated rat hepatocyte couplets, consisting of two hepatocytes enclosing a canalicular space, have been proposed as a primary secretory unit that may be useful for direct studies of unmodified canalicular bile secretion. The present study examines their structural characteristics and plasma membrane reorganization. The canalicular space of freshly isolated hepatocyte couplets is freely permeable to ruthenium red, but within 4 hr the junctional borders reseal in most couplets which then exclude ruthenium red from the luminal area. These resealed spaces expand in 61.8 +/- 10% of couplets as secretion is elaborated and after 4 hr in monolayer culture, 12.7 +/- 4.7% of the canalicular spaces are dilated to diameters greater than 3 microns. Normal appearing microvilli line these canalicular membranes in the majority of dilated spaces as assessed by electron microscopy. Immediately after isolation, Mg++ ATPase, a histochemical marker for canalicular membranes, is located as a discrete band corresponding to the normal in vivo circumferential distribution of the canalicular membrane domain. However, this pattern of Mg++-ATPase staining rapidly diminishes and reorganizes at the remaining canalicular pole within several hours. This membrane reorganization is a microfilament-dependent process, since it is inhibited by cytochalasin D but not by colchicine, an inhibitor of microtubular function or cycloheximide, an inhibitor of new protein synthesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557301 TI - Comparative effects of deoxycholate and 7-methyl-deoxycholate in the hamster. AB - The metabolism and effect on biliary lipids of a new bile acid analog, 7-methyl deoxycholic acid, were studied and compared with those of deoxycholic acid in the hamster. 14C-Labeled 7-methyl-deoxycholic acid and deoxycholic acid were administered intravenously or intraduodenally to bile fistula hamsters at 1.0 or 4.0 mumoles per min X kg, and hepatic bile was analyzed for radioactive metabolites and biliary lipid outputs. Deoxycholic acid and 7-methyl-deoxycholic acid were efficiently absorbed from the intestine, extracted by the liver and excreted into bile as taurine and glycine conjugates. Twenty per cent of deoxycholic acid was 7 alpha-hydroxylated to cholic acid while 7-methyl deoxycholic acid did not undergo hydroxylation. During deoxycholic acid infusion, the biliary secretion of phospholipid did not increase, and the bile became more lithogenic. In contrast, 7-methyl-deoxycholic acid stimulated phospholipid secretion, and bile became less lithogenic. Although pathologic changes in the liver were inconstant and mostly mild, both bile acids were toxic in the hamster; hemolysis and death due to respiratory distress were observed. PMID- 3557302 TI - Ultracentrifugal isolation of vesicular carriers of biliary cholesterol in native human and rat bile. AB - We have utilized ultracentrifugation of native bile-Metrizamide density gradients to isolate a vesicular transport system of biliary lipids in both man and rat. We identified vesicular structures by electron microscopy. Fresh bile specimens were obtained from bile fistula rats (unsaturated bile) and from patients 1 week after bile duct surgery (supersaturated bile). Metrizamide was dissolved in bile (33% w/v), and continuous density gradients were performed with undiluted bile (density limits = 1.020 to 1.300 gm per ml). The relative distribution of biliary cholesterol, phospholipid and bile salt was studied as a function of the density of the fractions. Approximately 50% of total rat biliary cholesterol and between 61 and 90% of human biliary cholesterol was concentrated in the lightest fractions of the gradients (density less than 1.060 gm per ml). In contrast, less than 20% of bile salts was present in fractions with densities lower than 1.060 gm per ml. The highest amounts of bile salts and phospholipids of the bile Metrizamide density gradients were found in the density range of 1.075 to 1.100 gm per ml in both human and rat bile. More than 80% of biliary proteins was found in fractions with densities greater than 1.075 gm per ml, and only 2% was found in the cholesterol-rich fraction with density less than 1.060 gm per ml in both species. When bile salt concentration was raised in rat bile from 38 to 97 mM by adding taurocholate, the low density cholesterol-rich fraction almost disappeared. Electron microscopy of negatively stained preparations of the fractions with density less than 1.060 gm per ml showed 40 to 120 nm vesicles, which were not apparent in the other fractions. Similar vesicles were demonstrated also in fresh rat bile and within the canaliculi after acute depletion of the bile salt pool (biliary bile salt concentration of 3.45 mM; total biliary lipid concentration of 0.25 gm%). The structure of these vesicles was shown in thin sections of liver specimens. They appeared as internal cavities surrounded by a single, continuous 6-nm-thick bilayer. These studies demonstrate that a high proportion of biliary cholesterol is transported in vesicles in human supersaturated native bile and that vesicular carriers are also responsible for the transport of a significant amount of biliary cholesterol in unsaturated rat bile. The presence of vesicles in unsaturated hepatic bile strongly supports the thesis that biliary lipids may be secreted as vesicles from the hepatocyte into the canaliculi. PMID- 3557303 TI - Bile salts induce calcium uptake in vitro by human erythrocytes. AB - At high concentrations, bile salts induce hemolysis by comicellization of lipid components of the cell membrane. However, bile salts are also associated with hemolysis at lower concentrations by mechanisms which have not been characterized. To investigate the possibility that bile salts promote calcium uptake by red blood cells and that bile salt-associated hemolysis is, in part, calcium-mediated, calcium uptake by red blood cells was measured in the presence of individual bile salts, and hemolysis dependence upon calcium availability was examined. Washed human red blood cells with or without ATP depletion were incubated with 1 mM CaCl2 and tracer amounts of 45CaCl2 in the presence of selected bile salts at concentrations (0.01 to 0.3 mM) reported to be below critical micellar concentrations. Calcium uptake (defined for the purposes of this study as 45Ca retained in red blood cells) was monitored over 5 hr, after which hemolysis and membrane phospholipid content were determined. The presence of bile salts stimulated calcium uptake 4- to 25-fold--the magnitude of which was partly related to the lipid solubility of the bile salts. ATP depletion or exposure to trifluoperazine, procedures which inhibit calcium pump activity in red blood cells, enhanced bile salt-induced calcium uptake relative to controls. The percentage of associated hemolysis (2 to 14%) at the end of 5 hr correlated directly with the observed calcium uptake. Removal of calcium from the extracellular space reduced hemolysis in the presence of bile salts to control levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557304 TI - Liver levels of vitamin A and cellular retinol-binding protein for patients with biliary atresia. AB - We have examined whether the amount of cellular retinol-binding protein in human liver is related to the amount of vitamin A stored in the liver. Levels of vitamin A, as retinol and retinol esters, and of cellular retinol-binding protein have been determined in liver samples from 6 normal adults and 11 children with biliary atresia, with and without vitamin A treatment. The level of cellular retinol-binding protein in the liver was not related to the liver vitamin A concentration examined over a 300-fold range of vitamin A levels. Also, biliary atresia did not appear to interfere with storage of vitamin A, and the level of cellular retinol-binding protein was comparable to that observed in the liver of normal adults. The demonstration of proper vitamin A storage in treated children as well as normal levels of cellular retinol-binding protein suggest the vitamin A deficiency frequently observed in children with biliary atresia may be due primarily to faulty absorption rather than a combination of poor absorption and impaired hepatic vitamin A metabolism. PMID- 3557305 TI - Different susceptibilities to the formation of cholesterol gallstones in mice. AB - In the search for an animal model of genetic determinants of cholesterol cholelithiasis, we found strain, gender and individual differences in mice. Male black (C57BL6J) mice had a 50% incidence of cholesterol gallstones after they consumed lithogenic food similar to that used by Tepperman et al. for 2 weeks, whereas similarly treated male agouti (CBA/J) mice and females of both strains were free of gallstones. The male and female mice of both strains were fertile at 8 weeks of age, and the male black mice were first susceptible to induction of gallstones at 24 weeks of age. Male agouti mice of the same age did not form gallstones until they had consumed the lithogenic food for 8 weeks. The gallbladder biles of both strains were supersaturated with cholesterol during the lithogenic regimen. The male agouti mice had much higher fractional turnover rates of [24-14C]cholic acid than did the male black mice. In spite of their small total cholate pools, the agouti mice had higher rates of new cholate synthesis than did the black mice. The rate of disappearance of [1,2 3H]cholesterol from the blood was higher in the male agouti than in the black mice. The gallbladders of the agouti mice contained less bile and weighed less empty than gallbladders of the black mice. They also did not increase in volume in response to the lithogenic diet as much as gallbladders of the black mice. The difference in gallstone induction times between male and female black mice was as great as the difference between the two strains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557306 TI - Accumulation of 7 alpha-hydroxy-4-cholesten-3-one and cholesta-4,6-dien-3-one in patients with cerebrotendinous xanthomatosis: effect of treatment with chenodeoxycholic acid. AB - Evidence was recently presented that an essential part of the accumulation of cholestanol in patients with cerebrotendinous xanthomatosis is due to acceleration of a novel pathway, involving 7 alpha-hydroxylated intermediates in bile acid biosynthesis as precursors (J. Clin. Invest. 1985; 75:448-456). Such intermediates accumulate in patients with cerebrotendinous xanthomatosis due to lack of the mitochondrial 26-hydroxylase involved in the major pathway for bile acid biosynthesis. The new pathway may involve the following steps: 7 alpha hydroxycholesterol----7 alpha-hydroxy-4-cholesten-3-one----cholesta-4,6- dien-3 one----4-cholesten-3-one----cholestanol. Accurate methods have been developed for assay of 7 alpha-hydroxy-4-cholesten-3-one and cholesta-4,6-dien-3-one in serum, based on isotope dilution-mass spectrometry. The serum levels of 7 alpha-hydroxy 4-cholesten-3-one as well as those of cholesta-4,6-dien-3-one were found to be markedly elevated in the three patients with cerebrotendinous xanthomatosis. Treatment of two of the patients with chenodeoxycholic acid reduced the serum levels of the two steroids by more than 80%. The concentration of cholestanol was reduced by 72% in one patient and by 48% in the other. The possibility is discussed that accumulation of cholestanol in patients with cerebrotendinous xanthomatosis is secondary to accumulation of 7 alpha-hydroxy-4-cholesten-3-one and cholesta-4,6-dien-3-one. PMID- 3557307 TI - An extrahepatic bile duct growth factor: in vivo effect and preliminary characterization. AB - Rabbit sera injected intraperitoneally into BALB/c mice were noted to produce a considerable and selective enlargement of extrahepatic bile ducts. The gallbladder, intrahepatic ducts, liver and other organs showed no stimulation of growth. Duct enlargement leading to widening of its outer diameter which, on average, was 3.6 times that of normal, was due entirely to an increased number of epithelial cells with prominent proliferation of intramural glandular components. There was no evidence of inflammatory bile duct injury, fibrosis or obstruction. All of the above changes were reversible and regressed slowly after discontinuation of injections. The bile duct growth-promoting factor was detected in sera of many animal species including humans and birds. Host response to this factor was determined by the number of injections and appeared to be strain related since it was not observed in C57BL or C3H mice. The sex and age of the donor or recipient were not of any relevance to the growth response. In order to isolate and characterize the bile duct growth factor, rabbit serum was separated into various fractions, and the effect of each fraction was tested in the animal model. Proteins in the 33 to 65% ammonium sulfate precipitate of whole rabbit sera had activity equal to that of native sera. Activity was abolished by treating this serum fraction with 1% sodium dodecyl sulfate plus proteinase K, suggesting that the bile duct growth factor is a protein. Lipids extracted from whole sera using chloroform: methanol or ultracentrifugation were devoid of activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557308 TI - Anticalmodulin autoantibody in liver diseases: a new antibody against a cytoskeleton-related protein. AB - An ELISA has been developed for detection of auto-antibodies against calmodulin. There was a significantly increased frequency (63.1%) of autoantibodies against calmodulin in 103 patients with chronic liver diseases as compared to that (30%) of patients with systemic lupus erythematosus and to that (6.9%) of normal subjects (p less than 0.01). IgG autoantibodies against calmodulin were detected in the patients with acute hepatitis (37.9%), chronic liver disease (45.6%) and also in the patients with systemic lupus erythematosus (30%). IgM autoantibodies against calmodulin were frequently found in patients with liver cirrhosis (52.2%), primary biliary cirrhosis (50%) and autoimmune chronic active hepatitis (38.7%), but rarely in patients with acute hepatitis (13.8%), chronic persistent hepatitis (9.5%) and systemic lupus erythematosus (0%). IgA autoantibodies against calmodulin were frequently found in liver cirrhosis (33.3%), primary biliary cirrhosis (42.9%) and autoimmune chronic active hepatitis (53.6%), but rarely in chronic persistent hepatitis (15.8%), chronic active hepatitis (14.3%) and systemic lupus erythematosus (0%). The occurrences of autoantibodies against calmodulin correlated neither with those of antismooth muscle antibody, antinuclear antibody and antimitochondrial antibody, nor with serum IgG concentrations. Autoantibodies against calmodulin did not cross-react with troponin, myosin light chain, calf thymus DNA and actin. The titer of autoantibodies against calmodulin was decreased by absorption of serum with calmodulin and the liver plasma membrane fraction. The immunoblotting experiment revealed the binding of autoantibodies against calmodulin to calmodulin. IgG fraction from a patient with autoimmune chronic active hepatitis inhibited the activation of phosphodiesterase by calmodulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557309 TI - Long-term follow-up study of asymptomatic HBsAg-positive voluntary blood donors in Austria: a clinical and histologic evaluation of 242 cases. AB - Two hundred forty-two voluntary blood donors, referred after detection of HBsAg positivity, underwent clinical evaluation and liver biopsy and were prospectively followed for an average of 3.5 years. At initial testing, 65% of HBsAg carriers had normal laboratory findings; during follow-up, 26% of these carriers developed abnormal test results, at least transiently. Liver histology was normal in 31.4%, revealed nonaggressive liver disease in 63.6% and chronic active hepatitis or cirrhosis in 5%, only. All except one case of chronic active hepatitis or cirrhosis were associated with abnormal blood biochemical tests. Sequential liver biopsies obtained in 56 HBsAg carriers after a minimal interval of 4 years showed mitigation of inflammatory changes in 5.4% and developing chronic active hepatitis in three cases (5.4%). One carrier died of primary hepatocellular carcinoma. Upon follow-up, HBsAg persisted in 98%. Anti-HBe was found in 90% of all carriers already at the initial testing. HBeAg positivity (7.5%) was associated with chronic active hepatitis as well as nonaggressive liver disease; clearance of HBeAg occurred in 40% after 2 to 8 years. Because of the subclinical progression of liver disease and the increased risk for developing primary hepatocellular carcinoma in asymptomatic HBsAg carriers, routine blood testing, including alpha-fetoprotein screening, as well as abdominal ultrasound surveillance are indicated. Liver biopsy, however, should be restricted to carriers with abnormal biochemical findings. PMID- 3557310 TI - Stimulatory effects of ethanol on amino acid transport by rat fetal hepatocytes. AB - Previous studies have indicated that acute, and especially chronic, maternal ethanol consumption can depress placental uptake of various amino acids. Since the fetal cell itself represents a second barrier to nutrients, one which may be altered by ethanol exposure, the effects of ethanol on amino acid net uptake by rat fetal hepatocytes was addressed. The present study determined that ethanol stimulated amino acid net uptake by fetal hepatocytes grown in monolayer culture. Fetal liver cells were grown in custom Williams' E medium (without L-arginine and with L-ornithine) and exposed to epidermal growth factor (0, 1, 2 or 5 ng per ml) and ethanol (1.7 +/- 0.1 or 3.9 +/- 0.2 mg per ml). Addition of ethanol (3.9 mg per ml) to the culture medium completely blocked measurable cell replication during a 48-hr exposure period. Fetal hepatocytes exposed to ethanol accrued both protein and water in a parallel fashion, both in excess of that by control cells. Ethanol (1.7 and 3.9 mg per ml) for 48 hr stimulated alpha-aminoisobutyric acid net uptake by fetal hepatocytes (p less than 0.05). Efflux was not affected (p greater than 0.05). The onset of this significant stimulation of net uptake was progressive and required in excess of 6 hr of contact with ethanol. This ethanol stimulation of alpha-aminoisobutyric acid net uptake persisted for at least 24 hr following ethanol withdrawal. The component(s) of alpha-aminoisobutyric acid net uptake stimulated by ethanol was independent of extracellular Na+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557311 TI - Hepatic metabolism during acute ethanol administration: a phosphorus-31 nuclear magnetic resonance study on the perfused rat liver under normoxic or hypoxic conditions. AB - The effect of ethanol metabolism on the energetic parameters and intracellular pH of the isolated perfused rat liver from fed rats was studied by phosphorus-31 nuclear magnetic resonance spectroscopy. This technique allowed us to analyze nondestructively and in real time the role of low oxygen tension on the possible injurious effect of ethanol on the liver cells. A quantitative analysis of nuclear magnetic resonance data recorded on a perfused rat liver within a 30 mm diameter probe has been performed at 80.9 MHz. Under normoxic and normothermic conditions, the levels of phosphorylated metabolites detected by nuclear magnetic resonance were 2.8, 0.3 and 2 mumoles per gm liver wet weight for ATP, ADP and inorganic orthophosphate, respectively. The cytosolic pH was 7.25 +/- 0.05. During a period of 4 min of hypoxia induced by reducing the perfusion flow rate to 25% of its initial value (i.e., from 12 ml to 3 ml per min per 100 gm body weight), the level of ATP dropped to 2.2 mumoles per gm liver wet weight. Concomitantly, ADP and inorganic orthophosphate increased to 0.6 and 3.3 mumoles per gm liver wet weight. Cytosolic pH fell to 7.02 +/- 0.05. Perfusion of the liver with a Krebs medium containing 70 mM (0.4%) ethanol induced a sharp decrease in intracellular inorganic orthophosphate to reach 1.3 mumole per gm liver wet weight and after a lag time of 4 to 6 min, a decrease in ATP level (2.15 mumoles per gm liver wet weight). A large increase in phosphomonoesters (mainly sn-glycerol 3-phosphate) up to 6 mumoles per gm liver wet weight was also observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557312 TI - Influence of branched-chain amino acids and branched-chain keto acids on protein synthesis in isolated hepatocytes. AB - We investigated the effects of the branched-chain amino acids--valine, leucine and isoleucine--or their keto analogs, the branched-chain keto acids--alpha ketoisovaleric acid, alpha-ketoisocaproic acid and alpha-keto-beta-methylvaleric acid--on protein synthesis and secretion by monolayers of rabbit hepatocytes incubated with [35S] methionine in pulse-chase and steady-state experiments. The branched-chain amino acids (2.0 mM or 1.0 mM), in the presence or absence of insulin (2 X 10(-4) IU per dish) and in both types of experiments, reduced the trichloroacetic acid-precipitable 35S-protein secreted into the medium. The branched-chain keto acids (2.0 mM or 1.0 mM) had a stimulatory effect on secreted trichloroacetic acid-precipitable 35S-protein which was observed only by the pulse-chase technique in the presence of insulin. Immunoaffinity chromatography of medium demonstrated a slight inhibition by branched-chain amino acids and a slight stimulation by branched-chain keto acids on secretion of 35S-albumin and no effect of either treatment on secretion of 35S-fibrinogen. ELISA analysis of total (i.e., 35S-labeled and unlabeled) secreted albumin revealed an inhibitory effect of the branched-chain amino acids in both pulse-chase and steady-state experiments, and a small stimulatory effect, in steady-state experiments, of the branched-chain keto acids; both effects were insulin-dependent. Total secreted fibrinogen, under steady-state conditions, was increased by the branched-chain keto acids in the presence of insulin, while transferrin production was unaffected by any treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557313 TI - Depression of peripheral blood monocyte aryl hydrocarbon hydroxylase activity in patients with liver disease: possible involvement of macrophage factors. AB - Aryl hydrocarbon hydroxylase activity was detectable in cultured macrophage monolayers of peripheral blood monocyte origin. Peripheral blood monocytes were isolated from patients with biopsy-confirmed liver disease and healthy volunteers. Macrophage monolayers were prepared and incubated at 37 degrees C. After 24 hr, the aryl hydrocarbon hydroxylase activity and cellular protein concentration were assayed on cell homogenates. The monocyte aryl hydrocarbon hydroxylase activity in cultured macrophages from normal volunteers was 1.23 +/- 0.16 (n = 19). The aryl hydrocarbon hydroxylase activity in macrophage cultures from patients with biopsy-confirmed liver disease was 0.48 +/- 0.05 (n = 20). This represents a significant (61%) decrease in monocyte aryl hydrocarbon hydroxylase compared to controls. The 20 patients have established cirrhosis or early stage liver disease. The established cirrhosis group includes alpha 1 antitrypsin deficiency-associated cirrhosis; primary biliary cirrhosis; alcoholic (Laennec's) cirrhosis; cryptogenic cirrhosis, and hemochromatosis. Early stage liver disease is attributed to methotrexate (Stage III), early stage primary biliary cirrhosis and alpha 1-antitrypsin deficiency. Our results indicate that the depression in monocyte aryl hydrocarbon hydroxylase activity is greater in patients with established cirrhosis than early stage liver disease. Our results further suggest that cultured monocytes from patients with liver disease spontaneously release soluble factors into the culture medium. Incubation of this medium, containing macrophage factors, with isolated hepatocytes significantly depress hepatocyte aryl hydrocarbon hydroxylase activity compared to medium obtained from cultures of monocytes from normal volunteers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557314 TI - Overnight salivary caffeine clearance: a liver function test suitable for routine use. AB - The feasibility of measuring caffeine clearance from saliva (SCl) was assessed in ambulatory patients with liver disease and in a control group, and the results were compared with quantitative liver function tests. For this purpose, the subjects were given 280 mg caffeine p.o. in decaffeinated coffee powder between noon and 4 p.m., and caffeine concentrations were measured in saliva (using an enzyme immunoassay) before bedtime and upon arising. In the cirrhotics (n = 29), SCl was 0.58 +/- S.D. 0.45 ml per min X kg, thus being reduced to approximately one-third of drug-free, nonsmoking controls (1.53 +/- 0.46, n = 18); although patients with noncirrhotic liver disease showed intermediate values (0.95 +/- 0.47), their reduction in SCl was significant (p less than 0.001). SCl was correlated with indocyanine green fractional clearance, galactose elimination capacity and aminopyrine breath test; however, the closest relationship (Rs = 0.80) was observed with the aminopyrine breath test. It is suggested that the measurement of SCl represents a noninvasive and innocuous procedure for quantifying hepatic microsomal function, and is suitable for routine use. Since a.m. saliva concentrations of caffeine are highly correlated (Rs = -0.94) with SCl, further simplification of the test to a single-point measurement appears possible. PMID- 3557316 TI - Toxic effects of the photoproducts of chlorpromazine on cultured hepatocytes. AB - The photodegradation of chlorpromazine, a drug frequently used in psychotherapy, was examined under different sets of experimental conditions. A primary culture of rat hepatocytes was used to evaluate the possible hepatotoxicity of the chlorpromazine photoproducts, keeping in mind the following criteria: leakage of cytosolic enzymes; attachment index to culture plates, and albumin synthesis. Cells exposed to concentrations greater than 10(-4) M of the photomixtures showed extensive leakage of GOT and GPT into the culture medium and, at the same time, the cell attachment was seriously impaired. A concentration of 10(-7) M of the photoproducts proved capable of inhibiting the synthesis of albumin (20%). Photoproducts obtained after aerobic irradiations were as toxic for hepatocytes as those found in anaerobic conditions. The implications of our results in connection with the relevance of oxygen-dependent photoreactions of chlorpromazine to its phototoxicity, and the possible appearance of hepatic alterations in patients treated with the drug after exposure to the sunlight, are discussed. PMID- 3557315 TI - The disposition of 6-deoxyacyclovir, a xanthine oxidase-activated prodrug of acyclovir, in the isolated perfused rat liver. AB - The antiviral drug, acyclovir, has been used in the treatment of chronic type B hepatitis. High serum concentrations of acyclovir are required to achieve inhibition of hepatitis B viral replication. Because only 15 to 20% of an oral dose is absorbed, it is necessary to administer acyclovir by intravenous infusion. 6-Deoxyacyclovir, an analog of acyclovir, is well absorbed when given orally, and is converted to acyclovir by xanthine oxidase which is present in the gut and liver. This study has examined the hepatic disposition of 6 deoxyacyclovir in a 100 ml recirculating (12 ml per min) perfused rat liver system. Following administration of a bolus dose of 5 mumoles 6-deoxyacyclovir to the reservoir, perfusate concentrations of 6-deoxyacyclovir declined monoexponentially, as the metabolite acyclovir appeared in the perfusate. Addition of the xanthine oxidase inhibitor allopurinol (5 mg) to the perfusate reservoir prior to the administration of 6-deoxyacyclovir resulted in impaired hepatic metabolism of 6-deoxyacyclovir, as demonstrated by a 47% reduction in systemic clearance rate (4.5 +/- 0.4 to 2.4 +/- 0.9 ml per min; p less than 0.05) (mean +/- S.E., n = 6) and a 1.8-fold increase in terminal elimination half-life of 6-deoxyacyclovir (23.5 +/- 2.7 to 42.7 +/- 4.1 min; p less than 0.05), accompanied by a 30% reduction in appearance of acyclovir. The efficient hepatic conversion of 6-deoxyacyclovir to the active antiviral drug, acyclovir, provides a rationale for trials of oral 6-deoxyacyclovir in the treatment of chronic type B hepatitis. PMID- 3557317 TI - The canalicular bile mystique: its end is in sight. PMID- 3557318 TI - Ethanol and amino acid uptake by hepatocytes. PMID- 3557319 TI - Correlation between ascitic protein concentration and its opsonic activity. PMID- 3557320 TI - Nutritional inadequacy of Lieber-DeCarli alcohol diet. PMID- 3557321 TI - Hyperammonemia and intracerebral transfer of tryptophan. PMID- 3557322 TI - Lymphohistiocytosis: a multi-factorial syndrome of macrophagic activation clinico pathological study of 38 cases. AB - Lymphohistiocytosis (LH) is defined by a widespread infiltrate of non-malignant lymphocytes and macrophages, involving principally the liver, spleen and central nervous system and associated with a severe lymphoid atrophy. For this histological study, 38 juvenile cases of LH were selected and reviewed. Morphological and histochemical studies revealed that the macrophages were activated. They appeared to be OKM1, OKT9 and HLA Dr positive and showed a patent or occult erythro and thrombocytophagocytosis. Comparatively, most of the lymphoid cells did not bear any immunoglobulin and did not label with a wide panel of monoclonal antibodies including T3, T4, T6, T8, T11. The review of the clinical and biological data of these 38 cases suggests that LH does not represent a single entity but can be regarded as a non-specific response to various causes. Three different conditions associated with LH can be isolated. The first group consists of patients in whom the disease is characterized by an early onset, high familial incidence and an inevitably fatal course. This category contains the largest number of cases (29 out of 38) and corresponds to the classic description of Familial Erythrophagocytic Reticulosis by Farquhar and Claireaux. The second group includes mainly male patients and children over 2 years old. Inheritance is not a predominant feature. The course of the disease is comparatively long. A viral infection was present in three of the seven cases. This category shares many of the clinico-pathological features of the Virus Hemophagocytic Syndrome and is presumably related to a chronic and latent viral infection. A third group can be identified on the basis of the presence of pigmentation abnormalities and immunodeficiency disorders probably associated with cytoskeletal abnormalities. This group includes Chediak-Higashi disease and Griscelli's disease. The fact that some genetic factors and immunodeficiency disorders are present in these three groups is probably significant and suggests that LH is a condition brought about by multiple factors--of which the common denominator is an apparent activation of the Mononuclear Phagocytic System. PMID- 3557324 TI - Cellular schwannoma: a distinct pseudosarcomatous entity. AB - Eighteen cases of cellular schwannoma, a recently delineated benign entity, are described. These tumours present most often in middle-aged adults of either sex and show a predilection for the paravertebral region of the mediastinum and retroperitoneum. More than half the tumours macroscopically arose from a nerve but none was associated with von Recklinghausen's disease. The light microscopic features are remarkably consistent but are not immediately recognizable as neural in type. Means of distinction from a malignant nerve sheath tumour and from a variety of other soft tissue tumours are discussed. Immunohistochemical positivity for S-100 protein has been demonstrated in 17 of the 18 cases. Prolonged follow-up has revealed local recurrence in only one case; none has metastasized. PMID- 3557323 TI - Hypoplastic acute leukemia: review of 70 cases with multivariate regression analysis. AB - Between 1971 and 1984, 22 of 190 adult patients (11.6 per cent) with acute leukemia seen at the University of Arizona had hypocellular acute leukemia (HAL), defined as lymphoblasts or myeloblasts (plus atypical promyelocytes) of greater than or equal to 30 per cent, but marrow cellularity of the core biopsy or clot section of less than or equal to 50 per cent based on a 1000 point count. These 22 patients with HAL plus the 48 previously published patients with well documented HAL (combined series of 70 patients) were evaluated in detail with multivariate analysis. The median leukocyte count was 2700/microL, hemoglobin of 8.2 g/dl, and platelet count 63,000/microL. Circulating blasts were noted in 27 of 52 patients (52 per cent). Twenty-seven of 34 patients (79 per cent) had abnormal cytogenetics. The overall median survival was 8 months (range: 0.1-48). The median survival for the 22 patients managed with supportive care alone was 4 months, 6 months for the 16 patients treated with non-aggressive induction therapy, and 13 months for the 32 patients treated with aggressive induction therapy (p less than 0.02 versus other categories). Multivariate analysis confirmed that aggressive induction therapy was a major favourable prognostic factor (p = 0.016). Multivariate analysis of the aggressively induced patients revealed that younger patients (less than or equal to 65; p = 0.04) and patients with no AHD (p = 0.09) lived longer. Thus, aggressive remission induction can be attempted in HAL and appears to contribute to prolonged survival especially under age 65 years. PMID- 3557325 TI - Fungal and nocardial infections of the kidney. AB - This report describes 16 cases of candidiasis, seven of aspergillosis, four of mucormycosis, two of cryptococcosis and one of nocardiosis in which the kidney was involved. Characteristic patterns of renal tissue injury were seen in each of these infections. Candida and nocardia caused microabscesses in the cortex and medulla. Tissue destruction was minimal with candidiasis and when present was confined to the papillary tips and produced only mild impairment of renal function. Aspergillus and mucor invaded blood vessels resulting in thrombosis and extensive necrosis of cortical and medullary tissue and most patients had clinical and biochemical evidence of renal disease. Cryptococcosis caused no tissue reaction or clinically evident renal disease in the two immunosuppressed patients studied. PMID- 3557326 TI - Effects of the antiandrogens cyproterone acetate and flutamide on male reproductive behavior in a lizard (Anolis sagrei). AB - This study examined the effects of the antiandrogens cyproterone acetate (CA) and flutamide (F) on male reproductive behavior in the lizard Anolis sagrei. Reproductively active males were implanted with subcutaneous pellets of either CA, F, or placebo (P). Pellets delivered CA and F at a constant rate of 0.1 mg/day. Three weeks after implantation, males were tested with stimulus males and two days later with stimulus females. Cyproterone acetate inhibited aspects of male aggressive and sexual behavior, and reduced testis weight and size of the renal sex segment. Plasma testosterone (T) levels in CA-treated males were not significantly different than those of P-treated males. Flutamide did not inhibit aggressive or sexual behavior, but did decrease testis weight as well as the size of the renal sex segment. Plasma T levels were significantly higher in F-treated males than in P-treated males. These data suggest that CA, an antiandrogen with antigonadotropic activity, may be used to inhibit reproductive behavior in male lizards. PMID- 3557327 TI - Aromatase inhibition depresses ultrasound production and copulation in male hamsters. AB - Rates of ultrasound production and copulatory behavior were observed in castrated male hamsters maintained on 100 micrograms/day of injected testosterone propionate (TP). Groups matched on their initial levels of behavior received either continued treatment with TP alone, or TP together with 6 mg/day injections of the aromatase inhibitor 1,4,6-androstatriene-3,17-dione (ATD). Testing at 11 15 days after the start of these treatments revealed deficits in the sexual behaviors of the subjects in the latter group. Specifically, these males showed lower rates of ultrasound production and intromission during, as opposed to before, treatment with ATD. These results support previous work suggesting that aromatization plays significant roles in the mediation of androgenic effects on both the courtship and copulatory behaviors of male hamsters. PMID- 3557328 TI - Endocrine events associated with spawning behavior in the sea lamprey (Petromyzon marinus). AB - Levels of estradiol, progesterone, and testosterone were determined in plasma of sea lamprey (Petromyzon marinus) undergoing certain behaviors associated with spawning in natural and artificial stream environments. Significantly higher levels of estradiol, progesterone, and testosterone were found in males than in females. In the artificial spawning channel, levels of estradiol were significantly higher in females exhibiting resting and swimming behaviors than in fanning, nest building, and spawning behaviors. No significant correlation was found with either progesterone or testosterone levels and the various reproductive behaviors. The data presented are the first experimental evidence that suggest gonadal steroids may be correlated with certain reproductive behaviors in the sea lamprey. PMID- 3557329 TI - Gonadal influences on sexual behavior in the male musk shrew (Suncus murinus). AB - In this series of experiments the hormonal bases for male copulatory behavior in the musk shrew (Suncus murinus) were examined. Male musk shrews failed to show copulatory behavior after castration. Testosterone replacement fully reinstated sexual behavior. Males castrated at birth, and tested as adults after receiving testosterone implants, did not show male-typical sexual behavior. It appears that the gonads are essential for the regulation of male sexual behavior in this primitive mammal. PMID- 3557330 TI - Hormonal control of sex differences in ultrasound production by hamsters. AB - Male and female hamsters differ in the stimulus control of the ultrasounds they produce during courtship and mating. In particular, untreated males show greater increases in ultrasound rate after exposure to stimulus females than after contact with other males. Conversely, estrous females are more responsive to stimulus males than females. This sex difference reflects both organizational and activational effects of gonadal hormones. Thus, responses to early castration or treatment with testosterone propionate (TP), estradiol benzoate (EB), or dihydrotestosterone propionate suggest that the development of male-like patterns of ultrasound production is facilitated by perinatal exposure to aromatizable androgen. However, even neonatally feminized subjects will show male-like calling if tested during adult treatment with TP. In contrast, the same subjects respond like naturally estrous females during adult treatment with EB plus progesterone (P). The contrasting responses of neonatally feminized subjects to later TP and EB + P treatments suggest that female hamsters retain a greater capacity for heterotypical patterns of ultrasound production than do males. This obviously differs from the common observation of greater "bipotentiality" for mating behavior in males. In turn, this suggests that the mechanisms controlling sexual bipotentiality are specific to their target behaviors, yielding distinct patterns of hormonal control for at least ultrasound production and lordosis. PMID- 3557331 TI - A prenatal source for defeminization of female rats is the maternal ovary. AB - Sexual behavior in laboratory rats is influenced by a variety of factors in the perinatal environment. Male rats are masculinized and defeminized in response to circulating testosterone perinatally. Females undergo a process of feminization but in some cases are exposed to testosterone. Previous work has shown that during prenatal development female rats normally undergo a partial masculinization and defeminization of sexual behavior as reflected by altered responsiveness to gonadal hormones in adulthood. In the present study we investigated whether the maternal ovary influences adult females' responsiveness to gonadal hormones. Pregnant rats were ovariectomized on Day 10 of pregnancy and their offspring tested for sexual behavior in adulthood. Following ovariectomy pregnancies were maintained by administration of systemic progesterone. In addition the ovariectomized pregnant rats were given one of three daily treatments (Days 10-21): 0.2 microgram estradiol benzoate in sesame oil and 0.1 cc propylene glycol, 5 mg of the aromatase inhibitor 1,4,6-androstatriene-3,17 dione (ATD) in 0.1 cc propylene glycol, or 0.1 cc propylene glycol. A control group was generated from SHAM operated mothers given daily control injections of propylene glycol and sesame oil. Offspring were ovariectomized in adulthood and tested for display of feminine sexual behavior in response to estradiol benzoate and progesterone or estradiol benzoate alone. Masculine sexual behavior was measured in response to testosterone propionate (TP). Feminine sexual behavior was enhanced in offspring from ovariectomized mothers given only progesterone replacement during pregnancy. Offspring from mothers treated with ATD displayed the greatest elevations in feminine sexual behavior. Estradiol treatments of ovariectomized mothers prevented the increase in feminine potential seen in offspring in the other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557332 TI - Stimulus and hormonal determinants of flehmen behavior in cats. AB - Felids are the main group of animals, other than ungulates, that display flehmen behavior during sociosexual interactions. In ungulates the behavior is evoked most readily by olfactory investigation of urine and vaginal secretions, and is believed to be involved in the transport of fluid-borne chemical stimuli, such as sex pheromones, from the oral cavity to the vomeronasal organ. In this study of cats flehmen was virtually always preceded by nasooral contact with the stimulus material, supporting the notion that flehmen in this species is also involved in the transport of fluid-borne stimuli. As in ungulates, flehmen in cats during heterosexual encounters was found to be displayed by males only. However, the sexual dimorphism was situation specific. In exploring a urine-marked room without another cat present, females also performed flehmen, albeit less frequently than males, and when urine was applied to the nasooral surface, flehmen was evoked equally reliably in females and males. Administration of testosterone propionate to spayed female cats paired with estrogen-treated females markedly increased their tendency to genitally inspect the female partner and subsequently perform flehmen. Thus the sexually dimorphic attributes of flehmen behavior are not only stimulus dependent, but also influenced by concurrent hormone stimulation. PMID- 3557333 TI - Hormonal responses to female conspecifics in hyperprolactinemic male rats and mice. AB - Exposure to a female results in an acute release of LH and testosterone (T) in normal male rats and mice. This study was conducted to determine whether these hormonal responses are altered in hyperprolactinemic (hyperPRL) male rats in which copulatory behavior is known to be suppressed and in hyperPRL male mice in which it is not. Adult male CDF (F-344) rats were made hyperPRL either by grafting of three anterior pituitaries under the kidney capsule or by treatment with diethylstilbestrol (DES). Exposure of control males to receptive females for 10-15 min produced the expected two- to fourfold statistically significant elevations in plasma LH levels. In contrast, plasma LH levels in pituitary grafted or DES-treated males were not altered by female exposure. Male mice were pituitary grafted (two pituitaries per recipient) or sham-operated and housed individually with a female for 1 week. The resident females were then replaced with novel females in half of the cages and blood samples were taken from the males after 5 min exposure for determination of LH levels or after 45-60 min exposure for T levels. Female-induced LH and T elevations occurred in both hyperPRL and control groups. Failure of hyperPRL male rats to experience an increase in plasma LH levels in response to a female suggests abnormality of mechanisms controlling LHRH release. Suppression of LHRH release may be involved also in the induction of deficits of sexual behavior in these animals. PMID- 3557334 TI - Plasma androgen levels during male parental care in a tropical frog (Eleutherodactylus). AB - Males of the Puerto Rican frog Eleutherodactylus coqui practice parental care of terrestrial eggs throughout embryonic development (17-26 days). Parental care is associated with marked changes in male behavior, including the cessation of normal calling activity (necessary for mate attraction) and reduction of egg cannibalism. To analyze the relationship between parental behavior and androgens, blood was collected from male frogs in the field and plasma analyzed for total androgens. Parental males had significantly lower androgen levels than both nonparental, calling males, and amplectant (mating) males. The decline in circulating androgens between the sexually active state (calling and mating) and the parental care state was fairly rapid (less than 12 hr). Androgen levels did not differ among parental males at different stages of the parental care period. PMID- 3557335 TI - Psychiatrists and community mental health centers. PMID- 3557336 TI - Structural inefficiencies at a state psychiatric hospital. PMID- 3557337 TI - Schizophrenia research heads NIMH priorities. PMID- 3557338 TI - The remedicalization of psychiatry. AB - The remedicalization of psychiatry does not mean the return to a reductionistic biomedical model of psychiatry or the renunciation of psychotherapy and psychodynamics. It does mean the refocusing of scientific advances in neurobiology and neuroscience as they affect psychiatric diagnosis and treatment, increased psychiatrist involvement in the treatment of the physically ill and in organized medicine, and revitalization of psychiatrists' clinical skills and knowledge through medical education. Within the medical context, the author addresses current problems in psychiatry related to standards, sub specialization, scientific research, and stigma. He sees the development of standards as an essential professional responsibility, considers subspecialization within psychiatry to be inevitable, calls for increased involvement by psychiatrists in scientific research, and warns against permitting the stigma associated with mental illness to further erode psychiatry's boundaries by allowing disorders with an organic etiology to be "given away" to other specialties. PMID- 3557339 TI - Applying modern management principles to clinical administration of a behaviorally oriented inpatient unit. AB - Very few clinical administrators are trained managers, and the combined role of clinician-manager is laden with conflicting expectations. This paper describes the planning, inception, and administration of a new, behaviorally oriented inpatient psychiatric unit in a university medical center that was designed by the unit's clinical director and assistant clinical director. Contemporary management practices were adapted and applied to the development and administration of the unit. The unit's clear boundaries have allowed it to maintain its integrity within the hospital system, and its decentralized horizontal organizational structure has fostered a sense of ownership and responsibility on the part of staff at the operating level. A participative, personnel-oriented approach to unit operations has led to minimal staff turnover and high morale. PMID- 3557340 TI - Clinical considerations in cross-cultural diagnosis. AB - When psychiatrists and patients come from different cultural backgrounds, special knowledge, assistance, and awareness are needed for accurate diagnosis. Understanding the sociocultural milieu in which the patient lives and functions is crucial for distinguishing psychopathology from culture-bound beliefs or behavior. Clinical observation and physical examination may be the primary diagnostic tools in the cross-cultural setting if clinical history is scanty or the mental status examination is unsatisfactory. Interviewing techniques must be designed to encourage rapport and reduce fear. The author discusses issues to be considered in choosing the language to be spoken during the interview and using a translator. He emphasizes the need for clinicians to detect and transcend their own cultural biases and those of their patients, as well as the need for professional training in making cross-cultural diagnostic assessments. PMID- 3557341 TI - Psychiatric assessment and treatment of American Indians and Alaska Natives. AB - It is widely recognized that the cultural uniqueness of American Indians and Alaska Natives must be reflected in the methods of diagnosing and treating their mental health problems, but empirical validation of specific diagnostic instruments and treatment has been slow in coming. The authors' literature review indicates that many standardized self-rating scales and interview schedules can accurately assess mental illness among Indians, provided they are modified to reflect cultural heritage and experiences. Group therapy is increasingly chosen as a psychiatric treatment for American Indians, as are family-network therapy and several traditional Indian therapies. The authors also review the demographics and psychiatric epidemiology of American Indians and Alaska Natives. PMID- 3557342 TI - Cross-cultural aspects of the somatization trait. AB - Studies using a variety of diagnostic rating scales have identified much higher levels of somatic symptoms in Hispanic psychiatric patients, particularly those with a diagnosis of schizophrenia or depression, than in their Anglo counterparts. However, this cultural difference cannot be generally demonstrated by using DSM-III somatoform disorders criteria. Many patients with "unfounded" somatic symptoms have another DSM-III primary diagnosis that is often assumed to cause or explain the somatic symptoms. In addition, the true prevalence of unfounded somatic symptoms is hidden because of the strict criteria required for a DSM-III primary diagnosis of somatization disorder. The author believes a more inclusive notion of somatization should be developed that would substantiate the presence of this trait among different populations and, if operationalized, would facilitate research on this important phenomenon. This is relevant not only because of the cross-cultural variability of somatization traits but also because they may become a salient feature of the primary syndrome and determine the use of clinical services. He proposes a new operational definition of somatization that encompasses the trait concept. PMID- 3557344 TI - Issues surrounding psychological testing of minority patients. AB - Psychological testing of minority patients is a frequently debated issue, not only in the scientific literature, but in the mass media, the courts, and legislative bodies. A historical overview of the controversy illustrates past abuses in such testing, but a closer look at methodological issues concerning cognitive-intellectual tests and objective personality assessment illustrates that the tests can be appropriately used with minority patients. Suggestions for appropriate use, backed by case illustrations, include gaining an understanding of a patient's cultural background; using interpreters and culture-appropriate reinforcers; supplementing formal testing with informal procedures; making sure patients understand required tasks; and taking into account ethnicity and social class during interpretation of results. PMID- 3557343 TI - Alcoholism in Mexican-Americans: intervention and treatment. AB - Studies have shown that Hispanic males have higher rates of heavier drinking and problems associated with drinking than the general population. The authors discuss Mexican-American cultural and religious views on alcohol consumption and sex-role differences that influence drinking behavior and intervention. Then, drawing on their experience with a chemical dependence program that serves a catchment area that is one-fifth Mexican-American, they discuss how clinicians can work with cultural beliefs and practices to effectively treat Mexican American alcoholics within a traditional treatment program. PMID- 3557345 TI - The use of self-rating scales in cross-cultural psychiatry. AB - The authors review the use of seven psychiatric self-rating scales in cross cultural research and practice and discuss some of the issues that limit their usefulness in cross-cultural settings. It is unclear whether any one scale can accurately assess the presence of psychiatric illness in different cultures because different cultures have specific ways of experiencing and reporting psychiatric disturbances. This limitation may be overcome through the use of culture-specific rating scales, such as the Vietnamese Depression Scale (VDS), whose development is described here. The authors' work on the VDS suggests that certain biological symptoms of depression may be universal but that psychological symptoms tend to be culturally rooted. The paper includes guidelines for using self-rating scales in cross-cultural psychiatry. PMID- 3557346 TI - Posttraumatic stress disorder in World War II naval veterans. PMID- 3557347 TI - Capgras' syndrome in a myxedema patient. PMID- 3557348 TI - Length of stay. PMID- 3557349 TI - Suicide and stress. PMID- 3557350 TI - Weapon screening. PMID- 3557351 TI - HMOs: not always the best medicine. PMID- 3557352 TI - Treating a man who wears women's clothes. PMID- 3557353 TI - Interactions between psychotropic and other drugs: an update. PMID- 3557355 TI - Reforming a system of care: the Arizona experiment. AB - In the aftermath of a successful class-action suit on behalf of seriously mentally ill patients, the Arizona legislature set into law five pilot projects to test a proposed system of care based on clinical teams, prepaid funding, and independent evaluations. The author, who drafted the proposal for the new system, discusses the system's principles and how the system's components will function under them. He then discusses some of the system's strengths and the difficulties it may encounter. PMID- 3557354 TI - Health maintenance organizations and their implications for psychiatry. AB - Rapidly rising health care costs, a growing surplus of physicians, and recent federal legislation have created a more competitive health care market and have led to rapid growth in the number of health maintenance organizations, or HMOs. HMOs may place psychiatrists and their patients at a disadvantage because they generally restrict coverage of mental illness, use mental health practitioners other than psychiatrists, and lack provision for treating chronic and indigent mentally ill patients. In this review article, the authors describe the characteristics of HMOs, review the historical, legislative, and economic forces that have contributed and will contribute to their explosive growth, and outline measures that psychiatrists must take to ensure that mental health care is not compromised in HMOs and other price-competitive health care delivery systems. PMID- 3557356 TI - Using family psychoeducation when there is no family. AB - High familial expressed emotion, which may be a specific form of social overstimulation, has been linked to schizophrenic relapse and rehospitalization. Research on expressed emotion has led to a new generation of demonstrably effective family treatments for schizophrenia that rely heavily on psychoeducational techniques. Although most schizophrenic patients do not live with families, the family psychoeducational model has not been applied in nonfamilial living settings. The authors report two examples in which the family psychoeducational model was successfully used in group living situations and discuss the implications of expressed emotion and family psychoeducation for schizophrenic patients who live in nonfamilial settings. PMID- 3557357 TI - Special considerations in integrating elderly patients into a general hospital psychiatric unit. AB - Geriatric patients with psychiatric disorders are highly treatable in an acute general hospital setting, but they require special attention in assessment, treatment, and discharge planning. Assessment must include the active involvement of a broad multidisciplinary team led by the psychiatrist. In the treatment process, staff must stay aware of the psychiatric symptoms, which may be obscured by medical problems, and should take therapeutic advantage of the transference issues that an age-mixed population can generate. Discharge planning must attend to resistances and the realistic dilemmas that are unique to the geriatric population. In discussing these issues, the authors describe how a university hospital inpatient unit with a full age range of adult patients adapted its milieu and staffing to treat a larger proportion of geriatric patients. PMID- 3557358 TI - Psychiatric manpower and services in a community mental health system. AB - Executive directors of Oregon's 36 community mental health programs were surveyed in the fall of 1983 to determine the nature of psychiatric services offered and the roles played by psychiatrists. The study showed that a total of 18.2 full time-equivalent psychiatrists were working in the community system, a mean of .5 per program, considerably below the national average. None of the responding directors were psychiatrists, and only six employed psychiatrists as medical directors. The directors valued psychiatrists most highly for their skills in educating, supervising, and consulting with staff; for their unique clinical skills; and for medication management. They considered the biggest disadvantage of employing psychiatrists to be the expense. The authors discuss factors that contribute to psychiatrists' satisfaction with work in community mental health programs and strategies for recruiting and retaining psychiatrists in the programs. PMID- 3557359 TI - Pathways and cycles of runaways: a model for understanding repetitive runaway behavior. AB - Based on information provided by 149 runaways staying in a Canadian shelter, the authors developed a model that explains repititious running away as the result of youths' cognitive confusion and unrealistic beliefs. The majority of the youths, who had run away an average of 8.9 times, felt that the events that led them to run away were unpredictable, yet 54 percent blamed only themselves for what happened. The paper describes the pathways, cycles, and outcomes of running away; analyzes the relationship between the youths' experiences with prostitution, delinquency, and sexual and physical abuse and the length of time they had been away from home; summarizes the youths' reasons for running away; compares the beliefs of runaways with and without a history of sexual abuse; and discusses interventions. PMID- 3557360 TI - The negative impacts of increased concurrent review of psychiatric inpatient care. PMID- 3557361 TI - Use of constant observation with potentially suicidal patients in general hospitals. PMID- 3557362 TI - Insight and injury. PMID- 3557363 TI - Liability for violent acts. PMID- 3557364 TI - Arizona revisited. PMID- 3557365 TI - BCBS mutuals like flexibility. PMID- 3557366 TI - Hospital profits low compared to other industries. PMID- 3557367 TI - Increased volume, pared costs stem price increases. PMID- 3557368 TI - Niche marketing: is it profitable for hospitals? PMID- 3557369 TI - Creating a niche aids consumer awareness. PMID- 3557371 TI - Boston: capitated contracts tried via joint ventures. PMID- 3557370 TI - Capitated contracts, competition hit HMO markets. PMID- 3557372 TI - Minneapolis: mature market has its own woes. PMID- 3557373 TI - Liability reshapes hospital/physician relationships. PMID- 3557375 TI - UT hospitals fight for tax exemption. PMID- 3557374 TI - Tort reforms discriminatory, impotent: opponents. PMID- 3557376 TI - MD with AIDS: scenario poses policy questions. PMID- 3557377 TI - MD manager heads "corporation" of physicians. PMID- 3557379 TI - Supply prices forecasted through 1987. PMID- 3557378 TI - Bad publicity forces evaluation of EMS services. PMID- 3557380 TI - Regional centers: innovations on the AIDS picture. PMID- 3557381 TI - Elder care pushed as a new employee benefit. PMID- 3557382 TI - Employee communication softens merger's toll. PMID- 3557383 TI - Hospital advertising okayed by 62% of public. PMID- 3557384 TI - MRI centers: 10 design mistakes to avoid. PMID- 3557385 TI - Channeling programs aid MD-hospital cooperation. PMID- 3557386 TI - Lab design that counts. PMID- 3557387 TI - Equipment changes with cost-efficient times. PMID- 3557389 TI - Failed merger: a fluke or end of a multi trend? PMID- 3557388 TI - Diversion controversy: hospital voices respond. PMID- 3557390 TI - 4 MRIs and counting: Mount Sinai's tech plan. PMID- 3557391 TI - Health policy agenda seeks approval. PMID- 3557392 TI - Lab software vendors expand market share. PMID- 3557393 TI - Flawed methods cripple study on not-for-profits. PMID- 3557394 TI - Risk retention law more trouble than it's worth? PMID- 3557395 TI - Both sides advance in OB liability war. PMID- 3557396 TI - Strategic blindness plagues hospitals. PMID- 3557398 TI - Survey profiles managed care winners/losers. PMID- 3557397 TI - Satisfaction surveys found to be deceptive. PMID- 3557399 TI - Is religion a competitive edge? PMID- 3557401 TI - New tort reforms address access to care problems. PMID- 3557400 TI - States continue to wrestle with rate-setting laws. PMID- 3557402 TI - Ruling may trip CHAMPUS reform. PMID- 3557403 TI - Awareness key to cost control: Martin. PMID- 3557404 TI - Ford seeks to define quality. PMID- 3557405 TI - Some reasons for drop in med school enrollments...and two areas med schools need to improve. PMID- 3557406 TI - Options: the name of the new lab game. PMID- 3557407 TI - Hospitals plunge into the drug testing market. PMID- 3557408 TI - Joint ventures for fun and--sometimes--profit. PMID- 3557409 TI - Are physician labs a competitive threat? PMID- 3557410 TI - Computerized labs speak. PMID- 3557411 TI - The metaconule in Australian Aboriginals: an accessory tubercle on maxillary molar teeth. PMID- 3557413 TI - Altitude differences in body composition among Bolivian newborns. PMID- 3557412 TI - Bone mineral content of elite lightweight amenorrheic oarswomen. PMID- 3557414 TI - Spinal curvature of young adult females. PMID- 3557415 TI - Head circumference growth patterns: birth to 18 years. PMID- 3557416 TI - Perinatal weight loss and recovery in well-nourished rhesus monkeys. PMID- 3557417 TI - Selection opportunities in seven Swedish 19th century populations. PMID- 3557418 TI - Postpartum amenorrhea, waiting time to conception, and prevalence of pregnancy of women in a Sudanese agricultural community. PMID- 3557419 TI - Subcutaneous fat topography: age changes and relationship to cardiovascular fitness in Canadians. PMID- 3557420 TI - [Detection of circulating antigens by McAb-AST for evaluation of the therapeutic effect of kala-azar cases]. PMID- 3557421 TI - [Induction of tumors in the stomach and small intestine of mice by N-methyl-N' nitro-N-nitrosoguanidine via intubation]. PMID- 3557422 TI - [Cancer cell lysis caused by lymphocytes in colonic carcinoma]. PMID- 3557423 TI - [CSS-II microcomputer assessment of electrocardiogram measurement in comparison with the gold standard of clinical practice for 1160 cases]. PMID- 3557424 TI - [Induction of a micronucleus by chloroprene inhalation]. PMID- 3557425 TI - [Prevention of vertical transmission of HBV infection to the fetus from the mother by HBIG and hepatitis B vaccine]. PMID- 3557426 TI - [Experimental study on liver injury by chlorobutadiene]. PMID- 3557427 TI - [Study on the stability of gastrodin injection]. PMID- 3557428 TI - [The QSAR of diphenic acids in increasing macrophage phagocytosis]. PMID- 3557429 TI - [Circadian rhythm of urinary hydroxyproline: creatinine ratio in schoolchildren]. PMID- 3557431 TI - [Stress hyperglycemia due to severe dehydration]. PMID- 3557430 TI - [Clinicopathologic analysis of 16 renal puncture biopsies--a light, electron and immunofluorescence microscopic study]. PMID- 3557432 TI - [The clinical application of gastric analysis with stimulation of pentagastrin]. PMID- 3557433 TI - [A study on the operative treatment of adduction contractures of the thumb]. PMID- 3557434 TI - [The surgical treatment of advanced laryngeal carcinoma]. PMID- 3557435 TI - [Clinical and pathological manifestations of a case of parotitis complicated by Guillain-Barre syndrome]. PMID- 3557436 TI - Immunopathology and toxicologic pathology. PMID- 3557437 TI - DNA flow cytometry in diagnostic pathology of the urinary tract. PMID- 3557438 TI - Amiodarone lung: pathologic findings in clinically toxic patients. AB - Lung biopsy and autopsy specimens of 12 patients with amiodarone pulmonary toxicity were studied to better characterize the pathology of amiodarone lung. For comparison, the autopsy specimens of five patients taking amiodarone without pulmonary side effects also were examined. Interstitial pneumonia was the most common manifestation of amiodarone lung and was characterized by interstitial inflammation, fibrosis, and hyperplasia of type II pneumocytes. Hyaline membranes were present in two cases. Foamy alveolar macrophages were present in all but one patient, and in four associated organizing pneumonia was present. Foamy alveolar macrophages also were present in three of five clinically nontoxic patients. Electron microscopy demonstrated membrane-bound lamellar inclusions in all of the three cases of amiodarone lung examined. Inclusions also were present in two of five patients who died of other causes. The authors conclude that amiodarone lung is primarily an interstitial pneumonia. Foamy alveolar macrophages and cytoplasmic lamellar inclusions are characteristic, but neither is specific, and their presence alone does not distinguish toxic from nontoxic patients. PMID- 3557440 TI - Apocrine cystic metaplasia: subgross pathology and prevalence in cancer associated versus random autopsy breasts. AB - Focal apocrine metaplasia was studied in 293 whole human breasts by a subgross sampling technique with histologic confirmation. There were 186 breasts obtained from random autopsies. Another 107 breasts were obtained that were cancer associated; these breasts either contained an invasive cancer or were situated contralateral to a cancer-containing breast. The observations support a lobular origin for most if not all apocrine metaplasia and demonstrate some correlation between the presence of apocrine metaplasia and coincident invasive breast cancer on either the contralateral or ipsilateral side. When extensive, apocrine metaplasia appears to be a useful phenotypic marker for tissue at a modestly increased risk for breast cancer. There were no breast carcinomas of the apocrine type in this series, supporting the belief that apocrine metaplastic epithelium has little intrinsic malignant potential. Finally, the data support the hypothesis that most breast cysts arise from apocrine metaplastic lobules. PMID- 3557439 TI - Thyrocalcitonin-containing cells in the Di George anomaly. AB - The Di George syndrome is an anomaly characterized by the complete or partial absence of derivatives of the third and fourth pharyngeal pouches often associated with defective development of the third, fourth, and sixth aortic arches leading to absence or hypoplasia of the thymus and parathyroid glands and to cardiovascular anomalies. The fifth pharyngeal pouch, often considered a part of the fourth pouch, gives rise to the ultimobranchial body (UB), which becomes incorporated into the thyroid gland and is thought to be the source of thyroid C cells. Robinson suggested that complete or partial absence of the UB should be considered a part of the Di George anomaly. To substantiate this theory, the thyroid glands of 11 patients with the Di George syndrome and 11 age-matched control infants were examined immunohistochemically using the immunoperoxidase technique for presence or absence of thyrocalcitonin (TC)-containing cells. Only three of 11 patients with the Di George syndrome had TC-containing cells in their thyroid glands (27 per cent), and nine of 11 control infants had these cells (82 per cent). It is concluded that thyroid C cell deficiency is present in most patients with Di George anomaly, suggesting a relationship between these cells and development of derivatives of the third through fifth visceral pouches. Furthermore, there is a spectrum of deficiency of thyroid C cells in these individuals comparable with the spectrum of partial to complete absence of third and fourth pharyngeal pouch derivatives regarding thymus and parathyroid glands. Immunostaining for TC of the lungs of all infants with the Di George syndrome and control infants revealed similar numbers of thyrocalcitonin-containing cells in both groups. Asynchronous development of thyroid and lung thyrocalcitonin containing cells in those with the Di George syndrome favors the theory that the latter develop independently of derivatives of the third through fifth visceral pouches. This study further supports a neural crest origin of the Di George anomaly and strengthens the concept that the Di George anomaly is a neurocristopathy. PMID- 3557441 TI - Do placental weights have clinical significance? AB - This study attempted to determine if placental size has implications for fetal/neonatal health and for subsequent childhood growth and development. 38,351 placentas were trimmed and weighed in a standardized way. The following factors were found to be associated with low placental weight: low maternal pregravid body weight, low pregnancy weight gain, high maternal hemoglobin levels during pregnancy, gestational hypertension, paid employment outside the home during pregnancy, and low parity. Taking these factors into consideration, placentas that were underweight for birth weight were associated with high hemoglobin values in neonates and lower-than-expected body size in later childhood. Overweight placentas, largely a result of villous edema, were associated with the following neonatal evidences of acute antenatal hypoxia: low Apgar scores, the respiratory distress syndrome, neurologic abnormalities, and neonatal death. Some of the neurologic abnormalities persisted so that at patient age of 7 years, they were 33 per cent more frequent when placentas had been overweight than when they had been of normal weight (P less than .001). PMID- 3557443 TI - Sarcomatous change in granulosa cell tumor. AB - Granulosa cell tumors have a tendency for indolent growth and late recurrence. The present case of granulosa cell tumor in a 67-year-old woman is the first, to the authors' knowledge, to be reported as showing sarcomatous transformation with a rapid fatal course. Both the granulosa cell and fibrothecomatous elements appear to have undergone sarcomatous change with some evidence to suggest rhabdomyosarcomatous differentiation. The sarcomatous component was present in metastatic deposits. PMID- 3557442 TI - The ventricular septal defect in complete transposition of the great arteries: pathologic anatomy in 57 cases with emphasis on subaortic, subpulmonary, and aortic arch obstruction. AB - Fifty-seven heart specimens with complete transposition (concordant atrioventricular and discordant ventriculo-arterial connections) and ventricular septal defect were reviewed to establish the spectrum of morphology of the ventricular septal deficiency and to correlate the type of defect with presence of subarterial and aortic arch obstruction. The ventricular septal defect was single in 52 cases (27 perimembranous and 25 muscular) and multiple in five. A normal alignment between the outlet component and the rest of the muscular septum was present in 18 cases (10 perimembranous, five muscular, and three multiple). The defect was the consequence of septal malalignment in the other 39 specimens; 29 with rightward and 10 with leftward displacement of the outlet septum. Rightward displacement led to perimembranous defects in 16 cases and muscular defects in 12. In another instance, a perimembranous malalignment defect was associated with a muscular inlet defect. Subaortic stenosis due to either deviation of the outlet septum or prominence of the ventriculo-infundibular fold and septoparietal trabeculations was observed in 14 cases. Leftward displacement of the outlet septum was associated with one perimembranous and eight muscular defects and with multiple (muscular outlet plus muscular inlet) defects in another case. Of these, five cases showed subpulmonary stenosis. Aortic arch obstructions were present in 19 cases; 14 showed rightward malalignment of the outlet septum, which produced subaortic stenosis. These findings suggest two things: Unlike the situation in hearts with "normally related" great arteries, most defects in complete transposition result from malalignment of the outlet septum, with many being of the muscular type. Rightward or leftward displacement of the outlet septum frequently results in subaortic or subpulmonary stenosis, respectively. Aortic arch obstructions, although frequent, are not always associated with subaortic stenosis. PMID- 3557444 TI - Granulomatous inflammation of minor salivary gland ducts: a new oral manifestation of Crohn's disease. AB - Multiple sublingual cystic masses developed in a 27-year-old man with active intestinal Crohn's disease during prednisone therapy. Surgical excision revealed noncaseating granulomatous inflammation involving the walls of minor salivary gland ducts. In some areas, this ductal lesion was associated with rupture and mucocele formation. Three weeks after excision of the salivary gland tissue, the patient experienced an exacerbation of his intestinal disease, accompanied by a recurrent lesion on the floor of his mouth and aphthous ulcerations of the buccal mucosa. The oral lesions and intestinal symptoms resolved only after azathioprine therapy. This salivary gland lesion represents a previously undescribed oral manifestation of Crohn's disease. PMID- 3557445 TI - Primary liposarcoma of the right atrium. AB - Primary intracardiac liposarcomas are among the rarest tumors of the heart, with a total of six reported cases. The previous reports have focused on clinical features with minimal histologic documentation. We report a primary right atrial liposarcoma showing extracardiac spread and three types of histologic differentiation. This case demonstrated that certain clinical and pathologic features are common to all intracavitary cardiac neoplasms, emphasizing the need for careful histologic examination. PMID- 3557446 TI - IgA nephropathy and membranous nephropathy associated with hepatitis B surface antigenemia. AB - This is the first report of glomerular disease in a 13-year-old boy who was a carrier of hepatitis B virus both mesangial IgA and subepithelial IgG deposits in the glomeruli at the same time. The clinical findings resembled those of IgA nephropathy. On electron microscopy, electron-dense deposits were identified not only in the mesangium but also on the epithelial side of the glomerular basement membrane. Immunofluorescence and immunoperoxidase staining demonstrated hepatitis B surface antigen and hepatitis B core antigen in the glomeruli but hepatitis B e antigen was not detected. Our findings suggest hepatitis B virus antigens have a pathogenetic role in the simultaneous development of these two glomerulopathies. PMID- 3557447 TI - Transfusion-associated graft-versus-host disease. PMID- 3557448 TI - Population data on benign and severe forms of X-linked muscular dystrophy. AB - Epidemiological data on Becker muscular dystrophy (BMD) and Duchenne muscular dystrophy (DMD) from a large sample of the Italian population are reported. For BMD the incidence rate was found to be 5.5 X 10(-5) live-born males (lbm) and the prevalence rate, 13.1 X 10(-6); the mutation rate was estimated to be about 6.0 X 10(-6). For DMD the incidence and prevalence rates were found to be respectively 26 X 10(-5) lbm and 31.6 X 10(-6). The DMD mutation rate obtained by the Haldane formula was 86.6 X 10(-6) and by the semi-direct method, 65.6 X 10(-6). The results are discussed in the light of possible allelism of BMD and DMD. PMID- 3557449 TI - Further cytologic evidence for Xp-Yp translocation in XX males using in situ hybridization with Y-derived probe. AB - Chromosome preparations from seven subjects with aberrations of sex chromosomes were utilized for in situ hybridization studies with the tritium-labeled Y derived probe p50f. Two subjects had a pseudodicentric chromosome consisting of two copies of Yp and a portion of Y long arm; two were XX males [46,XX,t(Xp;Yp)], one was missing part of the Y short arm, and another had t(5p;Yq); in addition cells from an XYY male as well as a normal 46,XY male, and a 46,XX female, were hybridized with the same probe. The hybridization technique of Harper and Saunders (1981) was used. There was excess labeling of the Yp/paracentromeric regions in the cases with the normal Y, the XYY, the pseudodicentric Y, and the 5/Y translocation. No significant label was seen on metaphases from the normal 46,XX female or the female with the partially missing Y short arm. Excess label was present on the X short arm in the cases of the XX males; there were 8% and 9.5% of cells with label. The combined cytogenetic and hybridization data indicate that one X short arm in these XX males has undergone a translocation with Yp, and that genes for sex determination probably reside on the distal half of the Y short arm. PMID- 3557450 TI - Distribution of Gd- alleles in some ethnic groups of the USSR. AB - A population study of Gd- allele distribution was made in similar (age-sex) samples of schoolchildren and students from different ethnic groups: Russians, Ashkenazi Jews, and Azerbaijanians. Both the frequency and the spectrum of the Gd alleles were quite different. The Gd- frequency in Russians (Kostroma region) was 0.36%; in Ashkenazim (Gomel region), 0.91%; in Azerbaijanians (Sheki region and Apsheron region), 3.6% and 10.5%, respectively. G6PD deficiency in Russians is represented by familial forms; in Ashkenazi Jews by class II alleles Kirovograd and Zhitomir; and in Azerbaijanians, by a wide spectrum of class II and III alleles. Genetic factors involved in the formation of Gd- allele frequencies and the spectrum in these three ethnic groups are discussed. PMID- 3557451 TI - Population genetics implications of the premutation hypothesis for the generation of the fragile X mental retardation gene. AB - The population genetics implications of the premutation hypothesis for the generation of the fragile X mental retardation gene are explored. With some broad assumptions, the consequences of the model are that 50% of mothers of probands carry the premutation; 6.5% of mothers of probands receive the premutation from their mothers, 18.9% from their fathers, and 24.6% as a "new mutation"; the incidence of carriers for the full mutation equals the incidence of affected males, whereas the incidence of carriers for the premutation is 1.35 times the incidence of affected males; assuming mutation rates are equal in eggs and sperm, the mutation rate from normal to premutation alleles is 1.67 X 10(-4); the expected segregation ratio in sibs of probands is 0.44, which corresponds to observed values. In addition, predictions using the premutation hypothesis of the expected segregation ratio in sibs of mothers of probands fits well with the data of Vogel and coworkers. PMID- 3557452 TI - Cystic fibrosis--a single locus disease? Results of a population genetics study. AB - In a population genetics study of cystic fibrosis (CF), we investigated the state of health of 1276 first cousins of CF index patients. Six hundred seventy-five married aunts and uncles (siblings of CF index patients' mothers and fathers) who had at least one child were interviewed. In only 1 of these 675 families, three children of a total of eight had died of CF. If CF occurs more frequently than in 1 in 3000 newborn babies in our population, our investigation supports the hypothesis that CF is caused by mutations at more than one locus. We also determined that the evidence furnished by such a study of other, more uncommon autosomal recessive disorders is limited. PMID- 3557453 TI - Hypothesis regarding the nature of the fragile X mutation. A reply to Winter and Pembrey. AB - Pembrey et al. (1985) proposed a hypothesis regarding the nature of the fragile X [fra(X)] mutation. Recently they analyzed DNA linkage data (Winter and Pembrey 1986) that we and others have published on fra(X) pedigrees, found significant linkage heterogeneity, and modified their hypothesis to explain the observations. We would like to point out that their modified hypothesis is not supported by the data available. PMID- 3557455 TI - The effects of pavement edgelines on performance in a driving simulator under sober and alcohol-dosed conditions. PMID- 3557454 TI - Ascertainment bias and power of procedures to estimate differences between male and female mutation rates. PMID- 3557456 TI - The effects of age, sleep deprivation, and altitude on complex performance. PMID- 3557457 TI - No effect of noise on vigilance performance? PMID- 3557458 TI - The sequence of chromosome 3 loci AHSG:TF:CHE1. AB - A large Hutterite kindred was examined for possible linkage between the chromosome 3 markers; cholinesterase (CHE1), transferrin (TF), and alpha-2HS glycoprotein (AHSG). Linkage between TF and AHSG was suggested in males (z = 1.515, theta = 0.08) and between CHE1 and TF(z = 0.661, theta = 0.21). However, linkage between CHE1 and AHSG in males was not established. Based on lods and a nuclear family informative for all three loci a possible chromosomal alignment for the loci is presented. PMID- 3557459 TI - Transferrin variants in Japan and New Zealand. Report of an unusually sialyzed TF variant. AB - The genetic polymorphism of transferrin (TF) was studied in 2,167 Japanese individuals and in 448 New Zealanders. The three TF C subtypes were identified, but TF C3 was absent from Japanese populations. In addition, three TF B and six TF D variants were observed, each of which occurred either in Japanese or in New Zealanders. Stepwise removal of N-acetyl-neuraminic acid (NANA) with neuraminidase revealed that the most cathodal variant TF DShinnanyo found in a Japanese family was characterized by having only two NANA residues. PMID- 3557460 TI - Occurrence of a rare variant of superoxide dismutase in Brazil. AB - During a paternity test performed in Porto Alegre, Brazil, a rare variant of superoxide dismutase, probably SOD A2, was found in a Caucasian child and the putative father. Studies of 1,700 unrelated white individuals from the same and nearby cities had never disclosed such a variant, which was also absent in 2,480 persons of other ethnic groups living in different regions of Brazil. The presence of this rare phenotype in the child and putative father led to the assignment of a very high probability of paternity to the latter. PMID- 3557461 TI - Familial Leydig cell hypoplasia as a cause of male pseudohermaphroditism. AB - A case of familial Leydig cell hypoplasia as a cause of male pseudohermaphroditism is described in two 46,XY female sibs. Biochemical and histologic evidence for such diagnosis is presented. PMID- 3557463 TI - Joint phenotype distributions at the glyoxalase I and haptoglobin loci in Finland. PMID- 3557462 TI - E1h, a new allele at cholinesterase locus 1. AB - Unusual inhibition characteristics in two unrelated suxamethonium-sensitive individuals were indicative of a new allele, E1h, segregating with the E1a gene. Family studies substantiate this hypothesis and three new genotypes are recognised. PMID- 3557464 TI - Gc and Tf subtypes in Greece. AB - PAGIF was used to investigate the distribution of Gc and Tf subtypes in a Greek population sample. The gene frequencies were compared to those reported for other European populations. PMID- 3557466 TI - Factors influencing carcinogenicity testing in rodents. PMID- 3557465 TI - Complex segregation analysis of plasma lipid and lipoprotein variables in a Jerusalem sample of nuclear families. AB - Plasma lipid and lipoprotein concentrations from 3,074 nuclear families in the multiethnic Jerusalem Lipid Research Clinic study population were analyzed for possible involvement of major genes in determination of high levels of these traits. Complex segregation analysis under a mixed model including major gene and multifactorial transmissible components was performed on transformed-plasma lipids and lipoproteins after covariance adjustment for age, sex and environmental measures. Likelihood analysis provided evidence for recessive major genes influencing plasma triglyceride, and low-density lipoprotein cholesterol (LDL-C). The estimated gene frequencies for triglyceride and for hyperbetalipoproteinemia in our study population were about 0.1. Our positive results for total cholesterol and high-density lipoprotein cholesterol (HDL-C) were nonconclusive and the major effects could result from causes other than major genes. The mixed-model parameters were homogeneous across origin groups for LDL-C and HDL-C and heterogeneous for total plasma cholesterol and triglyceride. The multifactorial-transmission heritability index was similar in all origin groups for all the traits. The origin heterogeneity in the major gene parameters appeared to be mainly due to the North African group which favored a multifactorial transmission for all traits except for LDL-C. PMID- 3557467 TI - Cadmium concentrations in human kidneys from the UK. AB - The concentration of cadmium in the cortex and medulla of nearly 1000 kidneys obtained at autopsy was determined by atomic absorption spectrophotometry. Particular care was taken over the analytical procedures to ensure the accuracy and precision of the results; intrakidney variability was examined and found to be small. The frequency distributions of cadmium concentrations were approximately lognormal. There was much variability in cadmium concentrations between individuals, with geometric coefficients of variation for both cortex and medulla of around 100%. Cadmium concentrations varied with age and smoking habits, but not sex. Values were successively higher than those in the previous age-group up to 50-59 years (geometric mean 19 micrograms/g), after which they were successively lower; on average, heavy smokers had cadmium concentrations some 15-20% higher than those in light smokers who in turn had values some 15-20% higher than those in non-smokers. No definite conclusions could be reached on the variation of cadmium concentrations with either cause of death or location, or over time. The present study, the first of its kind in the UK, has provided benchmark data; its results are broadly in line with those from previous but smaller studies in other countries. PMID- 3557469 TI - Antipyrine metabolism in the Venda. AB - The excretion of antipyrine metabolites over 48 h as percentage dose and the antipyrine kel and metabolite formation rate constants have been measured for 20 healthy Venda Africans. To allow comparison with published data from inter-ethnic studies with antipyrine, subjects were selected who had assumed a western life and diet. The values (mean +/- SE) for excretion of the metabolites, 4 hydroxyantipyrine (4OHA), norantipyrine (NORA) and 3-hydroxymethylantipyrine (3HMA) as percentage dose were 26.17 +/- 0.34, 7.44 +/- 0.34 and 13.28 +/- 0.31 respectively. The total of the three metabolites was 49.56 +/- 0.33. These results differ significantly from the values found for groups of Canadian students of Oriental and Caucasian backgrounds. The values (mean +/- SE) found for the antipyrine elimination rate constant and the metabolite formation rate constants of 4OHA, NORA and 3OHA were 6.56 (+/- 0.56) X 10(-2), 2.05 (+/- 0.24) X 10(-2), 0.60 (+/- 0.09) X 10(-2) and 1.06 (+/- 0.16) X 10(-2) respectively. Only the NORA formation rate constant showed any significant difference with the results obtained for Americans, although the Venda exhibited a wider distribution of the 3HMA data. The linearity of the probit plots obtained suggest that the subjects selected are homozygous for the oxidations investigated. The marked difference found in comparison with Caucasian and Oriental data on the one hand and American data on the other, also implies a marked difference between the Caucasian and Oriental data and the American data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557468 TI - Changes in plasma proteins in rats treated for short periods with hepatotoxins or with agents which induce cytochrome P450 isoenzymes. AB - We have compared the alterations in plasma proteins following treatment of rats with the centrilobular hepatotoxin carbon tetrachloride, the periportal hepatotoxin allyl alcohol and two inducers of hepatic microsomal drug metabolising enzymes, phenobarbitone and a mixture of polychlorinated biphenyls (Aroclor 1254). The results are compared with changes observed in animals treated with agents which caused proliferation of rat liver peroxisomes and described in an earlier publication. Our results indicate that: There is a marked induction of a minor glycoprotein which migrates as a prealbumin following treatment with both inducers of microsomal mixed function oxidases and inducers of peroxisome proliferation. There is a marked increase in a minor alpha 1-glycoprotein when there is chemically-induced mitosis in the liver but not in mitosis following liver damage. Two major alpha 1-glycoprotein are depressed in all forms of liver damage. There are indications of specific protein responses to allyl alcohol, to inducers of microsomal mixed function oxidases and to inducers of peroxisome proliferation. PMID- 3557470 TI - Effect of p-aminopropiophenone (PAPP), a cyanide antidote, on cyanide given by intravenous infusion. AB - Beagle bitches were infused with potassium cyanide solution after protection with p-aminopropiophenone (PAPP). Methaemoglobin levels fell very rapidly after the start of the infusion. Whole blood and plasma cyanide estimations revealed that most of the cyanide was sequestered inside the red cells. Animals survived a supralethal dose of cyanide when protected with PAPP. PMID- 3557471 TI - Effect on blood and plasma cyanide levels and on methaemoglobin levels of cyanide administered with and without previous protection using PAPP. AB - Hydrogen cyanide was administered intravenously at doses of 0.67 or 1.34 mg kg-1 to beagle bitches after protection with oral p-aminopropiophenone (0.5 mg kg-1). Hydrogen cyanide was also administered to unprotected bitches at the lower level (0.67 mg kg-1) only. PAPP protection caused sequestration of cyanide inside the red cells. In the case of the lower dose of cyanide this resulted in a lower plasma cyanide in protected than unprotected bitches. In the case of the higher dose it resulted in survival, despite 1.34 mg kg-1 being a known lethal dose. It is concluded that prior administration of PAPP ameliorated the effects of cyanide poisoning. PMID- 3557472 TI - Epidemiological aspects of childhood poisonings in Ankara: a 10-year survey. AB - In the 10-year period 1975-1984, 1188 children were admitted to the Children's Hospital of Hacettepe University in Ankara with a diagnosis of poisoning. Retrospective analysis of their medical records showed that the incidence of poisoning with medicinal drugs was 64.0%, while pesticides accounted for 17.8% and plants for 6.7% of total cases. The majority (69.9%) of cases were due to accidental poisoning, 70.6% of which occurred in children under 5 years of age; 15.1% of the poisonings were diagnosed as therapeutic mishaps of which 68.3% involved children under 5 years of age. Analgesics (186 cases), barbiturates (176 cases) and tranquilizers (37 cases) were the most common drugs encountered, however, the two drugs most frequently overused were aspirin (146 cases) and Optalidon (175 cases). Overall mortality was 4.9% (58 cases). Fifty per cent of fatalities were due to accidental poisoning while 41.4% (24 cases) were due to therapeutic mishaps. This study is presented as a background to the need for the development of a Poison Information Service for Ankara. PMID- 3557473 TI - Formation and persistence of isoniazid-DNA adducts in mouse tissues. AB - Further confirmation is provided to support the identity of the product formed by the in vitro reaction of isoniazid (INH) with cytosine as 4-deamino-4 isoniazidocytosine (INH-cytosine). Use of INH-treated mice, in which the tissue DNA is prelabelled by the neonatal administration of [3H]-deoxycytidine, has revealed the presence of two other DNA products in addition to INH-cytosine. Tissue differences in the persistence of these three DNA products suggest the presence of repair reactions for certain adducts. These processes and the effects of hepatotoxicity lead to a selective retention of adducts in the DNA of lung which is the target tissue for INH-carcinogenicity in mice. INH-modified DNA templates are weakly promutagenic during in vitro DNA synthesis. The implications of these observations for the role of INH as an initiating agent and for the species differences in its carcinogenicity are discussed. PMID- 3557474 TI - Safety evaluation of cimetidine: report at the termination of a seven-year study in dogs. AB - Cimetidine in tablet form was administered orally daily to eight male and four female beagle dogs at a dose level of 144 mg kg-1 for 385 weeks. Four male and two female control dogs received placebo tablets. Treatment with cimetidine did not affect the clinical condition of the dogs, but was associated with a slightly less rapid weight gain. Five dogs (two cimetidine-treated and three controls) were killed during the course of the study for reasons not related to treatment. Treatment with cimetidine did not affect haematological, clinical chemical, urinalysis or electrocardiographic parameters. Multiple biopsies of gastric mucosa taken at intervals of approximately six months from Week 177 to Week 363 showed no change which could be attributed to treatment with cimetidine. There were no toxic effects on the gastric mucosa of any dog. At necropsy no treatment related findings were reported except for reduction in prostate size in 6/8 males receiving cimetidine. This was expected in view of previous experience with cimetidine. PMID- 3557475 TI - The effects of a single intramuscular injection of atropine sulphate on visual performance in man. AB - The effects of a single intramuscular injection of 2 mg atropine sulphate on visual function were studied in volunteer subjects. The well-known effects of increased heart rate, dryness of the mouth, increased pupil diameter and reduced accommodative range were confirmed. Visual acuity, stereoacuity, red-green colour balance and reaction time to a visual stimulus were unaffected by atropine, while extraocular muscle balance (horizontal heterophoria and cyclophoria) underwent a transient change. There was no significant change in contrast sensitivity measurements to stationary sinusoidal grating patterns of spatial frequencies 1 30 c/deg; however contrast sensitivity to moving grating patterns of spatial frequencies 1-5 c/deg showed a sustained reduction which was still present at 6 h post-injection. It is concluded that atropine adversely affects movement detection but not stationary visual function. PMID- 3557476 TI - Ibuprofen overdose: the first two years of over-the-counter sales. AB - Experience during 14 years of prescription only use indicates that the non steroidal anti-inflammatory drug (NSAID) ibuprofen is of low toxicity in acute overdose. In August 1983 ibuprofen was licensed for over-the-counter (OTC) use in the UK and it was recognised that this change could have an impact upon the epidemiology of analgesic overdose in this country. The London centre of the National Poisons Information Service (NPIS) began a new prospective survey of ibuprofen overdose at the time of OTC release. The first 2 years of this survey detected a marked increase in enquiries concerning ibuprofen overdose but there was no evidence to contradict the former claims of low toxicity. The importance of continued monitoring is stressed. PMID- 3557477 TI - Mercury poisoning after disc-battery ingestion. AB - A case is described of a 2-year-old girl who swallowed an alkaline disc battery containing mercuric oxide. Two days after ingestion it disintegrated in the stomach necessitating laparotomy to remove the battery casing and most of its contents. Postoperatively her blood mercury concentration rose to 340 micrograms/l and subsequently she developed small bowel obstruction due to adhesions. She was treated with dimercaprol but blood mercury concentrations did not fall until after a second laparotomy to relieve the obstruction and to remove residual mercury salts from the colon. The corrosive effects of swallowed disc batteries are well documented. The maximum blood concentration of mercury reported in this case is 17 times the 'acceptable level of mercury in the blood' and nearly double the highest level recorded previously after disc-battery ingestion. A policy for management of swallowed batteries is suggested. PMID- 3557478 TI - Maximum likelihood identification of a posture control system. PMID- 3557479 TI - Optimum multielectrode a posteriori estimates of single-response evoked potentials. PMID- 3557480 TI - A new quantitative indicator of visual fatigue. PMID- 3557481 TI - Noninvasive assessment of human gastric motor function. PMID- 3557482 TI - Time-optimal control of saccadic eye movements. PMID- 3557483 TI - Open tip glass microelectrodes: conduction through the wall at the tip. PMID- 3557484 TI - Adaptive filtering of evoked potentials. PMID- 3557485 TI - Dielectric polarization of animal lung at radio frequencies. PMID- 3557486 TI - Line frequency rejection for biomedical application. PMID- 3557487 TI - An open two-compartment model for a double site of drug absorption. PMID- 3557488 TI - Comments on "Potentials produced by arbitrary current sources in an infinite- and finite-length circular conducting cylinder". PMID- 3557489 TI - An optical probe for on-line measurement of velopharyngeal valve opening. PMID- 3557490 TI - Spatial filtering of noninvasive multielectrode EMG: Part II--Filter performance in theory and modeling. PMID- 3557491 TI - Clinical evaluation of burn injuries using an optical reflectance technique. PMID- 3557492 TI - Manipulation of muscle force with various firing rate and recruitment control strategies. PMID- 3557493 TI - Adaptive control of electrically stimulated muscle. PMID- 3557494 TI - Use of the finite-difference time-domain method in calculating EM absorption in human tissues. PMID- 3557495 TI - Some aspects of nonstationary myoelectric signal processing. PMID- 3557497 TI - Thermoelastic signatures of tissue phantom absorption and thermal expansion. PMID- 3557496 TI - On the possibility of directly relating the pattern of ventricular surface activation to the pattern of body surface potential distribution. PMID- 3557498 TI - Corrected unipositional lead system for vector magnetocardiography. PMID- 3557500 TI - Spatial filtering of noninvasive multielectrode EMG: Part I--Introduction to measuring technique and applications. PMID- 3557499 TI - Circuit models and simulation analysis of electromyographic signal sources--I: The impedance of EMG electrodes. PMID- 3557501 TI - Persistent ductus arteriosus associates with congenital aortic stenosis. PMID- 3557502 TI - Noninvasive evaluation of acute effects of oral diltiazem in primary pulmonary hypertension--a preliminary study. PMID- 3557503 TI - Spatial vectorcardiographic (VCG) features of myocardial infarction with right ventricle (RV) endocardial pacing. PMID- 3557504 TI - Diaphragmatic palsy following open heart surgery. PMID- 3557505 TI - Arrhythmias in atrial septal defect: a pre- and postoperative evaluation. PMID- 3557506 TI - Study of blood pressure of a high altitude community at Spiti (4000 m). PMID- 3557507 TI - Experience with multiprogrammable pacemakers. PMID- 3557509 TI - A study of diastolic time intervals and a-wave in myocardial infarction. PMID- 3557508 TI - Electrocardiographic changes during endoscopy. PMID- 3557510 TI - Congenital absence of left pericardium with rheumatic mitral stenosis. PMID- 3557511 TI - Chronic constrictive pericarditis with rheumatic mitral stenosis: a case report. PMID- 3557512 TI - Myocardial infarction and normal coronary arteries: possible role of spasm. PMID- 3557513 TI - Profile of patients with myocardial infarction and angiographically normal coronary arteries. PMID- 3557514 TI - Evaluation of severity of valvular aortic stenosis: an echocardiographic haemodynamic correlative study. PMID- 3557515 TI - Clot selective thrombolysis. PMID- 3557516 TI - Electrophysiological effects of mexiletine in patients of sinus node dysfunction and intraventricular conduction defects. PMID- 3557517 TI - Aorto arteritis in childhood. PMID- 3557518 TI - Ventricular pacing in sick sinus syndrome--a long term follow-up. PMID- 3557519 TI - Cross-sectional echocardiography in recognition of left ventricular aneurysm following closed mitral valvotomy. PMID- 3557520 TI - Platelet adhesiveness in diabetes mellitus and hypertension. PMID- 3557521 TI - Comparative evaluation of acute effects of sublingual nifedipine and oral diltiazem by echocardiographic right ventricular systolic time intervals in primary pulmonary hypertension. PMID- 3557522 TI - Modified technique of aortic root widening for narrow aortic root. PMID- 3557523 TI - Electrocardiographic changes in experimental myocarditis induced by scorpion (Buthus tamulus) venom. PMID- 3557524 TI - Assessment of left ventricular performance following rapid blood transfusion in cases of chronic severe anaemia--a study of left ventricular filling pressure and systolic time intervals. PMID- 3557525 TI - A note on the normal measurements of the heart. PMID- 3557526 TI - "Coronary heart disease and smoking: a psychological study". PMID- 3557527 TI - Sinus node disease in chronic bundle branch block. PMID- 3557528 TI - Budd Chiari syndrome in a child with hepatic tuberculosis. PMID- 3557529 TI - Unusual electrocardiographic findings in a case of hypertrophic obstructive cardiomyopathy. PMID- 3557530 TI - Anti-tachycardia pacing. PMID- 3557531 TI - [Multicenter evaluation of the activity and tolerance of a new antimycotic agent: ciclopiroxolamine]. PMID- 3557532 TI - [Pruritus sine materia and prurigo. II. Prurigo]. PMID- 3557533 TI - [Skin lesions in carbon monoxide poisoning]. PMID- 3557534 TI - [Post-traumatic epitheliomas of the skin. Review of a 10-year case series]. PMID- 3557535 TI - [A case of angiolymphoid hyperplasia with eosinophilia]. PMID- 3557536 TI - [Zinsser-Cole-Engman syndrome]. PMID- 3557537 TI - [Cutaneous metastasis of clear-cell renal carcinoma]. PMID- 3557538 TI - [Zoon's plasma-cell nodular balanitis]. PMID- 3557540 TI - [Infundibular adenoma]. PMID- 3557539 TI - [Primary leiomyosarcoma of the skin]. PMID- 3557541 TI - [PUVA therapy. Considerations on a 7-year follow-up]. PMID- 3557542 TI - [Stevens-Johnson syndrome caused by isoxicam]. PMID- 3557543 TI - [Use of etretinate (tigason) in dermatologic therapy in Italy. Results of a clinical and laboratory monitoring]. PMID- 3557544 TI - [1% tioconazole lotion (Trosyd) in the treatment of superficial mycoses]. PMID- 3557545 TI - [Dermatologic and venereal pathology in drug addicts]. PMID- 3557546 TI - [Epidemiologic considerations apropos of 6 cases of lymphogranuloma venereum recorded in Sicily in a 1-year period]. PMID- 3557548 TI - [The HLA system and psoriasis. Analysis of the interactions between predisposing HLA antigens]. PMID- 3557549 TI - [Cutaneous beginning of Moschcowitz's syndrome. Observations on a case]. PMID- 3557547 TI - [Dermatoses associated with type I diabetes mellitus]. PMID- 3557550 TI - [A case of Lyme disease in Genoa]. PMID- 3557551 TI - [Generalized perforating granuloma annulare]. PMID- 3557552 TI - [Behcet's disease. Gastroenterological manifestations in 2 patients]. PMID- 3557553 TI - [Urticaria in an anaphylactic syndrome caused by the ingestion of food associated with physical exercise]. PMID- 3557555 TI - Role of cell density and cell shape in polyethylene glycol-induced cell hybridization. PMID- 3557554 TI - [Contact urticaria. Description of a case]. PMID- 3557556 TI - Inhibition of human natural killer cell activity by ethanol in vitro. PMID- 3557557 TI - In vitro activation of murine macrophages and their increased capacity to lyse target cells after cis-platin treatment. PMID- 3557558 TI - Evaluation of involvement of accessory olfactory (vomeronasal) system in estrous cyclicity and mating in female mice. PMID- 3557559 TI - Mouse myeloma (Sp 2/0-Ag-14) culture supernatant as a substitute for feeder cells in mouse x mouse and rat x mouse hybridomas. PMID- 3557560 TI - Ultrastructural pathology of nitrosamine induced hamster cheek pouch tumours exposed to TPA. PMID- 3557561 TI - Experimental investigations on diabetic heart disease. PMID- 3557562 TI - Cytogenetic effect of neomycin on human lymphocytes in vitro. PMID- 3557563 TI - Statement on the nomenclature of dog C4 allotypes. AB - As a collaborative work of three laboratories the polymorphism of the canine fourth complement component (C4) was studied in a total of 131 unrelated dogs from different breeds and mongrels. Using high voltage electrophoresis followed by an immunoblotting technique, we detected eight distinct variants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of canine C4 showed an additional heterogeneity of the alpha and gamma chains which resulted in a total of 11 variants in the population studied. So that more precise information concerning the respective C4 allotypes will be available, a nomenclature is proposed designating not only the migration pattern of the C4 variants in agarose gels but also the heterogeneity of the C4 chains observed in SDS-PAGE. PMID- 3557564 TI - A new medium for large scale production of Leishmania donovani promastigotes for biochemical studies. PMID- 3557565 TI - Nutrition of Leishmania donovani donovani: growth in new semidefined & completely chemically defined media. PMID- 3557566 TI - Monocyte functions in experimental amoebiasis. PMID- 3557567 TI - Field evaluation of FICAM W (bendiocarb), a carbamate adulticide in two villages of Pondicherry. PMID- 3557568 TI - Immunogenic behaviour of Mycobacterium marinum (SATO) in mice. PMID- 3557569 TI - Drug sensitivity of non-clostridial anaerobes. PMID- 3557570 TI - Postoperative sepsis in obstetric & gynaecological practice. PMID- 3557571 TI - Gas liquid chromatography in rapid diagnosis of anaerobic brain abscess. PMID- 3557572 TI - Post transfusion hepatitis--a prospective study. PMID- 3557573 TI - Hepatitis B virus state among donors & hospital staff--a serological survey using different techniques. PMID- 3557574 TI - Nasopharyngeal aspirate for prediction of respiratory distress syndrome. PMID- 3557575 TI - Association of growth status & age at menarche in urban upper middle income group girls of Hyderabad. PMID- 3557576 TI - Histochemical & electron histochemical studies on intracytoplasmic filaments in tumours of human mammary gland. PMID- 3557577 TI - Histopathology of hamster cheek & liver following topical application of lime. PMID- 3557579 TI - Localization of glycogen in the vaginal smear in determination of cytohormonal pattern of breast tumours. PMID- 3557578 TI - Attenuation of pulse rate & blood pressure-response to laryngoscopy & intubation with verapamil. PMID- 3557580 TI - Comparison of protoporphyrin haem ratio in capillary & venous blood. PMID- 3557581 TI - Dengue fever in India. PMID- 3557583 TI - Blood transfusion in neonates. PMID- 3557584 TI - Should we continue with use of syrups and suspensions. PMID- 3557585 TI - Evening colic. PMID- 3557582 TI - Utilising dais to impart health and nutrition education: impact on growth. PMID- 3557586 TI - Rural health care. PMID- 3557587 TI - Children's health: tomorrow's wealth. PMID- 3557588 TI - Risk factors in mothers and newborn. PMID- 3557589 TI - The Apgar score--a reappraisal. PMID- 3557590 TI - Weighing of children made simple. PMID- 3557591 TI - Periosteal reactions in pediatrics. PMID- 3557592 TI - Interaction between nutrition and measles. PMID- 3557593 TI - Study of neonatal kidney functions in preterm and term babies. PMID- 3557594 TI - Drug interactions--their mechanism and implications. PMID- 3557595 TI - Primary myocardial disease (cardiomyopathies): a study of 69 cases. PMID- 3557596 TI - Prelacteal feeds and breast-feeding problems. PMID- 3557597 TI - Visceral leishmaniasis: a worldwide disease. PMID- 3557598 TI - Enhanced cerebral vascular regulation occurs by age 4 to 5 weeks in spontaneously hypertensive rats. AB - Although the primary emphasis of research on spontaneously hypertensive rats (SHR) tends to be on adult animals, the young SHR can have a mean arterial pressure that is elevated above normal almost proportionately as much as in adult SHR. This study attempted to determine whether the cerebral vasculature of 4- to 5-week-old SHR used existing normal mechanisms to tolerate hypertension or had microvascular characteristics uniquely suited for hypertensive life. At mean arterial pressures above about 60 mm Hg, the arterioles of SHR were constricted compared with similar branch order vessels of normal Wistar-Kyoto rats (WKY). At arterial pressures below 60 mm Hg, however, the inner diameters of arterioles in normal and hypertensive rats can be similar. At arterial pressures of 40 to 120 mm Hg, normal WKY maintained blood flow within +/- 10 of that at the resting arterial pressure of 90 mm Hg; SHR with a mean arterial pressure of 120 mm Hg regulated blood flow over a pressure range of 60 to 160 mm Hg. Normal WKY had petechial hemorrhages from venules and sustained loss of arteriolar tone at arterial pressures above 120 mm Hg, which is the resting arterial pressure of 4- to 5-week-old SHR. Microvascular pressure measurements indicated that the resistance of cerebral arteries was increased, because they dissipated about 50% of the arterial pressure in SHR compared with about 40% in WKY.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557599 TI - Differences in pattern of plasma angiotensinogen in native and nephrectomized rats. AB - Rat plasma contains two distinct forms of angiotensinogen (Ao-1 and Ao-2) that can be found in single animals in a distinct ratio. The ratio of Ao-1 to Ao-2 was determined by separation of Ao-1 and Ao-2 from 1 ml of plasma from individual rats on an SP-Sephadex C-50 column. Plasma from rats of three different strains, Wistar, Wistar-Kyoto (WKY), and spontaneously hypertensive rats (SHR), was investigated. In Wistar rats native plasma contained Ao-1 and Ao-2 in a ratio of 2.6:1. Twenty-four hours after nephrectomy, which increased the total Ao content 4.1-fold, this ratio was changed to 1.1:1. In native WKY and SHR the ratio of the two forms was similar to that in Wistar rats: 2.4:1 and 2.8:1, respectively. After nephrectomy the ratio of Ao-1 to Ao-2 was changed to 1.1:1 and 0.78:1 in WKY and SHR, respectively, while the total Ao content increased 4.9-fold and 8.2 fold in the two strains. Endogenous plasma renin inactivated the two forms of Ao, with a Km of 4.0 +/- 0.46 and 3.7 +/- 0.43 microM and a Vmax of 176 +/- 15.5 and 155 +/- 12.7 nM/hr, respectively. These results suggest that 1) Ao-1 and Ao-2 are synthesized in equimolar amounts, 2) the clearance of Ao-2 is faster than that of Ao-1 in control rats, and 3) under conditions of stimulated synthesis (i.e., after nephrectomy), the plasma content of Ao-2 increases faster than that of the more highly glycosylated form, Ao-1. PMID- 3557600 TI - Renal nerves and the pathogenesis of angiotensin-induced hypertension. AB - The present study examined the role of the renal nerves in the development of hypertension produced by chronic infusion of angiotensin II in the conscious rat. The animals were divided into four groups, and a unilateral nephrectomy was performed. The remaining kidney was denervated in two groups, whereas in the other two groups of animals the nerves were left intact. Four days later either angiotensin II (83 ng/min) or saline infusions were begun through subcutaneously implanted osmotic minipumps. The rats were subsequently studied for 14 days. The results indicate that renal denervation significantly attenuated the pressor response to angiotensin II for approximately 6 days. Following this period, there was no difference in blood pressure between the innervated and denervated rats infused with angiotensin II, as both groups attained a hypertensive level of 170 to 180 mm Hg, which was 60 to 70 mm Hg above the blood pressure of the control rats infused with saline. Kidney norepinephrine content was reduced 95% by the denervation procedure and by 40% following infusion of angiotensin II into rats with intact renal nerves. These data demonstrate that, while the renal nerves appear to play a modulatory role in the development of the hypertension, they are not essential for the pathogenesis to occur nor do they determine the final level of hypertension achieved following chronic infusion of angiotensin II in the rat. PMID- 3557601 TI - Area postrema is critical for angiotensin-induced hypertension in rats. AB - The effect of surgical ablation of the area postrema on acute (5-10 minutes) and chronic (5-10 days) increases in mean arterial pressure produced by intravenous infusion of angiotensin II in conscious, instrumented rats was studied. In agreement with previous studies, pressor responses of area postrema-ablated rats (n = 11) to acute angiotensin II infusion were identical to those of control sham lesioned rats (n = 13). In these same rats, however, a 5-day infusion of angiotensin II produced a sustained hypertension in the sham-lesioned group whereas mean arterial pressure was increased only transiently (1-3 days) in the area postrema-ablated rats. No differences before infusion of arterial pressure, heart rate, water intake, urinary sodium excretion, and urinary potassium excretion were observed between sham-lesioned and area postrema-ablated rats; only arterial pressure was changed significantly during angiotensin II infusion in either group. Twenty-four hours after terminating angiotensin II infusion, mean arterial pressure was within the normotensive range in both sham-lesioned and area postrema-ablated rats. In a separate group of sham-lesioned (n = 13) and area postrema-ablated (n = 12) rats, angiotensin II was infused intravenously for a 10-day period; mean arterial pressure was increased significantly over the entire 10-day infusion in sham-lesioned rats, but for only 1 day in area postrema ablated rats. An intact area postrema appears necessary for the development of chronic, but not acute, hypertension during intravenous infusion of angiotensin II in the rat. PMID- 3557602 TI - Cardiovascular responses to acute stress in young-to-old spontaneously hypertensive rats. AB - Age-related changes in circulatory responses to short-term shaker stress were investigated in conscious spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). Hemodynamics (microspheres) were measured at 8, 24, 48, and 96 weeks of age, and plasma catecholamines were measured at 8 and 96 weeks. At rest, elevated mean arterial pressure was associated with unaltered cardiac index and heart rate in SHR compared with WKY at all ages. Regional blood flow was largely similar in both strains, except for a reduced renal flow in 96-week-old SHR. Cardiac index and most regional blood flow tended to or did decline in both strains between 8 and 96 weeks. Plasma catecholamines were similar in both strains at 8 and 96 weeks. Shaker stress evoked responses similar to defense reactions in both strains. The incremental responses in mean arterial pressure, heart rate, cardiac index, and cerebral, skeletal muscle, and myocardial flow and the decremental responses in splanchnic, renal, and skin flow were greater in SHR than in WKY, particularly at 8 weeks. Most of these responses tended to or did decline between 8 and 96 weeks in both strains. The plasma catecholamine responses were also greater in SHR at 8 and 96 weeks, and they did not differ in either strain between these ages. Thus, circulatory and sympathoadrenal reactivity to acute stress were enhanced in SHR compared with WKY, independently of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557603 TI - Analysis of the cardiovascular effects of arginine vasopressin in conscious dogs. AB - The effects of physiological elevations in arginine vasopressin on the cardiovascular system were studied in a group of nine conscious, chronically instrumented dogs. The animals were studied under normal conditions (plasma vasopressin, 4.1 +/- 0.4 pg/ml), after 24 hours of dehydration (plasma vasopressin, 7.3 +/- 1.5 pg/ml), after a 30-minute vasopressin infusion at 2.6 ng/kg/min (plasma vasopressin, 96.6 +/- 8.1 pg/ml). These increases in vasopressin concentration resulted in no change in arterial pressure and significant changes in the following: a 13 and 29% decrease in resting cardiac output during dehydration and acute infusion, respectively; a 26% reduction in heart rate during acute infusion; a 12 and 54% increase in total peripheral resistance during dehydration and acute infusion; a 16 and 22% reduction in mean circulatory filling pressure during dehydration and chronic vasopressin infusion. In addition, maximum pumping ability of the heart was reduced 16 and 31% during dehydration and acute infusion, respectively. These data suggest that elevations of vasopressin such as those occurring during dehydration or volume depletion potentially may affect cardiovascular performance by three mechanisms: greatly increasing resistance to flow, reducing heart rate, suppressing the pumping ability of the heart. PMID- 3557604 TI - Vertex-corrected blood pressure in black girls. Relation to obesity, glucose, and cations. AB - Correlates of resting blood pressure (BP) were explored among 32 inner-city, black girls, ages 11.7 to 13.9 years, a sample drawn from the second and fourth quartiles of the BP distribution in an earlier school survey. Customary BP measurements in the seated position were corrected for the height of the arterial column extending from the BP cuff to the top (vertex) of each girl's head. This vertex correction procedure has previously been shown to eliminate the childhood association between mean arterial pressure and age. Vertex-corrected systolic BP was correlated individually (p less than 0.03) with serum fasting glucose, ionized calcium, sodium, and calculated osmolality. The BP association with serum glucose did not persist after an oral sucrose challenge. Vertex-corrected diastolic BP was correlated individually (p less than 0.02) with serum ionized calcium and four indices of obesity, the best correlated of which was the subscapular skinfold (r = 0.66, p = 0.0001). Vertex-corrected BPs generally provided stronger correlations than customary (uncorrected) BPs with the variables of interest. Correlations with seated BPs were generally stronger than those with supine BPs. By multiple regression analysis, seated vertex-corrected systolic BP was related directly to serum fasting glucose and ionized calcium and inversely to pulse rate (R2 = 0.53). Seated vertex-corrected diastolic BP was related directly to subscapular skinfold and calculated osmolality (R2 = 0.54). Vertex correction may facilitate clinical or epidemiological studies of early hypertension. PMID- 3557605 TI - Hemodynamic characteristics of sodium-sensitive human subjects. AB - Fifty-eight normal subjects and 51 subjects with borderline hypertension underwent microvascular and hemodynamic studies while on an ad libitum diet and during periods of sodium depletion (10 mEq/day) and repletion (200 mEq/day). Hemodynamic measurements included arterial blood pressure, cardiac index, total peripheral resistance, forearm blood flow, vascular resistance, venous compliance, and capillary filtration fraction. Studies of the microcirculation consisted of macrophotography of the bulbar conjunctiva with measurement of anteriolar, venular, and capillary density and diameter. During sodium repletion, cardiac index increased significantly in the normal subjects (2.35 +/- 0.7 vs 2.44 +/- 0.7 L/min/m2; p less than 0.01) and in the borderline hypertensive subjects (2.50 +/- 0.7 vs 2.70 +/- 0.8 L/min/m2; p less than 0.01). However, mean blood pressure rose by more than 5% in only 33 subjects, 13 with normal and 20 with borderline hypertension. When these sodium-sensitive subjects were compared with those whose blood pressure did not rise, the former were found to have significantly higher forearm vascular resistance (32.2 +/- 21 vs 17.9 +/- 12 mm Hg/ml/min/100 g; p less than 0.01), lower forearm blood flow (4.42 +/- 2.7 vs 7.47 +/- 5.0 ml/min/100 g) and lower conjunctival capillary density (3.72 +/- 1.7 vs 5.18 +/- 2.1 [SD] mm/mm2; p less than 0.05). These results indicate that sodium sensitivity in humans is accompanied by elevation of forearm vascular resistance and attenuation of the microcirculation. PMID- 3557606 TI - Plasma norepinephrine and age as determinants of systemic hemodynamics in men with established essential hypertension. AB - Two primary predictor variables, age and supine plasma norepinephrine, were studied with respect to their influences on supine hemodynamic variables in 52 white men with essential hypertension who were 23 to 67 years of age and had been off active therapy for at least 4 weeks. Plasma norepinephrine was related to age (r = 0.39, p less than 0.01), correlated closely with mean arterial pressure (MAP; r = 0.54, p less than 0.0002) and systemic vascular resistance (r = 0.49, p less than 0.0005), and was related inversely to cardiac output (r = -0.26, p less than 0.06) and stroke volume (r = -0.31, p less than 0.05). Age correlated weakly with MAP (r = 0.31, p less than 0.05) and more strongly with systemic vascular resistance (r = 0.46, p less than 0.005) but was negatively related to cardiac output (r = -0.41, p less than 0.005) and heart rate (r = -0.33, p less than 0.05). Weight did not correlate with any of the hemodynamic variables. Partial regression techniques yielded significant residual correlations between age adjusted plasma norepinephrine and MAP (r = 0.42, p less than 0.005) or systemic vascular resistance (r = 0.38, p less than 0.005). Residual correlations with cardiac output (r = -0.34, p less than 0.05), heart rate (r = -0.36, p less than 0.02), and systemic vascular resistance (r = 0.33, p less than 0.05) remained after adjusting age for the corresponding plasma norepinephrine values. These correlations demonstrate the independent effects of sympathetic nervous activity and the aging process on the systemic vasoconstriction and decreased cardiac function observed in essential hypertension. PMID- 3557607 TI - Blood pressure treatment includes risk factor modification. PMID- 3557608 TI - Preliminary observations on interaction of 14C-metronidazole with macromolecules in vivo and in vitro. AB - Preliminary studies on the in vivo and in vitro interactions of 14C-metronidazole with macromolecules showed that the agent or its metabolite(s) can interact with nucleic acids and proteins in vivo. In vitro studies suggest that in absence of DNA synthesis trace amount of metronidazole does bind to DNA/protein and addition of metabolic activation system (from mouse liver) generates more reactive species from metronidazole. PMID- 3557609 TI - Anti-inflammatory property of ranitidine, a specific H2-receptor antagonist. AB - The effects of ranitidine (2 mg/kg, po) and phenylbutazone (100 mg/kg po) have been studied in different models of acute and chronic inflammation in rats. Ranitidine showed significant anti-inflammatory activity in the four models used. This observation supports the concept that histamine has a pro-inflammatory role that is mediated via stimulation of H2-receptors. PMID- 3557610 TI - Myoelectric activity of gastric antrum and jejunum in anaesthetised guinea pigs. AB - The myoelectric activity of gastric antrum and jejunum was recorded in anaesthetised guinea pigs with Ag-AgCl electrodes. The investigation demonstrated the presence of slow waves and spike potentials. The variability in the pattern of myoelectric activity observed in our study might be due to anaesthesia. PMID- 3557611 TI - Increased osmotic fragility of red cells in dogs with acute myocarditis produced by scorpion (Buthus tamulus) venom. AB - Stings from scorpions (Buthus tamulus) produce acute myocarditis and can result in death in children and adults. Acute myocarditis was induced in anaesthetised dogs by intravenous injection of 4 mg/kg venom (Buthus tamulus). Myocarditis was confirmed by ECG. Blood was collected before and 30 minutes after venom treatment and processed for osmotic fragility. An increase in osmotic fragility of red cells in addition to initial hypertension followed by hypotension were observed in venom treated animals. These results suggest that scorpion venom causes autonomic storm and the released catecholamines were responsible for acute myocarditis, changes in the blood pressure and increased osmotic fragility of red cells. PMID- 3557612 TI - Solvent artifacts likely to be induced by dimethylformamide. AB - Dimethylformamide (DMF) is widely used as a drug solvent. We found DMF to have wide-spread pharmacological effects including depressant effect on CNS evidenced by a decrease in locomotor activity, body and limb tone and rectal temperature, and potentiation of pentobarbitone sleep. A dose-dependent hypotensive effect was seen in cats and rats. In rats, it was partially blocked by atropine and was associated with bradycardia. DMF antagonised the contractions of smooth muscle induced by many agonists. An atropine sensitive spasmogenic effect was observed on rabbit ileum at 20 ml/l and a direct relaxant effect at 50 ml/l. A positive inotropic effect on guinea pig atria was observed with 5 ml/l. The results indicate DMF concentrations that may not perhaps produce 'solvent artifacts' when used as a solvent. PMID- 3557613 TI - Modification of thermal pain threshold by testosterone and ethinyloestradiol in male and female rats. PMID- 3557614 TI - Absence of teratogenicity of pyridoxine in Wistar rats. PMID- 3557615 TI - Bronchodilator and anti-inflammatory effect of glycosidal fraction of Acacia farnesiana. PMID- 3557616 TI - The measure for motivational drive of the female rats to approach the pups- preliminary report. PMID- 3557617 TI - Anaphylaxis or so-called encephalopathy in mice sensitized to an antigen with the aid of pertussigen (pertussis toxin). AB - Sensitization of mice with 1 mg of bovine serum albumin (BSA) or chicken egg albumin (EA) given intraperitoneally and 300 to 400 ng of pertussigen (pertussis toxin [Ptx]) given intravenously (i.v.) induced a high degree of anaphylactic sensitivity when the mice were challenged i.v. with 1 mg of antigen 14 days later. Regardless of H-2 haplotype, all of the strains tested (CFW, BALB/cJ, DBA/2J, and C3H.SW/SnJ) were susceptible to anaphylaxis. Sensitization of mice by a multiple-dose procedure that has been reported to induce fatal encephalopathy in mice (L. Steinman, A. Weiss, N. Adelman, M. Lim, R. Zuniga, J. Oehlert, E. Hewlett, and S. Falkow, Proc. Natl. Acad. Sci. USA 82, 8733-8736, 1982) (1 mg of BSA on day -1, 100 to 400 ng of Ptx on day zero 1 mg of BSA on day +1, 100 to 400 ng of Ptx on day +2, and 1 mg of BSA on day +6) induced shock in BALB/cJ, DBA/2J, and C3H.SW/SnJ mice, but not in CFW mice. When EA was used instead of BSA, CFW, BALB/cJ, and C3H.SW/SnJ mice did not develop fatal shock, whereas DBA/2J mice did. When dose 3 of antigen (BSA or EA) was postponed to day +21, all mouse strains sensitized by the multiple-dose procedure were found to be susceptible to shock. The fatal shock induced by this procedure, as well as that induced by giving a single sensitizing dose of antigen and Ptx, could be prevented by one to three 1-ml doses of saline given i.v. at the time signs of severe shock appeared. Although only one dose of saline was often sufficient to save the mice, two or three doses were usually needed. Microscopic changes were not found in midsagittal sections of the brains of mice sensitized by either procedure. This was true of mice that died from shock or were saved from shock by injections of saline. From these results, we concluded that the proposed model for encephalopathy induced in mice by Ptx and BSA demonstrates only the well-known anaphylactogenic effect of Ptx or pertussis vaccine. Since there are many other more sensitive methods to detect Ptx, induction of anaphylaxis is not of much value for detection or quantitation of Ptx in pertussis vaccine. PMID- 3557618 TI - Presence of high concentrations of circulating Toxoplasma antigens during acute Toxoplasma infection in athymic nude mice. AB - In mice infected with an avirulent strain of Toxoplasma gondii, circulating Toxoplasma antigens were detectable in the sera during weeks 1 to 3 of infection by a simple agglutination test that uses latex particles coated with anti Toxoplasma antibodies. An infection in athymic nude mice resulted in high agglutination titers in the anti-Toxoplasma antibody-coated latex particle test and the absence of anti-Toxoplasma antibodies in sera during the acute phase, suggesting that the detection of circulating Toxoplasma antigens is a good tool for the diagnosis of acute toxoplasmosis, especially in severely immunocompromised hosts. PMID- 3557619 TI - Specific and nonspecific mediation of protective immunity to Toxoplasma gondii. AB - We studied the specificity of protection conferred by Toxoplasma gondii immune lymphocytes and their supernatants on infected hamster kidney cells, using Besnoitia jellisoni immune lymphocytes as a nonspecific control. The intracellular growth of the organisms was measured by [3H]uracil incorporation, and inhibition of multiplication was used as a measurement of immunity. Although the immune lymphocytes restricted principally the multiplication of homologous organisms, partial protection, expressed against the heterologous organism, was found. This was true for either parasite with intact lymphocytes or their supernatants. Exposure of immune lymphocytes to antigen for 18 to 24 h and treatment of kidney cells with supernatant fluids for 18 to 24 h were required for maximal protection. The specific protective mediator in supernatants of immune lymphocytes was characterized by dialysis as having a molecular weight between 3,000 and 12,000 and was found in the 3,000 to 5,000 peak after Sephadex G-50 chromatography. Nonspecific protective activity was greater than 12,000 by dialysis; it chromatographed in the excluded peak, measuring over 43,000, and was destroyed by exposure to pH 2. In vitro production of lymphokines from toxoplasma immune lymphocytes was first detected 7 to 10 days after vaccination of hamsters. At about the same time, hamsters began to resist challenge infection with the pathogenic RH strain of T. gondii and were able to prevent its multiplication in lungs, liver, spleen, and the subcutaneous infection site. The expression of tissue immunity and the production of toxoplasma-immune lymphokines appear to be time-related events. PMID- 3557620 TI - Cell-associated hemagglutinin-deficient mutant of Vibrio cholerae. AB - Cell-associated hemagglutinin-negative mutants were derived from cholera enterotoxin-negative Vibrio cholerae JBK70 by Tn5 mutagenesis. One of the mutants identified, SB001, was characterized in greater detail. Its ability to colonize ilea of adult rabbits was determined by feeding approximately 10(8) V. cholerae to each animal. At 17 h after feeding, the numbers of viable vibrios in the ilea were determined. There was a significant, 4 log, decrease in the ability of the hemagglutinin-negative mutant to colonize ileal tissue compared with the parent strain JBK70. In addition, the higher levels of colonization attained by JBK70 and the wild-type parent of JBK70, N16961, were associated with intestinal fluid accumulation and death. Rabbits immunized orally with approximately 10(8) SB001, when challenged 3 weeks later with either homologous biotype and serotype El Tor Inaba N16961 or heterologous Classical Ogawa 395, were protected to the same extent as those animals immunized with either the challenge strain or JBK70. This was evidenced by decreases in both the number of animals showing detectable colonization and the level of colonization achieved. A hemagglutinin-negative mutant of V. cholerae may therefore be of potential use as a live oral vaccine against cholera. PMID- 3557622 TI - Effect of job satisfaction on stress, performance and health in self-paced repetitive work. AB - The present study was designed to investigate the effect of job satisfaction on stress, performance and health in self-paced repetitive work. There were two groups of subjects. One group consisted of 41 subjects with a high score on job satisfaction and the second group consisted of an equal number of subjects with a low score on job satisfaction. The mean age and experience of high and low satisfied groups are respectively 34.63 and 13.60 and 34.14 and 15.51 years. The educational qualifications of all the workers were below primary level. The results of the study indicate that the low satisfied workers experience more stress and describe their job more unfavourably than the highly satisfied workers. It is also observed that the high satisfied workers are better performers and possess good health (fewer health complaints and good mental health) than that the dissatisfied workers. The findings of the study suggest that the quality of working life may be improved by increasing the job satisfaction of the workers. PMID- 3557621 TI - In vitro and in vivo pathogenicity of Plesiomonas shigelloides. AB - Epidemiologic evidence suggests that Plesiomonas shigelloides is an enteric pathogen. We conducted in vitro, animal, and volunteer studies on P. shigelloides isolates from patients with diarrhea. Five strains gave a negative keratoconjunctivitis reaction in guinea pigs and did not invade HeLa cells. Genetic probes for heat-stable enterotoxins related to those of enterotoxigenic Escherichia coli and for gene sequences common to the invasiveness plasmids of Shigella spp. and enteroinvasive E. coli were negative. Heat-labile enterotoxins were not found when a modified GM1-enzyme-linked immunosorbent assay was used. Rabbits did not develop diarrhea but were transiently colonized when inoculated with up to 10(11) P. shigelloides CFU using the reversible intestinal tie adult rabbit diarrhea model. A very large plasmid (between 118 and 312 megadaltons) was found in all isolates. Strain P012 was cured of its plasmid by novobiocin. This strain, but not its cured derivative, invaded the mucosa of the distal ileum of gnotobiotic piglets given 10(10) CFU. At a lower inoculum (10(9) CFU), strain P012 induced inflammation of the colonic mucosa and diarrhea at day 6. The same isolate was fed to 33 healthy volunteers in doses of 1 X 10(3) to 4 X 10(9) CFU. Thirty-six percent of the volunteers shed the organism, but none became ill. These data are only weakly supportive of a role for P. shigelloides in diarrheal illness and suggest the need for more studies with other strains to better understand its pathogenicity. PMID- 3557624 TI - Non-auditory effects of noise in industry. VI. A final field study in industry. AB - Non-auditory effects of noise were studied among 539 male workers from seven industries. The LAeq, assessed by personal noise dosimetry, has been used to study acute effects. Various indices of total noise exposure, involving level and duration, were developed for long-term effect studies. In the analysis close attention was paid to prevent confounding, e.g. by other adverse working conditions. As expected, hearing loss increased with total noise exposure. Tinnitus was related particularly to hearing loss. Dizziness and hoarseness, however, were not related with noise exposure in this study. Also no correlation could be demonstrated between blood pressure and total noise exposure after correction for age, relative weight and various confounding variables. Use of hearing protection, selection processes and incomplete analysis of interactions between independent variables are suggested for possible explanation. About two thirds of the workers reported noise annoyance. Various aspects were mentioned, such as irritation, surprise and impairment of communication and perception. Mentally stressful tasks appeared to be the most noise-sensitive. Particularly annoying noise sources, mental work load and time pressure had a relatively large impact on noise annoyance in comparison with the influence of noise level (LAeq) itself. Stress responses were not simply related to the noise exposure level, although consistent positive relations could be demonstrated between symptoms of stress and noise annoyance. Various findings led to the conclusion that noise exposure together with stressful mental activities may lead to disturbed concentration, irritation and annoyance. Experienced stress in turn may render workers more susceptible to noise. To overcome some limitations of this study, cohort studies and studies designed to assess interaction-effects are recommended. PMID- 3557623 TI - Indoor exposure to radon from the ground and bronchial cancer in women. AB - A case-referent study on the possible association between radon emanating from the ground and bronchial cancer was carried out on 292 female lung cancer cases and 584 matched population referents. Both groups had lived for at least 30 years in the city of Stockholm, Sweden. The cases were diagnosed during 1972 to 1980 with oat-cell and other types of anaplastic pulmonary carcinomas. A sample of about 10% of the dwellings where cases and referents had lived was selected for measurements of radon and radon daughters. There was a relative risk of 2.2 (P = 0.01) for lung cancer associated with living in dwellings close to the ground in areas with an increased risk of radon emanation. Smoking habits did not appear to be a major confounding factor for this association, although a detailed evaluation was not possible. The measurements indicated increased radon daughter concentrations in ground level dwellings within radon risk areas where lung cancer cases had lived, suggesting that this exposure was of etiologic importance. PMID- 3557625 TI - Cadmium in kidney cortex of inhabitants of North-West Germany: its relationship to age, sex, smoking and environmental pollution by cadmium. AB - The cadmium concentration in kidney cortex (CdKc) was determined in 388 deceased persons, who at the time of death had lived in the cities of Dusseldorf and Duisburg, Federal Republic of Germany (FRG), and surrounding areas. The average CdKc concentration was found to be 17.1 micrograms/g wet weight. Individual values range from less than 0.4 to 94.3 micrograms/g wet weight. The CdKc levels rapidly increase during the first decades of life. At the age of about 40 years, a plateau phase is reached. At high ages (greater than 70 years), the CdKc levels tend to decrease. Cigarette smokers have significantly higher CdKc concentrations than non-smokers. The increase of CdKc depends on the number of cigarettes smoked. Cigar and pipe smokers have slightly increased CdKc levels compared to non-smokers. Non-smokers who had spent the major part of their life in the area of Duisburg, a cadmium-polluted area, have, on the average, significantly higher CdKc levels than non-smokers from the less-polluted surrounding areas. In smokers the residential factor is masked by the effect of cigarette smoking. PMID- 3557626 TI - Central and peripheral nervous system dysfunction in workers exposed to lead, zinc and copper. A follow-up study of visual and somatosensory evoked potentials. AB - To evaluate the effects of lead, zinc and copper in the causation of physiological changes in the central and peripheral nervous systems, we measured the latencies of pattern-reversal, visually-evoked potential (VEP) and of short latency, somatosensory-evoked potential (SSEP) twice at a 12-month interval in nineteen gun metal founders exposed to lead, zinc and copper. The workers' initial blood-lead (BPb) concentrations ranged from 16 to 64 (mean 42) micrograms/dl. BPb and plasma zinc and copper concentrations decreased significantly during the study period owing to the improvement in working environments. In the first examinations, we found that the N2 latency of VEP (conduction time from the retina to the visual cortex) and the N9-N13 latency of SSEP (conduction from the brachial plexus to the medulla oblongata) were both significantly prolonged in exposed workers. In the second examination, the N2 latency had returned to the "normal" level. These changes were correlated positively with changes in the indicators of lead absorption and inversely with changes in the indices of zinc and copper absorption. In the first examination, the N9 latency of SSEP (median nerve conduction) was also found to be significantly prolonged. This change also returned to normal over the study period in proportion to the reduction in BPb and the increase in intra erythrocytic enzyme delta-aminolevulinic acid dehydratase activity. On the other hand, no significant prolongation of the N13-N20 latency of SSEP (central nerve conduction) was found in either of the two examinations; this latency and alteration over the study period were inversely correlated with the indicators of zinc and copper absorption. These data suggest that lead interferes with both peripheral and central nerve conduction. zinc and copper appear to antagonize strongly the lead-induced conduction delay in the upper central nervous system, but only weakly in the lower central and peripheral nervous systems. PMID- 3557627 TI - Bone and joint disorders in the upper extremities of chipping and grinding operators. AB - X-ray examinations of the wrists, the elbows and the shoulders were carried out on 67 vibration-exposed foundry workers and on 46 comparable referents performing heavy manual work. Both groups had a mean age of 39.6 years. Musculoskeletal symptoms, such as arthralgias of the wrist and elbow joints, muscle pain and decreased muscular force, were found to be significantly increased in the chipping and grinding workers compared with the referents. After adjustment for age, the prevalence of cysts in the metacarpal and carpal bones was almost the same in the two groups, whereas radiological signs of osteoarthritis in the wrist joint were more frequent among the vibration-exposed workers (P less than 0.025). The overall prevalence of radiographic abnormalities in the elbow joint was higher in the vibration group than in the reference group (P less than 0.025). Olecranon spurs were observed in 50.7% of the exposed operators and in 28.2% of the referents (P less than 0.025). No difference in the prevalence of radiological changes in the should could be demonstrated between the populations studied. In both groups injuries of bones and joints were not associated with age. Among the chipping and grinding operators, a slight but not significant trend in the prevalence of skeletal abnormalities with increasing vibration exposure was observed. The results of this study indicate that the foundry workers using vibrating tools were affected with bone and joint disorders in the elbow and, to a lesser extent, in the wrist, which occurred more frequently than was observed in unexposed referents, who performed solely heavy manual activity. Among the vibration-exposed workers, no relationship between radiological changes in the upper limbs and symptoms of vibration white finger was found, pointing out that different pathogenic mechanisms are involved. PMID- 3557628 TI - Trans-3'-hydroxycotinine as a main metabolite in urine of smokers. AB - Nine male smokers smoked three types of cigarettes that differed in mainstream nicotine. The experiment was carried out in three runs, each consisting of 7 d when smoking was allowed and 5 d when it was not allowed. Urine fractions were collected throughout the whole period of the experiments. As assumed, nicotine and four of its known metabolites, i.e., cotinine, nicotine-N'-oxide, nornicotine, and N-methyl-nicotinum ions were found in the urine. In addition, trans-3'-hydroxycotinine was determined. The amount of this metabolite was well in excess of those of nicotine and cotinine in the urine. The serum concentration trans-3'-hydroxycotinine was found to be second to serum cotinine. PMID- 3557629 TI - Age, personality, and the Holtzman Inkblot Technique. AB - Recent longitudinal studies using personality questionnaires and ratings have shown remarkable stability across the adult years. In an investigation of age changes and differences in personality as measured by the Holtzman Inkblot Technique (HIT), ninety-three men and women aged twenty-five to ninety were administered Form A of the HIT; forty-four of these were retested one to three years later. Stability coefficients ranged from .07 for Form Appropriateness to .73 for Form Definiteness, with most variables showing significant but moderate stability. Repeated measures analyses of variance showed increases in six variables and decreases in two others, but only one of these changes was paralleled by cross-sectional age differences. Correlations with self-report measures of the broad personality domains of neuroticism, extraversion, and openness to experience failed to show hypothesized relations, and the associations seen were attributable to chance. It was concluded that the HIT measures perceptual-cognitive variables that are moderately stable in adulthood. PMID- 3557630 TI - The number, identity, meaning, and salience of ascriptive attributes in adult person perception. AB - The multidimensional scaling of similarities data was employed in a study of person perception in five adult-aged groups of both male and female respondents. Stimulus persons were males and females of the same five ages. Regardless of the age or gender of the respondent group studied, an identical set of three basic attributes was identified: perceived age, perceived gender, and perceived autonomy. However, respondents also assigned different saliencies to these attributes and used them in quite different ways to categorize the stimulus persons. While the amount of between-group variability observed in these data is large enough to suggest that adult person perception is somewhat idiosyncratic in nature, it was still possible to discern several generalizable trends for the attributes of perceived age and perceived autonomy. These trends and several methodological issues are presented and discussed within the text of this article. PMID- 3557631 TI - Management variables as predictors of service utilization by the elderly in mental health. AB - The problem of underservice to the elderly in mental health settings has been conceptionalized in terms of client variables, therapist variables, and systems variables. This investigation of management variables as a type of system level variable reveals that number of staff assigned to work with the elderly is strongly related to outpatient service use and that number of elders on the advisory board is an inverse predictor of inpatient use. It is recommended that future work on the underservice problem focus on system level analysis and intervention. PMID- 3557632 TI - The Speech-In-Noise test: a new approach to the assessment of communication capability of elderly persons. AB - The present investigation measured how well elderly persons hear in everyday auditory communication situations. It was felt that traditional clinical measures of auditory performance have not been shown to be valid predictors of communication function for an elderly population. Participants ranged in age from fifty-five to seventy-two years. In addition to several standard audiometric tests, a new speech test incorporating sentence material was administered in both quiet and noise. As a measure of general communication performance, a hearing questionnaire was developed. The findings indicated that the results of the new Speech-In-Noise (SIN) test were better predictors of hearing communication performance than any of the traditional audiometric measures by a wide margin (.73 versus .62). Statistical analysis further indicated that the SIN test could replace all of the standard audiometric tests in the evaluation of hearing of elderly listeners. Because the SIN test is so brief, given in five to seven minutes, and so easily administered, this test is ideal for mass screening of hearing among the elderly. PMID- 3557633 TI - The social context and resources of the unmarried in old age. AB - A model of singleness in later life was developed to show how the social context may influence the personal and social resources of older, unmarried persons. The unmarried (especially the divorced) will be an increasing proportion of the aged population in the future, and they will require more services than will the married. Role transitions of the unmarried over the life course, finances, health, and social relationships of older singles are discussed with implications for practice and future research. PMID- 3557634 TI - Aging and posture control: changes in sensory organization and muscular coordination. AB - The following study examined two aspects of balance control in the older adult: the coordination of the timing and the amplitude of muscle responses to postural perturbations, and the ability of the participant to reorganize sensory inputs and subsequently modify postural responses as a consequence of changing environmental conditions. Coordination of muscle activity in postural responses of twelve elderly (sixty-one to seventy-eight years) participants were compared to those of young (nineteen to thirty-eight years) adults using a movable platform and recording the electromyographic activity of muscles of the legs. The following changes were noted in the timing and amplitude of muscle activity within a postural response synergy: increases in the absolute latency of distal muscle responses were observed in all older adults; in five of the twelve older adults temporal reversals of proximal and distal muscle response onset were observed; and there was a breakdown in the correlation of the amplitude of responses within a synergy. The ability of the older adult to balance under conditions of reduced or conflicting sensory information was also impaired. When confronted with functionally inappropriate visual and/or somatosensory inputs, half of the older group lost balance. In most instances, however, the older participants were able to maintain stability during subsequent responses to conflicting stimuli. PMID- 3557635 TI - The construction of a day by elderly widowers. AB - The way in which some elderly widowers living alone experientially organize time can be viewed as on a continuum structured around the notion of a "day" as a central organizing focus. Related to this is the role of a "daily highlight" in organizing daily activities. The continuing role of bereavement, effects of living alone, and other factors may help structure this experiential continuum. PMID- 3557636 TI - The development of children's prejudice against the aged. AB - Children's prejudice against the aged was studied in terms of their responses to an attitude scale and measures of their social interaction with aged compared to nonaged confederates. Participants were 144 middle-class children, four, six, and eight years of age. Findings from the attitude scale indicated significant levels of ageist prejudice among six- and eight-year-olds but not in four-year-olds. Eight-year-olds had significantly higher prejudice scores than six-year-olds. There were six measures of participant interaction with aged compared to nonaged confederates: proxemic distance, productivity, eye-contact initiation, number of words spoken, number of conversation initiations, and number of verbal appeals. On all of these measures except productivity, participants in each age group showed significant levels of ageist prejudice. Ancillary findings indicated that, in general, participants were more prejudiced against women than against men. Attitude scores correlated significantly with some of the behavioral measures but not with all of them. PMID- 3557637 TI - Life expectancy of kibbutz members. AB - Data are presented demonstrating that the life expectancy (LE) of kibbutz members -both men and women--is higher than that of the overall Jewish population in Israel. Closer inspection of the death rates at various ages reveals that, from age thirty, those of kibbutz women are lower than those of the Jewish population. Although those of kibbutz men are actually higher until age forty-nine, nevertheless the LE of kibbutz members (based on death rates) surpasses that of Jews in Israel. These data add to and support other research findings illustrating the more positive mental health and well-being found among kibbutz members than among other comparative populations. Similarly, the factors contributing to kibbutz members' life expectancy evolve from this quality of life, especially as this quality of life affects old age. PMID- 3557638 TI - Service consciousness and service knowledge among older Americans. AB - This article explores statistical relationships between socioeconomic characteristics of elderly persons in a large region of California and their consciousness and knowledge of services available to them. Regression and probit estimation are used to analyze survey data. Service knowledge is a prerequisite to utilization or informal referrals and general consciousness of services increases the probability that older persons will search for services to meet their needs. Education, age, sex, rurality, and minority status are found to be associated with service consciousness and knowledge, although a number of other characteristics have significant associations for at most a few services. PMID- 3557639 TI - Aging widows and widowers: are there mental health differences? AB - Israeli Prime Minister Menachem Begin resigned shortly after the death of his wife. A classic portrait of the grieving widower, his despondency did not surprise mental health professionals. One psychiatrist explained that "Women take bereavement better than men because the widow keeps her domain" while the widower tends to become disoriented. This article examines the perception that men, specifically aging men, are more emotionally distressed than aging women by their spouse's death. A literature review reveals little evidence from behavioral or psychological studies to support the perception, along with mixed evidence of higher male mortality rates in some age groups. Data from a random probability community mental health survey are presented. Prevalence rates for the bereaved are significantly greater than are married rates for only one of the five measures of mental disorders. Widows report significantly more overall distress and depression, but these differences disappear when gender is examined, along with other sociodemographic variables in regression analyses. Clearly, these findings and those from studies of elders, do not support the perception that aging widowers experience more emotional problems during bereavement than do aging widows. Perceptions and mental health policies should be revised to reflect the reality of more similarities than differences among aging widows and widowers. PMID- 3557640 TI - The use of organizational strategies to improve memory for prose passages. AB - Previous studies have shown that incidental memory for the material increases when older adults are forced to analyze material to the extent necessary to impose an organizational structure. The present experiment sought to extend this finding by examining the effects of enforced organizational strategies on the memory of older adults for textual material. Young and old adults were required to sort the scrambled sentences of a prose passage into the correct order. A subsequent incidental memory test showed that, when older adults were required to make an in-depth analysis to sort the material, their incidental memory for the textual information was approximately equal to that of their younger counterparts. Additional analysis revealed that, although older adults spent more time sorting the material than did younger adults, it was only when required to analyze the material to a sufficient degree that the older adults showed any improvement in memory. PMID- 3557641 TI - Discourse performance in older adults. AB - Thirty-three elderly women, whose mean age was 76.2 years, and eighteen middle aged women, whose mean age was 45.6 years, were assessed on a number of linguistic discourse tasks. The women were well educated, and most of them were or had been engaged in the teaching profession. Each woman was given narrative discourse tasks involving recall of stories, summarizing stories, giving the morals of the stories, procedural discourse tasks, interview to assess cognitive functioning and communicative abilities, and the following cognitive tests: Block Design, Symbol-Digit, Raven Coloured Progressive Matrices, and Word Fluency. The findings were that the older group generally performed more poorly than did the middle-aged group on most of the discourse tasks and cognitive tests. Within the older group, measures of quality of discourse were generally negatively related to age and positively related to scores on cognitive tests. PMID- 3557642 TI - Successful career women at midlife: crises and transitions. AB - Recent theories and studies have gradually clarified some of the psychological processes of middle age. Most interesting are the contributions that maintain different developmental processes for women and men. Three of the major theories in the area seem to converge in proposing a process of gradual cross-sex transition in adulthood, the result of which may be a more integrated or androgynous personality structure in the second half of life. A different model of adult development, centered on midlife crisis, was proposed by Levinson et al. as a universal stage in men's life cycle. Similar theory and research about women are not as conclusive. The present study investigated in depth the life history of twenty-five American career women at midlife. Such women sociologically combine feminine and masculine roles and may be considered as a test case for the theories. The transitions experienced by these women during their lifetimes were categorized into "masculine" or "feminine" types. It was found that they were distributed about equally between the two types of transitions, thus excluding a simple biological approach. Acute midlife crisis was reported by only about a third of the sample. It is proposed that the double role protects these women from acute crisis. PMID- 3557643 TI - Food habits and future time: an exploratory study of age-appropriate food habits among the elderly. AB - This exploratory research effort examines future time perspective and its association with a behavioral change, i.e., food habits, among a sample of elderly persons. Demographic and social conditions under which a positive or negative future time may be associated with changes in food habits are explored. The findings suggest that the elderly do make changes in their food habits, and there is an association of positive or negative food habit changes with a positive or negative future time perspective. The future time perspective and the food habit changes are couched in certain types of demographic and social conditions such as with whom one lives, recent widowhood, health status, and sex. PMID- 3557644 TI - Correlates of life satisfaction for old Libyans compared with the judgments of Libyan youth. AB - Two hundred fifteen Libyans-106 young male and female undergraduate students and 109 aged male and female relatives--responded to a questionnaire designed to measure correlates of life satisfaction in old age. It was predicted that current cultural and social changes associated with the industrialization of Libya would result in significant differences in responses between young and old men and women. The young Libyan men rated close ties with their children, social relationships with individuals outside the family, and having basic physical needs met as more important than did the old Libyan men who considered social prestige, living with their spouse, and independence as more important for satisfaction in old age. The young Libyan women also considered social relationships outside the family and having basic physical needs met in old age as more important than did their older counterparts. Health and adequate living conditions were rated more highly by the young Libyan women than by the old. All participants rated social prestige equally high, but old women rated it higher than any other aspect except belief in God and self-understanding. Findings and implications for services to Libya's elderly are discussed. PMID- 3557645 TI - Interaction and well-being in old age: is it quantity or quality that counts? AB - This article explores the relationship between two dimensions of social interaction and well-being, controlling for the key antecedent variables of health and income. The two dimensions of interaction relate to the quantity and adequacy of social contact. Using more comprehensive indicators of social interaction than are generally available, the results indicate that it is the respondent's assessment of the adequacy of his or her social contact, rather than the amount of social contact per se, that is a critical determinant of well-being in old age. PMID- 3557646 TI - Loneliness and adjustment to old age. AB - Among two samples of older adults, loneliness (measured by the revised UCLA Loneliness Scale) was related to poor psychological adjustment, generally, and to dissatisfaction with family and social relationships. It was also related, however, to fears, expectations, and personality characteristics likely to inhibit the restoration of personal support networks after a stressful life event such as widowhood. Finally, loneliness was associated with maladaptive behavior patterns such as failure to: a) plan for old age, b) engage in rehearsal for widowhood, c) engage in social comparison, or d) learn about available community health and social services. PMID- 3557647 TI - A comparison of recruiting strategies for increasing older adults' initial entry and compliance in a memory training program. AB - Older adults in highrise buildings were recruited for memory training using positive ("build your memory power"), neutral ("learn memory skills"), or negative ("avoid memory failures") content approaches which were: printed on a poster mounted in a prominent place (CSA), presented orally at a building meeting (PC), and, finally, printed on flyers distributed to the residents (DC). There were more volunteers after PC with neutral or positive content, but the CSA respondents were more likely to complete the training. Negative content was most likely to attract persons concerned about age-related memory decline. The discussion focused on the appropriate recruitment methods for particular intervention programs. PMID- 3557648 TI - The age grading of physical activity among children. AB - To test the hypothesis that children view participation in physical activity as less appropriate among adults of increasing chronological age, pre-school children (N = 51 males; N = 51 females) were shown six facial pictures of two adults who had been aged fictitiously through make-up, and were asked to rate the competence of these adults on six physical activities. The most significant finding of the study was that these children's assessments of the competence of adult participation in physical activity was, to a large extent, dictated by their perceptions of the age of the adult. Adults perceived as more advanced in chronological age were viewed as less proficient at each physical activity. The children's chronological age, gender, or motor skill level did not interact with their responses to the pictures. PMID- 3557649 TI - Reminiscence intervention in nursing homes: what and who changes? AB - The results of experimental studies of reminiscing are not as uniformly optimistic about its therapeutic value as is the theoretical literature. Moreover, anecdotal evidence regarding the impact of reminiscence interventions is more positive than the statistical evidence. This study suggests reasons for these previous findings, and examines data from a discussion group intervention in thirty nursing homes, in which 185 residents completed pre- and posttests. It analyzes the characteristics of participants in relation to modifications in selected attitudes and behaviors over the intervention period. Analysis of variance and discriminant analysis revealed no significant relationships between attitudinal or behavioral modifications and demographic or other characteristics, with one exception. Value-choices made by participants were related to such modifications. The findings are interpreted in terms of the "mental adaptability" of participants and the compensatory nature of reminiscence in an institutional setting. PMID- 3557650 TI - Self-perceptions of aging across cultures: myth or reality? AB - This study attempted to correct the methodological shortcomings of previous studies by using semi-structured interviews to explore the differences and similarities of self-perceptions of aging and associated factors among Anglo Americans, Chinese Americans, and Chinese in Taiwan. Each of the three subgroups consisted of twenty middle- or lower-class female community residents who were sixty to seventy-five years of age. The results of both quantitative and qualitative analyses reveal that all three subgroups had positive self perceptions of aging, with Anglo Americans being most positive; Chinese Americans, the next; Chinese in Taiwan, the least. Correlates of self-perceptions of aging for each subgroup are presented. Implications for practice, policy, program development, and service delivery are also discussed. PMID- 3557651 TI - Rural/urban elderly and siblings: their value consensus. AB - Consensus is the level of agreement about life felt among kin and has been identified as a dimension of family solidarity with important implications for the family network. This investigation studied the factors contributing to the consensus between older adults (age sixty-five and older) and the sibling with whom they had the most contact. Respondents (N = 275) lived in a rural/urban area. Seven independent variables were entered into a multiple-regression model to determine their relative importance to consensus of the sibling relationship. Results showed that 7 percent of the variance in consensus could be explained. Filial expectations, educational disparity, and the brother/sister link were the only variables of relative importance to older adult/sibling consensus. There was greater consensus when there were fewer expectations of the sibling, similarity of educational backgrounds, and when the respondent was male and his sibling was female. Brother/sister and brother/brother links, residential proximity, communication by mail or telephone, helping behaviors, and marital status were of no relative importance to consensus. The results suggest that factors previously found to be associated with intergenerational consensus may vary in their importance to intragenerational consensus. PMID- 3557652 TI - Outdoor recreation participation across the lifespan: abandonment, continuity, or liberation? AB - The purpose of this study was to examine the extent to which outdoor recreation participation changes across the lifespan. Age differences and age changes in leisure involvement were examined within the framework of abandonment, liberation, and continuity. Personal interview data were gathered as part of the 1982-1983 Nationwide Recreation Survey (NRS). The NRS was conducted on a sample of individuals (N = 6720) twelve years of age or older in the non institutionalized United States population. The data indicated that neither the abandonment nor liberation perspective are accurate reflections of what happens with increasing age. In fact, there appears to be as much variation within age groups as across those groups. If any one pattern does occur more often than the other, it is continuity. There does, however, appear to be a perception of future abandonment among the oldest group of respondents. The findings of this study indicate variables other than age may account for expansion, contraction, and continuity across the lifespan. PMID- 3557653 TI - Biofiltration. Marrakech Symposium, November 1985. Proceedings. PMID- 3557654 TI - Biofiltration in chronic uremia: evaluation of long-term efficiency and hemodynamic tolerance with Swan-Ganz catheter. AB - Biochemical data and clinical tolerance were evaluated in eight uremic patients treated by Biofiltration (BF) for 5-20 months. In four patients hemodynamic parameters were monitored with a Swan-Ganz catheter during a session of BF. BF provides long-term biochemical safety and improved tolerance to fluid removal. PMID- 3557655 TI - Improvement of vascular instability after biofiltration and return to previous dialytic schedules. PMID- 3557656 TI - Biofiltration, a new method of short hemodiafiltration: preliminary report. AB - Four patients previously treated by traditional dialysis (HD, 240 min) were switched to biofiltration (BF, 180-210 min) and followed for twelve months. Before and at the end of this period, clinical and biochemical data were assessed for each patient. Patients treated for 180 min by BF presented no increase in BUN but a significant increase of predialytic phosphorus. The 210 min BF schedule achieved the same pattern of depuration as HD. Acidosis was corrected better in all patients during BF. No hypoxemia and no change of WBC count were observed during BF. Cardiac function, assessed by echocardiography, improved similarly with each session of both methods. BF is a useful alternative treatment procedure for patients with endstage renal failure. PMID- 3557657 TI - The optimal use of PAN membrane in RDT. AB - In order to compare the efficiency of PAN (Biospal 3000S) for small molecules, Cr, BUN, UA and Pi clearances were determined during hemodiafiltration with both pre and postdilution fluid (PreHDF, PostHDF) and during biofiltration in 3 regular dialysis treatment patients. The highest clearances were obtained during PostHDF. Therefore, since the small molecules are still considered the most important toxins in chronic renal failure, these findings indicate that optimal use of PAN is with PostHDF, in which high diffusion and convection are combined, in order to obtain best dialytic efficiency. PMID- 3557658 TI - Correction of uremic acid-base imbalance in biofiltration: standardization of the amount of bicarbonate infused. AB - Beneficial effects of biofiltration on acid-base balance have been described, especially in patients showing poor tolerance to standard hemodialysis. This study was designed to standardize the amounts of bicarbonate to be infused for optimal control of the acid-base balance, without the adverse reactions of symptomatic metabolic alkalosis. In three adult patients (body weight greater than 55 kg) a 300 mEq. bicarbonate infusion achieved normal pre- and post dialysis plasma levels of bicarbonate and normal pre- dialysis pH. Conversely, in three adolescent patients (body weight less than 40 kg) pre- dialysis plasma bicarbonate levels and pre- dialysis pH could not be adequately corrected in spite of increasingly high doses of bicarbonate infused up to a maximum of 240 mEq per treatment. Larger amounts brought on symptoms of metabolic alkalosis. PMID- 3557659 TI - Clearances and solutes extraction in biofiltration and hemodialysis with the AN 69 S. AB - Clearances and solutes extraction were assessed in biofiltration (BF) and in hemodialysis (HD) with the new polyacrylonitrile AN 69 S membrane. Three patients treated for three months by acetate dialysis (4 hours X 3) and subsequently by BF (3 hours X 3) were studied after achievement of steady state. Total intradepurative clearances (diffusive and convective) and solutes extraction of urea, creatinine, uric acid and phosphate were determined. Clearance of small molecular weight solutes was better in BF than in HD especially for uric acid and phosphate. This confirms the high depurative efficiency of the AN 69 S. BF gave better total clearances than HD, but the extraction of lower molecular weight solutes (due to the one-hour reduction of dialysis time) suggests that adequate treatment time is needed with this technique. PMID- 3557660 TI - Biofiltration in elderly uremic patients. AB - We treated five elderly patients with conventional hemodialysis (CH) or biofiltration (BF) to establish whether their dialytic tolerance was better. For three patients treatment time was reduced from twelve to nine hours a week; for the other two, treatment time remained unchanged (10.5-12 h/week) because of their high interdialytic weight gain. At the beginning and end of the study, clinical status, biochemical data, nutritional status and acid-base balance (ABB) were checked. Plasma levels of small molecules, potassium and phosphate were unchanged for all patients. All had a lower number of episodes or less severe hypotension and good control of ABB. No patients had metabolic alkalosis or worsened nutritional status. For all patients BF was an efficacious choice compared to CH, giving them good health. PMID- 3557661 TI - Biofiltration: an effective and simple method to reduce dialysis time. AB - Biofiltration: an effective and simple method to reduce dialysis time. Six stable anuric patients, on maintenance hemodialysis, were treated for 10 weeks with a parallel flow 1 m2 cuprophan filter, for 20 weeks with a parallel flow 1.2 m2 polyacrylonitrile filter using the biofiltration (BF) technique and again 10 weeks with the cuprophan filter. Usual monitors were used, without automatic control of ultrafiltration. Biochemical and hematological profile, urea kinetic parameters, incidence of hypotensive episodes, body weight and blood pressure did not change throughout the study. We conclude that three hours of BF, at least for 20 weeks, are as effective and well tolerated as four hours standard hemodialysis and could be of value in reducing dialysis time, to permit better utilization of dialysis beds. PMID- 3557662 TI - Clinical status and acid-base balance during biofiltration in patients with acetate dialysis intolerance. AB - Nine patients intolerant to acetate hemodialysis were treated with biofiltration. This consisted in a 4-h acetate hemodialysis during which an additional 2 liters of ultrafiltrate were replaced by a bicarbonate solution (100 mEq/l). Hypotensive episodes disappeared and six out of nine patients were symptom-free during the session. Compared to standard hemodialysis, arterial blood bicarbonate and pO2 did not drop during biofiltration. The anion gap did not change during standard hemodialysis, but was significantly reduced during biofiltration (24.5 +/- 2.9 vs 19.9 +/- 1.4 mEq/l). In our conditions clinical results were positive with biofiltration. On the basis of anion gap changes and preliminary results of plasma acetate determinations, it is suggested that a better cellular metabolism of acetate may be induced by bicarbonate infusion. PMID- 3557663 TI - Acid-base balance during biofiltration (BF). AB - Acid base balance during biofiltration (BF): Six patients on standard acetate hemodialysis (HD) were switched to BF with 1 m2 AN69-S membrane, 12 hours weekly (BF-4h) and, later on, to a stage with 1.2 m2 AN69-S, 9 hours weekly (BF-3h). During BF, in order not to exceed 25 mEq/l in intradialytic arterial HCO3, arterial acid-base was examined hourly and a mean of 178 and 199 mEq of HCO3 respectively were infused in BF-4h and BF-3h. We obtained a better control of acidosis with a reduction of the intradialytic pCO2 decrease and hypoxemia. The amount of HCO3 infused was related to the patients deficit in HCO3 total pool and therefore it can be predicted, to avoid postdialytic alkalosis. PMID- 3557664 TI - Biofiltration vs. bicarbonate dialysis: influence on plasma volume changes and extravascular fluid mobilization. AB - The present study compares the effects of bicarbonate hemodialysis (Bic. HD) and biofiltration (BF), a new hemodiafiltration technique, on plasma volume (PV) changes and extravascular fluid mobilization (Vfm). Ten uremic patients underwent one experimental session of Bic. HD and, one week later, one of BF, both on the second dialysis of the week. Net ultrafiltration rate was limited to 700 ml/min. At the start of each session, whole blood volume (WBV), PV and red cell volume (RCV) were determined using 5 mu Ci of radioiodinated serum albumin (RISA). PV and Vfm were calculated at hourly intervals using a serial hematocrit method. On Bic. HD, PV increased at 60 min. then decreased at 120 and 180 min., with efficient Vfm only during the first hour. On BF, PV increased throughout treatment, with greater Vfm. It would appear that PV is better preserved in BF, on account of more efficient Vfm. PMID- 3557665 TI - The clinical evaluation of biofiltration. AB - The clinical evaluation of biofiltration. The authors have studied the effectiveness of biofiltration (BF) in patients with terminal renal failure. They did not find any reduction in the number of hypotensive episodes during BF. The reduced length of the dialysis procedure made possible by BF is suitable for some patients. Subjective feeling during the interdialysis period was better under treatment with BF than under conventional hemodialysis. PMID- 3557666 TI - Ionized calcium/total calcium ratio during biofiltration. AB - The transmembrane transfer of calcium during hemodialysis is related to many factors (calcium gradient, plasma volume flow, plasma concentration of phosphate). During biofiltration the high ultrafiltration rate reduces the net transfer of calcium from dialysate to patient. Prolonged metabolic alkalosis occurs during biofiltration, lowering the ionized calcium/total calcium ratio. These two factors may stimulate PTH secretion, with negative long-term effects in dialysis bone disease. PMID- 3557667 TI - Effects of biofiltration versus hemofiltration in the treatment of chronic uremia. AB - Biofiltration (BF), a new depurative hemo-diafiltration employing a high efficiency membrane (acrylonitrile and metallylsulphonate of sodium) and reinfusion of 8-9 liters of fluid was tested as an alternative method to hemofiltration (HF). Sixteen uremic patients who showed circulatory instabilities during traditional hemodialysis (HD) were treated with HF (27 liters infused in postdilution), or BF (210 min/session) for 12 months. Low and middle molecular weight metabolites weekly clearances, calcium, phosphorus and bicarbonate serum levels in BF and HF showed no significant differences: in BF the incidence of symptomatic hypotension events and orthostatic changes of mean blood pressure were lower than in HD, but a little higher than in HF. Our results show that BF achieves satisfactory depuration of low and middle molecular weight metabolites in a shorter time than HF and an improvement of autonomic nervous system abnormalities is observed. PMID- 3557668 TI - Puglia cooperative study on biofiltration. AB - Biofiltration (BF) was performed on 60 patients from 12 dialytic centers in Puglia. The protocol was 9-10.5 hours a week with 1.2 m2 PAN dialyzers. A dialysate with 140 Na+, 2-2.5 K+, 3.5-4 Ca++, 38 mEq/l acetate was used in 49 patients; the acetate was replaced by bicarbonate (35-40 mEq/l) in 11 patients. The same patients were treated for 1 year with standard acetate dialysis (49 patients) and standard bicarbonate dialysis (11 patients). The two protocols were compared on the basis of the clinical state, BUN and serum creatinine, acid-base balance, PTH, anemia, and nerve conduction velocity (NCV). Favourable effects were achieved in 55 patients. Four patients left the program because of progressive hyperhydration. BUN and serum creatinine levels showed a moderate, but insignificant increase. PTH, anemia and NCV did not worsen. BF gave better correction of metabolic acidosis in the patients undergoing acetate dialysis. PMID- 3557670 TI - Removal of phosphate (Pi) by either bicarbonate dialysis or biofiltration in uremics. AB - The kinetics of extra and intracellular red blood cell (RBC) Pi and its removal by different therapeutic modalities were evaluated in 30 uremic patients over a 6 mo. period. Acetate hemodialysis alone, combined with hemoperfusion, or associated once a week with plasma-perfusion sessions using an activated bauxite cartridge, bicarbonate dialysis either in single pass or in recirculating system (40 L) and biofiltration, were the depurative treatments employed. The treatments with acetate buffer showed a temporary intracellular shift of Pi at the end of the sessions with post-dialytic plasma Pi rebound. This was not evident with bicarbonate buffer and biofiltration where acidosis was corrected better, and similarly during plasma perfusion treatment because blood pH remained unchanged. These findings may explain the better plasma Pi level at the end of our study with these later therapeutic models compared to acetate dialysis alone or combined with hemoperfusion. In these conditions Pi removal is limited by the correction of acidosis which implies acetate metabolism with ATP activation leading to a transient Pi intracellular influx and a subsequent efflux into the extracellular compartment. PMID- 3557669 TI - Is 3000 S Hospal a suitable dialyzer to shorten dialysis time schedule? A cooperative study on biofiltration. AB - The Biofilter 3000 S Hospal may combine higher convective clearance rates (Cc) with usual diffusive clearance rates (Cd) (i.e. similar to Cuprophan dialyzers), giving a higher total clearance rate (Ct) of small and middle molecules. Use of the Biofilter has been suggested to shorten dialysis time schedules. This study was carried out in 8 patients on RDT 3 times weekly, by cuprophan filter and acetate dialysis. The patients were shifted to dialysis with 3000 S guided by two principles: to shorten dialysis time by 1 hour per session, and to reinfuse 6 liters of bicarbonate-saline solution (40 mEq/l) per single dialysis. Besides the usual clinical and laboratory controls, in three patients clearance studies were carried out during four different dialysis sessions: Ct, Cc and Cd of urea K+, creatinine, uric acid and phosphate were measured. No change was observed in the main clinical and laboratory parameters after 3-5 months (average 3.9) of treatment with Biofilter 3000 S; in addition, serum alkaline phosphatase concentration decreased progressively. Clearance results, however, indicate that the expected high values of Ct do not occur, because Cd decreases as Cc is increased. A primary goal of research in hemodialysis is to reduce the average time of treatment while ensuring simultaneously "physiological" dialysis. A possible approach to this problem is to use dialyzers with highly permeable and biocompatible membranes such as the "biofilter" 3000 S Hospal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557671 TI - Clinical evaluation of biofiltration in uremic patients undergoing chronic hemodialysis. AB - The clinical efficiency of biofiltration (BF) was evaluated in six hemodialysis patients with poor clinical tolerance for standard hemodialysis. Three were adults (mean age 34 years, mean body weight 67 kg) and three adolescents (mean age 17 years, mean body weight 38 kg). Mean maintenance hemodialysis time was 90.5 months (range 49-132). BF treatments lasted three hours in all cases, for a total of nine hours weekly, with AN69 S membranes and infusion of 3 liters of HCO3 solution (100 mEq/l for the adults, 80 mEq/l for the adolescents). We recorded intra- and inter-dialytic symptoms daily, hematological values and acid base status monthly. Multimodality evoked potentials were recorded after 3 and 9 months. Biochemical values reached a steady state 9 months from the beginning of the study, metabolic acidosis was corrected more efficiently in both groups at the end of dialysis, but only in the adult patients, were pre-dialysis plasma bicarbonates within normal limits. A clear drop in the number of episodes of intradialytic hypotension was noticed in both groups, but the adolescent patients' tolerance for dialysis did not improve. In conclusion our data show that in adult patients with poor tolerance BF offers a dependable alternative to standard hemodialysis, and the length of treatment can be reduced. PMID- 3557672 TI - Soft and hard hemodiafiltration (HDF). AB - Soft and Hard Hemodiafiltration (HDF). A 32-month study was made to assess efficiency and clinical tolerance in a comparison between "soft" and "hard" HDF. Soft HDF was performed in 18 patients using a polyacrylonitrile AN 69 S 1.2m2 membrane and hard HDF in 12 patients using a polyacrylonitrile hollow-fibre 1.8m2 membrane. Different technical parameters were used for each of the two methods. Biochemical data registered during a single session showed the efficiency of both kinds of treatment and in this study clinical tolerance and patient well-being were significantly better than with hemodialysis. Hard HDF permits considerable shortening of treatment time. PMID- 3557673 TI - Biofiltration and calcium-phosphate metabolism. AB - We evaluated the effect of one session of biofiltration on calcium-phosphate metabolism in four uremic patients and compared the results with those of a previous traditional hemodialysis (Cuprophane membrane) session, on the same subjects. The most noteworthy results were: both total and ionized plasma calcium rose less in biofiltration; phosphate clearance and parathyroid hormone clearance were higher in biofiltration; plasma 25-OH D did not change in either dialysis technique. PMID- 3557674 TI - The acid-base balance and the electroencephalographic pattern in patients on biofiltration treatment. AB - Electroencephalogram (EEG) monitoring and arterial blood gases was performed during biofiltration (BF) treatment and during conventional acetate hemodialysis (HDA). Biofiltration is an ultrashort hemodiafiltration with 3 liters of substitution fluid (Na+ 145 mEq/l, HCO-3 100 mEq/l). Our data show a better correction of acid-base balance during BF than during HDA. Moreover, we observe a lower incidence of EEG disturbancies on BF, that suggests a better neurological tolerance of this treatment. PMID- 3557675 TI - The new AN69 membrane in biofiltration (BF): 18 month's follow-up. AB - BF is a dialytic procedure employing the new AN69 polyacrylonitrile membrane, which is more permeable to both water and solutes than the traditional AN69. A postdilutional bicarbonate infusion is necessary in BF. The treatment time is 3 hours. Six patients, previously on regular acetate (HD) or bicarbonate dialysis (BHD) with AN69 were treated for 18 months with BF. Biochemical and hematological parameters (BUN, creatinine, uric acid, CA, P, K, Na, blood pH, HCO3, hematocrit) and clinical signs were evaluated in BF, and compared to those of HD and BHD. An improvement in biochemical and hematological parameters accompanied by better clinical signs was seen in BF as compared to HD and BHD. In our opinion this is due both to better removal of small and middle molecules and the bicarbonate infusion, and to the shorter dialytic session. PMID- 3557676 TI - Hemorheology in biofiltration and acetate dialysis (preliminary results). AB - Hemorheological measurements were made in 8 stable chronic haemodialysis patients observed in conventional acetate dialysis (AD) with Cuprophan membrane and then in biofiltration (BF) with PAN AN69S membrane. Blood viscosity diminished at the beginning, both during BF and AD, reaching pre-dialytic values again at the end of treatment. Blood and erythrocyte filtration increased after 20 min in AD and throughout the session in BF. Preliminary results suggest an improvement of hemorheological parameters during dialytic treatment, more notable in BF than in AD. PMID- 3557677 TI - Efficacy of biofiltration for intradialytic hypotension. AB - Biofiltration, a simplified variant of hemodiafiltration, relieved intradialytic hypotension and acidosis in three patients previously on conventional hemodialysis. PMID- 3557678 TI - Oxalate depuration during biofiltration with AN69 and in conventional hemodialysis in chronic renal failure (CRF) patients. AB - Oxalate (Ox), an end product of amino acid metabolism, accumulates in CRF patients as calcium crystal deposits in many soft tissues such as myocardium, kidney interstitium, etc. Since BF employs AN69, a high efficiency membrane, we tested its depurative efficacy for Ox against a hollow-fiber cuprophan dialyzer. Five CRF patients previously in HD and after six months of BF were studied. End dialysis and pre-dialysis Ox values and dialyzer clearance were obtained. Predialysis Ox values were: 0.44 +/- 0.15 mg/dl in HD and 0.42 +/- 0.09 mg/dl in BF (NS). End-dialysis Ox values were: 0.30 +/- 0.09 mg/dl in HD and 0.22 +/- 0.04 mg/dl in BF (p less than 0.001). Pre and post dialysis values differed by 31% in HD and 47% in BF (p less than 0.001). Ox clearance was 98.8 +/- 10.3 ml/min in HD and 143 +/- 20.5 ml/min in BF. There was a rebound in Ox values at 48 hours (0.41 +/- 0.08 mg/dl in HD and 0.32 +/- 0.12 mg/dl in BF, (NS). These results indicate that Ox is depurated better during BF than during HD. PMID- 3557680 TI - Results of six months' biofiltration in six selected cases. AB - Results of six months' biofiltration in six selected cases. Biofiltration is a method by which haemodialytic treatment can be completed within three hours and acidosis is corrected in a shorter time than with bicarbonate dialysis. In six selected patients with different syndromes not one patient showed a symptom of insufficient dialysis. In one patient serious hypertension was resolved satisfactorily. PMID- 3557679 TI - Use of the AN69-S (Biospal) in conventional hemodialysis (HD) and in biofiltration (BF). AB - The authors report the results of a comparative study between biofiltration and conventional hemodialysis with cuprophan and AN69-S hemodialyzers. Using AN69-S in conventional hemodialysis and in biofiltration, there was an almost total absence of cramps, headache, nausea, vomiting and symptomatic hypotension even though map and DBW were reduced. PMID- 3557681 TI - Biofiltration: 58 months of experience. PMID- 3557682 TI - L-ascorbatemia during biofiltration. AB - In a study of the intradialytic behaviour of l-ascorbatemia during acetate and bicarbonate dialysis we noted the paradoxical increase in l-ascorbatemia during the first hour of acetate dialysis. During biofiltration, the intradialytic curve of l-ascorbatemia is similar to that in bicarbonate dialysis, even though an acetate dialysis bath is used. Thus the paradoxical rise of l-ascorbatemia during acetate dialysis may be due to the relative acidosis of the first hour. PMID- 3557683 TI - Evaluation of biofiltration in uremic children. PMID- 3557684 TI - Biofiltration with buffer-free dialysate. AB - The presence of acetate in the dialysate appears to be superfluous in the new depurative technique indicated as biofiltration, which consists in a standard hemodialysis with high ultrafiltration combined with the reinfusion of 3-4 1/2 liters of solution containing bicarbonate. The presence of acetate could in fact be contraindicated by a number of potential side effects, metabolic, cardiovascular and biological. Hence, starting from the consideration that in standard biofiltration a buffer is already infused directly as bicarbonate, we tried to overcome the potential hazards of the acetate-containing bath simply by using a dialysate without acetate and by increasing the concentration of bicarbonate in the reinfusate. A cumulative clinical experience of 20 months in 4 patients proved the feasibility and safety of the technique and suggests further advantages over standard biofiltration (better control of acid-base equilibrium, better cardiovascular stability. PMID- 3557685 TI - Acetate in predilution in bicarbonate. AB - Acetate in predilution in bicarbonate dialysis with AN69 S. The purpose of this work was to assess whether bicarbonate dialysis, with infusion of acetate in predilution, using an AN69-S filter, offered some advantage over bicarbonate and acetate dialysis. In a period of 16 months we analysed 11 patients with this method, comparing them with one group of 7 patients in bicarbonate dialysis and another of 11 in acetate dialysis. The following parameters were investigated: acid-basic balance, HCT, weight and the intradialytic symptoms. There was some improvement in both objective and subjective parameters in patients treated by this method compared to patients in the control groups and the results were lasting. PMID- 3557687 TI - Computing with light. PMID- 3557686 TI - Short-term plasma phosphate behaviour in biofiltration. PMID- 3557688 TI - The use of a multi-channel Kalman filter algorithm in structural analysis of the epileptic EEG. AB - An extension of the Kalman filter algorithm to the multi-channel case is presented and its application as a segmenting procedure in the analysis of the epileptic EEG is discussed. An analytical example of structural analysis, using the segments extracted by the proposed filter, is presented for a particular set of 4-channel EEG recordings. This analysis is shown to be especially fruitful if the autoregressive coefficients - a byproduct of the filtering procedure - are used to estimate the information flow between the channels by the calculation of partial as well as directed coherences for the representative segments. PMID- 3557689 TI - A four compartment model to study the kinetics of strontium metabolism in man. AB - Many drugs confer upon the body the characteristics of a four compartment model. This paper deals with the estimation of pharmacokinetic parameters of a four compartment model to study the distribution of strontium in the organism. The central compartment (where the introduction of the material takes place) is connected to two other compartments (which represent the organic fluids) and one of them is connected to the fourth compartment (which represents the fraction that can be exchanged in the bone). The elimination from the central compartment is through urine and the elimination from the third compartment is in the form of a non-exchangeable deposit. The method of solution involves an optimization method which provides the global minimum of delta, a single variable function. The model is tested for different sets of data and the results are compared with those obtained by the generalized least square method. PMID- 3557690 TI - A four compartment linear mammillary model. AB - Studies are made for a four compartment model in which the central compartment is connected reversibly to three other compartments and the elimination occurs from the central compartment only. Identification of different distribution rate constants is made, with concentrations of drug in the central compartment at different times of observation being known. The solution depends on an optimization method in which the different unknowns are reduced to single variable with the help of Archimedes spiral. Thus, the solution requires the global minimum of a functional of single variable. Results are compared with those obtained by the generalized least square method. PMID- 3557691 TI - Implants in the cochlea of deaf. PMID- 3557692 TI - The biological foundation of the Gompertz model. AB - The paper examines the biological reasoning of the Gompertz model for tumor growth: the increase and loss rates of the tumor volume are both proportional to the volume itself. The statement is proved mathematically. The theoretical foundation is therefore established, this ensures the application of the Gompertz model as an effective aid for the understanding of the experimental and clinical tumor process. PMID- 3557693 TI - Obtaining more from the laboratory computer. PMID- 3557694 TI - A study on the best order for autoregressive EEG modelling. AB - The autoregressive (AR) model is a widely used tool in electroencephalogram (EEG) analysis. The dependence of the AR model on both the segment length and several characteristic EEG patterns is addressed. The best AR model order is computed with three different criteria. The results show that the Rissanen criteria provides the more consistent order estimate for the EEG patterns considered. This study shows that for our data set, a 5th order AR model represents adequately 1- or 2-s EEG segments with the exception of featureless background, where higher order models are necessary. PMID- 3557696 TI - Variable heart rate pacemaker. PMID- 3557695 TI - Heart rate variability signal processing: a quantitative approach as an aid to diagnosis in cardiovascular pathologies. AB - The heart rate variability (HRV) signal carries important information about the systems controlling heat rate and blood pressure, mainly elicited by autonomic nervous system (sympathetic and parasympathetic) controls. The present paper illustrates methods of HRV signal processing by using autoregressive (AR) modeling and power spectral density estimate. The information enhanced in this way seems to be particularly sensitive in discriminating various cardiovascular pathologies (hypertension, myocardial infarction, diabetic neuropathy, etc.). This method provides a simple non-invasive analysis, based on the processing of spontaneous oscillations in heart rate. Particular emphasis is directed to the algorithms used and to their direct application by using proper computerized techniques: only a few paradigmatical examples will be illustrated as preliminary results. PMID- 3557697 TI - Identification of cellular and subcellular features by means of digital microscopy. AB - This paper presents two examples of the application of quantitative digital microscopy to two different fields of biological analysis: DNA content determination in microstructures and the study of the behaviour of microorganisms. In both cases the application of segmentation and labelling procedures was found to be essential in order to obtain the desired results, because it made it possible to overcome the measurement limits of traditional instrumentation and to obviate drawbacks normally present when analysis is placed in the hands of the human operator. PMID- 3557698 TI - Filter transient response to EEG waveforms. AB - The response of two types of linear filters to sinusoidal bursts was calculated to demonstrate how filters can distort EEG waveforms. Results show that the wider the filter bandwidth the less is the distortion, and for a given bandwidth, the higher the filter order the greater the distortion. The response of a linear phase filter was also calculated to demonstrate that this type of filter can also cause waveform distortion, although it is normally less than that caused by Butterworth, Tchebychev and elliptic filters. PMID- 3557699 TI - LILLY--a linear least squares curve fitting program for one independent variable. AB - A program was written to perform a linear least squares curve fitting on data. It includes facilities to report the usual statistics and digital plotter output. Seven types of curves are available for fitting the data. Other features of LILLY include provision of facilities for the selection of subsets in different symbols and separate curve fitting for these subsets. The program also provides a confidence region about the fitted line and the prediction interval for data points. Examples of the use of the program are described. PMID- 3557700 TI - Simulations of steady quaternary gas diffusion between alveolar and blood compartments. AB - Fick's law is usually employed to analyze diffusion phenomena in the lung. However, this law is only strictly applicable to two component mixtures. When there are more than two gases in the mixture. Stefan's equations are more appropriate. Under physiological conditions during respiration, at least three gases are involved (O2, CO2, N2). Furthermore, helium is often added in studies on the effect of density on pulmonary mixing. Features of quaternary gas diffusion (O2, CO2, N2, He), and computer simulations of physiologically relevant conditions are presented. The results of the simulations were found to be in agreement with results from studies on normal and disease lungs. PMID- 3557701 TI - Use of oral contraceptives and risk of invasive cervical cancer in previously screened women. AB - Within the context of a larger hospital-based case-control study carried out to assess the efficacy of cervical cancer screening, the possible association between oral contraceptives and risk of invasive cervical cancer has been studied as well. Because in the GDR cytological screening is an integral part of the gynaecological basic care, only a few women reported oral contraceptive use but had no Pap-smears in that study. Thus, the analysis was confined to those 129 cases and 275 controls who had at least one screening Pap-smear in their history and were below the age 55. The significantly increased relative risks for users decreased after adjustment for factors of sexual behaviour and interval since last Pap-smear but remained statistically significant or at borderline significance for some categories of usage. This concerns, in particular, long term use (7+ years) and early onset of use (less than or equal to 24 years) with relative risks of 1.8 and 3.0, respectively. PMID- 3557702 TI - Comparison of circulating MAM-6 and CEA levels and correlation with the estrogen receptor in patients with breast cancer. AB - MAM-6 and CEA serum levels of 136 staged breast cancer patients were determined concomitantly. The sensitivities of the MAM-6 assay using monoclonal antibody (MAb) 115D8 and a polyclonal CEA assay were equally low and only a limited number of patients with early stages of breast cancer showed elevated antigen levels. However, the sensitivity rose to 75% for MAM-6 and to 60% for CEA in stage-IV patients. The levels of both antigens correlated well in the sera of these patients, although MAM-6 serum levels were elevated more frequently, while only in a few cases were MAM-6-negative sera CEA-positive. A group of stage-II breast cancer patients who eventually developed distant metastases was followed in a longitudinal study. Tumor progression or regression was clinically determined and compared with the MAM-6 and CEA serum levels in order to establish the value of each assay for the monitoring of breast cancer. The course of the disease correlated significantly better with changes in MAM-6 antigen levels than with changes in CEA levels (p less than 0.05), being 79% and 42% respectively. The lower correlation of CEA levels with the course of the disease was mainly due to a lower sensitivity of the CEA assay for advanced breast cancer. The specificity of changing MAM-6 and CEA levels was not significantly different. The main advantage of the MAM-6 assay over the CEA assay is the higher sensitivity of the former. In a preliminary study among stage-IV patients a correlation was found between elevated MAM-6 levels and the presence of the estrogen receptor in the primary tumor. PMID- 3557703 TI - Analysis of the results of the micronucleus test in patients presenting upper digestive tract cancers and in non-cancerous subjects. AB - A micronucleus test was performed on 75 subjects of whom 38 presented with cancer of the upper digestive tract and 37 were free of disease; the absence of cancerous or pre-cancerous lesions in this latter group was confirmed by endoscopy and vital staining. The daily levels of alcohol and tobacco consumption of the 75 subjects were determined by precise questioning: 78% of the non cancerous subjects smoked less than 10 g of tobacco per day whereas 79% of the cancer patients smoked 10 g or more daily. The alcohol intake of 78% of the non cancerous subjects and 63% of the cancer patients was less than 101 ml per day. Only 10% of the cancer patients had combined daily intake levels corresponding to the threshold of sensitivity of the micronucleus test as defined by previous studies. The mean frequency of micronucleated buccal cells was 0.26% in the cancer patients and 0.13% in the non-cancerous subjects. All non-cancerous patients presented a negative test. Only 5% of the cancer patients presented a micronucleated cell frequency above 1% and could thus be considered as positive. It thus appears that the micronucleus test was not significantly positive in our population of 38 cancer patients. PMID- 3557705 TI - Dissociation between thromboxane generation and metastatic potential in cells from a murine fibrosarcoma. Studies with a selective thromboxane synthase inhibitor. AB - Since the highly metastatic variant M4 of the mFS6 fibrosarcoma has the peculiar feature of generating larger amounts of immunoreactive thromboxane B2 (TxB2) than the non-metastatic variant (M9), we used the thromboxane synthase inhibitor dazmegrel (UK-38,485) in an effort to influence its metastatic potential. TxB2 formation by tumor cells freshly harvested from the primary tumor could be completely inhibited by drug addition in vitro. TxB2 generation was inhibited with a dose-response curve, 2 microM being the lowest dazmegrel concentration giving 100% inhibition. Chronic treatment of tumor-bearing mice with dazmegrel (150 mg/kg b.w. twice daily by gavage) from the day of tumor-cell implantation until killing of the animals caused a more than 10-fold reduction in serum TxB2 formation; TxB2 generation by tumor cells was also significantly depressed. This treatment, however, did not significantly modify either primary tumor weight or metastasis formation. Our data suggest that selective inhibition of thromboxane generation in either blood or tumor cells does not prevent spontaneous metastasis formation in the murine model studied. PMID- 3557704 TI - Evaluation of monoclonal antibodies for the detection of exfoliative nasopharyngeal carcinoma cells. AB - Exfoliative cells were aspirated from 15 patients suspected of having nasopharyngeal carcinoma (NPC) and showing the presence of lesions or other abnormalities in the nasopharynx. They were tested for binding with a 125I monoclonal antibody (MAb) (MA6) which is selectively reactive against human B lymphocytes and a variety of carcinomas. A positive result was obtained from 6/9 patients with, and from 0/5 patients without, histologically confirmed disease. One patient with eskimoma also gave a negative binding result. Cytology was specific but less sensitive, tumour cells being detected in 3 of the patients with confirmed disease. Immunocytology using MA6 was limited, like cytology, by poor recovery of the tumour cells and the results were in complete concordance with cytology. The other MAbs used were raised against carcinoembryonic antigen (CEA) and a carcinoma cell line (Ca2), respectively. The latter was not reactive against the NPC tumour cells while the CEA antibody was not sufficiently selective to be useful. PMID- 3557706 TI - New reviewers--fresh air or hot air? PMID- 3557707 TI - Estimating operative risk, 1917 to 1987--plus ca change, plus c'est la meme chose. PMID- 3557708 TI - Severe isolated tricuspid insufficiency in coronary artery disease. AB - We describe 3 patients who presented with severe cardiac disability as a result of tricuspid insufficiency, in the setting of severe coronary disease. Pertinent physical findings were signs of right heart failure, a tricuspid regurgitant murmur, and absence of left heart failure. Echocardiography and subsequent cardiac catheterization demonstrated significant tricuspid insufficiency, dilated right ventricle, impairment of right ventricular function, and preserved left ventricular function. Two patients were treated successfully with DeVega annuloplasty. Symptomatic tricuspid insufficiency can be seen in the setting of coronary artery disease and, when left ventricular function is well preserved, surgical correction is feasible. PMID- 3557709 TI - Acute hemodynamic response to the S2-serotonergic receptor antagonist, ketanserin, in patients with primary pulmonary hypertension. AB - The acute hemodynamic effect of intravenous ketanserin, an S2-serotonergic receptor antagonist, was evaluated during right heart catheterization in 20 patients with primary pulmonary hypertension. Pulmonary and systemic vascular resistance and pressure and cardiac output were measured before and after infusion of low and high dose ketanserin. A small decrease in pulmonary vascular resistance occurred after high dose drug infusion (28.4 to 25.0 U X m2; P less than 0.001), and mean pulmonary arterial pressure was unchanged. Decreases in systemic arterial pressure (91.9 to 85.9 mm Hg; P less than 0.0005) and systemic resistance (46.2 to 38.6 U X m2; P less than 0.001) were more pronounced. Cardiac index increased significantly (2.16 to 2.42 l/min/m2; P less than 0.01) due to reduced ventricular afterload. This study indicates that ketanserin has a small pulmonary vasodilating effect in primary pulmonary hypertension of doubtful clinical significance, similar to conventional vasodilators. PMID- 3557710 TI - Diameters of the orifices of the aorta and pulmonary trunk in normal children--an angiocardiographic study. AB - The diameters of the orifices of the pulmonary trunk and aorta were measured from cineangiocardiographic films in 35 children (mean age 7 years and 6 months, mean height 124.3 cm) without heart disease. Measurements were obtained in the lateral projection in early systole. Calipers and a micrometer were used and the values were expressed to the nearest 0.5 mm. The measured size of the intracardiac catheter was used for calibration. The mean ratio of the squared diameters of the orifices was 1.22:1 (SD 0.17). The diameter of the orifice of the pulmonary trunk/100 cm of body height (14.0 +/- 2.0 mm) was greater than that of the aortic (12.7 +/- 2.0 mm) (P less than 0.01). Significant linear correlation was found between the diameter of the orifice of the pulmonary trunk and body height (r = 0.71, P less than 0.001), weight (r = 0.67, P less than 0.001), and surface area (r = 0.70, P less than 0.001). Similar correlations were found for measurements of the aortic orifice and body height (r = 0.70, P less than 0.001), weight (r = 0.71, P less than 0.001), and surface area (r = 0.71, P less than 0.001), and between the diameters of the two orifices themselves (r = 0.91, P less than 0.001). Body weight is more affected than body height in various types of congenital heart disease. The relationship of the sizes of the orifices of the pulmonary trunk and aorta to body height may therefore be more applicable than their relation to body weight and surface area. PMID- 3557711 TI - Effects of verapamil and nifedipine on rate of left ventricular relaxation in coronary arterial disease patients. AB - We have evaluated the effects of nifedipine and verapamil on rate of left ventricular relaxation in 26 patients having coronary arterial disease with normal ejection fraction and normal left ventricular contractility. None of the patients had myocardial infarction. All patients showed normal contractile indices and abnormally high values of T constant, neg, dP/dt and left ventricular protodiastolic pressure, suggesting an impairment of left ventricular relaxation. Nifedipine, injected intravenously (15 micrograms/kg) in 14 patients induced a significant reduction of afterload parameters and an increase of contractility. Nifedipine also improved left ventricular relaxation, as it induced a reduction of the T constant from 42 +/- 2 msec to 33 +/- 2 msec (P less than 0.01). It induced a tendency to a reduction of negative dP/dt and protodiastolic pressure without reaching statistical significance. Verapamil, injected intravenously in the remaining 12 patients (0.1 mg/kg as a bolus followed by chronic infusion of 0.005 mg/kg/min for 3 min) induced a reduction of the T constant from 43 +/- 10 to 37 +/- 6 msec (P less than 0.01). It reduced the negativity of dP/dt from 2302 +/- 273 to 2021 +/- 252 mm Hg/sec (P less than 0.05) and of left ventricular protodiastolic pressure from 3.2 +/- 1.4 to 1.5 +/- 1.1 mm Hg (P less than 0.01). Verapamil, like nifedipine, reduced the afterload parameters although to a lesser extent. It did not substantially affect the left ventricular contractility. These data suggest that abnormalities of left ventricular relaxation may precede changes in systolic function and that nifedipine and verapamil favourably modify the indices of left ventricular diastolic function in patients with coronary arterial disease. PMID- 3557712 TI - Effects of the bradycardic agent UL-FS 49 on exercise-induced regional contractile dysfunction in dogs. AB - The effects of the bradycardic agent UL-FS 49 on hemodynamic and segmental parameters were studied in a canine model of exercise-induced myocardial dysfunction which mimics exercise-induced angina pectoris. Ten dogs, trained to subunit to five treadmill exercise cycles consisting of 4 min of running and 11 min of recovery, were chronically instrumented with a microtip manometer in the left ventricle, two pairs of crystals for sonomicrometry, a hydraulic occluder around the circumflex branch of the left coronary artery and arterial and venous catheters. Control experiments with coronary stenosis clarified the reproducibility of exercise-induced regional contractile dysfunction and recovery of function in the intervening resting periods. In each individual dog, a similar degree of stenosis was used in the subsequent experiments with UL-FS 49. After two control runs, which exhibited regional contractile dysfunction of comparable magnitude, UL-FS 49 was administered intravenously at a dosage of 0.5 mg/kg/5 min (6 dogs) or 0.25 mg/kg/5 min (4 dogs). Both doses of UL-FS 49 markedly reduced heart rate without alteration of left ventricular positive dp/dtmax at rest and during exercise. A marked improvement of regional function in the area perfused by the stenosed coronary artery was also observed during exercise. This beneficial effect of selective bradycardia, here observed with UL-FS 49, remains to be confirmed in clinical trials. PMID- 3557713 TI - Staphylococcus aureus endocarditis in a newborn with transposition of the great arteries: successful treatment. AB - A newborn with transposition of the great arteries developed methicillin resistant Staphylococcus aureus endocarditis a few days after cardiac catheterization and atrial septostomy performed through the umbilical vein. The association of vancomycin and rifampicin was successful after vancomycin alone proved insufficient. PMID- 3557714 TI - Successful treatment of a recently thrombosed Bjork-Shiley mitral prosthesis with streptokinase--case report. AB - Recent thrombus on a Bjork-Shiley valve in mitral position was suspected clinically because of absence of valve clicks. On echocardiography partial obstruction of occluder was diagnosed. Streptokinase therapy was given for 4 days. Post-therapy echocardiogram, phono-cardiogram and cinefluoroscopy showed full disc excursion and patient is fine for last 6 months. PMID- 3557715 TI - Complete heart block as a complication of varicella. AB - A case of varicella myocarditis complicated by permanent complete heart block requiring treatment with a permanent pacemaker is presented. Antiviral therapy with Acyclovir from the moment of presentation had no effect on the course of the heart block, but may have induced recovery of myocardial contractile dysfunction. PMID- 3557716 TI - Acute left ventricular failure caused by acute on chronic alcohol consumption. AB - We present a case of acute left ventricular failure following acute on chronic alcohol consumption. Left ventricular ejection fraction, which was 26% on admission, returned to normal on discharge. Atrial fibrillation, a marked reduction in left ventricular ejection fraction and increase in left ventricular wall thickness were attributable to acute on chronic alcohol consumption. Left sided hemiplegia was associated with recurrence of atrial fibrillation. PMID- 3557717 TI - Cardiac tamponade as an initial clinical presentation of infective endocarditis. AB - Two cases of aortic valve endocarditis with valvar ring abscesses are described which presented clinically with pericardial tamponade. The difficulties in establishing the diagnosis are discussed, as well as the role of echocardiography. The diagnosis was confirmed at surgery in both cases. PMID- 3557718 TI - Cardiogenic shock due to papillary muscle rupture in acute myocardial infarction. AB - We report a case of papillary muscle rupture complicating acute myocardial infarction which resulted in acute cardiogenic shock. The patient underwent urgent replacement of the mitral valve and made an uncomplicated recovery. PMID- 3557719 TI - Pseudo-electrical alternation due to deformation of QRS-T by atrial flutter waves. AB - A case of pseudo-electrical alternation produced by deformation of QRS-T waves by atrial flutter waves is reported. It should be differentiated from the true electrical alternation which has definite diagnostic and prognostic implications. PMID- 3557720 TI - Cardiac involvement in relapsing polychondritis. AB - Relapsing polychondritis is a rare disease characterized by recurrent inflammatory lesions involving cartilaginous structures, the eyes, the ears and the cardiovascular system. Valvar insufficiency represents the most common of the cardiac abnormalities and appears in 8 percent of patients. We describe two patients having relapsing polychondritis with cardiac involvement. One of them required valvar substitution and died 6 months after surgery. PMID- 3557721 TI - Ischemic ST-segment changes after dipyridamole infusion. AB - Thirty consecutive patients were studied by thallium-201 myocardial imaging after dipyridamole infusion and by coronary angiography because of syndromes of chest pain. Eight patients (27%) had ischemic ST-segment changes after the infusion of dipyridamole. They all had significant coronary arterial disease. It is suggested that the combination of visual analysis of myocardial imaging and analysis of ST segment changes be used after dipyridamole infusion to improve the sensitivity of this non-invasive test. PMID- 3557722 TI - Stimulation of human pancreatic polypeptide and gastrin by Boots and GIH secretin: in vitro and in vivo studies. AB - We have studied the concentration of various gastrointestinal peptides in a crude porcine secretin (Boots) preparation and pure natural porcine secretin (GIH, Kabi) preparation. Boots secretin was found to contain 140.3 ng secretin, 1.27 ng human pancreatic polypeptide (hPP), 1.03 ng gastrin, 137.4 ng cholecystokinin (CCK), 241 microU insulin, 1.86 ng vasoactive intestinal polypeptide (VIP), 2.22 ng glucagon and 6.60 ng somatostatin (SRIF) per Crick Harper unit Boots secretin. Sephadex gel filtration demonstrated that the immunoreactivity was due to the hormone per se. GIH secretin contained 240 ng secretin per clinical unit (CU) and less than detectable concentrations of hPP, gastrin, CCK, insulin, VIP, glucagon and SRIF. To determine the clinical significance of having contaminating peptides in Boots secretin, we investigated the effect(s) in 4 subjects. Determined in a highly gastrin-specific assay, the mean plasma gastrin response to Boots secretin administration was slightly, but not significantly greater than the GIH secretin response at 1 and 2.5 minutes. However, in some subjects false positive elevations in plasma gastrin immunoreactivity occurred when some commercially available kit gastrin assays were employed. After intravenous injection of Boots secretin, mean plasma hPP levels rose significantly more than after GIH secretin administration. The mean peak plasma insulin level after GIH secretin administration was significantly higher than after Boots secretin. Neither secretin preparation caused a change in plasma glucose, glucagon and SRIF levels. From these results, it is suggested that GIH secretin be used as the preparation of choice in provocative testing for diagnosing gastrinoma or deficiencies of exocrine pancreatic function. PMID- 3557723 TI - Relative deconvolution. An explicit method for bioavailability comparison not requiring intravenous administration. AB - A method is presented which enables an explicit evaluation of the relative rate and extent of drug absorption of drug products using an oral drug solution as a reference, thereby avoiding the need for intravenous administration of the drug. The method is demonstrated using data from two sustained release phenylpropanolamine preparations and an oral solution of this drug in a human subject. PMID- 3557724 TI - Pirenzepin does not alter the pharmacokinetics of theophylline. AB - The possible pharmacokinetic interactions between pirenzepin and theophylline were investigated in an open single blind trial. Aminophylline (6.5 mg/kg body weight) was administered intravenously in five healthy male volunteers before and after chronic oral pirenzepin therapy (50 mg twice daily 5 days before to 2 days after giving aminophylline). To study the theophylline pharmacokinetics, serum and urine samples were collected up to 48 hours after aminophylline administration. It was demonstrated, that pirenzepin does not affect theophylline pharmacokinetics. Therefore, pirenzepin may be combined with aminophylline or theophylline without the risk of an interaction, which usually affect the coadministration of other antiulcer drugs, e.g. cimetidine, with theophylline. PMID- 3557725 TI - Evolution of renal function under chronic oral administration of labetalol. AB - The glomerular filtration rate (GFR, inulin clearance) and renal plasma flow (RPF, PAH clearance) were measured in 35 hypertensive patients during chronic administration of an alpha-beta-blocker, labetalol. No significant changes in GFR occurred but RPF increased significantly. The increase in RPF was positively correlated with the decrease in mean arterial blood pressure. Patients with renal failure showed changes similar to patients with normal renal function. Thus chronic treatment with labetalol, unlike most beta-blockers, can increase RPF, an effect which could be related to the alpha-blocking activity of the drug. PMID- 3557726 TI - Concentration of clofibric acid in blood after the administration of delayed release form of etofibrate. AB - The clofibric acid levels in blood are studied after the oral administration of 500 mg of etofibrate given as a unique dose in three different delayed-release tablets. These are enteric-coated, obtained by granule compression. An inert matrix containing the drug is the basis of these granules, differentiated by their granulometry and the chemical treatment applied. One of the three tablets presents a very interesting KE, which permits the substitution of three intakes throughout the day by only one dose daily. PMID- 3557727 TI - Radioactive uranium in various Indian tobaccos and consumable products (snuff, chutta, bidi and cigarette). AB - Tobacco is chewed in the form of snuff and thus its radioactivity--if there is any--goes directly into the body. Besides normal smoking, tobacco is also smoked in reverse manner in the form of "chutta", an indigenously prepared cigar made from the home grown plants of Nicotinia tobacum in South East coastal towns and villages in India. The burnt residue and the radioactive element--if there is any -in the case of chutta smoking will also go directly in the body causing hazardous effects. Uranium traces were determined in commercially available samples of snuff, chutta, bidi and cigarette tobacco using radiation damage etch technique. The analysis showed that uranium levels varied from 7.4 to 19.1 ppm in snuff, 0.16 to 0.37 ppm in chutta, 0.13 to 0.23 in bidi and 0.037 to 0.12 ppm in cigarette tobacco. PMID- 3557728 TI - Disposition kinetics of dibekacin in normal subjects and in patients with renal failure. AB - Dibekacin pharmacokinetics was studied in ten healthy volunteers and six patients with renal failure presenting Clcr less than 10 ml X min-1 per 1.73 m2 of body surface, given as a slow intravenous bolus to the volunteers and as a 30-minute intravenous infusion to the patients. The antibiotic was assayed in plasma and urine by means of a microbiological method using Bacillus subtilis. A two compartment kinetic model was used to describe the bi-phasic decline of the plasma concentration thus establishing the different pharmacokinetic parameters. Elimination parameters beta, k10 and total body clearance were markedly diminished in renal patients (p less than 0.001): t1/2 beta was 2.0 h, k10 = 0.016 min-1 and Cl = 0.87 ml X min-1 kg body weight in normal subjects and t1/2 beta = 21.4 h, k10 = 0.0011 min-1 and Cl = 0.131 ml X min-1 per kg in the patients. Other kinetic parameters, as distribution (alpha) and transfer (k12, k21) constants were lower in patients than in volunteers. Also the different terms of volume of distribution of the two-compartment model (V1, Vdss, Vdarea) were significantly higher in patients than in normal subjects (p less than 0.05). A good correlation (r = 0.987) between patients' beta constant and creatinine clearance was found. A similar relationship between serum creatinine levels and disposition half-life was found (r = 0.955). Urinary recovery at 24 h was 89.0% of the dose given to normals and 15.8% of the dose given to patients. PMID- 3557729 TI - Aminoglycoside redistribution phenomenon after hemodialysis: netilmicin and tobramycin. AB - The serum concentration time profile of netilmicin and tobramycin before, during, and after hemodialysis was assessed in 5 noninfected adult chronic hemodialysis patients. The pharmacokinetic profile was biexponential for both agents in the pre-hemodialysis period. The total body clearance of netilmicin was significantly greater than that of tobramycin (5.32 +/- 0.75 ml/min vs 3.66 +/- 1.00 ml/min; p less than 0.05). The hemodialysis clearances of netilmicin and tobramycin were similar (60.8 +/- 16.6 ml/min and 54.7 +/- 18.8 ml/min, respectively). Netilmicin and tobramycin serum concentrations increased significantly 10 minutes after cessation of hemodialysis and maximally rebounded to 38.3 +/- 16.2% and 18.3 +/- 3.0% at 1.7 +/- 0.3 hours and 1.9 +/- 0.7 hours, respectively. This phenomenon may be a primary contributor to the marked variability observed in the clinical pharmacokinetics of these agents in hemodialysis patients. These data suggest that clinical serum concentrations should not be drawn until two hours after hemodialysis. PMID- 3557730 TI - Respiratory responses to pirenzepine in healthy subjects. AB - Since no information is available concerning the action of pirenzepine in vivo on human tracheobronchial tree, we evaluated the respiratory responses to pirenzepine in a group of healthy subjects. This clinical study suggests that pirenzepine exerts its bronchodilatory action on small airways (from 9th generation to distal airways), but not on larger airways, in normal subjects. These results are consistent with a probable presence of muscarinic high affinity receptors (M1 subtype) only in peripheral airways. PMID- 3557731 TI - Results obtained from labetalol therapy in essential hypertension. AB - The purpose of the study was to investigate the antihypertensive effect and the dependability of labetalol in 21 essential hypertensive patients. After a period of one week without drugs, the patients were first given placebo for one week and subsequently 200 mg or 400 mg labetalol daily for eight weeks. Lipid assays were performed and renal and hepatic functions determined before and after therapy. In conclusion, it was shown that labetalol effectively controls blood pressure and reduces heart rate without causing any changes in renal and hepatic functions and lipid metabolism. PMID- 3557732 TI - Serum levels of free non-protein bound clofibrinic acid after single dosing to patients with impaired renal function of various degrees--a multicenter study. AB - As a basis for establishing dosing guidelines in order to avoid side effects due to overdosage, the concentrations of total and free non-protein bound clofibrinic acid (CA) were determined before and after the administration of a single clofibrate dose (0, 2, 6, 12, 24, 48, 72, 96h) in patients with various degrees of impaired renal function and in a control group (n = 56). The clofibrate doses administered to the five groups were: group 0 = control group without renal impairment: 1,000 mg; group 1 = serum creatinine up to 354 mumol/l: 1,000 mg; group 2a = creatinine levels greater than 354 mumol/l up to levels requiring dialysis: 1,000 mg; group 2b = creatinine levels like 2a, but only 500 mg; group 3 = patients requiring dialysis: 500 mg. In addition, serum albumin, CK, GOT and GPT were controlled. Total CA was determined by gas chromatography, the unbound fraction by equilibrium dialysis. Increasing serum creatinine levels were correlated with a decrease of total CA but with a statistically significant increase in free CA concentrations. The levels of non-protein bound CA of groups 1 and 2a were significantly different from control group 0 (same dosing). In addition, a significantly negative correlation between free CA and serum albumin levels was demonstrated. Determination of free CA as a control parameter of clofibrate therapy in patients with impaired renal function allows clofibrate dosing to be closer related to the individual subject than the determination of total CA only. PMID- 3557733 TI - Pharmacokinetic and clinical evaluation of ketamine administered by i.v. and epidural routes. AB - The evolution of the plasma levels of ketamine and its two biotransformation products, norketamine (metabolite I) and dehydronorketamine (metabolite II) was studied after i.v. and epidural administration at doses of 2 and 5 mg/kg, respectively. The results show a good access capacity of ketamine from the epidural space to the systemic circulation as reflected in the high value of its apparent incorporation constant (ka = 5.54 +/- 2.33 h-1) and its good bioavailability (F = 0.77 +/- 0.22). The evaluation of clinical parameters points to a more attenuated cardiovascular and respiratory response after administration of the anesthetic by the epidural route. PMID- 3557734 TI - Studies on kinetics of sulfadiazine and trimethoprim excretion in man. AB - The kinetics of sulfadiazine and trimethoprim excretion was determined. The examinations were performed on 10 healthy people. The compounds were given orally once, in the form of pure substances, applying three different doses: 80, 240 and 720 mg of sulfadiazine and 20, 60 and 180 mg of trimethoprim. In order to estimate the contents of sulfadiazine in urine, Bratton-Marshall's method was applied while the colorimetric method according to Vachek and Kakac was used in estimating the contents of trimethoprim. This method was adapted by Klimowicz to determine trimethoprim in blood and it was modified in our laboratory. It was stated that about 44 per cent of the administered dose of sulfadiazine and about 56 per cent of trimethoprim were excreted with urine in the form of unchanged compounds. The excretion processes of both compounds can be described in the way accepted for one-compartment kinetic models. The value of the half-life of sulfadiazine excretion is 8.4 hours while that of trimethoprim is 6 hours. The constant of loss is 0.083 for sulfadiazine and 0.118 for trimethoprim. The given formulae allow to calculate the rate of excretion of sulfadiazine and trimethoprim with urine at any time after being administered. The tests proposed to calculate the accepted drug doses, which are based on measuring the excretion rate of the unchanged substances with urine, so that they may be applied in controlled therapy and in poison therapy. PMID- 3557735 TI - Comparative bioavailability of three commercial acetaminophen tablets. AB - Three brands of acetaminophen tablets marketed in Turkey were evaluated for their in vitro properties, and their in vivo bioavailabilities were determined in comparison to a standard acetaminophen solution containing an equivalent amount of the drug. The total amount of acetaminophen in urine or in tablets was determined by the colorimetric method of Welch and Conney [1965]. No significant difference between the manufacturing parameters, namely the assay, hardness, diameter and thickness of the brands was observed except that the coefficients of variation for brand A were greater than the other two brands. Brand A also disintegrated more slowly and its dissolution time (80% of the drug dissolved in 45 min) did not meet the requirements of USP XX. In vivo bioavailability studies were carried out in six healthy volunteers who received the tablets or the standard solution in a single dose, cross-over study. The urine was collected for 24 h and the total acetaminophen excreted was determined according to the method of Welch and Conney. The relative bioavailabilities for Brands A, B and C were found to be 97.87, 95.41 and 98.78%, respectively, with respect to the solution. The differences were not statistically significant and it can be concluded that all tablets were rapidly and almost completely absorbed. This study also demonstrates that there is not always a good correlation between the in vitro disintegration and dissolution tests and the in vivo bioavailability of a drug. PMID- 3557736 TI - Pharmacokinetics and bioavailability of a controlled release amoxicillin formulation. AB - The pharmacokinetics and bioavailability of an in vitro controlled release amoxicillin formulation were studied in nine healthy volunteers, in comparison with an intravenous injection and a conventional tablet. The experiment was designed in a crossover fashion. The volunteers received the three formulations on separate occasions. The antibiotic was measured in plasma using a microbiological method. The absolute bioavailability of the two solid dosage forms was estimated comparing non-compartmental parameters. The results indicated that there was no correlation between the in vitro dissolution rate and the pharmacokinetic behavior in the body. PMID- 3557737 TI - Steady state absorption kinetics and pharmacodynamics of furosemide in congestive heart failure. AB - Furosemide, a potent loop diuretic, is commonly used in the treatment of congestive heart failure (CHF). Unpredictability in the diuretic effect following oral doses has been attributed to variable and incomplete absorption and to variability in the pharmacodynamic response to furosemide. The present study is undertaken to investigate the absorption kinetics and pharmacodynamics of furosemide in patients with CHF during chronic medication. Ten patients with congestive heart failure were maintained on 40 to 160 mg furosemide for a month. The final dose at the end of this period was administered on an empty stomach. Plasma and urine were collected and assayed for furosemide, potassium, chloride, sodium and creatinine. Urine flow was also measured as a function of time. Plasma furosemide concentration-time data were fit to a two-compartment model with either two consecutive, discontinuous first order absorption rate constants or with a single monoexponential input; the former absorption model describing the data better than the latter. Average values of the half-life (205 +/- 28 min) and renal clearance (0.8 +/- 0.09 ml/min/kg) were similar to those reported by previous investigators. Drug excretion-response curves were lower and shifted to the right compared to data reported for normal subjects. Furthermore, a clockwise hysteresis was evident indicating acute within-dose tolerance. PMID- 3557738 TI - Oral isosorbide-5-mononitrate: pharmacokinetics and clinical efficacy. AB - Isosorbide-5-mononitrate is a longer acting active metabolite than the parent drug, isosorbide dinitrate (ISDN), with a half-life of around 4 hours. In coronary heart disease, myocardial infarction and in heart failure it causes a typical nitrate action on the central hemodynamics, but due to a complete systemic availability with high and predictable systemic drug levels, a drug action with a lower interindividual variability than with ISDN is to be expected. There is a close correlation between serum level and effect. The antianginal exercise tolerance increasing and unwanted effects as well as the development of tolerance to the drug action are comparable with those of ISDN. This naturally long-acting metabolite in ISDN works usually with a standard dosage of 20 mg twice daily. PMID- 3557739 TI - Comparative bioequivalence study of furosemide in patients with edema of renal origin. AB - A double-blind cross-over randomized clinical study with two different brands of furosemide was carried out in seven patients with edema of renal origin. The study indicated that the two brands were biologically equivalent. PMID- 3557740 TI - Ranitidine disposition in severe hepatic cirrhosis. AB - The effect of severe liver disease on ranitidine disposition was evaluated by comparing its kinetics in 5 healthy subjects and 11 patients with alcoholic cirrhosis. Cirrhotic patients had severe liver disease as evidenced by the presence of ascites, hepatic encephalopathy, jaundice, muscle wasting, and low serum albumin, but creatinine clearance did not differ significantly between controls and cirrhosis. Following intravenous administration of ranitidine, systemic clearance was decreased in cirrhosis. These decrease may be associated with changes in renal function, and decrease in hepatic metabolism, usually present in patients with severe hepatic failure. The distribution volume of ranitidine was also decreased in cirrhotics, but the difference between patients and controls was not significant. Biological half-life was significantly longer in cirrhotic patients than volunteers. This difference may be due to decrease in total body clearance found in cirrhotic patients. It is concluded that patients with severe liver cirrhosis could have elevated plasma level of ranitidine and that a reduction of ranitidine dosage is warranted in these patients. PMID- 3557741 TI - Machine smoking results compared to human uptake of cigarette smoke. AB - Studies of plasma concentrations and the application of pharmacokinetic parameters in human smoking published during recent years are reviewed. It is clear that this approach contributes to better understanding and to the quantitative evaluation of many problems related to human smoking, such as: first, smoking behavior, second, self-regulation and compensation when switching between different brands and third, relationships between in vitro machine smoking yields and actual human uptake. The reviewed articles show that the widely believed opinion that cigarettes with low yields, when in vitro tested, are less hazardous, must be questioned. For the majority of cigarette brands there is no defensible correlation between in vitro analytical machine yields and actual uptake and bioavailability. Based on these findings suggestions are given to modify the use of tar and nicotine yields obtained by in vitro machine testing methods for classification purpose. PMID- 3557742 TI - Interactions of dihydralazine with furosemide in hypertonic patients. AB - In 9 hypertensive patients stage II we studied whether dihydralazine, which is known to increase the renal blood flow, influences the elimination of furosemide (40 mg i.v.) when given additionally over a period of 2 weeks (75 mg daily). The results were compared with data from 9 healthy volunteers. The most important alterations in hypertonics were significantly increased half-lives (28.0 +/- 3.7 and 35.1 +/- 5.7 min), distribution coefficients (0.105 +/- 0.017 and 0.132 +/- 0.028 ml/g) and unchanged plasma clearances (2.62 +/- 0.33 and 2.59 +/- 0.27 ml min-1 X kg-1). Pretreatment with dihydralazine resulted in normalization of distribution coefficients (0.134 +/- 0.027 and 0.102 +/- 0.020 ml/g), decrease in plasma clearance (2.55 +/- 0.29 and 2.08 +/- 0.23 ml min-1 X kg-1) without alterations in half-lives (36.3 +/- 6.0 and 34.2 +/- 7.0 min). The authors conclude that the effects after dihydralazine co-medication are only distribution mediated. PMID- 3557743 TI - Comparative pharmacokinetic analysis of latamoxef and CPW 86-363, a novel carboxy pyrazol-cephalosporin and formation of N-methyl-thiotetrazole. AB - The pharmacokinetics of latamoxef and CPW 86-363, a novel carboxy-pyrazol cephalosporin, were evaluated in healthy volunteers after intravenous bolus injection of 1 g. Based on concentration-time courses in serum both cephalosporins showed similar distribution properties, although CPW 86-363 was eliminated significantly faster. The route of elimination of latamoxef was mainly via the urine, whereas CPW 86-363 was also excreted into the bile. N methylthiotetrazole, which is the common side chain in position 3 of both cephalosporins, was found in the serum as well as in the urine. Its rate and extent of formation was higher for latamoxef than for CPW 86-363 and depends rather on the instability of the parent compound than on metabolic transformation. This is supported by studies on the in vitro degradation of both derivatives. The relevance of these findings are discussed in view of secondary coagulopathies, which are associated with cephalosporins having a N methylthiotetrazole side chain. PMID- 3557744 TI - Efficacy of maintenance of therapeutic serum concentrations of theophylline in chronic asthma. AB - The efficacy of maintenance theophylline therapy at serum concentrations ranging between 8 and 20 micrograms/ml was studied over a six-month period in a group of 100 outpatients (age range 18-80 years) with chronic asthma. The study was satisfactorily completed by 95 of the individuals. Theophylline therapy led to a progressive disappearance of the patients' clinical signs and symptoms. A significant improvement in pulmonary function was observed in all patients, which was related to the initial degree of airway obstruction. The improvement was more pronounced at the start of treatment. At the end of the study there were still anomalies in the respiratory parameters in those patients who originally showed greater pulmonary compromise (FEV1 less than 50% of the predicted value) which seemed to indicate persistent airway obstruction. However, the improvement shown by these patients was sufficient for them to carry out their normal daily activities. We conclude that controlled long-term therapy with theophylline may be beneficial for outpatients with chronic asthma. PMID- 3557745 TI - Early case finding/early identification. PMID- 3557746 TI - Associations between patient religiosity and alcohol attitudes and knowledge in an alcohol treatment program. AB - Studies, carried out in generalized populations, have shown inverse relationships between degree of religiosity and attitudes towards drinking, knowledge about alcohol, amount of alcohol consumed, and physical complications of alcohol abuse. Within a population of chronic male alcoholics, we found that the more religious patients had a more anti-alcohol attitude; however, none of the other correlations was statistically significant. Within this population, the least religious patients were more likely to change their attitude toward alcohol and to increase their knowledge of the deleterious effects of alcohol after 4 weeks of treatment on an inpatient rehabilitation unit. PMID- 3557747 TI - Conditional factors of maturing out: personal resources and preaddiction sociopathy. AB - The study continues exploration of the conditional nature of the process of maturing out of narcotics addiction over time. It tests hypotheses about the relationship of selected personal resource/sociodemographic variables (including ethnicity and employability) and preaddiction sociopathy characteristics to maturing out. Hypotheses were tested using log-linear models on data from the California Civil Addict Program. Results suggest that while the process of maturing out over time is not substantially different depending upon level of preaddiction sociopathy or ethnicity, the process may be influenced by levels of other personal resource characteristics. PMID- 3557748 TI - The prevalence and impact of major life stressors among pathological gamblers. AB - Major traumatic events were discovered in the histories of 23% of pathological gamblers seeking hospital treatment. These high-trauma patients were compared with groups of gambler patients who had experienced insignificant, low, or moderate amounts of life trauma. High-trauma patients tended, as measured by standard psychometrics, to be more depressed, anxious, and avoidant in personality style; they were also more likely to be abusing alcohol or other drugs. In their discussion the authors focus on the concept of learned dysthymia, a chronic state of negative affect related to cumulative life trauma and seemingly instrumental in potentiating addictive euphoria. PMID- 3557749 TI - Alcohol and psychoactive drug use among Israeli adolescents: an epidemiological and demographic investigation. AB - One thousand nine hundred Israeli adolescents--51.8% males and 48.2% females- aged 15 to 18, were questioned twice about their current and "ever" substance use. The first study was undertaken during September-October 1982 and the second about a year later. The findings clearly indicated a slight rise in the incidence and a moderate growth of the prevalence of substance use among Israeli adolescents. The relationships between substance use and several background sociodemographic variables that were studied are discussed. PMID- 3557750 TI - Mood state of heroin-dependent persons undergoing methadone detoxification. AB - A questionnaire (MSQ) was designed to evaluate subtle changes in subjective states accompanying methadone detoxification. A principal components analysis was applied to questionnaire data obtained from 29 male and female heroin-dependent persons at both moderate (42-22 mg) and low (21-1 mg) doses of methadone administration. Six factors were identified-a "schizophrenic" factor; general well-being; a mental outlook factor; a neurotic factor; a bipolar extroversion introversion factor; a bipolar excitation versus euphoria-depression factor. A shift to a more negative mental attitude, and an increase in extroversion and excitability, was found with decrease in methadone dose. PMID- 3557751 TI - Long-term results of Marmor arthroplasty in varus osteoarthritic knees. AB - Twenty-one osteoarthritic knees with an average varus angulation of 13 degrees were followed up for 7-10 years after resurfacing with the Marmor compartmental knee arthroplasty. There were 14 unicompartmental and 7 bicompartmental replacements, a total of 28 implants. The knees were assessed clinically according to the Hospital for Special Surgery knee rating scale. At the latest follow-up, 19 of these cases were still excellent or good. None of the knees had been corrected by more than the tightness of the ligaments allowed, and a varus inclination of an average of 2 degrees remained after operation and at the latest follow-up. Radiolucency of more than 2 mm around the tibial component was found in 2 out of 28 of the cases, but this was not associated with pain or disability, nor was wire breakage, found in 6 out of 28, or positional changes of the tibial component, which were seen in five patients. It is concluded that the Marmor compartmental knee arthroplasty is still indicated in osteoarthritic varus knees. PMID- 3557752 TI - Treatment of bone cysts with methylprednisolone acetate. A 9 to 11 year follow up. AB - The long-term results are reported of the treatment of bone cysts by means of the injection of methylprednisolone acetate (MPA) into the bony cavity using Scaglietti's technique. Eighteen patients were reviewed at a follow-up of 9-11 years from the beginning of the treatment. The results confirm the value of this technique and show a high percentage of recovery. During the growth period, a recurrence of osteolytic activity in the lesion may be observed after complete healing, though this does not happen frequently. In these cases further prompt treatment with MPA injected into the small osteolytic areas brings about their complete resolution. These observations lead us to conclude that a bone cyst can never be considered completely healed before complete skeletal maturity is reached. Regular radiological reviews must be carried out in order to recognise and treat promptly the first signs of a recurrence of cystic activity. PMID- 3557754 TI - [Van Nes rotation osteoplasty in congenital dysplasias and aplasias of the proximal femur in young children. A study of 6 cases]. AB - Six rotation-plasties, as described by Van Nes, have been carried out in children between 5 and 11 years of age, 5 of whom had congenital defects of the proximal femur, and the other femoral hypoplasia. The operation involved arthrodesis of the knee, accurate shortening of the leg so that the ankle would be at the same level as the opposite knee at the end of growth, and clockwise derotation of the leg through 180 degrees. The only complications encountered were 3 transient palsies of the peroneal nerve. Rerotation was only required if the operation was performed in early childhood, or if it had been carried out counterclockwise. The ideal age for operation seems to be between 8 and 10 years of age. The results are satisfactory. Function and gait are improved. The prosthesis may need to be long because of the pelvi-femoral instability associated with the basic deformity. The operation is indicated in some children with congenital abnormalities of the femur who would otherwise require a rigid brace or an amputation to accommodate a prosthesis. PMID- 3557753 TI - Bone scan in the patellofemoral pain syndrome. AB - Eighty patients who complained of retropatellar pain underwent evaluation by bone scintigraphy, intraosseous pressure determination, radiography, arthroscopy and physical diagnostic tests. The bone scans showed that 48% of the painful knees had an increased uptake compared with 9% for the normal joints. A highly significant correlation was evident between an increased uptake and established chondromalacia. For the diagnosis of a high pressure patella, radiography was only 7% sensitive (6/88), compared with 44% (39/88) for bone scintigraphy and 78% for the clinical "sustained flexion" test. The positive predictive value of a bone scan for detecting a high pressure patella was 0.72 (39/54). The best predictor was a positive sustained flexion test with a predictive value of 0.85 (69/81). PMID- 3557755 TI - [The shelf operation for painful hip dysplasia in adults. Apropos of a continuous series of 230 cases]. AB - 230 shelf operations were carried out between 1961 and 1985 for painful acetabular dysplasia or subluxation of the hip. 208 patients have been followed up for more than one year, with 79 for between 10 and 24 years. Substantial relief of pain was obtained in 88%. The benefits of operation usually continue for many years. Factors which may lead to a poor result are advanced age, dislocation of the hip and the presence of marked osteoarthritic changes. The results have been compared with those obtained for Chiari's osteotomy, and the relative indications for the two procedures are discussed. PMID- 3557756 TI - Ultrastructural modifications of muscle in three types of compartment syndrome. AB - The histological and ultrastructural aspects of three cases representing different types of compartment syndromes are analyzed. In the acute syndrome edema is the prominent feature. The two chronic cases are characterized by an accumulation of intermyofibrillar lipid globules. All three have in common mitochondrial enlargement, disorganization of the cristae and paracrystalline inclusions. These pathological findings are discussed in the light of lesions seen in striated muscle ischaemia or in certain metabolic myopathies. PMID- 3557758 TI - The biomechanical and metabolic effects of a running regime on the Achilles tendon in the rat. AB - The Achilles tendons of 192 albino rats were subjected to biomechemical and metabolic testing after a defined running period and compared with a control group. After 2, 4, 8, 12 and 16 weeks, the cross-sectional area, ultimate tensile strength and oxygen uptake of the Achilles tendons were determined. Different reactions were demonstrated particularly after intensive training. These tendons showed an increase in cross-sectional area and a decrease of ultimate tensile strength when compared to the control group after 12 and 16 weeks of training. In contrast to these results the oxygen uptake was higher than in the control groups after 4 and 8 weeks of training. Alterations in the biomechanical and metabolic properties of tendon tissue occur at different times after the running regime. PMID- 3557757 TI - Bone levels of cephradine and cefuroxime after intravenous administration in patients undergoing total hip replacement. AB - A randomised, comparative study is reported of single intravenous doses of cephradine 2 g or cefuroxime 1.5 g given as prophylactic cover for total hip replacements in 40 patients. The serum and bone levels of cephalosporin achieved were higher in the cephradine treated group in proportion to the higher dose employed. Both agents provided adequate bone levels on average, cephradine 25.34 mcg/g, cefuroxime 17.39 mcg/g, although bone penetration was more variable with cefuroxime. PMID- 3557759 TI - Client outcome as a function of agreement or disagreement with the modal group perception of curative factors in short-term, structured group psychotherapy. PMID- 3557760 TI - Effect of patients' evaluation of group behavior on therapy outcome. PMID- 3557761 TI - Presidential address: contributions of the group psychotherapist to education on the psychiatric unit: teaching through group dynamics. PMID- 3557762 TI - Clinical application of research instruments: editor's introduction. PMID- 3557763 TI - A survey of expectations about group therapy among clinical and nonclinical populations. PMID- 3557764 TI - An analysis of AGPA Institute groups. PMID- 3557765 TI - Preliminary findings on a new instrument to measure cohesion in group psychotherapy. PMID- 3557766 TI - Change patterns of borderline patients in individual and group therapy. PMID- 3557767 TI - The corporatization of medicine. Introduction. PMID- 3557768 TI - Overpopulation as crisis: redirecting health care services in rural Bangladesh. AB - This article examines the consequences of a "population-as-crisis" theme on the institutional configuration and resource endowments of health care services in an integrated Ministry of Health and Population Control in Bangladesh. The Ministry's focus on women as child bearers and its emphasis on sterilization supported by incentives has contradictory consequences as women become vulnerable to a limited health service and incentives encourage a focus on meeting sterilization targets. Both undermine people's access to and use of primary health care services. Findings from three studies, undertaken between 1978 and 1983, support the argument that despite international concern with preventive and promotive primary health care, simultaneous support for and emphasis on population control inhibits meeting the goals of a broad-based rural primary health care service. PMID- 3557769 TI - Gender hierarchies in the health labor force. AB - Rapid growth and increasing diversity characterize trends of the U.S. health labor force in recent decades. While these trends have promoted change on many different fronts of the health system, hierarchical organization of the health work force remains intact. Workers continue to be stratified by class and race. Superimposed on both strata is a structure that segregates jobs by gender, between and within health occupations. While female health workers outnumber males by three to one, they remain clustered in jobs and occupations lower in pay, less prestigious, and less autonomous than those of their male counterparts. What has prevented women from improving their economic and leadership status as health workers? Is work performed by men of higher prestige because men perform it? Would curative and technical fields have less status if dominated by women? Would health promotion be funded more generously if most health educators were men? In this article, two analytical constructs are presented to take a closer look at occupational categories, selected structural characteristics, differential rewards, and their relationship to gender segregation. Taken together, they demonstrate how women always cluster at the bottom and men at the top, no matter which dimension is chosen. PMID- 3557770 TI - Worker participation in occupational health research: theory and practice. AB - In the area of occupational health, progressive scientists in many countries are attempting to carry out scientific inquiry into the effects of working conditions on the health of workers in a participatory relationship with workers. The author proposes an action research model to describe the underlying research process, taking into account the interests of both workers and academics. For worker/scientist cooperation to be effective, means must be found for the two groups to work on an equal footing. Workers' participation in occupational health research projects takes two forms: informational input-workers' knowledge of working conditions and health problems systematized and used to better understand the work situation and its effects on health and well-being; and partnership- workers' participation in the design and realization of all stages of the research project. Institutional context and worker participation are analyzed in the present article in the light of the experiences of our research group, Group de Recherche-action en Biologie de Travail (Action Research on Work Biology), at the Universite du Quebec a Montreal. The group has been involved in action research with unions for the past ten years under the terms of a signed agreement between the University and the two major Quebec unions, the Federation des travailleurs (travailleuses) du Quebec and the Confederation des syndicats nationaux. PMID- 3557771 TI - Nicaragua: a health system developing under conditions of war. AB - Since its inception in 1979, the Nicaraguan National Health System has dramatically improved health care in Nicaragua through the provision of universal coverage, emphasis on preventive community-based primary care, and community participation in health activities. Of major importance in the development of the health system has been the decentralization of the administration, planning, and implementation of health programs. The war in Nicaragua has had a major impact on the development of the health system. Nicaraguan health personnel and facilities have been the objects of attack by the contras and scarce resources have been diverted from the development of social programs to military activities. A large refugee population has been created which further strains existing resources. Community-based preventive health programs have been adversely affected, particularly in rural areas where military activity is the most intense. Because of the war, efforts to optimize regionalization of the health system have been retarded. Economic pressures both within Nicaragua resulting from the war and within the entire Latin American area have further hampered efforts for development. Continued major improvements in health care in Nicaragua will depend on a settlement of the present military conflict which is draining resources in all sectors of development, including health. PMID- 3557772 TI - The prevention of health risks in Cuba. AB - Cuba still has a double burden of health risks. It must contend with some risks to health that persist in underdeveloped rural areas, and it must also deal with the risk factors associated with modern, urban living conditions. The economic and social changes fostered in the postrevolutionary period have reduced the relative importance of the first set of factors, but the changes have also introduced or intensified a myriad of factors derived from their own successes. In this article, the risk factors of greatest concern in contemporary Cuba are described, and the strategies adopted to combat these risk factors, together with the ways in which such strategies are shaped by Cuba's social and economic development are discussed. PMID- 3557773 TI - Proprietary hospital chains and academic medical centers. AB - This article examines the reasons why proprietary hospital chains have become interested in buying or managing academic health center hospitals. Among the explanations that are discussed are such factors as vertical integration of health care, chain legitimation, integration of finance and delivery systems, and short-term profit potential. These factors are further examined through the use of a structured analysis of the interpenetration of proprietary chain hospitals and academic medical centers. We also discuss the consequences of these linkages in terms of such issues as continued educational mission, types of sponsored research programs, degree of indigent care provision, and changes in the nature of physician and other health worker training. The larger social implications of the movement of proprietary chains into tertiary medical care are evaluated. PMID- 3557774 TI - The proprietarization of health care and the underdevelopment of the public sector. AB - Failure of hospitals in urban areas is a well documented, spreading phenomenon that is resulting in decreased care for the medically indigent. As financial conditions force greater closures and cutbacks among providers, this dismantling of institutions that have historically served the unfortunate deepens the crisis in access to medical care. In this article, pressure on private health care institutions to adhere to a more bottom-line approach is viewed in the light of an overall attempt by government to divert public capital into private sector coffers, a trend that is particularly significant because of the ongoing concentration and centralization within the delivery system. Set in a historical analysis of the corporatization of health care, a case is made to reveal the underdevelopment of public hospitals, certain urban voluntary institutions, and community-based clinics, i.e., those institutions left to serve the most needy, in the face of rampant financial success by proprietary providers catering to a middle-class clientele requiring less intensity of care. PMID- 3557775 TI - Business and the pushcart vendors in an age of supermarkets. AB - The subject of this article is the impact of the political participation of business on the substance, process, and power of State policymaking about medical care in the 1980s. The article focuses on organized business coalitions, how and why they emerged to participate in the health policy debate, and the impact of these interests on health policy itself. It asks the question, How and to what extent has the emergence of business as an actor in health care politics changed both the process by which health policy is formulated at the state and federal level and the substance of health policy itself? It comes to the conclusion that business involvement has varied in impact and intensity from state to state, that business participation ultimately reinforces the control of the private sector over medical care resources, that business power can be used to decrease the autonomy and power of medical providers and is consistent with and reinforces current trends toward privatization and corporatization of the medical care system, and that the political participation of business has produced a degree of structural change in the medical care system. These changes have profound implications for unorganized consumer constituencies and their access to the policy process. PMID- 3557776 TI - Pharmaceutical promotion in Canada: convince them or confuse them. AB - Currently, drug companies are spending in excess of $200 million annually on promoting their products to Canadian physicians. Although the industry has adopted a voluntary code of advertising practice, this has not prevented gross excesses in all forms of pharmaceutical promotion: drug-company sponsored continuing medical education, and promotion through the public media, detailers, direct mail, sampling, and journal advertising. Not only does advertising add to the cost of drugs, but physicians' reliance on information conveyed through advertising leads to poor prescribing and consequently to significant adverse health effects for patients. Reforms of promotional practices are possible, but the initiative is unlikely to come from either the medical profession or the government. Pressure applied through an emerging grass-roots movement is the best hope for change. PMID- 3557777 TI - Determination of endurance capacity and prediction of exercise intensities for training and competition in marathon runners. AB - Male and female marathon runners (n = 34) were studied in incremental and continuous running tests under both laboratory and field conditions. Aerobic capacity was determined based on the relationship between the lactate concentration and running velocity. We also analyzed the acid-base balance after the laboratory test of continuous running for 45 min. The individual running velocities in the incremental field test at given lactate concentrations were correlated with the marathon running velocities. Training workouts for six female runners were analyzed, and running speed during endurance training was compared with the lactate-velocity relationship in an incremental laboratory test. The main findings are summarized below. There is a very close relationship between the velocities determined at 2.5, 3, and 4 mmol/l in the incremental field test and the marathon running velocity (r = 0.88-0.99, P less than 0.001). The highest correlation between test and marathon velocities was found at a lactate concentration of 2.5 and 3.0 mmol/l. In field and laboratory running tests lasting 44 and 45 min at a speed chosen in accordance with the runner's current marathon time, lactate levels reached a steady state at approximately 3 mmol/l. A slight increase in blood lactate levels was compensated via respiratory mechanisms. In the continuous treadmill test (n = 8), we recorded the following changes after the first blood sample collection (i.e., 10 min) and post-exercise: blood lactate concentrations rose from 2.2 +/- 0.93 to 3.5 +/- 1.45 mmol/l; the negative base excess increased from -1.2 +/- 3.2 to -3.4 +/- 1.7 mval/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557778 TI - Hematological changes associated with marathon running. AB - Coulter profiles with differential white cell counts, serum ferritin, and haptoglobin levels were determined in venous blood samples obtained from 90 males (M) and 25 females (F) immediately before and after completion of a competitive marathon (42.2 km) race. In an additional 20 male runners, the same measurements were performed serially during the 24 h following their completion of the race. In the pre-race samples from 90 M and 25 F, hypoferritinemia was present in 4/22 M and 1 F found to be mildly anemic. Neutropenia was detected in 4 M and 3 F and mild thrombocytopenia in 2 M. Haptoglobin levels were normal in all the female runners but reduced (less than 0.3 g/l) in 6 M. All post-race samples (88 M and 25 F) were characterized by a reactive neutrophilia and thrombocytosis including those with pre-race neutropenia or thrombocytopenia. An unexpected and incompletely explained sex difference in packed cell volume (PCV) response was observed. In males, the mean PCV increased from 0.425 +/- 0.021 to 0.444 +/- 0.028 (P less than 0.0001) whereas in females it decreased from 0.437 +/- 0.029 to 0.423 +/- 0.036 (P less than 0.05). In the post-race samples, anhaptoglobinemia was found in 13/88 M and 4/25 F. In the 20 male runners studied serially for 24 h after the race, the major changes involved a progressive increase in mean plasma volume (17.4% +/- 12.2% at 24 h) compared with the pre race value, a progressive and significant increase in MCH and MCHC probably indicating a loss in red cell water and the gradual reversion of the reactive neutrophilia and thrombocytosis to basal levels. PMID- 3557779 TI - Effect of aerobic training quantity on the VO2 max of circumpubertal swimmers. AB - Maximal oxygen uptake (VO2 max) was measured in 38 swimmers aged 10-14 years. Thirty of 38 boys participated in this study for at least 2 consecutive years. Group 1 consisted of 23 subjects (48 measures) who trained for 7 h/week while group 2 consisted of 15 subjects (27 measures) who trained for 14 h/week. In group 2, VO2 max normalized to body weight was significantly higher at 14 years of age than at 10, whereas the increase was nonsignificant during this period in group 1. The subjects of group 2 showed a large increase of VO2 max/kg body weight from the age of 13, which corresponded in this study to the age of peak height growth velocity. The differences between the two groups were statistically significant at both 13 (P less than 0.02) and 14 years of age (P less than 0.05). At 13 and 14, the most trained subjects also showed significantly higher (P less than 0.05) values of maximal oxygen pulse/kg body weight (VO2 max/kg/HR max). Maximal heart rate (HR max) was similar in the two groups between 10 and 14 years of age. Therefore, we conclude that an increase in a training program of the aerobic type induces a large increase in VO2 max from the age of peak height growth velocity. This is likely due to an increase in the stroke volume. PMID- 3557780 TI - A comparison of four treadmill protocols for determination of maximum oxygen uptake in 10- to 12-year-old boys. AB - Little information is available regarding the relative effectiveness of various treadmill exercise protocols in eliciting maximal oxygen consumption (VO2 max) values in children. In this study of 10- to 12-year-old boys, running protocols produced significantly higher VO2 max levels compared with walking, but there were no important differences in continuous, intermittent, and handrail-supported running schedules. The intermittent run protocols, however, prolonged the test duration. Studies examining VO2 max in children should utilize standard criteria for demonstrating peak oxygen intake. In this study criteria of VO2 plateau, peak heart rate over 198 and respiratory quotient exceeding 1.0 were satisfied most commonly with running protocols. PMID- 3557781 TI - Performance during the Wingate anaerobic test and muscle morphology in males and females. AB - Performance indices during the Wingate 30-s anaerobic test and their relationship to muscle morphology of the vastus lateralis muscle were studied in 30 untrained male and female subjects. Absolute values for peak power (P05), total work performed (TW), power decrease (PD), and post-test blood lactate concentration were significantly greater for the male subjects. When expressed per unit of body mass or leg volume, both P05 and TW were larger for the males than the females (P less than 0.05). Significant correlations were noted for P05, TW, PD, and blood lactate and the percent of fast-twitch (FT) fibers and the percent relative area of FT fibers for the male but not the female subjects. The results from this experiment reveal a significant influence of muscle morphology on short-term anaerobic work performance for these male subjects. The absence of a similar relationship for the women subjects was likely due to the use of an inappropriately high resistance setting. PMID- 3557782 TI - Factors affecting selected reciprocal muscle group ratios in preadolescents. AB - This study examines the influence of limb velocity and lateral dominance on the relationship between the knee flexors and extensors. Thirty preadolescents, 18 male and 12 female, performed a series of reciprocal knee flexion-extension movements on the Cybex II isokinetic system. The tests were performed at a range of selected velocities and on both dominant and nondominant limbs. The agonist antagonist ratios considered were the peak torque ratios, the torque ratio produced at specific angles, and the ratio comparing the total work performed by the hamstrings with that of the quadriceps. The results showed that an increased limb velocity produces a significant increase in the peak torque and work ratios (P less than 0.05), limb velocity has no significant effect on the torque ratio produced at 30 degrees and 60 degrees in the preadolescents, and lower limb lateral dominance has no significant effect on the three ratios examined. PMID- 3557784 TI - Simple tests for surveying muscle strength and muscle stiffness in sportsmen. AB - Thirty-nine elite runners were examined by Cybex II for thigh muscle strength. In addition, the maximal abduction, flexion and extension in the hip, dorsal flexion in the ankle, standing five steps, long and vertical jump, and side and front split were measured. For the latter five tests, an ordinary measuring tape was used. To establish reference values, 111 district level runners and 24 keep-fit joggers were examined by the three jump tests and the side and front split. Twenty randomly selected runners were examined twice to determine the reproducibility. The mean CV% was 1.9 +/- 1.4. There was a statistically significant correlation between the results in the vertical jump, the standing five steps, and long jump and muscle strength (P less than 0.001), in particular as to the values in the higher angle velocity. Furthermore, there was a correlation (P less than 0.001) between the results in side and front split and the hip. There was a covariation between the three ranges of motion, suggesting that stiffness in the hip was a general condition involving all directions of movements. The sensitivity for the jump tests and the side/front splits was 75% 91%. The specificity for the same test varied between 70% and 100%. PMID- 3557783 TI - Protective effect of indomethacin against exercise-induced injuries in mouse skeletal muscle fibers. AB - The role of prostaglandin synthesis was evaluated by indomethacin administration in the pathogenesis of exercise-induced muscle fiber injuries in soleus and quadriceps femoris muscles of mice. The administration of indomethacin before, during, and after 9 h exertion (s.c., 6 mg/kg during and just after exertion and 1.5-3 mg/kg before exertion and later twice a day) caused a significant histologic protection against exercise injuries and considerably reduced the exercise responses of beta-glucuronidase and glucose-6-phosphate dehydrogenase activities (enzymatic indicators of necrotic lesions in skeletal muscles) on the 2nd post-exercise day. The administration of indomethacin before and during the exertion (3 and 10 mg/kg, respectively) but not after exertion caused only a slight histologic protection while the enzymatic indicators showed a nonsignificant effect. PMID- 3557785 TI - Extent of lactic anaerobic metabolism in handballers. AB - The authors investigated lactic anaerobic metabolism in handball players during practice games. Seven players aged 18-21, belonging to second division league clubs, took part in the study. In the laboratory, VO2 max and the onset of blood lactate accumulation (OBLA) were determined with progressive maximal ergocycle tests. On the field, video recordings, cardiotelemetry, and rectal temperature measurements made during the first half of the game were used to quantify exertion. An intravenous catheter worn permanently was used to draw blood for lactate measurements at the 5th, 10th, 15th, 20th, and 30th min of play and after a 10-min rest period. The results confirmed earlier observations showing the need for an excellent maximal aerobic power and capacity in handballers. However, the maximal lactate levels observed (4-9 mmol X l-1) were above those that could be expected from samples drawn only at the end of play. These findings indicate that players must be trained to tolerate high lactate levels to preserve their maximal efficiency throughout the game. Finally, lactate production increased with player exertion and with increasing OBLA. PMID- 3557786 TI - AIDS and the dermatologist. PMID- 3557787 TI - The mechanism of hypercalcemia in sarcoidosis. PMID- 3557788 TI - Atopic dermatitis. An evaluation of clinical and laboratory findings. AB - These hundred seventy-two Chinese patients with atopic dermatitis were compared with a Caucasian population for the basic features. Significant findings occurred: personal or family history of atopy, early age of onset, xerosis, ichthyosis, palmar hyperlinearity, and facial pallor. Laboratory findings of immunologic alteration and altered pharmacologic reactivity are relatively more important features for the diagnosis of atopic dermatitis. PMID- 3557789 TI - Malignant pyoderma. AB - A patient with malignant pyoderma brought into complete remission with immunosuppressive cyclophosphamide treatment after the failure of multiple other therapies is reported. The entity of malignant pyoderma with its clinical characteristics, laboratory and biopsy findings, complications, and modalities of therapy is reviewed. PMID- 3557790 TI - Bulleetus. PMID- 3557791 TI - Dermatology in a developing country. PMID- 3557792 TI - Efficacy of rifampicin and isoniazid in cutaneous leishmaniasis. AB - Thirty-nine patients with cutaneous leishmaniasis caused by Leishmania major were treated with rifampicin alone or in combination with isoniazid. No significant difference was found between these two therapeutic regimens, and about half of the patients were cured 2 months from the beginning of treatment. A review of rifampicin in cutaneous leishmaniasis is attached. PMID- 3557793 TI - [Analysis of atmospheric pollutants with coupled gas chromatography-atomic absorption or thermodesorption-gas chromatography]. AB - We have perfected a specific and original analytical method suitable for organic and inorganic compounds using sampled run-off water collected nearby a filling station. The dissolved lead species are volatilized by substituting the inorganic ligands with hydrogen, using sodium-borohydride in a suitable reaction medium (H2O2, KOH). The volatile lead hydrides are then trapped on a gas chromatographic column filled with Chromosorb W impregnated with 2% of OV 275 and immersed in liquid nitrogen. After desorption, the products are analysed by atomic absorption spectroscopy. We have carried out the analysis of aldehydes mixtures, sampled from a smog chamber. They are trapped, at room temperature, in a glass column filled with Tenax. These pollutants are then heated at 250 degrees C under a flow of nitrogen, and trapped again in a melted silica capillary column at -110 degrees C. This trapping being over, the column is drastically heated at 200 degrees C, which drives the products into the capillary column of a gas chromatograph apparatus. This method has also enabled us to carry out a direct analysis of these pollutants sorbed on particles which have been placed into the glass column. this thermodesorption-gas chromatography system, coupled with a mass-spectrometry apparatus, allows us to identify and analyse most atmospheric pollutants. PMID- 3557794 TI - Determination of lead and cadmium in milk by electrothermal atomic absorption spectrophotometry. AB - The concentration of lead and cadmium in different kinds of milk samples (powdered, infant formula, market, buffalo, condensed and human) were determined using electrothermal atomic absorption spectrophotometric technique. Among all the varieties of milk analysed, condensed milk was found to contain much higher amount of lead. Human milk as expected was found to have lowest concentration of these elements. The results were compared with the reported values of other countries. Daily intake of these toxic elements by adults and babies up to the age of six months through the consumption of various types of milk was estimated and compared with the tolerance levels. PMID- 3557795 TI - Determination of polycyclic aromatic hydrocarbons in Athens atmosphere. AB - Concentrations of total suspended particulates (TSP), benzene soluble fraction (BSF) and polycyclic aromatic hydrocarbons (PAH) have been determined in ambient air from four different sites in Athens, situated in urban, semi-industrial and industrial areas. GLC analysis has been applied for the determination of PAH, while the CGC/MS technique was used in order to confirm the obtained results. The same PAH pattern was observed for all stations. The identified PAH have been fluoranthene (FLA), pyrene (PYR), benzo(a)anthracene (BaA), chrysene (CHR), benzo(b)fluoranthene (BbF), benzo(k)fluoranthene (BkF), benzo(a)pyrene (BaP), benzo(e)pyrene (BeP) and benzo(ghi)perylene (B(ghi)P). The concentrations of individual PAH ranged from traces to 33 ng m-3 (e.g. same or lower comparing to other large cities). The higher values of PAH were found during adverse meteorological conditions. PMID- 3557796 TI - Polarographic determination of lead in drinking water samples of Western U.P. districts with 3-hydroxypyridine-2-thiol. AB - The polarographic determination of lead in presence of 3-hydroxypyridine-2-thiol (HPT) has been investigated. The method was applied to the determination of the lead concentration in drinking water samples from Western U.P. (Province) of India. PMID- 3557797 TI - A model to evaluate half-lives of PAHs naturally occurring on airborne particulate. AB - Constant decay of polycyclic aromatic hydrocarbons (PAHs) adsorbed onto airborne particulate collected in glass fibre filters and exposed to sunlight ranged from 1.8 to 4.4 X 10(-3) (min-1), corresponding respectively to a half-life of 100 and 425 min. Half-life of PAHs appeared to be positively correlated with filter loading. Experimental results showed that decay of PAHs adsorbed on airborne particulate was induced by two concomitant reactions; a photochemical reaction involving the outer layers of collected particulate, and a "dark" reaction that may occur in the inner layers. The constant decays of these two reactions were calculated using a simplified mathematical model. The authors suggest the use of this model to compare chemical stability of airborne PAHs exposed, during their permanence in the atmosphere, to different physical (light intensity, temperature, humidity) as well as chemical conditions (oxidant concentration, chemical composition of particulate). PMID- 3557798 TI - Determination of trialkyllead species in water samples. AB - An analytical compound procedure is described for the determination of trimethyl- and triethyllead in water samples like rain, melted snow, and surface waters. The method consists of an enrichment step (adsorption onto and elution from silica gel), a chromatographic separation with column switching (HPLC including pre column enrichment), and a spectrophotometric detection (chemical reaction detector). The detection limits for the whole procedure, starting with 500 ml sample volume, are 15 pg/ml and 20 pg/ml for trimethyl- and triethyllead resp. The standard deviation for repeated analysis of a sample containing 90 pg Et3Pb+/ml is calculated to +/- 4%. The method also covers the analysis of the chemically mixed trialkyllead species Me2EtPb+ and MeEt2Pb+. The investigation of several water samples taken from different locations shows the presence of trimethyl- and triethyllead in the concentration range of 20-100 pg/ml. PMID- 3557799 TI - A comparative determination of heavy metals in moss tissue by atomic absorption spectroscopy, differential pulse anodic stripping voltammetry, direct current plasma spectroscopy and X-ray fluorescence spectroscopy. AB - Heavy metal contents of mosses are usually determined routinely for pollution studies, by atomic absorption spectroscopy. Results obtained from a such study are here compared with levels obtained from a comparative determination of the metals in the mosses by three other techniques: Differential pulse anodic stripping voltammetry (DPASV), Direct current plasma (atomic emission) spectroscopy (DCPS) and X-ray fluorescence (XRF) spectroscopy. The levels of Pb, Cu and Cd determined by DPASV did not differ significantly from those obtained from AAS. Metal levels from DCPS analyses tended to be significantly higher than the AAS values. Although the XRF values were slightly higher than those of AAS for Pb and Zn, the differences were statistically insignificant. The implication of these trends in comparing the extents of pollution in different regions, is highlighted. PMID- 3557800 TI - 'Idiopathic' preretinal macular fibrosis in young individuals. AB - In order to evaluate possible etiological factors and the natural course of 'idiopathic' preretinal fibrosis in young persons, nine consecutive patients with macular pucker diagnosed under the age of 50 years were examined. There were six women and three men with the mean age of 27.2 years (range 15-50) and the mean follow-up of 4.5 years (range 1.5-10). The initial visual acuity varied from 0.25 to 1.0. The preretinal membrane was either central or paramacular. In two eyes the process was probably congenital (retinal hamartoma), one was postinflammatory (retinal vasculitis), and one was associated with sclerosis of the anomalous macular arterioles. In the others no causative factors were discovered. In seven of the nine eyes both the visual acuity and the fibrotic process remained stable, in one eye the vision improved, and in one eye deteriorated. It seems that most young persons with 'idiopathic' preretinal fibrosis of the macula can be followed up without surgical removal of the membrane. PMID- 3557801 TI - The neuronal and extraneuronal uptake and metabolism of 3H-(-)-noradrenaline in the rabbit iris. AB - The disposition of 3H-(-)-noradrenaline (NA) was studied in the iris isolated from albino and pigmented rabbits. Pigment cells bind some NA, but do not metabolize it. Cocaine-sensitive neuronal uptake leads either to an extensive neuronal deamination of NA (when vesicular uptake is inhibited by pretreatment of the animals with reserpine) or to a pronounced accumulation of NA in the axoplasm (if, additionally, neuronal monoamine oxidase is inhibited). Corticosterone sensitive extraneuronal uptake leads to O-methylation of NA by extraneuronal catechol-O-methyl-transferase. In the rabbit iris, there is no extra-neuronal deamination of NA. In contrast to findings with other tissues, the extraneuronal O-methylation of NA in the rabbit iris is not saturable. PMID- 3557802 TI - Improved photographic assessment of the pupils in the syndromes of Horner and Holmes-Adie. AB - The use of photographic methods to assess pupillary abnormalities has usually been restricted to the measurement of anisocoria in light and darkness. An improved, accurate and relatively inexpensive photographic technique of recording pupillary movement was described, and tested in normal individuals and in the Horner and Holmes-Adie syndromes. A modern SLR camera, preprogrammable for exposure frequency and interval, was used for serial flash-lit photographs of the eyes during the course of darkness and near vision/accommodation reflexes. Measurement of pupillary diameter from these photographs permitted graphs of pupillary reflexes to be drawn that resemble traces obtained by other authors, who used less readily available and cumbersome cinematographic and electronic infra-red pupillometric methods. In Horner's syndrome, the affected pupil was invariably smaller, and the anisocoria was more marked in bright light or darkness, depending on the individual. The rate of dark mydriasis was abnormally slow, and most effectively quantified by measuring the pupillary 'half opening time', which was the interval required for the initial 50% of dark-induced pupillary dilatation. Constriction of tonic pupils during near vision/accommodation in subjects with the Holmes-Adie syndrome was consistently slow, and these pupils also failed to dilate fully in darkness. The amplitude of the darkness and near vision accommodation reflexes correlated significantly. The diverse pathophysiological mechanisms implicated by these changes were discussed. PMID- 3557803 TI - A new method for the evacuation of aqueous humor in uncontrolled glaucoma. The vitreo-tenonian tube. AB - The vitreo-tenonian tube is a new procedure, used in uncontrolled glaucoma, for the drainage of aqueous humor. It presents three original characteristics: it is made of a stainless metal, it is implanted in the posterior segment after vitrectomy and it drains the aqueous humor in the subtenonian space. We will describe first the surgical technique for the implantation of the tube, and then we will present the results of the first eight cases treated by this method. The advantages and drawbacks of this type of drainage are discussed: they are compared with the other surgical techniques used in cases of glaucoma which is uncontrolled by the classical methods. PMID- 3557805 TI - 15th meeting of the Club Jules Gonin. Copenhagen, August 10-15, 1986. Abstracts. PMID- 3557804 TI - Late failures of trabeculoplasty. AB - The effects of trabeculoplasty, or Argon laser trabeculoretraction (A.L.T.R.) resulting from a study pursued over two years in 194 eyes, over 3 years in 45 eyes, and over 4 years in 22 eyes, show early and late failures. 151 phakic patients (76 women and 75 men aged between 25 and 93 with an average of 67 years) were treated. After a follow-up of two years we have an intra-ocular pressure (I.O.P.) drop of 6.93 mmHg and a failure rate of 28%; after a follow-up of 3 years the I.O.P. drop is 6.30 mmHg and the failure rate 36%; after a follow-up of 4 years the I.O.P. drop is 7.87 mmHg and the failure rate 41%. The initial medical treatment could be decreased in less than 50% of the cases. The frequency of failure is more important in the presurgical glaucoma with an intra-ocular pressure higher than 28 mmHg and submitted to maximum tolerated medical therapy. A.L.T.R. gives good results in combined mechanism glaucoma and after failure of trabeculectomy; a two-year follow-up shows similar efficacy in primary open angle glaucoma (P.O.A.G.) and in pigmentary glaucoma, bad results in myopic or in aphakic glaucoma (12 cases not included in this study) and 'escape' in pseudo capsular glaucoma. The total study conducted over 4 years shows 10% new failure cases per year.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557806 TI - Treatment of antidepressant-resistant bulimia with naltrexone. AB - Ten individuals with antidepressant-resistant bulimia were treated with the long acting opiate antagonist naltrexone. Seven of the ten experienced at least a 75 percent reduction of their bulimic symptoms, and have maintained their improvement on three to five month follow-up. These preliminary data suggest that naltrexone may be of use in bulimia unresponsive to standard antidepressant therapy, and may provide insight into the role of endogenous opioids in the etiology of eating disorders. PMID- 3557807 TI - Alexithymia and pain in an outpatient behavioral medicine clinic. AB - Alexithymia is defined as a "lack of words for feelings." This deficiency has been suggested to play a role in the formation and maintenance of somatic symptoms. Prior research has found alexithymia prevalent in "classic" psychosomatic disorders. The present study examines the prevalence of alexithymia and its relationship to patient age, sex, and report of pain. The sample was 208 consecutive outpatients evaluated on a Behavioral Medicine Service and presenting with pain as a primary symptom. Results indicated that the prevalence of alexithymia in this study is consistent with prior research using inpatient pain patients and a similar MMPI alexithymia subscale. Additional analyses of the MMPI clinical and validity scales revealed that alexithymic patients were more defensive and presented themselves in a favorable manner reflecting a "normal" picture of mental health. It is suggested that alexithymia may play a role in chronic pain syndromes. Further research is needed to examine this deficiency and its potential etiological significance in these disorders. PMID- 3557808 TI - The prediction of chronic pain outcome by psychological variables. AB - Followup telephone interviews were conducted with fifty-four former patients of a multidisciplinary clinic for the evaluation of chronic pain. Interviews were conducted between thirteen and fifty-five months following initial evaluation at the pain clinic. Followup levels of pain and physical disability were compared with the following measures obtained at initial evaluation: levels of pain and physical disability and scores on the Minnesota Multiphasic Personality Inventory (MMPI), McGill Pain Questionnaire (MPQ), and Zung Depression Inventory (ZDI). In general, both physical disability measures and psychological test scores obtained at initial interview were related to followup measures. However, when the predictive value of initial pain and physical disability was accounted for, psychological test scores tended not to produce further significant increment in predictability. These findings are interpreted to mean that the predictive value of these psychological tests stems less from their reflection of a psychological state or attitude with respect to pain, and more from their tendency to reflect ongoing level of pain, disability, and other pain sequelae. The results support the hypothesis that scores on these psychological tests are, at least in part, a reflection of the actual pain and disability and may not be subject to the same clinical interpretations that scores obtained from a psychiatric sample would be. PMID- 3557809 TI - Decreased interpretation of nonverbal cues in rape victims. AB - The ability to receive nonverbal facial cues was tested in twelve female victims of multiple nonserial rapes and matched controls. Subjects attempted to interpret nonverbal messages transmitted by male and female senders who were covertly taped while involved in a gambling task. Rape victims had significantly decreased ability to interpret the nonverbal facial cues of both male and female senders. PMID- 3557810 TI - Patient generated dysphoria in psychiatric residents. AB - Caring for patients can induce intense emotions in psychiatrists. Although clinical experience suggests that such feeling can become a source of stress for the psychiatrists, particularly the first year resident, and interfere adversely with patient care, research in this area has been lacking. We studied a group of psychiatric residents in order to identify what patient conditions or characteristics induce the greatest dysphoria and adversely affect the quality of patient care. Serious medical illnesses induced the greatest dysphoria. PMID- 3557811 TI - SIADH: a serious side effect of psychotropic drugs. AB - In this communication two cases of possibly drug induced hyponatremia secondary to amitriptyline and thioridazine have been reported. What is particularly important is the fact that in one, irreversible neurological symptoms were left as sequelae and in the other, the patient was in a coma and thus suffered from a potentially lethal complication. The physicians should be aware of this disturbing side effect while treating their patients with antidepressant and neuroleptic medications. PMID- 3557812 TI - Relationship between static strength and various other measures in hemiparetic stroke patients. AB - The strength of 16 muscle groups was measured bilaterally in 38 hemiparetic stroke patients. The relationship between the strengths and gender, weight, age, side of paresis and time since onset were calculated for each muscle group. Although often correlated with the strength of the non-paretic muscle groups; gender, weight and age were very rarely correlated with the strength of the paretic muscle groups. Side of paresis was only correlated with the strength of four non-paretic muscle groups. Time since onset was generally unrelated to strength. Final strength was always correlated with initial strength on the paretic side. These results suggest that cerebrovascular accidents disrupt some of the normal strength relationships on the hemiparetic side, and that the severity of the hemiparesis early in rehabilitation may provide a good indication of the severity to be expected later in rehabilitation. PMID- 3557814 TI - Vocational rehabilitation. PMID- 3557813 TI - Epidemiology of some neurological diseases with special reference to work load on the NHS. AB - This paper reviews evidence relating to the incidence, prevalence, and likely workload upon the NHS in relation to neurological diseases, particularly those causing long-term disability. Three studies suggest that a population of 250,000 people will contain about 5000 people with disabling neurological disease, of whom 1500 will be sufficiently disabled to require daily assistance. The review highlights the scarcity of reliable information concerning the epidemiology of neurological diseases and their disabilities, and emphasizes the need to plan neurological services at the level of the district general hospital serving a population of 250,000 people. PMID- 3557815 TI - Such sweet sorrow. PMID- 3557816 TI - Prevalence of motor impairment and disability in a rural community in KwaZulu. AB - A study to measure the prevalence of motor disability and impairment using an interview survey and a follow-up medical examination has been carried out in a rural area in KwaZulu, South Africa. A 10% random cluster sample yielded 1659 individuals of all ages. One hundred and forty-three were reported to have motor disability, giving a crude motor disability rate of 86/1000. One hundred and twenty-six were followed up and 86 had demonstrable impairment, giving a crude motor impairment rate of 52/1000. The commonest impairment was osteoarthritis of the hips (20/1000) which may be the same disease as has been reported in neighbouring areas and to which the name Mseleni joint disease (MJD) has been applied. PMID- 3557817 TI - Membrane elastic shear modulus of red blood cells with glucose-6-phosphate dehydrogenase and pyruvatekinase enzymopathies. AB - The membrane elastic shear modulus mu determined by a micropipette technique was found to be elevated by 25% to 200% for red blood cells (RBC) from 7 patients with glucose-6-phosphate dehydrogenase (G-6-PD) and 9 patients with pyruvate kinase (PK) enzymopathies above the mean value for normal controls. All patients exhibit chronic nonspherocytic hemolytic anemias. A negative linear correlation (r = -0.72) between mu and the number of reticulocytes was obtained in G-6-PD deficiencies. In contrast, a positive correlation (r = 0.88) was found for red blood cells of patients with PK deficiency. A mechanically induced swelling of RBC was observed for some deficient cells. The results are discussed in the framework of structural alterations of the RBC membrane due to the disturbed pentose-phosphate pathway and the diminished ATP supply through glycolysis, respectively. PMID- 3557818 TI - Haemoconcentration and accumulation of white cells in the feet during venous stasis. AB - In experiments on eight healthy human subjects changes in the composition of the venous blood leaving the foot were examined during a 45-min period of sitting. Each subject reclined for 30-min before sitting with the foot approximately 1 m below the heart. Fluid filtration from the plasma into the tissues during sitting raised the haematocrit from an initial value of 41 +/- 0.6% to 49 +/- 1% after 20 min and to 51 +/- 1.5% at 40-min. The corresponding increase in plasma protein concentration was from 6.5 +/- 0.1 gdl-1 to 8.0 +/- 0.2 gdl-1 after 20 min and to 9.0 +/- 0.3 gdl after 40-min of sitting. Plasminogen activator levels in the foot venous blood during sitting were raised two to three fold over those found in venous blood taken from the arm at the start of the experiment. By contrast, after 20 min of sitting, white cell count of the venous blood of the foot was unchanged from the initial value of 7.4 +/- 0.8 X 10(-9) l-1 and increased to only 7.8 +/- 0.9 X 10(-9) l-1 at 40-min. This was in spite of an increase in the number of circulating white cells which, in blood taken from the arm at 45-min, had risen to 8.3 +/- 0.8 X 10(-9) l-1. The venous blood leaving the feet also failed to show an increase in platelet numbers. It is argued that approximately 15-20% of the white cells entering the feet during quiet sitting, do not leave in the venous blood. The possible significance of the results to the pathophysiology of venous hypertension is discussed. PMID- 3557819 TI - Hematocrit fluctuations within capillary tubes and estimation of Fahraeus effect. AB - Experimental and theoretical approaches were used to study hematocrit fluctuations in blood flowing along a uniform microvessel. In the experimental studies, human blood cell suspensions were passed along glass tubes with inside diameters 9.8 micron to 16.8 micron. A characteristic pattern of hematocrit fluctuation was observed in the neighborhood of white blood cells, the cell being preceded by a 'plasma gap' with reduced hematocrit and followed by a 'train' of increased hematocrit. The passage times of trains and plasma gaps and the hematocrits within the plasma gaps were determined by microphotometry. From these data, train hematocrits were deduced, expressed as equivalent discharge hematocrits. They ranged from the feed hematocrit to a value of more than 0.8 and were found to vary inversely with white cell velocity at a given flow rate. A theoretical model was developed which relates train formation to the Fahraeus effect. The Fahraeus effect is the reduction of tube hematocrit (HT) below discharge hematocrit (HD) which occurs in capillary tubes because the mean velocity of the red blood cells (VRBC) is higher than the mean bulk flow velocity (VB). The ratio of these velocities decreased with increasing hematocrit, and it is shown that train hematocrit is sensitive to this hematocrit-dependence. Increased hematocrit in trains behind slowly moving white cells is associated with reduced red cell velocity in the trains. From the dependence of train hematocrit on white cell velocity, the variation of Fahraeus effect with hematocrit was deduced. The results were shown to be consistent with a model for the Fahraeus effect in which VRBC/VB varies linearly with discharge hematocrit HD. In addition, the Fahraeus effect was found to be approximately independent of vessel diameter over the range examined. PMID- 3557820 TI - Correlation between shear dependent blood viscosity, electrical resistance and calculated width of the marginal layer in blood perfused capillary tubes. AB - Viscosity and shear dependent changes in electrical resistance (delta R) were measured simultaneously in blood perfused capillaries (I.D. = 0.58 mm, 1 = 300 mm, TW = 0.04 to 0.5 Pa). It appears that delta R is primarily caused by the development of a low resistant cell free marginal layer. Red cell aggregation strongly supports the development of delta R, while in non-aggregating blood the shear induced change in conductivity is rather small. Theoretical and experimental data become closely correlated if the calculated width of the marginal layer, being 1 to 5% of the capillary radius, is inserted into a modified form of Poiseuille's law. It is concluded that under the conditions of plug flow the non-Newtonian flow behavior of EDTA blood almost exclusively depends upon the width of the marginal layer, being a function of shear stress and hematocrit. PMID- 3557821 TI - Capillary grouping in hamster tibials anterior muscles: flow patterns, and physiological significance. AB - We have used fluorescein-labeled albumin and epifluorescence videomicroscopy to visualize the organization and flow patterns in the capillaries of a postural muscle, the tibialis anterior, in the pentobarbital-anesthetized hamster. Video tape records were made of overlapping microscope fields comprising portions of the muscle up to two millimeters in length and as much as 180 micron in depth. Three-dimensional reconstructions made from these tapes incorporated observations on flow patterns and geometry of the microvessels. The microcirculation in the tibialis was found to be arranged in repeating modules or 'units', consisting of approximately 15 capillaries supplied by a common arteriole and drained by a common venule. The mean distance from arteriole to venule in a unit was 855 +/- 233 micron (X +/- SD) and the mean capillary length was 805 +/- 330 micron. Flow in the capillaries within a unit was almost entirely concurrent, and there was little interchange of blood flow between the capillaries of adjacent units. The flow in capillaries of adjacent units was both countercurrent and concurrent. For each capillary, a count of the adjacent capillaries with concurrent and countercurrent flow was made. The ratio of concurrent to countercurrent flow varied from 2.4 to 4.3, being greatest at the midpoint of the unit and least at the arterial and venous ends. Our observations suggest that the capillaries of striated muscle are arranged in modules which may function as the fundamental control and distribution elements in the microcirculation. PMID- 3557822 TI - Transcutaneous oxygen pressure measured at two different electrode core temperatures in healthy volunteers and patients with arterial occlusive disease. AB - The influence of two different electrode core temperatures on transcutaneous oxygen pressure (tcPO2) was studied in ten probands and 28 patients with peripheral arterial occlusive disease. Hyperaemisation of skin by an electrode core temperature of 44 degrees C reflects local hyperaemia flow and can be reproduced constantly. At 37 degrees C low tcPO2 values are recorded which are in good accordance with mathematically calculated capillary dome PO2. According to great physiological alterations in skin perfusion tcPO2 (37 degrees C) varies in wide ranges. This mode of measurement is well suited to study physiological autoregulation mechanisms or the influence of drugs on skin perfusion. The herein reported results are: forefoot tcPO2 (37 degrees C, 44 degrees C) in volunteers is significantly higher than in patients; forefoot tcPO2 (37 degrees C, 44 degrees C) of patients with diabetes mellitus is significantly higher than in nondiabetics; prestenotic tcPO2 (37 degrees C, 44 degrees C) is about two times higher than poststenotic tcPO2 (37 degrees C, 44 degrees C); tcPO2 (37 degrees C) in probands decreased significantly during occlusion of the venous circulation; tcPO2 (44 degrees C) increased in probands and patients when standing up; however, tcPO2 (37 degrees C) decreased in healthy persons and increased in patients when standing up; after a 5-min suprasystolic cuff occlusion of the arterial circulation there was a four- to six-fold increase of tcPO2 (37 degrees C) which indicates reactive skin capillary flow. In conclusion tcPO2 (37 degrees C) permits measurement of relative changes of skin capillary flow under physiological conditions so that autoregulating mechanisms can be studied. PMID- 3557823 TI - Angiogenic activity in human wound fluid. AB - Wound drainage fluid from postoperative patients was examined for its ability to induce blood vessel growth using the chick chorio-allantoic membrane (CAM) assay. Sixteen samples from 12 patients were tested. The tests were performed on both whole unfractionated fluid and fluid after separation using diethyl aminoethyl cellulose (DEAE) ion exchange chromatography. All 16 samples were inactive before DEAE-chromatography but a fraction, eluting at between 300-400 mM salt, induced neovascularization in 15 out of 16 samples. These differences were statistically highly significant (p less than 0.001). Angiogenic factor (AF) was detected in fluids obtained from both clean and contaminated wounds, and in patients with benign and malignant disease. As mentioned earlier unfractionated wound fluids were nonangiogenic by themselves and their addition to the active fractions greatly reduced the angiogenic effect of the latter. Therefore we suggest that wound fluid contains both promoters and inhibitors of angiogenesis. The local balance between these may govern the rate of vascularisation during healing. PMID- 3557824 TI - Abstracts of the Fourth World Congress of Biological Psychiatry. Philadelphia, Pennsylvania, USA, September 8-13, 1985. Part B. PMID- 3557825 TI - Urinary tract pathogens common amongst the inhabitants of a state capital, south west Nigeria. AB - In the course of a survey of urine samples collected over a period of 12 months from male and female patients of different socio-economic backgrounds in Ibadan, Esch. coli, Klebsiella spp. Pseudomonas aeruginosa, Proteus spp., Staphylococcus aureus and Candida albicans were the most common pathogens isolated. The bacteria were commonly sensitive to the cephalosporins, kanamycin, ampicillin and cotrimoxazole in decreasing order of sensitivity. PMID- 3557826 TI - Prevalence of Toxocara canis ova on playgrounds of nursery schools in Nsukka, Nigeria. AB - Soil samples taken from playgrounds in the eleven Nursery schools in Nsukka were examined for the prevalence of Toxocara canis ova. T. canis ova were identified from 6 out of the 11 schools samples, a prevalence of 54.5%. The public health risk of this finding to the children in these schools with regards to visceral larva migrans in highlighted and recommendations made for prevention and control. PMID- 3557827 TI - Community participation in veterinary public health and animal health in the Caribbean--results of a preliminary survey. AB - Veterinary public health and animal health activities are said to be a good entry point to get the community interested in their own health. Because of the pastoral traditions of veterinary medicine and the accompanying privilege of an intimate link with agricultural community life, veterinary public health and animal health workers are in and ideal strategic position to spearhead community organization and education across a much broader spectrum of health issues. A preliminary study on community participation in veterinary public health (VPH) and animal health (AH) in the Caribbean is herein presented. This study was conducted to pre-test two questionnaires which were developed to determine the extent to which the community is participating in VPH and AH programs in the Caribbean, and to identify ways and means to strengthen intersectoral collaboration between the Ministries of Agriculture, Health and Local Governments. Two questionnaires were designed to collect primary data. Eighty-two staff profile questionnaires were completed by staff belonging to six categories from 12 Caribbean countries and political units. The categories included Animal Health Assistants, Veterinary Public Health Assistants, Veterinarians, Extension Officers, Public Health Inspectors, and Artificial Insemination Officers. This questionnaire sought to obtain basic information on services provided, participation of staff in farmers organization, coordination between agencies, and training. Eighty-seven (87) farm profiles were completed by livestock farmers from eleven Caribbean countries and political units. This questionnaire sought to obtain basic information as to number and types of animals raised, role and services of Government staff, and farmers participation. Analysis of the different responses between the two groups demonstrated the potential value and application of the information that could be obtained from such a study. The results are discussed. PMID- 3557828 TI - Brucellosis--cause of abortion in sheep and its public health significance. AB - Present study was undertaken to determine the association of brucellosis with abortions occurring naturally in sheep at an organized local sheep breeding farm. A total of 15 strains of Brucella melitensis biovar I were isolated from the abortion material. Serologically the aborted ewes were positive for brucellosis by one or more tests. During acute infection (abortion), standard tube agglutination test (SAT) detected more positive reactors (70.7%) while counter immunoelectrophoresis (CIE) detected more positive reactors (33.9%) in chronic infection (in-contact and apparently healthy sheep). Personnel handling the abortion material at the farm were found positive clinically as well as serologically for brucellosis. These observations suggest the zoonotic importance of brucellosis. PMID- 3557829 TI - Isolation of Campylobacter subsp. jejuni from Oriental and American cockroaches caught in kitchens and poultry houses in Vom, Nigeria. AB - A total of 690 adult cockroaches (Periplaneta americana (L.), the American cockroach, and Blatta orientalis (L.), the oriental cockroach) were captured alive within domestic kitchens and near poultry houses in Vom. Using selective media, their external surfaces and internal (gut) contents, after adequate decontamination of the external surfaces, were culturally examined for the presence of campylobacters. 4 isolates of Campylobacter subsp jejuni were made (0.5%); 3 from the gut contents and 1 from the external surface. Nocardia asteroides was isolated from the gut contents of a batch of ten cockroaches. The low isolation rate notwithstanding, our results suggest that cockroaches may be a potential vector of campylobacters from other sources to human food. The somewhat fortuitous isolation of Nocardia asteroides and its significance are discussed. PMID- 3557830 TI - Toxoplasma antibodies in local domestic animals. AB - 211 sera obtained from domestic animals generally used for human consumption in this area, were tested for Toxoplasma antibodies by the Indirect Haemagglutination Test (IHA). Goat (34.4%) and pig sera (26.6%) showed a higher prevalence as compared to cattle (16.6%) and sheep (7.4%). Obviously, proper precautions at every stage of the preparation of a meat dish are necessary to avoid Toxoplasma infection. PMID- 3557831 TI - Epidemiological studies on human trichomoniasis in southwestern Nigeria. AB - Retrospective study was carried out on the incidence of Trichomoniasis vaginalis infection in Nigeria. Data were obtained from two main hospitals in Ibadan (Adeoyo State Hospital and the University Teaching Hospital) and compared the data were classified and analysed statistically using the chi-square test. The study showed a high yearly incidence of I. vaginalis infection in Nigeria and in particular with people of low socio-economic status. The incidence was also higher in females than males. PMID- 3557832 TI - Human amoebiasis: epidemiological studies at two hospitals in Ibadan, Nigeria. AB - Investigations were conducted into the prevalence rates of Entamoeba histolytica over a five year period in Ibadan, Qyo State of Nigeria. Between 1979 and 1983, 1465 (17.23%) patients out of 8499 people examined at the University of Ibadan Teaching Hospital were positive for the infection. Within the same period only 37 (0.88%) out of 4196 people examined at the Adeoyo State Hospital were infected. Both male and female were affected. There is also no influence of age on the prevalence rates as both adult and children were infected with amoebiasis. PMID- 3557833 TI - Anaplasmosis of small ruminants in Nigeria: incidence and parasite identification through blood smear and latex agglutination test (LAT). AB - A survey was carried out on the incidence of anaplasmosis in small ruminants at Bodija abattoir, Ibadan. 100 sheep and 200 goats were examined using and comparing two methods-the Giemsa stained blood smear and serodiagnosis by Latex Agglutination Technique. The sheep and goats examined were among those brought from various parts of northern states and some neighbouring countries like Chad, Benin, Niger and Burkina Faso. 27% of the sheep and 17.5% of goats were positive for Anaplasma bodies with blood smear method while 54% of sheep and 61% of goats were sero positive with latex agglutination test (LAT). There seems to be a high incidence of anaplasmosis among sheep and goats probably due to the abundance of its arthropod vectors. The serodiagnostic method showed a high degree of specificity and sensitivity and is useful in field diagnosis. PMID- 3557834 TI - An evaluation of the applicability of crossed immunoelectrophoresis in seroepidemiological studies of hydatid disease in livestock. AB - Hydatidosis is both an economic and public health problem all over the world. Although various tests have been used on serodiagnosis of the disease in laboratory infected sheep, there is a problem in detecting antibody to the parasite in sheep. The antibody response of people infected with E. granulosus differs from the antibody response of livestock. Crossed immunoelectrophoresis was used to search for antibodies in 44 goats known to have had the infection. Crossed immunoelectrophoresis was able to detect two antibodies produced by a goat naturally infected with hydatid disease. Three of 44 known cases were detected by the test method. None of the naturally infected animals' sera exhibited a pattern of arcs similar to the reference pattern. The test's sensitivity was poor. PMID- 3557835 TI - Isolation of leptospires from a one week dead coypu (Myocastor coypus Molina). AB - The isolation of L. Interrogans from a one week dead coypu is reported. The isolate was identified as a pathogenic strain of leptospira belonging to the Icterohaemorrhagiae serogroup. PMID- 3557836 TI - Serological diagnosis of hydatid disease by enzyme linked immunosorbent assay (ELISA) using partially purified hydatid cyst fluid antigens. AB - Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF. The two antigens were precipitated together from HCF. This was done by adding 2M phosphotungstic acid and 2M magnesium chloride solutions to clarified HCF while continuously stirring the mixture. The precipitate formed was suspended in physiological saline (P.S.). This antigens' solution was used to coat microtitre plates for indirect ELISA. Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%. The predictive value was 89%. Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity. PMID- 3557837 TI - Epidemiologic observations on infection with Toxoplasma gondii in three species of urban mammals from Baltimore, Maryland, USA. AB - The prevalence of antibodies to Toxoplasma gondii was determined in three species of domestic and commensal mammals, from Baltimore, Maryland, USA. Crude prevalences of infection were 14.5% in cats (N = 650), 32.2% in dogs (N = 233), and 49.5% in Norway rats (N = 109). Oocysts identical to T. gondii were detected in 0.5% of cat feces. Cats and rats showed antibody prevalence rates which were strongly age-(or some age-related variable) dependent, with the highest rates associated with older animals. Antibody prevalence increased in dogs up to three years of age, then declined slightly in older animals. PMID- 3557838 TI - Emerging zoonoses in Africa. 1: Swine encephalitis in man. AB - Some cases of human cerebro-spinal meningitis associated with swine streptococcal infections were reported. Five piggery workers were involved. A 23 year old nursing mother and four male attendants suffered persistent headaches followed by stiffneck and what a physician diagnosed as meningitis and was treated in a hospital. Typical clinical signs of cold, mucopurulent catarrh with diarrhea and other symptoms were seen. Precautionary measures to be taken when swine encephalitis is suspected were also discussed. PMID- 3557839 TI - The viability of Cysticercus cellulosae in Thai native food (NHAM). AB - The purpose of this study was to determine the viability of Cysticercus cellulosae in various forms of Thai native food (Nham). Four duplicated experiments were carried out and represent as in the average values. The results revealed that under the room temperature (27-30 degrees C), the intact C. cellulosae in Nham could survive as long as 12-18 hours after preparation while isolated C. cellulosae and C. cellulosae in a piece of 2 X 9 cm. of pork in 0.85% saline could survive as long as 60 and 66 hours, respectively. The Cysticercus in other ingredients of Nham and in saline solution (6%) could be viable for 48-96 and 12-18 hours, respectively. Under the temperature of 4 degrees C, Cysticercus in various recipes could survive for 96 hours while in the controls, it could survive as long as 20-30 days. However, C. cellulosae in various compositions of Nham could be viable 11-20 days which was longer than those in potassium nitrate or salt alone. The findings of this study might infer the suggest that optimum time for consumming Nham in raw condition with safety should be after preparation at least 2-3 days at room temperature. PMID- 3557840 TI - Studies on the nutritional physiology of zoophilic dermatophytes isolated from horses in Ibadan, Nigeria. AB - The effects of the various growth factors with regard to the nutritional physiology of zoophilic dermatophytes isolated from horses are reported. The optimum temperature, pH and growth period for the fungal isolates were found to be 30 degrees-35 degrees C, 5-6 and 7-12 days respectively while the carbon and nitrogen sources utilised by the organisms were sucrose, fructose, maltose, L arginine and calcium nitrate. The use of these factors in preparation of efficacious fungicides used in the treatment of ringworm infections in man and animals is discussed. PMID- 3557841 TI - Prevalence of human hydatidosis in Tripoli region of Libya. AB - The literature on human hydatid disease is briefly reviewed. Records of the surgical department of the central Hospital, Tripoli from 1972 to 1979 were thoroughly examined. One hundred and eleven cases of hydatid disease were confirmed out of a total of 22,979 admissions during the period, bringing the incidence of the disease of 0.48%. Amongst 111 cases, 73 patients (65.76%) were females and 38 patients (34.23%) were males. Highest incidence of the disease was recorded between the ages of 20-40 years followed by 41-60 years age group. Recommendations concerning the disease surveillance and documentation of epidemiological data are put forward. PMID- 3557842 TI - An evaluation of diagnostic methods for bovine brucellosis in Libya. AB - A total of 8,607 animals were examined for detection of brucellosis using blood serum agglutination as well as complement fixation tests. out of 8,607 sera samples examined, 125 sera played positive serum agglutination reactions in significant levels for brucella (1.45%). The percentage of reactors to the complement fixation test in the examined cattle was 1.82%. The relation between positive or doubtful cases of serum tube agglutination as regards to their complement fixation results were discussed in detail. PMID- 3557843 TI - Observations on Cysticercus cellulosae in the flesh of rural dogs. AB - Out of a total of 150 carcases of rural dogs examined in Eastern Nigeria, 4 (2.7%) had Cysticercus cellulosae in the heart, tongue, thigh muscles and liver. Visual examination, palpation and multiple serial incision technique were used in locating the cysts. The cysts uncovered were collected in specimen bottles and transported in ice to the laboratory for morphologic assessment. The ages and sexes of the dogs were also recorded. Viable cysts were found only in young dogs. Environmental pollution with human excreta predisposes dogs to cysticercal infection. Thus environmental sanitation and health education should be an ongoing exercise for successful control of cysticercosis in dogs. PMID- 3557844 TI - Sleeve lobectomy for bronchogenic carcinoma: the Rush-Presbyterian-St. Luke's Medical Center experience. AB - One hundred and fifteen various types of sleeve lobectomy procedures were performed from 1961 to June 1985 with a perioperative mortality of 1.7%. Six of the eight patients who required completion procedures were considered as technical failures, a failure rate of 5%. Cumulative survival is 33% at five years and 22% at ten years. PMID- 3557846 TI - Tracheobronchoplasty for lung cancer. AB - Forty-seven patients were pathologically studied in order to identify the kind of local tumoral spread occurring in lung cancer with particular reference to direct infiltration, intra and peribronchial metastasis and multicentricity. The potential absolute and relative criteria for bronchoplasty for lung cancer are discussed. Eighty-three patients were treated over a five-year period with bronchoplasty for malignancy. Survival data show that bronchoplasty can cure some patients with an absolute indication and save lobar function or improve surgical radicality in patients with relative indications. PMID- 3557845 TI - Bronchoplastic and angioplastic operation in bronchial carcinoma: long-term results of a retrospective analysis from 1973 to 1983. AB - From 1973 to 1983, 248 bronchoplastic and angioplastic operations were carried out in patients with bronchial cancer. The five-year survival rate of all radically operated patients (stages I and II, n = 108) was 35%. The three-year survival rate in bronchial sleeve resection in stages I and II (n = 46) was 46%. The thirty-day lethality in stages I and II was 9% in bronchial sleeve resection and 5% in combined bronchial and vascular sleeve resections. Indications, surgical technique and complications are discussed. PMID- 3557847 TI - Sleeve resection and other bronchoplasties in the surgery of bronchogenic tumors. AB - One-hundred and fifty-eight sleeve resections and other bronchoplasties were performed for bronchogenic tumors in the last 20 years. Carcinoma was the indication in 143 and other tumors in 15 cases. Histology and staging conditions are outlined. The importance of the intraoperative histological or cytological examination of the resection margin is emphasized. One-hundred and twenty operations were performed on the right and 38 on the left side. In 12 cases of semimalignant or benign tumors, bronchoplasty without lung resection was carried out. The use of a wedge bronchoplasty instead of the customary sleeve resection is discussed. Right lower sleeve lobectomy with replantation of the middle lobe is described. Mortality was 6.3%. Fifty-six patients were alive more than five years later (35.4%). Forty-six of them were operated upon for carcinoma which corresponds to a 32% five years survival. PMID- 3557848 TI - Sleeve lobectomy in the treatment of bronchogenic carcinoma. AB - From 1980 to 1985, 44 sleeve lobectomies were carried out in patients with bronchial cancer. Sixteen patients received preoperative radiotherapy. Perioperative mortality was 6.8%. There were seven anastomotic complications (three fistulae and four stenoses) and two recurrences at the anastomosis. Overall actuarial survival was 45% at four years. These results seem to suggest that sleeve lobectomy should be considered an elective rather than a compromise procedure and a viable alternative to pneumonectomy. Preoperative radiotherapy neither increases complications nor has a negative effect on outcome. It contributes towards reducing local recurrences and maximizes tissue salvage. Long term survival is related to stage or histology, factors generally governing the survival of lung cancer operated patients, although the TNM classification is ill suited to identifying tumors which can be resected by a sleeve lobectomy. PMID- 3557849 TI - Breast cancer statistics: use and misuse. AB - Statistics can be manipulated, by using various methods of reporting, to support almost any type of regime in breast cancer. The basis for statistical calculations include: the definition of the population of patients treated, the time used for starting calculations, the exact nature of the treatment used and any adjuvant therapy, the prognostic parameters utilized, the importance of long term follow-ups, adequate number of cases, therapy standardization and pathological reporting, methods of evaluating survival such as observed or crude, relative and no evidence of disease, methods of calculating observed survival rates such as absolute, actuarial or life-table and Kaplan Meier or product limit, statistical evaluation for planned improvement with acceptable Type I and Type II errors, and the use of arithmetic and logarithmic scales in plotting statistics. Purveyors of innovative methods for the treatment of breast cancer aimed at preserving part or all of the breast as cosmetic alternatives to mastectomy, by limited operations with and without primary radiotherapy, have a most appealing argument to a woman with breast cancer. To determine if such procedures are justifiable alternatives to selective mastectomies and reconstructions, detailed, long-term statistical data on large numbers of cases must be available and end-results comparisons of various therapeutic modalities must be made on the basis of comparable statistical data. PMID- 3557850 TI - Lymph node metastasis in early gastric cancer. AB - From 1969 through 1984, 304 case of early gastric cancer (EGC) were resected. Nodal status was studied in 272 cases in which lymph node dissection was performed. The lymph nodes were negative for metastasis in 90% of the cases. In 7%, metastasis was noted in the Group 1 lymph nodes alone and in 3%, as far as the Group 2 nodes. But in no case were the Group 3 involved. The 10-year survival rate was poorer in patients with positive nodes than in those with negative nodes (52.8% vs. 94.1%). Cancer recurred more often in patients who had no lymph node dissection than in those with node dissection (9.4% vs. 1.5%). Lymph node metastasis was more frequent in the following EGC types: macroscopically combined type, over 5 cm, and with submucosal invasion. Dissection as far as the Group 2 nodes should be routinely performed even in EGC, especially in cases with the above-mentioned characteristics. PMID- 3557851 TI - The "Fletching": a new implant for the treatment of inguino-femoral hernias. AB - Inguino-femoral hernias present a special problem. Destruction of vital structures such as the inguinal ligament, the femoral sheath, the transversalis fascia and the conjoined tendon, is usually extensive. Repairs have often relied upon the use of sheets of prosthetic materials but never on a three dimensional implant. This article will examine such an implant, the "Fletching". The latter is a three leaved prosthesis with a common reinforced backing, the aim of which is to replace the inguinal ligament and associated structures necessary for the successful repair of the much feared inguino-femoral hernia. This prosthesis has been implanted in 24 patients with excellent results. Follow-up has now been longer than 2-1/2 years and careful steps are taken to continue this follow-up. PMID- 3557852 TI - Clinical features of Crohn's disease: a clinical study of one hundred patients found in an unselected population. AB - One hundred patients (mean age 34 years, range from 12 to 70 years) were treated at Tampere University Hospital during the thirteen year period, 1972-1984. Our hospital takes responsibility for the treatment of patients with Crohn's disease found in an unselected population of 400,000 inhabitants. In 73% of cases Crohn's disease was diagnosed before the age of forty. The mean interval between the first clinical signs and the diagnosis was 3.3 years. In 57% of the patients the diagnosis was reached within one year. In nine patients the primary diagnosis was colitis ulcerosa. Most patient were anemic and were in the state of inflammation and/or catabolism suggested by low blood hemoglobin concentration and high ESR and CRP values on admission. Three percent of the patients had macroscopic Crohn's disease in all parts of the gastrointestinal tract, whereas 22% had it only in the small intestine and 18% only in the colon. Fifty of the hundred patients had lesions in the terminal ileum and 20% in the anus. The specific finding for the present series was a high frequency of rectal lesions, in 29% of the patients. Histologically the condition was more often (P less than 0.001) revealed by the laparatomy specimen than the endoscopic biopsy, which gave a positive histology more often (P less than 0.001) in the lower than in the upper gastrointestinal tract. No gastrointestinal malignancies were found. PMID- 3557853 TI - The rationale of surgical treatment of inguinal hernia. PMID- 3557854 TI - Overviews: Thirty-five years of cell biology. PMID- 3557856 TI - Electrically silent Na+ and Cl- fluxes across the rabbit ciliary epithelium. AB - Unidirectional Na+, Cl-, and mannitol fluxes were measured across the isolated and short-circuited rabbit iris-ciliary body as functions of the Cl- concentration in the bathing solution (0, 26 and 80 mM). At constant Na+ concentration, Na+ fluxes increased on the average from 8.0 to 11.9 mu eq/hr as the Cl- concentration was raised and vice versa. Cl- fluxes also increased more than expected from simple diffusion; from 2.0 (26 mM) to 8.1 mu eq/hr (80 mM). Mannitol permeability (9.0 X 10(-7) cm/sec) was independent of the Cl- concentration and similar to that measured in "tight" epithelia. In Cl(-)-free solutions, there was good agreement between the measured electrical resistance and that calculated with the partial conductance equation. In Cl(-)-rich solutions, the calculated resistance was smaller than the measured resistance, suggesting electrically silent fluxes of Na+ and Cl-. These silent fluxes were of similar magnitude and possibly coupled with each other. This mechanism may provide an additional pathway for electrolyte movement across the ciliary epithelium. PMID- 3557855 TI - Adrenergic stimulation of ciliary process epithelium causes surface membrane internalization. AB - An ultrastructural change induced in the nonpigmented epithelium (NPE) of the ciliary processes by adrenergic stimulation in the albino rabbit was studied. Thirty min after topical treatment with 2% isoproterenol, an extensive intracellular membranous network, previously reported to be smooth endoplasmic reticulum, was revealed by electron microscopy. It was postulated that this network originated from the plasma membrane. Using cationized ferritin (CF) as an ultrastructural tracer, freshly isolated anterior segments were incubated in buffer containing 10(-5) M isoproterenol and 0.2% CF. As early as 10 min, and for at least 30 min, the isoproterenol-treated NPE cells contained a membranous network that was morphologically similar to that which occurs in vivo. CF particles were present within the network, indicating that the membranous network had originated at the cell surface. This labeling was prevented by pretreatment with the beta-adrenergic antagonist timolol maleate. In both treated and control ciliary processes, CF was present in the ciliary canals between the NPE and the underlying pigmented epithelium after 10 min incubation. This suggests that the NPE is able to transport CF from its basilar to apical surface. These experiments imply that the NPE is able to internalize rapidly large amounts of plasma membrane in response to adrenergic stimulation. This response may be part of the mechanism of adrenergic receptor desensitization, alteration of aqueous humor production, or another adrenergic response. PMID- 3557857 TI - Fluorescence-labeled lectins, glycoconjugates, and the development of the mouse AOP. AB - The development of the aqueous outflow pathway (AOP) in early postnatal mouse eyes was examined for the presence of a variety of lectin receptors using fluorescein isothiocyanate (FITC) conjugated lectins, 1 micron araldite plastic sections, and computer-aided fluorescence photography. The trabecular meshwork anlage (days 1-4) was characterized by the presence of loosely arranged cells and an extracellular matrix that exhibited intense areas of Con A- and RCA-lectin staining, and absence of WGA- and LPA-lectin staining. By day 6, trabecular meshwork LPA- and WGA-positive materials were observed as focal areas of staining. By day 10, LPA- and WGA-positive materials were present as diffuse areas of staining, as the AOP differentiated into an organized and functional biological filter. The age-dependent pattern of LPA- and WGA-positive materials indicated that there were time-dependent points in the synthesis of glycoconjugates in the developing AOP. The results suggest: The composition and/or conformation of the glycoconjugates on cells and extracellular matrix changed as the AOP differentiated into a functional tissue. The use of FITC lectins as biological markers for studies of the AOP provided information on the potential role of glycoconjugates in the development of the normal AOP. Modification in the type, amount, and distribution of glycoconjugates may provide a basis for understanding the cellular mechanisms of abnormal development of the AOP, eg, congenital glaucoma. PMID- 3557858 TI - Delta 1-pyrroline-5-carboxylate dehydrogenase in the bovine ciliary body and iris. AB - Delta 1-pyrroline-5-carboxylate dehydrogenase extracted from the combined ciliary body and iris of bovine eyes was studied biochemically. The enzyme was purified 120-fold. The partially purified enzyme had broad optimum at pH 8.0. Apparent Km values for DL-delta 1-pyrroline-5-carboxylate and NAD were 0.14 and 0.18 mM, respectively. The enzyme activity was strongly inhibited by GABA, proline, hydroxyproline, and glutamine. PMID- 3557859 TI - Aqueous humor dynamics in experimental iridocyclitis. AB - Ocular inflammation was induced by intravitreal bovine serum albumin (BSA) injection in one eye of each of six cynomolgus monkeys. The fellow eyes were injected with sterile saline alone. The intraocular pressure decreased by 12.2 +/ 1.3 mmHg (mean +/- SE) 2 days after BSA injection and 4.0 +/- 1.1 mmHg after saline injection. Aqueous flow and uveoscleral outflow were determined with fluorescein isothiocyanate (FITC) dextran 70. Aqueous flow in inflamed eyes averaged 0.32 +/- 0.04 ul/min, less than half the rate of control eyes (0.77 +/- 0.08 ul/min, P = 0.01). The facility of uveoscleral outflow in inflamed eyes was four times that of control eyes (0.2 +/- 0.03 vs 0.05 +/- 0.01 ul/min/mmHg, respectively, P = 0.009). Fluorescence microscopic examination revealed intense fluorescence of the edematous ciliary body muscle and of the suprachoroidal space extending to the posterior pole. These findings indicate that BSA-induced ocular inflammation causes a simultaneous reduction in aqueous humor flow and an increase in uveoscleral outflow, resulting in ocular hypotony. PMID- 3557860 TI - Indomethacin and the epinephrine-induced breakdown of the blood-ocular barrier in rabbits. AB - Using aqueous and vitreous fluorophotometry, the authors examined the blood aqueous and blood-retinal barrier functions in three groups of pigmented rabbits. Epinephrine (1.25%) was applied topically five times daily and indomethacin (0.5% sesame oil suspension) was applied topically three times daily to one eye of each of the animals in Group 1; under the same regimen, epinephrine and indomethacin placebo were administered to one eye of each of the animals in Group 2 and epinephrine placebo and indomethacin placebo were administered to one eye of each of the animals in Group 3. Fluorophotometry was done 1, 2, and 3 months after drug administration. The results showed that epinephrine induced disruption of the blood-aqueous barrier 2 and 3 months after drug administration, and that the magnitude of this disruption increased with time. Epinephrine also induced disruption of the blood-retinal barrier 3 months after drug administration. Indomethacin significantly prevented disruption of the blood-aqueous barrier at 2 and 3 months and significantly prevented disruption of the blood-retinal barrier at 3 months. The magnitudes of the barrier disruptions in eyes treated with both epinephrine and indomethacin were slightly higher than, or the same as, those of the control eyes. The results strongly indicated that the epinephrine-induced disruption of the blood-ocular barrier was partially caused by prostaglandins and other cyclo-oxygenase products whose biosynthesis was initiated by epinephrine. PMID- 3557861 TI - Improved corneal penetration of timolol by prodrugs as a means to reduce systemic drug load. AB - A major problem in the use of timolol in glaucoma therapy is its relatively high incidence of cardiovascular and respiratory side effects. This report presents preliminary evidence for the feasibility of a prodrug approach to minimize systemic absorption of timolol using a reduced topical dose made possible by improved corneal drug penetration. The results indicate that the O-acetyl, propionyl, butyryl, and pivalyl ester prodrugs of timolol were virtually completely hydrolyzed between 30 and 150 min when incubated with plasma, aqueous humor, and ocular tissue homogenates of pigmented rabbits. Moreover, the in vitro corneal penetration of all but the O-pivalyl prodrug was 2-3 times higher than timolol. This was accompanied by a four- to sixfold increase in aqueous humor concentration at 5 and 30 min post-instillation of 15 mM solutions, although the plasma timolol concentration at the same time points was either unaltered or slightly reduced. Collectively, these preliminary findings suggest that at least a twofold reduction in the topical dose of timolol is possible by using prodrugs, thereby reducing timolol concentration in the systemic circulation and possibly the incidence of cardiovascular and respiratory side effects. PMID- 3557862 TI - The pattern ERG in man following surgical resection of the optic nerve. AB - Pattern electroretinogram (PERG) results recorded in different laboratories from patients with unilateral traumatic transections of the optic nerve have led investigators to opposite conclusions about the sources of this response. There was no absolute demonstration of complete transection in any of these studies. In the present study, PERGs and flash ERGs were recorded from a patient who, 30 months earlier, had undergone surgical resection of the right optic nerve to remove a glioma. The histological section of the biopsied nerve confirmed complete optic nerve transection. Ophthalmoscopically and angiographically, the right eye was normal except for marked optic atrophy. PERGs were produced by 10 Hz reversal of high contrast checks with check widths from 13 deg 30 min to 12 min arc. Field size was 27 deg X 21 deg and space-averaged screen luminance was 110 cd/m2. Smaller checks (3 deg 23 min to 12 min) produced responses in both eyes, but the responses in the right eye were much smaller than those in the left eye. Large checks and diffuse flashes produced approximately equal responses in the two eyes. The implicit times of the PERGs produced by stimulation of the right eye with smaller checks were shorter than those of the left eye. The authors conclude that, in humans, there is a contribution to the high contrast pattern reversal ERG from cells which are not dependent upon the integrity of the ganglion cell layer. These cells and cells dependent upon ganglion cells may both contribute to the high contrast PERG in the normal human eye. PMID- 3557863 TI - Fibronectin distribution in the rat eye. An immunohistochemical study. AB - Previous studies of fibronectin (FN) distribution in eye tissue have relied on immunofluorescence (IF) techniques on frozen sections, and have not included the rat. Using rat eyes, a technique was developed for immunoperoxidase (IP) staining of formalin fixed paraffin embedded material, and the results were compared to those obtained by IF. IP was technically more difficult, and required pepsinization of tissue after formalin fixation to obtain consistent results. The optimum pepsin time varied for different structures in the eye. IP offers better tissue preservation and stain resolution. Results with IF were consistent with those observed with the newly applied IP. The distribution of FN in rat eyes was similar though not identical to that reported in other species. Prominent stain was observed in the conjunctiva, basement membrane of the corneal epithelium, corneal stroma, anterior aspect of Descemet's membrane, trabecular meshwork, perivascular stroma of the ciliary body, choroid and retinal blood vessels. Lens structures, vitreous, and internal limiting membrane of the retina were negative. PMID- 3557864 TI - Alterations in the distribution of fibronectin and laminin in the diabetic human eye. AB - The distribution of fibronectin and laminin in diabetic human eyes was determined by indirect immunofluorescent techniques. The intense fluorescence suggests increased amounts of fibronectin and laminin in the diabetic internal limiting membrane (ILM). A double laminated pattern of fluorescence for both glycoproteins suggests structural abnormalities of the ILM of the posterior retina. Preretinal and subretinal proliferative tissues fluoresced strongly and diffusely with antifibronectin. This study indicates that in diabetic patients, the ILM, especially in the posterior retina, is biochemically and morphologically abnormal. PMID- 3557865 TI - Measurement of in vivo human corneal stromal pH: open and closed eyes. AB - The pH sensitive fluorescent properties of fluorescein were utilized to noninvasively measure human in vivo stromal pH in the normal open eye and following eye closure. Stromal pH after either 20 or 90 min of eye closure was 7.39 +/- 0.01 (n = 12, +/- SEM) and returned to 7.54 within 10-15 min of opening the eye, t1/2 = 3 min. Eye closure was simulated by exposing the eye to a gas mixture of 7.1% O2, 6.7% CO2, balance N2, which was passed through tight-fitting goggles. This gas mixture resulted in a steady-state stromal pH of 7.29 +/- 0.02 within 10-15 min, t1/2 = 2.2 min. The time course of the return of stromal pH to open eye levels after removal of the goggles, t1/2 = 2.3 min, was similar to that after eye opening. The extent of the pH change however, was 0.1 pH units greater with the test gas. Exposure of the eyes to 5% CO2 (CO2 concentration of blood) and balance air, produced a stromal pH of 7.38 + 0.01 (n = 6, +/- SEM), which closely matches that following eye closure suggesting that conjunctival [CO2] is 5% and is the major component controlling stromal pH when the eyes are closed. PMID- 3557866 TI - Unusual structure of rat conjunctival epithelium. Light and electron microscopy. AB - The conjunctiva of the adult Sprague-Dawley rat was studied by light microscopy of 3 micron glycol methacrylate sections of whole eyes with lids and by electron microscopy of conjunctiva from the lower fornix. Rat conjunctiva is unique among species studied. All the superficial epithelial cells are squamous cells rather than polyhedral or columnar cells. Furthermore, the goblet cells are aggregated into clusters rather than distributed randomly throughout the epithelium. These clusters are not found at the lid margin or limbus, but are present in the palpebral and bulbar conjunctivae and achieve maximal size and number near the fornix. The stratified squamous epithelium is typical, composed of a layer of basal cells, an intermediate zone of wing cells, and an upper zone of several layers of squamous cells. Dividing cells are seen only in the basal layer. Occasional mononuclear leukocytes are found in the basal and intermediate layers. The goblet cell clusters are largely composed of columnar cells. Goblet cells predominate, but there are also occasional tuft cells, characterized by thick microvilli at their apices. Basal cells form only an incomplete layer beneath the columnar cells, which in places span the entire epithelium. The conjunctiva of the adult rat has few cells with potential for immunological activity. It does not contain appreciable numbers of plasma cells, and lymphoid follicles are absent. PMID- 3557867 TI - Rhodopsin, vitamin A, and interstitial retinol-binding protein in the rd chicken. AB - In order to determine whether blindness in the rd strain of Rhode Island Red chickens is due to a defect in the vitamin A (visual) cycle, spectroscopy, high performance liquid chromatography, and immunochemical techniques were used to compare the amounts of rhodopsin, interstitial retinol-binding protein, and vitamin A compounds in the dark-adapted eyes of homozygous rd and heterozygous carriers. In both groups of chickens, (up to 6 weeks post-hatching) the distribution of stored vitamin A differed from other vertebrates (mammals, amphibians, fish) in that more than half of the retinyl palmitate/stearate occurred in the neurosensory retina. The 11-cis isomer accounted for nearly 100% of the retinyl palmitate/stearate in the neurosensory retinas of both groups. In the pigmented layers (pigment epithelium and choroid) the 11-cis isomer amounted to 70.1 +/- 4.2% in the carrier, and 65.1 +/- 2.9% in the rd birds. With respect to their content of rhodopsin, IRBP, retinyl palmitate/stearate and unesterified retinol, (both 11-cis and all-trans isomers) no significant difference could be demonstrated between the eyes of rd and carrier chickens (3 days and 28 days post hatching). These results therefore demonstrate that the ocular tissues of rd chickens do not lack IRBP, the putative extracellular transport protein for vitamin A, that these tissues synthesize and store the 11-cis isomer of vitamin A, and that the 11-cis isomer is used to form rhodopsin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557869 TI - Cytochemical characterization of sialoglycoconjugates on rat photoreceptor cell surface. AB - Terminal saccharide sequences in rat photoreceptor cell surface glycoconjugates were characterized. Lectin cytochemistry and electron microscopy were used for preembedding cytochemical localization of surface carbohydrates. Neuraminidase digestion was employed for the exposure of penultimate saccharides in sialoglycoconjugates. Isolated rat retinas were incubated with ferritin-labeled wheat germ agglutinin (WGA), peanut agglutinin (PNA), and soybean agglutinin (SBA) prior to and after neuraminidase digestion. PNA and SBA did not label untreated photoreceptors. WGA densely labeled the photoreceptor surface and interphotoreceptor matrix (IPM) components. Following neuraminidase treatment, PNA, but not SBA, labeled the photoreceptor surface and the IPM. WGA labeling of the IPM was abolished, and the labeling of the photoreceptor surface was reduced. Based on the lectin specificity, it was concluded that photoreceptor surface glycoconjugates in the rat retina contain a terminal trisaccharide: sialic acid-D galactose-(beta 1----3)-N-acetyl-D-galactosamine. PMID- 3557868 TI - Are sugars involved in the binding of rhodopsin-membranes by the retinal pigment epithelium? AB - The binding by the retinal pigment epithelium (RPE) cells of the embryonic chick, in culture, of recombinant membranes composed of phosphatidylcholine and bovine rhodopsin (rhodopsin-liposomes [RL]) was investigated to explore the influence that the carbohydrate groups of rhodopsin might have on this process. The reaction was quantitated by measuring the amount of RL associated with the cells using a radioimmunoassay for rhodopsin. The process was saturated at about 8 microM RL (calculated as rhodopsin-equivalents), and a two- to threefold greater rate and extent of binding was observed at 37 degrees C as compared with 4 degrees C. The presence of up to 30 X 10(3)-fold molar excess over RL of mannose and N-acetylglucosamine, the sugars present on rhodopsin, as well as other saccharides, had little or no effect on the binding. These observation indicate that lectin-like recognition involving the sugar groups of rhodopsin is not involved in the binding of rhodopsin-containing membranes by the RPE cells. In contrast, exogenously added concanavalin A and wheat germ agglutinin enhanced the binding, an effect which was blocked by appropriate sugars. PMID- 3557870 TI - Inward permeability of the blood-retinal barrier by fluorophotometry. AB - A method for assessing the inward permeability of the blood-retinal barrier by fluorophotometry is presented. The permeability value is calculated with the fluorophotometer computer from fluorophotometric scan values in vitreous and non protein-bound fluorescein concentration values in plasma. No diffusion coefficient of fluorescein in vitreous was required in the calculations. Corrections were performed for lens transmission, corneal transmission, and the spatial resolution of the apparatus. The method was applied to 58 healthy volunteers, aged 13-72 yr. An insignificant average increase of permeability values was found from 4.8 nm/s at 10 yr, up to 6.1 nm/s at 70 yr (P = 0.14; standard deviation: 1.8 nm/s). Permeability values showed an average increase of 10% between 30 min and 60 min after injection (P less than 0.001). PMID- 3557871 TI - Retinal blood flow in normal and diabetic dogs. AB - We have found retinal blood flow to be decreased in diabetic dogs 5 months after the onset of diabetes, which is long before they can be expected to develop morphological changes of diabetic retinopathy. Retinal blood flow was determined using radionuclide labelled microspheres. In eight alloxan diabetic dogs without retinopathy, the retinal blood flow was 0.53 +/- 0.08 (mean +/- SE) ml/min/gm dry tissue weight. This compares with 0.91 +/- 0.17 (mean +/- SE) ml/min/gm dry tissue weight in seven normal dogs. The decreased blood flow in diabetic retinas is statistically significant (P = 0.05). Blood glucose levels did not significantly affect retinal blood flow. This data suggest that changes in retinal blood flow and oxidative metabolism may precede the morphological signs of diabetic retinopathy. PMID- 3557873 TI - On quantifying the bipolarity and axis of the Farnsworth-Munsell 100-Hue test. AB - A simple method is introduced for analyzing error score distributions from the Farnsworth-Munsell 100-Hue test. The method involves fitting a sine wave directly to the error distribution, and produces estimates of three parameters that characterize the severity of the defect, the degree of bipolarity, and the orientation of the axis of bipolarity, if one is present. The method produces good estimates of the orientation of the axes for congenital defects. It is also amenable to statistical analysis. PMID- 3557872 TI - The response of retinal vasculature to angiotensin. AB - A retinal arterial constriction was produced in anesthetized cats with a continuous transvitreal infusion of angiotensin I or angiotensin II (Ile-5). Constriction of vessels near the infusion cannula tip occurred over a range of angiotensin II concentrations from 10(-9) to 10(-4) molar, and was reversibly blocked by a ten-fold excess of the competitive antagonist saralasin. Constriction did not occur in response to angiotensin I if angiotensin-converting enzyme was blocked with Captopril. Control infusions of saline did not elicit a contraction of the retinal arteries. Severe axonal and inner retinal damage and necrosis occurred when angiotensin II produced a prolonged vasospasm, but not after infusion with control solutions, or when-constriction caused by angiotensin was brief. PMID- 3557874 TI - A psychophysical technique for measuring cone photopigment bleaching. AB - A new, clinically applicable test has been developed to measure the bleaching of the foveal cone photopigments. This noninvasive test is called steady-state color matching. Steady-state color matching is based on the dependence of a color match on the optical density of the cone photopigments. By measuring the color match as a function of retinal illuminance, it is possible to compute the optical density of the cone photopigments at each illuminance. Thus, abnormalities of photopigment bleaching can be detected. This study demonstrates that the technique is readily performed by a clinical population. Patients with central serous retinopathy and retinitis pigmentosa are shown to have low effective optical densities. PMID- 3557875 TI - Cone photopigment bleaching abnormalities in diabetes. AB - We have used a color-matching technique to obtain estimates of the optical density of cone photopigments as a function of retinal illuminance in patients with insulin-dependent diabetes mellitus (IDDM). We found that the half-bleach illuminance of some patients is abnormally high. That is, it takes more light to bleach an equivalent amount of photopigment in these patients. Since low illuminance color matches for these patients are normal, this implies that these patients have normal amounts of photopigment, but the photopigment is not bleaching normally. This result clearly points to abnormalities in the outer retina of these diabetic patients. The most likely causes of this abnormality are either decreases in the ability of the cones to absorb light, or an increased rate of regeneration of the cone photopigments. PMID- 3557877 TI - Electrophysiological evidence for the oblique effect in human infants. AB - Visually-evoked potentials (VEPs) were recorded from infants between the ages of 2 and 11 months in response to 2.5 c/deg main axis and oblique square wave gratings. The oblique effect first appears at 3 months of age; some infants showed smaller VEP amplitude and/or longer VEP latency for obliquely oriented gratings. Regarding the age of onset of the oblique effect, VEP data from this study agree with the results obtained with preferential looking (PL) studies which have directly paired vertical and oblique gratings, but the current study found that fewer infants show an oblique effect by VEP than by PL. PMID- 3557876 TI - Abnormal foveal spectral sensitivity in retinitis pigmentosa. AB - The authors measured dark-adapted foveal spectral sensitivity functions in 30 patients with retinitis pigmentosa or Usher's syndrome, whose Snellen visual acuities were 20/30 or better. An analysis of variance of the spectral sensitivity functions (normalized at 575 nm) indicated a significant reduction in the patients' relative sensitivity at 450 and 475 nm compared with a group of 15 age-similar normal observers, while the patients' relative sensitivity at middle and long wavelengths was normal. A significant negative correlation between the patients' normalized sensitivity at 450 nm and their non-normalized sensitivity at 575 nm indicated that patients with a normal absolute sensitivity at 575 nm had the greatest reduction in relative sensitivity at 450 nm. The characteristics of the short-wavelength sensitivity loss suggest that it results from an increase in the effective optical density of the yellow macular pigment, rather than from a decreased sensitivity of a specific cone mechanism or an increased lens absorption. PMID- 3557878 TI - Photographic calibration of the Hirschberg test. AB - A series of direct photographic measurements of corneal reflex positions was taken to reconcile discrepant interpretations of the Hirschberg test. A value of 21 prism diopters per millimeter was obtained for the conversion factor relating ocular rotations to reflex displacement, valid over a range of 200 prism D. Quantitative interpretation of routine clinical photographs of strabismic patients can thus be easily obtained by including a millimeter scale in each picture. This value for the conversion factor is in agreement with a simple optical model for the corneal reflex. The discrepancy with the traditional value (about 14 prism D/mm) appears to arise from an attempt of most observers to measure reflex displacement from the corneal apex along the surface of the cornea, rather than to project the reflex and pupil onto a true frontal plane, as is done in a photograph. PMID- 3557879 TI - Near work, visual fatigue, and variations of oculomotor tonus. AB - One hour of near work produced adaptive changes in the resting states of accommodation and binocular vergence, which may be responsible for different aspects of visual fatigue. Two groups of college students read from either hard copy or a video display terminal (VDT). Immediately before and after reading, the subjects' distance acuity, dark vergence, dark focus, and accommodative response accuracy for a monocular stimulus were measured. After reading, subjects also rated their subjective feelings of visual fatigue. Reading produced significant changes in both accommodation and vergence, which did not differ for the hard copy and VDT modes of presentation. Dark focus and accommodative responses shifted in the myopic direction by an average of 0.6 D and at least 0.35 D, respectively; dark vergence distance shifted in the convergent direction by an average of 11.4 cm. These changes were greatest for subjects whose initial resting postures corresponded to a far distance. After reading, one third of the subjects exhibited lower visual acuity at distance. This change was significantly correlated with changes in dark focus (r = 0.35) but not with changes in dark vergence (r = -0.12). In contrast, subjective ratings of visual fatigue were not correlated with changes in the dark focus (rho = 0.13), but they were significantly correlated with changes in dark vergence (rho = 0.58). These findings indicate that ordinary near work can produce significant changes in the resting states of accommodation and vergence, whose magnitude depend on the subject's initial oculomotor resting tonus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557880 TI - Ocular axial length in unilateral congenital cataracts and blepharoptosis. AB - Biometry performed in patients with unilateral dense congenital cataracts and unilateral complete blepharoptosis did not show a consistent elongation of the involved eye. The antero-posterior axis of the visually deprived eye was longer than that in the normal fellow eye in some but shorter or unchanged in other patients. These findings are in accord with the hypothesis gained from monkey experiments that visual deprivation during infancy may deregulate axial growth of the eye. However, unlike in monkeys where axial elongation usually prevails, this effect of visual deprivation is less predictable in humans. PMID- 3557882 TI - Incidence of ventricular fibrillation during coronary arteriography in the rabbit. A comparative study of isotonic ioxaglate and iohexol. AB - The incidence of major ECG changes, particularly ventricular fibrillation, was evaluated in rabbits during prolonged, selective right coronary injection of sodium/meglumine ioxaglate (Hexabrix 160) and iohexol (Omnipaque 140), two isotonic contrast media. The anesthetized animals (n = 12) per test solution) each received 1.5 ml of contrast material, delivered at a rate of 3 ml/minute. Both contrast media caused major ECG changes, which were reversible within seconds after administration. No fibrillation occurred with ioxaglate, but ventricular fibrillation was seen in seven animals given iohexol. There was a significant difference in the incidence of ventricular fibrillation between the contrast media (P less than .01). Both test solutions induced transient, more or less marked bradycardia, but without significant differences. The intracoronary injections produced similar decreases in blood pressure for both contrast agents. Reactive hypertension was observed only in those animals in which an episode of fibrillation occurred with iohexol. The causes underlying these effects are analyzed for both contrast agents. PMID- 3557881 TI - Iris-ciliary complex inhibits protein synthesis by organ cultured mammalian ocular lens cells. AB - Freshly isolated rabbit ocular lenses with or without adhering iris-ciliary complex were organ cultured. It was found that lenses with iris-ciliary complex showed decreased protein synthetic ability. Vimentin, a cytoskeletal protein and MP-26, a membrane associated protein, were used as markers for protein synthetic activity. Removal of the iris-ciliary complex at least partially restores the protein synthetic capability of the lens. The ocular lenses cultured with iris ciliary complex for 48 hr showed marked equatorial opacities. PMID- 3557883 TI - Edema and the lack of blood perfusion produce opposite effects on the magnetic resonance characteristics of acutely ischemic rat kidneys. AB - Both kidneys of 28 rats were studied with magnetic resonance imaging (0.35 tesla, double spin-echo technique with echo-delay times [TEs] of 28 and 56 ms and repetition times [TRs] of 0.5 and 2.0 seconds). Kidneys were studied before and up to 4 hours after ligation of the abdominal aorta above the origin of the left renal artery (20 rats) or after ligation of the left renal artery (eight rats). Any changes in the relaxation times of cortex and medulla and in the cortex-to medulla contrast (CMC) were correlated to histologic data and renal water content. After the first hour following ligation of either the abdominal aorta or the left renal artery, the cortex of the left kidneys showed a 20% shortening of the mean T2 relaxation time (P less than .001), a 16% shortening of the mean T1 relaxation time (P less than .001), a 73% increase in mean CMC on T2-weighted images (P less than .001) and a 42% decrease in mean CMC on T1-weighted images (P less than .001). There were no significant changes either in relaxation times of the medulla of the left kidneys or in relaxation times and CMC of the right kidneys. During the next three hours, relaxation times of cortex and CMC remained unchanged in the rats with ligated abdominal aorta. In the rats with ligated renal artery, relaxation times of cortex and CMC returned to normal values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557884 TI - Peripheral hepatic arterial embolization with crosslinked collagen fibers. AB - Hepatic artery embolization with a nonimmunogenic, crosslinked microfibrillar collagen preparation (Angiostat, Collagen for Embolization, Target Therapeutics, Los Angeles, CA) was studied in mongrel dogs. Flow-directed technique was used to achieve complete distal arterial occlusion. Serial liver function evaluation demonstrated marked alterations at 48 to 72 hours, partial correction at one week, and resolution of abnormalities by one month. Restoration of large vessel blood flow was angiographically demonstrable at one week. Follow-up arteriograms showed no persistent arterial occlusion. Collagen was demonstrated in vessels of 20 to 250 micron. Recanalization was achieved by migration of endothelial cells around the collagen, development of a new vascular channel within an endothelial cell cleft, and subsequent complete removal of the collagen over a three- to four month period. Three months after embolization with a single dose, normal hepatic vascular and tissue anatomy and hepatic function were restored completely. Repeated embolization at two weekly intervals was well tolerated. PMID- 3557885 TI - Further support for the glucose hypothesis of metrizamide toxicity. The effect of metrizamide and glucose analogue-free contrast media on hexokinase. AB - Metrizamide neurotoxicity has been hypothesized to be caused by an inhibitory effect of the drug on glucose metabolism. Metrizamide contains a glucose side chain, and glucose analogues including metrizamide have been shown to be inhibitors of hexokinase, an enzyme that is central to cerebral glucose metabolism. We studied the effect of the nonionic contrast agents iohexol, iotrol, and iopamidol, and the ionic contrast meglumine diatrizoate, on hexokinase in vitro. Although metrizamide reproducibly caused competitive inhibition of the reaction, the nonglucose contrast agents had no significant effect on the enzyme. These results add further support for the glucose hypothesis of metrizamide neurotoxicity. PMID- 3557887 TI - Procurement of technology. An ethical dilemma. PMID- 3557886 TI - Characterization of liposomes containing iodine-125-labeled radiographic contrast agents. AB - Multilamellar liposomes were prepared containing either iodine-125-labeled (125I) diatrizoate or 125-I labeled iotrol in their aqueous phase. The in vitro permeabilities of liposomes containing both contrast agents were measured in the presence of saline and serum at 37 degrees C. Two different phospholipid compositions were studied: phosphatidylcholine/cholesterol/stearylamine (PC/C/S, 8: 1:1 molar ratio) and distearoylphosphatidylcholine/sphingomyelin (DSPC/SM, 5:2 mole ratio). In saline, similar permeabilities were observed for the four phospholipid-contrast agent combinations. In serum, however, leakage of 125I activity was 2 to 3 times greater from PC/C/S liposomes than from vesicles composed of DSPC/SM. When PC/C/S liposomes that contained 125I-diatrizoate were injected into rats, the clearance half-times for 125I activity from the liver, spleen, and whole body were 4.4 hours, 4.5 hours, and 2.8 hours, respectively. Liposomes composed of DSPC/SM cleared at a significantly slower rate from the liver, spleen, and whole body with half-times of 24.0 hours, 18.4 hours, and 17.2 hours observed from these tissues, respectively. PMID- 3557889 TI - The value of relaxation times and density measurements in clinical MRI. AB - The hope that MRI relaxation time signatures would identify tissues, specifically, malignancies, has not been realized. This is due much less to measurement inaccuracies than to a large intrinsic variability and overlaps between malignancies and many benign pathologies. Neither has there been success in predicting relaxation times from basic tissue compositions. Nevertheless, MRI provides a qualitative measure of tissue hydration, and of flow, on the basis of relaxation times. Furthermore, pixel-by-pixel maps of relaxation times have proven useful in understanding the MRI process, in predicting the efficacy of untried techniques, and replace, in many circumstances, the need for acquisition of images with diverse sequencing parameters. PMID- 3557888 TI - A rat model of liver cancer for imaging research. PMID- 3557890 TI - Painful swelling of the toe in a young boy. PMID- 3557891 TI - Current and future policies regarding laboratory animal welfare. AB - Laboratory animal welfare has made tremendous strides in recent years. The first laboratory animal welfare law was not enacted until 1966, and laboratory animal medicine as a specialty did not even exist until the 1960s. The AAALAC accreditation program has stimulated improvements in accredited institutions, and the FDA and EPA Good Laboratory Practices Acts had a major impact on industry in the 1970s, but the most visible impact upon academic institutions was made by NIH enforcing their Policy in the 1980s by suspending funding to several programs and institutions. The Association of American Medical Colleges and the Association of American Universities jointly published Recommendations for Governance and Management of Institutional Animal Resources in October 1985, following very closely the provisions of NIH and the Guide. Animal rights groups have even contributed toward the improvement of animal welfare policies by their recent flurry of demonstrations, thefts, and vandalism. The end result has been an impressively rapid upgrading and standardization of animal care and use policies and programs at all types of institutions that use animals in their work. Most major institutions now have qualified and credentialed laboratory animal medicine specialists directing their programs, conscientious and responsive animal care and use committees overseeing and evaluating animal welfare, and qualified, well trained animal care staff and investigators. Institutions that do not meet these standards undergo great pressure from the USDA, NIH, their peers, and the public to bring their programs into compliance quickly and appropriately.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3557892 TI - Imaging of the pulmonary hilum: a prospective comparative study in patients with lung cancer. PMID- 3557893 TI - Imaging diagnosis of traumatic aortic rupture. A review and experience at a major trauma center. PMID- 3557894 TI - Dissolution of gallstones using cholecystostomy tube in the pig. AB - Cholecystostomy catheters and human cholesterol gallstones were implanted surgically in the gallbladders of eight pigs. Through the catheters, mono octanoin or sterile water (H2O) was infused from two to seven days. The mono octanoin dissolved pure cholesterol gallstones smaller than 200 g. There was no stone dissolution with infusion of sterile water and only one stone larger than 250 g was dissolved with mono-octanoin. Side effects included moderate-to-severe inflammation and ulceration of the gallbladder with mono-octanoin instillation, which precludes its widespread use with the present treatment regimen. Infusion of water caused little gallbladder irritation. PMID- 3557895 TI - Magnetic resonance imaging evaluation of radiation-induced changes in experimentally implanted renal cell carcinoma. AB - The effect of radiation on the magnetic resonance imaging appearance and relaxation parameters of human renal cell tumors implanted in male white-Swiss athymic nude mice was evaluated. Twenty-three mice were treated with external beam radiation, receiving a total dose of 2,500 rads administered in a single treatment limited to subcutaneous tumor. Twenty-two tumor-bearing mice served as control animals. Experimental and control mice were studied with MRI at four (n = 9), seven (n = 20), 14 (n = 8), and 28 (n = 8) days following experimental radiotherapy. A 0.35 tesla superconductive MRI system was employed. Images were generated using spin-echo technique with repetition times (TR) of 500 and 2,000 ms and echo-delay times (TE) of 28 to 30 and 56 to 60. Relaxation time calculations were made on the basis of tumor signal-intensity measurements in assigned regions of interest. The MRI appearances and relaxation times of irradiated tumors that decreased in size following treatment, irradiated tumors that grew, and control tumors were similar, as were their histologic features. No statistically significant differences could be detected in relaxation times of the four experimental and four control groups. Statistical evaluation was performed using analysis of variance. Further investigation of MRIs potential in tissue characterization following radiotherapy is warranted, but evaluation of change in tumor dimensions remains the most reliable indicator of therapeutic response. PMID- 3557896 TI - Two postprocessing CT techniques for determining the composition of trabecular bone. AB - Two dual-energy CT techniques have been developed to analyze the mineral and fat content of trabecular bone. Both are postprocessing techniques that employ calibration standards. Experiments were performed to test these techniques against conventional single-energy techniques and two other dual-energy techniques. As expected, all of the dual-energy methods estimate the mineral content more accurately when fat is present. In contrast to the other dual-energy methods, the new methods described in this article are unique because they make a separate estimate of the fat content of the bone. The results of preliminary tests of these techniques in estimating fat content have been encouraging. Although not exact, the estimates show the correct trend in increasing proportionately as the fat content increases. Possible applications of the techniques in the study of osteoporosis and other bone diseases are described. PMID- 3557897 TI - Coumadin and 111In-labeled platelet uptake on experimental thrombi in dogs. Preliminary observations. AB - The effect of coumadin treatment upon the uptake of 111In platelets (111In-P) in dogs by experimental jugular thrombi and intravascular catheters was studied. Coumadin, in doses sufficient to raise the PT to the "therapeutic" range, did not impair scintigraphic visualization of thrombi on images obtained 4 hours after 111In-P injection. In addition, there was no obvious effect upon postmortem measurements of thrombus:blood or catheter:blood 111In activity ratios, consistent with the imaging data. However, slight delay in 111In-P accumulation on thrombi and catheters appeared to be present in dogs treated with coumadin, based on images obtained at 1, 2, and 3 hours after 111In-P injection. It is unlikely that coumadin's effect upon 111In-P uptake by thrombi would be significant in a clinical setting, although further studies would be required to confirm this. PMID- 3557898 TI - Enlarging mediastinal mass. PMID- 3557899 TI - Experience with an alternative curriculum. PMID- 3557900 TI - Preparing a grant proposal. PMID- 3557901 TI - Research protocol review for animal welfare. PMID- 3557902 TI - Central nervous system anoxic-ischemic insult in children due to near drowning. PMID- 3557903 TI - Four key elements in personnel management. PMID- 3557904 TI - Assessment: precursor to practice management improvement. PMID- 3557905 TI - Computed tomography and myelography of the lumbar spine--community hospital experience. PMID- 3557906 TI - Muromonab-CD3 (Orthoclone OKT3): the first monoclonal antibody approved for therapeutic use. PMID- 3557907 TI - Chronic Renal Disease Program. PMID- 3557908 TI - Medical specialties--changes and challenges. PMID- 3557909 TI - Banding technique for hemostasis of post polypectomy bleeding. PMID- 3557910 TI - Bumetanide, loop diuretic. PMID- 3557911 TI - Hospital Licensure by Service Study Committee. PMID- 3557912 TI - Mechanism of the inhibitory effect of etomidate on aldosterone production in isolated bovine glomerulosa cells. PMID- 3557913 TI - Keratotic (Norwegian) scabies. PMID- 3557914 TI - H.L.A. typing in a family with sarcoidosis and tuberculosis. PMID- 3557915 TI - Toxic shock syndrome in a penicillin sensitive patient. PMID- 3557917 TI - Writing for a medical journal: tips for tiros. PMID- 3557916 TI - Knowledge, attitudes and education background of sexually transmitted disease clinic attenders. PMID- 3557918 TI - From protocol to publication: preparation of a scientific paper. PMID- 3557919 TI - Writing medical articles on a word processor: the importance of editing. PMID- 3557920 TI - Lasers and the eye. PMID- 3557921 TI - Cardiology: future trends. PMID- 3557922 TI - Cutaneous changes during pregnancy. PMID- 3557923 TI - Thyrotoxicosis, subacute thyroiditis and thyroid pain in Ireland. PMID- 3557924 TI - Metacarpophalangeal joint arthroplasty of the rheumatoid hand. PMID- 3557925 TI - The diagnosis of intrauterine growth retardation and its influence on perinatal outcome. PMID- 3557926 TI - Is bovine, atypical or resistant tuberculosis a problem? PMID- 3557927 TI - Carcinoma of the stomach and gastro-oesophageal junction: the accuracy and limitations of endoscopic biopsy diagnosis. PMID- 3557928 TI - Calcium carbonate as an alternative to aluminium hydroxide in maintenance haemodialysis for chronic renal failure. PMID- 3557929 TI - The hazards of smoking. PMID- 3557930 TI - The so-called "carcinoid" tumors of the breast. AB - The so-called "carcinoid" tumors of the breast are at present a difficult entity to define. Two histopathological features are used to recognize such tumors: argyrophilia and ultrastructural dense-core granules. Eight cases of "carcinoid" tumor of the breast, observed over a 5-year period, with 3.6% incidence over the total of breast cancers recorded during the same period, are reported. All patients were females with a mean age of 55.2 years. Argyrophilia was found in all tumors and dense-core granules were observed in five studied ultrastructurally. No patient had nodal or distant metastases and no carcinoid syndrome was observed. A modified radical mastectomy was performed for tumors over 2.5 cm; in case of smaller tumors the surgical treatment was quadrantectomy with axillary dissection. All patients are alive and disease-free but follow-up is short. As the so-called "carcinoid" tumors of the breast have been only recently identified, additional morphological, immunohistochemical and clinical data are required for a full understanding of their significance. PMID- 3557931 TI - Pharyngoesophageal transmucosal potential difference in normal subjects and in patients with peptic esophagitis. AB - Results of a study carried out on pharyngoesophageal transmucosal potential difference (PD) in normal subjects and in patients with peptic esophagitis are reported. Ten healthy individuals used as control group and 12 patients with peptic esophagitis were examined. In all the cases an electric junctional pharyngoesophageal zone was evidenced, characterized by increased negativity at the level of the upper esophageal sphincter between the pharyngeal and esophageal potential difference. No statistically significant differences were observed between the two groups as for the length of PD and its location, which was always shown to be included in the high pressure zone. In healthy subjects the pharyngoesophageal PD was -16.2 +/- 4.23 mV; in patients with peptic esophagitis PD was -25.4 +/- 8.51 mV. However, in the latter PD was shown to be higher than normal in 66% of cases (p less than 0.01). No correlation was evidenced between PD values and manometric alterations of the upper esophageal sphincter. On this basis, such alterations should not be related to possible mucosal injuries, as suggested by several authors, but most likely to a reflected or primary phenomenon, common to that causing the gastroesophageal reflux. PMID- 3557932 TI - Acute cholangitis: diagnostic and therapeutic problems. AB - A retrospective study was carried out, analyzing the diagnostic and therapeutic problems in 80 patients with acute cholangitis at the time of hospitalization. 23% of the 17 patients with pus in the bile duct showed Reynolds' pentad, which was observed in 10% of patients with nonsuppurative acute cholangitis. Common bile duct lithiasis was responsible in 80% of cases presenting with Reynolds' pentad and in 66% of postoperative mortality. In 75% of patients with tumors, the clinical picture showed a rapid development following PTC. 79% of patients responded positively to antibiotic therapy with subsequent elective surgery, while in 21% of patients who did not respond to antibiotic therapy, biliary drainage was the treatment of choice. Mortality in patients with shock or hypotension was 30% while it was 17% in those undergoing early (less than 72 hours) surgery. On the basis of the results, it is concluded that, since it is not possible to assess preoperatively whether a patient belongs to the group of suppurative acute cholangitis or to that of nonsuppurative acute cholangitis, the different severity of the clinical picture should be based on clinical and biochemical parameters. The most severe developments were observed in common bile duct lithiasis or in patients with tumors who underwent PTC. In case of failure to respond to antibiotic therapy, decompression was shown to be the most suitable treatment. The mortality rate is related to the severity of the clinical picture (presence or not of shock) as well as to a prompt surgical treatment. PMID- 3557933 TI - Surgical treatment of chronic pancreatitis. AB - To contribute to the solution of the problems related to the treatment of chronic pancreatitis, a retrospective study was carried out on 60 cases of chronic pancreatitis treated by surgery over a period of 20 years. On the basis of the obtained results, it is believed that the derivative procedures are more likely to be successful in the treatment of the disease. Pancreaticojejunostomy according to Puestow should be the procedure of choice, since it shows a lower pre-and postoperative risk while preserving the endocrine and exocrine function of the organ. PMID- 3557934 TI - Delayed presentation of traumatic diaphragmatic rupture of right side with herniation of stomach and colon. A case report. AB - A case of post-traumatic diaphragmatic rupture with herniation of viscera on the right side is reported. The simple procedure of insertion of a nasogastric tube and subsequent chest X-ray were diagnostic. Methods of diagnosis, treatment and a short review of the literature are presented. PMID- 3557935 TI - Pylorus preserving pancreatoduodenectomy for gastrinoma. A case report. AB - A case of a young female patient affected by Zollinger-Ellison syndrome with occult gastrinoma during exploratory laparotomy, is reported. On the basis of transhepatic portal catheterization the patient underwent pylorus preserving pancreatoduodenectomy according to Longmire-Traverso. A malignant gastrinoma of the duodenal wall, 2 mm in diameter, was observed on the operative specimen in the suspected gastrinogenic area. The procedure led to complete clinical recovery of the patient who did not respond to the medical treatment of the ulcer. The prognosis was good with oncologic radicality of surgery confirmed at follow-up and excellent digestive function. PMID- 3557936 TI - Vascular access for hemodialysis: Thomas' shunt. AB - The immediate and long-term results obtained by the use of a Thomas' shunt as a vascular access through which periodical hemodialysis can be performed, are reported. The lower incidence of septic and thrombotic complications due to the iliac instead of the femoral implantation of the shunt, is stressed. PMID- 3557937 TI - Out-patient proctology, how far and how effective? PMID- 3557938 TI - Gallstone pancreatitis. PMID- 3557939 TI - The hasty British ban on commercial surrogacy. AB - While commercial surrogate parenting arrangements continue to flourish in the U.S., Britain has made it a criminal offense for third parties to benefit from surrogacy. Voluntary surrogacy, however, is still within the law. Banning commercial surrogacy while leaving voluntary surrogacy lawful seems neither logical nor fair. A more equitable solution would be to license stringently and control both commercial and nonprofit agencies to provide these services. PMID- 3557940 TI - At law. Transferring the ethical hot potato. PMID- 3557942 TI - In defense of IECs. PMID- 3557941 TI - Do-not-resuscitate orders: no longer secret, but still a problem. AB - Over the past decade, public discussion has focused on the ethics of issuing Do Not-Resuscitate Orders, and the failure of many hospitals to acknowledge their actions openly. Recent efforts on the part of some hospitals to establish formal DNR guidelines that are prudent, fair, and humane, are a helpful beginning, though they cannot account for all the vagaries of illness and human communication. But concerns about DNR should not divert us from looking closely and rigorously at other, more common treatment/nontreatment decisions in the critical care setting. PMID- 3557943 TI - Anencephalic donors: separate the dead from the dying. AB - Proposals to use organs from anencephalic infants to meet the growing need for transplantable organs are well-meaning but misguided. It would be unwise to amend the Uniform Determination of Death Act to classify anencephalics as "dead." They are in the same situation as other patients (such as the permanently comatose). Likewise, amending the Anatomical Gift Act to permit organs to be removed from anencephalics would be unjust, would set a bad precedent, and would likely reduce overall success in this field. PMID- 3557944 TI - The ethical options in transplanting fetal tissue. AB - Fetal tissue transplants have now been successful in primates, raising the possibility of treatment for Parkinson's disease and other chronic illnesses. Whether or not abortion is morally justified, use of human fetal tissue for research or therapy is justified in certain circumstances. The rationale, both for permitting transplantation of fetal tissue and for limitations in exercising the technology, is based on the same set of ethical principles that supported restrictive legislation in the past: respect for autonomy and a balancing of harms and benefits that gives priority to those most affected. PMID- 3557946 TI - Patient care issues (2). PMID- 3557945 TI - Women in medicine: patient care issues (1). PMID- 3557947 TI - Patient care issues (3). PMID- 3557948 TI - Playing by his rules (4). PMID- 3557949 TI - Career choices and tensions: the woman internist (5). PMID- 3557950 TI - The "Superwoman" syndrome (6). PMID- 3557951 TI - Extracorporeal shock wave lithotripsy. PMID- 3557952 TI - Endourologic treatment of urinary tract stones. PMID- 3557953 TI - Medical malpractice in the State of Hawaii (1979-1984). PMID- 3557954 TI - Cost-containment and communication with patients. PMID- 3557955 TI - Posterior cervical-thoracic thermograms: pattern persistence and correlation with chronic headache syndromes. PMID- 3557957 TI - Paresthesia of the second division of the trigeminal nerve secondary to endodontic manipulation with N2. PMID- 3557956 TI - Personality and behavioural characteristics in pediatric migraine. PMID- 3557958 TI - Defect of serotonin binding to mononuclear cells from episodic cluster headache patients. PMID- 3557960 TI - Eye and frontal pain in posterior lesions--a reappraisal. PMID- 3557959 TI - Auditory brainstem evoked potentials in patients with migraine. PMID- 3557961 TI - Cardiovascular reflexes and plasma noradrenaline levels in migraine patients before and during nimodipine medication. PMID- 3557962 TI - Scalp tenderness and sensitivity to pain in migraine and tension headache. PMID- 3557963 TI - Geriatric medicine in Dundee. PMID- 3557965 TI - Junior hospital doctors' 'promotion prospects'. PMID- 3557964 TI - An estimate of the effects of relocation on elderly mentally frail patients. PMID- 3557966 TI - The chief scientist reports ... a prospective evaluation of the Bjork-Shiley, Hancock and Carpentier-Edwards heart valve prostheses. PMID- 3557968 TI - The appropriate use of diagnostic services: (XII). Investigation of urinary infections in general practice: are we wasting facilities? PMID- 3557967 TI - Health care in the community: activities in primary health care. PMID- 3557969 TI - Learning by doing: strategic marketing management in hospitals. AB - Strategic marketing management in the hospital industry is maturing through a series of stages, from a passive, reactive posture toward a more aggressive, proactive stance. However, a survey of 80 hospitals shows that most have not yet made the critical transition from the traditional production orientation to the more progressive marketing orientation. PMID- 3557970 TI - How much should hospitals spend on advertising? AB - Hospitals are using several methods to establish a budget for advertising. The Strategic Planning Institute of Cambridge, Massachusetts, has developed a study of advertising practices on nearly 200 corporations and over 1,000 individual businesses. Decision rules, developed in the study, are used to show how hospitals can use a more scientific approach to budgeting for advertising. PMID- 3557971 TI - Medical care changes in the 1980s. PMID- 3557973 TI - Male labor and delivery nurses: favorable response. PMID- 3557972 TI - Wage differences and the concentration of women in hospital occupations. AB - Women earn substantially less money than men. Many argue that this situation is the result of wage discrimination. The effect of the concentration of female employees within selected hospital jobs on wage rates is examined. PMID- 3557974 TI - Performance appraisal systems in health care administration. AB - The application of performance appraisal systems to personnel administration represents an important development in health care administration. As health care administrators seek to more effectively manage their resources, performance appraisal systems offer the opportunity to reward and improve productivity by identifying behavioral performance criteria and relating them to promotion, retention, and evaluation systems. PMID- 3557975 TI - HCMR interview: Sister Mary Jean Ryan. Interview by Montague Brown. PMID- 3557976 TI - Viewpoint: why a medical staff marketing committee is needed. AB - Physician practices can be expanded through the formation of a hospital marketing committee for the medical staff. Such a committee could assist in establishing referral services, identifying locations for practices, assessing community needs, and assessing alternative delivery systems, as well as fulfilling other functions to increase medical staff visibility and improve performance. PMID- 3557977 TI - [Therapy of leprosy today]. AB - The rise in the incidence of dapsone-resistant leprosy requires new therapeutic approaches. Based on the recommendations of the WHO and the experiences from many countries where leprosy is endemic, a standardized treatment regimen is presented. It is based on the combination of three chemotherapeutically active substances. PMID- 3557978 TI - [Chronic systemic toxicity of oral photochemotherapy using 8-methoxypsoralen and UVA]. AB - The purpose of the study conducted was to clarify the question of chronic, systemic toxicity from PUVA therapy. Five groups of patients, classified according to length of treatment were examined with respect to 43 laboratory parameters. The results indicated that PUVA had no chronic toxic influence on the liver, kidneys, bone marrow, metabolism, or immune response. PMID- 3557979 TI - [Condylomata acuminata-associated STD infections of the urethra of the male. A comparative epidemiologic study]. AB - Urethral swabs from 322 men without urethritis, 73 of whom had venereal warts (condylomata acuminata, CA) and 249 who had none, were investigated between 1981 and 1984 by microscope and culture for the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma species, Trichomonas vaginalis, Garderella vaginalis, B streptococci, aerobic pathogenic bacteria and Candida species. The isolation frequencies in patients with and without CA were as follows: N. gonorrhoea: with CA 0%, without 0.4%; C. trachomatis: with CA 6%, without 4.4%; U. urealyticum in high CFU: with CA 15%, without 17.7%; Mycoplasma spp. in high CFU: with CA 6%, without 4%; T. vaginalis: with CA 0%, without 0.4%; G. vaginalis: with CA 4%, without 5%; B streptococci: with CA 4%, without 6%; Candida spp. only in low CFU: with CA 3%, without 2.4%.--The results indicate that as far as the isolation frequencies of sexually transmittable pathogens in the urethra are concerned, there are no significant differences between patients with CA and asymptomatic patients presenting to an STD department. However, N. gonorrhoeae was significantly less frequently isolated and C. trachomatis and U. urealyticum significantly more frequently isolated in our patients than has been reported in previous studies. PMID- 3557980 TI - [Pilar sheath acanthoma]. AB - Pilar sheath acanthoma is a rare, benign follicular hamartoma. A case is reported, and the histological and clinical features of this skin tumor are described. The tumor is elevated and characterized by a central punched-out area filled with amorphous whitish material. In contrast to the keratoacanthoma, which has a similar clinical appearance, pilar sheath acanthoma shows no spontaneous regression. PMID- 3557981 TI - Who should be blamed for being sick? AB - That individuals are responsible for staying healthy is becoming a truism of health promotion and health policy. However, it is unclear what the slogan means, whether it is true, and what the consequences would be or should be if it is. A careful examination of the contexts in which the notion of personal responsibility for health occurs reveals a number of distinct arguments for different policy ends, each relying in turn on key unstated assumptions whose validity is doubtful. There is no disputing the minimal claim that most of us would be healthier if we took better care of ourselves. However, assignment of responsibility for health to the individual is usually part of a more far reaching reassessment of obligations and entitlements in health care and health policy. A assessment of the concept of personal responsibility for health should precede any attempt to draw broad conclusions on rights and duties in maintaining health. PMID- 3557982 TI - Ethical issues in government sponsored public health campaigns. AB - Health communications campaigns are a major strategy used by governments to promote health. This article discusses key issues in the ethics of health communications campaigns, including the compatibility of health campaigns with the principle of respect for autonomy and how conflicts with this principle can be justified. Five potential justifications for state-sponsored health communications campaigns are reviewed: the public's health as an independent value; collective efficiency and majoritarian preferences; third party or state's interests; harm to the health of others; and countering the short-term contingencies of a market. PMID- 3557983 TI - The business of health promotion: ethical issues and professional responsibilities. PMID- 3557984 TI - Ethics in worksite health programming: who is served? AB - As relatively new innovations in the workplace, employee assistance and wellness/health promotion programs have not yet established clear identities. Thus ethical practices have not been fully considered or discussed. Based on extensive research experience with employee assistance programs, ethical issues are considered at three levels. Of primary concern are ethical issues affecting the individual employee, of which the scope of perceived or expected service relationships between employees and EAP coordinators is critical. There are tendencies to transfer models of community or private practice to the worksite, but the relationships both prescribed and implied at the worksite require that a different pattern of clinical relationships obtain. At the organizational level, it is critical for the worksite practitioners to be conscious of their authority in translating scientific data into recommended practices at the worksite and in transforming equivocal data and health practices into organizational norms. Finally, at the level of interorganizational relationships the worksite health program practitioner needs to be aware of the risks of becoming drawn into overly intimate relationships with external organizations who may come to benefit by special treatment that such relationships generate. PMID- 3557985 TI - Ethical dilemmas in health promotion: an introduction. PMID- 3557986 TI - Ethical and philosophical issues in developing a health promotion consortium. AB - This case study describes the establishment and operation of a community-based health promotion consortium. The ethical implications of membership criteria, use of mailing lists, public education and policy, and communications are examined. The organization's responses to questions raised in these areas are discussed. Increased communication and sharing of ideas and experiences among health promotion consortia are recommended. Issues in the activities of health promotion consortia which require further philosophical and sociological examination are identified. PMID- 3557987 TI - The business of health promotion: ethical issues and professional responsibilities. AB - In the nine years since an entire issue of Health Education Quarterly (then Health Education Monographs) was devoted to considering ethical issues in health education, several important social changes have occurred which have substantially influenced the practice of that discipline. New practice contexts and ethical issues have resulted, which require a fresh look at both these new issues as well as those addressed in the earlier monograph. The importance of understanding the principles underlying the ethical dilemmas raised by the authors is emphasized as a concern for both the individual practitioner as well as the profession of health education itself. Recommendations for personal and professional action are made by the authors. PMID- 3557988 TI - Design of bifunctional radiopharmaceutical for the development of 99mTc complexes for myocardial imaging agents. AB - Several bifunctional radiopharmaceuticals (BR), molecules containing a neutral 99mTc-dithiosemicarbazone (DTS) structure as a chelating site, along with a functional amino group (primary tertiary and quaternary amino group) are tested for their chemical or biological functionalities as myocardial agents. Investigation of these amino compounds is carried out in vitro and in vivo. Mice (ddY) distribution studies show a high radioactivity distribution in heart with every tested derivative, but the highest heart to blood ratio of 2.92 (1 h) is achieved with the quaternary amino DTS. Also, this derivative displays low lung uptake inducing a proper target/non-target ratio for myocardial agent. The role conveyed by the various amino containing side chain in the biodistribution and validity of DTS derivative as BR are discussed. PMID- 3557989 TI - 99mTc-tetracycline radiopharmaceutical: physical chemistry study related to the preparation and reaction products and thermodynamic stability. AB - The labelling of tetracycline hydrochloride with 99mTc at neutral pH, using Sn2+ as reducing agent, has been investigated by chromatography, using a 4:1:5 n butanol:acetic acid:H2O mixture as developing agent, with Whatman paper No 3. In such conditions, reduced 99mTc remained at the origin, while labelled 99mTc migrates at Rf approximately equal to 0.6. Radiochromatographic and u.v.-visible spectrophotometric results, demonstrated that the higher the tetracycline concentration the higher was the labelling of 99mTc to that ligand, obtaining a 50% labelling when the molar ratio of tetracycline:Sn2+ was approximately 20:1, independent of the Tc concentration level. The Tc oxidation state in the radiopharmaceutical is +4, deduced from iodimetric and radiometric techniques. Furthermore, it seems that time does not influence labelling, while pH does. The maximum labelling level occurs at physiological pH. The thermodynamic study performed with the radiopharmaceutical formation shows that the Tc-tetracycline complex has a 1:1 stoichiometry, thus a low stability constant (about 2 X 10(2)). PMID- 3557990 TI - Simultaneous estimation of liquid and solid gastric emptying using radiolabelled egg and water in supine normal subjects. AB - To develop an additional method for the measurement of gastric emptying in supine subjects, 10 normal subjects were given a test meal containing 99Tc-labelled scrambled egg as the "solid" phase marker and 111In in tapwater as the marker for the "liquid" phase. The mean time for emptying 50% of the "solid" phase (t1/2) was 85 min and 29 min for the "liquid" phase. Three individuals were restudied with a mean difference between the two determinations of 10.8% for the "solid" phase and 6.5% for the "liquid" phase. Twenty-six additional studies attempted have been successfully completed in symptomatic patients with advanced cancer. This method provides a simple and reproducible procedure for the determination of gastric emptying that yields results similar to those reported for other test meals and can be used in debilitated patients. PMID- 3557991 TI - Indirect cervical lymphoscintigraphy in healthy subjects via submucosal cheek injections. AB - A new method of cervical lymphoscintigraphy is presented. It was performed on 16 healthy individuals via bilateral submucosal cheek injections with 99mTc-rhenium sulfide-colloid. The ipsilateral uptake by the lymphatics on each side of the neck was consistently demonstrated in 15 subjects and allowed a comparative evaluation of the cervical lymphatic chains, including the submental, submandibular, jugulo-digastric and jugulo-omohyoid. The transverse cervical chain was demonstrated in 10 of 16 subjects. The method is simple, reliable and capable of clearly visualizing the lymphatic drainage of the oral cavity. PMID- 3557992 TI - Tin level requirements for multiple gated studies in humans: a new perspective. PMID- 3557993 TI - Hemoglobin D-Los Angeles [beta 121(GH4)Glu----Gln] in the Province of Liege, Belgium. AB - Since 1975, more than 19,000 persons have been tested for hemoglobin abnormalities in Liege. Nine unrelated carriers of Hb D-Los Angeles were discovered. They were of Belgian origin. The family of the ninth index case was studied thoroughly. In six generations, 372 descendants of a couple married in 1818 were recorded. Of the 93 tested, 31 were carriers of the Hb D variant. The complete pedigree indicates that Hb D-Los Angeles was already present in Liege province in the 18th century. A connection with India is unlikely. PMID- 3557995 TI - Functional studies, anion-binding and effects of bezafibrate on three high affinity hemoglobin variants: Hb Olympia, Hb Great Lakes and Hb North Chicago. PMID- 3557994 TI - Hemoglobin La Desirade alpha A2 beta 2 129 (H7) Ala----Val: a new unstable hemoglobin. AB - Hemoglobin La Desirade is a new unstable hemoglobin variant arising from the substitution of beta 129 (H7) Ala for Val. Hb La Desirade exhibits a low oxygen affinity and normal heme-heme interaction. The variant was found in two unrelated black families in association with Hb S, Hb C or beta o thalassemia. PMID- 3557996 TI - Hemoglobin Beirut [alpha 2 beta 2(126)(H4)Val----Ala] in an Algerian family. PMID- 3557997 TI - Hemoglobin Burke: an unstable hemoglobin rarely associated with hemolytic episodes. PMID- 3557998 TI - A note about the incidence and origin of Hb D-Punjab in Xinjiang, People's Republic of China. PMID- 3557999 TI - Hb Saint Louis or alpha 2 beta 2(28)(B10)Leu----Gln in a Czechoslovakian male. PMID- 3558000 TI - Microenvironments of photoreceptor and interphotoreceptor matrix glycoconjugates. AB - Enzyme-linked lectin cytochemical and biochemical analyses have been used to identify microdomains of retinal outer segments and interphotoreceptor matrix glycoconjugates. We have devised a highly reproducible trypsin digestion procedure to identify protease-resistant wheat germ agglutinin (WGA) domains on the distal tips of some photoreceptor outer segments, and on shed outer segment membrane in Xenopus laevis retina. WGA binding sites in the frog interphotoreceptor matrix were completely susceptible to trypsin digestion. In contrast, the cytochemical procedures revealed a distinct protease resistant WGA positive microdomain in the interphotoreceptor matrix of rat (and probably human) retina at the outer segment-pigment epithelium interface. Neuraminidase digestion of sections of rat retina previously digested with trypsin essentially completely removed WGA binding sites in this microdomain. These results indicated that the protease-resistant carbohydrates were sialoglycoconjugates. A potential role for this pool of sialoglycoconjugates would be to mediate adhesion of the outer segment-pigment epithelium interface. Analysis of solubilized retina digested with trypsin and separated by polyacrylamide gel electrophoresis revealed a set of protease resistant WGA binding glycoprotein of Mr 60 kDa on nitrocellulose transblots which we hypothesize may be a component of the protease resistant microdomain at the outer segment-pigment epithelium interface of rat retina. PMID- 3558002 TI - Simultaneous ultrastructural demonstration of heavy metals (silver, mercury) and acid phosphatase. AB - A histochemical technique which permits the simultaneous visualization of heavy metals and acid phosphatase at the ultrastructural level is described. The technique was applied to the anterior pituitary gland, the spinal cord and the liver. In all of the tested organs, both mercury and silver were found to accumulate primarily in the lysosomes, although small amounts of both metals could be observed in other organelles including endocytotic vesicles. In the anterior pituitary, few mercury deposits were found in the secretory granules. PMID- 3558001 TI - The distribution of sympathetic nerve fibres in the AV node and AV bundle of the bovine heart. AB - The sympathetic nervous system has important effects on the properties of the heart, including the conduction of the impulse. However, it is not known how this nervous system is distributed in the atrioventricular (AV) bundle, which together with the AV node constitutes the only conduction pathway between the atria and ventricles in normal hearts. Therefore, in the present study the adrenergic innervation in the bovine AV node/AV bundle was examined by use of the glyoxylic acid induced method for histofluorescence demonstration of catecholamines. Acetylcholinesterase (AChE) histochemistry was also used. It was found that the AChE-positive nerve fascicles in these regions partly contain sympathetic nerve fibres, that sympathetic nerve fibres occur in the proximity of some of the ganglionic cells that occur outside the AV node/AV bundle, that the arteries supplying AV bundle tissue as well as AV nodal tissue have perivascular plexuses of sympathetic nerve fibres, and that there is a substantial number of sympathetic nerve fibres outside Purkinje fibre bundle surfaces. The observations give new insight into the question of the distribution of the sympathetic nerves in the AV bundle in relation to the distribution of these nerves in the AV node. Possible functional implications of the observations are discussed. PMID- 3558005 TI - The provision of dietetic services to diabetics in the United Kingdom. Nutrition Sub-Committee of the Medical Advisory Committee of the British Diabetic Association. AB - Data on dietetic services to the diabetic in the United Kingdom was sought from dietitians and doctors, from Regional Health Authorities, from patients through local branches of the British Diabetic Association, and by detailed examination of dietitian's work loads in some districts. Considerable deficiencies are demonstrated in the provision of dietetic care and education to the diabetic in the country. A minimum provision for direct diabetic care and education of 15 hours of dietetic time per 100,000 of population per week is required. The data collected indicates that diabetes occupies some 25 per cent of total dietetic time in any one district. Individual district and unit managers should ensure that adequate numbers of WTE are available to offer this continuing commitment. Difficulties may arise in allocating exclusive responsibility for diabetic dietary education to any one individual. However, in any one district, one senior dietitian could be allocated the task of co-ordinating diabetes education and ensuring that all members of the dietetic staff and the diabetic team are kept up to date with all dietary developments. It is of considerable concern that some districts have no diabetic dietetic service or a very rudimentary one. It is of concern that even in districts provided with dietetic cover, the provision may vary by two- to three-fold. PMID- 3558004 TI - Can I afford the diet? AB - Members of the British Dietetic Association (BDA) have become increasingly concerned about the eating patterns of people on low incomes. Certain groups of the population are particularly vulnerable to the effects of restricted income on diet. These include children, the elderly, pregnant women, ethnic minorities, physically handicapped, mentally handicapped and the mentally ill. Individuals who require therapeutic diets may also be unable to afford the appropriate dietary modifications. Recommendations are listed which we consider would significantly improve the situation for people who are at greatest risk of ill health from nutritional causes. PMID- 3558006 TI - Food intake in three groups of cancer patients. A prospective study during cancer treatment. AB - The dietary intake of 105 adult Dutch Caucasian patients (28 women with endometrial or cervical cancer, 50 men with bladder or prostate cancer and 14 men and 13 women with malignant lymphoma) was studied for 19 weeks. Energy and nutrient intakes of all patients were assessed by a dietary history with cross check over 2 months prior to treatment and by seven 48-h dietary records filled in just before, during and after cancer therapy. No differences were observed between the results obtained with the dietary history and the first 48-h diary. In females treated with abdominal irradiation the mean daily intake of fat, dietary fibre, iron and thiamin decreased during therapy. In men treated with radiotherapy the intake of vegetable protein, polysaccharides, dietary fibre and thiamin also decreased during treatment. This may be partly explained by the observation that many of these patients had spontaneously chosen a 'constipating diet' because of diarrhoea. As compared with the Dutch Recommended Dietary Allowance only the iron intake of the women gave rise to some concern. In our study we did not observe marked changes in dietary intake and nutritional status. In females who underwent irradiation therapy especially, the dietary intake increased after a period of intensive treatment. This demonstrates that food intake of these groups of cancer patients is not consistently reduced by chemotherapy or even abdominal radiotherapy. PMID- 3558003 TI - Preliminary evidence for a cholinergic-like system in lichen morphogenesis. AB - Membrane acetylcholinesterase activity is considered to be a marker for a cholinergic system. When temporarily expressed in differentiating cells other than the nervous or muscular ones, it may play a role in morphogenesis. In the lichen Parmelia caperata (L.) Ach., acetylcholinesterase is histochemically localized mainly in the cell walls and/or membranes of both symbionts just where they proliferate and form well-organized propagation structures, the soredia. The enzyme activity is first detected in a few algae undergoing aplanosporogenesis and later in medullary hyphae that reach the dividing algae by elongating perpendicularly to the thallus surface. This histochemical pattern that is associated with algal proliferation and oriented hyphal growth is characteristic of early morphogenesis of the soredia; when fully differentiated, they consist of an inner dividing alga and an outer hyphal envelope, both showing cholinesterase activity. Substrate specificity and inhibitor sensitivity of the histochemical staining indicate an acetylcholinesterase-like activity. However, extracts of the thallus areas where soredia develop give four bands of cholinesterase activity on disc electrophoresis: the two cathodal bands have the characteristics of acetylcholinesterase, the others of pseudocholinesterase. One of the latter hydrolyses propionylthiocholine very rapidly. The findings suggest that in lichen symbiosis, a cholinergic-like system participates in regulating morphogenetic processes such as cell division, oriented tip growth and alga-fungus membrane interactions. Environmental stimuli, particularly light, might trigger the development of soredia by modulating the activity of the cholinergic mechanism. PMID- 3558007 TI - Meal frequency and nutritional intake during Ramadan: a pilot study. AB - A study was carried out to compare the nutritional intake and meal pattern during and after Ramadan. It was found that in a sample group of 15 young Saudis there was a significant increase in caloric, fat, carbohydrate and protein intake. Although there was a significant reduction in meal frequency and the number of meals taken outside the family, a significant increase in body weight was noted during Ramadan. PMID- 3558008 TI - Infant feeding practices in Kenya, Mexico and Malaysia. The rarity of the exclusively breast-fed infant. AB - Infant feeding practices of 6149 mothers in Kenya, Mexico and Malaysia are reported. A high proportion of mothers initiated breast-feeding in each country regardless of social class. Most Kenyan mothers continued to breast-feed for at least 12 months. In Mexico and Malaysia, however, breast-feeding was discontinued relatively early, especially among urban mothers. Early supplementation of breast fed infants with milk and/or other food was a common practice in each of the three countries. Among breast-fed infants below 4 months of age, the percentages who were exclusively breast-fed in the urban elite, urban poor and rural groups respectively were 6, 14 and 21 per cent in Kenya, 8, 19 and 31 per cent in Mexico, and 11, 9 and 11 per cent in Malaysia. Supplementation of breast-fed infants in the first two months of life was more likely to be with infant formula than with any other milk or food. At three months of age, however, nonmilk foods were the most common supplements in all population groups with the exception of those in urban Kenya. The policy implications are discussed. PMID- 3558009 TI - [Progress in microsurgery of the middle ear]. AB - Some advances in middle ear surgery during the last 15 years are discussed, including successful microsurgical methods, those that were more or less abandoned, and new techniques and materials. PMID- 3558010 TI - [Results of an interdisciplinary study of primary inoperable stage T3 and T4 squamous cell carcinoma of the mouth, oropharynx and hypopharynx]. AB - From Dec. 1980 to May 1984 26 patients with inoperable carcinomas of oral cavity, oropharynx and hypopharynx, were treated by us by a primary systemic chemotherapy. At all there were 95 patients with carcinoma of oral cavity, oropharynx, and hypopharynx, among these in 62 cases primary surgery was possible. In seven cases no tumor specific therapy was possible. A complete remission (CR) was obtained in 17% of tumors, partial remission (PR) in 39%. The results after subsequent operation (5 patient underwent operation) and radiation (all patients underwent radiation) were 35% CR and 26% PR. The median survival time of the patients with the multimodality-therapy was 13 months. Now 7 patients are alive with NED between 12+ and 38+ months. PMID- 3558011 TI - [Incidence of multiple tumors in the upper aerodigestive tract. Routine panendoscopy?]. AB - The incidence of multiple squamous cell carcinomas in the upper aerodigestive tract of 589 patients is presented and discussed. Multiple synchronous tumors had been found in 1.83% of patients in 1980-1984. Since the end of 1984 in most cases routine praetherapeutic panendoscopy was performed. 15.6% of these patients with panendoscopy had multiple synchronous primary tumors. The mouth and oropharynx were found to be high risk primary areas and the larynx a low risk area, concerning synchronous tumors in other localizations. The incidence of second primaries in the bronchi and especially in the oesophagus justifies routine praetherapeutic panendoscopy of which our technique is described. PMID- 3558013 TI - [Lymphoscintigraphic studies of regional lymph vessels in patients with head and neck tumors]. AB - Lymphatic drainage was followed with Tc lymphoscintigraphy. Micrometastases in head and neck cancer cases cannot be detected. The drainage pattern is highly variable and does not allow prognostic conclusions in tumors as demonstrated for the parasternal pathways. The method helps to determine the side and extent of a neck dissection prior to surgery as well as follow-up postoperatively. The development of lymphedema can be detected early in order to start treatment by manual lymph drainage. PMID- 3558012 TI - [Lymphatic metastases of verrucous carcinoma (Ackerman tumor)]. AB - Verrucous carcinomas (Ackerman tumors) are rare. The tumor is slow growing, locally invasive and is not supposed to metastasize. It is therefore thought to be unnecessary to perform a neck dissection. Two patients with local metastazing verrucous carcinomas (oral cavity and larynx) are presented. The possibilities of therapy are discussed with reference to the two cases presented and according to the literature. PMID- 3558015 TI - Views on management of acute pancreatitis. PMID- 3558014 TI - A comprehensive search for segregation distortion in HLA. AB - Segregation distortion, the non-Mendelian segregation of gametes, has been well documented among diverse groups of organisms. These cases are characterized by extreme segregation ratios found only in males. Previous reports have suggested the existence of segregation distortion operating in the HLA system of humans, a tightly linked complex of genes which regulates the immune system. In mice, some alleles of the T/t complex, which is linked to H-2 (the HLA homologue of mice), cause extreme segregation distortion in wild mice populations. Here we report on the examination of a large body of pedigree data on non-diseased families, scored for the alleles of five HLA region loci. We searched for segregation distortion on the basis of five different models of inheritance: allelic, haplotypic, genotypic, diffuse occurrence in families, and autosomal effects on the sex ratio. There was no clear evidence for segregation distortion. In particular, the possibility of extreme levels of segregation distortion was firmly rejected in the populations examined, thus reducing the likelihood of common distortion causing HLA associated haplotypes in our species. PMID- 3558016 TI - Hypokalemic subclinical neuromyopathy: report of a case. PMID- 3558017 TI - Hemolytic anemia and hyperbilirubinemia complicating infectious mononucleosis: report of a case. PMID- 3558018 TI - Osteopathic medicine's forgotten purpose. PMID- 3558019 TI - Correlation of palpatory observations with the anatomic locus of acute myocardial infarction. PMID- 3558020 TI - A somatic component to myocardial infarction. PMID- 3558021 TI - Sickle cell hepatopathy: diagnosis and treatment with exchange transfusion. PMID- 3558022 TI - Schamberg's disease: report of a case. PMID- 3558023 TI - Pelvic inflammatory disease: clinical update. PMID- 3558024 TI - A healthy lifestyle for a healthy heart. PMID- 3558025 TI - Quality of life of the hypertensive patient. PMID- 3558026 TI - Prognostic factors in carcinoma of the prostate--analysis of RTOG study 75-06. AB - A total of 566 evaluable patients were accessioned to a phase III RTOG study of extended field irradiation in carcinoma of the prostate from 1976 to 1983. Eligible patients were those with locally advanced disease, either clinical Stage C or clinical Stage A2 or B with pelvic lymph node involvement. The treatment consisted of irradiation of the regional lymphatics followed by a boost to the prostate. The data have been analyzed extensively to identify variables of potential prognostic significance. The assessed factors include tumor size, clinical stage, the degree of histological differentiation, nodal status, serum acid phosphatase status, hormonal management status, age, and race. These factors have been assessed as to their interdependence and correlation with the clinical course (study endpoints) using univariate analyses and Cox's Regression model. Significant interdependence of tumor size and Gleason score and tumor size and acid phosphatase was identified. The population receiving hormonal management either prior to or during radiotherapy had a significantly higher proportion of high grade tumors. Correlation of the assessed variables and the study endpoints (local control, incidence of distant metastases, NED survival, survival) singled out the degree of histological differentiation as the most powerful prognostic factor for all the endpoints. Age proved a useful predictor of local control (younger patients failed at a significantly higher rate), as did tumor size. Elevation of serum acid phosphatase correlated well with the incidence of metastatic disease but was not a useful predictor of survival. Tumor size and hormonal management status correlated well with the incidence of metastatic disease but only when analyzed separately from other factors. Their prognostic value was absent when Cox regression analysis was applied. Nodal status did not correlate well with any of the study endpoints, indicating then that in patients with clinical Stage C disease, treated with definitive radiotherapy to the prostate and regional lymphatics, this parameter may have limited prognostic usefulness. Although patients who received concomitant hormonal management had a significantly higher proportion of high grade lesions, their clinical course fared favorably in comparison with the population not receiving concomitant hormonal management. This may indicate a beneficial effect of adjuvant hormonal treatment which needs to be tested in a prospective study. PMID- 3558027 TI - Is cranial radiation necessary for CNS prophylaxis in pediatric NHL? AB - The records of 95 consecutive children less than or equal to 21 years of age with previously untreated diffuse histology NHL registered in our protocols from 1978 to 1983 were reviewed. Seventy-nine patients were considered eligible for analysis. The histologic subtypes represented included lymphoblastic (LB) 37%; histiocytic (DHL) 29%; undifferentiated (DU) 19%; poorly differentiated (DPDL) 9%; and unclassified (UNHL) 6%. Distribution of the patients according to stage showed Stage I, 0%; Stage II, 11%; Stage III, 53%; Stage IV, 36%. Four different Memorial Hospital protocols for systemic chemotherapy were used (LSA2L2 73%; L10 9%; L17 10%; L17M 8%); however, the IT (intrathecal) chemotherapy was uniform (Methotrexate: 6.0-6.25 mg/M2 per treatment course) and was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was not included in the CNS prophylaxis program. The overall median time of follow-up was 43 months. The overall CNS relapse rate was 6.3%, however, the incidence of CNS lymphoma presenting as the first isolated site of relapse in patients in otherwise complete remission (minimum follow-up of 19 months with 97% of patients off treatment) was only 1/58 (1.7%). Our data suggests that IT chemotherapy when given in combination with modern aggressive systemic combination chemotherapy, and without cranial radiation appears to be a highly effective modality for CNS prophylaxis regardless of stage, histology, or bone marrow or mediastinal involvement. Therefore, with the commonly used aggressive combination chemotherapy for the management of all stage diffuse pediatric NHL, and the known increased risk of leukoencephalopathy with combination of cranial radiation and intensive systemic and intrathecal chemotherapy, we believe that cranial radiation may not be indicated for CNS prophylaxis in pediatric NHL. PMID- 3558028 TI - The tumor bed effect: dependence of tumor take, growth rate, and metastasis on the time interval between irradiation and tumor cell transplantation. AB - Experiments were designed to investigate the influence of time interval between leg irradiation and tumor cell transplantation on 3 different aspects of the tumor bed effect (TBE): tumor take, growth rate, and metastasis formation. MCA-4 tumor cells were injected subcutaneously into the legs of syngeneic C3Hf/Kam mice that had been locally irradiated with 30 Gy gamma rays 1, 50, 100, or 200 days previously. Interim TD50 values were higher in the day 1, 50, and 100 preirradiated mice than in controls for about 100 days after tumor cell transplantation. However, the final TD50 values determined 220 days after cell transplantation were marginally lower than controls in the day 1, and 50 preirradiated groups. TD50 values in the day 200 preirradiated group were similar to those of controls at all times after tumor cell injection. Retardation of tumor growth rate was observed in all preirradiated groups, but with a progressive decrease in effect as the time between irradiation and tumor cell injection was increased. In the day 200 preirradiated group it was noted that the degree of tumor growth rate retardation decreased as the number of injected tumor cells was increased. The incidence of lung metastases when the "primary" tumor reached a size of 20 mm was higher than in controls in mice irradiated 1, 50, and 100 days before tumor cell injection, but not in the 200-day preirradiated group. Thus, in this tumor system TBE influences tumor take, growth rate, and lung metastasis formation differently; but for all parameters, the effect decayed with increasing time between irradiation and tumor cell transplantation. PMID- 3558029 TI - The effect of the hydrolytic state of dietary protein on post-irradiation morbidity and mucosal cell regeneration. AB - Diets containing hydrolyzed casein have been observed to enhance post-irradiation intestinal mucosal recovery. The intake and the composition of such diets were not carefully controlled. This study attempted to do so. Male specific pathogen free Sprague-Dawley rats were randomized to receive either an enzymatically hydrolyzed casein semi-purified diet (EHC), a whole casein semi-purified diet (WC), or powdered lab chow (C). All diets were isonitrogenous, and the WC and C rats were pair-fed to the ad libitum fed EHC rats. Seven days after initiation of feeding, the rats were abdominally irradiated with a single 9.0 Gy dose of 137Cs gamma rays. The rats were continued on the diets for another 5 days. Intestinal mucosa from transverse segments at the duodenum, jejunum, proximal ileum, and distal ileum were measured for incorporation of (3H methyl) Thymidine 1 hour after interperitoneal injection. Incorporation reached a maximum by day 4 post irradiation regardless of diet or segment. Incorporation in the duodenum was enhanced by the EHC diet compared to the C diet, while the incorporation in the jejunum was initially suppressed by the EHC diet compared to the WC diet. In the jejunum, the number of mitoses per crypt of 25 anti-mesenteric crypts post irradiation was increased by the EHC diet. Prior to irradiation, all groups gained similar amounts of weight. After irradiation, the C rats lost weight, while the EHC and WC rats remained the same or gained weight. Guaiac tests for occult blood were negative prior to irradiation, but positive for all rats on days 1-5 postirradiation. When calorie and protein intakes were controlled, different areas of the small intestine responded differently to EHC. PMID- 3558031 TI - A technique for interstitial nasopharyngeal brachytherapy. AB - Two patients have recently been seen with recurrent epidermoid carcinoma in the nasopharynx. Both have achieved local control and are disease-free after a brachytherapy procedure. Here we describe our technique for interstitial nasopharyngeal brachytherapy. PMID- 3558030 TI - Interstitial parametrial implants in carcinoma of the cervix stage II-B. AB - This retrospective analysis has been undertaken to ascertain whether an improvement in results can be obtained in Stage II-B cervical carcinoma with the use of interstitial parametrial irradiation. Between September 1972 and March 1982, 43 patients were treated by conventional intracavitary irradiation. Nine patients at high risk for local recurrence underwent post-radiation hysterectomy. Since 1980, 45 patients were entered into a study using parametrial interstitial implants and no hysterectomy. Patients were not allocated randomly and the interstitial group contained a disproportionate number of patients with poor prognostic features. Mean follow-up for the conventional radiotherapy group was 80 months, and for the interstitial group was 42 months. Overall pelvic control and actuarial survival in the conventional radiotherapy group (84 and 75%, respectively) were similar (log rank p-value = .61) to that observed in the interstitial implant group (80 and 77%). Analysis of pelvic control rates showed no significant advantage for either treatment group when compared by the various prognostic factors. The frequency of complications, however, was significantly higher in the interstitially irradiated patients (21% vs. 7%, p = .044). PMID- 3558032 TI - An integrated system for interstitial 192Ir implants. AB - An efficient system for preparing, afterloading, and removing interstitial 192Ir strands has been developed. Use of the system reduces the risk of personnel exposure and eliminates some patient discomfort. The system is "integrated" in that all aspects of the implantation process are considered, from source preparation to source removal. Strand preparation is facilitated by an "assembly line" process using shielded equipment. Components include a handling block for measuring and cutting active strands, a mirror, and a transport container. Afterloading and removal techniques use quick release devices and several forms of afterloading tubing and catheters, each terminated by a Luer lock adapter. Both blind-end and through-and-through implants are possible. Each 192Ir strand, threaded through an injection cap that mates with the Luer lock adapter, is quickly inserted into its tubing or catheter and locked into place. No crimping is required and no additional positioning of the sources is needed. Strand removal is easily accomplished by unlocking and removing the injection cap. The strands receive no mechanical damage and can be reused after appropriate cleaning. More than 100 cases have been performed without incident. Applications include head/neck, breast, and template and non-template vaginal wall treatments. PMID- 3558033 TI - Carcinoma of the anus. PMID- 3558034 TI - Cranial irradiation is not necessary for central-nervous-system prophylaxis in pediatric non-Hodgkin's lymphoma. PMID- 3558035 TI - Response to radiation of patients with carcinoid tumors. PMID- 3558036 TI - Misonidazole levels following misonidazole and hyperbaric oxygen exposure. PMID- 3558037 TI - Tolerance: a useful concept in radiation therapy. PMID- 3558038 TI - Management of the axilla in conservatively treated breast cancer: 592 patients treated at Institut Gustave-Roussy. AB - Between June 1970 and April 1982, 592 patients with unilateral T1 and small T2 breast cancers were managed conservatively at the Institut Gustave-Roussy. The treatment policy for the axilla was to perform a lower axillary dissection and to proceed to axillary clearance ( +/- radiotherapy) in patients with axillary invasion by tumor (N+). Some N+ patients had only lower axillary dissection and radiotherapy. Five hundred fifty-eight patients underwent axillary surgery which was a lower axillary dissection in 374 patients (67%) and axillary clearance in 184 patients (33%). There was axillary invasion in 198 cases (36%). Only five patients relapsed in the axilla and the probability of axillary relapse at 5 years was 1.2%. There were no axillary relapses in N+ patients who had had an axillary clearance whether irradiated or not. The incidence of upper limb complications was significantly greater in patients undergoing axillary surgery and radiotherapy compared with axillary surgery alone (p less than 0.0001). It is concluded that a lower axillary dissection accurately identifies N-patients and an axillary clearance in N+ patients ensures good local control and avoids the morbidity associated with axillary irradiation. PMID- 3558039 TI - Medically inoperable stage I adenocarcinoma of the endometrium treated with radiotherapy alone. AB - Definitive therapy for Stage I adenocarcinoma of the endometrium consists of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pre- and/or post-operative radiotherapy (RT) is employed in selected patients with poor prognostic factors such as poorly differentiated tumors or deep myometrial invasion by tumor. The results are reported of RT alone in 69 patients with Stage I adenocarcinoma of the endometrium who presented with severe, acute, and chronic medical illnesses which prevented surgical management of their disease. Sixty three patients (91.3%) were obese or hypertensive. Twenty-seven patients (39.1%) had diabetes mellitus, 16 (23.2%) had congestive heart failure, and the remaining patients had such conditions as stroke (17.4%), coronary artery disease (15.9%), and recent myocardial infarction (13.0%). The median age for this group of patients was 72.0 years compared to 60.0 years for a concurrent group of 304 patients with Stage I adenocarcinoma of the endometrium treated at our institution with combined surgery and RT. RT consisted of intracavitary insertions alone (11 patients), intracavitary plus low dose external beam therapy (9 patients), and intracavitary therapy plus high dose external beam therapy (49 patients, definitive RT). Younger patients and those with poorly differentiated disease were treated more aggressively. The 5- and 10-year overall survival for all patients was 76.8 and 33.3%, respectively. The 5- and 10-year disease-free survival was 88.1 and 82.4%, respectively. The 5-year overall and disease-free survival for the group of 49 patients treated with definitive RT was 85.4% and 88.7% with 15/49 (30.6%) having poorly differentiated tumors. For the definitive therapy group, the 5- and 10-year disease-free survival was 94.3, 92.3, and 78.0% for grades I, II, and III, respectively. Analysis of patterns of failure showed that none of the patients failed in the pelvis alone. Two out of 11 (18.2%) receiving intracavitary therapy alone and 3/49 (6.1%) receiving definitive RT failed in the pelvis with simultaneous distant metastasis (DM). Three patients in the definitive RT group failed with DM only. Severe complications occurred in 8 patients (16%), all of whom received definitive RT. PMID- 3558040 TI - A ten year follow-up of 682 patients treated for prostate cancer with radiation therapy in the United States. AB - This report extends the follow-up of patients studied in the Patterns of Care Survey of Prostate Cancer treated in the United States between 1973 and 1975 from a maximum of 5 years to a maximum of 10 years. Survival for 60 Stage A patients was the same as expected for their age distribution (83% at 5 years and 62% at 10 years). Survival for 312 Stage B patients was 73% at 5 years and 46% at 10 years and for 296 Stage C patients was 58% at 5 years and 38% at 10 years. Infield recurrence was determined by clinical means, at 5 years 97% of Stage A patients, 86% of Stage B patients, and 74% of Stage C patients were free of local recurrence. At 10 years 97% of Stage A patients, 74% of Stage B patients, and 69% of Stage C patients remained free of local recurrence. Patients with Stage B and C cancer who developed their first failure infield show a long-term survivorship after recurrence of 40% and 20% respectively. This is in contrast to Stage B and C patients who develop a first recurrence at a metastatic site where the rate of progress to death was slower in Stage B patients than for those with Stage C disease (mean survival 32 months versus 19 months), but eventually all are dead by 7 years after recurrence. Complications were infrequent, actuarial analysis shows 93% of patients free of serious complications at 5 years and 89% free at 10 years. There were 14 patients (2%) whose complications required surgical correction and 2 of the 682 patients died of complications. PMID- 3558041 TI - Time-dose relationships for local tumor control and complications following irradiation of squamous cell carcinoma of the base of tongue. AB - Between October 1964 and September 1981, 114 previously untreated patients with squamous cell carcinoma of the base of the tongue were treated with curative intent by a radical course of irradiation at the University of Florida. With a minimum 2-year follow-up, local control was achieved in 78, 65, 76, and 17% of T1, T2, T3, and T4 lesions, respectively. Control results could be correlated with time-dose factors and treatment techniques. No patient required mandibulectomy for osteoradionecrosis following radiation therapy. Complications of bone and soft tissue could not be related to time-dose factors. PMID- 3558043 TI - Dose-volume and complication in interstitial implants for breast carcinoma. AB - A common radiotherapeutic technique for treating breast cancer is the combination of external beam radiation with an interstitial iridium-192 boost. When smaller tumors (T1 and T2) are treated using this technique, the soft tissue complication rate is small. However, with treatment of more advanced stages of disease, where large volumes of breast tissue must be treated to high radiation doses, the incidence of complication increases. This paper investigates the dose and volume relationships for breast tissue treated by interstitial technique and correlates this to the risk of soft tissue radiation injury. A method of analysis of interstitial radiation implants suitable for intra- or inter-institutional clinical evaluations is offered. The records of 111 patients treated at Georgetown University Hospital, were retrospectively analyzed and the five who had experienced radiation-related complications were compared to 51 randomly selected patients experiencing no complications. The volumes of tissue enclosed by selected isodose surfaces were calculated and used to determine a relationship between these dose-volumes and the probability of complication. The mean volume at specified dose levels between 10 Gy and 50 Gy was significantly higher (p less than .05) for the patients developing complications than those in whom no complications were seen. Using the 20 Gy isodose surface as defining our usual treated volume, a complication probability versus dose-volume curve was developed using a linear logistic model. The curve fitted the data closely (p less than .006) suggesting that, for our cases, the calculated treatment volume (within the 20 Gy isodose surface) can be used to effectively separate patients into groups that have different probabilities of developing complications. We propose this method as a basis for specification of dose and volume which can be used for clinical risk assessment, and for intra- and inter-institutional comparison. PMID- 3558042 TI - A retrospective study of three treatment techniques for T1-T2 base of tongue lesions: surgery plus postoperative radiation, external radiation plus interstitial implantation and external radiation alone. AB - One hundred and ten patients with base of tongue tumors less than or equal to 4 cm in diameter (T1 and T2 by the UICC staging system) were treated according to three different methods; surgery followed by external radiation in 27 cases, external radiation followed by interstitial implantation in 29 cases, and external radiation alone in 54 cases. The median follow-up is 8 years with a minimum of 4 years. Local failure occurred twice as often in patients treated by external radiation alone (43%) compared to the other two therapeutic modalities (20.5% for external radiation plus implantation and 18.5% for surgery plus radiation). Ninety per cent of recurrences occurred within the first 2 years. The 5-year survival rate for N0 and N1 nodal disease is 30.5% for patients treated by external radiation alone and 50% for the other two methods. This survival difference is related to poorer local control. Surgery plus external radiation gives identical results to those of external radiation and interstitial implantation, but surgery is only practical for peripheral base of tongue tumors and it has poorer functional results. External radiation followed by interstitial implantation is, in our opinion, the best of the three therapeutic techniques for T1 and T2 base of tongue tumors. PMID- 3558044 TI - Role of irradiation in the management of superior vena cava syndrome. AB - The records of 125 patients treated for superior vena cava syndrome secondary to malignant disease were reviewed retrospectively. The mean age of patients was 55 years. Bronchogenic carcinoma was the cause of the syndrome in 79% of cases, malignant lymphoma 18%, and other tumors 6%. Approximately 80% of the patients obtained good to excellent symptomatic relief. High initial dose radiation therapy (300-400 cGy daily for three fractions) yielded good symptomatic relief in less than 2 weeks in 70% of patients; conventional dose radiation therapy (200 cGy daily, five weekly fractions) yielded the same response in 56% of patients (p = 0.09). Lymphoma patients displayed a 1 year survival of 41%, small cell carcinoma 24%, and other types of bronchogenic carcinoma 17%. Combination of radiation and chemotherapy did not improve response rate, degree of symptomatic relief or long-term survival. Patients exhibiting symptomatic relief within 30 days had a significantly better survival rate than those who did not (p = 0.002). Thirteen percent of patients showed a recurrence of superior vena cava syndrome. There was no correlation between tumor regression and symptomatic relief. Side effects of therapy were minimal; dysphagia was the most common complaint (26% of patients). PMID- 3558045 TI - Once weekly irradiation in breast cancer. AB - Eighty-four elderly patients with carcinoma of the breast were treated with a once-weekly schedule using 650 cGy per fraction to a total of six fractions. According to the TNM classification there were 8 patients with Stage I, 29 patients with Stage II, 45 patients with Stage III, and 2 patients with Stage IV disease. Primary surgical treatment included biopsy, that is, truecut needle biopsy or open biopsy in 53 patients and excision biopsy in 13 patients; the remaining 18 patients had mastectomy. The average age of patients was 69.2 years with the oldest 91 years of age. Ten patients died of concomitant causes during the follow-up period at an average age of 84.5 years. Patients included in this report had at least a 36 month follow-up period with the longest being 94 months. Acute reactions were noticeably less than those with daily treatment. Only one of the 36 patients, where the breast was preserved, had severe delayed skin reaction. Of the 37 patients with Stage I and II, 24 were alive and disease-free at the time of reporting. Three died of concomitant causes, 2 are alive with disease, and the remaining 8 patients died of recurrent of progressive disease. There were 45 patients with Stage IIIA and IIIB and in this group 11 are alive and disease-free, 7 died of concomitant causes, 12 died of progressive breast cancer, and the remaining 4 patients are alive with disease. The two remaining Stage IV patients died of their disease. Once-weekly treatment was well tolerated by all patients and the early local control result is encouraging. We are continuing to assess this type of fractionation in selected elderly patients, especially in those who live away from our center. PMID- 3558046 TI - Is the rate of repair of radiation-induced sublethal damage in rat spinal cord dependent on the size of dose per fraction? AB - In the present study the possible dependency of the kinetics of repair of sublethal damage in rat spinal cord on the fraction size has been further investigated. A wide range of sizes of dose per fraction (1.7-17.5 Gy) has been given with interfraction intervals varying from 0.5 to 24 hr. A direct method for analysis of quantal response and an incomplete-repair (IR) model for survival after fractionated exposures with short intervals were used to interpret the data. The half time of repair (T1/2) was found to be 1.6, 1.6 and 1.9 hrs for fraction sizes of approximately 4, 9, and 14 Gy respectively. There appears to be no significant effect of fraction size on the rate of repair. A clinically relevant feature observed from these experimental data is that in this tissue it takes more than 4 hrs for repair of sublethal damage, induced by a dose of approximately 4 Gy, to approach completion (i.e., sparing beyond the limit of the experimental resolution). This has to be taken into account when several fractions are to be given each day. Another feature noted from the analysis of these results is that the alpha/beta determined from the complete repair data is considerably smaller than that estimated from the incomplete repair data (interval less than or equal to 4 hrs). The nature of the inconsistency is discussed. PMID- 3558048 TI - The effect of hydralazine on the tumor cytotoxicity of the hypoxic cell cytotoxin RSU-1069: evidence for therapeutic gain. AB - The effect of the vasodilator hydralazine on both the tumor and systemic toxicity of RSU-1069 has been evaluated in C57B1 mice bearing Lewis lung tumors. The results obtained indicate that both hydralazine and RSU-1069 are cytotoxic to the Lewis lung tumor on their own. However, administration of hydralazine (5 mg/kg PO) at times up to either 3 hr before or 3 hr after RSU-1069 (0.1 mg/g IP) results in a level of cell killing greater than expected from additive effects. This potentiation by hydralazine was observed with doses of RSU-1069 from 0.01 to 0.1 mg/g. The results obtained using excision assays were confirmed using in situ growth delay as the endpoint. Growth delay (+/- s.e.m.) values for tumors to double in volume of 1.5 (+/- 1.2), 2.0 (+/- 1.3) and 6.0 (+/- 0.9) were obtained for hydralazine (5 mg/kg PO) alone, RSU-1069 (0.1 mg/g IP) alone and for hydralazine administered at the same time as RSU-1069 respectively. In contrast to the potentiating effect of hydralazine on the tumor cytotoxicity of RSU-1069, it had no significant effect on the systemic toxicity of RSU-1069 as measured by LD50/30d. No detailed studies to examine the mechanism responsible for the potentiation of tumor cytotoxicity have been performed in the present study. However, the results obtained would be consistent with previous reports that vasodilators such as hydralazine can selectively reduce tumor blood flow and thus oxygenation. Such reduced tumor oxygenation would increase the cytotoxic effects of RSU-1069 which is known to be more toxic to cells at reduced oxygen levels. PMID- 3558047 TI - Use of steroids to suppress vascular response to radiation. AB - A quantitative measure of the vascular permeability surface area product (PS) for albumin has been made using a double isotope technique. PS was significantly elevated in irradiated rat lung, heart, skin, and muscle, between 19 and 26 days following 18 or 25 Gray thorax irradiation. Administration of dexamethasone from 2 days before irradiation through the day of measurement suppressed the expected increase in PS in lung, heart, and muscle, but not in skin. Shorter periods of steroid administration were not as effective in suppressing this response to radiation exposure. Increased vascular permeability following radiation may be an essential element in the development of radiation fibrosis. We hypothesize that the ability to suppress this response could result in a long term reduction in the incidence of fibrosis. PMID- 3558049 TI - Modification of human tumor pH by elevation of blood glucose. AB - Nine patients with metastatic or recurrent superficial tumors of varying size and histology were administered 100 g oral glucose to investigate whether hyperglycemia can selectively lower tumor pH. pH was measured by a 21 ga modified glass needle electrode inserted through an 18 ga open-ended Angiocath. Serum glucose was monitored every 7.5 min by finger stick and a blood glucose analyzer. Tumor pH was measured over 50-80 min concomitantly with determination of blood glucose. In five nondiabetic patients (eight measurement points) tumor pH decreased 0.05-0.5 units from a pre-glucose range of 6.8-7.4 (7.14 +/- 0.08) to 6.4-7.3 (6.90 +/- 0.10) as blood glucose increased from a baseline of 80-120 mg/dl to 165-215 mg/dl. There was considerable heterogeneity from patient to patient regardless whether blood glucose increased to a peak at 40-60 min post ingestion and then decreased, or whether it remained elevated up to the end of the 80 min observation period. In general, tumor pH decreased as blood glucose increased and then continued to fall throughout the period of observation. In one patient, tumor pH did not change although blood glucose increased to 175 mg/dl. Normal tissue pH was 7.36 +/- 0.02 when determined on four occasions in three patients (subcutaneous and intramuscular sites), and was unaffected by glucose administration. As a further control for tumor tissue and pH probe stability, pH probes in two patients were left in place for 30 min before glucose ingestion. The tumor pH was stable for the entire interval. Interestingly, three patients had an abnormal glucose response: two of those patients (one patient on two separate occasions) had an increase in blood glucose to 230-260 mg/dl in 40-60 min and pH actually increased 0.1-0.3 units. The third patient had a transient increase in blood glucose to 290 mg/dl along with a corresponding increase and subsequent decrease in tumor pH. In summary, whether glucose was given pre- or post-hyperthermia, independently of position in the tumor, and independently of whether pH increased or decreased, the slope of the curve of pH = f(time) was similar in a given patient tumor on all measurement occasions. These preliminary results suggest that hyperglycemia may be useful in non-diabetic patients, and perhaps in diabetic patients given insulin, to selectively reduce tumor pH and sensitize tumors to hyperthermia. PMID- 3558050 TI - Combination of surgery, irradiation, and hyperthermia in treatment of recurrences of malignant tumors. AB - Management of recurrent tumors after initial treatment by surgery, radiotherapy, and sometimes chemotherapy is a formidable challenge. Proximity of tumor to critical organs (e.g., carotid artery in recurrent head and neck tumors) often makes radical surgery impossible. Prior definitive course of radiation therapy precludes delivering a second radical course of irradiation. In the Division of Radiation Oncology, Washington University, we have used combined postoperative hyperthermia and modest dose radiotherapy to treat 23 patients with recurrent tumors and postoperative residual disease. Generally, 3200 to 4000 cGy was delivered in eight to ten fractions in 4 to 5 weeks, in combination with eight to ten sessions of minimum tumor heating to 42.5 degrees to 43 degrees C for 60 minutes, twice a week as stated in the results. Follow-up period was one to 5+ years. Of the 23 patients treated, only three failed within the treatment volume. PMID- 3558051 TI - Radiotherapy for carcinoma of the uterine cervix by remotely controlled afterloading intracavitary system with high-dose-rate. AB - Between January 1978 and June 1985 seventy-nine patients with carcinoma of the uterine cervix were treated by a remotely controlled afterloading system (RALS) with high-dose-rate irradiation following external beam therapy. It was given once a week with a dose per fraction of 6 Gy to point A, 3 to 6 times, using applicators equipped with 1 Ci 60Co bead in each ovoid and two 1 Ci 60Co beads in a tandem 1 cm apart. Five-year survival rates were 85, 68, and 51 percent in Stages I, II, and III, respectively. Recurrences were noted in 12 patients (20%) with a minimum follow-up of 2 years: 4 patients in the parametrium, 2 in the central area, 5 in both the parametrium and central areas, and 5 in the para aortic lymph node. Complications were noted in 13 patients (22%): temporary rectal bleeding in 7, stenosis of the sigmoid in 2, recto-vaginal fistula in 1, ileo-sigmoidal fistula in 1, and perforation of the intestine in 2 patients. The treatment results of the high-dose-rate schedule for RALS appear to be comparable to those of conventional low-dose-rate systems reported by others. Therefore a fraction dose of 6 Gy to point A once a week by RALS should be considered to be practical, economical, and acceptable to patients. PMID- 3558052 TI - The treatment and prognosis of patients with renal adenocarcinoma with solitary metastasis. 10 year survival results. AB - From 1969-1976, 25 patients with renal adenocarcinoma and solitary metastasis were treated and are now eligible for 10-14-year survival analysis. There were 17 men and 8 women, mean age 60 years, range 37-75 years. Twelve patients had focus in bone and 13 patients in other localizations: lungs 6, thyroid 3, flank 3, and epididymis 1. Sixteen out of twenty-five patients were treated with the radiotherapy 45-50 Gy in 23-25 fractions as the only treatment. The median survival was 4.3 years, the 5-year survival 36%, and the 10-year survival 16%. Women had 5- and 10-year survival rates of 76% and 38% respectively. Men had 5 year survival of 18% and 10-year survival of 12% (p = 0.05). There were no significant differences between the survival of patients with bone metastases and patients with soft tissue metastases. Three patients are living NED at 14 years. Seventeen of twenty-two patients died of progressive renal adenocarcinoma whereas 5/22 died from other causes. We conclude: It is possible to obtain long term survival greater than 10 years and maybe even cure in a fraction of these patients by aggressive treatment. Radiotherapy is a highly potential treatment modality giving the same or better results as those reported in the literature after extensive and disabling surgical resections. However, it cannot be excluded that the favorable prognosis for these patients merely reflects the natural clinical course of the disease in this specific subgroup. PMID- 3558053 TI - A problem in rotation therapy with X rays. AB - The radiation field required to produce a dose distribution in rotation therapy may, in a certain approximation, be calculated using an integral equation, that is, the solution of the equation predicts the intensities needed to produce the dose distribution. The nature of this approximation is discussed and is shown to be connected with a Radon-type problem for circles through the origin provided the beam can be continuously modified during the rotation. The lowest order approximation provides a vivid geometrical way of looking at treatment planning which may be useful in novel situations and which will persist, to some extent, in higher-order approximations. Questions of scattering, and of the extension of the problem to a full three dimensional treatment are discussed. PMID- 3558054 TI - A spreadsheet program for brachytherapy planning. AB - A computer program (brachy-spread) which allows spreadsheet-like interactive adjustment of the loading of any brachytherapy application has been implemented. Sources are collected into objects, each assigned an activity and duration of implant. Activities and times may be adjusted by moving a cursor to the datum to be edited and entering a new value from the keyboard. Alternatively, the desired total dose to a given calculation point may be edited resulting in a recalculation of the time for all objects. For each of a set of calculation points, dose rates, total doses, and the percent contribution of each object to the point are displayed and instantly updated as the times and activities are adjusted. The program design includes rapidly updated display of isodose curves in previously selected arbitrary planes. A strategy for providing rapid dose display involving precalculation of fractional dose tables is used. The program has significantly reduced the time required to determine the appropriate loading of GYN applications and of implants which involve a combination of line sources and seeds. PMID- 3558055 TI - Radiation and chemotherapy induced lung toxicity. PMID- 3558056 TI - Multiple myeloma presenting as a pituitary tumor. PMID- 3558057 TI - Effect of early environment on electrodermal and cognitive correlates of schizotypy and psychopathy in criminals. AB - This study examined hypotheses concerning electrodermal hyporeactivity and psychopathy, electrodermal hyporeactivity in schizoid antisocials, poorer scores on the Attention-Distraction factor of the WAIS in schizoid antisocials and stronger support for these relationships in those from intact as opposed to broken home backgrounds. Thirty-seven prisoners were assessed for psychopathy, schizotypy (anhedonia-psychoticism and schizophrenism), the WAIS, and skin conductance recorded to orienting, consonant-vowel, and 90 dB stimuli. All hypothesized relationships for psychopathy were non-significant. High anhedonia psychoticism scores were significantly associated with reduced orienting frequency (r = -0.43) and with poor performance on Attention-Distraction (r = 0.43). Reduced orienting frequency was itself associated with poor Attention Distraction (r = 0.61). These relationships were stronger in subjects from intact as opposed to broken home backgrounds. Conclusions are drawn with respect to the mediating effects of attentional and social background factors in psychophysiology-schizotypy relationships. PMID- 3558058 TI - Rate of habituation of electrodermal orienting responses: a comparison of instructions to stop responding, count stimuli, or relax and remain indifferent. AB - Thirty-nine subjects listened to two series of repetitive tones, the second series of which was of higher or lower pitch and of higher intensity. Before the first series all subjects were given conventional instructions to relax and adopt a passive attitude to the tones. Before the second tone series one of three instructions was given: to maintain a relaxed and passive attitude, to inhibit responding, to count the stimuli silently. The three groups showed roughly equivalent rates of habituation to the first tones series but the group instructed to count the tones showed slower habituation than the groups instructed to remain indifferent or to inhibit responses. A recommendation to clarify task demands in habituation experiments, by informing subjects that the aim was to see how quickly subjects stopped responding, showed no advantages over conventional instructions. PMID- 3558059 TI - Time-dependent bradycardia: a new effect? AB - Time-dependent bradycardia, a term introduced by the Laceys (Lacey and Lacey, 1980), refers to the fact that the duration of a cardiac cycle is related to when in that cycle, or the just preceding cycle, certain stimuli occur. Since stimulus effects on heart activity with very short latencies have been known for a long time, the question arises whether the effect is one in its own right, or whether it is simply a result of the new way of data reduction introduced by the Laceys. Theoretically, the effect can be explained without assuming anything beyond the well-known short latency bradycardia often observed upon stimulation. Derivation of the effect from an empirical curve of cardiac activity not related to cycle phase shows that we are not dealing with a new effect. PMID- 3558060 TI - Comparison of principal components computed with principal factor analysis on the basis of averaged and single-trial ERPs using the Fischer-Roppert procedure. AB - Averaged and single-trial event-related potentials (ERPs) were analysed using the Principal Factor Analysis (PFA) with following varimax rotation, and the results were compared. The correspondence between the matrices of factor loadings was tested by means of the Fischer-Roppert-procedure. For the application of PFA, a preceding averaging to improve the signal to noise ratio is not necessary. If the group of subjects is homogeneous enough, the analysis of the single-trial ERPs provides results sufficient to investigate the component structure of the ERP. The ERPs from all subjects can be described with one common component structure. PMID- 3558061 TI - Hemispheric asymmetry of pattern reversal visual evoked potentials in healthy subjects. AB - Pattern reversal visual evoked potentials were recorded from temporal leads of both hemispheres in 3 right-handed and 3 left-handed subjects. The stimuli subtended 6 degrees of visual field (full field condition), or 1 degree of visual field (foveal condition), or were restricted to the peripheral portion of the visual field (annular condition). Check sizes varied from 16 to 2.8 min of arc. The stimuli were phase-reversed at 1 or 8 Hz. Remarkable hemispheric asymmetries were found, depending on the portion of the visual field and temporal frequency. In right-handed subjects the amplitude of visual evoked potentials recorded over the left hemisphere was larger for stimuli phase-reversed at 8 Hz in full-field and annular conditions, whereas the amplitude of visual evoked potentials recorded over the right hemisphere was larger for stimuli phase-reversed at 1 Hz in the foveal condition. Different patterns of hemispheric asymmetries were observed in left-handed subjects. PMID- 3558062 TI - Vertex potential functions. PMID- 3558064 TI - Insurance for veterinary medical association personnel. PMID- 3558063 TI - Questions diagnosis of ehrlichiosis. PMID- 3558065 TI - Doors and windows in veterinary security. PMID- 3558066 TI - Renal tubular acidosis in two horses: diagnostic studies. AB - An 11-year-old Quarter Horse mare and a 2-year-old Quarter Horse colt with clinical diagnoses of renal tubular acidosis (RTA) were donated to the University of California Veterinary Medical Teaching Hospital. A series of diagnostic tests was performed in an attempt to characterize the type and cause of RTA in these horses. Endogenous creatinine clearance and sodium sulfanilate clearance were within reference ranges; thus, no abnormality of glomerular function was detected. To assess renal tubular function in response to acid loading, each horse was given 0.1 g of NH4Cl/kg of body weight via nasogastric tube in 6 L of water. Urine acidification in response to the oral acid load was less than that observed in control horses. The urinary clearance ratio for sodium also was found to be greater for the principals than for the controls. These findings supported a diagnosis of RTA that closely resembled type 1 or distal RTA. In an attempt to determine the cause of RTA, renal ultrasonography, renal biopsy, and a mating study were performed. No abnormalities were identified, and the cause of RTA in these cases remained unknown. PMID- 3558067 TI - Traumatic tarsal luxation repaired without internal fixation in three horses and three ponies. AB - Three horses and three ponies were treated for traumatic luxation of the proximal intertarsal or tarsometatarsal joint. In each case, there were fractures of one or more tarsal bones. Three of the animals had disruption of one of the collateral ligaments. Five animals were treated by closed reduction and external coaptation. One pony was treated by open curettage, a cancellous bone graft, and cast immobilization. No internal fixation was used in any of these animals. From this series of cases, it would appear that closed reduction and external coaption alone is adequate treatment for most cases of tarsal luxation. PMID- 3558068 TI - Malignant teratoid medulloepithelioma in a horse. AB - Enlargement of the left eye, corneal opacification, and blindness were clinical signs of a teratoid medulloepithelioma in a 5-year-old Standardbred mare. Diagnosis was made on histologic examination of the enucleated eye. Medulloepitheliomas are congenital intraocular tumors arising from primitive ciliary body epithelium. Their development is rare in domestic animals. PMID- 3558069 TI - Ileocecocolic intussusception as a sequel to jejunocecostomy in a mare. AB - An excessively long ileal stump, the result of a previous jejunocecostomy, had intussuscepted into the cecum and subsequently obstructed the cecocolic orifice of a 12-year-old Quarter Horse mare. Clinical signs were dehydration, ileus, and endotoxemia. The diagnosis was made at necropsy. PMID- 3558070 TI - Compression bone plating of a medial condylar fracture of the third metatarsal bone in a Thoroughbred filly. AB - A medial condylar fracture of the third metatarsal bone in a 2-year-old Thoroughbred filly was repaired successfully by use of compression bone plating. At discharge from the hospital, thickening of the metatarsus was evident, and proliferative changes were associated with the site of bone plate application. It was expected that these changes would limit the filly's use as a racehorse, and a return to training was not recommended. Especially in horses that may return to racing, use of compression bone plating initially should not replace stall rest or lag screw fixation treatment of this type of injury. However, the use of a similar approach in selected cases of medial condylar fracture of the third metatarsal bone is encouraged, especially when additional fissure lines are evident on radiographs. PMID- 3558071 TI - Immune-mediated hemolytic anemia and thrombocytopenia in a foal. AB - A one-month-old Quarter Horse filly had unilateral epistaxis, hyphema, icterus, petechial hemorrhages in the oral, nasal, conjunctival, and vulvar mucous membranes, anemia, thrombocytopenia, negative antinuclear test result, and a positive direct Coombs' test result. Megakaryocytes or cell-associated IgG (fluorescent antibody and immunoperoxidase stains) were not found in bone marrow biopsy specimens. Treatment consisted of glucocorticoids, antibiotics, and a single whole blood transfusion. The foal responded well to treatment, did not develop relapses of the disease, and was clinically normal one year after treatment. PMID- 3558072 TI - Hemorrhagic fibrinonecrotic duodenitis-proximal jejunitis in horses: 20 cases (1977-1984). AB - Records of 20 horses with small intestinal disease causing acute colic and affecting the proximal portion of the small intestine were examined retrospectively. The disease was characterized by severe to moderate pain, which was replaced by depression, fever, gastric reflux, slight distention of the affected small intestine, leukocytosis, and high concentrations of total protein in the peritoneal fluid. Grossly, the affected intestines were hemorrhagic and had yellow discoloration. Histopathologic findings included submucosal edema, neutrophilic infiltration of the submucosal and laminal propria, and mucosal slough at the villous tips. Advanced lesions were characterized by mucosal sloughing with transmural edema, hemorrhage, fibrin deposition, and necrosis. No cause was determined. In 6 horses, bypass of most of the affected small intestine was helpful by alleviating the severe gastric reflux. PMID- 3558073 TI - Umbilical cord remnant infections in foals: 16 cases (1975-1985). AB - Infection of the umbilical cord remnants was diagnosed in 16 foals. The infection was found in the urachus alone in 3 foals, the umbilical arteries in 2 foals, the urachus and umbilical arteries in 3 foals, the urachus and umbilical vein in 2 foals, and the urachus, umbilical vein, and umbilical arteries in 2 foals. The specific location of the infection was not determined in 4 foals. Eleven foals developed an acquired patent urachus between 4 and 16 days of age. Seven foals had one or more joints infected. All foals with umbilical cord remnant infections were treated with orally, intramuscularly, or intravenously administered antibiotics and 9 foals had the umbilical cord remnants excised. Nine foals survived, 6 of which had had excision of the infected remnants. Only 2 foals with joint infections survived. PMID- 3558074 TI - Testing for feline leukemia. PMID- 3558075 TI - Diverse opportunities in the Army Veterinary Corps. PMID- 3558076 TI - Chlamydiosis in psittacine birds. PMID- 3558077 TI - Economic assessment of a pseudorabies epizootic, breeding herd removal/repopulation, and downtime in a commercial swine herd. AB - The effect of pseudorabies in a 150-sow farrow-to-finish operation on selected production and economic values was estimated. Mean litter size remained the same throughout the observation period; however, there was a 2-fold increase in suckling pig mortality and a 3.5-fold increase in stillbirths when the months of the epizootic were compared with pre-epizootic months. Following the epizootic, suckling pig mortality was 13.7% greater (P less than 0.05) than that observed in the months preceding the epizootic, whereas stillbirth rate was 71% higher (P less than 0.01) than that reported in the pre-epizootic months. Total net loss for this operation was estimated at +48,175. The major economic losses (approximately 88% of the total loss) were related to breeding herd removal/repopulation and production downtime. PMID- 3558078 TI - Modification and evaluation of a multichannel blood cell counting system for blood analysis in veterinary hematology. AB - A multichannel, semiautomated, blood cell counting system (Coulter Counter Model S550) was modified for use in veterinary hematology by increasing both the erythrocyte and leukocyte aperture currents to 225 V and 195 V, respectively, followed by calibration with human blood. It was evaluated by use of 350 samples from dogs, cats, horses, and cows. Values for leukocyte count, erythrocyte count, mean corpuscular volume, and hematocrit generated by the S550 were compared with values generated by an automated multichannel counter with histogram capability and other reference procedures when appropriate. Mean differences for values between S550 and reference values were less than calibration tolerance limits for the instrument. Correlation coefficients were excellent for all values of each species. To assess behavior of leukocytes of the different species with respect to the counting threshold, leukocyte size distribution histograms were generated for all samples analyzed on the S550. Means for mean leukocyte volumes in diluent and lysing reagents were 55.5, 56.6, 67.4, and 72.8 fl for dogs, cats, horses, and cows, respectively. Canine leukocyte counts, because of small leukocyte size, were an average of 14% less for 5 samples analyzed on the unmodified instrument, compared with analysis after increasing the leukocyte aperture current. Leukocyte threshold failures attributable to interfering particles, resulting in falsely high counts, were recognized in 14%, 10%, 8% and 0% of feline, bovine, canine, and equine samples, respectively. The magnitude of error in these samples averaged 5% for cows and dogs, but was considered not important. However, leukocyte counts of feline samples in this group averaged 44% falsely high. PMID- 3558079 TI - Effects of nonadherent dressing materials on the healing of open wounds in dogs. AB - Four types of nonadherent dressing materials (rayon/polyethylene dressing, cotton nonadherent film dressings, fine mesh gauze petrolatum dressings, and commercial petrolatum emulsion dressings) were applied on small full-thickness skin defects on the backs of 12 Beagles. At 7 days, the wounds treated with the petrolatum containing dressings had more contraction than wounds dressed with cotton nonadherent film dressings and wounds dressed with rayon/polyethylene dressings. However, by days 14 and 21, there was little difference in the amount of contraction of any of the wounds. At 7, 14, and 21 days, the wounds dressed with petrolatum-containing dressings had less epithelialization than wounds dressed with cotton nonadherent film dressings and rayon/polyethylene dressings. The uniform open mesh of the commercial petrolatum emulsion dressings allowed the best absorption of exudate and bacteria into the secondary overlying bandage. PMID- 3558080 TI - Effects of tolazoline and yohimbine on xylazine-induced central nervous system depression, bradycardia, and tachypnea in sheep. AB - We compared the ability of tolazoline and yohimbine to antagonize xylazine induced central nervous system depression, bradycardia, and tachypnea in 9 ewes and 5 rams. Once a week for 3 weeks, each sheep received one IV treatment of 0.4 mg xylazine/kg, 0.4 mg xylazine/kg followed in 10 minutes by 2 mg tolazoline/kg, or 0.4 mg xylazine/kg followed in 10 minutes by 0.2 mg yohimbine/kg. The order of the 3 treatments in each sheep was randomized. Xylazine alone caused recumbency for 41.0 +/- 3.7 minutes (mean +/- SEM). Tolazoline and yohimbine shortened the xylazine-induced recumbency to 12.1 +/- 0.9 minutes and 18.1 +/- 1.5 minutes, respectively. Sheep given xylazine alone had head droop for 34.0 +/- 5.4 minutes after rising. Head drooping of sheep given tolazoline or yohimbine was reduced to 10.1 +/- 1.7 minutes and 14.2 +/- 1.7 minutes, respectively. Both tolazoline and yohimbine reversed the bradycardia and tachypnea that followed xylazine administration. No statistical differences in the rate and magnitude of the reversal were observed between the 2 drugs. PMID- 3558082 TI - Heartworm disease manifested by encephalomyelitis and myositis in a dog. AB - A 2-year-old Boston Terrier was referred because of depression and hindlimb and tail paresis. Clinical examination and serum biochemical analysis resulted in a diagnosis of encephalomyelitis and myositis. Results of testing for Dirofilaria immitis were positive. Gross and histologic examination revealed an aberrant adult heartworm infection resulting in thrombosis of the femoral artery and multiple muscular branches, with subsequent muscle necrosis and inflammation in one hindlimb. Additionally, an unusual larval-tissue interaction to microfilariae yielded a multifocal encephalomyelitis in the brain and spinal cord. PMID- 3558081 TI - Intestinal lymphangiectasia with lipogranulomatous lymphangitis in a dog. AB - Intestinal lymphangiectasia with lipogranulomatous lymphangitis was diagnosed at necropsy in a 6.5-year-old Maltese dog that had a history of bouts of vomiting, abdominal distention, and diarrhea. The condition was attributed to trauma to the pleural and peritoneal cavities received from bite wounds inflicted one year previously. PMID- 3558083 TI - Congenital urethral obstruction, uroperitoneum, and omphalitis in a calf. AB - A neonatal calf with anuria, uroperitoneum, azotemia, hyperphosphatemia, and hyperkalemia was found to have a congenital urethral obstruction. The calf had a concomitant infection of the internal umbilical remnants. Surgical intervention corrected both conditions. PMID- 3558084 TI - Hypoglycemia and chronic renal failure in a cat. AB - Spontaneous hypoglycemia developed in a 9-year-old cat with chronic renal failure. Resulting seizures stopped after intravenous administration of glucose, but the cat died within 10 hours. This case and reports in human beings suggest that hypoglycemia should be considered in any cat with chronic renal failure that experiences sudden deterioration in mental status or begins having seizures. PMID- 3558086 TI - Equine ehrlichiosis in northern California: 49 cases (1968-1981). AB - Case records of horses with equine ehrlichiosis (Ehrlichia equi) at the University of California Veterinary Medical Teaching Hospital and Ackerman Creek Large Animal Clinic were analyzed for evaluation of clinical signs, time of onset, hematologic values, response to treatment, and recovery. Equine ehrlichiosis was found to be seasonal in horses in the foothills of northern California, with higher incidence than reported previously. The horses developed fever, anorexia, depression, limb edema, icterus, and ataxia. Hematologic changes were leukopenia, thrombocytopenia, icterus, anemia, and inclusion bodies in the neutrophils and eosinophils. Diagnosis was made by observing the characteristic inclusion bodies, using a standard Wright's stain. Mortality was low, although complications of opportunistic secondary infection and injury due to ataxia did develop. Treatment with tetracycline resulted in prompt clinical improvement within 24 hours. Chronic cases were not detected. Equine ehrlichiosis should be differentiated from diseases with similar clinical signs including encephalitis, liver disease, purpura hemorrhagica, equine infectious anemia, and equine viral arteritis. PMID- 3558085 TI - Urinary bladder fibromas in dogs: 51 cases (1981-1985). AB - Between Jan 1, 1981, and June 30, 1985, fibromas were diagnosed in tissues removed from the urinary bladders of 51 dogs. Hematuria, the most common clinical sign, was associated with the fibromas in 47 of 50 cases. Most dogs responded well to surgical excision of the neoplasms, with rapid resolution of the hematuria followed by long periods without abnormal clinical signs. Three dogs were euthanatized because of continuing or recurrent clinical problems, which included bladder dysfunction. One dog required continuing medication with antibiotics and corticosteroids to control hematuria. PMID- 3558087 TI - Employment of 1986 male and female graduates of US veterinary medical colleges. PMID- 3558088 TI - Long-term vs short-term treatment of urinary tract infections in dogs and cats. PMID- 3558089 TI - Influence of anesthetic regimen on the frequency of seizures after cervical myelography in the dog. AB - We examined the influence of various anesthetic drug combinations on the frequency of seizures in dogs after cervical myelography with metrizamide. Over a 12-month period, 78 dogs admitted to the teaching hospital for cervical myelography were assigned randomly to 1 of 6 anesthetic protocols. Myelography was performed, and the dogs were observed for signs of seizure activity after recovery from anesthesia. The person making the decision as to whether or not a dog had had a seizure was unaware of the anesthetic protocol that had been used. Preanesthetic treatment with pentobarbital (5.0 mg/kg) and maintenance of anesthesia with methoxyflurane significantly reduced the frequency of seizures (P less than 0.05). No reduction in seizure frequency was seen with any anesthetic protocol using halothane as the maintenance agent. PMID- 3558090 TI - Primary degenerative joint disease of the shoulder in a colony of beagles. AB - Shoulder joints of 149 Beagles over 8 years old at the time of death (mean age, 13.8 years +/- 3.21), were examined radiographically throughout their life-times for the frequency of degenerative joint disease (DJD). Clinical histories revealed no underlying cause for DJD. The shoulder joints of a subgroup of 18 dogs were examined at necropsy, and thin sections of the joints were evaluated radiographically and histologically. Serial clinical radiographic studies indicated that normal shoulder joint development during the first year of life was followed by the appearance of subchondral bone sclerosis and bony remodeling of normal joint contour, and by the formation of periarticular osteophytes and enthesiophytes. All changes were progressive with age and typical for DJD in dogs. Bilateral involvement was common. Evaluation of specimens obtained at necropsy revealed: articular cartilage change with roughening of the surface layer, degeneration and death of superficial chondrocytes, exposure of deeper layers of chondrocytes that had proliferated with fissuring of the damaged cartilage, total cartilage loss with polishing of the exposed subchondral bone, mixed patterns of subchondral bone sclerosis and osteoporosis, change in contour of the articular surfaces, and formation of periarticular osteophytes and enthesiophytes. Joint capsule thickening, synovitis, pannus formation, and synovial chondroma formation were observed. Because of the available clinical information, in addition to the typical changes of DJD, it was thought that the changes were primary. Instability appeared to play a role in the pathogenesis of the joint disease described; however, it was not clear whether the instability caused abnormal forces on healthy cartilage or whether the primary cartilage wear caused the instability. PMID- 3558091 TI - Pseudohyperkalemia in Akitas. AB - Hyperkalemia was observed in a clinically normal Akita with normal ACTH stimulation test results, endogenous ACTH concentration, and SUN concentration. A diagnosis of pseudohyperkalemia caused by red cell hemolysis was made by comparing plasma potassium content from hemolyzed and non-hemolyzed specimens. Red cell potassium content was measured in 8 Akitas and 6 non-Akita control dogs. Six of 8 Akitas had high erythrocyte potassium content relative to their plasma and to that of the control dogs. Five of eight Akitas had microcytosis. Plasma from affected dogs had high potassium content after being refrigerated in contact with red cells for 4 hours or more. The increase in plasma potassium content was progressive with prolonged contact with the red cells and was accompanied by a decrease in plasma sodium content. PMID- 3558092 TI - Neuromuscular abnormalities associated with hypothyroidism and lymphocytic thyroiditis in three dogs. AB - Various degrees of persistent or paroxysmal paresis involving only the hindlimbs or all four limbs were observed in 3 dogs with hypothyroidism and lymphocytic thyroiditis. Clinical features included lethargy, obesity, alopecia, insidious and progressive paresis, hypotonia, and slow segmental reflexes in 2 dogs. Obesity, alopecia, paroxysmal paresis, and behavior change were observed in the third dog. Laboratory tests indicated that thyroid function was less than normal in all 3 dogs. Abnormal electromyographic potentials and slow motor nerve conduction velocities were found in each dog. Muscle biopsy specimen abnormalities included selective type-II myofiber atrophy in all dogs, whereas one dog had angular atrophy of type-I and type-II myofibers indicative of denervation. A substance that stained with para-aminosalicylic acid was observed within vacuoles of type-I myofibers in one dog. Lymphocytic thyroiditis characterized by lymphocytic infiltration of excised thyroid glands was observed in all dogs. PMID- 3558093 TI - An unusual portosystemic shunt in a dog. AB - An unusual portosystemic shunt was diagnosed in a 4-month-old male Miniature Poodle examined because of stunted growth and episodes of dementia characterized by hysteria, ataxia, and staggering. Operative splenoportography revealed a portosystemic shunt. Exploratory surgery to identify and correct the shunt was attempted. Evidence of any portal circulation was not detected, and the dog was euthanatized. The possible embryologic basis for this vascular anomaly is discussed. PMID- 3558094 TI - Metastatic transmissible venereal sarcoma in a dog. AB - An adult male dog with large penile sheath and serosanguineous exudate from the preputial orifice and a cutaneous fistula in the right inguinal area was examined. Necropsy revealed tumor masses on the penis and prepuce, in superficial inguinal and external iliac lymph nodes, and in the liver. Histopathologic diagnosis of the tumor was confirmed by transplantation studies. PMID- 3558095 TI - Use of praziquantel for treatment of Diphyllobothrium sp infection in a dog. AB - Eggs of a tapeworm, Diphyllobothrium sp (probably D dendriticum), were detected in feces of a healthy, 5-month-old, Siberian Husky. The dog acquired its infection in northern Canada while consuming a diet that included raw salmonid fish. Such fish serve as intermediate hosts for Diphyllobothrium spp. The infection was successfully eliminated by oral administration of a single dose of praziquantel (7.5 mg/kg of body weight. PMID- 3558096 TI - Hyperadrenocorticism in a cat. AB - A diabetic cat with hyperadrenocorticism had polydipsia, polyuria, ventral abdominal alopecia, thin dry skin, and a pendulous abdomen. Results of laboratory testing indicated persistent resting hypercortisolemia, hyperresponsiveness of the adrenal glands (increased cortisol concentration) to ACTH gel, and no suppression of cortisol concentrations after administration of dexamethasone at 0.01 or 1.0 mg/kg of body weight. Necropsy revealed a pituitary gland tumor, bilateral adrenal hyperplasia, hepatic neoplasia, and demodicosis. Adrenal gland function was concurrently assessed in 2 cats with diabetes mellitus. One cat had resting hypercortisolemia, and both had hyperresponsiveness to ACTH gel (increased cortisol concentration) at one hour. After administration of dexamethasone (0.01 and 1.0 mg/kg), the diabetic cats appeared to have normal suppression of cortisol concentrations. The effects of mitotane were investigated in 4 clinically normal cats. Adrenocortical suppression of cortisol production occurred in 2 of 4 cats after dosages of 25, 37, and 50 mg/kg. Three cats remained clinically normal throughout the study. One cat experienced vomiting, diarrhea, and anorexia. PMID- 3558097 TI - Evaluation of some prognostic factors for advanced multicentric lymphosarcoma in the dog: 147 cases (1978-1981). AB - A total of 147 dogs treated with a combination of chemotherapy procedure (vincristine, L-asparaginase, cyclophosphamide, and methotrexate) were evaluated for response to therapy and the influence of age, sex, clinical stage, and body weight to duration of response. Complete response was achieved in 113 dogs (77%), partial response in 26 dogs (17.7%), and no response in 8 dogs (5.4%). The median survival time for the dogs with complete and partial responses was 265 days. An analysis of factors associated with prognosis revealed that age, clinical stage, and body weight were not associated with response to therapy, whereas sex was. Females had a significantly prolonged remission and survival time (P = 0.0001). PMID- 3558098 TI - Peripheral nerve injury associated with fracture or fracture-dislocation of the pelvis in dogs and cats: 34 cases (1978-1982). AB - Peripheral nerve injury was associated with fracture or fracture-dislocation of the pelvis in 23 dogs and 11 cats. In most cases, peripheral nerve injury resulted from ilial fracture with craniomedial displacement of bone fragments, or from sacroiliac fracture-dislocation with cranial displacement of the ilium. Sciatic nerve injury was associated with fracture of the acetabulum in 2 dogs. A combination of sensory, voluntary motor, and reflex abnormalities were observed in the ipsilateral extremity of affected animals. Signs of severe pain were noticed in 4 of the dogs and in 1 cat. Eight of the animals died or were euthanatized for reasons not directly related to the severity of peripheral nerve injury. Of the remaining 26 animals, 21 (81%) had good or excellent limb function 16 weeks after peripheral nerve injury was sustained. Limb function was lost or self-mutilation occurred in 4 (15%) of the animals. PMID- 3558099 TI - Research and the mission of schools of allied health. PMID- 3558100 TI - Simulated grading decisions of allied health educators: a survey of Texas faculty. AB - Using simulated student data, this study investigated the grading decisions and future performance expectations of faculty members from allied health programs in Texas. These randomly selected faculty members evaluated linear and nonlinear grade profiles and formed expectations of students' future performances based on these grade profiles. Results indicated that student grade-performance patterns were differentially related to assigned grades and future expectations. Factors related to overall grade assignment included mean performance level, slope of academic performance (ascending, descending), and time of performance change (early, late). Two potential grading biases were suggested (age, sex of faculty), particularly for ascending performance patterns. Other faculty characteristics were unrelated to grading decisions and expectations. PMID- 3558101 TI - The multicompetent practitioner: a needs analysis in an urban area. AB - This study examined the concept of the multicompetent practitioner - the health care worker trained in more than one specialty - as one way of meeting the changing needs of the health care system. Seventy-four hospital administrators, 74 directors of nursing, 14 directors of community health organizations, and 12 private physicians from the Philadelphia metropolitan area were surveyed to explore the feasibility of developing and using multicompetent practitioners at their participating institutions. The results indicated that multicompetent practitioners are already working in some institutions and that there is a willingness to hire this new type of health care worker. How the multicompetent practitioner fits into the institution, the level of education required beyond the original area of skill, and the question of salary were included in the survey. Findings also indicate positive support for the development of multicompetent practitioner training within allied health educational programs. PMID- 3558103 TI - Androgyny and the career choices of allied health professions students. AB - Psychological androgyny (the presence of both masculine and feminine personality characteristics in the same individual) has been shown to be related to career sex-role stereotyping and to the selection of some allied health professions careers. The purpose of this study was to determine what the distribution of the four types of gender-related personality categories (androgynous, masculine, feminine, undifferentiated) was among allied health professions students and whether these personality categories were related to actual career choice. The study involved 338 students enrolled in all six allied health professions programs at Weber State College in Ogden, Utah, who completed the Bem Sex-Role Inventory (BSRI), a measure of psychological androgyny. Findings indicated that, in contrast to national normative data, the androgynous personality was the most frequently occurring personality category, followed closely by feminine-typed subjects. Female subjects were nearly equally divided between androgynous and feminine personalities; male subjects were predominantly masculine-typed individuals. In addition, the largest percentage of students enrolled in the nursing, respiratory therapy, radiologic technology, and medical technology programs were androgynous personalities; the dental hygiene and paramedic programs had, respectively, more feminine and more masculine students enrolled. These findings indicated that, although some professions were still sexually stereotyped in terms of students' personality characteristics, there may be an emerging trend toward androgyny in the allied health professions. Future research efforts might be directed toward replications of this study using allied health students at other educational institutions. PMID- 3558102 TI - Self-esteem in nurse anesthesia students: a national investigation. AB - The purpose of the study was to determine the self-esteem (SE) profile of nurse anesthesia students and identify education or biographic variables that influenced positive self-esteem. It was the assumption of the investigators that these variables, once described, could be used in curriculum planning and development to facilitate positive learning outcomes. A sample of 96 nurse anesthesia students, selected by random stratification, provided data by means of the Tennessee Self-concept Scale (TSCS) and an investigator-devised questionnaire. Correlation coefficients and analysis of variance were run on score subscales of the TSCS grouped according to nine education and biographic variables. Sample TSCS profiles were found comparable to control groups. Students reporting high grade point averages (GPAs) and married students demonstrated higher SE profiles than other groups. Gender, degree of physician mentorship, time in training, degree levels of generic nursing or anesthesia education, years of critical care experience, or anesthesia program base did not significantly influence SE measures. PMID- 3558104 TI - A comparison of three allied health manpower projection methodologies. AB - Three manpower projection methodologies most often employed in the allied health sciences were compared: population ratio, occupational matrix, and regression analysis. Comparisons were made among the methodologies themselves, their strengths, and their weaknesses. These methodologies were then applied to the largest allied health discipline - clinical laboratory sciences - using Kentucky statewide data. The resultant projections were then compared with actual data (F.J. Morris, PhD, unpublished data, 1985). The most appropriate methodology to be used by the administrator should be determined by his/her specific needs and goals in relation to the specific strengths and weaknesses of the individual methodology. PMID- 3558106 TI - American Society of Andrology 12th annual meeting. Denver, Colorado, March 7-9, 1987. Abstracts. PMID- 3558105 TI - An investigation into problem solving in education: a problem-solving curricular framework. AB - The purpose of this study was to examine how two aspects of teaching, mastery of content and problem solving, could be linked in a curricular framework. A professional educational program in physical therapy which had been developed to teach both content and problem solving was evaluated. The subjects for the study were 81 students in a baccalaureate program in a Midwestern medical school who participated in this problem-solving curriculum. The primary assessment instrument used was the Watson-Glaser Critical Thinking Appraisal. Findings indicated that performance on a test of critical thinking was affected by the curriculum. Regression analysis indicated that one course designed as an introduction to problem solving was significantly related to changes in problem solving skill scores. Although significant change in the test scores did occur, these changes were not evident until the completion of the year-long program. Differing effects for lecture and field experience (or patient care) courses were not observed, and traditional measures such as grade point averages had no statistical relationship to problem-solving skill scores. PMID- 3558107 TI - Improvement in the quality and fertilization potential of a human sperm population using the rise technique. AB - Semen from 63 individuals participating in an in vitro fertilization program was processed using a modified rise technique. Overall normal morphology was significantly improved in the rise (79.2%) as compared with the unprocessed sample (57.8%), and six of seven specific morphologic abnormalities were significantly reduced. Motility was significantly enhanced from 51.8% in the unprocessed samples to 89.1% in the rise samples. Spermatozoa recovered in the rise portion of the sample represented 5.9% of the total sample. Ultrastructural morphometry revealed that the rise was relatively free of abnormal sperm forms, acellular debris and non-sperm cellular elements as compared with the non-rise portion of the sample or a typical unprocessed sample. Volume density measurements demonstrated that only 18.1% of the volume of the non-rise sample was composed of normal spermatozoa compared with 83.4% of the volume of the rise. In a separate set of experiments utilizing 21 samples, the penetration of hamster eggs was significantly enhanced from 37.9% to 67.2% using spermatozoa from the initial washed sample and those from the rise, respectively. These data demonstrate the qualitative and quantitative improvements, as well as the increase in fertilizing potential, of the rise portion of the semen sample. PMID- 3558108 TI - Nitrocellulose and polyvinyl coatings prevent sperm adhesion to glass without affecting the motility of intact and demembranated human spermatozoa. AB - The effectiveness of several glass coating agents in preventing sperm adherence to glass surfaces for both intact and demembranated human spermatozoa was investigated. These agents included bovine serum albumin (BSA), Sigmacote, poly glu-lys, Collodion and Formvar. The presence of at least 5% of seminal plasma in sperm suspensions prevented sperm adhesion to glass surfaces. On the other hand, 56% of washed spermatozoa resuspended in an isoosmotic buffer containing 1 mg/ml of BSA attached to glass. Collodion, Formvar and Sigmacote reduced sperm attachment to glass to 2, 5 and 7%, respectively. BSA was partially effective, with 20% sperm adherence to glass, and poly glu-lys was totally ineffective. Whereas Sigmacote and BSA coatings lacked transparency, Collodion always achieved the best light transmission. Demembranated reactivated spermatozoa were all attached to glass within 90 seconds of contact. This adhesion was prevented by Collodion and Formvar. Other agents were less effective or interfered with motility. In contrast to intact spermatozoa, demembranated spermatozoa have a very low progressiveness ratio (vector speed/track speed), a wide beating amplitude and because of their whiplash flagellar movement, their motility resembles that of hamster capacitated spermatozoa. PMID- 3558109 TI - Cryosurvival of human spermatozoa frozen in eight different buffer systems. AB - The present study was conducted to ascertain optimal cryoconditions for human spermatozoa by comparing the relative cryoprotective efficiency of eight buffer systems and assessing various cryovials and thaw rates under two freeze rates. Spermatozoa that were cryopreserved in one of four zwitterion buffers (TES-Tris citrate-egg yolk-glycerol; TES-Tris-citrate-I) maintained higher progressive motility at 0, 1, 2, and 4 hours post-thaw as compared to cells frozen in glycerol only, citrate-egg yolk-glycerol and TES-Tris-citrate-egg yolk without glycerol (TES-Tris-citrate-III; P less than 0.01). Freezing in TES-Tris-citrate-I also resulted in spermatozoa that penetrated the furthest distance through cervical mucus and possessed the highest percent live spermatozoa when compared to other cryoprotective media. Spermatozoa were analyzed for their ability to penetrate zona-free hamster ova and no difference was found between buffers when the assay was corrected for progressive motility. After removal of seminal plasma/buffers and incubation for 2 hours in BWW, TES-Tris-citrate-II and TES Tris-citrate-milk showed the greatest sperm longevity (P less than 0.05). Pooled semen was extended in TES-Tris-citrate-I and frozen in straws or ampoules in static N2 vapor or in pellets on dry ice. Thaw bath temperatures ranged from 0 to 37 C. Post-thaw progressive motility and cervical mucus penetration were similar in all treatment groups. In conclusion, the present results indicate the use of TES-Tris-citrate-I for cryopreservation of human spermatozoa. With this optimal cryoprotective buffer, the containers and thaw rates used have little effect on human sperm cryosurvival. PMID- 3558110 TI - Correlation between in vitro fertilization and human sperm density and motility. AB - The conventional sperm characteristics of density (millions per milliliter) and motility, scored in a semi-subjective way, were correlated with results of an on going in vitro fertilization and embryo transfer program. No male infertility patients were included in this study. Individual characteristics of the "successful" ejaculates are described. Sperm densities in the original ejaculate of more than 10 X 10(6) spermatozoa/ml did not significantly improve outcome (P less than 0.01). In contrast, sperm motility seemed to play the most important role, since most pregnancies (12/14) occurred using sperm samples with greater than or equal to 60% total motility (P less than 0.001). The incidence of multipronuclear fertilization is also described and discussed. These data, which were collected during 1984 in the in vitro fertilization unit of Professor R. Schoysman and coworkers (Vilvoorde, Brussels), may help to make fertilization in vitro and embryo transfer a viable method in cases of mild male subfertility, and to provide guidance in preparing some couples for the combined use of husband and donor semen if a sufficient number of oocytes are obtained. PMID- 3558111 TI - Identification of novel erythromycin derivatives in mother liquor concentrates of Streptomyces erythraeus. AB - The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin derivatives are characterized by a 12 membered macrocyclic ring as a result of C13----C11 trans-lactonization. The five compounds have very little antimicrobial activity. PMID- 3558112 TI - Isolation of new anthracycline antibiotics, A447 C and D. PMID- 3558113 TI - Synthesis and structure-activity relationships of C-4-amino acid substituted monobactam analogs. PMID- 3558114 TI - Leucinostatin D, a novel peptide antibiotic from Paecilomyces marquandii. PMID- 3558115 TI - Aminothiazolylglycyl derivatives of carbacephems. I. Synthesis and antibacterial activity of novel carbacephems with substituted aminothiazolyl groups. AB - A series of new carbacephem compounds which have substituted aminothiazolylglycyl side chain have been prepared starting from corresponding carbacephems with aminothiazolylmethoxyimino group. Among them, the compound having 3,4 dihydroxybenzoyl group showed very sharp activity against Pseudomonas aeruginosa. Moreover, the optical resolution of alpha carbon of aminothiazolylglycyl moiety was carried out through preparation of optically active side chain and the (S) isomer (KT-4380) was found to be the most active against Pseudomonas sp. as well as other Gram-negative strains. PMID- 3558116 TI - Cefodizime, an aminothiazolylcephalosporin. V. Synthesis and structure-activity relationships in the cefodizime series. AB - The synthesis as well as in vitro antibacterial activity and pharmacokinetic behavior of cefodizime (HR 221, 1a), its analogs and derivatives is described. In this comparison, cefodizime stands out for its balance between its high antibacterial activity, prolonged elimination half-life and high AUC in mice and dogs. PMID- 3558117 TI - Synthesis and antimicrobial activity of cephalosporins with a 1-pyridinium substituent carrying a 5-membered heterocycle at the C-3 position. AB - A series of potent antimicrobial agents have been prepared. These derivatives are cephalosporins carrying a pyridine ring substituted with a heterocycle in the C-3 position. Some of them showed excellent activity not only against Gram-negative organisms including Pseudomonas aeruginosa but also against Gram-positive ones. In view of their biological and physico-chemical properties, 7 beta-[2-(2 aminothiazol-4-yl)-2-methoxyiminoacetamido]-3-[4-(2 or 5-oxazolyl)-1 pyridinium]methyl-3-cephem-4-carboxylate 8f (DQ-2522) and 8g (DQ-2556) were chosen as candidates for further evaluation. PMID- 3558118 TI - Biological effects of acetomycin. I. Activity against tumor cells in vitro and in vivo. AB - The antibiotic acetomycin was active in vitro against HCT-8 human colon adenocarcinoma cells (IC50, 1.5 microgram/ml) and L1210 murine leukemia cells (IC50, 2.2 micrograms/ml). Acetomycin also had marked activity in the human tumor stem cell assay, with a 33% overall response rate (less than or equal to 30% survival) against 49 primary tumors. However, acetomycin was inactive in four in vivo tumor assay systems (L1210 and P388 leukemias, B16 melanoma and the MX-1 mammary xenograft system). This lack of in vivo activity may result from metabolic inactivation of acetomycin. PMID- 3558119 TI - Biological effects of acetomycin. II. Inactivation by esterases in vitro. AB - Acetomycin has antitumor activity in vitro but not in vivo. HCT-8 human colon adenocarcinoma assays in the presence of a drug metabolizing system (rat liver S9 fraction) demonstrated that liver enzymes inactivated acetomycin. The structure of acetomycin suggested that an esterase could be the key inactivating enzyme. Assays with porcine liver esterase (EC 3.1.1.1) showed that this enzyme rapidly abolishes the activity of acetomycin against HCT-8 cells. The potential utility of acetomycin as an antitumor agent thus depends on finding a means of preventing esterase inactivation. PMID- 3558120 TI - 2''-N-formimidoylsporaricin A produced by Saccharopolyspora hirsuta subsp. kobensis. PMID- 3558121 TI - The utilization of molecular oxygen during the biosynthesis of maduramicin. PMID- 3558122 TI - Cytochemical localization of specific carbohydrates in the cochlea using wheat germ agglutinin-gold. AB - Localization of specific carbohydrates in the cochlea was examined by postembedding labelling by wheat germ agglutinin (WGA)-gold at the electron microscopic level. Gold labelling was observed in the tectorial membrane, basilar membrane, basal membrane of the capillary and other connective tissues. In these areas, the labelling was observed over either fibrous structures or the ground substance. WGA is known to bind specifically with N-acetylneuraminic acid, N acetyl-D-galactosamine, N-acetyl-D-glucosamine and its beta-(1-4)-linked oligosaccharides. The labelled sites, therefore, are considered to indicate the presence of glycoconjugates that contain these carbohydrates as their constituent. PMID- 3558123 TI - Incorporation of palmitic acid in the organ of Corti as revealed by autoradiography. AB - The sites of incorporation of [3H]palmitic acid perfused through the scala tympani of the guinea pig cochlea were localized autoradiographically. The most active incorporation occurred in the lipid globules of Hensen's cells, followed by the hair cells, myelin of the cochlear nerve and other cells. It is speculated that the lipid globules of Hensen's cells act as a reservoir of the vitamin A esterified by fatty acids. PMID- 3558124 TI - Ultrastructural and electrophysiological maturation of the chick tegmentum vasculosum. AB - We have examined the ultrastructural and electrophysiological events associated with the embryonic development of the tegmentum vasculosum, the ion-transporting epithelium in the chick cochlear duct. The cytodifferentiation of the light and dark cells in the epithelium from embryonic day 6 through post-hatching day 7 was studied with transmission electron microscopy. The predominant ultrastructural change in the developing tegmentum vasculosum was the elaboration of the complex basolateral infoldings on the dark cells from embryonic day 11 through post hatching day 7. The relationship between the development of the endocochlear transepithelial electrical potential difference (PD) and the cytodifferentiation of the tegmentum vasculosum was examined with in vitro studies. Microelectrode impalements of the scala media showed that the positive endocochlear PD was first detectable on embryonic day 20 but did not reach a mature value of +16 mV until post-hatching day 7. Maturation of the endocochlear PD paralleled the time during which the dark cells in the tegmentum vasculosum displayed the most extensive increase in basolateral infoldings. This correlation suggests that the development of the endocochlear PD may result from an increase in the number of Na+-K+ pump sites located on the basolateral infoldings of the dark cells. PMID- 3558125 TI - The distribution of hair cell bundle lengths and orientations suggests an unexpected pattern of hair cell stimulation in the chick cochlea. AB - A detailed analysis of the morphological polarity of the hair cell bundles on the chick cochlea was carried out. Although the pattern is identical from cochlea to cochlea, the morphological polarity of the bundles varies at different positions on the cochlea. More specifically, the hair cell bundles located immediately adjacent to the inferior and superior edges are oriented with their morphological polarity perpendicular to the margins. As we move across the cochlea (transect it), there is a gradual rotation in the polarity of the bundles so that in the center of the cochlea the hair cells are oriented at an angle to those at the edges. As we continue to the superior edge the polarity gradually rotates back again. The amount of rotation depends on the position of the transect such that at the extreme proximal end there is little rotation, while at the distal end the rotation is up to 90 degrees. The rotation is always in the same direction with the tallest rows of stereocilia nearest the distal end of the cochlea. Measurements of the length of the longest stereocilia in the hair cell bundles revealed that not only are the bundles systematically longer from the proximal to distal end of the cochlea, but also the hair cells on the superior edge are significantly longer than those on the inferior edge at the same distance from one end of the cochlea. If we draw on micrographs of the cochlea contour lines through hair cells whose stereocilia are the same height, these lines coincide with the morphological polarity of the hair cells included in these contours. Furthermore analysis of damage to the cochlea induced by pure tones of high intensity also roughly follows the same contour lines. We conclude that unlike what has been thought, the stimulation of hair cells by pure tones may not occur in a strictly transverse pattern, but instead may follow the oblique contours demonstrated here. PMID- 3558126 TI - Vulnerability of tip links between stereocilia to acoustic trauma in the guinea pig. AB - The cochleae of anaesthetized guinea pigs were prepared for scanning electron microscopy, immediately after exposure to an intense tone. Stereocilia on hair cells showing relatively small degrees of disruption were analyzed. If the bundles of stereocilia showed no or only a very slight degree of disorganization, the fine links emerging from the tips of the shorter stereocilia remained intact. If the stereocilia were separated more than a very little, the tip links between stereocilia were no longer visible. However, it was possible for tip links to remain intact in some parts of the hair bundle, while tip links in other, more disrupted parts, were lost. In outer hair cells, tip links did not seem any more vulnerable in one position than in another. In inner hair cells, it was commonly found that the tip links running between the tallest stereocilia and the next row of shorter stereocilia had broken, while the tip links running between the other shorter rows of stereocilia remained intact. The results suggest that tip links between stereocilia are preserved as long as the other links between the stereocilia and the cytoskeleton of the stereocilium remain intact. When the latter are damaged the tip links fracture. The results also suggest that, if the tip links are indeed involved in transduction, some degree of stimulus transduction can continue in damaged inner hair cells, albeit with a reduced sensitivity. PMID- 3558127 TI - Glycoconjugates of the tectorial membrane. AB - The type and quantity of carbohydrate present in the tectorial membrane (TM) was analysed using gas-liquid chromatography and lectin staining of TM protein subunits previously separated by electrophoresis. A relatively large amount of carbohydrate was found, and glucose, N-acetylglucosamine, N-acetylgalactosamine, galactose, mannose and N-acetylneuraminic acid were detected. The presence of mannose and the reaction of many of the protein bands with lectins suggest that at least part of the carbohydrate present is in the form of glycoprotein. The reaction of the main protein band with the lectins RCA1 and ConA is consistent with the suggestion [Thalmann et al. (1985) J. Acoust. Soc. Am. Suppl. 1, Vol. 78, S66] that this band is similar to collagen type II. The failure to detect any uronic acid in these experiments indicates that the more common proteoglycans are probably not a major component of the TM (although keratan sulphate might be present). PMID- 3558128 TI - A comparison of AP and ABR tuning curves in the guinea pig. AB - AP and ABR tuning curves were measured using a forward masking paradigm in guinea pigs with chronically implanted electrodes. Measurements were made before exposure to wide-band noise and at several intervals after exposure. The noise exposure was sufficient to produce temporary threshold shifts up to 60 dB lasting several days. Results showed similar reductions in Q10, tip-to-tail ratio and slope of simultaneously recorded AP and ABR tuning curves as a function of threshold shift following noise exposure. Tuning curves based on changes in response latency are presented as well as tuning curves based on changes in response amplitude. AP and ABR latency tuning curves showed similar form and changes with hearing loss as amplitude tuning curves. The similarities between AP and ABR tuning characteristics provide evidence that the ABR is sensitive enough to peripheral changes to be useful as a tool to study auditory frequency selectivity. The similarities between amplitude and latency tuning characteristics suggest that information regarding frequency selectivity of the auditory system can be obtained using response latency as well as response amplitude. PMID- 3558129 TI - Shift of tonotopic organization in brain stem auditory nuclei of the chicken during late embryonic development. AB - The tonotopic organization of nucleus magnocellularis and nucleus laminaris, second and third order nuclei in the avian auditory system, was mapped in 19-20 day old chick embryos (E19-20). The characteristic frequency recorded at any given location in each nucleus was intermediate between the frequencies observed previously at E17 and one day after hatching. This indicates that tonotopic organization changes during the embryonic as well as the postnatal development of hearing in birds. PMID- 3558130 TI - Functional properties and interactions of neuron pairs simultaneously recorded in the medial geniculate body of the cat. AB - Pairs of single units were recorded simultaneously from the same microelectrode in the medial geniculate body (MGB) of nitrous oxide anaesthetized cats. Crosscorrelation histograms of each spike train pairs were computed and distributed in five main classes, interpreted in terms of functional interaction between neighbouring neurons. Overall 40% of the 950 recorded pairs showed independent firing during spontaneous activity. Histogram shapes suggestive of simple functional connectivity were found in 38% of the pairs: common inputs (20%), excitatory (15%) and inhibitory (3%) synaptic links. Complex and 'borderline' histogram shapes made up the rest of the sample (22%). Subdivisions of the MGB had the same types and proportions of interaction classes. Several of these interactions showed, in statistical terms only, preferential associations with some other descriptive features of neuronal behaviour: pattern of spontaneous firing, sensitivity to acoustic stimuli, and to a lesser extent characteristic frequency, response latency, response pattern and width of the response range. Simultaneous recording of nearby neuron pairs allowed to test if a given functional property is spatially organized or randomly distributed in the MGB. Response latency, width of the response range behaved as if randomly distributed, whereas binaural interactions and characteristic frequency as if spatially organized. PMID- 3558131 TI - Electrical coupling differs in the in vitro and in vivo organ of Corti. AB - Electrical communication between the supporting cells of the guinea pig organ of Corti was studied. For in vitro experiments, the inner ear was rapidly removed and placed in a heated perfusion chamber. Medium 199 was used. The bony cochlea and the lateral wall (spiral ligament and stria vascularis) were removed to expose the top two coils of the organ of Corti. In vivo experiments were performed upon anesthetized animals whose cochleas were exposed surgically. A tiny fenestra was made in the bony cochlea which permitted the passage of electrodes through the lateral wall and into the organ of Corti of the third turn. Coupling was assessed by impaling neighboring cells with 3 M KCl electrodes, and noting the spread of intracellularly injected current. Coupling ratios in the in vitro preparation were consistently greater than those obtained in vivo (0.58 +/- 0.17 vs. 0.104 +/- 0.064). Differences exist between the in vitro and in vivo preparations which might account for these results. In vivo the supporting cells are bathed in two different media, endolymph apically, and perilymph basally. Consequently, on their apical side the supporting cells are exposed to fluid high in K+, low in Ca2+ and at a potential of 80 mV, the endolymphatic potential. In vitro the cells are bathed on all sides in fluid similar to perilymph. Intermixing the fluids in an in vivo preparation, by tearing away the stria vascularis and Reissner's membrane, increases the magnitude of the coupling ratio (0.455 +/- 0.209). Thus the unique microenvironment of the inner ear maintains lower coupling ratios, and smaller space constants for the supporting cells. PMID- 3558132 TI - Frequency and time domain comparison of low-frequency auditory fiber responses in two anuran amphibians. AB - A comparative study of the phase-locked response of auditory nerve fibers was performed in two frog species, Eleutherodactylus coqui and Bombina orientalis. From the tuning characteristics and phase response of single auditory nerve fibers to low frequency tones (0.08-1.0 kHz) we attempt to deduce the mechanics of the auditory organ responsible for low-frequency hearing in the frog, the amphibian papilla (a.p.). The phase-locked responses of auditory nerve fibers in B. orientalis were essentially identical to those from cells with similar CFs in E. coqui, despite the presence of a conspicuous caudal extension of the a.p. in E. coqui (an apparently derived morphology), a feature completely absent in B. orientalis. The fine structure of the frequency-dependent phase behavior was examined in both species with a residual phase analysis. The most significant non linear phase behavior was confined to neurons with CFs less than 0.3 kHz. The intensity dependence of the phase response in E. coqui revealed that the preferred firing phase of an auditory nerve fiber depends upon the relation of test frequency (TF) and CF of the neuron examined. For TFs greater than CF there was a progressive phase lag as stimulus level was increased; the inverse was true for TFs less than CF. Click latencies measured in E. coqui were inversely related to CF and were similar though systematically shorter than the response latencies estimated from the phase-frequency functions. The click response was similar to that documented in other species, showing a significant level dependence and the presence of multiple peaks, with the time between peaks related to the period of the neuron's CF. A 'neurogram' was compiled for a.p. fiber responses in both species in response to several pure tones. Based on the known tonotopy of the a.p. this measure reflects the phase response of the a.p. over the extent of its length. The population phase response in anurans is quite similar to that obtained from mammalian auditory nerve fibers for the same range of test frequencies (0.08-1.0 kHz). The similarity between the responses of auditory fibers in these two anuran species suggests the micromechanics of the a.p. rostral to the tectorial curtain is similar in both species and that it is the likely site for the origin of the CF-dependent time delays. PMID- 3558133 TI - Development of brainstem auditory evoked responses in the hamster. AB - The hamster is relatively immature at birth compared with other mammalian species. Because of the amount of maturation that occurs postnatally, the development of the peripheral auditory system of the hamster has generated a great deal of interest. However, indices of the developing functional capabilities of the central auditory system of the hamster are lacking. The following study investigated the ontogeny of brainstem auditory evoked responses (BAERs) to clicks in young hamsters. The general maturational trends noted for other species were found for the hamster. The major peaks of the BAER decrease in latency at the same time relative to birth and at the same rate in the hamster as in the cat and rat. Some maturational events such as the onset of a recordable BAER, appearance of the late peaks and increase in amplitude of the late peaks occur later, relative to birth, in the hamster than in the other species. Development delays in the hamster make it an attractive model for studying postnatal development of the central auditory system. PMID- 3558134 TI - Current source density analysis of frequency coding in the inferior colliculus. AB - Current source density (CSD) analysis is a technique that provides information about the time course and spatial location of transmembrane currents derived from a laminar collection of evoked potentials. Restrictive conditions for acquisition of evoked potentials are required in order to yield a one-dimensional CSD analysis that is an accurate estimate of synaptic activity. Satisfaction of these conditions was assumed in recordings of tone-burst-evoked potentials along the axis of symmetry (tonotopic) in the inferior colliculus of adult mongolian gerbils. Off-line these data were converted into distance/voltage functions. The second spatial derivatives of these functions gave a family of profiles of the spatial distribution of current source and sink densities at discrete latencies relative to the stimulus. Results indicate a frequency-dependent spatial shift in the evoked current sink of about 280 microns octave. This sink, indicative of local excitatory synaptic drive, is surrounded, both spatially and temporally, by current sources. The spatial extent of excitation as estimated from CSD analysis, compares well quantitatively with predictions from an across-neuron model that is based on single unit data. PMID- 3558135 TI - Hair cell damage produced by acoustic trauma in the chick cochlea. AB - Examination of pure-tone acoustic damage in the chick basilar papilla revealed that the location and extent of hair cell damage was a function of both the stimulus intensity and the age at which the chicks were exposed. Scanning electron microscopic evaluation of noise-exposed cochleae at post-hatching days 1, 10 and 30 permitted the identification of discrete regions of damage, including hair cells with stereocilia injuries as well as those lost from the epithelium. The hair cell damage was tonotopically distributed along the cochlea according to frequency. However, for each exposure frequency two distinct sites of damage were often produced, and their locations were correlated with stimulus intensity. At low intensities, a longitudinal strip of hair cell damage ran along the superior edge of the basilar papilla. As exposure intensity increased, a second damage site developed along the inferior edge of the basilar papilla, distal to the longitudinal strip. This second type of damage initially took the form of a series of laterally-oriented wedges, but at higher intensities, the wedges coalesced to form a large crescent-shaped patch of damage. The location of the damage sites for each frequency did not shift with age. However, there were differences in the extent and position of the damage which could be correlated with stimulus intensity and with changes in middle ear admittance during development [(1983) Development of Auditory and Vestibular Systems, pp. 3-25. Editor: R. Romand. Academic Press, New York]. These results suggest that developmental changes in the location and extent of hair cell damage depend on the effective stimulus intensity reaching the cochlea, rather than on alterations in the frequency coding of the hair cells. PMID- 3558136 TI - Neural temporal coding of low pitch. I. Human frequency-following responses to complex tones. AB - The neural basis of low pitch was investigated in the present study by recording a brainstem potential from the scalp of human subjects during presentation of complex tones which evoke a variable sensation of pitch. The potential recorded, the frequency-following response (FFR), reflects the temporal discharge activity of auditory neurons in the upper brainstem pathway. It was used as an index of neural periodicity in order to determine the extent to which the low pitch of complex tones is encoded in the temporal discharge activity of auditory brainstem neurons. A tone composed of harmonics of a common fundamental produces a sensation of pitch equal to that of the 'missing' fundamental. Such signals generate brainstem potentials which are spectrally similar to FFR recorded in response to sinusoidal signals equal in frequency to the missing fundamental. Both types of signals generate FFR which are periodic, with a frequency similar to the perceived pitch of the stimuli. It is shown that the FFR to the missing fundamental is not the result of a distortion product by recording FFR to a complex signal in the presence of low-frequency bandpass noise. Neither is the FFR the result of neural synchronization to the waveform envelope modulation pattern. This was determined by recording FFR to inharmonic and quasi-frequency modulated signals. It was also determined that the 'existence region' for FFR to the missing fundamental lies below 2 kHz and that the most favorable spectral region for FFR to complex tones is between 0.5 and 1.0 kHz. These results are consistent with the hypothesis that far-field-recorded FFR does reflect neural activity germane to the processing of low pitch and that such pitch-relevant activity is based on the temporal discharge patterns of neurons in the upper auditory brainstem pathway. PMID- 3558137 TI - Asymmetries in the acoustic reflexes of the cat stapedius muscle. AB - Electromyographic activity (EMG) was used to monitor contractions of the stapedius muscle evoked by both ipsilateral and contralateral sound in ketamine anesthetized or decerebrate cats. After the onset of a continuing tone, stapedius EMG often had bursts of activity at regular intervals; similar bursts were also observed in the EMG from the tensor tympani muscle. Plots of the r.m.s. amplitude of stapedius-EMG versus sound level usually had a steep rising phase (small dynamic range) and a plateau at high sound levels. For sound stimulation at 1 kHz, the crossed stapedius reflex had a lower maximum amplitude (ave. amplitude ratio: 0.37) and a higher threshold (ave. 8 dB) than the uncrossed reflex. Since the uncrossed reflex evokes considerably more stapedius EMG than does the crossed reflex, it probably produces correspondingly greater changes in middle-ear sound transmission. PMID- 3558138 TI - Auditory unit responses to single-pulse and twin-pulse microwave stimuli. AB - Responses of units in the cat cochlear nucleus to single microwave pulses with different durations and to twin microwave pulses with different interpulse delays are used to study microwave hearing. Inferred threshold specific absorption rate is less than 6 mW/g; inferred threshold specific absorption, less than 0.5 microJ/g. The existence of responses from units with characteristic frequencies (CFs) from 931 Hz to 25.5 kHz is not consistent with a primary role for head resonance in microwave hearing. Patterns of response amplitude have a periodicity of 1/CF and are fully explained by frequency content of the pulse stimulus and signal processing of the auditory system. For pulses shorter than about 0.24/CF, it is shown that response amplitude is predictably proportional to pulse energy. PMID- 3558139 TI - The maturation of the central auditory conduction in preterm infants until three months post term. I. Composite group averages of brainstem (ABR) and middle latency (MLR) auditory evoked responses. AB - Brainstem (ABR) and middle latency (MLR) auditory evoked responses were obtained sequentially in 49 preterm infants until three months post term date. In addition, the records of 16 preterm infants, obtained at different conceptional age levels, were included. The recording of these responses was performed successively in one procedure, together with auditory cortical evoked responses. The infants were divided into 5 groups according to their gestational age, i.e. the term at birth. Composite group averages were determined, showing the group stable components of the 5 gestational age groups at 8 different conceptional age levels, i.e. term at the time of the recording. The intra group stable components could thus be determined for further study of developmental trends in the responses. The group averages also serve as a reference in the visual analysis of the individual records. The averaged ABRs showed that with increasing conceptional age increasingly better identifiable waveforms were obtained. These were particularly outstanding for peaks I and V ipsilateral to stimulation, and peaks IIc and Vc contralateral to stimulation. This enabled the measurement of the central conduction times. The MLRs were especially remarkable for their latency changes which occurred in peak PO and the troughs Na and Nb. The results indicated that the conduction of the subcortical auditory afferent signals can be measured successfully in groups of very premature infants with ABRs and MLRs. PMID- 3558140 TI - Induced temporary threshold shift in guinea pigs. AB - The etiology of an incidentally discovered temporary threshold shift observed in an experimental animal (Harley guinea pig) is discussed with its potential implications for auditory research. PMID- 3558141 TI - The maturation of the central auditory conduction in preterm infants until three months post term. II. The auditory brainstem responses (ABRs). AB - Auditory evoked brainstem responses (ABRs) were recorded in 65 preterm infants (serially in 55 of them), divided into 5 groups, according to their gestational age (GA). The recording sessions were performed at 8 conceptional age levels (CA = GA + chronological age), of which the last two were about 40 and 52 weeks CA. The number of recording sessions varied from one to seven. A full set of ABR latency and amplitude parameters was analyzed including peaks I, II, IIN, III, V and IIc, IIINc and Vc as well as some interpeak latency differences (IPLDs), and the amplitude ratios. The detectability of the different components in the ABR tests at 70 dB reached 80-100% at about 32 weeks CA. The side of stimulation nor the state of vigilance influences the detectability. The degree of prematurity in the 5 GA groups did not influence the development of the parameters. Neither the side of stimulation nor generally the state of vigilance give rise to different parameter values. The thresholds show an age dependent decrease, which is also determined by central maturation. The differential development of the latency decrease of the ABR parameters with increasing conceptional age can be associated with morphological maturational processes and may add weight to the arguments in the delineation of the sources of the ABR. The ipsi- and contralateral central conduction V-II and Vc-IIc do not show latency differences at any CA level. The components IIc and Vc, however, lagged behind in absolute latency compared with II and V. It is concluded that the ABR is a powerful instrument for the study of the maturation of the human auditory pathway in the brainstem. In view of the variability, the detectability and the complex changes within the ABR during the preterm period, its application for clinical purposes during this period has a limited value. PMID- 3558142 TI - Carbon monoxide exposure potentiates high-frequency auditory threshold shifts induced by noise. AB - Hypoxia has long been hypothesized to play a role in noise-induced hearing loss, and the disruption of auditory function by asphyxiation has been repeatedly demonstrated. Recent data, however, suggest that the cochlea is resistant to less extreme hypoxic events. The current report describes the combined effects of noise and hypoxia on a measure of auditory function, in an effort to clarify the role of hypoxia in hearing loss. Exposure to 1200 parts per million of carbon monoxide in air for 90 min preceding and 120 min concurrent with exposure to a broad-band noise at 110 dBA produced high-frequency threshold shifts of greater magnitude than those produced by exposure to noise alone. An equivalent carbon monoxide exposure in a 'quiet' environment did not produce any change in auditory detection thresholds. The potentiation of noise-induced threshold shifts by carbon monoxide provides additional support for the hypothesized role of metabolic exhaustion or bloodflow impairment in noise-induced hearing loss. It also suggests a possible interpretation of clinical findings of auditory impairment associated with carbon monoxide exposure. PMID- 3558144 TI - Chronic ultrastructural changes in acoustic trauma: serial-section reconstruction of stereocilia and cuticular plates. AB - Two cochleas with permanent, noise-induced threshold shifts of 40 to 60 dB (as measured by responses of single, auditory-nerve fibers) were analyzed in detail, first at the light-microscopic level, and subsequently with transmission electron microscopy of serial sections. The light-microscopic analysis showed that there was little hair cell loss, but widespread damage to the stereocilia, especially those on the inner hair cells and first-row outer hair cells. Transmission electron microscopy revealed no pathology in any cells or organelles in the organ of Corti except for the stereocilia and their rootlets. Stereocilia tufts on first-row OHCs and IHCs were badly damaged; those on second- and third-row OHCs appeared ultrastructurally normal. Within the IHC tuft, the damage to the tall, outer row of stereocilia was often selective: the shorter rows could remain ultrastructurally normal even when the tall row was completely missing. The data suggested that most of the structures which appear normal in a careful light microscopic analysis are also normal at the ultrastructural level. This strengthens earlier suggestions that the correlations between light-microscopic stereocilia changes and alterations in single-unit physiology are causal in nature. The most common stereocilia pathologies were fracture, attenuation or complete loss of the stereociliary rootlets, especially in the region of the cuticular plate near the endolymphatic surface of the cell. The degree and extent of these changes were well correlated with the degree and extent of stereocilia disarray. Abnormalities of the actin-filament matrix within the stereocilia were extremely rare in unfused stereocilia, however, they were common when the stereocilia were part of a fusion bundle. Fusion of stereocilia was always associated with ectopic supracuticular cytoplasm. Based on the ultrastructural observations, different sequences of structural changes preceding the generation of disarray, loss or fusion of stereocilia are suggested. PMID- 3558143 TI - Acute ultrastructural changes in acoustic trauma: serial-section reconstruction of stereocilia and cuticular plates. AB - Single-unit recordings were made from populations of auditory-nerve fibers in 12 cats before and after acoustic overstimulation. Cats were killed 4 to 16 h after exposure, and the cochleas were analyzed at the light- and electron-microscopic levels. The exposures were designed to create 40 to 60 dB of acute threshold shift. Physiological changes were similar to those seen in cases of permanent threshold shift: tuning curves with elevation of 'tips' and 'tails' were associated with significant decreases in the mean spontaneous discharge rates; tuning curves with elevated tips but hypersensitive tails were associated with clear elevation of the mean spontaneous rates. At the light-microscopic level, none of the ears showed any significant stereociliary pathology. Some of the ears showed no light-microscopic pathology whatsoever, while others showed signs of swelling and vacuolization in both inner and outer hair cell areas in cochlear regions appropriate to the CF regions showing threshold shifts. The presence or absence of these light-microscopic changes was, to some extent, dependent on the nature of the exposure stimulus. At the electron-microscopic level, in addition to apparent swelling of radial afferent terminals, the inner hair cells themselves were swollen. In two cochlear regions (from two ears) which showed acute threshold shifts of 20 to 40 dB, but no light-microscopic changes, serial section ultrastructural analysis of stereocilia and cuticular plates was performed. In contrast to the situation in ears with permanent threshold shifts [(1986) Hear Res. 26, 65-88], there was no pathology in the intracuticular portion of the stereocilia rootlets. There were, however, significant changes in the lengths of the supracuticular portion of the rootlets. It is suggested that this attenuation of the supracuticular rootlet could decrease the stiffness of the stereocilia tufts and thereby change the tuning properties and sensitivity of the cochlear partition. PMID- 3558145 TI - Composition and yield of milk from beef-type Bos taurus and Bos indicus X Bos taurus dams. AB - Yield, butterfat, protein, lactose and solids-not-fat of milk from mature dams (n = 128) representing eight Bos taurus and Bos indicus X Bos taurus breed types were evaluated approximately 60, 105 and 150 d postpartum. Breed type was a significant source of variation in milk yield at each stage of lactation. Average 24-h milk yields (kg) were: Hereford, 7.3; Red Poll, 9.1; Hereford X Red Poll, 9.1; Red Poll X Hereford, 9.1; Angus X Hereford, 8.6; Angus X Charolais, 9.3; Brahman X Hereford, 7.3 and Brahman X Angus, 8.3. Daily yields of Brahman X Angus dams increased as lactation progressed, while production levels of other breed types remained approximately the same or declined. Hereford-Red Poll crosses showed significant heterosis in 24-h milk production and component yields at 150 d. Breed type effects also were significant for lactose yield throughout lactation. Sex of calf influenced (P less than .05) milk yield at 60 and 105 d postpartum and yield of protein and solids-not-fat at 105 d. Mastitis caused a reduction (P less than .01) in percentage of lactose but had no effect on milk yield. Residual correlations between yield traits and preweaning average daily gain were all positive and significant, with values ranging from .22 to .45. Breed type was a major source of variation in milk traits of beef-type Bos taurus and Bos indicus X Bos taurus dams. PMID- 3558146 TI - Genetic control of immune response to pseudorabies and atrophic rhinitis vaccines: I. Heterosis, general combining ability and relationship to growth and backfat. AB - Data from 988 pigs from 119 litters farrowed in two seasons of a three-breed diallel crossbreeding experiment were analyzed to estimate general combining abilities of breeds and heterosis for humoral immune response to pseudorabies virus and atrophic rhinitis vaccines. Twenty purebred boars and 85 sows of the Duroc, Landrace and Yorkshire breeds were mated to provide the nine breed-of-sire and breed-of-dam combinations. Immune response was measured after vaccination. A modified-live pseudorabies virus (PR) vaccine was administered to piglets at 28 d of age and response measured as log2 serum neutralization titers at 56 d. An inactivated B. bronchiseptica bacterin was administered at 28, 42 and 112 d. Antibody levels were measured relative to positive and negative controls at 28, 56 and 119 d by using an enzyme-linked immunosorbent assay. The results of this study showed that ranking by breed of sire and breed of dam did not differ for general combining ability, and no evidence of significant heterosis for any immune responses was observed. Higher immune response at 56 d to B. bronchiseptica vaccine was associated with lower weaning weight (r = -.09, P less than .01). Correlations of days to 100 kg with 56-d and 119-d B. bronchiseptica antibody levels were .15 (P less than .01) and .12 (P less than .01). The relationship between humoral immune response to PR vaccine and growth traits was similar to that observed for B. bronchiseptica vaccine. Immune response to both antigens was not associated with backfat thickness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558147 TI - Genetic control of immune response to pseudorabies and atrophic rhinitis vaccines: II. Comparison of additive direct and maternal genetic effects. AB - Data from 52 litters farrowed in two seasons of a cross-fostering experiment were analyzed to estimate variances and covariances for additive direct and maternal genetic effects on immune response to pseudorabies virus and B. bronchiseptica vaccine. Twenty purebred boars and 44 sows of the Duroc, Landrace and Yorkshire breeds were used. Immune response was measured after vaccine challenge. A modified-live pseudorabies (PR) vaccine was administered to piglets at 28 d of age; response was measured by log2 serum neutralization titers at 56 d. An inactivated B. bronchiseptica bacterin was administered at 28, 42 and 112 d. Antibody levels were measured relative to positive and negative controls at 28, 56 and 119 d by using an enzyme-linked immunosorbent assay (ELISA). Results from this study for heritability were .18 +/- .09 for PR titer and .15 +/- .07 and .52 +/- .15 for 56- and 119-d ELISA values, respectively. The variability due to nurse environment (maternal genetic variance and common environmental variance) as a percentage of phenotypic variance was 11.1% for PR titers and 29.6 and 8.8% for 56- and 119-d ELISA values, respectively. The heritabilities estimated in this study indicate that, if improved immune response to vaccines is desired, selection may be useful. However, the importance of maternal environment would make early selections less accurate than selections based on immune response measured later in life. PMID- 3558148 TI - Absorption, plasma flux and oxidation of L-leucine in heifers at two levels of intake. AB - Four Hereford X Angus heifers (379 +/- 11 kg) with indwelling hepatic portal vein, iliac artery and mesenteric vein catheters were used in a switchback design to measure net portal absorption of leucine at two levels of energy intake, 130 and 260 kcal metabolizable energy.(kg.75.d)-1. Nine hourly measurements were made through two consecutive 4-h feeding periods on each heifer at each intake level. In separate experiments, N balance was determined and 6-h continuous infusions of L-[1-14C]-leucine were used to measure total plasma flux and oxidation of leucine with two of these heifers, one at each level of intake, and one additional Hereford heifer at both levels of intake. Net portal absorption of leucine increased with increasing intake from 5.4 to 12.4 mmol/h, and was associated with average leucine flux and oxidation rates of 30.7 and 4.7 mmol/h at low intake and 49.9 and 8.8 mmol/h at high intake. Protein synthesis (flux - oxidation) and protein accretion (N balance X 6.25) averaged 1,367 and 39 g/d at low intake and 2,156 and 219 g/d at high intake, respectively. Percent contributions of absorption and oxidation to total leucine flux were 17.6 and 15.3 at low intake and were 24.9 and 17.6 at high intake, respectively. PMID- 3558150 TI - Influence of meal frequency on postprandial variations in the production and absorption of volatile fatty acids in the digestive tract of conscious pigs. AB - Five Large White pigs of 62.2 +/- 1.4 kg mean body weight were fitted with permanent catheters in the portal vein and carotid artery and with an electromagnetic flow probe around the portal vein to study the absorption of volatile fatty acids (VFA) by measuring the concentration of these metabolites in hourly blood samples, and by determining the portal blood flow rate for a period of 12 h after intake of a single 800-g meal (6% crude fiber) preceded by 12 or 24 h of fasting. The portal concentration of VFA mixture always highly exceeded the arterial concentration. The arterial concentrations of propionic, butyric, valeric and isovaleric acids were nearly null, accounting for an almost complete uptake of these VFA by the liver. Acetic acid also was taken up, but to a lesser extent. Total VFA absorption during 12 h was 64% higher (P less than .05) after 12 h (1,160 +/- 100 mmol/12 h) than after 24 h of preprandial fasting (740 +/- 83 mmol/12 h). It increased after the meal (P less than .05) from 82.3 +/- 7.8 mmol/h between the first and fourth hour to 107.8 +/- 7.5 mmol/h between the fifth and tenth hour when the preprandial fasting lasted 12 h; a nonsignificant increase also was found when fasting prior to the meal lasted 24 h. The composition of the VFA mixture was not modified by the length of preprandial fasting. With this type of diet there was a large predominance of acetic acid (52%) followed by propionic and butyric acids (36 and 8.5%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558149 TI - Stimulation of pig growth performance by porcine growth hormone: determination of the dose-response relationship. AB - The present study was undertaken to determine the relationship between dose of porcine growth hormone (pGH) and growth performance of pigs. Porcine GH was administered daily for 35 d [buffer-injected control = (C); 10 micrograms/kg body weight (BW) = (L); 30 micrograms/kg BW = (M); 70 micrograms/kg BW = (H)] to barrows (initial wt = 50 kg). Growth rate was significantly increased by pGH (14% for H dose vs C). Feed efficiency was increased in a dose-related manner (L = 7%, M = 10%, H = 17%) by pGH. There was a concurrent change in carcass composition of pGH-treated pigs. The H dose of pGH decreased the percentage of carcass lipid by 25% (P less than .05). Muscle mass was significantly increased in H vs C pigs (31 vs 26 kg). Serum insulin-like growth factor 1 (IGF-1) concentration increased in a manner that was linearly related to the pGH dose (r = .87). No antibodies to pGH were detected in any of the pigs. In summary, these results extend our earlier findings that pGH increases growth performance markedly. Based on the present findings it appears that the maximally effective dose of pGH is greater than 70 micrograms.kg BW-1.d-1 since several indices of the growth-promoting and metabolic effects of pGH (% carcass protein, % carcass lipid and feed efficiency) had not plateaued. PMID- 3558151 TI - Factors contributing to early embryonic mortality in gilts bred at first estrus. AB - Gilts bred at first (n = 18) and third (n = 18) estrus were assigned in replicates of equal numbers to be slaughtered on d 3, 15 and 30 post-mating to assess fertilization rate, embryonic losses and serum concentrations of estrogen (estradiol-17 beta + estrone) and progesterone. Mean number of ovulations was lower among gilts bred at first vs third estrus (12.2 vs 14.5; P less than .05), with no difference in fertilization rate (100 vs 98%). Embryonic survival was lower (P less than .05) among gilts bred at first vs third estrus on d 15 (78.1 vs 95.4%) and 30 (66.7 vs 89.4%) of gestation. Serum estrogen (pg/ml) and progesterone (ng/ml) levels, although lower in gilts bred at first vs third estrus, were not significantly different at the three stages of gestation studied. The ratio of progesterone to estrogen in gilts bred at first estrus was higher than in those bred at third estrus on d 15 (439 +/- 71 vs 210 +/- 17) and 30 (597 +/- 106 vs 179 +/- 50), but was lower on d 3 (187 +/- 37 vs 444 +/- 123; stage of gestation X estrous period interaction, P less than .05). These data suggest that changes in the ratio of systemic levels of estrogen and progesterone may be related to early embryonic mortality in gilts bred at pubertal estrus. PMID- 3558152 TI - Blood and serum components and organ weights in steers, bulls and zeranol implanted bulls. AB - To investigate certain physiological aspects of the mode of action of zeranol or Ralgro on growth, behavior and carcass quality of young bulls, concentrations of 19 blood components and weights of eight organs were determined. Experimental animals consisted of 36 untreated steers, 36 untreated bulls, 36 bulls implanted with zeranol at 3 mo of age and subsequently at 5, 8 and 10 mo and 36 bulls implanted with zeranol at 6 mo of age and subsequently at 9 and 11 mo. In addition, half of the animals in each group were subjected to moderate pre slaughter stress (mixing and trucking 160 km); the other half was subjected to minimum pre-slaughter stress (no mixing and 4 km transport). Concentrations of cortisol, urea nitrogen and albumin in serum were higher (P less than .01) and those of glutamic oxaloacetic transaminase (GOT), lactate dehydrogenase (LDH), alkaline phosphatase (AP) and creatinine were lower (P less than .05) in steers than in intact males. Concentrations of GOT, LDH, and creatinine were higher (P less than .05) in implanted than those in control males. Pre-slaughter stress had a significant effect on several traits measured in blood or serum. Thyroid glands were smaller (P less than .01) in steers than in control and implanted males. Testes were smaller (P less than .01) in the zeranol-implanted than in untreated males. Results indicate that zeranol had only a minor effect on the 19 blood components studied, but it did reduce testicle size. Castration had a major impact on several of the blood components. Pre-slaughter management had a significant effect on several blood components. PMID- 3558153 TI - Influences of season and artificial photoperiod on stallions: testicular size, seminal characteristics and sexual behavior. AB - To investigate the influence of daylength on the seasonal reproductive cycle of stallions, 21 stallions were assigned to one of three treatments: control, ambient (natural) photoperiod; S-L, 8 h light and 16 h dark (8:16) for 20 wk beginning July 16, 1982 then 16:8 from December 2, 1982 until March 5, 1984; S-S, 8:16 from July 16, 1982 until March 1984. Temperature was not controlled and was similar for all groups. Total scrotal width (TSW) was measured every 4 wk throughout the experiment. During 10 periods, semen was collected and evaluated every other day for 3 wk and sexual behavior was assessed. The S-L stallions exposed to 16 h light in December had twice as much sperm output in February than in November. Within the February collection period, the sperm output for S-L stallions was greater (P less than .05) than that for either control of S-S stallions. The stimulatory effect of the S-L photoperiod also resulted in larger (P less than .05) testes and decreased (P less than .05) time to ejaculation for S-L stallions in February as compared with either controls or S-S stallions. Despite continued exposure to a 16:8 photoperiod, TSW and sperm output for S-L stallions eventually declined; presumably a consequence of photorefractoriness. The S-S stallions had seasonal cycles coincident with those for control stallions. Based on a sine wave model for TSW and sperm output, stallions in all three groups displayed significant seasonal cycles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558154 TI - Effects of long-term thrice-daily milking on mammary enzyme activity, cell population and milk yield in the goat. AB - In two separate experiments, lactating goats were milked unilaterally thrice daily instead of twice daily for periods of 13 and 37 wk, starting at 2 to 5 wk after parturition. The other gland was milked twice daily throughout. In both experiments thrice-daily milking increased milk yield significantly. In the first experiment, after 37 wk the amounts of RNA and DNA, rate of cell proliferation and activities of several enzymes per cell were greater in the thrice-milked gland (P less than .05). In the second experiment, after 9 or 10 d of thrice daily milking the activities of several key mammary enzymes per cell measured in biopsy samples had increased in the thrice-milked but not the twice-milked gland. After 13 wk of thrice-daily milking, the DNA content of the glands and the activity per cell of the key enzymes was the same in both glands, showing that the synthetic capacity of the gland was being used more effectively in the treated gland. These results indicate that several mechanisms contributed to the increased milk yield induced by thrice-daily milking. PMID- 3558155 TI - Simultaneous measures of rates of ruminal digestion and passage of feeds for prediction of ruminal nitrogen and dry matter digestion in lactating dairy cows. AB - Three ruminal-cannulated Holstein cows in early lactation were fed three diets, each containing different energy and protein supplements in two consecutive 3 X 3 Latin squares. Each supplement contained a combination of three different feedstuffs (ground corn, soybean meal and wheat mids; corn gluten feed, rolled oats and distiller's dried grains; ground barley, brewer's grains and cottonseed meal). Diets consisted of 30% corn silage, 10% alfalfa hay, 10% alfalfa haylage, 17.7% ground corn plus minerals and vitamins, with the remainder as supplemental feedstuffs individually marked for measurement of ruminal turnover and in situ digestion rates. An extra period at the end of each Latin square was used to measure ruminal turnover and in situ digestion of individual forages. Diet had no effect on dry matter intake or milk yield. Mean fractional turnover (per hour) rate, measured by labeling feedstuffs with cerium, samarium or lanthanum was .044, .048, .049, .043, .047, .046, .050, .047, .049, .037, .046 and .045 for corn, soybean meal, wheat mids, corn gluten feed, oats, distiller's dried grains with solubles, barley, brewer's dried grains, cottonseed meal, alfalfa hay, corn silage and alfalfa haylage (P greater than .1), respectively. In situ-predicted ruminal degradation of N weighted for rate of passage was 61.4, 67.0, 81.5, 74.8, 86.3, 71.0, 75.7, 52.1, 54.2, 60.8, 71.7 and 70.9% for respective feedstuffs (P less than .05). In comparison with mean literature values for in vivo-measured N degradability, mean literature value = 1.172 (in situ predicted) -9.73 (P less than .05, R2 = .51). Results are interpreted to indicate a tendency for overestimating ruminal N degradability by in situ methods in feedstuffs of low degradability, while underestimating degradability in more highly degraded feedstuffs. Estimates were 11 to 17 percentage units lower than literature values for alfalfa hay and haylage and 17 units lower than literature values for distiller's dried grains. PMID- 3558156 TI - Efficacy of actaplanin fed on a twice-weekly basis to grazing stocker heifers. AB - Brahman (16), Brangus (32) and Simmental X Brahman (16) open heifers were assigned to four treatment levels and two body weight categories. The weight categories were light (250 kg) and heavy (306 kg). Treatment groups were 0, 600, 900 and 1,200 mg actaplanin.head-1.feeding-1 with feeding only on Monday and Friday. Heifers were group-fed .91 kg/head of supplement (95% soybean meal: 5% molasses) containing actaplanin. Heifers grazed eight Coastal bermudagrass pastures throughout the experiment (July 29 to November 15, 1982). After 75 d on experiment, an additional 1.36 kg of a commercial 14% crude protein supplement was fed on the days that actaplanin was not fed. All heifers were weighted and rotated among pastures at 14-d intervals (last weight period was 11 d) as an attempt to equalize forage availability among groups. Over the entire experiment (109 d), light-weight heifers that were fed actaplanin responded (P less than .01) with greater average daily gain (ADG; .37, .35, .21 kg/d; 600, 900, 1,200) compared with controls (0 mg; .18 kg/d). A trend in response (P less than .10) to actaplanin feeding occurred for heavy-weight heifers (.23, .38, .34 kg/d; 600, 900, 1,200 mg vs controls (.22 kg/d). For light-weight heifers, ADG decreased lineraly (P less than .01) as actaplanin increased from 600 to 1,200 mg, while ADG for heavy-weight heifers increased linearly (P less than .10).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558157 TI - Serum proteins as carriers of amino acids to and from the hindlimbs of fed and fasted calves. AB - Venoarterial differences in the amino acid composition of serum proteins were measured across the hindlimbs of growing Holstein steer calves (147 kg) surgically fitted with abdominal aorta and caudal vena cava cannulae. Steers were maintained in near steady-state metabolism by feeding at hourly intervals in a continuously lighted environment. The steady-state blood samples were obtained 10 d post-surgery; then the steers were fasted and resampled. Arterial and venous serum proteins were chromatographically separated into four fractions and the amino acid composition of each was determined. Under steady-state conditions, there appeared to be a tendency for serum protein amino acids to appear on the venous side of the tissue in either greater or lesser concentrations than on the arterial side, depending upon the protein fraction. However, after the steers had fasted for 72 h, virtually all amino acids from all protein fractions were present in greater concentrations in venous serum than in arterial serum. Furthermore, the quantitative differences were several-fold larger than during steady-state sampling. It appears that serum proteins may contribute to the transport of amino acids to and from peripheral tissues. Data further suggest that all serum proteins do not appear to function in the same manner, and physiological state influences this process. PMID- 3558158 TI - Composition of intermediate filament subunit proteins in embryonic, neonatal and postnatal porcine skeletal muscle. AB - The intermediate (10-nm) filament subunit proteins (desmin and vimentin) in samples obtained from embryonic, neonatal, and postnatal porcine skeletal muscle were examined by two-dimensional electrophoresis (isoelectric focusing/sodium dodecylsulfate polyacrylamide gel electrophoresis). The skeletal muscle samples were taken from pig embryos at 45, 73 and 102 d of gestation; from neonatal pigs and from postnatal pigs at 1, 6 and 30 mo of age. Three fractions (namely, whole homogenized muscle, purified myofibrils and myofibrillar-protein-extracted residues) were prepared from each skeletal muscle sample for analysis. Vimentin was the major (approximately 75% vimentin: 25% desmin) 10-nm filament protein present in skeletal muscle samples obtained from the 45-d-old pig embryos. The relative proportion of vimentin decreased progressively during embryogenesis. At birth, the vimentin comprised approximately 15%, and desmin, 85%, of the 10-nm filament protein. The proportional amount of vimentin continued to decline postnatally, with the 10-nm filament protein of samples from the 30-mo-old animals consisting of less than approximately 5% vimentin and over 95% desmin. These results show a developmental stage-dependent pattern in the expression of vimentin and desmin intermediate filament subunit proteins in mammalian skeletal muscle. In the adult mammal, desmin is the significant 10-nm filament protein present. PMID- 3558159 TI - Screening of a bovine genomic library for myosin heavy-chain genes. AB - Restriction enzyme digests of bovine genomic DNA were hybridized against a .37 kilobase (kb) quail embryonic myosin heavy-chain (MHC) copy deoxyribonucleic acid (cDNA) probe; containing both translated and nontranslated regions surrounding the 3' end of the gene. These experiments revealed seven to eight different bands of hybridization, indicative of multiple genes of MHC in the bovine genome. Additionally, a bovine genomic recombinant DNA library was screened with the .37 kb probe. Of the 10(6) phage screened, 11 clones containing portions of the MHC genome were identified, and four were selected for further analyses. Characterization of these four clones was carried out by constructing partial restriction enzyme maps of the inserts using six restriction enzymes singly or in combination. Orientation of the inserts with respect to the arms of the vector and with respect to direction of transcription was determined by hybridizing the DNA fragments against either the .37-kb Pst 1 fragment of pcC128 or to the .23-kb Pst I fragment of pcC128. The .23-kb fragment is located upstream from the .37-kg fragment and contains only coding sequence. Therefore, the differential hybridization pattern of these two probes provided a means for determining the probable direction of transcription. These data provide evidence for a myosin multigene family in cattle, as well as illustrating that the organization of these genes around the 3' end is unique for each of the genes analyzed. PMID- 3558160 TI - A statistically standardized muscle cell culture bioassay measuring the effect of swine serum on muscle cell proliferation. AB - We have developed a statistically standardized bioassay for quantifying the effect of swine serum on the proliferation rate of cultured L6 myogenic cells. The intra-assay coefficient of variation for this assay is 2.5%. Over 29 experiments, the relationship between the assays response to 2.5% control swine serum and its response to 2.5% serum plus 10(-7) M insulin is linear (r2 = .9). This relationship can be used to adjust experimental data obtained in different experiment to a common control value so that valid inter-assay comparisons can be made. The inter-assay coefficient of variation is reduced four- to five fold by this adjustment procedure. We believe this standardized assay provides a useful system for identifying and isolating unknown growth factors that affect muscle growth rate in an economically important species. PMID- 3558161 TI - Stimulation of in vitro muscle cell proliferation by sera from swine injected with porcine growth hormone. AB - The proliferation-promoting activity of sera obtained from pigs before and after porcine growth hormone injections was tested in a muscle cell culture bioassay. For 3 d, purified porcine growth hormone (pGH) was administered by intramuscular injection to crossbred barrows. Two levels of pGH were administered: 18 micrograms pGH X kg-1 body weight X d-1 (low dose) or 143 micrograms pGH X kg-1 body weight X d-1 (high dose). Multiple blood samples were withdrawn from jugular catheters for 3 d prior to the injection, during the injection period and for 6 d after the last injection. Although serum pGH levels in low-dose pigs were raised from two to three times pre-injection levels, there was no significant change in serum proliferation-promoting activity or somatomedin-C (SmC), insulin or cortisol levels during or after administration of pGH. In contrast, the proliferation-promoting activity of sera obtained during and after the high-dose pGH injections was higher (P less than .005) than the pre-injection levels. Serum pGH levels were increased approximately 30-fold by 4 h after each injection, and increases in SmC levels were observed 10 to 16 h after the pGH injection. During the injection period SmC levels increased from 1.7 to 4 times pre-injection levels. Insulin and cortisol levels did not change significantly during the 3-d treatment period. We believe that this muscle cell culture bioassay system will be a useful addition to traditional radioimmunoassays and whole animal studies in elucidating the mode of action of pGH in pituitary-intact swine. PMID- 3558162 TI - Nuclear transplantation in bovine embryos. AB - This study was conducted to develop a method for transplanting nuclei in bovine embryos and to test the development of several stages of donor nuclei transplanted to enucleated pronuclear recipient embryos. Pronuclear embryos were centrifuged to reveal nuclei. Nuclei were removed without penetrating the plasma membrane as membrane-bound karyoplasts, and were inserted into enucleated zygotes by electrically induced cell fusion. The highest rate of fusion (79%) occurred in Zimmerman Cell Fusion medium at 100 V for 20 to 40 microseconds with the fusion membranes oriented parallel to the electrodes. The effect of nuclear transplantation on development was tested in pronuclear embryos in which nuclei were removed and reinserted and the embryos were then transferred to sheep oviducts for 5 d. Of the intact nuclear transplant embryos recovered, 5/29 (17%) developed to morulae or blastocysts compared with 11/30 (37%) of the non manipulated embryos. Two nuclear transplant embryos were transferred to a recipient cow, and both developed to normal offspring. When nuclei from two-, four-, or eight-cell embryos were transplanted to pronuclear recipient embryos, no development was observed. PMID- 3558163 TI - Role of selective pressure by screening organisms in the development of producer mutant isolates of different antibiotic markers. AB - The phenotypes of producer mutant isolates when obtained after mutagenesis of the spontaneous degenerate Aspergillus versicolor N5 by screening on Trichophyton rubrum and those on A. niger G3Br were found to be markedly different. In respect of phenotypic character anti-T. rubrum producer mutant isolates resembled the parental type more closely (which is specifically active against T. rubrum and generally against dermatophytes) than anti-A. niger mutant isolates. This clearly indicates not only the role of selective pressure of the screening organism in the development of a given producer mutant isolate but also shows the possibility of recovery of a producer type of the lost antibiotic marker. PMID- 3558164 TI - Growth and enterotoxin A production by Staphylococcus aureus S6 in Manchego type cheese. AB - Milk (from cow, goat and sheep) was inoculated with Staphylococcus aureus strain S6, which is generally considered to be a strong enterotoxin B producer and a weak enterotoxin A producer. It was then used to make Manchego type cheese as prepared industrially. Two concentrations of starter culture (1% and 0.1%) were tested. Staphylococcal growth was good in both but better in the more dilute culture. Staphylococcal enterotoxin B was not detected at any stage of the ripening process of any cheese tested. However enterotoxin A was detected in both starter concentrations, reaching as high as 769 ng/100 g of cheese in the 0.1% starter batches. PMID- 3558165 TI - The prophylactic use of ticarcillin/clavulanate in the neonate. AB - A combination of ticarcillin and clavulanic acid (ratio 15:1) was given prophylactically to 24 newborn infants at risk of infection. Serum and urine concentrations of ticarcillin and clavulanic acid were measured after the first parenteral dose. Fifteen of 22 organisms isolated from the infants were sensitive to the drug. The pharmacokinetic profile was satisfactory and the combination was well tolerated. PMID- 3558166 TI - In-vitro activity of CI-934 against gram-positive aerobes and anaerobes. PMID- 3558168 TI - Nitrofurantoin induced chronic liver disease. PMID- 3558167 TI - Hydrolysis of chloramphenicol succinate in local treatment of soft tissue infections. PMID- 3558169 TI - An experimental model for therapeutic trials of anthelminthic drugs. AB - An experimental model of infection by Strongyloides ratti in the rat, which takes account of recent observations on the life cycle of the parasite, is described. The model is suitable for trial of anthelminthic drugs. PMID- 3558170 TI - Albendazole and thiabendazole in murine strongyloidiasis. AB - The activity of albendazole and thiabendazole, two derivatives of benzimidazole, were tested in an experimental model of Strongyloides ratti infestation in the rat. Two series of seven consecutive daily negative parasitic plate cultures, separated by four weeks of steroid therapy, confirmed cure of the infestation. Both drugs were inactive against larvae in the tissue phase, but completely effective in the intestinal phase. PMID- 3558171 TI - Antibiotic susceptibility of staphylococci from CAPD peritonitis in children. AB - Over a six year period to 1985, 64 episodes of bacterial peritonitis in children on CAPD yielded 59 Gram-positive and 15 Gram-negative isolates. The former included 27 strains of Staphylococcus epidermidis (45.8%) and 24 Staph. aureus (40.7%). Staph. epidermidis is now the commonest cause of infection in these patients and like Staph. aureus is spread by leaks and disconnections. It is also more resistant to antibiotics than Staph. aureus and this causes problems in the choice of antibiotics with failure to control peritonitis and subsequent complications such as diminished efficacy of therapy, peritoneal adhesions, recourse to haemodialysis and superinfection with fungi. Both species showed 100% sensitivity to vancomycin, rifampicin and netilmicin. Other sensitivity figures for Staph. epidermidis were methicillin 52%, benzylpenicillin 15%, cefamandole 52%, cefotaxime 52%, amoxycillin-clavulanic acid 52%, gentamicin 63%, co trimoxazole 48%, fusidic acid 59% and erythromycin 52%. Apart from benzylpenicillin (8%), Staph. aureus was much more sensitive, the figures being 96% for methicillin and 92-100% for the others. Our initial choice of 'best guess' therapy early in the series was cefamandole with the addition of gentamicin or tobramycin for Gram-negatives. This is now inappropriate, based on relatively poor clinical results and increasing resistance to antibiotics, and we would now use vancomycin as first choice, with netilmicin added to cover Gram negatives. PMID- 3558172 TI - Leukotrienes C4 and D4 do not increase filtration coefficient of excised perfused guinea pig lungs. AB - We tested the direct effects of leukotriene (LT) C4 or D4 on the pulmonary vascular fluid filtration coefficient (Kf) by adding these LT's to the cell depleted perfusate of excised guinea pig lungs. Pulmonary arterial (Ppa) and airway (Paw) pressures were monitored, and left atrial pressure was kept constant during 10 min of constant-flow perfusion. Kf's were then calculated by two methods [Drake and colleagues (KfD), Am. J. Physiol. 234 (Heart Circ. Physiol. 3): H266-H274, 1978; and Goldberg (KfG), Am. J. Physiol. 239 (Heart Circ. Physiol. 8): H189-H198, 1980] from the change in lung weight resulting from a no flow zone 3 hydrostatic stress applied for 20 min. With no LT's (Tyrode's buffer alone), the mean +/- SE Paw was 9.0 +/- 0.7 cmH2O and the Ppa was 14.2 +/- 1.1 cmH2O throughout the 10-min perfusion. The KfD and KfG were 1.239 +/- 0.169 and 1.586 +/- 0.223 ml X min-1 X mmHg-1 X 100 g lung-1, respectively. The mean +/- SE lung wet-to-dry ratio (W/D) after the 20-min hydrostatic stress was 16.7 +/- 1.6. Within 30-45 s of adding 4 micrograms of LTC4 or LTD4, Paw and Ppa both increased and remained elevated throughout the perfusion period. The KfD and KfG were 1.586 +/- 0.223 and 2.071 +/- 0.234 ml X min-1 X mmHg-1 X 100 g lung-1, respectively, and the W/D was 18.1 +/- 1.7 after LTC4 (all P greater than 0.4 compared with Tyrode's buffer alone) and 1.417 +/- 0.200 and 1.851 +/- 0.244 ml X min-1 X mmHg 1 X 100 g lung-1, respectively, with a W/D of 20.5 +/- 1.3 after LTD4 (all P greater than 0.4 compared with Tyrode's buffer alone).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558173 TI - Thymidine kinase, thymidylate synthase, and endothelial cell growth under hyperoxia. AB - To determine the respective role of thymidine kinase and thymidylate synthase activities in the hyperoxia-induced decrease in DNA synthesis and their relationship with cell replication, we measured these two enzyme activities in primary cultures of porcine aortic endothelial cells under different O2 concentrations for various durations. In confluent cells, exposure to 95% O2 for 5 days reduced thymidine kinase activity to 15% of control values; thymidylate synthase activity was unaffected. In preconfluent cells exposed to 95% O2 for 2 days, similar results were obtained, together with evidence for arrest in cell proliferation. Thymidylate synthase activity could therefore not be related to decreased cell proliferation under hyperoxia. [3H]thymidine incorporation into DNA, thymidine kinase activity, and cell proliferation were all similarly affected under exposure to graded O2 concentration for 2 days. Thymidine kinase appears to be a key enzyme in the modulation of DNA synthesis from thymidine and in its replication in endothelial cells. PMID- 3558175 TI - Effect of ozone on breathing in dogs: vagal and nonvagal mechanisms. AB - We exposed two awake dogs with a chronic tracheostomy and the cervical vagus nerves exteriorized in skin loops to 1.0 ppm of ozone (O3) for 2 h at intervals of 4 wk. We measured ventilatory variables before and after O3 exposure during rest and exercise before and after vagal block. We compared the effects of vagal blockade, exercise, and O3 on the primary determinants of breathing pattern (VT/TI, VT/TE, TI, and TE) in each of three conditions: base line (steady state), during hypercapnia, and after inhalation of 1% histamine. Under base-line conditions, O3 increased respiratory rate and decreased tidal volume (VT) by shortening time of expiration (TE) and time of inspiration (TI) without affecting VT/TI, an indicator of the neural drive to breathing. During progressive hypercapnia, O3 shortened TE and TI by effects both on tonic (nonvolume-related) and on phasic (volume-related) vagal inputs, and only the latter were prevented completely by cooling of the vagus nerves. Histamine-induced tachypnea was increased by O3 and was totally blocked by cooling the vagus nerves. We conclude that O3 shortens the timing of respiration without increasing ventilatory drive, shortens TI and TE through vagal and nonvagal pathways, increases tonic nonvagal and phasic vagal inputs, and stimulates more than one vagal fiber type. PMID- 3558174 TI - Caudal ventrolateral medullary cells responsive to muscular contraction. AB - The pressor reflex evoked by muscular contraction (exercise pressor reflex) is held to be an important mechanism in producing the cardiovascular adjustments to static exercise. Recent experiments using lesioning and metabolic labeling methods have indicated that the caudal ventrolateral medulla may be a key integrative site for the reflex evoked by muscular contraction induced by ventral root stimulation. Therefore, we sought to determine whether cells in this region could be associated with the cardiovascular reflex accompanying muscular contraction through analysis of their discharge characteristics. Eighty cells were characterized as to their response to ventral root stimulus-induced static muscular contraction, intra-arterial capsaicin (selective groups III and IV stimulus), and mechanical probing. The cells' receptive fields were also determined by mechanical probing. The receptive fields were usually large, often including all four limbs and the trunk. Four response patterns were observed to static contractions: a brisk initial discharge followed by a gradual return toward control levels (slowly adapting), a brief onset and cessation response, a brief inhibition followed by a slowly adapting discharge, and inhibition alone. Virtually all cells tested were responsive to capsaicin. Histological analysis verified the position of the recorded cells. It is suggested that the cells most likely to participate in the pressor response to muscular contraction were those cells in the general region of the lateral reticular nucleus which responded with an initial and sustained discharge and the cells that were inhibited in the region of the nucleus ambiguus (possible inhibition of vagal outflow). PMID- 3558176 TI - Distortion of chest wall and work of diaphragm in preterm infants. AB - Chest wall distortion is common in infants and is especially visible in preterm infants. It has been suggested that this distortion increases the volume displacement of the diaphragm during inspiration, which may be associated with muscular fatigue and apnea. We studied 10 preterm infants who had no evidence of lung disease, investigating the effect of chest wall distortion on the volume displacement and work of the diaphragm. The volume changes of the respiratory system were partitioned using an inductance plethysmograph. The minute volume displacement and the work of the diaphragm were calculated using the partitioned abdominal volume change and the gastric and esophageal pressures. The paradoxical movement of the chest wall lasted an average of 36% of inspiration. The minute volume displacement of the diaphragm ranged from 72 to 176% of the minute pulmonary ventilation, and diaphragmatic work ranged from 94 to 793% of that performed on the lungs. The amount of chest wall distortion, as reflected by the duration of the paradoxical chest wall movement, the minute volume excursion, or work of the diaphragm, was not related to the mechanical properties of the lungs. This estimated work load may represent a significant expenditure of calories in these infants and may contribute to the development of diaphragmatic fatigue, apnea, and a prolonged need for mechanical ventilation. PMID- 3558177 TI - Dynamics of chest wall in preterm infants. AB - The chest wall of the preterm infant has visible paradoxical movement during breathing, because of its greater flexibility than those of older children and adults. We studied the dynamics of the chest wall in 10 preterm infants to describe the interaction of the chest wall volume, as partitioned by the inductance plethysmograph, and the transthoracic and abdominal pressures. There was considerable hysteresis between the chest wall volume and the transthoracic pressure, and it had linear pressure-volume behavior during airway occlusion, late inspiration, and early expiration. The slope of this pressure-volume relationship, or the instantaneous chest wall compliance, averaged 0.89 +/- 0.16 and 0.94 +/- 0.18 ml/cmH2O for the respiratory effort during airway occlusion and early expiration, respectively. The dynamic compliance was considerably greater, averaging 7.8 +/- 2.3 ml/cmH2O. This resistive pressure-volume behavior was not related to the absolute value of or the rate of development of the esophageal or abdominal pressures. This additional degree of freedom of motion of the chest wall suggests that its linkage to the diaphragm is flexible, which provides a braking force for expiration and allows free movement of the diaphragm for breathing movements before birth. PMID- 3558178 TI - Shape and size of the human diaphragm in vivo. AB - Serial computerized tomograph (CT) sections at 5-mm intervals of a human diaphragm in relaxed and contracted states were obtained in one subject while he held his breath and lay supine in a CT scanner. All sections for one state were scanned at the same chest wall configuration as monitored by rib cage and abdominal dimensions, using magnetometers. Sections were scanned at relaxed functional residual capacity and after inspiring approximately 1 liter in such a way that rib cage dimensions increased only slightly. Models of the diaphragm dome in the two states were constructed from the sets of serial sections. Diaphragm length and volume displaced were measured, the zone of apposition of diaphragm to rib cage was mapped, and the line of the diaphragm silhouette in anteroposterior and lateral X-rays identified. Coronal and sagittal sections were constructed. In the inspiration studied, the diaphragm movement displaced 680 ml. Meridian lines in sagittal, coronal, and transverse directions over the right hemidiaphragm dome shortened by 6.7-7.2 cm, but over the left dome by only 4.0 4.3 cm. Lines of X-ray silhouettes were close to meridian lines, and estimates of shortening were similar to those made previously from X-rays. The peculiar saddle shape of the muscle may help the hemidiaphragms to operate independently, the fibers of the saddle acting as an anchor for midline directed fibers of the hemidiaphragm domes. The shape of the diaphragm also has implications for the distribution of transdiaphragmatic pressure and for the kind of distortion of the lower rib cage margin that is seen during inspirations at high lung volume. PMID- 3558179 TI - Voluntary hyperventilation changes recruitment order of parasternal intercostal motor units. AB - The order of recruitment of single-motor units in parasternal intercostal muscles during inspiration was studied in normal human subjects during quiet breathing and voluntary hyperventilation. Electromyograms were recorded from the second and third intercostal spaces by means of bipolar fine wire electrodes. Flow at the mouth, volume, end-expired CO2, and rib cage and abdominal anterior-posterior diameters were monitored. Single-motor units were identified using criteria of amplitude and shape, and the time of first appearance of each unit in each inspiration was noted. Hyperventilation was performed with visual feedback of the display of rib cage and abdomen excursions, keeping the ratio of rib cage to abdominal expansion. Subjects were normocapnic in quiet breathing and developed hypocapnia during hyperventilation. Recruitment order was stable in quiet breathing, but in some cases was altered during voluntary hyperventilation. Some low threshold units that fired early in the breath in quiet breathing fired earlier at the beginning of a period of voluntary hyperventilation but progressively later in the breath as hyperventilation went on, whereas later firing units moved progressively toward the early part of inspiration. This suggests that different groups of motoneurons in the pool supplying parasternal intercostal muscles receive different patterns of synaptic input. PMID- 3558180 TI - Sweat lactate secretion during exercise in relation to women's aerobic capacity. AB - The purpose of this investigation was to determine whether sweat lactate secretion during exercise [approximately 70% maximum O2 consumption (VO2max), 60 min] differed in active vs. sedentary female subjects. Sweat rate, total sweat lactate secretion, and sweat lactate concentration were monitored in a group of sedentary (VO2max = 41.0 +/- 1.62 ml X kg-1 X min-1) and active (VO2max = 51.2 +/ 3.20 ml X kg-1 X min-1) women. Sweat rate was significantly (P less than 0.05) greater in the active subjects. There was a significant difference between groups in total amount of sweat lactate secreted (P less than 0.05), with the active group secreting less lactate (29.8 +/- 5.03 mmol, mean +/- SE) than the sedentary group (50.2 +/- 6.61 mmol). Concomitant with the lower total sweat lactate secretion in the active subjects was a significantly (P less than 0.05) more dilute sweat lactate concentration (42.6 +/- 14.08 vs. 100.4 +/- 32.37 mM). In these female subjects, sweat lactate concentration was inversely correlated (r = 0.79, P less than 0.01, n = 10) to sweat rate. It is concluded that total sweat lactate loss is significantly less in active than in sedentary women and that the active subjects secrete a greater quantity of lactate dilute sweat. PMID- 3558181 TI - Effect of endurance training on possible determinants of VO2 during heavy exercise. AB - When moderate exercise begins, O2 uptake (VO2) reaches a steady state within 3 min. However, with heavy exercise, VO2 continues to rise beyond 3 min (VO2 drift). We sought to identify factors contributing to VO2 drift. Ten young subjects performed cycle ergometer tests of 15 min duration for each of four constant work rates, corresponding to 90% of the anaerobic threshold (AT) and 25, 50, and 75% of the difference between maximum VO2 (VO2 max) and AT for that subject. Time courses of VO2, minute ventilation (VE), and rectal temperature were recorded. Blood lactate, norepinephrine, and epinephrine were measured at the end of exercise. Eight weeks of cycle ergometer endurance training improved average VO2 max by 15%. Subjects then performed four tests identical to pretraining studies. For the above AT tests, training reduced VO2 drift substantially; reduction in each of the possible mediators we measured was also demonstrated. The training-induced decrease in VO2 drift was well correlated with decreases in end exercise lactate and less well correlated with the drift in VE seen at above AT work rates. The training-induced reduction in VO2 drift was not significantly correlated with attenuation of rectal temperature rise or decrease in end-exercise level of the catecholamines. Thus the slow rise in VO2 during heavy exercise seems linked to lactate, though a component dictated by the work of breathing cannot be ruled out. PMID- 3558182 TI - Acute effects of thoracic irradiation on lung function and structure in awake sheep. AB - To investigate the acute physiological and structural changes after lung irradiation, the effects of whole-lung irradiation were investigated in fourteen sheep. Ten sheep were prepared with vascular and chronic lung lymph catheters, then a week later were given 1,500 rad whole-lung radiation and monitored for 2 days. Four sheep were given the same dose of radiation and were killed 4 h later for structural studies. Lung lymph flow increased at 3 h after radiation (14.6 +/ 2.1 ml/h) to twice the base-line flow rate (7.5 +/- 1.3), with a high lymph-to plasma protein concentration. Pulmonary arterial pressure increased twofold from base line (18 +/- 1.6 cmH2O) at 2 h after radiation (33 +/- 3.8). Cardiac output and systemic pressure in the aorta did not change after lung radiation. Arterial O2 tension decreased from 85 +/- 3 to 59 +/- 4 Torr at 1 day after radiation. Lymphocyte counts in both blood and lung lymph decreased to a nadir by 4 h and remained low. Thromboxane B2 concentration in lung lymph increased from base line (0.07 +/- 0.03 ng/ml) to peak at 3 h after radiation (8.2 +/- 3.7 ng/ml). The structural studies showed numerous damaged lymphocytes in the peripheral lung and bronchial associated lymphoid tissue. Quantitative analysis of the number of granulocytes in peripheral lung showed no significant change (base line 6.2 +/- 0.8 granulocytes/100 alveoli, 4 h = 10.3 +/- 2.3). The most striking change involved lung airways. The epithelial lining of the majority of airways from intrapulmonary bronchus to respiratory bronchiolus revealed damage with the appearance of intracellular and intercellular cell fragments and granules. This new large animal model of acute radiation lung injury can be used to monitor physiological, biochemical, and morphological changes after lung radiation. It is relevant to the investigation of diffuse oxidant lung injury as well as to radiobiology per se. PMID- 3558183 TI - Heterogeneity of mean alveolar pressure during high-frequency oscillations. AB - Mean alveolar pressure may exceed mean airway pressure during high-frequency oscillations (HFO). To assess the magnitude of this effect and its regional heterogeneity, we studied six excised dog lungs during HFO [frequency (f) 2-32 Hz; tidal volume (VT) 5-80 ml] at transpulmonary pressures (PL) of 6, 10, and 25 cmH2O. We measured mean pressure at the airway opening (Pao), trachea (Ptr), and four alveolar locations (PA) using alveolar capsules. Pao was measured at the oscillator pump, wherein the peak dynamic head was less than 0.2 cmH2O. Since the dynamic head was negligible here, and since these were excised lungs, Pao thus represented true applied transpulmonary pressure. Ptr increasingly underestimated Pao as f and VT increased, with Pao - Ptr approaching 8 cmH2O. PA (averaged over all locations) and Pao were nearly equal at all PL's, f's, and VT's, except at PL of 6, f 32 Hz, and VT 80 ml, where (PA - Pao) was 3 cmH2O. Remarkably, mean pressure in the base exceeded that in the apex increasingly as f and VT increased, the difference approaching 3 cmH2O at high f and VT. We conclude that, although global alveolar overdistension assessed by PA - Pao is small during HFO under these conditions, larger regional heterogeneity in PA's exists that may be a consequence of airway branching angle asymmetry and/or regional flow distribution. PMID- 3558184 TI - Anatomy of diaphragmatic circulation. AB - The diaphragmatic circulation was studied in 48 mongrel dogs weighing 10-35 kg by injecting acrylic coloring into the arteries and veins of the diaphragm. The phrenic arteries and internal mammary arteries were found to anastomose head to head, forming an internal arterial circle around the medial leaflet of the diaphragm tendon. This arterial circle emitted vascular branches that traveled between muscle fibers toward the periphery of the diaphragm. These branches anastomosed with vessels of the intercostal arteries to form costophrenic arcades all along the fibers of the crural and costal diaphragms. The intercostal arteries were anastomosed to one another by small vessels within the muscular diaphragm, thus forming an arterial ring around the insertions of the diaphragm on the ribs. The venous drainage has an anatomic distribution similar to that observed on the arterial side, but with the additional presence of valves that could play a role in directing blood flow. PMID- 3558185 TI - Role of diaphragmatic activity during singing: a study of transdiaphragmatic pressures. AB - Esophageal and gastric pressures during singing are measured in four male professional singers performing singing tasks requiring rapid changes of subglottal pressure. Evidence for a consistent use of the diaphragm is found in all subjects. Some subjects punctually activate the diaphragm when there is a need for a rapid decrease of subglottal pressure, such as when singing a falling octave interval, when shifting from a loud to a soft note, to save air during a /p/ explosion, and in performing a trillo involving a repeated switching between glottal adduction and abduction. The first three cases were observed in the beginning of the phrase, presumably over the period that the pressure generated by the passive expiratory recoil forces of the breathing system was higher than the intended subglottal pressure. In addition to this, one subject exhibited a diaphragmatic tonus throughout the entire phrase. The phonatory relevance of a diaphragmatic activity was evaluated in a subsequent experiment. The transdiaphragmatic pressure was displayed on an oscilloscope screen as a visual feedback signal for singers and nonsingers, who performed various phonatory tasks with and without voluntary coactivation of the diaphragm. In most subjects this activity tended to increase the glottal closed/open ratio as well as the amplitude of the glottogram (i.e., the transglottal volume velocity wave-form as determined by inverse filtering). These changes suggest that diaphragmatic coactivation tends to affect phonation. Also, it tended to reduce the formant frequency variability under conditions of changing fundamental frequency suggesting a better stabilization of the vocal tract. PMID- 3558187 TI - Echocardiographic evaluation of space shuttle crewmembers. AB - Echocardiographic measurements were obtained before and after space flight from 17 members of four shuttle crews. Measurements obtained 1 h after landing (L+0) compared with preflight values (n = 7) demonstrated an increase in heart rate (HR) (16 beats/min, 30.5%, P less than 0.05), mean arterial pressure (12%, P less than 0.05), and systemic vascular resistance (34%, P less than 0.05). End diastolic volume index (EDVI) fell 17 ml/m2 (-23%, P less than 0.005) and stroke volume index (SVI) fell 15 ml/m2 (-28%, P less than 0.05). Repeat measurements taken 1-2 wk later (n = 17) demonstrated that HR had returned to normal (4 beats/min, P less than 0.05); however, EDVI remained significantly below preflight levels (-11%, P less than 0.005). End-systolic volume index (ESVI) was also still significantly lower (-23%, P less than 0.01). This delayed recovery occurred despite ability of the subjects to fully ambulate and exercise during the postflight period. These results indicate that spaceflight induces significant changes in heart volume affecting left ventricular function. The exact reasons for these specific changes remain unknown and will require additional measurements before, during, and after flight. The prolonged recovery period for the present subject group probably relates to their high level of aerobic conditioning. PMID- 3558186 TI - Effect of granulocyte depletion in a ventilated surfactant-depleted lung. AB - In a previous paper Cutz, Bryan et al. showed that in rabbits after repetitive lung lavage high-frequency oscillatory ventilation maintained excellent gas exchange and did not cause hyaline membrane formation (J. Appl. Physiol. 55: 131 138, 1983). In contrast, conventional mechanical ventilation had poor gas exchange and extensive hyaline membrane formation and we attributed these differences to mechanical barotrauma. However, we completely overlooked the large number of granulocytes in the damaged lung. To investigate this using the same model we have used mechanical ventilation on two groups of rabbits, one with normal granulocytes, the other depleted of granulocytes by pretreatment with nitrogen mustard. The nondepleted rabbits had poor gas exchange, a substantial protein leak into the lung and extensive hyaline membranes. The depleted animals had good gas exchange, a very small protein leak and no hyaline membranes. Repletion of granulocytes from donor rabbits lead to poor gas exchange and hyaline membrane formation. It is concluded that lung lavage causes prompt margination of granulocytes which become activated by the ongoing epithelial barotrauma of conventional ventilation. PMID- 3558188 TI - Relationship of changes in diaphragmatic muscle blood flow to muscle contractile activity. AB - The effect of increases in diaphragmatic muscle contractile activity on diaphragm blood flow remains unclear. The present study examined the effect of electrically induced isometric diaphragmatic muscle contractions on diaphragmatic blood flow. Studies were performed on diaphragmatic muscle strips prepared in anesthetized mechanically ventilated dogs. Diaphragmatic contractile activity was quantitated as the tension-time index (TTI) (i.e., the product of tension magnitude and duration). Blood flow to the strip (Qdi) was measured from the volume of the phrenic venous effluent using a drop counter. The separate effects on Qdi of 30-s periods of continuous and rhythmic contractions were examined. Qdi increased with increases in TTI and peaked at a TTI of 20-30% of maximum after which Qdi fell progressively with further increases in TTI. At levels of TTI greater than 30%, the pattern of muscle contraction significantly affected blood flow. Qdi was significantly lower during activity and the postcontraction hyperemia significantly greater at a given TTI when contractions were continuous than when contractions were intermittent. Above a TTI of 30%, Qdi during contraction decreased linearly with increases in duty cycle and curvilinearly with increases in tension. We conclude that during isometric diaphragmatic contractions, diaphragmatic blood flow may become mechanically impeded, and the magnitude of the impediment in blood flow depends on the pattern of diaphragmatic contractions. With increases in contractile activity above a critical level, changes in duty cycle exert progressively greater effects on diaphragmatic blood flow than changes in muscle tension. PMID- 3558189 TI - Effect of inspiratory muscle fatigue on perception of effort during loaded breathing. AB - The present study examined the relationship between the intensity of the sense of effort during inspiratory threshold loading and the severity of inspiratory muscle fatigue. Studies were performed on normal subjects in whom the magnitude of airway pressure developed (Pm) and the duty cycle of breathing (TI/TT) were constrained to achieve a pressure-time integral (i.e., Pm/Pmax X TI/TT) 24% of maximum. In separate trials, the same pressure-time index (24%) was achieved using two widely different patterns of pressure magnitude and duty cycle to allow the effects of changes in the pattern of inspiratory muscle contraction on sensation and fatigue to be assessed. The intensity of the sense of effort was assessed using a category (Borg) scale. The severity of inspiratory muscle fatigue was assessed both from changes in the centroid frequency of the diaphragm electromyogram and from changes in the maximum static inspiratory pressure. Loaded breathing produced inspiratory muscle fatigue and a progressive increase in the sense of effort over time in all subjects. The rate at which the inspiratory muscles fatigued was the same with the two patterns of loading. In contrast, the rate of growth in the intensity of the sense of effort varied significantly as a function of the pattern of loaded breathing. The sense of effort increased at a faster rate with the high pressure-short duty cycle pattern of contraction as compared with the low pressure-long duty cycle pattern. As a result, the intensity of the sense of effort was not uniquely related to the severity of inspiratory muscle fatigue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558190 TI - Validation of esophageal balloon technique at different lung volumes and postures. AB - The esophageal balloon technique for measuring pleural surface pressure (Ppl) has recently been shown to be valid in recumbent positions. Questions remain regarding its validity at lung volumes higher and lower than normally observed in upright and horizontal postures, respectively. We therefore evaluated it further in 10 normal subjects, seated and supine, by measuring the ratio of esophageal to mouth pressure changes (delta Pes/delta Pm) during Mueller, Valsalva, and occlusion test maneuvers at FRC, 20, 40, 60, and 80% VC with the balloon placed 5, 10, and 15 cm above the cardia. In general, delta Pes/delta Pm was highest at the 5-cm level, during Mueller maneuvers and occlusion tests, regardless of posture or lung volume (mean range 1.00-1.08). At 10 and 15 cm, there was a progressive increase in delta Pes/delta Pm with volume (from 0.85 to 1.14). During Valsalva maneuvers, delta Pes/delta Pm also tended to increase with volume while supine (range 0.91-1.04), but was not volume-dependent while seated. Qualitatively, observed delta Pes/delta Pm fit predicted corresponding values (based on lung and upper airway compliances). Quantitatively there were discrepancies probably due to lack of measurement of esophageal elastance and to inhomogeneities in delta Ppl. At every lung volume in both postures, there was at least one esophageal site where delta Pes/delta Pm was within 10% of unity. PMID- 3558192 TI - State-related changes in lung liquid secretion and tracheal flow rate in fetal lambs. AB - The volume of liquid in the fetal lungs depends on the rate of liquid secretion (Vs) across the pulmonary epithelium and the rate of flow out of the trachea (Vtr). We measured Vs, by an isotope-dilution technique, and Vtr, with a bubble flowmeter, during low-voltage (LV) and high-voltage (HV) electrocortical activity. In nine chronically instrumented fetal lambs, Vtr was greater during the transition to and at LV (16.98 +/- 1.98 ml/h, mean +/- SE, n = 23) than values during the transition to and at HV (8.69 +/- 0.8 ml/h). A pronounced peak in Vtr of 22.3 +/- 1.8 ml/h (n = 197) occurred at the transition to LV and early in the LV state. Ten minutes or more into LV, Vtr had declined to 10.3 +/- 1.8 ml/h (n = 235). Vtr remained low throughout the HV state. Vs values were not significantly different throughout the LV (11.83 +/- 1.34 ml/h, n = 216) and the HV (13.61 +/- 2.34 ml/h, n = 174) states. Diaphragmatic burst rate during LV (146.9 +/- 6.7 bursts/5 min, n = 432) was greater than during HV (26.5 +/- 4.6 bursts/5 min, n = 348), but burst rate was not correlated with Vtr. In summary, Vtr reaches a peak during the early part of LV when breathing commences and Vs remains constant throughout the behavioral cycle. As a result, lung liquid volume increases slightly during HV and decreases by a similar amount in the early part of LV. PMID- 3558191 TI - Pliometric activity of inspiratory muscles: maximal pressure-flow curves. AB - We tested the hypothesis that inspiratory muscles, like other skeletal muscles, would exert greater force under pliometric conditions (being lengthened while active) than under isometric or miometric (active shortening) conditions. Maximal inspiratory pressure-flow curves of the respiratory system are analogous to the force-velocity curves for isolated muscle (Agostoni and Fenn, J. Appl. Physiol. 15:349-353, 1960). We measured esophageal pressure (Pes) and plethysmographic flow (V) at relaxation volume of the respiratory system in six trained subjects inspiring maximally through graded resistors (miometric), against a closed airway (isometric), and while constant expiratory flows were forced by a reduced pressure source at the airway opening (pliometric). Pes varied inversely with V and this trend continued into the pliometric range. In addition we found that the pressure-flow characteristics of the rib cage and of the abdomen are similar to those for the chest wall as a whole. The mechanical and energetic advantages of muscle activity under pliometric conditions may be available to some inspiratory muscles in both normal and pathological situations. PMID- 3558193 TI - Longitudinal distribution of pulmonary vascular resistance with very high pulmonary blood flow. AB - Dog left upper lobes (LUL) were perfused in situ via the left lower lobe artery. Lobe weight was continuously monitored. Increasing lobar flow from normal to 10 times normal had little effect on left atrial pressure, which ranged from 1 to 5 mmHg. There was a flow threshold (Qth) below which lobar weight was stable. Qth ranged from 1.1 to 1.55 l/min (mean 1.27) corresponding to four times normal LUL blood flow. Above Qth, step increases in lobar flow resulted in progressive weight gain at a constant rate that was proportional to flow. The effective pressure at the filtration site (EFP) at different flow rates was estimated from the static vascular pressure that resulted in the same rate of weight gain. From this value and from mean pulmonary arterial (PA) and left atrial (LA) pressures, we calculated resistance upstream (Rus) and downstream (Rds) from filtration site. At Qth, Rds accounted for 60% of total resistance. This fraction increased progressively with flow, reaching 83% at Q of 10 times normal. We conclude that during high pulmonary blood flow EFP is closer to PA pressure than it is to LA pressure, and that this becomes progressively more so as a function of flow. As a result, the lung accumulates water at flow rates in excess of four times normal despite a normal left atrial pressure. PMID- 3558194 TI - Measurement of thoracic gas volume by low-frequency ambient pressure changes. AB - When the whole body is exposed to sinusoidal variations of ambient pressure (delta Pam) at very low frequencies (f), the resulting compression and expansion of alveolar gas is almost entirely achieved by gas flow through the airways (Vaw). As a consequence thoracic gas volume (TGV) may be computed from the imaginary part (Im) of the delta Pam/Vaw relationship: TGV = PB/[2 pi f X Im(delta Pam/Vaw)], where PB is barometric minus alveolar water vapor pressure. The method was tested in 35 normal subjects and compared with body plethysmography. The subjects sat in a chamber connected to a large-stroke-volume reciprocating pump that brought about pressure swings of 40 cmH2O at 0.05 Hz. delta Pam and Vaw were digitally processed by fast Fourier transform to extract the low-frequency component from the much larger respiratory flow. Total lung capacities (TLC) obtained by ambient pressure changes and by plethylsmography were highly correlated (r = 0.959, p less than 0.001) and not significantly different (6.96 +/- 1.38 l vs. 6.99 +/- 1.38). TLC obtained by ambient pressure changes were not influenced by lowering the frequency to 0.03 Hz, adding an external resistance at the mouth, or increasing abdominal gas volume. We conclude that the method is practical and in agreement with body plethysmography in normal subjects. PMID- 3558195 TI - A modeling approach to the estimation of CO diffusing capacity. AB - Standard methods of measuring the diffusing capacity of the lung for CO are susceptible to inhomogeneity and to errors in the performance of a breathing maneuver by the subject. A mathematical model of CO uptake from a single alveolar lung is developed and used as the basis for an estimation procedure to measure both lung volume and diffusing capacity during a rebreathing maneuver. Because this estimator-model uses the exact flow generated by the subject, errors in such factors as breath-hold times or depth of inspiration do not result. The estimator model was tested using simulated data from uniformly and nonuniformly ventilated models and was found to be insensitive to noise and inhomogeneity, in contrast to the diffusing capacity of the lungs for CO (exhaled). The estimator-model makes greater use of the available data than traditional methods by utilizing both the slope of the alveolar plateaus for CO and the relative heights of such plateaus in a rebreathing experiment. PMID- 3558196 TI - Effects of swim training on lung volumes and inspiratory muscle conditioning. AB - Lung volumes and inspiratory muscle (IM) function tests were measured in 16 competitive female swimmers (age 19 +/- 1 yr) before and after 12 wk of swim training. Eight underwent additional IM training; the remaining eight were controls. Vital capacity (VC) increased 0.25 +/- 0.25 liters (P less than 0.01), functional residual capacity (FRC) increased 0.39 +/- 0.29 liters (P less than 0.001), and total lung capacity (TLC) increased 0.35 +/- 0.47 (P less than 0.025) in swimmers, irrespective of IM training. Residual volume (RV) did not change. Maximum inspiratory mouth pressure (PImax) measured at FRC changed -43 +/- 18 cmH2O (P less than 0.005) in swimmers undergoing IM conditioning and -29 +/- 25 (P less than 0.05) in controls. The time that 65% of prestudy PImax could be endured increased in IM trainers (P less than 0.001) and controls (P less than 0.05). All results were compared with similar IM training in normal females (age 21.1 +/- 0.8 yr) in which significant increases in PImax and endurance were observed in IM trainers only with no changes in VC, FRC, or TLC (Clanton et al., Chest 87: 62-66, 1985). We conclude that 1) swim training in mature females increases VC, TLC, and FRC with no effect on RV, and 2) swim training increases IM strength and endurance measured near FRC. PMID- 3558197 TI - Rat lung glutathione release: response to oxidative stress and selenium deficiency. AB - We performed experiments to characterize the glutathione-dependent metabolism occurring during tert-butyl hydroperoxide infusion in isolated perfused rat lungs and to examine the effect of selenium deficiency on this metabolism. Selenium deficiency resulted in decreased lung glutathione peroxidase activity but normal glutathione reductase activity and glutathione content. Infusion of the hydroperoxide into control lungs caused a proportional increase in tissue glutathione disulfide (GSSG) concentration and release of GSSG into the perfusate up to an infusion rate of 250 nmol of tert-butyl hydroperoxide X min-1 X 100 g body wt-1. Infusion rates greater than this resulted in continued rise of tissue GSSG concentrations but GSSG release into the perfusate plateaued. Infusion of tert-butyl hydroperoxide into selenium-deficient rat lungs resulted in much lower concentrations of tissue GSSG and GSSG release into the perfusate; however, release in the selenium-deficient rat lung was also found to be saturable at infusion rates of 450 nmol of tert-butyl hydroperoxide X min-1 X 100 g of body wt 1. Selenium deficiency in the rat decreases the rate of reduction of infused tert butyl hydroperoxide by glutathione and may predispose the lung to free radical damage. PMID- 3558198 TI - Impedance and relative displacements of relaxed chest wall up to 4 Hz. AB - We measured the effective resistance (Reff) and elastance (Eeff) of the chest wall in four subjects, relaxed at functional residual capacity (FRC), during sinusoidal volume changes (5% vital capacity up to 4 Hz) delivered at the mouth. Subjects sat in a head-out body plethysmograph, and transthoracic pressure was measured with an esophageal balloon. Changes in Reff and in Eeff with frequency were nearly the same in all subjects. Reff (in cmH2O X l-1 X s) was 2.9 +/- 0.8 at 0.2 Hz and fell sharply to minimum values (0.5-0.9) at 1-4 Hz. Eeff (in cmH2O X l-1) increased from approximately 10 at the lowest frequency to a plateau of about 15 at 1-3 Hz and decreased above 3 Hz. In the same subjects, we measured the relative magnitude and phase between the displacements of different parts of the chest wall with magnetometers during identical sinusoidal forcing. Results indicate that the chest wall expands and deflates uniformly at frequencies up to 1 Hz. Thereafter the abdomen makes relatively larger excursions, and the relative magnitude and phase of displacement at different points on the chest wall show complex changes. We conclude that the frequency dependence of Reff and Eeff below 1 Hz is not due to nonuniformities in displacement of different parts of the chest wall. The frequency dependency of Reff is consistent with an increasing contribution of rate-independent plastic dissipation to the pressure difference in phase with flow as breathing frequency decreases. PMID- 3558199 TI - Thoracic pressure and nasal patency. AB - Maximum nasal flow rate in the right and left nostrils was simultaneously determined during expiration with the help of two flowmeters in 10 healthy subjects in different postures and in two patients, one with Horner's syndrome and the other with facial palsy. It was found that pressure on the hemithorax from any surface (i.e., lateral, anterior, posterior, or superior) leads to reduced patency of the ipsilateral nostril but increased patency of the nostril on the opposite site. In the patient with Horner's syndrome, the nostril on the affected side remained blocked even on compression of the opposite hemithorax, and in the one with facial nerve palsy, the nostril on the affected side remained patent despite compression of the hemithorax on that side. The findings suggest that compression of hemithorax leads to changes in the congestion of the nasal mucosa that may be mediated through autonomic nerves. PMID- 3558200 TI - Reliability of parameter estimates from models applied to respiratory impedance data. AB - Many previous studies have fit lumped parameter models to respiratory input (Zin) and transfer (Ztr) impedance data. For frequency ranges higher than 4-32 Hz, a six-element model may be required in which an airway branch (with a resistance and inertance) is separated from a tissue branch (with a resistance, inertance, and compliance) by a shunt compliance. A sensitivity analysis is applied to predict the effects of frequency range on the accuracy of parameter estimates in this model obtained from Zin or Ztr data. Using a parameter set estimated from experimental data between 4 and 64 Hz in dogs, both Zin and Ztr were simulated from 4 to 200 Hz. Impedance sensitivity to each parameter was also calculated over this frequency range. The simulation predicted that for Zin a second resonance occurs near 80 Hz and that the impedance is considerably more sensitive to several of the parameters at frequencies surrounding this resonance than at any other frequencies. Also, unless data is obtained at very high frequencies (where the model is suspect), Zin data provides more accurate estimates than Ztr data. After adding random noise to the simulated Zin data, we attempted to extract the original parameters by using a nonlinear regression applied to three frequency ranges: 4-32, 4-64, and 4-110 Hz. Estimated parameters were substantially incorrect when using only 4- to 32-Hz or 4- to 64-Hz data, but nearly correct when fitting 4- to 110-Hz data. These results indicate that respiratory system parameters can be more accurately extracted from Zin than Ztr, and to make physiological inferences from parameter estimates based on Zin impedance data in dogs, the data must include frequencies surrounding the second resonance. PMID- 3558201 TI - Modeling of respiratory system impedances in dogs. AB - Mechanical impedances between 4 and 64 Hz of the respiratory system in dogs have been reported (A.C. Jackson et al. J. Appl. Physiol. 57: 34-39, 1984) previously by this laboratory. It was observed that resistance (the real part of impedance) decreased slightly with frequency between 4 and 22 Hz then increased considerably with frequency above 22 Hz. In the current study, these impedance data were analyzed using nonlinear regression analysis incorporating several different lumped linear element models. The five-element model of Eyles and Pimmel (IEEE Trans. Biomed. Eng. 28: 313-317, 1981) could only fit data where resistance decreased with frequency. However, when the model was applied to these data the returned parameter estimates were not physiologically realistic. Over the entire frequency range, a significantly improved fit was obtained with the six-element model of DuBois et al. (J. Appl. Physiol. 8: 587-594, 1956), since it could follow the predominate frequency-dependent characteristic that was the increase in resistance. The resulting parameter estimates suggested that the shunt compliance represents alveolar gas compressibility, the central branch represents airways, and the peripheral branch represents lung and chest wall tissues. This six-element model could not fit, with the same set of parameter values, both the frequency-dependent decrease in Rrs and the frequency-dependent increase in resistance. A nine-element model recently proposed by Peslin et al. (J. Appl. Physiol. 39: 523-534, 1975) was capable of fitting both the frequency-dependent decrease and the frequency-dependent increase in resistance. However, the data only between 4 and 64 Hz was not sufficient to consistently determine unique values for all nine parameters. PMID- 3558202 TI - Effect of habituation to subanesthetic N2 or N2O levels on pressure and anesthesia tolerance. AB - Exposure of CD-1 mice to subanesthetic partial pressures of N2O (0.5 atm) or N2 (10-20 atm) for periods up to 14 days results in up to 40% decreases in the mean threshold pressure eliciting type I high-pressure neurological syndrome (HPNS) seizures, and in increases up to 38% in the N2 partial pressure producing anesthesia. For all combinations of preexposure time, N2 partial pressure, as well as identity of the conditioning gas the relations between the convulsion threshold pressure (Pc) and the anesthesia N2 pressure (Pa) appear to be uniquely correlated by the equation Pa = 54.5 - 0.2(Pc - 60)1.2. The potency of N2O with respect to these habituation phenomena is between 28 and 33 times higher than that of N2, depending on the aspects compared. Evidence is presented indicating that after 14 days of habituation the animals have attained between 75 and 85% compensation for the anesthetic as well as the anticonvulsant effects of the conditioning gas. The bearing of the results on the problem of the nature of the antagonism between inert gas narcotic agents and high pressure and on the hypothesis that habituation tends toward restoration of isofluidity (or some analogous normalization process) are discussed. PMID- 3558203 TI - Artificial pulmonary surfactant inhibited by proteins. AB - With a pulsating bubble surfactometer we assessed the ability of various agents, fibrinogen, human serum, albumin, and a 55,000-dalton serum protein, to interfere with the surface activity of Surfactant TA. From a highest final protein concentration of 4 mg/ml the potential inhibitors were diluted down to 0.125 mg/ml in six steps, and each concentration was evaluated together with two final phospholipid concentrations, 6.25 and 1.25 mg/ml, of the surfactant preparation. The strongest inhibiting action was exerted by fibrinogen, followed by human serum and the 55,000-dalton serum protein; the weakest inhibitor was albumin. Bilirubin, when added in an amount of 1.73 mg/100 ml dissolved in human serum, significantly (P less than 0.001) augmented the inhibition over that exerted by human serum alone. Adsorption rate, as reflected in the mean value of surface tension 2 and 10 s after creation of a bubble, not pulsating, was seriously affected by each of the protein-containing inhibitors in concentrations exceeding 1 mg/ml. Surface tension was raised significantly when the pulsating bubble was at maximal and minimal size. The effect was dose dependent. At maximal size it showed no tendency to disappear during the 10-min recording, but at minimal bubble size the inhibition gradually diminished. We conclude that proteins present in the airways may seriously interfere with the activity of Surfactant TA. PMID- 3558204 TI - Vascular transport capacity of hindlimb muscles of exercise-trained rats. AB - The purpose of this study was to determine whether chronic exercise training is associated with increased vascular flow capacity and capillary exchange capacity in skeletal muscles. One group of male Sprague-Dawley rats was cage confined for a period of 13-17 wk (sedentary control, C) and a second was trained for 1 h/day at a speed of 30 m/min up a 5 degrees incline for 13-17 wk (exercise trained, ET). Studies were conducted with maximally dilated (papaverine) isolated hindquarters of 13 C rats and 10 ET rats perfused with Tyrode's solution containing 5% albumin. Vascular flow capacity was estimated by measuring total and regional flows at three to five different perfusion pressures. Capillary exchange capacity was estimated by measuring maximal capillary filtration coefficients and capillary diffusion capacity for 51Cr-ethylenediaminetetraacetic acid (51Cr-EDTA). The efficacy of the training was shown by significant increases in succinate dehydrogenase activities of the vastus intermedius muscle. Total hindquarter flow capacity was 50% higher in the ET rats. Regional flow data indicated that the higher total flow was due to increased muscle flow (85%), with the high-oxidative muscle tissue having the greatest increases (e.g., 200% increase in red gastrocnemius muscle). The maximal capillary diffusion capacity values for the ET rats were 70% greater than control values. However, the capillary filtration capacity values of the C and ET rats were not different. We conclude that the vascular transport capacity of the high-oxidative areas of extensor muscles is increased by endurance training. PMID- 3558205 TI - Pulmonary function of the green sea turtle, Chelonia mydas. AB - Lung volumes, oxygen uptake (VO2), end-tidal PO2, and PCO2, diffusing capacity of the lungs for CO (DLCO), pulmonary blood flow (QL) and respiratory frequency were measured in the green sea turtle (Chelonia mydas) (49-127 kg body wt). Mean lung volume (VL) determined from helium dilution was 57 ml/kg and physiological dead space volume (VD) was about 3.6 ml/kg. QL, determined from acetylene uptake during rebreathing, increased in proportion to VO2 with temperature. Therefore, constant O2 content difference was maintained between pulmonary arterial and venous blood. DLCO, measured using a rebreathing technique, was 0.04 ml X kg-1 X min-1 X Torr-1 at 25 degrees C. Several cardiopulmonary characteristics in C. mydas are advantageous to diving: large tidal volume relative to functional residual capacity promotes fast exchange of the alveolar gas when the turtle surfaces for breathing: and the concomitant rise of pulmonary blood flow and O2 uptake with temperature assures efficient O2 transport regardless of wide temperature variations encountered during migrations. PMID- 3558206 TI - Analysis of airway fluid protein concentration in neurogenic pulmonary edema. AB - Intracisternal administration of veratrine (40 micrograms/kg) in the alpha chloralose-anesthetized dog produces fulminant neurogenic pulmonary edema (NPE). To determine whether the edema resulted from increased microvascular pressure or from increased permeability, the airway fluid-to-plasma protein (A/P) concentration ratios were compared for both total proteins and endogenous protein fractions of known molecular radii (37-114 A) from dogs with edema produced by either veratrine, alloxan (permeability edema), or combined left atrial pressure and volume overload (hemodynamic edema). High A/P ratios (0.98 +/- 0.05) were observed after alloxan administration, whereas lower values (0.54 +/- 0.04) were observed in hemodynamic edema. A/P ratios were observed after veratrine administration that formed a continuum (0.48-0.84) between these extremes. Veratrine animals with high overall A/P ratios exhibited elevated A/P ratios for all protein fractions, whereas animals with lower overall A/P ratios exhibited A/P protein fraction ratios similar to those observed in the hemodynamic group. These data indicate that both hemodynamic and increased permeability mechanisms may play a role to varying degrees in the development of this form of NPE. PMID- 3558207 TI - Hemodynamic effects of rapidly evacuating prolonged pneumothorax in rabbits. AB - Clinical observations suggest that systemic hypotension may be caused by rapid evacuation of persistent pneumothorax. This observation has not been substantiated experimentally and the mechanism(s) are unknown. In this study, we measured systemic hemodynamic parameters in rabbits before and for 2 h during negative pressure evacuation of a right-sided pneumothorax of 7-9 days duration. Three groups of animals were studied: 10 rabbits breathed room air and were hypoxemic during pneumothorax (hypoxemic pneumothorax = HP); 10 rabbits breathed 40% O2-60% N2, which prevented arterial hypoxemia during pneumothorax (supraoxemic pneumothorax = SP); seven normal control animals were untreated during this time period (NC). Pneumothoraces in HP and SP were evacuated by negative pressure applied to the right pleural space for 2 h while animals were anesthetized and mechanically ventilated. The NC group was anesthetized and ventilated without prior pneumothorax. Serial hemodynamic measurements were made before and during pleural suction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558208 TI - Effect of duration of exercise on excess postexercise O2 consumption. AB - This study was undertaken to determine the effect of exercise duration on the time course and magnitude of excess postexercise O2 consumption (EPOC). Six healthy male subjects exercised on separate days for 80, 40, and 20 min at 70% of maximal O2 consumption on a cycle ergometer. A control experiment without exercise was performed. O2 uptake, respiratory exchange ratio (R), and rectal temperature were monitored while the subjects rested in bed 24 h postexercise. An increase in O2 uptake lasting 12 h was observed for all exercise durations, but no increase was seen after 24 h. The magnitude of 12-h EPOC was proportional to exercise duration and equaled 14.4 +/- 1.2, 6.8 +/- 1.7, and 5.1 +/- 1.2% after 80, 40, and 20 min of exercise, respectively. On the average, 12-h EPOC equaled 15.2 +/- 2.0% of total exercise O2 consumption (EOC). There was no difference in EPOC:EOC for different exercise durations. A linear decrease with exercise duration was observed in R between 2 and 24 h postexercise. No change was observed in recovery rectal temperature. It is concluded that EPOC increases linearly with exercise duration at a work intensity of 70% of maximal O2 consumption. PMID- 3558209 TI - Accuracy of the respiratory inductive plethysmograph during loaded breathing. AB - Indirect methods of measuring ventilation, such as the respiratory inductive plethysmograph (RIP), operate on the assumption that the respiratory system possesses two degrees of freedom of motion: the rib cage and abdomen. Accurate measurements have been obtained in many patients with pulmonary disease who possess additional degrees of freedom. Since calibration and validation of the RIP was carried out during quiet breathing in these patients, the amount of asynchronous or paradoxic breathing was presumably similar during the calibration and validation runs. Conversely, accuracy might be lost if following the initial calibration procedure the magnitude of chest wall distortion increased during subsequent validation runs. We calibrated the RIP during quiet breathing and examined its accuracy while subsequently breathing against resistive loads that required the generation of 20-80% of the subject's maximum inspiratory mouth pressure (Pmmax). We compared the relative accuracy of three commonly employed calibration methods: isovolume technique, least-squares technique, and single position loop-area technique. Up to 60% of Pmmax, 89% of the RIP values with the least-squares technique were within +/- 10% of simultaneous spirometric (SP) measurements and 100% were within +/- 20% of SP, compared with 63 and 91%, respectively, for the loop-area technique and 19 and 54%, respectively, for the isovolume technique. At 70 and 80% of Pmmax accuracy deteriorated. Accuracy of respiratory timing was judged in terms of fractional inspiratory time (TI/TT).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558210 TI - Interaction of hypoxic and hypercapnic stimuli on breathing pattern in the newborn rat. AB - We aimed to investigate whether newborn rats respond to acute hypoxia with a biphasic pattern as other newborn species, the characteristics of their ventilatory response to hypercapnia, and the ventilatory response to combined hypoxic and hypercapnic stimuli. First, we established that newborn unanesthetized rats (2-4 days old) exposed to 10% O2 respond as other species. Their ventilation (VE), measured by flow plethysmography, immediately increased by 30%, then dropped and remained around normoxic values within 5 min. The drop was due to a decrease in tidal volume, while frequency remained elevated. Hence, alveolar ventilation was about 10% below normoxic value. At the same time O2 consumption, measured manometrically, dropped (-23%), possibly indicating a mechanism to protect vital organs. Ten percent CO2 in O2 breathing determined a substantial increase in VE (+47%), indicating that the respiratory pump is capable of a marked sustained hyperventilation. When CO2 was added to the hypoxic mixture, VE increased by about 85%, significantly more than without the concurrent hypoxic stimulus. Thus, even during the drop in VE of the biphasic response to hypoxia, the respiratory control system can respond with excitation to a further increase in chemical drive. Analysis of the breathing patterns suggests that in the newborn rat in hypoxia the inspiratory drive is decreased but the inspiratory on-switch mechanism is stimulated, hypercapnia increases ventilation mainly through an increase in respiratory drive, and moderate asphyxia induces the most powerful ventilatory response by combining the stimulatory action of hypercapnia and hypoxia. PMID- 3558211 TI - Effect of autonomic blockade on tracheobronchial blood flow. AB - Tracheobronchial blood flow increases two to five times in response to cold and warm dry air hyperventilation in anesthetized tracheostomized dogs. In this series of experiments we have attempted to attenuate this increase by blockade of the autonomic nervous system. Four groups of anesthetized, tracheostomized, open chest dogs were studied. Group 1 (n = 5) were hyperventilated for 30 min with 1) warm humid [approximately 26 degrees C, 100% relative humidity, (rh)] air followed by bilateral vagotomy, 2) warm humid air, 3) cold (-22 degrees C, 0% rh) dry air, and 4) warm humid air. Groups 2, 3, and 4 (n = 3/group) were hyperventilated for 30 min with 1) warm humid (approximately 41 degrees C, 100% rh) air, 2) warm dry (approximately 41 degrees C) air, 3) warm humid air, and 4) warm dry air. Group 2 were controls. Group 3 were given phentolamine, 0.6 mg/kg intravenously, as an alpha-blockade, and group 4 were given propranolol, 1 mg/kg, as a beta-blockade after warm dry air hyperventilation (period 2). Five minutes before the end of each 30-min period of hyperventilation, measurements of vascular pressures, cardiac output, arterial blood gases, and inspired, body, and tracheal temperatures were measured, and differently labeled radioactive microspheres were injected into the left atrium to make separate measurements of airway blood flow. After the last measurements had been made animals were killed and their lungs were excised. Blood flow to the airways and lung parenchyma was calculated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558212 TI - Effect of cold and warm dry air hyperventilation on canine airway blood flow. AB - Tracheobronchial blood flow increases with cold air hyperventilation in the dog. The present study was designed to determine whether the cooling or the drying of the airway mucosa was the principal stimulus for this response. Six anesthetized dogs (group 1) were subjected to four periods of eucapnic hyperventilation for 30 min with warm humid air [100% relative humidity (rh)], cold dry air (-12 degrees C, 0% rh), warm humid air, and warm dry air (43 degrees C, 0% rh). Five minutes before the end of each period of hyperventilation, tracheal and central airway blood flow was determined using four differently labeled 15-micron diam radioactive microspheres. We studied another three dogs (group 2) in which 15- and 50-micron microspheres were injected simultaneously to determine whether there were any arteriovenous communications in the bronchovasculature greater than 15 micron diam. After the last measurements had been made, all dogs were killed, and the lungs, including the trachea, were excised and blood flow to the trachea, left lung bronchi, and parenchyma was calculated. Warm dry air hyperventilation produced a consistently greater increase in tracheobronchial blood flow (P less than 0.01) than cold dry air hyperventilation, despite the fact that there was a smaller fall (6 degrees C) in tracheal tissue temperature during warm dry air hyperventilation than during cold dry air hyperventilation (11 degrees C), suggesting that drying may be a more important stimulus than cold for increasing airway blood flow. In group 2, the 15-micron microspheres accurately reflected the distribution of airway blood flow but did not always give reliable measurements of parenchymal blood flow. PMID- 3558213 TI - Hyperbaric hyperoxia reversibly inhibits erythrocyte phospholipid fatty acid turnover. AB - The present study is one component of a comprehensive investigation of oxygen tolerance of tissues and organs in normal human subjects. The focus of this study was the acylation of membrane phospholipid in situ by erythrocytes. Activation of exogenous [9,10-3H]oleic acid to acyl thioester and transesterification of the acyl thioester into phospholipid by intact human erythrocytes incubated in vitro decreased 30% after exposure of 10 human subjects to hyperbaric hyperoxia (100% O2, 3 ATA, 3.5 h). Partial recovery of activity could be detected when additional cells were obtained from these subjects and assayed in vitro 24 h after cessation of exposure. No significant change in membrane phospholipid fatty acid composition was detected under these conditions. The reduced glutathione content of intact erythrocytes increased by 15% after hyperbaric hyperoxia and remained elevated 24 h after exposure. In isolated membranes prepared from the same cells activation of [9,10-3H]oleic acid to acyl thioester and its transesterification into phospholipid did not change after hyperoxia. Since the ability of intact cells to replace oxidized fatty acids in membrane phospholipids via deacylation and reacylation in situ may be necessary for the maintenance of membrane integrity during exposure to oxidative stress, the decrease in [9,10-3H]oleic acid incorporation by human erythrocytes detected in vitro after hyperbaric hyperoxia in vivo may reflect an early event in the pathogenesis of oxygen induced cellular injury and may be a useful index for assessment of the tolerance of tissues to hyperoxia. PMID- 3558214 TI - Heredity and overfeeding-induced changes in submaximal exercise VO2. AB - The present study investigated the role of heredity in determining changes in the energy cost of submaximal exercise in response to short-term overfeeding. Six pairs of monozygotic twins were subjected to a 1,000 kcal/day surplus for 22 days with careful experimental controls over food intake and physical activities. O2 consumption (VO2) was measured during a submaximal treadmill exercise test 165 min postprandially before and the morning after the overfeeding protocol. As expected, overfeeding induced significant increases in body weight and fat mass. No significant increase in mean exercise VO2 was observed after overfeeding. However, the interindividual variation in overfeeding-induced changes in exercise VO2 was large and not randomly distributed. When comparing intrapair variance for changes in exercise VO2 to interpair variance, a moderate to high within-pair resemblance in response, i.e., a genotype-overfeeding interaction, was observed. Changes in exercise VO2 were positively correlated with those in postexercise levels of blood catecholamines, particularly epinephrine. A negative correlation was found between changes in exercise VO2 and body fat gain. These results are consistent with the concept of a role for the sympathoadrenal system in the regulation of adaptive thermogenesis and the predisposition to store fat. Moreover, these data suggest that the sensitivity to adapt in exercise energy expenditure after overfeeding is inherited to a significant extent. PMID- 3558215 TI - Magnesium homeostasis during high-intensity anaerobic exercise in men. AB - This study was conducted to determine whether short-term, high-intensity anaerobic exercise alters Mg homeostasis. Thirteen men performed intermittent bouts of treadmill running at 90% of their predetermined maximum O2 uptake until exhaustion on one occasion during a week in which all men were consuming a standard diet (115 mg Mg/1,000 kcal). Plasma and erythrocyte Mg concentrations and peripheral blood mononuclear cell Mg content were measured before and after the exercise. Complete 24-h urine collections were obtained on control days, on the day of exercise, and on the day after exercise. Exercise induced a transient but significant decrease in plasma Mg content (-6.8%; P less than 0.01); over 85% of the loss could be accounted for by a shift to the erythrocytes. Significant increases in urinary excretion of Mg were observed on the day of exercise (131.5 +/- 6.8 mg/day) compared with control days (108 +/- 6.6 mg/day), with the percent increase correlating with postexercise blood lactate concentration (r = 0.68; P less than 0.01) and oxygen consumption during recovery (r = 0.84; P less than 0.001). The data indicate that high-intensity anaerobic exercise induces intercompartmental Mg shifts in blood that return to preexercise values within 2 h and urinary losses on the day of exercise that return to base line the day after exercise. It is postulated that the exercise-induced increase in Mg excretion may depend on the intensity of the exercise, and the relative contribution of anaerobic metabolism to the total energy expended during exercise. PMID- 3558216 TI - High-level quadriplegics perceive lung volume change. AB - We tested the ability of tracheostomized, high-level quadriplegics to detect changes in ventilator-delivered tidal volume. Single breaths larger or smaller than control breaths were delivered, and the subjects indicated which breath was altered in a forced-choice procedure that minimizes the effect of subject bias. Quadriplegic patients detected changes in tidal volume of as little as 100 ml. Their ability to detect changes was comparable to that of a group of normal subjects similarly tested. These quadriplegic patients had little or no somatic sensation below the neck, and airways above the tracheostomy were not exposed to the stimulus. The quadriplegics consistently and emphatically reported that the sensation used in volume discrimination arose within the chest. PMID- 3558217 TI - Mechanical function of hyoid muscles during spontaneous breathing in cats. AB - We assessed the mechanical behavior of the geniohyoid and sternohyoid muscles during spontaneous breathing using sonomicrometry in anesthetized cats. When the animals breathed O2, the hyoid muscles either became longer or did not change length (but never shortened) during inspiration. During progressive hyperoxic hypercapnia, transient increases in geniohyoid muscle inspiratory lengthening occurred in many animals; however, at high PCO2 the geniohyoid invariably shortened during inspiration (mean 4.9% of resting length at the end of CO2 rebreathing; P less than 0.001). The PCO2 at which geniohyoid inspiratory lengthening changed to inspiratory shortening was significantly higher than the CO2 threshold for the onset of geniohyoid electrical activity (P less than 0.01). For the sternohyoid muscle, hypercapnia caused inspiratory lengthening in 13 of 17 cats and inspiratory shortening in 4 of 17 cats; on average the sternohyoid lengthened by 1.6% of resting length at the end of CO2 rebreathing (P less than 0.01). Sternohyoid lengthening occurred in spite of this muscle being electrically active. These results suggest that the relationship between hyoid muscle electrical activity and respiratory changes in length is very complex, so that the presence of hyoid muscle electrical activity does not necessarily indicate muscle shortening, and among the geniohyoid and sternohyoid muscles, the geniohyoid has a primary role as a hypopharyngeal dilator in the spontaneously breathing cat, with the sternohyoid muscle acting in an accessory capacity. PMID- 3558218 TI - Quantification of thoracic volumes by three-dimensional imaging. AB - End-expiratory thoracic cavity volume (Vthx) was measured in eight volunteers lying supine by three-dimensional X-ray computed tomography using the Dynamic Spatial Reconstructor. Untrapped end-expiratory pulmonary gas volume at functional residual capacity (FRC) was determined by nitrogen clearance. Both measurements were done before and after induction of anesthesia-paralysis. After induction of anesthesia-paralysis, Vthx and FRC were consistently and significantly (P less than 0.01) reduced by 0.28 +/- 0.22 (SD) and 0.59 +/- 0.24 liter, respectively. The reduction of FRC was larger than the reduction of Vthx (delta Vthx) in six of the eight subjects, a finding suggesting that intrathoracic fluid (blood) plus trapped gas volume (Vtt) increased. Changes in Vthx were partitioned into volume changes from the thoracic rib cage (delta Vrc) and from shape and/or position changes of the diaphragm (delta Vdi). delta Vrc contributed significantly (0.17 +/- 0.15 liter, P less than 0.02) to delta Vthx, whereas delta Vdi contributed only in four of the eight subjects. We conclude that delta Vrc, delta Vdi, and delta Vtt contribute to the reduction of FRC after induction of anesthesia-paralysis in humans; the relative contribution of them varies among subjects. PMID- 3558219 TI - Maximal vascular leg conductance in trained and untrained men. AB - Lower leg blood flow and vascular conductance were studied and related to maximal oxygen uptake in 15 sedentary men (28.5 +/- 1.2 yr, mean +/- SE) and 11 endurance trained men (30.5 +/- 2.0 yr). Blood flows were obtained at rest and during reactive hyperemia produced by ischemic exercise to fatigue. Vascular conductance was computed from blood flow measured by venous occlusion plethysmography, and mean arterial blood pressure was determined by auscultation of the brachial artery. Resting blood flow and mean arterial pressure were similar in both groups (combined mean, 3.0 ml X min-1 X 100 ml-1 and 88.2 mmHg). After ischemic exercise, blood flows were 29- and 19-fold higher (P less than 0.001) than rest in trained (83.3 +/- 3.8 ml X min-1 X 100 ml-1) and sedentary subjects (61.5 +/- 2.3 ml X min-1 X 100 ml-1), respectively. Blood pressure and heart rate were only slightly elevated in both groups. Maximal vascular conductance was significantly higher (P less than 0.001) in the trained compared with the sedentary subjects. The correlation coefficients for maximal oxygen uptake vs. vascular conductance were 0.81 (trained) and 0.45 (sedentary). These data suggest that physical training increases the capacity for vasodilation in active limbs and also enables the trained individual to utilize a larger fraction of maximal vascular conductance than the sedentary subject. PMID- 3558220 TI - Anaerobic energy release in skeletal muscle during electrical stimulation in men. AB - The quadriceps femoris muscles of seven men were electrically stimulated under extended anaerobic conditions to quantitate anaerobic energy release and the contribution of the glycolytic system to total ATP production. Muscles were intermittently stimulated 64 times at 20 Hz while leg blood flow was occluded. Each contraction lasted 1.6 s and was followed by 1.6 s of rest. The total contraction time was 102.4 s. Muscle biopsies were taken at rest and following 16, 32, 48, and 64 contractions. The ATP turnover rates during the four 16 contraction periods were 6.12, 2.56, 2.17, and 0.64 mmol X kg dry muscle-1 X s-1 contraction time. Glycolysis provided 58%, phosphocreatine 40% and a decreased ATP store 2% of the consumed energy during the initial 16 contractions. Glycolysis was responsible for 90% of the total ATP production beyond contraction 16. Absolute glycolytic ATP production decreased to 60, 55, and 17% of the amount in the initial 16 contractions during the final three periods, respectively. In conclusion glycolysis produced approximately 195 mmol ATP/kg dry muscle during the initial 48 contractions (76.8 s) and only approximately 15 mmol ATP/kg dry muscle during the final 16 contractions. Equivalent values for total ATP turnover were 278 and 16.5 mmol/kg dry muscle. PMID- 3558221 TI - Skeletal muscle glycogenolysis, glycolysis, and pH during electrical stimulation in men. AB - Glycogenolytic and glycolytic rates were estimated and muscle pH (pHm) was measured in electrically stimulated quadriceps femoris muscles of seven men. Leg blood flow was occluded and muscles were stimulated 64 times at 20 Hz, with contractions lasting 1.6 s and separated by pauses of 1.6 s. Muscle biopsies were obtained at rest and following 16, 32, 48, and 64 contractions. Glycolytic intermediates and several modulators of the glycolytic enzyme phosphofructokinase (PFK) were measured. Glycogenolytic and glycolytic rates were 1.68 and 1.26 mmol glucosyl units X kg dry muscle-1 X S-1 contraction time during the initial 16 contractions and pHm decreased from 7.00 +/- 0.01 to 6.70 +/- 0.03. During the subsequent 32 contractions both glycogenolytic and glycolytic rates were maintained at approximately 0.70 mmol X kg-1 X S-1 and pHm decreased to 6.45 +/- 0.04. In the final 16 contractions, both rates were very low and pHm was unchanged. Therefore, PFK remained active despite increasing acidity until pHm decreased to approximately 6.45. We conclude that increases in the concentrations of several positive modulators partially reverses pH-dependent ATP inhibition of PFK in vivo, permitting glycolytic activity to continue in the pHm range of 6.70 6.45. PMID- 3558222 TI - Effect of variable parenchymal expansion on gas mixing. AB - Using implanted radiopaque markers, Hubmayr et al. (J. Appl. Physiol. 54: 1048 1056, 1983) and Olson et al. (J. Appl. Physiol. 57: 1710-1714, 1984) detected a variability in the volume changes of regions defined by the markers in intact and excised dog lungs, respectively. In dogs lying prone and in excised lobes, there is virtually no large-scale spatial organization of the variability. We interpret these data as evidence of an intrinsic heterogeneity of parenchymal expansion. The effect of variability of parenchymal expansion on gas mixing is calculated. From a statistical model, we infer that the variability of volume changes observed by Olson et al. is a result of an underlying variability with a larger magnitude at a smaller scale and that the variability at the smaller scale is large enough to explain the inefficiency of mixing observed in single-breath oxygen tests on excised dog lobes. PMID- 3558223 TI - Unaltered norepinephrine-heart rate relationship in exercise with exogenous heat. AB - We measured plasma norepinephrine (NE) concentration, an index of sympathetic nervous activity, and epinephrine (E), an index of adrenal medulla activity, in six normal young men during mild to severe exercise, with and without superimposed heat stress. The primary objective was to observe whether the normally close relationship between heart rate and log NE concentration in upset when heart rate at a given work load is increased by heat stress. Exercise, beginning at 50 W, was graded in 50-W increments lasting 10 min each up to 200 W, which lasted 5-10 min. Each subject went through the protocol twice, once with skin temperature kept low by a water-perfused suit and then with skin temperature raised to 38 degrees C. Exogenous heart stress raised log circulating NE concentration in proportion to the rise in heart rate at a given work load so that the usual relationship between these variables, previously observed during other stresses, was preserved. In contrast to some other stresses, heat stress had no added effect on E concentration, indicating that this stress during exercise raises sympathetic neural activity (as reflected in the rise in NE) without stimulating additional adrenal release of E. PMID- 3558224 TI - Responses of innervated and denervated gut to whole-body hypoxia. AB - As a significant user of O2 at rest (20% of whole body), the gut may be subject to more severe limitation of O2 supply during global hypoxia than more vital areas because of preferential redistribution of blood flow. Accordingly, its accumulation of O2 deficit during hypoxia and its excess O2 use during normoxic recovery might be altered by extrinsic neural activity. We measured blood flow and O2 uptake in whole body (WB) and gut segments while anesthetized dogs were ventilated with 9% O2-91% N2 for 30 min followed by 30-min normoxic recovery. In six dogs extrinsic innervation to the gut segment was left intact and it was severed in another six animals. O2 deficit and excess were the accumulated differences from the normoxic O2 uptake for both gut and WB corrected for O2 stores changes. The intact gut, although only 4% body wt, incurred 22% of WB O2 deficit but contributed only 8% to WB O2 excess. The imbalance (gut excess was only 44% of gut deficit) implied that O2 using functions were curtailed during hypoxia without obligating an energy stores deficit. Denervation did not alter these quantitative relationships. Blood flow responses to transition between normoxia and hypoxia were only transiently altered. Extrinsic innervation apparently plays no major role in gut responses to WB hypoxia. PMID- 3558225 TI - Seizure-associated pulmonary edema and cerebral oxygenation in the rat. AB - Cerebral partial pressure of O2 (PO2), relative changes in the ratio of reduced/oxidized cytochrome aa3, blood flow, and the arteriovenous difference in O2 content were measured during seizures with and without pulmonary edema. Seizures were induced with bicuculline (0.2-1.2 mg/kg iv) in rats anesthetized with 70% N2O and paralyzed with curare. Briefer seizures were accompanied by increased cerebral PO2 and increased oxidation of cytochrome aa3. Lung water content and arterial O2 partial pressure (PaO2) remained normal. Longer duration seizures were also accompanied initially by increases in cerebral oxygenation. Within minutes, however, PaO2 fell from a mean of 118 to 51 mmHg, and lung water content increased from 76.2 to 83.6%. Cerebral PO2 fell but most often rose back to or above control levels, while cytochrome aa3 became markedly reduced. Simultaneously, cerebral blood flow increased more than 300% above preseizure values and O2 delivery increased more than O2 consumption. The reductive shift of cytochrome aa3 was greater than that produced by lowering PaO2 to equivalent values in seizure-free rats. The reductive shift of cytochrome aa3, despite increased O2 delivery, may be indicative of derangements in cerebral O2 diffusion or energy metabolism. PMID- 3558226 TI - Influence of body size on oxygen consumption during bicycling. AB - Energy in bicycling is primarily expended to overcome air resistance, which is proportional to a cyclist's surface area (SA). Thus we hypothesized that large cyclists should have a lower O2 consumption normalized to body weight (VO2/BW) than small cyclists because of the former's lower SA/BW. We measured the VO2/BW of small (BW = 59.4 +/- 4.1 kg) and large (BW = 84.4 +/- 3.2 kg) cyclists while they bicycled on a flat road at 10, 15, and 20 mph. The large cyclists had a 22% lower VO2/BW than the small cyclists at all speeds. However, the SA/BW ratio of the large cyclists was only 11% lower than that of the small cyclists. We then photographically determined the frontal area (FA) of the cyclists in a racing posture, and found that the large cyclists had a 16% lower FA/BW ratio than the small cyclists. We conclude that large cyclists are at a distinct advantage, in terms of VO2/BW, while bicycling on level roads, and this advantage is principally due to their lower FA/BW ratio. PMID- 3558227 TI - Measurement in vitro of pulsatile arterial diameter using a helium-neon laser. AB - A noncontacting in vitro measurement of pulsatile arterial diameter using a scanning optical micrometer is described. The major component of this system is a He-Ne laser whose beam scans the pulsating artery to be measured. The laser micrometer was integrated into a pulsatile perfusion apparatus that imposed various hemodynamic conditions on excised canine vessels. The laser system reliably tracked the pulsating arterial diameter at a particular longitudinal site as well as at various increments in the presence of an experimentally created stenosis. The He-Ne laser measured the radial motion of canine arteries and various vascular substitutes anastomosed in an end-to-end fashion. From these novel measurements, calculations were made of arterial compliance and bending stress, two biomechanical parameters that are implicated as potential causes of anastomotic intimal hyperplasia and graft failure. Although this device is inherently limited to in vitro use, it is a potentially useful instrument for vascular physiology and biophysics. PMID- 3558228 TI - Hyperoxia damages phagocytic defenses of neonatal rabbit lung. AB - The effect of hyperoxia on phagocytic defenses of neonatal rabbit lung was ascertained by exposure to a fractional inspired O2 concentration of 0.95 + or 0.21 for 48, 96, or 168 h. Intrapulmonary clearance of inhaled staphylococci was reduced by 67 and 74% after 96 and 168 h in hyperoxia (P less than 0.05). Impaired phagocytic killing was not due to diminished bacterial ingestion. Alveolar macrophages (AM) lavaged from pups reared in normoxia had a progressive ability to release superoxide (O-2) and showed increasing cyanide-sensitive O2 consumption during the 1st wk of life. Conversely, AM recovered from litters housed in hyperoxia for 48 h produced 190% more O-2 than normoxic controls (P less than 0.005), but this capacity to generate O-2 fell by 43% after 96 h of exposure (P less than 0.05). After 96 h of hyperoxia, AM had a significant shift toward cyanide-insensitive metabolism compared with normoxic cells (P less than 0.05). Polymorphonuclear leukocytes (PMN) entered the alveoli after 96 h of hyperoxia, and mortality rose abruptly in animals exposed for 168 h (16%) vs. 96 h (3%). Our findings indicate neonatal hyperoxia induces metabolic and bactericidal dysfunction in the primary pulmonary phagocyte, the AM, and this injury is followed by additional lung insult during PMN migration into the airways. PMID- 3558229 TI - Density dependence of maximal flow is lung volume dependent during bronchoconstriction. AB - We examined the changes in maximum expiratory flow (Vmax) and the density dependence of maximum expiratory flow (delta Vmax) during histamine-induced bronchoconstriction in dogs. Histamine acid phosphate solution was nebulized into the airways of six dogs to produce predominantly peripheral airway obstruction. Vmax air, Vmax with the dogs breathing 80% He-20% O2 (delta Vmax), and airway sites of flow limitation (choke points) were examined at four lung volumes (VL), which ranged from 51 to 23% of the control vital capacity (VC). The findings were interpreted in terms of the wave-speed theory of flow limitation. At all VL, Vmax air decreased during bronchoconstriction by approximately 30% compared with the control value. Resistances peripheral to a 0.3-cm-diam airway were increased about threefold with histamine, whereas resistances between 0.6-cm-diam bronchi and main-stem bronchi increased just slightly. Airway diameters were measured in the air-dried lung at 20 cmH2O transpulmonary pressure. Our results showed that only at 44% VC did delta Vmax decrease in all experiments after histamine to indicate peripheral obstruction (mean: 68.5 to 45%). At 23% VC, delta Vmax increased slightly, from 22 to 28%. At 23 and 36% VC, substantial differences in the wave-speed variables between air and HeO2 were present before bronchoconstriction, so that delta Vmax was low in some dogs, although peripheral airway obstruction was not evident. When bronchoconstriction was produced, delta Vmax at 23% VC could not be decreased further and even increased in four of six dogs. Thus changes in delta Vmax at given lung volume may not reflect the predominant site of airflow obstruction during bronchoconstriction. PMID- 3558231 TI - Positive effort dependence of maximal expiratory flow. AB - The maximal expiratory-flow volume (MEFV) curve in normal subjects is thought to be relatively effort independent over most of the vital capacity (VC). We studied seven normal males and found positive effort dependence of maximal expiratory flow between 50 and 80% VC in five of them, as demonstrated by standard isovolume pressure-flow (IVPF) curves. We then attempted to distinguish the effects of chest wall conformational changes from possible mechanisms intrinsic to the lungs as an explanation for positive effort dependence. IVPF curves were repeated in four of the subjects who had demonstrated positive effort dependence. Transpulmonary pressure was varied by introducing varied resistances at the mouth but effort, as defined by pleural pressure, was maintained constant. By this method, chest wall conformation at a given volume would be expected to remain the same despite changing transpulmonary pressures. When these four subjects were retested in this way, no increases in flow with increasing transpulmonary pressure were found. In further studies, voluntarily altering the chest wall pattern of emptying (as defined by respiratory inductive plethysmography) did however alter maximal expiratory flows, with transpulmonary pressure maintained constant. We conclude that maximal expiratory flow can increase with effort over a larger portion of the vital capacity than is commonly recognized, and this effort dependence may be the result of changes in central airway mechanical properties that occur in relation to changes in chest wall shape during forced expiration. PMID- 3558230 TI - Effect of resting smooth muscle length on contractile response in resistance airways. AB - We studied the effect of resting smooth muscle length on the contractile response of the major resistance airways (generations 0-5) in 18 mongrel dogs in vivo using tantalum bronchography. Dose-response curves to 10(-10) to 10(-7) mol/kg methacholine (MCh) were generated [at functional residual capacity (FRC)] by repeated intravenous bolus administration using tantalum bronchography after each dose. Airway constriction varied substantially with dose-equivalent stimulation and varied sequentially from trachea (8.8 +/- 2.2% change in airway diam) to fifth-generation bronchus (49.8 +/- 3.0%; P less than 0.001). Length-tension curves were generated for each airway to determine the airway diameter (i.e., resting in situ smooth muscle length) at which maximal constriction was elicited using bolus intravenous injection of 10(-8) mol/kg MCh. A Frank-Starling relationship was obtained for each airway; the transpulmonary pressure at which maximal constriction was elicited increased progressively from 2.50 +/- 1.12 cmH2O for trachea (approximately FRC) to 18.3 +/- 1.05 cmH2O for fifth-generation airways (approximately 50% TLC) (P less than 0.001). A similar relationship was obtained when change in airway diameter was plotted as a function of airway radius. We demonstrate substantial heterogeneity in the lung volumes at which maximal constriction is elicited and in distribution of parasympathomimetic constriction within the first few generations of resistance bronchi. Our data also suggest that lung hyperinflation may lead to augmented airway contractile responses by shifting resting smooth muscle length toward optimum resting smooth muscle length. PMID- 3558232 TI - Effect of age and training on aerobic capacity and body composition of master athletes. AB - Maximum oxygen uptake (VO2max) and body composition have been shown to deteriorate with age. How much of the decline is attributable to aging and how much is affected by reduced physical activity is not known. The purpose of this investigation was to determine the aerobic capacity and body composition of 24 master track athletes and to evaluate the relationship to age and maintenance of training over a 10-yr period. The subjects (50-82 yr of age) were retested after a 10.1-yr follow-up (T2). All continued their aerobic training, but only 11 were still highly competitive (COMP) and continued to train at the same intensity. The other 13 athletes studied became noncompetitive (post-COMP) and reduced their training intensity. The results showed the COMP group to maintain its VO2max and maximum O2 pulse while the post-COMP group showed a significant decline (54.2 53.3 vs. 52.5-45.9 ml X kg-1 X min-1; 20.7-20.8 vs. 22.4-20.0 ml/beat from test one (T1) to T2 for the COMP vs. post-COMP groups, respectively). Maximum heart rate declined 7 beats/min for both groups. Body composition showed no difference between groups from T1 to T2. For both groups body weight declined slightly (70.0 68.9 kg), percent fat increased significantly (13.1-15.1%), and fat-free weight decreased significantly (61.0-59.0 kg). Thus, when training was maintained, aerobic capacity remained unchanged over the follow-up period. Body composition changed for both groups and may have been related to aging and/or the type of training performed. PMID- 3558233 TI - Increased leukotriene C4 in ethchlorvynol-induced acute lung injury in dogs. AB - We investigated whether ethchlorvynol (ECV)-induced acute lung injury (ALI) is associated with an increase in leukotriene C4 (LTC4) production. In six pentobarbital sodium-anesthetized dogs, ECV (15 mg/kg iv) introduced into the pulmonary circulation resulted in a 164 +/- 31% increase in extravascular lung water 120 min after ECV administration. Concomitantly, the mean (+/- SE) concentration of LTC4 in arterial plasma measured by radioimmunoassay following 80% EtOH precipitation, XAD-7 extraction and high-pressure liquid chromatography purification was 5.0 +/- 1.3 pg/ml, unchanged from control (pre-ECV) values. In contrast, in pulmonary edema fluid 120 min post-ECV, the LTC4 concentration was 35.2 +/- 10.8 pg/ml, sevenfold greater than those values found in the arterial plasma (P less than 0.01). In six additional dogs, 120 min after unilateral ALI had been induced with ECV (9 mg/kg iv), LTC4 in the bronchoalveolar lavage (BAL) of the uninjured lung was 12.1 +/- 1.5 pg/ml, unchanged from pre-ECV values, whereas, LTC4 in the BAL of the injured lung increased from a control value of 10.2 +/- 1.6 to 24.2 +/- 3.5 pg/ml (P less than 0.01) 120 min after ECV administration. These results demonstrate that, in ECV-induced acute lung injury, LTC4 concentrations in pulmonary edema fluid are considerably greater than those found in arterial plasma in the case of bilateral acute lung injury and significantly greater in the BAL of the injured lung compared with the uninjured lung in the case of unilateral acute lung injury. The results are a necessary first step in support of the hypothesis that leukotrienes participate in the altered permeability of ECV-induced acute lung injury. PMID- 3558234 TI - Regional surface areas of spontaneously hypertensive and Wistar-Kyoto rats. AB - Regional skin surface area and region-specific weighting factors for calculating mean skin temperature have not been determined for the rat. Therefore, measurements were made of total skin surface area segmented into five regions of 12 spontaneously hypertensive (SHR) and 12 normotensive Wistar-Kyoto (WKY) rats. SHR's were selected because chronically elevated core temperature and reduced ability of SHR's to withstand heat stress make them of interest for thermoregulatory studies. Area was determined by coating the skin with rubber base dental impression material, then measuring the area of the coating. The relationship between total skin surface area and mass of SHR's was not different from that of WKY's and is described by the equation SA = 8.62 M0.67. However, the ears of SHR's had larger surface area and their tails smaller surface area than those of WKY's. For the combined groups, the proportion of total surface area of the regions was as follows: ears, 0.022; front feet, 0.017; hind feet, 0.040; tail, 0.100; central skin, 0.826. These data provide a basis for calculating skin surface area, mean skin temperature, and related values for SHR and WKY rats. PMID- 3558235 TI - Mitigation of pulmonary hyperoxic injury by administration of exogenous surfactant. AB - We studied the effects of surfactant supplementation on the progression of lung injury in rabbits exposed to 100% O2 for 64 h and returned to room air for 24 h. At this time, rabbits not treated with surfactant exhibit a severe lung injury with hypoxemia, increased alveolar premeability to solute, decreased total lung capacity (TLC) and lung edema. For surfactant treatment, 125 mg of calf lung surfactant extract (CLSE), suspended in 6-8 ml of normal saline, were instilled intratracheally at 0 and 12 h posthyperoxic exposure. At 24 h postexposure, these CLSE-treated rabbits compared with saline controls had significantly higher amounts of lung phospolipids (34 +/- 4 vs. 4.5 +/- 0.6 mumol/kg body wt) and increased TLC (42 +/- 2 vs. 27 +/- 1 ml/kg), with significantly lower amounts of alveolar protein (36 +/- 3 vs. 56 +/- 3 mg/kg) and decreased lung wet weight-to dry weight ratios (5.6 +/- 0.1 vs. 6.3 +/- 0.3). Surfactant supplementation also decreased the degree of lung atelectasis as reflected by the increase in arterial O2 partial pressure (PaO2) after breathing 100% O2 for 20 min (PaO2 = 460 +/- 31 vs. 197 +/- 52 Torr). These findings indicate that instillation of exogenous surfactant mitigates the progression of hyperoxic lung injury in rabbits. PMID- 3558236 TI - Hypoxic pulmonary vasoconstriction does not affect hydrostatic pulmonary edema formation. AB - We studied the effects of regional hypoxic pulmonary vasoconstriction (HPV) on lobar flow diversion in the presence of hydrostatic pulmonary edema. Ten anesthetized dogs with the left lower lobe (LLL) suspended in a net for continuous weighing were ventilated with a bronchial divider so the LLL could be ventilated with either 100% O2 or a hypoxic gas mixture (90% N2-5% CO2-5% O2). A balloon was inflated in the left atrium until hydrostatic pulmonary edema occurred, as evidenced by a continuous increase in LLL weight. Left lower lobe flow (QLLL) was measured by electromagnetic flow meter and cardiac output (QT) by thermal dilution. At a left atrial pressure of 30 +/- 5 mmHg, ventilation of the LLL with the hypoxic gas mixture caused QLLL/QT to decrease from 17 +/- 4 to 11 +/- 3% (P less than 0.05), pulmonary arterial pressure to increase from 35 +/- 5 to 37 +/- 6 mmHg (P less than 0.05), and no significant change in rate of LLL weight gain. Gravimetric confirmation of our results was provided by experiments in four animals where the LLL was ventilated with an hypoxic gas mixture for 2 h while the right lung was ventilated with 100% O2. In these animals there was no difference in bloodless lung water between the LLL and right lower lobe. We conclude that in the presence of left atrial pressures high enough to cause hydrostatic pulmonary edema, HPV causes significant flow diversion from an hypoxic lobe but the decrease in flow does not affect edema formation. PMID- 3558237 TI - Micropuncture measurement of alveolar liquid pressure in excised dog lung lobes. AB - We have investigated the mechanism of alveolar liquid filling in pulmonary edema. We excised, degassed, and intrabronchially filled 14 dog lung lobes from nine dogs with 75, 150, 225, or 350 ml of 5% albumin solution, and then air inflated the lobes to a constant airway pressure of 25 cmH2O. By use of micropipettes, we punctured subpleural alveoli to measure alveolar liquid pressure by the servo null technique. Alveolar liquid pressure was constant in all lobes despite differences in lobe liquid volume and averaged 10.6 +/- 1.3 cmH2O. Thus, in all lobes a constant pressure drop of 14.4 cmH2O existed from airway to alveolar liquid across the air-liquid interface. We attribute this finding, on the basis of the Laplace equation, to an air-liquid interface of constant radius in all the lobes. In fact, we calculated from the Laplace equation an air-liquid interface radius which equalled morphological estimates of alveolar radius. We conclude that in the steady state, alveoli that contained liquid have a constant radius of curvature of the air-liquid interface possibly because they are always completely liquid filled. PMID- 3558238 TI - An in vitro capillary system for studies on microcirculatory O2 transport. AB - An in vitro artificial capillary system has been developed for use in examining the O2 transport properties of free hemoglobin and erythrocytes. The artificial capillary was constructed by casting a thin film of transparent silicone rubber around a strand of tungsten wire that was 24 micron in diameter. After the rubber had polymerized, the wire was removed. Typical dimensions of the silicone rubber film were 170 micron thick, 1 cm wide, 5 mm long in the direction of flow, and a 27-micron lumen diameter. The artificial capillary bed was mounted on a microscope and perfused by either hemoglobin solutions or cell suspensions. Fractional saturation was measured as a function of axial position by a dual-wave length microspectrophotometer, and the flow rate was regulated precisely by a syringe pump. O2 release experiments were carried out by suffusing the gas space surrounding the artificial capillary film with 100% N2 and perfusing with an oxygenated sample. O2 uptake experiments were carried out by suffusing the gas space with O2-N2 mixtures and perfusing with deoxygenated samples. The axial velocities were varied from 3 to 15 mm/s. The residence time (the time a particular red cell or hemoglobin molecule has spent in the capillary) for 50% oxygenation of a 4 mM (heme) deoxyhemoglobin solution was approximately 0.05 s at 37 degrees C when the gas space surrounding the capillary contained air. The corresponding time for 50% oxygenation of an equivalent red cell suspension was approximately 0.25 s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558239 TI - Physiological factors affecting O2 transport by hemoglobin in an in vitro capillary system. AB - O2 transport was examined by measuring the fractional saturation of concentrated hemoglobin solutions flowing through an artificial capillary that was approximately 27 micron in diameter and embedded in a silicone rubber film approximately 170 micron thick. The effects of pH, hemoglobin concentration, O2 tension, temperature, and organic phosphate were measured and analyzed quantitatively by a rigorous mathematical model that included the geometry of the capillary in the silicone film, parabolic flow velocity distributions inside the lumen, and cooperative O2 binding by hemoglobin. The rates of both oxygenation and deoxygenation were limited by diffusion and governed by the magnitude of the O2 gradient between the intracapillary fluid phase and the external gas space. In uptake experiments, O2 flux is determined primarily by the external O2 tension (16-160 mmHg in our experiments) because the internal O2 pressure is kept small due to chemical combination with hemoglobin. In release experiments, the external O2 tension is maintained at zero, and the transport rate is determined by the intracapillary partial pressure of O2 that is proportional to the O2 half saturation pressure of hemoglobin value of the hemoglobin sample. As a result, factors that change the affinity of hemoglobin for O2, such as pH, temperature, and organic phosphate concentration, influence strongly the rate of O2 release but have little effect on the rate of O2 uptake. These properties are physiologically advantageous, since a decrease in pH or an increase in temperature during exercise increases both the rate and extent of deoxygenation while not altering the kinetics of oxygenation. PMID- 3558240 TI - Partitioning of pulmonary resistance during constriction in the dog: effects of volume history. AB - We assessed the relative changes in airways and lung tissue with bronchoconstriction, and the changes in each during and following a deep inhalation (DI). We partitioned pulmonary resistance (RL) into airway (Raw) and tissue (Vtis) components using alveolar capsules in 10 anesthetized, paralyzed, and open-chested dogs ventilated sinusoidally with 350-ml breaths at 1 Hz. We made measurements before and during bronchoconstriction induced by vagal stimulation or inhalation of histamine or prostaglandin F2 alpha (PGF2 alpha), each of which decreased dynamic compliance by approximately 40%. With histamine and PGF2 alpha the rise in RL was predominantly due to Vtis. With vagal stimulation there was a relatively greater increase in Raw than Vtis. At higher lung volumes, Vtis increases offset falls in Raw, producing higher RL at these volumes before and during constriction with PGF2 alpha and histamine. During constriction with vagal stimulation, the fall in Raw with inflation overrode the rise in Vtis, resulting in a lower RL at the higher compared with the lower lung volume. The changes seen after a DI in the control and constricted states were due to alterations in tissue properties, both viscous and elastic. However, the relative hysteresis of the airways and parenchyma were equal, since Raw, our index of airway size, was unchanged after a DI. PMID- 3558241 TI - Severe pulmonary hypertension and arterial adventitial changes in newborn calves at 4,300 m. AB - Some human newborns have a syndrome characterized by irreversible pulmonary hypertension and severe hypoxemia and by medial hypertrophy and adventitial thickening of pulmonary arteries. We considered that newborn calves made severely hypoxic might reproduce features of the human disease. When 2-day-old calves were placed at 4,300 m simulated altitude, pulmonary arterial pressure was increased and could be reversed by 100% O2. However, after 2 wk at 4,300 m, pulmonary arterial pressures were suprasystemic and there was right-to-left shunting probably through the foramen ovale and a patent but restrictive ductus arteriosus. Suprasystemic pulmonary pressure and hypoxemia persisted with 100% O2 breathing. Morphometrical examination of the lung arteries showed a markedly thickened adventitia with cellular proliferation and collagen and elastin deposition. There was increased medial thickness and distal muscularization of the pulmonary arteries associated with decreased luminal diameter. The rapid development of severe pulmonary hypertension and poor responsiveness to O2 was associated with increased arterial wall thickness, particularly involving the adventitia. Thus the pulmonary arterial circulation in these calves, which were placed at high altitude for 2 wk, exhibited features resembling persistent pulmonary hypertension in newborn infants. PMID- 3558242 TI - Automated data collection and processing for a cycle ergometer. AB - A system is described for collection and processing of data from a cycle ergometer. Cycle pedals, specially made to withstand the extremely high forces exerted during maximal power cycling, contain transducers to measure pedal angle relative to the crank and foot forces both perpendicular and parallel to the pedal surface. An additional transducer monitors crank position. Output signals are conditioned, amplified, digitized by a 12-bit analog-to-digital converter, fed into a computer at 100 Hz/channel, and mathematically smoothed to attenuate noise. For each sample interval, foot force components perpendicular and parallel to the crank arm are calculated. Power generated on each crank revolution is determined from transducer information. Computer graphics display pedaling parameters vs. crank angle in both rectangular and circular format. Data files containing variables descriptive of pedaling force curves are produced to enable computerized statistical analysis of cycling performance. PMID- 3558244 TI - A new frontier in physiology? PMID- 3558243 TI - Delayed or accelerated oxygen uptake kinetics in the transition from prior exercise? AB - Reported experimental findings are at variance with each other on the question as to whether O2 uptake (VO2) kinetics are delayed, advanced, or remain unaltered in the transition from prior exercise. Critical examination of these studies tend to suggest that not a great deal of reliance can be placed on their evidence in attempting to resolve the question. They seem to display a disregard for the theoretical properties of the VO2 kinetic model used; in some cases incorrect statistical inferences appear to have been made; most are mathematically incomplete; and the experimental designs have not been appropriately chosen so as to examine the whole question of altered VO2 kinetics. These points are detailed and discussed so that future designed experiments obtain sufficient reliable evidence with which to resolve the question. PMID- 3558245 TI - Meeting the challenge of the new frontier. PMID- 3558246 TI - Artifact in the recording of fetal heart rates during material exercise. PMID- 3558247 TI - "Pseudo" fetal bradycardia during maternal exercise. PMID- 3558248 TI - Effects of negative ions on cognitive performance. PMID- 3558249 TI - Receptivity and planned change: community attitudes and deinstitutionalization. PMID- 3558250 TI - Phytohemagglutinin-enhanced hybrid colony formation by cells from aged mice: expression of TH 4Mod-1 mouse locus in human-mouse hybrids. AB - Cells from a continuous human line and freshly isolated cells from old adult mice heterozygous at the Mod-1 locus were fused in the presence of polyethylene glycol (PEG). The production of hybrid cells, as a function of PEG concentration in the presence and absence of phytohemagglutinin (PHA), was measured by cell survival and proliferation on selective medium. The incorporation of PHA into the fusion mixture allowed cell fusion to take place at nontoxic concentrations of PEG. PHA increased the frequency of cell fusion and increased the production of viable hybrid cells from 138- to over 2800-fold depending on cell type. The results suggest that the procedure may have broad application in promoting the fusion of cells sensitive to PEG. Clones were analyzed for isozymes of malic enzyme and glucose-6-phosphate dehydrogenase. The expression of the gene encoding X-linked mouse glucose-6-phosphate dehydrogenase confirmed that the cells were hybrids. These cells lost other mouse isozymes rapidly. In those clones in which the mouse malic enzyme gene was expressed, the product of Mod-1a was detected significantly more frequently than that of Mod-1b. PMID- 3558251 TI - Vaginal and uterine stroma maintain their inductive properties following primary culture. AB - Vaginal and uterine stromal (VS and UtS) cells have been cultured in a collagen gel matrix, and the ability of the cells to retain their identity and interact normally with epithelia after culture was examined. Stromal explants from 2-d-old mice were plated onto an extracellular matrix covered with collagen, and maintained in Ham's F12:DMEM (1:1) containing 15% fetal bovine serum. The fibroblastic stromal cells invaded and eventually filled the overlying collagen during the 4-wk growth period, and the total DNA of the UtS and VS cultures increased 3.5- and 4-fold, respectively. To assess the ability of the cultured stroma to perform its normal functions after the in vitro period, recombinations of cultured stroma and fresh epithelia were prepared and transplanted under the renal capsule of female hosts and grown for 4 wk. The epithelium in recombinants of cultured VS + vaginal epithelium (VE) and cultured UtS + uterine epithelium (UtE) was histologically normal and proliferated in response to estrogen. Cultured stroma also instructively induced heterologous epithelium; VS induced UtE to undergo vaginal differentiation, and UtS induced VE to undergo uterine differentiation. These results indicate that UtS and VS retain their identity and do not irreversibly dedifferentiate in culture. Stromal cells grown in a collagen gel matrix form a functional stroma; they interact normally with epithelium after culture and express normal permissive and instructive inductive functions when reassociated with epithelium and grown in vivo. PMID- 3558252 TI - Pleiotropic changes in cycloheximide-resistant insect cell clones. AB - Somatic cell mutants resistant to drugs that interact with the eukaryotic ribosome provide a useful tool for studies on ribosome structure, function, and genetics. From Aedes albopictus (mosquito) cells, cycloheximide-resistant mutants (Cx-705 and Cx-738) that were about 30-fold more resistant to cycloheximide than the parental cells have been obtained. The observation that protein synthesis in cell-free lysates from Cx-705 and Cx-738 cells was resistant to cycloheximide led us to suspect that the alteration in these mutants might affect the ribosome. The present studies show that the cycloheximide-resistant cells grow poorly and eventually die at 34.5 degrees C, a temperature at which wild-type cells grow normally. Relative to control cells, the cycloheximide-resistant cells show increased sensitivity to G-418, another antibiotic that interacts with the eukaryotic ribosome. However, there were no differences between cycloheximide resistant cells and wild-type cells in sensitivity to puromycin, emetine, or cryptopleurine. Cx-705 cells were predominantly diploid; in contrast, the frequency of tetraploid nuclei in Cx-738 cells was about 40%. PMID- 3558253 TI - A new diploid nontumorigenic human breast epithelial cell line isolated and propagated in chemically defined medium. AB - A new, nontumorigenic human breast epithelial cell line, HMT-3522, has been established from fibrocystic breast tissue. Cells were explanted and propagated in chemically defined medium including insulin, transferrin, epidermal growth factor, hydrocortisone, estradiol, prolactin, and Na-selenite. The epithelial nature of the cell line was established by immunocytochemical detection of cytokeratins. Moreover, electronmicroscopy revealed monolayers of polarized cells connected by desmosomes and provided with apical microvilli. Milk fat globule membrane antigen, specific for the apical membrane domain of normal, luminal breast epithelial cells, was expressed only in confluent cultures where some cells overlaid others, indicating "stem cell"-like properties. After 25 to 30 passages, the cells are diploid with a few marker chromosomes and loss of chromosomes in the D-group. The cells are nontumorigenic in athymic mice; they lack estrogen receptors, and estradiol does not stimulate growth. The HMT-3522 cell line may represent a useful model for the study of breast cell differentiation and carcinogenesis in vitro. PMID- 3558256 TI - Thirty-eighth annual meeting of the Tissue Culture Association. May 27-30, 1987, Washington, D.C. Abstracts. PMID- 3558254 TI - Optimization of fetal lung organ culture for surfactant biosynthesis. AB - Lung organ culture has been a widely used system for studying differentiation and maturation of alveolar epithelium through various culture conditions. The purpose of this work was to carefully characterize in vitro lung biochemical differentiation through isolation of surfactant fraction from tissue and to search for optimal culture conditions. Fetal rat lung was explanted on the 18th gestational day for studying glycogen storage, and on the 20th gestational day for studying surfactant accretion, and cultivated for 48 h. Morphologic differentiation was studied by electron microscopy on tissue explanted on the 17th or 18th gestational days and cultivated for various times. Glycogen storage was greater on fluid medium, although less than occurring in vivo. Cellular integrity and surfactant accumulation were maximal on a semisolid medium containing 0.5% agar. Use of O2-CO2 instead of air-CO2 for gassing the explants slightly decreased phospholipid accumulation. Among media used in previous lung culture studies, Waymouth MB 752/1 was the only one to allow net glycogen accumulation in vitro. The most favorable media for surfactant phospholipid accretion were Waymouth MB 752/1, Eagle's minimum essential and its Dulbecco's modification, CMRL 1066, and NCTC 109. They allowed a 12- to 14-fold increase of surfactant fraction phospholipids in vitro, which is similar to the increase occurring in vivo during the same period. Ham's F10 and F12 media allowed a six fold increase. RPMI 1640 and medium 199 (M199) allowed only a three fold increase. Phospholipid concentration in nonsurfactant fraction only doubled during culture, and differences between various media were much less marked. DNA concentration changed little during culture. Morphologic differentiation of epithelial cells was advanced as compared with in vivo timing in a medium allowing maximal surfactant accretion (Waymouth MB 752/1) but not in a medium allowing low surfactant increase (RPMI 1640). The possible role of compositional differences between media is discussed. PMID- 3558255 TI - Characterization of a rat liver epithelial cell line to detect inhibitors of metabolic cooperation. AB - A normal rat liver epithelial cell line, with phenotype characteristics of "oval" cells (WB-F344), was examined for its ability to perform gap-junctional intercellular communication as measured by metabolic cooperation. To test for gap junctional intercellular communication, 6-thioguanine-sensitive cells were cocultivated with 6-thioguanine-resistant cells. It was found that the recovery of 6-thioguanine-resistant cells depended on the densities of the 6-thioguanine sensitive cells. Higher densities of 6-thioguanine-sensitive cells reduced the recovery of 6-thioguanine-resistant cells. These observations demonstrate that rat liver epithelial cells could metabolically cooperate, implying they could perform gap-junctional intercellular communication. Two tumor-promoting organochlorine pesticides, aldrin and dieldrin, were potent inhibitors of metabolic cooperation for these cells, but 12-0-tetradecanoyl-phorbol-13-acetate and teleocidin, known mouse skin tumor promoters, were not significantly effective in inhibiting metabolic cooperation. The results suggest that these cells might provide the basis for an in vitro assay specifically to study liver tumor promoters. PMID- 3558258 TI - On-column partition cleanup of fatty extracts for organophosphate pesticide residue determination. AB - A fast, single-step, and efficient partition between n-hexane and acetonitrile on ready-to-use, disposable mini-columns of Kieselghur-type material has been developed for the cleanup of fatty extracts for organophosphate (OP) pesticide residue determination by gas chromatography with flame photometric detection. Nine OP pesticides (diazinon, etrimfos, chlorpyrifos-methyl, pyrimiphos-methyl, chlorpyrifos, bromophos, bromophos-ethyl, malathion, fenitrothion) most commonly used for protection of stored cereals, oil seeds, and legumes were separated from up to 2.0 g lipidic material with recoveries between 80 and 107% at spiking levels ranging for the different compounds from 0.1 to 5.0 ppm. PMID- 3558257 TI - Extraction and determination by gas chromatography of S,S,S-tri-n-butyl phosphorotrithioate (DEF) in fish and water. AB - A simple, low-cost, fast method for the extraction and cleanup of DEF (S,S,S-tri n-butyl phosphorotrithioate) from fish tissues and water samples was developed. The method combines extraction and cleanup in one step. The basis of the method is passing water samples or aqueous tissue homogenates containing DEF through a C 18 disposable cartridge. DEF is eluted from the cartridge by acetone or ethyl acetate. The eluates are analyzed by gas chromatography using a thermionic specific detector. The method detects levels as low as 100 parts per trillion (ppt) in water samples; recovery efficiency from spiked fish tissues was greater than 95%. In addition, detectable levels of DEF were recovered from liver, brain, and muscle tissue of fish exposed to this compound. The method has a potential for use with other pesticides. PMID- 3558259 TI - Automated sample cleanup for pesticide multiresidue analysis. III. Evaluation of complete system for screening subtolerance residues in vegetables. AB - An automated continuous flow sample cleanup system intended for rapid screening of foods for pesticide residues in fresh and processed vegetables has been developed. Recovery and precision data for 8 pesticides in each of 3 crops are compared for the automated and manual procedures. Average recovery for samples fortified with pesticides between 0.026 and 0.277 ppm was 98% for the automated system and 92% for the manual procedure. Average coefficient of variation was 6.6% for the automated system and 4.2% for the manual procedure. In another evaluation, the automated system gave an average recovery of 95% for 12 pesticides commonly found in imported foods; the manual procedure gave an average recovery of 91%. Thus, the results obtained so far indicate that the automated system for sample cleanup gives results comparable to those obtained by manual procedures. PMID- 3558260 TI - UV spectrophotometric determination of piperine in pepper preparations: collaborative study. AB - Eight collaborating laboratories performed replicate analyses for piperine on 5 samples representing pepper raw spice, oleoresins, and soluble seasonings. Piperine is extracted into ethylene dichloride and measured at maximal absorbance 342-345 nm with a UV light source. Piperine content is calculated using an absorbance factor derived from piperine. Intralaboratory coefficients of variation (CVo) ranged from 0.5 to 3.1%; interlaboratory coefficients of variation (CVx) ranged from 3.0 to 5.8%. The method has been adopted as an official method of the American Spice Trade Association and as an official first action method by AOAC. PMID- 3558261 TI - Determination of sulfur dioxide in foods by modified Monier-Williams distillation and polarographic detection. AB - A rapid, sensitive polarographic method is presented for determining sulfiting agents in foods and beverages. The method is based on the modified Monier Williams distillation followed by polarographic detection by differential pulse polarography or square wave voltammetry. A clearly defined wave is obtained by both techniques, with a current maximum at a potential (E) of about -600 mV vs an Ag/AgCl reference electrode. The reaction is based on the reduction of sulfur dioxide at a dropping mercury electrode. Peak current was linear over the range 0 20 micrograms/mL. Quantitation is done by linear regression analysis of standard addition data or by using a standard calibration graph. Screening levels of less than 1 ppm total SO2 were easily achieved in the foods analyzed, which had levels from less than 1 ppm (cereals) to thousands of parts per million (dried fruit). Recoveries from fortified samples ranged from 70 to 108% at fortification levels of 20, 100, and 1000 micrograms/g. PMID- 3558262 TI - Measurement of trace levels of total aluminum in foods by atomic absorption spectrophotometry. AB - A graphite furnace atomic absorption spectrophotometry method was used to determine the total aluminum content of various foods found in an average American diet. The food products were ashed in platinum dishes, and the inorganic residue was fused using a sodium carbonate-sodium borate mixture. The fusion step allowed detection of all the various forms of aluminum found in food products. A L'vov platform was used in the graphite furnace to increase the sensitivity of the assay. Care was taken throughout the analysis to avoid various sources of aluminum contamination such as glass and porcelain dishes. All reagents were ultra-pure grade and were continuously monitored for aluminum content. Sodium borate used in the fusion flux mixture had previously been extracted with 8 hydroxyquinoline in chloroform to remove any aluminum present. Both raw and cooked foods were analyzed for aluminum with this method. Average recoveries of aluminum from food products ranged from 84 to 112%. The overall coefficient of variation of this method on the food products tested was 10%. PMID- 3558263 TI - Liquid chromatographic determination of cyclopiazonic acid in poultry meat. AB - A liquid chromatographic procedure has been developed for the determination of cyclopiazonic acid (CPA) in poultry meat. CPA is extracted from ground meat with chloroform-methanol (80 + 20), partitioned into 0.1N sodium hydroxide, acidified, and extracted into dichloromethane. An interfering component of meat is removed by transferring the dichloromethane extract to a minicolumn containing silica gel and washing the column with petroleum ether and chloroform. CPA is eluted with methanol-acetic acid (99 + 1), and subjected to ligand-exchange liquid chromatography. Recovery of CPA from 40 separate samples of meat spiked with CPA at levels from 0.016 to 15.6 ppm was 70.4 +/- 14.1%. Analysis of meat from a chicken orally dosed with 10 mg CPA/kg body weight revealed that 14.5% of the dose was in muscle 48 h after administration. PMID- 3558264 TI - Cyclopiazonic acid production by cultures of Aspergillus and Penicillium species isolated from dried beans, corn meal, macaroni, and pecans. AB - Ninety-five isolates of Aspergillus and Penicillium species from selected dried foods were examined for their ability to produce cyclopiazonic acid (CPA). The isolates were grown in sterile synthetic liquid medium at 28 degrees C for 8 days in the dark. The medium and mold mycelia were then extracted with chloroform. CPA was semiquantitatively determined by thin layer chromatography through visual comparison with standards. The cultures of A. flavus were also examined for their ability to produce aflatoxin. One A. tamarii and all 13 P. urticae isolates produced CPA, whereas only 19 of the 31 (61%) A. flavus isolates produced CPA, and 6 (19%) A. flavus produced aflatoxin. All 13 P. urticae isolates also produced patulin and griseofulvin. CPA-producing A. flavus was found in all food types but not in all samples. CPA-producing P. urticae was found only in dried beans and macaroni. PMID- 3558265 TI - Isolation and liquid chromatographic determination of the cyclic peptide mycotoxin cyclosporin A from rice. AB - A simple method for determination and quantitation of a cyclic peptide mycotoxin, cyclosporin A, in rice is presented. Rice inoculated with Trichoderma polysporum (Link ex Pers.) was extracted with methylene chloride after 4 weeks of incubation. Cyclosporin A was isolated from extracts by using open bed gel filtration column chromatography (LH-20, acetonitrile) and monitored with thin layer chromatography and reverse phase liquid chromatography coelution with a standard. Preliminary thin layer chromatographic methods were developed. Cyclosporin A was detected by iodine and after partial acid hydrolysis by ninhydrin and UV light. A liquid chromatographic method was developed that used a reverse phase disposable cartridge cleanup and isocratic chromatography with a reverse phase octadecylsilica column and a UV detector set at 212 nm. Recovery of cyclosporin A from spiked rice samples (mg/g range) was 85%. PMID- 3558266 TI - Fast and sensitive screening method for detection of trichothecenes in maize by using protein synthesis inhibition in cultured fibroblasts. AB - A fast and sensitive bioassay with hamster (BHK-21 C13) fibroblasts for the detection of toxic trichothecenes in maize is described. Cells are exposed to pure toxins or crude maize extracts for 30 min. The mixture is then incubated with [1-14C]-leucine for an additional 60 min and the radioactivity incorporated into the protein of the washed cells is determined. The sensitivity of the assay was in the range 1-10 ng/mL (or 50 ppb in maize) for T-2, HT-2, and diacetoxyscirpenol. At least 1000-fold higher concentrations of non-trichothecene mycotoxins and plant toxins were necessary to cause an inhibition of protein synthesis in the cells. Of 24 maize samples tested, 14 gave a positive response in this assay and the presence of trichothecenes could be confirmed chemically in 11 samples. Therefore, the described bioassay is proposed as a useful screening method for cytotoxic trichothecenes in maize. PMID- 3558267 TI - Mass spectral investigations on trichothecene mycotoxins. II. Detection and quantitation of macrocyclic trichothecenes by gas chromatography/negative ion chemical ionization mass spectrometry. AB - A general, sensitive gas chromatographic/negative ion chemical ionization mass spectrometric (GC/NICIMS) method of analysis was developed for the detection and quantitation of several polar, thermally labile, toxic macrocyclic trichothecenes. The procedure involves the conversion of the molecules to their corresponding alcohols (verrucarols) by alkaline hydrolysis, followed by derivatization of the hydrolysate with heptafluorobutyrylimidazole and analysis by GC/MS technique under negative ion chemical ionization conditions. Nanogram (250 ng) quantities of several macrocyclic trichothecenes with different verrucarol and ester moieties were analyzed successfully with good precision by this procedure. The method was applicable for the accurate determination of at least low ppb levels of these macrocyclic trichothecenes in environmental samples, such as fungal products, fermentation broths, and plant samples. This is the first reported, well developed, sensitive, and applicable method for the detection and quantitation of these compounds in naturally occurring samples. PMID- 3558268 TI - Symposium on chromatography of amino acids. 99th annual international meeting of AOAC (Association of Official Analytical Chemists). October 1985. PMID- 3558269 TI - Gas chromatographic analysis of amino acids as the N-heptafluorobutyryl isobutyl esters. AB - The N-heptafluorobutyryl isobutyl derivatives of proteic amino acids are well resolved by gas chromatography and form the basis of a convenient, rapid assay. The derivatives are prepared by acid-catalyzed esterification at 120 degrees C for 20 min in 3N HCl-isobutanol followed by acylation with heptafluorobutyric anhydride at 150 degrees C for 10 min. The reaction sequence is performed without any transfers or extractions and thus is compatible with microscale analysis. A complete proteic amino acid profile can be completed in less than 20 min by using a packed column or less than 10 min by using a capillary column in combination with an elevated oven temperature program rate. Physiological sample matrixes, which frequently contain a complex mixture of components, and thus require maximum resolution, can be assayed in less than 1 h using a program rate of 4 degrees C/min. A capillary column is recommended for this application. Capillary column chromatography, in combination with a nitrogen-specific detector, is useful for identifying and assaying nonproteic amino acids in physiological sample matrixes. Frequently, a prior cleanup of the sample can be avoided. PMID- 3558270 TI - Analysis of amino acids by gas chromatography as the N-trifluoroacetyl n-butyl esters. AB - This presentation describes amino acid analysis with the gas chromatographic method and experimental conditions using the N-trifluoroacetyl n-butyl ester derivatives; the study we describe here was undertaken to compare gas chromatographic (GC) and ion-exchange chromatographic (IEC) analyses of amino acids in hydrolysates of 9 diverse sample types to gain insight into effects of these 2 chromatographic methods of analysis on variation in amino acid results. Our study showed that values for samples prepared by 2 separate laboratories using the same procedure were generally in good agreement when all of the hydrolysates were analyzed by a single laboratory using a single method of analysis. To compare results from gas chromatography with those from ion-exchange chromatography analyses were performed by 2 different laboratories on the same hydrolysates and on different hydrolysates prepared by the same method by both laboratories. The data demonstrate that GC and IEC can be expected to yield essentially identical results when applied to the same hydrolysate. Agreement is so close that interlaboratory differences in hydrolysate preparation of the same sample contribute as much to variation in amino acid results as does the method of analysis, a fact which should be noted in planning collaborative studies. PMID- 3558271 TI - Headspace gas chromatographic determination of residual 1,3-butadiene in rubber modified plastics and its migration from plastic containers into selected foods. AB - A headspace gas chromatographic procedure has been developed for the determination of 1,3-butadiene in rubber-modified plastics and in some foods. Polymer solutions or foods are equilibrated in sealed vials at 90 degrees C, and headspace samples are injected into a gas chromatograph. 1,3-Butadiene residues are measured using a flame ionization detector and are quantitated by the method of standard additions or an external calibration curve. Refrigerator tubs, vegetable oil bottles, chewing gum, and foods in contact with this type of packaging were analyzed. Limits of quantitation varied with the matrix, ranging from 2 ng/g (ppb) in chewing gum to 20 ng/g in polymers. 1,3-Butadiene was found in one polymer at 53 ng/g with an 8% coefficient of variation. The procedure yields "apparent" trace levels of 1,3-butadiene, and confirmation by a complementary technique is required. PMID- 3558272 TI - Rapid determination of methyl mercury in fish and shellfish: method development. AB - The AOAC official first action method for methyl mercury in fish and shellfish was modified to provide more rapid determination. Methyl mercury is isolated from homogenized, acetone-washed tissue by addition of HCl and extraction by toluene of the methyl mercuric chloride produced. The extract is analyzed by electron capture gas chromatography (GC) on 5% DEGS-PS treated with mercuric chloride solution. The quantitation limit of the method is 0.25 micrograms Hg/g. Swordfish, shark, tuna, shrimp, clams, oysters, and NBS Research Material-50 (tuna) were analyzed for methyl mercury by the AOAC official first action method. All products also were analyzed by the modified method and the AOAC official method for total Hg. In addition, selected extracts obtained with the modified method were analyzed by GC with Hg-selective, microwave-induced helium plasma detection. There was no significant difference between the results for the various methods. Essentially all the Hg present (determined as total Hg) was in the organic form. Coefficients of variation from analyses by the modified method ranged from 1 to 7% for fish and shellfish containing methyl mercury at levels of 0.50-2.30 micrograms Hg/g. The overall average recovery was 100.5%. PMID- 3558273 TI - Most probable number method for isolation and enumeration of Staphylococcus aureus in foods: collaborative study. AB - Enumeration of Staphylococcus aureus in foods was collaboratively studied by comparing the present AOAC final action method, 46.062, which uses trypticase soy broth with 10% NaCl to a proposed replacement method which uses the same broth with 1% sodium pyruvate added. Fifteen collaborators analyzed uninoculated samples of milk, tuna salad, and ground turkey, as well as samples inoculated with low (10(2) cells/g), middle (10(4) cells/g), and high (10(6) cells/g) levels of S. aureus. The samples were frozen immediately to maintain the inoculated level of S. aureus in the food. A different strain of S. aureus was used for each food; heat-stressed S. aureus cells were used to inoculate the milk samples. The pyruvate-amended broth significantly (alpha = 0.05) increased enumeration of low, middle, and high levels of S. aureus from milk and ground turkey, and from tuna salad at middle and high levels. The pyruvate-amended media method has been adopted official first action to replace method 46.062. PMID- 3558274 TI - Ultraviolet spectrophotometric determination of hydralazine hydrochloride in tablets following derivatization with nitrite. AB - Routine use of the USP XXI spectrophotometric method for the content uniformity determination of hydralazine hydrochloride tablets has shown that tablet excipients can significantly alter the spectral characteristics of the drug and thus cause inaccurate assay values to be obtained. Because of this problem, a simple and reliable alternative spectrophotometric assay method, based on the conversion of hydralazine to tetrazolo [5,1-alpha]phthalazine with nitrite ions under acidic conditions, was developed. The derivative showed an absorption maximum at about 274 nm and obeyed Beer's law over the concentration range 4-40 micrograms/mL. Mean recoveries of hydralazine hydrochloride added to commercial coated and uncoated tablets were 101.0% (n = 10) and 100.8% (n = 8), respectively. The proposed method was found suitable for the assay not only of individual tablets but also of tablet composites. PMID- 3558275 TI - Determination of N-nitrosodimethylamine levels in some Canadian 2,4-D amine formulations. AB - Levels of N-nitrosodimethylamine (NDMA) were determined in 112 samples of 2,4 dichlorophenoxyacetic acid, (2,4-D), formulated as the dimethylamine salt, collected over a 2 year period from products on the Canadian market. A sample aliquot is partitioned with dichloromethane, and the co-extracted dimethylamine is removed by cleanup on a silica gel column. The eluates containing NDMA are concentrated, an internal standard of N-nitrosodipropylamine is added, and nitrosamine levels are determined using a gas chromatograph interfaced with a thermal energy analyzer. Recoveries of NDMA and N-nitrosodiethylamine spiked into samples were 103 +/- 16 and 96.3 +/- 9.8%, respectively. Of the 112 samples analyzed, 92 were below 1 part per million (ppm) relative to the amount of 2,4-D in the samples, 16 were between 1 and 5 ppm, and 4 were greater than 5 ppm. The gas chromatographic column used is compared to a conventional packing material for volatile nitrosamine analysis. Formation of NDMA during cleanup and analysis was shown not to occur. PMID- 3558276 TI - Liquid chromatographic determination of saccharin in beverages and sweets: NMKL Collaborative Study. AB - A reverse phase liquid chromatographic method for the determination of saccharin in a soft drink and a juice was collaboratively studied in 8 laboratories. Collaborators were supplied with 3 samples of the soft drink and 3 samples of the juice containing sodium saccharin levels of 40-100 mg/L. Average recoveries of sodium saccharin were 95.3% for the soft drink and 98.0% for the juice. The reproducibility coefficients of variation were 16.9% for the soft drink and 10.4% for the juice. In addition, a mini-collaborative study was conducted for the determination of saccharin in 3 samples of sweets produced commercially. Five collaborators analyzed the samples, which contained saccharin at levels of 100 600 mg/kg according to the maker's specifications. Saccharin was extracted with water and ethanol and chromatographed using a modified liquid chromatographic method. The reproducibility coefficient of variation was 12.4% for the sweets. PMID- 3558277 TI - Phosphorus in wine: comparison of atomic absorption spectrometry methods. AB - Phosphorus in wine may be determined directly or indirectly by atomic absorption spectrometry. The direct method uses the carbon rod atomizer as the excitation source and a phosphorus hollow cathode lamp. In the indirect determination, one measures the amount of molybdenum that will complex with phosphorus in the wine. Both nitrous oxide-acetylene and air-acetylene flames are suitable as atomization sources in this indirect method. The resultant data have been compared with those from the AOAC colorimetric method (11.032-11.034). A 2-sample comparison test showed the results to be insignificantly different at the 95% confidence limits. PMID- 3558278 TI - Gas chromatographic-thermal energy analysis method for determination of volatile N-nitrosamines in baby bottle rubber nipples: collaborative study. AB - A collaborative study was conducted on the U.S. Food and Drug Administration (FDA) dichloromethane extraction method for determining volatile N-nitrosamines in baby bottle rubber nipples. Following dichloromethane extraction, N nitrosamines were determined by gas chromatography-thermal energy analysis. Six pairs of blind duplicate rubber nipple samples representing 6 lots were analyzed by 11 collaborating laboratories. All samples were portions taken from equilibrated composites of cut-up rubber nipples obtained from manufacturers in the United States. Recoveries of the internal standard (N-nitrosodipropylamine) at approximately 20 ppb ranged from 10 to 120%. Reproducibility relative standard deviations (RSDx) were between 35 and 45% for N-nitrosamine levels from 10 to 20 ppb. However, when data from laboratories with recoveries less than 75% were excluded (this is now specified in the method), RSDx values were between 11 and 32% for N-nitrosamine levels from 6 to 26 ppb. Values were consistent with or better than those reported for other analytical techniques designed to quantitate trace contaminants at the low ppb level, e.g., aflatoxin in foods. The method has been adopted official first action for the quantitation of volatile N nitrosamines in baby bottle rubber nipples. PMID- 3558279 TI - Determination of nitrogen and protein content of meat and meat products. AB - Chemical and instrumental methods for determination of nitrogen and protein are reviewed for their mode of action and utility in analysis of meat proteins and products. Although the Kjeldahl digestion method is satisfactory for determining total nitrogen, it is imprecise for determining total protein content. Presence of variable amounts of nonprotein nitrogenous components and of connective tissue proteins such as collagen and elastin produces error if the formula (N X 6.25) is used to calculate crude protein. Such fibrous proteins have higher nitrogen levels (over 18%) than other muscle proteins (about 16%), and a higher than actual protein value will be determined unless a lower conversion factor is used to correct for their content. To determine meat protein content more accurately, a combination of Kjeldahl determination with one or more additional tests to correct for nonprotein and fibrous protein content is recommended. The choice of the additional method(s) is based on the user's requirement for protein characterization, available time, type of meat product, and sample size. PMID- 3558280 TI - Symposium on critical analysis of analytical methods for meat foods. 99th annual international meeting of AOAC (Association of Official Analytical Chemists). October 1985. PMID- 3558281 TI - Determination of total lipid and lipid subclasses in meat and meat products. AB - Current interest in physiological and nutritional activities of the sterol, polyunsaturated fatty acid, and polar lipid fractions of meats and other foods indicates that analytical methods for lipids should be evaluated on their ability to recover and quantitate these classes. Current methods of lipid isolation furnish an extract that is dependent on the solvent(s) used, the type of food material, the temperature of extraction, and the relative proportions of the lipid classes present. Extraction with ethers or other relatively nonpolar solvents removes principally the neutral fats and nonpolar lipids. For an approximation of the crude fat content, such extraction is often sufficient, because the nonpolar fraction generally constitutes over 90% of the total lipids present. The polar lipids include the biochemically important (omega-3) and (omega-6) polyunsaturated fatty acid classes; thus, the method of lipid extraction of food products becomes relevant for a more complete and valuable characterization of their nutritional value. The various methods of lipid determination for meat products are examined for their total recovery of these important lipid groups. A sequential extraction in conjunction with subsequent analytical methods is recommended. PMID- 3558282 TI - Chemical analysis of meat products. AB - Meat, particularly muscle tissue, is basically a 3-component system of protein, moisture, and fat. Although this seems a simple analytical system in which to monitor product composition for regulatory compliance, the simplicity quickly erodes when meat is formulated into the broad variety of products commercially available today. Alternative protein sources, as well as preservatives, binders, extenders, emulsifiers, spices, and other flavoring ingredients, add to the analytes of concern and highlight the need for analytical methods suitable to support inspection and labeling requirements to ensure product compliance. Some key issues are noted which involve protein quality analysis, rapid compositional analysis, isolated soy protein analysis, and minced fish in meat products. PMID- 3558283 TI - Amino acid analysis for meat protein evaluation. AB - The Food Safety and Inspection Service procedure for determination of essential amino acid content of mechanically processed products from red meat animals and poultry is based on hydrolysis of a powder prepared by blending samples in acetone-chloroform. The hydrolysis procedure incorporates thioglycolic acid to prevent loss of tryptophan. Aliquots of prepared hydrolysates are injected into a liquid chromatographic system, using gradient elution on an ion-exchange column for separation. The system also uses post-column hypochlorite oxidation coupled with orthophthalaldehyde reagent and fluorescence detection. Modification of the elution program allows concurrent determination of tryptophan with minimal added cost. Chromatograms from beef, pork, and poultry products show adequate separation and quantitation of beta-alanine, 1-methyl-histidine, and 3-methyl histidine, indicating that the procedure could be used to estimate muscle content of products. A colorimetric procedure for assay of hydroxyproline was introduced and validated as an adjunct method for protein quality estimation. PMID- 3558284 TI - Determination of soy in meat. AB - A number of methods may be used for determining soy flour in meat products. Highly purified soy products are more difficult to determine because the nonprotein components used to quantify the flour are reduced. Immunoassays have been used to directly measure protein content of soy products. Immunological methods for determination of soy proteins in meat are complicated by changes in the structure of the soy proteins during processing. These changes alter the available epitopes, changing the immunoreactivity of soy proteins. The epitopes available are dictated by the details of the processing. Other workers circumvented this problem by denaturing the soy protein with urea and mercaptoethanol, and then removing these agents by dialysis; whatever the initial protein conformation, all soy samples came to the same final conformation after the denaturing agents were removed. The assay used antibody made against the "renatured protein." These steps made the assay long and laborious. Attempts to develop a rapid assay were complicated by the same protein denaturation problems. Sodium dodecylsulfate gel electrophoresis coupled with immunoblotting may be the best quantitative approach. PMID- 3558285 TI - Marine fish as source of protein supplement in meat. AB - For the past 2 decades, a great deal of research has been done in fish technology, particularly in the area of mechanically deboned minced fish. Minced fish is the edible muscle flesh of fish that has been mechanically separated from the bones and skin. Ideally, the product is prepared from a high quality fish and resembles hamburger meat. In its final form, minced fish is used either as an ingredient or as an extender in seafood or in food products that require further processing. On the basis of technological advancements, the National Marine Fisheries Service of the U.S. Department of Commerce and the National Fisheries Institute jointly petitioned the U.S. Department of Agriculture in 1980 to add minced fish at a level of 15% in the meat formulation of frankfurters. This paper explores certain aspects of processing, production, acceptance, and hazard assessment of minced fish ingredients as possible protein supplements in meat and poultry food products relative to this request. PMID- 3558286 TI - Rapid methods for determination of meat composition. AB - Rapid analytical procedures are needed to determine the total protein, moisture, and fat content of meat and poultry products. During the past 5 years, the U.S. Department of Agriculture (USDA) has been studying various methods involving instrumentation that test for these constituents either in combination or separately. The studies are initiated on request of the Department or the instrumentation manufacturer and are conducted at the manufacturers' facilities using 2 sets of samples preanalyzed by conventional means. One set, with values, is used for calibration purposes, the other set is tested as unknown samples. The resultant data are evaluated statistically vs the conventional test results. Most studies show the usefulness of these rapid tests for product quality control, but some fall short of regulatory requirements because of unacceptable bias or variability. Typical within-product standard deviations obtained in rapid methods instrumentation tests have ranged from 0.47 to 0.67 for percent total protein, 0.73 to 1.71 for moisture, and 0.41 to 1.14 for fat. For conventional methods, the acceptable USDA performance criteria for repeatability are standard deviations of less than 0.24 for protein, 0.46 for moisture, and 0.63 for fat. Improvements in instrumentation are being made and studies continue. PMID- 3558287 TI - The social behavior of autistic children with younger and same-age nonhandicapped peers. AB - Results of a study observing autistic children's interactions with nonhandicapped and autistic peers are reported. Six 8- to 12-year-old autistic children played in dyads with younger, normally developing kindergarten children and with nonhandicapped peers matched on chronological age for 10 15-minute sessions spaced over 3 weeks and then with a playmate of the alternate age for another 10 sessions. After intervention, all subjects showed gains in proximity, orientation, and responsiveness when playing with nonhandicapped peers and with autistic classmates. Same-age nonhandicapped playmates initiated more frequently than did younger nonhandicapped playmates and were better able to modify their initiations in ways that increased the likelihood of response from the autistic children. PMID- 3558288 TI - Empirically derived subclassification of the autistic syndrome. AB - A method is presented for empirical subclassification of autistic and autisticlike children, based on observations of current behavior. The advantage of the method is that it identifies profiles of co-occurring behaviors and accordingly assigns children to subtypes. The subtypes are more clinically homogeneous than the overall sample of autistic children. Preliminary findings are presented, including an effort to validate the subclasses by suggesting possible relationships between subtype membership and perinatal markers, developmental milestones, and independent measures of concurrent behavior. PMID- 3558289 TI - Ontogeny of communicative functions in autism. AB - Autistic children have been stereotyped as noncommunicative and noninteractive; however, this may be partly attributed to traditional research approaches that do not consider the intentions of the child or the context of the social interaction. This discussion reviews some recent investigations that have used a developmental pragmatics framework to study language and communicative behaviors associated with autism. A working model of the ontogeny of communicative functions in autistic children is proposed. The communicative profile associated with autism is explained by factors related to the child's language-learning environment, as well as factors inherent in the child. Clinical implications for the design of language intervention programs for autistic children are offered. PMID- 3558290 TI - The development of normal and autistic children: a comparative study. AB - This study tests the hypothesis that the development of normal and autistic children differs only in rate and asymptote. A total of 195 normal children between 1 and 5 years of age, 160 normal children between 3 months and 24 months of age, and 41 autistic children between 5 and 11 years of age were evaluated on the eight psychological variables constituting the Behavioral Rating Instrument for Autistic and other Atypical Children (BRIAAC). While many similarities were found, there were a sufficient number of differences to justify DMS-III's statement that certain autistic behaviors are not normal at any stage of development. Differences were particularly prominent when the development of normal infants was compared with that of severely disturbed autistic children. In general, the issue of whether deviant development differs only quantitatively from normal development can best be decided on the basis of developmental data and by utilizing instruments that sample all the major characteristics of both populations. PMID- 3558291 TI - Joint attention and language in autism and developmental language delay. AB - The relationship of gestural joint attention behaviors and the development of effective communication skills in autism and developmental language delay (DLD) was investigated. Autistic and DLD children matched for MA and MLU were compared on measures of gestural joint attention behavior, personal pronoun use, and spontaneous communicative behavior. DLD children responded correctly to joint attention interactions more often than autistic children, and their spontaneous gestural behavior was more communicative and developmentally advanced. Correct production of "I/you" pronouns was related to number of spontaneous initiations for autistic but not for DLD children. Measures of spontaneous joint attention behaviors were in general not related to MA, CA, or MLU for either group. DLD children's performance suggests no special impairment of joint attention skills, whereas autistic children's performance suggests a joint attention deficit in addition to a language deficit. PMID- 3558292 TI - A chart review of schizotypal personality disorders in children. AB - The objectives of this paper are to review the literature on the diagnostic validity of schizotypal personality disorders (SPD) in childhood and to present the results of a chart review of 20 DMS-III-defined SPD children. The literature on this disorder is relatively limited, and although there is some agreement on clinical presentation, various authors have used different diagnostic labels. The DSM-III criteria for SPD appear to have acceptable content validity, but whether these are the best criteria for identifying a disorder with a particular etiology and natural history has not been investigated. The chart review on 20 SPD children presents information on early history, family background, neurodevelopmental impairments, and the degree of overlap with other, better established diagnoses. On the basis of the chart review, suggestions for further research on the diagnostic validity of SPD are made. PMID- 3558293 TI - Onset at age 14 of a typical autistic syndrome. A case report of a girl with herpes simplex encephalitis. PMID- 3558294 TI - A 4- to 7-year questionnaire follow-up of participants in a training program for parents of autistic children. PMID- 3558295 TI - Preliminary evidence for multiple etiologies in autism. PMID- 3558296 TI - Disease modifying drugs in rheumatoid arthritis--what do they actually do? PMID- 3558297 TI - Acute effect of sublingual nifedipine on right and left ventricular function in patients with chronic cor pulmonale. PMID- 3558298 TI - Nifedipine in angina and blood glucose levels in diabetics. PMID- 3558299 TI - Medical intensive care. PMID- 3558300 TI - Assessment of asymptomatic coronary artery disease in diabetes mellitus. PMID- 3558301 TI - A comparative therapeutic trial of cimetidine and ranitidine in the treatment of duodenal ulcer. PMID- 3558302 TI - Dinitrochlorobenzene test in sarcoidosis. PMID- 3558303 TI - Shikata cells (HBsAg) in chronic liver diseases in Bundelkhand region. PMID- 3558304 TI - Platelet adhesiveness in diabetes mellitus with and without vascular complications. PMID- 3558305 TI - HLA and diabetes mellitus. PMID- 3558306 TI - Syndromes: imposters, gate-crashers and thrown outs in medicine. PMID- 3558307 TI - Two-dimensional contrast echocardiography in the diagnosis of atrial septal defect. PMID- 3558308 TI - "Fibroplastic parietal endocarditis with eosinophilia (Loeffler's endocarditis)". PMID- 3558309 TI - Mitral valve prolapse with cerebrovascular accident in a young patient. PMID- 3558310 TI - Pycnodysostosis. PMID- 3558311 TI - Pacemaker exit block. PMID- 3558312 TI - Adult haemolytic-uraemic syndrome (HUS). PMID- 3558313 TI - Recurrent acute tuberculous perforations of small intestine associated with miliary tuberculosis of lung. PMID- 3558314 TI - Agenesis of lung with pulmonary hypertension. PMID- 3558315 TI - Roundworms and pancreatitis. PMID- 3558316 TI - Carotid sinus massage. PMID- 3558317 TI - Antidepressants in peptic ulcer. PMID- 3558318 TI - Nickel uptake in Bradyrhizobium japonicum. AB - Free-living Bradyrhizobium japonicum grown heterotrophically with 1 microM 63Ni2+ accumulated label. Strain SR470, a Hupc mutant, accumulated almost 10-fold more 63Ni2+ on a per-cell basis than did strain SR, the wild type. Nongrowing cells were also able to accumulate nickel over a 2-h period, with the Hupc mutant strain SR470 again accumulating significantly more 63Ni2+ than strain SR. These results suggest that this mutant is constitutive for nickel uptake as well as for hydrogenase expression. The apparent Kms for nickel uptake in strain SR and strain SR470 were found to be similar, approximately 26 and 50 microM, respectively. The Vmax values, however, were significantly different, 0.29 nmol of Ni/min per 10(8) cells for SR and 1.40 nmol of Ni/min per 10(8) cells for SR470. The uptake process was relatively specific for nickel; only Cu2+ and Zn2+ (10 microM) were found to appreciably inhibit the uptake of 1 microM Ni, while a 10-fold excess of Mg2+, Co2+, Fe3+, or Mn2+ did not affect Ni2+ uptake. The lack of inhibition by Mg2+ indicates that nickel is not transported by a magnesium uptake system. Nickel uptake was also inhibited by cold (53% inhibition at 4 degrees C) and slightly by the ionophores nigericin and carbonyl cyanide m chlorophenylhydrazone. Other ionophores did not appreciably affect nickel uptake, even though they significantly stimulated O2 uptake. The cytochrome c oxidase inhibitors azide, cyanide, and hydroxylamine did not inhibit Ni2+ uptake, even at concentrations (of cyanide and hydroxylamine) that inhibited O2 uptake. The addition of oxidizable substrates such as succinate or gluconate did not increase nickel uptake, even though they increased respiratory activity. Nickel update showed a pH dependence with an optimum at 6.0. Most (approximately 85%) of the 63Ni2+ taken up in 1 min by strain SR470 was not exchangeable with cold nickel. PMID- 3558319 TI - Lipopolysaccharides of Pseudomonas spp. that stimulate plant growth: composition and use for strain identification. AB - The outer membrane proteins of a series of fluorescent, root-colonizing, plant growth-stimulating Pseudomonas spp. having been characterized (L. A. de Weger et al., J. Bacteriol. 165:585-594, 1986), the lipopolysaccharides (LPSs) of these strains were examined. The chemical composition of the LPSs of the three best studied plant-growth-stimulating Pseudomonas strains WCS358, WCS361, and WCS374 and of P. aeruginosa PAO1 as a reference strain was determined and appeared to differ from strain to strain. The 2,6-dideoxy-2-aminosugar quinovasamine was the most abundant compound in the LPS of strain WCS358. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of purified LPS and of proteinase K treated cell envelopes revealed ladderlike patterns for most of these strains. These patterns were not substantially influenced by differences in culture conditions. Analysis of proteinase K-treated cell envelopes of 24 root-colonizing Pseudomonas spp. revealed a unique band pattern for each strain, suggesting a great variety in the LPS structures present in these root colonizers. Therefore, electrophoretic analysis of LPS can be used for characterization and identification of the fluorescent root-colonizing Pseudomonas strains. PMID- 3558320 TI - Bioenergetic consequences of lactose starvation for continuously cultured Streptococcus cremoris. AB - Streptococcus cremoris cells that had been grown in a chemostat were starved for lactose. The viability of the culture remained essentially constant in the first hours of starvation and subsequently declined logarithmically. The viability pattern during starvation varied with the previously imposed growth rates. The death rates were 0.029, 0.076, and 0.298 h-1 for cells grown at dilution rates of 0.07, 0.11 and 0.38 h-1, respectively. The proton motive force and the pools of energy-rich phosphorylated intermediates in cells grown at a dilution rate of 0.10 h-1 fell to zero within 2 h of starvation. The culture, however, remained fully viable for at least 20 h, indicating that these energy-rich intermediates are not crucial for survival during long-term lactose starvation. Upon starvation, the intracellular pools of several amino acids depleted with the proton motive force, while large concentration gradients of the amino acids alanine, glycine, aspartate, and glutamate were retained for several hours. A quantitative analysis of the amino acids released indicated that nonspecific protein degradation was not a major cause of the loss in viability. The response of the energy metabolism of starved S. cremoris cells upon refeeding with lactose was monitored. Upon lactose starvation, the glycolytic activity and the rate of proton motive force generation decreased rapidly but the steady-state level of the proton motive force decreased significantly only after several hours. The decreasing steady-state level of the proton motive force and consequently the capacity to accumulate amino acids after the addition of lactose correlated well with the loss of viability. The response of the energy metabolism of starved S. cremoris cells upon refeeding with lactose was monitored. Upon lactose starvation, the glycolytic activity and the rate of proton motive force generation decreased rapidly but the steady-state level of the proton motive force decreased significantly only after several hours. The decreasing steady state level of the proton motive force and consequently the capacity to accumulate amino acids after the addition of lactose correlated well with the loss of viability. It is concluded that a regulatory loss of glycolytic capacity has pivotal role in the survival of S. cremoris under the conditions used. PMID- 3558321 TI - Copurification and characterization of deacetoxycephalosporin C synthetase/hydroxylase from Cephalosporium acremonium. AB - Deacetoxycephalosporin C synthetase (expandase), which catalyzes ring expansion of penicillin N to deacetoxycephalosporin C (DAOC), has been stabilized in vitro and purified to near homogeneity from the industrially important fungus Cephalosporium acremonium. Throughout the purification, the expandase activity remained physically associated with and in a constant ratio of 7:1 to DAOC hydroxylase activity. The latter activity mediates hydroxylation of DAOC to deacetylcephalosporin C (DAC). The copurified expandase/hydroxylase appeared to be monomeric, with a molecular weight of 41,000 +/- 2,000 and an isoelectric point of 6.3 +/- 0.3. Both catalytic activities required alpha-ketoglutarate, Fe2+, and O2 and were stimulated by ascorbate, dithiothreitol, and ATP. The Fe2+ requirement was specific, and sulfhydryl groups in the purified protein were apparently essential for both ring expansion and hydroxylation. The kinetics and stoichiometry of DAOC/DAC formation from the expandase/hydroxylase-catalyzed reactions suggested that ring expansion of penicillin N preceded hydroxylation of DAOC. PMID- 3558323 TI - Agrobacterium tumefaciens-mediated transformation of the monocot genus Gladiolus: detection of expression of T-DNA-encoded genes. AB - Agrobacterium tumefaciens was capable of directing the transformation of Gladiolus sp., a monocot genus belonging to the family Iridaceae. Only strains capable of transferring T-DNA formed tumors, sections of which could be cultured in phytohormone-free media. Opine synthase activities were also observed in homogenates made from these tumors. PMID- 3558322 TI - Purification and properties of methylamine dehydrogenase from Paracoccus denitrificans. AB - Methylamine dehydrogenase from Paracoccus denitrificans was purified to homogeneity in two steps from the periplasmic fraction of methylamine-grown cells. The enzyme exhibited a pI value of 4.3 and was composed of two 46,700 dalton subunits and two 15,500-dalton subunits. Each small subunit possessed a covalently bound pyrrolo-quinoline quinone prosthetic group. The amino acid compositions of the large and small subunits are very similar to those of other methylamine dehydrogenases which have been isolated from taxonomically different sources. The enzyme was able to catalyze the oxidation of a wide variety of primary aliphatic amines and diamines, but it did not react with secondary, tertiary, or aromatic amines. The enzyme exhibited optimal activity at pH 7.5, with Km values of 12.5 microM for methylamine and 156 microM for phenazine ethosulfate and a Vmax of 16.9 mumol/min per mg of protein. No loss of enzyme activity was observed after incubation for 48 h at pH values ranging from 3.0 to 10.5, and the enzyme was very stable to thermal denaturation. Enzyme activity and immunological detection of each subunit were only observed with cells which had been grown on methylamine as a carbon source. PMID- 3558324 TI - Characterization of a novel TOL-like plasmid from Pseudomonas putida involved in 1,2,4-trimethylbenzene degradation. AB - A strain of Pseudomonas putida (TMB) was found to resemble P. putida mt-2 (PaW1) in its ability to degrade 1,2,4-trimethylbenzene, toluene, m-xylene, and p-xylene via oxidation of a methyl substituent and reaction of the meta fission pathway, but a different regulatory model is suggested. The ability of P. putida TMB to degrade these substrates was encoded by plasmid pGB (85 kilobase pairs), which showed considerable differences in size, restriction patterns, and DNA sequence from those of plasmid pWWO of strain PaW1. PMID- 3558325 TI - Physical complaints are part of the core depressive syndrome: evidence from a cross-cultural study in Israel. AB - To clarify whether physical complaints are primary or secondary phenomena in depression, Israeli inpatients of Western and Oriental origin suffering from depressive and nondepressive illnesses were compared using the self-reported Physical Complaints List. There were no differences based on ethnic origin. Depressed patients scored higher than controls. The data support the view that subjective physical distress is part of the core depressive syndrome and that, for severe psychiatric illnesses at least, cultural factors are secondary phenomena affecting expression of physical symptoms and the emphasis placed on physical symptoms by patient and physician. PMID- 3558326 TI - Capgras' syndrome: the delusion of substitution. AB - The English and French literature on Capgras' syndrome yielded 315 patients, 212 of whom provided the basis for review. Forty-six percent presented with an affective disturbance. Seven variant forms of a unified delusion of substitution are described: Capgras; subjective doubles, Capgras type; Fregoli; intermetamorphosis; subjective doubles, autoscopic type; "reverse" subjective doubles; and "reverse" Fregoli. Classes of single and multiple forms of the delusion with either functional or organic etiology were compared. Multiple form classes had a greater diversity of variant forms. PMID- 3558327 TI - Characterizing depression in borderline patients. AB - The comorbidity of depression and borderline disorder was studied in 39 symptomatic borderline inpatients defined by the Diagnostic Interview for Borderlines using three independent methods for assessing depression and three definitions of depression. Evaluations were conducted by the Schedule for Affective Disorders and Schizophrenia interviews for Research Diagnostic Criteria (RDC) depressive disorders, by clinical ratings for atypical depressive disorder, and by self-rated questionnaires for hysteroid dysphoria. Diagnoses of an RDC depression were made in 25 (64.1%), atypical depressive disorder in 16 (41%), and hysteroid dysphoria in 25 (64.1%) of the borderline patients. Two depressive diagnoses were present in 64.1% of patients, while 17.9% of patients met criteria for all three depressive disorders. No one method accurately characterized depression in borderline patients. PMID- 3558328 TI - Anxiolytics and memory: a comparison of lorazepam and alprazolam. AB - Thirty healthy male volunteers participated in a double-blind, placebo-controlled study to investigate whether mild anterograde memory impairment is found after lorazepam has been taken for 5 days. The study compares the amnestic properties of lorazepam and alprazolam on immediate and delayed recall of word lists under the same conditions. Results suggest that individuals who take benzodiazepines will perform less well on an anterograde memory delayed recall task completed after dosing on the sixth day of treatment, but no similar difference will be found in performance on a similar task completed just before dosing on the sixth day. In addition, results suggest there is no significant difference between alprazolam and lorazepam on anterograde memory task effect. The chronic use of lorazepam 1 mg and alprazolam 0.5 mg had no effect on immediate recall of word lists, on the long-term recall of a word list already committed to memory, or on hand-eye coordination as measured in a standard way. PMID- 3558329 TI - Ibuprofen can increase serum lithium level in lithium-treated patients. AB - The interaction between lithium and ibuprofen was studied in nine male patients admitted to the geropsychiatric ward of a veterans administration medical center. The patients, diagnosed as having bipolar affective disorder or schizoaffective disorder, who had been kept on a steady-state lithium level, received lithium for 3 days, then lithium and ibuprofen (1800 mg/day) for 6 days, and then lithium for 5 days. Ibuprofen increased the serum lithium level and decreased the lithium clearance with marked interindividual variations. These findings indicate that lithium dosage may need to be reduced in some patients following initiation of ibuprofen therapy. There was no significant correlation between changes in lithium serum level and creatinine clearance. The possibility that a tubular renal prostaglandin system may affect lithium excretion needs further investigation. PMID- 3558330 TI - Sleep apnea and hypothyroidism presenting as depression in two patients. AB - Two patients are described who presented with depression and were later found to have both obstructive sleep apnea and hypothyroidism. Both patients had normal thyroxine (T4) levels but elevated thyroid-stimulating hormone (TSH) levels. Thyroid replacement led to resolution of both apnea and depression. The possibility of hypothyroidism as a cause of sleep apnea and depression is discussed. PMID- 3558331 TI - Amoxapine-induced cognitive impairment in two patients. AB - Two patients are described in whom subtle cognitive impairments are associated with therapeutic doses of amoxapine. The implications of this observation for the management of depression, particularly in patients with coexisting dementing illnesses, are discussed. PMID- 3558332 TI - A case of psychosis and delirium following withdrawal from triazolam. AB - A 53-year-old man with a 3-month addiction to approximately 5 mg/day of triazolam experienced psychosis and delirium following relatively abrupt withdrawal from the drug. In contrast to a previous report suggesting that triazolobenzodiazepine withdrawal may not respond to replacement doses of other benzodiazepines, this patient's withdrawal syndrome was effectively treated with lorazepam. PMID- 3558333 TI - Hypomania related to phenelzine and isoetharine interaction in one patient. AB - A case is reported of a man with apparent unipolar depression that was responsive to treatment with phenelzine who became hypomanic when isoetharine was added to treat his chronic obstructive pulmonary disease. The role of beta-adrenergic receptors in affective illness is reviewed in light of this case. PMID- 3558334 TI - PIP syndrome. PMID- 3558335 TI - Hyponatremic effect of carbamazepine. PMID- 3558336 TI - Multiple personality disorder? PMID- 3558337 TI - Phenytoin removal during plasma exchange. AB - Plasma exchange is currently being used to treat a variety of disorders including immune complex and hematologic disorders. It has been shown that the removal of plasma removes drugs bound to plasma proteins. This case documents the removal of phenytoin during plasma exchange therapy. Total and free phenytoin serum concentrations were obtained before and after each exchange. Aliquots were obtained from each pass, and total phenytoin concentrations were determined. The total phenytoin serum concentration increased during the first exchange, while the total concentration decreased as a result of the second exchange. It was determined that approximately 27.7 mg and 30.4 mg of phenytoin were removed by the first and second plasma exchanges, respectively. PMID- 3558338 TI - Lack of short-term effects on the donor during continuous-flow selective mononuclear cell collection. AB - In 50 individuals, intensive harvesting of relatively pure mononuclear cell fractions from the peripheral circulation was carried out in 195 procedures. Serial collections from bone marrow donors (group 1: n = 35) or isolated procedures from volunteers (group 2: n = 15) were without morbidity. A median yield of 4.0 X 10(9) mononuclear cells were recovered in a final volume of 104 ml of cell-rich plasma, for which 4,300 ml of venous blood was processed in 107 minutes. In neither group were changes documented in donor white cell count or lymphocyte numbers. In group 1, a statistically significant but clinically unimportant and transient fall occurred in the platelet count at the end of the 5 day intensive schedule. It is concluded that mononuclear fractions can efficiently be collected from normal donors without the development of relevant cell depletion. PMID- 3558339 TI - Implementation of a semiclosed large scale counterflow centrifugal elutriation system. AB - A semiclosed counterflow centrifugal elutriation system that minimizes the risks of contamination and cell loss is presented. A detailed description of the configuration of the system and its sterilization and assembly is provided along with examples of its application to large-scale separation of leukapheresis buffy coat and cadaveric bone marrow. We are currently using this system to deplete lymphocytes from human bone marrow prior to use in allogeneic bone marrow transplantation. The implementation of a semiclosed system increases the safety, ease of operation, and reproducibility of a technique that has the potential for a wide range of clinical applications. PMID- 3558340 TI - Aluminium loading during therapeutic plasma exchange. AB - Graphite furnace atomic absorption spectroscopy was used to demonstrate a fivefold increase in the median plasma aluminium levels of four patients undergoing therapeutic plasmapheresis. This plasma aluminium loading resulted from contamination of albumin incorporated in the replacement fluids and took place during its preparation, with albumin aluminium levels of 646, 669, and 715 micrograms/liter present in three representative samples. Aluminium overload may result in the development of encephalopathy and osteomalacia in patients with renal impairment, indicating the need to monitor aluminium levels in the albumin containing replacement fluids to avoid this potential hazard. PMID- 3558341 TI - Lymphocyte subpopulations of plateletapheresis products collected with the Fenwal CS-3000 Cell Separator. AB - To determine whether any lymphocyte subset is preferentially harvested and transfused as a consequence of plateletapheresis with the Fenwal CS-3000 Blood Cell Separator, the proportions of lymphocyte subpopulations in platelet concentrates were compared to their proportions in the donors' peripheral venous blood immediately prior to platelet collection. There was no difference in the proportion of B cells (surface immunoglobulin positive), T cells (OKT3 positive), helper/inducer T cells (OKT4 positive), suppressor/cytotoxic T cells (OKT8 positive), and natural killer cells (Leu 7 positive) in the donors' peripheral venous blood and the plateletapheresis product. Thus, although previous studies have demonstrated the ability to separate lymphocyte subpopulations by density centrifugation and velocity sedimentation, plateletapheresis with the CS-3000 harvests the lymphocyte subpopulations studied in the same proportions in which they circulate in donors' peripheral venous blood. PMID- 3558342 TI - Leukocytapheresis in inclusion body myositis. AB - A patient with inclusion body myositis was treated with a course of 22 leukocytaphereses combined with prednisone and azathioprine therapy. He improved clinically during an induction phase of frequent cytapheresis, which reduced the circulating levels of T lymphocytes and monocytes and decreased the ratio of the T4+ to T8+ lymphocyte subsets. During subsequent maintenance cytapheresis there was partial recovery of the T4+ population without recovery of T8+ lymphocytes, and the patient lost most of his clinical improvement. In contrast to T lymphocytes and monocytes, there was no persistent reduction in circulating B lymphocyte levels during the course of therapy. T8+ lymphocyte populations may regenerate more slowly than T4+ lymphocytes following depletion with leukocyatpheresis combined with prednisone and azathioprine therapy. A loss of T8+ suppressor relative to T4+ helper-cell function could lead to an intensification of autoimmune conditions. PMID- 3558343 TI - Evaluation of apheresis platelet concentrates stored for 5 days in PL 732 bags. AB - To assess the functional viability of platelets collected by standard apheresis techniques using the Fenwal CS-3000 "closed system" and stored in Fenwal PL 732 plastic bags for 5 days at room temperature with agitation, a number of in vitro parameters (pH, morphology, platelet volume distribution, osmotic recovery, aggregation, and platelet-associated IgG) were examined as a function of storage time. During the first 24 hours of storage, minimal changes were observed in the test parameters with the exception of ADP-induced aggregation (75% decrease [10 uM], 84% decrease [5 microM]). Significant differences were observed between fresh (day 0) and 5-day-old platelet concentrates in all parameters except median platelet volume. These observed changes in in vitro test parameters with storage time are similar to those previously observed for comparably stored random single donor platelet concentrates. Thus, the "closed-system" PL 732 apheresis platelet concentrates would be expected to be as effective in vivo as random single-donor platelet concentrates, while minimizing recipient exposure to transmissible agents of infectious disease. PMID- 3558344 TI - Nomograms for the prediction of patient's plasma volume in plasma exchange therapy from height, weight, and hematocrit. AB - The knowledge of plasma volume (PV) is a basic requirement for the standardization of plasma exchange therapy. PV has to be determined by calculation, as the measurement of PV before every plasma exchange is too cost- and time consuming. A known correlation with measured values results from calculation of plasma volume by means of patient's height and weight. But the present equations are only reliable at normal hematocrit. For this reason we modified the Retzlaff-equations and compared the validity of plasma volume predictions, calculated by these and own equations, with plasma volume measured by the 51Cr-method in 59 patients with pathological hematocrit. The correlation coefficient was 0.82 for men and 0.81 for women (2 0.001) with the modified Retzlaff-equations. On the average the relative error was -1.5% for all and 2.8% for fat and thin men. No significant improvement of accuracy was achieved with other equations. Thus, plasma volume can accurately be calculated from height, weight, and hematocrit with our modified Retzlaff-equations in patients with pathological hematocrit, even if they are very fat or thin. Nomograms for men and women were constructed in order to facilitate the calculation. PMID- 3558345 TI - Receptor-mediated in vitro gene transformation by a soluble DNA carrier system. AB - We present, here, evidence that foreign DNA can be specifically delivered to cells by a soluble carrier system that takes advantage of receptor-mediated endocytosis. Our experiments were based on the following concepts: hepatocytes possess a unique receptor that binds and internalizes galactose-terminal (asialo )glycoproteins; DNA can bind to polycations in a strong but noncovalent manner forming soluble complexes; and the gene for chloramphenicol acetyltransferase, a bacterial enzyme that acetylates chloramphenicol, is not present in mammalian cells. We coupled asialoorosomucoid (ASOR) to poly-L-lysine to form an asialoorosomucoid-poly-L-lysine conjugate. The plasmid, pSV2 CAT, was complexed to the conjugate in a molar ratio of 1:2. To test this complex, a model system was used consisting of hepatoma cell lines, Hep G2, asialoglycoprotein receptor (+), and SK-Hep 1, receptor (-). Each cell line was incubated with filtered ASOR X poly-L-lysine X DNA complex, or controls consisting of DNA plus ASOR, DNA plus poly-L-lysine, or DNA alone. Cells were assayed for the presence of chloramphenicol acetyltransferase activity as a measure of gene transformation. SK-Hep 1, receptor (-) cells, produced no detectable acetylated chloramphenicol derivatives under any condition. However, Hep G2, receptor (+) cells, incubated with the ASOR X poly-L-lysine X DNA complex were transformed as indicated by the presence of chloramphenicol acetyltransferase activity (0.028 chloramphenicol acetyltransferase units/10(6) cells). Mixtures of individual components of the complex failed to transform these cells. Competition by a 10-fold excess of ASOR prevented gene transformation by the ASOR X poly-L-lysine X DNA complex. PMID- 3558346 TI - Cholesterol is not synthesized in membranes bearing 3-hydroxy-3-methylglutaryl coenzyme A reductase. AB - We have shown previously that newly synthesized lanosterol and cholesterol in homogenates of cultured human fibroblasts do not have the same equilibrium buoyant density as the 3-hydroxy-3-methylglutaryl-CoA reductase (HMG-CoA reductase) in the smooth endoplasmic reticulum (SER) (Lange, Y., and Steck, T. L. (1985) J. Biol. Chem. 260, 15592-15597). This finding suggested two alternative and novel hypotheses: (a) that lanosterol and cholesterol might be transported rapidly from the SER to other internal membranes or (b) that synthesis of the sterols is not associated with the SER, or at least not with that portion of this organelle bearing HMG-CoA reductase. We therefore compared the subcellular distribution of HMG-CoA reductase with that of enzymes which convert lanosterol to cholesterol. The two activities studied were the consumption of exogenous [3H]lanosterol and the conversion of exogenous radiolanosterol to radiocholesterol. Differential centrifugation, rate zonal centrifugation, and equilibrium sucrose gradient centrifugation of rat liver homogenates all showed that these enzyme activities did not comigrate with HMG-CoA reductase. The subcellular distribution of newly synthesized sterols also was examined in cultured human fibroblasts. Cells were incubated with radioactive acetate to label endogenous sterols biosynthetically, homogenized, and spun to equilibrium on sucrose gradients. The buoyant density profiles of radioactive cholesterol and lanosterol both had a peak at 1.12 g/cm3. Digitonin treatment shifted both sterols to higher densities, strong evidence that they resided in cholesterol rich membranes. Pretreatment of intact cells with cholesterol oxidase, which selectively oxidizes plasma membrane cholesterol, abolished the digitonin shift of lanosterol but not of intracellular cholesterol. These findings provide support for the hypothesis that newly synthesized cholesterol and lanosterol are not in the same membrane. PMID- 3558347 TI - Acetylcholinesterase from bovine caudate nucleus is attached to membranes by a novel subunit distinct from those of acetylcholinesterases in other tissues. AB - Acetylcholinesterase extracted with Triton X-100 from bovine brain caudate nuclei was purified by affinity chromatography to apparent homogeneity. The purified enzyme was labeled with [3H]diisopropyl fluorophosphate at the active sites and with the photoactivated reagent 3-(trifluoromethyl)-3-(m [125I]iodophenyl)diazirine, a compound which has been shown to be selective for the hydrophobic membrane-binding domains of several other proteins. The subunit structure was analyzed by polyacrylamide gel electrophoresis in sodium dodecyl sulfate before and after disulfide reduction. After reduction, a single 3H labeled band at 70 kDa was stained by silver, but most of the 125I label corresponded to a 20-kDa species. Prior to reduction, five 3H-labeled and silver stained bands were apparent at 70, 140, 160, 260, and greater than 360 kDa. These species were presumed to represent monomer and disulfide-linked oligomers of 70 kDa catalytic subunits. 125I label was selectively associated with the 160-, 260 , greater than 360-, and a 90-kDa species. Quantitative gel slicing of 3H- and 125I-labeled nonreduced enzyme supported a structural model in which the tetrameric enzyme is a dimer of nonidentical catalytic subunit dimers, one of which involves a direct intersubunit disulfide linkage between two 70-kDa catalytic subunit monomers and the second of which contains two disulfide linkages through an intervening 125I-labeled 20-kDa noncatalytic subunit. This 20 kDa subunit is proposed to contain the membrane attachment site. The brain enzyme did not contain components characteristic of the glycolipid anchors of erythrocyte acetylcholinesterases. However, part of the 125I label was associated with fatty acids, indicating that at least a portion of the brain enzyme membrane anchor is composed of nonamino acid components. PMID- 3558348 TI - A structural mutation of the collagen alpha 1(I)CB7 peptide in lethal perinatal osteogenesis imperfecta. AB - Structurally abnormal type I collagen was identified in the dermis, bone, and cultured fibroblasts obtained from a baby with lethal perinatal osteogenesis imperfecta. Two-dimensional gel electrophoresis of the CNBr peptides demonstrated that the alpha 1(I)CB7 peptide from the alpha 1(I)-chain of type I collagen existed in a normal form and a mutant form with a more basic charge distribution. This heterozygous peptide defect was not detected in the collagens from either parent. The defect was localized to a 224-residue region at the NH2 terminus of the alpha 1(I)CB7 peptide by mammalian collagenase digestion. Analysis of unhydroxylated collagens produced in cell culture indicated that the mutant alpha 1(I)CB7 migrated faster on electrophoresis suggesting that the abnormality may be a small deletion or a mutation that alters sodium dodecyl sulfate binding. The post-translational hydroxylation of lysine residues was increased in the CB7 peptide and also in peptides CB3 and CB8 which are toward the NH2 terminus of the alpha 1(I)-chain. The COOH-terminal CB6 peptide was normally hydroxylated. These findings support the proposal that the lysine overhydroxylation resulted from a perturbation of helix propagation from the COOH to NH2 terminus of the collagen trimer caused by the structural defect in alpha 1(I)CB7. PMID- 3558349 TI - Energy expenditure in the control of biochemical systems by covalent modification. AB - Regulation by reversible, covalent modification of proteins requires a continuous expenditure of energy, even in a steady-state situation. The cost of this energy drain is evaluated for the case of an effector controlling the modifying enzyme and an effector controlling the demodifying enzyme and for the case of dual control in which an effector activates one of these enzymes and inhibits the other. Energy consumption is determined when the converter enzymes are functioning in the first-order and zero-order domains. The profile of energy expenditure versus fractional protein modification at steady state varies both as a function of the mechanism of control of the converter enzymes and of the kinetic domain in which they operate. This theory allows one to predict the strategies that would minimize energy costs. Dual control appears to provide maximum sensitivity with minimal energy expenditure. The analysis is applied to two experimental systems. Comparison of ATP turnover rates with rates for individual modification enzymes in living systems shows that a significant fraction of the total energy expenditure of an organism is required for the large number of reactions which involve covalent modification of proteins. It is concluded that there will be selection pressure for energy-efficient control of covalent regulation. PMID- 3558350 TI - DNase I site mapping and micrococcal nuclease digestion of pachytene chromatin reveal novel structural features. AB - A comparison of the DNase I digestion products of the 32P-5'-end-labeled pachytene nucleosome core particles (containing histones H2A, TH2A, X2, H2B, TH2B, H3, and H4) and liver nucleosome core particles (containing somatic histones H2A, H2B, H3, and H4) revealed that the cleavage sites that are 30, 40, and 110 nucleotides away from the 5'-end are significantly more accessible in the pachytene core particles than in the liver core particles. These cleavage sites correspond to the region wherein H2B interacts with the nucleosome core DNA. These results, therefore, suggest that the histone-DNA interaction at these sites in the pachytene core particles is weaker, possibly because of the presence of the histone variant TH2B interacting at similar topological positions in the nucleosome core as that of its somatic counterpart H2B. Such a loosened structure may also be maintained even in the native pachytene chromatin since micrococcal nuclease digestion of pachytene nuclei resulted in a higher ratio of subnucleosomes (SN4 + SN7) to mononucleosomes than that observed in liver chromatin. PMID- 3558351 TI - Na+-independent Cl(-)-HCO-3- exchange in Madin-Darby canine kidney cells. Role in intracellular pH regulation. AB - The role of plasma membrane Cl(-)-HCO-3-exchange in regulating intracellular pH (pHi) was examined in Madin-Darby canine kidney cell monolayers. In cells bathed in 25 mM HCO-3, pH 7.4, steady state pHi was 7.10 +/- 0.03 (n = 14) measured with the fluorescent pH probe 2',7'-biscarboxyethyl-5,6-carboxyfluorescein. Following acute alkaline loading, pHi recovered exponentially in approximately 4 min. The recovery rate was significantly decreased by Cl- or HCO-3 removal and in the presence of 50 microM 4,4'-diisothiocyano-2,2'-disulfonic stilbene (DIDS). Na+ removal or 10(-3) M amiloride did not inhibit the pHi recovery rate after an acute alkaline load. Following acute intracellular acidification, the pHi recovery rate was significantly inhibited by 10(-3) M amiloride but was not altered by Cl- removal or 50 microM DIDS. At an extracellular pH (pHo) of 7.4, pHi remained unchanged when the cells were bathed in either Cl- free media, HCO-3 free media, or in the presence of 50 microM DIDS. As pHo was increased to 8.0, steady state pHi was significantly greater than control in Cl(-)-free media and in the presence of 50 microM DIDS. It is concluded that Madin-Darby canine kidney cells possess a Na+-independent Cl(-)-HCO-3 exchanger with a Km for external Cl- of approximately 6 mM. The exchanger plays an important role in pHi regulation following an elevation of pHi above approximately 7.1. Recovery of pHi following intracellular acidification is mediated by the Na+/H+ antiporter and not the anion exchanger. PMID- 3558352 TI - The high mannose oligosaccharides of Dictyostelium discoideum glycoproteins contain a novel intersecting N-acetylglucosamine residue. AB - Previous studies have shown that the majority of the asparagine-linked high mannose oligosaccharide units present on the lysosomal enzymes of the slime mold Dictyostelium discoideum contain mannose 6-sulfate and mannose 6-phosphate residues, the latter being diesterified to methyl groups. Using a variety of techniques, including NMR spectroscopy and fast atom bombardment mass spectrometry, we have found that many of these oligosaccharides also contain an N acetylglucosamine residue linked beta 1-4 to the mannose residue linked alpha 1-6 to the beta-linked core mannose. (Formula: see text) As far as we are aware, this is the first description of an intersecting N-acetylglucosamine residue in this position on a high mannose oligosaccharide. PMID- 3558353 TI - The dissociation of carbon monoxide from hemoglobin intermediate. AB - To investigate the mechanism of allosteric switching in human hemoglobin, we have studied the dissociation of the ligand (CO) from several intermediate ligation states by a stopped-flow kinetic technique that utilizes competitive binding of CO by microperoxidase. The hemoglobin species investigated include Hb(CO)4, the diliganded symmetrical species (alpha beta-CO)2 and (alpha-CO beta)2, and the di- and monoliganded asymmetrical species (alpha-CO beta-CO)(alpha beta), (alpha-CO beta)(alpha beta-CO), (alpha beta-CO) (alpha beta), and (alpha-CO beta)(alpha beta). They were obtained by rapid reduction with dithionite of the corresponding valence intermediates that in turn were obtained by chromatography or by hybridization. The nature and concentration of the intermediates were determined by isoelectric focusing at -25 degrees C. The study was performed at varying hemoglobin concentrations (0.1, 0.02, and 0.001 mM [heme]), pH (6.0, 7.0, 8.0), with and without inositol hexaphosphate. The results indicate that: (a) hemoglobin concentration in the 0.1-0.02 mM range does not significantly affect the kinetic rates; (b) the alpha chains dissociate CO faster than the beta chains; (c) the symmetrical diliganded intermediates show cooperativity with respect to ligand dissociation that disappears in the presence of inositol hexaphosphate; (d) the monoliganded intermediates dissociate CO faster than the diliganded intermediates; (e) the asymmetrical diliganded intermediates are functionally different from the symmetrical species. PMID- 3558354 TI - Cadmium binding to metallothioneins. Domain specificity in reactions of alpha and beta fragments, apometallothionein, and zinc metallothionein with Cd2+. AB - The cadmium-binding properties of rabbit liver Zn7-metallothionein (MT) 2 and apo MT, rat liver apo-alpha MT and Zn4-alpha MT, and calf liver apo-beta MT, have been studied using circular dichroism (CD) and magnetic circular dichroism (MCD) spectroscopies. Both sets of spectra recorded during the titration of Zn7-MT 2 with Cd2+ exhibit a complicated pattern that is quite unexpected. Such behavior is not found at all in sets of spectra recorded during titrations of the apo species (apo-MT, apo-alpha MT, and apo-beta MT), and is observed to a much lesser extent in the titration of Zn-alpha MT. Comparison between the band centers of the Cd-alpha MT and Cd-beta MT indicates that the CD spectrum of Cd7-MT is dominated by intensity from transitions that originate on Cd-S chromophores in the alpha domain, with little direct contribution from the beta domain. Analysis of the spectra recorded during titrations of Zn7-MT 2 with Cd2+ suggests: (i) that Cd2+ replaces Zn2+ in Zn7-MT isomorphously; (ii) that cadmium binds in a nonspecific, "distributed" manner across both domains; (iii) that cluster formation in the alpha domain only occurs after 4 mol eq of cadmium have been added and is indicated by the presence of a cluster-sensitive, CD spectral feature; (iv) that the characteristic derivative CD spectrum of native Cd4,Zn3-MT is only obtained from "synthetic" Cd4,Zn3-MT following a treatment cycle that allows the redistribution of cadmium into the alpha domain; warming the synthetic "native," Cd4,Zn3-MT, to 65 degrees C results in cadmium being preferentially bound in the alpha domain; and (v) Zn7-MT will bind Cd2+ quite normally at up to 65 degrees C but with greater specificity for the alpha domain compared with titrations carried out at 25 degrees C. These results suggest that the initial presence of zinc in both domains is an important factor in the lack of any domain specificity during cadmium binding to Zn-MT which contrasts the domain specific manner observed for cadmium binding to apo-MT. PMID- 3558355 TI - Two types of conformers with distinct Fe-C-O configuration in the ferrous CO complex of horseradish peroxidase. Resonance Raman and infarared spectroscopic studies with native and deuteroheme-substituted enzymes. AB - The presence of at least two types of conformers in the ferrous CO complex of horseradish peroxidase has been demonstrated with the use of native and deuteroheme-substituted enzymes. Type I conformers, predominant in acidic pH, exhibited both an Fe-CO stretching and an Fe-C-O bending Raman line together with an infrared C-O stretch band below 1920 em-1. On the other hand, type II conformers, dominant species in alkaline pH, showed only an Fe-CO stretching Raman line with the C-O stretch above 1930 cm-1. They were interconvertible either by the changes in pH or by the binding of benzhydroxamate, a substrate for the enzyme. The pKa value for the pH-dependent interconversion of CO complex of deuteroheme-substituted enzyme was 8.3. These findings were interpreted to mean that the bound CO molecule in type I conformers was more tilted over the heme plane than that in type II conformers. A steric hindrance by the bound substrate or the protonated form of a distal amino acid residue, presumably of histidine, is considered to be the cause for the isomerization. By summarizing present and previous data on the vibrational frequencies of heme-carbonyl complexes, we found that there are inverse-linear relationships between the square of Fe-CO and that of C-O stretching frequencies, while squares of Fe-CO stretching and Fe-C-O bending frequencies were linearly correlated with each other. Also found is that the dissociation rate constant of CO molecule from heme-carbonyl complexes is a linear function of the Fe-CO stretching frequency. The significance of these results is discussed. PMID- 3558356 TI - Biosynthesis of the mycobacterial O-methylglucose lipopolysaccharide. Characterization of putative intermediates in the initiation, elongation, and termination reactions. AB - From the 70% ethanol extract of Mycobacterium smegmatis cells, we isolated a mixture of weakly acidic oligosaccharides composed mainly of glucose and 6-O methylglucose. The elution pattern from a Bio-Gel P-4 column suggested that the oligosaccharides were smaller than the O-methylglucose polysaccharide (MGP) and could be biosynthetic precursors. Analysis by fast-atom-bombardment mass spectrometry revealed that the oligosaccharides fit into a pattern for polysaccharide synthesis based on an alternate glucosylation-methylation mechanism until the chain reached the composition methylglucose11glucose5glyceric acid, at which time 2 glucose units are added to give glucose2methylglucose11glucose5glyceric acid. The addition of the last 2 glucoses and methylation of one of them to give mature MGP (methylglucose1glucose3methylglucose11glucose5glyceric acid) apparently occurs rapidly because the expected intermediates were not observed. Only 4 glucose units are present at the glyceric acid end of some molecules during all stages of the elongation process, and these represent precursors of a minor MGP homolog with an extra methyl group on the beta 1----3-linked glucose unit of MGP. alpha-D Glucopyranosyl-(1----2)-D-glyceric acid and alpha-D-glucopyranosyl-(1----6)-alpha D-glucopyranosyl-(1----2)-D-glycer ic acid were also isolated from the extract and correspond in structure to the expected initial precursors. PMID- 3558357 TI - Tyrosine phosphorylation of band 3 inhibits peripheral protein binding. AB - The cytoplasmic domain of band 3 (cdb3) of the human erythrocyte membrane is a good substrate of endogenous and exogenous protein-tyrosine kinases. Because one site of tyrosine phosphorylation is within the glycolytic enzyme/hemoglobin binding region at the N terminus of the polypeptide, we have investigated whether tyrosine phosphorylation of cdb3 might influence its interaction with the above peripheral proteins. Using p40, a protein-tyrosine kinase isolated from bovine thymus, we demonstrate that aldolase binding to cdb3 linked to Affi-Gel 15 is significantly inhibited by phosphorylation of the immobilized band 3. Importantly, upon dephosphorylation of the gel with acid phosphatase, aldolase binding returns to prephosphorylated values. Similarly, cdb3 phosphorylation was found to inhibit glyceraldehyde-3-phosphate dehydrogenase, phosphofructokinase, and hemoglobin binding to immobilized cdb3. In the converse experiment, untreated soluble cdb3 was shown to bind to immobilized aldolase, whereas phosphorylated cdb3 (approximately equal to 1.8 mol of Pi/mol of cdb3) did not. Furthermore, phosphorylated cdb3 was unable to inhibit aldolase catalysis, whereas untreated cdb3, as shown previously by others, was a potent inhibitor. Taken together, these results demonstrate that phosphorylation of cdb3 on tyrosine residues inhibits peripheral protein binding at the polypeptide's N terminus. In view of the known effect of glycolytic enzyme binding to band 3 on catalytic activity, tyrosine phosphorylation of band 3 may modulate glycolysis in vivo. PMID- 3558358 TI - A novel Ca2+-dependent protein kinase from Paramecium tetraurelia. AB - The ciliated protozoan Paramecium tetraurelia contained two protein kinase activities that were dependent on Ca2+. We purified one of the enzymes to homogeneity by Ca2+-dependent affinity chromatography on phenyl-Sepharose and ion exchange chromatography. The purified enzyme contained polypeptides of 50 and 55 kDa, with the 50-kDa species predominant. From its Stokes radius (32 A) and sedimentation coefficient (3.9 S), we calculated a native molecular weight of 51,000, suggesting that the active form is a monomer. Its specific activity was 65-130 nmol X min-1 X mg-1 and the Km for ATP was 17-35 microM, depending on the exogenous substrate used. Kinase activity was completely dependent upon Ca2+; half-maximal activation occurred at approximately 1 microM free Ca2+ at pH 7.2. Phosphatidylserine and diacylglycerol did not stimulate activity, nor did the addition of purified Paramecium calmodulin. The enzyme phosphorylated casein and histones, forming primarily phosphoserine and phosphothreonine, respectively. It also catalyzed its own phosphorylation in a Ca2+-dependent reaction; the half maximal rate of autophosphorylation occurred at approximately 1-1.5 microM free Ca2+, and both the 50- and 55-kDa species were autophosphorylated. After separation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and renaturation in situ, the 50-kDa protein retained its Ca2+-dependent ability to phosphorylate casein, suggesting that Ca2+ interacts directly with this polypeptide. This was confirmed by direct binding studies; when the enzyme was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis transferred to nitrocellulose, and renatured, there was 45Ca2+-binding in situ to both the 50- and 55-kDa polypeptides. The Paramecium enzyme appears to be a new and unique type of Ca2+-dependent protein kinase. PMID- 3558359 TI - Stimulation of glycogenolysis and vasoconstriction in the perfused rat liver by the thromboxane A2 analogue U-46619. AB - Infusion of the thromboxane A2 analogue U-46619 into isolated perfused rat livers resulted in dose-dependent increases in glucose output and portal vein pressure, indicative of constriction of the hepatic vasculature. At low concentrations, e.g. less than or equal to 42 ng/ml, glucose output occurred only during agonist infusion; whereas at concentrations greater than or equal to 63 ng/ml, a peak of glucose output also was observed upon termination of agonist infusion coincident with relief of hepatic vasoconstriction. Effluent perfusate lactate/pyruvate and beta-hydroxybutyrate/acetoacetate ratios increased significantly in response to U 46619 infusion. Hepatic oxygen consumption increased at low U-46619 concentrations (less than or equal to 20 ng/ml) and became biphasic with a transient spike of increased consumption followed by a prolonged decrease in consumption at higher concentrations. Increased glucose output in response to 42 ng/ml U-46619 was associated with a rapid activation of glycogen phosphorylase, slight increases in tissue ADP levels, and no increase in cAMP. At 1000 ng/ml, U 46619 activation of glycogen phosphorylase was accompanied by significant increases in tissue levels of AMP and ADP, decreases in ATP, and slight increases in cAMP. In isolated hepatocytes, U-46619 did not stimulate glucose output or activate glycogen phosphorylase. Reducing the perfusate calcium concentration from 1.25 to 0.05 mM resulted in a marked reduction of the glycogenolytic response to U-46619 (42 ng/ml) with no efflux of calcium from the liver. U-46619 induced glucose output and vasoconstriction displayed a similar dose dependence upon the perfusate calcium concentration. Thus, U-46619 exerts a potent agonist effect on glycogenolysis and vasoconstriction in the perfused rat liver. The present findings support the concept that U-46619 stimulates hepatic glycogenolysis indirectly via vasoconstriction-induced hypoxia within the liver. PMID- 3558360 TI - Metabolism of ethanol by human brain to fatty acid ethyl esters. AB - Although the most prominent acute and chronic effect of alcohol ingestion in man is alteration of brain function, metabolism of ethanol by human brain has not been documented. This study was designed to detect and localize a new family of nonoxidative ethanol metabolites, fatty acid ethyl esters, in human brain and characterize their synthetic pathways. Fatty acid ethyl ester synthase activity was present in 10 different locations in human brain, with gray matter containing more activity than white matter (0.53 nmol of ethyl oleate/mg of protein/h and 0.25 nmol of ethyl oleate/mg of protein/h, respectively). Two forms of this synthase, present in cytosol or loosely bound to membrane fractions, were isolated from human gray and white matter and then partially purified by ion exchange chromatography. Both were active at low ethanol concentrations easily attained in vivo in man. Importantly, fatty acid ethyl esters were also detected in brains of individuals dying while intoxicated; only small amounts were present in control subjects at autopsy. Thus, alcohol metabolism in human brain has been documented for the first time by identifying both fatty acid ethyl esters and their synthases in this important target-organ of alcohol abuse. PMID- 3558361 TI - Characterization of the catalytic defect in the dysthrombin, Thrombin Quick. AB - The dysthrombin, Thrombin Quick, is chromatographically separable into two components designated Thrombin Quick I and Thrombin Quick II. Thrombin Quick II lacks observable catalytic activity toward thrombin substrates. The steady-state kinetics of hydrolysis of benzoylarginine ethyl ester and Tos-Gly-Pro-Arg-p nitroanilide by Thrombin Quick I are equivalent to those of thrombin. These results, in addition to binding studies with the active site titrant N2-(5 dimethylaminonaphthalene-1-sulfonyl)arginine N-(3-ethyl-1,5-pentanediyl)amide, indicate that binding interactions at the catalytic site of Thrombin Quick I are unaltered. Thrombin Quick I is inhibited by anti-thrombin III at the same rate as thrombin. Steady-state kinetic parameters for the release of fibrinopeptide A indicate defects in both kcat and Km for Thrombin Quick I with kcat/Km equal to 0.012 of the value for thrombin, corresponding to the relative fibrinogen clotting activity of 0.013. The results are interpreted as indicating a defect in Thrombin Quick I at a binding site, external to the catalytic site, which is essential for determining specificity toward fibrinogen. The defect in kcat may result secondarily from small perturbations in the steric relationship of the catalytic triad residues. The rate of hydrolysis by Thrombin Quick I of the protein substrates bovine prothrombin and bovine protein C (in the absence of cofactors) is about one-third of that observed for thrombin, indicating that hydrolysis of these substrates by thrombin involves different specificity determinants than does the hydrolysis of fibrinogen. PMID- 3558362 TI - Hybridoma cells containing intracellular anti-ricin antibodies show ricin meets secretory antibody before entering the cytosol. AB - Hybridoma cells which synthesize monoclonal antibodies (mAb) that block ricin toxicity were 50-300-fold resistant to ricin compared with other hybridomas. Two of the mAb blocked two isozymes of ricin, D and E, to different and opposite extents, and the hybridoma cell resistance to the two forms of ricin closely corresponded with the mAb reactivity. The hybridoma cell resistance to ricin was therefore due to the binding activity of the mAb produced by the cells. Neither rabbit polyclonal antibodies, which neutralized extracellular anti-ricin mAb, nor quantitative removal of hybridoma cell surface IgG with papain affected the cellular resistance to ricin. Therefore, neither extracellular or cell surface antibodies contributed to the resistance of the hybridoma cells. In contrast, inhibition of protein synthesis by cycloheximide or puromycin, which selectively decreased levels of intracellular secretory IgG, decreased the hybridoma cell resistance to ricin. We conclude that intracellular mAb, synthesized de novo for subsequent secretion, block ricin toxicity. Ricin therefore must meet intracellular secretory antibodies before reaching the cytosol. The monoclonal antibodies can also be used to study toxin function within intracellular compartments. An antibody specific for the galactose-binding site of ricin blocks ricin intracellularly, showing that the ricin galactose-binding activity is required in an intracellular compartment for transport of ricin A chain to the cytosol. PMID- 3558363 TI - In vivo effects of dexamethasone and cycloheximide on the phosphorylation of 110 kDa proteins and the protein kinase activities of rat liver nucleoli. AB - In vivo effects of dexamethasone and cycloheximide on the phosphorylation of nucleolar proteins and the activities of nucleolar protein kinases of rat livers were studied. Phosphorylation of nucleolar proteins was accomplished by incubation of isolated nucleoli with [gamma-32P]ATP at 37 degrees C for 10 min followed by electrophoretic separation and autoradiographic demonstration of phosphorylated proteins. Of several nucleolar phosphoproteins observed in the liver of adrenalectomized rats, the incorporation of 32P into nucleolar 110-kDa proteins was rapidly increased, reaching about 1.8-fold of the adrenalectomized level at 12 h after administration of dexamethasone. In addition, the activities of liver nucleolar protein kinases which were measured using casein or phosvitin as substrates were stimulated similarly by the administration of dexamethasone. It was found by DEAE-Sephadex column chromatography that nucleolar protein kinases were separated into NI and NII, the activities being increased about 35 and 80% by dexamethasone treatment (12 h), respectively, and that the enhancements were completely abolished by 1-h treatment of cycloheximide. The injection of cycloheximide also suppressed the hormone-induced enhancement of 32P incorporation into 110-kDa proteins but did not reduce the amount of the proteins at least until 2 h. Evidence was obtained indicating that the phosphorylation of the nucleolar 110-kDa proteins is accomplished primarily by protein kinase NII. These results suggest that continuous synthesis of protein(s) is necessary for glucocorticoid-induced enhancement of phosphorylation of 110-kDa proteins of liver nucleoli and that the nucleolar protein kinase NII is involved in the glucocorticoid-induced short-lived protein(s). PMID- 3558364 TI - Biosynthesis of a novel bile acid nucleotide and mechanism of 7 alpha dehydroxylation by an intestinal Eubacterium species. AB - Eubacterium species V.P.I. 12708 has inducible bile acid 7-dehydroxylase activity that can use either 7 alpha or 7 beta bile acids as substrates. Cell extracts prepared from bacteria grown in the presence of cholic acid catalyzed the rapid conversion of free bile acids into a highly polar bile acid metabolite (HPBA). This conjugation activity co-eluted with bile acid 7-dehydroxylase activity on high performance gel filtration chromatography (GFC). The HPBA was purified by a combination of high performance GFC and reverse-phase high performance liquid chromatography (HPLC). The intact HPBA eluted earlier from reverse-phase HPLC than deoxycholyl-CoA and had a Mr of 1102 by Bio-Gel P-2 (GFC). The HPBA had an absorption peak at 255 nm and was sensitive to treatment with phosphodiesterase I or nucleotide pyrophosphatase. The HPBA has a free phosphate as shown by an increase in elution volume on reverse-phase HPLC following treatment with alkaline phosphatase. Treatment of the purified HPBA with nucleotide pyrophosphate plus alkaline phosphatase yielded adenosine, whereas, treatment with nucleotide pyrophosphatase alone generated 5',3'-ADP. A bile acid metabolite was also generated by nucleotide pyrophosphatase treatment. The bile acid metabolite had different chromatographic properties (HPLC and TLC) than the corresponding free bile acid. Gas liquid chromatography-mass spectrometry showed the bile acid metabolite to be 12 alpha-hydroxy-3-oxo-4-cholenoic acid. We hypothesize that the HPBA is an intermediate in 7-dehydroxylation and consists of this compound linked at the C-24 with an anhydride bond to the beta phosphate (5') of ADP-3'-phosphate. These results suggest a novel mechanism of bile acid 7 alpha/7 beta-dehydroxylation in Eubacterium sp. V.P.I. 12708. PMID- 3558365 TI - Further characterization of a conserved actin-binding 27-kDa fragment of actinogelin and alpha-actinins and mapping of their binding sites on the actin molecule by chemical cross-linking. AB - A conserved actin-binding domain (Mr = 27,000) of rat hepatic actinogelin, rat skeletal muscle, and chicken gizzard alpha-actinins (Mimura, N., and Asano, A. (1986) J. Biol. Chem. 261, 10680-10687) was separated into two components having different isoelectric points (peptides A and B) by chromatofocusing. Thermolysin digestion of peptide A generated peptide B with concomitant loss of peptide A. Amino acid compositions and tryptic maps of peptides A and B also demonstrated that peptide A is a precursor of peptide B upon thermolysin digestion. All of peptides A and B retained the activity to bind with F-actin competitively to each other. By the gel-filtration method, it was also shown that the native actin binding 27-kDa fragments are monomeric and globular. The non-actin-binding 50- or 53.5-kDa fragment of actinogelin/alpha-actinins was, however, found to be asymmetric and dimeric in the native state. Chemical cross-linking of the 27-kDa fragment with F-actin with a water-soluble carbodiimide produced at least four different complexes (I-IV). Chemical cleaving analysis of the cross-linked products (complexes I and II) indicated that the 27-kDa fragment possesses two possible binding sites on actin at the NH2-terminal residues 1-12 (for complex I) and at residues spanning 86-119 or 123 (for complex II). PMID- 3558366 TI - Structural studies of sialylated oligosaccharides of human midcycle cervical mucin. AB - It was previously shown that reductive alkali treatment of purified human cervical mucin releases a heterogeneous population of reduced neutral, sialylated, and sulfated oligosaccharides (Yurewicz, E. C., and Moghissi, K. S. (1981) J. Biol. Chem. 256, 11895-11904). Four major sialylated oligosaccharide fractions were isolated with approximate compositions of Fuc:GlcNac:Gal:NeuAc:N acetylgalactosaminitol (GalNAcol) = 0:0:0:1:1 (B1a), 0:0:1:1:1 (B2b), 0:1:2:1:1 (B3a), and 1:1:2:1:1 (B4a), where Fuc is fucose. They comprised roughly 3, 11, 7, and 6% of recovered oligosaccharide chains, respectively. On the basis of periodate oxidations, methylation analyses, and sequential degradations with glycosidases, the following structures were determined. (Formula: see text) Oligosaccharides 1 and 2 are characterized by the presence of N-acetylneuraminic acid in alpha 2,6-linkage to N-acetylgalactosaminitol. The remaining oligosaccharides contain N-acetylneuraminic acid in alpha 2,3-linkage to galactose residues. Oligosaccharides 3 and 4 and oligosaccharides 5 and 6 were isolated as unresolved isomeric mixtures in fractions B3a and B4a, respectively. Oligosaccharides 3 and 4 were distinguished on the basis of susceptibility to digestion with Aspergillus niger beta-galactosidase whereas oligosaccharides 5 and 6 were distinguished on the basis of differential rates of digestion with beef kidney alpha-fucosidase. The structural data indicate the presence of at least two sialyltransferases in human cervical epithelium and further suggest a potential physiologically significant competition between sialyltransferase and beta-N-acetylglucosaminyltransferase for C-6 of the N-acetylgalactosamine residue O-glycosidically linked to serine/threonine of the polypeptide core. PMID- 3558367 TI - Structure and biological relationships of Coxiella burnetii lipopolysaccharides. AB - Lipopolysaccharides (LPSs) extracted from nine strains of Coxiella burnetii were analyzed for chemical compositions, molecular heterogeneity by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and lethal toxicities in galactosamine-sensitized mice. The structure of a unique disaccharide of hydrolyzed phase I LPS was determined to be galactosaminuronyl-alpha (1-6) glucosamine (GalNU-alpha (1-6)-GlcN, C12H22N2O10) with an Mr of 354. The Mr of LPSs of C. burnetii intra- and interspecific strains and the content of GalNU alpha (1-6)-GlcN and two sugars, virenose and dihydrohydroxystreptose, were used as biochemical markers of truncated LPSs. Smooth-phase I LPS contained all three compounds, semi-rough-phase I LPS did not contain virenose, and rough-phase II LPS contained none of the three compounds. These analyses indicate that the intermediate to larger Mr LPSs require the addition of GalNU-alpha (1-6)-GlcN and dihydrohydroxystreptose to obtain the major (10.5 kDa), the intermediate (between 10.5 and 27 kDa), and the minor (23 kDa) LPS bands. The addition of virenose to the major and the minor bands produced the large Mr phase I LPSs. Extreme microheterogeneity in the banding profile ranging in Mr from the 2.5 to 10.5 kDa may be due to unidentified components, while the microheterogeneity in Mr of the 10.5-kDa and larger LPS bands is related to variations in the compounds described here. All of the LPSs were toxic in galactosamine-sensitized mice, albeit they were 100-1000-fold less toxic than Escherichia coli and Salmonella typhimurium endotoxin. PMID- 3558368 TI - Alpha-tropomyosin gene organization. Alternative splicing of duplicated isotype specific exons accounts for the production of smooth and striated muscle isoforms. AB - We have previously isolated and characterized cloned complementary DNAs (cDNAs) for striated and smooth muscle alpha-tropomyosin. The sequences of these cDNA clones suggested that these two isoforms were encoded by the same gene. Here, we have determined the complete structure of the alpha-tropomyosin (alpha-TM) gene, establishing that a single gene, with a sequence complexity of 28 kilobase pairs, is split into 12 exons and produces the smooth and striated muscle alpha-TM mRNA isoforms by alternative splicing of a minimum of five exchangeable isotype specific exons. The elucidation of the intron/exon organization of alpha-TM suggests that this gene evolved from an ancestral gene encoding a 21-aa protein that might represent the primordial actin binding domain. Sequence comparison between the pairs of exons coding for the "isotype switch regions" and among the corresponding regions of tropomyosin genes in a variety of species ranging from insects to mammals, suggests that the alternatively spliced exons are very old and might have arisen before the radiation of the arthropods, more than 600 million years ago. Additionally, the examination of the intronic sequences has uncovered potential alternative intramolecular secondary structures (hairpin-loop structures) which might be involved in the tissue-specific expression of the duplicated and mutually exclusive alpha-TM isotype-specific exons. PMID- 3558369 TI - Kinetic and catalytic mechanism of HhaI methyltransferase. AB - Kinetic and catalytic properties of the DNA (cytosine-5)-methyltransferase HhaI are described. With poly(dG-dC) as substrate, the reaction proceeds by an equilibrium (or processive) ordered Bi-Bi mechanism in which DNA binds to the enzyme first, followed by S-adenosylmethionine (AdoMet). After methyl transfer, S adenosylhomocysteine (AdoHcy) dissociates followed by methylated DNA. AdoHcy is a potent competitive inhibitor with respect to AdoMet (Ki = 2.0 microM) and its generation during reactions results in non-linear kinetics. AdoMet and AdoHcy significantly interact with only the substrate enzyme-DNA complex; they do not bind to free enzyme and bind poorly to the methylated enzyme-DNA complex. In the absence of AdoMet, HhaI methylase catalyzes exchange of the 5-H of substrate cytosines for protons of water at about 7-fold the rate of methylation. The 5-H exchange reaction is inhibited by AdoMet or AdoHcy. In the enzyme-DNA-AdoHcy complex, AdoHcy also suppresses dissociation of DNA and reassociation of the enzyme with other substrate sequences. Our studies reveal that the catalytic mechanism of DNA (cytosine-5)-methyltransferases involves attack of the C6 of substrate cytosines by an enzyme nucleophile and formation of a transient covalent adduct. Based on precedents of other enzymes which catalyze similar reactions and the susceptibility of HhaI to inactivation by N-ethylmaleimide, we propose that the sulfhydryl group of a cysteine residue is the nucleophilic catalyst. Furthermore, we propose that Cys-81 is the active-site catalyst in HhaI. This residue is found in a Pro-Cys doublet which is conserved in all DNA (cytosine-5)-methyltransferases whose sequences have been determined to date and is found in related enzymes. Finally, we discuss the possibility that covalent adducts between C6 of pyrimidines and nucleophiles of proteins may be important general components of protein-nucleic acid interactions. PMID- 3558371 TI - Purification and characterization of a proline-rich secretory protein that is a precursor to a structural protein of an insect spermatophore. AB - The spermatophore or sperm sac of Tenebrio molitor (yellow mealworm beetle) is an acellular structure composed mostly of structural proteins, termed spermatophorins. The proteins are derived from the bean-shaped accessory reproductive glands of the male and are assembled into the multilayered structure within the ejaculatory duct. Homogenates of the secretory plug from this gland were used as immunogens for the production of monoclonal antibodies, including one identified as PL 21.1 which recognizes an antigen in the gland and the spermatophore. With the aid of gel filtration and immunoaffinity chromatography with a PL 21.1, we isolated a glandular secretory protein that is a precursor to a spermatophorin with similar electrophoretic mobility. On native polyacrylamide gels, the antigen from gland homogenates has an apparent molecular mass of 370 kDa. On sodium dodecyl sulfate gels, the antigen from the gland and that from the spermatophore have apparent molecular masses of 23 kDa. According to immunoblots of sodium dodecyl sulfate gels, the 23-kDa glandular antigen is organ-specific and adult-specific. By immunocytochemistry with PL 21.1, we found the antigens to be restricted to secretory vesicles of only one cell type in the gland and to a discrete layer in the outer wall of the spermatophore. The 23-kDa secretory antigen is distinguished by being high in glutamic acid/glutamine (15.4%) and in proline (25.2%). PMID- 3558370 TI - The human apolipoprotein C-II gene sequence contains a novel chromosome 19 specific minisatellite in its third intron. AB - The human apolipoprotein C-II gene was sequenced and found to contain four exons and three introns, with a major transcription initiation site located 26 base pairs downstream from a TATA sequence element. The third intron was found to be composed almost entirely of a novel 37-base pair minisatellite that is repeated six times. The minisatellite sequence was found to be present in approximately 60 different genomic locations. The minisatellite DNA sequence at three of these loci were compared and found to be highly conserved. In situ hybridization indicated that the minisatellite loci were clustered in the q13.3 band of chromosome 19. This is the first example of a chromosome- and band-specific repetitive element in the mammalian genome. PMID- 3558372 TI - The binding components for 2,3,7,8-tetrachlorodibenzo-p-dioxin and polycyclic aromatic hydrocarbons. Separation from the rat and mouse hepatic cytosol and characterization of a light density component. AB - Using sucrose density gradient centrifugation in a vertical rotor, we have separated three major binding components contained in hepatic cytosols from C57BL/6 mice and Sprague-Dawley rats. Using this preparative method we have obtained, after a 3-h run of 2.4 ml of crude cytosol from 1,4-bis[2-(3,5 dichlorodipyridyloxy)]benzene-treated C57BL/6 mice (approximately 50 mg of protein: 10,000 fmol of Ah receptor) 50 and 75% yields of isolated Ah receptor and carcinogen-binding protein (4 S binding protein), respectively. Both binding components may be kept at -70 degrees C for several months without loss of activity. A third binding component, which did not sediment in a sucrose density gradient (5-20%), even after a 4-h run at 63,000 rpm, was recovered from the top fractions of gradients. When applied to Sephacryl S-300 columns this component was eluted in the void fraction. Resistant to the direct degradative action of nucleases and proteases, this large complex was sequentially converted to its subcomponents by lipoprotein-lipase, proteinase K, and phospholipases. Only the phospholipases are able to abolish the binding capacity of this light density component (LDC) for [3H]2,3,7,8-tetrachlorodibenzo-p-dioxin: hence, we conclude that phospholipids are the true binders of this radioligand. In vitro, this lipoprotein irreversibly binds many hydrophobic radioligands (2,3,7,8 tetrachlorodibenzo-p-dioxin,3-methylcholanthrene, benzo(a)pyrene, 7,12 dimethylbenz(a)anthracene, and dexamethasone). Using single vertical spin density gradient ultracentrifugation, the major part (80%) of LDC was characterized as a very low-density lipoprotein, and a minor part (20%) as a low-density lipoprotein. This conclusion was supported by the size of LDC particles (about 25 75 nm) observed in electron microscopy. PMID- 3558373 TI - Isolation and characterization of two distinct forms of protein kinase C. AB - Protein kinase C (Ca2+- and phospholipid-dependent protein kinase) has been purified from rat brain by a three-step, 18-h procedure resulting in the isolation of milligram quantities of enzyme. Unlike previous preparations from published protocols, which yield a single polypeptide, this procedure yields a protein which consists of a 78/80-kDa doublet upon sodium dodecyl sulfate polyacrylamide gel electrophoresis. The two polypeptides have been characterized with respect to structure and function and are very similar in both regards. However, the two forms can be distinguished immunologically by polyclonal antisera generated against purified protein kinase C. The 78- and 80-kDa proteins do not appear to be related to one another by proteolytic cleavage or by differential phosphorylation, although the two purified proteins do contain stoichiometric amounts of phosphate. The 78- and 80-kDa polypeptides therefore appear to represent two distinct forms of protein kinase C, thus providing evidence for the existence of multiple isozymes of this key regulatory protein. PMID- 3558374 TI - Transcriptional and translational regulation of ribosomal protein formation during mouse myoblast differentiation. AB - The metabolism of ribosomal proteins (r-proteins) and r-protein mRNAs was examined during mouse myoblast differentiation to identify the levels at which r protein accumulation is regulated. Pulse-chase analyses of r-proteins in myoblasts and fibers indicate that the synthesis of r-proteins is coordinately reduced 2.0-fold following myoblast differentiation and that newly synthesized r proteins do not turnover. This decreased synthesis of r-proteins in fibers is due to both a reduction in the steady-state levels of r-protein mRNAs and a decrease in the translational efficiency of r-protein mRNAs. Northern analyses of r protein mRNA indicate that the steady-state levels of r-protein mRNAs S16, L18, and L32 are decreased 1.5-2.0-fold in fibers as compared to myoblasts. Analyses of the distribution of r-protein mRNAs in polysome gradients indicate that their translational efficiencies are reduced 1.3-1.6-fold in fibers as compared to myoblasts. To determine if the decrease in the steady-state levels of r-protein mRNAs is regulated at the level of transcription, the transcription of these genes was measured in isolated nuclei. These experiments show that the transcription of these r-protein genes is reduced 2-6-fold following myoblast differentiation. Thus, the production of r-proteins is regulated both at the level of transcription and translation during mouse myoblast differentiation. PMID- 3558375 TI - Induction and suppression of glutathione transferases by interferon in the mouse. AB - The administration of interferon-alpha/beta to female nude (nu/nu) mice caused significant changes in the levels of the cytosolic hepatic glutathione transferases. Antibodies raised against rat subunits, Ya, Yc, Yb1, Yb2, and Yk, and the subunits of the human transferases, mu (YbYb), lambda (YfYf), and epsilon (B1B1) all reacted with enzymes in the mouse and were used to demonstrate suppression and induction of transferase levels. Western blot analysis followed by semiquantitation by laser scanning showed the Ya, Yb1, Yb2, Yc, Yk, mu, and B1 subunits to be suppressed by 11, 11, 44, 30, 12, 14, and 47%, respectively, by interferon treatment. In contrast to these findings, the Yf subunit was induced 5 7-fold. A concomitant 220% increase was observed in the specific activity of the hepatic cytosol for ethacrynic acid, a substrate for the Yf subunit. Changes in the levels of transferase enzymes in normal and tumor cells may have significant implications when cytotoxic drugs are used in combination with interferons in cancer therapy. The Yf subunit, an enzyme found in human tumors and in placenta (Polidoro, G., Di Mio, C., Del Boccio, G., Zulli, P., and Fererici, G. (1980) Biochem. Pharmacol. 29, 1677-1680) has also been shown to be elevated in hepatic preneoplastic lesions (Kitahara, A., Satoh, K., Nishimura, K., Ishikawa, T., Ruike, K., Sato, K., Tsuda, H., and Ito, N. (1984) Cancer Res. 44, 2698-2703). These data indicate that the Yf subunit represents a potentially important interferon-inducible gene product. PMID- 3558376 TI - Expression of new proteins of the intermediate filament protein family in differentiating F9 embryonal carcinoma cell cytoskeleton. AB - Differentiation of F9 embryonal carcinoma cells by retinoic acid treatment results in extraembryonic endoderm-like cells. The effects of this process on the protein composition of the intermediate filaments were studied by two-dimensional gel electrophoresis and by immunoblotting. By this approach, two new proteins induced in differentiating cells, p57 and p54, were identified in cytoskeletal preparations enriched in intermediate filaments. The 57-kDa protein could be resolved into at least three components (pI 5.6-5.9), and the 54-kDa protein into at least two components (pI approximately 5.6). Both proteins reacted with a monoclonal antibody which recognizes an antigenic determinant common to all intermediate filaments. Based on these results, the two proteins were identified as members of the intermediate filament protein family. Partial digestion with V8 protease showed that p57 was different from vimentin, another intermediate filament protein present in these cells. p57 and p54 were also immunodetected by a polyclonal anti-keratin anti-serum, which suggests that these proteins share some homology with the keratins. These two proteins are different from the endodermal cytoskeletal protein A and B (endo A and endo B) keratins, which are known to be present in extraembryonic endoderm-like cells. They were also more abundant than endo A and endo B in differentiating F9 embryonal carcinoma cells, but almost undetectable in terminally differentiated extraembryonic endoderm-like cells, where endo A and endo B are readily detectable. This suggests that p57 and p54 have a different pattern of expression than endo A and endo B. PMID- 3558377 TI - cDNA sequence of a novel sex-limited protein (Slp) from mice constitutive for Slp expression. Sequence comparisons suggest that Slp has no functional role. AB - Murine sex-limited protein (Slp) is a serum protein that shares 95% sequence identity with murine complement component C4 but does not have C4 activity. Mouse strain B10.WR, which carries the H-2w7 haplotype, has up to 4 Slp genes and is unusual in that both males and females express Slp. Here we report the sequence of a complete pro-Slp cDNA from this strain that we designate Slpw7.2. We find that the Slpw7.2 sequence differs at multiple dispersed sites from three previously reported Slp sequences: two complete pro-Slp sequences, Slpw7.1 and SlpFM, from the B10.WR and FM strains, respectively, and a partial sequence from the B10.WR strain that is distinct from Slpw7.1 as well. A detailed comparison of the complete Slpw7.1, Slpw7.2, and SlpFM sequences reveals that nucleotide changes that alter the amino acid sequence (replacement substitutions) are accumulating at the same relative rate as changes that do not affect the amino acid sequence (silent substitutions); in addition, the amino acid changes themselves tend to be nonconservative. Our results suggest that at least three Slp genes are transcriptionally active in B10.WR mice; that the protein product of the Slpw7.2 transcript predominates in B10.WR serum; and that the Slp protein probably has no function. The Slp system may be particularly suitable for the study of the evolution in the absence of selective pressures of a gene that encodes a stable protein. PMID- 3558378 TI - Estrogen induces transcription of the Xenopus laevis serum retinol-binding protein gene. AB - We have isolated and sequenced a full-length cDNA cloned tentatively identified as encoding Xenopus laevis serum retinol-binding protein (RBP) mRNA. The derived amino acid sequence of the Xenopus protein is 63% homologous to the sequence of the human RBP. 17 of 19 amino acids identified as critical in the retinol-binding pocket of human RBP are identical or conservative replacements in the Xenopus protein. The RBP cDNA clone has been used as a hybridization probe to demonstrate that administration of estradiol-17 beta to male X. laevis induces hepatic RBP mRNA 10-fold from its constitutive in vivo level of 1,800 molecules/cell to approximately 18,000 molecules/cell. Using a simplified method for determining relative rates of gene transcription, we demonstrate an estrogen-mediated increase in the rate of RBP gene transcription. These quantitative data provide the first demonstration that a steroid hormone regulates the levels of vertebrate retinol-binding protein mRNA. PMID- 3558379 TI - Metal ion binding sites of bacteriorhodopsin. Laser-induced lanthanide luminescence study. AB - Laser-excited luminescence lifetimes of lanthanide ions bound to bacteriorhodopsin have been measured in deionized membranes. The luminescence titration curve, as well as the binding curve of apomembrane (retinal-free) with Eu3+, has shown that the removal of the retinal does not significantly affect the affinity of Eu3+ for the two high affinity sites of bacteriorhodopsin. The D2O effects on decay rate constants indicate that Eu3+ bound to the high affinity sites of native membrane or apomembrane is coordinated by about six ligands in the first coordination sphere. Tb3+ is shown to be coordinated by four ligands. The data indicate that metal ions bind to the protein with a specific geometry. From intermetal energy transfer experiments using Eu3+-Pr3+, Tb3+-Ho3+, and Tb3+ Er3+, the distance between the two high affinity sites is estimated to be 7-8 A. PMID- 3558380 TI - Tight binding of divalent cations to monomeric actin. Binding kinetics support a simplified model. AB - Using the fluorescent Ca2+ selective chelator Quin2 to induce and measure the dissociation of Ca2+ from actin, we have recently found that actin binds Ca2+ and Mg2+ much more tightly than previously thought (Gershman, L.C., Selden, L.A., and Estes, J.E. (1986) Biochem. Biophys. Res. Commun. 135, 607-614). In this report, we show that the kinetics of dissociation of Ca2+ from Ca-actin and Mg2+ from Mg actin closely parallel the fluorescence changes in 1,5-I-N-iodoacetyl-N'-(5-sulfo 1-naphthyl)ethylenediamine (AEDANS)-actin, suggesting that the 1,5-I-AEDANS-actin fluorescence directly reflects slow first-order cation exchange rather than a slow Mg2+-induced isomerization as originally proposed by Frieden (Frieden, C. (1982) J. Biol. Chem. 257, 2882-2886). Measuring divalent cation exchange directly, we have determined the dissociation rate constants for Ca2+ (k-Ca) and Mg2+ (k-Mg), the equilibrium dissociation constants for Ca2+ (KCa), and the ratio of cation binding affinities, KMg/Kca, to actin over the pH range 7-8. We have found that k-Ca is 5-10 times greater than k-Mg and KMg is about 4 times greater than KCa. From the data we calculate the association rate constants for Ca2+ (kCa) and Mg2+ (kMg) to be about 7 X 10(6) M-1 s-1 and 2 X 10(5) M-1 s-1, respectively. kCa appears to be diffusion-limited, but kMg is significantly smaller due to the characteristics of the Mg2+ aquo ion. These findings are consistent with a simple first-order binding model for the tight binding of divalent cations to actin. PMID- 3558381 TI - Rapid increases in cytosolic free calcium in response to muscarinic stimulation of rat parotid acinar cells. AB - Carbachol-evoked rises in [Ca2+]i were measured in fura-2-loaded, rat parotid acinar cells. In suspensions of dissociated cells examined by dual wavelength excitation fluorimetry, a maximally effective concentration of carbachol produced a measured peak [Ca2+]i of 780 +/- 60 nM followed by a maintained elevation in the presence of 1 mM external Ca2+, and a peak of 630 +/- 95 nM followed by a return to resting values in the absence of external Ca2+. Stopped-flow, single wavelength fluorimetry was used to resolve the rising phase of the response. There was a dose-dependent lag of 70-220 ms before [Ca2+]i started to increase, and [Ca2+]i was maximal by 800-900 ms. These times were similar in the presence or absence of external Ca2+, although the initial rate of rise was faster in the presence of external Ca2+. These kinetics are consistent with a biochemical event, possibly phosphatidylinositol bisphosphate hydrolysis, mediating both internal release and Ca2+ entry, with a component of the initial rise being due to Ca2+ entry. PMID- 3558382 TI - Monoclonal antibodies as probes of the alpha-bungarotoxin and cholinergic binding regions of the acetylcholine receptor. AB - We have probed the acetylcholine receptor (AcChR) molecule with six anti-AcChR monoclonal antibodies (mAbs) whose binding to the AcChR is inhibited or blocked by alpha-bungarotoxin (alpha BgTx). mAbs bound with a maximum stoichiometry of either one mAb (387D, 247G) or two mAbs (383C, 572C, 370C, 249E) per AcChR monomer, and the extent to which they inhibited alpha BgTx binding directly correlated with their stoichiometry of binding. The effect of mAbs on the alpha BgTx and cholinergic ligand binding properties of the AcChR molecule defined three major categories of mAbs: those that block alpha BgTx and carbamylcholine (agonist) binding, but do not block d-tubocurarine (antagonist) binding (383C, 572C, 370C and 249E); mAb 387D, which blocks agonist binding and partially blocks alpha BgTx and d-tubocurarine binding; and mAb 247G, which does not affect agonist binding, blocks at most 50% of the alpha BgTx binding sites, and decreases the affinity of the high affinity component of d-tubocurarine binding (Mihovilovic, M., and Richman, D. P. (1984) J. Biol. Chem. 259, 15051-15059). Except for mAb 247G, these mAbs strongly competed with each other for binding to the AcChR. In contrast, mAb 247G blocks about 50% of the binding of all the other mAbs. The results demonstrate the ability of mAbs to stabilize different conformational states of the AcChR and to probe cholinergic epitopes of functional importance. They also indicate the nonequivalence of the two alpha toxin binding regions of the AcChR molecule and suggest that it is possible to identify epitopes within the alpha BgTx binding region that when bound produce differential effects on the binding of the agonist (carbamylcholine) and the antagonist (d-tubocurarine). PMID- 3558383 TI - Energy-linked nicotinamide-nucleotide transhydrogenase. Characterization of reconstituted ATP-driven transhydrogenase from beef heart mitochondria. AB - The interaction between pure transhydrogenase and ATPase (Complex V) from beef heart mitochondria was investigated with transhydrogenase-ATPase vesicles in which the two proteins were co-reconstituted by dialysis or dilution procedures. In addition to phosphatidylcholine and phosphatidylethanolamine, reconstitution required phosphatidylserine and lysophosphatidylcholine. Transhydrogenase-ATPase vesicles catalyzed a 20-30-fold stimulation of the reduction of NADP+ or thio NADP+ by NADH and a 70-fold shift of the apparent equilibrium expressed as the nicotinamide nucleotide ratio [NADPH][NAD+]/[NADP+][NADH]. In both of these respects, the transhydrogenase-ATPase vesicles were severalfold more efficient than beef heart submitochondrial particles. By measuring the ATP-driven transhydrogenase and the oligomycin-sensitive ATPase activities simultaneously and under the same conditions at low ATP concentrations, i.e. below 15 microM, the ATP-driven transhydrogenase/oligomycin-sensitive ATPase activity ratio was found to be about 3. This value is consistent with the stoichiometries of three protons translocated per ATP hydrolyzed and one proton translocated per NADPH formed and with a mechanism where the two enzymes interact through a delocalized proton-motive force. PMID- 3558384 TI - Energy-linked nicotinamide-nucleotide transhydrogenase. Light-driven transhydrogenase catalyzed by transhydrogenase from beef heart mitochondria reconstituted with bacteriorhodopsin. AB - Purified nicotinamide-nucleotide transhydrogenase from beef heart mitochondria was co-reconstituted with bacteriorhodopsin to from transhydrogenase bacteriorhodopsin vesicles that catalyze a 20-fold light-dependent and uncoupler sensitive stimulation of the reduction of NADP+ and NADP+ analogs by NADH and a 50-fold shift of the nicotinamide nucleotide ratio. In the presence of light, the transhydrogenase-bacteriorhodopsin vesicles catalyzed a pronounced light intensity-dependent inward proton pumping as indicated by a pH shift of the medium. As indicated by pH shifts, proton pumping by the bacteriorhodopsin essentially paralleled the light-driven transhydrogenase. Addition of valinomycin increased the pH shift twice with a concomitant 50% inhibition of the light driven transhydrogenase, whereas nigericin inhibited the pH shift completely and the light-driven transhydrogenase partially. Taken together, these results suggest that transhydrogenase and bacteriorhodopsin interact through a delocalized proton-motive force. Possible partial reactions of transhydrogenase were investigated with transhydrogenase-bacteriorhodopsin vesicles energized by light. Reduction of oxidized 3-acetylpyridine adenine dinucleotide by NADH, previously claimed to represent partial reactions, was found to require NADPH. Similarly, reduction of thio-NADP+ by NADPH required NADH. It is concluded that these reactions do not represent partial reactions. PMID- 3558385 TI - Inhibition of mammalian fatty acid synthetase activity by NADP involves decreased mobility of the 4'-phosphopantetheine prosthetic group. AB - Mammalian fatty acid synthetase carrying a 3-keto, 3-hydroxy, or 2-enoyl acyl enzyme intermediate on the 4'-phosphopantetheine thiol is reversibly inhibited by binding of NADP to the enoyl reductase domain. Acyl moieties which can normally leave the enzyme by thioester hydrolysis or by transfer to a CoA acceptor cannot readily be removed from the NADP-inhibited enzyme; in addition, 3-keto or 2-enoyl moieties attached to the enzyme 4'-phosphopantetheine cannot readily be reduced when NADP is replaced by NADPH, even though model substrates can be reduced immediately. Reactivation of the NADP-inhibited 3-ketoacyl-enzyme, by exposure to NADPH, is paralleled by reduction and dehydration of the 3-ketoacyl moiety to a saturated acyl moiety without accumulation of either the 3-hydroxy or 2-enoyl acyl-enzyme intermediates, indicating that once the 4'-phosphopantetheine engages the ketoacyl moiety in the ketoreductase domain, subsequent reactions occur very rapidly. The results are consistent with a hypothesis which proposes that NADP binding to the enoyl reductase domain of fatty acid synthetase carrying an acyl intermediate other than a saturated moiety induces a conformational change in the enzyme that results in decreased mobility of the 4'-phosphopantetheine prosthetic group. Normal mobility of the prosthetic group, essential for transfer of acyl enzyme intermediates through the active sites of the various functional domains, is restored relatively slowly when NADP is replaced by NADPH. It remains to be determined whether this modulation by pyridine nucleotides observed in vitro plays a role in the regulation of fatty acid synthetase activity in vivo. PMID- 3558386 TI - Cellular peptide processing after a single arginyl residue. Studies on the common precursor for pancreatic polypeptide and pancreatic icosapeptide. AB - The processing of the common precursor for pancreatic polypeptide and pancreatic icosapeptide was studied in primary cultures of endocrine cells isolated from the duodenal part of the canine pancreas. Biosynthetically labeled peptides were characterized by enzymatic digestion and radiosequencing and compared to a COOH terminally extended form of the icosapeptide which was isolated from canine pancreas and also sequenced. It was substantiated that, in these cell cultures, processing can be studied at a classical dibasic site between the pancreatic polypeptide and the icosapeptide, and at a monobasic processing site between the icosapeptide and its COOH-terminal extension. Pulse-chase experiments showed that the monobasic cleavage occurs later than the dibasic one in the biosynthetic process; the monobasic site was apparently not cleaved before the prohormone had been processed at the dibasic site. The monobasic processing could also be distinguished from the dibasic cleavage mechanism as, in time, the cells gradually lost the ability to cleave at the monobasic site while the dibasic processing was unaffected. It is concluded that monobasic conversion, which is important in the activation of a series of hormones, neuropeptides, and growth factors, is a distinct cellular processing mechanism. PMID- 3558387 TI - Excretion of glutathione conjugates by primary cultured rat hepatocytes. AB - Conjugation of xenobiotics with glutathione occurs commonly within the liver, and these glutathione conjugates are then preferentially excreted into bile. We have characterized this excretory process using primary cultured hepatocytes (24 h). 1 Chloro-2,4-dinitrobenzene rapidly entered the cells and formed a glutathione conjugate, S-(dinitrophenyl)glutathione, irrespective of the temperature of incubation. In contrast, the efflux of the glutathione conjugate was essentially absent in the cold but recovered rapidly upon rewarming of the cells. Therefore, initial rates of efflux of the conjugate at 37 degrees C were measured from cells preloaded biosynthetically at 10 degrees C. Efflux was a saturable process with respect to intracellular S-(dinitrophenyl)glutathione with an apparent Km of 0.58 +/- 0.12 mM and Vmax of 0.15 +/- 0.05 nmol/min/mg of protein. The excretion of S (dinitrophenyl)glutathione had an energy of activation of 15.3 kcal/mol. The glutathione conjugate of p-nitrobenzylchloride when formed within the hepatocytes acted as a competitive inhibitor of S-(dinitrophenyl)glutathione efflux. Cultured hepatocytes, therefore, appeared to have a specific transport process for the excretion of glutathione conjugates. The addition of S (dinitrophenyl)glutathione, but not GSH, GSSG, or methionine, to the medium caused a decrease in the rate of efflux of radiolabeled S (dinitrophenyl)glutathione. The hepatocytes were able, however, to excrete the glutathione conjugate against an excess of extracellular S (dinitrophenyl)glutathione. This observation suggested that extracellular S (dinitrophenyl)glutathione, although capable of binding to the carrier, entered the hepatocytes quite slowly relative to rates of efflux. This carrier may function in a manner that would minimize the reuptake by hepatocytes of conjugates that have been excreted into the bile. PMID- 3558388 TI - In vitro modulation of rat liver glucocorticoid receptor by urea. AB - We have examined the influence of urea on the properties of the rat liver glucocorticoid receptor (GR). A 1-h incubation of hepatic cytosol with 1-3 M urea at 0 or at 23 degrees C caused a progressive decrease in the steroid binding efficiency of GR. Urea treatment of cytosol incubated with 20 nM [3H]triamcinolone acetonide caused transformation of glucocorticoid-receptor complexes (GRc) and resulted in an increase in the binding of GRc to DNA cellulose and ATP-Sepharose. The transforming effect was maximal with 2.5 M urea at 0 degrees C for 1 h, and it caused a shift in the rate of sedimentation of the 9 S untransformed GRc to a 4 S form, similar to that observed upon incubation of the cytosol GRc at 23 degrees C. This 9 to 4 S transformation could also be observed in the presence of Na2MoO4. The Stokes radii of the GRc eluted from a Bio-Gel-A-0.5m agarose column were determined to be 5.9 and 4.9 nm in the absence and presence of 2.5 M urea. The aqueous two-phase partitioning analysis revealed a significant change in surface properties of GR following urea treatment; the observed partition coefficient values (cpm upper phase/bottom phase) were 0.022, 0.208, and 0.60 for GRc, GRc + 23 degrees C, and GRc + 2.5 M urea, respectively. Furthermore, the urea treatment rendered the GRc less negatively charged, forcing their appearance in the flow-through fractions of a DEAE-Sephacel column. These results suggest that urea is a potent in vitro modulator of the physicochemical behavior of GR, influencing both the steroid binding and the process of receptor transformation. PMID- 3558389 TI - Rapid mobilization of cellular Ca2+ in bovine parathyroid cells evoked by extracellular divalent cations. Evidence for a cell surface calcium receptor. AB - The concentration of intracellular free Ca2+ ([Ca2+]i) was measured in dissociated bovine parathyroid cells using the fluorescent indicator quin-2 or fura-2. Small increases in the concentration of extracellular Ca2+ produced relatively slow, monophasic increases in [Ca2+]i in quin-2-loaded cells, but rapid and transient increases followed by lower, yet sustained (steady-state), [Ca2+]i increases in fura-2-loaded cells. The different patterns of change in [Ca2+]i reported by quin-2 and fura-2 appear to result from the greater intracellular Ca2+-buffering capacity present within quin-2-loaded cells, which tends to damp rapid and transient changes in [Ca2+]i. In fura-2-loaded parathyroid cells, other divalent cations (Mg2+, Sr2+, Ba2+) also evoked transient increases in [Ca2+]i, and their competitive interactions suggest that they all affect Ca2+ transients by acting on a common site. In contrast, divalent cations failed to cause increases in steady-state levels of cytosolic Ca2+. Low concentrations of La3+ (0.5-10 microM) depressed steady-state levels of cytosolic Ca2+ elicited by extracellular Ca2+ but were without effect on transient increases in [Ca2+]i elicited by extracellular Ca2+, Mg2+ or Sr2+, suggesting that increases in the steady-state [Ca2+]i arise from the influx of extracellular Ca2+. Mg2+- and Sr2+-induced cytosolic Ca2+ transients persisted in the absence of extracellular Ca2+ but were abolished by pretreatment with ionomycin. These results show that cytosolic Ca2+ transients arise from the mobilization of cellular Ca2+ from a nonmitochondrial pool. Extracellular divalent cations thus appear to act at some site on the surface of the cell, and this site can be considered a "Ca2+ receptor" which enables the parathyroid cell to detect small changes in the concentration of extracellular Ca2+. PMID- 3558390 TI - A fluorescence stopped flow study of the competition and displacement kinetics of podophyllotoxin and the colchicine analog 2-methoxy-5-(2',3',4'-trimethoxyphenyl) tropone on tubulin. AB - The colchicine analog 2-methoxy-5-(2',3',4'-trimethoxyphenol) tropone (AC) was used as a fluorescent probe to study the binding kinetics of podophyllotoxin at high concentrations. The observed pseudo-first order rate constant showed a linear concentration dependence up to 1 mM. The bimolecular rate constant (195 M 1 s-1 at 15 degrees C) and the activation energy (57 kJ/mol) correspond perfectly with those previously determined in the submicromolar range (Cortese, F., Bhattacharyya, B., and Wolf, J. (1977) J. Biol. Chem. 252, 1134-1140). Displacement kinetics of bound AC by podophyllotoxin, allow the determination of the dissociation rate constants for AC. By studying the temperature dependence, and combining with the binding rate constants previously determined (Engelborghs, Y., and Fitzgerald, T.J. (1986) Ann. N.Y. Acad. Sci. 466, 709-717) a full characterization of the kinetic pathway is possible. This is shown to differ considerably from the pathway of colchicine binding. PMID- 3558392 TI - Purification and functional characterization of transcription factor SII from calf thymus. Role in RNA polymerase II elongation. AB - SII was purified from calf thymus tissue to apparent homogeneity by a rapid procedure. The 38-kDa protein stimulated RNA synthesis by purified calf thymus RNA polymerase II 4-fold. The calf thymus SII had similar chromatographic properties and molecular size and cross-reacted immunologically with antibodies to mouse SII (Sekimizu, K., Nakanishi, Y., Mizuno, D., and Natori, S. (1979) Biochemistry 18, 1582-1588). We have substituted the purified calf thymus SII for the partially purified HeLa transcription factor IIS fraction in a HeLa (human) transcription system reconstituted with purified factors and RNA polymerase II. The purified protein stimulated specific transcription from the adenovirus 2 major late promoter by increasing the efficiency of the elongation reaction. PMID- 3558391 TI - Acylation of disc membrane rhodopsin may be nonenzymatic. AB - Bovine retinal rod outer segments (ROS) support the incorporation of [3H]palmitate into rhodopsin. [14C] Palmitoyl-CoA serves as the donor with an apparent Km of 40 microM. Solubilization of ROS in the detergent, Emulphogene, results in increased incorporation of label into rhodopsin. A further increase is found when ConA-Sepharose-purified rhodopsin is used as the source of both "enzyme" and acceptor. Failure to separate enzyme from acceptor suggested the possibility of a nonenzymatic reaction. This was confirmed when boiled rhodopsin was found to support the reaction. However, the acylation of rhodopsin is not an artifact since analysis of purified native rhodopsin reveals the presence of covalently bound palmitate and we showed that whole bovine retinas incubated with [3H] palmitate incorporated the fatty acid into rhodopsin (O'Brien, P.J., and Zatz, M. (1984) J. Biol. Chem. 259, 5054-5057). Furthermore, in vivo experiments with rat retinas have revealed that opsin is acylated both in the rod inner and outer segments (St. Jules, R. S., and O'Brien, P.J. (1986) Exp. Eye Res. 43, 929 940). Incubation of labeled rhodopsin with mercaptoethanol resulted in release of the labeled palmitate indicating the presence of a thioester bond. This also illustrates the ease with which a thioester, such as palmitoyl cysteine or palmitoyl-CoA, can transfer the fatty acyl group to a free thiol, such as cysteine or mercaptoethanol. PMID- 3558393 TI - Genes encoding proteins with homologous contiguous repeat sequences are highly expressed in the serous cells of the rat submandibular gland. AB - An abundant class of secreted salivary polypeptides is characterized by the presence of identical and contiguous repeats of amino acid sequences within the polypeptide chains, and includes the proline-rich proteins. We discovered a new family of contiguous repeat polypeptides (CRPs) that is related to the proline rich proteins but contains little proline. Analysis of salivary mRNAs and liver DNA by molecular cloning, DNA sequence determinations, and Northern and Southern blot hybridization revealed several closely related CRP mRNAs and at least 10 CRP related genes. We further analyzed two CRP mRNAs of 850 and 920 nucleotides and the gene encoding the larger CRP mRNA. The two mRNAs contain the same 69-base repeats in their coding regions and are identical in their 5'- and 3' untranslated tracts. However, they differ in the number of contiguous repeats (four versus five) and a segment at the 3' end of the coding region which encodes closely related but unique COOH termini of the CRPs. These structural features suggest a recent gene conversion. The CRP gene analyzed is divided into three exons that encode (i) 5'-untranslated tract and signal sequence, (ii) secreted polypeptide, and (iii) 3'-untranslated tract, respectively. CRP mRNA contains two open reading frames. The longer open reading frame encodes a CRP precursor with a signal sequence of 17 amino acids, four to five contiguous repeats of 23 amino acids, and a variable COOH region that begins with two segments related to the contiguous repeats. Immunochemical analysis of salivary gland slices with antisera raised against peptides corresponding to two regions of the larger open reading frame revealed intense staining only of the serous cells of the submandibular glands. 35S-Labeled oligonucleotides complementary to CRP mRNA specifically hybridized to the same cells. PMID- 3558394 TI - Distribution of transferrin synthesis in brain and other tissues in the rat. AB - Levels of transferrin mRNA were measured by hybridization to transferrin cDNA in extracts from various areas of rat brain and other tissues. The highest concentrations of transferrin mRNA were found in the liver and the choroid plexus of the lateral and third ventricles. Lower concentrations were observed in the medulla and thalamus, choroid plexus of the fourth ventricle, cortex, hypothalamus, cerebellum, pituitary, testis, placenta, stomach, spleen, kidney, muscle, and heart. Yolk sac, small intestine, and adrenal glands did not contain detectable transferrin mRNA levels. The size of transferrin mRNA was the same in liver, brain, and testis. Upon incubation of choroid plexus pieces with [14C]leucine in vitro, about 4% of the radioactive protein secreted into the medium was found to be transferrin. Together with previous data (Dickson, P.W., Howlett, G.J., and Schreiber, G. (1985) J. Biol. Chem. 260, 8214-8219; Dickson, P.W., Aldred, A.R., Marley, P.D., Bannister, D., and Schreiber (1986) J. Biol. Chem. 261, 3475-3478) the obtained data suggest that the choroid plexus plays a role in maintenance of homeostasis in the microenvironment of the central nervous system by synthesizing and secreting plasma proteins. PMID- 3558395 TI - A complete complementary DNA for the oncodevelopmental calcium-binding protein, oncomodulin. AB - RNA from a rat liver tumor (Morris hepatoma 5123tc) was used to construct cDNAs together comprising the complete coding sequence of rat oncomodulin mRNA. Information obtained from these cDNAs as well as from primer extension analysis gave a deduced length for the complete oncomodulin mRNA of approximately 680 nucleotides (excluding the poly(A) tail) including a 5'-untranslated region of 97 +/- 2 nucleotides, a 324-nucleotide-coding sequence and a 259-nucleotide 3' noncoding region. Comparison of the oncomodulin cDNA sequence with those coding for other members of the calcium-binding protein family shows little homology with the exception of a recently reported parvalbumin cDNA where the oncomodulin and parvalbumin nucleotide sequences are 59% identical in the protein-coding region. RNA blot analysis of poly(A+) RNA from normal adult rat liver gave no evidence of oncomodulin expression in this tissue. A single RNA species was detected, however, in RNA extracts from the hepatoma and from rat and human placentas. A probe prepared from one of the rat oncomodulin cDNAs hybridized with a single DNA species in restriction digests of hepatoma and normal DNA from rat and sequences in DNA of humans and other mammals. A 38-nucleotide sequence spanning the 5'-untranslated region and the first seven codons of the oncomodulin cDNA, was far less homologous than was the same region of a parvalbumin cDNA, to a chicken calmodulin cDNA sequence coding for the first calcium-binding domain. The oncomodulin gene appears to have diverged more from that of calmodulin than has the parvalbumin gene. PMID- 3558396 TI - Bile acid: CoASH ligases from guinea pig and porcine liver microsomes. Purification and characterization. AB - A procedure for the purification of the enzyme bile acid:CoA ligase from guinea pig liver microsomes was developed. Activity toward chenodeoxycholate, cholate, deoxycholate, and lithocholate co-purified suggesting that a single enzyme form catalyzes the activation of all four bile acids. Activity toward lithocholate could not be accurately assayed during the earlier stages of purification due to a protein which interfered with the assay. The purified ligase had a specific activity that was 333-fold enriched relative to the microsomal cell fraction. The purification procedure successfully removed several enzymes that could potentially interfere with assay procedures for ligase activity, i.e. ATPase, AMPase, inorganic pyrophosphatase, and bile acid-CoA thiolase. On sodium dodecyl sulfate-polyacrylamide gel electrophoresis the purified ligase gave a single band of approximately 63,000 Mr. A molecular size of 116,000 +/- 4,000 daltons was obtained by radiation inactivation analysis of the ligase in its native microsomal environment, suggesting that the functional unit of the ligase is a dimer. The purified enzyme was extensively delipidated by adsorption to alumina. The delipidated enzyme was extremely unstable but could be partially stabilized by the addition of phospholipid vesicles or detergent. However, such additions did not enhance enzymatic activity. Kinetic analysis revealed that chenodeoxycholate, cholate, deoxycholate, and lithocholate were all relatively good substrates for the purified enzyme. The trihydroxy bile acid cholate was the least efficient substrate due to its relatively low affinity for the enzyme. Bile acid:CoA ligase could also be solubilized from porcine liver microsomes and purified 180-fold by a modification of the above procedure. The final preparation contains three polypeptides as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The three peptides range in size from 50,000 to 59,000, somewhat smaller than the guinea pig enzyme. The functional size of the porcine enzyme in its native microsomal environment was determined by the technique of radiation inactivation analysis to be 108,000 +/- 5,000 daltons. Thus, the functional form of the porcine enzyme also appears to be a dimer. PMID- 3558397 TI - The three-dimensional structure of ricin at 2.8 A. AB - The x-ray crystallographic structure of the heterodimeric plant toxin ricin has been determined at 2.8-A resolution. The A chain enzyme is a globular protein with extensive secondary structure and a reasonably prominent cleft assumed to be the active site. The B chain lectin folds into two topologically similar domains, each binding lactose in a shallow cleft. In each site a glutamine residue forms a hydrogen bond to the OH-4 of galactose, accounting for the epimerimic specificity of binding. The interface between the A and B chains shows some hydrophobic contacts in which proline and phenylalanine side chains play a prominent role. PMID- 3558398 TI - Studies of the role of the Escherichia coli heat shock regulatory protein sigma 32 by the use of monoclonal antibodies. AB - Purified Escherichia coli RNA polymerase containing the heat shock regulatory protein sigma 32 (gprpoH) was used to inject BALB/c mice, and the spleen cells of an immunized mouse were fused to NS1 cells. Three stable cell lines were isolated which produced monoclonal antibodies to sigma 32. The antibodies varied in their ability to bind sigma 32 which was bound to core polymerase. Each of the antibodies was found to inhibit transcription from the rpoD heat shock promoter to a different extent. Extensive homology at the protein level has been observed between various sigma factors. The monoclonal antibodies to sigma 32 were tested for the ability to cross-react with sigma 70 on Western blots. None of the antibodies reacted with electroblotted sigma 70. The sigma 32 content was examined in total cell extracts during heat shock Levels of sigma 32 were found to increase approximately 4-fold over pre-heat shock levels at five min after temperature upshift. These levels remained slightly elevated above pre-heat shock levels at 10 and 15 min after temperature upshift. PMID- 3558399 TI - A hepatic fibrogenic factor stimulates the synthesis of types I, III, and V procollagens in cultured cells. AB - A hepatic fibrogenic factor (HFF) isolated from fibrotic rat livers has previously been shown to stimulate the transcription of type I procollagen genes in cultured fibroblasts (Raghow, R., Gossage, D., Seyer, J. M., and Kang, A.H. (1984) J. Biol. Chem. 259, 12718-12723). To test if the expression of other collagen genes was similarly affected by the fibrogenic factor, we measured the rates of types I, III, and V procollagen synthesis in two different cell lines after treatment with HFF. The effect of fibrogenic factor on types I and III procollagens was tested in rat fibroblasts, while a human rhabdomyosarcoma cell line was used to evaluate the effect of HFF on type V procollagen synthesis. Incubation with rat fibroblasts resulted in a 3-4-fold stimulation of the synthesis of both types I and III procollagens in a time-dependent manner. The stimulated rates of types I and III procollagen synthesis accompanied an increase in the steady-state levels of their corresponding mRNAs. When A204 cells, which are derived from a rhabdomyosarcoma and exclusively synthesize type V procollagen, were incubated with the fibrogenic factor, a 3-4-fold stimulation of the synthesis of both pro-alpha 1(V) and pro-alpha 2(V) chains was seen. Using a cDNA probe for pro-alpha 2(V), we also observed that there was a 2-3-fold increase in the steady-state level of pro-alpha 2(V) mRNA in A204 cells after treatment with the fibrogenic factor. In both rat fibroblasts and A204 cells the steady-state levels of beta-actin mRNA were minimally affected by fibrogenic factor, suggesting that the procollagen genes were preferentially affected. Since types I, III, and V collagens are present in the normal liver and accumulate aberrantly in the fibrotic liver, we suggest that fibrogenic factor may play an important role in determining the altered collagen composition of the fibrotic liver. Based on these data, we also speculate that the regulation of the biosynthesis of a variety of procollagens in diverse cell types by HFF possibly occurs by a common mechanism. PMID- 3558400 TI - Accurate transcription of mouse metallothionein-I gene in a fractionated nuclear extract from a rat hepatoma. AB - Nuclear extract from Morris hepatoma 3924A was fractionated by DEAE-Sephadex chromatography. The fraction eluting with 300 mM (NH4)2SO4 (DE-C) was used for transcribing cloned mouse metallothionein-I (MT-I) gene in a run-off assay. This fraction contained the majority of RNA polymerase II as well as the transcription factor(s). Accuracy of MT-I DNA transcription was confirmed by S1 nuclease mapping. Low concentrations (1 microgram/ml) of alpha-amanitin inhibited the reaction, indicating that RNA polymerase II directed the transcription. Unfractionated nuclear extracts from the hepatoma or a rat mammary adenocarcinoma as well as whole cell extract obtained from the mammary tumor also transcribed MT I gene. The extent of transcriptional activity was in the following order: hepatoma nuclear fraction DE-C greater than whole cell extract derived from rat mammary adenocarcinoma cells greater than nuclear extract derived from rat hepatoma or rat mammary adenocarcinoma cells. These studies have demonstrated that a fractionated nuclear extract obtained from a tissue supports efficient and accurate RNA polymerase II-mediated transcription of MT-I DNA. PMID- 3558401 TI - Vitamin A uptake from retinol-binding protein in a cell-free system from pigment epithelial cells of bovine retina. Retinol transfer from plasma retinol-binding protein to cytoplasmic retinol-binding protein with retinyl-ester formation as the intermediate step. AB - We have investigated the steps by which retinol, released from plasma retinol binding protein (RBP), enters the cells and is accumulated for the most part as a retinyl-ester, only a small fraction of it being present as a complex with cytoplasmic retinol-binding protein (CRBP). For this purpose, we have developed a cell-free system composed of plasma membrane-enriched fractions from bovine retinal pigment epithelium which selectively incorporates exogenous vitamin A when presented as a retinol-RBP complex. Upon incubation in the presence of [3H]retinol-RBP, isolated plasma membrane fractions take up and esterify retinol. A 4-fold reduction of total vitamin A incorporation is observed in conditions which specifically inhibit retinyl-ester formation, thus indicating that the two processes of retinol uptake and esterification are functionally coupled. Evidence is presented that retinol bound to a plasma membrane receptor sharing functional and structural similarities with CRBP is the actual substrate for esterification. Vitamin A accumulation seems to require retinol esterification to allow the recycling of a limited number of free, plasma membrane-associated, retinol receptors. Mobilization of retinol stored as a membrane-bound retinyl-ester is mediated by a membrane-associated hydrolase activity selectively controlled by the level of apo-CRBP which acts as a carrier for the released retinol. Up to 90% of membrane-bound vitamin A is released upon incubation in the presence of apo CRBP (11 microM) with concomitant formation of retinol-CRBP. The overall process, in which retinol never needs to leave its binding proteins, allows the accumulation of vitamin A in the form of a membrane-bound retinyl-ester and its regulated mobilization as a retinol-CRBP complex. PMID- 3558402 TI - A unique gene for 5-aminolevulinate synthase in chickens. Evidence for expression of an identical messenger RNA in hepatic and erythroid tissues. AB - Reports to date have led to the conclusion that there are isozymes for 5 aminolevulinate synthase in the liver and erythroid tissue of chicken. Indeed, the existence of a multigene family for chicken 5-aminolevulinate synthase has been proposed. We find no evidence to support these proposals. In this work we show that 5-aminolevulinate synthase mRNA from chicken liver and reticulocytes is identical as determined by RNase mapping and primer extension studies and that the 5-aminolevulinate synthase protein from these tissues is the same size as judged by immunoblot analysis. We also show that a single mRNA species for 5 aminolevulinate synthase is present in chicken liver, reticulocytes, brain, and heart and an avian erythroblastosis virus-transformed chicken erythroblast cell line. Southern analysis shows the presence of only one gene copy for 5 aminolevulinate synthase in the chicken haploid genome. Overall, these results lead to the conclusion that in chickens 5-aminolevulinate synthase is encoded by a unique gene and is expressed as a single mRNA species in all tissues. PMID- 3558403 TI - n-Butyrate increases the level of thyroid hormone nuclear receptor in non pituitary cultured cells. AB - The thyroid hormone nuclear receptor is a chromatin-associated protein regulating expression of specific genes. Acetylation of nucleosomal core histones is thought to be one of the factors regulating transcriptional activity of chromatin, and it is suggested that this reaction negatively regulates thyroid hormone receptor levels in GH1 cells (Samuels, H.H., Stanley, F., Casanova, J., and Shao, T. C. J. Biol. Chem. 255, 2499-2508). In the present study, we found that n-butyrate, a potent inhibitor of histone deacetylase, increases thyroid hormone receptor levels in three distinct non-pituitary cells without changing binding affinity. This effect appeared within 30 min and reached a plateau (240% of control) after a 6-h treatment, before important cellular functions were affected. This effect was time-dependent, dose-dependent, reversible, and paralleled the changes in the electrophoretic mobilities of histones H3 and H4. n-Butyrate prolonged the receptor half-life, and this prolongation corresponded to the increase of receptor levels. Thyroid hormone did not reduce its own receptor levels or influence the effect of n-butyrate. Considering the difference between GH1 cells and non-pituitary cells in the regulation of thyroid hormone receptor levels, our observations, together with those of Samuels et al., suggest the possibility that the acetylation of chromatin-associated proteins has a physiological significance in the regulation of thyroid hormone nuclear receptor levels. PMID- 3558404 TI - Proton nuclear magnetic resonance studies on the iodide binding by horseradish peroxidase. AB - Binding of an iodide ion to horseradish peroxidase was studied by following the hyperfine-shifted proton nuclear magnetic resonance signals of the enzyme. For the enzyme in an iodide-free solution, the spectra of hyperfine-shifted methyl region were only slightly affected by varying pH. In the presence of iodide (200 mM), however, both chemical shifts and line widths of the heme peripheral 1- and 8-methyl proton signals were markedly affected by the pH change from 7 to 4 and broadened at pH 4. From the change in peak heights of these signals at various concentrations of iodide, the dissociation constant of the iodide to the enzyme was calculated to be about 100 mM at pH 4.0. The peak derived from the proximal histidyl imidazole N epsilon-H proton was not perturbed by the addition of 200 mM iodide at pH 4.0 and 7.1. The rate of oxidation of iodide with hydrogen peroxide catalyzed by the enzyme was increased with decreasing pH, indicating the participation of an ionizable group with the pKa value of 4.0. Optical difference spectrum studies showed that iodide exerts no effect both at pH 4.0 and 7.4 on the binding affinity of resorcinol which is associated with the enzyme in the vicinity of the heme peripheral 8-CH3 group. These results suggest that an iodide ion binds to the enzyme at almost equal distance from the heme peripheral 1- and 8-methyl groups at the distal side of the heme and that the interaction becomes stronger in acidic medium with protonation of the ionizable group with the pKa value of 4.0. PMID- 3558405 TI - Mg(II) binding by bovine prothrombin fragment 1 via equilibrium dialysis and the relative roles of Mg(II) and Ca(II) in blood coagulation. AB - The first direct equilibrium dialysis titration of the blood coagulation protein bovine prothrombin fragment 1 with Mg(II) is presented. Fragment 1 has fewer thermodynamic binding sites for Mg(II) than Ca(II), less overall binding affinity, and significantly less cooperativity. Several nonlinear curve fitting models were tested for describing the binding of fragment 1 with Mg(II), Ca(II), and mixed metal binding data. The Mg(II) data is represented by essentially five equivalent, noninteracting sites; for Ca(II), a model with three tight, cooperative sites and four "loose", equal affinity, noninteracting sites provides the best model. Based on the reported equilibrium dialysis data and in conjunction with other experimental data, a model for the binding of Ca(II) and Mg(II) to bovine prothrombin fragment 1 is proposed. The key difference between the binding of these divalent ions is that Ca(II) apparently causes a specific conformational change reflected by the cooperativity observed in the Ca(II) titration. The binding of Ca(II) ions to the three tight, cooperative sites establishes a conformation that is essential for phospholipid X Ca(II) X protein binding. The filling of the loose sites with Ca(II) ions leads to charge reduction and subsequent phospholipid X Ca(II) X protein complex interaction. Binding of Mg(II) to bovine prothrombin fragment 1 does not yield a complex with the necessary phospholipid-binding conformation. However, Mg(II) is apparently capable of stabilizing the Ca(II) conformation as is observed in the mixed metal ion binding data and the synergism in thrombin formation. PMID- 3558406 TI - The role of apolipophorin III in in vivo lipoprotein interconversions in adult Manduca sexta. AB - Sustained flight in the moth, Manduca sexta, necessitates lipid mobilization and transport to flight muscle, a process mediated by the adipokinetic hormone. An adult specific high density lipophorin (lipoprotein, HDLp-A, Mr = 7.68 X 10(5)) accepts diacylglycerol from the fat body, increasing in size and decreasing in density, to give a low density lipophorin (lipoprotein, LDLp, Mr = 1.56 X 10(6)). During this process, several molecules of the small apolipoprotein, apolipophorin III (apoLp-III), are added to the two molecules originally present in HDLp-A. A study of the time course of adipokinetic hormone-induced loading of diacylglycerol onto HDLp-A, using the analytical ultracentrifuge and gel filtration, suggests that a lipoprotein of density intermediate between HDLp-A and LDLp was formed transiently. Analysis of lipoproteins separated by density gradient ultracentrifugation in the course of the loading process indicates that apoLp-III is added more rapidly than diacylglycerol and that it changes its conformation on the surface as more diacylglycerol is added. Taken together with the known properties of apoLp-III, a prolate ellipsoid with an axial ratio of 3, we suggest that initially apoLp-III adds to the expanded hydrophobic surface of the lipoprotein with its short axis parallel to the surface and that apoLp-III subsequently unfolds to cover a greater area of hydrophobic surface. Exchange experiments with labeled apoLp-III showed that the two apoLp-III molecules in HDLp-A do not exchange with free apoLp-III, even when the lipoprotein passed through a loading and unloading cycle, suggesting a structural role for apoLp-III in HDLp-A. PMID- 3558407 TI - Human plasma platelet-activating factor acetylhydrolase. Purification and properties. AB - Platelet-activating factor (PAF, 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine) is a biologically active phospholipid synthesized by a variety of cell types upon appropriate stimulation. PAF is a potent hypotensive factor and it activates platelets and inflammatory cells at concentrations as low as 10(-10) M. Removal of the acetyl moiety at the sn-2 position abolishes the biological activity and this reaction is catalyzed by a specific acetylhydrolase present in plasma and animal tissues. Ultracentrifugation in density gradients showed that 30% of the activity is associated with high density lipoproteins and 70% with low density lipoproteins. We have purified the plasma low density lipoprotein-associated activity to near homogeneity using a rapid assay based on the separation of [3H]acetate from 1-O-alkyl-2-[3H]acetyl-sn-glycerol-3-phosphocholine on disposable reversed-phase columns. The enzyme was purified by 25,000-fold and approximately 10% of the starting activity was recovered. Plasma PAF acetylhydrolase has an apparent molecular weight of 43,000, does not require calcium, has preference for micellar versus monomeric substrate, and exhibits surface dilution kinetics. The purified protein has an apparent Km of 13.7 microM and a Vmax of 568 mumol/h/mg with micellar PAF. It can act both on 1-O-alkyl and 1-acyl substrates and on ethanolamine analogs of PAF. However, the enzyme has a marked preference for the sn-2 acetyl residue and therefore can be considered as a specific PAF-acetylhydrolase. PMID- 3558408 TI - Cell cycle-dependent methyl esterification of lamin B. AB - Previous work from this laboratory has shown that approximately 24 proteins are reversibly modified by methyl esterification in a mouse lymphoma cell line. Here, we analyze several mouse tissues as well as other mouse, hamster, and human cell lines and find that many protein-methyl esters are ubiquitous while others show apparent tissue specificity. One of the modified proteins is identified by cellular localization and immunological detection as lamin B, a nuclear envelope structural protein which undergoes depolymerization during mitosis. The average stoichiometry of methylation is at least 0.5 methyl groups per lamin B molecule as determined by radioactive incorporation. By immunoblotting, however, demethylation appears to result in a gain of two negative charges suggesting the loss of two neutral methyl esters producing two carboxylic acid groups per molecule. By comparing mitotic and interphase cells, lamin B is found to be demethylated in mitosis while most other methyl esterified proteins show no appreciable cell cycle dependence. In addition to the correlation with cell cycle, it is shown that lamin B does not incorporate radioactive methyl esters in intact mouse brain tissue yet can do so if the cells are lysed. Analysis of lamin B charge by immunoblotting after isoelectric focusing indicates that this protein is fully methylated in brain suggesting that turnover of methyl groups in intact brain tissue is inhibited. We propose that methylation of lamin B may be involved in the control of disassembly and reassembly of the nuclear envelope during mitosis. If this were the case, the apparent lack of methyl group turnover in brain would be consistent with the inability of those cells to divide. PMID- 3558409 TI - Control of gene expression during higher plant chloroplast biogenesis. Protein synthesis and transcript levels of psbA, psaA-psaB, and rbcL in dark-grown and illuminated barley seedlings. AB - Etioplasts of 4.5-day-old dark-grown barley synthesize and accumulate most of the membrane and nearly all the soluble polypeptides of mature chloroplasts of light grown seedlings. Etioplasts do not synthesize a limited set of chloroplast encoded polypeptides which are major constituents of chloroplast thylakoid membranes: two chlorophyll apoproteins of photosystem I (68 and 65 kDa), two chlorophyll apoproteins of photosystem II (47 and 43 kDa), and a 32-kDa polypeptide which has now been identified as the psbA gene product. Throughout development in the dark, etioplasts were unable to synthesize the chlorophyll apoproteins of photosystem I and II or the psbA gene product despite the presence of significant transcript levels for psbA and psaA-psaB (encode for photosystem I chlorophyll apoproteins). Light was not required for the synthesis of ribulose bisphosphate carboxylase large subunit with the highest rate of large subunit synthesis occurring in young dark-grown seedlings. Illumination of 4.5-day-old dark-grown barley rapidly induced the synthesis of the chlorophyll apoproteins and the psbA gene product at a time when transcript levels for psbA and psaA-psaB did not increase appreciably. Therefore, during the early stages of light-induced development the synthesis of the chlorophyll apoproteins of photosystem I and psbA gene product is regulated at the translational level. With continued chloroplast development in the light, the synthesis of the chlorophyll apoproteins of photosystem I and II decline rapidly as does the synthesis of the large subunit of ribulose bisphosphate carboxylase. The decline in polypeptide synthesis correlated with a decline in rbcL and psaA-psaB transcript levels and a light-dependent decline in plastid rRNA content. In contrast, synthesis of the psbA gene product was maintained throughout light-induced chloroplast development which correlated with the maintenance of psbA transcript levels. However, light is not strictly required for psbA transcript accumulation since psbA transcript levels increased slightly with continued plastid development in dark-grown seedlings. PMID- 3558410 TI - Lipid asymmetry induced by transmembrane pH gradients in large unilamellar vesicles. AB - We have investigated the influence of transmembrane pH gradients across large unilamellar vesicle membranes on the transbilayer distributions of simple lipids with weak base and weak acid characteristics. Trinitrobenzenesulfonic acid labeling results consistent with a rapid and complete migration of stearylamine and sphingosine to the inner monolayer of the large unilamellar vesicles are observed when the large unilamellar vesicles' interior is acidic. Alternatively, when the vesicle interior is basic, oleic and stearic acid cannot be removed by external bovine serum albumin, indicating a localization in the inner monolayer. Moreover, effects corresponding to the decrease in external surface charge predicted upon the migration of stearylamine or stearic acid to the inner monolayer are readily detected employing ion exchange chromatography. These results are consistent with transbilayer distributions of these agents dictated by a Henderson-Hasselbach equilibrium. The possible implications for metabolic regulation by pH gradients, as well as factors giving rise to phospholipid transbilayer asymmetry, are discussed. PMID- 3558411 TI - Reconstitution of the two terminal enzymes of the heme biosynthetic pathway into phospholipid vesicles. AB - Purified mouse protoporphyrinogen oxidase (EC 1.3.3.4) and ferrochelatase (EC 4.99.1.1), the two terminal enzymes of the heme biosynthetic pathway, have been reconstituted into phospholipid vesicles, and the kinetics of the enzymes in the reconstituted systems were compared with the values obtained with the free enzymes. The apparent Km for free protoporphyrinogen oxidase in detergent solution is 5.61 +/- 0.62 microM for free protoporphyrinogen. The Km was lower when the enzyme was inserted into phospholipid vesicles (0.78 +/- 0.28 microM) and when both enzyme and substrate were incorporated into phospholipid vesicles (0.61 +/- 0.14 microM). In the presence of cardiolipin, a phospholipid present mainly in the inner mitochondrial membrane, the value of the Km for the substrate decreased 3-fold (0.20 +/- 0.02 microM). For reconstituted ferrochelatase similar kinetic analyses were carried out and it was found that the apparent Km values were only weakly affected by the lipid environment. Studies on the orientation of ferrochelatase demonstrated that approximately 50% of the enzyme in the reconstituted system had the active site located in the inner face of the phospholipid vesicle. This is in contrast to intact mitochondria where the active site is located on the matrix side of the inner mitochondrial membrane. The activation energies for both enzymes were determined for free and reconstituted enzymes. It was found that for both enzymes the activation energies were lower for the reconstituted systems than for the free enzymes. PMID- 3558412 TI - Inhibition of aromatase cytochrome P-450 by 10-oxirane and 10-thiirane substituted androgens. Implications for the structure of the active site. AB - The mechanism of inhibition of estrogen synthetase (P-450arom) by 19R- and 19S isomers of 10-oxiranyl-and 10-thiiranyl-4-estrene-3,17-dione was investigated using human placental microsomes and purified enzyme preparations. The 19R isomers were potent inhibitors and exhibited affinities 36-fold (10-oxirane) and 80-fold (10-thiirane) greater than the respective 19S-isomers. Kinetic experiments showed that inhibition by the 19R-isomers is competitive with respect to substrate; inhibition constants for the (19R)-10-oxirane (Ki = 10 nM) and the 19R-10-thiirane (Ki = 2 nM) indicate that each binds with greater affinity than the androgen substrates androstenedione and testosterone. Inhibition time courses and kinetic data were consistent with high affinity, reversible binding. Spectral titrations of microsomal preparations and purified P-450arom showed that binding of the 19R-isomers shifts the Soret maximum of the ferric enzyme to 411 nm (10 oxirane) or 425 nm (10-thiirane); addition of excess androstenedione reversed the spectral changes, producing the high spin form of the enzyme with a Soret peak at 393 nm. These spectral shifts suggest that the oxygen atom of the 10-oxirane and the sulfur atom of the 10-thiirane are bound to the heme iron in the inhibitor complexes. These results suggest that the high affinities of the inhibitors arise from their dual interaction with the androgen binding site and with the heme. Coordination of the C19 heteroatom to the heme indicates that C19 of androgen substrates may be positioned sufficiently close to the heme to allow direct attack by an iron-bound oxidant. Stereoselective binding of the 19R-isomers by P 450arom further suggests that the heme is likely to be positioned above C1 and C2 of the A ring. PMID- 3558413 TI - Statistical aspects of the planning and analysis of collaborative studies on biological standards. AB - Statistical principles play a central role in the planning and analysis of collaborative studies on biological standards. These studies are carried out to assess the suitability of proposed biological standards, which should be demonstrated to provide valid and reproducible measurements of biological potency, and to assign units of activity (for example, by calibration against an existing standard). Guidelines have been published by the World Health Organization (WHO Tech Rep Ser 1978: 626: 101-141) describing the technical and general aspects of setting up biological standards and organizing collaborative studies. This paper, which is complementary to the WHO guidelines, expands on the statistical points which need to be considered. The general design of the study, the design of individual assays, the statistical analysis of the raw data, and the presentation of the results are described. PMID- 3558414 TI - [Evaluation of thermostable yellow fever vaccine from the Pasteur Institute on international travellers]. AB - The authors studied the tolerance and efficacy of the new stabilized 17D yellow fever vaccine produced by Pasteur Vaccins, on 50 international travellers at the University Hospital of Grenoble (France), comparing it with the standard 17D yellow fever vaccine. The short-term and long-term tolerance in all the travellers was excellent. The serological efficacy was estimated by seroneutralization assay with the vaccine virus Rockefeller 17D, which is the most sensitive and the most specific method. The seroconversion rate was 93.8%, the same as the rate obtained with the standard yellow fever vaccine in 50 other travellers. The authors studied also the serological response to the standard yellow fever vaccine associated with other vaccines (diphtheria, tetanus, oral or injectable poliomyelitis, and oral cholera): the seroconversion rates were similar to those obtained with the yellow fever vaccine alone, thus demonstrating that these associated vaccines do not interfere with immunization against yellow fever. PMID- 3558415 TI - The calibration of rabbit tissue thromboplastins: experience of the Dutch Reference Laboratory for anticoagulant control. AB - A number of commercial rabbit tissue thromboplastins used in oral anticoagulant control have been calibrated against the first International Reference Preparation for thromboplastins. This was done in a three-stage procedure by one laboratory, each stage representing a different level of thromboplastin comparability. The calibration model recently recommended by ICTH and ICSH was tested. This model proved to be suitable, although a statistically significant aberration was observed for some of the thromboplastins. The bias introduced by using the model in these non-ideal cases was small compared to the overall variation of the International Normalized Ratio, being the universal scale for reporting the prothrombin time during oral anticoagulant control. Batch-to-batch calibration using lyophilized pooled plasmas could be reliably performed for several commercial thromboplastins. PMID- 3558416 TI - Cell growth on microcarriers: comparison of proliferation on and recovery from various substrates. AB - Three commercially-important types of cell were grown on four different microcarrier substrates. The cells, which included normal human diploid fibroblasts (MRC-5), primary chick embryo cells and Madin-Darby bovine kidney cells (MDBK), were compared with regard to proliferation on the substrates and with regard to recovery of viable cells from the same substrates. The substrates used included glass-coated microcarriers (Biosil), collagen microcarriers (Ventregel), DEAE-dextran microcarriers (Cytodex I) and collagen-linked DEAE dextran microcarriers (Cytodex III). The established cell line (MDBK) grew well on all of the substrates and a high percentage of viable cells could be harvested from each substrate. The MRC-5 cells also grew well on all four substrates but high recovery rates were achieved only with cells grown on the glass-coated microcarriers or collagen microcarriers. In contrast, the primary chick embryo cells grew well only on the glass microcarriers and the recovery rate of cells harvested from this substrate was high. In some industrial operations, the re utilization of cells after removal from the substrate is necessary. In these situations the appropriate choice of microcarriers for the cultivation of the cells may be critical. PMID- 3558417 TI - The development of a potency test for Leptospira hardjo vaccines: a comparison of protection in calves and serology in guinea-pigs. AB - The protective properties of two commercial Leptospira hardjo vaccines in calves were compared with the serological responses induced in guinea-pigs with a view to establishing a potency test based on serology. Groups of calves were given graded doses of the two vaccines and after eight weeks were challenged with virulent L. hardjo. Infection was monitored by microscopy and culture of urine and, eight weeks after challenge, by culture of the kidneys post mortem. Groups of guinea-pigs also were tested by the microscopic agglutination test (MAT). A clear dose response was observed and the response was related to the degree of protection achieved in the calves. The MAT titre in guinea-pigs indicative of an effective vaccine was calculated for the minimum dose of each vaccine that gave full protection in calves. A close correlation was observed. Two further batches of each vaccine were tested in guinea-pigs on two occasions with reproducible results. A potency test based on the MAT response of guinea-pigs is proposed. PMID- 3558418 TI - Analysis of the immunoadjuvant octadecyl tyrosine hydrochloride. AB - A simple, rapid, high performance liquid chromatographic (HPLC) method for the analysis of the immunoadjuvant octadecyl tyrosine hydrochloride is described. The HPLC procedure can be applied to the direct determination of amino acid reactants present as contaminants in the adjuvant (tyrosine, ethyl tyrosine) and from this information the content of octadecanol reactant can be estimated. Further, these same determinations provide a means of monitoring immunoadjuvant stability in any vaccine preparation. PMID- 3558419 TI - A survey of the concentrations of eleven metals in vaccines, allergenic extracts, toxoids, blood, blood derivatives and other biological products. AB - Approximately 85 samples of injectable biological products regulated by the Center for Drugs and Biologics of the United States Food and Drug Administration were surveyed for the presence of 11 elements, namely aluminum, arsenic, barium, cadmium, chromium, lead, mercury, selenium, thallium and zinc, by flame and flameless methods of atomic absorption spectrometry and flame emission spectrometry. The range of products tested included whole blood, red cells, plasma, normal serum albumin, antihemophilic factor, and other products derived from blood; allergenic extracts including honey bee venom and house dust allergenic extracts; vaccines such as measles virus vaccine and typhoid vaccine; and tetanus toxoid. The metal concentrations found in the majority of these products were low or undetectable. The metal levels varied from manufacturer to manufacturer, product and lot-to-lot of the same manufacturer's products. House dust allergenic extracts had the highest concentrations of arsenic (2.4 ppm), cadmium (0.28 ppm), chromium (0.6 ppm) and lead (1.5 ppm) found in the study. A high zinc concentration (24 ppm) in an immune serum globulin was attributed to the zinc-containing rubber stopper in contact with the product. A range of 0.36 3.30 ppm aluminum was found for seven 25% normal serum albumin samples from seven manufacturers. Values of 8.2, 17 and 18 ppm aluminum were found in one manufacturer's 25% normal serum albumin. These aluminum values appeared to be the result of an anomaly in this manufacturer's production that has not been repeated to date. PMID- 3558420 TI - The International Standard for sisomicin. AB - An International Standard for Sisomicin has been established on the basis of a collaborative assay. There were seven participating laboratories in seven countries. The activity of the contents of each ampoule of the International Standard of Sisomicin is defined as 35,200 International Units of Sisomicin. PMID- 3558421 TI - The quantitative estimation of diphtheria and tetanus toxoids. 1. The flocculation test and the Lf-unit. AB - Considerable confusion exist in the quantitative estimation of diphtheria and tetanus toxoids. The present paper is the first in a series of papers comparing various quantitative methods. It describes the flocculation test, gives a mathematical model for the three-dimensional reaction surface, and suggests different designs which facilitate the unbiased calculation of the end-point. PMID- 3558422 TI - [Thermostabilization of the lyophilized yellow fever vaccine 17-D. II. Pilot lots prepared under conditions of industrial production]. PMID- 3558423 TI - The effect of aluminium phosphate adjuvant on the potency of pertussis vaccine. PMID- 3558424 TI - Analysis of cumulative strain in tendons and tendon sheaths. AB - Twenty-five fresh frozen flexor digitorum profundus tendons stratified by sex were subjected to uniaxial step stress and cyclic loads in twelve intact human cadaver hands. By attaching specially designed clip strain gage transducers on tendons just proximal and distal to an undisrupted carpal tunnel, the interactions of the tendons, tendon sheath and retinacula were measured. The elastic and viscous response of the tendon composites to step stresses were found to fit fractional power functions of stress and time respectively. A significant and quantifiable decrease in strain from the proximal to the distal tendon segment was found to be a function of wrist deviation. The results indicate that an accumulation of strain does occur in tendinous tissues during physiologic loading. PMID- 3558426 TI - Elastic moduli, yield stress, and ultimate stress of cancellous bone in the canine proximal femur. AB - Elastic moduli, yield stress and ultimate compressive stress were determined for cancellous bone from the femoral head and neck regions of the canine femur. Unconfined compression tests were performed on 5 mm cubic samples which were cut from two femurs. Elastic moduli were measured in three orthogonal directions, and the yield stress and ultimate stress were measured along the proximal-distal axis. The results from this investigation support previous assumptions that the mechanical behavior of canine cancellous bone is qualitatively similar to human cancellous bone. The canine cancellous bone was observed to be anisotropic in elastic modulus. For two thirds of the cubic specimens tested, the elastic modulus was largest in the load-bearing, proximal-distal direction. A linear relationship between yield stress and elastic modulus was observed for canine bone, as is typical of human bone. A similar linear relationship between ultimate stress and elastic modulus was observed. Thus, for canine bone as well as for human bone, failure appears to be governed by a strain level which is position independent. The yield strain of 0.0259 and ultimate strain of 0.0288 for canine bone were both less than the yield strain of 0.0395 reported for human bone. PMID- 3558425 TI - Stance phase control of above-knee prostheses: knee control versus SACH foot design. AB - The mobility of above-knee amputees (A/K) is limited, in part, due to the performance of A/K prostheses during the stance phase. Currently stance phase control of most conventional A/K prostheses can only be achieved through leg alignment and choice of the SACH (Solid Ankle Cushioned Heel) foot. This paper examines the role of the knee controller in relation to a SACH foot during the stance phase of level walking. The three-dimensional gait mechanics were measured under two stance phase conditions. In the first set of trials, the amputee used a prosthesis with a conventional knee controller that allowed the amputee to maintain the knee joint in full extension during the stance phase. In the second set of trials, the prosthetic knee, during stance, echoed the modified kinematics of the amputee's sound (intact) knee that had been recorded during the previous sound stance phase. Analysis and interpretation of the data indicate the following: (1) SACH foot design can strongly influence the walking mechanics independent of the knee controller; (2) knee controller design and SACH foot design are mutually interdependent; and (3) normal kinematics imposed on the prosthetic knee does not necessarily produce normal hip kinematics (e.g. reduce the abnormal rise in the prosthetic side hip trajectory). Future research is necessary to explore and exploit the interdependency of prosthetic knee control and foot design. PMID- 3558427 TI - The first heart sound during the isovolumetric contraction. AB - We make the first attempt to construct a qualitative theory covering the whole process of the major part of the first heart sound from an electrical activation to the phonocardiographic observations at the thorax. We calculate the amplitudes and frequencies of the radiated pressures during the isovolumetric contraction period generated by the muscular wall of the left ventricle and by the valves considered as a spherical shell and two-dimensional membranes, respectively. The analysis shows that both the hemodynamic and the valvular theory are able to explain most of the characteristic features of the first heart sound (linear relation between the amplitudes of the radiated pressure and the slope of the left ventricular pressure-time curve; directional polarity of the amplitudes; equidistant frequency peaks with a decline in amplitudes). However, existing magnitudes of the set of physiological parameters involved seems to favour the hemodynamic theory of the first heart sound. The aortic valve can be neglected as a source of sound. The initial conditions (like valve closure velocity), according to our theory, cannot be important. The predicted time-plot and frequency spectrum of the radiated pressure show a general resemblance with the recorded ones. It is essential to have considerably more quantitative acoustic data both for normal and diseased hearts for subsequent theoretical development. PMID- 3558428 TI - Quantitative functional anatomy of the lower limb with application to human gait. AB - A scheme was developed to classify muscles according to their primary, secondary and tertiary functions, e.g. a muscle which produces primarily a flexion moment may also produce secondary abduction and tertiary internal rotation moments. The functions of muscles crossing the hip and knee joints were computed based upon the changing relative positions of joint centers and muscle origins and insertions during one gait cycle. The function of several of the major muscles crossing the hip and knee joints is reported for the different limb positions corresponding to normal gait. It was found that the amount of force necessary to produce a given moment about a joint was dependent upon the limb position. In addition, the muscle functions changed significantly with limb position. Electrical stimulation of muscles of a paralyzed subject gave qualitative support to the results. PMID- 3558429 TI - Quantification of strains in biaxially tested soft tissues. AB - A technique for the quantification of the strain field in the central region of biaxially tested planar soft tissues is presented. A vidicon-based image analysis system interfaced to a PDP 11/34 minicomputer is employed to track particles affixed to the specimen surface in real-time, from which the strains are inferred. Illustrative results are given for tests on excised canine pleural specimens on which four particles were affixed. The technique is applicable, however, to any planar soft tissue and any number of tracking particles. This procedure is recommended over previously used methods when testing anisotropic tissues. PMID- 3558430 TI - Factors in the propagation of aortic dissections in canine thoracic aortas. AB - Factors were examined which altered the propagation of aortic dissections in canine aortas. Thoracic aortas were removed from sacrificed dogs from the distal end of the arch to the diaphragm. An intimal tear was created at the proximal end of the aorta. The dissection was propagated using a pulsatile pressure system with no flow. The aorta was perfused with a dilute black paint solution, which allowed both video monitoring of the extension of the dissection and measurement of the dissection rate. The dependence of the dissection rate on the variables peak pressure, (dP/dt)max and intimal tear depth was examined. The dissection rate was found to be dependent on (dP/dt)max (p less than 0.005) and the intimal tear depth, expressed as a percentage of wall thickness (p less than 0.01), but not on the peak pressure or intimal tear length. The equation relating the significant variables was log (dissection rate) = (-0.034) X % tear depth +(1.89 +/- 0.56) X (dP/dt)max -(4.3 +/- 1.8); r = 78. Thus a higher (dP/dt)max was associated with a more rapid dissection rate and a deeper intimal tear was associated with a slower dissection rate. PMID- 3558431 TI - Strain energy density function and uniform strain hypothesis for arterial mechanics. AB - Stress distribution through the wall thickness of the canine carotid artery was analyzed on the basis of the uniform strain hypothesis in which the wall circumferential strain was assumed to be constant over the wall cross-section under physiological loading condition. A newly proposed logarithmic type of strain energy density function was used to describe the wall properties. In contrast with other studies, this hypothesis gave almost uniform distribution of wall stresses under the physiological condition and non-zero residual stresses when all external forces were removed. PMID- 3558432 TI - Tendon stiffness: methods of measurement and significance for the control of movement. A review. AB - An appraisal of the role of tendons in transmitting muscle tension to skeletal parts during posture and movement requires accurate knowledge of the mechanical characteristics of the tendon. Here the most important property is tendon stiffness. While it is relatively easy to measure the stiffness of an isolated segment of tendon, more sophisticated methods must be sought to take into account the whole length of tendon, including its intramuscular portion. Two methods are currently available for measurement of whole tendon stiffness: each has a limited range of muscle tensions over which it appears to provide reliable values, one method being better at low tensions, the other at high tensions. Some controversy remains about the precise values obtained in the mid-tension range covered by both methods. Nevertheless it is now possible to achieve reasonable estimates of tendon stiffness over the whole working range of the muscle. An important consideration which has emerged from the discussion is that at low tensions the tendon is much less stiff than at higher tensions. PMID- 3558433 TI - Stiffness behaviour of trabecular bone specimens. AB - Trabecular bone specimens were tested by non-destructive technique with the purpose of investigating stiffness behaviour and optimizing stiffness determination. Cylindrical specimens (n = 25) were loaded repetitively (0.1 Hz, 30 cycles) by axial compression to 50% of predicted ultimate strength and finally compressed to failure. Analyses of single compression curves showed increasing stiffness (E') until a stress level about 50% of ultimate stress followed by decreasing stiffness. Curve fit analysis of the elastic part of the compression curve showed the best fit, when a second order polynomial was used (r = 0.94, p less than 0.001). The stiffness determined non-destructively at the 25% level of ultimate strength increased significantly to the tenth loading cycle followed by a steady state. The precision of stiffness determination as an average of five consecutive measurements at steady state was E' +/- less than 5% (95% confidence limits). A reproducibility test by repetition of the test sequence after 3 h rest showed qualitatively the same stiffness behaviour. The variation of stiffness determination between the two test sequences was +/- 27% at the first loading cycle falling to +/- 12% at steady state. PMID- 3558434 TI - Comment on 'A mathematical theory of running' and the applications of this theory. PMID- 3558435 TI - Growth of bone marrow cells on porous ceramics in vitro. AB - Following the transplantation of bone marrow cells to extra-osseous sites, bone formation occurs in those sites. This osteogenic potential of bone marrow cells might be utilized for filling defects in bone if they could be transported on porous ceramic materials. Before such an approach becomes feasible, it is important to know what happens to the cells in the presence of the ceramics that might be used. In order to investigate the interaction between bone marrow cells and ceramics, in vitro, a system for culturing bone marrow cells on ceramic materials has been developed. Bone marrow cells adhered well to the surface of calcium hydroxyapatite and tricalcium phosphate ceramics, and this was followed by the formation of fibrous tissue on and within the ceramics. These ceramics were compatible with bone marrow cells even in culture conditions in which there was a large surface area of ceramic interfacing with cells. The results support the proposal that calcium hydroxyapatite and tricalcium phosphate are appropriate as bone replacement materials. In contrast, calcium aluminate had an adverse effect on bone marrow cells when there was a high proportion of ceramic to culture medium. However, this effect was not present if the proportion of ceramic to culture medium was low. Therefore, a large amount of biodegradable porous calcium aluminate ceramic should not be used as an alternative to autogeneous bone grafting. PMID- 3558436 TI - Composites for use in posterior teeth: composition and conversion. AB - The purpose of this investigation was to determine the composition, as well as the conversion after polymerization, of some dental composite materials. Eight posterior composites and two anterior composites were investigated. The weight and volume fractions of inorganic fillers were determined by combustion and pycnometric analyses. The monomers were analyzed qualitatively and quantitatively by high performance liquid chromatography, nuclear magnetic resonance spectroscopy, and gel permeation chromatography. Infrared multiple internal reflection spectroscopy was applied for determination of conversion of the methacrylate groups. The conversion in light activated materials was examined at shallow depths, that is, the level of optimal conversion. This investigation demonstrated that the conversion can be correlated with the composition of monomers and oligomers used in the materials. PMID- 3558437 TI - Uptake of zinc and fluoride by several dentin components. AB - The uptake of zinc released from ZOE and Dispersalloy, and fluoride from ChemFil by different components of dentin was studied in vitro. These materials were placed over a 500-micron layer of the dentin fraction in a simulated cavity, and the zinc and fluoride levels in the fraction and underlying solution determined after 7 days. Parallel studies were also carried out in which these components, alone in simulated cavities, were placed over solutions containing different concentrations of zinc and fluoride and the uptake determined after 24 h. Zinc uptake was considerably greater by the inorganic than the organic fractions used in this study. Uptake from ZOE was disproportionately higher than from Dispersalloy presumably reflecting the fact that the zinc in ZOE is more loosely bound. In addition the high zinc levels in collagen beneath this material may be attributed to the binding of the eugenol component. In contrast fluoride uptake was generally highest by the organic fractions with relatively low uptake by the inorganic fractions which is in contrast to previous studies. Uptake of zinc and fluoride from solution by these fractions was consistent with these findings. Thus zinc is more strongly bound by the inorganic and fluoride by the organic fractions of dentin. PMID- 3558438 TI - Fracture toughness testing of biomaterials using a mini-short rod specimen design. PMID- 3558439 TI - An in vivo method for the evaluation of catheter thrombogenicity. AB - A new method has been developed to evaluate the relative thrombogenicity of vascular catheters. The technique provides a means to quantitatively differentiate between catheters made from different polymeric materials. Autologous In-111 labeled platelets were infused into a dog model and catheters were then inserted into the external jugular vein of the dog. The neck region was scanned using gamma camera imaging. Comparisons between catheter materials were made using computer generated uptake slopes during the first 40 min of the scan. In addition to scintigraphy, visual assessment of thrombus deposition, thrombus weight, platelet deposition, and scanning electron microscopy were used to validate the technique. Poly(vinyl chloride), polyurethane, heparinized polyurethane, and silicone catheter materials were tested. It was found that heparinized polyurethane was the least thrombogenic of all materials evaluated. PMID- 3558440 TI - Tissue biocompatibility of kevlar aramid fibers and polymethylmethacrylate, composites in rabbits. AB - Two groups of female NZW rabbits were implanted in the paravertebral muscles with aramid (du Pont Kevlar aramid 49) fibers and aramid-polymethylmethacrylate (PMMA) composites for 14 and 28 days. Rabbits were killed at these times periods, necropsies performed, sites scored for gross tissue response, and tissue specimens containing the implants removed for histopathological evaluation. A mild fibrous tissue reaction was observed around all implants containing aramid fiber similar to that observed around the silicone control implant. Some foreign body giant cells were also present adjacent to the fibers. An intense necrotic inflammatory reaction was present around the positive control material (PVC Y 78). The tissue response to implantation of aramid fiber and fiber-PMMA composites indicates that aramid is a biocompatible material. PMID- 3558441 TI - Textile arterial prostheses: is water permeability equivalent to porosity? AB - Porosity and water permeability are two distinct terms that describe different characteristics of vascular prostheses. The porosity is a measure of the void fraction within the prosthesis wall and is believed to give a rough prediction of the capacity of the graft to anchor newly formed surrounding tissue after implantation, whereas the water permeability indicates the rate at which water can flow through the prosthesis wall and, when measured under physiological pressure conditions, provides the surgeon with information about the need for preclotting prior to implantation. The literature has not always clearly distinguished between these two terms, and some authors in fact have suggested that they both refer to the same property of a prosthesis. In an attempt to clarify the issue, porosity and water permeability measurements were made on 34 commercial vascular prostheses having different textile constructions. Linear regression analysis demonstrated that these two characteristics are only weakly related (r = 0.59). It is therefore recommended that the current draft standards for such devices reference both properties: porosity and water permeability. PMID- 3558442 TI - A calorimetric study of the interaction of synthetic phospholipid liposomes with lipid-soluble small molecules used as dental materials and devices. AB - The interaction of 22 lipid-soluble small molecules, widely used in dental materials and devices, with synthetic phospholipid liposomes, was investigated by the application of differential scanning calorimetry (DSC), in order to clarify the mechanism of small molecules in biological systems. Dimyristoyl phosphatidyl choline (DMPC) and dipalmitoyl phosphatidyl choline (DPPC) were used as lipids. The interaction of various monomers with liposomes has been reported by us in this journal. In this experiment, various compounds such as redox-initiator, photo-initiator or photo-sensitizer, inhibitor, root-canal disinfectant, cement base materials (eugenol and 2-ethoxybenzoic acid) etc., were investigated. From changes in the phase transition temperature (T), enthalpy (delta H kcal mol-1) and H/HHW values of both DMPC and DPPC liposomes induced by these molecules, it was concluded that aromatic tertiary amine, benzoyl peroxide and hydroquinone monomethyl ether had a relatively large effect on liposomes, and that in phenol derivatives, m-cresol and p-chlorophenol had a large effect on liposomes compared to phenol. Eugenol used as dental cement also had a large effect on liposomes due to its high hydrophobicity. Changes in the transition properties of liposomes induced by small molecules (characterized by shift of T to a lower temperature, an increase or decrease in cooperativity (H/HHW), and a decrease in delta H of a endothermic peak) seemed to be related to biological activities. PMID- 3558444 TI - Characterization of UHMWPE hip cups run on joint simulators. AB - The density and crystallinity of UHMWPE-hip cups were investigated as a function of thickness from the inner stressed surface to the unstressed outer surface. The effects of mechanical strain and chemical reactions during simulation tests, and damage of the material due to pretreatments and storage, resulted in changes of the structure, as indicated by variations in the crystallinity. Independent of either the batch of UHMWPE supplied or the manufacturer and the type of simulator used, the individual sample-sets showed a similar characteristic curve of density versus wall thickness. Infrared spectroscopic evaluations indicated the presence of oxidative degradation, and answers the question as to which areas of the polymers are changed by aging and which compounds are newly formed. The characteristic carbonyl groups were also determined. The concentration trend of carbonyl groups versus wall thickness obtained agrees surprisingly well with the locally determined density and crystallinity trend. As these compounds are formed by reactions which produce stable oxidative degradation products and also crosslinking, we have determined the degree of cross-linking. The determination of the soluble constituents after extraction showed lower degree of crosslinking on the surface than in the middle of the material. Hence it follows that on the surfaces oxidative chain scission is prevailing, whereas in the interior mainly crosslinking is developed. These results indicate that the samples used for the simulation tests had distinct differences in characteristics. Generally the results show that wear tests in joint simulators lead to property changes in UHMWPE which differ considerably from test results previously obtained on retrieved hip cups. PMID- 3558443 TI - 125I-fibrinogen uptake on peripheral venous cannulas: a comparison between different cannula materials and coatings. AB - Using a similar technique as 125I-Fibrinogen uptake test for detection of deep venous thrombi, the radioactivity over cannulas inserted into veins on the dorsal aspect of the hands was measured 1, 2, 4 and 24 h after insertion. In three groups of 10 postoperative patients it was by random allocation inserted on one side a siliconized tetrafluorethylene cannula and on the other side one of either: a nonsiliconized tetrafluorethylene cannula and on the other side one of either: a nonsiliconized tetrafluorethylene, a heparinized tetrafluorethylene or a fluorethylenpropylene cannula. The same volume and type of infusion was given in both cannulas. No difference in protein deposition was seen between siliconized and nonsiliconized tetrafluorethylene. A tendency of lower protein deposition, especially at 24 h on heparinized tetrafluorethylene was found. The fluorethylenpropylene cannulas had both over cannula and adjacent vein higher protein deposition at all measurements compared to the siliconized tetrafluorethylene cannula (p less than 0.01). The results implicate that fluorethylenprophylene could induce a higher incidence of thrombophlebitis than tetrafluorethylene cannulas. PMID- 3558445 TI - Luminal surface fabrication for cardiovascular prostheses. AB - Methods to produce highly ordered, specific surface morphologies on poly tetrafluoroethylene (PTFE Teflon) surfaces were developed. These methods included the use of photolithographic techniques for pattern definition and directed argon ion beam sputter etching to produce the desired surface morphology. Use of these techniques resulted in the formation of regular arrays of sharply defined hexagonal pillars with smooth, vertical walls with heights of up to 80 microns. Pillar height-to-width ratios ranged up to 5.2-1. Surface hole depths of up to approximately 80 microns were also obtained. These surface morphologies could have an important application in medicine for improving the patency of cardiovascular prostheses. This would be accomplished by creating a luminal surface in the implant which promotes the development of a healthy neointima lining. PMID- 3558446 TI - Quantitative bone remodelling resulting from the use of porous dental implants. AB - Histomorphometric analyses were used to quantitatively determine the patterns of bony ingrowth which resulted from the placement of porous-surfaced dental implants into the mandibles of Rhesus monkeys for up to 74 months utilizing a two stage approach. Quantitative histopathologic evaluations were made using ground section microscopy. Implant stability resulting from bone remodelling and ingrowth occurred to varying degrees with all implants. Bone ingrowth occurred from medullary trabeculae and contact with the adjacent cortical plates. Quantitative histomorphometric analyses revealed that in only one case was the bone ingrowth into the available internal pores less than 45%. Minimal fibrous connective tissue ingrowth was observed in the implant crypts and was not thought to be due to micro-motion. The observed bone remodelling indicated a favorable prognosis for long-term implant performance. PMID- 3558447 TI - Collagen at interfaces. II: Competitive adsorption of collagen against albumin and fibrinogen. AB - Adsorption of chemically radiolabeled [14C] collagen from binary mixtures with albumin or fibrinogen was studied on the solution/air and solution/polyethylene interfaces and revealed the preferential adsorption of albumin. This phenomenon is confirmed by the data of surface tension measurements of single protein, collagen-albumin, and collagen-fibrinogen solutions. Desorption experiments clearly show that more irreversibly adsorbed collagen was found on polyethylene surfaces when adsorption was performed from collagen-fibrinogen than from collagen-albumin solutions. The combined adsorption-desorption and the surface tension data show that competitive adsorption of collagen at the hydrophobic surfaces is strongly influenced by the surface tension properties of the proteins in solution. PMID- 3558448 TI - In vitro and in vivo kinetics of regulated drug release from polymer matrices by oscillating magnetic fields. AB - The kinetics of drug release from polymer-drug matrices containing an embedded magnet was continuously monitored in vitro and in vivo. The application of an oscillating magnetic field increased the rate of drug release from the polymer matrices. Within the limits of detection the increase in release occurred immediately, remained stable for as long as the field was applied, and returned exactly to baseline upon withdrawal of the field. The increase in release was directly proportional to field amplitude. The same pattern of results were observed in vivo as in vitro, though higher strength fields were required in vivo to achieve the same effect observed in vitro. PMID- 3558449 TI - Ion implantation of surgical Ti-6Al-4V for improved resistance to wear accelerated corrosion. AB - The influence of nitrogen-ion implantation on the wear-accelerated corrosion behavior of surgical Ti-6Al-4V was studied. Nonpassivated and prepassivated unimplanted Ti-6Al-4V specimens were employed as controls for comparison. Corrosion rates as a function of time at open-circuit corrosion potentials were electrochemically measured in saline and serum solutions under both static and wear conditions. The wear parameters simulated those of a total artificial hip under average walking conditions. The results indicated that prepassivation of the control material was beneficial under static-corrosion conditions, but not under wear-corrosion conditions. The nitrogen-ion implantation process was found to significantly improve the material's resistance to wear-accelerated corrosion in both saline and serum solutions. PMID- 3558450 TI - Wear-accelerated corrosion of Ti-6Al-4V and nitrogen-ion-implanted Ti-6Al-4V: mechanisms and influence of fixed-stress magnitude. AB - Wear-accelerated corrosion rates at constant anodic potentials were evaluated for unimplanted and nitrogen-ion-implanted surgical Ti-6Al-4V while wearing against ultrahigh-molecular-weight polyethylene at stress levels up to 6.90 MPa (1000 psi). The ion implantation processing was found to reduce the wear corrosion rates in both saline and serum solutions at all applied stress levels. During wear testing, all of the ion-implanted surfaces remained visually unchanged from the polished condition. However, many of the unimplanted surfaces developed damage zones characterized by wear tracks and black wear debris. A surface-damage mechanism is proposed and discussed which involves disruption of the Ti-6Al-4V protective oxide film, subsequent entrapment of oxide particles in the polyethylene, then self-perpetuating damage due to the abrasive action of the embedded particles. PMID- 3558451 TI - Physicochemical characterization of a hydrophilic microporous polyurethane vascular graft. AB - There is still a need for a viable small-diameter synthetic vascular graft. The expanded PTFE device appears to be the best presently available, but is still inferior to the autologous saphenous vein. Recently, a novel microporous, small diameter vascular graft fabricated from Mitrathane, a polyether urethane urea (PEUU), has been developed. In this article, we report the findings of an in vitro evaluation of the morphological, mechanical, and chemical properties of this new device. The results are compared with those of established vascular prostheses made from alternative materials including expanded PTFE and bovine heterograft, and with natural blood vessels. The PEUU graft displays good mechanical properties in spite of the presence of some structural defects or anomalies. In particular it compares favorably to the expanded PTFE device by providing both superior radial compliance and improved suture tearing strength. PMID- 3558452 TI - Differential effects of 4-iodopyrazole and 3-methylpyrazole on the metabolic activation of methylazoxymethanol to a DNA methylating species by rat liver and rat colon mucosa in vivo. AB - Using a hybrid ion-exchange reverse phase HPLC system, we found that F344 rat liver microsomes, in the presence of an NADPH-generating system, can metabolize methylazoxymethanol (MAM), a colon and liver carcinogen, to methanol and formic acid. This is in contrast to the spontaneous decomposition of MAM which yields methanol and formaldehyde. The metabolism of MAM by rat liver microsomes is sensitive to inhibition by carbon monoxide as well as to inhibition by 3 methylpyrazole (3-MeP) and 4-iodopyrazole (4-IP), with 4-IP being more potent in this respect than 3-MeP. Pretreatment of rats with 4-IP decreased the level of MAM acetate-induced DNA methylation in both the liver and the colon mucosa. In contrast, pretreatment with 3-MeP decreased MAM acetate-induced liver DNA methylation, but increased DNA methylation in the colon mucosa. This differential effect of the two compounds on DNA methylation in the liver and the colon suggests that different enzymes are responsible for activation of the carcinogen in the two organs. PMID- 3558453 TI - DNA repair synthesis in fibroblast strains from patients with actinic keratosis, squamous cell carcinoma, basal cell carcinoma, or malignant melanoma after treatment with ultraviolet light, N-acetoxy-2-acetyl-aminofluorene, methyl methanesulfonate, and N-methyl-N-nitrosourea. AB - Fibroblast strains derived from skin biopsies of patients with actinic keratosis (6), malignant melanoma (18), squamous cell carcinoma (11), and basal cell carcinoma (12) were investigated for DNA repair synthesis, with 16 fibroblast strains for normal donors as controls. Cells were exposed to UV light, the "UV like" carcinogen (Ac)2ONFln, and the methylating carcinogens MeSO2OMe and MeNOUr. Dose-response experiments, which included 10 dose levels, were performed, the data analyzed by linear regression, and the slope of the regression line (term: G0) used as a measure of DNA repair synthesis. The mean experimental variability of G0 of individual fibroblast strains was 9.5%-15.4%, depending upon exposure. For comparison of all cell strains belonging to the same skin malignancy group with those of the control group, G0 values of the individual strains were combined to yield group-specific weighted mean G0 values. In addition, the capacity to incise UV-damaged DNA was measured in 24 cell strains from patients with skin tumors using the alkaline elution technique. For quantitating DNA incising capacity, the initial velocities of the elution curves were plotted versus the UV dose, and the slope of the resulting regression line was used to obtain the characteristic value E0. The mean experimental variability of E0 of individual strains was +/- 22%. These E0 values were combined to yield weighted mean values of groups. The fibroblast strains in the groups of patients with actinic keratosis and malignant melanoma were found to have normal mean G0 values when DNA repair synthesis was challenged with UV light or one of the three carcinogens. However, the squamous cell carcinoma group exhibited significantly lower mean G0 values after treatment with UV light (82% that of normal donors), (Ac)2ONFln (70%), MeSO2OMe (70%), and MeNOUr (69%). The basal cell carcinoma group showed significantly diminished repair synthesis upon treatment with UV light (81% that of normal donors) and MeSO2OMe (67%). In contrast to these findings, in no skin malignancy group was post UV DNA-incising capacity (E0) significantly diminished, although it should be noted that group sizes were only half as large as for G0 determinations. These data may be interpreted as indicating that DNA excision repair is impaired in fibroblast strains from patients with squamous cell carcinoma and-to a lesser extent-basal cell carcinoma.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3558454 TI - Prognostic significance of tumor volume in localized Ewing's sarcoma of bone in children and adolescents. AB - A total of 60 consecutive patients with localized Ewing's sarcoma of bone who were entered into the Cooperative Ewing's Sarcoma Study of the German Society of Pediatric Oncology from January 1981 until April 1985 were evaluable for tumor volume at diagnosis. The tumor volume was calculated from plain X-rays and CT scans as ellipsoidal or cylindrical depending on the tumor configuration and presence or absence of a soft tissue component. The 3-year disease-free survival rate according to Kaplan-Meier life table analysis was 78% for tumors with a volume less than 100 ml compared to 17% for tumors greater than or equal to 100 ml volume. These results were independent of the site of the tumor, though larger tumors were primarily located in central and proximal extremity sites. Maximal tumor extension was less precise than tumor volume in predicting prognosis. The ratio of tumor volume to body surface area, body length, or body weight did not increase the ability to separate prognostic groups compared to tumor volume. The better prognosis for patients following radical surgery seems to be in part due to a biased distribution of tumor volumes within local therapy groups, since more patients with smaller tumors had surgery for local control. PMID- 3558456 TI - Scientific proceedings fourth symposium of the Section of Experimental Cancer Research (SEK) of the German Cancer Society. Heidelberg, 18-21 March, 1987. Abstracts. PMID- 3558455 TI - Energy-dispersive, bulk specimen X-ray microanalytical measurement of the intracellular Na+/K+ ratio in human laryngeal tumors. AB - Energy-dispersive X-ray microanalysis was performed on human biopsy materials taken during laryngoscopic intervention in 18 cases. The removed tissue pieces were divided into two parts. One of them was used for pathohistological studies, the other was processed for X-ray microanalysis by the freeze-fracture freeze drying method. Of the cases investigated 4 proved to be of benign character, whereas the rest contained carcinoma planocellulare keratoides or non-keratoides. Bulk specimen energy-dispersive X-ray microanalysis of 135 cells from the benign tissue samples revealed an average Na+/K+ molar ratio of 0.13 +/- 0.01 (SEM) in the intracellular space, with a regular Gaussian distribution. In the cases of carcinomas 641 cells were measured, the average of the same ratio was 0.67 +/- 0.03 (SEM) due mostly to an increase in the Na+ content. The distribution of data was apparently not normal in the cancerous samples. These observations and some theoretical considerations support the notion that the intracellular Na+/K+ ratio correlates with the proliferative capacity of tissues. The relevance of some recent biochemical results is also discussed in this respect. PMID- 3558457 TI - Coarctation of the aorta in adults. Clinical presentation and results of surgery. AB - We studied the mode of presentation and results of surgery in 45 adults with coarctation of the aorta. Coarctation was unsuspected in 23 patients, 3 of whom presented with acute aortic dissection and 4 with severe aortic valve disease. Twenty seven were hypertensive before surgery. Three patients required emergency operation and all died. There was one death and one postoperative paraplegia amongst 39 patients who underwent elective operation. Of 21 preoperatively hypertensive patients studied at least 2 years after surgery blood pressure returned to normal levels in 10. Acute aortic dissection, aortic aneurysm formation and aortic valve disease complicate the surgical treatment of adult coarctation and hypertension may persist in as many as 50% of patients. Nevertheless surgery is preferable to the poor reported results of long term medical management. PMID- 3558458 TI - Comparison of operations for coarctation of the aorta in infants. AB - During a 12-year-period, 33 infants 4 days to 1 year old underwent 36 operations for treatment of coarctation of the aorta. Associated cardiac anomalies were present in 27 infants (81.8%). All patients presented with congestive heart failure and underwent cardiac catheterization and aortography. Resection was performed in 11 infants, patch aortoplasty in 6, bypass in 2 and subclavian flap angioplasty in 17. Pulmonary artery banding was performed in 4 patients and ligation of a patent ductus arteriosus in 21 patients. Aortic crossclamp time was shorter in the 17 patients who had subclavian flap angioplasty than in 9 patients who had resection (P less than 0.05). Thirty-day mortality was 5 patients (13.9%); all were under 2 months of age at operation and had intracardiac anomalies. Four of them had resection and one had bypass. Mean follow-up was 5 years. Reoperation for recurrent or residual coarctation was performed in 5 patients after resection, 2 after patch aortoplasty and 2 after subclavian flap angioplasty. There was no significant difference in early postoperative arm-to leg pressure gradients between patients who had resection and patients who had subclavian flap procedure. However, at last follow-up arm-to-leg pressure gradients were lower in 9 infants after subclavian flap (8 +/- 10.1 mmHg) than in 5 infants of similar age who had resection (34 +/- 23.9 mmHg) (P less than 0.05). Subclavian flap angioplasty is safe and more effective than resection for treatment of aortic coarctation in infants. PMID- 3558459 TI - Vascular tumor in the heart. AB - A rare case of a vascular tumor originating from the uterus growing up in the inferior vena cava into the right heart with clinical signs of tricuspid insufficiency is reported. Although this vascular tumor primarily showed no signs of malignancy, consequent re-evaluation seems to be necessary in order to detect possible tumor recurrence in time. PMID- 3558460 TI - Echocardiographic and surgical findings of a ball-like thrombus floating freely in the left atrium. AB - The M-Mode, two-dimensional echocardiographic and surgical findings of a ball like thrombus floating freely in the left atrium are described in a patient with mitral stenosis. These echocardiographic features are so impressive that further diagnostic procedures are not required for operation. PMID- 3558461 TI - Wound infection in cardiac surgery. AB - During the year 1983, 170 patients underwent open heart surgery; coronary bypass surgery in 50, valve replacement in 69, valve repair in 9 and congenital heart surgery in 47. Sternal wound infection was seen in 14 patients: 10 (5.8%) patients had minor infection, recovered with extended antibiotic therapy and local hygiene, and 4 (2.3%) patients had major wound infection which required debridement and resuturing of the wound, prolonged antibiotic treatment and hospitalization. However no one developed costochondral infection. Sternal wound infection was 6 times higher among coronary bypass patients (20%) than among patients with other types of open heart surgery (3.3%). Leg wound infection was observed in 7 (14%) patients, all minor. The prevalence of diabetics was 54% among coronary-bypass patients and 6.5% among non-coronary group. Wound infection was three times higher in diabetic--or obese patients than among non diabetic--or non obese patients. Infections were not related to age, sex, smoking habits or social class. The interval between catheterisation and operation, the preoperative stay in hospital, preoperative haemoglobin or albumin level, and the time during which the patient was on the ventilator and re-opening the chest for bleeding had no influence. A significantly higher incidence of infection in patients undergoing coronary artery surgery in addition to high prevalence of diabetic or obese patients was related to the longer duration of operation procedure and the coronary perfusion time. PMID- 3558462 TI - A simple mechanical system for pulsatile cardiopulmonary bypass. AB - The authors present a mechanical system for pulsatile cardiopulmonary bypass. Its major advantages are: simplicity, low cost and the synchronization of pulse generation with the arterial roller. This system has been used clinically since 1981. PMID- 3558463 TI - Civilian popliteal artery trauma. AB - An 18 year experience involved 36 civilian popliteal artery injuries is described. There were no operative or hospital deaths and the amputation rate was 3.6%. Penetrating traumas accounted for 30.6% and blunt traumas for 69.4%. In 20 patients (55.5%) the popliteal artery injury was associated with fracture and/or dislocation of the long bones and/or the knee joint. The average ischaemic time was 7.3 hours and postoperative angiography was performed in 25 patients (69.4%). Surgical reconstruction of the popliteal artery was accomplished by interposition or bypass of autogenous saphenous vein graft in 29 (80.5%), by saphenous vein patch in 5 (13.9%) and by primary end-to-end anastomosis in 1 (2.8%) and by PTFE prosthesis in 1 patient (2.8%). In all cases with bone fracture and/or dislocation bone stabilization was followed by the vascular procedure. The average time of follow-up was 76 months, 28 patients could be evaluated in the postoperative study: in 25 (89.2%) the reconstruction was patent, in 3 (10.8%) occluded. In 13 patients (46.4%) there was a complete success, 7 had a nerve deficit (25.0%), 3 had a claudication (10.7%), in one patient an amputation was necessary (3.6%) and 4 (14.3%) suffered from miscellaneous skeletal problems. Of the 36 patients originally operated, 29 (80.5%) received anticoagulant therapy for at least one year. PMID- 3558464 TI - Major lower extremity amputation in patients with peripheral arterial insufficiency with special reference to the transgenicular amputation. AB - The selection of the proper level for lower extremity amputation in patients with advanced arterial ischemia poses a multiplicity of problems with regard to operative mortality, stump healing, re-amputation rate and rehabilitation status. In a retrospective study all these parameters have been evaluated in 413 patients submitted to below-knee (bk, n = 196), transgenicular (tg, n = 93) and above-knee (ak, n = 124) amputation between 1971 and 1980. As compared to the ak resection, the bk amputation has the following advantages: lower operative mortality (9% vs. 30.5%), higher prosthetic fitting rate (85% vs. 66%) and significantly improved rehabilitation (walking with artificial limb: bk 84%, ak 22%). Regarding surgical mortality (8.5%) and prosthetic gait (66%), the tg amputation was nearly equivalent to the bk resection and turned out to be clearly superior to the ak amputation. As compared to the latter procedure, knee disarticulation and bk amputation had a greater risk of delayed wound healing and re-amputation at a higher level (ak: 13.5 resp. 1%, tg: 22.5 resp. 25%, bk: 35% resp. 16%). The patient with a bk amputation has the best prospect concerning a successful rehabilitation. Whenever the very important knee joint cannot be saved an ak amputation should be avoided in favour of a knee disarticulation. PMID- 3558466 TI - Cranial and cervical nerve injuries: local complications of carotid artery surgery. AB - Injury to the nervous structures extending through the operative field or in areas adjacent to it constitutes a local complication in surgery of the carotid artery. These lesions may become, after an otherwise well-tolerated reconstruction, the source of severe and, occasionally even permanent, complaints. In a series of 536 operations of the carotid artery, 14.4% of transient and 6% of permanent injuries to some of the distal cranial and cervical nerves occurred. The highest injury rate was observed in the hypoglossal nerve (8.6%), followed by the marginal mandibular branch of the facial nerve (6.2%) and the vagus nerve with its superior and recurrent laryngeal branches (3.7% of cases). Injury to the glossopharyngeal nerve and the greater auricular nerve occurs very rarely. A thorough knowledge of the topographic and anatomical situation combined with a cautious operation technique may lower the frequency of these lesions. That is why the essential data on the anatomy, function and the most frequent causes of injury to the individual nerves sustained during surgery within the trigonum caroticum are presented in this article. PMID- 3558465 TI - Urgent abdominal aortic aneurysm repair in patients over the age 80. AB - We present three patients with successful surgical repair of abdominal aortic aneurysms with signs of imminent rupture in octogenarians. The patients presented with evidence of severe left ventricular dysfunction and reduced compliance either before or during surgery. Extremely cautious delivery of fluids and of after-load reducing agents was employed under the guidance of measurements of cardiac output and filling pressures from a pulmonary arterial catheter inserted prior to surgery. PMID- 3558467 TI - Management of immediate occlusion after carotid-reconstruction. AB - In spite of clear cut indications for surgery and the use of standardized techniques, operative failures are still to be found in carotid surgery, that is, the occurrence or aggravation of neurologic symptoms in connection with surgical reconstruction. These can present when the patient regains consciousness or develop from hours to days postoperatively. Within 3 1/2 years 93 carotid artery operations were performed in 79 patients. The purpose of our presentation is to describe 5 patients who developed neurologic deficits after a successful carotid reconstructive procedure within 18 hours to 10 days postoperatively. These patients were immediately returned to the operation room and reoperated upon. In 4 of 5 cases we achieved a complete recovery. Even though our patient content is small we want to point out that in patients who develop neurological deficits postoperatively after successful surgical procedures an immediate reoperation is mandatory, and may be completely successful. In almost all patients with recurrent neurological deficits after primarily successful reconstructions we carried out control angiograms. We want to emphasize that these procedures are not obligatory since the cause for reoperation is nearly always technical and will require operative revision. PMID- 3558468 TI - Diagnosis and treatment of spontaneous aorto-caval fistula. AB - The diagnostic features and operative results of six patients with spontaneous aorto-caval fistula associated with abdominal aortic aneurysm were analyzed. Abdominal pain, pulsatile abdominal mass and haematuria were constant preoperative findings in all patients. Radiological signs of congestive heart failure of various degrees were present in five, abdominal bruit in four and preoperative renal failure in three patients. As preoperative diagnostic examinations i.v. pyelography was done in two patients and ultrasound scanning and angiography of the abdominal aorta in a further two patients. In one ultrasound scanning a dilated inferior vena cava and hepatic veins were seen as an indirect sign of ACF, while in both angiograms the ACF was seen. In these two cases the diagnosis of ACF was made preoperatively, while in four other cases the diagnosis was made during the operation. Three patients survived the operation and were still alive after eight months, four years and six years respectively. Postoperative complications developed in two patients: postoperative ileus in one and deep venous thrombosis and pneumonia in another. Because of its rarity aorto caval fistula is difficult to diagnose. The presence of haematuria in a patient suffering from abdominal aortic aneurysm should strongly suggest the diagnosis of an aorto-caval fistula. PMID- 3558469 TI - Arterial embolectomy in the leg: results in a referral hospital. AB - A review of 66 patients undergoing femoral embolectomy showed that 38 (58%) obtained a good final outcome (discharge from hospital with viable limb) while 28 (42%) died or required amputation prior to discharge. The major association with poor final outcome was pre-operative life-threatening cardiac disease which occurred in 17 (61%) of those patients who later died or underwent amputation and in six (16%) of those who were discharged with viable limbs (p less than 0.001). Age, sex, source of embolus, duration of ischaemia and pre-existing vascular disease had little effect on final outcome. Surgical dissatisfaction, at the time of operation, with the result of attempted revascularisation was of major prognostic significance in terms of future amputation or death. PMID- 3558470 TI - Femoral arterial thrombosis in nephrotic syndrome. Steroid and long term heparin therapy. AB - Thrombosis due to increased coagulability of the blood is a common complication in patients with nephrotic syndrome. Thrombosis has a tendency to recur in these patients. We recommend steroid and long term heparin therapy after thrombectomy for the prevention of the recurrence of thrombosis in nephrotic patients and for the control of nephrotic syndrome. This report deals with two cases of femoral arterial thrombosis complicated by nephrotic syndrome. In one case the result was not satisfactory despite usual postoperative treatment, while the other case was successfully treated by long term heparin infusion in combination with oral administration of steroid. PMID- 3558471 TI - Occult femoral artery injury in relation to fracture of the femoral shaft. AB - Recognized injury of the femoral artery occurs in two per cent of patients with fracture of the femoral shaft. Delay in detection of these arterial injuries has led to unsatisfactory results in a young group of patients. Therefore, 40 patients who had suffered fracture of the femoral shaft 6-20 months (mean 13 months) prior to examination, were haemodynamically assessed using Doppler ankle/arm pressure indices to determine the incidence of occult femoral artery injury. Six patients (15%) exhibited haemodynamically significant abnormalities all in relation to previously injured limbs. PMID- 3558472 TI - Plethysmography and the diagnosis of the steal syndrome following placement of arteriovenous fistulas and shunts for hemodialysis access. AB - An arteriovenous fistula, created for hemodialysis access, may on occasion produce ischemia or even gangrene of the extremity distal to the fistula. This article describes a simple plethysmographic test which will accurately differentiate a steal syndrome from other causes of ischemia, pain, or necrosis and will allow the surgeon to remedy the problem in a specific way. PMID- 3558473 TI - Sciatic pain: a diagnostic pitfall. AB - Neurological signs such as lower spinal cord lesions and/or femoral neuritis may be the presenting symptoms of a dissecting abdominal aortic aneurysm (AAA). We describe a patient in whom a severe sciatic pain was the presenting symptom of a non-dissecting AAA. The resection of the vascular mass resulted in dramatic relief of sciatic pain, thus indicating that the neurological impairment was caused by the non-dissecting aneurysm. PMID- 3558474 TI - Dissection of the internal carotid artery. Report of one case. AB - Spontaneous dissection is a very rare occurrence in the pathology of the carotid artery. The case of a 40 year old male patient affected by dissection of the right carotid artery is described. The patient was admitted to Hospital but was not operated on since he showed progressive improvement of his symptoms under medical treatment and had a favourable outcome. The aetio-pathology and surgical indications of this rare condition is considered with extensive review of the literature on this subject. PMID- 3558475 TI - The variable twist of actin and its modulation by actin-binding proteins. AB - Previous studies demonstrated that actin filaments have variable twist in which the intersubunit angles vary by approximately +/- 10 degrees within a filament. In this work we show that this variability was unchanged when different methods were used to prepare filaments for electron microscopy. We also show that actin binding proteins can modulate the variability in twist. Three preparations of actin filaments were photographed in the electron microscope: negatively stained filaments, replicas of rapidly frozen, etched filaments, and frozen hydrated filaments. In addition, micrographs of actin + tropomyosin + troponin (thin filaments), of actin + myosin S1 (decorated filaments), and of filaments frayed from the acrosomal process of Limulus sperm (Limulus filaments) were obtained. We used two independent methods to measure variable twist based on Fourier transforms of single filaments. The first involved measuring layer line intensity versus filament length and the second involved measuring layer line position. We measured a variability in the intersubunit angle of actin filaments of approximately 12 degrees independent of the method of preparation or of measurement. Thin filaments have 15 degrees of variability, but the increase over pure actin is not statistically significant. Decorated filaments and Limulus filaments, however, have significantly less variability (approximately 2 and 1 degree, respectively), indicating a torsional stiffening relative to actin. The results from actin alone using different preparative methods are evidence that variable twist is a property of actin in solution. The results from actin filaments in the presence of actin-binding proteins suggest that the angular variability can be modulated, depending on the biological function. PMID- 3558476 TI - Fluorescence ratio imaging microscopy: temporal and spatial measurements of cytoplasmic pH. AB - Fluorescence ratio imaging microscopy (Tanasugarn, L., P. McNeil, G. Reynolds, and D. L. Taylor, 1984, J. Cell Biol., 98:717-724) has been used to measure the spatial variations in cytoplasmic pH of individual quiescent and nonquiescent Swiss 3T3 cells. Fundamental issues of ratio imaging that permit precise and accurate temporal and spatial measurements have been addressed including: excitation light levels, lamp operation, intracellular probe concentrations, methods of threshold selection, photobleaching, and spatial signal-to-noise ratio measurements. Subcellular measurements can be measured accurately (less than 3% coefficient of variation) in an area of 3.65 microns 2 with the present imaging system. Quiescent Swiss 3T3 cells have a measured cytoplasmic pH of 7.09 (0.01 SEM), whereas nonquiescent cells have a pH of 7.35 (0.01 SEM) in the presence of bicarbonate buffer. A unimodal distribution of mean cytoplasmic pH in both quiescent and nonquiescent cells was identified from populations of cells measured on a cell by cell basis. Therefore, unlike earlier studies based on cell population averages, it can be stated that cells in each population exhibit a narrow range of cytoplasmic pH. However, the mean cytoplasmic pH can change based on the physiological state of the cells. In addition, there appears to be little, if any, spatial variation in cytoplasmic pH in either quiescent or nonquiescent Swiss 3T3 cells. The pH within the nucleus was always the same as the surrounding cytoplasm. These values will serve as a reference point for investigating the role of temporal and spatial variations in cytoplasmic pH in a variety of cellular processes including growth control and cell movement. PMID- 3558477 TI - Phase dynamics at microtubule ends: the coexistence of microtubule length changes and treadmilling. AB - The length dynamics both of microtubule-associated protein (MAP)-rich and MAP depleted bovine brain microtubules were examined at polymer mass steady state. In both preparations, the microtubules exhibited length redistributions shortly after polymer mass steady state was attained. With time, however, both populations relaxed to a state in which no further changes in length distributions could be detected. Shearing the microtubules or diluting the microtubule suspensions transiently increased the extent to which microtubule length redistributions occurred, but again the microtubules relaxed to a state in which changes in the polymer length distributions were not detected. Under steady state conditions of constant polymer mass and stable microtubule length distribution, both MAP-rich and MAP-depleted microtubules exhibited behavior consistent with treadmilling. MAPs strongly suppressed the magnitude of length redistributions and the steady-state treadmilling rates. These data indicate that the inherent tendency of microtubules in vitro is to relax to a steady state in which net changes in the microtubule length distributions are zero. If the basis of the observed length redistributions is the spontaneous loss and regain of GTP tubulin ("GTP caps") at microtubule ends, then in order to account for stable length distributions the microtubule ends must reside in the capped state far longer than in the uncapped state, and uncapped microtubule ends must be rapidly recapped. The data suggest that microtubules in cells may have an inherent tendency to remain in the polymerized state, and that microtubule disassembly must be induced actively. PMID- 3558478 TI - Tubulin-tyrosine ligase has a binding site on beta-tubulin: a two-domain structure of the enzyme. AB - Tubulin-tyrosine ligase and alpha beta-tubulin form a tight complex which is conveniently monitored by glycerol gradient centrifugation. Using two distinct ligase monoclonal antibodies, several subunit-specific tubulin monoclonal antibodies, and chemical cross-linking, a ligase-binding site was identified on beta-tubulin. This site is retained when the carboxy-terminal domains of both tubulin subunits are removed by subtilisin treatment. The ligase-tubulin complex is also formed when ligase is added to alpha beta-tubulin carrying the monoclonal antibody YL 1/2 which binds only to the carboxyl end of tyrosinated alpha tubulin. The beta-tubulin-binding site described here explains the extreme substrate specificity of ligase, which does not act on other cellular proteins or carboxy-terminal peptides derived from detyrosinated alpha-tubulin. Differential accessibility of this site in tubulin and in microtubules seems to explain why ligase acts preferentially on unpolymerized tubulin. Ligase exposed to V8 protease is converted to a nicked derivative. This is devoid of enzymatic activity but still forms the complex with tubulin. Gel electrophoresis documents both 30- and a 14-kD domains, each which is immunologically and biochemically distinct and seems to cover the entire molecule. The two domains interact tightly under physiological conditions. The 30-kD domain carries the binding sites for beta-tubulin and ATP. The 14-kD domain can possibly form an additional part of the catalytic site as it harbors the epitope for the monoclonal antibody ID3 which inhibits enzymatic activity but not the formation of the ligase-tubulin complex. PMID- 3558479 TI - Biochemical characterization of tektins from sperm flagellar doublet microtubules. AB - Tektins, protein components of stable protofilaments from sea urchin sperm flagellar outer doublet microtubules (Linck, R. W., and G. L. Langevin, 1982, J. Cell Sci., 58:1-22), are separable by preparative SDS PAGE into 47-, 51-, and 55 kD equimolar components. High resolution two-dimensional tryptic peptide mapping reveals 63-67% coincidence among peptides of the 51-kD tektin chain and its 47- and 55-kD counterparts, greater than 70% coincidence between the 47- and 55-kD tektins, but little obvious similarity to either alpha- or beta-tubulin. With reverse-phase HPLC on a C18 column, using 6 M guanidine-HCl solubilization and a 0.1% trifluoroacetic acid/CH3CN gradient system (Stephens, R. E., 1984, J. Cell Biol. 90:37a [Abstr.]), the relatively less hydrophobic 51-kD tektin elutes at greater than 45% CH3CN, immediately followed by the 55-kD chain. The 47-kD tektin is substantially more hydrophobic, eluting between the two tubulins. The amino acid compositions of the tektins are very similar to each other but totally distinct from tubulin chains, being characterized by a greater than 50% higher arginine plus lysine content (in good agreement with the number of tryptic peptides) and about half the content of glycine, histidine, proline, and tyrosine. The proline content correlates well with the fact that tektin filaments have twice as much alpha-helical content as tubulin. Total hydrophobic amino acid content correlates with HPLC elution times for the tektins but not tubulins. The average amino acid composition of the tektins indicates that they resemble intermediate filament proteins, as originally postulated from structural, solubility, and electrophoretic properties. Tektins have higher cysteine and tryptophan contents than desmin and vimentin, which characteristically have only one residue of each, more closely resembling certain keratins in these amino acids. PMID- 3558480 TI - Localization of types I, II, and III collagen mRNAs in developing human skeletal tissues by in situ hybridization. AB - Paraffin sections of human skeletal tissues were studied in order to identify cells responsible for production of types I, II, and III collagens by in situ hybridization. Northern hybridization and sequence information were used to select restriction fragments of cDNA clones for the corresponding mRNAs to obtain probes with a minimum of cross-hybridization. The specificity of the probes was proven in hybridizations to sections of developing fingers: osteoblasts and chondrocytes, known to produce only one type of fibrillar collagen each (I and II, respectively) were only recognized by the corresponding cDNA probes. Smooth connective tissues exhibited variable hybridization intensities with types I and III collagen cDNA probes. The technique was used to localize the activity of type II collagen production in the different zones of cartilage during the growth of long bones. Visual inspection and grain counting revealed the highest levels of pro alpha 1(II) collagen mRNAs in chondrocytes of the lower proliferative and upper hypertrophic zones of the growth plate cartilage. This finding was confirmed by Northern blotting of RNAs isolated from epiphyseal (resting) cartilage and from growth zone cartilage. Analysis of the osseochondral junction revealed virtually no overlap between hybridization patterns obtained with probes specific for type I and type II collagen mRNAs. Only a fraction of the chondrocytes in the degenerative zone were recognized by the pro alpha 1(II) collagen cDNA probe, and none by the type I collagen cDNA probe. In the mineralizing zone virtually all cells were recognized by the type I collagen cDNA probe, but only very few scattered cells appeared to contain type II collagen mRNA. These data indicate that in situ hybridization is a valuable tool for identification of connective tissue cells which are actively producing different types of collagens at the various stages of development, differentiation, and growth. PMID- 3558481 TI - Heparin modulates the organization of hydrated collagen gels and inhibits gel contraction by fibroblasts. AB - We studied the effects of extracellular matrix components on fibroblast contraction of hydrated collagen gels. After 4-h incubations, heparin-containing collagen gels contracted only 10% compared with 50% contraction of control gels. Contraction was not affected by hyaluronic acid, dermatan sulfate, or fibronectin, implying that the activity of heparin was specific. The possibility that heparin inhibited attachment of the cells to the gels was ruled out. Also, addition of heparin to the incubation medium had no effect on contraction. Microscopic examination showed that control collagen gels were composed of a uniform network of interlocking fibrils of similar sizes. Heparin-containing gels, on the other hand, were highly variable with some collagen bundles containing 5-6 collagen fibrils and other regions containing amorphous material. Unlike the control gels, the fibrils of heparin-containing gels were not continuously interconnected. Based on the results, we propose that fibroblasts attach normally to the collagen fibrils of heparin-containing gels and attempt to contract the gels, but the mechanical forces exerted by fibroblasts on individual collagen fibrils cannot be propagated throughout the gels. PMID- 3558482 TI - A 17-kD centromere protein (CENP-A) copurifies with nucleosome core particles and with histones. AB - We have detected and begun to characterize a 17-kD centromere-specific protein, CENP-A (Earnshaw, W. C., and N. Rothfield, 1985, Chromosoma., 91:313-321). Sera from several humans with CREST scleroderma autoimmune disease (CREST: calcinosis, Raynaud's phenomenon, esophageal dsymotility, sclerodactyly, and telangiectasia) bind this protein in immunoblot assays of HeLa whole cell or nuclear extracts. We have affinity purified the anti-17-kD centromere protein (anti-CENP-A) specific antibodies from immunoblots of HeLa nuclear protein. The antibodies react with epitopes present on CENP-A derived from humans but apparently do not recognize specific epitopes in either rat or chicken nuclei. Only human nuclear protein is CENP-A positive by immunoblot. Furthermore, human cells show localization of anti CENP-A antibody to centromeres by immunofluorescence microscopy, whereas rat cells do not. On extraction from the nucleus, CENP-A copurifies with core histones and with nucleosome core particles. We conclude that this centromere specific protein is a histone-like component of chromatin. The data suggest that CENP-A functions as a centromere-specific core histone. PMID- 3558483 TI - Dose-dependent relationship between oocyte cytoplasmic volume and transformation of sperm nuclei to metaphase chromosomes. AB - We have studied the chromosome condensation activity of mouse oocytes that have been inseminated during meiotic maturation. These oocytes remain unactivated, and in those penetrated by up to three or four sperm, each sperm nucleus is transformed, without prior development of a pronucleus, into metaphase chromosomes. However, those penetrated by more than four sperm never transform any of the nuclei into metaphase chromosomes (Clarke, H. J., and Y. Masui, 1986, J. Cell Biol. 102:1039-1046). We report here that, when the cytoplasmic volume of oocytes was doubled or tripled by cell fusion, up to five or eight sperm nuclei, respectively, could be transformed into metaphase chromosomes. Conversely, when the cytoplasmic volume was reduced by bisection of oocytes after the germinal vesicle (GV) had broken down, no more than two sperm could be transformed into metaphase chromosomes. Thus, the capacity of the oocyte cytoplasm to transform sperm nuclei to metaphase chromosomes was proportional to its volume. The contribution of the nucleoplasm of the GV and the cytoplasm outside the GV to the chromosome condensation activity was investigated by bisecting oocytes that contained a GV and then inseminating the nucleate and anucleate fragments. The anucleate fragments never induced sperm chromosome formation, indicating that GV nucleoplasm is required for this activity. In the nucleate fragments, the capacity to induce sperm chromosome formation was reduced as compared with whole oocytes, in spite of the fact that the fragments contained the entire GV nucleoplasm. This implies that non-GV cytoplasmic material also was required for chromosome condensation activity. When inseminated oocytes were incubated in the presence of puromycin, the sperm nuclei were transformed into interphase-like nuclei, but no metaphase chromosomes developed. However, when protein synthesis resumed, the interphase nuclei were transformed to metaphase chromosomes. These results suggest that the transformation of sperm nuclei to metaphase chromosomes in the cytoplasm of mouse oocytes requires both the nucleoplasm of the GV and non GV cytoplasmic substances, including proteins synthesized during maturation. PMID- 3558484 TI - Expression of the Ca2+-binding protein, parvalbumin, during embryonic development of the frog, Xenopus laevis. AB - A cDNA segment encoding the Ca2+-binding protein, parvalbumin, was isolated with the use of antibodies, from a lambda gtll expression library of Xenopus laevis tadpole poly(A)+ RNAs. The bacterially expressed beta-galactosidase-parvalbumin fusion protein of one lambda recombinant shows high affinity 45Ca2+ binding. The sequence of the tadpole parvalbumin is highly similar to previously characterized beta-parvalbumins of other organisms. Data from protein and RNA blotting experiments demonstrate that parvalbumin is absent in oocytes, eggs, and early staged embryos, and only becomes expressed during embryogenesis at the time of myogenesis. The protein can be detected in individual developing muscle cells and in muscle fibers of tadpole tail muscles. A simple method is also described for the isolation of neural tube-notochord-somite complexes from Xenopus embryos. PMID- 3558486 TI - Lateral diffusion of the PH-20 protein on guinea pig sperm: evidence that barriers to diffusion maintain plasma membrane domains in mammalian sperm. AB - PH-20 protein on the plasma membrane (PH-20PM) is restricted to the posterior head of acrosome-intact guinea pig sperm. During the exocytotic acrosome reaction the inner acrosomal membrane (IAM) becomes continuous with the posterior head plasma membrane, and PH-20PM migrates to the IAM. There it joins a second population of PH-20 protein localized to this region of the acrosomal membrane (PH-20AM) (Cowan, A.E., P. Primakoff, and D.G. Myles, 1986, J. Cell Biol. 103:1289-1297). To investigate how the localized distributions of PH-20 protein are maintained, the lateral mobility of PH-20 protein on these different membrane domains was determined using fluorescence redistribution after photobleaching. PH 20PM on the posterior head of acrosome-intact sperm was found to be mobile, with a diffusion coefficient and percent recovery typical of integral membrane proteins (D = 1.8 X 10(-10) cm2/s; %R = 73). This value of D was some 50-fold lower than that found for the lipid probe 1,1-ditetradecyl 3,3,3',3' tetramethylindocarbocyanine perchlorate (C14diI) in the same region (D = 8.9 X 10(-9) cm2/s). After migration to the IAM of acrosome-reacted sperm, this same population of molecules (PH-20PM) exhibited a 30-fold increase in diffusion rate (D = 4.9 X 10(-9) cm2/s; %R = 78). This rate was similar to diffusion of the lipid probe C14diI in the IAM (D = 5.4 X 10(-9) cm2/s). The finding of free diffusion of PH-20PM in the IAM of acrosome-reacted sperm supports the proposal that PH-20 is maintained within the IAM by a barrier to diffusion at the domain boundary. The slower diffusion of PH-20PM on the posterior head of acrosome intact sperm is also consistent with localization by barriers to diffusion, but does not rule out alternative mechanisms. PMID- 3558485 TI - Formation of the apical pole of epithelial (Madin-Darby canine kidney) cells: polarity of an apical protein is independent of tight junctions while segregation of a basolateral marker requires cell-cell interactions. AB - The time course of development of polarity of an apical (184-kD) and a basolateral (63-kD) plasma membrane protein of Madin-Darby canine kidney cells was followed using semiquantitative immunofluorescence on semithin (approximately 0.5-micron) frozen sections and monoclonal antibody probes. The 184-kD protein became highly polarized to the apical pole within the initial 24 h both in normal medium and in 1-5 microM Ca2+, which results in well-spread, dome-shaped cells, lacking tight junctions and other lateral membrane interactions. In contrast, the basolateral 63-kD membrane protein developed full polarity only after incubation in normal Ca2+ concentrations for greater than 72 h, a time much longer than that required for the formation of tight junctions (approximately 18 h) and failed to polarize in 1-5 microM Ca2+. These results demonstrate that intradomain restriction mechanisms independent of tight junctions, such as self-aggregation or specific interactions with the submembrane cytoskeleton, participate in the regionalization of at least some epithelial plasma membrane proteins. The full operation of these mechanisms depends on the presence of normal cell-cell interactions in the case of the basolateral 63-kD antigen but not in the case of the apical 184-kD protein. PMID- 3558487 TI - 300-kD subsynaptic protein copurifies with acetylcholine receptor-rich membranes and is concentrated at neuromuscular synapses. AB - Acetylcholine receptor-rich membranes from the electric organ of Torpedo californica are enriched in the four different subunits of the acetylcholine receptor and in two peripheral membrane proteins at 43 and 300 kD. We produced monoclonal antibodies against the 300-kD protein and have used these antibodies to determine the location of the protein, both in the electric organ and in skeletal muscle. Antibodies to the 300-kD protein were characterized by Western blots, binding assays to isolated membranes, and immunofluorescence on tissue. In Torpedo electric organ, antibodies to the 300-kD protein stain only the innervated face of the electrocytes. The 300-kD protein is on the intracellular surface of the postsynaptic membrane, since antibodies to the 300-kD protein bind more efficiently to saponin-permeabilized, right side out membranes than to intact membranes. Some antibodies against the Torpedo 300-kD protein cross-react with amphibian and mammalian neuromuscular synapses, and the cross-reacting protein is also highly concentrated on the intracellular surface of the post synaptic membrane. PMID- 3558488 TI - Microfilaments: dynamic arrays in higher plant cells. AB - By using fluorescently labeled phalloidin we have examined, at the light microscope level, the three-dimensional distribution and reorganization of actin like microfilaments (mfs) during plant cell cycle and differentiation. At interphase, mfs are organized into three distinct yet interconnected arrays: fine peripheral networks close to the plasma membrane; large axially oriented cables in the subcortical region; a nuclear "basket" of mfs extending into the transvacuolar strands. All these arrays, beginning with the peripheral network, disappear at the onset of mitosis and reappear, beginning with the nuclear basket, after cytokinesis. During mitotic and cytokinetic events, mfs are associated with the spindle and phragmoplast. Actin staining in the spindle is localized between the chromosomes and the spindle poles and changes in a functionally specific manner. The nuclear region appears to be the center for mf organization and/or initiation. During differentiation from rapid cell division to cell elongation, mf arrays switch from an axial to a transverse orientation, thus paralleling the microtubules. This change in orientation reflects a shift in the direction of cytoplasmic streaming. These observations show for the first time that actin-like mfs form intricate and dynamic arrays in plant cells which may be involved in many as yet undescribed cell functions. PMID- 3558489 TI - Toxicity of oxidized low-density lipoprotein to cultured fibroblasts is selective for S phase of the cell cycle. AB - Oxidized LDL (o-LDL) is toxic to a variety of cultured cells. Preliminary results suggested that susceptibility is enhanced by cell proliferation. As a step toward determining the mechanism of cytotoxicity, we chose to identify the cell cycle phase(s) during which exposure of cultured human fibroblasts to o-LDL leads to death. Cytochalasin B, which blocks cell migration and proliferation, and irradiation, which prevents mitosis but not migration, both blocked cytotoxicity. Colchicine, which arrests cells in mitosis but does not inhibit DNA synthesis, did not block cytotoxicity. Treatment of cells with hydroxyurea, which blocks cells prior to S phase, prevented cell death. Addition of o-LDL to cells immediately after S phase allowed mitosis without death. The above results coupled with results using cells synchronized by three different means indicate that cell death is selective for proliferating cells and occurs after exposure to o-LDL during S phase. Understanding the mechanism of o-LDL-induced death may have implications for tissue damage in vivo in the numerous instances of pathology in which oxidized lipoproteins or lipids are present. PMID- 3558490 TI - Species-specific differences in the toxicity of rhodamine 123 towards cultured mammalian cells. AB - The toxicity of cationic fluorescent dye, rhodamine 123, towards a number of independently established cell lines from three different species, namely human, mouse, and Chinese hamster, has been examined. All of the cell lines from any one species that were examined were found to exhibit similar sensitivities towards rhodamine 123 and no appreciable differences were observed between the normal and transformed cell types. However, in comparison to the cells of human origin, mouse and Chinese hamster cell lines exhibited about 10-fold and 70-fold higher resistance, respectively, and these differences appeared to be species related. In contrast to rhodamine 123, no differences in relative toxicities for these cell lines were observed for the structurally related neutral dye, rhodamine B. Fluorescence studies with rhodamine 123 show that in comparison to mouse and Chinese hamster cells, the more sensitive human cells show much higher uptake/binding of the drug, and a good correlation was seen in these studies between the extent of dye uptake/binding and the relative sensitivities of cell lines to rhodamine 123. These results provide evidence that the observed species related differences in cellular toxicities are due to differences in the cellular uptake/binding of the dye. PMID- 3558491 TI - Suppression of maturation of megakaryocyte colony forming unit in vitro by a platelet-released glycoprotein. AB - The suppressive role of platelets on the growth of human marrow megakaryocyte colony forming units (CFU-M) in vitro was investigated by the use of a plasma clot assay. An inverse correlation was established between the number of megakaryocytic colonies grown and the platelet concentration of the plasma or the resultant serum used in the culture system. The suppressive effect of platelets on megakaryocyte colony formation reached a plateau at normal human blood platelet concentration and was specific for CFU-M growth, since marrow cell erythroid burst formation (BFU-E) and granulocytic-monocytic colony formation (CFU-GM) remained unaffected. The inhibitory activity was detectable in the supernatants of platelet suspensions aggregated by thrombin or ADP, and the inhibitory activity released from ADP-stimulated platelets was blocked by pretreatment of platelets with monoclonal antibody HuPl-m1. Partial purification of this activity was achieved by diethylaminoethyl (DEAE)-ion exchange and phytohemagglutinin (PHA)-E agarose affinity chromatography. This inhibitor is a glycoprotein with a molecular weight of 12-17K daltons. This platelet released glycoprotein does not affect the early proliferative phase of CFU-M in vitro but acts on a day 6-8 CFU-M-derived cell by adversely affecting its maturation into recognizable megakaryocytes. These findings demonstrate that a glycoprotein released from platelets suppresses the maturation of CFU-M into megakaryocytes. PMID- 3558492 TI - Phorbol esters and mitogenesis: comparison of the proliferative response of parental and Na+K+Cl- -cotransport-defective BALB/c 3T3 cells to 12-0 tetradecanoylphorbol-13-acetate. AB - The ability of the phorbol ester 12-0-tetradecanoylphorbol-13-acetate (TPA) to stimulate the growth of quiescent BALB/c 3T3 cell lines lacking Na+K+Cl- cotransport activity was tested. We have previously isolated and characterized two mutant cell lines defective in this important ion transport system by mutagenesis and selection in medium containing low K+. To test our hypothesis that loss of this transport activity might abrogate the proliferative response to TPA, two kinds of mitogenesis assays were performed. First, the effect of 0.16 microM TPA on the saturation density of parental vs. mutant cell lines was determined. TPA caused a small but reproducible 30-35% increase in the saturation density of mutant cells compared to the 100-120% increase seen in parental cell lines. Second, the effect of TPA on the incorporation of 3H-thymidine into cell nuclei (labeling index) was measured. While some variability from experiment to experiment in the extent and time course of the response of mutant cells was noted, TPA either had no effect or only a small effect on the labeling index when compared to the response of parental cells. When a range of concentrations of TPA (0.016-1.6 microM) was tested, neither cell line exhibited a large response to any concentration. These results suggest that loss of Na+K+Cl- cotransport activity decreases the response of these cells to the mitogenic action of TPA. PMID- 3558494 TI - Effects of serum and conditioned medium on protein degradation, migration of nonhistone proteins to the nucleus, and DNA synthesis in transformed cells. AB - Stimulation of resting transformed cells (Chang liver cells), prelabeled with [3H] leucine, with fetal calf serum, caused increased nuclear translocation of [3H] nonhistone proteins ([3H] NHP) and DNA synthesis and a parallel inhibition of proteolysis of cellular proteins. [3H] NHP migration was independent of protein synthesis. Fractionation of the nuclear proteins in a pH gradient of 2.5 6.5, showed that [3H] NHP fractions with high degradation rates in resting cells corresponded to the [3H] NHP fractions with high migration rates in stimulated cells, suggesting that degradation and migration of [3H] NHP are linked. Conditioned medium (COM) produced by Chang cells had similar effects as serum, suggesting that factors produced by these transformed cells, control cell growth by a mechanism that is similar to serum. The lysosomotropic amine eserine had similar effects as serum and COM. Based on the similarity of the effects, it would appear that serum and COM inhibit lysosomal proteolysis. It is proposed that serum and COM induce NHP migration to the nucleus by inhibiting lysosomal degradation of these proteins. Serum and COM caused also migration of [3H] histones to the nucleus, however the mechanism is not clear. PMID- 3558495 TI - Effect of essential amino acids on the phosphorylation of a 40S ribosomal protein and protein synthesis in Acanthamoeba castellanii. AB - Reversible and multiple phosphorylation of a 40S ribosomal protein is observed in a variety of eukaryotic cells. In the primitive eukaryote Acanthamoeba, one or three phosphorylated S3 derivatives are observed during growth phase in nondefined nutrient medium (ND cells) or in chemically defined nutrient medium (D cells), respectively. In both cases, stationary phase cells exhibit nonphosphorylated S3; however, transfer of these cells into the respective fresh nutrient media results in a transient accumulation of four phosphorylated S3 derivatives. Transfer of D cells into nutrient medium, deficient in all or any single essential amino acids, leads to reversible inhibition of S3 phosphorylation and growth arrest. The low level of phosphorylated S3 is not simply the consequence of growth arrest, since in cells where growth is arrested differently, the level of phosphorylated S3 can be high. In response to amino acid deficiency, a number of other changes can be observed. These include a 2-3 fold decrease of total protein synthesis, 13 changes in the cellular protein pattern, and specific alterations in the ribosome absorbance profiles and in the distribution of poly-A+ RNA within subribosomal and ribosomal fractions. While the rate of total protein synthesis seems to be associated with the level of phosphorylated S3, the level of the synthesis of at least 10 of the particular proteins can be dissociated from the level of S3 phosphorylation. PMID- 3558497 TI - A system for cerebral blood flow measurement using an H215O autoradiographic method and positron emission tomography. AB - A system for CBF measurement using an H215O autoradiographic method and positron emission tomography (PET) has been designed and installed as a clinical tool. Following an intravenous injection of H215O, a radioactivity accumulation in the brain tissue for 60 s and a continuous record of radioactivity in arterial blood were measured by a high counting speed PET device and a beta-ray detector, respectively, and CBF was calculated by a table-lookup procedure. First, this method was compared with the C15O2 inhalation steady-state method on 17 cerebrovascular disease patients and four normal subjects. The two values for CBF agreed with each other when H215O autoradiographic method was applied by correction for the dispersion in the measured arterial radioactivity-time curve. However, without the correction, the CBF by the H215O autoradiographic method revealed substantial overestimation by 30.6 +/- 17.5%. A reduced gray/white ratio of CBF was also observed in the H215O autoradiographic method. Second, simulation was performed in order to determine optimal accumulation time by PET scan; the result was that errors due to dispersion and time mismatch became critical as the accumulation time was shortened to less than 60 s. PMID- 3558493 TI - Bombesin and phorbol ester stimulate phosphatidylcholine hydrolysis by phospholipase C: evidence for a role of protein kinase C. AB - Bombesin caused a marked stimulation of 32Pi into phosphatidylinositol (PI), with no apparent lag, and into phosphatidylcholine (PC), after a lag of about 20 min. Stimulation was blocked by the bombesin receptor antagonist, [D-Arg1, D-Pro2, D Trp7,9, Leu11] substance P, indicating that the effects on both PI and PC were mediated through the same receptor. The tumor-promoting phorbol ester 12-0 tetradecanoylphorbol-13-acetate (TPA) and dioctanoylglycerol (diC8) both directly activate protein kinase C and in this report were shown to stimulate 32Pi incorporation into PC but not into Pl. In addition, TPA stimulated the release of [3H]choline and [3H]phosphocholine and the accumulation of [3H]diacyglycerol from prelabelled cells. These results strongly suggest that TPA activates a phospholipase C specific for PC. Pretreatment of cells with phorbol-12, 13 dibutyrate (PDBu) for 24 h depleted cellular protein kinase C activity and inhibited the ability of TPA to induce these effects suggesting a direct involvement of protein kinase C. Similarly the bombesin stimulation of 32Pi into PC and of [3H]choline and [3H]phosphocholine release was inhibited by PDBu pretreatment. DiC8 and, to a lesser extent, TPA stimulated the translocation of CTP:phosphocholine cytidylytransferase from the cytosolic to the particulate fraction. DiC8 also stimulated this translocation in cells depleted of protein kinase C. It was concluded that both bombesin and TPA activated protein kinase C leading to activation of a phospholipase C specific for PC. PMID- 3558496 TI - Ionic responses and growth stimulation in rat astroglial cells: differential mechanisms of gangliosides and serum. AB - Rat astroglial cells respond to fetal calf serum (FCS) and gangliosides, including GM1, by undergoing proliferation. Here, we show that addition of FCS but not GM1 causes an increase in Na+, K+-pump activity, as measured by ouabain sensitive 86Rb+ influx. The increase of Na+, K+-pump activity by FCS was due to increased Na+ influx (measured with 22Na+). This increased Na+ influx was sensitive to amiloride, an inhibitor of Na+/H+ exchange. Amiloride also blocked the FCS-stimulated incorporation of [3H]thymidine into DNA. Two defined polypeptide growth factors, epidermal growth factor and fibroblast growth factor were also able to elicit an amiloride-sensitive Na+ influx and an ouabain sensitive K+ uptake in these astroglial cells, in the presence of FCS or insulin. Thus, GM1 differs from serum and growth factors in the mechanisms by which these agents stimulate the proliferation of the astroglial cells used here. PMID- 3558498 TI - Topography of capillary density, glucose metabolism, and microvascular function within the rat inferior colliculus. AB - A midbrain nucleus of the auditory system, the inferior colliculus, was used as a model for analyzing spatial correlations or "coupling" among capillary density, tissue glucose metabolism, and several measures of microvascular function in the rat. The capillary bed of the inferior colliculus was examined with stereological techniques, and physiological measures were obtained with radioactive tracers, quantitative autoradiography, and image processing. Within the colliculus, capillary density, volume fraction, length, and surface area were highest in the central nucleus where the packing densities of neuropil and perikarya are greatest. Rates of glucose metabolism and blood flow correlated closely with capillary density in a 3 X 2 matrix of collicular subregions in the sagittal and coronal planes. The strength of this correlation suggests that estimates of capillary density can be made from measurements of tissue glucose metabolism within this structure under normal conditions. Microvascular blood volume and transcapillary flux of a neutral amino acid, alpha-aminoisobutyric acid, were homogeneous throughout the colliculus. The studies demonstrate quantitatively in a single brain nucleus a close correspondence between cytoarchitecture, richness of the capillary bed, and complexity of neural activity (inferred from local measures of glucose metabolism and blood flow). Such relationships were suggested by Craigie 67 years ago. PMID- 3558500 TI - Increased brain interstitial fluid adenosine concentration during hypoxia in newborn piglet. AB - The effects of arterial hypoxia on interstitial fluid adenosine concentrations were studied in the frontal cortex and thalamus by the brain dialysis technique and in CSF from the cisterna magna of the newborn piglet. Acute hypoxia (PaO2 = 20 +/- 1 mm Hg) increased the interstitial fluid adenosine concentrations significantly from 0.68 +/- 0.29 (SEM) to 1.60 +/- 0.35 microM in the frontal cortex and from 1.03 +/- 0.32 to 2.60 +/- 0.86 microM in the thalamus (n = 8). Interstitial fluid inosine and hypoxanthine also increased significantly during hypoxia. In separate groups of piglets, the adenosine concentration in the cisterna magna CSF under normoxic conditions was 0.04 +/- 0.01 microM (n = 5), which increased significantly to 0.17 +/- 0.04 microM (n = 6) with hypoxia (PaO2 = 4.7 +/- 1.2 mm Hg). Cisterna magna CSF inosine levels did not change significantly during the severe hypoxia. Adenosine concentrations found in the interstitial space and CSF of newborn piglets under normoxic and hypoxic conditions are within the vasodilator range. These results thus suggest that in the neonatal brain adenosine may play a role in regulating blood flow during hypoxia. PMID- 3558501 TI - Acute cerebral ischaemia: concurrent changes in cerebral blood flow, energy metabolites, pH, and lactate measured with hydrogen clearance and 31P and 1H nuclear magnetic resonance spectroscopy. I. Methodology. AB - CBF has been measured with the hydrogen clearance technique in the two cerebral hemispheres of the gerbil under halothane anaesthesia. This has been correlated with changes in local pH, tissue lactate, and phosphorus energy metabolites measured in the same animals with 1H and 31P nuclear magnetic resonance (NMR) spectroscopy. The NMR measurements were made with two surface coils, one on each hemisphere. This article describes the experimental details and shows that in acute unilateral or bilateral forebrain ischaemia metabolic changes can be monitored by NMR with no significant interhemispheric cross talk. The metabolic effects of reperfusion are also shown. The model allows the definition of the time course of the metabolic consequences of regional ischaemia and reperfusion in individual laboratory animals. PMID- 3558503 TI - Mechanisms of cerebrovascular dilation by ether in monkeys. AB - We hypothesized that when the depth of ether anesthesia is increased from 2 to 5%, cerebral vessels dilate secondary to circulating catecholamine stimulation of cerebral metabolism. Cerebral blood flow (CBF) by 133Xe clearance and cerebral metabolic rate for oxygen (CMRO2) were measured on 2% and then 5% ether in air in two groups of seven monkeys each during mechanical ventilation. Propranolol, 0.5 mg/kg i.v., was infused over 5 min in one group, and the other received saline. All measurements were repeated on 5% and 2% ether. Cerebrovascular resistance (CVR) fell by 30%, from 2.28 +/- 0.61 (mean +/- SD) to 1.51 +/- 0.28 mm Hg ml-1 100 g-1 min-1 (p less than 0.01), with the increase in ether from 2 to 5%. CBF and CMRO2 were unaltered from values of about 45 ml 100 g-1 min-1 and 2.3 ml 100 g-1 min-1, respectively. During 5% ether anesthesia, propranolol had no effect on CBF, CMRO2, or CVR. On 2% ether, it increased CVR twofold, from 1.5 +/- 0.30 to 3.0 +/- 1.0 mm Hg ml-1 100 g-1 min-1, and decreased CBF by 33%, from 48 +/- 8 to 32 +/- 10 ml 100 g-1 min-1. Plasma epinephrine was two-fold higher on 2% compared to 5% ether, both before and after saline or propranolol infusion. In monkeys, cerebrovascular dilation by ether at 5% compared to 2% is not secondary to catecholamine stimulation of CMRO2. It may result from a direct effect of either plasma catecholamines or ether on the cerebrovasculature. PMID- 3558504 TI - Catecholamines. PMID- 3558505 TI - Chemical information science coverage in Chemical Abstracts. AB - For many years Chemical Abstracts has included in its coverage publications on chemical documentation or chemical information science. Although the bulk of those publications can be found in section 20 of Chemical Abstracts, many relevant articles were found scattered among 39 other sections of CA in 1984 1985. In addition to the scattering of references in CA, the comprehensiveness of Chemical Abstracts as a secondary source for chemical information science is called into question. Data are provided on the journals that contributed the most references on chemical information science and on the languages of publication of relevant articles. PMID- 3558499 TI - Measurement of glucose utilisation with [18F]2-fluoro-2-deoxy-D-glucose: a comparison of different analytical methods. AB - A number of different analytical methods were applied to dynamic scans obtained with [18F]2-fluoro-2-deoxy-D-glucose and positron emission tomography. In particular, methods applying three, four, standard, or no rate constants were compared in four studies on three normal subjects. In addition, regional cerebral blood flow, oxygen utilisation, and blood volume were measured using the oxygen 15 steady-state inhalation technique. There was a large difference between values of glucose utilisation obtained with the various analytical methods, in particular between methods using three or four rate constants. This difference was not due to contamination of the tracer with [18F]2-fluoro-2-deoxy-D-mannose. For dynamic techniques, the separate measurement of regional cerebral blood volume was essential. Static techniques (single scans with standard or no rate constants) were best related to dynamic techniques utilising four rate constants. From the results, it followed, however, that these static techniques can only be applied clinically if relatively large disturbances of glucose metabolism and no changes in rate constants are anticipated. The lumped constant was assessed from the combined measurement of oxygen and glucose utilisation and was higher than previously reported. PMID- 3558502 TI - Regional cerebral blood flow and focal cortical perfusion: a comparative study of 133Xe, 85Kr, and umbelliferone as diffusible indicators. AB - We report that regional CBF determined by the initial slope technique using 133Xe and 85Kr in cats and rabbits can be significantly influenced by the size of the field of measurement. The clearance curves of umbelliferone, a lipid-soluble intracellular pH fluorescent indicator, from a visually avascular 80-micron field were used to cross-correlate rCBF with focal cortical perfusion. Our findings indicate that in the cat, as the gamma or beta detector's field of volume was reduced, regional CBF (rCBF) measured by intraarterially injected 133Xe or 85Kr decreased in value by 33% and 28%, respectively, and the slope of the rCBF-PaCO2 response curve became less steep by 56% and 45%, respectively. Umbelliferone, measuring a much smaller volume of tissue, showed a lower normocapnic flow and a more oblique PaCO2 response curve. In the rabbits studied, the normocarbic rCBFs and the rCBF-PaCO2 response curves measured with the three techniques corresponded to those measured in the cat. These results suggest that large field/volume measurements assess a measure of flow that is a weighted average of several distinct flow compartments and that these compartments differ in their response to changes in PaCO2. PMID- 3558506 TI - Atomic physicochemical parameters for three-dimensional-structure-directed quantitative structure-activity relationships. 2. Modeling dispersive and hydrophobic interactions. AB - In an earlier paper (Ghose A. K.; Crippen, G. M. J. Comput. Chem. 1986, 7, 565) the need of atomic physicochemical properties for three-dimensional-structure directed quantitative structure-activity relationships was demonstrated, and it was shown how atomic parameters can be developed to successfully evaluate the molecular water-1-octanol partition coefficient, which is a measure of hydrophobicity. In the present work the atomic values of molar refractivity are reported. Carbon, hydrogen, oxygen, nitrogen, sulfur, and halogens are divided into 110 atom types of which 93 atomic values are evaluated from 504 molecules by using a constrained least-squares technique. These values gave a standard deviation of 1.269 and a correlation coefficient of 0.994. The parameters were used to predict the molar refractivities of 78 compounds. The predicted values have a standard deviation of 1.614 and a correlation coefficient of 0.994. The degree of closeness of the linear relationship between the atomic water-1-octanol partition coefficients and molar refractivities has been checked by the correlation coefficient of 89 atom types used for both the properties. The correlation coefficient has been found to be 0.322. The low value suggests that both parameters can be used to model the intermolecular interaction. The origin of these physicochemical properties and the types of interaction that can be modeled by these properties have been critically analyzed. PMID- 3558507 TI - [pH and the bacteriology of gastroplasties after esogastric resection]. AB - A study of pH of digestive fluid in 24 patients six days after esophagogastric resection (EGR) showed conservation of acidity (pH: 3 or less) in one-thirds of cases. Immediate postoperative course was invariable with respect to incidence of pneumopathy and fistulae. Fungal infection is almost a constant finding in digestive grafts together with microbial pullulation, with a linear relation to pH. Ecology of germs was that of digestive flora of patients with obstruction, selected by the antibiotic cover administered. Group D streptococci and Gram negative bacilli were usually resistant to cephalosporins. Regurgitation pneumopathy therefore requires modification of antibiotic therapy and possible antifungal treatment. When functional disturbance is provoked by EGR, as for example a reflux syndrome; only those patients (1/3) with a pH of 3 or less can obtain relief from treatment with antacids. PMID- 3558508 TI - [One-stage treatment of neoplastic occlusions of the left colon. Apropos of 3 cases. Review of the literature]. AB - The authors report of 3 news of subtotal colectomy with immediate anastomosis in the treatment of neoplastic occlusion of the left colon. They review all the cases (153) actually published. The advantages of this technic are: treatment of the occlusion and of the cancer in one stage; quicker social rehabilitation (14.8 days) useful overall in patients whom survival is short, lower mortality rate (10.45%) lower morbidity rate (25.6%) and quite none sequellae. PMID- 3558511 TI - [Sclerosing cholangitis and biliary sequelae of hydatid cyst of the surgically treated liver]. AB - Worldwide literature and ten or so personal cases are reviewed as a basis for distinction or intrication of two aspect of post-hydatid sclerosing cholangitis; that of a localized lesion of diffuse lesions of the biliary tract. In both cases the action of the hydatid cyst is not due to toxins but to pressure on biliary duct walls, very variable according to site and size. This local action may be the only cause, provoking a specific type of lesion, a true sequela of an incomplete or delayed operation. In certain regions, or in the presence of biliary stasis and angiocholitis, passage of hydatid fluid into biliary tracts, normally tolerated by healthy biliary pathways, leads to a diffuse sclerosing cholangitis. The serious consequence of this eventuality is proved by the failure of many treatments, with subsequent inevitable liver transplants. Clinical circumstances and data explaining this complication allow necessary precautions to be taken. Furthermore, early treatment of hydatidosis or as radical as possible therapy for advanced lesions is curative of localized forms of the disease. PMID- 3558510 TI - [Parathyroid adenoma at an atypical site, ectopic or not]. AB - Of 800 patients undergoing operation for primary hyperparathyroidism between 1960 and 1985, 163 presented parathyroid adenomas located in other than typical sites in normal parathyroid glands. A retrospective study of case-reports is used to demonstrate the value of complementary investigations in the localization of these lesions, and to emphasize certain operative factors indispensable for their detection. PMID- 3558509 TI - [Therapeutic attitude in choledocoduodenal fistulas complicating duodenal ulcer]. AB - The authors present 5 observations of choledocoduodenal fistula complicating chronic duodenal ulcer disease. Four cases were observed in Central Africa, the other in France. After a study of the frequency, and especially of the higher incidence in Africa, the authors review the problems associated with the pathology, clinical and diagnostic aspects of this complication. Moreover, they evoke the essential problems of management, as based on their experience and a review of the literature: medical vs. surgical treatment, should and how they treat the biliary lesions. Their individual results are criticized. A policy for the management of this complication is considered. PMID- 3558513 TI - [Early screening of cancer of the stomach in Japan]. AB - Gastric cancer is the most frequent malignant tumor reported in Japan, and increasing effort is being directed towards its early diagnosis. Radiographic imaging is considered to be the main exploratory investigation for screening of this cancer, fibroscopy being reserved for cases with suspected lesions on radiology. In the series studied, 40% of cases of gastric cancer were diagnosed at an early stage, a non-negligible result when one considers that the 5-year survival rate is better than 95% at this stage. PMID- 3558515 TI - [Value of the bilateral anterolateral approach for the treatment, by corporectomy and prosthesis, of metastases of the lower cervical spine. Apropos of 20 cases]. AB - The authors report their experience of the antero-lateral bilateral approach for the treatment of inferior spinal cervical metastasis. They underline the effect of osseous posterior wall compression. PMID- 3558512 TI - [Adenocarcinoma of the duodenojejunal angle. Diagnostic and therapeutic problems]. AB - The duodenojejunal is a rare site for the development of tumors. Diagnosis is difficult but two cases are reported in which the presence of a tumor was determined by small intestine follow through radiography and confirmed on endoscopy. Surgical treatment is limited by size of lesion. The two cases reported were treated by resection and the patients have survived for 8 months and 5 years respectively. PMID- 3558514 TI - [Arthroplastic resection of the shoulder. Results and indications apropos of 35 cases]. AB - The only aim of this retrospective study of 35 patients who had undergone resection of shoulder is to report overall results of this well established operation. Although no result could be rated as excellent, those in one half of the patients were evaluated as good and in one quarter as acceptable. The shoulder can be used in two-thirds of cases and of major importance is that pain is absent in two-thirds and tolerable in 80% of cases. In addition to cases of septic arthritis and poorly tolerated recurrent luxations, this operation is indicated for elderly patients with a fracture-luxation or compound fracture of upper end of humerus. However, the operation requires very strict conditions and re-attachment of the cap of rotator muscles. Resection of shoulder should therefore conserve a place in the therapeutic arsenal of shoulder disorders. PMID- 3558517 TI - [Meeting of the French Association of Surgery. Paris, September 1986. Abstracts]. PMID- 3558516 TI - [Apropos of a badly reduced traumatic dislocation of the hip in a child]. PMID- 3558520 TI - Writing in four- to six-year-olds: representation of semantic and phonetic similarities and differences. PMID- 3558519 TI - Performance factors in subject-auxiliary inversion by children. PMID- 3558518 TI - Intonation with single words: purposive and grammatical use. PMID- 3558521 TI - Prosody and the development of comprehension. PMID- 3558523 TI - Is the quantity maxim strategy child-specific? PMID- 3558522 TI - The relationship between age and MLU in young children: a second look at Klee and Fitzgerald's data. PMID- 3558525 TI - Early words of blind children. PMID- 3558524 TI - The eyes have it: lexical and syntactic comprehension in a new paradigm. PMID- 3558526 TI - Phonological development of two-year-old monolingual Puerto Rican Spanish speaking children. PMID- 3558527 TI - Learning to use prepositions: a case study. PMID- 3558528 TI - A Japanese child's use of stative and punctual verbs. PMID- 3558529 TI - The causes of specific developmental language disorder ("development dysphasia"). PMID- 3558530 TI - Rehabilitating severely head-injured adolescents: three case reports. AB - The case reports of 3 severely head-injured adolescents, who developed psychiatric sequelae after the trauma, are presented. All 3 cases displayed various socially disinhibited behaviours. Individually tailored treatment programmes helped these young people manage their maturational tasks of adolescence. Several issues, central to this rehabilitative work, are discussed, including the personal significance of the adolescent's injury, identity issues and defence mechanisms; a family perspective on coping with the injured adolescent and the components of a therapeutic package. PMID- 3558531 TI - The salience of facial expression for autistic children. AB - Autistic and non-autistic retarded children who were matched for verbal ability were shown 'standard' pairs of photographs of people who differed in three, two or one of the following respects: sex, age, facial expression of emotion, and the type of hat they were wearing. When given similar photographs to sort, the majority of non-autistic children sorted according to people's facial expressions before they sorted according to type of hat, but most autistic children gave priority to sorting by type of hat, and many neglected the facial expressions altogether. It is suggested that these results reflect autistic children's insensitivity to other people's facial expressions of emotion. PMID- 3558532 TI - A study of the frequency of suicidal behaviour in children aged 5 to 14. AB - 433 medical and mental health institutions in the Netherlands took part in an investigation into the incidence of suicide and suicide attempts in children. The investigation is also concerned with the form that suicidal behaviour takes and an attempt is made to identify demographic and social characteristics of the children involved. The results show that suicide attempts do not constitute a very large problem in children aged 5-14; attempts hardly occur at all in children under the age of 11, but the incidence increases with age. It is also clear that children who make suicide attempts live in a problematic background situation. PMID- 3558533 TI - Research note: sleep problems of normal Chinese adolescents. AB - Eight hundred and forty-six Chinese adolescents were surveyed concerning sleep behaviours including insomnia, nightmares, somniloquism, somnambulism, bruxism, and enuresis. Bruxism was reported most frequently (22%) followed by somniloquism (17%) and insomnia (14.9%). Subjects were compared by sex, age, and rearing by parents or parent surrogates. Cross cultural comparisons and the possible significance of findings are discussed. PMID- 3558534 TI - Research note: a learning disability index (LDI) derived from the WISC-R: age differences in referred children. AB - A learning disability index (LDI) based on a principal components analysis of the WISC-R normative data has been developed to depict verbal or nonverbal deficits on that test. This index was calculated for the individual test performance of a total of 1371 children referred to a school-board psychology service because of educational difficulties. These children, categorised by sex and age, returned mean scores on this index that were reliably different from the scores of the normative population only after the age of 8 years in the case of the boys, and 7 years in the girls. This cross-sectional age effect was confirmed by longitudinal data obtained from the test-retest scores of a subset of these children. PMID- 3558535 TI - Do tests help in teaching? PMID- 3558536 TI - The relevance of attachment theory to child psychiatric practice: an update. PMID- 3558537 TI - Children's Depression Scale: validation with child psychiatric inpatients. AB - The present investigation examined the psychometric characteristics and correlates of the Children's Depression Scale (CDS) with psychiatric impatient children (n = 185; ages 7-12) and their parents (n = 154). The results revealed: high internal consistency of the CDS, significant correlations of CDS scores with other measures of depression and related constructs (hopelessness, self-esteem) and significant differences in CDS depression and positive experience scores for children independently diagnosed as meeting Research Diagnostic Criteria for depression versus other disorders. Parent CDS scores permitted finer diagnostic discriminations and revealed age and gender differences in childhood depression not evident from the children's scores. PMID- 3558538 TI - Clinical evaluation of a self-rating scale for depressive disorder in childhood (Depression Self-Rating Scale). AB - The many conceptual and methodological difficulties involved in evaluating depression rating scales for children are discussed. A clinical validation of the Depression Self-Rating Scale for Children (DSRSC) is described. The instrument is easy to use and has a predictive value comparable with that of a psychiatric global rating of depressed appearance and history of depression obtained at interview. There was confirmation that the DSRSC can tap an internal dimension of depression and that children are able to evaluate their feeling states. An examination of misclassified children pointed to diagnostic overlap and some unreliability of diagnosis by clinicians. PMID- 3558540 TI - Research note: the use of the Birleson Depression Scale with a non-clinical sample of boys. AB - Attempts have been made to develop self-rating scales to assess depression in children. One of these scales, the Birleson Self-rating Scale, was administered to a non-clinical sample of boys which was larger, and covered a wider age-range, than Birleson's own non-clinical group. A comparison is made with Birleson's findings, and in addition data from the administration of the scale to a group of boys aged 13 to 18 years is presented. PMID- 3558539 TI - The application of temperament questionnaires to a British sample: issues of reliability and validity. AB - One hundred and five mothers of British children aged 1-5 years completed the EASI-1 Temperament Survey and the age appropriate version of the Carey questionnaire (Toddler Temperament Scale or Behavioural Style Questionnaire). Detailed statistical analyses revealed psychometric weakness in all three instruments, most notably in the Carey questionnaires. Neither factor analysis nor item-to-scale correlations provided clear support for the nine NYLS dimensions incorporated within the TTS and BSQ. Mothers' opinions of their child's temperament constellation differed considerably from those resulting from the questionnaire analysis for the STWU and Difficult constellations. Issues of reliability and validity are discussed. PMID- 3558541 TI - Child characteristics and the employment of mothers with young children: a longitudinal study. AB - The present longitudinal study investigated the relative influence of child, maternal, and demographic characteristics on the labor force participation of 93 mothers with young children in the New York Longitudinal Study. Multiple regression analyses revealed that child characteristics such as temperamental difficulty and the presence of physical problems were as potent as demographic features in predicting the mother's labor market activities throughout the child's early years. Conclusions were that multiple aspects of the context, including child characteristics, must be addressed if a more comprehensive picture of the employment patterns of mothers is to be gained. PMID- 3558542 TI - Prevention of behavioral and emotional disorders in children. PMID- 3558543 TI - The social context of delinquent conduct. AB - Findings from two studies are presented on degree of group involvement in delinquency among young people. The first study indicates that among boys, although there is wide variation in the degree to which particular types of offence are committed alone or in the company of others, there is no general category of offence that is predominantly solitary. Moreover we could identify no individuals who always offended alone. The second study compared adolescent boys and girls and indicated that girls are if anything even more likely than boys to commit any offences in the company of others. The findings are discussed in terms of their implications for the role of the group context in delinquency. PMID- 3558544 TI - Tenth International Symposium on Column Liquid Chromatography. San Francisco, CA (U.S.A), May 18-23, 1986. Proceedings. Part I. PMID- 3558545 TI - Resolution of enantiomeric amides on a Pirkle-type chiral stationary phase. A comparison of subcritical fluid and liquid chromatographic approaches. AB - Subcritical and supercritical fluid chromatography (SubFC and SFC) have been evaluated for the resolution of an homologous series of enantiomeric amides. The solutes were the 2-naphthoyl amides of an homologous series of amines, ranging from 2-aminobutane to 2-aminoctane, and the p-methyl-, p-methoxy- and p chlorophenylamides of 2-aminoheptane. The chiral stationary phase (CSP) used was the covalent form of (R)-N-(3,5-dinitrobenzoyl)phenylglycine. In liquid chromatography (LC) the mobile phase comprised hexane-2-propanol--acetonitrile (97:3:0.5) at a flow-rate of 2 ml/min and temperatures of 20-35 degrees C. In SFC, the mobile were various mixtures of carbon dioxide and polar modifiers, such as alcohols, chloroform and water. For the best conditions in LC, the chiral resolution, alpha, increased through the homologous series from alpha = 1.03 for the amide derived from 2-aminobutane to alpha = 1.11 for the 2-aminooctane amide. The values of alpha observed for the pi-basic amides of 2-aminoheptane (p-methyl and p-methoxy) were greater than that observed for the pi-acidic amide (p chloro), i.e., alpha = 1.08 versus 1.04. The selectivities, resolutions and efficiencies obtained by LC and SubFC were similar. These results indicate that the mechanism of chiral recognition is the same in LC and SubFC and that the methods should be interchangeable. The actual analysis time for SubFC was significantly shorter than that required for LC: as short as 2 min for the 2 aminooctane amide, whereas LC takes over 10 min under the best conditions. PMID- 3558546 TI - Elution order-absolute configuration relationship of K-region dihydrodiol enantiomers of benz[a]anthracene derivatives in chiral stationary phase high performance liquid chromatography. AB - The direct resolution of K-region cis- and trans-dihydrodiol enantiomers of 14 unsubstituted and methyl- and bromo-substituted benz[a]anthracene (BA) derivatives was investigated by high-performance liquid chromatography with commercially available columns, packed with gamma-aminopropylsilanized silica to which either (R)-N-(3,5-dinitrobenzoyl)phenylglycine (R-DNBPG) or (S)-N-(3,5 dinitrobenzoyl)leucine (S-DNBL) is either ionically or covalently bonded. BA derivatives used in this study include: BA, 1-methyl-BA, 4-methyl-BA, 7-methyl BA, 8-methyl-BA, 10-methyl-BA, 11-methyl-BA, 12-methyl-BA, 7,12-dimethyl-BA, 7 bromo-BA, 7-bromo-1-methyl-BA, 7-bromo-11-methyl-BA, 7-bromo-12-methyl-BA, and 3 methylcholanthrene. The enantiomers of BA trans-5,6-dihydrodiol were the only compounds not resolved by any of the four chiral stationary phases (CSPs) tested. The results indicate that conformational preference of the hydroxyl group is one of the most important factor in determining the elution order of dihydrodiol enantiomers. The presence and the location of a substituent and the molecular size and shape of the dihydrodiols can significantly affect the efficiency of enantiomeric resolution. In general, the ionically bonded R-DNBPG provides the best resolution of enantiomeric quasidiequatorial trans-dihydrodiols and the R,R enantiomers are consistently more strongly retained. In contrast, the enantiomeric pairs of quasidiaxial trans-dihydrodiols are generally better resolved by the covalently bonded R-DNBPG, and the S,S enantiomers are more strongly retained. The enantiomers of cis-dihydrodiols having hydroxyl groups that adopt quasiequatorial-quasiaxial and/or quasiaxial-quasiequatorial conformations are more consistently resolved by the ionically bonded S-DNBL and in all cases the S,R enantiomers are more strongly retained. Thus, it is possible to choose a CSP which resolves the K-region dihydrodiol enantiomers with a predictable elution order. PMID- 3558547 TI - Direct separation of non-K-region mono-ol and diol enantiomers of phenanthrene, benz[a]anthracene, and chrysene by high-performance liquid chromatography with chiral stationary phases. AB - The direct separation of 26 bay region and non-bay region mono-ol and diol enantiomers of phenanthrene, benz[a]anthracene, and chrysene was compared by high performance liquid chromatography on commercially available columns, packed with gamma-aminopropylsilanized silica to which either (R)-N-(3,5 dinitrobenzoyl)phenylglycine(R-DNBPG) or (S)-N-(3,5-dinitrobenzoyl)leucine(S DNBL) was either ionically or covalently bonded. In general, enantiomers of bay region mono-ols and diols are more efficiently resolved than those of non-bay region derivatives. Elution orders of enantiomers on either chiral stationary phase are the same, regardless of whether the chiral stationary phase is ionically or covalently bonded. Except for the enantiomers of 4-hydroxy-4-methyl 1,2,3,4-tetrahydrobenz[a]anthracene, 1,2,3,4-tetrahydrobenz[a]anthracene trans 1,2-diol, and benz[a]anthracene trans-1,2-dihydrodiol, elution orders of resolved enantiomers on R-DNBPG are reversed on S-DNBL. The enantiomers are generally more efficiently resolved on R-DNBPG than on S-DNBL. With the exception of the elution order of the enantiomeric 4-hydroxy-1,2,3,4-tetrahydrochrysene, the results of this study are consistent with the chiral recognition mechanisms proposed by Pirkle and co-workers, who developed the chiral stationary phases used in this study. PMID- 3558548 TI - Mobile phase effects on the separations of substituted anilines with a beta cyclodextrin-bonded column. AB - The capacity factors of several substituted anilines were measured on a beta cyclodextrin (beta-CD)-bonded column with mobile phases varying from the classical, normal-phase condition, e.g. n-heptane-2-propanol, to the classical, reversed-phase condition, e.g. water-2-propanol. Different modifiers, such as acetonitrile, methanol, and tetrahydrofuran and a Partisil PXS-ODS column were also used for comparison. In general, it was found that the beta-CD column, having the ability to form inclusion complexes with certain substrates is better and more selective in the reversed-phase separation of many aromatic compounds than the Partisil PXS-ODS column. The normal-phase separation on beta-CD was even more efficient, owing to the presence of large number of hydroxy groups on the surface of beta-CD molecules and the more rapid mass transfer in the column. In the present case, alcohols were found to be better modifiers than aprotic solvents. The effects of organic solvents on both normal-and reversed-phase separations are also discussed. The minima observed for the log k' vs. percent organic solvent plots for a number of substituted anilines are reasoned to originate from solute-solvent competition, which interacts with the stationary phase, as well as from the "relative solubility" of solutes in the stationary and mobile phases. PMID- 3558549 TI - Mild interaction of proteins with butyl and hydroxyl groups on the surface of polymer gels TSK HW-65 and butyl toyopearl 650-M. AB - Interaction of bovine serum albumin (BSA) with butyl and hydroxyl groups on adsorbent gel surfaces was investigated by using TSK HW-65 and Butyl Toyopearl 650-M gels. It was found that BSA was adsorbed on the gel not only from highly concentrated ammonium sulphate but also from dilute perchloric acid, trichloroacetic acid, etc. Some eluent modifiers, such as organic solvents (30% aqueous methanol or acetonitrile), salt solutions (0.18-0.2 M phosphate) and hydrogen-bond breaking reagents (3-7 M urea, 10 M ethylene glycol, 0.1% triethylamine) were found to be effective in facilitating the elution of trapped BSA from the gel. The conformational change of BSA in these solutions was slight except for urea, and it was reversibly recovered after removal of the modifier from the aqueous solutions, except for the hydrogen-bond breaking reagents. PMID- 3558550 TI - Assaying erythrocyte haem biosynthetic enzyme activities by high-performance liquid chromatography with the advanced automated sample processor. AB - The four cytosolic haem biosynthetic enzymes in erythrocytes were assayed with the Varian advanced automated sample processor (AASP) for rapid sample concentration and clean-up with fast and effective high-performance liquid chromatography systems for separation and quantitation. In the assay for 5 aminolaevulinic acid dehydrase, the porphobilinogen (PBG) formed was extracted on a C18 AASP cartridge and separated by reversed-phase ion-pair chromatography with 32% methanol in 0.05 M sodium acetate buffer (pH 3.5), containing 5.4 mM of 1 heptane-sulphonic acid as eluent. PBG was the substrate for the simultaneous assay of hydroxymethylbilane synthase and uroporphyrinogen III synthase. The uroporphyrinogen I and III isomers formed were oxidised to porphyrins, concentrated on a C2 or C8 cartridge, and separated by reversed-phase chromatography with 13% acetonitrile in 1 M ammonium acetate buffer (pH 5.16) as eluent. Uroporphyrinogen decarboxylase was estimated with pentacarboxylic porphyrinogen III as substrate. The coproporphyrinogen formed was extracted on a C2 or C8 cartridge, oxidised to coproporphyrin and separated by reversed-phase chromatography with 30% acetonitrile in 1 M ammonium acetate buffer (pH 5.16) as mobile phase. PMID- 3558551 TI - Microwave extraction. A novel sample preparation method for chromatography. AB - The applicability of microwave irradiation to the extraction of various types of compounds from soil, seeds, foods and feeds as a novel sample preparation method for chromatography was investigated. Samples were ground and mixed with an appropriate solvent, methanol or methanol-water for polar compounds and hexane for non-polar compounds. The suspensions were irradiated for 30 s, but they were not allowed to boil. After cooling, the irradiation was repeated several times. The samples were then centrifuged, and aliquots of the supernatant were injected into a chromatographic column. The yields of the extracted compounds obtained by microwave irradiation were compared with those obtained by the traditional Soxhlet or shake-flask extraction methods. The microwave extraction method was more effective than the conventional methods. Due to the considerable savings in time and energy, this novel method is suitable for fast extractions of large sample series. PMID- 3558552 TI - Protein conformational effects in hydrophobic interaction chromatography. Retention characterization and the role of mobile phase additives and stationary phase hydrophobicity. AB - We have studied the conformational behavior of alpha-lactalbumin (alpha-LACT) in hydrophobic interaction chromatography (HIC). Retention characterization in terms of Z (slope of plot of ln k' vs. ln phi B, where k' is the capacity factor and phi B is the volume fraction of mobile phase B) has been explored, and the relationship of Z to other slopes, such as S (slope of the plot of ln k' vs. phi B) has been derived. The reasons for the sensitivity of Z to conformational change are discussed. The enhanced broadening of alpha-LACT in a temperature transition region of conformational change has been studied by spectral analysis using on-line photodiode array detection. The influence of Ca2+ and Mg2+ addition to the mobile phase is further explored. Since alpha-LACT is a calcium binding protein, addition of this metal leads to stabilization, i.e. higher column temperatures are required for conformational change. On the other hand, addition of Mg2+ appears to destabilize the protein. We have explored the use of a more hydrophobic support, C2-(ethyl) ether phase, for the elution of alpha-LACT. In this case, two widely separated peaks are observed. By spectral analysis the first peak is shown to be native and the later eluted, broad second peak to be an unfolded mixture of species. As previously observed in reversed-phase liquid chromatography, the second peak grows at the expense of the first, as the column temperature is raised. The second peak also grows as the contact time of the protein with the surface increases. This behavior can be ascribed to the conformational change of alpha-LACT in the column, the late eluted species under the second peak binding significantly more strongly to the phase than the native peak. Reinjection of the late eluted fraction reveals that reformation of the native species takes place in solution within 30 min. As before, addition of Ca2+ reduces the extent of unfolding under any specific condition. These results add further to our understanding and ability to control conformational changes in high-performance liquid chromatography. PMID- 3558553 TI - High-performance liquid chromatographic determination of antiepileptic drugs by an advanced automated sample processor. PMID- 3558554 TI - Characterization of the reactivity of sulphydryl groups in tryptophanase by a dual-monitoring high-performance liquid chromatographic system with a site directed fluorescent reagent. AB - Sulphydryl groups of E. coli tryptophanase (L-tryptophan indole lyase, E.C. 4.1.99.1) were made to react with a fluorescent maleimide derivative, N-(4 anilino-1-naphthyl)maleimide(ANM). By carefully controlling the reaction conditions it was possible to limit the extent of sulphydryl group modification. The modified enzyme was digested with (L-1-tosylamide-2-phenylethyl chloromethyl ketone)-trypsin. The fluorescent peptides obtained were analysed by reversed phase high-performance liquid chromatography on a C18 column with a dual monitoring system consisting of a UV and a fluorescence monitor connected in tandem. This was followed by the determination of the amino acid composition of the fluorescent peptides. Comparison of these results with the known, complete primary structure of tryptophanase from the K-12 strain of E. coli allowed the assignment of position 298 to the cysteine residue, which is more selectively modified by ANM under the conditions chosen and is involved in the maintenance of the catalytic activity. PMID- 3558555 TI - Determination of phenylethanolamine-N-methyltransferase activity by high performance liquid chromatography with on-line radiochemical detection. AB - A new assay technique for phenylethanolamine N-methyltransferase (PNMT) activity by high-performance liquid chromatography with on-line radiochemical detection is described. The method is based on the measurement of 14C-labelled products of the substrate, normetanephrine, using S-adenosyl-L-[methyl-14C]methionine as the methyl donor. The reaction products are determined from the reaction mixture after removal of protein by injecting an aliquot into the liquid chromatograph. The detection limit with 60% counting efficiency is 1.2 pmol of 14C-labelled product. The method is suitable for assaying PNMT activity in the adrenal and in the brain tissue. PMID- 3558556 TI - Ion-exchange and hydrophobic-interaction high-performance liquid chromatography of proteins. A practical study. AB - A number of commercially available columns for ion-exchange and hydrophobic interaction high-performance liquid chromatography (HPLC) have been tested, ranging from very fast columns with low capacity to preparative columns. The experiments represent a selection of column applications likely to occur in a biochemical laboratory. The use of several ion-exchange columns for separation of serum and membrane proteins has been demonstrated. Columns with a silica gel matrix and with a polymer matrix have proved to be of equal value in experiments with water-soluble proteins. In experiments with hydrophobic membrane proteins the choice of the column depends on the protein to be isolated. A combination of a cation-exchange and an anion-exchange column as a tandem as well as a mixed-bed column, were applied for the separation of serum proteins and for the isolation of a 175,000-dalton membrane glycoprotein. One problem of hydrophobic-interaction HPLC is the poor solubility of some proteins, for example serum proteins at high salt concentrations. This difficulty can be overcome by the use of columns with higher hydrophobicity which require lower initial salt concentrations. Less hydrophobic columns have been shown to separate hydrophobic membrane proteins by a combination of salt and detergent gradients. PMID- 3558557 TI - Separation of proteins on a polymeric fluorocarbon high-performance liquid chromatography column packing. AB - A rigid, inert fluorocarbon resin has been evaluated as an high-performance liquid chromatography packing for the separation of proteins and peptides. Samples are separated with gradient elution of the mobile phase from aqueous buffer to acetonitrile. The selectivity and retention of the fluorocarbon resin packing for proteins are similar to that of aliphatic hydrocarbon-bonded silica packings. PMID- 3558558 TI - Determination of N-(3-acetamidopropyl)pyrrolidin-2-one, a metabolite of spermidine, in urine by isotope dilution mass fragmentography. AB - A capillary gas chromatographic method with mass spectrometric detection for the determination of N-(3-acetamidopropyl)pyrrolidin-2-one, the monoacetyl conjugate of isoputreanine-gamma-lactam, in urine has been developed. Using a quantification based on stable isotope dilution mass fragmentography, age dependent normal values for the urinary excretion of N-(3 acetamidopropyl)pyrrolidin-2-one by 44 apparently healthy control subjects were determined. Quality control data and normal values for 27 adults are given. The method was applied to the monitoring of the chemotherapeutic treatment of two patients with high-grade non-Hodgkin lymphoma. PMID- 3558559 TI - Sensitive determination of deuterated and non-deuterated tryptophan, tryptamine and serotonin by combined capillary gas chromatography and negative ion chemical ionization mass spectrometry. AB - Sensitive methods for the determination of deuterated and non-deuterated tryptophan, tryptamine and serotonin by combined capillary gas chromatography and negative ion chemical ionization mass spectrometry were developed. [3,3-2H2]-L Tryptophan, which was used as a tracer, was synthesized for studies of their in vivo metabolism. Tryptophan was converted into its trifluoroacetylmethyl derivative after prepurification with an AG 50W-X2 cation-exchange column. Tryptamine and serotonin were extracted with 20% butanol in diethyl ether and derivatized with trifluoroacetic anhydride. These derivatives were separated and determined by selected ion monitoring. In these determinations, [2',3,3,4',5',6',7'-2H7]-D,L-tryptophan, [alpha,alpha,beta,beta-2H4]tryptamine and [alpha,alpha,beta,beta-2H4]serotonin were used as internal standards. PMID- 3558560 TI - Determination of plasma amino acids by gas chromatography. AB - A complete methodology, incorporating a novel clean-up technique, for quantitative determination of amino acids in plasma by gas chromatography is described. Glucose, a component causing major analytical interference, is removed by an enzymic reaction included in the pre-chromatographic clean-up. The procedure for derivatisation of amino acid standards is shown to be reproducible down to a level of 2.5 micrograms for each amino acid, relative standard deviations for all amino acids except arginine and histidine being 3% or lower. For the entire procedure applied to plasma, relative standard deviations for most amino acids are below 5% with recoveries ranging from 90 to 120%. Normal values, obtained using eighteen plasma samples, are in reasonable agreement with published data. Plasma amino acid values were determined simultaneously by gas chromatographic and ion-exchange chromatographic techniques. Statistical evaluation shows there to be no significant difference between corresponding values for eleven amino acids. Values for tyrosine, histidine and particularly phenylalanine show significant differences (p less than 0.001). PMID- 3558561 TI - Separation of citric acid cycle intermediates by high-performance liquid chromatography with ion pairing. AB - A method to separate underivatized tricarboxylic acid cycle intermediates within 20 min using the commonly available C15 high-performance liquid chromatography column has been developed. Ion pairing using tetrabutylammonium cations and isocratic conditions is used to separate the intermediates which are then detected at 210 nm. Separation was optimized by altering pH, the concentration of sodium sulfate and the pairing ion. This technique permits the detection of as little as 120 nmol of citrate to 0.5 nmol of fumarate. Physiological samples of rat liver mitochondria, human urine, and orange juice were analyzed. PMID- 3558562 TI - Determination of 2,3-dinor-6-ketoprostaglandin F1 alpha in urine samples by liquid chromatography and radioimmunoassay. AB - A method for 2,3-dinor-6-ketoprostaglandin F1 alpha quantification based on high performance liquid chromatography-radioimmunoassay is described. Samples are acidified to pH 3 and processed through C18 disposable cartridges. The prostanoids are eluted with methyl formate and further separated on a reversed phase column using acetonitrile-acetic acid-triethylamine buffer (32:68). Studies of the effect of eluent pH were performed in order to optimize resolution and separation of 2,3-dinor-6-keto-PGF1 alpha from other prostanoids. Eluates were collected and assayed by radioimmunoassay using a heterologous system, with 6 keto-PGF1 alpha as radioligand and an antiserum with high cross-reactivity for 2,3-dinor-6-keto-PGF1 alpha. Sensitivity, precision and accuracy of the assay procedure are reported together with the validation of its specificity. The proposed method has been applied to the determination of this prostacyclin metabolite in human urine. PMID- 3558563 TI - High-performance liquid chromatographic on-line flow-through radioactivity detector system for analyzing amino acids and metabolites labeled with nitrogen 13. AB - A flow-through radioactivity detector was used for the high-performance liquid chromatographic determination of amino acids and other nitrogenous substances labeled with 13N, a short-lived (t1/2 9.96 min) positron-emitting radionuclide. 13N-Labeled compounds were analyzed using cation, anion and amino columns, or as the o-phthaldialdehyde derivative on an ODS column. Use of column-switching valves and a high-performance liquid chromatographic system with a quaternary eluting capability permits two to three 20-min analyses of labeled samples from a single 13N experiment to be carried out on different columns using a binary or a single mobile phase. Radioactivity in liver metabolites was quantified using an on-line flow-through monitor with data processing capability for integrating peaks and correcting for radioactivity decay. As an example, 1 min following an L [13N]glutamate injection via the hepatic portal vein, 77% of the label in the liver was in a metabolized form; at least ten labeled products were formed. PMID- 3558564 TI - Determination of cyclosporin A in whole blood by high-performance liquid chromatography using automated column switching. AB - A fully automated high-performance liquid chromatographic column-switching system is presented for the determination of cyclosporin A in whole blood. After blood proteins were precipitated with acetonitrile, the supernatant was automatically loaded on to a cyanopropyl column for initial separation, and then the fraction containing cyclosporin A was loaded on to a trimethylsilica column for final separation and quantitation. Cyclosporin A was detected by ultraviolet absorption at 205 nm. The minimum detectable concentration of cyclosporin A was 5 ng/ml in 100 microliter of blood. The coefficient of variation of the method was 1.755, 1.748 and 0.655% in whole blood when spiked at the 170, 425 and 850 ng/ml levels, respectively. One assay was completed in 15 min. PMID- 3558565 TI - Simultaneous determination of bupivacaine and its two metabolites, desbutyl- and 4'-hydroxybupivacaine, in human serum and urine. AB - A sensitive and selective high-performance liquid chromatographic (HPLC) method for the determination of bupivacaine and its two metabolites, desbutyl- and 4' hydroxybupivacaine, in human serum and urine is described. Bupivacaine, both metabolites and the internal standard, etidocaine, are extracted with diethyl ether and then back-extracted into an acidic aqueous phase. After subsequent extraction into diethyl ether, evaporation and reconstitution in the mobile phase, bupivacaine and the metabolites are determined by HPLC using a reversed phase C8 column with tetrahydrofuran-potassium phosphate buffer (8:92, v/v, pH 2.4) as the mobile phase. The sensitivity of the method is 10 micrograms/l for bupivacaine and both metabolites and the extraction efficiencies are 95, 54 and 92% for bupivacaine and desbutyl- and 4'-hydroxybupivacaine, respectively. The reproducibility of the method is good, the coefficients of variation varying between 1.8 and 7.4% in the concentration range 0.10-2.00 mg/l. The procedure was applied to human serum and urine samples from two elderly women who had been operated on under epidural analgesia (plain bupivacaine, 1.5 mg/kg) because of uterine prolapse. PMID- 3558566 TI - Sensitive high-performance liquid chromatographic method for the determination of chlorhexidine in human serum and urine. AB - A high-performance liquid chromatographic method for the analysis of chlorhexidine in human serum and urine was developed. Chlorhexidine and the internal standard, chlorpheniramine, were extracted into chloroform, containing 5% 2-propanol, and back-extracted into dilute sulfuric acid. Chromatographic separation was achieved on a C18 column equilibrated with methanol-water (70:30, v/v), containing 0.005 M sodium heptane-sulfonate. The sensitivity of the assay was 20 ng/ml of biological matrix, using 0.5-ml samples. The application of this method to monitor chlorhexidine levels in burn patients treated topically with a chlorhexidine-containing burn cream was demonstrated. PMID- 3558567 TI - Reaction of bilirubin glucuronides with serum albumin. PMID- 3558569 TI - Rapid gas chromatographic determination of dimethyl sulphoxide and its metabolite dimethyl sulphone in plasma and urine. PMID- 3558568 TI - Determination of quinupramin in plasma and urine by capillary column gas chromatography-mass spectrometry. PMID- 3558570 TI - Gas chromatographic assay for the quantitation of flordipine in human plasma. PMID- 3558571 TI - Simultaneous determination of diclofenac sodium and its metabolites in plasma by capillary column gas chromatography with electron-capture detection. PMID- 3558572 TI - Simple and rapid method for determining procetofenic acid, an active metabolite of procetofen, in biological fluids by solid-phase extraction and high performance liquid chromatography. PMID- 3558573 TI - Simultaneous assay of antipyrine and its major metabolites in urine using high performance liquid chromatography and on-line solid phase sample clean-up. PMID- 3558574 TI - Improved method for the determination of indomethacin in plasma and urine by reversed-phase high-performance liquid chromatography. PMID- 3558575 TI - High-performance liquid chromatographic determination of 6-desmethylnaproxen sulfate in human plasma. PMID- 3558576 TI - Quantitative determination of vitamin E and oxidized and reduced coenzyme Q by high-performance liquid chromatography with in-line ultraviolet and electrochemical detection. AB - We describe a sensitive quantitative high-performance liquid chromatographic (HPLC) assay for the simultaneous determination of vitamin E isomers (alpha-, gamma- and delta-tocopherol), oxidized coenzyme Q species (ubiquinone 9, ubiquinone 10) and reduced coenzyme Q homologues (ubiquinol 9, ubiquinol 10) in various tissues, including blood and plasma. The compounds of interest are quantitatively extracted with a fast one-step lipid extraction procedure and subjected to HPLC without further purification. The extract is separated on a reversed-phase column and the eluted compounds are monitored by sequential UV and electrochemical detection. Ubiquinones are detected at their 275 nm absorbance maximum, by the UV detector, whereas tocopherols and ubiquinols are monitored by the electrochemical detector with high sensitivity and selectivity. The method can detect as little as 1 pmol of the individual ubiquinones. Detection limits for tocopherols and ubiquinols are at least two orders of magnitude lower. PMID- 3558577 TI - Sensitive method for the measurement of amiodarone and desethylamiodarone in serum and tissue and its application to disposition studies. AB - A high-performance liquid chromatographic (HPLC) method for the measurement of amiodarone (AM) and its metabolite(s) in serum and tissues was developed. The method uses a 5-micron silica column, methanol containing 0.02% perchloric acid at pH 4 as the mobile phase, and ultraviolet detection at 240 nm. The standard curves for AM and desethylamiodarone (DAM) were linear for serum (range 0.025-6.0 microgram/ml) and tissues (range 0.1-0.5 micrograms for 10-25 mg wet weight). There was a significant decrease as a function of time in AM and DAM concentrations in patients' sera left at ambient temperature in the presence of light. This HPLC method was applied to studies on serum AM elimination kinetics in patients and on tissue uptake during chronic AM administration to rabbits. The elimination half-life (5.8 h) of AM after a 5 mg/kg intravenous dose to a patient was similar to that after acute oral doses. AM, being lipophilic, accumulated maximally in the fat tissue (56 micrograms/g wet weight), followed by lung and liver in rabbits injected with AM for six weeks. The latter two tissues also contained nearly equal quantities of DAM. The high concentrations of AM and DAM in the liver and lungs may be related to the hepatic toxicity and pulmonary fibrosis associated with chronic AM therapy. Two new metabolites were found in the lung and bile of AM-treated rabbits, but these have not yet been identified. PMID- 3558578 TI - Simultaneous determination of Zonisamide and nine other anti-epileptic drugs and metabolites in serum. A comparison of microbore and conventional high-performance liquid chromatography. PMID- 3558579 TI - Analysis of urinary catecholamines by high-performance liquid chromatography in the presence of labetalol metabolites. AB - Common sample preparation methods for catecholamines lead to contamination with metabolites of labetalol, an anti-hypertensive drug. When the extracts are analyzed by cation-exchange high-performance liquid chromatography, these metabolites are separated from the catecholamines, but their strong retention lengthens the analysis time. A procedure has been developed for complete removal of these drug metabolites from acidified urine by the use of XAD-4 resin. Loss of catecholamines is monitored by an internal standard. This pretreatment can be combined with extraction by weak cation-exchange resin and borate elution to simplify catecholamine analysis for patients receiving labetalol. PMID- 3558580 TI - Determination of hydralazine in human plasma by high-performance liquid chromatography with electrochemical detection. AB - Hydralazine is used as an antihypertensive vasodilator drug. A specific and sensitive method for extraction and analysis of hydralazine by high-performance liquid chromatography (HPLC) with electrochemical detection was developed. Hydralazine and 4-methylhydralazine (internal standard) in plasma were derivatized at room temperature with salicylaldehyde. The derivatives were extracted in basic medium with a mixture of heptane, methylene chloride and isopentyl alcohol. A very good separation of hydralazine and 4-methylhydralazine from matrix material was achieved on a Supelcosil LC-18-DB (5 microns) reversed phase column kept at 28 degrees C with a mobile phase of 66% methanol in 0.055 M citric acid/0.02 M dibasic sodium phosphate (pH 2.5). The hydralazine level was measured electrochemically by a screen oxidation mode. This method offers significant advantages in sensitivity, specificity and accuracy. Sample analysis by HPLC required less than 8 min. Application of the method to monitor plasma levels of hydralazine from a patient receiving the drug for the treatment of severe pregnancy-induced hypertension is discussed. PMID- 3558581 TI - Rapid high-performance liquid chromatography assay for salivary and serum caffeine following an oral load. An indicator of liver function. AB - A rapid isocratic reversed-phase high-performance liquid chromatography (HPLC) system for the quantitative measurement of serum and salivary caffeine is described. The best separation of caffeine from other methylxanthines was achieved by chromatography on an ODS-Hypersil column using a solvent system of 0.1 M ammonium acetate pH 4.6-acetonitrile (85:15, v/v). The effluent was monitored at 280 nm. Caffeine was extracted from diluted serum and saliva samples (10-500 microliter) by adsorption on a small Bond-Elut C18 cartridge and recovered by elution with methanol. Thermospray HPLC-mass spectrometry conditions were optimized to afford a means of directly identifying caffeine in samples. The positive-ion mass spectrum was characterized by an intense protonated molecular ion, MH+, at m/z 195 and negligible fragmentation. When the mass spectrometer was operated in selected ion monitoring mode, caffeine could be detected in less than 1 microliter of serum and saliva at a concentration of 1 microgram/ml. Caffeine (3.5 mg/kg body wt.) was administered orally to healthy adults, children, and newborn infants, and to patients with liver disease. The clearance rate and half life were determined as a test of liver function. A prolongation in the elimination of caffeine was observed in patients with liver disease and, although there was some overlap in the values obtained for patients with noncirrhotic liver disease and healthy persons, the oral caffeine load test may usefully serve as a dynamic assessment of liver function in the serial follow-up of patients with liver disease. PMID- 3558583 TI - Determination of riboflavine in human urine by the use of a hydrophilic gel column. PMID- 3558584 TI - Determination of ascorbic acid in human urine by high-performance liquid chromatography coupled with fluorimetry after post-column derivatization with benzamidine. AB - High-performance liquid chromatography on two Asahipak GS-320 hydrophilic gel columns (50 X 0.76 cm I.D.), connected in series, with 0.015 M tartrate buffer (pH 3.0), containing 2 mM ethylenediaminetetraacetate and 0.05% beta-thiodiglycol as eluent allowed the separation of glucose, diketogulonic acid + diketogluconic acid, dehydroisoascorbic acid, dehydroascorbic acid, ascorbic acid, and isoascorbic acid within 55 min. Ascorbic acid in a urine sample was stabilized by the addition of an equal volume of 5% metaphosphoric acid solution, containing 0.5% of beta-thiodiglycol. Filtration of the mixture through a column of Dowex 50W-X8 (H+) facilitated the determination of ascorbic acid and isoascorbic acid in human urine. Samples could be analyzed every 20 min. PMID- 3558582 TI - Determination of L-buthionine-(S,R)-sulfoximine in plasma by high-performance liquid chromatography with o-phthalaldehyde derivatization and fluorometric detection. AB - The development of a high-performance liquid chromatography system for the analysis of L-buthionine-(S,R)-sulfoximine (BSO) in human plasma is described. o Phthalaldehyde derivatization and fluorescence detection were used. The R- and S BSO peaks were partially separated from each other and completely separated from the matrix components. The limit of detection for BSO was 2 micrograms/ml plasma. PMID- 3558585 TI - Reversed-phase high-performance liquid chromatographic separation of phenolic derivatives of benzo[a]pyrene, benz[a]anthracene, and chrysene with monomeric and polymeric C18 columns. AB - The separation of monohydroxylated derivatives (phenols) of benzo[a]pyrene, benz[a]anthracene, and chrysene was studied by reversed-phase high-performance liquid chromatography using a monomeric Zorbax ODS column and a polymeric Vydac C18 column. The Vydac C18 column resolved the phenols of each hydrocarbon with a wide range of retention times than the Zorbax ODS column. Four K-region phenols of benzo[a]pyrene are either not separated or marginally separated on both monomeric and polymeric columns. Other K-region and non-K-region phenols of all three hydrocarbons can be separated by using the monomeric and polymeric columns in combination. PMID- 3558586 TI - Simultaneous determination of 5-aminosalicylic acid and 5-acetylaminosalicylic acid by high-performance liquid chromatography. AB - A high-performance liquid chromatographic method has been developed for the simultaneous determination of 5-aminosalicylic acid (5-ASA) and its main metabolite 5-acetylaminosalicylic acid (5-AcASA) in plasma, with 4 acetylaminosalicylic acid as an internal standard. Prior to extraction into ethyl acetate, 5-ASA is derivatized to 5-carbobenzyloxyaminosalicylic acid (5-CboASA). The calibration graphs for both 5-ASA and 5-CboASA are linear between 0.1 and 20.0 mumol/l. The limit of detection is 0.02 mumol/l for 5-ASA and 0.05 mumol/l for 5-AcASA. At 0.1 mumol/l, the coefficients of variation were 8.1 and 9.8% for 5-ASA and 5-AcASA, respectively. At 1.0 and 10.0 mumol/l, the coefficients of variation were 4.1% or less. The mean bias ranged from -6.2 to -2.0% for 5-ASA and from +6.0 to 0% for 5-AcASA. PMID- 3558587 TI - Liquid chromatographic determination of cyclosporine in whole blood with the advanced automated sample processing unit. AB - We describe a rapid, precise, cost-effective, and accurate isocratic liquid chromatographic (LC) procedure for determining cyclosporine in whole blood. The cyclosporine is extracted from 0.5 ml of whole blood together with 200 micrograms of cyclosporin D, added per liter as internal standard, by using an Advanced Automated Sample Processing (AASP) unit. The on-line solid-phase extraction is performed on an octasilane sorbent cartridge which is interfaced with a Perkin Elmer 83 X 4.6 mm I.D. cartridge column, packed with 3-micron octadecyl packing. The column is eluted with a mobile phase containing acetonitrile-water (13:7) at a flow-rate of 1.0 ml/min at a column temperature of 70 degrees C. The column effluent is monitored at 210 nm. The absolute recovery of cyclosporine exceeded 87% and the linearity extended up to 2000 micrograms/l. Within-run and day-to-day coefficients of variation were less than 8%. The correlation between AASP-LC and manual Bond-Elut extraction-LC method was excellent (r = 0.97). PMID- 3558588 TI - Precolumn-venting plug technique for direct injection of untreated blood plasma samples into reversed-phase liquid chromatography systems. AB - A simple column switching technique for the direct injection of untreated blood plasma samples is presented for the determination of drugs and related compounds. The system consists of injector valves, a precolumn, a three port valve and a separation column. The precolumn is used for trace enrichment and sample clean up. Aqueous plugs are introduced on both sides of the plasma sample before it enters the precolumn. This results in a stable system, because contact between plasma proteins and the organic solvent usually present in the mobile phase is prevented. The proteins are eluted to waste with the aqueous plug fluid. The stability of the chromatographic system was studied with respect to efficiency and column back-pressure. The influence of the concentration of organic solvent in the eluent, type and particle size of the packing material, precolumn filters, pH, and ionic strength was investigated for large sample volumes. Optimal stability was obtained at low concentrations of organic solvent in the eluent, with plugs of phosphate buffer (mu = 0.1) and with a spreader at the inlet and a screen (2 microns) at the outlet of the precolumn. The precolumn was packed with 10-microns particles for trace enrichment. Under favourable conditions 40-50 large-volume (0.5-ml) plasma injections can be made into a single precolumn. PMID- 3558589 TI - Determination of platinum-containing drugs in human plasma by liquid chromatography with reductive electrochemical detection. AB - The platinum complex cis-diamminedichloroplatinum(II)(cisplatin or CDDP), which is used successfully to treat various kinds of tumour, can be determined in human plasma ultrafiltrate using liquid chromatography with reductive electrochemical detection (LC-ED). Polarographic analyses of other platinum-containing drugs have been carried out, and the results indicate that some of them might be good candidates for detection using the ED method. cis-Dichloro-trans-dihydroxo-cis bis-(isopropylamine)platinum(IV) (CHIP or JM-9), diammine(1,1 cyclobutanedicarboxylato)platinum(II) (CBDCA or JM-8), and tetrachloro(trans-1,2 diaminocyclohexane)platinum(IV) (TCDCP), which are under evaluation for antitumour properties, have been investigated by this method. The results suggest that LC-ED may be a suitable technique for the determination of CHIP and TCDCP. The separation of cationic hydrolysis products from the neutral parent complex (CDDP) was carried out on reversed-phase columns, modified with alkylsulphonic acid ion-pair reagents. The rate of disappearance of CDDP in various media at 37.0 degrees C was studied using this method. These results are in good agreement with those determined by other investigators using different methods. In addition, the monoaqua hydrolysis product was detected after incubation of CDDP with plasma ultrafiltrate and 100 mM sodium chloride. Atomic absorption spectrophotometry with electrothermal atomisation was used to determine the total platinum content in eluate fractions. This aided the identification of platinum containing peaks in the LC-ED profile, and was also used to measure the percentage platinum recovered from the column. PMID- 3558590 TI - Reversed-phase high-performance liquid chromatographic determination of chloramphenicol in small biological samples. PMID- 3558591 TI - Determination of N-acetylcysteine, intact and oxidized, in plasma by column liquid chromatography and post-column derivatization. AB - N-Acetylcysteine in plasma may exist as intact N-acetylcysteine (NAC) or be oxidized to disulphides, either as a dimer or mixed with other thiol-containing compounds. To prevent oxidation of NAC, whole blood was immediately centrifuged after collection and the plasma proteins were precipitated with perchloric acid. NAC was measured by direct injection of the supernatant into the chromatographic system and the oxidized forms, coupled to small sulphides (ONACS), were determined after reductive cleavage of all NAC disulphides in the supernatant with dithiothreitol before injection. The total plasma concentration of the compound, i.e., including the fraction coupled to proteins (ONACP), was assayed after an initial reduction of the disulphide linkages in plasma. After subsequent precipitation of proteins, the supernatant was directly injected. The chromatographic system was a reversed-phase column (C18) with an acidic mobile phase. After a fast (less than 6 s) post-column reaction with pyrenemaleimide, NAC was detected by fluorimetry. The contribution to the band broadening by the reactor was about 10%. The limit of quantification of NAC in plasma was 240 nM, with an intra-assay precision of 14%. PMID- 3558592 TI - Gradient reversed-phase high-performance liquid chromatographic separation of paldimycin (U-70,138) antibiotics and related compounds. PMID- 3558593 TI - Chromatography of progesterone and its major metabolites in rat plasma using microbore high-performance liquid chromatography columns with conventional injection and detection systems. AB - A separation of progesterone and its metabolites 17 alpha-hydroxyprogesterone, 20 alpha-hydroxy-4-pregnen-3-one, androstenedione and testosterone by high performance liquid chromatography with a ternary solvent system is demonstrated. It is found that using a 100 X 1 mm microbore column, higher sensitivity is obtained in the ultraviolet detection of these compounds by using conventionally sized flow cells despite the higher efficiency resulting from the use of a micro flow cell. It is also shown that, when a non-eluting solvent is used for injection, large injection volumes do not reduce column efficiency, and a 14-fold increase in sensitivity is obtained with a 1-mm column in place of one 4.6 mm in diameter. Using solid-phase extraction and concentration of the sample as pretreatment, progesterone and its hydroxylated metabolites are determined in 0.5 ml samples of rat plasma. The progesterone levels are compared with those obtained by radioimmunoassay. PMID- 3558594 TI - High-performance liquid chromatography in the radioimmunoassay of urinary tetrahydroaldosterone. PMID- 3558595 TI - Development of a microbore high-performance liquid chromatographic system for biological applications. AB - Simple and relatively inexpensive modifications are described for conversion of an existing high-performance liquid chromatographic system to a microbore system capable of isocratic or gradient elution. Use of micro guard columns was shown to be a practical method of protecting the microbore analytical columns when chromatographing samples of physiological origin. The microbore chromatograph was successfully integrated with an autoinjector to permit automation of the system. The modified microbore system was used successfully for the isocratic and gradient separations of standard solutions as well as physiological samples. Evaluation of the system performance was based upon comparisons of column efficiency, selectivity, resolution, and sensitivity. PMID- 3558596 TI - Microbore flow-rates and protein chromatography. AB - Reversed-phase chromatography of proteins on microbore columns can achieve sensitivities that exceed those for standard-bore columns by a factor of 10-20, when operated at the same linear velocities. These gains in sensitivity are accompanied by proportional reductions in peak volume. Sensitivities on standard- (4.6 mm I.D.) and narrow-bore (2.1 mm I.D.) columns have been further improved by reducing the flow-rates to those typical for microbore (1 mm I.D.) columns. We have investigated the role of flow-rate in determining peak volumes for a constant time gradient and found that flow-rate affects peak volume to a much greater extent than column diameter. Column length was not found to have a significant effect on either peak volume or sensitivity. We have found that a four-fold reduction in flow-rate results in at least a two-fold reduction in peak volume over the flow-rate range from 25 to 400 microliters/min. Recovery of proteins in smaller volumes should prove beneficial to subsequent protein characterization methodologies. PMID- 3558597 TI - Tenth International Symposium on Column Liquid Chromatography. San Francisco, California (U.S.A.), May 18-23, 1986. Proceedings. Part IV. PMID- 3558598 TI - Liquid chromatographic determination of benzo[a]pyrene at part-per-billion concentrations in highly refined coal- and petroleum-derived fuels. AB - Benzo[a]pyrene (BaP), a well-known carcinogen, is frequently measured as an "indicator" of the potential dermal tumorigenicity of a sample. The present sequential high-performance liquid chromatography--high-performance liquid chromatography method overcomes problems in trace-level sample enrichment and recovery corrections encountered earlier. An amount of 5 g of naphtha or fuel oil is diluted to 10 ml with dichloromethane and spiked with a small quantity (ca. 0.25 micrograms) of 14C-labeled BaP tracer. A BaP-enriched fraction is obtained from a 1-ml aliquot of this sample by semipreparative chromatography on a Partisil PAC 10 column with dichloromethane-hexane (10:90) as the eluent, and concentrated to exactly 0.3, 0.5, or 1.0 ml in acetonitrile. Quantitation is performed using a reversed-phase Vydac 201 TP 5415 column with acetonitrile-water (75:25) as eluent and a Waters Model 420 E/420 AC fluorescence detector, employing an excitation/emission filter pair of 360/425 nm. The recovery of the radiolabeled tracer is evaluated by combustion of 50 microliter of the final isolate in pure oxygen, collection of the liberated 14CO2 in an alkaline desorber, and liquid scintillation counting. The recovery of BaP normally exceeded 90%, but values as low as ca. 50% were occasionally observed. Potential matrix interferences in the recovery determination were eliminated by sample combustion. The nominal precision of the overall method is approximately +/- 30% relative standard deviation at a BaP concentration of 30 ppb. The nominal analysis time for a single sample is approximately 4 h. PMID- 3558599 TI - Multi-component analysis of urine of dogs with liver diseases by high-performance liquid chromatography. AB - Components of the urine of normal dogs and dogs with liver diseases were analysed by high-performance liquid chromatography (HPLC) using a macroreticular anion exchange resin with UV detection. The dogs with liver diseases were experimentally prepared by either Eck fistula by portal-caval anastomosis, dimethylnitrosamine-induced liver failure or total hepatectomy by operation. Eighteen chromatographic peaks were numbered and the cross-correlation coefficient of the intensities of every pair of peaks was computed. There were high correlations between several pairs of peaks according to the types and degrees of the hepatic failures, whereas no significant correlation was observed for the peak pairs of normal urine samples. The results showed that HPLC analysis of urine is useful in the diagnosis of the physiological state in liver dysfunction. PMID- 3558600 TI - Elution behaviour of peropyrene-type polycyclic aromatic hydrocarbons in various chemically bonded stationary phases in reversed-phase liquid chromatography. AB - The elution behaviour of polycyclic aromatic hydrocarbons (PAHs, 13 of the 16 U.S. Environmental Protection Agency priority pollutants and peropyrene types) was studied on several chemically bonded stationary phases (octadecylsilicas, di- and triphenylsilicas, naphthylethylsilica and pyrenylethylsilica) under reversed phase conditions. The results showed that the elution order of peropyrene-type PAHs is highly dependent on the degree of planarity of the solute and on the orderlines of the bonded phases, whereas no definite differences were found in the retention behaviour of the 13 small PAHs on various stationary phases. The characteristics of all the stationary phases could be classified by statistical cluster analysis. PMID- 3558601 TI - Fluorescence detection of some nitrosoamines in high-performance liquid chromatography after post-column reaction. AB - A selective fluorescence detection method for the determination of some N nitrosoamines after post-column reaction has been developed for reversed-phase liquid chromatography. The N-nitroso compounds are analyzed by allowing their hydrolysis products to react with the oxidizing species Ce4+ to produce the fluorescent ion Ce3+. The detection limit for this method is at the ppb (the American billion, 10(9)) level with a linear dynamic range of 2-3 orders of magnitude. PMID- 3558602 TI - Analysis of mutagenic nitroarenes in carbon black by high-performance liquid chromatography. AB - A method was developed for the analysis of mutagenic nitroarenes in carbon black. The procedure included extraction, pre-separation column chromatography on silica gel, and determination by high-performance liquid chromatography (HPLC) using a diode-array detector. Different solvents, such as dichloromethane, benzene, toluene, and chlorobenzene were used for the extraction of carbon black. It was found that chlorobenzene yielded the highest amount of extracted material. The pre-separation, the optimization of the HPLC separation, the selection of detection wavelengths, and the calibration curve are discussed. 3-Nitro-9 fluorenone was detected in a treated carbon black, which is used for making carbon ink. The identification of peaks in the sample chromatograms was confirmed by comparing the retention time and the UV spectra with those of standards. PMID- 3558603 TI - Effect of sample preparation and liquid chromatography column choice on selectivity and precision of plasma catecholamine determination. AB - Research into the role of the catecholamines has often depended on the reliable determination of plasma catecholamine concentrations, which present a challenge since they are normally in the low pg/ml range. Most methods employ liquid chromatography, with variations in sample preparation, the separation mechanism, and detection. We tested a new approach to sample clean-up using boric acid gel instead of alumina. No advantage was found. We also compared cation-exchange separation with ion-pair chromatography. Several improvements are possible with the former, most notably greater precision, better specificity, and increased throughput. PMID- 3558604 TI - Effects of ion-pairing reagents on the prediction of peptide retention in reversed-phase high-performance liquid chromatography. AB - We have examined the resolution, on reversed-phase columns, of a series of model synthetic peptides and commercially available synthetic peptide standards under gradient elution conditions, using a water-acetonitrile mobile phase containing hydrophilic (phosphoric acid) or hydrophobic (trifluoroacetic acid, heptafluorobutyric acid) ion-pairing reagents. Increasing hydrophobicity or concentration of the ion-pairing reagents increased peptide retention times. It was clearly shown that these reagents effected changes in peptide retention time solely through interaction with the basic residues in the peptide. In general, each positive charge, whether originating from a lysine, arginine or histidine side-chain, or from an N-terminal alpha-amino group, exerts an equal effect on peptide retention. Different counterions have different effects on the change in peptide retention time per positively charged residue due to their differences in hydrophobicity. However, increasing concentrations of a specific counterion have an essentially equal effect per positively charged residue. These effects are also column dependent (n-alkyl chain length and ligand density). These results, demonstrating a simple relationship between peptide retention in different ion pairing systems, enabled the determination of rules for prediction of peptide retention times in one ion-pairing system from observed or predicted retention times in another system. The small average deviation of predicted and observed retention times for a series of basic peptides was good evidence for the value of this predictive method. This study provides a clear understanding of the effect of changing counterion hydrophobicity or concentration on peptide retention, and thus can be extremely beneficial in the purification of peptides and for providing proof of peptide homogeneity. PMID- 3558605 TI - Effect of positional environmental domains on the variation of high-performance liquid chromatographic peptide retention coefficients. AB - While attempting to derive a set of high-performance liquid chromatographic amino acid retention coefficients from a set of 298 related peptide analogues of a 13 amino acid peptide, we found that each position within the peptide would require a different set of retention coefficients to accurately predict peptide retention times. Furthermore, our results show that peptides having the same amino composition but slightly different sequences can have very different retention times. We believe that individual sequence domains and the resulting differences in the solid phase-mobile phase interactions must be taken into account for the accurate prediction of peptide retention times. PMID- 3558606 TI - Separation of amino acids and antibiotics by narrow-bore and normal-bore high performance liquid chromatography with pre-column derivatization. AB - The selectivity, efficiency and lifetime of normal- and narrow-bore columns for high-performance liquid chromatography were investigated for the separation and quantification of amino acids and the amino acid-like antibiotics phosphinothricin and phosphinothricylalanylalanine in biological samples. These compounds were determined by an automated pre-column derivatization with o phthalaldehyde-2-mercaptoethanol reagent and UV detection at 338 nm. PMID- 3558607 TI - Rapid and sensitive method for measuring norepinephrine, dopamine, 5 hydroxytryptamine and their major metabolites in rat brain by high-performance liquid chromatography. Differential effect of probenecid, haloperidol and yohimbine on the concentrations of biogenic amines and metabolites in various regions of rat brain. AB - A rapid and sensitive method has been developed for the simultaneous determination of norepinephrine, dopamine, 5-hydroxytryptamine and their respectively metabolites 3-methoxy-4-hydroxyphenylglycol, homovanillic acid, 3,4 dihydroxyphenylacetic acid, and 5-hydroxyindoleacetic acid in discrete brain regions of rats. The supernatants of tissue homogenates were injected directly into a reversed-phase liquid chromatography system, coupled with electrochemical detection. Each of these compounds gave a linear response over the range 5.5-200 ng/ml cerebellar homogenate (0.11-4.0 ng on column). Analytical recoveries of these compounds, added to the homogenate, were essentially complete when compared with standards dissolved in perchloric acid. The average between-assay coefficients of variation for all these compounds were lower than 6.9% over the range 5.5-200 ng/ml. The within-assay coefficients of variation were lower than 9.7%, measured at 5.5 or 23.6 ng/ml. With the present test parameters and mobile phase conditions, all compounds were readily oxidized at 0.8 V vs. a Ag/AgCl reference electrode. The method was applied to an analysis of the differential activity of biogenic amines in the rat striatum, hypothalamus, and hippocampus, produced by probenecid, haloperidol and yohimbine. PMID- 3558608 TI - Simultaneous quantification of myocardial adenine nucleotides and creatine phosphate by ion-pair reversed-phase high-performance liquid chromatography. AB - A new ion-pair reversed-phase high-performance liquid chromatography method was applied to simultaneous measurements of porcine myocardial adenine nucleotides and creatine phosphate. The homogeneity of each desired peak was tested by the retention times of standards, chromatography of spiked samples, the absorbance ratios at various wavelengths, and the differing retention times for a number of other compounds found in porcine myocardial extracts. PMID- 3558609 TI - Optimization of a high-performance liquid chromatographic method for the determination of nucleosides and their catabolites. Application to cat and rabbit heart perfusates. AB - A high-performance liquid chromatographic method is described for the separation of nucleosides and related compounds in a single isocratic run. The separation of a standard mixture of at least thirteen compounds is achieved within 15 min on a new type of reversed-phase column 25 cm long, filled with 5-micron particles of Select B. Pre-treatment of the silica particles before silanization has given this type of reversed-phase material unique characteristics for basic and acidic compounds. Chromatograms are shown to compare the effectiveness of the Select B column for the separation of nucleosides with that of other C18 and C8 phases. The separation is achieved with 0.3 M ammonium dihydrogen phosphate (pH 4.00) and a mixture of methanol, acetonitrile and tetrahydrofuran. Detection is carried out with a variable-wavelength UV detector at 254 nm. Sample preparation and the influence of the organic solvents, pH and buffer concentration are described. To illustrate the applicability of the method, representative chromatograms are shown of perfusates of Langendorff preparations and the working hearts of cats and rabbits. Remarkable differences were obtained before and after ischaemia and before and after treatment with a nucleoside transport inhibitor. Baseline separation of cytosine, orotic acid, cytidine, uracil, uric acid, hypoxanthine, xanthine, inosine, guanosine, xanthosine, allopurinol, thymine and adenosine was achieved. The detection limit for these compounds was less than 1 ng per injection. PMID- 3558610 TI - Analysis of total hydroxyproline in urine by high-performance liquid chromatography and pre-column derivatization. PMID- 3558611 TI - High-performance liquid chromatographic analysis of phytoestrogens in soy protein preparations with ultraviolet, electrochemical and thermospray mass spectrometric detection. AB - The phytoestrogens daidzein, genistein, coumestrol, formononetin, and Biochanin A are separated on a C18 reversed-phase column (Hypersil ODS) with methanol-0.1 M ammonium acetate buffer, pH 4.6 (60:40, v/v) as eluent. The retention and resolution are affected by buffer concentrations, pH type, and proportion of organic solvent in the mobile phase. Detection in the (low pg range) is achieved with an electrochemical detector, and the compounds are positively identified by high-performance liquid chromatography-thermospray mass spectrometry. Daidzein and genistein were found in high concentrations in all soy protein preparations analyzed. PMID- 3558612 TI - Preparative low-pressure chromatography of antibiotics on a column of diol-bonded silica gel. AB - Several schemes are presented which illustrate the general utility of column chromatography on diol-bonded silica gel for the purification of various antibiotics. The antibiotics include rosarimicin, rosarimicin dimethylacetal, everninomicin D, Juvenimicin A4, coloradocin and the benzanthrins. A set of partition coefficients, determined in different two-phase solvent systems, for a given antibiotic or antibiotic complex, can be used in selecting appropriate solvent systems for this chromatography as well as for semi-preparative counter current chromatography on the Ito coil planet centrifuge. PMID- 3558613 TI - Modeling of peak profiles. Application to the preparative liquid chromatography of steroids. AB - The solution of the mass balance equations in liquid chromatography describes the propagation of signals of finite concentration through the column. The general numerical solution requires the prior determination of the partition isotherm. For low solute concentrations, when the isotherm equation can be replaced with a two-term expansion, an analytical solution for the peak profiles is obtained. The theory is applied to predict, as a function of solute concentrations, the elution profiles of two steroids of similar structure, cis- and trans-androsterone, with organic solvents as the mobile phase and buffered silica gel as the stationary phase. At infinite dilution both steroids are well resolved, the trans isomer being eluted before the cis isomer. At high concentrations their adsorption isotherms intercept each other and, for large amounts injected, their elution order is reversed, with marked differences in the elution peak shapes of both steroids. PMID- 3558614 TI - Displacement chromatography of oligomycins. AB - Oligomycins A, B and C were separated by reversed-phase chromatography in the displacement mode on octadecylsilica columns. The carrier was a mixture of methanol and water and a saturated solution of palmitic acid in the carrier served as the displacer. The production rate was investigated as a function of the chromatographic conditions, i.e., methanol concentration in the carrier, displacer concentration, flow-rate and the amount and concentration of the oligomycin mixture in the feed solution. A practical guide for method development is given. PMID- 3558615 TI - Rapid and specific high-performance liquid chromatographic determination of clonazepam in plasma. PMID- 3558616 TI - Improved method for measuring the glycine and taurine conjugates of bile salts by high-performance liquid chromatography with tauro-7 alpha,12 alpha-dihydroxy-5 beta-cholanic acid as internal standard. PMID- 3558617 TI - Monitoring a potential carcinogen in pharmaceutical formulations at the low part per billion level. High-performance liquid chromatographic determination of N nitrosohexamethyleneimine in tolazamide. AB - A method is described for the determination of N-nitrosohexamethyleneimine, a potential carcinogen, in tolazamide bulk drug and pharmaceutical dosage forms. The technique of trace enrichment high-performance liquid chromatography is employed to obtain accurate quantitation of the analyte at levels approaching 1 ppb. Following extraction in diethyl ether and on-line cleanup and enrichment, the nitrosamine is detected by UV at 228 nm. PMID- 3558618 TI - Retention behavior of large polycyclic aromatics in bonded-phase high-performance liquid chromatography. AB - The retention behavior of 31 large polycyclic aromatic hydrocarbons was studied on polymeric octadecyl-bonded columns, with methanol-dichloromethane mobile phases. Three types of elution behavior were observed, dependent on the degree of intramolecular strain in the polycyclic aromatic hydrocarbons. PMID- 3558619 TI - Predicting bandwidth in the high-performance liquid chromatographic separation of large biomolecules. I. Size-exclusion studies and the role of solute stokes diameter versus particle pore diameter. AB - Column plate numbers, N, were measured for 12 different proteins as a function of mobile phase flow-rate in two gel filtration systems (either denaturing or non denaturing conditions). These data were used to extend a previous model that predicts bandwidths in reversed-phase and ion-exchange chromatography. Restriction of diffusion of large molecules within column packing pores is now defined more precisely, with a single relationship describing this effect for both reversed-phase and size-exclusion chromatography (SEC) (and presumably other high-performance liquid chromatography systems). Separations by gel filtration (SEC) are now included in our general model. A total of 17 flow-rate studies were carried out, involving different proteins, columns and/or mobile phase conditions (denaturing or non-denaturing). Comparisons of plate numbers predicted by the model with experimental values were satisfactory in 15 out of 17 cases. The remaining two cases appear to represent "non-well-behaved" systems, where experimental bandwidths were higher than predicted values by more than 20%. Initial attempts at understanding the origin of these non-ideal effects are described. PMID- 3558620 TI - Theoretical and experimental study of high-performance electrophoretic mobilization of isoelectrically focused protein zones. AB - In an earlier paper we showed that it is possible to mobilize a train of isoelectrically focused proteins and thus detect them on-tube or off-tube. The mobilization was performed in different ways, for instance electrophoretically by exchanging the anolyte for the catholyte or vice versa. In this paper we treat the electrophoretic mobilization theoretically, originating from the conditions of electroneutrality. The information thus gained was used to design anolytes and catholytes of appropriate compositions for mobilization of focused proteins. The usefulness of these electrode solutions is illustrated by focusing-mobilization experiments performed in free solution in a glass tube of length 110 mm. Since the inside diameter of the tube and its wall thickness were only 0.05 mm, the Joule heat was efficiently removed, which allowed the use of high field strengths (270 V/cm). The focusing time was therefore as short as 6 min. The time required for mobilization was about 15 min (360 V/cm). The mobilized protein zones were detected on-tube by absorbance measurements at 280 nm. The glass tube was treated with non-cross-linked polyacrylamide to eliminate electroendosmosis and adsorption of proteins onto the tube wall. The following conclusions drawn from the theoretical studies were experimentally verified: mobilization toward the anode (cathode) can be accomplished by selecting an anolyte (catholyte) containing a cation (anion) other than the proton (hydroxyl ion); the cation (anion) will then electrophoretically migrate into the separation tube and continuously increase (decrease) the pH from the anodic (cathodic) end of the tube. The pH of the electrode solution toward which the mobilization takes place is critical for off-tube, but not for on-tube detection. With the aid of the electroneutrality condition that applies in isoelectric focusing, one can easily explain the generation of the so-called plateau phenomenon. PMID- 3558621 TI - Liquid chromatography of phenylurea herbicides and related compounds on chemically bonded ion-exchange materials. AB - The possibilities of using new chemically bonded anion-exchange (Silasorb DEA) and cation-exchange (Silasorb S) materials for high-performance liquid chromatography of phenylurea herbicide compounds were investigated. The columns packed with Silasorb DEA or with Silasorb S ion-exchange materials can be used for efficient separations in normal-phase systems using n-propanol-n-hexane as mobile phases. Here, specific selectivity effects for phenylurea-type herbicides can be achieved in comparison to chromatography on unmodified silica or on chemically bonded aminosilica or cyanosilica, especially with Silasorb S columns. The influence of the mobile phase composition and of the structure of phenylurea herbicides on the chromatographic behaviour on Silasorb S and Silasorb DEA columns was investigated in detail and the possibilities of separation are illustrated by several examples. PMID- 3558622 TI - Predicting bandwidth in the high-performance liquid chromatographic separation of large biomolecules. II. A general model for the four common high-performance liquid chromatography methods. AB - A general model for describing gradient elution separations of peptides and proteins by reversed-phase high-performance liquid chromatography (HPLC) has been presented previously. This model has now been modified so that it can be applied to any of the four HPLC methods used for separating biological macromolecules: reversed-phase, ion-exchange, hydrophobic-interaction and size-exclusion chromatography, carried out in either an isocratic or gradient elution mode. The role of sample molecule structure and the particular column used has been further studied, so that previous empirical parameters for different column/sample choices can now be estimated from three physical properties of the sample and the column: sample molecular weight, native vs. denatured sample, column packing pore diameter. This eliminates much of the empiricism of our preceding model, and minimizes the number of experimental runs now required in order to apply the model in practice. The final model has been tested for several hundred runs involving peptides and proteins in the molecular weight range 600-162,000, all four of these HPLC methods, in both isocratic and gradient elution modes, and using data from several different laboratories (including our own). The model is able to predict bandwidth in HPLC separations of proteins and peptides with an accuracy of +/- 17% (1 standard deviation), for the case of "well-behaved" separations. Separations that are not "well-behaved" will give wider bands than predicted by the model. PMID- 3558623 TI - Analysis of amino acids by gas-liquid chromatography as tert.-butyldimethylsilyl derivatives. Preparation of derivatives in a single reaction. AB - The effect of temperature, solvent and reagents on the formation of the N(O) dimethyl-tert.-butylsilyl derivatives of proteic amino acids has been studied. Quantitative silylation is achieved using dimethyl-tert. butylsilyltrifluoroacetamide with 1% tert.-butyldimethylchlorosilane in dimethylformamide by heating at 75 degrees C for 30 min. Two peaks were obtained for arginine under these conditions. However, most of the standard proteic amino acids can be assayed. The N(O)-dimethyl-tert.-butylsilyl derivatives of the proteic amino acids have been analysed by gas chromatography-mass spectrometry using the methane chemical ionization mode. The spectral data are presented and have been used to confirm the structures of the amino acid derivatives. PMID- 3558625 TI - High-performance liquid chromatographic detection of side reactions in peptide synthesis. AB - High-performance liquid chromatographic systems with chemically bonded packing materials were elaborated for monitoring synthetic stages during peptide coupling, purity control of peptides produced by solid-phase methods and detection of impurities formed as a consequence of side reactions such as oxidation, desulphation, racemization, transpeptidation, alkylation and decomposition. The technique was applied to the analysis of peptide hormones, neuropeptides, cyclopeptides, isopeptides and branched polypeptides based on poly lysine. The mobile phases were methanol-acetonitrile-water mixtures containing phosphate, acetate, carbonate buffers or trifluoroacetic acid (pH 2-9). After optimization, baseline separations could be achieved for some critical peptide separations. PMID- 3558624 TI - High-performance liquid chromatographic determination of enantiomeric amino acids and amino alcohols after derivatization with o-phthaldialdehyde and various chiral mercaptans. Application to peptide hydrolysates. AB - o-Phthaldialdehyde in combination with a chiral mercaptan is a powerful chiral reagent for the pre-column derivatization of many enantiomeric compounds bearing primary amino groups. The diastereoisomers formed can efficiently be resolved on conventional reversed-phase columns. Simultaneous determination of the enantiomers of various amino acids, amino alcohols and biogenic amines was achieved by gradient elution and fluorescence detection. The resolution was optimized by varying the chiral mercaptan in the reagent, Boc-L-cysteine, N acetyl-L-cysteine and N-acetyl-D-penicillamine being used for this purpose. The resolutions were calculated. Most of the enantiomers showed good resolution with each of the three chiral mercaptans, whereas some enantiomers were only separable by one or two of them. The method was applied to the analysis of peptide hydrolysates. The composition of peptides bearing L- and D-amino acids and an amino alcohol was determined. PMID- 3558626 TI - Behaviour in a silica-based high-performance liquid gel permeation chromatographic column of the apo- and holo-forms of the haem-binding proteins haemopexin, histidine-rich glycoprotein, globin and albumin. AB - The elution of the apo- and holo-forms of four haem-binding proteins was studied using a TSK G 3000 SW HPLC column. Apo-haemopexin had a higher apparent molecular size [68,000 daltons (d)] than histidine-rich glycoprotein (HRG) (66,000 d) in gel chromatography, contrasting with the values in sodium dodecyl sulphate electrophoresis, 84,000 d for HRG and 69,000 d for haemopexin. The elution of the haem complexes of both proteins correlated better with their true molecular weights. Saturation of albumin with haem did not significantly influence its elution. The peaks were more symmetrical for the holo- than the apo-proteins, except for globin/haemoglobin. The results indicated that the apo-forms of haemopexin and HRG had affinity for the column matrix. HRG, which has several haem binding sites, was retained more than haemopexin, which binds only one haem. Free haem itself was bound to the silica column but could be released by globin. HRG had a tendency to polymerize after haem binding, in contrast to haemopexin, which remained monomeric. Globin was eluted from the column with an apparent molecular size of 16,000 d and after saturation with haem with a molecular size of 31,000 d. PMID- 3558627 TI - Determination of iodide and thiosulfate by paired-ion, reversed-phase high performance liquid chromatography with ultraviolet absorbance, electrochemical, and conductimetric detection. AB - Inorganic anions are typically determined by ion chromatography, ion-selective electrodes, or by "wet chemical" procedures. An alternative to these approaches is afforded by paired-ion, reversed-phase high-performance liquid chromatography (HPLC), and the application of this technique to the determination of iodide and thiosulfate is discussed. Each analyte can be determined using ultraviolet (UV) absorbance detection and oxidative, amperometric electrochemical detection (ED). Furthermore, in the case of iodide, an additional and quite selective ED scheme is available through the use of series-configured dual glassy carbon electrodes. The dual-series ED approach utilizes an upstream electrode which is maintained at an oxidative potential. This results in the formation of an electroactive species, which may be detected at a downstream electrode held at a reductive potential. Finally, it is demonstrated that non-suppressed conductimetric detection is also perfectly viable within the context of paired-ion, reversed phase HPLC, provided the overall conductance of the mobile phase is not excessive. PMID- 3558628 TI - Analysis of lipids by one-dimensional thin-layer chromatography. AB - A high-efficiency silica gel, (type HLF) thin-layer chromatography plate (HETLC), linear high-performance thin-layer chromatography plate (HPTLC) and densitometry method has been devised in order to resolve the major lipid classes obtained from rat brain tissues. This methodology, which has largely overcome prior problems, enhances the opportunity for assessing the glycerophospholipid and glycolipid compositions of tissues. DEAE-Sephadex column chromatography was used to separate the crude lipids extract into neutral and acidic lipid fractions. The lipid fractions were then spotted on separate HPTLC and HETLC plates and chromatographed in one dimension using one solvent system. Quantitation was by in situ densitometry with the absolute quantity of the lipid classes determined from co-chromatographed standards. Sensitivity was increased by using cupric sulfate reagent, which was found to be more sensitive than the conventional cupric acetate reagent. This method is applicable to a broader separation of lipid classes and has improved sensitivity. PMID- 3558629 TI - Determination of butyltin and phenyltin compounds in biological and sediment samples by electron-capture gas chromatography. AB - A method is described for the gas chromatographic determination of nanogram amounts of mono-, di- and tributyltin compounds and mono-, di- and triphenyltin compounds in biological and sediment samples. These compounds are converted into the corresponding chlorides with hydrochloric acid, extracted with ethyl acetate and hydrogenated with sodium tetrahydroborate. The corresponding hydrides, mono-n butyltin hydride, di-n-butyltin hydride, tri-n-butyltin hydride, monophenyltin hydride, diphenyltin hydride triphenyltin hydride, are detected by electron capture gas chromatography after clean-up by silica gel column chromatography. The detection limits are 10-20 ng/g for mono-n-butyltin chloride, 0.5-1 ng/g for di-n-butyltin chloride, 1-2 ng/g for tri-n-butyltin chloride and diphenyltin chloride and 2.5-5 ng/g for monophenyltin chloride and triphenyltin chloride, in biological and sediment samples. PMID- 3558630 TI - Identification of volatile compounds in poultry manure by gas chromatography-mass spectrometry. AB - Volatile components in poultry manure were isolated by freeze vacuum distillation and continuous extraction, and 72 compounds were identified by gas chromatography and gas chromatography-mass spectrometry. Branched alipathic alcohols, many esters, dimethyl trisulphide and alkanamides were detected for the first time. Carboxylic acids, sulphides, alkanamides, phenols and indoles were formed during rotting. Judging from the ratio of concentration to the threshold value (detectable amount of odour) of each component detected in poultry manure, the most important odorous components were butyric acid, 3-methylbutyric acid, dimethyl trisulphide, indole and skatole. PMID- 3558631 TI - Simultaneous determination of four active ingredients of dinocap in crops by high performance liquid chromatography. AB - A procedure for high-performance liquid chromatographic (HPLC) determination of four active ingredients of dinocap, 2,4-dinitro-6-octylphenyl crotonate, 2,6 dinitro-4-octylphenyl crotonate, 2,4-dinitro-6-octylphenol and 2,6-dinitro-4 octylphenol, in crops was examined. The four compounds were extracted with acetone and re-extracted into hexane. After clean-up successively by hexane acetonitrile partition and silica gel column chromatography, the compounds were determined by HPLC with an UV detector (245 nm). The column was Cosmosil 5C18 (ODS, 5 micron) and the eluent was methanol-water-acetic acid (330:70:1). The limit of detection was 0.02 ppm and the recoveries from crops (spiked with 0.5 ppm) were 85-100%. The four compounds were determined simultaneously and the method was shown to be applicable to residue analysis of these compounds in crops sprayed with dinocap. PMID- 3558632 TI - High-performance liquid chromatographic isolation of 14C-labelled gluco oligosaccharides, monosaccharides and sugar degradation products on ion-exchange resins. AB - Gluco-oligosaccharides, monosaccharides and sugar degradation products in biomass hydrolysates were isolated in milligram amounts by means of high-performance liquid chromatography on various ion-exchange stationary phases. Also, radioactively labelled carbohydrates and sugar decomposition products that had been obtained on hydrolysis of 14C-marked biomass were isolated and are thus available as reference samples. PMID- 3558633 TI - Sampling and determination of fenitrothion, dimethoate, mevinphos, linuron, metoxuron and trifluralin from air. PMID- 3558634 TI - Gamma-radiolysis of acetylsalicylic acid in the solid-state gas chromatographic mass spectrometric and high-performance liquid chromatographic identification and quantification of the radiolytic products. PMID- 3558635 TI - Derivatization of 2-amino-2-oxazolines with trimethylanilinium hydroxide. Determination of reaction products by gas chromatography-mass spectrometry. PMID- 3558636 TI - Some structural requirements for resolution of hydantoin enantiomers with a beta cyclodextrin liquid chromatography column. PMID- 3558637 TI - Behaviour of 3-methyl-2-benzothiazolone azines of carbonyl compounds in high performance liquid chromatography. PMID- 3558638 TI - Gel filtration of glycogens and their hydrolysis products. PMID- 3558639 TI - Purity assay of ketoprofen by high-performance liquid chromatography. PMID- 3558640 TI - Stability-indicating high-performance liquid chromatographic analysis of trimethoprim in pharmaceuticals. PMID- 3558641 TI - Rapid, sensitive high-performance liquid chromatographic assay for isoflavonoids from cowpea (Vigna unguiculata). PMID- 3558642 TI - High-performance liquid chromatographic determination of Fluazifop-butyl and Fluazifop in soil and water. PMID- 3558643 TI - Chromatographic and enzymatic evidence for the structure of an oxygenated and reduced metabolite of Benflurone. PMID- 3558644 TI - Resolution of six polar DL-amino acids by chromatography on native cellulose. PMID- 3558645 TI - Reversed-phase high-performance liquid chromatography of nucleoside analogues. Simultaneous analysis of anomeric D-xylo- and D-lyxofuranonucleosides and some other D-pentofuranonucleosides. AB - Reversed-phase high-performance liquid chromatography using a C18 column was applied to the analysis of reconstituted mixtures of previously synthesized alpha, beta D-xylo- and D-lyxofuranonucleosides as well as a number of commercially available D-ribo- and D-arabinofuranonucleosides. From a detailed study of various parameters (size of support particles, nature and pH of the mobile phase, temperature), optimized conditions were established. Correlations between the retention times and structures of the bases, the orientations of the secondary hydroxyl groups of the sugar moiety and the anomeric configurations of the nucleosides are also reported. PMID- 3558646 TI - Chromosorb 101 as a packing material for reversed-phase chromatography. AB - A procedure for preparing a Chromosorb 101 liquid chromatographic column is described. Some column parameters such as the permeability, efficiency and peak asymmetry factor were calculated. The elution of some benzene and phenol derivatives from the polymeric column with different mobile phases was performed. The results showed that some gas chromatographic adsorbents such as Chromosorb 101 can be used as packings for high-performance liquid chromatographic columns. The behaviour of these styrene copolymers resembles that of a C18 silica bonded phase. PMID- 3558647 TI - Quantitative determination by high-performance liquid chromatography of acetylsalicylic acid and related substances in tablets. AB - High-performance liquid chromatography on a Zorbax C8 7-micron column (25 cm X 0.46 cm I.D.) with methanol-water-1 M phosphoric acid (59:36:5) as the mobile phase has been used for the analysis of several naturally aged batches of fourteen brands of acetylsalicyclic acid tablets. The extraction solvent is methanol, containing 2% v/v of formic acid. Salicylic acid is the main impurity. Acetylsalicylsalicylic acid is the second most important impurity, and the corresponding salicylsalicylic acid is rarely present. Buffered or dispersible tablets contain relatively more of the latter two impurities and eventually also the corresponding higher oligomers. Acetylsalicylic anhydride is always a minor impurity. Comparison is made with classical spectrophotometric methods, which are observed to be selective for salicylic acid. PMID- 3558648 TI - Separation, quantitation and isolation of cannabinoids from Cannabis sativa L. by overpressured layer chromatography. AB - Two overpressured layer chromatography (OPLC) methods have been developed for the separation of neutral and acidic cannabinoids. The first is an adaptation of Korte's well known method to the OPLC system, which improves its reproducibility. The second one is a new technique based on the phenomenon of chromatographic solvent demixing. The eluent itself is also divided into zones. In the alpha-zone the neutral cannabinoids and in the beta-zone the acidic ones are separated. As a result of the good and reproducible separation, there is a possibility to quantitate cannabinoids by densitometry. The on-line version of OPLC proved suitable for the isolation of hemp constituents. PMID- 3558649 TI - Gas chromatographic separation of substituted pyridines. AB - Capillary gas chromatographic methodology for separation of complex mixtures of substituted pyridines has been demonstrated on polar (CAM) and non-polar (DB-5) columns. Separations are characterized by high resolution, high sensitivity, a wide dynamic detector range, and good reproducibility. For the first time, Kovats retention indices have been calculated for pyridine and substituted pyridines. Correlations of retention indices with physico-chemical properties, such as hydrogen bonding, pyridine pKa and Hammett substituent constants are discussed. PMID- 3558650 TI - Sample preparation: an alternative to flash evaporation for the concentration of extracts. PMID- 3558651 TI - Differences between retentions of various classes of aromatic hydrocarbons in reversed-phase high-performance liquid chromatography. Implications of using retention data for characterizing hydrophobicity. AB - Capacity factors of a series of alkylbenzenes (C1-C10), 12 chlorobenzenes, 9 chlorotoluenes, 17 chloronaphthalenes and 65 chlorobiphenyls have been measured on an octadecylsilica column. Aqueous methanol of four different compositions (80 95% methanol) was used as eluent. Logarithms of capacity factors of all eluites are linearly related to the amount of organic modifier in the eluent. In addition, linear relationships between the solvent strength and the logarithms of capacity factors extrapolated to zero methanol have been revealed. The proportionality factors are dependent on the structures of the eluites. Thermodynamic consideration of the retention processes shows that, within each type of eluite, enthalpy-entropy compensation is found. The compensation temperatures are not significantly different for the various types of eluite. Furthermore, it is shown that the compensation temperatures increase with increasing water content of the eluent. Since the intercepts of the delta G0 delta H0 plots are not equal for the various types of eluite, it was concluded that the distribution processes causing retention of benzene, naphthalene and biphenyl are different. When only the free energies of retention (i.e. the capacity factors) of different types of eluite are compared, no accurate information on the hydrophobicity of the eluites can be obtained if aqueous methanol is used as eluent. Therefore the possibilities for relating or predicting other physico-chemical parameters of the test compounds, such as octan 1-ol-water partition coefficients with isocratic retention data, will be limited. PMID- 3558652 TI - Resolution of enantiomeric amides on a cellulose tribenzoate chiral stationary phase. Mobile phase modifier effects on retention and stereo-selectivity. AB - The effect of the steric structure and concentration of the mobile phase modifier on the retention (kappa') and stereoselectivity (alpha) of a series of enantiomeric amides has been investigated. The amides were chromatographed on a commercially available cellulose tribenzoate chiral stationary phase (CSP) using mobile phases composed of hexane and two homologous series of alcohols: methanol, ethanol, 1-propanol and 2-propanol, 2-butanol, 2-pentanol, 2-hexanol. The results of the study indicate that the alcoholic mobile phase modifiers compete with the solutes for achiral and chiral binding sites and that the steric bulk around the hydroxyl moiety of the modifier plays a role in this competition. Increased steric bulk tends to result in increased kappa' and alpha. However, the results also suggest that the effect of the alcoholic mobile phase modifiers on stereoselectivity may also be due to binding to achiral sites near or at the chiral cavities of the CSP which alters the steric environment of these cavities. PMID- 3558654 TI - Studies on steroids. CCXXVIII Trace analysis of bile acids by gas chromatography mass spectrometry with negative ion chemical ionization detection. AB - A suitable derivatization method for the trace analysis of bile acids by gas chromatography (GC) in combination with negative ion chemical ionization (NICI) mass spectrometry is described. Of various derivatives for the carboxyl group, the pentafluorobenzyl (PFB) ester provided the highest value of the ratio of the negative to the positive ion current. A characteristic carboxylate anion [M - 181]- was produced as the most abundant ion by the loss of the PFB group in NICI. The PFB esters were further derivatized to the dimethylethylsilyl (DMES) ethers, whereby lithocholic acid, deoxycholic acid, chenodeoxycholic acid, ursodeoxycholic acid and cholic acid were distinctly separated by GC on a cross linked methyl silicone fused-silica capillary column. The detection limit for the PFB-DMES derivatives of dihydroxylated bile acids was 2 fg when the fragment ion was monitored at m/z 563 in the NICI mode using isobutane as a reagent gas. PMID- 3558653 TI - Detection of trace levels of trichothecene mycotoxins in environmental residues and foodstuffs using gas chromatography with mass spectrometric or electron capture detection. AB - Methods are described for the simultaneous detection of a wide range of trichothecenes, including the most polar ones and some macrocyclics, using either gas chromatography-mass spectrometry with selected ion monitoring, or gas chromatography with electron-capture detection. Trichothecenes were extracted directly from the various matrices, or from Clin Elut columns, and cleaned up on Florisil Sep-Pak cartridges. Macrocyclics and neosolaniol were detected after hydrolysis to verrucarol and T-2 tetraol respectively. For optimum sensitivity (0.5-10 ng per sample) over the range, trichothecenes were detected, both before and after hydrolysis of ester groups, as their heptafluorobutyrate derivatives using a quadrupole mass spectrometer and negative ion chemical ionisation. The use of a magnetic sector instrument with electron-impact ionisation gave comparable sensitivity for most trichothecenes, but was less useful for the simultaneous detection of verrucarol in the presence of other trichothecenes. The methods were used to detect the presence of scirpentriol, nivalenol and 15 monoacetoxyscirpendiol in sorghum from Thailand. Trichothecenes in less complex matrices could be detected, after hydrolysis, using gas chromatography with electron-capture detection. PMID- 3558655 TI - Characterization of biopolymers by pyrolysis gas chromatography and multidimensional analysis. Application to synthetic melanins. AB - A method for characterization of the melanin biopolymer has been developed and validated by the use of synthetic melanins derived from tyrosine, dopamine or hydroquinone. The technique involved pyrolysis gas-liquid chromatography with capillary columns. A back-flushing technique is described which improves pyrogram reproducibility such that closely related melanins can be distinguished with the aid of principal components analysis and non-metric multidimensional scaling. PMID- 3558656 TI - Analysis of aspartic acid racemization. Evaluation of a chiral capillary gas chromatographic and a diastereomeric high-performance liquid chromatographic method. AB - A recently developed chiral gas chromatographic method and a diastereomeric high performance liquid chromatographic method for the analysis of aspartic acid enantiomers in protein hydrolyzates have been evaluated. Although both techniques are fast and convenient, the latter is preferred because of its higher reproducibility and shorter analysis time. Furthermore, this method offers the possibility of on-line derivatization and analysis. PMID- 3558657 TI - Determination of coumarins in Cnidium monnieri fructus by high-performance liquid chromatography. PMID- 3558658 TI - High-performance liquid chromatographic method for the simultaneous determination of oxolinic, nalidixic and piromidic acids in cultured fish. PMID- 3558659 TI - Determination of stable isotopically substituted histidine in human plasma by gas chromatography-mass spectrometry. AB - A gas chromatographic-electron-impact mass spectrometric method for the determination of stable isotopically substituted histidine in human plasma has been developed. Histidine was derivatized to alpha N-trifluoroacetyl-imN carbethoxyhistidine n-butyl ester (TCB derivative) by a three-step reaction: an initial esterification by 3 M n-butanolic hydrochloric acid, followed by trifluoroacetylation with trifluoroacetic anhydride and then ethoxycarbonylation with diethyl pyrocarbonate. Quantitation was carried out by selected-ion monitoring on the molecular ions (m/z 379, 383 and 385) of the respective TCB derivatives of histidine, [1-15N,5,beta,beta-2H3]histidine (histidine-[M + 4]) and [1,3-15N2,5,alpha,beta,beta-2H4]histidine (histidine-[M + 6]). The sensitivity, specificity, precision and accuracy of the method were demonstrated to be satisfactory for application to a pharmacokinetic study of histidine after administration of a trace amount of stable isotopically substituted histidine (histidine-[M + 4]) in humans. PMID- 3558661 TI - Measurement of cyclosporin A and of four metabolites in whole blood by high performance liquid chromatography. AB - A high-performance liquid chromatographic procedure using cyclosporin D as internal standard for the routine measurement of cyclosporin A and four of its metabolites is described. Whole-blood samples were purified on refillable solid phase glass extraction columns. The chromatographic method includes a gradient elution using acetonitrile and water (pH 3.0) as eluents and an RP-8 analytical column. More than 1000 samples have already been analysed without any loss. The inter-assay variation was 6.3% and the intra-assay variation 4.9%. A linear correlation was found over a range of 0-3000 ng cyclosporin A per ml whole blood. The detection limit was 20 ng and the recovery was found to be 80-90%. Metabolites 1, 17, 18 and 21 could be characterized. PMID- 3558660 TI - Hospital routine analysis of penicillins, third-generation cephalosporins and aztreonam by conventional and high-speed high-performance liquid chromatography. AB - A high-performance liquid chromatographic procedure for the measurement of fifteen beta-lactam antibiotics in body fluids is described, with special reference to high-speed techniques. The procedure involves a unique sample preparation before analysis for all the following fifteen compounds: benzylpenicillin, ampicillin, cloxacillin, ticarcillin, mezlocillin, azlocillin, piperacillin, cefotaxime and its desacetyl metabolite, cefsulodin, cefoperazone, cefmenoxime, ceftazidime, ceftriaxone and the monobactam aztreonam; thus all biological samples arriving at the laboratory can be treated in batch. Of these fifteen antibiotics, eleven can be chromatographed with the same type of mobile phase, which consists of a mixture of ammonium acetate and acetonitrile in various ratios. Three others need ionpairing chromatography because of their polarity, and ticarcillin requires citric acid. High-speed high-performance liquid chromatography seems to be particularly suitable for the routine analysis of beta-lactam antibiotics because columns equilibrate more rapidly, retention times are much shorter, detection limits are lower and the longer lifetime of columns reduces analysis costs. PMID- 3558662 TI - New automated high-performance liquid chromatographic analysis of cyclosporin A and G in human serum. AB - An automated isocratic high-performance liquid chromatographic (HPLC) method is described for the determination of cyclosporin A and G in human serum. This method involves the use of an automated solid-liquid extraction procedure following rapid protein precipitation with acetonitrile. The use of a disposable C8 extraction cartridge allows a good recovery of cyclosporine (87%) from serum and a detection limit of 20 ng/ml with good reproducibility using 0.5 ml of sample. This method can also be adapted to whole blood measurements. The choice of a 3-micron cyano analytical column and of the mobile phase hexane-isopropanol (85:15) permitted a low column temperature (50 degrees C), a low flow-rate (0.6 ml/min) and a short run time (14 min). This method allows the accurate and fast routine monitoring of cyclosporine by HPLC, which is particularly important in hepatic transplantations. PMID- 3558663 TI - Rapid high-performance liquid chromatographic assay of acetaminophen in serum and tissue homogenates. AB - The quantitation of a hepatorenal toxic drug, acetaminophen, in blood and target organ tissues is needed for toxicokinetic and distribution studies. A rapid, sensitive and simple method is described to assay acetaminophen in rat serum and liver or kidney homogenates by reversed-phase high-performance liquid chromatography, using an octadecyl (3 micron particle size) Apex column, a mobile phase consisting of a mixture of distilled water-acetonitrile (86:14) and ultraviolet detection at 245 nm. Short retention times of ca. 3.75 and 6.25 min are observed for acetaminophen and the internal standard (sulfamerazine), respectively. A sensitivity of 50 ng/ml is easily achieved for 100-microliter serum and liver or kidney homogenate samples. The proposed method proved to have satisfactory recovery, precision and accuracy. The preliminary results obtained with human plasma of volunteers and of patients treated with various drugs show that the assay, with a sensitivity of 25 ng/ml, would be of considerable interest in clinical monitoring of acetaminophen. PMID- 3558664 TI - Trace analysis of diazepam in serum using microbore high-performance liquid chromatography and on-line preconcentration. AB - The feasibility of determining trace analytes in human serum using on-line preconcentration and microbore high-performance liquid chromatography has been demonstrated. The serum is subjected to ultracentrifugation and injected onto a hydrophobic pre-column using water as the mobile phase. This traps the components of interest which are then backflushed onto a microbore analytical column using a stronger mobile phase. The column-switching apparatus was evaluated using highly dilute aqueous paraben solutions and sample enrichment factors as high as 1500 were obtained. The procedure was then applied to diazepam in serum. Recovery was linear and quantitative over the range from at least 4 to 1000 ng/ml. The method was specific against caffeine and the three major metabolites of diazepam: oxazepam, temazepam, and nordiazepam. The effects of varying pre-column dimensions, pre-column loading time, and sample volume were evaluated. PMID- 3558665 TI - Direct measurement of dopamine O-sulfate in plasma and cerebrospinal fluid. AB - This paper describes a method for measurement of dopamine 3-O-sulfate (DA3S) and dopamine 4-O-sulfate (DA4S) in dog and human plasma and dog cerebrospinal fluid. C18 solid-phase extraction columns were utilized for sample preparation. DA3S and DA4S were separated by high-performance liquid chromatography and then quantified by dual-electrode electrochemical detection. [3H]Dopamine O-sulfate (DAS) was used as internal standard. Recovery of authentic DAS added to dog plasma and carried through the entire procedure was 49.9 +/- 6.3% for DA3S (n = 9) and 42.2 +/- 4.3% for DA4S (n = 8). The lower limit of detection (signal-to-noise ratio of 3) was 20 fmol for each DAS isomer. The within-assay coefficient of variation for DA3S in dog plasma averaged 5.8% (range 2.0-12%, n = 5). The between-assay coefficient of variation for DA3S in dog plasma was 3.8% (n = 3). DAS levels in plasma of conscious dogs were 20.3 +/- 6.9 pmol/ml DA3S and 5.91 +/- 3.5 pmol/ml DA4S (n = 5). Cerebrospinal fluid levels were 3.06 +/- 3.22 pmol/ml DA3S and 0.10 +/- 0.18 pmol/ml DA4S in dogs anesthetized with methoxyflurane and nitrous oxide (n = 3). This procedure is also appropriate for use with human plasma; DAS levels were 24.3 +/- 12.8 pmol/ml DA3S and 9.07 +/- 3.9 pmol/ml DA4S (n = 6). PMID- 3558666 TI - Analysis of sulindac and metabolites in plasma and urine by high-performance liquid chromatography. AB - A reversed-phase high-performance liquid chromatographic method with ultraviolet detection is described for the quantification of sulindac, sulindac sulfone and sulindac sulfide in plasma and sulindac, trans-sulindac, sulindac sulfone and sulindac sulfide in urine. Plasma samples are de-proteinized with acetonitrile and urine samples are injected directly following enzymatic hydrolysis of glucuronide metabolites. The resulting chromatograms are essentially free from endogenous interference and the limits of detection are 0.1 microgram/ml for plasma and 0.2 microgram/ml for urine for all of the above compounds. PMID- 3558667 TI - Determination of thalidomide and its major metabolites by high-performance liquid chromatography. AB - A rapid and sensitive isocratic high-performance liquid chromatography assay for the simultaneous and quantitative determination of thalidomide (alpha phthalimidoglutarimide) and its major metabolites from human serum has been developed. The parent compound and the metabolites can be efficiently separated by reversed-phase chromatography using tetramethylammonium bromide as an ion-pair forming reagent. PMID- 3558668 TI - High-performance liquid chromatographic assay of fenflumizole and its demethyl metabolites in biological samples. AB - This paper describes sensitive, selective and precise methods for the assay of fenflumizole and its chromatographically verified demethyl and didemethyl metabolites in whole blood, isolated red blood cells, plasma, saliva, urine and tissue (skin and fat) from human subjects. Also conjugates of the two metabolites with glucuronic acid and sulphate were assayable. The compounds were quantitated by means of reversed-phase liquid chromatography after diethyl ether extraction, followed by fluorescence and/or electrochemical detection. The assay using fluorescence detection is quantitative down to ca. 150 pg/ml; with electrochemistry this limit was ca. 600 pg/ml and included the demethyl metabolites only. Proteinaceous materials show an extraction yield of 70-75%, whereas analytes in sample materials without proteins show yields of better than 95%. The precision at concentration levels of ca. 50 ng/ml for the parent compound and ca. 5 ng/ml for the metabolites is at most 6% (relative standard deviation) with both detection modes. The analytical procedures developed were applied after both single and repetitive administration of fenflumizole. The administration of 14C-labelled fenflumizole in the single-dose study revealed the presence in plasma and urine of as yet unknown metabolites. The in vivo retention time of 14C activity was substantially greater in the blood cells than in plasma. Measurements of 14C activity in excreta demonstrated that excretion via the faeces is the preferred route. PMID- 3558669 TI - High-performance liquid chromatographic procedures for the determination of difloxacin and its metabolites in biological matrices. AB - A simple and extremely precise high-performance liquid chromatographic procedure has been developed for the determination of difloxacin and its metabolites in plasma and urine. Work-up of plasma samples entails ultrafiltration after addition of an internal standard in a displacing reagent containing sodium dodecyl sulfate. The ultrafiltrates are directly analyzed using a C18 reversed phase analytical column, a soap-chromatographic mobile phase, and a fluorescence or ultraviolet detector. The mean intra-assay coefficient of variation for difloxacin over a concentration range of 10 ng/ml to 10 micrograms/ml was 0.5% when fluorescence detection and an internal standard were employed. Inter-assay coefficients of variation were approximately 2%. Recoveries of difloxacin and its metabolites were essentially quantitative and calibration curves were strictly rectilinear. PMID- 3558670 TI - Quantification of tamoxifen and N-desmethyltamoxifen in human plasma by high performance liquid chromatography, photochemical reaction and fluorescence detection, and its application to biopharmaceutic investigations. AB - The anticancer drug tamoxifen and its major metabolite N-desmethyltamoxifen are quantified in human plasma down to subnanogram amounts by high-performance liquid chromatography. Plasma is alkali-buffered and extracted with hexane. The organic solvent is evaporated and the residue dissolved in the mobile phase. An aliquot is sampled automatically and chromatographed. The analytes are detected after postcolumn UV irradiation and rearrangement to substituted phenanthrenes by their intense fluorescence. Precise handling of exact volumes facilitates external calibration. Statistical data for precision and accuracy are given and illustrate reliable quantification. The method is applied to the samples of a clinical study, and the pharmacokinetic parameters of both analytes are presented. The novel design of the photochemical reactor is discussed, with respect to peak broadening and photochemical recovery. The measured peak broadening is smaller than theoretically predicted, owing to non-helical coiling. PMID- 3558671 TI - Liquid chromatographic determination of amoxicillin and its metabolites in human urine by postcolumn degradation with sodium hypochlorite. AB - A high-performance liquid chromatographic method has been developed for the determination of amoxicillin and its metabolites [(5R,6R)-amoxicilloic acid, the (5S,6R) epimer, and the (2R)-piperazine-2',5'-dione] in human urine. They were separated from the background components of urine on a reversed-phase C18 column using sodium heptylsulphonate as an ion-pairing agent and methanol as an organic mobile phase modifier. The eluent was led to the postcolumn degradation with 1.5 M sodium hydroxide plus 0.02% sodium hypochlorite solution at ambient temperature. The degradation product(s) of each compound was detected at 270 nm. The proposed method permits detection of I, II, III, and IV down to 1 microgram/ml in neat urine samples. At a concentration of 5 micrograms/ml of each compound, within- and between-run precisions (relative standard deviation) were 1.12-5.79 and 0.80-2.70%, respectively. The urinary levels of I and its metabolites were determined by the proposed method after administration of I to humans. PMID- 3558673 TI - Analysis of homogentisic acid in body fluids by high-performance liquid chromatography. PMID- 3558672 TI - Determination of hydroxylated metabolites of polycyclic aromatic hydrocarbons in urine. PMID- 3558674 TI - Determination of plasma lipoperoxides by high-performance liquid chromatography. PMID- 3558675 TI - Determination of free biotin in plasma by liquid chromatography with fluorimetric detection. PMID- 3558676 TI - Rapid and sensitive determination of Dns-amino acids in plasma using high-speed octadecyl liquid chromatographic columns. AB - Rapid and sensitive methods are described for the separation of Dns-derivatives of twenty common amino acids using high-speed liquid chromatographic columns with 5-micron or 3-micron C18 packings. With the 5-micron column, the separation was completed in 37 min and with the 3-micron column in less than 20 min. The fluorimetric detection sensitivity of individual amino acids varied between 5 and 0.5 pmol. Plasma-free amino acids in mink were determined with the 5-micron column with a mean recovery of 101% for different amino acids. The mean coefficient of variation for ten subsequently analysed plasma samples was 4.8%. PMID- 3558677 TI - Method for determination of different phospholipids by circular high-performance thin-layer chromatography. PMID- 3558678 TI - Quantitative determination of vinpocetine in human plasma by capillary gas chromatography-mass spectrometry. PMID- 3558679 TI - Derivatization of 2-amino alcohols with phosgene in aqueous media: limitations of the reaction selectivity as found in the presence of O-glucuronides of alprenolol in urine. PMID- 3558680 TI - Determination of picogram levels of (E)-3-(9-chloro-6,11-dihydro-5H-pyrrolo (2,1 B) (3) benzazepin-11-ylidene)-N,N-dimethyl-1-propanamine (Z)-2-butenedioate (1:1) in plasma using capillary gas chromatography with nitrogen-selective detection. PMID- 3558681 TI - Sensitive high-performance liquid chromatographic method for the routine determination of butylated hydroxyanisole in plasma. PMID- 3558682 TI - Separation of 1-beta-D-arabinofuranosylcytosine 5'-triphosphate and 9-beta-D arabinofuranosyl-2-fluoroadenine 5'-triphosphate in human leukemia cells by high performance liquid chromatography. PMID- 3558683 TI - Method for the determination of acemetacin, a non-steroidal anti-inflammatory drug, in plasma by high-performance liquid chromatography. PMID- 3558684 TI - Rapid method for the determination of the diuretic triamterene and its metabolites in plasma and urine by high-performance liquid chromatography. PMID- 3558685 TI - Rapid and simple assay for the measurement of methotrexate in serum, urine and red blood cells by reversed-phase high-performance liquid chromatography. PMID- 3558686 TI - Determination of 22,23-dihydroavermectin B1a in dog plasma using solid-phase extraction and high-performance liquid chromatography. PMID- 3558687 TI - Rapid high-performance liquid chromatography of 3-methylhistidine in human urine. AB - An internally standardized method for the determination of 3-methylhistidine in human urine is presented. This methylated amino acid and the chemically analogous internal standard 3-ethylhistidine were isolated from human urine specimens using small columns of cation-exchange resin. Quantification was accomplished by high performance liquid chromatography using post-column derivatization with o phthalicdicarboxaldehyde-2-mercaptoethanol followed by fluorometric detection. Sample-to-sample and day-to-day reproducibility were shown to have respective relative standard deviations of 2 and 5% for a human urine specimen containing 250 nmol/ml 3-methylhistidine when using 250 microliter urine per analysis. The chromatographic separation was evaluated in terms of various peak descriptors (capacity factor and retention time) and "Chromatographic Figures of Merit" (peak symmetry and chromatographic efficiency). The utility of the method was demonstrated by its successful application to 1000 human urine specimens. PMID- 3558688 TI - Determination of the non-steroidal anti-inflammatory drug flunoxaprofen, S(+)-2 (4-fluorophenyl)-alpha-methyl-5-benzoxazoleacetic acid, in blood and urine by high-performance liquid chromatography. PMID- 3558689 TI - Rapid and simultaneous determination of pyrazinamide and its major metabolites in human plasma by high-performance liquid chromatography. PMID- 3558690 TI - Determination of cefadroxil in serum by high-performance liquid chromatography with cephradine as internal standard. PMID- 3558691 TI - Determination of cefaclor and cephradine in serum by ion-pair reversed-phase chromatography. PMID- 3558692 TI - Determination of ranitidine in rat plasma and brain by high-performance liquid chromatography. PMID- 3558693 TI - Simultaneous determination of serum trimethadione and its metabolite by gas chromatography. PMID- 3558694 TI - Quantitative liquid chromatographic determination of disulfide-containing peptide analogues of vasopressin with dual Hg/Au electrochemical detection. AB - Quantitative methodology was developed for the analysis of disulfide-containing peptide analogues of vasopressin in biologic media. The procedure employs sample clean-up by an ion-exchange solid-phase extraction cartridge, followed by high performance liquid chromatography with electrochemical detection. The detector is a dual Hg/Au system operated in series in which the disulfide-containing peptides are first reduced at the upstream electrode and then detected as free thiols at the downstream electrode. The assay is linear in the range 2-100 ng/ml (approximately 2-100 pmol/ml) of urine with a lower limit of detection of 1 ng (approximately 1 pmol) on column. The method displayed general utility for a number of structural analogues of vasopressin. PMID- 3558695 TI - Isolation and partial characterization of pyridoxal 5'-phosphate hemoglobins by high-performance liquid chromatography as a quality-control method for hemoglobin based blood substitutes. AB - Pyridoxal 5'-phosphate hemoglobin (PLP-Hb), prepared from hemoglobin and a four fold excess of pyridoxal 5'-phosphate by the method of De Venuto and Zegna [J. Surg. Res., 34 (1983) 205], has been chromatographically resolved into six components via a quaternary ammonium monobead support. On an analytical scale, the separations have been found to be rapid (ca. 50 min) and highly reproducible. The results also indicate that the preparation of PLP-Hb yields a reproducible product ratio. The potential of the analytical method for the routine quality control of blood substitutes derived from PLP-Hb is discussed. All five of the PLP derivatives (components II-VI), isolated and purified via a combination of conventional and preparative monobead anion-exchange chromatography, gave single peaks when analyzed by high-performance liquid chromatography. Total phosphate analyses indicated that components II and III each contain two PLPs per Hb, IV and V four and VI six. PMID- 3558696 TI - Sugar-chain heterogeneity of human alkaline phosphatases: differences between normal and tumour-associated isozymes. AB - The sugar-chain heterogeneity of alkaline phosphatases (ALPs) from various human organs was investigated by using the serial lectin affinity technique. This technique revealed a possible structure of the sugar chain(s) of ALP isozymes and clarified a difference in affinity on the lectin column not only among three genetically different isozymes (liver/bone/kidney, intestinal and placental types) but also among liver, bone, and kidney ALPs. Lectin-binding profiles of ALPs in these human organs closely resembled those in the corresponding organs of the rat, as reported previously, suggesting that heterogeneities in sugar chains of ALPs have a specificity for the respective organs rather than being species specific. Lectin-binding profiles of tumour-produced placental and liver ALPs were significantly different from those of ALPs in the respective normal organs. However, the two altered ALPs exhibited similar lectin-binding affinities. Isoelectric focusing analysis showed essentially no difference in protein charge between the normal and tumor-produced ALPs. Moreover, tumour-produced ALPs had the same N-terminal amino acid sequence and peptide mapping as normal ALPs. From these results, it is possible to suggest that organ-specific sugar chains in ALP isozymes are changed into those peculiar to tumours in association with malignant transformation. PMID- 3558697 TI - Determination of tocopherol and tocopherol acetate concentrations in human feces using high-performance liquid chromatography. AB - A method of sample clarification and high-performance liquid chromatography (HPLC) specifically developed to permit simple and rapid determination of vitamin E (alpha-tocopherol, E) and vitamin E acetate (EA) in feces is reported. Retinol acetate (RA) was used as an internal standard. The vitamins of interest were extracted from an aqueous stool suspension into an organic phase (ethyl acetate butanol), which was injected directly onto the reversed-phase HPLC system. An isocratic mobile phase of methanol-water (97:3) was employed, with ultraviolet detection at 275 and 285 nm (to permit simultaneous monitoring and absorbance ratio determination). Recoveries of exogenous RA, E, and EA from stool suspensions (relative to water) were 99.0 +/- 7.0, 100.9 +/- 7.0, and 101.2 +/- 13.3%, respectively (n = 10). The organic matrix could be stored at -35 degrees C overnight with no change in E or EA results. Sensitivities for E and EA were 80 and 102 micrograms/g of stool, respectively. Each analysis required nine min. The within-day coefficients of variation were 2.9, 3.6, and 3.0% (n = 7) for RA, E, and EA, respectively. Neither E nor EA were detected in baseline fecal samples from fourteen subjects, but both were present in high but varied concentrations after four weeks supplementation with oral d,l-EA. E but not EA was present in blood samples drawn during periods of oral supplementation with EA. There was poor correlation between fecal levels of E and EA, and the increase in serum levels of E. This method permits rapid, selective, and precise determination of E and EA in human fecal samples. PMID- 3558698 TI - Capillary chromatographic analysis of volatile organic compounds in the indoor environment. AB - The wide variety of volatile organic compounds found in the indoor environment can present a difficult chromatographic problem for the analyst. Capillary-column gas chromatography is required to achieve adequate separation. Thermal desorption/capillary gas chromatography/mass spectrometry is usually the preferred method for broad spectrum analysis of the volatile organics detected indoors. Cryogenic trapping is required for capillary gas chromatographic analysis of the more volatile components. PMID- 3558699 TI - GLC analysis of thiabendazole residues in citrus fruit. AB - Analysis of thiabendazole (TBZ) residues in citrus fruit is performed using a bonded phase, SE-54, fused-silica capillary column. The fungicide is extracted with hexane: ethyl acetate (90:10, v/v) at high pH and, after a short cleanup, determined by gas-liquid chromatography with a nitrogen-phosphorus detector (NPD). Recoveries through the method are always higher than 80% and the limit of detection is 0.01 mg/Kg. TBZ residues are determined in whole fruit, peel, and pulp of "Washington Navel" oranges and "Hernandina" clementines treated with 1500 mg/L fungicide. Residues found in these samples and their changes during storage are reported. TBZ analysis in samples with high residue levels (peel and whole fruit) is also carried out by direct determination in the crude extracts. Results obtained with this shorter method are similar to those of the former proposed method. PMID- 3558700 TI - Use of enzyme amplification in an ELISA to increase sensitivity of detection of barley yellow dwarf virus in oats and in individual vector aphids. AB - A new technique of alkaline phosphatase amplification in an ELISA (amplified ELISA) was used to increase the sensitivity of detection of barley yellow dwarf virus (BYDV) from oat plant sap and in individual vector aphids. Amplified ELISA differs from conventional direct double antibody sandwich ELISA (DAS-ELISA) in the enzyme substrate reaction. The bound enzyme-labelled antibody catalyzes the conversion of NADP to NAD which is then used in a secondary enzyme-mediated cyclic reaction producing a red-coloured end product. Amplified ELISA was compared with DAS-ELISA for the detection of BYDV and each assay was done with both monoclonal and polyclonal antibody reagents. Both types of antibodies detected BYDV from oat sap and amplified ELISA increased the sensitivity of detection sufficiently to allow a diagnostic test to be completed in less than 2 h using microtitre plates precoated with antibodies. However, in the amplified ELISA using polyclonal antibodies the absorbance values obtained with the healthy oat sap samples were much greater than those obtained in the DAS-ELISA, or with the monoclonal antibodies, and were too large to be acceptable for reliable diagnostic tests. Both monoclonal and polyclonal antibodies were used successfully to detect BYDV in individual virus-carrying Rhopalosiphum padi by amplified ELISA and there was little nonspecific background reaction in the control samples with either of the antibodies. PMID- 3558701 TI - An oligonucleotide probe for the detection of hepatitis B virus DNA in serum. AB - A novel and practical assay for the detection of hepatitis B virus (HBV) DNA in serum is described that utilizes as probe a 21-nucleotide sequence 5'-d (CTTCGCTTCACCTCTGCACGT) labelled at the 3'-end with [32P]ddAMP. The oligonucleotide probe sequence occurs in all known HBV genomes and is complementary to a region near the end of the single-stranded gap. It includes the 11-nucleotide direct repeat 5'-d(TTCACCTCTGC). The method was tested on 988 serum HBsAg-positive or -negative specimens and compared to results with HBV DNA probe, with over 98% concordance between the methods. The sensitivity of the two assays was comparable. The assay was developed for testing serum samples fixed to nylon or nitrocellulose membranes. Hybridization time could be shortened to a few hours as compared to 16 h for HBV DNA probes. Immaculate backgrounds were obtained by using a hybridization medium containing polyethylene glycol, heparin and pyrophosphate, and a particular washing procedure. PMID- 3558702 TI - Single radial complement fixation test using NP-containing plates: a simple and sensitive method for the detection of influenza infection. AB - The single radial complement fixation (SRCF) test using nucleoprotein (NP) was compared with the haemagglutination inhibition (HAI) test in the course of the evaluation of the protective efficacy of influenza vaccine. In the case of persons who were not vaccinated, the percent incidence of infection was almost the same (which confirmed by HAI test or by SRCF test), whereas in the case of vaccinees, there was a significant difference between the incidence confirmed by HAI (7.9%) and SRCF (19.4%) tests. The SRCF test was shown to be a simple and sensitive method for detection of a significant rise in antibody titre against influenza virus. PMID- 3558703 TI - A method for the quantitative analysis of ELISA data. AB - A method is described for measuring relationships among virus serotypes. An indirect ELISA was used to obtain antibody-response curves for homologous and heterologous combinations of virus and dilutions of antibody. Data from the proportional response region of each curve were converted to logarithmic values and subjected to a form of regression analysis to derive relative titres for the various combinations of virus and antibody. SDI values were then obtained by calculating the mean difference in relative titres between homologous and reciprocal heterologous combinations. Virus models in two different groups were examined using this technique. Relative titres obtained were consistent and reproducible over several experiments indicating that the technique was capable of reliably discriminating among serotypes which differed by as little as 0.2 SDI. PMID- 3558705 TI - X and iprP: an improved summary for scientific communication. PMID- 3558706 TI - The "constant intake rate" assumption in interim recruitment goal methodology for multicenter clinical trials. AB - A primary concern of any multihospital clinical trial is the recruitment of a predetermined number of patients during a prespecified interval of time. In several recent papers a Poisson based model was used to estimate the time needed to recruit a predetermined number of patients and the probabilities of recruiting specified fractions of the sample during subintervals. The Poisson model requires the assumption that patients be recruited at a constant rate over the entire length of the interval. In this paper we test the adequacy of this model and assumption using patient intake data from nine multihospital VA clinical trials and propose an alternative Bayesian model. PMID- 3558704 TI - Detection and identification of plant viruses by ELISA using crude sap extracts and unfractionated antisera. AB - A simple and rapid procedure of enzyme immunoassay (PTA-ELISA) was used to detect and identify viruses in individual plants. Virus antigen in crude leaf extracts was adsorbed directly to a solid-phase support, allowed to react with unfractionated antiserum and the antigen-antibody complex detected with a general purpose conjugate of protein A and enzyme. Viral antigens were trapped most effectively by high bonding polystyrene microtitre plates loaded with leaf extracts prepared in carbonate buffer at pH 9.6. With protein A-alkaline phosphatase conjugate and the substrate p-nitrophenyl phosphate as the antibody detection system, 18 plant viruses in 8 virus groups were detected reliably and nonspecific reactions did not occur. However, when the substrate 3,3',5, tetramethyl benzidine was used in conjunction with protein A-horseradish peroxidase conjugate, nonspecific reactions were given by leaf extracts from some uninfected or virus-infected plant species. Where less sensitivity is required than is provided by versions of ELISA that rely on antibody-captured antigen, this method provides a simple and rapid means of detecting and identifying viruses in crude sap extracts with the aid of unfractionated antisera. PMID- 3558708 TI - The relationship of social support to psychological adjustment in end-stage renal disease patients. AB - The present study examined the social support system of patients suffering from end stage renal disease. Patients reported receiving considerable support from family, friends, and the medical treatment staff. Patients reported receiving considerably less support from voluntary associations (including religion) and leisure activities. This study also tested the proposition that social support lessens the impact of the stress of kidney disease. Multiple regression analysis indicated that social support variables increased the prediction (i.e. beyond the variance explained by demographic variables) of psychological adjustment. The hypothesis derived from crisis theory that social support would be more predictive of psychological adjustments in patients who recently became ill than in patients who had been ill longer was also supported. PMID- 3558707 TI - Black-white differences in serum lipoproteins during sexual maturation: the Bogalusa Heart Study. AB - Serum lipid, lipoprotein cholesterol, and apolipoprotein (A-I and B) levels were compared between 940 black and 1710 white children who were between the ages of 5 and 17 years. Stratification, matching, and analysis of covariance were used to determine whether black-white differences in levels of serum triglycerides (TG), very low- (VLDL-C), and high- (HDL-C) density lipoprotein cholesterol, and apolipoprotein A-I (apoA-I) could be explained by differences in sexual maturation, obesity, cigarette smoking, alcohol intake, oral contraceptive use, insulin, and glucose. Independently of these covariates, blacks had elevated levels of HDL-C and apoA-I (males only), and whites had increased levels of TG and VLDL-C. All differences were statistically significant at the 0.001 level. In addition, racial contrasts tended to be greater in sexually mature, as compared with prepubertal, males; a similar divergence of levels with sexual maturation was not observed in females. HDL-C levels in white males were partially explained (R2 = 0.12) by sexual maturation, insulin, and obesity; apoA-I levels were associated with only sexual maturation and insulin. Racial differences in levels of serum lipids, lipoprotein cholesterol, and apoA-I in early life, therefore, exist independently of differences in several lipoprotein determinants. Since the initial stages of atherosclerosis begin in the young, these black-white lipoprotein contrasts may influence differences in adult coronary heart disease rates between the races. PMID- 3558709 TI - Spring color. PMID- 3558710 TI - Breast palpation technique: what is the finger pad? PMID- 3558711 TI - Controlled clinical trials: an ethical imperative? PMID- 3558712 TI - Time-dependency in Cox's regression analysis. PMID- 3558713 TI - Screening and breast cancer. PMID- 3558715 TI - Publication of "negative" epidemiological studies. PMID- 3558714 TI - Etiologic fraction in case-control studies for the evaluation of screening. PMID- 3558716 TI - A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. AB - The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small. PMID- 3558717 TI - Nuclear scans: a clinical decision making tool that reduces the need for cardiac catheterization. AB - We have assessed the impact of cardiovascular nuclear medicine studies (CVNMS) on physicians' decisions to send patients with suspected ischemic heart disease (N = 439) on to cardiac catheterization at three Bronx hospitals. A change in management plans with respect to catheterization was observed in 31% of cases. Catheterization rates were reduced by 25% among patients referred for resting studies and by 49% for exercise studies (thallium perfusion or exercise wall motion studies). Results of CVNMS had little impact on catheterization decisions for resting study patients (N = 192). Among exercise study patients (N = 247), those with normal results had a relative reduction in catheterization post-CVNMS of 82% vs 27% for patients with abnormal results (p less than 0.001). However, impact of exercise CVNMS test results on post-CVNMS catheterization rates obtained for men only; women with abnormal exercise study results were much less likely to undergo subsequent catheterization (7.7%) than men with abnormal results (41.9%), p less than 0.005, independent of age. The apparent discrepancy in referral for catheterization based on sex needs to be investigated further. PMID- 3558718 TI - The association of the ratio of waist to hip girth with blood pressure, serum cholesterol and serum uric acid in children and youths aged 6-17 years. AB - To determine whether the association of the ratio of waist to hip girth with cardiovascular risk factors exists in prepubertal children and pubertal youths, the ratio was related to blood pressure, serum cholesterol and serum uric acid levels in children and youths aged 6-17 yr in the Health Examination Survey. In these samples drawn from the United States population, the ratio declined with increasing age. Boys had consistently higher ratios than girls. Black-white differences were inconsistent. The ratio was lower in girls whose menstrual periods had started at each age after 10. The ratio was significantly associated with systolic blood pressure in youths and with diastolic blood pressure in children independent of confounders. It was also significantly associated with serum uric acid but not serum cholesterol independent of confounders among youths. Longitudinal studies are needed of greater abdominal relative to lower body fat deposits in children and youths and risk of cardiovascular disease in adulthood. PMID- 3558719 TI - Mortality among Hispanics in metropolitan Chicago: an examination based on vital statistics data. AB - This paper analyzes the mortality of Mexican Americans and Puerto Ricans residing in the Chicago metropolitan area. In a comparison of these two groups with nonHispanic whites in the same area, it was found that Hispanic mortality is unusually low for the two leading causes of death in the mainstream U.S. population. Explanations discussed include underdiagnosis, underreporting of illness, the "healthy migrant" thesis and possible return migration of elderly ill. PMID- 3558720 TI - Tuberculosis control assisted by family planning. PMID- 3558721 TI - Free fatty acids alter calcium binding: a cause for misinterpretation of serum calcium values and hypocalcemia in critical illness. AB - FFAs are bound with calcium on the albumin molecule. We hypothesized that changes in circulating FFA levels during critical illness altered calcium-albumin binding. We found that serum from both normal subjects and critically ill patients contained an ether-extractable factor which lowered ionized calcium concentrations and increased albumin-calcium binding. This factor was found in higher concentrations in serum from ill patients. Oleic acid and palmitic acid increased albumin-calcium binding from 2-28% in a dose-dependent manner when added in vitro to calcium-albumin solutions. Scatchard analysis demonstrated that 0.1 mM oleic acid increased the number of calcium-binding sites on the albumin molecule (from three to five sites per molecule) without altering binding affinity. A similar effect was found when we performed Scatchard analyses of ether extracts in serum from three critically ill patients (number of calcium binding sites increased from three to six). We also found that lipid infusions (during parenteral nutrition) lowered mean serum ionized calcium values in six critically ill patients [4.6 +/- 0.2 (+/- SEM) to 4.1 +/- 0.2 mg/dL; P less than 0.05]. These data support the concept that FFAs increase calcium binding to the albumin molecule. Alterations in FFA concentrations during critical illness may contribute to the poor correlation between corrected total serum calcium and ionized calcium concentrations in critically ill patients. In addition, acute elevations in circulating FFA concentrations may contribute to hypocalcemia in patients with defects in bone calcium mobilization. PMID- 3558722 TI - Salivary testosterone in hirsutism: correlations with serum testosterone and the degree of hair growth. AB - Testosterone (T) concentrations in saliva and serum were measured in 53 women with various degrees of hirsutism and hyperandrogenism. The bioavailability of T was judged by comparing the correlations among the grade of hirsutism, salivary testosterone (SaT), and serum total and free T (fT) and sex hormone-binding globulin (SHBG) levels. The effect of body mass index on the correlations was also studied. The high SaT concentrations [mean, 237.6 +/- 66.7 (+/- SD) pmol/L] compared to the serum fT concentrations (mean, 29.1 +/- 11.8 pmol/L) in hirsute women may reflect the bioavailability of albumin-bound T or an ability of the salivary glands to metabolize steroids. SaT was more closely related to the T/SHBG ratio (mean, 82.5 X 10(-3) +/- 54.8), reflecting the non-SHBG-bound fraction of T, than to serum fT, which might support the former theory. SaT correlated better to the degree of hirsutism (rho = 0.45; P less than 0.01) than did any of the serum T parameters or SHBG. The correlation between SaT and hirsutism was partly dependent on the effect of body mass index. After eliminating this effect, SaT still correlated with hair growth on the total body area (rho = 0.36; P less than 0.05). On the basis of the results, SaT seems to relate to the bioavailable fraction of the hormone and, thus, appears to be an optimal method for studying hirsute women. PMID- 3558723 TI - Forearm and vertebral bone mineral in treated and untreated hyperprolactinemic amenorrhea. AB - To determine whether women with PRL-secreting pituitary tumors have similar decreases in cortical and trabecular bone and to determine whether bone loss associated with hyperprolactinemia is reversible, we measured forearm and vertebral bone mineral in normal women and in amenorrheic women with treated and untreated hyperprolactinemia. The mean spinal bone mineral content in hyperprolactinemic women [130 +/- 23 (+/- SD) mg/mL] was 25% lower than that in normal women (167 +/- 28 mg/mL), while the mean forearm bone mineral content (0.71 +/- 0.04 g/cm2) was similar to that in normal women (0.73 +/- 0.05 g/cm2). Women with normal serum PRL levels and regular menses after transsphenoidal surgery had slightly higher mean spinal bone mineral content (149 +/- 28 mg/mL) than women who remained amenorrheic after surgery (129 +/- 19 mg/mL), but the mean value in the cured women remained significantly lower than that in normal women. In contrast, women who had undergone successful transsphenoidal pituitary surgery had mean forearm bone mineral comparable to that in normal women. There was no correlation between vertebral and radial bone mineral in hyperprolactinemic women and no correlation between bone mineral and serum PRL, serum estradiol, or duration of amenorrhea when age was taken into account. These findings suggest that hyperprolactinemia and/or decreased gonadal function in women with PRL-secreting pituitary tumors are associated with more prominent effects on trabecular bone in the spine than on cortical bone in the wrist. In addition, the abnormal spinal bone mineral content after successful treatment suggest that normalization of estradiol and PRL secretion is not sufficient to restore bone mineral content to normal, although it may be stabilized. PMID- 3558724 TI - HLA and thyrotoxic periodic paralysis in Japanese patients. AB - Periodic paralysis (PP) is a well recognized although rare and peculiar complication of thyrotoxicosis, especially among Chinese and Japanese patients. The susceptibility to autoimmune thyroid disease has recently been reported to be strongly linked to certain immunogenetic factors, and increased frequency of certain HLA antigens has been found in patients with Graves' disease. This study was, therefore, undertaken to determine HLA haplotypes in Japanese men with thyrotoxic periodic paralysis (TPP). HLA typing in 35 TPP patients and 263 normal men and women demonstrated highly significant increases (P less than 0.01) in HLA A2, Cw3, and DRw8 in the TPP patients. In comparing TPP patients with thyrotoxic men who did not have PP, the frequency of DRw8 antigen was 2.5-fold greater in patients with PP than in those without it (62.8% vs. 28.6%). The data suggest that the HLA-DRw8 gene itself may play a significant role in the susceptibility to TPP among Japanese men. PMID- 3558725 TI - Dietary lipids: an additional regulator of plasma levels of sex hormone binding globulin. AB - The effect of dietary lipid consumption on plasma levels of sex-hormone binding globulin (SHBG), free testosterone and cholesterol was studied in 6 normal men. After consuming a diet with a high fat content (greater than 100 g fat/day) for two weeks, the mean plasma cholesterol level increased (p less than 0.02) while the mean SHBG level decreased (p less than 0.02). Changing the diet from one with a high fat to low fat content (less than 20 g fat/day) for a further two week period resulted in a significant reduction in mean plasma cholesterol level (p less than 0.001) while the mean SHBG level increased (p less than 0.01). The increase in plasma SHBG was associated with a significant decrease in the free testosterone fraction and free testosterone concentration. No significant changes were detected in plasma samples obtained from the same men during a control period. The results from this study demonstrate that dietary lipid intake is an additional factor involved in the regulation of plasma levels of SHBG. PMID- 3558726 TI - Rising plasma levels of 19-nortestosterone throughout pregnancy: determination by radioimmunoassay and validation by gas chromatography-mass spectrometry. AB - A highly sensitive and specific radioimmunoassay was developed to measure 19 nortestosterone (NT), which allowed us to demonstrate this steroid in the plasma of pregnant women. Plasma NT was detectable throughout gestation, reaching values of 12 to 60 pg/ml in the 3rd trimester. These results were validated by gas chromatography-mass spectrometry. No NT was detectable in the plasma of 12 normal men and 12 nonpregnant women in the mid follicular phase of their cycle (detection limit 4 pg/ml). Our results are compatible with current concepts concerning the possible involvement of 19-norsteroids in an accessory biosynthetic pathway for estrogen in the placenta. PMID- 3558727 TI - Revised nomenclature for tests of thyroid hormones and thyroid-related proteins in serum. PMID- 3558728 TI - Growth hormone administration conserves lean body mass during dietary restriction in obese subjects. AB - Because weight-reducing diets result in loss of lean body tissue as well as fat, we sought to determine whether injections of GH might facilitate the preservation of nitrogen and accelerate the loss of body fat during dietary restriction. The dietary intake of 8 obese subjects was restricted to 24 Cal/kg ideal BW and 1 g protein/kg for 11 weeks. During weeks 3-5, 4 subjects were given a total of 10 im injections of recombinant methionyl human GH, 1 morning injection every 48 h in a dosage of 0.1 mg/kg ideal BW. The other 4 subjects were given injections of vehicle. During weeks 8-10, the subjects who had received GH previously were given vehicle and vice versa. While receiving GH injections the mean daily nitrogen deficit [0.35 +/- 2.14 (+/- SD) g/day] was significantly less than the loss during injection of vehicle (2.21 +/- 1.45 g/day; P less than 0.001). Although three of six subjects lost 190% more fat (as determined by hydrostatic weighing) while receiving GH, the difference in group mean fat loss during GH injection was not significantly greater than that during injection of vehicle (3.06 +/- 1.39 kg lost with GH vs. 2.64 +/- 1.08 kg lost with vehicle; P = NS). In parallel with the changes in nitrogen balance, GH produced a significant increase in the mean plasma somatomedin-C/insulin-like growth factor I concentration. From a mean pretreatment value of 1.06 +/- 0.28 U/mL, a maximal value of 3.20 +/- 1.60 U/mL was achieved after 12 days of GH injection (P less than 0.001). Somatomedin-C/insulin-like growth factor I concentrations did not change during injection of vehicle. During GH injection weight loss was attenuated because of fluid retention. If weight loss was determined 1 week after the end of GH administration, however, the total weight loss (3.42 +/- 1.73 kg) was not significantly different from that during the 3 weeks of vehicle administration and the following week (4.16 +/- 1.30 kg). Fasting blood glucose and serum insulin concentrations did not change during GH administration, and no glycosuria was detected in morning urine samples. Short term GH administration is effective in decreasing the loss of lean body mass in individuals ingesting restricted diets. However, fat loss was not accelerated. PMID- 3558729 TI - Nyctohemeral growth hormone profiles in young and aged men: correlation with somatomedin-C levels. AB - The effects of aging on GH secretion and somatomedin-C (SM-C) levels were studied in 10 young (22-45 yr) and 10 elderly (65-85 yr) men. Plasma GH levels were measured in samples obtained at 20-min intervals for 1300 min. Plasma SM-C levels were measured in samples obtained at 0600, 1100, 1600, 2100, and 0200 h. In the elderly men the mean basal plasma GH level was similar to that in the young men, but the total GH peak area as well as the amplitude of the peaks were significantly (p less than 0.01) lower than those in young men during both the day and the night. Plasma SM-C levels were significantly lower in the elderly men and were correlated with the total integrated GH levels and total GH peak areas, but not with basal plasma GH levels, suggesting that the GH peaks determine SM-C levels and that the decreased GH secretion in elderly men has biological significance. PMID- 3558730 TI - Elevated urinary 19-Nor-deoxycorticosterone glucuronide in Cushing's syndrome. AB - Hypertension is a common finding in patients with Cushing's syndrome (CS), but the cause is unknown. One possibility is excess production of nonaldosterone mineralocorticoids, such as 19-nor-deoxycorticosterone (19-Nor-DOC). To evaluate this possibility we measured urinary 19-Nor-DOC glucuronide in normal subjects (n = 14) and patients with essential hypertension (n = 10), pituitary-dependent CS (n = 8), and adrenal tumors producing CS (n = 6). The subjects were admitted to a metabolic unit where 24-h urine samples were collected while they ate an isocaloric diet (128 meq Na+ 80 meq K+/day). 19-Nor-DOC glucuronide was purified by extraction and chromatography and measured by RIA. Urinary 19-Nor-DOC glucuronide excretion was significantly higher in patients with both pituitary CS and adrenal CS compared to that in normal subjects, while the values in the two CS groups were similar. The patients with essential hypertension also had elevated urinary 19-Nor-DOC glucuronide excretion, although the values were lower than those in either CS group. These results demonstrate that a nonaldosterone mineralocorticoid, 19-Nor-DOC, is produced in excess in patients with either pituitary or adrenal CS and, thus, suggest a possible role for 19-Nor-DOC in the pathogenesis of some hypertensive disorders. PMID- 3558731 TI - Thyroxine and 3,5,3'-triiodothyronine content of thyroglobulin in thyroid needle aspirates in hyperthyroidism and hypothyroidism. AB - Thyroglobulin (Tg) was obtained by fine needle aspiration from patients with untreated hyperthyroidism due to Graves' disease and untreated hypothyroidism to determine whether alterations in its T4 and T3 content could account for the disproportionately high serum T3 compared to serum T4 found in both diseases. For comparison aspiration was performed from normal thyroid tissue in euthyroid patients operated for solitary thyroid lesions. The average amounts of Tg aspirated were: normal 177 +/- 52 (SE) micrograms, n = 7, hyperthyroidism 82 +/- 32 micrograms (n = 8); hypothyroidism 4.6 +/- 1.9 micrograms, n = 9. The iodothyronine content of Tg was, normal, T4 3.7 +/- 0.5 mol/mol, T3 0.28 +/- 0.04 mol/mol, T4/T3 13.7 +/- 1.4; hyperthyroidism, T4 3.8 +/- 1.0, T3 0.59 +/- 0.15, T4/T3 6.8 +/- 1.1; hypothyroidism, T4 3.3 +/- 0.5, T3 0.54 +/- 0.09, T4/T3 6.8 +/ 0.7. The iodine content of Tg was 28 +/- 3.1 atoms/mol in the euthyroid subjects and 31 +/- 7.3 atoms/mol in hyperthyroid patients. Hence, both untreated hyperthyroidism and untreated hypothyroidism were characterized by Tg with a normal T4 but a relatively high T3 content. This is probably related to the prolonged hyperstimulation of functioning follicular cells present in both diseases. The relatively high T3 content of Tg could not alone explain the relatively high T3 production compared to T4 production in these two thyroid diseases. PMID- 3558732 TI - The molecular basis for HLA class II associations with rheumatoid arthritis. AB - The association of HLA-DR4 with rheumatoid arthritis strongly implicates genes of the major histocompatibility complex (MHC) as contributing to disease susceptibility. Molecular analysis of MHC genes expressed on haplotypes in association with HLA-DR4 reveals that at least six different alleles of the DR beta 1 locus and at least three different alleles of the DQ beta locus occur on different DR4+ haplotypes. Some of these allelic differences are quite substantial, and others are rather subtle, involving as few as two amino acids. The analysis of individual DR and DQ alleles in rheumatoid arthritis identifies some DR4+ genes strongly associated with disease susceptibility and some DR4+ genes which are not. The Dw4(DR4) and Dw14(DR4) DR beta 1 genes appear to represent specific alleles which confer disease risk in RA; other DR beta 1 genes, such as Dw10(DR4), may represent DR beta genes altered during evolution which have lost their contribution to RA susceptibility. DQ beta 3.1(DQw3) and DQ beta 3.2(DQw3) DQ beta genes, which are present on DR4+ haplotypes, represent discrete variable alleles not directly implicated in RA, but which account for HLA-DR4 associations with other diseases, such as the association of DQ beta 3.2(DQw3) with Type I diabetes. PMID- 3558733 TI - Humoral immunity in nasal mucosa of patients with common variable immunodeficiency. AB - Humoral immunodeficiency, as reflected by the low serum immunoglobulin (Ig) concentrations in adult patients with common variable immunodeficiency (CVID), was even more severely expressed at the B-cell level in their nasal mucosa. No Ig producing cells could be detected by immunohistochemistry in 11 of 19 mucosal specimens. The epithelial distribution of secretory component (SC) was normal in all specimens, but a sign of SC-dependent IgM transport was seen in only three. Epithelial IgA was completely lacking. All patients had had recurrent lower respiratory tract infections and 16 had recurrent or chronic infections of the upper respiratory tract. A previous report indicated that the intestinal mucosa is a privileged site for maturation of B cells in patients with CVID; the present study shows that this does not hold true for the nasal mucosa. This difference in B-cell maturation may in part explain the preferential susceptibility to infections in the respiratory tract of patients with CVID. PMID- 3558734 TI - Bovine milk IgG, but not serum IgG, inhibits pokeweed mitogen-induced antibody secretion by human peripheral blood mononuclear cells. AB - Bovine milk IgG markedly inhibits the pokeweed mitogen (PWM)-induced secretion of immunoglobulins from human peripheral blood mononuclear cells. Heat-aggregated bovine milk IgG is even more inhibitory, demonstrating significant inhibition when levels as low as 5-9 micrograms/ml are continuously present in the in vitro 14-day culture system. However, bovine serum IgG, regardless of its state of aggregation, and control proteins have little effect on PWM-induced secretion of human IgG, IgA, and IgM. In a similar fashion, goat milk IgG, especially when aggregated, inhibits human antibody secretion whereas goat serum IgG does not. Inhibition appears to be mediated by Fc gamma receptors since F(ab')2 fragments of milk-derived bovine IgG do not inhibit PWM-induced antibody secretion. The continuous presence of bovine milk IgG is not essential since preincubation of milk IgG with PWM and human mononuclear cells for 24 hr also results in inhibition of human immunoglobulin secretion. In examining potential mechanisms of inhibition, it was found that bovine milk IgG, bovine serum IgG, and another chitin-containing protein, bovine thyroglobulin, each caused a small and equal inhibition of the binding of 125I-labeled PWM to human mononuclear cells, yet only the milk IgG inhibited antibody production. These studies raise the question of whether bovine milk IgG might modulate the human immune system in vivo. PMID- 3558735 TI - Immunoglobulin A concentrations in commercial immune globulins. AB - Commercial immune globulins contain varying concentrations of IgA as a minor constituent. For patients who are both IgA deficient and IgA hypersensitive, the administration of most immune globulins is contraindicated due to potentially lethal anaphylactic reactions. We have measured the IgA levels in a broad range of commercial immune globulin preparations by means of a competitive-binding solid-phase radioimmunoassay. Of the products tested, all immune globulins intended for intramuscular administration and most immune globulins for intravenous use had IgA levels of over 150 micrograms/ml. Only two of the intravenous products had IgA concentrations in the range of 10 micrograms/ml or less. PMID- 3558736 TI - A study of human-human hybridomas from patients with autoimmune thyroid disease. AB - Human-human B-cell hybridomas were established using peripheral blood lymphocytes from patients with autoimmune thyroiditis and Graves' disease. Peripheral mononuclear cells (PMC), with or without mitogen prestimulation, were fused with HGPRT-negative human myeloma cell lines (Gm4672 and GM0462) using 44% polyethylene glycol. Developing hybridomas were screened by enzyme-linked immunosorbent assays (ELISAs) for human IgG and IgM and antibodies to human thyroglobulin (hTg) and microsomal antigen (M-Ag). A 125I-TSH binding inhibition assay was utilized for detecting antibodies to TSH receptor (TSH-R) protein. Hybridoma formation was observed only after prior mitogen stimulation of PMC. The amount of antibody secreted by the human-human hybridomas was highly variable (10 ng-100 micrograms/ml IgG/IgM). Nine and six-tenths percent of the hybrids secreted anti-hTg and 8.4% secreted anti-M-Ag. A 5% cloning efficiency was achieved, with detection of specific thyroid autoantibody secretion in one-third of the clones derived from positive hybridomas. Immunoglobulin secretion decreased with time and long-term stable clones were not achieved. Thyroid monoclonal autoantibodies to hTg, M-Ag, and TSH-R (IgG and IgM) detected during these studies were of a low affinity. In addition, antibodies were identified which exhibited marked specificity crossover between hTg, M-Ag, and nonthyroid antigens, suggesting the presence of recurrent epitopes. Such observations may help explain the multiplicity of thyroid autoantibodies in human thyroid disease and indicate a common defect in immunoregulation. We suggest that cross-reacting epitopes may be important in the derivation of thyroid-specific B-cell clones. PMID- 3558737 TI - [Cerebral circulation and metabolism in senile dementia]. PMID- 3558738 TI - [Investigation on the causes of bone disease in patients with renal disease]. PMID- 3558740 TI - [A comparative study on the prognosis and factors affecting putaminal hemorrhage and thalamic hemorrhage]. PMID- 3558739 TI - [Effect of chemotherapy on natural killer (NK) activity and antibody-dependent cell-mediated cytotoxicity (ADCC) in carcinoma of the lung and metastatic pulmonary tumor]. PMID- 3558741 TI - Spontaneous enhancement of synchronous discharges of pyramidal cells and synchronization of recurrent inhibitions in the kindled hippocampus of the rabbit. PMID- 3558742 TI - D-galactosamine-induced liver injury in mice fed on a diet of different protein content. PMID- 3558743 TI - Cognitive task influence on relative hemispheric motor control: mouth asymmetry and lateral eye movements. AB - While strictly verbal cognitive tasks showed a strong left-hemisphere dominance, the presence of visualization and emotion in cognitive tasks resulted in increased involvement of the right hemisphere in motor control of speech as measured by mouth asymmetry. Spontaneous smiles showed right-hemisphere dominance. Lateral eye movements showed an unexpected shift to left gaze during speech which may suggest a dual task interference between speech and gaze motor control. PMID- 3558745 TI - Evaluation of information-processing speed and neuropsychological functioning in patients with myotonic dystrophy. AB - Patients with myotonic dystrophy (MD) were compared to a control group, matched to the patients in important demographic variables including IQ, on the Sternberg Memory Scanning procedure, to investigate the hypothesis of a selective change in speed of information processing in MD patients. The neuropsychological functioning of these MD patients was also compared to normative data to provide a descriptive picture of their abilities; these results were correlated to the factors of age of onset and duration of the disease. Finally, the MD patients were also compared to the defined control group on the neuropsychological measures. There was little evidence of selective slowness of information processing or particular deficit independent of overall IQ. Neuropsychologically, the MD patients as a group performed at the low average level. There was, however, a wide range of abilities, suggesting that MD patients are not a unitary group in terms of neuropsychological functioning. Age of onset of the disease was important, at least for certain results. Further research of the neuropsychological functioning of MD patients must account for the wide range of results, with more precise measures of actual onset of the disease and muscular weakness, in a longitudinal evaluation. PMID- 3558744 TI - Effectiveness of an attention-training program. AB - Attention Process Training (APT), a hierarchical, multilevel treatment program, was designed to remediate attention deficits in brain-injured persons. The program incorporates current theories in the experimental attention literature. Four brain-injured subjects, varying widely in both etiology of injury and time post onset, underwent intensive cognitive remediation including 5 to 10 weeks of specific attention training. Results are displayed using a single subject multiple baseline across behaviors design. All four subjects demonstrated significant gains in attention following the initiation of attention training. Remediation of another cognitive function (visual processing) was not associated with alterations in attention behavior. The merits of a process-specific approach to cognitive rehabilitation are discussed. PMID- 3558746 TI - Effect of emotional context on bucco-facial apraxia. AB - Patients with left- and right-hemisphere cerebrovascular pathology and normal adult controls were videotaped while executing tasks of bucco-facial praxis in emotional and nonemotional conditions. Each practic movement was assessed for accuracy and motor execution. Left-brain-damaged patients were significantly impaired on these tasks relative to right-damaged patients and controls. When emotional context was provided, apractic performance improved significantly. PMID- 3558747 TI - Experimenters' expectation and subjects' knowledge of hypotheses in simple reaction time to lateralized visual stimuli. AB - Researchers in experimental neuropsychology usually recruit "naive" normal subjects. In this preliminary study, we attempt to consider the role of such a selection. Sixty-four normal, right-handed subjects were enlisted for an experiment on simple reaction times to laterally displayed visual stimuli for which, according to the literature, no cerebral asymmetry is expected. In the course of the experiment, the subjects were "informed" about the hypothesis of the current research. Four subgroups of 16 subjects received four different kinds of information, one for each subgroup; moreover, in each subgroup, half the subjects were examined by an experimenter who hoped to modify the performance and the other half by an experimenter who supposed that information would not affect the behavior of the subjects. The results do not reveal any effect of instructions or experimenters and are discussed to plan future research. PMID- 3558748 TI - Neuropsychological evidence of a factitious memory complaint. AB - The authors describe a patient who complained of a severe memory loss. Information gathered from the history, interview, and testing suggested malingering. The patient was then assessed by a strategy called Symptom Validity Testing. Her score was statistically worse than chance, which provided compelling evidence that she was faking bad. PMID- 3558749 TI - Contralateral visual masking may be an artifact. AB - There are serious methodological problems in studies which report contralateral visual masking. Contralateral masking occurs when detection of a hemifield target stimulus is impaired by a pattern-masking stimulus presented to the opposite hemifield. We demonstrate that, in studies which used positive stimuli (i.e., black letters on a white field), contralateral masking may be an artifact. Although we observed contralateral masking when positive stimuli were presented, there was no evidence of masking with negative stimuli (i.e., white letters on a black field). A special masking stimulus with a positive mask contralateral to the target and a black hemifield ipsilateral to the target also failed to produce masking. Contralateral masking in this experiment was due to the flash of light in the field ipsilateral to the target; it was this ipsilateral stimulation, rather than contralateral interference, which impeded target recognition. PMID- 3558750 TI - Wechsler Intelligence Scale profiles, the cholinergic system, and Alzheimer's disease. AB - Forty-one patients with putative Alzheimer's Disease (AD) were evaluated to determine the diagnostic utility of a profile of Wechsler Adult Intelligence Scale (WAIS) subtests which has been proposed by Fuld (1984) to identify cholinergic dysfunction. Only nine (21.9%) of these patients had positive Wechsler profiles. Half (n = 21) of the AD patients had been given the WAIS, and the other half (n = 20) the Wechsler Adult Intelligence Scale-Revised (WAIS-R). Positive profiles occurred more often in the AD subgroup given the WAIS-R, but this difference was not statistically significant. Specificity of the formula was evaluated using Wechsler results of 42 older normals and 30 patients who were being evaluated for dementia but who did not have AD. One of the 42 normals (2.4%) and five of the patient controls (16.7%) showed a positive Wechsler profile. Because of the Fuld formula's low sensitivity, a negative Wechsler profile cannot be used to help rule out AD. Although specificity of the formula is high, the diagnostic value of a positive Wechsler profile is modest even under the most favorable AD baserate conditions. PMID- 3558751 TI - Frequency of occurrence of a WAIS dementia profile in male head trauma patients. AB - This study investigated Fuld's (1983) contention that a WAIS dementia profile occurs infrequently in conditions other than Alzheimer's Disease. A sample of 50 male head trauma patients was examined for incidence of the profile. The WAIS profile occurred in five cases (10%) of the patients. This compares favourably with the figures reported for patients with multiple infarcts and is consistent with Fuld's position. PMID- 3558752 TI - Central cholinergic deficiency WAIS profiles in a nondemented aged sample. AB - Fuld (1984) described a WAIS profile associated with drug-induced cholinergic deficiency in young adults and dementia of the Alzheimer's type. The frequency of occurrence of this profile was examined in a group of healthy elderly persons who were administered the WAIS. The results of this study suggest that the profile occurs rarely in independently functioning elderly persons, thus lending support to Fuld's findings that the profile may be relatively specific to dementia of the Alzheimer's type. Hypotheses as to the significance of this index of pathology are discussed. PMID- 3558753 TI - Technical aspects and diagnostic problems of direct chromosome analysis using chorionic villus sampling in the first trimester. AB - This paper describes 18 months' experience of direct chromosome analysis applied to villi aspirated during the first trimester, using a catheter inserted trans cervically. A total of 325 biopsy samples were analysed, and there was a diagnostic failure in 6 of these cases (1.8%). An abnormal karyotype was detected in 12 cases (3.8%); three of them were chromosome mosaics not confirmed on amniotic fluid cultures drawn between the 16th and 18th week of gestation. Cytogenetic control was performed on fetal tissues after voluntary abortion. There was a karyotype discrepancy between the placenta and the fetus in two cases out of the 12 mentioned above. PMID- 3558754 TI - Factors leading to tripronucleate eggs during human in-vitro fertilization. AB - Four-hundred-and-ninety-one oocytes were collected from 142 successive patients attending for in-vitro fertilization. The systematic observation of pronuclei between 14 and 18 h after insemination revealed 27 cases of tripronucleate eggs among 391 fertilized eggs (6.9%), which corresponds to rates generally reported in the literature. The following parameters were analysed in relation to the incidence of these eggs: aetiology of infertility, follicular response to hormonal stimulation, type of ovulatory stimulus, sperm count and motility and the incidence of fertilization. Only fertilization rates and concentration of motile spermatozoa in the insemination medium were found to be correlated with tripronucleate eggs, confirming that the condition is predominantly due to polyspermy. Comparisons with data from animals, and measures aimed at preventing polyspermy are suggested. PMID- 3558755 TI - Study of synaptonemal complexes in human semen: results in the first 26 consecutive cases. AB - Synaptonemal complex studies can be carried out in the spermatogenic cells present in the ejaculate. The technique could advantageously avoid the need for a testicular biopsy for synaptic analysis and it is an excellent complement to classical meiotic studies in semen. PMID- 3558756 TI - Selenium in reproductive organs, seminal fluid and serum of men and bulls. AB - The concentrations of selenium in the reproductive organs, seminal fluid and serum of human males and bulls were analysed using an atomic absorption spectrometer with Zeeman background correction. The mean (+/- SD) concentration of selenium in human seminal fluid (33.4 +/- 14.1 micrograms/l, n = 70) was less than half the level detected in serum (78.2 +/- 9.9 micrograms/l, n = 32). In bulls, the mean selenium concentration in seminal fluid (457.4 +/- 108.7 micrograms/l, n = 113) was about nine times higher than in human males, while the level in serum (49.1 +/- 5.1 micrograms/l, n = 94) was significantly (P less than 0.001) lower than in human serum. The selenium concentration (500 +/- 244 micrograms/l) in the bovine seminal vesicle secretions were comparable to those in the seminal fluid and this gland appears to be mainly responsible for the high selenium levels in the seminal fluid. The mean selenium concentration in reproductive tissues of both species was highest in the testes. The distribution of selenium in the bovine epididymis was biphasic. The testicular and epididymal selenium are associated mainly with macromolecules of the spermatogenic cells and spermatozoa. It was concluded that studies in farm and laboratory animals do not necessarily form a reliable basis for conclusions with regard to human male reproduction, since selenium may have a different role and importance in the reproduction of various species. PMID- 3558757 TI - Oxygen concentration gradient across the ovarian follicular epithelium: model, predictions and implications. AB - A mathematical model has been devised for predicting the oxygen concentration gradient across the epithelium of ovarian follicles at pre-antral stages. Most dissolved oxygen entering the follicle by diffusion is evidently consumed in the outer layer of cells; little reaches the oocyte. Even when the rate of consumption or the diffusion coefficient of oxygen was adjusted by an order of magnitude to favour oxygen penetration, the concentration gradient into the follicle remained steep. On the basis of measurements of ovine granulosa cell respiration in vitro, the model predicts that a large pre-antral follicle with a radius of 0.15 mm consumes oxygen at the rate of 0.22 nmol min-1. PMID- 3558758 TI - Dynamics of follicular growth in the human: a model from preliminary results. AB - In the human species, follicle growth is a very long process. The ovulatory follicle originates from a cohort of pre-antral follicles that have differentiated their theca interna 85 days earlier under the control of the high peri-ovulatory steroid and gonadotrophin levels. During growth the number of follicles decreases by atresia under the influence of factors relating to the size of the follicles. Their growth rate is regulated by intra- and extra-ovarian hormonal factors. At the end of the luteal phase, 15-20 days before ovulation, the next ovulatory follicle is recruited among a follicle population of 2-5 mm in diameter. At the beginning of the menstrual cycle it can be distinguished only by its size; a few days later it starts its maturation and exhibits its dominance on the other healthy follicles present in the two ovaries. PMID- 3558759 TI - Volumetric behaviour and survival of mouse zygotes and embryos in hyperosmotic media. AB - Volume changes and survival of mouse zygotes and pre-implantation embryos were studied after their exposure to hyperosmotic media. Transfer of zygotes from culture medium to medium containing 1.5 M DMSO led to a rapid volume reduction to 60% of control values. After 10 min the volume was normal again, illustrating the rapid penetration of DMSO at room temperature. Re-transfer of zygotes equilibrated in 1.5 M DMSO to culture medium in one step doubled the volume. Twelve minutes later normal diameters were observed again. Volume changes were also recorded after transfer to media rendered hypertonic by the addition of NaCl or sucrose. A proportional decrease in volume was noticed up to 1500 mOsmol. A further increase in measured osmolarity up to 3100 mOsmol led only to limited further shrinkage of the zygotes (minimal volume observed was 27% of control volume). Addition of 1.5 M DMSO or 1.5 M propanediol had no influence on the final volume reaction to NaCl and sucrose. Exposure to media with a measured osmotic value of 3200 mOsmol (NaCl added) during 10 min did not prevent further development of the embryos to the hatched blastocyst stage. A solution of 4000 mOsmol proved lethal to nearly all embryos. Addition of 1.5 M DMSO to this medium did not have a protective effect against the osmotic stress at room temperature. PMID- 3558760 TI - Reproductive failure and parental chromosome abnormalities. AB - The effect of ascertaining on estimates of the frequency of parental chromosome abnormalities in couples with a previous history of pregnancy wastage was investigated by comparing three samples which differ in the ascertainment modality but not in the cytogenetical approach. The incidence of chromosome abnormalities was higher in the sample of 441 couples selected essentially on clinical criteria (6%) than in the two samples (659 and 479 couples) selected retrospectively from the files of two cytogenetic laboratories (4.6 and 3.2%). The comparison of these results with similar data, based on large samples reported in the literature, indicated that sample size may be relevant in producing the wide ranges of variation of the frequency of chromosomal abnormalities. Using our data and those from three other samples of greater than 300 couples a reasonable estimate of the overall incidence of chromosomal abnormalities in couples with a previous history of fetal wastage is approximately 5%. PMID- 3558761 TI - Steroid levels in ovarian follicular fluid related to follicle size and health status during the normal menstrual cycle in women. AB - Steroid levels in 308 follicular fluid (FF) aspirates obtained during laparotomy from 116 women with normal ovarian function were related to the size (greater than 1 mm diameter) and health of the aspirated follicles and the phase of the menstrual cycle in which the FF sampling was done. The percentage of granulosa cells (g.c.) in the DNA S phase (S fraction) in each FF aspirate was determined by flow cytometry and used to classify non-pre-ovulatory follicles as healthy or atretic. A significant correlation between g.c. DNA S fraction and concentration of oestradiol (E2) in FF (FF-E2) was found, restricted to non-pre-ovulatory follicles with diameter greater than 6 mm. This evidence supports the notion that E2 acts as a local g.c. mitogen in these follicles, but also indicates that other factors may be required to stimulate g.c. proliferation in the smaller antral follicles (less than or equal to 6 mm diameter). The pattern of steroids in FF of healthy follicles was related to the stage of follicular development, being predominantly 'androgenic' in small follicles (less than or equal to 6 mm diameter), 'oestrogenic' in larger non-pre-ovulatory follicles (greater than 6 mm diameter) and 'progestagenic' in pre-ovulatory follicles. In contrast, atretic follicles of all sizes (2-13 mm diameter) exhibited an 'androgenic' pattern of steroids in FF. The intrafollicular hormonal milieu in the larger healthy non-pre ovulatory and in pre-ovulatory follicles varied as a function of menstrual cycle phase, whereas that in small follicles (healthy as well as atretic) and in larger atretic follicles remained 'androgenic' through all the phases of the cycle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558762 TI - Evaluation of sperm motility by laser--Doppler-spectroscopy in an in-vitro fertilization programme. AB - Laser-Doppler-spectroscopy represents a new, fast and reliable technical method for the assessment of several parameters of sperm motility including the percentage of spermatozoa which are motile, and mean spermatozoal velocity. Serial measurements of these parameters in routine andrological work permit standards for four main spermiogram diagnoses to be established. Laser-Doppler spectroscopy was used to verify alterations in the motility of spermatozoa after capacitation in an in-vitro fertilization programme. An enhancement of 16% for total sperm motility and 36% for mean spermatozoal velocity could be observed. The results of in-vitro fertilization after various spermigram diagnoses, combined with long-term observations of mean spermatozoal velocity, may be considered as another step towards the elucidation of sperm-oocyte interactions. Comparisons between the development of embryos revealed significant differences between normo- and asthenozoospermic men versus oligozoospermic patients. PMID- 3558763 TI - Timing of in-vitro fertilization of cumulus-free and cumulus-enclosed human oocytes. AB - In humans, in contrast to other species, sperm capacitation requires a very short time, as in-vitro fertilization has been obtained after only 45 min of contact between oocytes and spermatozoa capacitated for 1 h. No fertilization occurred, whatever the duration of sperm capacitation, when gamete mixing did not exceed 30 min. On the contrary, 85% of cumulus-free mature oocytes exposed to sperm for 1-4 h were fertilized. The presence of the pre-ovulatory, fully-expanded or compact cumulus mass did not represent a physical barrier to sperm progression, as we observed no delay in fertilization when oocytes were enclosed in the cumulus. The use of a short insemination protocol (1-4 h instead of 17-20 h) did not reduce the fertilization rate of denuded or cumulus-enclosed oocytes and had no significant effect on the morphological appearance of the embryos or their cleavage rates. PMID- 3558764 TI - Chromosome analysis in polyploid human embryos. AB - Cytogenetic investigations have been performed on 436 unfertilized or polyploid human oocytes after in-vitro fertilization at the Department of Obstetrics and Gynaecology, University of Kiel. Thirty-two oocytes had more than two pronuclei 16-20 h after fertilization and were therefore potentially the precursors of polyploid embryos. The total number of fertilized oocytes was 667, and the frequency of tripronucleate ova was 4.8%. These tripronucleate eggs may develop normally up to birth but never lead to viable newborn children. Some of the resulting embryos displayed chromosomal mosaicism, where polyploid karyotypes and normal diploid cells occurred together. It is assumed that the survival rate of polyploid embryos depends upon the percentage of normal diploid cells. PMID- 3558765 TI - Elaboration of a new culture medium for physiological studies on human sperm motility and capacitation. AB - The formulation of a new medium based upon published data on human tubal fluid and blood plasma is described. Sperm motility was well maintained for periods of up to 6 h in this 'synthetic tubal fluid' (STF), and movement characteristics (velocity of progression and amplitude of lateral head displacement) were quantitatively and qualitatively similar to values previously reported for other complex media. STF also supported human sperm capacitation and the spontaneous acrosome reaction as determined using the zona-free hamster egg penetration test. Spermatozoa pre-incubated in STF containing blood plasma levels of taurine (86 microM) for 3 h penetrated significantly more oocytes than parallel sperm populations pre-incubate in STF lacking taurine (P less than 0.001). This difference was no longer significant after 5 h of pre-incubation. These findings indicate a possible role for taurine in human sperm capacitation, and demonstrate the potential value of STF for performing more physiological invitro studies on human sperm function. PMID- 3558766 TI - A comparison between multiple and single pregnancies obtained by in-vitro fertilization. AB - Thirty-eight single and 10 multiple pregnancies obtained after in-vitro fertilization were compared. In the group of multiple gestations, maternal age was lower and the amounts of ovulatory drugs given were significantly smaller than in relation to single pregnancies. All multiple pregnancies arose from triple embryo transfers and the embryos from this group exhibited significantly higher vitality scores. In both groups, plasma levels of oestradiol and progesterone followed the same pattern until day 8 after oocyte retrieval. Following implantation, the secretion of these hormones increased more rapidly in multiple pregnancies pointing at greater luteal activity in this group. HCG levels became significantly higher in multiple gestation on day 25 after oocyte collection. Echographic examination showed that, compared to normal pregnancy, growth in both groups of IVF conceptuses was initially retarded but caught up with normal evolution at approximately 30 days after egg retrieval. The need for adjusting the number of embryos transferred not only to expected success rates but also to the risk of high rank multiples is emphasized. PMID- 3558767 TI - In-vitro fertilization and embryo transfer: a collaborative study of 1163 pregnancies on the incidence and risk factors of ectopic pregnancies. AB - In a multi-centric study undertaken on 1163 pregnancies obtained by in-vitro fertilization, a 5% risk of ectopic pregnancies was observed. This figure is certainly higher than that admitted for natural reproduction. After simultaneous adjusting for all variables in our data by means of a multiple logistic regression technique, two factors have specific influence: the therapeutic use of clomiphene citrate which increased the rate of ectopic pregnancies from 3 to 6% and the number of patent Fallopian tubes with a change in ectopic pregnancies rate from 3 or 4% (with 0 or 2 patent tubes) to 13% (with one patent tube). These results suggest various physiologic hypotheses as well as therapeutic considerations. PMID- 3558768 TI - Reproductive technology and the law in Canada. AB - Even leaving aside the question of the impact of reproductive technology on property law, successions, commercial law and the legal qualification to be given to some of the relationships it entails (e.g. 'deposit' of genetic material, 'lease and hire' of wombs, 'gifts' of embryos), there is no doubt that, like the discovery of the atom, no other scientific advance portends such an enormous potential for human benefits or harm. No other scientific advance will so affect the personal, intimate life of the individual person in its public or private aspects. Beginning then with the positive law (Part I), we will attempt to trace, albeit summarily, possible legal approaches to reproductive technology in Canada and to conclude with an overview of proposed reforms (Part II). PMID- 3558769 TI - Responses to nine questions concerning research on human embryos. PMID- 3558770 TI - Oxytocin in human follicular fluid and its possible role in the ovulatory process as studied in vitro. AB - Oxytocin immunoreactivity was determined in follicular fluid from human follicles at different stages of development. The concentration of oxytocin was highest in pre-ovulatory follicles. The measured oxytocin was found to co-elute with synthetic oxytocin in an h.p.l.c. system. The influence of oxytocin on the incorporation of [3H]proline into isolated human follicular wall was studied in vitro. Oxytocin induced a decrease of radiolabelling in both unripe and pre ovulatory follicles, indicating an inhibitory effect on collagen synthesis. This effect of oxytocin was not affected by indomethacin. An oxytocin analogue, 1 deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-vasotocin, did not inhibit the incorporation of [3H]proline. The pre-ovulatory augmentation of oxytocin concentration in follicular fluid might reflect a physiological role for oxytocin in the ovulatory process. This assumption is strengthened by the observation that oxytocin may influence follicular collagen metabolism in vitro and by this means participate in the regulation of follicular rupture in the human. PMID- 3558771 TI - Human endometrium and menstrual fluid contain placental protein 5 (PP5). AB - Placental protein 5 (PP5), a serine protease inhibitor, was found in the endometrium and menstrual fluid of non-pregnant women. PP5 was present in all 16 endometrial samples taken at various phases of the menstrual cycle. In the secretory phase, the endometrial PP5 content was higher (median 17.4 micrograms/g protein; n = 8) than in the proliferative phase (median 3.8 micrograms/g protein; n = 8). In gel filtration, endometrial tissue homogenates yielded one immunoreactive peak corresponding to a mol. wt of 28,000 daltons, whereas placental PP5 eluted at 32,000 daltons. In sodium dodecyl sulphate polyacrylamide gel electrophoresis, endometrial PP5 comigrated with purified placental PP5 corresponding to a mol. wt of 30,000 daltons. All menstrual fluid samples (n = 14) contained immunoreactive PP5 at concentrations from 77 to 1150 micrograms/l. The mol. wt of menstrual fluid PP5-immunoreactivity was 13,000 daltons. The dose response curves of purified PP5 standard and endometrial and menstrual fluid PP5 were parallel in the PP5 radioimmunoassay. The higher concentration of PP5 in secretory endometrium indicates association of PP5 with endocrine events of the menstrual cycle. PMID- 3558772 TI - Early luteal function following danazol therapy for endometriosis. AB - The luteal phase of 20 infertile women with endometriosis who were treated with danazol (600 mg daily for 6 months) was studied by basal body temperature, plasma progesterone (P), oestradiol (E2) and prolactin (PRL) determination, and endometrial biopsy, in any one of the first three cycles after discontinuation of danazol. All endometrial specimens were noted to be fundal samples and were clearly progestational after danazol therapy. Abnormal secretory phases were detected in three patients, as in the pre-danazol control cycles. Moreover, plasma levels of P, E2 and PRL in post-danazol cycles were similar to those found in control cycles and fell within the normal range in all cases except for one patient having hyperprolactinaemia. In conclusion, our study shows that endometrial inadequacy is not the cause of the increased fetal wastage previously reported among proximally conceived pregnancies after danazol therapy for endometriosis. PMID- 3558773 TI - Standardization and quality control of sperm concentration and sperm motility counts in semen analysis. AB - The paper reports a study of standardization and quality control of sperm concentration counts and visual motility assessments in human semen analyses performed for infertility investigations and from internal quality control procedures. Sperm concentration determinations were performed in Improved Neubauer haemocytometers on volumetric dilutions made using a positive displacement pipettor for sampling the liquefied semen. In addition to a standard 1 + 19 dilution a second dilution of either 1 + 9, 1 + 19 or 1 + 49 was made according to whether the estimated sperm concentration was less than 20, 20-100 or greater than 100 X 10(6)/ml respectively. The duplicate determinations of sperm concentration were highly significantly correlated (P much less than 0.001) with less than 5% variability. Parallel visual sperm motility assessments were made by two pairs of technicians and showed highly significant correlations (P much less than 0.001) between technicians in the determination of the percentages of motile and progressive spermatozoa as well as the subjective rating of sperm progressivity. When these values were incorporated into a calculated motility index which gave added weight to the progressive spermatozoa and to their quality of progression the correlations between technicians remained highly significant (P much less than 0.001) with average differences of the order of 1.0%. Therefore, provided that sufficient attention is paid to technician training, regular standardization checks and the use of only proven reliable procedures, quantitatively accurate values for sperm concentration and motility can be obtained in routine semen analyses. PMID- 3558774 TI - Association of the in-vitro fertilizing capacity of human spermatozoa with sperm morphology as assessed by three classification systems. AB - Stained sperm morphology slides from an in-vitro fertilization programme were evaluated by the modified Williams system, the World Health Organization (WHO) system and morphometric size measurements (image analysis) to determine which system(s) were better predictors of fertility. Amorphous sperm head shape was the best predictor of fertility in both the modified Williams system and the WHO system, predicting the proper fertility status in 65% of the cases. Using only normal sperm in the statistical model, normal sperm became a correct predictor in 66% of the cases in the modified Williams system. Morphometric measurements were not useful in predicting the fertility status of these samples. These studies indicate that morphology can not be used as a sole predictor of fertilizing capacity of human spermatozoa. PMID- 3558776 TI - Purification of human secretory pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG) from cytosol of first trimester pregnancy endometrium. AB - Pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG), the major secretory protein as assessed by in-vitro synthesis and secretion by the endometrium during the luteal phase of the menstrual cycle and early first trimester of pregnancy, has been purified from the cytosolic fraction of pregnancy endometrium. The purification schedule involved anion exchange chromatography (DE52), gel filtration (Sephacryl S-200), concanavalin A Sepharose, chromatofocusing and negative immunoaffinity chromatography. On anion exchange chromatography alpha 2-PEG eluted at 0.11 M NaCl, on Sephacryl S-200 with an apparent Mr of 56 K, it bound to concanavalin A and eluted from a chromatofocusing column at a pH of 4.6. alpha 2-PEG was isolated with 98% purity, as assessed by one-dimensional sodium dodecyl sulphate (SDS)-gradient polyacrylamide gel electrophoresis (subunit Mr under reducing conditions 28 K), and a yield of 0.11 mg per g wet weight tissue. This purified alpha 2-PEG should enable in-vitro assessment of the function of this unique protein in implantation and pregnancy and provide antigenic material for the development of a radioimmunoassay. PMID- 3558775 TI - Successful in-vitro fertilization of frozen-thawed rabbit oocytes. AB - The objective of this study was to evaluate the capacity of frozen-thawed rabbit oocytes to be fertilized in vitro. After superovulation with FSH a total of 1040 oocytes was obtained by puncturing the follicles 6 or 9 h after the injection of LH or by flushing the oviducts 12 h after LH application. 1.5 M dimethylsulphoxide (DMSO) was used as cryoprotective agent and the oocytes were transferred into 0.25 ml French straws and cooled in a methanol bath to -30 degrees C and transferred to liquid nitrogen. After 1-14 days of storage the oocytes were thawed rapidly in a 15 degrees C water bath and DMSO was diluted in a stepwise manner. Subsequently the oocytes were cultured in Ham's F-10 + 10% fetal calf serum at 37 degrees C and 5% CO2 for 14, 7 and 4 h according to the time of oocyte collection. The survival rates of the oocytes based on morphological criteria were 5.4, 20.0 and 28.8%, respectively. For chromosomal analysis, morphologically intact frozen-thawed oocytes were fixed and stained using the technique described by Tarkowski. In 44 successful chromosomal preparations, 2 of 2, 10 of 19 and 22 of 23 preparations of oocytes collected 6, 9 and 12 h after LH application were in metaphase-II, respectively. Furthermore, the viability of the oocytes was also examined by using fluorescein diacetate. Out of 52 morphologically intact oocytes, 50 showed a positive intracellular fluorescence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558777 TI - Current status of first trimester fetal diagnosis of genetic diseases. PMID- 3558778 TI - Detection of syncytiotrophoblast in maternal peripheral and uterine veins using a monoclonal antibody and flow cytometry. AB - Using a monoclonal antibody (H315) and cytofluorimetry, the presence of deported syncytiotrophoblast was investigated in blood samples collected from peripheral and uterine veins at the time of elective Caesarean sections. In all 10 women studied, a higher incidence of H315-positive syncytiotrophoblast cells was detected in the uterine samples than in peripheral blood, thus confirming that in normal pregnancies a large number of cells are shed from the placenta and gain access into the maternal circulation at the time of delivery. PMID- 3558779 TI - Hydatidiform mole: a chromosomal search for a recessive mutation. AB - In a search for minute structural aberrations indicating chromosomal regions of importance for the development of a hydatidiform mole, five diploid androgenetic moles and two partial dispermic moles were examined by high resolution banding technique. The absence of consistent aberrations suggests that either submicroscopical lesion(s) or the ratio of paternal to maternal chromosome complement(s) could be the decisive factor for molar development. PMID- 3558780 TI - Early fetal losses related to maternal age in year to year intervals. PMID- 3558781 TI - Smoking and in-vitro fertilization. AB - One-hundred and fourteen patients who underwent IVF treatment were asked about their smoking habits. Their rhodanide (SCN) concentrations were then estimated in serum and follicular fluid. SCN has been identified as an indicator for the amount of cigarettes smoked. The IVF outcome of non-smokers was compared with that of the smokers and no significant differences of fertilization rate and pregnancy rate between the two groups were found, but the SCN concentrations in serum and follicular fluid were increased in smokers (P less than 0.05). The effect of cigarette smoke toxins was perhaps not observable because other factors influencing the IVF treatment could possibly overlap with the influence of these particular toxins. PMID- 3558782 TI - Neuropeptide Y and noradrenaline in human uterus and myometrium during normal and pre-eclamptic pregnancy. AB - The myometrial levels of noradrenaline (NA) and neuropeptide Y (NPY), a recently discovered neuropeptide that coexists with NA in many sympathetic nerves, have been measured by immunohistochemistry and biochemistry in normal and pre eclamptic pregnancy and compared with non-pregnant controls. In the non-pregnant uterus there were high levels of NA and NPY and a rich presence of NA/NPY nerves in the myometrium and around blood vessels. In pregnancy both substances were significantly lower as compared with non-pregnant women. Five patients with pre eclampsia had levels of NA/NPY that were less markedly reduced than in normal pregnant women. The results show that NA and NPY coexist also in human uterine nerves, and that both decrease significantly during pregnancy. Since both substances are vasoactive, the observed reduction might be of physiological importance for normal pregnancy. PMID- 3558783 TI - Within-subject variability of the percentage of morphologically abnormal spermatozoa among fertile men: biological and measurement components. AB - Two groups of men were studied to determine how much an individual's spermatozoal morphology varies and which part of the variability is due to biological and to measurement variation. A first group of ten subjects each provided five ejaculates; the other group of four subjects each provided one ejaculate, from each of which five smears were prepared, and evaluated twice. The slides were examined in random order and blindly by the same experienced technician. The total within-subject variability of the percentage of abnormal forms was large (SD = 8.8%), as was the component of this variability due to biologic fluctuation (SD = 5.8%). The distribution of the various abnormalities also varied greatly from one ejaculate to another. The results indicate that more work is needed to determine why biological variation exists, and that several ejaculates (three if possible, two at minimum) are needed for an accurate evaluation of spermatozoal morphology, whereas the examination of greater than 100 spermatozoa/ejaculate is not advantageous. PMID- 3558784 TI - Inherent fragility of zona pellucida in certain patients included in an in-vitro fertilization programme. AB - OOcytes with a fractured zona pellucida were previously reported to occur with a 16% frequency when follicle puncture was carried out using a 20-ml syringe. This paper demonstrates a high rate of recurrence of fractured zonae in certain patients included in an in-vitro fertilization programme. We hypothesize an inherent zona fragility affecting these patients. PMID- 3558785 TI - Pregnancies following transfer of human frozen--thawed embryos in Colombia, South America. AB - The surplus of fresh embryos obtained at our laboratory within the in-vitro fertilization programme led us to implement human embryo freezing--thawing techniques from August, 1985. Thus far, 20 freezing cycles (45 embryos) have been carried out using this method. Two fast-freezing techniques were used and one fast-thawing method in 1 M sucrose. In the first freezing technique, dimethyl sulphoxide (DMSO; 1.5 M) was added in a step-wise fashion and seeding was done directly on the embryo compartment. In the second, DMSO (1.5 M) was added in one step and seeding was carried out away from the embryo compartment. In both techniques, embryos were stored in 0.25-ml plastic straws in phosphate-buffered saline (PBS) containing 15% maternal serum. Embryos were replaced during the natural cycle, 48-50 h following the LH peak. Three pregnancies were obtained from six transfer cycles. Both freezing techniques were successful, but stepwise addition of DMSO and seeding the embryo compartment directly appeared to be more successful. One pregnancy was a pre-clinical abortion, the second a clinical abortion at 8 weeks, and the third is ongoing at 19 weeks. These are the first pregnancies in the American continent achieved with frozen embryos. PMID- 3558786 TI - Animal models: their use and limitations in long-term safety evaluation of fertility-regulating agents. AB - Animal studies are usually to predict the value of new compounds and to assess their incorporation into schemes to reduce or clarify recognized hazards. There are two assumptions, that animal models are appropriate and dose-response relationship can be derived. Such tests cannot provide definite evidence about the safety of such medical agents in man. Examples are given of data arising from studies of progestogens or oestrogens in animals in relation to clinical conditions. The scientific quality of these tests depends on the adequacy of an appropriate design, competent staff and a correct evaluation of the results. PMID- 3558787 TI - Pre-clinical evaluation of contraceptive steroids: regulatory requirements and scientific expectations. AB - The development of new contraceptive steroids placed great pressures on regulatory agencies. There was insufficient time to develop a novel pre-clinical safety evaluation, hence their toxicity in animals was assessed as with other drugs. The approach of regulatory agencies to toxicity and carcinogenicity testing of these steroids are discussed and evaluated. PMID- 3558788 TI - The practising lawyer's view of in-vitro fertilization. AB - Legal aspects of the in-vitro fertilization of human eggs are discussed by a practising solicitor involved in opening a private clinic. The nature of legal contracts, research protocols and consent forms for patients are discussed. The rights of the embryo are considered in relation to the patient, freezing and research. PMID- 3558789 TI - Legal aspects of freezing and filiation in in-vitro fertilization. AB - The legal rights of embryos are discussed by an academic lawyer. Medical liability in relation to in-vitro fertilization, oocyte donation and surrogacy and embryo stage are considered. The status of the human embryo is considered, including French law on embryonic rights. Embryo research and its donation are debated, and potential conflicts in relation to the laws of torts and contracts are discussed. PMID- 3558790 TI - Production and characterization of high titer antibodies to galactocerebroside. AB - High titer antibodies primarily of the IgG class were produced against galactocerebroside (GalC) by including keyhole limpet hemocyanin (KLH) and supplemental M. tuberculosis in the adjuvant mixture used for immunization of rabbits. Antibody titers were determined by an ELISA in which microtiter wells were coated with liposomes containing lecithin, cholesterol and GalC. The antibodies showed reactivity with GalC and psychosine, but not glucocerebroside, sulfatide, mixed gangliosides or asialo GM1. Specificity was further demonstrated by absorption of antibodies with GalC. Binding was inhibited by galactose, but only at high concentrations. Further, the antibodies did not bind to any brain proteins on immunoblots, indicating lack of reactivity with glycoproteins which might contain a terminal galactose. Antibodies to GalC are directed against different determinants than those reacting with peanut agglutinin since the lectin will not react with GalC, and the antibodies will not react with asialo GM1. The antibodies raised to GalC by this method show specific staining for oligodendroglia in culture. Peanut agglutinin binds intensely to process-bearing GalC+ oligodendroglia, but very poorly to the membrane sheets elaborated by oligodendroglia after longer times in culture. Other process-bearing GalC-, GFAP- cells were also stained with peanut agglutinin; these cells may represent glial precursors. PMID- 3558791 TI - Limb lengthening by callus distraction (callotasis). AB - Callotasis is a new technique of limb lengthening involving slow distraction of the callus formed in response to a proximal submetaphyseal corticotomy. Using a dynamic axial fixator with telescoping capabilities, distraction begins after 2 weeks. When the required length is attained, the fixator is held in the rigid mode until radiographic evidence of callus is observed. The locking screw is then released, and dynamic axial loading is instituted to promote corticalization. One hundred bony segments have been lengthened; 50 patients had limb length inequality, and 23 had achondroplasia. The mean lengthening achieved was 22% (maximum, 58%). There were 14 complications (14%). PMID- 3558792 TI - Tibial lengthening according to Ilizarov in congenital hypoplasia of the leg. AB - Thirteen patients with leg length discrepancy due to congenital tibial hypoplasia were treated by the Ilizarov lengthening method. Advantages and disadvantages as compared with the Wagner and Anderson methods are reported, as well as with complications and results. PMID- 3558793 TI - Early semiclosed intramedullary stabilization in osteogenesis imperfecta. AB - Fourteen patients with severe osteogenesis imperfecta (OI) were treated operatively by closed or semiclosed intramedullary stabilization, with nonextensible rods and nails. Altogether, 55 bones (both upper and lower limbs) were stabilized primarily. In infants with a severe form of OI (Sillence classification), the operative technique was modified significantly from those presented earlier in the literature. Early intramedullary stabilization, even soon after birth, seems justified in selected patients with severe OI. The possibilities for motor development are improved and later insertion of telescoping nails becomes easier. PMID- 3558794 TI - Surgery in residual clubfoot: one-stage medioposterior release "a la carte". AB - A series of 142 clubfeet in 113 children were treated by a one-stage medioposterior release for deformity persisting after vigorous physical therapy. The talonavicular joint and hindfoot are released to achieve correct alignment. Long-term good results were seen in 73% of the entire series and in 87% of the idiopathic subgroup. PMID- 3558795 TI - An analysis of the results of a modified one-stage posteromedial release (Turco operation) for the treatment of clubfoot. AB - Between 1971 and 1977, posteromedial release was performed on 47 feet of 30 children 9 months to 4 years of age. At review, full correction of equinus was achieved in 98%, heel varus in 91%, and cavus in 85%, but in only 50% of feet with forefoot adduction. Between 1978 and 1982, surgery was performed on 22 feet of 18 children 3-10 months of age. Recessions of the abductor hallucis and short plantar muscles and fascia were also performed at operation. Correction of equinus, heel varus, and cavus demonstrated results similar to those of the earlier group, but forefoot adduction was also satisfactorily corrected in 91% of feet. PMID- 3558796 TI - Pseudarthrosis following treatment of idiopathic scoliosis by Harrington instrumentation and fusion without added bone. AB - A retrospective review was conducted to assess the incidence of pseudarthrosis among 381 patients who had surgical treatment of idiopathic scoliosis by Harrington distraction rod and posterior fusion without added bone. In 260 patients where the lowest level of fusion was at or above the third lumbar vertebra, there were no cases of pseudarthrosis. In the remaining 121 patients with fusion extending below the third lumbar level, there were eight cases, an incidence of 6.6%, for an overall incidence of 2.5%. PMID- 3558797 TI - Assessment of bony bridge by computed tomography: experimental model in the rabbit and clinical application. AB - A bony bridge was created in the growth plates of young rabbits. Weekly computed tomography (CT) scanning was done in the axial (transverse) plane for 3 weeks. Transverse histological sections from the plate area were examined after 3 weeks. The CT image showed the exact location and extent of the sclerotic bony bridge. The area of the bony bridge as a percentage of the plate was measured from the CT image. Good correlation was found between the CT image and the histological section. This technique has been applied to children, and three such examples show accurate assessment of the growth plate. PMID- 3558798 TI - Physeal bridge resection in infantile Blount disease. AB - Physeal bridge resection and osteotomy were used in the treatment of three cases of Stage VI Blount disease. At follow-up, all patients showed continued growth of the proximal tibial physis, as well as maintenance of alignment. Bridge resection with realignment osteotomy offers an attractive alternative in the treatment of skeletally immature patients with Blount disease and a medial physeal bridge. PMID- 3558799 TI - Magnetic resonance imaging in the diagnosis of childhood discitis. AB - Diagnosis of disc space infection in childhood is often delayed and is usually made on the basis of multiple roentgenographic, laboratory, and nuclear imaging studies. Four cases of septic discitis in children are described. Special emphasis is placed on the diagnostic findings with magnetic resonance imaging. Magnetic resonance sensitivity for this entity and its role in comparison with other imaging modalities are discussed. PMID- 3558800 TI - Trabecular bone mineral density in idiopathic scoliosis. AB - The association of idiopathic scoliosis with an osteoporotic state has been indicated previously. The present study compared the trabecular bone mineral densities of 44 adolescent idiopathic scoliotic girls with 44 age-, weight-, sex , and race-matched controls. Their lumbar spine and femoral neck bone mineral densities were evaluated using dual-photon absorptiometry. Radiographs and scoliotic curve data were also obtained for the experimental group. The scoliotic subjects exhibited significantly lower lumbar and femoral neck bone mineral densities than the control subjects. No effect was found with respect to treatment, degree, or progression of curvature. The results of this study indicate that there is a generalized state of osteoporosis in idiopathic scoliotic girls when compared with matched controls. PMID- 3558801 TI - Spine deformity in familial dysautonomia (Riley-Day syndrome). AB - Familial dysautonomia spanning a 30-year period reviewed retrospectively. The 16 patients identified included nine with spine deformities. Serious general medical problems were common. Spine deformities included kyphosis, scoliosis, or a combination of both. Brace treatment was attempted and was unsuccessful in three patients. Seven underwent surgical stabilization. Although all seven patients tolerated the surgical procedures, at least one postoperative complication was noted in each case. Follow-up ranged from 1 1/2 to 16 1/2 years. We recommend close observation of the deformities, early stabilization when disorders are progressive, and a high level of awareness of potential complications. PMID- 3558802 TI - The likelihood of injuries when children fall out of bed. AB - Between 1980 and 1985, 76 children from birth to 16 years of age were reported to have fallen out of a bed, crib, or chair while in our hospital; 75% of the incidents occurred in children from birth to 5 years of age. The height of falls ranged from 1 to 3 ft. Most of the injuries were minor (scalp hematoma and facial lacerations). Our data indicate that severe head, neck, spine, and extremity injuries are extremely rare when children fall out of hospital beds. Child abuse should be suspected and ruled out when a child is seen with severe injury from a reported "fall at home." PMID- 3558803 TI - Gastroesophageal evaluation in totally involved cerebral palsy patients. AB - Fifty-two nonambulatory totally-involved cerebral palsy patients with spinal deformity who had barium swallow examinations of their gastroesophageal tract as part of their preoperative evaluation were retrospectively reviewed. Thirty-six patients (69%) were identified with abnormalities of their swallowing mechanism. Subnormal nutritional indices were identified as well in 41 patients (79%). Ten of 38 patients undergoing spinal surgery developed significant postoperative complications. Nine of the 10 complications occurred in patients in whom gastroesophageal or nutritional abnormalities were identified but not addressed before spinal surgery. We recommend gastroesophageal and nutritional evaluation of all patients with cerebral palsy before spinal surgery. PMID- 3558804 TI - The Vulpius procedure for correction of equinus deformity in cerebral palsy. AB - Seventy-nine Vulpius procedures were performed on 47 patients with equinus contractures. There were three recurrences, three cases of overlengthening, and no painful or hypertropic scars. All patients functioned at the same or a higher level after the procedure. PMID- 3558805 TI - Congenital dislocation of the knee. AB - Twenty-three congenital knee dislocations in 17 patients were reviewed after an average follow-up of 11 years. There was a 30% incidence of breech delivery along with a 41% incidence of clubfoot. Treatment in serial casts was successful in 10 knees; 13 required operations. Prognosis was most favorable in unilateral cases and when surgery was performed before 2 years of age. Quadriceps lengthening during knee surgery facilitated the subsequent reduction of ipsilateral dislocated hip. PMID- 3558806 TI - Eastern massasauga rattlesnake bites. AB - The Eastern massasauga rattlesnake is native to many Midwestern states. Although this rattlesnake is smaller in size than many other pit vipers, envenomation can still produce significant morbidity, particularly in children. Children bitten by Eastern massasauga rattlesnakes appear to do well with treatment programs consisting primarily of antivenom and blood component replacement. PMID- 3558807 TI - The chondroepitrochlearis muscle. AB - The chondroepitrochlearis is a rare muscle anomaly of the pectoral region in the human. The anomaly is an abnormal musculotendinous unit that is found to originate from the pectoralis major and inserts onto the medial epicondyle of the humerus. This muscle, at times, can be associated with the muscular arch of the axilla and can not be mistaken for the rare coracobrachialis longus. The authors are reporting a 2-week-old infant of normal gestational age with this exceedingly rare anomaly and the only known reported successful surgical release of this muscle with return to normal functional status and cosmetic improvement. PMID- 3558808 TI - Acquired spondylolysis after posterolateral spinal fusion. AB - A case of spondylolysis occurring immediately above a posterolateral lumbar spinal fusion in a 12-year-old girl is described. This case illustrates a potential problem of stress concentration at the pars interarticularis, previously only described after posterior interlaminar fusion. PMID- 3558809 TI - Congenital annular constricting bands: review of the literature and a case report. AB - Conditions associated with congenital annular constricting bands include autoamputation, acrosyndactyly of the hands and toes, clubfeet, lymphedema, pseud arthrosis, and nail deformities. The association of congenital annular constricting bands and angular deformities of long bones is exceedingly rare. Reported is one such case treated with fibrous release and crescentic osteotomy. PMID- 3558810 TI - Primary actinomycosis of the quadriceps. AB - Primary actinomycosis of the musculoskeletal system is an unusual occurrence. We report the case of a 14-year-old boy with isolated actinomycosis of the quadriceps. Surgical drainage followed by 6 weeks of treatment with oral tetracycline yielded a good result. PMID- 3558811 TI - Bifurcated femur with a normal tibia and fibula. AB - Bifurcation of the distal femur is not a common anomaly; there have been only 27 cases of bifurcated femur with tibial hemimelia reported in the literature. This is the first report of a bifurcated femur associated with a normal tibia, fibula, ankle, and foot. PMID- 3558812 TI - Infantile-onset arthritis and multisystem inflammatory disease: "a new syndrome". AB - A case is presented with early-onset polyarthritis involving both large and small joints, prolonged fever, skin rash, hepatosplenomegaly, persistent cerebro-spinal fluid pleocytosis, brain atrophy, macrocephaly with ventricular dilatation, a persistently open fontanelle, lymphadenopathy, subcutaneous nodules, developmental delay, failure to thrive, persistent hypochromic microcytic anemia, leukocytosis with shift to the left, early thrombocytopenia followed by thrombocytosis, high erythrocyte sedimentation rate, elevated immunoglobulin level, and vasculitis involving several organs. Thirteen cases have been previously reported under different names. A unified name is needed; we suggest "infantile-onset arthritis and multisystem inflammatory disease." PMID- 3558813 TI - Simple bone cyst with growth arrest. PMID- 3558814 TI - Apical membrane chloride/base exchange in the rat proximal convoluted tubule. AB - To examine whether Cl/base exchange is present on the apical membrane of the proximal convoluted tubule, cell pH was measured fluorometrically in the in vivo microperfused rat proximal tubule with (2',7')-bis(carboxyethyl)-(5,6) carboxyfluorescein. The effect of luminal chloride addition was examined in tubules perfused symmetrically with chloride-free solutions. In the absence of inhibitors, luminal chloride addition did not affect cell pH. However, after inhibition of basolateral membrane anion transport with peritubular 4-acetamido 4'-isothiocyano-(2,2')-disulfonic-stilbene (to amplify effects of apical membrane transport on cell pH), luminal chloride addition caused a small cell acidification (delta pHi = 0.02). When 1 mM formate was added to the solutions, luminal chloride addition caused a larger change in cell pH (delta pHi = 0.06) that was inhibited by (4,4')-diisothiocyano-(2,2')-disulfonic-stilbene. This stimulation of Cl/base exchange was not seen with 1 mM acetate addition. These results demonstrate apical membrane Cl/base exchange, a significant fraction of which is dependent on the presence of formate and probably represents Cl/formate exchange. PMID- 3558815 TI - Transketolase abnormality in cultured fibroblasts from familial chronic alcoholic men and their male offspring. AB - We have investigated a thiamine-dependent enzyme, transketolase, in cultured fibroblasts from 41 human subjects, including patients with alcoholism-associated Wernicke-Korsakoff syndrome (n = 3), familial chronic alcoholic males (n = 7), their sons (n = 7), nonalcoholic men (n = 7), their male offspring (n = 7), and three generations of an Amish family (n = 10) without any history of alcoholism. This study was undertaken to delineate whether transketolase abnormality (i.e., high Michaelis Menton constant (Km) for thiamine pyrophosphate), previously reported in patients with Wernicke-Korsakoff syndrome is prevalent among familial chronic alcoholic men and their sons without prior history of alcohol abuse but who are at high risk for alcoholism. Our data suggest that an inborn error (i.e., high Km of transketolase for thiamine pyrophosphate) predisposing to thiamine deficiency diseases similar to those reported in Wernicke-Korsakoff syndrome may occur in the general population. However, for some as yet unexplained reason(s) this variant seems to occur more frequently among familial chronic alcoholic men and their male offspring without any history of alcoholism. The inheritance pattern of this enzyme variant as revealed from an Amish pedigree study may be autosomal recessive as previously suggested. PMID- 3558816 TI - High frequency of autoantibodies bearing cross-reactive idiotopes among hybridomas using VH7183 genes prepared from normal and autoimmune murine strains. AB - Hybridomas obtained by in vitro stimulation with lipopolysaccharides (LPS) of BALB/c, MRL/lpr, and NZB splenocytes were selected for expression of VH7183 by hybridization using slot blotting. Northern blot analysis showed that the majority of hybrids produce a full length message complementary to the VH7183 probe. The frequency of VH7183 hybridomas was significantly higher in NZB mice as compared with BALB/c mice. Using multiple binding assays, 60% of the total antibodies encoded by VH7183 were specific for self-epitopes. Finally, the vast majority express cross-reactive idiotypes borne by autoantibodies of various specificities. PMID- 3558817 TI - Increased sensitivity of gastric acid secretion to gastrin in cirrhotic patients with portacaval shunt. AB - We studied acid secretory responses to exogenous pentagastrin and to exogenous and endogenous gastrin in 12 stable cirrhotic subjects with portacaval shunt, 12 unshunted cirrhotics, and 12 normal subjects. Basal and stimulated serum gastrin concentrations as well as basal and maximum acid outputs were similar in the three groups. At low doses of either exogenous pentagastrin or gastrin-17 (G17), cirrhotics with portacaval shunt secreted significantly greater amounts of gastric acid than unshunted subjects. After low doses of intragastric peptone, cirrhotics with portacaval shunt secreted significantly more acid than unshunted cirrhotics and normal subjects. At each measured serum gastrin concentration after either exogenous G17 or intragastric peptone meals, cirrhotics with portacaval shunt secreted more acid than the unshunted control groups and their dose-response curve was significantly shifted to the left. Thus, in cirrhotic patients with portacaval shunt, gastric acid secretion is abnormally sensitive to both exogenously administered or endogenously released gastrin. PMID- 3558818 TI - In vivo regulation of human mononuclear leukocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase. Studies in normal subjects. AB - In vivo regulation of microsomal HMG CoA reductase activity was investigated in freshly isolated mononuclear leukocytes from 26 healthy adult males. Reductase activity exhibited a diurnal rhythm and decreased during fasting. Enzyme activity was also modulated in vivo by alterations in dietary and plasma cholesterol, suggesting the existence of an operative cholesterol feedback regulatory system. A single, high cholesterol meal decreased reductase activity within 2 h. In addition, rapid depletion of circulating cholesterol levels by plasmapheresis led to an approximately twofold elevation in enzyme activity within 90 min of treatment. Finally, reductase activity was inhibited by dichloroacetate, a compound known to lower plasma cholesterol in man and inhibit the human leukocyte enzyme in vitro. The regulatory mechanisms controlling HMG CoA reductase activity in the human mononuclear leukocyte in vivo thus are similar to those that modulate the mammalian liver enzyme in vivo. Assessment of mononuclear leukocyte reductase activity may provide insight into the in vivo regulation of human cholesterol metabolism. PMID- 3558819 TI - Degradation of dipalmitoyl phosphatidylcholine by isolated rat granular pneumocytes and reutilization for surfactant synthesis. AB - We investigated metabolic utilization of exogenous (modelled after lung surfactant) phospholipids by granular pneumocytes in primary culture. Cells were incubated for 21, 65, and 140 min with [3H-methyl]dipalmitoylphosphatidylcholine (DPPC) containing liposomes prepared from synthetic lipids. Radioactivity in cellular phosphatidylcholine (PC) declined steadily to 50% of the total trypsin resistant cell-associated radioactivity. The proportion of radioactivity increased with time in cytidine-5'-diphosphate-choline and phosphorylcholine, which suggested reutilization of choline for PC synthesis. Cells incubated with liposomes for 2 h revealed that of the total cell-associated radioactivity, 7% was in lamellar bodies and 10% in the microsomal fraction. The lipid-associated radioactivity was 24% in "soluble," 96% in lamellar bodies, and 92% in the microsomal fraction. Percent of total PC label recovered in disaturated PC of microsomal fractions decreased (slope = -5.27%/h) with time of incubation (r = 0.67). Incubation of cells with liposomes containing ([3H-methyl]choline [14C]palmitoyl) DPPC led to altered isotope ratios in both lamellar bodies and microsomes. These observations indicate that granular pneumocytes degrade exogenous PC and resynthesize PC from degradation products. PMID- 3558820 TI - Hepatic disposition and biliary excretion of bilirubin and bilirubin glucuronides in intact rats. Differential processing of pigments derived from intra- and extrahepatic sources. AB - Mechanisms for transport of bilirubin and its conjugates in hepatocytes have not been defined. We investigated the hepatic processing of bilirubin glucuronides and their precursors, and characterized the disposition of bile pigments arising from intraversus extrahepatic sources. Tracer doses of purified radiolabeled biliverdin, bilirubin, bilirubin monoglucuronide (BMG) or diglucuronide (BDG) were administered intravenously to intact normal or jaundiced homozygous Gunn rats. Rapid sequential analysis of radiolabeled BMG and BDG in bile revealed comparable excretion patterns following biliverdin and bilirubin injection, with BDG as the major pigment. Biliary excretion of radiolabeled conjugates from injected BMG was more rapid, with BMG predominating. Excretion of injected BDG in normal rats and BMG or BDG in Gunn rats was virtually identical to that of unaltered BMG in normal rats. Model independent analysis by deconvolution provided objective comparison of the disposition of radiolabeled pigments from the different sources. These findings indicate that bilirubin glucuronides formed in the liver from endogenous (hepatic) and exogenous (extrahepatic) sources of bilirubin follow a similar excretory pathway. BMG formed endogenously is converted preferentially to BDG, whereas circulating BMG is excreted predominantly unchanged. Exogenous conjugated bilirubins are excreted more rapidly than those generated intrahepatically, by a transcellular pathway that is largely independent of the conjugation system. PMID- 3558821 TI - Impact of physical training on the ultrastructure of midthigh muscle in normal subjects and in patients treated with glucocorticoids. AB - Exercise-training might be a logical method to reverse muscle atrophy and weakness in patients treated with glucocorticoids. The purpose of the present investigation was to establish whether a treatment with low dose prednisone (10 +/- 2.9 mg/d) modulates the effect of a moderate strength type isokinetic training during 7 wk (21 sessions of 20 min) on "muscle efficiency" (power output/muscle mass) and on concomitant changes in ultrastructure of the thigh muscle measured by quantitative electron-microscopic morphometry. Training caused a similar increase in "muscle efficiency" in patients on prednisone (n = 9) as in normal volunteers (n = 9). In normal subjects the increase in muscle efficiency was associated with an increase in sarcoplasm, whereas in patients on prednisone the functional improvement was associated with an increase in sarcoplasm, capillaries, and mitochondria content. Thus, a therapy with low dose prednisone does not abrogate training-induced improvement of muscle efficiency but modulates the ultrastructural response of the muscle to the training. PMID- 3558822 TI - Accelerated transfer of cholesteryl esters in dyslipidemic plasma. Role of cholesteryl ester transfer protein. AB - Plasma cholesteryl esters, synthesized in the high density lipoproteins (HDL), may be transferred to other lipoproteins by a cholesteryl ester transfer protein (CETP). We found a twofold increase in mass transfer of cholesteryl ester from HDL to apoB-containing lipoproteins in incubated hypercholesterolemic rabbit plasma compared with control. There was a two- to fourfold increase in the activity of CETP, measured in an isotopic assay in hypercholesterolemic plasma. A CETP-like molecule was isolated in increased amounts from hypercholesterolemic plasma. Incubated plasma from four dysbetalipoproteinemic subjects also showed an increase (threefold) in cholesteryl ester mass transfer, compared with normolipidemic controls. There was a twofold increase in the activity of CETP, assayed in whole or lipoprotein-free plasma. Thus, there is increased transfer of cholesteryl esters from HDL to potentially atherogenic apoB-containing lipoproteins in dyslipidemic rabbit and human plasma. The enhanced transfer results in part from increased activity of CETP, possibly reflecting an increase in CETP mass. PMID- 3558823 TI - Cell surface expression of fMet-Leu-Phe receptors on human neutrophils. Correlation to changes in the cytosolic free Ca2+ level and action of phorbol myristate acetate. AB - We have studied how cytosolic free Ca2+ ([Ca2+]i) changes and phorbol myristate acetate (PMA) exposure affects ligand-independent cell surface expression of fMet Leu-Phe receptors on human neutrophils. Mere incubation primed neutrophils to double their binding of fMet-Leu-Phe. This spontaneous increase of peptide binding was unaffected by changes in the extracellular calcium concentration. However, depression of the [Ca2+]i totally abolished the increased binding of fMet-Leu-Phe. Scatchard-Plot analysis revealed that the observed increase of peptide binding was due to an increased number of receptors. Normalization of the [Ca2+]i in cells where it was initially depressed resulted in a slow but progressive increase in fMet-Leu-Phe binding. The rate of receptor recruitment could be enhanced by rapidly increasing the [Ca2+]i by addition of ionomycin. Addition of PMA to cells with near maximal receptor expression led to a marked reduction of fMet-Leu-Phe binding without affecting [Ca2+]i. These observations suggest the existence of a dual regulatory mechanism for up- and down-regulation of fMet-Leu-Phe receptors on the cell surface of human neutrophils. PMID- 3558824 TI - Crossreactivity and inheritance of idiotypes restricted to human anti-tetanus toxoid antibodies. AB - The presence of cross-reactive idiotypes on human IgG antibodies of tetanus toxoid (TT) antigen was assessed by examining the capacity of two anti-idiotypic (ID) antisera raised against IgG (Fab')2 anti-TT (idiotype) from two subjects to bind radiolabeled "idiotype" and to inhibit the binding of radiolabeled TT to IgG from unrelated subjects and from family members of the idiotype donors. Idiotypic crossreactivity with unrelated individuals was infrequent and weak but was frequent and stronger among siblings. The strongest idiotypic crossreactivity was seen between identical twins in studies using four anti-ID raised against the anti-TT idiotypes of two sets of twins. The results of the present study suggest that idiotypic determinants restricted to human anti-TT antibodies are, at least in part, encoded by inherited genes, which are infrequently shared among unrelated individuals. PMID- 3558825 TI - Stoichiometry of Na+-HCO-3 cotransport in basolateral membrane vesicles isolated from rabbit renal cortex. AB - The major pathway for HCO3- transport across the basolateral membrane of the proximal tubule cell is electrogenic Na+-HCO3- cotransport. In this study, we have determined the stoichiometry of the Na+-HCO3- cotransport system in basolateral membrane vesicles that were isolated from rabbit renal cortex by Percoll gradient centrifugation. When the membrane potential is approximated by the Nernst potential for K+, as in the presence of the K+ ionophore valinomycin, equilibrium thermodynamics predicts that the Na+-HCO3- cotransport system should come to equilibrium and mediate no net flux when (Na)i/(Na)o = [(HCO3)o/(HCO3)i]n[(K)o/(K)i]n-1, where n is the HCO3-:Na+ stoichiometry. Our experimental approach was to impose transmembrane Na+, HCO3-, and K+ gradients of varying magnitude and direction, and then to measure the net flux of Na+ over the subsequent 3-s period. In this way, we could determine the conditions for equilibrium of the transport system and thereby calculate n. The results of these experiments indicate that the value of n is greater than 2.6 and less than 3.5, consistent with a stoichiometry of 3 HCO3-:1 Na+, or a thermodynamically equivalent process. Based on reported intracellular potentials and ion activities, this value for the stoichiometry indicates that the inside-negative membrane potential is sufficient to drive HCO3- exit against the inward concentration gradients of HCO3- and Na+ that are present across the basolateral membrane of the intact proximal tubule cell under physiologic conditions. PMID- 3558826 TI - Radioimmunoassay of the phytotoxic compound zinniol. AB - The phytotoxic compound zinniol, produced by phytopathogenic fungi such as Alternaria spp. and Phoma macdonaldii was conjugated to bovine serum albumine by the mixed anhydride method. Antiserum against zinniol was obtained by injection at multiple intradermal sites of rabbits. Sensitivity of the R.I.A. was 0.14 ng/tube, the within and between-assay coefficient of variation were less than 10 and 14% respectively. Negligible binding occurred when analogs of zinniol were tested for cross reactivity. The excellent accuracy of this R.I.A., applied to ethanolic extracts of plants, might allow to determine the production of toxin by the parasite during the infection process. PMID- 3558827 TI - The use of 3,3',5,5'-tetramethylbenzidine as a peroxidase substrate in microplate enzyme-linked immunosorbent assay. AB - The assay conditions for the use of 3,3',5,5' tetramethylbenzidine (TMB) in microplate enzyme-linked immunosorbent assay are described. TMB is a safe (non mutagenic) chromogen that is more sensitive than OPD as a substrate for horseradish peroxidase. We describe the optimum storage and assay conditions for this chromogen. PMID- 3558828 TI - Solid phase enzyme immunoassays of pertussis toxin using peroxidase or biotin labelled antibodies. AB - The quantitative determination of pertussis toxin (PT) is generally estimated by biological tests which are time-consuming, cumbersome and unsuitable for simultaneous testing of a large number of samples. The present work describes a rapid and sensitive ELISA procedure allowing PT assay based on a sandwich technique amplified via avidin-biotin interaction. As low as 0.1 ng of PT in 0.1 ml sample could be detected by the procedure described. PMID- 3558829 TI - Methodological considerations for penicillin radioimmunoassay. AB - The objective of this study was to identify and define factors that compromise the utility of radioimmunoassay for quantitation of beta-lactam antibiotics in biological aqueous fluids. Serum containing antibodies to benzylpenicillin coupled as a hapten to keyhole limpet hemocyanin was used as the assay primary antibody. Two significant factors that limited the utility of the assay were the tendency for penicillin to hydrolyze in aqueous solutions, resulting in a mixture of immunorecognizable forms; and in the hydrolyzed state, to bind covalently with matrix proteins. Assay sensitivity, crossreactivity, and assay binding parameters varied with the state of hydrolysis of penicillin in tracer, standards, and unknowns and with the composition of the assay buffer. Hydrolysis of the beta lactam ring of penicillin immediately before assay by addition of 0.1 N NaOH or penicillinase resulted in improvements in assay repeatability and uniformity by forming predominantly the penicilloate form of the compound, which was immunologically well recognized by the antibody. Nonspecific binding of penicillin (and derivatives) to proteins in biological fluids such as milk or assay buffers was shown to be a possible cause of error in the immunoassay of penicillins. PMID- 3558830 TI - The Missouri Inpatient Behavior Scale. AB - The Missouri Inpatient Behavior Scale (MIBS) is described, and data are presented from the Missouri automated mental health information system (N = 12,106). The factor structure for MIBS was replicated and shown to be robust. Data on intrascale consistency and interscale correlations are presented, as well as a validity study that showed MIBS to be sensitive to changes on acute-receiving services and a comparison of MIBS and NOSIE-30 scores. PMID- 3558831 TI - Confirmatory factor analysis of the short form Beck Depression Inventory in elderly community samples. AB - The factor structure of the Beck Depression Inventory short form (BDI-SF) was investigated in two elderly samples, with the method of confirmatory factor analysis. Four models previously reported for the BDI-SF in the general adult population were compared for goodness of fit to the data for elderly respondents, and the best-fitting model was adjusted further for these data. Each step in the analyses of the BDI-SF responses of 199 elderly subjects from Tampa, Florida, was cross-validated with data from a second sample of 113 elderly subjects from Houston, Texas. The results confirmed that the three-factor model reported by Reynolds and Gould (1981) adequately fit the data from both elderly samples. The three identified factors were termed Negative Self-Esteem, Anergy, and Dysphoria and were considered to correspond with the cognitive, behavioral, and affective components that generally are thought to be part of the depressive syndrome. The internal consistency of the overall BDI-SF was .74 and .80 in the Tampa and Houston samples, respectively. These findings provide evidence for the construct validity of the BDI-SF by confirming that it displays a factor structure in the aged similar to that observed in the general adult population. PMID- 3558832 TI - Effects of anterior temporal lobectomy on cognitive function. AB - Sixty-three patients with intractable partial complex epilepsy were treated by anterior temporal lobectomy for seizure control. Psychometric studies before and after operation documented cognitive function and evaluated the effects of operation on cognition. The mean follow-up period was 7.7 months. Sixty-two of 63 patients had improved seizure control; 49 (78%) were seizure free. Operation had different effects on cognitive abilities in those with right vs. left temporal lobe excisions. Although both groups maintained summary IQ scores in the average range, after operation the left temporal group was less efficient on language dependent cognitive tasks, particularly those that involved complex learning and memory. In contrast, persons who had right temporal ablations were either unchanged or slightly better cognitively after operation. Future research and clinical evaluations should focus on the components of the learning and memory processes when the ramifications of temporal lobe ablations on cognitive function are studied. PMID- 3558833 TI - Age-corrected norms for Shipley Institute of Living Scale scores derived from psychiatric inpatients. AB - Age has been identified as a particularly powerful factor that affects neuropsychological test scores. The Shipley Institute of Living Scale especially requires age-corrected norms because the Abstraction subtest has been shown to decline with advancing age. This study attempts to improve upon the methodology employed in a previous study by the same authors (Tamkin & Jacobsen, 1986) by correcting only the Abstraction score, increasing the number of subjects to 486, and increasing the number of age groupings to 11. An empirically derived correction for each age group is added to the Abstraction score, and the total Shipley score then is entered in Table 5 of Paulson and Lin (1970) to determine the corresponding WAIS IQ. These norms are ecologically valid for adult, male inpatients with various psychiatric diagnoses, a population for whom the Shipley frequently is used. PMID- 3558834 TI - Methodological issues in the clinical evaluation of two- and four-subtest short forms of the WAIS-R. AB - The evaluation of two- and four-subtest short forms of the WAIS-R has proceeded with little empirical attention to the effects of shortened administration time upon test performance. Routinely, the full WAIS-R has been administered and short form estimates extracted from the complete set of test results. Time and motivational/attentional factors can be evaluated by the administration of short form subtests first, followed by the remaining subtests in standard order or, alternatively, by the test-retest paradigm with short and complete WAIS-R versions. Limitations of these methodologies and existing empirical results are discussed. PMID- 3558835 TI - Appropriate reporting of Wechsler IQ and subtest scores in assessments for disability. AB - Neuropsychological reports for disability claimants should be written with reference to definitions of disability. The exclusive use of age-corrected scaled scores on the Wechsler scales places the older claimant in an unfairly favorable light. IQ scores should be reported when actual or estimated IQ loss is greater than 14 points because the Social Security Administration definitions of disability include this finding as a criterion. PMID- 3558837 TI - Post-traumatic stress syndrome (PTSS): escape in the environment. PMID- 3558836 TI - Strength of handedness as an indicant of delinquent's behavior. AB - In a sample of incarcerated male delinquents (N = 254), dichotomous and continuous measures of handedness were compared in concurrent prediction of delinquent behavior and correlation with past delinquency. The continuous measures proved to be more sensitive indicants of scores on a rating scale of conduct disorder than was the simple dichotomy of left- vs. right-handed. This superiority of continuous measures was not seen on other indicants of delinquency, where sinistrality did not relate to delinquency. Sinistrality was related to the ratings of conduct disorder. No differences on measures of delinquency appeared when strongly and weakly lateralized groups of right- and left-handers were compared. PMID- 3558839 TI - Post-traumatic stress disorders among Vietnam veterans: introduction. PMID- 3558838 TI - Combat-related post-traumatic stress disorder etiology: replicated findings in a national sample of Vietnam-era men. AB - To examine the generality of recent findings on PTSD etiology in help-seeking Vietnam combat veterans, replication was attempted with data from a national study of Vietnam-era men that included combat veterans. Use of a Guttman scaling technique for assessing combat exposure was found to be robust for use with a national nonclinical sample as well. In addition, multiple regression analysis was used to examine predictive relationships between premilitary adjustment, military adjustment, combat exposure, and post-traumatic stress disorder (PTSD). Results obtained from the national sample showed the same patterning as that reported from the smaller clinical sample. Combat exposure was related significantly to PTSD symptomatology, while premilitary adjustment was not. A previously identified discriminant function, composed of psychological symptoms not found in the DSM III criteria for PTSD, also was cross-validated. PMID- 3558840 TI - Post-traumatic stress disorder: evidence for diagnostic validity and methods of psychological assessment. AB - Post-traumatic stress disorder (PTSD) is a diagnosis that has been the subject of considerable criticism in the clinical literature. Of primary concern has been the question of whether PTSD is a disorder that can be discriminated reliably from already existing diagnoses, such as depression, dysthymia, or generalized anxiety disorder. This paper reviews the evidence that surrounds this controversy and employs the guidelines for validating a diagnosis established by Robins and Guze (1970) as the framework for the review. A second purpose of this paper is to present a multiaxial approach for the assessment of PTSD. This approach includes the use of structured interviews, psychometrics, and a psychophysiological assessment procedure. Studies that support the reliability and validity of the components of the multiaxial method are reviewed. PMID- 3558841 TI - Epidemiology of PTSD in a national cohort of Vietnam veterans. AB - At age 36, Vietnam veterans in the high school class of 1963 reported significantly more problems related to nightmares, loss of control over behavior, emotional numbing, withdrawal from the external environment, hyperalertness, anxiety, and depression than did their classmates matched with them on 51 high school characteristics. These problems correspond closely to the disorder labeled post-traumatic stress disorder (PTSD) by the American Psychiatric Association. PTSD was associated with other family, mental health, and social interaction problems. Some environmental variables--e.g., the presence of a spouse or being a churchgoer--were associated with reduced levels of PTSD or with reductions in the degree of association between combat and PTSD. The direction of cause and effect in these associations cannot be ascertained from our data, but it seems plausible to postulate that support factors can and do help some Vietnam veterans with PTSD. PMID- 3558842 TI - A profile of male and female applicants for a special college program for learning-disabled students. AB - Intellectual, achievement, and personality profiles were developed for a sample of 245 applicants to a special college program for learning-disabled students. Only 15% of the applicants had WAIS IQs above 115; the most depressed subtests were Arithmetic, Digit Span, Information, Vocabulary, and Digit Symbol. For both sexes, mean WRAT reading levels were higher than spelling and arithmetic (roughly seventh- vs. sixth-grade competence). Although the male applicants (N = 174) had significantly higher WAIS Verbal IQs than the female applicants (N = 71), their WRAT spelling achievement levels were significantly lower. A higher percentage of the females than males exhibited specific arithmetic disability. For both sexes, but more robustly for females, specific arithmetic disability was associated with more elevated MMPI profiles. Dyslexic students, by contrast, admitted to fewer problem areas on the MMPI. Relatively few applicants had MMPI scaled scores greater than or equal to 70. PMID- 3558843 TI - MMPI overreporting by Vietnam combat veterans. AB - The MMPI-PTSD scale is the only psychometric measure that has been cross validated on Vietnam veterans for the determination of PTSD. Despite this, there may be problems with this scale related to symptom exaggeration. Three groups of Vietnam inpatients (N = 75) were defined carefully by both clinical and actuarial methods--PTSD combat, Non-PTSD combat, and Non-combat. This study applied symptom exaggeration methods based on the MMPI obvious/subtle items and on the F scale to these groups. Results show that all the items of this scale are either obvious or neutral, that a carefully distinguished PTSD group differentially responds to these obvious and neutral items relative to other inpatient Vietnam groups, and that the F scale is exaggerated by the PTSD group. In addition, a separate analysis on an independent sample of 50 combat and 50 non-combat Vietnam veterans showed that the combat group endorsed the obvious items on selected scales by 20 T score points at higher rates than other groups. Caution in the use of the MMPI PTSD scale is discussed. PMID- 3558844 TI - Irrational beliefs in relation to self-esteem and depression. AB - The joint relationship of depression and self-esteem to Ellis' "irrational beliefs" as measured by the Irrational Beliefs Test (Jones, 1968) was investigated in an Australian sample (N = 268) of students and nonstudents. Analysis that used partial correlation and canonical correlation showed six irrational beliefs to be jointly related to low self-esteem and depression: Demand for Approval, High Self-expectations, Frustration Reactivity, Anxious Overconcern, Problem Avoidance, and Helplessness. The results confirm the findings of previous studies and are consistent with the concept of depressive self-schemas. PMID- 3558845 TI - Object relations ego deficits in bulimic college women. AB - Two types of bulimic (purging and restricting) and two types of non-bulimic (binging or normal) eating patterns were reported by 547 undergraduate women who also were assessed for ego function deficits on the four subscales of the Bell Object Relations Inventory. As predicted by psychoanalytic theory, the two bulimic subgroups appeared significantly more pathological on the Insecure Attachment subscale, which identifies ambivalent interpersonal relations and fear of object loss. When the four groups were ranked according to severity of type of eating disorder, a linear increase in group means and in the proportion of high scoring subjects was found on Insecure Attachment and also on the Egocentricity subscale, which indicates suspicious and manipulative attitudes toward others. Results are interpreted to support theories that relate eating disorders to disturbances in object relations ego functioning. PMID- 3558846 TI - Higher-order factors assessed by the ISI and PRF. AB - The Interpersonal Style Inventory and the Personality Research Form were administered to 327 adolescents in order to test hypotheses with regard to the second-order factors that they share in common. The 37 scale scores were intercorrelated and factored by the principal axes method and rotated to an oblique solution. The seven correlated factors were interpreted as Impulse Control, Extraversion-Introversion, Autonomy, Level of Socialization, Achievement Motivation, Liking New Experience, and Adventure Seeking. These confirmed four of the hypothesized factors. PMID- 3558847 TI - A reconsideration of the Willoughby Personality Schedule with psychiatric inpatients. AB - Although the Willoughby Personality Schedule appears to be widely used to assess interpersonal anxiety, there are few studies of its clinical validity or psychometric properties. The purpose of this study was to investigate the factor analytic structure of the Willoughby Schedule in an inpatient psychiatric population. It also explored the relationship of the Willoughby Personality Schedule to the Beck Depression Inventory (BDI), the Gambrill-Richey Assertion Inventory and patient perception of treatment outcome. In contrast to three Willoughby Schedule factors previously reported in research with outpatients, six factors were found in this study. These were moderately correlated with scores on the BDI and the Assertion Inventory discomfort scale. Two Willoughby factors were related to the Assertion Inventory probability of assertive response scale and only one Willoughby factor was related to patient perception of treatment outcome. The overall results raise questions as to the usefulness of the Willoughby Schedule with inpatient populations. PMID- 3558848 TI - Analysis of demand conditions associated with stereotypy. AB - Possible escape/avoidance functions of stereotypic behavior were investigated in a classroom setting using functional academic tasks. A 6-year-old boy's stereotypic mouthing was assessed during high vs low response activities, familiar vs novel activities and avoidance vs partial-avoidance conditions. Results showed that stereotypy occurred at higher rates during more difficult activities (i.e. those that were novel or required a greater number of responses), and when stereotypy was allowed to effect a delay in instructional demands. Treatment procedures based on these analyses were implemented by the classroom teacher and shown to be effective. PMID- 3558849 TI - Anxiety sensitivity in agoraphobics. AB - This study further validated the "Reiss-Epstein-Gursky Anxiety Sensitivity Index" (ASI) as a measure of the fear of anxiety. Agoraphobics scored high on the ASI before, but not after, behavioral treatment. Residual anxiety sensitivity, however, did not predict resurgence of agoraphobic avoidance at six months follow up. Indeed, anxiety sensitivity continued to decline during the follow-up period. Multiple regression analyses indicated that the ASI predicted the number of fears in agoraphobics beyond that predicted by the level of general anxiety. This finding supports the hypothesis that high anxiety sensitivity enhances fear acquisition; it also suggests that the ASI measures a construct different from that measured by general anxiety scales. Empirical similarities and differences were found between the ASI and two other "fear of fear" measures: the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire. PMID- 3558850 TI - Self-efficacy and the control of anxious cognitions. AB - This study was designed to explore the possibility that Bandura's notion of self efficacy can be applied to control over cognitions as well as behavior. Subjects were asked to complete questionnaires designed to measure their dental anxiety, the number of their negative self-statements about a dental appointment and their perceived ability to control these thoughts. Subjects with low anxiety claimed to experience fewer negative thoughts than those with moderate or high anxiety, and also to have more control over these thoughts. Subjects believed that the extent of their control would decline as the appointment approached in time, but least for the low anxiety group and most for the high anxiety group. Finally, differences in self-efficacy scores between anxiety groups were maintained when the number of negative thoughts was controlled for, but differences in negative thinking between anxiety levels were not maintained when self-efficacy was controlled for. These results suggest that anxiety is more closely related to thinking processes than content. PMID- 3558851 TI - Bulimia: an individual behavioral analysis. AB - This transcript is taken from the initial interview with a 24-year-old woman presenting with the problems of depression related to episodic binge eating, and anxiety concerning her difficulty to control her weight. Behavior analysis of the problem indicates that while the patient's binge eating was a means to cope with feelings of anxiety and emotional distress, her struggle to exert strict dietary control and maintain a thin body shape was in order to avoid negative evaluation, criticism and social rejection. Predisposing factors and precipitating events were examined to help explain the development of this behavioral pattern. PMID- 3558852 TI - A social learning approach to teaching adolescents about alcohol and driving: a multiple variable follow-up evaluation. AB - Previously reported data have demonstrated the effectiveness of the Teams-Games Tournaments (TGT) alcohol education program. This manuscript reports on the follow-up effects of the program as compared with the traditional instruction and no instruction control groups. Follow-up data indicate that the TGT students maintained previous positive changes while the traditional and no-instruction groups showed little or no change. Issues in the follow-up of students are briefly discussed. PMID- 3558853 TI - Stimulus control of anticipatory nausea in cancer chemotherapy. AB - A single subject ABA design was used to evaluate the effect of a stimulus manipulation on anticipatory nausea. A lemon solution was orally administered to a 61-year-old female oncology patient in order to mask taste sensations thought to function as a conditioned stimulus eliciting anticipatory symptoms during chemotherapy. A decrease in anticipatory symptoms was observed with the introduction of the taste masking agent and was maintained following withdrawal of the agent. PMID- 3558854 TI - Habituation to fear stimuli in a case of obsessive compulsive disorder: examining the generalization process. AB - The purpose of this investigation was to determine if habituation of anxiety to a visual form of the number 13 would generalize to other forms (auditory, behavioral and cognitive) of the number 13 in a 20-year-old male with obsessive compulsive disorder. Treatment included exposure and response prevention. A multiple baseline design across fear stimulus forms was used. Habituation to the visual form began generalizing to other forms of the number 13 before prolonged exposures to these three stimulus forms were instituted. Results suggest that exposure to a single stimulus form may result in sufficient generalization of treatment effects in cases involving seemingly independent fear responses to several forms of a stimulus. PMID- 3558855 TI - The use of the changing criterion design in achieving controlled smoking in a heavy smoker: a controlled case study. AB - This study describes the use of the changing criterion design for decreasing smoking rate. Evidence is provided which demonstrates that boundaries exist within which a well-established, high frequency baseline smoking rate (82 cigarettes per day) can be successfully modified and maintained at the rate of 5 cigarettes per day over a 20-month follow-up period. It is concluded that controlled smoking can be a viable alternative for individuals unable or unwilling to quit; further, this goal can be achieved through the changing criterion design, which allows for the demonstration of experimental control in a situation requiring minimal therapist contact. PMID- 3558856 TI - Incidence and clinical importance of bone marrow eosinophilia in Hodgkin's disease (BNLI Report No 29). British National Lymphoma Investigation. AB - A retrospective study of 136 bone marrow aspirates was undertaken before treatment to evaluate the importance of bone marrow eosinophilia in Hodgkin's disease. This occurred in 28 patients (21%) but did not correlate with age, sex, B symptoms, histopathological type or peripheral blood count. It also had no effect on survival. Bone marrow eosinophilia, therefore, seems to represent a common but non-specific reaction to Hodgkin's disease. PMID- 3558857 TI - Selective peripheral blood eosinophilia associated with survival advantage in Hodgkin's disease (BNLI Report No 31). British National Lymphoma Investigation. AB - A peripheral blood eosinophilia was found at presentation in 193 of 1260 (15%) patients with Hodgkin's disease who had been entered into clinical studies by the British National Lymphoma Investigation (BNLI). Eosinophilia as a component of a general leucocytosis conferred no survival advantage. Eosinophilia without a general leucocytosis was present in 95 patients, and this selective eosinophilia was associated with a clear survival advantage. The association of selective eosinophilia and improved survival was limited to patients with mixed cellularity and grade I nodular sclerosis histology. Selective eosinophilia was found to be a good prognostic indicator both in local and generalised disease. Its survival advantage seemed to lie in the response to second line treatment following relapse. PMID- 3558858 TI - Small quantities of erythrocyte bound immunoglobulins and autoimmune haemolysis. AB - Enzyme linked and radioimmune direct antiglobulin tests (DAGTs) were used to assess red cell bound IgG, IgA, and IgM in 585 patients referred to an immunohaematology reference centre. One hundred and fifty eight patients with less than or equal to 200 mol IgG and small amounts of IgA and IgM coating their red cells were studied in detail. The presence of autoimmune haemolysis was determined from the clinical, haematological, and biochemical findings; it occurred in at least 25% of the 158 patients, the degree varying widely. There was a highly significant association between small increases in cell bound immunoglobulins and the presence of autoimmune haemolysis. Immunoglobulins of IgG, IgA, and IgM classes could produce autoimmune haemolysis when the classical agglutination DAGTs were negative; the IgA and IgM were usually found in association with IgG. The haemolytic effect was enhanced by the presence of complement and combinations of immunoglobulin classes on the red cells. PMID- 3558859 TI - Ultrastructure of bone marrow in patients with visceral leishmaniasis. AB - Ultrastructural studies were performed on bone marrow aspirates from three patients with visceral leishmaniasis. The patients were moderately anaemic but showed a suboptimal increase in the absolute reticulocyte count. Serum and red cell folate concentrations and serum vitamin B12 concentrations were normal in all three cases, and serum ferritin concentrations were normal or increased. The bone marrows were hypercellular and showed erythroid hyperplasia; a high proportion of the erythroblasts showed dyserythropoietic changes. Amastigote forms of Leishmania donovani were found within bone marrow macrophages and within occasional neutrophil and eosinophil granulocytes. Electron microscopy showed the presence of many abnormal cells, which probably represented immature erythroblasts with giant lysosomes. These cells were often large, usually contained immature nuclei with relatively little condensed chromatin, had 1-20 electron dense cytoplasmic granules with an average diameter of 0.5 micron, and regularly displayed substantial rhopheocytotic activity. A few abnormal cells and intermediate and late erythroblasts appeared to have been phagocytosed by macrophages. The data indicate that dyserythropoiesis and ineffective erythropoiesis have a role in the pathogenesis of the anaemia of at least some cases of kala-azar. PMID- 3558860 TI - Public Health Laboratory Service enzyme linked immunosorbent assay for detecting Toxoplasma specific IgM antibody. AB - An enzyme linked immunosorbent assay (ELISA) based on the antibody class capture method for the detection of specific IgM against Toxoplasma gondii, using the microtitre plate format, was developed. Antigen binding was detected using a monoclonal antibody, CIE3, conjugated to horseradish peroxidase. Prior mixing of the conjugate and antigen improved the stability of these reagents as well as removing an incubation stage from the assay. The incubation time of less than four hours permits a rapid throughput of specimens. Using the assay, a total of 163 sera were examined in a three centre study and good agreement was found. Results were expressed as arbitrary enzyme immunoassay units (EIUs) against a freeze dried standard. Throughout the study the standard serum showed a coefficient of variation less than 10% across the microtitre plate. By measuring IgM titres in patients having toxoplasmic lymphadenopathy with a known date of onset, IgM class antibodies were shown to peak at two months, persisting for about six months. In addition, a case of laboratory acquired toxoplasmosis was monitored. Sera shown to contain rheumatoid factor and antinuclear factor did not give false positive results. This rapid, robust, and simplified assay is used by the Public Health Laboratory Service Toxoplasma Reference Units and will provide a standard with which other assays can be compared. PMID- 3558861 TI - Streptococcus milleri and second trimester abortion. AB - Review of 214 fetal necropsies performed in the department of pathology, University of Aberdeen, showed 40 cases of chorioamnionitis or intrauterine pneumonia, five of which were associated with Streptococcus milleri. In two cases there was good evidence to implicate S milleri as the cause of infected abortion while in the other cases its pathogenic role was less clear. PMID- 3558862 TI - Plasma ultrafiltrable magnesium in insulin dependent diabetics. AB - Plasma ultrafiltrable (MgUF) and total magnesium concentrations were measured in 60 insulin dependent diabetics and compared with values in an age matched control group. Although the diabetic patients had lower plasma albumin concentrations (p less than 0.05), both ultrafiltrable and total magnesium concentrations were significantly decreased by 6.8% and 7.6%, respectively, compared with those of the controls (p less than 0.001). In the diabetic group MgUF varied inversely with fasting plasma glucose (r = -0.269, p less than 0.05). In 14 patients with significant hypomagnesaemia, fasting plasma glucose concentration was higher (p less than 0.01) and the diabetes was of shorter duration (p less than 0.05) than in 46 patients with an MgUF in the control range. The fasting urinary magnesium creatinine ratio was greater in the diabetic patients (p less than 0.05). Patients with retinopathy did not have lower plasma magnesium values than those without retinopathy. PMID- 3558863 TI - Evaluation and assessment of new disposable strip for determination of plasma potassium concentration. AB - Overall laboratory reproducibility for the Ames Seralyzer and plasma potassium test strips was less than 4% within the plasma reference range; and linearity extended from 2.1 to 10.2 mmol/l. Neither bilirubin nor lipaemia interfered in the analysis and selectivity for potassium over sodium was 450:1. Laboratory comparison with automated flame photometry and an indirect ion selective electrode showed a Seralyzer bias of +0.10 (+/- 25D 0.26) and +0.11 (0.27) mmol/l. Against flame photometry, comparison of analyses by six doctors from a coronary care unit and four nurses from a renal dialysis unit showed smaller positive biases (0.06 and 0.02 mmol/l) but substantially larger error ranges (0.43 and 0.55 mmol/l, respectively). Some 49% of the nurses' and 37% of the doctors' results differed from laboratory values by more than 0.2 mmol/l. Potassium test strip results proved acceptably comparable and reproducible when produced by an experienced analyst, but greater variability in clinical hands rendered the system unsuitable for precise monitoring of potassium concentration. PMID- 3558864 TI - Prospective evaluation of prognostic value of morphometry in patients with primary breast cancer. AB - In a prospective study the predictive value of a multivariate morphometric prognostic index was evaluated in 195 patients with primary breast cancer who had not been treated with any form of chemotherapy or hormonal treatment. The presence or absence of distant tumour recurrence combined with the scores of the prognostic index were compared with the survival curves predicted in a previous study. The value of the presence of lymph node metastases, number of positive nodes, tumour size, mitotic activity index, and oestrogen receptor status in prediction of prognosis were also investigated. In agreement with the results of the previous retrospective study, the prospective use of the index had the strongest predictive prognostic value, followed by the mitotic activity index. Statistical analysis showed that the actual prognoses of 43 of the 195 patients (22%) were more accurately determined by the prognostic index rather than by using the presence of the lymph node metastases as the classifying variable. The prognostic index is consistently reproducible by different technicians; it is a reliable method of predicting distant recurrence of tumour and hence the prognosis of patients with primary breast carcinoma. It provides more prognostic information than the presence of lymph node metastases alone, and the index should be incorporated in routine pathology reports. PMID- 3558865 TI - Class II antigen (HLA-DR) expression by intestinal epithelial cells in inflammatory diseases of colon. AB - Eighty four colonic biopsy specimens were obtained from patients with ulcerative colitis, Crohn's disease, radiation colitis, infectious colitis, and from normal controls. Paired specimens were examined by histological and immunohistochemical methods using monoclonal antibodies to the beta chain of HLA-DR antigen. The expression of HLA-DR antigen in mucosal epithelial cells was strongly related to whether the specimens were actively inflamed: epithelial cells from 34 of 37 inflamed specimens (nu three of 42 non-inflamed specimens) were HLA-DR positive (p less than 0.0001). Epithelial cells were uniformly HLA-DR negative in specimens from normal control patients despite the presence of HLA-DR positive lymphoid cells and macrophages in the lamina propria. Epithelial cells in specimens from patients with ulcerative colitis, Crohn's disease, and radiation colitis were HLA-DR positive in 30 of 33 inflamed biopsy specimens and in only three of 25 non-inflamed specimens (p less than 0.0001). Epithelial cells were HLA-DR positive in nine of 10 biopsy specimens from patients with acute infectious colitis (p less than 0.01). PMID- 3558867 TI - Foamy myocardial transformation of infancy: an inherited disease. AB - Five cases of foamy myocardial transformation of infancy, a condition which predominantly affects female children under 2 years of age and which causes cardiac arrhythmia or sudden death, are reported. Of these five cases, four occurred in two sets of siblings, suggesting a possible hereditary basis for the disease. As far as we know, no other familial cases have been reported. The other case was of focal disease of the myocardium, as opposed to the diffuse myocardial changes seen in the four familial cases. PMID- 3558866 TI - Thin basement membrane syndrome in adults. AB - Eight (two men, six women) cases of adult thin basement membrane syndrome were studied to clarify the clinicopathological characteristics of the disease. The average age at the time of biopsy was 40 years. All the patients had persistent microscopic haematuria, normal renal function, and normal blood pressure, with the exception of one who was hypotensive. Most of them had persistent or transient proteinuria. Renal symptoms were found in four families, although no relative had Alport's syndrome. Renal biopsy findings observed by light and immunofluorescence microscopy did not indicate any important abnormalities, but extensive diffuse thinning of the glomerular basement membrane, ranging from 153 to 213 nm, was a constant finding by electron microscopy. All the patients retained stable renal function at the time of final follow up, indicating a benign prognosis of the syndrome. PMID- 3558868 TI - Streptococcal necrotising fasciitis: comparison between histological and clinical features. AB - Nineteen acute and 17 subacute cases of necrotising fasciitis due to beta haemolytic streptococci are described. Excised tissue from seven and four cases, respectively, was available for histological examination. The two clinical types showed remarkable similarities, with inflammation and necrosis from epidermis to subcutaneous fat. Haemorrhage was present in variable amounts in both types. Gram positive cocci were not always identified in tissue, nor cultured, when serological tests were required to confirm the diagnosis. The only apparent difference between the acute and subacute type was the higher incidence of thrombi in some blood vessels of acute cases, whereas patent vessels or recanalized thrombus were usually found in subacute cases. This quantitative difference in the degree of thrombosis may alone be responsible for the varying clinical features and response to antibiotics. PMID- 3558869 TI - Prostatic infiltration in chronic lymphatic leukaemia. AB - Forty six men with chronic lymphatic leukaemia (CLL) were studied for up to seven years. Six patients required surgery for prostatic outlet obstruction. Histological examination of the prostatic chippings showed variable degrees of infiltration with small mature lymphocytes in all six patients, suggestive of a leukaemic origin for the cells. Patients with chronic lymphatic leukaemia who undergo prostatectomy may have a higher incidence of leukaemic infiltration than has been previously recognised. PMID- 3558870 TI - Microwave polymerisation of epoxy resin: rapid processing technique in ultrastructural pathology. PMID- 3558871 TI - Analysis of odontogenic keratocyst fluids for preoperative diagnosis. PMID- 3558872 TI - False positive results with heated sera in Toxoplasma ELISA for IgG antibody. PMID- 3558873 TI - Planning for the AIDS epidemic: public health control measures and the provision of patient care. PMID- 3558874 TI - A unified approach to health promotion and health protection. PMID- 3558875 TI - Marketing strategies for recruiting gay men into AIDS research and education projects. AB - Recruiting gay and bisexual men into AIDS-related research and education programs will become increasingly common as federal, state and local funds become available. The Pitt Men's Study, a study of the natural history of Human Immunodeficiency Virus (HIV) infection, developed a recruitment strategy based on marketing principles. These techniques allowed the study to target particular gay and bisexual groups for inclusion. 1718 gay and bisexual men were recruited. Non whites and unemployed men were targeted and recruited in numbers comparable to their representation in the larger community. PMID- 3558876 TI - AIDS risk-reduction guidelines: a review and analysis. AB - Until an effective treatment or vaccine for AIDS is developed, the principal strategy for controlling its spread will remain persuading at-risk and diseased populations to modify behaviors implicated in the transmission of the disease. In the case of homosexual and bisexual men the "risk-reduction" or "safe-sex" brochure has emerged as the most widely used public health intervention modality. While there has been a proliferation of such brochures, to date no systematic analysis of the content or potential efficacy of these materials has been undertaken. The authors carry out two kinds of analyses of a sample of risk reduction brochures. First, these materials are characterized in terms of 13 characteristics related to their content, and style. Second, the extent to which they incorporate the elements of a standard model of health communication is assessed. Limitations of existing brochures are identified and the implications of the findings for the development of future materials are discussed. PMID- 3558877 TI - Second year medical student opinion about public health and a second year course in preventive medicine and community health. AB - The results of five annual surveys of second year medical students over an eight year period of time (1978-1985) concerning perceptions and attitudes toward public health and a course in preventive medicine and community health are presented. The questionnaire format was a combined fixed alternate and free response type and was structured to require only ten to 15 minutes for its completion. Participation rates were generally high varying from 60.2% (1980) to 93.8% (1985). The majority of students in all years favorably evaluated most components of structure, content and presentation of the course. It was found that opinions about the course can be modified by the introduction of variables that are unrelated to the scope of the quality of the course as occurred in 1979, with a difficult midterm examination. Student anger over this examination was translated and expressed as negative opinion about many other aspects of the course which in other years were highly rated. This finding underscores the vulnerability of surveys of subjective opinion and demonstrates that course evaluations must include other objective aspects in addition to student perceptions. PMID- 3558878 TI - Teenage pregnancy in an urban hospital setting. AB - Recent research suggests that adverse consequences of teenage pregnancy are largely a function of social background factors and adequacy of prenatal care. This study examines the situation of young mothers with new babies in a low income, urban environment. The study explores the relationship between age and ethnicity and various life circumstance and life style differences which might effect long term developmental outcome. 475 Hispanic and black mothers were interviewed using a structured questionnaire. The majority are poorly educated, single parents. Educational attainment is higher for blacks than for Hispanics and for older mothers than for younger. Older mothers are more likely to be living with the father, to be married, and to have received adequate prenatal care. Hispanic parents are more likely than Blacks to be planning to live together. Hispanic mothers are more likely than blacks to be planning to be the primary caretaker for their babies. Adequacy of prenatal care is related to both prematurity and low birth weight. The implications of these findings are discussed in relation to pregnancy prevention and parenting education programs. PMID- 3558879 TI - Architecture and frontal cortical connections of the premotor cortex (area 6) in the rhesus monkey. AB - The premotor cortex (area 6) has several architectonic sectors that can be delineated on the basis of cytoarchitectonic and myeloarchitectonic features. Area 6 may be broadly subdivided into a dorsal and a ventral sector at the spur of the arcuate sulcus. Dorsal 6 lacks a granular layer IV, but ventral 6 has an emergent layer IV that separates laminae III and V. Dorsal 6 has a higher myelin content than ventral 6. Dorsal area 6 is further subdivided into a caudal and a rostral sector on the basis of the presence of large pyramidal cells in the caudal but not in the rostral sector. The rostral sector of area 6 can be subdivided into a medial region distinguished from a more laterally situated area by the presence of more compact and darkly stained cells in layers III and V. Ventral area 6 can be subdivided into an upper and lower division. The upper part has more prominent pyramidal cells in layers III and V, and a better developed outer Baillarger band and vertical plexus than the lower division. The efferent and afferent connections of area 6 were studied with anterograde and retrograde tracers. The frontal connections of dorsal area 6 are restricted to neighboring dorsal frontal regions. Only the caudal sector of dorsal area 6 is connected with the motor cortex. In contrast, ventral area 6 is not only connected with the prefrontal cortex, but also directly with the motor cortex, the parainsular gustatory area, and with somatosensory areas in the frontal operculum. The widespread connections of ventral area 6 may be related to the specialization of the head, neck, and face structures that are represented ventrally within the premotor cortex. PMID- 3558880 TI - The organization and mutability of the forepaw and hindpaw representations in the somatosensory cortex of the neonatal rat. AB - The present study demonstrates that the primary somatosensory cortex of the rat contains a map of the entire body surface that is discernible with a routine anatomical staining technique, the succinic dehydrogenase reaction. The overall proportions of this map are relatively constant from rat to rat and very similar to those reported in previous physiological investigations (Welker: Brain Res. 26:259-275, '71, J. Comp. Neurol. 166:173-190, '76). We found 67% of the map to be related to the head of the rat, 15% to the forelimb, 14% to the trunk, and 4% to the hindlimb. Within the forelimb and hindlimb representations, there is a consistent internal organization that can be related to specific peripheral structures (digits or palm pads). Further, damage to either the periphery or the nerves innervating these regions on the day of birth produces disruptions in the normal pattern, but damage on day 6 or later does not. We interpret these results as indicating that the role of the periphery in organizing central neuronal structures during development previously demonstrated for the trigeminal system extends to the entire rat somatosensory system. Comparison of the present results with physiological studies of adult cortical maps after peripheral damage suggests to us that different substrates underlie the changes reported in the adult. PMID- 3558881 TI - Morphology of pontomedullary raphe and reticular formation neurons in the brainstem of the cat: an intracellular HRP study. AB - In order to understand better the anatomical substrates underlying processing of sensory information, the cytoarchitecture of neurons in the pontomedullary raphe and reticular formation was investigated following intracellular injections of horseradish peroxidase in the cat. Raphe cells studied were located in the nucleus raphe magnus, nucleus raphe obscurus, and nucleus raphe pallidus. The most prominent type had a smooth, oval cell body and oval dendritic tree with dendrites extending laterally into the adjacent reticular formation. Two other raphe cell types, large cells with a dorsoventral orientation of both cell body and dendritic tree, and very small cells, were rarer. The primary dendritic orientation lay in the coronal plane for all three raphe cell types. Wispy, straight, or clublike spines were located on more distal regions of dendrites, although we also found spineless dendrites. Raphe cells lying near longitudinal fiber pathways exhibited bundling of dendrites around the passing axon fascicles. Reticular formation cells studied were located in the nucleus gigantocellularis, nucleus magnocellularis, nucleus paragigantocellularis dorsalis, and nucleus reticularis paramedianus. Two morphological types were found on the basis of dendritic branching patterns: sparsely branched and densely branched. Most reticular formation cells had round dendritic trees as viewed in the coronal plane and polygonal cell bodies that were medium to large in size. There was no correlation between reticular formation cell morphology and nuclear location. Spines were more common on the densely branched cells, but for both reticular cell types they were usually absent from cell bodies and proximal dendrites. Thus, by using the criteria of dendritic branching and arbor shape along with distance from the midline it was possible to identify raphe cells as distinct from reticular formation cells. In contrast, no morphological characteristics were found that would differentiate cells in the two major median reticular formation nuclei, gigantocellularis and magnocellularis. PMID- 3558882 TI - Plasticity of dendrodendritic microcircuits following mitral cell loss in the olfactory bulb of the murine mutant Purkinje cell degeneration. AB - Mitral cells of the olfactory bulb typically form reciprocal dendrodendritic synapses with anaxonic interneurons, granule cells, within a sublamina of the external plexiform layer. As a result of mitral cell loss in the murine mutant Purkinjie cell degeneration (PCD), subpopulations of these granule cells are denervated. The present report examines the capacity of these denervated interneurons to form new dendrodendritic microcircuits with a second population of olfactory bulb neurons, tufted cells. Quantitative ultrastructural assessments were made of the morphology and distribution of dendrodendritic circuits in the olfactory bulbs of normal heterozygous littermates and affected homozygous recessive PCD mice following mitral cell loss. There were no apparent morphological characteristics that distinguished the reciprocal synaptic connections formed by mitral cells from those formed by tufted cells. However, the segregation of mitral cell dendrodendritic circuits in the deep sublamina of the external plexiform layer (EPL) and tufted cell circuits in the superficial sublamina provided the basis for a comparative analysis of synaptic organization following mitral cell loss. Following mitral cell loss there was a significant reduction in the area occupied by characteristic mitral cell dendrites within the deep sublamina of the EPL. A slight but nonsignificant increase in the area occupied by granule cell spines was also observed. The number of synaptic appositions involving granule cells decreased slightly, the number involving tufted cells increased significantly in the mutant mice. This indicates that many granule cell spines survive denervation and establish new reciprocal dendrodendritic synapses at available sites on tufted cells. In both the control and mutant mice the ratios of symmetrical:asymmetrical dendrodendritic synapses closely approached 1. This demonstrates that not only do the denervated spines receive new afferent input from tufted cell dendrites, but they also establish the reciprocal efferent projection. These data are discussed in terms of the sublaminar organization of dendrodendritic microcircuits in the olfactory bulb and their capacity of plasticity and reorganization following pertubation. PMID- 3558883 TI - Ultrastructure of the caudal portion of the fourth ventricular roof in the mouse. AB - A scanning and transmission electron microscopic study was done of the caudal portion of the fourth ventricular roof in the adult mouse. The caudal portion of the fourth ventricular roof was divided into two parts: choroid plexus and nonchoroid plexus roof. The plexus epithelial cells had numerous microvilli and were connected with each other with a tight junction, gap junction, or zonula adherens. The nonchoroid plexus roof was a thin neuroglial membrane with a continuous basement membrane, which we designated as "the membranous roof." The membranous roof was mostly composed of a single layer of paving ependymal cells supported by discontinuous pial cells. The ependymal cells were characterized by their squamous cell configuration, various numbers of microvilli and cilia, and a continuous basement membrane. They were connected with each other by gap junctions or zonulae adherentes, but they lacked tight junctions. Neither a cytoplasmic pore nor a wide intercellular cleft was identified. Neuronal and glial cell processes were occasionally observed. The aperture that is supposed to exist in the caudal, median portion of the fourth ventricular roof of the adult mammalian brains, called the foramen of Magendie in the human brain, was not found. Our observations suggest that the membranous roof itself would permit passage of the cerebrospinal fluid containing macromolecules via the interependymal cell clefts, implying that the foramen of Magendie would not be an anatomical aperture but a functional channel for the outflow of the cerebrospinal fluid. PMID- 3558884 TI - Sexual dimorphism in sympathetic preganglionic neurons of the rat hypogastric nerve. AB - Horseradish peroxidase (HRP) applied to one hypogastric nerve labelled sensory neurons in T11-L3 dorsal root ganglia (DRG) bilaterally and preganglionic neurons (PGN) in the spinal cord segments T13-L3. An average of 130 small DRG neurons were labelled per animal (male or female). These were concentrated in the L1 + L2 DRGs (92%). About 75% were located ipsilateral to the site of HRP application. Central projections from DRG neurons were noted throughout Lissauer's tract and in the marginal zones (medial and lateral) near the borders of Lissauer's tract. A short projection was also seen extending to the dorsolateral funiculus. More than 90% of the preganglionic neurons were located in segments L1 + L2. Most of these were found in the dorsal commissural nucleus (75%) and most of the remainder were located bilaterally in the intermediolateral columns. Somewhat more intermediolateral neurons were labelled on the ipsilateral side than on the contralateral side. There were a few intercalating neurons and a very few funicular cells. An average of 415 PGNs were labelled in the male animals and 110 in the females, demonstrating a strong sexual dimorphism. No dimorphism was found in the sensory components. PMID- 3558885 TI - Autoradiographic study of descending pathways from the pontine reticular formation and the mesencephalic trigeminal nucleus in the rat. AB - Descending projections were studied in autoradiographically prepared material after injections of tritiated leucine in the pontine tegmentum of rats. Injections involving the medial pontine reticular formation resulted not only in labeling commissural fibers, the medial reticulospinal tract, and the dorsal cap of the inferior olive, but also, in two cases, in labeling a cerebellar projection that originated from a region near the midline and clearly dorsal to the nucleus reticularis tegmenti pontis. The labeled fibers passed ventral in the midline to the pontine gray, then laterally through the gray and into the middle cerebellar peduncle to terminate as mossy fibers primarily in the flocculus, lobulus simplex, and Crus I of the ansiform lobule. Injections involving the mesencephalic nucleus of the trigeminal nerve (Vmes), resulted in labeling of Probst's tract, which descends in the dorsolateral reticular formation. Probst's tract gave off extensive terminal branches to the lateral medullary reticular formation and weaker projections to restricted portions of the descending trigeminal nucleus, the solitary nucleus, and the hypoglossal nucleus. In one case, fibers could be traced into the dorsal horn of the upper cervical cord. PMID- 3558886 TI - Time course and distribution of motoneuronal loss in the dorsal motor vagal nucleus of guinea pig after cervical vagotomy. AB - Cells in the dorsal motor vagal nucleus (DMVN) of the adult guinea pig were counted at different times after unilateral cervical section of the vagus nerve. The counts were made from serial 30 microns coronal sections throughout the DMVN in normal and operated animals. There are three types of cells in the DMVN of guinea pig: medium-sized motoneurons that are retrogradely filled by HRP from the site of the vagotomy, small neurons, and glial cells. An interesting observation was a change in distribution of cells in the DMVN with age in unoperated guinea pigs. Following vagotomy degeneration was seen only in the motoneurons. Disappearance of motoneurons was slow and only 27% were present after 1 year. During that time the decrease in the total number of motoneurons was exponential with a time constant of 8.6 months, but degeneration in different parts of the nucleus was not uniform. Thirty-four percent of motoneurons in the caudal area of DMVN disappeared in the first month after vagotomy, while the rostral area was almost unchanged. The rostral area, however, showed rapid degeneration between 3 and 6 months after vagotomy. The central part of the nucleus degenerated at a constant rate between those of the rostral and caudal regions. At the end of 1 year, cell loss in all parts of the nucleus was approximately equal. Surviving motoneurons showed morphological changes: rounding of the soma, continuous reduction of the cell volume, and shrinkage of the nucleus. Occasional abnormal forms showing vacuolization or invaginated nuclei were seen. Calculations show that the process of degeneration lasts 25 days on the average. The marked degeneration found in dorsal vagal motoneurons, in contrast to recovery from axotomy in somatic motoneurons, is similar to that found in intrinsic neurons of the central nervous system. The slow and continuous time course of disappearance of motoneurons after vagotomy, however, is exceptional. It is reasonable to postulate that the increased vulnerability of these motoneurons may be sufficient to result in degeneration in response to what are normally nonpathological metabolic demands. PMID- 3558887 TI - Afferent connections of anterior thalamus in rats: sources and association with muscarinic acetylcholine receptors. AB - Afferent connections of the anterior thalamic nuclei (ATN) are classically thought to originate in the mammillary body and limbic cortex. This study explores nonlimbic sources of ATN afferents by using retrograde transport of horseradish peroxidase (HRP) to ascertain the relative contribution of these connections. Spread of HRP into adjacent regions was prevented either by removing the overlying cortex or by injecting through permanently implanted cannulas. The main sources of nonlimbic ATN afferents are the pretectum and central gray. Pretectal neurons were HRP-labeled primarily in the contralateral medial pretectal nucleus with a smaller number in the ipsilateral posterior pretectal nucleus. In the central gray, labeled cells were concentrated ipsilaterally in the laterodorsal tegmental nucleus. Additional projections to ATN originate in the reticular and ventral lateral geniculate nuclei of the thalamus, raphe nuclei, peripontine tegmental nucleus, and locus coeruleus. The association of ATN afferents with muscarinic receptors was also explored by means of in vitro receptor autoradiography with the muscarinic ligands propylbenzilylcholine mustard (PrBCM) and pirenzepine (PZ) in normal rats and rats with ablations. Ibotenic acid injections into ATN were used to destroy intrinsic neurons while leaving afferent fibers intact. Whereas such ablations produced statistically significant decreases in PrBCM binding in the anterior dorsal (AD, -45%) and anterior ventral, magnocellular part (AVm, -51%) nuclei, binding in the anterior ventral, parvicellular part (AVp) and anterior medial (AM) nuclei was not significantly decreased. Furthermore, PZ binding in normal rat ATN was significantly less (-72%) than PrBCM binding. These results suggest that a major proportion of muscarinic binding is associated with presynaptic elements. Ibotenic acid ablations of the mammillary body reduced PrBCM binding in ATN whereas lesions in cingulate cortex and laterodorsal tegmental nucleus had no effect. Compared to sham lesion controls, mammillary body lesions resulted in statistically significant decreases in binding bilaterally in AD (-15%), AVm ( 19%), and AM (-20%). In conclusion, ATN receive afferents from several nonlimbic regions. Of these inputs, the pretectum may be the primary route through which sensory information reaches ATN. In addition, cholinergic input may modulate activity in projections from the mammillary body to ATN through presynaptic muscarinic receptors. PMID- 3558888 TI - Specific neurotrophic interactions between cortical and subcortical visual structures in developing rat: in vitro studies. AB - We investigated the influence of different subcortical structures on the survival of specific populations of occipital cortex neurons developing in vitro. Explants of embryonic day 14-15 (E14-15) rat cortex were cultured for 5 days with explants of either diencephalon or optic tectum or another occipital cortex explant. Stereological analysis of the explants revealed that after 5 days in vitro (5 DIV) all the cortical explants contained equal proportions of healthy neurons, glia, neuropil, and degenerating profiles, regardless of the culturing conditions. In order to determine if different neuronal populations survived preferentially in the cortical explants as a result of the presence of potential target or afferent structures, we used HRP filling and 3H-thymidine labeling techniques. Specific differences in the morphology of the cells and their time of origin are found in the cortical explants. In the cortical explants cocultured with diencephalon (Cx + D) the cortical cells that survive tend to be round with small cross-sectional areas and have few neurites. These cells are generated late in the culturing period. The surviving cortical neurons in the cortex plus tectum (Cx + T) cultures are larger--many with a pyramidal-shaped soma and several neurites. These cells are generated earlier in vitro. The cortex cultured with other cortex (Cx + Cx) gives values intermediate to the Cx + D and Cx + T cultures. The results of these experiments suggest that there are diffusible trophic factors that arise from subcortical structures that selectively support the survival of neuron populations in the developing neocortex. PMID- 3558889 TI - Specific neurotrophic interactions between cortical and subcortical visual structures in developing rat: in vivo studies. AB - The specificity of trophic interactions in the rat visual system is investigated in vivo by using a combination of tissue culture and CNS transplantation methods. In a companion paper (Repka and Cunningham: '87) we showed that explants of embryonic day 14 (E14) occipital cortex are biased to contain different cortical cell populations depending on whether the explants develop in culture with diencephalon or with optic tectum. In this study we transplanted these precultured cortical explants into the cavity created by a lesion of the occipital cortex in newborn rats and then measured the neuron-occupied volume and the numbers of thymidine-labeled cells in the surviving ipsilateral dorsal lateral geniculate nucleus (dLGN) of the host rats. The results were compared to animals with lesions but no transplants, animals with transplants of E14 cortical tissue that had not been precultured, and animals with cerebellar transplants that had been similarly precultured either with other cerebellar tissue or with diencephalon. At 5 days postlesion, both the largest dLGN volume and the greatest number of labeled dLGN neurons survive in animals with cortical transplants precultured with diencephalon or other cortex. The surviving dLGN neurons that are rescued by these transplants are generated on E15 or E16, a period that corresponds to the latter part of geniculate neurogenesis. Relatively few cells generated on E14 survive in any group of animals. Furthermore, animals with all types of cortical transplants have significantly larger volumes of surviving dLGN than animals with either lesions only or cerebellar transplants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558890 TI - Topography of the corticofugal projection to the lateral reticular nucleus in the monkey. AB - The cortical projection to the lateral reticular nucleus (LRN) was explored in monkeys prepared for autoradiography and horseradish peroxidase (HRP) histochemistry. An unambiguous projection was revealed only in cases with injections of the precentral forelimb and hindlimb areas. The forelimb area projection occupied centromedial segments, the hindlimb area projection occupied ventrolateral segments of the LRN with very little overlap. Some sparse labeling was also seen with injections of the supplementary motor area (SMA), but only when the lectin-bound tracer HRP was injected and not when autoradiography was used. Retrogradely labeled cortical cells occupied a larger cortical area in one case with injection of free HRP into the LRN. Since the additional expanse of cortex, however, was not examined in anterograde cases, and since the injected marker substance had diffused to neighboring structures, the significance of the labeled cells outside the precentral motor cortex is questionable. There was no evidence for a projection from the precentral face area with either anterograde tracing method. The corticoreticular projection was bilateral and only slightly more marked contralateral to the injection. The labeling was largely confined to the magnocellular division with minor amounts in the parvicellular division (especially in the hindlimb cases). The subtrigeminal portion was spared in all cases. It is concluded that the LRN constitutes another somatotopically organized precerebellar nucleus relaying signals from the motor cortex to the cerebellum. Compared with the corticopontocerebellar pathway in monkeys, however, the LRN is only a minor component of the corticocerebellar transmission system. PMID- 3558891 TI - Cortical and peripheral effects on single neurons of the lateral reticular nucleus in the monkey. AB - The aim of this study was to extend the anatomical study of the corticoreticular organization in the monkey by means of microelectrophysiological techniques. Considering the relatively modest projection (see companion paper, Wiesendanger and Wiesendanger, '87), it was surprising to see that over 70% of the investigated LRN neurons were influenced from at least one cortical stimulation site. Many neurons responded, however, with long latencies suggesting an indirect transmission line. In line with the anatomical tracing study, most short-latency responses were obtained from the motor cortex. Postcentral cortex and the SMA were, in general, less effective sites for evoking responses in the LRN. LRN neurons with similar cortical inputs tended to be clustered together suggesting that the corticoreticular projection is discretely organized with an "intermingled somatotopy". The majority of the 87 tested LRN neurons were not reactive to any peripheral stimulus (33%) or responded only to nociceptive peripheral stimulation (31%). Very large receptive fields were seen in 8% of the units. However, a significant proportion of LRN neurons (10%) had restricted receptive fields and reacted to gentle cutaneous stimuli, and others (17%) responded to discrete passive rotations of one or more joints. There was often a somatotopical correspondence between the peripheral and the cortical inputs. It is concluded that the LRN in monkeys is under the influence of the motor cortex, which, however, may be exerted to a major extent via indirect pathways. The electrophysiological data suggest a discrete rather than a diffuse relationship with the LRN. PMID- 3558892 TI - Morphology and distribution of the projection neurons in the cerebellum in a teleost, Sebastiscus marmoratus. AB - Cerebellar efferent neurons in a teleost, Sebastiscus marmoratus, were studied by means of the horseradish peroxidase (HRP) tracing and Golgi impregnation methods. The cerebellar efferents or eurydendroid neurons are classified into two types (A and B) on the basis of the morphology of the dendrites, intracerebellar distribution, and other afferent connections. Type A neurons form a cell cluster in the lobus caudalis and have one thick primary dendrite from which several branches with sparse but long spines extend into the molecular layer of the lobus caudalis. Type B neurons, observed in both the valvula and corpus cerebelli, have two or three primary dendrites running along the ganglion cell layer, and the distal dendritic branches are distributed in molecular layer perpendicularly to the cerebellar surface. Small spines are densely studded on the dendrites of type B neurons. Somata of type A and B neurons are located in and just beneath the ganglion cell layer. The cerebellum projects to the ipsilateral nucleus lateralis valvulae and torus longitudinalis and bilaterally, but mostly contralaterally to the nucleus ventromedialis thalami of Schnitzlein ('62), nucleus ruber, the vicinity of the oculomotor complex, torus semicircularis, and brainstem reticular formation. Type A neurons send axons primarily to the vicinity of the oculomotor complex and partly to the nucleus ventromedialis thalami and the nucleus ruber, whereas type B cells project to all main cerebellar targets. In addition, type B cells are organized topographically in the cerebellum in relation to the efferent targets in the brainstem. PMID- 3558893 TI - Opposing parallel connections through crayfish local nonspiking interneurons. AB - Unilateral local nonspiking interneurons in the terminal (sixth) abdominal ganglion of crayfish (Procambarus clarkii Girard) can be classified into two major groups of PL and AL types by their gross morphology and somatic position. These premotor interneurons are the neural components of uropod motor pattern formation. They receive sensory input from the exopodite of the contralateral side as well as that of the ipsilateral side. Small fluctuations in their membrane potentials cause sustained change in activity of the motoneurons innervating the uropod muscles. PL interneurons, which make noninverting connections to an identified closer, the reductor motoneuron No. 1, mainly receive excitatory input from the afferents of the contralateral exopodite, whereas inverting PL interneurons receive inhibitory input. AL interneurons receive distinctly different input from the afferents. Noninverting AL interneurons mainly receive inhibitory input, whereas inverting AL interneurons receive excitatory input. The rate of discharge of the reductor motoneurons is increased by sensory stimulation. The PL interneurons form either excitatory or disinhibitory pathways, which are relevant in function to the observed increase of the motoneuron. Conversely, the AL interneurons form either inhibitory or disfacilitatory pathways. Thus, the PL and the AL interneurons are fractionated in function and distinguishable in terms of their physiology by their input and output correlations. Functional meaning of the presence of these two types of unilateral local nonspiking interneurons of opposing connections in the uropod motor control system is discussed. PMID- 3558894 TI - Organization of intracortical and commissural connections in somatosensory cortical areas I and II in the raccoon. AB - The organization of intracortical and callosal projecting cell bodies was examined in somatosensory representation areas I (SI) and II (SII) of the raccoon by use of horseradish peroxidase (HRP) or horseradish peroxidase-wheat germ agglutin (HRP-WHA). HRP and HRP-WHA were injected into commissurally and noncommissurally connected subdivisions of SI and SII. Injection sites in SII were identified electrophysiologically. Results were obtained from transverse sections in which the HRP was visualized with the aid of the substrates dihydrochlorobenzidine or tetramethyl benzidine in the presence of hydrogen peroxidase. The principal findings were the following: (1) there are reciprocal connections between SI and SII; (2) in SI the intracortically projecting cell bodies and terminals are located primarily in sulcal cortex; (3) intracortically projecting neurons in SI are located primarily in layers III whereas in SII they are located principally in layers III and V; (4) there are connections between disparate areas within SI; and (5) there are intracortical connections between callosum-connected and acallosal regions in SII. These results are discussed with regard to the results of mapping studies of the SI, the significance of intracortical connections to the formation of sulci in SI, and the possible roles of nonhomotopic connections in the intermanual transfer of learning. PMID- 3558895 TI - Effect of prenatal exposure to alcohol on the distribution and time of origin of corticospinal neurons in the rat. AB - The distribution and the time of origin of corticospinal neurons were examined in rats prenatally exposed to ethanol and in control rats. The distribution of corticospinal neurons was determined by tracing the retrograde transport of horseradish peroxidase (HRP) from an injection site in the cervical spinal cord. In control rats, HRP-positive neurons were distributed in layer Vb throughout motor area 4, rostral motor area 6/8, dorsal somatosensory area 3, caudal somatosensory area 2, and various "association" regions including parietal areas 14, 39, and 40, occipital areas 18a and 18b, cingulate areas 24a and 24b, and prefrontal area 32. In ethanol-exposed rats, the distribution of retrogradely labeled neurons was similar to control animals with three notable exceptions: (1) HRP-positive neurons were evident throughout the rostrocaudal extent of area 6/8; (2) occasionally ectopic labeled neurons were identified in the supragranular layers, layers Va and Vc, and superficial layer VI; and (3) the density of HRP labeled neurons and the ratio of labeled neurons to the total number of neurons in areas 4, 6/8, 3 and 2 were significantly greater (20-48%) in ethanol-exposed rats than in controls. There was, however, no intergroup difference in the area of the cell bodies of HRP-positive neurons. Taken together, these findings indicate that ethanol exposure resulted in an increased number of corticospinal neurons. The time of origin of corticospinal neurons was determined by using a technique that combined tritiated thymidine autoradiography and retrograde transport of HRP. In control animals, HRP-positive neurons were double labeled by an injection of tritiated thymidine on gestational day (GD) 15, 16, or 17. In ethanol-exposed rats, corticospinal neurons were generated on GD 16, 17, and 18, the late-generated ones being distributed in caudal area 6/8. These intergroup differences represent a persisting ethanol-induced alteration of cortical structure that may underlie motor dysfunction and mental retardation in fetal alcohol-affected offspring. Moreover, the increase in the number and the delay in the time of origin of corticospinal neurons suggest that the normal process of paring down exuberant corticospinal projections may be affected by prenatal exposure to ethanol. PMID- 3558896 TI - Single-unit study of lateral line cells in the optic tectum of Xenopus laevis: evidence for bimodal lateral line/optic units. AB - Responses of single units in the Xenopus tectum to stimulation of the contralateral anterior lateral line nerve (cALLN) and optic nerve were studied. Cells responded to cALLN stimulation with a phasic burst of spikes that was repeatable between trials; latencies ranged from 4 to 23 msec. The most excitable cells were located in layer 6 of the ventrolateral tectum. Cells responding to stimulation of the ipsilateral ALLN were far less numerous and robust, and showed latencies 3-10 msec greater than those of contralateral responses. Tectal cell responses to cALLN nerve stimulation grew progressively to saturation with stimulus voltage and paralleled the growth of the ALLN compound action potential; cells responded to stimulation of either supra- or infraorbital branches of cALLN. These observations indicate convergence of primary lateral line afferents in the medulla and/or tectum. Lateral line tectal cells showed strong habituation at interstimulus times less than 8-20 seconds. Experiments on bimodal cells revealed facilitatory and inhibitory interactions between optic and lateral line inputs. Some cells responded to stimulation of either lateral line or optic nerves, with combined stimulation producing responses exceeding the sum of responses to separate nerve stimulation. In other cells the response to optic nerve stimulation was markedly increased by lateral line nerve stimulation, despite the absence of response to lateral line nerve stimulation alone. Facilitation was also evident in cells that responded only to combined stimulation of lateral line and optic nerves. Some cells exhibited an early (5-10 msec) and late (20-40 msec) response to optic nerve stimulation; lateral line nerve stimulation, despite eliciting no response itself, produced strong facilitation of the early but almost complete suppression of the late optic nerve response. PMID- 3558897 TI - Thalamic connectivity of the primary motor cortex of normal and reeler mutant mice. AB - Reeler, an autosomal recessive mutation in mice, causes cytoarchitectonic abnormalities of the cerebral cortex, which are characterized by malposition of neurons. Retrograde and anterograde transport of horseradish peroxidase (HRP) was employed to examine the reciprocal connectivity between the hindlimb area of the primary motor cortex (MI) and thalamus of normal and reeler mutant mice. In the normal mouse, most of the cells labelled after HRP injection into the hindlimb area of MI were located in the ventrolateral nucleus, the lateral division of the ventrobasal nucleus, the central lateral, paracentral and central intralaminar nuclei, and the medial division of the posterior complex. HRP reaction product anterogradely transported was also observed in the same nuclei and in the thalamic reticular nucleus. In the reeler mutant mouse, retrogradely labelled neurons and anterogradely labelled terminals were again found in the nuclei referred to above, and the distribution pattern and morphology of HRP-filled neurons were also similar to those of normal controls. The present results suggest therefore that the normal reciprocal connectivity between MI (hindlimb representation) and thalamus is preserved in the reeler mouse. That is to say, dislocated cortical neurons appropriately project to their target nuclei of the thalamus, and conversely, thalamic neurons send their axons precisely to their target cortical areas of the radially disorganized cortex. PMID- 3558898 TI - Functional organization of primary visual cortex in the mink (Mustela vison), and a comparison with the cat. AB - The functional organization of geniculocortical afferents and the visual responses of neurons in primary visual cortex (area 17) were studied in barbiturate-anesthetized, paralyzed minks and cats. Responses of the afferents were studied after silencing intrinsic cortical activity with injections of kainic acid. In both species, afferents were segregated into patches on the basis of eye of origin. In the mink, but not in the cat, there was a further segregation on the basis of center type, with on- and off-center afferents terminating in alternating, partially overlapping patches. The visual responses of cortical neurons in the mink showed many similarities to those in the cat. Nearly all units were orientation-selective, and there was a columnar organization for preferred orientation. Many units were selective for one direction of movement. Within the binocular segment of cortex, although many units could be driven from either eye, there was a marked bias toward the contralateral eye compared to the cat. There was a columnar system for ocular dominance, but contralateral eye columns were wider than ipsilateral. In both species, a quantitative study was made of the responses of cortical neurons to stationary, flashing slits as a function of position in the receptive field. In the mink, and less clearly in the cat, units could be identified as simple or complex on the basis of the spatial separation or overlap of "on" and "off" discharge zones. In both species, simple cells were found most commonly in layers IV and VI, while layer V contained the greatest proportion of complex cells. The relative strengths of the on and off discharges of single cells were also measured. In the mink, many units gave better overall responses to the on or off phase of the stimulus, and 15% showed a strong (greater than 9:1) preference for one or the other, compared to 4% in the cat. In the mink, units with a common preference for the on or off phase of stationary stimuli were arranged in columnar aggregates, a feature of cortical organization that was not found in the cat. These columns probably result from the partial segregation of on-center and off-center geniculate afferents within layers IV and VI of the mink's cortex. On dominated columns were, however, wider or more numerous than off-dominated columns. PMID- 3558899 TI - Immunohistochemical and biochemical studies on Lys8-Asn9-neurotensin8-13 (LANT6) related peptides in the basal ganglia of pigeons, turtles, and hamsters. AB - The distribution of the neurotensin-related hexapeptide LANT6 within the basal ganglia and its projection targets was studied in turtles, pigeons, and hamsters by using immunohistochemical techniques, radioimmunoassay (RIA), gel chromatography, and high performance liquid chromatography (HPLC). The results in turtles and pigeons were fundamentally similar. Within the basal ganglia, LANT6 like immunoreactivity (LLI) was observed in a population of large striatal neurons (comprising 1-5% of the total number of striatal neurons) and in essentially all of the medium-large pallidal neurons. In addition, LLI was observed in neurons of such other "striatal" and "pallidal" cell groups as the olfactory tubercle and ventral pallidum, respectively. Within the dopaminergic cell fields of the tegmentum, to which the pallidal cell groups project, LLI containing fibers were abundant. Knife-cut studies confirmed that the majority of these LLI-containing fibers arise from telencephalic levels. Biochemical studies with RIA and HPLC showed large amounts of immunoreactive LANT6 (iLANT6) in the basal telencephalon (477 pmol/g) and tegmentum of pigeons (259 pmol/g), and this material was indistinguishable from the synthetic peptide. Lower levels of iLANT6 were demonstrated in the basal telencephalon (82 pmol/g) and tegmentum (156 pmol/g) of turtles, and the majority of this activity appeared to be associated with larger molecular forms of LANT6 or a peptide related to LANT6. In addition, one or more substances resembling Neuromedin N (NMN), a mammalian counterpart to LANT6, were detected in the turtle nervous system. The labeling patterns in hamsters were similar to those in pigeons and turtles, except that in hamsters fewer neurons were labeled and the labeling was generally lighter. The lighter level of labeling may reflect a difference between the LANT6-like material present in hamster nervous system and authentic LANT6. Biochemical studies revealed that a Neuromedin N-like substance, as well as high molecular weight forms of a LANT6-like substance, are present in hamster brain. In hamsters, neurons within globus pallidus, the entopeduncular nucleus, the ventral pallidum, and the polymorph layer of the olfactory tubercle were labeled for the presence of LANT6. Fiber labeling for LANT6 in the dopaminergic tegmental cell groups that receive pallidal input was, however, light. Thus, the present results establish that LANT6 in pigeons and LANT6-related peptides in turtles and hamsters are present within many pallidal neurons. In pigeons and turtles, these pallidal neurons give rise to a major LLI-containing projection to the dopaminergic cell groups of the tegmentum.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3558900 TI - Alimentary lymphomas in the horse. AB - A series of 9 cases of primary diffuse alimentary lymphoma of the equine small intestine is described. Clinically, the principal effects were attributable to malabsorption and disordered alimentary function and several cases had severe anaemia; in four this was of the haemolytic type. Hypoalbuminaemia and elevated gamma globulin levels were often present. The neoplasms were confined mainly to the small intestine and mesenteric lymph nodes, sometimes with some involvement of other lymph nodes as well. The large bowel was affected in one horse, but none of the cases showed detectable invasion of parenchymatous organs. Evidence is presented that some of these lymphomas were of follicle centre cell origin and it is suggested that they had probably arisen from B lymphocytes in gut-associated lymphoid tissue. PMID- 3558901 TI - Control of a line of E. tenella, partly resistant to monensin, by including toltrazuril discontinuously in the drinking water of chickens. AB - Discontinuous medication with toltrazuril, given in the drinking water at a concentration of 50 ppm, was effective in controlling infection resulting from repeated inoculation of oocysts of a line of E. tenella partly resistant to monensin. Treatment was very effective when the drug was given for periods of 3 days, on two or three occasions at weekly intervals. Monensin, at a concentration of 120 ppm, given continuously in the feed was only partially effective. Following treatment with toltrazuril, birds inoculated with high doses of oocysts were immune to subsequent challenge. It is suggested that discontinuous medication with toltrazuril in the drinking water might provide an alternative to the current practice of incorporating drugs continuously in the feed. PMID- 3558902 TI - Molluscum contagiosum in a horse with granulomatous enteritis. AB - Widespread cutaneous papules in a yearling Standardbred filly were attributed by light and electron microscopic examination to molluscum contagiosum. Concomitant granulomatous enteritis, suspected clinically due to protein-losing enteropathy, was verified histopathologically. An associated altered altered immune response is suggested as the reason for the widespread poxvirus infection. PMID- 3558903 TI - Electron microscopic observations on dystrophic neurites in hamster brains infected with the 263K strain of scrapie. AB - Increased numbers of dystrophic neurites filled with inclusions were found in the brains of Syrian hamsters inoculated with scrapie but not in control animals. These neurites were seen as single entities or as clusters of up to three. The possibility that these structures are the beginning of the formation of plaques is discussed. PMID- 3558904 TI - Thinning of articular cartilage in the domestic fowl. AB - Thinning of articular cartilage was identified in pelvic limb joints of broiler and Leghorn-type fowls. Almost all of 100 fowls examined showed cartilage thinning or loss in hip and knee joints. Particular attention was paid to proximal femora; in these, the principal mechanism of cartilage loss involved processes described as "peripheral remodelling". From the edge of cartilage sheets, fibrovascular tissue removed articular cartilage by two mechanisms. Either a pannus of fibrovascular tissue covered the articular surface or non osseous tissue invaded through discontinuities in the bone plate. As in man, peripheral remodelling appears to be age-related and unrelated to regressive or destructive cartilage loss. PMID- 3558905 TI - Astrocytic reaction in experimental scrapie in hamsters. AB - Severe glial reaction (gliocytosis) in hamsters infected with the 263K strain of scrapie is described. Gliocytosis is an extremely rare phenomenon in scrapie affected mice. In hamsters, however, it forms an important and stable feature of the neuropathology. Both astrocytic hyperplasia and hypertrophy are described. The author discusses briefly the possible contribution of the scrapie agent and of the host use in the experiments described here to the development of glial changes. PMID- 3558906 TI - Glioma of the optic nerve with intraocular and intracranial involvement in a dog. AB - An anaplastic glioma of the optic nerve, involving the globe, optic chiasma and brain in a 3 1/2-year-old Labrador Retriever is described. The tumour consisted of lobules of small, dark cells intersected by a delicate fibrovascular stroma. There was a high degree of anaplasia and an average of 19 mitoses per x 200 field. The clinical signs were exophthalmos and mydriasis, followed several months later by blindness and, only terminally, by signs of brain involvement. PMID- 3558907 TI - Vacuolar degeneration of the cochlea in young rats. AB - In the course of investigations of the post-natal development of the ear in Sprague-Dawley rats, a hitherto unrecorded degenerative process was seen in two animals (7-and-8-days old). The process was characterized by vacuolization of almost all the cellular elements of the cochlear tissues. The overall shape and size of the cochlear structures remained well preserved. The organ of Corti did not atrophy but its components were vacuolized, as well as the cells of other inner ear tissues, except for nuclei in the lower part of the modiolus. PMID- 3558908 TI - Cleft palate, brachygnathia inferior, and mandibular oligodontia in a Holstein calf. AB - A case of cleft palate, brachygnathia inferior and mandibular oligodontia is described in a calf. Otitis media may be a complication of cleft palate in the calf as it is in man. Cleft palate in the calf may be further classified into at least 4 major groups and some of the cases might be suitable models for a study of cleft palate in man. PMID- 3558909 TI - Rogaine (topical minoxidil, 2%) in the management of male pattern baldness and alopecia areata. Proceedings of a symposium. Palm Beach, FL, May 17, 1986. PMID- 3558910 TI - Potential mechanisms of minoxidil-induced hair growth in alopecia areata. AB - In vivo, topical minoxidil therapy is associated with changes in the follicular epithelium, tissue and blood lymphocyte populations, lymphocyte blastogenic response to mitogens, and perifollicular vasculature. Biopsy specimens taken from areas of terminal hair regrowth show a dose-dependent increase in hair follicle length, a decrease in tissue lymphocyte populations associated with a simultaneous increase in peripheral blood lymphocyte counts, and reopening of previously closed lumina of perifollicular vessels. Responder lymphocytes show pretreatment-increased concanavalin A and phytohemagglutinin-induced blastogenesis, which decrease toward control values after treatment. In vitro, at concentrations approximating the range of tissue levels in patients treated topically with the 5% solution, minoxidil affects both epithelial cells and lymphocytes in tissue culture. Cultured murine epithelial cells show increased cell proliferation and delayed senescence. Cultured human lymphocytes show suppression of mitogen-induced blast transformation. Differential effects on responder, nonresponder, and control lymphocytes are seen. Minoxidil may induce hair regrowth in alopecia areata by a synergistic stimulatory effect on follicular epithelium and a suppressive effect on lymphocyte-mediated immunologic phenomena. A contributing role for its vasodilatory properties must also be considered. PMID- 3558911 TI - Action of topical minoxidil in the bald stump-tailed macaque. AB - The effect of topical minoxidil (5% and 2% solutions) on hair regrowth was studied in the frontal bald scalp of 18 adolescent and adult stump-tailed macaques (Macaca arctoides). Gross observation of the hairiness and folliculogram analysis of the skin biopsy specimens have shown that minoxidil induces the enlargement of vellus follicles to the size of middle to terminal follicles (regrowth of hair effect), minoxidil maintains the terminal follicles in the prebald scalp of periadolescent animals (prevention of baldness effect), enlarged follicles regress after minoxidil is withdrawn, and hair follicular growth is once again stimulated when treatment with minoxidil is reinstituted. Hair regrowth was more prominent in the early stage of baldness among younger macaques than in baldness of longer duration in older animals. An in vitro study of 3H thymidine uptake revealed that the hair follicles in minoxidil-treated macaque skin showed significant enhancement of deoxyribonucleic acid synthesis in the follicular and perifollicular cells but not in the epidermal keratinocytes. Furthermore, the uptake of 3H minoxidil and its conversion to minoxidil sulfate (the active metabolite producing vasodilation) was relatively higher in the hair follicles than in the epidermis and dermis. Serum concentration of minoxidil was fairly constant 2, 4, 6, 15, and 24 hours after a single application (averaging 15 ng/ml with 5% minoxidil). Minoxidil's essential action in hair follicular growth may be as a potent vasodilator. However, a direct action on the hair follicle cannot be ruled out considering uptake and conversion of the drug to minoxidil sulfate within the hair follicle itself. PMID- 3558912 TI - Use of topical minoxidil as a possible adjunct to hair transplant surgery. A pilot study. AB - Twelve patients, aged 21 to 60 years, with varying Hamilton classifications of androgenetic alopecia (male pattern baldness) were treated with a 3% solution of topical minoxidil. Therapy began 48 to 72 hours after hair transplant surgery. Two patients demonstrated hair growth in the grafts without the shedding that usually occurs 2 to 4 weeks after surgery. (In untreated patients after hair transplant surgery, regrowth begins 3 to 5 months after surgery, after the shedding period.) A review of the literature--and personal discussions with surgeons whose hair transplant experience spans 25 years--revealed no evidence of a similar report. In addition, two of the remaining 10 patients had regrowth less than 4 weeks after postsurgical telogen effluvium. Neither patient age nor number of grafts transplanted played a predictive role. The location of the operative procedure also failed to predict, or preclude, successful regrowth. Topical minoxidil may be an important adjunctive therapy during the recuperative period in patients who have undergone hair transplant surgery. Carefully controlled studies are needed to substantiate this preliminary observation. PMID- 3558913 TI - Mitotic figures in sweat gland adenomas. AB - Mitotic rates (mitotic figures per 10 400X fields) were determined for 115 sweat gland adenomas. The observations were also combined for all lesions within each category of adenoma. The combined mitotic rates of spiradenoma, cylindroma, syringoma, and chondroid syringoma were each less than 1.0. Individual lesions within these categories often lacked mitotic figures. With the exception of 1 chondroid syringoma, none of the individual lesions within these groups had mitotic rates exceeding 2.0. The combined mitotic rates of acrospiroma and hidradenoma papilliferum were 1.6 and 1.52, respectively. Twenty-five percent of the acrospiromas had mitotic rates exceeding 2.0 (maximum 7.5). Mitotic figures were concentrated in specific cell populations, particularly in acrospiromas and chondroid syringomas. The potential for cell division appeared to be reduced or lost in areas of increased cytologic or structural differentiation. A review of the literature indicates that there can be overlap between the mitotic rates of sweat gland adenomas and those of carcinomas. PMID- 3558914 TI - Electron microscopic studies of Moll's gland cyst. AB - Several Moll's gland cysts from 4 different patients were studied with the light and electron microscopes. The cysts were lined with a combination of several different epithelia, such as completely keratinized epithelium, glycogen-rich, stratified squamous epithelium with incompletely keratinized luminal cells, sweat duct epithelium, and secretory cells. In one case in addition to the above components, secretory-type wall cells contained very large lamellar inclusions which were PAS positive and diastase resistant. It was concluded that Moll's gland cyst is composed of dilated duct of the Moll's gland and secretory segment; the proportion of each segment is variable but the portion showing ductal differentiation is usually predominant and typical secretory epithelium is not always seen. PMID- 3558915 TI - Granular cell basal cell carcinoma. AB - Granular cell basal cell carcinoma (BCC) is a rare histologic variant of BCC. In this, the third reported case, the tumor consisted almost entirely of granular cells. By electron microscopy, these cells were filled with pleomorphic lysosome like granules lined by unit membranes and containing homogeneous or granular electron-dense bodies, membranous debris and amorphous material. The epithelial origin of the tumor was suggested by the characteristic light microscopic appearance of tumor cell islands with some areas of peripheral palisading, and was confirmed by electron microscopic features of numerous well-formed pentalaminate desmosome junctions and sparse cytoplasmic tonofilament bundles, some of which showed attachments to the desmosomes. Histochemical immunoperoxidase stains for lysozyme showed no cytoplasmic lysozyme activity, in common with other granular cell tumors, but ultrastructural examination did not reveal angulate bodies, in contrast to findings in non-epithelial granular cell tumors. PMID- 3558916 TI - Ultrastructural study of macromelanosomes in a unique case of spindle and epithelioid cell nevus. AB - Macromelanosomes in a spindle and epithelioid cell nevus, which occurred in the electron beam-damaged skin of a woman with mycosis fungoides, were ultrastructurally investigated. The melanosomes in the spindle and epithelioid cells were varied in size but uniformly spherical in shape and composed of a core and cortex structure. Electron-lucent bodies were observed in the small melanosomes as well as in the macromelanosomes. Positive dopa-oxidase reaction was revealed on the cortex of these melanosomes and partly on their electron lucent bodies. The electron-lucent bodies were not vesicular structures but were aggregates of filamentous elements, which had a continuity with fibrous structures in the melanosome cortex. It is concluded that the electron-lucent bodies may be one of the matrices of melanization. Anomalously large accumulations of these bodies and concentrical melanization seem to lead to the formation of macromelanosomes. PMID- 3558917 TI - Quality assessment of pasteurized fluid milk as related to lipopolysaccharide content. AB - A study was conducted to investigate any relationship between lipopolysaccharide (endotoxin) concentration in milk and parameters associated with the keeping quality of milk. Parameters investigated were flavor intensity, standard plate count, coliform count, psychrotrophic count, and gram-negative count. Lipopolysaccharide content was determined using the Limulus Amoebocyte Lysate assay. Pasteurized whole milk samples were obtained the day of processing in .94 L containers with samples analyzed on d 0 through 21. Significant linear relationships were detected between lipopolysaccharide concentration and days storage at 7 degrees C, flavor intensity, and psychrotrophic count. PMID- 3558918 TI - Milk clotting activity in bovine fetal abomasa. AB - Abomasa (vells) were removed from 30 fetal calves at each of the 6th, 7th, 8th, and 9th mo of development. Milk clotting enzymes were exhaustively extracted in 10% NaCl solutions from the dried abomasal tissue. Total enzyme activity at each stage of fetal development was compared with that from abomasa of 3 to 5-day-old milk-fed calves. Enzyme activity was present in the abomasa of bovine fetuses as early as the 6th mo of development and increased as the fetuses approached full term. Average activity recovered from fetal vells at the 6th, 7th, 8th, and 9th mo of development represented 2, 7, 12, and 31% of the activity per vell, and 8, 14, 22, and 38% of the activity per unit vell weight, of that recovered from high quality calf vells. Diffusion patterns on casein-agar gels produced by bovine fetal extracts differed from those produced by commercial calf rennet extract or porcine pepsin. PMID- 3558919 TI - Induction of lactation: histological and biochemical development of mammary tissue and milk yields of cows injected with estradiol-17 beta and progesterone for 21 days. AB - Lactations were induced in nonpregnant, nonlactating dairy cows by subcutaneous injections of estradiol-17 beta and progesterone for 21 d (.10 and .25 mg/kg body weight/d) and dexamethasone (.028 mg/kg body weight/d) on d 31 to 34. Milking was initiated on d 35. Each cow was biopsied two or three times during the experiment with five to eight mammary tissue biopsies on d 0, 7, 14, 21, 28, 35, 49, and 130. Mammary tissue preinjection had abundant connective and adipose tissues with limited lobuloalveolar structures. Beginning on d 7, there was decreased stroma, increased epithelial cell area, increased lobuloalveolar architecture, plus the accumulation of intracellular and intraluminal secretions which were high in lipid droplets. From d 7 through 35, these changes were progressive although variable among cows. Changes in activities of enzymes and concentrations of ribonucleic acid and deoxyribonucleic acid were gradual during this time but essentially paralleled histological development. Tissue samples during lactation (d 49 and 130) showed increased histological and biochemical development; development was maximal for d 130 samples. Fourteen of 15 cows that lactated had mean daily yields of milk more than 5 kg and yields of milk of 12 cows with projected or actual 305-d lactations were 63.0% of that during their previous natural lactations. Reasons for less yields of milk and for varied patterns of tissue development were not identified nor explained by concentrations of several selected hormones in plasma. PMID- 3558920 TI - Regulation of bovine adipose tissue metabolism during lactation. 1. Lipid synthesis in response to increased milk production and decreased energy intake. AB - Effects of genetic selection for milk secretion and dietary energy restriction on adipose tissue lipid synthesis were tested in first lactation Holsteins. Daughters of bulls of 795 kg or 167 kg of Predicted Difference, base 1974, for milk had a 305 d first lactation of 8626 and 7038 kg of milk at 3.02 and 2.71% milk fat, respectively. Animals of each genetic group were allotted to treatments of a diet of 40% hay and 60% concentrate or of 60% hay, 40% concentrate ad libitum from 0 to 140 d of lactation. First lactation heifers fed the low energy diet ate 19% less net energy and produced 7% less milk of 28% more milk fat percent compared with heifers fed the high energy diet. Lipogenesis rates at 15, 30, 60, and 180 d postpartum in heifers fed low energy diets were 107, 66, 21, and 166% of those in heifers fed high energy diets. Rates of lipogenesis in adipose tissue of heifers of high genetic merit were 40, 10, 45, and 66% of those in low genetic merit heifers at 15, 30, 60, and 180 d postpartum. Lipogenesis in bovine adipose tissue homeostatically adapts to decreased energy intake and homeostatically adapts to genetically selected increase in milk fat secretion. PMID- 3558921 TI - Regulation of bovine adipose tissue metabolism during lactation. 2. Lipolysis response to milk production and energy intake. AB - Lipolytic adaptations of bovine adipose tissue during late pregnancy, lactation, and dry period were studied in Holsteins. Treatment groups consisted of first lactation daughters of high or low bulls based on Predicted Difference for milk. Heifers were fed either a 60% concentrate, 40% hay diet or a 40% concentrate, 60% hay diet from 0 to 140 d lactation. Feeding a low energy diet for the first 140 d of lactation did not affect adipose tissue lipolytic rates measured in vitro. Epinephrine and norepinephrine responsiveness of bovine adipose tissue increased prior to parturition, increased further in early lactation, then remained elevated during lactation and into the dry period. This responsiveness was unaffected by feeding low energy diets. Basal glycerol release in high genetic merit heifers was 64, 17, 40, 23, 20, and 42% greater than in low genetic merit heifers at -30, -15, 30, 60, 180, and 349 d about parturition. Response to norepinephrine was 15, 20, 18, and 15% greater in high genetic than low genetic merit heifers and response to epinephrine was 12, 20, 14, and 50% greater in high genetic than low genetic merit heifers at 30, 60, 180, and 349 d postpartum. The lack of a dietary energy restriction effect on lipolysis in early lactation suggested that these rates were near the physiological maximum for those animals. Rates of lipolysis were positively related with milk fat production. This study indicates a genetic component in adrenergic regulation of lipolysis in adipose tissue, independent of energy balance, in supporting lactation. PMID- 3558922 TI - Influence of niacin and whole cottonseed on intake, milk yield and composition, and systemic responses of dairy cows. AB - Twenty-four Holstein cows (early postpartum) were used in a randomized complete block design with a 2 X 2 factorial arrangement of treatments to compare effects of nicotinic acid (niacin) and whole cottonseed. Cows were fed individually isonitrogenous complete mixed rations ad libitum, containing corn-soy concentrate, corn silage, chopped coastal bermudagrass hay, and either 1) 0% niacin and 0% whole cottonseed, 2) 0% niacin and 15% whole cottonseed, 3) .03% niacin and 0% whole cottonseed, or 4) .03% niacin and 15% whole cottonseed. Dry matter and energy consumption, actual milk yield, total milk solids, and milk fat yield were not affected by treatment. Either niacin or whole cottonseed increased milk fat percentage and 4% fat-corrected milk. Milk protein percentage and yield were higher with niacin supplementation but tended to be lower with cottonseed feeding. The milk protein depression with whole cottonseed was alleviated by niacin due to stimulation of mammary casein synthesis. Supplemental niacin tended to elevate glucose and insulin in blood plasma, but whole cottonseed tended to reduce these plasma components. Plasma urea nitrogen was higher in cows fed whole cottonseed. Plasma-free tryptophan tended to be slightly higher in cows receiving supplemental niacin. PMID- 3558923 TI - Effect of feeding method on nonnutritive oral activities in Holstein calves. AB - Forty Holstein heifer calves were assigned to be fed whole milk from either bucket, bucket with pacifier, nipple bottle, or nipple bottle with pacifier. The pacifier was a nursing bottle with an unperforated nipple. Calves were housed in individual hutches and fed twice daily. Calves were 3 d of age at first observation and were observed biweekly until 42 d of age. Observations were conducted beginning at either 1000 or 1400 h from September through March. A novel object (bicycle inner tube), selected to serve as a focal object for the sucking drive, was placed in the calf's environment and calf behaviors observed during the next 5 min. Time of observation did not influence nonnutritive oral behaviors (sniffing, licking, sucking, chewing, oral grooming, and nose licking). Time spent in nonnutritive oral behaviors increased with age. Regardless of availability of a pacifier, bucket-fed calves spent more time in sniffing the focal object than bottle-fed calves. Calves with access to pacifiers sucked other objects more than calves without pacifiers. The more curious animals spent more time involved in nonnutritive oral behaviors. PMID- 3558924 TI - A further look at evidence for cytoplasmic inheritance of production traits in dairy cattle. AB - A recent study interpreted significant effects of source of cytoplasm as evidence for cytoplasmic inheritance. An alternative interpretation that observed results reflected residual additive genetic effects unaccounted for by statistical models used was tested by computer simulation of records over 60 yr for milk yield (h2 = .30) and fat percentage (h2 = .60) under an additive genetic model with no cytoplasmic effects. First lactation records for the last 30 yr were analyzed by least squares according to models that included effects of cytoplasmic source, generations to cytoplasmic source, herd, and year as well as effects of sire (model 1), sire and record of dam (model 2), Predicted Difference of sire (model 3), or Predicted Difference of sire and 1/2 Predicted Difference of maternal grandsire (model 4). Ten replicates were performed. Significant cytoplasmic effects were observed for all models in at least 8 of 10 replicates for milk yield and in all replicates for fat percentage. Average F ratios for cytoplasmic effects were 1.43, 1.25, 1.46, and 1.43 for milk yield and 2.00, 1.29, 2.04, and 1.96 for fat percentage for models 1, 2, 3, and 4. Cytoplasmic variances were 1.4 and 3.2% of residual variances for milk yield and fat percentage for model 1. Unaccounted for additive genetic effects can produce spurious cytoplasmic effects. PMID- 3558925 TI - Relationships between conformation and calving interval in Holstein cows. AB - Type information collected by the Holstein Association of Canada from 1976 to 1983 was matched with calving interval records from the Record of Performance program of Agriculture Canada. Type traits considered were final class, major scorecard breakdown traits (general appearance, dairy character, capacity, rump, feet and legs, mammary system, fore udder, rear udder), and eight descriptive traits (stature, size, style, dairyness, chest floor, loin strength, thurl width, pin setting). The edited data consisted of 22,791 records on first calf heifers by 2548 sires in 9272 herd-round of classification groups. Sire evaluations for both type and calving interval were available for 3312 sires. Heritability of calving interval was estimated to be .04. Heritability estimates of type traits ranged from .06 for style to .33 for size. Phenotypic correlations between the type traits and calving interval were essentially zero. The highest favorable genetic correlations with calving interval were for chest floor (-.42), rear udder (-.37), capacity (-.34), and highest antagonistic correlations were for dairyness (.43) and dairy character (.38). Direct selection for improved calving interval was estimated to be more efficient than indirect selection on any of the type traits considered. PMID- 3558926 TI - Health care of Holsteins selected for large or small body size. AB - Genetic groups of Holsteins selected for large size or small size were compared for health care needs. Two groups were formed from a paired foundation population. Large group was mated to sires with extreme estimates of transmitting ability for tall height and deep and wide bodies. Small group was similarly mated to extreme sires but to those transmitting short height and shallow and narrow bodies. Predicted Differences for milk and fat of sires were above breed average. Actual expenses for veterinary treatment, health supplies and drugs, and value of labor required of animal attendants were evaluated. Large cows required significantly more health care than small cows. Digestive disorders accounted for much of the group difference, and displaced abomasums were more frequent among large cows. Small cows may have economic advantages over large cows of the same breed. PMID- 3558927 TI - Cooling dairy cattle by a combination of sprinkling and forced ventilation and its implementation in the shelter system. AB - A method for cooling dairy cattle based on repeated wetting to attain maximal water trapping in the coat, followed by its rapid evaporation by using forced ventilation has been examined. Effects examined include duration of wetting, duration of cooling, and density of the animals in the holding area. The coat was wetted by inverted static sprinklers. Also examined was the extent to which the diurnal increase in rectal temperature can be prevented. The maximal decrement of temperature was attained at 30 min after cessation of cooling in all trials. Wetting the coat for 10 s was less effective than for 20 or 30 s; the latter did not differ in their effects. Cooling animals for 15, 30, and 45 min produced decrements in temperature of .6, .7, and 1.0 degrees C, respectively. Maintaining animals at a density of 1.9 m2/cow in the holding area reduced to about half the decrement as compared with a density of 3.5 m2/cow. When cows were cooled 5 times per day for 30 min, temperatures were maintained within 38.2 to 38.9 degrees C during the day, which were significantly lower than for those not cooled. PMID- 3558928 TI - Association of bovine lymphocyte antigens with milk fat percentage differences. AB - A group of 246 Holstein artificial insemination bulls was examined for associations of bovine lymphocyte antigens with differences in transmitting ability for milk and fat yield and fat percent. The mean fat percentage associated with the w10 allele was .15% greater than the mean for four other alleles. No differences in phenotypic or allelic effects were detected for milk or fat yield. PMID- 3558929 TI - Phytate phosphorus intake and disappearance in the gastrointestinal tract of high producing dairy cows. AB - Thirty Holstein cows were fed diets of 50% grain and 50% corn silage (dry matter basis) through the first 18 wk of lactation. Grain mixes were supplemented with inorganic calcium sources (aragonite, calcite flour, or albacar) to provide .6 or .9% dietary calcium (dry matter basis). Phytate phosphorus intake averaged 38.3 and 42.6 g/d in digestion trials conducted during wk 4 and 10 of lactation, respectively. Even though large quantities of feed and significant amounts of grain were consumed, 98% of dietary phytate phosphorus was hydrolyzed to inorganic phosphorus. Neither calcium source nor calcium quantity affected the hydrolysis of phytate phosphorus. PMID- 3558930 TI - Thickness of malignant melanoma: global analysis of related factors. PMID- 3558931 TI - Dobutamine in elderly septic shock patients refractory to dopamine. AB - The hemodynamic effects of dobutamine (2.5-20 micrograms/kg per min) were studied in six elderly patients with septic shock which was refractory to dopamine (15 micrograms/kg per min). Dobutamine infusion resulted in significant increases in cardiac index (CI), stroke index (SI) and left ventricular stroke work index (LVSWI) and similar declines in heart rate (HR), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance (SVR) and total pulmonary resistance (TPR). Dose response curves demonstrated a linear rise in CI with increasing doses of dobutamine and parallel decreases in HR and PCWP. MAP was unchanged. These data indicate that dobutamine may be a useful adjunct to dopamine therapy in the management of elderly patients with septic shock. PMID- 3558932 TI - Volume/pressure curve of total respiratory system in paralysed patients: artefacts and correction factors. AB - The volume/pressure (V/P) curve of the total respiratory system in paralysed patients is drawn assuming that volume changes of the respiratory system (delta V resp) equals volume displacement of the measuring apparatus (delta V syr), usually a supersyringe. However, in 93 VP curves we found that O2 removed from the lung-syringe system during the procedure (proportional to the time) largely exceeds the CO2 added to the lung-syringe system (delta V gas). This results in a net loss of volume from the system (delta V resp less than delta V-syr). Deflation compliance, hysteresis area and ratio are significantly affected by this phenomenon. Inflation compliance is less influenced by delta V gas, partially compensated by the intrapulmonary gas expansion due to the temperature changes. We conclude that the parameters computed on the deflation limb of V/P curve are misleading if proper correction of the volume scale is not introduced. PMID- 3558933 TI - Acute and chronic effects of xanthine oxidase on lung thorax-compliance in guinea pigs. AB - Xanthine oxidase was given intratracheally in a single dose to guinea pigs. Lung compliance was measured after 4 h and 14 days respectively. Lung-thorax compliance was significantly lower compared with saline-treated controls both 4 h and 14 days after application of fluid. At 14 days there was a dose-related response between lung-thorax compliance and xanthine oxidase administered in the range 0-1.0 U. Superoxide dismutase (SOD) had a protective effect on xanthine oxidase action at 4 h, but not after 14 days. We suggest that the decreased lung thorax compliance was caused by superoxide radicals, produced by the hypoxanthine xanthine oxidase system, damaging lung tissue. We speculate that free oxygen radicals produced by the hypoxanthine-xanthine oxidase system could be an important contributory pathogenetic factor in producing both acute and chronic lung damage in, for instance, premature babies or adults, with respiratory distress syndrome. PMID- 3558934 TI - Massive thyroxine intoxication: evaluation of plasma extraction. AB - Six patients were admitted after erroneous massive intake of levothyroxine (70 1200 mg over an interval of 2-12 days). All patients developed classical symptoms of thyrotoxicosis within 3 days of the first dose; five patients presented grade II-III coma and one became stuporous (days 7-10). Two patients developed left ventricular failure and three had arrhythmias (days 8-11). Total thyroid hormone levels in serum on admission ranged 935-7728 nmol/l for T4 (TT4) and 23-399 nmol/l for T3 (TT3). All patients received treatment with hydrocortisone and Propranolol. Propylthiouracil was also given in 3 cases. Extractive techniques (charcoal haemoperfusion and/or plasmapheresis) were initiated 8-14 days after the first dose of L-T4. The plasma disappearance rate (K) of TT4 with plasmapheresis was 30 times higher, on average, than under standard medical treatment (M). Also, K of TT4 under haemoperfusion was about five times higher than K under M. K changes for TT3 were higher under haemoperfusion than under plasmapheresis. Furthermore, extractive procedures shortened the average half life of TT4, (from 106.5 +/- 44.6 to 59.7 +/- 20.2 h, p less than 0.05). PMID- 3558935 TI - A combined technique of local thrombolysis and regional neural blockade in severe venous occlusions. AB - Four patients with venous occlusions were treated with a combined technique including thrombolysis and regional sympathetic blockade. The thrombolytic therapy was achieved with streptokinase and/or urokinase infusion via venous catheter located distal to the obliteration in flow direction. The dose of the thrombolytic agents ranged between 40,000 and 200,000 U/h and lasted for a period of 3 days to 6 weeks. Subsequent anticoagulation using systemic low dose heparin was conducted for a further 2 weeks. Initial sympathetic blockade with concomitant analgesia and vasodilatation was accomplished by bupivacain either at the stellate ganglion or epidurally depending on the thrombus location. The circulation and function of the affected extremities were restored after lysis and no amputation was necessary. The described procedure seems to offer promising possibility in the treatment of severe venous thromboses in high-risk patients. PMID- 3558936 TI - Thrombogenicity of pulmonary-artery catheters. AB - The thrombogenicity of heparin-bonded and non-heparin-bonded pulmonary-artery catheters was compared by means of pull-out phlebography in a prospective, randomized clinical study of 20 patients in an intensive care unit (ICU). The duration of catheterization averaged 47.4 +/- 4.1 h in the heparin-bonded group (10 patients) and 45.7 +/- 7.1 h in the non-heparin-bonded (10 patients). Age, clinical diagnosis, mean time required to obtain a stable wedge position, heparin dose administered and clotting indices were comparable between the groups. There was no statistically significant difference in the length of formed thrombi (2.3 +/- 1.89 vs 5.88 +/- 4.62 cm) or frequency of thrombus formation between the groups. The thrombi originated and propagated from the puncture site. They were mural proximally and formed sleeves in the superior vena cava. Several sleeves stripped off on withdrawal of the catheter. Protection from thrombosis offered by heparin bonding of pulmonary-artery catheters should, therefore, not be overestimated--at least not in long-term catheterization of ICU patients. PMID- 3558937 TI - Measurement of irradiation doses secondary to bedside radiographs in a medical intensive care unit. AB - The authors prospectively studied the radiation doses to radio-sensitive organs secondary to bedside radiographs in intensive care patients and in a control phantom. Dosimeters were taped on different organs during each bedside X-ray. The mean radiation doses, expressed in 10(-5) Gy (m-rad), for an "average patient" who was hospitalized 9 days and had 6 chest X-rays were respectively: 292 to the sternal bone marrow; 239 to the thyroid gland; 3 to the testes; 1 to the ovaries; 605 to the eye for 2 maxillary sinus X-rays. No diffused irradiation was measured during a 2-month period in the intensive care unit nor on dosimeters worn by four nurses. PMID- 3558938 TI - Evaluation of pediatric intensive care in Europe. A collaborative study by the European Club of Pediatric Intensive Care. AB - There are no reports analyzing the results of pediatric intensive care in Europe. We evaluated quantitatively the severity of illness and the amount of care required for 714 consecutively admitted patients. We used simultaneously the Clinical Classification System (CCS) the Acute Physiology Score (APS) and the Therapeutic Intervention Scoring System (TISS). Overall mortality at 1 month was 15%. The mortality rate was higher for CCS Class IV patients (32.3%) than for CCS III (4.5%) and CCS II (3.2%). The difference was significant between CCS IV and CCS III and II respectively (p less than 0.001) but no difference was observed between CCS III and CCS II. The patients were also classified among 7 major organ system failures: cardio vascular, respiratory, neurologic, gastro intestinal, renal, metabolic, hematologic. Three of them were primarily involved: respiratory (44.9%) cardio-vascular (20.7%), neurologic (18.8%). Among these 3 groups the highest mortality was observed in cardio-vascular patients (p less than 0.01 v.s. respiratory, p less than 0.05 v.s. neurologic). The death rate was 22% among the 264 neonates, 9.7% among the 247 infants (p less than 0.01) and 12.6% among the 198 children. APS and TISS scores increased significantly with the CCS classes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558939 TI - High-frequency ventilation (HFV) in hyaline membrane disease--a preliminary report. AB - Eight premature babies affected by hyaline membrane disease and needing mechanical respiratory support were ventilated by means of a VDR 1 (Bird Space Technology) respirator at 10 Hz during a mean time of 51 h. Before HFV 7 infants had been on conventional mechanical ventilation (CMV) and one on nasal CPAP. The values of mean airway pressure (MAP) and oxygenation index (PaO2/FIO2) on CMV and HFV were (mean and range): CMV: MAP 15 (4-29) mm Hg, ox. index 15.47 (5.07-23.19) kPa; HFV after 1 h: MAP 15 (10-19) mm Hg, ox. index 24.13 (9.07-46.12) kPa. Improved oxygenation allowed rapid reduction of FIO2 in the following hours. Only 3 infants were weaned directly from VDR 1, 5 were switched back to CMV mainly because of technical failures of the respirator. The change from HFV to CMV was associated with a fall of PaO2/FIO2 from 35.99 (15.86-74.52) to 22.39 (7.33 31.46) kPa. The mean time of artificial ventilation (CMV + HFV) was 121 h (range 46-166). Except for 1 pneumothorax no medical complications were seen during HFV, and all patients survived. Despite impressive improvements in oxygenation it is cautioned against the use of the VDR 1 because of the high incidence of technical problems. PMID- 3558940 TI - Torsade de pointes as a complication of brainstem encephalitis. AB - A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monitoring. PMID- 3558941 TI - Minitracheostomy in the treatment of sputum retention. AB - Cricothyroid puncture in the process of minitracheostomy may encounter aberrant blood vessels and require surgical exploration. PMID- 3558943 TI - Dependency and self-criticism: vulnerability factors for depressive affective states. PMID- 3558942 TI - Influence of patients' age on survival, level of therapy and length of stay in intensive care units. AB - The influence of patients' age on survival, level of therapy and length of stay was analyzed from data collected in 792 consecutive admissions to eight intensive care units. Mortality rate increased progressively with age; over 65 years of age, it was more than double that of patients under 45 years (36.8% versus 14.8%). However, mortality rate in patients over 75 years was equal to that observed in the 55 to 59 years group. There was a significant relationship between age and acute physiology score (APS) and the influence of age upon outcome decreased when APS increased. The number of TISS (therapeutic intervention scoring system) points delivered to patients increased slightly but significantly with age (r = 0.14). Standard care was responsible for the main part of this increase. Both in survivors and in non-survivors the length of stay was not different comparing the stay of the oldest patient with that of the younger age groups. We conclude that, in ICU patients, age is an important factor of prognosis but not as important as the severity of illness, and that there is no major difference in outcome of patients over 65 years of age compared to the entire study group of ICU patients. PMID- 3558944 TI - Cognition and social adversity in the depressed elderly. PMID- 3558945 TI - Psychopathology and marital distress: the positive side of positive symptoms. PMID- 3558946 TI - Risk, resistance, and psychological distress: a longitudinal analysis with adults and children. PMID- 3558947 TI - Specificity and stability of self-referent encoding in clinical depression. PMID- 3558948 TI - Method to study anhedonia in hospitalized psychiatric patients. PMID- 3558949 TI - An analysis of factors that contribute to the efficacy of hypnotic analgesia. PMID- 3558950 TI - Failure of posthypnotic responding to occur outside the experimental setting. PMID- 3558951 TI - Control-related beliefs and depression among clinic-referred children and adolescents. PMID- 3558952 TI - Dexamethasone suppression and self-reinforcement correlates of clinical depression. PMID- 3558953 TI - Cognitive abstraction, shifting, and control: clinical sample comparisons of psychopaths and nonpsychopaths. PMID- 3558954 TI - Inductions versus suggestions: effects of direct and indirect wording on hypnotic responding and experience. PMID- 3558955 TI - Measuring helmet sound attenuation characteristics using an acoustic manikin. AB - The sound attenuation characteristics of two military helmets were measured using an acoustic manikin as the test apparatus. The manikin results are compared to the results of attenuation measurements made on human subjects wearing identical helmets. The testing room and instrumentation were the same for both the manikin and human subjects. Procedures in ANSI S3.19-1974 were used in the real-ear attentuation at threshold (REAT) part of this study. The results are encouraging as they suggest that the manikin may be used in place of a panel of human subjects to evaluate the hearing protection characteristics of military head gear. PMID- 3558956 TI - On Riccati equations describing impedance relations for forward and backward excitation in the one-dimensional cochlea model. AB - Recent experimental observations of otoacoustic emissions suggest the existence of spontaneous emitters of sound on the basilar membrane. These tend to send off waves not only in the normal direction of propagation. It is therefore significant to study the environmental conditions such an emitter finds inside the cochlea. The impedance relations seen by these emitters are described by the Riccati equation for an inhomogeneous transmission line. The results reported in this paper differ considerably for forward and backward excitation. This reflects the quite different behavior of the cochlea pertaining to waves traveling forward and backward. Because of reflections, backward waves cannot be treated with the Liouville-Green approximation. PMID- 3558957 TI - Auditory brain stem responses from human adults and infants: wave V tuning curves. AB - Decrement in ABR wave V amplitude was measured in the presence of simultaneous tonal maskers. Probe stimuli were 1.0, 4.0, and 8.0-kHz third-octave-filtered clicks. Adults and 3-month-old infants served as subjects. The resultant amplitude-decrement functions for each tonal masker were fit with regression lines. The sound pressure level (SPL) required to reduce wave V to 50% of the unmasked probe amplitude was plotted for each masker to develop tuning curves. The tuning curves were quantified by calculations of tip-to-tail difference, Q 10, and SPL at maximum masker frequency (MMF). Tuning curves for adult and infant subjects were similar for the 1.0-kHz probe. For the high-frequency probes (4.0 and 8.0 kHz), smaller tip-to-tail differences and lower Q 10 values were observed for the infant subjects. Ranges of MMF level were similar across adult and infant subjects. For the 8.0-kHz probe, tuning curves from infant subjects consistently showed maximum masker frequencies which were lower than the probe. PMID- 3558958 TI - A release from masking by continuous, random, notched noise. AB - Thresholds for 10-ms sinusoids simultaneously masked by bursts of bandpass noise centered on the signal frequency were measured for a wide range of signal frequencies and noise levels. Thresholds were defined as the signal power relative to the masker power at the output of an auditory filter centered on the signal frequency. It was found that the presentation of a continuous random noise, with a spectral notch centered on the signal frequency, produced a reduction in signal thresholds of up to 11 dB. A notched noise spectrum level of 0-5 dB above that of the masker proved most effective in producing a masking release, as measured by a reduction in masked threshold. A release from masking of up to 7 dB could be obtained with a continuous bandpass noise. The most effective spectrum level of this noise was 5 dB below that of the masker. The effect of the continuous notched noise was to reduce signal-to-masker ratios at threshold to about 0 dB, regardless of the threshold in the absence of continuous noise. Thus the greatest release from masking occurred when "unreleased" thresholds were highest. The release from masking is almost complete within 320 ms of notched noise onset, and persists for about 160 ms after notched noise offset, regardless of notched noise level. The phenomenon is similar in many ways to the "overshoot" effect reported by Zwicker [J. Acoust. Soc. Am. 37, 653-663 (1965)]. It is argued that both effects can be largely attributed to peripheral short-term adaptation, a mechanism which is also believed to be involved in forward masking. PMID- 3558959 TI - Individual differences in auditory capabilities. I. AB - Twenty-eight audiometrically normal adult listeners were given a variety of auditory tests, ranging from quiet and masked thresholds through the discrimination of simple and moderately complex temporal patterns. Test-retest reliability was good. Individual differences persisted on a variety of psychoacoustic tasks following a period of training using adaptive threshold tracking methods, and with trial-by-trial feedback. Large individual differences in performance on temporal-sequence-discrimination tasks suggest that this form of temporal processing may be of clinical significance. In addition, high correlations were obtained within given classes of tests (as, between all tests of frequency discrimination) and between certain classes of tests (as, between tests of frequency discrimination and those of sequence discrimination). Patterns of individual differences were found which support the conclusion that individual differences in auditory performance are, in part, a function of patterns of independent abilities. PMID- 3558960 TI - Effects of signal envelope on the pitch of short complex tones. AB - Envelope-induced pitch shifts were measured for exponentially decaying complex tones consisting of two sinusoidal components with frequencies f1 = nf0 + 50 Hz and f2 = (n + 1) f0 + 50 Hz, where n equals 3, 4, or 5 and exponential decay rates were 0, 0.5, 1, and 2 dB/ms. Four subjects adjusted a sinusoidal comparison tone to match the virtual pitch of the (missing) fundamental and the pitches of the lower and upper partials f1 and f2. Pitch shifts for f1 are generally less, and pitch shifts for f2 always greater, than envelope-induced shifts observed in isolated sinusoidal tones of comparable frequency and envelope decay rate. Pitch shift functions for virtual pitch are similar in magnitude and shape to average pitch-shift functions of the partials, which supports the idea that virtual pitch depends on spectral pitch. PMID- 3558961 TI - Discrimination of spectral-peak amplitude by normal and hearing-impaired subjects. AB - The present study compared the abilities of normal and hearing-impaired subjects to discriminate differences in the spectral shapes of speechlike sounds. The minimum detectable change in amplitude of a second-formant spectral peak was determined for steady-state stimuli across a range of presentation levels. In many cases, the hearing-impaired subjects required larger spectral peaks than did the normal-hearing subjects. The performance of all subjects showed a dependence upon presentation level. For some hearing-impaired subjects, high presentation levels resulted in discrimination values similar to that of normal-hearing subjects, while for other hearing-loss subjects, increases in presentation level did not yield normal values, even when the second-formant spectral region was presented at levels above the subject's sensitivity thresholds. These results demonstrate that under certain conditions, some sensorineural hearing-impaired subjects require more prominent spectral peaks in certain speech sounds than normal subjects for equivalent performance. For the group of subjects who did not achieve normal discrimination results at any presentation level, application of high-frequency amplification to the stimuli was successful in returning those subjects' performance to within normal values. PMID- 3558962 TI - Influence of place synchrony on detection of a sinusoid. AB - A series of experiments was performed to study the ability of the ear to code the temporal envelope of a waveform as demonstrated by comodulation masking release (CMR). The stimulus for all experiments was composed of a tone-burst signal, a 100-Hz-wide masker band centered at the signal frequency, and a second 100-Hz wide noise band of variable frequency, the cue band. The cue band had a temporal envelope which was either correlated with or independent of that of the masker. The signal was a 100-Hz tone burst for most experiments. For the monotic stimulus, the correlated cue band results in lowered signal detection thresholds over a range extending from around 2/3 oct below the signal frequency to 1/3 oct above that frequency. When measured dichotically, with the signal and masker band in one ear and the cue band in the opposite ear, that effective range is expanded but the detection threshold shifts are a bit smaller. The greatest CMR is observed when the stimulus is presented diotically. With regard to effects of level and frequency, our data show CMR increasing with increasing stimulus level for a cue band lower in frequency than the signal, but show little effect of level for a cue band higher in frequency. Similarly, CMR increases with increasing stimulus frequency when the cue band is lower in frequency, but shows little effect of frequency for a cue band higher in frequency. PMID- 3558963 TI - Masker-bandwidth dependence in homophasic and antiphasic tone detection. AB - Thresholds for the detection of 500-ms tones in noise at either 0.25 or 4 kHz and either interaurally in-phase (NoSo) or out-of-phase (NoS pi) were measured as a function of the bandwidth of a diotic masking noise (with total noise power held constant). NoSo thresholds followed the classic trend indicative of an effective critical band in noise masking. NoS pi thresholds also indicated critical-band filtering, but with a wider effective critical bandwidth. At subcritical masker bandwidths, for both 0.25 and 4 kHz, NoS pi thresholds increased with an increase in noise bandwidth, despite the fact that total noise power was constant. This latter finding is attributed to binaural insensitivity to rapid fluctuations in the interaural cues that subserve detection in the NoS pi condition. These results suggest a new interpretation for the small difference between NoSo and NoS pi thresholds measured with high-frequency tones in a broadband noise masker. This interpretation is based partly on the inability to utilize rapidly varying interaural cues, partly on out-of-band interference effects, and partly on loss of information related to stimulus fine structure. PMID- 3558964 TI - The effect of varying the slope of the amplitude-frequency response on the masked speech-reception threshold of sentences. AB - Within the framework of a study on the merits of a frequency-dependent automatic gain control in hearing aids, the effect of varying the slope of the amplitude frequency response on the speech-reception threshold (SRT) for sentences in noise was studied for normal-hearing listeners. Speech and noise were both subjected to the same amplitude-frequency response. In the first experiment, the effect of a constant slope was investigated (20 listeners). Over a range of about -7 to +10 dB/oct, the SRT in noise remained constant. In the second experiment, a single change in the slope of the amplitude-frequency response was introduced halfway through the sentence. The effect of varying the transition time over a range down to 0.125 s appeared to be very small. In the third experiment, the slope varied continuously with range and variation frequency (0.25-2 Hz) as the parameters. The masked SRT increased gradually with variation frequency. The results indicate that the masked SRT for sentences is remarkably resistant to dynamic variations in the slope of the amplitude-frequency response. PMID- 3558965 TI - Calibration of ear canals for audiometry at high frequencies. AB - A procedure is described for determining the absolute sound pressure at the inner end of the ear canal when a sound source is coupled to the ear, for frequencies in the range 8-20 kHz. The transducer that generates the sound is coupled to the ear canal through a lossy tube, yielding a source impedance that is approximately matched to the characteristic impedance of the ear canal. A small microphone is located in the coupling tube close to the entrance to the ear canal. Calibration is carried out by measuring the response at this microphone when an impulse is applied at the transducer. To estimate the sound pressure at the medial end of the ear canal, the Fourier transform of this impulse response is corrected by an all-pole function in which the poles are estimated from the minima in this Fourier transform. Data on individual ear canals are presented in terms of gain functions relating the sound pressure at the medial end of the ear canal to the sound pressure when the coupling tube is blocked. The average gain function for a group of adult ears increases from 2 to 12 dB over the frequency range 8-20 kHz, in rough agreement with data from ear-canal models. Possible sources of error in the calibration procedure are discussed. PMID- 3558966 TI - High-frequency audiometric assessment of a young adult population. AB - The hearing thresholds of 37 young adults (18-26 years) were measured at 13 frequencies (8, 9,10,...,20 kHz) using a newly developed high-frequency audiometer. All subjects were screened at 15 dB HL at the low audiometric frequencies, had tympanometry within normal limits, and had no history of significant hearing problems. The audiometer delivers sound from a driver unit to the ear canal through a lossy tube and earpiece providing a source impedance essentially equal to the characteristic impedance of the tube. A small microphone located within the earpiece is used to measure the response of the ear canal when an impulse is applied at the driver unit. From this response, a gain function is calculated relating the equivalent sound-pressure level of the source to the SPL at the medial end of the ear canal. For the subjects tested, this gain function showed a gradual increase from 2 to 12 dB over the frequency range. The standard deviation of the gain function was about 2.5 dB across subjects in the lower frequency region (8-14 kHz) and about 4 dB at the higher frequencies. Cross modes and poor fit of the earpiece to the ear canal prevented accurate calibration for some subjects at the highest frequencies. The average SPL at threshold was 23 dB at 8 kHz, 30 dB at 12 kHz, and 87 dB at 18 kHz. Despite the homogeneous nature of the sample, the younger subjects in the sample had reliably better thresholds than the older subjects. Repeated measurements of threshold over an interval as long as 1 month showed a standard deviation of 2.5 dB at the lower frequencies (8 14 kHz) and 4.5 dB at the higher frequencies. PMID- 3558967 TI - Measures of phonation type in Hmong. AB - This study examines measures of glottal flow for vowels of Hmong, a Southeast Asian language which uses breathy and normal phonation contrastively. A software inverse filter was used to recover glottal airflow from oral airflow recordings. Properties of glottal flow measured in the time domain were glottal pulse symmetry and relative closed-phase duration. In the frequency domain, measures of spectral tilt and the amplitude difference between F0 and H2 were applied to discrete Fourier transforms (DFTs) of the glottal flow waveforms. Spectral tilt could not be reliably measured for many tokens. For the other measures, values were available for all tokens and were compared across phonation types. Flow pulse symmetry is not significantly different for breathy and normal-voice vowels. On the other hand, prominence of the fundamental relative to the second harmonic is a very significant correlate of the breathy/normal distinction, as is the relative closed-phase duration. These results are considered in light of an existing model of the voice source. PMID- 3558968 TI - Acoustic analyses of infant fricative and trill vocalizations. AB - Closants, or consonantlike sounds in infant vocalizations, were described acoustically using 16-kHz spectrograms and LPC or FFT analyses based on waveforms sampled at 20 or 40 kHz. The two major closant types studied were fricatives and trills. Compared to similar fricative sounds in adult speech, the fricative sounds of the 3-, 6-, 9-, and 12-month-old infants had primary spectral components at higher frequencies, i.e., to and above 14 kHz. Trill rate varied from 16-180 Hz with a mean of about 100, approximately four times the mean trill rate reported for adult talkers. Acoustic features are described for various places of articulation for fricatives and trills. The discussion of the data emphasizes dimensions of acoustic contrast that appear in infant vocalizations during the first year of life, and implications of the spectral data for auditory and motor self-stimulation by normal-hearing and hearing-impaired infants. PMID- 3558969 TI - Acoustic analyses and perceptual data on anticipatory labial coarticulation in adults and children. AB - The present study investigated anticipatory labial coarticulation in the speech of adults and children. CV syllables, composed of [s], [t], and [d] before [i] and [u], were produced by four adult speakers and eight child speakers aged 3-7 years. Each stimulus was computer edited to include only the aperiodic portion of fricative-vowel and stop-vowel syllables. LPC spectra were then computed for each excised segment. Analyses of the effect of the following vowel on the spectral peak associated with the second formant frequency and on the characteristic spectral prominence for each consonant were performed. Perceptual data were obtained by presenting the aperiodic consonantal segments to subjects who were instructed to identify the following vowel as [i] or [u]. Both the acoustic and the perceptual data show strong coarticulatory effects for the adults and comparable, although less consistent, coarticulation in the speech stimuli of the children. The results are discussed in terms of the articulatory and perceptual aspects of coarticulation in language learning. PMID- 3558970 TI - Perception of front vowels: the role of harmonics in the first formant region. AB - Vowel matching and identification experiments were carried out to investigate the perceptual contribution of harmonics in the first formant region of synthetic front vowels. In the first experiment, listeners selected the best phonetic match from an F1 continuum, for reference stimuli in which a band of two to five adjacent harmonics of equal intensity replaced the F1 peak; F1 values of best matches were near the frequency of the highest frequency harmonic in the band. Attenuation of the highest harmonic in the band resulted in lower F1 matches. Attenuation of the lowest harmonic had no significant effects, except in the case of a 2-harmonic band, where higher F1 matches were selected. A second experiment investigated the shifts in matched F1 resulting from an intensity increment to either one of a pair of harmonics in the F1 region. These shifts were relatively invariant over different harmonic frequencies and proportional to the fundamental frequency. A third experiment used a vowel identification task to determine phoneme boundaries on an F1 continuum. These boundaries were not substantially altered when the stimuli comprised only the two most prominent harmonics in the F1 region, or these plus either the higher or lower frequency subset of the remaining F1 harmonics. The results are consistent with an estimation procedure for the F1 peak which assigns greatest weight to the two most prominent harmonics in the first formant region. PMID- 3558971 TI - A model for the nearfield acoustics of the fish swimbladder and its relevance for directional hearing. AB - It is a well-known fact that fish can determine the direction of an underwater sound source. For bony fish without Weberian ossicles the mechanism proposed here is the analysis of the elliptical movement of the otolith macula relative to the otolith in case a pure tone is emitted. This movement results from the superposition of the direct displacement wave and the displacement wave scattered by the swimbladder acting as a damped harmonic oscillator. A derivation of a closed analytical expression of the scattered wave is given for a prolate spheroidal air bubble (representing the swimbladder) in water. The elliptical displacement orbits of the surrounding medium were calculated. A general numerical approach is given for irregular gas bodies. PMID- 3558972 TI - Vowel intelligibility in the absence of the acoustic reflex: performance intensity characteristics. AB - Performance-intensity functions were defined for ten synthetic vowels whose durations (50 ms) were shorter than the time necessary for the acoustic reflex to alter the transmission characteristics of the middle ear. Recognition accuracy for ten listeners with normal auditory function was asymptotic from 72 to 90 dB and then fell linearly to 108 dB. Thus, at SPLs greater than approximately 90 dB, the auditory encoding of vowels is altered by the absence of the acoustic reflex. PMID- 3558973 TI - The 113th meeting of the Acoustical Society of America. Indianapolis, 11-15 May 1987. Abstracts. PMID- 3558974 TI - Balloon dilation of mitral stenosis in adult patients: postmortem and percutaneous mitral valvuloplasty studies. AB - Preliminary reports have documented the utility of percutaneous balloon valvuloplasty of the mitral valve in adult patients with mitral stenosis, but the mechanism of successful valve dilation and the effect of mitral valvuloplasty on cardiac performance have not been studied in detail. Accordingly, mitral valvuloplasty was performed in five postmortem specimens and in 18 adult patients with rheumatic mitral stenosis, using either one (25 mm) or two (18 and 20 mm) dilation balloons. Postmortem balloon dilation resulted in increased valve orifice area in all five postmortem specimens, secondary to separation of fused commissures and fracture of nodular calcium within the mitral leaflets. In no case did balloon dilation result in tearing of valve leaflets, disruption of the mitral ring or liberation of potentially embolic debris. Percutaneous mitral valvuloplasty in 18 patients with severe mitral stenosis (including 9 with a heavily calcified valve) resulted in an increase in cardiac output (4.3 +/- 1.1 to 5.1 +/- 1.5 liters/min, p less than 0.01) and mitral valve area (0.9 +/- 0.2 to 1.6 +/- 0.4 cm2, p less than 0.0001), and a decrease in mean mitral pressure gradient (15 +/- 5 to 9 +/- 4 mm Hg, p less than 0.0001), pulmonary capillary wedge pressure (23 +/- 7 to 18 +/- 7 mm Hg, p less than 0.0001) and mean pulmonary artery pressure (36 +/- 12 to 33 +/- 12 mm Hg, p less than 0.01). Left ventriculography before and after valvuloplasty in 14 of the 18 patients showed a mild (less than or equal to 1+) increase in mitral regurgitation in five patients and no change in the remainder.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558975 TI - Impaired coronary vasodilator responsiveness as a cause of lactate production during pacing-induced ischemia in patients with angina pectoris and normal coronary arteries. AB - Subgroups of patients with angina pectoris and normal coronary arteries are known to have pacing-induced lactate production and, therefore, myocardial ischemia. To examine the mechanism of this pacing-induced ischemia, the effect of incremental atrial pacing on coronary blood flow and metabolism was studied in 27 patients with angina and normal coronary arteries. Seventeen patients continued to exhibit normal lactate extraction even at heart rates up to 160 beats/min (Group 1), whereas in 10 patients (Group 2) lactate extraction changed to production at the highest pacing rate. Coronary blood flow increased in Group 1 patients by 18, 41 and 75%, respectively, as heart rate was increased by 20 beat/min increments from 100 to 160 beats/min. In contrast, coronary blood flow increased by only 8, 7 and 14%, at the three respective pacing rates in Group 2. Between the heart rates of 100 and 160 beats/min, coronary vascular resistance decreased 32% in Group 1 patients but was unchanged in Group 2 patients. There was no significant change in the ratio of myocardial O2 consumption/rate-pressure product in Group 1 patients, but this ratio decreased from 0.91 +/- 0.26 ml O2 X min-1 X (mm Hg X beats/min)-1 to 0.53 +/- 0.11 (p less than 0.05) in Group 2 patients as heart rate increased from baseline to 160 beats/min. Thus, patients with angina and normal coronary arteries who develop ischemia with pacing have a decreased coronary vasodilator response that interferes with their ability to increase myocardial oxygen supply to match the higher demand. PMID- 3558976 TI - Transient ischemic dilation of the left ventricle on stress thallium-201 scintigraphy: a marker of severe and extensive coronary artery disease. AB - On exercise thallium-201 scintigraphy, it has been noted that the size of the left ventricle is sometimes larger on the immediate poststress image than on the 4 hour redistribution image; this phenomenon has been termed transient ischemic dilation of the left ventricle. The angiographic correlates of this finding were assessed in 89 consecutive patients who underwent both stress-redistribution thallium-201 scintigraphy and coronary arteriography. A transient dilation ratio was determined by dividing the computer-derived left ventricular area of the immediate postexercise anterior image by the area of the 4 hour redistribution image. In patients with a normal coronary arteriogram or nonsignificant coronary stenoses (less than 50%), the transient dilation ratio was 1.02 +/- 0.05 and, therefore, an abnormal transient dilation ratio was defined as greater than 1.12 (mean + 2SD). The transient dilation ratio was insignificantly elevated in patients with noncritical coronary artery disease (50 to 89% stenosis) (1.05 +/- 0.05) and in patients with critical stenosis (greater than or equal to 90%) of only one coronary artery (1.05 +/- 0.05). In contrast, in patients with critical stenoses in two or three vessels, the transient dilation ratio was significantly elevated (1.12 +/- 0.08 and 1.17 +/- 0.09, respectively; p less than 0.05 compared with all other patient groups). An abnormal transient dilation ratio had a sensitivity of 60% and a specificity of 95% for identifying patients with multivessel critical stenosis and was more specific (p less than 0.05) than were other known markers of severe and extensive coronary artery disease, such as the presence of multiple perfusion defects or washout abnormalities, or both.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558977 TI - A new, highly specific thallium-201 marker for severe and extensive coronary artery disease. PMID- 3558978 TI - Transient entrainment and interruption of atrioventricular node tachycardia. AB - The possibility of transiently entraining and interrupting the common type of atrioventricular (AV) node tachycardia (anterograde slow, retrograde fast AV node pathway) was studied using atrial and ventricular pacing in 18 patients with paroxysmal AV node tachycardia. Transient entrainment occurred in all patients. During atrial pacing, localized block in the AV node for one beat followed by anterograde conduction over the fast pathway was observed in three patients. During ventricular pacing, localized block for one beat followed by retrograde conduction over the slow pathway was not observed in any patient. Neither atrial nor ventricular fusion beats were observed during entrainment. These observations indicate in a way not previously shown that reentry involving two functionally dissociated pathways in the AV node is the underlying mechanism of paroxysmal AV node tachycardia. The inability to demonstrate atrial or ventricular fusion beats during entrainment suggests a true intranodal location of the reentrant circuit. Finally, the ability to transiently entrain intranodal tachycardia demonstrates that this electrophysiologic phenomenon is not exclusively limited to macroreentrant circuits. PMID- 3558979 TI - Atrial tracking (synchronous) pacing in a pediatric and young adult population. AB - One hundred pediatric and young adult patients underwent implantation of an atrial tracking pacemaker. Seventy-four pacemakers paced in an atrioventricular (AV) sequential mode at the lower rate limit (DDD) while 26 paced in a ventricular demand mode at the lower rate limit (VDD). Five patients required reoperation during follow-up of 1 month to 2.5 years (mean 1.5 years). Six additional patients required programming to ventricular demand (3) or AV sequential (3) pacing, because of development of sinus bradycardia (2), atrial sensing problems (1) or pacemaker-mediated tachycardia (3). Pulse generators that could sense atrial signals less than 1.0 mV and had a programmable atrial refractory period did not require reprogramming out of the atrial tracking mode. No patient developed atrial flutter or fibrillation. Sensing problems during exercise occurred in 37% of the first 60 pacemakers but in none of the last 40, which had improved electronic components. Atrial tracking pacing is feasible in pediatric and young adult patients. PMID- 3558980 TI - Balloon dilation of the aortic valve: studies in normal lambs and in children with aortic stenosis. AB - To evaluate the risks of and optimal method for valve dilation in aortic stenosis, balloons of different sizes were used to dilate the normal aortic root in 16 lambs and then stenotic valves in 15 children. In the lambs, inflated balloon to aortic anulus diameter ratios ranged from 0.9 to 1.5. These hearts were examined immediately after the procedure. Ratios of 0.9 to 1.1 did not produce significant damage to the left ventricular outflow tract, whereas those of 1.2 to 1.5 produced tears or hematomas, or both, of the aortic valve leaflets (n = 3), mitral valve leaflets (n = 4) and interventricular septum (n = 4). The 15 patients, aged 10 days to 15 years, underwent 16 balloon aortic valvotomy procedures. The balloon-aortic anulus ratio ranged from 0.67 to 1.1 (mean 0.90). The average pressure gradient decreased 69% and, overall, the peak systolic gradient decreased from 86 +/- 21 to 28 +/- 14 mm Hg (p less than 0.01) and the aortic valve area increased from 0.44 +/- 0.11 to 0.73 +/- 0.22 cm2/m2 (p less than 0.01). Immediately after the procedure an increase in aortic regurgitation was noted in 8 (57%) of 14 patients, but was never greater than 3+ and has been well tolerated. Other early complications encountered consisted of transient left bundle branch block in two patients, temporary femoral artery occlusion in three and femoral artery rupture requiring operative management in one infant. Balloon valvotomy can reduce the transvalvular gradient in most patients with valvular aortic stenosis when a balloon less than 1.1 times the aortic root diameter is used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558981 TI - Surgery without catheterization for congenital heart defects: management of 100 patients. AB - Little information is available regarding the surgical mortality of children with congenital heart disease who undergo operation on the basis of clinical assessment and echocardiographic diagnosis without cardiac catheterization. If catheterization affects early surgical mortality then perhaps omitting it would improve survival. Early operative mortality of 100 patients managed with echocardiography without preoperative catheterization (Group I) was compared with that of 151 diagnosis-matched control patients who had catheterization (Group II). The catheterization (Group II) and echocardiographic (Group I) groups included patients with the following diagnoses: atrial septal defect (33 and 17 in Group II and Group I, respectively); pulmonary stenosis/pulmonary atresia (33 and 15), aortic stenosis (14 and 3), coarctation of aorta (36 and 29), patent ductus arteriosus (10 and 15) and miscellaneous (25 and 21). Age range was 1 day to 16 years (mean 3.5); 114 (45%) of the 251 patients were less than 1 year of age and 59 (29%) were less than 1 month of age. With one exception, echocardiographic diagnosis was correct when compared with findings at surgery or autopsy, or both. Surgical mortality was 18% in Group I and 9% in Group II; however, multiple logistic regression analysis adjusting for differences in age and preoperative condition showed no significant difference between the two groups with a trend toward lower mortality in Group I (p = 0.075). Echocardiography as the definitive imaging modality in selected patients with congenital heart disease is accurate and is comparable with conventional methods of preoperative diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558982 TI - Pulmonary venous obstruction and atrioventricular canal anomalies: role of cor triatriatum and double outlet right atrium. AB - Two-dimensional echocardiographic findings and surgical repair in three infants with atrioventricular (AV) canal and pulmonary venous obstruction are described. The AV canal was complicated by cor triatriatum in two patients and by double outlet right atrium in the other. In patients with AV canal, anatomic obstruction of pulmonary venous return should be excluded by detailed cardiac ultrasound examination. PMID- 3558983 TI - Hemodynamic effects of intravenous digoxin in patients with severe heart failure initially treated with diuretics and vasodilators. AB - The purpose of this study was to assess the hemodynamic effects of intravenous digoxin in patients with New York Heart Association class IV heart failure, who had never previously been treated with digitalis drugs, and who were initially treated only with diuretics and systemic vasodilators to clinical end points of compensation. Eleven male patients, 5 with idiopathic and 6 with ischemic cardiomyopathy, had sinus rhythm and were hospitalized with congestive heart failure not precipitated by an acute ischemic event. All 11 patients were treated with intravenous furosemide and various vasodilators without invasive hemodynamic monitoring for a mean period of 4.3 +/- 2.1 days. This therapy resulted in subjective and objective improvement in all patients as reflected by a significant decrease in heart failure score from 9.5 +/- 2.2 to 2.7 +/- 2.3 (p less than 0.001). When compensation was achieved by clinical criteria, the patients were instrumented and hemodynamics obtained before and serially thereafter for 6 hours after the intravenous administration of digoxin given in two 0.5 mg doses 2 hours apart. In response to digoxin, cardiac index increased from 2.6 +/- 0.7 liters/min per m2 to a peak of 3.3 +/- 0.6 liters/min per m2 (p less than 0.005); left ventricular stroke work index (g X m/m2) increased from 27 +/- 16 to 43 +/- 23 (p less than 0.005) and the ejection fraction (eight patients) increased from 21 +/- 13% to 29 +/- 11% (p less than 0.04). Mean pulmonary capillary wedge pressure decreased from 24 +/- 7 to a minimum of 17 +/- 4 mm Hg (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558984 TI - Acute hemodynamic effects of a new inotropic agent (OPC-8212) in patients with congestive heart failure. AB - The acute effects of OPC-8212, a newly synthesized orally effective inotropic agent, were assessed clinically. Eleven patients with moderate congestive heart failure received a single mean dose of 6.5 mg/kg body weight of the drug. Eight hours after administration, the cardiac and stroke work indexes increased by 11% (p less than 0.01) and 20% (p less than 0.005), respectively, with concomitant decreases in the diastolic pulmonary artery (25%, p less than 0.005) and right atrial pressures (33%, p less than 0.01). There were no significant changes in blood pressure or heart rate. The contractile state of the left ventricle was also assessed by the shift of the Starling curve. To construct the function curve, lower body negative pressure was used to regulate the venous return to the heart. An inotropic effect of the agent was confirmed by the shift of this function curve upward and to the left, even when an augmentation of the cardiac output was masked by the marked reduction in preload. The hemodynamic and clinical effects of OPC-8212 were encouraging and the drug appears to be promising for the treatment of congestive heart failure. PMID- 3558985 TI - Interaction of amiodarone and desethylamiodarone with solubilized nuclear thyroid hormone receptors. AB - The mechanisms of action of the potent antiarrhythmic drug amiodarone are unknown. However, amiodarone and its abundant metabolite, desethylamiodarone, bear a striking structural resemblance to thyroid hormones. In addition, certain cardiac electrophysiologic effects of amiodarone treatment are similar to those of hypothyroidism. These facts suggest that amiodarone or desethylamiodarone could be acting, in part, by blocking thyroid hormone action. Because thyroid hormones are known to act through nuclear receptor proteins, the binding of amiodarone and desethylamiodarone was measured to nuclear extracts derived from human lymphocytes, bovine atrium and ventricle and rat liver. The capacity of increasing concentrations of amiodarone and desethylamiodarone nuclear extracts to block receptor binding of radiolabeled triiodothyronine (T3) in a standard in vitro competition assay was tested. Nuclear extracts demonstrated only minimal binding to amiodarone. However, all receptor preparations had substantial affinities (KD) for the desethyl analog: lymphocyte, 8.6 microM; atrium, 35.0 microM; ventricle, 26.9 microM and liver, 8.6 microM. Desethylamiodarone accumulates in very large quantities in parenchymatous organs during long-term amiodarone treatment. Taking its usual therapeutic serum level (about 4 microM or 2.7 micrograms/ml) as an estimate of intranuclear concentration, desethylamiodarone would partially saturate nuclear thyroid hormone receptors in several different tissues, including the heart. Thus, amiodarone treatment may exert some of its electrophysiologic effects by metabolic conversion to desethylamiodarone. This metabolite may then exclude thyroid hormone from nuclear receptor sites within the myocardium. PMID- 3558986 TI - Comparison of survival of amiodarone-treated patients with coronary artery disease and malignant ventricular arrhythmias with that of a control group with coronary artery disease. AB - Although amiodarone is effective in the treatment of ventricular arrhythmias, it is associated with serious toxic effects. In addition, the prognosis of patients with malignant ventricular arrhythmias and coronary artery disease treated with amiodarone remains poor. The survival of 54 consecutive patients with angiographically documented coronary artery disease and symptomatic ventricular tachycardia or ventricular fibrillation treated with amiodarone was compared with that of 5,125 medically treated patients with coronary artery disease. The amiodarone group was older, with worse left ventricular function and more peripheral and cerebrovascular disease. The 1 year survival probability was 0.73 for the amiodarone group and 0.94 for the control coronary artery disease group. At 2 years of follow-up, the survival probabilities were 0.60 and 0.90 for the amiodarone and the control group, respectively. When the survival curves were adjusted for group differences in baseline prognostic characteristics (integrated as a previously published hazard score), there was no difference in the prognosis of the two groups. These findings suggest that treatment with amiodarone of malignant ventricular arrhythmias associated with coronary artery disease maintains patients on an underlying survival curve determined by the degree of myocardial dysfunction, clinical characteristics and coronary anatomy, and that amiodarone does not have a deleterious effect on survival. PMID- 3558987 TI - Procainamide, disopyramide and quinidine: discordant antiarrhythmic effects during crossover comparison in patients with inducible ventricular tachycardia. AB - A crossover comparison of intravenous procainamide, disopyramide and quinidine was made in 32 patients. All three drugs had dosage-related effects on electrocardiographic intervals, refractory periods and cycle length of ventricular tachycardia. Significant linear relations between serum drug levels and changes in refractory periods and ventricular tachycardia cycle length were also observed. Ventricular tachycardia was no longer inducible on at least one drug in 11 patients but concordance of this effect on both of the others was 36% and on either of the others it was 45%. Ventricular tachycardia remained inducible on at least one drug in 28 patients and concordance of this effect on both of the others was 75% and on either of the others was 79%. Continued inducibility on quinidine, the drug producing the greatest electrophysiologic effects, was the best individual predictor of continued inducibility on the others. Subdivision of continued inducibility into easier to induce, inducibility unchanged, or harder to induce dramatically decreased concordance of this effect. Thus the antiarrhythmic effects of these drugs are discordant in individual patients despite electrophysiologic similarities. Nevertheless, continued inducibility after high dosages of any one of these drugs is clinically useful for screening for continued inducibility on the others and this is dose-related rather than drug specific. PMID- 3558988 TI - Assessment of myocardial perfusion by videodensitometry in the canine model. AB - Assessment of the functional severity of coronary stenoses has become increasingly important as the intrinsic limitations of coronary angiography have been documented. Videodensitometric coronary flow reserve has been proposed as a means to assess the physiologic significance of a coronary stenosis in humans. This study compared videodensitometric assessment of coronary flow with microsphere quantitation in the closed chest canine model. In five dogs, flow rates were assessed at baseline, after vasodilation with adenosine, after vasoconstriction with vasopressin and during rapid cardiac pacing. The videodensitometric peak density, time to one-half peak density and washout time (time from peak to one-half peak density) were compared at each flow state with flow assessed by microsphere injection. Reproducibility of videodensitometric measurements from two different coronary injections during the same flow state was best with peak density (r = 0.94). Videodensitometric flow ratios (flow state under study to flow at rest) using peak density demonstrated a fair correlation with flow ratios by microsphere (r = 0.81). There was poor correlation between flow ratios when time to one-half peak or washout time was used. Videodensitometric flow measurements used in vivo to assess a wide range of drug induced coronary flows may not accurately reflect coronary flow measured by microsphere. PMID- 3558989 TI - Superoxide dismutase does not cause scar thinning after myocardial infarction. AB - Previous studies demonstrated that treatment with superoxide dismutase, a scavenger of superoxide anions, limits the extent of myocardial injury in a canine preparation of regional myocardial ischemia and reperfusion. Little is known, however, about the effects of superoxide dismutase on the healing of a myocardial infarct. Therefore, this study was performed to determine whether treatment with superoxide dismutase during myocardial ischemia impairs formation of scar tissue after infarction. Dogs received 2 hour infusions of superoxide dismutase or albumin (controls) by way of the left atrium beginning 15 minutes before and ending 15 minutes after a 90 minute occlusion of the left circumflex coronary artery. Six weeks later the animals were killed. Two-dimensional echocardiography was performed before surgery and before induced death. Wall thickening in the central ischemic zone was decreased at 6 weeks compared with baseline studies (p less than 0.05), but the decrease was similar for both groups. The hydroxyproline concentrations (microgram/mg dry weight) of the scar tissue in the superoxide dismutase and control groups, respectively, were 35.3 +/ 3.8 and 28.7 +/- 5.0 (p less than 0.05). The ratios of the scar thickness to normal wall thickness were superoxide dismutase 0.91 +/- 0.03 and control 0.89 +/ 0.03 (p greater than 0.05). Thus, superoxide dismutase had no adverse effect on wall thickening or scar formation assessed 6 weeks after myocardial infarction, and may be useful to limit oxygen radical-mediated damage during reperfusion of the ischemic myocardium. PMID- 3558991 TI - Comparison of echocardiographic methods for assessment of left ventricular shortening and wall stress. AB - M-mode echocardiographic measurement of left ventricular fractional shortening and meridional wall stress has been used extensively alone and in combination to describe left ventricular systolic function. To determine whether the improved dimensional information afforded by two-dimensional echocardiography might result in shortening and stress calculations yielding a different view of left ventricular function, we compared two-dimensional and M-mode echocardiograms in 69 subjects (19 normal, 13 with aortic stenosis, 22 with aortic regurgitation and 15 with congestive cardiomyopathy). Fractional shortening was greater with M-mode than with two-dimensional echocardiography in all subjects, especially in those with cardiomyopathy (p less than 0.05). In aortic stenosis, two-dimensional shortening, at 24 +/- 5%, was reduced (p less than 0.05 versus normal), but M mode shortening, at 34 +/- 5%, was not. M-mode estimates of meridional stress were higher than two-dimensional values, again especially in cardiomyopathy. Two dimensional echocardiography enabled determination of long- and short-axis ratios, circumferential stress and the ratio of circumferential to meridional stresses. Circumferential stress was elevated in aortic stenosis at 302 +/- 65 X 10(3) dynes/cm2, suggesting afterload excess as the cause for the observed reduction in two-dimensional shortening. The more spherical cardiomyopathic hearts had a meridional to circumferential stress ratio closer to 1, such that use of meridional stress alone would overestimate effective afterload. It is concluded that M-mode and two-dimensional echocardiographic analyses of left ventricular shortening and stress produce different results. Two-dimensional echocardiographic methods may enhance the assessment of ventricular function, especially in patients with aortic stenosis and cardiomyopathy. PMID- 3558990 TI - Echocardiographic contrast agents: effect of microbubbles and carrier solutions on left ventricular contractility. AB - Recently, there has been a resurgence of interest in the use of contrast-enhanced echocardiography as a means of noninvasively assessing myocardial perfusion. However, if injections of echocardiographic contrast agents are to be used for this purpose it is essential that they are not intrinsically toxic to the heart. In this study, the left ventricular end-systolic wall stress-rate-corrected velocity of fiber shortening relation, a load independent index of contractility, was studied in nine dogs. Two-dimensional and targeted M-mode echocardiographic as well as central aortic pressure tracings were made during echocardiographically gated, pressure- and volume-controlled aortic root injections of nonsonicated and sonicated Renografin-76, saline and dextrose 70% (n = 6), and sonicated and hand-agitated Renografin-76/saline mixture (n = 5). Two of nine dogs received all agents. Off-line computer videodensitometric analysis documented myocardial perfusion. In all cases, data were obtained at control and 5 and 15 seconds after injection. Additional data were collected at 25 seconds after injection for the Renografin-76/saline mixture. Alterations in contractility were measured relative to control as changes in rate-corrected velocity of fiber shortening after afterload (measured as end-systolic wall stress) was eliminated as a confounding variable. Under no condition did saline or Renografin-76 cause alterations in left ventricular contractility. Nonsonicated and sonicated dextrose 70% increased left ventricular contractility at 15 seconds but not at 5 seconds after injection. Hand-agitated Renografin 76/saline mixture induced a negative inotropic effect at 5 and 15 seconds after injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558992 TI - Evaluation of aortic insufficiency by Doppler color flow mapping. AB - The color Doppler echocardiographic studies and aortic angiograms of all patients who had these procedures performed within 2 weeks of each other between October 1984 and August 1985 were reviewed to determine whether any parameters of the regurgitant jet visualized by color Doppler study predicted the severity of aortic insufficiency as assessed by angiographic grading. Patients with an aortic valve prosthesis were excluded. Twenty-nine patients had aortic insufficiency and had adequate color Doppler studies for analysis. The mean time between color Doppler examination and angiography was 2.3 days (range 0 to 12). The maximal length and area of the regurgitant jet were poorly predictive of the angiographic grade of aortic insufficiency. The short-axis area of the regurgitant jet from the parasternal short-axis view at the level of the high left ventricular outflow tract relative to the short-axis area of the left ventricular outflow tract at the same location best predicted angiographic grade, correctly classifying 23 of 24 patients. However, the jet could be seen from this view in only 24 of the 29 patients. The height of the regurgitant jet relative to left ventricular outflow tract height measured from the parasternal long-axis view just beneath the aortic valve correctly classified 23 of the 29 patients. Mitral stenosis or valve prosthesis, which was present in 10 patients, did not interfere with the diagnosis or quantitation of aortic insufficiency by these methods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3558993 TI - Right atrial-esophageal fistula and hydropneumopericardium after esophageal dilation. AB - Esophagoatrial fistula formation is a rare and heretofore fatal event. A patient presented with esophageal reflux and stricture that later developed into a right atrial-esophageal fistula during biweekly esophageal dilation. Clinical recognition and surgical therapy led to a successful outcome. There were several unique features of this case, including fistulous connection to the right rather than the left atrium, concomitant hydropneumopericardium and esophagoatrial fistula, occurrence during esophageal dilation and surgical cure. PMID- 3558994 TI - Peripartum cardiomyopathy. PMID- 3558995 TI - Fatal misadventures. PMID- 3558996 TI - The effect of a topical tricyclic antihistamine on the response of the nasal mucosa to challenge with cold, dry air and histamine. AB - We have previously demonstrated that azatadine, a tricyclic antihistamine, known also to inhibit mediator release from mast cells and basophils in vitro, inhibits the early release of histamine and other mediators after nasal challenge with antigen. In this article, we studied the effect of azatadine on preventing the release of histamine after nasal challenge with cold, dry air (CDA) and its effect on antagonizing nasal challenge with histamine. With histamine challenge, azatadine inhibited symptoms (sneezing, nasal congestion, and rhinorrhea) and the increase in the level of albumin in nasal secretions (p less than 0.01 all). With challenge with CDA, the drug had no effect on either symptoms or histamine and N tosyl-L-arginine methyl ester-esterase release. Although the patterns of mediator release after CDA and after the early reaction to antigen are similar, the pharmacologic control differs, suggesting different mechanisms of induction of histamine release from mast cells. PMID- 3558997 TI - Immunologic studies in subjects with a serum sickness-like illness after immunization with human diploid cell rabies vaccine. AB - Ten patients developing a serum sickness-like hypersensitivity reaction to human diploid cell rabies vaccine were studied and compared with control subjects matched for previous vaccination history and level of rabies virus-specific IgG response to immunization. The clinical reaction consisted of delayed onset, generalized urticaria, and angioedema, with some arthralgias. Skin biopsy specimens demonstrated a leukocytoclastic vasculitis. Individuals reacting to the vaccine possessed IgE antibodies to human diploid cell rabies vaccine, to mock vaccine lacking viral antigen, and to fetal calf serum (FCS), a vaccine trace contaminant. Increased levels of IgG antibodies to FCS, mock vaccine, and beta propiolactone-modified FCS, and human serum albumin were also found. Such humoral responses to vaccine components other than rabies virus might be responsible for the hypersensitivity reactions developing after rabies vaccination. PMID- 3558998 TI - Leukotriene C4 production by normal-density and low-density eosinophils of atopic individuals and other patients with eosinophilia. AB - With the use of a percoll gradient separation procedure, eosinophils of individuals with asthma and with allergy could be separated into normal- and low density cell fractions. The presence of low-density eosinophils possibly reflects an ongoing process of activation of these cells induced by the allergic reaction. Ca-ionophore-induced leukotriene (LT) C4 production, in the absence of added substrates, demonstrated a decreased potency for LT generation by low-density eosinophils compared with the LT generation of normal-density cells (57 +/- 33 ng and 103 +/- 44 ng per 10(6) cells, respectively). In contrast with the Ca ionophore-induced LT formation, incubations with serum-treated zymosan in the presence of glutathione demonstrated higher productions of LTC4 with the low density eosinophilic subpopulation compared with normal-density cells. This is compatible with a possibly higher expression of complement C3b receptors on the low-density eosinophils. Total arylsulfatase contents demonstrated that low density eosinophils are not degranulated with respect to their small granules. Although release of the large granules by low-density eosinophils cannot be excluded, electron-microscopy studies indicated that degranulation is not the only (or major) factor that determines the density of the various eosinophilic subpopulations. PMID- 3558999 TI - The role of chemical mediators and mucosal hyperreactivity in nasal hypersecretion in nasal allergy. AB - This study was designed to elucidate, first, the degree of participation of direct effects of histamine on the nasal glands and the nasal vasculature in clinical manifestation of hyperrhinorrhea in nasal allergy and, second, the existence of hyperreactivity of the nasal glands to acetylcholine in nasal allergy. The study demonstrates that histamine released by degranulation of basophilic cells in the nasal mucosa causes nasal hypersecretion mostly by way of the reflexive pathway. Approximately 4% of the amount of nasal secretion induced by an antigen challenge in subjects with house-dust nasal allergy was due to a leakage of plasma. There were almost no direct effects of histamine on the nasal glands. Nasal secretion induced by nasal challenge with acetylcholine after vidian neurectomy comes from the nasal glands by its direct effects on the nasal glands, the amount of which indicates degree of reactivity of the nasal glands to acetylcholine independent of hypersensitivity of the mucosal sensory system. The nasal glands of vidian neurectomized subjects having nasal allergy reacted more excessively to extrinsic acetylcholine than nasal glands of subjects of the control group. This verifies the existence of hyperreactivity in the nasal glands to acetylcholine in nasal allergy. The nasal glands of nasal allergy patients may respond more excessively to a given amount of acetylcholine released from parasympathetic terminals. PMID- 3559000 TI - Absence of changes in airway responsiveness during the menstrual cycle. AB - The effect of sex hormones on airway function has not been well studied in spite of much evidence to suggest that they are important. We asked if the normal physiologic variation in hormone levels during the menstrual cycle resulted in changes in airway responsiveness and pulmonary function that were not clinically apparent. Nine women with asthma and with normal menstrual cycles but not taking systemic asthma medication were asked to chart temperatures, asthma attacks, and use of asthma medication for four menstrual cycles. We measured baseline spirograms, skin and airway responsiveness to histamine, and serum levels for estradiol, progesterone, and testosterone on approximately day 7 and day 24 of two consecutive cycles. None of the women reported cyclic asthma symptoms, and review of subjects' charts demonstrated no menstrual variation in asthma attacks or use of asthma medications. We found no differences in forced vital capacity or FEV1 early compared to late in the menstrual cycle. Neither did we find a change in airway responsiveness, as indicated by the histamine dose causing a 15% fall in FEV1 or a 35% fall in specific airway conductance. Skin responsiveness as indicated by the wheal response to intradermal histamine was also unchanged. We conclude that physiologic changes in hormone levels during the menstrual cycle are not in themselves associated with changes in airway or skin responsiveness to histamine. PMID- 3559001 TI - Fatalities from immunotherapy (IT) and skin testing (ST) AB - The Committee on Allergen Standardization of the American Academy of Allergy and Immunology obtained information about 46 fatalities that had occurred during immunotherapy (IT) or skin testing (ST) since 1945. Sufficient information for complete analysis was provided for 30 patients (six for ST and 24 for IT). Of the 30 fatalities, there were 15 male and 15 female fatalities ranging in age from 7 to 70 years (x = 33 years). Known errors of administration accounted for three and possibly an additional three fatalities. Ten fatalities occurred during seasonal exacerbation of the patient's disease, four in patients who had been symptomatic at the time of the injection, two of whom had been receiving beta adrenergic blockers. Of the 24 fatalities associated with IT, four had experienced previous reactions, 11 manifested a high degree of sensitivity, and four had been injected with newly prepared extracts. Fifteen of the 30 fatalities had received pollen extracts as part of the fatal injection. Of the six fatalities associated with ST, five were due to intradermal testing without prior puncture testing. The signs and symptoms were variable and did not indicate that death was imminent nor predict the cause of death. The time to onset of the reaction was less than 30 minutes in 22/30, more than 30 minutes in 3/30, and not reported in 5/30. The cause of death in 14/16 patients with asthma was respiratory. Epinephrine had been administered to 18, not administered to three, and was either not recorded or unknown in the remaining nine patients. Since seven to 10 million allergen injections are administered yearly, the risk of a fatal reaction is low and may be lessened even further as additional precautions are taken in the selection and treatment of allergic patients and in improved treatment of the anaphylactic reactions. PMID- 3559002 TI - America's health care revolution: health promotion and disease prevention. PMID- 3559003 TI - Dietary characteristics and nutrient intake in an urban homebound population. AB - The food and nutrient intake of 53 homebound older persons (mean age = 82 years) who receive home medical care in metropolitan Boston was examined, using the 24 hour recall and food frequency methodologies. Demographic data were collected in personal interviews, and systematic analyses were conducted of subjects' medical records. Mean intake of energy, folic acid, and calcium was below the RDAs for both men and women, and intake of thiamin was below the RDA for men. Nutrient intake failed to meet the RDAs for nine leader nutrients in 40% to 80% of the sample. Fewer than 20% of the subjects were able to name the Basic Food Groups or any of their food components. The subjects' age, income, gender, marital and health status, living situation, and educational level did not predict nutrient intake. Poor dietary intake among older, homebound persons, coupled with diverse medical problems, places them at major risk of nutrition problems. The nutrition needs and problems of the homebound elderly should be considered in the delivery of home health care services. PMID- 3559004 TI - Diet counseling modifies nutrient intake of patients with Crohn's disease. AB - The nutrient intake of 137 outpatients with Crohn's disease was recorded, and the effect of diet counseling was assessed. Half the patients received monthly diet counseling that was individualized and aimed at normalizing nutrient intake; the other half of the patients received no diet counseling and served as controls. Over the 6-month study period, the mean nutrient intakes met or exceeded the 1980 U.S. Recommended Dietary Allowances (RDAs) for all nutrients except folate in the men and iron and folate in the women. However, at study entry, for each nutrient there was a substantial proportion of patients whose intake did not meet the full RDA. Less than 50% of the men consumed the full RDA for energy and folate, and less than 50% of the women consumed the full RDA for energy, folate, calcium, iron, thiamin, and vitamin B-12. Monthly diet counseling sessions were associated with increases in the mean intake of most nutrients, whereas similar improvement was not observed in the control group members, who did not receive counseling. By 6 months, significantly more counseled than non-counseled patients were consuming the full RDA for protein, riboflavin, and vitamin C (p less than .05). Thus, diet counseling was found to be an important tool for improving the nutrient intake of outpatients with Crohn's disease. PMID- 3559005 TI - Impact of commercial eating on nutrient adequacy. AB - The purpose of this study was to investigate the impact of eating away from home (at commercial establishments) on nutrient adequacy by examining frequency of eating away from home, the nutritional value of foods eaten both away and at home, and the nutritional adequacy of the daily diets of individuals. Data from 3,500 individuals, 15 years of age or older, interviewed in the fall quarter of the 1977-78 Nationwide Food Consumption Survey were used. Results indicate that although the nutrient density of food eaten away from home was lower than that of food eaten at home, the persons studied did not eat out frequently enough to influence the adequacy of their diets significantly. The low nutrient density of food eaten away from home does suggest, however, that individuals could be putting themselves at risk of some nutrient inadequacies (particularly of calcium and vitamins A, B-6, and C) or of caloric excess if they substantially increase their frequency of eating away from home. Teenagers and senior citizens seem most vulnerable to potential nutritional inadequacies. PMID- 3559006 TI - Estimation of the mid-upper arm circumference measurement error. AB - The mid-upper arm circumference measurement error was estimated in order to assess the usefulness of this measurement for detecting small changes in a patient's arm circumference during hospitalization. In a study having a 3 X 3 X 2 factorial design, 10 trained observers recorded 1,560 measurements from 52 healthy adult subjects selected to represent three factors: sex, age, and weight for height. Each observer obtained three independent measurements from every subject. By analysis of variance, the variation between different observers' measurements of the same subject was estimated with 95% confidence to be less than or equal to 2.8% for men and less than or equal to 3.8% for women. This variation was unaffected by age but decreased with decreasing weight for height in women (p less than .05). Variation between each observer's repeated measurements of the same subject was estimated with 95% confidence to be less than or equal to 1.1% and was unaffected by sex, age, or weight for height. It was concluded that the smallest detectable change in arm circumference is 7.8% for men and 9.8% for women when successive measurements are recorded by different observers. However, arm circumference changes as small as 2.2% can be detected in both men and women when successive measurements are obtained by the same observer. PMID- 3559007 TI - The effect of urea kinetic modeling on the nutrition management of hemodialysis patients. AB - Urea kinetic modeling is a hemodialysis prescription technique that includes calculation of patients' protein catabolic rate (grams per kilogram body weight per day). This study compared the use of current guidelines alone with the integration of the urea kinetic modeling-derived protein catabolic rate and current guidelines for the nutrition assessment and management of 27 chronic renal failure patients on hemodialysis. In phase 1, subjects were counseled according to current renal nutrition guidelines. In phase 2, subjects were kinetically modeled and counseled with incorporation of the urea kinetic modeling derived protein catabolic rate value. Thirteen subjects received a 1-month follow up. Food records and time length of counseling sessions were recorded in phases 1 and 2. Significant changes seen in the mean blood urea nitrogen value during phase 2 (no. = 22, p less than or equal to .05) and follow-up phase (no. = 13, p less than or equal to 0.05) reflected an improved protein intake from phase 1 for the majority of subjects. Dietary intake and time length of counseling sessions in both phases were not significantly different. The following correlations were noted: reported protein intake and protein catabolic rate: r = .685, p less than or equal to .001; protein catabolic rate and blood urea nitrogen: r = .799, p less than or equal to .001; blood urea nitrogen and serum albumin: r = .485, p less than or equal to .05. Results suggest that the urea kinetic modeling-derived protein catabolic rate value positively affects patient adherence to diet recommendations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559008 TI - Diet and exercise in noninsulin-dependent diabetes mellitus: implications for dietitians from the NIH Consensus Development Conference. AB - Noninsulin-dependent diabetes mellitus is a major health problem, highly correlated with obesity and, therefore, overeating. Diet continues as the cornerstone of therapy, with oral hypoglycemic agents or insulin added, if needed, to maintain normal blood glucose values. The diet prescription should be implemented in stages, with caloric restriction the first priority, as weight loss itself diminishes hyperglycemia to or toward normal. Combinations of foods and even different processing or cooking of the same food may produce different glucose responses. These factors minimize the role of the glycemic index in overall diabetes management. Foods with high soluble fiber content may diminish glucose elevations after meals; however, high-fiber foods appear to be less important for the obese diabetic person than adhering to a calorie-restricted diet and achieving weight loss. Attempts should be made to alter life-style within an acceptable degree for any given patient to encourage weight reduction. For example, although exercise may have a small but transient direct effect in lowering blood glucose and insulin resistance, it can be considered an adjunct to decreased calorie diets for weight reduction. Finally, it appears prudent to prevent or reverse obesity, especially in individuals with a family history of diabetes, in the hope that the onset of diabetes may be prevented or postponed. PMID- 3559009 TI - Promoting nutrition in commercial foodservice establishments: a realistic approach. AB - Americans are eating out an average of 3.7 times per week and are spending almost 40% of their food dollar doing so. A Gallup Survey shows about 39% of consumers claim to have improved their eating habits while eating out, but restaurant patrons are most concerned about nutrition when dining out on a routine visit or while in a family-style restaurant. Restaurant patrons are also now more likely to order lower sodium meals, small-size portions, and lower calorie entrees. Although the opportunity to promote nutrition in the foodservice setting exists, restaurant chefs and managers often lack the background to take advantage of it and could benefit from the services of qualified nutrition professionals. Dietitians could assist in identifying menu items appropriate for nutrition promotion, recipe development, and staff training. However, a realistic approach must be maintained, and the following facts should be kept in mind: Nutritious restaurant fare should blend with the theme of the menu and be promoted primarily on its sensory attributes. Nutrition in restaurants is best received when promoted generally and within the scope of health and wellness. Descriptive menu items should be carefully used. A restaurant consultant should be current on controversial food and nutrition trends. The wait staff should be properly trained. PMID- 3559010 TI - Development and implementation of a human accuracy program in patient foodservice. AB - For many years, industry has utilized the concept of human error rates to monitor and minimize human errors in the production process. A consistent quality controlled product increases consumer satisfaction and repeat purchase of product. Administrative dietitians have applied the concepts of using human error rates (the number of errors divided by the number of opportunities for error) at four hospitals, with a total bed capacity of 788, within a tertiary-care medical center. Human error rate was used to monitor and evaluate trayline employee performance and to evaluate layout and tasks of trayline stations, in addition to evaluating employees in patient service areas. Long-term employees initially opposed the error rate system with some hostility and resentment, while newer employees accepted the system. All employees now believe that the constant feedback given by supervisors enhances their self-esteem and productivity. Employee error rates are monitored daily and are used to counsel employees when necessary; they are also utilized during annual performance evaluation. Average daily error rates for a facility staffed by new employees decreased from 7% to an acceptable 3%. In a facility staffed by long-term employees, the error rate increased, reflecting improper error documentation. Patient satisfaction surveys reveal satisfaction, for tray accuracy increased from 88% to 92% in the facility staffed by long-term employees and has remained above the 90% standard in the facility staffed by new employees. PMID- 3559011 TI - Promoting oral rehydration therapy for acute diarrhea. PMID- 3559012 TI - The computer as an aid in clinical management. AB - Clinical dietitians' time and expertise have been allocated much more efficiently at Fairview General Hospital through computer analysis of information that is readily available in existing mainframe programs. Other health care institutions may be able to achieve similar results by examining information about patient populations and diet orders stored in their computers. PMID- 3559013 TI - TWIGS--a weight-control program designed for children. Team Watchers in Growth Standards. PMID- 3559014 TI - Position of the American Dietetic Association: nutrition standards in day-care programs for children. AB - ADA supports the achievement of comprehensive nutrition standards in day-care programs. Recommended standards focus on meeting the child's nutrition needs in a safe and pleasant environment that promotes sound physical, social, and emotional development. Staff and parents should be informed of the child care program's role in meeting the nutrition needs of enrolled children. Parents should be encouraged to participate actively in the program's nutrition activities to assure continuity in the child's nutrition education. PMID- 3559015 TI - A practical method of estimating stature of bedridden female nursing home patients. AB - Accurate measurement of stature is important for the determination of several nutritional indices as well as body surface area (BSA) for the normalization of creatinine clearances. Direct standing measurement of stature of bedridden elderly nursing home patients is impossible, and stature as recorded in the chart may not be valid. An accurate stature obtained by summing five segmental measurements was compared to the stature recorded in the patient's chart and calculated estimates of stature from measurement of a long bone (humerus, tibia, knee height). Estimation of stature from measurement of knee height was highly correlated (r = 0.93) to the segmental measurement of stature while estimates from other long-bone measurements were less highly correlated (r = 0.71 to 0.81). Recorded chart stature was poorly correlated (r = 0.37). Measurement of knee height provides a simple, quick, and accurate means of estimating stature for bedridden females in nursing homes. PMID- 3559016 TI - Binding the elderly: a prospective study of the use of mechanical restraints in an acute care hospital. AB - Little information exists on the use of mechanical restraints among nonpsychiatric inpatients. This prospective study evaluates their use among consecutive medical and surgical admissions to an acute care hospital. Daily direct observation of patients and hospital record review provided data on potential predictors of restraint, reasons for their application, complications, and outcome. Cox regression analysis was used to calculate relative risk of restraint while adjusting for duration of hospitalization as well as other variables. Restraints were applied to 37 (17%) of the 222 study patients. Restrained patients were eight times more likely to die during hospitalization (24% v 3%; P less than 0.01). Abnormal mental status exam, diagnosis of dementia, surgery, and presence of monitoring and support devices (eg, intravenous lines) were statistically significant independent predictors of restraint. Mechanical restraint is a common occurrence among nonpsychiatric inpatients particularly those with impaired mentation, requirement for surgery, or intensive medical intervention. Identification of medical and surgical patients at risk for restraint may reduce the use of these devices by concentrating surveillance and prevention on this group. PMID- 3559017 TI - Unrecognized drug dependence in psychiatrically hospitalized elderly patients. AB - The psychiatric in-patient records of 90 patients greater than or equal to 65 years of age were reviewed retrospectively to determine the prevalence of chemical dependence and if lack of recognition and treatment of chemical dependence resulted in serious complications. Nineteen of the 90 patients were characterized as drug dependent and ten of these patients were neither recognized nor detoxified. Seven of the ten nondetoxified patients, but only one of the nine detoxified patients, experienced serious medical complications typically requiring transfer to a medical floor or medical intensive care unit. Unrecognized chemically-dependent patients were significantly more likely to be female benzodiazepine abusers, while recognized chemically dependent patients were significantly more likely to be male alcohol abusers. PMID- 3559018 TI - Assessment and care of the community-dwelling Alzheimer's disease patient. AB - A two-year study of 159 community dwelling Alzheimer's disease (AD) patients evaluated in a geriatric clinic is reported. Patients were not as disabled as commonly supposed, having only a moderate reduction in cognitive function (Folstein mean Mini-Mental Status [MMS], 15.3) and physical activities of daily living (PADL), mean, 3.3, but were more dependent in their instrumental activities of daily living (IADL), mean, 1.9. Associated medical problems averaged 3.4 per patient. Forty-seven percent lived alone and 39% had not been out of the home in the previous week, making isolation a major concern. During the study, 34% went into nursing homes. Initial mean MMS of these patients was 12.4 compared to 16.6 for patients who remained at home, but activities of daily living (ADL) mean scores were not significantly different. Based on this assessment, the management of AD patients, including medication use, daycare, education and support for family caregivers, and nursing home placement, is discussed. PMID- 3559019 TI - Intensive care for the elderly: outcome of elective and nonelective admissions. AB - Survival, quality of life, and need for continuing medical care were evaluated for 134 elderly patients admitted to the intensive care units (ICU) at Stanford University Hospital and for a control group. Of the patient group, 57.5% were admitted to the ICU following elective surgery; 42.5% were emergency surgical and medical patients. Hospital mortality was 3.9% for elective and 22.8% for nonelective patients; 18-month mortality was 13.0% and 47.4%, respectively. Fifty nine patients (60.8% of survivors) completed follow-up questionnaires. Subjective and objective quality of life was good. Quality of life was slightly worse for ICU survivors than for controls; elective and nonelective patients did not differ significantly. Although the cost of ICU hospitalization was high, additional medical care was not excessive. Nonelective patients required more continuing care than elective patients, and both groups required more than controls. PMID- 3559020 TI - Establishment and impact of a dementia unit within the nursing home. AB - Thirty-two demented, elderly residents of a nursing home were admitted to a specially designed dementia unit. Each patient was assessed three times: prior to admission, and at four and 12 months after admission to the unit. Patients were evaluated using a modified version of a previously published assessment scale as well as with a standardized New York State numerical rating system. There was an increased level of functioning in both mental and emotional status and basic functions of daily living at both four (P less than or equal to 0.001) and 12 months (P less than or equal to 0.005). The improvement in scores was maintained over a prolonged time period, despite the expectation of progression of the dementing process. There was no change noted on the New York State assessment. Our data suggest that a select group of demented elderly can benefit from being placed on a specialized dementia unit. PMID- 3559022 TI - Sexuality and the institutionalized elderly. AB - Sexuality is considered to be among the more disturbing sexual problems in skilled nursing facilities. Staff attitudes and beliefs often lead to discomfort in dealing with the continued sexual interests of patients. It is clear that if sexuality has been an important part of self-image and of coping, then it remains important. Staff reaction to two cases is used to illustrate the need for programmatic interventions with staff, residents, and families. PMID- 3559021 TI - Incontinence among nursing home patients: clinical and functional correlates. AB - This study was undertaken to examine the association of specific medical and genitourinary conditions, medications, and functional disabilities with urinary incontinence (UI) in a nursing home (NH) population. Seventy-six incontinent and 38 continent patients in a Veterans Administration NH were studied. Incontinence was highly associated with each of the physical and mental functional disabilities we examined. However, with the exception of recurrent urinary tract infections and dementia, no specific clinical factors were significantly more common among incontinent than continent patients. Although precise causes for the UI were not determined, these data highlight the potential role of impairments of physical and/or mental function in the pathogenesis of UI among NH patients, and emphasize the need to address these impairments in future research on the assessment and treatment of UI in this population. PMID- 3559023 TI - An elderly woman with isolated auditory hallucinations. PMID- 3559025 TI - Can pediatrics contribute to geriatrics? PMID- 3559024 TI - Hemodynamic changes during food ingestion in a patient with postprandial hypotension. PMID- 3559027 TI - Treatment resistant depression in the elderly. PMID- 3559026 TI - Antirheumatic drug therapy in the elderly: a case of failure to identify the correct issues? PMID- 3559028 TI - Causes of the sex differential in longevity. PMID- 3559029 TI - An alternative paradigm for the study of the aging. PMID- 3559030 TI - An interdisciplinary approach to medication renewals. PMID- 3559031 TI - Why depression scales should not include all diagnostic criteria. PMID- 3559032 TI - Anticoagulant therapy. PMID- 3559033 TI - Preliminary observations on naltrexone for treatment of Alzheimer's type dementia. PMID- 3559034 TI - The use of metalloproteins as standards for X-ray microanalysis of biological material. AB - Thin films of metalloprotein, deposited directly onto carbon-formvar-coated electron microscope grids, provide a potentially useful, but little developed, type of standard for biological transmission X-ray microanalysis. The possibility of using various metalloproteins was investigated in terms of their suitability as standards, and compared with an evaporated film of gelatin-salt mixture. The metalloproteins that were selected comprised conalbumin (containing detectable S, Fe), hemocyanin (S, K, Ca, Fe and Cu), insulin (S, Zn), phosvitin (P, Ca, Fe, and Zn) and alpha-lactalbumin (S, Ca). In each case, the metalloprotein preparation was homogeneous at the microlevel (unlike evaporated gelatin-salt mixtures), and was stable in the electron beam up to a current of 120 nA, over a lifetime of 200 s. PMID- 3559035 TI - A non-radioactive automated method for DNA sequence determination. AB - A method and instrument for automated DNA sequencing without radioactivity have been developed. In spite of the success with radioactive labels there are drawbacks attached to the technique, such as hazards in the handling, storage and disposal of radioactive materials, and the considerable cost of the radiolabelled nucleoside triphosphates. In addition, there is deterioration of sample quality with time. A sulphydryl containing M13 sequencing primer has been synthesised and subsequently conjugated with tetramethylrhodamine iodoacetamide. The fluorescent primer is used to generate a nested set of fluorescent DNA fragments. The fluorescent bands are excited by a laser and detected in the gel (detection limit about 0.1 fmol per band) during electrophoresis, and sequence data from the four tracks are transferred directly into a computer. Standard gels, 200 mm wide with 20 sample slots have also been used. The device contains no moving parts. At present 250-300 bases can be read in 6 h. The system is capable of single base resolution at a fragment length of at least 400 bases. PMID- 3559036 TI - Quantitative determination of triosephosphates during enzymatic reaction by high performance liquid chromatography: effect of isomerase on aldolase activity. AB - Fructose-1,6-bisphosphate and triosephosphates have been separated by high performance liquid chromatography utilizing a SynChropack AX anion exchange column with 50-200 mM KH2PO4, pH 2.5-4.6 as mobile phase. The best resolution for each compound was reached in a system of 150 mM KH2PO4, pH 2.5. If radioactive fructose-1,6-bisphosphate as initial substrate was enzymatically converted in triosephosphates, the recoveries of metabolites after the precipitation and chromatographic procedures were higher than 95%. The concentration of radioactive 3-phosphoglycerate measured by liquid scintillation shows a good correlation (correlation coefficient: 0.997) with the spectrophotometrically determined concentration of NADH, which is formed from [U-14C]fructose-1,6-bisphosphate in equimolar concentration with 3-phosphoglycerate in aldolase and glyceraldehyde-3 phosphate dehydrogenase system. The method developed was applied to detect the inhibitory effect of triosephosphate isomerase on aldolase activity which takes place due to the heterologous complex formation. PMID- 3559038 TI - Techniques of ankle arthroscopy. AB - Although arthroscopic instrumentation varies widely, the technique for use is quite similar. Surgeon preferences vary but most arthroscopists agree that it is technique that makes the procedure. Discussed in this presentation is the author's method for preparing the patient for arthroscopic surgery, as well as techniques for using the arthroscope, hand instruments, and power instrumentation. PMID- 3559037 TI - Ankle arthroscopic portals and intra-articular anatomy. AB - This article will attempt to detail the surface and intra-articular anatomy of the ankle. The surface anatomy will highlight the ankle capsule, tendons, and neurovascular structures surrounding the ankle. The intra-articular anatomy will detail those structures, such as articular surfaces and intra-capsular ligaments that will be visualized through the arthroscope. The five entry portals (three anterior and two posterior) will be described. The purpose is to familiarize the reader with surface anatomy of the ankle to allow accurate placement of the arthroscope. This will decrease the risk of iatrogenic complications and improve the chances of intra-articular visualization of pathology. Thus, awareness of normal anatomy will enable better recognition of pathology. PMID- 3559039 TI - Accuracy of diagnostic arthroscopy of the ankle joint. AB - A series of 34 diagnostic arthroscopic examinations of the ankle joint has been performed. All of the patients in this study also had an arthrotomy procedure after the arthroscopy. The arthroscopic diagnosis was confirmed by gross examination of the ankle joint in 32 of 34 patients. This resulted in a 94% diagnostic accuracy. PMID- 3559040 TI - Review of diagnostic arthroscopy of the foot and ankle. AB - This paper reviews 79 cases of diagnostic ankle arthroscopy. Primary diagnoses and the effects of arthroscopy in relieving the preoperative symptoms are evaluated. In addition to the ankle, arthroscopy of the subtalar and first metatarsophalangeal joints is discussed. PMID- 3559041 TI - Medial impingement lesions of the tibial plafond. AB - This paper presents a newly recognized post-traumatic lesion of the ankle resulting from the impingement of the medial aspect of the talar dome against the adjacent area of the tibial plafond secondary to dorsiflexory and plantarflexory inversion injuries. Subsequently, a transchondral fracture is produced, resulting in a medial impingement lesion. This lesion is usually associated with ankle trauma, such as lateral ankle sprains, ruptures of the fibular collateral ligaments, and transchondral fractures of the talar dome. It may also be associated with a fracture, but may be present as a specific pathologic entity causing chronic ankle pain. This presentation reviews the etiology, incidence, and prognosis of such lesions. PMID- 3559042 TI - Metatarsal osteotomies: which operation? AB - Surgical correction of hallux valgus by metatarsal osteotomy should aim to restore normal foot anatomy. The operation selected, therefore, needs to be a compromise between biologic and biomechanical considerations. Particular attention should be addressed to the preoperative length and direction of the first metatarsal, as well as the alignment of the first metatarsophalangeal joint. Reducing an already short first metatarsal should be avoided. Realignment of a subluxed first metatarsophalangeal joint requires medial capsular plication, and marked metatarsus primus varus warrants a basal osteotomy. PMID- 3559043 TI - Reverse Austin osteotomy for correction of hallux varus. AB - A case of hallux varus and extensus of unusual etiology and treatment is presented. Special emphasis is directed toward the angle formed between the first metatarsal base and medial cuneiform, which these investigators believe has not been previously described. The procedure performed is a reverse Austin bunionectomy with a step-by-step outline of soft tissue procedures attempted before osteotomy. The cartilage at the first metatarsal head was medially adapted and of normal structure and function preoperatively; therefore, the decision was made to perform a joint preservation procedure. PMID- 3559044 TI - Spontaneous fractures of the lesser metatarsals secondary to an amputated hallux and peripheral neuropathy. AB - A general overview of the literature concerning the development of diabetic neuropathic arthropathy is discussed. A case report is presented dealing with spontaneous fractures of the lesser metatarsal in a patient with an amputated hallux and peripheral neuropathy secondary to diabetes mellitus. PMID- 3559045 TI - A modification of the Hibbs tenosuspension for flexible cavus deformity. AB - The authors present a modification of the Hibbs tenosuspension for the correction of clawtoes associated with flexible cavus deformity. A release of the plantar fascia is performed along with the procedure. The major advantages offered by this procedure are the ease in which it can be performed, the vector of the extensor digitorum longus tendon at the ankle is not disrupted, and the only osseous work necessary is digital arthroplasty. PMID- 3559046 TI - A new classification of first metatarsophalangeal joint dislocations (type I B). AB - Dorsal dislocation of the first metatarsophalangeal joint is a rare occurrence that has been infrequently reported in the podiatric literature. Two types of dislocations have been described. The authors review the mechanisms of injury and describe a third type of dislocation not yet reported in the literature. PMID- 3559048 TI - Instrumentation for small joint arthroscopy. AB - Proper instrumentation is basic to all podiatric surgical procedures, but in many instances one instrument can be substituted for another. In podiatric arthroscopy, however, the instrumentation is the "sine qua non" of the procedure; one instrument does not substitute for another and all have specific functions. PMID- 3559047 TI - Epithelioma cuniculatum plantare. AB - Epithelioma cuniculatum plantare is a tumor of epithelial origin occurring on the plantar aspect of the foot. It is an uncommon, locally aggressive neoplasm, not limited to this area, and in other body sites is referred to as verrucous carcinoma. The history and treatment of a patient with plantar verrucous carcinoma is presented; a survey of the literature reflects difficulty in establishing an early diagnosis. This, however, can be facilitated when the gross appearance and a history of prior surgical attempts to excise the lesion are known to the surgeon and the pathologist, and the surgical specimen ideally encompasses the deeper portions of the lesion. PMID- 3559049 TI - A team approach to infections of the lower extremity in the diabetic patient. PMID- 3559050 TI - Team approach in the management of diabetic foot infections. AB - Foot infections are common in the diabetic patient. They result from a interplay of neuropathy, ischemia, and metabolic alterations. The team approach in the management of diabetic foot infections can provide the most optimal and probably the most cost-effective care. The cornerstone of treatment is early recognition and prompt intervention. After diagnostic cultures are obtained, infections should be treated with appropriate antibiotics. Bony deformities should be corrected. The vascular status of the patient should be evaluated, and if necessary, treatment should be directed at improving blood flow to the affected foot. PMID- 3559051 TI - The surgical management of osteomyelitis: with special reference to a surgical classification. AB - Bone infection requires a multifaceted approach that may be more clearly defined by a pathophysiologic and pathoanatomic classification. Seven types of bone infection are described, which differ by pathophysiology. Anatomically, infection may involve nonmedullary bone tissues, medullary bone, or the epiphyseal growth plate. Treatment can be prescribed accordingly. The isolation and persistence of bone infection usually requires invasion of the septic space by a surgical approach. By this means, bacterial colonization is denied and vascular return can reclaim the tissue domain. Bone infection is difficult to eradicate, yet a proficient surgical approach to sepsis can restore skeletal health and form. PMID- 3559052 TI - Infections involving the skin and soft tissues of the lower extremities. AB - A variety of infectious processes produce cutaneous and soft-tissue involvement of the lower extremities. Patients with conditions leading to ischemia and devitalized tissues, and those with diabetes mellitus are predisposed to developing these infections. The signs and symptoms and bacteriology of many of these infections may overlap, leading to confusion in diagnosis and subsequent management. Very often the progression of some of these infections is rapid and life-threatening, although mutilating-type infections are not uncommon. Optimal management requires a multidisciplinary approach, with the surgeon, microbiologist, pathologist, internist, and infectious disease specialist working in close cooperation with each other. PMID- 3559053 TI - The penicillins and bone penetration of antibiotics. PMID- 3559054 TI - International symposium: thyroid autoimmunity thirtieth anniversary: memories and perspectives. Historical papers reproduced. PMID- 3559055 TI - Symposium on Evaluation of Thyroid Function in Thyroidal and Non-Thyroidal Disease. Rotterdam, The Netherlands, April 25, 1986. Proceedings. PMID- 3559056 TI - Adequacy of TSH suppression by L-thyroxine administration in thyroid cancer patients after total thyroidectomy. PMID- 3559057 TI - Strategy of thyroid-function testing, a comparative study using TT4, FT4I, various FT4 and IRMA-TSH kits. PMID- 3559058 TI - Effects of moderate hypoxia on fetal electrocortical activity, eye movements, and breathing activity in sheep. AB - Isocapnic hypoxaemia (delta PaO2 = -8.0 +/- 0.5 mmHg; delta CaO2 = -2.86 +/- 0.20 ml/dl) was produced in fetal sheep by having the ewe breathe for one hour a gas mixture (v/v) of 10.5% O2 and 1.5% CO2 in N2. Mean fetal heart rate, blood pressure, and incidence of low voltage electrocortical activity were not affected. However, the incidence of rapid-eye-movements and breathing activity was reduced by about 40%. Breathing movements during hypoxaemia had a mean inspiratory time, breath interval, and tracheal pressure amplitude which did not differ significantly from those during control experiments in which the ewe breathed air from the plastic bag. These observations suggest that hypoxia decreases the incidence of breathing movements but does not affect the amplitude or pattern of breathing activity and that it may reduce the incidence of eye movements and breathing activity through a common mechanism. PMID- 3559059 TI - Evidence of saturable uptake mechanisms at maternal and fetal sides of the perfused human placenta by rapid paired-tracer dilution: studies with calcium and choline. AB - Rapid uptake and efflux of 45Ca2+ and [3H]choline at the maternal and fetal interfaces of the syncytiotrophoblast in the dually-perfused human placenta was investigated by application of the single circulation paired-tracer dilution method (Yudilevich, Eaton, Short & Leichtweiss 1979). Cotyledons were perfused with Krebs-bicarbonate containing dextran (30 g/l; MW = 60-70,000) at 20 and 6 ml/min on maternal and fetal sides, respectively. The paired-tracer (test substrate and extracellular marker) technique consisted of an intra-arterial injection of a tracer bolus, followed by venous sampling over 5-6 min. There was a rapid (sec) uptake of 45Ca2+, followed by backflux (efflux into the ipsilateral circulation) which, over 5-6 min, was 59-100% on the fetal side. It was more variable but generally lower on the maternal interface. At 0.1 mM calcium, 45Ca2+ maximal uptake (Umax) was about 53% on the fetal side but on the maternal side it was variable and averaged 17%. At 2.4 mM calcium fetal side Umax was reduced to 40%. However, on the maternal side the effect was not consistent. Unidirectional influx (nmol/min per g) appeared to be not different on the two sides of the placenta. For [3H]choline (in choline-free perfusates) Umax was about 50% and 30% on fetal and maternal sides, respectively; tracer backflux was variable on the maternal side and averaged 50% on the fetal side. [3H]Choline uptake was highly inhibited by either 1.0 mM choline or the specific competitive inhibitor, hemicholinium-3 (0.1 mM). Specific transplacental transfer of 45Ca2+ (i.e. in excess of the extracellular marker) was not significant in either direction. For [3H]choline there was an apparent small excess (about 4%) preferential towards the fetal circulation. These findings in the human placenta are similar to those demonstrated previously in the guinea-pig placenta which suggested the existence of specific transport systems for choline and calcium on both sides of the syncytiotrophoblast. PMID- 3559060 TI - Fetal oxygen consumption and PO2 during hypercapnia in pregnant sheep. AB - In 12 experiments on 9 chronically-cathetized pregnant sheep (116-143 days of gestation), fetal oxygen consumption, umbilical blood flow and blood gas values were measured before, during and after a 30-min period of hypercapnia, induced by having the ewes breathe 5% CO2 and 18% O2 in N2. During the large amplitude breathing stimulated by hypercapnia, O2 consumption increased by 21%, solely via a rise in O2 extraction. During apnoeic periods and low amplitude breathing in the hypercapnia period, oxygen consumption was not different from the control value, but fetal arterial and umbilical venous PO2 was significantly raised, by 3 and 6 mm Hg respectively. These changes were probably due to a Bohr shift in the maternal oxygen dissociation curve. During large amplitude breathing, PO2 fell to control levels, probably due in part to the increase in O2 extraction. It is concluded that vigorous breathing movements in the fetal sheep, such as those stimulated by hypercapnia, result to an increase in fetal O2 demands. Further, the work of such breathing is large, and probably equivalent to that performed in adults during vigorous hyperventilation against an inspiratory resistance. PMID- 3559061 TI - Temperature responses following ventilation of the fetal sheep in utero. AB - The mammalian fetus produces significant quantities of heat. This passes to the mother principally through the placenta and to a lesser extent via a pathway comprising the skin, amniotic fluid, and uterine wall. To assess the importance of the lesser pathway, temperature responses were recorded in 7 near-term fetal sheep after intrauterine ventilation with oxygen, after snaring the umbilical cord to block the placental route, and following fetal death. Four distinguishing characteristics of responses were observed: fetal temperature rose 0.10 +/- 0.03 (SEM) degrees C after oxygenation; it rose progressively an additional 0.9 +/- 0.1 degrees C during the 90-min interval after cord snaring; amniotic fluid temperature rose slowly until it was about midway between fetal and maternal temperature; and after fetal death, fetal amniotic fluid temperatures fell slowly. In a simple mathematical model with constant parameters these results could not be explained fully. It was necessary to assume that heat production rose with increased oxygenation and elevated body temperature and that ventilation increased heat transfer through the amniotic fluid, as would occur if chest wall movement were stirring the fluid. Using the model, the value for heat conductance from fetal skin to amniotic fluid was estimated to be 10.5 watts degrees C-1 under basal conditions. PMID- 3559062 TI - Effects of acute and prolonged exposure to heat on regional blood flows in pregnant sheep. AB - This study deals with fetal growth retardation in heat-exposed sheep, and provides information on mechanisms of acclimation to heat. Radioactive microspheres were used to measure regional capillary blood flows in conscious sheep 80-100 days pregnant, at first in a thermoneutral environment, next after 2.5-6 h exposure to a hot environment of 40 degrees C, 25 mmHg water vapour pressure, and then 7 days and 15-20 days later, after spending 9 h daily in the heat. Maternal blood flow in the placental cotyledons was decreased by the first heat exposure, and remained depressed during the period of periodic heating. Reduction in placental blood flow on the maternal side could be part of the mechanism by which fetal development is retarded in heat-stressed sheep. Acclimation to heat was indicated by a decrease in the rate of rise in rectal temperature during the first 2 h of daily exposure to heat. Concomitantly, there was a progressive increase in the blood flow in extremity skin and nasal mucosa, which are tissues concerned with facilitation of heat loss during acute heat stress. However, in respiratory muscles which are also concerned with heat-loss, there was no further increase in flow after the initial response to to acute heat, indicating that heat acclimation is not due to an increased ability to pant. Blood flow in other tissues such as gut, pancreas and adipose tissue progressively decreased. These changes in blood flow have possible adaptive significance. PMID- 3559063 TI - Some aspects of placental function in chronically heat-stressed ewes. AB - Pregnant ewes were exposed continuously to high ambient temperature (38-40 degrees C for 9 h, 30-32 degrees C for 15 h daily, relative humidity 40-50%) between about 45 days and 120 days of gestation and studied at 132-137 days. Results were compared with those of ewes of similar gestational age which were not exposed to heat at any stage of pregnancy. Heat exposure did not depress appetite but caused variable reductions in placental weight. Fetal weight was reduced to a lesser extent and correlated with placental weight. Uterine and umbilical blood flows and placental glucose transfer capacity were all significantly reduced and highly correlated with placental weight. These effects were accompanied by an enlargement of the PO2 difference between uterine and umbilical venous blood, a decrease in the PO2 and oxygen saturation of fetal arterial blood, and fetal hypoglycemia. Uteroplacental rates of oxygen and glucose utilization and the concentration of fructose in fetal blood were each significantly correlated with placental weight. It is suggested that reduced placental growth is a primary effect of chronic maternal heat stress and that the associated retardation of fetal growth represents a fetal adaptation to a decreased placental ability to supply oxygen and nutrients. PMID- 3559064 TI - Redistribution of fetal circulation during repeated asphyxia in sheep: effects on skin blood flow, transcutaneous PO2, and plasma catecholamines. AB - To improve the understanding of fetal responses to labour, we have ascertained whether reduced fetal skin blood flow after asphyxia reflects redistribution of the circulation, and if so, whether this can be detected by transcutaneous PO2 monitoring. We also studied the relation between plasma concentrations of catecholamines and organ blood flow. Eight experiments were conducted on 8 acutely-prepared fetal sheep in utero between 125 and 135 days of gestation. In each fetus 11 episodes of asphyxia were induced within 33 min by intermittent arrest of uterine blood flow for 90 s. The distribution of blood flow was measured before and after asphyxia (at 35.5 min) by the isotope-labelled microsphere method. Blood samples were drawn at 0, 33 (i.e. after 90 s recovery), and 40 min to determine blood gases, acid-base balance, and catecholamine concentrations. Fetal transcutaneous PO2, heart rate, arterial blood pressure, and arterial O2 saturation were recorded continuously. Repeated fetal asphyxia increased plasma catecholamine concentrations and caused a circulatory redistribution to the brain (181% change), adrenals (116% change), and lungs (105% change) at the expense of many peripheral organs, particularly of the skin (-61% change). The pattern of these changes was different from that observed by others in persistent hypoxia or asphyxia. The decrease in skin blood flow, which depressed transcutaneous PO2 and increased the arterial-transcutaneous PO2 difference, correlated with the decrease in blood flow to other peripheral organs and with an increase in blood flow to the brain stem. We conclude that reduced blood flow to the fetal skin after repeated episodes of asphyxia indicates circulatory redistribution, which can be detected by transcutaneous PO2 measurements. We suggest that monitoring of variables that depend on skin blood flow may improve fetal surveillance during complicated labour. PMID- 3559065 TI - Effect of chronic maternal hyperkalaemia on plasma, cerebrospinal fluid and brain interstitial fluid potassium in developing rats. AB - Plasma hyperkalaemia was induced in pregnant and lactating rats using a high potassium diet. Fetuses of high-K-diet mothers showed no increase in the potassium concentration [( K+]) of plasma, cerebrospinal fluid (CSF) and brain interstitial fluid, presumably due to placental control. Neonates from high-K diet rats did show an increase in plasma [K+] but this increase was very small and there was no increase in CSF or interstitial fluid [K+]. Maternal milk [K+] was not affected by plasma hyperkalaemia. Weanling rats fed the high-K diet directly showed marked plasma hyperkalaemia but no increase in CSF or interstitial fluid [K+]. Thus, prior to weaning, a relatively stable plasma [K+] is maintained by maternal influence reducing the need for direct brain fluid K+ regulation. PMID- 3559066 TI - Long-term review of the surgical treatment of radial deficiencies. AB - Sixty-four patients with 101 radial deficiencies form the basis of this review of anatomy, treatment, and long-term follow-up. Average follow-up was 8.6 years, with a range of 1 to 27 years. A radiologic classification of radial deficiencies is presented. The preferred method of treatment is centralization. The goal is to create a centralized, cosmetically and functionally improved hand, yet maintain wrist motion. There were 21 good, 20 satisfactory, and 10 unsatisfactory results. Good and satisfactory results all had adequate preoperative stretching, proper surgical technique, and postoperative brace compliance. Failure to adhere to outlined principles of soft tissue release and adequate centralization resulted in the unsatisfactory results. PMID- 3559067 TI - Posttraumatic ulnar translation of the carpus. AB - Ulnar translation of the carpus is a rare posttraumatic carpal instability pattern, in which the entire carpus is displaced ulnarward on the radioulnar surface. No previous formal reports of this problem have been located although it has been described in general discussions of wrist instability. Seven men and one woman were diagnosed with this condition although the diagnosis was delayed from 2 to 23 months, an average of 7.3 months. Three patients were treated surgically before diagnosis; the other five patients were treated conservatively before diagnosis. At the time of definitive diagnosis the radiographs showed an ulnar translation of the carpus, which was quantified on the radiographs in all eight patients by the method of Chamay. Four patients had an attempt to repair the radiolunate and radiocapitate ligaments. One patient had a ligamentous augmentation of the radiocapitate ligament complex. Two patients had ligamentous repairs of a scapholunate dissociation; one of these had simultaneous radiocarpal ligamentous augmentation. The eighth patient had a radiolunate arthrodesis. Follow-up averaged 32 months. Three patients had formal wrist arthrodeses at 10, 13, and 26 months after initial ligamentous repair, which were considered treatment failures. In the remaining five patients, four had partial recurrent ulnar shift, which was seen radiographically. Of these, three patients rated the result as good, with near normal strength and returned to full activities while two obtained fair results, with minimal pain but decreased range of motion and decreased strength. One patient has shown progressive degenerative radiocarpal changes and may become a candidate for a limited or formal wrist arthrodesis. PMID- 3559068 TI - Treatment of distal radioulnar disorders. AB - Twenty-nine wrists of 29 patients were treated with three procedures: distal ulnar resection (Darrach's procedure), distal ulnar recession, or hemiresection interposition arthroplasty. The indications were pain and limitation of motion associated with primary osteoarthritis of the distal radioulnar joint, derangement after distal forearm bone fracture, Madelung's deformity, and distal radioulnar sprain. The age of the patients averaged 48.3 years. Follow-up averaged 1 year and 9 months. Radiographic evaluations were done preoperatively and postoperatively. Relief of pain was good in the wrists treated by Darrach's procedure; however, diminished grip strength and wrist instability occurred. Relief of pain in the wrists treated by distal ulnar recession and hemiresection interposition arthroplasty was inferior to that of Darrach's procedure; however, postoperative grip strength increased and wrist instability did not occur. PMID- 3559069 TI - Forearm force transmission after surgical treatment of distal radioulnar joint disorders. AB - To evaluate the effect of silicone replacement of the distal ulnar, hemiresection arthroplasty and the Darrach procedure on ulnar support of the carpus, changes in force transmission to the radius and ulnar were measured using load cells in axially loaded cadaver arms. Testing of the intact specimens in neutral position showed that an average of 17% of the axial load was borne by the ulna whereas the load decreased to 3.6% after silicone arthroplasty, to 2.4% after hemiresection arthroplasty, and to 1.0% after the Darrach procedure. Only by placing the silicone cap on the ulna to lengthen it by 4 mm did the ulna load become within 75% of that in the intact specimen. In the intact specimen, ulna loading increased with wrist extension and ulna deviation and decreased with flexion and radial deviation, while after the surgical procedures there was no significant change in ulna loading with wrist position. PMID- 3559070 TI - Madelung's deformity: treatment by osteotomy of the radius and Lauenstein procedure. AB - A 22-year-old woman with Madelung's deformity was treated by radial osteotomy and a Lauenstein procedure. This technique allows near normal restoration of the distal radius architecture, support of the ulnar side of the carpus, maintenance of forearm pronation and supination, and a satisfactory cosmetic result. PMID- 3559071 TI - Ulnar variance in carpal instability. AB - Ulnar variance was measured in wrist conditions of patients with carpal instability and compared to values obtained from the assessment of normal wrist x ray films. The results showed a significantly greater amount of negative ulnar variance in patients with scapholunate dissociations than in normal controls (t test, p less than 0.0005; chi-square test, p less than 0.02). Ulnar variance in lunotriquetral dissociations and old scapholunate dissociations with arthrosis did not differ significantly from controls (p greater than 0.6). Posttraumatic scapholunate dissociations do correlate with negative ulnar variance. PMID- 3559072 TI - Wrist arthrodesis using dorsal radial bone graft. AB - A modification of the Gill technique of wrist arthrodesis using a local bone graft and a combination of Kirschner wires and a tension band wire is described. This technique was used in 17 patients for either limited or complete wrist fusion. Follow-up over an average period of 18.1 months in 16 patients showed union in all 16. Time to union averaged 2.36 months. In three patients, the tension band wire needed to be removed. The advantages of this technique are its simplicity, versatility, and reliability without the need for a distant bone graft. PMID- 3559073 TI - Extraskeletal osteochondromas of the wrist. AB - Extraskeletal osteochondromas of the wrist are described in two patients. They both had painless, slow-growing wrist masses, one palmar and one dorsal. Radiographs demonstrated the presence of an extraskeletal, radiopaque mass. Excisional biopsy showed extraskeletal, firm, calcified masses. Histologic examination revealed mature hyaline cartilage, with extensive ossification consistent with the diagnosis of extraskeletal osteochondroma. The ambiguous nomenclature for this cartilage lesion and the differential diagnosis of extraskeletal calcification are reviewed. PMID- 3559074 TI - Power staple fixation in hand and wrist surgery: new applications of an old fixation device. AB - After laboratory testing power driven staples were used in metaphyseal type bone 39 times from December 1983 through April 1985 in 33 patients with hand or wrist problems. Applications included arthrodeses, nonunions, and osteotomy fixation. Diagnoses included rheumatoid and degenerative arthritis, scaphoid, and interphalangeal nonunions. There were no infections, and only one staple has broken. There has been little evidence of loosening or inflammation. Shattering of bone has not occurred; osteoporotic bone appears to be ideal tissue in which to use this fixation. PMID- 3559075 TI - Posttraumatic ulnar subluxation of the extensor tendons: a reconstructive technique. AB - Ulnar subluxation of the extensor digitorum communis over the metacarpal head can compromise the function of the extensor mechanism to the affected digit. Extensor displacement can be posttraumatic, developmental, congenital, or caused by arthritis of the metacarpophalangeal joint. A tendon centralizing procedure was performed on five digits in three patients who had posttraumatic ulnar subluxation of the extensors at the metacarpophalangeal joint after conservative management failed. No recurrences of subluxation have been noted in this series, and all patients have regained full range of motion. PMID- 3559076 TI - Independent index extension after extensor indicis proprius transfer. AB - The extensor indicis proprius was used to restore mobility to a variety of hand movements in 27 patients. Retained independent index finger extension was obtained in a majority of patients postoperatively. Potential postoperative complications of index extension lag and deviation may be avoided if the extensor indicis proprius is sectioned immediately proximal to the dorsal hood. A corresponding laboratory study was undertaken to better define the anatomic constraints limiting independent finger extension. Distinct differences between juncturae tendinum and extensor compartment musculature help explain why the index finger may function as a relatively independent unit. PMID- 3559077 TI - Effect of triceps function on the brachioradialis transfer in quadriplegia. AB - Fifteen patients with traumatic quadriplegia who had transfer of the brachioradialis to the flexor pollicis longus were evaluated to determine the influence of triceps function on pinch strength. Pinch was measured with the elbow free and with the elbow locked at 90 degrees in an orthosis that served as an external means of blocking elbow flexion in those patients with impaired triceps strength. Those patients having two foot-pounds or less elbow extension torque had an average pinch of 1.20 kg without elbow immobilization. With the elbow immobilized, pinch strength increased 153%, averaging 3.04 pounds. Those patients having more than two foot-pounds elbow extension torque had an average pinch of 4.08 pounds with the elbow free and pinch strength was not improved by immobilization in the orthosis. The absence of triceps function significantly decreases the effectiveness of the brachioradialis when used to motor a tendon transfer. Surgical procedures, such as posterior deltoid to triceps transfer, which provide active elbow extension can be expected to significantly increase the pinch strength supplied through the brachioradialis transfer in patients without voluntary elbow extension. PMID- 3559078 TI - The role of thromboxane in experimental inadvertent intra-arterial drug injections. AB - Inadvertent intra-arterial injection of drugs produces a well-defined clinical syndrome whose pathophysiology remains unclear. This study was designed to determine the role of the inflammatory mediator, thromboxane, in intra-arterial drug injections. The rabbit ear model, as described by Kinmonth and Sheppard, was used. Five of the experimental groups were treated with specific or nonspecific thromboxane blocking agents and two groups served as controls. Immunohistochemical staining of the control ears showed elevated levels of thromboxane within the first 6 hours postinjury. The specific thromboxane blocking agents, methimazole and Aloe vera, showed almost complete blockade of thromboxane production. The percentage of ear survival was significantly greater in the group treated with topical Aloe vera (p less than 0.05) and even greater survival was achieved in the combined Aloe vera/methimazole group (p less than 0.01). On the basis of these results, we have begun treatment of such injuries with specific and nonspecific thromboxane blocking agents. PMID- 3559079 TI - Arterial stump pressure: a determinant of arterial patency? AB - Twenty-seven patients with acute injuries to the radial or ulnar arteries had arterial repairs using microvascular techniques. No patient had an ischemic hand secondary to his arterial injury. The overall patency rate for all repaired vessels was 56%. For sharp, clean lacerations, the success rate for repairs was 55%. Repairs of acute, sharp lacerations yielded no better results than delayed reconstructions. The average distal end arterial stump pressure for patent arteries was 66% of mean, while for thrombosed vessels it was 76% of mean; this was not a statistically significant difference (p = 0.9). There was no statistical correlation between forearm arterial patency, age, sex, vessel injured, mechanism of injury, time of repair, or clinically measured distal arterial stump pressure. At the present time, it does not appear to be possible to predict arterial patency by measuring arterial stump pressure at the time of definitive repair. PMID- 3559080 TI - Quantitative fluorometry as a monitor for microvascular surgery. AB - There is a clear need for effective methods of monitoring for postoperative occlusion of vessels in microvascular surgery. We have evaluated one technique, quantitative fluorometry, in the laboratory and clinically. Our laboratory study used rat abdominal flaps under conditions of controlled occlusion. We found accurate detection of vascular occlusion within 20 minutes, but we were unable to differentiate arterial from venous occlusion. Our clinical review of 34 microvascular cases (14 free flaps and 20 replantations) that employed fluorometry revealed corroboration of occlusion (indicated by another monitoring technique) in six cases and a diagnosis at variance with other monitoring methods in one case, thus preventing an operative exploration. We recommend the use of quantitative fluorometry as a primary or adjunctive method of monitoring when patency is in question and have outlined a protocol for clinical use. PMID- 3559081 TI - Digital angiography and osteoblastoma of the triquetrum. AB - A patient had persistent pain in left wrist of 2 years' duration. Only intravenous digital subtraction angiography was specific in establishing a tumor in the left triquetrum as the cause. The tumor was an osteoblastoma. PMID- 3559082 TI - Acute vascular compromise after avulsion of the distal phalanx with the flexor digitorum profundus tendon. AB - An unusual case of avulsion fracture of the insertion of the flexor digitorum profundus tendon is presented. In most such avulsion fractures a small amount of fractured bone may remain with the tendon. In this case almost the entire distal phalanx was avulsed, and vascular compromise of the digit then occurred. Prompt reduction restored vascularity. PMID- 3559083 TI - Traumatic dorsoradial dislocation of the trapezium. AB - Two examples of traumatic dorsoradial dislocation of the trapezium are presented. Only three cases have previously been reported. Forced flexion of the first metacarpal is probably the basic mode of dislocation. It is suggested that open reduction and Kirschner wire fixation is the treatment of choice. Late excision or arthrodesis should be used in failed cases. PMID- 3559084 TI - Dorsal fractures of the triquetrum-avulsion or compression fractures? AB - In 76 wrists, which had a dorsal fracture of the os triquetrum, the mean size of the ulnar styloid process was radiologically measured and found to be significantly larger (p less than 0.0001) that those in a control group of 100 noninjured hands. This finding supports the view that such injuries are not avulsions, as they are assumed to be, but are the product of a chisel action of a powerful ulnar styloid process on the dorsum of the triquetrum during strong dorsiflexion and ulnar deviation. In accordance, persons with a long styloid process have an increased chance of this kind of injury. PMID- 3559085 TI - Fracture of the thumb sesamoid bones. AB - Two cases of sesamoid fracture of the thumb are reported. The condition is presumably underdiagnosed because of incomplete ossification of the bone. If pain persists after immobilization, excision of the bone is curative. PMID- 3559086 TI - Simultaneous fracture of the scaphoid and capitate in a child. AB - An 11-year-old boy had an ipsilateral scaphoid fracture and a capitate fracture, a rare combination of injuries that has not been previously reported. The importance by identification by x-ray film of the fracture pattern is emphasized. A fall on the palm forcing the wrist in extreme extension is the most likely mechanism of injury in this patient. Bony union and normal painless wrist motion were obtained in these nondisplaced fractures with immobilization for 6 weeks. PMID- 3559088 TI - Carpal tunnel syndrome in the adolescent. AB - Three cases of carpal tunnel syndrome in the adolescent age group are described. All were associated with an increase in the patient's athletic activities. After a trial of conservative treatment, all symptoms were successfully relieved by surgical release. PMID- 3559087 TI - Longitudinal epiphyseal growth after replantation and transplantation in children. AB - Previous investigators have shown that epiphyses are unlikely to grow after free grafting although there have been rare reports of good and even normal growth. However, growth has usually continued whenever the epiphyseal vascular supply has been maintained by microanastomosis. Of 25 growing epiphyses in our series that were transferred, 17 by replantation and eight by free tissue transfer supported by microvascular anastomosis, over an interval varying from 27 to 81 months, average length attained was 89% of normal in elective transfer, 93% of normal in replanted digits, and 92% overall. Maximum growth attained in any digit in our series was 102% of the length of the normal contralateral digit; the minimum attained was 70%. PMID- 3559089 TI - Salvage of severe recurrent Dupuytren's contracture of the ring and small fingers. AB - Severe recurrent digital Dupuytren's contracture, with pseudomotor changes and inadequate palmar tissue, is often treated with amputation. In this study, 11 patients had 14 proximal interphalangeal joint fusions with shortening done for salvage of recurrent Dupuytren's rather than amputation. Indications for operation were pseudomotor changes, severe palmar fibrosis, previous operations, and a flexion contracture of greater than 70 degrees. PMID- 3559090 TI - Isolated contracture of the abductor digiti minimi. AB - A case of isolated contracture of an intrinsic hand muscle, the abductor digiti minimi, after the use of an upper extremity tourniquet is reported. Six cadaver specimens were studied after latex arterial injection. We present an anatomic study and pathomechanical analysis, along with a review of the literature on tourniquet-associated injuries. PMID- 3559091 TI - Extensor digitorum brevis manus in the nondominant hand of two brothers. AB - This is the first reported case in the English-language literature of surgical confirmation of the extensor digitorum brevis manus in the nondominant hand of two brothers. The familial incidence of this atavistic muscle has not been widely studied. PMID- 3559092 TI - Chronic tenosynovitis caused by Actinobacillus actinomycetemcomitans. AB - This is the first report of a patient with a history of painless chronic flexor tenosynovitis caused by Actinobacillus actinomycetemcomitans. The slow growth of the organism on culture makes early identification difficult. Flexor tenosynovitis along with proper antibiotic treatment resulted in complete resolution in this patient. PMID- 3559093 TI - Aerobic mouth flora of the rhesus monkey. AB - The aerobic and facultative anaerobic mouth flora of 17 rhesus monkeys was studied qualitatively, including antibiotic susceptibilities. The organisms most often encountered were Neisseria species (19.8%), alpha haemolytic streptococci (19.8%), and Haemophilus parainfluenzae (17.2%). All Haemophilus parainfluenzae isolates were susceptible to cefoperazone. The combination of penicillin and cefoperazone may be the most appropriate initial antibiotic treatment for monkey bite injuries. PMID- 3559094 TI - Treatment of neuromas about a major amputation stump. AB - In five patients, with intractable pain from neuromas that developed after amputations at the wrist or forearm, the neuromas were resected and the median nerve anastamosed to the ulnar nerve under the pronator teres muscle. In one patient, the anterior interosseous nerve was also anastamosed to the superficial radial nerve under the muscles of the forearm. Patients reported an 80% to 90% reduction in pain. This procedure is limited to patients in which all other treatments have failed. PMID- 3559095 TI - Multiplicity of neurilemomas in the upper extremity. AB - Multiple neurilemomas in two patients show that these tumors may indeed be multiple, may involve the same nerve trunk, may occur over a period of years, and may involve different regions of the body. Twelve neurilemomas were removed from the right upper extremity of a patient over a 3-year period. They varied in size from 0.5 cm to 4 cm in diameter and had the typical histopathologic appearance of neurilemomas. The second patient had median nerve compression and at operation a neurilemoma was found compressing the nerve. Two years later, the patient had evidence of median nerve compression in the opposite extremity, and again a neurilemoma was found. Both of these patients had evidence of peripheral nerve compression, but the existence of multiple neurilemomas was not apparent on initial examination. These cases show that patients with neurilemomas may have additional sequential tumors discovered at a later date that were not apparent initially. PMID- 3559096 TI - Metastatic tumors of the hand. AB - During a 43-year period, 18 patients with 22 lesions metastatic to the hand were treated at our institution. Twelve lesions were located in the distal phalanges, and the remainder were found in the carpus, metacarpals, proximal phalanges, and soft tissues of the hand. The primary tumor was in the lung in five cases and in the kidney in five cases. Treatment consisted of local excision or radiation for proximal lesions and amputation for distal lesions. Although the median survival was only 5 months, five patients lived longer than 2 years; including two who had no further evidence of malignant disease. In two patients, hand metastasis was the first sign of malignant disease. Metastatic malignancy should be considered in the differential diagnosis of inflammatory lesions of the hand. Although in general, the goal of treatment should be palliation, in some patients long disease-free intervals can be provided by wide excision of the metastatic focus. PMID- 3559097 TI - Soft tissue chondromas in the hand. AB - Benign chondromas are rare soft tissue tumors of the hand. Five cases are presented. These tumors are generally seen as a painless lump, easily removed, as shown in three cases. Two additional patients had pain and stiffness at the proximal interphalangeal (PIP) joint. They demonstrate the occasional difficulty in making an accurate preoperative diagnosis, requiring a more extensive exposure at surgery as they can extend in various directions and may involve the tendon sheath or joint. PMID- 3559098 TI - Upper extremity preservation before replantation. PMID- 3559099 TI - The image intensifier as an operating table. PMID- 3559101 TI - Will it float? PMID- 3559100 TI - Prolonged cholestasis after cyproheptadine-induced acute hepatitis. AB - We report a patient in whom cyproheptadine-induced hepatitis was followed by prolonged cholestasis marked by elevation of serum alkaline phosphatase levels, gammaglutamyltransferase and bile acid levels, and disappearance of small bile ducts. Chlorpromazine and imipramine, which can induce a similar acute hepatitis followed by protracted cholestasis, have a close chemical structure (i.e., a tricyclic ring). We suggest that this structure might be involved in this type of hepatotoxicity. PMID- 3559102 TI - Doxycycline-induced esophageal ulceration: do old capsules play a role? PMID- 3559103 TI - Gastrogastric intussusception. PMID- 3559104 TI - Vancomycin-induced pseudomembranous colitis. PMID- 3559105 TI - Primary myelofibrosis associated with portal venous thrombotic occlusion and cavernous transformation around the biliary tree. PMID- 3559106 TI - Treatment of reflux esophagitis with cimetidine in a liquid suspension. PMID- 3559107 TI - Esophageal acid sensitivity in Barrett's esophagus. AB - Esophageal acid sensitivity was evaluated in 15 patients with Barrett's esophagus and in 15 patients with reflux esophagitis uncomplicated by Barrett's. Patients with Barrett's esophagus had sensitivity to esophageal acid perfusion less frequently than those with uncomplicated reflux esophagitis (66 vs. 100%; p less than 0.05). Moreover, patients with Barrett's esophagus with acid sensitivity took longer to develop pain during acid perfusion (p less than 0.05), and overall, experienced less severe symptoms (p less than 0.01) than those with reflux esophagitis. Over a 2-week period, as judged by diary, the Barrett's group had less frequent (p less than 0.01) and less severe (p less than 0.01) heartburn symptoms than the other patients. These results indicate that patients with Barrett's esophagus have significantly reduced esophageal acid sensitivity and, as a consequence, have an impaired ability to recognize acid reflux. PMID- 3559109 TI - Nonpathogenic nematodes in gastrointestinal aspirates obtained during endoscopy. AB - The gastroenterologist must be alert to diagnosing parasitic diseases when collecting intestinal fluid samples or cytologies during endoscopy. Between 1979 and 1982, we identified nematodes in 10 endoscopic specimens. None were Strongyloides stercoralis. We emphasize the importance and technical aspects of distinguishing nonpathogenic nematodes from Strongyloides. PMID- 3559108 TI - Bubble-mania. PMID- 3559110 TI - Does duodenal ulcer lead to an early diagnosis of gastric cancer? AB - In four of five patients with gastric cancer who also had a chronic duodenal ulcer, the histologic type was "early gastric cancer," which offers a better prognosis than the more common type. Patients with duodenal ulcer who develop gastric cancer may have a better prognosis than patients with gastric cancer without duodenal ulcer because their duodenal ulcer places them under more frequent surveillance, including clinical and endoscopic follow-up. PMID- 3559111 TI - Acute biliary pancreatitis. The role of interventional radiology. PMID- 3559112 TI - Upper endoscopy for occult bleeding in renal failure. AB - We studied 41 patients with renal failure prospectively to assess the value of upper gastrointestinal endoscopy in detecting occult bleeding after an abrupt fall in hemoglobin (Hb) level. Thirty-four patients were on maintenance dialysis, six on plasma exchange, and one on dialysis and plasma exchange. At gastroscopy two patients (4.9%) had bleeding lesions, five patients (12%) peptic ulcers without bleeding, and 18 patients (44%) mild esophagitis, gastritis, or duodenitis. Although mucosal abnormalities in the upper gastrointestinal tract were common, clinically inapparent gastrointestinal bleeding was only rarely responsible for sudden changes of Hb in these patients. PMID- 3559113 TI - Duodenal fistulas in Crohn's disease. AB - Of 1,480 patients with Crohn's disease admitted to The Mount Sinai Hospital between 1960 and 1983, eight (0.5%) had duodenal fistulas (DF), all originating from diseased small or large bowel and not from primary disease of the duodenum. The extent, duration, and major clinical features of Crohn's disease did not differ between patients with DF and those with other fistulas. Six of the patients underwent surgery for refractory disease or abscess formation and two patients were treated medically. All improved and were able to maintain an adequate oral intake after treatment. At follow-up 3-10 years later, the surgically treated patients were well but both medically treated patients had died, one from a probably unrelated brain tumor 7 years after discharge and one from necrotizing pancreatitis 10 years later. Our experience suggests that the presence of a DF is not an absolute indication for early surgery. The initial therapeutic management of such patients should be determined by the nature and severity of the underlying Crohn's disease rather than the presence of a DF. The late pancreatic complication in a patient with a chronic DF, however, raises the question of an association between the two. PMID- 3559114 TI - Ulcerative colitis in sickle cell disease. AB - Four patients with homozygous sickle cell disease and severe proctocolitis are described. The current prevalence is three patients per 1,000 attending a sickle cell clinic. The reasons for the apparent predisposition of sickle cell disease to proctocolitis could not be determined but was revealed by the large follow-up clinic. PMID- 3559115 TI - Sigmoid perforation in patients with chronic constipation. AB - From 1976 to 1982, seven cases of free perforation of the sigmoid colon were treated at the Soroka University Hospital. None of the patients suffered any known underlying disease of the affected bowel such as malignancy, diverticulosis, stercoral ulcer, colitis, or trauma. The only feature common to all seven patients was a long history of chronic constipation. All patients were treated surgically with no mortality and with minimal morbidity. We believe that severe untreated chronic constipation may, on rare occasions, cause free perforation of the sigmoid colon. PMID- 3559116 TI - Gallstones in women younger than thirty. AB - In contrast to the usual 2:1 female:male ratio for the presence of gallstones, we found that the 12 patients with symptomatic gallstones under age 30 in this study were all female. This prompted a retrospective study of clinicopathologic findings in these 12 women with gallstones. Chemical analyses of the gallstones confirmed that all were cholesterol stones. Obesity and pregnancy proved to be the outstanding risk factors. The mechanism of obesity and pregnancy as lithogenic factors are reviewed and discussed. PMID- 3559117 TI - Short-term biliary dilatation and stenting in primary sclerosing cholangitis. AB - Operative biliary dilatation and prolonged percutaneous transhepatic biliary stenting have been useful in the management of primary sclerosing cholangitis, both intrahepatic and extrahepatic biliary strictures regressing after 12-16 months of treatment. We report the results of less prolonged treatment in a further four patients, in whom removal of a percutaneous transhepatic biliary stent 3-11 months after treatment led to an improvement in radiological appearances of the extrahepatic bile ducts, with no discernible effect on intrahepatic disease. Extrahepatic stricture recurred rapidly in one patient stented for only 3 months. Operative biliary dilatation and stenting for 5-11 months may lead to regression of extrahepatic biliary strictures in patients with primary sclerosing cholangitis, whereas intrahepatic disease requires stenting for 12-16 months. Further study is required to determine the applicability of this approach to primary sclerosing cholangitis. PMID- 3559118 TI - Serum cholesterol levels three years before and after viral hepatitis. AB - The serum cholesterol levels 3 years before and 3 years after an acute episode of hepatitis in 12 men aged 21-36 were compared to those in 22 age-matched controls. Serum cholesterol increased significantly during the acute icteric phase of the illness and remained elevated for 3 years after recovery. We conclude that cholesterol metabolism does not return to the prehepatitic state even 3 years after recovery. PMID- 3559119 TI - Hypercalcemia of cancer in the digestive tract. AB - We made a retrospective review of the patients with cancer of the digestive organs who died between January 1, 1975 and December 31, 1985, at Shinshu University Hospital. Of 183 patients with such cancers 15 (8.2%) had hypercalcemia. Hypercalcemia was defined as serum calcium level greater than 11.0 mg/dl on at least two determinations. The incidence of hypercalcemia by site was 5 of 74 (6.8%) liver, 1 of 16 (6.3%) biliary tract, 4 of 33 (12.1%) pancreas, 3 of 15 (20.0%) esophagus, 0 of 37 stomach, 0 of 2 duodenum, 2 of 5 colon, and 0 of 1 rectum carcinomas. There was no sexual or age predisposition to hypercalcemia. Bone scans and/or x-ray results were positive in three of eight, negative in five of eight, and were not evaluated in the remaining seven patients. Of five patients tested, four had low to normal serum parathyroid hormone (PTH) levels, and one had a serum PTH level high by C-terminal assay but normal by N-terminal assay. Serum chloride levels at the late stage of hypercalcemia were less than 102 mEq/L in all patients. Therefore, hyperproduction of PTH was unlikely to be a causative factor for hypercalcemia. Indomethacin was given to four patients with hypercalcemia with no effect on serum calcium levels in any cases. Survival from the diagnosis of hypercalcemia ranged from 2 to 96 days (mean 33 days). We conclude that hypercalcemia is a complication not infrequent at the late stages of cancers of the digestive organs, with the exception of gastric cancer, and a portent of a poor prognosis. PMID- 3559120 TI - Do antihypertensive agents cause chronic pancreatitis? PMID- 3559121 TI - Snore-induced Mallory-Weiss syndrome. AB - A Mallory-Weiss gastric mucosa laceration and upper gastrointestinal bleed was caused by intense snoring. This cause of gastrointestinal hemorrhage should be considered in the patient who snores. PMID- 3559122 TI - Ischemic jejunal stenosis and blind loop syndrome after blunt abdominal trauma. AB - One month after suffering blunt abdominal trauma a patient developed severe steatorrhea and profound weight loss in association with an ischemic distal jejunal stricture and blind loop syndrome. Evidence for a partial mesenteric tear was found at resection of the stricture, which resulted in complete cure. PMID- 3559123 TI - Small bowel injury simulating Crohn's disease after blunt abdominal trauma. AB - Seat belt-induced blunt abdominal trauma can result in a condition that both clinically and pathologically simulates Crohn's disease. Prompt recognition of this sequel to injury can save prolonged morbidity. PMID- 3559125 TI - Directing intervention from afar: the telephone dynamics of managing acute poisonings. PMID- 3559124 TI - Contact with the mentally ill and perceptions of how dangerous they are. PMID- 3559126 TI - The social costs of unemployment: implications for social support. PMID- 3559127 TI - Longevity, gender, and life quality. PMID- 3559128 TI - The internal structure of self-reported health measures among older male workers and retirees. PMID- 3559129 TI - Physician oversupply as a socially constructed reality. PMID- 3559130 TI - Body and mind: the effect of exercise, overweight, and physical health on psychological well-being. PMID- 3559131 TI - Catheter aspiration for simple pneumothorax. AB - A prospective study was conducted in the emergency setting to determine the efficacy of treatment of simple pneumothorax by catheter aspiration. Patients who were successfully treated were discharged to home. Sixty-one patients with a total of 76 pneumothoraces were involved in the study. The overall success rate was 75.6%, with an 82% success rate for needle-induced, 75% for traumatic, and 45% for spontaneous pneumothorax. The duration of symptoms, the size of the pneumothorax, the patient's age, and a prior history of pneumothorax did not affect the outcome. The poorest results were noted with spontaneous pneumothoraces, as would be expected since a majority of these patients have preexistent lung disease. Catheter aspiration of simple pneumothorax offers a cost-effective approach to this clinical problem. PMID- 3559132 TI - Traumatic rupture of right mainstem bronchus in a child. AB - We report a case of a 7-year-old boy who sustained a ruptured right mainstem bronchus in a motor vehicle accident. The clinical presentation, pathophysiology, and diagnosis of tracheobronchial injuries secondary to nonpenetrating thoracic trauma are discussed. PMID- 3559133 TI - Hyperkalemia: ECG manifestations and clinical considerations. AB - Hyperkalemia is a common cause of electrolyte induced cardiac conduction disturbance. A well-defined series of changes at the cellular level leads to characteristic evolutionary changes in the surface electrocardiogram. Initial high T waves and shortened intervals give way to prolongation of conduction and lethal dysrhythmias as the serum potassium level rises. The patterns of electrocardiographic changes associated with hyperkalemia are reviewed and an outline of appropriate therapeutic interventions. PMID- 3559134 TI - Brown recluse spider bites. AB - The brown recluse spider (Loxosceles reclusa), found in many areas of the United States, is capable of producing significant medical problems and potentially life threatening systemic manifestations. This paper reviews the clinical presentation, diagnostic workup, pathophysiology, and management of the brown spider bite. Emphasis is placed on the potential for error in establishing this diagnosis. The need for a simplified management program is discussed along with current concepts on how to achieve this management program. Attention is also directed to the more serious complications. PMID- 3559135 TI - The impact of aeromedical helicopter programs on emergency medicine resident training: resident attitudes, perceived risks, and benefits. AB - Using emergency medicine residents as helicopter flight physicians is a recent evolution in residency training. In an effort to study the impact such a system has on residents in emergency medicine, residents participating in helicopter transport were surveyed at 10 programs in the United States. The potential survey field was 118 residents with (81%) responding. Generally helicopter transport was perceived to be educational (80%), enjoyable (88%), and safe (74%). A total of 75% felt that benefits of transport outweighed the risks, despite an increase in aeromedical helicopter fatalities in 1985. In six of ten programs residents wore shoulder restraints, in two they wore helmets, and in no program were fire retardant clothing worn on a regular basis. Of the 72 residents involved in mandatory participation, 69% would continue flying in a voluntary system. Although it is clear that selected patients benefit from aeromedical transports, refined triage protocols as well as further studies to identify the costs and benefits of such transport programs to participating emergency medicine residents are needed. Flight safety equipment including helmets, shoulder-harness restraints, and fire-retardant suits are underutilized at all programs surveyed. PMID- 3559136 TI - When those called upon are also the victims. PMID- 3559138 TI - The bright balloons of medicine. PMID- 3559137 TI - The prophylaxis of hepatitis B infection. AB - Hepatitis B is a common viral infection that is increasing in incidence. The emergency physician is often responsible for administering prophylactic measures against hepatitis B infection to hospital employees who have sustained percutaneous exposure to blood or blood products and to members of the community who come to the emergency department because of exposure to hepatitis B. Therefore, the emergency physician must be familiar with the current data on the safety and efficacy of available prophylactic measures, hepatitis B immune globulin and hepatitis B vaccine, and any protocols for hepatitis B prophylaxis in effect in the institution. The data supporting current recommendations for hepatitis B prophylaxis are reviewed, and a sample protocol is given. PMID- 3559139 TI - Liver lobe disparity consequent upon atrophy. Diagnostic, operative and therapeutic considerations. AB - Liver lobe disparity consequent upon lobar atrophy with compensatory hypertrophy of the contralateral lobe is a pathological entity usually encountered with high bile duct obstruction and is associated with particular diagnostic and operative problems, discussed here by reference to 10 patients. The hypertrophied lobe presented as an abdominal 'mass' in all 10 whilst the atrophied lobe imitated a 'cold' area on liver scintigraphy and was misinterpreted as a tumour in 2 cases. The operative difficulties, exemplified by 8 patients, arise from the distortion of the configuration of the liver, the alteration of the anatomical relations of the vascular and biliary structures, and the reduced functional capacity of the atrophied liver. Pre-operative diagnosis of the condition is important to allow optimal treatment. PMID- 3559140 TI - Kupffer cells from CCl4-induced fibrotic livers stimulate proliferation of fat storing cells. AB - The interaction between fat-storing cells (FSCs) and Kupffer cells (KCs) in vitro has been studied in an attempt to clarify certain aspects of the pathogenesis of fibrotic process in the liver. FSCs and KCs were isolated from the livers of rats either treated with CCl4 for 6 weeks, or with vitamin A for 6 weeks or from untreated rats by the pronase-collagenase digestion method. FSCs were further purified by centrifugation over a double layered metrizamide gradient, and KCs were separated from other sinusoidal cells by the dish adherence technique. FSCs from CCl4-treated rats divided rapidly, while those from vitamin A-treated rats divided slowly, as compared with untreated rats. Furthermore, the proliferation of FSCs was enhanced in the presence of KCs from CCl4-treated rats, but was slightly suppressed by KCs from normal and vitamin A-treated rats. This enhancement was mediated by a non-dialyzable, soluble factor present in the conditioned medium of KCs from CCl4-treated rats, but was not detected in the conditioned medium of KCs from normal or vitamin A-treated rats. From the present study, a growth factor secreted by KCs from CCl4-treated rats may play an important role in controlling the proliferation of FSCs during the pathogenesis of liver fibrosis. PMID- 3559141 TI - Postobstructive subcellular organelle and biliary lipid composition in the rat. A selective increase in biliary lecithin output is not reflected by changes in organelle composition. AB - Rats infused intravenously with taurocholate shortly after relief of 48 h of biliary obstruction excrete in bile twice as much phospholipid in relation to cholesterol and bile acid as controls. In an effort to identify a subcellular compartment as the source of this biliary lipid, we examined several hepatic subcellular organelles for an increase in phospholipid to cholesterol ratio or an increase in biliary-type lecithins (16:0-18:2; 16:0-20:4) either absolute or relative to non-biliary-type lecithins (18:0-20:4; 18:0-22:6) as analyzed by high performance liquid chromatography. Subcellular fractions studied were: three microsomal subfractions, Golgi heavy and intermediate fractions, and plasma membrane light (canaliculus-enriched) fraction. No organelle fraction from rats with biliary obstruction displayed either a significant increase in phospholipid to cholesterol ratio or a relative or absolute increase in biliary type lecithin. This suggests that biliary lipid changes are not attributable to measurable alterations in lipid composition of any anatomical compartment in the liver cells; changes are probably more related to changes in lipid turnover than to organelle total lipid pool sizes. PMID- 3559142 TI - Effect of lactulose on biliary lipid composition. AB - It has been reported that lactulose can reduce biliary secondary bile acid (deoxycholate) composition and by this action can decrease biliary cholesterol saturation in patients with supersaturated bile. We tried to confirm this by feeding 60 g of lactulose per day during a period of 12 weeks to 8 healthy females with colonic adenomatous polyps and slightly elevated biliary cholesterol saturation. Although a 38% reduction of biliary deoxycholate was noted--38% after 4 weeks, and 32% after 12 weeks of lactulose feeding (P less than 0.01)--at the expense of a rise in both primary bile acids, cholate and chenodeoxycholate, no significant change in biliary cholesterol saturation was found after 4 nor after 12 weeks of lactulose feeding. These results do not support the concept that colonic bacterial metabolites of bile acids play a major role in the production of supersaturated bile and cholesterol gallstone formation. PMID- 3559143 TI - Early alcoholic liver injury. Activation of lipocytes in acinar zone 3 and correlation to degree of collagen formation in the Disse space. AB - Acinar zone 3 areas in liver biopsy specimens from 23 alcoholics and 47 non alcoholics were investigated by light microscopy and transmission electron microscopy to asses fibrosis in the perisinusoidal space and to evaluate the role of the lipocytes. Quantitative analysis by light microscopy on toluidine blue stained sections showed a significant reduction in number of lipocytes--median values of 2.7 and 1.2 lipocytes per 100 hepatocytes in biopsies from chronic alcoholics showing no or varying degrees of zone 3 fibrosis, respectively, as compared to 3.6 lipocytes per 100 hepatocytes in non-alcoholic livers. By transmission electron microscopy, the reduction in number of lipocytes was related to a corresponding increase in number of cells rich in rough endoplasmic reticulum and microfilaments (activated lipocytes). The occurrence of activated cells was significantly correlated to fibrosis of the perisinusoidal space. Activation of lipocytes and collagenization of the perisinusoidal space appeared before light microscopic evidence of fibrosis and were topographically not related to Mallory bodies or alcoholic hepatitis. PMID- 3559144 TI - Isomers of bilirubin glucuronide in serum and bile before and after relief of common duct obstruction. AB - Isomers of bilirubin glucuronide with the bilirubin acyl group attached to the C1 , C2-, C3- and C4-positions of the glucuronyl residue are present in bile of patients with extrahepatic cholestasis, whereas in normal bile only C1-isomers are found. In the present study, these bilirubin glucuronide isomers, and the fractions of unconjugated bilirubin, and bilirubin mono- and diconjugates were determined in serum and bile of 8 patients before and after relief of common duct obstruction by endoscopic papillotomy. Before papillotomy we found 39.6% C1 isomers (median value), 22.2% C2-isomers, 19.3% C3-isomers and 11.4% C4-isomers in the bile. The values in serum before papillotomy were comparable. Twenty-four hours after papillotomy, the level of C1-isomers in bile increased significantly to 56.3% (P less than 0.05) with a concomitant decrease of the non-C1-isomers. In contrast, in serum the isomers of bilirubin glucuronide did not change significantly at 24 h after papillotomy. Before papillotomy, the fraction of unconjugated bilirubin in bile was 3.6% of the total, with 15.8% bilirubin monoconjugates and 75.5% bilirubin disconjugates. After papillotomy, unconjugated bilirubin decreased to 1.6% (n.s.) and bilirubin monoconjugates to 11.9% (n.s.), while bilirubin diconjugates increased to 86.1% (P less than 0.05). In serum, the elevated fractions of bilirubin diconjugates and monoconjugates decreased from 38.4 to 32.2% (P less than 0.05) and from 29.6 to 23.4% (n.s.), respectively. In parallel, the fraction of unconjugated bilirubin in serum increased from 24.1 to 37.0% (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559145 TI - Splanchnic and leg exchange of free fatty acids in patients with liver cirrhosis. AB - Splanchnic and leg exchange of free fatty acids (FFA), glycerol and ketone bodies, as well as FFA turnover, were determined in the post-absorptive state in 8 patients with liver cirrhosis and in 6 healthy control subjects. The catheter technique was used together with tracer ([14C]oleate) infusion. The arterial concentrations of FFA, glycerol and ketone bodies were 2-6-fold higher in the patients than in the controls. The FFA turnover was 230% greater in the patients, while the fractional turnover was similar in the two groups. In the splanchnic region as well as in the leg, both FFA uptake and release were increased 2-4-fold in the patients. The fractional uptake of FFA was reduced in both areas, indicating that the augmented uptake was due to the high circulating FFA levels alone. The splanchnic production of ketone bodies was four times higher in the patients than in the controls (295 +/- 30 vs 87 +/- 11 mumol/min). The fraction of FFA converted to ketone bodies was greater (42 +/- 6 vs 20 +/- 5%, P less than 0.05), indicating that the accelerated ketone body production was a combined effect of raised FFA uptake and altered intrahepatic metabolism of FFA. The splanchnic production of glucose was reduced by approximately 50% in the patients, while the uptake of glycerol was augmented. The leg uptake of 3 hydroxybutyrate was increased 300% and the release of glycerol was 200% greater in the patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559146 TI - Rotative agitation RIA. A high sensitivity technique for hepatitis B surface antigen (HBsAg) determinations. AB - With the objective of finding a simpler and more sensitive method than conventional radioimmunoassay testing to detect HBsAg, we have modified the sample volume and first incubation procedure of the Ausria IIA method. There was an up to 9-fold increase in sensitivity without loss of specificity, in different assays, when the first incubation was carried out with a serum sample of 1 ml that was rotatively agitated for 22 h at room temperature. Additionally, 71 samples from which conventional testing had isolated hepatitis B core antibodies were tested with the modified rotative agitation technique and 9 of these specimens (12.67%) were positive for HBsAg. Routine employment of the rotative agitation radioimmunoassay technique to screen HBsAg by blood banks, to detect potential infectious donations that escape conventional testing, could be an effective as well as low-cost procedure to prevent post-transfusion hepatitis B. PMID- 3559147 TI - Ketoconazole-associated hepatic injury. A clinicopathological study of 55 cases. AB - Fifty-five cases of ketoconazole-associated hepatic injury, reported to the Netherlands Centre for Monitoring of Adverse Reactions to Drugs, were analysed in detail. In 50 cases a causal relationship was considered likely, i.e. 'probable' (27 cases) or 'possible' (23 cases). Eighty-four % of individuals were women. Forty-six % of patients were over 50 years of age which suggests that, considering the lower prescription rate in this age group, the elderly are more vulnerable to ketoconazole. In 60% of all cases hepatic injury appeared within the first 6 weeks of therapy but in the group of 'probable'-cases the onset was mostly later. Jaundice was present in 44% of all cases but in 63% of the group of 'probable'-cases. Eosinophilia (10%), fever (6%) and rash (2%) were uncommon. Biochemically the pattern was hepatocellular in 54%, cholestatic in 16% and mixed cholestatic-hepatocellular in 30%. Histology (14 cases) showed a predominantly hepatocellular pattern in 57% with extensive centrilobular necrosis and mild to moderate bridging. In 43% cholestasis predominated. None of the cases had a fatal course. The incidence of symptomatic hepatic injury may be estimated at approximately 1:2000 but is probably higher. The mechanism of ketoconazole induced hepatic injury seems to be based on metabolic idiosyncrasy although it is not excluded that in some patients an immunoallergic mechanism is causative. PMID- 3559149 TI - Delta virus hepatitis. PMID- 3559148 TI - Chenodeoxycholic acid therapy in erythrohepatic protoporphyria. AB - The short-term effect of chenodeoxycholic acid administration on the excretion of protoporphyrin was investigated in 5 patients suffering from erythrohepatic protoporphyria. Faeces were collected for 7 days, 10 ml of bile was sampled daily and blood was drawn every 2 to 3 days. Chenodeoxycholic acid was given in a dosage of 15 mg/kg/day from the 8th day. Collection of faeces, bile and blood was then continued for 10 more days. Protoporphyrin concentration was measured by high-pressure liquid chromatography and fluorometry. Following the administration of chenodeoxycholic acid the concentration of protoporphyrin in faeces and bile decreased significantly. In addition, all patients showed a significant decrease in erythrocyte protoporphyrin concentration. These results indicate that chenodeoxycholic acid therapy causes a marked decrease in the excretion of protoporphyrin in patients with erythrohepatic protoporphyria. The subsequent decrease in erythrocyte protoporphyrin suggests that chenodeoxycholic acid inhibits the production of protoporphyrin in the liver. PMID- 3559150 TI - Evaluation of the sedative properties of PK 8165 (pipequaline), a benzodiazepine partial agonist, in normal subjects. AB - The sedative properties of two doses (50 and 150 mg) of a benzodiazepine partial agonist, PK 8165 (pipequaline), were compared to diazepam 10 mg and placebo in 12 normal volunteers. The assessment, performed before drug intake and 2 and 5 hours after drug intake, included a battery of visual analogue scales and standardized computerized tests (labyrinths, series of digits, colour test, and Zazzo test). Results showed that, at low dose, PK 8165 is not only devoid of any sedative effect but presents psychostimulating properties. In contrast, diazepam 2 hours after intake and PK 8165 150 mg, 5 hours after drug intake induced a significant decrease in performance compared to placebo. This study suggests that small doses of PK 8165 merits further development as an anxiolytic/psychostimulating drug devoid of sedative properties. PMID- 3559151 TI - Five to fifteen years' maintenance doxepin therapy. AB - The subject of this presentation is depression in patients with concomitant chronic disease. With this focus, it is perhaps easy to overlook the fact that, for many patients, depression is, in itself, a chronic condition requiring a long term management strategy. The most familiar model of depression is that of an illness which, though it may have been present for a long period, is usually curable with an 8 to 12 month course of medication. An unknown number of depressed patients, however, may require long-term or maintenance antidepressant drug therapy. The definition, recognition, and management of chronic depression are briefly reviewed. An ongoing prospective study of the long term (5-15 years) use of doxepin indicates that this tricyclic antidepressant is feasible, efficacious, and safe in the treatment of judiciously selected and carefully monitored patients. Advantages of doxepin therapy include its lack of adverse interactions with prescription and non-prescription drugs taken by these patients and the high degree of safety seen in patients with concomitant cardiovascular and other physical disorders. Thus, doxepin appears to be a suitable drug for the long-term maintenance outpatient treatment of chronic depression. PMID- 3559152 TI - Susceptibility to drug-induced hypotension in post-partum psychosis. AB - Three consecutive cases of post-partum psychosis, admitted to a specialist unit, developed severe postural hypotension during treatment with standard doses of antipsychotic drugs. Post-partum patients may be particularly vulnerable to this side-effect, and the possible role of alpha-adrenoceptors in mediating this increased susceptibility to hypotension is discussed. It is suggested that antipsychotic drugs with relatively selective dopamine-blocking activity may be specifically indicated in the treatment of post-partum psychosis. PMID- 3559153 TI - Post-partum depression and the effect of nomifensine treatment. AB - The purpose of this study was to examine the difference in certain hormonal and biochemical parameters in post-partum depressed women and age and status matched post-partum, non-depressed controls and study the effect of 6 weeks treatment with nomifensine on these parameters in the depressed group. The parameters examined were: plasma oestradiol, progesterone and prolactin concentrations, platelet 3H-serotonin uptake and alpha-2adrenoceptor density and lymphocyte beta adrenoceptor densities. There was a significant decrease in platelet serotonin uptake rate in the depressed pre-treatment group as compared to controls. Six weeks treatment with nomifensine normalized the rate of uptake in the depressed group. Lymphocyte beta-adrenoceptor density was increased in the untreated depressed group as compared to the control group. This difference was also eliminated by 6 weeks of nomifensine treatment. Both plasma prolactin levels and platelet alpha-adrenoceptor density were decreased in the depressed group following 6 weeks treatment with nomifensine. There was no difference between the untreated depressed and control groups in any of the other parameters studied. PMID- 3559154 TI - Adverse cognitive effects of general anaesthesia in young and elderly patients. AB - For many years, reports have appeared indicating cognitive deficits in elderly patients following anaesthesia. However, there is no general consensus of opinion concerning the putative relationship between these deficits and the anaesthetic process. In a prospective study, 85 patients undergoing elective surgery were assessed on a battery of standardized cognitive tests, 1 day before and 2 days after surgery. Analysis of results indicated that anaesthesia does produce post operative cognitive deficits in both young and elderly patients, and a possible causative mechanism is discussed. PMID- 3559155 TI - Loeffler's syndrome: an uncommon adverse reaction to imipramine. AB - Loeffler's syndrome (simple pulmonary eosinophilia) is an uncommon side effect of tricyclic antidepressants. It is an allergic reaction characterised by diffuse eosinophilic lung infiltrates and a peripheral blood eosinophilia. It is often asymptomatic, but can also present with mild to moderate pulmonary symptoms. Although it has been only rarely reported with imipramine and desmethylimipramine, it may be a more common side effect to tricyclic antidepressants than has been previously recognized. PMID- 3559156 TI - Visual hallucinations due to indomethacin: a case report. AB - Visual hallucinations may be caused by organic cerebral lesions and by drugs including indomethacin. We report here a case of indomethacin-induced visual hallucinations in which a clear description of the phenomenology shows how a complex hallucinatory experience may arise from the relatively non-specific effects of cerebral irritation. PMID- 3559158 TI - The presentation and treatment of delusional parasitosis: a dermatological perspective. AB - A postal survey of dermatologists identified 365 patients with a presumptive diagnosis of delusional parasitosis. One hundred and forty-four dermatologists had seen at least 1 such patient in the previous 5 years and 78 were current. The data provided on 53 patients who met the study criteria were examined in more detail. Racial origin, marital status and age at presentation varied widely. Females predominated in the older age-groups, but there was an equal sex distribution under the age of 50. Abnormal personality traits were commonly identified, especially of the obsessional type. Physical disorders associated with pruritus co-existed in a substantial minority. Previous dermatological and psychiatric disorders were uncommon and non-specific. The disorder was often, though not invariably, of long duration. Relatively few patients were successfully referred to psychiatrists. Dermatologists often treated the disorder effectively, especially when neuroleptic agents were employed. Pimozide appeared to be particularly helpful in many patients. PMID- 3559157 TI - Increases in platelet 5HT uptake rates following treatment with "uptake inhibiting" drugs. AB - A kinetic analysis of 5HT uptake into platelets and its inhibition by antidepressants is the most commonly used method of assessing the effects of antidepressants on 5HT uptake in humans. This study suggests that there is a naturally occurring variation in the uptake rates for 5HT into platelets, consistent with the presence of a circadian rhythm in uptake. There appears to be a derangement of this variation in depressed patients, which is reversed by effective treatment. Antidepressants may have effects both at the 5HT transport site and on the overall degree of variation. In view of this variation and its disruption in depression, it is suggested that measurement of the effects of "uptake inhibiting" drugs in depressed patients may yield different results to those obtained from controls. This difference is most apparent when uptake is measured at several time points. Furthermore, results from in vitro and ex vivo assays may yield distinctly different findings. PMID- 3559159 TI - Pharmacology, pharmacokinetics and clinical development of haloperidol decanoate. AB - The absorption mechanism of haloperidol decanoate from the intramuscular depot was studied in dogs. Haloperidol, a pharmacologically active molecule characterised by selective dopamine antagonism, was detectable in plasma within one hour after dosing. Peak plasma levels were obtained within three to seven days. After single and repeated doses of haloperidol decanoate, plasma levels were found to be dose related. Human pharmacokinetics in schizophrenic patients were studied by giving four-weekly deep intramuscular injections of haloperidol decanoate at doses equivalent to the patients' previous antipsychotic medication. Within each interval between doses, haloperidol plasma levels were maximal within the first week after each dose, decaying with an average half-life of three weeks. Steady-state was reached within three months giving therapeutic plasma levels in the same range as those found during oral treatment with haloperidol. Open and double-blind clinical trials have demonstrated the clinical efficacy of haloperidol decanoate given four-weekly by deep intramuscular injection over a dose range from 50 to 300 mg, principally in schizophrenic patients. Low incidences of extrapyramidal side effects were noted, often allowing a reduction of antiparkinsonian medication required through previous antipsychotic treatment. PMID- 3559161 TI - Depot neuroleptics and manic depressive psychosis. AB - Twelve patients (eight men and four women) suffering from manic depressive disorder who were receiving both lithium and antipsychotic medication had their antipsychotic changed to depot haloperidol decanoate, with their lithium medication remaining unchanged. Successful transfer to haloperidol decanoate was achieved with a reduced incidence of extrapyramidal side effects, and 100% compliance in eight patients who all remained free of hypomanic relapse, including four patients with rapid-cycling disorder. By comparison, in the three years before switching to haloperidol decanoate these four patients had required sixteen admissions for hypomanic relapses resulting in thirty-four months in patient treatment. PMID- 3559160 TI - The response of untreated chronic schizophrenics to haloperidol and haloperidol decanoate. AB - A group of 13 untreated schizophrenic patients was collected over two and a half years. They were prescribed a standard regime of oral haloperidol, and where possible were transferred to haloperidol decanoate depot injections when their clinical condition stabilised. The progress of their symptoms was monitored weekly with a modification of the Present State Examination called the PSE Change Rating Scale. The ratings demonstrated a surprisingly good response to neuroleptic treatment in these chronic patients. Ten out of the 13 reached an arbitrary criterion of improvement with respect to psychotic symptoms, and in six patients these disappeared entirely. The reasons why the patients remained untreated for so long are considered, and include vagrancy, living with high Expressed Emotion relatives, and neglect in the community. PMID- 3559162 TI - Violent and self-injurious behaviour in mentally handicapped patients- psychopharmacological control. AB - Aggressive and self-destructive behaviour in mentally handicapped patients presents the psychiatrist with formidable problems, especially in the diagnosis of specific mental disorders using the criteria of current classificatory systems. Having reviewed the use of antidepressants, antianxiety agents and the wide range of oral antipsychotics previously employed, the literature describing treatment with depot neuroleptics is considered. The results of switching twenty one patients to the depot butyrophenone haloperidol decanoate, dose range 50 to 300 mg given four-weekly over a nine month period, are described: they confirm previous observations that the "knock-on" effect of disruptive behaviour and the overall level of violence and self-injury can be considerably reduced when only some of the patients in any one ward are adequately treated. PMID- 3559163 TI - Chromosomal mapping of beta-globin and albino loci in the domestic cat. A conserved mammalian chromosome group. AB - Siamese cats are homozygous for the recessive cs allele of the color (albino) locus. The c locus is shown here by backcross analysis to be linked to the beta hemoglobin (HBB) locus in the cat at a distance of approximately eight centiMorgans. The HBB locus and, by inference, the c locus were assigned to feline chromosome D1, by analysis of genomic DNAs from a panel of rodent X cat somatic cell hybrids with a molecular clone of the human beta-globin locus. Evolutionary conservation of the synthetic homology of feline chromosome D1 and human chromosome 11 is extensive. Comparison of high resolution G-trypsin-banded preparations of the two chromosomes permitted cytological alignment of the long arm of the conserved chromosomes providing that a minimum of one paracentric inversion is hypothesized. The placement of the albino locus on conserved syntenic groups of several markers (HBB, HRAS, LDHA) in both cat and mouse strongly indicates the conservative placement of the as yet unmapped human albino locus in the homologous syntenic group on human chromosome 11p. PMID- 3559164 TI - A mouse model for Niemann-Pick disease. Influence of genetic background on disease expression in spm/spm mice. AB - Sphingomyelinosis (spm), an autosomal recessive mutation in mice originally occurred in the C57BL/KsJ inbred strain. Spm/spm mice of this genetic background show striking hepatosplenomegaly with a marked accumulation of sphingomyelin and cholesterol due to a deficiency of sphingomyelinase. However, in spm/spm mice of C57BL/6J and DBA/2J backgrounds, hepatosplenomegaly was not pronounced in spite of marked elevation of hepatic lipid concentrations. The lifespan of C57BL/6J spm/spm and DBA/2J-spm/spm mice was shorter than that of C57BL/KsJ-spm/spm mice. This appeared to be associated with the comparatively rapid rise in hepatic lipid concentrations, which in turn might be related to the absence of hepatomegaly. Histological study revealed the formation of massive foam cell clusters in the livers and spleens of C57BL/KsJ-spm/spm mice, whereas in the case of C57BL/6J spm/spm and DBA/2J-spm/spm mice, diffusely scattered foam cells were found. These findings suggest that the functions of reticuloendothelial system (RES) play a crucial role in the development of hepatosplenomegaly in response to lipid accumulation. PMID- 3559165 TI - Breakpoint distribution in male-linked translocations in Anopheles stephensi Liston. AB - A series of translocations involving the male chromosome and chromosome 3 was analyzed in Anopheles stephensi. Using three genetic markers in 3R, namely sp, dp, and Bl, the recombination distance between the breakpoint and each of the three markers was assessed. On the basis of control recombination it was possible to assign the breakpoint to the chromosome relative to the three markers. It was shown that the majority of breakpoints were located in the vicinity of dp-Bl and translocations were identified that showed complete linkage with each of the markers. The results are compared with the published data on radiation-induced breakage and used to interpret the difficulties that have been experienced in producing a genetic sexing system in this species. PMID- 3559166 TI - Gene mapping of isozyme loci in chum salmon. AB - Recombination values were used to calculate the gene-centromere map distances for four electrophoretically detected loci, Aat3, Idh1, Idh4, and Mpi, in chum salmon (Oncorhynchus keta). We also report the results from 39 pairwise examinations for joint segregation for 10 loci in nine testcross families. Only two loci assorted nonrandomly--either Aat1 or Aat2 with Gpt. Gene-centromere distances for Aat3 and Mpi differed significantly from those reported previously for rainbow trout (Salmo gairdneri), a closely related species. This difference indicates either the presence of chromosome rearrangements or a different rate of recombination between the species. These results contrast with the conservation of linkage distances previously reported within and between other salmonid genera. PMID- 3559167 TI - Four independent electrophoretic markers in spadefoot toads. AB - Four enzyme-encoding genes (Idh-1, Idh-2, Ldh-1, and Mdh-1), with alleles diagnostic for the spadefoot toads Scaphiopus multiplicatus and Scaphiopus bombifrons, were investigated in order to characterize their inheritance and linkage relationships. Electrophoretic phenotypes in the offspring of natural crosses exhibit Mendelian segregation, behaving as genotypes produced by alternative alleles at four independently assorting loci. These phenotypes are useful markers of genetic identity and the degree of genetic admixture in the analyses of hybrid zone dynamics for these two species. Concurrent use of a morphological index verified the diagnostic value of the markers. The morphological index is useful for the identification of parental species and many F1 hybrids, however offspring of backcrosses usually express parental species characteristics. Electrophoretic typing allows the identification of all hybrids and 87 percent of the offspring from backcrosses. It also facilitates the identification of tadpoles, which are extremely difficult to distinguish morphologically. The technique is useful for the assessment of introgression and the evaluation of reproductive interaction in these species, even though it slightly underestimates backcross offspring. PMID- 3559168 TI - Epileptic seizures in rats homozygous for two mutations, zitter and tremor. AB - In the rat, zitter (zi) and tremor (tm) are autosomal recessive mutations that in homozygotes caused curled whisker hair, and tremor when the animals move. In both mutant types, the presence of many vacuoles gives the central nervous system a spongy appearance. The mutants differ sharply in one important characteristic: zitter rats are fertile, tremor rats are sterile. The F1 hybrids between zitter homozygous females and a tremor heterozygous male were all normal, and data from subsequent crosses revealed that zi and tm are neither allelic nor linked to each other. In animals homozygous for both mutations, an epileptic seizure frequently and spontaneously occurred from 7 or 8 weeks of age. Although the epileptic seizure has not been studied in detail, it may be an excellent animal model of epilepsy. PMID- 3559169 TI - Mutant allele frequencies in the cat population of Omaha, Nebraska. AB - The phenotypes of 256 cats seen in Omaha, Nebraska, during the summer of 1983 were recorded and compared to those of other midcontinental USA cat populations. When cats that were "pure-bred," or derived from pure breeds, were excluded, random breeding at the O locus was confirmed and mutant allele frequencies were: O = 0.352, a = 0.813, tb = 0.354, d = 0.525, I = 0.369, S = 0.197, and W = 0.039. Siamese and Himalayan cats constituted 10.9 percent of the total sample (cs = 0.342), but analysis suggests that they are not randomly mating with the general population. Mutant allele frequencies of Omaha cats are more similar to those of cats in Champaign, Illinois, than to those of St. Louis, suggesting that an overland route was more important than a river route in founding the Omaha cat population. PMID- 3559170 TI - The sex-linked black cat fallacy: a textbook case. AB - Textbook presentations of the genetics of coat color in cats are compared with research literature on cat genetics. There is general failure of the textbook authors to identify mutants by contrast with wild-type standard, thus leading to the erroneous conclusion that black is sex-linked and allelic with yellow. PMID- 3559171 TI - Estimating the degree of sperm precedence in laboratory mating experiments: a maximum likelihood method. AB - Allozyme polymorphisms have been used frequently in laboratory mating experiments to study patterns of sperm utilization in multiply mated females. In some instances, due either to chance or to design, there is a diagnostic difference between male genotypes that allows unambiguous assignment of paternity. In other instances, there is some overlap in allelic composition of males, so that attribution of paternity is often uncertain. This paper presents a statistical method for analyzing data of the second sort obtained from twice-mated females, based on the principle of maximum likelihood. The method allows the estimation of a mating parameter, psi the frequency with which sperm from the first male fertilizes the female's eggs. Various hypotheses about the null value of psi may be tested by a likelihood ratio test statistic. Also presented is a method of testing for homogeneity in psi values across different broods produced by the same female. PMID- 3559172 TI - BASIC programs to determine genotype structure of autopolyploid progeny populations. PMID- 3559174 TI - Advanced cardiac life support, 1986: the rationale for new recommendations. PMID- 3559173 TI - Software package for record-keeping and analysis of a breeding mouse colony. PMID- 3559176 TI - Craniocerebral wound ballistics. PMID- 3559175 TI - Methadone: pluses and minuses. PMID- 3559177 TI - Anti-arrhythmic agents. Update on new drugs and their classification (Part 1). PMID- 3559178 TI - Sleep/wake laboratory testing: indications and techniques. PMID- 3559179 TI - Atrial infarction. PMID- 3559180 TI - What every physician should know about controlled substance registration. PMID- 3559181 TI - Nonspecific esterase activity expressed in Weibel-Palade bodies of cloned guinea pig aortic endothelial cells. AB - We studied the localization of nonspecific esterase activities in cloned guinea pig aortic endothelial cells using ultrastructural cytochemistry. Weibel-Palade bodies (WPB), which are known to contain von Willebrand protein, were positive for esterase, defining a heretofore unrecognized activity of these organelles. Esterase activity was also found localized to the external surface of the plasma membrane, to cytoplasmic lipid bodies, and to the outer (cytoplasm-facing) surface of certain membrane-bound cytoplasmic vacuoles. Localization of esterase activity to these four discrete sites probably reflects the presence of a number of endothelial cell enzymes capable of hydrolyzing alpha-naphthyl acetate or butyrate. The physiological substrate and biological function of these enzyme activities are not presently understood. PMID- 3559182 TI - Application of nile blue and nile red, two fluorescent probes, for detection of lipid droplets in human skeletal muscle. AB - Using frozen sections from human muscle biopsies, we assessed the value of Nile blue and Nile red, two fluorescent probes, as stains for lipid droplets in normal and pathological skeletal muscle fibers. In normal muscle, lipid storage disorders, and mitochondrial myopathies, Nile blue stained the lipid droplets as yellow-gold fluorescent structures. The lipid droplets were also seen as yellow gold fluorescent structures in Nile red-stained sections, but the outstanding feature in these preparations was the staining of the membrane network of the muscle fibers and membrane proliferations in pathological muscle as red-orange fluorescent structures. These results suggest that both Nile blue and Nile red stains are useful for visualization of lipid droplets and membrane proliferations in pathological muscle biopsies. PMID- 3559183 TI - Life events assessment of depressed patients: a comparison of self-report and interview formats. AB - Both self-report questionnaires and semi-structured interviews have been employed in past research on the association between life events and psychiatric disorder. We examined the comparability of these two approaches by giving both a self report life events scale and semi-structured life events interview to 38 depressed patients. About 40% of the items noted on the interview were missed when using the questionnaire. Approximately 15% of the items noted on the questionnaire were errors since the events did not meet the definition or time criteria specified in the questionnaire. Twenty percent of the items noted on the questionnaire were not noted on the interview and may represent underinclusiveness on the part of the interview. The implications of these differences were examined by comparing the association between a variety of demographic and clinical variables and life events under each methodology. There were no significant differences between the two methods except when examining the association between life events and other subjective self-report measures. PMID- 3559184 TI - The effect of social support and the work environment upon burnout among nurses. AB - Burnout among hospital-based nurses appears to be a serious problem affecting the delivery of health care. Findings from previous empirical research indicate that burnout among these nurses results from reactions to adversities inherent in the hospital work environment, and that burnout can lead nurses to change jobs and/or abandon the practice of nursing. This paper presents and discusses research findings on the effects of various aspects of the hospital work environment on burnout among nurses, and, in addition, evaluates the effects of social support in reducing and/or mitigating the relationship between negative aspects of the work environment and burnout. A multiple regression approach is employed to test the hypothesized model. The data were collected from a sample of nurses (n = 310) employed at Fitzsimons Army Medical Center (FAMC), Aurora, Colorado. The major determinants of burnout were found to be low job enhancement (autonomy, task orientation, clarity, innovation, and physical comfort); work pressure; and lack of supervisor support, along with the interaction term involving the combined effects of job enhancement and supervisor support. These predictors, in conjunction with demographic and job-related variables explained 53% of the variance in emotional exhaustion, a central component of the burnout syndrome. PMID- 3559185 TI - Post-shooting stress reactions among police officers. AB - Post-shooting stress reactions were studied in a large police force to develop a psychological services policy and procedures in support of members of the force. Two empirical studies were conducted using a mail survey of a total of 66 members involved in shootings plus clinical interviews of a sample of these members. The results showed that members experienced most stress reactions within three days of the shooting. The average time for feeling that they were back to normal working, social, and family life was 20 weeks. There was strong support for various proposed psychological services and actions to support members involved in shootings. Recommendations were made concerning the conduct of psychological debriefings, counselling and brief therapy, the use of peer counsellors, services for affected police families, and stress training in the force. PMID- 3559187 TI - Relationship of life stress to injury in intercollegiate volleyball. AB - The present study examined whether male and female National Collegiate Athletic Association (NCAA) Division I intercollegiate volleyball players with high life stress would be at greater risk for the occurrence of injury. Life stress was measured with the Social and Athletic Readjustment Rating Scale (SARRS) and the Athletic Life Experiences Survey (ALES). Regardless of how the data were analyzed (injured v noninjured, high stress v low stress, severity of injury), no relationship was found between life stress and injury, indicating that previous findings for football players were not duplicated for intercollegiate volleyball players. Also, different levels of coping resources among volleyball players did not mediate the life stress to injury rate but did differentiate injured from noninjured players. PMID- 3559186 TI - Periodontal disease as a function of life events stress. AB - Studies relating stress and oral pathology have been limited to animal experiments or clinical studies of personality and psychological health that have ignored the role of specific life events. The present study related measurements of life events stress to measurements of periodontal disease. Subjects were fifty male volunteers recruited from a pool of dental patients from the Brooklyn VA Outpatient Dental Clinic. Oral examinations were given to determine the degree of periodontitis and gingivitis. Evidence of other somatic symptomatology was assessed by the somatization subscale of the Brief Symptom Inventory. The degree of life events stress was assessed with the Life Experience Survey. Measurements of life events stress were found to be significantly correlated with measures of periodontal disease. Periodontal disease was more severe and widespread as stressors increased. Subjects were found whose general physical health was unrelated to their life situation. PMID- 3559188 TI - The measurement of subjective response to stressful life events. AB - A scale was developed to assess subjective responses to stressful life events. Over 400 subjects (divided between psychiatric patients and nonpatients) completed the 14-item response-to-stress scale for events perceived as personally important. Optimal scale item weights were assigned on the basis of Nishisato's dual scaling procedure. Four items, typically associated with responses to stress, did not contribute to the item-weight solution and were dropped from the scale. Factor analyses showed that responses to stress loaded on one bipolar factor composed of four emotional distress items and six control-management items. In contrast to previous methods developed to assess response to stress, there was less than 4% overlap between the subjective response to stress mean scores and the total number of events endorsed by each subject. Also, the correlations between simple event counts and symptom index scores were smaller than those between the subjective stress-response scores and the symptom variable. The influence of demographic factors on both the patients' and nonpatients' responses to stress were analyzed. PMID- 3559190 TI - A comparison of life events scoring methods as predictors of psychological symptomatology. AB - Seven scoring methods for the Life Events Survey (LES) were compared to determine which, if any, is superior for prediction of psychological symptomatology as measured by the Brief Symptom Inventory (BSI). Every scoring method tested, except one utilizing an individual's positive ratings of events, was significantly correlated with symptomatology. The method using an individual's negative ratings of events was a significantly better predictor than any other. These findings suggest several conclusions. First, nomothetic methods for weighting life events do not increase a scale's predictive ability beyond that achieved by a frequency count of events. Second, frequency of life events predicts psychological symptomatology only insofar as life events are perceived as negative. That is, positively perceived events do not predict symptomatology. Finally, a life events scale's predictive ability is increased by utilizing the individual's negative perceptions of events. PMID- 3559189 TI - The effects of personal interaction on triglyceride and uric acid levels, and coronary risk in a managerial population: a longitudinal study. AB - This two year longitudinal study of managers investigated whether the level of interaction with other individuals was a job stressor that influences coronary risk factors. The results presented here show that increased levels of interaction were associated with increased serum triglyceride and increased serum uric acid levels. It is suggested that past research positing stress effects from responsibility for people may be due to interaction levels rather than responsibility per se. It was also found that Type A behavior and physical activity levels moderated these effects. While it is difficult to say that personal interaction, as a job stressor, contributes very significantly to either coronary risk factors or coronary heart disease the evidence supports the hypothesis that the amount of interaction has some specific stress effects. PMID- 3559191 TI - Stressors and tasks: how and when should stressors be introduced during training for task performance in stressful situations? AB - Studies on the training of individuals for task performance in stressful situations have typically evaluated procedures that simultaneously expose trainees to tasks and to stressors. Such procedures might create a mutual interference of the stressor with task acquisition, or conversely, of preoccupation with task acquisition with familiarization with the stressors. Using a sample of 180 males, the present study compared a procedure that temporally separates task acquisition from exposure to stressors ("phased training") with the more typical approach which combines the two ("combined training"). The comparison was carried out under varying degrees of stressor fidelity representation in the course of training, and under two degrees of contingency between quality of task performance and the possibility of avoiding stress. The main result indicates that phased and combined training are equally effective under conditions of noncontingency. In a contingent condition, on the other hand, phased training proves to be significantly superior. PMID- 3559192 TI - The effect of recent life events stress, life assets, and temperament pattern on cardiovascular risk factors for Akron City police officers. AB - Police officers, as a group, experience many occupational demands with physiological and psychological effects that could be harmful to their health. A primary objective of this study was to analyze specific behavioral and physiological risk factors that could lead to hypertension and accelerated coronary artery disease. Three hundred thirty-one male Akron City police officers participated in the study. A group of volunteer males (n = 48) who worked in city clerical jobs were used as controls. Questionnaires were administered in order to measure such behavioral variables as recent life change, life assets, and temperament pattern. Blood chemistry and physiological variables were also measured. The police officers had higher diastolic blood pressure (DBP), norepinephrine (NE) levels, and recent life change unit (LCU) scores than the control group. Increased hostility and depression scores were associated with higher DBP and recent LCU scores and lower life asset unit (LAU) scores. Individuals with higher "dominant" scores and moderate to high recent LCU scores had higher cardiovascular risk factors than those with moderate to high recent LCU scores who were ranked as "subordinate." Rotating shift workers had abnormally elevated NE levels, which, if not controlled, may lead to higher cardiovascular risk. Behavioral intervention programs have been introduced with the goals of reducing stress, increasing life assets, and teaching relaxation techniques. PMID- 3559193 TI - Principal dimensions of the Framingham Type A scale: differential relationships to cardiovascular reactivity and anxiety. AB - The present investigation sought to identify the principal dimensions of the Framingham Type A scale (FTAS) and then to examine their physiological and psychological correlates. A factor analysis of the FTAS items, which was cross validated, revealed two factors. Items concerning achievement and competitive striving loaded primarily on the first factor. Scores on a subscale composed of these items (labeled Competitive Drive) were related to systolic blood pressure reactivity during an interpersonal task but were unrelated to anxiety. FTAS items concerning impatient, time urgent, and domineering propensities loaded primarily on the second factor. Scores on a subscale composed of these items (labeled Speed and Impatience) were not related to cardiovascular reactivity during the task but were related to anxiety. Results are discussed in terms of the psychological heterogeneity of the Type A behavior pattern and possible differences between dimensions of the overall Type A pattern and their association with different manifestations of coronary heart disease. PMID- 3559194 TI - Psychological distress, depression and prolactin response in stressed persons. AB - We examined the relationship of psychological distress to serum prolactin response in 54 persons who had lost a spouse or were threatened with a loss. We found that our two measures of psychological distress, both separation anxiety and depression, were directly correlated with prolactin response during a stressful interview (p less than .05). When we stratified the sample first by depression score and then by separation anxiety, we found a positive correlation between separation anxiety and prolactin response only in the highly depressed half of the sample (r = .32) and a positive correlation between depression and prolactin response only in the highest quartile of intensity for separation anxiety (r = .49, p less than .05). This suggested that both depression and separation anxiety, each in conjunction with high levels of the other but not independently, rendered the individual under stress more physiologically sensitive to distressing challenges such as a stressful interview. Alternatively, it was global distress above a certain threshold that was associated with degree of physiological response. PMID- 3559195 TI - Genital herpes and personality. AB - Genital herpes, while having gained considerable attention as an important psychosexual disease, is not well understood. Precisely what factors trigger infectious reactivation is an important question that has yet to be answered. The present study investigated the relationship between recurrent genital herpes and personality. High and low recurrers were administered a demographic and disease history questionnaire and the Minnesota Multiphasic Personality Inventory (MMPI). Results revealed that, compared to low recurrers, the mean MMPI profile of high recurrers showed significantly greater elevations on nine of ten scales. The degree and pattern of elevation in the high profile is consistent with increased levels of autonomic arousal and stress. These findings are interpreted as suggestive of the possible role of personality in influencing the rate of infectious recurrence in genital herpes sufferers. The implications for psychologically based treatment strategies are discussed. PMID- 3559196 TI - Stress and well-being in adolescence: the moderating role of physical exercise. AB - Adolescence is quite often a period of personal adjustment and stress, and previous research has found that adolescents are vulnerable to the negative effects of stressful life events. The present research sought to determine whether a subset of adolescent girls, those who routinely engage in physical exercise, escape stress-induced disturbances in physical and psychological well being. Self-report measures of stressful life events, physical and emotional well being, and exercise habits were obtained from 220 females of secondary school age. In accordance with experimental hypotheses, stress had a substantial debilitating effect on physical and emotional health among persons who reported exercising infrequently but not among those who reported exercising regularly. Potential mediating mechanisms are identified and implications of the findings for primary prevention programs targeted toward adolescents are discussed. PMID- 3559197 TI - Relationships among negative life events, physiological reactivity, and health symptomatology. AB - College undergraduates classified as high (n = 25) and low (n = 25) on recent life stress participated in an experiment involving a novel laboratory stressor. Heart rate and pulse arrival time (PAT) were measured during baseline, anticipation, testing, and recovery periods of the experiment. The results did not replicate those obtained by Pardine and Napoli in that high and low life stress subjects did not show differential physiological reactions. In addition, regression analyses failed to demonstrate that physiological reactivity moderated the relationship between life stress and subsequent self-reported psychiatric or physical health symptomatology. The present findings demonstrated neither the stress-buffering effects of physiological reactivity nor a relationship between life stress and reactivity when the latter was conceptualized as an outcome. PMID- 3559198 TI - Global perceived stress level as a moderator of the relationship between negative life events and depression. AB - The present research investigated the proposal that global perceived stress level moderates the degree of relationship between negative life events and depression. Accordingly, subjects in this study completed the Beck Depression Inventory (BDI), the Life Experiences Survey (LES), and the Perceived Stress Scale (PSS). The PSS provides a measure of global perceived stress level, or the general tendency to view one's life as being unpredictable, out of control, and overwhelming. Consistent with past research, the findings revealed an increase in depression level as negative life change scores increased. Of special importance, however, was the finding that global level of stress significantly moderated the relationship between depression and negative life events. For those low on perceived stress, negative life changes had only a minimal impact on depression level. In contrast, for those high on perceived stress, the relationship was more pronounced. These findings were then discussed with regard to the possible role of cognitive appraisals in enhancing the symptoms of psychopathology experienced by individuals high on global level of perceived stress. PMID- 3559199 TI - Catecholamine response of children in a naturally occurring stressor situation. AB - The present study examined the response of children to a stressor condition. Urine samples were collected from 38 children between ages 10 and 12 preceding a class presentation and again one week later, when no unusual event was occurring. Cognitive tasks and a state anxiety inventory were administered on both occasions. Personality and stressor situation inventories (hypothesized antecedent factors) were completed. Bidirectional changes in catecholamine levels were demonstrated (adrenalin: 55% of the children showed an increase, 29% a decrease; noradrenalin: 47% increase, 40% decrease; 3-methoxy-4 hydroxyphenethylene glycol: 40% increase, 42% decrease). Distinct differences in gender distribution and cognitive performance were demonstrated for the increase and decrease subgroups. It was suggested that both increases and decreases in catecholamine levels represent responses to the stressor situation, with an increase representing an adaptive response and a decrease representing a less adaptive response. PMID- 3559200 TI - Adolescent mothers, stress, and prevention. AB - Adolescent mothers face problems that can lead to psychological stress. Based on prospective data from the present study, these problems point toward the need for a coping skills prevention approach to help adolescent mothers manage stress. This paper reports data from outcome research on such an approach with adolescent mothers. Subjects were 79 adolescent mothers who were tested before, immediately after, and three months following the provision of coping skills intervention in an experimental condition. Subjects in a test-only control condition received no special intervention. At posttest, experimental condition subjects showed more positive outcomes on measures of social support, cognitive performance, conflict management, and interpersonal competence. At three-month follow-up, experimental condition subjects had more positive outcomes on social support, cognitive performance, parenting ability, child care self-efficacy, and measures of psychological well-being. PMID- 3559201 TI - Type A and B subjects' self-reported cognitive/affective/behavioral responses to descriptions of potentially frustrating situations. AB - This study compared Type A and Type B individuals' self-reported thoughts and behavioral responses to descriptions of potentially frustrating situations. The Jenkins Activity Survey was first administered to 181 adults to assess their TYpe A tendencies. The Type A scores were then used in forming two groups of 40 extreme Type A's and 40 extreme Type B's. These 80 subjects were subsequently presented with written descriptions of 16 potentially frustrating situations included in the questionnaire "What Pushes Your Button?" and asked to provide two responses to each situation: what they might think if confronted with that situation and what they might actually do in that situation. Their self-reported thoughts and behaviors were classified by independent raters into designated categories. The results showed that Type A individuals' self-reported thoughts reflected significantly more negative than neutral affect and significantly more negative affect than the Type B individuals' thoughts. However, the two groups did not differ significantly in any of the self-reported behavior categories (e.g., nonassertion, aggression, assertion, problem solving, and neutral). Some gender differences were evidenced for the Type A subjects. Women were more inclined than men to report negative affect at the covert level but much less inclined than men to report aggressive responses at the behavioral level. PMID- 3559202 TI - Open communication as an effective stress management method for breast cancer patients. AB - The social and emotional adaptation of 51 breast cancer patients was assessed four times during the first year after mastectomy according to Weissman and Paykel's Social Adaptation Scale (SAS) and judges' ratings. Openness of communication was measured by eight indices during the first two interviews. It was predicted that they would correlate positively with successful adaptation as measured at the third and fourth interviews. Most patients were aware of their diagnosis, and their communication about their plight was found to be multifaceted. Successful copers sought information; less successful copers avoided it. However, where emotions and not facts were the issue, palliative measures such as avoidance of speaking about the threat and refusal to accept its further implications were connected with better adjustment. The findings indicate that palliation is a prerequisite to good instrumental adjustment when the emotional reactions are intense and countermeasures are limited. More research is needed for assessing communication with specific others and change over time. PMID- 3559203 TI - Detection of activated terminal complement (C5b-9) in cerebrospinal fluid from patients with central nervous system involvement of primary Sjogren's syndrome or systemic lupus erythematosus. AB - We have examined cerebrospinal fluid (CSF) and serum from patients with Sjogren's syndrome (SS) and systemic lupus erythematosus (SLE) for evidence of activation of the terminal pathway of complement. Fluid phase terminal complement complexes (SC5b-9), quantitated by ELISA, were detected in the CSF of 14 of 16 patients with SS and focal central nervous system (CNS) disease. Five of six SS patients without focal CNS disease but with psychiatric disease or cognitive dysfunction had detectable CSF SC5b-9, whereas two other SS patients without focal CNS or neuropsychiatric disease had no detectable CSF SC5b-9. Six of seven patients with SLE or SLE overlap syndrome with CNS involvement had CSF SC5b-9, whereas two patients with SLE without CNS involvement had no CSF SC5b-9. A subset of SS and SLE patients with CNS disease had SC5b-9 detected in CSF but not in serum. SC5b-9 was generally absent from the CSF of patients with noninflammatory CNS diseases. These findings demonstrate intrathecal activation of terminal complement in patients with CNS SS or CNS SLE, and suggest a role for terminal complement activation in the pathophysiology of CNS involvement in both SS and SLE. PMID- 3559204 TI - Idiotype restriction in murine lupus; high frequency of three public idiotypes on serum IgG in nephritic NZB/NZW F1 mice. AB - Antibodies to self-antigens are characteristic of several human and murine autoimmune diseases. Subsets of those autoantibodies cause organ damage in some instances, such as IgG antibodies to DNA in human and murine systemic lupus erythematosus (SLE). Our experiments in the NZB/NZW F1 (BW) female mouse model of SLE were designed to define idiotypic (Id) structures on antibodies to DNA in attempts to distinguish pathogens from nonpathogens within the anti-DNA population. Two important findings emerged. First, the number of public Id expressed became relatively restricted as the mice aged, with three such Id (IdX, IdGN1 and IdGN2) dominating and accounting for 30 to 95% of the total serum IgG in all individual nephritic mice studied, and 81 to 86% of the total IgG in serum pools from 30-wk-old nephritic mice. Second, IdGN1 and IdGN2 constituted approximately 50% of the IgG deposited in glomeruli of nephritic mice; IdX was present in negligible quantities in glomeruli, whereas it was usually the most frequent Id in BW serum. These latter findings suggested that pathogens and nonpathogens can be distinguished by their idiotypy in this animal model. The finding of relative Id restriction suggests the occurrence of an idiotypic "spreading" phenomenon, in which a regulatory process appears as BW mice age that results in repeated selection and expansion of this small number of Id, one group of which, the IdGN, is pathogenic. This process was further suggested in experiments in which IdX was suppressed by administration of anti-IdX; the "escape" antibodies to DNA appearing after suppression of IdX were composed largely of IdGN1 and IdGN2, without a major contribution from Id-negative mutants. Defining the basis of this Id spreading or restriction phenomenon may provide important information regarding the pathogenesis of this autoimmune disease. PMID- 3559205 TI - Anti-RNA polymerase I antibodies: potential role in the induction and progression of murine lupus nephritis. AB - Antibodies against RNA polymerase I were detected in plasma and kidney eluates of NZB/W mice. Plasma concentrations of the antibodies were the highest in mice with incipient nephritis and the lowest in mice with progressive nephritis. Mice with attenuated nephritis due to immunosuppressive therapy had intermediate plasma concentrations of the antibodies. The specific concentrations (ng/microgram IgG) of anti-RNA polymerase I antibodies in kidney eluates were significantly (10- to 70-fold) greater than the corresponding plasma concentrations. These results indicated that the decreased plasma concentration of the antibodies in mice with more advanced disease was at least partially due to selective concentration of anti-RNA polymerase I antibodies in the kidneys. The degree of this selective concentration was directly proportional (R2 = 0.9962) to the severity of renal disease, as reflected by the concentration (microgram/g tissue) of IgG eluted from the kidneys. The concentration (microgram/g tissue) of anti-RNA polymerase I eluted from the kidneys also was increased in mice with more severe renal disease. Further, the extent of this increase was greater than that of total IgG, again suggesting that anti-RNA polymerase I antibodies had been selectively concentrated in the kidneys. These findings are strongly suggestive of an important role for the RNA polymerase I/anti-RNA polymerase I antibody system in the pathogenesis of murine lupus nephritis. PMID- 3559206 TI - Monoclonal antibody 53.6 recognizes a novel proliferation-associated antigen encoded on human chromosome 11. AB - This paper describes the characterization of a novel cell surface antigen associated with proliferation. Previous work demonstrated that monoclonal antibody 53.6 reacted with every human cell line tested, as well as with subpopulations of normal bone marrow and peripheral blood lymphocytes. Mitogen stimulation of peripheral blood lymphocytes with phytohemagglutinin resulted in increased expression of the antigen recognized by 53.6. Immunoprecipitation of biosynthetically labeled KG-1A cell extracts with 53.6 revealed that the antigen is a nonglycosylated acidic protein of Mr 34,000. Analysis of mouse-human hybrid cell lines indicated that the structural gene for the antigen is encoded on chromosome 11. The antigen recognized by 53.6 is distinct from previously described cell surface antigens based on its distribution on activated cells and biochemical characteristics. These studies indicate that the 53.6 antigen is a novel proliferation-associated antigen, and may be useful in analyzing lymphocyte activation. PMID- 3559207 TI - T cell receptor genes do not rearrange or express functional transcripts in natural killer cells of scid mice. AB - The lineage of natural killer (NK) cells is poorly understood. To examine the relationship between NK cells and cells of the T lineage we have examined purified NK cells from a mutant mouse strain (scid) with severe combined immunodeficiency. Approximately 40% of the lymphoid cells in the spleens of scid mice expressed the NK-specific marker NK-2.1. All NK activity of the scid spleen cells could be accounted for by the NK-2.1+ population, similar to results obtained by using normal C57BL/6 X DBA/2 (B6D2F1) mice. Sorted NK-2.1+ cells proliferated in response to human recombinant interleukin 2 (r-IL 2) but not to concanavalin A (Con A), and were maintained in culture for 2 to 3 wk. Cultured NK 2.1+ cells displayed a cell surface phenotype (Asialo-GM1+, Thy-1.2+, L3T4-, Lyt 2-) and lytic activity similar to that described for freshly isolated NK cells of normal mice. Furthermore, T cell receptor (TCR) genes of the TCR-gamma and TCR beta loci were in germline configuration, and no functional transcripts of TCR gamma, TCR-beta, or TCR-alpha were detected. We propose that the expression of the TCR is not necessary for functional NK activity, and NK cells are distinct from both mature cytotoxic T lymphocytes and the earliest identifiable T cells. PMID- 3559208 TI - Interactions between precipitating and nonprecipitating antibodies in the formation of immune complexes. AB - In the present study, we used monoclonal antidinitrophenol (DNP) antibodies to determine certain of the biophysical characteristics of precipitating and nonprecipitating antibodies. In addition, we studied the dynamics of immune complex (IC) formation when precipitating antibodies react with antigen in the presence of nonprecipitating antibodies. The antigen utilized in these studies was DNP-bovine serum albumin. All isolated nonprecipitating anti-DNP antibodies were of the IgG2b isotype, whereas all antibodies with other isotypes (IgG1, IgG3, IgM, IgA and IgE) were precipitating. Nonprecipitating antibodies did not differ significantly from precipitating antibodies in affinity, valence, or isoelectric point. Nonprecipitating antibodies inhibited the formation of precipitable IC between antigen and precipitating antibodies. In addition, preformed IC precipitates were solubilized by nonprecipitating antibodies. The solubilization of IC precipitates was influenced by the isotype of the precipitating antibody and by the antibody:antigen ratio in the IC precipitate. By isokinetic sucrose density centrifugation, we determined that solubilization of IC precipitates by nonprecipitating antibodies was associated with release of free precipitating antibody and formation of soluble IC between the antigen and the nonprecipitating antibody. In conclusion, in this study the nonprecipitating property of mouse anti-DNP antibodies is isotype-specific. Nonprecipitating antibodies compete and displace precipitating antibodies from the antigen, resulting in inhibition of IC precipitation and in IC solubilization. On the basis of the present results, we postulate that antibody-antibody interactions are important determinants of precipitating ability, and that these interactions are a characteristic of antibody isotype. PMID- 3559209 TI - Blood clearance of Streptococcus pneumoniae by C-reactive protein. AB - C-reactive protein (CRP) has long been known to be an acute phase protein associated with infection and various forms of tissue damage. Recent studies have shown that human CRP can be used to passively protect mice from lethal infection with Streptococci pneumoniae. In this study we have undertaken a detailed examination of the ability of human CRP and rabbit CRP (CxRP) to mediate the blood clearance of pneumococci in mice. We have shown that the optimal activity of these acute-phase proteins requires a functioning complement system, and it can take place even in the xid mouse, which has virtually no naturally occurring anti-pneumococcal antibody in its serum. These studies provide additional evidence that CRP may play a protective role in pneumococcal infections, and it may help postpone the development of fatal levels of pneumococci in the blood, long enough for an effective anti-pneumococcal antibody response to be generated. PMID- 3559210 TI - Uptake of 3H-deoxyglucose as a microassay of human neutrophil and monocyte activation. AB - The accumulation of 2-deoxy-D-[1-3H]glucose, a non-metabolised analogue of glucose provides a quantitative measurement of the state of activation of phagocytic cells. A microassay for 3H-deoxyglucose uptake by human neutrophils and monocytes is described. Optimal conditions for the assay include the use of 5 X 10(5) cells and 0.78 microCi/ml of deoxyglucose in a final volume of 0.2 ml per microtitre well, and an incubation time of 30 min at 37 degrees C. This simple, rapid and reproducible technique may find application in experimental immunology. PMID- 3559211 TI - Monoclonal antibody ELISA to quantitate wheat gliadin contamination of gluten free foods. AB - A sensitive reproducible monoclonal antibody-based sandwich ELISA has been developed to measure the gliadin content of foods. Using the assay we have confirmed that nominally gluten-free products based on wheat starch contain trace amounts of gliadin. The level of gliadin contamination in these foods is sufficient to cause relapse of coeliac disease in specific patients. We have also examined the cross-reactivity of different cereal proteins in the assay and found good correlation with their known toxicity to patients with coeliac disease. PMID- 3559212 TI - Covalent binding of proteins to grafted plastic surfaces suitable for immunoassays. I. Binding capacity and characteristics of grafted polymers. AB - A method for the introduction of chemically reactive groups onto polymeric surfaces, suitable for immunoassays, is described. The method, referred to as grafting, uses gamma irradiation from a 60Co source to initiate the free radical reaction. Polystyrene and polyvinyl chloride surfaces were grafted with crotonic acid and characterized with ESCA. 2 nmol/cm2 of carboxylic groups were added during the method. Increased hydrophilic properties of the carboxylated surfaces were recorded by contact angle measurements. The grafting reaction did not impair the optical quality of the polymers studied. Various proteins were covalently linked to the modified surfaces of microtiter plates and tubes by means of a water-soluble carbodiimide. A significantly enhanced total capacity and strength of binding to grafted surfaces was demonstrated as compared to passive adsorption of the proteins to untreated surfaces. PMID- 3559213 TI - An improved selection procedure for the rescue of hybridomas. A comparative study of methotrexate versus aminopterin. AB - Several of aminopterin's drawbacks such as photosensitivity and high toxicity prompted us to compare the ability of methotrexate to select for hybridomas. Assessing the effect of both drugs on X63/Ag 8.653 myeloma cells and hybrid cells secreting monoclonal antibodies by tritiated thymidine incorporation and percentage of viable cells, we have shown that methotrexate could be used in place of aminopterin for the rescue of hybrid cells in selective medium. In addition, methotrexate hybrids develop more rapidly and can therefore be processed earlier. The stability and low toxicity of methotrexate also favor its use in the selection of hybridomas. PMID- 3559214 TI - C3 nephritic factor determination. A comparison between two methods. AB - C3 nephritic factor (NEF), an IgG autoantibody to the alternative pathway C3 convertase, is usually measured by crossed immunoelectrophoresis (CI) but recently a reliable haemolytic assay (HA) was described by Rother (1982). This method is more specific than CI because it is negative in sera with immune complexes, SLE and sera incubated with IgG aggregates. The haemolytic assay is sensitive enough to detect NEF antibody in serum from patients with only slightly low C3 levels and NEF negatives by CI. The haemolytic assay is easy to perform and reproducible, the interassay coefficient of variation being 10.7% compared to 64% in the CI. The intra-assay coefficient of variation in CI was 28% compared to 5.5% in the haemolytic assay. The haemolytic method enabled us to study the kinetic effects of NEF on C3b.Bb bound to sheep erythrocytes, and the lysis mediated by ShE.C3b.Bb.NEF complex. Also the C and NEF binding to sheep erythrocytes was studied. PMID- 3559215 TI - Preparation of human sera containing one single IgG subclass using affinity chromatography. AB - Monoclonal antibodies reactive against one or three human IgG subclasses were immobilised on agarose beads, put into columns and used in combination with coupled polyclonal anti-IgA and anti-IgM reactive gels to obtain serum preparations devoid of IgA, IgM and all but one IgG subclass. This was possible after one single run over the appropriate combination of columns; only for IgG4 preparations was a second purification step sometimes required to reach purity. Negative affinity chromatography was used throughout, thus the resulting preparations had not been exposed to high ionic strength conditions, non physiological pH buffers or chaotropic agents in concentrations ordinarily used to elute bound material from affinity columns. The yield was approximately 50% and 20-30% if two runs were required. Regeneration of the columns permitted repetitive use, so far up to 30 times without substantial loss of activity. The protocol offers an easy, comparatively fast and reproducible method to obtain human serum preparations containing only IgG1,2,3, or 4. PMID- 3559216 TI - Demographic trends in India and the tasks ahead. PMID- 3559217 TI - Highly selective vagotomy versus truncal vagotomy with drainage in the treatment of chronic duodenal ulcer. PMID- 3559218 TI - Avoidable factors in head injury mortality. PMID- 3559219 TI - Correlation of amniotic pulmonary surfactant with birth weight and respiratory distress in newborn. PMID- 3559220 TI - Osteitis of humerus following BCG vaccination. PMID- 3559221 TI - Mesenteric cysts. PMID- 3559222 TI - Eventration of diaphragm. PMID- 3559223 TI - Toxic epidermal necrolysis in a patient induced by phenolphthalein. PMID- 3559224 TI - Rheumatic mitral stenosis: accelerated and delayed types. PMID- 3559225 TI - Injections cripple, injections kill. PMID- 3559226 TI - Treatment of eclampsia. PMID- 3559227 TI - Hidden menace in the Universal Child Immunisation Programme. PMID- 3559228 TI - The role of zinc in renal diseases. PMID- 3559230 TI - Incarcerated umbilical hernia in children. PMID- 3559229 TI - Glycopyrrolate in paediatric premedication. PMID- 3559231 TI - Familial pure depressive disorder versus sporadic depressive disorder: a dermatoglyphic study. PMID- 3559232 TI - A preliminary study on pyogenic arthritis. PMID- 3559233 TI - Prolapse of the urinary bladder through suprapubic cystostomy wound. PMID- 3559234 TI - Sodium nitroprusside in the operative management of phaeochromocytoma. PMID- 3559235 TI - Multiple intracranial tuberculomas. PMID- 3559236 TI - Tubercular lymphadenitis with purpura. PMID- 3559237 TI - Primary non-Hodgkin's lymphoma of duodenum. PMID- 3559239 TI - Bilateral optic neuritis following multiple wasp stings. PMID- 3559238 TI - Decompression sickness in a diver. PMID- 3559240 TI - The Indian medical profession and the Indian drug industry. PMID- 3559241 TI - Rifampicin induced acute tubulo-interstitial nephritis. PMID- 3559242 TI - Vaccination against measles. PMID- 3559243 TI - Malignant lymphomas: observations in North Bengal. PMID- 3559244 TI - Primary resection and anastomosis for volvulus of sigmoid colon. PMID- 3559245 TI - Influence of diazepam on the effects of suxamethonium. PMID- 3559246 TI - Midline depressed fractures of the skull. PMID- 3559247 TI - Outbreak of measles--epidemiological study. PMID- 3559248 TI - Typhoid hepatitis. PMID- 3559249 TI - Lithopaedion--an unusual abdominal lump. PMID- 3559250 TI - Dystocia due to true foetal ascites. PMID- 3559252 TI - Cor pulmonale. PMID- 3559251 TI - Arthroscopy--a new route to orthopaedic surgery. PMID- 3559253 TI - Bent-limb disease in lambs. Apparent transmission with an autosomal recessive gene linked to the OL-Z minor lymphocyte antigen locus and the I locus involved in the expression of R and O antigens in sheep. AB - In crossbred Charmois lambs, Bent-limb disease appears to be associated with the phenotype 'z,i' which corresponds to a doubly recessive genotype at the two loci OL-Z (a minor lymphocyte antigen locus independent of OLA, the major histocompatibility complex of the sheep) and I (involved in genetic control of the expression of R and O antigens found in various body fluids and on erythrocytes). The disease seems to be controlled by a single autosomal recessive gene, provisionally named bl (its normal or healthy allele Bl being dominant) which is distinct from, though linked to, the genes at the OL-Z and I loci (observed haplotype: bl,z,i). In the Lacaune breed, besides the already observed bl,z,i haplotype, there is an additional one: bl,z,I. In Vendeen sheep, and in animals which belong to two other breeds, the bl,Z11,I haplotype (bl linked to the two dominant alleles) appears to be relatively frequent. Further studies are needed in order to confirm the genetic hypothesis suggested by the present data. PMID- 3559254 TI - [Tubulopapillary tumors of the kidney. Apropos of 20 new cases and a review of the literature]. AB - Tubulo-papillary tumors constitute a particular group of renal tumor. A study of 20 cases treated personally and review of 130 cases reported in the literature showed: hypo or heterogenic ultrasound images, hypovascularization on angiography, particular density on CT scan image. Histologically they can be distinguished from clear cell epithelioma not only by their appearance (papillary and tubular structures, cystic and hemorrhagic changes) but also by the frequency of stage I on histology. The latter feature is not the only explanation for a more favorable prognosis: other significant factors are necrotic lesions and degree of anisocaryocytosis of epithelial proliferation. PMID- 3559255 TI - [Diagnostic value of flow cytometry of bladder lavage in the surveillance of bladder tumors]. AB - DNA index and proliferation index (% greater than 2 n) of 125 bladder washings were studied with flow cytometry. Cystoscopy was positive in 49 patients and negative in 56 patients with a previous history of bladder cancer. There were 20 control patients with a normal bladder. Flow cytometric data was compared with cystoscopic and cytologic data. In the group of 49 patients with a positive cystoscopy, conventional cytology was suspicious or positive in 70% (34/49) whereas flow cytometry was positive in only 43% of the cases (21/49). The diagnostic sensitivity of flow cytometry increased with grade elevation: 7% of grade 1 tumors, 43% of grade 2 and 77% of grade 3 had a positive flow cytometric examination. In the group of 56 patients with a negative cystoscopy, flow cytometry was positive in 36% of the cases and cytology in 6% of the cases. The diagnostic sensitivity of flow cytometry was rather disappointing in the study on bladder washings. Flow cytometric follow-up of bladder washings should be reserved preferentially to patients with a poor prognosis, i.e., superficial bladder cancer with an aneuploid DNA content. PMID- 3559256 TI - [Course of superficial carcinoma of bladder (Ta-T1). Apropos of 171 cases]. AB - 171 patients with superficial bladder carcinoma (Ta-T1) treatment by endoscopic surgery only, were followed during the period from 1.1.1976 to 31.12.1980. The effect of previous tumors in case history, multiplicity, cellular differentiation and tumor size on the frequency of recurrence and tendency to tumor progression was investigated. It was established that the size of tumor most influences the frequency of recurrence, followed by tumors in case history, multiplicity and epithelial anaplasia. A tendency to muscular invasion during recurrence depends mainly on the tumors size and its grade of cellular anaplasia. PMID- 3559257 TI - [Evaluation of the results of endoscopic internal urethrotomy in the treatment of urethral stricture. Apropos of 163 controlled cases]. AB - Results are reported of 294 internal urethrotomies performed over 5 years to treat 196 urethral strictures. In this series the predominant etiology was sclero inflammatory (55% of cases) but there was also a fairly high incidence of iatrogenic (52 cases) and post-traumatic (30 cases) lesions. The length of the narrowed segment varied between 0.5 and 3 cm, the most frequent site the bulbar region. Results at 1-year follow up or longer were assessed by quality of micturition and flowmeter curve. Of the 163 cases controlled good results exceeded 60% of patients treated by this method. Mastery of internal urethrotomy has allowed almost complete elimination of blind instrumental dilatation, and has markedly decreased number of urethroplasties since adoption of this therapeutic procedure. PMID- 3559258 TI - [Puigvert's operation in male urinary incontinence]. AB - Puigvert's operation for male urinary incontinence was performed in 9 patients. In 8 cases the incontinence was secondary to prostate surgery. Results on continence were evaluated at follow-up during the immediate postoperative period and after 6 weeks, 3 and 6 months and two years. (Table: see text). Results indicate that this technique is simple and safe but unsatisfactory. PMID- 3559259 TI - [Study and treatment using an endovascular approach of erectile insufficiency of venous origin]. AB - Forty-six patients with defective erection of venous origin were treated by embolization of deep dorsal vein at the Santorini plexus level. Embolization was by insertion of disposable balloons after surgical approach to deep dorsal vein of penis. Follow up showed that 57% of patients had recovered satisfactory, normal sexual activity and 15% a fairly satisfactory sexual activity. PMID- 3559260 TI - [Verruciform xanthoma of penis]. AB - We report a clinical case of a patient suffering from a verruciform xanthoma of the penis, which was shown by an erythematous and pruriginous papule in the glans. 30 months after exeresis there is no local recurrence, nor any similar lesions in other mucosae. The extreme rarity of the case and the obligatory differential diagnosis of the lesions in the penis have led us to present it here. PMID- 3559261 TI - The two-phase recognition process of allografts in a Brazilian strain of Biomphalaria glabrata. PMID- 3559262 TI - A lymphoma-like neoplasm arising from hematopoietic tissue in the white shrimp, Penaeus vannamei Boone (Crustacea: Decapoda). PMID- 3559263 TI - Kinetics of mast cell, fibroblast, and epidermal cell proliferation during acute graft-versus-host disease in the neonatal rat. AB - Acute graft-versus-host disease (GVHD) was induced in newborn Brown-Norway (BN) and DA rats by i.v. injection of 3 X 10(7) Lewis (L) lymph node cells. Control BN and DA rats received syngeneic cells. Rats were injected i.v. with [methyl 3H]thymidine for 1 h before being killed at 1, 2, 4, 5, 6, 8, 10, 11, 12, 13, and 14 days after the cellular inoculum. A piece of ventral abdominal skin was removed. Autoradiography was used to determine cell proliferative activity (labeling index, LI) in mast cells and fibroblasts of the dermis and basal cells of the epidermis. In addition, the number of mast cells per high-power field was determined for all 4 groups of rats: control DA, GVHD-DA, control BN, and GVHD BN. Only GVHD-BN rats demonstrated extensive dermatitis. The LI of mast cells, fibroblasts, and basal cells decreased in control rats with increasing age. Although there were differences between DA and BN rats, there was a general pattern of increased proliferation of mast cells at early time points of GVHD followed by a decrease to or below control levels. The number of mast cells per high-power field also increased at early time intervals in both the DA and BN GVHD rats, but decreased significantly at later time points. These data confirm previous studies on chronic GVHD which demonstrated a decrease in the number of mast cells in the skin. Fibroblast LI was decreased at day 1 in both DA and BN GVHD rats. In GVHD-DA, fibroblast LI remained depressed while GVHD-BN demonstrated a second peak in LI at day 10 before declining below control levels. The most prominent basal cell response occurred in GVHD-BN between days 6-14 and is probably indicative of an attempted reparative response associated with GVHD dermatitis in this species. These data demonstrate that the activation of mast cells (proliferation and subsequent degranulation) correlates temporally with cell kinetic alterations occurring in the dermis and epidermis during acute GVHD. PMID- 3559264 TI - Patients with bone marrow failure demonstrate decreased cutaneous reactivity to human C5a. AB - In vivo studies have shown that human C5a, a potent complement-derived anaphylatoxin and chemoattractant, produces immediate inflammatory reactions following intradermal injection in human skin. At concentrations within its potential physiologic range, intradermal injection of C5a elicits immediate wheal and flare reactions, increased vascular permeability, mast cell degranulation, and neutrophil-rich infiltrates. To assess the relative contribution of interacting cellular elements to C5a-induced inflammation in normal human skin, purified human C5a was tested intradermally in 8 patients with bone marrow failure (BMF). Reactions to C5a in patients with BMF were compared with responses at identical test sites in healthy volunteers and other patients with cutaneous disorders. Patients with BMF demonstrated significantly less wheal and flare reactivity following intradermal injection of C5a than controls (p less than 0.05 and less than 0.02, respectively). In these studies, patients with the greatest cytopenia generally showed the least cutaneous reactivity to human C5a. Biopsies of C5a test sites in patients with BMF revealed an absence of leukocytes in marked contrast to neutrophil-rich infiltrates observed at test sites in healthy volunteers. Avidin-fluorescent and/or Giemsa staining of skin biopsies revealed no difference between the number of dermal mast cells in patients with BMF and samples of normal human skin. In addition, skin test studies with histamine (2 micrograms) and morphine (5 micrograms) performed to assess cutaneous vascular and mast cell responsiveness in patients with BMF, normal volunteers and controls with rhinitis revealed no significant differences in cutaneous reactivity to these pharmacologic agents. These in vivo studies demonstrate that patients with BMF specifically exhibit decreased cutaneous reactivity to human C5a and suggest that neutrophils make an important and an immediate contribution to inflammatory responses elicited by this anaphylatoxin. PMID- 3559265 TI - Separation and identification of cathepsins in newborn rat epidermis. AB - Cathepsins B, D, H, and L were identified in the extract of 2-day-old rat epidermis and separated by gel filtration from aminoendopeptidase with a Mr of 400,000 and from the low-molecular-weight cysteine proteinase inhibitor. They were further purified by ion exchange column chromatography. The final separation for cathepsins B and H was performed by gel filtration, while cathepsin D was purified by pepstatin affinity chromatography and cathepsin L by fast protein liquid chromatography (FPLC). Substrate specificity, inhibitor susceptibility, and apparent molecular weights of the separated proteinases were determined and values compared to rat liver enzymes. Apparent molecular weights for epidermal cathepsins B, H, and L were higher than those for comparable liver enzymes of adult rats. The cysteine proteinase inhibitor in epidermis was found to inhibit cathepsins B, H, and L but not cathepsin D and aminoendopeptidase of rat epidermis. This study demonstrates the presence of cathepsin L in the epidermis and describes simultaneous separation and comparison of epidermal catheptic proteinases. PMID- 3559266 TI - Retinol esterification by mouse epidermal microsomes: evidence for acyl CoA:retinol acyltransferase activity. AB - In an attempt to characterize the enzyme(s) responsible for retinol esterification in hairless mouse epidermis, various subcellular fractions were incubated with [3H]retinol and the reaction products (retinyl esters) isolated by high-performance liquid chromatography. The microsomal fraction exhibited the highest esterifying activity and was stimulated by the addition of palmitoyl-CoA and dithiothreitol, but not by palmitic acid. Saturation kinetics with an apparent Km of about 6 microM for retinol were noted. Experiments with competitive and noncompetitive inhibitors of [3H]retinol esterification established that the epidermal enzyme was an acyl-CoA:retinol acyltransferase (ARAT; EC 2.3.1.76). The specificity for retinol was not absolute; a few closely related vitamin A alcohols were equally good substrates. The ARAT activity was not significantly altered by physiologic variations in the epidermal vitamin A content. In conclusion, mouse epidermis expresses ARAT activity which may be of importance for the regulation of vitamin A metabolism at the cellular level. PMID- 3559267 TI - Loss of retinol-binding properties for plasma retinol-binding protein in normal human epidermis. AB - Terminal differentiation of the keratinocytes (cornification) has been linked to a restricted supply of retinol. Retinol is distributed to target cells by the retinol-binding protein (RBP), which circulates in the plasma in complex with transthyretin (TTR). In this study we have addressed the question of retinol delivery to the epidermis via RBP. Retinol radiobinding assays, affinity chromatography with TTR coupled to Sepharose beads, polyacrylamide gel electrophoresis, and immunoblotting techniques were used to show that epidermal extracts contain retinol binding sites with no affinity for TTR. Immunoreactive RBP was detected in the epidermal extracts. The RBP in the epidermis was in the apoform (without retinol) in contrast to serum where the majority of RBP is in the holoform (with retinol). Epidermal RBP was converted in vitro into the holoform only after addition of 20 times more retinol, which was needed to reconstitute holoforms of RBP in dermal extracts, human buccal mucosal extracts, and delipidized normal serum or purified delipidized RBP. Moreover, several immunoreactive RBP bands (possibly degradation products) were identified in the epidermal but not in dermal extracts. Retinol-binding protein from nonkeratinizing human oral mucosa showed different immunoblotting patterns when compared to epidermal RBP. These results suggest that degradation of RBP within the epidermis may result in a decreased retinol supply to the keratinocytes, and may lead to the cornification of the epidermis. PMID- 3559268 TI - Skin permeability in the newborn. AB - Skin permeability to drugs was assessed in the newborn infant using an in vitro method. Excised skin samples were studied in a Franz-type cell, and permeability to 0.1 M sodium salicylate was measured. Fourteen samples were studied, from infants of 25-41 weeks gestation and up to 8 days old. Gestation markedly affected skin permeability to salicylate, absorption being 10(2)-10(3) times greater in infants of 30 weeks gestation or less than in term infants. There are important implications for the high permeability of the preterm infant's skin; accidental poisoning from absorption of topically applied agents can easily occur, and the percutaneous route offers an alternative method of therapeutic drug administration. PMID- 3559269 TI - Production of pyrimidine dimers in DNA of human skin exposed in situ to UVA radiation. AB - Cyclobutyl pyrimidine dimers, measured as sites recognized by the dimer-specific ultraviolet (UV) endonuclease from Micrococcus luteus, were produced in DNA of human skin exposed in situ to UVA (320-400 nm) radiation. The dimer yields produced by a broadband UVA source, by broadband UVA filtered to remove all light of wavelength less than 340 nm, and by narrow band radiation centered at 365 nm were similar, indicating that UVA radiation, and not stray shorter wavelength radiation, was responsible for dimer production. The identity of the UVA-induced DNA lesions was confirmed as pyrimidine dimers by photoreactivation of approximately 100% of the endonuclease-sensitive sites in vitro with the 40,000 dalton Escherichia coli photoreactivating enzyme. PMID- 3559270 TI - In vitro growth characteristics of melanocytes obtained from adult normal and vitiligo subjects. AB - The in vitro growth characteristics of melanocytes obtained from uninvolved and perilesional skin of vitiligo vulgaris subjects have been investigated in comparison to those from healthy adult donors. Normal human melanocytes have been found to grow exponentially in the presence of 10(-11) M cholera toxin and 10 ng/ml of 12-O-tetradecanoylphorbol-13-acetate in routine tissue culture media. They could be trypsinized up to 3-4 passages. Melanocytes of the uninvolved skin of vitiligo subjects manifested a lag of 8-11 days for the onset of growth and they could not be passaged. Melanocytes obtained from both hypo- and hyper pigmented perilesional skin failed to grow under these conditions. Only in a few cases where the perilesional skin was normally pigmented did the melanocytes manifest some growth after a lag of 15 days. The initial seeding capacity of the melanocytes from uninvolved and perilesional skin of vitiligo patients were, respectively, 50% and 25% of the normal individuals. Vitiligo lesions themselves gave rise to unidentified dendritic cells that survived for 10-15 days without manifesting any growth. Our results suggest that melanocytes of individuals with vitiligo are defective. This fact has to be taken into account in any theory on the etiology of vitiligo. PMID- 3559272 TI - Partial characterization of phospholipase C activity in normal, psoriatic uninvolved, and lesional epidermis. AB - Arachidonic acid (AA), the precursor of prostaglandins and leukotrienes, can be directly liberated from membrane phospholipids by phospholipase A2 or indirectly by phospholipase C. One or both of these enzymes may be responsible for the increased content of AA found in psoriatic lesional epidermis. Keratome biopsies were obtained from normal and psoriatic individuals. After homogenization and sonication, a 10,000 g supernatant was used as the enzyme source. The activities of both phospholipase A2 and C were assayed in each sample using phosphatidylcholine and phosphatidylinositol, respectively, as substrates. Phospholipase A2 activity was found to be significantly higher than normal in both uninvolved and lesional psoriatic epidermis. In contrast, phospholipase C activity was significantly higher than normal in only the psoriatic plaque on the basis of wet weight (p less than 0.001), protein (p = 0.01), and DNA (p = 0.004) content. Phospholipase C activity in pmol diacylglycerol formed/min/microgram DNA was: normal 4.96 +/- 0.80, n = 13; uninvolved 7.29 +/- 1.06, n = 18; plaque 14.44 +/- 2.50, n = 18. Analysis (pH profile, calcium requirement, substrate specificity, and saturation kinetics) of pooled epidermal extracts showed no inherent differences in phospholipase C from normal and psoriatic epidermis, suggesting either a higher concentration or the presence of an activated form of the enzyme in psoriatic plaque. Since phospholipase C activity, in contrast to phospholipase A2 activity, is elevated only in lesional epidermis, it is possible that this enzyme contributes to AA accumulation observed in this tissue. PMID- 3559271 TI - An experimental skin sandwich flap on an independent vascular supply for the study of percutaneous absorption. AB - Further insights into the composite interactive processes of topically applied agents and percutaneous absorption and metabolism by functional skin in vivo have been hampered by the lack of a model system wherein the blood flow to and from the skin is independent but experimentally accessible. Utilizing microsurgical techniques, split-thickness skin grafting with syngeneic skin grafts, and the congenitally athymic (nude) rat, a skin sandwich flap system has been generated that has an independent but accessible vasculature and thus fills this void. We describe the methodology that has been developed to create the flap and present experiments that: demonstrate a lack of significant collateral circulation; quantify the microcirculation of the skin sandwich flap, host side, and graft side at various times during and after the flap has been generated, and note that blood flow to the flap is basically unchanged from host skin; demonstrate the utility of the system in measuring the amount of [14C]benzoic acid that appears in the flap when deposited on the surface in volatile and nonvolatile vehicles as a function of time; and demonstrate the fact that the flap can be reused, and that the total amount of [14C]benzoic acid absorbed across skin does not change in a substantial way as the flap ages. PMID- 3559274 TI - Epidermal permeability barrier: transformation of lamellar granule-disks into intercellular sheets by a membrane fusion process. PMID- 3559273 TI - Substrate specificity of human cutaneous alcohol dehydrogenase and erythema provoked by lower aliphatic alcohols. AB - The substrate utilization rates of human cutaneous alcohol dehydrogenase were determined for 7 lower aliphatic primary alcohols: ethanol, propanol, butanol, pentanol, 2-methylpropanol, 3-methylbutanol, and 2,2-dimethyl-propanol. 1 Pentanol gave the highest relative activity and 2,2-dimethylpropanol the lowest. The frequency of erythemogenesis was determined in vivo for these 7 lower aliphatic primary alcohols. The frequency of erythemogenesis correlated strongly and significantly with the rate of substrate utilization by alcohol dehydrogenase. These results are consistent with the view that the reaction to primary alcohols applied topically to human skin is provoked, in large part, by the corresponding aldehyde. PMID- 3559275 TI - Mycobacterium paratuberculosis infection in a colony of stumptail macaques (Macaca arctoides). AB - Mycobacterium paratuberculosis infection was documented in a colony of stumptail macaque monkeys (Macaca arctoides), with 29 (76%) of 38 monkeys infected and shedding organisms in feces. Thirteen deaths have occurred during the past five years. Animals without overt clinical disease were shedding as many as 2 X 10(6) colony-forming units of M. paratuberculosis/g of feces. Intestinal tissues from animals dying of this disease contained up to 10(8) colony-forming units of M. paratuberculosis/g of tissue. The clinical and pathological features of paratuberculosis in this species were comparable to those reported for paratuberculosis in ruminants and Mycobacterium avium infections in primates. By enzyme-linked immunosorbent assay, antibodies to M. paratuberculosis were found in 79%-84% of the animals. Antibodies could not be detected in six animals with clinical disease. These findings extend the natural host range of M. paratuberculosis to include nonhuman primates and add support to current suggestions that M. paratuberculosis may be pathogenic for humans. PMID- 3559276 TI - Effect of azotemia in dogs on the pharmacokinetics of pentamidine. AB - We used a new high-performance liquid-chromatography assay to study the pharmacokinetics of pentamidine isethionate given intravenously to 10 dogs before and after surgically induced renal failure. The presurgery peak serum concentration of pentamidine averaged 867 ng/ml and by 6 hr had fallen to 30 ng/ml. After surgery the peak and 6-hr concentrations were 780 ng/ml and 28 ng/ml. Mean total body clearance of pentamidine before surgery was 46.7 ml/min per kg, of which only 2.0 ml/min per kg was due to renal clearance had fallen 80% -to 0.4 ml/min per kg. Two dogs with azotemia and two control dogs received 14 daily infusions of pentamidine. Kinetic parameters measured after the last dose were not significantly different from those after the first dose, and the amount of pentamidine recovered from tissues was similar for dogs with azotemia and controls. In summary, because renal clearance of pentamidine accounted for such a small proportion of total body clearance, none of the parameters measured was affected significantly by moderate azotemia. PMID- 3559277 TI - Effect of ribavirin therapy on respiratory syncytial virus-specific IgE and IgA responses after infection. PMID- 3559278 TI - Chronic cystitis due to Cokeromyces recurvatus: a case report. PMID- 3559279 TI - Monosaccharide inhibition of Staphylococcus aureus adherence to human solid-phase fibronectin. PMID- 3559280 TI - Recurrent Broviac catheter infections. PMID- 3559281 TI - Pyelonephritis and sepsis due to Staphylococcus saprophyticus. PMID- 3559282 TI - Stomatococcus mucilaginosus endocarditis in an intravenous drug abuser. PMID- 3559283 TI - Cutaneous, ocular, and osteoarticular candidiasis in patients who are not heroin addicts. PMID- 3559284 TI - Familial occurrence of anthrax in Eastern Algeria. PMID- 3559285 TI - Effects of hyperbaric oxygen. PMID- 3559286 TI - Triples. PMID- 3559287 TI - Legionella, microbial ecology, and inconspicuous consumption. PMID- 3559288 TI - Diagnosis of bacteriuria in men: specimen collection and culture interpretation. AB - Bacteriologic criteria for diagnosing urinary tract infections in men have not been well defined. For determination of the bacterial colony count in voided specimens that most accurately reflects bladder bacteriuria, culture results were compared for voided urine and bladder urine (obtained by suprapubic aspiration and urethral catheterization) from men with various genitourinary problems. Bladder bacteriuria was found in 36 (47.3%) of 76 sets of specimens from 66 individuals. Culture results of bladder specimens showed excellent agreement with those of clean-catch midstream-void and uncleansed first-void specimens (weighted kappa = 0.924 and 0.906, respectively). The criterion for clean-catch midstream void specimens that best differentiated sterile from infected bladder urine was growth of greater than or equal to 10(3) cfu of one predominant species/ml; this definition had a sensitivity of 0.97 and a specificity of 0.97. Uncleansed first void specimens were equally sensitive (0.97) but less specific (0.91-0.92) in detection of bacteriuria. Pyuria (greater than or equal to leukocytes/mm3) and irritative genitourinary symptoms showed modest correlations with bladder bacteriuria. PMID- 3559289 TI - Bronchoalveolar lavage for diagnosing acute bacterial pneumonia. AB - The utility of gram stain and semiquantitative culture of the fluid retrieved by bronchoalveolar lavage (BAL) in identifying the causative agent in acute bacterial pneumonia was initially assessed in 92 patients. Fifteen of these patients presented with clinically active bacterial pneumonia; the remaining patients underwent bronchoscopy to evaluate other processes in the lung. Thirteen of the 15 patients with clinically active bacterial pneumonia had a BAL culture greater than or equal to 10(5) colony-forming units per milliliter of BAL fluid, whereas none of the other groups had a positive culture (chi 2 = 70.7, P less than .001). Gram stain of cytocentrifuged BAL fluid was positive (one or more organisms seen per 1,000 X field) only in those patients with an active bacterial pneumonia. Applying this technique, we studied 59 immunocompromised patients presenting with pulmonary infiltrates. Eight (21%) of the 39 patients presenting with microbial-related infiltrates proved to have acute bacterial pneumonia by BAL culture; the pneumonia resolved with appropriate antimicrobial therapy. PMID- 3559290 TI - Diagnosing bacterial respiratory infection by bronchoalveolar lavage. AB - We prospectively evaluated 75 patients by fiber-optic bronchoscopy and bronchoalveolar lavage (BAL) for the presence of bacterial lower-respiratory tract infection. BAL specimens were cultured quantitatively for aerobic bacteria, and a cell differential was obtained of the BAL cell population. In 18 "control" patients without evidence of respiratory infection, the presence of greater than 1% squamous epithelial cells (SECs) in the BAL sample accurately predicted the presence of heavy contamination of the sample by oropharyngeal flora. In the remaining "study" patients with potential infection, polymorphonuclear leukocytes were readily identified, and potential lower-respiratory-tract pathogens were recovered in concentrations greater than 10(5) colony-forming units (cfu) per milliliter in 16 of 18 patients with bacterial infection (none had greater than 1% SECs in their BAL sample). No patients without evidence of bacterial infection and with less than or equal to 1% SECs had greater than 10(5) cfu/ml in BAL cultures. These studies establish the ability of BAL techniques to diagnose bacterial respiratory infection. PMID- 3559291 TI - IgE and IgG antibodies to beta-propiolactone and human serum albumin associated with urticarial reactions to rabies vaccine. AB - We examined the antibody response to a rabies vaccine doubly inactivated with 0.025% beta-propiolactone and 0.1% tri(n)butyl phosphate and stabilized with 2.5% human serum albumin. Antibodies were measured by using the following four antigen preparations: complete doubly inactivated rabies vaccine, rabies vaccine inactivated only with tri(n)butyl phosphate, beta-propiolactone and human serum albumin, and human serum albumin alone. The fluid phase of the preparation of beta-propiolactone and human serum albumin completely inhibited IgE binding to solid-phase vaccine. Of 21 subjects with urticarial reactions to a booster, 19 had IgE to doubly inactivated vaccine and to beta-propiolactone and human serum albumin. None of 27 immunized subjects without urticaria had detectable IgE. In paired pre- and postimmunization sera, IgE appeared in six of seven of the subjects with urticaria and in one of seven nonreactors. These sera did not contain a significant level of IgE to singly inactivated vaccine or to human serum albumin alone. PMID- 3559292 TI - Influence of hepatitis delta virus infection on progression to cirrhosis in chronic hepatitis type B. AB - Serological markers of hepatitis delta virus (HDV) infection were found in 18 (12%) of 146 consecutive patients with chronic hepatitis B, and the characteristics of patients who had antibody to HDV (anti-HDV-positive) were analyzed. During one to 15 years of follow-up, histological deterioration was documented in 77% of anti-HDV-positive patients; however, in hepatitis B surface antigen (HBsAg) carriers without HDV infection, histology deteriorated in 30% but improved or remained unchanged in the majority of patients (P less than .01). In seven (70%) of the 10 anti-HDV-positive patients who showed transition from chronic active hepatitis to cirrhosis, this event was observed within the first two years of follow-up. The probability of evolution to cirrhosis was significantly higher in anti-HDV-positive patients than in patients without antibody to HDV (P less than .001). These findings indicate that HDV infection in patients with chronic hepatitis B is associated with a more-rapid progression to cirrhosis compared with HBsAg carriers with chronic hepatitis and no evidence of HDV infection. PMID- 3559293 TI - Alkaline phosphatase-positive reticular cells of chicken bone marrow--in vivo and in vitro studies. AB - We examined alkaline phosphatase (ALPase)-positive reticular cells from chicken bone marrow in vitro in relation to other varieties of adherent cells. ALPase activity was found in both reticular and adipose cells which formed epithelioid cell colonies and were negative for fibronectin. We observed transition between two cell types. ALPase-negative macrophages as small round cells in culture revealed positive fibronectin and transformed into ALPase-negative spindle cells in long-term culture. Thus, we suggest two cell lineages, each with distinct cell characteristics. PMID- 3559294 TI - The effect of hemin in vitro and in vivo on human erythroid progenitor cells. AB - Hemin stimulates erythropoiesis and hemoglobin synthesis in vitro. We cultured erythroid progenitor cells from normal individuals, patients with sickle cell anemia, and a patient with acute variegate porphyria who received intravenous hemin treatment, with 0-800 microM hemin added in vitro. Fifty to 200 microM hemin consistently stimulated colony growth from normal donors 2- to 8-fold, while concentrations of up to 400 microM were stimulatory in cultures from donors with sickle cell anemia. In vivo hemin decreased the number of blood BFU-e in the patient with porphyria, but did not abrogate the in vitro stimulatory effect of hemin. Hemin concentrations which increased colony numbers increased gamma globin synthesis in some studies and decreased it in others. Hemin thus has clearcut erythroid growth-potentiating activity, although a consistent effect on globin chain regulation is not apparent. PMID- 3559295 TI - Hyperthermia and radiation in the treatment of superficial malignancy: an analysis of treatment parameters, response and toxicity. AB - A total of 41 superficial tumours have been treated with radiation alone (21 lesions) or in combination with hyperthermia (20 lesions) in a non-randomized study on 16 patients. A minimum tumour heat dose in excess of 30 min equivalent at 43 degrees C was achieved in 46 of the 80 (57 per cent) hyperthermia treatments. Small lesions received better quality heat treatments and were more likely to achieve a complete response. There is a significant increase in the response of lesions treated with the combined modality compared with radiation alone (P less than 0.01). Similar results were obtained when matched lesions with internal controls were analysed separately. There was an increased incidence of severe skin reactions in the hyperthermia-treated group with the reaction tending to develop more quickly. There were three instances of late fibrosis in the hyperthermia group. There is a significant correlation between the severity of the skin reaction and the average maximum skin heat dose per treatment. PMID- 3559296 TI - A scanned, focused, multiple transducer ultrasonic system for localized hyperthermia treatments. AB - A commercial diagnostic ultrasound scanner (Octoson) was modified for performing hyperthermia treatments. The temperature elevations were induced in tissues by four large, focused ultrasonic transducers whose common focal zone was scanned along a computer controlled path as determined from B-scan images. The system is described and the results of preliminary tests demonstrating some of its capabilities are given. Extensive tests with canine thighs and kidneys were performed. The blood flow to the kidneys was controllable, and thus tumours having different blood perfusion rates could be simulated. The results showed that the system is capable of inducing a local temperature maximum deep in tissues (up to 10 cm was tested) and that tissues with high perfusion rates could be heated. PMID- 3559297 TI - Interstitial microwave antennas for thermal therapy. AB - This paper presents a new microwave antenna design with improved heating at the tip for interstitial hyperthermia and thermocoagulation. Temperature distribution patterns surrounding a conventional insulated antenna and the new sleeved coaxial slot radiator are measured in a saline phantom under transient and steady-state conditions. The new design provides an improved steady-state temperature distribution over the active region of the radiator. In contrast to the cold zone at the tip of a conventional insulated antenna the new sleeved coaxial slot antenna provides maximal (sixfold greater) power deposition at its tip. PMID- 3559298 TI - Restoration of hyperthermia-associated increased protein to DNA ratio of nucleoids. AB - The sedimentation of L1210 nucleoids has been used to demonstrate a hyperthermia associated increased protein to DNA ratio and an apparent inhibition of processes involved in the restoration of the protein to DNA ratio. The distance of nucleoid sedimentation increased as a function of exposure temperature and exposure time, and was proportional to an increased protein to DNA ratio in the nucleoids. Studies in which control and hyperthermia-treated cells were mixed prior to nucleoid preparation indicated that the association of protein with the nucleoid occurred during hyperthermia treatment and not during nucleoid preparation. However, double-labelling studies suggested an interaction between control and hyperthermia-treated cells since the presence of control cells during lysis resulted in near normalization of nucleoid sedimentation. Treatment with proteinase K also restored the nucleoid sedimentation. Incubation at 37 degrees C following hyperthermia revealed a rapid restoration of nucleoid sedimentation and a slower restoration of the protein to DNA ratio. Ethidium bromide-induced changes in nucleoid sedimentation were altered by the hyperthermia-associated increased protein content of nucleoids and the alterations were overcome by enzymatic digestion of the protein prior to the ethidium bromide exposure. Thus, hyperthermia caused, and inhibited the repair of, an increased protein content of nucleoids. The restoration of the increased protein possibly occurs by a heat sensitive proteolytic enzyme. The temporal use of an appropriate chemotherapy agent to inhibit the restoration of hyperthermia-associated changes may be a useful treatment option. PMID- 3559299 TI - Development of thermotolerance in CHO cells: modification by procaine. AB - We have tested the reported ability of procaine to inhibit the induction and the development of thermotolerance in Chinese hamster ovary cells. Thermotolerance was induced either by hyperthermia alone (10 min, 45 degrees C) or by combining hyperthermia and procaine (5 min, 45 degrees C + 10 mM procaine) with heating times adjusted to yield similar cell survival after the conditioning treatments. Both the kinetics of thermotolerance development in fresh medium without procaine and the magnitude of thermotolerance 6 h after heat conditioning were similar for the two treatment groups. Development of thermotolerance in the presence of procaine was tested by adding the drug at 5 or 10 mM to culture medium between, but not during two fractionated heat treatments. Thermotolerance development was observed even in the presence of 10 mM procaine, but only if cell survival was corrected for the 37 degrees C-procaine toxicity. Complete survival curves of cells incubated for 6 h at 37 degrees C in 7.5 mM procaine between heat conditioning and test heating showed a D0 that was only 35 per cent lower than that of thermotolerant controls. The data are consistent with the reported sensitization to heat killing by procaine, but show that thermotolerance induction and development were only minimally perturbed by procaine. PMID- 3559300 TI - Factors of importance for the development of the step-down heating effect in a C3H mammary carcinoma in vivo. AB - The effect of step-down heating (SDH) was investigated in a C3H mammary carcinoma inoculated into the feet of CDF1 mice. The SDH effect was evaluated by comparing slopes of time versus growth delay curves of SDH-heated with the curve for single heated controls. The effect was quantified by a ratio: 'step-down ratio' (SDR), defined as slope (SDH-heated)/slope (single-heated). Step-down heating resulted in thermosensitization in contrast to step-up heating which did not affect the heat sensitivity. The kinetics of the step-down heating effect was investigated by inserting an interval between a 44.5 degrees C/10 min sensitizing treatment (ST) and a 42.0 degrees C test treatment (TT). The effect of SDH was maximal with no interval between ST and TT (SDR = 2.3), decayed within 2 h and turned into thermotolerance. This thermotolerance was maximal after 12 h and decayed within 120 h. The effect of varying the TT temperature was investigated in the range 39.0-44.5 degrees C (ST = 44.5 degrees C/10 min). Below 42.5 degrees C the SDR value increased exponentially, and even a 39 degrees C TT produced a significant heat damage. An Arrhenius analysis was made showing a straight line in the whole temperature range with an activation energy of 526 kJ/mol and an increased activation entropy. These data show that thermosensitization can be induced by SDH in C3H mammary carcinomas in vivo. The effect seems to decay within 2 h, and by decreasing the heat activation energies the effect of low temperature heating is increased. PMID- 3559301 TI - A new method for thermal dosimetry in microwave hyperthermia using microwave radiometry for temperature control. AB - Microwave radiometry has been used during the last few years in some clinical centres (Lille, Freiburg, Strasbourg, Brussels) for the non-invasive control of temperature during microwave hyperthermia. The principal objective of this paper is to present an atraumatic thermal dosimetry system based on numerical simulations of hyperthermia and radiometric temperature measurements for TEM propagation. To gauge the feasibility and performance of the method, a one dimensional model in a homogeneous medium is considered, neglecting the curvature of the tissue layer. The good correlation between the theoretical and experimental values obtained allowed the likely thermal profile on the probe axis to be computed using the dielectric and thermal properties of the medium and measurement of the radiometric and cutaneous temperatures. PMID- 3559302 TI - [Problems and limitations of the IABP support after open heart surgery]. PMID- 3559303 TI - [Experimental study of pyruvate on myocardial protective effect]. PMID- 3559304 TI - [Experimental studies on the hypothermic preservation of the rat heart]. PMID- 3559305 TI - [Clinical study of complement activation during cardiopulmonary bypass--analyses of complement activation pathway and transpulmonary leukosequestration]. PMID- 3559306 TI - [Evaluation of aortic valve lesions and determination of operative procedures by two-dimensional echocardiography]. PMID- 3559307 TI - [Factors influencing late results on post infarction left ventricular aneurysmectomy]. PMID- 3559308 TI - [Intra-aortic balloon pumping in 122 patients: an analysis of 10 years' experience]. PMID- 3559309 TI - [Plasma catecholamine responses to cardiopulmonary bypass]. PMID- 3559310 TI - [Evaluation of continuous perfusion of cold blood cardioplegia]. PMID- 3559311 TI - [Fetal restriction of ventricular septal defect in infant with type II tricuspid atresia--a case report]. PMID- 3559312 TI - [Left ventricular-right atrial communication with a prolapsing non-coronary cusp of the aortic valve--a successfully treated case]. PMID- 3559313 TI - [Severe mechanical hemolysis after valve replacement with St. Jude Medical valve- a report of five cases]. PMID- 3559314 TI - [Chest wall reconstruction using polycrystal alumina ceramic pins in patients with chest wall trauma]. PMID- 3559315 TI - Extended femoro-distal bypasses for limb salvage: are they worthwhile? AB - In this report on 93 patients with limb-threatening leg ischemia the surgical procedures applied were malleolar bypasses (14), sequential bypasses (12) and femoro-distal bypasses with adjunct AV fistulas (67). The first two methods resulted in favourable limb-salvage and patency rates. However the results of such reconstructions essentially depend on the quality of primary and secondary foot arcades. In peripheral calf and foot arterial occlusions we have applied a distal arteriovenous fistula as an adjunct measure to maintain bypass patency in the crural region. 67 patients were operated on according to this method: 30 females and 37 males with an average age of 70.3 years. 29% had rest-pain and 71% had gangrene. The majority had already been operated on at least once. 7 patients had been amputated contralaterally. RESULTS: 79% of the patients had a patent graft after one month. The incidence of limb salvage was 77%. At two years 47% of all grafts are still patent and the incidence of limb-salvage is 52%. However, this operation should be exclusively designed for limb-salvage and for cases with extremely poor run-off. PMID- 3559316 TI - Isovolemic hemodilution: a therapeutical intervention for improving microcirculation. AB - A controlled reduction of hematocrit levels can be of value in the conservative treatment of inoperable arterial occlusive disease in advanced clinical stages. Long term success can be achieved in up to nearly 50%. The more and the longer the occlusions, the poorer the results. PMID- 3559317 TI - The role of hemorheology in the pathophysiology and treatment of arterial occlusive disease. AB - Hemorheological types of treatment are more and more used in the field of clinical angiology. On the other hand a good portion of criticism is necessary not to go the wrong way. In spite of really attractive pathophysiological ideas the bed side situation is quite a different affair. Up to now it is not clear under which conditions and to what extent pathological hemorheological values are causative or at least aggravating factors of arterial occlusive diseases and the resultant functional impairment. So the essential points of what is called "clinical hemorheology" are not yet solved. Direct observation and documentation of hemorheological induced clinically interesting effects in humans as well as the serious trial to give definitions of clinical conditions in which the effects obtained are of clinical relevance are extremely necessary to enlighten an attractive and exciting component of clinical angiology. PMID- 3559318 TI - Leg swelling after aortic surgery. AB - Thirty patients undergoing aorto-femoral reconstruction, during which i.v. heparin was used, are reviewed (19 bilateral and 11 unilateral procedures). No operation was performed therefore on 11 of 60 limbs. Ankle swelling occurred in 12 operated limbs (9 transient and 3 permanent swelling) and 1 non operated limb. Deep vein thrombosis (DVT) occurred in 7 limbs and in only 3 of these was swelling coincident (1 permanent swelling). The coincidence of limb swelling and DVT of the arterial reconstruction is insignificant. PMID- 3559319 TI - [Clinico-pathological study and appraisal of treatment for endometrial cancer at the Ehime University Hospital]. AB - Clinical and pathological studies were performed on 51 cases with endometrial cancer. The results are as follows: The average age was 58.9 years and the range 41 to 80 years. Forty-one (80.4%) patients were postmenopausal and the average menopausal age was 49.1 years. All cases were symptomatic and in 35 (76.5%) cases the postmenopausal bleeding was noted as a chief complaint. The chief complications were obesity (37.5%), hypertension (25.0%), infertility (13.7%) and diabetes mellitus (9.4%). Of 51 cases, 36(70.6%) were in Stage I, 7(13.7%) in Stage II, 6(11.8%) in Stage III and 2(3.9%) in Stage IV. When the depth of the invasion was classified into 3 grades, less than 1/3 of the muscular layer, between 1/3 and 2/3, and over 2/3 in 48 cases examined, they were observed in 20(41.7%), 10(20.8%) and 18 cases (37.5%) respectively. There were 6 cases (15%) with lymph node involvement in 40 cases examined. Those in which the depth of invasion was over 2/3, had a significantly higher incidence of lymph node involvement. The five year cumulative survival rate was 66.7%(14/21) for all cases. The clinical stage and age of the patients had a significant correlation with the prognosis of endometrial cancer, but the histological grades, the depth of invasion, and lymph node involvement did not demonstrate the a significant correlation in prognosis in this study. The five year survival rate for the group treated by modified pan-hysterectomy with pelvic lymphadenectomy was 92.3% which was significantly higher than the 25% of the group treated by simple hysterectomy or than the 0% of non-surgical group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559320 TI - [Absorption of D-glucose by the small intestine of the human fetus (using brush border membrane vesicles of the jejunum)]. AB - using brush border membrane vesicles prepared from human mid gestational fetal intestine (jejunum), the intestinal D-glucose transport mechanism was studied using a rapid filtration technique. The uptake of D-glucose into the vesicles was osmotically sensitive. This finding indicated that the uptake of D-glucose into the vesicles represented transport into the vesicles. A Na+ electrochemical gradient (extravesicular greater than intravesicular) stimulated the initial rate of D-glucose uptake, and Na+ dependent uptake of D-glucose into vesicles showed a typical overshoot phenomenon. This overshoot and the initial rate of uptake were markedly increased when the intravesicular space was rendered electrically more negative by membrane diffusion potentials induced by the use of highly permeant anions. A similar stimulation of D-glucose uptake was observed, when membrane potential (inside negative) was imposed by K+ diffusion potentials via valinomycin. These results indicated that a sodium dependent uptake of D-glucose into the brush border membrane vesicles was dependent on the electrical potential difference of the membrane. The initial rate of D-glucose transport exhibited saturation kinetics with respect to the D-glucose concentration; an apparent Km of 3.2mM and Vmax of 8.1n mol/mg protein/20 sec were calculated. In conclusion the mid gestational fetal intestine (jejunum) already has a D-glucose absorption system which is comparable to the adult one. PMID- 3559321 TI - [A simple and rapid crystal violet uptake sensitivity test for anticancer agents]. AB - Hitherto, the selection of anticancer drug has been based on clinical experience. But to succeed for chemotherapy to succeed, effective drugs must be selected for individual patients with cancer. We have developed the following new in vitro micromethod. Method. In brief, tumor cells obtained by surgery were incubated with anticancer drugs for 48 hrs at 37 degrees C in 5% CO2 in a microplate. After incubation, the surviving cells were fixed with methanol and stained with crystal violet. Then the stained cells were solubilized with 1% lauryl sulfate and the absorbance of each well was measured at 540 nm with a multiscan spectrophotometer. In this method, cytotoxicity was quantitated by the absorbance. The method is simple, rapid (48 hrs) and reproducible, and it requires only a small amount of cells (5 X 10(3) approximately 1 X 10(4]. This method correlates well with sensitivity tests using isotopes. We have examined the chemosensitivity of 22 specimens from gynecologic malignancies by this method. The success rate is 77% and higher than with any other in vitro method. This method will be widely utilized in several fields of cancer treatment in the near future. PMID- 3559323 TI - [Screening for endometrial cancer using a curettage stamp method]. AB - The present study shows the value of a routine screening program for the detection of endometrial malignancies. From 1980 to 1985, 5,640 subjects were screened for endometrial malignancies using the curettage stamp method. Of 60 cases whose smears were abnormal, 25 were found to have malignant lesions. These patients included endometrial cancer (15 cases), sarcoma (3 cases) and metastatic cancer (4 cases). Three cases were found to have cervical cancer. Among 22 patients, excluding 3 cases with cervical cancer, 17 cases had negative results in a cervical smear test. Also 3 cases of endometrial cancer showed no history of abnormal genital bleeding. All 15 patients with endometrial cancer were over 40 years of age. These results indicated the clinical importance of the routine endometrial cytological smear in the detection of malignancies of the uterine body, especially in women over 40 years of age. PMID- 3559322 TI - [Immunohistochemical localization of estradiol in malignant epithelial tumors of the ovary]. AB - Granulosa cell tumors derived from sexcord-stromal cells are thought to be generally estrogen producing neoplasms. However recent reports show that these common epithelial tumors, adenocarcinomas and Brenner tumors, are capable of estrogen activity. We have studied the production of estrogen in common epithelial malignant tumors of the ovary. Two cases of serous cystadeno carcinomas, five cases of mucinous cystadeno-carcinomas and two cases of endometrioid carcinomas were examined for the presence of estradiol using an indirect immunoperoxidase method. The results were as follows: In all tumors, one case of serous cystadeno-carcinoma, four cases of mucinous cystadeno-carcinomas and one case of endometrioid carcinoma had a positive immunoperoxidase reaction. The incidence of positive reaction showed that mucinous cystadeno-carcinomas were more numerous than others. In positive cases, estradiol localization was recognized in the epithelial cell of mucinous tumors to various degrees, but there was no estradiol localization in admixed goblet like cells. In serous tumors and endometrioid carcinomas also estradiol localization was seen in the cytoplasm. Stromal cells tended to be more weakly positive than epithelial cells. No estradiol localization was detected in any of the spindle cells or fibrinous connective tissues. These results suggest that some common epithelial malignant tumors of the ovary have estrogen activity and estradiol is produced not only in stromal cells but also in epithelial cells. PMID- 3559324 TI - [Fetal blood sampling by liver puncture]. AB - Fetal blood sampling has been performed in several ways; placentacentesis, fetoscopy, or umbilical code puncture. The problems with these methods are technical difficulties and contamination of maternal blood or amniotic fluid. To solve these problems, we have tried fetal blood sampling by fetal liver puncture with a 21 approximately 23 gauge needle through the maternal abdomen under real time scan guidance. 10 patients underwent this procedure. They ranged from 18 weeks to 22 weeks of gestation at the time of sampling. The sampling procedures were done easily and the samples taken were shown to be pure fetal blood by red blood cell sizing. All the patients continued pregnancy after the examination and none of the pregnancies was influenced by the puncture. 7 patients have been delivered with neither sampling scars nor damage to liver function. This method provides pure fetal blood, the procedure is simple and, in our experience, no complications have occurred. PMID- 3559325 TI - [Nonenzymatic glucosylation of human placental trophoblast basement membrane collagen (relation to diabetic placenta pathology)]. AB - Nonenzymatic glucosylation is a reaction in which glucose binds nonenzymatically to hemoglobin, serum protein and glomerular basement membrane collagen etc. It has been thought that nonenzymatic glucosylation results in functional and chemical changes in those substances (hemoglobin etc) and contributes to the pathological changes in diabetes mellitus. This time we investigated whether nonenzymatic glucosylation occurred in human placental trophoblast basement (TrBM) collagen or not. The ability of glucose to interact with TrBM collagen (nonenzymatic glucosylation of TrBM collagen) was examined by incubating TrBM collagen with 3H-D-glucose in vitro. As a result it was shown that nonenzymatic glucosylation occurred in TrBM collagen and nonenzymatic glucosylation of TrBM collagen depended on the glucose concentration, reaction time and reaction temperature. These results indicate that possibly hyperglycemia, via nonenzymatic glucosylation modifies the function and chemistry of TrBM collagen and is related to the placental pathological changes in diabetic pregnancy. PMID- 3559326 TI - [Semi-quantitative evaluation of the intrapartum variable deceleration of the FHR pattern and its association with umbilical cord blood gas analysis]. AB - Variable daceleration of FHR combined with no other abnormal pattern was semi quantitatively evaluated to establish the diagnostic value of variable deceleration for fetal distress. FHR charts of 55 low risk vaginal deliveries by direct monitoring were analysed and the SDA (Sum of Dip Area) was calculated using the following equation: SDA = sigma Duration of dip (sec.) X Amplitude of dip (bpm.) X 10(-2) and correlation between SDA and umbilical cord blood gas analysis was obtained. A significant correlation was observed between SDA during labor (from 5 cm cervical dilation to delivery) and cord blood gas data. pHuv:r = -0.445 (p less than 0.005), PO2uv:r = -0.358 (p less than 0.01), BEuv:r = -0.538 (p less than 0.001), pHua:r = -0.441 (p less than 0.005), BEua:r = -0.463 (p less than 0.001). In 14 cases which showed prolonged deceleration (PD:more than 120 sec. in duration and below 100 bpm. in dip), excellent correlation was observed between the SDA of PD and pHuv:pHuv = 7.425-7.74 X 10(-4) SDA of PD (r = -0.756, p less than 0.005), whereas in 21 cases with severe variable deceleration (SVD:more than 60 sec. and recovered within 120 sec. in duration or below 60 bpm. in dip) no significant correlation was seen between the SDA of SVD and pHuv. These results suggest that the SDA value is helpful in evaluating variable deceleration during labor. PMID- 3559327 TI - [Regional registration study of uterine neoplasia in Niigata Prefecture]. AB - In this study, we examined the incidence of the uterine neoplasia in Niigata prefecture on the basis of the data collected by the Niigata Gynecologic Cancer Registry between 1982 and 1984. The results are as follows: The registered cases with dysplasia (Dysp.), cervical carcinoma in situ (CIS), cervical invasive carcinoma (Inv. Ca.) and endometrial carcinoma (End. Ca) were 358, 147, 530 and 141, respectively. One hundred and ninety-six cases with Dysp., 81 cases with CIS, 99 cases with Inv. Ca. and 10 cases with End. Ca. were detected by mass cancer screening. The crude incidence rate for Dysp., CIS, Inv. Ca. and End. Ca. was 9.44, 3.88, 13.98 and 3.72, respectively. The age standardized incidence rate (all age, world population) for Dysp., CIS, Inv. Ca. and End. Ca. was 7.48, 3.08, 9.45 and 2.63, respectively. The age standardized incidence rate (over 30 years, world population) for Dysp., CIS, Inv. Ca, and End. Ca. was 16.48, 6.77, 21.00 and 5.90, respectively. The lifetime incidence rate for uterine carcinoma in women aged 0 approximately 75 years was 1.65%. PMID- 3559328 TI - [Study on enhancement of antitumor immunity in cervical cancer--with reference to administration of immunopotentiators]. AB - The immunopotentiator OK-432 was injected intracutaneously, locally, or both, to patients with cervical cancer. The results were as follows: Histological changes: There was a marked increase in the infiltration of T3, Ia1, M1, Leu7 into the interstices surrounding the cancer and the regional lymphnodes. An analysis of the mononuclear cells in the regional lymphnodes by flow cytometry showed an increase in the percentage of M1 and Leu7. Cytotoxicity: There were significant increases in NK activity, LAK activity and killer activity in the mononuclear cells around the cancer and of the regional lymphnodes. These changes in the intracutaneous administration concomitantly with local administration were more marked than in the intracutaneous or local administration. PMID- 3559329 TI - [Effects of maternal glucose loading on brain energy metabolism of fetal rats during hypoxia and recovery]. AB - The effect of maternal infusions of hypertonic glucose on fetal brain carbohydrate metabolisms was investigated during the state of induced fetal hypoxia and its recovery using Wistar rats. Three milliliters of 20% glucose was injected into the pregnant rats and then the fetuses were delivered by hysterotomy after 20 minutes of induced hypoxia. The concentrations of glucose, lactate, ATP, ADP, AMP in fetal brain, and the levels of glucose and lactate in fetal blood were measured. The brain glucose concentrations in the loaded group was 3.9 times higher than that in the non-loaded group, and it decreased during hypoxia in both groups followed by a gradual increase in the recovery phase. Brain lactate levels were elevated during hypoxia in both groups, but the difference in the lactate levels was slight compared with the difference in the brain glucose levels in both groups. Brain ATP decreased by 21% in the glucose loaded group but 70% in the non-loaded group after hypoxia. The calculated brain energy charge potential [(ATP) + 0.5(ADP)]/[(ATP) + (ADP) + (AMP)] after hypoxia was 0.59 in the loaded group and 0.37 in the non-loaded group. This shows a high energy state in the brain of the glucose loaded group. It may be suggested that maternal glucose administration before and during fetal hypoxia does not cause remarkable lactate accumulation in the fetal brain, but serves to maintain a high intracellular energy state in the brain. PMID- 3559330 TI - [Study on general anesthesia for cesarean section--condition of ventilation and inhaled O2 concentration]. AB - The effects of ventilation on the fetus during general anesthesia for elective cesarean section were evaluated. METHOD: 62 healthy parturients (37-42 weeks) were divided into two groups, 40 received general anesthesia (G group) and 22 received spinal anesthesia (C group). All were given pre-operative infusion, journey tilt position and LUDD application. The G group was further divided according to the combination of O2 concentration and respiratory rate. General anesthesia was maintained by N2O-O2-halothane (0.5%). The C group was given 0.3% dibucaine with 100% O2 inhalation. ABM was used to monitor blood pressure, pulse rate, EMG, EEG, NMT and EtCO2. Maternal arterial blood (MA) and umbilical arterial and venous blood (UA, UV) were taken at delivery for measurement of PO2, PCO2, pH and B.E.. RESULTS: No significant change in blood pressure was found. There were positive correlations in EtCO2, MAPCO2 and UVPCO2. MAPCO2 decreased when the respiratory rate was increased. UVPCO2 and UVPO2 were not affected when MAPCO2 was below 23mmHg. When the O2 concentration was increased, MAPO2 also increased. Thus, pre-operative infusion, journey tilt position and LUDD application help to prevent hypotension. ABM, and especially, EtCO2, provides useful information. Slight hyperventilation and hyperoxygenation are better for the fetus. PMID- 3559331 TI - Human trophoblast and endometrial interactions in vitro. AB - Human trophoblast and endometrial cell interaction was studied by using tissue culture techniques as an in vitro model experiment on ovum implantation. Mixed cultures of trophoblast of the early gestational stage and endometrial cells of the mid-secretory phase were performed, and the interactions between these cells were observed by using a phase contrast microscope and microcinematographs. Trophoblast cells showed marked affinity and firm attachment to endometrial cells, and their outgrowth and maintenance were significantly better in the mixed cultures with endometrial cells than in the cultures of trophoblast alone. These characteristic interactions appeared to be closely related to attachment and anchoring of trophoblast to endometrium, and suggested the supportive and nutritive roles of endometrial cells in trophoblast development in the process of implantation. Trophoblast cells showed active cell locomotion, pinocytosis, and phagocytosis. Aggressive action on epithelial endometrial cells observed in the cinematographs seemed to be suggestive of the cytolytic activity of trophoblast cells. Trophoblast cells invaded endometrial cell sheet in the same manner as malignant tumor cells in vivo. Outgrowth and invasion of trophoblast cells were finally arrested by transformed endometrial cells similar to decidual cells morphologically. These results demonstrated the in vitro decidualization of endometrial cells and suggested their control action against trophoblast invasion. PMID- 3559332 TI - The mechanism of hormonal receptor regulation in the rat ovary following administration of gonadotropin and prolactin. AB - In order to understand the role of hormonal receptors in patients with hyperprolactinemia, changes in the ovarian receptors for prolactin and LH and in the serum hormone levels were studied in mature female rats. Wistar-Imamichi strain rats were pretreated with ovine prolactin (oPRL; 1IU), hCG (10IU) or hMG (20IU) for 4 days and oPRL, hCG, oPRL plus hCG for 8 days. The ovarian LH receptor levels fell significantly in rats stimulated with hCG, oPRL or hCG plus oPRL for 4 or 8 days. The serum estradiol level rose with hCG, and fell with oPRL. Combined treatment with oPRL and hCG synergistically reduced LH receptor to below the control level, and the estradiol level near the control compared with that by hCG alone. A decrease in LH receptor (60%) after the 4-day treatment with oPRL was further lowered to 53% of the control level after the 8 day treatment. Prolactin receptor levels rose with hCG after the 4-day administration, and then returned to normal after the 8-day treatment. The hMG treatment for 4 days raised the serum estradiol and progesterone levels to 9 times and twice those of the controls, respectively, without changing ovarian receptor levels. Prolactin seems to lower the ovarian LH receptor levels under certain conditions, and this may be one of the causes of the refractory reaction to gonadotropin therapy in patients with hyperprolactinemia. PMID- 3559333 TI - Comparison of three regimens containing rifampin for treatment of paucibacillary leprosy patients. AB - Three regimens containing rifampin have been tried in paucibacillary leprosy patients. The patients were selected according to the criteria laid down by the World Health Organization (WHO). In Regimen I, rifampin 600 mg is given once a month for 6 months with dapsone 100 mg daily. Treatment is stopped at the end of 6 months. Regimen II is the same as Regimen I, and is supplemented with an additional 6 months' treatment with dapsone 100 mg daily. Regimen III is the same as Regimen II, except that rifampin is administered daily for the first 7 days. At the end of the scheduled treatment period, 72.2% of the patients in Regimen I, 94.9% of the patients in Regimen II, and 97.1% in Regimen III became inactive. Eighteen out of the 25 active cases at the time Regimen I treatment was stopped had to be restarted on drug therapy since they showed a worsening of their disease, as indicated by an increase in their bacterial index, the appearance of new lesions, renewed activity in old lesions, an increase in the size of old lesions, or development of nerve abscesses. The remaining seven cases regressed without further treatment. All four Regimen II patients and two Regimen III patients who had evidence of activity at the time treatment was stopped did not require any further treatment. On follow-up for 1 1/2 years, three Regimen I patients and none of the Regimen II or Regimen III patients showed relapses. It is thus apparent that rifampin helps to shorten the time duration and to increase the cost effectiveness of treatment of paucibacillary leprosy cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559334 TI - Experimental leprosy in a rhesus monkey: necropsy findings. AB - A 6-month-old male rhesus monkey (Macaca mulatta) was inoculated intravenously and intracutaneously with Mycobacterium leprae obtained from a naturally infected mangabey monkey. The animal developed generalized lepromatous leprosy, and was killed for pathological examination 56 months after inoculation. Lesions were observed in the skin, nasal mucosa, peripheral nerves, and peripheral lymph nodes, with relative sparing of viscera. The monkey was carefully evaluated for the retrovirus STLV-III infection and was found negative. The rhesus monkey thus provides another animal model for the study of leprosy. PMID- 3559335 TI - Photoactivated 8-methoxypsoralen in repigmentation of tuberculoid leprosy. PMID- 3559336 TI - Simplified surgical technique for flexible clawed hand rehabilitation. PMID- 3559337 TI - Lipid composition of human leprous tissue. PMID- 3559338 TI - Histopathological examination of skin biopsies from an epidemiological study of leprosy in northern Malawi. AB - This report describes the histopathological findings in 686 biopsies obtained from 664 individuals during the course of a total population survey for leprosy in Northern Malawi. The criteria for the selection of cases for biopsy, the biopsy technique using a 4-mm punch, fixation method, transport of biopsies from Africa to the United Kingdom, and the method of coding histopathological results are described. Fifty-two percent (354) of the biopsies showed definite evidence of leprosy on histopathological examination. Using the Ridley-Jopling system, these biopsies were classified as follows: TT = 60 (17%); TT/BT = 68 (19%); BT = 194 (55%); BT/BB = 4 (1%); BB = 4 (1%); BB/BL = 4 (1%); BL = 7 (2%); BL/LL = 3 (1%); LL = 6 (2%). In addition, four (1%) biopsies were classified as "indeterminate" on histology, meaning that although there was evidence of leprosy it was not possible to provide a precise classification. A further 117 biopsies (17% of the total) had abnormal changes, often including epithelioid cell granulomas, possibly caused by leprosy but lacking specific criteria for that diagnosis. Finally, 203 (30%) of the biopsies had nonspecific (often minimal) changes, and 11 (2%) of the total showed evidence of some dermatological condition other than leprosy. Histopathological examination of biopsies in this study confirmed the clinical classification in 98% of the cases in which the histopathologist found evidence of leprosy, and supplied further evidence for the very high proportion of paucibacillary cases in this part of the world. PMID- 3559339 TI - Pharmacokinetics of clofazimine in healthy volunteers. AB - The pharmacokinetics of clofazimine was evaluated in 12 healthy male volunteers following single and multiple oral doses of clofazimine. Six volunteers received a single dose of 200 mg together with food. A 200-mg dose was administered to three volunteers either with or without food. In a multiple-dose experiment, three volunteers were repeatedly dosed with 50 mg per day together with food for 8 days. Following a single oral dose of 200 mg, the mean peak plasma concentration of clofazimine was 861 +/- 289 pmol/g (+/- S.D., N = 6) after 8 hr (median). The mean terminal half-life was 10.6 +/- 4.0 days. Comparison of the bioavailability of clofazimine administered with or without food revealed a 60% higher mean area under the curve (AUC) value and a 30% higher mean maximum concentration (Cmax) value with food (N = 3). The median of times to peak (Tmax) was 8 hr with food and 12 hr without food. In the multiple-dose study, good agreement was found between the mean experimental plasma concentration values and the plasma concentration profile predicted from the single-dose pharmacokinetics. The elimination half-life calculated from the terminal phase of the individual profiles after the last dose was 8.8 +/- 1.0 days (+/- S.D., N = 3). The half life obtained from the fitted mean multiple-dose profile was 10.5 days. The slow elimination of clofazimine has its implications for the treatment regimen in patients. To avoid the long-lasting accumulation toward the steady state, higher daily loading doses are recommended at the beginning of therapy followed by a daily maintenance dose. PMID- 3559340 TI - [Studies on whole blood viscosity in polycythemia vera: the evaluation on the effect of phlebotomy and the prevention of cerebral thromboembolism]. PMID- 3559341 TI - [Acute effect of nitrites on ischemic heart disease--evaluation by coronary angiography]. PMID- 3559342 TI - [Interrelationships among blood pressure, sodium, potassium, and protein intake in a small employee population in Japan]. PMID- 3559343 TI - [A study of the clinical feature of 29 cases with aspirin-induced asthma]. PMID- 3559344 TI - [Coronary artery spasm induced by intracoronary administration of acetylcholine in a patient with variant angina]. PMID- 3559345 TI - [A case of lupoid hepatitis, factor XI deficiency and Hashimoto's disease with circulating anticoagulant]. PMID- 3559346 TI - [The effect of changes in sodium load on plasma and urinary catecholamine in a patient with uncomplicated pheochromocytoma]. PMID- 3559347 TI - [A case of transposition of the great arteries in adult]. PMID- 3559348 TI - [A case of reversible hypopituitarism with hyperprolactinemia caused by a large suprasellar aneurysm]. PMID- 3559349 TI - [Surgery of thymus lipoma accompanied by myasthenia gravis]. PMID- 3559350 TI - [An autopsy case of tuberous sclerosis with hitherto unrecognized complication of primary pericardial mesothelioma]. PMID- 3559351 TI - [Sjogren's syndrome and periodic paralysis. A case report and review of the literature]. PMID- 3559352 TI - [Akinesia and kinesie paradoxale occurring after cerebral hypoxia]. PMID- 3559353 TI - [A case of incomplete vasculo-Behcet's disease associated with hereditary abnormal plasminogenemia]. PMID- 3559354 TI - [A case report of allergic pericarditis associated with urticaria]. PMID- 3559355 TI - [ECG changes simulating ventricular aneurysm in dilated cardiomyopathy. A case report]. PMID- 3559356 TI - [A case of sepsis, shock, disseminated intravascular coagulation, and necrotizing fasciitis caused by Vibrio vulnificus treated with early debridement]. PMID- 3559357 TI - [A case of bilateral non-functioning adrenocortical adenomas]. PMID- 3559358 TI - [A case of idiopathic portal hypertension supervening on SLE (systemic lupus erythematosus)--a study on the possible role of SLE in the pathogenesis of IPH]. PMID- 3559359 TI - [Familial plasma cell dyscrasia in mother and daughter]. PMID- 3559360 TI - [A case of occlusion of the abdominal aorta (Leriche's Syndrome) associated with thrombocythemia]. PMID- 3559362 TI - Learning disabilities: issues on definition. National Joint Committee on Learning Disabilities. PMID- 3559361 TI - The National Joint Committee on Learning Disabilities: history, mission, process. PMID- 3559363 TI - A new definition of learning disabilities. PMID- 3559364 TI - Performance of adults with auditory figure-ground disorders under conditions of unilateral and bilateral ear occlusion. PMID- 3559365 TI - States' criteria and procedures for identifying learning disabled children: a comparison of 1981/82 and 1985/86 guidelines. PMID- 3559366 TI - Using computer guided practice to increase decoding fluency in learning disabled children: a study using the Hint and Hunt I program. PMID- 3559367 TI - Enhancing instructional time through attention to metacognition. PMID- 3559368 TI - Elaborating to learn and learning to elaborate. PMID- 3559369 TI - Oh, OK, I'm LD! PMID- 3559371 TI - Reaction to Kolligian and Sternberg's triarchic synthesis. PMID- 3559370 TI - Making decisions about special education placement: do low-income parents have the information they need? PMID- 3559372 TI - The impact of automaticity theory. PMID- 3559373 TI - Comments on "Elaborating to learn and learning to elaborate" by Pressley, Johnson, and Symons. PMID- 3559374 TI - Commentary on Palincsar and Brown's "Enhancing instructional time through attention to metacognition". PMID- 3559375 TI - The elusive relationship between laterality performance and cognitive ability: a commentary. PMID- 3559376 TI - Meeting the transition needs of college-bound students with learning disabilities. PMID- 3559377 TI - A survey of programs and services for learning disabled students in graduate and professional schools. PMID- 3559378 TI - SAT verbal-math discrepancies: accurate indicators of college learning disability? PMID- 3559379 TI - A low density lipoprotein-sized particle isolated from human atherosclerotic lesions is internalized by macrophages via a non-scavenger-receptor mechanism. AB - A lipoprotein particle designated A-LDL, which contains apolipoprotein B (apoB) and which is the size of plasma low density lipoproteins (LDL), was isolated from homogenates of human aortic athersclerotic plaques by a combination of affinity chromatography and gel-filtration. Compared to plasma LDL, A-LDL was more electronegative, its hydrated density was lower and more heterogeneous, and its protein-to-lipid ratio was lower. In addition, apoB in A-LDL was highly degraded, and A-LDL was recognized by mouse peritoneal macrophages (MPM) as indicated by its ability to stimulate cholesterol esterification. Cholesterol esterification was saturable with an apparent Km of 100 micrograms of A-LDL cholesterol/ml. Stimulation of cholesterol esterification was linear with time, leading to extensive accumulation of cholesteryl ester in MPM over a 48-hr time interval. The uptake or degradation of acetyl-LDL (radiolabeled either in the protein with 125I or hydrophobic core with [3H]cholesteryl ether) was markedly decreased by excess unlabeled acetyl-LDL but not by A-LDL, and excess acetyl-LDL did not inhibit the uptake or degradation of labeled A-LDL. However, a 10-fold excess of A-LDL also failed to inhibit the uptake of labeled A-LDL. This finding was consistent with the observation that, unlike the saturable stimulation of cholesterol esterification in MPM induced by A-LDL, the uptake of cholesteryl ether-labeled A-LDL was almost linear over a 0-400 micrograms cholesterol/ml range. This discrepancy between dose response curves for A-LDL, which did not occur for acetyl-LDL, could be eliminated by a 24-hr postincubation period in the absence of lipoprotein, suggesting that A-LDL is catabolized less efficiently than acetyl-LDL following internalization. In summary, we conclude that A-LDL uptake by MPM occurs via a low affinity-high capacity process. Although the uptake of A-LDL is not readily saturated, it is of sufficient affinity to lead to lipid loading of macrophages even when A-LDL is present at relatively low concentrations. If these mechanisms are operative in vivo, they could explain how foam cells in human fatty streak lesions develop. PMID- 3559380 TI - Selective incorporation of various C-22 polyunsaturated fatty acids in Ehrlich ascites tumor cells. AB - Three 14C-labeled 22-carbon polyunsaturated fatty acids, 7,10,13,16 [14C]docosatetraenoic acid (22:4(n-6)), 7,10,13,16,19-[14C]docosapentaenoic acid (22:5(n-3)), and 4,7,10,13,16,19-[14C]docosahexaenoic acid (22:6(n-3)), were compared with [3H]arachidonic acid (20:4(n-6] and [14C]linoleic acid (18:2(n-6)) to characterize their incorporation into the lipids of Ehrlich ascites cells. The relatively rapid incorporation of the labeled 22-carbon acids into phosphatidic acid indicated that substantial amounts of these acids may be incorporated through the de novo pathway of phospholipid synthesis. In marked contrast to 20:4(n-6), the 22-carbon acids were incorporated much less into choline glycerophospholipids (CGP) and inositol glycerophospholipids (IGP). No selective preference was apparent for the (n-3) or (n-6) type of fatty acids. The amounts of the acids incorporated into diacylglycerophosphoethanolamine were in the order of: 22:6(n-3) greater than 20:4(n-6) much greater than 22:5(n-3) greater than or equal to 22:4(n-6) greater than 18:2(n-6), whereas for alkylacylglycerophosphoethanolamine they were in the order of: 22:4(n-6) greater than 22:6(n-3) greater than 22:5(n-3) much greater than 20:4(n-6) greater than 18:2(n-6). Of the mechanisms possibly responsible for the selective entry of 22 carbon acids into ethanolamine glycerophospholipids, the most reasonable explanation was that the cytidine-mediated ethanolamine phosphotransferase may have a unique double selectivity: for hexaenoic species of diacylglycerol and for 22-carbon polyunsaturated fatty acid-containing species of alkylacylglycerol. The relative distribution of fatty acids between newly incorporated and already maintained lipid classes suggested that IGP may function in Ehrlich cells as an intermediate pool for the retention of polyunsaturated fatty acids in glycerolipids. PMID- 3559381 TI - Identification of unconjugated bile acids in human bile. AB - Unconjugated bile acids in the bile of healthy and diseased humans were determined qualitatively and quantitatively by means of gas-liquid chromatography and gas-liquid chromatography-mass spectrometry, after their isolation by ion exchange chromatography. In a healthy person and three patients with cholelithiasis, unconjugated bile acids comprised 0.1-0.4% of total biliary bile acids. The bile acid composition of the unconjugated fraction was quite different from that of the glycine- or taurine-conjugate fraction, in that it contained a relatively large proportion of unusual bile acids including C23 and C27 bile acids. In two patients with cerebrotendinous xanthomatosis, C22 and C23 bile acids were the major constituents of the biliary unconjugated bile acids, and comprised about 0.8% of total bile acids; no detectable amounts of C27 bile acids were found in their bile. The analysis of biliary unconjugated bile acids may be useful for the diagnosis of metabolic diseases concerning bile acids, particularly the accumulation or disappearance of unusual bile acids. PMID- 3559382 TI - ApoA-IV metabolism in the rat: role of lipoprotein lipase and apolipoprotein transfer. AB - Factors influencing the association of apoA-IV with high density lipoproteins (HDL) were investigated by employing a crossed immunoelectrophoresis assay to estimate the distribution of rat plasma apoA-IV between the lipoprotein-free and HDL fractions. Incubation of rat plasma at 37 degrees C resulted in the complete transfer of lipoprotein-free apoA-IV to HDL within 45 min. When plasma obtained from fat-fed rats was incubated at 37 degrees C in the presence of postheparin plasma as a source of lipolytic activity, there was a complete transfer of HDL apoA-IV to the lipoprotein-free fraction within 30 min. With extended incubation (120 min), lipoprotein-free apoA-IV began to transfer back to HDL. Similar patterns of apoA-IV redistribution were seen when plasma from fat-fed rats was incubated with postheparin heart perfusate or was perfused through a beating heart. Incubations conducted with plasma obtained from fasted rats showed similar but markedly attenuated apoA-IV responses. Similar observations were found in vivo following intravenous heparin administration. To determine whether the transfer of apolipoproteins from triglyceride-rich lipoproteins to HDL was partially responsible for the lipolysis-induced redistribution of apoA-IV, purified apoA-I, apoE, and C apolipoproteins were added to plasma from fasted rats. When added to plasma, all of the apolipoproteins tested displaced apoA-IV from HDL in a dose-dependent manner. Conversely, apolipoproteins were removed from HDL by adding Intralipid to plasma from fasted rats. With increasing concentrations of Intralipid, there was a progressive loss of HDL apoC-III and a progressive increase in HDL apoA-IV. Intravenous injection of a bolus of Intralipid to fasted rats resulted in a transient decrease of HDL apoC-III and concomitant increase in HDL apoA-IV. From these studies, we conclude that the binding of apoA-IV to HDL is favored under conditions that result in a relative deficit of HDL surface components, such as following cholesterol esterification by LCAT or transfer of apolipoproteins to nascent triglyceride-rich lipoproteins. PMID- 3559383 TI - Hepatocellular triglyceride synthesis and transfer to lipid droplets and nascent very low density lipoproteins. AB - The transfer of triglyceride from sites of synthesis in the endoplasmic reticulum to cytoplasmic lipid droplets and nascent VLDL (very low density lipoproteins) in rat liver in vivo has been examined with [3H]glycerol, cell fractionation, and electron microscopy. Rates of mass transfer of newly synthesized triglyceride were estimated from the specific radioactivity of triglyceride present in microsomal membranes and the radioactivity observed in recipient triglyceride pools. Fasting decreased the transfer of triglyceride to nascent VLDL without affecting transfer to lipid droplets. Stimulation of triglyceride synthesis with 2-tetradecylglycidic acid (TDGA) increased transfer of triglyceride to nascent VLDL 5-fold, and to lipid droplets 14-fold, 1 hr after TDGA administration. Triglyceride transfer to nascent VLDL was increased 6-fold, and to lipid droplets 37-fold, above control rates 6 hr following TDGA treatment, indicative of saturation of triglyceride assembly into nascent VLDL and storage of excess triglyceride in lipid droplet reservoirs. These liver triglyceride pools were concurrently expanded and electron microscopy demonstrated more abundant VLDL particles in the endoplasmic reticulum together with a proliferation of lipid droplets in hepatocytes. TDGA progressively decreased hepatic sn-glycerol-3 phosphate in fasting rats while triglyceride synthesis increased, indicating that sn-glycerol-3-phosphate does not limit the rate of triglyceride synthesis in this metabolic state. Results implicate triglyceride transfer from endoplasmic reticulum membranes to nascent VLDL as a regulated determinant of hepatic VLDL assembly and VLDL triglyceride secretion in vivo. PMID- 3559384 TI - Isolation and identification of 1(3),2-diacylglyceryl-(3)-O-4'-(N,N,N trimethyl)homoserine from the soil amoeba, Acanthamoeba castellanii. AB - A polar lipid accounting for 12.5% of the total lipid nitrogen has been isolated from the protozoan Acanthamoeba castellanii. On the basis of thin-layer chromatography and mass spectral analysis, the lipid has been identified as diacylglyceryltrimethylhomoserine (DGTS). Fast atom bombardment (FAB) mass spectra of DGTS are reported for the first time and are compared to the FAB mass spectra of phosphatidylcholines and the electron ionization (EI) and field desorption (FD) mass spectra of DGTS. Gas-liquid chromatographic-mass spectrometric (GLC-MS) analysis of the acyl chain composition of this lipid has shown that 87.5% consists of cis-9-octadecenoic acid. Plasma membrane isolated from this organism has shown that labeled DGTS appears in the plasma membrane but is not enriched in this fraction. DGTS has been isolated previously only from a limited number of green plants and one species of fungus. Identification of this lipid in Acanthamoeba indicates that this lipid is distributed among a diverse group of lower eucaryotes. PMID- 3559385 TI - Regulation of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and cholesterol biosynthesis by oxylanosterols. AB - Treatment of rat intestinal epithelial cell cultures with the oxidosqualene cyclase inhibitor, 3 beta-[2-(diethylamino)-ethoxy]androst-5-en-17-one (U18666A), resulted in an accumulation of squalene 2,3:22,23-dioxide (SDO). When U18666A was withdrawn and the cells were treated with the sterol 14 alpha-demethylase inhibitor, ketoconazole, SDO was metabolized to a product identified as 24(S),25 epoxylanosterol. To test the biological effects and cellular metabolism of this compound, we prepared 24(RS),25-epoxylanosterol by chemical synthesis. The epimeric mixture of 24,25-epoxylanosterols could be resolved by high performance liquid chromatography on a wide-pore, non-endcapped, reverse phase column. Both epimers were effective suppressors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase activity of IEC-6 cells. The suppressive action of the natural epimer, 24(S),25-epoxylanosterol, but not that of 24(R),25-epoxylanosterol could be completely prevented by ketoconazole. IEC-6 cells could efficiently metabolize biosynthetic 24(S),25-epoxy[3H]anosterol mainly to the known reductase-suppressor 24(S),25-epoxycholesterol. This metabolism was substantially reduced by ketoconazole. These data support the conclusion that 24(S),25-epoxylanosterol per se is not a suppressor of HMG-CoA reductase activity but is a precursor to a regulatory oxysterol(s). It has recently been reported that 25-hydroxycholesterol can occur naturally in cultured cells in amounts sufficient to effect regulation of HMG-CoA reductase (Saucier et al. 1985. J. Biol. Chem. 260: 14571-14579). In order to investigate the biological effects of possible precursors of 25 hydroxycholesterol, we chemically synthesized 25-hydroxylanosterol and 25 hydroxylanostene-3-one. Both oxylanosterol derivatives suppressed cellular sterol synthesis at the level of HMG-CoA reductase. U18666A had the unusual effect of potentiating the inhibitory effect of 25-hydroxylanostene-3-one but did not influence the effect of other oxylanosterols. All the oxylanosterols, with the exception of 25-hydroxylanostene-3-one, enhanced intracellular esterification of cholesterol. The foregoing observations support consideration of oxylanosterols as playing an important role in the biological formation of regulatory oxysterols that modulate sterol biosynthesis at the level of HMG-CoA reductase. PMID- 3559386 TI - Effect of ethanolamine on choline uptake and incorporation into phosphatidylcholine in human Y79 retinoblastoma cells. AB - The effect of physiological concentrations of ethanolamine on choline uptake and incorporation into phosphatidylcholine was investigated in human Y79 retinoblastoma cells, a multipotential, undifferentiated retinal cell line that has retained many neural characteristics. These cells have a high-affinity uptake system for choline, and the majority of the choline taken up was incorporated into phosphatidylcholine via the CDP-choline pathway. The presence of extracellular ethanolamine significantly decreased high-affinity choline uptake and, subsequently, the amount of choline incorporated into phosphatidylcholine. When 100 mumol/L ethanolamine was added, there was a decrease of about 8% in the phosphatidylcholine content. Ethanolamine had no effect on choline incorporation into phosphatidylcholine, however, once choline was taken up by the cell. The K'M and V'max for high-affinity choline uptake was increased from 0.93 to 9.74 microM and 19.60 to 79.25 pmol/min per mg protein, respectively, by the presence of 25 mumol/L ethanolamine. In contrast, 25 mumol/L choline had no effect on the kinetic parameters of high-affinity ethanolamine uptake. Therefore, the reduction in high-affinity choline transport by ethanolamine apparently is not simply due to competitive inhibition. 2,2-Dimethylethanolamine and 2-methylethanolamine both reduced choline uptake to a greater extent than ethanolamine. However, because these compounds exist at much lower concentrations than ethanolamine, they probably have little physiological influence. These results suggest that changes in ethanolamine concentration within the physiologic range can regulate the synthesis and content of phosphatidylcholine in a neural cell by influencing the uptake of choline. PMID- 3559387 TI - Conformation of the oleate chains in crystals of cholesteryl oleate at 123 K. AB - At 123 K, crystals of cholesteryl cis-9-octadecenoate (cholesteryl oleate, C45H78O2) are monoclinic, space group P2(1) with unit cell dimensions a = 12.356(2), b = 8.980(3), c = 18.382(2) A, beta = 85.49(2) degrees, and have two molecules in the unit cell. The crystal structure including all H atoms has been determined from 3812 independent X-ray reflections with sin theta/lambda less than 0.61 A-1 and refined to give Rw = 0.08. At 123 K, the crystal structure consists of an antiparallel efficient packing of cholesteryl ring systems to form layers that are very similar to those observed in the room temperature structure. The oleate chains that protrude from these layers have a somewhat different packing arrangement from the room temperature structure because they have undergone a conformational change. At 123 K, the oleate chains are well ordered and are almost fully extended except for a kink at the cis double bond. The oleate chains at 123 K are 1.7 A longer than at 295 K due in part to an uncoiling whereby their helical character is lost. On cooling, there is a substantial change in the unit cell beta-angle from obtuse (93.3 degrees) to acute (85.5 degrees) which involves a shearing motion of 2.5 A between adjacent molecular layers. Cell dimension measurements at 10 temperatures in the range 295 K to 123 K show that much of the change occurs in two narrow ranges centered at 262 K and 215 K. PMID- 3559388 TI - Determination of deoxycholic acid pool size and input rate using [24 13C]deoxycholic acid and serum sampling. AB - We have developed an isotope dilution method for determination of deoxycholic acid pool size and input rate which employs oral administration of 50 mg of [24 13C]deoxycholic acid and serum sampling. The method has been validated by classical isotope dilution technique using [24-14C]deoxycholic acid and bile sampling in five patients with colonic adenomas. Excellent agreement between pool sizes and input rates determined with 13C/12C isotope ratio measurements in serum and 14C measurements in bile was obtained when isotope ratios were measured in the conjugated fraction of deoxycholic acid in serum. We conclude that pool size and input rate of deoxycholic acid can accurately be determined by blood sampling after oral administration of [24-13C]deoxycholic acid, therewith eliminating the use of radioactive tracers and the need for bile sampling. PMID- 3559389 TI - Modifications of plasma lipoproteins after lipase activation in patients with chylomicronemia. AB - Lipoprotein lipase (LPL) and hepatic lipase (HL) are enzymatic activities involved in lipoprotein metabolism. The purpose of this study was to analyze the physicochemical modifications of plasma lipoproteins produced by LPL activation in two patients with apoC-II deficiency syndrome and by HL activation in two patients with LPL deficiency. LPL activation was achieved by the infusion of normal plasma containing apoC-II and HL was released by the injection of heparin. Lipoproteins were analyzed by ultracentrifugation in a zonal rotor under rate flotation conditions before and after lipase activation. The LPL activation resulted in: a reduction of plasma triglycerides; a reduction of fast-floating very low density lipoprotein (VLDL) concentration; an increase of intermediate density lipoprotein (IDL), which maintained unaltered flotation properties; an increase of low density lipoproteins (LDL) accompanied by modifications of their flotation rates and composition; no significant variations of high density lipoprotein (HDL) levels; and an increase of the HDL flotation rate. The HL activation resulted in: a slight reduction of plasma triglycerides; a reduction of the relative triglyceride content of slow-floating VLDL, IDL, LDL2, and HDL3 accompanied by an increase of phospholipid in VLDL and by an increase of cholesteryl ester in IDL; and a reduction of the HDL flotation rate. These experiments in chylomicronemic patients provide in vivo evidence that LPL and HL are responsible for plasma triglyceride hydrolysis of different lipoproteins, and that LPL is particularly involved in determining the levels and physicochemical properties of LDL. Moreover, in these patients, the LPL activation does not directly change the HDL levels, and LPL or HL does not produce a step-wise conversion of HDL3 to HDL2 (or vice versa) but rather modifies the flotation rates of all the HDL molecules present in plasma. PMID- 3559390 TI - Role of triglyceride-rich lipoproteins and hepatic lipase in determining the particle size and composition of high density lipoproteins. AB - These studies examined the proposition that the small particle size of HDL3 in the plasma of hypertriglyceridemic subjects is the consequence of the sequential actions of lipid transfer protein and hepatic lipase on HDL. Incubation of unmodified total HDL or HDL3 in the presence of hepatic lipase resulted in a depletion of phospholipid, but little change in the size of the particles. On the other hand, HDL3 that had first been depleted of cholesteryl ester and enriched with triglyceride and phospholipid, during prior incubation with Intralipid and a source of lipid transfer protein, were much more susceptible to the action of hepatic lipase. When these modified HDL3 were incubated with hepatic lipase there was a depletion of the triglyceride and phospholipid content and a conversion into much smaller particles the same size as those predominant in hypertriglyceridemic subjects. These very small particles were derived from a population of modified particles that were larger than the original HDL3 and were within the size range of HDL2. It is proposed, therefore, that in the plasma of hypertriglyceridemic subjects there exists a dynamic balance between the formation of enlarged triglyceride-rich HDL and a secondary conversion of these particles by hepatic lipase to form populations of very small HDL. PMID- 3559391 TI - In vivo evaluation of cholesterol 7 alpha-hydroxylation in humans: effect of disease and drug treatment. AB - 7 alpha-Hydroxylation of cholesterol is a stereospecific reaction consisting of the replacement of the 7 alpha-hydrogen with a hydroxyl group. When cholesterol labeled with tritium at the 7 alpha position is administered, the hydroxylation of the substrate will result in the loss of tritium which in turn will label the body water. The rate of tritium enrichment of the body water could thus give a quantitative estimate of the hydroxylation rate. This study describes the validation of the procedure with some 21 studies performed on 15 subjects in different conditions. [7 alpha-3H]cholesterol was administered intravenously in 50 ml of plasma and thereafter blood was sampled at timed intervals for 4 to 5 days. The rate of the hydroxylation of cholesterol was calculated from the time course of the specific activities of plasma cholesterol and body water after tracer administration and was expressed as 7 alpha-hydroxycholesterol formed/24 hr. Calculated values of hydroxylation in three control subjects (493 +/- 206), five patients with hyperlipoproteinemia (539 +/- 168), and seven cirrhotic patients (153 +/- 136) are in good agreement with figures reported for bile acid synthesis determined with other techniques. Cholesterol 7 alpha-hydroxylation rate is reduced in patients with cirrhosis, the impairment being related to the severity of the disease. Cholestyramine administered to one subject for 4 weeks produced a threefold increase of the hydroxylation. Administration of chenodeoxycholic acid resulted in a 50% decrease, whereas that of ursodeoxycholic did not produce consistent changes of the hydroxylation rate. The results support the current view that 7 alpha-hydroxylation of cholesterol is rate-limiting in the synthesis of bile acids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559392 TI - Characterization of inositol lipids from Leishmania donovani promastigotes: identification of an inositol sphingophospholipid. AB - Inositol lipids account for 15% of the total cellular phospholipids of Leishmania donovani promastigotes. Four major inositol lipids were identified and characterized: phosphatidylinositol (PI), phosphatidylinositol phosphate (PI-P), phosphatidylinositol diphosphate (PI-P2), and an inositol sphingophospholipid (InSL). Diacyl and alkyl acyl PI were identified. The major esterified fatty acids of PI, PI-P, and PI-P2 were similar and unlike those of mammalian inositol glycerolipids. Leishmania inositol glycerolipids contained only trace amounts of arachidonic acid; the major species were C16 and C18 acids. The InSL comprised about 40% of the inositol lipids. The amide-linked fatty acids of InSL were mainly C16 and C18 acids. Differential hydrolysis and nuclear magnetic resonance spectrometry indicated that the InSL had a phosphoryl bond. The major long chain bases of the InSL were identified by gas-liquid chromatography and high resolution mass spectrometry as straight chain C16 and C18 sphingosines. The finding of InSL in Leishmania is of interest because InSL have previously been found only in plants and fungi. Metabolic radiolabeling experiments suggest that this lipid may be a precursor of an antigenic cell surface membrane lipophosphoglycan which is shed into the culture medium by the organism. PMID- 3559393 TI - Lecithin:cholesterol acyltransferase-induced modifications of liver perfusate discoidal high density lipoproteins from African green monkeys. AB - The role of lecithin:cholesterol acyltransferase (LCAT) in the formation of plasma high density lipoproteins (HDL) was studied in a series of in vitro incubations in which perfusates from isolated African green monkey livers were incubated at 37 degrees C with partially purified LCAT for between 1 and 13 hr. The HDL particles isolated from monkey liver perfusate stored at 4 degrees C and not exposed to added LCAT contained apoA-I and apoE, were deficient in neutral lipids, and were observed by electron microscopy as discoidal particles. Particle sizes, measured as Stokes' diameters by gradient gel electrophoresis (GGE), ranged between 7.8 nm and 15.0 nm. The properties of perfusate HDL were unchanged following incubation at 37 degrees C in the presence of an LCAT inhibitor. However, HDL subfractions derived from incubations at 37 degrees C with active LCAT contained apoA-I as the major apoprotein, appeared round by electron microscopy, and possessed chemical compositions similar to plasma HDL. The HDL isolated from perfusate incubations at 37 degrees C with low amounts of LCAT had a particle size and chemical composition similar to plasma HDL3a. In three of four perfusates incubated with higher levels of LCAT activity, the HDL products consisted of two distinct HDL subpopulations when examined by GGE. The major subpopulation was similar in size and composition to plasma HDL2a, while the minor subpopulation demonstrated the characteristics of plasma HDL2b. The data indicate that the discoidal HDL particles secreted by perfused monkey livers can serve as precursors to three of the major HDL subpopulations observed in plasma. PMID- 3559394 TI - Identification of new bile alcohols, 5 beta-cholestane-3 alpha,7 alpha,24,26 tetrol, 5 beta-cholestane-3 alpha,7 alpha,25,26-tetrol, and 5 beta-cholestane-3 alpha,7 alpha,26,27-tetrol in human gallbladder bile. AB - The nature of cholestanetetrols present as the glucurono-conjugates in human gallbladder bile was studied. Glucurono-conjugated bile alcohols were isolated by ion exchange chromatography and, after enzymatic hydrolysis, were fractionated by reversed phase partition chromatography to give a fraction containing tetrahydroxy bile alcohols which was analyzed by gas-liquid chromatography and mass spectrometry. Along with the three previously identified bile alcohols, 5 alpha- and 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,24-tetrols, and 5 beta cholestane-3 alpha, 7 alpha, 12 alpha,26-tetrol, three new cholestanetetrols, possessing two hydroxyl groups in the ring system and two in the side chain, were detected in the tetrahydroxy bile alcohol fraction. These new bile alcohols were identified as 5 beta-cholestane-3 alpha, 7 alpha,24,26-tetrol, 5 beta-cholestane 3 alpha, 7 alpha,25,26-tetrol, and 5 beta-cholestane-3 alpha, 7 alpha,26,27 tetrol by direct comparison of their gas-liquid chromatographic behaviors and mass spectral data with those of authentic standards prepared from chenodeoxycholic acid by partial synthesis. PMID- 3559395 TI - Preparative electrophoresis of human apolipoprotein E: an improved method. AB - Apolipoprotein E was isolated from human very low density lipoproteins by a two step electrophoretic procedure derived from that of Mendez (1982. Anal. Biochem. 126: 403-408). It included separation in a sodium dodecylsulfate polyacrylamide slab gel, transfer into an agarose gel, and extraction by ultracentrifugation for 30 min. No protein labeling, dialysis, or concentration procedures were needed. The method was fast, showed an excellent protein recovery, and could be suitable as a general method of protein isolation by polyacrylamide gel electrophoresis. PMID- 3559396 TI - Configuration at C-25 in 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25,26-pentol excreted by patients with cerebrotendinous xanthomatosis: circular dichroism and 13C-NMR studies. AB - The configuration at C-25 in 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,25,26 pentol isolated from the bile and feces of patients with cerebrotendinous xanthomtosis (CTX) was determined from the lanthanide-induced circular dichroism (CD) Cotton effects and 13C-NMR measurements. Under anhydrous conditions, CD spectra of 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,25,26-pentol in the presence of Eu(fod)3 exhibited a large induced negative Cotton effect at 320 nm. On the basis of the empirical rule (primary-tertiary-alpha-diols) in which R compounds have positive Cotton effects and S compounds have negative Cotton effects at 320 nm, it was concluded that 25,26-pentol has the 1,2,glycol structure with C-25 having the S-configuration. This assignment was based upon comparison with model compounds, 25(R and S),26-dihydroxy cholesterols and 25(R and S),26-dihydroxy cholecalciferols whose single-crystal X-ray structure and 13C NMR studies have been performed. It is suggested that these data may be helpful to clarify the stereospecificity of the hydroxylation of the terminal methyl group of the cholesterol side chain in CTX. PMID- 3559397 TI - Effects of synthetic glycosides on steroid balance in Macaca fascicularis. AB - The predominantly beta-anomer of diosgenin glucoside (DG) was synthesized and its effects on cholesterol homeostasis were tested in monkeys. Cynomolgus macaques (Macaca fascicularis) were fed, during two 3-week periods, a semipurified diet with 0.1% cholesterol and a similar ration containing 1% DG, respectively. A Chow diet was given for 5 weeks between the experimental periods. Cholesterol and bile acid balance were analyzed during the last week of each semipurified diet. Diosgenin glucoside reduced cholesterolemia from 292 mg/dl to 172 mg/dl, decreased intestinal absorption of exogenous cholesterol from 62.4% to 26.0%, and increased secretion of endogenous cholesterol from -0.8 to 93.5 mg/day. The fecal excretion of neutral steroids rose from 40.7 to 157.3 mg/day; that of bile acids changed, nonsignificantly, from 23.1 to 16.0 mg/day. The cholesterol balance was 44 mg/day in the control period, and 88 mg/day in the DG-fed animals. No toxic signs were observed. Thus, when long-term studies demonstrate that the glucoside is well tolerated, DG and other synthetic glycosides with similar activities may be of use in the management of hypercholesterolemia and atherosclerosis. PMID- 3559398 TI - Vulpecholic acid (1 alpha, 3 alpha, 7 alpha-trihydroxy-5 beta-cholan-24-oic acid): a novel bile acid of a marsupial, Trichosurus vulpecula (Lesson). AB - A novel trihydroxylated C24 bile acid was isolated from the gallbladder bile of the Australian opossum, Trichosurus vulpecula (Lesson). This acid, for which the name vulpecholic acid is proposed, was identified as 1 alpha, 3 alpha, 7 alpha trihydroxy-5 beta-cholan-24-oic. The structure proof included mass spectral and 1H and 13C nuclear magnetic resonance characterization of all crucial derivatives obtained by: oxidation of the methyl ester to a triketone with the enolizable 1,3 diketone function; methylation of this triketone to two isomeric methyl enol ethers; and reductive removal of oxygen functions from this triketone to give 5 beta-cholan-24-oic and 7-oxo-5 beta-cholan-24-oic acids. Vulpecholic acid was found in the bile in the unconjugated form; it accounted for more than 60% of the solid bile material. The marsupial T. vulpecula is the first example of a mammal secreting a 1 alpha-hydroxylated bile acid as well as the first example of a mammal secreting the major bile acid in a free form. PMID- 3559399 TI - Role of receptor-independent low density lipoprotein transport in the maintenance of tissue cholesterol balance in the normal and WHHL rabbit. AB - These studies were undertaken to determine the role of receptor-independent low density lipoprotein (LDL) transport in cholesterol balance across individual tissues and the whole animal. Homologous LDL, which measures total LDL transport, and methylated heterologous LDL, which measures receptor-independent LDL uptake, were cleared from the plasma at very different rates in the NZ control rabbit (3,900 and 1,010 microliter/hr per kg, respectively) whereas in the WHHL rabbit both preparations were cleared at essentially the same rate (approximately 1,070 microliter/hr per kg). Receptor-independent LDL clearance was detected in all tissues of the NZ control rabbit and these varied from 32 (spleen) to less than 0.5 (skeletal muscle) microliter/hr per g. In contrast, receptor-dependent LDL uptake was found in only about half of these same organs. In the WHHL rabbit, the rates of receptor-independent LDL transport were the same as in the NZ control rabbit, but no receptor-dependent uptake was detected. Using these clearance values it was calculated that in the control rabbit nearly 70% of LDL-cholesterol was removed from the plasma by the liver and 89% of this was receptor-mediated. With loss of receptor activity, however, the burden of LDL degradation was shifted away from the liver so that approximately 70% of LDL-cholesterol uptake took place in the extra-hepatic tissues of the WHHL rabbit. Thus, in the normal animal, the primary function of receptor-dependent LDL transport is to promote the rapid uptake and disposal of plasma LDL by the liver. In the absence of such receptor activity, cholesterol balance across most individual organs and the whole animal remains essentially normal and is mediated by the receptor independent process. Because of the much lower absolute clearance rates manifested by this transport mechanism, however, substantial and predictable elevations in the circulating plasma LDL-cholesterol levels are required to maintain this balance. PMID- 3559400 TI - Effect of dietary n-3 fatty acids on HMG-CoA reductase and ACAT activities in liver and intestine of the rabbit. AB - The regulation of hepatic and intestinal 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase and acyl-CoA; cholesterol acyltransferase (ACAT) activities by dietary fish oil was examined in the rabbit. Rabbits were fed 10% menhaden oil or menhaden oil plus 1% cholesterol for 14 days. They were compared with animals fed a control diet or one enriched with long-chain saturated fats consisting of 10% cocoa butter oil or cocoa butter oil plus 1% cholesterol. Plasma cholesterol was increased in rabbits fed the fish oil and the two cholesterol-containing diets. In the liver, ACAT activity was increased and HMG-CoA reductase activity was decreased in rabbits ingesting the fish oil. The same was true for animals ingesting both cholesterol-containing diets. In the intestine, ACAT activity was not affected by the ingestion of the fish oil compared to control rabbits; however, it was significantly higher in animals fed the fish oil compared to animals ingesting the cocoa butter. HMG-CoA reductase activity was decreased in the distal two-thirds of the intestine in animals fed the menhaden oil compared to activities observed in controls. In animals ingesting the cholesterol diets, intestinal reductase was significantly decreased, whereas intestinal ACAT activity was increased in rabbits ingesting the cocoa butter and cholesterol diet when compared to their controls. Lipid analysis of hepatic and intestinal microsomes demonstrated an enrichment of n-3 polyunsaturated fatty acids in membranes from rabbits ingesting the menhaden oil.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559402 TI - Commensurate molecules in isostructural crystals of cholesteryl cis- and trans-9 hexadecenoate. AB - At 295 K, crystals of form I of cholesteryl cis-9-hexadecenoate (palmitoleate) and cholesteryl trans-9-hexadecenoate (palmitelaidate) are difficult to distinguish by X-ray diffraction. Both form monoclinic thin plates, space group P21 with two molecules (C43H74O2) A and B in the asymmetric unit. Unit cell dimensions for cholesteryl palmitelaidate (I) are a = 12.827(4), b = 9.075(4), c = 35.67(1) A, beta = 93.42(3) degrees, very similar to those of the palmitoleate crystals. Other crystals (form II) of the palmitelaidate ester are described. The crystal structure of form I of cholesteryl palmitelaidate has been determined from 3657 reflections (sin theta/lambda less than 0.46 A-1) measured at 295 K using CuK alpha X-radiation and refined to give Rw(F) = 0.095. The molecular packing arrangement is isostructural to that of the previously determined crystal structure of cholesteryl palmitoleate. In both crystals, the fatty acid chains of the A molecules are kinked at the double bond but are nearly straight. The chains of B molecules have more complicated dislocations and are bent. It is remarkable that, neglecting their detailed conformations, corresponding fatty acid chains in the two crystal structures have similar overall shapes, although palmitoleate chains have cis-ethylenic groups and palmitelaidate chains have trans groups. PMID- 3559401 TI - Characterization of the estrogen-induced lipoprotein receptor of rat liver. AB - The ethinyl estradiol-induced lipoprotein receptor of rat liver was purified and characterized. Liver membranes were prepared from ethinyl estradiol-treated rats, solubilized, and subjected to DEAE chromatography. A fraction with a high specific activity for low density lipoprotein (LDL) binding was isolated and used to immunize mice. Hybridomas were prepared from their spleen cells, and a clone that secreted an IgG antibody, which cross-reacted with an ethinyl estradiol induced protein of the same molecular weight as the bovine adrenal LDL receptor, was expanded. This antibody, designated P1B3, immunoprecipitated the induced lipoprotein receptor. P1B3 was used to purify the receptor, and a polyclonal antibody was raised against the pure protein. This antibody recognized a protein of similar molecular weight in rat liver, adult dog liver, and human skin fibroblasts, thus demonstrating that the induced rat lipoprotein receptor was related to the LDL receptor of other species. This receptor is present in normal rat liver, and its content is reduced by feeding an atherogenic diet, but not by feeding a diet containing 0.5% cholesterol. Moreover, cholestyramine supplementation of the diet did not induce the receptor on liver membranes. The polyclonal antibody could prevent the binding of LDL to liver membranes from control or ethinyl estradiol-treated rats. It decreased chylomicron remnant binding to membranes from ethinyl estradiol-treated membranes, but did not affect chylomicron remnant binding to liver membranes of untreated rats, a result compatible with the existence of a distinct receptor for these latter particles. The amount of LDL receptor-independent, specific remnant binding was the same in both control and ethinyl estradiol-treated rats. This is consistent with the concept that the remnant receptor is not regulated by this treatment. Based on the above, we conclude that the ethinyl estradiol-induced lipoprotein receptor of rat liver is biochemically and immunologically similar to the LDL receptor of other species. It is present on the liver of normal adult rats and could account for LDL as well as beta VLDL and HDLc removal. Although it may contribute to chylomicron remnant removal, there appears to be a second unrelated receptor or process which recognizes this lipoprotein. PMID- 3559403 TI - Interaction of Tangier lipoproteins with cholesteryl ester-laden mouse peritoneal macrophages. AB - Cholesterol efflux was studied from cholesteryl esterladen mouse peritoneal macrophages in the presence of Tangier lipoproteins derived from fasting and postprandial sera of three patients homozygous for Tangier disease (analphalipoproteinemia). The d greater than 1.063 g/ml fractions isolated from fasting patients and 3 hr and 18 hr after an oral fat load were all effective in cellular cholesterol removal. By contrast, the d greater than 1.063 g/ml fractions isolated 6 hr and 12 hr after fat ingestion did not affect net removal of cellular cholesterol. The d greater than 1.21 g/ml protein fractions derived from fasting as well as postprandial sera were all effective in removing cholesterol. D 1.063-1.21 g/ml fractions from fasting Tangier patients contained HDLT. In the corresponding postprandial fractions, in addition to HDLT, apoB-100- and apoB-48-containing lipoproteins were present. Furthermore, the 6 hr and 12 hr postprandial Tangier HDL fractions contained apoB-immunoreactive proteins of lower molecular weight. The abnormal activity of the elastase/alpha 1-antitrypsin proteolytic system and the abnormal fibronectin concentration we found in Tangier plasma suggests a possible relationship to the in vivo degradation of apoB. The peculiar type of membrane-bound lipid droplets in Tangier splenic macrophages points to a lipoprotein source of lipid accumulation which possibly originates from the uptake of chylomicrons or chylomicron-derived particles. It is concluded that cholesteryl ester storage in Tangier macrophages results from an imbalance of cholesterol influx and efflux. In the absence of HDL, the net increase of cholesterol caused by abnormal lipoproteins in certain postprandial states cannot be fully compensated by effective efflux and ultimately leads to macrophage cholesteryl ester accumulation. PMID- 3559404 TI - [Modification of the level of adenosine triphosphate in digital pulp capillary blood in patients with microcirculatory disorders following i.v. injection of coenzyme A (CoA 1000)]. AB - Capillary blood ATP assay was performed in 2 groups of patients (diabetic and non diabetic) with disorders of microcirculation, before and several minutes after 2 mg I.V. of Coenzyme A (CoA 1000). Values obtained showed a significant increase in both groups. The hypothesis advanced, based on previous experimental data indicating an action of CoA on intracellular calcium movement, is that CoA 1000 acts by elevation of the membrane ATP/Ca+ ratio of red corpuscles, and possible activation of their deformability and flow rate in the microcirculation. PMID- 3559405 TI - [Hemorheologic study of different forms of vasomotor acrosyndromes]. AB - Hemorheologic disorders are a frequent finding in circulating blood during vascular diseases (arterial disease of lower limb, cerebrovascular accidents). They participate in thrombogenesis and tissue ischemia production, and also in microcirculatory disturbances as shown by behavior in microvessels of red cells with decreased hereditary deformability (sickle cell anemia). Active alterations in erythrocyte rheology have also been demonstrated during vascular diseases in relation to inflammation: cell-protein inflammatory reaction, action of leukocytes. Therapy should be adapted for these microcirculatory disorders by suitable specific clinical trials. PMID- 3559406 TI - [Foreign bodies in the body following vascular surgery (11 cases)]. AB - Eleven cases of foreign body (F.B.) (3 autochthonous and 8 of other sources) demonstrate the rarity but also the persistent reality of these accidents. Incidence between 1970 and 1985 was close to one F.B. per 3,000 vascular procedures. In 4 cases the F.B. followed surgical non-reconstructive surgery and in the other 7 cases revascularization procedure, material involved being most often textile, sponges in 7 cases and towel in one case. Circumstances leading to let F.B., without disculpating the surgeon, included long and difficult operations conducted as emergencies or requiring one or more recovery operations. Clinical findings of the F.B. were of post-operative sepsis (10 cases) of varied clinical expression. General (4 cases of septicemia) and local (3 thrombosis, 1 anastomotic hemorrhage) consequences were serious. Prognosis in patients with F.B. closely follows that of vascular sepsis, with maximum seriousness after bifurcated prosthetic shunt. An essential prognostic factor is early diagnosis of F.B.: it is dependent on a series of clinical and paraclinical etiologic arguments, particularly results of radiography of the operated zone, fistulography and echography. Surgical intervention is a function of initial operation and is that proposed for all cases of vascular sepsis, with the common denominator of the total revision of the operated zone and removal of foreign bodies. Prophylaxis of F.B. in vascular surgery follows the rules for general surgery; these have been enounced for the last 50 years but have failed to prevent the postoperative F.B. This rare but always possible accident justifies its knowledge by even the most serious, experienced vascular surgeon. PMID- 3559407 TI - [Hemangioendothelioma of the supraclavicular fossa associated with multifocal emboli. Apropos of a case]. AB - An adult with hemangioendothelioma of right supraclavicular fossa presented with a history of recurrent emboli of fingers and more particularly of occipital lobe. The mechanism of origin of these emboli from this pseudo-tumor is discussed and related to a possible development from a post-traumatic hematoma. PMID- 3559409 TI - [Scintigraphic study (81mKr) of venous return activation using intravenous dihydroergotamine]. AB - We study by 81mKr radionuclide phlebography 13 normal lower limbs and 22 limbs suffering from sequelae of deep vein thrombosis. We assess the spontaneous venous return and the effect of an intravenous injection of 0.5 mg dihydroergotamine (DHE), a powerful venoconstrictor agent. The phlebograms are analysed on a morphological basis. Dynamic data are also collected: the delay of arrival of the radioactivity at the groin and the regional radioactivity level at steady state (during the steady 81mKr perfusion). This segmental radioactivity is a positive marker of the venous stasis because it increases when the venous system dilates and when the flow goes down. It is normalized with regard to the radioactivity measured in the proximal segment (lower vena cava and proximal iliac vein). The influence of DHE on the delay of arrival of the radioactivity in the groin is variable: it is regularly and significantly shortened in the normal limbs (mean decrease of 6.5 s, table II). The segmental radioactivity is relatively low among these limbs (2.76 at the pelvic level, 9.68 at the high, tables IV and V). It drops significantly with DHE in all segments (tables IV and V: -44% in the pelvic veins, -57% in the great saphenous vein and -46% in the femoral tract). The post thrombotic limbs showing spontaneously an abnormal deep network are characterized by a high radioactivity level (total in the high: 14.25, deep system 5.70 and 8.55 in the saphenous vein, table V). This segmental total radioactivity does not decrease significantly under the influence of DHE; even more it increases in the deep tract (+24%, table V).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559408 TI - [Autologous venous graft disease. Incidence, physiopathologic aspects and therapeutic means of graft salvage]. AB - From 1980 to 1985, 134 patients with severe ischemia of lower limbs benefited from surgical recovery by inversed autologous venous graft in subarticular femoropopliteal and distal femoral position. During the 5 year follow-up period, 14 grafts (9%) developed hemodynamic degradation requiring angiographic surveillance followed by surgical repair or percutaneous dilatation. A retrospective study of evolution of venous grafts implanted in the contralateral supra-articular femoropopliteal and femoro (ilio) femoral position demonstrated a lower incidence of hemodynamic degradation (5.3%). Localizations (proximal and distal anastomotic stenosis, valvular stenosis, stenotic degradation of the donor or receiving arterial segment) and physiopathologic mechanisms (progressive atheromatosis, anastomotic or valvular fibrosis, premature atheromatosis of graft) are systematically reviewed together with results of pathology. Etiopathogenic factors invoked for this affection are discussed as a function of findings, together with choice of therapy used, including surgical repair, fibrinolysis and percutaneous dilatation. PMID- 3559410 TI - [Significance of the penile pressure index and value of the papaverine mini-test (8 mg)]. AB - The main non invasive test to quantify arteriogenic impotence is the penile blood pressure (P.B.P.I.). However, its signification is still in discussion. In this work, after discussion of the previous literature, we have revisited the P.B.P.I. signification by quoting it in comparison to the dynamic tests of erection (artificial erection, papaverine test, nocturnal penile tumescence (N.P.T.) with the findings of arteriography. A series of 51 cases having been studied with the multidisciplinary evaluation that we recommend were analyzed and compared to the location of the arterial lesions (aorto-iliac and/or internal pudendal) and to the response to the 80 mg papaverine test (rigidity and initial intracavernous flow (I.I.F.). A significant difference (p less than 0.05) for P.B.P.I. has been demonstrated between normal arteriograms and bilateral lesions. The P.B.P.I. is significantly lower when the lesions are located to the main arteries and bilateral. I.I.F. helps to differentiate hemodynamically severe arterial lesions where surgery is recommended from mild lesions where intracavernous drugs are first proposed. After discussion of the risks of the 80 mg papaverine test in unspecialized units, the authors propose a standardized method to evaluate the penile arteries, using the Doppler and the 8 mg papaverine mini-test which does not carry the risks of prolonged erection. This approach allows a precise morphologic and hemodynamic evaluation for the arterial impotence. PMID- 3559411 TI - [Exploratory hierarchy and surgical indications for carotid surgery in patients with coronary disease]. AB - The major cause of death from carotid artery surgery (1.2% in 1984 in this series) is still coronary disease and myocardial infarct. A series of 50 patients were randomly selected for detailed study of post-operative cardiologic complications and the following sequelae were noted: mortality = 1 myocardial infarct; morbidity = 1 myocardial infarct, 3 documented anginal pains, 8 repolarization disorders, 4 benign ventricular arrhythmias. Analysis of these complications and a literature review demonstrated: the high frequency of combined carotid artery and coronary artery stenosis even in asymptomatic patients (25 to 40% of cases); the elevated percentage of complications in patients with symptomatic coronary disease (mortality risk multiplied by ten), hypertension or arterial disease; the low effect of age taken alone as risk factor. Pre-operative explorations to detect angina, particularly when latent and asymptomatic, should include a questionnaire, strict patient clinical examination and detailed reading of electrocardiogram tracings. An effort test should be performed as a function of results and patients' medical history and when positive should lead to coronarography in patients under 70 in good general condition, and when doubt persists after the effort tests. The indication for surgical treatment is dependent on results of these explorations: Carotid artery surgery (stenosis with high cerebral risk) should be performed under pre- and post-operative myocardial protection in patients with coronary artery disease who are too old or inoperable for cardiac reasons. Simultaneous myocardial and cerebral revascularization in the presence of severe lesions and at equivalent risk of progression. First intention carotid artery surgery for bilateral stable lesions with subsequent simultaneous myocardial and cerebral revascularization. First intention carotid artery surgery in case of cerebral ischemia with coronary artery shunt surgery at a later stage. Improved exploration of patients and close cooperation between cardiologists, anaesthetists and surgeons should allow patients at high risk to be operated upon under improved conditions of safety. PMID- 3559412 TI - [Aneurysms of the infrarenal aorta and visceral cancer. Therapeutic problems]. AB - The association of an abdominal aortic aneurysm (AAA) and a long-standing or progressing cancer is a frequent finding: 14 cases among the 112 infrarenal aortic aneurysms treated by one of us (J.C.) are discussed in this report. The marked predominance in bronchial and ORL epithelioma (50%) is explained by the common pathogenic factors of these neoplasms and atheroma. Surgical treatment is difficult because of the potentially lethal character of the two lesions: it must allow for size and possible progressive nature of aneurysm and prognosis of the neoplasm as defined by the TNM classification. Detection of an AAA in a patient with a history of neoplasm means that the opportunity for aortic surgery is dependent of therapeutic control (or otherwise) of the neoplastic disease and therefore frequently the length of follow up period after therapy. When detection of the AAA and neoplasm is simultaneous, the aneurysm progressing or ruptured, surgical complications leave little choice with regard to operative strategy. In 3 cases, simultaneous treatment of an AAA and a neoplasm was possible, particularly in the case of Grawitz tumors of cortical development without pyelocaliceal invasion. In most patients, separate operative stages are necessary in order to ensure asepsis of AAA surgery. Aneurysmal occlusion with an extrafocal shunt can allow one-stage surgery when aneurysm and neoplasm are equally menacing. PMID- 3559414 TI - [Phosphorus-31 NMR spectrometry of the calf muscles in patients with arterial claudication. Preliminary results]. AB - Phosphorus NMR spectrometry allows non-invasive exploration in vivo of certain aspects of muscle energy metabolism. A study was conducted in 10 healthy volunteers and 12 patients with lower limb affections (stage II claudication) to define a precise methodology and to discuss perspectives offered by this new method, in the light of preliminary findings. Changes with time of amplitude of peaks of phosphocreatine (Pcr), inorganic phosphorus (Pi) and ATP, and of intracellular pH, showed that recovery of 80% of resting value of the ratio Pcr/Pi + Pcr after quantified exercise is a very discriminatory parameter correlated with severity of arteriographic findings in patients with claudication. PMID- 3559413 TI - [Partial interruption of the inferior vena cava using the 2612 filter. Apropos of 35 patients]. AB - Partial interruption of inferior vena cava (I.C.V.) forms an integral part of treatment of thromboembolic disease. The most frequently used filter worldwide is currently that of Greenfield, but although its effectiveness and permeability are remarkable it can be the subject of transfixions, sliding movements and migrations. A new model of the authors' own conception is presented which eliminates these faults. The "2612" filter is based on the same concepts, but has added to it 6 lateral flanges soldered to the base of the arms, these applying pressure to the I.V.C. and ensuring its perfect positioning, and 12 hooks (6 turned downwards and 6 upwards) ensuring perfect stability. Results of a multicentre trial in 35 patients, after insertion of the "2612" filter and follow up assessment after 3 months (28 cases) by cavography and in some patients by a scan, showed permeability of 93% and total efficacy. No side effects were reported. This filter appears to represent true progress in the means of interrupting I.V.C., and further studies are contemplated. PMID- 3559416 TI - [Buerger's disease: etiologic role of the rickettsiae?]. AB - Specific seroagglutination tests were performed in 70 patients with Buerger's disease to detect possible antibodies to rickettsia, the test being repeated in 8 cases after activation by doxycycline administration over 10 days. In 21 patients a Weil-Felix test was also carried out. Tests were assessed as positive in 44 cases (62.8%): 18 times for Rickettsia Q. 18, 14 times for Rickettsia Mooseri, 13 times for Rickettsia Burnetii, 5 times for Rickettsia Conorii and 3 times for Rickettsia Prowazekii. After activation by doxycycline the antibody titre was increased 5 times, unchanged 3 times and reduced once. The Weil-Felix gave positive results in 3 of the 21 cases (14.28%), the reaction being positive to Rickettsia Prowazekii. These findings provide supplementary arguments for a possible pathogenic role of rickettsial infection in Buerger's disease. PMID- 3559415 TI - [Transcutaneous measures of oxygen partial pressure and capillaroscopic parameters as affected by naftidrofuryl in patients with obliterative arteriopathies, Fontaine stages II-IV]. AB - Transcutaneous partial oxygen pressure on dorsum of foot was determined and capillaroscopy of big toes performed before and after infusions of naftidrofuryl (200 mg/l/h) and of 5% levulose to 30 patients with obliterative arterial disease of lower limbs, stages II to IV (10 patients in each stage). Naftidrofuryl provoked an increase in cutaneous partial oxygen pressure of 26.8 to 36.4 mm Hg (p less than 0.001) whereas no significant change was noted after 5% levulose. In addition, density of visible capillaries increased from 23.5 to 26.1/mm2 with naftidrofuryl. Severe stages of ischemia, evaluated as described by Fagrell, were improved by naftidrofuryl treatment. These findings suggest a favorable action of naftidrofuryl on cutaneous microcirculation distal to arterial obliteration at all Fontaine's stages. PMID- 3559417 TI - [Muscular fixation of thallium-201 in lower limb arteriopathies before and after injection of Royat thermal gas]. AB - Thirty patients with peripheral vascular disease (grade II) were studied by way of thallium-201 (Tl-201) muscular scan in order to assess a possible muscular effect of the Royat spa natural gas. Immediately after a 1.1 MBq/kg Tl-201 IV injection, a dynamic scintigraphic study was performed during 15 minutes in order to obtain a time-activity curve (characterized by Tmax) over the thighs, at rest. Then static anterior and posterior views were performed over thighs and calves during 4 minutes each. Perfusion ratios were calculated as thigh/knee and calf/ankle. The GE maxi 400 T gamma-camera was connected to an Informatek treatment system, zones of interest being chosen to obtain anterior and posterior thigh/knee, leg/ankle uptake ratios. Two studies were realized: the first one in basal conditions, the second one 7 days later, immediately after a s/c injection of natural gas. The later study was preceded by a static counting to subtract the residual muscular activity. After gas injection, one observed that Tmax was shorter, on the average, and that the difference between time-activity curves observed during the first study disappeared for patients with unilateral disease. A significant Tl-201 uptake increase was observed for the anterior image of the calf, while no difference was noted on posterior images, natural gas being injected on the front face of legs. This was particularly clear for patients with unilateral disease and receiving only unilateral gas injection. PMID- 3559418 TI - [Transcranial Doppler study of sylvian vascular reactivity as affected by a calcium inhibitor. Preliminary results apropos of 28 cases]. AB - The transcranial Doppler 2 MHz test, a new non-invasive investigatory method, allows direct instantaneous recording from middle cerebral artery in 96% of healthy subjects and, in contrast to classical means of measuring cerebral blood flow, the possibility of continuous monitoring of middle cerebral artery in bedridden patients or during operation. This transcranial pulsed Doppler (T.P.D.) test was used to study the effect of a calcium inhibitor, Nifedipine, on middle cerebral artery smooth muscle and its cerebrovascular effects in 28 subjects: 8 cases of hypertension, 9 of sylvian artery stenosis confirmed by arteriography (5 approximately equal to 30% and 4 greater than or equal to 50%) and 11 healthy volunteers. Recording of middle cerebral artery flow by T.P.D. was preceded by cervicocephalic continuous emission Doppler exploration (DMS, MIRA 4 MHz) and vascular echotomography (Duplex Sonedap 10 MHz). Recordings from the first segment of middle cerebral artery were obtained from a low frequency (2 MHz) and high power (maximum 350 mW) probe introduced facing squamous portion of temporal bone. Identification of this artery is dependent on its depth of access--average 5 cm--its response to homolateral carotid artery compression and the convergence of its flux towards the probe. After sublingual absorption of 2 to 3 capsules of Nifedipine, systolic and diastolic blood pressure and systolic and diastolic frequencies of middle cerebral activity were recorded regularly over 20 minutes with the patient at rest in dorsal decubitus. Variations in these parameters were considered significant when 10% or more. Criteria proposed for identification of middle cerebral artery stenosis were segmental acceleration of 3 kHz or more with or without associated turbulence (fig. 2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559419 TI - [Do arteriopathies in patients in their 50s present special characteristics?]. AB - The 50s represent a hinge age-period during which atherosclerosis is more frequent but arterial disease does not appear to present features differing from those observed in neighbouring age groups. There is of course a higher frequency of atherosclerotic lesions of other arterial territories and a fairly high incidence of diabetes. With respect to the latter disease, apart from the typical association arteritis-diabetes, some cases are simply of atherosclerosis developing at the same time as the diabetes. Arteritis of lower limbs can present as two principal types in patient in their 50s: elective aorto-iliac arterial disease similar to early onset atherosclerosis in younger patients and more diffuse forms more typical of arterial disease in the elderly. PMID- 3559420 TI - Inter- and intra-examiner reliability of motion palpation for the thoracolumbar spine. AB - An inter- and intra-examiner reliability study was conducted to determine the reliability of a standardized method of motion palpation. Eight senior students in the Palmer College Public Clinic palpated the thoracolumbar spine of 32 student volunteers. Each volunteer was palpated twice by each examiner to allow inter- and intra-examiner analysis. Each examiner had at least 1 yr of experience using the procedure. Only the most hypomobile motor unit of the spine was recorded. Analysis of the data revealed statistically significant agreement for intra-examiner reliability. Inter-examiner reliability was not statistically significant. T9-T10 was chosen significantly more often by the palpators as the most hypomobile motor unit. PMID- 3559421 TI - Anterolisthesis in the cervical spine--spondylolysis. AB - Two cases of cervical spondylolisthesis are reported, and the relevant English language literature is reviewed. Analysis of data derived from all of the cases reported revealed no statistically significant etiological or prognostic factors. The roentgenological evaluation, including associated anomalous findings, is presented. Etiological and clinical aspects of cervical spondylolisthesis are discussed. It is concluded that cervical spondylolysis is a relatively rare congenital defect. The role of manipulative therapy in the treatment of associated symptoms is discussed. PMID- 3559422 TI - Dystrophia myotonica: a case report. AB - A case study is presented to demonstrate the importance of utilizing clinical and laboratory diagnosis to confirm dystrophic disease. A review of the signs and symptoms of myotonic dystrophy is discussed, and a chiropractic approach is outlined for management of this debilitating disease. PMID- 3559423 TI - Five contributions to a philosophy of the science of chiropractic. PMID- 3559424 TI - Commentary: The future role of the chiropractor in the health care system. PMID- 3559425 TI - Chiropractic's functional integration into conventional health care: some implications. AB - Australian chiropractors have achieved functional integration into a referral network within conventional health care. In order that benefits from this achievement be maximized, one issue that needs to be addressed includes the streamlining of interprofessional referrals. Most respondents indicated that their preferred interprofessional communication pattern within this network was either by telephone or written report. Delineation of chiropractic scope of practice and/or the services available within chiropractic clinics is suggested as a means of further refining the efficiency of interprofessional referrals. Another issue to be addressed is the implementation of a rational approach when chiropractic belief and traditional medical practice are in conflict. As complementary conventional health care practitioners, chiropractors are representatives of the orthodox health care system. This paper proposes a format whereby resolution of conflicts between ascribed and perceived roles may be attempted. Evolutionary progress rather than revolutionary disruption is possible within conventional health care. PMID- 3559427 TI - Surgical treatment of varicose veins: a downward trend. PMID- 3559426 TI - Heart Month: a look at activities of the Georgia Affiliate. PMID- 3559428 TI - You and malpractice stress: V. A death in the family. PMID- 3559429 TI - The effects of excluding less than 500 gram infants on infant mortality rates in Georgia. PMID- 3559430 TI - What does alcohol consumption cost Georgia? PMID- 3559431 TI - Fifteen-year review of extracranial carotid artery injury. PMID- 3559432 TI - Progressive dyspnea and pulmonary edema in an obese somnolent man. PMID- 3559433 TI - Hospital peer review in a hostile environment. PMID- 3559434 TI - The Georgia Division enters its 41st year. PMID- 3559435 TI - The future of cardiovascular medicine. PMID- 3559436 TI - Comments on infant mortality. PMID- 3559437 TI - National Survey of Hospital Data Processing--1985. AB - The National Survey of Hospital Data Processing contains a great wealth of information that the hospitals have contributed in respect to the trends and changes that are now occurring within our hospital data-processing environment. 2 5 We wish to thank all of those hospitals that have participated in this study and have been willing to provide the kind of information that is so essential in tabulating these results. It is our hope that this report will provide some measure of return on your investment and that it will supply some answers to you as you face the difficult questions of planning and projecting for the future. A great deal more information is contained within the study, but it cannot be presented because of the sheer volume of information that remains. For this reason, the survey has been structured as an on-line database rather than a report. We ask that those who have interests in seeking more in-depth information from these files contact our publishing office so that we can advise you of ways that this information can be conveniently made available to you for your special project. There will be a follow-up report for 1986 when that database is complete. For those who wish to do longitudinal studies, a parallel volume was published in August 1985 that should provide a 4-year perspective on the field of hospital data processing. PMID- 3559438 TI - Fine detail in body surface potential maps: accuracy of maps using a limited lead array and spatial and temporal data representation. AB - In order to evaluate the accuracy with which a limited lead array can be used to estimate fine details of the thoracic distribution of cardiac potentials, we compared 192-lead body surface maps and those constructed using a subset of 32 leads. We also evaluated preservation of detail in body surface maps reconstructed following spatial and temporal data representation, a method proposed for quantitative comparison of maps. Maps were analyzed with respect to four previously reported normal map features recorded with extensive lead arrays. The maps constructed from 32 leads accurately reproduced all map features with 92% or greater accuracy. Maps constructed after spatial and temporal data representation had a reproduction accuracy of 93% and 98% respectively for two map features more than 100 microV in amplitude but accuracy with respect to the two map features less than 100 microV in amplitude was 86% and 59% respectively. The study demonstrates that a selected limited lead array permits accurate estimation of the body surface distribution of cardiac potentials even when potentials are low level or occur in regions not directly sampled by a recording electrode. To represent potentials of less than 100 microV, more coefficients would be required to permit accurate spatial and temporal representation. PMID- 3559439 TI - The normal right chest electrocardiogram. AB - Right chest leads, V3R-V7R were recorded in 109 persons (40 women, 69 men, mean age 41 years) without evidence of heart disease. An rS or rSr' configuration was found in V3R in 98% and in V4R in 91%. Secondary r waves increased in amplitude and frequency in lateral leads and were found in V7R in 65%. The r or r' waves did not exceed 5 mm in amplitude in any lead. A qS configuration was found most frequently in V6R (16%) but none had qS configuration in all leads. An r/s ratio greater than one was found in eight persons, but the ratio never exceeded 1.5. Measurements of r and S wave amplitudes and ST-segment deviations in V4R in a 45 degree sitting position including deep inspiration and expiration did not change the amplitudes significantly. Normal values for QRS-amplitudes and q-duration, J point and ST-segment measured 40 msec and 80 msec after the last QRS-deflection are presented. PMID- 3559440 TI - Triggered rhythms in atrial muscle. AB - Intracellular and extracellular recording techniques were used to study triggered activity in tissues isolated from the inferior right atrium of the dog. In the presence of norepinephrine (greater than 10(-7) M) single stimuli or short rapid pacing elicited action potentials with delayed after-depolarizations, leading to single or repetitive non-driven beats. Most commonly, during sustained triggered activity action potential and electrogram configurations remained constant. In addition, cycle length changed gradually, initially decreasing and then increasing before activity stopped. However in some preparations, once sustained triggered activity was initiated there were abrupt spontaneous changes in action potential and electrogram configurations that were coincident with abrupt spontaneous changes in cycle length. When quiescent, short rapid pacing initiated triggered activity with a relatively short cycle length that abruptly shifted to a longer cycle length before stopping. During sustained triggered activity, short rapid pacing caused an abrupt decrease in cycle length that was coincident with changes in action potential and electrogram configurations. The present results indicate that abrupt changes in cycle length can occur during bouts of triggered activity resulting in unique patterns of arrhythmias. These rhythms may be due to interactions and shifts between multiple sites of triggered pacemaker activity. PMID- 3559441 TI - Atrio-ventricular junctional parasystole: modulation by sinus impulses. AB - A rare case of atrio-ventricular (A-V) junctional parasystole with a quinquageminy and a trigeminy in the presence of a right bundle branch block (RBBB) is reported, in which the ectopic beats showed the same QRS complex as that of the conducted sinus beats. After taking a bath and after intravenous administration of 1.0 mg of atropine, viz. the maneuver to block the vagal effects, the short interectopic interval shortened from control of 2.65-2.70 sec to 2.08 sec, when the shortest interval of 0.98 sec was observed. Thus, the short interectopic intervals resulted from a 2:1 exit block. When the intrinsic ectopic cycle length was about 1.52 sec, the second of four intervening sinus beats in quinquageminy reset the parasystolic pacemaker and a 2:1 exit block ensued, which was attributed to entrance block failure due to a supernormal phase of excitability and conductivity in the His bundle. PMID- 3559442 TI - Non-sustained ventricular tachycardia with Wenckebach exit block. AB - A case of non-sustained, recurrent ventricular tachycardia, manifesting with irregular R-R intervals, is described. Analysis of a long electrocardiographic recording reveals that the arrhythmia is generated by a regularly discharging ectopic ventricular focus, the R-R interval variations being due to a Wenckebach form of exit block. PMID- 3559443 TI - Two different patterns of entrainment of ventricular tachycardia. AB - In a patient with two morphologic forms of ventricular tachycardia, rapid pacing from different ventricular sites produced two distinctively different patterns of entrainment. Pacing from sites contralateral to the site of emergence of ventricular tachycardia caused progressive fusion. Following pacing, the interval (return interval) between the first tachycardia beat (return beat) and the preceding beat was equal to the pacing cycle length. Near the site of emergence, the local electrogram of the return beat was morphologically identical to that of the preceding paced beats. In contrast, pacing from sites ipsilateral to the site of emergence did not cause fusion. The return intervals increased with decreasing pacing cycle lengths. The local electrogram of the return beat was morphologically different from that of the preceding paced beats. Using a model of ventricular reentrance, both patterns of responses can be explained. Pacing impulses arising from sites contralateral to the site of emergence activate the latter orthodromically. Fusion occurs between the emerging tachycardia wavefront and the next pacing wavefront. In contrast, pacing impulses arising from sites ipsilateral to the site of emergence activate the latter antidromically. Fusion is not observed because collision within the area of slow conduction prevents the emergence of the tachycardia during pacing. PMID- 3559444 TI - A case of swallow syncope induced by vagotonic visceral reflex resulting in atrioventricular node suppression. AB - A 48-year-old man repeatedly experienced syncope associated with paroxysmal atrioventricular block (PAVB) while swallowing. PAVB ("Mobitz type II" AH block) occurred only when "balloon-like" deformity of the lower esophagus developed. Balloon inflation in the lower esophagus induced PAVB. However, inflation in the upper or mid portion, or other vagal maneuvers, caused only sinus slowing. PAVB was not induced after intravenous atropine. The PAVB in this patient was probably caused by a vagotonic reflex triggered by tensoreceptors in the lower esophagus, resulting in selective suppression of the atrioventricular node. PMID- 3559445 TI - Production of inhibin bioactivity by human granulosa-lutein cells: stimulation by LH and testosterone in vitro. AB - Granulosa-lutein cells from human preovulatory ovarian follicles were cultured for up to 12 days to determine their capacity for production of inhibin in vitro. Using a highly sensitive sheep pituitary cell bioassay we observed time-related changes in basal inhibin production, maximal during the first 4 days of culture (48 +/- 15 units/million cells every 2 days, means +/- S.E.M.; n = 5 patients) falling to values five times lower by day 12. After 4-6 days of culture in the presence of human LH (hLH) inhibin production was enhanced in proportion to the hLH dose (maximum five fold at 10 ng/ml); hFSH over the same dose-range had no effect. Progesterone production in response to hLH followed a similar pattern to that of inhibin and was also unresponsive to hFSH. In the absence of exogenous aromatase substrate, basal and gonadotrophin-stimulated oestradiol production was negligible after the first 4 days. Addition of testosterone (1 mumol/l) to the culture medium increased oestrogen formation several hundred-fold with no effect on progesterone production. Inhibin production was also increased by 50-100% in the presence of testosterone. These results demonstrate that LH and testosterone stimulate the production of inhibin by granulosa-lutein cells in vitro. It is suggested that inhibin production occurs under hormonal control in the corpus luteum as well as in the preovulatory follicle in the human ovary. PMID- 3559446 TI - Thyroidectomy of nestling starlings appears to cause neotenous sexual maturation. AB - Nestling starlings (Sturnus vulgaris) were thyroidectomized, in the wild, when 8 days old. They were later brought into captivity and hand reared on a daylength of 16h light: 8h darkness per day. Thyroidectomy dramatically affected somatic development so that even at 23 weeks of age these birds retained the physical characteristics of approximately 3-week-old euthyroid birds. Nevertheless, they appeared to be healthy and were active. Despite retaining juvenile features, these thyroidectomized birds became sexually mature. In males, testicular growth began at 8 weeks of age and by 23 weeks both males and females had well developed gonads. PMID- 3559447 TI - Steroidal pure antioestrogens. AB - The effects of some novel 7 alpha-alkyl amide analogues of oestradiol on the rat and mouse uterus have been measured. The compound ICI 164,384 [N-n-butyl-N-methyl 11-(3,17 beta-dihydroxyoestra-1,3,5(10)-trien-7 alpha-yl) undecamide] was entirely devoid of oestrogenic activity in the rat and mouse uterus but completely blocked the uterine stimulatory effects of oestradiol and of tamoxifen. Biological activity was confined to 7 alpha-isomers. The affinity of ICI 164,384 for the rat uterus oestrogen receptor (0.19) was substantially greater than that of tamoxifen (0.025 c.f. oestradiol = 1). The compound inhibited oestradiol-induced growth of ZR-71-1 cells in a dose-dependent manner in vitro. ICI 164,384 thus has the characteristics of a pure antagonist of oestrogen action. PMID- 3559448 TI - Comparison of the cellular composition and steroidogenic properties of preparations of interstitial cells isolated from immature and mature rat testis. AB - The morphological and steroidogenic properties of preparations of interstitial cells isolated by collagenase treatment from testes of immature and mature rats have been compared. After additional purification on a Ficoll gradient, 80% of cells from mature rat testes were found to be Leydig cells; 20% were macrophages. Forty to sixty per cent of collagenase-dispersed cells isolated from immature rats were Leydig cells, 37% were mesenchymal cells and there were no macrophages. A preparation in which 90% cells were Leydig cells could be obtained from immature testes after further purification by centrifugation through a Percoll gradient. The distribution of steroidogenic enzymes through the gradient corresponded to the distribution of LH-dependent steroid production. The results indicate that the steroidogenic activity per Leydig cell from mature rats is fourfold greater than the activity in immature rat Leydig cells in control incubations or after stimulation with LH, dibutyryl cyclic AMP or in the presence of 22R-hydroxycholesterol. PMID- 3559449 TI - Inhibitory effect of various radiographic contrast agents on secretion of thyroxine by the dog thyroid and on peripheral and thyroidal deiodination of thyroxine to tri-iodothyronine. AB - In previous studies we have found that the cholecystographic contrast agent ipodate induced a rapid, sustained and reversible inhibition of thyroxine (T4) secretion from perfused dog thyroid lobes. This type of inhibition of thyroid secretion has not been observed previously. To evaluate whether this effect is unique for ipodate, ten other iodine-containing radiographic contrast agents were tested. The four agents used for cholecystography (iocetamate, iodipamide, ioglycamate and iotroxate) all induced rapid inhibition of T4 secretion from TSH stimulated perfused dog thyroid lobes, while none of six agents predominantly excreted through the kidneys (amidotrizoate, metrizamid, metrizoate, iodamide, diodone and ioxithalamate) influenced T4 secretion significantly. All the cholecystographic agents inhibited T4 deiodinases from dog thyroid and liver. Diodone also inhibited the deiodinases while none of the other compounds tested had any effect. The results indicate that the structure necessary to inhibit thyroid secretion is common to a number of cholecystographic agents and that it could be related to the structure responsible for the inhibitory effect of cholecystographic agents on T4 deiodinases. PMID- 3559450 TI - Ionic mechanisms regulating thyroidal secretion: effects of ouabain and medium sodium concentration on radioiodine release from cultured porcine thyroid cells. AB - Thyrotrophin stimulated release of radioiodine from the organic iodine pool of cultured porcine thyroid cells. The response was well developed within 2-4 h of incubation. Inhibition of the Na+/K+ pump with ouabain or incubation in sodium free medium inhibited the response to TSH. The magnesium content of cultures was reduced by ouabain, and increasing the magnesium concentration of the medium to 10 mmol/l reversed the inhibition of the TSH response by ouabain. After prolonged incubation (4-6 h), ouabain in magnesium-enriched medium stimulated release of radioiodine. Its effects were not additive with those of TSH. Incubation for 4-6 h in media of reduced sodium concentration (34 mmol/l) also stimulated release. Sodium-free medium alone did not alter basal release rates, but magnesium enrichment of sodium-free medium promoted release after 4 h of incubation. It was concluded that the previously reported inhibition of the TSH response in thyroid tissue by ouabain or sodium-free medium was due to secondary derangements of cellular function rather than to a specific blockade of the secretomotor signal. The data are consistent with the hypothesis that a reduction in the sodium ion electrochemical gradient across the cell membrane mediates the secretomotor effect of TSH. PMID- 3559451 TI - 1,25-Dihydroxycholecalciferol regulates salivary phosphate secretion in cattle. AB - The influence of 1,25-dihydroxycholecalciferol (1,25-(OH)2D3) on salivary inorganic phosphorus (Pi) concentration and secretion was studied in two groups of four heifers, the right parotid ducts of which were chronically fitted with a re-entrant cannula. In four heifers i.v. Pi loading (5 mmol/min for 2 h) induced hyperphosphataemia associated with a decrease in plasma 1,25-(OH)2D concentration and an increase in salivary Pi concentration and secretion. In four other heifers, daily 1 alpha-hydroxycholecalciferol injections (1 microgram/kg body wt per day for 3 days) induced hyperphosphataemia associated with an increase in plasma 1,25-(OH)2D concentration and a decrease in salivary Pi concentration and secretion. These treatments had no significant effect on salivary calcium concentration and secretion. Our results indicate that plasma 1,25-(OH)2D concentrations rather than phosphataemia regulate salivary Pi concentration and secretion in cattle. PMID- 3559452 TI - Antidiuretic antagonism and agonism of 1-deamino-pentamethylene-2-D-phenylalanine 4-isoleucine-arginine vasopressin in rats with diabetes insipidus. AB - Using implanted minipumps it was shown over a period of 7 days that the vasopressin antagonist, 1-deamino-pentamethylene-2-D-Phe-4-Ile-arginine vasopressin, caused increased diuresis in normal rats and reversed vasopressin- or oxytocin-induced antidiuresis in Brattleboro rats. When the antagonist was infused alone in Brattleboro rats it induced a marked antidiuretic response, indicating that the analogue also possessed agonistic properties. The agonist action could not be demonstrated in anaesthetized, hydrated normal rats. In these animals the analogue behaved as a pure antagonist. It is concluded that analogues which behave as antagonists in one test model may display agonistic properties under different experimental conditions. PMID- 3559453 TI - Influence of administration of ovarian steroids on the function of neutrophils isolated from the blood and uterus of ovariectomized mares. AB - The function of blood and uterine luminal neutrophils from ovariectomized mares treated with ovarian steroids was investigated 18 h after intrauterine infusion of 1 X 10(9) Streptococcus zooepidemicus. Random migration of blood neutrophils under agarose was reduced by treatment with progesterone compared with that of neutrophils from oestradiol-treated and control mares. In-vitro addition of progesterone to blood neutrophils from acyclic ponies also reduced migration. Uterine neutrophils did not migrate under agarose which was probably an effect of bacterial phagocytosis. Hormone treatment had little effect on phagocytosis of yeast blastospores by blood neutrophils. Phagocytosis by uterine neutrophils from oestradiol-treated and control mares was significantly better than that by blood neutrophils. In progesterone-treated mares, however, phagocytosis by uterine neutrophils was significantly lower than that in the other two treatment groups and was similar to that measured in blood neutrophils. The results indicate a marked effect of progesterone in reducing both migration of blood neutrophils and phagocytosis by uterine neutrophils. PMID- 3559454 TI - Local production of progesterone by the corpus luteum of the marmoset monkey in response to perfusion with chorionic gonadotrophin and melatonin in vivo. AB - The effect of human chorionic gonadotrophin (hCG) and melatonin on the local production of progesterone by the marmoset corpus luteum was investigated in vivo using a perfusion cannula system. Progesterone secretion was measured in 10-min fractions of buffer which had been perfused through the corpus luteum at a flow rate of 70 microliters/min for a maximum of 3 h in anaesthetized animals. Two corpora lutea were cannulated in each animal; one for perfusion of test material and the other for perfusion with buffer alone as a control. Perfusion with hCG (25 i.u./ml), investigated as a positive control, produced a marked stimulation of progesterone secretion which increased 10-20 min from the start of perfusion and reached a peak after 30-60 min. A stimulation of progesterone was also observed after perfusion with melatonin (860 pmol/l). The response was evident within 10-30 min of the hormone reaching the corpus luteum and was similar in magnitude to that observed for hCG. The ability of melatonin to stimulate progesterone secretion supports previous in-vitro studies and suggests an ovarian action for melatonin in the primate. The local perfusion system described may have potential uses in studies of luteal function related to aspects of infertility or regulation of fertility. PMID- 3559455 TI - The effect of thyroid hormones on growth hormone gene expression in vivo in rats. AB - Thyroid hormones are important regulators of GH synthesis and secretion. In this study we have made a detailed examination of the time-course of the effects of hypothyroidism and tri-iodothyronine (T3) replacement in the intact rat on GH gene expression in the anterior pituitary gland. Changes in pituitary cytoplasmic GH messenger (m)RNA levels were compared with total pituitary GH content and serum GH concentration during the development of hypothyroidism and following short-term T3 replacement in vivo. Hypothyroidism was associated with a fall in pituitary GH mRNA levels. Treatment of hypothyroid animals with T3 rapidly stimulated GH mRNA levels to values above those seen in euthyroid controls. The reduction in GH mRNA levels seen during the development of hypothyroidism was accompanied by a fall in serum GH and pituitary GH content, both of which were partially restored by T3 replacement. Thus thyroid hormone replacement in hypothyroidism rapidly stimulates GH mRNA synthesis, which is followed by the gradual restoration of pituitary GH stores and serum GH concentration. PMID- 3559456 TI - Adrenal status during the first month of life in mature and premature human infants. AB - Measurements of 17-hydroxyprogesterone (17-OHP) in blood collected onto filter paper after heel puncture by lancet and steroid metabolites in random collections of urine, were made in human infants born from 25 weeks of gestation onwards. The concentration of 17-OHP in blood eluted from filter paper samples was inversely related to both gestational age and birth weight. In mature infants, 17-OHP concentrations fell rapidly soon after birth, whereas concentrations remained high over the first month of life in infants born earlier than 33 weeks of gestation. Sulphated urinary steroids were identified as having a 3 beta-hydroxy 5-ene structure and although the pattern of excretion was similar in mature and premature infants, significantly higher concentrations were found in the premature group. Steroid metabolites normally present when concentrations of circulating 17-OHP are increased due to 21-hydroxylase deficiency were not detectable in urine samples collected from infants born prematurely. Where direct comparison of 17-OHP in blood spots and urinary steroid metabolites was possible, the concentrations of 17-OHP in blood samples paralleled 3 beta-hydroxy-5-ene steroid metabolites in urine. The results suggest that a circulating cross reacting 3 beta-hydroxy-5-ene steroid may be responsible for increased concentrations of 17-OHP in infants born prematurely. Increased concentrations of both 17-OHP in blood spots and steroid sulphates in urine were associated with stress in premature, but not in more mature, infants suggesting that in infants born prematurely postnatal stress may delay adrenal maturation. PMID- 3559457 TI - Variable-interval schedules of timeout from avoidance: effects of chlordiazepoxide, CGS 8216, morphine, and naltrexone. AB - Rats were trained on concurrent schedules in which pressing one lever postponed shock and pressing the other occasionally (variable-interval schedule) produced a 2-min timeout during which the shock-postponement schedule was suspended and its correlated stimuli were removed. These procedures provided a baseline for studying the effects of drugs on behavior maintained by different sources of negative reinforcement (shock avoidance and timeout from avoidance). Experiment 1 studied a benzodiazepine agonist, chlordiazepoxide, and antagonist, CGS 8216. Chlordiazepoxide (2.5-30 mg/kg) had little effect on avoidance responding except at higher doses, when it reduced responding. By comparison, responding on the timeout lever was increased in 5 of 6 rats. These effects were reversed by CGS 8216 (2.5-5 mg/kg) in the 2 rats tested, but CGS 8216 had no effect by itself. Experiment 2 studied an opiate agonist, morphine, and antagonist, naltrexone, with 3 rats. Morphine's (2.5-20 mg/kg) effects were opposite those of chlordiazepoxide: At doses that either increased or had no effect on avoidance responding, morphine depressed timeout responding. Naltrexone (5 mg/kg) reversed these actions but had no effect by itself. PMID- 3559458 TI - Effects of delayed conditioned reinforcement in chain schedules. AB - The contingency between responding and stimulus change on a chain variable interval 33-s, variable-interval 33-s, variable-interval 33-s schedule was weakened by interposing 3-s delays between either the first and second or the second and third links. No stimulus change signaled the delay interval and responses could occur during it, so the obtained delays were often shorter than the scheduled delay. When the delay occurred after the initial link, initial-link response rates decreased by an average of 77% with no systematic change in response rates in the second or third links. Response rates in the second link decreased an average of 59% when the delay followed that link, again with little effect on response rates in the first or third links. Because the effect of delaying stimulus change was comparable to the effect of delaying primary reinforcement in a simple variable-interval schedule, and the effect of the unsignaled delay was specific to the link in which the delay occurred, the results provide strong evidence for the concept of conditioned reinforcement. PMID- 3559459 TI - Choice between reliable and unreliable outcomes: mixed percentage-reinforcement in concurrent chains. AB - Pigeons' choices between alternatives that provided different percentages of reinforcement in mixed schedules were studied using the concurrent-chains procedure. In Experiment 1, the alternatives were terminal-link schedules that were equal in delay and magnitude of reinforcement, but that provided different percentages of reinforcement, with one schedule providing, reinforcement twice as reliably as the other. All pigeons preferred the more reliable schedule, and their level of preference was not systematically affected by variation in the absolute percentage values, or in the magnitude of reinforcement. In Experiment 2, preference for a schedule providing 100% reinforcement over one providing 33% reinforcement increased systematically with increases in the duration of the terminal links. In contrast, preference decreased systematically with increases in the duration of the initial links. Experiment 3 examined choice with equal percentages of reinforcement but unequal delays to reinforcement. Preference for the shorter delay to reinforcement was not systematically affected by variation in the absolute percentage of reinforcement. The overall pattern of results supported predictions based on an extension of the delay-reduction hypothesis to choice procedures involving mixed schedules of percentage reinforcement. PMID- 3559460 TI - Studies of the cardiac-like action potential in crayfish giant axons induced by platinized tungsten metal electrodes. AB - A lightly platinized tungsten (Pt-W) wire electrode, axially inserted into a crayfish giant axon, causes the development of cardiac-like action potentials with durations of up to 4 s. The plateau in membrane potential typically occurs within 10 min of the start of action potential elongation. The effect occurs without passing current through the Pt-W electrode and is temporally related to a dramatic decrease in intracellular pH (pHi). Such an effect cannot be induced by a decrease in pHi produced by equilibrating the axon with HCO3(-)-CO2 solution (pH6), and NH4Cl rebound or direct intracellular injection of PO4(3-) buffer (pH 4 X 5). Action potential elongation is accompanied by a block of delayed rectification and the possibility that inward rectification also develops cannot be ruled out. Plateau generation requires Na+ and Ca2+ inward currents as demonstrated by abolition of the plateau by [Na+]o or [Ca2+]o depletion or treatment with tetrodotoxin (TTX) or verapamil. The block of outward rectification by Pt-W requires external Na+ or Ca2+. Action potential elongation produced by 3,4-diaminopyridine is not sensitive to verapamil and the waveform is different from that produced by Pt-W. The data support the possibility that different classes of excitable membranes have similar channel populations and that the functional differences between them reside in the inhibitory or masking influences that are present in the microenvironments of the various membrane channels. PMID- 3559461 TI - Developmental endocrinology of larval moulting in the tobacco hornworm, Manduca sexta. AB - A larval moult in the tobacco hornworm, Manduca sexta, involves an endocrine cascade that begins with the release of a cerebral peptide hormone, the prothoracicotropic hormone (PTTH). The release of PTTH is gated, occurs during the scotophase and appears to be developmentally cued. In fourth instar Manduca larvae, PTTH release into the haemolymph occurs as a single burst over a few hours during the head critical period, i.e. the time during which the head (brain) is needed for the initiation of the moult to the fifth (last) instar. Released PTTH activates the prothoracic glands (PGs), and within a few hours the cumulative effect of this event results in a dramatic increase in the haemolymph ecdysteroid titre, which then elicits the moult. An assessment of the capacity of the corpora allata (CA) to synthesize juvenile hormone (JH) in vitro indicates that the above sequence of endocrine events begins only when JH synthesis has reached a nadir for the instar. Since CA activity is an indirect measure of the haemolymph titre of the hormone, it is conceivable that the developmentally cued release of PTTH is permissively controlled by a decreasing haemolymph titre of JH. With the increase in the ecdysteroid titre which marks the end of this endocrine cascade, the CA again become active, presumably to cause the increase in the JH haemolymph titre which directs the larval moult. This investigation has thus established the temporal and quantitative dynamics of the PTTH-PG axis that drive larval moulting and provides insight into the interendocrine regulatory relationships that may exist between the ecdysteroids and JHs. These possible relationships and the role of the brain in their regulation are discussed. PMID- 3559462 TI - Cuticular mechanics during larval development of the tobacco hornworm, Manduca sexta. AB - Tensile properties of the larval cuticle of Manduca sexta were measured during the fifth instar. It was found that as the larvae grew and the cuticle thickened, the tangent modulus (intrinsic stiffness) for the cuticle declined rapidly. The extensibility of the cuticle during the growth period remained relatively high and fairly constant, while the flexural stiffness remained low. Subsequently, during the wandering and burrowing stage the extensibility decreased dramatically. Finally, in the prepupal stage extensibility remained low while flexural stiffness was highest. Using the cuticle deposition inhibitor diflubenzuron we demonstrated that the increase in larval cuticular flexural stiffness was required for normal pupation to proceed. Thus, during larval growth the cuticle remains flexible and extensible. Once growth is completed, the cuticle becomes much less extensible and more rigid, converting the previously hydrostatic skeleton into a self-supporting skeleton. This conversion was associated with changes in cuticular structure, hydration and protein composition. PMID- 3559463 TI - The thermal dependence of locomotor performance and muscle contractile function in the salamander Ambystoma tigrinum nebulosum. AB - The thermal dependence of locomotor performance and in vitro muscle mechanical properties were studied after acclimation at 10 degrees and 20 degrees C in the salamander Ambystoma tigrinum nebulosum Hallowell. Performance measurements included burst and endurance capacities on land and in water. No significant differences in locomotor performance or muscle contractile properties were found between acclimation groups. Locomotor performance had only a slight thermal dependence, with Q10 values of 0.99-1.36 for running and swimming burst capacities (i.e. maximum speed and leg/tail cycling frequency). Running and swimming endurance capacities had thermal ratios of 1.58-1.66. Thermal dependence of muscle contractile rates was higher than that of locomotor performance: rates of force development for both isometric twitch and tetanus and maximal shortening velocity had Q10 values of 1.89-2.01. Maximal power output was also thermally dependent (Q10 = 2.33) and occurred at 38% of maximal (tetanic) force output. Force-generating capacities in isometric twitch and tetanus were relatively temperature-independent. PMID- 3559464 TI - The effects of prolonged epinephrine infusion on the physiology of the rainbow trout, Salmo gairdneri. I. Blood respiratory, acid-base and ionic states. AB - Rainbow trout were infused continuously for 24 h with epinephrine in order to elevate circulating levels of this hormone to those measured during periods of acute extracellular acidosis (approximately 5 X 10(-8) mol l-1). Concomitant effects on selected blood respiratory acid-base and ionic variables were evaluated. Infusion of epinephrine caused a transient respiratory acidosis as a result of hypoventilation and/or inhibition of red blood cell (RBC) bicarbonate dehydration. The acidosis was regulated by gradual accumulation of plasma bicarbonate. Even though whole blood pH (pHe) was depressed by 0.16 units, RBC pH (pHi) remained constant, thereby causing the transmembrane pH gradient (pHe-pHi) to decrease. A similar effect of epinephrine on RBC pH was observed in vitro, although the response required a higher concentration of epinephrine (2.0 X 10( 7) mol l-1). We speculate that the release of epinephrine during periods of depressed blood pH is important for preventing excessive shifts in RBC pH and for initiating a series of responses leading to plasma HCO3- accumulation and eventual restoration of blood acid-base status. PMID- 3559466 TI - The effects of prolonged epinephrine infusion on the physiology of the rainbow trout, Salmo gairdneri. III. Renal ionic fluxes. AB - Rainbow trout were infused continuously for 24 h with epinephrine in order to evaluate the effects of elevated circulating levels of epinephrine on selected renal variables. Pronounced effects of epinephrine included elevation of urine flow rate and concomitant increases in the excretion of all measured electrolytes (Na+, Cl-, K+, Ca2+, inorganic phosphate) with the exception of ammonium and bicarbonate ions. Significant reductions in the tubular reabsorption of Na+ and Cl- also contributed to enhanced excretion of these ions. Similarly, epinephrine affected the tubular handling of NH4+ and HCO3- with NH4+ secretion decreasing and HCO3- reabsorption increasing. We speculate that the stimulation of HCO3- reabsorption was a consequence of elevated tubular H+ secretion. Such a mechanism may be important to permit plasma HCO3- retention during periods of internal acidosis. The results are discussed with reference to the role of the fish kidney in regulating acid-base disturbances and the possible interactive effects of elevated epinephrine. PMID- 3559465 TI - The effects of prolonged epinephrine infusion on the physiology of the rainbow trout, Salmo gairdneri. II. Branchial solute fluxes. AB - Rainbow trout were infused continuously for 24 h with epinephrine in order to elevate circulating levels to those measured during periods of acute extracellular acidosis (about 5 X 10(-8) mol l-1). Concomitant effects on branchial solute fluxes were evaluated. Epinephrine infusion caused complex and differential adjustments of Na+ and Cl- unidirectional fluxes (influx and efflux) resulting in a significant elevation of the arithmetic difference between Na+ and Cl- net fluxes (JnetNa+-JnetCl-). A significant correlation existed between JnetNa+-JnetCl- and net branchial acid excretion (JnetH+), thereby suggesting a role for epinephrine in piscine acid-base regulation. The stimulation of JnetH+ by epinephrine was due primarily to a reduction in the excretion of titratable acid (JTA) accompanied by non-significant changes in ammonia excretion (JAmm). The results are discussed with respect to a role for epinephrine in regulating acid-base disturbances by interacting with branchial ionic exchange mechanisms. PMID- 3559467 TI - Pharyngeal movements during feeding sequences of Navanax inermis (Gastropoda: Opisthobranchia) in successive stages of dissection. AB - Feeding in Navanax inermis Cooper was filmed and analysed after various dissections. In preparations with a cut through the body wall exposing the pharynx and buccal ganglia, completely normal feeding was observed. In addition to seven motor acts previously described in intact animals, an eighth act, peristalsis, was observed. In preparations with the pharynx excised from the animal but attached to the buccal ganglia, four motor acts were observed: flaring, expansion, contraction and peristalsis. In addition to increasing information about the nature of feeding movements in Navanax, these data indicate that preparations suitable for neurophysiological studies are capable of producing a variety of feeding acts. PMID- 3559468 TI - Turning flight of bats. AB - The turning flight of six microchiropteran bat species is described. The bats' abilities to turn tightly were determined by their abilities to fly slowly and to generate high lateral accelerations. Rhinolophus ferrumequinum developed high lateral accelerations by flapping its banked wings while flying at very low speed. Plecotus auritus turned at relatively low speed and at low lateral acceleration. The other species were all moving fast as they turned and generated lateral accelerations either by developing high bank angles or by flapping their wings with low bank angles. There was a significant correlation between wing loading and turning curvature, indicating that low wing loadings improve manoeuvrability. PMID- 3559469 TI - Evidence that myoglobin does not support heart performance at maximal levels of oxygen demand. PMID- 3559470 TI - Effect of stimulus configuration on spatial judgments in search tasks. AB - Although children over one year of age are able to code spatial information with respect to objects other than the self, there are many instances in which the self is inappropriately used as a spatial referent by children between 2 and 4 years of age. L. G. Braine and R. A. Eder (1983, Developmental Psychology, 19, 45 55) found that, in a search task, the nature of the array influenced the spatial referent used by 2-year-old children. The present work investigated the effect of varying the number, size, and arrangement of boxes in the array. It was found that only the number of boxes defining the left and right sides of the array influenced performance; that is, multiple boxes were associated with the use of external objects as spatial referents. These results were interpreted as stemming from the tendency of young children to code the location of an object with respect to nearby objects. This tendency would lead to the use of adjacent boxes and environmental objects as spatial referents for the multiple-box side, and the use of the self as a spatial referent for the single-box side. PMID- 3559471 TI - Sources of meaning in the acquisition of complex syntax: the sample case of causality. AB - The study reported here is concerned with how children acquire complex sentences for expressing their beliefs about causally related events, in the transition in language development from simple to complex syntax. Subjects were three girls and four boys, observed longitudinally from 26 to 38 months of age in their homes. Data analysis began with those observations in which each child began to produce causally related propositions without syntactic connectives, and continued until the children were about 3 years old. Two broad categories of causal meaning were expressed in the children's causal statements. Objective meaning concerned means end and consequence relations that were evidential and fixed in the physical world. Subjective meaning expressed causal connections concerned with personal, affective, or sociocultural beliefs. While most of the children's statements expressed subjective meaning overall, the acquisition of syntactic connectives was associated with objective meaning. These results are discussed in terms of the development of these children's understanding of causality and the acquisition of increasingly complex language. PMID- 3559472 TI - Development of strategic skills in impulsive and reflective children: a longitudinal study of metacognition. AB - This study examined the relationships between metamemory and strategic behavior in impulsive and reflective children. One hundred thirty children from the fourth, fifth, and sixth grades participated. Seventy-seven of these children had been tested 3 years earlier on metamemory and cognitive tempo tasks. At pretraining, children were assessed on metamemory, cognitive tempo, summarization skills, and teacher ratings of impulsive behavior in the classroom. Next, children in three experimental groups received prose summarization instructions, summarization instructions in conjunction with metacognitive training about the importance of a reflective approach to learning, or no instructions. Following training, children were again measured on tempo, summarization skills, and teacher ratings of impulsivity. Analyses of strategy maintenance data indicated superior performance for children who had received both summarization and metacognitive training. Causal modeling analyses showed that early metamemory was an antecedent of later strategy acquisition. The dual role of metacognition as a precursor of later strategy acquisition and controller of lower level strategies was highlighted. PMID- 3559473 TI - Knowledge and behavior relationships in the memory ability of retarded and nonretarded students. AB - Twenty mildly mentally retarded adolescents were matched with two groups of nonretarded students, one of the same chronological age (CA 16) and the other of the same mental age (MA 9), to examine the influence of age and metamemory on recall. This was achieved using an adapted metamemory instrument which included relevant recall tasks. Recall scores showed that when tasks exhibited some organizational features, the retarded group was as accurate as their CA counterparts; when tasks were less organized, they responded much like their MA counterparts. Regression analyses indicated that, depending on task characteristics, chronological age emerged as a significant predictor of recall in certain situations, and in others, mental age accounted for more variance. Metamemory responses in one task accounted for more variance than either CA or MA. PMID- 3559474 TI - The effects of current mood and prior depressive history on self-schematic processing in children. AB - Previous research has indicated that children display facilitated recall of personal adjectives judged to be self-descriptive; and most critically, positive and negative adjectives are differentially recalled by relatively depressed and nondepressed children. Such evidence of apparent self-schemas was explored in additional samples of children with current or past histories of diagnosable depression. As predicted, clinically depressed children showed even stronger recall of negative self-descriptive adjectives than in previous research. However, extent of previous experience with depression did not predict degree of negativity of current self-schema beyond that predicted by current mood. The results are discussed in terms of recent findings with depressed adults and are seen as compatible with a developmental model of self-schemas in which prior experience may affect accessibility of negative cognitions once the self-schema has been activated. PMID- 3559475 TI - The drawing of squares and diamonds: a perceptual-motor task analysis. AB - The aim of the present study was to establish the role of perceptual-motor factors in copying an equilateral four-sided figure. Children, 5 to 12 years, and adults, were asked to copy the figure presented in either "square" or "diamond" orientation under five conditions: control; large model presentation; neutral picture frame surround; partial visual information reduction; and total visual information loss. The model was present at all times. Scores were orientation and angular variability. Developmental trends were found for both figures; the diamond was less well performed than the square at all ages tested. Three perceptual-motor factors were found to be important: formulation of the movement plan; movement programming, and sensory feedback. The difficulty of the diamond is thought to be due to the high programming and hence planning demands in drawing oblique lines. Both kinaesthesis and sequential vision are important factors in drawing; and only from 12 years of age are environmental cues used efficiently to orient the figure. PMID- 3559476 TI - Purification and characterization of the major iron-regulated protein expressed by pathogenic Neisseriae. AB - This report describes a method to purify the major iron-regulated protein (MIRP) expressed by N. gonorrhoeae and N. meningitidis. This purification procedure involves maximal expression of the MIRP by growing the organisms on iron-limited media; cellular disruption by sonication followed by centrifugal fractionation; selective solubilization of the MIRP with the cationic detergent hexadecyltrimethylammonium bromide; cation-exchange chromatography in the presence of this detergent; and gel filtration chromatography. The MIRP purified by this technique migrates as a single band when analyzed by SDS-PAGE. The purified MIRP displayed an unusually basic isoelectric point, this value being greater than 9.35. Further biochemical analysis revealed the highly conserved nature of this protein isolated from the two pathogenic species of the genus Neisseria. For example, the amino acid composition of the meningococcal and gonococcal MIRPs were nearly identical and amino terminal sequence analysis showed that both shared the identical primary sequence through residue 48. Surprisingly, the first five NH2-terminal residues of the MIRPs exhibited homology with the first five residues of the gonococcal porin, protein I. Purified preparations of the MIRP exhibited a characteristic pink color reminiscent of the basic iron-binding protein lactoferrin. This observation coupled with the property of iron-regulation prompted us to analyze purified MIRP for iron-content. Approximately 0.5 mol iron per 1 mol of MIRP was detected. This study is the first to show that iron is associated with the MIRP, a property that may implicate this protein as playing a direct role in neisserial iron assimilation. While the precise function of the MIRP is not known, the availability of this protein in pure and biologically relevant quantities will allow further studies to elucidate its pathobiologic function. PMID- 3559477 TI - Proof that Sn-protoporphyrin inhibits the enzymatic catabolism of heme in vivo. Suppression of 14CO generation from radiolabeled endogenous and exogenous heme sources. AB - Sn-protoporphyrin (SnPP) suppresses generation of 14CO from hepatic heme labeled with delta-aminolevulinic acid (5-[14C]ALA) or from infused [14C]hemin in rats. SnPP administered 1 h before administration of 5-[14C]ALA virtually abolished the peak output of 14CO occurring 2-3 h after injection of this heme precursor, and during the succeeding 12 h reduced 14CO excretion by approximately 61% compared with controls. When [14C]hemin was infused, SnPP diminished 14CO excretion by approximately 50%. These findings, derived from experiments using radiolabeled endogenous and exogenous heme sources, establish conclusively that the synthetic metalloporphyrin SnPP inhibits the oxidative degradation of heme in the intact animal. PMID- 3559478 TI - The macrophage response to central and peripheral nerve injury. A possible role for macrophages in regeneration. AB - Using mAbs and immunocytochemistry we have examined the response of macrophages (M phi) after crush injury to the sciatic or optic nerve in the mouse and rat. We have established that large numbers of M phi enter peripheral nerves containing degenerating axons; the M phi are localized to the portion containing damaged axons, and they phagocytose myelin. The period of recruitment of the M phi in the peripheral nerve is before and during the period of maximal proliferation of the Schwann cells. In contrast, the degenerating optic nerve attracts few M phi, and the removal of myelin is much slower. These results show the clearly different responses of M phi to damage in the central and peripheral nervous systems, and suggest that M phi may be an important component of subsequent repair as well as myelin degradation. PMID- 3559479 TI - Clinical significance and source of raised catalytic activities of phosphohexose isomerase in the CSF in meningitis. AB - The value of phosphohexose isomerase (EC 5.3.1.9) determination in the CSF in the diagnosis of meningitis was tested under routine conditions. In 48 patients with untreated bacterial meningitis, enzyme activity concentrations between 40 and 2335 U/l were measured, whereas the highest phosphohexose isomerase activity concentration in 92 patients with viral meningitis was 34 U/l. Lysis of the CSF leukocytes with Triton X-100 resulted in a substantial increase of phosphohexose isomerase activity. In bacterial meningitis these values increased to 200 to 7000 U/l, but remained under 150 U/l in viral meningitis. The raised enzyme activities are derived from the leukocytes and appear to reflect their functional and metabolic state. The information provided by the leukocyte morphology can thus be appreciably extended by phosphohexose isomerase determination. PMID- 3559480 TI - Plasma pyridoxal-5'-phosphate concentration and its relation to apo aminotransferase levels. PMID- 3559481 TI - The analytical value for kinin concentration in blood depends on the antiserum used in the bradykinin radioimmunoassay. AB - Recently published blood kinin concentrations are subject a wide scatter, due to sampling time and technique. In our study we tested the influence of the used antibradykinin antiserum on the measured kinin concentration in blood. Blood was collected from the anticubital vein by a teflon cannula and inactivated immediately by hydrochloric acid in the syringe. Subsequent extraction was performed using diethylether, n-butanol, distilled water and Biorex-70. The blood extract containing the kinins was divided into four samples and measured by four radioimmunoassays using different antibradykinin antibodies. All four assays were performed under standard conditions and at the same time. The resulting kinin values were similar in two assays: 7.4 +/- 2.6 ng/l and 5.6 +/- 1.3 ng/l. In the two other assays, however, the measured kinin concentrations differed markedly from these values: 127.5 +/- 46.7 ng/l and 693.0 +/- 85.7 ng/l. These results indicate clearly that the antibody used in the assay can be a major factor determining the range of the recorded kinin concentration. PMID- 3559482 TI - Chemical analysis of the bronchoalveolar washing fluid in the diagnosis of liquid paraffin pneumonia. AB - Lipid analyses of the bronchoalveolar washing fluid of three patients affected with chronic unidentified pneumonia showed the presence of a major hydrophobic compound identified as paraffin oil by thin layer chromatography, infrared spectroscopy and gas liquid chromatography (by comparison with various paraffin preparations as standards). Moreover the phospholipid and neutral lipid composition was determined. In conclusion, the usefulness of bronchoalveolar lavage and its biochemical analysis is discussed as a non-invasive method of diagnosis and therapeutic approach to liquid paraffin pneumonia (in the cases herein described, between 100 and 500 mg of paraffin oil were extracted from 100 ml of bronchoalveolar washing fluid. PMID- 3559483 TI - Interference by the new antibiotic cefpirome and other cephalosporins in clinical laboratory tests, with special regard to the "Jaffe" reaction. AB - The new cephalosporin, cefpirome, was investigated for its possible interference in clinical laboratory tests, especially the determination of creatinine. Tests for bilirubin, cholesterol, protein, urea, and uric acid were also studied. A selection of commercially available compounds such as cefoperazone, cefazolin, cefamandole, cefoxitin, latamoxef, ceftriaxon, cefotiam, cephaloridine, cephalotin, cefotaxime, cefazedone and cefuroxime, and cefodizime (a compound under development) were also included in these investigations. Interference was found only with the "Jaffe method" for the determination of creatinine. Pronounced interactions with alkaline picrate were observed with cefpirome, cefoxitin, cephalotin and cephaloridine, whereas the other compounds showed only weak reaction or no reaction at all. The cephalosporins did not interfere in any of the other tests mentioned above. Care must therefore be taken in the determination of creatinine in samples from patients under treatment with these drugs. The assay methods of choice at present are enzymatic or specific HPLC assays. PMID- 3559484 TI - Aminolaevulinate dehydratase porphyria in infancy. A clinical and biochemical study. AB - Homozygous deficiency of aminolaevulinate dehydratase (porphobilinogen synthase, EC 4.2.1.24) was diagnosed in a small child. The clinical presentation was unique since severe symptoms were already present in the neonatal period. The patient, a boy, now three-years old, had recurrent attacks of pain, vomiting, hyponatraemia and symptoms of polyneuropathy engaging motor functions including respiration. The clinical course of the disease from birth on is related, as are the results of various attempts at therapy. The patient excreted large amounts of 5 aminolaevulinic acid and coproporphyrin and minor amounts of porphobilinogen in the urine. Faecal excretion of coproporphyrin and harderoporphyrin was increased as was erythrocyte porphyrin concentration. Diagnosis was established by the finding that erythrocyte aminolaevulinate dehydratase activity was less than 5 per cent of normal in the patient and between 26 and 51 per cent of normal in both the parents, the grandfathers and a sibling. The activity of the enzyme could not be restored by the addition of dithiothreitol (10(-3) mol/l) alone, or in combination with zinc or manganese in varying concentrations. The enzyme Km did not differ between affected and nonaffected members of the family. PMID- 3559485 TI - Standards of care in family practice. PMID- 3559486 TI - A report on health care in Nicaragua. PMID- 3559487 TI - The natural history of palpitations in a family practice. AB - A retrospective cohort study was conducted to assess whether palpitations are an independent risk factor for increased cardiac morbidity or mortality. A cohort of 109 patients with palpitations, seen over a five-year period in a primary care setting, was compared with an age- and sex-matched control cohort. Mean length of follow-up was 42 months. There was no statistically significant difference in incidence of morbidity or mortality (6.4 percent for the cohort with palpitations and 7.2 percent for the control cohort) between the two groups. This study suggests that palpitations are not an independent risk factor for increased cardiac morbidity or mortality. PMID- 3559488 TI - Clinical value of the electrocardiogram in ambulatory care. AB - The direct impact of the electrocardiogram (ECG) on clinical outcome in an ambulatory health care population during a six-month period was reviewed. Three hundred seventy-six ECG tracings were recorded, of which 262 (69.7 percent) were interpreted as normal. The ECG was clinically useful and had direct impact on treatment in only two instances (0.5 percent of all tracings recorded). Three patients were inappropriately referred or treated because of an incorrect ECG interpretation. No electrocardiograms done on asymptomatic persons led to useful medical interventions. PMID- 3559489 TI - The vitamin-mineral supplement history. AB - The prolonged use of vitamin or mineral supplements in amounts greater than their recommended dietary allowance (RDA) can lead to medical complications or interfere with the treatment of some diseases. A vitamin-mineral supplement history is necessary to determine whether patients may be contributing to a medical problem and for physicians to counsel patients about the appropriate use of vitamins and minerals. This article provides a three-phased guide for obtaining a comprehensive history of vitamin-mineral supplement use. Phase 1 determines current and past behaviors with respect to kind, dosage, frequency, duration, and constancy of supplement intake. Phase 2 considers patient beliefs about taking supplements and outcomes of supplement usage. Phase 3 outlines considerations important for patient guidance. A vitamin-mineral supplement history should be a routine component of every complete medical history. PMID- 3559490 TI - Evaluation of standards of practice for primary care physicians using 12 hypothetical cases. AB - Concerns about the quality of medical care are increasing. As quality of medical care is difficult to measure, physicians have relied on standards based on research, consensus, or personal experience. The authors surveyed primary care physicians in Missouri to determine the presence and extent of standards of care for 12 hypothetical cases. The results demonstrate that within and between diagnoses there is both consensus and disagreement in case management. A standard of practice can be inferred for those management options achieving consensus. Further research is indicated for those options generating considerable disagreement to resolve the discrepancies in standards of care. PMID- 3559491 TI - Nonemergency emergency room use in patients with and without primary care physicians. PMID- 3559492 TI - The use of the family APGAR in screening for family dysfunction in a family practice center. AB - The Family APGAR questionnaire was used to determine the prevalence of self reported family dysfunction present in patients who attended a family practice center, to determine whether knowledge of the Family APGAR score increased the frequency with which family physicians evaluated family functioning and diagnosed family dysfunction, and to determine whether certain psychosomatic complaints associated with family dysfunction were more common in a group of patients with a Family APGAR score of less than 6. To achieve these purposes, all patients entering the center were asked to fill out a Family APGAR questionnaire during the month of March 1984. Physicians learned of the results in a randomly selected one half of all cases. A chart review was conducted one month later. Twenty-four percent of patients reported family dysfunction (APGAR less than 6). Knowledge of the APGAR score did not increase the frequency with which physicians evaluated family function (20 percent known vs 17 percent unknown) or diagnosed family dysfunction (6.3 percent known vs 6.4 percent unknown). Patients with self reported family dysfunction as defined by the Family APGAR did not have more psychosomatic complaints noted in their charts than patients without self reported family dysfunction. Family dysfunction is a common problem in family practice patients, it is recorded infrequently in patients' charts, and knowledge of the results of a screening device does not increase the frequency with which family dysfunction is noticed. PMID- 3559493 TI - Tardive dystonia after a short course of thioridazine. PMID- 3559494 TI - Paternal adaptation through the course of the partner's pregnancy. PMID- 3559495 TI - Patient satisfaction with an office visit for the common cold. PMID- 3559496 TI - Rapid change to HMO systems: profile of the Dane County, Wisconsin, experience. AB - Dane County (Madison), Wisconsin, has experienced a dramatic transformation of its health services into competing closed-panel health maintenance organizations (HMOs). The change occurred literally overnight after the state, as the dominant employer, implemented price competition. In 1983, 22 percent of the 24,000 state employees in Dane County were enrolled in closed-panel HMOs; in 1984 about 85 percent enrolled in one of seven major competing physician HMO plans. In 1985 state employees basically stayed with the HMO they had chosen in 1984, and the only major shift was continued movement away from the standard fee-for-service plan. The Dane County HMO plans were less costly than fee-for-service plans to the state and to the state employee. Fee-for-service state enrollees self reported greater use of inpatient hospital services and self-reported poorer health than employees selecting HMOs when controlling for age between the two groups. This article describes these changes, why they occurred, and the initial impact on employees as an example relevant to HMO development that may occur elsewhere. PMID- 3559497 TI - Immunochemical evidence that the single lactate dehydrogenase of lampreys is more similar to LDHB4 than to LDHA4 of hagfish. AB - The tetrameric lactate dehydrogenases (LDH) of vertebrates contain several different subunits that arose by gene duplication. While the A and B subunits occur in all classes of gnathostomes, the enzymes of agnathans appear to represent two stages in the evolution of vertebrate LDH. Lampreys of the family Petromyzontidae have a single enzyme classified as LDHA4, while hagfish possess both A and B subunits which form only the two homopolymers LDHA4 and LDHB4. It is generally assumed that the original vertebrate LDH was an A4 type, that duplication to give the B subunit occurred prior to the divergence of lampreys and hagfish, and that modern lampreys subsequently lost expression of the B gene. Lactate dehydrogenases were purified from representatives of all three lamprey families, and it was confirmed that members of the Mordaciidae and Geotriidae also possess single tetrameric LDH enzymes containing one subunit type. The kinetic properties of the lamprey LDH enzymes were compared with the LDH homopolymers of hagfish, skate, and sardine. These properties did not allow the lamprey enzymes to be unequivocally identified as either LDHA4 or LDHB4. Immunochemical titration using antisera against lamprey and hagfish LDH homopolymers demonstrated that the lamprey LDH enzymes showed greater immunochemical similarity to LDHB4 than to LDHA4 of hagfish. It is concluded that there is little evidence for the claim that the original vertebrate LDH was an A4 rather than B4 type. PMID- 3559498 TI - Pregnancy-associated esterase in sera of baboons. AB - Baboon serum samples were resolved by starch gel electrophoresis and polyacrylamide gradient gel electrophoresis and stained with naphthol substrates for esterase activity. An esterase that hydrolyzed alpha-naphthyl butyrate in preference to alpha-naphthyl acetate was found in very high activities in some individuals but not others. It migrated just cathodal of the albumin band in starch gels. In polyacrylamide gradient gels, it co-migrated with albumin and had an apparent molecular weight of approximately 65,000 daltons. Electrophoretic analysis by gel electrophoresis of random serum samples from male and female baboons indicated that this esterase was present only in the sera of pregnant baboons. Further investigation of serial samples collected from carefully monitored baboons confirmed that the amount of activity of this esterase was correlated with stage of pregnancy. Therefore, it was named pregnancy esterase (PE). PE was detectable by gel electrophoresis and chromogenic staining techniques as early as day 30 of pregnancy; its activity gradually increased with progressive pregnancy and reached maximum activity near full term (182 days). Soon after parturition, the activity of PE decreased rapidly and was not detected in maternal sera by day 14 postpartum. No evidence of PE was detected in sera of pregnant humans. PMID- 3559500 TI - Effect of ouabain on the meiotic maturation of stage IV-V Xenopus laevis oocytes. AB - Full-grown stage VI Xenopus laevis oocytes (1,200 to 1,300 micron) respond to progesterone stimulation by undergoing a series of physiological and morphological changes that are referred to as meiotic maturation. Oocytes in earlier stages of oogenesis (I through V) do not undergo these changes and remain in prophase arrest when exposed to this steroid. We have found that oocytes ranging from 850 micron (stage IV) to 1,000 micron (stage V) are capable of responding to progesterone under the appropriate conditions. Oocytes greater than or equal to 850 micron in diameter underwent germinal vesicle breakdown (GVBD) after 10-12 hr of exposure to progesterone when ouabain was added to the medium at a concentration greater than 2.5 X 10(-6) M. Under this culture condition, progesterone was now able to induce a 0.3- to 0.4-unit increase in the intracellular pH of stage IV-V oocytes, a 4- to 5-fold increase in 40s ribosomal protein S-6 phosphorylation, and a 2.3-fold increase in their rate of protein synthesis. All of these physiological changes are characteristic of full-grown stage VI oocytes undergoing meiotic maturation. In addition, we have found that oocytes greater than or equal to 750 micron are capable of amplifying maturation promoting factor (MPF) in their cytoplasm leading to GVBD. Therefore, stage IV-V Xenopus oocytes have the potential for undergoing meiotic maturation, but they are blocked at a point in prophase that appears to be alleviated by the combination of progesterone and ouabain. PMID- 3559499 TI - Reexamination of metabolic potential in the toadfish sonic muscle. AB - Activities of eight enzymes were measured in the sonic muscle of the gulf toadfish, Opsanus beta, to determine the metabolic poise of this unique tissue and to evaluate potential sex related differences in metabolism. In contrast to a prior study (Pennypacker et al., '85, J. Exp. Zool., 239: 259-264), we observed substantial activities of M4-lactate dehydrogenase, 333 to 482 units/g wet sonic muscle weight. This observation and the presence of high activities of other enzymes of glycolytic and anaerobic metabolism (pyruvate kinase and creatine phosphokinase) lead us to conclude that this tissue has high anaerobic capacity. Also in contrast to the observations of Pennypacker et al. ('85), we found that the activities of some enzymes indicative of aerobic metabolism are relatively low. For example, the activities of citrate synthase found in sonic muscle (1.5 to 2.7 units/g) are only slightly higher than values obtained for toadfish white skeletal muscle (1.2 units/g). The discrepancies between the results obtained by the two studies appear to be methodological ones. Lastly, significant differences in enzyme activities between males and females were observed for lactate dehydrogenase, malate dehydrogenase, and citrate synthase, and possible explanations for these differences are discussed. PMID- 3559501 TI - Circadian and circannual rhythms of melatonin in plasma of male white-tailed deer and the effect of oral administration of melatonin. AB - Circadian levels of melatonin (M) were determined in plasma of four male white tailed deer sampled hourly in September for 24 h via indwelling jugular catheter. Concentrations of M, detected by the radioimmunoassay rise with the onset of darkness, peak at 1.00 h (265 pg/ml) and then quickly decline to baseline levels (60 to 70 pg/ml) maintained during the scotophase. Orally administered M (5 mg, given at 13:00 h) induced a rapid elevation of plasma M (peak 980 pg/ml at 15:00 h) followed by a decline to baseline (100 pg/ml) reached at 22:00 h. The usual midscotophase peak was abolished by exogenous M administration. Seasonal midscotophase levels of M (determined in three samples taken 45 min apart between 23:00 and 1:00 h reach maximum in December (1530 pg/ml) followed by decline to minimum (69 to 90 pg/ml) observed between May and July. The data indicate that: 1) similarly to other mammals, deer exhibit peak levels of M during the dark phase; 2) 5 mg of M given orally caused a rapid elevation of M levels in blood followed by a depression of the normally present night-time peak; and 3) midscotophase levels of M exhibit very pronounced seasonal fluctuations which might be related to yearly cycles, such as the reproduction, hair molt, and antler growth. PMID- 3559502 TI - Factors involved in the testicular development from fetal mouse ovaries following transplantation. AB - We have previously shown that fetal mouse ovaries develop testicular structures after transplantation into adult male mice. The mechanisms of gonadal sex reversal is poorly understood. In the present study, we examined how a host environment is involved in the induction of testicular development in ovarian grafts. Fetal ovaries on the twelfth day of gestation were microencapsulated with semipermeable membranes, transplanted beneath the kidney capsules of adult male mice, and fixed for histological examinations between the sixteenth and twenty second day after transplantation. Fifteen of forty-seven ovarian grafts were found to be completely enclosed in microcapsules, whereas the microcapsule membranes of other grafts were partly broken or had been lost. These differences of microencapsulation conditions made it possible to study the role of host factors in gonadal sex reversal. All ovarian grafts surrounded by microcapsule membranes developed ovarian structures. In contrast, most ovarian grafts which had lost the microcapsules developed testicular structures in addition to ovarian structures. When ovarian grafts were partially enclosed in microcapsule membranes, testicular structures developed only in the area in contract with the host kidney. These results suggest that direct interaction between the ovarian graft and cells or large macromolecules from the host is involved in the development of testicular structures in ovarian grafts. PMID- 3559503 TI - Effects of changes in Ca2+ concentration of the culture medium on the in vitro development of 11-day mouse embryos. AB - The present study was designed to examine the effects of changes in Ca2+ concentration in a culture medium on the development of 11-day mouse embryos (plug day = day 0). The embryos were individually cultured for 24 hours by rotating bottles using a culture medium of 25% rat serum and 75% Waymouth's medium. The Ca2+ concentration was changed by adding EGTA or CaCl2 to the Waymouth's medium. The Ca2+ concentrations examined were 0.5, 1.0, 1.5, 2.0, and 3.0 mM in 95% oxygen and 1.0, 2.0, and 3.0 mM in 60% oxygen. Development of embryos was evaluated on the basis of heartbeat, survival, growth, and differentiation. In 95% oxygen, the best survival was obtained at 1.5 mM Ca2+, while growth and differentiation were little affected by changes in Ca2+ concentrations except at 0.5 mM. In 60% oxygen, rhythmical heartbeats were difficult to maintain in many of the embryos at all Ca2+ concentrations examined, although reasonable development was obtained at 3.0 mM Ca2+. The optimal conditions were a culture medium containing 1.5 mM Ca2+ and an oxygen concentration of 95%. The addition of Waymouth's medium to the rat serum is useful in controlling the Ca2+ concentration of the culture medium. PMID- 3559504 TI - Studies on the mechanisms of neurulation in the chick: morphometric analysis of the relationship between regional variations in cell shape and sites of motive force generation. AB - Microfilaments, which are organized into bundles in the apical ends of neuroepithelial cells, are generally thought to play a major role in generating the driving forces for neural tube closure. Because of their proximity to the luminal surface, the contractile activity of these microfilament bundles results in conspicuous changes in the overall shape of neuroepithelial cells, most notably apical constriction and apical surface folding. In the present study, we have used morphometric methods and computer-assisted image analysis to reveal the distribution of microfilament-mediated forces in the developing midbrain during initial contact of apposing neural folds in chick embryos at Hamburger and Hamilton stage 8+ of development (Hamburger and Hamilton (1951) J. Morphol., 88:49-92). The degree of apical constriction, apical surface folding, and bending of the neuroepithelium was used as a barometer of local microfilament activity. Results indicate that cells forming the floor and midlateral walls of the developing midbrain consistently show a higher degree of apical constriction and surface folding than those at other locations. These same regions of the neuroepithelium also exhibit the greatest degree of bending. We conclude that the principal driving forces for closure of the neural tube, at the level of the midbrain, are concentrated in certain regions of the neuroepithelium (i.e., the floor and midlateral walls of the forming neural tube) rather than uniformly distributed. PMID- 3559505 TI - Intermittent erythropoiesis in anemic newts. AB - A group of 88 newts, Triturus cristatus carnifex (Laurenti), was rendered totally anemic by administering acetylphenylhydrazine (APH) in the breeding water for 48 h at a concentration of 25 mg/liter. The course of erythron restoration was followed for 5 months, sacrificing four specimens per week and analyzing the blood and spleen hemopoietic tissue. The return to the normal values of the red blood cell count occurred through marked increases in concentration at fairly regular intervals, which is best explained by a discontinuous, rhythmic erythropoiesis. This fact is strictly correlated with the intermittent mitotic activity observed in the spleen and with the periodic appearance of large quantities of immature elements in the blood smears. The APH-induced synchronization of newt erythropoietic activity revealed the approximate length of each erythropoietic cycle to be 4 to 5 weeks and the erythropoietic life span to be 50 to 60 days. PMID- 3559506 TI - Age-dependent changes in fluorescent neurons in the brain of Notoplana acticola, a polyclad flatworm. AB - The formaldehyde-glutaraldehyde-sucrose (FGS) method for in situ localization of catecholamines has been applied to the nervous system of the marine polyclad flatworm Notoplana acticola. This histochemical fluorescence technique revealed the presence of a small population of fluorescent cells within the brain. The number and positions of these neurons were constant in animals of the same size, but varied with the size of the worm. The brains of small animals (8 mm in length) were found to contain 20 fluorescent cells, whereas the largest animals studied (30 mm in length) were found to have 28 such cells. Various intermediate cell numbers were found in animals between these two sizes. The origin of the newly added fluorescent cells is uncertain. Peripheral fluorescence was found in association with the tentacular ocelli (eyespots) and interneurons within the ventral submuscular nerve plexus. The fluorescent spectrum from these cells measured in situ had a lambda max of 526 nm. Treatment with HCl shifts this peak to 530 nm. L-dopamine fluoresces with a similar peak emission before HCl treatment (525.5 nm) and shifts to the appropriate longer wavelength (530 nm) following acidification. This strongly suggests that the fluorescent substance in the neurons is dopaminergic in nature. PMID- 3559507 TI - Hormonal regulation of myoblast proliferation and myotube production in vivo: influence of prostaglandins. AB - The study of myoblast proliferation and fusion to form myotubes in vivo has centered around the role of the innervating motoneurones. Hormonal factors such as prostaglandin E1 (PGE1) are important during in vitro myogenesis, but their role in vivo has yet to be elucidated. In vitro, PGE1 appears to switch myoblast from a mitotic to a fusion mode. Consistent with this hypothesis, administration of PGE1 to chicken embryos decreased the number of myonuclei incorporated into their muscles. The effect of inhibitors of prostaglandin synthesis (aspirin and indomethacin) on in vivo myogenesis was not, however, as expected. Both drugs decreased the number of myonuclei incorporated into the muscles of treated embryos, which is the opposite of what would have been expected if they were enabling myoblasts to undergo additional divisions by delaying their onset from the mitotic cycle. The simplest explanation of this observation is that the effect of aspirin and indomethacin is mediated by a prostaglandin other than E1, or by a systemic factor whose levels are regulated by a prostaglandin. The maximum extent of the reduction caused by PGE1 and the inhibitors of prostaglandin synthesis was only 25-30%, suggesting that only a subpopulation of myoblasts is effected by these drugs. The number of myotubes formed in the treated embryos closely paralleled the total number of myonuclei, indicating that the number of myoblasts fusing to form a myotube is constant even when the total number of available myoblasts is diminished. PMID- 3559508 TI - Differences in the macromolecular composition of the zona pellucida isolated from pig oocytes, eggs, and zygotes. AB - The macromolecular differences in the zona pellucida (ZP) isolated from pig oocytes, eggs, and zygotes were investigated using two-dimensional polyacrylamide gel electrophoresis. The ZP was isolated from individual cells or zygotes using micropipettes, radiolabeled with 125I and analyzed using disulfide bond reducing and nonreducing conditions. The reduced ZP isolated from oocytes was composed of four glycoprotein components. The gel pattern of the ZP isolated from a single oocyte was indistinguishable from that isolated en masse. The ovulated egg ZP contained the four oocyte components plus three additional macromolecules. Relative to the egg ZP, the zygote ZP lacked one component but had three additional smaller macromolecules. We concluded that: the macromolecular differences between the oocyte and egg ZPs are caused by the addition of macromolecules to the ZP as the egg transits the oviduct, the macromolecular differences between the egg and the zygote ZPs reflect hydrolytic processing of ZP glycoproteins probably by enzymes derived from the egg cortical granules, and the microheterogeneity of the pig ZP glycoproteins is due to posttranslational modification and is not due to population genetic variation. PMID- 3559509 TI - Heat shock protein induction and induced thermal tolerance are independent in adult salamanders. AB - Ectothermic vertebrates become thermally tolerant (heat hardened) after exposure to heat shock. Eukaryotic cells show a similar response. Cellular thermal tolerance is correlated with the induction of heat shock proteins (hsps). We have investigated the relationship between heat hardening in salamanders and the induction of hsps in the tissues of these organisms. Although the synthesis of hsps can be induced in these animals by sublethal heat shocks, conditions required for hsp induction and heat hardening often do not coincide. We conclude that induced thermal tolerance in adult salamanders is independent of hsp induction in their tissues. PMID- 3559510 TI - Some effects of adrenaline on anion transport and nitrite-induced methaemoglobin formation in the rainbow trout (Salmo gairdneri Richardson). AB - The effects of adrenaline on branchial anion transport and nitrite-induced methaemoglobinaemia have been investigated in rainbow trout. Nitrite uptake and efflux results suggest that adrenaline effects a net anion efflux principally by stimulation of the unidirectional branchial anion efflux. In oxygenated whole blood nitrite-induced methaemogloblin was significantly reduced in the presence of adrenaline. The physiological and environmental consequences of nitrite induced stress are discussed. PMID- 3559511 TI - Group-specific component subtyping by isoelectric focusing in narrow range ultrathin-layer polyacrylamide gels containing a mixture of separators. PMID- 3559512 TI - Cytoplasmic [Ca2+] and intracellular pH in lymphocytes. Role of membrane potential and volume-activated Na+/H+ exchange. AB - The effect of elevating cytoplasmic Ca2+ [( Ca2+]i) on the intracellular pH (pHi) of thymic lymphocytes was investigated. In Na+-containing media, treatment of the cells with ionomycin, a divalent cation ionophore, induced a moderate cytoplasmic alkalinization. In the presence of amiloride or in Na+-free media, an acidification was observed. This acidification is at least partly due to H+ (equivalent) uptake in response to membrane hyperpolarization since: it was enhanced by pretreatment with conductive protonophores, it could be mimicked by valinomycin, and it was decreased by depolarization with K+ or gramicidin. In addition, activation of metabolic H+ production also contributes to the acidification. The alkalinization is due to Na+/H+ exchange inasmuch as it is Na+ dependent, amiloride sensitive, and accompanied by H+ efflux and net Na+ gain. A shift in the pHi dependence underlies the activation of the antiport. The effect of [Ca2+]i on Na+/H+ exchange was not associated with redistribution of protein kinase C and was also observed in cells previously depleted of this enzyme. Treatment with ionomycin induced significant cell shrinking. Prevention of shrinking largely eliminated the activation of the antiport. Moreover, a comparable shrinking produced by hypertonic media also activated the antiport. It is concluded that stimulation of Na+/H+ exchange by elevation of [Ca2+]i is due, at least in part, to cell shrinking and does not require stimulation of protein kinase C. PMID- 3559513 TI - Mechanisms of the Ba2+-induced contraction in smooth muscle cells of the rabbit mesenteric artery. AB - The mechanism of the Ba2+-induced contraction was investigated using intact and saponin-treated skinned smooth muscle (skinned muscle) strips of the rabbit mesenteric artery. After depletion of Ca2+ stored in the caffeine-sensitive site, greater than 0.65 mM Ba2+ evoked contraction in muscle strips depolarized with 128 mM K+ in Ca2+-free solution in a dose-dependent fashion, and the ED50 values for Ca2+ and Ba2+ were 0.5 mM and 1.2 mM in intact muscle strips, respectively. Nisoldipine (10 nM) blocked the contraction evoked by high K+ or 10 microM norepinephrine (NE) in the presence of 2.6 mM Ba2+, but did not block the contraction evoked in the presence of 2.6 mM Ca2+. These results may indicate that Ba2+ permeates the voltage-dependent Ca2+ channel. In skinned muscle strips, the ED50 values for Ca2+ and Ba2+ were 0.34 and 90 microM, respectively, as estimated from the pCa- and pBa-tension relationships. Calmodulin enhanced and trifluoperazine inhibited the Ba2+- and Ca2+-induced contractions. After the application of Ba2+ or Ca2+ with ATP gamma S in rigor solution, myosin light chain (MLC) was irreversibly thiophosphorylated, as estimated from the Ba2+- or Ca2+-independent contraction. Furthermore, both divalent cations phosphorylated MLC, as measured using two-dimensional gel electrophoresis, to the extent expected from the amplitudes of the contraction evoked by these cations. Thus, Ba2+ is capable of activating the contractile proteins as Ca2+ does. The amount of Ca2+ or Ba2+ stored in cells was estimated from the caffeine response evoked in Ca2+-free solution in intact and skinned muscle strips. After the application of 0.3 microM Ca2+ or 0.1 mM Ba2+ for 60 s to skinned muscle strips after the depletion of Ca2+ stored in cells, caffeine produced a contraction only upon pretreatment with Ca2+ but not with Ba2+. When Ba2+ was applied successively just after the application of Ca2+, the subsequently evoked caffeine-induced contraction was much smaller than that evoked by pretreatment with Ca2+ alone. The above results indicate that Ba2+ permeates the voltage-dependent Ca2+ channel but may not permeate the receptor-operated Ca2+ channel, it releases Ca2+ from store sites but is not accumulated into the store site, and it directly activates the contractile proteins via formation of a Ba2+-calmodulin complex. PMID- 3559514 TI - Dynamics of turtle cones. AB - The response dynamics of turtle photoreceptors (cones) were studied by the cross correlation method using a white-noise-modulated light stimulus. Incremental responses were characterized by the kernels. White-noise-evoked responses with a peak-to-peak excursion of greater than 5 mV were linear, with mean square errors of approximately 8%, a degree of linearity comparable to the horizontal cell responses. Both a spot (0.17 mm diam) and a large field of light produced almost identical kernels. The amplitudes of receptor kernels obtained at various mean irradiances fitted approximately the Weber-Fechner relationship and the mean levels controlled both the amplitude and the response dynamics; kernels were slow and monophasic at low mean irradiance and were fast and biphasic at high mean irradiance. This is a parametric change and is a piecewise linearization. Horizontal cell kernels evoked by the small spot of light were monophasic and slower than the receptor kernels produced by the same stimulus. Larger spots of light or a steady annular illumination transformed the slow horizontal cell kernel into a fast kernel similar to those of the receptors. The slowing down of the kernel waveform was modeled by a simple low-pass circuit and the presumed feedback from horizontal cells onto cones did not appear to play a major role. PMID- 3559515 TI - Circadian rhythms in Limulus photoreceptors. I. Intracellular studies. AB - The sensitivity of the lateral eye of the horseshoe crab, Limulus polyphemus, is modulated by efferent optic nerve impulses transmitted from a circadian clock located in the brain (Barlow, R. B., Jr., S. J. Bolanowski, and M. L. Brachman. 1977. Science. 197:86-89). At night, the efferent impulses invade the retinular, eccentric, and pigment cells of every ommatidium, inducing multiple anatomical and physiological changes that combine to increase retinal sensitivity as much as 100,000 times. We developed techniques for recording transmembrane potentials from a single cell in situ for several days to determine what circadian changes in retinal sensitivity originate in the primary phototransducing cell, the retinular cell. We found that the direct efferent input to the photoreceptor cell decreases its noise and increases its response. Noise is decreased by reducing the rate of spontaneous bumps by up to 100%. The response is increased by elevating photon catch (photons absorbed per flash) as much as 30 times, and increasing gain (response per absorbed photon) as much as 40%. The cellular mechanism for reducing the rate of spontaneous quantum bumps is not known. The mechanism for increasing gain appears to be the modulation of ionic conductances in the photoreceptor cell membrane. The mechanism for increasing photon catch is multiple changes in the anatomy of retinal cells. We combine these cellular events in a proposed scheme for the circadian rhythm in the intensity coding of single photoreceptors. PMID- 3559516 TI - Contractile inactivation in frog skeletal muscle fibers. The effects of low calcium, tetracaine, dantrolene, D-600, and nifedipine. AB - Short muscle fibers (approximately 1.5 mm) of Rana pipiens were voltage-clamped with a two-microelectrode technique at a holding potential of -100 mV. Using conditioning depolarizing ramps, with slopes greater than 0.2 mV/s, partially inactivated responses are obtained at threshold values between -55 and -35 mV. With slopes equal to or slower than 0.1 mV/s, one inactivates contraction without ever activating it. When the membrane potential is brought slowly to values more positive than about -40 mV, test pulses, applied on top of the ramps, bringing the membrane potential to values up to +100 mV, are ineffective in eliciting contractile responses, which indicates complete inactivation. After inactivation, contractile threshold is shifted by perhaps 10 mV, to about -40 mV. The sensitivity of fibers to depolarizing ramps is increased by D-600 (50 microM), dantrolene (50 microM), tetracaine (100 microM), and low calcium (10(-8) M). In the presence of these agents, complete inactivation was obtained using ramp slopes of 1, 0.8, 0.4, and 0.2 mV/s, respectively. Nifedipine was less effective. With D-600, once inactivation had been induced, no repriming occurred after repolarization to -100 mV, and partial recovery occurred after washing out the drug. With low calcium, tetracaine, and nifedipine, the tension-voltage relationship was not affected, whereas the steady state inactivation curve (obtained in repriming experiments) was shifted by 10-25 mV toward more negative potentials. With D-600, the activation curve was not modified, whereas the inactivation curve could not be obtained, because of repriming failure. With dantrolene, the inactivation curve was not affected, whereas the activation curve was shifted toward less negative potentials and peak tension diminished, depending on the pulse duration. The results indicate that it is possible to induce complete inactivation without activation, and to differentiate activation and inactivation parameters pharmacologically, which suggests that the two are separate processes. PMID- 3559517 TI - Cell suspensions from porcine olfactory mucosa. Changes in membrane potential and membrane fluidity in response to various odorants. AB - A suspension of olfactory epithelial cells was prepared from porcine olfactory mucosa and the physiological functions of the suspension were examined. The membrane potential of the cell suspension, which was monitored by measuring the fluorescence changes of rhodamine 6G, was depolarized by an increase in the K+ concentration in the external medium. Various odorants depolarized the cell suspension in a dose-dependent fashion. The magnitude of depolarization by odorants was either unchanged or slightly increased by a reduction of the concentration of Na+, Ca2+, and Cl- in the external medium, which suggests that changes in the permeabilities of specific ions are not involved in depolarization by odorants. The application of various odorants to the cell suspension induced changes in the membrane fluidity at different sites of the membrane that were monitored with various fluorescent dyes [8-anilino-1-naphthalene sulfonate, n-(9 anthroyloxy) stearic acids, 12-(9-anthroyloxy) oleic acid, and (1,6-diphenyl 1,3,5-hexatriene)], which suggests that the odorants having different odors are adsorbed on different sites in the membrane. On the basis of these results, a possible mechanism of odor discrimination is discussed. PMID- 3559518 TI - Convective paracellular solute flux. A source of ion-ion interaction in the epithelial transport equations. AB - An electrolyte model of an epithelium (a cell and a tight junction in parallel, both in series with a lateral interspace basement membrane) is analyzed using the formalism of nonequilibrium thermodynamics. It is shown that if the parallel structures are heteroporous (i.e., reflection coefficients for two ion species differ between the components), then a cross-term will appear in the overall transport equations of the epithelium. Formally, this cross-term represents an ion-ion interaction. With respect to the rat proximal tubule, data indicating epithelial ionic reflection coefficients less than unity, together with the assumption of no transcellular solvent drag, imply the presence of convective paracellular solute flux. This means that a model applicable to a heteroporous structure must be used to represent the tubule, and, in particular, the cross terms for ion-ion interaction must also be evaluated in permeability determinations. A series of calculations is presented that permits the estimation of the Na-Cl interaction for rat proximal tubule from available experimental data. One consequence of tubule heteroporosity is that an electrical potential may be substantially less effective than an equivalent concentration gradient in driving reabsorptive ion fluxes. PMID- 3559519 TI - [12th meeting of the European Club of Genetic Counseling. Montecatini (Italy), 2 5 October 1985]. PMID- 3559521 TI - [Social diffusion of genetic counseling in the Provence Alpes-Cote d'Azur region]. AB - Accessibility to medical care in general, and to new techniques in particular, is unequal as much from a social as a geographical standpoint. We have reconstituted the geographical distribution network for genetic consultation at Marseilles for consultees having benefitted from genetic counselling in 1983 (984 files). For the region (except the Alpes Maritimes) the incidence rate for this consultation was 13.6 per 10,000 women of child bearing age. A parallel study of doctors participating in the recruitment of these patients objectifies the essential role of obstetricians, gynaecologists as well as general practitioners and shows different directions for training and data for the medical profession liable to contribute to better prevention of handicaps of genetic origin. PMID- 3559520 TI - [Analogy of Blaschko lines in the eye]. AB - In females random X-inactivation and subsequent embryonic development cause a specific distribution of cell clones. This aspect can be seen in carrier women for different X-linked diseases. In such dermopathies the carrier women show striated skin affections following a system of lines, which has been described by A. Blaschko in 1901. An analogous pattern can be seen in the retina of carrier women for the X-linked ocular albinism. The fundus shows a partial involvement with a striated pattern diverging from the papilla. In X-linked cataracts carrier women have lens opacities with an irregularly radiated pattern as well as segmental cataracts. This finding is demonstrated in the isolated X-linked cataract, the X-linked chondrodysplasia punctata, and in Lowe's syndrome. PMID- 3559522 TI - [Value of chromosome tests in genetic counseling of infertile couples]. AB - A cytogenetic analysis of more than 7000 subjects has been performed in the aetiological screening of infertile couples. This study revealed that infertile couples can be divided into three groups: those with one or more spontaneous abortions before 13 weeks of gestations, those with primary sterility (no gestation for at least 24 months) or those with secondary sterility (after one or more children, no further gestation for at least 24 months). The frequency of chromosomal abnormalities observed in this population is 2,9%, i.e. 1/17 couple. The results, according to sex of subjects bearing the chromosomal abnormality, were then analysed in each of the three groups. From this study, the authors insist on the advantage of systematically performing a chromosome analysis in the case of infertile couples for two main reasons: frequency of chromosomal abnormalities is relatively high in this population, detection of such abnormalities enables some couple to be rapidly directed to other solutions (Artificial Insemination), and others, due to prenatal chromosomal diagnosis, to have offspring in safety. PMID- 3559523 TI - [An excess of mental retardation and/or congenital malformations in carriers of reciprocal translocations. A difficult and delicate problem in genetic counseling]. AB - Excess of mental retardation and/or congenital malformations in reciprocal translocations in man. A difficult problem in genetic counselling: In this report the Leuven experience (1970-1984) on reciprocal translocations is summarized. A total number of 154 unrelated index-patients, carriers of different types of reciprocal translocations, and their families were investigated. The excess of MR/CM in de novo and familial balanced translocation carriers is illustrated and discussed. PMID- 3559524 TI - [Mosaic tetrasomy 12p. Identical nature of the Pallister syndrome, the Teschler Nicola/Killian syndrome and mosaic tetrasomy 21]. AB - In two cases, first interpreted as mosaic tetrasomy 21, the R banding and the gene dosage studies lead us to conclude to a mosaic tetrasomy 12 p. In Pallister mosaic syndrome and in Teschler-Nicola/Killian syndrome, the very similar clinical signs and the identical abnormal chromosome, missing in leucocytes, led us to conclude that Pallister and Teschler-Nicola/Killian syndrome, as well as mosaic tetrasomy 21 are one and the same syndrome tetrasomy 12 p. This tissue limited mosaic is probably more frequent than it is assumed. Prenatal diagnosis can be made since the supernumerary chromosome is found in amniocytes. The distinctive tissue distribution is probably a selective process due to cellular differentiation gene, CD9 (or Alb 6) located to 12 p. PMID- 3559525 TI - [What course should be adopted after the discovery of a gonosome anomaly in the fetal karyotype?]. AB - An experience of three centers of genetic counselling (West France). The authors attempts to explain why in 9 cases the pregnancy was not terminated. PMID- 3559526 TI - Isolation of Inoue-Melnick virus from human meningioma-derived cell cultures and detection of antibody in patients with meningioma. AB - Inoue-Melnick virus (IMV) was isolated from six of seven human meningioma-derived cell cultures, while the virus was not isolated from six other brain tumor cell cultures. Sera of 145 consecutive neurosurgical inpatients were tested for IMV neutralizing antibody. Of 26 patients with meningioma, 22 were positive for IMV antibody (84.6%). Of the remaining 119 patients, 16 were positive. PMID- 3559527 TI - Chronic, relapsing encephalomyelitis associated with experimental measles virus infection. AB - An experimental central nervous system (CNS) disease that bears some similarity to human multiple sclerosis and that is associated with infection by measles virus has been induced in hamsters. This disease has been described previously (Carrigan and Johnson: Proceedings of the National Academy of Sciences 77:4297 4300, 1980). At that time, it was believed that the disease was restricted to the spinal cords of affected animals. The present work demonstrates that the disease can also affect the brain, describes in more complete detail the types of clinical disease that occur, illustrates the histopathological changes found in diseased CNS tissues, and documents more accurately the incidence of the disease in the virally infected animals. In summary, the disease, which has now been termed chronic, relapsing encephalomyelitis (CRE) is associated with neonatal CNS infection of hamsters with a particular strain of measles virus. CRE occurs in approximately 12% of animals that survive the acute viral infection, and of these affected animals about half develop detectable clinical signs of neurological disease. The balance of the animals have subclinical disease detectable only by histopathologic changes within the CNS. These lesions are composed of varying degrees of demyelination, necrosis, mononuclear cell inflammation, and gliosis. PMID- 3559528 TI - Character traits underlying self-neglect and their connection with heart disease. PMID- 3559529 TI - Masqueraders: wide QRS complexes. PMID- 3559530 TI - Tripartite block. PMID- 3559531 TI - Do dreams reflect a biological state? AB - The purpose of this study was to prospectively evaluate the hypothesis that dreams reflect biological states. Inpatients on a nonacute cardiology service were studied. Dream material was gathered by an independent interviewer using the Staged Interview Technique, a newly developed interview technique that limited bias. The outcome measures used were obtained at the time of cardiac catheterization. Different levels of severity of cardiac disease with these measures were interpreted as representing different biological states. The patients' dreams were evaluated for the predicted correlations of the number of dream references to death (men) and separation (women) with different levels of severity of heart disease. The severity of heart disease was evaluated with anatomical (coronary angiography) and physiological (ejection fraction) measures obtained at cardiac catheterization, each represented by a 6-point scale of increasing severity. There was no correlation of the number of dream references with the severity of abnormalities on coronary angiography. However, the number of dream references to death and separation correlated with the severity of cardiac dysfunction, as measured by the ejection fraction, which is a more sensitive parameter of disease severity. The data provided prospective support for the hypothesis by showing that dreams reflected a biological state, the ejection fraction. This suggested a possible biological "meaning" of dreams. PMID- 3559532 TI - Learning impairment in alcoholics using an ecologically relevant test. AB - Sober male middle-aged alcoholics with a mean duration of 11.5 years of abuse and abstinence for a minimum of 3 weeks performed more poorly than age- and education equated controls on a face-name learning test, replicating previously reported findings. Duration of alcoholism was unrelated to learning scores; however, a measure of alcohol intake (maximal quantity-frequency) over the 6 months before treatment was significantly and inversely correlated with learning. Significant positive correlations between face-name learning and ratings of alcoholics' treatment behavior by their therapists provided objective evidence that the face name learning test is ecologically relevant. PMID- 3559533 TI - Verbal reasoning deficits in alcoholics. AB - The Conceptual Level Analogies Test (CLAT), a well-constructed test of analogical reasoning, was given to groups of middle-aged male alcoholics and control subjects in two separate studies. As predicted, the alcoholics had lower CLAT scores than nonalcoholics in both studies. These results support the generalized diffuse model of the neuropsychological effects of alcoholism. Contrary to prediction, alcoholics differed from control subjects as much on the easy analogies as they did on the hard analogies, which suggested that alcoholics differ both qualitatively and quantitatively from nonalcoholics in cognitive impairment. Finally, in two of three studies in our laboratory, familial alcoholics had significantly lower CLAT scores than nonfamilial alcoholics. These findings emphasize the importance of considering familial history of alcoholism when studying the neuropsychological functioning of alcoholics. PMID- 3559534 TI - Short-term retest reliability of the Halstead-Reitan Battery in a normal sample. AB - Very few studies have examined short-term retest reliability of the Halstead Reitan Battery in patient samples or normal subjects. The present study examined 3-week retest reliability in a sample of normal healthy subjects. Both psychometric and clinical reliability issues were addressed. On most of the tests the changes between testing were nonsignificant. The measures with the greatest changes were those that appear to incorporate a problem-solving or adaptability component. It was concluded that some of the Halstead-Reitan measures may not be useful in studying short-term changes in performance. On the other hand, most of the measures did not demonstrate significant changes over the 3-week interval and may be useful in examining such short-term changes in performance. PMID- 3559535 TI - Electroconvulsive therapy use in geriatric depression. AB - A retrospective review of elderly patients who received electroconvulsive therapy (ECT) over an 18-month period found ECT to be safe and effective. Of the 1159 patients admitted to the psychiatric unit during this time period, 50 patients (4.3%) aged 61 to 88 received between two and 14 ECT treatments. Brief pulse current with bilateral electrode placement and electroencephalogram monitoring were used with each patient. A total of 46 patients (92%) were much improved after ECT. Of the four nonresponders, three terminated treatment prematurely due to increased confusion, and one failed to respond after a course of 12 ECT treatments. There were no medical complications related to the ECT. A mean of 4.93 months from the onset of symptoms until receiving ECT may be one factor in our better outcome compared to some recent studies where treatment was delayed. The exclusive use of brief pulse current and its resultant lower level of confusion also may be important. PMID- 3559536 TI - Intractable manic-depressive psychosis with rapid cycling in an 18-year-old woman successfully treated with electroconvulsive therapy. AB - An adolescent patient with a history of progressively more severe seasonal depression subsequently developed a refractory manic-depressive psychosis with rapid cycling after the initiation of treatment with trimipramine. A complete remission was obtained after a course of six electroconvulsive therapy (ECT) treatments. This unusual case and its outcome are discussed in terms of apparent drug-induced rapid cycling and the treatment of this condition. It is suggested that ECT can be successfully used as an alternative therapeutic option for patients with intractable rapid-cycling manic-depressive disorder. PMID- 3559537 TI - Conformationally rigid dopamine analogues as inhibitors of dopamine and 5 hydroxytryptamine uptake by synaptosomes. AB - Derivatives of trans-decalin with a dopamine moiety incorporated in different conformations were studied as inhibitors of dopamine and 5-HT uptake in rat brain synaptosomes. In three derivatives the relation of the catechol ring and the amino function was gauche, in one isomer it was anti. One of the gauche isomers, (+/-)-2(a)-amino-3(e)-3, 4-dihydroxyphenol-trans-decalin had an affinity to the dopamine uptake system which was about one fourth of that of dopamine itself. The inhibition was competitive. The affinity of other isomers was about ten per cent or less of the affinity of dopamine. The active isomer was identical in conformation to the most active isomer in respective noradrenaline-derivatives tested previously. These results favour the view that the dopamine uptake site is able to accept the substrate as the gauche rotamer. This was not true with 5-HT uptake, and requirements for these two uptake sites may be conformationally different. PMID- 3559538 TI - Distribution of 3,4-dihydroxyphenylacetic acid (DOPAC) and 3,4 dihydroxyphenylglycol (DOPEG) in microdissected brain structures and the pituitary gland: metabolite changes in the median eminence in response to hyperprolactinemia and suckling. AB - Dopamine (DA), norepinephrine (NE), epinephrine (E), 3,4-dihydroxyphenylglycol (DOPEG) and dihydroxyphenylacetic acid (DOPAC) were determined simultaneously by a radioenzymatic, thin-layer chromatographic assay able to detect 1-10 pg of the parent compounds and 80-120 pg of their metabolites. A localization study of these compounds in 20 micro-dissected hypothalamic and limbic structures and the anterior and posterior pituitary glands of male rats was completed. DOPAC was detectable in 14 of 22 structures with the lowest DOPAC/DA ratio being found in the caudate nucleus (7.1%) and the highest in the medial aspect of the ventromedial nucleus of the hypothalamus (422.0%). There was a higher DOPAC/DA ratio in the lateral (21.5%) than in the medial (11.3%) portion of the median eminence suggesting that a greater portion of released DA in the medial median eminence enters the portal circulation. DOPEG was detectable in 6 of 22 structures with DOPEG/NE ratios ranging from 8% (interstitial nucleus of the stria terminalis, ventral aspect) to 32% (medial median eminence). A poor correlation exists between DOPAC and DA concentrations in the various brain regions while there was a stronger relationship between DOPEG and NE concentrations. Male rats were rendered hyper-prolactinemic for 48 hours with injections of ovine prolactin (oPRL) every 8 hours (4 mg/kg body weight sc). In such rats there was a suppression of endogenous rat PRL (rPRL) secretion, the DOPAC/DA ratio increased 2.2-fold in the medial (MEm) and 1.9-fold in the lateral median eminence (MEl), and the DA concentration in the anterior pituitary also increased 2.6-fold. In 10 day postpartum lactating rats, suckling produced marked increases in serum rPRL but no change in DOPAC/DA ratios in the ME or in the DA concentration in the anterior pituitary. The data reveal a wide range of DOPAC/DA ratios (7-422%) in brain regions containing cell bodies, axons and terminals of the different dopaminergic neuronal tracts in brain and pituitary. Considering the DOPAC/DA ratios in the MEm and MEl, it is suggested that a large perturbation of dopaminergic transmission produces a significant ratio change while a smaller perturbation is not detected by this index of neuronal metabolism. PMID- 3559539 TI - Diltiazem or verapamil prevents haloperidol-induced apomorphine supersensitivity in mice. AB - Chronic thioridazine treatment in animals has been reported to produce less dopaminergic supersensitivity than other neuroleptics. This difference may be due to the potent calcium channel inhibitory effect of thioridazine. To test this hypothesis Swiss-Webster mice were treated chronically (28 d) with calcium channel inhibitors (CCI's) - diltiazem, nifedipine or verapamil - with or without haloperidol. Following three days of drug withdrawal, mice were tested for amphetamine-induced locomotion and apomorphine-induced cage climbing. Co administration of diltiazem or verapamil (but not nifedipine) prevented the development of haloperidol-induced behavioral supersensitivity to apomorphine. Co administration of CCI's with haloperidol did not affect the development of amphetamine supersensitivity. These data support the hypothesis that co administration of haloperidol and a CCI (verapamil or diltiazem, but not nifedipine) would mimic the effects of thioridazine treatment alone. PMID- 3559540 TI - Regional differences in local cerebral blood flow (LCBF) and glucose utilization (LCGU) in the basal ganglia after occlusion of the middle cerebral artery in rats. AB - Acute effects of occlusion of the middle cerebral artery on local cerebral blood flow (LCBF) and local cerebral glucose utilization (LCGU) were investigated quantitatively in separate groups of rats using (14C) iodoantipyrine (14C-IAP) or (14C) 2-deoxyglucose (14C-DG) respectively. LCBF was significantly decreased in the ipsilateral cerebral cortices (to less than 45 ml/100 g/min or 30% of the control side) and the lateral part of the striatum (to 22 ml/100 g/min or 10% of the control side) which were supplied by the middle cerebral artery. No significant changes in LCBF were found in any other of the subcortical regions. In contrast to the unanimous decrease of LCBF in the ipsilateral cortices and the lateral striatum, complexed changes in LCGU were found in not only the cortex and striatum but also in many other subcortical regions which were closely related to the distribution of the mesencephalic dopamine neurons, such as globus pallidus, substantia nigra, subthalamic nucleus, nucleus accumbens, olfactory tubercle and lateral habenular nucleus. Relevance of this putative neurotransmitter and GABA on the glucose metabolism in ischemic brain is discussed. PMID- 3559541 TI - Studies in postmortem dopamine uptake. I. Kinetic characterization of the synaptosomal dopamine uptake in rat and human brain after postmortem storage and cryopreservation. Comparison with noradrenaline and serotonin uptake. AB - The effect of various post-mortem storage times and temperatures on the kinetic parameters of synaptosomal high-affinity dopamine (DA) uptake was studied in rat nucleus accumbens. After post-mortem storage up to 48 hours of rat heads in situ at 22 degrees C the KM data increase moderately in contrast to the Vmax data decreasing rapidly (t1/2 = 30 hours); at 2 degrees C similar changes were observed. The post-mortem changes of the kinetic parameters of noradrenaline (NA) and serotonin (5 HT) uptake were shown in this model to be similar. It is proposed to use this animal model for correcting the kinetic data of DA, NA and 5 HT uptake in human brains regarding the various post-mortem delays. Furthermore, in cryopreservation experiments using a two-step freezing procedure in liquid nitrogen of brain pieces preincubated with dimethylsulfoxide DA uptake of rat and human brain synaptosomes was unchanged after freezing-thawing. The same is true for both NA and 5 HT uptake as demonstrated in human brain tissue. Therefore, post-mortem human brain seems to be suitable for investigating synaptosomal DA, NA, and 5 HT uptake after cryopreservation and correcting for post-mortem delay, when determining kinetic parameters. PMID- 3559542 TI - Studies in postmortem dopamine uptake. II. Alterations of the synaptosomal catecholamine uptake in postmortem brain regions in schizophrenia. AB - Kinetic parameters KM and Vmax of the synaptosomal high-affinity dopamine (DA) and noradrenaline (NA) uptake were measured in the nucleus (n.) accumbens, n. caudatus and frontal cortex from post-mortem brains of schizophrenic patients and matched controls. Additionally, the 5-hydroxytryptamine (5 HT) uptake was determined in the n. accumbens of the same specimens. The KM and Vmax data of DA uptake were significantly elevated in the n. accumbens (KM to 253%, Vmax to 271%) and in the n. caudatus (KM to 201%, Vmax to 174%) of schizophrenics in comparison with controls. The kinetic parameters of the NA uptake increased similarly in the n. accumbens and n. caudatus of schizophrenics in comparison with controls. The alterations in DA and NA uptake kinetics do not seem to be primarily dependent on neuroleptic medication. On the other hand, DA and NA uptake in the frontal cortex as well as 5 HT uptake in the n. accumbens was unchanged. The results are compatible with the hypothesis that both DA and NA transmission systems are changed in schizophrenia. They give a first indication of presynaptic functional alterations in schizophrenia. PMID- 3559543 TI - Reduced concentrations and increased metabolism of biogenic amines in a single case of Rett-syndrome: a postmortem brain study. AB - Preliminary data of a postmortem brain study in a single case with Rett-syndrome compared to a single control case show a severe reduction of dopamine (DA), noradrenaline (NA), and serotonin (5-HT) in most regions studied and in two regions of adrenaline (A). A marked increase in the 3,4-dihydroxyphenyl acetic acid (DOPAC)/DA, homovanillic acid (HVA)/DA, and the 5-hydroxyindole acetic acid (5-HIAA)/5-HT ratios indicates increased metabolism of DA and 5-HT. Also a marked reduction of 3H-spiroperidol-binding in putamen was found. This agrees with the assumption that a defect in maturation processes of central monoaminergic systems could be an underlying cause of Rett-syndrome. PMID- 3559544 TI - Spin, oxidation, and ligand states of p-nitrothiophenolatoiron(III) complex of protoporphyrin-IX-dimethylester in the presence of 1-MeIm: magnetic circular dichroism and 1H nuclear magnetic resonance spectroscopic studies. AB - Complex formation of 5-coordinated iron(III) heme containing thiolate anion (p nitrothiophenol) with imidazole (1-methylimidazole) showed very interesting features depending on the nature of the solvent and the ratio of the ligand to heme. The complexes formed under different conditions were not only low spin iron(III) complexes with a thiolate anion and an imidazole or with two imidazoles, but also reduced (iron(II] complexes with a thiolate and an imidazole or with two imidazoles. Absorption, magnetic circular dichroism, and 1H NMR spectroscopies could identify the complex formed when they were used concurrently. The dependence of polarity of the solvents used on the resultant chemical species was ascribed to the stability of Fe(III) or Fe(II) complex in the different solvents. The iron(III) complex with a thiolate anion and an imidazole was found to be reduced automatically to the iron(II) complex with a thiolate and an imidazole which exchanged ligand to the iron(II) bisimidazoles in the presence of excess imidazole. This study showed that the ligands of heme are easily exchanged and that the heme iron(III) is automatically reduced in several conditions. Possible significance with respect to biological systems containing a sulfur ligand is discussed. PMID- 3559546 TI - Differences in effect of Mn(II), Fe(III), Co(II), and Zn(II) ions on trypsinogen activation. AB - The influence of Mn2+, Fe3+, Co2+, and Zn2+ ions on the extent of trypsinogen activation has been determined for several ion concentrations at pH 7.4 and 36.4 degrees C. For the Mn2+ ion also the autocatalytic rate constants have been detected. The effect of Ca2+ has been reinvestigated for comparison purposes. The apparent dissociation constants of KMn2+ = 0.01 (M) and KCa2+ = 0.02 (M) have been found for the given metal ion-trypsinogen complexes. For Co2+ ion, however, only a slight effect and for Fe3+ and Zn2+ ions no significant effect could be detected on trypsinogen activation. The investigated ions are of empty, open, and completed d subshells of electrons and they are different also in their ionic size. The differences in effects of the ions are discussed on the basis of these factors. PMID- 3559545 TI - Iron binding by phosvitins: variable mechanism of iron release by phosvitins of diverse species characterized by different degrees of phosphorylation. AB - The rate of reductive iron release from Fe(III) complexes of phosvitins of diverse fish species, at varied initial degrees of saturation with iron, was studied with particular attention to the effect of the degree of phosvitin phosphorylation on the kinetics of iron release. The reaction was followed colorimetrically as phosphorprotein-bound iron was transferred to an excess of o phenanthroline, in the presence of hydroquinone as a reducing agent. The principal finding was the variability of the kinetic order or iron release by phosvitins, depending on their degree of saturation with iron and the extent to which their serine residues were phosphorylated. Highly phosphorylated proteins, especially at high initial degrees of iron saturation, obey first-order kinetics. Partially phosphorylated proteins, especially at low initial degrees of iron saturation, release their iron in a zero-order fashion. First-order rates imply that the iron binding sites are kinetically independent of each other. Zero-order behavior appears to reflect iron release from hypothetical iron-binding clusters serving as kinetically effective reactive centers of unchanging concentration for most of the time course of the reaction. Variations of the initial degree of iron saturation of given phosvitins produced variations in their kinetic behavior. The results are considered in terms of a dynamic model of phosvitin iron binding sites which may constitute themselves diversely, in response to the amount of iron that is to be accommodated, or may reconstitute themselves as their molecular environment becomes altered. PMID- 3559547 TI - Spectroscopic studies on Zn(II)-phthalocyanine in homogeneous and microheterogeneous systems. AB - The absorption and fluorescence properties of Zn2+-phthalocyanine (Zn-Pc) have been characterized in homogeneous and microheterogeneous media. By our preparation procedure, the phthalocyanine can be associated in a monomeric state with cationic micelles, unilamellar liposomes, and low-density lipoproteins; the distribution of Zn-Pc in the hydrophobic phases appears to be controlled by the nature of the lipid environment. The potential use of liposome-bound Zn-Pc for photosensitization studies in aqueous media and for phototherapeutic applications in vivo is briefly discussed. PMID- 3559548 TI - Complexation of aluminum with DNA. AB - The extent of complexation of aluminum(III) with DNA (Calf thymus, Sigma type I) was estimated by means of two experimental techniques: potentiometric titration with a fluoride selective indicator electrode and dialysis followed by aluminum determination by graphite furnace AAS. Both types of experiments indicate that aluminum(III) is bound to DNA. The data are treated by assuming an ion exchange reaction with the phosphate diester groups. Using Rt to denote the concentration of these groups the values of log [AlMn-3R]/(Rt-3[AlMn-3R])[Al3+] decrease from approx. 7.6 to 5.6 when the concentration of sodium chloride is increased from 1 to 100 mM. In the pH range 4.5-5.5 the ion exchange constant increases approximately 0.5 log units. Dialysis gives lower values for the complex formation constant than potentiometry. PMID- 3559549 TI - Metabolism of selenomethionine and effects of interacting compounds by mammalian cells in culture. AB - Since differences have been found in animals, the efficacies of selenomethionine (SeMet), selenite, and selenocystine (SeCys) for glutathione peroxidase (GPx) induction and cellular incorporation were compared and some effects of interacting nutrients on SeMet utilization were examined in tissue cultures. In three cell lines, Chang liver cells, mouse myoblasts and human fibroblasts, selenite was more effective than SeMet for GPx induction. However, radiotracer studies showed that SeMet was more rapidly incorporated into all cells than either selenite or SeCys. Chromatography of acid hydrolysates of Chang liver cells grown with 75Se-labeled SeMet indicated that approximately 90% of incorporated 75Se remained as SeMet, and less than 10% was as SeCys, the form of Se in GPx. Selenite supplementation slightly reduced both the incorporation of 75SeMet and the proportion of cellular 75Se recoverable as SeCys in Chang liver cells. Supplementation with L-methionine, however, significantly reduced 75SeMet incorporation, but significantly increased the proportion of cellular 75Se recovered as SeCys. L-cystine supplementation had no effect on either the cellular incorporation of 75SeMet or the proportion of cellular 75Se recovered as SeCys. These studies of SeMet utilization and effects of interacting nutrients are reflective of observations on SeMet metabolism in whole animals and humans. PMID- 3559550 TI - On coordination modes of adenine in cadmium(II) complexes. AB - Complexes of cadmium(II) derivatives with adenine from water or by simulation of physiological conditions are obtained. The complexes have been studied by spectroscopic, conductometric, 1H-NMR, and by TG and DSC measurements. Possible coordination modes of the ligand are proposed. PMID- 3559551 TI - Platinum(IV) chloride complexes with heterocyclic ligands. AB - Platinum(IV) chloride complexes with heterocyclic ligands have been prepared and characterized by infrared and electronic spectra. The compounds are of general formula Pt(L)nCl4, where L = N-ethylimidazole, N-propylimidazole, isoxazole, 3,5 dimethylisoxazole, benzoxazole, 2-methylbenzoxazole, 2,5-dimethylbenzoxazole, ethylenediamine, n = 2, 4, and also Pt(enEt2)3Cl4 X 2H2O, where enEt2 = N,N diethylethylenediamine. These complexes are hexacoordinate with cis or trans configuration. The antitumoral activity of some complexes in mice inoculated with leukemia L1210 is reported. PMID- 3559552 TI - Developmental change in the amount of polysialosyl glycopeptides isolated from the rat brain. AB - Polysialosyl glycopeptides were coisolated with glycosaminoglycans by Pronase digestion of the whole brains of perinatal rats and could be separated from known glycosaminoglycans by two-dimensional electrophoresis on cellulose acetate film. The polysialosyl glycopeptides could not be obtained from fetal rat brain on day 13 of gestation, but began to be detected on day 14. The amount of polysialosyl glycopeptides was estimated from the dye concentration of the Alcian blue-stained spot in the electrophoretogram. The glycopeptide content increased almost linearly, on the basis of brain DNA, up to 10 days after birth. Thereafter, the content decreased rapidly, and hardly any polysialosyl glycopeptides could be isolated from the brain at approximately 30 days. This developmental change may be involved in morphogenesis and maturation of the brain. The polysialosyl glycopeptides could be isolated from the cerebellum, from the cerebrum, or from the brainstem of the neonatal rat. However, each region of the brain had a postnatal developmental change in glycopeptide content different from those of the other regions. PMID- 3559553 TI - Prenatal monosodium glutamate causes long-lasting cholinergic and adrenergic changes in various brain regions. AB - Prenatal monosodium glutamate (MSG) given through the mother's diet was found previously to cause behavioral changes in the offspring, including learning disabilities. In the present study, neurochemical parameters were measured in the brains of prenatally exposed rats at various ages throughout development up to adulthood. At 15 days of age, choline uptake and choline acetyltransferase (ChAT) activity in the frontal cortex were significantly reduced (by 80 and 25%, respectively) in MSG-exposed animals, whereas the same cholinergic parameters in hippocampus were not changed. During later development, choline uptake gradually increased, until in adulthood it became significantly higher in MSG-exposed animals than in the controls. This enhancement was found in both males and females. Our previous study showed that only the male offspring were learning disabled. Choline uptake and ChAT activity were enhanced in the hippocampus of adult male animals. Norepinephrine (NE) uptake was reduced (by 25%) in the frontal cortex of males only. There was no change in NE uptake in the hypothalamus. PMID- 3559554 TI - An in vivo model for studying function of brain tissue temporarily devoid of glial cell metabolism: the use of fluorocitrate. AB - The effect of intrastriatal injection of fluorocitrate on amino acid pattern, cell enzyme markers, and ultrastructural appearance was investigated. A dose of 1 nmol of fluorocitrate resulted in temporarily decreased levels of glutamine, glutamate, and aspartate, whereas the level of alanine was increased. The glutamine level was severely reduced after 4 h but was reversed after 24 h. The activity of different cellular enzyme markers did not change markedly after this dose. Ultrastructural changes in glial cells were observed, concomitant with the biochemical changes. A dose of greater than or equal to 2 nmol of fluorocitrate resulted in more marked and irreversible changes in amino acid levels. By 24-72 h after the injection of this dose, several marker enzyme activities decreased markedly. The ultrastructural changes affected the neurons as well as the glial cells and were not reversible. The use of microinjection of 1 nmol of fluorocitrate into the neostriatum of the rat to provide a model for studying transmitter amino acid metabolism in brain devoid of glial cell activity is discussed. PMID- 3559555 TI - Quantitative autoradiographic analysis of the effects of electroconvulsive shock on serotonin-2 receptors in male and female rats. AB - Chronic electroconvulsive shock (ECS) is known to increase the level of serotonin 2 (S2) receptors in male rat brain. Using quantitative autoradiography, we have studied the distribution pattern of these receptors in female as well as male rats and the effect of repeated ECS on the receptor level in both sexes. We find that although the distribution of S2 receptors is generally similar in males and females, they respond differently to repeated ECS. In males we found the expected increase in S2 binding, which was localized to specific cortical, hippocampal, and septal regions. In females, no increase was found in the cortex or septum and relatively small increases were found in the hippocampus. It appears that the regulation of S2 receptors by ECS is sex-dependent. PMID- 3559556 TI - Histamine acting on H2 receptors stimulates phospholipid methylation in synaptic membranes of rat brain. AB - Histamine stimulated [3H]methyl group incorporation into phospholipids in crude synaptic membranes of rat whole brain (without cerebellum) in modified Krebs Ringer solution containing the methyl donor S-adenosyl-[methyl-3H]methionine. The transient increase of [3H]methyl incorporation into lipids peaked within 45 s after addition of histamine (5 or 10 microM) and decreased the basal level in 60 s. Histamine-stimulated [3H]methyl incorporation was increased linearly in a protein concentration-dependent manner. The stimulation was temperature and histamine concentration dependent. TLC analysis of a chloroform/methanol extract indicated that radioactive phospholipids (phosphatidylcholine, phosphatidyl-N,N dimethylethanolamine, and phosphatidyl-N-monomethylethanolamine) accounted for 60 65% of the total radioactivity recovered. The synaptosomal fraction had the highest specific activity of all the subfractions of crude synaptic membranes (P2). Histamine-induced [3H]methyl incorporation was inhibited by addition of cimetidine (0.01-10 microM) or famotidine (0.01-1.0 microM) in a concentration dependent manner but not by mepyramine (0.1-10 microM) or diphenhydramine (0.1-10 microM). The stimulation of [3H]methyl incorporation was also observed by addition of impromidine (0.01-10 microM) or dimaprit (1.0 microM-1.0 mM) in a concentration-dependent manner but not by 2-pyridylethylamine (1.0 microM-1.0 mM). These results indicate that phospholipid methylation is induced by histamine acting on H2 receptors in rat brain synaptosomes. PMID- 3559557 TI - Enzymatic protection against peroxidative damage in isolated brain capillaries. AB - The content of polyunsaturated fatty acids, the activities of superoxide dismutase (SOD), glutathione peroxidase, glutathione reductase, and catalase, and the concentration of reduced glutathione were measured in cerebral microvessels isolated from rat brain. Polyunsaturated fatty acids, mainly arachidonic, linoleic, and docosahexaenoic acids, accounted for 32% of total fatty acids in cerebral microvessels. Whereas total SOD activity in the microvessels was slightly lower than that found in cerebrum and cerebellum, glutathione peroxidase and glutathione reductase activities were twice as high and catalase activity was four times higher. Glutathione peroxidase in microvessels is active on both hydrogen peroxide and cumen hydroperoxide, and it is strongly inhibited by mercaptosuccinate. After several hours of preparation, the concentration of reduced glutathione in isolated microvessels was 0.7 mumol/mg of protein, which corresponds to a concentration of approximately 3.5 mM. Our results indicate that the blood-brain barrier contains large amounts of peroxide-detoxifying enzymes, which may act, in vivo, to protect its highly polyunsaturated membranes against oxidative alterations. PMID- 3559558 TI - Characterization and partial purification of a novel neuronotrophic factor from bovine seminal vesicle. AB - Extracts from bovine seminal vesicles have been shown to contain high concentrations of nerve growth factor (NGF)-like biological activity and of the NGF protein with properties corresponding to that of NGF from other sources. We now demonstrate that a second neuronotrophic protein, termed seminal vesicle derived neuronotrophic factor (SVNF), is present in seminal vesicle extracts (SVEs), which could not be distinguished from NGF on the basis of biological activity. SVNF has neuronotrophic activity on NGF target cells like embryonic chicken-sensory and sympathetic neurons, sympathetic neurons, and chromaffin cells from neonatal rats, but it is inactive on embryonic chicken ciliary or neonatal rat nodose ganglion neurons. It also stimulates fiber outgrowth from rat pheochromocytoma (PC 12) cells. In gel filtration chromatography on Biogel A 1.5 m, the activity is eluted with an apparent molecular weight of 40 kilodaltons, and by preparative isoelectric focusing, the isoelectric point was determined to be in the neutral range (6.8-7.8). The biological activity of SVNF, in contrast to that of NGF, is partially retained after preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis and can be electrophoretically eluted with an apparent molecular weight of 16-20 kilodaltons. Electrophoretically purified SVNF is not inhibited by antisera to mouse NGF, but its activity is increased greater than 10-fold in the presence of very low concentrations of NGF. For partially purified SVNF, a specific activity of 2.9-5.8 X 10(5) biological units/mg of protein was determined in the presence of subthreshold NGF concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559559 TI - Regional selectivity of a gamma-aminobutyric acid-induced [3H]acetylcholine release sensitive to inhibitors of gamma-aminobutyric acid uptake. AB - The effects of gamma-aminobutyric acid (GABA) on the release of [3H]acetylcholine ([3H]ACh) were studied in synaptosomes prepared from rat hippocampus, cerebral cortex, hypothalamus, and striatum and prelabelled with [3H]choline. When synaptosomes were exposed in superfusion to exogenous GABA (0.01-0.3 mM) the basal release of newly synthesized [3H]ACh was increased in a concentration dependent way in hippocampus, cortex, and hypothalamus nerve endings. In contrast, the release of [3H]ACh was not significantly affected by GABA in striatal synaptosomes. The effect of GABA was not antagonized significantly by bicuculline or picrotoxin. Muscimol caused only a slight not significant increase of [3H]ACh release when tested at 0.3 mM whereas, at this concentration, (-) baclofen was totally inactive. The GABA-induced release of [3H]ACh was counteracted by SKF 89976A, SKF 100561, and SKF 100330A, three strong and selective GABA uptake inhibitors. The data suggest that, in selective areas of the rat brain, GABA causes release of [3H]ACh following penetration into cholinergic nerve terminals through a GABA transport system. PMID- 3559561 TI - Dopamine and serotonin metabolism in brain sites ipsi- and contralateral to direction of conditioned turning in rats. AB - Concentrations of dopamine, serotonin, and some of their metabolites were analyzed by means of HPLC in brain samples obtained from rats operantly conditioned to turn in circles to obtain water reinforcement. In experiment 1 using Wistar rats, no differences in the levels of transmitters or metabolites were detected between brain samples (frontal cortex, ventral striatum, dorsal striatum, septum, amygdala, substantia nigra) from the hemispheres located ipsi- and contralateral to the direction of turning. A higher dopamine metabolism (indicated by higher metabolite/transmitter ratios) in ventral striatum, dorsal striatum, and amygdala was found after 15 min than after 5 min of turning in both hemispheres. A higher dopamine metabolism was found in water-deprived rats compared to nondeprived rats independently of whether or not deprived rats were trained to turn for water reinforcement. In two additional experiments, no differences in dopamine metabolism were found between the ipsi- and contralateral striatum of Wistar rats after 25 min and Sprague-Dawley rats after 10 min of operantly conditioned turning. The present results confirm that dopamine metabolism can change with different behavioral or physiological states; they do not support the hypothesis that conditioned turning is correlated with asymmetrical changes in the metabolism of dopamine or serotonin in the brain. PMID- 3559560 TI - Determination of endogenous acetylcholine release in freely moving rats by transstriatal dialysis coupled to a radioenzymatic assay: effect of drugs. AB - The technique of intracerebral dialysis in combination with a sensitive and specific radioenzymatic method was used for recovery and quantification of endogenous extracellular acetylcholine from the striata of freely moving rats. A thin dialysis tube was inserted transversally through the caudate nuclei, and the tube was perfused with Ringer solution, pH 6.1, at a constant rate of 2 microliter min-1. The perfusates were collected at 10-min intervals. In the presence of 1 and 10 microM physostigmine, acetylcholine release was 4.5 +/- 0.02 and 7.3 +/- 0.3 pmol/10 min, respectively (not corrected for recovery). The latter concentration of the acetylcholinesterase inhibitor was used in all experiments. Under basal conditions, acetylcholine output was stable over at least 4 h. A depolarizing K+ concentration produced a sharp, reversible 87% increase in acetylcholine output. Both the basal and K+-stimulated release were Ca2+ dependent. The choline uptake inhibitor hemicholinium-3 (20 micrograms intracerebroventricularly) reduced striatal acetylcholine output to 35% of the basal value within 90 min. Scopolamine (0.34 mg/kg s.c.) provoked a sharp enhancement of acetylcholine release of approximately 63% over basal values, whereas oxotremorine (0.53 mg/kg i.p.) transiently reduced acetylcholine release by 54%. These results indicate the physiological and pharmacological suitability of transstriatal dialysis for monitoring endogenous acetylcholine release. PMID- 3559562 TI - Muscarinic mobilization of choline in rat brain in vivo as shown by the cerebral arterio-venous difference of choline. AB - In anesthetized rats, the choline levels of cerebrospinal fluid and plasma obtained from blood collected from peripheral vessels (carotid artery, cardiac vessels) and from the transverse sinus were determined with a radioenzymatic assay. Cortical release of choline was studied using the "cup technique." The plasma choline level of the peripheral blood (11.5 mumol/L) was lower than that of the sinus blood. The resulting cerebral arterio-venous difference of choline was negative (3.2 mumol/L) and reflected the net release of choline from the whole brain. The plasma choline levels were not different irrespective of whether the rats were anesthetized with ether, urethane, or pentobarbital. However, the choline level of the cerebrospinal fluid, which normally was lower than the plasma choline levels, was increased by urethane anesthesia to a level between the arterial and venous plasma concentrations of the brain. In old rats (24 months), the choline level of the cerebrospinal fluid was significantly lowered, when compared with the results obtained with younger rats (2-4 months). In rats kept on a low-choline diet for 2 weeks, the plasma choline level of the peripheral blood was reduced to 51% of the control. The effect on the choline level of the sinus blood was smaller; the cerebral arterio-venous difference of choline was not reduced (it was even slightly enhanced). Likewise, the choline level of the cerebrospinal fluid and the cortical release of choline were not altered. Intraperitoneal administration of oxotremorine in pentobarbital anesthetized rats kept on a low-choline diet increased the plasma levels of choline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559563 TI - Postnatal D2-CAM/N-CAM sialylation state is controlled by a developmentally regulated Golgi sialyltransferase. AB - Golgi-enriched fractions have been isolated from rat brain of increasing postnatal age and defined by electron microscopy and distribution of marker enzymes. The expression of sialyltransferase activity associated with these fractions has been demonstrated to developmentally decrease and this appeared to be, in part, dependent on endogenous competitive inhibition. The developmental regulation of this activity paralleled the sialylation state of the neural cell adhesion molecule (D2-CAM/N-CAM) and could be demonstrated to be capable of endogenously sialylating this protein in the isolated Golgi fractions. In 12-day old animals the majority of the transferred [14C]sialic acid was found to be associated with the high-molecular-weight [greater than 200 kilodaltons (kd)] form of D2-CAM/N-CAM, indicative of the protein having been heavily sialylated. Sialylation of the individual D2-CAM/N-CAM polypeptides was also demonstrated in both 12-day and adult animals and transfer was evident only in the 180-kd and 115 kd components and not in the 140-kd component. In contrast, Golgi-enriched fractions prepared from adult animals showed little capability of heavily sialylating D2-CAM/N-CAM to any significant extent. PMID- 3559564 TI - Stimulated release of phosphatidylinositol phosphodiesterase in an isolated phrenic nerve-diaphragm preparation. AB - Electrical stimulation of the phrenic nerve in an isolated nerve-diaphragm preparation resulted in the release of phosphatidylinositol phosphodiesterase into the organ bath. The released enzyme was Ca2+-dependent and exhibited two pH optima. The enzyme was released in response to nerve stimulation even in the presence of d-tubocurarine in concentrations that block neuromuscular transmission, and was not therefore released from the muscle as a consequence of its contractile activity. Phosphatidylinositol phosphodiesterase activity was determined in the soluble cytosol fractions prepared from different regions of skeletal muscles and from normal peripheral nerves and nerves that were degenerating after transection. The specific activity of the enzyme in the cytosol from the endplate-rich region of the diaphragm was significantly greater than that in cytosol from either the endplate-free region of the diaphragm or from the phrenic nerve. In degenerating nerve the activity of the enzyme was greater in the distal stump than in the proximal stump at 36 h after nerve section. Possible roles for released phosphatidylinositol phosphodiesterase at the neuromuscular junction are discussed. PMID- 3559565 TI - Measurement of acetylcholine release in freely moving rats by means of automated intracerebral dialysis. AB - The present study demonstrates the feasibility of measuring acetylcholine in perfusion samples collected by means of in vivo brain dialysis in the striata of freely moving rats. The output of the dialysis device was directly connected to an automated sample valve of a HPLC-assay system that comprises a cation exchanger, a post-column enzyme reactor, and an electrochemical detector. The presence of an acetylcholinesterase inhibitor (neostigmine) in the perfusion fluid was required for the detection of acetylcholine in the perfusate. Increasing concentrations of neostigmine induced increasing amounts of acetylcholine. Continuous perfusion with a fixed concentration (2 microM) of neostigmine resulted in gradually increasing amounts of collected acetylcholine over time although a considerable variation between successive samples exists. The brain dialysis technique was further validated by studying the effect of various drugs. Systemically administered atropine increased the output of acetylcholine, whereas the addition of tetrodotoxin to the perfusion fluid resulted in a complete disappearance of the neurotransmitter. PMID- 3559566 TI - Angiotensin II inactivation process in cultured mouse spinal cord cells. AB - The pattern of hydrolysis of [3H]angiotensin II ( [3H]AII; 20 nM) by intact cells was studied on cultured mouse spinal cord cells. Degradation products were identified by HPLC analysis after incubation for 2 h at 37 degrees C. In the absence of peptidase inhibitors, 70% of [3H]AII was degraded, and the main labeled metabolite was [3H]tyrosine (40% of total radioactivity). Minor quantities of [3H]AII1-5 and [3H]AII4-8 were formed. Results obtained in the presence of various inhibitors indicate that several enzymes were involved in the AII-hydrolyzing process. Dipeptidyl aminopeptidase III (EC 3.4.14.4) could play a critical role, as suggested by the formation of [3H]Val3-Tyr4 and [3H]-Tyr4-Ile5 in the presence of bestatin (2 X 10(-5) M). This hypothesis was confirmed by the potency of dipeptidyl amino-peptidase III inhibitors to inhibit both [3H]AII hydrolysis and formation of these 3H-labeled dipeptides. An arylamidase-like activity could also be participating in [3H]AII hydrolysis, because higher concentrations of bestatin (10(-4) M) in association with dipeptidyl aminopeptidase III inhibitors totally inhibited [3H]tyrosine formation, increased protection of [3H]AII and [3H]AII1-7 formed, and provoked a slight accumulation of [3H]AII2-8. These results suggest that the formation of [3H]AII2-8 is due to the action of a bestatin-insensitive acidic aminopeptidase and that the Pro7-Phe8 cleavage is also a step of AII hydrolysis, resulting from the action of an unidentified peptidase different from prolyl endopeptidase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559567 TI - Biogenic aldehydes in brain: on their preparation and reactions with rat brain tissue. AB - When 1 mM serotonin, dopamine, or norepinephrine was incubated with a monoamine oxidase preparation (mitochondrial membranes) in the presence of 4 mM sodium bisulfite, 85-95% of the amines were oxidized to the corresponding aldehydes. In the absence of bisulfite, the recoveries were only approximately 30%, and dark colored products were formed during the incubations. The aldehydes derived from tyramine, octopamine, methoxytyramine, and normetanephrine were also prepared by the use of this method. The bisulfite-aldehyde compounds were stable during storage at -20 degrees C. Bisulfite-free aldehyde solutions were made by diethylether extraction. When the aldehydes derived from dopamine or serotonin were incubated with rat brain homogenates, they were found to disappear in an aldehyde dehydrogenase- and aldehyde reductase-independent manner. The disappearance of the latter aldehyde was more pronounced, and the results indicated that this aldehyde may react with both proteins and phospholipids. PMID- 3559568 TI - Inhibition of catecholamine secretion from bovine chromaffin cells by adenine nucleotides and adenosine. AB - ATP, ADP, and adenosine have been found to inhibit acetylcholine-stimulated secretion from isolated cells of bovine adrenal medulla (chromaffin cells). Maximal inhibition is approximately 30% under the conditions studied; half maximal inhibition occurs at nucleotide concentration in the micromolar range. Cells must be incubated with ATP for approximately 90 s for maximal inhibition, but inhibition by adenosine occurs much faster, an observation suggesting the possibility that ATP and ADP exert their effect after being converted to adenosine. Experiments with cells preloaded with the fluorescent calcium chelator quin 2 indicate that external ATP can diminish the rise in cytosolic Ca2+ concentration that follows stimulation by acetylcholine. PMID- 3559569 TI - Phosphatidylethanol formation via transphosphatidylation by rat brain synaptosomal phospholipase D. AB - Phosphatidylethanol (Peth) formation catalyzed by the transphosphatidylation activity of phospholipase D was demonstrated to occur in a rat brain synaptosomal enriched preparation. The optimal pH was determined to be 6.5, and the optimal ethanol concentration was determined to be 0.3-0.4 M with an apparent Km of 0.2 M. Peth formation was barely detectable in the absence of an appropriate activator and several unsaturated fatty acids were found to be effective activators. The concentrations of oleic acid required for maximum activation varied with the concentration of exogenous phosphatidylcholine present in the incubation mixtures. All detergents tested were significantly less active than the unsaturated fatty acids and divalent ions were not required for Peth formation. Phosphatidylcholine was the most effective phosphatidyl donor of the phospholipids tested. Peth forming activity was greatest in the synaptic membrane fraction of the various brain subfractions examined. The 12,000 g-100,000 g particulate fraction of lung, heart, and adipose tissue had activities similar to that of brain. PMID- 3559570 TI - Characterization of fucosyl oligosaccharides associated with synaptic membrane and synaptic junctional glycoproteins. AB - Rats were administered [3H]fucose by intracranial injection and synaptic membranes (SMs) isolated 18 h later. Oligosaccharides associated with SM glycoproteins were prepared by hydrazinolysis and analyzed by a combination of affinity chromatography on concanavalin A (Con A)-agarose, ion-exchange chromatography on DEAE-cellulose, and gel permeation chromatography. Most (94%) of the [3H]fucose-labelled oligosaccharides were present in the fraction that did not bind to Con A. Of these 41% did not bind to DEAE-cellulose, indicating the absence of negatively charged groups and the remainder were resolved into four fractions of increasing acidity. Gel permeation chromatography of the fractions from the DEAE-cellulose column suggested that the major oligosaccharides corresponded to fucosylated triantennary structures containing varying amounts of sialic acid although more highly branched structures containing peripheral branches lacking one or more sugars may also have been present. Comparison of fucosyl oligosaccharides associated with SMs prepared from 10- and 28-day-old animals indicated that although the general oligosaccharide content was similar at both ages, membranes from younger animals were characterized by an increase in the proportion of highly acidic structures. Fucosylated glycans derived from synaptic junctional (SJ) glycoproteins were also characterized by a greater percentage of highly acidic structures than SMs. The results indicate that SMs and SJs are characterized by specific complements of fucosylated glycoprotein oligosaccharides. PMID- 3559571 TI - Molecular properties of the growth-associated protein GAP-43 (B-50). AB - The protein that has been identified in different contexts as growth-associated protein (GAP)-43, GAP-48, protein 4, B-50, F-1 gamma 5, and pp46, has been implicated in neural development, axonal regeneration, and the modulation of synaptic function. The present study investigated various properties of this protein (designated here as GAP/B-50), including its correct molecular weight and possible polymeric structure. GAP/B-50 was purified to greater than 90% homogeneity using an alkaline extraction procedure followed by a two-stage separation on a size-exclusion HPLC column. The equivalence of the purified protein to the B-50 phosphoprotein was confirmed by peptide digests, comigration, immunostaining, and amino acid composition. On a series of sodium dodecyl sulfate polyacrylamide gels the apparent molecular weight of the protein was seen to vary inversely with the concentration of acrylamide in the gels. Using these data in the method of Ferguson, the molecular weight of GAP/B-50 was calculated to be 32.8 kilodaltons (kD), considerably lower than the previously reported values of 43-67 kD. The low molecular weight of the protein in the presence of detergent was confirmed by density centrifugation. In the absence of detergent, however, the protein was found to be part of a polymeric structure whose retention time by size-exclusion chromatography indicated a size of 124 kD; this property was also confirmed by density centrifugation under nondetergent conditions. These data suggest the possibility that the native form of GAP/B-50 in the presynaptic membrane may be a tetramer of four identical subunits. PMID- 3559572 TI - The separation, from mammalian brain, of separate fractions of recycling and reserve cholinergic synaptic vesicles. PMID- 3559573 TI - RMC total knee replacement. A review of 166 cases. AB - This article describes a retrospective analysis of 166 total knee replacements using Richard's Maximum Contact prosthesis. Implant insertion was facilitated by instrumentation to guide the accuracy of the bony cuts; the bony surfaces were prepared using pulsatile lavage, and cement was inserted in a low viscous state. Ninety-four percent of all of the reconstructed knees were within 2 degrees of normal anatomic alignment, and more than 96% of both femoral and tibial components were within 2 degrees of optimal orientation to their respective bones. The radiographic appearance of bone cement radiolucency was 9.5% at 3 years. This was a dramatic improvement, compared with a previous series in which instrumentation and low-viscosity cement were not routinely used (P less than .01). In those cases, however, in which the implant was malaligned, the radiolucency rate was significantly increased (P less than .01). When evaluated with a modified British Orthopaedic Association rating system, decrease in pain was found in almost all patients, regardless of the etiology of their arthritis or of their preoperative score. Correction of deformity and achievement of knee stability were achieved in more than 90% of the knees. PMID- 3559574 TI - Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. AB - A prospective study of displaced femoral neck fractures was conducted with patients randomized into three groups: cemented total hip replacement (THR), cemented hemiarthroplasty (UHR-C), and noncemented hemiarthroplasty (UHR-NC). Eighty-nine patients were treated for displaced (Garden type 3 or 4) fracture with a prosthesis; 39 patients had THR, 37 had UHR-C, and 13 had UHR-NC. No difference was found in the level of pain, ambulation, or aids required between the THR group and the UHR-C group, except for active community ambulators, who demonstrated decreased endurance capability when treated with UHR-C. The patients treated with UHR-NC had increased pain and decreased ambulation and required assistive devices. The most significant complication was dislocation, which occurred in 7 patients with THR and 2 with UHR-C. The mortality rate at 2 years was 18%; all but two of the deaths were in patients with one of five different medical diseases: clinically significant cardiac or pulmonary disease, cancer, alcoholism, or psychosis. The mortality rate was insignificant in patients younger than 70 years of age. Roentgenographic review showed only 2 of 76 cemented stems with progressive cement-bone demarcation, with one patient requiring revision for a loose prosthesis. No evidence of protrusio was seen with the use of the bipolar cap. The uncemented hemiarthroplasties demonstrated lucency between the metal and bone in the proximal femur in 9 of 13 stems. The authors make recommendations regarding hip replacement. PMID- 3559575 TI - Effects of total knee replacement design on femoral-tibial contact conditions. AB - Ten fresh knee specimens with prosthetic components inserted were tested in a loading rig. Compressive and shear force were applied to the femur with the tibia held fixed. The location of the femoral-tibial contact points was measured. The contact reaction forces, the shear forces, and the rocking moments transmitted to the tibial component were calculated. The variations in the test conditions were: high and low compressive force, flexion angles of 0 degree, 45 degrees, and 90 degrees, three curvatures of tibial plastic inserts, and the posterior cruciate retained or resected. When the posterior cruciate was retained, the contact points were close to the center of the component; for cruciate resection, the contacts were close to the anterior of the component. The shear forces and rocking moments were higher for cruciate resection, but the contact reaction forces were lower. There is a wide variety of knee prosthesis designs, but the amount of inherent stability between the femoral and tibial surfaces, and whether the posterior cruciate ligament is retained or sacrificed, are two of the most important design variables. This study shows that cruciate resection increases the shear forces and the rocking moments to the tibial components and that additional fixation means may be necessary to compensate. On the other hand, cruciate retention with low conformity gives higher contact forces, which may lead to more wear in the long term. Cruciate sacrificing designs with intercondylar guiding surfaces are a separate category of design and were not considered in this study. PMID- 3559576 TI - Scaphoid implant resection arthroplasty. Long-term results. AB - A silicone scaphoid implant was developed in 1967 to help improve the results of simple resection arthroplasty in the treatment of arthritic changes associated with advanced scaphoid disease. Patients who had scaphoid implant surgery since 1967 were studied. Preoperative and postoperative roentgenograms, charts, surgical pathology, and clinical evaluations were reviewed. A total of 55 cases of scaphoid implant arthroplasty were evaluated. A classification system was developed based on progressive severity, and treatment recommendations were developed for each stage of disease progression. Cystic and degenerative changes in contiguous carpal bones were evaluated. No evidence of cystic change could be found in 37 wrists, minimal changes were found in 9, moderate changes in 5, and severe changes in 4. There were no implant infections or fractures. Implant rotation occurred in two cases. Functional use of the hand with decreased pain was observed. It is important to detect and treat carpal instability, which may be associated with scaphoid disease. Cystic formation can be minimized by avoiding oversized implants, treating the associated carpal instability, bone grafting preexisting cysts, and avoiding Kirschner wire fixation. By following treatment protocols as established in the classification system, the scaphoid implant can be successfully used in the management of scaphoid pathology. PMID- 3559577 TI - Histologic changes in the dog femur following total hip replacement with current cementing techniques. AB - Histologic changes in the femurs of adult dogs were studied following total hip replacement using current cementing techniques. In the diaphyseal region, remodeling was initiated in the periosteum and progressed centripetally over 3 months. In the proximal (metaphyseal) region, remodeling was seen throughout the section by the second week. No fibrous membrane was formed at the bone-cement interface in the proximal region, and only isolated, non-progressive patches of fibrous membrane were formed in the distal region of the implant. The authors attribute the absence of membrane formation to careful preparation of the cement bed and use of pressurized cement injection. The exact congruence of vascularization and remodeling indicates a vascular etiology for the reaction of bone to cemented implantation. Vascular compromise at the time of operation leads to bone necrosis in the affected regions, and subsequent revascularization is a necessary precursor to bone remodeling. Thermal effects and monomer toxicity are considered unimportant. PMID- 3559578 TI - Survivorship analysis in the evaluation of joint replacement. AB - A major problem in the evaluation of patients receiving joint replacements is the lack of complete information on all patients. That is, at the time of analysis patients will not have been followed long enough to know what their status will be at the time point of interest (5 years, for example). The statistical technique of survivorship analysis is the appropriate method for evaluating this type of data. The authors illustrate the technique of survivorship analysis as it applies to total joint arthroplasty, using examples from the UCLA total hip arthroplasty data base. In addition, the benefits of using this technique over the usual "failure rate" analysis are discussed, as well as other issues concerning the analysis of joint replacement data. PMID- 3559579 TI - Factors influencing walking and stairclimbing following unicompartmental knee arthroplasty. AB - The authors quantitatively evaluated the relationship between component placement, limb alignment, and function following unicompartmental knee replacement surgery. It was found that anatomic alignment, prosthetic positioning, and prosthetic design influence the patients' ability to walk and climb stairs. There was wide variation in the placement of the tibial and femoral component among patients. The placement of the femoral component corresponded directly to function during stairclimbing and level walking. Anterior malpositioning of the femoral component resulted in reduced ability to climb stairs. The tibial component position varied primarily in varus-valgus position. Varus-valgus alignment in the frontal plane correlated directly with the magnitude of the adduction moment during level walking. A varus alignment produced a twofold increase in the magnitude of the adduction moment at the knee during walking. Given the potential advantages of the unicompartmental knee, improved precision in component placement should improve the long-term results of hemiarthroplasty knee surgery. PMID- 3559580 TI - Reflex sympathetic dystrophy as a cause of poor results after total knee arthroplasty. AB - In a series of 662 primary total knee arthroplasties, reflex sympathetic dystrophy (RSD) was diagnosed in five patients (0.8%), four of whom demonstrated marked limitation of flexion requiring manipulation during the early postoperative period. Limitation of flexion, along with excessive pain and cutaneous hypersensitivity, should alert the surgeon to the possibility of RSD. Classic posttraumatic RSD findings of objective vasomotor changes and radiographic osteopenia may be difficult to interpret in patients after total knee arthroplasty. Sympathetic blockade is the key diagnostic and therapeutic measure in the management of RSD. RSD should be considered in a differential diagnosis of early poor results after total knee arthroplasty. PMID- 3559581 TI - Screw and cement fixation of large defects in total knee arthroplasty. AB - Fifty-seven total knee arthroplasties with defects in the tibial plateaus filled with screw and cement were followed longer than 3 years. At 3 years, 15 of them had radiolucency between the cement-bone interface that was unchanged from the 2 month postoperative radiograph. No radiolucency was noted about the stem bone cement interface or between the screw and the bone. Ten of the 27 knees followed longer than 4 years had similar findings. There were no loose tibial components in any of the 57 total knee arthroplasties. It is possible to fill defects with screws rather than cut off more bone or use expensive custom prostheses. PMID- 3559582 TI - Total knee arthroplasty in Paget's disease of the knee. AB - Seven patients with Paget's disease about the knee underwent total knee arthroplasty; they accounted for 0.1% of the population who underwent knee arthroplasty at the author's institution. The results were satisfactory at up to 12 years of follow-up study. Two patients had radiographic evidence of loosening, but neither required revision. PMID- 3559583 TI - Properties of biomaterials. AB - Metallic biomaterials, including iron-, cobalt-, and titanium-based systems, have a long history of applications for surgical implant devices. The mechanical properties of these alloys (modulus, strength, and ductility) have been used to make devices to replace skeletal structures with long-term in vivo stabilities. In addition, the passive surface oxide layers have provided chemical inertness within biologic environments. Recent trends to provide porous metallic conditions for biologic ingrowth and fixation have introduced questions with regard to the relative strength and biodegradation properties. Some biomaterial strengths have been reduced to magnitudes less than 50% of the nonporous alloys, which emphasizes the criticality of design. Surface area increases of 3-10 times has emphasized biocorrosion magnitudes, the elements released to the tissues, and the biologic consequences of these products. This article provides a brief review of these issues with emphasis on mechanical-biomechanical and chemical-biochemical properties of metallic alloys. PMID- 3559584 TI - Total elbow arthroplasty in the face of significant bone stock or soft tissue losses. Preliminary results of custom-fit arthroplasty. AB - There is a class of patients with severe bone stock or soft tissue losses who remain an unsolved problem in elbow reconstruction. The authors report the results of 16 such patients who underwent 16 total elbow replacements. Follow-up averaged 4.0 years (range, 2.0-9.6 years). Fourteen patients had previous surgery on their elbows and three had been previously infected. Fourteen of the 16 patients had a good or excellent result, and overall elbow scores averaged 90 (range, 53-100). There were three reoperations and one case of nonprogressive circumferential lucent lines about a humeral component with clinical symptoms. There were no other cases of clinical or radiographic implant loosening and no implant fractures. The preliminary results of this study indicate that custom-fit total elbow arthroplasty offers acceptable functional results in a devastated elbow when normal methods of reconstruction are not suitable. PMID- 3559585 TI - Resection arthroplasty following infected total hip replacement arthroplasty. AB - Thirty-nine patients with 41 hips with resection arthroplasty for infected total hip replacement arthroplasty were evaluated for functional level and factors that contribute to that level. Eighty-three percent were either minimal community ambulators or nonambulators, and only two patients walked without assistive devices. At last follow-up, 93% of the patients had pain in their hips. The best function was obtained in patients with a healed wound and heterotopic ossification. The worst functional result was in patients with chronic drainage. Fifteen of the patients with resection arthroplasties had foot-switch studies to determine gait velocity and single-limb stance time. Ten patients also had oxygen consumption studies performed. The average gait velocity was 35 m/minute (41% of normal). The average oxygen consumption was 0.41 ml/gm (264% normal) with an average heart rate of 121. The energy consumption was greater than that recorded in patients with above-knee amputation. PMID- 3559586 TI - The effect of total knee design on patellar strain. AB - Total knee arthroplasty with patellar resurfacing produces an increase in anterior patellar strain up to three times that observed in controls. This increase is independent of surgical capsulotomy and is prominent at flexion angles greater than 30 degrees. Minor alterations in surgical technique do not affect the observed strain. Peak strains were seen at the extremes of flexion in all prostheses. The highest strains were recorded for the Total Condylar prosthesis throughout the range of motion. Although the difference was not statistically significant, the Insall-Burstein knee consistently produced higher strains than did the Robert Brigham knee throughout the functional range of motion (30-90 degrees). For the Robert Brigham knee, sectioning of the posterior cruciate ligament resulted in no significant change in the measured strains. PMID- 3559587 TI - Aseptic loosening after total hip arthroplasty. Incidence, clinical significance, and etiology. AB - Three hundred forty-one consecutive Charnley total hip arthroplasties were reviewed after a 3-10-year follow-up period to correlate the radiographic signs of aseptic loosening to clinical outcome, femoral cementing technique, and epidemiologic patient characteristics. High-grade femoral demarcation at the bone cement interface (75-100%) correlated with a significantly higher incidence of unsatisfactory follow-up clinical scores. The incidence of high-grade femoral bone-cement demarcation and the associated radiographic signs of aseptic loosening had a direct correlation with the quality of the femoral cementing technique (P less than .01). Trochanter nonunion or trochanter separation demonstrated a highly significant correlation with high-grade femoral bone-cement demarcation (P less than .001). Patients having secondary total hip arthroplasty for failed cup arthroplasty or endoprosthesis had a higher rate of unsatisfactory pain and function scores, compared with those having arthroplasties performed after failed internal fixation. Male patients or patients with a high activity level demonstrated a twofold greater incidence of high-grade femoral demarcation (P less than .05). Patient weight by itself did not demonstrate any effect on radiographic outcome. PMID- 3559588 TI - A critical analysis of alignment factors influencing functional results following trispherical total wrist arthroplasty. AB - In a study of the impact of selected patient factors and alignment variables on functional results of total wrist arthroplasty, functional score and range of motion were found to be improved and incidence of component shift and progressive radiolucent lines decreased by proper positioning of the implant center of rotation and restoration of carpal height. Angulation of the implant stems was secondary in importance to the other positioning variables with respect to overall function and durability. A neutral alignment range for this implant arthroplasty was proposed. Within this neutral range, functional score averaged 94 points and range of motion averaged 68 degrees. There were no reoperations, component shifting, or progressive radiolucent lines, and all wrists rated an excellent score. PMID- 3559589 TI - A clinical and radiographic analysis of loosening of total knee arthroplasty components using a bilateral model. AB - Patients undergoing bilateral, simultaneous total knee replacement provide a unique opportunity to study the role of operative techniques in the development of radiolucent lines because variables such as age, sex, weight, diagnosis, and bone quality are internally matched when the result on one side is compared with that of the other. This allows more conclusive examination of operative factors, such as component alignment, level of tibial bone resection, and cement handling. With this as the objective, the clinical and radiographic results of the first 50 bilateral total knee replacements performed by the senior author were studied. Postoperative alignment was found to influence significantly the incidence of tibial radiolucent lines. Use of cement to reconstruct defects in the proximal tibia resulting from preoperative deformity consistently led to the development of radiolucent lines in the area of the defect. There was also indirect evidence that failure to achieve an intimate microinterlock at the bone-cement interface may play a major role in the development of tibial radiolucent lines. PMID- 3559590 TI - The addition of tobramycin to contrast bone cement. Effect on flexural strength. AB - Samples of polymethylmethacrylate (PMMA) bone cement were polymerized in vitro with no additives and with the following additives: methylene blue dye, tobramycin, methylene blue plus tobramycin. After storage for 7 days in saline, samples were tested to failure in three-point bending. Addition of the antibiotic significantly weakened the cement (to 87% of control). However, the combination of tobramycin plus methylene blue was no weaker than tobramycin alone, suggesting that addition of both dye and antibiotic to bone cement is probably a reasonable clinical practice. PMID- 3559591 TI - A critical analysis of alignment factors affecting functional outcome in total elbow arthroplasty. AB - Fifty-six elbows were evaluated for correlation between implant alignment and functional results following total elbow arthroplasty. Accurate reconstruction of the anatomic center of rotation of the humerus and ulna and accurate placement of the implant stem were correlated with improved durability and decreased complications. PMID- 3559592 TI - A critical analysis of mechanical factors correlated with bone remodeling following total elbow arthroplasty. AB - Thirty elbows were critically reviewed for quantitative evidence of bone remodeling, with demonstrable bone remodeling noted in more than one half of the ulnae and humerii. Bone remodeling was analyzed statistically with independent variables of age, sex, handedness, diagnosis, implant design considerations, and implant alignment. Only implant design and alignment had a statistically significant impact on bone remodeling. Periarticular (zone 1) bone loss was statistically significantly correlated with a high percentage of diaphyseal medullary canal occupied by prosthesis, the presence of assymetric stem cortical contact, and lack of metaphyseal (zone 1) load transfer. Diaphyseal bone hypertrophy (zone 4) was statistically significantly correlated with a high percentage of diaphyseal medullary canal occupied by prosthesis (zone 4) and assymetric stem tip-to-cortical wall contact. Periarticular bone hypertrophy and diaphyseal bone atrophy did not occur. Fractures through the humeral condyles occurred in three elbows undergoing bone atrophy, but no implant loosening or failure could be correlated with bone remodeling. Bone remodeling does occur in a high percentage of stemmed elbow implants but to date has not been a factor in clinical failure. PMID- 3559593 TI - Tissue reactions to titanium endoprostheses. Autopsy studies in four cases. AB - Four cementless prosthetic hip implants of Ti-6Al-4V-alloy with and without longitudinal grooves and Al2O2 ceramic ball heads, with implant periods of 3, 4, 5, and 10 months, were sectioned and examined histologically in undecalcified thin ground sections. Especially on the medial and lateral sides of the prostheses, there was direct bone-to-metal contact without interposed connective tissue, spreading to the dorsal and ventral areas of the prosthesis shaft, which was considered osseointegration. This is based mainly on the technique of implantation with primary stability in the cortical bone by press-fit and on the bioinertness of the titanium alloy. Ungrooved prosthesis areas seem to favor bone growth at the shaft. The secondary bone ring, occurring on the dorsal and ventral areas of the prosthesis, with evidence of further bone remodeling with the passage of time, indicates that osseointegration is a dynamic process that continues to improve prosthetic stability. PMID- 3559594 TI - The impact of modern cement techniques on acetabular fixation in cemented total hip replacement. AB - A radiographic study was performed to assess acetabular fixation in 78 total hip replacements performed between 1971 and 1980. In 1979, the technique of acetabular component insertion was modified to include water-pik lavage, preservation of subchondral bone of the acetabulum during reaming, multiple fixation holes in the pubis ischium and ilium, and devices that improve pressurization of the cement into the cancellous bone surfaces. The impact of these techniques was studied. A cumulative radiolucency score was calculated for each acetabulum from 5-year follow-up radiographs, and the mean cup radiolucency scores for two chronologic groups were compared using the t-test for independent samples. No significant differences in patient age, weight, or sex, type of prosthesis, or approach used was found between groups. The acetabular components inserted between 1979 and 1980 had significantly lower cup radiolucency scores than those inserted between 1971 and 1978, at 5-year follow-up evaluation. Modern cement technique may be responsible for significantly enhanced durability of acetabular fixation in cemented total hip replacement. PMID- 3559595 TI - In vivo construction of a metal-backed, high-molecular-weight polyethylene cup during McKee-Farrar revision total joint arthroplasty. A case report. AB - The need for revision total hip arthroplasty after metal-to-metal articulating prostheses is well known. An alternative to conventional acetabular revision in the clinical circumstance of isolated femoral component loosening is in vivo construction of a metal-backed, high-molecular-weight polyethylene (HMWPE) acetabular component. This surgical approach reduces the likelihood of intraoperative acetabular bone loss, should minimize subsequent loosening, and virtually eliminates the source of metallic wear debris. Follow-up evaluation after 3 years revealed maintenance of the acetabular component position and a satisfactory clinical result. In vivo construction of a metal-backed HMWPE acetabular component is an effective alternative in the management of this potentially difficult orthopedic problem. PMID- 3559596 TI - Autologous blood transfusion in total joint arthroplasty. AB - In 1974, an autologous blood transfusion program for total joint replacements was established at William Beaumont Hospital. From 1980 through 1984, 396 patients donated 1,619 units of blood. The patients' ages ranged from 23 to 89 years (median, 63 years) in men and 29 to 89 years (median, 67 years) in women. Blood was collected on a weekly basis, if the patient's hematocrit was greater than 34%. Blood collected within 49 days of surgery was maintained in a liquid state; otherwise, it was frozen. Patients with a history of cardiovascular disease received permission from their internist before donating blood. The cost per unit of frozen blood was much higher than that of liquid blood. Autologous blood transfusion is safe, there is no age limitation for blood donors, and blood can be collected at weekly intervals. PMID- 3559597 TI - Knee biomechanics and total knee replacement. AB - The biomechanics of the knee joint provide an important basis for the rationale in the design and selection of appropriate total knee arthroplasty. This article examines knee biomechanics in terms of patient function, prosthesis design, cruciate ligament retention, alignment, and fixation of the tibial component. While design and surgical technique for total knee replacement progress, a better understanding of the characteristics of joint loading, stress distribution, and the biologic response of bone to stress will provide the potential to improve both function and implant longevity. PMID- 3559598 TI - Staged versus simultaneous bilateral total knee replacement. AB - Bilateral total knee replacements were reviewed to determine whether any difference exists in the perioperative course between procedures done under one anesthetic (simultaneous) and those done under two anesthetics (staged). There were 29 staged and 18 simultaneous cases, therefore 76 separate procedures and 94 knees done. The total operative time, blood loss, and complications were similar between the two groups. However, the staged replacements had more than twice the hospital days (34.6 +/- 7.7 vs. 16.8 +/- 5.6, P less than .001) and 18% greater hospital bills. In fact, for a given patient, the hospital bill may be greater than 50% higher if a staged rather than simultaneous replacement is done. Therefore, simultaneous replacement is recommended for appropriate patients. PMID- 3559599 TI - Long-term results of Harris total hip replacement. AB - The long-term clinical and radiographic results of 38 Harris total hip replacements performed on 31 patients (average age, 50.7 years), with an average follow-up period of 11.5 years, were reviewed. According to a modified d'Aubigne Postel hip rating system, 14 hips were rated excellent, 19 good, 4 fair, and 1 poor. Only one patient had revision surgery for symptomatic acetabular and femoral loosening. Eight acetabular components migrated, usually after 10 years; this did not correlate with an unsatisfactory clinical result, except in one hip. There was subsidence or loosening of the femoral component in five hips, usually associated with a technical error or severe calcar resorption; this occurred early and did correlate with an unsatisfactory clinical result. Clinical results were satisfactory in 86% of the hips with long-term follow-up study. However, radiographic failure occurred in 34% of the hips, with a predominance of late acetabular migration. PMID- 3559600 TI - Bilateral hip and knee replacement in rheumatoid arthritis. AB - A series of 20 patients who had bilateral hip and knee replacement are reviewed and analyzed. Early surgical opinion should be sought before all four joints are irreparably destroyed and the patient is nonambulant so that the joints can be replaced one at a time, as necessary to maintain mobility. This considerably reduces stress to the patient, the surgeon, the nursing staff, and the rehabilitation team. The follow-up period ranged from 2 to 13 years. The early postoperative complications were few and the reoperation rate for aseptic loosening in this study was 3.75%. PMID- 3559601 TI - Radiographic comparison of cementing techniques in total hip arthroplasty. AB - Using a single prosthetic design, the authors conducted a radiographic comparison of the results of changes in cementing techniques in 58 total hip arthroplasties with respect to the initial postoperative and equivalent follow-up radiographs. The study period, 1975-1982, spanned the advent of cement restrictors, canal preparation, and pressurization techniques. In matched patients, the use of modern cementing techniques and canal preparation led to a significant improvement in the initial postoperative radiographic appearance and subsequent loosening rate of the femoral component, suggesting that these techniques may change the expected rate of late femoral component loosening, based on previous studies done with prepressurization cementing techniques. PMID- 3559602 TI - The biologic interface between bone and cementless femoral endoprostheses. AB - Femoral canal membrane tissue from patients who had revision of an uncemented endoprosthesis to a total hip replacement was analyzed and interlocking bone specimens were retrieved from implant fenestrations to compare membrane histology with microscopic bony remodelling. Radiographs of each hip were evaluated for bony adaptations and correlated with implant stability and interface histology. Uncemented canal membranes are composed mostly of mildly cellular dense connective tissue. Significant inflammation is rare, even in the presence of moderate metallic debris. A fibrocartilage interface often occurs above interlocking bone in areas subject to direct compressive loads. A thin membrane helps to distribute loads evenly from the rigid implant to more compliant bone. Dense lines of bone around the implant stem may be a biologic response indicating a steady-state, load-sharing equilibrium; they are not a reliable sign of implant instability. Retrieved interface membranes allow a direct view of the prosthetic bone junction of human joint implants. In the absence of polyethylene and methacrylate wear debris, the membrane contains quiescent fibrous tissue with little inflammation. Membrane formation appears to be a mechanical adaptation to improve load distribution in the proximal femur. Presence and function of the membrane must be considered in the design and application of future press-fit implants. PMID- 3559603 TI - Long-term results of total ankle replacement. AB - The results are reported of 19 total ankle replacements in 18 patients with rheumatoid or other inflammatory arthritis. After a mean follow-up period of 54.4 months (minimum, 24 months), three arthroplasties had failed, all because of loosening. Although all of the remaining patients were improved in terms of pain and function, there was radiographic evidence of loosening in a further eight patients. Indications for the operation are discussed. PMID- 3559604 TI - Total hip arthroplasty complicated by mismatched implant sizes. Report of two cases. AB - Numerous alternative types and sizes of implants for total hip arthroplasties are currently available. Two cases are reported in which the head size of the femoral component inserted was larger than the corresponding inner diameter of the acetabular cup. These are the first reported cases of this technical complication. The error can be avoided with careful preoperative planning and proper selection of implants. At 12- and 30-month follow-up evaluation, however, neither of these hips had dislocated or required revision. Immediate revision is not recommended, unless the hip dislocates or has symptomatic subluxations. PMID- 3559605 TI - Bilateral hip and knee arthroplasty. AB - Twenty-six severely deformed patients with prosthetic arthroplasty of both hips and both knees because of rheumatoid arthritis (16), juvenile rheumatoid arthritis (6), ankylosing spondylitis (2), osteoarthritis (1), and inflammatory arthritis, cause unknown (1), were followed for a mean of 6.8 years. Severe pain was the primary indication for surgery, and consistent and substantial pain relief was achieved. Most patients also had limited ambulatory and functional improvement. Computer analysis showed that this improvement was related only to preoperative walking and function and a combined hip and knee flexion of at least 190 degrees. All other parameters had no correlation with walking and function improvement. Of the 104 arthroplasties (52 hips and 52 knees), six implants (4 hips and 2 knees) in two patients failed and another seven implants (2 hips and 5 knees) in five patients were revised. Of the remaining 91 implants, 89 were clinically stable, and only two hip implants in two patients appeared destined for revision. However, when radiographic review was included, nine acetabular components, three THA femoral components, and five tibial components in 12 patients had some evidence of impending aseptic loosening, despite low patient activity levels. PMID- 3559606 TI - Biologic fixation. AB - One of the major problems of implant surgery is the failure of the bone-cement interface. Because of such failures, observed with increasing frequency with the passage of time, biologic fixation of total joint implants by means of bone ingrowth has become the focus of considerable interest among orthopedic surgeons. Actual bone ingrowth has been demonstrated into porous metals, resulting in a strong interface between metal and bone. Many clinical trials of biologic fixation, including endoprostheses and total hip, shoulder, and knee prostheses, are being conducted. The brief experience of such fixation in humans supports the hypothesis that bone ingrowth will provide stable fixation for load-bearing prostheses. Many questions remain to be answered about biologic fixation and the burden that falls upon the clinical scientist to identify the proper niche for this process in the care of the musculoskeletal patient. PMID- 3559607 TI - Patterns of reinnervation and motor unit recruitment in human hand muscles after complete ulnar and median nerve section and resuture. AB - Following complete ulnar or above-elbow median nerve sections, there was no significant correlation between motor unit size (twitch amplitude) and recruitment threshold, as assessed by spike triggered averaging. This absence of orderly recruitment was attributed to misdirection of motor axons during regeneration. Following median nerve section at wrist level, where the reinnervated muscles have more synergistic actions, orderly recruitment by size appeared to be re-established. Thus, the size principle of motor unit recruitment can be re-established after nerve section in humans, if motor axons innervate their original muscles or ones with closely synergistic functions. PMID- 3559608 TI - Supersensitivity to both tyramine and noradrenaline in diabetic autonomic neuropathy. AB - Cardiovascular responses to intravenously infused tyramine and noradrenaline were measured in five normal subjects, five insulin-dependent diabetics and five insulin-dependent diabetics with autonomic neuropathy. Tyramine infusion produced a statistically significant increase in systolic blood pressure (BP) in the autonomic neuropaths only (p less than 0.001). No change occurred in diastolic BP. Noradrenaline infusion produced a statistically significant increase in systolic BP in the normal subjects (p less than 0.01) and in the autonomic neuropaths (p less than 0.001). The increase in systolic BP in the neuropaths was significantly greater (p less than 0.001) than in normal subjects. Diastolic BP rose significantly only in the normal subjects (p less than 0.05). There was no change in heart rate in response to either agent. Thus super-sensitivity to noradrenaline occurred in patients with diabetic autonomic neuropathy indicating post-denervation hypersensitivity. Tyramine hypersensitivity also occurred indicating that denervation is not complete and suggesting dysfunction at a pre synaptic level. PMID- 3559609 TI - Focal cervical poliopathy causing juvenile muscular atrophy of distal upper extremity: a pathological study. AB - A new clinical entity under the name of "juvenile muscular atrophy of unilateral upper extremity" was first described in 1959. Although about 150 cases in Japan, and several additional cases in other countries, have been clinically reported in the literature, the pathology has remained unknown because of the benign course of the disease. The first necropsy findings are reported, obtained from a patient with this disease, who died of lung cancer at the age of 38, 23 years after the onset of the disease. The lesions existed only in the anterior horns of the spinal cord at C5 approximately T1, particularly marked at C7 and C8, showing shrinkage and necrosis, degeneration of various degrees of large and small nerve cells, and mild gliosis. The pathological findings differ from those of reported cases of spinal vascular disorders, but some circulatory insufficiency in the territory of the spinal cord would seem to be suggested, although the underlying aetiology remains unknown. PMID- 3559610 TI - Isolated painless manual incoordination in 57 musicians. AB - Focal motor syndromes are reported in 57 instrumental musicians who presented with painless uncoordinated movement of the upper limbs. Three stereotyped afflictions were noted: flexion of the 4th and 5th fingers in pianists, flexion of the 3rd finger in guitarists, and extension of the 3rd finger in clarinetists. Our patients differed from those with generalised dystonia in that their disabilities were focal, activity-specific, and non-progressive. Because these disabilities represent entrained responses to peripheral stimuli, distinct from progressive dystonias, they may provide insights into control of fine limb movement and sensory triggers of abnormal movement. PMID- 3559611 TI - Simple and complex movements off and on treatment in patients with Parkinson's disease. AB - The performance of a 15 degrees elbow flexion and a 30N hand squeeze was studied in nine normal subjects and in five patients with Parkinson's disease. The patients were studied when immobile after 12-18 hours withdrawal from antiparkinsonian drug therapy (OFF) and when more mobile after drugs (ON). Subjects performed each movement separately (simple movements) and both movements either simultaneously or sequentially (complex movements). The duration of both movements and the time between the onset of each movement in the sequential task (interonset latency) were measured. The patients OFF therapy had longer movement times than normal for both movements; these improved after levodopa but still were not normal. When the patients performed complex movements there was an extra slowness, over and above that seen for simple movements, in both movements of the simultaneous task and in the second movement of the sequential task. In addition, the interonset latency in the sequential task was longer than normal. After levodopa there was a more striking improvement in the movement times of complex movements than there had been for simple movements. The interonset latency in the sequential task was shorter than before therapy though still was not the same as in normal subjects. It is suggested that the basal ganglia are not only involved in the execution of simple motor programmes, but also play some role in the superimposition and sequencing of motor programmes. PMID- 3559612 TI - Oligodendroglioma: an analysis of 42 cases. AB - This paper presents the clinical and pathological data obtained from 42 patients with oligodendroglioma diagnosed over a 20 year period at Addenbrooke's Hospital, Cambridge. In all cases the diagnosis was established unequivocally by histological examination. The principal conclusions of this study were: (1) the outcome was not as favourable as anticipated, nine patients dying within 1 year of diagnosis, and only 10 patients surviving 5 years, (2) age at the time of diagnosis was the single most important prognostic factor, patients under 45 years at diagnosis having a significantly greater survival time than older patients, (3) two other factors had a significantly adverse effect on prognosis, namely the presence of a focal neurological deficit at the time of diagnosis and the presence of nuclear pleomorphism in the tumour when examined histologically, (4) although cells containing glial fibrillary acidic protein were demonstrated in almost every tumour, their number and distribution did not appear to influence the prognosis. PMID- 3559613 TI - Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours. AB - Lactate dehydrogenase (LDH) activities were measured in cerebrospinal fluid in 350 patients with various neurological diseases to establish the sensitivity and specificity of the CSF LDH as a marker for the diagnosis of leptomeningeal metastases. Slight elevations of CSF LDH were observed in nonmalignant diseases, while marked elevations were observed in a considerable number of patients with bacterial meningitis. A sensitivity of 79% and a specificity of 83% were calculated. In the 34 patients with leptomeningeal metastases from solid and haematological tumours, the LDH in lumbar and ventricular CSF were measured simultaneously. The lumbar CSF LDH concentration in patients with leptomeningeal metastases was about five times greater than that in the ventricular CSF. No relationship was found between the CSF LDH and histology of the primary tumour. A good correlation was demonstrated between the lumbar CSF LDH and the effected area of the neuraxis. Serial determinations of CSF LDH showed a relationship between level changes and responses to therapy or progression. The findings of this study indicate that measurement of LDH in CSF can be used as an adjunctive diagnostic test for leptomeningeal metastases and in monitoring the efficacy of treatment. PMID- 3559614 TI - Multiple sclerosis among the United Kingdom-born children of immigrants from the West Indies. AB - Multiple sclerosis has been reported to be very uncommon in the West Indies. In previous studies immigrants from the West Indies resident in Greater London had only one-eighth the likelihood of being diagnosed in hospital as having multiple sclerosis compared with those born in the United Kingdom. No studies of the incidence and prevalence of multiple sclerosis were available for London or South East England but there is evidence that it is much the same as occurs in Ireland. In the age groups studied the United Kingdom-born children of West Indian immigrants had an incidence and prevalence of probable multiple sclerosis of the same order as has been reported in Northern Ireland and in the Irish Republic. Although there is evidence that genetic factors play a part, our findings are strong evidence that the cause of the disease is mainly environmental and is therefore potentially preventable. PMID- 3559615 TI - Juvenile Parkinsonism: clinical and metabolic characteristics. AB - Twenty one patients with idiopathic Parkinsonism beginning before the age of 40 years were investigated. The mean duration of the disease was 19 years. There was a good and sustained response to levodopa. Only four patients reached stages IV and V (Hoehn and Yahr). Intolerance to levodopa was observed in the more advanced stages of the disease. In the series the familial incidence of Parkinsonism (2 cases) and essential tremor (3 cases) was very low. Thyroid disorder, diabetes mellitus or macrocytic anaemia was not found in any of the cases. PMID- 3559616 TI - Dissecting aneurysms of the vertebral arteries following cervical manipulation: a case report. AB - Neck manipulation may uncommonly be associated with serious and even fatal vascular complications. Although well recognised, the nature of the vascular injury has only rarely been directly established by pathological examination. The case is reported of a 43-year-old man who died following neck manipulation, and in whom multiple dissecting aneurysms within both vertebral arteries were demonstrated radiologically and found at necropsy. Bilateral dissecting aneurysms were found both at the level of atlanto-axial articulation and close to the origins of the vertebral arteries. No predisposition was found, other than early atheroma consistent with the patient's age. PMID- 3559617 TI - Benign transient urinary retention. AB - Three cases of acute urinary retention due to sacral myeloradiculitis are described. The authors stress the importance of diagnosing this rare and benign condition, which, in the past, has too often been mislabelled as either psychogenic or the first manifestation of a demyelinating disease. PMID- 3559618 TI - Primary cerebral lymphoma mimicking tuberculosis: case report. PMID- 3559620 TI - Protein C deficiency: a cause of amaurosis fugax? PMID- 3559619 TI - A pituitary tuberculoma. PMID- 3559621 TI - Exercise provoked faecal incontinence in spinal stenosis. PMID- 3559622 TI - Argyll Robertson pupils in lymphocytic meningoradiculitis (Bannwarth's syndrome) PMID- 3559623 TI - Oculogyric crisis in acute herpetic brainstem encephalitis. PMID- 3559624 TI - Palatal myoclonus influenced by head posture. PMID- 3559625 TI - Role of the basal ganglia and cerebral cortex in tardive dyskinesia: evidence from cerebrovascular accident. PMID- 3559626 TI - Observations on the combined systemic administration of mixed bacterial vaccine, bacillus Calmette-Guerin, transfer factor, and lymphoblastoid lymphocytes to patients with cancer, 1974-1985. AB - Herein are reported the results of treating 139 cancer patients with combined immunomodulation that consisted of bacillus Calmette-Guerin, transfer factor, and mixed bacterial vaccine. In addition 28 patients were given infusions of lymphoblastoid lymphocytes. Patients were admitted to this treatment program who either had failed to respond to other modalities, had elected to add immunomodulation to usual therapy, or had refused chemotherapy and/or radiation therapy. The results suggested that combined immunomodulation therapy is well tolerated and safe and that this approach on a prima facie basis had a salutary effect on the courses of a number of the patients treated. The results also illustrate alternative pathways that can be taken by patients and physicians who are not comfortable with protocolized double-blind methods of approaching patients with poor prognosis cancer. PMID- 3559627 TI - Effect of forphenicinol, a low molecular weight immunomodifier, on the growth of and the immune responses to murine lymphoma EL4. AB - Oral administration of forphenicinol, S-2-(3-hydroxy-4 hydroxymethylphenyl)glycine, inhibited the growth of EL4 lymphoma by both pre- and posttreatment. Although some mice given this drug rejected the tumor, they could not obtain acquired immunity against the tumor. Macrophages taken from normal mice did not inhibit the growth of EL4 cells in vivo (tumor neutralization assay) or in vitro (cytostasis assay). Forphenicinol induced effector activity in such macrophages neither in vitro nor in vivo. Forphenicinol administration to mice bearing EL4 activated macrophages to inhibit the growth of EL4 in vitro and in vivo. Moreover, it stimulated the tumor growth-inhibitory activity of splenocytes in both tumor-free and tumor-bearing mice. PMID- 3559628 TI - Antitumor activity of pyrimidinones, a class of small-molecule biological response modifiers. AB - This study was undertaken in an attempt to evaluate the structure-activity relationship of pyrimidinones. Of 20 pyrimidinones tested, only those with a monohalogen substitution at the ortho- or meta-position of the phenyl moiety of the 2-amino-5-halo-6-phenyl-4(3H)-pyrimidinone and ABPP showed statistically significant synergism with cyclophosphamide (CY) against P388 leukemia. Therefore, ABMFPP, AIMFPP, and ABPP were selected for detailed therapeutic evaluation. The pyrimidinone alone had small but significant activity against B16 melanoma with slightly more than a 25% increase in lifespan (ILS); however, when used in combination with CY, ABPP or ABMFPP did not yield an effect greater than treatment with CY alone. Only AIMFPP appeared to produce a more or less additive effect with CY. Although none of these pyrimidinones alone had any significant activity against M5076 tumor, the combination with CY (100 mg/kg) produced a range of 102 to 123% ILS and six to nine of 10 mice per group survived greater than 45 days, whereas the treatment with CY alone yielded only a 48% ILS and none survived greater than 45 days. The synergism of the combination therapy was statistically significant (p less than 0.01). The combination used against L1210 leukemia also appeared to be superior to the treatment with CY alone and produced 25 to 50% long-term survivors (greater than 30 days). The significance of these findings is discussed in terms of its clinical implications. PMID- 3559629 TI - Endogenous production of TNF-like cytotoxic factor in BCG-primed mice by heterologous fibrinogen. AB - The triggering activities of heterologous fibrinogen and fibrin on endogenous production of tumor necrosis factor (TNF)-like cytotoxic factor in vivo were examined. The triggering activities of fibrinogen or fibrin from four species injected into the peritoneal cavity of C3H/He mice infected i.p. with bacillus Calmette-Guerin (BCG) were tested. Heterologous, but not homologous, fibrinogen and fibrin showed triggering activity. The route of triggering by heterologous fibrinogen to elicit TNF-like activity systemically was studied. Injection of heterologous fibrinogen i.v. into mice infected i.v. with BCG resulted in a 40 fold higher serum TNF-like activity level than after its i.p. injection. The serum TNF-like activity level was maximal 1 h after i.v. injection of heterologous fibrinogen. When heterologous fibrinogen was injected several times i.v. into mice bearing solid-tumors, TNF-like activity was also released into the serum after every injection, although the activity decreased progressively on second and third injections to 10 and 1%, respectively, of that after the first injection. We used heterologous fibrinogens derived from different species for triggering every week to avoid this gradual decrease of TNF-like activity. In this way TNF-like activity was induced as highly as the primary induction. These results showed that TNF-like cytotoxic factor could be produced in vivo locally or systemically by heterologous fibrinogen or fibrin. Thus both agents should be useful as nontoxic triggering agents. PMID- 3559630 TI - Sequence of central nervous system myelination in human infancy. I. An autopsy study of myelination. AB - This study establishes the sequence of myelination in a population of autopsied infants from birth through the second postnatal year. Myelination was assessed in 62 precisely defined central nervous system (CNS) sites of 162 infants with diverse diseases who were autopsied from 1972 to 1984 at Children's Hospital, Boston. The degree of myelination was graded on an ordinal scale of 0-4 using the inferior cerebellar peduncle as an internal standard. This grading system is a modification of that used for fetal myelination in the National Collaborative Perinatal Project (NCPP). The data are summarized by, median degree of myelination for each age group and site; and Ayer estimates for the age at which at least 10, 50, and 90% of infants reach a particular myelin degree in each site. "Marker" sites in the cerebrum are provided for the pathologist to compare myelination between an individual infant brain and the brains from our autopsy population. These data should be useful in identifying diverse peri- and postnatal conditions affecting myelination in human infancy. They also provide guidelines for the assessment of CNS myelination by sophisticated imaging techniques in living infants. PMID- 3559631 TI - Maturation, dystrophic changes and the continuous production of fibers in skeletal muscle regenerating in the absence of nerve. AB - To investigate how much skeletal muscle depends on influences coming from peripheral nerve, we studied muscle regeneration induced by bupivacaine in the permanently denervated soleus muscle of adult rats. Using light and electron microscopy, we studied the extent of maturation attained by regenerated myofibers and their ability to regenerate again after repeated bupivacaine injury. Morphometric analyses showed that within the first two weeks after injury, the regenerated denervated fibers increased in diameter, matured and then became atrophic. By electron microscopy the morphological characteristics of mature fibers are evident, but final differentiation into adult fiber types is not attained. This is in keeping with previously reported biochemical results. A new phase of massive regeneration occurred when bupivacaine treatment was repeated, thus demonstrating that regenerated myofibers devoid of innervation keep their intrinsic ability to regenerate after injury. Spontaneous though scanty regeneration also occurred in denervated regenerated muscle at late stages, when atrophy and dystrophy of fibers became prominent. Concomitantly the relative number of myosatellite cells remained high. These morphological observations further support the hypothesis that fiber regeneration participates in the maintenance of chronically denervated muscles. PMID- 3559632 TI - Frequency and urgency of micturition in hemiplegic patients: relationship to hemisphere laterality of lesions. AB - To determine the individual contribution of the right and left cerebral hemispheres to micturition control, a clinical analysis was performed concerning frequency and urgency of micturition in 134 chronic hemiplegic patients. A mean frequency of urination, 9 times or more in 24h, was found more frequently in left than right hemiplegics. Left hemiplegics also complained more often of urgency than did right hemiplegics. A mean frequency of urination of 9 times or more in 24h and urgency co-existed more frequently in left hemiplegics than in right hemiplegics. In the present study, dealing with the chronic sequelae of stroke, frequency and urgency of micturition were found more commonly in patients with right hemisphere than left hemisphere lesions. PMID- 3559633 TI - Mollaret's meningitis: CSF-immunocytological examinations. AB - Mollaret's meningitis is a rare clinical entity consisting of recurrent attacks of meningeal irritation, which, after a sudden onset, last for a few days. The prognosis appears to be excellent, although the aetiology has not been established. In the CSF so-called endothelial cells are a typical finding, but their classification is not yet clear. In the present case immunocytological examination of CSF cells revealed that the so-called Mollaret cells are monocytes. The time course of changes in helper/suppressor ratio is similar to that in other infectious diseases of the central nervous system. PMID- 3559634 TI - Extensive form of progressive multifocal leucoencephalopathy associated with laryngeal carcinoma. AB - A case is reported of the rare association between progressive multifocal leucoencephalopathy and carcinoma. A 66-year-old man underwent a laryngectomy for carcinoma. Four years later he developed a local recurrence. Simultaneously there were behavioural disturbances and a left motor neglect followed by dense hemiplegia and coma. The patient died a further 5 months later. Anergy was demonstrated by skin tests. CT scan showed asymmetrical non-enhancing low-density areas in the hemispheric white matter, brain-stem and cerebellum and neuropathological examination confirmed extensive myelin loss with typical papovavirus inclusions in oligodendrocytes identified by electron microscopy. PMID- 3559636 TI - Progressive cerebellar syndrome in adult coeliac disease. AB - A case of slowly progressing cerebellar syndrome and pathologically confirmed adult coeliac disease is presented. Neurological symptoms progressed although the patient had no enteric complaints. This case seems to be identical with 18 previously reported cases of encephalopathy and adult coeliac disease. However, the aetiology and pathogenesis of the encephalopathy are still not known. PMID- 3559635 TI - Tolosa-Hunt syndrome versus recurrent cranial neuropathy. Report of two cases with a prolonged follow-up. AB - Two patients are described who had suffered for 12 years from episodes of painful ophthalmoplegia consistent with a Tolosa-Hunt syndrome (THS) alternating with palsies of cranial nerves other than the oculomotor (fifth motor and seventh on both sides). These two cases, as well as other similar ones previously reported in the literature, suggest that THS may sometimes be a variant of so-called recurrent cranial neuropathy, which is a benign and poorly understood clinical entity on an inflammatory or ischaemic basis. PMID- 3559637 TI - Rhabdomyolysis in hypokalaemic periodic paralysis: a clue to the mechanism that terminates the paralytic attack? AB - The changes in serum levels of myoglobin (Mb) and creatine kinase (CK) during a spontaneous attack of hypokalaemic periodic paralysis were studied. During paralysis, serum Mb and CK were normal. A rise in plasma potassium, resulting in clinical recovery, was associated with a simultaneous rise in serum Mb, and followed by a rise in serum CK. It is postulated that hypokalaemia might cause muscle ischaemia, which would result in an accumulation of free fatty acids (FFA) within the muscle cells. High concentrations of FFA may induce molecular changes and increase the permeability of the sarcolemma. This might be the mechanism by which potassium is released from muscle cells into the circulation and muscle membrane excitability is restored. PMID- 3559638 TI - Hemichorea-hemiballism caused by arteriovenous malformations in the putamen. PMID- 3559639 TI - Transient global amnesia: neuropsychological study of a "pure" case. PMID- 3559640 TI - Acute Guillain-Barre syndrome in multiple sclerosis. PMID- 3559641 TI - The role of plasma hyperviscosity in subcortical arteriosclerotic encephalopathy (Binswanger's disease). AB - Five haemorheological variables (haematocrit, plasma viscosity, red cell aggregation, red cell deformability and yield shear stress) and the plasma fibrinogen concentration were determined in blood samples from 21 untreated patients with subcortical arteriosclerotic encephalopathy (SAE, Binswanger's disease). The results were compared with those obtained in blood samples from 40 untreated patients with lacunar infarcts and from 275 healthy control subjects without vascular risk factors. Pathological ("solid body") flow behaviour was detected in the blood of both groups of patients (SAE and lacunar infarcts). However, highly elevated plasma viscosity was a consistent feature only of SAE. The authors present the hypothesis that the high plasma viscosity in patients with SAE may account for the progressive degeneration of cerebral white matter. It is postulated that microcirculatory abnormalities due to microrheological changes may be one of the many missing links in the pathophysiology of SAE. PMID- 3559643 TI - A clinical, EEG and CT study in 21 cases of chronic respiratory failure. AB - A clinical, EEG and CT study was carried out on 21 patients with chronic stable respiratory failure. The neurological disturbances and mental deterioration observed were of a mild degree, and no severe alterations were detected at EEG. CT showed cerebral atrophy, but the type and prevalence did not differ substantially between patients studied and normal sex- and age-matched control subjects. The data gave evidence that in chronic stable respiratory failure cerebral function is only slightly affected. PMID- 3559642 TI - Short- and long-latency tibial somatosensory evoked potentials in cerebral lesions affecting Rolandic leg areas. AB - Short- and long-latency tibial somatosensory evoked potentials (SEPs) were studied in nine patients with clinical presentation primarily involving one lower extremity. In group 1, with extensive infarcts in the territory of anterior cerebral artery, tibial cortical SEPs were uniformly absent. In group 2, with small infarcts involving Rolandic leg areas, tibial SEPs showed a decrease in overall response amplitude and attenuation of P40. In group 3, with discrete mass lesions compressing Rolandic leg areas, P40 was preserved but might be delayed. Late SEP components (N75, P100 and N135) tended to be preserved in the patients of group 2 and 3. The data suggest that Rolandic leg areas and the neighboring cortex are crucial for short- and long-latency tibial cortical SEPs and that small lesions affecting Rolandic leg areas tend to affect short- and mid-latency SEP components. PMID- 3559644 TI - Lobar vs thalamic and basal ganglion hemorrhage: clinical and radiographic features. AB - One hundred and twelve patients with spontaneous supratentorial intracerebral hemorrhages were reviewed to identify features which distinguish lobar intracerebral hemorrhage (LH; n = 42) from thalamic or basal ganglionic hemorrhage (TGH; n = 70). Chronic hypertension occurred more commonly in TGH (TGH 67%; LH 48%) while bleeding diathesis was more common in LH (LH 19%; TGH 6%). Clinical presentations were extremely variable and not associated with the type of hemorrhage. Bleeding into the ventricles and hydrocephalus occurred more often with TGH. At last follow-up, there were minimal differences between LH and TGH in overall mortality and functional outcome of the survivors. Alertness on admission was associated with a good outcome regardless of the type of hemorrhage, while a low Glasgow Coma Scale score, coma, ataxic respiration, abnormal pupil reactions, acute hypertension, large hemorrhage size and intraventricular blood were associated with a poor outcome. These data confirm etiological distinctions between LH and TGH, but fail to confirm previously reported differences in clinical presentation and outcome. PMID- 3559645 TI - Ideomotor apraxia in patients with dementia of Alzheimer type. AB - Ideomotor apraxia was checked in a carefully selected group of patients with Alzheimer's dementia, all in the mild stage of the disease. It was shown that ideomotor apraxia is not an early neuropsychological feature. When compared with other cognitive measures, the speed of deterioration of ideomotor apraxia appears to be particularly slow. PMID- 3559646 TI - Psychogenic relapses in childhood epilepsy in puberty and adolescence. AB - Epileptic patients who, after years of being free from symptoms, have relapses during puberty or adolescence (some-times coinciding with a reduction in therapy) pose special therapeutic and diagnostic problems. Because of pubertal lability, the cause of a relapse might seem to be "organic", especially if the EEG also shows a "deterioration", yet psychogenic factors must not be disregarded. On the basis of typical case studies, a characteristic constellation is presented. The achievement of a "well-behaved" child at first dramatically improves and this correlates with the success of antiepileptic therapy. Then individuation and further development cannot adequately take place because the family unit is not functioning properly. At a critical stage of development, the excessive expectations of the parents lead to too much stress on the child, thus destroying the balance within the family system, which has hitherto been maintained only with difficulty. Attempts to improve the situation by changing the medication (increasing the dose or switching to another drug) fail. If, however, it is realized that the symptoms are of psychogenic origin, adequate therapeutic interventions (e.g. adequate schooling or professional training as well as psychotherapy) promise good results. PMID- 3559647 TI - Wide-field radiation therapy alone or with chemotherapy for Hodgkin's disease in relapse from combination chemotherapy. AB - Nineteen patients with Hodgkin's disease who relapsed primarily in nodal sites after intensive combination chemotherapy were retreated with wide-field radiation therapy alone or with additional chemotherapy between January 1971 and December 1984. Six patients presented in second relapse and 13 patients in first relapse. Seven patients were treated with combination chemotherapy and radiation therapy and twelve patients were treated with radiation therapy alone. Radiation therapy field sizes and doses were similar to those recommended for early-stage Hodgkin's disease patients treated with radiation therapy alone. The 5-year actuarial freedom from relapse (FFR) and survival following retreatment were 48% and 69%, respectively. Twelve patients are currently disease-free 12 to 172 months following retreatment. Wide-field radiation therapy alone or with additional chemotherapy should be considered for patients with advanced Hodgkin's disease who relapse in nodal sites after initial combination chemotherapy. PMID- 3559648 TI - Radiotherapy with curative intent: an option in selected patients relapsing after chemotherapy for advanced Hodgkin's disease. AB - Thirteen patients who had relapsed or failed to obtain a complete remission after combination chemotherapy for the treatment of advanced Hodgkin's disease were treated with subtotal or total lymphoid irradiation with curative intent. Twelve of the 13 patients achieved a complete response (CR). Five of the 12 CRs subsequently relapsed at 3, 9, 9, 12, and 19 months. One patient died of leukemia 11 months following radiotherapy. The actuarial relapse-free survival at 1 year was 60%, and six patients (50%) remain disease-free with a median follow-up of 34 months (range, 10 to 115 months) following the completion of radiotherapy. Patients who failed to obtain a CR to their initial chemotherapy, whose chemotherapy CR was of short duration, or who relapsed initially in extranodal sites, tended to have a worse outcome with radiotherapy. Patients who had long disease-free intervals after initial chemotherapy or relapsed only in nodal sites tended to do relatively well. Radiation therapy was well tolerated with no major toxicity. Potentially curative radiation therapy should be considered an option in the management of selected patients who relapse following combination chemotherapy for advanced Hodgkin's disease. PMID- 3559649 TI - MIME chemotherapy (methyl-GAG, ifosfamide, methotrexate, etoposide) as treatment for recurrent Hodgkin's disease. AB - Forty-seven patients with Hodgkin's disease in relapse were treated with MIME combination chemotherapy (methyl-GAG, ifosfamide, methotrexate, etoposide). All patients had previously received nitrogen mustard, vincristine, prednisone, procarbazine (MOPP) or similar regimens and doxorubicin-containing combinations, and many had received extensive irradiation. Complete remission (CR) occurred in 23%, and was influenced by presence of extranodal disease, hemoglobin, lactic dehydrogenase (LDH), and number of prior relapses. Median survival for all patients was 50 weeks, and was affected adversely by the presence of extranodal disease and the number of prior relapses. Toxicity was significant, including infections (23%), neutropenic fever (34%), and hemorrhagic cystitis (23%), but was related in part to the extent of prior therapy. These results with this novel chemotherapy program in heavily pretreated patients suggest that MIME should be studied in less extensively treated patients and considered as a part of treatment programs for patients with Hodgkin's disease in first relapse. PMID- 3559650 TI - The role of misonidazole combined with intraoperative radiation therapy in the treatment of pancreatic carcinoma. AB - We tested the efficacy of the hypoxic cell sensitizer misonidazole in conjunction with intraoperative electron beam radiation therapy (IORT) and external beam irradiation in patients with locally advanced, nonmetastatic adenocarcinoma of the pancreas. Misonidazole was delivered intravenously (IV) at a dose of 3.5 g/m2 in conjunction with IORT of 1,500 to 2,000 cGy to the pancreas. Additional external beam radiation as administered to 4,960 cGy. The study was based on the premise that the effect of misonidazole would be maximized when a high dose of the drug was administered and, thus, high hypoxic cell sensitization could be obtained when using a high single dose of radiation where the hypoxic fraction would be expected to dominate in the survivors. In a nonrandomized study of 41 patients treated with misonidazole and 22 without, the 1-year local control was 67% and 55%, and 1-year survival was 50% and 77%, respectively. Although there was a bias towards larger tumors in the patients treated with the sensitizer, we were unable to demonstrate an advantage to misonidazole in this clinical situation. PMID- 3559651 TI - Localized extremity soft tissue sarcoma: an analysis of factors affecting survival. AB - The management of extremity soft tissue sarcoma is undergoing rapid change as new techniques of adjuvant treatment are developed. Critical assessment of these advances requires a fundamental understanding of the natural course of this disease. In an effort to define important prognostic factors, this review of 423 adults with localized extremity soft tissue sarcomas, treated at one institution (1968 to 1978), was undertaken. The effect of the following variables on survival was examined: patient factors, ie, age, sex, symptoms, and status at presentation; tumor factors, ie, site, size, depth, bone or neurovascular invasion, histogenesis, grade, and nodal status; and treatment factors, ie, biopsy technique, type of operation, surgical margins, adjuvant treatment, and subsequent local treatment failure. Patient factors with an adverse impact on survival included age greater than 53 and the presence of local symptoms. High tumor grade, positive regional nodes, histology other than liposarcoma, fibrosarcoma or malignant fibrohistiocytoma, invasion of vital structures, proximal site, deep location, and size greater than 10 cm were also poor prognosticators. Treatment factors correlating with optimal survival included limb sparing surgery, adequate margins, biopsy with delayed definitive resection, and absence of subsequent local failure. Patients treated by amputation had a greater proportion of risk factors than patients treated with limb-sparing surgery (LSS). When the data were subjected to multivariate analysis, the following variables emerged as independent predictors of poor outcome: local symptoms, age greater than 53, high grade, proximal site, size greater than 10 cm, positive regional nodes, surgery by amputation, and inadequate margins. These factors are now to be evaluated in our prospective study based on 600 patients with soft tissue sarcoma of all sites admitted to our institution in the last 3 years. These factors should be considered as important stratifications in prospective trials. PMID- 3559652 TI - Cisplatin therapy for disseminated mixed mesodermal sarcoma of the uterus. AB - Eighteen patients with metastatic mixed mesodermal sarcoma of the uterus received cisplatin therapy at the University of Texas (UT) M.D. Anderson Hospital and Tumor Institute at Houston. The dose of cisplatin varied from 75 mg/m2 to 100 mg/m2. Previous therapy included surgery in 11 patients, radiotherapy in two patients, and surgery plus radiotherapy in four patients. One patient had no prior therapy. Seven patients had also received prior chemotherapy with doxorubicin. Of 12 patients with measurable disease, one (8%) had a complete response and four (33%) had a partial response for an overall response rate of 42%. The median progression-free survival of patients treated with cisplatin as first- and second-line therapy was 4.5 and 5.5 months, respectively. Cisplatin demonstrated moderate activity with mild toxicity in this group of patients with metastatic mixed mesodermal uterine sarcomas. Further studies including cisplatin containing combination regimens seem to be warranted. PMID- 3559653 TI - Combined therapies for squamous-cell carcinoma of the esophagus, a Southwest Oncology Group Study (SWOG-8037). AB - Conservative treatment of esophageal cancer with radiation therapy has afforded few long-term survivors. In order to improve outcome, patients with locoregional disease were treated using a combined modality approach. Patients were treated with chemotherapy consisting of a 96-hour continuous infusion of 5-fluorouracil (5-FU), 1,000 mg/m2/d, days 1 to 4 and days 29 to 32; cisplatin 75 mg/m2, day 1 and 29; and radiation 3,000 rad, days 1 to 19. In the absence of progressive disease, patients underwent esophagectomy. One hundred twenty-eight patients were registered of whom 113 were eligible and 106 were evaluable. Toxicity included gastrointestinal (GI) symptoms, mucositis, and myelosuppression. One hundred two patients completed chemoradiotherapy. Following its completion, 11 patients refused surgery, six were considered poor surgical risks, and 14 had progressive disease. Of the remaining 71 patients, 16 had unresectable disease, 13 had residual disease which was incompletely resected, 24 had disease which could be completely resected, and 18 were without disease on pathologic examination. The overall operability rate was 63% and the overall resectability rate, 49%. Surgical mortality was 11%. Eighty-nine of 113 eligible patients have died, with a median survival of 12 months and a 2-year survival of 28%. The median postsurgical survival for all 71 patients was 14 months and was 32 months for those patients attaining complete remission (CR). Combined modality therapy remains an investigational approach. Attempts should be directed at increasing response rate to initial therapy. A randomized comparison between combined modality treatment and radiation therapy is necessary to definitively determine the usefulness of this more aggressive approach. PMID- 3559654 TI - Verapamil and adriamycin in the treatment of drug-resistant ovarian cancer patients. AB - Eight patients with refractory ovarian cancer were treated on a pilot protocol of verapamil plus Adriamycin (Adria Laboratories, Columbus, OH). This trial was based on our previous laboratory studies which demonstrated that Adriamycin resistance in human ovarian cancer cell lines could be partially reversed by exposure of the cells to high concentrations of verapamil (3,000 ng/mL). Patients were treated in an intensive care unit with continuous cardiovascular monitoring. The dose of verapamil was escalated in each patient until hypotension or heart block developed, and this dose was maintained for 72 hours. Adriamycin (50 mg/m2) was infused over 24 hours during the second day of the verapamil infusion and verapamil alone was administered on the third day in an effort to block efflux from drug-resistant cells. This intensive approach led to a median plasma verapamil level of 1,273 ng/mL (range, 720 to 2,767). However, the high infusion rates of verapamil (9 micrograms/kg/min) required to achieve these plasma levels produced an unacceptable degree of cardiac toxicity. Two patients developed transient atropine-responsive complete heart block and four patients developed transient congestive heart failure with increases in pulmonary capillary wedge pressure. There was no evidence that the noncardiac toxicities of Adriamycin were enhanced by verapamil. There were no objective responses to therapy. Future studies should use less cardiotoxic calcium channel blockers that can be safely administered to produce the plasma levels required for in vitro sensitization of drug resistant cells. PMID- 3559655 TI - Herniated lumbar disc disease in patients with malignancy. AB - Six patients with cancer presented with signs and symptoms of a lumbar herniated disc syndrome due to a herniated lumbar disc. The differential diagnosis and literature are reviewed. In four of the six, the patients' complaints were attributed to the malignancy, with delay in diagnosis and institution of appropriate therapy. In two of the patients, treatment was administered for presumed spinal metastasis with radiation therapy and/or chemotherapy with castration before the correct diagnosis was made. Surgery was performed on all six patients confirming the diagnosis of a herniated lumbar disc at the involved level and relieving the patients' pain. PMID- 3559656 TI - Local infusion of urokinase for the lysis of thrombosis associated with permanent central venous catheters in cancer patients. AB - We assessed the efficacy of local fibrinolytic therapy in 35 axillary-subclavian vein thromboses (SVT) that occurred in cancer patients with percutaneous central venous catheters (CVC). These catheters were indwelling for a median of 1 month (range, one day to 10 months) before thrombosis developed. Urokinase was administered at a dose of 500 to 2,000 U/kg/h. Complete lysis occurred in 25 of 30 thrombi that were directly infused, after a median of four days. Complete lysis occurred in one of 12 thrombi that could not be directly infused with urokinase and in two of six with associated phlebitis. Eighty-one percent of the thrombi that were symptomatic for less than 1 week before treatment resolved, compared with 56% present for longer than 1 week. Sixteen patients who had complete (12) or partial (four) thrombolysis did not have their CVCs removed. All four patients with partial thrombolysis had recurrent thrombosis at a median of eight days (range, one to 90). Only two patients who had complete thrombolysis had recurrent thrombosis, at 8 and 16 months. Only minor hemorrhagic toxicity was seen. PMID- 3559657 TI - Treatment-related toxicity in elderly patients with malignant lymphoma. PMID- 3559658 TI - Doxorubicin combination chemotherapy in ovarian carcinoma. PMID- 3559659 TI - Cerebral dysfunction secondary to high-dose methotrexate. PMID- 3559660 TI - Commentary on diagnosis and surgical management of metastatic brain tumors. PMID- 3559662 TI - Radiation therapy for brain metastases. PMID- 3559661 TI - Brain surface invasion and metastasis of murine malignant melanoma variants. AB - Mouse B16 melanoma sublines were selected sequentially for their abilities to colonize brain meninges and leptomeninges of C57BL/6 mice. After 14 selections subline B16-B14b was established that formed significantly more brain tumor colonies than the parental B16 line. Examination of brains at various times after intravenous or intra-arterial injection of B16 cells by electron microscopy revealed that B14b melanoma cells lodged in small brain blood vessels, proliferated and invaded through vessel walls into brain parenchyma and also along small blood vessels at perivascular sites. Invasion into brain parenchyma was characterized by extension of melanoma cell filopodia resulting in fragmentation and sometimes enfulgment of glial and neural cells. Analysis of cell surface proteins of B16 melanoma sublines revealed increased exposure of a Mr approximately 90,000 glycoprotein on the high brain-colonizing cells. Antibodies against the Mr approximately 90,000 glycoprotein reacted with a variety of human melanoma cell lines and with some fetal and adult tissues, indicating that this melanoma-associated component is not species-, tumor- or tissue-specific. The glycoprotein could be a cell surface receptor important in the survival and growth properties of melanoma cells in brain microenvironments. PMID- 3559663 TI - Metastatic malignant glioma with resultant extradural compression of a sacral nerve root. AB - A patient with a malignant cerebral mixed oligodendroglioma-astrocytoma presented with a severe, painful S-1 radiculopathy. Neuroradiological examinations revealed an extradural soft-tissue mass compressing the first sacral nerve root. Spinal fluid examination and myelography gave no evidence of intradural disease. Surgery confirmed the presence of metastatic glioma compressing the S-1 nerve root. The tumor was entirely epidural in location. Mechanisms of dissemination are discussed. PMID- 3559664 TI - Alteration of blood-brain-CSF barrier in experimental meningeal carcinomatosis. A morphologic and adriamycin-penetration study. AB - An experimental model of meningeal carcinomatosis has been produced by subarachnoid inoculation of B16 melanoma cells into C57BL mice. Injection of 10(3) viable cells was sufficient to cause 100% tumor incidence and death within a median survival time of 17 days. The tumor infiltrated diffusely the meninges of the brain and spinal cord and filled the ventricular system. Electron microscopic study of the leptomeningeal tumor revealed newly formed microvessels with fenestrated endothelium. The integrity of the blood-brain barrier was studied by the extravasation of the Evans blue and the Horseradish peroxidase tracers. Barrier disruption became evident from the seventh day on, using Evans blue. Electron microscopy study showed peroxidase activity in the luminal and abluminal sides of the meningeal microvessels, and within the tight junctions. Similar findings were noted in cortical capillaries adjacent to the meningeal tumor. Brain concentrations of Adriamycin (ADR) following administration of an intravenous dose of either 10 mg/kg or 50 mg/kg were measured on days 0 to 14 after tumor inoculation. A significant increase in mean +/- SEM content of whole brain ADR was observed only with the 50 mg/kg dose in days 7 to 14 (0.69 +/- 0.02 micrograms/g wet tissue weight) as compared to tumor-free controls (0.43 +/- 0.01, p less than 0.05). Our study suggests that barrier alteration in meningeal carcinomatosis allows extravasation of tracer solutes. Still, in order to achieve a significant increase in a water soluble drug penetration through the disrupted barrier, a high-dose drug regimen is required. PMID- 3559665 TI - Cytogenetic studies of human brain tumors and their clinical significance. 1. Medulloblastoma. AB - Four medulloblastomas were studied cytogenetically with clinical follow-up of the patients. Three of these lesions were diploid and the patients manifested no recurrence at 40, 37 and 36 months respectively. The remaining tumor was aneuploid with 52 chromosomes and the patient expired of the medulloblastoma in 7 months. These findings are compared to nine previously reported karyotypes of primary medulloblastomas only two of which had clinical follow-up of the patients. On the basis of our results and these previously reported cases it appears that medulloblastomas with a diploid chromosomal pattern have a better prognosis than those with aneuploidy. PMID- 3559666 TI - Cerebellar astrocytomas. Clinical characteristics and prognostic indices. AB - The present study has been based on a detailed, computer-assisted, analysis of 112 astrocytomas from patients of all ages seen at The Radcliffe Infirmary between 1938 and 1984. There have been only six studies larger than the present one. From the results obtained in the present study, and the review of the literature, the following conclusions have been reached. Between 70 and 80% of cerebellar astrocytomas are found in children. Few patients are less than 1 year of age or older than 40 at the time of diagnosis. There appear to be no age peaks. Prognosis is poorest at the extremes of life, children less than 5 years old tending to suffer an early recurrence and patients in the oldest age groups having not only a very rapid recurrence but also a very low overall survival rate. In the present study, there was a slight predominance of males although basically, when all studies are considered, the incidence appears to be equal amongst the sexes. Around puberty there appears to be an abrupt drop in the number of tumours in females and a concomitant rise in the number of males. There appears to be no relationship between sex and the length of survival. It would appear that cerebellar astrocytomas can begin either within the vermis or one hemisphere. There appears to be no laterality, the right and left sides of the cerebellum being affected equally. In the present study, the hemispheres were affected three times more frequently than the vermis (34.8%: 12.5%). The rate of recurrence is much faster with tumors of the vermis, whilst the length of survival to death is much longer with tumours of one hemisphere at least up to 10 years after surgery. The most rapid recurrences take place in tumours which involve both hemispheres and the vermis whilst the poorest survival is associated with tumours infiltrating the brain stem. The average length of history is 18.7 months, being under forty-eight months in approximately 60% of patients, but only greater than 60 months in 6.2% of cases. The length of history was not related to either patient age or survival time. Most patients present with obstructive hydrocephalus with or without localising symptoms. The presentation is usually chronic and intermittent but may also be acute.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559667 TI - Proximal retinal contribution to the intraretinal 8-Hz pattern ERG of cat. AB - We investigated the retinal depth of origin of the pattern ERG (PERG) in cat by recording extracellular responses to contrast reversal grating stimuli and performing a current source-density analysis of the depth profiles. The local ERG (LERG) was recorded within the retina; the waveform varied with grating spatial phase position of the microelectrode. The LERG at any arbitrary single spatial phase was not equivalent to the corneal PERG. To obtain an "intraretinal PERG" equivalent to the corneal PERG, we summed LERGs from many spatial phases over a complete grating cycle. This intraretinal PERG was analogous to the corneal PERG in having only even harmonic components and also in being independent of the grating spatial phase. The absence of the fundamental and odd harmonics appeared to result from the summation of responses across grating spatial phase rather than from an intrinsic generator mechanism. The spatial contrast sensitivity function for the intraretinal PERG at 8 Hz was tuned, with peak sensitivity between 0.5 and 0.75 cycles per degree in the area centralis. The 8-Hz PERG response was maximum in the proximal retina at approximately 23% depth from the internal limiting membrane (ILM). This depth lies within the inner plexiform layer and is proximal to the depth at which the b-wave was maximum (49-61% depth). PERG and flash-elicited ERG responses exhibited different amplitude profiles as a function of retinal depth. Analysis of the 8-Hz PERG depth profiles identified generators in the proximal retina between the ILM and the inner plexiform-inner nuclear boundary. The analysis suggested that at least two generators were present. The proportional contribution to the corneal PERG from each of the two or more proximal generators was not determined. Contributions to the corneal PERG from more distal generators, however, were not specifically excluded. The intraretinal recordings suggest that under some conditions contrast reversal gratings at 8 Hz can elicit current generators in the proximal retina of cat. These generators appear to respond to local retinal illumination, and the intraretinal PERG results from nonlinear elements of at least two generators. Spatial tuning of the intraretinal PERG may reflect properties of the underlying LERG components, including the M-wave. PMID- 3559668 TI - Temporal encoding of two-dimensional patterns by single units in primate inferior temporal cortex. I. Response characteristics. AB - We seek a general approach to determine what stimulus features visual neurons are sensitive to and how those features are represented by the neuron's responses. Because lesions of inferior temporal (IT) cortex interfere with a monkey's ability to perform pattern discrimination tasks we studied IT neurons. Previous single-unit studies have shown that IT neurons sometimes respond more strongly to complex stimuli (brushes, hands, faces) than to simple stimuli (bars, slits, edges). However, it is not known how specific stimulus parameters are represented by responses. We studied the responses of IT neurons in alert behaving monkeys to a large set of two-dimensional black and white patterns. The stimulus set was based on 64 Walsh functions that can be used to represent any picture with a resolution of one part in eight along each of two dimensions. The responses to these stimuli spanned a continuum from inhibition to strong excitation. A statistical test showed that the spike count was determined by which Walsh stimulus was presented. Hence, these stimuli form an adequate set for testing IT neurons. The responses showed temporal modulation of the spike train that could not be represented by a change in the spike count alone. Examples of this modulation were changes in latency, changes in the duration of the response, and alternating periods of excitation and inhibition. This temporal modulation may be important in representing stimulus parameters. The next paper in this series develops a method for quantifying this temporal modulation and shows that it is dependent on the stimulus. The third paper in this series shows that this temporal modulation contains more information about stimulus parameters than is contained in the spike count alone. PMID- 3559669 TI - Temporal encoding of two-dimensional patterns by single units in primate inferior temporal cortex. II. Quantification of response waveform. AB - The purpose of this study was to describe how the responses of neurons in inferior temporal (IT) cortex represent visual stimuli. In the preceding paper we described the responses of IT neurons to a large set of two-dimensional black and white patterns. The responses to different stimuli showed temporal modulation of the spike trains. This paper develops a method for quantifying temporal modulation and shows that the stimulus determines the distribution over time, as well as the number, of spikes in a response. The responses were quantified using an orthogonal set of temporal waveforms called principal components. The principal components related to each neuron were extracted from all the responses of that neuron to all of the stimuli, regardless of which stimulus elicited which response. Each response was then projected onto the set of principal components to obtain a set of coefficients that quantified its temporal modulation. This decomposition produces coefficients that are uncorrelated with each other. Thus each coefficient could be tested individually, with univariate statistics, to determine whether its relation to the stimulus was nonrandom. The waveforms of the principal components are unconstrained and depend only on the responses from which they are derived; hence, they can assume any shape. Nonetheless, the 21 neurons we analyzed all had principal components that belonged to only one of two sets. The two sets could be characterized by their first principal component, which was either phasic or tonic. This suggests that these neurons may use as few as two different mechanisms in generating responses. The first principal component was highly correlated with spike count, and both were driven by the stimulus. Higher principal components were uncorrelated with spike count, yet some of them were also driven by the stimulus. Thus the principal components form a richer description of the stimulus-dependent aspects of a neuronal response than does spike count. Bootstrap tests showed that several principal components (usually 3 or 4) were determined by the stimulus. Since higher principal components were not correlated with the spike count, the stimulus must have determined the distribution of spikes in the response as well as their number. However, it is possible that the number and distribution of spikes are both determined by the same characteristics of the stimulus. In this case, the temporal modulation would be redundant, and a simple univariate measure would be sufficient to characterize the stimulus-response relationship.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559670 TI - Temporal encoding of two-dimensional patterns by single units in primate inferior temporal cortex. III. Information theoretic analysis. AB - Ablation and single-unit studies in primates have shown that inferior temporal (IT) cortex is important for pattern discrimination. The first paper in this series suggested that single units in IT cortex of alert monkeys respond to a set of two-dimensional patterns with complex temporal modulation of their spike trains. The second paper quantified the waveform of the modulated responses of IT neurons with principal components and demonstrated that the coefficients of two to four of the principal components were stimulus dependent. Although the coefficients of the principal components are uncorrelated, it is possible that they are not statistically independent. That is, several coefficients could be determined by the same feature of the stimulus, and thus could be conveying the same information. The final part of this study examined this issue by comparing the amount of information about the stimulus that can be conveyed by two codes: a temporal waveform code derived from the coefficients of the first three principal components and a mean rate code derived from the spike count. We considered the neuron to be an information channel conveying messages about stimulus parameters. Previous applications of information theory to neurophysiology have dealt either with the theoretical capacity of neuronal channels or the temporal distribution of information within the spike train. This previous work usually used a general binary code to represent the spike train of a neuron's response. Such a general approach yields no indication of the nature of the neuron's intrinsic coding scheme because it depends only on the timing of spikes in the response. In particular, it is independent of any statistical properties of the responses. Our approach uses the principal components of the response waveform to derive a code for representing information about the stimuli. We regard this code as an indication of the neuron's intrinsic coding scheme, because it is based on the statistical properties of the neuronal responses. We measured how much information about the stimulus was present in the neuron's responses. This transmitted information was calculated for codes based on either the spike count or on the first three principal components of the response waveform. The information transmitted by each of the first three principal components was largely independent of that transmitted by the others. It was found that the average amount of information transmitted by the principal components was about twice as large as that transmitted by the spike count.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559672 TI - Responses of nigrostriatal dopamine neurons to high-intensity somatosensory stimulation in the anesthetized monkey. AB - Nigrostriatal dopamine (DA) neurons of the mammalian midbrain play an important role in behavioral reactions. Their destruction in Parkinsonian patients and experimentally lesioned animals leads to a reduction and slowing of movements as well as other motor, cognitive, and motivational deficits. We tested the responses of DA neurons to somatosensory stimulation to gain insight into the nature of peripheral information reaching these neurons. Experiments were performed as repeated sessions in two anesthetized monkeys having chronically implanted recording chambers, thereby reducing the number of primates required for experimentation. Midbrain DA neurons were characterized by their histological location, by the form, duration, and frequency of extracellularly recorded, spontaneously occurring impulses, by antidromic activation from caudate and putamen, and by the reduction of impulse rate following systemic administration of low doses of the DA autoreceptor agonist apomorphine. Half of the midbrain DA neurons (65 of 145 neurons, 45%) were antidromically activated from chronically implanted stimulating electrodes in caudate (35 neurons), putamen (47 neurons), or both structures (17 of them). Conduction velocities ranged from 0.7 to 2.5 m/s, with medians of 1.2 and 1.5 m/s for neurons projecting to caudate and putamen, respectively. Half of the midbrain DA neurons were depressed (72 of 140 neurons, 51%) and less than a quarter activated (24 of 140 neurons, 17%) by intense noxious pinch stimulation to the body surface. Innocuous, even intense, surface or deep somatosensory stimuli were ineffective. Pinch responses continued during the whole stimulating period of several seconds in most DA neurons. There was no response habituation during repeated stimulation. Convergence between spinal and trigeminal input and from both body sides was seen for virtually all noxious pinch responses. Thus DA neurons typically responded in the same direction to pinch stimulation of hand, foot, face, tail, and dorsum of both sides. Systemic administration of the DA receptor antagonist haloperidol (0.33 or 0.50 mg/kg) strongly reduced pinch responses in all seven DA neurons tested. This provides evidence for an involvement of DAergic neurotransmission in the representation of exteroceptive input in the brain. The results show that midbrain DA neurons projecting to the striatum respond to noxious somatosensory input in the anesthetized monkey. The bilateral nontopographic nature of the responses does not support a role in precise stimulus recognition, rather it suggests a mechanism involved in basic neuronal processes underlying behavioral responsiveness. PMID- 3559671 TI - Evidence for a supplementary eye field. AB - Electrical microstimulation and unit recording were performed in dorsomedial frontal cortex of four alert monkeys to identify an oculomotor area whose existence had been postulated rostral to the supplementary motor area. Contraversive saccades were evoked from 129 sites by stimulation. Threshold currents were lower than 20 microA in half the tests. Response latencies were usually longer than 50 ms (minimum: 30 ms). Eye movements were occasionally accompanied by blinks, ear, or neck movements. The cortical area yielding these movements was at the superior edge of the frontal lobe just rostral to the region from which limb movements could be elicited. Depending on the site of stimulation, saccades varied between two extremes: from having rather uniform direction and size, to converging toward a goal defined in space. The transition between these extremes was gradual with no evidence that these two types were fundamentally different. From surface to depth of cortex, direction and amplitude of evoked saccades were similar or changed progressively. No clear systematization was found depending on location along rostrocaudal or mediolateral axes of the cortex. The dorsomedial oculomotor area mapped was approximately 7 mm long and 6 mm wide. Combined eye and head movements were elicited from one of ten sites stimulated when the head was unrestrained. In the other nine cases, saccades were not accompanied by head rotation, even when higher currents or longer stimulus trains were applied. Presaccadic unit activity was recorded from 62 cells. Each of these cells had a preferred direction that corresponded to the direction of the movement evoked by local microstimulation. Presaccadic activity occurred with self-initiated as well as visually triggered saccades. It often led self-initiated saccades by more than 300 ms. Recordings made with the head free showed that the firing could not be interpreted as due to attempted head movements. Many dorsomedial cortical neurons responded to photic stimuli, either phasically or tonically. Sustained responses (activation or inhibition) were observed during target fixation. Twenty-one presaccadic units showed tonic changes of activity with fixation. Justification is given for considering the cortical area studied as a supplementary eye field. It shares many common properties with the arcuate frontal eye field. Differences noted in this study include: longer latency of response to electrical stimulation, possibility to evoke saccades converging apparently toward a goal, and long-lead unit activity with spontaneous saccades. PMID- 3559673 TI - Sensorimotor integration in the primate superior colliculus. I. Motor convergence. AB - Orienting movements of the eyes and head are made to both auditory and visual stimuli even though in the primary sensory pathways the locations of auditory and visual stimuli are encoded in different coordinates. This study was designed to differentiate between two possible mechanisms for sensory-to-motor transformation. Auditory and visual signals could be translated into common coordinates in order to share a single motor pathway or they could maintain anatomically separate sensory and motor routes for the initiation and guidance of orienting eye movements. The primary purpose of the study was to determine whether neurons in the superior colliculus (SC) that discharge before saccades to visual targets also discharge before saccades directed toward auditory targets. If they do, this would indicate that auditory and visual signals, originally encoded in different coordinates, have been converted into a single coordinate system and are sharing a motor circuit. Trained monkeys made saccadic eye movements to auditory or visual targets while the activity of visual-motor (V-M) cells and saccade-related burst (SRB) cells was monitored. The pattern of spike activity observed during trials in which saccades were made to visual targets was compared with that observed when comparable saccades were made to auditory targets. For most (57 of 59) V-M cells, sensory responses were observed only on visual trials. Auditory stimuli originating from the same region of space did not activate these cells. Yet, of the 72 V-M and SRB cells studied, 79% showed motor bursts prior to saccades to either auditory or visual targets. This finding indicates that visual and auditory signals, originally encoded in retinal and head-centered coordinates, respectively, have undergone a transformation that allows them to share a common efferent pathway for the generation of saccadic eye movements. Saccades to auditory targets usually have lower velocities than saccades of the same amplitude and direction made to acquire visual targets. Since fewer collicular cells are active prior to saccades to auditory targets, one determinant of saccadic velocity may be the number of collicular neurons discharging before a particular saccade. PMID- 3559674 TI - Correlation of recruitment order with axonal conduction velocity for supraspinally driven diaphragmatic motor units. AB - Spontaneous activities of pairs of single diaphragmatic motor units (MUs) were recorded via two electrodes in anesthetized cats, ventilated with CO2 added to the inspired gas, which slightly enhanced respiratory drive (endtidal CO2 less than 6%). These MUs were characterized by their axonal conduction velocities (CVs) and relative onset times (defined as the time after onset of phrenic nerve activity until the MU began discharging divided by the duration of inspiration). Motor unit axonal CV was estimated by the conduction time and the distance between two points on the phrenic nerve. Results were compared from two experimental preparations: one with dorsal roots intact and the other with dorsal roots transected bilaterally between fourth (C4) and seventh (C7) cervical segments. Estimated mean CV for phrenic MUs was 46.2 m/s(n = 180 MU). Motor units were classified as early and late recruited MUs depending on their relative onset times. We correlated MU axonal CV with its relative recruitment time. A highly significant (P less than 0.0001), positive correlation between axonal CV and relative recruitment time was established for those diaphragmatic MUs recruited with this respiratory drive. Correlation coefficients were r = 0.70 for intact animals, r = 0.72 for dorsal rhizotomized animals, and r = 0.72 overall population. For pairs of MUs, the CV of the earlier recruited unit was compared with the CV of the later recruited unit. In 96% of pairs from intact animals and 92% of pairs from dorsal rhizotomized animals, the first MU had a lower CV than the MU recruited later. Difference in relative times of recruitment was directly related to difference in axonal CVs. However, a portion of the motor pool with high-axonal CVs was not sampled. Under conditions of these experiments, afferent input in cervical dorsal roots, including that from diaphragmatic receptors, did not influence the distribution of MU relative onset times. Further, a similar proportion of MU pairs wherein the earlier recruited MU had a CV lower than the later recruited unit was observed in intact and dorsal rhizotomized animals. We also cross-correlated 31 pairs of simultaneously recorded MUs to assess common input onto phrenic motoneurons. Common input was characterized by the presence of peaks having widths of greater than or equal to 3 ms in the cross-correlation histograms (CCHs) and occurring within 20 ms of the trigger event. Peaks were judged significant if the bin with the largest number of occurrences was significantly greater than base line and if neighboring bins were above base line.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559675 TI - The deafferented reticular thalamic nucleus generates spindle rhythmicity. AB - The hypothesis that nucleus reticularis thalami (RE) is the generator of spindle rhythmicity during electroencephalogram (EEG) synchronization was tested in acutely prepared cats. Unit discharges and focal waves were extracellularly recorded in the rostral pole of RE nucleus, which was completely disconnected by transections from all other thalamic nuclei. In some experiments, additional transections through corona radiata created a triangular island in which the rostral RE pole survived with the caudate nucleus, putamen, basal forebrain nuclei, prepyriform area, and the adjacent cortex. Similar results were obtained in two types of experiments: brain stem-transected preparations that exhibited spontaneous spindle sequences, and animals under ketamine anesthesia in which transient spindling was repeatedly precipitated during recording by very low doses of a short-acting barbiturate. Both spindle-related rhythms (7- to 16-Hz waves grouped in sequences that recur with a rhythm of 0.1-0.3 Hz) are seen in focal recordings of the deafferented RE nucleus. The presence of spindling rhythmicity in the disconnected RE nucleus contrasts with total absence of spindles in cortical EEG leads and in thalamic recordings behind the transection. Oscillations within the same frequency range as that of spontaneous spindles can be evoked in the deafferented RE nucleus by subcortical white matter stimulation. In deafferented RE cells, the burst structure consists of an initially biphasic acceleration-deceleration pattern, eventually leading to a long-lasting tonic tail. Quantitative group data show that the burst parameters of disconnected RE cells are very similar to those of RE neurons with intact connections. In the deafferented RE nucleus, spike bursts of RE neurons recur periodically (0.1-0.3 Hz) in close time-relation with simultaneously recorded focal spindle sequences. The burst occurrence of deafferented RE cells is greatly reduced after systemic administration of bicuculline. The preservation of both spindle-related rhythms in the disconnected RE nucleus, together with our recent experiments showing abolition of spindle oscillations in thalamic nuclei after lesions of RE nucleus (24), demonstrate that RE nucleus is the generator of spindle rhythms. PMID- 3559676 TI - Inspiratory muscle responses to airway occlusion during learned breathing movements. AB - Respiratory muscle responses to sudden obstruction of learned breathing movements were studied in seven normal adults. Subjects were trained to inspire at a constant rate (0.4 liters/s), or maintain a static inspiratory effort(-10 cmH2O). On each trial these efforts were loaded unpredictably by occluding the airway or applying an opposing negative pressure at the mouth. Surface EMGs were recorded from the neck, parasternal intercostal, pectoral, diaphragmatic, and abdominal muscles. The latency and pattern of the responses to occlusion or to negative pressure were obtained from 10-trial computer-averaged records. When subjects were trained to relax in response to loading, inhibitory responses (mean latency: 32 ms) were recorded from the neck (16 out of 21 10-trial averages), diaphragm (9 out of 21), and parasternal (3 out of 21) locations. Excitatory responses (mean latency: 69 ms) were also recorded from the neck (11 out of 21 10-trial averages), diaphragm (8 out of 21), and parasternal (1 out of 21) sites. These responses were also observed in many single trial records. When subjects were trained to make an additional inspiratory effort as quickly as possible after loading, the reaction was a high-amplitude EMG burst, sometimes preceded by a brief inhibitory response. The mean reaction times for the large bursts were: 70 ms for the neck, 86 ms for the diaphragm, and 91 ms for the parasternal intercostals. Latencies in the 60- to 70-ms range were found on many 10-trial averages. Because the latencies of the excitatory responses evoked when subjects were trained to relax in response to loading were similar to those of the EMG bursts recorded when subjects were trained to react quickly in response to loading, it is not possible to distinguish long-latency reflex and learned response components on the basis of latency alone. Previous work, which has assumed that responses in the 50- to 70-ms latency range must be reflexive rather than learned, may need to be reexamined. PMID- 3559677 TI - Task-related responses of monkey medullary dorsal horn neurons. AB - Medullary dorsal horn neurons with trigeminal sensory properties have been previously shown to have additional responses associated with cues relevant to the successful execution of a behavioral task. These "task-related" responses were evoked by environmental cues but were independent of the specific stimulus parameters. We have examined further the characteristics of task-related responses in medullary dorsal horn neurons of three monkeys. Single-unit activity was recorded while the monkeys were performing behavioral tasks that required them to discriminate thermal or visual stimuli for a liquid reward. Forty-five percent (34/75) of the medullary dorsal horn neurons studied exhibited task related activity that was significantly correlated with the stereotypical behavioral events that occurred during the tasks. Similar events occurring outside of the task produced no response. In addition to the task-related activity of these medullary dorsal horn neurons, responses to mechanical and/or thermal stimuli presented within the neuron's receptive field were demonstrated in 28 of 34 cases. These sensory responses also were evoked by the same stimuli presented outside of the behavioral task. Fifteen of the neurons with task related responses could be activated antidromically from thalamic stimulating electrodes. Task-related responses were categorized according to their relationship to the three phases of the behavioral trial: trial initiation, trial continuation, and trial termination. Although an individual task-related response was associated with a single behavioral event, most medullary dorsal horn neurons (30/34) exhibited a reproducible pattern of task-related responses that occurred during more than one phase of the trial. Trial-initiation task-related responses were subdivided depending on their correlation with specific events that occurred within that phase of the trial. One-third of the 18 excitatory trial-initiation responses were associated with the visual stimulus that cued the monkey to begin the trial; the remaining two-thirds were associated with the monkey's press of the button that actually initiated the trial. Trial-continuation task-related responses (observed while the monkey waited for a thermal stimulus that triggered a rewarded motor response) were shown to be independent of the actual temperature of the thermal stimulus. In addition these trial-continuation task-related responses were also noted during trials without a thermal stimulus, in which the trigger cue was the onset of a light (in a visual task).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559678 TI - Human motor-unit recruitment during isometric contractions and repeated dynamic movements. AB - Spike-triggered averaging was used to determine the twitch tensions and contraction times of motor units in the abductor pollicis brevis muscle of two human subjects for two directions of isometric contraction: abduction and opposition of the thumb. During isometric contractions in each direction, the threshold force for motor-unit recruitment and the twitch amplitude were correlated linearly. These data suggested that an orderly pattern of recruitment, according to increasing twitch size, describes the function of the human abductor pollicis brevis muscle for each contraction direction. Rank order of motor-unit recruitment in each isometric contraction direction was correlated, but not identical. All units contributed tension in each direction of contraction, so no clear evidence was found for task-dependent motor units. In two subjects, motor unit recruitment order during isometric contraction of the first dorsal interosseous and abductor pollicis brevis muscles was then compared with that of motor-unit pairs in both muscles during repetitive dynamic movements. Recruitment according to increasing twitch size was largely preserved during the repetitive opening and closing of scissors. The recruitment reversals that were observed were usually between pairs of units with similar thresholds. PMID- 3559679 TI - Epileptiform burst activity induced by potassium in the hippocampus and its regulation by GABA-mediated inhibition. AB - Intracellular and extracellular recordings were made from pyramidal neurons in hippocampal slices in order to study spontaneous paroxysmal bursting induced by raising the extracellular potassium concentration from 3.5 to 8.5 mM. Extracellular recordings from all hippocampal subfields indicated that spontaneous bursts appeared to originate in region CA3c or CA3b as judged by burst onset. Burst intensity was also greatest in regions CA3b and CA3c and became progressively less toward region CA2. Intracellular recordings indicated that in 8.5 mM potassium, large spontaneous excitatory postsynaptic potentials (EPSPs), large burst afterhyperpolarizations, and rhythmic hyperpolarizing depolarizing waves of membrane potential were invariably present in CA3c neurons. High potassium (8.5 mM) induced a positive shift (+9 mV) in the reversal potential of GABAergic inhibitory postsynaptic potentials (IPSPs) in CA3c neurons without changing input resistance or resting potential. This resulted in a drastic reduction in amplitude of the IPSP. Reduction of IPSP amplitude occurred before the onset of spontaneous bursting and was reversible upon return to normal potassium. A new technique to quantify the relative intensity of interictal-like burst discharges is described. Pentobarbital, diazepam, and GABA uptake inhibitors, which enhance GABA-mediated synaptic inhibition, reduced the intensity of potassium-induced bursts, whereas the GABA antagonist bicuculline increased burst intensity. Diphenylhydantoin and phenobarbital, anticonvulsants that have little effect on GABAergic inhibition, were without effect on spontaneous bursts. Burst frequency was reduced by bicuculline and 4,5,6,7 tetrahydroisoxazolo[5,4-c]pyridin-3-ol but was unaffected by other drugs. Reduction of slice temperature from 35 to 19 degrees C dramatically reduced burst intensity but did not markedly affect burst frequency. We hypothesize that high potassium induces a rise in intracellular chloride concentration, possibly by activating an inward KCl pump or by a passive Donnan effect, which results in a decreased IPSP amplitude. With inhibition suppressed, the large spontaneous EPSPs that appear in high potassium cause individual CA3c neurons to fire. A combination of synaptic and electrical interactions among CA3c cells then synchronizes discharges into interictal spike bursts. PMID- 3559680 TI - Sensorimotor integration in the primate superior colliculus. II. Coordinates of auditory signals. AB - Based on the findings of the preceding paper, it is known that auditory and visual signals have been translated into common coordinates at the level of the superior colliculus (SC) and share a motor circuit involved in the generation of saccadic eye movements. It is not known, however, whether the translation of sensory signals into motor coordinates occurs prior to or within the SC. Nor is it known in what coordinates auditory signals observed in the SC are encoded. The present experiment tested two alternative hypotheses concerning the frame of reference of auditory signals found in the deeper layers of the SC. The hypothesis that auditory signals are encoded in head coordinates predicts that, with the head stationary, the response of auditory neurons will not be affected by variations in eye position but will be determined by the location of the sound source. The hypothesis that auditory responses encode the trajectory of the eye movement required to look to the target (motor error) predicts that the response of auditory cells will depend on both the position of the sound source and the position of the eyes in the orbit. Extracellular single-unit recordings were obtained from neurons in the SC while monkeys made delayed saccades to auditory or visual targets in a darkened room. The coordinates of auditory signals were studied by plotting auditory receptive fields while the animal fixated one of three targets placed 24 degrees apart along the horizontal plane. For 99 of 121 SC cells, the spatial location of the auditory receptive field was significantly altered by the position of the eyes in the orbit. In contrast, the responses of five sound-sensitive cells isolated in the inferior colliculus were not affected by variations in eye position. The possibility that systematic variations in the position of the pinnae associated with different fixation positions could account for these findings was controlled for by plotting auditory receptive fields while the pinnae were mechanically restrained. Under these conditions, the position of the eyes in the orbit still had a significant effect on the responsiveness of collicular neurons to auditory stimuli. The average magnitude of the shift of the auditory receptive field with changes in eye position (12.9 degrees) did not correspond to the magnitude of the shift in eye position (24 degrees). Alternative explanations for this finding were considered. One possibility is that, within the SC, there is a gradual transition from auditory signals in head coordinates to signals in motor error coordinates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559681 TI - Ia inhibitory interneurons and Renshaw cells as contributors to the spinal mechanisms of fictive locomotion. AB - The activity of selected single alpha-motoneurons, Renshaw cells (RCs), and Ia inhibitory interneurons (IaINs) during fictive locomotion was recorded via microelectrodes in decerebrate (precollicular-postmammillary) cats in which fictive locomotion was induced by stimulation of the mesencephalic locomotor region. The interrelationships in the timing and frequency of discharge among these three interconnected cell types were determined by comparing their averaged step cycle firing histograms, which were normalized in reference to motoneuron activity recorded in ventral root filaments. Previous findings that RCs are rhythmically active during locomotion and discharge in phase with the motoneurons from which they are excited were confirmed, and further details of the phase relationships between RC and alpha-motoneuron activity during fictive locomotion were obtained. Flexor and extensor RCs became active after the onset of flexor and extensor motoneuron activity, respectively. Maximal activity in extensor RCs occurred at the end of the extension phase coincidental with the onset of hyperpolarization and a decrease in activity in extensor motoneurons. Maximal flexor RC activity occurred during middle to late flexion and was temporally related to the onset of reduced flexor motoneuron activity. The IaINs recorded in the present experiments were rhythmically active during fictive locomotion, as previously reported. The quadriceps IaINs were mainly active during the extension phase of the step cycle, along with extensor RCs. Thus the known inhibition of quadriceps IaINs by RCs coupled to quadriceps and other extensor motoneurons is obviously not sufficient to interfere with the appropriate phasing of IaIN activity and reciprocal inhibition during fictive locomotion, as had been speculated. Most of the quadriceps IaINs analyzed exhibited a decrease in discharge frequency at the end of the extension phase of the step cycle, which was coincidental with increased rates of firing in extensor RCs. These data are consistent with the possibility that extensor RCs contribute to the reduction in quadriceps IaIN discharge at the end of the extension phase of the step cycle. The possibility that IaIN rhythmicity during fictive locomotion arises from periodic inhibition, possibly from Renshaw cells, was tested by stimulating the reciprocal inhibitory pathway throughout the fictive step cycle. The amplitude of Ia inhibitory postsynaptic potentials (IPSPs) varied significantly throughout the fictive step cycle in 14 of the 17 motoneurons tested, and, in 11 of these 14 motoneurons, the Ia IPSPs were maximal during the phase of the step cycle in which the motoneuron was most PMID- 3559682 TI - Functional involvement of catecholamines in reward-related neuronal activity of the monkey amygdala. AB - Neuronal activity was studied in the behaving active monkey to elucidate the functional significance of catecholamines (CA) in the amygdala during reward related behavior, and the effects of noradrenaline (NA), dopamine (DA), and their antagonists, electrophoretically applied, were examined using multibarreled electrode techniques. The operant food intake task had four phases: 1) cue light on to signal the start of bar pressing, 2) execution of high fixed-ratio bar pressing (FR 20), 3) short cue tone triggered by the last bar press to signal the presentation of food, and 4) ingestion, reward. More than half of the 292 cells tested (198, 68%) changed activity during the task. Most changes occurred during the bar press and/or reward periods (164/198, 83%), the former affecting neuronal activity more (127/198, 64%) than the latter (70/198, 35%). Phasic responses to the cue light and cue tone were observed in 62 cells (31%) and 19 cells (10%), respectively. The effects of NA and DA were studied in 199 and 177 cells, respectively. Of these, 90 cells (46%) responded to NA, 87 (97%) with a decrease of firing, and only 3 (3%) with an increase, whereas 40 (26%) responded to DA by increasing (28 cells, 70%) or decreasing (18 cells, 30%) activity. The inhibitory effect of NA was blocked by alpha- and/or beta-adrenoceptive antagonists. Task related activity changes occurred significantly more often among DA sensitive cells than among DA insensitive cells. CA sensitivity and task-related neuronal activity were functionally correlated only in the reward period. Activity of NA sensitive cells decreased in this period more frequently than insensitive cells, and DA sensitive cells increased more often than insensitive cells. Application of a beta-adrenoceptive antagonist or a DA antagonist attenuated the activity changes during the reward period. Application of a alpha-adrenoceptive antagonist had no effect on the reward-related neuronal activity changes. When grouped according to recording site, centromedial cells had a significantly higher occurrence of task-related activity changes than those in the basolateral parts of the amygdala. The bar-press responsive and reward-related cells, the firing of which decreased, were found more often in the centromedial than in the basolateral division, although the numbers of cells that responded to sensory cues were not different in the two parts. Catecholaminergic involvement in the task-related activity changes was also different.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559683 TI - The pattern of changes produced in the saccadic system and vestibuloocular reflex by visually patching one eye. AB - The purpose of the present study was to determine whether, in the absence of visual input to one eye, saccades remained equal in the two eyes. The same question was addressed for the VOR gain of the two eyes. After 1 wk during which one eye was continuously patched, the saccadic properties of only the unseeing eye showed changes consisting of a change, usually a decrease, in saccadic step magnitude, postsaccadic drift with an exponentially decaying component in the temporal direction, and the appearance of a vertical component as well as vertical postsaccadic drift during horizontally directed saccades. Effects were also observed in the VOR consisting of a change in gain and a vertical component during horizontal head rotation. As with saccades, the vertical component in the patched eye was upward when the eye was deviated nasally. When the patch was removed, normal function was restored within 1 day to the previously patched eye without impairing the function of the unpatched eye. These results suggest that the conjugate nature of saccades and the VOR is in part the consequence of a selective, visually driven, calibration mechanism, which can alter commands to motoneurons of one muscle of a conjugate muscle pair without affecting commands to the other. The similarity of changes observed in the VOR and saccades after patching suggests that elements common to both are altered in the absence of vision. PMID- 3559684 TI - Two classes of single-input X-cells in cat lateral geniculate nucleus. I. Receptive-field properties and classification of cells. AB - Cells in the cat's dorsal lateral geniculate nucleus (LGN) were studied by presentation of visual stimuli and also by simultaneous recording of their ganglion cell inputs in the retina. This paper describes receptive-field properties and a new system of classification for LGN X-cells that appear to receive essentially only one excitatory retinal input. These X-cells were of two distinct classes. The visual responses of one class of cell (XS, single) replicated the basic form of the responses of a retinal X-cell. The other class of cell (XL, lagged) had responses with two remarkable features: their firing lagged 40-80 ms behind that of XS-cells or ganglion cells at response onset, and they fired anomalously at times when XS-cells or ganglion cells would not be firing. Thus, for a flashing spot, XL-cells were inhibited from firing after stimulus onset, during the time when XS-cells or retinal X-cells had an initial transient peak in firing; XL-cells generally had an anomalous peak in firing after stimulus offset, after XS-cells or retinal X-cells had stopped firing. For a moving bar, XS-cells or retinal X-cells responded primarily while the bar was in the receptive-field center, whereas most of a typical XL-cell's response occurred after the bar had left the receptive-field center. The latencies of various features in the visual responses were analyzed. For several visual response latencies, the distribution was clearly bimodal, thus objectively demonstrating the existence of two cell classes. Using only the latencies from spot and bar responses, over 90% of these single-input cells could be reliably identified as belonging to one of the two classes. The remaining cells (7 of 128) were intermediate between the two classes in some but not all respects; because they had some properties in common, these cells were kept in a separate group (XPL, partially lagged). The axons of both XS- and XL-cells could be antidromically activated from visual cortex. Cortical latencies were typically 0.7-2.0 ms for XS-cells but much longer, typically 2.4-5.0 ms, for XL-cells. It is possible that XL-cells have not previously been recognized as a separate class because cells with such long latencies have been recorded infrequently in the past. Responses to central flashing spots were more transient than those of retinal X-cells for most XS-cells and more sustained for most XL-cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559686 TI - Physiological study of neurons in the dorsal and posteroventral cochlear nucleus of the unanesthetized cat. AB - The responses of neurons in the posteroventral (PVCN) and dorsal (DCN) cochlear nucleus of the unanesthetized cat were determined for both long and short tones. These results were compared with recent studies in the barbiturate-anesthetized cat conducted in the same laboratory using similar stimuli and analysis programs. Every response pattern (poststimulus time histogram to short tones), which has been observed in previous studies using anesthetized animals, was also observed without anesthetic. The converse was also true: no novel response patterns were observed in the unanesthetized cat. This was also true for interval histogram, response area, isorate curve, and frequency sweep data. Some neurons were difficult to classify into existing descriptions of cochlear nucleus response patterns. For example: primary-like, onset, pauser, and buildup response patterns could also show chopper-like properties; onset-inhibitory, pauser, and buildup neurons appeared to form a response continuum rather than exist as separate response categories; and onset neurons with low characteristic frequencies (CFs) often showed sustained and strongly phase-locked responses below approximately 1,000 Hz. In addition, single neurons often showed more than one response pattern depending on the intensity and frequency of the acoustic stimulus. These ambiguities were also observed under anesthetic. Onset neurons within the PVCN appear to be well suited for the encoding of temporal and intensity information. At low stimulus frequencies they often respond to every cycle of a pure tone stimulus and exhibit the highest degree of phase-locking in the cochlear nucleus. The dynamic ranges associated with many onset neurons can exceed 80 dB compared with the 30- to 40-dB dynamic ranges associated with most other cochlear nucleus neurons. Onset neurons show a similar range of activities in the anesthetized cat. Neurons in the DCN have response properties that are more complex than those seen in the PVCN. Response patterns can change from sustained excitation to complete inhibition and are more often nonmonotonic near CF. DCN neurons can show well-defined tuning in the frequency domain and may be used to encode spectral information, but appear to be poorly suited for encoding temporal or intensity information as they are weakly phase-locked and have relatively small dynamic ranges. When DCN neurons "chop" they usually do so more slowly than do PVCN neurons. DCN neurons recorded in the anesthetized cat behave similarly. The relative frequency of a particular response pattern did vary with anesthetic state.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559685 TI - Two classes of single-input X-cells in cat lateral geniculate nucleus. II. Retinal inputs and the generation of receptive-field properties. AB - The retinal inputs to cells in the cat's lateral geniculate nucleus (LGN) were directly recorded to study the basis for the properties of two classes of LGN X cells: Xs (single) and XL (lagged). The presence of excitatory or inhibitory input to an LGN cell from a particular simultaneously recorded ganglion cell was assessed with cross-correlograms during unstimulated activity. Because neighboring ganglion cells do not fire independently, features in a retinogeniculate correlogram can arise in two ways that must be distinguished by a direct effect of the ganglion cell on the LGN cell, or by correlated firing between that ganglion cell and some other ganglion cell that is an excitatory or inhibitory input to the LGN cell. It was possible to determine the origin of correlogram features because features indicating a retinogeniculate effect were distinctly different in timing and strength from features arising solely from correlated firing in the retina. The characteristic feature in a correlogram between an LGN cell and an excitatory retinal input was a sharp peak in LGN cell firing rate at the appropriate latency after the firing of the ganglion cell. The characteristic feature for an inhibitory input was a dip in LGN cell firing rate after the firing of the ganglion cell. Typically, this dip lasted 10-40 ms and was followed by a prolonged enhancement in LGN cell firing rate, which may reflect a postinhibitory rebound. XS-cells had a single retinal X input whose excitatory effect caused most of the LGN cell's spikes during stimulated and unstimulated activity. There was no conclusive evidence that any XS-cell received excitatory retinal input from either Y-cells or other X-cells of the same center sign. There was usually evidence for inhibition of XS-cells by retinal X-cells of opposite center sign with receptive fields highly overlapping that of the XS cell, but rarely evidence for inhibition by Y-cells. XL-cells also had only a single excitatory input, but this X input had a relatively weak effect that caused only a minority of the LGN cell's spikes, typically 17% during maintained activity and 29% during visual stimulation. The input's excitatory effect was immediately followed by strong inhibition of the XL-cell. XL-cells were also inhibited by retinal X-cells of the same center sign that were adjacent (nearest neighbors) to the excitatory input. The strength and latency of both of these inhibitory effects indicate that the inhibition was disynaptic.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559687 TI - Operant conditioning of primate spinal reflexes: the H-reflex. AB - The study of primate memory substrates, the CNS alterations which preserve conditioned responses, requires an experimental model that fulfills two criteria. First, the essential alterations must be in a technically accessible location. Second, they must persist without input from other CNS regions. The spinal cord is the most technically accessible and readily isolated portion of the primate CNS. Recent work has demonstrated that the spinal stretch reflex (SSR), the initial, wholly segmental response to muscle stretch, can be operantly conditioned and suggests that this conditioning may produce persistent spinal alteration. The present study attempted similar operant conditioning of the H reflex, the electrical analog of the SSR. The primary goals were to demonstrate that spinal reflex conditioning can occur even if the muscle spindle is removed from the reflex arc and to demonstrate conditioning in the lumbosacral cord, which is far preferable to the cervical cord for future studies of neuronal and synaptic mechanisms. Nine monkeys prepared with chronic fine-wire triceps surae (gastrocnemius and soleus) electromyographic (EMG) electrodes were taught by computer to maintain a given level of background EMG activity. At random times, a voltage pulse just above M response (direct muscle response) threshold was delivered to the posterior tibial nerve via a chronically implanted silicon nerve cuff and elicited the triceps surae H-reflex. Under the control mode, reward always followed. Under the HR increases or HR decreases mode, reward followed only if the absolute value of triceps surae EMG from 12 to 22 ms after the pulse (the H-reflex interval) was above (HR increases) or below (HR decreases) a set value. Monkeys completed 3,000-6,000 trials/day over study periods of 2-3 mo. Background EMG and M response amplitude remained stable throughout data collection. H-reflex amplitude remained stable under the control mode. Under the HR increases mode (5 animals) or HR decreases mode (4 animals), H-reflex amplitude (EMG amplitude in the H-reflex interval minus background EMG amplitude) changed appropriately over at least 6 wk. Change appeared to occur in two phases: an abrupt change within the first day, followed by slower change, which continued indefinitely. Change occurred in all three triceps surae muscles (medial and lateral gastrocnemii and soleus). Under the HR increases mode, H-reflex amplitude rose to an average of 213% of control, whereas under the HR decreases mode it fell to an average of 68% of control. The results demonstrate that the H-reflex can be operantly conditioned.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559688 TI - Target neurons of floccular caudal zone inhibition in Y-group nucleus of vestibular nuclear complex. AB - Extracellular unit spikes were recorded in and around the Y-group nucleus in the anesthetized cat. Target (T) neurons of floccular caudal zone inhibition were identified by observing cessation of their spontaneous discharges following stimulation of the floccular caudal zone. The axonal trajectories of the T neurons to the rostral brain stem were studied by observing the antidromic responses of single neurons during systematic tracking with a stimulating microelectrode in the brain stem. The axons of the T neurons pass through a region closely ventral to the lateral part of the brachium conjunctivum (BC), continue rostrally in a region between the BC and the lateral lemniscus, arch medially around the rostral part of the nucleus reticularis tegmenti pontis, cross the midline, continue to the contralateral side by about 1.5 mm lateral from the midline, arch rostrally, run in the central tegmental field on the contralateral side, arch dorsomedially around the caudal pole of the red nucleus, and enter the contralateral oculomotor nucleus (OMN) from the ventrolateral side. In the caudal half of the contralateral OMN, the axons of the T neurons branch out and terminate. The T neurons were exclusively located in the dorsal subdivision of the Y-group nucleus (DY), whereas some were in the medial part of the subnucleus lateralis parvocellularis (SLP, Ref. 12) of the lateral cerebellar nucleus. T neurons were not found in the ventral subdivision of the Y-group nucleus (VY). Differences in neuronal connections between the DY and VY neurons were investigated by observing responses of single neurons to stimulation of the contralateral OMN, the ipsilateral floccular caudal zone, the ipsilateral eighth nerve (i8N), and the contralateral eighth nerve (c8N). Most neurons in the DY and the adjacent medial part of the SLP, receiving inhibitory inputs from the ipsilateral flocculus (exclusively from the caudal zone), project to the contralateral OMN, and about one-half of these neurons receive polysynaptic inputs from the i8N and the c8N. On the other hand, most neurons in the VY receive monosynaptic inputs from the i8N, and some of these neurons project to the ipsilateral flocculus. The neuronal tract via the ventral part of the pontine tegmentum demonstrated in the present experiments is distinct from the classically established vestibulooculomotor tracts via the BC, the medial longitudinal fasciculus, or the ascending tract of Deiters. We call this tract the 'crossing ventral tegmental tract'. Previously, we reported that electrical stimulation of the caudal zone elicited conjugate downward eye movement.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559689 TI - Development of taste responses in the rat parabrachial nucleus. AB - Extracellular responses from neurons in the parabrachial nuclei (PBN) were studied in rats 4 days old to adulthood during chemical stimulation of the tongue with monochloride salts, citric and hydrochloric acids, sucrose, sodium saccharin, and quinine hydrochloride. Multiunit taste responses were recorded in rats at 4-7 days of age and single-unit responses were recorded from 121 neurons in four other age groups of 14-20 days, 25-35 days, 50-60 days, and adults. PBN neurons in rats 4-7 days old consistently responded to 0.1 M solutions of NH4Cl and NaCl, to 0.5 M solutions of NH4Cl, NaCl, and KCl, and to 1.0 M sucrose, 0.1 M sodium saccharin, 0.1 M citric acid, and 0.1 N HCl. They often did not respond, however, to 0.1 M KCl and 0.01 M quinine hydrochloride. Single PBN neurons in rats 14 days old and older characteristically responded to all stimuli, which consisted of 0.1 and 0.5 M salts, acids, sucrose, sodium saccharin, and quinine hydrochloride. Thus no developmental differences occurred in the number of stimuli to which neurons responded after rats were 14 days old. With the exception of responses to hydrochloric acid, there were significant increases in response frequencies to all stimuli after 14 days of age. Average response frequencies to NH4Cl and citric acid increased after 20 days of age and those to NaCl, LiCl, KCl, sucrose, sodium saccharin, and quinine hydrochloride increased after 35 days of age. Average response frequencies for hydrochloric acid did not alter after 14 days of age. The proportion of single PBN neurons that responded maximally to specific monochloride salts did not change during development. Most single neurons in all age groups responded equally well to NH4Cl, NaCl, and LiCl. No PBN neuron responded maximally to KCl. Developmental differences in response frequencies of third-order gustatory neurons in the PBN generally reflect developmental response changes in first-order neurons of the chorda tympani nerve and second-order neurons of the solitary nucleus. However, unique developmental changes are evident in the PBN. Thus the ontogenetic changes that occur in PBN responses likely relate to modifications of lower-order peripheral and central nervous system afferents and peripheral receptor sensitivities. PMID- 3559690 TI - Cat hindlimb motoneurons during locomotion. I. Destination, axonal conduction velocity, and recruitment threshold. AB - Fine flexible wire microelectrodes chronically implanted in the fifth lumbar ventral root (L5 VR) of 17 cats rendered stable records of the natural discharge patterns of 164 individual axons during locomotion on a treadmill. Fifty-one out of 164 axons were identified as motoneurons projecting to the anterior thigh muscle group. For these axons, the centrifugal propagation of action potentials was demonstrated by the technique of spike-triggered averaging using signals recorded from cuff electrodes implanted around the femoral nerve. The axonal conduction velocity was measured from the femoral nerve cuff records. For 43/51 motoneurons, the corresponding target muscle was identified by spike-triggered averaging of signals recorded from bipolar EMG electrodes implanted in each of the anterior thigh muscles: vastus intermedius, medialis and lateralis, sartorius anterior and medialis, and rectus femoris. For 32/51 motoneurons, the recruitment threshold during locomotion was determined from the mean value of the rectified digitally smoothed EMG of the target muscle measured at the time when the motoneuron fired its first spike for each step. The recruitment threshold of every motoneuron was relatively constant for a given speed of walking, but for some units there were small systematic variations as a function of treadmill speed (range: 0.1-1.3 m/s). Recruitment thresholds were standardized with respect to the mean value of peak EMG activity of the target muscle during 16 s of walking at 0.5 m/s. For 28/51 motoneurons recorded in nine cats, recruitment thresholds (range: 3-93% of peak target muscle EMG) were linearly correlated (r = 0.51, P less than 0.02) to axonal conduction velocities (range: 57-117 m/s). In addition, for seven recorded pairs of motoneurons that projected to the same muscle in the same cat, the recruitment thresholds were ordered by relative conduction velocities. Taken together, these results are consistent with the notion that, in normal cat locomotion up to a medium trot, anterior thigh motoneurons are progressively recruited in an orderly fashion. PMID- 3559691 TI - Cat hindlimb motoneurons during locomotion. II. Normal activity patterns. AB - Activity patterns were recorded from 51 motoneurons in the fifth lumbar ventral root of cats walking on a motorized treadmill at a range of speeds between 0.1 and 1.3 m/s. The muscle of destination of recorded motoneurons was identified by spike-triggered averaging of EMG recordings from each of the anterior thigh muscles. Forty-three motoneurons projected to one of the quadriceps (vastus medialis, vastus lateralis, vastus intermedius, or rectus femoris) or sartorius (anterior or medial) muscles of the anterior thigh. Anterior thigh motoneurons always discharged a single burst of action potentials per step cycle, even in multifunctional muscles (e.g., sartorius anterior) that exhibited more than one burst of EMG activity per step cycle. The instantaneous firing rates of most motoneurons were lowest upon recruitment and increased progressively during a burst, as long as the EMG was still increasing. Firing rates peaked midway through each burst and tended to decline toward the end of the burst. The initial, mean, and peak firing rates of single motoneurons typically increased for faster walking speeds. At any given walking speed, early recruited motoneurons typically reached higher firing rates than late recruited motoneurons. In contrast to decerebrated cats, initial doublets at the beginning of bursts were seen only rarely. In the 4/51 motoneurons that showed initial doublets, both the instantaneous frequency of the doublet and the probability of starting a burst with a doublet decreased for faster walking speeds. The modulations in firing rate of every motoneuron were found to be closely correlated to the smoothed electromyogram of its target muscle. For 32 identified motoneurons, the unit's instantaneous frequencygram was scaled linearly by computer to the rectified smoothed EMG recorded from each of the anterior thigh muscles. The covariance between unitary frequencygram and muscle EMG was computed for each muscle. Typically, the EMG profile of the target muscle accounted for 0.88-0.96 of the variance in unitary firing rate. The EMG profiles of the other anterior thigh muscles, when tested in the same way, usually accounted only for a significantly smaller fraction of the variance. Brief amplitude fluctuations observed in the EMG envelopes were usually also reflected in the individual motoneuron frequencygrams. To further demonstrate the relationship between unitary frequencygrams and EMG, EMG envelopes recorded during walking were used as templates to generate depolarizing currents that were applied intracellularly to lumbar motoneurons in an acute spinal preparation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559692 TI - Cat hindlimb motoneurons during locomotion. III. Functional segregation in sartorius. AB - Cat sartorius has two distinct anatomical portions, anterior (SA-a) and medial (SA-m). SA-a acts to extend the knee and also to flex the hip. SA-m acts to flex both the knee and the hip. The objective of this study was to investigate how a "single motoneuron pool" is used to control at least three separate functions mediated by the two anatomical portions of one muscle. Discharge patterns of single motoneurons projecting to the sartorius muscle were recorded using floating microelectrodes implanted in the L5 ventral root of cats. The electromyographic activity generated by the anterior and medial portions of sartorius was recorded with chronically implanted electrodes. The muscle portion innervated by each motoneuron was determined by spike-triggered averaging of the EMGs during walking on a motorized treadmill. During normal locomotion, SA-a exhibited two bursts of EMG activity per step cycle, one during the stance phase and one during the late swing phase. In contrast, every recorded motoneuron projecting to SA-a discharged a single burst of action potentials per step cycle. Some SA-a motoneurons discharged only during the stance phase, whereas other motoneurons discharged only during the late swing phase. In all cases, the instantaneous frequencygram of the motoneuron was well fit by the rectified smoothed EMG envelope generated by SA-a during the appropriate phase of the step cycle. During normal locomotion, SA-m exhibited a single burst of EMG activity per step cycle, during the swing phase. The temporal characteristics of the EMG bursts recorded from SA-m differed from the swing-phase EMG bursts generated by SA-a.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559693 TI - Cat hindlimb motoneurons during locomotion. IV. Participation in cutaneous reflexes. AB - The responses of 11 individual motoneurons, the muscle to which each projected, plus all other muscles in the anterior thigh of the cat, were recorded following single non-noxious electrical stimuli to cutaneous nerves while the intact animal walked on a treadmill. The various excitatory and/or inhibitory responses were qualitatively similar for stimuli within the range 1.1-10 times threshold for group I fibers in the stimulated nerve (usually saphenous). Monarticular knee extensor muscles in the vastus group and their motoneurons were usually inhibited in the period 10- to 25-ms poststimulus. The faster contracting vastus medialis and lateralis muscles tended to have an excitatory rebound at approximately 25- to 40-ms poststimulus that was confined to the stance phase of the step cycle when these muscles were normally active. Biarticular hip flexor muscles rectus femoris and both the anterior and medial parts of sartorius and their motoneurons all had similar bimodal excitatory responses, including an early period 3- to 18 ms poststimulus and a later period 20- to 35-ms poststimulus. The short-latency excitatory responses appeared to be proportional to the normal recruitment of the muscles in the step cycle, whereas the long-latency responses tended to be phase advanced with respect to normal recruitment. Motoneurons projecting to muscles with two excitatory peaks tended to have similar excitatory responses at both latencies and occasionally responded at both latencies to a single stimulus. PMID- 3559694 TI - Spatial response properties of acoustically responsive neurons in the superior colliculus of the ferret: a map of auditory space. AB - Extracellular single-unit recordings were made from auditory neurons in the superior colliculus of ferrets anesthetized with either a neuroleptic or a combination of barbiturate with paralysis. The response properties of these neurons were studied using white-noise bursts presented under free-field conditions in an anechoic chamber. Auditory neurons were found throughout the intermediate and deep layers of the superior colliculus. All neurons were spontaneously active, the rates of discharge varying from 0.1 to 61.1 spikes X s 1. Although the spontaneous discharge interspike-interval histograms for many units approximated to exponential distributions, the histograms of 44% had clear secondary peaks, indicating more than one preferred interval, and could not be modeled by a simple process. Most neurons (50%) responded only at stimulus onset, whereas 12% exhibited sustained discharges and 38% gave onset responses followed by a period of silence or reduced activity and then a period of elevated discharge, which was not apparently related to stimulus offset. Neurons with multipeaked response patterns were concentrated in the stratum griseum profundum. The latencies from arrival of the stimulus at the ear to the onset of neural activity ranged from 6 to 49 ms and decreased with increasing stimulus intensity. Although responsive to sounds over a large region of space, most neurons had clearly defined best positions at which the strongest response was obtained. The response declined as the speaker was moved away from this position, and nearly all units had peaked response profiles. The spatial tuning varied between different neurons, but most were more sharply tuned in elevation than in azimuth. Increasing the stimulus intensity did not, in general, alter the best positions of these neurons, but usually resulted in a broadening of the receptive fields, although other units became more sharply tuned. The best positions of auditory neurons varied systematically in azimuth from 20 degrees into the ipsilateral hemifield to 130 degrees into the contralateral hemifield as the electrode was moved from the rostrolateral to the caudomedial end of the superior colliculus. The best positions shifted in elevation along a rostromedial to caudolateral axis from 60 degrees above to 50 degrees below the visuoaural plane.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559695 TI - The American Physiological Society in its centenary year. PMID- 3559697 TI - Binaural mechanisms of spatial tuning in the cat's superior colliculus distinguished using monaural occlusion. AB - This study explores the mechanisms of auditory spatial tuning in the superior colliculus of the anesthetized cat by correlating spatial tuning within specific regions of space with particular types of binaural interaction. The auditory spatial tuning of units was measured using a movable, broad-band stimulus presented in a free sound field. The contribution of each ear to the response of a unit was identified by acutely plugging one or the other ear. Every unit became largely or entirely unresponsive when a foam-rubber earplug was placed in the ear contralateral to the recording site. Thus, every unit exhibited an excitatory or facilitatory influence from the contralateral ear. A plug placed in the ipsilateral ear had different effects on different units. For half of the units (16/32), an ipsilateral earplug produced increases in the sizes of the units' receptive fields and increases in the magnitudes of their responses to stimuli presented from most locations. Thus, these units exhibited inhibition from the ipsilateral ear. Another class of units (9/32) exhibited ipsilateral facilitation, in that an ipsilateral earplug caused decreases in the sizes of the units' receptive fields and prominent decreases in their response magnitudes. For the remaining units (7/32), an ipsilateral earplug resulted in decreases in the sizes of the units' receptive fields, but produced both decreases in the responses of units to stimuli presented in their best areas and increases in the responses to stimuli presented away from the best areas. Thus these units exhibited mixed facilitatory and inhibitory ipsilateral influences. The influence of an ipsilateral earplug on a unit's response tended to correlate with its spatial tuning. The region of space within which a sound source was most effective in activating a unit was its "best area". The best areas of units exhibiting ipsilateral inhibition were located furthest peripherally, those of units showing ipsilateral facilitation were located furthest frontally, and the best areas of units showing mixed ipsilateral influences were located in an intermediate area. The frequency tuning of units measured using a free-field tone source also tended to correlate with the locations of their best areas. Half of the units tested (27/54) responded to tones of the sound pressure levels (SPLs) that were used (up to 50 dB SPL).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559696 TI - Changes in external ear position modify the spatial tuning of auditory units in the cat's superior colliculus. AB - This study examines the influence of external ear position on the auditory spatial tuning of single units in the superior colliculus of the anesthetized cat. Unit responses to broad-band stimuli presented in a free sound field were measured with the external ears in a forward symmetrical position or with one or the other ear turned 40 degrees to the side; the ears are referred to as contra- or ipsilateral with respect to the side of the recording site. Changes in the position of either ear modified the spatial tuning of units. The region of space from which a stimulus was most effective in activating a unit is referred to as the unit's "best area". Whenever the contralateral ear was turned to the side, best areas shifted peripherally and somewhat upward, roughly in proportion to the magnitude of the change in ear position. A turn of the ipsilateral ear to the side had more variable effects, but best areas generally shifted frontally. Best areas located between approximately 10 and 40 degrees contralateral when the ears were forward were least affected by changes in ipsilateral ear position. Changes in ear position also modified the maximum response rates of many units. Units with best areas located within approximately 20 degrees of the frontal midline when the ears were forward exhibited a pronounced decrease in responsiveness when either ear was turned. Units with more peripheral best areas tended to show no change or a slight increase in responsiveness. The influence of ear position on the directionality of the external ears was determined by mapping the cochlear microphonic response to tones or one-third-octave bands of noise before and after turning the ear. When the ears were forward, maximum interaural intensity differences (IIDs) were produced by high-frequency sound sources (greater than or equal to 20 kHz) located 20-40 degrees from the frontal midline and by lower frequency sources located further peripherally. The influence of ear position on the locations from which maximum IIDs were produced was similar to the influence of ear position on unit best areas. Changes in ipsilateral ear position had different effects on high- and low-frequency IIDs that were comparable with the effects of changes in ear position on frontally and peripherally located best areas, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559698 TI - Response properties of polymodal receptors studied using in vitro testis superior spermatic nerve preparations of dogs. AB - Characteristics of the polymodal receptor were studied using in vitro testis superior spermatic nerve preparations excised from anesthetized dogs. They were in most aspects similar to those reported previously using in vivo preparations. The majority (90%) of the tested polymodal units had small myelinated nerve fibers; the rest had nonmyelinated fibers. The mean mechanical threshold as determined by von Frey hairs was 17.5 g/mm2 (n = 476). There was a tendency for a unit with a higher conduction velocity to have a lower mechanical threshold. Bradykinin and hypertonic saline consistently caused a dose-dependent increase in discharge rate of these units; high K+ solution was also found to be a consistent stimulant. The responses of C-fiber receptors were not significantly different from those of A-delta-fibers. Heat stimulation up to 50 degrees C evoked discharges in 99 out of the total 103 units tested. The mean threshold temperature was 44.4 degrees C for the first trial. In 19 units in which the same heat stimulation was tested after an interval of 10 min, 10 units showed sensitization; 3 units were deactivated; and no clear difference was observed in the rest. No unit responded with a substantial increase in discharge rate to cold stimuli of 20 degrees C or less. A small temperature rise of 2 degrees C from the normal surface temperature of the testis (34 degrees C) significantly increased the response to hypertonic saline (616 mM) (2.41 +/- 0.22 impulses/s at 34 degrees C to 3.23 +/- 0.44 impulses/s at 36 degrees C) and to bradykinin (9 X 10( 8) M) (1.95 +/- 0.35 impulses/s at 34 degrees C to 2.85 +/- 0.19 impulses/s at 36 degrees C). The majority of the units recorded from the superior spermatic nerve in this experiment were most probably of polymodal receptor type, although the heat response was tested in a limited number of units. A very small number of a different type of receptor was discovered: rapidly adapting mechano-receptors, which responded almost exclusively to mechanical stimulation and were especially sensitive to a light mechanical stimulus moving across the receptive fields. The response properties of receptors studied in vitro remained practically unchanged during the experiments of several hours. The present experiments have shown that this preparation is suitable for systematic investigations, especially of the effects of chemical agents, on the polymodal receptor, which plays important roles in nociceptive functions. PMID- 3559699 TI - Activity-dependent changes in extracellular potassium and excitability in turtle olfactory nerve. AB - The excitability properties of turtle olfactory nerve (o.n.) were studied in vitro using potassium-sensitive microelectrodes (KSM), a modified sucrose gap chamber, and a standard nerve chamber to measure conduction velocity. A pronounced supernormal period (SNP), as indicated by increased conduction velocity of the o.n. fiber volley, lasting up to several seconds, was observed following a single stimulus. The compound action potential recorded in the sucrose gap chamber showed a prolonged depolarization with a similar time course to the SNP. When stimulation intensity was submaximal the response amplitude, and the extracellular potassium concentration [K+]o, continuously increased during repetitive stimulation. In contrast, when supramaximal stimuli were applied, the amplitude of the o.n. fiber volley was reduced during a high-frequency stimulus train for all responses after the initial one even though latency was maximally reduced, i.e., during supernormal conduction. Superfusion with various levels of K+ elicited changes in the excitability of the o.n. fibers. Small increases in [K+]o above the resting concentration of 2.6 mM led to an increase in resting excitability, whereas larger increases resulted in decreased excitability and conduction block. The SNP was eliminated when extracellular potassium was elevated between 3 and 4 mM above resting levels. Microstimulation of a small bundle of o.n. fibers led to an increase in [K+]o along the bundle but also around adjacent nonactivated fibers. The excitability of these neighboring nonactivated fibers was increased, further indicating the importance of activity dependent changes in [K+]o in modulating axonal excitability. These results demonstrate the importance of activity-dependent increases in extracellular potassium in modulating nonmyelinated o.n. fiber excitability. They also indicate that increases in [K+]o and an associated membrane depolarization contribute to the increased excitability observed during fiber recruitment and the supernormal period. PMID- 3559700 TI - Visual orientation and spatial frequency discrimination: a comparison of single neurons and behavior. AB - Neurons in the visual cortex respond selectively to stimulus orientation and spatial frequency. Changes in response amplitudes of these neurons could be the neurophysiological basis of orientation and spatial frequency discrimination. We have estimated the minimum differences in stimulus orientation and spatial frequency that can produce reliable changes in the responses of individual neurons in cat visual cortex. We compare these values with orientation and spatial frequency discrimination thresholds determined behaviorally. Slopes of the tuning functions and response variability determine the minimum orientation and spatial frequency differences that can elicit a reliable response change. These minimum values were obtained from single cells using receiver operating characteristic (ROC) analysis. The average minimum orientation and spatial frequency differences that could be signaled reliably by cells from our sample were 6.4 degrees (n = 22) and 21.3% (n = 18), respectively. These values are approximately 0.20 of the average full tuning width at one-half height of the cells. Although these average values are well above the behaviorally determined thresholds, the most selective cells signaled orientation and frequency differences of 1.84 degrees and 5.25%, respectively. These values are of the same order of magnitude as the behavioral thresholds. We show that, because of slow fluctuations in a cell's responsivity, ROC analysis overestimates response variability. We estimate that these slow response fluctuations elevated our estimates of single cell "thresholds" by, on average, 30%. Our data point to an approximate correspondence between orientation and spatial frequency discrimination "thresholds" determined behaviorally and those estimated from the most selective single cortical cells. Interpretation of this quantitative correspondence is considered in the discussion. PMID- 3559701 TI - The effects of contrast on visual orientation and spatial frequency discrimination: a comparison of single cells and behavior. AB - We have compared the effects of contrast on human psychophysical orientation and spatial frequency discrimination thresholds and on the responses of individual neurons in the cat's striate cortex. Contrast has similar effects on orientation and spatial frequency discrimination: as contrast is increased above detection threshold, orientation and spatial frequency discrimination performance improves but reaches maximum levels at quite low contrasts. Further increases in contrast produce no further improvements in discrimination. We measured the effects of contrast on response amplitude, orientation and spatial frequency selectivity, and response variance of neurons in the cat's striate cortex. Orientation and spatial frequency selectivity vary little with contrast. Also, the ratio of response variance to response mean is unaffected by contrast. Although, in many cells, response amplitude increases approximately linearly with log contrast over most of the visible range, some cells show complete or partial saturation of response amplitude at medium contrasts. Therefore, some cells show a clear increase in slope of the orientation and spatial frequency tuning functions with increasing contrast, whereas in others the slopes reach maximum values at medium contrasts. Using receiver operating characteristic analysis, we estimated the minimum orientation and spatial frequency differences that can be signaled reliably as a response change by an individual cell. This analysis shows that, on average, the discrimination of orientation or spatial frequency improves with contrast at low contrasts more than at higher contrasts. Using the optimal stimulus for each cell, we estimated the contrast threshold of 48 neurons. Most cells had contrast thresholds below 5%. Thresholds were only slightly higher for nonoptimal stimuli. Therefore, increasing the contrast of sinusoidal gratings above approximately 10% will not produce large increases in the number of responding cells. The observed effects of contrast on the response characteristics of nonsaturating cortical cells do not appear consistent with the psychophysical results. Cells that reach their maximum response at low-to-medium contrasts may account for the contrast independence of psychophysical orientation and spatial frequency discrimination thresholds at medium and high contrasts. PMID- 3559702 TI - Climbing fiber afferent modulation during treadmill locomotion in the cat. AB - The relationship of the climbing fiber afferent discharge to the unperturbed and perturbed step cycle was evaluated in the cat. Following a precollicular premamillary decerebration, cats walked spontaneously on a motorized treadmill. Purkinje cells were recorded extracellularly and simple and complex spikes were discriminated. Right forelimb displacement, biceps and triceps EMG activity, as well as treadmill velocity, were also monitored. In some animals pressure measurements of the contact of the footpad with the treadmill were obtained. Cells were studied during both "normal" and perturbed locomotion. The perturbation consisted of a braking of the treadmill at different phases in the step cycle. Histograms of the simple and complex spike activity, and averages of the right forelimb displacement, biceps, and triceps EMG activity and treadmill velocity were constructed. The complex spike activity of 163 Purkinje cells was averaged through a minimum of 50 sweeps in either normal and/or perturbed locomotion. Statistical analysis revealed that the probability of the climbing fiber afferent discharge in 54% of the cells (36/67) studied during normal locomotion was significantly modulated with the step cycle. For most Purkinje cells the onset of the increase in climbing fiber afferent discharge was coupled to triceps activity and the onset of stance phase. A group of cells exhibited complex spike discharge in association with biceps onset and swing. These observations suggest that complex spike discharge occurs preferentially at the phase transition periods in the step cycle when the trajectory of the forelimb changes from swing to stance or stance to swing. During treadmill braking 51% of the cells exhibited complex spike modulation (70/137). A number of different patterns of climbing fiber afferent modulation occurred. The most common pattern was an increase in complex spike discharge with the resumption of the treadmill movement and locomotion. Analysis of the time of these periods of increased climbing fiber activity suggests that, although in some cells the response is coupled to the treadmill onset, in other cells the modulation occurs at longer latencies. Subsequent analysis aligning the EMG, displacement, and treadmill velocity signals with the times of the climbing fiber afferent discharge suggested some responses were coupled to the reinitiation of the locomotor cycle. The second most common pattern was an increase in climbing fiber afferent discharge at the onset of the perturbation. Also, in some cells, complex spike discharge decreased during the period in which the step cycle was arrested.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559703 TI - Reorganization of the receptive fields of spinocervical tract neurons following denervation of a single digit in the cat. AB - The effect of acute and chronic section of the digital nerves of a single toe on the organization of low-threshold, mechanoreceptive fields of lumbosacral spinocervical tract (SCT) neurons has been studied in adult cats anesthetized with chloralose. The immediate effect of sectioning the digital nerves of a single toe is to produce a patch of dorsal horn in the medial region of the ipsilateral lumbosacral cord in which SCT neurons lack any peripheral receptive field when gentle hair movement or light touch of glabrous skin are used as stimuli. Other SCT neurons in the region may lose only part of their receptive fields. Between 30 and 70 days later most of the affected SCT neurons have established receptive fields. These are mainly on somatotopically inappropriate areas of skin medially and laterally adjacent to the denervated region. A small proportion of SCT neurons form discontinuous receptive fields. The relative somatotopic organization within the affected region remains unchanged. As there is no sign of regeneration of the sectioned nerves the new receptive fields must result from a central reorganization of excitatory inputs to SCT neurons. It is concluded that chronic peripheral nerve section affects the anatomical and physiological mechanisms underlying the formation of light touch receptive fields of dorsal horn neurons in the lumbosacral cord of the adult cat, but that the resulting reorganization of receptive fields is spatially restricted. PMID- 3559704 TI - Visual properties of neurons in area V4 of the macaque: sensitivity to stimulus form. AB - Area V4, a visuotopically organized area in prestriate cortex of the macaque, is the major source of visual input to the inferior temporal cortex, known to be crucial for object recognition. To examine the selectivity of cells in V4 for stimulus form, we quantitatively measured the responses of 322 cells to bars varying in length, width, orientation, and polarity of contrast, and sinusoidal gratings varying in spatial frequency, phase, orientation, and overall size. All of the cells recorded in V4 were located on the lower portion of the prelunate gyrus. Receptive fields were located almost exclusively within the representation of the central 5 degrees of the lower visual field, and receptive field size, in linear dimension, was 4-7 times greater than that in the corresponding representation of striate cortex (V1). Nearly all receptive fields consisted of overlapping dark and light zones, like "classic" complex fields in V1, but the relative strengths of the dark and light zones often differed. A few cells responded exclusively to light or dark stimuli. Many cells in V4 were selective for stimulus orientation, and a few were selective for direction of motion as well. Although the median orientation bandwidth of the orientation-selective cells (52 degrees) was wider than that reported for oriented cells in V1, approximately 8% of the oriented cells had bandwidths of less than 30 degrees, which is nearly as narrow as the most narrowly tuned cells in V1. The proportion of cells selective for direction of motion (13%) was not markedly different from that reported in V1. The large majority of V4 cells were tuned to the length and width of bars, and the "shape" of the optimal bar varied from cell to cell, as has been reported for cells in the dorsolateral visual area (DL) of the owl monkey, a possible homologue of V4 in the macaque. Preferred lengths and widths varied independently from approximately 0.05 to 6 degrees, with the smallest preferred bars about the size of the smallest receptive fields in V1 and the largest preferred bars larger than any fields in V1. The relationship between the size of the optimal bar and the size of the receptive field varied from cell to cell. Some cells, for example, responded best to bars much narrower or shorter than the field, whereas other cells responded best to bars that filled (but did not extend beyond) the excitatory field in the length, width, or both dimensions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559705 TI - Spinal cholinergic neurons and the expression of morphine withdrawal symptoms in the rat. AB - Behavioral and autonomic signs of the morphine withdrawal syndrome were measured in dependent rats injected with the opiate antagonist naloxone. The purpose of this study was to determine whether spinal cholinergic pathways play a role in the expression of spinally mediated withdrawal symptoms. Intrathecal (i.t.) administration of 1 microgram carbachol or 5 micrograms neostigmine resulted in increases in mean arterial pressure (MAP) of 32 and 45 mm Hg, respectively, in conscious, freely moving rats. The pressor response to carbachol began almost immediately after injection, but that to neostigmine was delayed in onset. Both responses were completely abolished following i.v. injection of 2 mg/kg atropine. However, in spinal-transected (C-1), ventilated rats, i.t. injection of carbachol or neostigmine resulted in only small, transient increases in MAP. Intraarterial (i.a.) injection of 0.5 mg/kg naloxone to morphine-dependent rats resulted in an immediate increase in MAP (to 33 mm Hg) that lasted at least 1 hr. This was accompanied by classical behavioral signs of withdrawal. Pretreatment of dependent rats with i.t. injection of atropine or hemicholinium-3 (HC-3) significantly reduced the pressor and several behavioral responses elicited by naloxone. In contrast, when morphine-dependent, spinal-transected rats were pretreated with i.t. injection of cholinergic antagonists, i.a. injection of naloxone resulted in an enhanced MAP response. Finally, in intact dependent rats, i.t. injection of naloxone (6 micrograms) produced a 14 mm Hg increase in MAP that was significantly augmented (21 mm Hg) following i.t. pretreatment with HC 3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559706 TI - Comparison of electrical responses of terminals, axons, and somata of a peptidergic neurosecretory system. AB - Spontaneous and evoked electrical activity was recorded intracellularly from somata, axons, and terminal dilatations of an isolated peptidergic neurosecretory system, the X-organ-sinus gland, of the crabs Cardisoma carnifex and Podophthalmus vigil in order to compare their electrical characteristics. Spontaneous impulse activity was present in most penetrations and included irregular and pacemaker-like firing, as well as patterned activity (bursting). Extracellular recording showed that spontaneous impulses and bursting originate in a proximal region of the axon tract. Somata vary from being electrically nonresponsive to having overshooting impulses with a relatively slow rate of rise. Overshooting impulses were consistently recorded from axons and terminals. Regional differences include (1) a longer action potential duration in terminals, (2) ability of axons and terminals but not somata to sustain repetitive firing, (3) presence of depolarizing afterpotentials in axons but of hyperpolarizing afterpotentials in somata and terminals, and (4) occurrence of impulse broadening during repetitive firing in some terminals but not in axons or somata. Somata and terminals sustained reduced and slowed, but regenerative impulses in nominally Na free saline and showed alterations of waveform in nominally Ca-free salines, while axons showed no regenerative responses in Na-free saline and no change of impulse form in Ca-free saline. Terminal responses in the presence of tetraethylammonium chloride (TEA) (50 mM) or Ba (50 mM) exhibited long depolarized plateaus, while impulses of somata were much less prolonged. Bursts often took the form of impulses superimposed on a depolarized plateau. Bursts could be evoked by single stimuli applied to the axon tract but not by current passed intracellularly. After addition of TTX, axon tract stimulation evoked plateaus without superimposed impulses. Terminals exhibit specialization of their electrical responses by comparison to axons and somata in having long-duration action potentials attributable to participation of Ca, capability of sustained firing, impulse broadening, and channels supporting sustained inward currents, all of which might enhance the admission of Ca for initiation of peptide secretion. PMID- 3559707 TI - Schwann cell proliferation and migration during paranodal demyelination. AB - This study examined Schwann cell behavior during paranodal demyelination induced by beta,beta'-iminodipropionitrile (IDPN). The stimuli for Schwann cell proliferation, extensively studied in vitro, are less well understood in vivo. Most in vivo systems previously used to examine Schwann cell proliferation in disease are dominated by loss of internodal myelin sheaths. As used in this study, IDPN administration produces neurofilamentous axonal swellings and paranodal demyelination, without segmental demyelination or fiber degeneration. We asked whether Schwann cells would proliferate following the restricted paranodal demyelination that accompanies the axonal swellings, and if so what the sources and distributions of new Schwann cells might be. IDPN was given as a single large dose (2 ml/kg) to 21-d-old rats. Neurofilamentous axonal swellings formed in the proximal regions of motor axons, reaching their greatest enlargement in the root exit zone 8 d after IDPN administration. These swellings subsequently migrated distally down the nerves at rates approaching 1 mm/d. The axonal enlargement was consistently associated with displacement of the myelin sheath attachment sites into internodal regions, and consequent paranodal demyelination. This stage was associated with perikaryal changes, including nucleolar enlargement, "girdling" of the perikaryon, and formation of attenuated stalks separating the perinuclear region from the external cytoplasmic collar. Schwann cells proliferated abundantly during this stage. Daughter Schwann cells migrated within the endoneurial space (outside the nerve fiber basal laminae) to overlie the demyelinated paranodes of swollen nerve fibers. In these regions, local proliferation of Schwann cells continued, resulting in large paranodal clusters of Schwann cells. As the axonal calibers subsequently returned to normal, the outermost myelin lamellae of the original internodes returned to their paranodal attachment sites and the supernumerary Schwann cells disappeared. Formation of short internodes, segmental demyelination, and nerve fiber loss were rare phenomena. These results indicate that paranodal demyelination is a sufficient stimulus to excite abundant Schwann cell proliferation; neither internodal demyelination nor myelin breakdown is a necessary stimulus for mitosis. The 3H-thymidine incorporation studies indicated that the sources of new Schwann cells included markedly increased division of the Schwann cells of unmyelinated fibers and, as they formed, supernumerary Schwann cells. In addition, there were rare examples of 3H-thymidine incorporation by Schwann cells associated with myelinated nerve fibers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559708 TI - The nerve growth factor-inducible large external (NILE) glycoprotein and neural cell adhesion molecule (N-CAM) have distinct patterns of expression in the developing rat central nervous system. AB - The nerve growth factor-inducible large external (NILE) glycoprotein and the neural cell adhesion molecule (N-CAM) have both been implicated in the process of nerve fiber fasciculation. To evaluate the respective roles of the 2 molecules in fiber tract formation, we used immunohistochemical means to compare their distributions in the developing rat central nervous system. In the spinal cord, hindbrain, forebrain, retina, and cerebellum, N-CAM was present on undifferentiated cells in germinal zones as well as on differentiating cells and in nerve fiber tracts. In contrast, NILE was restricted to the developing fiber tracts in all these areas. No fiber tracts were found that were obviously lacking one or the other of the 2 molecules during the period of tract development. However, in all cases except that of the cerebellar molecular layer, nerve fiber tracts appeared to lose NILE and retain N-CAM after the major phases of tract development were completed. The fact that NILE is restricted to nerve fiber tracts during relatively short but crucial phases of tract development suggests that NILE plays a very specific role in the formation of fiber bundles. The more ubiquitous N-CAM molecule may have a more general role in neural histogenesis. PMID- 3559709 TI - Cue-sampling and goal-approach correlates of hippocampal unit activity in rats performing an odor-discrimination task. AB - Several techniques previously used to describe behavioral correlates of hippocampal unit and slow-wave activity are combined in a single odor discrimination paradigm. Rats repetitively performed a sequence of behaviors during each trial: approach to a stimulus-sampling port, investigatory sniffing of the odor cue, orientation and approach toward a separate reward location, and water reward consumption. In a series of post hoc analyses, spike activity was time-locked to variations of each task event to uncover behavioral and physiological parameters that best synchronized unit firing. Three major categories of cells were identified: (1) "Cue-sampling" cells fired after onset of odor-cue sampling. Response magnitude was related to cue valence on both the current and past trials. (2) "Goal-approach" cells fired prior to arrival at either the odor-sampling port or reward cup. A number of sampling and approach cells also had place correlates. However, detailed analyses indicated that specific behaviors associated with increased firing reliably occurred at the same place. Unit activity was at least as well described by behavioral as spatial parameters. (3) "Theta" cells fired at high rates in strict relation to the ongoing limbic theta rhythm. This categorization suggests a functional organization of the hippocampus in which different cell types play complementary roles. Cue-sampling cells activated by discriminative stimuli during attentive fixations may be involved in comparing relative cue valence. Goal-approach cells may be involved in orientation movements for successive cue-sampling periods. Theta cells may provide synchronization of sensory acquisition during sampling, as well as in orientation movements during approach. PMID- 3559710 TI - Voltage clamp analysis of cholinergic action in the hippocampus. AB - A slow muscarinic EPSP, accompanied by an increase in membrane input resistance, can be elicited in hippocampal CA1 pyramidal cells in vitro by electrical stimulation of cholinergic afferents in the slice preparation. Associated with the slow EPSP is a blockade of calcium-activated potassium afterhyperpolarizations (AHPs) (Cole and Nicoll, 1984a). In this study a single electrode voltage clamp was used to examine the currents affected by activation of muscarinic receptors, using either bath application of carbachol or electrical stimulation of the cholinergic afferents. The 3 main findings of this study are that (1) of the 2 calcium-activated potassium currents (termed IAHP and IC) in hippocampal pyramidal cells, only IAHP is sensitive to carbachol; (2) IAHP is approximately 10-fold more sensitive to carbachol than is another muscarine sensitive current, IM; and (3) neither blockade of IAHP nor of IM can account for the production of the slow EPSP. Rather, the slow EPSP appears to be generated by the blockade of a nonvoltage-dependent, resting potassium current. We propose that the muscarinic blockade of IAHP, which largely accounts for spike frequency adaptation, is primarily involved in enhancing action potential discharge to depolarizing stimuli, while the slow EPSP acts directly to cause action potential discharge. PMID- 3559712 TI - Circling behavior following unilateral microinjections of cocaine into the medial prefrontal cortex: dopaminergic or local anesthetic effect? AB - Dopaminergic projections to the medial prefrontal cortex have been implicated in cocaine reinforcement; therefore, it was of interest to examine the locomotor effects of acute administration of cocaine to this area. Circling behavior was assessed following injections of 1.0 microliter of cocaine in doses of 0 (0.9% saline), 25, 50, and 100 micrograms/microliters into the medial prefrontal cortex of rats prepared with chronic unilateral guide cannulae. Animals were scored during four 5 min intervals of a 60 min test session that began with the central injection and placement in a flat circular arena. Cocaine was found to produce dose-dependent contraversive circling, an effect previously seen with the dopamine (DA) agonists LY 14 1865 and (+)-amphetamine, suggesting a unilateral stimulant effect. However, since cocaine has potent local anesthetic properties that have been reported to produce behavioral effects and also to inhibit the reuptake of norepinephrine and 5-HT, it was important to demonstrate that the directional bias was a dopaminergic effect. Intra-frontocortical microinjections of the local anesthetic procaine (10, 100, and 1000 micrograms in 0.5 microliter) did not induce circling. Sulpiride (0.001-10.0 micrograms in 0.5 microliter), a DA antagonist specific for the D-2 receptors, produced ipsiversive circling in a dose-dependent manner in rats treated with (+)-amphetamine (1.5 mg/kg, i.p.). In addition, sulpiride (1.0 micrograms in 0.5 microliter) blocked the circling behavior induced by cocaine (50 micrograms in 0.5 microliter) when administered into the medial prefrontal cortex 15 min prior to the cocaine injection. These results provide further evidence for an excitatory influence of mesocortical DA on motor control. PMID- 3559711 TI - Enkephalin biosynthesis and enkephalin gene expression are increased in hippocampal mossy fibers following a unilateral lesion of the hilus. AB - The biosynthesis and posttranslational processing of proenkephalin and the level of preproenkephalin mRNA were investigated in the mossy fiber system of the granule cells of the hippocampus in the presence or absence of a unilateral lesion of the hilus, a procedure that produces an episode of recurrent bilateral hippocampal seizures lasting several hours. Both immunocytochemistry and radioimmunoassay (RIA) have demonstrated that the hilus lesion leads to large bilateral increases in enkephalin immunoreactivity in the mossy fiber system. In the present study, RIA data indicate that following an initial decline in immunoreactivity, enkephalin content within the mossy fibers first begins to increase between 18 and 24 hr after lesioning. Using the technique of in vivo radiolabeling and high-performance liquid chromatographic purification of identified radiolabeled peptides, we observed a 14-fold increase in incorporation of radiolabeled methionine into Met5-enkephalin at 24-30 hr postlesion, as compared with control animals, when Met5-enkephalin was purified from the mossy fiber terminal fields. To examine the posttranslational proteolytic processing of proenkephalin, the biosynthesis of 5 additional Met5-enkephalin-containing peptides was also examined. We determined that the posttranslational processing of proenkephalin did not yield exclusively penta-, hepta-, and octapeptides but larger opioid peptides as well in both control and lesioned animals, and that the ratio of the enkephalin peptides was not altered following the lesion. Measurement of preproenkephalin messenger RNA levels in the granule cells by Northern analysis revealed a marked increase following the lesion. Compared with the control animals, preproenkephalin mRNA was 8.5-fold higher in the contralateral dentate gyrus at 12 hr postlesion and 14- to 15-fold higher by 24 hr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559713 TI - Changes in spatial scale in drawing and handwriting: kinematic contributions by proximal and distal joints. AB - The coordination of arm and hand motions was studied in tasks involving drawing and handwriting movements of different amplitudes. To this end, pen motion was recorded by means of a digitizing table, while the positions of different markers on the limb were monitored by the ELITE system. It was found that the amplitude of shoulder and elbow angular motions scales roughly with the size of the figure drawn or of the script, whereas the amplitude of wrist and finger motions is small, independent of size. Consequently, the larger the limb movement, the smaller the magnitude of the contributions by motions at distal joints relative to that at proximal joints. Furthermore, while shoulder and elbow motions are tightly coupled (constant phase relation), motions at distal joints are loosely coupled to those at the proximal joints (variable phase relation). On the other hand, motion at distal joints increases the accuracy of the movement, as indicated by the smaller variability of pen trajectories compared to that of wrist trajectories. PMID- 3559714 TI - Numerical matching during cerebellar development: quantitative analysis of granule cell death in staggerer mouse chimeras. AB - Cell death is a common yet puzzling feature of the development of many populations of neurons in the CNS. In the invertebrate phyla, such death is often preprogrammed; by contrast, in vertebrates, the best studied examples of histogenetic cell death are influenced by interactions among the neurons and their target. One attempt to explain this seemingly wasteful scheme of development has led to the hypothesis that this target-related cell death allows 2 populations of cells, which develop in isolation, to come into numerical and functional balance and hence to provide an epigenetic "buffer" mechanism to accommodate developmental variations. In the current study we have examined the extent to which the cell death observed in the cerebellar granule cell population serves to numerically match these neurons with their primary postsynaptic target, the Purkinje cell. Staggerer chimeras were made by aggregating 8-cell staggerer embryos with embryos of wild-type genotype. The cerebella of the resulting animals developed with widely varying numbers of normal (wild-type) Purkinje cell targets. Although staggerer Purkinje cells were present in the chimeric brains, these cells are intrinsically deficient in their normal developmental program (in the mutant, because of this deficiency, 100% of the granule cells die). Both granule cells and Purkinje cells were counted in chimeras and several wild-type mice. The results reveal that the number of granule cells present in these brains has a linear relationship with the number of Purkinje cells, and that the line connecting the points intersects the Y-axis close to the origin. These observations suggest that numerical matching is an important function of target related cell death in the granule cell population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559715 TI - Development and regulation of dendrites in the rat superior cervical ganglion. AB - Intracellular injection of HRP was used to study the postnatal development of dendrites in the rat superior cervical ganglion (SCG). This study had 2 goals: to describe the growth of dendrites during normal development and to determine the influence of preganglionic innervation on dendritic growth. At birth, ganglion cell morphology is relatively simple; cells have few dendritic branches and an average total dendritic length under 300 micron. In the first postnatal month there is a 4-fold increase in dendritic length and a marked increase in the complexity of branching. Dendrites continue to grow into adulthood; at each age studied (up to 16 months old), the dendritic geometries of SCG cells became progressively more extensive and complex. The influence of innervation on the development of dendrites was assessed by cutting the cervical sympathetic trunk (CST) within a day of birth; reinnervation was prevented by ligating and displacing the proximal end of the CST. During the first postnatal month, the cells in denervated ganglia showed an increase in dendritic length indistinguishable from that seen in unoperated control ganglia. The rate of growth after 1 month was somewhat slower in experimental animals than in controls; nevertheless, the dendrites of cells in denervated ganglia showed progressively larger arbors at each time point measured. These results indicate that in the SCG the majority of dendritic growth occurs postnatally, dendrites continue to grow in adult rats, and dendritic growth is largely independent of the presence of preganglionic innervation. The significance of these findings for the regulation of innervation in this part of the nervous system is discussed. PMID- 3559716 TI - Aneurysms of the basilar artery trunk. AB - Ten cases of basilar artery trunk aneurysms are reported; nine were operated on by a middle subtemporal approach and one by a pterional transsylvian technique. The middle subtemporal approach facilitated clipping of aneurysms located as deep as 25 mm below the posterior clinoid process as seen on the lateral views of the angiogram, such that the junction of the vertebral arteries was visible in most cases. The authors emphasize the usefulness of direct retraction of the trigeminal nerve, the pons, and the aneurysm itself; occasionally, drilling off the pyrimidal edge is also valuable. Surgical results were satisfactory in seven cases and poor in one; two patients died. PMID- 3559717 TI - Management of simple depressed skull fractures in children. AB - Surgical elevation is the treatment usually recommended for a simple depressed skull fracture if the depression is more than the full thickness of the adjacent skull, but there is no clinical evidence to support this management. On that basis, a progressively more conservative approach to the treatment of this condition was adopted, especially in young children. Experience with this mode of management over the period 1972 to 1984 is presented. Of 111 patients under 16 years of age with depressed skull fractures, 64 had simple and 47 compound fractures. Simple depressed skull fractures occurred in a younger age group after less significant trauma than compound fractures. In those patients who were treated surgically, there was an 11% incidence of dural laceration in patients with simple depressed fractures versus 67% for the patients with compound depressed fractures. There was no difference in outcome between surgically and nonsurgically treated patients with simple depressed fractures with respect to the occurrence of seizures, neurological dysfunction, or cosmetic appearance. Surgical treatment prolonged hospitalization, and the only case with a fatal outcome was found in the group of patients treated surgically. It is suggested that the standard treatment of simple depressed skull fractures in the pediatric age group should not include surgery. Surgery is indicated when there is definite evidence of dural penetration and in the older child with an unacceptable cosmetic appearance. PMID- 3559718 TI - Familial intracranial aneurysms. AB - The authors report seven individuals from two families, all of whom had aneurysmal subarachnoid hemorrhage. These cases and all reported cases of familial aneurysms (243 aneurysms in 177 patients from 74 families) were submitted to computer-aided multivariate analysis to determine if the aneurysms or the patients who harbor them differ from sporadic aneurysm cases. Familial aneurysms rupture at a smaller size (mean diameter 10.5 mm), and when the patient is younger (mean age 42.3 years and decennial age at peak incidence 40 to 49 years). There is a similar sex distribution (male to female ratio 48:52), a similar incidence of multiple aneurysms (21.5%), and a similar predominance of females over males with multiple aneurysms (2.2:1). Anterior communicating artery aneurysms occur less often in familial cases (19%) than in sporadic cases. In sibling pairs the aneurysms occur at the same or at mirror sites, and rupture within the same decade twice as frequently as randomly selected nonfamilial aneurysm patient pairs. The occurrence of aneurysms at identical and mirror sites is more frequent in familial cases and appears to be a function of the degree of kinship between affected individuals. These observations suggest a genetic basis for the pathogenesis of familial intracranial aneurysms. PMID- 3559719 TI - The impact-absorbing effects of facial fractures in closed-head injuries. An analysis of 210 patients. AB - A series of 210 patients with facial fractures sufficiently severe to require cranial computerized tomography (CT) to evaluate suspected closed-head injury (CHI) was studied. The injuries were separated into five grades of severity based on neurological examination, including cranial CT. The injuries were also grouped into three categories based on facial regional involvement, using chi-square contingency table analysis. The data demonstrated that patients with upper facial fractures were at greatest risk for serious CHI. Injuries to both the mandibular and the midfacial regions with no upper facial involvement more frequently resulted in mild CHI with a modest likelihood of no neurological deficits. Trauma to only the mandibular region or to only the midfacial region was least likely to involve CHI. PMID- 3559720 TI - Effect of stimulation of the medullary reticular formation on cerebral vasomotor tonus and intracranial pressure. AB - The authors report the results of a study to evaluate the effect of stimulation of the medullary reticular formation on cerebral vasomotor tonus and intracranial pressure (ICP) after the hypothalamic dorsomedial nucleus and midbrain reticular formation were destroyed. Systemic arterial pressure (BP), ICP, and local cerebral blood volume (CBV) were continuously recorded in 32 cats. To assess the changes in the cerebral vasomotor tonus, the vasomotor index defined by the increase in ICP per unit change in BP was calculated. In 29 of the 32 animals, BP, ICP, and CBV increased simultaneously immediately after stimulation. The increase in ICP was not secondary to the increase in BP, because the vasomotor index during stimulation was significantly higher than the vasomotor index after administration of angiotensin II. The vasomotor index was high during stimulation of the area around the nucleus reticularis parvocellularis. In animals with the spinal cord transected at the C-2 vertebral level, ICP increased without a change in BP. These findings indicate that the areas stimulated in the medullary reticular formation play an important role in decreasing cerebral vasomotor tonus. This effect was not influenced by bilateral superior cervical ganglionectomy, indicating that there is an intrinsic neural pathway that regulates cerebral vasomotor tonus directly. In three animals, marked biphasic or progressive increases in ICP up to 100 mm Hg were evoked by stimulation. The reduction of cerebral vasomotor tonus and concomitant vasopressor response induced by stimulation of the medullary reticular formation may be one of the causes of acute brain swelling. PMID- 3559721 TI - Effects of experimental intracerebral hemorrhage on blood flow, capillary permeability, and histochemistry. AB - Experimental intracerebral hemorrhage has been shown to cause extensive cerebral ischemia. This study was performed to ascertain the time course of these changes and also to examine the type of brain damage that may occur under such circumstances. Halothane anesthesia was induced in rats, and 25 microliter autologous blood was injected into the caudate nucleus; the effects were studied with autoradiographic measurement of local cerebral blood flow and capillary permeability, and also by light microscopy and histochemical techniques. Blood flow returned to normal or to slightly increased levels within the first 3 hours, and ischemic levels of flow were found to persist only to a marginal degree beyond 10 minutes after the lesions were made. Capillary permeability was maximum during the first 30 minutes after the hemorrhage and diminished with time. Structural evidence of ischemic damage was localized to the cortex overlying the hemorrhage, but was not seen in the caudate nucleus. Nevertheless, histochemical investigation did reveal an area of disturbed enzyme function in the striatum. This finding of biochemical disturbance without structural evidence of ischemic damage reveals that there is an area around the hematoma that, although demonstrating disturbed function, does not show structural damage, and the milieu of this partially injured brain may be implicated in the delayed development of the ischemic brain damage that follows intracerebral hemorrhage in man. PMID- 3559722 TI - Cerebral arteriovenous malformations, steal, and the hypertensive breakthrough threshold. An experimental study in rats. AB - An experiment was designed to investigate the effects of arteriovenous (AV) fistula occlusion on cerebral autoregulation. A right carotid-jugular fistula was created in 63 rats in such a way as to produce an intracranial AV fistula with a loop extension into the neck. The fistula was occluded after an 8-week interval with the rats under both normotension and metaraminol-induced hypertension, and evidence of blood-brain barrier disruption was investigated with an Evans blue dye technique. The results indicate that an intracranial AV fistula may cause cerebral steal which is responsible for a reduction in the threshold for hypertensive breakthrough following fistula occlusion. PMID- 3559723 TI - Experimental intracerebral hemorrhage: effects of a temporary mass lesion. AB - Late pathophysiological events after the production and subsequent removal of an intracerebral mass were investigated using a mechanical microballoon model to simulate intracerebral hemorrhage. Immediately following balloon inflation in the caudate nucleus of rats, there was a significant increase in intracranial pressure to 14 +/- 1 mm Hg (mean +/- standard error of the mean), accompanied by a reduction in cerebral blood flow (CBF) in the ipsilateral frontal cortex, as measured by the hydrogen-clearance technique. Carbon-14-iodoantipyrine autoradiography revealed a significant reduction in the CBF of the ipsilateral caudate nucleus 4 hours after balloon inflation: 31% of the caudate nucleus had a CBF of less than 20 ml X 100 gm-1 X min-1 compared to only 1% in the sham-treated control group (balloon insertion without inflation). The rats with an intracerebral mass exhibited a significant increase in the volume of ischemic damage in the ipsilateral caudate nucleus (17.1% of total volume) compared to only 1.7% in the sham-treated group; however, there was no evidence of cerebral edema. Ischemic damage and reduced CBF persisted for 4 hours after transient inflation of a microballoon in the caudate nucleus. This suggests that ischemic damage occurs at the time of formation of the lesion and is not prevented by its early removal. PMID- 3559724 TI - Influence of the rate of ventricular enlargement on the white matter water content in progressive feline hydrocephalus. AB - The effectiveness of transependymal absorption of cerebrospinal fluid in hydrocephalus was studied by correlating the measured water content of feline hydrocephalic white matter with the rate of enlargement of the ventricles. Two groups of cats were subjected to opening of either the calvaria or the calvaria and dura before the intracisternal injection of kaolin to obtain two profiles of ventricular enlargement. The water content 1, 2, and 3 mm from the lateral ventricles was measured in each group using the dry/wet weight and microgravimetric techniques after sacrificing the animals in each group at 2, 3, or 6 weeks after inducing hydrocephalus. In the animals with both calvarial and dural opening, the ventricles enlarged rapidly in the first 2 to 3 weeks and then continued to increase but at a slower rate. Concomitant with this early increase of ventricular size was a progressive increase in white matter water content both adjacent to and remote from the ventricles, which continued through 6 weeks. When only the calvaria was opened, ventricular size increased gradually, but continued to increase at a constant rate throughout the 6 weeks. Water content adjacent to the ventricle did not increase until the 3rd week, with little spread to adjacent areas by the 6th week. The central canals of the spinal cord were enlarged in both groups at all sampling levels. Neither increased periventricular water nor dilatation of the central canal was associated with stabilization of ventricular size in these studies. The authors conclude that these pathways are not sufficient to arrest the hydrocephalic process in these models. PMID- 3559726 TI - DNA in meningioma tissues and explant cell cultures. A flow cytometric study with clinicopathological correlates. AB - Flow cytometry was performed on stored frozen tissues and explant cell cultures from 39 meningiomas using ethidium bromide and mithramycin in a selective staining technique for deoxyribonucleic acid (DNA). The ploidy index and percentage of cells in the G0/G1, S, and G2/M phases were calculated for each specimen. The results were compared with the age and sex of the patients; the site, the histological subtype, and mitotic rate of the neoplasms; and the estrogen- and progesterone-receptor levels assayed in cytosol-enriched supernatants from cryostat-cut sections. Sixteen neoplasms (41%) were aneuploid. These included two recurrent neoplasms, seven of the eight neoplasms from patients with multiple meningiomas, and three clinically aggressive neoplasms (one hemangiopericytic and two anaplastic meningiomas). Significant correlations were found between values for the ploidy index (r = 0.75, p less than 0.01), the percentage of S-phase cells (r = 0.82, p less than 0.01), and the percentage of G2/M-phase cells (r = 0.69, p less than 0.05) in vivo and in vitro. The results support the suggestion that flow cytometry for DNA in meningiomas may be of value in predicting the behavior of these neoplasms, and indicate that under controlled conditions explant cell cultures may provide a useful model for the proliferative characteristics of meningiomas in vivo. PMID- 3559725 TI - Effect of the antiprogesterone RU-38486 on meningioma implanted into nude mice. AB - Meningiomas have been shown to have steroid-binding proteins. In vitro, estradiol, progesterone, and the antiestrogen tamoxifen stimulate tumor growth. However, incubation of tumor cells with an antiprogesterone agent results in tumor inhibition. In this investigation, a human meningioma was implanted subcutaneously in athymic nude mice. Two treatment groups were established, one receiving the antiprogesterone agent RU-38486 (10 mg/kg/day in suspension) and the other receiving only vehicle. After 3 months, the tumor growth index (defined as the tumor volume at 3 months divided by the initial tumor volume) was 0.25 +/- 0.46 (mean +/- standard deviation) in the group receiving antiprogesterone and was 1.54 +/- 0.58 in the control group (p = 0.041). Further investigation of the effect of antiprogestational agents on the growth and hormone-binding proteins of other meningiomas will better define the mechanism of their effects. PMID- 3559727 TI - Cerebral endometriosis. Case report. AB - A 20-year-old woman presented with a 3-year history of intermittent focal headaches and a generalized seizure. Computerized tomography demonstrated a hypodense ring-enhancing cystic right parietal lobe lesion. At operation, a chocolate-colored cyst was excised which on histological examination proved to be endometriosis. PMID- 3559728 TI - Syringomyelia as a complication of Paget's disease. Case report. AB - Cranial settling and basilar invagination with medullospinal compression is believed to have resulted in the production of a syrinx in a case of Paget's disease of the cranium. This mechanism of compression at the craniovertebral junction resembles the development of syringomyelia in Chiari malformations presenting in adult life. PMID- 3559729 TI - Acute herniated nucleus pulposus with cauda equina compression syndrome following chemonucleolysis. Report of three cases. AB - Three cases of acute disc herniation causing cauda equina compression syndrome after chemonucleolysis are described. All three patients had myelographic blocks and, despite emergency decompression procedures, were left with residual neurological deficits. Recommendations are made regarding evaluation and therapeutic intervention, and possible etiologies of this problem are reviewed. PMID- 3559730 TI - Squamous cell carcinoma as a late complication of intracerebroventricular epidermoid cyst. Case report. AB - Primary intracerebral squamous cell carcinoma is a rare sequela of benign cerebral epidermoid cysts. A case of presumed malignant transformation in a lateral ventricular epidermoid cyst is described, in which squamous cell carcinoma arose 33 years after the surgical resection of a benign epidermoid cyst. Three years after diagnosis of malignancy, the patient remains functional with a slowly invasive tumor. This case provides a rare description of the natural history of forebrain squamous cell carcinoma, which would appear to be a more indolent tumor than previously realized. PMID- 3559731 TI - Experimental model for producing cerebral aneurysms. PMID- 3559732 TI - Spasmodic torticollis resulting from neurovascular compression. PMID- 3559733 TI - AVM grading in assessing surgical risk. PMID- 3559734 TI - Phenol injection into cisterna magna for relief of advanced intractable cancer pain in the faciocephalic area. AB - Between 1973 and 1980 a solution of phenol in glycerin into the cisterna magna was injected in 38 patients suffering from advanced intractable pain due to neoplasm of faciocephalic area. Owing to the poor neurological and general condition of our patients, surgical procedures were discarded. Patient's age ranged from 36 to 76 years and pain diffusion involved many cranial and cervical nerves. Follow-up studies after phenol injections were carried out in 22 patients: mean survival time proved to be 137 days. In 76% of cases, before neurolytic treatment, narcotics had been administered. In this series pain relief seemed to be poor in 50%, good in 34% while it was unclassifiable in the remaining 16% of the cases due to an incomplete follow-up. These last patients were likely to show favorable results. Complications arising immediately after phenol injections are described. Long lasting disabling neurological deficits were recorded in 18% of cases. Less severe complications were shown in 71% of the patients. The most frequent ones were impairment of sensory functions of the trigeminal area and reversible paresis of the 7th cranial nerve. Despite the poor general conditions, no fatal outcome was seen in our patients. No significant relationship between pain relief and sensory deficit was found. The pathophysiological mechanisms of pain suppression, induced by phenol injection in the faciocephalic area are discussed. The value of this simple technique is briefly assessed in comparison to other analgesic procedures. PMID- 3559735 TI - Epidural pressure measurement in the rat. AB - An original device for the epidural pressure measurement in the rat is presented. The reliability of epidural pressure as an index of intracranial pressure is discussed and several possible causes of error are examined. The device has been tested under conditions both of transient and prolonged cerebral blood volume increase, obtained by venous outflow obstruction. PMID- 3559736 TI - Alterations of coagulation and fibrinolysis in cerebrospinal fluid in subarachnoid haemorrhage. AB - The authors analyze the mechanism of CSF in fibrinolytic activity in the cause of subarachnoid haemorrhage. The intrathecal administration of antifibrinolytic agents is proposed to avoid ischaemic cerebrovascular complication of systemic therapy. PMID- 3559737 TI - Paramedian hourglass epidermoid cysts extending in the middle and posterior cranial fossa. AB - Four cases of large paramedian hourglass epidermoid tumors extending both in the middle and posterior cranial fossa are reported and other 16 cases from the literature are reviewed. The length of the clinical history and the triviality of neurological symptoms in spite of the size of the tumor are emphasized. CT scanning well documents the extension of these epidermoids and usually consents to differentiate them from the arachnoid cysts. The subtemporal transtentorial approach is more advisable, although a two-stage operation by subtemporal and suboccipital route can be necessary in some cases. Nevertheless the difficulties and the risk of the surgical treatment make very hard the complete removal of the tumor in most cases. PMID- 3559738 TI - Acute spontaneous subdural hematomas. AB - Fifteen cases of spontaneous subdural hematoma are presented. A review of the literature reveals the rarity of this pathology. Symptomatological onset cannot be distinguished from the other cerebrovascular lesions. High mortality is connected with patient's consciousness level. CT scan performed in all patients presenting symptoms of cerebral stroke permitted to demonstrate this clinical entity is not so rare as the literature asserted. PMID- 3559740 TI - Proceedings of the 33rd annual meeting of the Society of Nuclear Medicine. June 22-25, 1986, Washington, D.C. Abstracts. PMID- 3559739 TI - XXXIV Congress of the Italian Society of Neurosurgery. Catania, Italy, November 6 9, 1985. Abstracts. PMID- 3559742 TI - Utilization of intravenously administered glycogen by young pigs. AB - Previous studies evaluated solutions of small oligosaccharides as potential sources of carbohydrate-derived energy for patients fed intravenously. Although results with these solutions were disappointing, the data suggested that very large oligosaccharides were potential sources of intravenous carbohydrate. To test this hypothesis, four young pigs (3.6 +/- 0.2 kg; mean +/- SD) were infused with sterile solutions for a 6-d period. On days 1 and 6, a balanced isotonic electrolyte solution was infused. On days 2-5 a 9% solution of glycogen was infused at a rate providing 17.7 +/- 0.77 g/d. For each study day the remaining portion of the energy, protein, essential fatty acids and micronutrients was supplied enterally. No adverse reactions were noted during glycogen infusion, and the animals continued to grow. Glycogen utilization was 66.4 +/- 4.3%. Of the total carbohydrate excreted, 85.4% was composed of oligosaccharides of maltotetraose size or larger. Free glucose accounted for 3.5% of the total excreted, while maltose plus maltotriose accounted for 11.1%. Plasma concentrations of oligosaccharide-bound glucose increased during glycogen infusion, rising from a base-line value of 11.0 +/- 14 mg/dL to an overall mean value for the 4-d period of 100.3 +/- 31.6 mg/dL. PMID- 3559741 TI - Pancreatic response to long-term feeding of soy protein isolate, casein or egg white in rats. AB - Rats were fed purified diets which provided 24% protein from casein (C), soy protein isolate (SPI), or egg white (EW) for 18 mo. Groups of rats were killed at 3, 6, 12 and 18 mo; the pancreata were removed and examined histologically for occurrence of atypical nodules. The weight, protein, DNA, trypsin and chymotrypsin concentrations of the pancreas at each period were measured. Over the entire experimental period, body weight did not differ among groups. Pancreatic weight, protein and trypsin activity were highest in the EW group, followed by the SPI group, and lowest in the C group. Chymotrypsin activity was significantly higher in the EW and SPI groups than the C group. DNA content did not differ significantly among groups over the entire experimental period, although it was elevated in the SPI or EW groups compared to the C groups at some of the time periods. Only one microscopic nodule was observed in all of the animals; it was found at 3 mo in the pancreas from an animal fed EW. Overall, the results suggest that the elevation in enzyme activity and pancreatic weight associated with long-term consumption of EW and SPI did not result in development of pancreatic lesions in rats. PMID- 3559743 TI - Apparent inability of channel catfish to utilize dietary mono- and disaccharides as energy sources. AB - Purified diets containing equivalent amounts of glucose, maltose, fructose, sucrose, corn starch and dextrin were fed to fingerling channel catfish (Icatalurus punctatus) to compare the growth responses to these various carbohydrates. The best growth response was achieved with dextrin and the next best with corn starch. Fish grew at the same rate when glucose, maltose or sucrose was the only dietary carbohydrate source. Dietary fructose resulted in the lowest growth rate. Feed efficiency and percent retained energy values followed the same pattern as growth rates. These data suggest that the catfish is apparently unable to utilize dietary mono- and disaccharides as energy sources. Oral carbohydrate tolerance tests using glucose, maltose, fructose, sucrose and dextrin were conducted with larger channel catfish. Oral glucose and maltose resulted in a persistent hyperglycemia indicative of a diabetic-like status. Fructose appeared to be poorly absorbed from the intestinal tract and did not appear to be converted to glucose. Oral administration of sucrose was followed by a gradual increase in plasma glucose, with no detectable fructose being absorbed until the 6-h period. Oral dextrin resulted in less than a two-fold increase in plasma glucose, which remained constant from 2 to 4 h after administration and then declined. These observations are consistent with the hypothesis that certain fishes, including the channel catfish, resemble diabetic animals by having insufficient insulin for maximum carbohydrate utilization. PMID- 3559744 TI - Effect of dietary ascorbic acid intake on tissue vitamin C in mice. AB - The effect of graded levels of dietary ascorbic acid on blood and tissue ascorbic acid levels in mice has been studied. Six levels of dietary ascorbic acid (0, 0.076, 0.5, 1, 5 and 8%) were used. Plasma ascorbic acid rose as dietary ascorbic acid intake increased from 1 to 8%. Mice fed a diet with 5 or 8% added ascorbic acid had significantly higher levels of ascorbic acid in the heart, kidney, lung, muscle and spleen than did control mice fed an ascorbic acid-free diet. Mice fed a diet with 1% added ascorbic acid had elevated ascorbic acid levels in the heart, kidney, lung and spleen. No significant change was observed in ascorbic acid level in the brain, adrenal gland or leukocytes in any of the experimental groups. Ascorbic acid level in the eyes was only slightly higher in mice fed a diet containing 8% added ascorbic acid than in control mice. The observation that the kidney had the greatest increase in ascorbic acid content suggests that the kidney may be a very important organ not only in elimination but also in catabolism of this vitamin. A diet containing 0.5 or 0.076% added ascorbic acid did not significantly increase ascorbic acid content in any of the organs studied. Mice fed a diet with 0.076% added ascorbic acid had slightly, but statistically significantly, lower levels of ascorbic acid in the liver, lung, muscle and spleen that control mice. Mice fed a diet with 0.5% added ascorbic acid had a lower ascorbic acid content in the liver and muscle than the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559745 TI - Effect of exercise on riboflavin status of rats. AB - The effect of exercise on the riboflavin status of male rats was studied after 6 or 8 wk of treadmill running. Sedentary and exercised rats were pair fed diets marginal in riboflavin (2.0 or 2.5 mg/kg), and their tissue riboflavin concentrations and erythrocyte glutathione reductase activity coefficients (EGRAC) were compared. The rats exercised for 8 wk had similar body weights but significantly greater weights for heart, gastrocnemius and soleus muscles, less epididymal fat and more total muscle nitrogen and riboflavin than their sedentary controls. Similar changes were evident after 6 wk of exercise, but some were not statistically significant. The EGRAC values of both exercised and sedentary rats responded to changes in dietary riboflavin but were not different from each other. The specific activity of mitochondrial acyl-CoA dehydrogenase (per milligram protein) of the soleus muscle was unaffected by exercise; however, when expressed per gram of tissue or per muscle, the activities in exercised rats were 25% (P less than 0.05) and 60% (P less than 0.01) higher, respectively, than in sedentary rats. On the basis of the riboflavin-dependent parameters measured in this study, exercise did not increase the dietary riboflavin requirement of growing rats but did increase total riboflavin retention in gastrocnemius and soleus muscles. PMID- 3559746 TI - Accumulation and metabolism of iron-dextran by hepatocytes, Kupffer cells and endothelial cells in the neonatal pig liver. AB - Treatment of newborn pigs with supplemental iron is a common procedure utilized to prevent neonatal anemia. The aim of this study was to investigate the hepatic distribution and intracellular metabolism of iron-dextran, a widely used colloidal-iron-carbohydrate preparation. Piglets were injected intramuscularly with iron-dextran (50 mg Fe/kg body wt) at 1 d of age. Hepatocytes and sinusoidal cells (Kupffer cells and endothelial cells) were isolated from iron-treated and control (uninjected) piglets at 2, 6 and 11 d of age. The concentrations of iron, copper and zinc in isolated cells were determined by atomic-absorption spectroscopy. In addition, the quantities of ferritin-protein and ferritin-iron were measured by immunoelectrophoresis and ion-exchange chromatography, respectively. At 2 d of age, the concentration (microgram/mg cell protein) of iron was 5-, 62- and 54-fold higher in hepatocytes, Kupffer cells and endothelial cells, respectively, isolated from iron-treated piglets than from control piglets. Hepatocytes, Kupffer cells and endothelial cells accumulated ferritin in response to iron-dextran treatment. Higher concentrations of ferritin-protein and ferritin-iron were present in Kupffer cells and endothelial cells than in hepatocytes at all times after treatment with iron-dextran. The percentage of cellular iron that was associated with ferritin, however, was greater in hepatocytes than in sinusoidal cells. Iron accumulated by all three liver cell types was mobilized to extrahepatic sites. Slight alterations in zinc and copper status of liver cells were evident at 11 d of age as a result of iron treatment. PMID- 3559747 TI - Absorption of zinc from soy protein meals in humans. AB - The absorption of zinc from soy protein-containing meals was studied in healthy human subjects by means of extrinsic labelling with 65Zn and whole body counting. Three types of soy protein, a soy flour, a soy concentrate and a soy isolate, were used in two types of meals: one consisting of rice and meat sauce and the other of white or whole-meal bread. Thirty and 100% of the protein of the meat sauce and 50% of the protein of bread was replaced with the soy protein products. Replacement of 30% of the protein in meat sauce had a marginal effect on the percentage absorption of zinc, whereas the absolute amount of zinc absorbed was lower due to the lower zinc content in soy products than in meat. After total replacement of the meat protein, a significantly lower percentage and absolute absorption of zinc was observed. A lower absorption of zinc was observed when soy protein was added to white bread. The absorption of zinc from the whole-meal bread was low and did not change when 50% of the flour protein was replaced by soy protein. We conclude that the effect of soy protein on zinc absorption depends on the degree of replacement, the phytic acid and zinc content of the soy product and the protein content of the meal. PMID- 3559748 TI - Growth of juvenile white sturgeon (Acipenser transmontanus) fed different purified diets. AB - Two experiments were conducted to develop a purified diet suitable for studying nutritional requirements of juvenile white sturgeon (Acipenser transmontanus). In the first experiment, growth and survival rates of fish fed a purified diet (SPD) containing 50% casein:wheat gluten:egg white (6.2:3.0:0.8) and 8% refined soy lecithin were significantly (P less than 0.05) better than those fed a commercial nonpurified rainbow trout diet, a purified rainbow trout diet containing 50% casein:gelatin (7:3) or a purified catfish diet containing 34% spray-dried egg white. In the second experiment, fish fed SPD diet with or without cholesterol but with the same amount of lipid grew equally well. Fish fed SPD diet with lecithin grew significantly better than those fed SPD diet with its 8% lecithin replaced with an equal amount of an oil mixture. In both experiments, fish with good growth and survival rates also had significantly lower body moisture and higher protein and lipid contents than fish with poor growth and survival rates. Results suggest that the SPD diet with lecithin and without cholesterol (SPD-C) is a suitable purified diet for juvenile white sturgeon. PMID- 3559749 TI - Maintenance nitrogen requirements and intestinal microorganisms in rats. AB - Nitrogen (N) balance trials with young growing rats fed diets with and without nonabsorbable antibiotics and with various concentrations of crude protein (CP) were conducted to measure maintenance N requirements. In addition, cecal contents were analyzed for ammonia (NH3), urea (U) and free amino acids (AA) to study the reduction in maintenance N requirements due to the action of antibiotics. Results of the N-balance trials verified the reduction in maintenance N requirements with antibiotics as described in the literature. The reduction, however, was not as large as previously demonstrated, possibly because of severe diarrhea and greater liquid accumulation in the cecum of rats fed antibiotics. The concentration of free AA and U in the postabsorptive region of the intestine (cecum) of rats consuming antibiotics was greater than when antibiotics were not consumed. Cecal N concentrations supported the concept that the mode of action of antibiotics in reducing maintenance N requirements was via reduced destruction of AA of body origin in the lower intestine. Cecal levels of NH3 were similar in both antibiotic and nonantibiotic groups. The amount of N needed for body maintenance when conditions favored minimum destruction of body AA by lower intestine microorganisms was small, less than 1% dietary CP. Maintenance N may be limited to the needs for tissues on the exterior of the body, such as hair, which are poorly recycled through the digestive tract. PMID- 3559750 TI - Lipoprotein lipase activity in skeletal muscle and brown adipose tissue of pregnant and lactating rats. AB - Changes in lipoprotein lipase (LPL) activity during pregnancy and lactation were followed in skeletal muscles and interscapular brown adipose tissue (BAT) of rats fed two diets differing in energy density (high carbohydrate or high fat). Rats were decapitated after 7, 19 or 21 d of pregnancy or after 3 or 12 d of lactation. Virgin rats and females separated from their litter just after delivery were used as nonpregnant and nonlactating controls, respectively. Blood was collected for determination of plasma glucose, triglycerides (TG) and nonesterified fatty acids (NEFA). Soleus, extensor digitorum longus (EDL), diaphragm and interscapular BAT were rapidly removed and frozen in liquid nitrogen for LPL activity measurement. LPL activity was not significantly higher in muscles and BAT of virgin rats fed the high fat diet than in those of rats fed the high carbohydrate diet. No significant change of skeletal muscle LPL activity was observed during pregnancy, regardless of the diet fed. Although BAT exhibited a transitory hypertrophy during pregnancy, its LPL activity was not significantly altered; during lactation BAT lost weight and its LPL activity dropped sharply when either diet was fed, leaving more TG available for milk production. PMID- 3559751 TI - Iodothyronine 5'-deiodination in rats fed low protein diets: lack of correlation with energy balance. AB - Rats fed low protein diets often exhibit an elevation in adaptive thermogenesis that may result in part from activation of thyroid hormone action at the level of peripheral deiodination of thyroxine (T4) to 3,5,3'-triiodothyronine (T3). This possibility was examined by comparing the kinetic parameters of iodothyronine 5' deiodination in hepatic and renal microsomes and the efficiency of energy retention in weanling rats fed diets containing 5% (LP-5), 8% (LP-8) or 22% (NP) casein. Energy balance measurements revealed that efficiency of energy retention was reduced in rats fed LP-5, whereas no significant change in adaptive thermogenesis was observed in rats fed LP-8. In the LP-5 group the maximal activity of hepatic 5'-deiodinase per milligram of microsomal protein was not different from that of the NP group; however, the Vmax of the renal enzyme was 21% higher. In both tissues, the Km of the reaction was not affected by dietary treatment. Hepatic and renal 5'-deiodination in rats fed LP-8 was similar to that in rats fed LP-5. When compared to corresponding NP controls, each of the low protein dietary groups (LP-5, LP-8) had a higher serum total T3 concentration, whereas serum free T3 and total T4 concentrations were unaffected by the dietary treatments. The findings demonstrate that iodothyronine 5'-deiodination and circulating thyroid hormone concentrations vary in a similar manner in LP-5 and LP-8 animals even though these two groups exhibit different responses in energy efficiency relative to NP controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559752 TI - Genetic differences in effects of food restriction on aging in mice. AB - Lifelong food restriction to two-thirds of normal ad libitum consumption extended mean and maximum life spans more than 200 d in male B6CBAF1 hybrid mice, already a long-lived genotype. The following biological systems were improved by food restriction, with values for older mice being similar to those previously found for younger individuals: tight wire clinging, a measure of neuromuscular performance; open field movement, a measure of voluntary activity; tail tendon denaturation rate, a measure of collagen solubility; urine concentrating ability, a measure of renal function, and hair regrowth rate, a measure of the frequency of hair follicle cycling. However, wound healing was slower in food-restricted mice than in ad libitum-fed controls. The same food restriction treatment had entirely different effects on longevities of a different genotype, male B6 (C57BL/6J) mice, reducing mean and maximum life spans 265 and 27 d, respectively. This surprising deleterious effect was not predicted by tests of tight wire clinging, open field movement and tail tendon denaturation, but was predicted by hair regrowth rates, as these were lower in restricted B6 mice than in fed controls. In genetically obese (ob/ob) B6 mice, food restriction extended mean and maximum longevities 327 and 440 d, yet no biological systems tested performed better than those of food-restricted normal (+/+) mice whose life spans were reduced. Thus the food restriction regimen that increased longevities for individuals of two genotypes decreased them for individuals of a third genotype tested in the same set of experiments. PMID- 3559753 TI - Reversal of obesity in the genetically obese fa/fa Zucker rat with an ephedrine/methylxanthines thermogenic mixture. AB - Administration of a thermogenic mixture of ephedrine, caffeine and theophylline to grossly obese (11-12 mo old) fa/fa Zucker rats led to a rapid decline in their body weight, which reached lean levels within 9-10 wk, and this postobese weight was maintained for another 5-6 wk. Compared to the no-drug obese controls (O-ND), food intake was reduced by 70% during the dynamic phase of weight loss and by 50% during the postobese period in the food-restricted animals (O-FR) and by about 40% during both phases in the ephedrine/methylxanthines (O-E/Mx) animals. Energy expenditure in the O-FR group was lower than in the O-E/Mx group by 25-33%. Analysis of body composition showed that body fat in both O-FR and O-E/Mx groups was much lower than in the O-ND group, by 2.5- and 4-fold, respectively, and body protein was lower by 50 and 28%, respectively. Thus, compared to the O-ND group, the fat:protein ratio was only 25% lower in the O-FR animals but was three times less in the O-E/Mx group. These findings demonstrate that in the fa/fa rat a mixture of ephedrine and methylxanthines reduces food intake but also minimizes the fall in metabolic rate that usually accompanies such an energy deficit, effects that led to a reversal of their gross obesity. The ability of ephedrine alone or in combination with methylxanthines to reverse obesity in animal models with dietary and hypothalamic etiologies is thus extended to the obesity resulting from the inheritance of a single-gene recessive defect. PMID- 3559754 TI - Beneficial effects of exercise on growth of rats during intermittent fasting. AB - An 8-wk trial was conducted to compare the effects of exercise and intermittent fasting, either singly or combined, on growth responses of rats. Four-week-old male Wistar rats, 85-110 g each, were assigned to one of four groups (n = 9): control, exercise on a motor-driven treadmill, fasting every other day (EOD) and fasting EOD and exercise combined. At the end of the trial, the exercised rats had consumed 7% less feed, had gained 7% less weight and had 36% less carcass fat than the control rats. Fasting on alternate days markedly reduced the growth rate of the young rats. Fasted-EOD rats weighed less than half as much as the control rats, had 64% less carcass fat and 51% less lean mass and had smaller livers, kidneys, hearts, tibias and tibialis anterior muscles. The addition of exercise to the fasting EOD regimen improved the growth of the animals. When the fasted EOD rats were also exercised, they gained 29% more weight, consumed 11% more feed and had carcasses that contained 29% more lean mass and 18% less fat than the fasted-EOD rats. The data suggest that exercise may be beneficial where feed restriction is episodic, allowing some capacity for catch-up growth. PMID- 3559756 TI - Nutritional epidemiology and national surveys. PMID- 3559755 TI - Trypsin inhibitors: potential concern for humans? PMID- 3559757 TI - Membrane-to-membrane transfer of tocopherol in red blood cells. AB - The direct cell-to-cell transfer of tocopherol between red blood cells (RBCs) was examined. Two kinds of RBCs were provided; 1) Tocopherol-deficient ones showing complete dialuric acid-hemolysis and 2) tocopherol-supplemented ones showing no dialuric acid-hemolysis. The two kinds of RBCs were mixed and incubated with gentle swirling in a buffer solution. If no tocopherol transfer occurred between the two kinds of RBCs in the cell suspensions, hemolysis should not change during incubation because hemolysis is limited only in the -deficient cells in the suspensions. However, it was actually observed that when RBCs with adequate amounts of tocopherol were incubated with tocopherol-deficient RBCs, dialuric acid-induced hemolysis decreased during a 3-h incubation period. Contrarily, when an inadequate amount of tocopherol constituting a limiting level for inhibition of hemolysis, existed in RBCs which were mixed with -deficient ones, hemolysis increased after incubation. This indicates that tocopherol is transferred from the tocopherol-rich RBCs to the -deficient RBCs. The transfer was greater as the hematocrit of cell suspensions increased. Gum arabic contained in the suspensions inhibited the transfer, while bromelain (a protease which lowers the electric charge on the cell surface) increased it. These findings indicate that the transfer of tocopherol is related to the frequency of collision between cells. PMID- 3559759 TI - Enhancing effect of carrageenan on the induction of rat colonic tumors by 1,2 dimethylhydrazine and its relation to beta-glucuronidase activities in feces and other tissues. AB - Since it has been demonstrated that a high level of fat is a dietary factor in the etiology of colon cancer, the effect of carrageenan, a polysaccharide extracted from the red seaweeds, on 1,2-dimethylhydrazine-induced colonic tumors in rats fed a semipurified control diet containing an ordinary level of fat was studied. Nevertheless, the enhancing effect of carrageenan on colonic tumors was observed. The rats fed a carrageenan diet had approximately twice the fecal weight compared to the rats fed a control diet. While no significant differences were found in beta-glucuronidase activities in colonic mucosa, liver or plasma in the carrageenan-fed rats and controls, the activity in feces was significantly lower in the carrageenan-fed rats. At least, no beta-glucuronidase activity seemed to be related to the tumor-enhancing effect of carrageenan. PMID- 3559758 TI - Free radical chain oxidation and hemolysis of erythrocytes by molecular oxygen and their inhibition by vitamin E. AB - Erythrocytes of vitamin E-deficient rats and normal rats were oxidized at 37 degrees C by molecular oxygen using a free radical initiator. The erythrocytes were oxidized by a free radical chain mechanism with kinetic chain length considerably larger than 1 and resulted in hemolysis. Vitamin E suppressed both oxidation and hemolysis, but the extent of hemolysis was determined primarily by the extent of oxidation independent of the presence or absence of vitamin E. PMID- 3559760 TI - Dietary manipulation of the disappearance of trans-octadecenoates in rat tissues. AB - The effects of dietary manipulations on the fate of trans-octadecenoates deposited in the tissues of rats were examined. Male rats were fed on a 15% fat diet containing trans-octadecenoic acids (46.6% of total fatty acids) for 35 days followed by various diets free of trans-fatty acids. After removal of trans-fatty acids from the diet, there were phased disappearances of trans-octadecenoates from the circulation; a rapid and broad reduction in one day and a slow and gradual reduction thereafter. The rate of the initial reduction in serum trans octadecenoates was highest on a high fat (20%) diet in relation to low fat (1 or 5%) diets. However, the disappearance rate at the later stage was apparently the same among the various groups and trans-fatty acid contents in the serum declined to about 10% of the initial value in 2 weeks and thereafter. After 35 days, the concentration of trans-octadecenoates remaining in the adipose tissue was markedly lower in rats fed on a high protein (40%) diet. The effects of dietary fat type and cholesterol on the fate of serum trans-octadecenoates were virtually the same, but livers from rats fed on the cholesterol-free safflower oil diet contained more trans-fatty acids than those from rats fed on the corresponding olive oil diet. Thus, the amounts of trans-fatty acids stored in the tissues cannot be merely predicted from serum levels. It seems that both dietary fat and protein affect the metabolic rate of trans-octadecenoates in rats. PMID- 3559761 TI - Heat-inactivation of liver glucose-6-phosphate dehydrogenase and malic enzyme in 1- and 12-month-old rats. AB - The heat-labilities of liver glucose-6-phosphate dehydrogenase and malic enzyme of 1- and 12-month-old rats were observed by incubation of the crude enzymes at 52 and 55 degrees C, respectively. The biphasic heat-inactivation curves were obtained for those enzymes of the 12-month-olds, whereas no biphasic curves were obtained for the enzymes of the 1-month-olds. The age-dependent rapid inactivations of glucose-6-phosphate dehydrogenase and malic enzyme were not relieved by addition of their substrates in the incubation media. However, the rapid age-dependent inactivations of these enzymes disappeared by addition of NADP. It is suggested that the age-dependent heat-inactivation of these enzymes is ascribed to the conformational modification of the proteins. PMID- 3559762 TI - Effects of dietary level of protein on the maintenance energy requirement and net energetic efficiency for growth of post-weaning rats. AB - The effects of dietary protein on the maintenance energy requirement (MEm) and net utilization efficiency of metabolizable energy for growth (MEg) were investigated by regression analysis of energy balance with various energy intakes. Weanling rats of the Wistar strain, weighing about 85 g, were given a diet containing 0 to 70% casein freely or in restricted amounts (equivalent to two-thirds or one-third of the intake of the ad libitum group) for 5 days. The MEm was fairly constant in rats given 10 to 50% casein diets, being about 29 kcal/100 g BW/day, but increased at higher or lower dietary protein levels, indicating inefficient energy utilization in protein-malnourished animals. From the slope of the regression line between energy balance and metabolizable energy intake, the net energetic efficiencies for growth were estimated as 68, 71, 74, 77, 82, 83, 80, 78, 77 and 74% with 0, 3, 6, 10, 20, 30, 40, 50, 60 and 70% casein diets, respectively. Weanling rats fed 20 to 30% casein diets utilized the dietary energy for growth most efficiently. At protein levels higher or lower than 20 to 30%, the efficiency was less, showing that MEg utilization depended on dietary protein. The energy necessary for 1 g body weight gain was 2.6 kcal in rats receiving 30% casein diet, but increased with an increase or decrease in the protein level. These data on the food efficiency, MEm, the net efficiency of MEg and the energy necessary for 1 g weight gain show that dietary protein affects energy utilization and that protein-malnourished animals use energy inefficiently. PMID- 3559763 TI - Maintenance energy requirement in pregnant rats and net energetic efficiency for fetal growth during late pregnancy. AB - The maintenance energy requirement (MEm) of pregnant rats and net energetic efficiency for fetal growth during late pregnancy were examined by regression analysis. Pregnant rats, weighing about 180 g, were fed on 20% casein diet during early-mid pregnancy and then divided into three groups--ad libitum-fed, 50% food restricted, or starved. A linear relation between the energy balance (Y, kcal/100 g BW/day) and the metabolizable energy intake (X, kcal/100 g BW/day) was obtained as Y = 0.81 X-14.83 (n: 17, r = +0.99, p less than 0.001). The X-intercept, MEm, was calculated to be 18.31 kcal/100 g BW/day. Pregnant animals fed ad libitum retained 6.1 and 1.1 kcal of energy daily in their conceptuses and their own body, respectively, during late pregnancy. Assuming that the net efficiency of maternal energy deposition is equal to that for size- and age-matched nonpregnant rats, the net energetic efficiency for fetal growth was calculated to be 82%. This value was very close to the net efficiency for weanling rats reported previously, suggesting that the net energetic efficiency for maximum growth in well-nourished rats is about 82%. PMID- 3559764 TI - Effects of methionine and related compounds on plasma cholesterol level in rats fed a high cholesterol diet. AB - The comparative effects of methionine and its structurally and metabolically related compounds on plasma cholesterol level were investigated with rats fed a high cholesterol diet. The plasma cholesterol level was significantly enhanced by the dietary addition of methyl compounds such as L-methionine, D-methionine, choline and betaine. On the other hand, the intermediary metabolites of methionine such as homocystine, cysteine and 3-methylthiopropionate reduced plasma cholesterol. S-Methyl-L-cysteine and dimethylglycine had no significant effect. The plasma cholesterol-elevating effects of methionine, betaine and histidine were all prevented, more or less, by the concurrent addition of glycine to the diet, suggesting the existence of a common mechanism for their effects. The results support a possibility that the plasma cholesterol-elevating efficacy of methionine is attributable to its methyl group. PMID- 3559765 TI - Thermotropic interaction of vitamin E with dimyristoyl and dipalmitoyl phosphatidylcholine liposomes. AB - The effect of vitamin E on the thermal behavior of two saturated phosphatidylcholines was investigated by differential scanning calorimetry. For dimyristoyl and dipalmitoyl phosphatidylcholines, the addition of vitamin E at concentrations of 1, 5 and 10 mol% vitamin E, resulted in a lowering of the phase transition temperature and a broadening of the temperature range of the phase transition indicating an increase in the fluidity of the phospholipids. Taken together with other physical studies on the effect of vitamin E on (unsaturated) phospholipids, these results indicate that vitamin E could influence the physical properties of membrane phospholipids in addition to its known antioxidant role. The likelihood of this interaction would be enhanced if vitamin E was not randomly distributed in biological membranes but rather was located in domains where its local concentration, relative to phospholipids, was elevated. PMID- 3559767 TI - Interview with Antonio Granda Ibarra, MD. Interview by Peter Orris. PMID- 3559768 TI - Guidelines for contact lens use in industry. AB - Contact lens use in industry is controversial. National eye organizations recommend that companies establish their own policies on contact lens use. A survey questionnaire was sent to 100 corporations to gather descriptive data on the existence and content of their policies. Data were collected on policy enforcement, areas of contact lens restriction and basis for restriction, identification of workers who wear contacts, and use of eye protection. Among the 67 respondents, 43 companies have a policy on contact lens use. It was found that companies need to identify workers who wear contact lenses. The decision whether or not to allow the use of contact lenses in the industrial environment appeared to be dependent upon the perceived level of risk in a specific environment. More importantly, the current written policies do not appear to recognize the results of recent research. Guidelines for contact lens use in industry are presented. PMID- 3559766 TI - Methylene chloride mortality study: dose-response characterization and animal model comparison. AB - To assess the potential chronic health effects of methylene chloride, the mortality experience of a maturing 1964 to 1970 cohort of 1,013 hourly men was evaluated through 1984. On average, employees were exposed at a rate of 26 ppm (eight-hour time-weighted average) for 22 years; median latency was 30 years. Compared with the general population, no statistically significant excesses were observed for such hypothesized causes as lung cancer (14 observed v 21.0 expected), liver cancer (0 v 0.8), and ischemic heart disease (69 v 98.1); dose response relationships based on career methylene chloride exposure and latency were not demonstrated. Among nonhypothesized causes, a significant deficit was reported for total deaths (176 v 253.2). None of the industrial referent comparisons achieved statistical significance. Sufficient power was available to detect relative risks of 1.6 for lung malignancy and 1.3 for ischemic heart disease. In contrast, there was inadequate power to identify meaningful risk levels for hepatic cancer. With 14 combined lung and liver cancer deaths observed v 36.3 predicted (P less than .0001), the mortality estimate projected from a mathematical model derived from an animal bioassay substantially overestimated cancer mortality for these sites. This inconsistency emphasizes the need to incorporate epidemiologic evidence in assessing the human health risks associated with long-term exposure to this widely used solvent. PMID- 3559769 TI - Cancer incidence and mortality in the Du Pont Company: an update. AB - In a previous publication, Pell et al described the cancer epidemiologic surveillance program that was begun in the Du Pont Company in 1956 and presented standardized cancer incidence and mortality data through 1974 for Du Pont employees compared with such data for the US general population. This report provides the analysis of an additional 10 years of cancer incidence and mortality data, and examines time trends for specific cancer sites. Conoco, Inc, acquired in 1981, is not included in the analysis. PMID- 3559770 TI - Apportionment of risk among environmental exposures: application to asbestos exposure and cigarette smoking. AB - A new method for assessing the attribution of risk for each of two exposures is developed. In one instance it generalizes a method now used to evaluate compensation for smokers who have been exposed to asbestos and it extends the notion of attributable risk. This method of apportioning risk is applicable in occupational settings where risk assessment and/or compensation is required and an application is presented. PMID- 3559771 TI - Sources of bias in retrospective cohort mortality studies: a note on treatment of subjects lost to follow-up. AB - The three important sources of bias in retrospective cohort mortality studies are: the healthy worker confounding bias, the lost to follow-up bias, and bias due to methods of follow-up that result in underascertainment of deaths. This paper presents how the treatment of the lost to follow-up impacts ultimately on the apparent forces of mortality in a cohort. The findings are discussed in the context of the other sources of bias. The treatment of subjects lost to follow-up as lost at the time of loss offers the best estimate of expected mortality and should be the preferred approach. PMID- 3559773 TI - Asbestos and air flow limitation. PMID- 3559772 TI - Hazard communication and the occupational physician. PMID- 3559774 TI - Impact of therapeutic guidelines on antibiotic use by residents in primary care clinics. AB - Inappropriate use of antibiotics has been well documented for inpatient settings, but there are few studies in ambulatory patients. In a prospective study, the authors monitored the outpatient prescribing patterns of internal medicine residents and evaluated the effect of placing a one-page set of antibiotic guidelines in each patient examining room. Appropriateness of antibiotic choices was scored periodically. A 12-month pre-intervention survey of antibiotic use showed that 50% of the choices were inappropriate. Comparison of a four-month post-intervention analysis with the same four-month interval in the pre intervention period showed no significant difference between the percentages of inappropriate prescriptions. The most common reasons for inappropriate use were: 1) failure to document a clinically significant bronchial infection, and 2) inadequate evaluation of nonspecific urinary tract complaints. The authors conclude that the ready availability of information about appropriate antibiotic use is not effective in changing antibiotic choices, and that educational strategies regarding antibiotic use must also address diagnostic evaluation. PMID- 3559775 TI - Funding for medical care research. AB - Funding for medical care research in the interrelated fields of health services research, clinical decision-making, clinical epidemiology, the medical humanities and social sciences, and medical education has been unstable, and relatively little is available in the form of investigator-initiated grants. Stable funding for these fields is important to society and critical to the healthy development of academic general internal medicine. Strategies to augment funding can include political interventions to increase support for the National Center for Health Services Research and Health Care Technology Assessment and to secure designated funds within the National Institutes of Health. Public funding is also needed for career development awards in these fields. Research support also could be enhanced by establishing a consortium of foundations interested in funding investigator-initiated grants through open competition, by developing a mechanism for reviewing proposals from small foundations, by developing consortia in the private sector to support focused research, and by developing endowments to support research. PMID- 3559777 TI - The role and significance of medical care research. PMID- 3559776 TI - Relative erythrocytosis: an approach to the patient. PMID- 3559778 TI - Quantification in clinical research: our days are numbered. PMID- 3559779 TI - Teaching medical students to estimate probability of coronary artery disease. AB - The authors conducted a randomized trial of two methods for teaching medical students how to estimate the probability of coronary artery disease in patients with chest pain. Eighty-two students were given a pre-test consisting of written protocols summarizing the histories of 25 patients who had undergone coronary arteriography. The students estimated the likelihood of coronary artery disease for each case and were then randomized to receive one of two short written clinical lessons: a cardiology textbook chapter on interpreting chest pain, or a lesson based on a prediction rule for estimating probability of coronary artery disease. All students were given a post-test similar to the pre-test. Students who were given the textbook lesson showed no change in the accuracy of their probability estimates. Students who were taught the prediction rule significantly improved their probability estimates, as measured by a statistical index of calibration. The authors conclude that traditional teaching methods do not provide students with guidance in estimating disease probability, and that better teaching methods are needed. In this study, a clinical prediction rule fulfilled the need for instruction in probability estimation. PMID- 3559780 TI - Hip fracture: a prospective study of hospital course, complications, and costs. AB - A prospective study of 79 patients with recent hip fracture revealed prior functional impairments with community mobility (49%), using a bathtub (40%), walking outdoors (26%), and stair-climbing (18%). Eighty-six per cent of patients (mean age 77.9 years) were admitted from home, with 95% surviving to discharge but only 28% returning directly home following surgical repair. In-hospital complications included confusion (49%), urinary tract infection (33%), and heart rhythm disturbance (26%). Mean length of stay was 21.7 days and mean hospital charges were $11,052. The outliers (15%) averaged 60.6 days in length of stay and $28,190 in charges. Stepwise multivariate regression revealed that lengths of stay varied significantly with prefracture functional status, presence of intertrochanteric fractures, and in-hospital complications, but not with patient age. Examination of these findings in relation to prospective reimbursement led to the conclusion that hip fracture patients are particularly vulnerable in the era of new hospital strategies to avoid high-cost patients and curtail hospital costs. PMID- 3559781 TI - Preoperative medical consultations in a community hospital. AB - To evaluate the practice of consultations in the community hospital, chart reviews and consultant/surgeon interviews were conducted for 85 consecutive medical preoperative consultations for patients discharged from the Surgical Service. In 78 cases (92%) the authors agreed with the need or reason for the preoperative consultation; the majority were required for the management of chronic medical problems. Continuity of care was considered important by surgeons and consultants. Verbal communication was common, particularly from surgeon to consultant. Brief response time, specific recommendations, focused evaluations, and physician satisfaction with the existing system were the rule. However, 23 preoperative consultations (27%) were judged to be deficient. Compliance with recommendations was high (95%) but other measures of consultation effect were low. PMID- 3559782 TI - Anxiety and depression among medical and surgical patients nearing hospital discharge. AB - Ninety-eight medical and surgical inpatients were interviewed 24-72 hours prior to discharge. Thirty-five (36%) had clinical levels of anxiety and depression as defined by the SCL-90-R, a self-report symptom inventory. Compared with patients with normal SCL-90-R subtest scores, anxious and depressed patients more often had the following characteristics: older age, black race, lower socioeconomic class, a recent previous hospitalization, and impaired functional status prior to admission. Three to four weeks after discharge, 25 of the 35 anxious and depressed patients were again interviewed. Thirteen remained anxious and depressed, while 11 patients had returned to normative distress levels. Older, black, poor inpatients with a recent prior hospitalization and impaired functional status are at high risk for clinical anxiety and depression. Half of those with anxiety and depression may remain anxious and depressed after discharge. Intervention should be considered for these patients. PMID- 3559783 TI - Corneal polarization in the living human eye explained with a biaxial model. AB - We have applied Mueller matrix ellipsometry to assess the change in the state of polarization of a light beam that has double passed the ocular media and is scattered at the fundus of the human eye in vivo. At several positions in the pupil plane, which together cover the area of the dilated pupil, Mueller matrices are assessed. From them the magnitude of the retardation and the orientation of the eigenvector are calculated. The properties of the retardation process are surveyed by measuring the retardation along a horizontal meridian as a function of wavelength, density of visual pigment, and location of retinal fixation. Furthermore, photographs are taken from the polarization patterns on the iris with circularly polarized light. We posit that the cornea behaves as a biaxial crystal with its fastest principal axis normal to its surface and its slowest nasally downward. The retardation of light by a model eye with such a cornea is calculated, and the results are compared with the data. PMID- 3559784 TI - Short-wavelength-sensitive cones do not contribute to mesopic luminosity. AB - It has been suggested that the short-wavelength-sensitive cones (S cones) play a significant role in the transition from scotopic to photopic vision (the Purkinje shift). We address this issue directly over a 5-log10-unit range of light levels covering scotopic, mesopic, and photopic vision. At each light level we make flicker matches to two reference stimuli by 2-Hz flicker photometry. The two reference lights (441 and 481 nm) differ only in their stimulation of S This novel technique utilizes the different magnitudes of the rod and cone Stiles- Crawford effects. Despite the large difference in S-cone stimulation by the two reference lights (more than 1 log10 unit), the pairs of luminosity functions are indistinguishable at each light level tested. The results indicate that S cones do not contribute to either photopic or mesopic luminosity. PMID- 3559785 TI - Contrast discrimination in noise. AB - Even the highest contrast sensitivities that humans can achieve for the detection of targets on uniform fields fall far short of ideal values. Recent theoretical formulations have attributed departures from ideal performance to two factors- the existence of internal noise within the observer and suboptimal stimulus information sampling by the observer. It has been postulated that the contributions of these two factors can be evaluated separately by measuring contrast-detection thresholds as a function of the level of externally added visual noise. We wished to determine whether a similar analysis could be applied to contrast discrimination and whether variation of the increment threshold with pedestal contrast is due to changes in internal noise or sampling efficiency. We measured contrast-increment thresholds as a function of noise spectral density for near-threshold and suprathreshold pedestal contrasts. The experiments were conducted separately for static and dynamic noise. Our findings indicate that the same formulation can be applied to contrast discrimination and that changes in the estimated values of internal noise, rather than changes in sampling efficiency, play the major role in determining properties of contrast discrimination. Implications for models of contrast coding in vision are discussed. PMID- 3559786 TI - What is psychophysically perfect image stabilization? Do perfectly stabilized images always disappear?: comment. AB - This Communication calls attention to an earlier paper [L. E. Arend and G. T. Timberlake, J. Opt. Soc. Am. A 3, 235 (1986)] in which direct measurements have shown that retinal-image movements less than 1 arc min are required for perfect stabilization. It also cites papers that show that stabilized images of targets that contain no sharp structure in the foveal region disappear completely and permanently. Other targets disappear and reappear as a whole or as fragments intermittently. PMID- 3559787 TI - What is psychophysically perfect stabilization? Do perfectly stabilized images always disappear?: reply to comment. AB - We acknowledge the earlier work cited by Ditchburn in his comment [R. W. Ditchburn, J. Opt. Soc. Am. A 4, 405-406 (1987).] and point out a crucial difference between that work and our novel approach [L. E. Arend and G. T. Timberlake, J. Opt. Soc. Am. A 3, 235 (1986)]. Our procedure provides measurements uncontaminated by residual errors of stabilization. The visual system's extreme sensitivity to small temporal changes and the indirectness of the evidence cited by Ditchburn leave the meaning of stabilized-image reappearance unclear. PMID- 3559788 TI - Glycosylation ... an aid in assessing diabetic control. PMID- 3559789 TI - Adie's syndrome: report of a case. PMID- 3559790 TI - The recurrence rate of adenomas following polypectomy and complete colonoscopy. PMID- 3559792 TI - Erythromelalgia--pathophysiological and therapeutic aspects. A preliminary report. PMID- 3559793 TI - The eyeless mutant Mexican salamander (Ambystoma mexicanum): evidence for an imbalanced anteroposterior morphogenetic system. AB - Prospective anterolateral neural fold was grafted from normal axolotls into the posterior neural fold region (statocyst area) of eyeless mutant hosts. These unilateral anteroposterior grafts stimulated bilateral eye formation in the eyeless mutant at a rate of 79%. Replacing the statocyst area of mutants with the statocyst area from normals stimulated bilateral eye formation in 49% of the cases. Grafting of prospective anterolateral neural fold between normals and mutants or excising the statocyst region of mutants, had no effect. The results are interpreted on the basis of a hypothetical anteroposterior morphogenetic system that might be out of balance in the mutant. PMID- 3559791 TI - Pre- and postoperative colonoscopy in patients with resectable colorectal cancer. Detection of associated neoplastic lesions. PMID- 3559794 TI - Myotonic dystrophy and chromosome translocation segregating in the same family. AB - We report on a family segregating the myotonic dystrophy (DM) gene and a t(5;8) reciprocal translocation. The DM presented the characteristics typically seen in this disease, i.e. full penetrance, broad expressivity, apparent anticipation in successive generations, presence of a congenital form transmitted by a carrier mother. The family was uninformative for linkage studies with the Lutheran and Secretor loci. The concordance between DM and chromosome translocation in 8 out of 9 individuals at risk was apparently due to chance. PMID- 3559795 TI - Clinical and electrophysiological studies in a patient with keratitis, ichthyosis and deafness (KID) syndrome. AB - Neurological studies were performed in a young boy with keratitis, ichthyosis and deafness syndrome. Skin biopsy showed features of ichthyosis. Clinically and electrophysiologically, he had normal motor and sensory systems, but there was an acoustic nerve lesion and absence of tendon reflexes. Audiometry and brainstem auditory evoked potentials showed bilateral neurosensory deafness. Poor vision may not be due to an optic nerve lesion as evidenced on visual evoked potential findings, but is probably due to pronounced vascularizing keratitis of the cornea. Computer tomography scan showed mild hypoplasia of the inferior vermis and left side of the cerebellum. PMID- 3559796 TI - Pathological Society of Great Britain and Ireland. 154th meeting, 7-9 January 1987. Synopses of papers. PMID- 3559797 TI - Lesions of the renal papilla induced by paracetamol. AB - The acute nephrotoxic effects of paracetamol in the uninephrectomized homozygous Gunn rat are different from those of aspirin. Both compounds induce renal papillary necrosis but paracetamol produces accumulation of non-cellular material in the interstitial space, less damage to interstitial cells, more damage to tubular epithelium, and more severe necrosis of proximal convoluted tubules. In both cortex and papilla only a small fraction of the cells at risk are affected. It is concluded that the findings are consistent with a synergistic nephrotoxic effect between the two compounds, but that the lesions are not sufficiently severe for the natural history of analgesic nephropathy to be wholly explicable by such synergism. PMID- 3559798 TI - Surgical treatment of pediatric cardiac arrhythmia. AB - The combination of improved diagnostic techniques, new and potent antiarrhythmia agents, and progress in antiarrhythmia surgical procedures has resulted in successful management of complex cardiac arrhythmia in children. The kinds of arrhythmia that can be considered for possible surgical intervention share several features. Each produces symptoms and usually is hemodynamically compromising. Each requires extensive preoperative and intraoperative electrophysiologic evaluation to establish the mechanism, response to drugs, and suitability for surgery. Although reports of surgical arrhythmia treatment have been limited in children, with increasing success the indications for such treatment may become less stringent. Our recommendations are shown in the Table. In general, patients intolerant of or unresponsive to medical treatment for symptomatic arrhythmia (tachycardia or bradycardia), should be considered candidates for surgical antiarrhythmia procedures. These patients should be referred for testing to cardiac centers staffed by pediatric cardiac electrophysiologists and surgeons experienced in arrhythmia diagnosis and ablation. Careful evaluation can identify those patients in whom surgical approaches are most appropriate. At present, surgical operations for selected, serious pediatric cardiac arrhythmias offer definitive and possibly curative treatment, and may be preferable to inadequate, poorly tolerated, or long-term medical therapy. PMID- 3559800 TI - Predictive value of minor anomalies. I. Association with major malformations. AB - We examined 4305 white newborn infants for 114 minor physical features and major malformations to evaluate the hypothesis that the presence of three or more minor anomalies is highly predictive of a major malformation. We confirmed that the infant with three or more minor anomalies is at increased risk for a major malformation. However, this risk (19.6%) was much lower than the risk of 90% popularized by Smith and based on the study of Marden et al. (J Pediatr 1964;64:357). Analysis of the findings in the two studies showed that the lower predictive value was probably related to differences in study design. Nevertheless, some minor anomalies remain essential to the early recognition of several serious malformation syndromes. PMID- 3559799 TI - Cervicomedullary compression in young patients with achondroplasia: value of comprehensive neurologic and respiratory evaluation. AB - We studied prospectively 26 young patients with achondroplasia to test two hypotheses: that respiratory problems may be the result of occult spinal cord compression, and that achondroplastic patients with cord compression might have occult respiratory abnormalities. Respiratory abnormalities were present in 85%, the majority caused by a primary problem of the pulmonary system, such as small thoracic cage or obstructed airway. Three patients had hypoxemia, recurrent cyanotic spells, and episodes of respiratory distress explainable only by cervicomedullary cord compression; in each patient, respiratory problems were alleviated by decompressive surgery. Another six patients with cervicomedullary compression had, in addition, at least one primary pulmonary cause of respiratory problems. After decompressive surgery the respiratory problems improved in three and were unchanged in three. Reconstructed sagittal CT images proved the most sensitive technique for detecting craniocervical stenosis as a cause of cervicomedullary cord compression, although some degree of stenosis was present in nearly all of the patients. PMID- 3559801 TI - Serum erythropoietin levels in patients with congenital heart disease. AB - Serum erythropoietin levels were measured by radioimmunoassay in 146 children and young adults with congenital heart disease to assess the relationship between erythropoietin and clinical factors (heart failure, anemia, cyanosis) and hemodynamic variables affecting oxygen delivery and utilization. Erythropoietin values were in the normal range (10 to 30 microU/mL) in 73% (58 of 80) of the patients with and 82% (54 of 66) of those without cyanosis. Elevated erythropoietin values in cyanotic patients were associated with lower mixed venous oxygen saturation and tension than in cyanotic patients with normal erythropoietin levels, even though the degree of polycythemia was similar. In contrast, most of the acyanotic patients who had elevated erythropoietin levels were anemic. Of the blood oxygen measurements, mixed venous oxygen saturation and tension had the closest inverse correlation with erythropoietin values. The normal erythropoietin values in most patients are in accord with other observations that show that an elevation in erythropoietin level in response to hypoxia will be transient if it results in a rise in hemoglobin concentration "appropriate" to the degree of hypoxia. Persistent elevation of erythropoietin in patients with congenital heart disease may indicate harmful impairment of hemoglobin production that is potentially correctable. PMID- 3559802 TI - Defective humoral and cellular immune functions associated with veno-occlusive disease of the liver. AB - We describe veno-occlusive disease of the liver associated with humoral and cellular immune defects in two siblings. Another child, with aplastic anemia, died before the age of 1 year. No consanguinity was found in the family. Both infants had lymphopenia and hypogammaglobulinemia; the surviving infant has defective in vitro immunoglobulin production after stimulation of lymphocytes with pokeweed mitogen, increased proportions of OKT8 positive cells, defective proliferative responses to phytomitogens, and decreased help for immunoglobulin production. A therapeutic trial with cimetidine, an H2 receptor antagonist, has not changed the immunologic status of the surviving child. PMID- 3559803 TI - Antibody responses to bacterial toxoids in children infected with human immunodeficiency virus. PMID- 3559804 TI - Rapid diagnosis of Campylobacter pyloridis-associated gastritis. PMID- 3559806 TI - Central nervous system infections following esophageal dilation in children. PMID- 3559805 TI - Transplacental/perinatal babesiosis. PMID- 3559807 TI - Childhood stroke following intraoral trauma. PMID- 3559808 TI - Spectrum of congenital heart disease in CHARGE association. PMID- 3559809 TI - Achievement of in utero retention of calcium and phosphorus accompanied by high calcium excretion in very low birth weight infants fed a fortified formula. AB - Calcium and phosphorus retention was evaluated in 13 very low birth weight infants who were fed an experimental formula designed to deliver quantities of calcium and phosphorus sufficient to meet the intrauterine accretion rates for these minerals. Retention of calcium and phosphorus in slight excess of these rates was achieved without any apparent difficulties for the infants. Biochemical measurements demonstrated normal serum calcium (9.8 +/- 8 mg/dL) and alkaline phosphatase (242 +/- 51.6 IU) values. However, there was evidence of high tubular reabsorption of phosphate (98.1% +/- 3.3%), hypercalciuria (7.2 +/- 3.8 mg/kg/d), and a relatively low serum phosphorus concentration (5.7 +/- 0.6 mg/dL). This biochemical picture is similar to that seen in phosphorus deficiency except for the low alkaline phosphatase activity. The latter finding, in concert with the high retention of calcium and phosphorus in these balance studies, makes such a diagnosis unlikely. We speculate that this biochemical picture is the result of an inappropriately high calcium/phosphorus ratio. PMID- 3559810 TI - Pathogenesis of early neonatal hypocalcemia: studies of serum calcitonin, gastrin, and plasma glucagon. AB - In 64 maternal-infant pairs, we tested the hypotheses that serum calcitonin, serum gastrin, and plasma glucagon concentrations are elevated in infants at risk for early neonatal hypocalcemia, and that elevated serum gastrin and plasma glucagon result in elevated serum calcitonin and low serum calcium values in neonates. Serum Ca declined significantly in neonates at 24 hours of age, and was inversely correlated with serum calcitonin. Cord serum calcitonin, gastrin, and plasma glucagon concentrations rose significantly at 24 hours of age. Cord calcitonin was significantly higher in preterm compared with term infants, and there was no significant difference between asphyxiated and nonasphyxiated preterm neonates; in term neonates cord calcitonin concentration was inversely correlated with Apgar scores at 1 and 5 minutes. Cord calcitonin was not correlated with cord gastrin or glucagon. Cord and 24-hour gastrin and glucagon values were not related to prematurity; cord glucagon, but not gastrin, was related to birth asphyxia. We conclude that (1) serum calcitonin, gastrin, and plasma glucagon values rise postnatally; cord calcitonin is elevated in preterm and in asphyxiated term infants; serum calcitonin concentration does not correlate with the elevated serum gastrin and plasma glucagon values; and at 24 hours of age, decreased serum Ca is correlated with serum calcitonin, and hence calcitonin might play a role in the pathogenesis of early neonatal hypocalcemia. PMID- 3559811 TI - Inositol supplementation in respiratory distress syndrome: relationship between serum concentration, renal excretion, and lung effluent phospholipids. AB - Inositol or placebo was given to 48 small preterm infants with respiratory distress syndrome (mean birth weight 1365 g, gestational age 30.1 weeks) between 48 hours and 10 days of age. The dose of inositol, 40 mg/kg every 6 hours, was at least as high as amounts received in full preterm human milk feedings. Serum inositol concentration increased between days 2 and 3 from a mean of 566 mumol/L to 823 mumol/L in the infants given supplement and fell from 451 mumol/L to 292 mumol/L in the controls. On day 16, serum inositol values remained higher in the infants given supplement than in those given placebo (mean 334 mumol/L vs 146 mumol/L, P = 0.014). The infants who developed bronchopulmonary dysplasia had significantly higher renal inositol clearance, lower inositol intake, and lower serum inositol concentrations. Inositol supplementation increased the saturated phosphatidylcholine/sphingomyelin ratio in tracheal aspirates. According to these results, supplementation with inositol in preterm infants leads to a rise in serum inositol concentration and improvement in the surfactant phospholipids. Inositol deserves further study as a dietary supplement for immature preterm infants who do not receive full human milk feeds. PMID- 3559812 TI - Dynamic trend monitoring of cerebral blood flow velocity in newborn infants. AB - A method for obtaining reproducible Doppler cerebral blood flow velocity (CBFV) measurements over several hours, utilizing a probe fixation technique and an on line system for making beat-to-beat area under the curve (AUC) measurements, is described. Thirty heartbeat samples were collected at three time intervals over 3 hours in a group of 22 healthy preterm infants. The stability of the AUC measurements despite changes in behavioral state was demonstrated by randomized block ANOVA. The sampling error was +/- 6.92%, with 95% confidence intervals of +/- 13.1%. By facilitating reproducible serial measurements of CBFV, this trend monitoring technique encourages a dynamic view of cerebrovascular control, and may be used to probe central nervous system autoregulatory pathophysiology and to evaluate the effects of therapeutic interventions. PMID- 3559813 TI - Circulating pluripotent hematopoietic progenitor cells in neonates. PMID- 3559815 TI - Nonlinear elimination of benzoate in patients with congenital hyperammonemia. PMID- 3559814 TI - Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. AB - The effect of high orally administered doses of prednisone for 1 week early in the course of an acute exacerbation of asthma incompletely responsive to bronchodilators was examined in 41 patients randomly assigned to receive either prednisone or an identical appearing placebo. All 22 of the patients who received prednisone improved during the week of treatment, although one had a subsequent exacerbation 5 days after discontinuing the study medication. Of the 19 who received placebo, eight required rescue intervention (P = less than 0.004) in association with continued symptoms, increased frequency of metered-dose inhaler use, and decreased pulmonary function; the other 11 improved at about the same rate as those who received prednisone. Although the mean initial FEV1 was suggestively lower among those who did not improve and required intervention, there was considerable overlap with those who improved spontaneously, and no reliable distinguishing characteristics were found at entry into the study that could serve as predictors of those who would or would not improve spontaneously. There were no clinically important adverse effects from the prednisone. Because continued symptoms of asthma often result in emergency care or hospitalization, these data support early intervention with orally administered prednisone for acute exacerbations that do not respond fully to bronchodilators, at least in those patients with a prior history of a protracted course or emergency care. PMID- 3559816 TI - Theophylline versus caffeine: comparative effects in treatment of idiopathic apnea in the preterm infant. PMID- 3559817 TI - Transient chorea induced by phenytoin. PMID- 3559818 TI - Persistence of sleep disturbances in preschool children. AB - The purpose of our study was to determine if common sleep disturbances in young children, such as night waking and bedtime struggle, tend to persist; if they are related to environmental stress factors and are accompanied by other behavior problems; and if their persistence is related to other factors. Sixty children aged 15 to 48 months (mean age 26.4 months) were studied by interviewing their mothers initially and after 3 years. Children with and without sleep disturbances were compared, with the latter serving as the control group. Twenty-five (42%: night waking, 22%; bedtime struggle, 13%; both night waking and bedtime struggle, 7%) of 60 children had sleep disturbances at the initial interview, and of these 25 children, 21 (84%) had persistence of sleep disturbances after 3 years, persistent sleep disturbances had a significant relationship with increased frequency of stress factors in the environment (P less than 0.01). Other generalized behavior difficulties were present in 30% of sleep-disturbed and 19% of non-sleep-disturbed children (P = NS). Co-sleeping (sleeping with a parent or sibling) was noted more frequently in sleep-disturbed (34%) than in non-sleep disturbed (16%) children. Twenty percent of the mothers at initial interview and 30% at 3-year follow-up perceived their child's sleep disturbances as stressful to them and to their family life. Early identification of the child with sleep disturbances and timely intervention would help both the child and the family. PMID- 3559819 TI - Breast-feeding and health. PMID- 3559820 TI - Bioavailability of supplemental iron in commercially prepared dry infant cereals. PMID- 3559821 TI - Consumption of aspartame by heterozygotes for phenylketonuria. PMID- 3559822 TI - Penicillin versus cefadroxil for streptococcal pharyngitis. PMID- 3559823 TI - Ethnic differences in adverse drug reaction reporting. PMID- 3559824 TI - Risk of SIDS in siblings. PMID- 3559825 TI - Simultaneous administration of caffeine and phenobarbitone in infants with apnea. PMID- 3559826 TI - Cactus spine removal. PMID- 3559827 TI - Pupillary abnormalities: light and sight. PMID- 3559828 TI - Analytical challenges of biotechnology. PMID- 3559829 TI - Development of an intravenous formulation for the antiviral drug 9-(beta-D arabinofuranosyl)-adenine. PMID- 3559830 TI - Headspace sampling and analysis of oxygen. PMID- 3559832 TI - A new parenteral vehicle for the administration of some poorly water soluble anti cancer drugs. PMID- 3559831 TI - The difficulties of drawing blood from venous catheters; a hydraulic model. PMID- 3559833 TI - A procedure for validating the sterility of individual gamma radiation sterilized production batches. PMID- 3559834 TI - Lysis of human red blood cells in the presence of various cosolvents. III. The relationship between hemolytic potential and structure. PMID- 3559835 TI - Behavioral intention as an indicator of drug and alcohol use. PMID- 3559836 TI - Can school-based educational programs really be expected to solve the adolescent drug abuse problem? PMID- 3559837 TI - Attempts to dissuade drinkers from driving: the effect of driver characteristics. PMID- 3559838 TI - Alcohol education research and practice: a logical analysis of the two realities. PMID- 3559839 TI - Over-the-counter drug advertising in gender oriented popular magazines. PMID- 3559840 TI - Smokeless tobacco use among adolescents: demographic differences, other substance use, and psychological correlates. PMID- 3559841 TI - Adaptation to diabetes: behavior symptoms and family context. PMID- 3559842 TI - Life stress and diabetic control in children and adolescents with insulin dependent diabetes. PMID- 3559843 TI - "Telling" the child with cancer: parental choices to share information with ill children. PMID- 3559844 TI - Environmental influences and perinatal risk factors in high-risk children. PMID- 3559845 TI - Influence of labeling on ratings of infant behavior: a prematurity prejudice. PMID- 3559846 TI - Munchausen's syndrome by proxy: update. PMID- 3559847 TI - Management of superior oblique palsy after surgery for true Brown's syndrome. AB - Thirty patients requiring surgery for true Brown's syndrome were examined postoperatively. Follow-up ranged from three months to 20 years. Eight-five percent of patients demonstrated some degree of superior oblique palsy, with 54% having a decompensated condition and 30% requiring a second surgical procedure. Patients with marked preoperative restriction appear to be at increased risk for developing a decompensated superior oblique palsy postoperatively. Solutions to this problem are suggested: 1) perform tenotomy at insertion and preserve the adjacent intermuscular septum so a less crippling effect is seen; 2) combine tenotomy with inferior oblique weakening initially in those patients with marked preoperative restriction. PMID- 3559848 TI - Acquired Brown's syndrome from blunt orbital trauma. AB - Blunt trauma to the supero-medial orbit resulted in an isolated Brown's syndrome in two patients. One recovered spontaneously in three weeks; the other had a good outcome after surgery two years post trauma. Recognition of the characteristic motility abnormality and forced duction testing will differentiate this condition from other, more common, motility disorders caused by orbital trauma. Spontaneous resolution may occur but in persistent deviations a superior oblique muscle weakening procedure should be considered. PMID- 3559849 TI - Excision of individual follicles for the management of congenital distichiasis and localized trichiasis. AB - This paper presents a brief review of the literature regarding congenital distichiasis. The literature is confusing regarding the term distichiasis. Distichiasis should be utilized to describe congenital partial or complete accessory rows of eyelashes which exit from the posterior lid margin behind the meibomian gland orifices. The term acquired trichiasis and congenital distichiasis are significantly different. This paper also describes a new method for microscopically dissecting and excising the follicles of distichiatic eyelashes. The technical details of the surgical procedure are described with appropriate illustrations. This procedure can also be utilized for removal of localized areas of acquired trichiasis. The advantage of this procedure over previously utilized procedures for congenital distichiasis is the lower incidence of recurrent distichiatic lashes, combined with complete preservation of normal eyelashes and essentially no risk of cicatricial entropion following this procedure. PMID- 3559850 TI - Progressive hemifacial atrophy (Parry-Romberg disease). AB - Hemifacial atrophy (Parry-Romberg syndrome) is characterized by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissue and fat. The onset is usually in the first two decades. Ophthalmic involvement is common; the most frequent abnormality is progressive endophthalmos with subsequent changes in the palpebral fissure. Pupillary disturbances, heterochromia, uveitis, and restrictive strabismus have also been frequently reported. We describe six cases that manifest a wide spectrum of ocular and systemic findings. They are noteworthy in that all exhibit pigmentary disturbances of the ocular fundus, a finding rarely reported. Another unusual ocular manifestation in one patient was an acquired partial third nerve palsy on the unaffected side. PMID- 3559851 TI - Accommodation in hyperopic and myopic school children. AB - Binocular accommodation of 150 consecutive hyperopic and 150 myopic school children was measured during the eye examination. There were 99 girls and 51 boys in the hyperopic group and 100 girls and 50 boys in the myopic group. The ages varied from seven to 16 years. Accommodation of the hyperopic children varied from 4 to 20 D (mean 10.6 +/- 3.4), and in the myopic children also from 4 to 20 D (mean 10.9 +/- 2.5). The difference between these means was not statistically significant. However, hyperopic girls aged 12 to 16 years showed low values of accommodation (mean 9.0 +/- 2.7) compared to the other corresponding age groups. In the second part of the study the refraction of 80 children, aged seven to 15 years, with decreased accommodation was studied retrospectively to see if they had a tendency to become myopic. The follow-up time was from one to eight years, and the accommodation at the beginning of the observation time varied from 2 to 7 D. The mean annual change of the refraction of these children was from -0.03 to 0.17 D. In 34 children there was no change at all, and in 12 children the change of refraction was slightly toward more hyperopia. Only three of these 80 children became myopic during the observation time. This incidence is lower than the incidence of myopia at these ages. Thus, accommodative power of hyperopic and myopic school children appears to be on the same level, and low accommodation does not predict the development of myopic refraction in the school years. PMID- 3559852 TI - Superior oblique tenotomy in the treatment of isolated inferior oblique paresis. AB - Both tenotomy and tenectomy of the homolateral superior oblique muscle have been advocated as surgical treatment for isolated paresis of the inferior oblique muscle. An iatrogenic superior oblique palsy has been reported to be a frequent complication of superior oblique tenectomy. This complication appears to be less frequent following superior oblique tenotomy. Of 16 consecutive patients with isolated inferior oblique paresis treated by homolateral superior oblique tenotomy and followed an average of 5.0 years (range six months to 11.6 years), only two patients demonstrated a superior oblique palsy postoperatively. Large vertical deviations with spread of comitance, however, required a superior rectus recession of the fellow eye in addition to superior oblique tenotomy. PMID- 3559853 TI - Secondary cataracts in infants after lensectomies. AB - Three infants, one who was two weeks old, and two who were two months old, underwent lensectomy and vitrectomy in a total of four eyes for congenital cataracts by means of an automated suction cutter. Two patients with unilateral opacities underwent combined cataract extraction and epikeratophakia, and one with bilateral congenital cataracts underwent cataract extractions and was fit with extended wear contact lenses. In all cases, the surgery involved at least a 5-mm posterior capsulotomy with a shallow anterior vitrectomy, and was uneventful. Three of the four eyes developed new opacities that required surgical removal three to five months after the original surgery. Cytological evaluation of the specimen obtained from one patient showed this material to be lens epithelium. In all three cases, the material grew without the support of the posterior capsule; in one patient the material appeared to have seeded onto the iris. This previously unreported complication in infants with congenital cataracts who have undergone posterior capsulotomy and anterior vitrectomy emphasizes the need for frequent retinoscopies on such patients. The absence of the posterior capsule does not guarantee that these children will not develop secondary growth of lens epithelium which may obstruct the visual axis. PMID- 3559854 TI - Familial iridoplegia. AB - Fixed, dilated pupils in childhood are usually due to interruption of parasympathetic innervation as a result of neurologic impairments or occur following pharmacologic mydriasis. We present a familial form of iridoplegia without structural defects of the eye which is consistent with a probable autosomal dominant mode of inheritance. Examination of other family members should be part of an affected individual's evaluation particularly when this finding occurs as an isolated defect. Recognition of such an entity may avoid unnecessary neurodiagnostic studies in an affected individual. PMID- 3559855 TI - Barrett's esophagus in children: a histologic and histochemical study of 11 cases. AB - Columnar epithelium-lined esophagus is an acquired phenomenon arising secondarily to chronic mucosal injury from gastroesophageal reflux. This report documents 11 children with complications of reflux and the histologic finding of gastric mucosa in the esophagus. Five children had strictures, one requiring esophageal replacement and four treated by antireflux surgery followed by sleeve-resection of a short fibrotic stricture. Specimens from two patients showed mild dysplasia and from six others slight nuclear atypia. Intestinal metaplasia was apparent in one case on routine histology and was revealed in six other cases by mucin histochemical strains. The significance of the histopathologic findings is discussed in the context of possible malignant potential. PMID- 3559856 TI - Deleterious consequences of gastroesophageal reflux in cleft larynx surgery. AB - Our series of 17 children with laryngotracheal clefts is reported. In three of four cases with a complicated postoperative course, gastroesophageal reflux (GER) has been found. Three breakdowns of the surgical repair opposed to be due to GER. Only one child with a cleft type III died, although a mortality rate of 93% is reported in the literature. GER has to be excluded before tracheoesophageal cleft surgery is undertaken. PMID- 3559857 TI - The extent of muscle hypertrophy in infantile hypertrophic pyloric stenosis does not depend on age and duration of symptoms. AB - There are conflicting views in the literature about the relationship between the extent of muscle hypertrophy in infantile hypertrophic pyloric stenosis (IHPS) and the age of the patient and duration of symptoms. This study was undertaken to elucidate the exact nature of these relationships. The degree of muscle hypertrophy was assessed by measurement of the DNA concentration in biopsy specimens, a technique that has been used to quantify organ hypertrophy objectively and accurately. Forty-one patients were studied prospectively over 12 months. The results show that the degree of hypertrophy is not age-related, and that all the patients tend to progress to about the same degree of hypertrophy, which then remains constant regardless of the duration of symptoms. PMID- 3559858 TI - Abnormal crypts of Morgagni: the cause of perianal abscess and fistula-in-ano. AB - Fistula-in-ano in infants is thought to begin with a cryptitis that proceeds to a perianal abscess. Of 52 patients in 15 years, 51 were male, 45 were under 12 months, 7 had multiple tracts, and 2 recurred in 6 years; all of which points to a developmental anomaly. We believe the anomaly to be a markedly irregular thickened dentate line that harbors from 3 to 13 deep (3 to 10 mm) abnormal crypts (AC), which foster cryptitis. There have been no recurrences since we started doing cryptotomies on these AC in addition to the fistulotomy. The cause may be a defect in the dorsal portion of the cloacal membrane which fuses with the hindgut during the seventh week. PMID- 3559859 TI - The role of intraluminal tension and pH in the development of necrotizing enterocolitis: an animal model. AB - Presented is an in vivo animal model of necrotizing enterocolitis (NEC) in which we used an isolated loop of rabbit colon. Changes in mucosal perfusion and macroscopic and microscopic appearances were studied after exposure of the mucosa to different intraluminal tensions and pHs. Mucosal perfusion was reduced with increasing intraluminal tension and decreasing pH. Histologic changes consistent with NEC were identified after five hours when the mucosa had been exposed to both increased intraluminal tension and decreased pH. Factors affecting intraluminal tension and pH could influence the development of NEC in the neonate. PMID- 3559860 TI - Sequential assay of expired breath hydrogen as a means of predicting necrotizing enterocolitis in susceptible infants. AB - Breath hydrogen levels were investigated prospectively from birth, in a population of neonates at risk of developing NEC. This was standardized to the quantity of carbohydrate in the feed. Children who developed NEC, confirmed radiologically, were compared with matched controls. There was a significant increase in breath hydrogen, in the 24 hours prior to the onset of disease, in index cases as compared with controls. This test may be effective in discriminating between those children who are going to develop NEC and those in whom feeding can be continued safely. PMID- 3559862 TI - Prune belly syndrome associated with exomphalos and anorectal agenesis. AB - We have recently treated a child with prune belly syndrome in association with exomphalos and anorectal agenesis. This case raises the total incidence of exomphalos and anorectal agenesis to four and five, respectively, in our series of 13 cases of prune belly syndrome. Our case report lays emphasis on the severe respiratory problems that can complicate surgery in prune belly patients. We also attempt to relate the pattern of anomalies in our series to the controversy surrounding the embryogenesis of prune belly syndrome and suggest that our case material lends support to the concept of prune belly syndrome being due to an early disturbance of mesodermal development in both the abdominal wall and the urinary tract. We also suggest that the reported occurrence of gastroschisis in association with prune belly syndrome adds weight to the unifying theory of the embryogenesis of gastroschisis and exomphalos. PMID- 3559861 TI - Noninvasive assessment of portosystemic shunting in extrahepatic portal hypertension in rats. AB - A simple reproducible animal model of extrahepatic portal hypertension (EHPHT) has been developed in weanling Wistar rats using a two-stage ligation of the portal vein. This model consistently produces substantial collaterals, both portosystemic (hepatofugal) and portoportal (hepatopetal). Using dynamic hepatic scintigraphy (DHS) with 99mTechnetium sulphurcolloid, hepatopetal collateral flow was measured as the mesenteric fraction (MF) of total hepatic blood flow and compared with measurement of hepatofugal collateral flow (portosystemic shunting) following intraportal injection of radiolabeled microspheres. Strong and significant correlation between the two assessments was found with reduction in MF denoting increased portosystemic shunting (PSS). The technique of DHS has been used successfully in adults to assess compromised portal venous flow and is a simple noninvasive test to aid diagnosis, assessment, and follow-up of children with EHPHT. PMID- 3559864 TI - Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy in children. AB - The possibilities for treating children with renal stone disease by extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) have not been widely explored. We report ten children, aged between 5 and 16 years, treated by PCNL, and six children, aged between 6 and 15 years, treated by ESWL alone. A 16-year-old spina bifida child with a staghorn calculus was treated electively by a combination of the two methods. Hospital stay was 3 to 8 days for treatment by PCNL or ESWL, and was only 11 days for the combination treatment. Complete stone clearance was achieved in 12 children followed for 3 months. No significant complications occurred. ESWL and PCNL are suitable methods for the management of renal calculi in children. PMID- 3559863 TI - Urinary mucoprotein in pediatric urolithiasis. AB - Primary bladder stone is a common pediatric surgical problem in developing countries. Many theories are prevalent. The stone matrix theory is based on increased excretion of its precursor, the uromucoid (the urinary mucoprotein). Uromucoid, studied in urine and stones by the electroimmunodiffusion technique in 49 cases with controls, showed significantly increased excretion in stone cases. Family income and serum protein were the only important influencing factors (negative). Causal relationship between uromucoid excretion, stone matrix, and pediatric bladder stones is discussed. Methylene blue decreased uromucoid excretion but not magnesium oxide, vitamin C or B6 (four common therapeutic drugs for prevention/dissolution of urolithiasis). PMID- 3559865 TI - Long-term follow-up of surgical renal hypertension. AB - A retrospective study of 42 children with hypertension secondary to renal disease is presented. Thirty-three had scarred kidneys, 5 had renovascular disease, 2 had renal venous thrombosis, 1 had an angiomatous malformation of the upper pole of the kidney, and 1 had glomerulonephritis. Twenty-six children were managed surgically. The etiology, presentation, and management are presented. Follow-up varied from 2 to 14 years and the outcome is discussed. PMID- 3559866 TI - Testicular salvage following spermatic cord torsion. AB - There have been several reports indicating that men who have suffered from spermatic cord torsion are likely to have abnormal seminal analyses. It is now well recognized that unilateral spermatic cord torsion can result in contralateral testicular damage. This study was instituted to evaluate possible methods of preventing post-torsion contralateral testicular damage. Experimental torsion was produced in 250 g Wistar rats. The duration of torsion was either 3, 6, or 24 hours. The rats were then treated by one of three methods, namely, detorsion, immediate ipsilateral orchidectomy, or detorsion and adjuvant immunotherapy. Contralateral testicular damage was prevented by immediate ipsilateral orchidectomy and by detorsion with adjuvant immunotherapy. The immunotherapeutic agents administered were either hydrocortisone, azathioprine, or cyclosporin A. The results strongly support the premise that detorsion with adjuvant immunotherapy results in salvage of the ipsilateral testis while preventing contralateral testicular damage. Hydrocortisone is the immunotherapeutic agent of choice because its administration was associated with the fewest complications. PMID- 3559867 TI - Congenital giant megaureter. AB - We have seen 21 patients with unilateral congenital giant megaureter. Age ranged from 2 months to 8 years. This condition is characterized by giant focal segmental ureteral dilatation producing an elongated and distorted ureter; distally there may be congenital ureteral stenosis or atresia, or a ureter of approximately normal caliber. They usually have a dysplastic and disorganized muscular coat, lined with a columnar epithelial mucosa rather than the usual transitional epithelium. The associated kidney or moiety was hypoplastic, dysplastic, or the site of comparatively mild hydronephrosis associated with atrophic renal parenchyma. Function and volume of the bladder was normal. Twelve of 21 patients had a duplex collecting system on the affected side. One patient had four pelves and proximal ureters opening into a single lower ureter, which was the site of a giant cyst. One of eight simple giant megaureters was suspected of being associated with a solitary kidney. Depending on whether the giant segmental ureteral dilatation was multiple or single, these cases have presented either with marked protruberance of the mid and lower abdomen, which was distended by transverse elongated cysts, or with a round cyst mass in the lower abdomen. Nineteen patients treated by excision of the giant megaureter and the associated kidney or moiety were free of symptoms postoperatively. One 4-month old infant with multiple congenital abnormalities and urinary tract infections died soon after operation. Another 4-month-old infant with suspected solitary kidney was treated by ureterostomy and was discharged in a critical condition without follow-up. PMID- 3559869 TI - Elastic fibers in musculature of rectosigmoid colon: normal findings in children and changes in Hirschsprung's disease--a preliminary report. AB - In order to determine the possible implication of elastin in spasticity of the aganglionic segment in Hirschsprung's disease the elastic fibers in the colon at rectosigmoid level were studied in seven surgical specimens of aganglionic bowel and in seven normal controls. Elastic fibers in both the muscle layers of normal bowel are thin, tend to be straight, and follow the line of muscle fasciculi. In aganglionic bowel, however, the fibers are more numerous and thicker in both layers, and in the longitudinal layer they are laid down in spirals. The total elastin content is increased by approximately 100% as compared with controls. These structural and quantitative changes in the elastin may contribute both to the spasticity and to the increased elasticity of the aganglionic segment. PMID- 3559868 TI - Urinary bladder innervation in children. AB - Muscle strips from the fundus, trigone, and distal ureter obtained from children at operation for vesicoureteric reflux were studied using histochemical and immunohistochemical methods, and electrical nerve stimulation in an organ bath. A rich supply of cholinergic nerves was found and the transmitter causing contraction of the detrusor muscle was regarded as being acetylcholine. The adrenergic innervation was very sparse except around the ureteric orifices. No contractile alpha-adrenoceptors could be detected but beta-receptor-mediated relaxation was found. The type was not beta 1 or beta 2, suggesting a third type of beta-receptor. Peptidergic nerves containing vasoactive intestinal peptide (VIP) were demonstrated in a few nerve terminals. No nerves containing enkephalin, somatostatin, or substance P were found. VIP affected the detrusor muscle, indicating a possible role as a modulator of transmitter action. Imipramine, used for enuresis, had no anticholinergic effect on the bladder in the doses used clinically. The anticholinergic and calcium antagonistic drug terodiline inhibited all muscle activity, making it suitable for treatment of diurnal enuresis. PMID- 3559870 TI - Pseudomembranous colitis: a lethal complication of Hirschsprung's disease unrelated to antibiotic usage. AB - Seventy-two new cases of Hirschsprung's disease were seen between 1980 and 1985. Twenty-six patients (36%) developed the clinical features of enterocolitis and, of nine patients who died, colitis was the immediate cause of death in six. Histologic material was available from 20 patients with colitis; this showed nonspecific inflammation typical of Hirschsprung's colitis in 13 cases but seven had pseudomembranous colitis (PMC). Five of the patients with PMC had not recently been exposed to antibiotics. PMC was responsible for three of the six deaths from colitis. All patients with Hirschsprung's disease who develop signs of colitis should have stool testing for Clostridium difficile toxin and should be treated with an antibiotic active against Clostridium difficile. PMID- 3559871 TI - Cytoprotective agents in experimental small bowel volvulus. AB - An accepted experimental model for midgut volvulus was used to produce small bowel strangulation obstruction of 48 hours duration in Sprague-Dawley rats. A 93% perioperative mortality rate resulted after release of the volvulus. Treatment with three cytoprotective agents at the time of volvulus release resulted in the following mortality rates: superoxide dismutase, 89%; ibuprofen, 50%; prostaglandin E1 (PGE1, 11%. The predominant cause of death in all treatment groups was bowel infarction, with a smaller number succumbing to either sepsis or circulatory collapse. Concomitant administration of ephedrine or indomethacin to suppress prostaglandin E1's splanchnic vasodilatory activity did not cause any increase in mortality. A trial of aspirin, to simulate PGE's antiplatelet actions, showed no reduction in mortality when compared with detorsion alone. Prostaglandin E1 and, to a lesser extent, ibuprofen, appear to have cytoprotective effects during reperfusion of bowel compromised by volvulus, independent of their influence on the mesenteric vasculature and thrombogenesis. PMID- 3559872 TI - Sacrococcygeal teratoma: has chemotherapy improved survival? AB - Case records of 57 patients (50 female, 7 male) with sacrococcygeal teratoma who were treated at the Royal Children's Hospital in Melbourne between 1948 and 1986 were reviewed. There were 40 benign and 19 malignant tumors; two patients had malignant recurrence following excision of a benign tumor. The majority of the benign lesions were readily excised; 80% of these patients presented under the age of 6 months. In contrast, 16 of the 19 patients with malignant disease presented after 6 months of age and 12 of these died. Before 1975, malignant lesions were treated with surgery or irradiation, and in a few patients, single agent chemotherapy. No patients survived. In 1970, intensive multiagent chemotherapy was introduced, with planned delayed surgical resection, with or without postoperative irradiation. Three of five patients treated between 1976 and 1980 survive disease-free and are almost certainly cured. Modern therapy is with cisplatin-containing regimens, and while initial responses in six patients with extensive disease are impressive, it is too early to evaluate the impact of these newer programs on cure. PMID- 3559873 TI - Vascular hamartomas in childhood. AB - Vascular hamartomas in childhood may occur in isolation, or in a more generalized form with both cutaneous and visceral involvement. Many isolated hamartomas require no active intervention, but those arising around the eye may seriously compromise developing vision, either by obscuring the visual axis, or by modifying the refractive status of the involved eye. Therefore, lesions in this site demand vigorous treatment if sight-threatening complications are to be avoided. We report our experience in treating 15 children using local steroid injections to accelerate regression of such vascular hamartomas. Seven of the children (46.7%) showed complete regression of their hemangiomas, and only two (13.3%) showed no response to the injections. Intralesional steroid injection seems to be a relatively effective, safe, and nondisfiguring method of dealing with periocular vascular malformations. PMID- 3559874 TI - Day-case ligation of patent ductus arteriosus in premature infants. AB - Over a 3-year period patent ductus arterious (PDA) ligation was performed on a day-case transfer basis on 45 premature infants. The overall survival rate was 93%. We would recommend this practice as an alternative to surgery in the neonatal intensive care unit. PMID- 3559875 TI - [Comparison of 3 immunologic methods of measuring serum levels of digoxin]. PMID- 3559876 TI - [Effect of the interaction between paracetamol and non-ionic surfactants on rectal absorption from suppositories]. PMID- 3559877 TI - [Hypertension and drug therapy]. PMID- 3559878 TI - Contribution of renal active secretion in renal excretion of N4 acetylsulfamonomethoxine in conscious pigs. AB - The contribution of renal active tubular secretion of N4-acetylsulfamonomethoxine (AcSMM) in renal excretion was examined using 3 conscious pigs with permanent ureter cannulae. AcSMM was the main metabolite of sulfamonomethoxine (SMM) in pigs. When AcSMM (100 mg/kg) was intravenously injected, the renal clearance of AcSMM increased with the decrease of AcSMM plasma concentration. Michaelis-Menten kinetics was demonstrated in the renal excretion of AcSMM. It can be concluded that AcSMM is mostly excreted through active tubular secretion. The decrease of renal clearance of AcSMM may be thought as the causal factor of nonlinear plasma kinetics of SMM in pig. PMID- 3559879 TI - Age-dependent changes in warfarin tissue distribution. AB - Whole blood levels, serum protein binding and tissue concentration following intravenous administration of warfarin were investigated in 1-d-old, 1-, 3- and 8 week-old rats to determine the drug disposition in the growth process. It was shown that the clearance of warfarin in 1-d-old or 1-week-old rats was considerably lower than that in 3- or 8-week-old rats. The decrease in clearance in infant and young rats was considered to be caused by the immaturity of the physiological function of the liver to remove exogenous compounds. The distribution volume in 1-d-old or 1-week-old rats was larger than that in 3- or 8 old rats. The percentages of serum free warfarin in 1-d-old and 1-week-old rats were about twice those in 3- and 8-week-old rats. The increased distribution volume in infant rats was considered to be caused by a lower serum protein binding in these rats. PMID- 3559880 TI - Influence of beta-lactam antibiotics on platelets. I. In vivo effects of latamoxef and related beta-lactam antibiotics on membrane proteins and glycoproteins of rat platelets. AB - The effects of latamoxef (moxalactam) and the other beta-lactam antibiotics on platelet membrane were studied by intravenous administration of these drugs to rats for 8 d. Blood was taken from the abdominal aorta and washed platelets were prepared by centrifugation. Platelet membrane proteins labeled with 125I and the glycoproteins with 3H were used and analyzed by electrophoresis. Differences of membrane proteins and glycoproteins, compared with the control, were not observed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and two dimensional electrophoresis. PMID- 3559881 TI - Autoinduction of 450191-S, a new sleep inducer of 1H-1,2,4-triazolyl benzophenone derivative, in dogs. AB - Alterations of plasma metabolite profiles were studied following single or multiple oral administrations of 5-[(2-aminoacetamido) methyl]-1-[p-chloro-2-(o chlorobenzoyl)phenyl]-N, N-dimethyl-1H-1, 2,4-triazole-3-carboxamide hydrochloride dihydrate (450191-S) in Beagle dogs. In plasma, unchanged 450191-S was not detected, but active metabolite, 8-chloro-6-(2-chlorophenyl)-2-(N, N dimethylcarbamoyl)-4H-1,2, 4-triazolo [1, 5-a] [1, 4] benzodiazepine (M-1) appeared first, followed by four active metabolites that were hydroxylated or demethylated in the N, N-dimethylcarbamoyl side chain of M-1. At single doses of 5 to 50 mg/kg, the areas under the plasma concentration-time curves (AUCs) of the metabolites were linearly increased, showing that there was no saturable process in the steps of absorption, distribution, metabolism and excretion. After multiple administrations (50 mg/kg/d for 15 d), the same metabolites appeared in the plasma but the patterns of the plasma metabolite profiles were considerably different from those after single administrations. The peak plasma levels of M-1 and its hydroxylated metabolites in the carbamoyl side chain were attained more rapidly in the multiple administrations, demonstrating higher peak values compared to those in the single administrations, and the eliminations of these metabolites from plasma were also rapid. However, no difference in the values of the AUCs were observed between single and multiple administrations. With the other active metabolites, the peak plasma levels after multiple administrations were considerably lowered by rapid elimination, resulting in a marked increase in AUCs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559882 TI - Conjugation of salicylamide in the intestinal wall of dogs and rabbits. AB - The intestinal conjugation of salicylamide (SAM) the formation of SAM sulfate (SAMS) and SAM glucuronide (SAMG) were investigated in dogs and rabbits by using in situ intestinal sac preparation with mesenteric vein cannulation. SAM, SAMS and SAMG in the mesenteric venous blood, sampled at successive intervals after injection of SAM solutions into the sac, were determined. Total recoveries in 1 h were not significantly different in dogs (71%) and rabbits (64%). Both animals, however, showed a quantitative difference in intestinal conjugation. Sulfation predominated over glucuronidation in dog intestine while the formation of the glucuronide was exclusively high in rabbit intestine. Furthermore, the dose dependent conjugation of SAM was investigated in dog intestine at four doses, 2, 3, 6 and 10 mg/one animal. Upon increasing the doses from 2 to 10 mg, the amounts of SAMS appearing in the blood remained unchanged, those of SAMG increased about two times and those of free SAM increased about six times, while the total recoveries increased parallel to the doses, suggesting saturation kinetics in the formation step of the two conjugates. Simultaneous computer-fitting of the experimental data for 2 and 10 mg doses to a simplified model, containing Michaelis-Menten kinetics in the formation of the conjugates, was examined and good agreement between the observed data and the theoretical values was obtained. PMID- 3559883 TI - Effect of taurine and homotaurine on bile acid metabolism in dietary hyperlipidemic rats. AB - The effects of taurine (2-aminoethanesulfonic acid) and its homologue, homotaurine (3-aminopropanesulfonic acid), on biliary and fecal excretion of bile acids were investigated in dietary hyperlipidemic rats. Taurocholic acid was a major component in the bile of rats on laboratory chow and the ratio between glycine and taurine conjugated bile acids (G/T ratio) was 0.14. In feces, more free bile acids were present than in bile and the G/T ratio increased to 1.49. The biliary bile acid level increased approximately 2-fold in rats fed a diet containing 0.5% cholesterol and 1.0% cholic acid for 10 days. The glycine conjugated bile acid level increased approximately 7.5-fold, so that the G/T ratio was reversed to 1.17. the level of fecal bile acids increased approximately 19-fold while the G/T ratio remained at 1.43. Taurine or homotaurine (500 mg/kg/d each) was orally administered for 10 d concurrently with the cholesterol diet. Taurine suppressed elevation in the glycine conjugated bile acid level so the bile acid composition was roughly similar to that of the rats on laboratory chow and the G/T ratio became 0.06. In fecal excretion, the bile acid level increased significantly 1.2-fold over that of the control and the G/T ratio was 0.45. Homotaurine did not significantly alter the biliary bile acid level or the composition. These results indicated that taurine stimulated the excretion of bile acids, resulting in a reduction in serum cholesterol. Homotaurine did not influence bile acid metabolism. PMID- 3559884 TI - The inhibition of acetylcholinesterase by ranitidine: a study on the guinea pig ileum. AB - The present work was performed to investigate if the stimulating effect of ranitidine on the intestinal smooth muscle is connected with a possible inhibition of the acetylcholinesterase. Isolated segments of guinea pig ileum were used in Tyrode solution at 37 degrees C. The maximum activity of ranitidine on the ileum was about 79% of the maximum activity of acetylcholine and about 90% of the maximum activity of physostigmine. The contractile responses induced by ranitidine were prevented by atropine and this prevention was stronger against physostigmine. Ranitidine produced an augmentation of the acetylcholine induced contractions which was less against physostigmine. The contractile responses induced by acetylcholine were prevented by acetylcholinesterase. This acetylcholinesterase activity was inhibited by ranitidine and this inhibition was weaker than that caused by physostigmine. These findings suggest that ranitidine exerts at least an anticholinesterase activity which is weaker against physostigmine. PMID- 3559885 TI - Both hydroxy- and methoxyindoles modify basal temperature in the rat. AB - The various pineal gland tryptophan metabolites were administered to male rats intraperitoneally (100 micrograms/kg) and rectal temperatures were recorded. Of the compounds tested, hydroxytryptophan, N-acetylserotonin, hydroxytryptophol, and their corresponding methoxyindoles all caused a marked hypothermia, indicating that several indolic products may be involved in thermoregulation. Although the brain penetration of indoles is poor, a central site of action would be most likely, although peripheral actions cannot be excluded. The mechanism of induction of hypothermia may involve peptides, the pituitary-thyroid axis, the adrenal gland, or a combination of these. These results may suggest that the pineal gland integrates environmental cues to act in concert with physiological thermostats in the fine tuning of thermoregulation. PMID- 3559886 TI - Investigation of circadian rhythms for pineal 5-hydroxytryptophol and other indoles in the rat. AB - 5-hydroxytryptophol (5HTL) occurs in the pineal gland of the rat at levels comparable to those of melatonin, yet few studies have been conducted to investigate 5HTL as a potential alternative pineal hormone. In this study the pineals of 90-day-old male Sprague Dawley rats have been assayed by high performance liquid chromatography coupled with electrochemical detection. Significant (P less than .0001) circadian variation was measured in 5HTL levels, and a fivefold plateau elevation occurred during the middle of the light period. By comparison with the timing of the variations in N-acetyl serotonin and melatonin levels, it is suggested that 5HTL may not be regulated by simple competition with N-acetyl transferase for the common substrate 5HT but may, in fact, be regulated independently. Literature supporting such a suggestion, and a model incorporating it, are presented for discussion. PMID- 3559887 TI - Ultrastructural demonstration of exocytosis in the pineal gland. AB - Granular vesicles are present in pinealocytes and in rudimentary photoreceptor cells of many vertebrates, sometimes in large amounts. Their dense cores have been shown to store proteinaceous compounds, but the way they are released remains speculative. The aim of this study was to demonstrate whether or not exocytosis is the mechanism by which secretory products stored within granular vesicles are released. Therefore, a method has been used allowing a clear ultrastructural study of secretory products by exocytosis, even in tissues in which this process of secretion is quite rare and/or very slow. Exocytotic figures have been clearly demonstrated in the three species studied: golden hamster, snake, and parakeet. Nevertheless, they were never commonly observed as it was the case in neurohypophysis, even in such animals as the parakeet and snake, in which granular vesicles are very numerous. The possible reasons of this observation are discussed. PMID- 3559888 TI - Detailed diurnal rhythm of sensitivity to melatonin injections in Turkish hamsters, Mesocricetus brandti. AB - A diurnal rhythm of sensitivity to exogenous melatonin was defined in adult male Turkish hamsters, Mesocricetus brandti. Melatonin was administered daily by subcutaneous injections (15 micrograms in 0.1 ml 10% ethanolic saline) for 10 weeks in animals exposed to 16 L:8 D. As in golden and Djungarian hamsters, two periods of melatonin sensitivity were identified. The first, in late afternoon, persisted for 6 hr, from 7 hr to 1 hr before lights off. The second period was briefer, of only 2 hr duration in the late night, terminating at the time of lights on. Melatonin injections given during these sensitive periods promoted testicular regression in most animals; melatonin administered at other times of the day was without effect on testicular function in most animals of these groups. Gonadal regression induced by properly timed melatonin injections was rapid, in many groups nearly complete in 6 to 7 weeks. The results are discussed in relation to the function of pineal melatonin in photoperiodic time measurement in hamsters. PMID- 3559889 TI - Production of methoxyindoles in vitro from methoxytryptophan by rat pineal gland. AB - Pineal glands were incubated in the presence of [3H] methoxytryptophan with and without methoxamine, epinephrine, and norepinephrine. The beta-adrenoceptor stimulated pineal glands were capable of converting methoxytryptophan to methoxytryptamine, melatonin, methoxyindole acetic acid, and methoxytryptophol, albeit in small quantities. Only methoxyindole acetic acid was detectable after incubation of unstimulated and alpha-adrenergic-agonist-treated pineal glands. These results support the proposal that melatonin can be formed from methoxytryptophan although this is a minor synthetic pathway, and the classic pathway from serotonin via N-acetylserotonin should be considered to be responsible for the majority of pineal melatonin production. PMID- 3559890 TI - [3H] melatonin binding in membrane and cytosol fractions from rat and calf brain. AB - The binding characteristics of the tritiated pineal hormone, [3H] melatonin, were studied in brain tissues using in vitro binding techniques. In synaptosomal membranes prepared from rat hippocampus and subjected to preincubation at 37 degrees C and multiple washings, high-affinity binding of [3H] melatonin significantly exceeds that previously reported for membrane or cytosol fractions from mammalian brain. Scatchard analysis of saturation binding data indicates that binding affinities are similar in membrane (Kd = 15 nM) and cytosol (Kd = 11 nM) preparations. However, binding is about sevenfold greater in membranes than in cytosol prepared by centrifugation of homogenates at 104,000g for 60 min. Specific binding is also present in both particulate and soluble fractions from calf brain. Inhibition experiments, in rat hippocampal membranes, indicate that norepinephrine is the most potent inhibitor of about 55% of total binding. Serotonin also exhibited high affinity for about 25% of total binding, suggesting that [3H] melatonin labels both adrenergic and serotonergic sites in this brain region. Further studies are required to characterize the serotonergic and adrenergic sites labelled by [3H] melatonin and to determine whether these sites are functionally important receptors for melatonin. PMID- 3559891 TI - The pattern of motor activity, light, and melatonin production in Syrian hamsters. AB - To investigate the motor rhythm of the Syrian hamster under natural photoperiod and to relate these findings to pineal rhythm, animals were left undisturbed in metabolic cages in which stabilimeter systems registered motor activity, photovoltaic cells registered light intensity, and in which urinary output was used for the assay of the major melatonin metabolite 6-sulphatoxymelatonin. The motor activity of two animals was monitored during 1 month and showed a striking similarity. Melatonin secretion was measured during 3 consecutive days and showed a night/day ratio in both animals that was relatively constant and that was coupled to the diurnal rhythm of the animals' activity. PMID- 3559892 TI - Constructing causal scenarios: a knowledge structure approach to causal reasoning. AB - A model of causal reasoning based on Schank and Abelson's (1977) analysis of knowledge structures is presented. The first part of this article outlines the necessary characteristics of such a model. It is argued that a central attributional problem is to explain extended sequences of behavior. To do this people must relate actions in a sequence to one another and construct a coherent scenario from them. Because the relation among actions is not given, people must use detailed social and physical knowledge to make connecting inferences. The resulting scenario typically includes information about the plans and goals of the actor. The second part of this article analyzes how the knowledge structures outlined by Schank and Abelson (1977)--scripts, plans, goals, and themes--can be used to construct such causal scenarios, and it presents a process model for the construction of such scenarios. The last part of this article examines the implications of this model and its relations to other attribution models by Kelley (1967, 1971a, 1971b) and Jones (Jones & Davis, 1965; Jones & McGillis, 1976). PMID- 3559893 TI - Accuracy of person perception: do people know what kinds of impressions they convey? AB - Do people know what kinds of impressions they convey to other people during particular social interactions? In a study designed to answer this question, subjects interacted individually with three partners on each of four different tasks. After each interaction, participants reported their impressions of the other person's likability and competence. They also postdicted the impressions they believed they conveyed to the other person along the same dimensions. Accuracy was computed as recommended by Cronbach (1955) and by Kenny's (1981) Social Relations Model. Subjects could tell to a significant degree how the impressions they conveyed to their partners changed over time (time accuracy) and how they changed over time in different ways with different partners (differential accuracy). They could also tell how their competence was differentially perceived by different partners (dyadic accuracy). However, they were not very accurate at discerning which partners perceived them as most competent or most likable across all interactions (person accuracy). Subjects believed that they conveyed similar impressions of themselves to all of their partners, although actually partners evidenced little agreement with each other in their impressions of a given subject. The implications of these findings for symbolic-interactionist theories of the development of the self and impression management perspectives on social behavior are described. PMID- 3559894 TI - An attributional analysis of excuse giving: studies of a naive theory of emotion. AB - We conducted four studies that pertained to excuses given for a broken social contract. In an initial field investigation, participants recalled occasions in which they had given true and false reasons for not fulfilling a social obligation. Communicated reasons tended to be external to the person, uncontrollable, and unintentional (e.g., "My car broke down"), whereas withheld reasons tended to be internal, controllable, and either intentional (e.g., "I did not want to go") or unintentional (e.g., "I forgot"). The external uncontrollable excuses were anticipated to lessen the anger of the wronged party. In a subsequent simulation study, excuses based on the categories detected in Experiment 1 were manipulated and related to anger ratings. The same pattern of results was displayed, with intent and negligence provoking the highest anger ratings. The final two studies involved laboratory manipulation of a communicated reason for coming late to an experiment. In Experiment 3, a confederate conveyed either an internal controllable, an external uncontrollable, or no reason for making a subject wait, whereas in Experiment 4, subjects were detained and created their own good, bad, any, or no excuse for being tardy, which was communicated to a second, waiting subject. A consistent pattern of good excuse/external uncontrollable reason and bad excuse/internal controllable reason was displayed; offering no excuse resulted in the same judgments as giving a poor excuse. Relative to the external uncontrollable reasons, internal controllable excuses for being late augmented aversive emotional reactions, increased negative personality ratings, and resulted in a desire for no further social contact.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559895 TI - Monitoring and blunting: validation of a questionnaire to assess styles of information seeking under threat. AB - Subjects were divided into information seekers (high monitors)/information avoiders (low monitors) and distractors (high blunters)/nondistractors (low blunters) on the basis of their scores on a self-report scale to measure coping styles, the Miller Behavioral Style Scale (MBSS). In Experiment 1, subjects were faced with a physically aversive event (the prospect of electric shock). High monitors and low blunters chose to seek out information about its nature and onset whereas low monitors and high blunters chose to distract themselves. This effect was strongest with the blunting dimension. High monitoring and low blunting were also accompanied by sustained high anxiety and arousal. In contrast, low monitors and high blunters were able to relax themselves over time. In Experiment 2, subjects worked on a series of tests that presumably predicted success in college. They could attend as often as they wished to a light that signaled how well they were performing. Results showed that coping-style scores accurately predicted informational strategy, particularly with the monitoring dimension: High monitors tended to look at the light whereas low monitors tended to ignore it. Thus the MBSS measure of coping styles appears to be a valid instrument for predicting behavioral strategies in response to both physical and psychological stressors. The theoretical and practical implications of these findings are discussed. PMID- 3559896 TI - Depression and pessimism for the future: biased use of statistically relevant information in predictions for self versus others. AB - The cognitive theories of depression emphasize the role of pessimism about the future in the etiology and maintenance of depression. The present research was designed for two reasons: to provide a clear demonstration that depressed individuals' predictions of the likelihood of future outcomes are more pessimistic than those of nondepressed individuals given identical information with which to make forecasts and identical conditions for forecasting, and to test two additional hypotheses regarding possible mechanisms underlying depressives' relative pessimism in forecasting: a social-comparison and a differential attributional-style hypothesis. We used a modification of the cue use paradigm developed by Ajzen (1977, Experiment 1) and examined depressed and nondepressed people's predictions of the likelihood of future positive and negative outcomes for themselves and for others. The results provided strong support for pessimism on the part of depressed individuals relative to nondepressed individuals in forecasts for both self and others. In addition, whereas nondepressives exhibited a self-enhancing bias in which they overestimated their probability of success and underestimated their probability of failure relative to that of similar others, depressives did not succumb to either positive or negative social comparison biases in prediction. Finally, in line with the attributional-style hypothesis, depressed-nondepressed differences in subjects' cue-use patterns were obtained, especially in forecasts for self. The findings are discussed with respect to the mechanisms underlying predictive optimism and pessimism and the possible functions and implications of these predictive biases. PMID- 3559897 TI - Vulnerability to depressive mood reactions: toward a more powerful test of the diathesis-stress and causal mediation components of the reformulated theory of depression. AB - To provide a more powerful test of the diathesis-stress component of the reformulated theory of depression (Abramson, Seligman, & Teasdale, 1978), we extended and refined the Metalsky, Abramson, Seligman, Semmel, and Peterson (1982) study and examined whether the content of college students' attributional styles (hypothesized attributional diathesis) as measured at Time 1 interacted with the outcomes students received on a class midterm exam to predict their subsequent depressive mood responses. In addition, to test the mediation component of the theory, we examined whether the relation between the hypothesized attributional diathesis and failure students' subsequent depressive mood responses to their low midterm grades was mediated by the particular causal attributions these students made for their low grades. The results partially corroborated the current statement (Abramson, Alloy, & Metalsky, 1986; Abramson, Metalsky, & Alloy, 1986a, 1986b) of the diathesis-stress component of the theory. Whereas students' immediate depressive mood reactions were predicted solely by the outcomes they received on the class midterm exams, their enduring depressive mood reactions were predicted solely by the hypothesized Attributional Diathesis X Outcome on Midterm Exam interaction. The direction and form of the interaction were in line with prediction. The results fully corroborated predictions derived from the mediation component of the theory as they applied to students' enduring mood responses. PMID- 3559898 TI - Differences between traits: properties associated with interjudge agreement. AB - The present study concerns the relation between properties of personality traits and the agreement with which they are applied to real individuals. Subjects rated the 100 personality items of the California Q-Set on nine subjective dimensions, six of which loaded highly on a first principal component. This factor was interpreted as reflecting each trait's "easy visibility" to an outside observer. Actual interjudge agreement in applying each trait to real individuals was assessed in two ways: Self-other agreement was assessed in two independent samples, and interpeer agreement was assessed in three samples. Impressive and stable agreement was found for most Q items. The traits that were applied to individuals with the greatest interjudge agreement were the same ones that seemed most easily visible and tended to be positively relevant to extraversion and negatively relevant to neuroticism (identified through a factor analysis by McCrae, Costa, & Busch, 1986). The results suggest that traits defining extraversion are revealed relatively directly in social behavior and, therefore, are easy to judge, that traits defining neuroticism are less visible and, so, are judged less accurately, and that lay perceivers of personality are generally sensitive to this difference between traits. PMID- 3559899 TI - Judgment of contingency: cognitive biases in depressed and nondepressed subjects. AB - In this research I investigated whether the use of relevant affective outcomes influences depressed and nondepressed subjects' judgment of contingency. Similar to previous studies (Alloy & Abramson, 1979, Experiments 1 and 2), Experiments 1 and 2 confirmed that when the outcome is affectively neutral (i.e., the onset of a light) depressed subjects make accurate judgments of contingency, whereas nondepressed subjects show (in noncontingent situations) a significant illusion of control. In Experiments 3 and 4 (a contingency situation and a noncontingency situation, respectively) different types of sentences (negative self-referent, negative other-referent, positive self-referent, positive other-referent) were used as outcomes. Although depressed subjects were more reluctant to show biased judgments than were the nondepressed subjects, in noncontingency situations depressed subjects made overestimated judgments of contingency when the outcomes were negative self-referent sentences. Results are discussed with regard to current cognitive theories of depression, particularly the learned helplessness model. PMID- 3559900 TI - [Synthesis and pharmacological activity of 2,3-dihydro-1H-pyrazolo-[1,2 a]indazolium derivatives]. PMID- 3559901 TI - [Synthesis and antiinflammatory activity of pyrido[4,3-e]-1,2-thiazine-3 carboxamide derivatives]. PMID- 3559902 TI - [Studies on isosorbide dinitrate. I. Determination of isosorbide dinitrate in human plasma by capillary column gas liquid chromatography]. PMID- 3559903 TI - [Mode of action of O-phosphoethanolamine as colony inhibitory material for mouse bone marrow cells]. PMID- 3559904 TI - [Synthesis and pharmacological activity of 3-phenylindazole derivatives]. PMID- 3559905 TI - [Mouse melanoma antigen. Its immunological properties, partial structure and genes]. PMID- 3559906 TI - [Possible utility of beta-cyclodextrin complexation in the preparation of biphenyl acetic acid suppositories]. PMID- 3559907 TI - [Preparation of sustained-release granules of nifedipine using a solid dispersion system and pharmacokinetic study after oral administration to rabbits]. PMID- 3559908 TI - [Antiulcer activity of extracts and isolated compounds from zedoary (gajutsu) cultivated in Yakushima (Japan)]. PMID- 3559909 TI - [High performance liquid chromatographic method for the determination of ticlopidine in human serum]. PMID- 3559910 TI - [Effects of salicylic acid and salicylamide on sulfisoxazole disposition in rabbits]. PMID- 3559911 TI - [The heptose region of lipopolysaccharides of Pasteurella multocida]. AB - The heptose region of the lipopolysaccharides (LPS) of Pasteurella multocida consists of the trisaccharide L Hep 1----2 L Hep 1----3 L Hep or L Hep 1----3 L Hep 1----2 L Hep. This trisaccharide and the oligosaccharide consisting of 3 moles heptose and 1 mole glucose were isolated from the LPS of the strain D 33. The data suggest that the LPS biosynthesis of P. multocida is different from that of Salmonella spp. PMID- 3559912 TI - Adhesion and phagocytosis of Staphylococcus aureus L-forms. AB - Electron microscopical investigations on in vitro and in vivo interactions of normal Staphylococcus aureus cells with rat peritoneal macrophages showed that these bacteria were rapidly endocytosed and digested even in the absence of specific antibodies. In contrast to the parental strains oxacilin-induced and stable variante lacking a cell wall (L-forms) were ingested without subsequent formation of phagolysomes and digestive vacuoles. The intracytoplasmic L-form bodies retained their characteristic ultrastructure, i.e. no visible alterations occurred. Some morphological aspects of the L-forms and their persistence in macrophages 7 days after intraperitoneal administration of L-form to rats, suggest the possibility of their intracellular survival. PMID- 3559913 TI - Effect of dietary fats and proteins on drug metabolism. AB - Rats were given diets ad libitum which varied in the amount (5 or 15%) and kind of fat [coconut oil (CNO) vs corn oil (CO)]. Animals were injected either with hexobarbital or pentobarbital and sleeping time was recorded. With animals eating a low fat diet, there were slight differences between the CNO vs CO groups. At the higher fat level, animals receiving the polyunsaturated diet slept more than twice as long as compared to animals eating a diet with saturated oil. Simultaneous injection with carbon tetrachloride significantly increased the sleeping time between the two dietary fat groups. Also, the kind of protein and level of fat in the diet had an influence on sleeping times. It was concluded that both the quality and quantity of fat as well as the quality of the protein can influence drug metabolism. PMID- 3559914 TI - Role of dietary corn oil in the function of hepatic drug and carcinogen metabolizing enzymes of starved-refed rats: response to the mixed function oxidase inducer, 3-methylcholanthrene. AB - Hepatic microsomes from rats starved 48 hours and refed diets containing zero, 3 or 20% corn oil metabolized benzo(a)pyrene, aniline and N-nitrosodimethylamine in proportion to the quantity of corn oil in the diet. No diet-related changes in apparent Km for these reactions were evident. The content of microsomal cytochrome P-450 was also clearly dependent upon the content of corn oil in the refed diets. When metabolism of these three substrates is expressed as product formed per unit of cytochrome P-450, the activities are least in microsomes from rats fed the 20% corn oil diet, suggesting that P-450 species responsible for metabolizing substrates other than these are enhanced preferentially. Cytosolic glutathione S-transferase activities are also increased with increasing corn oil in the diet. The administration of 3-MC increased cytochrome P-448 content of microsomes from all rats, regardless of diet, however highest content was present in microsomes from rats fed the 20% corn oil diet. Induction of benzo(a)pyrene hydroxylase was not influenced by dietary corn oil and, as anticipated, 3-MC caused significant repression of DMN N-demethylase in microsomes from rats fed the 20% corn oil diet. In like manner, 3-MC induced glutathione S-transferase only in cytosol from rats fed the fat-free diet. PMID- 3559915 TI - Effect of copper sulphate on alpha-ketoglutarate metabolism in the digestive gland of the snail host, Lymnaealuteola. AB - Significant drop in the size of fuel depots was noted in copper sulphate treated snails. Free amino acid levels dropped and lactate level increased. The effects of copper treatment on rates of fuel oxidation and ammonia production in the presence of exogenously added alpha-ketoglutarate were evaluated. 92% drop in Kg dh complex activity, 33% drop in Alanine amino transferase (ALAT) activity with 78% rise in Glucose-6-phosphatase activity were recorded. Results were discussed in relation to metal ion binding with proteins and its inhibitory effect on alpha Kg dh complex enzyme activity. Molluscicidal activity of copper was found to be due to metabolic block in the TCA cycle at the alpha-ketoglutarate level. PMID- 3559916 TI - Ultrastructural effects of DDT on cells grown in vitro. AB - In vitro administration of DDT at 0.5 ppm, 10 ppm, and 50 ppm (0.5, 10 and 50 micrograms/ml culture medium) to HeLa S, human amnion (HA-FL), canine venereal tumor (CVT), canine kidney (MD-CK) and rat nephroma (RN) cells resulted in alterations of the ultrastructure of cells. Responses to the cytotoxic chemical compound were qualitatively and quantitatively similar among all mammalian cell lines tested. The tested cells exhibited dose-specific responses. Al low dose (0.5 ppm) rough endoplasmic reticulum and free ribosomes increased as did the number and size of smooth endoplasmic reticulum profiles. At higher doses (10 ppm and 50 ppm) there was indication of cellular degradation including mitochondrial disorganization, nuclear heterochromatic condensation and peripheralization, and increases in numbers of lysosomes, autophagic vacuoles and multivesicular bodies. This suggests that low level exposure to cytotoxic elements such as DDT initiates a repair and regeneration response from the cells while degenerative changes at higher exposure levels suggest less success with detoxification and possible irreversible cellular damage. PMID- 3559917 TI - Concentrations of lead, cadmium, mercury and other elements in seeds of Lupinus mutabilis and of other legumes. AB - Several species of legumes and varieties of lupins were examined for their heavy metal content in the seeds. Atomic absorption spectrometry was the main analytical tool. Validity and reproducibility of the results was checked by analyzing the same materials at two different laboratories performing the same technique. Additionally, inductively coupled plasma emission spectroscopy was applied. In grains of Lupinus mutabilis which constitute a traditional food in Andean populations, the following contents of heavy metals were determined: 0.10 0.25 microgram/g Cd; 0.5-1.6 microgram/g Pb; 0.10-0.15 microgram/g Hg. Seeds of other legumes contained 0.05-0.35 microgram/g Cd; 0.1-0.2 microgram/g Pb; 0.01 0.04 microgram/g Hg. The high lead content of lupins is easily reduced to one tenth by traditional extraction with boiling water. The mercury content, too, is decreased by this technique. The high manganese content of 1 300-1,400 micrograms/g of Lupinus albus compared to other legumes (25-37 micrograms/g) seems to be characteristic for this species and may be of nutritional significance. The comparison of the heavy metal contents of legume seeds of different origin and variety indicates a complex pattern of environmental and genetic factors that contribute to the specific metal contents of individual harvests. On the level of varieties the environmental factors (climate, soil, geology, agricultural techniques) seem to exhibit more important influences on the specific accumulation of heavy metals than genetic factors. In contrast, on the level of species or genera, the accumulation of heavy metals seems to be dominated by genetic factors rather than by environmental influences. PMID- 3559918 TI - The effects of short term diazinon exposure on blood clotting activity in the rat. AB - Female rats were exposed to a drinking solution containing 157 parts per million (ppm) of the organophosphate insecticide diazinon for 14 days. Plasma samples were assayed for prothrombin time (PT), partial thromboplastin time (APTT), hematocrit (HCT), platelet count (PLT) and clotting times for coagulation factors I (Fibrinogen), II, V, VII, VIII, X and XII. Significant change following ingestion of diazinon were noted for the PT, APTT, Fibrinogen, factors II, VII, VIII, X, XII and hematocrit. The data suggest that in the rat, diazinon ingestion has a direct effect on the clotting activity of various blood coagulation parameters. PMID- 3559919 TI - Bipyridylium herbicide toxicity: effects of paraquat and diquat on isolated rat hepatocytes. AB - Paraquat (1,1'-dimethyl-4,4'-bipyridylium) and diquat (1,1'-ethylene-2,2' bipyridylium) are the two most widely used bipyridylium herbicides today. Both compounds, however, have also been found to cause liver damage in animals and man. In this study, isolated rat hepatocytes were used to assess the cytotoxicity of these two compounds. Five indices of cell damage were used to quantitate cytotoxicity: dye (trypan blue) uptake, loss of cell respiration, the extracellular release of lysosomal enzymes, the formation of thiobarbiturate (TBA)-reacting substances, and the oxidation of cellular NADH and NADPH. Diquat was shown to be more toxic than paraquat toward these cells in the first three assay systems. The acute LC50 for diquat was determined to be 80 mM, whereas the acute LC50 for paraquat was estimated to be greater than 1 M. This difference in cell sensitivity could be explained, at least in part, by the observed differences in herbicide uptake rates for these two compounds. Diquat uptake was calculated to be 9.0 +/- 1.1 nmoles/hour/10(6) cells, whereas paraquat uptake was only 5.5 +/- 0.5 nmoles/hour/10(6) cells. The dose-response curves for enzyme release and loss of cell respiration superimposed the lethality curves for both compounds. An oxidative mechanism of cytotoxicity was suggested for diquat by: the establishment of both a concentration-dependent and a time-dependent increase in lipid peroxidation (formation of TBA-reacting substances); complete oxidation of both NADPH and NADH at herbicide levels less than the LC50; and the finding that diquat stimulated glucose oxidation at subtoxic doses. PMID- 3559920 TI - Single pass mean residence time in peripheral tissues: a distribution parameter intrinsic to the tissue affinity of a drug. AB - The single pass mean residence time in peripheral tissues, tp1, is a characteristic constant of linear pharmacokinetic systems and nonlinear systems with linear distribution kinetics. It is descriptive of distribution kinetics in such systems and is not dependent on elimination kinetics as are other related parameters, e.g., mean residence time in peripheral tissues, tp. Equations are derived which permit estimation of tp1 from experimental data for systems in which no peripheral elimination occurs. The type of data required are systemic drug levels resulting from iv administration. The probability density function for single pass residence time in peripheral tissues is derived. It is shown that tp1 is related to the amount of drug in the peripheral tissues at steady state according to (Ap)ss = CLdCsstp1, where CLd is the distribution clearance, and Css is the steady-state systemic drug level. Values of tp1 are presented for several drugs. PMID- 3559921 TI - Pharmacokinetics of morphine and its surrogates. VIII: Naloxone and naloxone conjugate pharmacokinetics in dogs as a function of dose and as affected by simultaneously administered morphine. AB - Reversed-phase HPLC assays with electrochemical detection, developed to quantify naloxone, 6 beta-naloxol, and their hydrolyzed conjugates in biological fluids provided assay sensitivities of 10 to 20 ng/mL in plasma, urine, and bile. These fluids were monitored in dogs after iv bolus administrations of 0.47 and 4.7 mg/kg of naloxone. Plasma concentration-time data were well fitted by the sums of two exponentials with two sequential half-lives of 11 +/- 1 (SEM) and 56 +/- 3 min. Pharmacokinetics were dose-independent; total and renal clearances were 1334 +/- 133 mL/min and 42 +/- 9 mL/min, respectively, with a renal clearance of 65 +/ 5 mL/min for the conjugate. The percentage of the dose excreted in the urine as naloxone was 4.4 +/- 1.0%. There was a possible dose-dependent excretion of conjugate with 46 +/- 1 and 22 +/- 5% of the dose renally excreted at the high and low doses, respectively. In incomplete biliary cannulation, 13 and 18% were collected as conjugate in the bile of two bile-cannulated dogs. There was negligible biliary secretion of unchanged naloxone. Neither 6 beta-naloxol nor its conjugates were metabolites of naloxone in dogs. The simultaneous administration of naloxone does not reverse the dose-dependent pharmacokinetic perturbations of morphine. Morphine significantly lessened its own body, renal, and biliary clearances, as well as those of naloxone, and also lowered their apparent overall volumes of distribution. Plasma levels of naloxone and its conjugate were elevated with simultaneous morphine administration. Urinary flow rates were also greatly lessened and initial renal shut-down was implied at the higher morphine dose. Thus, the established competitive antagonistic action of naloxone on morphine does not extend to the reversal of the biological feedback effects of morphine on the metabolism and excretion of itself and simultaneously administered naloxone. PMID- 3559922 TI - Drug availability to noneliminating tissues and sites of action following an intravenous dose. AB - It is shown that for drugs with high clearance, administered as an intravenous (iv) bolus, the amount of drug available to noneliminating tissues may be significantly less than the administered dose. This arises as a result of recirculation and elimination of some drug within an eliminating circuit, without contact of the drug with tissues outside the eliminating circuit. The same effect also influences drug availability to noneliminating tissues following an oral dose. The relative availability of a drug to sites of action and drug toxicity are also discussed and shown to depend on clearance and blood flow to these sites. PMID- 3559923 TI - Studies on freeze-dried drug-milk formulations. II: Effect of regenerated fluid volume on nitrofurantoin bioavailability. AB - The effect of different milk volumes on the extent and consistency of nitrofurantoin (1-[(5-nitrofurfurylidene)amino]hydantoin) absorption from freeze dried nitrofurantoin-milk formulations was studied in four male volunteers in three separate crossover designs. Each volunteer received six single-dose treatments (one 100-mg nitrofurantoin capsule with 100, 200, and 400 mL of milk and 100 mg of nitrofurantoin as a freeze-dried nitrofurantoin milk formulation regenerated with 100, 200, and 400 mL of water). Analysis of the urine data revealed superiority of the nitrofurantoin-milk formulations regenerated with 200 and 400 mL of milk over the corresponding capsule formulations in the rates and extents of nitrofurantoin excretion. The binding of nitrofurantoin to casein and bovine serum albumin and its solubility in the presence of the proteins were measured in vitro. The presence of both proteins caused increases in the solubility of nitrofurantoin. Normal protein binding is responsible for the increase of nitrofurantoin solubility in the presence of bovine serum albumin, whereas the increase of nitrofurantoin solubility in the presence of casein is attributed to the formation of aggregates in casein solution at 37 degrees C. The in vivo data were discussed in light of the in vitro data. The freeze-dried nitrofurantoin-milk formulation regenerated with 200 mL of water has a potential for use as a nitrofurantoin delivery system. PMID- 3559924 TI - Absorption of cyclosporine from rabbit small intestine in situ. AB - The absorption of the immunosuppressive drug, cyclosporine, from intestinal segments in the anesthetized rabbit in situ is reported. The experimental technique allows serial blood sampling with simultaneous sampling of the intestinal perfusate. The method of Loo and Riegelman for estimating the systemically absorbed fraction of the drug was used in conjunction with the in situ method. Taking the length of the rabbit small intestine as 300 cm and using the apparent permeability of cyclosporine determined in polyethylene glycol 400 (PEG 400) at a bulk fluid flow rate of 0.27 mL/min, the anatomical reserve length for cyclosporine was calculated to be -302 cm. The studies demonstrate that a significant portion of the loss of cyclosporine from rabbit small intestine cannot be accounted for as systemically absorbed drug. Furthermore, the apparent permeability coefficient of cyclosporine in these studies is so low that the length of small intestine in the rabbit is not sufficient for complete absorption of the drug from the lumen under the conditions used. PMID- 3559925 TI - Solute transport resistance at water-oil interfaces. AB - The barriers to transport of methyl nicotinate across the water-octanol, water 2,2,4-trimethylpentane, and water-isopropyl myristate interfaces at 25 degrees C have been studied using a rotating diffusion cell. Comparison of results for systems which comprise zero, one, and two interfacial barriers shows that, contrary to previous reports, interfacial resistance is not a significant barrier in these cases and is below the limit of detection of the rotating diffusion cell method. PMID- 3559926 TI - Effects of potential damaging agents on the microclimate-pH in the rat jejunum. AB - This study was designed to determine the pH of the intestinal surface in the rat jejunum in an attempt to investigate the effect of potential damaging agents on the microclimate-pH. A significant pH gradient was observed between the mucosal surface and the bulk phase; however, the microclimate-pH usually ranged from 6.5 to 7.5, irrespective of the wide range in the bulk pH. When the bulk pH was either 7.3 or 4, the microclimate-pH was approximately 6.7, while the microclimate-pH was approximately 7.4 when the bulk pH was raised to 9. The distance of the pH gradient was found to be approximately 900-1300 microns. After treatment with ouabain (10 mM) or amiloride (8 mM), or replacement of Na+ with Li+, the microclimate-pH significantly increased compared with the control (buffer solution). Chlorpromazine (2 mM) and ouabain also significantly increased the microclimate-pH, but at the same time, chlorpromazine decreased the bulk pH so that a more marked pH gradient was observed. Both aspirin (10 mM) and acetazolamide (80 mg/kg, iv) significantly decreased the microclimate-pH under the condition of the acidic bulk phase pH. N-Acetyl-L-cysteine (5%) induced marked changes in microclimate-pH, the direction depending upon the bulk phase pH. Neither taurocholic acid (10 mM) nor glucose (10 mM) significantly changed the microclimate pH. PMID- 3559927 TI - Dehydropipernonaline, an amide possessing coronary vasodilating activity, isolated from Piper longum L. AB - An amide (dehydropipernonaline) that has coronary vasorelaxant activity was isolated from the fruit of Piper longum L. This substance was characterized on the basis of spectroscopic data. PMID- 3559928 TI - Cytotoxic effects of 1,2-dichloroethane, nitrobenzene, and carbon disulfide on human KB and monkey AGMK cells. AB - The toxicity of 1,2-dichloroethane, carbon disulfide, and nitrobenzene on cultured human (KB) and African green monkey kidney (AGMK) cells was studied. Nitrobenzene proved to be the most toxic to these two cell lines. PMID- 3559929 TI - Liquid chromatographic determination of folic acid in multivitamin preparations. AB - A reversed-phase high-performance liquid chromatographic method is described for a stability-indicating assay of folic acid in multivitamin preparations. This method shows excellent recovery and precision characteristics, allows the determination of folic acid to levels of 0.1 microgram/mL, is simple to execute, and is suitable for high volume routine work. A good correlation was demonstrated between the HPLC method and the currently used bioassay. PMID- 3559931 TI - Coulometric high-performance liquid chromatographic analysis of morphine in biological fluids. AB - A simple method is described for the determination of morphine in biological fluids (plasma and urine) by high-performance liquid chromatography with coulometric detection. The detector consists of three porous electrodes which are arranged in a way to give maximum selectivity and sensitivity. Quantitation of morphine is performed using naloxone as the internal standard. Sample preparation involves an extraction procedure from plasma and urine. The limit of quantification of the method is 1 ng/mL plasma. The methodology was applied to measure blood levels in rats after subcutaneous administration of a slow-release morphine pellet. PMID- 3559930 TI - Liquid chromatographic assay and disposition of carvedilol in healthy volunteers. AB - Quantitative determination of serum concentrations of carvedilol [(+/-)-1 (carbazol-4-yloxy)-3-[[2-(o-methoxyphenoxy)ethyl) amino]-2-propanol], a combined alpha- and beta-adrenergic receptor antagonist, was obtained using HPLC with spectrofluorometric detection. Carvedilol was extracted from alkalinized serum with ether and was subsequently back extracted with diluted phosphoric acid. This method proved to be sensitive and reproducible (mean coefficient of variation of 6.1% for 0.25 to 150 nanograms per milliliter of serum). A single dose of carvedilol (5, 10, or 15 mg) was given as an intravenous infusion to three healthy volunteers. Carvedilol serum concentration-time profiles were fitted best to a three-compartment model and the pharmacokinetic data revealed the following mean values: Vdss of 1.97 L/kg, mean residence time (MRT) of 4.66 h, and CL of 0.437 L X h-1 X kg-1. PMID- 3559932 TI - Influence of a high fat breakfast on the bioavailability of theophylline controlled-release formulations: an in vitro demonstration of an in vivo observation. PMID- 3559933 TI - Angioleiomyoma. A case report and literature review. PMID- 3559935 TI - Autonomic neuropathy. PMID- 3559934 TI - Iliac apophysitis. PMID- 3559936 TI - Silicone implants. PMID- 3559937 TI - Malpractice 1987. PMID- 3559938 TI - A new treatment for Charcot joint in the diabetic foot. PMID- 3559939 TI - Regenerate bone. An assessment of digital manifestations. PMID- 3559940 TI - Anatomical characteristics of the talus in relation to forefoot deformities. PMID- 3559941 TI - Granuloma annulare. Case reports of superficial and deep forms. PMID- 3559942 TI - Utilization of computerized tomography in osteomyelitis of the foot. A case report. PMID- 3559944 TI - Melorheostosis. A review of the literature and case report. PMID- 3559943 TI - Kaposi's sarcoma of the lower extremity. A case report. PMID- 3559945 TI - Irreducible dorsal dislocation of the hallucal interphalangeal joint. PMID- 3559946 TI - Secondary intraocular lens implantation. AB - We conducted a retrospective study of our first 75 consecutive patients receiving secondary intraocular lens implants. Ninety-seven percent had postoperative visual acuities of greater than or equal to 20/40; 86%, greater than or equal to 20/25. Four percent of patients lost two or more lines of vision. Complications included retinal detachment (4%), transient cystoid macular edema (3%), transient corneal edema (3%), pupillary block glaucoma (1%), and progression of an epiretinal membrane (1%). Patients requiring anterior vitrectomy had the least favorable outcome, with a 28% incidence of retinal complications. Overall, these data show secondary intraocular lens implantations to be safe and effective. However, greater caution is recommended for patients who will require anterior vitrectomy because of the higher rate of retinal complications. PMID- 3559947 TI - Secondary intraocular lens implantation: rigid/semi-rigid versus flexible lenses. AB - Two series of secondary intraocular lens implantations with anterior chamber lenses are reported. Series 1 consisted of our first 199 consecutive procedures using rigid or semi-rigid lenses, performed between May 1, 1977, and September 30, 1982. Series 2 consisted of our first 101 consecutive procedures using flexible lenses, performed between October 1, 1982, and October 30, 1984. Best corrected final postoperative visual acuity was either better than or within one Snellen line of best-corrected preoperative vision in 84% of cases with rigid or semi-rigid lenses and in 85% of cases with flexible lenses. Surgical complications were minimal in both series. No instances of uveitis-glaucoma hyphema syndrome were encountered. Endothelial cell loss was low. Because of the short follow-up in Series 2 and the fact that these groups were operated upon at different times, the two series are not directly comparable. Nonetheless, the results do show that secondary intraocular lens implantation is a viable alternative for aphakic patients, particularly those who are intolerant of aphakic spectacles and contact lenses. Certain provisos involving patient education and motivation as well as lens selection are noted in this report. PMID- 3559948 TI - Graded nonintersecting transverse incisions for correction of idiopathic astigmatism. AB - We present the results of a consecutive series of graded transverse (T) incisions for correcting idiopathic astigmatism evaluated by vector analysis, a method not previously used to report T-incision results. In fact, no clinical studies on the results of the T-incision method have been reported. For comparison with conventional reporting methods, the results of graded T incisions on a series of eyes were evaluated, using both vector analysis and simplified analytic procedures. Sixty eyes were evaluated following surgery based on the Thornton guide for astigmatism correction. The mean preoperative cylinder in the series was 1.5 diopters (D) (SD = 0.43, range 1.00 D to 2.25 D); mean postoperative cylinder was 0.4 D (SD = 0.61, range 0 to 3.75 D). The mean decrease of 1.1 D was statistically significant. The results show that it is possible to quantify astigmatism correction using vector analysis. PMID- 3559949 TI - Radial keratotomy: analysis of efficacy and predictability in 1,058 consecutive cases. Part II: Predictability. AB - Effectiveness and predictability of anterior radial keratotomy to correct myopia and/or astigmatism were evaluated in 1,058 consecutive surgeries. The surgical technique, results, and comparison to other series are detailed in Part I. In this paper, a retrospective study for predicting the change in refraction of eyes having radial keratotomy with and without astigmatism incisions, statistically derived predictors accounted for 72.9% of the variations in outcome. PMID- 3559950 TI - A prospective study of intraocular pressure four months after extracapsular cataract extraction with implantation of posterior chamber lenses. AB - Sixty-six consecutive cases of extracapsular cataract extraction (ECCE) and sulcus implantation of a posterior chamber lens had intraocular pressure (IOP) measurements recorded four months postoperatively. These results were compared to the fellow unoperated eyes, as well as to a group of 64 patients, whom we reported previously, who had intracapsular cataract extraction (ICCE) and implantation of an anterior chamber lens. The ECCE and posterior chamber lens group demonstrated a significant reduction in the IOP of the operated eye after four months (P less than 0.001), with none of the patients having an IOP greater than 20 mm Hg. No significant IOP change could be demonstrated in the fellow eye (0.1 less than P less than 0.2). We found a significant difference between the ECCE and ICCE groups in the IOP of the operated eye (P less than 0.001). PMID- 3559951 TI - Trabeculectomy and intraocular lens implantation: a combined procedure. AB - We present the results achieved in 26 cases of trabeculectomy combined with intraocular lens implantation after extracapsular surgery in eyes with open-angle glaucoma. Phacoemulsification was performed in nine cases, planned extracapsular cataract extraction in 17. In 23 eyes, a posterior chamber lens was implanted; in three eyes an anterior chamber lens was used because of a ruptured posterior capsule. After a follow-up period ranging from four to 29 months, the postoperative results were satisfactory in all eyes treated. The patients achieved postoperative intraocular pressure of 20 mm Hg or less. In 28% of the cases, however, additional antiglaucomatous medication is required. Given proper indications and present-day surgical techniques, this combined procedure provides effective one-time treatment for cataract and glaucoma patients as well as optimal visual rehabilitation. PMID- 3559952 TI - Pathology and physics of YAG-laser intraocular lens damage. AB - Polymethylmethacrylate and silicone intraocular lenses were subjected to controlled Nd:YAG laser irradiation. Following damage, each lens was examined by scanning electron microscopy. Highly specific morphologic patterns, believed to be pathognomonic for each material, were observed. The physics of damage mechanisms and clinical correlation of damage morphology are discussed. PMID- 3559953 TI - Clinical experience with soft intraocular lens implantation. AB - A retrospective study of 205 consecutive, planned extracapsular cataract extractions with posterior chamber silicone elastomer lens implants inserted in the ciliary sulcus region were examined between six and 23 months postoperatively. When the patients with preexisting pathology were excluded, the percentage of patients seeing 20/40 or better was 94.1%. The postoperative complications included intraocular lens dislocation in two cases, cystoid macular edema in one case, and secondary glaucoma in one case. PMID- 3559954 TI - Cataract extraction in eyes with congenital colobomata. AB - Cataract surgery was performed in six eyes of four patients with typical colobomata of the iris, choroid, and retina. Contrary to previous reports of poor surgical results in these eyes, we saw no surgical or postoperative complications. Final visual acuity was excellent in four eyes. The other two had preexisting amblyopia. Most previous reports describe outmoded extracapsular techniques or contemporary intracapsular cataract extraction, all without an intraocular lens. Five of the six eyes in this study had modern cataract surgery- phacoemulsification with a posterior chamber lens placed in the capsular bag. PMID- 3559955 TI - Epikeratophakia for control of pediatric bullous keratopathy. AB - A child who had had a congenital cataract phacoemulsified at age four months became contact lens intolerant, and at age two years had an implantation of a Worst metal-looped iris-clip intraocular lens. He developed painful pseudophakic bullous keratopathy three years later. Since the child remained with dense deprivation amblyopia and contact lens intolerance, when the IOL was removed an epikeratophakia graft was applied. The bullous keratopathy resolved and the patient has remained asymptomatic for 22 postoperative months. The proposed mechanism for relief of the bullous keratopathy is to increase tissue thickness and resistance, thus reducing fluid volume transferred to the subepithelial space. PMID- 3559956 TI - Protrusion of a posterior chamber lens haptic into the anterior chamber through iris erosion. PMID- 3559957 TI - Brightness acuity test and outdoor visual acuity in cataract patients. AB - The disparity between functional outdoor vision and the acuity measured in the standard refracting lane is well known among clinicians. A simple device, the brightness acuity tester (B.A.T.), was developed to predict a patient's functional outdoor acuity. The B.A.T. has an illuminated hemispheric bowl, 60 mm in diameter, with a 12-mm aperture. Fourteen normals and 50 patients with cataracts were tested using the B.A.T. and then tested outside in bright sunlight. The B.A.T. correlated extremely well (r = +0.84, P less than .0001) with the acuities measured outside. There was no decrease in visual acuity in the 14 normal patients, but there was a one to ten line decrease in vision among the cataract patients. Upon retesting, the B.A.T. scores did not vary, while outside testing scores did change due to variable outdoor ambient light levels on sunny days. The B.A.T. is a simple, repeatable, useful test for predicting functional outdoor acuity. PMID- 3559958 TI - Phacoemulsification devices: a consumer's report. AB - This report deals with our evaluation of six phacoemulsification devices tested at the Neumann Eye Institute (two additional devices have been evaluated since this paper was presented at the ASCRS meeting). The devices were compared for operating cost of the first 1,000 cases, dependability, ease of usage, and level of safety for the patient. PMID- 3559959 TI - Double cannula for removal of viscoelastic material at surgery. PMID- 3559961 TI - Notched cystotome for use with small pupils. PMID- 3559960 TI - Syringe-type inserter for silicone implants. PMID- 3559962 TI - Contamination of irrigating solution. PMID- 3559963 TI - Use of the Fox shield for the UGH syndrome. PMID- 3559964 TI - Follow-up on the Stableflex lens. PMID- 3559966 TI - Experience with the Choyce-Tennant implant. PMID- 3559965 TI - Laser damage in injection-molded lenses. PMID- 3559968 TI - Ascorbic acid prevents nonreceptor "specific" binding of [3H]-5-hydroxytryptamine to bovine cerebral cortex membranes. AB - [3H]-5-Hydroxytryptamine ([3H]-5-HT) decomposes rapidly when exposed to air in solution at physiological pH if antioxidants are not present. The decomposition products appear to bind to two saturable sites on brain membranes (apparent Kd values = 1-2 and 100-1000 nM). This binding mimics "specific" ligand/receptor binding in that it is inhibited by 10 microM unlabeled 5-HT. This inhibition is not competitive, but rather is due to the prevention of [3H]-5-HT breakdown by excess unlabeled 5-HT. Unlike genuine ligand/receptor binding, the binding of [3H]-5-HT breakdown products is essentially irreversible and does not display a tissue distribution consistent with binding to authentic 5-HT receptors. [3H]-5 HT decomposition can be eliminated by the inclusion of 0.05 to 5 mM ascorbic acid. At these concentrations ascorbic acid is not deleterious to reversible [3H] 5-HT binding. When [3H] 5-HT exposure to air occurs in the presence of brain membranes, the apparent antioxidant activity of brain membranes themselves affords protection against [3H]-5-HT degradation equal to ascorbic acid. This protection is effective below final [3H]-5-HT concentrations of 10 nM. Above 10 nM [3H]-5-HT, addition of ascorbic acid or other antioxidants is necessary to avoid the occurrence of additional low affinity (apparent Kd = 15-2000 nM) binding sites that are specific but nonetheless irreversible. When care is taken to limit [3H]-5-HT oxidation, the only reversible and saturable specific binding sites observed are of the 5-HT1 high affinity (Kd = 1-2 nM) type. Radioligand oxidation artifacts may be involved in previous reports of low affinity (Kd = 15 250 nM) [3H]-5-HT binding sites in brain membrane preparations. PMID- 3559967 TI - Dog model to study the effects of pharmacologic agents on the peripheral circulation: effects of milrinone. AB - To study the effects of an inotropic agent, milrinone, on the entire cardiovascular system, we developed an intact dog model to assess the responses of the heart, arterial and venous circulations. At a dose that increased left ventricular dP/dt by 30% (P less than .001) from 2033 +/- 133 to 2688 +/- 140 mm Hg/sec, milrinone caused a decrease (P less than .001) in mean aortic pressure from 88.4 +/- 3.5 to 73.1 +/- 3.0 mm Hg and cardiac output from 148.0 +/- 14.6 to 134.5 +/- 13.9 ml/kg/min. Heart rate increased (P less than .01) from 124 +/- 8 to 135 +/- 8 beats/min. Systemic vascular resistance did not change. Right atrial pressure and left ventricular end-diastolic pressure decreased (P less than .01). Total blood volume did not change but central blood volume decreased (P less than .01) from 26.1 +/- 0.9 to 22.3 +/- 0.5 ml/kg. After milrinone administration, mean circulatory filling pressure decreased (P less than .01) by 30% from 7.4 +/- 0.4 to 5.0 +/- 0.2 mm Hg. Vascular or venous compliance increased (P less than .05) slightly from 1.96 +/- 0.4 to 2.20 +/- 0.1 ml/mm Hg/kg. This was accompanied by an increase (P less than .01) in unstressed vascular blood volume of 3.3 +/- 0.6 ml/kg. Arterial compliance also increased (P less than .05). In summary, milrinone produces an increase in inotropy, arterial vasodilatation and venodilatation as evidenced by the increased venous compliance and unstressed vascular volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559969 TI - Drug inhibition of penicillin tubular secretion: concordance between in vitro and clinical findings. AB - Using the rabbit kidney slice model of active tubular secretion, I studied the active accumulation of penicillin (PEN) in the absence and presence of competing drugs to evaluate the feasibility of using in vitro uptake to predict in vivo secretion. Active accumulation of PEN by these slices was saturable at high PEN concentrations and was inhibited by incubation conditions which decreased ATP production. PEN uptake in the presence of 1 mM concentrations of mannitol, tolazoline and tetraethylammonium was unchanged. However, PEN uptake in the presence of eight weak organic acid drugs (probenecid, phenylbutazone, sulfinpyrazone, salicylate, sulfamethizole, chlorothiazide, sulfamethoxypyridazine and indomethacin) was inhibited significantly. This inhibition appeared to be competitive in nature and the inhibitor-transport carrier protein dissociation constant (Ki) for each inhibitory drug was calculated (range, 0.38-74.8 X 10(-5) M). When these values for Ki obtained with PEN were compared to values obtained with methotrexate and p- aminohippurate, the values of Ki were similar, implying the presence of a similar transport carrier protein for PEN, methotrexate and p-aminohippurate. The effects of these eight drugs upon PEN clearance in vivo were extrapolated from the medical literature. The relative inhibitory strengths of these drugs based upon in vitro findings (drug plasma concentration/Ki ratios) and clinical findings (inhibition of PEN clearance) were concordant. This in vitro model for assessing inhibition of renal tubular secretion may be of general utility in predicting clinically important drug interactions between weak organic acid drugs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559970 TI - Transport of diphenhydramine in the central nervous system. AB - The transport and metabolism of diphenhydramine was studied in vitro in the isolated rabbit choroid plexus and in vivo in New Zealand white rabbits and Sprague-Dawley rats. In vitro, [14C] diphenhydramine was accumulated by a saturable, energy-requiring system in choroid plexus. In vivo, 20 min after intraventricular injection into rabbits, [14C]diphenhydramine was cleared from cerebrospinal fluid much more rapidly than [3H]sucrose, a molecule transported in the central nervous system by simple diffusion. In vivo, employing the in situ rat brain perfusion technique, [14C]diphenhydramine was cleared from the cerebral perfusion fluid as rapidly as [14C]diazepam. However, the clearance of [14C]diphenhydramine, but not [14C]diazepam, was inhibited by the addition of 10 mM unlabeled diphenhydramine to the perfusate. These in vivo and in vitro results show that diphenhydramine, unlike diazepam, is transported between blood, brain and cerebrospinal fluid, in part, by saturable, carrier-mediated transport processes at both the blood-brain and blood-cerebrospinal fluid barriers. PMID- 3559971 TI - Influence of thiamine deficiency on the response to ethanol in two inbred rat strains. AB - We investigated whether thiamine deficiency (TD), a frequent concomitant of chronic alcoholism, differentially modifies the response to ethanol in two inbred rat strains with highly different genetic susceptibilities to development of TD encephalopathy. Ethanol-induced (3 g/kg i.p.) behavioral impairment and hypothermia were studied after 2, 5 and 7 weeks of TD and after 6 weeks of repletion on normal diet. Controls of the M520/N (TD-sensitive) strain metabolized ethanol more rapidly, had a greater liver to body weight ratio, greater total body water, earlier and lower peak blood ethanol concentrations (BEC), diminished area under the BEC curve and lesser behavioral impairment and hypothermia (even at equivalent BEC values) than those of the F344/N (TD resistant) strain. In both strains, TD resulted in reduced ethanol metabolic rate and liver to body weight ratio and equivalent ethanol-induced hypothermia and behavioral impairment at lower BEC. Lower and delayed peak BEC and unchanged area under the BEC curve suggest an increased volume of ethanol distribution during TD. Recovery appeared complete after 6 weeks of normal diet. Both strains lost an equivalent proportion of body weight during TD but M520/N rats had lesser decrements in ethanol metabolic rate, had greater reductions in liver weight, peak BEC and baseline body temperature and developed overt encephalopathy whereas F344/N rats did not. Therefore, in the chronic alcoholic, TD may modify ethanol's effects via pharmacokinetic and pharmacodynamic mechanisms. Relatively high ethanol tolerance of the strain with a genetic predisposition to TD encephalopathy is consistent with the hypothesized role of this avitaminosis in the pharmacogenetics of alcoholism. PMID- 3559972 TI - Norepinephrine depletion and sensitivity changes in rat heart induced by pretreatment with reserpine. AB - Depletion of norepinephrine, sensitivity to isoproterenol and sensitivity to tyramine in rat atria were investigated after various doses and schedules of pretreatment of rats with reserpine. Virtually complete depletion of norepinephrine occurred in both right and left atria and ventricles after doses of 1.0 mg/kg/day of reserpine for one or more days of pretreatment. A smaller dose, 0.3 mg/kg/day, produced lesser depletion, and a larger dose, 2.5 mg/kg/day, caused severe central nervous system depression and high mortality. Chronic treatment (5 days or longer) with the 1.0-mg/kg/day dose produced supersensitivity of right atria to the chronotropic, but not inotropic, responses to isoproterenol. Chronic treatment with this dose for 7 days produced inotropic supersensitivity in left atria. Most of the schedules of pretreatment with reserpine depressed the maximum response to tyramine. However, the data indicate that the tyramine-releasable norepinephrine was not a consistent reflection of the total norepinephrine pool, even when depletion was very pronounced. The effects of depletion of cardiac stores of norepinephrine with reserpine in comparison with the effects of cardiac sympathectomy are discussed. PMID- 3559973 TI - Comparison of Ca++ uptake and spontaneous Ca++ release from sarcoplasmic reticulum vesicles isolated from muscle of malignant hyperthermia diagnostic patients. AB - Inward Ca++ transport and spontaneous Ca++ release activities were compared among sarcoplasmic reticulum (SR) membrane fractions isolated from human skeletal muscle in patients undergoing malignant hyperthermia (MH) diagnostic contracture testing. Two different membrane fractions were isolated, a heavy (8-12,000 X g) and light (12-48,000 X g) fraction, from each diagnostic subject. The rates of inward Ca++ transport were faster in light SR compared to heavy SR, but no statistically significant difference was observed among MH diagnostic groups. Spontaneous Ca++ release occurred at optimum Ca++ preload in all SR fractions and this preload did not differ among MH diagnostic groups. Optimal Ca++ preload for rate of spontaneously released Ca++ was greater in light SR compared to heavy SR. Similarly, rate of Ca++ release was faster in light SR than in heavy SR, but no difference in rate of spontaneously released Ca++ was observed among MH diagnostic groups. Amount of Ca++ released did not differ among SR fractions and it did not differ among diagnostic groups. In contrast to previous studies showing a defect in Ca++-induced Ca++ release, the mechanisms related to spontaneous Ca++ release and to oxalate-facilitated inward Ca++ transport, as measured in this study, appear to be normal in SR from human MH skeletal muscle. PMID- 3559974 TI - Muscarinic and antimuscarinic activity of acetamides related to oxotremorine in the guinea pig urinary bladder. AB - Eight acetamide analogs of oxotremorine, shown previously to be full or nearly full muscarinic agonists on the isolated guinea pig ileum, were investigated for muscarinic activity on muscle strips of guinea pig urinary bladder. Several compounds demonstrated pronounced organ selectivity when compared to carbachol by being partial agonists or antagonists on the bladder. For example, oxotremorine and BM 34, both potent, full agonists on the ileum, were partial agonists, the latter producing less than one-half the maximum response of carbachol. BM 5 elicited no significant response, but instead was a potent antagonist to carbachol. Schild analysis with BM 5 and BM 61 indicated no muscarinic receptor heterogeneity between the bladder and ileum. Also dissociation constants of agonists and partial agonists generally agreed with those determined previously on the ileum. Furthermore, the relative efficacy of each agonist appeared to be similar in the two tissues, confirming the homogeneity of muscarinic receptors in the bladder and ileum with respect to the compounds studied. Compounds having high affinity and low intrinsic efficacy, e.g., BM 5, thus may stimulate contractile responses on the ileum and block responses on the bladder and therefore display tissue selectivity without discriminating between tissue receptors. It is suggested that this selectivity is derived from a smaller effective receptor reserve for muscarinic agonists in the bladder. PMID- 3559975 TI - Ionic mechanism of dopaminergic and muscarinic auto- and heteroreceptor activation in superfused striatal slices: role of extracellular chloride. AB - The Cl dependency of agonist-induced ionic mechanisms involved in the receptor mediated modulation of electrically stimulated release of dopamine (DA) and acetylcholine (ACh) was examined in superfused rabbit striatal slices prelabeled with [3H] DA (3,4-[8-3H]dihydroxyphenylethylamine) and [14C]choline ([ methyl 14C]choline Cl). Cl- was substituted in the superfusion medium to varying degrees with the impermeant anions isethionate, methanesulfonate or gluconate. The sodium concentration was held constant. Apomorphine (30 nM), a DA receptor agonist, inhibited the stimulation-evoked (1 Hz, 2 min) release of both DA and ACh in Krebs-Ringer-bicarbonate medium (KRB; 125.4 mM Cl-). The inhibitory effects of the agonist were not altered significantly in media containing 66.4 mM Cl-. In 7.4 mM Cl- medium (isethionate replacement), apomorphine-induced inhibition of DA release was reduced (40% inhibition vs. 67% inhibition in KRB). Similarly, apomorphine inhibition of ACh release was lowered from 38% in KRB to 25% in 7.4 mM Cl-. The muscarinic receptor agonist carbachol (10 microM) inhibited the stimulation-evoked release of ACh while enhancing the evoked release of DA in normal Cl- (125.4 mM) medium. Inhibition of ACh release was not altered in 66.4 mM Cl- media but was increased in 7.4 mM Cl- (63% inhibition in low Cl- vs. 50% in KRB). The enhancing effects of carbachol on stimulated DA release were potentiated in 66.4 mM Cl- (88% enhancement vs. 57% in KRB), whereas no change in the agonist effect was observed in the lower Cl- medium (7.4 mM Cl-).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559976 TI - Mouse thiopurine methyltransferase pharmacogenetics: monogenic inheritance. AB - Thiopurine methyltransferase (TPMT) catalyzes the S-methylation of aromatic and heterocyclic sulfhydryl compounds such as the drug 6-mercaptopurine. In humans, TPMT activity is inherited as a monogenic trait. It would be useful if there were an animal model in which the genetic regulation of TPMT could be studied. Average TPMT activities in livers of C57BL/6J (B6) and AKR/J (AK) mice were only 17 to 29% of average activities in livers of like-sexed DBA/2J (D2) mice. Average TPMT activities in kidneys of B6 and AK mice were only 41 to 45% of average activities in kidneys of like-sexed D2 mice. Breeding experiments were performed to study the possible role of inheritance in regulating variations in TPMT activity in these mice. TPMT activities in livers and kidneys of F1 (hybrid) animals (N = 38) from D2 X B6 matings were intermediate to those in the parental strains but were closer to D2 than to B6 values, an observation that suggested partial dominance of the D2 phenotype. The results of studies of F2 (N = 107) and backcross (N = 102) animals derived from these matings were compatible with autosomal recessive inheritance of the trait of low TPMT activity in these mouse strains. Of the F2 animals, 27.1% were included in a "low" TPMT subgroup when enzyme activities in livers and kidneys were both used for phenotypic classification. TPMT activities in livers and kidneys of F1 mice (N = 40) from D2 X AK matings were also intermediate to those in the parental strains but were closer to D2 than to AK values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559977 TI - Role of reactive metabolites in suppression of humoral immunity by N nitrosodimethylamine. AB - The hypothesis that dimethylnitrosamine (DMN)-induced humoral immune suppression is mediated by reactive intermediates was tested in female B6C3F1 mice using three approaches. First, distribution of reactive species to known target organs (liver and kidney) and to immune organs (peripheral blood components, bone marrow cells, thymus and spleen) was demonstrated by monitoring acid-insoluble radioactivity after single or multiple doses of 6 mg/kg and 2 microCi of [methyl 14C] DMN. Most of the radioactivity resided in acid-insoluble material, which increased with the number of exposures and correlated with suppression of the in vivo antibody response to sheep erythrocytes as determined by enumerating immunoglobulin M antibody-forming cells. Fractionation of spleens from exposed animals into various cell types indicated greater association of acid-insoluble radioactivity with T- and B-lymphocytes as compared to macrophages. Fractionation of spleen cell lysates into protein, DNA and RNA indicated that most radioactivity was associated with the nucleic acid component. Pretreatment of mice with aminoacetonitrile reduced acid-insoluble disintegrations per minute in the spleen. The second approach was to demonstrate the immunosuppressive nature of compounds forming the same toxic intermediate as DMN. The addition of N nitroso(acetoxymethyl)methylamine to spleen cell cultures resulted in completely suppressed in vitro antibody responses to sheep erythrocytes and dinitrophenylated Ficoll at micromolar concentrations. The third approach involved activating DMN to an immunosuppressive form in vitro. Preincubation of splenocytes with Aroclor-induced mouse hepatocytes resulted in activation of DMN to intermediates capable of markedly suppressing the response of antibody-forming cells to sheep erythrocytes. PMID- 3559978 TI - Biochemical changes in tissue catecholamines and serotonin in duodenal ulceration caused by cysteamine or propionitrile in the rat. AB - Previous structure-activity and pharmacologic studies with duodenal ulcerogens cysteamine and propionitrile implicating catecholamines in the pathogenesis of duodenal ulceration have now been followed up by dose- and time-response biochemical investigations to assess the importance of monoamines in the development of duodenal ulcers. The concentrations of norepinephrine (noradrenaline), dopamine, serotonin and their metabolites were measured in total brain, brain regions, stomach, duodenum, pancreas and adrenals in the rat. Turnover of catecholamines was determined in rats pretreated with the inhibitor of tyrosine hydroxylase alpha-methyl-p-tyrosine. The duodenal ulcerogens caused a dose- and time-dependent depletion of norepinephrine in virtually all the tissues examined. The effect was maximal 4 or 7 hr after cysteamine or propionitrile, and norepinephrine levels returned to normal in 24 hr. Dopamine changes were selective and often biphasic, e.g., elevation in adrenals, biphasic in brain cortex, hippocampus and midbrain, but uniformly decreasing in glandular stomach and duodenum. In the median eminence dopamine levels decreased by 181 and 324% at 15 and 30 min, respectively, after cysteamine, but neither dopamine nor 3,4 dihydroxyphenylacetic acid was modified in the periventricular nucleus. Serotonin levels were relatively stable, revealing slight elevations or no changes in most of the tissues. The turnover of norepinephrine was accelerated by both chemicals in virtually all brain regions, but dopamine turnover was affected only in a few areas, e.g., in the corpus striatum and medulla oblongata cysteamine decreased dopamine turnover, whereas propionitrile first (at 1 hr) accelerated then (at 8 hr) significantly suppressed it.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559979 TI - Effect of tyrosine administration on duodenal ulcer induced by cysteamine in the rat. AB - Duodenal ulcers were produced by administering cysteamine to rats. Pretreatment with the catecholamine precursor, L-tyrosine (40 mg/100 g i.p. for 5 days), decreased the intensity of duodenal ulcers induced by cysteamine. Equimolar doses of tyrosine methyl ester (51.2 mg/100 g i.p. or s.c.) were equally effective in reducing ulcer intensity. Other amino acids (i.e., alanine, aspartic acid, glutamic acid, glycine, leucine, lysine, tryptophan and valine) did not prevent experimental duodenal ulcers. Coadministration of other large neutral amino acids (e.g., leucine and valine) that compete with tyrosine for uptake into the brain did not inhibit the effect of tyrosine on duodenal ulcers induced by cysteamine. Gastric, duodenal and brain dopamine concentrations were increased 1 hr after the injection of tyrosine methyl ester (25.6 mg/100 g s.c.). These results suggest that the effect of tyrosine on duodenal ulcer induced by cysteamine may be mediated by changes in gastrointestinal dopamine metabolism. PMID- 3559980 TI - Effect of dopamine-related drugs on duodenal ulcer induced by cysteamine or propionitrile: prevention and aggravation may not be mediated by gastrointestinal secretory changes in the rat. AB - Dose- and time-response studies have been performed with dopamine agonists and antagonists using the cysteamine and propionitrile duodenal ulcer models in the rat. The experiments demonstrate that the chemically induced duodenal ulcer is prevented by bromocriptine, lergotrile and reduced by apomorphine or L-dopa. Aggravation of cysteamine-induced duodenal ulcer was seen especially after (-) butaclamol, (-)-sulpiride, haloperidol and, less effectively, after other dopaminergic antagonists. The duodenal antiulcerogenic action of dopamine agonists was more prominent after chronic administration than after a single dose, whereas the opposite was found concerning the proulcerogenic effect of dopamine antagonists. In the chronic gastric fistula rat, both the antiulcerogens bromocriptine or lergotrile and the proulcerogens haloperidol, pimozide or (-)-N (2-chlorethyl)-norapomorphine decreased the cysteamine- or propionitrile-induced gastric secretion. No correlation was apparent between the influence of these drugs on duodenal ulcer development and gastric and duodenal (pancreatic/biliary) secretions. In the chronic duodenal fistula rat, decreased acid content was measured in the proximal duodenum after haloperidol, and diminished duodenal pepsin exposure was recorded after bromocriptine. Furthermore, the aggravation by dopamine antagonists of experimental duodenal ulcer probably involves a peripheral component. The site of dopamine receptors and physiologic effects which modulate experimental duodenal ulcer remain to be identified, but their elucidation may prove to be an important element in the pathogenesis and treatment of duodenal ulcer. PMID- 3559981 TI - N alpha-acetyl-beta-endorphin stimulates ornithine decarboxylase activity in preweanling rat pups: opioid- and non-opioid-mediated mechanisms. AB - Our laboratory has demonstrated recently that administration of beta-endorphin to rat pups results in profound changes in the levels of the growth-related enzyme ornithine decarboxylase (ODC) in both brain and peripheral tissues. These findings are consistent with accumulated evidence indicating that, in addition to their analgesic and behavioral effects in the adult, endogenous opioid peptides and opioid receptors may be involved as mediators of tissue growth and function in the neonate. This study examines the effects of N alpha-acetyl-beta-endorphin on tissue ODC activity to determine whether post-translational acetylation of beta-endorphin at the N alpha-terminus affects its capability to alter ODC activity and, consequently, tissue development. Intracisternal administration of N alpha-acetyl-beta-endorphin evoked profound increases in brain ODC activity in 6- and 9-day-old rats, whereas normal ODC levels were observed in 25-day-old animals and in adult rats. Centrally administered N alpha-acetyl-beta-endorphin had no effect on ODC in peripheral tissues. In contrast, s.c. administration of this peptide to 6-day-old animals resulted in marked increases in ODC activity in the heart, liver and brain. Naloxone inhibited the stimulatory actions of N alpha acetyl-beta-endorphin on brain ODC completely, indicating the involvement of opioid receptors in that process. On the other hand, the increases in liver ODC were not prevented by naloxone, suggesting that these effects are not mediated through opioid-sensitive structures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559982 TI - Comparative evaluation of morphine, pentazocine and ciramadol in postaddicts. AB - The subjective, physiological and behavioral effects of morphine, pentazocine and ciramadol, an opioid agonist/antagonist, were studied in adult male nondependent opioid abusers living on a clinical research ward. Fifteen subjects were assigned randomly to one of three groups. Each group received, by i.m. injection, placebo and three doses of one active drug, twice in randomized block order under double blind conditions in 4.5-hr experimental sessions. Physiological measures did not differentiate between the three drugs. All three drugs decreased respiratory rate and pupil diameter and increased blood pressure. However, morphine, ciramadol and pentazocine produced different profiles on the subjective effect measures. All three drugs increased "liking," "good effects," "any effects" and "high" subjective effect scales. Pentazocine increased subjective "bad effects" scale scores and scales measuring dysphoria and sedation. Observers reported significant behavioral changes after administration of morphine and pentazocine, but not after ciramadol. Overall, the effects of morphine (7.5, 15 and 30 mg) and pentazocine (22.5, 45 and 90 mg) were dose-related. Although pentazocine produced increases in scales that indicated negative subjective effects, it also produced significant changes in most self-report measures that were increased by morphine, including liking and good effects scales. The effects of ciramadol were not dose related, with all three doses (30, 60 and 120 mg) producing effects approximately equivalent to morphine 15 mg. Thus, ciramadol exhibited a ceiling effect typical of the opioid agonist/antagonist. PMID- 3559984 TI - Failure of chronic aspirin treatment to inhibit urinary prostaglandin excretion in spontaneously hypertensive rats: comparison with indomethacin and flurbiprofen. AB - The inability of chronic treatment with aspirin to cause sustained inhibition of urinary prostaglandin (PG) excretion observed previously prompted us to compare the effects of 9-day treatment of spontaneously hypertensive rats with aspirin, 200 mg/kg/day s.c., flurbiprofen, 2.5 mg/kg/b.i.d. s.c. and indomethacin, 2.5 mg/kg/b.i.d. s.c. on the excretion rate of radioimmunoassayable PGE2 and PGF2 alpha. Conversion of 1-[14C]arachidonic acid and the release of PGs from endogenous substrate by the renal papilla were also examined. In vehicle-treated control rats, PGF2 alpha excretion ranged from 32.2 +/- 6.2 (mean +/- S.E.M.) to 41.6 +/- 7.3 ng/6 h, and was 2- to 4-fold higher than that of PGE2. Within 6 h of administration all three drugs reduced excretion of PGF2 alpha and PGE2 to less than 20% and 35% of control rats, respectively. Thereafter, PGF2 alpha and PGE2 excretion in aspirin-treated rats returned to values similar to the vehicle treated group, whereas inhibition of PG excretion in indomethacin and flurbiprofen groups was sustained. Urine volume was doubled by aspirin throughout the study. In contrast, urine volume in flurbiprofen- and indomethacin-treated rats was unaffected. Paradoxically, metabolism of 1-[14C]arachidonic acid to PGs by renal papilla dissected on day 10, 2 to 4 h after the last drug dose, was reduced markedly by aspirin as was the release of immunoreactive PGs but was unaffected by flurbiprofen or indomethacin. The failure of long-term aspirin treatment to inhibit urinary PG excretion and the disparity between in vivo and ex vivo indices of PG release emphasize the need to verify their intended action by measuring PGs in biological fluids. PMID- 3559985 TI - Hypoxia impairs conjugation and elimination of harmol in the isolated perfused rat liver. AB - Although studies in isolated hepatocytes have demonstrated that hypoxia adversely affects drug conjugation, the impact of hypoxia on drug elimination by conjugation in the intact liver has not been defined. This study in the isolated perfused rat liver examines the effect of acute hypoxia on the hepatic elimination of harmol, a phenolic compound eliminated by conjugation without first undergoing oxidative metabolism. In the preparation used in these experiments, harmol glucuronide is the major metabolite (greater than 80%), with the remainder being sulfate. The hypoxic insult consisted of an 80% reduction of hepatic oxygen delivery for 1 hr. During normal oxygenation, a 20-mumol dose was rapidly eliminated (T1/2 = 4.3 +/- 0.8 min; mean +/- S.D., n = 5). A second dose given after 30 min of hypoxia was eliminated much more slowly (T1/2 = 21 +/- 7.9 min, P less than .01). Upon reoxygenation, T1/2 recovered to 4.2 +/- 0.5 min. Similar effects were observed in steady-state experiments, in which perfusate levels rose from 15.7 +/- 1.3 microM to 31.0 +/- 1.6 microM (P less than .005) during hypoxia, indicating a fall in harmol clearance of at least 50%. In each group of experiments, there was a significant reduction in both the formation and elimination of harmol conjugates during hypoxia. Upon reoxygenation, harmol conjugation recovered, but conjugate elimination remained significantly impaired. The authors conclude that acute hypoxia slows the hepatic elimination of harmol by reducing drug conjugation, an effect that is promptly reversed by reoxygenation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3559983 TI - Further characterization of the renovascular effects of N6-cyclohexyladenosine in the isolated perfused rat kidney. AB - Previous studies have shown that activation of A1 adenosine receptors results in renal vasoconstriction at submicromolar concentrations of N6-cyclohexyladenosine (CHA) followed by relative vasodilation at higher concentrations. The present data confirm these findings and demonstrate that Na loading enhances the vasoconstrictor effects of CHA in the isolated rat kidney perfused at constant flow. Furthermore, adenosine receptor antagonism with both theophylline and the A1-selective antagonist, xanthine amine congener (8-[4-[(2-aminoethyl) aminocarbonylmethyloxy]phenyl]-1, 3-dipropylxanthine), produced a rightward and apparently parallel shift in the dose response to CHA. Determination of the inhibitory constants for both antagonists revealed that xanthine amine congener was three orders of magnitude more potent than theophylline in antagonizing CHA induced renal vasoconstriction. Other investigators have hypothesized that angiotensin II mediates adenosine-induced renal vasoconstriction. However, we have been able to show that A1 receptor activation can result in renal vasoconstriction in the isolated perfused rat kidney devoid of renin substrate. Moreover, a competitive inhibitor of angiotensin II (saralasin) failed to attenuate the hemodynamic effects of CHA at doses that completely blocked the effects of angiotensin II itself. Taken together, these data are consistent with the hypothesis that A1 receptor activation in the kidney leads to vasoconstriction, a response that is enhanced by Na loading, and that A1 adenosine receptors and angiotensin II receptors are separate and distinct biochemical entities. Independent activation of either receptor leads to renal vasoconstriction, which can be prevented by its respective antagonist. PMID- 3559986 TI - Differential effects of hypoxia on the turnover of norepinephrine and epinephrine in the heart, adrenal gland, submaxillary gland and stomach. AB - The authors examined the effects of hypoxia (8% O2 in N2) on the turnover rates of norepinephrine (NE) and epinephrine (E) in the heart, adrenal gland, submaxillary gland and stomach. The turnover rates were estimated by measuring the decrease in the content of NE and E after an i.p. injection of alpha-methyl-p tyrosine (250 mg/kg), an inhibitor of tyrosine hydroxylase. After a 4-h exposure to hypoxia, the turnover rate of NE in the heart and those of NE and E in the adrenal gland were increased, whereas that of NE in the submaxillary gland was decreased. The turnover rate of NE in the stomach was unchanged. Pretreatment with hexamethonium, a ganglionic nicotinic receptor blocker, abolished the hypoxia-induced changes in the turnover rate of NE or E in the heart, adrenal gland and submaxillary gland. Furthermore, transection of the spinal cord at the level of C5-6 abolished hypoxia-induced alterations in the turnover rate of NE and E in the adrenal gland and submaxillary gland. In contrast, the hypoxia induced changes seen in the heart persisted, although at a lower level, even after transection. These results show that the effects of hypoxia on the activities of the sympathoadrenal system differ depending on the organs; activities are increased in the heart and adrenal gland, decreased in the submaxillary gland and unchanged in the stomach. Furthermore, the present data suggest that hypoxia-induced alterations in the activities of cardiac sympathetic nerves originate in both the brain and spinal cord, including preganglionic neurons, whereas changes in the activities of the sympathetic nerves to the adrenal gland and submaxillary gland originate mainly in the brain. PMID- 3559987 TI - Actions of flunarizine, a Ca++ antagonist, on ionic currents in fragmented smooth muscle cells of the rabbit small intestine. AB - Actions of flunarizine on the Ca++ inward and K+ outward currents were investigated using fragmented smooth muscle cells (smooth muscle ball) prepared from the longitudinal muscle layer of the rabbit ileum. Flunarizine dose dependently inhibited the Ca++ inward current (ID50 = 1.4 microM). The decay of the inward current consisted of two exponentials and flunarizine had no effect on these time constants. When command pulses (100 msec; stepped up to 0 mV from -60 mV) were applied every 20 sec, the peak amplitude of the inward current remained unchanged. Flunarizine above 0.3 microM slowly inhibited the peak amplitude of inward current, in a voltage- and use-dependent manner. Intracellular perfusion of flunarizine, up to 100 microM, did not modify the peak amplitude of the inward current. This Ca++ antagonist also inhibited the K+ outward current, in a dose dependent manner (ID50 = 5.8 microM) and accelerated inactivations of this current. When the command pulses (300 msec; stepped up to +20 mV from -60 mV) were applied repetitively every 20 sec, amplitudes of the K+ outward current were not affected. However, flunarizine, above 1 microM, reduced the peak amplitude of the K+ outward current slowly. These results indicate that although flunarizine possesses the property of a Ca++ antagonist, it also inhibits the K+ outward current, in a manner different from that observed on the Ca++ inward current. PMID- 3559988 TI - Evaluation of the receptor selectivities of opioid drugs by investigating the block of their effect on urine output by beta-funaltrexamine. AB - The effects of a series of opioid drugs on urine output in the water-loaded rat were studied and also the block of those effects by the irreversible opioid receptor antagonist, beta-funaltrexamine (beta-FNA). Fentanyl, d-propoxyphene, profadol, bromadoline, buprenorphine and nalbuphine produced only a decrease in urine output, which was antagonised by pretreatment with beta-FNA, 40 mg/kg s.c., 24 hr beforehand. These drugs were thus characterized as selective mu receptor agonists. U-50,488, tifluadom, Mr2034, proxorphan, ethylketocyclazocine and butorphanol all produced an initial decrease in urine output, which was antagonized by beta-FNA, and therefore probably mu receptor mediated, followed by a beta-FNA insensitive diuretic effect, which was probably kappa receptor mediated. For U-50,488, tifluadom, Mr2034 and proxorphan the threshold dose for increasing urine output was lower than that for decreasing it, suggesting that these four compounds are kappa-selective agonists. For ethylketocyclazocine and butorphanol, the threshold doses for producing both effects were similar, suggesting that these two drugs are non-selective agonists. SKF 10,047 produced a diuretic effect at low dose-levels, which may be kappa receptor mediated, and a beta-FNA insensitive decrease in urine output at higher dose-levels, which may suggest a sigma receptor mediated effect. PMID- 3559989 TI - Spinal and supraspinal components of GABAergic inhibition of the micturition reflex in rats. AB - The effect of gamma-aminobutyric acid (GABA)ergic drugs on micturition reflexes was investigated in urethane-anesthetized rats. Intracisternally administered GABA or homotaurine inhibited, in a bicuculline-sensitive manner, the supraspinal micturition reflex. Bicuculline or picrotoxin increased the amplitude and duration of the micturition contractions of supraspinal origin, suggesting the existence of a tonic GABAergic inhibitory mechanism. Neither diazepam nor bicuculline or picrotoxin had any significant effect on threshold of the spinal vesico-vesical micturition reflex. Aminooxyacetic acid, an inhibitor of GABA catabolism, increased threshold of the spinal but not of the supraspinal vesico vesical reflex in a bicuculline-sensitive manner. Volume threshold for eliciting the supraspinal reflex was increased by diazepam and decreased by picrotoxin. Neither picrotoxin nor aminooxyacetic acid modified amplitude of bladder contractions elicited by pinching of the perineal skin (spinal somato-vesical reflex) nor of that produced by preganglionic nerve stimulation of the excitatory nerves. It is concluded that endogenous GABAergic mechanisms involving the activation of GABA A receptors modulate both the spinal and the supraspinal vesico-vesical micturition reflexes. These endogenous GABAergic mechanism(s) are operating tonically in inhibiting micturition at supraspinal but not spinal level. PMID- 3559990 TI - Human fixation and pursuit in normal and open-loop conditions: effects of central and peripheral retinal targets. AB - Eye movements were recorded precisely with a scleral-coil method under three experimental conditions: fixation of a central, stationary target; pursuit of a central, moving target; pursuit of eccentric, moving targets. Subjects were instructed to attend to and fixate the target and to pursue it when it moved. The target was presented either in darkness (no visible background), on a diffusely lighted background, or on a large, structured background. Target and/or background could be moved independently with single sinusoids, pseudo-random mixtures of sinusoids or triangular waves. The target was usually presented under normal viewing conditions, but in some measurements (interleaved with normal ones) retinal target motion was uncoupled from eye motion by electronical addition of the eye position to the target position (open-loop conditions). The gain and phase relations of eye movements induced by motion of the target and/or background were calculated for the total, composite (smooth and saccadic) eye movement and for the reconstructed cumulative smooth component separately. Horizontal motion of a large, structured background induced correlated smooth eye movements while subjects fixated a stationary point target. The induced horizontal movements were very small (gain about 0.05) when the target was seen normally, and larger (gain about 0.20) when the target was horizontally stabilized on the retina. The phase lag of the induced eye movements relative to the background movements was usually smaller than 90 deg. When the target moved vertically and the background horizontally, vertical pursuit was similar to that with a stationary background, but in addition horizontal smooth eye movements, correlated with the background movements, were elicited with a gain of about 0.1 and a phase lag which was usually smaller than 90 deg. Imposed pseudo-random retinal motion of a central target under open-loop conditions (retinal image motion uncoupled from eye movements) elicited highly idiosyncratic responses which varied too much among subjects to allow any general conclusions, other than that open-loop stimulation seems unsuitable as a tool for analysing the response characteristics of the smooth pursuit system. In the absence of a background, an eccentric target configuration (two vertically aligned arrows with the points localized 5 deg above and 5 deg below the fovea) in horizontal motion was pursued equally well as a central target.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559991 TI - Human ocular vergence movements induced by changing size and disparity. AB - Human subjects viewed an electronically generated bright square. Horizontal movements of the two eyes were recorded with the scleral coil method. The dynamic properties of vergence movements induced by movement of the bright square were investigated for the following three kinds of stimulus motion: (a) both the size and the binocular disparity of the square changed together, in such a way as to exactly mimic the retinal image changes produced by a real object's motion in depth; (b) the changing-size component in (a) was present with no disparity component; (c) the changing-disparity component in (a) was present with no size component. The gain and phase of the ocular vergence responses to these three stimuli were computed. Ocular vergence movements were induced by changing size in all five subjects. Responses during binocular viewing were higher and less variable than responses during monocular viewing. Size oscillations induced ocular vergence oscillations with a phase lead of up to 65 deg relative to target size for frequencies of stimulation below 1.0 Hz. Vergence oscillation amplitudes were of the order of 10 min of arc and maximal for frequencies of 0.4-0.7 Hz. Ocular vergence movements were not induced by changes in target size in one dimension nor by flickering a stationary square. Ocular vergence movements induced by size changes were entirely transient with no sustained component: vergence responses to disparity were sustained. When the stimulus combined size change with disparity change in the ratio characteristic of a real moving object, vergence tracking was more accurate and less noisy than when the eyes were stimulated with the disparity component alone. The ocular vergence response induced by the combination of size change with disparity change was accurately predicted by linearly adding the vergence response produced by the size change alone to the vergence response produced by the disparity change alone: combined stimulation produced no evidence of non-linear interaction between responses to size change and to disparity change. The properties of vergence responses induced by changing size and by changing disparity showed several close correlations with the corresponding data on psychophysical sensitivity for motion-in-depth sensation. We suggest that responses to changing size contribute to the accuracy with which ocular vergence tracks real objects moving in depth. PMID- 3559992 TI - Afferent fibres in cat ventral roots: electrophysiological and histological evidence. AB - Electrophysiological experiments using averaging techniques, as well as anatomical experiments using horseradish peroxidase staining, have provided further evidence of afferent axons in lumbosacral ventral roots of cats. Recording from dorsal root filaments in L7, S1 or S2, following stimulation of the companion ventral root close to the dura, often shows action potentials of slow conduction velocity belonging to the A delta or C group. Stimulation applied to the proximal part of the ventral root failed to evoke such responses. Recording from multiple sites along a centrally cut ventral root filament shows responses of two types: action potentials of long latency to peripheral nerve stimulation which are seen at all recording locations and which are not seen following dorsal root stimulation. These appear to be afferent fibres which enter the cord via the ventral root; action potentials which follow dorsal root stimulation and which are usually seen only at the most distal ventral root recording site. Some of these were also activated by stimulation of some skin or muscle nerves. At appropriate intervals collision of impulses from dorsal root or peripheral nerve can be demonstrated. Such axons appear to have a recurrent course in the ventral root. Section of the spinal nerve at points progressively closer to the dorsal root ganglion abolishes the dorsal to ventral root continuity of most recurrent type axons at 2 mm distal to the ganglion. Following application of horseradish peroxidase to crushed ends of distal stumps of cut dorsal roots, thin fibres marked by the enzyme are observed in the distal part of companion ventral roots. U-turns of axons have been observed in the distal part of ventral roots and in the spinal nerve near the pole of the ganglion. PMID- 3559993 TI - Small intestinal motility and transit by electromyography and radiology in the fasted and fed pig. AB - The pattern of small intestinal digesta transit was studied in six young pigs (20 30 kg) by simultaneous electromyography and radiology. Pigs showed migrating myoelectric complexes (m.m.c.s) in the small intestine both when fasted and after feeding. The m.m.c.s were modified by feeding; quiescence was much reduced in duration and irregular spiking activity (i.s.a.) was prolonged; m.m.c.s were not disrupted and phases of regular spiking activity (r.s.a.) were still seen after feeding. The r.s.a. phase could be recognized on the screen and in spot films from both fasting and fed pigs as a band of intense rhythmic contractions pinching off the intestine and propelling all intestinal contents ahead of it. The r.s.a. moved caudad clearing the small intestine of digesta and leaving an empty quiescent intestine behind it. It was particularly characteristic in the fasted pig where it was usually associated with the progression of a gas bubble. The pattern of m.m.c.s in both fasted and fed animals along with the intermittent nature of stomach emptying, divided digesta into batches which progressed through the small intestine. Each batch--propelled by a m.m.c.--normally took 180-190 min to pass through the small intestine. M.m.c.s had a cycle length of 70-115 min in different parts of the small intestine. Usually two or three m.m.c.s and batches of intestinal contents were present in the small intestine at any one time. 22 33% of the m.m.c.s faded out in the proximal ileum. Batches of digesta propelled by these m.m.c.s had transit times increased by one m.m.c. duration and fused with the subsequent batch. Sometimes new m.m.c.s were generated in the terminal ileum. Two patterns of transport into the large intestine were seen. Usually digesta was transported by peristaltic rushes starting 100-200 cm from the ileo caecal junction. The rush then continued through 1-1 1/2 turns of the spiral colon; occasionally the terminal ileum emptied by slow peristalsis. In this case there was no colonic rush and digesta went into the caecum. PMID- 3559994 TI - The influence of intestinal infusion of fats on small intestinal motility and digesta transit in pigs. AB - The influence of duodenal and ileal infusion of nutrients on small intestinal transit of digesta, measured by the passage of phenol red marker, was studied in twelve pigs fitted with duodenal and ileal catheters, and a terminal ileal cannula. Changes in gastrointestinal motility were observed by electromyography and by use of an X-ray image intensifier in four of the pigs fitted additionally with nichrome wire electrodes in the gut wall and in seven pigs fitted only with a gastric catheter. Small intestinal transit time was unaffected by intestinal catheterization per se, or by duodenal or ileal infusion of glucose or peptone. It was reduced by duodenal infusion of fat or of some of the products of fat digestion including oleic acid and a monoglyceride containing unsaturated fatty acids (monoglyceride LS) but was not affected by infusion of glycerol, stearic acid or a monoglyceride containing saturated fatty acids (monoglyceride P). Ileal transit time was greatly reduced by ileal infusion of soya bean oil mixed with bile salts and lipase and by monoglyceride LS but not by soya bean oil alone. Total small intestinal transit time was reduced to a lesser degree by ileal infusion of soya bean oil mixed with bile salts and lipase and by monoglyceride LS and was unaffected by soya bean oil alone. The level of irregular spiking activity of the small intestine was greatly reduced by both duodenal and ileal infusion of fat, but rapidly propagated spike bursts were initiated from the point of infusion (identified radiologically as peristaltic rushes) many of which travelled right through to the ileo-caecal junction. It is concluded that intestinal infusion of fat accelerates small intestinal transit in pigs by induction of peristaltic rushes; that since the ileal transit times were more severely reduced than total small intestinal transit times by ileal infusion of fat the response is probably only seen over those areas of intestine in direct contract with the fat; and that the effect depends upon the presence of fat digestion products, i.e. the fatty acid and the monoglyceride, although probably only those containing unsaturated fatty acids. PMID- 3559995 TI - Synaptic physiology of spinal motoneurones of normal and spastic mice: an in vitro study. AB - Spinal cord reflexes have been examined in a preparation of the mouse spinal cord maintained in vitro. Responses of the motoneurone population of normal and spastic mutant mice to stimulation of a segmental dorsal root were compared. In the normal spinal cord, a monosynaptic response with very little polysynaptic excitation was typical. In the mutant, the monosynaptic response was typically followed by a depolarizing wave on which asynchronous compound action potentials were superimposed. In some spastic cords, an oscillating depolarizing wave was seen, lasting up to 500 ms. The stimulus range from threshold to maximal response was the same for the normal and mutant. The dorsal root reflex (d.r.r.) and dorsal root potential (d.r.p.) were prominent in both normal and mutant, and no consistent difference could be identified. Intracellular recordings were made from motoneurones using electrodes filled with potassium acetate. Mean resting potentials and input resistances were not significantly different in mutant and normal mice. The voltage-dependent conductances, seen as the after-depolarization and after-hyperpolarizations following antidromic action potentials and the responses of motoneurones to depolarizing current injection were similar in both populations. The synaptic responses of motoneurones following stimulation of the segmental dorsal root were clearly abnormal in the mutant. In the normal mice, a monosynaptic excitatory post-synaptic potential (e.p.s.p.), seen at low stimulus intensities, was followed at higher stimulus intensities by polysynaptic activity lasting up to 100 ms, which rarely reached threshold for action potential discharge. In the mutant mice, the monosynaptic response was typically followed by depolarizing synaptic responses which often evoked action potentials before the monosynaptic response reached threshold. At higher stimulus intensities, the monosynaptic response was followed by at least one and often multiple action potentials generated on prolonged depolarizing synaptic activity. When cells were impaled with potassium-acetate-filled electrodes, very little spontaneous synaptic activity was seen in either normal or mutant mice. Spontaneous depolarizing post-synaptic potentials (p.s.p.s) were prominent in normal motoneurones when potassium chloride was used to fill electrodes and were increased in amplitude by ionophoresis of chloride into the cells. Under these conditions stimulation of a ventral root evoked a depolarizing p.s.p. and the Renshaw i.p.s.p. reversed. The spontaneous p.s.p.s were blocked by ionophoresis or bath application of the glycine antagonist strychnine.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559996 TI - Effects of high potassium on the release of [3H]dopamine from the cat carotid body in vitro. AB - Using an in vitro preparation of the cat carotid body, we have characterized the release of [3H]dopamine (DA) induced by high extracellular K+. Pulse superfusion (3 min) with high K+ Tyrode solution (20-80 mM) evoked a concentration-dependent release of [3H]DA from type I cells with a threshold at about 20 mM-extracellular K+ and a plateau at about 60 mM-extracellular K+. Equivalent low extracellular Na+ concentration ([Na+]o) solutions osmotically balanced with sucrose did not induce release. The high extracellular K+ concentration ([K+]o)-evoked release of [3H]DA by type I cells was dependent on the presence of Ca2+ in the superfusion media. On prolonged (10-14 min) superfusion with high K+ Tyrode solution, the [3H]DA release evoked by 60 mM-extracellular K+ was transient, while that evoked by 30 mM-extracellular K+ was sustained. In preparations superfused for 6 min with 60 mM-extracellular K+ and zero extracellular Ca2+ concentration ([Ca2+]o) Tyrode solution, reintroduction of Ca2+ did not elicit a secretory response. Ba2+ was a potent secretagogue of [3H]DA in preparations superfused with normal and zero [Ca2+]o Tyrode solution. Additionally, Ba2+ was capable of eliciting a secretory response from type I cells in preparations previously exposed (6 min) to 60 mM-extracellular K+, whether or not [Ca2+]o was present. With regards to stimulus-secretion coupling, our results indicate that high [K+]o probably depolarizes type I cells. This effect would, in turn, activate voltage-dependent Ca2+ channels, allowing the entrance of this ion to activate the neurosecretory response. PMID- 3559997 TI - Sulphate transport into vesicles prepared from human placental brush border membranes: inhibition by trace element oxides. AB - Inhibitors of SO4(2-) entry into and efflux from vesicles prepared from the brush border membrane of term human placenta have been studied, using 35SO4(2-) and an anion-exchange column assay. Divalent anions were found to be either potent or relatively feeble inhibitors of SO4(2-) uptake. Those which, like SO4(2-) itself, have a tetrahedral configuration, were strongly inhibitory and all of these anions were the metal oxides of elements of group VI (A and B) of the Periodic Table (chromate, molybdate, tungstate, selenate and thiosulphate). Divalent anions which were only weak inhibitors of SO4(2-) uptake were arsenate, phosphate and tetraborate. Chromate and to a lesser extent molybdate were effective inhibitors of SO4(2-) efflux from vesicles pre-loaded with SO4(2-). SO4(2-) efflux was insensitive to the electrical potential across the vesicle membrane. These results are discussed with respect to the mechanism for SO4(2-) transport across this membrane from mother to fetus and in the context of the transport to the feto-placental unit of the essential trace elements, selenium, chromium and molybdenum. PMID- 3559998 TI - An investigation of chloride-bicarbonate exchange in the sheep cardiac Purkinje fibre. AB - Intracellular Cl activity (aiCl), and intracellular pH (pHi) were measured in isolated sheep cardiac Purkinje fibres using a liquid ion exchanger Cl-selective micro-electrode and a glass recessed-tip, pH-selective micro-electrode. Removal of external Cl (glucuronate substituted) produced a fall in aiCl from about 20 to about 4 mmol/l: the residual level is probably caused by intracellular interference on the Cl-sensitive electrode. Re-exposure of the fibre to increased levels of external Cl produced, in the steady state, increased levels of aiCl. The dependence of steady-state aiCl upon external Cl activity, aoCl, was roughly hyperbolic with 50% recovery occurring at an aoCl of about 9.5 mmol/l. At all levels of external Cl tested, Cl was accumulated to a level much higher than that predicted for passive electrochemical equilibrium. Exposure of a Cl-depleted fibre to various levels of external Cl produced an exponential rise with time in aiCl. The initial rate-of-rise in aiCl was estimated to be a saturating function of aoCl, with a half-maximal effect occurring at an aoCl of about 33 mmol/l. The rate-of-rise was about 10-fold greater than that predicted from constant-field theory using published values for PCl, the Cl permeability coefficient. Steady state aiCl was essentially insensitive to changes in external HCO3 concentration, [HCO3]o, if these changes were made at a constant external pH, pHo, i.e. when a reduction in [HCO3]o was accompanied by a simultaneous reduction in the partial pressure of CO2, PCO2. In contrast, if PCO2 was maintained constant, then a change in [HCO3]o (thus producing a change in pHo) resulted in an inverse change in aiCl. This change in aiCl was also accompanied by a change in pHi: when aiCl increased, pHi decreased and vice versa. The anion-exchange inhibitor, DIDS (4,4 diisothiocyanato-stilbene disulphonic acid) abolished the effect on aiCl of changes in [HCO3]o and pHo (at constant PCO2). Furthermore DIDS reduced the influence of pHo upon pHi. Both the fall of aiCl in Cl-free solution and the subsequent reuptake of Cl following re-exposure to Cl-containing solution were slowed by a reduction in [HCO3]o (constant pHo, reduced PCO2). Both reuptake and wash-out of Cl were saturating functions of [HCO3]o with half-maximal effect occurring at an [HCO3]o of 1-1.3 mmol/l. The reuptake of Cl was little affected by removal of external Na (bis,2-hydroxy ethyl, dimethyl ammonium substituted). The reuptake of Cl was unaffected by amiloride (1 mmol/l) but slowed by piretanide (1 mmol/l).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3559999 TI - Mossy fibres sending retinal-slip, eye, and head velocity signals to the flocculus of the monkey. AB - Discharges of mossy fibres were recorded from the cerebellar flocculus of monkeys trained to fixate a small visual target and to track the target when it moved slowly. The experimental paradigms used were designed to study neural responses to retinal-slip velocity, eye velocity, or head velocity, individually or in combination. Among 485 mossy-fibre units recorded from the flocculus, sixty-four units (or 13%) responded to movement of the visual stimulus in the horizontal plane. Two distinct groups of visual mossy fibres were found: they were designated 'visual units' (thirty-nine/sixty-four units or 61%) and 'visuomotor units' (twenty-five/sixty-four units or 39%). The visual units responded exclusively to the retinal-slip velocity. Stationary fixation was necessary for clear cyclic modulation of activity. Their responses declined when the retinal slip velocity was reduced by eye movements in the same direction. The responses of the visual units were directionally selective and lagged behind the occurrence of 'turnabouts' (changes in direction of stimulus movement) and their peak discharges also lagged the occurrence of peak velocity. Each visual unit had a limited range of velocity sensitivity; in some units the range covered the velocity range of smooth-pursuit eye movements. The visuomotor units had visual receptive fields in the peripheral retina (outside of the central 10 deg); they received also oculomotor and vestibular signals. When the head was stationary, the visuomotor units responded to the target velocity (or visual stimulus velocity) which is the algebraic sum of the retinal-slip velocity and the eye velocity. Their responses reflected the retinal-slip velocity during stationary fixation and the eye velocity during smooth-pursuit eye movements. The responses to stimulus movements were, therefore, almost identical regardless of whether the eyes remained stationary or moved with the stimulus. In response to sinusoidal stimulus movements, the responses of the visuomotor units frequently preceded the stimulus velocity, and the phase lead relative to the velocity curve increased when the frequency of sinusoidal movements was increased. This reflected a relatively constant lead of neural discharges (circa 125 ms) during various frequencies. When the head was moved, the responses of the visuomotor units were dominated by the head velocity, and discharges in response either to the retinal slip velocity or to the eye velocity (both in the direction opposite to the head velocity) were occluded.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3560001 TI - Reflex origin for the slowing of motoneurone firing rates in fatigue of human voluntary contractions. AB - During fatigue from a sustained maximal voluntary contraction (m.v.c.) the mean motoneurone discharge rates decline. In the present experiments we found no recovery of firing rates after 3 min of rest if the fatigued muscle was kept ischaemic, but near full recovery 3 min after the blood supply was restored. Since 3 min is thus sufficient time for recovery of any central changes in excitability, the results support the hypothesis that, during fatigue, motoneurone firing rates may be regulated by a peripheral reflex originating in response to fatigue-induced changes within the muscle. PMID- 3560002 TI - [A thalamo-cerebral connection in vocal center of canary]. AB - Canary song is controlled by two groups of thalamo-cerebral nuclei. One, the hyperstriatum ventrale pars caudale (HVc) and the robust nucleus of the archistriatum (RA), is a motor driving system for vocalization. The other group, which includes the HVc, the nucleus magnocellularis of neostriatum (MAN), Area X and the nucleus dorsointermedius posterior thalami (DIP), modulates the driving system. The HVc receives synaptic projections from the MAN and sends fibers to Area X. Axons of Area X monosynaptically innervate the thalamic nucleus, the DIP, from which neurons extend axons back to the cerebral nucleus, the MAN. DIP neurons relay incoming impulses by way of Area X to the MAN. Double labeling of DIP neurons with HRP and Fast Blue shows that axonal terminals from Area X connect directly with DIP neurons which send fibers to the MAN. The axon formed a bulge from which multiple branches extended to the postsynaptic cell bodies covering most of the surface. The structure of the DIP synapse may be related to a characteristic pattern of discharge of the DIP neuron, which is transmitted over thalamic projection to cerebral vocal nuclei. PMID- 3560000 TI - Thalamic burst patterns in the naturally sleeping cat: a comparison between cortically projecting and reticularis neurones. AB - Unit discharges were extracellularly recorded from antidromically identified thalamocortical neurones of ventralis lateralis (v.l.) and centralis lateralis (c.l.) nuclei as well as from reticularis thalami (re.) neurones during wakefulness and electroencephalogram-synchronized sleep of the behaving cat. Various parameters of sleep-related discharge bursts were analysed. Statistical analyses revealed striking similarities between motor relay (v.l.) and intralaminar (c.l.) neurones. More than 60% of bursts consist of three to five spikes at 250-400 Hz. The defining feature of bursts in all cortically projecting neurones is a progressive increase in the duration of successive interspike intervals. As in thalamocortical cells, all re. neurones change their tonic discharges in waking to bursting firing in sleep, regardless of the increased or decreased firing rates from wake to sleep in individual neurones. The bursts of re. neurones are essentially different from those of thalamocortical cells. In re. neurones, burst structure consists of an initial progressive decrease in duration of interspike intervals, followed by an increase in duration of successive intervals, eventually leading to a long-lasting tonic spike train at about 100 Hz. In contrast with bursts of thalamocortical neurones, only 6% of re. bursts are shorter than 50 ms; the total duration of the burst extends between 50 ms and 1.5 s. Population periburst histograms show the beginning of a decline in firing probability about 1.5 s prior to burst onset and an increased firing probability persisting for 300-350 ms after burst onset. The different electrophysiological properties underlying the burst structure of cat's thalamocortical and re. neurones are discussed, with emphasis on dissimilar aspects of re. bursts in unanaesthetized and barbituratized preparations. Various factors that may account for the transition from tonic mode in waking to bursting mode in sleep are envisaged. PMID- 3560003 TI - [The effect of vigorous exercise training on cholesterol metabolism in rats]. AB - Twenty-eight male Wistar rats, aged 7 weeks, were subjected to a vigorous exercise regimen of running for 5 weeks and 35 rats were selected as their controls. After 5 weeks both exercised and control rats were injected 2 microCi of 14C-mevalonate per 100 g body weight into peritoneal cavities and sequentially sacrificed at 20, 40, 60, 80, 100, 120, and 180 min after the injections in each subgroup. The exercised rats showed a significantly lower level of serum total cholesterol than the control rats. The activity of HMG-CoA reductase in liver microsome was significantly higher in the exercised rats than in the control rats. No differences existed in intestinal HMG-CoA reductase activity between exercise and control groups. The incorporation of mevalonate into liver cholesterol and serum cholesterol (especially HDL fraction) in the exercised rats were significantly higher compared with these of the control. Furthermore, the exercised rats showed a higher rate of cholesterol synthesis activity in liver. From these results it was concluded that the hepatic lipoprotein cholesterol production was elevated by exercise compared with that of control. PMID- 3560004 TI - Cardiac regulation and depression. AB - Heart rate and heart rate regulation during sleep and wakefulness was studied in 28 patients with major depressive disorder and in 19 control subjects. Heart rate during quiet wakefulness was greater in the depressed group (H.R. = 73.04) than in the control group (H.R. = 65.35) (t = 3.06, p less than 0.005). Heart rate remained elevated throughout sleep in the depressed group as measured in Stage II (H.R. = 67.81) compared with the control group (H.R. = 60.84) (t = 2.49, p less than 0.01). Heart rate increased during movements in sleep in all subjects. The heart rate increases were attenuated in the depressed subjects compared with nondepressed controls (p less than 0.001). The effect was independent of sleep stage or baseline heart rate. All effects were independent of subject age. These findings point to a change in autonomic regulation of heart rate in depression. PMID- 3560005 TI - Age-period-cohort analysis of secular trends in onset of major depression: findings in siblings of patients with major affective disorder. AB - Analyses of data from the NIMH-CRB Collaborative Depression Study on age at onset of Major Depressive Disorder (MDD) in 1144 directly interviewed siblings of patients with major affective disorder show a strong secular trend toward increased lifetime risk and earlier onset in successive cohorts of birth since 1930. The proportionate increases in the instantaneous probabilities (hazard) of onset of MDD for each one year difference in year of birth were 5% for brothers and 7% for sisters. Age-period-cohort analysis suggests a powerful period effect may be responsible for this secular trend in rates of MDD, with rates of onset for siblings between 15 and 50 years of age doubling between the 1960s and 1970s. Possible artifacts are investigated. PMID- 3560006 TI - Evidence for homogeneity of major depression and bipolar affective disorder. AB - This study compared the morbidity risk for affective disorder in relatives of probands who had bipolar (BP) or major depression (UP). Other risk factors were also evaluated. 112 consecutively admitted inpatients yielded 621 relatives with diagnostic information based on either the Renard diagnostic interview, hospital records or information from at least two reliable relatives using the Feighner diagnostic criteria. Similar age corrected morbid risk estimates were found for family members of UP and BP probands of 0.243 and 0.246. There was a 50% increase in morbidity risk for women in all three generations but no relationship to the diagnosis of the proband. A proportional hazards (life table) analysis demonstrated that probands with onset prior to age 40 had relatives with younger onset and higher risk. None of the analyses, including logistic regression and proportional hazards, differentiated UP from BP illness. PMID- 3560007 TI - The impact of diagnostic misclassification on the pattern of familial aggregation and coaggregation of psychiatric illness. AB - Family studies in psychiatry have traditionally been interpreted as if psychiatric diagnoses were made without error. This is unlikely to be true. The first section of this paper presents a model, based on several simplifying assumptions, which examines the impact of diagnostic misclassification on patterns of familial aggregation and coaggregation of two disorders. In the second section, the model is illustrated by examining the effect of varying misclassification rates on the patterns of aggregation and coaggregation in four simulated family studies of psychotic illness. Misclassification is considered which is equal or unequal for the two disorders, which is the same in probands and relatives or greater in relatives and which occurs between disorders of similar or quite different population risk. Misclassification in the range which commonly occurs in psychiatry can produce substantial effects on the observed pattern of familial aggregation and coaggregation. Furthermore, the proportion of diagnosed cases which are misclassified varies widely depending upon whether an affected individual is from the general population or is a relative of an individual affected with the same or a different psychiatric disorder. The third section of the paper illustrates a method for examining the fit of the proposed model to observed data and "correcting" for the effects of misclassification in family studies. For example, the familial coaggregation between bipolar illness and schizophrenia in a recent large family study can be entirely explained by the observed rates of diagnostic misclassification between the two disorders. The results of the proposed model strongly suggest that diagnostic misclassification should be considered in the interpretation of family studies of psychiatric illness. PMID- 3560008 TI - Psychiatric diagnosis of patients with substance abuse problems: a comparison of two procedures, the DIS and the SADS-L. Alcoholism, drug abuse/dependence, anxiety disorders and antisocial personality disorder. AB - We compared DSM-III and RDC diagnoses from the DIS to RDC diagnoses from the SADS L for alcohol and drug use disorders, anxiety disorders and Antisocial Personality Disorder in a group of patients with substance abuse problems. Kappa values for substance use disorders were fairly good. The instruments did not agree well on anxiety disorders, or on Antisocial Personality Disorder. Criterion differences gave rise to some of the disagreement between the instruments on Antisocial Personality Disorder, but the causes of disagreement for the anxiety disorders were not so clear. The implications of these findings are discussed. PMID- 3560010 TI - Spatial role-taking ability among bilingual and monolingual kindergarten children. AB - Fifty-seven children enrolled in a bilingual Spanish kindergarten program, assigned to appropriate language and age-related groups, were shown a graduated sequence of increasingly complex arrangements of multicolored blocks and were asked to judge how the original arrangement would look from the opposite and the side perspectives. A series of 2(younger vs. older) X 3(Spanish Monolingual vs. English Monolingual vs. Spanish-English Bilingual) ANOVAs for each of the types of responses (correct, incorrect, egocentric) showed a significant main effect for age on the incorrect answers. No differences associated with egocentrism were obtained. There was no relationship between age and success with simple and complex spatial tasks. As opposed to other studies that suggest certain cognitive advantages for young bilingual children, this study indicates no perceptible differences associated with being monolingual or bilingual at the ages of 5 and 6 for spatial tasks. PMID- 3560009 TI - Separating the redundancy of voicing from nasality in American English. AB - This paper reports the results of a study designed to separate the voicing redundancy from nasality in American English and to determine their individual saliencies. Sixty-seven subjects judged the similarity of nonnasal pairs versus nasal pairs of CV and VC nonsense syllables on a 5-point magnitude-estimation task. The 80 stimuli were constructed to control and to demand subjects' cognitive strategies for coping with redundancy rather than experimental manipulation of the data. They were developed from the consonantal repertoire of (b d g m n p t k) paired with the vowels (i a u), totaling 72 pairs of dyads. Eight additional stimuli of similar structure, testing multifeature and identity contrasts, were included to monitor the validity of the experimental procedure. Results indicated that speech redundancy can be circumvented cognitively, nasality was more salient (different) than voicing, and a recency effect was found. These findings are discussed in reference to existing data. PMID- 3560011 TI - Two-stage gastrectomy for the difficult duodenal stump. PMID- 3560012 TI - Towards a selective policy of operative cholangiography: a prospective clinical study. PMID- 3560013 TI - Silicone lymphadenopathy, synovitis and osteitis complicating big toe Silastic prostheses. PMID- 3560014 TI - Intra-ocular haemorrhage in menstruation. PMID- 3560015 TI - Delayed presentation of traumatic false aneurysms. PMID- 3560016 TI - Surgeon's workshop. A method of tube drain fixation. PMID- 3560017 TI - Myositis ossificans progressiva. PMID- 3560018 TI - Recurrent haematemesis from an aneurysm of the gastroduodenal artery after pancreatectomy. PMID- 3560019 TI - Giant exogastric leiomyoma: a diagnostic pitfall. PMID- 3560020 TI - Incisional hernia of the diaphragm causing large bowel obstruction. PMID- 3560021 TI - Retrogastric hernia through the lesser omentum: a rare complication of proctocolectomy. PMID- 3560022 TI - Differential wound bleeding at laparotomy can be a sign of an aortocaval fistula. PMID- 3560023 TI - Operative endoscopic decompression of colonic pseudo-obstruction. PMID- 3560024 TI - Metachronous squamous cell carcinoma and adenocarcinoma of the colon. PMID- 3560025 TI - Impaction and disintegration of a swallowed table knife. PMID- 3560026 TI - Is a conservative approach to vascular graft infection feasible? PMID- 3560027 TI - [Value of small intestine transit by enteroclysis in obstructive syndromes of the small intestine. Apropos of 212 examinations]. AB - During seven years, 212 small bowel examinations are made on patients with suspected small bowel obstruction by barium infusion. We find all the main small bowel pathology: Crohn's disease (16.5%), carcinomatosis (14.6%), neoplasia (10.3%), vascular disease (17.8%), actinic enteritis (9.5%) and miscellanous (18%). The small bowel infusion is normal in 15%. Surgery is avoided in 51% of the cases. There is non complications associated with the examination but in 12% of the cases, the examination is unsuccessful. PMID- 3560028 TI - [Double-contrast colonic radiography. Comparative, randomized study of 4 colon preparations]. AB - Since diagnostic value of double contrast colon imaging is dependent on the colon preparation used, tolerance and efficacy of 4 colon preparations were evaluated by a simple-blind, comparative, randomized study in 185 outpatients. Colon preparation involves variable combinations of 3 means: residue-free diet, laxatives and wash-out enemas. Principal criteria were evaluated under blind conditions by the same investigator during all examinations, with quantitative rating by segment (left, transverse and right colon) of adherence and colon cleanliness, and global assessment of quality of preparation. The 4 groups were comparable: mean age 44.7 years, sex ratio (male/female) 51.3%. Tolerance and compliance were elevated without significant inter-group differences. The colon preparations studied did not allow a homogeneous preparation to be obtained throughout the colon, efficacy in left colon being superior to right colon, whatever the method used. Analysis of cleanliness and adherence by segment failed to show significant differences between procedures, probably related to weak differences in their effectiveness and the strict nature of the study. The use of a global criterion tended to show value of wash-out enemas as a routine procedure, whether in outpatients or in the Radiology department. PMID- 3560029 TI - [Straight azygos continuation of the inferior vena cava. Apropos of 3 cases using an NMR study]. AB - Three patients with straight azygos vein continuation of inferior vena cava (IVC) were studied by nuclear magnetic resonance (NMR) imaging. In all three cases the diagnosis had been established previously by ultrasound and/or computed tomography imaging, but NMR images provided better anatomical precision of the venous anomaly : visualization of the total trajectory of the major azygos vein, the caliber of which can exceed that of aorta, and absence of retrohepatic segment of IVC but presence of a short supradiaphragmatic segment towards which converge the suprahepatic veins; anastomotic etwork between IVC and major azygos vein contributing to ensure continuity of venous drainage superior to its renal segment. The advantages of NMR are described and the precise diagnostic role of this new method of imaging in the diagnosis of this type of anomaly discussed. PMID- 3560031 TI - [Inhalation of metallic mercury. Radiological aspect. Apropos of 2 cases]. AB - Two patients were treated for lesions due to inhalation of mercury, one accidental and the other a suicidal attempt. The pulmonary image showed the mercury fragmented into numerous particles of very enhanced density. In one patient these particles were in the right basal pyramid while in the other they were disseminated throughout the lung fields. The immediate outcome was favorable in both cases. PMID- 3560030 TI - [X-ray computed tomographic diagnosis of connective tissue tumors of the stomach of extrinsic development. Apropos of 6 cases]. AB - Computed tomography findings appear to be very useful for the diagnosis of exogastric tumors on the basis of six cases: 4 leiomyosarcomas, 1 leiomyoblastoma and 1 schwannoma. The diagnosis of these usually large tumors arising within the gastric wall is often difficult through baryum opacification of the stomach (U.G.I.) owing to their exogastric growth. In the same way, endoscopy usually fails to evidence these tumors. Computed tomography permits to rule out an extrinsic tumor such as a hepatic or pancreatic one for instance and then to demonstrate the tumor originates within the gastric wall. The hypervascular pattern associated in most cases with central necrosis is demonstrated through contrast medium injection, what is a very typical and relatively constant-finding in these tumors. PMID- 3560032 TI - [Epithelioid hemangioendothelioma of the liver and superior vena cava. Radiological results apropos of a case in an adult]. AB - Epithelioid hemangioendothelioma is a rare, ubiquitous, vascular tumor, difficult to diagnosis but sometimes identified after detection of metastases, and with a prognosis intermediary between angioma and angiosarcoma. The tumors have been described as developing in the large venous trunks and recently lesions have been reported in liver. Little documented data exist with respect to radiologic appearances. A case is reported with a histologically confirmed hepatic localization in association with a lesion in superior vena cava. PMID- 3560033 TI - [X-ray computed tomographic aspect of gastric leiomyoma. Apropos of a case]. AB - This report studies the diagnostic problem raised by benign pedunculated gastric leiomyoma identified by CT scan imaging and associated with hepatic metastases. Evaluation of the angle of attachment to the wall, the conventional feature enabling distinction between malignant and benign submucous tumours is not always a reliable indicator. PMID- 3560034 TI - [Radiological diagnosis of calcifications of the portal vein. Apropos of a case]. AB - The very rare portal vein calcifictions are detected in patients with a portal hypertension syndrome (PHT). A patient with hepatosplenomegaly and mild signs of PHT presented images of parietal calcifications, and the diagnostic values of different imaging techniques, particularly ultrasound and CT scan, are compared. PMID- 3560035 TI - Free peroneal flap for wide skin defects of the foot and volar scar contracture of the hand. AB - Since May 1981, the authors have transferred 14 free peroneal flaps, with no failures. The advantages of this flap are that the subcutaneous fat is thin, branches of the peroneal artery can be easily located, the vascular pedicle is long, and vessel diameter at the junction of the peroneal artery is 1.0 to 1.5 mm. After the branches of the peroneal artery and vein are identified and carefully preserved, they are anastomosed to preselected vessels at the recipient site, using the operating microscope at 10 to 16 X magnification. When two branches of the peroneal artery are used, a larger flap is obtainable, but no sequelae or dysfunction at the donor site have been observed. In the reported series, the anastomoses were all carried out by one surgeon (HN). PMID- 3560037 TI - The lateral arm flap: an anatomic study. AB - The anatomy of the lateral arm flap is further elucidated, and the surgical techniques involved in raising the flap are described in detail. The data are derived from studies in 25 cadavers and five clinical cases. The relative merits of this versatile free flap are discussed. Three clinical cases are cited for illustration. PMID- 3560036 TI - Venous flaps in digital revascularization and replantation. AB - This is a report on 15 patients who underwent replantation/revascularization of a single digit with a substantial dorsal soft tissue defect. The dorsal defect was covered with a venous flap, a free flap that has only venous inflow and outflow. Postoperatively, the venous flaps were warm, pink, and appeared to exhibit a blanch and refill phenomenon, clinically resembling capillary filling. The flaps from the dorsal aspect of an uninjured digit had a survival rate of 100 percent, with no partial necrosis, while the flaps from a forearm or dorsal foot donor site failed. The advantages of using venous free flaps are twofold. Not only does this technique provide for venous drainage, but it also provides flap coverage and avoids complications, such as vessel occlusion or hematoma formation, associated with skin grafting over a venous anastomosis, with subsequent loss of the skin graft. PMID- 3560038 TI - A new disposable microvascular double clip. AB - A new disposable microvascular double clip made of polycarbonate has been designed. In order to investigate whether or not the clip causes vascular damage, experiments were conducted with scanning electron microscopy and light microscopy, using the common carotid arteries of Fischer rats. The study revealed that the new clip did not produce any damage to the arterial wall. The clip has also been used in 30 clinical cases, with generally good results. The new microvascular clip is economical, atraumatic to the vascular wall, and is always in the best condition, because of its disposability. The device is very useful for both laboratory and clinical microvascular surgery. PMID- 3560039 TI - Teaching the technique of microsurgical intraneural neurolysis. PMID- 3560040 TI - A case of replantation of a completely amputated digit after 26 hours of warm ischemia. AB - A seven-year-old-boy received a digit replantation after 26 hours of warm ischemia and showed good recovery of motor and sensory functions. In the case reported, replantation was performed after a much longer ischemic time than had been considered an indication for the procedure in previous reports. Successful replantation and revascularization can thus be achieved, even in cases of extensive warm ischemia. PMID- 3560041 TI - Relief of blood-induced arterial vasospasm by pharmacologic solutions. AB - A partially amputated rat hind limb model was used to evaluate the potency of 1 percent, 2 percent, and 20 percent Xylocaine, 0.3 percent papaverine, and normal saline in both the treatment and prevention of blood-induced arterial spasm. Direct application of blood to the femoral artery was shown to produce a 60 percent reduction in limb perfusion. The 0.3 percent papaverine and 20 percent Xylocaine solutions were statistically superior to normal saline and the lower Xylocaine concentrations in their ability to relieve the blood-induced vasospasm and prevent further spasm. Normal saline, 1 percent Xylocaine, and 2 percent Xylocaine showed no preventive effect against blood-induced spasm. These findings emphasize the importance of good hemostasis in microsurgery, and simplify the choice of an effective spasmolytic agent. PMID- 3560042 TI - The effects of intra-arterially injected adriamycin on microvascular anastomosis. AB - Although free tissue transfer following limb-saving wide resection has become increasingly necessary in the treatment of sarcomas of the extremities, the side effects of adjuvant chemotherapy on the microvascular structure are not yet known. There may be significant effects, especially with intra-arterial administration. In order to study the time-dependent manifestations of possible effects, experimental microvascular anastomoses in the rat femoral artery were performed at various intervals, after intra-arterial injection of Adriamycin. This drug was used because of its popularity as an adjuvant chemotherapeutic agent. Vessels were examined at varying intervals for macroscopic changes affecting patency and for histologic changes. Anastomoses done at three weeks after Adriamycin injection resulted in the worst patency rate. Histologically, thrombotic occlusion was associated with widespread and profound disruption of the internal elastic lamina, thought to be thrombogenic trauma: the vessel was presumed to have been made fragile by preoperative Adriamycin treatment. Five weeks or longer after injection, this effect was reduced, according to patency rates and histologic findings. Endothelial damage was minimal and appeared insignificant. PMID- 3560043 TI - Polytetrafluoroethylene microprosthesis in the venous system of the rat. AB - In this study, a 2 mm internal diameter (i.d.) polytetrafluoroethylene (PTFE) microprosthesis was used in the venous system of the rat, to determine whether or not it could serve as an acceptable microvenous substitute. Forty Long-Evans rats were divided into four groups: Group 1-10 rats with autotransplant of an inferior vena cava segment; Group 2-10 rats with a segment substitution of the inferior vena cava by a 2 mm i.d. PFTE microprosthesis; Group 3-10 rats with a laterolateral portacaval shunt; and Group 4-10 rats with a portacaval shunt and interposition of a 2 mm i.d. PTFE microprosthesis (new model). The rats were sacrificed at different time intervals up to 100 days, with cavography (femoral access) in Groups 1 and 2 and spleenoportography (direct puncture of the spleen) in Groups 3 and 4, before sacrifice. In Group 1, a 100 percent patency was observed at a mean of 49 days; in Group 2, a 70 percent patency with a 30 percent stenosis at a mean of 39.4 days (p less than 0.05); in Group 3, a 100 percent patency at a mean of 42.5 days; and in Group 4, a 30 percent patency at a mean of 38.4 days (p less than 0.01). Results showed that the 2 mm i.d. PTFE microprosthesis placed in the venous system of the rat is not an efficacious procedure, and that the search for better microvenous substitutes should focus on those of biologic origin. PMID- 3560044 TI - Spanish Society of Microsurgery, fourth annual meeting. June 5-7, 1986, Zaragoza, Spain. Abstracts. PMID- 3560046 TI - Fortuitous discovery of a left atrial myxoma following acute myocardial infarction. AB - Routine echocardiography following acute myocardial infarction revealed a large totally asymptomatic left atrial myxoma. One year after excision of the myxoma and coronary artery by-pass grafting, the patient remains well. PMID- 3560045 TI - Usefulness of the Y-shaped anastomotic technique in free flap surgery. AB - This is a report of three cases using the Y-shaped anastomotic technique. Y shaped anastomoses were found to be extremely useful in selected clinical situations for free flap transfers. PMID- 3560047 TI - Sudden infant death in service families. AB - A study of all the cot deaths in infancy which occurred in Service families in British Forces Germany (BFG) from 1981-4 was undertaken in order to ascertain the frequency of these tragedies. The total number of deaths was ninety-seven and in sixty cases no cause of death was found at post mortem. The incidence in the Service community was calculated so that comparison could be made with the civilian population of England and Wales. The results of the study indicated that cot deaths occurred relatively more frequently in the Service population even allowing for socio-economic differences between the two groups. However, postneonatal deaths from causes other than cot death occurred less often in BFG. Cot deaths are therefore the cause of the higher postneonatal mortality rates in the Service community and they constitute an important target for preventive medicine. The measures which have been taken in BFG in recent years to reduce the number of cot deaths are discussed in this paper together with some further ideas which might help to solve this distressing problem. PMID- 3560048 TI - Hyperbaric oxygen for a thalassaemic leg ulcer. AB - A thalassaemic ulcer in a male Greek Cypriot patient, resistant to standard medical treatment, was treated using hyperbaric oxygen in a recompression chamber. The patient breathed 100% oxygen by face mask whilst the chamber was compressed with air to a pressure of 2.5 atmospheres absolute. The ulcer became fully epithelialised within three weeks of starting treatment. PMID- 3560049 TI - Mitchiner Memorial Lecture, 1986: the surgeon's oldest enemy. PMID- 3560050 TI - Alcohol associated deaths in British soldiers. AB - In the decade 1968-77, 203 (12%) of the 1723 deaths in off duty British Army males were associated with a blood alcohol concentration (BAC) in excess of 80 mgs/100 mls. These deaths occurred in road traffic accidents (49%), acute alcohol poisoning (23%), suicide (9%), drowning (8%), falling from a height (7%), burns (3%), and interpersonal violence (1%). The mean BAC was similar in all of these categories (180 mgs/100 mls) except in acute alcohol poisoning where it was double this figure. The mean age at death was similar, approximately 24 years, for all categories except suicide, where it was 28 years. The mean age at death of those with raised alcohol levels was not significantly different from that of the total number in the same group. Alcohol associated death is generally more common abroad than in the United Kingdom, with the notable exception that, in the British Army of the Rhine (BAOR), the incidence of alcohol associated road traffic deaths is no higher than that in the United Kingdom. BAC above 80 mgs % is much less common in soldiers whose deaths occur on duty (1.6%). PMID- 3560051 TI - The enlistment medical examination--reasons for failure. AB - During 1984 a short summary of all recruits who failed their recruitment medical examination at Leven was kept. An overall failure rate of 19% was discovered and no recruit examined in 1984 from Army Careers Information Office, Leven, was dismissed from service on medical grounds. It seems quite likely, therefore, that the Regulations covering medical fitness are adequate. Indeed, the Regulations may sometimes exclude fit men from Army service. PMID- 3560052 TI - A study into medical wastage of recruits. AB - The discharge for medical reasons of recruits in the first five months of 1984 was studied. The rate of discharge for medical reasons was found to be 3.3% of the total intake for the same period. Many recruits were discharged without appearing before a medical board. The number of medically discharged recruits represents 12.4% of the total discharges for all reasons. The conditions giving rise to discharge were investigated and it was found that most were related to lower limb problems, particularly patellofemoral pain. Suggestions are made as to ways of decreasing the medical wastage, but it is thought to be unlikely that much impact would be made on the low rate of 3.3%. PMID- 3560053 TI - Dyspepsia among young conscripts: correlations with psychoemotional state and eating habits. AB - The prevalence of dyspepsia was evaluated in 83 young conscripted soldiers: 38 of them were normally resident in the town where the barracks was sited (Genoa) while 45 came from different districts. Dyspepsia was observed in 49.4% of total cases, and there were significant differences in the incidence between the two groups. In 40 out of 41 cases, dyspepsia was of the functional type. Psychoneurotic reactions were found in 69.8% of total cases and these reactions were closely correlated with the occurrence of dyspepsia both in soldiers who were local residents and those who were not. Dyspepsia could not however be correlated with eating habits, or with the consumption of alcohol, coffee or tobacco. PMID- 3560054 TI - Whatever happened to AMD research project 247? PMID- 3560056 TI - Medical indemnity for service medical and dental officers. PMID- 3560055 TI - A case of frostbite. PMID- 3560057 TI - Clinical utility of the nonstress test in the conservative management of women with preterm spontaneous premature rupture of the membranes. AB - Preterm spontaneous premature rupture of the membranes (SPROM) is responsible for significant perinatal morbidity and mortality, largely related to prematurity. Consequently, conservative management is frequently elected. These pregnancies, however, are still at risk. Antepartum fetal heart rate testing has been of demonstrable value in other high-risk pregnancies and should offer a method of assessing risk in SPROM. Therefore, a retrospective analysis of patients with SPROM who underwent antepartum fetal heart rate testing was undertaken to evaluate its clinical utility in identifying the fetus at risk. Forty-eight patients underwent 154 nonstress tests in the study population. Indications for delivery included fetal pulmonary maturity, amnionitis and persistent variable decelerations with the failure of amniotic fluid to reaccumulate. Variable decelerations were present in 32% of all tests. Fetal heart rate abnormalities severe enough to warrant delivery were noted in 10 of 48 patients (21%). No intrauterine deaths occurred. Our data suggest that once conservative management is elected in preterm patients with SPROM, the nonstress test may identify fetuses at risk of repeated umbilical cord compression and may allow continuous monitoring or delivery. PMID- 3560058 TI - Nonmenstrual toxic shock syndrome. Methodologic problems in estimating incidence and delineating risk factors. AB - Toxic shock syndrome (TSS) gained notoriety through its association with menstruation and tampon use. Most studies conducted in the past did not systematically ascertain the incidence of nonmenstrual TSS but relied on voluntarily reported cases, which may be biased. Moreover, some factors that influence the recognition of TSS in menstruating and nonmenstruating women may distort the risk factor status of recognized cases. For these reasons, reliable information on nonmenstrual TSS is largely unavailable. PMID- 3560059 TI - Adhesion reduction in the rabbit uterine horn model using an absorbable barrier, TC-7. AB - Use of a resorbable barrier (TC-7) to reduce adhesion formation was examined in the rabbit uterine horn model. Early evaluation (four days) established that the material remained where initially placed. Examination at two, four and eight weeks postoperatively in both control and treated groups revealed that the extent of adhesion formation did not change as a function of time. When compared to control animals without TC-7, the treated rabbits has a significant reduction (P less than .01) in postoperative adhesion formation. No complications from use of this fabric were noted, and no gross remnants were noted at the two-week time point. TC-7 appears to be an efficacious barrier for reducing adhesion formation in the rabbit uterine horn model. PMID- 3560060 TI - Fetal gender effects on maternal serum prolactin levels. AB - Circulating maternal prolactin (PRL) levels have been reported to be higher in term pregnancies yielding male infants. The mechanism for this gender difference is unknown, but we theorized that it was mediated through the fetal adrenal cortex. To test this theory we measured circulating PRL and estriol (E3) concentrations with radioimmunoassay in 37 pregnant women at 34 and 36 weeks' gestation. We then separated the groups by newborn gender. Maternal serum PRL levels were significantly higher in the women bearing male fetuses. There was no significant difference by gender in E3 concentrations, and there was no PRL surge corresponding to the E3 surge at 34-36 weeks' gestational age. There was no correlation between E3 and PRL levels. Transmission of the fetal gender effect on maternal PRL does not appear to be mediated through the fetal adrenal as measured by the fetoplacental production of E3. The effect probably is mediated by the fetal gonad. PMID- 3560061 TI - Analysis of chromosomally normal spontaneous abortions after chorionic villus sampling. AB - Analysis of patients who spontaneously aborted chromosomally normal pregnancies following chorionic villus sampling (CVS) revealed an overall loss rate of 5.4% but a rate of only 3.2% if the procedure was performed between 9 and 12 menstrual weeks. There is preliminary evidence to suggest that a small but significant risk of infection is related to CVS. PMID- 3560062 TI - Lithokelyphos. A case report and literature review. AB - Retained abdominal pregnancy is an extremely rare complication of pregnancy. A patient presented with an intraabdominal pregnancy that had been retained for 29 years. PMID- 3560063 TI - Uterus didelphys with unilateral hematocolpos, ipsilateral renal agenesis and menses. A case report and literature review. AB - A 13-year-old girl with signs and symptoms of an acute abdomen was found to have uterus didelphys, unilateral hematocolpos, ipsilateral renal agenesis and menses. A review of the literature in English revealed 115 reported cases. This complex congenital anomaly is seen most commonly in adolescents with dysmenorrhea of progressive severity, abdominal pain and a pelvic mass. PMID- 3560064 TI - Nutmeg intoxication in pregnancy. A case report. AB - A case of acute anticholinergic hyperstimulation in a pregnant woman was associated with excessive ingestion of nutmeg. The typical symptoms and signs, differential diagnosis and therapy are reviewed, with a special emphasis on the pregnant state. PMID- 3560065 TI - Successful pregnancy in an adolescent with metastatic undifferentiated sarcoma. A case report. AB - An adolescent with metastatic sarcoma conceived after chemotherapy and delivered a normal but premature infant. Therapeutic intervention during the first trimester was avoided. This case emphasizes the need for intensive birth control counseling among adolescent oncology patients, the ethical problems associated with treatment of cancer during pregnancy and the potential neonatal problems, such as prematurity and hypothyroidism, arising from such pregnancies. PMID- 3560066 TI - Prolonged delivery-abortion interval in twin and triplet pregnancies. A report of two cases. AB - Two cases occurred of a delayed interval between the second-trimester delivery and abortion of a nonviable fetus from a multifetal gestation with a surviving fetus or fetuses. In twin pregnancy, there was a 23-day interval between the delivery of twin A (at 21 weeks) and of twin B (at 24 weeks). In a clomiphene induced triplet pregnancy there was a 74-day interval between the spontaneous abortion of triplet A at 17 weeks and of triplets B and C at 27 weeks. This is the second reported case of two surviving infants after a delayed abortion delivery interval in a triplet pregnancy in a single uterus. PMID- 3560067 TI - Ovum transport after microsurgical anastomosis of the rabbit oviduct. AB - From experimental work in rabbits it is known that pregnancy outcome is influenced unfavorably by tubal resection anastomosis in spite of the preservation of tubal patency. In 104 Dutch belted rabbits the impact of microsurgical resection anastomoses on ovum transport during the first 24 hours after ovulation was examined. In oviducts in which the ampulla had been operated on, ovum transport was delayed. Mucosal irregularities that interfere with normal ampullary transport by cilia activity may account for the delay noted. Alterations in the duration of ovum transport in the oviduct may influence pregnancy outcome by creating an inappropriate tubal environment for the early embryo or by creating asynchrony between the embryo and the endometrium. No changes were observed in transport in oviducts in which the isthmus had been operated on: even a small segment of isthmus seems to act as a physiologic sphincter and to prevent premature ovum entrance into the uterus. PMID- 3560068 TI - Immunoglobulin therapy for autoimmune thrombocytopenia purpura during pregnancy. A report of two cases. AB - High-dose, intravenous immunoglobulin therapy may be effective in elevating low platelet counts in nonpregnant patients with autoimmune thrombocytopenia purpura (ATP). We used immunoglobulin successfully on two pregnant women with ATP who had been refractory to high-dose corticosteroid therapy. The 5-day infusions were started at 12 and 29 weeks' gestation, and the subsequent uncomplicated vaginal deliveries occurred after the shortest reported interval (8 days) and longest (28 weeks) following a single immunoglobulin infusion. A splenectomy was avoided, and no adverse maternal or neonatal effects were apparent. PMID- 3560069 TI - Vulvar vestibulitis syndrome. AB - Eighty-six patients were treated for vulvar vestibulitis syndrome. Prospective history forms and retrospective questionnaires were used to identify the frequency of various features of this condition and to assess the subjective responses of the patients to various methods of therapy. The term vulvar vestibulitis syndrome should be adopted as the standard description of this disorder. PMID- 3560070 TI - Metergoline as an inhibitor of prolactin release. AB - In a randomized, double-blind study, 12 and 16 mg of metergoline and 5 mg of bromoergocriptine were given daily to three groups of 100 women each for ten consecutive days to prevent lactation. Excellent or good results were obtained in 86%, 90% and 83%, respectively. Serum prolactin (PRL) levels were evaluated in three settings. The first was after a single dose in four groups of patients (4, 6 and 8 mg of metergoline and 2.5 mg of bromoergocriptine were studied for ten hours). Second, for a study of the suckling reflex, PRL levels were measured 15, 30 and 60 minutes after breast stimulation in four groups of five patients each: two groups on the fourth postpartum day with and without metergoline treatment and two groups on the eighth postpartum day (the reflex was suppressed in the two groups treated with metergoline). Third, serum PRL levels rose after the intravenous administration of 200 mg of thyrotropin-releasing hormone (TRH) in another two groups of ten patients, one treated with metergoline and the other not so treated. TRH stimulation was not blocked in the treated groups. PMID- 3560072 TI - Hyperparathyroidism secondary to parathyroid carcinoma in pregnancy. A case report. AB - Although rare, hyperparathyroidism during pregnancy is associated with increased fetal and maternal morbidity. This is the second reported case of co-existing parathyroid carcinoma hyperparathyroidism and pregnancy. PMID- 3560071 TI - Chlamydia trachomatis attached to spermatozoa recovered from the peritoneal cavity of patients with salpingitis. AB - Five in a series of ten patients with laparoscopically demonstrated salpingitis had cultures positive for Chlamydia trachomatis obtained from tubal and peritoneal surfaces. Spermatozoa were observed in the peritoneal fluid of three of these patients, and two had cultures positive for C trachomatis. C trachomatis was attached to spermatozoa recovered from the peritoneal cavity in both patients. This observation suggests that spermatozoa may serve as vectors for C trachomatis and spread this pathogen to the peritoneal surfaces of the uterus and fallopian tubes. PMID- 3560073 TI - The capricious fetal heart rate response to acute blood loss. A report of three cases. AB - Three full-term infants experienced acute blood loss. The fetuses with profound bradycardia could be resuscitated, while the one with accelerations in its heart rate patterns could not. PMID- 3560075 TI - Lithopedion. A case report. AB - In a case of lithopedion the fetus survived to 15 weeks' gestation. The mother had an infertility problem, and following tuboplasty she became pregnant and had an incomplete abortion, although no fetal parts or chorionic villi were found at dilatation and curettage. Five and one-half years later a second laparotomy was performed, and the lithopedion was discovered. PMID- 3560074 TI - Vaginal mullerian stromal sarcoma. A case report. AB - Primary malignancies of the vagina are among those encountered most rarely in the female reproductive tract. Even more rare are primary vaginal sarcomas. The fourth case of vaginal mullerian stromal sarcoma is reported on here. PMID- 3560076 TI - Ruptured chordae tendineae complicating pregnancy. A case report. AB - A 29-year-old women at 30 weeks' gestation had acute mitral insufficiency secondary to bacterial endocarditis and ruptured chordae tendineae. Although this complication has been reported on previously, recent advances in technology have led to significant improvements in its diagnosis and treatment. PMID- 3560077 TI - Percutaneous drainage of fluid collections in the bladder flap of febrile post cesarean-section patients. A report of seven cases. AB - Post-cesarean-section infections are a common cause of fevers on obstetric wards. Patients whose fevers are refractory to antibiotics often have pelvic collections. The contents of these collections and course of patients with collections have not been reported on before in detail. The development of sophisticated imaging techniques has led to the frequent use of percutaneous drainage in the management of abdominal collections. We used percutaneous drainage of collections in febrile post-cesarean-section patients. Hematomas were the most common collections associated with post-cesarean-section infection, and percutaneous drainage was a useful technique for obtaining material for culture and for distinguishing hematomas from abscesses. Most patients defervesced shortly after percutaneous drainage. PMID- 3560078 TI - Abnormal fetal heart rate pattern associated with severe intrapartum maternal ethanol intoxication. A case report. AB - Acute intrapartum ethanol intoxication occurred in a chronic ethanol abuser. Continuous fetal heart rate monitoring revealed a pattern of fetal tachycardia, decreased variability and late and variable decelerations in association with a maternal serum ethanol level of 300 mg/dL. This case gives evidence of an association between very high maternal serum ethanol levels and acute fetal distress. PMID- 3560079 TI - Psammoma bodies in a cervicovaginal smear associated with an intrauterine device. A case report. AB - Psammoma bodies were found in a cervicovaginal smear, presumably related to the patient's use of an intrauterine device. Colposcopy, endocervical and uterine curettage, and laparoscopy with pelvic washings ruled out other conditions that may be associated with psammoma bodies. PMID- 3560080 TI - Respiratory arrest and prolonged respiratory depression after one low, subcutaneous dose of alphaprodine for obstetric analgesia. A case report. AB - Alphaprodine hydrochloride is an analgesic used commonly in the obstetric suite. A case of prolonged respiratory depression occurred after the administration of low-dose alphaprodine. Other cases of serious sequelae associated with the use of this drug have been reported on. PMID- 3560081 TI - Coexistent renal, mullerian and alimentary tract developmental defects. A case report. AB - Unilateral renal agenesis has been found independently in relation to mullerian tract and alimentary tract abnormalities. We treated a woman for coexistent developmental defects in the renal, mullerian and alimentary tracts. PMID- 3560082 TI - Primary retroperitoneal sarcoma in the female pelvis. A report of three cases. AB - Retroperitoneal sarcoma can occur in the female pelvis and be confused with other pelvic masses. Its diagnosis depends on an awareness of its occurrence. Aggressive surgery to completely excise the tumor determines survival. PMID- 3560083 TI - Perinatal malpractice. Risks and prevention. AB - An analysis of 25 perinatal malpractice cases filed in Wisconsin between 1978 and 1984 clearly revealed that the unfavorable outcomes were preventable and caused by professional negligence. Each case was settled or adjudicated in favor of the plaintiff, and the awards totaled $25.1 million. Although cases with a total recovery of over $1 million are relatively infrequent, they are not so rare as to be considered extra-ordinary occurrences. Fifty-six percent of physicians involved failed to recognize a high-risk pregnancy or fetal distress, while 44% failed to render proper care. The most common errors involved inadequate fetal monitoring, the injudicious use of oxytocin and the failure to recognize a high risk pregnancy, such as prematurity or postterm or multiple gestation. The purpose of this study was to examine the medicolegal issues operating in such cases in order to develop guidelines for reducing professional negligence, thereby preventing injury to women and their newborns. PMID- 3560084 TI - Uterine hyperstimulation. The need for standard terminology. AB - The incidence of uterine hyperstimulation during oxytocin augmentation in labor and in breast-stimulated and oxytocin contraction stress tests showed a wide variation in a number of reported studies. One major reason is the lack of a standard definition of uterine hyperstimulation. PMID- 3560085 TI - Endometrial and endocervical curettage findings at the time of cervical conization. AB - The medical records and histopathology of 250 patients who underwent cervical conization between January 1979 and December 1982 were reviewed. Two hundred thirty (92%) had endometrial curettage at the time of cervical conization. Abnormal findings were present in 7 (3%) of the 230 curettings. Limiting the performance of endometrial curettage at the time of conization to patients meeting specific criteria would have reduced the number of combined procedures by 75% without jeopardizing our ability to detect significant pathology. Endocervical curettage was performed on 221 (88%) of the 250 patients undergoing conization. The endocervical curettings were not a good predictor of the involvement of the cone margins with neoplasia. Only 7 (20%) of 35 patients with involved endocervical margins had a positive endocervical curettage. While the cone margins predicted residual carcinoma in the hysterectomy specimen with a sensitivity of 1.0, the sensitivity of the endocervical curettings for predicting residual carcinoma was 0.5. Although endocervical curettings can detect an invasive cancer not detected in the cone specimen, a negative endocervical curettage does not rule out invasive cancer above the excision line. PMID- 3560086 TI - Does the left hand know what the right hand is doing? or Clinical pharmacology: the use of optically pure (R or S) forms of chiral drugs rather than racemic mixtures. PMID- 3560088 TI - The in vitro effect of select classes of nonsteroidal antiinflammatory drugs on normal cartilage metabolism. AB - The in vitro effect of piroxicam, a newer nonsteroidal antiinflammatory drug (NSAID), on normal cartilage metabolism has been studied and response contrasted to indomethacin and sodium salicylate. Therapeutic levels of piroxicam has no effect on cartilage glycosaminoglycan (GAG), collagen or noncollagen protein synthesis by porcine weight bearing articular cartilage explants. Salicylate consistently suppressed GAG and protein synthesis, whereas indomethacin had no consistent effect on GAG production but suppressed protein synthesis. NSAID studied had no effect on proteoglycan catabolism. The potential significance of the effect of NSAID on cartilage metabolism is discussed and placed in perspective as regards selection of these agents for human use. PMID- 3560087 TI - Influence of prednisolone and methotrexate on cellular and biochemical aspects of acute and chronic inflammation studied in subcutaneously implanted sponges in rats. AB - The effects of prednisolone and methotrexate on the histology and the content of collagen and proteoglycans of the inflammatory tissue in polyurethane sponges impregnated with heat killed M. tuberculosis and implanted subcutaneously in hooded Wistar rats for up to 63 days were studied. Drugs were administered during the 6-day period before sponge removal 7, 21, 35, 49 and 63 days after implantation. Our findings indicate that prednisolone and methotrexate have profound effects on the cellular events of acute and chronic inflammation, and influence the synthesis or degradation of connective tissue macromolecules at certain stages of the inflammatory process. PMID- 3560089 TI - Phenytoin in rheumatoid arthritis. AB - In a prospective open study, 18 patients with active rheumatoid arthritis were treated with phenytoin (300 mg/day) for 32 weeks. Clinical assessments improved significantly and there was no relapse 8 weeks after drug withdrawal. Serum C reactive protein, plasma viscosity and hemoglobin also improved but changes were not significant. Serum phenytoin concentrations were lower than anticipated. Side effects were mild and caused 2 patients to withdraw. Our observations and the known effects of phenytoin on the immune system and collagen metabolism suggest that further controlled studies using higher doses are warranted. PMID- 3560090 TI - Patient, observer and instrument variation in the measurement of strength of shoulder abductor muscles in patients with rheumatoid arthritis using a modified sphygmomanometer. AB - We describe the use of a modified sphygmomanometer to measure the strength of shoulder abductor muscles. Using a 5 x 5 Greco-Latin square design we compared the measurements of 5 physical therapists taken on 5 patients with rheumatoid arthritis with 2 cuff adaptations. The design variables explained 96.4% of the pressure readings, with patients accounting for 76.6%. There was no significant variation due to order of testing, cuff preparations or observers. The method is simple, portable, inexpensive, comfortable and safe to use. It can also be applied to 26 different muscle groups. PMID- 3560091 TI - Hepatitis B virus infection and liver function in patients with systemic lupus erythematosus. AB - One hundred patients with systemic lupus erythematosus (SLE) were investigated for serological markers of hepatitis B virus (HBV) and had liver function evaluated. One patient had hepatitis B surface antigen and 25 had antibodies to HBsAg which is not significantly different from normal blood donor controls. Minor liver function abnormalities were found in 35 patients and there was no difference between those with and without anti-HBs. A single patient without HBV markers had more severe liver enzyme elevation. Our data do not show a relationship between SLE and HBV and support the contention that liver diseases in lupus is mild. PMID- 3560092 TI - Severe arthralgias after wide fluctuation in corticosteroid dosage. AB - A clinical syndrome consisting of severe acute nocturnal knee arthralgias, absent signs of inflammation, and spontaneous resolution in 12 to 72 h was observed in 3 patients in close temporal relationship to wide swings in corticosteroid dosage. A similar clinical picture has previously been described in several renal transplant recipients. With increasing use of pulse corticosteroid treatment for a variety of medical and surgical conditions, this disorder is likely to be encountered in many different settings and deserves recognition because of its dramatic presentation and self-limited course. PMID- 3560093 TI - Immunogenetics of juvenile chronic arthritis in Israel. AB - Typing for HLA-A,B,C and DR antigens was performed in 61 Israeli patients with juvenile chronic arthritis (JCA) and in 120 unrelated controls. No significant associations were apparent in the overall patient group. DR5 was significantly increased in the non-Ashkenazi patients with pauciarticular onset of disease. The only three DRw8 positive patients in the study had pauciarticular onset. DR5 and DRw8 were found in 9 of 10 patients with age of onset less than 3 years. Increased frequencies of Bw50 and Cw6 were observed in patients with systemic onset. Typing for properdin factor (Bf) and glyoxylase (GLO) was carried out in 45 and 50 of the patients, respectively. No associations with alleles of the complement Bf system or the HLA linked GLO system were evident. The confirmation in the ethnically distinct Israeli population of the previously described association of DR5 with pauciarticular JCA suggests that this gene may be closely related to the disease susceptibility gene. PMID- 3560094 TI - Routine analysis of synovial fluid cells is of value in the differential diagnosis of arthritis in children. AB - Results of synovianalysis are reported in 129 children, 91 with juvenile rheumatoid arthritis (JRA), 13 with septic arthritis, 12 with enteroarthritis, 12 with acute transient arthritis and 1 with bacillus Calmette-Guerin arthritis. Mononuclear cells were dominant in the patients with oligoarticular JRA (mean 64%, median 74%), and among these, significantly lower proportions of polymorphonuclear (PMN) cells were found in patients with early onset disease with antinuclear antibodies or chronic uveitis than in those with late onset with HLA-B27. PMN cells were dominant in polyarticular and systemic onset JRA, septic arthritis and enteroarthritis. The sensitivity and specificity of a white cell count above 40,000/mm3 exceeded 90% in differentiating septic arthritis from the other kinds of arthritis. Measurement of total protein, glucose and lactate in synovial fluid was of limited diagnostic value. PMID- 3560095 TI - Flurbiprofen in the treatment of juvenile rheumatoid arthritis. AB - Thirty-four patients with juvenile rheumatoid arthritis, who were treated with flurbiprofen at a maximum dose of 4 mg/kg/day, had statistically significant decreases from baseline in 6 arthritis indices after 12 weeks of treatment. Improvements were seen in the number of tender joints, the severity of swelling and tenderness, the time of walk 50 feet, the duration of morning stiffness and the circumference of the left knee. The most frequently observed side effect was fecal occult blood (25% of patients); however, there was no other evidence of gastrointestinal (GI) bleeding in these patients. One patient was prematurely discontinued from the study for severe headache and abdominal pain. Most side effects were mild and related to the GI tract. PMID- 3560097 TI - Pressure related changes in human lumbosacral zygapophyseal joint articular cartilage. AB - A brief histomorphologic study is presented of pressure related changes in the hyaline cartilage of paired left and right lumbosacral zygapophyseal joints in 6 cadavers. A comparison of the histology of the left and right zygapophyseal joint cartilages by light microscopy and dark field microscopy showed that, when dark field microscopy is used, a different histological reaction to staining can be highlighted. A similar change was not found using polarized light. It is not within the scope of this brief report to investigate the changes observed in this histological study. PMID- 3560096 TI - Hyperkalemia associated with sulindac therapy. AB - Hyperkalemia has recently been recognized as a complication of nonsteroidal antiinflammatory agents (NSAID) such as indomethacin. Several recent studies have stressed the renal sparing features of sulindac, owing to its lack of interference with renal prostacyclin synthesis. We describe 4 patients in whom hyperkalemia ranging from 6.1 to 6.9 mEq/l developed within 3 to 8 days of sulindac administration. In all of them normal serum potassium levels reached within 2 to 4 days of stopping sulindac. As no other medications known to effect serum potassium had been given concomitantly, this course of events is suggestive of a cause-and-effect relationship between sulindac and hyperkalemia. These observations indicate that initial hopes that sulindac may not be associated with the adverse renal effects of other NSAID are probably not justified. PMID- 3560098 TI - Computerized tomographic findings in the temporomandibular joint in patients with psoriatic arthritis. AB - Three male patients with psoriatic arthritis of the temporomandibular joint (TMJ) were evaluated by computerized tomography (CT). Only one patient showed changes of the mandibular condyle on the panoramic view, which failed to show the condition in the other 2 patients. All 3 had normal conventional radiographs of the affected TMJ. In all 3 cases the high resolution CT scan demonstrated significant changes of the mandibular condyle and glenoid fossa, which were consistent with the clinical diagnosis of psoriatic arthritis of the TMJ. PMID- 3560099 TI - Unexpected sites of wear in the femoral head. AB - In a study of 637 femoral heads removed surgically because of osteoarthritis, the wear was predominantly on the posterior half in 13.2% and was more than two thirds posterior in 7.5%. Wear was more than two-thirds anterior in 37.8%. In 36 heads from patients with rheumatoid arthritis, the wear was predominant posterior in 27.8%. No anatomical reason was found for these marked asymmetries, which, from their position, could not possibly be the result of simple weight bearing. The finding underlines the importance of muscular action in the causation of wear. PMID- 3560100 TI - Potential of indium-111 to measure inflammatory arthritis. AB - Since an objective noninvasive method for measuring inflammation in arthritis is lacking, radioimaging experiments were conducted with 111indium-chloride (111InCl3) in the collagen model. A computer imaging index, reflecting uptake in the feet and ankles, was significantly greater in 16 rats immunized with collagen than in 6 nonimmunized rats (mean +/- SEM 1.18 +/- 0.04 vs 0.39 +/- 0.02, for the 2 groups, respectively, p less than 0.001). Additional analyses provided evidence that the 111InCl3 technique can be used to measure objectively progression of the arthritic response of rats of immunization with collagen, and pilot comparisons with conventional bone scintigraphy in 2 patients with rheumatoid arthritis suggested that the method is applicable to human arthritic disease. PMID- 3560101 TI - Adverse reactions to azathioprine mimicking gastroenteritis. AB - We describe two patients with rheumatic disease who developed nausea, vomiting, fever and diarrhea after a single dose of azathioprine. Both patients had recurrence of these symptoms upon rechallenge. PMID- 3560102 TI - Lowering of plasma isoxicam concentrations with acetylsalicylic acid. AB - The pharmacokinetics of isoxicam 200 mg administered orally in 10 healthy male volunteers was studied before and during administration of acetylsalicylic acid 3.9 g daily by mouth starting 5 days after isoxicam. There was a statistically significant decrease in plasma isoxicam concentrations, but no significant change in time to reach maximum plasma concentration or disappearance time. The mechanisms of this interaction is probably competitive displacement of isoxicam from albumin by acetylsalicylic acid or salicylate. These results are consistent with the known effect of ASA in producing competitive displacement of other protein bound antiinflammatory drugs. PMID- 3560103 TI - Spontaneous and forced cutaneous absorption of indomethacin in pigs and humans. AB - Indomethacin can permeate the normal skin of laboratory animals as well as humans, therefore, we investigated whether and what extent this process may be intensified by sonophoresis or iontophoresis. To 6 pigs Amuno-Gel (MSD Sharp & Dohme) (indocid gel) containing 1% indomethacin was applied over 5 h iontophoretically through the skin of the back, and the blood and urine concentrations were measured by high performance liquid chromatography with inline post column hydrolysis and fluorimetric detection. Nonassisted skin uptake was measured 1 to 2 weeks later in the same animals each serving as its own control. Iontophoresis (0.1 mA/cm2) increased maximum indomethacin levels from 32 (controls) to 82 ng/ml and urinary excretion over 5 h from 29.4 to 181.1 ng/cm2 of treated skin area. Sonophoresis did not improve indomethacin absorption. In 7 human volunteers, iontophoretic application of indomethacin over 1 h onto the skin of the back (1380 cm2 surface area) increased maximum plasma levels from 43 ng/ml (controls) to 221 ng/ml, and the urinary excretion over a total of 5 h from 18.1 (controls) to 97.6 ng/cm2. As calculated from the fraction of indomethacin excreted in the urine, about 0.2 microgram indomethacin/cm2 of treated skin area taken up spontaneously and about 1.0 microgram/cm2 was transported by iontophoresis. PMID- 3560104 TI - Bilateral internuclear ophthalmoplegia in systemic lupus erythematosus. AB - The case of a 25-year-old female with bilateral internuclear ophthalmoplegia as a presenting feature of systemic lupus erythematosus (SLE) is described. It is important to recognize that bilateral internuclear ophthalmoplegia may be an early manifestation of cerebral involvement in SLE in addition to its occurrence in multiple sclerosis. PMID- 3560105 TI - Vasculitis in hairy cell leukemia: review of literature and consideration of possible pathogenic mechanisms. AB - Systemic vasculitis is an unusual but recently recognized complication of hairy cell leukemia. We studied this relationship further in an attempt to better understand pathogenetic mechanisms of vasculitis. We examined the records of 129 cases of hairy cell leukemia seen at the Mayo Clinic between 1976 and 1983, and identified 2 cases with evidence of systemic vasculitis. The first of these cases is discussed in detail. Immunologic studies were performed but we were unable to demonstrate the presence of shared antigen on hairy cells and endothelial cells. The literature is reviewed and reports of this association are summarized. Possible mechanisms of vascular injury are discussed. PMID- 3560106 TI - Discoid meniscus presenting as juvenile rheumatoid arthritis. AB - Discoid meniscus is a mechanical lesion described as having little inflammatory reaction. We describe a child with lateral discoid meniscus misdiagnosed as juvenile rheumatoid arthritis (JRA). Synovitis responded to aspirin, but function gradually deteriorated with increasing flexion deformity until arthrotomy and meniscectomy. Histology showed intense inflammatory changes compatible with JRA. Clinical and laboratory clues to early diagnosis were the localized nature of the inflammation on physical examination, radiographs and bone scan. PMID- 3560107 TI - Subclinical autoimmune disease and recurrent spontaneous abortion. AB - We describe a patient with no clinical complaints except 5 unexplained spontaneous abortions in whom investigations revealed a positive antinuclear factor, antibodies to native double-stranded DNA, LE cells, a positive Coombs' test, a positive lupus anticoagulant test, and anticardiolipin antibodies. Despite preeclampsia our patient successfully completed her 6th pregnancy after treatment with corticosteroids, subcutaneous heparin, and low dose aspirin throughout the pregnancy. Serial measurements of anticardiolipin antibody showed suppression of anticardiolipin antibody levels with corticosteroids. The response of the lupus anticoagulant was less obvious. No anticardiolipin antibodies were detected in the baby. PMID- 3560108 TI - A shorter plasma half life does not predict less drug accumulation. PMID- 3560109 TI - Longterm sucralfate therapy. PMID- 3560110 TI - Whole blood viscosity in rheumatoid arthritis. PMID- 3560111 TI - Histamine levels in the rheumatoid joint. PMID- 3560113 TI - The relationship of polymyalgia rheumatica to giant cell arteritis--single or separate syndromes? PMID- 3560112 TI - Successful treatment of aplastic anemia associated with chronic thyroiditis and Sjogren's syndrome. PMID- 3560114 TI - Herpes zoster: serological study and cranial giant cell arteritis. PMID- 3560115 TI - Contrasting reactivity of young and old human cartilage to mononuclear cell factors. PMID- 3560116 TI - Biotechnology and new therapies for arthritis. PMID- 3560117 TI - Dependence and interdependence. PMID- 3560118 TI - Psychiatric disorders among elderly patients admitted to hospital medical wards. AB - A psychiatric investigation was carried out on patients aged 65-80 years who were admitted to the medical wards of six general hospitals in an industrial urban area of West Germany. In all, 626 patients were screened for cognitive and affective disorder using a short standardized interview, and at the second stage all those with abnormal responses, as well as a subsample of the apparently normal patients, were examined in greater detail. After correction for inaccuracies of screening, the frequency of psychiatric illness in this patient population was estimated as 30.2%, made up of 9.1% with organic brain syndromes and 21.1% with functional mental disorders. Comparison with field-study data for the same background population showed that the hospital patients were at increased risk for mental disturbance. At follow up after one year, outcome in terms of mortality, admission to long-term care and dependency on others was worst for patients with organic mental disorder, even after matching for age and initial severity of physical impairment. Functional mental illness was also associated with a relatively poor outcome in terms of dependency. The mental status of elderly medical patients appears to be important for the prognosis. PMID- 3560119 TI - Retinitis pigmentosa and deafness. AB - Seventeen patients with retinitis pigmentosa (RP) have been investigated audiologically. Of 9 found to have a significant hearing loss, 6 were examples of Usher's syndrome; these patients had a cochlear pattern of hearing loss. The other 3 were examples of Senior's syndrome, Kearne-Sayre syndrome and Lawrence Moon-Biedle syndrome respectively. Two of these patients had absent stapedius reflexes. It is suggested that patients with different RP-deafness syndromes may have lesions in different parts of the auditory system. PMID- 3560120 TI - Decline in deaths from choking on food in infancy: an association with change in feeding practice? PMID- 3560121 TI - Renal trauma and the intravenous urogram. AB - A retrospective analysis of all patients with blunt abdominal trauma associated with haematuria admitted to one hospital (Royal United, Bath) in a 10-year period was conducted to establish the contribution of the intravenous urogram (IVU) in their management. Eighty-one case records were analysed. Of 35 IVUs performed in patients with microscopic (reagentstrip positive) haematuria, only one was abnormal. In contrast, 27 IVUs performed in patients with macroscopic (naked eye) haematuria revealed 17 major injuries and 5 previously unrecognized congenital abnormalities. It is concluded that an IVU is an unnecessary and non-contributory investigation in patients with microscopic haematuria and guidelines are suggested for the role of IVU in patients with blunt abdominal trauma associated with haematuria. PMID- 3560122 TI - Problems of patients' dependency on doctors: discussion paper. PMID- 3560123 TI - Personality assessment of future doctors: discussion paper. PMID- 3560124 TI - Cervical subluxation: a deceptive soft tissue injury. PMID- 3560125 TI - Crohn's disease with metastatic cutaneous involvement and granulomatous cheilitis. PMID- 3560126 TI - Small bowel adenocarcinoma complicating Crohn's disease. PMID- 3560127 TI - Inferior vena cava thrombosis following a game of squash. PMID- 3560128 TI - Difficulties in breast feeding: midwives in disarray? Report of meeting . PMID- 3560129 TI - Head injuries: whither specialization? PMID- 3560131 TI - Vitamin A and colonic cancer in women. PMID- 3560130 TI - Do psychological studies upset patients? PMID- 3560132 TI - Weight control in university students. AB - A total of 1858 students of United Kingdom origin aged between 18 and 20 years of age completed questionnaires which investigated present weight, bingeing, vomiting and weight control. Men were significantly more likely than women to be overweight, while women were significantly more likely to be underweight. One third of the women were actively controlling weight, with dieting as the preferred method, while over half had attempted weight control in the past three years. Daily or more frequent bingeing was reported by 1.9% of men and 1.2% of women. There was a statistically significant relationship between weight control and bingeing. Eleven percent of men and 24% of women thought they had a problem with weight control, although amongst both men and women the proportion who felt they were overweight was in excess of the proportion who actually were overweight. It is suggested that health education programmes should take account of the pressures upon young women to conform to predetermined ideals in terms of body weight. PMID- 3560133 TI - Compartmental syndrome diagnosis. PMID- 3560134 TI - Cardiovascular risk in patients with treated familial hypercholesterolaemia and patients with severe hypertriglyceridaemia. PMID- 3560135 TI - Anorectal ulceration due to abuse of dextropropoxyphene and paracetamol suppositories. PMID- 3560136 TI - Infections caused by opportunistic mycobacteria. PMID- 3560137 TI - Growth impairment in children with atopic eczema. AB - Growth was studied in 89 children with atopic eczema aged 1-16 years. Nine (10%) had a standing height below the 3rd centile. Both boys and girls had significantly reduced sitting height but normal subischial leg length, and both sexes had significantly delayed skeletal maturity scores. Impaired growth was particularly associated with widespread eczema, but also with the presence of asthma and the potency of topical corticosteroid. Six of the 15 patients with a corrected height centile below the 10th centile had been receiving potent (British National Formulary category I or II) topical corticosteroids. This study suggests that impaired linear growth is a feature of atopic eczema. While the causes of the growth impairment are unclear, there is a need for caution in the use of potent topical corticosteroids in children. PMID- 3560138 TI - A brush with tenosynovitis. PMID- 3560139 TI - Thyrotoxic heart disease presenting as unilateral pulmonary consolidation. PMID- 3560141 TI - An unusual place to find hydatid. PMID- 3560140 TI - Stercoral perforation of the colon following postoperative analgesia. PMID- 3560142 TI - Albendazole in the treatment of hydatid disease. PMID- 3560143 TI - Pulmonary eosinophilia associated with naproxen therapy. PMID- 3560145 TI - Homozygous variegate porphyria: vitamin E as a possible therapeutic approach. PMID- 3560144 TI - Pathogenesis of Alzheimer's disease. PMID- 3560146 TI - Drug safety and the CSM. PMID- 3560147 TI - Tenosynovitis. PMID- 3560148 TI - Lymphomania. Non-Hodgkin's lymphoma as possibly viewed through the eyes of Lewis Carroll. PMID- 3560149 TI - Hyperthyroidism in elderly patients with atrial fibrillation and normal thyroid hormone measurements. AB - The results of a study to investigate possible underdiagnosis of hyperthyroidism in the elderly are reported. Four out of 24 patients with atrial fibrillation for which there was no obvious cause and who had normal thyroid hormone measurements were found to have subnormal thyrotropin responses to thyrotropin-releasing hormone and abnormal thyroid scans. The implications of this finding are discussed. PMID- 3560150 TI - Thyroid function screening of psychiatric inpatient admissions: a worthwhile procedure? AB - A thyroid function screening programme of admissions to a general psychiatric service was established. Over a 22-week period 588 patients were admitted and thyroid function tests were performed on 336, a screening rate of 57.1%. Initial investigation showed that 21.3% had a total thyroxine outside the range 75-130 nmol/l. On further investigation only 9 patients (1 thyrotoxic, 8 hypothyroid) had confirmed thyroid disease. In 7 of the 9 patients the disease had been clinically suspected. Thus the screening programme identified only 2 unsuspected cases of thyroid dysfunction and we conclude that this level of detection does not warrant a formal screening programme. PMID- 3560151 TI - Effects of carotid compression, as assessed by near infrared spectroscopy, upon cerebral blood volume and hemoglobin oxygen saturation. AB - Near infrared spectroscopy, a recently developed optoelectronic technique, has been studied as a possible method of monitoring the adequacy of cerebral perfusion in 22 patients who were candidates for carotid endarterectomy. Using this technique, changes in haemoglobin volume, haemoglobin oxygen saturation and redox level of cytochrome-c-oxidase were recorded from the frontoparietal region during routine carotid compression tests performed under continuous electroencephalographic (EEG) monitoring. A highly significant association was found between EEG slowing, indicating impaired cerebral function, and a fall in haemoglobin volume and oxygen saturation, indicating a reduced blood and oxygen supply to the brain (Fisher exact test, P less than 10(-5]. In a few tests haemoglobin volume and oxygen saturation were reduced without changes in the EEG recording. This study raises new issues concerning the compensatory mechanisms taking place during carotid occlusion and suggests that near infrared spectroscopy might be useful in monitoring the blood and oxygen supply to the brain during carotid endarterectomy. PMID- 3560152 TI - Practical appraisal of a new rating scale (MRSS) for rehabilitation. AB - Rating scales are available to assess patients undergoing rehabilitation for chronic psychiatric disorders. Few are universally acceptable because of pitfalls in their structure or administration. This study examines the recently printed Morningside Rehabilitation Status Scale in one rehabilitation network. The MRSS was found to be suitable in discriminating between severely and moderately disabled groups but not between mildly and moderately disabled groups. PMID- 3560153 TI - Clinical trials in cancer research--philosophical and methodological considerations: discussion paper. PMID- 3560154 TI - Thienothiopyran-2-sulfonamides: a novel class of water-soluble carbonic anhydrase inhibitors. AB - An attempt to develop a water-soluble carbonic anhydrase inhibitor focused on exploring structure-activity relationships in the thienothiopyransulfonamide class. The strategy to influence water solubility while retaining carbonic anhydrase activity involved the introduction of a hydroxyl moiety and adjusting the oxidation state of the sulfur on the thiopyran portion of the molecule. Compounds 4 and 17 best fit the criteria of aqueous solubility and inhibitory potency vs. human carbonic anhydrase II and are candidates for evaluation as topically effective antiglaucoma agents. PMID- 3560155 TI - Linear free energy relationships and cytotoxicities of para-substituted 2 haloethyl aryl selenides and bis(2-chloroethyl) selenides. AB - Examples of a new class of alkylating agents, selenium mustards, were prepared for study of their chemical kinetic properties and cytotoxicities against human lymphoblastoid CCRF-CEM cells. In a series of para-substituted aryl 2-chloroethyl selenides, a linear free energy relationship between the first-order rate constant, k'nbp and sigma p gave a rho value of -1.3, indicating that formation of a cyclic ethylene selenonium ion is the rate-controlling step for alkylation of 4-(4-nitrobenzyl)pyridine (NBP). Consistent with the ethyleneselenonium ion pathway, rates of solvolyses were extremely sensitive to increasing water content, and a positive correlation was found between reactivity with NBP and nucleophilic selectivity (Swain-Scott s constant). The s constant, which predicts for variation in intracellular product spread, varied from 0.53 up to 0.95, equal to aliphatic nitrogen mustards. Alkylating activities based on extent of NBP alkylation, however, showed relatively low values, 8-23% of that of mechlorethamine, possibly due to hydrolysis occurring by a separate pathway from nucleophilic substitution. Reactivities and nucleophilic selectivities both showed positive correlations with cytotoxicities, suggesting that the rate and extent of alkylation of relatively strong nucleophilic centers mediate the biologic effects of these compounds. Two bifunctional selenium mustards were substantially more cytotoxic than monofunctional aromatic selenides. No additional cytotoxicity due to the selenium atom was observed, with the exception of diselenide (-SeSe-) compounds. Thus, selenium alkylating agents kinetically and biologically resemble classical, mustard-type alkylating agents. PMID- 3560157 TI - Synthesis and calcium channel antagonist activity of dialkyl 4- (dihydropyridinyl)-1,4-dihydro-2,6-dimethyl-3,5-pyridinecarboxylates. AB - The sodium borohydride reduction of 3,5-disubstituted 1,4-dihydro-2,6-dimethyl-4 (pyridinyl)pyridines 2 and 5 in the presence of methyl, phenyl, or tert-butyl chloroformate afforded the respective 4-(dihydropyridinyl)-1,4-dihydropyridines 4 and 6 in good yield. Products 4 comprised a mixture of the 1,2- and 1,6 dihydropyridinyl regioisomers 4a and 4b where 4a was always the predominant regioisomer. Compounds possessing a 4-[dihydro-1-(phenoxycarbonyl)-3-pyridinyl] substituent, such as 26, were also a mixture of two regioisomers 26a and 26b, and each regioisomer existed as a mixture of two rotamers in Me2SO-d6 at 25 degrees C (26a', 26a'', and 26b', 26b'') due to restricted rotation about the nitrogen-to carbonyl carbamate bond. The calcium antagonist activities for 4 and 6 were determined by using the muscarinic receptor-mediated Ca2+-dependent contraction of guinea pig ileal longitudinal smooth muscle. The relative order of activities for the 4-(dihydropyridinyl) analogues was 4-(dihydro-3-pyridinyl) greater than 4 (dihydro-4-pyridinyl). Increasing the size of the C-3(5) alkyl ester substituents increased activity. Compounds having nonidentical ester substituents were more active than those having identical ester substituents. Replacement of the C-3 and/or C-5 ester substituents by a cyano substituent(s) decreased activity significantly. An approximate 1:1 correlation between the IC50 value for inhibition of [3H]nitrendipine binding and inhibition of the tonic component of the muscarinic-induced contractile response was observed. The test results suggest that a 4-(dihydropyridinyl) substituent is bioisosteric with a 4 (nitrophenyl) substituent on a 1,4-dihydropyridine ring where m- and p nitrophenyl are bioisosteric with the 4-[1,2(1,6)-dihydro-3-pyridinyl] 4 and 4 (1,2-dihydro-4-pyridinyl) 6 isomers, respectively. PMID- 3560156 TI - Resolved cis- and trans-2-amino-5-methoxy-1-methyltetralins: central dopamine receptor agonists and antagonists. AB - A series of 35 stereochemically well-defined C1-methyl-substituted derivatives of the potent dopamine (DA) receptor agonist 5-hydroxy-2-(di-n-propylamino)tetralin (5-OH-DPAT) have been synthesized. The compounds were tested for central DA receptor agonistic and antagonistic activity, by use of biochemical and behavioral tests in rats. In addition, the compounds were tested for in vivo interactions with 5,6-dihydroxy-2-(di-n-propylamino)tetralin (DiPr-5,6-ADTN). On the basis of pharmacological activity profiles, the active compounds have been classified into four groups: classical pre- and postsynaptic DA receptor agonists, DA receptor agonists with preferential action at presynaptic receptors, pre- and postsynaptic DA receptor antagonists, and DA receptor antagonists with preferential action at presynaptic receptors. Results obtained indicate that both 2R and 2S enantiomers of C5-oxygenated 2-aminotetralins may be able to bind to DA receptors but that only 2S antipodes are able to activate the receptors. O Methylation of the C5-oxygenated (1S,2R)-2-amino-1-methyltetralin derivatives tends to increase their DA receptor antagonistic activity, whereas decrease of the size of the N-substituent(s) from n-propyl to ethyl or methyl appears to increase their activity at postsynaptic DA receptors. PMID- 3560158 TI - Steroidal silicon side-chain analogues as potential antifertility agents. AB - A number of silicon-substituted analogues of ethynylestradiol that exhibit modified and enhanced biological activities have been synthesized. Particularly noteworthy are a group of [(trialkylsilyl)ethynyl]estradiol analogues that exhibit high antifertility potency and markedly reduced estrogenic activity. The best compounds synthesized are 17 alpha-[(triethylsilyl)ethynyl]estradiol (5) and 17 alpha-[(tert-butyldimethylsilyl)ethynyl]estradiol (33), which show a separation of antifertility from estrogenic activity in the rat. The results of structure-activity studies indicate a good correlation between the observed biological activities and the calculated van der Waals volumes of the three variable silicon substituents. PMID- 3560159 TI - Potential antitumor agents. 48. 3'-Dimethylamino derivatives of amsacrine: redox chemistry and in vivo solid tumor activity. AB - Structure-activity relationships for a series of acridine-substituted 3'-N(CH3)2 derivatives of the clinical antileukemic drug amsacrine (1) are reported. The parent (unsubstituted) compound 3 has activity against the Lewis lung solid tumor that is superior to amsacrine (1), the new clinical amsacrine analogue 4, and the recently developed 3'-NHCH3 derivative 2. Although the compounds generally bind less well to DNA and are less dose potent in vivo than either their amsacrine (3' OCH3) or 3'-NHCH3 analogues, they show very high levels of antitumor activity, with the 4-OCH3 derivative capable of effecting 100% cures of the Lewis lung solid tumor. The broad structure-activity relationships for acridine substitution more closely resemble those of the amsacrine than the 3'-NHCH3 series, with 4 substituted and 4,5-disubstituted compounds showing the highest activity. PMID- 3560160 TI - Potential antitumor agents. 49. 5-substituted derivatives of N-[2 (dimethylamino)ethyl]-9-aminoacridine-4-carboxamide with in vivo solid-tumor activity. AB - Derivatives of N-[2-(dimethylamino)ethyl]-9-aminoacridine-4-carboxamide bearing a wide variety of different groups at the 5-position (and for comparative purposes at the 7-position) have been prepared, and their physicochemical properties and biological activities have been determined. Although both 5- and 7-substituted compounds bind equally well to DNA by intercalation, only the 5-substituted compounds have in vivo antitumor activity. All the 5-substituted compounds showed in vivo antileukemic activity, but only those bearing electron-withdrawing substituents sufficiently powerful to ensure the acridine chromophore was uncharged at physiological pH showed activity in vivo against the Lewis lung solid tumor. The weakly basic derivatives do not show greater intrinsic cytotoxicity or selectivity toward solid tumor cells, and their broader spectrum of in vivo antitumor activity is attributed to the fact that they exist predominantly as monocations, which can distribute more efficiently. PMID- 3560162 TI - Synthesis and antiarrhythmic activity of novel 3-alkyl-1-[omega-[4 [(alkylsulfonyl)amino]phenyl]-omega- hydroxyalkyl]-1H-imidazolium salts and related compounds. AB - Novel 3-alkyl-1-[omega-[4-[(alkylsulfonyl)amino]phenyl]-omega-hydroxyalkyl]-1H imidazolium salts were synthesized and investigated for their class III electrophysiological activity on isolated canine cardiac Purkinje fibers and ventricular muscle tissue. Structure-activity relationships are discussed for a series of 25 compounds. Compound 3, 1-[2-hydroxy-2-[4 [(methylsulfonyl)amino]phenyl]ethyl]-3-methyl-1H- imidazolium chloride, prolonged the functional refractory period in anesthetized dogs when given intraduodenally and was also effective in preventing reentrant ventricular tachycardia induced by programmed electrical stimulation when administered intravenously in anesthetized dogs 24 h after an acute myocardial infarction. Both enantiomers of 3 were synthesized. No enantioselectivity was found in the electrophysiological effects of 3. PMID- 3560161 TI - Potential antitumor agents. 50. In vivo solid-tumor activity of derivatives of N [2-(dimethylamino)ethyl]acridine-4-carboxamide. AB - The synthesis, physicochemical properties, and antitumor activity of a series of N-[2-(dialkylamino)alkyl]-acridine-4-carboxamides are reported. The compounds bind to DNA by intercalation, but exist under physiological conditions as monocations due to the weakly basic acridine chromophore (pKa = 3.5-4.5). The acridine-4-carboxamides show very broad structure-activity relationships (SAR) for antileukemic activity, with substituents at nearly all acridine positions proving acceptable. The compounds also show remarkable activity against the Lewis lung solid tumor in vivo, with several analogues capable of effecting 100% cures of the advanced disease. The broad SAR and high solid-tumor activity of the 9 acridine-4-carboxamides imply they should be considered as a completely new class of antitumor agent. PMID- 3560164 TI - Synthesis and binding affinities of analogues of cholecystokinin-(30-33) as probes for central nervous system cholecystokinin receptors. AB - CCK-30-33 has been identified as the minimum fragment of CCK with nanomolar affinity for the central CCK receptors, as assayed by displacement of [3H]-Boc beta-alanyl-CCK-30-33 (pentagastrin) in homogenized mouse cerebral cortex. Examination of binding using this assay in the two series Boc-Trp-X-Phe-NH2 when X = Met-Asp (Boc-CCK-30-33), Gly-Asp, Met-Gly, and Gly-Gly and when X = (CH2)n (n = 0-4) reveals that modification of the tetrapeptide reduces affinity to a maximum of micromolar affinity (Boc-Trp-Gly-Asp-Phe-NH2; Ki = 2 X 10(-6) M), whereas in the series when n = 0 and 2 pentamolar affinity is still retained (Boc Trp-Phe-NH2, Ki = 7 X 10(-5) M; Boc-Trp NH CH2-CH2-CO-Phe-NH2, Ki = 3 X 10(-5) M). Modification of the tetrapeptide CCK-30-33 reduces affinity 1000-fold, whereas di- and tripeptide fragments are identified that reduce affinity only a further 10-fold. This structure-activity relationship establishes a basis to design "peptoid" analogues of CCK that have therapeutic potential. PMID- 3560163 TI - Comparative antitumor studies on platinum(II) and platinum(IV) complexes containing 1,2-diaminocyclohexane. AB - The synthesis and characterization of a group of platinum(IV) compounds containing the various isomeric forms of 1,2-diaminocyclohexane (DACH) are described. Antitumor tests with the new complexes, as well as with other platinum(II) compounds containing the DACH ligand, revealed that trans,cis PtIV(SS-DACH)(OH)2Cl2, 7, is more active than its mirror image, trans,cis-PtIV(RR DACH)(OH)2Cl2, 6, against L1210 leukemia implanted in mice. However, activity is dependent on the tumor model, and against B16 melanoma implanted in mice, the activities of the two enantiomers are reversed, with 6 being more active than 7. The results of the tests are discussed in light of the mechanism by which Pt(IV) compounds are believed to express their antitumor effects. PMID- 3560165 TI - A novel synthesis of colchicide and analogues from thiocolchicine and congeners: reevaluation of colchicide as a potential antitumor agent. AB - Desulfurization of thiocolchicine with Raney nickel in a hydrogen atmosphere yielded tetrahydromethoxycolchicine (2), which was readily separated from unreacted thiocolchicine by chromatography and was smoothly oxidized to 10 demethoxycolchicine (colchicide) by Pd/C in refluxing toluene. Several analogues of colchicide were prepared from the corresponding thiocolchicines by this procedure. Treatment of colchicide with concentrated sulfuric acid yielded 2 demethylcolchicide. Colchicide and its analogues were found to be inactive in a tubulin-binding assay. Evidence is presented that colchicide prepared earlier from thiocolchicine with Raney nicel in aerial atmosphere was contamination with 1-2% thiocolchicine. PMID- 3560167 TI - Frontonasal dysplasia associated with tetralogy of Fallot. AB - Three children with frontonasal dysplasia associated with tetralogy of Fallot are reported. All cases had true hypertelorism and a median nasal groove with absence of the nasal tip. There was no mental deficiency. The facial anomaly is a sporadic, non-genetic interference of the normal development of the face. This is the first report of frontonasal dysplasia associated with a cardiac defect. Multifactorial inheritance of this syndrome is proposed. PMID- 3560166 TI - Ring XY bivalent: a new phenomenon at metaphase I of meiosis in man. AB - The unusual appearance of a ring XY bivalent at metaphase I of meiosis is reported in some cells of an oligospermic human male. Higher than usual frequencies of ring configuration in the XY pair were also observed during prophase I. The defect could be attributable to loss of some DNA sequences from the distal heterochromatic tip of the Y chromosome long arm. PMID- 3560168 TI - Translocation chromosome map of oncogenes. PMID- 3560169 TI - An improved lymphocyte culture technique: deoxycytidine release of a thymidine block and use of a constant humidity chamber for slide making. PMID- 3560170 TI - Orofaciodigital syndrome type I associated with polycystic kidneys and agenesis of the corpus callosum. AB - We report a female case of orofaciodigital syndrome type I (OFD I) associated with polycystic kidneys and agenesis of the corpus callosum. She had chronic renal failure requiring maintenance dialysis and significant neurological deficits. Her mother had less severe OFD I associated with polycystic kidneys but her renal function was normal and there was no clinical or radiological evidence of a structural abnormality of the brain. PMID- 3560171 TI - Thrombocytopenia and absent radius (TAR) syndrome. PMID- 3560172 TI - Familial orofaciodigital syndrome type I presenting as adult polycystic kidney disease. AB - A three generation family with orofaciodigital syndrome type I is described. Several family members had been thought to suffer from autosomal dominant polycystic kidney disease but examination of the proband led to establishment of the correct diagnosis. The genetic implications for the offspring of the affected women and other family members were significantly altered. PMID- 3560173 TI - Confirmation of a suspected 16q deletion in a dysmorphic child by flow karyotype analysis. AB - Cytogenetic examination of a dysmorphic infant with multiple congenital abnormalities revealed a possible de novo interstitial deletion in the long arm of chromosome 16. Conclusive proof of the deletion was obtained by flow karyotype analysis of the patient and both parents, which showed that the deleted segment was approximately 7000 kb in size. PMID- 3560175 TI - Comparing the effects of problem-based and conventional curricula in an international sample. AB - In this article, the authors review 15 studies that compare various educational outcomes of problem-based, community-oriented medical curricula with those of conventional programs. The data suggest that problem-based curricula provide a student-centered learning environment and encourage an inquisitive style of learning in their students as opposed to the rote memorization and short-term learning strategies induced by conventional medical education. In addition, community-oriented schools appear to influence the career preferences of their students. The few data available show that significantly larger proportions of graduates from these schools seek careers in primary care. Some of the studies reviewed suggest that students in conventional programs perform somewhat better on traditional measures of academic achievement than do students in problem-based curricula. However, these differences, if any, tend to be very small. Data with respect to performance on instruments measuring clinical competence are inconclusive. Finally, the authors discuss the difficulties involved in carrying out comparative research at the curriculum level. PMID- 3560174 TI - New assignment of the adenosine deaminase gene locus to chromosome 20q13 X 11 by study of a patient with interstitial deletion 20q. AB - A karyotype 46,XY,del(20)(q11 X 23q13 X 11) was found in a three year old boy with mental and growth retardation, low set ears, broad nasal bridge, and macrostomia. Adenosine deaminase (ADA) activity was reduced by about 50%, assigning the gene locus to the deleted segment. A review of the previously reported regional assignments suggests that the ADA gene is in the region of band 20q13 X 11. PMID- 3560177 TI - Use of a medical reasoning aptitude test to help predict performance in medical school. AB - A medical reasoning aptitude test (MRAT) was designed to assess aptitude for clinical problem-solving in medical school applicants. The purpose of the study reported here was to determine whether the information provided by this test, when used in conjunction with college grade-point averages (GPAs) and scores on the Medical College Admission Test (MCAT), would improve the prediction of medical school performance. Specifically, the authors investigated the incremental predictive value of the MRAT relative to students' overall performance in medical school and, more specifically, to their knowledge and clinical reasoning during preclinical years and clinical performance during the clerkship year. Overall, it was found that, with the exception of the first year, the addition of MRAT scores to the GPAs and MCAT scores increased precision in identifying students who performed poorly or exceptionally well in the second year and the clinical clerkship year. This last finding is especially useful, since few other tests have provided that information. On the basis of the preliminary findings, the authors propose further use and validation of the MRAT. PMID- 3560176 TI - Relationship of scholarships and indebtedness to medical students' career plans. AB - Discriminant functions analyses of data from the 1983 survey of senior medical students by the Association of American Medical Colleges showed that the effects of scholarships must be taken into account when assessing the influence of indebtedness on medical students' career choices. Receipt of a federal scholarship, type of medical school attended (public or private), marital status, sex, and receipt of a nonfederal scholarship were found to be more powerful than indebtedness as predictors of whether the students preferred primary care or nonprimary care specialties. Receipt of a federal scholarship, type of school attended, and sex were found to be more powerful than indebtedness as predictors of whether the students preferred private clinical practice, salaried clinical practice in a hospital or clinic, salaried clinical practice in a public agency, or a nonclinical career. Indebtedness was found not to be a predictor of willingness to locate in a socioeconomically deprived area. PMID- 3560178 TI - Experience with and attitudes toward computers in medicine of students and clinical faculty members at one school. PMID- 3560179 TI - Relationship of students' prior knowledge and order of questions on test to students' test scores. PMID- 3560180 TI - Physicians' assessments of a rural preceptorship and its influence on career choice and practice site. PMID- 3560181 TI - Physicians' evaluations of their moonlighting during residency training. PMID- 3560182 TI - A system for evaluating and counseling marginal students during clinical clerkships. PMID- 3560183 TI - Evaluating the computer networks. PMID- 3560184 TI - Reapplicants to U.S. medical schools, 1983 through 1986. PMID- 3560186 TI - Dean's letters. PMID- 3560185 TI - GPEP' admonitions'. PMID- 3560187 TI - Laboratory medicine. PMID- 3560188 TI - Aeromonas cytotonic enterotoxin cross reactive with cholera toxin. AB - Isolation by affinity chromatography from crude culture filtrate of Aeromonas sobria of protein that cross reacted with cholera toxin (CT) revealed a toxin that produced fluid accumulation in rat ileal loops and in infant mice and caused rounding of Y1 adrenal cells. All these activities were neutralised by antiserum to CT. There was no haemolytic or cytotoxic activity associated with this CT cross reactive cytotonic enterotoxin. CT-cross reactive material detected in enzyme linked immunosorbent assay (ELISA) was produced by 25% of Aeromonas isolates from faeces of children with or without diarrhoea-26% of A. sobria, 20.0% of A. hydrophila and 24% of A. caviae tested gave positive ELISA results. Most strains that produced this cytotonic enterotoxin but no cytotoxic enterotoxin were isolated from children without diarrhoea. Toxin preparations from Aeromonas spp. that completely inhibited adenosine-5'-diphosphate-induced platelet aggregation, an effect related to elevation of intracellular cAMP, were, with one exception, cross reactive with CT in ELISA. PMID- 3560189 TI - Variations in the virulence, for pregnant guinea pigs, of campylobacters isolated from man. AB - Pregnant guinea pigs were used to compare the virulence of four human isolates of Campylobacter fetus ss. fetus and four of C. jejuni on the basis of their ability to cause abortion and bacteraemia. Of the four strains of C. fetus ss. fetus two produced abortion readily after intramuscular injection. The four C. jejuni isolates were, however, of comparatively low virulence and no differences between them were demonstrated. Some of the isolates differed in their ability to survive in vitro in human and guinea-pig serum. It is suggested that campylobacters vary in their virulence for man and that this may influence the outcome of infections. Guinea pigs may prove useful in studying the pathogenesis of systemic campylobacter infections. PMID- 3560190 TI - Autoantibodies to albumin in the plasma of patients with diabetes mellitus. Relationship with circulating immune complexes. AB - Anti-albumin antibodies that recognize glutaraldehyde treated albumin have been detected in diabetes mellitus, belonging to all immunoglobulin classes. Anti albumin antibodies have been found to be closely associated with circulating immune complexes, suggesting a role in their formation. It is suggested that such immune complexes may account for the positive immunofluorescence findings of albumin, immunoglobulin and complement in blood vessels previously reported in diabetes mellitus. PMID- 3560191 TI - High-density lipoproteins inhibit the bacterial lipopolysaccharide mediated increase in oxidative metabolism and lysozyme release by neutrophilic granulocytes in vitro. AB - The effects of purified Salmonella endotoxin (LPS) and of LPS combined with isolated human plasma high density lipoproteins (HDL) on oxidative metabolism, measured by nitroblue tetrazolium (NBT)-test, and on lysozyme release of human granulocytes have been studied in vitro. A considerable increase in the NBT reduction and in lysozyme release was noted in granulocytes exposed to LPS. The stimulating effect of LPS on NBT-reduction and lysozyme release was significantly diminished when the cells were incubated with LPS together with HDL. These observations suggest that HDL in vivo may play an important part in inhibition of metabolic changes induced in granulocytes by LPS which leads to the production and secretion of tissue damaging mediators. PMID- 3560192 TI - A simple one-step hemolytic assay of the first component of human complement (C1) with polyethylene glycol treated human serum: details of the assay procedures and its application to the C1 activation study. AB - C1 was removed from human serum by polyethylene glycol (PEG) precipitation and the supernatant (C1 deficient serum, C1D) was used for assay of C1 hemolytic activity (C1D method). Serum concentration of PEG 6,000 ranging from 3.5-4% was determined to be suitable for preparation of C1D, but C1D prepared by PEG 4,000 were proved unsatisfactory for use. Oxidation of C1D by iodine treatment increased C1 activity by two-fold. The C1D method was comparable in sensitivity to the conventional method, and the correlation between the 2 methods was good (r = 0.94). The C1D method was shown to be a useful tool for the study of C1 activation, since the method specifically measured C1, but not C1 activity. A half-life (T1/2) of C1 activity in fluid phase at 37 degrees C was 20 min under physiologic conditions. PMID- 3560193 TI - Monoclonal autoantibodies from rats with inherited retinal dystrophy. AB - The Royal College of Surgeons (RCS) rat carries a recessive gene for retinal dystrophy and is used as an experimental model for human retinal degenerative conditions such as retinitis pigmentosa (RP). It has been suggested that an autoimmune response to retinal antigens may contribute to the retinal degenerative processes. In this study, fusions of RCS rat splenic lymphocytes with the rat Y3 Ag 1.2.3 myeloma cell line, resulted in primary fusion cultures, some of which were positive to retinal S-antigen and others to insoluble components of rod outer segments. Three fully cloned IgM monoclonal antibodies were generated and the reaction of 2 of them to S-antigen and opsin was confirmed by immunoblotting. PMID- 3560194 TI - Induction of tumor necrosis factor by administration of OK-432 in cancer patients. AB - We examined whether OK-432, a streptococcal preparation, could induce tumor necrosis factor in cancer patients. OK-432 was administered at a dose of 100 KE intratumorally to 4 advanced gastric cancer patients and 10KE intracavitary to 8 patients with malignant pleuroperitoneal effusion. The cytostatic activity of the sera and malignant effusions was assayed by the growth inhibition of L929 cells. OK-432 induced significant cytostatic activity in the sera and malignant effusions. The activity was partially neutralized by the monoclonal antibody against human recombinant tumor necrosis factor. These data suggest that OK-432 induces tumor necrosis factor in the sera and malignant effusions of cancer patients. PMID- 3560196 TI - Development of a rapid kinetic assay for the function of the classical pathway of the complement system and for C2 and C4. AB - A simple functional complement assay (FCA) is described which is based on kinetic turbidimetry. 25 microliter of sample are combined with 250 microliter of a suspension of antibody coated ovine erythrocytes in a microprocessor controlled photometer. After a lag phase the activation of complement leads to a rapid lysis of the cells which is measured photometrically at 578 nm. The time for a decrease of absorbance of 0.1 is defined as the endpoint of the reaction. Normal citrated plasma which is the preferred specimen for the assay shows a reaction time of about 42 sec whereas pathological or diluted samples show a prolongation. With specific antibodies it was demonstrated that the assay was sensitive for a deficiency of factors of the classical pathway. Factors of the alternative pathway do not influence the assay. In combination with deficient sera a modified form of the assay allows also the determination of C2 and C4. Because of its simplicity, speed and accuracy these assays may be well suited to perform functional complement assays in a routine laboratory. PMID- 3560195 TI - Chronic relapsing experimental allergic encephalomyelitis: cyclosporin-A treatment of relapsing and remitting disease. AB - Adult strain 13 guinea pigs in the relapsing-remitting phase of chronic relapsing experimental allergic encephalomyelitis were treated with cyclosporin-A (CS-A) at an oral dose of 35 mg kg-1 body wt. for periods of 17-32 days. Of the animals treated in relapse or remission the majority (6/11) showed a deterioration in clinical condition during treatment with the remaining 5 showing no change and 6/8 developed more severe clinical signs after treatment had ceased. In contrast, a similar group of untreated or vehicle-only treated relapsing-remitting animals developed a worse or better clinical condition in similar numbers when assessed over a similar time period with the majority (22/33) showing no change in clinical signs. Blood white cell counts and plasma IgG values remained constant throughout treatment and no clinical signs of drug toxicity were evident. Cerebrospinal fluid (CSF) mononuclear cell counts rose initially only in CS-A treated animals but fell to levels below those of controls by the end of treatment. These results are discussed in the context of the effectiveness of CS A therapy in autoimmune diseases of the central nervous system. PMID- 3560197 TI - Immunological findings during an acute relapse of subacute sclerosing panencephalitis in a patient with an unusually prolonged disease course. AB - A 171/2-year-old male subacute sclerosing panencephalitis patient underwent a disease relapse after an 8 year remission. A total of 14 paired peripheral blood/cerebrospinal fluid specimens were obtained during this relapse. These specimens were tested for 13 parameters of non-specific or measles virus-specific cell-mediated and humoral immunity. There was a rapid and significant fluctuation in all of these tests. Total loss of measles-specific T cells response was found during the relapse. The response re-appeared and measles-specific antibodies increased significantly later on. The results suggest that measles virus infection was reactivated in this patient and that the observed immunological changes could at least partially be explained by this. PMID- 3560198 TI - Electrogenic properties of the sodium-alanine cotransporter in pancreatic acinar cells: II. Comparison with transport models. AB - In this paper, the results of the preceding electrophysiological study of sodium alanine cotransport in pancreatic acinar cells are compared with kinetic models. Two different types of transport mechanisms are considered. In the "simultaneous" mechanism the cotransporter C forms a ternary complex NCS with Na+ and the substrate S; coupled transport of Na+ and S involves a conformational transition between states NC'S and NC"S with inward- and outward-facing binding sites. In the "consecutive" (or "ping-pong") mechanism, formation of a ternary complex is not required; coupled transport occurs by an alternating sequence of association dissociation steps and conformational transitions. It is shown that the experimentally observed alanine- and sodium-concentration dependence of transport rates is consistent with the predictions of the "simultaneous" model, but incompatible with the "consecutive" mechanism. Assuming that the association dissociation reactions are not rate-limiting, a number of kinetic parameters of the "simultaneous" model can be estimated from the experimental results. The equilibrium dissociation constants of Na+ and alanine at the extracellular side are determined to be K"N less than or equal to 64 mM and K"S less than or equal to 18 mM. Furthermore, the ratio K"N/KS"N of the dissociation constants of Na+ from the binary (NC) and the ternary complex (NCS) at the extracellular side is estimated to be less than or equal to 6. This indicates that the binding sequence of Na+ and S to the transporter is not ordered. The current-voltage behavior of the transporter is analyzed in terms of charge translocations associated with the single-reaction steps. The observed voltage-dependence of the half-saturation concentration of sodium is consistent with the assumption that a Na+ ion that migrates from the extracellular medium to the binding site has to traverse part of the transmembrane voltage. PMID- 3560199 TI - Evidence for a Na+/K+/Cl- cotransport system in basolateral membrane vesicles from the rabbit parotid. AB - Sodium (22Na) transport was studied in a basolateral membrane vesicle preparation from rabbit parotid. Sodium uptake was markedly dependent on the presence of both K+ and Cl- in the extravesicular medium, being reduced 5 times when K+ was replaced by a nonphysiologic cation and 10 times when Cl was replaced by a nonphysiologic anion. Sodium uptake was stimulated by gradients of either K+ or Cl (relative to nongradient conditions) and could be driven against a sodium concentration gradient by a KCl gradient. No effect of membrane potentials on KCl dependent sodium flux could be detected, indicating that this is an electroneutral process. A KCl-dependent component of sodium flux could also be demonstrated under equilibrium exchange conditions, indicating a direct effect of K+ and Cl on the sodium transport pathway. KCl-dependent sodium uptake exhibited a hyperbolic dependence on sodium concentration consistent with the existence of a single-transport system with Km = 3.2 mM at 80 mM KCl and 23 degrees C. Furosemide inhibited this transporter with K0.5 = 2 X 10(4) M (23 degrees C). When sodium uptake was measured as a function of potassium and chloride concentrations a hyperbolic dependence on [K] (Hill coefficient = 0.87 +/- 0.09) and a sigmoidal dependence on [Cl] (Hill coefficient = 1.31 +/- 0.07) were observed, consistent with a Na/K/Cl stoichiometry of 1:1:2. Taken together these data provide strong evidence for the electroneutral coupling of sodium and KCl movements in this preparation and strongly support the hypothesis that a Na+/K+/Cl cotransport system thought to be associated with transepithelial chloride and water movements in many exocrine glands is present in the parotid acinar basolateral membrane. PMID- 3560200 TI - Heterogeneity of calcium compartmentation: electron probe analysis of renal tubules. AB - The objective of this study has been to determine the intracellular localization of calcium in cryofixed, cryosectioned suspensions of kidney proximal tubules using quantitative electron probe X-ray microanalysis. Two populations of cells have been identified: 1) "Viable" cells, representing the majority of cells probed, are defined by their relatively normal K/Na concentration ratio of approximately 4:1. Their measured Ca content is 4.1 +/- 1.4 (SEM) mmol/kg dry wt in the cytoplasm and 3.1 +/- 1.1 mmol/kg dry wt in the mitochondria, or an average cell calcium content of approximately 3.8 mmol/kg dry wt. 2) "Nonviable" cells, defined by the presence of dense inclusions in their mitochondria and a K/Na concentration ratio of approximately 1. The Ca content is 15 +/- 2 mmol/kg dry wt in the cytoplasm and 685 +/- 139 mmol/kg dry wt in the mitochondria of such cells. Assuming 25 to 30% of the cell volume is mitochondrial, the overall calcium content of such nonviable cells is approximately 210 mmol/kg dry wt. The presence of these inclusions in 4 to 5% of the cells would account for the average total Ca content measured in perchloric acid extracts of isolated proximal tubule suspensions (approximately equal to 18 nmol/mg protein or 12.6 mmol/kg dry wt). Whole kidney tissues display a large variability in total Ca content (4.5 to 18 nmol/mg protein, or 3.4 to 13.5 mmol/kg dry wt), which could be accounted for by inclusions in 0 to 4% of the cells. The electron probe X-ray microanalysis (EPXMA) data conclusively demonstrate that the in situ mitochondrial Ca content of viable cells from the kidney proximal tubule is low and support the idea that mitochondrial Ca may regulate dehydrogenase activity but probably does not normally control cytosolic free Ca. PMID- 3560202 TI - Relationship of the Donnan potential to the transmembrane pH gradient in tracheal apical membrane vesicles. AB - Experiments were performed to determine the factors which contribute to the transmembrane pH gradient (delta pH) and the potential gradient (delta psi) in apical plasma membrane vesicles isolated from bovine tracheal epithelium. As indicated by the accumulation of 14C-methylamine, the vesicles maintained a delta pH (inside acidic) which was dependent upon the external pH. The delta pH was also proportional to the ionic strength of the suspending medium, suggesting that the H+ distribution was dictated by a Donnan potential. Measurements of the distribution of 86Rb+ demonstrated an electrical potential gradient across the vesicle membrane, inside negative which was proportional to the medium ionic strength. delta pH changed in parallel with delta psi in response to a variety of imposed conditions. These results are compatible with the existence of a H+ conductance in the vesicle membrane. Thus the endogenous electrical and proton gradients may be manipulated and used as a general experimental tool to complement kinetic analysis in investigations of transport mechanisms using isolated vesicle preparations. PMID- 3560201 TI - Electrogenic properties of the sodium-alanine cotransporter in pancreatic acinar cells: I. Tight-seal whole-cell recordings. AB - Electrical currents associated with sodium-coupled alanine transport in mouse pancreatic acinar cells were studied using the method of whole-cell recording with patch pipettes. Single cells or small clusters of (electrically coupled) cells were isolated by collagenase treatment. The composition of the intracellular solution could be controlled by internal perfusion of the patch pipette. In this way both inward and outward currents could be measured under "zero-trans" conditions, i.e., with finite concentrations of sodium and L-alanine on one side and zero concentrations on the other. Inward and outward currents for equal but opposite concentration gradients were found to be of similar magnitude, meaning that the cotransporter is functionally nearly symmetric. The dependence of current on the concentrations of sodium and L-alanine exhibited a Michaelis Menten behavior. From the sodium-concentration dependence of current as well as from the reversal potential of the current in the presence of an alanine concentration gradient, a sodium/alanine stoichiometric ratio of 1:1 can be inferred. The finding that N-methylated amino acids may substitute for L-alanine, as well as the observed pH dependence of currents indicate that the pancreatic alanine transport system is similar to (or identical with) the "A-system" which is widespread in animal cells. The transport system is tightly coupled with respect to Na+; alanine-coupled inward flow of Na+ is at least 30 times higher than uncoupled Na+ flow mediated by the cotransporter. The current-voltage characteristic of the cotransporter could be (approximately) determined from the difference of transmembrane current in the presence and in the absence of L alanine. The sodium-concentration dependence of the current-voltage characteristic indicates that a Na+ ion approaching the binding site from the extracellular medium has to cross part of the transmembrane electric field. PMID- 3560203 TI - Role for sulfur-containing groups in the Na+-Ca2+ exchange of cardiac sarcolemmal vesicles. AB - Different amino acid residues in cardiac sarcolemmal vesicles were modified by incubation with various chemical reagents. The effects of these modifications on sarcolemmal Na+-Ca2+ exchange were examined. Dithiothreitol, an agent that maintains sulfur-containing residues in a reduced state, caused a time- and concentration-dependent decrease in Na+-Ca2+ exchange. The treatment with dithiothreitol resulted in a decrease in Vmax values but did not alter the Km for Ca2+ for the Na2+-Ca2+ exchange reaction. If Na+ replaced K+ as the ion present during the modification of sarcolemmal membranes with dithiothreitol, there was substantially less of an inhibitor effect on Na+-Ca2+ exchange. Similar results were obtained with reduced glutathione, a reagent that also maintains sulfur containing residues in a reduced state. Two sulfhydryl modifying reagents, methylmethanethiosulfonate and N'-ethylmaleimide, were capable of altering Na+ Ca2+ exchange, and the type of ion present during modification significantly affected the extent of this alteration. Almost all of the chemical reagents investigated that modified other amino acid resides (carboxyl, lysyl, histidyl, tyrosyl, tryptophanyl, arginyl and hydroxyl) had the capacity to alter Na+-Ca2+ exchange after preincubation with the sarcolemmal membrane vesicles. However, the sulfur residue-modifying reagents were the only compounds to exhibit significant differences in their action on Na+-Ca2+ exchange, depending on whether Na+ or K+ was present in the preincubation modification medium. The tryptophan modifier, N bromosuccinimide, was the sole reagent that elicited a substantial increase in membrane permeability. The evidence is consistent with the hypothesis that sulfur containing residues interact with a Na+-binding site for Na+-Ca2+ exchange in cardiac sarcolemmal vesicles. PMID- 3560205 TI - Lowering of pH does not directly affect the junctional resistance of crayfish lateral axons. AB - The effect of pH was tested on the junction between crayfish lateral axons. By means of a glass capillary inserted into one of the axons, one side of the junction was perfused with solutions of known pH while the junctional resistance, Rj, was monitored. Integrity of the gap junction was checked electron microscopically. Rj remained unchanged when the pH of the perfusate was lowered from 7.1 to 6.0. However, when the pH of the unperfused side of the junction was lowered by substituting acetate for chloride in the external solution, Rj rose, attesting to the integrity of the junction and its capacity to uncouple in the perfused state. We suggest that H+ does not affect the junctional channels directly, but acts through an intermediary which is inactivated or removed by the perfusion. PMID- 3560204 TI - Ammonium transport in medullary thick ascending limb of rabbit kidney: involvement of the Na+,K+,Cl(-)-cotransporter. AB - In order to investigate the question whether ammonium reabsorption in the thick ascending limb of Henle's loop (TALH) proceeds via the Na+,K+,Cl(-) cotransporter, plasma membrane vesicles were prepared from TALH cells isolated from rabbit kidney outer medulla and the effect of NH+4 on their transport properties was investigated. It was found that, in the presence of a 78 mmol/liter NaCl gradient, 5 mmol/liter NH+4 inhibited bumetanide-sensitive rubidium flux by 86%; a similar decrease was observed for 5 mmol/liter, K+. Inhibition of bumetanide-sensitive rubidium uptake by NH+4 was competitive and an apparent Ki of 1.9 mmol/liter was found. Bumetanide-sensitive sodium uptake measured in the presence of a 83 mmol/liter KCl gradient was not inhibited by 5 mmol/liter NH+4. A 100-mmol/liter NH4Cl gradient was, however, capable of stimulating bumetanide-sensitive sodium uptake to the same extent as a KCl gradient. These data suggest that NH+4 is accepted by the K+ site of the Na+,K+,Cl-cotransport system and that the transporter can function in a Na+,NH+4,2Cl mode. Since the affinity of the transporter for NH+4 lies in the concentration range found in the TALH lumen in vivo, it is concluded that Na+,NH+4,2Cl-cotransport can contribute to the NH+4 reabsorption in this tubular segment. PMID- 3560206 TI - Formation of ion-translocating oligomers by nigericin. AB - At pH 4.0, greater than 10(-7) M nigericin was found capable of conducting net charge transfer across bimolecular lecithin membranes, with a stoichiometry of three uncharged ionophore moieties per cation. At neutral or alkaline pH, nigericin catalyzed the transfer of net charge through dimer forms. In agreement with these results, quantitative analysis of nigericin-potassium complexes formed at pH 4.0 showed a 3:1 ratio, and a 2:1 ratio at neutral or alkaline pH. A 1:1 stoichiometry was observed when the ionophore complex was not transferred from methanol-water to chloroform. Moreover, 1H-NMR spectra of nigericin-cation complexes formed at pH 4.0, displayed clear-cut chemical shift variations different to those observed at neutral or alkaline pH. Thus, it is apparent that acid pH causes a transition from dimeric to trimeric forms of nigericin-cation complexes. The membrane conductance increased up to ten times when negatively charged phosphatidyl glycerol was used, while the conductance decreased in positively charged cetylpyridinium containing membranes at pH 4.0. These results suggest that the nigericin-K+ oligomeric complex is positively charged. In this respect, pKa values around 8.0 were obtained for the nigericin carboxylate group in media of different dielectric constant, indicating that this chemical group is undissociated under these conditions. Moreover, the values for the complex formation constants as well as the delta G values calculated for the dimers and trimers indicated that such ionophore cation oligomeric complexes are thermodynamically stable. PMID- 3560207 TI - Transport-dependent alterations of membrane properties of mammalian colon measured using impedance analysis. AB - Direct current (DC) measurement methods have been commonly used to characterize the conductance properties of the mammalian colon. However, these methods provide no information concerning the effects of tissue morphology on the electrophysiological properties of this epithelium. For example, distribution of membrane resistances along narrow fluid-filled spaces such as the lateral intercellular spaces (LIS) or colonic crypts can influence DC measurements of apical and basolateral membrane properties. We used impedance analysis to determine the extent of such distributed resistance effects and to assess the conductance and capacitance properties of the colon. Because capacitance is proportional to membrane area, this method provides new information concerning membrane areas and specific ionic conductances for these membranes. We measured transepithelial impedance under three conditions: control conditions in which the epithelium was open-circuited and bathed on both sides with NaCl-HCO3 Ringer's solutions, amiloride conditions which were similar to control except that 100 microM amiloride was present in the mucosal bathing solution, and mucosal NaCl free conditions in which mucosal Na and Cl were replaced by potassium and sulfate or gluconate ("K+ Ringer's"). Three morphologically-based equivalent circuit models were used to evaluate the data: a lumped model (which ignores LIS resistance), a LIS distributed model (distributed basolateral membrane impedance) and a crypt-distributed model (distributed apical membrane impedance). To estimate membrane impedances, an independent measurement of paracellular conductance (Gs) was incorporated in the analysis. Although distributed models yielded improved fits of the data, the distributed and lumped models produced similar estimates of membrane parameters. The predicted effects of distributed resistances on DC microelectrode measurements were largest for the LIS distributed model. LIS-distributed effects would cause a 12-15% underestimate of membrane resistance ratio (Ra/Rb) for the control and amiloride conditions and a 34% underestimate for the "K Ringer's" condition. Distributed resistance effects arising from the crypts would produce a 1-2% overestimate of Ra/Rb. Apical and basolateral membrane impedances differed in the three different experimental conditions. For control conditions, apical membrane capacitance averaged 21 microF/cm2 and the mean apical membrane specific conductance (Ga-norm) was 0.17 mS/microF. The average basolateral membrane capacitance was 11 microF/cm2 with a mean specific conductance (Gb-norm) of 1.27 mS/microF.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3560208 TI - Permeation of divalent cations through alpha-latrotoxin channels in lipid bilayers: steady-state current-voltage relationships. AB - alpha-Latrotoxin, a polypeptide neurotoxin known to cause massive release of transmitter from vertebrate nerve terminals, is thought to act by forming cation selective channels in plasma membranes. This paper describes the steady-state current carried by Ca2+, Sr2+ and Ba2+ through pores of alpha-LaTx molecules incorporated in artificial bilayer membranes made of neutral lipids. Even when the solutions separated by the membrane are identical, the I-V relations rectify strongly, the current being higher when the side to which the toxin is added is positive. The polarity of the rectification is consistent with the hypothesis that the mechanism of action of the toxin is, at least in part, that of promoting inwardly directed flow of cations, and thus, accumulation of Ca2+ and other ions in the intracellular spaces. The dependence of the I-V characteristics on voltage and Ca2+ concentration is well described by a one-site, one-ion model for a channel. Three parameters of the model are deduced: the binding constant of the site for Ca2+, K = 1.5 M-1 (or K = 7 M-1 when activities are used instead of concentrations); the "electrical" distance of the site from the toxin-containing solution, alpha = 0.3; the free energy difference between the two barrier peaks, delta F = 0.26 kT. The values of the parameters deduced by studying the channel in the presence of Ca2+ give theoretical curves that also fit the data with Sr2+ and Ba2+, indicating a low level of discrimination among these three cations. PMID- 3560209 TI - Protamine alters structure and conductance of Necturus gallbladder tight junctions without major electrical effects on the apical cell membrane. AB - Protamine is a naturally occurring basic protein (pI; 9.7 to 12.0). We have recently reported that protamine dissolved in the mucosal bath (2 to 20 microM), induces about a twofold increase in transepithelial resistance in Necturus gallbladder within 10 min. Conductance decreased concomitantly with cation selectivity. In this leaky epithelium, where greater than 90% of an applied current passes between cells, an increment in resistance of this magnitude suggests a paracellular action a priori. To confirm this, ionic conductance across the apical cell membrane was studied with microelectrodes. Protamine increased transepithelial resistance without changing apical cell membrane voltage or fractional membrane resistance. Variation in extracellular K concentration (6 to 50 mM) caused changes in apical membrane voltage not different from control. To determine if protamine-induced resistance changes were associated with structural alteration of tight junctions, gallbladders were fixed in situ at peak response and analyzed by freeze-fracture electron microscopy. According to a morphometrical analysis, the tight junctional intramembranous domain expands vertically due to incorporation of new strands (fibrils) into the main compact fibrillar meshwork. Since morphologic changes are complete within 10 min, strands are probably recycled into and out of the tight junctional membrane domain possibly by the cytoskeleton either from cytoplasmic vesicles or from intramembranous precursors. Regulation of tight junctional permeability by protamine and other perturbations may constitute a common mechanism by which leaky epithelia regulate transport, and protamine, in concentrations employed in this study, seems reasonably specific for the tight junction. PMID- 3560210 TI - Type A, hardiness, and psychological distress. AB - This study examined the effects of hardiness and Type A behavior to burnout and psychological distress in the face of daily life hassles. Measures of hassles, hardiness, Type A behavior, and psychological distress were collected for 193 employees in the human services over 4 months. Analyses of covariance revealed that cognitively hardly Type A individuals experienced significantly less burnout and psychological distress than their less hardy Type B counterparts. The conceptual overlap and inherent confound between the hassles and the psychological distress measures are discussed in light of the research findings. PMID- 3560211 TI - Mastery, stress, and coping in marriage among chronic pain patients. AB - Marital stress, strain, and coping strategies were investigated in chronic pain patients by administering the Problems of Everyday Life Interview (PEL) to 55 married chronic pain patients. Subjects were assigned to either limited, moderate, or heightened mastery groups based upon PEL mastery scores. The heightened mastery group reported less marital strain, less marital stress, more use of negotiation, less use of selective ignoring, and less use of manage-stress coping strategies than either limited mastery or moderate mastery groups. There were no significant differences between limited mastery and moderate mastery groups on any variables measured. There were no differences between mastery groups on advice seeking. The effects of mastery as a mediator of coping and stress are discussed, as well as the advisability of incorporating treatments that specifically address feelings of lack of control over stressful events into chronic pain programs, especially when marital problems are identified. PMID- 3560212 TI - Do older children take in more smoke from their cigarettes? Evidence from carbon monoxide levels. AB - Expired-air carbon monoxide (CO) concentrations were measured in 125 pupils aged 11-17 years attending a girls' comprehensive school in the South of England who had smoked at least one cigarette on the day of testing. Both number of cigarettes smoked on the day of testing and time since the last cigarette were independently related to CO concentrations. Although there was a positive correlation between age and CO, this disappeared when number of cigarettes smoked on the day of testing and time since the last cigarette were taken into account. Previous reports of increasing CO concentrations with age taking account of cigarette consumption may be due to the use of usual daily cigarette consumption rather than number on the day of testing, which is more relevant given the short half-life of CO in the blood. In this sample, no evidence was found for an increase in smoke inhalation with increasing age. PMID- 3560213 TI - Coping with dental treatment: the potential impact of situational demands. AB - Coping strategies and anxiety responding of dental patients were studied in order to test the generalizability of previous findings based on volunteer blood donors. State and trait coping measures were administered once, and a process coping scale was administered at three points throughout treatment. Self-report, behavioral observation, and psychophysiological measures of anxiety were sampled for the same periods as process coping. Findings included the replication of a negative relationship between avoidant coping and patient anxiety ratings. Fluctuations in coping were evident across periods, and impact of situational demands and constraints was introduced as an explanation for these variations. A method for direct assessment of coping consistency was introduced. On the basis of the replicable associations with anxiety measures, the ability to detect changes in coping within a situation, and the ability to provide direct evidence of coping consistency, the use of process methodology for coping assessment is encouraged. PMID- 3560214 TI - Attenuation of stress-induced hypertension by exercise independent of training effects: an animal model. AB - The present study attempted to determine if exercise, in the absence of physical training, could alter development of hypertension during chronic exposure to a psychosocial stressor. Two groups of genetically normotensive rats were exposed to social stress for 7 days, following 5 weeks of acclimation to social isolation. One group had access to exercise in a running wheel during the stress period, while the second group did not. Blood pressure, heart rate, body weight, and running activity were monitored throughout the study, and heart and adrenal gland weights were obtained following sacrifice of the animals after exposure to stress. Blood pressure increased significantly to hypertensive levels on days 4 and 7 in the group denied access to exercise but was unchanged in the exercise group. Degree of attenuation of stress-induced hypertension was unrelated to amount of running activity. There were no differences in body weight, heart rate, or organ weight between groups. Exercise appeared to act specifically via diversional, or coping, mechanisms to buffer the response of the body to stress. PMID- 3560215 TI - High risk factors for cesarean febrile morbidity. PMID- 3560216 TI - Intra-arterial digital angiography of distal tibial vessels: improved preoperative evaluation for limb salvage procedures. PMID- 3560217 TI - P1 plasmid replication. Role of initiator titration in copy number control. AB - The copy number control locus incA of unit copy plasmid P1 maps in a region containing nine 19 base-pair repeats. Previous results from studies in vivo and in vitro indicated that incA interacts with the plasmid-encoded RepA protein, which is essential for replication. It has been proposed that the repeat sequences negatively control copy number by sequestering the RepA protein, which is rate-limiting for replication. Our results lend further support to this hypothesis. Here we show that the repeats can be deleted completely from P1 miniplasmids and the deletion results in an approximately eightfold increase in plasmid copy number. So, incA sequences are totally dispensable for replication and have only a regulatory role. The copy number of incA-deleted plasmids can be reduced if incA sequences are present in trans or are reincorporated at two different positions in the plasmid. This reduction in copy number is not due to lowered expression of the repA gene in the presence of incA. We show that one repeat sequence is sufficient to bind RepA and can reduce the copy number of incA deleted plasmids. When part of the repeat was deleted, it lost its ability to bind as well as influence copy number. These results show a strong correlation between the capacity of incA repeats to bind RepA protein both in vivo and in vitro, and the function of incA in the control of copy number. PMID- 3560218 TI - Net N-C charge imbalance may be important for signal sequence function in bacteria. AB - The net charge distribution in a region around the signal sequence cleavage site has been calculated for samples of 41 prokaryotic and 165 eukaryotic exported proteins. The results show that prokaryotic proteins in particular have a markedly higher incidence of acidic than of basic residues in this region. The possibility that a "dipolar" structure with a positive net charge difference between the N and C-terminal regions is important for signal sequence function in bacteria is suggested, and invoked to rationalize a number of known export defective signal sequence mutations. PMID- 3560219 TI - Oxygen equilibrium study and light absorption spectra of Ni(II)-Fe(II) hybrid hemoglobins. AB - Ni(II)-Fe(II) hybrid hemoglobins, in which hemes in either the alpha or beta subunit are substituted with Ni(II) protoporphyrin IX, have been prepared and characterized. Since Ni(II) protoporphyrin IX binds neither oxygen nor carbon monoxide, the oxygen equilibrium properties of the Fe subunit in these hybrid hemoglobins were specifically determined. K1 values, namely the equilibrium constants for the first oxygen molecule to bind to hemoglobin, agreed well for these hybrid hemoglobins with the K1 value of native hemoglobin A in various conditions. Therefore, Ni(II) protoporphyrin IX in these hybrid hemoglobins behaves like a permanently deoxygenated heme. Both Ne-Fe hybrid hemoglobins bound oxygen non-co-operatively at low pH values. When the pH was raised, alpha 2 (Fe) beta 2 (Ni) showed co-operativity, but the complementary hybrid, alpha 2 (Ni) beta 2 (Fe), did not show co-operativity even at pH 8.5. The light absorption spectra of Ni(II)-Fe(II) hybrid hemoglobins indicated that the coordination states of Ni(II) protoporphyrin IX in the alpha subunits responded to the structure of the hybrid, whereas those in the beta subunits were hardly changed. In a deoxy-like structure (the structure that looks like that observed in deoxyhemoglobin), four-co-ordinated Ni(II) protoporphyrin IX was dominant in the alpha (Ni) subunits, while under the conditions that stabilized an oxy-like structure (the structure that looks like that observed in oxyhemoglobin), five-co ordinated Ni(II) protoporphyrin IX increased. The small change observed in the absorption spectrum of the beta (Ni) subunits is not related to the change of the co-ordination number of Ni(II) protoporphyrin IX. Non-co-operative binding of oxygen to the beta subunits in alpha 2 (Ni) beta 2 (Fe) accompanied the change of absorption spectrum in the alpha (Ni) subunits. We propose a possible interpretation of this unique feature. PMID- 3560221 TI - Crystal structure analyses of reduced (CuI) poplar plastocyanin at six pH values. AB - The structure of poplar plastocyanin in the reduced (CuI) state has been determined and refined, using counter data recorded from crystals at pH 3.8, 4.4, 5.1, 5.9, 7.0 and 7.8 (resolution 1.9 A, 1.9 A, 2.05 A, 1.7 A, 1.8 A and 2.15 A; the final residual R value was 0.15, 0.15, 0.16, 0.17, 0.16 and 0.15, respectively). The molecular and crystal structure of the protein is substantially the same in the reduced state as in the oxidized state. The refinements of the structures of the six forms of the reduced protein could therefore be commenced with a model derived from the known structure of CuII plastocyanin. The refinements were made by reciprocal space least-squares calculations interspersed with inspections of electron-density difference maps. Precautions were taken to minimize any bias of the results of the refinements in the direction of the starting model. The most significant differences among the structures of the reduced protein at the six pH values, or between them and the structure of the oxidized protein, are concentrated at the Cu site. In the reduced protein at high pH (pH 7.8), the CuI atom is co-ordinated by the N delta(imidazole) atoms of His37 and His87, the S gamma(thiolate) atom of Cys84, and the S delta(thioether) atom of Met92, just as in CuII-plastocyanin. The distorted tetrahedral geometry and the unusually long Cu-S(Met92) bond are retained. The only effects of the change in oxidation state are a lengthening of the two Cu-N(His) bonds by about 0.1 A, and small changes in two bond angles involving the Cu-S(Cys) bond. The high-pH form of reduced plastocyanin accordingly meets all the requirements for efficient electron transfer. As the pH is lowered, the Cu atom and the four Cu-binding protein side-chains appear to undergo small but concerted movements in relation to the rest of the molecule. At low pH (pH 3.8), the CuI atom is trigonally co-ordinated by N delta(His37), S gamma(Cys84) and S delta(Met92). The fourth Cu-ligand bond is broken, the Cu atom making only a van der Waals' contact with the imidazole ring of His87. The trigonal geometry of the Cu atom strongly favours CuI, so that this form of the protein should be redox-inactive. This is known to be the case.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3560220 TI - Properties of chemically modified Ni(II)-Fe(II) hybrid hemoglobins. Ni(II) protoporphyrin IX as a model for a permanent deoxy-heme. AB - Chemical modifications, NES-Cys(beta 93), des-Arg(alpha 141), and both modifications on the same molecule, were made to Ni-Fe hybrid hemoglobins, and their effect on individual subunits was investigated by measuring oxygen equilibrium curves, the Fe(II)-N epsilon (His F8) stretching Raman lines, and light-absorption spectra. The oxygen equilibrium properties indicated that modified Ni-Fe hybrid hemoglobins remain good models for the corresponding deoxy ferrous hemoglobins, although K1, the dissociation equilibrium constant for the first oxygen to bind to hemoglobin, was decreased by the chemical modifications. Resonance Raman spectra of deoxy alpha 2 (Fe) beta 2 (Ni) and light-absorption spectra of deoxy alpha 2 (Ni) beta 2 (Fe), revealed that the state of alpha hemes in both hybrid hemoglobins underwent a transition from a deoxy-like state to an oxy-like state caused by these chemical modifications when K1 was about 3 mm Hg (1 mm Hg approximately 133.3 Pa). On the other hand, the state of beta hemes in hybrid hemoglobins was little affected, when K1 was larger than 1 mm Hg. Modified alpha 2 (Fe) beta 2 (Ni) gave a Hill coefficient greater than unity with a maximum of 1.4 when K1 was about 4 mm Hg. The two-state model predicts that the K1 value at the maximum Hill coefficient should be much larger than this value. For oxygen binding to unmodified alpha 2 (Ni) beta 2 (Fe), oxygen equilibrium data suggested no structural change, while the spectral data showed a structural change around Ni(II) protoporphyrin IX in the alpha subunits. A similar situation was encountered with modified alpha 2 (Ni) beta 2 (Fe), although K1 was decreased as a result of the structural changes induced by the modifications. PMID- 3560222 TI - Computational studies of the interaction of myoglobin and xenon. AB - Computational studies are used to investigate the energies of xenon binding to myoglobin and to describe pathways through the protein interior for a metmyoglobin-xenon complex. Empirical energy calculations indicate a favorable enthalpic contribution of 0.6 to 4.2 kcal/mol to xenon binding for four experimentally determined xenon sites. These calculated enthalpies help to explain the different xenon occupancies observed experimentally. A fifth site, modeled in place of the iron co-ordinated water molecule in the distal cavity, is also predicted to bind xenon. The largest contribution to the binding energy is from van der Waals' interactions with smaller contributions from polarization and protein strain terms. Ligand trajectory calculations as well as a new geometric algorithm define a connecting network of channel-like pathways through the static protein structure. One or two pathways appear to lead most easily from each major internal cavity to the protein surface. The importance of these channels in protein dynamics and their implications as routes for ligand motion are discussed. PMID- 3560223 TI - Nucleotide sequence of the goat embryonic alpha globin gene (zeta) and linkage and evolutionary analysis of the complete alpha globin cluster. AB - In previous studies we identified and sequenced clones containing two adult alpha globin genes of the goat. Additional studies have revealed the presence of an embryonic alpha globin gene termed zeta. Sequence analysis of the gene shows that it is the largest mammalian or avian globin gene cloned to date. Its unusual size is mainly due to a 14 base-pair tandem repeat sequence in its first intron. A similar sequence is also found in the first intron of the human zeta gene. The goat zeta coding sequence differs greatly from that of the adult alpha, particularly at amino acid position 38, where it codes for the amino acid replacement of Gln for Thr. This change may confer a higher intrinsic O2 affinity on the zeta globin protein, ensuring a sufficient O2 supply for the developing goat embryo. The cloning and sequencing of this gene completes the alpha globin locus of the goat, composed of three genes in the following order 5'-zeta-I alpha II alpha-3'. Evolutionary comparisons of the goat alpha locus with other amphibian, avian and mammalian loci reveal several interesting features. Statistical analysis confirms the hypothesis that the embryonic alpha gene is much older (400 million years) than the embryonic beta gene (200 million years), and that it is descended from a primordial gene, whose present-day counterpart is the Xenopus larval alpha globin gene. Our results also suggest that after the divergence of the avian line, the alpha A gene converted the alpha D gene during the evolution of the pre-mammalian line. The alpha D globin gene remains unconverted in the avian line, potentially because of insertion/deletion sequences that may prevent any gene conversion event. The divergence rates of specific globin genes have been analyzed and found to form an essentially straight line, in agreement with the neutralist view of evolution. PMID- 3560224 TI - Characterization of a member of the highly repeated long interspersed rat DNA family with long open reading frames. AB - A highly repetitive long interspersed sequence from rat DNA has been isolated and partly characterized. This sequence comprises at least a 1300 base-pair and a 2400 base-pair EcoRI fragment and probably additional elements. The 2400 base pair segment has been analyzed in detail. It appears to be part of the chromosomal DNA in rat cells. The 2400 base-pair repeat is likely to be distributed over several regions in the rat genome. The 2400 base-pair segment has been cloned, mapped for restriction sites, and part of its nucleotide sequence has been determined. The 2400 base-pair sequence is a member of a typical highly repetitive long interspersed sequence with high copy number and restriction site polymorphism. There are sequence homologies to mouse and human DNA. A striking homology has been detected to the flanking sequences of a repetitive mouse DNA sequence that has been described to be located adjacent to one of the kappa-immunoglobulin variable genes. Elements in the 2400 base-pair rat repeat are transcribed in cells from most rat organs and from several continuous rat cell lines. This RNA from rat cell lines was found polyadenylated or not polyadenylated. The nucleotide sequence of parts of the 2400 base-pair DNA segment revealed open reading frames for polypeptide sequences. Such open reading frames have been detected in two different segments of the 2400 base-pair DNA repeat. Open reading frames exist in the two complementary strands in the same DNA segment. The hypothetical polypeptide whose sequence has been determined in toto has a length of 190 amino acid residues and is enriched in hydrophobic amino acids, reminiscent of the amino acid composition in membrane proteins. Hence, it is conceivable that the 2400 base-pair repeat sequence from rat DNA, at least in part, encodes messenger RNAs that might be translated into functional proteins. PMID- 3560225 TI - Structural conservation and variation in the D-loop-containing region of vertebrate mitochondrial DNA. AB - The nucleotide sequences of the D-loop-containing regions of three rat mitochondrial DNAs (mtDNAs), two from the species Rattus norvegicus and one from R. rattus, were determined. Comparisons made among these sequences and with the mouse sequence showed that, on the basis of both base composition and frequency of nucleotide alterations, three domains could be defined within the D-loop containing region: a central conserved segment, poor in L-strand adenine, flanked by two divergent, adenine-rich regions. Deletions and insertions were found to occur at an unexpectedly high frequency in these sequences and the conserved sequence block called CSB-1 was found not to be intact in the R. rattus sequence. Although in comparisons of more distantly related mtDNAs the D-loop region is the most divergent on the molecule, it does not diverge more than typical protein genes between R. norvegicus and R. rattus, and its central conserved domain appears to be one of the molecule's most conserved regions. The most variable domain borders the tRNAPhe gene and contains the L and H-strand promoters and the 5' terminus for H-strand DNA synthesis. Within this region we have found sequences in all the mtDNAs we have examined, including those of human, two artiodactyls and Xenopus, that are capable of folding into cloverleaf structures. In the other divergent domain of the same mtDNAs, we find sequences capable of assuming similar secondary structural configurations at or near the sites for the termination of D-loop DNA synthesis. The evolutionary preservation of the potential to form such structures despite the high primary-structural divergence of the regions they occur in, suggests the structures are of principal importance for some processes occurring in the D-loop-containing region. PMID- 3560226 TI - Structure and expression of the parotid secretory protein gene of mouse. AB - Parotid secretory protein (PSP) is the most abundant gene product in the mouse parotid gland. In this tissue, its mRNA accumulates to approximately 5 X 10(4) molecules per cell. Our analysis of 11 mouse tissues indicates that the parotid secretory protein gene is expressed exclusively in the parotid gland. We have cloned a 27,000 base DNA segment of mouse chromosome 2 containing the PSP transcription unit. Hybridization with nascent parotid transcripts elongated in vitro indicates that the parotid secretory protein gene is the only gene present within the cloned DNA segment, which is expressed efficiently in the parotid gland. The gene is composed of eight introns and nine exons, whose sizes and order was determined by a novel S1 nuclease method. The parotid secretory protein transcription unit measures 8300 bases from cap nucleotide to poly(A) addition site. Using nascent parotid transcript hybridization, we localized the area of transcription termination to a 700 base-pair region located 2500 bases downstream from the poly(A) addition site. The initiating nucleotide of transcription was determined by primer extension sequencing of the PSP mRNA. The genomic DNA sequence upstream from the transcription initiation site includes both TATA and CAAT motifs. In addition, there are sequence elements homologous to the simian virus 40 and polyoma core enhancer sequences located at position -422 and -653, respectively. PMID- 3560227 TI - Mapping of the sites of protection on a 5 S RNA gene by the Xenopus transcription factor IIIA. A model for the interaction. AB - The contact points of transcription factor IIIA with the internal control region of the 5 S RNA gene of Xenopus have been investigated by probing the accessibility of the DNA in the protein-DNA complex to dimethylsulphate and to micrococcal nuclease. The results of quantitative measurements, combined with those from earlier DNase I and DNase II protection studies, are consistent with a series of multiple contacts about five base-pairs apart, or half a double-helical turn, along the whole length of the internal control region. The nine patches of contact we have mapped could correspond to nine DNA-binding fingers in the protein. A model for the overall geometry of the interaction is presented in which the protein lies on one face of the DNA double helix. PMID- 3560228 TI - Molecular dynamics simulations of the holo and apo forms of retinol binding protein. Structural and dynamical changes induced by retinol removal. AB - The effects of removing retinol from the X-ray structure of holo-retinol binding protein are studied using the molecular dynamics technique. Structural and dynamical properties emerging from an 80 ps simulation of the apo form, for which no crystallographic structure is available, are compared with the results of a 70 ps trajectory of the holo-protein. Dynamical stationarity is attained after roughly 30 ps, and the resulting average structure is proposed as a reasonable model of the apo-protein. Conformational changes are observed for the loops at the beta-barrel entrance during the non-equilibrium part of the apo-trajectory. Tryptophan labelling experiments and retinoid reconstitution experiments point towards this part of the molecule as being involved in prealbumin binding. Structural changes in this region may therefore explain the differences in prealbumin affinity between the apo and holo forms. Furthermore, a change in the position of the alpha-helix, corresponding to a pivot around its C terminus, is observed for the apo-protein. The resulting conformation of the alpha-helix is found to be similar to that in apo-beta-lactoglobulin, which also can bind retinol and for which a crystal structure exists. The results from the holo simulation are compared to the crystallographic data and show good agreement. The dynamics of the secondary and tertiary structural elements are analysed and compared for the two forms. The beta-barrel is found to be extremely cooperative in its atomic motions in both simulations, and the top and bottom beta-sheets perform collective fluctuations with respect to each other in the low-frequency limit of the simulations. The dynamics of the alpha-helical region presents clear differences between the two forms; while the holo-protein has a well-defined spectrum for the longitudinal stretching mode, the apo form displays a fairly large bending of the alpha-helix at several points of the trajectory. PMID- 3560229 TI - Crystallographic refinement and structure of DNase I at 2 A resolution. AB - The structure of bovine pancreatic deoxyribonuclease I (DNase I) has been refined at 2 A resolution using the restrained parameter, reciprocal least-squares procedure of Hendrickson and Konnert. The conventional R-factor for 16,104 reflections with I greater than or equal to 3 sigma (I) from 6.0 to 2.0 A resolution is 0.157. Bond lengths and angles of the refined structure are close to ideal values with root-mean-square (r.m.s.) deviations of 0.023 A and 1.4 degrees, respectively. The r.m.s. deviation of short non-bonded contacts from the sum of van der Waals' radii is 0.18 A. The orientation of side-chains shows a clear trimodal distribution of chi 1-angles at -60 degrees, 180 degrees, 60 degrees (in the order of preference) corresponding to staggered conformations. The chemically determined sequence was corrected at four positions, the major correction being an insertion of the tripeptide Ile-Val-Arg between Arg27 and Arg28. Extended hydrophobic regions in between, and on either side of, the two central six-stranded beta-pleated sheets are mainly responsible for the low average isotropic temperature factor of 11.9 A2 for the 2033 protein atoms. Besides the flexible loop region between Gly97 and Gly102 (Glu99 and Ser100 are disordered) and the carbohydrate side-chain, which both extend into a large solvent channel, only the exposed loop Arg70 to Lys74 shows elevated thermal mobility. The longest of the eight helices in DNase I, together representing 26% of the structure, has a 22 degree kink and consists of two alpha-helical segments (residues 136 to 144 and 145 to 155) separated by a 3(10)-helical turn. DNase I fragments 1 to 120 and 121 to 257 can be superimposed by an approximate 2-fold axis (r.m.s. deviation 1.49 A for 61 equivalent C alpha positions), suggesting that the enzyme might be the result of gene duplication. The two Ca2+ bound to DNase I under crystallization conditions are important for its structural integrity by stabilizing the surface loop Asp198 to Thr204 and limiting the region of high thermal mobility in the flexible loop to residues Gly97 to Gly102. The N-linked carbohydrate side-chain attached to Asn18 is of the high-mannose type with a branching point at the mannose residue in position 3.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3560230 TI - Properties of supercoiled DNA in gel electrophoresis. The V-like dependence of mobility on topological constraint. DNA-matrix interactions. AB - The dependence of the electrophoretic mobility of small DNA rings on topological constraint was investigated in acrylamide or agarose gels as a function of DNA size (from approximately 350 to 1400 base-pairs), gel concentration and nucleotide sequence. Under appropriate adjustment between the size of the DNA and the gel concentration, this dependence was found to be V-shaped in a limited interval around constraint O, the minimum mobility at the apex of the V being obtained for relaxed DNA. Analysis of the DNA size dependence of the V suggests that it is the result of a modulated compaction of the DNA rings by the gel matrix. Compaction appears to be maximum upon relaxation, and to decrease with increase in supercoiling. Consistent with this interpretation, gels were found to oppose structural departures from the B helix, such as Z transition and cruciform extrusion, which tend to relax the DNA molecule and make it more expanded. In contrast, when DNA size or gel concentration are large enough relative to one another, U shapes are observed instead of Vs, as a consequence of an increase in the mobility of the rings closer to relaxation. The relevance of these results to the situation of superhelical DNA in vivo is discussed. Application of the V to the measurement of the DNA helical twist is mentioned. PMID- 3560231 TI - Structure and sequence of mutations induced by ionizing radiation at selectable loci in Chinese hamster ovary cells. AB - The spectrum of mutations induced by ionizing radiation at two non-essential genetic loci varies markedly. Those at the adenine phosphoribosyl transferase (aprt) locus predominantly have no detectable alterations of gene structure on Southern blots, while those at the hypoxanthine guanine phosphoribosyl transferase (hprt) locus are largely massive deletions eliminating all coding sequence. Insertion mutations were detected at both loci. To characterize the sequence alterations producing the minor changes at the aprt locus, two mutant genes were cloned from lambda genomic libraries and sequenced. One of these mutants proved to be a 20 base-pair deletion formed between two short (3 base pair) direct repeat sequences, while the second was the result of a 58 base-pair insertion accompanied by a 13 base-pair deletion. PMID- 3560232 TI - Crystallization of the delta toxin of Staphylococcus aureus. AB - Delta toxin is a small cytolytic polypeptide produced and secreted by the organism Staphylococcus aureus and belongs to a family of surface-active toxins that exhibit pronounced effects on a wide variety of cellular membranes. Although this class of proteins has been much studied by a wide variety of physical techniques, no consensus has been reached on their mode of action. Therefore, in order to investigate their role in causing membrane damage, a structural analysis of the delta toxin has been initiated. Crystals of this protein have been grown by dialysis against mixtures of 2-methylpentan-2,4-diol and water. These crystals are relatively insensitive to radiation damage and diffract to high resolution. The results of this study should provide a valuable insight into the cytolytic properties of these molecules. PMID- 3560233 TI - Morphology, distribution, and density of sensory receptors in the glabrous skin of the cat rhinarium. AB - The sensory organization of the cat rhinarium has been investigated. Individual rete pegs were found to contain a triad of receptors comprising free nerve endings ascending in the peg to terminate in close proximity to the skin surface, a basally situated layer of Merkel corpuscles, and an abundance of encapsulated receptors lying at the base and to one side of the rete peg. Neither the Merkel corpuscles nor the encapsulated receptors were evenly distributed. Merkel corpuscles were more abundant dorsally; ventrally they were fewer and asymmetrically arranged within individual rete pegs. The encapsulated corpuscles were more evenly distributed, but dorsally they were consistently present as encapsulated clusters of up to nine corpuscles. PMID- 3560234 TI - An anatomical and functional analysis of cat biceps femoris and semitendinosus muscles. AB - The anatomy, architecture, and innervation patterns of the hamstring muscles, biceps femoris, and semitendinosus were examined in adult cats using microdissection and glycogen-depletion techniques. The biceps femoris muscle consists of two heads. The anterior head, which attaches mainly to the femur, is divided into two parts by the extramuscular branches of its nerve. The posterior head is innervated by a single nerve. Semitendinosus is composed of two heads, one proximal and one distal to a tendinosus inscription, each of which is separately innervated. The extramuscular branches of the nerves to these hamstring muscles thus partition them into innervation subvolumes termed parts. The available evidence suggests that each of the parts of these muscles so innervated is not equivalent to the collections of single motor units that have been described for ankle extensors as neuromuscular compartments. It is quite likely that each of the parts of the hamstring muscles may contain more than one neuromuscular compartment. Using chronically implanted EMG electrodes, the activation patterns of different parts of the hamstring muscles were analyzed during locomotion. The anterior and middle parts of biceps femoris are active during the early stance phase, probably producing hip extensor torque. The posterior part of biceps femoris and semi-tendinosus act most consistently as flexors, during the early swing phase, but also may function in synergy with hip, knee, and ankle joint extensors near the time of foot placement. Greater variability is found in the activity patterns of posterior biceps femoris and semitendinosus with respect to the kinematics of the step cycle than is observed for anterior and middle biceps femoris. It is suggested that this variation may reflect a larger role of sensory feedback in shaping the timing of activity in posterior biceps femoris and semitendinosus than in "nonarticular" muscles. PMID- 3560235 TI - Why do cells need phosphocreatine and a phosphocreatine shuttle. PMID- 3560236 TI - Influence of collateral blood flow and of variations in MVO2 on tissue-ATP content in ischemic and infarcted myocardium. AB - The left anterior descending coronary artery was occluded for 22.5, 45, 90, 180, and 360 mins in anesthesized open-chest dogs and pigs and thereafter reperfused for 30 min. Myocardial oxygen consumption was varied in dogs by cholinergic stimulation (bradycardia) and by cutting of the right and left vagus nerve (tachycardia). Regional myocardial blood flow was measured with radioactive tracer microspheres at the end of the occlusion period and 5 and 30 min after reflow. Tissue content of adenine nucleotides and of phosphocreatine were determined in the subendo- and subepicardium of transmural biopsies at the end of reflow. Infarct size was determined with nitrobluetetrazolium and compared with risk region size. Porcine hearts developed infarcts sooner. Those canines with a high MVO2 due to tachycardia had larger infarcts than those with bradycardia and resembled infarct development in the pig. The evolution of infarcts with time depended strongly on collateral flow which was significantly higher in canine hearts. Higher collateral flow and lower MVO2 in one group of canine hearts also resulted in better preserved tissue ATP. The fall in tissue ATP with time after coronary occlusion was compared with the O2-supply via collateral flow during occlusion. Assuming that the oxygen entering ischemic myocardium was used for ADP phosphorylation, we could estimate the degree of ATP-"overspending". Overspending was highest in low-flow ischemia and it correlated well with the speed of infarction. The ATP-data are best explained by the phosphocreatine energy shuttle model and by assuming slow access of cytosolic ATP to the ATP-splitting sites at the myofibrils. In conclusion, we postulate that both collateral flow as well as myocardial oxygen consumption before and during occlusion determine infarct size. PMID- 3560237 TI - Role of the basic sciences in the practice of cardiology. PMID- 3560240 TI - A racial view of medical education. PMID- 3560238 TI - Muscarinic receptor regulation of cardiac adenylate cyclase activity. AB - Stimulation and inhibition of adenylate cyclase activity are mediated by the guanine nucleotide regulatory proteins Gs and Gi, respectively. Two general mechanisms have been proposed for the inhibition of activated adenylate cyclase: direct inhibition of the catalyst by Gi, and indirect inhibition of the activated catalyst mediated by Gi inhibition of Gs. We have assessed direct inhibition of adenylate cyclase by evaluating the ability of Gpp(NH)p to inhibit the forskolin stimulated enzyme in the presence of various concentrations of magnesium ions and the guanine nucleotide. Gpp(NH)p inhibition of adenylate cyclase activity was only observed in the presence of forskolin and low concentrations of MgCl2. Muscarinic agonists did not increase Gpp(NH)p inhibition of the forskolin stimulated enzyme, even in the presence of low concentrations of MgCl2 and guanine nucleotide (near the respective Kact or Ki). Whether in the absence or presence of muscarinic agonists, no concentration of Gpp(NH)p was found to inhibit basal adenylate cyclase activity in the absence of forskolin. In addition, muscarinic agonists had no effect on the rate constant (kon) for Gpp(NH)p activation of the enzyme. In contrast to these data, the muscarinic agonist methacholine stimulated the inactivation rate constant (koff) for isoproterenol plus GTP-activated adenylate cyclase activity 15-fold, and the increase in koff was blocked by atropine. Moreover, the sarcolemma displayed specific, high affinity GTP hydrolytic activity which was stimulated by methacholine activation of muscarinic receptors. These data further support our original hypothesis, indicating that although direct inhibition of the catalyst by Gi may occur in cardiac sarcolemma, physiologically relevant attenuation of adenylate cyclase activity by muscarinic agonists occurs by a mechanism linked to GTP hydrolysis. PMID- 3560239 TI - Mouse therapy and religion. PMID- 3560241 TI - Tailoring antihypertensive drug therapy for the black patient. AB - Blacks experience greater incidence, morbidity, and mortality from hypertension in comparison with whites. Blacks also respond differently to antihypertensive agents. While whites tend to respond in similar fashion to many of the different classes of antihypertensives, blacks consistently have the best response to thiazide diuretics. When a second drug is needed for blood pressure control, there are a number of choices: a beta-blocker, an alpha-beta blocker, an alphablocker, a centrally acting agent, a peripherally acting agent, an angiotensin-converting enzyme (ACE) inhibitor, or a calcium channel blocker. Choosing among these involves considerations of efficacy, likelihood of compliance, and symptomatic and metabolic side effects-all important factors. Clinical experience with the ACE inhibitors, and captopril in particular, has shown the value of adding such a drug to a diuretic regimen, both in terms of controlling blood pressure and reducing metabolic derangements, and subsequently, cardiovascular risk factors. Labetalol, the alpha-beta blocker, and prazosin, the alphablocker, have also produced good results in some studies when combined with a thiazide in black patients. PMID- 3560242 TI - Pride and purpose as antidotes to black homicidal violence. AB - The incidence of black male homicide is a major public menace. The lowest incidence of black male homicide was when the black power movement was visible and flourishing. Psychohistorical data support the contention that racial pride is an effective means for regulating intragroup tensions. In the absence of an Afrocentric orientation that promotes community power and self-determination, the need for self-reliance is eroded by value illnesses.The value orientation of the black movement supplied the pride used to obtain academic success, to reduce juvenile delinquency, and to help Afro-Americans to structure their lives for personal satisfactions. Blackness has always been about personal power and social control, but society does not allow much access to either for Afro-Americans. As a consequence, stress from racism is severe, asymptomatic, and multi-faceted. The best antidote to black homicidal violence comes from a pro-social effort based upon a self-image that gives a feeling of positive accomplishment and appreciation. Afrocentric pride promotes or enhances pro-social behavior. PMID- 3560243 TI - Combining test-taking intervention with course remediation: effects on National Board subtest performance. AB - Effects of test-taking skills instruction over a five-year period were assessed by examining retest performances of second-year medical students who, because of unsatisfactory performance, were required to repeat National Board Part I subtests and who all participated in a summer review program. Two groups of students were involved in the study: an intervention group consisting of 14 students who participated in a special intervention program involving test-taking skills instruction and a comparison group that included 13 nonparticipants. The intervention group's mean retest performance was significantly greater (F = 9.38, P < .005). The results suggest that intervention programs can have a significant impact on academic success, and deserve serious consideration by medical students who demonstrate low performances on examinations because of comparatively poor test-taking skills and for students undergoing academic remediation. PMID- 3560244 TI - Volvulus of the stomach: an African series and a review. AB - A radiological diagnosis of gastric volvulus (GV) was made in 11 of 576 consecutive upper gastrointestinal series at the University of Benin Teaching Hospital, Nigeria, over a two-year period. The clinical symptoms were thoracico abdominal in three and abdominal in eight; these cases were evaluated as acute in three, acute upon chronic in two, and chronic in six. There was a significant delay in the diagnosis in all cases (except a neonate in the series), and no case was diagnosed on clinical grounds alone.THE PREDISPOSING FACTORS (EXCEPT THE CLINICAL MISDIAGNOSIS OF THE NEONATE) IN SIX OF THE SEVEN CASES THAT CAME TO SURGERY WERE: diaphragmatic hernia and perigastritis (left lung abscess, thoracic empyema), arteriomesenteric compression of the duodenum in pregnancy (peptic ulcer), splenomegaly (hepatosplenomegaly, ascites, esophageal varices), previous gastrojejunostomy (stomal ulcer, left subphrenic abscess) and two cases of intestinal malrotation with mesenteric abnormalities (small bowel obstruction in one and duodenal atresia in the other). In one idiopathic case, gastric outlet obstruction was clinically suspected prior to surgery. Thus, the putative rarity of GV in black Africans is not supported by this experience.Gastric volvulus is a clinico-radiologic entity that may present with a confusing thoracico-abdominal symptom complex. A greater awareness of the radiologic features is quintessential to an expeditious and usually successful surgical management that will avoid potentially serious complications. Negative surgical findings do not exclude GV as the underlying cause of acute abdomens necessitating emergency laparotomies. PMID- 3560245 TI - Psychotherapy and black women: a survey. AB - A survey of black and white psychiatrists on the subject of nonpsychotic black female patients in psychotherapy yielded 93 usable responses. Among the findings are a profile of the average black woman in psychotherapy, responses to questions on clinical and therapeutic issues, and the role of racism as reported by the psychiatrists.THE PROFILE OF THE AVERAGE BLACK WOMAN IN PSYCHOTHERAPY THAT EMERGED WAS: she is married, in a technical or semi-professional occupation, with some college experience, in the age range of 26 to 40 years, and most often diagnosed with an anxiety disorder. The most frequent presenting problem is depression, with family problems second in frequency. Developing new coping mechanisms was the most difficult stage of the treatment process. Self-esteem was the most frequent unconscious conflict. Racial discrimination was most often incorportated as a symptom. The impact of racism on the treatment process most frequently occurred in the area of working through conflicts. PMID- 3560246 TI - Diagnosis of hyperthyroidism in patients with thyroiditis: a case study. AB - A diagnosis of subacute thyroiditis can be difficult to make in the early stages of disease, especially when patients present with symptoms of a hyperthyroid state that are nonspecific and mild. Using three case histories, the authors demonstrate how an early diagnosis of thyroiditis was made in these patients. PMID- 3560247 TI - Use of interstitial hyperthermia to produce homogeneous heat distribution patterns. AB - The preliminary experience of the use of a prototype hyperthermia unit (Astro 200) for tumor regression in Howard University Hospital's Department of Radiotherapy is described. The purpose of this study was to produce homogeneous heat distribution patterns within a 5-cm cylinder in the middle of a phantom (ground beef) using radio frequency conducted through electrodes implanted in the medium. Homogeneous heat distribution was achieved by finding the optimal spatial distribution of electrodes within the phantom and by sequencing the radio frequency in the electrodes. Monitored observation revealed a steady state homogeneous temperature of 42.5 degrees C within a 4-cm diameter. There was a temperature difference of 0.5 degrees C within 1 cm of the periphery.Heat in the clinical range of 42 to 43 degrees C has caused tumor regression, and was found to be most effective when combined with another modality of radiation. At Howard University Hospital, hyperthermia is used in conjunction with conventional modalities-surgery, radiotherapy, and chemotherapy-in the treatment of tumors. PMID- 3560248 TI - Metastasis to the umbilicus: possible racial difference. AB - Umbilical metastasis is rare. A review of the available American literature suggests that it is relatively more common in blacks than in whites. Prospective research is indicated, as this would add to knowledge of cutaneous-reaction patterns peculiar to racial groups. PMID- 3560249 TI - Breast carcinoma with pericardial metastasis. AB - Neoplastic involvement of the pericardium occurs frequently in post-mortem studies. Symptoms of this involvement of the pericardium prior to death are unusual. This report describes a case of breast carcinoma in a 54-year-old woman who presented with cardiac tamponade. Because breast carcinoma as a cause of cardiac tamponade is unusual, its presentation is reported. Early recognition of the possibility of malignancy allows for initiation of appropriate treatment, thereby improving the patient's chance of survival. It is recommended that all patients who present with tamponade have pericardial fluid sent for cytologic examination. PMID- 3560251 TI - A Minority Health Careers Exposure Program. AB - The University of Tennessee-Memphis (UT-M) Health Careers Exposure Program was initiated in response to the complaint of minority college students that basic medical science laboratories and clinical centers at private and state-supported health-science organizations in Tennessee were inaccessible to them as career motivating, summer work experiences. The preceptor-apprentice relationship was the means utilized to expose and stimulate minority college students to enter health careers in this study. The formal activity was usually conducted for eight to ten weeks of summer vacation in the basic science and clinical facilities on the UT-M campus.A survey of the current career activities of former apprentices suggests that direct exposure of academically talented, minority college students to health careers is a factor that increases the number entering the health professions. PMID- 3560250 TI - Primary lymphoma of the central nervous system: a diagnostic problem. AB - Primary lymphoma of the central nervous system (CNS) is difficult to diagnose because of the difficulty in differentiating it from multiple sclerosis, sarcoidosis, metastatic disease, chronic granulomatous disease, and cerebral cysticercosis. With the patient presented in this report, no abnormalities were found after performing laboratory tests, using radiographic modalities, and taking biopsies. Dexamethasone treatment was initiated, and patient's symptoms improved.Primary CNS lymphoma was not diagnosed until a year after presentation, due to lack of tissue diagnosis. CNS must be suspected when a diagnosed tumor treated with steroid is not found at surgery. It is suggested that a computerized tomographic scan be requested before the start of steroid therapy, as the lesion can disappear with steroid treatment. PMID- 3560252 TI - Nonorthopedic conditions in veterans with musculoskeletal disorders: a survey. AB - A survey of 1,000 veterans with musculoskeletal disorders in the Philadelphia Veterans Administration Ambulatory Care Clinic was undertaken to determine the number with nonorthopedic conditions. The survey revealed that 429 of 1,000 veterans who were under treatment for musculoskeletal disorders had additional problems requiring medical care. Ninety percent were under the care of a physician for their nonorthopedic conditions and approximately 88 percent were receiving medications. One hundred sixteen had two or more medical conditions and approximately 45 percent were receiving care at the Veterans Administration Clinic for these medical conditions. Thirty-one female veterans were seen and eight had nonorthopedic problems. Two were pregnant. PMID- 3560253 TI - Behavioral efficacy of propranolol in black patients. AB - A review of records and telephone contact with authors of reports pertaining to the use of propranolol in psychiatric patients revealed no systematic comparison of its efficacy in managing behavioral disturbances in black patients as compared with white patients. Too few black patients have been included in studies to reach any conclusions about the efficacy of propranolol, or whether race is a differentiating factor. PMID- 3560254 TI - Preparing high school students for a career in the health sciences. AB - The Summer Scholars Programs at the University of Missouri-Kansas City School of Medicine are designed to identify talented minority or economically disadvantaged high school students and to encourage these students toward careers in the health sciences. In the summer of 1984, 31 students participated in a one-month educational program during which they observed and participated in selected patient care procedures. They developed interpersonal and interviewing skills needed for successful application to health education programs. Students were provided information about numerous health careers to help them clarify their perceptions of health roles.To assess the programs' impact, the 18 scholar participants, who were high school seniors, responded to a questionnaire that sought information about their academic program during the senior year and their plans for higher education. Responses indicated that all had pursued rigorous academic programs, had achieved at a superior level in these courses, and were enrolling in college in the fall of 1985. Fourteen of the 18 students were planning careers in medicine. Responses indicated that the students felt that the programs had been effective in helping them learn about, prepare for, and make appropriate choices regarding careers in the health sciences. PMID- 3560255 TI - Dental education: trends and assumptions for the 21st century. AB - Dental educational institutions, as components of university systems, must develop strategic plans for program development, resource allocation, evaluation, and continued financial support. This dynamic process will be accomplished in a competitive academic arena where program excellence and program relevance are key issues in the game of survival. This article focuses on issues and trends that form the basis for planning assumptions and initiatives into the next decade and into the 21st century. This is our challenge, this is our mission if we are to be catalysts for change in the future. PMID- 3560256 TI - A sense of tragedy: medicine, the profession. AB - The author reviews the position of several ethicists who address the conflicts inherent in the medical profession as it confronts new technologies, societal diversity, and pluralism. Definitions of appropriate mechanisms of self regulation within an increasingly legalistic environment are discussed. PMID- 3560257 TI - Nephrotoxicity of N-(3,5-dihalophenyl)succinimides in Fischer 344 rats. AB - Previous studies have demonstrated that N-(3,5-dichlorophenyl)succinimide (NDCPS) is the most nephrotoxic compound among the N-(mono- or dichlorophenyl)succinimides. The purpose of this study was to examine the nephrotoxic potential of the different N-(3,5-dihalophenyl)succinimides (NDHPS) to determine the importance of the halogen species for NDHPS-induced nephrotoxicity. Male Fischer 344 rats were administered a single intraperitoneal injection of an NDHPS (0.4, 0.8, or 1.0 mmol/kg) or vehicle (2.5 ml/kg), and renal function was monitored at 24 and 48 h. NDCPS or N-(3,5 diiodophenyl)succinimide administration produced the greatest nephrotoxic response. Nephrotoxicity was characterized by diuresis, increased proteinuria, glucosuria, increased kidney weight and blood urea nitrogen (BUN) concentration, decreased accumulation of p-aminohippurate (PAH) and tetraethylammonium (TEA) by renal cortical slices and proximal tubular necrosis. N-(3,5 Dibromophenyl)succinimide injection produced mild nephrotoxicity, while N-(3,5, difluorophenyl)succinimide administration did not result in nephrotoxicity. These results indicate that the halogen species can influence the nephrotoxicity produced by the NDHPS. In addition, nephrotoxic potential did not correlate with fungicidal efficacy, which suggests that the nephrotoxic and fungicidal mechanisms of these compounds might be different. PMID- 3560258 TI - Tissue distribution and excretion of tri-(2-ethylhexyl)trimellitate in rats. AB - The disposition kinetics of tri-(2-ethylhexyl)trimellitate (TEHTM), a new plasticizer for polyvinyl chloride (PVC) plastic, was studied in rats following intravenous administration of [14C-carbonyl]tri-(2-ethylhexyl)trimellitate using an oil in water emulsion as the vehicle. The distribution half-life, elimination half-life, and clearance values estimated from the plasma concentration of radioactivity data obtained following iv administration of 10.5 mg/kg of TEHTM (59.9 muCi/kg), were 46.2 min, 5.34 d, and 40.5 ml/kg X h, respectively. Following iv dosage of 15.6 mg/kg of TEHTM (28.0 muCi/kg), significant accumulation of radioactivity was found in the liver, lungs, and spleen, with liver accounting for 72% of the administered dosage at 24 h. Excretion of TEHTM and its biotransformation products was slow, with 21.3% of the administered radioactivity found in the feces and 2.8% in the urine during the 14-d collection period. Biliary excretion seems to be the major route of elimination of TEHTM. The pharmacokinetic data gathered in the present investigation are compared to di (2-ethylhexyl)phthalate (DEHP), a widely used plasticizer for PVC. PMID- 3560259 TI - Dietary toxicity of picloram herbicide in rats. AB - The toxicity of orally administered technical-grade picloram was evaluated in male and female Fischer 344 rats. Dietary dose levels were up to 2000 mg/kg body weight (bw) X d for 2 wk, 500 mg/kg bw X d for 13 wk, or 200 mg/kg bw X d for 12 mo. Routine indices of toxicity were evaluated at all of the respective time periods. Body weight, food consumption, clinical chemistries, urinalyses, and hematological determinations were considered unaffected by treatment. The only treatment-related effect, regardless of the duration of exposure, was in the liver of both male and female rats. This was generally manifested as an increase in the liver-to-body weight ratio and slight hypertrophy and pallor of the centrilobular hepatocytes. These effects were consistently present in rats receiving 1000 mg/kg bw X d for 2 wk, 300 mg/kg bw X d for 13 wk, or 200 mg/kg bw X d for 6 or 12 mo. Similar effects were marginally evident for rats receiving 500 mg/kg bw X d for 2 wk, 150 mg/kg bw X d for 13 wk, or 60 mg/kg bw X d for 6 or 12 mo. At 60 mg/kg bw X d, the effects were not progressive from 6 to 12 mo. The no-observable-effect level (NOEL) was 20 mg/kg bw X d for male and female rats fed picloram for 12 mo. PMID- 3560261 TI - Effects of the fungicide methyl-benzimidazol-2-yl carbamate (MBC) on mouse germ cells as determined by flow cytometry. AB - Dual-parameter (DNA, RNA) flow cytometry (FCM) measurements were made on testicular and epididymal sperm cells isolated from mice exposed by oral gavage to 0, 250, 500, or 1000 mg/kg X 5 d of the fungicide methylbenzimidazol-2-yl carbamate (MBC), which is known to bind with tubulin subunits and inhibit polymerization and microtubule formation. Effects of exposure to MBC were measured at 7, 24, and 39 d posttreatment. MBC had no effect on body weights, but testis weights and sperm parameters were altered, with few exceptions, only at the highest exposure level. Testis weights were reduced by about 25% at 7 and 24 d after exposure; recovery was observed by 39 d after treatment. FCM measurements of testicular cells showed relative percentages of certain testicular populations (round, elongating, and elongated spermatids) were different from the control pattern 7 and 24 d after treatment. The mean percent of cauda epididymal sperm head morphology abnormalities and the susceptibility of the nuclear DNA to denaturation were both elevated at 7, 24, and 39 d after exposure to 1000 mg/kg. The level of denaturation was determined by FCM measurements of the metachromatic shift in acridine orange (AO) stained sperm nuclei from green (native DNA) to red (single-stranded DNA) fluorescence and quantitated by the expression alpha t[red/(red + green] fluorescence. These data demonstrate that spermatogenesis is sensitive to high-dose MBC exposure resulting in an altered ratio of testicular cell types present, abnormal sperm head morphology, and an altered sperm chromatin structure. PMID- 3560260 TI - Methylxanthine treatment of rats reduces 2,5-oligoadenylate synthesis in liver nuclei. AB - The in vivo effects of methylxanthines on 2',5'-oligoadenylate (2,5An) synthetase activity, an interferon-inducible enzyme, were investigated in rat liver nuclei. Caffeine given at 50 mg/kg ip or theobromine given at 80 mg/kg sc twice daily for 5 d resulted in a 60% reduction (p less than 0.01 and p less than 0.05, respectively) of 2,5An synthetase activity in liver nuclei. Theophylline given at 80 mg/kg sc by the same regimen reduced the enzyme activity by 42% (p less than 0.05). Nuclear 2'-phosphodiesterase activity, which catalyzes the degradation of 2,5An, remained low and unchanged following the drug treatments. When animals receiving caffeine were also given the interferon inducer poly(I)poly(C) at 500 micrograms/kg ip once daily for the last 2 d of caffeine treatment, it resulted in the same fourfold increase in 2,5An synthetase activity as shown with poly(I)poly(C) alone. These results suggest that methylxanthines may interact with interferon-mediated actions. The reason for the inhibitory effect of methylxanthines on the basal but not on the induced 2,5An synthetase remains to be investigated. PMID- 3560263 TI - Biomechanics of liver injury by steering wheel loading. AB - Abdominal injury induced by steering wheel contact at a velocity of 32 km/hr was investigated using anesthetized swine as the surrogate on a Hyge sled. The lower rim of the wheel was positioned 5 cm below the xyphoid. By varying wheel stiffness, wheel orientation, and column angle, resultant abdominal injury ranged from fatal or critical to minor or none. Wheel stiffness was found to be the primary determinant of abdominal injury severity. The mechanism of abdominal injury was identified to be the rim impacting the abdomen and exceeding a combined velocity and compression sensitive tolerance limit. Abdominal injury occurred within the initial 15 ms of wheel contact before whole body movement of the surrogate of column compression, which were initiated by hub contact with the thorax. The severity of abdominal injury correlated with the peak viscous response which can be represented by the product of the instantaneous velocity of abdominal deformation and abdominal compression. It did not correlate with spinal acceleration. PMID- 3560262 TI - Subacute study of rats fed ground beef treated with aqueous chlorine: hematologic and clinical pathology. AB - Aqueous chlorine is effective in reducing surface spoilage bacterial counts on carcasses of slaughter animals and is presently being used for washing beef, pork, lamb, and poultry in some plants under an interim authorization. At present, at least three GRAS affirmation petitions have been submitted by industry groups for the continued use of chlorinated water on carcasses of slaughter animals. A dearth of information exists describing the hematological and clinical pathology associated with the consumption of such treated meat by mammals. Our research evaluated the response of rats to diets containing ground beef which had been treated with aqueous chlorine. Results of the hematologic evaluations demonstrated almost no effects associated with the feeding of rats with chlorine-treated meat for 92 d. There was a slight prolongation of the prothrombin time in all male groups fed the chlorine-treated meat. This prolongation was most pronounced in the 600 ppm group and was significant (p less than 0.05) when compared with the control males. In the absence of any other hematologic evidence, it is not possible to attribute the prolonged prothrombin time to the administration of the test compound. Prothrombin times of females did not differ significantly. The clinical chemistry and urine analysis yielded results wherein the values for the control and test rats are consistent with reported values for rats under standard laboratory conditions. On the basis of these hematologic and clinical data, there were no adverse effects on male or female rats fed ground beef treated with up to 600 ppm aqueous chlorine. PMID- 3560265 TI - Influence of hematocrit on cardiopulmonary function after acute hemorrhage. AB - The 'optimal' hematocrit to which patients should be resuscitated after shock and trauma is controversial. To test the hypothesis that sufficient oxygen delivery can be provided at a lower hematocrit without impairing oxygen consumption or hemodynamic function, 25 patients were prospectively studied immediately following injury and/or acute hemorrhage. Patients were randomized to have their hematocrits (HCT) maintained near 30% (29.7 +/- 0.4% (M +/- SEM); n = 12) or 40% (38.4 +/- 0.6%, n = 13). Cardiopulmonary parameters were measured twice a day for 3 days. Statistical analysis used a repeated measures analysis of variance with patient age, and ventilator parameters (FIO2, PEEP, and ventilator mode) as covariates. Arterial and venous O2 saturations were not significantly different at different hematocrits, although arterial and venous O2 contents were lower at 30% HCT (a = 14.1 +/- 0.2 m10(2)/dl, v = 10.1 +/- 0.3 m10(2)/dl; vs. a = 17.4 +/- 0.4 m10(2)/dl, v = 13.6 +/- 0.6 m10(2)/dl; p less than 0.05). This resulted in a lower oxygen delivery at the lower HCT. Between the two groups, there also was no significant difference in cardiac index (overall mean, 3.64 +/- 0.16 ml/min/m2), heart rate (99 +/- 4 bpm), systemic vascular resistance (1,058 +/- 55 dyne sec/cm5), or left ventricular stroke work index (4.3 +/- 0.3 X 10(6) dyne-cm/m2). Intrapulmonary shunt was higher with higher hematocrit (22.6 +/- 2.4% at 40% HCT vs. 14.6 +/- 1.6% at 30% HCT; p less than 0.05) with no difference in end expiratory pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3560264 TI - The role of high-frequency ventilation in post-traumatic respiratory insufficiency. AB - Post-traumatic pulmonary insufficiency or the adult respiratory distress syndrome is not infrequently associated with multiple organ-system injury. Mortality presently approaches 50%. Mechanical ventilation (CMV) with continuous positive airway pressure (CPAP) remains the mainstay of therapy. High peak inspiration (PIP) and mean airway (PAW) pressure in association with the delivery of large, conventional mechanical breaths are major determinants of complications. The efficacy of HFV was evaluated in this patient population (45 patients, mean age, 32.7 +/- 14.4 years; range, 11-75). CMV was provided with a time-cycled ventilator delivering 12-15 cc/kg tidal volume and a mechanical rate adjusted to provide a PaCO2 38-42 torr for patients previously eucapneic. CPAP was titrated to achieve a preselected endpoint of an intrapulmonary shunt of less than equal to 15%. FIO2 was maintained at or below 0.45 whenever possible. The Trauma Index Score for the group was 8.8 +/- 2.4. CMV yielded a mechanical rate of 6.3 +/- 3.2 and a CPAP of 13.9 +/- 8.5 cm H2O. High-frequency ventilation was provided by either a solenoid-based jet ventilator (HFJV) or a pneumatic cartridge high frequency pulse generator (HFPG). Measured and calculated hemodynamic and pulmonary variables were obtained prior to and 20 minutes after transition to HFV. Thirty-three patients received HFJV; 12 patients received HFPG. Data were evaluated with a paired t-test. All patients on HFJV demonstrated improved CO2 elimination with the same hemodynamic profiles. Those on HFPG demonstrated comparable gas exchange and hemodynamic profiles with lower CPAP/PIP. Where measured, PAW was significantly lower with HFPG when compared with CMV. PMID- 3560266 TI - Penetrating abdominal trauma: the use of operative findings to determine length of antibiotic therapy. AB - Penetrating abdominal trauma is associated with a high incidence of postinjury infection which can be reduced by appropriate surgical management and short-term antibiotic therapy. Patients at high risk for developing infectious complications may be identified on the basis of operative findings and the duration of the postinjury antibiotic regimen determined. Colonic injury is the most important determinant of infectious complications. Number of other organs injured, age, and mode of injury have little or no additional impact on infection rates. Low-risk patients can be successfully managed with three perioperative doses of antibiotics. Nontrauma related nosocomial infections appear to be associated with trauma related infections in high-risk patients. Intravenous clindamycin plus tobramycin and metronidazole plus tobramycin for 72 hours postinjury are equally effective in reducing postinjury infections in "high-risk" patients. PMID- 3560267 TI - Urethral trauma: radiological aspects and treatment options. AB - Experience with treatment of 38 patients in an early phase with urethral trauma is presented. The site of injury was the penile urethra in three cases, the bulbous urethra in seven, and the prostatomembranous urethra in 28. Different surgical procedures were used, according to the site and the extent of urethral damage and the presence of associated lesions. All patients with penile and bulbous urethral trauma were cured and only one has diminished sexual potency, while in the posterior urethral group nine were cured, and 19 developed strictures requiring further surgical treatment. Total impotence developed in 17 and partial impotence in one patient. Another case presents urinary urge incontinence. PMID- 3560268 TI - Effects of acute, oral ethanol on cardiovascular performance before and after experimental blunt cardiac trauma. AB - Acute changes in hemodynamic and electrophysiologic indices were measured following blunt cardiac trauma, oral ethanol, and a combination of both in dogs. Impacts with a velocity of 10 m/sec and a contact compression of 5 cm were delivered to most of the pericardium. Transient arrhythmias in impacted animals resulted in significant reductions in all hemodynamic responses at 15 minutes post-impact. Intragastric doses of 50% ethanol/distilled water yielded average blood alcohol concentrations of 60 +/- 10 mg%, 120 +/- 20 mg%, and 180 +/- 15 mg%. Alcohol effected significant reductions in dp/dt and cardiac index and elevations in total peripheral resistance during treatment. Alcohol and trauma resulted in per cent mortalities of 17, 50, and 71% for each such group primarily from electrical-mechanical dissociation. Surviving animals experienced significant declines in dp/dt, cardiac index, and mean aortic pressure at 15 minutes post-impact. Mean aortic pressure remained depressed while dp/dt, cardiac index, and total peripheral resistance returned to control values. PMID- 3560270 TI - Open reduction and internal fixation of vertical shear pelvic fractures. AB - The goal in the treatment of vertical shear fractures of the pelvis is to achieve and maintain an accurate reduction of the displaced hemipelvis. Open reduction and internal fixation of the posterior pelvic ring injury along with either internal or external fixation of the anterior pelvic ring injury was used in 12 vertical shear fractures in 11 patients. The posterior fixation was aided by accurate definition of the injury pattern, use of preoperative traction, early surgical treatment, use of flexible instruments, and identification of the posterior sacral foramina, which were used as a guide to allow accurate screw placement into the sacrum and avoid nerve root injury. The procedure was not associated with an increased rate of infection or neural injury. In the ten patients followed more than 1 year there were no late displacements of the hemipelvis and all of the fractures healed. PMID- 3560271 TI - Autotransfusion from experimental hemothorax: levels of coagulation factors. AB - The coagulation system was investigated in five dogs undergoing autotransfusion from experimental hemothorax. One fourth of the blood volume was bled into the pleural space, drained, and autotransfused. The hemothorax blood showed: very prolonged PT and PTT; very low platelets and fibrinogen; midly elevated FDP; very low coagulation factors VIII, and V; reduced XII, prothrombin, X, XI, and VII. Partial clotting, mild fibrinolysis, and fibrin deposition over the pulmonary pleura seemed to cause incoagulability of hemothorax blood. Post autotransfusion arterial blood showed: normal PT and PTT; 25% decrease in platelets, and 31% decrease in fibrinogen from baseline values. There was also an overall 20% reduction of fibrinogen from baseline values. There was also an overall 20% reduction of all clotting factors, but their levels remained above 50% activity. It was concluded that autotransfusion from a hemothorax of 25% the blood volume in dogs causes a mild loss of hemostatic components, but does not significantly compromise the clotting mechanism. PMID- 3560269 TI - Comparative study of four wound dressings on epithelization of partial-thickness wounds in pigs. AB - Sixteen shallow wounds were inflicted in each of five Yorkshire white female piglets, 18-20 kg body weight, by a 2-cm diameter, fast-rotating abrasive disc. The injury is similar to a second-degree burn. The wounds were dressed with one of four dressings: Duoderm (Squibb), Op-Site (Smith & Nephew) [corrected], and collagen sponge, covered with either occlusive or semiocclusive polyurethane film (Datascope Corp.). The last two dressings were moistened with saline before application. The rate of epithelization by planimetric quantitation after 3 to 5 days was the same regardless of the dressing used, although the epithelium layer was thicker in wounds treated with Duoderm. Wounds dressed by either of the collagen sponge materials showed a better appearance when visually scored. Wounds dressed with Duoderm or Op-Site were often macerated; Duoderm's paste-like material remained on the wound and was difficult to remove without inflicting discomfort to the patient. Duoderm, and also Op-Site, adhered much more strongly to the intact skin than either type of collagen sponge dressing. PMID- 3560272 TI - Silver nylon cloth: in vitro and in vivo evaluation of antimicrobial activity. AB - The topical agents used in burn care today, although beneficial, do have limitations, the most important of which is the failure to prevent or treat burn wound infections in patients with extensive injuries. Therefore, we evaluated the antimicrobial activity of two silver nylon fabrics (SN and HRS) on the growth of S. aureus, P. aeruginosa, and C. albicans. The theoretical advantages of these nylon fabrics over presently available silver compounds is their ability to continuously release silver ions into the burn wound as long as the material is in contact with the wound. Additionally, the release of silver from these fabrics can be augmented electrolytically. The results of these experiments indicated that both materials were microbicidal in vitro for all three test organisms. Furthermore, the antimicrobial activity could be significantly augmented by passing a weak DC current through the material, which increased the rate of release of silver ions from the fabrics. In vivo, HRS was as effective as silver sulfadiazine in preventing colonization of the burn wound. The use of silver nylon fabrics thus appears to be a promising way of delivering large quantities of silver ions into the burn wound without the potential side effects of a carrier molecule or cream. PMID- 3560273 TI - Vascular complications related to drug abuse. AB - Vascular complications resulting from drug abuse constitute a widespread and common clinical problem. A 3-year experience with 32 vascular complications (13 arterial, 19 venous) related to intravenous drug abuse is reported. Fourteen (48%) of the 29 patients in this series presented with septic vascular complications. These infections were a major cause of morbidity and mortality, resulting in two hospital deaths and a disrupted arterial repair. In addition, intra-arterial drug injection caused digital gangrene in two patients. Early recognition, diagnostic arteriography and venography, and planned therapeutic interventions are possible if a high level of suspicion is maintained. PMID- 3560274 TI - The early biochemical and hormonal profile of patients with long bone fractures at risk of fat embolism syndrome. AB - Free fatty acids (FFA) are believed to play a role in the genesis of the fat embolism syndrome (FES). Levels of plasma FFA, glucose, insulin, and the stress hormones cortisol, growth hormone, prolactin, glucagon, and catecholamines were measured on admission to hospital in: a) 14 patients with long bone fractures at risk of developing FES, b) 14 patients with soft-tissue injuries of comparable severity, and c) 20 healthy fasting subjects. The findings were similar in both groups of injured patients and in keeping with the hormonal and substrate responses to the stress of trauma; plasma FFA levels were raised but in neither group was the rise pronounced. Plasma FFA levels of the fracture patients were only moderately higher than the values of the healthy fasting subjects. These findings suggest that mobilized FFA from peripheral adipose tissue are not important in the genesis of the FES, but do not exclude a role for FFA derived mainly from hydrolysis of triglyceride emboli in the lung. PMID- 3560275 TI - Nonoperative management of blunt splenic trauma in the adult: a community hospital's experience. AB - Nonoperative management of blunt splenic injury has been infrequently selected for adults. Nonoperative management was initially utilized in seven adult patients (23%) with blunt splenic injury during a 6-year period. Two patients eventually failed nonoperative management and required surgical intervention. No morbidity or mortality has been recorded in the remaining five patients (16%) successfully followed after 32.6 months. No added morbidity was sustained by the two patients who failed nonoperative management during the delay of surgical intervention. Hospitalization was briefer in the nonoperative group. Our experience indicates that blunt splenic injury can be successfully nonoperatively managed in an adult population seen at a community hospital. PMID- 3560276 TI - Deaths from urologic injury due to external trauma. AB - The priority for treatment of a urologic injury in multiple injured patients from external trauma should be determined by the frequency of death from the urologic injury. The medical records of 2,058 patients with urologic injury from external trauma including 214 deaths were reviewed. Four deaths were attributed mainly to the urologic injury; one early in the postinjury period from continued severe hemorrhage from a ruptured kidney managed conservatively and three 6 to 8 weeks after injury from sepsis with a pelvic abscess from a ruptured urethra or bladder. The remaining 210 deaths were attributed to the associated injuries and occurred in the more severely injured older patients compared to the survivors. Death in multiple injured patients was rarely due to the urologic injury. PMID- 3560277 TI - Management of burned long bones. AB - The management of severely burned and exposed supportive osseous tissues is not fully standardized. We present two patients in whom extensive debridement and decortication of the involved bone may have contributed to subsequent stress fractures. We propose an alternative therapeutic approach for this problem, including: minimal debridement of the bone, early coverage of the exposed bone with vascularized muscle, and adequate prophylactic protection. PMID- 3560278 TI - Amputation salvage with microvascular free flap from the amputated extremity. AB - Microvascular surgery has allowed creative primary reconstruction using undamaged parts of amputated limbs as donor sites. We present a case of lower extremity below-knee amputation salvage with a free flap of heel, calcaneus, and soft tissues from the amputated lower leg, ankle, and foot supplied by the posterior tibial neurovascular bundle. PMID- 3560279 TI - Management of high cervical-intracranial internal carotid artery traumatic aneurysms. AB - The successful surgical management of a patient with a traumatic aneurysm of the internal carotid artery (ICA) at the base of the skull and a second traumatic aneurysm of the ipsilateral superficial temporal artery is described. EC-IC bypass was not necessary, and graded occlusion of the ICA was employed. Direct repair was not chosen because of its high risk of distal embolization. Electrophysiologic monitoring techniques are helpful in predicting hemispheric ischemia. PMID- 3560280 TI - Traumatic disruptions of right upper bronchus and truncus intermedius in a five year-old boy. AB - A case of uncommon ruptures of right upper bronchus and truncus intermedius in a 5-year-old boy is presented. Two operations provided bronchial continuity, with insertion of an 18-gauge catheter required at the second operation. Problems in anastomosis and early postoperative management in small airways of growing children are also discussed. PMID- 3560281 TI - Hypocupremia in a major burn. AB - Trace element deficiency in burns is an area which apparently has not been investigated. We recently encountered a severely burned patient with profound copper depletion. Neuropsychiatric symptoms and delayed healing may have been secondary to this deficiency. Further study is needed to clearly delineate the role of acquired copper deficiency in recovering burned patients. PMID- 3560282 TI - Solitary splenic abscess: a new complication of splenic salvage treated by percutaneous drainage. AB - A patient sustained a gunshot injury to the spleen. The spleen was left intact in an attempt to maintain normal immune function in the patient. The patient developed a splenic abscess as a result of the injury, a complication of splenic salvage that we have not found reported before. The abscess was treated successfully via CT-guided percutaneous drainage. PMID- 3560283 TI - Nucleolus-like bodies in the posterior subnucleus of the rat paraventricular nucleus during postnatal development. An ultrastructural, cytochemical and morphometric study. AB - Dense intracytoplasmic bodies which lack surrounding membranes and referred to as nucleolus-like bodies (NLBs), have been observed in the big sized neurons of the rat posterior subnucleus in the hypothalamic paraventricular nucleus (PVNP) during neonatal stages. The NLBs suddenly appear from 8th to 16th postnatal days, coinciding with an increase of the nuclear activity in these neurons. NLBs present a granular aspect, showing a close morphological association with ribosomes and rough endoplasmic reticulum. The specific silver-staining procedure used in the study of the nucleolar organizing regions shows no silver grains deposited in the NLBs. The hypothetical nuclear origin of NLBs and the relationship of its frequency within the neuronal cytoplasm, when an increased protein synthesis process takes place, are discussed. PMID- 3560284 TI - Ultrastructure of the protonephridial system of larval Austramphilina elongata (Platyhelminthes, Amphilinidea). AB - The ultrastructure of the flame cell, protonephridial capillaries and excretory pore of larval and embryonic Austramphilina elongata is described. The weir apparatus of the flame cell consists of internal and external longitudinal rods (ribs) connected by a membrane and with many internal and some external leptotriches. Cilia are densely packed and have cross-striated and branching vertical rootlets. Axonemal doublets lose one tubule and decrease in number towards the tip of the cilia. The cell body proximal to the weir apparatus contains a nucleus, numerous mitochondria, Golgi complexes, and many ribosomes. Serial cross-sections of flame cells in embryos revealed that there are no desmosome-connected cytoplasmic cords anywhere along the flame cells; external ribs are in contact with the proximal cytoplasm by means of desmosomes and fuse to form the distal cytoplasmic tube; internal ribs continue as free processes between the flame and the distal cytoplasmic tube. Numerous 'filaments' (microtubules?) extend between the ciliary rootlets and into the cytoplasm of embryonic flame cells. Some free axonemes were seen in the cell body of embryonic flame cells. PMID- 3560285 TI - Ultrastructural features of the vasculogenetic processes in the thyroid and suprarenal glands of the chick embryo. AB - This paper reports the results of an ultrastructural investigation on the differentiation of the blood capillary network in the thyroid and suprarenal glands of the chick embryo, from the 6th to the 21st incubation day. Apart from some morphological features of the capillary wall, which change in the same way during gland organogenesis (thickness of the endothelium, quantity and distribution of cytoplasmic organelles, pores), differences have been pointed out concerning the beginning and temporal evolution of the maturative events of the endothelium lining and the pericapillary spaces. Close relationships between morphofunctional maturation of the secretory cells and blood vessel differentiation have been emphasized, and the roles played by intraendothelial vacuoles and endothelial basement lamina during the capillarogenesis are discussed. PMID- 3560286 TI - Cyclosporine A nephrotoxicity: evidence for mesangial foam-cells in dogs. AB - Nephrotoxicity of cyclosporine A was studied in dog after 3 weeks' administration of the drug at high doses (20 mg/kg/day). Cyclosporine A concentrations measured in different organs revealed a high ratio between renal tissue and plasma. Renal histopathology showed non-specific tubular lesions and glomerular modifications. There were lipids in the mesangial cells which took on a foamy aspect. Ultrastructural study and lipid staining confirmed these findings, and non specific esterase reaction revealed no macrophagic infiltration. Using anti-CSA antibodies it was not possible to demonstrate CSA in the mesangial cells. This alteration has never been described before in CSA therapy and its meaning is not clear; however, it does suggest that there occur modifications in the lipid metabolism or in the phagocytic function of the mesangial cells when cyclosporine A is administered over long periods. PMID- 3560288 TI - Chronic idiopathic vitritis. Cytopathogenicity of unusual bacteria for vitreous polymorphonuclear leukocytes. AB - In acute exacerbations of chronic idiopathic vitritis (CIV) non-cultivatable ultrastructurally unusual 0.5-0.7 micron cell walled coccal bacteria (B) are commonly present within phagolysosomes of 3-5% of vitreous polymorphonuclear (PMN) leukocytes. Inoculation of that CIV vitreous into mouse eyelids produces chronic mouse vitritis (CMV) with identical B within CMV PMN leukocyte phagolysosomes. This transmission electron microscopic restudy of all PMN leukocytes in those 8 CIV and 3 CMV specimens demonstrated in all 11 severe cytoskeletal lytic damage associated with pleomorphic 0.1-1.4 micron cell wall deficient B in 1-2% of the cells; both those cell wall deficient and the unusual cell walled B within the same cell in 1-3 cells per specimens; and within the cell walled B complex internal structures resembling the cell wall deficient B. The study results suggest that the morphologically diverse B may be subportions of a single unusual pathogenic B, which parasitizes, undergoes complex morphologic differentiation within, and produces profound cytoskeletal damage to host PMN leukocytes. PMID- 3560290 TI - A serial section study of tubular confronting cisternae (so-called 'test-tube and ring-shaped forms') in AIDS. AB - A serial section study was executed on a lymph node from a case of AIDS (acquired immune deficiency syndrome) to determine the true three-dimensional morphology and mode of genesis of tubular confronting cisternae which are found in the lymphocytes in this condition. Serial sections from over a hundred such structures show that these are tubular structures and that the 'test-tube and ring-shaped' forms described in the literature are no more than profiles one expects to see when a tubular structure is sectioned. The view at times expressed in the literature that these structures are truly test-tube-shaped (i.e. one end closed) appears to be erroneous, for our serial section study did not reveal a single instance where one end was closed; all were tubular structures with both ends open. We found that tubular confronting cisternae develop by a process of twisting and spiralling of ribbon-shaped confronting cisternae, and that at one stage of development there is a spiralling groove on the wall of this structure. Microtubuloreticular structures were seen in several lymphoid cells, sometimes they were found in cells containing tubular confronting cisternae. At times microtubules (similar to those seen in microtubuloreticular structures) were seen lying within and/or outside the profiles of dense lamina of tubular confronting cisternae. PMID- 3560287 TI - Electron microscopy study of Mott and Russell bodies in myeloma cells. AB - Ultrastructural examination of the bone marrow of 3 patients with multiple myeloma--two presenting with Mott cells and one with cells containing numerous Russell bodies--showed that these two types of intracytoplasmic inclusions are different in size and location. The Mott bodies in one patient appeared as clusters of electron dense material with round or oval shape and poorly delineated membrane. In the second, they possessed an amorphous structure, and were not surrounded by membrane. In both cases, they were not located in the endoplasmic reticulum. The Russell bodies were round, with high electron density, surrounded by membrane and located in dilated portions of the endoplasmic reticulum. It is concluded that Mott and Russell bodies are different types of inclusions in myeloma cells, at least from the ultrastructural point of view. PMID- 3560289 TI - Electron microscopic observation on the epithelial-connective tissue junction of pemphigus vulgaris. A case report. AB - An electron microscopic observation on the erosive buccal mucosa of a buccal mucosa of a patient with typical pemphigus vulgaris was carried out. The ultrastructural features of the basal cells and the basal lamina in the advanced oral lesion varied from section to section of the biopsy specimen. The basal lamina showed various morphologic alterations indicating the presence of both destructive and regenerative processes in different sections. The filamentous bodies were also observed both in the basal cell layer and in the upper lamina propria. PMID- 3560291 TI - Morphometric evaluation of zymogen granule membrane transfer to Golgi cisternae following exocytosis in pancreatic acinar cells from suckling newborn rats. AB - Pancreatic acinar cells from unfed, newborn rats and sucking for 4, 8 and 16 h were studied morphometrically in semi- and ultrathin sections. In the cells of the unfed, newborn rats, numerical and volume densities of the zymogen granules (ZG) and volume of the Golgi apparatus are respectively the highest and lowest observed during peri- and postnatal life. Cisternae of the rough endoplasmic reticulum (RER) appear irregularly disposed among the ZG. Once feeding starts, cytoplasmic volume becomes progressively reduced until the 16th hour owing to sustained exocytosis of ZG contents. The decline in numerical density of ZG between 0 and 4 h revealed the minimum number of ZG exocytosed in the first 240 min. The sum of the membrane surfaces measured in the various subcellular compartments [RER, condensing vacuoles (CV), Golgi cisternae (GC), Golgi apparatus-associated microvesicles (GM), 'other structures', apical and basolateral plasmalemmae and mitochondria] did not vary significantly in the various groups of rats. After 4 and 8 h, the net amount of cellular ZG membrane surface internalized represents 10% and 15% respectively of the total measured cell membrane. These quantities are sufficient to account for the expressive increase in membrane surfaces occurring at these times in CV, GC, and GM. The curves showing membrane surface decrease in ZG and increase in the Golgi appear to express a precursor----product relationship. The results of topochemical reactions are consistent with the interpretation that part of the ZG membrane internalized after exocytosis induced by alimentary stimulus is reused to expand and/or form trans (thiamine pyrophosphatase positive) and trans-most (acid phosphatase positive) GC. PMID- 3560292 TI - Hybridoma process: ultrastructural cytology of different stages. AB - In order to define the ultrastructure of the hybridoma cell and to learn more about the plasmocytic differentiation process, a scanning (SEM) and transmission (TEM) electron microscopy study of several cell types involved in the production of monoclonal antibodies was performed. Cells of the three different stages in hybridoma process were studied. These cells included NS/1 murine myeloma cells, 40-3A4 in vitro cultured hybridoma and 33-1D2 ascitic tumor hybridoma cells. A stereological analysis of the Sv parameter (surface of RER per volume unit of cytoplasm) was performed in the murine myeloma line, the in vitro cultured hybridoma and the ascitic tumor hybridoma. In order to comparatively evaluate the plasmocytic differentiation of these cells the same methodology was applied to splenic lymphocytes from immunized mouse and to mature human myelomatous plasma cells. As expected, during the hybridoma process, a progressive increase in the amount of RER was detected. This was in contrast with the surface characteristics of the cells which become progressively smooth when the hybridoma was cloned, either in vitro or in vivo. From these results it can be inferred that the amount of RER is a more reliable parameter than surface blebs as a morphological element indicative of plasmocytic differentiation. On the other hand, numerous viral particles were present not only in murine myeloma line but also in hybridoma clones secreting monoclonal antibodies. PMID- 3560293 TI - Alveolar septal changes in pulmonary edema: a subcellular study of lung clearance in the dog. AB - Left lobe lung biopsies were obtained in dogs allowed to breathe in atmospheres of coal or barium sulphate dust before ligature of the left pulmonary veins and at 15 min, 1, 5, 7, 15, and 30 days after ligature. All samples were prepared for transmission electron microscopy (TEM) and scanning electron microscopy (SEM); in addition, samples from the barium sulphate group were examined by electron diffraction analysis (EDA). Two main phagocytic cell types were identified. In addition lymphatic capillary-like structures were observed in the alveolar septum after ligature of the pulmonary veins. PMID- 3560296 TI - Cell death in the normal development of Gallotia galloti mesencephalon (Reptilia Lacertidae). An ultrastructural study. AB - We have studied the development of the mesencephalon of Gallotia galloti and we have observed two classes of cellular death: 'nuclear' or 'Type I' and 'cytoplasmatic' or 'Type II'. The first appears in stages around E-34 and the second one is observed from stages around hatching to the adult lizard. The degenerative cells have been observed in the profundus, torus semicircularis, the 5th pair of the trigeminal nerve nuclei as well as the 4th and 5th layers of the optic tectum where this last nucleus mentioned is situated. PMID- 3560294 TI - Tetramine dichloro-palladium subcellular localization in the kidney: electron microprobe study. AB - Palladium salt has been used for some time in experimental therapy protocols; with this in mind, we carried out a study of the effect of tetramine dichloro palladium (soluble salt) upon kidney cells. Using an electron microprobe, we were able to detect the presence of palladium associated with sulfur and iron in the lysosomes of the proximal tubule cells. Our results were compared with those obtained using Cis-diaminedichloro-platinum (Cis-DDP), an anti-cancer drug used in the treatment of diverse tumors. The mechanism of intralysosomal concentration of palladium as a non soluble salt associated with sulfur appeared to be related to local sulfatase activity. Finally, iron concentration appeared to be related to the inhibition process of erythropoiesis. PMID- 3560295 TI - Cytochemical localization of calcium in mitochondria of regenerating rat adrenal cortex. A study of adrenal regeneration hypertension. AB - The distribution of calcium in the mitochondria of the adrenal gland was studied during development of adrenal regeneration hypertension. Electron opaque precipitate (calcium antimonate) was localized predominantly in the intercristal space within mitochondria and in cisternae of smooth endoplasmic reticulum. Stereological techniques were employed to quantitate the volume per cell of precipitate. Compared to the zona glomerulosa or zona fasciculata of controls, the volume per cell of electron opaque precipitate in mitochondria of the regenerating gland was significantly reduced at 5 and 14 days after enucleation. By 21 days, the volume of mitochondrial precipitate per cell, while more than that in zona glomerulosa cells, was less than in mitochondria from control zona fasciculata cells. As a comparison, normal rats were treated with ACTH or were hypophysectomized. ACTH-treatment did not greatly increase the precipitate associated with mitochondria in the zona fasciculata. Mitochondria in the zona fasciculata of hypophysectomized rats however showed a significant reduction in precipitate per cell correlating with a significantly reduced volume of mitochondria per cell as compared to those of control zona fasciculata cells. Giant mitochondria were observed in hypophysectomized animals. Volume of precipitate per cell associated with smooth endoplasmic reticulum was increased slightly, but significantly, as compared to that in controls treated with ACTH, whereas in hypophysectomized rats, it was decreased significantly. Adrenocortical cells arising from the zona glomerulosa and sub zona glomerulosa region differentiate to zona fasciculata cells during regeneration and may have an altered capacity to concentrate calcium. Change in intramitochondrial calcium may be correlated with the reduced formation of corticosterone from its precursor, deoxycorticosterone, thereby contributing to the pathogenesis of adrenal regeneration hypertension. PMID- 3560297 TI - Comparative morphology of the prostate in adult male and female Praomys (Mastomys) Natalensis studied with electron microscopy. AB - Comparative study at the cellular and subcellular levels of the adult male and female prostates of a unique species of rodent--Praomys (Mastomys) Natalensis- was made. The female possesses a well-developed prostate throughout life that may be considered homologous to the ventral prostatic lobe in the male Praomys. Histologically, only small differences exist to indicate that the female prostate is somewhat less active than the male (less secretion and the presence of fewer supranuclear light areas in the female than in the male prostate). At the electron microscopic level, within the female prostatic cells, there is less rough endoplasmic reticulum, and the number of secretory granules is lower than in the male. The arrangement of the cells, the organization of the subcellular structures, and the mode of secretion in both female and male prostates, however, are similar. PMID- 3560298 TI - Modified smooth endoplasmic reticulum in type II cells of rabbit taste buds. AB - Type II cells of taste buds from rabbit foliate papillae are characterized by a widespread system of smooth endoplasmic reticulum (SER), usually in the form of a loose network. In some cells, the SER is tightly compacted into a juxtanuclear aggregate that is continuous with the perinuclear space and that appears to merge with the Golgi complex. In other type II cells, the SER is in a honeycomb arrangement. Where type II cells confront nerves, they may have extensive smooth membraned subsurface cisternae. The presence of manifold forms of SER in type II cells suggests that these cells may have a variety of secretory functions. PMID- 3560299 TI - Red cell genetic abnormalities and environmental interactions: a study in Tehamat Aseer. AB - In a study conducted in the lowland areas of Tehamat Aseer and low mountainous areas of Al-Hepatah in the South Western Province of Saudi Arabia, different villages were screened for parasite infestation, anaemia prevalence and frequency of sickle cell (HbS) gene. The prevalence of alpha- and beta-thalassaemias and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency were also investigated. The prevalence of anaemia was found to range between 3.5% and 9.1% in the different villages, while parasite infestation ranged from 0 to 36.4%. Sickle cell gene frequency was similar in the different villages, ranging between 0.06% and 0.11%. G-6-PD deficiency ranged from 8% to 14%, alpha-thalassaemia from 20% to 30% and beta-thalassaemia from 10% to 15%. Parasite infestation was found to be a major cause of anaemia in these populations. PMID- 3560301 TI - Metastatic renal carcinoma to larynx. AB - The larynx is a most unusual site for metastatic cancer. A case of metastatic renal cell carcinoma of the larynx is presented to illustrate the following features: its exceptional indolent course; the difficulty in arriving at a correct diagnosis, and the good result following local excision. PMID- 3560300 TI - Meningococcal hepatitis: a case report. AB - A case of meningococcal septicaemia is described in which the clinical presentation resembled that of viral hepatitis, and which responded rapidly to treatment with penicillin. PMID- 3560302 TI - Orbital complications of acute sinusitis. AB - Although the association of sinusitis and inflammation of the orbits has been known for centuries, and the incidence widespread until the introduction of antibiotics, there has been a marked decline in the number of case reports in the medical literature since the 1940s. In this paper three recent cases are presented, with a review of the anatomy, clinical features and the authors' approach to the management of the problem, along with a literature search of this topic. PMID- 3560303 TI - Bilateral facial nerve palsy: a case study and literature review. AB - Facial diplegia is a rare clinical finding and can be the presenting complaint in a wide spectrum of diseases. This paper describes a case of bilateral facial palsy occurring in a diabetic patient. Electroneurographic studies demonstrated severe acute denervation of both facial nerves and a widespread polyneuropathy. A gallium scan revealed hilar and paratracheal lymphadenopathy. Heerfordt's syndrome was suspected; however, histological confirmation of sarcoidosis has not been obtained. The patient was treated with high dose steroid therapy and has made an almost complete recovery after six months. A review of the literature is discussed with particular reference to the differential diagnosis in this patient. PMID- 3560305 TI - Cavernous hemangioma of the external ear canal. AB - Cavernous hemangiomas are benign tumors of blood vessel origin. Cavernous hemangiomas arising from the tympanic membrane with or without involvement of the skin of the deep external auditory canal may occur in rare cases. In this paper, the clinical and pathological findings in the first recorded case of a patient with a cavernous hemangioma arising from the skin of the deep external canal with no involvement of the tympanic membrane are presented. PMID- 3560304 TI - Caloric vertical nystagmus: the vertical semicircular canal in caloric testing. AB - Vertical nystagmus elicited by caloric testing does not necessarily mean there is central pathology. In a patient with confirmed peripheral vestibular disease, caloric stimulation produced an intense vertical nystagmus, which showed all the features of a caloric nystagmus. The patient had bilateral mastoid cavities, allowing easy stimulation of the posterior semicircular canal, using air. At the same time, a unilateral horizontal semicircular canal functional loss was observed, raising the possibility of dissociated canal dysfunction. PMID- 3560308 TI - The use of suction cautery in adenoidectomy. AB - The use of a malleable curved disposable suction cautery for the control of any persistent bleeding at the conclusion of adenoidectomy in over 1000 cases has prevented any primary postoperative hemorrhages from the nasopharynx, and obviated the need for post-nasal packing. PMID- 3560307 TI - The geometry of alar base resection. AB - There are many types of alar base excisions. However, analysis of the nostril circumference into the columella, nostril sill, and the alar flare (the ovoid subset of the alar base esthetic unit) is critical in assessing the location and amount of circumference reduction in alar base excisions. PMID- 3560306 TI - Eccrine hidrocystoma of the external ear canal: a case report. AB - Eccrine hidrocystomas are essentially sweat gland retention cysts located in the dermis. Clinically, an eccrine hidrocystoma presents as a small, translucent cystic swelling (often having a bluish hue), and measuring from 1 to 3 mm in diameter. The clinical and histopathological features of an eccrine hidrocystoma of the external auditory canal are presented, and the morphologic differences between an eccrine and an apocrine hidrocystoma are discussed. PMID- 3560309 TI - Blow the whistle. AB - The existence of impaired physicians is usually denied by them and their colleagues. The experience of the Manitoba Physicians at Risk Committee over an eight-year period indicates that physicians of all ages and fields of practice may be affected. A plea is made for earlier recognition and intervention by colleagues. PMID- 3560311 TI - An inexpensive collector for middle ear aspirates. PMID- 3560310 TI - Granuloma formation in eosinophilic ulcer of the tongue. PMID- 3560314 TI - Doppler shift frequency data. PMID- 3560312 TI - Pre- and postoperative Doppler echocardiographic evaluation of anomalous left coronary artery arising from the pulmonary artery. PMID- 3560315 TI - Cephalad renal movement during percutaneous nephrostolithotomy. AB - The change in the position of the kidney during percutaneous nephrostomy is a major concern to urologists who participate in percutaneous stone removal. We report that the majority of kidneys ascend an average of 2.2 cm. when the patient turns from a supine to a prone position. This change in position is more marked on the right side and is more common in male patients. Knowledge of this anatomical variation is important to determine which patients are suitable candidates for percutaneous nephrostolithotomy and to plan a percutaneous approach to a renal or ureteral calculus. PMID- 3560313 TI - A comparison of fetal biometric ratios to neonatal morphometrics. AB - Ratios of fetal abdominal circumference to femur length (AC/FL) and thigh circumference to femur length (TC/FL) have been suggested as indices of fetal nutrition. Birthweight, skin-fold thickness, and ponderal index are accepted neonatal indices of nutrition. The purpose of this study was to compare fetal to neonatal indices of nutrition. In 52 patients in term labor, fetal abdominal circumference, thigh circumference, and femur length were measured ultrasonographically. Neonatal skin-fold thickness was calculated as the average of tricipital, subscapular, abdominal, and anterior thigh measurements determined with Harpenden skin-fold calipers. Linear correlation analysis demonstrated a significant relationship between AC/FL and ponderal index (r = 0.340, P = 0.028) and between TC/FL and ponderal index (r = 0.368, P = 0.007). Neither AC/FL nor TC/FL were significantly related to birthweight or skin-fold thickness. These data suggest that the diagnostic reliability of antenatal studies of fetal biometric ratios may be enhanced by using the ponderal index as a neonatal endpoint rather than birthweight or skin-fold thickness. PMID- 3560316 TI - Use of local anesthesia for extracorporeal shock wave lithotripsy. AB - Extracorporeal shock wave lithotripsy is being performed at many centers with the use of either general or epidural anesthesia. We report our experience with 39 patients treated by extracorporeal shock wave lithotripsy under local anesthesia. These patients tolerated the procedure well and had good fragmentation of the stones. Of the patients 18 were treated on an outpatient basis. In selected patients local anesthesia offers an alternative that can decrease the risk of anesthesia, and reduce the cost and hospital stay associated with extracorporeal shock wave lithotripsy. PMID- 3560317 TI - Operative fiberoptic nephroureteroscopy: removal of upper ureteral and renal calculi. AB - We tested 2 prototypes of an operating fiberoptic nephroureteroscope, measuring 3.5 and 4.5 mm. in diameter, that have an adequate working channel for auxiliary instruments and irrigation. Difficulty in passing the fiberscope through the ureteral orifice was overcome by dilation with balloon and polytetrafluoroethylene (Teflon) dilators. Our initial trial for stone retrieval under fiberscopic control was performed on 21 patients with upper ureteral and renal calculi. A stone was removed successfully in 15 of the 21 patients (71 per cent). After electrohydraulic lithotripsy calculi were extracted successfully in 9 of 11 patients (82 per cent). Three patients suffered ureteral perforation. The fiberscope was especially helpful when an upper ureteral stone moved back to the kidney during stone manipulation. PMID- 3560319 TI - The model AS 800 artificial urinary sphincter: Mayo Clinic experience. AB - The model AS 800 artificial urinary sphincter was implanted in 100 male and 9 female patients between 7 and 89 years old. Postoperative followup was 1 to 32 months. The indication for implantation was total urinary incontinence in 86 patients (78.9 per cent), stress incontinence in 22 (21.2 per cent) and urgency incontinence in 1 (0.9 per cent). Of the patients 97 (89 per cent) underwent implantation for the first time, 7 (6.4 per cent) had a previous artificial urinary sphincter model replaced by the AS 800 device and 5 (4.6 per cent) underwent reimplantation of a previous model. The cuff was placed around the bladder neck in all 9 female patients, whereas in the male patients the cuff was implanted around the bladder neck in 20 and around the bulbous urethra in 80. Thirty-one patients (28.4 per cent), 29 of whom were continent at night, were practicing nocturnal deactivation of the device. Complete post-activation continence was achieved in 91 patients (83.5 per cent), some leakage occurred in 10 (9.2 per cent) and 8 (7.3 per cent) remained incontinent. A total of 23 patients required 1 or more revisions, the most common indications for the first revision being loss of cuff compression (9), tubing kink (3), cuff erosion (3) and infection (2). At the time of this report 89 patients (81.7 per cent) were continent, 9 (8.3 per cent) still had some leakage, 3 (2.8 per cent) were incontinent, 5 (4.6 per cent) were awaiting reimplantation and 3 (2.8 per cent) had died of unrelated causes. PMID- 3560320 TI - Chromosome abnormalities in Peyronie's disease. AB - Peyronie's disease is a localized and progressive fibrosis of unknown etiology that affects the tunica albuginea of the penis. We examined cytogenetically cell cultures derived from plaque, adjacent tunica, dermis and lymphocytes in patients with Peyronie's disease, and compared the results to cell cultures established from the tunica albuginea of control patients. Chromosomal abnormalities were detected in 9 plaque-derived cell cultures from 7 of 12 Peyronie's disease patients (58 per cent). Cells cultured from adjacent tunica, dermis and lymphocytes from the same patients were karyotypically normal, as were cultures derived from control (chordee and penile scar) patients. Chromosomal aberrations consisted of 5 numerical changes and 4 structural rearrangements, and included chromosomal additions (trisomy 7 and trisomy 8), deletions (45X,-Y), reciprocal translocations and inversions or markers. In 2 instances cultures derived from plaque tissue contained 2 independent chromosomal abnormalities. The apparently random chromosomal changes associated with Peyronie's disease suggests that karyotypic instability may be a common feature of cells within the plaque. It presently is unclear whether this finding represents multiple pathways for the development of Peyronie's disease or secondary consequences of Peyronie's disease. PMID- 3560318 TI - Combination chemotherapy with cisplatin and methotrexate in advanced transitional cell cancer of the bladder. AB - We studied 53 patients with bidimensionally measurable metastases of transitional cell cancer of the bladder who were treated with a planned regimen of 70 mg. per m. cisplatin intravenously on day 1, and 40 mg. per m. methotrexate intravenously on days 8 and 15 every 3 weeks. The toxicity of this regimen, with agranulocytosis and mucositis as the most important side effects, was so severe that only 17 per cent of the patients actually received the protocol regimen without modification. Six patients were ineligible and 47 were evaluable for toxicity, including 43 who were evaluable for response. The response to treatment was assessed after each second treatment cycle. A complete response was achieved in 10 patients (23 per cent) and a partial response was achieved in 10 (23 per cent). The median duration of response was 64 weeks for patients with a complete response and 23 weeks for those with a partial response, while the median duration of survival was 81 and 37 weeks, respectively. The aforementioned regimen with allowance of routine leucovorin rescue is tested as preoperative chemotherapy in patients with stages T3 to T4 nonmetastatic bladder cancer. PMID- 3560322 TI - Penile prosthesis surgery in the treatment of impotence in the immunosuppressed man. AB - Thirteen male diabetic patients on immunosuppressive therapy following organ transplantation underwent implantation of 14 penile prostheses for treatment of organic impotence. Except for extended parenteral antibiotic therapy and increased steroid coverage postoperatively, the preoperative, perioperative and postoperative management in all 13 patients was similar to that of routine penile implantation procedures. No infections or erosion complications were encountered. We conclude that the penile prosthesis should be included in the armamentarium for the treatment of impotence in the immunosuppressed man. PMID- 3560321 TI - Scott's inflatable penile prosthesis: evaluation of mechanical survival in the series 700 model. AB - The series 700 penile prosthesis was implanted in 131 patients. Actuarial analysis revealed survival of the cylinders to be 98 per cent at 1 year and 92 per cent at 36 months. The only additional failures were leaks in the reinforced tubing in 9 cases. No tubing leaks have occurred since revisions were made by the manufacturer in October 1983. PMID- 3560323 TI - Dietary protein levels affect the excretion of oxalate and calcium in patients with absorptive hypercalciuria type II. AB - A total of 12 patients with absorptive hypercalciuria type II and 11 normal controls participated in a study to evaluate the effects of dietary protein levels on urinary calcium and oxalate excretion before and after a 1 gm. dose of oxalate. Two test periods were used during which calcium (less than 400 mg. per day) and oxalate were restricted. The first test was done under conditions of low dietary protein (12 per cent total caloric intake, 60 gm.) and the second test was done at a high protein level (25 per cent, 125 gm. protein). Twelve-hour urine specimens were obtained after dinner on day 3 of each diet (low and high protein) and again on day 4 when 1 gm. oxalate (spinach) was added to the dinner meal. The specimens were analyzed for calcium, oxalate and relative calcium oxalate saturation (concentration product ratio). There were no significant differences between the controls and subjects with absorptive hypercalciuria type II in oxalate excretion before the oxalate load on the low protein (controls 31.4 +/- 4.2 standard error, expressed as mmol. oxalate per mol. creatinine, and absorptive hypercalciuria type II 23.1 +/- 3.1) and high protein (controls 30.4 +/- 4.2 and absorptive hypercalciuria type II 28.8 +/- 5.9) diets. After the oxalate bolus the positive changes in oxalate excretion were 11.8 +/- 4.8 (low protein) and 17.8 +/- 4.7 (high protein) for controls, and 11.4 +/- 4.4 (low protein) and 31.8 +/- 5.2 (high protein) for patients with absorptive hypercalciuria type II. Thus, the increases in post-load urinary oxalate levels observed for controls and patients were greater on the high protein than on the low protein diets. After the oxalate load the increases in urinary oxalate and calcium oxalate supersaturation were significantly greater for patients with absorptive hypercalciuria type II than for control subjects for the high protein but not the low protein diets (p less than 0.05). PMID- 3560324 TI - Intraoperative color transparencies: how to improve your results. AB - Improvements in film speed and the availability of 55 and 105 mm. macro lenses used with appropriate lens filters have obviated the necessity for flash equipment to obtain high quality intraoperative color transparencies. We have had good results without flash, using only available operating room spotlights with a lens/film/filter combination readily available to the surgeon. We present this system and the rationale for its effectiveness. PMID- 3560326 TI - One-stage complete genital reconstruction for patients with congenital adrenal hyperplasia. AB - We performed 1-stage complete genital reconstruction on 20 female subjects with congenital adrenal hyperplasia. The blood and nerve supply to the glans was retained by preserving the neurovascular bundle, as well as the ventral mucosal strip. Preservation of the neurovascular bundle was simplified. The phallic skin was used to form labia minora and a flap vaginoplasty was performed simultaneously. There were no operative complications and all 20 patients had satisfactory results. PMID- 3560325 TI - Comparison of self-reported voided volume with cystometric bladder capacity. AB - We determined the validity of cystometric bladder capacity compared to self reported voided urine volumes measured by the patient at home. The subjects included 200 ambulatory incontinent women 55 or more years old who were evaluated with a prospective protocol of home diaries, history, physical examination and urodynamic studies. The mean smallest and largest daily voided volumes, and the daily mean of all voided volumes were determined from the diary. Comparison of the cystometric bladder capacity with the daily voided volumes showed a significant positive correlation between cystometric bladder capacity and the largest voided volume (r equals 0.4938, p less than 0.01). Comparison of the mean daily and mean largest daily void, and the cystometric capacity with the different urodynamic diagnoses using analysis of variance revealed a statistical significance among the groups (p less than 0.01). We established the validity of cystometric bladder capacity in the measurement of functional bladder volume and that a home diary may be useful in clinical practice. PMID- 3560328 TI - Management of the short ureter in urinary tract reconstruction. AB - Among our 56 patients who have undergone urinary tract reconstruction with intact bladders 45 have required some compensation for lost ureteral length. Of these patients 33 had only distal ureteral loss and underwent reconstruction with a combination of a psoas hitch, transureteroureterostomy and primary reimplantation. Four patients with more extensive ureteral loss underwent a Boari flap procedure, and of the 8 patients with major ureteral loss 6 had small bowel interposition and 2 have had renal autotransplantation to compensate for lost ureteral length. All patients are well with stable renal function at 1 to 7-year followup. PMID- 3560327 TI - Simple ectopia of the kidney in monozygotic twins. AB - We report a case of simple ectopia of the kidney in monozygotic twins. The hypothesis of a genetic mechanism for renal dysmorphogenesis could be tested by banking autopsy tissue and analyzing the messenger ribonucleic acid. PMID- 3560329 TI - Acquired megalourethra: an uncommon complication of the transverse preputial island flap urethroplasty. AB - We describe 4 patients with significant dilatation of the entire neourethra following transverse preputial island flap urethroplasty. Two patients presented after repair of chordee without hypospadias, which was corrected by interposition with a pedicle graft. The problem arises about 6 months after the repair and is manifested by ballooning of the urethra during urination and postvoid dribbling. We have labeled this entity acquired megalourethra and the repair is similar to that for congenital megalourethra. PMID- 3560331 TI - Routine intraoperative post-ligation venography in the treatment of the pediatric varicocele. AB - Varicocelectomy in the adult is followed by a relatively low recurrence rate but children treated by conventional techniques seem prone to have more frequent recurrences. We believe that the higher recurrence rate observed in children after routine varicocelectomy actually represents residual varicose communications that had been missed at the primary operation. Routine post ligation intraoperative venography has been used to detect these occult communications in 26 children undergoing varicocelectomy. Our results indicate a low recurrence rate (3.6 per cent), suggesting that routine use of this procedure with childhood varicocelectomy is beneficial. PMID- 3560330 TI - One-stage reconstruction of moderately severe hypospadias. AB - Single stage repair of moderately severe degrees of hypospadias with correction of chordee and reconstruction of the neourethra presents a difficult challenge for the surgeon. Traditionally, a 2-stage approach to correct these defects has been used. However, more recently a 1-stage repair with correction of chordee and creation of a neourethra has increased in popularity. From 1978 to 1985 we treated 86 patients with moderately severe hypospadias and chordee with a 1-stage technique using either a transverse island pedicle flap, a Hodgson III hypospadias repair or a free preputial skin graft. Despite an over-all complication rate of 50 per cent, our final results based on cosmesis and function were deemed excellent in 90 per cent of the cases. Of the 44 complications 23 were strictures, most frequently at the proximal anastomosis. Two-thirds of these strictures responded to a single dilation with the patient under anesthesia. Our fistula rate was 10 per cent and flap necrosis, meatal stenosis or prolapse and residual chordee accounted for the remaining 12 complications. Our experience indicates that a 1-stage repair for moderately severe hypospadias and chordee can be performed in patients with a satisfactory success rate of more than 90 per cent, minimal morbidity and an acceptable complication rate. PMID- 3560332 TI - Genitourinary abnormalities associated with the Smith-Lemli-Opitz syndrome. AB - The Smith-Lemli-Opitz syndrome is characterized by mental retardation, hypotonia, facial dysmorphism and abnormalities of the limbs, genitalia and kidneys. Since the latter 2 features have not been emphasized in the urological literature, the experience from the institution at which the syndrome was first described is reviewed and an illustrative case is reported. Upper urinary tract abnormalities were noted in 57 per cent and genital abnormalities in 71 per cent of the children evaluated. PMID- 3560333 TI - Renal arteriovenous fistula associated with a huge renal vein dilatation. AB - We report a case of an aneurysmal type of renal arteriovenous fistula with a huge spherically dilated renal vein. Although the findings on routine computerized tomography made us strongly suspect renal cell carcinoma associated with a hilar lymph node metastasis, we were able to diagnose the arteriovenous fistula by means of a dynamic computerized tomography scan. On the basis of the roentgenographic findings, partial nephrectomy was performed successfully. PMID- 3560335 TI - Traumatic renal artery occlusion: is late reconstruction advisable? AB - We report a case of traumatic renal artery occlusion treated successfully by reconstruction several years after the injury. Hypertension resulted in diagnostic investigation by means of excretory urography, computerized tomography, angiography and perfusion scintigraphy. Treatment consisted of a thin walled polytetrafluoroethylene (Gore-Tex) bypass between the aorta and left renal artery near the hilus. When the patient was discharged from the hospital the creatinine level was normal and blood pressure was 180/90. PMID- 3560334 TI - Spontaneous regression of an intrarenal arteriovenous malformation. AB - We report a case of spontaneous regression of a right intrarenal arteriovenous malformation 6 months after initial examination without surgical intervention, arterial embolization or radiotherapy. The patient presented with massive hematuria from the right kidney, which disappeared completely after spontaneous regression. PMID- 3560336 TI - Unusual renal sarcoma in a young adult: its similarities to clear cell sarcoma of the kidney. AB - We report an unusual case of renal sarcoma in a young adult. Histological examination demonstrated many similarities to the histopathological features of clear cell sarcoma of the kidney. Immunohistochemically, none of the intrinsic tumor cells showed positive staining with the antibodies against the intermediate filament proteins, epithelial membrane antigen, S100 protein, neuron-specific enolase, Leu-7 or myoglobin. The clinical course of this tumor was that of high grade malignancy, resulting in death with generalized metastases 13 months after tumor resection. PMID- 3560337 TI - Primary carcinosarcoma: a rare cause of unilateral ureteral obstruction. AB - We report a case of unilateral ureteral obstruction owing to carcinosarcoma of the distal ureter. Tumor recurred 6 months after ureteronephrectomy and the patient died 2 1/2 years later. A review of the literature revealed only 3 other cases of ureteral carcinosarcoma, all of which had a similar aggressive course. Recognition and separation of this entity from the more usual transitional cell carcinoma are important because of its apparent poorer prognosis. PMID- 3560338 TI - Metastatic transitional cell carcinoma in an ileal conduit following cystectomy. AB - We report a case of recurrent transitional cell carcinoma involving an ileal conduit. The patient presented with a febrile urinary tract infection and upper tract obstruction. This is the third case reported of such a tumor occurring in the absence of upper tract malignancy. The literature is reviewed. PMID- 3560339 TI - Intraoperative management of penile erection with intracorporeal phenylephrine during endoscopic surgery. AB - Intraoperative penile tumescence during endoscopic surgery is a troublesome complication that often is refractory to recommended methods of management. We report a new approach of pharmacological management with intracorporeal penile injections of phenylephrine (total dose of 0.1 mg.), which was successful in 3 successive patients. This approach is prompt, safe and reproducible, and it provides sustained resolution of erection without systemic side effects. It is concluded that local intracorporeal penile administration of this sympathomimetic agent appears to be a potent new tool in the armamentarium of the endoscopic surgeon dealing with this frustrating clinical situation, which merits further clinical trial. PMID- 3560340 TI - Constrictive penile band injury: anatomical and reconstructive considerations. AB - Cases of constrictive penile band injury are seen often in the emergency room, and most require only removal of the constriction and conservative management. Occasionally, patients present with long-standing constriction, necrosis of the penile tissue and urethral injury. We report 2 such cases. We believe that a thorough understanding of the penile anatomy, aggressive debridement, skin grafting and temporary urinary diversion are essential for successful management of these severe cases. PMID- 3560342 TI - Late recurrence of a seminoma. AB - We report a case of an extragonadal mediastinal seminoma that recurred almost 19 years after successful initial remission had been achieved with actinomycin D and chlorambucil. Treatment of the recurrence consisted of excision of a single involved supraclavicular lymph node followed by combination chemotherapy with cis platinum, vinblastine and bleomycin. The patient has remained free of residual disease for 3 years. To our knowledge this case represents the longest reported interval to recurrence for a germ cell neoplasm. PMID- 3560341 TI - Plasmacytoma of the testis. AB - We report a case of plasmacytoma of the testis without evidence of bone or immunoglobulin abnormalities. The presentation, evaluation and management of this extremely unusual tumor are reviewed. PMID- 3560344 TI - Cystitis cystica: an electron and immunofluorescence microscopic study. AB - Cystitis cystica was studied with the aid of electron and immunofluorescence microscopy. By electron microscopy, the epithelium demonstrated morphologic features suggestive of an active metabolism. Secretory-type granules were seen in the cytoplasm just beneath the luminal membrane of surface columnar cells. Microvilli of the plasma membrane also were seen at the luminal surface. Rough endoplasmic reticulum and Golgi apparatuses were present. The cells were rich in mitochondria. By immunofluorescence microscopy, IgA, secretory piece and IgM were localized in the epithelial cells, especially at the luminal surfaces. IgG was occasionally found. These findings contrast markedly with the transitional cells and their relatively scanty content of secretory-type organelles. In addition, they may explain the large amounts of IgA in the urine of patients with cystitis cystica. PMID- 3560345 TI - N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide-induced bladder cancer in mice: augmentation by sutures through the bladder wall. AB - The augmenting effect of chronic inflammation on bladder cancer was studied in female Swiss mice treated with N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide (FANFT), 0.15% by weight of diet for 20 weeks. To produce chronic inflammation one silk suture and one catgut suture were placed through the bladder wall of 63 mice to receive FANFT and 18 to receive normal diet. In remaining mice (no. = 62) the bladder was simply touched without suture insertion. Thirty-two animals treated with FANFT and 33 treated with FANFT + sutures also received supplements to their drinking water throughout the experiment of the sulfhydryl-reducing agent N-acetylcysteine (500 mg./kg. body weight/day). Seven weeks following FANFT treatment, bladder cancers developed in 12% of mice with sutures and FANFT and in 19% of those with sutures, FANFT, and N-acetylcysteine. No cancers developed in mice receiving FANFT alone or FANFT with N-acetylcysteine and none in mice treated with sutures only. Placement of silk sutures through the bladder wall of mice augments FANFT-induced bladder cancer. N-acetylcysteine at these doses does not influence the incidence. PMID- 3560343 TI - Solitary benign schwannoma in the psoas muscle. AB - Schwannomas, which also are referred to as neurinoma or neurilemmoma, are rare. We report a case of a solitary benign schwannoma in the psoas muscle, which was not associated with von Recklinghausen's disease. The tumor was excised successfully. Its appearance on clinical examination is described, the preoperative investigations and operative findings are presented, and the literature is reviewed. PMID- 3560346 TI - Penile pharmacocavernosography and cavernosometry in the evaluation of impotence. AB - Within the past few years, veno-occlusion of the corpora cavernosa has become generally recognized as an essential prerequisite for adequate penile erection. Veno-occlusive incompetence is suspected to be a frequent cause of impotence. Our recent experience with cavernosography in two normal volunteers and 36 impotent patients indicates that angiography is reliable in evaluating the competence of the veno-occlusive mechanism only if both pharmacocavernosography (PCG) and pharmacocavernosometry (PCM) are applied. Twenty minutes after intracavernosal (IC) injection of a mixture of 60 mg. papaverine and one mg. phentolamine (regitine), 100 ml. of diluted radiographic contrast medium are infused at the rate of one or two ml./sec. while pressure is recorded, and radiographic films are exposed at the rate of one every eight to 15 seconds. PCM and PCG of the corpora cavernosa indicated the overall degree of competence of the cavernosal veno-occlusive mechanisms, and the sites of veno-occlusive incompetence; non pharmacologic studies were unreliable in these regards. During non-pharmacologic infusion in normals, pressures rose to 40 to 45 mm. Hg, and free efflux could be visualized from multiple venous systems. After pharmacologic injection in normals, all venous channels closed, and pressures rapidly rose toward or above 200 mm. Hg, at which time the infusion was stopped. Veno-occlusive incompetence was defined angiographically when more than minimal efflux occurred during pharmacocavernosography from any venous system. The incompetence could involve the deep penile system, the deep dorsal system, or the spongiosal system, alone or in combination. Severe veno-occlusive incompetence was considered diagnostic of venogenic impotence, and was defined manometrically when IC pressures failed to exceed 100 mm. Hg during infusion of 100 ml. of fluid at 2 mm./second after IC papaverine and phentolamine injection. We believe these angiographic methods will improve the criteria against which other diagnostic and therapeutic methods can be assessed. PMID- 3560347 TI - Prevention of human bladder tumor cell implantation in an in vitro assay. AB - The high recurrence rate of bladder tumors can be reduced by prevention of tumor cell reimplantation on denuded urothelium following transurethral resection. This can be achieved by intravesical chemotherapy immediately after the resection of the bladder tumors. We have demonstrated, in an in-vitro system, the process of human bladder tumor cell implantation on a naturally produced extracellular matrix (ECM) which simulates the exposed bladder basement membrane and submucosa. Using this model we examined the efficacy of various cytotoxic agents in preventing tumor cell adhesion to the ECM. Human bladder tumor cell implantation was prevented following exposure of the cells to distilled water, epodyl or mitomycin C, and significantly reduced following one hour incubation in cisplatinum and doxorubicin. The maximal effect for each of these cytotoxic agents was reached within 30 to 60 minutes of treatment. Mitomycin C reached maximal effect within 10 minutes. In contrast, thiotepa did not cause a significant reduction in cell adherence to ECM as compared to untreated control cells. PMID- 3560348 TI - Experimental treatment of prostatic cancer by intermittent hormonal therapy. AB - In order to determine if intermittent hormonal therapy might prove to be beneficial in the treatment of prostatic cancer, animals bearing the Dunning R3327H prostatic adenocarcinoma were castrated and intermittently subjected to hormonal stimulation by means of indwelling silastic testosterone-filled implants. The growth of these tumors, as measured by increases in volume, was compared to that of a castrate control group, a chronic implant group and an intact control group. By the end of an initial 49 day experimental period there was no significant growth reduction with the intermittent stimulation group as compared to the implanted control or intact groups. The castrate group had a significant lower rate of growth than any other group. The incidence of massive tumor growth or tumor necrosis was significantly lower in the castrate group than the other groups by the end of the 16 week experimental period. Intermittent hormonal therapy is clearly inferior to early castration in preventing tumor growth; furthermore it does not appear to offer any growth-retarding advantages when compared to delayed hormone therapy. The most effective growth-retarding technique for the Dunning R3327H hormone dependent prostatic adenocarcinoma is early castration. PMID- 3560349 TI - Investigative grammar. Guidelines for review articles. PMID- 3560350 TI - Impact of endothelial cell seeding on long-term patency and subendothelial proliferation in a small-caliber highly porous polytetrafluoroethylene graft. AB - Previous reports have demonstrated that endothelial cell seeding of polytetrafluoroethylene (PTFE) grafts enhances short-term patency. This experiment was undertaken to study its impact on the long-term patency of a highly porous, experimental PTFE graft and to determine whether increasing the internodal distance of the graft material resulted in increased proliferation of the subendothelium. Ten centimeter long, 4 mm internal diameter segments of an unreinforced, experimental PTFE graft were implanted into 36 mongrel dogs as carotid interpositions. In each animal, one graft was seeded with autologous endothelial cells, enzymatically derived from the external jugular veins, whereas the contralateral graft was treated in identical fashion except that endothelial cells were not added to the preclot mixture. Nineteen animals were killed at 12 weeks; six at 22 weeks; eight at 26 weeks; and three at 52 weeks. The mean follow up period was 20.1 weeks. The overall patency rate was 58.3% (21 of 36 grafts) for seeded grafts vs. 27.8% (10 of 36 grafts) for control grafts (p less than 0.01). The thrombus-free area was planimetrically measured at 83.4% +/- 4.5% in seeded grafts vs. 55.1% +/- 9.7% in control grafts (p less than 0.05). Scanning electron microscopy confirmed the presence of a confluent cellular monolayer in seeded grafts, whereas control grafts exhibited a variable coagulum of fibrin, platelets, and endothelial cells. The thickness of the subendothelial layer varied from 56 to 95 micron with no progressive increase in thickness between 12 and 52 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3560351 TI - Rehabilitation of the bilateral amputee. AB - One hundred sixteen patients with bilateral amputation as a result of severe ischemia were reviewed to evaluate their rehabilitation potential. Seventy patients were male and 46 were female; ages ranged from 31 to 92 years (mean 68 years). The operative mortality rate after the second amputation was 9.5% (11 of 116 patients). The time from the first to second amputation ranged from zero to 144 months (mean 23 months). Follow-up from 1 to 14 years was available on all patients. Sixty percent of the patients surviving the postoperative period were alive at 2 years and 40% at 5 years. Of the 105 patients available for follow-up, only 27 (26%) were able to use bilateral prostheses. Twenty-three (85%) of these patients were ambulatory after their first amputation. Four patients not walking after their first amputation became ambulatory after their second. All four had bilateral below-knee amputations. Of the 78 patients unable to use a bilateral prosthesis, 68 (87%) were able to function independently and 10 became bedridden. Successful prosthetic rehabilitation in the bilateral amputee appears primarily dependent on the use of a prosthesis after the first amputation. The acceptable long-term survival and the number of patients who became independent in their activities justify an aggressive approach to the rehabilitation of the bilateral amputee. PMID- 3560352 TI - Minimizing blood transfusions during abdominal aortic surgery: recent advances in rapid autotransfusion. AB - The purpose of this study was to determine what percentage of patients could avoid the transfusion of any homologous bank blood products during elective abdominal aortic surgery with a recently developed semicontinuous, rapid autotransfusion device. Fifty patients (26 with abdominal aortic aneurysms and 24 with aortic occlusive disease) prospectively received intraoperative autologous transfusion (group 1) and were matched for comparison with 50 patients receiving homologous blood without use of any autotransfusion equipment (group 2). For the entire perioperative period, 34 group 1 patients (68%) received only their own autotransfused blood and no other homologous blood components compared with group 2 in which 48 patients (96%) required some bank blood (p less than 0.0001). Rapid autotransfusion reduced usage of homologous red cell transfusion by 75%. The mean postoperative hemoglobin was similar in both groups (group 1, 11.91 gm/dl vs. group 2, 11.90 gm/dl, p = 0.73). Rapid autotransfusion was not associated with significant hemolysis, air embolism, or coagulopathy and did not increase morbidity or death. By eliminating the need for any bank blood components in most patients, rapid autotransfusion minimizes the risk of blood-borne diseases and transfusion reactions. New rapid autotransfusion devices offer a distinct advantage over past equipment and allow significant changes in current transfusion practices during elective abdominal aortic reconstructions. PMID- 3560353 TI - Transesophageal echocardiographic monitoring of myocardial ischemia during vascular surgery. AB - Transesophageal echocardiography (TEE) was used to detect segmental ventricular wall motion abnormalities (SWMAs) associated with ischemia in 49 high-risk patients who had 50 major vascular procedures, including 23 infrarenal aortic, five suprarenal aortic, 14 carotid, seven distal, and one axillofemoral reconstructions. A modified gastroscope tipped with an echocardiographic transducer was inserted into the esophagus and positioned behind the heart to obtain a reproducible cross-sectional view of the left ventricle at the level of the papillary muscles. Twelve patients (24%) had SWMA at baseline, probably representing areas of old infarction. Fourteen patients (28%) had new intraoperative SWMAs. Ten of 14 patients were successfully treated and wall motion was normalized. One of the four patients with persistent SWMA suffered a nonfatal subendocardial infarct; another patient suffered intraoperative cardiac arrest and died. No infarcts were documented in the 10 patients successfully treated. The mortality rate in the entire high-risk group was 6%. Alterations in ventricular wall motion were noted in almost 50% of high-risk patients undergoing major vascular surgery. Seventy-one percent of acute SWMAs were reversed without any evidence of myocardial infarction. TEE allowed early recognition of evolving myocardial ischemia and facilitated immediate and specific fluid and pharamcologic interventions. Continued application of this technique may reduce the incidence and morbidity of perioperative cardiac complications. PMID- 3560356 TI - Cerebral hyperperfusion syndrome: a cause of neurologic dysfunction after carotid endarterectomy. AB - Neurologic deficits evident when patients initially awaken from surgery are generally due to intraoperative embolization or inadequate cerebral protection in patients with marginal cerebral perfusion; neurologic deficits occurring in the immediate postoperative period are usually related to acute carotid occlusion or embolization. However, in a small subset of patients, transient postoperative neurologic dysfunction seems to be related to a syndrome of cerebral hyperperfusion rather than a lack of adequate cerebral blood flow. This study describes the courses of 10 patients with classic findings of cerebral hyperperfusion syndrome. Typically, this syndrome occurred in patients with longstanding severe chronic cerebral ischemia and occurred after correction of a very high-grade carotid stenosis. Intraoperatively, there was often a dramatic increase in xenon-labeled cerebral blood flows, with postocclusion flows sometimes attaining three to four times baseline levels. Postoperatively, the patients initially did well. However, over the next several days, many of them began to complain of unilateral headache on the operated side and subsequently had seizures. Electroencephalography obtained during this period uniformly revealed periodic lateralizing epileptiform discharges on the side of the brain ipsilateral to the endarterectomy. Although neurologic dysfunction fully resolved in all of the patients in this group, it is possible that intracerebral hemorrhage may occur in some patients with hyperperfusion syndrome. The pathophysiology of this syndrome is believed to be related to preoperative loss of cerebral autoregulatory mechanisms caused by chronic cerebral ischemia. PMID- 3560357 TI - An overview of research in peripheral vascular disease, 1986. PMID- 3560354 TI - Intimal integrity and fibrinolytic potential of reversed and in situ vein grafts. AB - The improved patency rates of in situ vein grafts are attributed to better flow characteristics, anastomotic "fit," and intimal preservation. This study compared the early changes in intimal morphology and fibrinolytic activity of in situ and reversed vein bypass grafts from mongrel dogs. Four to six centimeter in situ and reversed vein segments were used to bypass left and right femoral and internal carotid arteries, respectively. Heparin (100 U/kg) was administered before arterial clamping. Anastomoses were fashioned end to side and the intervening artery was ligated. Fifty-two grafts were harvested at day 1 (12 grafts), day 7 (16 grafts), day 14 (12 grafts), and 12 weeks (12 grafts). The veins were analyzed for histologic changes by light microscopy and scanning electron microscopy. The fibrinolytic activity of the grafts was assayed by the fibrin slide and fibrin plate techniques. There were no significant differences in morphology or fibrinolytic activity between the reversed and in situ grafts at any time period. These findings indicate that the improved patency rates associated with in situ grafts are not dependent on improved preservation of intimal structure or fibrinolytic activity. PMID- 3560358 TI - Insertion of the inferior vena cava filter followed by iliofemoral venous thrombectomy for ischemic venous thrombosis. AB - An elderly man, with ischemic venous thrombosis of the left lower extremity, underwent insertion of the inferior vena cava filter through the right internal jugular vein, followed by left iliofemoral venous thrombectomy with the Fogarty balloon catheter, both with fluoroscopic guidance. The inferior vena cava filter was inserted before venous thrombectomy to prevent pulmonary embolism from dislodged clots during the latter procedure. PMID- 3560355 TI - Renovascular operations in patients with chronic renal insufficiency: do the benefits justify the risks? AB - To define the benefits and risks of renal revascularization or nephrectomy in patients with both severe hypertension and chronic renal insufficiency, we analyzed 98 patients who underwent renovascular operations after serum creatinine levels exceeded 2 mg/dl. This subset of patients was selected from a retrospective review of 652 renal operations performed at the Mayo Clinic for renovascular disease between 1970 and 1981. Special attention was given to the type of operations, their effect on hypertension and renal function, specific factors that affected operative deaths, and late survival. Unilateral renal operations were performed in 48 patients with bilateral procedures in 50. Simultaneous aortic reconstruction was necessary in 55 patients (56%). Postoperative diastolic blood pressure was less than 90 mm Hg in 55% of patients and 90 to 100 mm Hg in an additional 33%. Seventy-six percent of patients required less antihypertension medication. Serum creatinine improved or stabilized in 69%. Ninety percent of patients avoided any early or late renal dialysis. The operative mortality rate was 7.1% and tended to be higher in patients with a serum creatinine greater than 3 mg/dl and in those with past myocardial infarction (p = 0.05). The late survival rate was 64% at 5 years. The main cause of operative and late death was myocardial infarction. In conclusion, most patients with renovascular hypertension and early chronic renal insufficiency can be benefited by surgical revascularization or nephrectomy. Future improvement in early and late survival may require a more aggressive approach to the identification and correction of significant coronary artery disease. PMID- 3560359 TI - Bilateral carotid body tumors managed with preoperative embolization: a case report and review. AB - A patient with large bilateral carotid body tumors had preoperative, superselective embolization of major arterial afferent vessels. After marked reduction in tumor vascularity, total surgical extirpation was then possible without significant morbidity or carotid sacrifice. The use of preoperative embolization in the treatment of large bilateral lesions is emphasized and discussed. PMID- 3560360 TI - Contained rupture of the suprarenal aorta. AB - A contained rupture of the aorta is a rare event; however, this has been recognized with increased frequency in the abdominal aorta. There have previously been two reports of the containment of rupture of the suprarenal aorta. We report two additional cases of contained rupture of the suprarenal aorta, one caused by a penetrating atherosclerotic ulcer, the other from a ruptured aneurysm. Surgical treatment was successful in both patients. PMID- 3560363 TI - Clinical applications of video angioscopy. PMID- 3560361 TI - Coumadin-induced skin necrosis versus venous gangrene of the extremities. PMID- 3560362 TI - Extended use of computed tomography in the management of complex aortic problems. PMID- 3560364 TI - Technical frontiers for the vascular surgeon: laser anastomotic welding and angioscopy-assisted intraluminal instrumentation. AB - Innovations in therapy for peripheral vascular disease include laser vessel welding and angioscopy-assisted intraluminal laser instrumentation. Vascular tissue fusion by laser occurs at energy levels lower than those required to coagulate or vaporize. CO2, argon, and Nd:YAG (1.06 micron) lasers have all been reported to fuse anastomoses in microvessels, but adequate welding of larger veins and arteries (3 to 8 mm in diameter) has only been accomplished with the argon laser. Laser welds heal comparably to sutured wounds but do not have the chronic foreign body reaction and disorientation of elastin and collagen associated with sutures. Preliminary evidence suggests that argon laser-welded anastomoses have less intimal hyperplasia than sutured anastomoses. Laser welding may also be a useful adjunct for sealing intimal flaps during endarterectomy. Additional work is needed to determine the mechanism, optimal parameters, and wavelengths required for vascular tissue fusion by laser. Direct application of laser light intraluminally has thus far been associated with a high incidence of vessel perforation. Angioscopy-assisted delivery of a metal hot-tip probe shows promise for angioplasty of occluded medium-sized arteries and for valvulotomy in in situ vein bypasses. PMID- 3560365 TI - Routine screening considered to end perinatal hepatitis transmission. PMID- 3560367 TI - Growth of a multitalented medical tool. PMID- 3560366 TI - Laser applications amplified as new developments, uses abound. PMID- 3560371 TI - The inevitable failure of cost-containment strategies. PMID- 3560370 TI - Leads from the MMWR. Pertussis surveillance--United States, 1984 and 1985. PMID- 3560368 TI - Biologic heart-assist device problems similar to difficulties with mechanical pumps. PMID- 3560369 TI - Ophthalmologic debate: is it reasonable to remove a healthy lens to improve vision? PMID- 3560372 TI - Patients and the habits of house officers. PMID- 3560373 TI - Accidental strangulation from vest restraints. PMID- 3560374 TI - OK, OK, OK: the facts of Kew--more on squatter's palsy. PMID- 3560375 TI - Reflux esophagitis and the water bed. PMID- 3560378 TI - Visual hallucinations: more diagnoses. PMID- 3560376 TI - Acromegaly after pituitary apoplexy. PMID- 3560377 TI - Alternative anticoagulation. PMID- 3560379 TI - Epidemiology of AIDS in women in the United States. 1981 through 1986. AB - An analysis of 1819 cases of acquired immunodeficiency syndrome (AIDS) in women reported between 1981 and 1986 showed that the majority of women with AIDS were intravenous drug users. The second most common risk group was heterosexual contact with a person at risk for AIDS. The proportion of women with AIDS in this risk group increased significantly between 1982 and 1986, from 12% to 26%. This trend may prove to be a good marker for following trends in heterosexual transmission. Since the majority of childhood AIDS cases are a result of perinatal transmission from the mother, trends in AIDS cases in women may also predict future trends for AIDS in children. PMID- 3560380 TI - Antibody responses after influenza and pneumococcal immunization in HIV-infected homosexual men. AB - We conducted a study to assess the effect of human immunodeficiency virus (HIV) infection on humoral immunity. Fifty-five homosexual men and 19 heterosexual men had four- to six-week postimmunization antibody responses measured to trivalent influenza vaccine and 23-valent pneumococcal vaccine. The homosexual men were divided into three groups: 20 asymptomatic HIV-seronegative men, 10 asymptomatic HIV-seropositive men, and 25 HIV-seropositive men with persistent generalized lymphadenopathy. Antibody responses to influenza antigens in the subgroups of homosexual men did not significantly differ from those of heterosexual controls. The IgG antibody responses to pneumococcal capsular types 9N and 18C in men with lymphadenopathy, and type 18C in HIV-seronegative homosexual men, were lower than those of heterosexual controls. Otherwise, responses to other ten capsular types showed no significant differences. There was no evidence of an immunosuppressive effect of vaccination on T-cell numbers, or deterioration of clinical status associated with vaccination. This study demonstrates that HIV-infected homosexual men, asymptomatic or with persistent generalized lymphadenopathy, are able to mount appropriate antibody responses to two commonly used vaccines. PMID- 3560381 TI - A randomized controlled trial of academic group practice. Improving the operation of the medicine clinic. AB - We conducted a controlled trial of the adoption of a group-practice model within an academic department of medicine. Ongoing randomization yielded similar groups of patients and residents. To determine the effect of the intervention on medicine-clinic operation, we monitored the hospital outpatient activity of 28 residents and 2299 patients during an 11-month study period. The group-practice clinics generated 20% more patient encounters per month than did the traditional, control clinics (328 vs 273 encounters), primarily because twice as many voluntary, overflow clinic sessions were scheduled (20.2 vs 9.7 sessions). Yet, because group-practice registration was decentralized, patients spent 15% less time in completing scheduled visits (93.2 vs 109.9 minutes). Regular utilizers of the group practices made 7% more scheduled clinic visits on average (3.27 vs 3.05 visits), but 39% fewer walk-in visits (0.14 vs 0.23 visits). Hospital-wide, continuity of care was not affected. We conclude that adoption of a group practice model at our institution improved clinic productivity, enhanced patient flow, and decreased unscheduled clinic visits. PMID- 3560382 TI - National adverse drug reaction surveillance: 1985. AB - The Food and Drug Administration received about 37,000 adverse drug reaction reports in 1985. Seventy-one percent of the reports involved toxic reactions to usual doses of drugs and were sent by medical care professionals directly to the Food and Drug Administration or to pharmaceutical manufacturers. In terms of severity, 2% of reports involved death while 21% involved hospitalization. The highest proportions of hospitalization or death were found for reports describing cardiovascular, hematologic, or respiratory effects. Nearly half of the reported deaths were in patients more than 59 years of age. The majority of reports described an adverse drug reaction occurring within two weeks of initial exposure to the suspected drug. Adverse drug reaction reporting by physicians is crucial to ensuring that pharmaceutical products are used appropriately. PMID- 3560383 TI - Chlamydia trachomatis infections in the United States. What are they costing us? AB - Chlamydia trachomatis has emerged as the most common sexually transmitted bacterial pathogen in the United States and is now recognized to cause substantial morbidity. To determine the economic consequences of chlamydial infections in the United States, we analyzed data from local, state, and national sources. We estimate that C trachomatis infections cost Americans over $1.4 billion per year in direct and indirect costs. Chlamydial infections in women account for 79% of this cost, although men and infants are also affected. Three fourths of the total cost is due to sequelae of untreated, uncomplicated infections. If the current rate of chlamydial infection persists, the projected annual costs will exceed $2.18 billion by 1990. Reducing the incidence of personal suffering and heavy economic burden imposed by C trachomatis infections requires establishment and maintenance of effective prevention/control programs. PMID- 3560384 TI - Control of sexually transmitted chlamydial infections. PMID- 3560385 TI - Human immunodeficiency virus infection in women. PMID- 3560386 TI - Ophthalmology's new tools may have profound impact on refractive surgery. PMID- 3560387 TI - Comparison studies needed before new lasers join the medical mainstream. PMID- 3560388 TI - New Framingham data indicate that smoking is also a risk factor for stroke. PMID- 3560389 TI - Multicenter study indicates one aspirin can do the job of four in preventing stroke. PMID- 3560391 TI - Leads from the MMWR. Survey of worksite smoking policies--New York City. PMID- 3560392 TI - Bowen's disease as a predictor of malignancy. PMID- 3560390 TI - Leads from the MMWR. Progress toward achieving the national 1990 objectives for sexually transmitted diseases. PMID- 3560393 TI - The double iatrogenic hazard. PMID- 3560394 TI - Estrogens and risk of breast cancer. PMID- 3560395 TI - The appropriateness of carotid endarterectomy. PMID- 3560396 TI - Ionizing radiation from tobacco. PMID- 3560397 TI - Toxic epidermal necrolysis. A step forward in treatment. AB - Toxic epidermal necrolysis is an uncommon but severe form of epidermal sloughing with associated mucositis. Treated in a general hospital, it carries a high mortality (25% to 70%) and substantial long-term morbidity. If the patient is referred early to a burn center, where it can be treated with biologic dressings and intensive support care, the mortality can be reduced below 20% and there may be negligible long-term morbidity. We describe 19 patients so treated, with three deaths and no long-term complications. PMID- 3560398 TI - Cholesterol and mortality. 30 years of follow-up from the Framingham study. AB - From 1951 to 1955 serum cholesterol levels were measured in 1959 men and 2415 women aged between 31 and 65 years who were free of cardiovascular disease (CVD) and cancer. Under age 50 years, cholesterol levels are directly related with 30 year overall and CVD mortality; overall death increases 5% and CVD death 9% for each 10 mg/dL. After age 50 years there is no increased overall mortality with either high or low serum cholesterol levels. There is a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years (11% overall and 14% CVD death rate increase per 1 mg/dL per year drop in cholesterol levels). Under age 50 years these data suggest that having a very low cholesterol level improves longevity. After age 50 years the association of mortality with cholesterol values is confounded by people whose cholesterol levels are falling--perhaps due to diseases predisposing to death. PMID- 3560399 TI - Hematologic data of healthy very old people. AB - Hematologic values were analyzed for 44 people who were 84 years of age or older. Individuals were selected based on extensive long-term records confirming their excellent health. Mean hemoglobin values were 14.8 +/- 1.1 g/dL (148 +/- 11 g/L) for men and 13.6 +/- 1.0 g/dL (136 +/- 10 g/L) for women. Mean values were also computed for red blood cell indexes, red and white blood cell counts, sedimentation rate, and serum iron, and all values were compared with those of a concurrent control group of healthy young adults. Results are discussed in the context of previous reports on hematologic data of the elderly. PMID- 3560402 TI - Cerebral angiography as a guide for therapy in isolated central nervous system vasculitis. PMID- 3560400 TI - Dipyridamole-thallium scanning in patients undergoing vascular surgery. Optimizing preoperative evaluation of cardiac risk. AB - Dipyridamole-thallium imaging has been suggested as a method of preoperatively assessing cardiac risk in patients undergoing major surgery. To define more clearly its proper role in preoperative assessment, we prospectively evaluated 111 patients undergoing vascular surgery. In the first set of 61 patients, our data confirmed the value of preoperative dipyridamole-thallium scanning in identifying the patients who suffered postoperative ischemic events. Events occurred in eight of 18 patients with reversible defects on preoperative imaging, compared with no events in 43 patients with no thallium redistribution (confidence interval for the risk difference: 0.624, 0.256). The results also suggested that clinical factors might allow identification of a low-risk subset of patients. To test the hypothesis that patients with no evidence of congestive heart failure, angina, prior myocardial infarction, or diabetes do not require further preoperative testing, we evaluated an additional 50 patients having vascular procedures. None of the 23 without the clinical markers had untoward outcomes, while ten of 27 patients with one or more of these clinical markers suffered postoperative ischemic events (confidence interval for the risk difference: 0.592, 0.148). In the clinical high-risk subset, further risk stratification is achieved with dipyridamole-thallium scanning. PMID- 3560401 TI - Fatal poisoning from sodium phosphate enema. Case report and experimental study. AB - An overdose of a common over-the-counter sodium phosphate enema solution was fatal in an infant. The marked hypernatremia, acidemia, hyperphosphatemia, and hypocalcemia observed before death were also produced in a porcine model. A study using pigs showed that the enema solution was lethal if retained in doses above 20 mL/kg, equivalent to four pediatric-sized enemas in a 2-year-old child. Even normal doses of the enema solution caused measurable changes in serum phosphorus and calcium levels. PMID- 3560404 TI - Burn treatment for the unburned. PMID- 3560403 TI - Preventive services in clinical practice: designing the periodic health examination. PMID- 3560405 TI - [The effect of nitrous oxide on somato-sympathetic reflexes]. PMID- 3560406 TI - [Measurement of the right ventricular ejection fraction by a rapid response thermistor catheter; evaluation using a circulatory model]. PMID- 3560407 TI - [The renin, angiotensin,and catecholamine system and brain-protective drugs during extracorporeal bypass]. PMID- 3560408 TI - [Anesthesia in patients with previous myocardial infarction]. PMID- 3560409 TI - [Comparison of the hemodynamic effects of diazepam-morphine-ketamine micro drip infusion and high-dose fentanyl anesthesia in patients undergoing cardiovascular surgery]. PMID- 3560410 TI - [The effects of dopamine administration on plasma catecholamine and serum dopamine-beta-hydroxylase levels during general anesthesia]. PMID- 3560412 TI - [Dopamine and norepinephrine concentrations in the human digestive tract following exogenous dopamine administration]. PMID- 3560411 TI - [Effect of the oral dopamine prodrug (TA-8704) on renal function in surgical patients]. PMID- 3560413 TI - [Effect of dichloroacetate on plasma lactic acid in experimentally produced hypoxia]. PMID- 3560414 TI - [The effects of neostigmine and atropine on intraductal pressure in the choledochoduodenal junction in dogs]. PMID- 3560415 TI - [Halothane and increased discharge of the muscle spindle induced by succinylcholine]. PMID- 3560416 TI - [Perioperative changes in the coagulation and fibrinolysis system]. PMID- 3560417 TI - [Anesthetic management of a neonate patient with nonimmunologic hydrops fetalis complicated with gastric rupture]. PMID- 3560418 TI - [Two cases of coronary artery spasm under epidural anesthesia]. PMID- 3560420 TI - [Aspiration while awake in high spinal anesthesia after cesarean section]. PMID- 3560419 TI - [Measurement of nitrous oxide exposure during routine anesthetic work by a personal monitor]. PMID- 3560421 TI - [The participation of nucleus raphe magnus in morphine-induced descending antinociceptive system]. PMID- 3560422 TI - [Current concept of obstetrical anesthesia in the United States]. PMID- 3560423 TI - [Future of inhalation anesthetics: structure-activity relationship]. PMID- 3560424 TI - [Changes in complement and catecholamine during anesthesia in open-heart surgery]. PMID- 3560425 TI - [Effect of propranolol on regional oxygen balance in the ischemic canine myocardium]. PMID- 3560427 TI - [Time course of hypoxic pulmonary vasoconstriction in dogs]. PMID- 3560426 TI - [A study on the development of the 6 inert gas elimination method for VA/Q distribution measurement during inhalational anesthesia]. PMID- 3560428 TI - [The interactions between dantrolene and bovine serum albumin]. PMID- 3560429 TI - [Thermometric study of compensatory vasoconstriction under epidural anesthesia]. PMID- 3560430 TI - [Relation between epidural pressure and cerebrospinal fluid pressure in dogs]. PMID- 3560431 TI - [Comparison of lactated Ringer's and 5% dextrose-saline mixture solutions as intra-operative hydrating agents]. PMID- 3560432 TI - [High performance liquid chromatographic determination of astromicin and cefsulodin used in combination in blood samples]. AB - Aminoglycoside and beta-lactam antibiotics are often used in combination. This paper reports a high performance liquid chromatographic determination method for each of astromicin (ASTM) and cefsulodin (CFS) in blood samples of several species. The procedure for ASTM included purification with CM-Sephadex, separation on a reversed phase column (C-18) and derivatization with o phthalaldehyde (OPA). The procedure for CFS included deproteinization with methanol, centrifugation, filtration and separation on a reversed phase column (C 18). Either of the drugs did not affect the determination of the other. The detection limits were 0.1 microgram/ml for ASTM and 0.5 microgram/ml for CFS. These sensitivities seem good enough for a clinical application of the method considering usual dosage levels of the drugs. PMID- 3560433 TI - [High performance liquid chromatographic determination of astromicin and cefoperazone used in combination in blood samples]. AB - Combination therapy of aminoglycoside and beta-lactam antibiotics is often used clinically because of its effectiveness. This paper reports a high performance liquid chromatographic (HPLC) determination method for each of astromicin (ASTM) and cefoperazone (CPZ) in blood samples of several species. The procedure for ASTM included purification with CM-Sephadex, separation on a reversed phase column (C-18) and derivatization with o-phthalaldehyde (OPA). The procedure for CPZ included deproteinization with methanol, centrifugation and separation on a reversed phase column (C-18). Either of the drugs did not affect the determination of the other. The detection limits were 0.1 microgram/ml for ASTM and 0.5 microgram/ml for CPZ. These sensitivities seem good enough for a clinical application of the method considering usual dosage levels of the drugs. PMID- 3560434 TI - [High performance liquid chromatographic determination of astromicin and piperacillin used in combination in blood samples]. AB - Aminoglycoside and beta-lactam antibiotics are often used in combination, and many synergistic effects have been reported. We describe here a high performance liquid chromatographic determination method for each of astromicin (ASTM) and piperacillin (PIPC) in blood samples of several species. The procedure for ASTM included purification with CM-Sephadex, separation on a reversed phase column (C 18) and derivatization with o-phthalaldehyde (OPA). The procedure for PIPC included deproteinization with acetonitrile, centrifugation and separation on a reversed phase column (C-18). Either of the drugs did not affect the determination of the other. The detection limits were 0.1 microgram/ml for ASTM and 0.5 microgram/ml for PIPC. These sensitivities seem good enough for a clinical application of the method considering usual dosage levels of these drugs. PMID- 3560435 TI - [Toxicological studies on isepamicin (HAPA-B). I. Acute toxicity test in the mouse, rat and dog]. AB - Acute toxicity of isepamicin (HAPA-B), a new aminoglycoside antibiotic, in mice, rats and dogs was examined in comparison with amikacin (AMK) and gentamicin (GM). Intravenous LD50 values of HAPA-B were 234 mg/kg in male and 236 mg/kg in female for mice, 489 mg/kg in male and 476 mg/kg in female for rats and 720-864 mg/kg for dogs. Those of AMK were 183 mg/kg in male and 181 mg/kg in female for mice, 420 mg/kg in male and 417 mg/kg in female for rats. Those of GM were 50 mg/kg in male and 47 mg/kg in female for mice, 119 mg/kg in male and 124 mg/kg in female for rats. Intraperitoneal LD50 values of HAPA-B were 2,244 mg/kg in male and 2,272 mg/kg in female for mice, 1,664 mg/kg in male and 1,591 mg/kg in female for rats. Intramuscular LD50 values of HAPA-B were 2,508 mg/kg in male and 2,632 mg/kg in female for mice, 2,088 mg/kg in male and 2,111 mg/kg in female for rats and greater than 1,800 mg/kg for dogs. Those of AMK were 1,247 mg/kg in male and 1,334 mg/kg in female for mice, 2,324 mg/kg in male and 2,244 mg/kg in female for rats. Those of GM were 359 mg/kg in male and 360 mg/kg in female for mice, 559 mg/kg in male and 557 mg/kg in female for rats. Subcutaneous LD50 values of HAPA B were 3,321 mg/kg in male and 3,320 mg/kg in female for mice, 3,451 mg/kg in male and 3,392 mg/kg in female for rats. Oral LD50 values of HAPA-B were more than 5,000 mg/kg in mice and rats. Ataxia, acratia, dyspnea and convulsions were observed following administration by all routes, except for oral route, of all drugs in mice, rats and dogs. The cause of early death was due to respiratory paralysis which is the typical acute toxic sign of aminoglycoside antibiotics, and that of late death was due to renal injuries. BUN and creatinine values of surviving dogs after day 14 increased after administration by either intravenous or intramuscular routes. Disintegration, necrosis and calcification of epithelial cells of the proximal convoluted tubuli were observed in rats which died during the course of the study, and atrophy, dilatation and eosinophilic degeneration in epithelial cells of the proximal convoluted tubuli and thickening of Bowman's capsule were observed in surviving dogs. PMID- 3560437 TI - [Toxicological studies on isepamicin (HAPA-B). IV. Intramuscular subacute toxicity test in the dog]. AB - The subacute toxicity in the dog of isepamicin (HAPA-B), a new aminoglycoside antibiotic, was studied in comparison with amikacin (AMK). HAPA-B at dose levels of 6.25, 25 and 100 mg/kg/day and AMK at dose levels of 25 and 100 mg/kg/day were given intramuscularly for 30 days. Only one female dog in the AMK 100 mg/kg dose group died on day 29. The activities of urinary NAG and gamma-GTP increased dose relatedly in dogs in the 25 and 100 mg/kg dose groups of either drug. Discoloration and/or enlargement of the kidneys were observed in dogs at 100 mg/kg of either drug. Hemorrhage and/or edema at the injection sites were observed in dogs in the 25 and 100 mg/kg dose groups of either drug. Increases of absolute and relative kidney weights were observed in the AMK 100 mg/kg group. An increase of relative kidney weights was also observed in the HAPA-B 100 mg/kg group. In microscopic observations, various histopathological changes of renal tubules and tubular epithelium were observed dose-relatedly in the 25 and 100 mg/kg groups of both drugs. At a dose of 25 mg/kg, there was no significant difference of the incidence and severity of these renal changes between HAPA-B and AMK groups. Desquamation and necrosis of the renal tubular epithelium were observed only in the AMK 100 mg/kg group. The necrosis in these changes was considered to be one of the severest possible changes in renal tubules, hence the renal toxicity of HAPA-B was judged to be milder than that of AMK at the dose level of 100 mg/kg. The non-toxic dose of HAPA-B in this study was estimated to be 6.25 mg/kg. PMID- 3560436 TI - [Toxicological studies on isepamicin (HAPA-B). II. Intramuscular subacute toxicity test in the rat]. AB - Subacute toxicity in the rat of isepamicin (HAPA-B), a new aminoglycoside antibiotic, was examined in comparison with amikacin (AMK). Daily doses of 12.5, 25, 100 and 300 mg/kg of HAPA-B or 25 and 100 mg/kg of AMK were injected intramuscularly for 28 days. No animal died and there were no changes in general symptoms except for hemorrhage at injection sites of both drugs. Decreases in body weight gain and food consumption were observed in males and females in the HAPA-B 300 mg/kg dose group. Water consumption was increased in males in the HAPA B 300 mg/kg and AMK 100 mg/kg dose groups. Elevations of serum creatinine and/or BUN in males and females were occasionally observed in the HAPA-B 300 mg/kg and AMK 100 mg/kg dose groups, and elevation of GOT, which seemed to be due to muscle injuries, was occasionally observed in a no dose-dependent manner with either drug. Increases in kidney and caecum weights of males and females in the HAPA-B 100, 300 mg/kg and AMK 25, 100 mg/kg dose groups and increases in adrenal relative-weights in males and females in the HAPA-B 300 mg/kg dose group were observed. At necropsy, discoloration and enlargement of the kidney were observed in a dose-dependent manner at or above 100 mg/kg with either drug. Histopathological findings indicated degeneration and necrosis in epithelial cells of the proximal convolute tubuli and thickening of basement membrane. Electron microscopic findings indicated an increase in number of large lysosomes containing myeloid bodies in the epithelial cells of the proximal convolute tubuli with both drugs. The above results suggest that HAPA-B has renal toxicity like other aminoglycoside antibiotics but its toxicity was lower than AMK. The non-toxic dose of HAPA-B in this test was 12.5 mg/kg. PMID- 3560438 TI - [Toxicological studies on isepamicin (HAPA-B). VII. Chronic intramuscular test in the rat]. AB - Chronic toxicity in the rat of isepamicin (HAPA-B), a new aminoglycoside antibiotic, was examined in comparison with amikacin (AMK). Daily doses of 3.125, 6.25, 25 and 100 mg/kg of HAPA-B or 25 and 100 mg/kg of AMK were injected intramuscularly for 6 months, and recovery test was carried out for 2 months after discontinuing the drug. No animal died and there were no changes in general symptoms except for hemorrhage of injection sites of both drugs. Decreases in body weight gain and food consumption were observed in 100 mg/kg dose group of either drug. Water consumption was markedly increased in males of the AMK 100 mg/kg dose group during administration and recovery periods. Decreases in erythrocytes, hematocrit and hemoglobin were observed in 100 mg/kg dose group of either drug. These decreases seemed to be due to renal injury. An increase in the number of platelets was also observed. This was likely caused by the hemorrhage at injection sites. These changes persisted into the recovery period. Elevation of BUN was observed in the 100 mg/kg dose group of either drug. Its value in the AMK 100 mg/kg dose group was markedly higher than that in the HAPA-B 100 mg/kg dose group and did not decrease back to the normal values even during the recovery period. An increase of urine volume and a decrease of urine specific gravity were observed in males in the 100 mg/kg group of either drug. Furthermore, NAG was elevated in a dose-dependent manner from 25 mg/kg with both drugs. The weight of kidney increased dose-relatedly and significantly in groups administered with 25 mg/kg or more of either drug and weight of caecum increased dose-relatedly and significantly in groups administered with 6.25 mg/kg or more of HAPA-B or 25 mg/kg or more of AMK. Discoloration and enlargement of the kidney occurred in a dose-dependent manner as observed by necropsy. Eosinophilic granular degeneration, swelling, fatty degeneration, necrosis, calcification in the epithelial cells of the proximal convoluted tubuli, and thickenings of Bowman'S capsule and tubular basement membrane were observed at 25 and 100 mg/kg dose groups of either drug. In recovery periods, after the necrosis disappeared, calcification and regeneration were observed in epithelial cells. Electron microscopic findings showed an increase in the number of large lysosomes containing myeloid bodies in the epithelial cells of the proximal convolute tubuli with either drug.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3560439 TI - [Effect of isepamicin (HAPA-B) on reproduction. I. Fertility study in rats (intramuscular administration)]. AB - Effect of isepamicin (HAPA-B), a new aminoglycoside antibiotic, on fertility and reproductive performance in Wistar rats was studied. The drug was injected intramuscularly to rats at a daily dose of 25, 100 or 200 mg/kg. Male rats were treated for 63 days before mating and during the mating period, and female rats were treated for 2 weeks and through the mating period to the 7th day after mating. In male rats, an inhibition of body weight gain and a development of a pale color and hypertrophy of the kidney were observed in 100 and 200 mg/kg dose groups. In female rats, inhibition of body weight gain was observed in 100 and 200 mg/kg dose-groups and a pale color of the kidney was seen in the 200 mg/kg group. No significant differences were observed in mating and fertility performance of male and female rats between the control and treated groups. Numbers of corpora lutea, implantation sites and living fetuses in the 200 mg/kg group decreased significantly. No external, visceral and skeletal anomalies due to the treatment of HAPA-B were observed in the live fetuses. No effect dose levels of HAPA-B found in this study were 25 mg/kg on parent rats and 100 mg/kg on reproduction ability and their fetuses. PMID- 3560440 TI - [Effect of isepamicin (HAPA-B) on reproduction. II. Teratological study in rats (intramuscular administration)]. AB - Teratological study of isepamicin (HAPA-B), a new aminoglycoside antibiotic, was performed in Jcl: Wistar rat. The drug was given intramuscularly to dams at doses of 25, 100 and 200 mg/kg from day 7 to 17 after mating. The influence on dams, their fetuses and offspring was studied. A decrease in food intake and a development of pale color of the kidney of dams at a dose level of 200 mg/kg were observed in the prenatal study. The HAPA-B did not show any influence on prenatal development of fetuses. In the postnatal study, no effect of HAPA-B on parturition and lactation of dams was seen except that a discoloration of the kidney was observed at autopsy. However, some differences were observed between the control and treatment groups in postnatal development, behavior and reproduction performance of offspring. Dose-response effects of HAPA-B on offspring were not observed in the postnatal study. No effect dose levels of HAPA B established in this study on rat fetuses and offspring were 200 mg/kg and 100 mg/kg on pregnant rat, respectively. PMID- 3560441 TI - [Effect of isepamicin (HAPA-B) on reproduction. IV. Peri- and post-natal study in rats (intramuscular administration)]. AB - Peri- and post-natal effect of HAPA-B, a new aminoglycoside antibiotic, was studied in Jcl: Wistar rats. The antibiotic was given intramuscularly to dams at doses of 25, 100 and 200 mg/kg from day 17 of gestation to 21 days after delivery and throughout lactation. Influences of the drug on dams and their offspring were studied. A decrease in food intake and an increase in water intake were observed in the 200 mg/kg treated group. At autopsy of dams after weaning, pale discoloration and hypertrophy of the kidney were observed in 100 and 200 mg/kg groups. All other observations including delivery and nursing performance of dams, postnatal development of offspring, behavior and reproduction performance of the offspring were normal. The no effect dose level of HAPA-B found in this study was 25 mg/kg on rat dams and 100 mg/kg on the offspring. PMID- 3560442 TI - [Immunological properties of isepamicin (HAPA-B)]. AB - Immunological properties of isepamicin (HAPA-B), a new semisynthetic aminoglycoside, were compared with those of gentamicin (GM). The results are summarized as follows. Rabbits were immunized by HAPA-B or GM with a strong adjuvant, Freund's complete adjuvant, and specific IgG antibodies were found in sera when assayed using PHA and PCA reactions. In sera from guinea pigs and mice immunized by HAPA-B or GM with aluminum hydroxide gel, no specific IgG nor IgE antibody was detected when assayed using PCA reactions. Specific antibodies (IgG, IgE) produced against HAPA-B and GM were confirmed in different animals immunized by chemically introduced antigens of HAPA-B-carrier protein conjugate and GM carrier protein conjugate, respectively. Guinea pigs immunized by HAPA-B or HAPA B-carrier protein conjugate with aluminum hydroxide gel did not exhibit typical systemic anaphylactic reactions when elicited with HAPA-B alone. HAPA-B had some immunocross-reactivity with GM. These results suggested that the antibody producing activity of HAPA-B was similar to that of GM. PMID- 3560443 TI - [Mutagenicity tests for isepamicin (HAPA-B)]. AB - To detect mutagenic activity of isepamicin (HAPA-B), a new aminoglycoside antibiotic, we carried out several mutagenicity tests using microorganisms and cultured mammalian cells. Effects of the antibiotic on DNA-lesion induction and repair were examined using the Rec-assay with Bacillus subtilis and a sister chromatid exchange test with cultured Chinese hamster cells. The drug caused no increase of mutagenicity indices in both tests, suggesting that the antibiotic has no DNA-damaging effect. To further investigate the effect of HAPA-B on gene mutation, we performed the Ames Salmonella/microsome plate assay and the thioguanine resistance mutation test using cultured Chinese hamster cells. In both tests, the antibiotic induced no increase of mutation frequencies over spontaneous levels. Clastogenic activities of HAPA-B and its effect on chromosome disjunction were examined by the chromosomal aberration test using cultured Chinese hamster cells. After a short- or long-time exposure, the antibiotic induced neither structural chromosome aberrations nor an increase in the number of tetraploid cells. The negative results from these five test systems with different mechanisms strongly suggest the safety of HAPA-B regarding mutagenicity. PMID- 3560444 TI - [Local irritation study with isepamicin]. AB - Local irritative effects of isepamicin (HAPA-B) were studied using muscle and blood vessel of Japanese White rabbits. Muscle irritation experiment was carried out with a single dosage of 100 mg HAPA-B, 100 mg amikacin (AMK), saline, 0.75% acetic acid or 6.0% acetic acid administered into musculus sacrospinalis. Vascular irritation experiment was carried out by allowing HAPA-B to remain in a sealed section of vena retroauricularis for 3 minutes after injection. In result, the muscular irritative activity of HAPA-B was less severe than 0.75% acetic acid but more than saline, and almost equal activity to AMK was observed. The HAPA-B caused very slight inflammation while thrombus was not formed. The vascular irritative activity was very little. PMID- 3560445 TI - [The 60th congress of the Japanese Society for Bacteriology, Tokyo, March 28-30, 1987. Abstracts]. PMID- 3560446 TI - [Nuclear DNA content in small thyroid papillary carcinomas determined by microfluorometry]. AB - Microfluorometric measurement of the DNA content of cell nuclei was performed on echo-guided aspiration specimens or imprints of operated fresh materials of fourty-one small thyroid papillary carcinomas of 10 mm or less in diameter and of six large ones more than 20 mm in diameter. The distribution patterns of the DNA content were classified into three groups: IIa, IIb and III. The DNA values in so called sclerosing carcinomas mostly fell into Group-IIa, while ordinary papillary carcinomas were classified as Group-IIb and III. Our date suggests that the DNA microfluorometry of echo-guided aspiration specimens of small papillary carcinomas gives the index whether they will remain occult or not. PMID- 3560447 TI - [Fourteen cases of mucosal melanomas of the oral cavity]. AB - Fourteen cases of mucosal melanomas of the oral cavity were treated from January, 1970 to April, 1986 in our department. The patients were 10 males and 4 females and in their fifth and sixth decades with the primary sites in the upper gingiva and palates in the majority. The 3 and 5 year survival rates were 21.4% and 14.3% respectively, with unfavorable prognosis in comparison with cutaneous melanoma. The clinical stages were as follows: stage Ia (1), Ib (8), II (5), which affected the prognosis. The depth of invasion, as described by Breslow et al., were beyond 1.50 mm except in one case, which might be a significant prognostic factor in the study of mucosal melanoma of the oral cavity. Seventy one percent had neck node metastases and 35% had distant metastases. The high occurrence of metastases might be related to their poor prognosis. PMID- 3560448 TI - [Radiotherapy for patients with metastatic brain tumor]. AB - Fourty-one patients with a metastatic brain tumor were analyzed to evaluate the usefulness of irradiation. The radiation was given conventionally 3 to 5 times a week with a fractional dose of 1.5 to 2 Gy. The mean survival times was 5.0 months in all cases. The survival times did not change in a dose of 20 to 60 Gy, and symptomatic response was also not perceived in this dose of 20 to 60 Gy. The condition of the primary disease seems to be deeply related to the survival time. It is considered that radiation therapy for brain metastasis is particularly useful in a patients with well-controlled, primary tumors and dose of more than 20 Gy should be given at least. PMID- 3560449 TI - [Hormone-dependency of human breast cancer in in vitro clonogenic assay]. AB - The in vitro clonogenic assay has been used to assess the biological effects of estradiol-17 beta (E 2) and an antiestrogen, tamoxifen (TAM) on human breast cancer, and the results were compared with the estrogen receptor status (ER). The sera used were treated with dextran-coated charcoal to avoid the modification effects of the endogenous hormones. There was a significant difference between ER (+) and ER (-) breast cancers in the incidence of cases in which the plating efficiency of cancers increased more than 50% over those of untreated control by adding 10(-8) M of E 2 (40.2% vs. 21.3%). TAM, 10(-6) M revealed a less than 50% colony formation of the control in 30.5% of ER (+) cancers, whereas only 13.0% of ER (-) cancers showed a response to TAM. PMID- 3560450 TI - [Immunohistological observation of blood group-related antigens in lung adenocarcinomas using monoclonal antibodies]. AB - The immunohistological distribution of blood group (BG)-related antigens including A, B, H type 2, and sialylated Lex in lung adenocarcinomas was examined using monoclonal antibodies. BG-A, B, and H type 2 compatible with the ABO status in tumor cells were expressed in 60% of the cases. Accumulation of H type 2, associated with loss of BG-A and B, was observed in tumor cells of patients with BG status other than 0. Tumor-associated antigens, Lex and sialylated Lex were detected in 36.0% and 72.0%, respectively. Modification of carbohydrate antigens in cancer may be associated with incomplete synthesis; accumulation of precursor antigen; and activated sialylation. PMID- 3560451 TI - [Brain metastases of colorectal cancer--a case report]. AB - Metastatic brain tumors from colorectal cancers are relatively rate. In previous reports, the incidence, ranged from 1.9 to 3.5 percent of all metastatic brain tumors. We reported 2 cases of metastatic brain tumors from colorectal cancers. Metastasis to the lung and liver were not found in 2 cases at the time of the diagnosis of the single brain metastasis. The CEA levels in the serum were highly elevated in these 2 cases. On a contrast-enhanced CT scan, tumors were equally demonstrated as high density and cystic, with a ring-like mass with surrounding brain edema. Brain metastases of colorectal cancer were discussed with a review of the literature. PMID- 3560452 TI - [A case of breast carcinoma, possibly the result of malignant transformation of an intraductal papilloma in a 26-year period]. AB - A 74-year old female presented a giant tumor and serosanguineous nipple discharge from the left breast. The tumor was first recognized 26 years ago, and untreated. The resected breast contained several cysts and some small white nodules. Some of the cysts contained intracystic tumors. Histologically, the tumor consisted of a mixture of papillotubular carcinoma and intraductal papilloma. This case seems to represent a malignant change in intraductal papilloma from its long clinical course and by the microscopic findings. Review of this case seems to warrant clinical attention to the possibility that benign intraductal papilloma may transform itself into malignancy after many years. PMID- 3560453 TI - [A long-surviving case of gastric cancer with liver metastasis without signs of recurrence for six years after palliative operation]. AB - A 51-year-old man was admitted because of Borrmann 2 type gastric cancer located in the antrum. Since he had bilateral liver metastasis, palliative gastrectomy and liver biopsy was performed. Histopathologically, the primary cancer showed poorly differentiated adenocarcinoma and the liver biopsy showed the same. This patient has been alive without sign of recurrence for more than six years after he was given 40 mg of MMC, 12.5 KE of Picibanil and 528 g of PSK postoperatively. In addition, eight similar cases, with a survival rate of more than 5 years after resection of liver metastasis, have been reported in Japan and are reviewed. PMID- 3560454 TI - [A case of extramedullary plasmacytoma]. AB - The patient is 51-year-old male. A tumor arose on the upper eye lid at the age of 44 years and 6 years later, a tumor arose on the forearm. The tumor recurred 3 times on the forearm and were resected each times. When he was 51 years old, 3 tumors arose on the upper arm. Tumors were found in the cutis and subcutis of the jaw, back, forearm and thigh. A tumor was also found on the palatine tonsil. Bence Jones protein was negative in serum and urine. There were no particular findings in serum immunoelectrophoresis, bone X ray films, bone marrow aspiration and bone scintigram. The Borrmann 4-like pattern was revealed on the stomach by barium examination. By chemotherapy and radiotherapy, the tumors decreased markedly in size. Excisional biopsy showed that the tumor was composed of atypical plasma cells and gamma-chain and lambda-chain were immunohistologically detected. PMID- 3560455 TI - [Gliomatosis peritonei]. AB - Gliomatosis peritonei, the miliary implants of mature glial tissues on the peritoneum or omentum, is a rare complication of solid ovarian teratoma. Our case is reported and 38 previously reported cases are reviewed. The grade of the primary tumors varied from grade 0 to grade 3. Only five cases were composed entirely of mature tissues. Five of the 39 patients died. Despite of varied therapy, the rest of the patients were alive from 3 months to 38 years later. Inspite of intraperitoneal implants, the prognosis in patients with these tumors is good, irrespective of the mode of therapy. On the basis of this study, we recommended a conservative therapy for the primary tumor and therapy for the implants is not required. PMID- 3560456 TI - [A new drug therapy manual--the basis of drug administration and therapeutic programs]. PMID- 3560457 TI - [Programs for emergency care]. PMID- 3560459 TI - [Therapeutic agents]. PMID- 3560460 TI - [Drug therapy for various disease entities]. PMID- 3560458 TI - [A list of therapeutic agents and their standard dosages]. PMID- 3560461 TI - [Basic theories of drug administration--pharmacokinetics and pharmacodynamics]. PMID- 3560462 TI - [Drug therapy]. PMID- 3560463 TI - A statistical study of brain tumors in Japan: general features. The Committee of the Brain Tumor Registry in Japan. AB - A total of 20,192 brain tumors, registered in Japan between 1969 and 1978 have been studied. Differences in frequency between Japan and other countries, and also between children and adults were discussed in relation to tumor distribution, by site in the brain, and the frequencies of various types tumor were classified pathologically and by age and sex. Glioma frequency in Japan was a little lower (38.1%) than in western countries and China (43-49%). Germinomas occurred in 435 patients in all age groups (2.7% of primary tumors), of whom 184 were children (7.8% of primary pediatric brain tumors), these percentages being also much larger than those found outside Japan. The frequencies of craniopharyngiomas were also high in Japan, having totals of 914 cases, or 5.8%, from all primary tumors, and 295 cases, or 12.5%, from all primary pediatric brain tumors. Teratomas occurred mostly in children (67% of the total) and at a relatively high frequency in infants, but, in contrast, dermoid and epidermoid cysts appeared frequently in people between 30 and 55 years of age. PMID- 3560464 TI - Acoustic screening for laryngeal cancer. AB - An acoustic screening method for indicating the possible presence of laryngeal cancer was investigated. Three acoustic parameters, comprising perturbations in pitch-period and peak-amplitude sequences, and vocal noise, were measured from a sustained vowel, e, spoken by the subjects taking part in the investigation. Experiments to discriminate between normal and cancer groups were performed with voice samples taken from 64 normal control subjects and 57 patients with laryngeal cancer. Experiments were also carried out to test the perceptual significance of the three parameters. From the results, we have been able to conclude that their combined use will enable us to build an acoustic screening system for laryngeal cancer. PMID- 3560465 TI - Primary leiomyosarcoma in the breast. AB - The case is presented of a 62-year-old woman having a well-circumscribed, painless breast lump which led to the discovery of pure mammary leiomyosarcoma. There are only a few documented cases of primary leiomyosarcoma in the breast, and a brief review of the literature on the diagnostic findings and histogenesis of a smooth muscle malignant neoplasm in this site is, therefore, provided. As far as the histogenesis is concerned, ultrastructural features of the present case suggest a tumor of pluripotent mesenchymal cell nature rather than of vascular smooth muscle cell origin. PMID- 3560466 TI - A case of pancreatic cancer with liver metastasis which responded to chemotherapy. AB - A case of pancreatic cancer with liver metastasis is reported, in which chemotherapy had a marked effect, with the responses clearly documented. The patient was a 59-year-old male who experienced epigastric pain in February 1985, upper gastrointestinal X-ray examination revealing extragastric compression by the pancreas. He visited the National Cancer Center Hospital, Tokyo, in April 1985 and the diagnosis of pancreatic cancer with liver metastasis was made using the imaging procedures of ultrasonography, computed tomograph scanning and endoscopic retrograde cholangiopancreatography as well as by biochemical and serological tests. At the time a 5 cm tumor was palpable in the middle upper abdomen. The patient was treated with Cis-diaminedichloro platinum, tegafur, and 5-fluorouracil, successively, and the abdominal tumor gradually diminished, finally becoming impalpable. The response was evaluated as one of partial responses (PR) by ultrasonography, and the improvement substantiated by computed tomography and tumor markers. PMID- 3560467 TI - Extramedullary plasmacytoma of the mediastinum. AB - A case of extramedullary plasmacytoma originating from the upper mediastinum is described. Its pathologic, cytologic and immunohistopathologic findings were distinctive. The neoplastic cells had dense bodies in the cytoplasm. Neither M protein in the serum nor Bence Jones protein in the urine was detected. However, cellular IgG, having a lambda-type light chain was shown, by immunohistochemical staining following trypsin digestion, to be present in the tissue sections. PMID- 3560468 TI - [Clinical significance of ventricular late potentials]. PMID- 3560469 TI - [Monoclonal antibody studies in non-Hodgkin's lymphomas]. PMID- 3560470 TI - [Production of monoclonal antibodies to human esophageal cancer cell and preliminary study of clinical application]. PMID- 3560471 TI - [Hereditary hypocholinesterasemia (silent gene type II)]. PMID- 3560472 TI - [The measurement of circulating immune complexes using anti-C3 antibody micro ELISA]. PMID- 3560473 TI - [Measurement of spontaneous platelet aggregation by electrical impedance method of whole-blood aggregometer]. PMID- 3560474 TI - [Coagulation tests for laboratory diagnosis in DIC]. PMID- 3560475 TI - [Clinico-pathological studies of gallbladder diseases-6 early carcinoma of the gallbladder]. PMID- 3560476 TI - [Relation between age and the bronchodilatory effect of deep inspiration in normal women: evaluation by partial and maximum expiratory flow-volume curve]. PMID- 3560477 TI - [Studies on the characteristics of ambulatory EEG system (Medidata M-300)]. PMID- 3560478 TI - [Clinico-pathological studies of gallbladder diseases--7. Prognostic factors in gallbladder carcinoma]. PMID- 3560479 TI - [Cardiac abnormalities in cerebrovascular disorders]. PMID- 3560481 TI - [Tests of platelet aggregation and blood coagulation with the automatic analyzer]. PMID- 3560480 TI - [Recent advances in the clinical laboratory; clinical and technical advances in thyroid hormones and TSH]. PMID- 3560482 TI - [Clinical significance of two-dimensional echocardiography in patients with membranous ventricular septal defect in childhood]. PMID- 3560483 TI - [Latex agglutination nephelometric immunoassay for microalbuminuria]. PMID- 3560484 TI - [Detection of lipoprotein-X subfractions by isoelectric focusing on agarose gel]. PMID- 3560485 TI - [The relationship between glycemic control and urinary NAG in diabetics]. PMID- 3560486 TI - [Infection by hepatitis B virus and its prevention]. PMID- 3560487 TI - [A case of pyoderma vegetans (pyo-rhino-blepharo-stomatitis vegetans)]. PMID- 3560488 TI - [Cholesterol esterification in experimental xanthoma tissues]. PMID- 3560489 TI - [Plasma lipids and lipoproteins in patients with xanthelasma: significance of low levels of high-density lipoproteins in the normolipemic patients]. PMID- 3560490 TI - [Esophageal ulcers after endoscopic injection sclerotherapy and changes in esophageal motility]. PMID- 3560491 TI - [Predictive studies of hepatic encephalopathy in patients with liver cirrhosis by oral glucose tolerance tests and blood ketone body ratios]. PMID- 3560492 TI - [Ductal and vascular factors in the etiology of experimentally induced pancreatic fibrosis and fat replacement in dogs]. PMID- 3560493 TI - [A case of systemic lupus erythematosus with esophageal mucosal bridge]. PMID- 3560494 TI - [A case of aneurysm developing in the common hepatic artery]. PMID- 3560495 TI - [Three suspected cases of perihepatitis caused by Chlamydia trachomatis infection (Fitz Hugh-Curtis syndrome)]. PMID- 3560496 TI - [Hepatic failure due to disseminated intrahepatic portal vein thrombosis after endoscopic sclerotherapy of a cirrhotic patient]. PMID- 3560497 TI - [Cholesterol gallstone of the bile ducts with a silk suture in its center--report of two cases]. PMID- 3560498 TI - [Comparative study of the growth rate of primary and metastatic lesions in xenotransplanted tumors in nude mice]. PMID- 3560499 TI - [Role of oxygen-derived free radicals in hemorrhagic shock-induced small intestinal lesions in the rat]. PMID- 3560500 TI - [A cell kinetic study of biliary tract mucosa by using anti-bromodeoxyuridine monoclonal antibody in an experimental model of an abnormal pancreatico choledocho-ductal junction]. PMID- 3560501 TI - [Disturbances of consciousness in the aged]. PMID- 3560502 TI - [A case-control study of femoral neck fracture in aged Japanese women]. PMID- 3560504 TI - [Hemodynamic profile and the prognostic value of hemodynamic parameters in the aged with acute myocardial infarction]. PMID- 3560503 TI - [The effect of aging on catecholamine secretion in acute myocardial infarction]. PMID- 3560505 TI - [Clinical features of peptic ulcer in an aged group]. PMID- 3560506 TI - [The current status of accidental hypothermia--analysis of individuals alive at the time of discovery]. PMID- 3560507 TI - [A clinico-pathological study of aged patients with malignancy--based on consecutive autopsy cases, 70-years-old or over]. PMID- 3560508 TI - [Painless myocardial infarction in the aged]. PMID- 3560509 TI - [Forms and functions of the cardia in the aged]. PMID- 3560510 TI - [A report on a case of an elderly patient with pulmonary thromboembolism]. PMID- 3560512 TI - Genetic polymorphisms of complement C6 and C7 in two Chinese populations. PMID- 3560513 TI - Determination of esterase D (EsD) genotype in cases with trisomy 13. PMID- 3560511 TI - Localization of the human prealbumin gene to 18p11.1-q12.3 by gene dose effect study of Southern blot hybridization. PMID- 3560514 TI - Assignment of ABO locus to 9q31.3----qter by study of a family in which an intrachromosomal shift involving chromosome 9 is segregating. PMID- 3560515 TI - Determination of chromosomal area of double minute chromosomes and a homogeneously staining region in HL-60 human leukemia cells by the use of a color image analyzer. PMID- 3560516 TI - Additional evidence for the location of the alpha-neuraminidase gene on chromosome 6. PMID- 3560517 TI - Detection and classification of murine anti-DNP immunoglobulins in hybridoma supernatants by latex agglutination methods. PMID- 3560518 TI - Common antigen detected in urine from healthy men, women and girls. PMID- 3560519 TI - Availability of decapacitation factor for the detection of semen. PMID- 3560520 TI - [Reversible reactivity of the dansyl derivative of N-acetylgalactosamine with Helix pomatia A hemagglutinin]. PMID- 3560521 TI - [Fluorometric investigation of anti-methamphetamine antibody-hapten reactions]. PMID- 3560522 TI - [Two burned bodies with self-inflicted wounds: autopsy case reports with some discussion of death due to fire]. PMID- 3560523 TI - [Determination and fluorescent-histochemical approach to catecholamines in the rat brain after inhalation of tetrahydrofuran]. PMID- 3560524 TI - Identification of alpha-hydroxybutyrate in rabbit serum after ethanol ingestion. PMID- 3560525 TI - [Evaluation of left ventricular functions using a cadmium telluride probe]. PMID- 3560526 TI - [Exercise-induced ST-T changes and severity of myocardial ischemia in single vessel coronary artery disease: quantitative assessment by stress thallium scan]. PMID- 3560527 TI - [Quantitative in vivo analysis of the muscle degeneration in Duchenne type muscular dystrophy using NMR-CT]. PMID- 3560528 TI - [Assessment of left ventricular function with the nuclear single probe and angiotensin II infusion]. PMID- 3560530 TI - [Experimental studies on a sensitive TSH immunoradiometric assay using monoclonal antibodies]. PMID- 3560529 TI - [A new method for a left ventricular pressure-volume loop using gated radionuclide ventriculography and simultaneous micromanometer pressure measurements in human beings]. PMID- 3560531 TI - [Fundamental and clinical evaluation of an immunoradiometric assay kit for serum TSH: SUCROSEP TSH IRMA]. PMID- 3560532 TI - Effects of carotid chemoreceptor stimulating and depressing agents on internal intercostal muscle activity in the rabbit. AB - The effects of carotid chemoreceptor stimulating and depressing agents on internal intercostal muscle activity (IIMA) were studied before and after surgical denervation of the carotid sinus nerve (CSN) in the rabbit. An intracarotid injection of 30 micrograms of sodium cyanide (NaCN) during inspiration caused an increase in both IIMA and respiratory rate (RR). In contrast, intracarotid administration of 10 micrograms of dopamine (DA) during inspiration resulted in a decrease in both IIMA and RR. The NaCN- and DA-induced characteristic responses in IIMA were abolished by the section of the CSN. The results indicate that the excitatory and inhibitory responses of IIMA to intracarotid injections of NaCN and DA are mainly mediated through carotid chemoreflexes. PMID- 3560533 TI - Determination of Hufner's factor and inactive hemoglobins in human, canine, and murine blood. AB - Determination of Hufner's factor and simultaneous measurement of met- and carboxyhemoglobin were performed in 31 human, 16 canine, and 2 murine blood samples. Both measured and corrected values of Hufner's factor were lower than the theoretical value of 1.39, suggesting the possibility of the presence of unidentifiable inactive hemoglobin(s) in blood. PMID- 3560534 TI - Different responses of muscle sympathetic nerve activity to sustained and rhythmic handgrip exercises. AB - Muscle sympathetic nerve activity (MSA) was recorded by microneurographic technique from the human tibial nerve before and during voluntary sustained and rhythmic handgrip exercises. The MSA increased significantly during sustained contractions but not during rhythmic contractions, whereas no differences in resting activity before the two modes of handgrip were seen at rest. The results demonstrate that MSA responses to sustained and rhythmic exercises are distinctly different, showing less sympathetic outflow during rhythmic than during sustained contraction. PMID- 3560535 TI - Comparison of pancreatic exocrine secretion via endogenous secretin by intestinal infusion of hydrochloric acid and monocarboxylic acid in anesthetized piglets. AB - The secretory response of the exocrine pancreas via endogenous secretin (IRS) by intraduodenal instillation of hydrochloric acid (HCl) and various monocarboxylic acid solutions was studied in anesthetized piglets. The secretion induced by HCl solutions of various concentrations containing 250 mM NaCl occurred when pH of the solutions was lower than 1.5. After instillation of the HCl solution of pH 1.0, juice flow and protein output increased 26 times and 9 times, respectively, as compared with basal levels. Such pancreatic responses paralleled an increase in plasma IRS concentration in the portal vein. The pancreatic response induced by a lactic acid solution occurred when pH of the solutions was lower than 3.8. The juice flow and protein output stimulated by a lactic acid solution of 250 mM and pH 2.0 were 16 and 8 times higher than the basal levels. The responses to the lactic acid solution of pH 2.0 increased concentration dependently, and were followed by an increase in IRS concentration in the portal vein. The pancreatic exocrine responses induced by other monocarboxylic acid solutions (250 mM) of pH 2.0 were in the following order: formic acid greater than lactic acid greater than pyruvic acid much greater than acetic acid greater than butyric acid greater than propionic acid. Lactamide, an analogous substance of lactic acid, did not evoke any pancreatic secretion. The results indicate the possibility that pancreatic exocrine response induced by HCl is dependent upon hydrogen ion, while the response induced by monocarboxylic acid is not always dependent on dissociation constant of acid. PMID- 3560536 TI - Changes in intracranial pressure and arterial blood pressure following electric stimulation to restricted regions in the cat brainstem. AB - The brainstem of anesthetized cats was electrically stimulated to examine the changes in the intracranial pressure (ICP). There were pressor and depressor sites, which preferentially produced an immediate increase and decrease in ICP in association with the arterial pressor and depressor responses, respectively. A preferential increase in ICP was also observed by stimulation of some depressor sites. The stimulus-induced ICP responses were usually different from the secondary ICP changes due to nonneurogenic alteration of arterial blood pressure (BP) as evoked by arterial bleeding and infusion of saline solution; the stimulus induced increase in ICP was greatly enhanced when the stimulation to the pressor sites was applied at lowered BP levels and at moderately elevated ICP levels. In addition, when a gradual elevation in ICP was spontaneously observed with the lowering of the BP level, the pressor site-induced increase in ICP exceeded 70 100 mmHg at the peak plateau-like waves, regardless of the magnitude of accompanying arterial pressor response. We propose that the stimulus-induced ICP responses cannot be explained merely by the metabolic changes, the decreased intracranial compliance, and the secondary transmural action on the intracranial space of the arterial pressor and depressor responses. A neurogenic mechanism that directly affects intracranial blood diameter may be involved in the ICP responses, especially those observed at a lower BP level, in addition to extracranic action of sympathetic and parasympathetic nerve activities. PMID- 3560538 TI - Ascending and descending pathways of reflex straining in the dog. AB - The location of ascending and descending pathways of the straining reflex was studied by making bulbar cuts in dogs. Rhythmic increases, which were elicited simultaneously in nervous outflows to the diaphragm and rectus abdominis by activation of pelvic afferent fibers, were used to indicate rhythmic straining. The increases were not affected by cutting the dorsal funiculus at the bulbospinal junction, but stopped after cutting both lateral funiculi and by longitudinally cutting the roof of the central canal just caudal to the obex. The increases were impaired by unilateral section of the bulbospinal junction, but were abolished completely after successive ipsilateral hemisection of the rostral bulb. Moreover, rhythmic increases, which appeared synchronously with rhythmic straining in unit discharges recorded from the Kolliker-Fuse nucleus and neighboring structures, disappeared after the longitudinal bulbar cut. However, reflex discharges elicited in pelvic vesical and rectal branches by stimulation of corresponding pelvic afferent fibers were not reduced. These results show that the indispensable part of the ascending pathway of rhythmic straining passes through the lateral funiculus and decussates at the lower bulb, but the pathway of micturition and defecation reflexes do not cross at that level. PMID- 3560537 TI - Comparative effects of Mg, Ca, Sr, and verapamil on the uterine longitudinal muscle of spayed and estrogen-treated rats. AB - A comparison was made of effects of Mg, Ca, Sr, or verapamil on the mechanical and electrical activities in the uterine longitudinal muscles of spayed and estrogen-treated rats. The muscle strips taken from spayed rat exhibited spontaneous rhythmic activity in the Locke solution which did not contain Mg, whereas spontaneous activity was less frequent in the preparation taken from estrogen-treated rat. The resting potentials were -54 and -61 mV in the spayed and the estrogen-treated preparations, respectively. An initial spike potential followed by plateau potential with abortive spikes on the top was generated in both spayed and estrogen-treated preparations. In the spayed preparation, the frequency of rhythmic contractions was reduced, and the base-line tension was lowered when 0.6 mM Mg was added to the solution. The base-line tension was elevated progressively when the external Ca concentration was raised, and reached a maximal value up to 10 mM. The amplitude of phasic contraction was progressively increased by increasing Ca concentrations in the range from 1.25 to 5 mM, and was reduced by Ca higher than 10 mM. In the estrogen-treated preparation, the amplitude of phasic contraction was increased by increasing Ca concentrations in the range from 1.25 up to 17.5 mM. When the amplitude of phasic contraction was increased, the duration of plateau potential became protracted. Substitution of the external Ca with Sr caused an increase in the spike activity generated on the top of plateau potential. However, the amplitude of phasic contraction was diminished in both the spayed and the estrogen-treated preparations. Verapamil (2 microM) caused a stronger depression of electrical and mechanical activity in the spayed preparation. Results were discussed in relation to the genomic effects of estradiol on the membrane properties so as to change the interaction with divalent cations. PMID- 3560539 TI - Extracellular fluid volume and composition changes during sodium pentobarbitone anaesthesia in the dog. AB - Serial measurements of extracellular fluid (ECF), and plasma volumes were evaluated in dogs before and during general anaesthesia with sodium pentobarbitone and under controlled conditions of arterial pH, pO2, pCO2, and blood pressure. Sodium pentobarbitone anaesthesia caused an early, significant rise in ECF volume with a fall in haematocrit, plasma protein, and plasma potassium concentrations. Plasma osmolality and sodium concentrations were unchanged. The lack of change in ECF sodium concentration suggests that the total ECF sodium content increased in parallel with the expansion of this compartment. Sodium bound to macromolecules in the interstitial space or to bone is suggested as a possible source of sodium ions. It is unlikely that intracellular sodium stores contribute to a significant extent in these changes. During prolonged anaesthesia plasma volume progressively increased while total ECF volume returned towards control values. This work clarifies previous observations and suggests that major fluid movements occur during sodium pentobarbitone anaesthesia primarily associated with altered cell membrane properties and generalised haemodynamic changes. PMID- 3560540 TI - Blockade by cycloheximide of the prepartum changes in membrane activity and adrenergic response of the circular muscle of rat uterus. AB - A study was made of the effects of cycloheximide, an inhibitor of protein synthesis, on the transformations of electrical activity and adrenergic response of the circular muscle of rat uterus during pregnancy and postpartum. Electrical activity proceeded from plateau type on Day 18 of gestation to spike type on Day 22. Excitatory reaction of the contraction to noradrenaline (10(-7), 3 X 10(-7) M) on Day 18 altered to an inhibitory one on Day 22. When pregnant rats were injected intraperitoneally with 50 micrograms cycloheximide daily from Day 18, the changes mentioned above were suppressed and parturition delayed. In the preparations obtained on Day 21, the excitatory effect of 10(-7) M noradrenaline on the contraction changed to an inhibitory one by in vitro incubation for 7 h with Krebs solution. This transformation was prevented by the incubation with 2 micrograms/ml cycloheximide for 7 h. Membrane activity and adrenergic response turned to plateau-dominant action potential with long duration and potentiation of the contraction by noradrenaline (10(-7), 3 X 10(-7) M) 48 h after parturition, respectively. Cycloheximide (50 micrograms/day, i.p., immediately after delivery and on the next day) failed to inhibit these postpartum changes. The results suggest that the process of protein synthesis is involved in the alterations in electrical activity and adrenergic response of the circular muscle of rat uterus during late pregnancy stage. PMID- 3560541 TI - Proceedings: 60th general meeting, Japanese Pharmacological Society. March 29 April 1, 1987, Chiba, Japan. Abstracts. PMID- 3560542 TI - [Fusional vergence hysteresis and sensorimotor connection of the two eyes]. AB - Three experiments were conducted to replicate and extend Helmholtz's observation indicating vergence hysteresis. The two stimuli were presented dichoptically to the eyes in the mirror stereoscope and moved temporalward or nasalward. Helmholtz's finding was confirmed in Experiment 1, in which the critical separations were measured for the stimuli divergently moving temporalward when fusion of their images was abruptly broken (breakaway point) and when fusion was re-established (refusion point) for the stimuli moving nasalward. In Experiment 2, in which only the stimulus for one eye moved temporalward while the stimulus for the other eye was stationary, the breakaway point of the moving stimulus was found to be linearly dependent on the position of the stationary stimulus. Experiment 3 showed that, in the asymmetric divergent tracking as in Experiment 2, the change of the perceived visual direction of the fused image was smaller than the angular magnitude of the movement of the tracking eye. These results were discussed as evidence indicating the sensory and motor connection of the two eyes. PMID- 3560543 TI - [The N2 component of event-related potentials to CV syllables in a task-free situation]. AB - Event-related potentials (ERPs) were recorded while subjects simply listened to sequences of consonant-vowel (CV) syllables. Each sequence was presented in random order and consisted of two kinds of CV syllables--90% ('frequent') and 10% ('rare deviant'), respectively. The features separating these two syllables were varied in phoneme (consonant and/or vowel) or intensity in different runs. In all eight conditions, a fronto-centrally dominant, negative wave peaking around 200 ms (N2) was observed for the deviants. The shorter latency N2 was found for the separating features of vowels or intensities but not for consonants. The results were interpreted as showing that N2 reflects a covert orienting response to rare deviants and that its latency can serve as an index for identifying the separating feature. Observation of N2 in the task-free situation suggested that it might be a useful tool for assessing linguistic discriminability in a clinical setting. PMID- 3560544 TI - [The pathogenesis, diagnosis and treatment of sarcoidosis]. PMID- 3560545 TI - [The fine structure of respiratory tract epithelium in various animals]. PMID- 3560546 TI - [Analysis of the host defense mechanism of the broncho-alveolar system, and pathogenesis of chronic airway disease by the lavage methods with special reference to local specificity]. PMID- 3560547 TI - [From the point of view of infection]. PMID- 3560548 TI - [Pathogenesis of airway diseases--the relationship between upper and lower airway]. PMID- 3560549 TI - [Penetration of antimicrobial agents into the broncho-alveolar system and fibrin deposition in bronchial basement membrane]. PMID- 3560551 TI - [A case of Swyer-James syndrome: a study and review with special reference to the pathophysiology]. PMID- 3560550 TI - [Treatment of pneumothorax--with special reference to using the Heimlich valve at the outpatient department]. PMID- 3560552 TI - [A case of organizing pneumonia demonstrated by biopsy]. PMID- 3560553 TI - [A case of hypersensitivity pneumonitis caused by a humidifier]. PMID- 3560554 TI - [Theoretically possible modes of tracheobronchial plasty]. PMID- 3560555 TI - [A case of successful arterial switch repair for transposition of the great arteries associated with pulmonary stenosis]. PMID- 3560556 TI - [A simple method for repair of partial anomalous pulmonary venous return to the superior vena cava]. PMID- 3560557 TI - [Concentration of cefotaxime in the serum during cardiopulmonary bypass]. PMID- 3560558 TI - [A new effective bronchofiberscopic aspiration of secretion after reconstruction of segmental bronchi]. PMID- 3560559 TI - [A case of left atrial wall aneurysm associated with right brachial artery embolism]. PMID- 3560561 TI - [A case report of the surgical treatment of cor triatriatum]. PMID- 3560560 TI - [A case of mediastinal hemangioma]. PMID- 3560562 TI - [Span plasty and internal tracheal tube fixation in a case of tracheobronchomalacia]. PMID- 3560563 TI - [Surgery of the coronary steal syndrome due to a fistula between the coronary artery and the pulmonary artery associated with the aortitis syndrome]. PMID- 3560564 TI - [A case report of a pulmonary arteriovenous fistula treated by fistulectomy- investigation of surgical methods for single cases]. PMID- 3560565 TI - [Comparison between membrane and bubble oxygenators in cardiopulmonary bypass without donor blood combined with ultrafiltration]. PMID- 3560566 TI - [A case report of implantation of a programmable automatic scanning arrhythmia reversion system for intractable supraventricular tachycardia]. PMID- 3560567 TI - [Our technic of internal mammary artery-coronary artery anastomosis]. PMID- 3560568 TI - [Clinical experience with a membrane oxygenator, COBE VPCML, for pediatric open heart surgery--comparison with the bubble oxygenator]. PMID- 3560569 TI - [Aortic dissection beginning in the lowermost descending aorta--report of two successfully operated cases]. PMID- 3560570 TI - [A case of complete mediastinal malignant goiter]. PMID- 3560571 TI - [Successful surgical removal of a right atrial myxoma]. PMID- 3560572 TI - [Acute cardiogenic shock in prosthetic valve endocarditis in the mitral position]. PMID- 3560573 TI - [Absent pulmonary valve syndrome--report of a case]. PMID- 3560575 TI - [A case of ventricular septal defect due to nonpenetrating injury]. PMID- 3560574 TI - [A successful surgical treatment of prosthetic valve endocarditis due to Salmonella species]. PMID- 3560576 TI - [Ischemic damage to the liver and kidney by IABP--report of a case with a rare complication]. PMID- 3560577 TI - [Surgical treatment for d-transposition of the great arteries; the operative period and late results]. PMID- 3560578 TI - [Tracheoplasty for thyroid carcinoma infiltrating the trachea]. PMID- 3560579 TI - [Bile flow and the motor function of the duodenal papilla]. PMID- 3560580 TI - The role of membrane depolarization in norepinephrine-induced contractions of the rabbit mesenteric resistance artery. AB - Changes in membrane potential during norepinephrine-induced contractions in the rabbit mesenteric resistance artery (3rd or 4th branch) were investigated using microelectrodes. Norepinephrine at concentrations greater than 10(-6) M depolarized the membrane and induced contractions dose-dependently. Maximum effects were produced by 10(-4) M norepinephrine. Depolarization was maintained at almost steady level during 15 min application of norepinephrine. During the same period, contractions continued with slight decay. Oscillatory contractions were observed at more than 3 X 10(-6) M norepinephrine, and occasionally persisted throughout the application of norepinephrine. Treatments with Ca2+-rich 1 mM EGTA solution, 10(-5) M diltiazem, 3 X 10(-6) M D600 and 1 mM La3+ did not significantly affect the amount of depolarization induced by 10(-4) M norepinephrine; however, contractions were greatly inhibited by these treatments. Replacement of Na+ by choline markedly reduced depolarization while contractions were not affected. In Ca2+ -free Na+-free solution, no depolarization was induced, while contractions were still produced by norepinephrine, indicating that Cl- was not essential for membrane depolarization. These results suggest that contractions of the rabbit mesenteric resistance artery to norepinephrine are mainly due to the enhanced influx of extracellular Ca2+ which is not dependent on potential-sensitive mechanisms. Depolarization is thought to be due to the increase in the membrane permeability to Na+ and Cl- which is coincidentally produced by norepinephrine. The membrane potential oscillations were dependent on Ca entry but could not be shown to be the result of fluctuations in Ca current. PMID- 3560581 TI - A note on responses of isolated guinea-pig tracheal strip preparation to electrical stimulation. AB - Authors observed the mechanical response of the tracheal muscle to electrical stimulation using only one transverse strip preparation of isolated guinea-pig trachea, 4-5 mm in width, which included only one tracheal muscle strip. The effects of various pharmacological agents on these responses were also investigated. A biphasic response which is a contractile response followed by a relaxing response usually appeared when the preparation was stimulated with rectangular pulses (50 volt, 0.5 msec) at 40 Hz for a period of 5 sec. A monophasic contractile response also appeared, only rarely but this response was shifted to the biphasic response as the resting tonus level of the preparation gradually increased in the course of the experiment. When the preparation was stimulated electrically at intervals of 15 min, the resting tonus level of the preparation gradually decreased and it subsequently reached a stable state. Then the amplitude of contractile response and depth of relaxing response in the biphasic response evoked by electrical stimulation of constant condition were, respectively, almost constant, whenever the preparation was stimulated at intervals of 15 min. The amplitude of monophasic contractile response which appeared only rarely was relatively constant to every trial of electrical stimulation throughout the experiment. The amplitude of contractile response and depth of relaxing response in the biphasic response were 283 +/- 65 mg (mean +/- SD, n = 10) and 293 +/- 93 mg (mean +/- SD, n = 10), respectively. The monophasic contractile response was abolished by atropine (5 X 10(-7) g/ml) or tetrodotoxin (2 X 10(-7) g/ml). The contractile response in the biphasic response was abolished by atropine (5 X 10(-7) g/ml). In the presence of atropine (5 X 10(-7) g/ml), therefore, only the relaxing response appeared. This relaxing response was respectively reduced by guanethidine (1 X 10(-5) g/ml-1 X 10(-6) g/ml) and propranolol (1 X 10(-5) g/ml-1 X 10(-6) g/ml), but complete inhibition was never seen. These findings suggest that the excitatory innervation is cholinergic and the inhibitory innervation is both adrenergic and non-adrenergic. In addition, from the results of this work it is clear that the preparation used by the authors are good enough to observe the electrical stimulation-induced response of the preparation. PMID- 3560582 TI - [Electromyographical study on motor function of residual intestine after massive resection of small intestine]. AB - Canine intestine 80% was resected, and the post-operative residual intestine was observed on its motor-function in time course by the use of electro-myographic test. The results are as follows. Post-operative frequency of electric discharge was reduced, and it was reduced at the residual jejunum in time course, while it was nearly constant at the residual ileum. Residual jejunum showed no significant change in the continuous time and amplitude of spike burst after operation. While residual ileum showed the post-operative increasing tendency. When the ratio of active phase, average of spike burst occurrences in one minute was regarded as index of intestinal excitability, the excitability was increased in both jejunum and ileum at earlier stage after operation. However, the ileum showed earlier recovery tendency. Electric discharge interval after resection became irregular, and the occurrence rate of antiperistaltic propagation was elevated. Residual ileum showed a longer tendency of one series of MMC after operation. Residual jejunum showed numerous occurrences of MMC up to 3 months after operation, there after, occurring interval of MMC was extended, and MMC-series showed the shortened tendency. Conduction velocity was higher after operation at the residual ileum, and it was not recovered even after 2-3 years, while residual jejunum showed a recovery trend with the peak at the 6th week after operation. PMID- 3560583 TI - [An electromyographic study of the effect of synthetic motilin on gastric motility in dogs]. AB - To clarify the effect of synthetic motilin on gastric motility, the electromyograms after the bolus injection of synthetic motilin in dogs were investigated. The results were summarized as follows: After the bolus injection of synthetic motilin, the discharge interval was shortened and the propagation velocity was accelerated. Therefore, synthetic motilin stimulated gastric muscle in dogs. The dose-response effect of synthetic motilin on discharge interval was observed. On propagation velocity, the dose-response effect was observed, too. Between motilin and secretin, competitive antagonistic action was observed on electromyographic study. On the occasion of the combined use of motilin and tetragastrin, additive effect was observed. After atropine injection, synthetic motilin stimulated gastric muscle. After vagotomy, synthetic motilin also stimulated gastric muscle. After feeding, it was appeared that synthetic motilin did not stimulated gastric muscle. PMID- 3560584 TI - Ribavirin: case reports & discussion. PMID- 3560585 TI - Asthma complicated by sinusitis. PMID- 3560586 TI - Reflections upon the social implications of medical malpractice litigation. PMID- 3560588 TI - Epilepsy and driving privileges. PMID- 3560587 TI - Penicillin allergy update. PMID- 3560589 TI - Total spinal anesthesia--a complication of intercostal nerve block. PMID- 3560590 TI - Evaluation of clinical immunologic tests. PMID- 3560591 TI - Chiropractors and staff privileges. PMID- 3560592 TI - [Impedance rheography in the evaluation of vasodilation treatment of congestive cardiomyopathy]. PMID- 3560593 TI - [Dynamics of right ventricular contraction and pulmonary circulation in children with tetralogy of Fallot. I. Preoperative diagnosis]. PMID- 3560595 TI - [Circulating immune complexes in myocarditis]. PMID- 3560594 TI - [Dynamics of right ventricular contraction and pulmonary circulation in children with tetralogy of Fallot. II. Use of impedance rheography in evaluating the results of correction of the defect]. PMID- 3560596 TI - [Evaluation of the effect of lipid metabolism disorders on circulatory hemodynamics and the elasticity of the vascular wall in children with simple obesity. II]. PMID- 3560597 TI - [Rheologic aspects of the hematocrit and fibrinogen in evaluating rheographic measurements in patients with arteriosclerosis of the lower extremities]. PMID- 3560598 TI - [Theoretic principles of arterial blood pressure determination using the sphygmo oscillography method]. PMID- 3560599 TI - [Advantages of hemodynamic studies in determining the final diagnosis and indications for surgical treatment]. PMID- 3560600 TI - [Value of computerized tomography of the heart in the selection of the surgical treatment method in mitral valve stenosis]. PMID- 3560601 TI - [Echogram of an artificial mitral valve in one- and two-dimensional recordings]. PMID- 3560602 TI - [Cinematographic image of artificial valve dysfunction in patients with perivalvular infection. Correlation of the radiologic image and intraoperative findings]. PMID- 3560603 TI - [Use of preserved autologous blood of patients in open heart surgery with extracorporeal circulation]. PMID- 3560604 TI - [Myocardial infarct in a 13-year-old]. PMID- 3560605 TI - [Features of the heart conduction system in alcoholic lesions of the myocardium]. AB - An electrophysiologic functional study of the atrial conductive structure, the atrioventricular junction, the His-Purkinje system in 33 patients with second stage chronic alcoholism showed impaired cardiac conduction through the atrioventricular node and, less commonly, the His-Purkinje system, to be the principal manifestation of alcoholic heart damage. PMID- 3560606 TI - [Effect of alcohol on conduction of afferent impulsation from the area of the sinus node of the heart to structures of the central nervous system]. AB - Acute experiments in cats, using the induced potentials technique, showed intraperitoneal 30% alcohol administration (1.5-2 ml per 1 kg body weight) as well as direct application of 2 or 3 ml of similarly concentrated alcohol solution to the sinus node area (SNA) to block afferent impulse conduction from the SNA to central nervous structures, such as cerebral cortex, reticular formation of the midbrain, peri-aqueduct gray matter. The fact that the induced potentials generated within the cerebral cortex and subcortical structures in response to SNA stimulation showed a pattern of change that was similar to the one associated with alcohol administered intraperitoneally or applied directly to SNA has suggested that alcohol may block the cardiac afferent flow directly at the level of SNA structures. PMID- 3560607 TI - [Postradiation pericarditis in lymphogranulomatosis patients]. AB - Postradiation pericarditis was diagnosed in 11 of 52 patients treated for lymphogranulomatosis with radiation applied to enlarged mediastinal lymph nodes. The risk of postradiation pericarditis is greater in cases of high radiation doses (more than 45 Gy) and in patients with postradiation pneumonitis. Postradiation pericarditis can develop both during the exposure and long after radiation therapy; therefore long-term follow-up is required for these patients. PMID- 3560608 TI - [Calculation of mass of necrosis developing in the necrotic period of a myocardial infarct]. AB - A method is proposed for the estimation of intravital necrotic weight in myocardial infarction (MI) that permits the assessment of necrotic weight at any hour of the necrotic MI stage. It is based on a mathematical model of nonlinear diffusion of a biochemical enzyme into the blood from necrotized tissue, followed by nonlinear enzyme washing out of the blood, with an adjustment for enzyme deactivation. The estimated values showed good correlation to autopsy findings. A formula for necrotic weight determination at any time of the necrotic MI stage is derived on the basis of variation in blood MB CPK level. Mean necrotic weight increment rate was 3 +/- 0.1 g/hour in the necrotic stage of myocardial infarction. PMID- 3560609 TI - [Antithrombogenic properties of the vascular walls and intravascular platelet activation in ischemic heart disease]. AB - A study of 150 coronary patients demonstrated compromized athrombogenic endothelial properties, as compared to normal subjects whose vascular wall endothelial cells show high anti-aggregation and anti-coagulant activity and prevent intravascular platelet aggregation. The cuff test performed in coronary patients during acute myocardial infarction or an anginal attack induced no release of prostacycline, antithrombin III or plasminogen activators from endothelial cells into the blood flow. Coronary patients demonstrated intravascular platelet activation, impaired platelet release and increased factor 4, thromboxane B2 and beta-thromboglobulin levels. PMID- 3560610 TI - [Comparative study of the value of bicycle ergometry and the dipyridamole test in the diagnosis of ischemic heart disease]. AB - Pharmacologic tests with i.v. dipyridamole were performed in 192 patients between 18 and 65 years of age, for purposes of differential diagnosis between angina and cardiology; bicycle ergometry was carried out in 167 of those. The results of the two tests proved identical, as shown by electrocardiographic evidence of myocardial ischemia. PMID- 3560611 TI - [Alcoholic lesions of the heart]. PMID- 3560612 TI - [Comparative evaluation of the results of the bicycle ergometry test in patients with stress stenocardia after treatment with propranolol and nifedipine]. AB - The results of bicycle ergometry (BE) following administration of placebo, 80 mg propranolol (anaprilin), 30 mg nifedipine (corinfar) and a combination of 60 mg propranolol and 20 mg nifedipine were reviewed in coronary patients with angina pectoris of functional classes (FC) II-IV. Patients with FC-II angina showed the greatest increment in stress tolerance after nifedipine administration, and patients with FC-IV angina, after propranolol, apparently due to a predominance of the functional (coronaro-spastic) pathogenetic factor in the FC-II angina, and the organic factor, in angina of more severe functional classes. In patients belonging to FC-III, the two drugs had similar antianginal efficiency. Stress tolerance increased considerably after simultaneous administration of both drugs in all patients with angina of effort, irrespective of functional class. PMID- 3560613 TI - [Effect of physical training on lipid metabolism and the rheologic properties of the blood of patients with ischemic heart disease]. AB - A therapeutic rationed exercise course (30 daily sessions of bicycle ergometry) was carried out in 30 male coronary patients and 11 normal subjects. Central hemodynamic parameters, lipid metabolism and blood rheologic properties were examined before and after exercise. Regular exercise was shown to bring down erythrocyte membrane levels of triglycerides, fibrinogen and cholesterol and raise the level of high density lipoprotein cholesterol in coronary patients. There was a direct correlation between triglycerides and total peripheral resistance, and an inverse correlation between triglycerides and the cardiac index and another one between fibrinogen and the stroke index. The demonstrated decrease of blood viscosity is evidence of favorable clinical and hemodynamic changes in coronary patients. PMID- 3560614 TI - [Characterologic personality traits, premorbid and current mental status of patients with ischemic heart disease]. AB - Personality characteristics, and premorbid and actual mental states were studied in 130 male coronary patients suffering from anginal attacks. Psychasthenic, stenotic and rigid personalities prevailed in the examined sample. At the same time, 69.6% of patients showed unbalanced personality manifested in character accentuation (58.2%) and psychopathy (11.4%). Mental changes (neurotic reactions and neuroses) were first recorded well in advance of coronary symptoms in 72.4% of the patients. They were usually found in unbalanced personalities and grew worse after the onset of first signs of coronary insufficiency. PMID- 3560615 TI - [Effect of characterologic risk factors of ischemic heart disease on lipid metabolism indices in young persons during adaptation to long-term psychoemotional and physical loads]. AB - A study of changes in lipid metabolism in young men throughout their adaptation to lasting physical and mental/emotional stress demonstrated an increase in blood cholesterol, triglycerides, cholesterol of low and of very low density lipoproteins, and a significant decrease in cholesterol of high density lipoproteins. This period of time particularly favors the activation of atherogenic developments in the body. Changes were the greatest in people of behavior type A. They are assumed to be living under constant emotional stress because of their specific character traits, hence the marked shifts in their blood lipid composition. PMID- 3560616 TI - [Use of sympathomimetic agents in the treatment of acute circulatory insufficiency in the immediate postoperative period of heart surgery patients]. AB - Sympathomimetic agents: isoproterenol (novodrin), dopamine, noradrenalin, adrenalin were used in 137 patients with acute circulatory insufficiency. Their hemodynamic effects were assessed, using catheterization of heart chambers and radiocardiography, and studies of circulating blood oxygen transport, acid-base state and metabolic product levels. A differential approach to sympathomimetic treatment has been developed. Isoproterenol is primarily indicated in those cases where myocardial failure is combined with decreased heart rate, conductivity disorders and markedly increased total peripheral resistance. Dopamine is more justified in cases where increasing the heart rate is more desirable, and there are signs of renal failure and heart rhythm disorders. The possibility of dopamine-induced pulmonary hypertension and pO2 fall should not be dismissed. Correct choice of an agent or a combination of agents makes it possible to control the patient's condition through action on various hemodynamic mechanisms that determine the magnitude of cardiac output. PMID- 3560617 TI - [Long-term use of prazosin alone and combined with propranolol in patients with essential hypertension]. AB - Therapeutic efficiency and hemodynamic effects of prazosin were examined in 42 patients with essential hypertension in the course of prolonged treatment. Where the adrenoblocker showed low efficiency, the beta-blocker propranolol was added to the treatment scheme. The mechanism of the hypotensive effect was shown to be dependent on correlations between arteriolo- and venodilatation. In the presence of prevailing precapillary dilatation, BP dropped owing to reduced total and regional vascular resistance. If venodilatation was more pronounced, the hypotensive effect was due to reduced minute volume. The addition of propranolol eliminated the manifestations of sympathetic stimulation, enhanced the hypotensive effect and improved general condition of the patients. Combined treatment is indicated particularly in those cases of stable hypertension where prazosin alone has failed to produce an adequate effect. PMID- 3560619 TI - [Efficacy of physical training and types of hemodynamics of essential hypertension patients and healthy subjects]. AB - Physical stress tolerance and the effect of swimming-pool exercise were examined in patients with essential hypertension (EH) and normal untrained subjects with respect to their hemodynamic types. Threshold load capacity at bicycle ergometry and the amount of swimming-pool exercise were lower in EH patients and normal individuals with hypokinetic circulation, as compared to other hemodynamic types. Insufficient dilatation of the precapillary channel during exercise may be implicated here. In patients with stable EH and hypokinetic hemodynamics, exercise should be less intensive. PMID- 3560618 TI - [Clinical use of chloranolol (tobanum) in essential hypertension patients]. AB - A clinical study of the efficiency of a new beta-blocker, chloranolol (Tobanum, Hungary), was carried out in 24 patients with second-stage essential hypertension. Central and intracardiac hemodynamics, left-ventricular myocardial function (echocardiography) and regional hemodynamics (occlusion plethysmography) were assessed in 14 patients before treatment and on days 10-15 and 25-30 of chloranolol administration. During the fourth or fifth week of chloranolol treatment, arterial BP diminished by 12/10% (p less than 0.01) owing to an 11.5% reduction in the cardiac index and a 15.7% reduction in heart rate (p less than 0.001), while the stroke index and total peripheral resistance showed no significant change. No basic changes in end diastolic and systolic left ventricular size and volume, nor in the ejection fraction were seen during treatment. Myocardial contractility dropped by 9.8% (p less than 0.05), and intramyocardial tension, by 14% (p less than 0.001), while the thickness of the interventricular septum declined by 7% (p less than 0.001), and that of left ventricular posterior wall, by 4.2% (p less than 0.005). Chloranolol treatment was particularly efficient in moderately hypertensive patients and also in some highly-hypertensive ones that had not responded to propranolol. PMID- 3560620 TI - [Dynamics of the level of acylhydroperoxides and platelet aggregation in chronic ischemic heart disease and essential hypertension during treatment]. AB - Platelet aggregation has been found to be increased in chronic coronary disease of any type, whereas the acylhydroperoxide level was only increased in anginal patients. Conventional therapy normalizes platelet aggregation in patients with angina or angina plus essential hypertension, yet it has no effect on acylhydroperoxides. In essential hypertension, platelet aggregation and acylhydroperoxides increase near the time of discharge. PMID- 3560621 TI - [Echocardiography in the diagnosis and evaluation of the results of the surgical treatment of interatrial septal defects in adult patients]. AB - Pre- and postoperative echocardiographic findings in 67 patients above 18 years of age with atrial septal defects were compared with hemodynamic data obtained at catheterization of heart cavities. No possible ways of accurate noninvasive assessment of arteriovenous discharge were found. Echocardiographic parameters of the followed-up patients returned to normal within 3 to 4 years after surgical correction of the defect. In some cases where mitral prolapse was found preoperatively, angiographically documented mitral regurgitation was seen at long term follow-up. PMID- 3560622 TI - [Lesions of the coronary arteries in nonspecific aortoarteritis]. AB - Clinical and angiographic signs of coronary arterial lesions associated with nonspecific aorto-arteritis are considered. Three kinds of coronary arterial affection are described: affected arterial opening, combined affection of the opening and proximal arterial portions and affected distal portions. It is concluded that the diagnosis of coronary arterial lesions in this condition can be based on combined investigation including continuous ECG recording for 10 or 12 days, bicycle ergometry and selective coronarography. PMID- 3560623 TI - [Smoking and the risk of developing ischemic heart disease]. PMID- 3560624 TI - [Chief risk factors of ischemic heart disease and mortality of the middle-aged male population of Kaunas]. AB - A prospective study, averaging 11 years, of a representative sample of 2455 male residents of Kaunas between 45 and 59 years of age has explored relationships between coronary risk factors and mortality due to coronary heart disease (CHD), cancer, injuries, as well as total mortality rates. An original analytical approach has been developed for the analysis of associations between individual risk factors and mortality that allows to exclude the effects of age and other examined factors. A marked relationship has been demonstrated between: coronary mortality and age, arterial blood pressure, cholesterol, glucose tolerance, smoking, body weight, the presence and clinical form of CHD; cancer-related mortality, and age or smoking; traumatic mortality and smoking; total mortality and age, arterial blood pressure, glucose tolerance, body weight, smoking, and the presence and type of CHD. PMID- 3560625 TI - [Various aspects of the relation between blood sugar levels and the prevalence of ischemic heart disease among 20 to 69-year-old men and women (a simultaneous epidemiologic study)]. AB - A random sample of 1,225 male and 1,243 female residents of a Moscow district, aged 20 to 69, has been studied. Their carbohydrate metabolism was assessed by means of an oral glucose tolerance test, and the diagnosis of coronary heart disease (CHD) was made on the basis of a WHO questionnaire and electrocardiography. The incidence of CHD was shown to be unassociated with the distribution of glycemia (both fasting and provoked by the glucose tolerance test) in males, while the association was significant in females. It is suggested that hyperglycemia is important as a coronary risk factor in women only. PMID- 3560626 TI - [Angina of effort as an unfavorable prognostic factor]. AB - A seven-year prospective study of a random 10% sample of a population of 50- to 59-year-old males from one municipal district in Moscow is reported. Mortality was reviewed among patients with complicated angina pectoris, i.e. those exhibiting other coronary symptoms as well, and among patients with uncomplicated angina as the primary and only sign of coronary heart disease (CHD). At long-term follow-up, the diagnosis of both varieties of angina is associated with aggravated vital prognosis. Some correlations between CHD risk factors and mortality are presented for both groups of anginal patients. PMID- 3560628 TI - [Evaluation of the efficacy of verapamil and nifedipine as long-term crossover therapy with individually selected doses in ischemic heart disease. Work Group for the Cooperative Study of Antianginal Preparations (SCAP)]. AB - Paired bicycle ergometric tests are an adequate means for the selection of an antianginal agent to be used on a long-term basis in anginal patients. It allows to choose the most effective type of antianginal medication out of three major groups (the nitrates, calcium antagonists and beta-adrenoblockers) and determine the dose and regimen of administration that would be optimum for an individual patient. Teh efficiency of verapamil and nifedipine was similar during long-term treatment with individually-selected doses in those cases where calcium antagonists were found to be preferable. Administration regimens of the two drugs were, however, somewhat different. PMID- 3560627 TI - [Epidemiologic and preventive studies of the precursors of atherosclerosis in children and adults]. AB - A total of 1920 schoolchildren of both sexes were examined at 12 to 13 years of age, with a follow-up of 242 children showing elevated BP and a random normotensive sample of 230. A set of features was identified that showed the greatest predictive value with respect to mean BP at five years' follow-up: baseline BP, the Katle index, the magnitude of the S wave and heart rate. A study of possible approaches to the prevention of atherosclerotic precursors in eleven year-olds has been launched, with the action on certain risk factors, such as limited physical activity, elevated BP, smoking, excessive body weight lipid disorders (in boys only). PMID- 3560629 TI - [Effect of multifactorial sanatorium-based preventive measures on excessive body weight]. AB - The effects of various procedures and behavior patterns on excessive weight loss are demonstrated in males between 40 and 59 years of age in the course of a program carried out on a standard protocol at 15 sanatoria. The best effect was produced where medical recommendations on diet adjustment were followed strictly, as the reduction of caloric intake was more efficient here, as compared to other diets or exercise. Relative preventive effect was higher, after the same preventive procedures, in individuals with marginal obesity, as compared to those with marked obesity. PMID- 3560630 TI - [Method of quantitative evaluation of functional status and its dynamics among patients with ischemic heart disease during treatment at the Palanga health resort]. AB - The evaluation of functional status of coronary patients has been made by means of a computerized numerical scoring system, using the results of clinical examination, functional cardiovascular and cerebrovascular tests, and psychosocial tests. The effectiveness of rehabilitation and secondary preventive programs for coronary patients treated at a health resort are rated on the basis of a difference between their functional status at the starting and finishing points of the program, as well as the resulting functional status after the program is over. PMID- 3560631 TI - [Efficacy of a graded plan for long-term prevention using antihypertensive drugs. Work Group for the Cooperative Study for the Testing of New Preparations for the Prevention of Arterial Hypertension (CSPPAH)]. AB - Data on the efficiency of stepwise long-term preventive medication with antihypertensive agents are presented. The stepwise regimen of antihypertensive medication produced at least a short-term hypotensive effect (more than month) in 93.5% of patients within 1 year, with complete arterial BP normalization in 67.7% and partial effect in another 25.8%. Stable effect (more than 6 months) was however achieved in 1/5 of patients only. Side effects associated with this regimen were seen in 19.4% of patients. Since the effect persisted for more than 2 months in 52.6% of patients only, and was only stable (over 6 months) in one fifth, follow-up examination of patients with arterial hypertension should be made at least once a month to allow assessment of the efficiency and safety of medication. PMID- 3560632 TI - [Secondary prevention of arterial hypertension in an organized population: methods of implementation, efficacy, prospects]. AB - Five-year follow-up of an organized population of males between 35 and 54 years of age and medication of patients with arterial hypertension (AH) demonstrated possibilities of considerably reducing the incidence of cerebral insult (by 42.9%) and myocardial infarction (by 15.5%) and the respective mortality rates (by 56.1% and 23.8%), invalidism associated with cardiovascular diseases (by 36%), temporary disability because of AH (by 38.2%). The efficiency of treatment for AH increases considerably where medication is given on a regular basis. Possible approaches to improving the efficiency of secondary AH prevention within an organized population are discussed, as are possibilities of introducing preventive measures in routine work of the factory therapeutic service. PMID- 3560633 TI - [Prospective epidemiologic study of arterial hypertension in an organized male population]. AB - The effect of active arterial-hypertension preventive programs on the epidemiologic situation was studied over a nine-year period, 1977 through 1985. In the first five years, the number of effectively treated cases increased, while essential hypertension morbidity associated with temporary disability diminished, as did mortality and the incidence of myocardial infarction and cerebral accidents among 40- to 54-year-old male industrial workers. After an active preventive program was abandoned at one factory, the parameters examined deteriorated considerably, and a sample selected for comparison showed an abrupt drop in treatment efficiency within three years after annual screenings were discontinued. PMID- 3560634 TI - [Predicting the dynamics of elevated arterial pressure in 12--13-year-old children of Kaunas and Berlin]. AB - The increased arterial blood pressure (BP) variation between 12-13 and 15-16 years of age was examined in 119 schoolchildren of Kaunas and 169 schoolchildren of Berlin. The 90th percentile for systolic and/or diastolic BP was used as a criterion of increased arterial BP. The data were treated by multivariate logistical regression analysis. Independent samples were used to construct and test the model. The reproducibility of increased arterial BP was shown to be affected by physical developmental status as well as baseline systolic and diastolic BP, the influence being more pronounced in girls, as compared to boys. The derived formulas are presented as a nomogram to facilitate their practical application. PMID- 3560635 TI - [Personality traits of persons with borderline arterial hypertension and patients with essential hypertension]. AB - A study of 402 individuals with marginal arterial hypertension (MAH) and patients with essential hypertension (EH), stages 1, 2 and 3, demonstrated a variety of psychopathologic syndromes (hypochondria, anxiety, hysteria, depression, cardiophobia) in 52.8, 77.3, 82.5 and 80%, respectively. Specific personality features have been identified as pertaining to MAH (hyperthymism, sthenism, demonstrativeness, psychasthenia) and EH (psychasthenia, intraversion, cycloidy). PMID- 3560636 TI - [Laser angioplasty combined with ileo-femoro-popliteal shunting]. PMID- 3560638 TI - [Tetrad of Fallot associated with patent common atrioventricular canal]. PMID- 3560637 TI - [Combination of atrioventricular nodal and sinoatrial reciprocal paroxysmal tachycardias]. PMID- 3560639 TI - Plasma and urinary catecholamines as related to renal function in man. AB - To assess the relationship between renal plasma flow (ERPF) or glomerular filtration rate (GFR) and the levels of norepinephrine (NE) or epinephrine (E) in plasma or urine in the presence of progressive degrees of non-oliguric renal functional impairment, these variables were assessed simultaneously in 18 normal subjects, 72 with parenchymal kidney disease and 14 with essential hypertension. ERPF and GFR were lower (P less than 0.01 to 0.001) in the groups with renal disease (mean +/- SD, 340 +/- 230 and 68 +/- 43 ml/min/1.73 m2, respectively) or essential hypertension (434 +/- 101 and 97 +/- 25 ml/min/1.73 m2) than normal subjects (597 +/- 133 and 118 +/- 14 ml/min/1.73 m2). Plasma and urinary NE and E did not differ significantly among groups and were unrelated with ERPF or GFR (range 4 to 160 ml/min/1.73 m2), except for reduced (P less than 0.001) urinary NE and E excretion in the presence of a GFR less than 20 ml/min. Subgroups with renal disease and a normal (N = 39) or high blood pressure (N = 33) also were comparable in their plasma and urinary NE and E, while ERPF and GFR tended to be lower in hypertensive patients. It is concluded that a chronic reduction in excretory kidney function may have no relevant impact on circulating levels of NE and E per se, although their urinary excretion falls distinctly at the stage of advanced renal failure. These aspects deserve consideration when pathogenetic or diagnostic studies of catecholamines are performed in normotensive or hypertensive patients with impaired kidney function. PMID- 3560640 TI - The hypercalcemia of malignancy. AB - The hypercalcemia of malignancy is mediated by complex and heterogeneous mechanisms. Once thought of as a simple paraneoplastic syndrome mediated by the effects of tumor production of PTH, it is now clear that multiple mechanisms are involved and that these mechanisms involve abnormalities in calcium transport in bone, kidney, and gut. Calcium homeostasis in normal individuals is complex and tightly regulated. Although much has been learned over the last 20 years about the effects of individual hormones on target organs, much remains to be understood about how these hormonal systems interact to control extracellular fluid calcium. Future studies on disturbances in calcium homeostasis, such as that occurring in association with malignant disease, should do much to clarify how these complex hormonal mechanisms function in the normal individual. PMID- 3560642 TI - Abstracts. American Society of Nephrology. December 7-10, 1986, Washington, DC. PMID- 3560641 TI - Parathyroid response to aluminum in vitro: ultrastructural changes and PTH release. AB - The endocrine response of porcine parathyroid gland tissue slices in vitro to aluminum was studied by electron microscopy and radioimmunoassay of PTH. Medium aluminum concentrations were 20 to 500 ng/ml covering the range corresponding to concentrations reported in the plasma of aluminum-intoxicated hemodialyzed patients. Aluminum inhibited iPTH-release and caused severe cell alterations. This inhibition was incomplete and there was an aluminum-insensitive iPTH-release capacity. This phenomenon seemed to be due to heterogeneous parathyroid cell population as regards aluminum sensitivity, perhaps linked to the spontaneous asynchronous cyclic parathyroid cell changes. Sensitivity to aluminum was modulated by the extra-cellular calcium concentration. Sensitivity to extra cellular calcium concentration variations persisted in aluminum intoxicated tissues. The severity of the observed cell lesions induced by high concentrations of aluminum suggested that the recovery of an iPTH-release capacity when parathyroid tissue was withdrawn from a toxic environment and switched to aluminum-free media is more likely to be due to activation of a "less-sensitive to aluminum" cell pool than to a true reversibility of the toxic effect. PMID- 3560643 TI - Glomerulonephritis induced in sheep by immunization with human glomerular basement membrane. AB - The specificity of the anti-glomerular basement membrane (GBM) antibodies in experimental nephritis in sheep (Steblay's nephritis) was studied and compared with the specificity of antibodies in human anti-GBM nephritis (Goodpasture's syndrome). Sheep were injected monthly with isolated human GBM and antibody reactivities with isolated human and sheep GBM proteins were quantified with ELISA. Expectedly, the sheep had high titers of antibodies against several human GBM antigens. These antibodies remained for the most part in the circulation. In contrast, circulating antibody levels against sheep GBM antigens remained low for a long period of time, but a significant and progressive increase coincided with the development of acute nephritis. These antibodies accumulated in the kidneys of the nephritic sheep and could be eluted from diseased kidneys. They represent auto-antibodies immunologically cross-reacting with antigens of both sheep and human GBM. The specificity of auto-antibodies eluted from the kidneys was analyzed by immunoblotting and ELISA. The major populations reacted with one subunit, termed M2, of the globular domain of collagen IV. The same subunit contains the major antigen in Goodpasture's syndrome. It is concluded that the M2 subunit of the globular domain of collagen IV is recognized by IgG antibodies that primarily bind to the glomerular basement membrane in both Steblay's nephritis and Goodpasture's syndrome, indicating that it is a main nephritogen in both diseases. PMID- 3560644 TI - Verapamil protects against progression of experimental chronic renal failure. AB - Chronic administration of verapamil (Ver) decreases nephrocalcinosis and tubular ultrastructural abnormalities in the remnant model of chronic renal disease. In the present study, the effect of chronic Ver administration on renal function, renal histology and mortality after subtotal nephrectomy was examined. Fourteen days after staged subtotal nephrectomy rats were paired according to renal functional impairment, mean arterial pressure (MAP), and body weight. Rats were pair fed and received either Ver (0.1 micrograms/g sc bid, N = 10) or saline (0.1 ml sc bid, N = 10) for up to 23 weeks. Both members of each pair were sacrificed shortly before the uremic death of controls. At sacrifice, rats treated with Ver had a lower serum creatinine (2.29 vs. 2.99 mg/dl, P less than 0.05) and a higher creatinine clearance (318 vs. 164 microliters/min, P less than 0.05) than controls. In a second experiment, survival was superior in rats treated with Ver than in controls from week seven (P less than 0.0025 by week 14). Serum creatinine was higher at week 10 in control rats (1.68 vs. 1.10 mg/dl, P less than 0.05). MAP was no different between the two groups, irrespective of the time between Ver administration and the measurement of MAP. Histological damage and nephrocalcinosis were worse, and renal and myocardial calcium content was higher in controls. In conclusion, independent of any effect on systematic MAP, chronic administration of Ver protects against renal dysfunction, histological damage, nephrocalcinosis and myocardial calcification, and improves survival in the remnant model of chronic renal disease. PMID- 3560645 TI - The anionic sites at luminal surface of peritubular capillaries in rats. AB - Anionic sites have been demonstrated in the basement membranes of peritubular capillaries. The anionic barrier function of peritubular capillary wall has been ascribed to these sites. Fenestrated capillaries in other organs have anionic sites in the endothelial cell glycocalyx and at the luminal surface of the fenestral diaphragms. The purpose of this study was to map anionic sites at the luminal surface of peritubular capillaries and to assess whether a concentration gradient for albumin exists across the endothelium. Partial chemical characterization of these anionic sites was done by in vivo enzymatic degradation. The difference in distribution of albumin following enzyme digestion was also studied. The binding of cationized ferritin to the luminal surface indicated that the rat peritubular capillaries have anionic sites along the entire luminal surface of the endothelial cell, including the fenestral diaphragms. Partial biochemical characterization of these sites shows that the sites in the glycocalyx are mainly from neuraminic acid, while the fenestral diaphragms have mainly heparan sulfate proteoglycans. Intravascular albumin extended to the endothelial luminal plasmalemma and to the luminal surface of fenestral diaphragms. Digestion with heparitinase was associated with the leakage of albumin outside the capillary wall. These findings suggest that the anionic surface of fenestrae constitutes a charge barrier of the peritubular capillaries. PMID- 3560646 TI - The contribution of vascular obstruction to the functional defect that follows renal ischemia. AB - Experiments were performed on rats subjected to renal ischemia and various treatment procedures to determine the origin and functional consequences of vascular obstruction. To this end, its occurrence and severity was assessed qualitatively and quantitatively in the outer medulla, where it is particularly prominent. The incidence of medullary hyperemia was not influenced by inhibiting thrombocyte aggregation with 5 or 70 mg/kg of acetyl salicylic acid or preventing fibrin deposition with 100 IE/kg of heparin before ischemia, and these substances produced no improvement renal function. The incidence and degree of hyperemia, however, could be substantially reduced or completely eliminated by acutely raising blood pressure after ischemia or by decreasing the number of circulating erythrocytes before ischemia. These procedures were effective in raising filtration rate and tubular reabsorption from 20% to 60% of normal, in restoring renal blood flow and vascular resistance to completely normal, and in diminishing epithelial damage both three and 18 hours after ischemia. The following conclusions are drawn: first, vascular obstruction, which is not lessened by inhibiting thrombus formation but is easily reversed or prevented by raising perfusion pressure or decreasing hematocrit, is probably caused by erythrocyte aggregation during ischemia. Second, vascular obstruction, which appears to raise renal vascular resistance and lower blood flow and filtration rate, cannot be limited to the medulla but must also be present in the cortex. Finally, reversing or preventing vascular obstruction can fully restore renal perfusion, partially restore glomerular and tubular function, greatly reduce tubular necrosis and thus prevent renal failure. PMID- 3560647 TI - Spermine and spermidine are non-specific inhibitors of in vitro hematopoiesis. AB - The polyamine spermine has been reported to be the inhibitor of in vitro erythropoiesis present in uremic serum. We have employed a panel of hematopoietic colony-forming assays to evaluate the specificity of the inhibitory activity. Spermine and its precursor spermidine when added to culture inhibited mouse and human erythroid (CFU-E and BFU-E), granulocyte-macrophage, and megakaryocyte colony growth in a non-specific, dose-dependent fashion. Erythroid and non erythroid colony growth were equally sensitive to spermine- and spermidine induced inhibition. Increasing concentrations in culture of erythropoietin and mitogen-stimulated leukocyte-conditioned medium, a source of colony-stimulating activity, failed to overcome the in vitro inhibition. Although anemia is characteristic of chronic renal failure (CRF), leukopenia and thrombocytopenia are not. Therefore, we conclude that the non-specific inhibitory activity of spermine and spermidine, as defined by in vitro colony assays, is either of no pathophysiologic significance in the anemia of CRF, or else there are unrecognized repair mechanisms in vivo which maintain granulopoiesis and thrombopoiesis at normal levels. PMID- 3560648 TI - Relation between renal calcium content and renal impairment in 246 human renal biopsies. AB - Tissue calcium content from 246 diagnostic human renal biopsies was measured to assess whether elevated tissue calcium concentration could be demonstrated to exist early during the course of human renal disease or was only a manifestation of advanced renal impairment. Renal calcium content correlated significantly with serum creatinine (r = +0.23, P less than 0.001, N = 246); serum phosphate P less than 0.001, N = 169) but not with serum calcium (r = -0.10, P greater than 0.1, N = 193). Fivefold greater calcium content was measured in biopsied patients with normal renal function than in normal postmortem renal tissue (35.7 +/- 5.2 vs. 7.6 +/- 0.7 mgCa/100 g wet renal tissue, P less than 0.001). Those biopsied patients with significant functional impairment (SCr greater than 1.5 mg/dl) had a higher mean level of serum phosphorus and serum [Ca] X [P] product than patients with normal renal function (5.19 +/- 0.22 vs. 3.92 +/- 0.11 mg P/dl and 44.8 +/- 1.8 vs. 35.7 +/- 1.2 mg2/dl2, respectively), and slightly higher renal calcium content (85.3 +/- 32.2 vs. 35.7 +/- 5.2 Ca/100 g wet renal tissue, P = 0.06), which correlated with histologic calcium deposition (r = +0.52, P less than 0.02, N = 20). These findings are consistent with the hypothesis that renal calcium deposition begins early in the course of a variety of renal diseases and hence may play a secondary pathogenetic role that accelerates progression to chronic renal failure. Severity of renal calcium deposition is equally closely related to hyperphosphatemia and to the level of renal impairment. PMID- 3560649 TI - History of the urinary concentrating mechanism. PMID- 3560650 TI - [Results of a prospective study of the treatment of rhabdomyosarcoma in childhood]. PMID- 3560651 TI - [Leukocytes and erythrocytes in the urine of newborn infants]. PMID- 3560653 TI - [The von Bonsdorff test in childhood. Methodology and results in healthy children]. PMID- 3560652 TI - [Urodynamically controlled effect of propiverin on the function of the lower urinary tract in children with enuresis]. PMID- 3560654 TI - Comparative sensitivities of several diagnostic methods used to detect fish furunculosis. PMID- 3560655 TI - A comparative study of the nucleosomes of diffuse and condensed chromatin. PMID- 3560656 TI - Transovular transmission of Theileria sergenti in the tick, Haemaphysalis longicornis. PMID- 3560657 TI - Photochemical reaction of sulfur dioxide with hydrocarbon. PMID- 3560658 TI - [Introduction of scientific achievements into the practice of health care--the most important condition for the further improvement of surgical services to the population]. PMID- 3560659 TI - [Inadequate detoxification therapy as 1 of the reasons for mortality in diffuse peritonitis]. PMID- 3560660 TI - [Status of hepatic blood flow in peritonitis]. PMID- 3560662 TI - [Variants of the clinical course of sepsis]. PMID- 3560661 TI - [Experimental and clinical basis for lymphotropic antibiotic therapy in surgery]. PMID- 3560663 TI - [Complex treatment of suppurative-inflammatory diseases of the sacral region]. PMID- 3560664 TI - [Manifestations and treatment of anaerobic non-clostridial infections in patients with diabetes mellitus]. PMID- 3560665 TI - [Objective assessment of the severity of the condition of patients after intraperitoneal surgical procedures]. PMID- 3560666 TI - [Circulation of conditionally-pathogenetic bacteria in a surgical hospital]. PMID- 3560667 TI - [Viral hepatitis B among surgical personnel]. PMID- 3560668 TI - [Comparative efficacy of the endolymphatic and intramuscular methods of administering ampicillin in experimental peritonitis]. PMID- 3560669 TI - [Cyto- and biochemical characteristics of the course of experimental peritonitis]. PMID- 3560670 TI - [Complex iodopyrone-based preparations in the prevention and treatment of wound infections]. PMID- 3560671 TI - [Comparative evaluation of the healing of skin wounds inflicted with plasma and steel scalpels and the electric knife]. PMID- 3560672 TI - [Effect of collagen sponges on the healing of gunshot wounds in experimental animals]. PMID- 3560673 TI - [Guided peritoneostomy in the complex treatment of patients with diffuse purulent peritonitis]. PMID- 3560674 TI - [Ultrastructural changes in the peritoneum after treatment with low-frequency ultrasound]. PMID- 3560675 TI - [Determination of the viability of mechanically injured muscle tissue]. PMID- 3560676 TI - [Evaluation of the relation between oxygen, hemodynamics and metabolism in the toxic stage of acute diffuse suppurative peritonitis]. PMID- 3560677 TI - [Use of perfusion of the lymphatic system in surgical clinical practice]. PMID- 3560678 TI - [Tissue electrophoresis in the complex treatment of suppurative-necrotic processes in the soft tissues]. PMID- 3560679 TI - [Use of papain with dimexide and furacillin in the treatment of suppurative wounds]. PMID- 3560680 TI - [Use of a dressing material with immobilized papain]. PMID- 3560682 TI - [Laser therapy in the treatment of suppurative postoperative wounds]. PMID- 3560681 TI - [Effect of mumie on the healing of suppurative wounds]. PMID- 3560683 TI - [Regional perfusion with oxygenation of the blood in an animal in the treatment of patients with post-traumatic osteomyelitis of the lower extremities]. PMID- 3560684 TI - [Use of an electric field to reduce the contamination of operating room air with aerosols]. PMID- 3560685 TI - [Is the use of corticosteroids in suppurative surgery wise?]. PMID- 3560686 TI - [Method of extracorporeal connection to the spleen of a swine]. PMID- 3560687 TI - [Anaerobic gas infection after an injection]. PMID- 3560688 TI - [A complication of catheterization of the subclavian vein]. PMID- 3560689 TI - [Rare variants of catheter position after catheterization of the right internal jugular vein]. PMID- 3560690 TI - [Rare localization of an intra-abdominal abscess]. PMID- 3560691 TI - [Role of the leukocyte poisoning index in evaluating the severity of endotoxicosis in sepsis]. PMID- 3560692 TI - [Moist gangrene of the breast]. PMID- 3560693 TI - [Effect of ultraviolet irradiation of the blood on the status of immunologic reactivity and nonspecific immune factors in patients with suppurative surgical infections]. PMID- 3560695 TI - [Association of disseminated pulmonary tuberculosis with specific involvement of the sternoclavicular joint and clavicle complicated by a tuberculous abscess and fistulae]. PMID- 3560694 TI - [Regional antibiotic therapy of erysipelatous inflammation]. PMID- 3560696 TI - [A rare postoperative complication]. PMID- 3560697 TI - [Hemostasis during surgery on parenchymatous organs]. PMID- 3560698 TI - [Splenic cysts of great size]. PMID- 3560699 TI - [Technic for a retroperitoneal approach to the abdominal portion of the aorta and iliac arteries]. PMID- 3560700 TI - [Changes in the concentration of biogenic amines after hemosorption of patients with peritonitis]. PMID- 3560701 TI - [The problem of integrity in the diagnostic process in surgery]. PMID- 3560702 TI - [Use of hyperoxygenated solutions in patients with bronchial asthma]. PMID- 3560703 TI - [Blood reinfusion in the surgical treatment of suppurative diseases of the lungs and pleura]. PMID- 3560704 TI - [Repeat esophagoplasty in reconstructive surgery of the esophagus]. PMID- 3560705 TI - [Current complex diagnosis of diffuse alveococcosis of the liver]. PMID- 3560707 TI - [Acid-secretory function of the gastric stump in post-gastrectomy peptic ulcers of the jejunum]. PMID- 3560708 TI - [Clinico-phlebographic forms of varicose veins of the lower extremities]. PMID- 3560706 TI - [Results and prospects of improving services for patients with acute surgical diseases of the abdominal organs]. PMID- 3560709 TI - [Classification of lesions of the collateral network of the femoro-popliteal segment for the selection of surgical tactics]. PMID- 3560710 TI - [Microflora of suppurative foci of foot lesions in patients with diabetic angiopathy]. PMID- 3560711 TI - [Lymphotropic antibiotic therapy]. PMID- 3560713 TI - [Is it necessary to remove polyps of the large intestine?]. PMID- 3560712 TI - [Status of nonspecific humoral immunity in endolymphatic antibiotic therapy of surgical infection]. PMID- 3560714 TI - [Diagnosis and treatment of postoperative peritonitis]. PMID- 3560715 TI - [Relaparotomy in emergency surgery]. PMID- 3560716 TI - [Complications after specific prevention of tetanus]. PMID- 3560717 TI - [A method of selective proximal vagotomy]. PMID- 3560718 TI - [Surgical treatment of post-burn contracture of the shoulder]. PMID- 3560719 TI - [Spontaneous internal biliary fistulae]. PMID- 3560720 TI - [Hemoperfusion through a mixture of living donor hepatocytes in the treatment of severe hepatic failure]. PMID- 3560721 TI - [Dilatation of strictures of the terminal portion of the common bile duct]. PMID- 3560722 TI - [Microsurgery during pancreatic resection (experimental study)]. PMID- 3560723 TI - [Fat emulsions and heparin in the treatment of acute pancreatitis]. PMID- 3560724 TI - [Embolization of branches of the portal vein in the treatment of portal hypertension]. PMID- 3560725 TI - [Pancreatoduodenal resection in a patient who had sustained diffuse peritonitis and pancreatic necrosis]. PMID- 3560726 TI - [Occlusion of the duct system of the pancreas in acute pancreatitis]. PMID- 3560727 TI - [Surgical treatment of congenital dilatation of the pancreatic duct with calculus formation]. PMID- 3560728 TI - [Spontaneous rupture of the gallbladder complicated by intraabdominal hemorrhage]. PMID- 3560729 TI - [Transduodenal papillosphincterotomy]. PMID- 3560730 TI - [Diseases of the neck and duct of the gallbladder]. PMID- 3560731 TI - [Treatment tactics in reoperations on the biliary tract]. PMID- 3560732 TI - [Emphysematous cholecystitis]. PMID- 3560733 TI - [Is organ-sparing surgery permissible in cholelithiasis?]. PMID- 3560734 TI - [Antibacterial therapy of acute cholecystitis during decompression of the gallbladder]. PMID- 3560736 TI - [Surgical treatment of intrahepatic cholestasis]. PMID- 3560735 TI - [Treatment of patients with mechanical jaundice]. PMID- 3560737 TI - [Endoscopic retrograde cholangiopancreatoscopy]. PMID- 3560738 TI - [Combinations of cholelithiasis and urolithiasis]. PMID- 3560739 TI - [Antibacterial therapy of acute purulent cholangitis]. PMID- 3560740 TI - [Surgical treatment of cholelithiasis in uncorrected acquired heart defects]. PMID- 3560741 TI - [Experimental basis and initial clinical experience with the surgical treatment of diabetes mellitus]. PMID- 3560742 TI - [Intraoperative diagnosis and surgical tactics in cystic formations of the pancreas]. PMID- 3560743 TI - [Diagnostic value of gastric juice pH and beta-lipoprotein determinations in acute pancreatitis]. PMID- 3560744 TI - [Surgical treatment of secondary malignant tumors of the liver]. PMID- 3560745 TI - [Effect of inflammation and cholestasis on the metabolic function of the liver]. PMID- 3560746 TI - [Relation between age and the intrinsic topography of the portal and hepatic veins of the liver and its shape and size]. PMID- 3560747 TI - [Bilio-bronchial fistulae in patients with echinococcosis of the liver]. PMID- 3560748 TI - [The law regarding surgical operations]. PMID- 3560749 TI - [Results of a discussion on the problem of "acute cholecystitis"]. PMID- 3560750 TI - [Active diagnostic tactics for optimizing the treatment of acute cholecystitis]. PMID- 3560751 TI - [Diagnosis and treatment of hemorrhages from the pancreatic duct]. PMID- 3560752 TI - [The incidence of visually impaired drivers seen in ophthalmologic consultation]. AB - On the basis of a critical review by Dr. rer. nat. Bresser the calculation contained in the paper "Ophthalmological Experiences with Automobile Drivers with Inadequate Visual Acuity" is corrected. From the information on visits to the ophthalmologist contained in the study data, the average frequency of repeated visits can be worked out to 1.56. As a consequence, the average duration of unsuitable vision is 22.1 months. This results in a prevalence P = 360750. However, this figure can only apply to drivers who visit an ophthalmologist. According to a recent study based on a random sample of the population, the true number of drivers with unsuitable vision seems to be more than 4 times the figure quoted. PMID- 3560753 TI - [Weather influences on intraocular pressure in patients with chronic glaucoma or ocular hypertension]. AB - From January 1979 to August 1984 intraocular pressure (IOP) was measured on the first Friday of each month under comparable conditions (same instruments, nearly always the same examiner) in a total of 109 patients in whom a primary chronic open-angle glaucoma or ocular hypertension had been diagnosed: The IOP was correlated to the local weather parameters (atmospheric pressure, cloud cover, relative air humidity, mean, maximum and minimum temperature, precipitation, duration of sunshine, mean and maximum wind velocity). In the large number of measurements a significant correlation was found only between IOP and atmospheric pressure: IOP was lower when air pressure was high. There was only a suggestion of a significant correlation between IOP and relative air humidity. However, further statistical analysis revealed that in fact both atmospheric pressure and relative air humidity account for only a negligible part of the variation in IOP values. From a practical point of view, therefore, the IOP of patients with primary chronic open-angle glaucoma or ocular hypertension is not influenced by weather conditions. PMID- 3560754 TI - [Planimetric studies of the behavior of the visual field following glaucoma operations]. AB - This article presents the results of functional investigation of the central and peripheral visual fields of 30 patients 3 years after glaucoma surgery. The authors studied the relationship between intraocular pressure and the site of the visual field, and also between vision and the quality of the central visual field. The results of the investigation support the demand for early surgery in glaucoma cases. Patients should be advised and informed thoroughly, because in 36 percent of all cases the cataract grows postoperatively. PMID- 3560755 TI - [Cryocoagulation of the retina in retinopathy of prematurity]. AB - Of 246 systematically screened prematurely born infants, the majority with high neonatological risk, 12 developed a retinopathy of prematurity of at least Stage 3 according to the international classification of 1984, and underwent transconjunctival cryocoagulation. At a follow-up examination at age 6 months and later, there were no retinal changes apart from coagulation scars in 7 of the treated eyes; in 7 eyes slight connective tissue proliferations were seen (stage 1 cicatrization), in 4 eyes peripheral connective tissue proliferations with macula traction (stage 2 cicatrization), and stage 4 or 5 cicatrization in 2 eyes each. Five eyes were myopic, 2 of them severely so, and 4 eyes had a positive gamma angle. Unfavorable prognosis was indicated by a large avascular zone, preoperative stage 4, and early occurrence and rapid progression of retinopathic stages. PMID- 3560756 TI - [Significance of fundus evaluation in the staging of hypertensive disease compared to electrocardiography and renal circulation]. AB - In order to determine the relevance of ophthalmoscopic findings in cases of hypertension as compared to electrocardiographic abnormalities and disorders of the renal function, the authors examined 728 patients admitted to the German diagnostic Clinic (Wiesbaden) with hypertension over a period of 2 years. In all cases blood pressure was measured twice, and ophthalmoscopy, electrocardiography, a chest X-ray, and a laboratory checkup were performed. The effective renal plasma flow was measured in 100 cases using the 131 iodine-Hippuran clearance method. The results revealed that ophthalmoscopy is the most reliable method for classifying early and more advanced stages of hypertension, as compared to ECG and measurement of the effective renal plasma flow. PMID- 3560757 TI - [Ophthalmologic implants--a risk at high altitudes?]. AB - In the course of an experimental study typical ophthalmological implant materials were transported to altitudes of up to 48,000 feet. Spherical prostheses manifested practically no changes in volume, while scleral sponge material for detachment surgery released death bubbles during decompression. It is pointed out that less severe effects are likely to occur in this respect under clinical conditions, and likewise that the measured values are only of consequence for the patient in cases of rapid decompression. PMID- 3560758 TI - [Infantile cataract, hypertrophic cardiomyopathy and lactic acidosis following minor muscular exertion--a little known metabolic disease]. AB - Three children from two unrelated families were found to be suffering from a hitherto little-known disorder. Infantile cataract was the primary symptom at the age of 3 months, progressed quickly and necessitated surgery. At the same age, muscular hypotonia was prominent and delayed gross motor development. At preschool and school ages muscle strength and exercise tolerance were reduced, and slight muscular exercise caused marked lactic acidemia. Subsequently, hypertrophic cardiomyopathy was discovered by echocardiography, though with no signs of cardiac obstruction at that time. There were no neurological symptoms. Intellectual development was normal. The disorder is inherited as an autosomal recessive. It can be recognized from the combination of infantile cataract, muscular hypotonia, cardiomyopathy, and lactic acidosis, which, however, must be looked for carefully. Early diagnosis is mandatory for genetic counseling. The ophthalmologist holds the key to diagnosis. PMID- 3560759 TI - [Proceedings of the 35th Congress of Polish Ophthalmologists. Katowice, 23-25 September 1985. I]. PMID- 3560760 TI - [Neurenteric cyst of the mediastinum--case report and review of the literature]. AB - A case of an infant with a mediastinal neurenteric cyst is used to review this rare entity. By definition a neurenteric cyst is the combination of an entodermal cyst with a vertebral dysplasia. Neurenteric cysts are located in the posterior mediastinum, preferentially on the right side. In a third of the patients these cysts are associated with malformations of CNS a./o. GI tract. They occur predominantly in males. The symptoms of a mediastinal mass usually become obvious during the first months of life. The therapy of choice is complete resection. PMID- 3560761 TI - [Local recurrence of mediastinal non-Hodgkin lymphomas in childhood]. AB - Local relapses in mediastinal non-Hodgkin's lymphomas in childhood are rare. Of the 15 children treated in our hospital during the last 11 years, 2 had early local or pleural relapses. At presentation both had extensive pleural effusions, and after completion of induction therapy still some fluid in the pleural space was present. A local irradiation was not performed initially. Be review of the literature for risks and benefit of local irradiation in mediastinal non Hodgkin's lymphoma, local irradiation in children receiving aggressive chemotherapy should only be considered in few patients; preferentially in those, with incomplete disappearance of the mediastinal tumor or, as we may conclude from our patients, incomplete disappearance of pleural effusion. PMID- 3560762 TI - [Ependymoma with cervical lymph node metastases]. AB - The authors report a case of an ependymoma in which metastases in cervical lymph nodes appeared four and a half years after diagnosis and operation. The primary tumor, an ependymoma grade I (WHO) in the left occipital region, had been completely resected and irradiated. Beside metastases in the cervical lymph nodes, several recurrences in the primary region and multiple metastases to the spinal canal had occurred. PMID- 3560763 TI - [Image quality and radiation exposure of chest x-rays in childhood]. AB - Chest X-rays are the most commonly performed pediatric X-ray examinations, accounting for 50% of all films. Therefore, any change in radiological technique is bound to affect many patients. In the study reported here, image quality was visibly and measurably improved and the radiation dose lowered at the same time, by employing the slit technique for chest X-rays first described by Pasche in 1903. PMID- 3560764 TI - [Determination of C-reactive protein in serum using a fluorescence polarization immunoassay--comparison with the method of kinetic nephelometry (KNM)]. AB - The determination of CRP in serum was performed by the fluorescence polarization immunoassay (FPIA) and the kinetic nephelometry (KNM). Both methods showed a good precision and accuracy. The investigation was carried out in 190 sera with a CRP concentration up to 49 mg/dl. The comparison of the two methods in 100 sera with a CRP concentration between 0.6 and 5 mg/dl showed a good correlation (correlation coefficient r = 0.9753). Close correlation (correlation coefficient r = 0.9947) was also found in 90 sera with a CRP concentration between 5 and 49 mg/dl. Discussion of the FPIA and KNM methods. PMID- 3560765 TI - [Pregnancy and labor in 12 to 14-year-old girls]. AB - This retrospective study reports on the course of pregnancy and delivery in 12- to 14-year old girls during a period of 8 years. At the time of delivery 44 mothers (0.3%) out of 13,178 had not finished their 15th year; this adolescent primiparae were compared to a group of equal size including primiparae between 20 and 30 years of age. Whereas other studies report a higher risk of several pregnancy-related complications, our investigation mainly found a higher percentage of premature deliveries (13.6%). A significantly shorter duration of pregnancy resulted in lower birth weights in the adolescent group. Furthermore we noted a higher frequency of pyelitis gravidarum in this group. Operative delivery had to be performed in 9.1% of the cases (3 X cesarean sections, 1 X forceps), compared to 13.6% in the control group (3 X cesarean sections, 3 X forceps). In the adolescent group no other obstetric complications occurred; whereas a higher incidence of puerperal infections (endometritis) was noted. 26 adolescent mothers were foreigners of southern European descendence; in only 8 cases the putative father was notified; a third of the young mothers decided to enter their child in the state adoption program. PMID- 3560766 TI - [Respiratory failure in a newborn infant following repeated sedation for computerized tomography]. AB - In very young pediatric patients, computed tomography can only be performed successfully after adequate immobilization with sedatives. The special age- and maturity-related features of the premature and neonatal period have to be considered when selecting the drug and the form of administration. Oral, intramuscular, or rectal premedication cannot be recommended for CT sedation of premature and newborn children. Likewise, multiple or repeated medication with different forms of administration should be avoided. A case report of a newborn with respiratory arrest following repeated sedation for computed cranial tomography illustrates the risks associated with such measures. Recommendations concerning drugs and procedure for the sedation of high-risk neonates for CT examinations are given. PMID- 3560767 TI - [Cohen syndrome in 2 brothers]. AB - A new familiar observation of Cohen syndrome in two brothers is reported. A patient exhibited the typical features of the disease, i.e. obesity, mental retardation, hypotonia, limb abnormalities and a characteristic craniofacial appearance. The frequency of clinical signs is reviewed from all the published reports. PMID- 3560768 TI - [Oligosymptomatic celiac disease--axis correction of extreme genu valgum with a gliadin-free diet]. AB - We report on a girl who suffered from a severe left-sided Genu valgum. As there was a remarkable deterioration despite a conservative orthopedic therapy on osteotomy was planned. However, preoperative investigations revealed a malabsorption syndrome with osteomalacia due to coeliac disease. This gliadin sensitive enteropathy had already been diagnosed and treated in infancy but had been ignored, since no abdominal symptoms had occurred after re-introduction of normal food. Four years after start of gliadin-free diet the false position of the left leg had disappeared and an operative correction had not to be performed. PMID- 3560769 TI - [Fetal and neonatal ascites: a report of 15 cases and a review of the literature]. AB - Fifteen patients with non-immune fetal or neonatal ascites and absence of generalized edema are described. Nine patients were diagnosed prenatally. Nine patients were preterm. Artificial ventilation was necessary in twelve infants immediately after birth. In five cases, including two cases of transitory ascites, the etiology could not be established. In accordance with previous reports, we found the following underlying disorders in our patients: urinary tract obstruction, polycystic disease of the kidneys, chylous ascites, sepsis, intrahepatic atresia of the biliary ducts, hepatic and renal failure following severe asphyxia. 8 out of 15 patients died. A survey of the literature shows a variety of underlying disorders. Therefore, several diagnostic tests are necessary, in order to identify the etiology. Causative treatment is possible in some cases of urogenital , gastrointestinal, infectious and chylous ascites. Sophisticated perinatal management is essential for the outcome of patients with fetal or neonatal ascites; nevertheless the mortality rate is still about 50%. PMID- 3560770 TI - International Symposium on Mechanisms of Cell Injury, Cytoprotection Organoprotection. Heidelberg, June 9-11, 1986. Proceedings. PMID- 3560771 TI - Gastroduodenal mucosal secretion of bicarbonate and mucus: physiological control and role in protection. AB - Bicarbonate secretion by the surface epithelium in the stomach and duodenum maintains a near neutral pH in the mucus gel adherent to the surface in spite of acidities as high as pH 2.0-3.0 in the gastric and pH 1.5-2.0 in the duodenal lumen. This strongly suggests that the alkaline secretion together with the mucus gel provides a first line of protection in the stomach and this may be the main mechanism of defense in the duodenum. The secretion is increased by physiological stimuli such as sham-feeding or the presence of acid in the lumen. Mucosal endogenous production of prostaglandins as well as humoral and neural mechanisms are involved in the control of the secretion. PMID- 3560772 TI - Experimental basis for a role for sulfhydryls and dopamine in ulcerogenesis: a primer for cytoprotection--organoprotection. AB - This brief review presents the evolution of the concept of cytoprotection which was originally described by Robert (1979) to represent prevention of chemically induced hemorrhagic gastric erosions without inhibiting acid secretion. Prostaglandins (PG) and sulfhydryls (SH) protect only against deep hemorrhagic necrosis in the mucosa without altering the initial damage to surface epithelial cells. Organ integrity and function are thus maintained (i.e., organoprotection) despite the loss of several layers of mucosal cells. While both PG and SH are natural products it must be stressed that only SH compounds can enter directly into protective reactions (e.g., free radical scavenging, modification of receptor SH groups, oxidation of certain structural and enzyme proteins). In addition, SH compounds also stimulate PG synthesis. A major target of gastroprotection by either PG or SH is the preservation of mucosal microvasculature to maintain blood flow for rapid restitution and cell proliferation. Dopamine-related compounds are reviewed because of their possible role in duodenal ulceration. Dopamine and dopamine agonists are antiulcerogens in duodenal ulcer models. Dopamine antagonists are proulcerogens and the dopamine neurotoxin MPTP causes duodenal ulcer in experimental animals. The mechanism of duodenal antiulcerogenic effect involves inhibition of gastric acid and pepsin secretion, stimulation of duodenal bicarbonate secretion, correction of duodenal dysmotility, and maybe increased blood flow. Because of their multiple beneficial effects, SH compounds and dopamine drugs are good models for gastroenteroprotection. PMID- 3560773 TI - Verapamil in the prevention of adriamycin-induced cardiomyopathy. PMID- 3560774 TI - Myocardial membranes, calcium, and cellular injury. PMID- 3560775 TI - Shock-induced alterations in hemostasis. AB - The major constituents of the hemostatic potential, i.e., platelets and the plasma factors of coagulation and fibrinolysis, guarantee the integrity of the vessel wall and provide effective hemostasis in case of vascular damage. The equilibrium between anticoagulant and procoagulant forces which is essential for the maintenance of the fluidity of blood is controlled by inhibitors, the fibrinolytic system, and the clearance of activated components by the reticuloendothelial system. The proper function of this humoral balance is essentially dependent on hemodynamic factors such as adequate circulation and capillary perfusion. PMID- 3560776 TI - Biochemical mechanisms of toxic cell injury. AB - The recent studies of the toxicity of the well known hepatotoxins bromobenzene and acetaminophen have suggested an alternative to covalent binding as the mechanism coupling mixed-function oxidation to lethal cell injury. Formation of activated oxygen species and the loss of GSH as a result of its conjugation with the electrophilic products of toxin metabolism may overwhelm cellular defenses and induce oxidative damage to cellular membranes and resulting necrosis. PMID- 3560778 TI - Clinical aspects of fluid transport and vascular permeability in the lung. PMID- 3560777 TI - Metabolism of the thyroid hormones with respect to cytoprotection. PMID- 3560779 TI - Gastroprotection by antisecretory and non-antisecretory agents. PMID- 3560780 TI - Cytoprotection and prostaglandins. AB - Among substances producing gastrointestinal cytoprotection, prostaglandins are the most potent. They protect the mucosa after either exogenous administration or stimulation of endogenous release by the stomach. The first type is called "direct" cytoprotection, and the second "adaptive" cytoprotection. Certain agents are cytoprotective by a mechanism other than endogenous formation of prostaglandins. Depletion of the gastrointestinal tract of prostaglandins by administration of nonsteroidal antiinflammatory compounds or corticosteroids can lead to ulcer formation. The mechanism of cytoprotection is unknown. It may involve stimulation of bicarbonate and mucus secretion, protection of the gastric mucosal barrier, and increase in mucosal phospholipid surfactants, and maintenance in mucosal blood flow, increase in sulfhydryl agents or increase in cellular resistance. PMID- 3560781 TI - Fibronectin cell interaction. AB - Fibronectin is an adhesive protein which mediates the interaction of cells with matrix compounds. The protein consists of two subunits with domains exhibiting affinity for cell receptors as well as for extracellular structures. Fibronectin is involved in the phagocytosis of various substrates, either by mediating their cell recognition or by stimulating internalization. PMID- 3560782 TI - Protective effect of fibronectin in temporary liver ischemia: an experimental study. AB - Only 50% of rabbits survive 90 min hepatic ischemia in spite of decompression of the gut. The remainder die within 36 h after operation. A single application of fibronectin before hepatic ischemia delays death for only a few hours. However, three postischemic applications of fibronectin--immediately after operation and 5 h and 24 h later--are associated with a statistically significant rise in the survival rate. Analysis of the transaminases indicates that fibronectin obviously limits the extent of ischemic liver cell necrosis. Of major significance is the fact that fibronectin supplement enables the RES of the liver to improve its phagocytic capacity, as shown by the RES clearance test. The presented experimental model shows that the liver with its RES, located between the splanchnic and the systemic circulation, is of particular significance for the entire organism. Hepatic ischemia or shock, independent of the initial cause, leads to significant reduction of hepatic phagocytosis. The results indicate that substitution of opsonins supports the phagocytic capacity. PMID- 3560783 TI - New aspects of phalloidin poisoning. PMID- 3560784 TI - Cellular metabolic alterations in shock. AB - Circulatory shock is considered one of the most severe stimulus of the pituitary adrenal axis, therefore causing profound physiologic and metabolic sequelae. It is defined as inadequate circulating blood volume producing decreased perfusion first to nonvital tissues (skin, connective tissue, bone, and muscle), and subsequently to vital organs (brain, heart, lungs, liver, and kidney). Decreased perfusion of nonvital tissues results in anaerobic metabolism because the nonvital tissue cell mass is significantly larger than the vital tissue cell mass. As circulating blood volume decreases, catecholamines and angiotensin are secreted which increases peripheral resistance thus producing low flow in the periphery. Later, baroreceptors in the auricles and carotid and aortic bodies stimulate the vasomotor center in the medulla oblongata via the sympathetic nerves. The vasomotor center compounds sympathetic vasoconstriction further, increasing peripheral resistance. PMID- 3560786 TI - Biological markers and therapeutic outcome in alcoholic disease: a twelve-year survey. AB - The early diagnosis and evaluation of the biological consequences of alcohol abuse are reviewed in a population of 401 chronic alcoholics admitted to our Toxicological Unit from January 1973 to the end of December 1984; selected cases were treated with disulfiram implantation. The results of the study indicate that anemia with increased globular volume of erythrocytes, elevated serum gamma glutamyl-transferase activity, increased postprandial cholalemia, and increased elimination of pentane in the breath can be considered suitable markers for the early diagnosis of alcohol abuse. Disulfiram implantation significantly prolonged the abstinence duration in the treated patients. PMID- 3560787 TI - Thymic hyperplasia. I. True thymic hyperplasia. Review of the literature. AB - The condition of true thymic hyperplasia is defined as an increase of both size and weight of the gland while it maintains normal microscopic architecture. It occurs in three different clinicopathologic forms: True thymic hyperplasia without any other disease is extremely rare and only seven well documented examples could be found in a review of the literature. Enlargement of the thymus gland is reported as a form of rebound phenomenon in a number of conditions like recovery from severe stress situations, after administration of steroids, and after treatment of malignant tumors. Finally, thymic hyperplasia has been described in association with endocrine abnormalities, sarcoidosis, and Beckwith Wiedeman syndrome. PMID- 3560788 TI - [Treatment of hyperkinetic heart syndrome with alinidine and propranolol]. AB - A hyperkinetic heart syndrome has been diagnosed in 10 patients by clinical investigation and right-heart catheterization at rest and during exercise. Subsequently, the patients received 3 X 40 mg alinidine, and 2 X 40 mg propranolol and placebo, each for 2 weeks in a double-blind crossover study. Heart rate at rest (P less than 0.05) and during exercise (P less than 0.001) decreased significantly under alinidine and propranolol to the same extent (control, 83/170; alinidine, 68/146; propranolol, 73/139; placebo, 83/162 beats per min). Lower limb flow at rest and after exercise, measured by plethysmography, as well as left-ventricular fractional shortening and mean velocity of circumferential fiber shortening, measured by echocardiography, decreased insignificantly. Sedation and a dry mouth occurred in six patients under alinidine, while fatigue and cold hands and/or feet were reported by five patients under propranolol. Thus, alinidine may be used as an alternative to beta blocking in the treatment of the hyperkinetic heart syndrome. PMID- 3560789 TI - Excessive myocardial calcinosis in a chronic hemodialyzed patient. AB - Secondary oxalosis in chronic hemodialyzed patients is caused by impaired renal excretion and inadequate removal of oxalic acid during hemodialysis. Ascorbic acid is a precursor of oxalic acid. We report a parathyroidectomized patient with chronic renal failure, on hemodialysis, who received over a period of several months a total dose of 91.0 g ascorbic acid i.v. The plasma oxalic acid level in this patient was 14-fold higher than in healthy persons. Increased oxalic acid synthesis from its precursor ascorbic acid may be responsible for hyperoxalemia, high content of oxalic acid in myocardium, aorta and lung, and calcium oxalate deposition in soft tissues. Application of high doses of ascorbic acid should be avoided in hemodialysed patients with chronic renal failure. PMID- 3560785 TI - Analgesic-associated nephropathy. AB - Although the question of whether or not analgesic abuse leads to a certain type of nephropathy has been investigated since 1953, no conclusive answer has been forthcoming. Epidemiologic investigations on the correlation between analgesic abuse and renal function as well as experimental animal studies have given contradictory results concerning the possibility of analgesic-associated kidney damage. However, studies on the correlation between analgesic abuse and papillary necrosis have demonstrated that this lesion coincides in 69% of the cases with an analgesic history. Follow-up studies of patients with analgesic nephropathy have shown that renal function deteriorates in 60% of the patients with continued abuse and that it stabilizes in 80% of the patients after cessation of abuse. Studies on the legislative restriction of phenacetin/acetaminophen, carried out mostly in Scandinavian countries since 1965, show a 50%-90% decline in signs of analgesic nephropathy (papillary necrosis) following a reduction in the sale of these drugs. The prevalence of analgesic abuse may be underestimated, since up to 80% of the abusers tend to deny their analgesic intake. Obviously, only a small percentage of analgesic abusers (approximately 1%) finally develop nephropathy. Even though the results of epidemiologic and experimental studies are contradictory, the results of investigations on papillary necrosis and on legislative prevention as well as of patient follow-ups tend to indicate a correlation between analgesic abuse and a well-defined type of nephropathy. PMID- 3560791 TI - Evidence of in vivo iodine-induced hyperthyroidism in hyperfunctional autoimmune and autonomous human thyroid tissue xenotransplanted to nude mice. AB - The effect of different doses of continuous iodine infusion on xenotransplanted human thyroid tissue from toxic adenoma, and Graves' disease was examined using 131I scintigraphy in athymic nude mice. In spite of pretreatment with high iodine doses (1.25 micrograms or 12.5 micrograms 131I per day via i.p. implanted minipumps, Alzet 2002), the radioactivity localized in the transplanted tissue of toxic adenoma was more than 50% of the radioactivity in the transplants of the controls without iodine pretreatment 2 h after 131I injection, which was not a significant difference. Moreover, after high iodine treatment the 131I turnover rate in the thyroid transplants of toxic adenoma increased significantly. A tendency to an increased turnover rate was already observed with the lower dose. In contrast to that the transplants of Graves' disease tissue and mouse thyroids responded to high iodine treatment with a significant decrease in 131I retention. Serum of an untreated patient with active Graves' disease or injections of TSH increased 131I retention and the 131I turnover rate in the transplanted tissue of Graves' disease significantly (P less than 0.01). Iodine turnover was still increased after high iodine treatment. These results again show that thyroid tissue of toxic adenoma remains hyperfunctional after transplantation to athymic nude mice in contrast to thyroid tissue of Graves' disease which loses all signs of hyperfunction, when no exogenous stimulator is administered. In addition, these data clearly demonstrate, for the first time under in vivo conditions, that high iodine doses accelerate iodine turnover and thus presumably hyperfunction of human toxic adenoma in a dose-dependent manner as well as of the activated thyroid in Graves' disease. PMID- 3560792 TI - [Clinical aspects of Osler-Rendu disease]. PMID- 3560793 TI - [Lyell's syndrome]. PMID- 3560790 TI - [Is the increase in brain volume of abstinent alcoholics a sequela of rehydration?]. AB - A group of 30 alcoholics as identified using the MALT score were examined both within the first 36 h of alcohol withdrawal and then again at the end of a 10-day treatment in hospital. We looked for clinical signs of dehydration, water and electrolyte imbalance, and concentration of steroid metabolites in the urine. Cranial computed tomography was also performed twice, again at the beginning and end of the 10-day period. The size of cerebrospinal fluid spaces was calculated through measuring the frontal interhemisphere distance, the width of cortical sulci, the ventricle III diameter, the Cella media index and also the number of vermal sulci. All patients had a brain atrophy which did not disappear within the 10 days. The neuroradiological parameters remained completely unchanged in the control examination. However, the laboratory parameters of the internal milieu had normalized. Therefore, it is submitted that the shrinkage of the brain of alcoholics cannot be due to a reversible intra- or extracellulary dehydration. There was also no proof of a hormonal cause for the brain shrinkage. As a consequence other etiological factors gain importance, such as malnutrition or a toxic alcohol effect. PMID- 3560794 TI - [A case of acute pneumonia complicated by recurrent ventricular fibrillation]. PMID- 3560795 TI - [Meningism syndrome in acute pneumonia]. PMID- 3560796 TI - [A case of eosinophilic pneumonia in a patient with chronic opisthorchiasis]. PMID- 3560797 TI - [A case of late diagnosis of tuberculosis at a general hospital]. PMID- 3560798 TI - [Chronic pulmonary heart disease]. PMID- 3560799 TI - [Current prevention of tuberculosis in adults]. PMID- 3560800 TI - [Use of ultrasonic aerosols in phthisiology and pulmonology]. PMID- 3560801 TI - [The problem of bronchial asthma]. PMID- 3560802 TI - [Pulmonary syphilis]. PMID- 3560803 TI - [Clinical aspects of acute exogenous allergic alveolitis]. PMID- 3560805 TI - [Etiology and pathogenesis of acute infectious destruction of the lungs]. PMID- 3560804 TI - [Clinico-anatomical characteristics of croupous pneumonia]. PMID- 3560806 TI - [The pre-disease state in chronic bronchitis]. PMID- 3560807 TI - [Clinical aspects and treatment of right ventricular failure in chronic obstructive bronchitis]. PMID- 3560808 TI - [Immunologic reactivity of the body in patients with chronic bronchitis]. PMID- 3560809 TI - [Characteristics of the elimination of non-volatile substances with expired air in patients with chronic bronchitis]. PMID- 3560810 TI - [Clinico-biochemical and endoscopic indicators in chronic bronchitis]. PMID- 3560811 TI - [Status of pulmonary microcirculation in chronic nonspecific lung diseases]. PMID- 3560812 TI - [Expiratory stenosis of the trachea and bronchi as a therapeutic problem]. PMID- 3560813 TI - [Characteristics of the pathogenesis and diagnosis of aspirin-induced bronchial asthma]. PMID- 3560814 TI - [Effect of steroid hormones tachystin and nerobolil on the calcium level in the bones of patients with bronchial asthma]. PMID- 3560816 TI - [Effect of chronic alcoholism on the immune status in protracted pneumonia]. PMID- 3560815 TI - [Pachydermoperiostosis syndrome]. PMID- 3560817 TI - [Diagnostic significance of changes in intracardiac hemodynamics during veloergometry in women with the cardialgic syndrome]. PMID- 3560818 TI - [Clinical variants of non-rheumatic myocarditis]. PMID- 3560819 TI - [Thrombocytic-vascular hemostasis and its regulation in embolism of the major arteries of the extremities]. PMID- 3560820 TI - [Hepatic blood flow and hepatocyte function in patients with congestive heart failure]. PMID- 3560821 TI - [Plasmapheresis in the treatment of patients with renal failure]. PMID- 3560822 TI - [Various problems of the treatment of gastric and duodenal ulcers]. PMID- 3560823 TI - [Clinico-bacteriological characteristics of Proteus dysbacteriosis in patients with chronic enteritis]. PMID- 3560824 TI - [Lichenoid amyloidosis]. PMID- 3560825 TI - [Psychological prevention and psychotherapy of alcoholism]. PMID- 3560826 TI - [A case of heart contusion]. PMID- 3560827 TI - [Aneurysm of the aortic sinus of Valsalva]. PMID- 3560828 TI - [Gastric bezoar]. PMID- 3560829 TI - [Treatment of liver cirrhosis]. PMID- 3560830 TI - [3 severe complications of electroimpulse therapy of cardiac rhythm disorders]. PMID- 3560831 TI - [Diurnal rhythm of the electrocardiogram in patients with hypertension]. PMID- 3560832 TI - [Experience using tranquilizers in the ambulatory treatment of hypertension]. PMID- 3560833 TI - [Fibrinolytic system of the blood in ischemic heart disease associated with arterial hypertension in middle-aged and elderly patients]. PMID- 3560834 TI - [Various problems of the clinical course and pathogenesis of abdominal angina in arteriosclerosis]. PMID- 3560835 TI - [Value of morphometry for clinical diagnosis]. PMID- 3560836 TI - [Remote prognosis in stenocardia in males aged 40-59 years based on the results of prospective studies]. PMID- 3560837 TI - [Functional status of thrombocytes in patients with acute forms of ischemic heart disease]. PMID- 3560838 TI - [Reconstructive vascular operations in patients with chronic ischemic heart disease]. PMID- 3560839 TI - [Reflexotherapy of patients with spinal osteochondrosis associated with ischemic heart disease]. PMID- 3560840 TI - [Information-activation relations and mental work capacity of operators]. AB - This paper presents the results of studying diagnostic potentials of the method used to assess mental performance of operators based on a combined application of the information carrying capacity and psychophysiological expenditures of man. Three groups of operators (45 subjects) that differed in their health status and motivation when performing sensorimotor tests were examined. Psychophysiological cost was measured with respect to autonomic responses (heart rate, respiration frequency, minute respiration volume, arm temperature) combined into an integrated parameter of psychic stress. It was found that the extremes of the relationship between information and activation parameters were invariant. The data obtained suggest that the information-activation relationship may be used to advantage in the clinical and physiological expertise of operators. PMID- 3560841 TI - [Dynamics of hormones, sugar and electrolytes during hypodynamia according to blood biochemical indices]. AB - Time-course variations in hormones, carbohydrates and electrolytes (specifically, cortisol, aldosterone, testosterone, T3, T4, sugar, potassium, sodium and chlorides) in blood of essentially healthy men, aged 19-59 years, kept for 30 days in a closed life-support system were measured. The hormones, sugar and electrolytes varied in a different manner. The subjects, aged 48-59 years, who performed regular exercises showed a higher stability of potassium, sodium and chlorides and a normalization of hormones by test day 30 in contrast to other groups of subjects. PMID- 3560842 TI - [Effect of weightlessness and hypokinesia on the velocity-strength properties of human muscles]. AB - Before and after exposure to short- and long-term microgravity and prolonged bed rest velocity and strength parameters of leg muscles were measured by isokinetic dynamometry. It was found that long-term exposure to microgravity produced a more distinct decline of muscle strength than short-term exposure. At the same time prolonged bed rest led to greater strength losses than microgravity of comparable duration. After long-term flights individual variability of changes was twice as high as after prolonged bed rest. A comparable analysis of the above exposures demonstrated that the changes observed after long-duration exposures were associated with atrophic changes due to disuse while those seen after short-term effects were induced, as shown previously, by reflex tonic shifts related to support unloading. PMID- 3560843 TI - [Relation between the probability of development of altitude-decompression disorders and the duration of pre-exposure to a hypobaric atmosphere]. AB - Healthy volunteers, aged 21-47 years, were kept in an altitude chamber. Before decompression to a residual pressure of 293.3 GPa the test subjects were consecutively exposed to 1120 GPa for 2 hrs and then to 733.3 GPa for 24, 18 or 12 hrs. At 293.3 GPa the test subjects performed a moderate workload for 6 hrs. It has been concluded that prior to the use of a space suit with the working pressure 0.3 kgf/cm2 (293.3 GPa) the time of exposure to a hypobaric normoxic (29 30% O2) atmosphere with the total barometric pressure 733.3 GPa should not be less than 18 hrs and it should preferably be 24 hrs. In this situation decompression safety of 6-hr extravehicular activity can be predicted with a high probability. PMID- 3560844 TI - [Various individual features of human adaptation to altitude]. AB - Two groups of young healthy men--natives of lowlands who for one year lived and worked in chronic hypoxia (Group 1 at an altitude of 1680 m with PO2 = 120 mm Hg and Group 2 at an altitude of 3650 with PO2 = 90 mm Hg) were examined. It was found that after this prolonged exposure the subjects showed a higher sensitivity of the respiration system to hypoxia, an enhanced lung ventilation and circulation, a lower gas exchange and physical work capacity. The concentration of lactic acid at rest in the Group 2 subjects was 47% higher than in the Group 1 subjects. The lactate/pyruvate ratio in the Group 2 subjects increased by 46% thus indicating an enhanced rate of anaerobic processes. A higher deficiency of buffer bases, a lower concentration of bicarbonates in blood at rest and during exercise tests of the Group 2 subjects pointed to metabolic acidosis. The subjects with a higher rate of anaerobic metabolism in a low PO2 environment displayed a diminished sensitivity of the hypoxic stimulation of respiration, an increased tolerance to the very low PAO2 and a reduced work capacity in chronic hypoxia. PMID- 3560845 TI - [Features of the atropine test in persons of different ages]. AB - The diagnostic value of the atropine test was investigated in 47 essentially healthy men of different age groups (25-39, 40-49 and 50-59 years). The cardiovascular responses were evaluated from ECG recorded continuously for an hour after subcutaneous injection of 1.0-0.1% atropine sulphate. Atropine caused a two-stage effect of the cardiac chronotropic function. The first, bradycarditic, stage was induced by vagal stimulation while the second, tachycarditic, stage was, by contrast, produced by atropine blockade of the acetylcholine effect on M-cholinoreceptors of myocardial cells. The atropine effect was identical in sign in all age groups. However, in the young age group the bradycarditic effect was more distinct and atropine-induced arrhythmias were more frequent. In the 50-59 years subjects the tachycarditic effect grew at a slower rate and the electric systole response to a higher heart rate was less pronounced. PMID- 3560846 TI - [Concentration of water and electrolytes in pregnant rats and their offspring after a flight aboard the biosatellite "Cosmos-1514"]. AB - The female rats were flown on Cosmos-1514 for 5 days during gestation days 13 through 18. The rats showed a significant reduction of the Ca concentration in the liver and kidneys, its smaller decrease in the skin, and no changes in bones. The fetus weight decreased, its water content increased, and the content of Na, K, Ca and Mg remained unchanged. The 15- and 30-day pups of the flown rats did not exhibit any differences in the water and electrolyte content in bones, skin, liver or kidneys as compared to the controls. These data indicate that water and electrolyte homeostasis of growing fetuses was highly stable and the deviations that emerged under the influence of space flight factors on the mother-fetus system rapidly returned to the norm. PMID- 3560847 TI - [Effect of diphosphonates on the development of osteoporosis in the hypokinetic rat]. AB - Using histomorphometric methods, the effect of diphosphonates (hydroxydimethylaminopropylene diphosphonic acid and hydroxyethylene diphosphonic acid) on the development of osteoporosis in spongy matter of tibia and vertebrae of the rats exposed to hypokinesia for 60 days was investigated. It was found that aminopropylene diphosphonic acid in the dose 6 mg phosphorus/kg/day prevented osteoporosis and caused an increase in the volume density and abnormal (cartilage rich and poorly ossified) spongy bone. By contrast, ethylene diphosphonic acid in the dose 9 mg phosphorus/kg/day did not prevent osteoporosis but reduced its severity. PMID- 3560848 TI - [Incidence of morphologic changes in cerebral cortex neurons of the rat exposed to accelerated carbon ions]. AB - Structural lesions in neurons of the brain cortex of rats were investigated 1 and 3 months after their exposure to accelerated carbon ions with the energy 320 MeV/nuclon 10(4) particles/cm2 (LET = 120 MeVcm2/g) as well as to gamma-radiation in the dose 1.0 Gy. The irradiated animals showed morphofunctional, dystrophic and reparative lesions in neurons. The rats exposed to carbon ions developed more distinct changes that the animals exposed to gamma-radiation. It is postulated that similar fluxes of cosmic radiations will not produce a deleterious effect on the integrative functions of the central nervous system of cosmonauts. PMID- 3560849 TI - [Relation between the status of central hemodynamics in the monkey in the postoperative period and the conditions of its maintenance prior to the surgical procedure]. AB - The pumping and contractile cardiac function of monkeys was examined at different time intervals after electrode and transducer implantation. The study was carried out using 26 rhesus monkeys under ketalar anesthesia. The effect this surgical intervention on intracardiac hemodynamics depended on the initial health state of the animals. Prior to operation the pumping function declined due to diminished motor activity of the animals. It remained decreased to a greater extent 10-15 days after operation. When normal motor activity was allowed even for a short time before surgical implantation, this was sufficient for the normalization of the cardiovascular function. In view of these observations, we should be very cautious to expose monkeys to diminished motor activity for long periods of time. PMID- 3560851 TI - [Comparative study of central hemodynamics, myocardial contractility and left ventricular wall tension in athletes and patients]. AB - The purpose of the study was to extend our knowledge about the "athletic" heart and improve diagnosis of latent manifestations of cardiac insufficiency. Echocardiography was used to examine central hemodynamics, myocardial contractility and left-ventricle wall tension in athletes and patients with ischemic heart disease (IHD) and arterial hypertension at rest and after exercise tests. The study of time-course variations of these parameters revealed different patterns of initial dilation and development of further dilation and hypertrophy in athletes and patients. The most sensitive index of contractility was meridional and circular tension of the left-ventricle wall which was the lowest in athletes and the highest in IHD patients. PMID- 3560850 TI - [Features of volume and pressure pulsations during changes in "reserve space" within the cranial cavity]. AB - Changes in the amplitude and phase characteristics of pulse variations of volumes and pressures in response to an increase in the intracranial pressure are discussed. The study of 60 neurosurgical patients has shown that as the intracranial (subdural) pressure grows the amplitude of pulse variations of subdural pressure increase to 30 mm Hg and then decreases, the phase characteristics of the pulse waves changing accordingly. The changes in the amplitudes of pulse variations produced by mechanical displacement of the walls of cerebral lateral ventricles measured with the aid of the noninvasive ultrasonic method suggest that an increase in the CSF pressure above 200 mm H2O makes the intracranial cavity too "tight", which depletes the reserve spaces of the cerebrospinal system. If the above changes develop consistently, then it can be assumed that each of the pressure ranges isolated can be characterized by amplitude-phase parameters of pulse waves that form a specific pattern. Taking into consideration the potentials of noninvasive measurements of amplitude-phase characteristics of the intracranial pulse wave by means of ultrasonic echolocation, it deems possible to develop noninvasive techniques for measuring compensatory abilities of the cerebrospinal system. PMID- 3560852 TI - [Spectral representation of vestibular nystagmus]. PMID- 3560853 TI - [Method of obtaining small volumes of water in the desert]. PMID- 3560854 TI - [Dynamics of mental status during the performance of occupational activities involved in air traffic control]. PMID- 3560855 TI - [Conceptions of automated studies of operator activity]. PMID- 3560856 TI - [Long-latency evoked potentials during human exposure to linear accelerations]. PMID- 3560857 TI - [Isoenzyme composition of human blood lactate dehydrogenase after a single exposure to acute hypoxia and its relation to levels of physical work capacity]. PMID- 3560858 TI - Effect of pentobarbital or urethane on bile secretion and chemical composition of blood in the rabbit. AB - A study was made of the effects of anaesthesia with pentobarbital and urethane on the bile secretion and the chemical composition of the blood of New Zealand rabbits. Neither of the agents was observed to affect arterial pH or pO2, but with urethane pCO2 values decreased significantly. This was associated with a pronounced hyperglycaemia. Bile flow was significantly higher in pentobarbital anaesthetized animals than in urethane-anaesthetized animals, a phenomenon that can be attributed to a different canalicular flow and that will not be related to differences in the bile-acid-dependent fraction of secretion. Under both anaesthetics, bile sodium concentrations were greater than those found in plasma, which can be explained by the formation of micelles with low osmotic activity. Bile bicarbonate concentrations proved to be greater than those observed in plasma. Plasma calcium concentrations were significantly lower with urethane than with pentobarbital, whereas in bile the situation was reversed; both these aspects are discussed. PMID- 3560859 TI - Tupaiataenia quentini (Schmidt & File, 1977) in Tupaia belangeri (Wagner, 1841): transmission experiments and Praziquantel treatment. AB - Tupaiataenia quentini was found in many Tupaia belangeri from a closed colony in West Germany. 1.25 mg Praziquantel per animal proved to be efficient for deworming. Direct transmission experiments to non-parasitized tree shrews from another colony failed. PMID- 3560860 TI - Intestinal bacteria antagonistic to Clostridium difficile in mice. AB - Overgrowth by Clostridium difficile has been reported in conventional mice injected intraperitoneally with ampicillin. In this study, we aimed to determine which types of indigenous intestinal bacteria were eliminated by ampicillin to allow overgrowth by C. difficile. C. difficile overgrowth was associated with a decrease in the numbers of lactobacilli, an increase in bacteroidaceae and a slight decrease in the frequency of isolation of fusiform-shaped bacteria (clostridia). C. difficile cytotoxin was detected in caeca from mice in which the numbers of C. difficile were greater than 10(5) per gram of faeces. Gnotobiotic mice were inoculated with various groups of intestinal anaerobes to determine which members of the indigenous flora would antagonize C. difficile. Gnotobiotic mice inoculated with three strains of lactobacilli, 37 strains of bacteroides or 46 strains of clostridia isolated from limited-flora mice were unable to eliminate C. difficile. C. difficile was eliminated, however, from the gastrointestinal tracts of gnotobiotic mice inoculated with whole faeces or chloroform-treated faeces from conventional mice or whole faeces from limited flora mice containing only clostridia. PMID- 3560861 TI - Patterns of lymphatic drainage to individual thoracic and cervical lymph nodes in the rat. AB - Colloidal carbon was used as tracer material to determine the lymphatic drainage to the cervical and thoracic lymph nodes from various regions of the respiratory tract in the F344 rat. While the lung region may be drained mainly to the posterior mediastinal lymph nodes, the tracheal wall drains primarily to the internal jugular and posterior cervical nodes. PMID- 3560862 TI - Assessment of discomfort in gallstone-bearing mice: a practical example of the problems encountered in an attempt to recognize discomfort in laboratory animals. AB - In order to obtain practical experience on the recognition, assessment and evaluation of discomfort in laboratory animals, the degree of discomfort was studied in gallstone-free and gallstone-bearing mice. Out of nine parameters to which scores were assigned per individual mouse, only the response to palpation of the right hypochondrium was found to score significantly higher in gallstone bearing mice. That is, the incidence of squeaking and the magnitude of muscular contractions were significantly higher in these animals compared with the gallstone-free mice. The stance of the gallstone-bearing mice also tended to be abnormal, although the difference between gallstone-free and gallstone-bearing animals did not reach statistical significance. Although this study does not prove unequivocally that the induction of gallstones per se causes discomfort or pain in mice, we tentatively conclude that it does. We feel that this should be taken into account in any projected work in which gallstone induction in animals may occur. There was considerable between-assessor variation in the assignment of scores to the variables used to assess discomfort, including the response to palpation. It is concluded that the selection of parameters and the experience and/or attitude of the assessor are critically important when the magnitude of discomfort, if any, is assessed in experimental animals. PMID- 3560863 TI - A cage for the ferret. AB - A cage for ferrets is described that consists of a plastic box with a metal sliding-grill top and metal front lattice. It contains a new feeding system using dishes that can be removed without opening the cage. The cages are kept in mobile racks and are commercially available. PMID- 3560864 TI - The attachment of filamentous segmented micro-organisms to the distal ileum wall of the mouse: a scanning and transmission electron microscopy study. AB - Scanning electron micrographs are presented of the ileal epithelium of mice aged 5, 15, 20 and 25 days. During this period the villous pattern develops to full maturity. By the twentieth day of life a segmented filamentous micro-organism colonizes the ileal epithelium and is firmly attached via a small segment. During the first days of colonization the segmented filamentous micro-organisms themselves are subcolonized by small rod-shaped bacteria, presumably lactobacilli. At the age of 25 days this subcolonization was no longer observed. PMID- 3560865 TI - A technique for rearing germfree piglets obtained without surgery. AB - A relatively simple procedure is described for obtaining germfree piglets which does not involve hysterectomy or hysterotomy. Newborn pigs were delivered into an isolator and their freedom from microbial contamination was ensured by applying bactericidal solutions externally and a combination of antibiotics in solution per os. 40 piglets so derived have been maintained free from detectable micro organisms, some for up to 140 days. Equipment is described which allowed the long term holding of these animals so that nutritional balance studies could be completed. PMID- 3560866 TI - Studies on beige-nude mice with low natural killer cell activity. 1. Introduction of the bg gene into nude mice and the characteristics of beige-nude mice. AB - To improve the take-rate of human tumours in nude mice, a nude mouse strain with the bg gene was established. The introduction of the bg gene was confirmed by examination of giant granules of blood neutrophils. The genetic profile of beige nude mice was the same as that of the C57BL/6 strain according to genetic screening. The natural killer cell activity in the beige-nude mice was much lower than that in ordinary nude mice but slightly higher than that in beige mice. The reproductivity of beige-nude mice was as high as that of ordinary nude mice. PMID- 3560867 TI - Development of cysteamine-induced ultrastructural surface changes on duodenal mucosa. AB - Duodenal ulcers were induced acutely in female rats by a single oral administration of cysteamine, 70 mg/100 gm, in order to study morphologic progression of lesion development from the perspective of cellular surface changes by scanning electron microscopy. Thick sections of resin-embedded specimens were also studied by light microscopy, and animals were sacrificed at intervals of 30 minutes, 1, 2, 4, 8, 12, 20, and 24 hours post-treatment. Earliest evidence of cytologic lesions was apparent at 2 hours and data confirmed earlier reports that alterations began at villous tips. Both cellular sloughing and in situ cellular injury were evident, the latter phenomenon constituting the principal mode of cysteamine-induced erosion. In situ change began, from surface perspective, as a minute cavitation on the apical aspect of an isolated, single epithelial cell which was surrounded by normal cells. These early lesions progressed to in situ necrosis either of isolated cells or of small clusters of adjacent cells. This phenomenon occurred concurrently on multiple villi, all within the localized site at which cysteamine-induced duodenal ulcers are known to develop. An additional early morphologic change was the occasional appearance of a background of pleomorphic cellular apices of variable size on the villous ridges. By 8 to 12 hours, cellular damage advanced to erosions with some cells in the preulcer area still showing initial stages of in situ cellular injury. Precipitated mucus on the surface was increased in the preulcer area, and by 20 to 24 hours typical duodenal ulcers were evident. These scanning electron microscopic data confirm the significance of surface damage at villous tips very early in the cysteamine-induced ulcerogenesis. The present higher resolution findings demonstrated that earliest cellular damage, principally in situ cell injury, occurred simultaneously at multiple sites in the preulcer zone rather than at a single cluster of cellular damage which enlarges peripherally. PMID- 3560868 TI - Comparison of coronary atherosclerosis in middle-aged Norwegian and Japanese men. An autopsy study. AB - We compared the extent of lesions in the coronary arteries of autopsied middle aged men from Oslo, Norway, with lesions in autopsied men of similar ages in Tokyo, Japan. Certain risk factors for coronary heart disease as serum cholesterol, triglycerides, and blood pressure were also available from these men in the two locations. Our comparisons reveal large differences in the extent of atherosclerosis between Oslo and Tokyo, which are reflected in the levels of the risk factors, particularly serum cholesterol levels. Our findings suggest that preventive strategies could retard the development of atherosclerosis and coronary heart disease without the economic and nutritional problems that affect technically underdeveloped societies where atherosclerosis and coronary heart disease are not prevalent. PMID- 3560869 TI - Perceptions of two deviant and two nondeviant groups. PMID- 3560870 TI - Personality correlates of nuclear war threat perception. PMID- 3560871 TI - Relationships among anxiety, belief system, and creativity. PMID- 3560872 TI - Choking phenomena in a lung-like model. AB - A simple, continuous, one-dimensional model for the geometry and structure of the bronchial airways is used for the analysis of fluid flow patterns which have been observed in forced expiration maneuvers. Various phenomena within the conducting system associated with flow limitation are investigated: the conditions in which a "choke" (flow limitation) can occur in a compliant system; theoretical flows that are physically impossible; the possibility of having elastic jumps downstream of the choke point; perturbations in the physical parameters of the conducting system. PMID- 3560873 TI - Deformation analyses in cell and developmental biology. Part I--Formal methodology. AB - This study presents a computational approach for the deformation analyses of problems in cell and developmental biology. Cells and embryos are viewed mechanically as axisymmetric shell-like bodies containing a body of incompressible material. The analysis approach is based on the finite element method. It is comprised of three finite element ingredients: an axisymmetric shell/membrane element valid for modeling finite bending, shearing and stretching; a volume constraint algorithm for modeling the membrane-bound incompressible material; and a contact algorithm for modeling the mechanical interactions between deformable bodies. Part II of this study will demonstrate how these three ingredients can be applied to analyze mechanical experiments on cells. This same method is also useful for simulating embryonic shape changes during development. PMID- 3560874 TI - Deformation analyses in cell and developmental biology. Part II--Mechanical experiments on cells. AB - This study employs the finite element approach developed in Part I to analyze mechanical experiments on cells. It views cells as axisymmetric membrane structures containing a body of incompressible material, and models the mechanical contact between a cell and the loading apparatus by a contact algorithm. Since the method is valid for analyzing axisymmetric shell-like bodies with arbitrary shapes, it treates various mechanical experiments on cells in a unified manner. For demonstration purposes, three commonly used mechanical experiments on cells are considered; the compression experiment; the suction (micropipette aspiration) experiment; and the magnetic particle experiment. Based on an estimate of the mechanical property data for unfertilized sea urchin eggs, this analysis method predicts the responses for all three experiments using the same assumptions and approximations. This parallel treatment gives a broad basis for data correlation with experiments. The method also provides insights into mechanical experiments not offered by other approximate methods. For example, it gives the distributions of tensions and stretches on the cell cortex, and suggests the role of friction in the suction experiment. PMID- 3560875 TI - Correlation among shear rate measures in vascular flows. AB - A variety of shear rate measures have been calculated from hemodynamic data obtained by laser Doppler anemometry in flow-through casts of human aortic bifurcations. Included are measures sensitive to the mean and amplitude of the shear rate, its maximum rate of change, the duration of stasis and flow reversal near the wall, and the unidirectionality of the flow. Many of these measures are highly correlated with one another. This suggests that that it will be difficult to identify from in vivo measurements those aspects of the flow field to which the vessel wall is most sensitive. It may be possible to separate the effects of purely temporal factors (e.g., the duration of flow reversal) from those related to wall shear stress. PMID- 3560876 TI - An application of the micropipette technique to the measurement of the mechanical properties of cultured bovine aortic endothelial cells. AB - The mechanical properties of endothelial cells were measured using the micropipette technique. The cells employed were collected from bovine aortic endothelium and cultured in our laboratory. Endothelial cells from confluent monolayers under no-flow conditions were detached from their substrate by trypsin or by a mechanical method and suspended in modified Dulbecco medium (MDM). In the micropipette technique, a part of the cell is aspirated into the tip of the micropipette under a microscope, and the deformation measured from a photograph. In this study, the data obtained were analyzed using a model where the cytoskeletal elements, which are considered to be the primary stress bearing components, are assumed to reside in a submembranous, cortical layer. Detached cells were found to have almost homogeneous mechanical properties based on measurements from different regions of the surface of a single cell. However, a hysteresis loop was observed in the relation between pressure and cell deformation during the loading and unloading processes. The calculated elastic shear moduli obtained for the trypsin-detached cells were as much as 10-20 times larger than those of a red blood cell. Mechanically-detached cells had moduli approximately twice that of the trypsin detached cells. Passage time, i.e., cell culture age, had no influence on the mechanical properties of the trypsin detached cells, but did have an effect on the mechanically-detached cells, with both the younger and older cells being somewhat stiffer. PMID- 3560877 TI - Variation of lumbar spine stiffness with load. AB - Mechanical studies of the Functional Spinal Unit (FSU) in-vitro have shown that the slopes of the load-displacement curves increase with load. This nonlinearity implies that the stiffness of the FSU is not constant over the range of physiologic loads, and that measurements obtained for FSU specimens through the application of individual loads cannot be summed to predict the response of the specimens to combined loads. Both experimental and analytical methods were developed in the present study to better quantify the nonlinear FSU load displacement response and to calculate the coupled stiffness of FSU specimens at combined states of load reflecting in-vivo conditions. Results referenced to the center of the vertebral body indicate that lumbar FSU specimens are stiffer in flexion than in extension, and that FSU specimens loaded in flexion are stiffer at high loads than at low loads. The importance of combined load testing and a nonlinear interpretation of load-displacement data is demonstrated. PMID- 3560878 TI - Design of a new pulse duplicator system for prosthetic heart valves. AB - This paper discusses results of a computer simulation for designing a new pulse duplicator system for mechanical heart valves. The design objective of the system is to obtain a compact, efficient pulse duplicator system capable of accurately measuring the volume flow rate across a valve. The volume flow rate is determined as the derivative of the volume displacement of an actuator piston which directly drives the fluid. The system does not need any circulatory loop, since the piston is controlled on-line to follow command signals representing an aortic impedance. The results of the computer simulation show: the designed PI-controllers of the actuator can precisely control valve motion to follow given command signals, the eigenvalues of the controllers have to be carefully chosen to prevent unstable behaviors of a valve in diastole, and the dimensions of the actuator is optimized by minimizing a cost function of the total efficiency of the system. PMID- 3560879 TI - The recovery of terminal lymph flow following occlusion. AB - The effects of external pressure on the relative terminal lymphatic flow rate following occlusion of the lymph system were studied. Sulfur colloid tagged with 99mTc was injected into the hind thigh of dogs prior to compressive loading. Initially, the lymphatic clearance of the tracer was measured for approximately forty minutes with no applied external pressure. The terminal lymph vessels were then occluded for thirty minutes with the application of an applied external pressure of 75 mm Hg. Finally, the lymphatic clearance following occlusion was measured with the application of a nonocclusive pressure. External pressures of 0, 30, and 45 mm Hg were tested to determine the effects of post-occlusive pressure application on terminal lymphatic clearance. Results indicated that terminal lymphatic clearance did not resume for an applied pressure of 45 mm Hg following occlusion. The relative lymphatic clearance rate at an external pressure of 30 mm Hg following occlusion was 54% of the clearance rate for a 0 mm Hg applied pressure prior to lymph occlusion. The results for a 0 mm Hg external pressure following occlusion indicated a 23 percent clearance rate compared to the pre-occlusive state. A two compartment model was utilized to determine the lymphatic clearance rate per unit tissue volume of subcutaneous tissue from the experimental data for each pressure phase. PMID- 3560880 TI - Cracks emanating from a fluid filled void loaded in compression: application to the bone-implant interface. AB - Loosening of orthopedic implants is believed to be caused, in part, by fracture at the bone-cement interface. This loosening occurs even in regions where the interfacial load is primarily compressive. A model is developed whereby cracks can radiate from an elliptical fluid filled void. The incompressible fluid is allowed to penetrate into the cracks when the system is loaded compressively. The mode I stress intensity factor is calculated to test the feasibility of crack growth, and a numerical scheme which uses piecewise quadratic polynomials is used to solve the resulting singular integral equations. The results show the combinations of parameters for which cracks are likely to grow. PMID- 3560881 TI - The frequency response of electrochemical wall shear probes in pulsatile flow. AB - The frequency response of surface-mounted electrochemical mass transfer probes used to deduce wall shear rates has been investigated experimentally for the case of fully developed laminar pulsatile flow in a straight tube. Generally good agreement is found with the asymptotic results obtained by Lighthill's methods. The significance of the results with regard to the investigation of models of pulsatile flows of physiological interest is discussed. It is concluded that the frequency-dependent phase and amplitude corrections required to obtain accurate wall shear measurements are of such magnitudes as to render impractical the use of electrochemical probes to determine wall shear rates in these flows. PMID- 3560882 TI - Basic mechanical properties of retina in simple elongation. PMID- 3560883 TI - Temperature dependent behavior of the canine medial collateral ligament. AB - The temperature dependent tensile behavior of ligament was investigated from 2 degrees C to 37 degrees C. Nondestructive cyclic tests were performed on ten canine femur-medial collateral ligament-tibia (FMT) complexes at sequential temperatures of 22 degrees C, 22 degrees C, 27 degrees C, 32 degrees C, 37 degrees C, and again at 22 degrees C. The samples were rested at zero load between tests for sufficient time periods to allow for full recovery from the ligament's time and history dependent viscoelastic properties. Ten additional FMT complexes were sequentially tested in a similar fashion, but at temperatures of 22 degrees C, 22 degrees C, 2 degrees C, 6 degrees C, 14 degrees C, and 22 degrees C. All canine FMT complexes showed temperature dependent viscoelastic properties: the measured area of hysteresis decreased with increasing temperature; the cyclic load relaxation behavior plateaued to a higher value at lower temperatures; and the tensile load at a predetermined ligament substance strain level had an inversely proportional relationship with respect to temperature. PMID- 3560884 TI - A theoretical model for peripheral tissue heat transfer using the bioheat equation of Weinbaum and Jiji. AB - In this paper the new bioheat equation derived in Weinbaum and Jiji is applied to the three layer conceptual model of microvascular surface tissue organization proposed in. A simplified one-dimensional quantitative model of peripheral tissue energy exchange is then developed for application in limb and whole body heat transfer studies. A representative vasculature is constructed for each layer and the enhancement in the local tensor conductivity of the tissue as a function of vascular geometry and blood flow is examined. Numerical solutions for the boundary value problem coupling the three layers are presented and these results used to study the thermal behavior of peripheral tissue for a wide variety of physiological conditions from supine resting state to maximum exercise. PMID- 3560885 TI - The kinetics of chemically induced nonequilibrium swelling of articular cartilage and corneal stroma. AB - An electromechanical model for charged, hydrated tissues is developed to predict the kinetics of changes in swelling and isometric compressive stress induced by changes in bath salt concentration. The model focuses on ionic transport as the rate limiting step in chemically modulating electrical interactions between the charged macromolecules of the extracellular matrix. The swelling response to such changes in local interaction forces is determined by the relative rates of chemical diffusion and fluid redistribution in the tissue sample. We have tested the model by comparing the experimentally observed salt-induced stress relaxation response in bovine articular cartilage and corneal stroma to the response predicted by the model using constitutive relations for the concentration dependent material properties of the tissues reported in a related study. The qualitatively good agreement between our experimental measurements and the predictions of the model supports the physical basis of the model and demonstrates the model's ability to discriminate between the two soft connective tissues that were examined. PMID- 3560886 TI - Flow resistance in curved femoral artery flow models of man for steady flow. PMID- 3560888 TI - An effect of modeling and imitation teaching procedures on children with and without specific language impairment. AB - Following a treatment program in which an invented morpheme was taught through either imitation or modeling procedures, the generalization of 40 specific language-impaired children was compared to that of 40 children learning language normally. The results of the comparison indicated that the two teaching procedures have opposite relative effects on the two groups. The abnormal group generalized more extensively following imitation teaching while the normal group generalized more extensively following modeling teaching. The opposing results of the two procedures on the two groups suggest that language-impaired children will benefit more from teaching strategies that are adapted to their unique learning styles than from strategies fashioned after the styles of children who learn language normally. PMID- 3560887 TI - Fluid particle motion and Lagrangian velocities for pulsatile flow through a femoral artery branch model. AB - A flow visualization study using selective dye injection and frame by frame analysis of a movie provided qualitative and quantitative data on the motion of marked fluid particles in a 60 degree artery branch model for simulation of physiological femoral artery flow. Physical flow features observed included jetting of the branch flow into the main lumen during the brief reverse flow period, flow separation along the main lumen wall during the near zero flow phase of diastole when the core flow was in the downstream direction, and inference of flow separation conditions along the wall opposite the branch later in systole at higher branch flow ratios. There were many similarities between dye particle motions in pulsatile flow and the comparative steady flow observations. PMID- 3560889 TI - Contrastive stress, phonetic context, and misarticulation of /r/ in young speakers. AB - The purpose of this study was to examine the effects of contrastive stress and phonetic context on misarticulations of consonantal /r/. Subjects were 9 children between the ages of 4:5 (years:months) and 5:7 who exhibited normal articulation development but inconsistently misarticulated /r/. The experimental task was designed to elicit consonantal /r/ in two phonetic contexts ([rV] & [CrV]) and two stress conditions (primary & nonprimary stress). Three listeners who were naive to the experimental hypotheses judged the children's productions for accuracy of /r/ production and for stress. Significant main effects were obtained for context and stress: /r/ productions were more often judged as correct in clusters than in singletons and in words not receiving primary stress than in words receiving primary stress. Results are discussed in terms of the possible effects of production and perceptual variables on listener judgments. Inferences are drawn concerning future research on speaker and listener effects in the study of articulation. PMID- 3560890 TI - Digital inverse filtering for linguistic research. AB - To enable differences in modes of glottal vibration to be studied, glottal air volume velocity waveforms can be recovered from speech recordings by inverse filtering. Most previous published work in this area has made use of analog filters. Digital inverse filters offer many advantages, including the ability to change filter settings to match changing vocal tract filter functions. Although the theory and many of the methods necessary for digital inverse filtering have been described in the literature, a straightforward description of the entire process has been lacking. The digital inverse filtering process developed for linguistic research at the UCLA Phonetics Laboratory is described in detail in this paper, with the intention of facilitating such work at other institutions. PMID- 3560891 TI - A method for relating loudness-matching and intensity-discrimination data. AB - A method that allows direct comparisons between pure-tone loudness-matching and intensity-discrimination data in normal and hearing-impaired listeners is described. This method makes a minimal number of assumptions about the relations between loudness perception and intensity-discrimination performance. Loudness is considered to be related to overall, perceived stimulus magnitude and intensity discrimination performance is considered to reflect the accuracy with which a loudness judgment can be made. Because pure-tone intensity-discrimination performance varies as a function of stimulus level in normal ears, the standard level required to produce a particular difference limen in an impaired ear can be inferred from normal-ear intensity-discrimination data. Thus, plotting standard levels yielding normal difference limens as a function of standard levels yielding the equivalent sized difference limens from a threshold-shifted ear produces a function directly comparable to loudness recruitment functions. If loudness-growth and intensity-difference limens were tightly coupled in threshold shifted ears, then stimuli that yield equal size difference limens would be equally loud. This relation was tested by obtaining loudness-matching and intensity-discrimination data from normal-hearing listeners with thresholds shifted by a wideband noise and hearing-impaired listeners with cochlear-type hearing losses. The results from these listeners show similarities between the traditional loudness-recruitment functions and "intensity-recruitment" functions derived from the assumed relation between the two measures. The primary difference between the functions is at low and moderate sensation levels where loudness grows at a more rapid rate than the difference limen. PMID- 3560892 TI - Comparison of onset and steady-state responses of hearing aids: implications for use of the auditory brainstem response in the selection of hearing aids. AB - Input-output (I/O) functions of hearing aids were measured in response to a 2000 Hz tone burst, having 0.5 ms rise/fall time and 10 ms duration. I/O functions, measured with a hearing-aid analyzer, served as reference conditions. Hearing-aid outputs at onset and during the steady-state portion of the waveform differed; these differences often depended upon stimulus rate. The relation between onset and steady-state estimates of output were not always predictable from hearing-aid attack and release times. These findings indicate that the steady-state output limitation characteristics of hearing aids cannot be estimated from their onset responses. In turn, this suggests that ABR measurements may not provide accurate estimates of the compressive characteristics of hearing aids. PMID- 3560893 TI - Word and feature identification by profoundly deaf teenagers using the Queen's University tactile vocoder. AB - The experiments described are part of an ongoing evaluation of the Queen's University Tactile Vocoder, a device that allows the acoustic waveform to be felt as a vibrational pattern on the skin. Two prelingually profoundly deaf teenagers reached criterion on a 50-word vocabulary (live voice, single speaker) using information obtained solely from the tactile vocoder with 28.5 and 24.0 hours of training. Immediately following word-learning experiments, subjects were asked to place 16 CVs into five phonemic categories (voiced & unvoiced stops, voiced & unvoiced fricatives, approximants). Average accuracy was 84.5%. Similar performance (89.6%) was obtained for placement of 12 VCs into four phonemic categories. Subjects were able to acquire some general rules about voicing and manner of articulation cues. PMID- 3560894 TI - Reaction times of moderate and severe stutterers to monaural verbal stimuli: some implications for neurolinguistic organization. AB - Fourteen right-handed stutterers and 14 normal speakers (7 men & 7 women) responded to monaurally presented stimuli with their right and left hands. Results of an ANOVA with repeated measures showed that a significant ear-hand interaction existed in the normal subjects' data, with the right-ear, right-hand configuration producing the fastest responses. These findings were in concert with an efficiency model of neurolinguistic organization that suggests that the left hemisphere is dominant for language processing with the right hemisphere being capable of performing less efficient auditory-verbal analysis. Results of a similar ANOVA procedure showed that all main effects and interactions were nonsignificant for the stutterers. From these data a bilateral model of neurolinguistic organization was derived for the stutterers where both hemispheres must participate simultaneously in the decoding process. This held true regardless of sex or severity of stuttering. PMID- 3560895 TI - Frequency discrimination of short- versus long-duration tones by normal and hearing-impaired listeners. AB - This investigation explored the effects of stimulus level on the frequency discrimination of long- and short-duration pure tones by 5 subjects with normal hearing and 7 with sensorineural hearing impairment. Frequency difference limens (DLs) were obtained as a function of signal intensity for 5-ms and 300-ms tones at 500, 1000, and 2000 Hz. The performance of most of the hearing-impaired subjects was poorer than normal for 300-ms tones, but not for 5-ms tones. This result was relatively independent of the stimulus sensation levels at which the data were compared. However, the current results also show an unexpected dependence of the frequency DL on the sensation level of short-duration tones. In several normal-hearing subjects, frequency discrimination performance for these short tones is poorer at moderately high levels than at low levels. PMID- 3560896 TI - Burst and transition cues to voicing perception for spoken initial stops by impaired- and normal-hearing listeners. AB - The use of cues to voicing perception of initial stop consonants in multiple spoken syllables was studied for moderately/severely hearing-impaired (n = 43) and normal-hearing listeners (n = 12). The test stimuli were ten utterances each of the syllables/baed, gaed, daed, paed, kaed, taed/. The utterances were analyzed acoustically to confirm the presence of certain cues to initial-stop voicing, namely, differences in voice onset time (VOT), aspiration, and vowel onset values of the first formant and of fundamental frequency (fo). Test conditions were prepared in which different portions of the syllable onsets were either deleted or interchanged for voicing-cognate syllables. Also the fo contour was flattened for syllable pairs via analysis/synthesis using linear predictor code (LPC) processing. The results confirmed that VOT was a strong voicing cue for both the hearing-impaired and normal-hearing listeners. When the aspirations of the voiceless stops were inserted between the release and the vowel of the voiced-stop syllables, the normal-hearing listeners perceived voiceless stops predominantly. The transition portions of the vowel onsets in burstless /baed, gaed, daed/ contained strong cues for voicing perception of /b,g,d/. The hearing impaired listeners seemed less sensitive than the normal-hearing listeners to the aspiration-presence and the vowel-onset cues. The fo difference at vowel onset appeared to have no cue value for either group of listeners. PMID- 3560897 TI - Binaural loudness summation in the hearing impaired. AB - Binaural loudness summation was measured using three different paradigms with 10 normally hearing and 20 bilaterally symmetrical high-frequency sensorineural hearing loss subjects. An adaptive paradigm and a loudness matching procedure measured summation at the lower and upper level of comfortable loudness and the loudness discomfort level (LDL). Monaural and binaural LDLs also were obtained with a clinical procedure designed to select maximum output of hearing aids. Stimuli for all three tasks consisted of 500- and 4000-Hz pure tones and a speech spectrum noise. Binaural summation increased with presentation level using the loudness matching procedure, with values in the 6-10 dB range. Summation decreased with level using the adaptive paradigm, and no summation was present with the clinical LDL task. The hearing-impaired subjects demonstrated binaural summation that was not significantly different from the normally hearing subjects. The results suggest that a bilaterally symmetrical sensorineural hearing loss does not affect binaural loudness summation. The monaural and binaural dynamic range widths were similar, and the LDL results suggest that binaural loudness summation may not be an important factor in selecting maximum output of hearing aids. PMID- 3560898 TI - Story structure and retelling of narratives by aphasic and non-brain-damaged adults. AB - Aphasic and non-brain-damaged subjects listened to and retold two narrative stories three times in succession. Both aphasic and non-brain-damaged subjects were affected by story structure--they retold a greater proportion of information units that were central to the story structure than information units that were peripheral to the story structure. Both aphasic and non-brain-damaged subjects increased the amount of information retold across three retellings, although only the increases from Retelling 1 to Retelling 2 were statistically significant. Non brain-damaged subjects consistently retold slightly more information units than aphasic subjects, but the differences were not statistically significant. In all three retellings, both groups of subjects retold information in the same order that it occurred in the stories. PMID- 3560899 TI - Effects of consonantal context on vowel lipreading. AB - The effects of consonantal context on vowel lipreading were assessed for 30 adults with mild-to-moderate sensorineural hearing loss who lipread videotape recordings of two female talkers. The stimuli were the vowels /i,I,alpha,U,u/ in symmetric CVC form with the consonants /p,b,f,v,t,d,f,g/ and in the asymmetric consonantal contexts /h/-V-/g/, /w/-V-/g/, /r/-V-/g/. Analyses of the confusion matrices from each talker indicated that vowel intelligibility was significantly poorer in most contexts involving highly visible consonants, although the utterances of one talker were highly intelligible in the bilabial context. Among the visible contexts, the fricative and labiodental contexts in particular produced the lowest vowel intelligibility regardless of talker. Lax vowels were consistently more difficult to perceive than tense vowels. Implications for talker selection and refinement of the concept of viseme were drawn. PMID- 3560900 TI - Reflex responses in human jaw, lip, and tongue muscles elicited by mechanical stimulation. AB - Reflex responses in human jaw, lip, and tongue muscles were elicited with brief, innocuous mechanical stimuli. Stimuli were applied to the masseter (and overlying tissue), the lower lip vermilion, and the tongue dorsum. Reflex responses occurred in masseter, orbicularis oris inferior, and genioglossus muscles upon direct stimulation of the sites associated with each of these muscles. In contrast, reflex responses to stimulation of "distant" sites occurred almost exclusively in masseter; that is, stimulation of the lip and tongue produced responses in masseter, but, stimulation of jaw muscle spindle afferents and overlying cutaneous receptors had no observable effect on activity in genioglossus or orbicularis oris inferior muscles. It could be hypothesized that the motoneuron pools controlling jaw muscles are more sensitive to synaptic inputs generated by reflex pathways originating in other structures. The sensitivity of the masseter muscle to inputs from the lip and tongue may serve to link these structures functionally. PMID- 3560901 TI - Temporal acoustic measures of dysarthria associated with amyotrophic lateral sclerosis. AB - The purpose of this study was to investigate stop-gap duration, voice onset time (VOT), and vowel duration in intelligible speakers with amyotrophic lateral sclerosis (ALS). Broadband sound spectrograms were used to measure 8 normal and 8 ALS speakers' intelligible speech productions of monosyllabic words containing word-initial stop-plosive consonants (/p, t, k, b, d, g/). Significant differences were found between the two groups for both vowel duration and stop gap duration; moreover, correlational analysis indicated that the ALS speakers, as a group, exhibited a direct relationship between stop-gap and vowel durations associated with productions of /t/ and /k/. No significant differences were found between the two talker groups for VOT. Results will be related to the neuroanatomical and physiological mechanisms involved in dysarthric (ALS) speech. PMID- 3560902 TI - Cohesion in the discourse of normal and head-injured adults. AB - Cohesion strategies used by 3 normal and 3 head-injured adults were examined in both conversational and narrative conditions. Two major findings emerged. First, the head-injured subjects used different cohesion patterns from the normal adults in both conditions. Second, both groups used different cohesion patterns in the conversational and narrative conditions. The study highlights the importance of viewing the language of head-injured adults within the context of discourse. Testing the language system through narrative as well as conversational discourse is important since both conditions are characterized by their own distinctive internal structure and organization. PMID- 3560903 TI - Effects of vowel context on the articulatory closure postures of deaf speakers. AB - Using cinefluorography, this investigation evaluated how the bilabial and dorsal stop closure postures of 2 hearing and 5 deaf speakers varied with vowel context. The jaw and tongue body postures of the hearing and the 2 most intelligible deaf speakers altered with the identity of the following vowel. This did not occur consistently for the remaining deaf speakers. The results concur with a previous suggestion (Tye, Zimmerman, & Kelso, 1983) that some speakers who learn speech without audition may develop a different articulatory coordination than hearing speakers. Discovering these differences may lead to a general account for many of their intelligibility deficits. PMID- 3560904 TI - Predicting competitive bicycling performance with training and physiological variables. PMID- 3560905 TI - Heart rate overshoot following sustained isometric and repeated isotonic arm flexion and knee extension. PMID- 3560906 TI - A study to evaluate and promote total fitness among fire fighters. PMID- 3560908 TI - An empirical investigation of triathlon performance. PMID- 3560907 TI - Pulmonary responses of black and white females. PMID- 3560909 TI - The effects of an acute physical exercise on some serum enzymes in older women. PMID- 3560910 TI - Plasma LDH activity and LDH isozymes after 400 m and 3,000 m runs in sprint and long distance runners. PMID- 3560911 TI - Incidence of sunburn during mountaineering expedition. PMID- 3560912 TI - Ocular injuries due to sports in Kuwait. PMID- 3560913 TI - Muscular strength as a predictor of personality in adult females. PMID- 3560914 TI - Effects of chewing tobacco on heart rate and blood pressure during exercise. PMID- 3560915 TI - The relationship between tibial nerve conduction velocity and selected strength and power variables in college football lineman. PMID- 3560916 TI - Anthropometric measurements, body composition, biological maturation and growth predictions in young male gymnasts of high agonistic level. PMID- 3560917 TI - Differential effects of age-group gymnastics and swimming on body composition, strength, and flexibility. PMID- 3560919 TI - A practical assessment of body composition in young women. PMID- 3560918 TI - Assessment of body composition by novice practitioners after a short intensive training session. PMID- 3560920 TI - Suppurative aortitis. PMID- 3560921 TI - Management of traumatic chest wall defects. PMID- 3560922 TI - Airway obstruction. PMID- 3560923 TI - Syringomyelia. PMID- 3560924 TI - Obstetrical services in Tennessee. PMID- 3560925 TI - Consider first things first. PMID- 3560926 TI - Treatment of a complex hepatic injury. PMID- 3560928 TI - Chemonucleolysis in private practice. PMID- 3560927 TI - Fallopian tube prolapse following abdominal hysterectomy. PMID- 3560929 TI - Rupture of the azygos vein: an unusual cause of hemothorax due to blunt trauma. PMID- 3560930 TI - Hemothorax. PMID- 3560931 TI - A patient with Carman-Kirklin sign on a barium study. PMID- 3560932 TI - The status of the Nation and Tennessee in reaching the 1990 Health Objectives. PMID- 3560933 TI - Patient care and bureaucracy. PMID- 3560934 TI - Steroid hormone antagonism and a cyclic model of receptor kinetics. AB - Steady state agonist-antagonist relations have been derived for a general version of a cyclic model of glucocorticoid-receptor kinetics. The model was previously shown to account quantitatively for the transient and steady state distribution of hormone-receptor complexes formed in thymus cells by several glucocorticoids. Agonist-antagonist properties of a steroid in the model are expressed quantitatively by its "agonist activity" A, the steady state ratio of nuclear bound to total complexes it forms. For a pure agonist A = 1, for a pure antagonist A = 0. This ratio is found to be independent of steroid concentration and a function only of the rate constants of reactions involving complexes formed by the steroid. Analysis of the dependence of A on each rate constant reveals how each reaction in the cyclic model--activation, nuclear binding, dissociation of activated and nuclear-bound complexes--influences antagonist properties. The steady state interaction of an antagonist with an agonist is shown to be governed by relations that are indistinguishable from competition relations for the simplest equilibrium system, and to yield dose-response curves that are very similar to those produced by two-state allosteric models of steroid hormone antagonism, despite the fact that the cyclic model includes no allosteric mechanisms. With steroids for which relevant rate constants can be measured, the model is directly testable. Limitations of the model arise from lack of information about the nuclear events that lead to biological activity following binding of activated complexes to the nucleus. PMID- 3560935 TI - Analysis of the glucocorticoid antagonist action of dexamethasone 21-mesylate in HeLa S3 cells. AB - Several properties of human glucocorticoid receptors complexed to the synthetic glucocorticoid agonists dexamethasone (DEX) and triamcinolone acetonide (TA) and the antagonist dexamethasone 21-mesylate (DM) are compared in an attempt to define the mode of action of DM. Both DEX and TA induce an increase in alkaline phosphatase activity in HeLa S3 cells. Not only is DM without effect on alkaline phosphatase activity at concentrations as great as 10(-7) M, it blocks the action of DEX and TA on enzyme induction, thus acting as a pure antagonist in this system. DM-receptor complexes, like agonist-receptor complexes, are recovered in the cytosol when cells are incubated with ligand at 0 degrees C but are recovered from the nucleus when incubation is shifted to 37 degrees C, suggesting that activation of the antagonist-receptor complex occurs in vivo. The molecular species that undergoes this temperature-dependent shift from the cytosolic compartment to the nuclear compartment exhibits saturable binding to the antagonist. Both the cytosolic and nuclear species exhibit a relative molecular mass of approximately equal to 94,000 Daltons when analysed by SDS-polyacrylamide gel electrophoresis. Receptors labeled in intact cells with [3H]DM at 0 degrees C sediment at approximately 8S in sucrose gradients, shifting to 4S when the gradients contain 0.4 M KCl. DEX- and TA-labeled receptors show the same sedimentation behavior, which has been accepted as one criterion of receptor subunit dissociation, or activation. PMID- 3560937 TI - Developmental changes of glucocorticoid receptors in the rat pancreas. AB - Glucocorticoids are known to play a role in the maturation of the exocrine pancreas. The exact mechanism of glucocorticoid action in pancreatic ontogeny is, however, not clear. The present study characterized and quantitated the binding of [3H]dexamethasone to cytosol fractions from pancreata of rats at various ages. Trunk blood samples from these rats were also checked for levels of free and bound corticosterone. Specific and saturable bindings for dexamethasone were found in pancreatic cytosol fractions from newborn suckling and adult rats. Competition studies showed a preference for steroids with glucocorticoid activity. Specific binding was relatively low in pancreatic cytosol from newly born and 1-day old pups. A significant rise was seen after day 15. Cytosolic binding capacities were greatest from pancreata obtained from pups at weaning (3rd to 5th weeks). Values then declined toward the adult level. Scatchard analysis revealed a single class of binding sites with a dissociation constant (Kd) of 7.3 (+/- 1.1) X 10(-8) M and number of binding sites equalled to 1.29 (+/ 0.18) X 10(-13) mole/mg of cytosolic protein in adult rat pancreas. Pancreata from 25- and 15-day old rats had Kds of 3.4 (+/- 0.8) X 10(-8) M and 2.7 (+/- 0.7) X 10(-8) M with the number of binding sites equal to 1.77 (+/- 0.21) X 10( 13) mole/mg protein and 1.31 (+/- 0.16) X 10(-13) mole/mg protein respectively. Total plasma corticosterone concentration was low before day 10. It rose significantly by day 15, peaked at day 25, and then declined after weaning. About 5-15% of corticosterone during weaning and about 20-30% before and after weaning were in the free form. The peak level of dexamethasone binding corresponded to an increase in the plasma corticosterone level during weaning. This suggests a close relationship between plasma corticosterone levels and pancreatic glucocorticoid receptors. Both may, therefore, play a role in pancreatic development in the rat. PMID- 3560936 TI - Clinical use of unbound plasma cortisol as calculated from total cortisol and corticosteroid-binding globulin. AB - A method to calculate unbound cortisol from total cortisol (measured by competitive protein binding) and CBG (measured by radial immunodiffusion) based on the binding equilibrium has been evaluated. The calculated results (y) correlate well with those (x) obtained by centrifugal ultrafiltration at 37 degrees C (y = 1.04 x - 2.11 ng/ml; r = 0.975; n = 150). The concentration of CBG is similar in normal men (37.7 +/- 3.5 (SD) micrograms/ml; n = 12) and women (39.5 +/- 3.7 (SD) micrograms/ml; n = 7) and shows no diurnal variation, but marked diurnal variation is observed for total cortisol (193.7 +/- 35.0 (SD) ng/ml at 08.00 h vs 43.2 +/- 23.3 (SD) ng/ml at 22.00 h; n = 19) and particularly for unbound cortisol (16.5 +/- 5.6 (SD) ng/ml at 08.00 h vs 2.3 +/- 1.8 (SD) ng/ml at 22.00 h; n = 19). The concentration of CBG (89.1 +/- 11.2 (SD) micrograms/ml) and of total cortisol (395.6 +/- 103.3 (SD) ng/ml at 08.00 h; 110.3 +/- 16.6 (SD) ng/ml at 22.00 h) are clearly elevated in estrogen treated women (n = 11) but unbound cortisol levels (17.2 +/- 7.7 (SD) ng/ml at 08.00 h; 2.5 +/- 0.5 (SD) ng/ml at 22.00 h) are similar to the control group. The concentration of CBG is significantly decreased in patients with Cushing's syndrome (33.2 +/- 5.6 micrograms/ml; n = 17) and unbound cortisol is relatively more elevated than total cortisol in these patients. In adrenal insufficiently CBG is normal, but total and unbound cortisol are markedly decreased. There is a significant decrease of CBG in hyperthyroidism (35.7 +/- 5.5 micrograms/ml; n = 22), in cirrhosis (32.0 +/- 8.0 micrograms/ml; n = 14) and in renal disease and a significant increase in patients treated with antiepileptic drugs (47.5 +/- 6.3 micrograms/ml; n = 14), but total and unbound cortisol are normal in all these conditions. We conclude that unbound cortisol can be calculated in a simple and reliable way from total cortisol and CBG and permits a better evaluation of adrenal function, particularly in patients with altered CBG concentrations. PMID- 3560938 TI - Occupied and unoccupied type II estrogen binding sites in human breast cancer. AB - Using a saturation analysis over a wide range of [3H]estradiol at two temperatures 4 and 22 degrees C we have determined unoccupied (4 degrees C) and total (22 degrees C) type II estrogen binding site (EBS) levels in individual cytosols of 100 patients with breast cancer (50 post and 50 premenopausal). Exchange was found to be complete after 18 h at 22 degrees C and receptor degradation was negligible during this treatment. Steroid specificity and affinity determined by Scatchard and Rosenthal plot analysis were not altered at 22 degrees C. Carcinomas presented a higher total type II REBS level as compared unfilled type II binding sites or the classical ER, independently of menopausal status, phase of the menstrual cycle or positivity of ER. On the other hand, unoccupied type II EBS level was strongly correlated to the concentration of type I ER, being higher on the post-menopausal group and older patients. PMID- 3560939 TI - Radioimmunoassay of plasma progesterone after oral administration of micronized progesterone. AB - A 200 mg dose of micronized progesterone (P) was administered orally to six healthy volunteers. Serial blood samples were collected and plasma P was assayed according to three methods of different specificity. The results were compared to those obtained with a reference technique based on gas chromatography-mass spectrometry. The interference of P metabolites particularly 5 alpha- and 5 beta dihydroprogesterone was shown to be important when no or inadequate chromatography was included in the method. Radioimmunoassay after chromatography on a Celite column yielded results similar to those of the reference method. After oral administration, plasma P reached a peak at 3.00 +/- 0.44 h (mean +/- SEM; range: 1-4 h). The mean peak level 4.70 +/- 1.15 ng/ml (mean +/- SEM; range: 2.40-10.10 ng/ml) was at the lower limit of the range defined for a normal functional corpus luteum. The levels returned to initial values by 24 h after the single oral dose. The separation of P from its metabolites by an adequate chromatographic system appears mandatory after oral administration of micronized P. PMID- 3560940 TI - Comparison of saliva and plasma 17-hydroxyprogesterone time-course response to hCG administration in normal men. AB - 17-Hydroxyprogesterone (17-OHP) time-course response to hCG (5000 IU) was studied simultaneously in the saliva and the plasma of 12 adult healthy men. Baseline levels in plasma and saliva were: 1.0 +/- 0.1 ng/ml (mean +/- SEM) and 24 +/- 2 pg/ml respectively. After hCG, a biphasic pattern was observed in both fluids with a similar early response but the peak elicited at 33 h in plasma was not observed in saliva where the levels were lower than those recorded at 24 h. Since saliva steroids are believed to reflect the plasma non-protein bound fraction, this difference was assumed to be due to the decrease of the unbound fraction of plasma 17-OHP in the late afternoon as a consequence of the increase of CBG-bound fraction since at that time cortisol levels are low. The ratio of saliva to plasma 17-OHP levels was significantly correlated with plasma cortisol levels: r = 0.44 (P less than 0.01; n = 140). However the similar response in saliva at 24 and at 48 h after hCG allows the evaluation of the endocrine testicular function using saliva instead of plasma. PMID- 3560941 TI - Diurnal fluctuation in saliva aldosterone concentration. AB - We have measured saliva aldosterone concentration (SA) at frequent intervals in subjects going about their normal daytime activities. Four hourly sampling sufficed to give a reasonable estimate of mean diurnal SA but hourly sampling is necessary if it is desired to study the temporal pattern of SA. In subjects with normal or elevated mean levels, SA fluctuated considerably suggestive of several distinct episodes of aldosterone secretion. Such fluctuations show little correlation with the concentrations in saliva of glucocorticoids (cortisol + cortisone) nor are they consistent with a circadian rhythm of aldosterone secretion. We suggest that they may represent responses to such stimuli as eating, drinking or physical activity, and possibly to other as yet unidentified factors. These observations show the importance of comprehensive diurnal assessment of aldosterone level in physiological and pathological investigations. Because of its non-invasive nature and the high productivity of the assay, measurement of SA is ideally suited for this purpose. PMID- 3560942 TI - Amniotic fluid testosterone and testosterone glucuronide levels in the determination of foetal sex. AB - Unconjugated testosterone levels were assayed in 351 amniotic fluid samples obtained at 15-19 weeks gestation. The median values for unconjugated testosterone in the 166 female foetuses and 185 male foetuses were 137 and 712 pmol/l respectively. Sixteen amniotic fluid samples from male foetuses had unconjugated testosterone levels lower than the highest female unconjugated testosterone value (361 pmol/l). Testosterone glucuronide was measured in amniotic fluid from 48 female and 55 male foetuses. There was a significant sex difference in the median values of testosterone glucuronide between female (median 160 pmol/l, range 64-465 pmol/l) and male (median 817 pmol/l, range 68 3707 pmol/l) amniotic fluid specimens (P less than 0.001). Of the sixteen male foetuses with amniotic fluid unconjugated testosterone levels in the female range, 12 had amniotic fluid testosterone glucuronide levels within the male testosterone glucuronide range of values. Hence used in conjunction with unconjugated testosterone, testosterone glucuronide increased the predictive accuracy of foetal sexing from 95.4 to 98.9%. Testosterone sulphate was measured in 24 female and 25 male amniotic fluid samples. There was no Testosterone sulphate was measured in 24 female and 25 male amniotic fluid samples. There was no significant difference between female (median 2591 pmol/l) and male (median 2964 pmol/l) testosterone sulphate levels. PMID- 3560943 TI - Plasma concentrations and receptor binding of RU 486 and its metabolites in humans. AB - Using Chromosorb chromatography and HPLC, we measured the plasma concentrations of RU 486, and its monodemethylated (RU 42633), didemethylated (RU 42848) and alcoholic nondemethylated (RU 42698) metabolites up to 72 h following oral ingestion of 100 mg of RU 486 by five female volunteers. The peak plasma level of RU 486 (4.5 mumol/l) occurred within 1 h after ingestion of the compound; at this point significant amounts of the metabolites were also present in the plasma. After the initial redistribution within 6 h the plasma concentrations of RU 486 and three of its metabolites measured remained stable for 24 h. Concentrations of the monodomethylated metabolite exceeded those of the parent steroid during the time period measured, whereas the concentrations of the didemethylated and alcoholic metabolites were lower than those of RU 486, but still notable. At 72 h the concentrations of all the four steroids were still in the micromolar range. The relative binding affinities of these metabolites to human endometrial and myometrial progesterone receptors as well as to human placental glucocorticoid receptors were determined in vitro. The affinity of RU 486 for the human uterine progesterone receptor (Kd = 1.3 X 10(-9) M for RU 486) was higher than that of progesterone but lower than that of ORG-2058, a potent synthetic progestin. The relative binding affinities of the monodemethylated, alcoholic and didemethylated metabolites to the progesterone receptor were 21, 15 and 9%, respectively, compared with the parent compound RU 486; each was lower than that of progesterone (43%). RU 486 had an approx. 4-fold higher relative binding affinity to the glucocorticoid receptor than dexamethasone. Interestingly, the relative binding affinities of the metabolites studied to the human glucocorticoid receptor exceeded those of dexamethasone or cortisol. Compared with the parent compound RU 486, they were 61, 48 and 45% for the monodemethylated, alcoholic and didemethylated metabolites, respectively; each was higher than that of dexamethasone (23%). The affinity of dexamethasone to the human glucocorticoid receptor was 1.6 X 10(-9) M. These data indicate that the pool of certain metabolites of RU 486 may contribute to a significant extent to the antiprogestagenic (23-33%) and even greater extent to the antiglucocorticoid (47 61%) effects of RU 486. PMID- 3560944 TI - Plasma binding of oestradiol in progesterone-treated rats. AB - Progesterone treatment of female rats causes an increase in body weight possibly via suppression of oestradiol secretion. This study was carried out to investigate the effect of progesterone on the non-protein bound and hence presumably biologically active fraction of oestradiol. Oestradiol binding to plasma proteins was studied in female Wistar rats during the oestrous cycle and after 12 days of treatment with progesterone (5 mg/day). There was no change in either the unbound fraction of oestradiol or plasma albumin concentrations during the oestrous cycle. Plasma oestradiol concentrations in progesterone-treated rats were similar to those seen during dioestrus, as were the degree of oestrogen binding and the plasma albumin concentrations. Although it was not feasible to calculate unbound concentrations, these results suggest that the increased body weight seen in progesterone-treated rats, and also during pregnancy, may be a result of suppression of unbound oestradiol concentrations to levels similar to those occurring during dioestrus. PMID- 3560945 TI - Agreement between two measures of alcohol consumption. AB - Responses on the Quantity-Frequency Questionnaire (QF) were compared with those on the self-report diary. The QF was administered to 778 general practice patients prior to their consultation and the same patients completed the diary at home within 24 hours. The diary overestimated the number of nondrinkers in the population relative to the QF and classified a higher proportion of patients as heavy drinkers. The QF failed to detect 78% of heavy drinkers identified by the diary. Significantly (p less than .001) more alcohol was reported to be consumed overall on the diary (mean, 10.51 drinks/week) than on the QF (mean, 6.87 drinks/week). The relationship between responses on the two measures was nonlinear. At low consumption levels patients indicated drinking twice as much on the diary as on the QF, but the magnitude of the reported consumption difference decreased with increasing consumption levels. The results are discussed in terms of their implications for self-report measures of alcohol consumption. PMID- 3560946 TI - Types of male drinkers: a multivariate study. AB - Data from 1070 recent male drinkers were analyzed using factor analysis (as a form of data reduction) and cluster analysis to identify groups of different types of drinkers. The data were derived from a sample of 3600 face-to-face interviews conducted in the early part of 1982 in six provincial cities in New Zealand. Of this total, 1509 interviews were with male respondents, of whom 28% were either abstainers or were not recent drinkers (i.e., had not consumed alcohol in the 7 days preceding the interview). The variables that were factor analyzed included attitudinal, motivational, situational and consumption items. The resulting factor scores were submitted for clustering and the final cluster solutions were cross-tabulated by alcohol consumption measures and demographic characteristics. Six segments were identified and appeared to be primarily distinguishable on the basis of common drinking situations: Light Drinkers (43%), Frequent Early Evening Drinkers (28%), Heavy Hotel-Tavern Drinkers (21%), Club Drinkers (4%), Solitary Drinkers (2%) and Party Drinkers (2%). PMID- 3560947 TI - The characteristics of alcoholics frequently lost to follow-up. AB - In a follow-up of 85 alcoholic men, 93% were interviewed or confirmed deceased 8 years after discharge from hospital. The sample was also followed up at 1 and 3 years postdischarge. Follow-up rates of other published studies are discussed. Scales to assess difficulty of interview and difficulty of location were developed. Factor analysis revealed the differential characteristics of subjects defined as difficult to locate, difficult to interview or missing. Subjects who are difficult to locate, or who in the extreme case will go missing, tended to have poorer social functioning prior to intake and to be residentially unstable during the follow-up period, characteristics that tend to correlate with worse drinking outcome. Subjects who are unwilling to be interviewed tended to be residentially stable and show better interpersonal adjustment at follow-up. Less intensive location procedures would have resulted in data loss from those classified as difficult to locate. Less persuasive interview techniques would have resulted in data loss from those classified as difficult to interview. Early termination of the follow-up would also have resulted in data loss from the latter group. The distinct types of data biases that would be introduced by loss of information from each of the above subgroups are examined. PMID- 3560948 TI - Reduction of community alcohol problems: computer simulation experiments in three counties. AB - A series of alcohol abuse prevention strategies was evaluated using computer simulation for three counties in the United States: Wake County, North Carolina, Washington County, Vermont and Alameda County, California. A system dynamics model composed of a network of interacting variables was developed for the pattern of alcoholic beverage consumption in a community. The relationship of community drinking patterns to various stimulus factors was specified in the model based on available empirical research. Stimulus factors included disposable income, alcoholic beverage prices, advertising exposure, minimum drinking age and changes in cultural norms. After a generic model was developed and validated on the national level, a computer-based system dynamics model was developed for each county, and a series of experiments was conducted to project the potential impact of specific prevention strategies. The project concluded that prevention efforts can both lower current levels of alcohol abuse and reduce projected increases in alcohol-related problems. Without such efforts, already high levels of alcohol related family disruptions in the three counties could be expected to rise an additional 6% and drinking-related work problems 1-5%, over the next 10 years after controlling for population growth. Of the strategies tested, indexing the price of alcoholic beverages to the consumer price index in conjunction with the implementation of a community educational program with well-defined target audiences has the best potential for significant problem reduction in all three counties. PMID- 3560949 TI - A comparative study of familial alcoholism. AB - In a large multicenter study of 568 male alcoholics, structured interviews were used to compare the clinical characteristics of patients with a positive (65%) or negative (35%) family history of abusive drinking among first degree relatives. Alcoholics with a positive family history were found to have: an earlier onset of alcoholism, greater alcoholic severity, more medical and legal problems, a broader range of treatments, an increased lifetime prevalence of additional psychiatric disorders and a greater diversity of psychiatric disturbance among biological relatives. The degree of psychiatric heterogeneity in the patients roughly corresponded to the degree of psychiatric heterogeneity in their families. Assortative mating was proposed as a possible mechanism to account for clinical differences between the familial and nonfamilial alcoholic. PMID- 3560950 TI - Drinking-driving and health lifestyle in the United States: Behavioral Risk Factors Surveys. AB - National patterns of self-reported drinking-driving were examined using aggregated Behavioral Risk Factor Survey data. Drinking-driving is reported by 6.1% of U.S. adults, is almost three times more prevalent among men than women and is most prevalent in 18-24-year-old men (15.4%). Sociodemographic characteristics of self-reported drinking drivers correspond with those characteristics based on alcohol-associated motor vehicle accident and arrest data. Heavy smokers and those who fail to use seatbelts are more likely to drink and drive than those without these health-risk behaviors. Men reporting stress in interpersonal relationships are more likely to drink and drive. Individuals who drink or smoke in response to stress are more likely to drink and drive than those who exercise in response to stress. The concurrent practice of drinking driving with lack of seatbelt use, use of alcohol in response to stress and smoking probably contributes substantially to the risk of accident and serious injury among drinking drivers and has implications for both prevention and treatment programs. PMID- 3560951 TI - Public opinions about alcoholism and its treatment. AB - Survey respondents' views about alcoholism as an illness, support for treatment, treatment recommendation and stigma surrounding alcoholics are examined. Subjects (N = 482) comprise a random sample of the population of Contra Costa County, California. About 91% of the respondents agree with the notion that alcoholism is an illness, but 40% also agree that alcoholics drink because they want to. More women than men support the idea that to recover alcoholics will have to quit drinking forever. The contrary is true of the idea of controlled drinking. Education and income are negatively associated with items on loss of control and controlled drinking. Respondents who have had their lives deeply affected by an alcoholic and those who report a drinking problem of their own do not differ in their opinions about alcoholism from those who do not have these characteristics. Alcoholics Anonymous is the most common form of treatment recommended by the respondents. In general, results show considerable support for treatment as well as ambivalence regarding the disease concept. PMID- 3560952 TI - Wine, women, suspiciousness and advertising. AB - Women college students (N = 66) viewed videotapes of a soap opera episode and a rock music program, ostensibly to evaluate the appeal of such material to college women. Different versions of the videotape included zero, three or nine wine commercials. Refreshments, including white wine, were available to the subjects. Suspiciousness about the experiment was evaluated through an open-ended questionnaire, responses to which were independently content-analyzed by two scorers. Major findings were as follows: Women exposed to nine wine commercials consumed more wine than those exposed to three. Twelve women were judged suspicious about the experiment, but none showed continued specific awareness of the study's true purpose. The differential consumption patterns of women in the three-wine-commercial and nine-wine-commercial conditions were exaggerated among suspicious women. These findings, in light of previous observations, suggest opposite reactions to soft-sell versus hard-sell persuasive appeals by men and women, notably ones predisposed to be suspicious about the purpose of experiments. PMID- 3560953 TI - A panel study of normative structure, adolescent alcohol use and peer alcohol use. AB - Panel data and multiple regression of follow-up data on baseline data are used to explore direction of relationship among normative structure, adolescent alcohol use and peer alcohol use. Baseline and follow-up data were collected on a random sample of 100 adolescents (54 males). Two separate measures of each of the six variables--Adolescent Alcohol Involvement Scale (AAIS), Quantity-Frequency Index (QF), close friend drinking level, other friend drinking level, perceived harm due to alcohol use and attitudes toward alcohol--were used. The relationship between adolescent self-drinking and peer alcohol use was found to be reciprocal, complex and limited to close friends. Baseline AAIS predicted follow-up close friend drinking level, but baseline QF Index did not. Baseline close friend drinking level predicted follow-up QF Index but not follow-up AAIS. Normative structure toward alcohol was found to be stable over time and unrelated to baseline self or peer alcohol use. Baseline perceived harm due to alcohol use predicted follow-up QF Index, indicating that adolescents adjust behavior to prior attitudes. PMID- 3560954 TI - A comparison among some measures of depression in male alcoholics. AB - The efficacy of three depression scales--the Dysthymic scale of the Millon Clinical Multiaxial Inventory, the Beck Depression Inventory and the Geriatric Depression Scale (GDS)--in assessing depressive symptoms in 67 male alcoholic patients was compared. The criterion of depression was the patient's score on the Depression scale of the Minnesota Multiphasic Personality Inventory. In addition, the effects of age on the test results were explored as it was believed that the GDS would be less affected by age than the other two scales. The findings disclosed that all three depression scales are comparable in assessing depressive symptoms and that age is not a factor in any of the scales. PMID- 3560955 TI - A prospective study of successful long-term adjustment in alcohol dependence: social drinking versus abstinence. AB - A series of 1312 alcoholics admitted to the Department of Psychiatry, University Hospital, Lund, Sweden, from 1949 through 1969 was followed up by record data up to 31 December 1980. The conditions of the patients were evaluated with a multidimensional diagnostic rating schedule when first admitted. Two decades after their first admission, 70 male alcoholics with a good social adjustment were chosen for personal examination and of these 60 (86%) were interviewed. Social drinking was twice as common as abstinence among the former alcohol dependent subjects. Abstainers had a higher frequency of initial ratings indicating lack of internal control of behavior and were less often socially stable when first admitted as compared with the social drinkers. Early improvement was related to initial abstinence; the subjects who improved later in life more often reported a gradual change from alcohol abuse to social drinking. PMID- 3560956 TI - Granulomatous reactions in mycosis fungoides. AB - Granulomatous reaction characterized by the formation of noncaseating accumulations of epithelioid histiocytes and multinucleated giant cells of the foreign-body type is a rare, poorly understood, and generally ignored phenomenon seen in various types of lymphoma. Its presence in cutaneous infiltrates of mycosis fungoides is equally unusual, but some favorable prognostic significance has been ascribed to it previously. In this paper, four patients with typical mycosis fungoides and granulomas demonstrated histologically in their cutaneous infiltrates are presented. All four died of disseminated disease with evidence of central nervous system involvement in three of them. These clinical histories lend no support to the notion that granulomatous mycosis fungoides is a benign variant of this lymphoma. Relevant literature is reviewed and discussed. PMID- 3560957 TI - Solitary pulmonary metastasis: an enigma. AB - Lung metastases, which are an expression of the new phase of the underlying neoplastic disorder, have been treated in the recent years by multiple disciplinary approach. When the metastases to the lungs are multiple, it is indicative of extensive tumor burden, and the organ plays an insignificant role in the distribution of the metastases in the different lobes of the lungs. However, when the pulmonary metastases appear after a prolonged disease-free interval it becomes an enigma; when the metastases are solitary, the majority (over 80% in this series) are located in the upper zone of the lungs. This study of 28 patients with solitary lung metastases explores the possible etiology of this clinical observation and proposes that the pattern of perfusion and anatomopathological features of the upper lobes are the main reasons why these lobes are prevalently the sites for solitary lung metastases. PMID- 3560958 TI - Indolent lymphadenopathic Kaposi's sarcoma. AB - Kaposi's sarcoma is usually an indolent skin neoplasm. Diffuse lymph node and visceral involvement have been described in young African patients and in patients who are immunosuppressed; in such patients the disease is usually rapidly progressive. We describe the case of a 64-year-old man of Italian ancestry with diffuse lymph node involvement by Kaposi's sarcoma in the absence of any skin lesions. The patient had no evidence of immunosuppression. The course has been indolent, with no disease progression over 2 years of follow-up on no therapy. PMID- 3560959 TI - Early metastatic patterns and survival in malignant melanoma. AB - Two hundred fifty patients with distant metastasis from malignant melanoma were analyzed at the first appearance of systemic metastasis. Commonly involved sites were lung, subcutaneous tissue, brain, and liver. Frequency of liver metastasis was higher with eye and mucous membrane primary sites (P less than 0.01). Liver involvement had the worse survival compared to lung and brain. Patients with mucosal or unknown primary sites had decreased survival compared to other sites (P less than 0.01). Patients with primary melanomas thicker than 4 mm had significantly shorter survival (P less than 0.02). Single-organ involvement correlated with longer survival compared to multiple-organ involvement (P less than 0.04). Survival of metastatic disease was more favorable in patients with involvement of subcutaneous tissue only and in those with a disease-free interval of 2 years or longer. Five-year survival from first appearance of metastasis was 7% and median survival was 8 months. PMID- 3560960 TI - Three synchronous bilateral lung tumors: a case report. AB - Two synchronous primary lung carcinomas presenting bilaterally are rare. Their presentation, predisposing factors, and treatment are similar to those of single lung carcinomas. The authors present the first reported case known to them of three synchronous primary lung carcinomas involving both lungs. These tumors fulfill accepted criteria for synchronous tumors--each is malignant, each is anatomically separate and distinct from the other, and each is histologically different and is not a manifestation of metastatic disease. PMID- 3560961 TI - Five-year survival after extended resection of colon cancer. AB - Eleven cases of prolonged survival after extensive resection of colon cancer including neighboring structures are presented. Our understanding of colon cancer as a rapidly invasive but slowly metastasizing tumor has provided the rationale for this approach. Techniques of ureteral and abdominal wall reconstruction are presented. Cures are possible with this approach, and without the availability of adequate chemotherapy aggressive resections remain the mainstay of treatment. PMID- 3560962 TI - Adenocarcinoma of the duodenum. AB - Three patients with carcinoma of the first and the third part of the duodenum are reported. A review of the literature shows the diagnosis of this rare lesion of the duodenum is usually late. In order for surgical resection to be successful, suspicion of such a lesion and an aggressive workup is needed. PMID- 3560963 TI - Use of the 90Sr applicator for intraoperative radiation therapy in a mouse tumor model. AB - Intraoperative radiation therapy (IORT) research is limited by the lack of small animal models. We have implanted B16 melanoma into mouse kidneys, which we subsequently operated upon and irradiated with beta rays from a 90Sr ophthalmic applicator. The IORT has effectively prolonged survival and produced some cures. The strategy should be applicable to other murine tumors and to other internal implantation sites. PMID- 3560964 TI - Effect of splenectomy on treatment of Lewis lung carcinoma by an immunomodulatory polysaccharide and a cytotoxic agent. AB - The effect of the spleen on the efficiency of chemotherapy (cyclophosphamide) and immunotherapy (the polysaccharide levan) of C57BL mice bearing the Lewis lung carcinoma was studied. The development of Lewis lung carcinoma caused a gradual splenomegaly in the C57BL mice. Splenectomy did not, however, affect tumor growth in the nontreated host. Levan induced a pronounced splenomegaly. Splenectomy reduced markedly the antitumoral effect of the polysaccharide. These results indicate that spleen elements participate in the inhibitory activity of levan. By contrast, splenectomy had no effect on the efficiency of treatment of cyclophosphamide. PMID- 3560965 TI - [Analysis of results of a trial using the subject as its own control with a criterion of binary response]. AB - The two-period cross-over design is often used in clinical trials in which subjects serve as their own controls. This procedure may produce a more powerful test, but also may produce bias due to carry-over effects. Three tests have been proposed for the analysis of two-period binary response cross-over trials (McNemar, Gart and Prescott). These tests and a simple test for the carry-over effect are presented in this paper. The contrasts used are similar for the three tests, but McNemar's test does not allow an order effect, contrary to the other methods. The Prescott's test is more powerful, but calculations are heavy and need computer assistance. Therefore, McNemar's test can be used as a first approximation. PMID- 3560966 TI - [Effects of progesterone and nomegestrol acetate on the endometrial epithelium of the rabbit. A study with scanning electron microscopy]. AB - Immature female rabbits were tested by the Clauberg-MacPhail technique using progesterone (P), or nomegestrol acetate (NOM), a 19-norprogesterone derivative. The endometrial surface was observed by scanning electron microscopy. Estrogen priming followed by treatment with P induced changes on the endometrial surface which were very close to those observed in menopausal women under sequential estroprogestative therapy. After treatment with NOM the aspect of endometrium surface was very close to those observed after treatment with P. This is in accordance with the pharmacological profile of the product. Scanning electron microscopy confirms the previsional value of Clauberg-MacPhail's test and provides useful complementary information for the pharmacological understanding of a new synthetic progestogen. PMID- 3560967 TI - The pharmacological effects of acute and chronic clenbuterol treatments after lesions of central noradrenergic nerve terminals. AB - Acute administration of clenbuterol, a lipophilic beta-adrenergic agonist, decreases motor activity and antagonizes the reserpine-induced hypothermia in mice. After chronic administration of clenbuterol, the acute effect on motor activity disappears (tachyphylaxis) and the acute effect on reserpine hypothermia is potentiated (facilitation). These effects of clenbuterol (either acute or chronic + acute treatments) are not abolished after specific lesions of the noradrenergic system by the neurotoxin DSP-4 which reduces the cerebral levels of norepinephrine to 30% of controls. Although it cannot be excluded that a 70% lesion may be insufficient, another explanation is that beta-adrenergic receptors involved in hypomotility and in reserpine-induced hypothermia may not be located on noradrenergic neurons or may be different from the post-synaptic beta adrenergic receptors which become hypersensitive after DSP-4 denervation. PMID- 3560968 TI - Model of global forebrain ischemia in the unanesthetized rat. AB - Global forebrain ischemia was induced in unanesthetized rats by electrocauterization of the vertebral arteries and transient occlusion of the common carotid arteries for 30 minutes. Local cerebral blood flow (l-CBF), cortical tissular pO2 (tpO2), electrocorticogram (ECoG), mean arterial pressure, pH and blood gas determinations and neurologic deficit were evaluated during and after ischemia. Cerebral ischemia induced a substantial decrease in l-CBF and tpO2 and the ECoG was flattened. One hour after ischemia, the neurologic deficit was at its maximum, l-CBF was still decreased and ECoG depressed. Twenty-four hours later, the neurologic deficit was still present but ECoG, l-CBF and tpO2 had returned to their preischemic values. Treatments with naloxone were performed during, after or during and after ischemia. When naloxone was administered during or after ischemia, postischemic neurologic deficit was not influenced by the treatment. A slight but significant improvement of the neurologic score was observed when naloxone was injected during ischemia and infused thereafter. Our results show that this experimental model of cerebral ischemia is suitable for quantification of neurologic alterations during the postischemic period. The slight improvement observed with naloxone suggests that endogenous opioids may have a minor role in the neurologic consequences of ischemia. PMID- 3560970 TI - [Experimental validation of a procedure for modulated perfusion of thiopental]. AB - The pharmacokinetics of sodium thiopental was studied in 9 normal dogs of various ages by the usual bolus method. Data were fittable by a two compartment open model in 8, three compartments were needed in one. Constant-rate infusions, as used in cerebral resuscitation, were performed in 6 of them. As expected, constant blood levels could not be obtained during the distribution phase which lasted about 6 hours. From the individual pharmacokinetic constants, the time equation of infusion rate intended to exactly compensate for distribution was calculated. The resulting "modulated infusions" succeeded in reducing the blood level trough from 50% to 20%. After the end of infusions, the decrease of plasma levels exhibited a non linear pattern which had not been noticeable in the elimination phase after boluses. Such unknown non linearity may lead to systematic errors when calculating pharmacokinetic parameters: this could explain why a complete correction was not obtained with modulated infusions. A better parametrization method in the case of non-linear elimination is under study. PMID- 3560969 TI - Reversal effect of isaxonine on modifications of rat polymorphonuclear migration by colchicine. AB - Using a modified Boyden chamber, random migration and chemotaxis of rat polymorphonuclear leucocytes (PMN) were assessed after incubation in vitro in a solution of colchicine (1.5 X 10(-5) M). The results obtained were compared to random migration or chemotaxis of the same cellular pool treated in vitro or in vivo by N-isopropyl-amino-2-pyrimidine phosphate (isaxonine 4.10(-5) M or 75 and 150 mg/kg respectively). Isaxonine partially inhibited the effect of colchicine on PMN chemotaxis while random migration remained unaffected. Isaxonine might partially inhibit the noxious effect of colchicine on microtubule disruption by a direct effect (polymerization of free tubulin) and/or indirect effect (impairment of disorganizing activity) on PMN microtubules. PMID- 3560971 TI - [The role of serotonin in the behavioral changes induced in the rat by cyclazocine]. AB - Cyclazocine is a benzomorphan derivative, considered as a mixed kappa and and sigma opioid receptor agonist. In experimental study with rats, cyclazocine is known to increase locomotor activity and to produce a bizarre behavioral syndrome including head swaying, backward walking, circling. The present study was undertaken to investigate the effects of various drugs modifying the serotoninergic neuronal systems, upon the locomotor activity and the abnormal behaviors induced by cyclazocine. Pretreatment with p-chlorophenylalanine (PCPA, 400 mg/kg, 72, 48, 24 hr) resulted in an inhibition of the three abnormal behaviors. Pretreatment with p-chloromethylamphetamine (PCMA, 15 mg/kg, 24 hr) antagonized head swaying, backward walking and markedly enhanced locomotor activity. In the contrary, pretreatment with PCMA (2.5 mg/kg, 15 min) resulted in enhanced abnormal behavioral responses to cyclazocine. L-tryptophan (50 mg/kg), 5 hydroxytryptophan (5-HTP, 50 mg/kg), or pargyline (50 mg/kg) inhibited abnormal behaviors and decreased locomotor activity. Serotonin antagonists with affinity fir both 5-HT1 and 5-HT2 receptors, metergoline (0.25-1 mg/kg), methysergide (1-5 mg/kg), amitriptyline (5-20 mg/kg), dl-propranolol (10-40 mg/kg) blocked head swaying and backward walking; only methysergide inhibited circling. All these drugs, except methysergide, markedly enhanced the cyclazocine-induced locomotor activity. In contrast, ketanserine (0.5-2 mg/kg) and pirenperone (0.05-0.2 mg/kg), serotonin antagonists with selective affinity for 5-HT2 receptors had no effects on the abnormal behaviors and locomotor activity. Taken together, these results suggest that a serotoninergic mediation is involved in the cyclazocine induced abnormal behaviors, and that serotonin exerts an inhibitory control on the locomotor activity produced by the drug. These effects are probably associated with 5-HT1 receptors. Further experiments have shown that the drugs having being able to potentiate cyclazocine-induced locomotor activity, similarly potentiate the locomotor activity induced by levallorphan, morphinan derivative with cyclazocine-like properties but do not enhance the hyperactivity produced by a low dose of morphine. The data reported here, provide a contribution to the informations concerning the neuromediation of the effects of mixed kappa and sigma agonists and allow to compare the mechanism of action of cyclazocine with those of other psychotomimetic drugs. PMID- 3560972 TI - Possible involvement of endogenous acetylcholine in the tetraethylammonium induced depolarization of avian skeletal muscle. AB - The depolarization produced by acetylcholine (ACh) (5.5 microM-11 mM) and by tetraethylammonium (TEA) (0.95-48 mM) in chick skeletal muscle were recorded using a sucrose-gap external recording device. The gap is constructed from perspex blocks of 3 main chambers which contain the preparation and are superfused with Krebs solution (chamber 1), Krebs solution containing test drug solution (chamber 3) and isotonic sucrose solution (chamber 2). Drugs were added directly into the superfusion stream leading to chamber 3 which contained the distal and active part of the muscle. Recordings of electrical responses were made via a pair of calomel electrodes, in contact with woollen wicks extending from chambers 1 and 3, leading to a preamplifier linked to a cathode ray oscilloscope and a potentiometric pen recorder. The results showed that TEA, a potassium channel blocker, produced a small depolarization (about 1 mV), whereas ACh produced a large depolarization (about 8 mV), and that the TEA-induced depolarization was in part due to the release of endogenous ACh at the neuromuscular junction. Other findings include the characteristic feature of TEA induced depolarization, i.e. its long latency (about 1 min) and the biphasic response, a small depolarization followed by an after-hyperpolarization (about 2 mV). The results are in favour of the possibility that TEA may act at both pre- and postsynaptic membranes at the avian neuromuscular junction. PMID- 3560973 TI - [The influence of aging on cerebral energy metabolism following post-hypoglycemic recovery in the rat. Pharmacologic application]. AB - Influence of aging on cerebral energetic metabolism was evaluated during and after severe hypoglycemia in rats respectively 20 (adults), 60 (matures) or 100 (senescents) week-old. Cerebral content of carbohydrates, amino-acids, ammonia, ATP, ADP, AMP, creatine phosphate and creatine was analysed after 20 min insulin induced hypoglycemia and after 20 min hypoglycemic recovery induced by glucose infusion. In the rats of different ages tested, effect of raubasine (0.85 mg X kg 1 i.p. and i.v.), almitrine (2.68 mg X kg-1 i.p. and i.v.) and association almitrine plus raubasine (at the same doses) on post-hypoglycemic recovery was tested. Aging does not affect the cerebral metabolic disorders occurring in severe hypoglycemia, but rather the metabolic changes during the post hypoglycemic restitution. In fact there is lower restitution of the concentrations of cerebral cortical metabolites in older rats: the concentrations of many amino-acids and adenylate nucleotides remains largely abnormal. Compared with saline treated post-hypoglycemic rats, raubasine decreases by 15 to 20% cerebral glucose and pyruvate contents in "adults" and "matures" rats and by 10 to 15% glutamate content in rat of different ages tested. Almitrine decreases by 20% cerebral glucose concentration in "matures" and "senescent" rats. In this latter group, almitrine decreases lactate and ammonium contents and increases by 23% glutamine level. In rats of all ages that were submitted to 20 min insulin induced hypoglycemia followed by 20 min glucose induced post-hypoglycemic recovery, the association almitrine plus raubasine decreases by 20 to 30% cerebral glucose, pyruvate and lactate contents and decreases by 15% glutamate. In older brains the association almitrine plus raubasine decreases by 50% cerebral content in ammonium and concomitantly induces an equivalent increase in glutamine content. The effect of the combination almitrine plus raubasine is characterized by an increase in rate of metabolic recovery process in all ages tested. PMID- 3560974 TI - The antagonistic effects of ouabain and calcium channel blockers on the contractility of the isolated rat heart. AB - The simultaneous prescription of a calcium channel blocker and a cardiac glycoside is a frequently used therapeutic combination in cardiology, although its consequences on inotropism have not been really evaluated. This association is studied on isolated rat heart perfused at constant coronary pressure, paced at a constant frequency and working against a left intraventricular balloon. Since the inotropic effects are dependent on the basic level of myocardium contractility, controls were made hypocontractile by lowering external calcium level to 0.25 mM. For the same initial systolic pressure (45 mm Hg) and + dP/dTmax (150 mm Hg X s-1) the inotropic effect of 10(-5) M ouabain was significantly less pronounced in the presence of 10(-6) M verapamil or 10(-7) M nifedipine at 2.5 mM CaCl2 than at the low external calcium concentration of 0.25 mM (increasing the + dP/dtmax by 35% +/- 4, 29% +/- 6 and 110% +/- 18 respectively). Since we know that the inotropic properties of digitalis are probably due to an increase of the slow calcium inward current, we conclude that the observed effect would be due to a blockade of these channels by calcium blockers. PMID- 3560975 TI - The inhibitory effect of guanabenz on submandibulary salivation induced by chorda tympani stimulation in anaesthetized cat. AB - The actions of guanabenz, an alpha 2-adrenoceptor agonist, on submandibulary salivation were examined in the anaesthetized cat. Guanabenz reduces submandibulary salivation evoked by electrical stimulation of the chorda tympani in dose and frequency dependent manner. This effect was antagonized by yohimbine but not by prazosin. Guanabenz increased salivation elicited by intraarterial injection of carbachol. This potentiated effect was suppressed by yohimbine, but not by prazosin. On noradrenaline induced salivation guanabenz has no effect, while prazosin virtually abolished it, indicating involvement of alpha 1 adrenoceptors. It appears that guanabenz reduces peripheral parasympathetically evoked submandibulary salivation influencing the presynaptic control of transmitter release alpha 2-adrenoceptors. Postsynaptic alpha 2-adrenoceptors are not involved in the inhibition of salivation by this agent. PMID- 3560976 TI - [A peptide (a magnesium salt of N-acetyl (alpha, beta)-aspartyl-glutamic acid). Demonstration of the protection against local cellular destruction induced by in situ complement activation]. AB - A peptide of simple chemical structure has demonstrated its efficiency in preventing the large cellular destruction that locally activated complement produced on the ciliary epithelium of the respiratory tract. Previously (1980), it was demonstrated by the authors that these cellular destructions after sensitization of the epithelium was due to the local activation of the complement (alternate pathway) by immune complexes with secretory IgA. The cellular protection afforded by Naaga was demonstrated by the persistance of a normal ciliary beating when the sensitized mucosa is in contact with the antigen; by electron microscopic studies both in transmission and scanning E.M. contrasting with the complete cellular destructions of the epithelium which appear obvious. The protection appear complete when Naaga (56 mM) is present in the testing solution (or instillated before the test). By in vitro human complement studies; study of the cytolytic sequence inhibition for the classical pathway 1,5.10(-3) M of Naaga produces a 50% inhibition of 1 H50 hemolytic unit. For the alternate pathway, the same inhibition is observed with 1,75.10(-3) M of Naaga; by two dimensions immuno-electrophoresis: a dilution of 1/2 of C3 in Naaga reduced to 1/10 of its normal value the C3b profile; the "Rockets" technique demonstrated that the same 1/2 dilution of Naaga in complement prevents the clivage of factor B and that this peptide acts by inhibition of the alternate C3 convertase formation (see illustrations). If we consider the subject of this study i.e. the upper respiratory tract mucosa and knowing the physiopathological importance of the muco ciliary complex in preventing dust, microbs and other particulate foreign materiel to penetrate the epithelium, the therapeutic importance of such a simple non toxic and unharmful chemical compound must be stressed. PMID- 3560977 TI - [Comparative study of the tissue distribution of two beta-mimetics: clenbuterol and salbutamol in the dog]. AB - Especially because of their physico-chemical properties, and in particular of their lipo-solubility, it was interesting to compare the tissue distribution of two beta 2 sympathomimetics: the clenbuterol and the salbutamol. The study was realised after a direct intravenous administration of clenbuterol chlorhydrate (5 micrograms/kg) and one of salbutamol sulfate (50 micrograms/kg) given to a dog. In a first time, the determination by mass-spectrometry of the two drugs in the plasma allows the pharmacokinetic study in dogs. After a three days wash out, this same experience was repeated. The animals are sacrificed and the assays of the two beta 2 sympathomimetics were effected in lung, bronchial, muscle, heart and brain tissue samples. The tissue distribution was different for clenbuterol and salbutamol and had to be considered as factors of selectivity in the sympathomimetic beta 2 activity. Nervous central diffusion of clenbuterol is higher than salbutamol but cardiac distribution is very important for salbutamol. PMID- 3560978 TI - Interaction of new 19 nor progesterone derivatives with progestagen, mineralocorticoid and glucocorticoid cytosolic receptors. AB - Structure-activity relationships were studied in vitro on a number of natural and artificial steroids in order to assess their progestagen specificity. These substances included a new compound derived from 19 nor progesterone, TX066 or nomegestrol acetate, and two synthetic intermediates, TX045 and TX071, all prepared by Laboratoires Theramex. The experiments involved binding competition on the cytosolic receptors prepared from target organs against specific radiolabelled ligands. Relative affinities were determined in rats against progesterone (P), aldosterone (A) and dexamethasone (DM), by displacement of: (3H)-ORG 2058 from the progestagen receptor of uterus, (3H)-A from Type I (mineralocorticoid) receptor of the kidneys and (3H)-DM from glucocorticoid receptors of the kidney (Type II) and of the liver. The various modifications introduced in the progesterone molecule led to sequences in competition potency which were either parallel or opposite in the progesterone compared to the 19 nor progesterone series. The main practical conclusion is that TX066 which is intended for use as a progestagen presents very little mineralo- and glucocorticoid activities at the receptor level, while its affinity for the progestin receptor is nearly as good as that of progesterone. The two derivatives TX045 and TX071 displayed very little or no progestagen affinity while their mineralo- and glucocorticoid potencies were between those of 19NP and TX066. PMID- 3560979 TI - The effect of L-N6-phenylisopropyladenosine (L-PIA) on the isolated hemidiaphragm of the rat. AB - The effect of L-N6-phenylisopropyladenosine (L-PIA) on the maximum tension developed (Td) and the maximum rate of rise of tension (dT/dt max) of the isolated hemidiaphragm of the rat was investigated during direct electrical stimulation. L-PIA itself (0.07-5.5 mumol l-1) did not produce significant changes in either Td, or dT/dt max. In the presence of a standard concentration of dipyridamole (26.4 mumol l-1), L-PIA produced a significant and concentration dependent increase in both Td and dT/dt max. In the presence of a standard concentration of aminophylline (640 mumol l-1), L-PIA produced a small and insignificant, but concentration-dependent decrease of both Td and dT/dt max. In the presence of both dipyridamole (26.4 mumol l-1) and of aminophylline (640 mumol l-1), L-PIA (0.07-5.5 mumol l-1) produced a small and insignificant potentiation of the isometric contraction of the isolated hemidiaphragm. It is concluded that antagonistic action between L-PIA and aminophylline probably takes place at A1-receptors. The inhibitory action of L-PIA, observed after blockade of adenosine receptors by aminophylline, is presumably realized through some other mechanism(s) independent of adenosine receptor sites. PMID- 3560980 TI - [Method of studying the effective ventricular refractory period and of the cardiac electrical activity in the ventilated anesthetized guinea pig. Differentiation of Class I and Class III effects]. PMID- 3560981 TI - [Implantation of a permanent flexible permanent cannula duodenal in the rabbit, application to the study of drug resorption]. PMID- 3560982 TI - Factors affecting the stability and separation of biogenic amines and their metabolites. Simultaneous measurement by HPLC with electrochemical detection. AB - We describe a simple and sensitive method for the rapid and simultaneous quantification of dopamine, 3-methoxytyramine, 3,4-dihydroxyphenylacetic acid, homovanillic acid, serotonin, 5-hydroxyindoleacetic acid, and 5-hydroxytryptophan in the picogram range in small samples of brain tissue. After minimal sample preparation the amines were analyzed utilizing isocratic separation and reversed phase high-performance liquid chromatography with amperometric detection. The effects of pH and methanol concentration in the solvent on the retention times of the amines on two different C-18 columns were investigated. Stabilities of the amines in solution were determined under various conditions. Light and air were found to be detrimental to the stability of indoles. In the absence of light, their stability was dependent on temperature and the presence of air; however, in the absence of air, light and/or temperature had little effect. The catechols were stable under most of these conditions. The assay has been applied to study the postmortem stability of dopamine, serotonin, and their metabolites in the striatum of rat brain. In the striatum 4 hr after death, the content of dopamine and 3,4-dihydroxyphenylacetic acid decreased by less than 20%, and 3 methoxytyramine increased by 158%, with no changes in serotonin, 5 hydroxyindoleacetic acid, and homovanillic acid. PMID- 3560983 TI - Multiple comparisons and nonparametric statistical tests on a programmable calculator. AB - Calculator programs are provided for statistical tests for comparing groups of data. These tests can be applied when t-tests are inappropriate, as for multiple comparisons, or for evaluating groups of data that are not distributed normally or have unequal variances. The programs, designed to run on the least expensive Hewlett-Packard programmable scientific calculator, Model HP-11C, should place these statistical tests within easy reach of most students and investigators. PMID- 3560984 TI - Techniques for comparison of thermal and mechanical nociceptive stimuli in the sheep. AB - The assessment of analgesia in conscious unrestrained farm animals presents particular problems. In order to provide a reliable nociceptive stimulus, two devices have been constructed, one that provides a threshold reading for a ramped thermal stimulus of the pinna of the ear and another that measures a threshold reading for a pressure stimulus to the foreleg. Both devices allow the rapid termination of the stimulus once a reaction has occurred and allow repeated readings without causing tissue damage. Examples of the analgesic action of alpha 2-adrenoceptor agonists and opioids measured by using the two pieces of apparatus are shown. PMID- 3560985 TI - Extraction and isolation by high performance liquid chromatography of uroporphyrin and coproporphyrin isomers from biological tissues. AB - A simple, rapid procedure has been developed for extraction of uroporphyrin and coproporphyrin isomers from biological tissues. The recoveries of known standards of uroporphyrin I and III and coproporphyrin I and III were performed from liver, kidney, testis, and bone marrow of the rat. The extracted samples were analyzed by high performance liquid chromatography. This method is suitable for the study of drug- and toxicant-induced porphyrias characterized by alterations of the ratios of the I and III isomers of uroporphyrin and coproporphyrin. PMID- 3560986 TI - Determination of in utero fetal rat heart rate by ultrasound. AB - A technique for in utero determination of rat fetal heart rat in conscious and anesthetized animals is described. Fetal heart rate was analyzed using echocardiography by recording two-dimensional ultrasound images along with the derived M-mode tracing. This method allows for the simultaneous and sequential analysis of both maternal and fetal heart rate after exposure to therapeutic or environmental agents. When compared to other techniques, this noninvasive approach can clearly yield a more accurate assessment of drug effects on the fetal cardiovascular system. The method eliminates the influence of surgical manipulation on cardiac activity. More importantly, this approach can avoid the use of cardiodepressant anesthetic drugs and their potential interaction with agents under investigation. This method is thereby more sensitive and specific for determining the effects of compounds under study than previously described techniques. To illustrate this system, fetal heart rates are compared after maternal propranolol administration in conscious and anesthetized animals. PMID- 3560988 TI - A method for hemorrhagic shock in the rat. AB - Normovolemic hemorrhagic shock was induced in unanesthetized as well as anesthetized rats. The animals were bled according to predetermined schedules followed by reinfusion of all shed blood. In these models mortality during the hypovolemic phase was avoided, while practically 100% mortality ensued a number of hours after the reinfusion. To this end, a certain individualization of the bleeding procedure was necessary. The pathology induced was very similar in the two models. The survival time as well as the course of the plasma-glucose concentration (a tendency to a high degree of hypoglycemia) and the plasma-K+ concentration (extreme hyperkalemia) were also very similar. The causes of the hypoglycemia and hyperkalemia are not elucidated. PMID- 3560987 TI - Method for chronic portal vein infusion in unrestrained rats. AB - Surgical procedures for the chronic cannulation of the portal and the femoral veins in the rat are described. The surgical procedure for portal vein cannulation is delicate and requires practice, but has proven useful for chronic drug administration. Cannulation of the femoral vein was less involved and cannula patency was extended by proper cannula preparation and placement. This dual cannulation of the rat allowed infusion of racemic mephenytoin into the portal vein and blood collection from the femoral vein for characterizing blood concentrations of the individual isomers. Chronic portal vein drug infusions may provide a useful approach to studies of time-dependent change in hepatic metabolism and stereoselective first-pass drug elimination in unrestrained animals. PMID- 3560989 TI - Anaphylaxis in guinea pigs induced by ovalbumin aerosol in vivo and in vitro methods. AB - We describe in this paper a simple aerosol method of provoking bronchial anaphylaxis in both anesthetized guinea pigs and guinea pig isolated lungs. We also show the time course of bronchoconstriction induced by an aerosol of ovalbumin in previously sensitized guinea pigs in vivo and in vitro and the effect of the H1 antagonist mepyramine on this bronchoconstriction. We believe this method of inducing anaphylaxis is important, since the antigen is delivered via a more relevant route, i.e., the airways. Furthermore, the in vitro technique should greatly facilitate the analysis of the anaphylactic mediators released in guinea pig lung following inhalational challenge. PMID- 3560990 TI - Anticonvulsant activity of the volatile oil from the fruit of Tetrapleura tetraptera. AB - The anticonvulsant effect of the volatile oil extracted from the fresh fruits of Tetrapleura tetraptera was investigated in mice. The results obtained show that the fresh oil given intraperitoneally offers some protection against leptazol induced convulsions. A dose of 0.4 ml of the oil per mouse protected 78% of the animals when administered 30 min prior to leptazol. While 0.6 ml offered no protection from death, the onset of convulsions and the average time of death was prolonged. PMID- 3560991 TI - Immunomodulating agents of plant origin. I: Preliminary screening. AB - The immunobiological activity was investigated of certain medicinal plants widely used in the Ayurvedic and Unani systems of medicine for treatment of chronic infections and immunological disorders. The effect of an ethanolic extract of each drug was studied on delayed type hypersensitivity, humoral responses to sheep red blood cells, skin allograft rejection, and phagocytic activity of the reticuloendothelial system in mice. Picrorhiza kurroa was found to be a potent immunostimulant, stimulating both cell-mediated and humoral immunity. Tylophora indica, Aconitum heterophyllum and Holarrhena antidysenterica appeared to stimulate phagocytic function while inhibiting the humoral component of the immune system. Tinospora cordifolia and Ocimum gratissimum appeared to improve the phagocytic function without affecting the humoral or cell-mediated immune system. Hemidesmus indicus suppressed both the cell-mediated and humoral components of the immune system. PMID- 3560993 TI - A survey of prescriptions used in traditional medicine in Gondar region, northwestern Ethiopia: general pharmaceutical practice. AB - A survey of prescriptions used in traditional medicine in Gondar region, northwestern Ethiopia, was undertaken and some aspects of general pharmaceutical practice are described. Results obtained regarding sources, preparation and application or usage of medicines are discussed with respect to modern pharmaceutical or medical practice and their significance to health care delivery among the indigenous people is also pointed out. PMID- 3560992 TI - Effect of feeding Gymnema sylvestre leaves on blood glucose in beryllium nitrate treated rats. AB - The feeding of powdered leaves of Gymnema sylvestre in the diet of rats for 10 days prior and 15 days after i.v. beryllium nitrate significantly protected the animals from the full fall of blood glucose seen in rats receiving beryllium nitrate alone. The feeding of the leaves for 25 days to normal rats did not alter blood glucose significantly. The leaves may contain a principle that could be useful as a prophylactic against beryllium toxicity. PMID- 3560994 TI - Schumanniofoside, the antisnake venom principle from the stem bark of Schumanniophyton magnificum Harms. AB - The methanol extract of the stem bark of Schumanniophyton magnificum and schumanniofoside, a chromone alkaloidal glycoside isolated from it, reduced the lethal effect of black cobra (Naja melanoleuca) venom in mice. This effect is greatest when the venom is mixed and incubated with the extract or schumanniofoside. It is thought that the mode of action is by oxidative inactivation of the venom. PMID- 3560995 TI - Effects of five kampohozais on the mitogenic activity of lipopolysaccharide, concanavalin A, phorbol myristate acetate and phytohemagglutinin in vivo. AB - Mitogenic activity of lipopolysaccharide (LPS), concanavalin A (Con A), phorbol myristate acetate (PMA) and phytohemagglutinin (PHA) were investigated using spleen cells prepared from C57BL/6 mice orally pretreated with one of five kampohozai extracts (Shosaikoto, Daisaikoto, Hochuekkito, Juzendaihoto and Tokishakuyakusan). Shosaikoto and Daisaikoto elevated the mitogenic activity of LPS and reduced those of Con A. The mitogenic activities of PMA and PHA were elevated by low doses of Shosaikoto and Daisaikoto and suppressed by high doses. Juzendaihoto and Tokishakuyakusan showed no effect on the mitogenic activity of LPS and Con A, but increased those of PMA and PHA. Hochuekkito increased the mitogenic activity of LPS, Con A, PMA and PHA. In the absence of mitogens, these five kampohozais showed no mitogenic activity. These results indicate that the kampohozais used in this experiment appear to possess the immunomodulating or immunostimulating activities that might be expected from clinical experiences in Japan and China. PMID- 3560996 TI - Trivial Pursuit or education? PMID- 3560997 TI - Primary cardiac neoplasms. Early and late results of surgical treatment in 42 patients. AB - Forty-two patients underwent resection of primary cardiac neoplasms at Stanford University Medical Center and the Palo Alto Veterans Administration Medical Center between 1961 and 1986. A total of 27 atrial myxomas, seven benign nonmyxomatous tumors, and eight malignant tumors were resected. The mean age was 47 years (range 8 to 79) in 27 female and 15 male patients. The clinical presentations included congestive heart failure in 24 patients, palpitations in nine, neurologic symptoms in six, recurrent cardiac tamponade in three, vasculitis in two, and chest pain in two. Thirty-one of 34 benign lesions were completely resected, although one patient required cardiac transplantation to resect completely an "inoperable" benign tumor. All gross tumor was resected in four of eight patients with malignant lesions. All patients survived operation, but three with malignant disease died within 30 days. Late outcome was known for 41 of 42 (98%) patients. Total follow-up for the series was 200.1 patient-years, for an average of 4.7 years (range 1 month to 18 years). Excellent early and late results were obtained in patients with benign lesions, as there was no known tumor recurrence even if resection was incomplete. Effective palliation and local control of disease is possible with extensive resection of malignant primary tumors, but more effective adjuvant therapy will be necessary to improve long term prognosis. PMID- 3560998 TI - Anomalous systemic and pulmonary venous connections in conjunction with atriopulmonary anastomosis (Fontan-Kreutzer). Technical considerations. AB - Anomalous systemic or pulmonary venous connections can coexist with certain forms of complex cyanotic heart diseases that are reparable only by atriopulmonary anastomotic procedures, thus complicating the intraatrial separation of systemic and pulmonary venous pathways. Anomalous systemic or pulmonary venous connections were encountered isolated or in combination in 17 patients (10%) among a series of 170 modified Fontan-Kreutzer procedures. Fourteen of these 17 patients (82.3%) survived their operations, which utilized different techniques to deal with the various forms of anomalous systemic and pulmonary venous connections. There was one late death (5.8%). Extracardiac exclusion of a left superior vena cava with an end-to-side left cavopulmonary shunt proved to be a more successful alternative than the use of complicated intratrial baffles. Because of the complexity of the anatomic variables, repair of anomalous systemic or pulmonary venous connections in conjunction with a modified Fontan-Kreutzer procedure requires a detailed preoperative anatomical and physiologic diagnosis, and an individualized plan for each patient must be formulated to provide unobstructed venous pathways. PMID- 3560999 TI - Postoperative functional assessment of a modified surgical approach to repair of tetralogy of Fallot. AB - Since February 1982, we have used a modified technique to repair tetralogy of Fallot with transatrial closure of the ventricular septal defect, a short infundibular incision with avoidance of muscle resection, and anterior expansion of the right ventricular outflow tract using a patch in every case. The pulmonary anulus is approached in the usual manner. Twenty-six patients have had repair with this technique without mortality, and 20 patients (Group 1) have been evaluated 1 to 3 years postoperatively. Their results are compared with those of all patients followed up in our division who had had repair by the traditional technique in the 5 years before February 1982, with the same evaluation within 4 years of operation (Group 2, n = 22). Ten of 20 patients in Group 1 and 14 of 22 in Group 2 required a transannular patch. At cardiac catheterization, right ventricular outflow tract obstruction was effectively relieved in both groups (right ventricular systolic pressure [mean +/- standard error], Group 1 versus Group 2, 45 +/- 5 versus 49 +/- 4 mm Hg). No patient with the modified technique had a residual ventricular septal defect. By M-mode echocardiography, right ventricular-left ventricular end-diastolic dimension ratio was significantly lower for Group 1 patients (0.58 +/- 0.03 versus 0.78 +/- 0.04; normal less than 0.45; p less than 0.001). With radionuclide ventriculography, right ventricular ejection fractions were significantly higher for Group 1 patients with the modified repair (38% +/- 2.2% versus 33% +/- 1.8%; normal greater than or equal to 45%; p less than 0.05). Because the incidence of obligatory pulmonary insufficiency caused by transannular patch is similar in both groups, these results cannot be directly attributed to the presence of pulmonary insufficiency alone. With ambulatory electrocardiographic monitoring, no patient in Group 1 had any ventricular premature contractions whatsoever, whereas six of 22 patients in Group 2 had demonstrable ventricular premature contractions. These results suggest that in children with tetralogy of Fallot, right ventricular outflow tract obstruction can be effectively relieved with this modified approach with improved early preservation of right ventricular function. PMID- 3561000 TI - Primary repair of interrupted aortic arch and severe aortic stenosis in neonates. AB - Two infants, aged 36 days old (Case 1) and 18 days old (Case 2) with interrupted aortic arch types B and A, respectively, and with severe aortic stenosis, were successfully operated on by use of pulsatile cardiopulmonary bypass. The great arteries were normally related in Case 1 and were transposed in Case 2. Repair involved the following procedure: ligation of the patent ductus arteriosus, restoration of aortic continuity with an 8 mm polytetrafluoroethylene graft, placement of an internal patch to tunnel all left ventricular blood from the left ventricle through the ventricular septal defect into the pulmonary artery in Case 1 and patch closure of the ventricular septal defect in Case 2, transection of the main pulmonary artery, anastomosis between the proximal pulmonary artery and the ascending aorta, and interposition of a valved conduit between the right ventricle and the distal pulmonary artery. The operative field could be approached easily through a median sternotomy. Postoperative cardiac catheterization revealed satisfactory anatomical and hemodynamic results in both cases. PMID- 3561001 TI - Transventricular aortic valvotomy for critical aortic stenosis in infants. AB - Ten infants with critical aortic stenosis underwent transventricular valvotomy between November 1983 and September 1984. The ages of the patients ranged from 1 to 38 days (mean 21.2 days). Three patients were less than 1 week of age. One had undergone a previous valvotomy performed with inflow occlusion. Most infants were critically ill when admitted to the hospital, six required inotropic and ventilatory support, and two had peritoneal dialysis before the operation. Transventricular valvotomy was performed through a left thoracotomy with Hegar dilators. Postvalvotomy peak-to-peak gradients ranged from 0 to 35 mm Hg. Three patients died at 2, 3, and 6 weeks after operation. A severe degree of endocardial fibroelastosis was present in one patient, and a second patient died of septicemia caused by wound infection, empyema, and a bronchopleural fistula. Severe left ventricular hypertrophy, with moderate fibroelastosis, was found at autopsy in the third patient. Aortic incompetence was not detected postoperatively. One patient required reoperation 7 months after the transventricular valvotomy. Transventricular valvotomy has proved to be a simple and effective technique to relieve aortic stenosis in sick infants. It permits the correction of associated coarctation of the aorta and avoids a median sternotomy. Results are comparable with the results obtained with either cardiopulmonary bypass or inflow occlusion as seen in both our experience and in the experience of others. PMID- 3561002 TI - The long-term risk of warfarin sodium therapy and the incidence of thromboembolism in children after prosthetic cardiac valve replacement. AB - Thirty children less than 18 years of age underwent cardiac valve replacement with a prosthetic valve between 1967 and 1984 and have been followed up for a mean of 6 years (range 1 to 17 years). Their mean age at the time of operation was 13 years (range 6 to 17 years). All patients were begun on a regimen of warfarin before hospital discharge. One major and four minor bleeding episodes occurred in 211 patient-years of warfarin therapy, an incidence of 2.3 per 100 patient-years. Three of those five episodes occurred in patients who were receiving excessively anticoagulation or who were participating in physical activities inappropriate for a patient on warfarin therapy. Thus, the majority of the bleeding episodes were preventable. There were five thromboembolic events in 211 patient-years, an incidence of 2.3 per 100 patient-years. Three of those five patients had intentionally stopped their warfarin therapy. The majority of thromboembolic episodes, like the bleeding episodes, were preventable. Eight teenage patients were noncompliant with the warfarin therapy. More than one third of that group experienced a thromboembolic event, an incidence of 5.5 per 100 patient-years (55 patient-years). Twenty-two patients adhered to the warfarin regimen and only two (9%) of them had a thromboembolic event, an incidence of 1.3 per 100 patient-years (156 patient-years). Warfarin therapy presented no greater risk of serious bleeding to this pediatric age group than it does to an adult age group. The incidence of thromboembolism among these patients was less than that which is generally reported for adult patients. Discontinuation of or noncompliance with warfarin therapy substantially increased the risk of thromboembolism. Continuous warfarin therapy is recommended for every child after prosthetic valve replacement. PMID- 3561003 TI - Replacement of obstructed extracardiac conduits with autogenous tissue reconstructions. AB - Tissue-valved prosthetic extracardiac conduits fail in 6% to 30% of patients within 5 years of implantation. Failure is caused both by valve degeneration and by conduit peel formation. This report describes a technique, performed in 16 children, in which an obstructed right ventricle-to-pulmonary artery valved conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and a patch of xenograft pericardium (n = 10), homograft dura mater (n = 5), or Dacron (n = 1) as the roof of the conduit. One child with pulmonary hypertension required a Bjork-Shiley pulmonary valve; in the others no valve was inserted. This technique simplifies conduit replacement, allows for a generous-sized outflow tract that may grow with patient growth, and uses material unlikely to become obstructed. PMID- 3561004 TI - The surgical anatomy of the Taussig-Bing malformation. AB - There is no consensus as to the most appropriate definition of the use of the term Taussig-Bing malformation. In this study, we endorse the suggestion that the lesion be considered a spectrum of anomalies, unified by a juxtapulmonary ventricular septal defect with malalignment of the infundibular septum. The ends of the spectrum are hearts with, on the one hand, double-outlet right ventricle and, on the other hand, a discordant ventriculoarterial connection. We studied 10 hearts within this spectrum, eight with a double outlet and two with discordant ventriculoarterial connection. We found that the same basic morphology could exist with a bilaterally complete infundibulum or in the presence of fibrous continuity between the mitral and the pulmonary valves. Features of most significance for surgical correction were the arrangement of the outlet septum (particularly the presence or absence of chordal attachments from the atrioventricular valves), the morphology of the coronary arteries, and the state of the subaortic infundibulum. The options for surgical correction are determined by the internal morphology of the lesions rather than by the precise ventriculoarterial connection. PMID- 3561005 TI - Dilatation, compensatory growth, or both after pneumonectomy during childhood and adolescence. A thirty-year follow-up study. AB - The ventilatory function of 230 patients with pneumonectomy, performed at ages ranging from 2 to 40 years, has been followed for more than 30 years (mean 33 years). We have tried to analyze whether the available data gave information about the nature and the mechanisms adapting the remaining lung to the larger than normal pleural space and about the persistence of this adaptation in the longer term. There were 32 patients with a persistent, disturbed forced expiration (mean 50% of vital capacity). This group of patients was excluded from the study to answer the above questions, because the subdivisions of the total lung capacity in this group differed significantly from those in the group of 98 patients with a normal forced expiratory volume of 72% (mean) of vital capacity. The data of the 98 patients, who were subdivided into seven age groups at the time of pneumonectomy, permitted the following conclusions: In the youngest age group (0 to 5 years), the ventilatory capacity is hardly smaller than the predicted capacity for two lungs; this suggests that compensatory growth by way of hyperplasia might have been the most important adaptive mechanism in this group. In the age group 6 to 20 years, a significant difference is still found as compared to the group of patients operated on at an older age; this difference indicates that in this period compensatory growth, possibly mainly simple hypertrophy, still played an important but gradually decreasing role. The fact that the effect of the adaptational mechanisms could be observed more than 30 years after ablation of one lung, without loss in quality of function (i.e., forced expiratory volume constituting a normal percentage of the vital capacity), indicates that the adaptive mechanisms also compensate for the loss in lung tissue in the longer term. A striking finding was the stability of the tidal volume/functional residual capacity ratio, which, especially in the younger age groups, was very close to the predicted value for two lungs. This finding is in agreement with the fact that most persons with a healthy remaining lung lead a normal family and social life after pneumonectomy. PMID- 3561006 TI - An evaluation of operative outcome in patients with funnel chest diagnosed by means of the computed tomogram. AB - A questionnaire survey of 66 patients with funnel chest who underwent corrective surgical procedures by the sternal elevation method, with or without the application of metal strut, demonstrated that the operative result was good in 60.6% and fair in 39.4%. None of the patients rated the result as unsatisfactory. A computed tomogram of the chest wall was performed to study the depression (b/c), asymmetry (b'/b), and flatness (a/b) of the chest wall, where a was the maximum transverse distance of the chest wall, b and b' were the maximum distance from the anterior to the posterior chest wall at the left and right sides (b greater than b'), and c was the perpendicular distance from the point of the anterior chest wall at its greatest deformity to the level of the anterior tip of the spine. In patients with a good result, b/c and b'/b were well corrected, while in patients with a fair postoperative result, they were still significantly different from those in subjects with normal chest walls. Moreover, 85.7% of the patients (6/7) with b/c over 3.0 before operation had a fair postoperative result. The degree of a/b was not corrected in patients with either good or fair postoperative results. We conclude that an operative approach to lengthen ribs would be necessary to improve the degree of a/b, that in patients with severely depressed funnel chest, expressed as a b/c value over 3.0 by computed tomography, a transient support with struts should be applied, and finally, that a more careful approach for correction of asymmetry should be undertaken to improve the operative results. PMID- 3561007 TI - Intraoperative two-dimensional echocardiography in complicated infective endocarditis of the aortic valve. AB - Six patients with complicated native and prosthetic aortic valve endocarditis were operated on. The data from cineangiocardiography and from precordial and intraoperative two-dimensional echocardiography were compared with the surgical findings. Surgical inspection revealed a mycotic aneurysm in six patients. In addition, a fistulous connection to the right atrium, an abscess in the interventricular septum, and mitral valve endocarditis were found in one of the patients. The pathologic conditions disclosed during the operation were correctly visualized with two-dimensional epicardial echocardiography, done before cardiopulmonary bypass. Cineangiography provided this information in one patient, and precordial two-dimensional echocardiographic analysis was correct in two patients. Thus, intraoperative two-dimensional echocardiography provides detailed information in complicated native and prosthetic aortic valve endocarditis that is of importance in the surgical management. PMID- 3561008 TI - A comparative analysis of left ventriculography and root aortography for estimating aortic annular size. AB - This study was undertaken to compare the usefulness of left ventriculography versus root aortography as a means of assessing the aortic annular size in 75 patients with a narrow aortic anulus. These patients were divided into two groups: Group I consisted of 57 patients undergoing standard aortic valve replacement with a 21 mm prosthesis and Group II consisted of 18 patients undergoing modified aortic valve replacement with the aid of an anulus-enlarging procedure or an apico-aortic conduit. In Group I, left ventriculography gave 23.2 +/- 1.8 mm (mean +/- standard deviation), whereas the aortography method showed 22.4 +/- 2.7 mm (p less than 0.05). Those values of 20 mm or less were regarded as imperfect measurements; inaccurate results were more frequent in the aortography method (16 cases; 28%) than in the left ventriculography method (only two cases; 3.5%), with significant difference (p less than 0.025%). In Group II, there was no significant difference in respective values determined by the two different methods; 18.7 +/- 3.0 mm, with a range from 13 to 23 mm in the left ventriculography method, and 19.9 +/- 3.1 mm, with a range from 14 to 24 mm, in the aortography method (p greater than 0.2). Imperfect measurement by the aortography method tended to occur when the cusp base was severely deformed. The results indicated that left ventriculography was more reliable than root aortography for estimating the size of the aortic anulus. PMID- 3561009 TI - Comparison of left ventricular assist and intra-aortic balloon counterpulsation during early reperfusion after ischemic arrest of the heart. AB - In most centers, intra-aortic balloon counterpulsation and inotrope infusion are used for patients who require support to be weaned from cardiopulmonary bypass at the end of a cardiac surgical procedure. Where available, early institution of a left ventricular assist device is an alternative with possible advantages. In a canine model of left ventricular failure caused by 45 minutes of normothermic ischemic arrest, these two methods of support were instituted after an initial 30 minute reperfusion period. Both methods provided adequate support of the circulation (cardiac output greater than 2 L/min and mean arterial pressure greater than 50 mm Hg). After only 3 hours, however, significant differences were seen between the two groups. When the hearts were examined histologically, dogs in the group with intra-aortic balloon counterpulsation and inotrope infusion had significantly more necrosis than those in the group with a left ventricular assist device, 7.7% +/- 5.0% (mean +/- standard deviation) versus 2.0% +/- 1.3%. Decreases in compliance and systolic function were significantly greater in the group with intra-aortic balloon counterpulsation and inotrope infusion when compared with those supported with a left ventricular assist device. These findings suggest that even when support with intra-aortic balloon counterpulsation and inotrope infusion resulted in satisfactory hemodynamics, early institution of a left ventricular assist device was significantly more effective in preserving myocardial structure and function. PMID- 3561010 TI - Animal model of acute pulmonary thromboembolism treated by local recirculation of streptokinase through the lung. AB - Massive acute pulmonary thromboembolism has a high mortality within the first few hours. Surgical intervention can remove only larger thrombi. Systemic fibrinolytic administration requires many hours for adequate treatment. We describe an anesthetized dog model of acute, massive, disseminated pulmonary thromboembolism achieved by injection of 1.7 ml/kg of 1-hour-old thrombi directly into the pulmonary artery. The emboli were lysed with 50,000 IU streptokinase recirculated for 20 minutes through the isolated pulmonary vascular bed by use of a roller pump while the systemic bed was supported by conventional cardiopulmonary bypass. On reestablishing natural circulation all hemodynamic parameters returned to preembolism values. Success of lysis was histologically confirmed. Perfusion of the pulmonary vascular bed without inclusion of streptokinase in the perfusate worsened the hemodynamic state of the animals compared with an untreated nonperfused control group. PMID- 3561011 TI - Clinical applications of the supraceliac aorta: anatomical and pathologic observations. AB - To assess the extent of atherosclerosis in the supraceliac aorta, we studied autopsy samples from 100 men with severe atherosclerotic disease and from 135 men who had died of noncoronary causes. In both groups, the extent of atherosclerotic involvement was consistently less in the supraceliac aorta than in the infrarenal aorta. For this reason and because of other desirable characteristics, the supraceliac aorta is useful as an anastomotic site for apicoaortic conduits; in cases of graft infection; in coarctation of the aorta, when a concomitant cardiac procedure has been performed; and when the infrarenal aorta is inaccessible. PMID- 3561012 TI - Partial supracoronary translocation of the aortic valve prosthesis in a case of septic destruction of the aortic root. AB - A patient with infective endocarditis and septic disruption of the anterior aspect of the aortic root was successfully treated by insertion of a prosthetic valve obliquely, above the right coronary ostium anteriorly and below the left posteriorly. The right coronary ostium was closed and the artery was bypassed by use of an autogenous saphenous vein graft. The procedure is considered to be an alternative to the more radical complete supracoronary translocation of the prosthetic valve, as described by Danielson and colleagues. PMID- 3561013 TI - Surgical treatment of hydatid cyst. PMID- 3561014 TI - Pulmonary embolectomy. PMID- 3561015 TI - Modified ascending aorta-right pulmonary artery shunt. PMID- 3561016 TI - Further studies on the mechanism of CFU-S determination--I. Pluripoietin(s) responsible for CFU-S determination toward granulopoiesis after fractionated doses of Ara-C. AB - Fractionated doses of Ara-C orient CFU-S differentiation towards granulopoiesis and megakaryocytopoiesis in vivo in contrast to the preferential channelling towards erythropoiesis after a similar dose of Ara-C given as a single injection. In this paper, we show that pluripoietin found in the serum of mice treated with fractionated doses of Ara-C is responsible for the choice of CFU-S differentiation towards granulopoiesis. Therefore, we confirm our previous results involving single doses of Ara-C, that humoral factors can commit CFU-S preferentially towards one of the cell lineages. It is not as yet known whether there is a specific pluripoietin for each cell lineage or whether the same pluripoietin has a different effect according to its concentration in the organism. The difference in response of CFU-S commitment to single and fractionated doses of Ara-C is not due to the difference in the kinetic status of CFU-S:CFU-S are cycling after both treatments. PMID- 3561017 TI - Further studies on the mechanism of CFU-S determination--II. Feedback regulation. AB - In previous papers, we have demonstrated that the determination of CFU-S differentiation is under the control of humoral factors, which we have called pluripoietins. The activity of these regulators varies according to the experimental protocol. The aim of this work was to determine the mechanisms involved in the regulation of pluripoietin secretion after each treatment. The results suggest that the production of pluripoietin(s) is under the control of a feedback mechanism, originating, at least in part, in the progenitor compartments. After one dose of 20 mg of Ara-C, CFU-S determination is channelled towards erythropoiesis when the BFU-E compartment is more depleted than the GM CFC compartment. During fractionated doses of Ara-C, at the time of the third injection, GM-CFC survival is lower than BFU-E survival and CFU-S orient their differentiation towards granulopoiesis. After bleeding, there is no difference of survival between the two compartments and CFU-S determination is not changed. These results seem to indicate that CFU-S determination is modified in order to restore normal homeostasis of the hemopoietic tissues by preferentially replenishing the more depleted compartment. This is most likely achieved by the secretion of pluripoietin(s) that vary in either their nature or their concentration according to the events occurring in the more mature compartments. PMID- 3561018 TI - Residual leukemia cannot be detected in very early remission peripheral blood stem cell collections in acute non-lymphoblastic leukemia. AB - We have used a combined cell culture and cytogenetic approach to study the level of residual leukemia during the very early remission (VER) phase of acute non lymphoblastic leukemia. Clonogenic leukemic cells were induced to proliferate by phytohemagglutinin-stimulated leucocyte conditioned medium and identified by a leukemia-associated karyotype t(8;21) and a morphological marker (Auer rod). When leukemic blasts were cultured, the leukemic karyotype and Auer rods were most readily detected after 3-9 days. When VER blood cells were cultured, no leukemia associated karyotype or Auer rods could be detected. Based on the number of VER blood cell derived metaphases analysed, the incidence of leukemic blasts among dividing cells is less than 2%. PMID- 3561019 TI - The effect of low dose ARA-C on in-vitro haemopoiesis of marrow cells from myelodysplastic patients. AB - The effect of low dose (10(-12)-10(-7) M) ARA-C on differentiation and proliferation in liquid and semisolid culture of marrow cells from 13 patients with myelodysplastic syndrome (MDS) were studied following incubation in liquid culture with low dose ARA-C. In six of ten patients an increasing number of myeloid cells acquired the morphologic appearance of mature monocyte-macrophages. Increasing number of cells reacted positively to fluoride sensitive naphthyl acetate esterase and specifically bound MY4 monoclonal antibody. Phagocytosis and killing of Candida albicans by monocyte-macrophages incubated with low dose ARA-C was normal and similar to that of the untreated cells. All MDS patients showed reduced myeloid colony and increased cluster formation. Low dose ARA-C had slight but non-significant inhibitory effects on myeloid colony growth. The results indicated that the differentiation pattern of myeloid precursor cells form a subset of MDS patients was altered by exposure to low dose ARA-C in vitro. PMID- 3561020 TI - Effects of cytapheresis on cell cycle distribution of peripheral blood and bone marrow cells in some hematological malignancies. AB - Feulgen-DNA cytophotometry and 3H-thymidine autoradiography were used to evaluate therapeutic cytapheresis effects on cell cycle distributions of peripheral blood leukemic cells in 15 acute leukemia, 5 CML and 8 CLL patients and of bone marrow erythroblasts in 18 PV patients. Both individual cytapheresis procedures and a long-term program of cytapheresis altered cell cycle distributions and biochemistry which may be summarized as follows: An increase in percentage of cells in S-phase (acute leukemia, CML); a decrease in the differences between values of S-cell number obtained by cytophotometry and autoradiography (acute leukemia, CML, PV); a decrease in some cases in enlarged fraction of cells in G2 (blast crisis of CML, PV); an activation of G0----G1 transition and an increase in the PAS-positive lymphocyte fraction in CLL patients. An apparent increase of blasts in S-phase was found after a pheresis in acute leukemia patients who responded to subsequent chemotherapy. In "nonresponders", a pheresis had no effect on cell cycle distributions. The results of the study demonstrate that despite the wide variability of individual responses, cytapheresis activates cell proliferation and metabolic processes in patients with hematological malignancies. PMID- 3561021 TI - [Gonocytes in the fetal and early postnatal period (stereologic study)]. AB - The behaviour of gonocytes from the 15th prenatal to the 6th postnatal day was studied in testicles of 32 Wistar rats. Histological and cytological methods were applied. Cytological smears were obtained by the imprint method. It was established that the number of gonocytes per cubic millimeter of the tissue for the postnatal group of rat testicles was seven times smaller in respect to the postnatal group. It was 102,338 +/- 15,903 mm0/mm3 for the prenatal group and 13,783 +/- 2538 mm0/mm3 for the postnatal group. The number of gonocytes in the first investigated prenatal day (the fifteenth day) in comparison with the last postnatal day (the sixth day) was even thirty times smaller (i.e. 157,800 against 4,900 mm0/mm3). This work is the first to give morphologic and quantitative data on gonocytes in cytologic smears. PMID- 3561022 TI - [The effect of induced abortion in adolescence on the manifestations of spontaneous abortion, premature labor and birth weight]. AB - An experimental group of adolescents having become pregnant after induced abortion (n = 320) were compared with 514 primigravid adolescents, 391 women 20 24 years old having become pregnant after induced abortion, and 368 primigravid women of the same age. Spontaneous abortion appeared more frequently in the experimental group (5.9%) than in all control groups (5.1%, 3.3%, and 3.8% respectively. Preterm delivery was more frequent in the experimental group (9.3%) than in the control groups (6.8%, 6.4%, 5.7%, respectively). In the young adolescents (14-16 years old) of the experimental group, spontaneous abortion was almost twice as frequent (10.7%) as in the older adolescents of the same group (5.5%) and preterm delivery two and a half times as frequent (24.0%) as in the primigravid adolescents of the same age (10.3%). The weight of the newborns in the experimental group (3,155.7 +/- 536.3 g) was significantly lower than that in primigravid adolescents (3,228 +/- 488 g; t = 1.97, p less than 0.05), in women 20-24 years old with an earlier induced abortion (3,303 +/- 556 d; t = 3.49, p less than 0.01), and in primigravid women 20-24 years old (3.331 +/- 508; t = 4.30, p less than 0.001). The adolescents of the experimental group had on term deliveries in the 40th to the 42nd week significantly less frequently (31.6%) than primigravid adolescents (47.1%), 20-24 year-old women with earlier induced abortion (47.4%), and 20-24 year-old primigravid women (53.8%). PMID- 3561023 TI - [The Allen-Masters syndrome]. AB - The authors present 18 cases of the Allen-Masters syndrome diagnosed from 1978 to 1985. The pelvic peritoneal defect was diagnosed by laparoscopy in 15 cases, by laparotomy in 3 cases. There was some doubt about the presence of the syndrome in 4 cases. The syndrome was diagnosed by chance in 11 cases while investigating causes of sterility. The locations of peritoneal laceration were distributed between broad ligaments in 13 cases and the other areas of the Douglas pouch in 5 cases. In 3 cases there were no previous gynaecological and obstetrical traumas that might explain the cause of the presence of the syndrome. The treatment was surgical in 5 cases, i.e. the sutural of the ligament-peritoneal scarred laceration. PMID- 3561024 TI - [Topography of carcinoma in situ and carcinoma with minimal invasion of the uterine cervix]. AB - There were 160 coni histologically analysed in which carcinoma in situ (CIS) or carcinoma cum invasione minimali (CIM) were diagnosed. Their most frequent localization was the transitional zone. CIS was spreading in 95.4% of cases to the transitional zone, in 67.4% to the part covered with a cylindrical epithelium, and in 19.8% to the part covered with a squamous epithelium. CIM was found to have affected the transitional zone in 90.5%, the cervical zone covered with a cylindrical epithelium in 78.4% and the zone partly covered with a squamous epithelium in 52.7% of cases. CIS was spread to both cervical labia in 65.1% of cases--to the front labium in 23.3% and the back labium in 11.6% of cases. CIM was found to have affected both labia in 90.5% of cases--the front labium in 6.7% and the back labium in 2.7% of cases. CIS and CIM were formed from three types of cells, i.e. types A, B, and C. Both CIS and CIM formed from type A were located in the zone of the squamous epithelium in the portio, those formed from type C endocervically, and those from type B in--between. There were also carcinomas formed from two or three cell types. In the mixed types of carcinoma, type C cells were never found in the portio, nor type A cells in the endo-cervix. PMID- 3561025 TI - [Prenatal diagnosis in the 1st trimester of pregnancy of the male fetus at risk for hemophilia B]. AB - It is for the first time that chorionic villi biopsy was performed for diagnostic purposes; the indication for prenatal testing was haemophilia B-X-linked disease. The chorionic tissue was obtained by transcervical aspiration in the 9th week of gestation under ultrasound guidance. The techniques used for cytogenetic investigation were the Y body technique and direct fetal karyotyping. The presence of Y body was determined by slide examination. The analysis of the fetal karyotype confirmed the diagnosis of a male fetus. As this fetus had a great risk (50%) of being born with haemophilia B, the parents decided to terminate the pregnancy. It was done 9 days following the test. During this period no complications were observed. The chorionic villi biopsy has proved easy, quick, and successful in the diagnosis of X-linked disorders. PMID- 3561026 TI - [Diagnosis of breast cancer in the gynecology department]. AB - Breast examinations were performed in 4199 women by a simultaneous carrying out of clinical investigation, thermography and mammography, and, if needed, also by ultrasonic examination and aspiration cytology. A total of 169 women were referred to treatment and biopsy. Among them, 78 had breast cancer. In 6 patients ca in situ intraductale was discovered, while the disease was limited to the breast with negative lymph nodes in the axilla in 48 (61.5%) patients. Mammography proved more successful than clinical investigation. Its sensitivity amounted to 92% and that of clinical investigation only to 69%. The cost of a complete diagnostic process (on the first of April, 1986) was 5.717 dinars, which means that the cost of a diagnosed carcinoma was 307.765 dinars. PMID- 3561027 TI - [Delivery after previous cesarean section]. AB - In a four-year period (1980-1983) there were 452 women in whom one of the previous pregnancies terminated by cesarean section. Out of them, 283 (62.6%) delivered vaginally and 169 (37.4%) by repeated cesarean section. Vacuum extractor was used in 106 deliveries (23.5%). In 254 (89.8%) parturients of the examined group and in 21 (5%) parturients of the control group the manual revision of the uterus was performed. Seven incomplete and one complete silent ruptures of the uterus occurred in the examined group, the incidence being 1.8%. Six rupture of the uterus were revealed during cesarean section. Two ruptures were detected by the manual revision of the uterus. The authors are of the opinion that the manual revision of the uterus in women with previous cesarean section is necessary and that the prophylactic use of vacuum extractor is not justified. PMID- 3561028 TI - [Massive adrenal hemorrhage in a neonate due to neuroblastoma]. AB - A newborn with symptoms of massive adrenal hemorrhage is presented. The cause was a unilateral neuroblastoma of the adrenal gland, bringing about severe anemia and hemorrhagic shock. The suspicion of a tumor of the adrenal gland was confirmed by infusion urography, ultrasound examination of the kidney, and the increased amount of vanillymandelic acid in the urine. Nephrectomy was performed on the fourth day of the newborn's life. The tumour was classified in the IV-S stage after Evans et al. Following the operation, neither cytostatics nor radiation was applied. The child is developing normally and the amount of vanillymandelic acid in the urine is within normal limits. The child is now in the 16th month of life. PMID- 3561029 TI - Tracheal reconstruction with hydroxyapatite tracheal prosthesis. AB - A porous hydroxyapatite tracheal prosthesis was implanted in rabbits after resection of a 15 mm circular segment of the cervical trachea. Postoperatively the animals were followed by radiography, bronchoscopy, and microscopy at the time of autopsy. The longest survival time was 22 weeks. All the rabbits died of infection at the prosthetic site or of progressive stenosis at the anastomoses. The prosthesis was incorporated by surrounding tissues, but no overgrowth of ciliated epithelium on the luminal surface of the prosthesis was observed. Although a hydroxyapatite tracheal prosthesis is tolerated in rabbits, covering of the luminal surface of the prosthesis with a non-porous layer to prevent infection and to permit mucosal overgrowth is necessary to achieve better long term results. PMID- 3561030 TI - Dependence of tissue valve leaflet motion on the viscosity of blood analogue fluid. AB - The dependence of the leaflet motion of bioprosthetic heart valves on the viscosity of the blood analogue fluid was studied in this work. A pericardial and a porcine tissue valve were mounted in a pulse duplicator and high-speed films were taken to record the motion of the valve leaflets. The blood analogue fluids used were physiological saline with a viscosity coefficient of 1.0 cP, and glycerol solution with a viscosity of 3.5 cP. The transvalvular pressure drop and percentage of regurgitation were also measured with the time-averaged flow rate maintained at 6.00 +/- 0.05 litres/min. Our results show that the leaflets did not stiffen with up to 15 days' exposure to glycerol. Also, there was no substantial difference in the time of opening of the leaflets or in the area of opening of the valves with the two blood analogue fluids. However, the leaflets closed substantially later in the cardiac cycle in the case of glycerol solution, owing to the interaction between the leaflets and the viscosity of the fluid. For proper comparison of the flow dynamics past prosthetic valves at comparable Reynolds number and Womersley number, our results suggest that glycerol solution should be used as the blood analogue fluid for tissue valves also. PMID- 3561031 TI - The Donnan effect in artificial kidney therapy. AB - The calculation of the effective sodium gradient in dialysis has to consider a membrane potential difference which is generally derived from the Donnan effect. Strictly this is allowed only under equilibrium conditions. This paper considered the effect of the deviation from equilibrium in haemodialysis and haemofiltration. The mathematical analysis is based on the integration of the local transport rate over the membrane area. The local transport rate is calculated from the Nernst-Planck equation using the constant field assumption. Deviation from equilibrium results in a diffusion potential across the membrane. Experimental evidence was presented for part of the theoretical results. The diffusion potential, both in haemodialysis and in haemofiltration, is too small to have any clinical significance. From the theory it follows that better tolerance of haemofiltration in comparison with haemodialysis cannot be explained by a difference in sodium transport. Calculation of the sodium transport in dialysis therapy based on the equilibrium Donnan effect is sufficiently accurate for kinetic considerations in the dialysis routine. PMID- 3561032 TI - Functional geometrical parameters of the flow through prosthetic heart valves. PMID- 3561033 TI - Cholesterol removal by haemoperfusion of whole blood in vivo. AB - Familial hypercholesterolaemia is caused by genetic defects in the cellular metabolism of cholesterol (C) and is characterized by high levels of low-density lipoproteins (LDL) and premature atherosclerosis. The C is carried in the plasma mainly as an LDL-C complex, and removal of the latter from plasma is highly desirable. This task can be achieved by selective haemoperfusion (HP), thereby eliminating the need for plasmapheresis. Agarose beads (2 per cent agarose, 0.85 to 1.4 mm in diameter) were prepared, and crosslinked with epichlorohydrin. Heparin and/or ethanolamine were subsequently attached. The beads thus obtained were found to be suitable for the removal of LDL-C from the whole blood of hypercholesterolaemic rabbits, using a simple HP technique. A single two-hour HP treatment with a 40 ml column packed with active agarose beads resulted in a 30 per cent decrease in the C plasma level in the experimental animals. Our previous, in vitro, studies with the plasma of hypercholesterolaemic patients showed a high selectivity of the beads for LDL. Yet when used with hypercholesterolaemic rabbits, a relatively high amount of HDL was also removed from the blood. This can be attributed to a significant difference between the structure of human hypercholesterolaemic lipoproteins and that of rabbits. Upon treatment of blood using the active agarose beads, no abnormalities in plasma and blood composition were detected, except for some prolongation of PT. It is to be hoped that this new system will replace the presently used and highly expensive plasmapheresis. PMID- 3561034 TI - Evolution of lymph thrombi in experimental Brugia malayi infections: a scanning electron microscopic study. AB - Lymph thrombi in cats experimentally-infected with Brugia malayi were examined by scanning electron microscopy. A variety of morphological forms were noted and it appeared that thrombi undergo a maturation process characterized by at least three transitional phases. Initially, the thrombus consists of erythrocytes encased in fibrin (Phase I). Phase II thrombi are characterized by the appearance of phagocytic cells and fibroblasts on the surface of the thrombus. At the end of the maturation process, the thrombus surface consists solely of fibroblasts or endothelial cells, perhaps derived from the vessel wall (Phase III). Occlusion of the lymphatic lumen by thrombi and the accompanying inflammatory response triggered by B. malayi infection may be a major factor in the pathogenesis of lymph stasis in this disorder. PMID- 3561035 TI - Sheep lung lymph shunting. AB - The caudal mediastinal lymph node (CMN) has several efferent lymph vessels in most sheep. When investigators cannulate one of the CMN efferent vessels in order to collect lung lymph, it is possible that lymph may be shunted between the cannulated vessel and other vessels which drain from the CMN into the systemic veins. If shunting does occur then an increase in venous pressure could cause lymph to be shunted to the cannulated lymph vessel. This would increase the flow of lymph from the cannula and could falsely indicate that lung lymph flow had increased. To test this possibility we cannulated CMN efferent vessels in 7 sheep and then used a balloon to raise the pressure in the superior vena cava. Because uncannulated CMN efferent vessels ultimately drain into the superior vena cava, an increase in pressure may cause lymph to be shunted through the lymph cannula. We found, however, that lymph flow increased in only one of seven sheep and conclude that lymph shunting is uncommon when operative preparation includes meticulous ligation of collateral common efferent lymph vessels. PMID- 3561037 TI - A technical modification to improve experimental production of hepatogenic ascites. AB - Constriction of the thoracic inferior vena cava is a useful experimental maneuver to reproduce massive ascites. Unfortunately, the margin of safety of this technique is narrow in that too much constriction overly restricts venous return with subsequent shock and death, and lesser constriction is often associated with extensive venous collateralization via the azygos system and failure to sustain hepatic congestion. By combining azygos vein ligation with 50% constriction of the supradiaphragmatic inferior vena caval circumference at the time of the initial thoracotomy, we have found that intense hepatic congestion is sustained and that dogs consistently develop massive ascites within 2-3 weeks. PMID- 3561036 TI - Lymphatics in the aorta of rats treated with a soy-bean oil extract (lipofundin). AB - Lipofundin-S 20% (a soy-bean oil extract) when administered intravenously to rats resulted in dilation of aortic lymphatics at the media-adventitia junction. Increased endothelial permeability as demonstrated by intraaortic colloidal iron uptake with dynamic insufficiency of lymphatic drainage is suggested as the basis for dilatation of intraaortic adventitial lymphatics. PMID- 3561038 TI - Reexamination of testicular lymphatic drainage in the rat. AB - To clarify the route of gonadal lymph drainage in the rat we injected dilute India ink into testicular lymphatics and concomitantly replaced the entire blood volume with Ringers lactate. This technique intensified the blackness of injected lymph vessels against a background of pale, "washed out" tissues. Whereas rat testicular lymphatics may drain into regional lymph nodes, they also commonly bypass nodal tissue entirely and enter the cisterna chyli directly. This anomalous lymphatic group suggests the testis may be an immunologically privileged site. PMID- 3561039 TI - Monitoring of cortical evoked potentials during surgical procedures on the cervical spine. AB - We reviewed the results of intraoperative monitoring of short-latency cortical evoked potentials in 81 patients who underwent surgical procedures of the cervical spine. Of these patients, 43 had baseline somatosensory evoked potentials from stimulation of the upper and lower extremities, intraoperative monitoring for at least 3 hours, and absence of an intrinsic lesion of the spinal cord. Major reductions in amplitude of the ulnar and tibial cortical evoked potentials occurred shortly after induction of anesthesia in 12% of patients. Latencies gradually increased during the operation as the concentration of volatile anesthetic agents increased. In patients with preoperative evidence of cervical cord damage, the cortical responses showed more fluctuations and could be lost without major changes in the concentration of the anesthetic agent or surgical manipulation. In one patient, intraoperative monitoring of the cervical cord function prevented a postoperative neurologic deficit. Ulnar and tibial cortical evoked potentials were successfully monitored throughout operation in all patients in whom baseline scalp responses could be obtained, but careful monitoring of anesthetic effect is necessary for proper interpretation. PMID- 3561040 TI - Assessment of Campylobacter-like organisms in the postoperative stomach, iatrogenic gastritis, and chronic gastroduodenal diseases: preliminary observations. AB - Campylobacter-like organisms (provisionally named C. pyloridis) were demonstrated in gastric biopsy specimens by histopathologic analysis and bacterial culture. C. pyloridis organisms were found in 12 of 26 patients (46%) with gastric or duodenal ulcer but in none of 10 healthy volunteers without histologic evidence of gastritis. Iatrogenic antral gastritis, induced by 7 days of treatment with nonsteroidal anti-inflammatory drugs, was not associated with the presence of C. pyloridis. Organisms were found in 6 of 24 patients who had undergone gastric operations, but the prevalence of C. pyloridis was not higher in those with symptoms of alkaline reflux gastritis than in asymptomatic postgastrectomy control patients. We conclude that C. pyloridis is less common in patients with drug-induced and postoperative gastritis than in patients with peptic ulcer. PMID- 3561041 TI - Plasma aluminum levels in pediatric dialysis patients: comparison of hemodialysis and continuous ambulatory peritoneal dialysis. AB - Accumulation of aluminum occurs in children with renal failure and can cause anemia, disabling osteodystrophy, and encephalopathy. Effects on bone mineralization are of particular concern in pediatric patients with growth potential. We measured plasma aluminum levels in 36 patients on continuous ambulatory peritoneal dialysis (CAPD) and 22 on hemodialysis under surveillance at a single pediatric center. The levels were above normal in 35 and 21 patients, respectively, and the values correlated with the oral dose of aluminum-containing phosphate-binding medications (r = 0.57; P less than 0.001). Younger and smaller children had higher plasma aluminum levels and also received larger doses of oral aluminum-containing compounds. Mean plasma aluminum levels (57.2 +/- 52.8 and 48.7 +/- 32.1 micrograms/liter, respectively) and the daily oral doses of elemental aluminum (47.3 +/- 37.6 and 39.2 +/- 26.7 mg/kg, respectively) were not statistically different in patients on CAPD and those on hemodialysis. Plasma aluminum levels did not correlate with estimated cumulative oral intake of aluminum, total duration of dialysis, serum calcium and phosphorus concentrations, N-terminal parathyroid hormone levels, or transfusion requirements. Retention of aluminum is common in children undergoing dialysis, correlates with the amount of aluminum administered orally, and results in similar elevations of plasma aluminum with CAPD and hemodialysis. Younger and smaller children are at increased risk for accumulation of aluminum. Alternative methods for control of serum phosphorus are needed in children with end-stage renal disease. PMID- 3561042 TI - Leiomyosarcomas and benign smooth muscle tumors of the stomach: nuclear DNA patterns studied by flow cytometry. AB - Paraffin-embedded archival tissue samples were used for determination of DNA ploidy by flow cytometry on 117 surgically resected gastric smooth muscle tumors (44 leiomyosarcomas, 53 leiomyomas, and 20 benign leiomyoblastomas). The technique of Hedley was used for preparation of paraffin-embedded tissue into single dissociated nuclei, and the method of Vindelov was used for staining with propidium iodide. Among the 53 leiomyomas, the DNA ploidy pattern was diploid in most tumors (87%), except for 2 DNA tetraploid/polyploid and 5 DNA aneuploid samples. In comparison, the 20 benign leiomyoblastomas had more frequent abnormal DNA histograms: DNA tetraploidy/polyploidy in 5 (25%) and DNA aneuploidy in 2 (10%). The DNA histograms of the 44 leiomyosarcomas (including 4 epithelioid leiomyosarcomas) were classified as follows: 20 cases (45%) exhibited a DNA diploid pattern, 14 cases (32%) had a DNA tetraploid/polyploid pattern, and 10 cases (23%) had DNA aneuploid peaks. For the patients with leiomyosarcomas, the DNA ploidy pattern was significantly correlated with survival (P less than 0.001), as were tumor grade (P less than 0.001) and tumor size (P less than 0.05). Furthermore, both benign and malignant gastric smooth muscle tumors with DNA tetraploid/polyploid patterns were significantly larger than those with a DNA diploid histogram (P less than 0.05). DNA ploidy pattern cannot be used for diagnosis--that is, to distinguish malignant from benign gastric smooth muscle tumors. For gastric leiomyosarcomas, however, nuclear DNA ploidy pattern is an easily measured objective determination with important prognostic significance. PMID- 3561043 TI - A short test of mental status: description and preliminary results. AB - A short test of mental status (encompassing about 5 minutes) was administered to 93 consecutive neurologic outpatients without dementia, 67 outpatients with Alzheimer-type dementia, and 20 outpatients with dementia of miscellaneous causes. The mean scores for patients with Alzheimer-type dementia were lower than those for the nondemented patients in the total scoring and on all subtests (P less than 0.001). When a total score of 29 or less (maximal attainable score, 38) was used as a screen for dementia, a sensitivity of 92% and a specificity of 91% were reached. For patients older than 60 years of age, a score of 29 or less resulted in a sensitivity of 95% and a specificity of 88%. Thus, in general, this easily administered test distinguishes demented from nondemented patients, but it should not be used as the sole means of diagnosing dementia. PMID- 3561044 TI - Transluminal balloon valvotomy for pulmonic stenosis in an adult. AB - Transluminal balloon valvotomy has become a widely used nonsurgical approach to treatment of certain valvular lesions in children. In adults, however, experience with this technique is limited. We performed balloon valvotomy in a 61-year-old woman who had pulmonic stenosis. Four months after the procedure, her exercise tolerance had increased and she no longer had exertional dyspnea. Among the few reported cases of balloon valvotomy in adult patients with pulmonary stenosis, the systolic pressure gradient and the peak systolic ventricular pressure have been considerably reduced. Possible mechanisms by which transluminal balloon valvotomy relieves obstruction are tearing or deformation of the valve cusps, separation of fused commissures, fracture of valvular calcification, dilation of the annulus, or some combination of these factors. Balloon valvotomy seems to be an appropriate therapeutic choice for pulmonic stenosis in adult patients. PMID- 3561045 TI - Focal encephalitis in a young woman 6 years after the onset of Lyme disease: tertiary Lyme disease? AB - A 19-year-old woman had severe focal inflammatory encephalitis. Six years previously, she had had classic untreated Lyme disease characterized by erythema chronicum migrans, bilateral facial palsies, and lymphocytic meningitis. During her recent encephalitic illness, Lyme disease serologic tests were positive by indirect immunofluorescence microscopy, enzyme-linked immunosorbent assay, and western blot (immunoblot technique) testing. We hypothesize that the patient's focal inflammatory encephalitis was a result of a persistent spirochetal infection of the central nervous system. PMID- 3561046 TI - [Hodgkin's disease. Study of 100 cases]. PMID- 3561047 TI - [Infection by hepatitis B virus among dentists in Guipuzcoa]. PMID- 3561048 TI - [Cytology using aspiration puncture as a method of preoperative diagnosis in breast tumor pathology]. PMID- 3561049 TI - [Value of a reagent strip in the diagnostic orientation of urinary infection]. PMID- 3561050 TI - [Hodgkin's disease 1986]. PMID- 3561051 TI - [Acute renal insufficiency during an episode of macroscopic hematuria in IgA glomerulonephritis]. PMID- 3561052 TI - [Alpha-1 thalassemia trait: 1st minor form of alpha thalassemia diagnosed at birth in Spain]. PMID- 3561053 TI - [25-year-old male drug addict with fever and aortic valvulopathy]. PMID- 3561054 TI - [Tuberculosis of the tongue. Presentation of 2 cases]. PMID- 3561055 TI - [Statistics and medicine]. PMID- 3561056 TI - [Serum levels of a new monoclonal carcinoembryonic antigen (CEA MARIA) in patients with non-neoplastic pathologies. Preliminary results]. PMID- 3561057 TI - [Lymphomas in hemophiliac patients. Apropos of 2 cases]. PMID- 3561058 TI - [Intensive polychemotherapy in the treatment of acute non-lymphoblastic leukemia: comparison of the prospective protocols DATOP/79 and DATOP/82]. PMID- 3561059 TI - [Hepatitis B in hospital personnel: morbidity, accidental exposure, vaccination and cost analysis. Spanish Group for the Study of Hepatitis B]. PMID- 3561060 TI - [Material and method: basic things told in small print]. PMID- 3561061 TI - [Amenorrhea-galactorrhea and primary brain lymphoma]. PMID- 3561062 TI - [Depressions with an organic basis]. PMID- 3561063 TI - [Bilateral adrenal hyperplasia: an entity of confusing diagnosis]. PMID- 3561064 TI - [Intractable hiccups after myelography with metrizamide]. PMID- 3561065 TI - [Post-chemotherapy hypothermia in non-Hodgkin's lymphoma]. PMID- 3561066 TI - [Disseminated candidiasis, immunocompetence and HTLV-III infection in intravenous narcotic addicts]. PMID- 3561067 TI - [Rhabdomyolysis and drug abuse]. PMID- 3561068 TI - [Systemic mastocytosis]. PMID- 3561069 TI - [Hypertrophic osteoarthropathy associated with Hodgkin's disease]. PMID- 3561070 TI - [Legionella pneumophila infection in hotel guests: showers as a probable source of infection]. PMID- 3561071 TI - [Value of bloodless methods in the study of renal osteodystrophy: comparison with bone histomorphometry]. PMID- 3561073 TI - [Legionellosis and tourism]. PMID- 3561072 TI - [Peak systolic and diastolic Dv/Dt by isotopic ventriculography. Its value in the characterization of patients with myocardial disease and infarcts at different sites]. PMID- 3561074 TI - [The dynamic phenomenon of the heterogenicity of cancer cell populations and its clinicopathologic implications]. PMID- 3561075 TI - [Measurement of the frequency of disease]. PMID- 3561076 TI - [Is primary biliary cirrhosis a generalized disease of autoimmune type?]. PMID- 3561077 TI - [Tuberculosis in Spain]. PMID- 3561078 TI - [The Medical Association of the Spanish Pharmaceutical Industry: a medical association worthy of attention]. PMID- 3561079 TI - [Hyperthermia and rhabdomyolysis caused by a monoamine oxidase inhibitor]. PMID- 3561080 TI - [Usefulness of medroxyprogesterone acetate in the co-adjuvant treatment of renal carcinoma in advanced stages]. PMID- 3561081 TI - [5 cases of acquired immunodeficiency syndrome in Elgoibar (Guipuzcoa)]. PMID- 3561082 TI - Factitious Bartter's syndrome induced by diuretics. PMID- 3561083 TI - [Diagnosis of pulmonary infiltrates in patients with acquired immunodeficiency syndrome]. PMID- 3561084 TI - [Influence of salmon calcitonin on the tubular stage regulating the excretion of uric acid]. PMID- 3561086 TI - [Blood transfusion error]. PMID- 3561085 TI - [Acquired immunodeficiency syndrome and the lung]. PMID- 3561088 TI - [Radiographic images of acupuncture]. PMID- 3561087 TI - [Sickle cell anemia (Hb S/S) in the native Spanish population. Description of a case]. PMID- 3561089 TI - [Acromegaly and cancer of the colon]. PMID- 3561090 TI - [Exclusive medical treatment of a single hepatic abscess caused by Streptococcus faecium]. PMID- 3561091 TI - [Progression of thrombosis of the vena cava to the renal veins as an infrequent cause of terminal renal insufficiency]. PMID- 3561093 TI - [Use of statistical methods in medical publications]. PMID- 3561092 TI - [isolation of Legionella pneumophila in bone marrow]. PMID- 3561094 TI - [Evaluation of the results of the identification of selected strains of Enterobacteriaceae in local bacteriologic laboratories of the sanitaro epidemiologic stations in Poland]. PMID- 3561095 TI - [Preparation and biological evaluation of toxoids obtained from Vibrio cholerae]. PMID- 3561096 TI - [Adaptation of strains of the rabies virus Flury LEP and HEP to primary culture of fibroblasts of the embryo of Japanese quail (Coturnix coturnix japonica)]. PMID- 3561097 TI - [Immunogenicity and protective properties for mice of the formalin-inactivated tick-borne encephalitis virus]. PMID- 3561098 TI - [Biologically active substances, other than antibodies, in preparations of normal human immunoglobulin. I. Serum proteins, blood group substances and hemoprotein compounds]. PMID- 3561099 TI - [Biologically active substances, other than antibodies, in preparations of normal human immunoglobulin. II. Placental proteins]. PMID- 3561100 TI - [Acute epiglottitis in adults--clinical aspects and therapy]. PMID- 3561101 TI - [Sciatica is not always sciatica]. PMID- 3561102 TI - [Intra-arterial streptokinase as an active method against peripheral arterial thrombosis]. PMID- 3561103 TI - [Traumatic diaphragmatic hernia. Case reports and review of the literature]. PMID- 3561104 TI - [Synergistic effect of furosemide and metolazone in edema cases difficult to handle]. PMID- 3561105 TI - [Eye infections in dogs give their owners tonsillitis]. PMID- 3561106 TI - [Earlier discovery of esophageal cancer? Apropos of 7 cases of delayed diagnosis]. PMID- 3561107 TI - [Fertilization in vitro as an alternative to tubal surgery]. PMID- 3561108 TI - [Vision disability--an underdiagnosed additional handicap in the mentally retarded]. PMID- 3561109 TI - [Familial erythrocyto-phagocytic lymphohistiocytosis--successful treatment of 4 children]. PMID- 3561110 TI - [Temporary swallowing disorder caused by tablets]. PMID- 3561111 TI - [The strategy in the prevention of ischemic heart disease--European guidelines]. PMID- 3561112 TI - [Internal fixation of cervical spinal injuries shortens the length of stay and rehabilitation can be started earlier]. PMID- 3561113 TI - [Cytoprotection in stomach ulcers--a new way of thinking in the treatment strategy]. PMID- 3561114 TI - [Pseudothrombocytopenia--a laboratory disease]. PMID- 3561115 TI - [Hyperprolactinemia--differential diagnosis]. PMID- 3561116 TI - [Therapeutic failure in acute streptococcal tonsillitis--a overview]. PMID- 3561117 TI - [Borrelia infection causing dementia. Intensive attention in the early stages is needed]. PMID- 3561118 TI - [Genital abnormalities in the child after gestagen treatment during pregnancy]. PMID- 3561119 TI - [Scanning electron microscopy studies of the structure of tissue in the cochlear opening of the cochlear aqueduct]. AB - The structure of the internal and external tissue of the cochlear opening of the cochlear aquaeduct was examined by light microscopy on semithin sections and by scanning electron microscopy. The whole area is filled with a net of mesenchymal cells. The cell axes are randomly orientated inside the aquaeduct. On the outside of the cochlear aquaeduct fibrocytic tissue fills a space which is triangular in cross-section between the basal part of the cochlea wall of the tympanic scala and the middle portion of the round window membrane. In this area the direction of the net is uniform and it gives the impression of anchorage of the round window membrane on the perilymphatic side. The rim bordering the perilymphatic space is a dense net but not fully closed. The scanning electron microscopic pictures taken perpendicular to this border structure show clearly a texture of mesenchymal cells with open spaces. No closed "membrana limitans" was found. The possible function of the fixation of the round window membrane to the perilymphatic space giving rise to an asymmetric perilymph movement is discussed with regard to the physiology of sound transmission. PMID- 3561120 TI - [Sample distribution of inner ear fluids in the submicroliter range]. AB - Biochemical analysis of inner ear fluids is fraught with numerous problems. After developing accurate techniques to measure inorganic and organic substances in fluid amounts of 0.1 microliter the problem of measuring and handling series of samples arose. It became necessary to develop methods to handle inner ear fluid taken without sophisticated techniques, i.e. to measure, to store and to dispatch inner ear fluid samples. The fluid volume is measured with a "nanocap" technique and is then transferred to cellulose acetate membranes. A 3 mm long glas capillary tube held by a special device is dipped into the inner ear fluid sample. The capillary tube is then placed on a membrane piece that adheres to the tube. The higher capillary forces of the membrane transfer the fluid out of the glass tube into the membrane which is put into a plastic reaction tube and stored. The reproducibility of the method was tested by flame photometric assays of standard sodium solutions and of perilymph from the scala tympani of guinea pigs. The variation coefficient is below 3% for a standard solution and below 5% for perilymph. The method developed to measure and handle inner ear fluids with the aid of "nanocap" and membrane pieces is easier and faster than the conventional techniques. PMID- 3561121 TI - [Chronic suppurative otitis media in the child. Treatment and results]. AB - 122 children with chronic otitis media were operated on in the ENT-clinic of the University of Tubingen between 1977 and 1984. The tympanic membrane was successfully closed in 85% of the children. The hearing was improved markedly in the majority of the patients. We therefore recommend an early operation for children with chronic otitis media to prevent further damage to the middle ear and to enable the children to take part in extracurricular activities such as swimming. PMID- 3561122 TI - [Cholesteatoma in childhood. Surgical treatment and results]. AB - 261 children with 281 cholesteatoma operations performed between 1970 and 1982 in the ENT-Clinic of the University of Tubingen were followed-up. In 77 ears an open technique (attico-antrotomy with removal of the posterior canal wall) was employed. In 103 ears a combined approach with posterior tympanotomy and preservation of the posterior canal wall was performed. In 47 ears an atticotomy with reconstruction of the lateral attix wall defect with tragal cartilage and perichondrium was done. The cholesteatoma was limited to the middle ear in 54 patients; treatment consisted of a transcanal tympanoplasty. 36.3% of the children had a residual or a recurrent cholesteatoma, 19.5% after open technique, 61.2% after a combined approach operation, 17% after atticoantrotomy and reconstruction of the scutum and 29.6% after a transcanal tympanoplasty. We therefore conclude that a second look operation is necessary especially after closed technique surgery. PMID- 3561123 TI - [Otogenic extradural pneumatocele, 36 years after a gunshot injury]. AB - In the reported case an extradural pneumatocele developed 36 years after the mastoid tip had been destroyed by a bullet. It had reached the occiput and led to destruction of the bone surrounding its distal end, so that air could be found directly under the galea. In the literature there are only few case reports referring the otogenic origin of a posttraumatic extradural pneumatocele. Furthermore, an overpressure in the middle ear cleft or mastoid could be excluded because of the presence of a tympanic membrane perforation. In spite of a chronically infected middle ear, there was no infection of the pneumatocele. PMID- 3561125 TI - [Diagnosis and therapy of vertebrogenic vertigo]. AB - Functional disorders of the cervical spine may lead to vertigenous symptoms. The typical pathological finding in these patients is a hyperlordotic position of the cervical spine. This causes functional problems of the C0/C1 and C1/C2 joints. X rays show morphological changes of the vertebrae and may also point to functional disorders. Physiotherapy is the most important treatment modality and preventative measure in static dysbalance of the cervical spine. sometimes chiropractic therapy by an experienced manual therapist or carefully directed infiltration therapy is necessary. PMID- 3561124 TI - [Stapedius reflex audiometry as an objective screening test in newborn infants]. AB - The stapedial reflex was formerly regarded to be unreliable in neonates. Recent investigations by Weatherby and Bennett (1982) showed, that when using higher probe tone frequencies (800-1200 Hz), the reflex is present during the first days of life. Measuring amount and phase of impedance change, we investigated 40 neonates using probe tone frequencies of 800 and 1200 Hz. The results obtained indicate that 1200 Hz is more suited to investigate reflex activity. The Niemeyer Sesterhenn equation was applied to distinguish between normal hearing and hearing loss. In 29 babies normal hearing could be determined objectively. 7 babies stirred during the procedure and the examination could therefore not be completed. In 4 cases the stapedial reflex was not detectable in spite of an apparently normal hearing. Reasons for the false positive results are discussed. PMID- 3561126 TI - [Surgically treated diseases of the parotid gland in childhood and adolescence]. AB - Between 1969 and 1986 parotid gland surgery was performed on 86 children and adolescents in the ENT clinic of the University of Tubingen. Chronic recurrent parotitis was found to be the most common chronic inflammatory disease in our young patients. Total parotidectomy was done on 24 children. Because of the high incidence of potential complications the indication for a total parotidectomy in chronic parotitis should be carefully considered. A more hopeful attitude applies to the cystic tumours (haemangioma, lymphangioma and branchiogenic cysts). A solid tumour of the parotid gland in children and adolescents, however, necessitates surgical extirpation without delay because one-third of these tumours are malignant. PMID- 3561127 TI - Postoperative risks of pediatric tonsilloadenoidectomy. AB - Tonsilloadenoidectomy is performed over 340,000 times per year in the United States, usually as a same day admission procedure with a postoperative overnight stay. Because of the current emphasis on reducing health care costs, many insurers are requiring the procedure of tonsilloadenoidectomy be performed on an outpatient basis, even though there is a lack of data supporting the safety of such a requirement. The charts of 2,944 pediatric patients who underwent tonsillectomy and/or adenoidectomy from January 1, 1983 to December 31, 1984 were reviewed. Analyses revealed predictive variables that could be used to identify patients with a low risk of complications. Nineteen percent of the patients could be released 4 hours postoperatively with an 8.1% chance of subsequent complications. No patients who underwent the combined procedure of tonsillectomy and adenoidectomy were in this group. Of the remaining patients, 0.4% could be released 6 hours after surgery, or 85.9% could be released 8 hours after surgery, or 98.2% could be released 10 hours after surgery, all with a less than 10% chance of subsequent complications. This study supports keeping tonsilloadenoidectomy patients at least 8 hours and possible 10 hours after surgery to minimize the risk of complications after discharge. PMID- 3561128 TI - The risk for otolaryngologists who treat patients with AIDS and AIDS virus infection: report of an in-process study. AB - The risk of contracting acquired immune deficiency syndrome (AIDS) is a concern to otolaryngologists and other health care workers. Failure to appreciate this valid concern is dangerous, but overestimating it may be equally injurious to the delivery of good patient care. We review the data on antibody titers and recovery of cultured virus in blood, saliva, middle ear fluid, cerumen, tears, and nasal mucous. We also report the initial findings of a prospective study of otolaryngologists at the San Francisco General Hospital. It appears that the risk of transmission of AIDS is low and can be minimized by sound infection control measures similar to those for hepatitis B. PMID- 3561129 TI - The efferent supply of the trapezius muscle: a neuroanatomic basis for the preservation of shoulder function during neck dissection. AB - The hypothesis that there is an alternative motor input to the trapezius muscle through cervical spinal nerves is evaluated through a review of the literature and through experimental studies performed by the author. Electrophysiologic testing of the spinal accessory nerve and of the ventral rami of the cervical spinal nerves was performed in cats and humans. These studies indicated that motor potentials recorded in the trapezius muscle after stimulation of the ventral rami of cervical spinal nerves in general represented the spread of current to the contiguous portions of the spinal accessory nerve or directly to the trapezius muscle. Rarely did there seem to be evidence of motor innervation to the upper and lower trapezius by fibers conveyed by the ventral rami of cervical spinal nerves. The predominant motor input to the trapezius muscle is through the spinal accessory nerve. Subjective evaluation, objective strength testing, and electromyographic evaluation were performed on patients who had undergone neck dissections. Three types of neck dissection were employed. These were modified neck dissection with preservation of the spinal accessory nerve, radical neck dissection with sacrifice of the spinal accessory nerve, and reconstruction using a cable graft and classical radical neck dissection. Regarding all of the methods of evaluation and comparison, the patients who retained function of the spinal accessory nerve in the postoperative period fared better than those who had a classical radical neck dissection with sacrifice of the spinal accessory nerve. This again supports the concept that the most important and predominant motor supply to the trapezius muscle is through the spinal accessory nerve. All of this information was used to construct a model of the spinal portion of the accessory nerve and of the innervation of the trapezius muscle. The clinical implications of this model are stated. PMID- 3561130 TI - Phonatory characteristics associated with bilateral diffuse polypoid degeneration. AB - This paper describes the speaking fundamental frequency (SFF) and phonational range characteristics of 35 patients with bilateral diffuse polypoid degeneration. These speakers had average SFFs that were not only substantially lower than normal but also below those associated with many other types of laryngeal pathology. These patients also had phonational ranges that were substantially different from normal. Although both extremes of the pitch range were altered, the upper limit of the voice range was affected profoundly by the morphologic changes in the vocal folds that occur as a result of polypoid degeneration. PMID- 3561131 TI - Pharyngoesophageal myotomy for vocal rehabilitation of laryngectomees. AB - Pharyngoesophageal myotomy, performed in 16 laryngectomees to improve vocal rehabilitation, proved to have some negative side effects. Although no failures of speech rehabilitation using a button were consequently found, a considerable number of button assisted esophageal speakers had a breathy voice. Also, the number of poor injection-esophageal speakers was much higher than in the group of nonmyotomized laryngectomees. A "normal" pseudoglottis could only rarely be identified by fluoroscopy in the myotomized group. A significantly lower intratracheal pressure appeared to be required for tracheo-esophageal phonation after myotomy. To improve the slightly disappointing voice rehabilitation results of the myotomized laryngectomees, a modified myotomy is proposed. PMID- 3561132 TI - Preoperative assessment of tracheoesophageal speech. AB - Air insufflation testing of tracheoesophageal (TE) puncture candidates as currently practiced lacks objectivity and relies on subjective evaluation of the sound produced. Intraesophageal pressure measurements were obtained from 21 consecutive laryngectomized patients during air insufflation by either experienced examiners or a compressed air source at 1 liter or 3 liters per minute. Postoperatively, three levels of TE speech fluency were identified. Preoperative intraesophageal pressure measurements were associated with a specific post-TE puncture speech fluency result. Intraesophageal pressure measurements may offer a reliable objective preoperative assessment of post-TE puncture speech fluency and identify patients who would benefit from pharyngeal myotomy at the time of TE puncture. PMID- 3561133 TI - The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) following neck dissection. AB - The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is characterized by hyponatremia and urinary osmolality generally greater than serum osmolality. It is due to inappropriate water retention resulting from excessive release of antidiuretic hormone (ADH). Seventeen patients undergoing neck dissection were studied. Six developed SIADH and two became symptomatic due to profound hyponatremia. Five of the six patients who developed SIADH had previously undergone a neck dissection and/or had received radiation therapy. A suggested pathophysiologic mechanism for this phenomenon is discussed. The syndrome can usually be prevented by fluid restriction during and after surgery. PMID- 3561134 TI - Treatment of cervical esophageal stenosis with a long-term indwelling prosthesis. AB - Intubation of the cervical esophagus with a long-term indwelling prosthesis is described to palliate malignant strictures, and manage benign strictures in high risk patients. The inner cannula of a Moore design tracheostomy tube was used as the prosthesis. Over a 10-year period, seven cases were managed in this fashion. The tube remained in place in five of seven patients for periods of 1.5 to 11 months, while a pureed or well-masticated soft diet was tolerated. There were no major complications in this small series. Retrograde displacement was the most common minor complication; displacement did not occur in the last two cases after addition of a silicone sponge ring to the distal end of the prosthesis. Pain and discomfort was experienced in two cases, requiring temporary removal in one patient. PMID- 3561135 TI - Function in the pharyngoesophageal segment. AB - Examination of the pharyngoesophageal (PE) segment is usually limited to manometry or barium swallow. Manofluorography is a technique which allows simultaneous analysis of both manometry and videofluoroscopy of deglutition on a single video screen. Using manofluorography, the physician can see the cause of the manometric pressure waves. Understanding of the PE segment pathophysiology has been limited. Dysfunction is usually labeled as cricopharyngeal achalasia or incoordination, which may lead to cricopharyngeal myotomy. However, this approach has yielded poor results. This study demonstrates that laryngeal elevation and timing of the swallowing reflex also play an important role in controlling pressures and function in the PE segment during deglutition. These factors must also be examined in assessment of cricopharyngeal dysfunction to guide appropriate management. PMID- 3561136 TI - Efficacy of acoustic otoscope in detecting middle ear effusion in children. AB - The sensitivity and specificity of the acoustic otoscope in detecting middle ear effusion (MEE) was determined for 200 children. Based upon results from otoscopy, tympanometry, pure tone audiometry, and myringotomy, 100 of the children (175 ears) had MEE. The remaining 100 (200 ears) had no MEE. Using acoustic otoscope reflectivity (AOR) units 4 through 9 to indicate pathologic ears, its sensitivity and specificity were found to be 93.14% and 83%, respectively. These findings led to the conclusion that the acoustic otoscope may provide a simple and cost effective way of detecting MEE in children. Suggestions are provided for improving the effectiveness of this new device as a clinical tool. PMID- 3561138 TI - Myofacial pain dysfunction: analysis of 476 patients. PMID- 3561137 TI - Nebulized anesthesia for the nose, pharynx, larynx, and trachea. PMID- 3561139 TI - Sphenoethmoidectomy: the case for the ethmoid marsupialization. PMID- 3561140 TI - [Motility disorders of the esophagus]. AB - The paper describes the physiology of swallowing, the methods for the assessment of esophageal motility, and the motility disorders of the tubular part and the lower sphincter of the esophagus, except for gastroesophageal reflux disease. Primary esophageal motility disorders are achalasia (incomplete relaxation of the lower sphincter in response to swallowing), diffuse esophagospasm (simultaneous repetitive contractions), and the nutcracker esophagus (propulsive peristalsis with abnormally high amplitude). Besides, there are non-specific as yet unclassified contraction abnormalities. Since hypermotile contraction abnormalities can mimic chest pain of cardiac origin, differential diagnosis of anginal chest pain should include esophageal motility disorders. Contraction abnormalities of the esophagus may occur in diffuse scleroderma, after therapeutic radiation of the mediastinum, and possibly after sclerotherapy of esophageal varices. PMID- 3561141 TI - [Hepatobiliary diseases in Crohn disease and ulcerative colitis]. AB - Hepatobiliary diseases are certainly not very frequent extraintestinal complications of chronic intestinal inflammatory diseases, however, they are an important prognostic factor. 2% of patients with ulcerative colitis develop liver cirrhosis but 10% of those die as a direct result of liver failure. Other associated severe hepatobiliary diseases include primary sclerosing cholangitis, carcinoma of the bile duct and amyloidosis. The present review attempts to divide the associated hepatobiliary diseases into three groups. 1. those that are the result of therapy. 2. those that are the result of the pathophysiological mechanisms of the underlying disease and 3. those of unknown etiological origin. This division might serve not only for a better understanding of the various mechanisms but should have some impact on therapeutic regimens. PMID- 3561142 TI - [Diagnosis and therapy of late intestinal radiation sequelae]. AB - Diagnosis and therapy of the complications of intestinal radiation is characterized by uncertainty due to the lack of data. We report our experience of 285 patients who have been followed through the years 1967-1984 which might serve as a basis for diagnosis and therapy. In emergency situations diagnosis includes ileus, perforation and massive bleeding. Operative therapy should be performed stepwise and with caution. During free intervals complete diagnosis of all possible complications including a restaging of the underlying disease should be performed. Resection of the affected intestine is the surgical method of choice. The rate of severe complications was lowered substantially; mortality was 4% (7/159). PMID- 3561143 TI - [Flat tubulovillous adenoma in the duodenal bulb]. AB - Yet within the last years adenomas were described in the duodenum, which are frequently found in the colon. The incidence of the lesions in the routine endoscopy of the upper GI-tract was estimated to be 0.23% for tubulo-villous and 0.86% for all adenoma. This case report describes an unusual flat tubulovillous adenoma with cellular atypia covering nearly the whole duodenal bulb which was endoscopically diagnosed. PMID- 3561145 TI - Sulfate metabolism. I. Sulfate uptake and redistribution of acid rain sulfate by edible plants. AB - Sulfur is the major component of polluted air in industrialized societies. Atmospheric sulfur is converted to sulfuric acid through a series of chemical reactions which can eventually reenter many ecosystems. When edible plants are grown in soils containing varying amounts of sulfate, the roots take up and transport inorganic sulfate to the stems and leaves. The sulfate taken up by the roots and the amount transported to the stem and leaves was found to be a function of the concentration of sulfate in the soil. Inorganic sulfate taken up by a corn plant seedling can be rapidly converted to organic sulfate by the root system. Nine days after one of a pair of pea plants was inoculated with artificial acid rain sulfate (dilute H2 35SO4) it was found that the sulfate was translocated not only in the inoculated plant, but also to the uninoculated pea plant in the same container. Also, when the leaves of a mature potato plant were inoculated with artificial acid rain sulfate it was found that the sulfate was translocated into the edible potatoes. Fractionation of the potatoes showed that most of the sulfate was water soluble of which 30% was inorganic sulfate and 70% was in the form of organic sulfur. One third of the non-water soluble translocated acid rain sulfate was equally divided between lipid and non-lipid organic sulfur of the potato. PMID- 3561144 TI - [Roentgen diagnosis of motility disorders of the pharynx and esophagus]. AB - This review discusses the radiological findings and diagnostic procedures of pharyngeal and esophageal motility disorders. The physiological and gastroenterological aspects of these different pathological entities are described in another article of the same issue. Both articles together are supposed to deliver a review of the most important esophageal motility disorders. PMID- 3561146 TI - Sexual differentiation of mammalian frontal cortex. AB - The pattern of distribution of the progesterone binding sites was examined in selected nuclei of the brain of male and female rat. In female rats the frontal cortex resulted to be the region with the highest concentration of 3H R5020 binding sites. However, in male rats the same region showed very little progestin binding activity. When female rats were androgenized via neonatal exposure to testosterone, the progestin binding activity of the frontal cortex became similar to that we observed in male rats. The present investigation indicates that sexual differentiation of the rat brain may include also brain regions not clearly involved in sex related functions like the frontal cortex. PMID- 3561147 TI - Ontogenetic development of convulsant action of Ro 5-3663 in the rat. AB - Motor seizures were induced by Ro 5-3663 in 156 male albino rats aged 7,12,18,25, and 90 days. Both minimal and maximal seizures could be elicited in 18-day-old and older animals, whereas only maximal seizures were induced in the two youngest groups. ECoG changes were studied in other 21 young rats. First changes induced by Ro 5-3663 were formed by isolated sharp waves in 7- and 12-day-old rats and by episodes of rhythmic activity in older animals. An imperfect form of this rhythmic activity could be seen even in 12-day-old rats. Ictal ECoG activity exhibited an increase in frequency of individual graphoelements, in generalization and in synchronization of activity among different cortical regions with maturation. Correlation between motor and ECoG phenomena was poor in 7-day-old rats and ameliorated with age but it never reached perfection. The actions of Ro 5-3663 are identical with those induced by metrazol but they differ from those elicited by bicuculline or 3-mercaptopropionic acid. PMID- 3561148 TI - Modulation of the progesterone receptor in the fetal uterus of the progesterone primed guinea pig in vivo and in organ culture. AB - Guinea pig fetuses were treated with progesterone for 7 days before placing fetal uteri in organ culture to see if progesterone pre-treatment of fetuses in utero would permanently inhibit the spontaneous rise in progesterone receptor which occurs in organ culture. The data show that: the basal level of progesterone receptor in fetal uteri was not affected by the progesterone treatment and progesterone receptor concentrations in vitro were also not inhibited. When guinea pig fetuses were treated sequentially with progesterone and estradiol, estradiol failed to provoke an uterotrophic effect but it retained its ability to stimulate progesterone receptor concentrations. PMID- 3561149 TI - Specific high-affinity binding sites for a synthetic gliadin heptapeptide on human peripheral blood lymphocytes. AB - The synthetic peptide containing residues 43-49 of alpha-gliadin, the major protein component of gluten, has previously been shown to inhibit the production of lymphokine activities by mononuclear leukocytes. We now demonstrate using radiolabeled alpha-gliadin(43-49) that human peripheral blood lymphocytes express approximately 20,000-25,000 surface receptors for this peptide, with a dissociation constant (KD) of 20 nM. In addition, binding is inhibited by naloxone and an enkephalin analog, thus confirming the functional correlate which demonstrates inhibition by these agents of alpha-gliadin(43-49) functional effects. Furthermore, B-lymphocytes bind specifically a greater amount of [125I]alpha-gliadin(43-49) than T-lymphocytes. The lymphocyte alpha-gliadin(43 49) receptor may play an important role in mediating the immunological response to alpha-gliadin. PMID- 3561150 TI - Unpredictable cold-immobilization stress effects on voluntary ethanol consumption in rats. AB - The effects of exposure to a schedule of unpredictable cold-immobilization stress on voluntary ethanol consumption were examined. Following testing for ethanol preference, rats were divided into high, medium and low ethanol consuming groups on the basis of daily ethanol intake (g/kg/day) and exposed to immobilization stress over an 18 day period. Voluntary ethanol consumption was monitored during the stress period and for an additional 36 days post-stress. Results indicated a differential effect of stress on ethanol intake in that low ethanol consuming rats increased their ethanol intake during the stress period and maintained this increase throughout the entire post-stress period as compared to non-stressed controls. High ethanol consuming groups demonstrated a small (marginally significant) decrease in ethanol intake during the stress period as compared to baseline levels. No change in ethanol intake was observed for the medium ethanol consuming groups. The results suggest that unpredictable immobilization stress has a differential effect on ethanol intake depending upon pre-stress levels of ethanol consumption. PMID- 3561151 TI - Ontogeny of susceptibility to the convulsant, Ro 5-4864, and its relationship to audiogenic seizure susceptibility in inbred mice. AB - The postnatal development of susceptibility to the convulsant effects of Ro5-4864 (4'-chlorodiazepam) was characterized in two inbred mouse strains (DBA/2J and BALB/c ByJ) which as adults differ markedly in their response to this convulsant. Onset of susceptibility to a dose of Ro5-4864 which caused a high frequency of clonic seizures in adults was observed at 10 days of age in DBA/2 mice, but not until 35 days in BALB/c By mice. At 14 days of age an abrupt increase in susceptibility to Ro5-4864-induced tonic seizures was found in DBA/2 but not BALB/c By mice. Both the peak of tonic seizure susceptibility (21 days) and the time course of its subsequent age-dependent decline closely paralleled the change in audiogenic seizure susceptibility in the DBA/2 strain. PK11195 (40 mg/kg) blocked Ro5-4864 (25 mg/kg)-induced, age-dependent tonic seizures but had no effect on clonic seizure induction in the same mice. These observations establish that both the susceptibility to Ro5-4864 in adult mice and the postnatal time course for development of susceptibility to this convulsant are inherently different in these two strains of mice. The lack of coincidence between the developmental onset of susceptibility to Ro5-4864-induced seizures and the onset of supersensitivity to Ro5-4864-induced tonic seizures during the period of peak audiogenic seizure susceptibility in DBA/2 mice implies that more than one neurochemical mechanism is involved in the ability of Ro5-4864 to induce seizures in this strain. However, the blockade of Ro5-4864-induced tonic seizures by PK11195 suggests that peripheral type benzodiazepine receptors may mediate this effect. PMID- 3561152 TI - Neuroimmunology: modulation of the hamster immune system by photoperiod. AB - Groups of adult male Syrian hamsters were kept in a long photoperiod (LD 14:10) or a short photoperiod (LD 10:14). After 12 weeks, half of the animals in each light:dark cycle were immunized with an immunogenic amino acid polymer. Exposure to short photoperiod was associated with a significant reduction in testicular, accessory sex organ, splenic and brown fat weights. However, photoperiod length did not influence whole body, thymic, adrenal or kidney weights. Spleens of immunized animals in the long photoperiod were significantly heavier than those of unimmunized animals in the long photoperiod, and both were heavier than spleens from immunized or unimmuized animals in the short photoperiod. This reflected increased splenic lymphocyte and macrophage counts. However, there was no difference in antibody production between animals kept in different photoperiods. These results demonstrate that the daily photoperiod length affects both hamster reproductive competence as well as selected immune parameters (splenic weight and mononuclear cell hyperplasia) but does not alter antibody production. PMID- 3561153 TI - A novel redox system for CNS-directed delivery of estradiol causes sustained LH suppression in castrate rats. AB - A series of 4 studies was conducted to examine the estrogen-like activity of a chemical delivery system (CDS) coupled to estradiol (E2). The CDS is based on a redox system, analogous to the NAD+ in equilibrium NADH coenzyme system and has previously been shown capable of sustained and site specific drug delivery to the central nervous system. The ability of CDS-E2 to suppress luteinizing hormone (LH) in gonadectomized rats was examined as an index of sustained estrogen action. A single dose of CDS-E2 resulted in significantly decreased LH serum levels in castrate rats through at least 24 days while an equimolar dose of E2 resulted in only transient LH decrease. Serum E2 levels were not different between the treatment groups, indicating that peripheral estrogen could not readily explain sustained hormone activity. A dose-response relationship was observed 12 days post-drug treatment in all monitored estrogen activities which showed CDS-E2 is more potent compared to equimolar E2. Further, LH suppression was significantly greater compared to ovariectomized rats treated with equimolar estradiol valerate, while anterior pituitary weights were not different between groups. Together with our previous data, these studies show that CDS-E2 exerts sustained estrogen-like activity which cannot be readily attributed to circulating E2 levels. These findings are consistent with a sustained, brain directed delivery of estrogen. PMID- 3561154 TI - Radioimmunoassay of detomidine, a new benzylimidazole drug with analgesic sedation properties. AB - A sensitive and specific radioimmunoassay was developed for detomidine, 4(5)-(2,3 dimethylbenzyl)imidazole. The antibodies were raised in rabbits against a conjugate of detomidine and bovine thyroglobulin prepared by diazo reaction. Detomidine was iodinated with chloramine-T and immunoreactive tracer was purified in cation exchange chromatography. The sensitivity of the RIA was 1.6 fmol/tube allowing direct detomidine measurements from minute serum and urine samples (0.1 0.2 microliter) as well as tissue homogenates (10 microliters). For concentrations below 16 pmol/ml chloroform extraction was used to extend the measurement range to 0.3 pmol/ml. Detomidine (80 micrograms/kg iv and im) was given to one horse and two calves and blood samples were taken and urine collected for 24 h whereafter the horse was slaughtered and tissue samples taken for RIA analyses. Serially diluted serum, urine and tissue samples produced a linear displacement curve parallel to synthetic detomidine in RIA. HPLC studies showed that serum and tissue immunoreactivity was unchanged detomidine whereas most immunoreactivity in the urine was due to an unknown metabolite. PMID- 3561155 TI - Neurotensin-like immunoreactivity (NTLI) concentration in the cerebrospinal fluid of children and its alteration in a febrile aseptic meningitis. AB - Neurotensin-like immunoreactivity (NTLI) concentrations in the cerebrospinal fluid (CSF) of normal children and patients with febrile aseptic meningitis, aged 7 months to 15 years, were studied. The NTLI concentrations in CSF of 27 children with normal CSF findings were 160.1 +/- 54.6 pg/ml (mean +/- S.D.). The NTLI concentration in CSF of 26 patients in an acute phase of aseptic meningitis was 110.6 +/- 51.1 pg/ml which was significantly (P less than 0.01) lower than the controls. These patients had a mean temperature of 101.4 +/- 1.5 degrees F which remained elevated for an average of 3.5 days. The NTLI concentrations in CSF of 23 patients in a recovery phase (after blood and CSF findings became normal with no fever) were 166.5 +/- 57.8 pg/ml, which did not differ significantly from the normal. There were no statistical correlations between the NTLI concentration in CSF and the protein concentration or total cell count in CSF. These results suggest that NTLI concentration changes during a febrile aseptic meningitis and that it may be associated with thermoregulation. PMID- 3561156 TI - Motilin-like-immunoreactivity in intestine and brain of dog. AB - Motilin-like-immunoreactivity was detected in various regions of canine intestinal tract and brain. Its content in the brain was much smaller than in the gut. Its regional distribution was not uniform in both organs. On gel chromatography (G-50 SF), intestinal extracts revealed a main molecular form of motilin-like-immunoreactivity corresponding to motilin 1-22, while, in the brain, it eluted predominantly with the void volume. Further characterization of this later substance does not suggest it is strongly related to motilin. Putative motilin precursors of 14 kd and 6 kd are detectable in small concentration in intestinal mucosa. PMID- 3561157 TI - Decreased vascular reactivity to norepinephrine in Fischer rats with neoplasia induced hypercalcemia. AB - The effect of a hypercalcemia-producing Leydig cell tumor on vascular reactivity in Fischer rats was studied. Seven to eight days after tumor implantation, there was no difference between tumor (T) and control (C) animals in serum calcium, serum phosphate, plasma catecholamine levels, mean arterial pressure (MAP), or blood pressure responses to norepinephrine (NE) infusion. At day 12-13 of tumor growth, the serum calcium in the tumor-bearing rats was significantly higher (12.2 +/- 0.8 vs. 9.7 +/- 0.3 mg%, P less than .01) and their serum phosphate significantly lower (4.5 +/- 0.3 vs. 5.7 +/- 0.4 mg%, P less than .01) than controls. Plasma epinephrine (E) (497 +/- 154 vs. 62 +/- 13 pg/ml, P less than .05), and norepinephrine (NE) (686 +/- 85 vs. 329 +/- 75 pg/ml, P less than .01) were markedly elevated in the tumor rats. MAP and the blood pressure responses to graded NE infusions were significantly lower in tumor animals at Day 12-13, whereas there was no change in sensitivity to angiotensin II (AII) infusions. In vitro contractile responses of tail artery segments to transmural nerve stimulation (TNS) in animals with tumors were lower than in controls but there were no differences in sensitivity to exogenous NE in vitro. These results suggest that the tumor stimulates production of a circulating factor which desensitizes NE receptors and that this tumor also decreases neurovascular function by an undefined mechanism. PMID- 3561158 TI - N,N'-diallylpentobarbital: antagonism of barbital in mice and rats. AB - N,N'-Diallylpentobarbital (DAPB) antagonized barbital (B)-induced sleep in mice and rats. DAPB [80 mg/kg, intraperitoneal (i.p.)] reduced the barbital (350 mg/kg, i.p.)-induced sleeping time to 40% of the control in mice. Twenty, 40 and 80 mg/kg, i.p. of DAPB reduced barbital-induced sleeping time when administered 60 min prior to injection of barbital. DAPB (80 mg/kg, i.p.) also shortened barbital (250 mg/kg, i.p.)-induced sleeping time to about 70% of the control in rats. The result indicates that DAPB is an antagonist against hypnotic activity of barbital. PMID- 3561159 TI - Pineal N-acetyltransferase, pineal and serum melatonin response to isoproterenol stimulation in underfed male rats. AB - Adult male rats were subjected to 4 weeks of 50% food restriction under lighting regimen of 14 h light and 10 h dark. The pineal response to isoproterenol (ISO) was determined. In the time-course study, animals were injected with 0.5 mg/Kg ISO subcutaneously (SC) and killed at different times up to 180 min post injection. In the dose-response study, various doses of ISO (0.2 mg/Kg to 5.0 mg/Kg) were injected intraperitoneally (IP) and animals were killed 120 min post injection. Body weight, pineal N-acetyltransferase (NATase), pineal and serum melatonin (MT) were determined. After 4 weeks of restricted feeding, body weight was reduced by 40%. In the time-course study, peak pineal NATase occurred 120 min post injection in the ad libitum fed animals. By contrast, the food restricted animals showed a gradual increase of pineal NATase up to 180 min post injection. In the dose-response study, the ad libitum fed animals demonstrated a dose dependent increase of pineal NATase up to 5 mg/kg dose. The food restricted animals, however, achieved their maximal pineal NATase at 1 mg/Kg dose with no further increment at 5 mg/Kg dose. These differences in responsiveness were also reflected in pineal and serum MT levels. These results indicate that underfed animals have abnormal pineal NATase, pineal and serum MT responses to ISO stimulation. PMID- 3561160 TI - Metoclopramide decreases baroreflex sensitivity in patients with essential hypertension. AB - The effect of metoclopramide (10 mg, iv.) or physiological saline on the exercise induced (standardized bicycle ergometry) increase in blood pressure and heart rate of patients with essential hypertension was investigated in a double blind, randomized, self controlled study. Metoclopramide had no effect on the exercise induced increase in blood pressure but significantly enhanced the tachycardia due to ergometry after 4-6 min exercise. The mean slope of linear regression lines calculated from the systolic blood pressure and the corresponding heart rate measured before and during (at 1,2,3,4,5 min) exercise after metoclopramide was significantly steeper than after physiological saline (1.1 +/- 0.12 vs 0.79 +/- 0.09; mean +/- SEM), indicating the decrease in baroreflex sensitivity after metoclopramide. On the basis of results the possible role of endogenous dopaminergic mechanisms in suppressing some components of pressor effect of physical exercise can be hypothesized. PMID- 3561161 TI - Mammary gland growth and serum levels of prolactin and growth hormone in four strains of male mice in comparison with females. AB - Male mammary gland growth in 4 strains of mice (SHN/Mei, SLN/Mei, GR/AMei and C3H/HeMei) was studied and compared to that in females of the same strains. The area of the mammary glands in female mice was greater in SHN and SLN, as compared to GR/A and C3H/He strains on both 20 and 60 days of age. A similar trend was seen in mammary gland growth in males on day 20. However, on day 60, there was a marked growth in SLN and GR/A strains, slight growth in SHN mice and no glands were found in C3H/He males. These patterns of mammary gland growth were not related to circulating levels of prolactin or growth hormone (GH) or to body growth in either sex. These findings provide the first description of these characteristic patterns of mammary gland growth in male mice. PMID- 3561162 TI - AF-DX 116 discriminates between muscarinic M2 receptors of the heart and vasculature. AB - The newly developed muscarinic antagonist, AF-DX 116, has been reported to have a higher affinity in vivo for muscarinic receptors in the heart than in the vasculature. Therefore two in vitro preparations, the rabbit ear artery and spontaneously beating right atrium, were compared. AF-DX 116 had a 29 times greater affinity for muscarinic receptors in the cardiac preparation than in the ear artery, with a pA2 in the heart of 7.42 compared to a value of 5.95 in the ear artery. Thus AF-DX 116 shows promise as an approach to differentiating sub classes of muscarinic M2 receptors. PMID- 3561163 TI - Liquid chromatographic assay for cerebrospinal fluid normetanephrine. AB - A method for quantitation of normetanephrine in human cerebrospinal fluid is described. An amine-specific reagent, sulfosuccinimidyl propionate, is used to obtain the lipid soluble N-propionyl derivative of normetanephrine, which can be separated and quantitated in presence of other biogenic amines by liquid chromatography with electrochemical detection. The method is reproducible, linear, and precise at the relatively low concentrations of unconjugated normetanephrine occurring in human cerebrospinal fluid. Hospitalized, drug-free, alcoholic patients were found to have cerebrospinal fluid unconjugated normetanephrine concentrations in the 0.5-1.5 nanomolar range. The practical limit of sensitivity for the method is about 0.025 pmole per ml of CSF. PMID- 3561165 TI - Targeting of colloidal particles to the bone marrow. AB - Since intravenously administered colloidal particles are normally removed efficiently by the reticuloendothelial cells of the liver and spleen only a small fraction of these particles will reach the bone marrow. By coating model microspheres with a block co-polymer (poloxamer 407) it has been possible effectively to hinder the liver/spleen uptake and obtain a deposition of the microspheres primarily in the bone marrow. Such a carrier system will have application in radiodiagnosis and for treatment of various diseases in the bone marrow. PMID- 3561164 TI - Inhibition of the Na+/Ca2+ exchange in cardiac sarcolemmal vesicles by amiloride. AB - The pyrazine diuretic amiloride inhibits the Na+/Ca2+ exchange activity of cardiac sarcolemmal vesicles in a concentration-dependent way. A good relationship between the uptake of amiloride by the vesicles and the inhibition of the exchanger has been found. Kinetic analyses indicate that the inhibition of Na+/Ca2+ exchange activity by amiloride is non-competitively removed by Ca2+ and competitively overcome by an outwardly directed Na+ gradient. PMID- 3561166 TI - Genetically obese (ob/ob) mice are hypersensitive to glucocorticoid stimulation of feeding but dramatically resist glucocorticoid-induced weight loss. AB - The genetically obese (ob/ob) mouse is hyperphagic and hypercorticosteronemic; both hyperphagia and excessive weight gain are ameliorated by adrenalectomy. We report here that corticosterone or dexamethasone stimulate feeding in obese mice at one-fifth the dose needed to increase feeding in lean littermates. Metabolic weight loss, a measure of carbon dioxide and water lost due to respiration, is stimulated by glucocorticoids. Yet we find that obese mice are only one-seventh as sensitive as lean mice to the enhancement of metabolic weight loss following corticosterone. Therefore, hypersensitivity to glucocorticoid-induced feeding and hyposensitivity to glucocorticoid-stimulated weight loss may act in tandem to produce the ob/ob's exaggerated weight gain. PMID- 3561167 TI - Cytotoxic activity of various snake venoms on melanoma, B16F10 and chondrosarcoma. AB - Elapid, crotalid and viperid venoms were screened in vitro and in vivo for cytotoxicity towards B16F10 melanoma and chondrosarcoma cell lines. The cytotoxic activity of elapid venoms was considerably higher than that of viperid or crotalid venoms. Elapid venoms disrupted the cell membrane within the first hour, leading to cell death. The strongest activity was found in the venom of Naja nigricollis. The venoms of some Viperidae and of all Crotalidae examined caused the cells to become rounded, without loss in their original volume, and to form aggregates. These changes were reversible when cells were changed to fresh medium. In vivo experiments with the venom of Naja nigricollis were in total agreement with the results achieved in vitro with melanoma cells and the venom exhibited similar cytotoxic activity on chondrosarcoma, inhibiting its development in vivo. PMID- 3561168 TI - Tolerance to effects of clonidine and morphine on sulfobromophthalein disposition in mice. AB - Chronic treatment of mice with clonidine or morphine caused tolerance to the analgesic and thermoregulatory effects of these drugs. After chronic morphine, mice also became tolerant to the analgesic and thermoregulatory effects of clonidine. Cross tolerance to the hypothermic effect of morphine was demonstrated after chronic clonidine administration, but no diminution of morphine-induced analgesia could be shown. Morphine and clonidine acutely increased the retention of sulfobromophthalein (BSP) in plasma and liver. Chronic dosing with morphine or clonidine caused partial tolerance and cross-tolerance to the rise in hepatic BSP caused by an acute challenge with either agonist. However, both drugs elevated plasma BSP levels similarly in tolerant and non-tolerant mice. Thus, regimens which readily induced tolerance to the analgesic and hypothermic effects of morphine or clonidine were only partially effective in modifying the acute hepatobiliary effects of these drugs. PMID- 3561170 TI - Nicotine administration to rats: methodological considerations. AB - The effects of nicotine on normal physiological function are of increasing concern. Preliminary to studies on the effects of prenatal exposure to nicotine, we examined methods of administering nicotine to rats. Drinking water containing nicotine was not palatable to rats and was an unsatisfactory method in our hands, producing weight loss and large decreases in fluid intake. Administration of nicotine in a complete liquid diet produced better results but the data suggest that oral administration of nicotine may interfere with absorption of some nutrients. Osmotic mini-pumps were found to be the best mechanism of nicotine delivery of those tried. There were no significant effects on food or water intake nor on weight gain, particularly when using a short term anesthetic for pump implantation. Plasma nicotine and cotinine levels were directly correlated to dose of nicotine delivered. Plasma nicotine levels similar to levels reported in humans were obtained. PMID- 3561169 TI - Exogenous ATP-stimulated calcium uptake in isolated rat intestinal epithelial cells. AB - ATP in the extracellular medium is known to stimulate Ca uptake into avian intestinal epithelial cells. We have now demonstrated a similar effect of ATP in mammalian intestinal epithelial cells and have further characterized this effect. Exogenous ATP increased 45Ca uptake 2-6 fold in isolated rat small intestinal epithelial cells, with a maximal effect at 1 mM and an ED50 of 290 microM. A strict structural requirement for nucleotide-stimulated 45Ca uptake was observed. ADP was much less effective than ATP and gamma-thio-ATP, and 5'-AMP, cyclic AMP, adenosine, non-adenine nucleotides, non-hydrolyzable ATP analogs and ATP analogs with ring substitutions at the 8 position were inactive. Prenylamine (100 microM) completely inhibited ATP-stimulated 45Ca uptake, while verapamil (100 microM) had only a small effect. In the intact intestine, ATP increased short-circuit current (Isc) when added to the mucosal side of the tissue. This effect was reduced by 10 microM and abolished by 100 microM prenylamine. The effect of ATP on Isc was markedly reduced in Cl-free solutions and in reduced-Ca solutions. Serosal and mucosal addition of the nonhydrolyzable ATP analog, beta, gamma-methylene-ATP, and serosal addition of ATP had little or no effect on Isc. The similarities between the effects of ATP in isolated cells and in the intact intestine suggest that the effect of ATP on Isc may be at least partially mediated through stimulation of Ca uptake into the epithelial cells. PMID- 3561171 TI - Central muscarinic control of the pattern of small intestinal motility in rats. AB - The effects of central and peripheral administration of muscarinic agonists and antagonists on small intestinal motility were examined in conscious rats chronically fitted with electrodes implanted in the duodeno-jejunal wall and a cannula in a cerebral lateral ventricle. Intracerebroventricular (i.c.v.) administration of either atropine or pirenzepine at doses from 1 to 10 micrograms, 15 min before a 3 and 6 g lab chow meal significantly reduced the duration of the postprandial disruption of the migrating myoelectric complexes (MMC). The reduction was significantly greater for atropine, a mixed M1 and M2 muscarinic receptor antagonist, than for pirenzepine, an antagonist with a high affinity for M1 receptors. At a higher dose (10 micrograms) intra peritoneal (i.p.) administration of atropine or pirenzepine did not modify the postprandial disruption of MMC. Oxotremorine (10 ng) a M2 agonist, but not McNeil A343 (5 micrograms), a selective M1 agonist, given i.c.v. in fasted rats disrupted for 1.5 h the MMC pattern. At the same doses given i.p. oxotremorine and McNeil A343 disrupted the MMC for 15 and 45 min respectively. We conclude that the postprandial changes in the small intestinal motility involve muscarinic receptors, mainly of M2 subtype, at the level of the central nervous system. PMID- 3561172 TI - Differential effect of zinc on teratogen-induced inhibition of pinocytosis by cultured rat yolk sac. AB - Pinocytosis as measured by the uptake of 125I labelled PVP by the isolated cultured day 12 rat yolk sac was observed to be linear over a 4 h incubation period and to proceed at a rate of approximately 2.5 microliters/mg protein/h. Cadmium, anti-visceral yolk sac antibody (AVYS) and trypan blue all inhibited pinocytosis in a concentration-dependent fashion when added to the culture medium, although at low concentrations trypan blue was slightly stimulatory. The effect of zinc on the inhibition of pinocytosis by these three teratogens was studied. It was observed that zinc ameliorated the inhibitory effects of cadmium and AVYS, but had no effect on inhibition by trypan blue. These results indicate that the previously demonstrated protective action of zinc against cadmium induced yolk sac dysfunction is not specific to that agent but extends to inhibition of pinocytosis by AVYS, and further suggest that, because of its refractoriness to zinc, trypan blue-induced inhibition of pinocytosis by yolk sac occurs by a mechanism different from that effected by cadmium and AVYS. PMID- 3561173 TI - Glucocorticoid action on the growth and development of insects. AB - Cortisol increased growth and differentiation in the large milkweed insect (Oncopeltus fasciatus). The glucocorticoid significantly increased the growth of the insect as analyzed by wet and dry weights. Cortisol also stimulated the development of the insects over that of the controls during the six day bioassay. PMID- 3561174 TI - Corticosteroidogenesis in the isolated Mongolian gerbil adrenal gland during continuous and discontinuous superfusion. AB - Corticosteroid (C) release by adrenals of male Mongolian gerbils (Meriones unguiculatus) has been studied during continuous and discontinuous (flow stop) superfusion. Flow stops of superfusion for 1, 5, 10 or 20 min resulted in a significant accumulation of C within adrenal tissue and superfusion flask. Amounts of C in the first 2-min samples after re-start of superfusion were positively correlated with the amounts secreted during continuous superfusion (5 min: r = 0.97, 10 min: r = 0.97, 15 min: r = 0.74, 20 min: r = 0.84, all p less than 0.001) and with the length of flow stops (1-20 min: r = 0.92, p less than 0.001). However, C concentrations in superfusates were significantly lower than values calculated from secretion during continuous superfusion and the length of flow stops (0 min = 100%, 1 min: 92%, 5 min: 65%, 10 min: 49%, 15 min: 39%, 20 min: 35%). As is evident from the very similar C amounts secreted by adrenals incubated for 15 min without or with 95%O2/5%CO2 (234 vs 256% of basal secretion), flow stop-induced inhibition of corticosteroidogenesis was not due to a lack of oxygen during flow stops. The results demonstrate that superfusion of sliced adrenal tissue gives insights into regulatory mechanisms, including the rapid changes of corticosteroidogenesis during short-lasting flow stops, which cannot be studied in static incubation of either tissue slices or isolated cells. The possibility that the observed decline in steroidogenesis during flow stops may be due to a local feedback inhibition resulting from C accumulating in the microenvironment of adrenal cells is discussed. PMID- 3561175 TI - Measurement of free and bound malondialdehyde in vitamin E-deficient and supplemented rat liver tissues. AB - The quantity of free malondialdehyde (MDA) in liver tissues of rats fed vitamin E deficient or -supplemented diets for 43 wk was measured by a newly developed high performance liquid chromatographic (HPLC) method. Bound MDA was quantified by the same HPLC method after alkaline hydrolysis of tissue homogenates. Tissues from vitamin E-deficient animals showed levels of free MDA about 15 times higher but levels of bound MDA less than 2 times higher than the vitamin E-supplemented animals. Free MDA is the major form in vitamin E-deficient tissues, but bound MDA is predominant in vitamin E-supplemented tissues. Conventional thiobarbituric acid (TBA) test results revealed that the content of TBA-reactive substances expressed in MDA equivalents was much higher than the actual free MDA levels in all groups. Results indicate that free MDA level measured by HPLC is a more sensitive index than the TBA value for lipid peroxidation. Some other TBA reactive substances seem to exist in liver tissue regardless of the dietary treatment. PMID- 3561176 TI - Oleic acid modulates the partitioning of cholesterol from micellar bile salt solution. AB - The effects of monounsaturated fatty acid (oleic acid) on cholesterol monomer activity and on the rate of cholesterol influx were studied in vitro. A polyethylene disc method was employed to determine cholesterol monomer activity in constant sodium taurocholate-cholesterol micellar solution containing different oleic acid concentration levels at pH 5.5, 6.5 and 7.2. In addition, the effect of oleic acid on the rates of cholesterol influx was determined using an everted rat jejunal sac technique. At pH 5.5, increased oleic acid concentration from 5 to 10 mM resulted in significant decreased apparent cholesterol monomer activity (3.8 +/- 0.21 nmol/disc vs 1.0 +/- 0.08, P less than 0.001). At pH 6.5, apparent cholesterol monomer activity was 2.3 +/- 0.19 nmol/disc at 5 mM and 0.5 +/- 0.09 at 16 mM oleic acid level (P less than 0.001). Apparent monomer activity of cholesterol in micellar solutions at pH 7.2 used for the influx study at 5 and 15 mM oleic acid concentration level was 1.8 +/- 0.14 and 0.7 +/- 0.08 nmol/disc, respectively (P less than 0.001). Thus there was a significant decrease in cholesterol monomer activity by the addition of oleic acid at each pH. The rate of cholesterol influx across the brush border membrane of the rat jejunum at 5 and 15 mM oleic acid concentration level was 3.2 +/- 0.31 and 1.5 +/- 0.21 nmol/100 mg dry weight tissues/min, respectively (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561177 TI - Electrochemical detection of phospholipid hydroperoxides in reverse-phase high performance liquid chromatography. AB - Hydroperoxy derivatives of phosphatidylcholine (PC) and phosphatidylethanolamine (PE) can be separated from their respective phospholipids by reverse-phase high performance liquid chromatography (HPLC). However, ultraviolet absorption due to conjugated diene cannot detect the hydroperoxy group. In this work, an electrochemical (EC) detector was first applied to the analysis of hydroperoxy phospholipids. Both the PC and PE hydroperoxides from rat liver were reduced quantitatively by the glassy carbon electrode at -300 mV vs Ag/AgCl. Since neither the hydroxy derivatives nor unoxidized phospholipids showed any response, it would seem this technique can be used to distinguish phospholipid hydroperoxides from their hydroxy derivatives. Thus, the reverse phase HPLC-EC detection method is proposed for the specific analysis of hydroperoxy phospholipids in biological tissues. PMID- 3561179 TI - The adoptee: interface between psychiatry, law and ethics. PMID- 3561178 TI - The effects of fat-free, saturated and polyunsaturated fat diets on rat liver and plasma lipids. AB - The liver and plasma lipids and fatty acid composition of rats fed synthetic diets of differing fat type and content were studied. All animals were starved for 48 hr and then refed a high carbohydrate, fat-free diet for 48 hr. They were then divided into three groups and fed for an additional 48 hrs the following: group 1, the fat-free diet; group 2, a diet containing 44% of calories from corn oil; and group 3, a diet containing 44% calories from completely hydrogenated soybean oil. The total lipid concentration of the liver in the animals on the fat free diet was elevated at 72 and 96 hr. The addition of either saturated or unsaturated fat in the diet at 48 hr prevented this accumulation. The total phospholipid and cholesterol concentrations of the liver were relatively uninfluenced by any diet in this study. Plasma total fatty acid concentration was elevated at 72 hr in the animals on a fat-free diet compared to those fed the stock diet, starved for 48 hr or fed the fat-containing diets. By 96 hr, however, plasma fatty acid concentrations in all groups were similar to those in animals fed only the stock diet. The release of de novo synthesized fatty acids into plasma from the liver was strongly inhibited by dietary fat, either saturated or polyunsaturated. With the fat-free diet there was a significant increase in the saturated and monounsaturated fatty acids in both liver and plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561180 TI - Compensation for subjects of clinical trials and strict products liability in German pharmaceutical law. PMID- 3561181 TI - The physician's duty to stop, look, listen, and communicate. PMID- 3561182 TI - Physicians and nurses: partners in communication. PMID- 3561183 TI - The physician-patient relationship: the art and science of communication. PMID- 3561184 TI - Assessment of fitness to stand trial: a critique. PMID- 3561185 TI - Dental ethics in practice. PMID- 3561186 TI - Therapeutic work with drug addicts in prison. PMID- 3561187 TI - Prevention and sexually transmitted diseases. PMID- 3561188 TI - Update on HIV infection. Epidemiologic and clinical aspects. PMID- 3561189 TI - Update on HIV infection. Neurological aspects. PMID- 3561190 TI - Update on HIV infection. Psychiatric aspects. PMID- 3561191 TI - Update on HIV infection. Pediatric aspects. PMID- 3561192 TI - Update on HIV infection. Counseling and HIV: test results and risk reduction. PMID- 3561193 TI - Update on HIV infection. The Governor's Task Force on AIDS. PMID- 3561194 TI - Chlamydial infections. PMID- 3561195 TI - Pelvic inflammatory disease and infertility. PMID- 3561196 TI - Sexually transmitted diseases and the gay male. PMID- 3561197 TI - Legal aspects of sexually transmitted diseases. PMID- 3561198 TI - Smoking. Part IV. Maintenance of cessation. PMID- 3561199 TI - Humanistic medicine revisited. PMID- 3561200 TI - The body and its mind. PMID- 3561201 TI - Assessment of dietary status using national guidelines. PMID- 3561202 TI - Hepatitis B surveillance in Korean adoptees. PMID- 3561203 TI - [The postoperative period in malignant tumors of the paranasal sinuses following preoperative and radical regimens of neutron therapy]. AB - Surgical intervention was performed in 16 patients with advanced tumors of the accessory sinuses and nose receiving neutron teletherapy. The 1st group (10 persons) was treated by combined therapy including preoperative irradiation with fast neutrons: 2 fractions a week at a dose of 1.2-1.4 Gy, total focal dose of 10 Gy corresponding to an equivalent dose of 40 Gy. Surgical intervention was performed in 10-15 days. In the 1st group during the post-operative period there were no complications, the period of wound healing was not increased as compared to that in the use of routine methods of combined therapy of tumors of the above site. In the 2nd group (6 persons) surgical intervention was performed 2-3 mos. after a radical course of combined neutron-photon therapy. The frequency of postoperative complications was 67%. The period of post-operative wound healing considerably increased. PMID- 3561204 TI - [Proliferative activity and the efficacy of radiation therapy in melanoma and squamous-cell keratinizing cancer of the skin]. AB - Proliferative activity (growth fraction) of malignant melanoma and keratinizing squamous cell carcinoma of the skin (19 patients) was studied using L. Schiffer's method (1975) modified by R. K. Karakulov (1982) and based on differences in the activity of DNA-polymerase in proliferating cells and cells "beyond the cycle". The number of active DNA-polymerase containing nuclei was determined using tumor cell nuclear DNA as matrices. The results obtained showed that malignant skin melanoma possessed a low proliferative activity (13.4% before radiation exposure). After the delivery of a dose of 30 Gy growth fraction was lowered by 25% (approximately 10%). Squamous cell skin carcinoma possessed a high proliferative activity, its basal value was 39.4%. After a dose of 30 Gy growth fraction was decreased 3-fold (approximately 12.9%). In malignant melanoma there was no correlation between a growth fraction value, the period and stage of disease as well as between a decrease in growth fraction and a degree of tumor regression by the end of irradiation. In skin cancer there was direct correlation between the depth of a growth fraction drop and a degree of tumor regression after a dose of 30 Gy. Therefore one can assume that the determination of a value of proliferative activity of radiosensitive tumors can serve as a criterion of therapeutic efficacy. PMID- 3561205 TI - [Effectiveness of various therapeutic schemes for patients with radiation edema of the extremities]. AB - The efficacy of various therapeutic schemes: medicinal (basic therapy--BT), acupuncture (AP) and laser therapy (LT) against a background of basic therapy- was assessed and compared in 36 patients with radiation limb edema. It was established that a degree of a decrease in edemas, the improvement of indices of rheovasography grew in the following order: BT----AP----LT. The recovery of the lymph flow and immunological indices were the same in all therapeutic schemes. PMID- 3561206 TI - [Current problems of radiation therapy]. PMID- 3561207 TI - [Dynamic scintigraphy of the liver using 131I-rose bengal and the bile acid content of the blood following gastrectomy for cancer]. AB - Liver function was studied in 84 patients with operable stomach cancer prior to and at varying times after gastrectomy using dynamic scintigraphy with 131I-rose bengal and determination by a radioimmunoassay of bile acids in the peripheral blood. A group of patients without signs of focal lesion of the liver and a history of its diseases was examined. It was shown that disorders of hepatocytic function took place before the operation. After gastrectomy the disorders were accompanied by considerable retardation of the basal secretion of bile into the intestine. At the same time an increase in the concentration of bile acids in the peripheral blood above the discriminant level of healthy persons, i.e. over 0.5 mg/l was observed. Disorders of liver function were of long duration and persistent over 1 year after gastrectomy. PMID- 3561208 TI - [Radionuclide research on liver and kidney function in thyroid cancer after radioiodine therapy]. AB - A study was made of liver and renal function using radionuclide methods in 51 thyroid cancer patients on radio-iodine therapy. Multimodality examination of the patients revealed no clinical manifestations of hepatocellular and renal failure even in significant therapeutic activities up to 40 GBq and more. Hepatography and renography showed a decrease in absorptive and secretory hepatocytic function, an increase in the period of hippuran half-life and a decrease in total renal function. The revealed changes were of moderate nature, stable and related both to hypothyrosis and a radiation factor. PMID- 3561209 TI - [Osteoscintigraphy in the diagnosis of rheumatoid arthritis and Bechterew's diseases]. AB - The paper is concerned with an analysis of the results of clinical and radionuclide examination of 36 patients with ankylosing spondylitis (AS) and 63 patients with rheumatoid arthritis (RA). The period of observation lasted from several week to 5 yrs. Osteoscintigraphy was performed using labeled agents. The data obtained coincided with pain sensations whereas the correspondence of painful zones and x-ray findings was noted in 39% of the patients. In RA hyperfixation of the drug was determined mainly in small and big joints (130 250%) in 92% of the patients coinciding with the pain syndrome and with X-ray findings in 38% of the cases only. Radionuclide signs of therapeutic efficacy were noted in 56% of the patients with AS and in 82% of the patients with RA. Radiation exposure of the bone marrow in osteoscintigraphy and x-ray investigation was defined (4.1 and 14.4 microGy). A radioimmunoassay showed elevated content of PTH in 67% of the patients with AS up to 4.0 +/- 0.5 iu/ml. PMID- 3561210 TI - [Radionuclide research on the bones using 99mTc-phosphonium in ear diseases]. AB - The state of the skeleton was studied in 62 patients with otosclerosis to investigate diagnostic potentialities of 99mTc-phosphonium, of them in 34 patients the diagnosis was confirmed at operation. 38 patients suffered from acute and chronic otitis media, 18 from cochlear neuritis, 4 from Meniere's disease. Scintigraphic imaging was processed quantitatively. When comparing skeleton images of the patients and persons of the control group (25 persons) it was established that radionuclide investigation of the bones with 99mTc phosphonium of patients with hypoacusis was a highly informative method for determination of a degree of disorder of the temporal bone. Systemic bone affection was observed in otosclerosis. Considerable RP fixation was found in patients with an active course of the otosclerotic process. A group of patients in whom hypoacusis was combined with disorder of the osseous capsule, was detected among the patients with acoustic neuritis. Scintigraphy with 99mTc phosphonium was recommended as an obligatory diagnostic procedure for patients with hypoacusis. PMID- 3561211 TI - [Qualitative characteristics of Soviet kits for the radioimmunological determination of cortisol and progesterone in human blood serum]. AB - Radioimmunoassays and kits of reagents based on them CORT-I-3H,STERON-K-125I, STERON-P-3H and STERON-P-125I intended for medical microanalysis, were studied. Their development and serial production were undertaken in the Institute of Bioorganic Chemistry, AS BSSR. The data obtained characterized the quality of the radioimmunoassays under study, long-term stability and reliability of the kits of reagents. A high specificity of antisera and correlation between the results of measurements and a degree of native blood serum dilution as well as the accuracy of the results obtained and sensitivity of the assays as a whole were demonstrated. The above properties of the radioimmunoassays made it possible to develop serial kits of reagents for determination of cortisol and progesterone concentration in the human blood serum, employed effectively in medical diagnosis of endocrine and other diseases. A long-term control over the reproducibility of parameters of calibration charts and the results of determination of the level of cortisol and progesterone in the pool blood serum of women showed a high reliability of the kits of reagents of different production lots within the time of their application observing instructions for use. PMID- 3561212 TI - [Biological action of the radiation from high-activity 252Cf sources]. AB - The radiobiological properties of mixed gamma-neutron radiation from 252Cf sources of high activity have been studied on chinese sand hamster cell culture. The source used has contained 1500 micrograms of radionuclide. In the study of radioprotective effect of hypoxia on the cells it is proposed to use anoxic attenuation factor (AAF) instead of the widely used oxygen enhancement ratio (OER). The comparison of radiation doses leading to a 90% decrease in initial cell viability provided the value of relative biological effectiveness (RBE) of 1.8 +/- 0.2 for mixed radiation and 2.2 +/- 0.2 for the neutron component at the dose of 10 Gy/h. AAF of mixed radiation was estimated as a ratio of radiation doses resulting in the above decrease of the cells viability, defined for the cells irradiation under anoxic or normoxic conditions. Simultaneously, AAF has been defined for gamma-radiation of 60Co. AAF has been shown to be 1.7 +/- 0.2 for 252Cf at dose rate of mixed radiation 10 Gy/h and 3.3 for 60Co. The index of "play back" is proposed as a more objective criterion of any modifier capability to overcome the radioprotective effect of hypoxia on tumour cells. The use of 252Cf sources of high activity instead of 60Co for intracavitary radiotherapy will increase the damage to hypoxic cells of malignant tumours. PMID- 3561213 TI - [Effect of ionizing radiation and other factors on the thermal sensitivity of mouse skin]. AB - A study was made of the effect of various agents on skin injury by hyperthermia in experiments on noninbred albino mice. The effects of heating were assessed by the frequency of skin necrosis development. The results of the study showed that irradiation of the skin (30 Gy) before heating did not influence its thermosensitivity whereas heating 45-180 days after irradiation proved more effective. Ethanol, metronidazole, thyrocalcitonin and actinomycin D decreased skin thermosensitivity, and cyclohexamide, serotonin, hyperglycemia and applying a tourniquet increased it. The DMF value for actinomycin D depended on the temperature of heating. One should distinguish between true modification of tissue thermosensitivity (determined by cellular factors) and indirect modification (associated with change in volumetric circulation rate). PMID- 3561214 TI - [Combined treatment of thyroid cancer metastases to the lungs in children and young people]. AB - Basing on a study of the results of therapy of 47 pediatric patients with thyroid cancer metastases to the lungs the authors worked out methods of hormono- and radiotherapy, specified indications for a volume of operations in locally spread primary tumor or regional metastases. The use of multimodality hormono- and radiotherapy of distant thyroid cancer metastases in children resulted in the 5 year survival rate of 90.9%. PMID- 3561215 TI - [Secondary splenomegaly in cholestasis and disorders of portal blood flow in an experiment detectable by intravenous liposome splenography]. AB - The paper is concerned with the results showing high diagnostic potentialities of i.v. liposome lienography for the detection of the splenomegalic syndrome in acute cholestasis, cholestatic hepatitis and disturbances of the extrahepatic portal blood flow. The authors managed to establish the dependence of the value of secondary splenomegaly on the period of cholestasis and a degree of occlusion of the portal vein. In acute cholestasis splenomegaly was manifested in 5 days by a two-fold increase in the spleen with reverse development within 2.5 mos. A rapid 2-fold increase in the spleen for 24 h was noted in occlusion of the portal vein by 40%, and a three-fold increase was noted in 5 mos. with subsequent death of the animals. A decrease in the extrahepatic portal blood flow by 25% also resulted in splenomegaly but without death of the animals. The authors have assumed that the use of i.v. liposome lienography ensures timely diagnosis of the splenomegalic syndrome and provides an opportunity to assess function of the reticuloendothelial system of the spleen. PMID- 3561217 TI - [Metrological requirements for devices for automatic coagulogram tests]. AB - A possibility of metrological provision for coagulation test automating equipment without creating standard patterns was proved on the blood coagulation meter of the thermoconductometric type. It was shown that the main metrological requirement for such equipment is the retention of the uniqueness of the results of the measurements made manually in standard conditions and those made by means of the new equipment. PMID- 3561216 TI - [Use of chromatographic-mass spectrometers in diagnosis]. AB - Conditions for extraction, desorption and concentration of specific substances, such as metabolites, and characteristics of their gas-chromatographic division and mass-spectrometric identification have been established. A library for mass spectra of specific metabolite compounds characteristic of various diseases has been set up. Computer programs for metabolite analysis and for diagnosis were modified. An experimental introduction of chromatographic-mass-spectrometric diagnosis into practice in a number of hospitals and research institutions for prophylactic medical examination of people will make it possible to quickly accumulate statistic data and create the necessary data bank. PMID- 3561218 TI - [Light-optical device for fiber light guides]. AB - The paper gives a calculation method for a lighting optical device consisting of light flux concentrator lamps rigidly installed in an ellipsoid reflector with heat-permeable coating, and the parameters of two big concentrator lamps for fibre endoscopes. PMID- 3561219 TI - [Analysis of the gas exchange efficiency in a membrane oxygenator with repeated agitation of the blood flow]. AB - Approaches to improvement of gas exchange function of membrane oxygenator are studied. A mathematical analysis of the principle of repeated agitation of oxygenator blood layer is carried out, and the efficiency of its application in membrane oxygenators is shown. PMID- 3561220 TI - [Effect of basic parameters of air sterilizers on the temperature-time regimen for sterilization]. AB - The effect of the basic parameters of the air sterilizers on the sterilization temperature and time conditions was studied on the basis of the mathematical simulation method. A method of engineering calculations was developed, providing the optimum values of thermal power and sterilizing agent consumption. That would help to achieve the maximum capacity of the equipment and high quality of sterilizing treatment. Conditions for using different methods and automated systems to handle the sterilization process were determined. PMID- 3561221 TI - [Mechanization and automation of loading-unloading and of hauling-storing operations]. PMID- 3561222 TI - [Devices simplifying research on the Rubin-2 thermograph]. AB - A changed position of the mirror-reflector in the Rubin-2 thermovision unit as well as the use of an improved model of the couch-chair and a special cassette for electrochemical paper reduce the labour input and raise the information value of the method. PMID- 3561223 TI - [Feedback channel for transmission of the ECG signal via telephone lines]. AB - The elaborated devices produce a feedback channel in the three-channel system for ECG transmission through the telephone line. Crystal-controlled frequencies and medium-scale integrated microcircuits are used in the receiving and transmitting parts of the device. The system trial operation has demonstrated serviceability and interference immunity. PMID- 3561224 TI - [The Integral-2MT television analyzer of the morphological characteristics of tumor cells]. AB - Integral-2MT is designed for differential diagnosis of tumor-like neoplasms. It also provides for automatized morphological parameter examination of cells which are either deposited on the slides or photographed in the form of a positive or negative picture. The analyser design and its operation principle are described. The analyser structural diagram is based on the modular main principle using the Electronika-60M microcomputer. The analyser software permits to determine 8 morphological cell parameters, to calculate statistical cell population features, to draw automatically histograms in various scales according to the operator's choice. The possible application spheres are described. PMID- 3561225 TI - [An apparatus for melting a hydrocolloid mass]. PMID- 3561226 TI - [Forceps and clamps for pediatric lung surgery]. AB - The paper describes new instruments for operations on thoracic organs in newborns and babies. The instruments are light, small-sized and convenient which provides great possibilities for their large-scale application in children's lung surgery. PMID- 3561227 TI - [Dissectors and clamps for pediatric cardiovascular surgery]. AB - The new multi-purpose instruments for cardiovascular surgery in infants and newborns are designed. As compared to their analogues they have smaller mass and dimensions, they are atraumatic and more convenient which makes it possible to use them widely in children's cardiovascular surgery. PMID- 3561228 TI - [Automated system for research on intragastric pH measurement]. AB - An automated system for the study of the intragastric PH-metry on the basis of the Electronika KI-20 microcomputer has been considered. The paper gives a brief description of the apparatus, program and the operator's work with the system. PMID- 3561229 TI - [The professional identity crisis of the psychiatrist]. PMID- 3561230 TI - [Levels of anxiety and depression in the medical profession]. PMID- 3561231 TI - [Changes in the self image of 2 groups of women after breast surgery]. PMID- 3561232 TI - [Schizoaffective psychoses]. PMID- 3561233 TI - [The Ranking Rorschach Test in neurotics]. PMID- 3561234 TI - [Proposal for automating the marking and numerical summarizing of the Rorschach Test using a home computer]. PMID- 3561235 TI - [Efficacy and tolerability of dothiepin in the elderly patient. Comparison with mianserin]. PMID- 3561236 TI - [Neuroradiologic diagnostic possibilities of "symptomatic" vasospasm in subarachnoid hemorrhage. Case report]. PMID- 3561237 TI - [Antipsychotherapy and antipedagogy: models of totalitarian sociotechnics]. PMID- 3561238 TI - [Acute lethal catatonia]. PMID- 3561239 TI - 1987 American College of Sports Medicine. Annual meeting abstracts. May 27-30, Las Vegas, Nevada. PMID- 3561240 TI - Cardiac transfer function relating energy metabolism to workload in different species as studied with 31P NMR. AB - Cardiac metabolism was studied with 31P NMR in 7 dogs and 4 cats to determine whether animals adapted for different life-styles (stalk and sprint vs endurance running) respond to increased work loads (heart rate X blood pressure product) with different high-energy phosphate kinetics. Hearts were exposed via a left lateral thoracotomy under Nembutal anesthesia (40 mg/kg). Two-turned solenoid surface coils were placed on the left ventricles; pacing wires were sutured into the left ventricular apices. The femoral artery and vein were cannulated for blood pressure and arterial blood gas monitoring and fluid and drug infusion, respectively. Animals were placed in a plexiglass holder into a 2.1-T, 31-cm bore, superconducting magnet. 31P spectra were obtained from the heart using respiratory and electrocardiogram gating. Cardiac work loads were changed by pacing the heart at 4, 4.5, and 5 Hz. Heart rate X blood pressure product "work" was correlated with Pi/PCr ratios. Dog hearts were more resistant than those of cats to changes in Pi/PCr with increasing work load. It is possible that animals adapted to different life-styles may have cardiovascular systems which are metabolically and mechanically adapted for different forms of stress. These differences may be elicited and effectively delineated using in vivo NMR techniques during various physiological interventions, such as pacing. The basis for these differences may be related to cardiac microvasculature or to intrinsic differences in enzyme kinetics. Delineation of these mechanisms may be helpful in the understanding of the physiological basis of cardiac function in health and disease. PMID- 3561241 TI - Effects of selective pulses on the measurement of T2 and apparent diffusion in multiecho MRI. AB - The effects of using spatially selective and nonuniform radiofrequency pulses on the apparent T2 of a train of multiple echoes have been calculated by computer simulation. It is demonstrated that the use of selective pulses produces errors in estimates of T2 in imaging experiments because regions of the slice are effectively off resonance and therefore receive spin rotations less than in an ideal case. Components of the transverse magnetization that are incompletely rotated by 180 degrees refocusing pulses produce longitudinal components that are later returned to the transverse plane and add to subsequent echoes. These so called ghost components influence the precise value of T2 estimated, but even when completely removed the resultant estimate is too short. The apparent T2 is influenced by the magnitude of the nutation angle inhomogeneity across the slice and paradoxically is not always more accurate with larger numbers of echoes. The reduction of apparent T2 caused by increasing the slice-selection gradient across a thin slab of material replicates the effects previously ascribed to diffusion and affords an alternative explanation for these without recourse to motion of the spins. PMID- 3561242 TI - Frequency-modulated radiofrequency pulses in spin-echo and stimulated-echo experiments. AB - Frequency-modulated rf pulses based on a linear frequency sweep are studied experimentally in spin-echo and stimulated-echo sequences. It turns out that these FM pulses generate a quadratic phase perpendicular to the selected slice and that the quadratic phases of the FM pulses in a spin-echo or stimulated-echo sequence may compensate each other if sweep velocity and gradients are suitably chosen. For a complete rephasing, a formula is given and supported by measured slice profiles. Slice profiles of excellent rectangularity are obtained. Finally, it is shown that with this technique images can be obtained using pulses of increased bandwidth and reduced peak power compared with the AM situation. PMID- 3561243 TI - In vivo 31P nuclear magnetic resonance studies of T1 and T2 relaxation times in rat brain and in rat brain tumors implanted to nude mice. AB - 31P NMR spin-lattice (T1) and spin-spin (T2) relaxation times of phosphocreatine, ATP, inorganic phosphate, and phosphomonoesters have been measured in vivo at 4.7 T in rat brain and rat brain tumors implanted on nude mice. The relaxation data were acquired using a phase-cycled saturation-recovery spin-echo sequence. The problems associated with the phase modulation of the ATP lines by the homonuclear coupling constants were overcome by using selective refocusing pulses for the T2 measurements. In all the metabolites, large differences (1 to 2 orders of magnitude) are observed between the two relaxation times. T1 values in rat brain tumors are 30 to 90% longer than their counterparts in normal rat brain. T2 values follow the same trend with smaller variations except for phosphocreatine values which seem much less sensitive to the metabolic state of the tissues. PMID- 3561244 TI - In vivo proton spin-lattice relaxation times of normal and dystrophic muscles. AB - In vivo spin-lattice relaxation times (T1) of water and lipid protons were measured in normal and dystrophic chicken pectoralis muscles at different ages. Values were obtained with a surface coil used as both a receiver and a transmitter. A 2 theta-T1-theta-Acquisition sequence was used for these measurements. Accuracy was verified with an inversion-recovery method using a slotted tube resonator as the transmitter and a surface coil as the receiver. It was observed that the T1 values of water protons in normal muscles decrease with age, the T1 values of water protons do not change with age in dystrophic muscles, and the T1 values of lipid protons increase with age in normal and dystrophic muscles. These results indicate a failure of the normal maturation of dystrophic muscles. PMID- 3561245 TI - Pseudo-gating: elimination of periodic motion artifacts in magnetic resonance imaging without gating. AB - This note explains and illustrates a technique of reducing artifacts produced by periodic motion without using physiologic gating. The method is simple and can be applied on any standard MRI unit. For periodic motion, effective gating can be attained by setting the product of the number of acquisitions (at each phase encoding step), N, times the repeat time, TR, equal to the period of the motion, T. This pseudo-gating can be used with any TR but, if changes in the period occur, is most robust with short TR values. The method is also applicable to multislice and volume imaging. For fast field echo methods, the above rule can be used if the period of the motion is smaller than the total scan time. Otherwise, the scan need only be repeated N times to avoid artifacts and improve signal-to noise. The method has been implemented to remove both respiratory and/or cardiac motion artifacts. PMID- 3561246 TI - A pulse reflectometer for routine monitoring of transmitted and reflected power in physiological NMR studies. AB - A simple circuit design is described which provides LED readout of transmitted and reflected pulsed rf power. The utility of monitoring these variables in physiological NMR studies is discussed. PMID- 3561247 TI - Quadrature detection surface coil. AB - A surface coil assembly consisting of two interleaved coplanar resonators that are intrinsically decoupled from each other is described for imaging at 1.5 T. Vector reception fields on-axis at 3 cm depth are orthogonal and of equal magnitude. Both components of magnetization were received and combined resulting in a 2 1/2 improvement in signal-to-noise for temporomandibular joint images. PMID- 3561248 TI - Anatomical interpretation of MR scans of the brain. AB - A stereotactic method of brain localization is applied to magnetic resonance imaging for the interpretation of brain structures. This proportional grid system developed by Talairach is based on two intracerebral structures, the anterior and posterior commissures. It takes into account individual variations in brain size and shape. In an experimental study on cadavers we demonstrated that his system permitted accurate identification of cortical structures on CT scan. In this paper, we describe its application to MR. It provides, on a routine basis, a simple reliable method of anatomical interpretation. The use of this grid system is made easier by the fact that both commissures are seen on midsagittal MR scans. PMID- 3561249 TI - Biological tissue simulation and standard testing material for MRI. AB - The polyacrylamide gel is proposed here as a phantom material for NMR imaging. This substance has electrical and NMR relaxation characteristics very similar to those of biological tissues. The thermal and time stabilities also make this material a convenient standard for MRI. PMID- 3561250 TI - MR angiography by selective inversion recovery. AB - A modified inversion-recovery sequence is introduced which performs subtraction angiography by varying time-of-flight effects of blood flowing into an imaged slab. The selective 180 degrees excitation inverts different regions between measurements to isolate arterial and/or venous blood. On normal human subjects, high-resolution carotid artery angiograms have been obtained. PMID- 3561251 TI - Secondary structure prediction of human SAA1. Presumptive identification of calcium and lipid binding sites. AB - Serum amyloid A protein (SAA), an apolipoprotein of high density lipoprotein (HDL), is an acute phase protein thought to be the precursor of amyloid fibrils in reactive systemic (AA) amyloidosis. A prediction of the secondary structure of the human serum amyloid protein SAA1(alpha) is presented. The prediction was based upon one-dimensional Fourier analysis of the amino acid sequence together with sequence matching to known structural motifs. The results were compared with those from prediction algorithms based upon statistical techniques. Our findings are consistent with available experimental data. They include the putative identification of the amino-terminal 11 residues as the functionally important lipid-binding site of SAA and of a likely, neutral, calcium-binding sequence: Gly48-Pro49-Gly50-Gly51. Sequence comparisons between SAA and protein tyrosine kinases, phospholipases A2 and delta-crystallin, all of which bind both calcium and phospholipid, revealed significant homologies that support our proposals concerning structure-function relationships in SAA. PMID- 3561252 TI - X-ray scattering and diffraction by wet gels of AA amyloid fibrils. AB - Systemic amyloidosis is characterized by the extracellular accumulation of protein fibrils with typical ultrastructural morphology. The persistence in vivo of amyloid fibrils, which is responsible for their serious clinical effects, has been thought to reflect the particular, specific conformation of peptide chains constituting the fibrils. On the basis of earlier structural studies this conformation is generally considered to be almost exclusively anti-parallel beta sheets. We have re-examined X-ray scattering by human amyloid A protein (AA) amyloid fibrils, with careful attention to the state of hydration of the preparations. We show that a stack of anti-parallel sheets is not consistent with the details of the X-ray pattern, which contains diffracted intensities that can be indexed on a 33A X 33A lattice. A structural model for the AA fibre consistent with the X-ray data is presented. The model takes account of the prediction of the secondary structure of the AA precursor SAA1(alpha) presented in our accompanying paper, and has the AA monomers arranged on a primitive lattice, with two unique molecules per unit cell. PMID- 3561253 TI - Serum testosterone concentrations in men with alcoholic cirrhosis: background for variation. AB - Median serum testosterone concentration of men with alcoholic cirrhosis (n = 216) did not differ significantly from normal controls (n = 51), but serum testosterone concentrations varied by a factor 43.9 in patients compared to 3.2 in controls (P less than .001). Nineteen percent of the patients had serum testosterone concentrations above 30 nmol/L. Serum concentrations of sex-hormone binding globulin (SHBG) were significantly (P less than .001) raised, and serum concentrations of calculated nonprotein-bound and non-SHBG-bound testosterone were significantly (P less than .001) decreased in patients compared to normal control values. A number of background variables were analyzed with reference to serum testosterone concentrations by means of multiple regression techniques after having divided the patients into groups (A, B, C) with decreasing liver function by a modification of the Child-Turcotte's criteria. The only significant (P less than .01) background variables associated with log serum testosterone concentrations were: group C (beta = -0.828), group B (beta = -0.222), age (years) (beta = -0.012), duration of hospitalization (days) (beta = -0.0077), and concentration of SHBG (nmol/L) (beta = 0.0044). Neither previous nor recent (within last six months) alcohol consumption influenced serum testosterone concentrations significantly, but about 50% of the patients had abstained from ethanol for two months or more. The same background variables as above were included as significantly (P less than .01) associated with log serum concentrations of calculated nonprotein-bound testosterone and calculated non SHBG-bound testosterone, except that SHBG was insignificantly associated to any of the two proportions and that testicular volume was significantly (P less than .05) associated with log non-SHBG bound testosterone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561254 TI - Characterization of nuclear thyroid hormone receptors of cultured skin fibroblasts from patients with resistance to thyroid hormone. AB - Nuclear thyroid hormone receptors of patients with the syndrome of resistance to thyroid hormone were investigated in cell lines from seven patients in four affected families and compared to results from six normals. Fibroblasts cultured from skin biopsies were used. When binding affinity and capacity for L triiodothyronine (T3) were examined by incubating whole cells or isolated nuclei, no significant differences were found. The amount of receptor released during the incubation of nuclei (9.3% to 19.0% of total nuclear receptors) was also within the normal range in these patients. When T3 binding assays were performed on 0.3 mol/L KCl extracted receptor, a significant decrease in binding capacity (MBC) without a difference in binding affinity (Ka) was observed in four patients and a lower Ka with normal MBC was found in two patients. Recovery of receptors in saline extracts, from patients' fibroblasts showing a low MBC, was low in comparison to normals. Lability of salt extracted receptors at 38 degrees C was normal and salt extractability of T3 occupied receptors, examined by incubation of [125I]-T3 labeled nuclei with various concentrations of KCl, was only slightly decreased. This lower salt extractability of receptors was insufficient to account for the low MBC obtained by Scatchard analysis of T3 binding to nuclear extracts. Gel filtration and density gradient sedimentation of salt-extracted receptors showed Stokes radius of 34 A, and sedimentation coefficient of 3.4 S in all patients and normals. From these values, molecular weight of 49,000 and total frictional ratio (f/fo) of 1.4 were calculated for nuclear receptors from patients and normals, suggesting a somewhat asymmetrical shape of receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561255 TI - HAZARD: an expert system for risk assessment of environmental chemicals. PMID- 3561256 TI - A comprehensive database management system for a variety of clinical trials. PMID- 3561257 TI - From medical data to health knowledge. PMID- 3561258 TI - Statistical analysis of a clinical trial in orthostatic hypotension--a nonparametric approach. PMID- 3561259 TI - A graphic method of estimating the specificity of screening programmes from incomplete follow-up data. PMID- 3561260 TI - Attempts to isolate parvovirus from human acute non-bacterial gastro-enteritis cases. AB - It has been suggested that the causative agent of human acute non-bacterial gastro-enteritis, based on morphology, buoyant density in caesium choloride, resistance to acid, and reactions to ether and heat, may be a parvovirus. Using conditions optimal for parvovirus multiplication, attempts were made to isolate a parvovirus from such specimens. Results were negative indicating that the agent is not a parvovirus. PMID- 3561261 TI - The development of a filtration system for evaluating flow characteristics of erythrocytes. AB - A complete description of the pathophysiology of sickle cell disease requires a physiologically meaningful measurement of red cell deformability. We have designed and built a system which allows one to determine filtration characteristics of erythrocytes. A dilute red cell suspension is forced through a 3.0-micron polycarbonate Nuclepore membrane with a constant positive pressure of 20 mm Hg. Under these conditions blockage of the pores in the polycarbonate membrane is insignificant and flow is linear. We use the relative number of cells filtered through the membrane as a means of approximating the means deformability of cells in the suspension. Using this system we have compared erythrocytes from various mammals and shown that our technique is sensitive in detecting not only differences in cell deformabilities between mammalian species but also changes in cell deformability of human red cells due to exchange transfusion and application of drugs. There was a positive correlation between cell filtrability and percentage cell recovery (coefficient of correlation, 0.65) and a negative correlation between cell size and filtrability (coefficient of correlation, 0.61). The filtrabilities of normal volunteers and sickle cell disease patients were found to be 71.8 +/- 6.6 and 53.6 +/- 5.0%, respectively. This system is sensitive and reliable, and should be useful in evaluating both the contribution of filtrability to the viability of red cells in vivo and potential therapeutic agents for sickle cell disease. PMID- 3561262 TI - Kinetics of red blood cell passage through interendothelial slits into venous sinuses in rat spleen, analyzed by in vivo microscopy. AB - Sequential photomicrographs of RBCs passing through interendothelial slits (IES) in walls of venous sinuses in rat spleen were obtained by video recording in vivo microscopic views. Kinetics of RBC passage were analyzed by slow-motion playback of recordings. An inverted microscope and oblique lighting from a water-cooled fiber optic light source were key elements in obtaining images of sufficient quality for analysis. The direction of RBC passage through IES was, invariably, from reticular spaces of the red pulp into venous sinuses. RBC flow through an individual IES occurred as brief discontinuous bursts, separated by periods of zero, or near zero, flow. Mean rates of RBC flow through six IES analyzed in normal relaxed spleen ranged from 1.4 to 9.1 cells/15 sec, the total RBCs studied being 1523 and the total combined period of observation 98 min. The maximum instantaneous rate was 10 RBCs/sec. RBC transit times ranged from 0.02 to 60.5 sec, even for a single IES; the distribution was highly skewed: median 0.23 sec, mean 1.7 sec. Analysis of RBC flow through two closely adjacent IES simultaneously, for 30 min, showed that most bursts were asynchronous. The results indicate that changes in caliber of IES are primarily responsible for the observed pattern of flow. It was estimated that only 19% of the total IES present anatomically actually allowed passage of RBCs during any 5-min period. PMID- 3561263 TI - Outflow pressure reduces lymph flow rate from various tissues. AB - We previously reported that the very act of cannulating a lung lymph vessel could alter the unique flow characteristics that existed within the lymphatic before cannulation. We postulated that this phenomenon could hold true for lymphatics draining any organ within the body. Since it is frequently important to know the relationship between the transmicrovascular fluid flux and true lymph flow rate, it would be critical that a cannulated lymphatic vessel have the same flow characteristics as those uncannulated vessels draining the same organ. In order to test our hypothesis we cannulated lymph vessels draining the heart, liver, small intestine, kidney, and skeletal muscle. By altering the lymphatic outflow pressure (normally related to systemic venous pressure) and by using lymphatic cannulas of various resistance, we were able to demonstrate that lymph flow varied linearly with lymphatic outflow pressure in every organ. By increasing transmicrovascular fluid flux and lymph flow rate in each organ we were also able to demonstrate that effective resistance of the lymphatic vessels and the effective pressure driving lymph flow varied as a function of the physical characteristics of the organ under investigation. Characteristic effective resistances of the heart, liver, skeletal muscle, kidney, and small intestine lymphatics decreased by 83, 40, 61, 36, and 50%, respectively. Along with these changes in effective resistance, the effective lymph driving pressure in the same organs varied by 49, 0, 257, 0, and 63%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561264 TI - Diet-induced changes in rabbit serum potassium do not alter size or number of brain capillary endothelial cell mitochondria. AB - Previous studies have shown brain extracellular (EC) [K+] to remain constant during wide variations of the plasma-brain [K+] gradient. High serum [K+] is hypothesized to increase K+ pumping by the blood-brain barrier (BBB) to maintain normal EC levels. This changing metabolic work could be reflected in endothelial cell mitochondria which have been shown to be three to four times more numerous in the BBB than in other capillary endothelial cells. We measured several morphologic parameters of brain capillary endothelial cells in white male New Zealand rabbits following dietary manipulation of their serum [K+] levels. Four groups, based on serum [K+] levels, were formed: Deficient, Low, Normal, and High. Following the final day's weight and blood samples, rabbits were anesthetized and perfused for transmission electron microscopic planimetry. Variables included number and area of mitochondria, areas of capillary lumen and capillary diameter, area of endothelial cell, and proportion of endothelial cell taken up by mitochondria. With the exception of the area of the endothelial cell (P less than 0.01), which decreased with increasing serum [K+] levels, no differences appeared among the variables in any of the four groups. Lack of anticipated differences in mitochondrial number or proportional area indicates either that pumping K+ occupies a minor fraction of cell energy, or changes in mitochondrial size or number are not sufficiently sensitive indicators of metabolic workload in this model. PMID- 3561265 TI - Leukocyte adherence initiation in skeletal muscle capillaries and venules. AB - In vivo leukocyte adherence has many physiological implications but the effect of vessel size and hemodynamic parameters on adherence initiation remains unclarified. The early phases of adherence, defined to include attachment of previously freely moving leukocytes to endothelium or leukocytes which roll along the vessel wall, are the focus of this report. Blood velocity and diameter in 121 capillaries and venules in the cremaster of 13 rats were measured. The hemodynamic and vessel size difference characterizing vessels in which either initial leukocyte wall attachment or leukocyte rolling occurred (termed "adherent vessels"), as distinguished from vessels in which neither transient stoppage nor cell rolling was observed (termed "nonadherent vessels"), was then determined. Fifty-seven percent of the vessels observed were adherent vessels. These vessels were characterized by a larger diameter, a smaller blood velocity, and a smaller calculated wall shear rate than the nonadherent vessels. The results show that leukocyte adherence can be initiated in capillaries and postcapillary vessels with diameters that are equal to and less than the leukocyte size. Within vessels less than 11 micron, adherence or nonadherence appears dependent on local hemodynamics with the possibility of a critical shear rate threshold of about 400 sec-1. In vessels with shear rates greater than this value only 7% were observed to have adherence. In vessels greater than 11 micron the absence of hemodynamic differences between adherent and nonadherent vessels suggests the presence of other adherence-initiating mechanisms. It is thought that in these larger size vessels both local erythrocyte effects and adherence initiation within upstream capillaries affect observed adherence. PMID- 3561266 TI - Concentration dependence of protein permeability across the canine visceral pleura. AB - Water and protein movement across the pulmonary endothelial-visceral pleural membrane of spontaneously breathing anesthetized dogs was analyzed to determine if the protein concentration at the microvascular membrane (Cpro) influences microvascular permeability. The left lung was enclosed in a water-impermeable membrane, creating a visceral pleural space (VPS); fluid and solute fluxes were determined as the filtration or reabsorption of water and protein in the VPS. The plasma protein concentration was experimentally varied by plasmapheresis with saline replacement while the pleural fluid protein concentration was varied by introducing different concentrations of plasma mixed with saline into the VPS. Hydrostatic pressures were maintained within a physiologic range (pulmonary capillary pressure 12.1-16.1 mm Hg). The plasma protein concentration fell as low as 1.98 g/dl, and Cpro, calculated as the mean of the plasma and pleural fluid protein concentrations, ranged from 1.73 to 6.23 g/dl. The relationship between Cpro and the apparent homoporous diffusional permeability for protein (Phs), Phs(cm/sec X 10(-6] = 0.95 Cpro (g/dl) + 2.28, was highly significant (r = 0.87, P less than 0.01). In contrast, the hydraulic conductivity was not affected by a reduction in Cpro to this level (r = 0.21, P greater than 0.4). Although the solute concentration at the endothelial membrane should be considered when evaluating changes in protein permeability, under most experimental conditions the magnitude of this effect will be small. PMID- 3561267 TI - Effect of hepatic nerves, norepinephrine, angiotensin, and elevated central venous pressure on postsinusoidal resistance sites and intrahepatic pressures in cats. AB - Portal venous pressure was controlled by resistance localized to specific sites in hepatic lobar veins in cats. All of the pressure drop from the portal vein to the vena cava occurred across postsinusoidal vessels; portal pressure, lobar venous pressure, and, therefore, sinusoidal pressure were not significantly different. Norepinephrine and angiotensin infusions (intraportal) caused elevation in portal pressure due to constriction of hepatic venous resistance sites as well as some constriction of presinusoidal (portal or sinusoidal) resistance sites. At low doses of norepinephrine presinusoidal constriction dominated whereas at higher doses the postsinusoidal constriction increased proportionately more. Hepatic nerve stimulation produced a similar response measured at an early time (1 min), but by 3 min the presinusoidal constriction showed complete escape so that elevated portal pressure was entirely due to hepatic venous constriction. The same site that provided basal vascular resistance also provided the increased hepatic venous resistance with nerve stimulation and infusion of angiotensin and norepinephrine. Rapid elevation of central venous pressure (CVP) caused elevated sinusoidal pressure. At high CVP (16 mm Hg), 75% of a rise in CVP was transmitted whereas at normal CVP (less than 4.5 mm Hg) less than 20% transmission occurred. The presence of a high resistance in the hepatic veins protected intrahepatic pressure from the effects of normal fluctuation of CVP. PMID- 3561269 TI - Arteriolar vasomotion and arterial pressure reduction in rabbit tenuissimus muscle. AB - Spontaneous arteriolar vasomotion and its relation to arterial pressure reduction was studied in the rabbit tenuissimus muscle using intravital microscopy. Vasomotion was observed in all transverse arterioles and their first-order side branches. Vasomotion frequency ranged from 5 to 32 cycles per minute (median: 25 cpm). The relative vasomotion amplitude in transverse arterioles varied from 0.06 to 0.44 (median: 0.22). Vasomotion was generally of the on-off type in first order side branches. A gradual reduction in arterial pressure as achieved by aortic occlusion resulted in an abrupt disappearance of vasomotion. Vasomotion disappeared between 19 and 59 mm Hg (median: 30.4 mm Hg). No differences were found between the pressures at which vasomotion ceased in transverse arterioles and first-order side branches. With a further reduction of arterial pressure transverse arterioles attained a maximal diameter of 98-265% (median: 119%) of the maximal diameter during vasomotion. After release of occlusion vasomotion reappeared much earlier in the first-order side branches than in their feeding transverse arterioles. It is concluded that although vasomotion influences capillary perfusion, it does not play a major role in the adaptation of vascular resistance following a reduction in arterial pressure. PMID- 3561268 TI - The effect of fluid shear stress on the migration and proliferation of cultured endothelial cells. AB - We have examined the effect of shear stress on the regenerative response of cultured vascular endothelial cells by using a fluid shear apparatus designed in our laboratory. The shear stress was created on the endothelial cell layer of a fetal calf and grown confluently in a culture dish by whirling the medium, with a rotating disk placed on the fluid surface. The effect of the shear load (0.3-1.7 dyn/cm2) over 24 hr was evaluated by counting the number of regenerated cells in a denuded area that had been created by mechanically removing some cells before rotating the medium. The cell number observed in the denuded area after the exposure to shear stress was about twice as great as that of the static control. The difference was statistically significant (P less than 0.01 to P less than 0.05). Cell migration and proliferation occurred more prominently in the downstream portion of the flow than in the upstream part. The cell number in the downstream portions correlated significantly with the intensity of the applied shear stress (P less than 0.05). These results indicate that shear stress can stimulate the migration and proliferation of endothelial cells. PMID- 3561271 TI - Effects of the 1986 Tax Reform Act on your personal tax return. PMID- 3561270 TI - Anatomic and hemodynamic characteristics of the blood vessels feeding the cremaster skeletal muscle in the rat. AB - The anatomic arrangement, pressure distribution, and resting vascular tone of the feed arteries located upstream from the rat cremaster microcirculation were determined to characterize the sites of the vascular resistance in this macrovessel segment of the cremaster circulation. The cremaster microcirculation and its feeding arteries were studied using an intravital video microscopy system. Vascular diameters and pressures were measured with an image shearing monitor and servo-null micropipet system, respectively. The central arteriole of the cremaster muscle was found to be a distal segment of the external spermatic artery which branched from the pudic-epigastric artery that in turn arose from the common iliac artery. Together the length of these vessels, from the aorta to the cremaster muscle, was 37 mm and they accounted for 42% of the total pressure drop across the cremaster vascular network. The largest pressure drop (31 mm Hg) upstream from the cremaster occurred across the external spermatic artery which was also the longest (17.7 mm) feed vessel. Topical application of adenosine (1 X 10(-3) M) significantly dilated the pudic-epigastric artery and the external spermatic artery, indicating that these vessels had significant tone. In summary, our data indicate that the large fraction of network vascular resistance located in the feed vessels upstream from the cremaster is the result of both architectural features and vascular tone. PMID- 3561272 TI - Investing after tax reform. PMID- 3561273 TI - Pension plans remain the ultimate tax shelters. PMID- 3561274 TI - Due process is a time consuming protection. PMID- 3561275 TI - New hope for sudden death survivors. PMID- 3561276 TI - Nuclear war: no treatment, no cure. PMID- 3561277 TI - [Comparison of Campylobacter jejuni isolation methods and the effect of moisture content on colony morphology]. AB - Several isolation methods and media and the effect of moisture content on colony morphology were compared for the primary isolation of Campylobacter jejuni. Of the 200 rectal swabs from cattle and sheep tested for the isolation of C. jejuni, 19.5% were positive on Butzler medium and 16.5% were positive on Skirrow medium. The transportation of samples in modified Cary-Blair medium increased the isolation rate. Of the 300 gallbladder from cattle and sheep tested for the isolation of C. jejuni, 5% were positive by direct inoculation of bile, 27% were positive by swabbing and 31% were positive by selective enrichment method. The organism produced two different type of colonies on fresh and dried media. PMID- 3561278 TI - [The incidence of Campylobacter jejuni and other pathogenic bacteria in childhood summer diarrhea]. AB - It was investigated the incidence of Campylobacter jejuni which has been recognized as a common cause of akut gastroenteritis and other pathogenic bacteria in childhood summer diarrhea. It was examined 94 diarrheic patients stool in 0-5 years old in summer months 1985-86. Campylobacter jejuni, Salmonella, Shigella were isolated as a pathogenic bacteria. PMID- 3561279 TI - [In vitro susceptibility of gram-negative bacteria isolated from urinary tract infections to acylureidopenicillins]. AB - Ureidopenicillins exert antibacterial activity on many Gram negative bacteria and also some Gram positive bacteria Two acylureido penicillins called azlocillin and mezlocillin have been introduced recently into medical practice in many countries as broad spectrum antibiotics. In this communication we present the sensitivity of Gram negative bacteria isolated from urinary tract infection of pediatric age patients to azlocillin, mezlocillin, another semisynthetic penicillin called pipercillin and aminoglycoside antibiotic gentamicin by MIC and disk-diffusion methods. The results are discussed in the view of the use of new semisythetic penicillins in clinical practice. PMID- 3561280 TI - [Bacterial etiology of eye infections]. AB - The purpose of this study was to determine the etiologic agents in bacterial ocular infections, their antibiotic sensitivities and the most suitable conditions for the microbiological diagnosis, using several methods. 200 patients who were diagnosed to have bacterial conjuntivitis (111 cases), corneal ulcers (39 cases), dacryocystitis (34 cases) or infections of the eyelids (16 cases) at the ophthalmology department of our university were taken as the patient group and there were 100 normal people in the control group. The frequency and species of bacteria isolated from both groups are similar to those in the literature. In cases of conjunctivitis, the results of the direct smears were parallel to the results obtained by cultures in 8.2% of the cases. The percentage of growth was higher when the specimen was inoculated immediately in the clinic compared to the results obtained by inoculations which were performed in the laboratory. According to the results of the antibiotic sensitivity tests, chloramphenicol should take the first place among the antibiotics which are in general use for gr (+) and gr (-) bacteria, and tetracyclines should take the second place while waiting for the results of the cultures. PMID- 3561282 TI - [Detection of candidiasis in non-gonococcal urethritis resistant to therapy]. AB - In this study, candida sp. and all other microorganisms were attempted to be isolated in 30 patients with non-gonococcal urethritis who hadn't responded to classical antimicrobial therapy. Candida sp. in 6, various bacteries in 11, salmonella in one and trichomonas vaginalis in one of them were detected. Not any microorganisms were isolated in 13, 4 of these candida species which were detected by sabouraud culture, were also evaluated by direct microspoic examination. PMID- 3561281 TI - [The specificity and sensitivity of some methods of determining Brucella antibodies in milk in comparison with the whey antiglobulin test (WAGT)]. AB - 156 Milk samples were obtained from farms, dairies and streets and brucella antibodies were searched by serologic methods. Results were compared by whey antiglobulin test (WAGT) findings. In order to established the Brucella antibodies presence according to WAGT at the performed serologic tests, milk Ring test (MRT) was found the most sensitive and pratic test. The application of milk and serum (whey) to slide aglutination tests were not seen reliable. PMID- 3561284 TI - The looming storm. PMID- 3561283 TI - [Bacillus thuringiensis plasmids]. AB - Several B. thuringiensis serotypes are used for the production of bacterial insecticides. The important ingradient of bacterial insecticide produced by B. thuringiensis is a parasporal crystal protein formed during sporulation. The bioinsecticide containing several B. thuringiensis serotypes have great potential in the control of certain insects, because of their high selectivity and the absense of any harmful effect on humans, plants, animals, polinators and predators. But the generation of cry- (non-virulent or acrystalliferous) strains during the growth in the medium are relatively high without mutagenic treatments. Plasmids can play role in this area. Because plasmids have been detected in Bacillus thuringiensis strains belonging to several serotypes and have not been found in certain cry- varyants. It is concluded that parasporal crystals are plasmid determined in B. thuringiensis varyants. PMID- 3561285 TI - In-vitro fertilization. PMID- 3561286 TI - Looking forward to better health. PMID- 3561287 TI - The clinical impact of in-vitro fertilization. Part 1. Results and limitations of conventional reproductive medicine. AB - Conception is a matter of chance. A couple's monthly probability of conceiving naturally is known as their fecundability. The average "normal" fecundability (as a proportion) is approximately 0.2. This means that most young couples can expect to have children and will conceive within 12 months of attempting pregnancy. This article examines the causes of infertility and the results that can be achieved by conventional treatment among couples with a single cause for their infertility. The difficulties that are faced when conventional infertility treatment is applied to infertility with multiple causes or with no apparent cause are explained. PMID- 3561288 TI - Human leptospirosis in New South Wales, 1975-1985. AB - From July 1975 to June 1985, 14,630 sera from patients in New South Wales were tested for serological evidence of leptospirosis. Among these, 361 sera contained evidence of past infections and 150 of these 361 specimens had evidence of recent or current infections. Serologically-diagnosed cases of leptospirosis were distributed mainly in the central and eastern parts of the State. Pomona, hardjo and icterohaemorrhagiae were the most common serovars to be detected; male abattoir workers and farmers were the most common occupational groups that were infected. An increase in seropositive cases occurred from 1981, largely due to hardjo and to a lesser extent pomona infections among farmers. Clinical histories indicated that most cases presented as pyrexias of unknown origin or as febrile illnesses; however, four patients were reported to have presented with renal failure; three patients were reported to have presented with meningitis; and 10 patients were jaundiced at presentation. PMID- 3561289 TI - Pineal neoplasms and third-ventricular teratomas in Niigata (Japan) and Western Australia. A comparative study of their incidence and clinicopathological features. AB - It is claimed that Japan has the highest incidence of pineal neoplasms in the world. To test this hypothesis, we reviewed all pineal neoplasms and third ventricular teratomas that were diagnosed histopathologically and treated neurosurgically over 10 years (1975-1984) in Niigata City, Japan (12 patients) and in Perth, Western Australia (9 patients). The age-standardized incidence rates per million person-years were 0.61 for Niigata and 0.70 for Western Australia; thus, the contention that Japan has the highest incidence in the world of pineal neoplasms is not confirmed. PMID- 3561290 TI - Should the primary prevention of coronary heart disease commence in childhood? PMID- 3561291 TI - The clinical impact of in-vitro fertilization. Part 2. Regulation, money and research. AB - Assisted conception with in-vitro fertilization and related reproductive interventions is the only practical way of treating many infertile couples. This article examines the cost-effectiveness of in-vitro fertilization procedures, the importance of not isolating these procedures from the general management of infertility, and the urgent need to clarify the ethical justification for research on the early human embryo. PMID- 3561292 TI - Father Brown and the case of Australian medicine. PMID- 3561293 TI - Suffering a surfeit of doctors, Professor Doherty? PMID- 3561294 TI - Treatment of chronic active hepatitis and other liver diseases with corticosteroid agents. AB - The term chronic active hepatitis covers aetiologically different conditions with similar histological features. Autoimmune chronic active hepatitis - the type that was described originally - is the only type which responds well to prednisolone therapy. Autoimmune chronic active hepatitis can be differentiated from other types by serological and other markers. Treatment with prednisolone should be given for at least two years, with adjustment of dosage according to the serum levels of aspartate transaminase; maintenance does should be 8-12 mg a day. Azathioprine (50-100 mg a day) may be given concurrently as a corticosteroid sparing agent. Prednisolone therapy in patients with autoimmune chronic active hepatitis enhances the quality of life and survival is prolonged greatly; currently the survival rate after 10 years for prednisolone-treated cases is at least 70%. Prednisolone is not effective in hepatitis B-associated chronic active hepatitis and may be deleterious. In cryptogenic chronic active hepatitis, in which markers of autoimmunity or hepatitis B viral infection are lacking, a trial of prednisolone therapy may be given for three months, and continued only if the indices of disease activity indicate a response. Corticosteroid agents have not proved of benefit in other liver diseases, including alcoholic hepatitis and acute liver failure, and a beneficial effect in primary biliary cirrhosis is yet to be established. PMID- 3561295 TI - Moyamoya disease causing recurrent cerebrovascular episodes in a young adult. AB - A case of moyamoya disease in a young white adult is described. The patient presented at the age of 27 years with a cerebrovascular accident and over subsequent years has suffered several cerebrovascular accidents and, more recently, transient ischaemic attacks. Serial angiographic studies have demonstrated the development of the classical radiological findings of moyamoya disease. This case illustrates a rare cause of cerebrovascular disease in a non Japanese individual. PMID- 3561296 TI - Moyamoya disease: presentation and treatment of two cases by surgery. AB - Stroke prophylaxis in patients with moyamoya disease has not been described previously in Australia. Two cases are presented in which superficial temporal to middle cerebral arterial bypass has been successful in halting the progress of the disease. The presentation, investigation and management of this occlusive vasculopathy are discussed. PMID- 3561297 TI - Research into the regional pain syndrome. PMID- 3561298 TI - Overuse syndrome in musicians. PMID- 3561299 TI - The legality of vasectomy. PMID- 3561301 TI - Breast-feeding of infants. PMID- 3561300 TI - Evidence that the Australian sylvatic strain of Echinococcus granulosus is infective to humans. PMID- 3561302 TI - Pruritus in dialysis patients. PMID- 3561304 TI - Mammographic screening programmes. PMID- 3561303 TI - Geriatric medicine. PMID- 3561305 TI - Decompression in Caisson's disease. PMID- 3561306 TI - Depression in grandmothers. PMID- 3561307 TI - Guillain-Barre syndrome. PMID- 3561308 TI - [Increase in the values of blood lead and erythrocyte zinc protoporphyrin in the first years of occupational exposure]. PMID- 3561309 TI - [Gas chromatographic determination of 2,5-hexanedione in the urine]. PMID- 3561310 TI - [Renal effects of exposure to mercury in a thermometer factory]. PMID- 3561311 TI - [Therapy of metal poisoning with chelating agents]. PMID- 3561312 TI - [Molecular viewpoint of carcinogenesis]. PMID- 3561313 TI - [Herpes simplex]. PMID- 3561314 TI - [Glaucoma]. PMID- 3561315 TI - [Osteoporosis-a public health problem today?]. PMID- 3561316 TI - [Magnesium-deficiency syndrome]. PMID- 3561317 TI - [Strabismus]. PMID- 3561318 TI - [Sudden deafness. Diagnosis and new knowledge concerning therapy]. PMID- 3561319 TI - [Hypertension: therapeutic possibilities]. PMID- 3561321 TI - [Acclimatization at mid- and high-altitude conditions. What role do vitamins play?]. PMID- 3561320 TI - [Silent myocardial ischemia]. PMID- 3561322 TI - Cancer chemotherapy. PMID- 3561323 TI - Verapamil for hypertension. PMID- 3561324 TI - The neutron weapon: a link in mass destruction. PMID- 3561325 TI - A psychosocial view of the nuclear arms race. PMID- 3561326 TI - What if a nuclear warhead explodes over a one gigawatt nuclear power reactor in France? A reappraisal of the radioactive consequences. PMID- 3561327 TI - Number and cure rate of neuroblastoma cases detected by the mass screening program in Japan: future aspects. AB - The annual incidence of neuroblastoma in Japan, a common malignancy of young children which has a very poor prognosis in progressive cases, was previously estimated to be 8.2 cases/million children under 15 years of age. Based on the Japanese National Census of the Population for 1982, the annual number of cases of this tumor is predicted to be 220. (Sawada et al: Med Pediatr Oncol 12:101 103, 1984). Before the mass screening program was started, one-fourth of all neuroblastoma cases were detected before the age of one by clinical symptoms and other findings. Since 1974, a neuroblastoma mass screening program for 6-month old infants by means of a qualitative Vanilmandelic Acid (VMA) test has been in effect in Kyoto, Japan, for the prognostic improvement of neuroblastoma patients (Sawada et al: Am J Dis Child 136:710-712, 1982). A Neuroblastoma Mass Screening Study Group (NBMSSG) was organized in 1981 (Sawada et al: Lancet ii:271-272, 1984), and the mass screening program has grown to encompass eight selected areas. This group discovered 15 cases of neuroblastoma among 247,500 6-month-old infants, 1 of every 16,500, until the end of 1983, and 23 cases among 434,970, 1 of every 18,900, until the end of 1984. All cases were asymptomatic. As the incidence of infantile neuroblastoma detected by this program is projected to be 52.9-60.6 cases/million 6-month-old infants, it could be predicted that 80-91 neuroblastoma cases will be discovered annually in Japan by mass screening. The cure rate of 25 cases discovered by the mass screening and followed up over 20 months was 92% (Sawada: Lancet i:377,1986). In Japan, it should be possible to detect 135-146 cases--[symptomatic 55 = 220 X 1/4] + [80-91 cases detected by mass screening]--(61.4-66.4% of the total neuroblastoma cases) in infants under 1 year of age annually, and the cure rate of all neuroblastoma cases in Japan is expected to reach 60% or more. PMID- 3561328 TI - Resistant and relapsing neuroblastoma: improved response rate with a new multiagent regimen (OC-HDP) including high-dose cisplatinum. AB - From September 1984 to July 1985, 11 children from 6 months to 6 years of age were treated with a three-drug regimen (OC-HDP), including vincristine, cyclophosphamide, and cisplatinum 200 mg/m2 given as five dose-fractions over 5 days. Nine had resistant and two relapsed neuroblastoma. Nine children had previously been treated with cisplatinum at conventional doses; nine had not received cyclophosphamide and ten had not received vincristine. Nine of eleven patients had a good response to treatment; six are presently alive in continuous complete remission 11-23 months (median 13 months) after diagnosis. Toxicity was moderate: no child showed either severe myelotoxicity or clinical or laboratory evidence of nephrotoxicity. No child had clinically significant ototoxicity. In six children audiometry showed hearing loss for high frequencies after the third cycle of treatment. It is concluded that OC-HDP regimen could be considered as a first-line treatment for advanced neuroblastoma. PMID- 3561329 TI - Massive acute hemolysis secondary to Clostridium perfringens sepsis in a recently transfused oncology patient with multiple alloantibodies. AB - Sepsis with clostridia species is seen infrequently in oncology patients, and the massive acute intravascular hemolysis known to be associated with these organisms is rare. The urgency of making the diagnosis of clostridial sepsis is imperative since the course is rapidly fatal if untreated. We describe a patient with metastatic adenocarcinoma of the pancreas, known to have recent transfusions as well as multiple red cell alloantibodies, who developed massive nonimmunologic hemolysis associated with Clostridium perfringens sepsis. Because the hemolysis of C. perfringens sepsis can mimic that of a severe delayed hemolytic transfusion reaction, care must be taken to differentiate these conditions, especially in view of the frequency of transfusion in these patients as well as their predisposition to develop disseminated infections. PMID- 3561330 TI - Randomised study of ticarcillin, cefamandole with or without tobramycin in febrile, neutropenic patients with solid tumors. AB - A prospective randomised study was conducted comparing the efficacy and toxicity of the antibiotics ticarcillin and cefamandole (TC) with or without tobramycin (TCT) in 100 febrile neutropenic patients with solid tumours undergoing conventional chemotherapy. In this study, neutropenia less than 100/microliter was noted in 31% of 106 evaluable infectious episodes and neutrophil counts less than 1,000/microliter persisted for a median 4 days. Infection was microbiologically documented in 42% of episodes (bacteremia 24%) with gram negative organisms responsible for 63% of bacterial isolates. Overall, 65% of episodes responded to TC and 76% to TCT (p greater than 0.05). Patients with initial shock bacteremia, pulmonary infection, or gram-negative sepsis responded relatively poorly. Neutrophil nadir and pathogen susceptibility did not influence outcome. Antibiotic toxicity was minimal with no tobramycin-related nephrotoxicity. These results are broadly comparable to those observed with leukemic patients, but the relatively short duration of neutropenia in the solid tumour patients appears to minimize the need for additional antibiotics provided there is adequate antimicrobial coverage with the initial choice of antibiotics. PMID- 3561332 TI - Analysis of vessel absorption profiles in retinal oximetry. AB - The optical densities of vessel absorption features in small bandwidth fundus photographs have been used by many people for finding the oxygenation of the blood in retinal vessels. The purpose of this article is to show that the information found in this way can be made more accurate, and more information can be found by considering the details of the absorption profile (intensity as a function of distance across the vessel). The "wings" of the profile are primarily determined by the line-spread function of the video camera or film. A four parameter curve fitting procedure using the line-spread function and an "ideal" vessel profile can be used to eliminate the effects both of the line-spread function and of any central reflection (vessel reflex) that may be present, yielding estimates of the vessel diameter and central absorption. The conclusions concerning the reflection are supported by studies of reflections from capillary tubes and wires in a model eye. PMID- 3561331 TI - Detection efficiency of a high-pressure gas scintillation proportional chamber. AB - The detection efficiency of a high-pressure, gas scintillation proportional chamber (GSPC), designed for medical imaging in the 30-150 keV energy range, has been investigated through measurement and Monte Carlo simulation. Measurements were conducted on a GSPC containing 4 atm of pure xenon separated from a hexagonal array of seven ultraviolet-sensitive photomultiplier tubes by 1.27-cm thick fused-silica windows. Experimental measurements of the photopeak efficiency, fluorescence escape efficiency, and the energy collection efficiency were obtained. Results were also obtained for different photon energies and different values of temporal resolution. The measurements were compared with the results obtained from a Monte Carlo simulation designed specifically for investigating the imaging of low-energy photons (below 150 keV) with a gas-filled detector. The simulation was used to estimate photopeak efficiency, fluorescence escape efficiency, photopeak-to-fluorescence escape peak ratio, quantum interaction efficiency, energy collection efficiency, and local energy collection efficiency. The photopeak efficiency of the GSPC relative to that of a 3-in. (7.62-cm)-thick sodium iodide crystal was measured to be 0.284 +/- 0.001 at 60 keV and 0.057 +/- 0.001 at 140 keV. Of the 60-keV photons incident upon the detector, 70% +/- 4% interacted in the detector, with 28% +/- 1% being in the photopeak, as estimated both by experimentation and through the simulation. The maximum energy collection efficiency was found to be 65% at 60 keV, with 46% being deposited within 0.2 cm of the initial photon interaction. The information gained from this study is being used to design an optimized detector for use in specialized nuclear medicine studies. PMID- 3561333 TI - Magnetic resonance imaging system stability: temporal variability in signal intensity, signal-to-noise, T1, and T2 measurements on a 0.15-T resistive system. AB - Signal intensity (SI) variability was evaluated on a 0.15-T resistive instrument using a phantom and was found to increase with time, repetition time (TR), and echo time (TE), ranging from 0.24% standard deviation (SD) over 34 min for 500/30 (TR/TE) images, to 2.1% SD over 5 days for 2000/30 images. Signal-to-noise (S/N) variability increased with time and TE but not TR and ranged from 4.2% SD over 34 min to 7.1% SD over 5 days in 500/30 images. Variability in T1 and T2 measurements on phantoms ranged from 1.8% to 4.8% SD for T1 and 3.6% to 6.5% SD for T2 in the biological range over 5 h. High reproducibility of SI, T1, and T2 measurements was demonstrated over a 6-week period in normal muscle measurements. PMID- 3561334 TI - Pulse sequence design for volume selective excitation in magnetic resonance. AB - The design of a pulse sequence for volume localization in magnetic resonance spectroscopy is described in detail. The sequence is based on the volume selective excitation technique (VSE) proposed by Aue et al. [J. Magn. Reson. 56, 350 (1984)] and overcomes the high rf power requirements of VSE. The implications of various design stages are demonstrated experimentally and by computer simulations. PMID- 3561335 TI - The effects of random directional distributed flow in nuclear magnetic resonance imaging. AB - Capillary flow or microscopic random directional coherent flow as a model of perfusion is investigated both theoretically and experimentally. In the model, we assumed that molecular motion within a finite resolvable volume element (voxel) is a superposition of flow of randomly oriented small capillaries. In such a case, the observed signal from the capillary flow within a voxel will be attenuated in signal amplitude without any change in phase. Although this attenuation effect is similar to the diffusion phenomenon, it differs basically in the following aspects: since the motion in each capillary segment is coherent, phase cancellation occurs at even echoes due to spin rephasing, while the diffusion phenomenon is a purely random Brownian motion of the thermally agitated molecules, changing both in direction and speed during the measurement period. Because of the random character of diffusion, even-echo rephasing cannot be observed. Thus capillary flow or perfusionlike microscopic flow can be measured based on the above distinct flow characteristics, i.e., signal restoration at even echoes versus signal amplitude attenuation at odd echoes. By applying a suitable mathematical algorithm, information on the capillary flow alone can be extracted from the two separate distinct measurements, i.e., one with a single echo and the other with a double echo. Both a theoretical calculation of the capillary flow, as well as the experimental results with a human volunteer by a 0.6-T nuclear magnetic resonance imager, are presented. PMID- 3561337 TI - Digital image motion correction by spatial warp methods. AB - A technique for correction of motion between images which are obtained in high speed digital subtraction or cine angiographic acquisitions is being tested. The method is based on the application of quadratic polynomial equations which transform one image so that it matches a reference image. Images which have been processed in this manner can be summed to improve the signal-to-noise ratios over individual images. The technique for motion correction currently being tested uses operator interaction to establish the appropriate polynomial transformation. An operator selects fiducial (reference) points on an image which will be the reference. Then he selects the corresponding fiducial points on the image to be processed. The algorithm calculates the coefficients of a pair of quadratic polynomial equations and applies them to each pixel in the image. Results demonstrate the application of the technique in phantoms and in digitized cine angiograms. PMID- 3561336 TI - Electronic scanning-slit fluorography: design and performance of a prototype unit. AB - Electronic scanning-slit fluorography involves replacing paired fore and aft slits for scatter rejection with only one beam-defining tantalum fore aperture. Since the video signal within the projection of the aperture on the image intensifier is much more intense than behind the tantalum, one can discriminate electronically between these two signals and thus eliminate the unwanted x-ray scatter and veiling glare. The general features of a prototype unit are described along with the rationale for the choice of design factors employed. Imaging time of 1-2 s has been achieved using multiple scanning slits. Small focal-spot size and large number of pixels are favored for higher dose utilization, shorter imaging time, and lower x-ray tube loading, as well as for better spatial resolution. Images of a chest phantom show better visibility of low-contrast details, especially in poorly penetrated areas, when compared with the image obtained and displayed under the same conditions, but using a conventional grid to reject scattered radiation. PMID- 3561339 TI - [Crohn disease: clinical disease pattern in relation to site. A prospective analysis of 300 patients]. PMID- 3561338 TI - Systematic errors in bone-mineral measurements by quantitative computed tomography. AB - Bone-mineral measurements using quantitative computed tomography (QCT) are commonly based on comparisons with solutions in water of known concentrations of K2HPO4. In this paper are described theoretical and experimental studies that have led to the conclusion that large systematic errors can arise in these measurements, depending on the soft-tissue and fat concentrations in the vertebral spongiosa. In the case of single energy scanning, such large errors have been identified to be due to the varying water content (displacement effect) in the calibration samples and the varying fat content in the region of interest (ROI) within the patient. In the case of dual energy scanning, the error arises because when normalized to that of water, the mass attenuation coefficient of fat increases with photon energy while the reverse is true for K2HPO4. Our studies have also revealed that total trabecular bone density (which includes the mineral, soft tissue, and fat) can be much more accurately determined by the dual energy QCT method than bone mineral alone. This finding is especially interesting since there have been several reports in the literature suggesting that bone density rather than bone-mineral content is a better predictor of the risk of osteoporosis-related fractures. PMID- 3561340 TI - [Treatment of multiple myeloma. Chemotherapy in primary and secondary therapeutic failure in renal failure]. PMID- 3561341 TI - [First prospective findings on the incidence of Campylobacter pyloridis in human antrum mucosa in West Germany]. PMID- 3561342 TI - [Modern therapy of reflux esophagitis]. PMID- 3561343 TI - [Secondary lymphedema of the lower extremities as an unusual initial manifestation of stomach cancer]. PMID- 3561344 TI - [Adenocarcinoma of the large intestine in a 20-year-old patient with Crohn disease]. PMID- 3561345 TI - [Effect of diltiazem on peripheral hemodynamics, plasma catecholamines and metabolic parameters]. PMID- 3561346 TI - [Effect of functional stimulators of the thyroid and excess iodine on xenotransplanted human tissue in patients with autoimmune thyroid diseases]. PMID- 3561347 TI - [Paresis of the femoral nerve following spontaneous retroperitoneal hemorrhage in therapy using anticoagulants]. PMID- 3561349 TI - [Effort-induced urticaria and anaphylaxis]. PMID- 3561348 TI - [Bacterial enterocolitis as an imitator of ulcerative colitis and Crohn disease]. PMID- 3561350 TI - [Diagnostic and therapeutic strategies in acute pulmonary artery embolism]. PMID- 3561352 TI - [Disease as a fate of being ill?]. PMID- 3561351 TI - [Low-molecular weight heparin in the therapy of heparin-induced thrombocytopenia]. PMID- 3561354 TI - [Hypermelatoninemia in patients with hypophyseal tumors]. PMID- 3561353 TI - [Follow-up in sarcoidosis. On the value of various diagnostic procedures]. PMID- 3561355 TI - [Hyperparathyroidism: symptoms and therapy today]. PMID- 3561356 TI - [Localization and extent of Crohn disease at initial diagnosis]. PMID- 3561357 TI - [Clinicopathologic conference. Spontaneous esophageal rupture (Boerhaave syndrome) in a 41-year-old male]. PMID- 3561358 TI - [Diagnosis, monitoring and therapy of neuroblastoma using I-131 meta iodobenzylguanidine]. PMID- 3561359 TI - [Thyroid function in pediatric patients with Hodgkin's disease]. PMID- 3561361 TI - [Analysis of the causes of neonatal and infant mortality in relation to the birth weight in Palermo in the years 1971, 1977 and 1982]. PMID- 3561360 TI - [Pilomatrixoma: a childhood neoplasm]. PMID- 3561362 TI - [A monodimensional electrophoretic picture of urinary amino acids in de Toni Debre-Fanconi syndrome caused by cystinosis]. PMID- 3561363 TI - [Amniotic fluid stained with meconium as a risk factor in neonatal pathology]. PMID- 3561364 TI - [Surveillance of congenital malformations. Data for the biennium, 1984-1985]. PMID- 3561365 TI - [Thyroid function in the newborn at risk. Significance of the gestational age, weight and concomitant pathology]. PMID- 3561366 TI - [A new type of approach to the study of the newborn: behavioral examination]. PMID- 3561367 TI - [An epidemic of hand, foot and mouth syndrome]. PMID- 3561368 TI - [Sexual impotence in diabetic patients]. PMID- 3561369 TI - [Osteoporosis in young hypogonadal subjects. Relation between gonadal steroids and calcitonin secretion]. PMID- 3561370 TI - [Impaired response to adrenal suppression tests in epileptic patients in treatment with carbamazepine]. PMID- 3561371 TI - [Modulation of the hypermetabolizing effect of various drugs by actinomycin D]. PMID- 3561372 TI - [Familial hypocalciuric hypercalcemia]. PMID- 3561373 TI - [Effectiveness of danazol in the treatment of idiopathic precocious puberty. Review of the literature and description of a clinical case]. PMID- 3561374 TI - [A case of pericentric inversion of chromosome 5 in a subject with papillary carcinoma of the thyroid and primary amenorrhea]. PMID- 3561375 TI - Pseudohypoparathyroidism. A case report with low immunoreactive parathyroid hormone and multiple endocrine dysfunctions. PMID- 3561376 TI - [Discordant response to hCG in 2 first-degree cousins with idiopathic hypogonadotropic hypogonadism]. PMID- 3561377 TI - Modern medicine. PMID- 3561378 TI - Ethics committees in Minnesota hospitals. PMID- 3561379 TI - Fatal paradoxical cerebral thromboembolus. PMID- 3561380 TI - The quality of occupational data recorded from the face sheet of Minnesota hospital medical records. PMID- 3561381 TI - Amyotrophic lateral sclerosis. PMID- 3561382 TI - Amyotrophic lateral sclerosis. Its natural history. AB - ALS is the most common of the various MNDs, which also include the clinical entities of PBP, PMA, and PLS. Mean age of onset of ALS is 57 years, and there is a sex predilection for men in a ratio of 1.5:1. Area of first symptom is in the lower extremity is 36 per cent of cases, in the upper extremity in 32 per cent, and 25 per cent of patients have a bulbar onset. Motor cranial nerves in the lower brain stem from cranial nerve nuclei or corticobulbar tract degeneration are affected. This results in symptoms of speech and swallowing difficulty and emotional lability in up to 60 per cent of cases. One hundred per cent of cases have motor weakness, over 90 per cent have muscle atrophy and fasciculations, and 47 per cent have spasticity. There seems to be a pattern of progression of ALS signs and symptoms based on area of onset with LLE involvement tending to follow RLE weakness, LUE weakness following RUE onset, and RUE involvement following next in patients whose onset is bulbar. Significant numbers of ALS patients had sparing of involvement of parts of the body for follow-up times approaching 3 years. Although the majority of patients experience a deterioration that is significantly linear, seven of 28 patients or 25 per cent achieved a plateau lasting a minimum of 9 months. Survival in our series was 4.08 years for all forms of MND.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561383 TI - The family support group in the treatment of amyotrophic lateral sclerosis. AB - Support groups are effective means of addressing the psychosocial needs of patients with amyotrophic lateral sclerosis and their families. An education support group for family members of patients with ALS has been functioning at New England Medical Center in Boston and has been found to be successful in helping families and, therefore, patients to cope with this stressful illness. This article discusses the benefits of this group to families and patients, family members' roles in caring for and coping with this illness, the group's structure and development, and gives suggestions to others who are considering running a group of this kind. Our experience has shown that group participants feel less isolated, less fearful, and less threatened than prior to their involvement in the group and gain a sense of empowerment that enables them to meet the extensive caretaking demands of the patient with ALS. The contribution that an ALS Family Support Group provides is a component in the care of the patient with ALS that can be critical to families dealing with this illness. PMID- 3561384 TI - Potent adenosine receptor antagonists that are selective for the A1 receptor subtype. AB - The xanthines currently represent the most potent class of adenosine receptor antagonists. However, known derivatives of xanthine show little difference in antagonist potency between the two putative adenosine receptor subtypes, A1 and A2. We conducted a systematic study of xanthine structure-activity relationships that compared antagonist potency at the A1 receptor of adipocytes with potency at the A2 receptor of platelets. Since adenosine receptors are coupled to adenylate cyclase in these tissues, inhibition of adenylate cyclase via A1 receptors and stimulation via A2 receptors were used as models of receptor activation. Antagonist potency was quantitated by Schild analysis, which yields an estimate of affinity (Ki) for the drug-receptor interaction. Ki values of a series of xanthine analogues enabled us to identify structural modifications than enhanced antagonist selectivity for one receptor subtype over the other. We found that changes in the substituent at position 8 of the xanthine nucleus influenced antagonist potency at the A1 adenosine receptor more than at the A2 receptor. In particular, an 8-cyclohexyl or 8-cyclopentyl substituent promoted antagonist selectivity for the A1 receptor subtype. Thus, 1,3-dipropyl-8-cyclopentylxanthine had comparatively high affinity (Ki = 0.47 +/- 2 nM) at the A1 receptor, and was roughly 150-fold more potent as an antagonist of the A1- than of the A2-adenosine receptor subtype. In addition, the cycloalkylxanthines were relatively ineffective as inhibitors of cyclic nucleotide phosphodiesterases when used at concentrations that produced marked adenosine receptor antagonism. PMID- 3561385 TI - Effects of histamine on the metabolism of isolated rat hepatocytes: roles of H1- and H2-histamine receptors. AB - In isolated rat hepatocytes histamine stimulates in a dose-dependent fashion three of the major metabolic pathways: glycogenolysis (70-80% increase over basal), gluconeogenesis from lactate (50-60%), and ureagenesis (50-60%). It was observed that both H1 and H2 receptors mediate the action of histamine and that, in control hepatocytes, the H1-mediated action predominates over the H2. The H1 mediated effect diminished in the absence of extracellular calcium, whereas the H2-mediated action did not. Interestingly, in hepatocytes from hypothyroid rats, the H2 action increased and the H1-mediated effect decreased as compared to those in the controls, with an inversion in efficacy (i.e., H1 greater than H2 in the controls and H2 greater than H1 in cells from hypothyroid rats). Furthermore, it was observed that pertussis toxin treatment and forskolin both enhance the H2 mediated effects without altering the H1-mediated actions of histamine (i.e., H1 approximately equal to H2). The active phorbol ester, phorbol 12-myristate 13 acetate, did not alter the effect of the autacoid. In summary, the data show that histamine modulates liver metabolism through H1 and H2 receptors. The relative importance of the two receptor types in mediating the actions of histamine varies depending on the specific conditions used. PMID- 3561386 TI - Oxygen-dependent effect of microsomes on the binding of doxorubicin to rat hepatic nuclear DNA. AB - Doxorubicin is metabolically activated by microsomal NADPH-dependent cytochrome P450 reductase as well as by intact nuclei forming semiquinone free radicals, which reoxidize to doxorubicin in the presence of oxygen. Nuclear activated doxorubicin became bound to DNA in a time-dependent fashion. The addition of microsomal protein to intact nuclei increased the amount of doxorubicin bound to DNA under aerobic conditions. In contrast, inclusion of microsomes virtually abolished DNA binding under anaerobic conditions. Disruption of the nuclear membrane by sonification increased the amount of drug bound to DNA, indicating that the nuclear envelope serves as a partial barrier to the diffusion of microsomal DNA-directed intermediates. The data indicate that under aerobic conditions metabolites produced by microsomes either traverse the nuclear membrane and bind to DNA or act indirectly by disrupting the nuclear membrane. In contrast, inhibition of DNA binding by doxorubicin under anaerobic conditions suggests either that the microsomal metabolites do not diffuse across the nuclear membrane or that the metabolites are not capable of binding to DNA. The decreased diffusibility of the anaerobic metabolites may represent either the generation of metabolites having lower diffusion constants or the formation of highly reactive intermediates which preferentially bind in the immediate vicinity to the site of generation on the microsomal surface. In conclusion, it appears that, under aerobic conditions, metabolic activation of doxorubicin on the surface of the endoplasmic reticulum can contribute to the amount of the drug which becomes closely associated with nuclear DNA. Consequently, the microsomal drug metabolizing system may be important in affecting the therapeutic or cytotoxic properties of the drug. PMID- 3561387 TI - Computer simulation of biological systems. Current trends. AB - The current status of mathematical models of biological systems is reviewed. Advances in supercomputer hardware allows more complex models to be constructed. The new generation of microcomputers are quite adequate for many computer simulations of biological systems. A theory of modeling is being developed to improve the relationship between the real biological system and the model. Deterministic models, stochastic models and applications of control theory and optimization methods are discussed. Examples given include models of molecular structure, of experimental techniques, and of biochemical reactions. It is recommended that experimental biologists consider the use of microcomputers to model the system under study as a part of their research program. PMID- 3561388 TI - Interaction of the dye Remazol Yellow GGL to prealbumin and albumin studied by affinity phase partition, difference spectroscopy and equilibrium dialysis. AB - In partition experiments in aqueous two-phase systems composed of 10% (w/w) dextran (Mr = 500,000) and 7.5% (w/w) poly(ethylene-glycol) (Mr = 6,000) prealbumin and albumin are directed into the dextran-rich phase. Addition of Remazol Yellow GGL covalently bound to poly(ethylene-glycol) causes a transfer of prealbumin and albumin into the poly(ethylene-glycol)-rich phase. This indicates an interaction of both proteins with the dye (affinity phase partitioning). The affinity partitioning effect on prealbumin is markedly increased by an excess of monomeric albumin. This points to an interaction of the two proteins in the presence of the dye. Binding of free Remazol Yellow GGL to prealbumin and albumin was investigated by means of equilibrium dialysis and difference spectroscopy. In respect to prealbumin equilibrium dialysis resulted in the binding of four molecules of the dye to two classes of binding sites with dissociation constants of KH = 3.3 microM and KL = 258 microM respectively whereas albumin was found to bind eight molecules of the dye to two classes of binding sites with KH = 5.8 microM and KL = 282 microM. Similar binding stoichiometries were found by difference spectroscopy. By application of difference spectroscopy and affinity phase partitioning thyroxine and triiodothyronine known as natural ligands of prealbumin and albumin were found to compete with Remazol Yellow GGL for the dye binding sites of the proteins. PMID- 3561389 TI - Extrachromosomal recombination in mammalian cells as studied with single- and double-stranded DNA substrates. AB - We have previously proposed a model to account for the high levels of homologous recombination that can occur during the introduction of DNA into mammalian cells (F.-L. Lin, K. Sperle, and N. Sternberg, Mol. Cell. Biol. 4:1020-1034, 1984). An essential feature of that model is that linear molecules with ends appropriately located between homologous DNA segments are efficient substrates for an exonuclease that acts in a 5'----3' direction. That process generates complementary single strands that pair in homologous regions to produce an intermediate that is processed efficiently to a recombinant molecule. An alternative model, in which strand degradation occurs in the 3'----5' direction, is also possible. In this report, we describe experiments that tested several of the essential features of the model. We first confirmed and extended our previous results with double-stranded DNA substrates containing truncated herpesvirus thymidine kinase (tk) genes (tk delta 5' and tk delta 3'). The results illustrate the importance of the location of double-strand breaks in the successful reconstruction of the tk gene by recombination. We next transformed cells with pairs of single-stranded DNAs containing truncated tk genes which should anneal in cells to generate the recombination intermediates predicted by the two alternative models. One of the intermediates would be the favored substrate in our original 5'----3' degradative model and the other would be the favored substrate in the alternative 3'----5' degradative model. Our results indicate that the intermediate favored by the 3'----5' model is 10 to 20 times more efficient in generating recombinant tk genes than is the other intermediate. PMID- 3561390 TI - The yes-related cellular gene lyn encodes a possible tyrosine kinase similar to p56lck. AB - With v-yes DNA as the probe, a human cDNA library made from placental RNA was screened under relaxed conditions, and DNA clones derived from a novel genetic locus, termed lyn, were obtained. Nucleotide sequencing revealed that lyn could encode a novel tyrosine kinase that was very similar to mouse T-lymphocyte specific tyrosine kinase p56lck and the v-yes protein as well as to the gene products of v-fgr and v-src. Northern hybridization analysis revealed that a 3.2 kilobase lyn mRNA was expressed in a variety of tissues of the human fetus. The pattern of lyn mRNA expression was different from those of related genes, such as yes and syn. Hybridization analysis of DNA from sorted chromosomes showed that the lyn gene is located on human chromosome 8 q13-qter. PMID- 3561391 TI - Binding of a nuclear factor to a regulatory sequence in the promoter of the mouse H-2Kb class I major histocompatibility gene. AB - A cis-acting regulatory sequence was identified upstream of the mouse H-2Kb class I major histocompatibility gene. Deletions in the H-2Kb promoter revealed that sequences located between 190 and 138 nucleotides upstream of the transcription initiation site contribute to basal gene expression as well as to stimulation by alpha-interferon. Furthermore, a nuclear factor found in several cell types binds with high affinity to a sequence centered 166 nucleotides upstream of the H-2Kb initiation site. In vivo competition experiments demonstrated that this factor plays a direct role in H-2Kb expression in mouse fibroblasts. The binding site for this factor is TGGGGATTCCCCA, a sequence of perfect dyad symmetry. This factor also binds a similar sequence in the 72-base-pair repeat enhancer element of simian virus 40. PMID- 3561392 TI - Gene expression of the chondroitin sulfate proteoglycan core protein PG19. AB - We have examined genomic sequences and mRNA species hybridizing to a cDNA clone of a yolk sac carcinoma chondroitin sulfate proteoglycan designated PG19. Genomic blot hybridizations with cDNAs covering the majority of the PG19 mRNA sequence revealed 15 to 17 gene fragments. Similar analysis with probes representing either the propeptide or the combined core protein COOH-terminal domain and 3' untranslated sequences revealed single genomic fragments indicating that a single gene codes for the PG19 proteoglycan. Genomic blot analysis with cDNA sequences coding for the serine-glycine repeat of the core protein identified the same gene fragments observed with the entire PG19 cDNA, indicating that this coding region is homologous with sequences present in multiple genes. The same probes were also used to examine mRNA expression. In addition to the PG19 mRNA, several PG19 related mRNAs could be seen. These PG19-related mRNAs had homology with the serine-glycine coding sequence of the PG19 cDNA. These mRNAs may be coding for proteoglycans. The mRNA coding for PG19 appeared to be uniquely expressed in parietal yolk sac and mast cell lineages. The PG19 mRNA existed in different forms in parietal yolk sac and mast cell lines due to cell-type-specific differences in the length of the 5' untranslated sequences. These results indicate that expression of the PG19 proteoglycan gene is regulated both in terms of cell-type-specific transcription and selection of a transcriptional start site. PMID- 3561393 TI - Transcriptional activation of plant defense genes by fungal elicitor, wounding, and infection. AB - Activation of plant defense genes was investigated by analysis of transcripts completed in vitro by isolated nuclei. Elicitor treatment of suspension-cultured bean (Phaseolus vulgaris L.) cells caused marked transient stimulation of transcription of genes encoding apoproteins of cell wall hydroxyproline-rich glycoproteins (HRGP) and the phenylpropanoid biosynthetic enzymes phenylalanine ammonia-lyase (PAL) and chalcone synthase (CHS), concomitant with the onset of rapid accumulation of the respective mRNAs and hence expression of the phytoalexin (PAL, CHS), lignin (PAL), and HRGP defense responses. While there was a lag of 2 h prior to stimulation of HRGP gene transcription, induction of the transcription of PAL and CHS genes occurred within 5 min of elicitor treatment. Induction of transcription of PAL, CHS, and HRGP genes was also observed in wounded hypocotyls and in infected hypocotyls during race-cultivar-specific interactions with the fungus Colletotrichum lindemuthianum, the causal agent of anthracnose. Transcriptional activation occurred not only in directly infected tissue but also in distant, hitherto uninfected tissue, indicating intercellular transmission of an endogenous signal for defense gene activation. It is concluded that transcriptional activation of defense genes characteristically underlies induction of the corresponding defense responses and expression of disease resistance. PMID- 3561394 TI - Genomic organization of alpha satellite DNA on human chromosome 7: evidence for two distinct alphoid domains on a single chromosome. AB - A complete understanding of chromosomal disjunction during mitosis and meiosis in complex genomes such as the human genome awaits detailed characterization of both the molecular structure and genetic behavior of the centromeric regions of chromosomes. Such analyses in turn require knowledge of the organization and nature of DNA sequences associated with centromeres. The most prominent class of centromeric DNA sequences in the human genome is the alpha satellite family of tandemly repeated DNA, which is organized as distinct chromosomal subsets. Each subset is characterized by a particular multimeric higher-order repeat unit consisting of tandemly reiterated, diverged alpha satellite monomers of approximately 171 base pairs. The higher-order repeat units are themselves tandemly reiterated and represent the most recently amplified or fixed alphoid sequences. We present evidence that there are at least two independent domains of alpha satellite DNA on chromosome 7, each characterized by their own distinct higher-order repeat structure. We determined the complete nucleotide sequences of a 6-monomer higher-order repeat unit, which is present in approximately 500 copies per chromosome 7, as well as those of a less-abundant (approximately 10 copies) 16-monomer higher-order repeat unit. Sequence analysis indicated that these repeats are evolutionarily distinct. Genomic hybridization experiments established that each is maintained in relatively homogeneous tandem arrays with no detectable interspersion. We propose mechanisms by which multiple unrelated higher-order repeat domains may be formed and maintained within a single chromosomal subset. PMID- 3561395 TI - Rearrangement and expression of erythropoietin genes in transformed mouse cells. AB - The erythroleukemia cell line IW32, derived by transformation with the Friend murine leukemia virus, has been shown previously to produce erythropoietin (EPO) constitutively. Here we demonstrate that, in addition to the normal mouse EPO locus, this cell line has another EPO locus which has undergone rearrangement and amplification. Both loci were cloned, and the rearrangement breakpoint of the second EPO locus was located within a 1.1-kilobase region upstream of an otherwise apparently normal EPO gene. There are no viral sequences present in the immediate vicinity of the rearranged EPO gene. DNase I digestion studies suggest that the rearranged gene is in a region where the chromatin is more sensitive to DNase hydrolysis than is the site of the normal gene. We conclude, tentatively, that the rearranged EPO locus is probably the transcriptionally active one and that either proviral sequences are acting at a distance to activate the EPO gene or the rearrangement itself has served to activate the gene. PMID- 3561396 TI - Human globin gene promoter sequences are sufficient for specific expression of a hybrid gene transfected into tissue culture cells. AB - The contribution of the human globin gene promoters to tissue-specific transcription was studied by using globin promoters to transcribe the neo (G418 resistance) gene. After transfection into different cell types, neo gene expression was assayed by scoring colony formation in the presence of G418. In K562 human erythroleukemia cells, which express fetal and embryonic globin genes but not the adult beta-globin gene, the neo gene was expressed strongly from a fetal gamma- or embryonic zeta-globin gene promoter but only weakly from the beta promoter. In murine erythroleukemia cells which express the endogenous mouse beta genes, the neo gene was strongly expressed from both beta and gamma promoters. In two nonerythroid cell lines, human HeLa cells and mouse 3T3 fibroblasts, the globin gene promoters did not allow neo gene expression. Globin-neo genes were integrated in the erythroleukemia cell genomes mostly as a single copy per cell and were transcribed from the appropriate globin gene cap site. We conclude that globin gene promoter sequences extending from -373 to +48 base pairs (bp) (relative to the cap site) for the beta gene, -385 to +34 bp for the gamma gene, and -555 to +38 bp for the zeta gene are sufficient for tissue-specific and perhaps developmentally specific transcription. PMID- 3561397 TI - Virus-encoded toxin of Ustilago maydis: two polypeptides are essential for activity. AB - Cells of Ustilago maydis containing double-stranded RNA viruses secrete a virus encoded toxin to which other cells of the same species and related species are sensitive. Mutants affected in the expression of the KP6 toxin were characterized, and all were viral mutants. A temperature-sensitive nonkiller mutant indicated that the toxin consists of two polypeptides, 12.5K and 10K, that are essential for the toxic activity. The temperature-sensitive nonkiller mutant was affected in the expression of the 10K polypeptide, and its toxic activity was restored by the addition of the 10K polypeptide to its secreted inactive toxin. These results led to the reexamination of other mutants that were known to complement in vitro. Each was found to secrete one of the two polypeptides. Here we show for the first time that P6 toxin consists of two polypeptides that do not interact in solution, but both are essential for the toxic effect. Studies on the interaction between the two polypeptides indicated that there are no covalent or hydrogen bonds between the polypeptides. Toxin activity is not affected by the presence of 0.3 M NaCl in the toxin preparations and in the medium, suggesting that no electrostatic forces are involved in this interaction. Also, the two polypeptides do not share common antigenic determinants. The activity of the two polypeptides appears to be dependent on a sequential interaction with the target cell, and it is the 10K polypeptide that initiates the toxic effect. The similarity of the U. maydis virus-encoded toxin to that of Saccharomyces cerevisiae is discussed. PMID- 3561398 TI - Metallothionein genes MTa and MTb expressed under distinct quantitative and tissue-specific regulation in sea urchin embryos. AB - Sea urchin embryo metallothionein (MT) mRNAs MTa and MTb have distinct cDNA sequences and are transcripts of different genes of a multigene family. These MT mRNAs differ in size and in their 3'-untranslated sequences. They encode proteins that are unusual among MT isotypes in that the relative positions of their cysteine residues are partially out of register, suggesting potential differences in function. In pluteus larvae MTa mRNA is expressed abundantly and exclusively in the ectoderm, while MTb mRNA, which is restricted to the endomesoderm at a low endogenous level, can be induced to a high level by heavy metal ions (M2+). MT mRNA is present in the maternal reservoir of the egg and is predominantly (greater than 95%) MTa mRNA. Endogenous expression in the embryo, which is at a much higher level than in the egg, requires M2+ for gene transcription, is developmentally regulated, and is greater than 90% MTa mRNA. When induced by added M2+, however, MTa and MTb mRNAs accumulate to almost equal levels. The differences in the ratios of MTa/MTb expressed endogenously and inductively are not attributable to differences in the stabilities of these MT mRNAs, which were observed under conditions of M2+ depletion, or in their inducibilities, which were observed at moderate to high M2+ levels. We found, instead, that the MTa gene responds to M2+ at a lower threshold level than MTb, so that at very low M2+ concentrations the ratio of induced MTa/MTb mRNA is high and equivalent to the endogenous ratio. Thus, endogenous expression of the MTa gene is selectively enhanced in the ectoderm by determinants that are responsive at low M2+ threshold concentrations. PMID- 3561399 TI - Transition mutations within the Xenopus borealis somatic 5S RNA gene can have independent effects on transcription and TFIIIA binding. AB - Base-pair changes were introduced into the Xenopus borealis somatic 5S RNA gene by treatment with sodium bisulfite. Mutants were screened by sequence determination. The collection of mutants permitted a detailed investigation of the fine structure of the intragenic control region that binds the transcription factor TFIIIA. Selected mutants were recloned in tandem with a somatic 5S RNA maxigene to permit sensitive measurement of their relative transcription activities. The transcription efficiencies of a number of mutations at the borders of the control region were correlated with TFIIIA binding by using DNase I protection (footprinting) assays. Mutations affecting transcription and TFIIIA binding extended from gene residues 46 to 91. The results reinforce a model in which the distal half of the protected region constitutes a tight binding domain for TFIIIA. A number of transitions in the 5' domain led to significant increases or decreases in transcription efficiency, but resulted in barely detectable changes in TFIIIA binding. Two mutants with C----T transitions at gene residues 52 and 53 were transcribed with increased efficiencies (up phenotype). These results suggest that TFIIIA must make appropriate contacts within the 5' domain of the control region to permit subsequent binding of other factors in stable transcription complexes. PMID- 3561400 TI - Transcriptional analyses of interferon-inducible mRNAs. AB - Using nuclear runoff transcription assays we demonstrated that alpha interferon mediated induction of transcription of four mRNAs in HeLa monolayer cells needed ongoing protein synthesis and that such a need could be obviated by pretreating the cells with gamma interferon which, by itself, did not induce transcription of these mRNAs. In another human cell line, RD-114, synthesis of alpha interferon inducible mRNA 561 did not need ongoing protein synthesis. In this line, however, in which interferon inhibits replication of some viruses but not of others, transcription of two of the six interferon-inducible mRNAs that we examined was not appreciably enhanced by interferon. PMID- 3561401 TI - Cell cycle-dependent effects on deoxyribonucleotide and DNA labeling by nucleoside precursors in mammalian cells. AB - dCTP pools equilibrated to equivalent specific activities in Chinese hamster ovary cells or in nuclei after incubation of cells with radiolabeled nucleosides, indicating that dCTP in nuclei does not constitute a distinct metabolic pool. In the G1 phase, [5-3H]deoxycytidine labeled dCTP to unexpectedly high specific activities. This may explain reports of replication-excluded DNA precursor pools. PMID- 3561402 TI - A divergent testis-specific alpha-tubulin isotype that does not contain a coded C terminal tyrosine. AB - On the basis of analysis of cDNA clones of alpha-tubulin RNAs expressed during spermiogenesis in chickens, we report the identification of a novel alpha-tubulin which is expressed exclusively in chicken testes. Comparison of its sequence with those previously determined not only demonstrates that the encoded polypeptide is significantly divergent from other alpha-tubulins but also supports the hypothesis that alpha-tubulin isotypes are distinguished by a carboxy-terminal variable region sequence and, to a lesser extent, by a domain near the amino terminus. Since essentially all previously known alpha-tubulins undergo a unique cycle of removal and posttranslational readdition of a tyrosine residue at the extreme carboxy terminus, the presence in this testes alpha-tubulin of a very divergent carboxy terminus that does not contain an encoded tyrosine raises the possibility that this polypeptide does not participate in the usual cycle of tyrosination/detyrosination. PMID- 3561403 TI - Immunological evidence for two physiological forms of protein kinase C. AB - Our recently described purification scheme for rat brain protein kinase C yields an enzyme consisting of a 78/80-kilodalton (kDa) doublet upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis (submitted for publication). Antisera against this preparation were raised in two rabbits. One of the antisera detected only the 80-kDa component by immunoblotting of purified protein kinase C and immunoprecipitated an 80-kDa [35S]methionine-labeled protein from a variety of human, rodent, and bovine cells, which was shown to represent protein kinase C by comparative one-dimensional peptide mapping. In contrast, the second antiserum detected both 78- and 80-kDa enzyme forms by immunoblotting and immunoprecipitated a [35S]methionine-labeled 78/80-kDa doublet from mammalian cells. One-dimensional peptide maps of these 78- and 80-kDa proteins were similar to those derived from the 78- and 80-kDa forms of purified protein kinase C, respectively. The two forms were not related by either partial proteolysis or differential phosphorylation, showing that two distinct forms of this enzyme exist in mammalian cells. Treatment of mouse B82 L cells with 2.5 micrograms of 12-O-tetradecanoylphorbol-13-acetate (TPA) per ml for 18 h resulted in complete loss of immunoprecipitable protein kinase C with a half time of disappearance of 48 min. Since the normal half-life of protein kinase C was greater than 24 h and the biosynthetic rate of the protein was not decreased after 18 h by TPA treatment, TPA induces down-regulation by increasing the degradation rate of the enzyme. Treatment of cells with 50 ng of TPA per ml followed by resolution of the membrane and cytosol in the presence of ethylene glycol-bis(beta-aminoethyl ether)N,N,N',N'-tetraacetic acid (EGTA) promoted an apparent translocation of both 78- and 80-kDa proteins from the cytosol to the membrane fraction. A similar translocation was effected by cell lysis in the presence of Ca2+, indicating the subcellular localization of protein kinase C to be sensitive to the presence of both activators and micromolar amounts of Ca2+. PMID- 3561404 TI - Expression of the high-affinity purine nucleobase transporter in mutant mouse S49 cells does not require a functional wild-type nucleoside-nucleobase transporter. AB - A novel type of somatic mutation that causes the expression of a high-affinity purine base permease (B. Aronow, D. Toll, J. Patrick, P. Hollingsworth, K. McCartan, and B. Ullmann, Mol. Cell Biol. 6:2957-2962, 1986) has been inserted into nucleoside transport-deficient S49 cells. Two classes of mutants expressing this nucleobase permease were generated. The first, as exemplified by the AE1HADPAB2 cell line, possessed an augmented capacity to transport low concentrations of the three purine bases, hypoxanthine, guanine, and adenine. The second class of mutants, as typified by the AE1HADPAB5 clone, possessed an augmented capability to translocate low levels of hypoxanthine and guanine, but not adenine. Neither the AE1HADPAB2 nor the AE1HADPAB5 cells could transport nucleosides, suggesting that the expression of the high-affinity base transporter did not reverse the mutation in the nucleoside transport system. The transport of purine bases by both AE1HADPAB2 and AE1HADPAB5 cells was much less sensitive than that by wild-type cells to inhibition by dipyridamole, 4-nitrobenzylthionosine, and N-ethylmaleimide, potent inhibitors of nucleoside and nucleobase transport in wild-type S49 cells. Fusion of the AE1HADPAB2 and AE1HADPAB5 cell lines with wild type cells indicated that the expression of the high-affinity base transporter behaved in a dominant fashion, while the nucleoside transport deficiency was a recessive trait. These data suggest that the high-affinity purine base transporter of mutant cells and the nucleoside transport function of wild-type cells are products of different genes and that expression of the former probably requires the unmasking or alteration of a specific genetic locus that is silent or different in wild-type cells. PMID- 3561406 TI - Cell cycle regulation of a mouse histone H4 gene requires the H4 promoter. AB - The mouse histone H4 gene, when stably transformed into L cells on the PSV2gpt shuttle vector, is cell cycle regulated in parallel with the endogenous H4 genes. This was determined in exponentially growing pools of transformants fractionated into cell cycle-specific stages by centrifugal elutriation, a method for purifying cells at each stage of the cell cycle without the use of treatments that arrest growth. Linker additions in the 5' noncoding region of the H4 RNA or in the coding region of the gene did not affect the cell cycle-regulated expression of the modified H4 gene even though the overall level of expression was altered. However, replacing the H4 promoter with the human alpha-2 globin promoter, so that the histone transcript produced by the chimeric gene remains essentially unchanged, resulted in the constitutive expression of H4 mRNA during all phases of the cell cycle with no net increase in H4 mRNA levels during the G1 to-S transition. From these results we conclude that all the information necessary for the cell cycle-regulated expression of the H4 gene is contained in the 5.2-kilobase subclone used in these studies with 228 nucleotides of 5' flanking DNA and that the increase in H4 mRNA during the G1-to-S transition in the cell cycle is mediated by the H4 promoter and not by the increased stability of the H4 RNA. PMID- 3561405 TI - Multiple proteins bind to VA RNA genes of adenovirus type 2. AB - Using fractionated HeLa cell nuclear extracts and both nuclease (DNase I) cleavage and chemical cleavage (methidiumpropyl-EDTA X Fe(II) protection methodologies, we demonstrated the presence of three proteins which interacted specifically, yet differentially, with the two VA genes of adenovirus type 2. One, previously identified as transcription initiation factor TFIIIC, bound to a site centered on the transcriptionally essential B-block concensus element of the VAI gene and, with a lower affinity, to the analogous site in the VAII gene. Another, identified as the cellular protein involved in adenovirus replication, nuclear factor I, bound to sites immediately downstream from the two VAI terminators (at approximately +160 and +200). The third, a previously unrecognized VA gene binding protein termed VBP, bound immediately upstream of the B-block element in the VAI gene but showed no binding to VAII. Possible roles for these proteins in VA gene transcription were investigated in in vitro assay systems reconstituted with partially purified transcription factors (RNA polymerase III, TFIIIB, and TFIIIC). Although TFIIIC activity was present predominantly in fractions containing B-block binding activity, there was not complete correspondence between functional and DNA binding activities. The nuclear factor I-like protein had no effect when added to a complete transcription reaction. The presence of VBP appeared to depress the intrinsic ratio of VAI-VAII synthesis, thereby simulating the relative transcription levels observed early in adenovirus infection of HeLa cells. These observations suggest a model, involving both intragenic binding factors (VBP and TFIIIC) and variable template concentrations, for the differential regulation of VA transcription during the course of adenovirus infection. PMID- 3561407 TI - Cotransfection with adenovirus DNA enhances transcription from linear DNA containing eucaryotic promoters. AB - Linear DNAs, containing a copy of the adenovirus serotype 2 (Ad2) inverted terminal repeat sequence at each end, replicate in 293 cells when cotransfected with Ad2 DNA (Hay et al., J. Mol. Biol. 175:493-510, 1984). We have linked either the Ad2 IVa2 promoter (IVa2) or major late promoter (MLP) to the chloramphenicol acetyltransferase gene and inserted this DNA into such a plasmid (pARKR) between its two inverted terminal repeats. These recombinant plasmids were linearized and then used to transfect 293 cells in the presence or absence of Ad2 helper DNA. Synthesis of IVa2 and MLP RNAs, and production of chloramphenicol acetyltransferase was increased dramatically when the Ad2 DNA was included. However, unlike the patterns of temporal regulation which are seen during a cycle of virus replication when these genes are contained within the virion, there was no obvious difference in the timing of RNA synthesis from plasmid IVa2 or MLP after cotransfection. When linearized plasmids containing IVa2 and MLP sequences but lacking inverted terminal repeats at their ends (replication deficient plasmids) were used for transfection, an increase in RNA synthesis from IVa2 or MLP was also observed and similarly required cotransfection with Ad2 DNA. When HeLa cells, which do not constitutively express the adenovirus E1a gene, were cotransfected with linearized plasmids and adenovirus DNA that lacks the E1a region (H5dl312), a stimulation of transcription was also observed, although it was less than the level observed with wild-type DNA. The results of the present study demonstrate that an early gene product(s) besides E1a functions in trans to regulate transcription. PMID- 3561408 TI - Genetic variations in kinetic constants that describe beta-glucuronidase mRNA induction in androgen-treated mice. AB - The kinetics of beta-glucuronidase mRNA induction by androgen in mouse kidney were determined for A, B, and CS haplotypes of the beta-glucuronidase gene. After a lag period, the kinetics of mRNA (R) induction are approximated by the turnover equation dR/dt = k1 - k2R. The A haplotype differs from the B primarily in the duration of the lag period and in k1, the rate constant determining the initial slope of the induction curve. The CS haplotype differs from B primarily in k2, the first-order rate constant that determines the half-time for induction. None of the haplotypes differs significantly in the half-life of beta-glucuronidase mRNA as measured by deinduction. Thus, there was no correlation between the half time or extent of induction and the half-life of the RNA. Comparing half-times for induction with the half-life of the mRNA suggests that message stabilization can at most account for only part of the induction. We conclude that transcriptional activation of the beta-glucuronidase gene must be an important component of induction. Estimating absolute numbers of mRNA molecules and absolute rates of gene transcription, it appears that before induction there is approximately one molecule of beta-glucuronidase mRNA per cell and that each gene copy is transcribed once every 35 to 40 h. Depending on the haplotype examined, after induction, mRNA goes up to 80 to 400 molecules per induced cell. In the A haplotype, which has the highest induction, this corresponds to one transcript from each gene every 6 min if there is no induced stabilization of beta glucuronidase mRNA, and one every 30 min if there is. Thus, it seems unlikely that more than one transcript is ever being synthesized at the same time from the beta-glucuronidase gene. PMID- 3561409 TI - Mutations in the adenovirus major late promoter: effects on viability and transcription during infection. AB - We developed an experimental system to examine the effects of mutations in the adenovirus major late promoter in its correct genomic location during a productive infection. A virus was constructed whose genome could be digested to give a rightward terminal DNA fragment extending from the XhoI site at 22.9 map units, which can be ligated or recombined with plasmid DNA containing adenovirus sequences extending from 0 to 22.9 or 26.5 map units, respectively. Mutations were made by bisulfite mutagenesis in the region between base pairs -52 and -12 with respect to the cap site at +1 and transferred to the appropriate plasmids for viral reconstruction. Of 19 mutant plasmid sequences containing single or multiple G-to-A transitions, 14 could be placed in the viral genome with no apparent change in phenotype. These mutant sequences included those which contained four transitions in the string of G residues immediately downstream of the TATA box. There were no alterations in rates of transcription from the major late promoter, sites of transcription initiation, or steady-state levels of late mRNAs. All of the five mutant sequences which could not be placed in virus contained multiple transitions both up- and downstream of the TATA box. Two of these apparently lethal mutant sequences were used in promoter fusion experiments to test their ability to promote transcription of rabbit beta-globin sequences placed in the dispensable E1 region of the virus. Both sequences showed diminished ability compared with wild-type sequences to promote transcription in this context. Comparisons between these two sequences and the viable mutant sequences suggest a role for the string of G residues located between -38 and -33 in promoting transcription from the major late promoter. The data as a whole also demonstrate that the specific nucleotide sequence of this region of the major late promoter, which overlaps transcription elements of the divergent IVa2 transcription unit and coding sequences of the adenovirus DNA polymerase, is not rigidly constrained but can mutate extensively without loss of these several functions. PMID- 3561410 TI - Six distinct nuclear factors interact with the 75-base-pair repeat of the Moloney murine leukemia virus enhancer. AB - Binding sites for six distinct nuclear factors on the 75-base-pair repeat of the Moloney murine leukemia virus enhancer have been identified by an electrophoretic mobility shift assay combined with methylation interference. Three of these factors, found in WEHI 231 nuclear extracts, which we have named LVa, LVb, and LVc (for leukemia virus factors a, b, and c) have not been previously identified. Nuclear factors that bind to the conserved simian virus 40 corelike motif, the NF 1 motif, and the glucocorticoid response element were also detected. Testing of multiple cell lines showed that most factors appeared ubiquitous, except that the NF-1 binding factor was found neither in nuclear extracts from MEL cells nor in the embryonal carcinoma cell lines PCC4 and F9, and core-binding factor was relatively depleted from MEL and F9 nuclear extracts. PMID- 3561411 TI - Two transcriptional activators, CCAAT-box-binding transcription factor and heat shock transcription factor, interact with a human hsp70 gene promoter. AB - We characterized the activity of a human hsp70 gene promoter by in vitro transcription. Analysis of 5' deletion and substitution mutants in HeLa nuclear extracts showed that the basal activity of the promoter depends primarily on a CCAAT-box sequence located at -65. A protein factor, CCAAT-box-binding transcription factor (CTF), was isolated from HeLa nuclear extracts and shown to be responsible for stimulation of transcription in a reconstituted in vitro system. DNase I footprinting revealed that CTF interacts with two CCAAT-box elements located at -65 and -147 of the human hsp70 promoter. An additional binding activity, heat shock transcription factor (HSTF), which interacted with the heat shock element, was also identified in HeLa extract fractions. This demonstrates that the promoter of this human hsp70 gene interacts with at least two positive transcriptional activators, CTF, which is required for CCAAT-box dependent transcription as in other promoters such as those of globin and herpes simplex virus thymidine kinase genes, and HSTF, which is involved in heat inducibility. PMID- 3561412 TI - Evidence for transcriptional and post-transcriptional control of the cellular thymidine kinase gene. AB - We have studied the cell cycle-regulated expression of the thymidine kinase (TK) gene in mammalian tissue culture cells. TK mRNA and enzyme levels are low in resting, G0-phase cells, but increase dramatically (10- to 20-fold) during the S phase in both serum-stimulated and simian virus 40-infected cells. To determine whether an increase in the rate of TK gene transcription is responsible for this induction, nuclear run-on transcription assays were performed at various times after serum stimulation or simian virus 40 infection of growth-arrested simian CV1 cells. When assays were performed at 12-h intervals, a small (two- to threefold) but reproducible increase in TK transcription was detected during the S phase. When time points were chosen to span the G1-S interface a larger (six- to sevenfold) increase in transcriptional activity was observed in serum stimulated cells but not in simian virus 40-infected cells. The large increase in TK mRNA levels and the relatively small increase in transcription rates in growth stimulated cells suggest that TK gene expression is controlled at both a transcriptional and post-transcriptional level during the mammalian cell cycle. To identify the DNA sequences required for cell cycle-regulated expression, several TK cDNA clones were transfected into Rat-3 TK- cells, and their expression was examined in resting and serum-stimulated cultures. These experiments indicated that the body of the TK cDNA is sufficient to insure cell cycle-regulated expression regardless of the promoter or polyadenylation signal used. PMID- 3561413 TI - Activation of human raf transforming genes by deletion of normal amino-terminal coding sequences. AB - Three activated cellular raf genes have been detected by transfection of NIH 3T3 cells with human tumor DNAs. Blot hybridization analysis indicated that all three transforming raf genes had recombined with non-raf sequences in the vicinity of raf exon 7-intron 7, resulting in the deletion of about 40% of the normal coding sequence from the raf amino terminus. By cloning sequences upstream of the truncated raf loci we have shown that the rearrangements involve the fusion of three different 5' non-raf human sequences to the human raf gene. No rearrangements could be detected in the raf loci of the three original human tumor DNAs, suggesting that the raf genes were activated by DNA rearrangements occurring during transfection. Significant overexpression of raf mRNA was not evident in two of the three transformant lines, indicating that raf overexpression is not necessary and 5' truncation alone may be sufficient to activate the transforming potential of cellular raf genes. PMID- 3561414 TI - Interaction of a tissue-specific factor with an essential rat growth hormone gene promoter element. AB - Rat growth hormone (rGH) gene expression is normally restricted to the anterior pituitary. As a model of this tissue specificity, we compared the transient expression of an rGH-chloramphenicol acetyltransferase (CAT) hybrid gene in rGH producing rat pituitary tumor (GC) cells and in non-rGH-producing rat fibroblast (rat-2) cells. Deletion analysis of the rGH portion of this hybrid gene demonstrated that DNA sequences within 140 base pairs 5' to the rGH gene were sufficient for correct cell type-specific expression. Deletion of an additional 35 base pairs of the rGH 5'-flanking DNA resulted in a loss of expression of the transfected hybrid gene and correlated with the interaction of a putative trans acting factor with this region of the rGH promoter. This factor was detectable by DNase I footprinting in a crude nuclear extract from GC cells but not from rat-2 cells. Site-directed mutagenesis of the footprint region caused complete loss of expression of a hybrid gene containing 530 base pairs 5' to the rGH gene. Thus, the interaction of this factor, which we term GC2, is likely to be essential for the tissue-specific expression of the rGH gene. PMID- 3561415 TI - Mutation of the c-fos gene dyad symmetry element inhibits serum inducibility of transcription in vivo and the nuclear regulatory factor binding in vitro. AB - In vitro mutagenesis of a 61-base-pair DNA sequence element that is necessary for induction of the c-fos proto-oncogene by growth factors revealed that a small region of dyad symmetry within the sequence element is critical for c-fos transcriptional activation. The same c-fos dyad symmetry element was found to bind a nuclear protein in vitro, causing a specific mobility shift of this c-fos regulatory sequence. An analysis of insertion and deletion mutants established a strict correlation between the ability of the dyad symmetry element to promote serum activation of c-fos transcription and in vitro nuclear protein binding. These experiments suggest that the DNA mobility shift assay detects a nuclear protein that mediates growth factor stimulation of c-fos expression. In vitro competition experiments indicate that the c-fos regulatory factor also binds to sequences within another growth factor-inducible gene, the beta-actin gene. PMID- 3561416 TI - A rat spermatocyte surface protein is involved in adhesion of pachytene spermatocytes to Sertoli cells in vitro. AB - Immunochemical approaches were used in trying to identify rat spermatocyte molecules involved in the adhesion to Sertoli cells in coculture. The results show that a surface protein of 80,000 apparent molecular weight strongly inhibits spermatocyte adhesion, suggesting it to be the germ cell surface component involved in the recognition of Sertoli cells. PMID- 3561418 TI - [Disorders of kidney function and acute kidney failure in newborn infants]. AB - Compromised kidney function in the perinatal period has been increasingly recognized during recent years, and acute renal failure is a frequent clinical situation in neonatal intensive care units. Renal underperfusion due to various prerenal conditions is assumed to be the most common cause of renal failure in neonates. With rapid restoration of renal blood flow, prerenal failure is completely reversible in the early course of the disease. If adequate treatment is delayed, however, structural damage to the kidneys by prolonged ischemia will ensue leading to a poor prognostic outcome. This review, therefore, mainly focuses on early diagnosis of disturbed neonatal kidney function and prophylactic therapeutical aspects which may be of particular benefit for critically ill newborns at high risk for developing acute renal failure. PMID- 3561419 TI - [Does the premature infant need more sodium?]. PMID- 3561417 TI - Initiation factor protein modifications and inhibition of protein synthesis. AB - The protein covalent modification state of eucaryotic initiation factors eIF-2 and eIF-4B in HeLa cells was examined after they were exposed to a variety of conditions or treatments that regulate protein synthesis. A few factors (e.g., variant pH and sodium fluoride) altered the phosphorylation state of the initiation factor proteins, but the majority (hypertonic medium, ethanol, dimethyl sulfoxide sodium selenite, sodium azide, and colchicine) had no effect on either protein. While initiation factor phosphorylation may regulate protein synthesis in response to many physiological situations, other pathways can regulate protein synthesis under nonphysiological circumstances. PMID- 3561420 TI - [Varying rates of phagocytosis of human blood monocytes and breast milk macrophages: effect of intralipid and milk fat globules]. AB - Phagocytosis of antibody/complement or anti-D coated and neuraminidase treated erythrocytes by human blood monocytes and milk macrophages has been investigated. About 90% of the blood monocytes phagocytized erythrocytes whereas only 40% of the milk macrophages engulfed pretreated red blood cells. After preincubation of blood monocytes with Intralipid, no erythrocytes were phagocytized, while after preincubation with milk-fat-globules half the monocytes ingested erythrocytes. PMID- 3561421 TI - [Cerebro-costo-mandibular syndrome without cerebral involvement in a 4-year-old boy]. AB - In a four year old boy the combination of Robin sequence and multiple dorsal rib defects on the first day of life could be classified as cerebro-costo-mandibular syndrome. In contrast to an unfavorable clinical course with cerebral involvement which has repeatedly been observed, in our patient psychomotor development has been normal so far. A brief literature review of a total of 36 patients shows that despite a unfavorable prognosis quoad vitam, roughly half the patients have survived. Half of the surviving patients showed functional disorders of the central nervous system, and only one third was mentally retarded. The favorable clinical course documented here thus supports the hypothesis that cerebral symptoms are not an obligatory component of the syndrome, but are only to be regarded as a facultative risk in the "costo-mandibular" syndrome. Accordingly, therapeutic nihilism does not seem to be justified. The etiology of the cerebro costo-mandibular syndrome could not be clarified unequivocally up to now. A series of family observations indicate a monogenic cause, but genetic heterogeneity can not be ruled out. PMID- 3561422 TI - [Various characteristics of the structure and synthesis of procollagens produced by cultured skin fibroblasts from patients with Danlos-Ehlers syndrome type I]. AB - The electrophoretic mobilities of the collagen and procollagen type I and III chains synthesized by the fibroblasts isolated from patients with type I Ehlers Danlos syndrome as well as a set of peptides obtained by splitting of pro alpha 1(I) and pro alpha 2(I) type I procollagens by cyanbromide are not different from the normal ones. The fact demonstrates the absence of long insertions or deletions, or the sufficient defects in intracellular chain modifications. The changes were also nor registered for the ratio of type I and III collagens from the digested by pepsin preparations of protein accumulating in the culture media of the cultured skin fibroblasts from patients. The studied strains of cultured fibroblasts from patients suffering the Ehlers-Danlos syndrome have the trend to increased accumulation of partially processed chains of proc alpha 1(I) and proc alpha 2(I) type I procollagen and to the increased ratio of pro alpha 1(I) to pro alpha 2(I). PMID- 3561423 TI - DNA base modification: ionized base pairs and mutagenesis. AB - The nature of hydrogen bonding between normal and modified bases has been re examined. It is proposed that hydrogen-bonding schemes may involve tautomeric, ionized or conformational forms (syn, anti and wobble). Several important cases are presented or reviewed in which physical evidence indicates the existence of ionized base pairs. When thermodynamic values determined in aqueous solution under physiological conditions are considered, it can be argued that base ionization will contribute substantially to the stability of many biologically relevant base pairs containing modified bases. A significant incidence of ionized bases in DNA may have important kinetic ramifications for the further chemical reactivity of both the modified base and its cross-strand pairing partner. Moreover, DNA structure at and surrounding ionized base pairs may be altered. For this reason, the model presented in this study should be useful as DNA-sequence analysis becomes more commonly applied to the study of mutagenesis. PMID- 3561424 TI - Analysis by BrUdR-labelling technique of induced aneuploidy in mammalian cells in culture. AB - To study the origin of induced aneuploid cells, the BrUdR-labelling technique was applied to V79/AP4 Chinese hamster cells treated with colcemid or benomyl. In this way we were able to recognize the cells which had undergone one cellular division after the treatment since their chromosomes exhibited sister-chromatid differentiation. The results showed that the induced aneuploid cells can have either a few or numerous additional chromosomes depending on the concentrations of the drug. Moreover, it could be established that aneuploid cells with numerous additional chromosomes were obtained mainly when polyploid cells were also present in the treated population. This strongly suggests that the excess of additional chromosomes found in the aneuploid cells induced by the highest concentrations may be derived by disturbances of the whole mitotic apparatus rather than by a multiplicity of errors affecting individual chromosomes. PMID- 3561425 TI - Origin of araC-induced endoreduplicated cells. AB - To investigate the origin of endoreduplicated cells induced by DNA-synthesis inhibitors, V79 Chinese hamster cells were treated with 1-beta-D arabinofuranosylcytosine (araC). During the treatment, BrUdR was present in the culture medium. If endoreduplicated cells originate from cells which have undergone rereplication of DNA segments randomly distributed over the genome during araC treatment, the diplochromosomes should exhibit lightly stained bands. The data indicate that endoreduplicated cells originate from cells blocked at the G2 stage of the cell cycle rather than from cells which have undergone an aberrant rereplication during araC treatment. PMID- 3561426 TI - Cell killing by various monofunctional alkylating agents in Chinese hamster ovary cells. AB - Cell killing by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), N-methyl-N nitrosourea (MNU), N-ethyl-N-nitrosourea (ENU), and methyl methanesulfonate (MMS) was measured in Chinese hamster ovary (CHO) cells using the colony-formation assay. Cell killing by these agents was determined in exponentially growing asynchronous cells, in synchronous cells as a function of cell-cycle position and in nondividing cells. Distinct differences in the cytotoxic effect of the 4 alkylating agents were found in respect to dose-response, cell cycle phase sensitivity and growth state. MNNG and MNU showed the same biphasic dose-survival relationship in exponentially growing cells, with an initial steep decline followed by a shallow component. The shallow component disappeared in growth arrested cells. MNNG and MNU differed, however, in the cell-cycle age response. No cell-cycle phase difference was seen with MNNG, whereas cells in G1 seemed more sensitive to MNU than cells in S phase. MMS and ENU both showed shouldered dose-response curves for exponentially growing asynchronous cells, and the same cell-cycle pattern for synchronous cultures with cells in early S phase being the most sensitive. However, survival of nondividing cells versus dividing cells was reduced much more by MMS than by ENU. Caffeine, which interferes with the regulation of DNA synthesis and is known to modify cell killing by DNA-damaging agents, enhanced cell killing by all agents. It is concluded that there must be a number of factors which contribute to cell killing by monofunctional alkylating agents, and that besides alkylation of DNA reaction with other cellular macromolecules should be considered. PMID- 3561427 TI - Lethal sectoring is not the basis for EMS-induced pure mutant clones in Chinese hamster cells. AB - Treatment of G1-synchronized mammalian cells with mutagenic agents which act on one strand of the DNA at a given site would be expected to produce colonies containing both mutant and wild-type cells (mosaic). We have observed that in addition to mosaic colonies, G1-synchronized Chinese hamster ovary cells which had been treated with the single-strand mutagen ethyl methanesulfonate (EMS), produced colonies in which all the cells lacked glucose-6-phosphate dehydrogenase activity. These completely mutant (pure) colonies could be derived from a potentially mosaic colony by the "death" of the wild-type cell after the first cell division, leaving only the glucose-6-phosphate dehydrogenase (G6PD) deficient cell to grow into a colony (lethal sectoring). Using time-lapse photography to analyze cell lineages after EMS treatment, we find that cell lysis, cell release, cell migration, or proliferative failure of one lineage at the 2-cell stage accounts for only 20-25% of the pure mutant colonies observed. This result suggests that in the Chinese hamster cell there exists a mutational mechanism which fixes the mutation in both strands of the DNA before the next replication cycle following EMS treatment. PMID- 3561428 TI - Mutagenicity of N4-aminocytidine and its derivatives in Chinese hamster lung V79 cells. Incorporation of N4-aminocytosine into cellular DNA. AB - N4-Aminocytidine induced mutation to 6-thioguanine resistance in Chinese hamster lung V79 cells in culture. Previous studies with experimental systems of in vitro DNA synthesis and of phage and bacterial mutagenesis have shown that this nucleoside analog induces base-pair transitions through its incorporation into DNA, with its erroneous base-pairing property. Incorporation of exogenously added [5-3H]N4-aminocytidine into the DNA of V79 cells was in fact observed in the present study. N4-Aminodeoxycytidine was not mutagenic for the V79 cells. Several alkylated N4-aminocytidine derivatives were tested for their mutagenicity in this system. Those with an alkyl group on the N'-nitrogen of the hydrazino group at position 4 of N4-aminocytidine were mutagenic, but those having an alkyl on the N4-nitrogen were not. These results are consistent with those previously observed in the bacterial mutagenesis systems, and agree with a mechanism of mutation in which a tautomerization of N4-aminocytosine is the necessary step for causing the erroneous base pairing. PMID- 3561429 TI - DNA synthesis, mitotic index, drug-metabolising systems and cytogenetic analysis in regenerating rat liver. Comparison with bone marrow test after 'in vivo' treatment with cyclophosphamide. AB - Rat-liver cells can be used to reveal "in vivo" clastogenic activity of indirect mutagens, provided that they are stimulated to divide by partial hepatectomy. In order to characterize the rat-liver metabolic capacity in such experimental conditions, several biochemical parameters were measured during the first 54-66 h of liver regeneration in Sprague-Dawley male rats, subjected to a partial hepatectomy. The levels of cytochrome P-450, the activities of styrene monooxygenase, epoxide hydrolase and glutathione-S-epoxide transferase were chosen as markers. All the enzymatic activities and the level of cytochrome P-450 decreased during the first 12 h after the hepatectomy to about 50% of the activities of the sham-operated rats considered as controls. Subsequent recovery of the metabolic capacity was not observed. DNA synthesis and the mitotic index were measured to find the most suitable time for metaphase analysis. DNA synthesis and the number of metaphases were maximal at, respectively, 22-25 and 28-31 h after partial removal of the liver. The sensitivity to clastogenic damage induced by "in vivo" treatment with cyclophosphamide (CPA) was assayed in regenerating liver cells by chromosome-aberration analysis. Different doses, ranging from 5 to 30 mg/kg b.w., were given i.p. to the rats 17 h before or 7 h after partial hepatectomy. Liver cells were collected 31 h after surgery. Clastogenic damage was greater when the drug was administered to the animals after the hepatectomy (24 h of exposure) than before (48 h of exposure). The sensitivity to CPA-induced damage was compared with a bone marrow cell test carried out on non-hepatectomized rats treated in the same way. The results indicated that in these conditions regenerating liver cells are more sensitive than bone marrow cells to the induction of chromosome aberrations by CPA. PMID- 3561430 TI - A procedure for the CHO/HGPRT mutation assay involving treatment of cells in suspension culture and selection of mutants in soft-agar. AB - A procedure involving treatment of cells in suspension culture and soft-agar cloning was developed for measuring mutation of Chinese hamster ovary (CHO) cells to 6-thioguanine (6TG) resistance. The use of suspension cultures precluded the need for trypsinization and also permitted a 5-fold increase in cell population for compound exposure and mutant selection as compared to former monolayer techniques. Soft-agar cloning reduced the opportunity for metabolic cooperation and permitted the use of non-dialyzed fetal calf serum which resulted in spontaneous mutant frequencies of 6.6 +/- 3.2 X 10(-6) and cloning efficiencies of 91 +/- 18%. Relative total growth values were calculated based on suspension growth and cloning efficiencies such that an assessment of toxicity could be estimated from treatment through cloning. Dose-dependent mutagenic responses were observed in CHO cells following treatment with ethyl methanesulfonate, methyl methanesulfonate, 4-nitroquinoline-1-oxide, methylnitrosourea and N-methyl-N' nitro-N-nitrosoguanidine. Clones of 6TG-resistant cells harvested from soft agar maintained 6TG resistance and methotrexate sensitivity and did not incorporate [3H]hypoxanthine into DNA. These preliminary findings indicate that the use of suspension cultures and soft-agar cloning has improved the efficiency and cost effectiveness of the CHO/HGPRT mutation assay. PMID- 3561431 TI - Sister-chromatid exchanges in peripheral lymphocytes of workers occupationally exposed to xylenes. PMID- 3561432 TI - Chloramine-induced sister-chromatid exchanges. AB - Nitrogen-chlorine (N-Cl) derivatives are a class of long-lived oxidants produced by stimulated phagocytes which may be important mediators of the inflammatory response. Because other phagocyte-generated oxidants cause genetic damage in cultured mammalian cells, we studied the ability of the synthetic N-Cl compound, chloramine T (Cl-T), to produce sister-chromatid exchanges (SCEs) in cultured Chinese hamster ovary (CHO) cells. CHO cells were incubated for 30 h with Cl-T (10(-8) M-10(-5) M) and genetic damage was analyzed utilizing the SCE assay. A significant (p less than 0.0005) dose-dependent increase in SCEs was observed. This effect was diminished when cells were treated concomitantly with methionine (10(-5) M), a thioether which reduces N-Cl back to the parent amine. Extracellularly-generated oxidants must traverse long distances before interacting with nuclear target molecules. Therefore, long-lived N-Cl derivatives may represent an important class of oxidants which mediate the process of carcinogenesis associated with chronic inflammatory states in vivo. PMID- 3561433 TI - Host-mediated transformation: metronidazole. AB - To evaluate the possible genotoxic effects of the drug, metronidazole in the fetus, we employed the hamster embryo host-mediated assay. Pregnant golden Syrian hamsters were fed metronidazole at doses ranging from 200 mg/kg to 900 mg/kg on days 11 and 12 of pregnancy. Embryonic cells obtained from the treated animals were studied in vitro for morphologic evidence of transformation. To further assess the significance of the in vitro finding, cells from mass culture were tested for their ability to grow in soft agar. The drug-treated cells and cells previously treated with diethyl nitrosamine (positive controls) showed comparable growth characteristics. To confirm the neoplastic potential of the drug-treated embryonic cells, subcultivated cells from the tenth passage were implanted into nude mice and irradiated immunosuppressed hamsters. Cells from the 300 mg/kg treatment produced fibrosarcoma in nude mice but not in the irradiated hamsters. Cells from no other dose level employed in the study produced tumors in host animals. It is concluded that metronidazole is capable of vertical transmission of potential genotoxic effects to the fetus. PMID- 3561434 TI - An examination of some factors influencing creatine kinase in the blood of patients with muscular dystrophy. AB - The natural variability of plasma creatine kinase activity has been examined in patients suffering from muscular dystrophy and in normal subjects. The coefficient of variation of the plasma creatine kinase activities was found to be large (approximately 35%) in both patients with Duchenne muscular dystrophy and normal control subjects. A comparison of the plasma activities of creatine kinase with other muscle-derived enzymes suggests that the cause of this variability is changes in the release of enzymes from muscle. Data obtained concerning the effect of physical activity on plasma creatine kinase activity are contradictory, but several young patients with Duchenne muscular dystrophy and a very high creatine kinase activity (greater than 5000 IU/liter) showed a decreased activity following admission to hospital. An estimate of the rate of efflux of certain kinase from muscle has been made, indicating that young ambulant patients with Duchenne muscular dystrophy have a grossly elevated muscle creatine kinase efflux (495.0 +/- 61.3 IU/kg muscle/hr) compared to control subjects (1.4 +/- 0.5 IU/kg muscle/hr). PMID- 3561435 TI - Creatine kinase isoforms following isometric exercise. AB - The present study assessed creatine kinase (CK) activity, CK MM isoforms, and muscle soreness following an exercise regimen designed to induce skeletal muscle damage. Eight college-age subjects performed 40 maximal isometric contractions of the knee extensor muscles (10-second contraction/20-second rest). Serum samples and soreness ratings were taken prior to and 2, 6, 18, and 24 hours after the exercise. The CK MM1 and CK MM3 isoforms were determined by flatbed isoelectric focusing (IEF). In serum, the MM1 isoform (the pure gene product) is considered to be evidence of newly released CK from muscle, as upon entering the plasma, the CK MM1 is converted to MM2 and then MM3. A significant increase in serum CK activity was found at 6 hours and remained elevated at 24 hours. CK MM1 increased significantly at 2 hours, peaked at 6 hours, then approached baseline. Soreness did not increase significantly until 18 hours. Analysis of CK isoforms in serum can provide an earlier indicator of skeletal muscle damage than total CK or perception of soreness and may be useful in tracking the time course of skeletal muscle damage and repair. PMID- 3561436 TI - Prevention of recurrent exertional rhabdomyolysis by dantrolene sodium. AB - A patient with recurrent attacks of exertional rhabdomyolysis and easy fatiguability was treated with dantrolene sodium. She experienced a complete prevention of myoglobinuric attacks and gained a better exercise tolerance. Biochemical findings in this patient suggest a loosely coupled oxidative phosphorylation in mitochondria. The question is raised as to whether dantrolene sodium exerts an effect on the mitochondrial calcium uptake and influences the state of coupling of the mitochondria. PMID- 3561437 TI - Morphometric studies of sural nerve in childhood. AB - Sural nerve myelinated fiber density and myelinated fiber diameter distribution have been examined in 27 control subjects, ranging in age from 1 day to 59 years. Total transverse fascicular area was measured in 10 of the subjects. There is an exponential decline in myelinated fiber density from birth to adult life. The predicted normal density (D) at any age may be derived from the formula D = (1 X 10(3]/(0.0699 + 0.00725 square root t). The distribution of myelinated fiber diameters is unimodal in the first 4 months of life, and there is a definite bimodal distribution by 2 years of age. Total transverse fascicular area of sural nerve increases progressively from values of about 0.25 mm2 in the first week to about 0.82 mm2 at 9 years. Control values for sural nerve morphometry in childhood are essential for accurate interpretation of biopsies in patients with peripheral neuropathy. PMID- 3561438 TI - Practical analysis of variability of muscle function measurements in Duchenne muscular dystrophy. AB - To determine the possible sources of variation in performance indicators used in therapeutic trials, electrical stimulation techniques were used to measure contractile properties of the adductor pollicis and quadriceps muscles in boys with Duchenne muscular dystrophy. As no therapeutic effects were observed, longitudinal data obtained are taken to indicate changes in disease progress. Variance in voluntary contractions was found to be similar to that with electrically stimulated contractions; thus, variation could not be attributed to motivational changes, but rather to physiologic changes. Dystrophic muscle was slower to relax and less fatiguable than normal. However, such changes are of less significance to the overall disability compared to the loss of muscle bulk (cross-sectional area). Important variations in the function of individual muscles essential to complex performance, such as walking or getting up from the floor, could be masked by combining results from several muscle groups. PMID- 3561439 TI - Neuralgic amyotrophy: an increasingly diverse entity. AB - We describe nine cases of neuralgic amyotrophy whose clinical and electrophysiologic findings suggest lesions of individual peripheral nerves or peripheral nerve branches occurring singly (mononeuropathy) or in various combinations (mononeuropathy multiplex). There were four occurrences of isolated denervation of the pronator teres muscle; four occurrences of anterior interosseous nerve lesions; three occurrences of lateral antebrachial cutaneous nerve lesions; two occurrences of long thoracic nerve lesions; and one occurrence each of a median nerve trunk lesion, a median palmar cutaneous branch lesion, a suprascapular nerve lesion, and an axillary nerve lesion. "Neuralgic" pain was a prominent feature in all cases, and the location of the pain correlated with the location of the nerve lesions. We hypothesize that the specific course of certain nerves (especially their location across joints) selectively exposes them to mild focal trauma that increases their susceptibility to this disease. Whatever the etiology, this entity is considerably more diverse than generally appreciated. PMID- 3561440 TI - Calmodulin levels in developing muscle tissues and primary cultures of normal and dystrophic (UM-X7.1) hamsters. AB - Calmodulin levels have been assessed in whole muscle and primary culture extracts in order to examine the relationship between calmodulin and the accumulation of calcium in dystrophic hamster muscle tissues. Significant decreases in both normal and dystrophic skeletal muscle, tongue, and heart calmodulin levels were observed between 2 and 12 weeks of age. Dystrophic values, however, tended to be somewhat higher than normal, especially in 12-week-old skeletal muscle total and soluble extracts (normal 29.7 and 0.6 and dystrophic 117.0 and 3.1 micrograms/g wet weight, respectively). No significant differences were observed in dystrophic myoblast (total 2.22-2.78, soluble 2.85-3.26 micrograms/mg protein) or fibroblast (total 2.64-2.94, soluble 2.54-3.60 micrograms/mg protein) calmodulin levels, except for a significant decrease in dystrophic fibroblast levels (total 1.97, soluble 2.18 micrograms/mg protein) at 7 days in culture. Elevated calmodulin levels in dystrophic muscle are discussed in terms of increases in intracellular Ca2+ concentrations and immature regenerating fibers. PMID- 3561441 TI - Dantrolene sodium is able to reduce the resting ionic [Ca2+]i in muscle from humans with malignant hyperthermia. AB - Malignant hyperthermia (MH) is a hereditary myopathy, triggered when susceptible patients are exposed to a depolarizing muscle relaxant and/or potent volatile anesthetics. We have studied the effects of dantrolene on the free [Ca2+]i of intercostal muscle biopsies obtained from two MH-susceptible patients before and after administration of dantrolene orally (2.5 mg/kg for 3 days) and intravenously (1.0 mg/kg 2 hours before the biopsy). The free [Ca2+]i was measured by Ca2+-selective microelectrodes. The mean resting free [Ca2+]i in the MH-susceptible muscle before dantrolene treatment was 0.42 +/- 0.01 microM (mean +/- SEM, n = 12). The administration of dantrolene reduced this value to 0.27 +/- 0.01 microM (n = 14). There was no detectable difference in the resting membrane potential after dantrolene. These results represent the first direct demonstration that dantrolene is able to reduce the resting free [Ca2+]i in skeletal muscle of MH-susceptible patients. PMID- 3561442 TI - Remarkable resistance of the nerve to ischemia. PMID- 3561443 TI - Fiber types in and around fascicles. PMID- 3561445 TI - Demyelination in vivo by Guillain-Barre syndrome and other human serum. AB - Serum from patients with acute inflammatory polyneuropathy (the Guillain-Barre syndrome, GBS) demyelinates peripheral nerves in vivo more intensely than control human serum. To clarify the processes leading to demyelination we injected rat sciatic nerves with serum from GBS and control subjects in the presence of complement and examined the sequential morphologic changes over 7 days. One day after injection, five of six GBS sera but none of seven control sera caused vesicular demyelination; 3-5 days after injection both GBS and control sera produced macrophage-mediated demyelination. These observations suggest that GBS serum can initiate acute myelin injury through a humoral mechanism that is disease associated. This response appears to be distinct from delayed cell mediated serum-induced demyelination that is not disease specific. PMID- 3561446 TI - [Comparison of the release of active substances from antimycotic ointments on isolated pig skin and lipid agar]. PMID- 3561444 TI - The time course of creatine kinase elevation following concentric needle EMG. AB - The electromyographic (EMG) exam and creatine kinase (CK) are commonly used to evaluate patients with neuromuscular diseases. Prior studies have demonstrated minimal elevation of CK following monopolar needle examination, indicating that a false positive elevation does not occur in normal individuals. We studied the magnitude and time course of CK change resulting from concentric (CNEMG) and monopolar (MNEMG) needle EMG examination on healthy volunteers. CK increased in all subjects following CNEMG and MNEMG. Statistically significant mean CK elevations over baseline were observed at 4, 8, 12, and 24 hours for CNEMG and at 12 and 24 hours for MNEMG. Maximum elevation occurred at 12 and 24 hours for both CNEMG (mean, 178% of baseline) and MNEMG (mean, 134% of baseline). CK returned to baseline by 48 to 72 hours. In 25-30% of subjects CK elevation significantly exceeded the normal range. The magnitude of CK elevation is greater and the time course more prolonged than previously reported. CK measurements should be avoided 4 to 48 hours following CNEMG because of the potential for false positive results. Measurements immediately after and at 72 hours are not affected by the CNEMG or MNEMG. The time course for CK change following MNEMG is similar to CNEMG, but the magnitude is less. PMID- 3561447 TI - Funding subspecialty training for clinical investigators. PMID- 3561448 TI - Apartheid and the academic boycott of South Africa. PMID- 3561449 TI - Sexually transmitted diseases in victims of sexual assault. PMID- 3561450 TI - Suprofen-induced transient flank pain and renal failure. PMID- 3561451 TI - Hemophilia in a girl. PMID- 3561452 TI - Informed consent by proxy. PMID- 3561453 TI - Doctor-patient relationships in new health care systems. PMID- 3561454 TI - Prenatal diagnosis and detection of carriers with DNA probes in Duchenne's muscular dystrophy. AB - We performed genetic analyses for the prenatal diagnosis of Duchenne's muscular dystrophy and detection of the carrier state in five families with seven pregnancies at risk for the disease. As genetic markers for the disorder, we used DNA-sequence polymorphisms detected with 12 different DNA probes derived from the vicinity of the Duchenne's muscular dystrophy locus or from within the gene, on the X chromosome. One male fetus of a proved carrier mother was predicted to be unaffected, and this was confirmed after birth. Another male fetus was predicted to be unaffected (probability, 95 percent or greater), although a crossover event had been identified in a region of the X chromosome thought to be distal to the Duchenne gene. Unfortunately, an elevated serum creatine kinase level after birth indicated that the infant had inherited the Duchenne mutation. Three male fetuses predicted to be affected with 66 percent or 95 percent probabilities were aborted, and the presence of the DNA-marker alleles was confirmed in fetal tissues. In one family, in which the maternal grandparents were unavailable, the initial genetic interpretation had to be revised after a second male fetus was analyzed with intragenic probes. Our experience suggests that despite the large number of intragenic and flanking DNA polymorphisms available, uncertainties often remain in the prenatal diagnosis of Duchenne's muscular dystrophy. Pitfalls are presented by the large size of the region in which Duchenne's mutations can occur. Crossover events in this region, which result in an exchange of DNA between two X chromosomes, can render DNA-marker studies inaccurate. Also, an autosomal recessive mutation can produce the same clinical picture. PMID- 3561455 TI - An outbreak of thyrotoxicosis caused by the consumption of bovine thyroid gland in ground beef. AB - We report an outbreak of thyrotoxicosis without true hyperthyroidism that occurred between April 1984 and August 1985 among residents of southwestern Minnesota and adjacent areas of South Dakota and Iowa. One hundred twenty-one cases were identified through surveillance of medical clinics, laboratories, hospitals, and physicians' offices. Investigation of the outbreak demonstrated an association between the occurrence of thyrotoxicosis and the consumption of ground beef prepared from neck trimmings processed by a single slaughtering plant (odds ratio, 19.0; P = 0.0001). The cause was confirmed by the findings of bovine thyroid tissue in samples of these trimmings and high concentrations of thyroid hormone in implicated samples of ground beef and the demonstration of prompt increases in serum thyroid hormone concentrations in volunteers who ate the implicated ground beef. Bovine thyroid tissue had been introduced into the neck trimmings inadvertently during the process of "gullet trimming," a procedure that harvests muscles from the bovine larynx. The outbreak resolved after this procedure was discontinued at the plant. The clinical features of the illness suggested the diagnosis of silent thyroiditis, and it is possible that sporadic cases--or even outbreaks--of thyrotoxicosis factitia caused by this mechanism may have occurred in the past but were not recognized. PMID- 3561456 TI - Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development. AB - In a prospective cohort study of 249 children from birth to two years of age, we assessed the relation between prenatal and postnatal lead exposure and early cognitive development. On the basis of lead levels in umbilical-cord blood, children were assigned to one of three prenatal-exposure groups: low (less than 3 micrograms per deciliter), medium (6 to 7 micrograms per deciliter), or high (greater than or equal to 10 micrograms per deciliter). Development was assessed semiannually, beginning at the age of six months, with use of the Mental Development Index of the Bayley Scales of Infant Development (mean +/- SD, 100 +/ 16). Capillary-blood samples obtained at the same times provided measures of postnatal lead exposure. Regression methods for longitudinal data were used to evaluate the association between infants' lead levels and their development scores after adjustment for potential confounders. At all ages, infants in the high-prenatal-exposure group scored lower than infants in the other two groups. The estimated difference between the overall performance of the low-exposure and high-exposure groups was 4.8 points (95 percent confidence interval, 2.3 to 7.3). Between the medium- and high-exposure groups, the estimated difference was 3.8 points (95 percent confidence interval, 1.3 to 6.3). Scores were not related to infants' postnatal blood lead levels. It appears that the fetus may be adversely affected at blood lead concentrations well below 25 micrograms per deciliter, the level currently defined by the Centers for Disease Control as the highest acceptable level for young children. PMID- 3561457 TI - Benzene and leukemia. An epidemiologic risk assessment. AB - To assess quantitatively the association between benzene exposure and leukemia, we examined the mortality rate of a cohort with occupational exposure to benzene. Cumulative exposure for each cohort member was estimated from historical air sampling data and, when no sampling data existed, from interpolation on the basis of existing data. The overall standardized mortality ratio (a measure of relative risk multiplied by 100) for leukemia was 337 (95 percent confidence interval, 154 to 641), and that for multiple myeloma was 409 (95 percent confidence interval, 110 to 1047). With stratification according to levels of cumulative exposure, the standardized mortality ratios for leukemia increased from 109 to 322, 1186, and 6637 with increases in cumulative benzene exposure from less than 40 parts per million-years (ppm-years), to 40 to 199, 200 to 399, and 400 or more, respectively. A cumulative benzene exposure of 400 ppm-years is equivalent to a mean annual exposure of 10 ppm over a 40-year working lifetime; 10 ppm is the currently enforceable standard in the United States for occupational exposure to benzene. To examine the shape of the exposure-response relation, we performed a conditional logistic-regression analysis, in which 10 controls were matched to each cohort member with leukemia. From this model, it can be calculated that protection from benzene-induced leukemia would increase exponentially with any reduction in the permissible exposure limit. PMID- 3561458 TI - The types of renal disease in the acquired immunodeficiency syndrome. AB - Between January 1982 and December 1986, among the 750 patients with the acquired immunodeficiency syndrome (AIDS) who were treated at two adjacent hospitals in New York City, 78 (10.4 percent) needed evaluation for renal disorders. Reversible acute renal failure due to nephrotoxic injury, ischemic injury, or both was present in 23 patients (30 percent) (Group I). The remaining 55 (70 percent) had massive proteinuria, azotemia, or both (AIDS-associated nephropathy; Group II), and irreversible uremia developed in 43. In an additional 18 patients, all of whom had a history of intravenous narcotic drug use, AIDS was diagnosed after the initiation of maintenance hemodialysis for chronic renal failure (Group III). Survival for more than six months after the onset of chronic uremia occurred in only two subjects in Group II; all patients in Group III died within three months of the diagnosis of AIDS. Death in the patients in Groups II and III followed a syndrome of "failure to thrive" characterized by inanition unresponsive to intensive nutritional support and hemodialysis. In contrast, 8 of 17 patients with acute renal failure (Group I) and a serum creatinine concentration above 6 mg per deciliter regained renal function (serum creatinine level, less than 2.0 mg per deciliter). Four of the seven lived for 10 to 24 months, whereas the other four died of sepsis within a month. Our observations suggest that maintenance hemodialysis is not effective in prolonging life either in patients with AIDS-associated nephropathy and uremia or in patients with end stage renal failure in whom AIDS develops during the course of maintenance dialysis. Hemodialysis may be useful in the management of potentially reversible acute renal failure in patients with AIDS. PMID- 3561460 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 17-1987. A 38-year-old woman with a history of radiation treatment for a malignant tumor in the right hemithorax and persistent chest pain and pleural abnormality. PMID- 3561461 TI - New scientific evidence and public health imperatives. PMID- 3561459 TI - Diabetes insipidus in pregnancy associated with abnormally high circulating vasopressinase activity. PMID- 3561462 TI - Outcome in patients with asymptomatic neck bruits. PMID- 3561463 TI - Control of asthma by aerosols. PMID- 3561464 TI - Iron sepsis: Yersinia enterocolitica septicemia possibly caused by an overdose of iron. PMID- 3561465 TI - False negative results in patients with fra(X) (q) mental retardation taking oral vitamin supplements. PMID- 3561467 TI - Overseas medical graduates in the United Kingdom. PMID- 3561466 TI - Teratogens and "litogens". PMID- 3561468 TI - Psychiatric consultation in professional football. PMID- 3561469 TI - Fungi in bathwater and sludge of bathroom drainpipes. 1. Frequent isolation of Exophiala species. AB - Samples of bathwater from 14 homes and 22 public bathhouses and sludge in drainpipes from 19 household bathrooms were plated out onto potato dextrose agar supplemented with chloramphenicol. Several media were used to study colony morphology of the isolates and the thermotolerance and alkaline tolerance of each isolate were examined. Eleven sludge samples produced 12 isolates of Exophiala jeanselmei, 2 of E. dermatitidis and 1 of E. moniliae. Five household bathwater samples produced 2 isolates of E. jeanselmei, 4 of E. dermatitidis and 1 of E. alcalophila. One isolate of E. jeanselmei, 2 of E. dermatitidis, 3 of E. moniliae and 2 of unidentified Exophiala species were recovered from 6 samples of the bathwater dissolving 'Chinese medicine' in the bathtubs of public bathhouses. One isolate of E. jeanselmei was recovered from the 15 samples of bathwater from public bathhouses. Bathwater and sludge in bathroom drainpipes may be an important habitat of Exophiala species. PMID- 3561470 TI - The role of fractions from Paracoccidioides brasiliensis in the genesis of inflammatory response. AB - The influx of inflammatory cells towards the peritoneal cavity in rats inoculated intraperitoneally with subcellular preparations of the fungus Paracoccidioides brasiliensis was studied. In addition to the dead fungus, also fractions F1 of the cell wall, which mainly consisted of polysaccharides and the lipid extract, induced intense cell migration 4 hr after inoculation, with a greatly increased number of polymorphonuclear leucocytes (PMN). Study of the kinetics of cell influx showed that both fraction F1 and the lipid extract initially induced intense PMN migration between the 4th and 24th hr after inoculation of these agents, followed by migration of mononuclear cells (MN) around the 48th hr. We also observed that migration of these cells increased gradually after inoculation of growing doses of fraction F1. The present data suggest that polysaccharides and lipids isolated from P. brasiliensis may participate in the initial phase of the inflammatory response in paracoccidioidomycosis. PMID- 3561472 TI - Description of a case of rhinosporidiosis in Spain. AB - Rhinosporidiosis is reviewed, and the first autochthonous case in Spain is presented (site: in the nasal cavity of a 19-year-old male from a rural background). Diagnosis was established morphologically after eliminating the possibilities of Cryptococcus neoformans, Coccidioides immitis, and Chrysosporium crescens. Clinico-pathological features are described. Preparations were stained with hematoxylin-eosin, PAS, and methenamine silver, and studied for fluorescence. Certain aspects of the epidemiology and diagnosis are commented upon. PMID- 3561473 TI - AIDS institute for India? PMID- 3561471 TI - Acute toxicity of sterigmatocystin to chicks. AB - Four experiments were carried out with 10 to 12 day old leghorn chicks weighing approximately 93 to 101 g. The chicks were injected intraperitoneally with sterigmatocystin (STG) dissolved in olive oil. The LD50 values as established in the first two experiments were 10.0 and 14.0 mg/kg body weight with most of the deaths occurring between 9 and 21 h following injection. Histopathological studies demonstrated that there was hemorrhage, foci of degeneration and necrosis with fibroblastic proliferation in sinusoids of the liver while the kidneys showed tubular degeneration and necrosis. Biochemical analysis of blood sera demonstrated that STG caused a marked elevation in the activities of lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase, and a depression of creatine kinase, but no effects on gamma-glutamyl transferase, amylase and lipase. Free and conjugated bilirubin were elevated in the sera while total protein, albumin, glucose, potassium, chloride and phosphorous concentrations were depressed. In addition, total white blood cells and circulating agranulocytes were depressed while circulating granulocytes were elevated. STG did not significantly affect the concentration of uric acid, cholesterol, triglycerides, calcium, magnesium and sodium in blood. PMID- 3561474 TI - India seeks scientific basis of traditional remedies. PMID- 3561475 TI - Japanese plans to sequence human genome. PMID- 3561476 TI - Eukaryotes with no mitochondria. PMID- 3561477 TI - Antibody-antigen flexibility. PMID- 3561478 TI - Electroreceptors in the platypus. AB - It has been known since the last century that the bill of the platypus contains densely packed arrays of specialized receptor organs and their afferent nerves. Until recently these were thought to be largely mechanoreceptive in function. However Scheich et al. provide both behavioural and electrophysiological evidence that there are electroreceptors in the bill of the platypus. These authors were able to record evoked potentials from the somatosensory cortex of the brain in response to weak voltage pulses applied across the bill. Behavioural observations showed that a platypus could detect weak electric dipoles and it was suggested the animal was able to locate moving prey by the electrical activity associated with muscle contractions. From these observations, and in view of the fact that it was known that the bill contained gland receptors which in several respects resembled the ampullary electroreceptors in fresh-water fish, Scheich et al. concluded that the receptor array of the platypus bill included electroreceptors. In this report we present direct electrophysiological evidence for the existence of such receptors. PMID- 3561480 TI - High-speed countercurrent chromatography. AB - Support-free high-speed countercurrent liquid chromatography provides a rich domain of applications, some beyond reach of conventional liquid chromatography. PMID- 3561479 TI - Influence of parental chromosomes on spatial specificity in androgenetic--- parthenogenetic chimaeras in the mouse. AB - The presence of both parental genomes is essential for development to term in the mouse embryo probably because of germline-specific modifications of homologous chromosomes. Neither androgenetic nor parthenogenetic embryos can by themselves develop to term; any post-implantation embryos they produce have opposite phenotypes, which reflects the presence of complementary information in parental chromosomes. The development of androgenetic----parthenogenetic chimaeras is of considerable interest because in this case both parental chromosomes are available even though they are in separate cells. We demonstrate here that in post-implantation chimaeric fetuses, the expression of parental information results in spatial specificity so that parthenogenetic cells are confined to the embryo but the trophoblast consists almost entirely of androgenetic cells. The yolk sac contains both cell types. However, there is incomplete functional complementation because the chimaeras do not reach term. Although failure to reach term may occur partly because of inadequate intermingling and interactions between embryonic cells, it is more likely that further control of mouse development depends on the presence of both sets of chromosomes within the same cells. PMID- 3561481 TI - Human genome sequencing plan wins unanimous approval in US. PMID- 3561482 TI - Evolution: sex determination in fish. PMID- 3561483 TI - Developmental genetics: mechanisms of differentiation. PMID- 3561484 TI - Cytoskeleton: role of fodrin in secretion. PMID- 3561485 TI - How many Chernobyl fatalities? PMID- 3561486 TI - Differentiated parental DNA strands confer developmental asymmetry on daughter cells in fission yeast. AB - The two strands of the DNA molecule are complementary but not identical. Hence, upon semiconservative replication, different parental DNA strands are segregated to daughter cells. A molecular analysis suggests that the process of fission yeast mating-type interconversion uses asymmetry of the DNA strands to generate a regular lineage of cellular differentiation. PMID- 3561487 TI - Adaptive variation in environmental and genetic sex determination in a fish. AB - Two general mechanisms of sex determination have been identified among gonochoristic vertebrates: environmental sex determination where offspring become male or female in response to an environmental factor(s) during development (for example, some fishes and reptiles); and genetic sex determination where sex is determined by genotype at conception (as in birds and mammals). How do these sex determining systems evolve? Direct evidence is virtually non-existent because the sex-determining systems of most species appear to have little genetic variation. Here we provide the first evidence of adaptive variation in environmental and genetic sex determination within a species. We show that in a fish with temperature-dependent sex determination, populations at different latitudes compensate for differences in thermal environment and seasonality by adjusting the response of sex ratio to temperature, and by altering the level of environmental as opposed to genetic control. The adjustments observed are precisely those predicted by adaptive sex ratio theory. PMID- 3561488 TI - Anti-alpha-fodrin inhibits secretion from permeabilized chromaffin cells. AB - Chromaffin cells release catecholamine- and peptide-containing granules by exocytosis, by a mechanism involving movement of secretory granules towards the cell membrane, their apposition to it and the fusion of the granule membrane with the plasma membrane. One of the two subunits of membrane-associated brain spectrin, alpha-fodrin is an actin-binding protein which is found at the periphery of chromaffin cells and may be involved in secretion. Because cultured chromaffin cells can be permeabilized with detergents, giving pores large enough to permit the entry of immunoglobulin molecules, we used permeabilized cells to test the effect of specific antibodies on secretory mechanisms. Incubation of permeabilized cells with polyclonal immunoaffinity-purified monospecific anti alpha-fodrin antibody or its Fab fragments did not modify basal release but did specifically inhibit Ca2+-induced catecholamine release by exocytosis. Our observations indicate that fodrin and the cytoskeleton participate in the release mechanism. PMID- 3561489 TI - Modulation of c-fos gene transcription by negative and positive cellular factors. AB - Regulation of transcription in eukaryotes is mediated by the specific interaction between cellular factors and promoter sequences. Cis-acting DNA sequences, frequently located upstream of the TATA box, have been implicated in modulating the expression of many genes. We are interested in the transcriptional regulation of proto-oncogenes because they may have a pivotal function in cell growth and differentiation. Expression of the proto-oncogene c-fos is induced in response to a variety of growth factors and differentiation-specific agents. The viral cognate of the c-fos gene is the resident transforming gene of FBJ-murine osteosarcoma virus which causes bone tumours in vivo and cellular transformation in vitro. We report here that transcription of the human c-fos gene is modulated by negatively and positively acting cellular factors. PMID- 3561490 TI - Cloning and sequencing of a cDNA for a ligninase from Phanerochaete chrysosporium. AB - Lignin is a complex polymer of phenylpropanoid subunits. It is an essential component of woody tissue, to which it imparts structural rigidity. Lignin is remarkably resistant to degradation by most microbes; nevertheless, a few species of white-rot fungi are able to catalyse its oxidation to CO2. Its biodegradation is of great ecological significance because, next to cellulose, lignin is the most abundant renewable polymer on Earth. The first step in lignin degradation is depolymerization, catalysed by the lignin peroxidase isozymes (ligninases). These isozymes are secreted, along with hydrogen peroxide (H2O2) by the fungus Phanerochaete chrysosporium Burds, under conditions of nutrient (nitrogen) limitation. Ligninases are not only important in lignin biodegradation, but are also potentially valuable in chemical waste disposal because of their ability to degrade environmental pollutants. We have undertaken the cloning of the ligninase genes to understand further their regulation and enzymology. We report here the isolation and characterization of a ligninase complementary DNA clone with a full length insert. The cDNA sequence shows that the sequence of the mature ligninase is preceded by a 28-residue leader, and the mature protein is predicted to have a relative molecular mass of 37,000 (Mr 37K). Consistent with the classification of ligninase as a peroxidase certain residues thought to be essential for peroxidase activity can be identified and near these residues the ligninase shows homology with other known peroxidases. Our cDNA clone has also allowed us to show that expression of ligninase is regulated at the messenger RNA level. PMID- 3561491 TI - Judge confirms injunction in sandwich assay patent suit. PMID- 3561492 TI - German AIDS registration row. PMID- 3561493 TI - OTA gives Congress options on cell-line donor ownership. PMID- 3561494 TI - US experimental drug rule change may help biotechnology. PMID- 3561495 TI - Confining AIDS. PMID- 3561496 TI - Protein structure. Stability of alpha-helices. PMID- 3561497 TI - Physics and the riddle of life. PMID- 3561498 TI - Tests of the helix dipole model for stabilization of alpha-helices. AB - Charged groups play a critical role in the stability of the helix formed by the isolated C-peptide (residues 1-13 of ribonuclease A) in aqueous solution. One charged-group effect may arise from interactions between charged residues at either end of the helix and the helix dipole. We report here that studies of C peptide analogues support the helix dipole model, and provide further evidence for the importance of electrostatic interactions not included in the Zimm-Bragg model for alpha-helix formation. PMID- 3561499 TI - Spontaneous and evoked activity of fetal primary afferents in vivo. AB - The first movements of the fetus are apparently random and spontaneous. Their onset coincides with the growth of dorsal root afferents into the spinal cord and it is possible that they are not simply a result of spontaneous motoneuron activity but are reflex responses to sensory stimulation. It is not clear what stimuli could normally evoke such reflexes because nothing is known of the properties of primary afferent neurons in the fetus. I have investigated this by making recordings from single dorsal root ganglion cells in fetal rats in vivo. The afferents have small, defined receptive fields and respond to mechanical stimulation of skin or muscle at intensities that might occur in utero. Many of them are also chemosensitive. Unlike postnatal afferents they display background activity which peaks at the same age as fetal movements. Repeated stimulation causes long-lasting increases of both background and evoked activity. Such sensory input is likely to have a considerable influence on fetal movements and on the development of spinal cord connections. PMID- 3561500 TI - A clue to the basic defect in cystic fibrosis from cloning the CF antigen gene. AB - The metabolic basis of the autosomal recessive disease cystic fibrosis (CF) remains unidentified. Elevated levels of a serum protein in CF homozygotes and obligate heterozygotes have been described. As heterozygotes are clinically unaffected, any consistently observed abnormality in these individuals is a likely pointer to the aetiology of the disease. The gene for this serum protein, called cystic fibrosis (CF) antigen, has been mapped to chromosome 1. It is not the gene that is mutant in CF because this has since been assigned to chromosome 7 by cosegregation of the disease with closely linked DNA markers in CF families. CF antigen is a product of normal and leukaemic granulocytes and is inducible in the promyelocytic cell line HL60 (M.N., J.D., C. Hayward, F. Northrop, D.J.H.B., J. Walker, V. van H. and D.S.S., manuscript in preparation). We have isolated cDNA clones for this protein from a library constructed with messenger RNA from chronic myeloid leukaemia (CML) cells. The complete nucleotide sequence was obtained from the cDNA clone and by primer extension of mRNA. We have confirmed that the gene encoding CF antigen is on chromosome 1 and have localized it to a particular region. RNA blot analysis shows a 550-bp major transcript in CML cells and in induced HL60. The amino-acid sequence predicted from the nucleotide sequence shows significant homology with intestinal and brain calcium-binding proteins. Abnormal accumulation of such a protein in CF is a clue which must be pursued now that evidence is gathering that the basic defect in CF is in pathways controlling chloride channel activity. PMID- 3561501 TI - The enzyme lactate dehydrogenase as a structural protein in avian and crocodilian lenses. AB - The major components of mammalian lenses are tissue-specific, soluble proteins, the alpha-, beta- and gamma-crystallins. The lenses of other vertebrate classes often contain other major proteins, notably delta-crystallin in birds and reptiles. A fourth distinct type, described as epsilon-crystallin, is prominent in many bird and crocodile lenses. Here we show that epsilon-crystallin is an active glycolytic enzyme, lactate dehydrogenase (LDH) (EC 1.1.1.27) and that duck epsilon-crystallin appears to be identical to duck LDH-B4. LDH is a normal metabolic component in other lenses, but in duck is present in amounts far exceeding the requirements of any likely catalytic role. It appears that an active enzyme has been recruited, unchanged, to an extra role as a structural protein in the lens without gene duplication and sequence divergence. This surprising discovery raises the possibility that other crystallins may similarly be enzymes expressed at high levels in lens as structural proteins. PMID- 3561503 TI - AIDS caused by a slow virus. PMID- 3561502 TI - Structure and evolution of ricin B chain. AB - Ricin is a dimeric toxin from the castor bean Ricinus communis, which is composed of a sugar-binding subunit (B) that attaches to receptors on the surfaces of target cells and a subunit (A) with enzymatic activity that attacks and inactivates ribosomes. We report here that comparison of amino-acid sequence data with high-resolution structure analysis of the ricin B subunit shows it to be the product of a series of gene duplications. The modern protein has two sugar binding domains, each of which is composed of three copies of a more ancient galactose-binding peptide of about 40 residues. PMID- 3561504 TI - Rabies experiment. PMID- 3561505 TI - Soviet AIDS. PMID- 3561506 TI - Vertebrate palaeontology: Long night for owl monkeys. PMID- 3561508 TI - Body temperature and heat and water balance. PMID- 3561507 TI - Globin gene gains credentials. PMID- 3561509 TI - Quantitative receptor autoradiography. PMID- 3561510 TI - An analogue approach to the travelling salesman problem using an elastic net method. AB - The travelling salesman problem is a classical problem in the field of combinatorial optimization, concerned with efficient methods for maximizing or minimizing a function of many independent variables. Given the positions of N cities, which in the simplest case lie in the plane, what is the shortest closed tour in which each city can be visited once? We describe how a parallel analogue algorithm, derived from a formal model for the establishment of topographically ordered projections in the brain, can be applied to the travelling salesman problem. Using an iterative procedure, a circular closed path is gradually elongated non-uniformly until it eventually passes sufficiently near to all the cities to define a tour. This produces shorter tour lengths than another recent parallel analogue algorithm, scales well with the size of the problem, and is naturally extendable to a large class of optimization problems involving topographic mappings between geometrical structures. PMID- 3561511 TI - A fossil owl monkey from La Venta, Colombia. AB - Knowledge of the evolutionary history of living New World anthropoids is limited by a relatively poor fossil record. The discovery in 1986 of a new fossil monkey from the middle Miocene deposits of La Venta, Colombia, 12-15 million years ago (Myr BP), is the first example of a living New World monkey genus appearing in Tertiary rocks. Including anatomical evidence of the dentition and facial skull, it provides an unambiguous link between a Neogene fossil and the owl monkey, Aotus, the only modern crepuscular-nocturnal anthropoid primate. This new form brings to three the number of La Venta fossil monkeys which preserve excellent dentitions sharing extensive similarities with modern genera. All of these species are potentially ancestral to their extant relatives. The La Ventan Aotus is additional support for the idea that the modern platyrrhine radiation includes long-lived genera or generic lineages, some of which may be traceable to the early Miocene, 20 Myr BP. PMID- 3561512 TI - Early experience of tactile stimulation influences organization of somatic sensory cortex. AB - Visual experience is essential for the establishment of the cerebral cortical circuitry that allows normal binocular vision. For example, the pattern of right eye, left-eye dominance columns is permanently altered by simply closing an eye of a young primate. A critical issue is whether environmental factors also influence the development of other cortical sensory areas. In the present experiments we manipulated the tactile experience of young rats by depriving them of the sensory information that is normally provided by their large facial whiskers. Electrophysiological analyses showed that simply trimming the whiskers from the day of birth results in pronounced abnormalities in the response properties of single neurons in the adult somatic sensory cortex. Thus functional plasticity in response to early experience appears to be a fundamental aspect of cortical development. PMID- 3561513 TI - Evidence that the recently discovered theta 1-globin gene is functional in higher primates. AB - A new subfamily of the alpha-globin-like family has recently been identified in higher primates, rabbit, galago and possibly the horse. One member of this subfamily, theta 1, is downstream from the adult alpha 1-globin gene. In orang utan, but not in rabbit or galago, the theta 1-gene appears to be structurally intact, suggesting that it may be functional in this species. The orang-utan theta 1-gene possesses initiation and termination codons, and the predicted polypeptide differs from the orang-utan alpha 1-globin by 55 amino acids. The upstream promoter boxes CCAAT and ATA are present, although approximately 150 base pairs (bp) farther upstream than in the alpha 1-gene. This structural difference in the promoter between the orang-utan theta 1- and alpha 1-genes has led Proudfoot to speculate that the theta 1-gene may be inactive. We have now cloned the theta 1- and alpha 1-globin genes from the olive baboon, and have compared their sequences with those of orang-utan. The unique promoter structure of the orang-utan theta 1-gene is highly conserved in baboon, although the orang utan and baboon diverged nearly 30 million years ago. The coding sequences of the two theta 1-genes differ by only 6.3% with 22 out of 27 nucleotide substitutions being codon third position silent changes. These data support the view that the theta 1-gene has been functional in the baboon, orang-utan, and by implication, in man. We also estimate that the duplication event generating the theta 1- and alpha-globin-like subfamilies may have occurred as much as 260 million years ago. PMID- 3561514 TI - Estimation of wedge components in curved DNA. AB - There are growing indications that the inherent curvature of DNA is important in protein-DNA recognition. The 10.5-base-pair (bp) periodicity of some dinucleotides first found in eukaryotic DNA sequences was interpreted as the expression of curvature of periodic segments of double-stranded DNA, the curvature resulting from co-orientation of periodically spaced 'wedges' between stacked base pairs. The wedge can be decomposed into roll and tilt components, opening towards a groove and a backbone respectively, both contributing to DNA curvature. The largest wedge was estimated to belong to the AA-TT dinucleotides. Recent work provided new experimental data on synthetic curved DNA. The authors tried to apply the wedge model to their results and met problems in doing so. We have found that taking into account both roll and tilt components of the AA-TT wedge, in the correct ratio, leads to remarkable consistency between the wedge model and the data. PMID- 3561515 TI - [Genetic effects of low doses of radiation]. AB - There are several approaches to evaluate the genetic effects of low doses of ionizing radiation in a human population. Based on experiments on mice using high doses, the genetic risk for humans has to be derived by extrapolation to low doses, assuming mouse and man respond in a similar way. Microdosimetric considerations indicate a linear relationship; studies on the molecular mechanism of radiation-induced mutagenesis lead to the conclusion that, in addition to a constitutive mutagenic process, an inducible compound exists which may cause linear-quadratic dose-effect curves. Linear extrapolation seems thus to be justified; however, the genetic risk of low doses may be slightly overestimated. PMID- 3561516 TI - [The structure of eukaryotic chromosomes]. AB - Recent models for the organization of the chromosomes of eukaryotes in mitosis and interphase are discussed with respect to their condensation hierarchy. Possible functional interpretations are indicated. At present, an alternating coiling and loop formation, induced by histones and nonhistone proteins, respectively, appears to be the most probable structure. The relationship of DNA properties to chromatin structure and function is also briefly discussed. PMID- 3561517 TI - Membrane lectins in human malignant melanoma. PMID- 3561518 TI - Effects of an earth-strength magnetic field on pineal melatonin synthesis in pigeons. PMID- 3561519 TI - Magnetic-field-induced skin-temperature changes of animals originate from modified air convection. PMID- 3561520 TI - Auditory evoked potentials indicate the loss of neuronal oscillations during general anaesthesia. PMID- 3561521 TI - Sex and parental experience determine the onset of an instinctive behavior in mice. PMID- 3561522 TI - Bioinorganic chemistry. Inorganic chemistry in a perspective of biology, medicine and the environment. AB - A brief overview of recent developments in the area of bioinorganic chemistry is presented. After a description of the field and the relationships with other disciplines, a short presentation of the historical developments in the field are discussed. The main part of the paper deals with a discussion of the current highlights and the applications of bioinorganic principles in other fields. At the end an expectation is presented of future developments. PMID- 3561523 TI - Pigeon homing. Olfactory experiments with inexperienced birds. PMID- 3561524 TI - A distinct ultrasound-processing area in the auditory cortex of the mouse. PMID- 3561525 TI - The effects on Schild regressions of antagonist removal from the receptor compartment by a saturable process. AB - A theoretical model of the effects of a saturable removal mechanism for an antagonist diffusing into the receptor compartment of a tissue is used to calculate expected deviations in Schild regressions. At concentrations of antagonist which do not saturate the removal mechanism, there can be a deficit of antagonist in the receptor compartment as compared to the concentration of antagonist bathing the tissue. This results in a shift to the right of the Schild regression and a corresponding underestimation of antagonist potency. The model predicts that as the concentration of antagonist exceeds the Km for removal (saturation of the removal process), this concentration deficit is eliminated, resulting in a proportionate increase in antagonist concentration at the receptor and a concomitant increase in receptor antagonism. This results in a steepening of the Schild regression; the slope in the region of saturation is greater than one. Experimental evidence in support of this model was found in studies of the antagonism of responses to bethanechol by atropine in rabbit ileum; this species is known to have an atropinesterase capable of hydrolyzing atropine. The Schild regression for atropine was curvilinear with an overall slope of 1.42 (1.34-1.5) and pKB = 8.5 (8.36-8.8); in the ileum from guinea pigs, a species which does not possess this enzyme, the Schild regression for atropine was linear, had a slope not significantly different from unity (1.1; 0.95-1.2) and a pKb of 9.0 (8.9 9.2). The slope of the regression in rabbit ileum was corrected to unity by the addition of an excess concentration of methylbutyrate, an alternate substrate for atropinesterase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561526 TI - Effects of extraneuronal uptake inhibitors on the positive chronotropic response to isoprenaline and on the accumulation of isoprenaline in perfused rat heart after inhibition of catechol-O-methyl transferase. AB - Experiments were carried out in isolated perfused rat hearts. The presence of tropolone (100 mumol/l), an inhibitor of catechol-O-methyl transferase (COMT), significantly potentiated the positive chronotropic response to isoprenaline (0.1, 1, 3 and 10 nmol/l). Two uptake2 inhibitors, 3-O-methylisoprenaline (100 mumol/l) and normetanephrine (100 mumol/l), induced a positive chronotropic response, but corticosterone (100 mumol/l) and hydrocortisone (100 mumol/l) had no such effect. 3-O-methylisoprenaline (100 mumol/l) and normetanephrine (100 mumol/l) enhanced the positive chronotropic response to isoprenaline (0.1, 1, 3 and 10 nmol/l). Corticosterone (100 mumol/l) potentiated the positive chronotropic response to isoprenaline (0.1 and 1 nmol/l). Hydrocortisone (30 mumol/l) enhanced the response to 0.1 nmol/l isoprenaline but did not affect the positive chronotropic responses to 1, 3 or 10 nmol/l isoprenaline. The addition of uptake2 inhibitors (3-O-methylisoprenaline, 100 mumol/l; normetanephrine, 100 mumol/l; corticosterone, 100 mumol/l) to the perfusion medium significantly reduced the positive chronotropic response to the perfusion with isoprenaline (3 nmol/l) and tropolone (100 mumol/l). The accumulation of 3H-isoprenaline in the heart perfused with 3H-isoprenaline (1, 10 and 100 nmol/l) was significantly increased by the presence of tropolone (100 mumol/l): the accumulation for 1, 10 and 100 nmol/l of 3H-isoprenaline was 5.07, 47.0 and 500 pmol/g, respectively. The high accumulation observed during perfusion with 3H-isoprenaline (3 nmol/l) and tropolone (100 mumol/l) was significantly decreased by the addition of an uptake2 inhibitor, 3-O-methylisoprenaline (100 mumol/l), normetanephrine (100 mumol/l) or corticosterone (100 mumol/l), but not by hydrocortisone (30 mumol/l).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561527 TI - Ventilatory effects of adenosine mediated by carotid body chemoreceptors in the rat. AB - The effects of intracarotid injections of adenosine and adenosine analogues [5'-N ethylcarboxamidoadenosine (NECA), 2-chloroadenosine (CADO), L-N6 phenylisopropyladenosine (L-PIA) and D-N6-phenylisopropyladenosine (D-PIA)] on ventilation were studied in rats anaesthetized with sodium pentobarbitone or urethane. Adenosine and its analogues increased in a dose-dependent manner respiratory ventilation determined as increases in tidal volume (VT), respiratory frequency (f) and minute volume (VE). These excitatory effects were abolished after section of the carotid sinus nerve. The order of potency of the adenosine analogues was NECA greater than CADO greater than D-PIA, L-PIA, and no marked stereoselectivity was found for the PIA isomers. The methylxanthine, theophylline, in a dose that did not modify respiratory ventilation, antagonized the excitatory action of CADO. An inhibitory, delayed and long-lasting effect of L-PIA on respiration was also observed after its intravenous administration, an effect which was not prevented by section of the carotid sinus nerves. It is concluded that adenosine can have both excitatory and inhibitory effects on ventilation, and that its excitatory effect mediated through carotid body chemoreceptors involves an A2 adenosine receptor. PMID- 3561528 TI - Effects of acute and chronic treatment with an atypical antidepressant drug, nomifensine, on the sleep-wake activity in rats. AB - After the chronic administration of saline, rats were treated with nomifensine (0.1 or 1.0 mg/kg, twice a day, at light and dark onset) for 11 days. The sleep wake activity was recorded for 24 h on the baseline day (saline), on nomifensine days 1, 5 and 11, and also on day 12, when saline was injected again (withdrawal day). Another group of rats was treated with saline throughout the experiment, without significant effect on the sleep-wake activity. The smaller dose of nomifensine increased non-REM sleep (NREMS) at the expense of wakefulness (W) in the light period. The effect persisted throughout the chronic treatment. A late increase in REM sleep (REMS) was noted on nomifensine days 5 and 11. Nomifensine failed to affect the sleep-wake activity in the dark period. On withdrawal, the baseline percentages of the vigilance states were recovered. As evaluated through spectral analysis of the EEG, the increase in NREMS was accompanied by an increase in slow wave activity. The higher dose of nomifensine elicited an increase in W and a reduction in both sleep states, followed by changes in W and NREMS in the opposite directions. These effects were evident in both the light and the dark periods of the day. Chronic treatment resulted in circadian variations in the effects. Withdrawal of the drug abolished the arousal reaction, but the late increase in NREMS persisted. The dose-dependent biphasic effects of nomifensine on sleep-wake activity can be explained by considering the proposed indirect dopamine and possibly noradrenaline agonist activity of the drug.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561529 TI - The role of descending inhibition in the antinociceptive effects of the pyrazolone derivatives, metamizol (dipyrone) and aminophenazone ("Pyramidon"). AB - The study was carried out to provide further evidence that the two pyrazolone derivatives, metamizol and aminophenazone, produce central antinociceptive effects by stimulating inhibition descending from the periaqueductal grey (PAG) to the spinal cord. Experiments were carried out on rats in which the tail-flick response to radiant heat, nociceptive activity in ascending axons of the spinal cord, and activity of neurones in the PAG and the substantia nigra were studied. Microinjection of procaine (10 micrograms) into the PAG reduced the tail-flick latency and abolished the increase in latency caused by i.p. injection of metamizol (40 mg/kg) and aminophenazone (150 mg/kg); it did not significantly reduce the antinociceptive effect of i.p. injection of morphine (2 mg/kg). Threshold doses of morphine (1 and 2 micrograms) administered by intrathecal (i.t.) injection potentiated the effect of threshold doses of metamizol injected i.p. (10 mg/kg) or into the PAG (10 micrograms) in the tail-flick test. Morphine (2 micrograms) injected i.t. potentiated the effect of i.v. injection of metamizol (80 mg/kg) on nociceptive activity in ascending axons by eliminating the stimulant effect of metamizol on about one third of the axons. Threshold doses of morphine injected i.t. failed to potentiate the antinociceptive effect of aminophenazone (50 mg/kg) injected i.p. in the tail-flick test. The results support the view that metamizol and aminophenazone activate pathways descending from the PAG and exerting an inhibitory effect on nociceptive impulse transmission at the spinal level. PMID- 3561530 TI - Effects of bile acids on ventricular muscle contraction and electrophysiological properties: studies in rat papillary muscle and isolated ventricular myocytes. AB - The effects of sodium salts of various bile acids on the contractile force and the electrophysiological properties of rat ventricular muscle were studied in vitro. Primary, conjugated, and secondary bile acids were studied in a concentration range of 10(-9)-10(-6) mol/l, which corresponds to concentrations found in the plasma of patients with cholestatic jaundice. In general, the bile acid induced a negative inotropic effect which was manifested as a reduction in active tension, maximum rate of tension activation, and maximum rate of tension relaxation. Twitch duration and time to peak tension were unaffected by the bile acids. The negative inotropism was associated with a reduction in ventricular action potential duration. Resting potential, action potential amplitude, and maximum upstroke velocity of phase 0 depolarization were unaffected. Voltage clamp experiments in rat ventricular myocytes demonstrated that sodium taurocholate decreased the slow inward current and slightly increased the outward potassium current. Hence, these effects on the membrane currents are probably responsible for the negative inotropic effect. PMID- 3561531 TI - Effects of some antianginal and vasodilating drugs on sodium influx and on the binding of 3H-batrachotoxinin-A 20-alpha-benzoate and 3H-tetracaine. AB - The effects of antianginal drugs, especially arylalkylamines and structurally related derivatives, on 3H-batrachotoxinin-A 20-alpha-benzoate (3H-BTX-B) binding and on 3H-tetracaine binding were studied on rat synaptosomal and heart membrane preparations. The effect of the same drugs on the Na+ influx induced by protoveratrine B was studied on the rat synaptosomal preparation. Antianginal drugs tested inhibited 3H-BTX-B binding in rat synaptosomes, arylalkylamine derivatives being the most potent: IC50 values were 27 nM for flunarizine, 32 nM for prenylamine, 79 nM for cinnarizine. Similarly, these drugs were the most potent when tested in cardiac membrane preparations. All the drugs tested were very weak inhibitors of 3H-tetracaine binding (IC50 ranging from 0.01 mM to more than 1 mM) except for guanabenz, which was more potent (IC50:0.3 microM on the synaptosomal preparation). The various drugs tested inhibited the 22Na+ influx induced by protoveratrine B, with IC50 values ranging from 15 microM (prenylamine) to 110 microM (verapamil), with the exception of nifedipine which had an IC50 of more than 0.1 mM. The inhibition of 22Na+ influx correlated well with the inhibition of 3H-BTX-B binding. These findings suggest that some antianginal drugs, especially the arylalkylamines may have, in addition to their calcium antagonist activity, direct effects on sodium channels. PMID- 3561532 TI - Closed rat jejunal segment in situ: role of pre-epithelial diffusion resistance (unstirred layer) in the absorption process and model analysis. AB - After intraluminal injection of 0.5 ml buffer solution into closed jejunal segments (length, 3-5 cm) of anesthetized rats the appearance rates of a series of labeled substances in jejunal venous blood were measured for 30 min in situ (initial concentration, 0.02-10 mmol/l or 1 GBq/l tritiated water). The appearance rates quickly rose to a maximum and then declined almost exponentially. Model analysis of the descending of branch of the curves by two one-compartment models (perfect luminal mixing, radial diffusion without convection) revealed a relative pre-epithelial diffusion resistance of nearly 100% for benzoic acid, salicylic acid, L-lysine (0.02 and 1 mmol/l), alpha-methyl D-glucoside, and L-phenylalanine; 80% to 95% for aniline and butanol; 50% to 80% for benzyl alcohol, theophylline, aminopyrine, antipyrine, dodecanol, and D galactose; approximately 40% for tritiated water; approximately 30% for L-lysine (10 mmol/l); 10% to 20% for urea and benzylamine; and approximately 4% for erythritol. The shape of the curves was well described by a two-compartment model (intestinal lumen and "tissue", radial luminal diffusion without convection); the variability of the data, however, prevented closer analysis of the parameters of this model. Since pre-epithelial diffusion (unstirred layer) in the closed jejunal segment without peristalsis is the rate limiting step in the absorption process of highly permeant substances, information on intestinal epithelium can be obtained only with poorly permeant substances. PMID- 3561533 TI - [Appetite depressants: do they carry any weight?]. PMID- 3561534 TI - [Ischemic colitis]. PMID- 3561535 TI - [To operate or not when carotid artery stenosis is symptomless; a decision-making approach]. PMID- 3561536 TI - [Arthroscopy of the shoulder]. PMID- 3561537 TI - [2 patients with idiopathic retroperitoneal fibrosis]. PMID- 3561538 TI - [Policy after evaluation of Pap class IIIA in mass screening for cervix carcinoma]. PMID- 3561539 TI - [Wisdom tooth problems]. PMID- 3561540 TI - [Free tissue transplantation with microsurgery]. PMID- 3561541 TI - [Serous otitis media]. PMID- 3561542 TI - [A small measles outbreak in a completely vaccinated population]. PMID- 3561543 TI - [Post-antibiotic diarrhea; a tip of the pseudomembrane lifted]. PMID- 3561544 TI - [Vitamin D content of food]. PMID- 3561545 TI - [The treatment of pancreatic carcinoma with cytostatic agents]. PMID- 3561546 TI - [Intracoronary thrombosis as an acute expression of coronary heart disease]. PMID- 3561547 TI - [Word processing to order for the medical author]. PMID- 3561548 TI - [Management of a melanoma of the choroid or ciliary body]. PMID- 3561549 TI - [Diagnosis and treatment of the solitary rectal ulcer syndrome]. PMID- 3561550 TI - [Treatment of the spastic pelvic floor syndrome using biofeedback]. PMID- 3561551 TI - [Health Maintenance Organizations; the quality of integrated health care]. PMID- 3561553 TI - [Stress fractures of the femoral neck]. PMID- 3561552 TI - [Genetic counseling and genetic studies]. PMID- 3561554 TI - [Another form for the recording of cause of death]. PMID- 3561555 TI - [Sensitization for tromantadine (Viru-Merz) in herpes simplex infections]. PMID- 3561556 TI - [Menstruation disorders]. PMID- 3561557 TI - [Polycystic liver in adults]. PMID- 3561558 TI - [Antiparkinson agents]. PMID- 3561559 TI - [Continuous arteriovenous hemofiltration, a welcome therapeutic addition?]. PMID- 3561560 TI - [Kathon CG: an important allergen in cosmetics]. PMID- 3561561 TI - [Medicine and technology]. PMID- 3561562 TI - [Analgesics in self medication and in general practice]. PMID- 3561563 TI - [The significance of the registration of cause of death by the family physician for the quality of vital statistics]. PMID- 3561565 TI - [Chemotherapeutic agents and antibiotics in urinary tract infections]. PMID- 3561564 TI - [Depression following brain infarct]. PMID- 3561566 TI - [Dissecting aneurysm; problems in diagnosis]. PMID- 3561567 TI - [Halothane and hepatitis]. PMID- 3561568 TI - [Can organic and functional abdominal complaints be distinguished on the basis of the anamnesis and psychological examination?]. PMID- 3561569 TI - [The discipline called Medicine and the new priorities presented in the 1985 Stimulation of Health Research Program]. PMID- 3561570 TI - [Has determination of carcinoembryonic antigen levels during follow-ups of patients with breast carcinoma proven to be of value?]. PMID- 3561571 TI - [Genu varum and genu valgum in children]. PMID- 3561572 TI - [Diagnosis of the hyperventilation syndrome]. PMID- 3561573 TI - [CARA is no diagnosis? CARA therapy is made to measure!]. PMID- 3561574 TI - [Control of pain at the death bed by the family physician]. PMID- 3561575 TI - [Neurological manifestations in dissecting aortic aneurysm]. PMID- 3561576 TI - [Controlled clinical trials]. PMID- 3561577 TI - [Infections caused by Campylobacter fetus]. PMID- 3561578 TI - [Complications following implantatation of a Tenckhoff catheter for the intraperitoneal administration of chemotherapeutic agents]. PMID- 3561579 TI - [Hip fractures; surgical treatment and clinical mortality]. PMID- 3561580 TI - [The increase in body length of the Dutchman and the attraction of tennis]. PMID- 3561582 TI - [Recommendation of the Public Health Council on the number of kidney lithotriptors in the Netherlands]. PMID- 3561583 TI - [Subtalar dislocation and dislocation-fracture]. PMID- 3561584 TI - [The pH of umbilical artery blood in neonates in deliveries managed by midwives]. PMID- 3561581 TI - [Lipedema of the legs]. PMID- 3561586 TI - [Recommendation of the Public Health Council on artificial reproduction: summary and criticism]. PMID- 3561585 TI - [The antidepressive effect of an epileptic seizure]. PMID- 3561587 TI - [Severe methanol poisoning]. PMID- 3561588 TI - [Analgesics in self medication and in general practice]. PMID- 3561589 TI - [Fracture statistics from the General Administration Service]. PMID- 3561590 TI - [The increase in the height of Dutchmen and the attraction of tennis]. PMID- 3561591 TI - A computer in the office: yesterday, today and tomorrow. PMID- 3561592 TI - Transcatheter closure of patent ductus arteriosus. PMID- 3561593 TI - The assessment of physical fitness. PMID- 3561594 TI - Maternal mortality review 1983-1984-1985. PMID- 3561595 TI - Urinary tract calculi in pregnancy. PMID- 3561596 TI - Transient leukopenia associated with topical silver sulfadiazine in burn therapy. PMID- 3561597 TI - Retained grass seed in the eye or "where not to sow your wild oats". PMID- 3561598 TI - Cesarean section and the small fetus. PMID- 3561599 TI - Medical training "can change nice guy into egotist". PMID- 3561600 TI - Nitroblue tetrazolium test in patients with Hodgkin's disease in the course of chemotherapy. AB - In 41 patients with Hodgkin's disease nitroblue tetrazolium (NBT) dye reduction with resting and stimulated granulocytes, before, in the course and after chemotherapy was examined. Twofold decrease of the capability of NBT reduction test with stimulated granulocytes was found, whereas with resting granulocytes only slight diminution was noted. Chemotherapy did not improve the tested parameters. No relationship was observed between the stage of disease and the presence of systemic symptoms and the NBT dye reduction. It can be assumed that granulocytes from patients with Hodgkin's disease are resistant to stimulation. The observations suggest that NBT test may be useful for evaluation of the function of granulocytes and to some extent for monitoring of the chemotherapy. PMID- 3561601 TI - Lung tumor presentation in relation to histology and smoking habit of operable and inoperable patients. AB - In two separate groups of lung cancer patients, the cranio-caudal site of tumor presentation was related to smoking habits. Group I consisted of 47 inoperable lung cancer patients. In this group apical lung tumor presentation was significantly more common in nonsmokers than in smokers (p less than 0.04). The proportion of women and patients with adenocarcinoma was higher for nonsmokers (p less than 0.01 and p less than 0.01, respectively). In order to validate these findings the site of tumor presentation in relation to smoking habits was studied for a separate group of 369 lung cancer patients. All these patients (group II) had operable tumors. In general, these patients were younger and came from more urban areas than the patients in group I. In group II, upper lobe tumor presentation was not more common among nonsmokers compared with tumor presentation in smokers (p greater than 0.05). However, there were more patients with adenocarcinomas and women among nonsmokers (p less than 0.0001 and p less than 0.0001, respectively). The findings indicate that either the tumor site of presentation in operable and in inoperable lung cancer patients has different epidemiological characteristics, or that, due to chance, a difference in the groups has been observed. However, consistently in the two groups, women with adenocarcinomas who were smokers were younger than other women with adenocarcinomas. PMID- 3561602 TI - Occult thyroid carcinoma in a Greek population. AB - Eleven occult carcinomas (1.8%) were found in 611 specimens from partial and radical thyroidectomies performed in Metaxa's Memorial Hospital of Piraeus and 3 (1.5%) in 200 autopsies from Athens City Forensic Department. Both surgical and autopsy specimens were thoroughly examined. Autopsies were selected to match for age and sex to the surgical material, from non hospitalized relatively healthy individuals. The prevalence found by us was lower than that reported from other European countries. The prevalence found in autopsies and surgicals was almost identical and it appears that thyroid lesions due to which the patients were operated are not related to the presence of the tumors. PMID- 3561603 TI - High-resolution chromosome analysis in retinoblastoma. AB - Peripheral blood chromosomes of 13 patients with retinoblastoma and of their 20 first degree relatives were examined. In three of them chromosomal aberrations were found. Chromosomal anomalies were revealed in one case the patient's father only (the child died and the examination could not be performed) [del(13)(q12.11 q12.13)] and in another case both in the patient [t(13;14)] and in the father as well. This data support the view that some cases of retinoblastoma are closely linked to chromosomal rearrangements in the parental karyotype. PMID- 3561604 TI - Comparative evaluation of two administration schedules of cis dichlorodiammineplatinum (DDP) in ovarian and head and neck cancers: a CMEA chemotherapy group study. AB - The therapeutic effectivity of two administration schedules of DDP were compared. The dose was either 100 mg/m2 infused for 4 h or 20 mg/m2 infused for 1 h on 5 consecutive days. The combined objective remission rate of the two regimens were 37/53 (23% CR ++ 44% PR) for ovarian cancer and 8/35 (9% CR + 14% PR) for head and neck cancer. WHO Grade 1-2 myelo- and nephrotoxicity was observed in 26% and 20%, respectively, out of the 105 cases evaluable for toxicity in the two groups. Nausea and vomiting was moderate to severe. Neither the remission rate nor the toxicity of the two schedules were significantly different. PMID- 3561605 TI - Derivatives of benzo(c)fluorene. XXIV. Cytostatic effect of benfluron on human leukemic cells in vitro. AB - Benfluoron (BF), a new cytostatic drug, synthesized at the Institute of Pharmacy and Biochemistry in Prague, was tested for its cytostatic and cytotoxic effect. The concentrations of BF ranging from 0.1-2 micrograms/ml had a significant cytostatic effect on nine stabilized human leukemic cell lines. This effect was demonstrated by cell counts, cell viability and 3H-thymidine incorporation. The BF concentrations of 2 micrograms/ml and higher were considerably cytostatic causing the cell death and cell degradation. The effect of BF on the cell growth being irreversible could not be eliminated by washing the cells and recultivating them in fresh medium. The BF concentrations halving the total number of viable cells (EC50 value) induced a higher cytotoxicity in lymphoblastoid cell lines then in myeloid ones. BF did not influence the binding of monoclonal antibodies with membrane markers of different cell subpopulations. Prospective application of BF as a cytostatic and immunosuppressive drug is discussed. PMID- 3561606 TI - Photodynamic therapy in vitro and in vivo with hematoporphyrin derivative and laser light. AB - Photodynamic therapy is currently under investigation as a new form of treatment for solid malignant tumors in animals and in humans. The method involves photosensitization of drugs and fluorescent dyes, such as hematoporphyrin derivative (Hpd), after preferential incorporation by neoplastic cells. In in vitro experiments laser light activation completely destroys Hpd-pretreated EL4 cells. Mice bearing MS-2 fibrosarcoma treated with Hpd and laser light survived indefinitely, in comparison with control animals that were untreated or treated only with Hpd or laser light. In mice bearing the highly metastatic tumors B16 melanoma and Lewis lung carcinoma (LLC) treated with Hpd and laser light delivered through a quartz fiber optic significantly prolonged the median survival time. This therapy was compared with surgical excision of primary tumors and, for superficial nonmetastatic neoplasma MS-2, the photodynamic therapy was more effective than surgery, while for metastatic tumors B16 and LLC, there was no significant difference between the two methodologies. However, phototherapy is much less traumatic to the animals. PMID- 3561607 TI - Carcinoembryonic antigen in bronchogenic carcinoma. AB - The authors determined carcinoembryonic antigen concentration in the sera of patients with bronchogenic carcinoma, some noncancerous lung diseases and in the sera of healthy subjects in order to assess the contribution of this method to the diagnosis of bronchogenic carcinoma with regard to the morphological type. Increased levels of carcinoembryonic antigen in patients with bronchogenic carcinoma were observed in 32% of cases. Among the morphological types of bronchogenic carcinoma statistically significant differences were not found. The comparison of bronchogenic carcinoma regardless of the type with the groups of noncancerous lung diseases and healthy subjects revealed statistically significant differences. PMID- 3561608 TI - Influence of splenectomy on the levels of circulating immune complexes (CIC) in Hodgkin's disease (HD). AB - A 3.75% polyethylene glycol 6000-precipitation method was used to estimate the levels of circulating immune complexes (CIC) in pre- and postsplenectomy serum samples obtained from 34 patients suffering from Hodgkin's disease (HD). In 26 out of the 34 patients (76.47%) the postsplenectomy samples showed a considerable decrease in CIC levels compared to the levels in the presplenectomy samples. Two patients showed a marginal change while the remaining 6 patients exhibited elevated levels of CICs after splenectomy. The mean levels (in terms of OD 450 nm) in the pre- and postsplenectomy sample sets were 0.66 +/- 0.07 and 0.42 +/- 0.05, respectively (p less than 0.01). There was no apparent relationship between the interval elapsed after splenectomy (6-22 days) and the magnitude of decrease (1.7-91.8%). Patients with LP-type histology and splenic involvement formed a category that preferentially showed a substantial decrease in CIC levels after splenectomy. PMID- 3561609 TI - [The Tromner reflex: a continuing misunderstanding?]. PMID- 3561610 TI - [Intracranial pressure-controlled treatment of brain edema with glycerin and sorbitol in intracerebral hemorrhage]. AB - The continuous epidural registration of intracerebral pressure showed that the pronounced brain edema which develops during the 4th to 14th day of an intracerebral hemorrhage could lead to an increase in intracerebral pressure (ICP greater than 25 mmHg) requiring treatment. During the therapy extensive ICP crises (ICP greater than 35 mmHg), lasting for 1 to 3 days and only controllable through high doses of glycerol and sorbitol, developed. Glycerol (50 g orally) and sorbitol (50 g i.v.) lowered the pressure during this phase for approximately 3 h and 1.5 h respectively. These time intervals were in accordance with the changes in plasma osmolality through the administration of both substances. Due to its longer efficacy, glycerol provides an important supplement or alternative to sorbitol therapy, especially as the permitted maximum dosage would have to have been exceeded in a treatment consisting exclusively of sorbitol. The duration of the decrease in intracerebral pressure lasted longer during the remainder of the treatment in the case of both substances, being decisively dependent on the intracerebral pressure intensity. The relatively harmless epidural measurement of intracerebral pressure allowed an optimal control of the brain edema therapy as the dosage of the hyperosmolar substances could be given exactly in accordance with the intracerebral pressure intensity and subsequently varying efficacy. PMID- 3561611 TI - [The supinator syndrome. Study of the course in 20 patients and therapeutic recommendations]. AB - Between 1972 and 1984, 20 cases of the supinator syndrome were examined with clinical and electrophysiological methods in our clinic. In 12 cases we found an idiopathic supinator syndrome in the strict sense and in 8 cases a traumatic lesion of the r. profundus of the radial nerve. We carried out follow-up studies in most of the patients. From these findings we attempt to derive guidelines for treatment. An absolute indication for operative revision in our opinion is present only in the case of complete transsection by trauma. Otherwise, the spontaneous course can be observed. The operative results in idiopathic cases are poor; it seems to be purposeless to operate patients who have a paresis for a long time. Therefore, the decision for or against an operative intervention has to be made soon after the diagnosis is secured. PMID- 3561612 TI - [Trigeminal neuralgia. Results of microsurgical parapontine decompression]. AB - In typical trigeminal neuralgia lasting painlessness can be obtained in 85-90% of all cases by microsurgical decompression of the nerve at the pons. Generally neurological deficits of the trigeminal nerve are not observed after surgery. The method has a favourable effect on many cases of secondary atypical neuralgia too, at least respective the tic douloureux. The follow-up period runs up to several years in most of our 151 cases. In about 5% of these cases recurrence of the neuralgia takes place, for the most part within the first year. The most frequent surgical complication is damage to the acoustic nerve (bradyacousia or deafness), which occurs in about 8% of cases. The over-all surgical mortality is 1.0-1.5%. In every case of typical trigeminal neuralgia there is an indication for microsurgical decompression of the fifth cranial nerve at the pons, provided pharmacotherapy has proved ineffective and anaesthesia carries no increased risk due to old age or ill-health. PMID- 3561613 TI - [Diagnostic and prognostic significance of electromyography in laryngeal movement disorders]. AB - Electromyography of the larynx has been increasingly used during recent years in the diagnosis and differential diagnosis of laryngeal motility disorders. The method is routinely employed at the university ENT department in Gottingen. The qualitative experience gained with regard to the diagnostic and prognostic value of electromyography in the region of the larynx is described and compared with the results and experience reported so far in the literature. PMID- 3561614 TI - [Cervical radiation myelopathy with spastic paraparesis of the arms. Case report and a review of the literature]. AB - A case of cervical radiation myelopathy following telecobalt-radiation therapy to the cervical lymph-nodes in Hodgkin's disease is described. After a latent period of 3 months neurological symptoms presented with a pure spastic paraparesis of the upper extremities. Diagnosis was confirmed neuropathologically. A review is given on clinical signs of cervical radiation myelopathy. PMID- 3561615 TI - [Convulsive tic in combination with vertigo attacks and their surgical treatment by microvascular decompression]. PMID- 3561616 TI - [Classification of electromyography findings in Parkinson syndrome compared with clinical assessment scales]. PMID- 3561617 TI - [Neurogenic disorders of the bladder in Parkinson disease. Clinical and combined cystomanometric-electromyographic study]. PMID- 3561618 TI - [Disorders of smell and taste in treatment with thiamazole and carbimazole]. PMID- 3561619 TI - HLA antigens and serum ferritin in hemodialysis patients. AB - The evolution of serum ferritin levels in 111 chronic-hemodialysis patients is prospectively studied. Patients were classified in two groups according to the presence or absence of 'hemochromatosis antigens' (HLA A3, B7 or B14) in their HLA typing. Levels of serum ferritin were similar in both groups before they started dialysis and during the first year. On the contrary, in the second and third hemodialysis years serum ferritin was higher in the group carrying 'hemochromatosis antigens'. These differences were observed in patients treated with parenteral iron either in the form of transfusions or as intravenous dextran iron but not in patients receiving oral iron. We conclude that the risk of developing iron overload is greater in hemodialysis patients with HLA A3, B7 or B14. Nevertheless, this potential risk can be minimized with a restrictive policy on the use of parenteral iron (transfusions, intravenous dextran-iron). PMID- 3561620 TI - Association of class II antigens of HLA with primary glomerulopathies. AB - HLA antigens of Japanese patients with primary glomerulopathies were determined, and the frequency of each HLA antigen was compared with that of Japanese normal controls. IgA nephropathy with HLA-DR4, idiopathic membraneous glomerulopathy with DR2, lipoid nephrosis with DRw53 and poststreptococcal glomerulonephritis with DR1 were definitely or probably associated. It was suggested that primary glomerulopathies might all be associated with HLA class II and not class I antigens. Japanese patients with HLA-Bw48 and -DRw8 were less susceptible to primary glomerulopathies. PMID- 3561622 TI - Staphylococcal epidermidis infection of a hemodialysis button-graft complex controlled by vancomycin for 11 months. AB - A 54 year old woman had a Bentley DiaTAP button implanted in her thigh for hemodialysis access. She had been started on continuous ambulatory peritoneal dialysis (CAPD) because of intractable vascular access problems. Unfortunately, CAPD had to be discontinued because of fungal peritonitis. Transplantation had not been possible because of circulating cytotoxic antibodies. The prosthetic complex soon became infected with Staphylococcus epidermidis and blood cultures were intermittently positive for 11 months. However, with continuing vancomycin therapy she remained in her usual state of health, without side effects from vancomycin, until venous thrombosis resolved and it became possible to remove the infected prosthetic complex and implant a button in an arm. As a last resort, it may be possible to maintain a patient on dialysis in reasonable health with a DiaTAP button graft complex infected with Staphylococcus epidermidis and intermittent positive blood cultures using long term vancomycin therapy. Such management probably would not be appropriate for any other organism. PMID- 3561621 TI - Serum oxalate in chronic renal failure. AB - Serum oxalate is easily controlled in patients with chronic renal failure not yet on dialysis by dietary protein restriction but poorly controlled by both haemodialysis and continuous ambulatory peritoneal dialysis (CAPD). In the control of serum oxalate in chronic renal failure dietary protein restriction is effective in the pre-dialysis patient whereas both CAPD and haemodialysis are relatively inefficient in end-stage renal failure. PMID- 3561623 TI - Serum and corpuscular nickel and zinc in chronic hemodialysis patients. AB - Serum and corpuscular nickel and zinc concentrations in 30 chronic hemodialysis patients were examined. Serum nickel and zinc levels before dialysis were 0.22 +/ 0.03 microgram/dl (normal value: 0.56 +/- 0.08 microgram/dl) and 70.0 +/- 13.4 micrograms/dl (normal value: 96 +/- 8 micrograms/dl) low, respectively. However, corpuscular nickel and zinc levels before dialysis were high: 1.25 +/- 0.24 microgram/dl (normal value: 0.88 +/- 0.17 microgram/dl) and 1,299 +/- 146 micrograms/dl (normal value: 1,120 +/- 80 micrograms/dl). Serum zinc levels significantly increased after dialysis, but serum nickel concentrations did not significantly increase during dialysis. Corpuscular nickel and zinc concentrations did not significantly change during dialysis. PMID- 3561624 TI - Mefenamic acid nephropathy. PMID- 3561625 TI - Hypersensitivity reactions related to acetate dialyzate and cellulose acetate membrane. PMID- 3561626 TI - Branhamella catarrhalis peritonitis in a continuous ambulatory peritoneal dialysis patient. PMID- 3561627 TI - Rapid alterations in plasma aluminium in association with varied oral aluminium intake in dialysis patients. PMID- 3561628 TI - Normocalcaemic nephrocalcinosis in sarcoidosis. PMID- 3561629 TI - Increased incidence of cerebral hemorrhage mortality in patients with analgesic nephropathy on hemodialysis. PMID- 3561630 TI - Usefulness of the ratio UK/UNa+K for the study of the renal handling of sodium and potassium in full-term neonates. PMID- 3561631 TI - Enhanced platelet aggregation and membrane biocompatibility: possible influence on thrombosis and embolism in hemodialysis patients. PMID- 3561632 TI - Successful systemic fibrinolysis in permanent hemodialysis catheter obstruction. PMID- 3561633 TI - Elevated salivary IgA in patients with IgA nephropathy. PMID- 3561634 TI - Sodium fluxes during hemodialysis. AB - Three sets of experiments were performed to determine the effect of the dialysate sodium concentration on the sodium balance of patients undergoing maintenance hemodialysis. First, patients were treated with three different dialysate bath sodium concentrations: 125-132 mEq/l (n = 7), 135-140 mEq/l (n = 11) and 145-150 mEq/l (n = 6). We demonstrated that the pretreatment plasma sodium concentration was independent of the sodium concentration of the dialysate used. Second, the plasma sodium concentration available for diffusion during the treatment was calculated from the plasma sodium concentration and the plasma proteins. The accuracy of this calculation was demonstrated by comparing the predicted value with the concentration of sodium measured in an ultrafiltrate obtained at minimal filtration fraction. Third, the sodium fluxes using a hypernatremic or hyponatremic dialysate were calculated for 100 ml of plasma going through the dialyzer. At steady state, no significant differences in net sodium fluxes were demonstrated between hyper- and hyponatremic dialysis. PMID- 3561635 TI - Spinal meningiomas. AB - Between the years of 1970-1982 29 spinal meningioma cases were operated on; 22 cases (76%) were female and 7 (24%) were male. The youngest patient was 16, and the oldest was 68 years old. On neurological examination, patients had neurological deficits in varying degrees. Diagnosis were done by myelography in all cases. Laminectomy was performed in all cases. 34.4% of cases were situated in cervical region and 65.6% were in thoracic region. 14% of the tumours were located extradurally and 68% were intradural. Multiple spinal meningioma was seen in only one case. One case died after operation; the mortality rate is 4%. 22 cases came for follow-up examination, 86.5% of them were in excellent or good condition. Only three cases showed no improvement. PMID- 3561636 TI - Early posterior acrylic fixation of traumatic odontoid fractures. AB - Nine cases of traumatic odontoid fractures had, as a primary treatment, a posterior surgical fixation (C1 + C2 + C3) by means of acrylate, without waiting for the unpredictable results of external systems of immobilisation. No immediate or late (follow-up: six months to seven yrs) neurological complications occurred. Solid union took place in all the cases but one. Two cases of wound infection were recorded. All the patients were actively mobilised on the second postoperative day without external immobilisation. PMID- 3561637 TI - [Subtotal bone resorption following reimplantation of a bone flap. 2 case examples]. AB - This is a report on two cases of an extensive absorption of bone following reimplantation of an osteoplastic flap of the cranial vault. Although it is not yet possible to give a final explanation of the phenomenon, this complication must always be considered as a possible event in this kind of cranial vault implant and the patient should therefore be informed about such an eventuality. PMID- 3561639 TI - Familial incidence of foramina parietalia permagna. AB - The author presents three cases of congenital parietal bone defects in two generations of one family. Two of them present paired, symmetrically located perforations of the parietal bones and case No. 3 presents a single, 6 X 7 cm defect of the parietal bones, located in the midline. In the presented cases the diagnosis was confirmed by skull radiograph, however, in case 1 angiography was also performed. These congenital skull defects are considered, so far, of no clinical significance, and no associated abnormalities among affected individuals have been found. The problems involved with the formation and assessment of treatment of these defects are discussed. PMID- 3561638 TI - Adult manifestation of the Dandy-Walker syndrome. Report of two cases with review of the literature. AB - Two cases of Dandy-Walker syndrome that became manifest in adult life are reported. A review of the literature of Dandy-Walker syndrome revealed 13 additional cases with onset in adult life and three cases that could not be differentiated from arachnoid cysts. While shunting is the primary treatment in infantile Dandy-Walker, the usual treatment of adult Dandy-Walker has been excision of the membrane covering the enlarged fourth ventricle. The outcome of our two cases treated with membrane excision indicates that primary shunting should also be tried in adult Dandy-Walker. PMID- 3561640 TI - Multiple meningiomas evaluated by computed tomography. AB - The authors report ten cases of multiple meningiomas in a series of 227 intracranial meningiomas from 1977 to 1984. The incidence of multiple meningiomas was 4.4% (according to Cushing and Eisenhardt's [1938] concept of "multiplicity" of such tumours). These results are comparable to those obtained by other authors. All patients were females and all underwent CT scan before operation. Clinical symptoms are presented along with location and size of the tumours. Pathogenetic theories and research prospects are discussed. PMID- 3561641 TI - [Intracranial hematoma in ruptured aneurysms. Apropos of 57 cases]. AB - In 200 consecutive cases of ruptured aneurysms volume of resulting hematomas exceeded 5 ml in 57 patients (28.5%) and 50 ml in 25 patients (12.5%). We have studied the radio anatomical and clinical datas of these 57 cases: In most of them (90%) the aneurysm situation appears to determine hematomas characteristic features. Fatal issues are related to hematoma volume when above 50 ml and to vasospasm in other cases. Results in the 48 operated cases lead to advise neurosurgeons against surgical procedure when volume is greater than 60 ml in grade V patients (unless operation could take place immediately after rupture onset), and when severe intra ventricular hemorrhage is present. Death in ruptured aneurysms is a consequence of hematomas volume in at least 10% cases. Hematomas or vasospasm are responsible for sequellae or fatal issues which still occurs in 15-20% of overall population of patients with ruptured aneurysms, despite improvement in management and timing. Cases finding and preventive surgery of non incidental aneurysms should be a matter of concern. PMID- 3561642 TI - [Post-traumatic intracerebral hematoma]. AB - The clinical and therapeutic features of 18 delayed traumatic intracerebral hematomas (DTICH) were compared with those of 84 primitive traumatic intracerebral hematomas in order to determine the origin of this complication. This retrospective study found that: DTICH usually occurs the first week after trauma, but could happen several weeks later; patients with skull fractures are at higher risk (p less than 0.01); osmotherapy as well as barbiturate therapy seem to have no influence on this complication; craniotomy (or craniectomy) appears to be a significant factor in the cause of DTICH (p less than 0.05). The pathogenesis of DTICH could be the evolution of delayed necrosis in vessel walls from the contused area which frequently bleed after the evacuation of an extracerebral hematoma. On the other hand the cause of a DTICH after conservative therapy remained unclear. PMID- 3561643 TI - [Chronic subdural hematoma in adults. Prognostic factors of surgery. Apropos of 100 cases]. AB - One hundred chronic subdural haematomas in the adult are presented in a retrospective study, looking for correlations between results and aetiological, clinical, radiological and therapeutic elements. Only four parameters are correlated with results: headache and isodensity on C.T. Scan are good prognostic factors (p less than 0.02 and p less than 0.04 respectively); on the other hand chronic alcoholism (p less than 0.03) and even more postoperative pneumatocele (p less than 0.007) are correlated with a poor result. Pneumatocele is due to intracranial hypotension which is the major factor promoting formation and development of chronic subdural haematoma occurring in aged population. PMID- 3561644 TI - [Surgery of the remaining carotid artery]. AB - Seven patients with unilateral arterial carotid occlusion and contralateral arterial carotid stenosis in the neck are reported. Authors perform an extra cranial to intra-cranial anastomosis on the occluded side prior to realize endarterectomy on the stenosed side. This policy obviates the need of an internal vascular shunt during temporary occlusion of I.C.A. PMID- 3561645 TI - [Open-door decompressive cervical laminotomy. Technic and initial experiences]. AB - The cervical laminectomy is usually applied in the treatment of cervical myelopathy caused by cervical canal stenosis and multiple spondylosis. Nevertheless, late complications are often reported, especially scar formation, the so-called laminectomy membrane, between the dura and overlying paraspinal muscles, which, compressing the cord, reduces until to abolish the favourable effects of the previous laminectomy; moreover, malalignment of the cervical spine with secondary kyphosis may follow an expansive laminectomy. In order to avoid these complications, in 1977 Hirabayashi introduced a new surgical technique, the "expansive open-door laminoplasty", which permits the enlargement of the spinal canal over multiple segments by completely incising the laminae laterally on one side and partially on the opposite: elevation with tilting of the laminae upward in the incised side, allows enlargement of the canal. The Authors describe in detail the operative procedure and report their experience in 10 patients. PMID- 3561646 TI - [Cervico-arthrotic myelopathies. Treatment and prognosis]. AB - The authors present 50 cases of cervical spondylotic myelopathy treated by anterior or posterior approach. To assess the severity of the pre- and postoperative neurological symptoms, they define an original ten-point classification scale taking into account gait and urinary disturbance, ability to manipulate objects and pain. With C2-C7 laminectomy, 60% of the patients are improved, essentially for walk. A few cases only (14%) are upgraded for upper limbs function. The authors conclude that this surgical treatment should be applied only when there is a multi-level narrowed canal and predominant lower limbs deficits. The efficacy of the anterior approach depends on complete removal of osteophytes. In cases with complete osteophytectomy, this surgical treatment can improve both the upper and lower limbs function and 77.8% good results are obtained. In a few cases it may be necessary to use both approach successively. Discriminant analysis applied to 12 factors shows that pre-operative scores of upper and lower limbs and sagittal diameter of spinal canal are the most important factors for neurological prognosis. PMID- 3561647 TI - [Distal intracranial arterial aneurysms. Apropos of a case of giant aneurysm of the right angular gyrus artery]. AB - A 57 year old man presented with a giant, fusiform, partially thrombosed aneurysm, located distally to the right angular gyrus artery, and revealed by a subarachnoid hemorrhage. There was no history of head trauma, endocarditis or systemic infection, and physical examination was normal. The treatment consisted in simple trapping of the aneurysm, responsible for a transient ischemic parietal syndrome. After a short review of the pathogenesis of peripheral aneurysm of the C.N.S., and previously reported cases of distally located aneurysms of the middle cerebral artery, only one similar case was found concerning a posterior temporal artery aneurysm involving to a giant serpentine aneurysm. The case presented is believed to be a segmentary form of cerebral arterial dolicho ectasia; relations between arterial ectasia or fusiform aneurysms and serpentine aneurysms are discussed. PMID- 3561648 TI - [Early syringomyelia following benign cervical injury. Contribution of postoperative MRI]. AB - The authors show an observation of a post traumatic syringomyelia syndrome which gradually developed a few months after a cervical sprain. The diagnosis has been mentioned after the discovery of a "big medulla" with myelography and computed tomography. The presence of a cervical cystic cavity with viscous liquid has been confirmed by surgery. A syringosubarachnoid shunt has been carried out with excellent post operative results as the patient has recovered all his sensory and motor functions. For the pathogenic hypothesis mention is made of a small subclinic early hematomyelia which then develops on its own to form a genuine syringomyelic cavity. The authors emphasize the future interest of M.R.I. for the pathogenic diagnosis as well for the post operative effects. PMID- 3561649 TI - [Sudden tetraplegia caused by hemorrhage in a central-medullary astrocytoma]. AB - A case is reported of central-medullary cervical astrocytoma, which without any previous history is shown by a sudden pattern of tetraplegia and breathing insufficiency. The myelography suggested the existence of an expansive intramedullary process, carrying out an urgent surgical decompression and evacuating a central-medullary hematoma in relation to a glial benign type. Various aspects of the sudden tetraplegia are discussed. PMID- 3561650 TI - [Spontaneous cervical epidural hematoma. Apropos of a case]. AB - We report one case of spinal epidural hematoma located in the cervical area, so called spontaneous because this unknown etiology, extended over C3-C6, diagnosed by Computed Tomography, with complete recovery after surgical treatment accomplished 36 hours after the onset of symptoms. The clinical picture is characterized by sudden onset of severe cervical or interscapular pain, associated with radicular radiation into the upper extremities, followed by development of progressive signs of spinal cord compression with varying degree of motor and sensory paralysis. We emphasized the importance of an early diagnosis, easily possible with Computed Tomography. The CT findings are similar to intracranial acute epidural hematoma: showing a characteristic hyperdense lenticular collection, typically localized in the dorsolateral spinal epidural space. Computed Tomography appears to be the procedure of choice for preoperative diagnosis and for postoperative control. The surgical indication is absolute. PMID- 3561651 TI - [Lumbar extradural Brucella abscess without spondylitis. Apropos of a case]. AB - One case of lumbar extradural abscess of brucellar etiology without spondylodiscitis is described. The recovery was obtained only with antibiotic therapy. PMID- 3561652 TI - [Cervical foraminal disk hernia. Treatment by diskoforaminotomy]. AB - The authors report their experience of cervical foramina disk herniation. They underline the interest of C.T. scan for its diagnosis and use for the approach a combined antero- and lateral approach by diskoforaminotomy. PMID- 3561653 TI - [Value of approach to the cervical spine by bilateral anterolateral route]. AB - The authors report their experience of anterolateral bilateral approach of cervical spine. They underline the advantages and inconvenience of this route and discuss the indications. PMID- 3561654 TI - Tracers for paralysis agitans in epidemiological research. V. Prevalence of the disease in Swedish counties. AB - The prevalence of parkinsonism varies severalfold between different countries in the world. This could be due to an accumulation of risk factors in certain areas. In the present paper we have analyzed the regional distribution of parkinsonism in Sweden in order to see if such areas could be found within one country. The study was based on sales of levodopa in the different counties of Sweden, and the results were standardized for age and quality of health services as indicated by the local infant mortality rates. The mean prevalence of the different Swedish counties was estimated to be in the middle range of known prevalences. There was a 60% variation within Sweden between the different counties, but the regional distribution did not show a systematic pattern. Further analysis of the causes for this variation showed that differences in case ascertainment and in drug policy could well account for the observed regional differences in parkinsonism prevalence. PMID- 3561655 TI - Epidemiology of primary intracranial neoplasms. Experiment in the Province of Trento, (Italy), 1977-1984. AB - The incidence rate for primary intracranial tumors in the Province of Trento (Italy) from 1977 to 1984, adjusted to the Italian population, is 8.5/100,000/year (8.0 for males and 9.1 for females). The age-specific distribution is nearly the same as that reported in other studies. It is bimodal with a mild increase until the ages of 40-44 years followed by a peak reaching a maximum at the ages of 55-64 years and then declining. The commonest tumors in males were glioblastomas (m/f ratio = 1.3) and in females meningiomas (m/f = 0.4). Pituitary adenomas were 15.3% of all tumors with a m/f ratio of 0.6. Factors causing discrepancies between the rates reported by various authors are discussed. PMID- 3561656 TI - Commentaries: Plaques and tangles of Alzheimer's disease. PMID- 3561657 TI - Commentaries: The genetics of Alzheimer's disease. PMID- 3561658 TI - Commentaries: The pathogenesis and progression of Alzheimer's disease. PMID- 3561659 TI - Commentaries: Aluminum and Alzheimer's disease. PMID- 3561660 TI - First Canadian Symposium on the Organic Dementias. PMID- 3561661 TI - An immunohistochemical quantification of fibrous astrocytes in the aging human cerebral cortex. AB - In order to determine whether cortical fibrous astrocytes increase with age, we studied 25 patients ranging in age from 24 to 100 years with no clinical or pathological evidence of dementia or other cerebral disorder. Paraffin sections of mid-frontal cortex were obtained and stained with the avidin-biotin immunolabeling procedure for glial intermediate filament protein. The resulting immunolabeled fibrous astrocytes were then counted in the molecular and cellular (cortical laminae 2-6) layers. Populations of fibrous astrocytes in both layers varied widely among individuals, and in the molecular layer their numbers were not significantly correlated with advancing age. In the cellular layer, however, despite widely ranging cell counts among individuals within the same decades of life, there was a significant linear increase with age. Our data suggest that the increase occurs or accelerates significantly after age 70, but the case numbers preclude reaching such a conclusion with statistical confidence. However, when the patients are divided into those less than 70 and those older, fibrous astrocytes in the cellular layer are shown to be significantly increased in the latter group compared to the former. PMID- 3561662 TI - CSF and serum concentrations of albumin and IgG in Alzheimer's disease. AB - Cerebrospinal fluid (CSF) and serum concentrations of albumin and immunoglobulin G (IgG) were measured in 31 patients with presumptive Alzheimer's disease (AD) and in 14 healthy control subjects. The albumin and IgG quotients, and IgG index were calculated to evaluate the permeability of the blood-brain barrier and the intrathecal production of immunoglobulins. X-ray computerized tomography (CT) of the head was performed to investigate the relation between cerebral atrophy and CSF protein concentrations. The albumin and IgG quotients, and the IgG index did not differ significantly between the AD and control groups. Cerebral atrophy, as measured by CSF volume, was not related to CSF protein concentrations in either group. The results do not support the hypothesized roles of blood-brain barrier disruption or of immunologically-mediated injury of the central nervous system in the pathogenesis of AD. PMID- 3561664 TI - Degeneration of hippocampal fibers and spatial memory deficit in the aged rat. AB - Old and young Fisher 344 rats were compared for their ability to learn a delayed alternation task. The old animals displayed significant impairment of alternation learning, and were slower than the young animals. The brains of these animals were examined using a silver degeneration stain, and among old rats there was conspicuous degeneration. The greatest density of degenerating fibers was seen in the hippocampus and in anatomically related tracts, but there was substantial fiber staining in the corpus callosum, anterior commissure, and internal capsule. Examination of the young brains revealed only an occasional fiber. There were no signs of cortical atrophy in the old animals. The histopathology of the aged animals' hippocampus and fiber tracts supports the possibility that the delayed alternation impairment shown by these animals was a result of age related degenerative changes. PMID- 3561663 TI - Absence of age differences in protein synthesis by rat brain, measured with an initiating cell-free system. AB - A cell-free protein synthesis system was derived from brains of young (3 month) and old (greater than 23 month) male Fischer-344 rats in order to examine brain protein synthesis in relation to age. The system was shown to be capable of reinitiating protein synthesis in vitro, and of synthesizing protein from exogenously added mRNA. Optimal ionic conditions for amino acid incorporation were 200 mM potassium ion and 5 mM magnesium ion, and amino acid incorporation depended on addition of ATP, GTP, and an energy-generating system (creatine phosphate and creatine phosphokinase). Amino acid incorporation was sensitive to the initiation inhibitors aurintricarboxylic acid and sodium fluoride. Optimal conditions were independent of the age of the rat from which the brain was taken. There was no statistically significant relation (p greater than 0.05) between capacity of amino acid incorporation and age. The aggregation state of brain polyribosomes also did not differ between young (3 month) and old (30 month) rats. The results suggest that overall brain protein synthesis capacity is age invariant in the rat. PMID- 3561665 TI - Age-related decreases in dopamine receptors in the caudate nucleus and putamen of the rhesus monkey (Macaca mulatta). AB - Specific binding of the dopamine receptor ligand 3H-spiroperidol to cell membranes prepared from the caudate nuclei and putamens of 29 rhesus monkeys (M. mulatta), ranging in age from 2 to 22 years, was investigated. Receptor concentration (Bmax) decreased in the caudate nucleus and putamen with age at mean rates of 2.1 and 1.7% per year, respectively, whereas binding affinity (Kd) did not change significantly with age. The rate of decline in Bmax appeared to be more rapid before adulthood and in old age than during young adulthood and middle age. These data are compared with the results from similar studies of other animal species including human, rabbit, rat, and mouse. The rate of decline in striatal dopamine receptors is closely related to the rate of aging and maximal life span of the species. It may reflect both maturational and senescent processes modifying the behavior of animals as they age. PMID- 3561666 TI - Spontaneous tumors in aging female mice are more prevalent in the lateral pituitary zones. AB - The localization of gross and microscopic spontaneous pituitary tumors was examined in aging female C57BL/6J mice. These tumors were lactotroph adenomas, by morphological and immunocytochemical criteria. Each lobe of the pars distalis was divided into three zones of approximately equal size and the number of tumors in each zone was counted. Twelve out of 30 tumors were located entirely within the most lateral zone. An additional 14 tumors occurred in both the most lateral and the interjacent zones. Thus, almost 90% of the observed tumors were localized in more lateral zones of the pars distalis (Chi-squared test, p less than 0.01). These findings support a hypothesis that lower portal blood dopamine levels reaching lateral portions of the pars distalis are a factor in the higher incidence of lactotroph adenomas in these zones. PMID- 3561667 TI - [Pain as a symptom of parkinsonism]. AB - The authors describe 5 patients with Parkinson's disease with coexistent sensory symptoms, mainly pains. In the light of the pertinent literature the authors regard pain as one of the symptoms in the parkinsonian syndrome. Diagnostic and therapeutic difficulties in this form of parkinsonism are stressed. PMID- 3561668 TI - [Clinico-electrophysiological correlations in the evaluation of sciatica]. AB - The electromyographic investigations of the mental and temporal muscles have been completed in 50 patients treated because of sciatic pain. The activity of these muscles is inseparably associated with the emotional response to pain. Than the parameters of the above mentioned investigations have been compared with the subjective evaluation of pain intensity and with the neurological examination results. In patients with sciatic pain, the bioelectric activity of the mental and temporal muscles growing clearly with the increase of pain, have bean kept as rest. This activity has been more intensive on the ill side of the muscles; also, it has been more distinct in patients with loss symptoms and with some changes in the radiological examination of the spine. The increase of the bioelectric activity of the mental muscles has correlated positively to the degree of pain intensity (measured by Domzal standards) and the number of radicular symptoms. The EMG investigation of the mental muscles has proved to be more useful for the assessment of sciatic pain than the same investigation of the temporal muscles. PMID- 3561669 TI - [EEG in children with spinal muscular atrophy]. AB - EEG curves were evaluated in 40 children with spinal muscular atrophy. The compared group comprised 81 boys with Duchenne's dystrophy in the same age group. In the children with muscular spinal atrophy the EEG was considered abnormal for age in 42% of cases. The type of EEG changes might suggest bioelectric immaturity. In Duchenne's dystrophy the proportion of children with abnormal EEG records was 70%, and the changes were mostly focal. PMID- 3561670 TI - [Neurologic complications after extracorporeal circulation in the light of experimental studies]. AB - On the basis of experimental investigations the authors describe the causes of certain complications after extracorporeal circulation. The experiments were carried out in 11 sheep. The duration of extracorporeal circulation was from 1 to 2 hours. It was found that the intracranial pressure, which is an indicator of intracranial expansion, increased with increasing time of cannule introduction into the heart and veins, with the volume of perfusing fluid given during the procedure, with falling value of the arterial blood pressure and impairment of venous return. The intracranial pressure increased also with the duration of extracorporeal circulation. Falls of the arterial blood pressure and venous return occurred simultaneously with impairment of the cerebral blood flow causing cerebral hypoxia. The results of histological examinations of brain tissue were consistent with central nervous system hypoxia, and showed also that these changes developed within the first hour of extracorporeal circulation. The complications arising after extracorporeal circulation may be due to brain oedema. Thus it would be recommendable to pay attention during preoperative management of the patients to the possibility of brain oedema as a complication of the procedure. PMID- 3561671 TI - [Rheoencephalographic studies in patients with vertebrobasilar insufficiency]. AB - Rheoencephalographic investigations in different head positions were carried out in 62 subjects, including 22 healthy ones and 40 patients with vertebrobasilar arterial failure comparing the results with degenerative changes in the cervical spine. In patients with advanced changes in this spine the blood flow in the cerebral vessels was lower and their tonus was greater than in the remaining patients. Rheoencephalographic investigations may be particularly useful in patients in whom vertebral angiography is contraindicated. PMID- 3561672 TI - [Results of non-operative treatment of primary brain tumors using teleradiotherapy and chemotherapy]. AB - In the years 1979-1984 25 patients with inoperable primary brain tumours were treated. The clinical diagnosis in all cases was glioma, histological examinations were not done. The patients received teleradiotherapy (DG 6000 rads) and simultaneously combined chemotherapy by the Hildebrand schedule (methotrexate, vincristine, CCNU, dexamethasone). In one case severe toxicity was observed. The median survival time was 41 weeks and 10 patients survived over one year. PMID- 3561673 TI - [Evaluation of cerebral blood flow in postoperative increased intracranial pressure]. AB - In 20 patients with expanding intracranial lesions the intracranial pressure, cerebral blood flow, mean arterial blood pressure were determined and the cerebral perfusing pressure and cerebral vascular resistance were calculated before the operation and after removal of the expanding lesion. In 7 cases rises of the intracranial pressure occurred after the operation. In 5 of them they were associated with increased cerebral blood flow and decreased vascular cerebral resistance which was an evidence of their vasogenous mechanism. In 2 cases increased intracranial pressure was associated with raised cerebral vascular resistance suggesting oedema as the cause. The value of the investigations is discussed which give the results on which the choice of a proper management can be based in cases of increased intracranial pressure. PMID- 3561674 TI - [Use of brachytherapy in supratentorial brain gliomas]. PMID- 3561675 TI - [Confabulations in the light of current theories]. PMID- 3561676 TI - [Porphyria variegata--a case report]. AB - In a man aged 28 years abdominal pains with constipation appeared, and were followed after 2 weeks by generalized maximal epileptic seizures, gradually progressing signs of proximal polyneuropathy, numerous brownish patches on the face and trunk, and hepatomegaly. In the urine raised levels were found of delta aminolaevulinic acid, prophobilinogen, coproporphyrins and uroporphyrins. Examination of stools demonstrated an increase of protoporphyrins and coproporphyrins, with prevalence of the former, characteristic of porphyria variegata. A gradual regression of changes was observed after treatment with high doses of propranolol and intravenous glucose infusions. PMID- 3561677 TI - [A case of recurrent brain stem insufficiency associated with the menstrual cycle]. PMID- 3561678 TI - [A case of familial hemangioblastoma]. PMID- 3561679 TI - [A classification of the herniated cervical disc based on metrizamide CT]. AB - In 202 surgical cases of anterior fusion of cervical spine, there were 150 cases in which disc herniation was the responsible lesion. According to metrizamide CT (met. CT) findings of these 150 cases, we proposed to classify the herniated cervical disc into 7 types. In the 150 cases there were 103 men and 47 women. Seventy-seven had single disc lesion, 57 had the two and 6 had three disc lesions. The most frequent involvement was of C 5/6 in 107 cases (51.2%). The next was of C 6/7 in 50 cases (23.9%) and the third was of C 4/5 in 36 (17.2%). Primarily herniated discs were classified into soft or hard disc. The soft discs were classified into medial, mediolateral and lateral type according to the direction of the protrusion of the disc. Each of the three types indicates that herniated disc compresses the median portion of the cord, lateral part of the cord and root simultaneously and root alone, respectively. The hard discs were classified into central, bilateral and unilateral types. The central type means the case in which the cord was compressed by the centromedian part of the posterior aspect of the vertebral body. The unilateral and bilateral type indicate that lateral portion of the cord and root were simultaneously compressed by the disc unilaterally or bilaterally. The other one was combined type. The combined type is that which belongs neither of the types noted above. In the soft disc group there were 37 cases (17.7%) of medial type, 28 (12.4%) of mediolateral and 8 (3.8%) of lateral type.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561680 TI - [Evaluation of changes in brain tissues surrounding cerebral arteriovenous malformations using NMR-CT]. AB - Patients with cerebral arteriovenous malformation (AVM) show various clinical symptoms, but they can be divided into two groups; one resulting from rupture of AVM and another derived from chronic ischemia in surrounding tissues of AVM. Intracerebral or subarachnoid hemorrhages due to rupture of AVM can be detected by X-ray CT scan, however, it is difficult to obtain three dimensional image of changes in the surrounding area of AVM that has never experienced hemorrhagic attacks. We are using 0.15 Tesla NMR-CT (resistive type) produced by Bruker Company in West Germany and its pulse sequence is Carr-Purcell-Meiboom-Gill (CPMG) method which is best reformed type of spin echo. With this machine, we observed images of AVM and its surrounding tissue, made calculated images of T1 and T2 relaxation time and measured T1 and T2 values of ROI. On images of NMR, nidus and many dilated vessels were distinctly revealed as low or no signal intensity area in all cases without contrast media. And it is noteworthy that surrounding areas of AVM on calculated T1 and T2 images were observed as tissues showing elongated relaxation time in all cases. These tendencies were confirmed by measurement of T1 and T2 in ROI compared with contralateral side. We think elongations of T1 and T2 in surrounding tissues mean ischemic or necrotic changes in these areas induced by steal phenomena due to arteriovenous shunting. PMID- 3561681 TI - [Report on successful surgery of cavernous angioma in the dorsal part of the pons -usefulness of MRI in diagnosis]. AB - A case with cavernous angioma which was located in the dorsal of the pons was cured surgically. A 16-year-old male was admitted with complaints of right motor and sensory disturbance. On neurological examination, the patient had right hemiparesis and hemiparesthesia, and right cerebellar signs. X-ray CT scan demonstrated a high density mass in the pons. Carotid and vertebral angiograms showed no abnormality. T1 and T2 weighted MRI clarified the pontine mass not as a tumor but a hematoma. Then, from the age of the patient, his clinical course, follow up X-ray CT and MRI findings, it was considered that a pontine lesion must have been an angioma with hemorrhage. Therefore, the operation was performed in an attempt to removal the hematoma and the mass of abnormal vessels in the dorsal part of the pons. Histological examination of the surgical specimen revealed abnormal vessels as a cavernous angioma. The postoperative course was uneventful. PMID- 3561682 TI - [A case of tuberous sclerosis associated with a pineal region tumor]. AB - The authors report a rare case of tuberous sclerosis associated with pineal region mixed glioma. A 38-year-old woman with tuberous sclerosis, who had a past history of left nephrectomy and tumorectomy of the right kidney for bilateral renal angiomyolipomas, was admitted because of headache and ataxic gait. CT scan and cerebral angiography suggested a pineal region tumor. Suboccipital craniectomy and partial removal of the tumor was performed via infratentorial supracerebellar approach. Microscopic examination revealed mixed oligodendroglioma and astrocytoma. It is well known that tuberous sclerosis is occasionally associated with brain tumors. However, with few exceptions, these have been subependymal giant cell astrocytomas in the lateral ventricles. They seem to originate from subependymal nodules of hamartomatous nature. As far as we are aware, association of pineal region tumor with tuberous sclerosis as in this case has not been reported. PMID- 3561683 TI - [Three cases of scalp arteriovenous malformations]. AB - Three cases of scalp arteriovenous malformation (AVM) are presented and the pertinent literature is reviewed. Case 1 was a 50-year-old male who was admitted to hospital with a pulsatile mass involving the right parietal region. Selective angiography revealed a scalp AVM fed by bilateral superficial temporal and right occipital arteries. The AVM was embolized with Gelfoam pieces through catheterization and there was no evidence of recurrence of the lesion after follow-up period of three years. Case 2 was a 25-year-old male who was noticed to have a birth mark in the left occipito-parietal region and was hospitalized with a pulsatile gradually expanding mass after an episode of minor trauma in the same region. Selective angiography revealed a cirsoid type scalp AVM fed by bilateral superficial temporal and occipital arteries, and the authors performed a total resection of the mass because of selective Gelfoam embolization was not successful. Case 3 was a 49-year-old male who was hospitalized with the chief complaints of left tinnitus and pulsatile left supra-auricular mass. There was no history of trauma. Selective angiography revealed a scalp AVM fed by the left superficial temporal and occipital arteries and the authors performed a selective Gelfoam embolization and this was successful, but three months later, the AVM recurred and mainly fed by instead this was the left posterior auricular artery. Preoperative selective Gelfoam embolization followed by a total resection of the AMV with minimal blood loss.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561684 TI - [Fusiform aneurysm of the vertebral artery presenting with foramen magnum syndrome: a case report]. AB - A 33-year-old male developed stiffness of the left neck and pain of the left shoulder two years previously. Six months prior to admission, he noticed tingling sensation of the left 2nd, 3rd and 4th fingers and motor weakness of the left hand, both of which gradually progressed. On admission, positive neurological findings were neck pain on dorsal extension, left hemiparesis more advanced in the upper limb, diffuse muscle atrophy of the left upper limb, hyperreflexia of the left upper and lower limbs with positive Babinski sign and dysesthesia corresponding to the left C3-T5 sensory dermatomes. Enhanced CT and Metrizamide CT myelography showed a large extra- and intra-dural mass from the C1 segment to the medulla oblongata on the left. Angiography disclosed a fusiform aneurysm of the left vertebral artery. Proximal ligation of the left vertebral artery was performed. Postoperatively, clinical signs were markedly improved and shrinkage of the aneurysm was demonstrated on postoperative Metrizamide CT myelogram. Pathogenesis of diffuse muscle atrophy of the left upper limb was undetermined, but was probably not due to disturbance of the anterior spinal artery because of good visualization of the artery on the angiogram. Indication of the proximal ligation of the vertebral artery with an aneurysm was discussed. PMID- 3561685 TI - [Oligodendroglioma of the lateral ventricle--report of 2 cases and a review]. AB - Oligodendrogliomas rarely grow primarily in the ventricles. When compared to more common hemispheric counterparts, such intraventricular oligodendrogliomas, or oligodendrogliomas of the midline group (Martin), present distinct clinical features, namely, (1) they occur in the younger age, (2) an interval between clinical onset and diagnosis or operation is shorter, and (3) initial symptoms are most often limited to those of increased intracranial pressure, although the patient may occasionally present mild organic dementia, callosal disconnection syndrome, and/or mild gait ataxia. Two cases of oligodendroglioma primarily involving the lateral ventricle are reported in female patients, aged 29 and 19, respectively, with sole complaints of an increased intracranial pressure. Magnetic resonance imaging proved to be most useful as a radiologic diagnostic procedure. The tumor was radically removed via a para-falcine transcallosal approach without causing any persistent neurological deficits. Merit and demerit of the approach are briefly discussed. PMID- 3561686 TI - [Two cases of glioblastoma involving the orbit and maxillary sinus]. AB - Two cases of glioblastoma involving orbit and maxillary sinus are presented. Case 1: A 49-year-old male was admitted on May 20, 1982, with complaints of headache and impairment of memory. On July 27, 1982, operation was carried out. The tumor in the left temporal lobe was totally removed, and he subsequently received chemotherapy and irradiation. The postoperative course was uneventful. On Oct. 26, 1983, he was readmitted with complaints of disturbance of gait and memory. A CT scan revealed no local recurrence of the tumor but a diffusely enhanced mass in orbit and maxillary sinus. Reoperation was carried out on Nov. 10, 1983. No recurrence was seen at the original site where the first operation was done. The dura was intact so far as observed from inside and was protruding into the cavity from the side of the sphenoidal ridge. The tumor showed destructive growth to orbit and maxillary sinus. He died on May 20, 1984. The autopsy was refused. Case 2: A 33-year-old male was admitted on Oct. 24, 1981, with complaints of headache, vomiting and impairment of memory. A CT scan revealed a right temporal mass lesion. He was operated on three times, on Oct. 27, 1981, Feb. 23, 1984 and Sep. 6, 1984, respectively. He also received chemotherapy and irradiation. Finally, a CT scan revealed the recurrence of the tumor in the right frontal, temporal, parietal lobe and basal ganglia, and an invasion into orbit on a CT scan. He died on Nov. 26, 1984. We discussed the course of the extension of tumors and the reports in the literature were reviewed. PMID- 3561687 TI - [Extramedullary plasmacytoma forming a mass in the epidural space of the spinal cord: report of a case]. AB - Plasmacytoma often forms an intramedullary mass in the vertebrae with absorption of trabecula and cortex of the bone. However, occasionally, it forms a mass in the extramedullary space of the vertebrae. The authors report such a rare case with plasmacytoma which formed a mass in the thoracic epidural space without evidence of involvement of the adjacent vertebra. On May 22, 1985, a 80-year-old man was admitted to our clinic with chief complaints of gait disturbance and hypesthesia below the umbilical level. Difficulty of walking developed approximately four months prior to admission with gradual aggravation and hypesthesia added thereafter. Neurological examinations at admission showed paraparesis with positive Babinski's and Chaddock's reflexes, hypesthesia and disturbances of vibration and position senses below the 9th thoracic nerve level. Myelography and CT scan using metrizamide indicated a presence of epidural mass at the 8th to 9th thoracic vertebrae. There was no abnormal bony change in the spine on plain X-ray and CT scan. On May 30, 1985, total removal of epidural tumor was performed by removing the laminae from the 7th to 10th vertebrae. Histological examinations including immunological stainings showed a plasmacytoma which produced monoclonal immunoglobulin of IgG-lambda type. Radiation therapy was not carried out. The serum protein fraction, immunoglobulin, immunoelectrophoresis, Bence-Jones protein and CSF immunoglobulin examined after operation, supported a histological diagnosis of plasmacytoma. Also, slight proliferation of plasma cells was noted in the bone marrow and peripheral blood.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561688 TI - [Aplasia of the posterior arch of the atlas--report on two cases]. AB - Two cases of aplasia of the posterior arch of the atlas incidentally found are reported. Case 1: A 37-year-old man hit the forehead and the right mandible against the front glass at a head-on collision of his car and was brought to the emergency room. He was alert and neurologically normal except for multiple incision wounds with glass fragments in the face. CT, and cervical X-rays revealed total absence of the posterior arch of the atlas. Case 2: A 73-year-old woman, who sustained whip lash injury at an automobile accident, was admitted several hours after injury, complaining of neck and occipital pain. No neurological deficit was seen. CT demonstrated hemi-aplasia of the posterior arch of the atlas and isolated rudimentary posterior tubercle. Review of the literature and discussions were made on the incidence and genesis of this anomaly. PMID- 3561689 TI - Inaugural Dorothy S. Russell memorial lecture. Immunohistochemical signposts--not markers--in neural tumour differentiation. PMID- 3561690 TI - Steroid hormone receptors in pituitary adenomas: a biochemical, immunohistochemical and morphometric study on cryostat sections. AB - Oestrogen receptors and progesterone receptors were measured by an isoelectric focussing technique in cytosols from cryostat sections of eight human pituitary adenomas. Cryostat sections adjacent to the assayed sample were stained for anterior pituitary hormones using the peroxidase-antiperoxidase technique, and the cellularity of each neoplasm was calculated with the aid of a computerized image analysis system. The results of ER and PR assays were adjusted to compensate for variations in cellularity. ER were present in three prolactin adenomas, one growth hormone adenoma and one gonadotrophin adenoma. The latter also contained PR. Steroid hormone receptors were not detected in two null cell adenomas and one non-secretory oncocytoma. The results support the suggestion that antihormonal chemotherapy may be valuable in the treatment of certain pituitary adenomas. PMID- 3561691 TI - Chronic human nerve compression--a histological assessment. AB - While compression neuropathy is a common clinical problem, the opportunity to study human nerve material is rare. A histological assessment of the superficial radial nerve of four human cases with entrapment syndrome is reported. Changes in the perineurium and the endoneurial microvessels as well as the presence of Renaut bodies were the earliest histological abnormalities noted. Connective tissue changes included epineurial and perineurial fibrosis. Nerve fibre pathology varied from fascicle to fascicle. The myelinated and unmyelinated fibre populations responded differently to this compression. In the myelinated fibre population, marked thinning of the myelin was noted. In the unmyelinated fibre population, a shift in the fibre histogram due to a new population of very small fibres was observed suggesting degeneration with subsequent regeneration of this fibre population. PMID- 3561693 TI - Delayed remyelination in rat spinal cord following ethidium bromide injection. AB - Areas of demyelination were produced by injecting ethidium bromide into the white matter of the lumbar spinal cord of rats. There was variation in the nature of the process of demyelination and a difference in the speed with which Schwann cells remyelinated the demyelinated axons. In some lesions, or areas within lesions, myelin debris was rapidly processed by macrophages and axons were rapidly remyelinated by Schwann cells, while in other lesions of similar duration, or in areas within the same lesion, the myelin was transformed into lattices of membranous profiles which persisted around axons for long periods of time. In the lesions containing such myelin derived membranes, there were few macrophages and remyelination by Schwann cells was delayed compared to that seen in the more rapidly resolving lesions. It was concluded that the slow resolution of some lesions resulted from the delay between intoxication and cell disintegration (7-10 days) which meant that the cell responses to demyelination took place in a glial free area which could not support cell movement needed for removal of myelin debris and remyelination. This study indicates that the tempo and results of demyelination can be altered by the cellular events which accompany degeneration of oligodendrocytes. PMID- 3561692 TI - The effects of thyroid hormone on differentiation and neurofilament expression in rat brain aggregating cultures. AB - The effects of thyroid hormone on neural development in vitro were studied using rat fetal forebrain aggregating cultures. They were examined morphologically after growth for 21 days in medium containing fetal calf serum (S+), in a chemically defined medium (S-), or in serum-free medium containing 30 nM triiodothyronine (T3). Aggregates grown in S+ showed certain morphological differences compared to those grown in the absence of serum: a glia limitans was present in the former, but not the latter, which were further characterized by a marginal zone rich in fibres and containing few cells. Immunocytochemistry using a monoclonal antibody against neurofilaments showed that immunostaining was most pronounced in aggregates grown in T3 (especially in the marginal zone) and weakest in those grown in S+. Quantitative estimation using an immunoadsorbent assay confirmed that T3 medium increased the amount of neurofilament protein in the aggregates, consistent with the view that thyroid hormone promotes neural development in vitro. PMID- 3561694 TI - Neuroendocrine effects of light deprivation and pinealectomy in vivo on the time course of changes in prolactin cell activity in vitro. AB - The purpose of this investigation was to elucidate the differences in the nature and time course of changes in in vitro prolactin (PRL) cell activity between blinded and blind/pinealectomized female hamsters. Adult female golden hamsters were either left intact, blinded and sham-pinealectomized (Blind/Sham) or blinded and pinealectomized (Blind/Pinx). Twelve weeks after surgeries, animals were killed by decapitation and randomized hemipituitaries were incubated for a total of either 30, 60, 90, 120, 180 or 240 min. PRL release in vivo, as estimated by monitoring serum titers of immunoreactive PRL (IR-PRL), was markedly reduced in Blind/Sham animals; pinealectomy completely prevented this depression. PRL storage was assessed by measuring total levels (i.e., medium + pituitaries) of IR PRL in vitro. Total, pituitary and media values of IR-PRL were all significantly depressed in Blind/Sham females. Pinealectomy of blinded animals almost completely prevented these reductions. PRL synthesis, as evaluated by measuring the amount of 3H-leucine incorporated into PRL in vitro, was profoundly reduced in Blind/Sham females. Surprisingly, pinealectomy failed to prevent the blinding induced decrease in PRL production. From these data, we conclude that in the light-deprived female hamster the pineal gland inhibits PRL storage and release, while the depression in PRL synthesis may be independent of a pineal influence. PMID- 3561695 TI - Antagonism of sexual behavior in female rats by ventromedial hypothalamic implants of antiestrogen. AB - The present experiments sought to identify brain regions in which implants of an antiestrogen would antagonize the ability of a systemic estradiol treatment to activate sexual behavior in female rats. In experiment 1, ovariectomized female rats were implanted subcutaneously with 5-mm Silastic capsules containing a 5% concentration of estradiol and injected with 500 micrograms progesterone 2 days later, 4-5 h before testing for sexual behavior. Bilateral intracranial implants of 1% crystalline concentrations of the high-affinity antiestrogens monohydroxytamoxifen (TAM) or keoxifene placed into the ventromedial nucleus of the hypothalamus (VM) 24 h prior to estradiol treatment significantly reduced lordosis responsivity compared with control females receiving empty cannulae. Implants of 1% TAM into the medial preoptic area or medial amygdala 24 h prior to estradiol that no significant effect on lordosis. Similarly, implants of 1% TAM into the VM 12 h after estradiol had no effect on lordosis. In experiment 2, lordosis was activated by subcutaneous implants of Silastic capsules containing 1% estradiol plus 500 micrograms progesterone. In this experiment, implants of 1% TAM into the VM 24 h prior to estradiol significantly reduced lordosis only if both cannulae tips were in, or adjacent to, the VM. Females receiving intracranial 1% TAM, but whose cannulae (even unilaterally) were outside the VM, had levels of lordosis equivalent to those of control females. Increasing the concentration of intracranial TAM to 10% virtually eliminated lordosis in females with bilateral implants in the VM, whereas females receiving intracranial 10% TAM in the region of, but outside, the VM showed no evidence of a lordosis deficit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561696 TI - Effect of elevated prolactin levels on the synthesis and release of catecholamines from the adrenal medulla in female rats. AB - Recent evidence suggests that increased plasma prolactin (PRL) levels could be modifying the synthesis and release of catecholamines (CA) from the adrenal medulla. In order to study this possibility, female rats bearing an anterior pituitary gland, from a litter-mate donor, under the right kidney capsule since day 30 of life and their sham-operated controls were sacrificed by decapitation 45 days after the transplant operation. Plasma PRL and CA levels and CA content in the adrenal medulla were analyzed. A significant increase in plasma PRL levels was shown in grafted (22 +/- 2 micrograms/l) when compared to control rats (6 +/- 0.3 micrograms/l), together with a significant increase in plasma norepinephrine (NE) (4.2 +/- 1.1 micrograms/l vs. 1.7 +/- 0.7 micrograms/l) and epinephrine (E) (2.9 +/- 0.6 micrograms/l vs. 1.6 +/- 0.2 micrograms/l). Similar plasma dopamine (DA) levels were found in both groups (0.6 +/- 0.2 micrograms/l vs. 0.8 +/- 0.3 micrograms/l). An increase in adrenal DA content (29.1 +/- 6.8 ng/mg protein), together with a decrease in NE (33.3 +/- 6.8 ng/mg protein) and E content (65.9 +/- 11.8 ng/mg protein) was detected in grafted as compared to control rats (DA: 12.0 +/- 3.6 ng/mg protein; NE: 79.3 +/- 22.1 ng/mg protein; E: 184.2 +/- 39.2 ng/mg protein). We can conclude from these data that the elevation of circulating PRL levels induced by a pituitary graft is able to increase the synthesis and release of CA from the adrenal medulla in female rats. PMID- 3561697 TI - Vasopressin activation of phosphatidylinositol metabolism in rat anterior pituitary in vitro and its modification by changes in the hypothalamo-pituitary adrenal axis. AB - The ability of vasopressin to stimulate the accumulation of 3H-labelled inositol phosphates was studied in vitro using prelabelled rat anterior pituitary quarters. [8-Arginine] vasopressin activates inositol lipid breakdown in this system in a time- and dose-dependent manner; vasopressin (3 X 10(-7) M) resulted in a 1.8-fold stimulation of inositol phosphate accumulation over control accumulation after 10 min. This response to vasopressin is inhibited by the specific V1 antagonist (CH2)5Tyr(Me)AVP. Both oxytocin and the selective V2 agonist DDAVP also show some agonist activity, but are considerably less potent than arginine vasopressin. Corticotrophin-releasing factor alone had no effect on inositol phosphate production, whilst a high dose given in conjunction with vasopressin resulted in a diminution of the response below that found with the same concentration of vasopressin alone. Anterior pituitaries from vasopressin deficient Brattleboro rats also show a phosphatidylinositol response to vasopressin. Pituitaries from rats that had been adrenalectomized 4 days earlier showed no increase in inositol phosphate accumulation in response to vasopressin. Daily administration of dexamethasone (40 micrograms/day) reversed this effect of adrenalectomy. This reversal was not seen when dexamethasone (40 micrograms/ml) was added to the incubation medium of adrenalectomized rat pituitary quarters. These results confirm that the rat anterior pituitary contains functional vasopressin receptors capable of activating inositol phospholipid metabolism and that this biochemical response is modified by changes in the hypothalamo pituitary-adrenal axis. PMID- 3561698 TI - Responsiveness of tuberoinfundibular dopamine neurons in the aged female rat to the stimulatory actions of prolactin. AB - The autoregulatory feedback control of prolactin, which is mediated by tuberoinfundibular dopamine (DA) neurons, is altered in the aged rat; this is evidenced by increased circulating concentrations of prolactin and decreased activity of these neurons. In the present study the action of prolactin on tuberoinfundibular DA neurons in young and aged female rats was estimated by measuring the rate of DA synthesis (dopa accumulation following the administration of a decarboxylase inhibitor) in the median eminence. The rate of dopa accumulation in the median eminence of the aged (26 months) rat was reduced to 50-60% of that in the young (3 months) rat. The acute systemic administration of haloperidol, a DA antagonist which increases serum concentrations of prolactin or intracerebroventricular infusions of prolactin increased the rate of dopa accumulation in the median eminence of both young and aged rats by the same relative amount. The administration of haloperidol and prolactin increased the rate of DA synthesis to a greater extent in young than in aged rats. The administration of bromocriptine, a DA agonist which reduces serum concentrations of prolactin, decreased the rate of dopa accumulation in the median eminence of both young and aged rats. In young animals the intracerebroventricular administration of prolactin reversed the bromocriptine-induced decrease in DA synthesis in the median eminence after 4 h and caused a further increase after 12 h. Qualitatively similar effects were seen in the aged rats; however, prolactin treated young rats had much higher levels of DA synthesis than aged rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561700 TI - Follow-up studies of children with fetal alcohol syndrome. AB - Data coming from a prospective multidisciplinary study with repeated examinations of children with fetal alcohol syndrome (FAS) are reported. These patients underwent pediatric, neurological and psychiatric assessment, EEG-recordings and psychological testing. After a period of 3-4 years various subgroups of these children were re-examined. Follow-up examinations revealed that with increasing age dysmorphic signs became less apparent in children with FAS. Furthermore, neurologic performance improved and EEG-recordings revealed less pathological patterns. These positive findings were confirmed by the observation that these patients also experienced an improvement with regard to psychiatric status and cognitive functions. But it must be stated that the affected children did not become normal in all psychiatric areas. Hyperactivity and distractibility seem to be the major handicap for a normal school career of these children. In general biological maturation seems to be the main factor responsible for the outcome of FAS. PMID- 3561699 TI - Neurological abnormalities in Wilson's disease are reversible. AB - The therapeutic responses of seven children with Wilson's disease who presented with neurological disease were evaluated. Neurological abnormalities comprised intellectual deterioration in 7, conduct disorder in five, dystonia in three, choreoathetosis in three, seizures in one and hemiparesis in one. Lethargy and weight loss were present for several months in 6 children. Four children had clinically demonstrable liver disease which was fatal in two. Electroencephalography performed in two children was normal. Computed tomography (CT) of the brain in three children showed cerebral atrophy in all and areas of low attenuation in the basal ganglia which resolved on treatment in one. All patients were treated with penicillamine but, in four, triethylene tetramine (TETA) was substituted because of adverse effects. Neurological abnormalities in these patients were reversible. PMID- 3561701 TI - The pathogenesis of fetal hypokinesia. A neurological study of 75 cases of congenital contractures with emphasis on cerebral lesions. AB - A comprehensive prospective clinical study is presented of 75 cases of fetal hypokinesia and congenital contractures of various causes, with neuropathological investigation in 23 cases. With the data of medical history, neurological examination, laboratory tests and neuropathology an exact or probable nosological or syndromal diagnosis could be made in 61 cases. These cases were categorized by localisation of causal pathology in the subsequent levels of the developing motor system. In 14 of 61 cases developmental brain disorders (f.i. hydrocephalus, hydranencephaly, microcephaly) were the cause of fetal hypokinesia, often with perinatal death, whereas in 7 cases both cerebral and/or spinal cord lesions were found. Besides cerebral involvement was frequently present in cases with congenital contractures of other origin, concomitant or due to perinatal complications. In a large number of cases clinical evidence of spinal cord lesions, especially anterior horn cell degeneration was present. Myopathic disorders occurred in only four cases, whereas congenital myasthenia and congenital neuropathy were present in one case each. In cases without muscle weakness miscellaneous disorders including congenital skin anomalies and probably primary connective tissue disorders were encountered. The etiologic role of intrauterine viral infection is discussed. PMID- 3561702 TI - Relapse of herpes simplex encephalitis. AB - This report describes a child with herpes simplex virus (HSV) encephalitis who improved dramatically while being treated with acyclovir but subsequently had neurological deterioration and died. A severe necrotizing process was present in the brain at autopsy but there were no focal areas of demyelination and poor inflammatory response. HSV was not cultured from brain biopsy during relapse or autopsy. Fourteen previous cases of relapsing herpes encephalitis are reviewed and treatment regime and mechanisms of relapse are discussed. PMID- 3561703 TI - Aggregation of bilirubin in injectates and incubation media: its significance in experimental studies of CNS toxicity. AB - In experimental work with bilirubin toxicity, incubates or injectates are prepared without added albumin, or with a molar excess of bilirubin over albumin. Bilirubin is liable to aggregation as free bilirubin acid under these circumstances, giving rise to variable toxicity. Stable solutions are obtained with a molar excess of albumin over bilirubin; such solutions show no toxicity, however. It is suggested that this difficulty may be circumvented by using an excess of albumin, adding a sulfonamide as a bilirubin displacer, to provoke toxicity. PMID- 3561704 TI - Empty sella associated with inappropriate TSH secretion. AB - A child diagnosed with long-standing primary hypothyroidism at age 10 and subsequent pseudotumor cerebri after initiation of thyroid therapy developed an empty sella and inappropriate thyrotropin secretion. No other evidence of thyroid hormone resistance was evident nor was there evidence of other endocrine dysfunction. This case confirms previous reports of a relationship between autoimmune thyroid disease, pseudotumor cerebri, empty sella and inappropriate anterior pituitary function. PMID- 3561705 TI - Neurenteric cyst of medulla oblongata--a curiosity. AB - A case of a newborn infant with a complex cerebral malformation, including a neurenteric cyst of medulla oblongata is presented. This localization is extremely rare, only one such case has been reported in the world literature. Other cerebral malformations were spina bifida posterior with cervico-dorsal dysraphia, cerebellar hypoplasy, cervico-dorsal cystic meningocele and hydrocephalus. The etiology of this complex malformation remained unknown. PMID- 3561706 TI - Cerebral thromboembolism due to antithrombin III deficiency in two children. AB - Despite numerous well-described causes of stroke in infancy and childhood, a significant proportion remains unexplained. Venous thromboembolism is a common complication in adult patients undergoing surgery, and after severe trauma, but not in otherwise healthy children less than 10 years old. However, it may also occur spontaneously without recognizable cause. It has been known for a long time that some patients are particularly prone to venous thrombosis and in recent years great efforts have been made to identify the risk factors. The attention of haematologists has been focused on the possibility that certain abnormalities of coagulation may be associated with a tendency to thrombosis, but only in a few instances a clear causal relationship has been established. One such example is a deficiency of antithrombine III, but such a deficiency has hitherto been recognized as a cause for thrombosis in children only in very particular circumstances. We present two young children with stroke of which one was purely ischemic and the other ischemic with secondary hemorrhage. Both our patients showed an AT III deficiency. Patient one also had a cyanotic congenital heart disease with right to left shunting which made cerebral embolism originating from a thrombus in the iliac vein possible to occur. We consider her hematocrit values too low to be a predisposing factor for this thrombosis. AT III deficiency may be caused by several different mechanisms. Either it exists as a congenital (hereditary) or as an acquired disorder. In patient two the family history was positive for hereditary AT III deficiency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561707 TI - The heterogeneity of the Pena-Shokeir syndrome. AB - There is evidence that the Pena-Shokeir syndrome is not a specific phenotype but should be regarded as a "fetal akinesia deformation sequence". A neuropathological study of six random new cases was performed to evaluate this theory. Brain pathology observed included persistent fetal meningeal vascularization (two cases), agenesis of the septum pellucidum (one case) and hydranencephaly (one case). Investigation of the spinal cord (in two cases) revealed no abnormalities. Muscle histology (in four cases) was indicative of neurogenic atrophy in two cases. These findings are compared with the data of the 28 cases previously described. It is concluded that the Pena-Shokeir syndrome is a heterogeneous syndrome in which cerebral lesions may play an important role in the pathogenesis. The cerebral malformations may also indicate the time of origin and contribute in the perinatal death of this syndrome. PMID- 3561708 TI - Auditory brainstem response (ABR) in congenital central alveolar hypoventilation. AB - Auditory brainstem responses (ABRs) were studied in a child with congenital central alveolar hypoventilation showing marked depression of respiratory drive during sleep. During wakefulness and normoventilation no ABR abnormalities were found, either at the age of 14 months or five years. ABR recordings during sleep at 14 months of age showed marked wave V latency and wave I to wave V interpeak latency prolongation of about 0.4 ms both for periods of hypoventilation and normoxic hypercapnia. ABR findings of this and other studies carried out in sleep apneas are discussed with respect to brainstem dysfunction associated with varied sleep apnea syndromes. PMID- 3561709 TI - Neurological complications associated with Mycoplasma pneumoniae infection in children. AB - Meningoencephalitis associated with serological evidence of Mycoplasma pneumoniae infection is reported in two children, aged 11 and 12. In both cases the neurological illness started with an attack of generalised convulsions, followed by changes in the electroencephalogram, which lasted up to 5 wks. Both children recovered completely without signs of sequelae. Attention is drawn to the wide spectrum of neurological complications which can be associated with this infection. PMID- 3561710 TI - The coexistence of myasthenia gravis and myotonic dystrophy in one family. AB - We are reporting the unique coexistence of two distinct neuromuscular diseases, myotonic dystrophy and the juvenile form of myasthenia gravis, occurring in one family. A 16-month-old previously healthy female presented with a two month history of bilateral varying drooping of both eyelids and bilateral external ophthalmoparesis. The acetylcholine receptor antibodies were elevated, and there was a dramatic response to edrophonium confirming the clinical impression of myasthenia gravis. Spontaneous remission of the ptosis was noted after six months with no specific treatment. Many other family members were examined; none of them had clinical or laboratory evidence of myasthenia gravis. The clinical examination of the mother and the maternal grandmother, neither of whom had any complaints, resulted in a definite diagnosis of myotonic dystrophy. The proband's father and a 3-year-old sister were examined and found to be normal. We studied the HLA antigens of all of the available family members; none were found to have the HLA antigens most commonly associated with myasthenia gravis. Secretor gene studies were not helpful in providing additional genetic identification. The question generated by the coexistence of these two uncommon disorders in one family is if there is a genetic or other relationship between them or if this was merely a coincidental occurrence. At this point in time the question remains unanswered and must await demonstration of additional similar circumstances. PMID- 3561711 TI - Vesicular site of action of lithium ion in choline-calcium stimulated adrenergic nerve endings of rat heart. AB - Reports from this laboratory have suggested that the secretion of norepinephrine (NE) in slices of ventricle from the rat heart, incubated in a medium of choline and Ca2+ (Ch+-Ca2+) deprived of Na+, is mediated by the outward transport of NE (blocked by cocaine) from synaptic vesicles fused or attached to the axolemma. Lithium (and reserpine), block the Mg2+-ATP-stimulated uptake of NE by isolated synaptic vesicles (Slotkin, Seidler, Whitmore, Salvaggio, and Lau, 1978). Hence, a hypothesis to be tested was that lithium ions would increase secretion of NE stimulated by Ch+-Ca2+. By contrast, amines mobilized by lithium ions (or reserpine) in control nerves would be deaminated. Experiments showed that lithium Krebs increased the excretion of [3H]deaminated metabolites of [3H]NE. A much smaller quantity of [3H]NE was released by a process that was independent of Ca2+ and weakly inhibited by cocaine. When combined with Ch+Ca2+, lithium ions, in concentrations that were known to block uptake in isolated vesicles, induced a Ca2+-dependent secretion of [3H]amines. A small quantity of [3H]deaminated metabolites was excreted. Both processes were strongly inhibited by both cocaine and desipramine. Both reserpine (Bogdanski, 1982) and lithium ions blocked the inhibitory effect of exogenous ATP (2 mM) on secretion induced by Ch+-Ca2+. This effect indicated a proximity of vesicles to the axolemma. The effects of lithium ions could be explained by the hypothesis if lithium prevented storage of [3H]NE in vesicles by blocking the Mg2+ + ATP-dependent amine pump in vesicle membranes. PMID- 3561712 TI - Phenylcyclohexylamine: effect of a metabolite of phencyclidine on the efflux of dopamine in the rat. AB - The effect of phenylcyclohexylamine (PCA) on the efflux of dopamine (DA) in the neostriatum was examined using in vivo electrochemical techniques. Phenylcyclohexylamine produced a long-lasting dose-dependent biphasic effect on the efflux of DA in the rat. This response, to one of the major metabolites of phencyclidine, was similar in duration to but less potent than that seen with phencyclidine. PMID- 3561713 TI - Modulation of dopamine function by glycine in the nucleus accumbens of the brain of the rat. AB - The effects of glycine on the phasic changes in locomotor activity in the rat, caused by a persistent infusion of dopamine (DA) into the nucleus accumbens (ACB) were investigated. Dopamine (25 micrograms/24 hr), infused into the nucleus accumbens for 13 days, caused hyperactivity, with two peaks occurring on days 3-4 and 9-11. Glycine (12.5 or 25 micrograms/24 hr) infused into the nucleus accumbens on its own did not alter the locomotor activity, yet when infused at the same time as DA (25 micrograms/24 hr), glycine (12.5 or 25 micrograms/24 hr) inhibited the development of the first peak of hyperactivity induced by DA, with no effect on the second peak. A larger dose of glycine (50 micrograms/24 hr), infused alone, significantly increased locomotor activity, and a combination of this dose with DA (25 micrograms/24 hr), led to a temporal shift in the response to DA such that the first peak of hyperactivity was delayed to "fuse" with the second peak. The locomotor response to a threshold dose of DA (6.25 micrograms/24 hr) plus glycine (50 micrograms/24 hr) was no greater than could be accounted for by the hyperactivity response to glycine alone (50 micrograms/24 hr). Strychnine (10 micrograms/24 hr), infused into the nucleus accumbens, produced no alteration in locomotor activity. Similarly, when infused together with DA (25 micrograms/24 hr), strychnine (10 micrograms/24 hr) caused no significant alteration in the phasic hyperactivity induced by DA. However, strychnine (10 micrograms/24 hr), infused together with DA and glycine (25 and 12.5 micrograms/24 hr respectively), prevented the inhibition by glycine of the first peak of hyperactivity induced by DA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561714 TI - Glycine potentiates the anticonvulsant action of diazepam and phenobarbital in kindled amygdaloid seizures of rats. AB - The effect of glycine on the anticonvulsant activity of diazepam and phenobarbital in fully developed kindled amygdaloid seizures in rats was determined. Glycine alone had no significant effect on the seizure response, either when administered orally 1 hr prior to the seizure test or when given chronically in a 0.5 M solution as the source of water. Administration of glycine (10 mmol/kg, oral) together with diazepam produced a significant reduction in both cortical epileptiform afterdischarge and the severity of seizures at doses of diazepam which had no significant effect on the seizures when administered alone. Glycine potentiated the effects of phenobarbital on the cortical afterdischarge but not the severity of the seizures. The observed potentiation of the effects of diazepam and phenobarbital suggests a glycinergic mechanism in the anticonvulsant action of these drugs which may be mediated in part by the inhibitory gamma-aminobutyric acid (GABA) systems. PMID- 3561715 TI - Inhibitory effect of taurine on wet-dog shakes produced by [D-Ala2,Met5] enkephalinamide with reference to effects on hippocampal epileptic discharges. AB - The effects of taurine on wet-dog shakes produced by [D-Ala2,Met5]enkephalinamide (DAME) were investigated in rats. Wet-dog shakes and epileptic discharges in the hippocampus were produced by intraventricular administration of 50 micrograms of DAME. Pretreatment with 10 microliter of taurine, given intraventricularly in a dose of 0.95 mumol, inhibited wet-dog shakes and epileptic discharges in the hippocampus. While the same dose of gamma-aminobutyric acid (GABA) also inhibited the wet-dog shakes, the same dose of L-leucine did not suppress them. These observations indicate that the inhibition of DAME-induced wet-dog shakes by taurine is associated with the suppression of seizure activities in the hippocampus. The possibility that taurine possesses an antagonistic action on opioid peptides is discussed. PMID- 3561716 TI - Interaction between acetylcholine and bradykinin in the lateral septal area of the rat brain: involvement of muscarinic receptors in cardiovascular responses. AB - The lateral septal area was used as a model to study the interaction between acetylcholine (Ach) and bradykinin on arterial blood pressure, since both mediators are present in this region. In the lateral septal area, the administration of the peptide or Ach produced a long-lasting, sympathetic mediated increase of arterial blood pressure which was blocked by atropine. Pretreatment of the lateral septal area with hemicholinium-3, which depletes stores of acetylcholine, partially blocked the pressor effect of bradykinin but not that of Ach. Captopril--an inhibitor of kininase II--enhanced the pressor effects of bradykinin and Ach. Synaptosomal studies showed that bradykinin increased sodium-dependent, high-affinity uptake of choline and the conversion of [3H]choline to [3H]acetylcholine. Competition experiments using the highly specific muscarinic antagonist [3H]quinuclidinyl benzilate, demonstrated that bradykinin displaced the muscarinic antagonist from its receptor-ligand complexes. These results suggest that in the lateral septal area acetylcholine and bradykinin interact in a positive feed-back which amplifies pressor responses. PMID- 3561717 TI - Effects of 1.2 microM lead in the laboratory mouse: developmental and behavioural consequences of chronic treatment. AB - Lead acetate, as a 0.025% (1.2 microM) solution in the drinking fluid, did not adversely affect the reproductive success in breeding mice, weights of pups at birth or cause delays in development. At 21 days, the treated offspring showed reduced weights but these returned to normal values in adulthood. Offspring of treated mice were given 1.2 microM lead acetate as drinking fluid after weaning. The mean daily intake of lead amounted to 2.4 and 2.6 mg/100 g body wt in females and males respectively and caused significant increases in the concentrations of lead in bone and brain. Sequestration of bone was greater in females than males. The behaviour of the offspring was examined by ethological analysis of social encounters between pairs of unfamiliar mice of similar treatment groups in a neutral cage. Evidence of enhanced reactivity to the test situation was seen in treated males at age 3-4 weeks by increased social investigation during the first 3 min of the 20 min encounter, at 7-8 weeks by decreased immobility in the final 5 min of the test and at 18-19 weeks by an increased duration of exploratory behaviour. However, when encountering females at 30-31 weeks, the treated males showed more immobility than did the controls. Treated females at 3-4 weeks, in the first 3 min of the test, showed a decreased frequency of exploratory behaviour and increased immobility, but at 7-8 and 18-19 weeks they showed enhancement of social and sexual investigation. Behaviour was unaltered at 30-31 weeks in encounters with unfamiliar males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561718 TI - Further studies on the blockade of 5-HT depolarizations of rabbit vagal afferent and sympathetic ganglion cells by MDL 72222 and other antagonists. AB - The blocking action of MDL 72222 (1 alpha H, 3 alpha, 5 alpha H-tropan-3-yl-3, 5 dichlorobenzoate at 5-hydroxytryptamine (5-HT) receptors on nodose (NG) and superior cervical ganglia (SCG) has been investigated further. The sucrose-gap technique was used to record potential changes from populations of neurones. The surmountable blockade induced by small concentrations of the antagonist was quantified and the blocking potency compared with that of a number of other compounds. In nodose ganglia three 4-5 point dose-response (DR) curves were established, using bolus injections of 5-HT (5-80 nmol). The mean amplitude of the response to 80 nmol was 4.18 +/- 0.53 mV and the ED50 was 18.2 nmol. Second and 3rd dose-response curves showed small displacements to the right, indicating a slight reduction in sensitivity. In superior cervical ganglia responsiveness was less. Amounts of 5-HT ranging from 20 to 320 nmol evoked dose-related depolarizations. The mean amplitude of the response evoked by 320 nmol 5-HT was 1.7 +/- 0.14 mV. Three 4-5 point dose-response curves could be elicited from a single ganglion. The ED50 was 55.8 nmol. Initial, 2nd and 3rd dose-response curves could be superimposed, there being no significant rightward shift. The results confirm that MDL 72222 is a potent, selective antagonist at 5-HT receptors in nodose and superior cervical ganglia. In the nodose ganglion, after equilibration for 1 hr with 10(-8) or 10(-7) M MDL 72222, dose-response curves for 5-HT showed rightward, parallel shifts. In contrast, 10(-6) M MDL 72222 or prolonged exposure (3-4 hr) to 10(-8), 10(-7) or 10(-6) M caused larger rightward shifts of the dose-response curves and depressed the maximum responses. In the superior cervical ganglion, equilibration for 1 hr with concentrations of 10(-8) or 10(-7) M produced effects on the dose-response curves similar to those seen in the nodose ganglion, but longer exposures (3-4 hr) did not depress the maximum. Apparent pA2 values were determined from individual experiments on both the nodose and superior cervical ganglia, where MDL 72222 (10(-7) M or less, for 1 hr) caused parallel or near parallel shifts of dose-response curves. In the nodose ganglion the apparent pA2 was 7.7 +/- 0.1, while in the superior cervical ganglion it was 7.8 +/- 0.1 (mean +/- SEM). The nature of the blockade induced by prolonged exposures or by concentrations greater than 10(-7) M is discussed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3561719 TI - The behavioural effects of intravenously administered tryptamine in mice. AB - The behavioural effects of intravenously administered tryptamine were examined in mice. Tryptamine in a dose greater than 15 mg/kg induced distinct head-weaving and hindlimb abduction. These behavioural syndromes appeared immediately after the injection and disappeared within 3 min. The changes in time course of the behaviour induced by tryptamine were consistent with those of the levels of tryptamine in the brain. Pretreatment with p-chlorophenylalanine, a depleter of 5 hydroxytryptamine (5-HT), failed to alter the effects of tryptamine on head weaving or hindlimb abduction but did result in head-twitches which were never seen after tryptamine alone. Metergoline strongly antagonized the behavior induced by tryptamine. Pirenperone and haloperidol inhibited the behavioural syndrome, antagonizing the head-weaving in particular. alpha-Methyl-p-tyrosine, a depleter of dopamine, reduced the head-weaving without affecting the hindlimb abduction. These results indicate that the 5-HT syndrome induced by intravenous administration of tryptamine is due to the direct effect of tryptamine on the 5 HT receptor. Tryptamine-induced behaviour, especially head-weaving, seems to be linked with dopaminergic neurones. PMID- 3561720 TI - The interaction of brain insulin receptors with wheat germ agglutinin. AB - Brain insulin receptors adsorb to and are recoverable from wheat germ agglutinin agarose (WGA) columns. Similar results are obtained using dissuccinimidyl suberate (DSS)-crosslinked receptors or photo-affinity labeled receptors. WGA can be used for partial purification of brain insulin receptors provided the appropriate WGA preparation is chosen and the optimal ratio of receptor protein to lectin is achieved. PMID- 3561721 TI - Evidence for the expression of peptides derived from three opioid precursors in NG 108CC15 hybrid cells. AB - Five opioid peptides (immunoreactivity) derived from their respective opioid precursors were measured in neuroblastoma-glioma hybrid cells (NG 108CC15; pmol/g protein): heptapeptide (Tyr-Gly-Gly-Phe-Met-Arg-Phe), 13.0 +/- 2.6; alpha neoendorphin, 6.6 +/- 0.8; dynorphin A, 4.4 +/- 1.5; dynorphin A 1-8, 1.3 +/- 0.29; beta-endorphin, 0.3 +/- 0.13. These peptides originate from preproenkephalin A (heptapeptide), prodynorphin (alpha-neonedorphin, dynorphin A, dynorphin A 1-8) and proopiomelanocortin (beta-endorphin). The data suggest the expression of all three known opioid precursors in a single hybrid cell line, permitting a simultaneous investigation of the processing of different opioid peptides under identical experimental conditions. PMID- 3561722 TI - Differential sensitivity to phenoxybenzamine alkylation among types of neurokinin binding sites. AB - The effect of phenoxybenzamine (PBZ) treatment of crude membranes was examined on binding to neurokinin/tachykinin NK-1, NK-2, and NK-3 binding sites. PBZ in concentrations up to 300 microM resulted in only a slight reduction in Bmax in binding of iodinated substance P to NK-1 sites in rat submaxillary gland and in rat urinary bladder. PBZ in concentrations as low as 30 microM resulted in a decrease in Bmax or in affinity in binding of iodinated neurokinin A (substance K) to NK-2 sites in hamster bladder and in rat bladder, and a decrease in affinity in binding of iodinated eledoisin to NK-3 sites in rat cerebral cortex. The results indicate a parallelism in differential sensitivity to PBZ alkylation between neurokinin biological receptors and neurokinin ligand binding sites. PMID- 3561723 TI - The effect of glutaurine on thyroid hormones in the rat. AB - Glutaurine (gamma-L-glutamyl taurine), a proposed hormone isolated from parathyroid gland oxyphil cells, was examined for its effect on circulating thyroid hormones in the rat. In acute experiments performed over a 24 hr. period, glutaurine depressed plasma triiodothyronine (T3) levels in a dose-dependent manner; however, thyroxine (T4) levels were not affected significantly. In chronic experiments performed over a 2 wk. period, glutaurine significantly increased T3 levels, but, as with acute studies, the effect of T4 levels was not significantly altered. Following acute glutaurine administration, TSH levels were elevated above control. The increased T3 observed following chronic glutaurine administration may be due to a secondary increase in TSH levels. These data support the hypothesis that glutaurine aids in peripheral thyroid hormonal regulation. Observed differences between acute and chronic glutaurine action are though to result from the effect of glutaurine on the negative feedback inhibiting action of TSH. PMID- 3561724 TI - Release of [Met]enkephalin in the central nucleus of the amygdala is increased by application of potassium in the substantia nigra. AB - Release of [Met]enkephalin immunoreactivity (Met-IR) in the central nucleus of the amygdala (ACE) was investigated in vivo in anesthetized rats implanted with push-pull cannulae. A stable spontaneous release of this peptide (1.3 fmol/15 min fraction) could be measured in the superfusates using a highly sensitive radioimmunoassay. The addition to the superfusion medium of cocktail of peptidase inhibitors increased three times the spontaneous release of the peptide. Superfusion with 30 mM potassium increased ten times the release of the peptide. Chemical stimulation of the substantia nigra with K+ enhanced four times the Met IR release in the ipsilateral ACE. The dopaminergic component of the nigro amygdaloid pathway appeared not to be directly implicated in this effect, since: d(+)amphetamine application in the ACE, which enhanced the local release of DA, remained without effect on Met-IR release and haloperidol-induced blockade of dopaminergic receptors in the ACE similarly did not affect Met-IR release. PMID- 3561725 TI - Cavernous branches of the internal carotid artery: anatomy and nomenclature. AB - In most standard anatomical textbooks, the cavernous branches of the internal carotid artery (ICA) are rarely or shortly described. Among three reports dealing with these branches, there is a lack of agreement in description and nomenclature. This study presents a systematic nomenclature based on the result of anatomical dissection in the cavernous sinus (CS) of 32 human subjects. The ophthalmic artery was found arising inside the CS in 5 subjects (15.6%). The posterior trunk (meningohypophyseal trunk of Parkinson) was present in all subjects (100%), but its distribution varied considerably. In 9 subjects, one or two of its primary divisions originated directly from the ICA. The lateral trunk was found in 21 subjects (65.8%), and the capsular arteries of McConnell of the median group were found in 9 (28.1%). Other branches to the surrounding structures (trigeminal ganglion and divisions, superior wall of the CS, the 3rd, 4th, and 6th cranial nerves, and osseous branches) were inconstant. Anastomotic branches to the ophthalmic, middle meningeal, and ascending pharyngeal arteries were also noted. A systematic nomenclature is proposed, in which the branches of the ICA are named according to their topographical origins from the artery and their primary or secondary divisions are named according to their destinations. PMID- 3561726 TI - Hydrocephalus: increased intracranial pressure and brain stem auditory evoked responses in the hydrocephalic rabbit. AB - The auditory evoked response (AER) was used to study the effect of increased intracranial pressure (ICP) on the auditory pathway in normal New Zealand rabbits and in those made hydrocephalic by intracisternal injections of kaolin. AERs were studied: (a) in the normal and then in the hydrocephalic animal; and (b) in the hydrocephalic animal during further ICP elevation by cerebrospinal fluid infusion. The AER was obtained from ongoing electroencephalographic activity after rarefaction auditory clicks presented at 90 dB sound pressure equivalent. In comparing base line normal AERs to those found in hydrocephalic conditions, a statistically significant increase in latency for AER components N2, P2, and P5 was noted in hydrocephalic rabbits. Increased ICP in the hydrocephalic model showed an increase in the latencies of AER components for P0 and P1 at 250 mm H2O, and a prolongation of P3-P5 central conduction time at 700 mm H2O above base line cerebrospinal fluid pressure. In addition, a decrease in the P4/N5 amplitude and an increase in P1-P3 central conduction times at 700 mm H2O was observed. The differences between normal and hydrocephalic rabbit AER base lines may be the result of the chronically increased ICP and presumed chronic anatomical changes within the auditory pathway due to kaolin itself. The differences in the AER from base line hydrocephalus to acute increased ICP may indicate that the hydrocephalic system is more sensitive to acute neuropraxic pressure effects on the brain stem auditory structures than is the normal brain. PMID- 3561727 TI - Incidental lesions noted on magnetic resonance imaging of the brain: prevalence and clinical significance in various age groups. AB - With the advent of magnetic resonance imaging (MRI) of the brain, a large number of incidental lesions (ILs) are being identified. The prevalence and clinical significance of these ILs are not known. The MRI and clinical records of 86 consecutive patients who underwent technically satisfactory brain imaging at a large urban referral center were reviewed. Patients with definite or probably demyelinating disease were excluded. Incidental lesions were defined as parenchymal areas of increased signal intensity on T2-weighted imaging, which could not be directly explained by the patient's current clinical diagnosis, neurological status, or computed tomographic (CT) scan. The ILs were noted and graded according to size, multiplicity, and location and were correlated with age, clinical presentation, CT scan findings, and risk factors for cerebrovascular disease. One or more IL were identified in 22% of patients under 40 years of age, in 57% of patients 41 to 60 years of age, and in 90% of patients over 60 years of age. Large patches of confluent ILs were not encountered in any patient less than 40 years of age; they were present in 10% of patients 41 to 60 years of age, and in 30% of patients over 60 years of age. The incidence of severity of ILs correlated significantly with age (P less than 0.0005) and with risk factors for cerebrovascular disease (P less than 0.02). Patients with most severe ILs also had areas of vague periventricular leukomalacia on the CT scan. The clinical significance of incidental MRI lesions in various age groups is discussed in detail.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561728 TI - Microanatomy of the posterior communicating artery. AB - Fifty unfixed cerebral hemispheres were injected with polyester resin and dissected under the operating microscope to show the anatomy of the posterior communicating artery (PCoA). There was a single PCoA in every hemisphere. Eleven (22%) were of fetal origin, and 17 (34%) were hypoplastic. Infundibular dilatations were found in 5 (10%) of the arteries. The outer diameter (OD) of the PCoA at its origin was 1.5 +/- 0.8 mm on the right and 1.6 +/- 0.6 mm on the left. At the junction of the PCoA with the P1 segment of the posterior cerebral artery, the PCoA had an OD of 1.4 +/- 0.7 mm on the right side and 1.6 +/- 0.6 mm on the left. The total length of the PCoA was 12.7 +/- 3.2 mm on the right and 12.5 +/- 1.7 mm on the left side. PCoA branches originated from the superior (36%) or lateral (64%) surface of the PCoA and coursed superiorly, posteriorly, or laterally. These vessels supplied the paramedian perforated substance (21%), the tuber cinereum (16.8%), the sulcus between the optic tract and the tuber cinereum (14.4%), the circuminfundibular anastomosis (11.5%), the mamillary bodies (8.4%), the sulcus between the optic tract and the cerebral peduncles (7.6%), and the cerebral peduncles (5.7%). The largest and most constant branch of the PCoA was the premamillary artery. The number and size of the branches from the PCoA were independent of the size of the parent artery. PMID- 3561729 TI - Intracranial aneurysms and heredity. AB - The occurrence of intracranial aneurysms (IAs) in the families of 579 consecutive patients with subarachnoid hemorrhage (SAH), of whom 485 had verified IAs, was studied retrospectively. IAs occurred in the families of 6.7% of the IA patients, but only 0.4% of their siblings had IAs. However, there were differences between the familial and nonfamilial IA patients, indicating that the familial patients are a specific small subpopulation of IA patients. The familial patients were younger, often had multiple aneurysms, and had aneurysms frequently located on arteries other than those in the nonfamilial group. PMID- 3561730 TI - Techniques of spinal cord surgery in fetal rats. AB - These experiments were done to develop techniques to expose and manipulate the spinal cord in fetal rats, techniques that could be used to study spinal cord regeneration and transplantation. Adequate maternal anesthesia required a mixture of acepromazine-ketamine supplemented by thiopental. Fetal rats were operated on at 16 to 22 days of gestation. Fetal mortality increased as the age of the fetus decreased. Microsurgical techniques were developed to expose, divide, and transplant the distal spinal cord. PMID- 3561731 TI - Intramembranous cytochemistry: a new morphological technique for studying cholesterol in the astrocyte plasma membrane of ischemic brain cells. AB - The distribution of cholesterol in the astrocytic plasma membranes of normal and ischemic caudate nucleus in the cat was investigated with the polyene antibiotic, filipin, a morphological probe for membrane cholesterol domains in freeze fracture tissue replicas. After filipin incubation of prefixed vibratome slices, filipin-cholesterol complexes appeared as 20 to 30 nm protuberances and pits on P and E-faces of the replicas. Distinct patterns of filipin-cholesterol complexes were found on nonischemic and ischemic astrocyte membranes. The filipin-treated specimens showed an 80% decrease in astroglial plasmalemma of cholesterol 1 hour after cerebral ischemia. PMID- 3561732 TI - Hemodynamic method to predict whether hunterian ligation of the basilar artery will lead to thrombosis of basilar bifurcation aneurysms. AB - In some cases, basilar artery aneurysms cannot be repaired surgically and the basilar artery is occluded near the neck of the aneurysm to stop flow into the aneurysm. After the operation, the aneurysm can fill only by flow through the posterior communicating arteries (PCoAs). Hemodynamically if the flow were the same in both PCoAs and there were no phase lag in the pressures, there would be no pressure gradient for flow to go across the neck of the aneurysm and therefore the aneurysm would thrombose. We have assumed that the diameter of the artery is roughly proportional to the flow that goes through it chronically. We measured the diameters of the PCoAs in 25 patients who had hunterian ligation of the basilar artery. We also measured the maximal width, height, and depth of the aneurysms on angiograms obtained before and after operation. Eleven aneurysms thrombosed completely and had a diameter ratio of greater than 0.6; 10 aneurysms thrombosed partially and had a diameter ratio of 0.46 approximately 1.0; 4 aneurysms did not change and had a diameter ratio of less than 0.45. The ratio of the sizes of the PCoAs pre- and postoperatively was comparable in most cases, so we believe that it is possible to predict reasonably accurately from this simple measurement whether the aneurysm is likely to thrombose if the basilar artery is ligated. PMID- 3561734 TI - New kneeling attachment and cushioned face rest for spinal surgery. AB - Surgical frames, kneeling attachments, and special operating tables for lumbar spinal surgery are designed to promote good positioning, lower the intraabdominal pressure, and reduce epidural bleeding. The frame reported here fulfills these objectives and produces either lumbar spinal extension to reduce paraspinal muscle tension or mild flexion to distract the neural arches. The new frame unit is made of lightweight fiberglass and aluminum, weighing only 14 lb (6.5 kg), and utilizes the hydraulic elevator pump of the operating table as a means to raise or lower the frame. Thus, adjusting the horizontal plane of the lumbar spine requires no separate crank system. The anterior tibial cushions, lying in hemicylindrical troughs, and the ergonomically designed cushions for chest and buttocks improve the distribution of body weight. A new, fully adjustable, cushioned face rest is used to maintain the neck in a neutral position, with the patient placed fully face-down. PMID- 3561733 TI - General metabolism in head injury. AB - Seventy-six patients with closed head injuries alone were studied to define the relation between the severity of the head injury and secondary alterations of general metabolism. The effect of metabolic changes on neurological outcome and the importance of nutritional support on nutritional status and neurological outcome were also evaluated. Using a powerful statistical tool, convergence analysis, it was possible to take into consideration the effects of a number of confounding factors that obviously affected general metabolism. Most of the patients were hypermetabolic for prolonged periods. In addition, many did not receive even basal requirements of calories or protein for many days. Despite this, their outcomes were determined by their initial neurological status and the amounts that they were fed, admittedly relatively modest, did not influence their courses. Despite such feedings, their visceral protein levels, which often dropped initially, rose toward normal levels, indicating effective adaptation. Indeed, it could not be shown that these patients developed complications of malnutrition such as infections. However, it will require a sophisticated randomized clinical trial of vigorous intravenous hyperalimentation to determine whether this complex, dangerous, and expensive therapy is helpful for severely head-injured patients. PMID- 3561735 TI - Machete wounds to the head: report of three cases. AB - Three cases of machete wounds to the head are described. The resulting injuries from this unusual mode of trauma varied in severity and included transection of a previously placed ventriculoperitoneal shunt. Complications of these injuries resulted from delayed and inadequate treatment. PMID- 3561736 TI - Autogeneic skull bone grafts to reconstruct large or complex skull defects in children and adolescents. AB - Autogeneic split or free skull bone grafts harvested at the time of operation were used to repair large or complex skull defects in 19 children; in 2 children, autogeneic fresh rib grafts were also used. Follow-up examinations for periods of 1 and 7 years showed that the use of autogeneic grafts is superior to the use of materials such as acrylic or metals for cranioplasty in children. PMID- 3561737 TI - Civilian gunshot wounds to the spinal cord and cauda equina. AB - We evaluated 42 patients with neurological deficits after civilian gunshot wounds to the spine. Thirty-five of these patients (the study population presented here) received their initial and follow-up care at Louisiana State University Medical Center in Shreveport over a 4-year period. Each patient had incurred a single gunshot wound to the spinal cord or cauda equina with an accompanying neurological deficit. The patient population was divided into three groups. Group 1 patients had incurred a complete motor and sensory loss below the injury (20 patients (57%]. Group 2 patients had incurred incomplete spinal cord injuries (9 patients (26%], whereas Group 3 patients had cauda equina injuries (6 patients (17%]. Myelography was performed for all Group 2 and 3 patients as well as Group 1 patients in whom the trajectory of the bullet did not explain a higher level of neurological injury (3 patients (15%]. A decompressive operation was performed in the patients whose myelography showed neural compression. Three patients in Group 1 (15%), 5 patients in Group 2 (56%), and 5 Group 3 patients (83%) underwent operation. All 3 Group 1 patients who underwent operation had some improvement of nerve root function postoperatively. All operated Group 2 and 3 patients had improvement of myelopathic or radicular function postoperatively. All began improving within several days of operation, implying a cause and effect relationship. None of the 17 nonoperated Group 1 patients improved neurologically, whereas 3 of the 4 nonoperated Group 2 patients improved. The single nonoperated Group 3 patient improved neurologically.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561738 TI - Visual hallucinations associated with pituitary adenoma. AB - Visual hallucinations were the presenting symptom in three patients with pituitary adenoma. One patient reported only simple unformed hallucinations, which are a well-documented phenomenon occurring in lesions compressing the optic nerves and chiasm. The other two patients, however, experienced complex formed visual hallucinations believed to be of the release type. No evidence of seizure activity responsible for the hallucinations was found; the mechanism producing them is discussed with correlation to operative findings and electrophysiological studies. PMID- 3561739 TI - Brain tissue pH in severely head-injured patients: a report of three cases. AB - It is well established that low cerebrospinal fluid (CSF) pH and high CSF lactate concentration indicate the development of brain acidosis after severe human head injury. However, there is no direct evidence that tissue acidosis actually occurs. We measured brain extracellular pH (pHe) in three patients undergoing operation for the evacuation of acute subdural hematomas. A pH-sensitive polymer membrane electrode was inserted 500 micron into the cerebral cortex close to the damaged area. The pHe values obtained were correlated with ventricular CSF acid based parameters and extension of the brain lesion. The CSF pH was higher than the pHe in all cases; the pHe was particularly low in areas of contusion or compression by mass lesion. The effect of focal brain tissue acidosis on clinical course after severe head injury is discussed. PMID- 3561740 TI - Diagnostic value of computed tomography in recurrent pain after discectomy. AB - Intravenously enhanced computed tomography (CT) was used in patients in whom the differential diagnosis between recurrent herniated disc and postoperative scar was considered. Enhanced CT images demonstrated postoperative herniated discs more accurately than clinical criteria, myelography, or plain or postmetrizamide CT. The scar tissue shows contrast enhancement, but recurrent disc herniation does not. Therefore, contrast-enhanced CT is considered to be a valuable aid in distinguishing between recurrent disc herniation and hypertropic scar formation. PMID- 3561741 TI - Isolated central nervous system angiitis first presenting as spontaneous intracranial hemorrhage. AB - Two cases of isolated central nervous system angiitis presenting as spontaneous intracranial hemorrhage are reported. The usefulness and limitations of cortical/leptomeningeal biopsy in this condition is described. Emphasis is placed on the clinical awareness of this unusual association to ensure early recognition and prompt management with immunosuppressive therapy. PMID- 3561742 TI - Synovial cyst of the cervical spine. AB - A case of acute posttraumatic myelopathy resulting from hemorrhage into synovial cysts bilaterally at the C-6, C-7 facet joints is presented. The pathogenesis of synovial cysts remains unclear, although reports in the literature have implicated trauma leading to cyst enlargement. Hemorrhage into the cavity of the synovial cysts resulted in epidural compression of the spinal cord in this patient. Because spinal synovial cysts cannot be unequivocally diagnosed preoperatively, other more common conditions must be considered in the differential diagnosis. Radiographic analysis including plain films, computed axial tomography, and metrizamide myelography are of value in establishing a neurological diagnosis. Surgical decompression and excision of the lesion may result in significant neurological improvement. PMID- 3561743 TI - Acute brain swelling during evacuation of subdural hematoma caused by delayed contralateral extradural hematoma: report of two cases. AB - Two patients experienced severe brain swelling during the evacuation of acute subdural hematomas. Postoperative computed tomographic (CT) scans revealed delayed extradural hematomas on the sides opposite the subdural hematomas. Extradural bleeding occurred in the area of the fractured skull. One patient improved neurologically after evacuation of the extradural hematoma, and the other was not operated because he was moribund. Drilling exploratory burr holes in the fractured area may have been a better strategy than awaiting a postoperative CT scan. The reduction of intracranial pressure after the removal of subdural hematoma was postulated to be the most important factor contributing to the formation of the extradural hematoma. PMID- 3561744 TI - Primary myxoma in the pituitary fossa: case report. AB - A case of primary myxoma in the pituitary fossa is described. The tumor presented as an intrasellar and suprasellar mass and was successfully removed during a transsphenoidal operation. It was verified as a myxoma by histopathological studies, and there was no evidence that it was a metastasis. This is thought to be the first report of this tumor occurring in the pituitary fossa. PMID- 3561745 TI - Persistent nerve root compression by buckling of the longitudinal ligament after chemonucleolysis. AB - Buckling of the posterior longitudinal ligament with compression against the thecal sac was the cause of persistent positional back pain after chemonucleolysis. Computed tomography in the supine and prone positions was helpful in making the diagnosis, and the cause was confirmed at laminectomy. PMID- 3561746 TI - Choice of anesthetics for MEP studies. PMID- 3561747 TI - Emergent micro comment. PMID- 3561748 TI - Meningioma in a child. PMID- 3561749 TI - Trigeminal DREZ. PMID- 3561751 TI - Effect of serotonin and acetylcholine on electrical activity of the isolated rabbit cortex. AB - Neuronal isolation of the rabbit cerebral hemisphere shifts the EEG spectrum in the direction of slower processes. Application of acetylcholine to the cortex brings about EEG activation and appearance of the theta rhythm. Initially serotonin application is accompanied by the appearance of theta rhythm periods; during subsequent administration of the drug these periods are gradually substituted by slow delta waves. Combined application of serotonin and acetylcholine to the isolated cortex brings about bursts of high amplitude activity, abruptly substituted by "silent" phases. In contrast to the intact cortex, where serotonin brought about prolonged and rhythmic alternation on the EEG of phases of high amplitude activity and of silent periods, in the isolated cortex the bursts of activity of about 1 min duration appeared only after application of acetylcholine to the serotonin-saturated cortex. Repeated phases of activation were either absent or of short duration and were rapidly extinguished. PMID- 3561750 TI - Influence of a cyclic enkephalin analog on learning and memory in mice. PMID- 3561752 TI - Influence of immunization with neurospecific proteins and tubulin on learning in rats. PMID- 3561753 TI - Intercellular relationships in elementary neuronal ensembles. AB - The mechanisms of combination of cortical neurons into discrete modules or elementary ensembles, serving as functional units and forming a mosaic of activity in which incoming information is coded, have been investigated. Neurons activated primarily by terminals of specific afferents respond stably with a minimal latent period and become the centers of ensembles, whose periphery is formed by secondarily activated neurons, responding variably with a longer latent period. The stochastic participation of these neurons in the structure of the ensembles lies at the basis of plasticity of cortical mechanisms. Neurons inhibited intracortically, and possibly, via ascending inhibitory pathways, are concentrated at the periphery and near the output cells of the ensemble. PMID- 3561754 TI - Prolonged negative surface potentials of the cat sensomotor cortex and responses of neurons and glial cells. AB - Evoked potentials to stimulation of the ventrolateral and intralaminar thalamic nuclei, the surface of the sensomotor cortex, and the pyramidal pathways, derived from the same point, and also corresponding postsynaptic responses of pyramidal neurons were studied in acute experiments on cats anesthetized with ether or superficially with pentobarbital (25-30 mg/kg, intraperitoneally), and immobilized with muscle relaxants. Surface application of strychnine inhibits the slow negative potential arising in response to direct and primary responses, and the corresponding slow potentials of the IPSP. The action of iontophoretic application of strychnine on IPSP of pyramidal neurons and responses of cortical glial cells also were studied. Both methods of application of strychnine block mainly the early component of the IPSP, during which the input resistance is significantly lower than that during the late component, evidence of their different genesis. The results of the investigation show that slow negative potentials are a reflection of hyperpolarization of pyramidal neurons, and that the separate components of the responses have a common genesis. PMID- 3561755 TI - Neurochemical mechanisms of the involvement of cortical sensorimotor neurons in alimentary and orientational behavior. AB - The object of these experiments was the study of the features of the neurochemical mechanisms of the involvement of individual neurons of the sensorimotor cortex of the rabbit brain the orienting reaction and the goal oriented alimentary behavior elicited by stimulation of the "hunger center" of the lateral hypothalamus using electrical current of varying intensity. It is demonstrated that the neurotransmitters acetylcholine and norepinephrine, in approximately equal percentages, reorganize the reaction of neurons at the subthreshold as much as at the threshold level of stimulation. The microiontophoretic application to cortical sensorimotor neurons of the protein synthesis blocker, cycloheximide, also elicits alterations in their reactions to threshold and subthreshold stimulation of the lateral hypothalamus which are apparently linked to the suppression of synthesis of neuropeptides specific to both behaviors. It is proposed that the orienting, and especially the alimentary, motivational reactions are achieved by the activation of the synthesis of specific peptide molecules in the cortical sensorimotor neurons, which in fact may induce a change in their sensitivity to neurotransmitters. PMID- 3561756 TI - Locus ceruleus and neuronal activity of the reticular nucleus of the thalamus. AB - Reactions of neurons of the reticular nucleus of the thalamus and lateral geniculate body to stimulation of the locus ceruleus were studied on their unanesthetized, immobilized cats. It was found that preliminary brief rhythmic stimulation of the locus ceruleus causes inhibition of the activity of the majority of neurons of the reticular nucleus and facilitation of relay neurons of the lateral geniculate body. Such reactions are clearly exhibited during simultaneous recording (by means of two microelectrodes) of the neuronal activity of these brain structures. PMID- 3561757 TI - Variability of morphological parameters of individual neurons and their aggregations in visceral ganglion of the mollusk Lymnaea stagnalis. PMID- 3561758 TI - Initial neurons of associative and callosal pathways of lateral suprasylvian area of the cat brain. PMID- 3561759 TI - Receptor binding of corticosterone in some rat brain structures following neonatal blockade of the hypophyseoadrenal system. AB - Administration of hydrocortisone to rats during the first five postnatal days leads to the blockade of the hypophyseoadrenal system and results in a decrease in the number of corticosterone receptors in the hypophysis, hypothalamus, and hippocampus. Such a decrease in the receptor binding of corticosterone in the brain structures involved in the regulation of the hypophyseoadrenal system by a feedback mechanism is due to a change in the number of true glucocorticoid receptors. PMID- 3561760 TI - Reconstruction of the defective cerebellar circuitry in adult Purkinje cell degeneration mutant mice by Purkinje cell replacement through transplantation of solid embryonic implants. AB - Solid pieces of cerebellar primordia taken from 12-day-old C57BL embryos were implanted into the cerebellar parenchyma of 3- to 4-month-old "Purkinje cell degeneration" mutant mice and analysed 2-3 months later. Purkinje cell replacement was followed by means of immunocytochemistry with antisera against either cyclic guanosine monophosphate-dependent protein kinase or vitamin D dependent calcium-binding protein, which allows the complete staining of these neurons. Although all solid graft implants survived, their fate within the mutant cerebellum varied in three ways: Often, a more or less large fragment of the solid graft remained in the white matter, close to the cortex or even partially replacing it. These remnants contained a few distorted Purkinje cells and a region corresponding to the transplanted deep nuclei, composed of numerous immunostained axons and axon terminals surrounding immunonegative neurons. Less frequently remnants of the graft were extruded to an extracerebellar location, between two adjacent folia. They contained a few Purkinje cells intermixed with granule cells and other neurons. In a few cases corresponding to superficial deposition, the implants developed lobulated and trilaminated minicerebella which were located outside the mutant cerebellum but integrated into it. In all three situations, a large number of grafted Purkinje cells succeeded in moving out of the implants and in invading the host molecular layer. These Purkinje cells develop flattened dendritic trees perpendicular to host bundles of parallel fibres. Ultrastructural examination of the synaptic investment of Purkinje cells which have reached the host molecular layer revealed that they acquire normal synaptic inputs although complex pericellular baskets and pinceau formation do not develop. Axons from molecular layer interneurons synapse on perikaryal and smooth dendritic membranes, climbing fibres synapse on stubby spines emerging from thick dendritic branches, and parallel fibres contact almost exclusively the long-necked spines of the distal spiny branchlets. Finally, Purkinje cells which succeed in migrating to molecular layer regions no further than 0.6 mm from the host deep nuclei are able to grow axons which reach appropriate target areas and establish synaptic connections on nuclear neurons. The results obtained from this series of long-term survival cerebellar transplantations point to the possibility of fulfilling most of the conditions necessary for functional restoration of neural grafts in systems in which neurons are connected in a point-to-point manner.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3561761 TI - A cuneocochlear pathway in the rat. AB - Following injections of wheat germ agglutinin-conjugated horseradish peroxidase into the cuneate nucleus of anesthetized rats, retrograde and anterograde label was observed in the cochlear nucleus. Labeled cochlear neurons were found mostly in the ipsilateral dorsal cochlear nucleus and in the contralateral ventral cochlear nucleus. Anterograde label was found primarily ipsilateral to the injection site, and was restricted mainly to the dorsal cochlear nucleus, although label was also observed in the anteroventral cochlear nucleus. Horseradish peroxidase injections were made in the dorsal cochlear nucleus to investigate the source of this pathway. Retrogradely labeled cells in the region of the dorsal column nuclei were located mainly in a shell on the dorsal edge of the cuneate nucleus extending into the white matter of the cuneate fasciculus. The cuneocochlear pathway could provide a direct link between the auditory and somatosensory systems; connections between these two sensory systems may be explained on phylogenetic grounds. PMID- 3561762 TI - The mode of projections of single locus coeruleus neurons to the cerebral cortex in rats. AB - Axonal distributions of single locus coeruleus neurons within the cerebral cortex were examined with antidromic stimulation technique combined with cortical lesions (frontal lobotomy and lobectomy). In urethan-anesthetized rats, stimulating electrodes were implanted in 10 points extending over nearly the entire cerebral cortex, and antidromic responses of single locus coeruleus neurons to stimulation of these stimulus sites were analysed. Fifty percent of locus coeruleus neurons examined were activated antidromically from at least one cortical point in the cerebral cortex. The pattern and extent of axonal distributions of single locus coeruleus neurons in the cortex appeared to vary from cell to cell. From the results obtained in rats with the cortical lesions, it is concluded that in addition to locus coeruleus neurons with intracortical axons running from rostral to caudal, there are the neurons projecting to the occipital cortex without innervating the frontal cortex and those projecting simultaneously to the frontal and occipital cortex with two axonal branches. There was no topographic order between the recording sites within the locus coeruleus and the projection sites in the cortex. PMID- 3561763 TI - Morphological adaptability at neurosecretory axonal endings on the neurovascular contact zone of the rat neurohypophysis. AB - To compare the effects of a variety of acute and chronic stimuli that bring about or terminate hormone release the ultrastructure of nerve terminal contact at the basal lamina of the neurohypophysial neurovascular contact zone was examined quantitatively in young adult rats of the following treatment groups: untreated virgin females, untreated male rats, prepartum (day 21 of gestation), postpartum (on the day of parturition), lactating (14 days of suckling), mothers 10 days after their pups were weaned, 48 h water-deprived males, males given 2% saline solution (dehydrated) for 10 days, males given 2% saline as described then given tap water to rehydrate for 2 or 5 weeks. Morphometric analysis of electron micrographs revealed that all stimuli leading to increased hormone release were accompanied by both increased occupation of the basal lamina by nerve terminals as well as decreased enclosure of neurosecretory processes by pituicyte cytoplasm. Neural occupation of the basal lamina remained significantly elevated 10 days post-weaning and at 2 weeks (but not 5 weeks) of rehydration following 10 days of dehydration. Pituicyte enclosure of neurosecretory axons had returned to control values in the postweaning and 5 week (but not 2 week) rehydrated animals. The mean length of individual nerve terminal contact with the basal lamina was found to increase under some, but not all, conditions associated with increased hormone release (i.e. parturition, acute and chronic dehydration, but not during lactation) and to decrease below control values in prepartum females and after 5 weeks of rehydration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3561764 TI - Morphological basis for nonsynaptic communication within the central nervous system by exocytotic release of secretory material from the egg-laying stimulating neuroendocrine caudodorsal cells of Lymnaea stagnalis. AB - The fine structure of the axons of the cerebral, egg-laying stimulating caudodorsal cells of the snail Lymnaea stagnalis has been studied with various light and electron microscope techniques. Special attention was paid to exocytotic release of secretory material (demonstrated with the tanic acid method) from nonsynaptic release sites in the cerebral commissure. This phenomenon has been compared with neurohaemal release. The commissure consists of two morphological compartments, separated by a sheath of glial cells. The outer compartment is formed by the neurohaemal area of the caudodorsal cells, the inner consists of thousands of, mainly unidentified, axons. Furthermore, ventral caudodorsal cells send axons through the inner compartment. These give rise to collaterals, which divide into smaller collaterals, forming an extensive network ("collateral system") throughout the inner compartment. Eventually, collaterals end blindly within the inner compartment. They contain the same three morphological types of secretory granule as the neurohaemal axon terminals. The collaterals never form synaptic contacts; exocytotic release of the contents of secretory granules takes place at nonsynaptic release sites. These sites occur rather dispersed and do not face one particular type of neighbouring neural element. As in the neurohaemal area, both single and multiple exocytoses occur. Widened intercellular spaces, filled with flocculent, electron-dense material, occur near highly active nonsynaptic release sites. The spaces are often bordered by glial cells and may facilitate diffusion of released secretory material through the inner compartment. Apparently, a ventral caudodorsal cell releases secretory material in two fashions: from neurohaemal axon terminals into the haemolymph, and nonsynaptically, from the collaterals into the intercellular space of the central nervous system. Possible functions of the glial sheath between the neurohaemal area and the inner compartment are proposed. Most likely, the collateral system enables the caudodorsal cells to communicate with targets within the central nervous system in a nonsynaptic fashion. A possible target is the cerebral Ring Neuron, which sends an axon branch through the inner compartment and, as was previously shown neurophysiologically, is controlled by the caudodorsal cells in a nonsynaptic fashion. PMID- 3561765 TI - Thalamic projections to the paleostriatum and neostriatum in the pigeon (Columba livia). AB - Thalamic projections to the paleostriatum and neostriatum in the pigeon have been studied using wheat germ agglutinin-horseradish peroxidase in anterograde and retrograde tracing experiments. Injections centred on different mediolateral regions of the dorsal thalamus produced terminal labelling in correspondingly different mediolateral regions of the striatal complex, comprising paleostriatum augmentation and lobus parolfactorius, within the ventral paleostriatum, and within the neostriatum. Injections into various loci within these regions retrogradely labelled numerous neurons within the dorsal thalamus, the location of which varied systematically with the injection placement; and within various regions of the midbrain and pons. These experiments demonstrate a major thalamic projection to the striatum analogous to that from the midline and intralaminar nuclei to the caudatoputamen in mammals, although the patchy characteristic of mammalian striatal afferent terminations was observed only within ventral regions of the pigeon paleostriatum. In addition the experiments demonstrate that striatal afferents also originate from certain nuclei of the mesencephalic midline which are possibly equivalent to the raphe nuclei. PMID- 3561766 TI - Cholinergic systems influence local cerebral glucose use in specific anatomical areas: diisopropyl phosphorofluoridate versus soman. AB - The organophosphates, diisopropyl phosphorofluoridate and soman have a common mechanism of action (inhibition of acetylcholinesterase), but result in very different behavioral responses in the rat. Soman rapidly produced persistent tonic convulsions whereas diisopropyl phosphorofluoridate only infrequently produced transient convulsive-like activity. Soman increased local cerebral glucose use in most of the cortex, striato-pallido-nigral pathway, limbic system and in specific thalamic nuclei whereas diisopropyl phosphorofluoridate increased glucose use in a limited fashion, primarily in the dorsal striato-pallido-nigral pathway. When diazepam blocked soman-induced convulsions, the pattern of glucose use was strikingly similar to that caused by diisopropyl phosphorofluoridate. Soman or diisopropyl phosphorofluoridate depressed local cerebral glucose use in rats pretreated with the antidotal mixture of trimedoxime, atropine and benactyzine (muscarinic antagonists). Also, this antidotal mixture blocked the increased glucose use in the dorsal striato-pallido-nigral system produced by either acetylcholinesterase inhibitor, indicating that muscarinic receptors mediate the excitation of this pathway. Both diisopropyl phosphorofluoridate and soman activate the striato-pallido-nigral pathway but soman also causes spread of activity producing overt motor convulsions. Possible explanations for this difference in response to the organophosphates are differential responses in cholinergic actions within specific brain regions or some non-cholinergic action of soman. PMID- 3561767 TI - Ultrastructural localization of GABA in the supraoptic nucleus and neural lobe. AB - Antibodies directed against the neurotransmitter gamma-aminobutyric acid (GABA) enabled the ultrastructural localization of GABA in conventional glutaraldehyde fixed and osmium postfixed material of the rat supraoptic nucleus and neural lobe. GABA was visualized using immunogold postembedding staining in axonal profiles that terminate on dendrites, axons or cell bodies throughout the supraoptic nucleus. The optimum ultrastructural preservation made possible the visualization of GABA terminals, also in the neural lobe. Here GABA axons were found to terminate synaptically on pituicytes and axonal profiles containing large dense core vesicles. These results emphasize, from an anatomical point of view, the potency of GABA to influence, as a transmitter, the release of vasopressin and oxytocin, both at the level of the cell body and of the neural lobe. PMID- 3561768 TI - Target cell stimulation of dissociated serotonergic neurons in culture. AB - Dissociated mesencephalic raphe cells from fetal rats (14-18 days) were grown in culture in 96 well Linbro plates. The maturation of serotonergic cells was qualitatively studied using immunocytochemistry with a serotonin antibody and quantitatively by measuring the retention of radioactivity following incubation in the presence of a low concentration of [3H]5-hydroxytryptamine (6 X 10(-8) M). The 5-hydroxytryptamine immunoreactive neurons showed specific staining in the perikaryon, nucleus, dendrites, axons and growth cones. These neurons formed varicose fibers and growth cones after 18 h in culture and survived for up to 21 days in culture. Each serotonergic neuron concentrated approximately 1 fmol of serotonin after 20 min of incubation. Maturation of mesencephalic serotonergic neurons was increased in co-cultures of both normal (hippocampus, cerebral cortex, olfactory bulb and striatum) and abnormal (spinal cord) target neurons. The best stimulation was produced by dissociated hippocampal neurons (14-18 days of gestation) on mesencephalic raphe cells (14 days of gestation) after 4 days in culture. This stimulation was seen in culture conditions which favored neuronal but not glial survival. Our results obtained using cultures of dissociated serotonergic cells are consistent with an expansive network pattern developed by this chemical transmitter system in the adult brain. PMID- 3561769 TI - Quantitative light microscopic autoradiographic localization of cholinergic muscarinic receptors in the human brain: forebrain. AB - The distribution of muscarinic cholinergic receptors in the human forebrain and cerebellum was studied in detail by quantitative autoradiography using N [3H]methylscopolamine as a ligand. Only postmortem tissue from patients free of neurological diseases was used in this study. The highest densities of muscarinic cholinergic receptors were found in the striatum, olfactory tubercle and tuberal nuclei of the hypothalamus. Intermediate to high densities were observed in the amygdala, hippocampal formation and cerebral cortex. In the thalamus muscarinic cholinergic receptors were heterogeneously distributed, with densities ranging from very low to intermediate or high. N-[3H]Methylscopolamine binding was low in the hypothalamus, globus pallidus and basal forebrain nuclei, and very low in the cerebellum and white matter tracts. The localization of the putative muscarinic cholinergic receptors subtypes M1 and M2 was analysed in parallel using carbachol and pirenzepine at a single concentration to partially inhibit N [3H]methylscopolamine binding. Mixed populations of both subtypes were found in all regions. M1 sites were largely predominant in the basal ganglia, amygdala and hippocampus, and constituted the majority of muscarinic cholinergic receptors in the cerebral cortex. M2 sites were preferentially localized in the diencephalon, basal forebrain and cerebellum. In some areas such as the striatum and substantia innominata there was a tendency to lower densities of muscarinic cholinergic receptors with increasing age. In general, we observed a slight decrease in M2 sites in elderly cases. Muscarinic cholinergic receptor concentrations seemed to be reduced following longer postmortem periods. The distribution of acetylcholinesterase was also studied using histochemical methods, and compared with the localization of muscarinic cholinergic receptors and other cholinergic markers. The correlation between the presence of muscarinic cholinergic receptors and the involvement of cholinergic mechanisms in the function of specific brain areas is discussed. Their implication in neurological diseases is also reviewed. PMID- 3561771 TI - Progressive supranuclear palsy and a multi-infarct state. AB - In 58 patients with progressive supranuclear palsy (PSP), 19 (32.8%) had CT, MRI, or autopsy evidence of a multi-infarct (MI) state. The clinical findings in the infarct syndrome were similar to idiopathic PSP. Five MI-PSP patients had had a stroke, four had focal dystonia, two had hemiparesis, and one had an intention tremor of recent onset. In contrast, only 5.9% (12.9% of those with CT or MRI) of 426 Parkinson's disease patients had evidence of strokes. One case of PSP studied pathologically was attributed to cerebral amyloid angiopathy. PMID- 3561770 TI - Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection. AB - Subacute encephalitis, characterized by demyelination, gliosis of the gray and white matter, focal necrosis, microglial nodules, atypical oligodendrocyte nuclei, and multinucleation of cells, was present in 27 of 30 (90%) autopsied patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex. Subacute encephalitis was mainly distributed in the frontal (58%) and temporal (69%) lobes, basal ganglia (77%), amygdala (80%), and hippocampus (64%). Ten (37%) with moderate or severe subacute encephalitis were demented; 82% with mild subacute encephalitis had no recognized neurologic disorder. Human T-lymphotropic virus type III (HTLV-III) was isolated from neural tissue or CSF in 11 of 13 patients, 10 with subacute encephalitis, and 1 without CNS lesions. We conclude that subacute encephalitis is common in AIDS patients and is most likely caused by CNS infection with HTLV-III. PMID- 3561772 TI - A physiologic and pharmacologic study in anticholinergic-responsive essential myoclonus. AB - We report the physiologic and pharmacologic analysis in two women, aged 18 and 17 years, with essential myoclonus. Both responded to benztropine mesylate and had been functioning normally. The physiologic analysis suggested ballistic movement overflow and audiogenic stimulus-sensitive myoclonus. The pharmacologic study showed a direct and mutual antagonism of physostigmine and anticholinergic agent on myoclonus, implying cholinergic hyperactivity in the pathophysiology of myoclonus. PMID- 3561773 TI - Botulinum A toxin for cranial-cervical dystonia: a double-blind, placebo controlled study. AB - We studied the effects of botulinum A toxin in 12 patients with blepharospasm and 10 patients with oromandibular-cervical dystonia received in a double-blind manner. All blepharospasm patients improved, 71.6% on a clinical rating score, 60.7% by self-assessment, and 38.9% by video-rating; there was no improvement with placebo. The beneficial effects lasted a mean of 12.5 weeks (range, 5 to 28). Only 37.5% of the patients with oromandibular-cervical dystonia improved. Patients with pharyngeal dystonia and spasmodic dysphonia also improved. PMID- 3561774 TI - Lack of heart rate changes during an attention-demanding task after right hemisphere lesions. AB - Patients with right hemisphere lesions may be impaired in mobilizing attention and in emotional behavior. If so, autonomic responses to the mobilization of attention should be blunted. This was found when we studied the anticipatory heart rate deceleration that is seen normally in the foreperiod of a warned reaction task. PMID- 3561775 TI - Neurophysiologic assessment of trigeminal function after surgery for trigeminal neuralgia. AB - To assess the function of the three trigeminal divisions, we studied corneal reflex, early and late blink reflexes, early and late masseter silent periods, and jaw jerk in normal subjects and in 35 patients submitted to surgery for trigeminal neuralgia. The corneal reflex was most sensitive to thermocoagulation and the jaw jerk to microcompression; the other reflexes showed an intermediate behavior, depending on afferent fiber size. Trigeminal function was less impaired after microcompression and recovered earlier than after thermocoagulation. PMID- 3561776 TI - Chorea-amyotrophy with chronic hemolytic anemia: a variant of chorea-amyotrophy with acanthocytosis. AB - We studied two siblings with chorea and amyotrophy of adult onset and spherocytic hemolytic anemia. Autopsy revealed an atrophic striatum with iron deposition and spheroid bodies. Degeneration of the substantia nigra and spinal cord anterior horns was seen without iron deposition. The disorder seems to be a variant of the chorea-amyotrophy-acanthocytosis syndrome, and the pathology may account for evidence of parkinsonism and amyotrophy in that syndrome. Acanthocytosis may not be the only hematologic abnormality in this disorder. PMID- 3561777 TI - Effect of movement on human spinal and subcortical somatosensory evoked potentials. AB - Sensory transmission in dorsal column nuclei is inhibited during voluntary movement in experimental animals. We have studied the human response by recording spine and scalp somatosensory evoked potentials. Finger movement attenuated the amplitude and duration of the cervical N13 and the scalp N18 and N20 waves. Foot movement did not alter the lumbar N22 after foot stimulation, but the scalp P38 was attenuated. N22 results solely from activation of interneurons in the dorsal gray of the cord at the root entry zone, but N13 may receive contributions from the nucleus cuneatus. Therefore, the movement-induced attenuation of N13 is attributed to decreased contribution from the nucleus cuneatus. PMID- 3561778 TI - Usefulness of different stimuli in visual evoked potentials. AB - The goal of this study was to determine the relative usefulness of the flash (FL), pattern reversal (PR) of 56', and PR of 28' in 62 patients (pts) with either MS (34) or non-MS (28) compared with normals (19). An abnormal visual evoked potential was found in 58%, 69%, and 81% of the eyes tested in possible, probable, and definite MS and in 88% of the non-MS group. The 28' PR produced the most abnormal responses, the greatest number with either greater than 3 standard deviations (SD) from the mean or greater than 2 SD in both MS and non-MS groups. The FL was second best at producing the most abnormal responses, but more often produced the only abnormality (29), compared with 28' PR (11). The 56' PR produced the only abnormality in none of the MS pts and in only one of the non-MS pts. In all categories (most abnormal, greater than 3 SD, greater than 2 SD, the only abnormality of greater than 3 SD or greater than 2 SD, and other peaks abnormal), the 28' PR was usually by far the best stimulus for definite (and probable) MS, but equally as effective was the FL in the possible MS pts Our data suggest the usefulness of 28' and not 56' PR, but the FL is especially useful in pts with possible MS. PMID- 3561779 TI - Comparison of Duchenne and normal myoblasts from a heterozygote. AB - To test the hypothesis that the Duchenne muscular dystrophy gene limits the proliferation of myoblasts, we studied myoblasts from a woman who was a carrier of the Duchenne gene and also heterozygous for glucose-6-phosphate dehydrogenase (G6PD), an X-linked enzyme. G6PD-A and G6PD-B cells did not differ in proliferative capacity, implying no difference in proliferative capacity of cells bearing the Duchenne gene or the normal allele. PMID- 3561780 TI - Speech without conscious awareness. AB - Following commissurotomy, it is usually the case that information presented to the left hemisphere can be named and described, while information presented to the mute, right hemisphere cannot be spoken about. In the present study, it was discovered that under special test conditions, an MRI-verified, callosally sectioned adult could name or write about information presented to the right hemisphere. Studies revealed this was not an instance of right hemisphere expression. Rather, the right hemisphere was somehow able to program the left hemisphere for a spoken or written response. Further, the studies also showed that the left hemisphere was not consciously aware that it possessed the information transmitted to it by the right half brain. PMID- 3561781 TI - Risk factors for Guillain-Barre syndrome. AB - In 100 cases of Guillain-Barre syndrome (GBS) reported from 10 metropolitan areas to the Centers for Disease Control (CDC) after the 1976-77 influenza vaccination campaign and matched associate or spouse controls, we searched for risk factors for GBS other than A/New Jersey/1976 influenza vaccination and acute respiratory infection. The 47 vaccinated cases recalled influenza vaccination in past years less frequently than did controls (p less than 0.025). Cases and controls did not differ in the number of previous vaccinations or in interval from last vaccination. Cases also gave a history of allergy less frequently than controls. There were no other significant differences. PMID- 3561782 TI - The role of nuclear magnetic resonance imaging in the diagnosis of MS in childhood. AB - MS in the pediatric age group is a rare condition, often diagnosed after a considerable delay. Nuclear magnetic resonance imaging (NMR) has proven to be the single most useful diagnostic modality in adult MS patients. We present three patients with childhood MS. NMR demonstrated multiple white matter lesions in the supratentorial and posterior fossa regions consistent with those lesions described by NMR in adults. This report suggests that NMR is a valuable diagnostic procedure in children as well as adults. PMID- 3561784 TI - Delayed reduplicative paramnesia. AB - A 25-year-old man with a remote history of closed head injury and left hemiparesis developed the false belief that his hospital was located in another city, close to his home. This delusion appeared more than 3 years after his injury, from which he had made a good recovery. No previous delusional or other psychotic thinking had occurred. Clinical and neuropsychological data supported the existence of right hemisphere and bifrontal pathology. This case illustrates that a specific delusional belief may arise in a patient with appropriate cerebral pathology years after the initial event. PMID- 3561785 TI - Lateral pontine tegmental hemorrhage presenting as isolated trigeminal sensory neuropathy. AB - A 45-year-old man awoke with numbness and paresthesias on the right side of his face, scalp, ear, and tongue. CT and MRI demonstrated a focal hemorrhage in the dorsolateral right pontine tegmentum. Cerebral angiography was negative for vascular malformation or aneurysm. CT performed 1 month later showed complete resolution of the pontine hematoma, with residual minimal lateral pontine atrophy. PMID- 3561783 TI - Progression of Parkinson's disease without levodopa. AB - We studied 100 consecutive patients with Parkinson's disease (PD) who were not receiving levodopa and followed them until symptoms advanced and levodopa was given. Eighty-three patients eventually received levodopa; 50% started within 36 months after a mean duration of symptoms of 48 months. Patients starting on levodopa showed significant progression of their disease compared with their baseline examination. These data have direct applicability to the design and implementation of future protocols aimed at preventing disease progression of PD. PMID- 3561786 TI - Testosterone levels in adult male epileptic patients. AB - Total and free testosterone levels were assayed in 80 epileptic outpatients. The levels were in the low-normal range, and there was no dissociation between free and total levels observable in this sample. No relationships to clinical epilepsy parameters or anticonvulsant levels were found, but significant inverse relationships existed with age and the number of different anticonvulsant medications a patient was taking. The age effect was independent of the medication contribution and raises the question of premature aging of the sexual system in patients with epilepsy. Whether or not this is part of a more general premature decrease in the functions of the pituitary hypothalamic axis needs to be investigated. PMID- 3561787 TI - Hormones and handedness: left-hand bias in female congenital adrenal hyperplasia patients. AB - An excess of left-handers among males has been attributed to early androgen exposure. This theory was supported by our observation that girls with congenital adrenal hyperplasia (CAH) are more left-biased than their normal sisters. Male CAH patients, with prenatal androgen exposure similar to that of unaffected brothers, had typical male-handedness patterns. PMID- 3561788 TI - Amyotrophic lateral sclerosis and history of skeletal fracture: a case-control study. AB - A retrospective case-control study was conducted, using 66 amyotrophic lateral sclerosis (ALS) patients and 66 closely matched controls. Cases were ascertained primarily through a neurology clinic. A self-administered questionnaire probed for history of skeletal fractures. Using McNemar's test, no association was found between history of skeletal fracture and pathogenesis of ALS. No predilection for the head, neck, or spine was demonstrated. The extremities accounted for most fracture sites in cases and controls. Among cases, 68% of the fractures occurred before diagnosis, 58% occurring more than 10 years before diagnosis of ALS. PMID- 3561789 TI - Terguride, a mixed dopamine agonist-antagonist, in animal models of Parkinson's disease. AB - Terguride, an analogue of lisuride, decreased locomotor activity, produced cataplexy, and blocked apomorphine-induced stereotypic behavior. It did not induce stereotypies in rodents or emesis in dogs. However, in rats with unilateral 6-hydroxydopamine lesions of the substantia nigra, terguride produced contralateral rotation. Terguride bound to D-2 striatal dopamine receptors. Terguride has both agonist and antagonist actions at striatal dopamine receptors, but chronic administration did not produce behavioral supersensitivity. These pharmacologic properties differ from those of other antiparkinsonian agents; terguride may be effective for the chronic treatment of Parkinson's disease. PMID- 3561790 TI - Paraquat and Parkinson's disease. PMID- 3561791 TI - Evoked potentials in relatives of MS patients. PMID- 3561792 TI - Small dorsal mesencephalic hemorrhages. PMID- 3561793 TI - [Ultrastructure of the choroid plexus]. PMID- 3561794 TI - [Aminoacylation of tRNA in the pt rabbit brain. I. Amino acyl T RNA synthetase activity]. PMID- 3561795 TI - [Myelination of selected tracts of the temporal lobe in the normal state and in chronic diseases of early childhood]. PMID- 3561796 TI - Brain myelin in senile patients with brain infarction. PMID- 3561797 TI - Glial fibrillary acidic protein and S100 protein in abnormal astrocytes in Wilson's disease. PMID- 3561798 TI - Effect of calcium on protein synthesis in rat brain postmitochondrial fraction. PMID- 3561799 TI - [The invasiveness of cerebral gliomas in patients of various ages]. PMID- 3561800 TI - Controversial effect of endoxan administration on maturing rabbit brain. PMID- 3561801 TI - [Electron microscopic studies of the supraoptic and paraventricular hypothalamic nuclei in rabbits after long-term hyperthermic stress]. PMID- 3561802 TI - Hemangiomas of the central nervous system in Japan: an epidemiological and clinicopathological study with special reference to venous and cavernous malformations. AB - Our experiences with cerebrovascular malformations in Japanese patients have been reviewed, presenting 29 cases of venous malformation, 30 cases of cavernous angiomas and one case of capillary telangiectasis. We also present the data from the 763 cases of AVM obtained in the cooperative studies which were supported by the Ministry of Health and Welfare of Japan, and discussed the epidemiological and clinicopathological aspects in relation to those reported in the literature. The cooperative studies on these subjects were primarily done in conjunction with the investigation of Moya-Moya disease which is by far frequently found in Japan. Regarding the vascular malformations of the C.N.S., there seem to be no noticeable differences in the epidemiological aspects as seen in Japan and in other countries. It should be stressed also from our experiences that all kinds of vascular malformation, either intracranial or intraspinal, bleed probably more often than we expect. Neurosurgeons should pay more careful attention to these vascular malformations with appropriate concepts of the disease. PMID- 3561803 TI - [Depression of the ST segment in the precordial leads in acute inferior myocardial infarct]. PMID- 3561804 TI - [Coronary aneurysm. Review of the literature and description of 2 illustrative cases]. PMID- 3561805 TI - [Brucella endocarditis. Apropos of 3 clinical cases]. PMID- 3561806 TI - [Atrio-ventricular septum defect (canal-type defect). Anatomo-pathologic study in situs solitus and situs inversus]. PMID- 3561807 TI - [Physiology of the peripheral circulation. Observations on a population of 100 hundred normal subjects with strain-gauge plethysmography]. PMID- 3561808 TI - [Massive or ischemic venous thrombosis]. PMID- 3561809 TI - [Fibro-muscular dysplasia of the renal artery. Clinico-angiographic study and etiopathogenetic observations]. PMID- 3561810 TI - [Aneurysm of the hepatic artery. A clinical case and anti-pain considerations]. PMID- 3561811 TI - [Correlations between the QT interval, ventricular arrhythmias and left ventricular kinetics in infarct patients before their hospital discharge]. PMID- 3561812 TI - [Effectiveness of sublingual isosorbide dinitrate in chest pain: coronary or esophageal angina?]. PMID- 3561813 TI - [Therapeutic effectiveness of isosorbide-5-mono nitrate in the treatment of exertion myocardial ischemia]. PMID- 3561814 TI - [Echocardiographic study of left ventricular function during treatment with oral quinidine]. PMID- 3561815 TI - [Monitoring of conjunctival PO2 during general anesthesia for eye surgery]. PMID- 3561816 TI - [Personality and psychological reactions in primary headache]. PMID- 3561817 TI - [Anxiety and depression in chronic pain]. PMID- 3561818 TI - [Treatment of early postoperative hypotonic polyuria in pituitary surgery]. PMID- 3561819 TI - [Lefetamine 0.6%: continuous subarachnoid nerve block. Our experience through an infusion pump]. PMID- 3561820 TI - [Fatal shock in a case of Lyell's syndrome]. PMID- 3561821 TI - [Epidural and intraventricular morphine therapy in the treatment of cancer pain]. PMID- 3561822 TI - [Antipollution systems for operating theatres. A critical review and new prospects for the GTPA-Tornado system]. PMID- 3561823 TI - [Diverticulitis of the cecum. Remarks on 2 cases]. PMID- 3561824 TI - [Unusual bilio-digestive anastomosis: termino-terminal choledochoduodenostomy]. PMID- 3561826 TI - [Jejunostomy: technical note]. PMID- 3561825 TI - [Unusual aspect of iatrogenic pathology of the biliary tract: recurrent choledocholithiasis caused by nonabsorbable suture]. PMID- 3561827 TI - [Association of lumbar sympathectomy and bypass in the treatment of femoro popliteal obstructive arteriopathies]. PMID- 3561828 TI - [Agenesis of the right pulmonary artery and systemic pulmonary vascularization in 4 cases observed in childhood]. PMID- 3561829 TI - [Cranial trauma as a negative prognostic factor in the treatment of patients with multiple injuries]. PMID- 3561830 TI - [Angiographic study of the stomach: data for esophagogastroplasty]. PMID- 3561831 TI - [Internal pudendal artery of the male in childhood. Submacroscopic anatomicosurgical study]. PMID- 3561832 TI - [Radiological anatomy of the renal artery and its branches]. PMID- 3561833 TI - [Chemoprophylaxis in surgery. Study on the use of antibiotics in Italian hospitals]. PMID- 3561834 TI - [Leiomyosarcoma of the stomach. Apropos of a case]. PMID- 3561835 TI - [Voluminous gastric trichobezoar]. PMID- 3561836 TI - [Vascular compression of the duodenum associated with compression of the celiac axis]. PMID- 3561837 TI - [A case of submucous lipoma of the cecum]. PMID- 3561838 TI - [Primary extra-lymph node localization of non-Hodgkin's lymphoma. Considerations on a clinical case]. AB - The location on first diagnosis of a non-Hodgkin lymphoma (NH lymphoma) in the respiratory structures (bronchi, pleura, pulmonary parenchyma) is rather rare (2 4%) in the absence of mediastinic and/or hilar adenopathy. In any event diagnosis is extremely difficult, often impossible even with the aid of a properly conducted biopsy since the biopsy does not provide suitable material. The case is presented of a 72 year old woman with intermittent hyperpyrexia and multiple alveolar masses, the aetiology of which was only identified 8 months after the onset of the symptoms with the appearance of latero-cervical lymphadenopathy where biopsy revealed the presence of an N.H. lymphoma that was highly malignant but otherwise unspecificable. PMID- 3561839 TI - [Clinico-pathological aspects of farmer's lung. Review of the literature and personal cases]. AB - Data are presented on 9 subjects with Farmer's lung encountered in 1981-85. In all cases dyspnea arose within several hours after exposure to the allergen and in 4 cases only a few minutes after exposure. The radiological picture was altered in 7 cases (6 miliary pictures and 1 case of medial and basal nodulation). In functional terms 6 restrictive and 3 mixed forms were identified. The specific bronchial provocation test was positive wherever it was performed. Bronchoalveolar lavage revealed predominantly lymphocytic alveolitis in the most recent cases. Transbronchial biopsy also revealed the presence of pulmonary granulomatosis in various stages of development. Finally skin tests were positive to various antigens in several cases while specific precipitin were found in all cases. These data are compared with reports in the literature. PMID- 3561840 TI - [The electrocardiogram in hypothermia]. AB - Hypothermia is reflected in the electrocardiogram in the form of alterations that permit early recognition of the condition. In fact the electrocardiogram is a more sensitive indicator of temperature than the standard measurements of body temperature used in clinical practice. The various aetiological aspects of hypothermia are described as are its electrocardiographic features. PMID- 3561841 TI - [Tetracycline in the evaluation of bone turnover]. AB - A new and easy technique for the fluorimetric evaluation of rolitetracycline calcium complex was studied. The study was carried out in 3 different groups of rats; an increase in power of fluorescence in the rats on a low calcium diet (LC) and on a low calcium diet plus vitamin D (LC + D) versus the group of rats on a normal calcium diet (NC) was found. Moreover, the amount of spongy bone showed a significant decrease in bone mass in the first two groups (LC and LC + D) versus control. These data indicated that the bone tie of tetracycline was only related to the high turnover of bone and there was no relationship with bone mass. This new technique, in comparison with the others, (double marking and evaluation of space between the two fluorescent bands) enables to evaluate the kind and the evolution of bone rarefaction by biopsy. PMID- 3561842 TI - [Problems in the treatment of the hypertensive diabetic patient]. AB - Hypertension is much more common among diabetics than non-diabetics and particular care must be taken in treating both chronic pathologies. It is in fact vital to consider the effect antihypertensive drugs may have on diabetes and its complications. Hence the choice of anti-hypertensive drug for a patient with diabetes mellitus must be preceded by a careful study of the metabolic effects of that drug. An attempt is made to assess the interference by antihypertensive agents with glucose metabolism and to identify an appropriate treatment protocol for the patient with both arterial hypertension and diabetes mellitus. PMID- 3561843 TI - [Considerations on the protection of non-ionizing radiation workers]. AB - After a brief examination of the physical properties and biological effects on man of e.m. and u.s. type N.I.R., their most common fields of use in industry and medicine are described. The report goes on to examine the risks and possible damage that may be incurred by those who work with these radiations on the basis of their intensity and the type and distance of the source as well as their duration with particular reference to the so-called "target" organs. The hope is then expressed that regulations will be produced for the protection of these workers. Particularly as far as preventive medicine is concerned such regulations should be on the same lines as those formulated for workers with ionising radiations by Presidential Decree 185/64 in line with E.E.C. and I.C.R.P. recommendations. PMID- 3561844 TI - [Affective disorders in general hospitals: the organic affective syndrome]. AB - After a survey of the literature on secondary depression and mania caused by physical illness or drugs, a retrospective study on 77 inpatients (seen in the hospital psychiatric consultation service) is reported. Forty per cent of patients presented a diagnosis of depression; 58% of depressed patients had at least one of the "risk factors" for secondary depression (physical illness and drugs known to cause affective disturbances) compared to 24% and 16% of patients with other or no mental disorders (p less than 0.05). PMID- 3561845 TI - [Radiation-induced intestinal injuries]. AB - Postoperative radiation after the removal of radiosensitive tumours may cause acute or chronic intestinal lesions. In some cases severe complications requiring one or more operations may arise even years later and unfortunately the morbidity and mortality rates are high. The paper presents a discussion of the clinical onset of these pictures as well as diagnostic and therapeutic possibilities in the light of personal experience and information obtained from the literature. PMID- 3561846 TI - [Effect of polyunsaturated phosphatidylcholine and vitamin B complex on the metabolism of selenium homotaurocholic acid in patients with chronic liver disease]. AB - SeHCAT, a synthetic homologue of thaurocolic acid, may be used to examine the dynamics of enterohepatic circulation. A greater retention of SeHCAT may be attributed to a defective hepatic clearance and to a partial redistribution of the biliary acid pool outside the enterohepatic circle. This method has been applied to 20 patients affected with chronic hepatic disorders. The percentage of retention of SeHCAT in normal subjects was 19-20 on average. The hepatopathic patient has an average SeHCAT retention of 54%. After treatment with polyunsaturated phosphatidylcholine (EPL) plus vitamin B complex i.v., the percentage of SeHCAT retention was significantly less than 31% (P less than 0.001). It can be hypothesized that the drug determines an improvement of the enterohepatic circle (acting on the hepatic clearance) in patients with chronic hepatic disorders as shown by the reduction of the percentage of SeHCAT retention noticed. PMID- 3561848 TI - [Changes in various indices of thyroid function in obese adults during diet therapy]. AB - Modifications in thyroid function caused by changes in diet have been reported in the literature though the results are often conflicting. The present study was conducted on 48 obese adults divided into two groups: the first over 60% and the second under 60% above their ideal weight. A control group of healthy subjects of normal weight and comparable age was also studied. The observation lasted 9 weeks during which a low calorie diet providing about 1250 kCal was administered. Mean basal levels of FT3, TT3, FT4 and TSH revealed no significant differences between the obese subjects and the control group. Mean TT4 was significantly higher in the obese and mean T3U significantly lower. During low calorie diet treatment the obese subjects produced no significant variations in the above parameters, apart from a significant increase in T3U. The study revealed no evidence of the low T3 syndrome that has long been reported in the literature. PMID- 3561847 TI - [Current status of the use of vitamins (A, E, C, D), folates and selenium in the chemoprevention and treatment of malignant tumors]. AB - The role of vitamins A, E, C, D, folates and selenium in the chemical prevention of tumours and/or precancerous conditions is examined in the light of epidemiological studies and experimental observations. Particular mention is made of significant clinical studies that provide valuable indications about the use of vitamin A and its derivates in particular for the treatment of precancerous and cancerous conditions. Vitamin A and its derivates apparently play a fundamental role not only in the treatment of proliferating malignancies of the skin (carcinomas, severe aclinic keratosis) or involving the skin (fungoid mycosis, skin metastases of solid tumours) but also in the prevention of recurring bladder tumours and the treatment of several bronchial dysplasias. PMID- 3561849 TI - [Hypocalcemia after thyroidectomy. Pathogenetic and clinical aspects]. AB - Hypocalcaemia may arise after thyroidectomy. This condition has been attributed to various causes but the explanations of the phenomenon are not always convincing. The present study was designed to investigate the frequency of the phenomenon and its causes via the early and tardive monitoring of calcaemia, phosphoraemia, calcitoninaemia, thyroid hormones and TSH. The results obtained reveal that hypocalcaemia is due to postoperative hypothyroidism that is revealed more clearly by the behaviour of TSH than that of the thyroid hormones. Patients must be treated with vitamin D until thyroid hormone function is normalised. The behaviour of PTH after thyroidectomy and in hypothyroidism reveals the appearance of inane hyperparathyroidism secondary to and related to the hypocalcaemia. PMID- 3561850 TI - [Changes in urinary NAG activity in patients with climacteric syndrome treated with estrogens]. AB - The behaviour of urinary NAG activity was studied in patients during menopause, some of whom were given estrogen therapy due to severe vasomotor symptoms (hot flushes etc.). One group of these patients revealed slightly higher than normal blood pressure. A second group had slight arterial hypertension and pancreatic diabetes. The third group consisted of apparently healthy menopausal women. The significant increase in enzymuria in the first two groups suggests that blood pressure should be carefully checked before starting estrogen therapy. Furthermore this treatment should be given very cautiously and under constant surveillance in the presence of slight hypertension. In patients with diabetes or more severe hypertension, estrogens should never be given. PMID- 3561851 TI - [Partial anterior hypopituitarism caused by toxoplasmosis congenita. Description of a clinical case]. AB - A case of incomplete anterior hypopituitarism due to congenital toxoplasmosis is reported. The rare pituitary involvement in congenital toxoplasmosis and the uncommon remark of associated endocrine symptomatology support this description. PMID- 3561852 TI - [Endoscopic evaluation of the effects of diacerhein and naproxen on the gastroduodenal mucosa]. AB - The potential capacity of diacerheine (DAR), a new drug known to have no anti prostaglandin effect and therefore a different action mechanism from the standard non-steroid anti-inflammatory drugs, to cause damage to the gastroduodenal mucosa was compared with that of a well-known NSAID, naproxene. Gastroscopic examination of 10 + 10 patients before and 4 weeks after treatment showed that DAR produced endoscopic lesions without subjective symptoms in 10% of the patients whereas naproxene produced lesions of varying size in 50%, with or without symptoms. PMID- 3561853 TI - Ethical principles for the maintenance and use of animals in neuroscience research. PMID- 3561854 TI - A study of the centrifugal projections to the pigeon retina using two fluorescent markers. AB - The centrifugal projection to the retina of the adult pigeon was studied by the retrograde transport of Diamidino yellow and Fast blue. On the contralateral side in the nucleus isthmo-opticus 8400-10,900 cells were stained while in the surrounding area 1500-2800 marked ectopic cells were counted. Up to 94 neurones, which are nearly all ectopic, project to the ipsilateral eye. Using double labelling we concluded that there are no cells projecting to both eyes. This study shows that in the adult pigeon there exist more ectopic cells projecting to the retina than previously reported in horseradish peroxidase experiments. PMID- 3561855 TI - Synaptic responses of red nucleus neurons in the alert cat to cortical and cerebellar inputs. AB - Postsynaptic potentials of neurons of the red nucleus (RN), evoked to stimulation of the sensorimotor region of the cerebral cortex and cerebellar nucleus interpositus, were studied in chronic experiments on alert cats by means of an intracellular recording technique. Movements of the animals were restricted by rigid fixation (through a special device previously attached to the head) of the animal's head on the frame of the stereotaxic apparatus. Rubrospinal neurons were identified according to their antidromic activation in response to stimulation of the rubrospinal tract at the decussation level. A decrease in the critical level of depolarization necessary for spike generation was shown to be a characteristic peculiarity for mono- and polysynaptic reaction of the RN neurons in the alert animals. A rare possibility of recording separate EPSPs, the presence of burst discharges of rubrospinal neurons as well as a higher activity of RN interneurons was observed. PMID- 3561856 TI - Electrophysiological properties of cortically projecting histamine neurons of the rat hypothalamus. AB - The tuberomammillary (TM) nuclei of the hypothalamus appear to be the sole histaminergic cell group in the brain. The extracellular electrophysiological properties of cortically projecting TM neurons were studied in the urethane anesthetized rat. TM neurons, antidromically activated from either ipsi- or contralateral cerebral cortex, displayed relatively slow conduction velocities, consistent with reports suggesting that TM neurons possess unmyelinated axons. Spontaneous activity was slow and regular, with action potentials of long duration. There was often a noticeable delay between initial segment and somatodendritic portions of spontaneous action potentials, and complete loss of the somatodendritic portion of the second antidromic action potential was commonly seen when double pulse paradigms were employed. These data demonstrate that in addition to anatomical and biochemical similarities, TM neurons share a constellation of physiological properties with other central aminergic neurons. PMID- 3561857 TI - Effect of cooling of the culmen of the cerebellar vermis on chemically induced stepping in guinea pigs. AB - A regular 'stepping automatism' was induced via our recently reported SIS (substances capable of inducing stepping) in guinea pigs. Reversible cooling (5-0 degrees C) or partial ablation of the culmen of the cerebellar vermis could facilitate SIS-induced stepping, whereas electrical stimulation (300 microA up) of the same region could attenuate or abolish stepping. Cooling could only facilitate, but not trigger stepping movements. The above-mentioned facilitation was most prominent in those guinea pigs that exhibited a weak stepping automatism. Cooling of the lateral part of the culmen of the cerebellar vermis and hemisphere mainly facilitated stepping of the ipsilateral forelimb. When the interfacial temperature between the cooling probe and tentorium cerebelli was appropriate (5-0 degrees C), cooling could mimic the effects of ablation to a great extent. PMID- 3561858 TI - Regional distribution in rat brain of tryptophan hydroxylase apoenzyme determined by enzyme-linked immunoassay. AB - Tryptophan hydroxylase apoenzyme was measured in 21 regions of the rat brain by a competitive enzyme-linked immunoassay (ELISA) technique using a recently developed antiserum from the sheep to this protein. Highest apoenzyme levels were found in the pineal gland and in the dorsal raphe. An insignificant level was observed in the cerebellum. In general, the distribution of tryptophan hydroxylase apoenzyme follows the distribution of serotonin previously detected by immunocytochemistry. A turnover number for tryptophan hydroxylase in a rat brain supernatant fraction of 7.5 s-1 was estimated, a value far higher than that estimated for serotonin turnover in vivo. This result confirms that serotonin biosynthesis is additionally regulated by factors other than tryptophan hydroxylase apoenzyme concentration. PMID- 3561860 TI - Subcortical pathways involved in the mediation of adrenocortical responses following frontal cortex stimulation. AB - The purpose of this study was to identify the subcortical neural pathways which mediate adrenocortical responses following cortical stimulation. The frontal cortex was stimulated in intact rats and in animals with medial or lateral septal or preoptic lesions or with large or small anterior hypothalamic deafferentations. All the above-mentioned lesions have significantly blocked the adrenocortical responses following frontal cortex stimulation, suggesting that the above-mentioned subcortical structures are involved in the mediation of this response. PMID- 3561859 TI - Neuroanatomical effects of chronic ethanol consumption on dorsomedial and anterior thalamic nuclei and on substantia innominata in mice. AB - Quantitative analysis, using histological sections, showed that chronic ethanol consumption for 7 months produced a weak but significant cellular loss in the dorsomedial thalamic nucleus, anterior thalamus and substantia innominata in the mouse. These results are in agreement with patterns of neuroanatomical damage observed in human alcoholics. PMID- 3561861 TI - Cell length to diameter relation of rat fetal radial glia--does impaired K+ transport capacity of long thin cells cause their perinatal transformation into multipolar astrocytes? AB - In thick sections of Golgi-impregnated late fetal rat brains, radial glial cells were measured for both length and diameter of their main (basal) processes. The process diameter was found to decrease proportionally to the square root of cell length; thus, the cytoplasm volume remained fairly constant for cells in the range of lengths studied (100-2500 microns). The measured data were used for calculation of the cell's space constant lambda in order to estimate their capability to carry spatial buffering K+ currents. These calculations show that long and slender cells are unable to perform sufficient K+ clearance by such currents. This supports the hypothesis that perinatally when the maturing neurons release enhanced K+ during electrical activity, such long thin cells are subject to long-lasting depolarizations and, thereby, forced to undergo mitotic cell division transforming them into multipolar astrocytes. PMID- 3561862 TI - Non-myelinated axons are rare in the medullary pyramids of the macaque monkey. AB - Previous electron microscopic studies of the medullary pyramids have concluded that non-myelinated axons constitute about 30-60% of all axons in the pyramid of the rat, and about 8-15% in the cat and monkey. Physiological studies of pyramidal tract axons have not found fibers conducting in the range predicted for non-myelinated axons, less than 1 m/s. This present study of the primate pyramid demonstrates that most of the profiles which could be interpreted as being non myelinated axons when viewed in cross-section, are actually astroglial processes when examined in longitudinal section. We conclude that non-myelinated axons constitute less than 1% of the pyramidal tract axons in the old world adult primate. PMID- 3561863 TI - Neurotensin in the human fallopian tube: immunohistochemical localization and effects of synthetic neurotensin on motor activity in vitro. AB - With the use of different region-specific antisera and the peroxidase antiperoxidase (PAP) technique, neurotensin-immunoreactivity was found in nerve fibers of the human fallopian tube. Neurotensin-immunoreactive fibers occurred at blood vessels and in contact with smooth muscle cells of the muscular stratum. In vitro experiments with helical strips of the myometrium revealed dose-dependent excitatory actions of neurotensin on resting tension as well as on amplitude and frequency of spontaneous contractions. The results may suggest a neurotransmitter function of neurotensin in the regulation of human oviductal smooth muscle activity. Thus, neurotensin may be essential in the transport of the eggs through the fallopian tube. PMID- 3561864 TI - Immunohistochemical evidence for the presence of somatostatin-containing sensory nerve fibres in the human skin. AB - Somatostatin-like immunoreactivity has been found to occur in nerve terminals and fibres of the normal human skin using immunohistochemistry. The immunoreactivity seemed predominantly to be associated with sensory nerves. Thus, nerve fibres displaying weak or moderately strong somatostatin immunofluorescence were observed as free nerve endings of the epidermis and as nerve fibres in the dermis. The immunoreactive nerves were found in low numbers in skin from arm, back and chest, however, only single fibres were seen in sensory specialized areas, such as fingertips. Very few fibres were found close to e.g. blood vessels and sweat glands. Somatostatin, generally believed to be a strongly inhibitory substance, should also be considered when examining the role of different sensory chemical messenger candidates in the human skin. PMID- 3561865 TI - Effect of capsaicin on neurites of cultured dorsal root ganglia and isolated neurons of chick embryos. AB - The effects of capsaicin on neurites of cultured chick lumbar dorsal root ganglia and their isolated single neurons were investigated. Capsaicin-treated neurites showed a disappearance of their tips, dumpling-like structures, and retardation as a result of degeneration. However, some of the retarded neurites showed a reextension. By electron microscopy the degeneration appeared similar to that caused by beta,beta'-iminodipropionitrile with respect to segregation of the cytoskeleton. This finding provides support for the idea that capsaicin inhibits axonal transport. PMID- 3561866 TI - Neurons (presumably A1-cells) projecting from the caudal ventrolateral medulla to the region of the supraoptic nucleus respond to baroreceptor inputs in the rabbit. AB - Extracellular recordings were made in the caudal ventrolateral medulla from 29 neurons that could be antidromically activated from the region of the supraoptic nucleus in the rabbit. The median axonal conduction velocity was 0.8 m/s. Of 15 cells tested only one did not respond to some form of baroreceptor input. Fourteen were inhibited by experimentally increasing arterial pressure and 8 were excited by decreasing arterial pressure. Stimulation of the aortic depressor nerve decreased the discharge rate of 8 out of 12 cells tested. The location and projections of these neurons suggest that they were A1 noradrenaline-synthesizing cells. PMID- 3561867 TI - ATP and GTP are essential for olfactory response. AB - The steady-state conductance of planar bimolecular lipid membranes (BLMs) modified with rat olfactory epithelial homogenate (ROH) becomes sensitive to very low concentrations of odorant in the presence of adenosine triphosphate (ATP) and guanosine triphosphate (GTP). The chemosensitivity is not observed when ATP and GTP are absent. Adenosine 3',5'monophosphate (cAMP) mimics the effect of the odorant. Effects of odorants and cAMP are dose dependent. These data are consistent with the hypothesis that cAMP is a second messenger in the initial steps of olfactory transduction. PMID- 3561868 TI - gamma-Aminobutyric acid as an inhibitory neurotransmitter in the rat supraoptic nucleus: intracellular recordings in the hypothalamic slice. AB - Intracellular recordings have been made from rat supraoptic neurones in the hypothalamic slice preparation. Application of gamma-aminobutyric acid (GABA) caused all neurones to hyperpolarise and this was accompanied by an increase in membrane conductance. GABA application examined on a variety of cells was found to have a potent influence on patterning of electrical activity, always consistent with an inhibitory action. PMID- 3561869 TI - Platelet-derived growth factor is a mitogen for glial but not for neuronal rat brain cells in vitro. AB - The effects of platelet-derived growth factor (PDGF) on the proliferation of isolated rat neural cells grown in serum-free chemically defined media have been investigated. It was found that PDGF drastically stimulates the proliferation of astroblasts and oligodendroblasts, but has no effect on the proliferation of neuroblasts in primary culture. A role of PDGF in the reactive gliosis, occurring after brain injury, can be suggested. PMID- 3561870 TI - Reduced and oxidized glutathione in human and monkey brain. AB - Prior animal studies have indicated that levels of oxidized glutathione (GSSG) in brain and other organs are low, comprising several percent, or less, of the total glutathione. An exception is seen in reports for autopsy and biopsy specimens of human brain, where very high levels of GSSG have been indicated. The latter observations imply an unusual redox state for human brain. In the current study, GSSG and reduced glutathione (GSH) were measured in monkey brain and autopsy specimens of human brain. Levels of GSSG were 1.2% or less, of the total glutathione. These results are similar to those for rodent brain, but disagree with earlier reports concerning human brain. PMID- 3561871 TI - Myeloid bodies associated with lipid droplets in pinealocytes of blind, blind bulbectomized, blind-underfed or blind cold-exposed rats. AB - The ultrastructure of pinealocytes was studied in rats subjected to manipulations known as enhancers of pineal actions: blindness (B), blindness + olfactory bulbectomy (BObx), blindness + underfeeding (BU), blindness + cold exposure (BC). A large number of myeloid bodies (MBs) were found especially in the light pinealocytes of BObx, BU and BC rats but not in intact controls. These MBs were, in most cases, associated with lipid droplets. The presence of a large number of MBs in rats in which pineal-dependent gonadal impairment has been demonstrated, strongly supports the hypothesis that MBs play a role in pineal photoneuroendocrine activity. PMID- 3561872 TI - Responses of neurones in the brainstem raphe nuclei to stimulation of the cerebellar fastigial nuclei in the cat. AB - Stimulation of the fastigial nuclei of the cerebellum was found to excite units located throughout the raphe nuclei of the brainstem. Raphe spinal units with axons conducting at velocities below 20 m/s were either unaffected by fastigial nucleus stimulation or inconsistently excited at long latency. In contrast units with faster conducting spinal axons throughout the raphe and more dorsally in the reticular formation were excited by stimulation of the fastigial nuclei. Many of these units responded at short latency and followed high rates of repetitive stimulation. PMID- 3561873 TI - Solitary magnocellular neurons in the avian optic tectum: cytoarchitectonic, histochemical and [3H]thymidine autoradiographic characterization. AB - Solitary magnocellular neurons are described in the adult chick optic tectum on the basis of their large size, polygonal shape, intensely basophilic perikarya, characteristic position at the border between the stratum griseum centrale and the stratum album centrale, decreasing density along a rostrocaudal gradient, and intense activity of NADH-diaphorase. These characteristics distinguish this population from the adjacent ganglion cells of the stratum griseum centrale, which are more numerous, smaller, paler staining and have background levels of NADH-diaphorase. Moreover, the solitary magnocellular neurons appear unlabeled after tritiated-thymidine administration after stage 17+, and are thus born before the stratum griseum centrale neurons, which are generated after stage 19. These large cells may correspond to a class of stellate ganglion cells with thick spiny dendrites described by Ramon (1943). PMID- 3561874 TI - Relationship between phrenic and hindlimb extensor activities during fictive locomotion. AB - In decorticate and in spinal curarized rabbit preparations, respiratory and locomotor rhythms can be closely related (1:1 coupling between successive periods), demonstrating central relationships between the two types of pattern generators. In both preparation types, phrenic discharges are highly correlated to the extensor activities. PMID- 3561875 TI - Long-latency OFF-responses from the human sensorimotor cortex to tetanizing stimulation of thenar muscles. AB - Neuromagnetic recordings revealed a new type of OFF-response from the human sensorimotor cortex 170-235 ms after the end of tetanization of the thenar muscles with 10-240 Hz electrical pulse trains, delivered directly to the thenar eminence or to the median nerve at the wrist. No OFF-responses were discerned when the skin of the thumb was stimulated. The role of muscle afferents in the generation of the OFF-response is discussed. PMID- 3561876 TI - Monopodal fictive locomotion evoked by cervical cord stimulation in decerebrate cats. AB - Rhythmic motor discharges evoked by stimulation of the cervical lateral funiculus (LF) were compared with fictive forelimb locomotion evoked by stimulation of the mesencephalic locomotor region (MLR). In the same animals, extensor and flexor nerve discharges alternated in an essentially similar fashion on the LF stimulated side, but on the contralateral side, such alternated activities were found only in the MLR-evoked fictive locomotion. Thus, it was concluded that the LF-evoked rhythm is monopodal fictive locomotion. Detailed analysis of temporal patterns of nerve discharges during monopodal fictive locomotion revealed 4 components of centrally programmed locomotor discharges for the elbow extensors; tonic back-ground discharges; gradually increasing excitation prior to flexor bursts; small excitation following flexor bursts; crossed excitation. These functional meanings are discussed. PMID- 3561877 TI - Epileptogenic gamma-aminobutyric acid-withdrawal syndrome after chronic, intracortical infusion in baboons. AB - We studied the effects of chronic (7 days) infusion of GABA (100 micrograms/microliter) applied intracortically into the fronto-rolandic (FR) area of baboons, via osmotic minipumps. In photosensitive animals, bilateral GABA application produced a complete blockade of the paroxysmal discharges and associated clinical signs induced by intermittent light stimulation. Unilateral administration had similar effects, although these developed more gradually. At the end of the infusion period, both photosensitive and non-photosensitive animals showed a transitory state (3-4 days) of cortical hyperexcitability (spontaneous epileptogenic activity) localized to the infused area. The data indicate a role of GABA both in the natural photosensitivity of the epileptic baboon and in the withdrawal syndrome consecutive to the sudden interruption of chronically enhanced GABA levels in the FR territories of this monkey. PMID- 3561878 TI - Enkephalin enhances responsiveness to perforant path input while decreasing spontaneous activity in the dentate gyrus. AB - The opioid peptide [D-Ala2-Met5]-enkephalin-amide (DAMEA) was electrophoretically applied to the dentate gyrus in vivo to investigate opioid effects on evoked responsiveness to perforant path input and on spontaneous granule cell activity. DAMEA increased the amplitude of population spikes evoked by stimulation of the perforant path, and decreased sequential (recurrent or feed-forward) inhibition as determined by a paired-pulse paradigm. However, DAMEA concurrently inhibited spontaneous activity of individual granule cells. The effects of DAMEA on population and unit responses were antagonized by intravenous naloxone. These results confirm previous findings of opioid enhanced responsiveness to perforant path input and decreased sequential inhibition, but demonstrate a paradoxical inhibition of spontaneous unit activity by opioids in the granule cell layer. PMID- 3561879 TI - Proteins that bind serotonin in the nervous system of Aplysia californica. AB - The central nervous system of Aplysia has been found to contain two forms of proteins that bind serotonin with high affinity. These proteins share several similarities with the serotonin binding proteins that have been isolated from the vertebrate nervous system. Their ability to bind serotonin is enhanced by Fe2+ and inhibited by Na+,-SH reagents as well as reserpine and N-acetyl-5 hydroxytryptophyl-5-hydroxytryptophanamide. PMID- 3561880 TI - Light labeling of red nucleus neurons following an injection of peroxidase conjugated wheat germ agglutinin into the inferior olivary nucleus of the rat. AB - Since the rubro-olivary projection has not been demonstrated in the rat, unlike the monkey and cat (refs. in text). HRP or highly-concentrated wheat germ agglutinin-horseradish peroxidase (WGA-HRP) was injected into the inferior olivary nucleus using a ventral approach. After processing with a modified technique, sections were examined under high power. Three rats injected with WGA HRP showed labelling in the red nucleus. In one of those rats with a well confined injection, 583 neurons contained grains of HRP reaction product consistent with light retrograde labeling. This observation lends support to the existence of a rubro-olivary projection in the rat. PMID- 3561881 TI - Anatomical evidence for an ipsilateral rubrospinal pathway and for direct rubrospinal projections to motoneurons in the cat. AB - In 11 cases [3H]leucine injections were made in various parts of the red nucleus (NR) and surrounding area. The autoradiographical tracing results confirmed the existence of a somatotopic organization in the location of the rubrospinal neurons. Moreover the results demonstrated direct NR projections to the most dorsolaterally located motoneuronal cell group in the C8 and upper T1 spinal segments and some ipsilaterally descending rubrospinal fibers terminating in the lateral part of the cervical intermediate zone. PMID- 3561882 TI - Monosynaptic raphespinal and reticulospinal projection to forelimb motoneurones in cats. AB - Wheat germ agglutinin conjugated horseradish peroxidase (WGA-HRP) was injected in the nerve branches to the spino- and acromiodeltoid muscles. After injection, the cats were awake for a period of 100 h during which they performed target-reaching and/or walking movements. Transneuronally labelled neurones were found in the nucleus raphe pallidus, in the magno- and gigantocellular parts of the medial reticular formation. All neurones were located between the level of the obex and 6 mm rostrally of the obex. These results demonstrate that medullary raphespinal and reticulospinal neurones have monosynaptic connexions with deltoid motoneurones. The raphespinal projection is partly from neurones with large cell bodies assumed to be non-monoaminergic. PMID- 3561883 TI - Branching and termination of C3-C4 propriospinal neurones in the cervical spinal cord of the cat. AB - Antidromic stimulation and intra-axonal injections of horseradish peroxidase have been used to investigate axonal branching and termination of single C3-C4 propriospinal neurones (PNs) that project to the forelimb segments (C6-Th1). Branching at several spinal cord levels and terminations were found in laminae VI VIII and IX. With respect to terminations in laminae VII and IX, 3 patterns were observed: (i) termination only in lamina IX, (ii) only in lamina VII in the region of Ia inhibitory interneurones and (iii) in both laminae VII and IX. These findings are consistent with previous results showing monosynaptic projections of C3-C4 PNs to forelimb motoneurones and Ia inhibitory interneurones. Terminations in laminae VI, VIII and other parts of lamina VII suggest that C3-C4 PNs also project to other neurones in the forelimb segments. PMID- 3561884 TI - Carbachol-induced increases in locus coeruleus spontaneous activity are associated with an altered pattern of response to sensory stimuli. AB - In order to evaluate the relationship between locus coeruleus (LC) spontaneous activity and LC activity in response to sensory stimuli, the effects of carbachol on both types of LC neuronal activity were investigated in anesthetized rats. Carbachol increased LC spontaneous discharge rate and altered the pattern of LC discharge in response to sciatic nerve stimulation, while saline had no effect. Moreover, the magnitudes of increases in LC spontaneous discharge rate produced by carbachol were highly correlated (r = 0.79) with a measure of simultaneous effects on LC sensory responses. These results suggest that drugs which increase LC spontaneous activity will also disrupt the pattern of LC discharge to sensory stimuli. PMID- 3561885 TI - Intramural distribution of Met5-enkephalin-Arg6-Gly7-Leu8 in sphincter regions of the human gut. AB - The intramural distribution of Met5-enkephalin-Arg6-Gly7-Leu8 (MERGL) was studied in the oesophago-cardiac, pyloric, ileo-caecal and sigmoid-recto-anal regions of the human digestive tract. Serial samples encompassing each area were separated into mucosa, submucosa and muscularis externa and extracted for radioimmunoassay. Comparatively low levels of MERGL immunoreactivity were measured throughout the cardiac junction. Conversely, a remarkable peak of MERGL concentration was detected at the pyloric junction, in both submucosa and muscularis. A progressive decrease in tissue levels of the same peptide, most evident in the submucosa, was detected on the proximal side of the ileo-caecal region. In the distal sigmoid colon and rectum MERGL concentrations showed a rapid decline, down to very low levels in the anal canal. The results may suggest the involvement of an enkephalinergic mechanism in the control of the human pylorus. PMID- 3561886 TI - Time-dependent effects of papaverine on electrically induced seizures in rats. AB - We tested the effects of papaverine, an adenosine uptake blocker, on hippocampal elicited afterdischarges in rats. Rats were injected with 35 mg/kg papaverine and tested for seizure responses at 5, 20, and 60 min postinjection. Papaverine produced a potent inhibition of afterdischarge generation, greatly reduced afterdischarge duration, and blocked hippocampal-kindled seizures. This anticonvulsant effect was greatest 5 min postinjection and had largely dissipated by 60 min. Because papaverine also produced a Parkinson-like syndrome involving muscle rigidity, these results are discussed in terms of effects on dopamine and adenosine systems. PMID- 3561888 TI - Protein turnover in subcellular fractions of brain from the ethanol-fed rat. AB - The effect of ethanol consumption (27% of energy intake) for 21 days, on protein synthesis and degradation in subcellular fractions of rat brain was investigated using the Na2(14)CO3 labelling procedure. Ethanol administration elicited an increase in the rate of protein synthesis in all fractions which was accompanied by an increase of similar magnitude in the rate of breakdown. These results imply that whilst ethanol increases the rate of protein turnover it is without effect on the rate of protein accretion. PMID- 3561887 TI - Behavioral evidence for the involvement of endogenous opioids in the interaction between cholecystokinin and brain dopamine systems. AB - The hyperactivity induced by injection of the dopamine (DA) agonist apomorphine into the nucleus accumbens of rats was dose dependently inhibited by intra accumbal pretreatment with cholecystokinin (CCK-8) (ED50, 0.34 ng). Local treatment with the opioid antagonist naloxone antagonized this inhibitory action of CCK-8 (ED50, 18 ng), but did not change the blocking effect of haloperidol on the apomorphine-induced hyperactivity. These data show that endogenous opioids are concerned in certain interactions between CCK-8 and DA systems. PMID- 3561889 TI - Swim stress reduces chronic pain in mice through an opioid mechanism. AB - Chronic nociception has been studied in male mice by means of the formalin test in which forelimb motor behaviour is scored after subcutaneous formalin injection. The rating remained above 2.0 for 30 min after the injection (scale range 0-3). The magnitude of the nociception has been compared with that reported in other animal types. Mice are more sensitive than rats, cats and monkeys. The stress of a swim of 3 min has been found to reduce nociception by up to 25%. This analgesia is wholly opioid in nature, being abolished by a moderate dose of naloxone (1 mg/kg). PMID- 3561890 TI - Brain lipids of a myelin-deficient rabbit mutant during development. AB - The paralytic tremor (pt) rabbit, a neurological mutant, exhibits hypomyelination transmitted in X-linked recessive fashion. This rabbit mutant was used for regional lipid analyses of different brain structures during development. There was a significant decrease of myelin-specific lipids, particularly in the cerebroside and sulfatide in pt rabbits. The decrease of phospholipid and cholesterol was relevant to the total lipids depletion. The molar ratio of galactolipid to phospholipid decreased in the pt rabbit brain in each age group examined. The other lipids typical for myelin, such as ethanolamine glycerophospholipids, sphingomyelin, and GM1 ganglioside, were also diminished in the myelin-rich structures, but were not changed in the cortical gray matter of pt rabbits. In contrast, the total amount of gangliosides was near control levels and, therefore, in the mutant rabbits, the white matter and brain stem contained a higher proportion of lipid, as ganglioside, relative to the control animals. This result suggests that neuronal membranes were not involved in this pathology. The characteristic biochemical abnormalities exhibited in the pt rabbit suggest that a defect of oligodendroglial cell function is primarily responsible for the myelin abnormality. PMID- 3561892 TI - Diabetic rat serum has an increased capacity to inhibit brain microtubule formation in vitro. AB - The assembly of pig brain microtubule proteins was measured in vitro in the presence of serum from control rats and rats that had been rendered diabetic with 50 mg/kg streptozotocin 14 d previously. Control serum inhibited total microtubule assembly and increased the lag time before assembly commenced. Serum from diabetic animals was significantly more potent in both respects. The effect on lag time was reproduced in a predominantly albumin-containing fraction of serum that had been fractionated by affinity chromatography. Glycosylation of rat albumin in vitro led to an increase in its ability to increase polymerization lag time, but the concentration of albumin required was greater than that found in the serum fractions. The results indicate that diabetic serum contains factors that can adversely affect microtubule formation and that part of this effect may be caused by the presence of glycosylated albumin. This phenomenon may underlie some of the complications associated with diabetes. PMID- 3561891 TI - Rabbit brain lipids during short-term hyperthermia. AB - Rabbits were subjected to 3 h of hyperthermia at 40 degrees C. The phospholipid content of the brain was unchanged, whereas the free fatty acids increased by about 73% over control levels. Hyperthermia also induced inhibition of fatty acid peroxidation processes. The last products of fatty acid peroxidation, the thiobarbituric acid reactive substances, diminished significantly during hyperthermia, whereas the level of the first intermediate of this pathway, the conjugated double bonds, remained unchanged. Simultaneously, the levels of lipid soluble antioxidants decreased significantly. The content of free fatty acids, malondialdehyde, and lipid-soluble anti-oxidant returned toward control levels during 3 h of recovery. The content of gangliosides was 10-20% above control values in the groups of animals examined immediately and 3 h after hyperthermia. The ganglioside-specific enzymes, neuraminidase and sialyltransferase, both directed toward endogenous lipid substrates, were activated by hyperthermia, suggesting the stimulation of turnover of the gangliosides during the course of hyperthermia. Lipid alterations resulting from short-term hyperthermia may influence the physicochemical properties of neuronal membranes. PMID- 3561893 TI - Optimization of freezing, storage, and thawing conditions for the preparation of metabolically active synaptosomes from frozen rat and human brain. AB - Samples of rat and human cerebral cortex were frozen, stored, and thawed under a variety of conditions to define further the optimal procedure for storing human brain samples for subsequent metabolic and functional studies that use incubated synaptosomes. Tissue samples were best preserved by immersing them in isotonic sucrose prior to slow freezing, but there was no advantage in first chopping up the material. High concentrations of sucrose, rather than exerting a cryoprotective effect, were detrimental to subsequent synaptosomal performance (oxygen uptake, K+ accumulation, stimulus-induced release of amino acid neurotransmitters). However, good activity was observed in preparations from rat brain frozen in the absence of fluid. This result was confirmed by studies on the uptake of gamma-aminobutyrate (GABA) into an osmotically sensitive compartment in synaptosomes prepared from frozen human autopsy material transshipped from the brain tissue collection ("brain bank") at Harvard Medical School, MA, USA, to Sydney, Australia. Although activity was slowly lost over a 3-mo period in rat tissue samples stored at -20 degrees C, there was little or no such loss at -70 degrees C. PMID- 3561894 TI - Potential biochemical markers for infantile autism. AB - Biochemical markers are crucial to the development of early diagnosis of infantile autism. The blood concentrations of neuroanalytes epinephrine, norepinephrine, dopamine, and serotonin were elevated in autistic subjects (n = 13) as compared to normal controls (n = 10). Autistic subjects had peptide patterns (peaks I-V, Sephadex G-25) that were different from those of normal controls. Methionine-enkephalin has been tentatively identified from fraction I of autistic subjects by HPLC as one of a large number of peptides that appears to be elevated. The HPLC chromatographic patterns of fraction V from all autistic subjects show a peak with retention time of 7.6 min. The HPLC of control urine fraction V revealed no comparable peaks. PMID- 3561895 TI - Effects of subperineurial injections of very-long-chain and medium-chain fatty acids into rat sciatic nerve. AB - [9,10-3H] palmitic (C16:0) and [1-14C] lignoceric (C24:0) acid dissolved in 10 microL of ethanol were injected subperineurially into the sciatic nerve of rats. Both C16:0 and C24:0 were incorporated into lipids, and in most lipid fractions C16:0 incorporation exceeded that of C24:0. Free ceramide and cholesterol ester were the only lipid moieties in which C24:0 incorporation was equal to or greater than that of C16:0. This finding is of particular interest since the very-long chain fatty acid excess is by far the most striking in the cholesterol ester fraction in adrenoleukodystrophy. Furthermore, incorporation into cerebroside and sulfatide indicates that at least some of the injected fatty acids were metabolized in the Schwann cell. Subperineurial injections of either very-long chain fatty acids or medium-chain fatty acids into rat sciatic nerve caused demyelination, and this morphological change does not occur following injection of pure solvent. PMID- 3561896 TI - Chemical indices of neurotoxicity. Proceedings from a symposium. September 2, 1986, Baltimore, Maryland, USA. PMID- 3561897 TI - Comparative seizure inducing properties of various cholinesterase inhibitors: antagonism by diazepam and midazolam. PMID- 3561898 TI - An electron microscopic study of endrin induced alterations in unmyelinated fibers of mouse sciatic nerve. AB - This study examined the ultrastructural alterations in peripheral nerve of adult mouse following repeated sublethal exposures to endrin, a toxic chlorinated hydrocarbon which produces symptoms indicative of neuromuscular dysfunction. Male mice were given 20 daily ip injections of endrin in sesame oil (0.2 ml) in doses that increased from 1.5 mg/kg on days 0-3, to 2.0 mg/kg on days 4-11, and to 4.0 mg/kg on days 12-19. Controls were given the same intraperitoneal volume of sesame oil without endrin. Animals were sacrificed by glutaraldehyde perfusion after 4, 7, 14, and 20 days of exposure and 14 and 92 days postinjection and sciatic nerve tissue was prepared for electron microscopy. Myelinated nerve fibers, myelin and associated Schwann cells from endrin exposed animals appeared similar to those of controls and normal animals. Various morphological alterations were observed in many unmyelinated axons from endrin exposed animals. Such alterations included swelling, dissolution of microtubules and neurofilaments, the presence of unusual numbers of axoplasmic vesicles, both scattered and in packets, and less often, extreme vacuolation. In those Schwann cells associated with damaged axons the cytoplasm and the adaxonal space frequently contained vesicles, often in packets invaginating the axolemma. The results of this study indicate that repeated subacute doses of endrin can produce morphological alterations in unmyelinated peripheral nerve fibers and their associated Schwann cells without apparent damage to myelinated nerve fibers. The results are discussed relative to other studies producing similar nerve damage and to the potential mechanisms responsible for such damage. PMID- 3561899 TI - Cytoskeletal changes in axons of rats exposed to 2,5-hexanediol, demonstrated using monoclonal antibodies. AB - The changes in axons seen following exposure to 2,5-hexanedione and its metabolites have to date been studied using electron microscopy and conventional silver impregnation techniques. These have their draw-backs and do not identify the molecular components of a pathological change. We have used monoclonal antibodies to neurofilament proteins and tubulin with immunohistochemical techniques. Sprague-Dawley rats were given 2,5-hexanediol in their drinking water. After 2 weeks the rats showed signs of central and peripheral neuropathy, firstly in the hind limbs and this progressed with time of exposure. After 6 weeks, the administration of 2,5-hexanediol was ceased. Many of the rats were by this time paralyzed in the hind limbs. One third of the rats were then sacrificed. The remaining rats were allowed to recover for a 5 or 10 week period. The axonal changes were studied using an indirect immunoperoxidase method with monoclonal antibodies to the neurofilament proteins and tubulin. The injuries were simply, distinctly and reproducibly demonstrated. With this method it was possible to state that the excess material in the axon swellings was formed of neurofilament proteins and not tubulin. New findings such as the grouping of axon swellings in specific areas of cerebral cortex are reported. This report shows the advantage of using immunohistochemical techniques with monoclonal antibodies. These are easily reproducible and dependable methods for demonstrating pathological changes in the neuronal cytoskeleton. PMID- 3561900 TI - Banked milk is low in immunologically protective proteins. PMID- 3561901 TI - Vitamin A supplementation and childhood mortality. PMID- 3561902 TI - Diabetes mellitus in an obese woman. PMID- 3561903 TI - Genetic factors in copper deficiency. PMID- 3561904 TI - The interaction of alcohol, vitamin A, and zinc in rats. PMID- 3561905 TI - Economic savvy is key to job security for NPs. PMID- 3561906 TI - Physician-perceived incentives for association with nurse practitioners. AB - A 1985 study was conducted concerning physician motivation to form an association with nurse practitioners. The study explored NP-association incentives in relation to year of physician graduation from medical school, physician specialty and type of practice. Subjects for the study were 58 Arizona physicians associated in practice with nurse practitioners. Data were collected via mail questionnaires. Data analysis included descriptions of the demographic characteristics, factor analysis, analysis of variance and a specific comparison test. Results indicated physicians perceived increased accessibility to their services and improved quality of their care as being the most important incentives for NP association. Economic incentives were a low priority for the majority of respondents. There were significant differences related to physician specialty. Internists placed less importance on all incentives than other specialties did; emergency medicine physicians placed more importance on physician satisfaction; obstetricians and gynecologists placed more importance on economics. The relatively low importance ratings of the internal medicine physicians may represent a resistance to extension of hospital privileges to nurse practitioners. PMID- 3561907 TI - Understanding cervical cytology. AB - Nurse practitioners and nurse midwives perform Pap smears routinely as a part of well-woman health care. However, the clinician may not understand the terminology used to express the results of the test or the rationale for strict adherence to correct technique. Information on basic histology and cytology is presented with the goal of helping the clinician understand what the cytologist is looking for and what the results from a Pap smear mean. Two sets of nomenclature for results are presented. Risk factors for development of cancerous and precancerous conditions of the cervix and the controversy regarding frequency of Pap smear sampling are discussed, as are guidelines for treatment and referral of women with class II Pap smears. PMID- 3561908 TI - Right-to-know laws: maintaining compliance. PMID- 3561909 TI - Improving hearing conservation in the industrial workplace setting. PMID- 3561910 TI - Opening patient records to the public could hamper quality medical care. PMID- 3561911 TI - OSHA workplace inspections tied to reported injury and illness rates. PMID- 3561912 TI - Proactive surveillance programs, spirometry tests reduce illness. PMID- 3561914 TI - "The legal basis of malpractice suits" clarified. PMID- 3561913 TI - Fluoridation of public water supply draws concern over health effects. PMID- 3561915 TI - Physician unions ... the time may never be ripe. PMID- 3561916 TI - The health care dollar. PMID- 3561917 TI - Is there a place for the adolescent patient? PMID- 3561918 TI - Sexuality and pregnancy: a change in values. PMID- 3561919 TI - Adolescence and stress. Children coping in an adult world. PMID- 3561920 TI - Teaching teens to trust. PMID- 3561921 TI - Medical liability tort reform. Physician action needed. The OSMA Department of Legislation. PMID- 3561922 TI - Correlation between PMS and alcoholism among women. PMID- 3561923 TI - In vitro and in vivo enhancement of vincristine antitumor activity on B16 melanoma cells by calcium antagonist flunarizine. AB - Flunarizine, a calcium antagonist commonly employed in therapy for vascular diseases, enhances the in vitro and in vivo antitumor activity of vincristine on B16 melanoma cells. In the presence of flunarizine higher intracellular levels of vincristine were observed in vitro and for a longer time. B16 melanoma bearing mice treated with both the drugs presented a median survival time that was significantly longer than that of the controls. The possible mechanism of the enhancement is herein discussed. PMID- 3561924 TI - Relationship between flow cytometric parameters, steroid receptors, and menopausal status in breast cancers. AB - Of 163 human breast cancers examined, 68% contained detectable aneuploid populations, whilst 32% had apparently normal DNA distributions. A slightly higher incidence of aneuploidy was observed in pre-menopausal patients (83%) than in post-menopausal patients (66%). Also, pre-menopausal patients had slightly higher proportions of S-phase or cycling (S + G2 + M) cells. Estradiol receptor negative (ER-) tumours from post-menopausal patients were found to have the lowest incidence of aneuploidy (59%) and ER- tumours from pre-menopausal patients the highest (91%). There were no significant differences in the proportions of cycling nuclei when receptor status and menopausal status were considered. A weak relationship is shown to exist between flow cytometric data and two common prognostic indicators of breast cancer, namely receptor status and menopausal status. PMID- 3561925 TI - Aromatisation of androstenedione by human breast cancer tissue: correlation with hormone receptor activity and possible biologic significance. AB - The conversion of 1 beta [3H] androstenedione to estrone in the presence of NADPH by breast cancer homogenates was assessed in tumors from 35 subjects together with estrogen and progesterone receptor concentration. Breast cancers from post menopausal women had significantly higher aromatase activity than those from premenopausal women. Although in many instances the local production of estrogens was sufficient to the capable of exerting a biologic effect, there was, however, no correlation with tumor estrogen or progesterone receptor content. Further studies of the biological significance of tumor aromatisation will depend on direct observation of tumor aromatase and response to suitable doses of aromatase inhibitors. PMID- 3561926 TI - Reduction of cis-dichlorodiammineplatinum(II) caused nephrotoxicity by indazolone carboxylic acid. AB - To reduce the nephrotoxicity of cis-dichlorodiammineplatinum (cis-DDP) we have used tetrahydroindazolonedicarboxylic acid (HIDA) in doses of 200, 100 or 50 mg/kg 4, 2 and 1 h before or 1, 2 and 4 h after cis-DDP treatment (10 mg/kg). At any dose, given 2 or 1 h before or 1 h after cis-DDP, HIDA reduced the kidney damage as judged by the blood urea nitrogen (BUN) levels in blood. No protective effect was seen when HIDA was given 4 h before cis-DDP injection. Studies in vitro on L1210 cells have revealed that HIDA does not directly interact with cis DDP. PMID- 3561927 TI - Peripheral blood lymphocyte subsets in nasopharyngeal carcinoma. AB - Peripheral blood lymphocyte subsets were studied in 29 untreated Chinese nasopharyngeal carcinoma (NPC) patients and 20 normal controls of similar age range and sex ratio with indirect immunofluorescence using monoclonal antibodies. The percentage T lymphocyte (T11) count, percentage and absolute T helper (T4) lymphocyte counts and the T helper/T suppressor-cytotoxic cell ratio (T4/T8) were significantly lower, while the percentage and absolute T8 counts were significantly higher in NPC patients. Concerning B lymphocytes, B1 cell count was normal while B4 cell count (B lymphocytes including early B lymphocytes) was significantly lower in NPC patients. These various lymphocyte subset changes were not related to the clinical stage or to Epstein-Barr viral IgA viral capsid antibodies and IgA early antibodies. The pathogenetic and prognostic significance of peripheral blood lymphocyte changes in NPC requires further investigation. PMID- 3561928 TI - In vivo effect of didemnin B on two tumors of the rat. AB - Didemnin B administered at a dose of 0.06 mg/kg, highest nontoxic dose for the rat, shows a high antitumor activity against Yoshida ascites tumor only after intraperitoneal injection of the drug; supplied by other routes both against T8 sarcoma of Guerin and Yoshida ascites tumor is ineffective. PMID- 3561929 TI - Restoration of doxorubicin responsiveness in doxorubicin-resistant P388 murine leukaemia cells by dipyrone. AB - The effect of dipyrone along with doxorubicin and mitoxantrone was studied alone and in combination on the 3H-thymidine (3H-TdR) incorporation in P388 leukaemia sensitive (P388/S) and resistant (P388/ADR) to doxorubicin. Dipyrone 10(-4) M demonstrated minimal inhibitory effect on DNA biosynthesis in both the sensitive and resistant cells. Doxorubicin and mitoxantrone at equimolar concentrations, indicated time and dose-dependent inhibition in 3H-TdR incorporation in the sensitive cells. The inhibition was more at the higher drug concentrations at 4 h drug exposure. Mitoxantrone showed cross-resistance in P388/ADR compared to P388/S. Both the drugs along with 10(-4) M dipyrone in the incubating medium revealed synergistic inhibitory activity in P388/S and P388/ADR. Observations indicate circumvention of doxorubicin and mitoxantrone resistance in P388/ADR by dipyrone. PMID- 3561930 TI - Energy status in HeLa cells after treatment with an arresting anticancer drug. AB - The energy status of HeLa cells arrested in the G2 phase of the cell cycle by the antineoplastic agent cis-acid was compared with that of normal G2-phase synchronized cells. The results showed that treatment with the drug has significantly decreased the adenylate pool, adenylate energy charge and phosphorylation potential. PMID- 3561931 TI - Cerebral spinal fluid recovery of lidocaine and bupivacaine following respiratory arrest subsequent to retrobulbar block. AB - A 75-year-old man experienced a self-limited respiratory arrest following a retrobulbar injection. The injection was a mixture of bupivacaine and lidocaine. Forty-five minutes after the injection, quantities of both drugs were recovered from the patient's cerebral spinal fluid (CSF) obtained via a lumbar puncture. Theoretical evidence is presented to show that the drug levels obtained resulted from a direct intrathecal injection. PMID- 3561932 TI - A modified Gills' block and its effectiveness for lid muscle akinesia. AB - We developed a prospective clinical study to determine the effectiveness of a new method of retrobulbar anesthesia and akinesia of the levator and orbicularis muscles. This study involved 50 patients who underwent extracapsular cataract extractions (ECCE) with intraocular lens implant (IOL). We found levator and orbicularis muscle akinesia was achieved in 49 of 50 eyes. One reblock was necessary. We also wish to point out the advantages of this technique as a means of reducing the rare but serious complications associated with retrobulbar anesthesia. PMID- 3561933 TI - Simple modification of the explant-encircling element combination. PMID- 3561934 TI - Vitreoretinal changes associated with rise in intraocular pressure after Nd:YAG capsulotomy. AB - In a chart review of 100 consecutive Nd:YAG laser capsulotomies, six presumed risk factors of the rise in intraocular pressure (IOP) after capsulotomy were identified. A group of 15 patients in which the pressure rose to at least 10 mmHg above baseline postoperatively showed a significant (P less than or equal to 0.01) association with myopia, vitreoretinal disease, and vitreous prolapse into the anterior chamber. The previously known association of high pressures with glaucoma, a large capsular opening, or absence of a posterior chamber lens were also confirmed. There was no correlation between the energy used and IOP. These retrospective findings are suggestively consistent with the concept that injury to a liquefied vitreous may contribute to the IOP rise after capsulotomy. PMID- 3561935 TI - Free autogenous grafts in eyelid tarsoconjunctival reconstruction. AB - Classical techniques of reconstruction of large eyelid defects require temporary occlusion of the eye. Use of a free autogenous tarsoconjunctival graft with a skin-muscle flap is described. Twelve patients were operated with ten good, two fair, and no poor results. This method can be used to repair medial, lateral, and central defects of the upper and lower eyelids. PMID- 3561936 TI - Treatment of iris melanoma by photocoagulation: a case report. AB - A 13-year-old white male was found to have a melanoma of the iris. Three treatments with xenon arc photocoagulation resulted in regression of the lesion with development of an iris coloboma. There were no complications, and corrected visual acuity has remained at 20/15 after a 19-year follow-up. PMID- 3561937 TI - Effect of peripheral cryocoagulation on ocular blood flow. AB - Using the labeled microsphere impaction technique, we studied the effect of peripheral panretinal transscleral cryocoagulation in pigmented rabbits. One eye of each animal received peripheral cryocoagulation, and the fellow eye of the same animal was used as the control. Thirty-two animals received 40 exposures of peripheral cryocoagulation; twenty-six rabbits received 20 exposures. After 40 exposures of cryocoagulation, choroidal-retinal blood flow was significantly decreased when measured at one to two hours, 24 hours, and two weeks; normal flow recovered by four weeks. After 20 exposures of cryocoagulation, there was a significant reduction in choroidal-retinal blood flow at the earliest measurement time (one to two hours) only. The iris-ciliary body blood flow also was substantially decreased only at the earliest measurement time (one to two hours) and only after 40 exposures. PMID- 3561938 TI - Toxicity of intravitreally administered alpha-interferon. AB - We studied the toxicity of single doses of intravitreally administered alpha interferon in albino rabbits. Doses of 420,000, 210,000, 105,000, 52,500, and 26,250 units/0.1 cc showed no significant histologic changes by light microscopy or altered retinal function assessed by photopic and scotopic electroretinography. PMID- 3561939 TI - Proposal for a new contact lens for YAG laser posterior capsulotomies. AB - A contact lens designed for neodymium-YAG laser posterior capsulotomy which angulates the beam with respect to the posterior capsule is presented. This lens may minimize injury to the corneal endothelium. PMID- 3561940 TI - A step-zoom probe for laser endophotocoagulation: I. Design. AB - A step-zoom probe for laser endophotocoagulation of the eye has been developed, using fiber optics and a gradient index (GRIN) rod lens. It provides the operator with five or more focused spots ranging in size from 50 to 500 microns, and the spot size on the target is independent of the media filling the vitreous cavity, i.e., fluid or air. Each spot is located at the waist of the beam and therefore can be easily placed on the target, reducing the potential for overtreatment. A prototype model is currently undergoing animal testing. PMID- 3561941 TI - More of the conservative management of cyanoacrylate ankyloblepharon. PMID- 3561942 TI - Doubts regarding value of trapezoidal relaxing incision for relief of astigmatism. PMID- 3561943 TI - [Spheroid degeneration of the cornea]. AB - This is a clinical, histopathological and electron microscopical study on the spheroidal degeneration of the cornea by means of 48 histologically verified cases. False clinical diagnoses are surveyed and the presumed mechanism of the development of spheroidal degeneration is discussed. PMID- 3561944 TI - [Vision aids for patients with senile exudative macular degeneration. Comparison of spontaneous fibrovascular scars and scotomas induced by photocoagulation]. AB - Aging exudative macular degeneration frequently results in a fibrovascular scar which entails the loss of central vision. This scar implies an often large and deep scotoma which makes it very difficult for the patient to be fitted with low vision aids. A Goldmann static perimetry study of retinal sensitivity in the treated areas showed that krypton laser at liminar doses does not induce deep scotomas. PMID- 3561945 TI - Congenital retinal macrovessel. AB - The authors describe a case of congenital retinal macrovessel with decreased visual acuity. Ophthalmoscopy and fluorescein angiography showed the malformation to be congenital and benign. PMID- 3561946 TI - Effect of timolol on optic nerve head autoregulation. AB - Healthy subjects show, in a special pressure compliance test of the optic nerve head, signs of autoregulation of optic nerve head circulation. In this test visual evoked response (VER) amplitudes were recorded during stepwise increased intraocular pressures. In the resulting VER amplitude/pressure curves glaucoma patients did not show the sign of autoregulation of optic nerve head circulation which is seen in healthy subjects. It is known that topically applied timolol maleate may affect optic nerve head circulation. Therefore the pressure compliance test was performed in 20 healthy eyes before and after 3 days of topically applied timolol maleate 0.5%. The aim of the study was to test the effect of topically applied timolol on optic nerve head autoregulation. In addition we determined the ocular perfusion pressures, heart rate and mean arterial blood pressure. While the ocular perfusion pressures show a slight, but statistically not significant, decrease under timolol, the systemic parameters and the autoregulation behavior did not change. PMID- 3561947 TI - [Malignant lymphoma of the eyelids]. AB - A 51-year-old patient developed malignant lymphoma of both lower eyelids, which turned out to be immunocytoma of the lymphoplasmocytic subtype. The lymphatic tumor grew after several episodes of severe inflammation of the lids and conjunctiva in the presence of an underlying marked occupational allergy to chloramphenicol. The development of a so-called oculocutaneous immunocytoma from a reactive proliferation, its histological characteristics and its special clinical course are discussed on the basis of the present case. PMID- 3561948 TI - A family with iridoschisis, narrow anterior chamber angle, and presenile cataract. AB - Familial iridoschisis is a rare ocular disease and is probably transmitted as an autosomal dominant trait. The underlying abnormalities are not understood. Family members should be screened for this condition as well as for associated ocular abnormalities, namely presenile cataracts and narrow anterior chamber angle. PMID- 3561949 TI - Tapetoretinal degeneration associated with multisystem abnormalities. A case report. AB - Tapetoretinal degeneration is not infrequently associated with other systemic abnormalities. The authors have examined an 11-year-old girl with severe pigmentary degeneration of the retina associated with severe musculoskeletal abnormalities, growth failure, recurrent respiratory problems, sensorineural hearing loss, and mental retardation. To the best of their knowledge, this constellation of features has not been described previously and probably represents a new clinical entity. PMID- 3561950 TI - Optic atrophy in Wolfram syndrome. AB - The clinical and electrophysiologic findings in 11 cases of Wolfram syndrome are presented. These findings suggest that optic atrophy in Wolfram syndrome is not secondary to retinal pathology, but probably represents part of a generalized degeneration of neural structures. The relationship of diabetes mellitus to this process of neural degeneration remains unclear. PMID- 3561951 TI - Retinal cone dysfunction and mental retardation associated with a de novo balanced translocation 1;6(q44;q27). AB - The authors describe a six-year-old boy with cone dystrophy, mental retardation, facial dysmorphism and short neck, hands and feet in whom they found a 1:6 chromosomal translocation. This is the first description of retinal cone dystrophy and a chromosomal aberration. The hypothesize that the cone dystrophy in the patient may be assigned to 1q44 or 6q27. PMID- 3561952 TI - Partial trisomy 6q and bilateral retinal detachment. AB - An eight-year-old boy with trisomy 6q13----q21 is described with growth retardation, severe mental retardation, unusual facies, cleft palate, joint contractures and bilateral retinal detachment. To the authors' knowledge, this is the first case in which such an association has been recorded. PMID- 3561953 TI - Pseudopapilledema and macrocephaly in a child. AB - A seven-year old female with primary megalencephaly and pseudopapilledema has been followed for over four consecutive years. Physical examinations of the patient and her family, funduscopic photography, and fluorescein angiography have failed to identify the etiology of her pseudopapilledema. Macrocephaly and pseudopapilledema have been seen in association in only one previous report to our knowledge. The importance of distinguishing pseudopapilledema from true papilledema in children with large heads is reviewed. PMID- 3561954 TI - The intravitreal penetration of cefotaxime in man following systemic and subconjunctival administrations. AB - Of 30 patients scheduled to undergo elective vitreal surgery, five received a single dose of 1000 mg of cefotaxime intramuscularly and 25 received 100 mg subconjuctivally. Specimens of serum and vitreous were collected from 30 minutes to five hours after drug administration, and were assayed for cetotaxime concentration by bioassay and high pressure liquid chromatography. In the five patients who received the intramuscular dose, no cefotaxime or its major metabolite could be detected in the vitreous. In the 25 patients who received the subconjunctival dose, cefotaxime or its metabolite could be only detected in patients with aphakia or in those who previously underwent vitreal surgery. Cefotaxime in intramuscular administration should not be relied upon as appropriate prophylaxis for vitreal surgery. Cefotaxime in subconjunctival administration reaches therapeutic levels in the vitreous only in previously operated eyes. PMID- 3561955 TI - Arteriovenous anastomoses of the retina. AB - The authors reviewed the clinical findings in 13 patients followed at Montefiore Medical Center and in 85 cases described in the literature with primary arteriovenous communication of the retina (AVCR). The characteristics of AVCR include: young age at detection; both sexes affected; detected on routine examination, and less frequently after decreased vision or referral after diagnosing systemic arteriovenous communication (AVC); unilateral involvement; single or multiple sites in the same fundus; and predilection for the papillomacular area and the superotemporal quadrant. Vision correlated inversely with the grade of AVCR. The presence of concomitant systemic AVC correlated directly with the grade of AVCR. It is concluded that grade I AVCR and the majority of grade II AVCR represent isolated retinal vascular anomalies, and there is no need for extensive search for systemic AVC if these patients remain asymptomatic. PMID- 3561957 TI - The test light affects quantitation of the afferent pupillary defect. AB - Nineteen patients with afferent pupillary defects (APDs) from a variety of lesions were examined using a brighter and dimmer test light. A denser neutral density filter was required to balance the afferent defect using the brighter test light in every case. For quantitation of an afferent defect to have meaning, the test light used must be specified. An indirect ophthalmoscope set to 6 V and held 1 foot from the eyes will allow easier detection of subtle relative APDs than it will if set to 3 V. PMID- 3561956 TI - Ophthalmologic manifestations of X-linked childhood adrenoleukodystrophy. AB - The ophthalmologic findings in 15 patients with childhood adrenoleukodystrophy (ALD) are reviewed. In this X-linked demyelinating disease with adrenal dysfunction, relentlessly progressive visual loss followed by optic atrophy occurs months to years after the diagnosis is established based on neurologic symptoms and biochemical abnormalities. Visual loss is mainly due to central nervous system (CNS) demyelination involving the visual tracts, but primary retinal ganglion cell degeneration may also be operative. All patients in this study were male. Vision ranged from 20/20 to no light perception (NLP). All but one patient with bilateral cataracts had normal anterior segment examinations. Seven patients had exotropia, and esotropia developed in one patient. Electroretinography (ERG) and electrooculography (EOG) findings were normal in two patients with severe visual loss. Macular pigmentary changes were observed in three patients. Optic pallor was noticed in seven patients. Optic nerve hypoplasia was seen in one patient. Visual-evoked responses were abnormal in two patients and borderline in one. Progressive visual field abnormalities were noticed in three patients, large field cuts in two patients, and normal fields in another two patients. The diagnosis of ALD should be considered in all boys presenting with unexplained visual loss, dementia, and adrenal dysfunction. PMID- 3561958 TI - Recurrent conjunctival melanoma with neuroidal spindle cell features. AB - A 66-year-old white woman had had a 20-year history of flat primary acquired melanosis involving the left inferior forniceal and palpebral conjunctiva. Over the ensuring 12 years, the patient experienced multiple recurrences of invasive malignant melanoma that emerged from the progressive primary acquired melanosis. Two of these recurrences were composed of nonpigmented spindle cells, and in the most florid invasive malignant melanoma that developed, the spindle cells formed a nodule 7.5 mm thick. The spindle cells were organized into fascicles and small bundles, the latter separated by a loose stroma that was devoid of mucopolysaccharides. The fascicular and neuroidal features in this case were sufficiently well developed to suggest the incorrect diagnosis of a neural tumor or a neurofibroma. However, the presence of intraepithelial atypical melanocytes at the edge of the spindle cell lesion, the absence of mucopolysaccharides in the stroma, the mitotic activity, and the absence of intercellular reticulin fibers favored the diagnosis of a spindle cell invasive malignant melanoma. This morphologic variant of conjunctival melanoma is compared with related cutaneous lesions of melanoma featuring a spindle cell population. PMID- 3561959 TI - Multiple bilateral apocrine cystadenomas of the lower eyelids. Light and electron microscopic studies. AB - An 88-year-old man presented with 13 apocrine cystadenomas of both lower eyelids of at least 10 years' duration. The cysts were remarkable for possessing a superior dome of either creamy or yellowish material (probably reflecting the lipid-rich decapitation secretion), surmounting a clearer fluid inferiorly, as well as for being restricted to the eyelid margins where the glands of Moll are located. Light microscopy disclosed a double-layered cuboidal cellular lining, which focally became more plump or hobnailed, exhibited apical decapitation secretion, and was occasionally thrown into papillary folds. Electron microscopy demonstrated cellular debris and segments of interrupted plasmalemmas within the cystic cavity, intercellular widenings constituting canaliculi, cytoplasmic election-dense secretory granules, flocculent mucous vacuoles, and swirls of smooth-surfaced endoplasmic reticulum. Basal cells were focally interspersed between the secretory cells and the basement membrane, and occasionally manifested spotty myofilamentary differentiation. These findings are supportive of an origin of the lesions from the secretory rather than the ductal portion of the glands of Moll. They corroborate conclusions drawn from dermatologic investigations that the cysts are an essentially proliferative process as opposed to the result of passive ductal dilatation. PMID- 3561960 TI - Neodymium: YAG laser damage threshold. A comparison of injection-molded and lathe cut polymethylmethacrylate intraocular lenses. AB - The possibility that injection-molded intraocular lenses (IOLs) with imperfections called iridescent clefts could have a decreased threshold to neodymium: YAG (Nd:YAG) laser-induced damage was investigated. Thresholds for Nd:YAG laser-induced damage were determined for injection-molded and lathe-cut polymethylmethacrylate lenses. When aimed at a membrane in contact with a posterior convex surface, the average thresholds were 0.96 +/- 0.18 mJ (Standard deviation [SD]) and 1.80 +/- 0.55 mJ, respectively. The difference was significant at P = 0.001. When injection-molding polymethylmethacrylate was used to make lathe-cut IOLs, very few iridescent clefts were present, and the threshold to Nd:YAG laser-induced damage was 0.94 +/- 0.25 mJ. Iridescent clefts are therefore produced during the injection-molding process but they do not lower the threshold to Nd:YAG laser-induced damage. Rather, the reduced threshold in injection-molded lenses is most probably a result of the polymethylmethacrylate used in their manufacture. Clinically, iridescent clefts in a lens suggest that it has been manufactured by an injection-molding process and that Nd:YAG laser posterior capsulotomy must be performed at the lowest possible energy level to avoid damage. PMID- 3561961 TI - Canaliculops. AB - Over a 1-year period, a cystic bluish coloration developed in the most medial aspect at the margin of the right upper eyelid of a 40-year-old man. The clinical diagnoses were either a conjunctival inclusion cyst or an adnexal cyst, possibly of the gland of Moll. The excised specimen was studied histopathologically and exhibited a lining that was virtually indistinguishable from that of the normal canaliculus, except for hyperplasia of the cellular wall and the focal presence of a superficial mucin-producing columnar cell monolayer at the lumen. The medial edge of the excised specimen showed a merging of the cyst into a nonectatic portion of the canaliculus. Inflammation in the wall of the cyst and in this terminal portion of the canaliculus was not identified. This is believed to be a unique entity of an idiopathic ectasia with mild epithelial proliferation of a segment of the canaliculus. The authors have termed this condition canaliculops, to draw a parallel between it and ectasia of the ducts of the lacrimal gland, so called dacryops. PMID- 3561962 TI - Large iridotomies by the linear incision technique using the neodymium:YAG laser at low energy levels. A study using cynomolgus monkeys. AB - Multiple Q-switched neodymium:YAG (Nd:YAG) laser impacts at energy levels of 1.0 to 1.7 mJ, focused on the iris through the 103-diopter (D) iridotomy sphincterotomy lens, were applied back and forth in a line across the radial fibers of the mid-peripheral iris in eyes of the cynomolgus monkey (Macaca fasicularis) to produce large iridotomies of controllable size. Oozing of blood was minimal and no lens capsule damage occurred. These iridotomies showed less iris concussion damage than did conventional Nd:YAG laser iridotomies made by directing high-energy laser shots through the Abraham lens upon a single iris spot. PMID- 3561963 TI - Efforts to measure strabismus deviations using Purkinje imagery. PMID- 3561964 TI - A unifying mechanism that could explain the varying cause and course of heterogeneous retinopathy. PMID- 3561965 TI - The fat adherence syndrome and strabismus after retina surgery. PMID- 3561966 TI - Galactokinase activity in patients with cataracts. PMID- 3561967 TI - Endolymph formation in the inner ear of pigeons. AB - The endolymphatic space of pigeons was studied by using double-barrelled electrodes with a potassium liquid ion exchanger. The K+ activity of the endolymph was 155 mM in the cochlea and 133 mM in the ampulla, respectively. Positive DC potential in the cochlea (+14.5 mV) was much lower than in guinea pigs (+80 mV) whereas in the ampulla of pigeons the DC potential (+7.4 mV) was 2 times higher than that of guinea pigs (+3.9 mV). General application of ethacrynic acid in pigeons induced a weak change in DC potential and no typical intercellular edema in the cochlea and ampulla. Local application of ethacrynic acid and ouabain in the cochlea and ampulla of pigeons induced a negative DC potential of between -30 and -40 mV. This negative DC potential was higher than the anoxia-induced negative potential. Short hypoxia during a drug-induced DC potential resulted in a decrease in DC potential above the diffusion potential. Below the diffusion potential additional hypoxia increased the DC potential independent of the cause of intoxication. PMID- 3561968 TI - Effect of prazosin and 'intracranial hypertension' on cochlear blood flow. AB - The cochlear and cerebral blood flow were simultaneously measured with the microsphere method in albino rabbits before and after administration of prazosin (0.5 mg/kg body weight) and before and during an increase in intracranial pressure (ICP) and intracochlear pressure. Increments in ICP were induced by intracranial infusion of Ringer solution prewarmed to body temperature. The increments were accompanied by an intravenous administration of prazosin to abolish the Cushing effect. The cochlear blood flow was unaffected by the intravenously administered prazosin. A decrease was found when the perfusion pressure of the cochlear, i.e. mean arterial blood pressure minus ICP fell below 5 kPa. PMID- 3561969 TI - Neural activity, alertness and visual orientation in intact and unilaterally labyrinthectomized rabbits. AB - Electrical brain activity and eye movements were recorded in 10 intact and 6 unilaterally labyrinthectomized rabbits, each with implanted electrodes. The frequency of optokinetic nystagmus (OKN) and a 10-second aggregate of theta waves in the dorsal hippocampus were determined after exposure of the animals to sound, vibration and optokinetic stimulation. Each stimulus used caused significant increases in OKN and theta activity. Vibratory stimuli caused stronger increases in OKN and theta activity than did sound stimuli. Not only was OKN significantly reduced after unilateral labyrinthectomy (UL), but alerting the rabbit with sound or vibration failed to restore the responses to normal, and hippocampal EEG responses to sound, vibration or optokinetic stimulus were significantly reduced. The findings indicate that a visual orientation reflex is normally improved by simultaneous sensory stimulation. Reduced response to stimuli after UL affects not only orientational reflexes but other sensory responses as well, and is accompanied by a reduced state of alertness. PMID- 3561970 TI - Maximal expiratory and inspiratory flow-volume curves in bilateral vocal-cord paralysis. Changes after surgical treatment and comparison with glottic resistance characteristics. AB - The maximal expiratory flow-volume (MEFV) and maximal inspiratory flow-volume (MIFV) curve present maximal attainable flows, plotted against the displaced volume at the mouth during a forced expiratory manoeuvre from total lung capacity (TLC) and a subsequent forced inspiratory manoeuvre from residual volume (RV), respectively. Depending on the glottic resistance characteristics, the usual flow limitation may be absent during forced expiration, drastically influencing the form of MEFV curves. During forced inspiration however, the flow remains effort dependent. We tested this hypothesis by comparing the form of MEFV and MIFV curves, and the glottic resistance characteristics, before and after an endolaryngeal superolateralization of a vocal cord, in 12 patients with bilateral vocal-cord paralysis. Peak expiratory and inspiratory flows were estimated with the aid of the measured glottic resistance characteristics on the assumption that the maximal alveolar pressures were normal during the manoeuvres. The estimated values agreed well with measured values. The form of the MEFV and MIFV curves was also found to be closely linked to the glottic resistance characteristics. It is concluded that the MEFV and MIFV curves are sensitive indicators of flow limitation in patients with upper-airway obstructions. PMID- 3561971 TI - Flow limitation in upper-airway obstruction. Theoretical analysis. AB - During a maximal forced expiration from total lung capacity (TLC) in normal human subjects flow limitation will occur (i.e., the flow will become independent of muscular effort) after the initial part of the expiratory manoeuvre. Flow limitation starts at the flow that causes a pressure drop in the bronchial tree large enough for the generation of a flow-limiting segment. In patients with upper-airway obstruction such as laryngeal obstruction or tracheal stenosis, the upper-airway resistance may keep the flow so low that flow limitation cannot arise. The present theoretical study confirms that glottic resistance does not prevent flow limitation from arising in normal human subjects. On the other hand, the mean glottic resistance characteristics measured for 19 patients with bilateral vocal-cord paralysis were found to be such as to prevent flow limitation. This means that in such patients and also in patients with other types of upper-airway obstruction flow may remain effort-dependent throughout the forced expiratory manoeuvre or in any case during much more of this manoeuvre than normal. PMID- 3561972 TI - Effects of kanamycin sulfate on cochlear potentials and potassium ion permeability through the cochlear partitions. AB - The cochlear microphonics (CM), endocochlear potential (EP) and potassium ion activities in the endolymph and perilymph were measured in guinea pigs which received daily successive intramuscular injections of 500 mg/kg of body weight of kanamycin sulfate. Preyer's reflex threshold at 8 kHz began to increase after the 5th day of kanamycin treatment and disappeared on the 11th day. The maximum output of CM at 8 kHz began to decrease with a time course similar to Preyer's reflex. The potassium ion activities in the endolymph and perilymph and the EP did not change appreciably through all experimental days. The magnitude of the negative EP decreased in parallel with the reduction in CM and the relative potassium conductance (GK) between the endolymph and perilymph. These results lend support to the hypothesis that the site of production of the negative EP is probably in the hair cells and that the negative EP is mainly dependent on the permeability of the potassium ions in the organ of Corti. PMID- 3561973 TI - Biology of vascularized bone grafts. AB - Vascularized canine fibular autografts demonstrated improved biologic and mechanical characteristics 3 months after surgery when compared with nonvascularized controls. The vascularized proximal fibula maintained its overall architecture without bony collapse or significant bone turnover. The strength and stiffness of these grafts were approximately 40 per cent and 56 per cent more than nonvascularized grafts, respectively. PMID- 3561974 TI - Biologic principles of bone induction. AB - This article provides a concise review of bone induction. Bone induction by demineralized bone matrix is a multistep cascade. The purification and elucidation of the chemistry of osteogens will improve bone grafting methods. PMID- 3561975 TI - Biomechanical aspects of bone autografts and allografts. AB - The structural requirements of skeletal reconstruction should be included in the consideration of an appropriate type of bone graft, whether autogenous or allogeneic tissues are chosen. This analysis should include the nature of any fixation devices to be used, as well as characteristics of the host and donor bone. The mechanical properties and biomechanical response of the graft must be balanced against the type and magnitude of the load to which the graft will be subject. For example, the information presented here suggests that, from a biomechanical perspective, frozen bone would be better suited than freeze-dried bone when the graft is subject to large torsional loads or else the graft must be appropriately protected during incorporation by adequate internal fixation or external bracing. In a situation that is primarily subjected to compressive loads, however, freeze-dried grafts would be just as biomechanically sound. Thus, an understanding of the normal biomechanics of the anatomic region to be reconstructed is crucial. The mechanical properties of the graft are affected by preservation, storage, and sterilization. Incorporation and remodeling of the graft further alter its properties. These properties are, in turn, influenced by the host immune response as well as the local biomechanical environment. The influence of each of these factors is predictable. Obviously, there are numerous considerations in choosing approaches to skeletal reconstruction other than the mechanical issues discussed here. However, an understanding of the mechanical properties involved will help in optimizing the clinical success of these choices. PMID- 3561976 TI - Total hip reconstruction using frozen femoral head allografts in patients with acetabular bone loss. AB - Major acetabular bone loss associated with failed total hip replacements can be managed successfully using frozen femoral heads as structural allografts during revision surgery. In 29 cases followed for an average period of 3.9 years, all of the grafts showed radiographic evidence of union. Five hips showed clinical or radiographic evidence for acetabular loosening. Three of these hips required reoperations for symptomatic loosening. In two of these, sufficient bone stock was present to permit another revision without further bone grafting. Twenty-five of the remaining 26 hips were functioning satisfactorily with a mean Harris score of 84 points. In view of the major bone loss following multiple previous operative procedures in these young patients, the results of revisions using structural femoral head allografts were clearly superior to those with resection arthroplasty, the most likely alternate solution. Graft resorption, lack of posterior coverage, and incomplete cement mantle contributed to the failures. PMID- 3561977 TI - Clinical use of bone allografts in the elbow. AB - Transplantation of total or partial elbow allografts has been performed in 12 patients with excessive bone loss secondary to trauma or tumor resection. Nine of 12 implants remain with a 2- to 9-year follow-up. Functional, painless elbow motion is present in these nine patients, but degenerative joint changes become apparent at 2 years on radiographs. Although not recommended for routine use, this procedure is viewed as a salvage procedure in patients who refuse arthrodesis or are not candidates for conventional total elbow replacement because of excessive bone loss or young age. PMID- 3561978 TI - Hydroxyapatite and tricalcium phosphate bone graft substitutes. AB - Autografts have consistently outperformed calcium phosphate implants in most experimental models and clinical applications. However, human trials in metaphyseal defects demonstrate comparable results with autograft, hydroxyapatite, and TCP. Diaphyseal fractures and segmental defects represent more challenging problems, with less predictable results achieved with the synthetic bone graft substitutes. Improvements in the pore configuration, mechanical properties, and osteoinductive capacity of these implants should widen their future clinical application. PMID- 3561979 TI - [Anatomo-histologic basis for the surgical treatment of neglected Monteggia injuries in children]. PMID- 3561980 TI - [Treatment of fractures of the distal end of the radius in children]. PMID- 3561981 TI - [Surgical treatment of deformities of the lower extremities in renal osteodystrophy]. PMID- 3561982 TI - [Roentgenofunctional basis for surgical tactics in children with congenital clubfoot]. PMID- 3561983 TI - [Surgical treatment of pes planus transversus and valgus deformity of the great toe in children]. PMID- 3561984 TI - [Use of hinged-distraction apparatus in the treatment of congenital dislocation and subluxation of the hip and Perthes disease in older children and adolescents]. PMID- 3561985 TI - [Feasibility of automatic processing of the results of thermographic examinations of patients with pathology of the musculoskeletal system]. PMID- 3561987 TI - [Methods of surgical treatment of congenital radioulnar synostosis]. PMID- 3561986 TI - [Status of the joints of the lower extremities in sports veterans]. PMID- 3561988 TI - [A method of osteoplastic laminectomy]. PMID- 3561989 TI - [Method of hemostasis for hemorrhages from the bed of a resected vertebral body]. PMID- 3561990 TI - [Fracture dislocations of the axis]. PMID- 3561991 TI - [Elevation thoracoplasty in the scheme of surgical treatment of scoliosis]. PMID- 3561992 TI - [Controlled correction of funnel chest deformity]. PMID- 3561993 TI - [Method of surgical treatment of neglected ruptures of the symphysis pubis with instability of the pelvic ring]. PMID- 3561994 TI - [Methods of surgical treatment of the sequelae of birth injuries of the brachial plexus using myolavsanoplasty]. PMID- 3561995 TI - [A device for developing movement in the elbow joint in contractures]. PMID- 3561996 TI - [Electroroentgenography in the diagnosis of injuries of the extremities]. PMID- 3561997 TI - [Program for calculating the proper volume of circulating blood]. PMID- 3561998 TI - [Military-patriotic education of students in a department of traumatology, orthopedics and military field surgery]. PMID- 3561999 TI - [Outcome of treatment of isolated fractures of the long tubular bones of children]. PMID- 3562000 TI - [Results of a discussion on "Problems of the etiology and pathogenesis of scoliosis"]. PMID- 3562001 TI - [Classification of scoliosis by degree of severity]. PMID- 3562002 TI - [The pathogenesis, clinical picture and treatment of disorders of digestive function in scoliosis patients following surgery]. PMID- 3562003 TI - [Serum thyrotropin determination by a supersensitive immunoradiometry assay in functioning thyroid adenomas]. PMID- 3562004 TI - [Simultaneous occurrence of diabetes mellitus and multiple sclerosis]. PMID- 3562005 TI - [The value of rhino-thermometry in children with allergic rhinitis]. PMID- 3562006 TI - [Uretero-ileo-cystoplasty in the management of ureteral obstruction after surgical and radiotherapy of malignant gynecologic tumors]. PMID- 3562007 TI - [Comment on the article "Current characteristics of the international status of clinical research"]. PMID- 3562008 TI - [Fighting pseudoscience, quackery and charlatanism]. PMID- 3562009 TI - [Diagnostic difficulties of malignant melanoma]. PMID- 3562010 TI - [Microangiopathies of diabetics (epidemiologic and clinical observations]. PMID- 3562011 TI - [Malignant melanoma localized of the penis]. PMID- 3562012 TI - [Simultaneous occurrence of supernumerary nipples and urinary tract abnormalities in children]. PMID- 3562013 TI - [Early ergometry in acute myocardial infarct]. PMID- 3562014 TI - [Unilateral hilar lymph node enlargement in sarcoidosis]. PMID- 3562015 TI - [Treatment of mastopathy with danol]. PMID- 3562016 TI - [Sleep and sleep disorders in connection with sudden infant death]. PMID- 3562017 TI - [Diagnosis and therapy of polycystic kidney]. PMID- 3562018 TI - [Monitoring of artificial insemination]. PMID- 3562019 TI - [Results in modified phlebectomy]. PMID- 3562020 TI - [Primary tubal carcinoma originating from a tubo-ovarian cyst]. PMID- 3562021 TI - [Is there a need for the screening of adolescents for hypertension?]. PMID- 3562022 TI - [Modification of the composition of Gerovit capsules]. PMID- 3562024 TI - Neurologic disorders in otolaryngology. PMID- 3562023 TI - [Possible correlation between chlamydiasis and AIDS]. PMID- 3562025 TI - Acute and chronic demyelinating disease. AB - There are multiple entities subsumed under this title that have in common the primary destruction of central nervous system myelin with relative sparing of axons. The hereditary diseases are often referred to as dysmyelinating diseases in which there is a genetic defect in the formation or maintenance of myelin; they usually occur in children. The other processes are sometimes called myelinoclastic, which implies an attack on otherwise normal myelin. PMID- 3562026 TI - Physician employers and 'right to know'. PMID- 3562027 TI - Breast cancer in Pennsylvania. PMID- 3562028 TI - Personnel concerns in the medical office. PMID- 3562029 TI - The failure of success. PMID- 3562030 TI - The family physician and behavioral science. PMID- 3562031 TI - Accounting software helpful in medical practice. PMID- 3562032 TI - Resolution of a mediastinal cyst by transtracheal needle aspiration. PMID- 3562033 TI - The Medical Practice Act of 1985. Part VI--Impaired professionals and mandatory reporting of impaired professionals to the medical board. PMID- 3562034 TI - Surrogacy questions involve ethics. PMID- 3562036 TI - Height, weight and nutritional status of children with rheumatic fever and rheumatic heart disease admitted to Dr. Sardjito Hospital Yogyakarta, Indonesia. PMID- 3562035 TI - Colloid oncotic pressure in severe dengue shock syndrome. PMID- 3562037 TI - The advantages of rooming-in. PMID- 3562039 TI - The correlation between nutritional status, head circumference and intelligence of primary school pupils. PMID- 3562038 TI - Extrophy of the cloaca. PMID- 3562040 TI - Plasma protein in dengue hemorrhagic fever/dengue shock syndrome. PMID- 3562041 TI - Rapid histamine challenge method for measurement of bronchial hyperreactivity. PMID- 3562042 TI - Caroli's disease. PMID- 3562043 TI - [The biochemistry of the cancer cell. Purine and pyrimidine metabolism]. PMID- 3562044 TI - Influence of cephalosporines III generation with varying biliary excretion on fecal flora and emergence of resistant bacteria during and after cessation of therapy. AB - Excretion of an antibiotic bile may result in high intraintestinal concentrations and thus alteration in the fecal flora. We investigated the effect of ceftriaxone (45% biliary excretion) and cefotaxime (less than 5% biliary excretion) on the aerobic fecal flora. Ceftriaxone eradicated susceptible enteric organisms and resulted in overgrowth of Candida spp. and resistant enterococci. In some patients multiresistant gram negative bacteria appeared during of after therapy. Cefotaxime had a moderate effect on fecal microecology and did not promote the emergence of resistant organisms. PMID- 3562045 TI - [Reduced optimal obstetric and postnatal conditions in children with phenylketonuria and their effect on the success of treatment]. AB - We found a total of 433 reduced obstetric an postnatal conditions in 115 newborns with pku with a range of 0 (n = 4) to -11 (n = 1) per child. The 50th percentile of reduced optimal conditions was at -3, the 90th at -6. Early treated patients with excellent or good dietary control have significantly reduced developmental quotients (DQ) at the age of 3 years when the optimal conditions were reduced above the 90th percentile. Reduced optimal obstetric and postnatal conditions could be found in about 25 per cent of the patients with excellent or good dietary control and a DQ below 100, and in about 50 per cent with a DQ below 85. The effect of treatment is better in patients with excellent and good dietary control and a high value of reduced optimal conditions compared with patients with poor dietary control and an only low value of reduced optimal condition. The quality of dietary control therefore is the most important point to reach an optimal effect in early treated patients. PMID- 3562046 TI - [Folic acid concentration in the serum and erythrocytes of patients with celiac disease]. AB - In 16 children with coeliac disease consecutively diagnosed on the basis of 3 peroral small bowel biopsies in a period of 3 years 13 (81%) had low levels of folic acid in the serum (norm. reference range: 1.8-9 ng/ml) and in erythrocytes (norm. reference range: 150-450 ng/ml cells). The determination of folic acid has a better diagnostic value as the one-hour-D-Xylosetest. The low level of folic acid is the most constant nutritional deficiency in our group of coeliac patients. The determination of folate in the serum and erythrocytes is a highly sensitive screening and at the time it will indicate the adequate therapy. PMID- 3562047 TI - ["The screaming baby": Remarks on the article by Mangold and Fuchs ]. AB - Mangold and Fuchs (1986) have pointed out that the topic "Screaming Babies" has only been cursorily addressed in the German literature. Some remarks and elaborations to the theoretical analysis by Mangold anf Fuchs are offered from the perspective of Developmental Psychology and Behavioural Paediatrics. Reviewing the anglo-american literature and our own research it is argued that infants cannot be viewed as "tabula rasa". Instead we conclude that they make a significant contribution to the interactions with the caretaker. It is emphasised that maternal descriptions of infant "difficultness" are reflections of both, infant behaviour and maternal emotional and cognitive state. In the single case we do not know that mother information reflects and we need to employ a multi method multi-source approach for diagnosis. Finally suggestions for prevention and intervention are outlined based on our experiences in England. PMID- 3562048 TI - [You make the diagnosis. Hodgkin's disease]. PMID- 3562049 TI - [Sudden infant death from the cybernetic viewpoint]. PMID- 3562050 TI - Urethral sphincter dyssynergia in spinal cord injury patients. AB - On the basis of several hundreds of urodynamic investigations done in 105 SCI patients the phenomenon of urethral sphincter dyssynergia was studied. In Upper Motor Neuron Lesion (UMNL) patients, dyssynergic contractions of the external urethral sphincter during spontaneous bladder contractions were demonstrated in 86% and, during bladder contractions initiated by suprapubic tapping, also in 86%. CREDE manoeuvre or abdominal straining gave an augmentation of the urethral sphincter activity in 53%. Interrupted tapping could lower a dyssynergic sphincter activity in a great number of UMNL patients. This technique of bladder stimulation was important to acquire a balanced bladder function in 28% of the patients. In patients with a non-contracting detrusor, a non-relaxing sphincter or augmentation of the sphincter spasticity with the crede manoeuvre or abdominal straining was found in at least 50%. The values of different forms of conservative treatment and of sphincterotomy are discussed. The final outcome of the bladder reeducation is given. PMID- 3562051 TI - Spinal injuries as a result of sporting accidents. PMID- 3562052 TI - The long-term results of localised anterior cervical decompression and fusion in spondylotic myelopathy. AB - A retrospective analysis is presented of 46 patients with cervical spondylotic myelopathy treated by anterior cervical decompression and fusion. In each case the spondylosis was localised and a maximum of two intervertebral levels was fused. Operation had been carried out 7.0 to 14.4 years (mean 10.0 years) previously and the mean age at surgery was 60 years. Disability was such that no patient was able to work prior to operation and only 10 patients (22%) could walk unaided. The functional results, in terms of walking ability, show that 36 patients (78%) have been improved, six (13%) remain unchanged and in 4 patients (9%) the disease has progressed. Twenty nine patients (63%) were able to walk without aid at the time of review. On a subjective basis 30 patients (65%) felt that they had benefitted from surgery. PMID- 3562053 TI - Post-surgical ischaemic myelopathy. AB - Ischaemic myelopathy is an infrequent but well-known cause of spinal cord injury. While the overall incidence of neurological injury following thoraco-abdominal aortic surgery is low (1-14%), procedures requiring surgical cross-clamping of the aorta have been reported as the major cause of ischaemic cord injury (31%). Little has been reported regarding the clinical and functional outcomes of these injuries. Three patients with a non-penetrating aortic injury who showed evidence of ischaemic cord injury within 72 hours of surgical cross-clamping of the aorta are presented. Data includes functional assessments, muscle strength testing and electromyographic findings. All three patients showed lower thoracic incomplete motor and sensory spinal cord injuries. These findings suggest that, after a period of neurological improvement, a plateau phase is reached at approximately 3 months post injury after which no significant gain in muscle strength is made. All patients were functionally independent and able to ambulate using a straight cane. PMID- 3562054 TI - Augmentation of the Oswestry Parawalker orthosis by means of surface electrical stimulation: gait analysis of three patients. AB - The Oswestry 'Parawalker' orthosis has been supplied to 15 adult thoracic level complete paraplegic patients enabling them to achieve a reciprocal gait with an inherent low energy demand. In order to further off-load the work demands on the upper limb girdle musculature during ambulation, three of these patients have undergone electrical stimulation of the gluteal muscles in stance phase. This was shown to increase the stability of the adduction and also provided forward propulsion by driving the stance-leg into extension. Bilateral stimulation of the quadriceps muscles has been shown to facilitate standing and sitting in the orthosis. Using a Kistler force platform, the crutch impulse can be seen to be reduced by as much as 36%. We speculate that this leads to a similar order of reduction in the work done by the upper limbs in these patients. PMID- 3562055 TI - Bilateral hip resection for closure of trochanteric pressure sores: case report. AB - Bilateral resection of the proximal femur, an orthopaedic procedure advocated in selected cases of infected hip joints, can be useful in the treatment of extensive pressure sores in paraplegics. It is especially indicated in those cases where a total thigh flap is considered with the advantage of saving the limb, and by shortening the leg providing more skin and soft tissue for closure of the pressure sores. PMID- 3562056 TI - Omento-myelo-synangiosis in the management of chronic traumatic paraplegia: case report. AB - A case of traumatic paraplegia, with almost complete motor and sensory loss up to the umbilicus, who had an operation for post traumatic arachnoiditis and diagnosed as having recurrence of arachnoiditis and traumatic syringomyelia and treated by a pedicled omental onlay graft to the spinal cord, is described. The patient made a remarkable recovery and 1 year after surgery he continues to maintain excellent progress. He is now able to walk with support and is completely independent. It is suggested that chronic paraplegics should be assessed for possible arachnoiditis and traumatic syringomyelia and if detected an omental transposition be considered as one means of increasing rehabilitation potential. PMID- 3562057 TI - The correlation between delayed hypersensitivity, lymphocyte activation and protective immunity in experimental murine leishmaniasis. AB - The growth of Leishmania major and Leishmania mexicana lesions and the concomitant development of delayed-type hypersensitivity (DTH) to homologous or heterologous soluble antigen was studied in BALB/c and CBA/Ca mice. Although CBA/Ca mice are highly susceptible to L. mexicana, developing non-healing lesions, they are resistant to L. major; while BALB/c mice develop non-healing lesions when infected with either species. The development of resistance was associated with the acquisition of DTH which peaked at 48 h (L. major infected CBA/Ca mice). Non healing lesions were associated with either negative DTH (L. major infected BALB/c mice) or DTH that peaked at 24 h but had significantly subsided by 48 h (L. mexicana infected CBA/Ca and BALB/c mice). The latter response was associated with basophilic infiltration of the skin test site. Pre irradiating (600 rad) CBA/Ca and BALB/c mice induced resistance against L. mexicana and L. major respectively in conjunction with the appearance of 48 h DTH to the homologous antigen. There was clear dissociation in the skin reactivity produced by the heterologous antigen. Thus L. major-derived antigen failed to produce DTH in L. mexicana infected mice of either strain. L. mexicana-derived antigen on the other hand produced a quicker response and of greater magnitude than the homologous antigen in L. major infected CBA/Ca mice. This correlated well with the strong cross-immunity induced by L. major in these mice to L. mexicana infection. PMID- 3562058 TI - Lysis and immobilization of Giardia muris trophozoites in vitro by immune serum from susceptible and resistant mice. AB - To define the potential role of antibody in host defence against Giardia muris, comparative assessment of in-vitro anti-trophozoite effects of immune serum obtained from susceptible (A/J) and resistant (B10.A) mice was done. Two anti parasite effects of serum were identified and quantified: lysis and immobilization of trophozoites. These giardicidal activities were present in the serum from both A/J and B10.A mice. Maximal lysis of trophozoites by serum from A/J or B10.A mice was 40 to 50%. The lysis of trophozoites was abolished after incubation of serum at 56 degrees C for 30 min. The addition of exogenous complement restored lytic activity of heat-inactivated serum. The immobilization of trophozoites was dependent on both the duration of incubation and concentration of serum. After 30 min of incubation, over 98% of trophozoites were immobilized by immune serum from A/J or B10.A mice. There was no apparent relationship between the capacity of immune sera from A/J and B10.A mice to kill trophozoites in vitro and the ability of these strains of mice to control the infection with G. muris. PMID- 3562059 TI - Reconstitution of mucosal mast cells in W/WV mice by adoptive transfer of bone marrow-derived cultured mast cells and its effects on the protective capacity to Strongyloides ratti-infection. AB - Bone marrow-derived cultured mast cells (BMMC) were transferred intravenously into W/WV mice to examine if they could reconstitute defective mucosal mast cell response or defective protective capacity against infection with Strongyloides ratti. When mast cell growth factor-producing activity of W/WV mice were examined, mesenteric lymph node cells obtained at 7 to 14 days after infection could produce this factor in vitro by stimulation with S. ratti-adult worm antigen. A single injection of BMMC (1 X 10(7] on day 7 post-infection (p.i.) neither caused an increase in number of intestinal mucosal mast cells not altered the kinetics of faecal larval output (LPG). On the other hand, serial injections of BMMC (5 X 10(6] from day 5 to 10 p.i. (total 3 X 10(7) cells) resulted in the significant increase in number of intestinal mucosal mast cells. However, this treatment too could not alter the kinetics of LPG. Therefore, adoptive transfer of BMMC could cause the increase in number of histologically detectable-mucosal mast cells, but these cells are, by themselves, not sufficient to cause the expulsion of S. ratti adult worms from the intestine. PMID- 3562060 TI - Variants with reduced virulence derived from Leishmania major after mutagen treatment. AB - After several in vitro treatments of a virulent population of Leishmania major with the mutagen, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), five clones (vir-) were obtained that did not produce cutaneous lesions after subcutaneous injection of 10(6) promastigotes. All the control clones (vir+) obtained from the non mutagenized parasite population produced progressive cutaneous lesions with as few as 10(3) parasites. Late lesions were observed occasionally after injection of 10(7) vir- parasites. These late lesions appeared to result from the selection of virulent revertants, since parasites isolated from these lesions produced progressive lesions in BALB/c mice almost as readily as the control parasites. Two vir- clones, one vir+ clone and one revertant clone were examined for survival in BALB/c macrophages in vitro. All clones were taken up by the macrophages and transformed into amastigotes. However, vir- clones failed to multiply inside the macrophages. A vir- clone was found to protect mice against a subsequent challenge with vir+ parasites. PMID- 3562061 TI - [Role of oxidative-reductive enzymes of the tissues of the eye and brain in the mechanism of action of low-intensity IR-laser radiation]. PMID- 3562062 TI - [Participation of catecholamines in regulating microvascular permeability in stress]. PMID- 3562063 TI - [Effect of thrombogenic substances and drugs on the antiaggregation activity of the vessels in atherosclerosis]. PMID- 3562064 TI - [Effect of hyperlipoproteinemia on the nature of arrhythmia induced by adrenaline administration]. PMID- 3562065 TI - [Cardiac transmembrane potentials during deep body cooling]. PMID- 3562066 TI - [Support of acetylcholine synthesis by the initial substances in the thyrotoxic heart]. PMID- 3562067 TI - [Immunological aspects of postresuscitation damage to the myocardium]. PMID- 3562068 TI - [Characteristics of pulmonary hemodynamic reactions as dependent on the extent of bronchial obstruction]. PMID- 3562069 TI - [Functional and structural-metabolic changes in the lung of intact rats exposed to hyperbaric oxygenation]. PMID- 3562070 TI - [Action of a weak alternating magnetic field on oxygen transport in the body in nonspecific inflammatory lung diseases]. PMID- 3562071 TI - [Vascular resistance and blood flow in the brain during the development of osmotic edema in rabbits]. PMID- 3562072 TI - [Effect of starvation on oxygen tension in rabbit tissue]. PMID- 3562073 TI - [Effect of a session with donor spleen perfusion on blood indices of the recipient with staphylococcal bacteremia]. PMID- 3562074 TI - [Changes in the concentration of hydrocortisone, corticosterone and aldosterone in the peripheral blood of dogs undergoing hemosorption]. PMID- 3562075 TI - [Changes in the fractional composition of the water in the blood and organs of rats during hyperbiotic processes]. PMID- 3562076 TI - [Growth-regulating substances in reparative regeneration of the spleen]. PMID- 3562077 TI - [Clinico-diagnostic potentials of a new method of interpreting separate research on arterial and portal blood flow of the liver]. PMID- 3562078 TI - [Individual and typological behavioral characteristics of rats following mild mechanical injury]. PMID- 3562079 TI - [The problem of predisease]. PMID- 3562080 TI - [Differential diagnosis of cancer in fine needle aspirates using transmission electron microscopy. I. Adenocarcinoma]. PMID- 3562082 TI - [Ultrastructure of the surface epithelium of the ovary and the epithelium lining the inclusion cysts]. PMID- 3562081 TI - [Histopathologic prognostic indicators in leiomyosarcoma of the uterine body]. PMID- 3562083 TI - [Morphologic picture of the liver after administration of thyroxine and estradiol]. PMID- 3562084 TI - [Ultrastructural studies of the myocardium of rats fed an atherogenic diet]. PMID- 3562085 TI - Study on osmotic fragility of red blood cells in workers exposed to styrene or a mixture of toluene and methyletylketone using a coil planet centrifuge. PMID- 3562086 TI - [Pulmonary alveolar proteinosis (PAP). I. Morphologic description of a case. Comparative histologic and histochemical studies of the lungs and sputum]. PMID- 3562087 TI - [Pulmonary alveolar proteinosis (PAP). II. Studies on the lungs using scanning (SEM) and transmission electron microscopy (TEM)]. PMID- 3562088 TI - Motor response information influence on CNV shape and resolution time. AB - This study systematically investigates changes in CNV waveform shape and resolution time that result from the presentation of facilitatory, inhibitory, or no motor response (MR) information simultaneously with the warning (S1) or imperative (S2) stimulus of the S1-S2-MR CNV paradigm. Analyses indicate that the simultaneous presentation of S1 and information to produce or inhibit a MR attenuates initial CNV development. Further, when the S1 information is inhibitive, CNV development is retarded throughout. The contribution of an inhibitory psychological process during CNV development is proposed. The data also indicate that CNV resolution time is not dependent on the presence of a motor response. It is suggested that CNV resolution time is indicative of psychological completion or closure. PMID- 3562089 TI - Conditioning, attention, and the CS-US interval. A theoretical statement of relations. AB - A revised version of the Rescorla-Wagner (1972) mathematical model is presented. A metatheoretical assumption of an attentional process, the added revision, is conceived as an independent alpha-salience growth factor determining both rate of association and performance. Conditioned stimulus-unconditioned stimulus (CS-US) correlation, and CS-US interval (two primary conditioning parameters) are incorporated in the mathematical model as alpha-salience growth rate and as alpha salience and association asymptote factors, respectively. In this manner, the long-standing issue of necessary and sufficient factors in classical conditioning is resolved. An empirical assessment of the model's parameters has been included. PMID- 3562090 TI - Smoking, personality, and imagery preference in relation to spontaneous bilateral electrodermal activity. AB - Effects of smoking on spontaneous bilateral skin conductance were studied as a consequence of interactions with set and setting. Bilateral skin conductance was recorded in six men and six women who smoked and an equal number of nonsmokers on two different days. On the first day, spontaneous electrodermal activity was recorded before and after a 10-minute rest period during which half the smokers smoked a cigarette. On the second day, one week later, spontaneous activity was again recorded before and after a 10-minute rest period during which the remaining smokers smoked a cigarette. Nonsmokers did not smoke at any time. Following smoking there was a significant negative correlation between a preference for visual over nonvisual imagery and spontaneous skin conductance responsivity in the left as compared to the right hand. Correlations were significantly different in smokers and nonsmokers. Smokers showed significantly greater preferences for either visual or nonvisual imagery than nonsmokers. Nonresponding nonsmokers were higher on the psychoticism (P) scale of the Eysenck Personality Questionnaire (EPQ) than responding nonsmokers. Smokers scored higher on P than nonsmokers. Interactions between personality, cognitive style, and the experimental situation, set, and setting were discussed in relation to the arousing effects of nicotine. PMID- 3562091 TI - Hemangiomas in infancy and childhood. PMID- 3562093 TI - Warts and molluscum contagiosum in children. PMID- 3562092 TI - Practical aspects of the diagnosis and management of atopic dermatitis. AB - Atopic dermatitis is a common skin problem among infants, children, and adolescents. Despite the chronic, recurrent nature of this disorder, the majority of patients can be effectively managed using a comprehensive treatment program. PMID- 3562095 TI - An update on learning disabilities. PMID- 3562094 TI - Sunburn, sun reactions, and sun protection. PMID- 3562096 TI - Attention deficits: the diverse effects of weak control systems in childhood. PMID- 3562097 TI - Nonverbal learning disabilities. PMID- 3562098 TI - Language disorders in childhood and adolescence: implications for learning and socialization. AB - Children and adolescents with language disorders encounter disruption in the fluency of social interaction. Because of the chronic nature of language disabilities, problems in academic achievement and success become the hallmark of the disorders during the school years. Since adolescence represents a time of experimentation and definition of the self, individuals with language disorders are at high risk for the development of fragmented and inappropriate perspectives about themselves. Treatment must address, in a functionally coordinated manner, the acquisition of essential linguistic and basic academic skills, the learning of curriculum content, and the development of appropriate perspectives of the self and the environment. PMID- 3562099 TI - Mathematical disabilities. PMID- 3562100 TI - Chemical dependency. PMID- 3562101 TI - The clinical utility and evaluation of drug screening techniques. AB - A better understanding of the methods of drug detection, their sensitivities, and limitations increases the efficiency of medical decision making for better patient care. Many of the sociomedical and medicolegal questions are yet to be answered through court challenge. The physician must remember his or her role as a clinician, and practice the art in a fashion that best serves the interest of his or her teenage patient. PMID- 3562102 TI - Treatment approaches in adolescent chemical dependency. AB - Treatment of the chemically dependent adolescent has recently evolved from the realization that youth also suffer from the primary, progressive, and chronic disease of compulsive addiction. Although based on models known to be effective with adults, treatment of the adolescent recognizes developmental needs and differences. A brief overview of the inpatient, residential, and outpatient approaches to treatment is provided. PMID- 3562103 TI - Issues in the evaluation of chemical dependency treatment programs for adolescents. AB - To summarize, six issues have been identified in this article that need to be considered before adequate assessment of relative efficacy of treatment programs can be attempted, starting at the front door of treatment. First, the differential referral sources that bring these youngsters to treatment must be considered, with their differential perspectives and definitions of problem behavior. Second, the differential characteristics of the patient population must be assessed. This involves, primarily, systematic and thorough medical and psychiatric diagnosis, but it also includes careful assessment of genetic, familial, social, legal, and developmental characteristics that subcategorize these youngsters. As indicated, when this is done the typical adolescent referred for treatment is likely to have a lifetime diagnosis of attention deficit disorder, conduct disorder, some drug use diagnosis (most likely alcohol and marijuana), past legal problems, a family in turmoil (which has included personal, physical, and possibly sexual abuse to the youngster and also genetic loading for alcoholism), or some learning disability. Third, the differential characteristics of treatment programs must be adequately described and catalogued. No such assessment instruments currently exists. The differential characteristics based on philosophy, treatment strategies, personnel selection, patient admission criteria, treatment techniques employed, length and type of treatment, and length and type of aftercare, all must be assessed. Fourth, the presence or absence of differential treatment strategies responsive to the particular needs of individual adolescents must be categorized. In addition to the overall philosophic flexibility of the program, the capability of responding to particular issues such as the presence of major depressive disorder, learning disability, sexual abuse, or the need for a careful neurologic assessment for subtle temporal lobe issues, must be identified in the program. Fifth, the differential response of the youngster to the treatment process as it is progressing must be able to be assessed and considered as a variable. For example, the ability of the youngster to participate in group confrontational sessions and honestly review his or her past behavior is a measurable variable that to date is ignored in program evaluation. Essentially the only variable currently assessed is treatment completion or failure to complete treatment. Sixth, appropriate outcome variables need to be identified and used. While abstinence is a laudable theoretic goal of treatment, the reality falls somewhat short of that goal.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3562105 TI - Prevention of adolescent chemical dependency. AB - Chemical dependency is part of a significant pattern of serious health problems resulting from the breakdown of social control over impulsive, pleasure-driven adolescent behavior. The drug epidemic in North America, after two decades of relentless increases, shows encouraging signs that stopping it may be possible. Chemical dependency prevention became a serious concern in the 1970s in response to the rising drug epidemic. Initial efforts focused on drug-specific education in the mass media and in the schools. After discouraging and even counterproductive results, nonspecific or generic prevention efforts were tried in both areas. These efforts, too, did not prevent drug use or drug problems. More recently, using cigarette smoking prevention initiatives in schools as a model, hopeful results have been achieved. These efforts combine education about immediate negative effects of drug use with training in skills to resist peer pressure to use drugs. These efforts also build youth peer rejection of drug use. Promising a wider community effort to prevent chemical dependency are several macro prevention programs. These include efforts to decrease tolerance for drug use and to identify drug users in four specific areas: families, schools, highways, and the workplace. Chemical dependency can be prevented by a variety of interventions, including one-to-one encounters, school-based skills training, and society-wide initiatives to reject drug use. The teenage years are a time of unique vulnerability to initiation of drug and alcohol use. The clear goal of prevention is to help young people to survive these years without using drugs, including the gateway drugs: alcohol, tobacco, marijuana, and cocaine. The pediatrician can play a vital role in successful prevention activities with patients, with their families, in communities, and in the nation as a whole. PMID- 3562104 TI - Risk factors for adolescent substance abuse. Implications for pediatric practice. AB - This article describes the range of indicators to observe when considering which teenagers may be at risk for development of substance abuse. Currently, the notion of what constitutes a problem among teenagers is a controversy--thus the subject is approached from several major viewpoints. First, one may look at longitudinal studies and then make an attempt to construct some sort of substance abuser profile. Also, genetic predisposition may be considered. PMID- 3562106 TI - Family issues in working with chemically dependent adolescents. AB - The authors review research describing family dynamics in adolescent chemical abuse and dependency. Family systems theory is outlined, suggesting that family members, parents in particular, be included in accurate diagnosis and effective treatment. The pediatrician is viewed as having a relationship of trust with parents, being in a unique position to provide counsel, direction, and referral. Specific treatment strategies are recommended and illustrated with case studies. PMID- 3562107 TI - Obliterative bronchiolitis due to Mycoplasma pneumoniae infection in a child. AB - A 6-year-old girl presented with Mycoplasma pneumoniae involving the right upper and lower lobes. She made a slow but complete recovery with resolution of the radiological changes. She re-presented 5 years later with a productive cough, recurrent wheezing and physical and radiological signs suggestive of obliterative bronchiolitis. This diagnosis was confirmed by ventilation - perfusion (V/Q) lung scan, and bronchography. The case highlights the value of V/Q scanning in the diagnosis of obliterative bronchiolitis and confirms the previous reports that mycoplasma infections are not always benign. PMID- 3562108 TI - Atelosteogenesis: evidence for heterogeneity. AB - Four cases of neonatal death dwarfism resembling atelosteogenesis but with some distinctive radiographic and characteristic histopathologic features are reported. The name atelosteogenesis II is proposed for this entity. PMID- 3562109 TI - Murk Jansen's metaphyseal chondrodysplasia with long-term followup. AB - The fourteenth reported patient with Murk Jansen's metaphyseal chondrodysplasia is presented, with a remarkable followup from birth to the age of 15 years. Numerous invasive procedures were performed in pursuit of erroneous provisional diagnoses. Five of these patients presented in infancy with radiographic metaphyseal changes similar to rickets, but with preservation of the provisional zone of calcification. Following infancy, these patients reveal the more typical short-limbed dwarfism, with fusiform joints and bowed extremities. PMID- 3562110 TI - Thickened cortical bones in congenital neutropenia. AB - Congenital neutropenia is an uncommon entity which may be familial and has a wide spectrum of clinical expression. Three sisters with the severe form of the disease, that suffered from recurrent infections which lead to their demise, are described. Review of their radiographs revealed the presence of cortical thickening of the bones. Although several syndromes with different bone abnormalities have been reported associated with neutropenia, the radiographic finding of thickened cortex in children with congenital neutropenia has not been previously described. PMID- 3562111 TI - Hematogenous spinal leptomeningeal metastasis: a unique CT enhancement pattern. AB - A distinct CT enhancement pattern of leptomeningeal metastasis from a systemic malignancy is described, corresponding to the pathologic and myelographic patterns of this entity. The uniform total subarachnoid enhancement, simulating intrathecal contrast, heralded sheetlike tumor proliferation along the surface of the spinal cord in an asymptomatic patient. Since the majority of hypervascular intraspinal abnormalities show focal enhancement with intravenous contrast, recognition of this pattern may provide unique clinical information. PMID- 3562112 TI - Magnetic resonance imaging in non-specific discitis. AB - In this 20-month-old girl with non-specific spondylodiscitis the typical clinical presentation was absent. A definite diagnosis was made by radiological examination. Several reports have appeared in the literature concerning the importance of MRI as a new imaging modality in the diseases of the spine, including spondylodiscitis. In the present report we discuss the potential role of MRI in early diagnosis of spondylodiscitis in childhood. PMID- 3562113 TI - Osteomyelitis deriving from BCG-vaccination. AB - Secondary complications after BCG-vaccination are unusual. There is an almost invariably lethal generalized infection affecting the immunodepressed. Late dissemination of BCG to bone is characterized by lytic lesions, it is not normally associated with immunologic changes and has a good prognosis. The histology of BCG-osteomyelitis resembles that produced by Koch bacillus. We present a rare case of a lytic lesion in the femur improving after specific treatment. PMID- 3562114 TI - Computed tomography of "iliac horns" in hereditary osteo-onychodysplasia (nail patella syndrome). AB - Posterior "iliac horns" are a common finding in nail-patella syndrome and when present are considered pathognomonic of the disease. We have had an opportunity to study a patient with these iliac horns and describe their appearance on computerized tomography. PMID- 3562115 TI - Disappearance of calcification in meconium peritonitis in a black African baby. PMID- 3562116 TI - Viral vs. bacterial pulmonary infections--radiographic differentiation. PMID- 3562117 TI - Radiographic features of appendiceal colic. PMID- 3562118 TI - Cloverleaf skull associated with unusual skeletal anomalies. AB - A male infant with cloverleaf skull and multiple other birth defects born to unrelated, healthy, young parents is presented. Radiologic findings in addition to the cloverleaf skull configuration included short, wide clavicles, winged scapulae, unusual shapes of ribs with abnormal spacing between them and with prominent costovertebral junctions, and widely separated ischia. Ulnae appeared angular with probable fusion to the midportion of the radial bones bilaterally. There was polydactyly of the hands and feet with grossly abnormal metacarpal and metatarsal bones. Skeletal maturation was normal. Computed tomography of the skull showed dilated lateral and third ventricles as well as agenesis of the corpus callosum. The mother denies any teratogenic exposure during the pregnancy. The findings in this infant do not seem to fit into any previously described syndrome. PMID- 3562119 TI - Cardiac morphogenesis--recent research advances. AB - It has been demonstrated recently that a specific region of neural crest contributes cells to the septa of the outflow tract of the heart. Removal of this region of cardiac neural crest prior to migration from the neural fold results in persistent truncus arteriosus in chick embryos. Removal of other regions of cranial neural crest results in double outlet right ventricle. Since double outlet right ventricle is produced by manipulation of noncardiac neural crest, this malformation is thought to be an indirect rather than direct effect of neural crest ablation. The cranial neural crest forms the walls of all of the aortic arch arteries and it is proposed herein that flow abnormalities are produced in the pharyngeal region by injury to the neural crest. These abnormal hemodynamic characteristics influence heart development. Cardiac neural crest seeds the heart with parasympathetic postganglionic neurons as well as ectomesenchyme. Removal of the cardiac neural crest results in cardiac malformations because of the decreased ectomesenchymal cells. However, the neural population undergoes regeneration and so the innervation of malformed hearts is morphologically normal. The mechanism for this regeneration is not understood. PMID- 3562120 TI - Prostaglandin E1 opens the ductus venosus in the newborn lamb. AB - There is in vitro evidence that the ductus venosus of the fetal and newborn lamb relaxes to administration of E-series prostaglandins. We performed this study to determine whether the ductus venosus of the newborn lamb could be reopened by an infusion of prostaglandin E1. Fifteen lambs between 4 and 28 h of life and six lambs between 42 and 96 h of life had portal angiograms to determine whether the ductus venosus was patent. Ten of the lambs between 4 and 28 h of age had a closed ductus venosus as did all of the lambs between 42 and 96 h of age. The lambs with a closed ductus venosus received an infusion of either prostaglandin E1 or normal saline followed by repeat portal angiography. In the 4- to 28-h-old lambs, prostaglandin E1 opened the ductus venosus in each of the five lambs who received it, while saline did not in any of the five who received it. In the 42- to 96-h-old lambs, neither prostaglandin E1 in four lambs nor saline in two lambs opened the ductus venosus. Prostaglandin E1, then, reopens the ductus venosus in the newborn lamb during the first day of life. We speculate that prostaglandin E1 may be useful in reopening the ductus venosus in certain newborn infants such as those requiring catheterization of the right atrium and those with total anomalous pulmonary venous return below the diaphragm. PMID- 3562121 TI - Renal hemodynamics and functional changes during the transition from fetal to newborn life in sheep. AB - The effects of delivery on renal function and renal hemodynamics were studied in conscious and chronically instrumented fetal sheep. Each fetus was studied 1 h before delivery and 1, 4, and 24 h following delivery by cesarean section. Delivery was not associated with significant changes in plasma renin activity, plasma angiotensin II, plasma aldosterone, and plasma arginine vasopressin concentrations when determined 1 h after birth. On the other hand, the transition from fetal to newborn life was accompanied by significant increases in plasma epinephrine and norepinephrine concentrations. No significant changes in renal blood flow velocity or in renal vascular resistance were observed during the transition from fetal to newborn life; percent changes in renal blood flow velocity and renal vascular resistance values were respectively 15.4 +/- 11 and 2.4 +/- 1.0% at 1 h, 4.0 +/- 8.0 and 5.8 +/- 9.1% at 4 h, and 3.2 +/- 8.0 and 9.7 +/- 13% at 24 h. No significant changes in urinary flow rate, urine osmolality, free water clearance, and osmolar clearance were observed in the first 24 h following delivery. On the other hand, glomerular filtration rate increased 3 fold from 3.3 +/- 0.4 ml/min in fetuses to 10.1 +/- 1.2 ml/min in newborn lambs at 24 h of age. This rise in glomerular filtration rate was associated with significant decreases in urinary sodium excretion (UNaV) (from 36 +/- 7 to 13 +/- 3 microEq/min) and fractional excretion of sodium (FENa) (from 7.6 +/- 0.9 to 1.1 +/- 0.3%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562122 TI - Spectral analysis of diaphragmatic EMG during the neonatal biphasic hypoxic ventilatory response. AB - The newborn infant monkey consistently demonstrates a biphasic ventilatory response to hypoxemia. We have previously shown that the ventilatory depression during the late portion of this biphasic response is secondary to a decline in inspiratory volume that cannot be explained solely by central neural depression. We hypothesized that hypoxemia caused the diaphragm to fatigue, thereby accounting for the late ventilatory depression during the biphasic neonatal hypoxic response. Diaphragmatic fatigue has been reported to be associated with a decrease in the centroid frequency (Fc) of the electromyogram derived through frequency spectral analysis. Therefore, we analyzed the power spectral density of the diaphragmatic electromyogram recorded from percutaneously implanted crural diaphragmatic electrodes in five 2-day-old infant monkeys while they breathed room air and after 5 min exposure to two levels of hypoxemia during the late ventilatory depression. A fast Fourier transform of EKG free diaphragmatic electromyogram was used to compute the power spectral density and the Fc. The Fc during room air breathing was statistically equivalent to the Fc observed after five minutes exposure to 12% FiO2 (p = 0.79), and 8% FiO2 (p = 0.74) when ventilation was falling. In conclusion, our data demonstrate that changes in the centroid frequency are not present during the biphasic ventilatory decline that occurs with the hypoxic ventilatory response in newborn monkeys. Thus, diaphragmatic fatigue, as defined by a decline in Fc, does not occur during the neonatal biphasic hypoxic response. PMID- 3562123 TI - Progressive shortening of the periodic breathing cycle duration in normal infants. AB - Ten normal full-term neonates were monitored by oxycardiorespirography in hospital during the 1st wk of life, and subsequently at home at 4, 8, and 12 wk of age in a longitudinal study of the duration of the periodic breathing cycle during spontaneous sleep. Periodic breathing was observed in 25 of the 40 studies, with a total of 168 epochs of periodicity noted. Eighty-four percent of the periodic epochs occurring during nonrapid eye movements were preceded by a sigh, body movements, or sleep state transition, compared with 41% during rapid eye movements (p less than 0.005). There was a progressive reduction in the periodic breathing cycle duration, which fell significantly between the 1st and 4th wk, in both sleep states, (p less than 0.001). There was a further significant fall between 4 and 12 wk in nonrapid eye movement sleep (p less than 0.05), and there was no significant difference between sleep states at any postnatal age. The overall change in the duration of the periodic cycle, for both sleep states combined, was from 15.0 +/- 3.6 s at less than 1 wk to 12.4 +/- 1.8 s at 12 wk of age. The periodic breathing cycle duration progressively shortens over the first 3 months of life. We postulate that this shortening may be useful indicator of peripheral chemoreceptor maturation over this time period. PMID- 3562124 TI - Intestinal maturation: calcium transport by basolateral membranes. AB - The overall characteristics of calcium transport across the intestine have been defined using in vivo perfusion techniques and in vitro everted gut sacs. However, calcium transport represents three separate processes: entry at the brush border membranes, movement across the cytoplasm, and exit at the basolateral membranes (BLM). Studies in adult animals indicated that the active step in calcium transport is located at the BLM. The present studies describe for the first time the maturational aspects of calcium transport across the BLM of the enterocyte. We utilized a percoll density gradient to prepare enriched BLMs from suckling and adolescent rats. Calcium uptake into BLMs represented mainly transport into the intravesicular space. Calcium transport in both age groups was driven by ATP; the calcium transport in the presence and absence of ATP was significantly greater in suckling rats compared to adolescent rats. Kinetics of calcium uptake calculated from uptake values in the presence of ATP minus no ATP conditions showed a Km of 0.06 +/- 0.01 and 0.03 +/- 0.01 microM for adolescent and suckling rats respectively (p less than 0.05). Vmax was 1.5 +/- 0.1 and 0.8 +/- 0.08 nmol/mg protein/min for adolescent and suckling rats respectively (p less than 0.01). Calcium/sodium exchange mechanisms was also present in both age groups. However, the magnitude of sodium-dependent calcium exchange was smaller in suckling rats compared to adolescent rats. These data suggest that calcium exit at the BLMs of enterocytes of suckling and adolescent rats occurs by an ATP dependent and a calcium/sodium exchange mechanism. Both mechanisms exhibit maturational changes. PMID- 3562125 TI - Dolichol content and isoprenolog distribution in developing rat small intestine. AB - We examined developmental changes in dolichol concentration and isoprenolog distribution during the postnatal development of rat small intestine. We isolated dolichols from rat small intestinal lipids and quantified the isoprenologs by high performance liquid chromatography. The concentration of intestinal dolichol was highest in the intestine of the newborn rat and lowest in intestine from 19 day-old and lactating female rats. The predominant isoprenolog at all ages examined was that with 18 isoprene units. There was a significant increase in isoprenolog 17 during the 3rd wk of postnatal development and an increase in isoprenolog 19 in the adult rat small intestine. The timing of the changes in dolichol content suggests that this might be an important control point in intestinal glycoprotein synthesis during development. PMID- 3562126 TI - Neonatal hypoxia or maternal diabetes delays postnatal development of liver mitochondria. AB - The matrix adenine nucleotide pool size of rat liver mitochondria was low at birth (2.6-3.0 nmol ATP + ADP + AMP/mg mitochondrial protein). After parturition, the pool size was increased by 50-75% within 1 h, which was sufficient for full development of state 3 respiration rates. The adenine nucleotide pool size continued to increase to 100-150% of the value at birth by 2-3 h postnatal. The ATP/ADP ratio in isolated mitochondria also increased postnatally, to about double the value at birth by 3 h. There were no matrix volume changes over this postnatal period, so the increased ATP + ADP + AMP pool size and the increased ATP/ADP ratio together inferred an overall increase of about 5-fold in the matrix ATP concentration under aerobic conditions. The postnatal uptake of adenine nucleotides into mitochondria occurred at a slower rate in newborns that were hypoxic (11% 02) and in newborns of diabetic mothers (diabetes induced on day 5 of gestation by streptozotocin injection). The normal increase in matrix ATP content is responsible for the rapid stimulation of pyruvate carboxylation (an ATP-requiring matrix reaction) and this in turn contributes to the rapid postnatal onset of gluconeogenesis. The results suggest that delayed adenine nucleotide uptake into liver mitochondria may retard initiation of gluconeogenesis in newborns experiencing hypoxia, as in respiratory distress or in newborns of diabetic mothers. We speculate that this mechanism contributes to the persistent hypoglycemia that is typical of these at-risk newborns. PMID- 3562127 TI - Transepithelial electric potential difference in newborns undergoing phototherapy. AB - When hyperbilirubinemic newborn babies underwent phototherapy, a significant decrease of the transepithelial electric potential difference of duodenal mucosa was observed, while the content of nonconjugated bilirubin and photobilirubins in the duodenal juice increased. This may indicate that the mucosa barrier function is damaged by bilirubin, with resulting increased sodium and water secretion into the gut. This phenomenon seems to be one of the reasons for diarrhea which is frequently observed in newborns undergoing phototherapy. Further investigations are necessary to understand the mechanism of bilirubin toxicity of the gut in detail. PMID- 3562128 TI - Contractile activity of neonatal platelets. AB - Platelet contractile activity was evaluated by observation of tension development during isometric contraction of platelet-fibrin clots. Cylindrical clots were made with platelet-rich plasma obtained from cord blood or from adult controls. These clots were allowed to contract isometrically at 37 degrees C while attached to a transducer to record tension development. The rate of tension development was dependent on platelet concentration but was equivalent for neonatal and adult platelet clots. Although abnormalities in neonatal platelet aggregation and secretion have been well documented the platelet functions required for clot contraction such as fibrin binding and actin-myosin interaction appear to be intact in neonatal platelets. PMID- 3562129 TI - [Serum levels of copper, zinc and magnesium in parturients and newborn infants in term and prolonged pregnancies]. PMID- 3562130 TI - [Zinc and copper levels in human milk during the first week after labor]. PMID- 3562131 TI - [Selected clinical aspects of the treatment of malignant melanoma]. PMID- 3562132 TI - [Osteogenesis imperfecta congenita in a newborn infant]. PMID- 3562134 TI - [Abnormal systemic venous return associated with congenital defects of the cardiovascular system]. PMID- 3562135 TI - The return of pertussis. PMID- 3562133 TI - [Marble disease in children (clinical data based on observations of 3 patients)]. PMID- 3562136 TI - Aerosolized ribavirin treatment of respiratory syncytial virus infection in infants hospitalized during an epidemic. AB - Thirty-three infants with predisposing conditions and/or severely symptomatic with respiratory syncytial virus (RSV) infection were treated with aerosolized ribavirin during a 12-week period at Oklahoma Children's Memorial Hospital. These patients were compared with 97 untreated patients with RSV infection hospitalized during the same epidemic. Despite preconditions which selected for a more seriously ill treatment group, patients who received ribavirin showed prompter resolution of the illness than did untreated controls. Greatest clinical improvement in treated patients occurred between the first and second days of ribavirin therapy; mean ribavirin treatment duration was 4.5 days. Ten of 22 ribavirin-treated patients continued to excrete RSV after conclusion of antiviral therapy. No adverse hematologic, renal or metabolic effects occurred with ribavirin therapy. Our experience with ribavirin therapy during a major epidemic confirms and extends the results of previous controlled evaluations demonstrating this treatment safe and effective in high risk and seriously ill infants with RSV bronchiolitis and bronchopneumonia. PMID- 3562138 TI - Bacteremia in children afebrile at presentation to an emergency room. AB - Charts of 182 outpatient children with bacteremia caused by Streptococcus pneumoniae, Haemophilus influenza type b or Neisseria meningitidis were reviewed. Twenty-four patients (13%) were afebrile (temperature less than 37.8 degrees C) at presentation. Five afebrile patients had no history of fever. Four of the five had localizing signs of infection and one appeared toxic. Afebrile patients were not strikingly different from febrile bacteremic patients by any assessments. Bacteremia in children cannot be excluded on the basis of absence of fever by history and examination. Blood cultures should be performed on afebrile children who either have localizing signs of serious bacterial infection or appear toxic. PMID- 3562137 TI - Infectious complications of intraventricular reservoirs in cancer patients. AB - Drug administration via an intraventricular reservoir is useful in the treatment of leukemic and carcinomatous meningitis that occurs in patients who have previously received lumbar intrathecal chemotherapy. The intraventricular route, however, is associated with a higher incidence of infectious complications compared with therapy given by the lumbar route. To characterize the infectious complications associated with such reservoirs, we reviewed the 10-year experience of the Pediatric Branch, National Cancer Institute, National Institutes of Health, and Children's Orthopedic Hospital, Seattle, WA, with 61 patients (49 with leukemia, 8 with lymphoma, 4 with solid tumors) who had intraventricular reservoirs placed for administration of chemotherapy. The reservoirs were in place for a median of 36 weeks and were punctured a median of 29.5 times, Infectious complications occurred in 14 of 61 patients (23%) and Propionibacterium acnes was the most common organism recovered from cultures. Twelve patients (19.7%) had 19 episodes of clinically suspected and microbiologically documented meningitis or of positive intraventricular reservoir cerebrospinal fluid cultures without symptoms which were treated successfully. Local cellulitis occurred at the site of intraventricular reservoir placement in 2 patients (3.3%) and removal of the intraventricular reservoir was necessary for successful management. Nine patients had their intraventricular reservoir removed (5 because of associated infection and 4 because of malfunction unassociated with infection).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562139 TI - Granulomatous osteolytic lesion of the skull associated with cat-scratch disease. PMID- 3562140 TI - Histoplasma duboisii infection in a Liberian girl. PMID- 3562142 TI - Immunization of children infected with human T-lymphotropic virus type III/ lymphadenopathy-associated virus. PMID- 3562141 TI - Monoplegia caused by Enterovirus 71: an outbreak in Hong Kong. PMID- 3562143 TI - Failure of single-dose intraventricular vancomycin for cerebrospinal fluid shunt surgery prophylaxis. PMID- 3562144 TI - Brain abscess and ethmoid sinusitis presenting as periorbital cellulitis in a two month-old infant. PMID- 3562145 TI - Invasive pulmonary aspergillosis in an infant: an unusual presentation of chronic granulomatous disease. PMID- 3562146 TI - Non-anthrax Bacillus infections in children. PMID- 3562147 TI - Diphenhydramine toxicity mimicking varicella encephalitis. PMID- 3562148 TI - Mandibular actinomycosis treated with oral clindamycin. PMID- 3562149 TI - Parotitis associated with Kawasaki syndrome. PMID- 3562150 TI - Subconjunctival hemorrhage in pertussis. PMID- 3562151 TI - [Serum protein composition of premature children according to the results of disc electrophoresis in polyacrylamide gel]. PMID- 3562152 TI - [Immunologic indices in acute intestinal infections of newborn infants]. PMID- 3562153 TI - [Composition of alveolar air and the alveolo-arterial gradient of respiratory gases and its significance in evaluation pulmonary respiration in newborn infants which have developed in utero in normal and complicated conditions]. PMID- 3562154 TI - [Experience in using a carotene mixture in the treatment of acute intestinal infections in young children]. PMID- 3562155 TI - [Arterial hypertension in obese children]. PMID- 3562156 TI - [Etiology of synpneumonic pleurisy and the development of pulmonary destruction]. PMID- 3562157 TI - [The role of gastroesophageal reflux and microaspiration in the development of respiratory pathology in children]. PMID- 3562158 TI - [Genetic risk factors for the development of chronic bronchopulmonary diseases and persistent viral infection]. PMID- 3562159 TI - [Status of the phagocytic function of the neutrophilic granulocytes of children with chronic and recurrent diseases of the respiratory organs]. PMID- 3562160 TI - [Clinico-roentgenologic characteristics of bronchopulmonary mycoplasmosis in children]. PMID- 3562161 TI - [Diagnosis of early manifestations of cor pulmonale in children with mucoviscidosis]. PMID- 3562162 TI - [Electrocardiographic monitoring of children with cardiac rhythms disorders]. PMID- 3562163 TI - [Early diagnosis of sepsis in children during the 1st two months of life and monitoring of the efficacy of its treatment]. PMID- 3562164 TI - [Social aspects of children's health]. PMID- 3562165 TI - [Clinico-laboratory characteristics of rotavirus infections in children]. PMID- 3562166 TI - [Clinico-immunologic characteristics of complicated forms of acute respiratory viral diseases in young children and the use of protease inhibitors]. PMID- 3562167 TI - [Modern methods of differential diagnosis of diffuse goiter in children]. PMID- 3562168 TI - [Incidence and character of precocious sexual development]. PMID- 3562169 TI - [Prevention of frequent diseases of the respiratory organs in children at polyclinics]. PMID- 3562170 TI - [Clinical physiology of respiration in pediatric pulmonology]. PMID- 3562171 TI - [The nervous child]. PMID- 3562172 TI - [Reiter's syndrome in a 10-year-old child]. PMID- 3562173 TI - [Broncho-fibroscopic removal of foreign bodies, resistant to extraction by a rigid bronchoscope, from subsegmental bronchi of children]. PMID- 3562174 TI - [Aerosol method of administering heparin in the complex therapy of primary glomerulonephritis in children]. PMID- 3562175 TI - [Ways of improving the etiologic diagnosis of acute pneumonia and pleurisy in children]. PMID- 3562176 TI - Walking by a profoundly retarded woman: five-year follow-up. PMID- 3562177 TI - Attention demands of spatially locating position of a ball in flight. AB - This study assessed the relative attention demands of an "open skill", that of spatially locating position of a ball in flight, using the dual task technique. 7 right-handed male university students stood behind a large Plexiglas screen and spatially matched a ball projected over a distance of 20 feet. After 1-sec. flight time the ball contacted the Plexiglas. A secondary task required response to an auditory stimulus, designed to probe ball flight at 700, 800, or 900 msec. Both vocal and manual responses to the secondary probe were recorded. No significant correlations were noted between radial error and probe RT for either manual or vocal responses. Subjects did not trade off between tasks. Radial error across all probe positions, including catch trials, showed no significant differences. Three factor analyses of variance for manual and vocal probe types showed that more attention was devoted to monitoring the ball as it neared the screen. PMID- 3562178 TI - Sex differences and practice effects on two visual-spatial tasks. AB - Sex differences on visual-spatial tasks have been assumed to be present in young children, and performance on visual-spatial tasks has been assumed to be resistant to modification. Third and fifth graders were pretested on embedded and successive figures. Half of the 110 children then received limited feedback after which both groups were posttested. Grade, time of testing, and type of task significantly affected visual-spatial performance. Additional study might indicate whether amount of practice influences final level of performance for girls and boys and the asymptote on visual-spatial tasks is similar. PMID- 3562179 TI - Initial relaxation response: contrasts between clinical patients and normal volunteers. AB - The effectiveness of EMG biofeedback, progressive muscle relaxation, autogenic training, and self-relaxation were compared using a within-subjects design. Thirteen clinical subjects and 48 normal volunteers participated in 4 counterbalanced relaxation sessions using one of the techniques. Frontalis EMG and surface skin temperature were monitored throughout the sessions. For reducing EMG, biofeedback was more effective than the other three techniques. A significant interaction of treatment X subjects was found for changes in skin temperature. Clinical subjects had the greatest increase in skin temperature with EMG biofeedback and analog subjects responded best to self-relaxation. There were no significant differences in initial measures of EMG or skin temperature for the two samples. PMID- 3562180 TI - Wife abuse and psychogenic motives in nonliterate societies. PMID- 3562181 TI - Left-handedness in twin families: support of an environmental hypothesis. AB - Information on handedness, assessed as writing-hand, was collected from 197 MZ twin pairs and 203 DZ twin pairs and from their parents, spouses, and children. Associations for pairs of relatives were studied by 2 X 2 tables, computing chi squared-values and tetrachoric correlations. Correlations of about .3 were obtained for mother-offspring and sibling pairs, while for cousins the correlation was .25 (in a small sample). No other significant associations were found, not even for twins. These results suggest only a small, if any, genetic effect, and only a small environmental between family effect, most of which seems to be a maternal effect. The lack of cotwin correlations and correlations for one of the twins with her/his ordinary brothers/sisters suggest the existence of an effect specific to twins, since the correlation for pairs of ordinary siblings is significant. Conclusions drawn from twin studies alone may be biased. The frequency of left-hand writers has increased from 1% to 10% in the different age groups born during the last century in Norway. This age effect is present mainly in hand writing and not so much in handedness generally, suggesting a decrease in cultural repression against left-hand writing. PMID- 3562182 TI - Effects of depression upon reading: a case for distinguishing effortful from automatic processes. AB - This study was designed to test the view that depression would have selective effects upon effortful but not automatic aspects of reading. Relationships were determined between 59 fifth graders' depression scores (on the Children's Depression Inventory and a teacher's rating of depression) and their performance on measures of automatic aspects of reading (word recognition and word attack skills) and effortful aspects of reading (comprehension). A stepwise multiple regression, using statistical controls for sex and mental ability, showed expected relationships of depression to over-all comprehension for the 7 teachers' ratings, but not for the inventory. As expected, relationships of depression to word recognition and word attack scores were statistically non significant. PMID- 3562183 TI - Relation of spelling and writing in learning disabilities. AB - The paper describes a study in which the relationship between the cognitive and psychomotor aspects of children's spelling and writing performances was investigated. By comparing data from various categories of children the relationship between the semantic and psychomotor functions could be examined, and differences between the skill performances of the three groups of students were predicted. A four-way 3 X 3 X 2 X 2 orthogonal design with categories of subjects, type, structure, and length of task as independent variables was used in the laboratory study, with 24 "normal", 24 dyslexic, and 24 dysgraphic nine year-old children as subjects. Most of the 16 hypotheses were verified by data identifying some of the spelling and writing characteristics of the three groups of children and the effects of contextual parameters on their performances. Dyslexic children, for example, seemed to write more slowly than the others, and their mean score of spelling errors was the highest one, whereas the dysgraphic children had the lowest mean score in writing accuracy and rhythm. PMID- 3562184 TI - Sensation of thirst in normal and laryngectomized man. AB - The purpose of this study was to evaluate the role of the larynx in sensation of thirst and to identify precise areas responsible for the sensation in normal and laryngectomized groups. The present analysis showed that the laryngectomized group was less aware of the sensation and less able to localize it than the normal group. Both groups localized the sensation from the base of the tongue to the larynx as well as in the pharynx. PMID- 3562185 TI - Attitudes toward risk taking in disadvantaged and academically excellent students. PMID- 3562186 TI - Some evidence regarding development of cerebral lateralization. AB - Frequencies of significant rs for right- and left-hemisphere scales of Elementary School and Youth forms of Style of Learning and Thinking increase from K through Grade 8 (Ns = 1360) as would be expected if cerebral lateralization begins with acquisition of language and is completed in puberty. PMID- 3562187 TI - Fitting index of predominance based on periodicity of strengths of pattern and suppression in binocular rivalry. AB - The predominance of the strength of pattern over the strength of suppression during binocular rivalry has generally been defined as the percentage of total time of appearance. Is this fit for an index of the predominance? Theoretically, the strengths of pattern and suppression periodically oscillate throughout the observation period. From this assumption, the best fitting indices of predominance were examined. The simplest model of the visual system was one in which the periodicity of the two originates was expressed by a differential equation. Various indices were examined by the solution of its equation so that a power function of the ratio of the time of appearance to that of disappearance was obtained as the most suitable index of the predominance. PMID- 3562188 TI - Specific temporal-lobe signs and enhanced delayed cross-modal matching performance. AB - Structural damage to the amygdala severely retards delayed cross-modal (tactile to-sight) matching in primates. Conversely, we hypothesized that people who display signs suggestive of specific temporal lobe lability should show enhanced delayed cross-modal matching performance. The hypothesis was supported. In a single experiment involving 25 subjects, significant negative correlations obtained between the numbers of errors on the cross-modal matching task and numbers of affirmative responses within clusters of items that contained themes of meaningfulness, religious beliefs or ictal, complex partial epileptic (limbic) states. On the other hand, the numbers of errors were not significantly correlated with either clusters of control items or items that are presumed to reflect the function of other temporal-lobe structures. Both matching and questionnaire data were collected under double-blind conditions. PMID- 3562189 TI - Evaluating adolescents' popularity with the Draw-a-Friend Test. PMID- 3562190 TI - Effects of unavoidable electric shocks on voluntary alcohol consumption in the rat. AB - The purpose of this experiment was to study the effects of electric shocks on voluntary alcohol intake in rats. Alcohol intake was measured using individually determined alcohol concentrations. Contrary to many previous studies, alcohol intake was reduced during the stressful treatment. It is concluded that accounting for individual differences in alcohol intake is important when studying the effect of stress on alcohol consumption. PMID- 3562191 TI - Level of stress and sleep duration. AB - 30 subjects kept daily diaries of sleep-duration and stress levels for 4 mo. From these data, it was determined that during periods of high stress, sleep was reduced by about one standard deviation while during periods of low stress, sleep increased by about one-half a standard deviation. The relationship of these results to the relevant sleep-stress literature was briefly discussed. PMID- 3562192 TI - Primary and secondary deviational salience: predictors, consequences, symptoms and strategies. AB - In this article, the model of deviational salience [italics added], which explains the relationship between self-perceptions and perceptions in general is extended. Original analysis indicated that when individuals evaluate themselves as deviating negatively from their perception of the norm of a salient environmental stimulus, that stimulus becomes more meaningful. Reexamination of the original data indicates that this outcome also occurs when an individual's self-perceptions are incongruent with quantifiable objective norms. Furthermore, interaction between the two sufficient antecedent conditions of primary deviational salience, negative self-perceptions and incongruence, produces secondary deviational salience. The major dysfunctional consequences of both primary and secondary classifications have been examined. Those most debilitating involve misattribution based on the salient feature and obsessive concern over the feature. Finally, several rational-emotive approaches aimed at reducing deviational salience along with the maladaptive behavioral symptoms have been proposed. PMID- 3562193 TI - Is the matching familiar figures test a measure of cognitive style? A warning for users. AB - A probabilistic model of reflection-impulsivity as measured by the Matching Familiar Figures Test (MFFT) is presented and tested on 77 fourth graders. In testing the model two groups emerged, a random response group (n = 22) and a cognitive response group (n = 55), who use the evaluation process. Correlations among latencies, total errors, initial errors, school-scores, and IQs were compared for our total sample and the two groups. The correlation of MFFT latencies and errors disappeared for the random-response group and new correlations with errors appeared while the cognitive response group kept a statistically significant correlation of latencies with errors and no other error correlation was shown. This last group was classified by Kagan's median-split procedure showing that most reflective subjects kept their classification. Preliminary results suggest a reinterpretation of reflection-impulsivity literature, especially as related to the impulsive style. PMID- 3562194 TI - Stress as a state of anticipatory vigilance. AB - The pituitary-adrenocortical system is activated in stressful situations, and the adrenocortical hormones have been implicated by Selye in the diseases of stress. Evidence indicates that the adrenocortical hormones peak during the period of anticipation of stressful events, not during actual confrontation with them. The circadian cortisol rhythm shows peaks before waking, not during active periods of the day, and cortisol does not appear to be required during physical activity. The role of these hormones appears to be to suppress ongoing physiological activity in order to increase vigilance and to get the organism ready to take action before the impact of dangers. PMID- 3562195 TI - Ectomorphy ratios of completed suicides. PMID- 3562196 TI - Relation of scores on the Open Middle Test to self-control and academic achievement of inner-city fourth-grade children. AB - The construct validity of the Open Middle Test, a measure of children's social problem-solving ability, was investigated by assessing its relationship to self control (Self-control Rating Scale) and academic achievement (Wide-Range Achievement Test). Subjects were 113 minority fourth graders from two urban parochial schools. A significant correlation was obtained between Open Middle Test effectiveness scores of first responses and WRAT Reading scores. No other correlations were significant. However, mean differences were significant for Open Middle Test effectiveness ratings of first responses and chosen responses, suggesting possible deficits in the evaluation of self-generated problem solutions. Implications of the results for training programs and for the use of the Open Middle Test as an outcome measure are discussed. PMID- 3562197 TI - Quality of life and rates of suicide and homicide. PMID- 3562198 TI - Selected parameters of response organization in mildly mentally retarded children. AB - The purpose of this study was to investigate the effect of response organization on reaction time (RT) and movement time (MT) of mildly mentally retarded children. Two groups of 30 subjects each were formed: a retarded group 9 yr. of age and a normal group matched for chronological age. Subjects were randomly assigned to one of three precued conditions in which they were told that the forthcoming response would be performed with the right or left hand (precue hand), be to the right or left side (precue direction), or cross or not cross the body midline (precue midline). The retarded group performed significantly more slowly than the normal group on both RT and MT. Both groups, however, were able to utilize precued hand information as opposed to other precued variables, indicating that knowing which hand to use is important when organizing responses. PMID- 3562199 TI - Relations between tablet properties. AB - With the aid of simple mathematical models the relations between specific crushing strength (i.e. crushing strength divided by the breaking surface), friability and disintegration time of a tablet can be given. The friability is related to the porosity of the tablets and the specific crushing strength, independent of the process conditions. For the disintegration time two models have been used, depending on the disintegration mechanism. In the first one the disintegration time is only dependent on the porosity, in the second on the specific surface by weight of the granules of which the tablets are made. The theoretical relationships were verified for two tablet formulations, made under varying process conditions. PMID- 3562200 TI - Incompatibility of indometacin and benzalkonium in eye drops due to ion-pair formation. AB - Eye drop formulations containing indometacin and benzalkonium salt often show an opalescence as a result of ion-pair formation. The insoluble ion pair was isolated and characterized by infrared and ultraviolet spectroscopy and thin layer chromatography. This ion pair is also responsible for the bad assay results of benzalkonium using the ion-pair extraction method with bromothymol blue as counterion. The distribution constant (KD = 1O4) of indometacin and the extraction constant (Kex = 3 X 1O4) of the ion pair indometacin-benzalkonium in a water-chloroform system at various pH values were determined. A discussion on the preservation of indometacin eye drop formulations with benzalkonium salt in view of this chemical incompatibility is presented. PMID- 3562201 TI - Apparent dissociation between myosin light chain phosphorylation and maximal velocity of shortening in KCl depolarized swine carotid artery: effect of temperature and KCl concentration. AB - Stimulation of swine carotid artery medial fibers with 110 mM KCl at 37 degrees C results in increases in myosin light chain (MLC) phosphorylation levels and maximal shortening velocity (Vo) during the period of stress development. During the period of stress maintenance, MLC phosphorylation levels and Vo are not maintained, but fall to suprabasal levels, resulting in a correlation between MLC phosphorylation and Vo and suggesting that MLC phosphorylation regulates Vo. This study identifies other conditions of KCl depolarization of swine carotid medial fibers in which this relationship between MLC phosphorylation and Vo is altered. A decrease in temperature from 37 degrees to 23 degrees C results in a similar magnitude of stress maintenance in response to 110 mM KCl and similar levels of MLC phosphorylation, but a reduction in Vo by approximately 50%. This differential effect of temperature on Vo and MLC phosphorylation results in a downward shift in the slope of the regression line describing the relationship between these two parameters. Decreasing [KCl] to 40 mM in the stimulating solution results again in similar magnitudes of maintained stress. MLC phosphorylation levels are not transient, but maintained at a constant value and Vo is transient at levels approximately 50% of those at 110 mM KCl at 37 degrees C. This results in a complete lack of correlation between MLC phosphorylation and Vo. Thus, stress can be developed to equal magnitudes under differing activation conditions with dissimilar patterns of MLC phosphorylation and Vo. Therefore, there is not a strict relationship between MLC phosphorylation and Vo in all cases. PMID- 3562202 TI - Effects of external cations and calcium-channel blockers on depolarization contraction coupling in denervated rat twitch skeletal muscles. AB - In the double mannitol gap arrangement the contraction was estimated in single fibres isolated from rat extensor digitorum longus (e.d.l.) muscles that had been denervated for 2-48 days. Denervation induced large changes in the characteristics of the action potential and of the twitch. Up to 15-20 days after denervation the contraction-depolarization curve was sigmoidal and the maximum amplitude of the contraction was not modified by variation of [Ca]o or [Na]o. After 15-20 days of denervation a bell-shaped curve described the relation between contraction and potential. The maximum amplitude was dependent upon the [Ca]o. In Ca-free solution no contractile response was obtained. In Na-free, Ca containing solution the relationship between contraction and potential was not modified by the addition of divalent cations Co2+, Cd2+, Mn2+, Mg2+, Ni2+, or Ba2+. The contraction, which appeared in Ca-free solution, was restored by adding Sr2+. D600, verapamil and bepridil failed to change the amplitude of the contraction while a marked reduction was found with dihydropyridines. The reduction was overcome by increasing [Ca]o. The present results suggest that the slow calcium current is not involved in the generation of the contractile responses developed by denervated muscles in Na-free (TEA) solution. PMID- 3562203 TI - Membrane Ca2+ interactions and contraction in denervated rat soleus muscle. AB - Under voltage clamp conditions contractile responses and ionic currents of single fibres isolated from rat soleus, denervated for more than 20 days, were recorded in Na-free TEA containing solutions. The relationship between membrane potential and contraction has been analysed under various conditions. The addition of trivalent cations (La3+, Gd3+) resulted in a dose dependent reduction of the contractile response and similar effects were produced by polymyxin B (0.05-0.5 mM). By contrast in the presence of phospholipase D (1-5 U/ml) contractions were significantly increased for all values of depolarization. The time course of the change of tension amplitude after the application of Ca-free medium, was dependent on the amplitude, the duration and the frequency of the depolarization. Upon depolarization glycerol-treated fibres generated contractile responses which were similar to those recorded in normal muscle and were also dependent on [Ca]o. It is proposed that in denervated soleus muscle the negatively charged phospholipids at the outside of the membrane were involved in the depolarization contraction coupling by means of their Ca binding properties. The quantity of Ca binding sites would be dependent on [Ca]o and membrane potential and their binding properties modified during and/or following variation in membrane potential. PMID- 3562204 TI - Geometrical variations of the canine superior vena cava: relationship between diameter, segment length and transmural venous pressure. AB - The dimensional variations of the superior vena cava throughout the cardiac cycle were investigated by means of angiographic and ultrasonic techniques. Results obtained by both methods were largely in agreement. In frontal direction the diameter curve resembled the transmural pressure variations, the sagittal diameter curve was not related to the venous pressure variations during certain phases of the cardiac cycle and compressional and/or stretching forces exerted by respectively the distending aorta and/or pulmonary artery and the contracting heart may have been responsible. Also segment length variations occurred: during atrial contraction, ventricular systole and early diastole the vein elongated, indicating the varying longitudinal traction forces, possibly exerted by the rotational movement of the contracting heart. Assuming elliptical symmetry the vena caval cross-section could be reconstructed, and the cross-sectional area, perimeter and segmental volume could be calculated throughout the cardiac cycle. Despite the high venous distensibility, no extreme collapse of the vein was observed during the cardiac cycle at low transmural pressures. PMID- 3562205 TI - Autonomic nervous control of the heart rate during isometric exercise in normal man. AB - The relative contribution of the efferent components of the autonomic nervous system to the regulation of tachycardia induced by isometric exercise was assessed in 23 normal males. The isometric exercise (handgrip) was performed at the maximum intensity tolerated by the individual over a period of 10 s (maximal voluntary contraction-MVC) and at levels equivalent to 75, 50 and 25% of MVC for 20, 40 and 10 s, respectively. The study was performed both under control conditions and after pharmacological blockade with atropine (12 individuals) or propranolol (11 individuals). Under control conditions, the heart rate (HR) responses to isometric effort were dependent on the intensity and duration of the exercise, showing a tendency towards progressive elevation with the maintenance of muscular contraction at the levels studied. The tachycardia evoked by this effort was of considerable magnitude and of rapid onset, especially at the more intense levels of activity. Parasympathetic blockade markedly decreased tachycardia, which manifested itself during the first 10 s of exercise at all levels of intensity, whereas sympathetic blockade markedly modified the HR response after 10 s of effort at the 75 and 50% MVC levels. A slight depression of the tachycardiac response could be observed already after 10 s of maximum effort after propranolol. The present results suggest that the autonomic regulation of these responses is based on a biphasic mechanism, with the initial phase depending on the rapid withdrawal of the parasympathetic influence, followed by a marked sympathetic contribution to the induction of tachycardia after 10 s of isometric contraction or even a little before at maximum exertion. PMID- 3562206 TI - Does the xanthine-xanthine oxidase system alter contractile behaviour of vascular smooth muscle? AB - Since xanthine oxidase (XOD) preparations are usually applied as crystalline suspensions in ammonium sulphate solution, we studied separately the contractile responses of excised rabbit carotid arteries to the free radical generating system of xanthine-XOD and ammonium ions. Using dialyzed XOD (0.1-0.2 U/ml) the contractile pattern of the xanthine-XOD system was characterized by initial contraction followed by relaxation. Identical contractile behaviour was observed when xanthine was omitted from that system. These contractile responses were indistinguishable from those obtained with ammonium sulphate (10-20 mM). The threshold concentration of ammonium sulphate for inducing contraction was 1-2 mM. Both Ca++-free solution and verapamil only slightly inhibited the contractions produced by XOD and ammonium sulphate. No contractile effect was observed with dialyzed XOD. We conclude that the contractile effects of the xanthine-XOD system on vascular smooth muscle are due to simultaneously applied ammonium ions, and our findings emphasize the need for further purification of XOD preparations when investigating their effects on smooth muscle. PMID- 3562207 TI - A transient outward rectification in the cat sympathetic preganglionic neuron. AB - Intracellular recordings were made from sympathetic preganglionic neurons of the intermediolateral nucleus, in the slice of the T3 segment of the cat spinal cord. Depolarization to -60 mV from membrane potentials more negative than -75 to -80 mV caused a transient outward rectification which decayed in 0.5-2.0s. The rectification was sensitive to changes in K concentration, was abolished by 4AP (2 mM), and was unaffected by low Ca (0.25 mM), Co (2 mM), Ba (1 mM), TEA (20 mM) or intracellular Cs. These properties suggest that the rectification is due to a transient K-current similar to the A-current described in other neurons. PMID- 3562208 TI - [From the blood center to the department of transfusion medicine]. PMID- 3562209 TI - [Experience of the BAS test in the control of blood group compatibility]. PMID- 3562210 TI - [The blood service of the Finnish Red Cross. Unique organization makes Finland self-sufficient]. PMID- 3562211 TI - [Serum ferritin in blood donors--an evaluation of iron reserves]. PMID- 3562212 TI - [Radiological renal papillary necrosis in patients with capillary sclerosis and transitional cell tumors in the upper urinary tract]. PMID- 3562213 TI - [Medical records--clinical aspects]. PMID- 3562214 TI - [A review of various parasites of rabbits]. AB - The increased interest in breeding and production of rabbits has initiated the present work, in which a review on the occurrence, significance and control of some important parasite infections of the domestic rabbit is given. In wild rabbits parasite diseases often affect single animals, whereas the intensive production of domestic rabbits typically has to deal with parasites as herd problems which in some cases may invalidate the economy of commercial rabbitries. The most important parasite diseases of the domestic rabbit comprise coccidiosis caused by Eimeria-spp. and ear mange caused by Psoroptes cuniculi. PMID- 3562215 TI - Profiles of progesterone in milk and clinical ovarian findings in postpartum cows with ovarian dysfunctions. AB - Milk progesterone profiles, based on twice or once weekly sampling, were constructed for postpartum dairy cows. The cows were simultaneously examined by rectal palpation and clinical ovarian findings were related to the progesterone profiles. The combination of progesterone analysis and clinical examination may be used to optimize diagnostic accuracy and a number of practical recommendations are given on the basis of the results from this study. PMID- 3562216 TI - Variation in hair coat and skin texture in blue dogs. AB - A clinical examination of 6 dogs with blue coat color (genotype dd) has been carried out. The results show that the majority of blue dogs have an abnormally textured hair coat and skin. These changes, however, are not observed in all blue dogs. PMID- 3562217 TI - Progressive retinal atrophy in the Abyssinian cat. AB - Eight cases of hereditary progressive retinal atrophy in Abyssinian cats in Denmark are reported. Pedigree studies indicate direct lineage to affected cats of the same breed in Sweden. The disease is bilateral, progressive, and of the generalized type, and ultimately leads to blindness. PMID- 3562218 TI - Disease in 27 Norwegian dairy goat farms. AB - A combination of field registrations and laboratory examinations was used to describe the distribution, morbidity and mortality of disease among dairy goats in the western part of Norway. PMID- 3562219 TI - Comparison of antithrombotic activity of two heparin fragments PK 10169 (mol. wt. 5,000) and EMT 680 (mol. wt. 2,500) and unfractionated heparin in a rabbit experimental thrombosis model: relative importance of systemic anti-Xa and anti IIa activities. AB - Two fragments obtained by chemical depolymerization of heparin from porcine mucosal origin PK 10169 (mol. wt. 5,000) and EMT 680 (mol. wt. 2,500) were compared to the original heparin in a rabbit experimental thrombosis model. Thrombosis was induced either by human serum or by bovine Xa. Various doses of heparins (6 animals per dose and per inducer) were injected in order to find the lowest systemic levels of anti-Xa and anti-IIa activities able to inhibit venous induced thrombogenesis. The systemic activities associated with an inhibition of 50% of the generated thrombi were as follows: 0.17 +/- 0.02 anti-Xa and 0.16 +/- 0.03 anti-IIa units obtained after injection of 97 micrograms/kg (14 anti-Xa and anti-IIa units/kg) of unfractionated heparin, 0.28 +/- 0.04 anti-Xa and 0.14 +/- 0.03 anti-IIa units obtained after injection of 250 micrograms/kg (15 anti-Xa and 7.5 anti-IIa units/kg of PK 10169, and 2.6 +/- 0.2 anti-Xa and 0.06 +/- 0.01 anti IIa units obtained after injection of 5000 micrograms/kg (260 anti-Xa and 5 anti IIa units/kg) of EMT 680. These results suggest that the presence of an anti-IIa activity associated with the anti-Xa activity strongly increases the thrombogenesis inhibition in the serum and Xa-induced thrombosis for the heparin fragments of low and very low molecular weight used in this study. PMID- 3562220 TI - [Failure of anti-pneumococcal vaccination and prophylactic antibiotic therapy in 2 splenectomized subjects]. AB - Asplenic patients are at high risk for the development of fulminant pneumococcal bacteremia. The mortality rate in those infected patients remains high. Therefore pneumococcal polysaccharide vaccine has been recommended, but despite penicillin prophylaxis pneumococcal sepsis can occur in vaccinated patients. We have observed two cases (one fatal) of overwhelming postsplenectomy pneumococcal sepsis in vaccinated patients who received long-term antibiotic prophylaxis. Both exhibited a poor antibody response to polyvalent vaccine. PMID- 3562221 TI - [Multiple bone localizations in hair cell leukemia. Efficacy of treatment with alpha 2 interferon]. AB - We report a case of hairy cell leukemia with multiple bone lesions (skull, tibia, spine, femoral head) clinically, radiologically, and histologically documented. Radiotherapy failed to improve tibial pain. Treatment with alpha interferon resulted in bone pain improvement. Diagnoses and therapy strategies of these unusual features are discussed with respect cases to previously published in the literature. PMID- 3562222 TI - [Thoracoscopic talc poudrage in pleurisies of blood diseases]. AB - A total of 20 patients aged 50.5 +/- 4.5 years with 24 chronic pleural effusions associated with lymphomas underwent 24 thoracoscopic talc poudrages. Effusions were serofibrinous (32%), hemorrhagic (41%), or chylous (27%). The mean volume of pleural liquid evacuated by repeated thoracenteses before thoracoscopy was 5.2 +/ 0.6 l. Thoracoscopic biopsies confirmed a lymphomatous infiltration of the pleura in 95.5% of cases. A definitive pleural symphysis was obtained in all cases but 2 (92% positive results): in 1 case, a further single thoracentesis of 400 ml was necessary, and in the 2nd case the patient died within 6 days from an acute evolution of her Hodgkin's disease. The mean drainage time was 4.8 +/- 0.2 days. Overall results are thus identical to those obtained in solid tumor-related pleural effusions (91% positive results). PMID- 3562223 TI - The synthesis of some branched-chain-sugar nucleoside analogues. AB - 1-(2,3-Epoxy-5-O-trityl-beta-D-lyxofuranosyl)uracil was treated with a number of carbon nucleophiles. Ethynyl lithium gave 3'-deoxy-3'-ethynyl-5'-O-trityl-ara uridine, which was reduced to the corresponding 3'-ethenyl compound. Sodium cyanide gave 3'-cyano-3'-deoxy-5'-O-trityl-ara-uridine which upon alkaline hydrolysis gave the corresponding 3'-carboxamido compound. 1,3-Dithian-2-yl lithium gave 3'-deoxy-3'-(1,3-dithian-2-yl)-5'-O-trityl-ara-uridine. The trityl group was removed from each of these compounds by mild acidic hydrolysis. Treatment of 2 with 0.1M H2sO4 and mercury (II) acetate afforded 3'-acetyl-3' deoxy-ara-uridine which upon reduction with NaBH4 gave 3'-deoxy-3'-(1 hydroxyethan-1-yl)-ara-uridine. Acetylation of 6 yielded 5'-O-acetyl-3'-acetyl 2',3'-didehydro-2',3'-dideoxyuridine which upon reduction with NaBH4 produced a mixture of 5'-O-acetyl-2',3'-didehydro-2',3'-dideoxy-3'-(1-hydroxyethan -1 yl)uridine and 1-(R)[5-(S)-acetoxymethyl-4-(1-hydroxyethan-1-yl)-tetrahydrofuran- 2-yl]- uracil. Reduction of 14 with Raney nickel followed by removal of the trityl group gave 3'-deoxy-3'-methyl-ara-uridine. PMID- 3562224 TI - Isolation of a conserved sequence deleted in Duchenne muscular dystrophy patients. AB - We have isolated a DNA sequence (HIP25) by subtraction- hybridisation which is deleted in a number of Duchenne muscular dystrophy (DMD) patients. HIP25 is conserved in evolution and hybridises to human fetal and adult muscle mRNA. HIP25 is absent in human fetal fibroblast mRNA. Physical mapping data localise this sequence within Xp21 between the breakpoints of X;autosome translocations found in two females suffering from the disease. HIP25 is a candidate exon sequence for the basic defect in DMD boys deleted at this locus. PMID- 3562225 TI - NMR and CD studies on an oligonucleotide containing N4-methylcytosine. AB - The hexamer d(CGm4CGCG) exists predominantly as a right handed B form helix at 20 degrees C in 150 mM NaCl, as shown by 2D NOE spectra. Under these conditions a minor species is also observed which corresponds to the single strand in slow exchange on a proton NMR time scale with the double strand. This exchange is unusually slow and separate resonances for the two species are seen up to 65 degrees C. At 50 degrees C the lifetime of the single strand species is 0.85 s. Under high salt conditions the hexamer is partly converted into the Z form, but the complete transition is only observed at 5M NaCl at -6 degrees C. PMID- 3562226 TI - DNA sequence preferences for an intercalating porphyrin compound revealed by footprinting. AB - The DNA sequence preferences of the compound meso-tetra-(4-N-methyl(pyridyl) porphyrin and its nickel complex have been investigated by means of footprinting experiments on several DNA fragments, using DNAase I and micrococcal nuclease as footprinting agents. A complex pattern of both AT and GC-protected sites was found. Ligand-induced long-range conformational changes were inferred in several instances to be related to the observed large-scale blockages of enzymatic cutting. PMID- 3562227 TI - The LINE-1 DNA sequences in four mammalian orders predict proteins that conserve homologies to retrovirus proteins. AB - Recent work suggests that one or more members of the highly repeated LINE-1 (L1) DNA family found in all mammals may encode one or more proteins. Here we report the sequence of a portion of an L1 cloned from the domestic cat (Felis catus). These data permit comparison of the L1 sequences in four mammalian orders (Carnivore, Lagomorph, Rodent and Primate) and the comparison supports the suggested coding potential. In two separate, noncontiguous regions in the carboxy terminal half of the proteins predicted from the DNA sequences, there are several strongly conserved segments. In one region, these share homology with known or suspected reverse transcriptases, as described by others in rodents and primates. In the second region, closer to the carboxy terminus, the strongly conserved segments are over 90% homologous among the four orders. One of the latter segments is cysteine rich and resembles the putative metal binding domains of nucleic acid binding proteins, including those of TFIIIA and retroviruses. PMID- 3562228 TI - Apparent stimulation of calf thymus DNA polymerase alpha by ATP. AB - The mechanism by which millimolar concentrations of ATP stimulate the activity and increase the processivity of calf thymus DNA polymerase alpha has been investigated with poly(dA)/oligo(dT) as template/primer to eliminate possible effects due to primer synthesis. The effect of ATP on the rate of DNA synthesis with this template/primer was found to be dependent upon whether or not the ATP was neutralized and the species of buffer used in the reaction. The present studies suggest that ATP stimulation of calf thymus DNA polymerase can be attributed to changes in the pH of the reaction mixture, a shift in the magnesium ion optimum, or both. Furthermore, effects of ATP on the processivity of DNA polymerase alpha could be mimicked by lowering the pH of the reaction mixture. PMID- 3562229 TI - A new moderately repetitive DNA sequence family of novel organization. AB - In cloning adenovirus homologous sequences, from a human cosmid library, we identified a moderately repetitive DNA sequence family consisting of tandem arrays of 2.5 kb members. A member was sequenced and several non-adjacent, 15-20 bp G-C rich segments with homology to the left side of adenovirus were discovered. The copy number of 400 members is highly conserved among humans. Southern blots of partial digests of human DNA have verified the tandem array of the sequence family. The chromosomal location was defined by somatic cell genetics and in situ hybridization. Tandem arrays are found only on chromosomes 4 (4q31) and 19 (q13.1-q13.5). Homologous repetitive sequences are found in DNA of other primates but not in cat or mouse. Thus we have identified a new family of moderately repetitive DNA sequences, unique because of its organization in clustered tandem arrays, its length, its chromosomal location, and its lack of homology to other moderately repetitive sequence families. PMID- 3562230 TI - Complete sequence of 'divided' rps12 (r-protein S12) and rps7 (r-protein S7) gene in soybean chloroplast DNA. PMID- 3562231 TI - Nucleotide sequence of the large ribosomal RNA of honeybee mitochondria. PMID- 3562232 TI - Sequence of the apocytochrome f gene encoded by the Vicia faba chloroplast genome. PMID- 3562233 TI - 23S ribosomal RNA mutations in halobacteria conferring resistance to the anti-80S ribosome targeted antibiotic anisomycin. AB - Halobacterium (H.) halobium and H. cutirubrum mutants resistant to the anti-80S ribosome targeted inhibitor anisomycin were isolated. Three classes of mutants were obtained: Class I displayed a minimal inhibitory concentration (MIC) to anisomycin of 10 micrograms/ml, class II of 25 micrograms/ml and class III of at least 400 micrograms/ml. In vitro polyphenylalanine synthesis assays demonstrated that in those cases tested resistance was a property of the large ribosomal subunit. By primer extension analysis, each mutation class could be correlated with a distinct base change within the peptidyltransferase loop of 235 rRNA. In class I A2472 was changed to C, in class II G2466 was changed to C and in the high-level resistant class III C2471 was replaced by U. A. double mutant - obtained by selection of a class I mutant for high-level anisomycin resistance - acquired the C2471 to U replacement of class III in addition to the class I mutation. The results provide information on the action of a eukaryotic protein synthesis inhibitor on archaebacterial ribosomes and demonstrate the suitability of organisms with a single rRNA transcriptional unit on the chromosome for direct selection of mutations in ribosomal RNA. PMID- 3562235 TI - Consensus sequences of the Rattus norvegicus B1- and B2 repeats. PMID- 3562234 TI - Defining the binding site of Xenopus transcription factor IIIA on 5S RNA using truncated and chimeric 5S RNA molecules. AB - The interaction of TFIIIA with deletion fragments of Xenopus 5S RNA has been quantified using a nitrocellulose filter binding assay. TFIIIA binding was found to be more sensitive to the deletion of nucleotides from the 5' terminus of the 5S RNA as opposed to the 3' terminus. These effects have been correlated to the changes in RNA secondary structure resulting from the deletions. Nucleotides 11 108 of the intact 5S RNA provide the necessary sequence and conformational information required for the binding of TFIIIA. Synthetic 5S RNA genes have been constructed so that in vitro transcription with T7 RNA polymerase yields mature 5S RNA. The transcription factor has a higher affinity for somatic vs. oocyte 5S RNA, similar to the differential affinity of TFIIIA for the two genes. Binding studies with chimeric 5S RNA molecules indicated that the increased binding strength of somatic 5S RNA is conferred by nucleotide substitutions in the 5' half of the molecule. PMID- 3562236 TI - Nucleotide sequence of the gamma chain gene of rat fibrinogen: conserved intronic sequences. PMID- 3562237 TI - Sequencing refractory GC rich regions in plasmid DNA. PMID- 3562238 TI - Nucleotide sequence of the coding region of two actin genes in Bombyx mori. PMID- 3562239 TI - Helical repeat of DNA in solution. The V curve method. AB - The V-like dependence of the electrophoretic mobility of small DNA rings on their topological constraint, which has been documented in a recent paper [Zivanovic et al. (1986), J. Mol. Biol., 192, 645-660], has been explored as a tool to measure the helical twist of the torsionally unstressed duplex. The method was applied to single mixed sequence fragments approximately 350 to 1400 base pairs in length, providing estimates of their average helical periodicity. It was also used to compare two DNA fragments, and to evaluate the helical repeat of poly(dA.dT).poly(dA.dT) and poly(dA).poly(dT) inserts, and the helix unwindings associated with dA and dC methylations by dam and Hhal methylases, respectively. Data were found to be highly reproducible and helical repeat estimates were in good agreement with those obtained from previous techniques. PMID- 3562240 TI - Mouse DNA 'fingerprints': analysis of chromosome localization and germ-line stability of hypervariable loci in recombinant inbred strains. AB - Human minisatellite probes cross-hybridize to mouse DNA and detect multiple variable loci. The resulting DNA "fingerprints" vary substantially between inbred strains but relatively little within an inbred strain. By studying the segregation of variable DNA fragments in BXD recombinant inbred strains of mice, at least 13 hypervariable loci were defined, 8 of which could be regionally assigned to mouse chromosomes. The assigned loci are autosomal, dispersed and not preferentially associated with centromeres or telomeres. One of these minisatellites is complex, with alleles 90 kb or more long and with internal restriction endonuclease cleavage sites which produce a minisatellite "haplotype" of multiple cosegregating fragments. In addition, one locus shows extreme germ line instability and should provide a useful system for studying more directly the rates and processes of allelic variation of minisatellites. PMID- 3562241 TI - Immobilization of DNA via oligonucleotides containing an aldehyde or carboxylic acid group at the 5' terminus. AB - A general method for the immobilization of DNA through its 5'-end has been developed. A synthetic oligonucleotide, modified at its 5'-end with an aldehyde or carboxylic acid, was attached to latex microspheres containing hydrazide residues. Using T4 polynucleotide ligase and an oligonucleotide splint, a single stranded 98mer was efficiently joined to the immobilized synthetic fragment. After impregnation of the latex microspheres with the fluorescent dye, Nile Red and attachment of an aldehyde 16mer, 5 X 10(5) bead-DNA conjugates could be detected with a conventional fluorimeter. PMID- 3562242 TI - Molecular cloning and sequence analysis of a mouse Y chromosome RNA transcript expressed in the testis. AB - Using a Y specific probe (pY353/B) taken from a flow sorted mouse Y chromosome library we have identified a family of RNA transcripts encoded by the Y chromosome. These transcripts which are approximately 1.3 Kb in length are present in testis PolyA+ RNA but can not be detected in either male liver, spleen, kidney, brain, heart or lung tissues. Isolation and sequence analysis of a corresponding cDNA shows it to contain a potential coding sequence of 696bp. These data show that the Y chromosome is transcriptionally active in the adult mouse testis. PMID- 3562243 TI - A germline transformation analysis reveals flexibility in the organization of heat shock consensus elements. AB - Maximal expression of the Drosophila heat shock gene hsp70 can be activated by a pair of heat shock consensus elements (HSE's) positioned close to the transcription start site. In contrast, required HSE's of other heat shock genes (i.e., hsp26, 27, 23) are located several hundred base pairs (bp) farther upstream of their start sites. Using germline transformation, we analyzed the requirements for HSE organization in the hsp70 and hsp26 regulatory regions. A 51 bp fragment containing the two proximal hsp70 HSE's was sufficient to rescue the heat shock response of an hsp26-lacZ gene devoid of its HSE's. Heat inducibility was restored with either orientation of the fragment relative to the hsp26 transcription start. In hsp70 gene constructions, relocation of hsp70 HSE's to more remote positions by inserting 127 or 331 bp into the regulatory region failed to substantially reduce expression. Thus, in contrast to their native configurations, the hsp26 promoter can be activated by HSE's solely in a proximal position and the hsp70 promoter can be activated by remote HSE's. In addition, a simple and sensitive assay for quantitative measurement of beta-galactosidase activity in crude fly extracts is described. PMID- 3562244 TI - Mouse histone H2A and H2B genes: four functional genes and a pseudogene undergoing gene conversion with a closely linked functional gene. AB - The sequence of five mouse histone genes, two H2a and three H2b genes on chromosome 13 has been determined. The three H2b genes all code for different proteins, each differing in two amino acids from the others. The H2b specific elements present 5' to H2b genes from other species are present in all three mouse H2b genes. All three H2b genes are expressed in the same relative amounts in three different mouse cell lines and fetal mice. The H2b gene with the H2b specific sequence closest to the TATAA sequence is expressed in the highest amount. One of the H2a genes lacks the first 9 amino acids, the promoter region, the last 3 amino acids and contains an altered 3' end sequence. Despite these multiple defects, there is only one nucleotide change between the two H2a genes from codon 9 to 126. This indicates that a recent gene conversion has occurred between these two genes. The similarity of the nucleotide sequences in the coding regions of mouse histone genes is probably due to gene conversion events targeted precisely at the coding region. PMID- 3562245 TI - Nucleotide sequence and in vitro expression of rubella virus 24S subgenomic messenger RNA encoding the structural proteins E1, E2 and C. AB - The complete nucleotide sequence of the 24S subgenomic mRNA of wild-type M33 strain rubella virus has been determined. This RNA is 3,383 nucleotides in length excluding the 3'-terminal poly(A) tract. After the three multiple in-phase termination codons clustered in the 5' terminus of this RNA, there are 81 nucleotides of nontranslated nucleic acid followed by a reading frame of 2,978 nucleotides that encodes the 110 kD precursor of the structural proteins. The 3' untranslated region is 263 nucleotides. The 110 kD polyprotein is processed to produce nucleocapsid C, the glycoproteins E2 and E1 in that order. Sites of post translational cleavage to produce E2 and E1 were located using available N terminal amino acid sequences. RNAs synthesized by transcription in vitro are effective messengers in the rabbit reticulocyte cell-free translation system. Post-translational processing of the structural proteins was observed in the cell free system supplemented with microsomes from dog pancreas. PMID- 3562246 TI - Oligodeoxyribonucleotides containing 1,3-propanediol as nucleoside substitute. AB - 1,3-Propanediol was protected with one dimethoxytrityl residue and converted into the methoxy- and cyanoethoxyphosphoramidites 2a and 2b, respectively. Solid-phase oligonucleotide synthesis, employing the phosphoramidite 2a resulted in the dodecamers d(CGCGAATTCGCG) (6-9), in which dA or dT residues were replaced by 1,3 propanediol. These oligomers showed a high tendency to form hairpins. Their phosphodiester bonds between the 3'-position of a nucleoside and the propanediol moiety was not cleaved by snake venom phosphodiesterase. PMID- 3562247 TI - The synthesis of oligonucleotides containing a primary amino group at the 5' terminus. AB - Oligonucleotides containing a primary amino group at their 5'-termini have been prepared and further derivatised with amino specific probes. The sequence required is prepared using standard solid phase phosphoramidite techniques and an extra round of synthesis is then performed with N-monomethoxytrityl-0 methoxydiisopropylaminophosphinyl 3-aminopropan(1)ol. After cleavage from the resin, removal of the phosphate and base protecting groups and purification gives a monomethoxytrityl-NH(CH2)3PO4-oligomer. The monomethoxytrityl group can be removed with acetic acid to give the desired amino containing oligomer. The amino group can be further derivatised with amino specific probes yielding fluorescent or biotinylated oligonucleotide products. PMID- 3562249 TI - Sequence of a cDNA coding for bovine pancreatic phospholipase A2. PMID- 3562248 TI - The monogenetic kinetoplastid protozoan, Crithidia fasciculata, contains a transcriptionally active, multicopy mini-exon sequence. AB - A repeated sequence from the Crithidia fasciculata nuclear genome has been isolated which is homologous to the mini-exon genes of other kinetoplastid protozoa. Sequence analysis of the 417 bp monomeric unit confirmed the presence of a 35 nt sequence within the repeat that is 77% homologous with the Trypanosoma brucei 35-mer mini-exon or spliced leader sequence. The repeat is present at approximately 250 copies per cell and is organized into one, or a few, large head to tail tandem clusters predominantly on a single chromosome. The mini-exon repeat unit hybridizes to a major 84 nt and a minor 87 nt poly (A)- steady state transcript, the first 35 nts of which comprise the mini-exon sequence found at the 5' end of mRNAs in several other kinetoplastid species. The 3'-termini of the transcripts map to positions on the DNA sense strand directly preceeding a stretch of 8 thymidine residues. Crithidia represents the most primitive kinetoplastid species which apparently possesses a discontinuous type of mRNA processing, implying that this represents a conserved feature in possibly all genera of kinetoplastid protozoa. PMID- 3562250 TI - Isolation and sequence analysis of a full length cDNA clone coding for human mitochondrial aldehyde dehydrogenase. PMID- 3562251 TI - A gene upstream of the Rhizobium trifolii nifA gene encodes a ferredoxin-like protein. PMID- 3562252 TI - Fourteenth symposium on nucleic acids chemistry. Tokushima, Japan, October 30th November 1st, 1986. PMID- 3562253 TI - A novel synthesis of carbocyclic C-nucleoside precursors by nonoxidative C-C bond fission. AB - New carbocyclic c-nucleoside precursors have been synthesized in stereocontrolled manner by nonoxidative C-C bond fission (i.e., Grob fragmentation or retrograde aldol reaction) starting from Diels-Alder adducts of cyclopentadiene with 3 acetoxyacrylates or dimethyl 2-acetoxymethylenemalonate. PMID- 3562254 TI - Separation of purine derivatives by polymer-bound nucleic acid bases. AB - Separation of a variety of purine bases, which include 7-methyl derivatives, was studied by using polyethyleneimine-coated silicagel which bound hypoxanthine, cytosine or guanine moieties. The separation behavior seems to be related to the interaction of imidazole part of purine derivatives with the resins through hydrogen bonding. PMID- 3562255 TI - Analysis and purification of synthetic large oligodeoxyribonucleotides by HPLC on RPC-5 like resin. AB - Large oligodeoxyribonucleotides (20-160 bases), synthesized by the phosphoramidite method, have been analyzed and purified by HPLC on a RPC-5 like resin (Neosorb LC). Linear gradient of NaClO4 solution containing 10 mM NaOH and 0.1 mM EDTA was carried out for the elution. Large oligodeoxyribonucleotides bearing 4,4'-dimethoxytrytyl (DMT) group were separated very well from the shorter failed by-products. After removal of the DMT group, the products were analyzed and purified by repeating HPLC on Neosorb LC. This HPLC system gave well resolution of the desired oligodeoxyribonucleotide (over 50 bases) from the base modified by-products with the same chain length. The chromatogram showed the presence of large amount of by-products in addition to the desired product when methylphosphoramidite method was employed for the DNA synthesis. PMID- 3562256 TI - Characterization of recombinant cDNA clones for canine cardiac phospholamban. AB - Complementary DNA clones specific for phospholamban have been isolated from a canine cardiac cDNA library. The amino acid sequence deduced from the cDNA sequence showed that phospholamban consisted of 52 amino acid residues and was synthesized without an amino-terminal signal sequence. The RNA blot analysis revealed that phospholamban mRNAs were represented by two main species of approximately 1.2kb and approximately 2.8kb. These mRNAs appeared to differ primarily in the length of the 3' untranslated region. PMID- 3562257 TI - The mechanism and structure of thymidylate synthetase. AB - We have been involved in studies of the mechanism, inhibition and structure of the enzyme thymidylate synthetase. Knowledge of fundamental catalytic features of thymidylate synthetase has accumulated over the past decade, and will be described. Recently, we have been involved in studies of the x-ray crystallography of thymidylate synthetase, the first phase of which has been completed. PMID- 3562258 TI - A highly regioselective C-5 lithiation of uridine: a simple and general entry to 5-substituted uridines. AB - A highly regioselective C-5 lithiation of uridine was accomplished by using 2',3',5'-tris-O-(tert-butyldimethylsilyl)-uridine and sec-BuLi/TMEDA. The reactions of the C-5 lithiated species with various types of electrophiles and subsequent deprotection provide a simple and general entry to 5-substituted uridines. PMID- 3562259 TI - Aminations of guanosine and deoxyguanosine with hydroxylamine-O-sulfonic acid and 2,4-dinitrophenoxyamine. Dependence on the reaction medium. AB - Amination of guanosine (Guo) with 2,4-dinitrophenoxyamine in aqueous DMF gave 7 amino-Guo, which was readily converted to 8,5'-O-cyclo-Guo, and 8-hydroxy-Guo. Deoxyguanosine (dG) gave only deglycosylated 7-amino-G under the same reaction condition. Aminations of Guo and dG with hydroxylamine-O-sulfonic acid above pH 9 gave the corresponding 1-amino derivatives, whereas those in acidic media at pH 2 4 gave 8-amino-Guo and 7-amino-G as the main products, respectively. Amination of Guo in neutral media gave 1-amino-Guo and decomposed products of 7-amino-Guo. The mechanisms of these amination reactions are described. PMID- 3562260 TI - Anti-parasite activity of nucleoside analogues: the metabolism of carbocyclic inosine in promastigotes of Leishmania tropica and Leishmania donovani and its activity against amastigotes of Leishmania donovani in vitro. AB - Carbocyclic inosine is a potent inhibitor for the growth of the promastigote form of Leishmania tropica and Leishmania donovani. In culture, the EC50 values of carbocyclic inosine are 8.3 X 10(-8) and 1.3 X 10(-7) M for the promastigotes of L. tropica and L. donovani, respectively. On the other hand, it is less toxic towards mouse mammary tumor FM3A cells: the EC50 value is 2.7 X 10(-4)M. Carbocyclic inosine is metabolized by Leishmania promastigotes to give carbocyclic adenosine-5'-triphosphate(aristeromycin-5'-triphosphate) and carbocyclic guanosine-5'-triphosphate. This metabolic conversion provides a mechanism for the parasite-selective toxicity of carbocyclic inosine. Carbocyclic inosine was found to be active against L. donovani amastigotes in an in vivo-like cultivation in vitro. PMID- 3562261 TI - Recognition of sugar moieties on substrate analogues by DNA polymerase alpha 2 primase from developing cherry salmon (Oncorhynchus masou) testes. AB - Several dCTP or dATP analogues, bearing an azido or amino group on 2'- or 3' position of its sugar moiety, were examined for their inhibitory effects on DNA polymerase alpha 2-primase from developing cherry salmon (Oncorhynchus masou) testes, and the recognition of sugar moieties of the analogues by primase and related nucleic acid polymerases were compared. Among the dCTP analogues tested, 2'-azido-2',3'-dideoxy CTP inhibited primase strongly and RNA polymerases I and II to lesser extent. Although, the Ki value for primase was larger than those of RNA polymerases, the Ki/Km value for primase was smaller. In contrast, 3'-amino 2',3'-dideoxy CTP selectively inhibited DNA polymerase beta. In dATP analogue series, 3'-amino-3'-deoxy ATP inhibited RNA polymerases I and II very strongly to the same extent as 3'-deoxy ATP. This analogues was a more selective inhibitor for RNA polymerases I and II than 3'-dATP itself. PMID- 3562262 TI - Cleavage of DNA by model complexes of cytochrome P-450. AB - Thiolate-hemin complexes as chemical models for cytochrome P-450 have been shown to cause cleavage of DNA. The cleavage of DNA to open-circular and linear forms depended on the structure of thiol ligand and the thiol ligand:hemin ratio at pH 7.8. Complete cleavage of DNA was observed by complexes containing thioglycolate ethylester and mercaptoethanol at 400-600 moles excess of thiol ligand to hemin, those containing cysteine, cysteine methylester and cysteine ethylester at 50-200 moles excess, and those containing mercaptopropionylglycine, glutathione, glutathione dimethylester, penta- and nonapeptides at 5-100 moles excess. Inhibition experiments suggested the involvement of active oxygen species in the cleavage of DNA. PMID- 3562263 TI - Oxidation of pyrimidine bases and their derivatives with hydrogen peroxide in hydrochloric acid. AB - Oxidation of cytosine with H2O2 in 1 N-HCl gave 5-chlorocytosine and 5 chlorouracil. The reaction of uracil gave 5-chlorouracil. Treatment of thymine with H2O2 in 0.1 N-HCl gave 5-chloro-6-hydroperoxy-5,6-dihydrothymine, while the reaction in 1 N-HCl gave 5-chloro-6-hydroxy-5,6-dihydrothymine. Heating of 5 chloro-6-hydroperoxy-5,6-dihydrothymine in water gave 5-chloro-5-methylbarbituric acid. PMID- 3562264 TI - Differential inhibitory effects of Evans blue on various DNA polymerases. AB - Evans Blue, an anionic dye which has been found to inhibit the replication of human immunodeficiency virus, proved also inhibitory to the DNA polymerases alpha and beta. The mode of inhibition was competitive with respect to the template X primer, and noncompetitive with respect to the deoxynucleoside triphosphate substrates. The inhibitory effect of Evans Blue on DNA polymerases is discussed in relation to that of suramin. PMID- 3562265 TI - Mechanism of action of ricin and related toxic lectins on eukaryotic ribosomes. AB - We have studied on the mechanism of ricin action on rat liver ribosomes and present evidence which shows that the toxin inactivates ribosomes by modifying two bases at positions G-4323 and A-4324 of 28S rRNA adjacent to alpha-sarcin cleavage site. Further results showing that those phosphodiester bonds are very labile against alkaline digestion and aniline-treatment strongly suggest that these purine bases are removed by N-glycosidase activity of the toxin. In parallel, we also present evidence showing that abrin and modeccin have the same activity on eukaryotic ribosomes as ricin does. PMID- 3562266 TI - A Raman spectroscopic study on the sequence dependent conformations of DNA oligomers. AB - Eighteen kinds of oligodeoxyribonucleic acids have been examined to reveal their structures in aqueous solutions at different ionic strengths by Raman spectroscopy. The structures in solutions were found to be very polymorphic depending on their sequences as well as on the salt concentrations. At a low salt condition a DNA oligomer assumes a unique B form within a B family, for examples Ba, Bh, B', or Bn form. Amongst these DNA oligomers, d(CGCG)2 showed a salt induced Ba-Z transition, while d(GGGGCCCC)2 showed a salt induced Bh-A transition. DNA oligomers with AA/TT sequences were found to prefer B' form even at high salt condition. From comparing the structures of DNA oligomers in solutions with their crystal structures, it is safe to say that the crystal structure of a DNA oligomer is very similar to the structure in the high salt solution. PMID- 3562267 TI - Conformation of B. stearothermophilus 5S ribosomal RNA. AB - The thermal melting of B. stearothermophilus 5S ribosomal RNA was studied, by means of derivative optical absorption and CD spectra, and high performance liquid chromatography, in Tris buffers with K+ and Mg2+ at pH 7.6. Biphasic changes in optical absorption and CD ellipticity were observed, which mean the melting of two helices. Change in molecular size was also examined in the melting process. The melting temperatures depended on ionic strength and concentration of Mg2+. Enhanced stability of the helix was indicated, as compared with the corresponding one in B. subtilis 5S ribosomal RNA. In the presence of a large amount of Mg2+, the third melting process was observed at low temperatures, which was suggested due to change in the tertiary structure. PMID- 3562268 TI - Quenching of polyadenylic acid emission by divalent metal ions at room temperature. AB - A quenching of poly A emission at 293K in neutral pH by transition metal ions and alkaline earth ions has been studied. The results indicate that the longer wavelength emission of poly A is quenched by not only Co(II) and Ni(II) but also Mg(II). The measured large values of quenching efficiency suggest that the excitation energy migrate more than 10 adenine bases even at 293K. PMID- 3562269 TI - The molecular structure of cyclonucleotide hexamer, CoGoCoGoCoGo having a high anti conformation. AB - Cyclonucleotide hexamer, CoGoCoGoCoGo, was synthesized and crystallized as orthorhombic with space group C222(1), and unit cell dimensions: a = 48.30, b = 41.53, and c = 31.76A. The X-ray diffraction data up to 1.8A resolution were collected, and the crystal structure analysis by molecular replacement technique is now in progress using two energetically adequate left-handed helical models, which are obtained by conformational energy calculation. PMID- 3562270 TI - On the cross-coupling reaction of 1,3-dimethylthymine and thymidine epoxides with nucleophiles. AB - Solvent effect in reaction of 1,3-dimethylthymine epoxide (1) with amines was investigated. The results are summarized in Table I, indicating that the ratio of formation of the cis product (2) increases as a solvent becomes more polar. Reaction of thymidine epoxide (5) with nucleophiles was also examined. PMID- 3562271 TI - Synthesis of C-5' chirally deuterated nucleosides with 100% optical purity. AB - The syntheses of chirally pure (5R)- and (5S)-[5-2H1]-D-ribose and (5R)-(5-2H1)-3 C-methyl-D-ribose and the syntheses of chirally pure (5'R)- and (5'S)-[5-2H1] adenosine and (5'R)-[5'-2H1]-3'-C-methyladenosine are described. The 1H-NMR characteristics of these nucleosides and the mechanism of the reaction of adenosine and thionyl chloride-hexamethyl phosphoric triamide (HMPA) are also described. The stereospecific presence of deuterium in these nucleosides permits specific assignments for the resonances of 5'-protons. From the observed spin spin coupling between H5' and H4', the estimates have been made of the rotamer population of the exocyclic 5'-carbinol groups of these nucleosides. It is shown that these nucleosides exist in gauche-gauche rotamer (ca. 70%) in aqueous solution. The SN2 mechanism of the chlorination reaction is suggested. PMID- 3562272 TI - The deoxygenations of tosylated adenosine derivatives with Grignard reagents. AB - The reactions of 2'-O- or 3'-O-tosylated adenosines with Grignard reagents resulted in the formation of various products, which were deoxy or branched-chain deoxy sugar nucleosides, 1',2'-unsaturated nucleosides, 3'-deoxy-2'-keto sugar nucleosides, and so on. The convenient method for the synthesis of the 3'-deoxy 2'-keto adenine nucleoside is described. PMID- 3562273 TI - The synthesis and biological activity of certain pentaazaacenaphthylenes, hexaazaacenaphthylenes and their corresponding nucleosides. AB - Synthesis of the tricyclic nucleoside 8-amino-6-N-methyl-2-(beta-D-ribo furanosyl)-1,2,3,5,6,7-hexaazaacena phthylene (5) has been accomplished by the ring closure of an appropriately substituted pyrazolo[3,4-d]-pyrimidine nucleoside followed by the requisite chemical conversions. The formation, isolation and structural elucidation of two unexpected nucleosides formed by a reductive ring cleavage of the hexaazaacenaphthylene ring system is discussed. A comparison of the antitumor and biological activity of 5 with the structurally related tricyclic pentaazaacenaphthylene nucleoside which is currently in phase II clinical trials at the 5'-phosphate pro-drug is also presented. PMID- 3562274 TI - Synthesis of acyclonucleosides of imidazole and purine series. AB - In order to search for improved syntheses of 9-(2-hydroxyethoxymethyl) guanine and related antiviral agents, we tried several well documented general procedures (viz., fusion method) for the synthesis of N-glycosyl bond. Product distribution on alkylation of 4,5-disubstituted imidazoles as well as 2,6-disubstituted purines may depend upon the nature of alkylating agents (viz., 2-oxa-1,4 butanediol diacetate or 1-bromo-2-oxa-4-butanol acetate) and reaction conditions. A procedure for the synthesis of acyclovir and its N2-acetyl derivative could be improved to a considerable extent. PMID- 3562275 TI - Synthesis of 2'-deoxy-6,3'-methano-cyclo-pyrimidine nucleosides. AB - The nucleophilic attack of lithiated pyrimidines to a suitably-protected 3 ketosugar, afforded the 3-branched sugar stereospecifically, followed by intramolecular glycosylation to give 6,3'-methano-cyclo-pyrimidine nucleosides. The 2'-deoxygenation was achieved by sequential protection, deprotection and radical reduction. PMID- 3562276 TI - Synthesis and crystal structures of some 8,5'-carbamoyloxy-bridged purine nucleosides. AB - The X-ray analysis of 8,5'-(N-carbamoyloxy)-2-dimethylamino- methylene-9-(2',3'-0 isopropylidene-beta-D-ribofuranosyl)guanine (2a) has disclosed that some bond angles are significantly larger or smaller than the corresponding angles of normal ribonucleosides. Abnormally longer or shorter bond lengths have also been found. The base-sugar torsion angle of 2a has proved to reside between the C1' C2' and C1'-C3' lines, and quite near the latter line. Some new 8,5'-carbamoyloxy bridged adenosines were also synthesized as 2',3'-protected forms. PMID- 3562277 TI - Synthesis of 8-(2"-hydroxyethoxy)adenosine-5',2"-phosphate derivative. AB - Reaction of 8-bromo-2',3'-O-isopropylidene-5'-O-(tetrahydropyran-2-yl) adenosine (Ib) with lithium 2-(tetrahydropyran-2-yloxy) ethoxide, followed by removal of the tetrahydropyran-2-yl groups, afforded 8-(2''-hydroxyethoxy)-2',3'-O isopropylideneadenosine (II). Successive treatment of II with n-butyllithium and with methyl dichlorophosphate provided the 5',2''-(methyl phosphate) derivative (IIIa and IIIb). PMID- 3562278 TI - Structure-catalytic activity relationships of dicyclohexylcarboxamidine analogs in phosphorylation and alkylation of nucleosides by a two-step phosphorylating agent, 2-methylthio-4H-1,3,2-benzodioxaphosphorin 2-oxide (MTBO). AB - Adenosine borate complex was phosphorylated and o-hydroxybenzylated by 2 methylthio-4H-1,3,2-benzodioxaphosphorin 2-oxide (MTBO) in the presence of 4 morpholine-N,N'-dicyclohexylcarboxamidine (MDC) at first to give 1-(o hydroxybenzyl)adenosine derivative followed by the rearrangement of the benzyl group to the N-6 amino group to give N6-(o-hydroxybenzyl)adenosine 5'-S-methyl phosphorothiolate. More than 20 analogs of MDC were examined for their catalytic activity in phosphorylation and o-hydroxybenzylation of ribonucleoside by MTBO. Dicyclohexylformamidine (DCF) and n-alkylamino analogs of MDC had no effect on the o-hydroxybenzylation of ribonucleoside by MTBO, but had great effect on the phosphorylation. Dialkylamino and cyclic imino analogs of MDC had high catalytic activities to the both reaction. The dicyclohexylcarboxamidine structure of MDC gave the catalytic ability for phosphorylation by MTBO, while the morpholine moiety had great effect on the selectivity of o-hydroxybenzylation by MTBO. PMID- 3562279 TI - Phosphorylation of AMP by inorganic phosphorylating agents. AB - AMP was phosphorylated by inorganic phosphorylating agents: cyclo-triphosphate and diphosphonate, in aqueous solution (70-80 degrees C, pH 6-12). The molecular structures of phosphorylated products were established by use of phosphorus-31 NMR and high-performance liquid chromatography (HPLC). The OH groups on AMP were phosphorylated by both phosphorylating agents to form 2'- or 3'-phosphate but an OH group on dAMP was not phosphorylated. Phosphorylation of OH group proceeds in two steps: formation of hydrogen bond between OH group and phosphorylating agent; subsequent nucleophilic attack of OH group on a phosphorus atom. Phosphate group on AMP was phosphorylated by diphosphonate but not by cyclo-triphosphate. The difference in the reactivities is explained in terms of charge repulsion between AMP and agents. PMID- 3562280 TI - Synthesis of 5'-phosphatidylnucleosides by phospholipase D-catalyzed transphosphatidylation. AB - Phospholipase D from Streptomyces effectively catalyzed the transfer reaction of the phosphatidyl residue from phosphatidylcholine to the 5'-hydroxyl group of nucleosides. A variety of 5'-phosphatidylnucleosides were prepared by this reaction in high yields. Some of them showed marked antitumor activities in mice. PMID- 3562281 TI - The phosphorothioite method. Synthesis of deoxyoligonucleotides on polymer supports by using nucleoside phosphorothioites. AB - The development of a new method, which is called "the phosphorothioite method", for synthesizing deoxyoligonucleotides on polymer supports is described. Nucleoside phosphorothioites were easily prepared and readily activated by iodine or silver acetate. In the case of the use of iodine, the present method did not require the oxidation step, because it could be simultaneously performed during condensation and thereby the reaction time could be shorten. This method was applied successfully to the polymer support synthesis. PMID- 3562282 TI - An approach to DNA fragment synthesis from unprotected nucleoside. AB - Oligodeoxynucleotides have been synthesized from unprotected nucleoside by use of morpholinophosphordichloridite as a phosphorylating reagent. This procedure consists of three (in situ) steps; the reaction of 5'-O-protected deoxynucleotide with morpholinophosphordichloridite, the reaction of the resulting on active mononucleotide derivative with the second nucleoside, non-aqueous oxidation, and then removal of amino moiety at phosphate diester linkage. PMID- 3562283 TI - Synthesis of 5'-phosphorylated oligonucleotides on a polymer support. AB - Highly lipophilic trityloxyethylamine (TEAm) or trityloxyethylaniline (TEAn) were prepared and used for the protection of the 5'-terminal phosphate. We synthesized 5'-phosphorylated oligodeoxyribonucleotides by the solid phase synthesis. TEAm or TEAn groups enabled us to isolate the desired oligonucleotide easily by the reversed phase column due to their high lipophilicity and could be removed by the aq. AcOH treatment. PMID- 3562284 TI - Oligonucleotide synthesis on a cellulose acetate functionalized with a spacer. AB - 4-(2-Hydroxyethylsulfonyl)dihydrocinnamate derivative of cellulose acetate (D.S. 1.77) was used for polymer support synthesis of oligonucleotides bearing a phosphodiester function at the 3'-terminal position, taking into consideration that the cellulose derivative is readily soluble in pyridine, but slightly soluble in a solvent such as ethanol. PMID- 3562286 TI - 2-(2-Pyridyl)ethyl group: new type protecting group in the synthesis of DNA via phosphoramidite intermediates. AB - 2-(2-Pyridyl)ethyl group is a new type P-O protecting group for the synthesis of oligodeoxyribonucleotides by the phosphite triester method. This group is stable to alkali and acid conditions, and to be removed from internucleotidic bonds under mild conditions via two step procedures without any side reactions. Further we have found that bis(diisopropylamino)chlorophosphine is much more effective for the preparation of bis(diisopropylamino)alkoxyphosphines than various dichlorophosphines. PMID- 3562285 TI - Novel reactions of 5-bromouracil derivatives with active methylene compounds. AB - 5-Bromouracil derivatives (1) reacted with carbanions at room temperature to give 6-substituted uracils (6), 2,4-diazabicyclo[4,1,0] heptanes (8) and 2,4 diazabicyclo[4,3,0]nonane derivative (9), which depend largely upon the structure of the active methylene compounds employed for the generation of carbanions. PMID- 3562287 TI - Allyl and allyloxycarbonyl groups as versatile protecting groups in nucleotide synthesis. AB - Allyl group serves as a useful protecting group for an protection of sugar hydroxyls and amino and imide moieties of by brief treatment with a palladium catalyst and a variety of nucleophiles at room temperature. PMID- 3562288 TI - Alpha-ecdysone, a new bracken fern factor responsible for neoplasm induction in the Egyptian toad (Bufo regularis). AB - Neoplastic lesions were induced in 10 out of 58 experimental toads (Bufo regularis) force-fed with alpha-ecdysone, which naturally occurs in the leaves of bracken fern (Pteris aquilina). The results of this study prove that alpha ecdysone may be one of the factors responsible for the carcinogenicity of bracken fern plant fed to cattle and other experimental animals. PMID- 3562289 TI - Dietary vitamin A and lung cancer: results of a case-control study among chemical workers. AB - A nested case-control study conducted among a cohort of chemical manufacturing employees provided an opportunity to test the hypothesis that lung cancer risk is inversely related to dietary intake of vitamin A. Eligible for study were 308 former male employees who had died of lung cancer between 1940 and 1980. Two control groups, one a decedent and the other a "living" series, were individually matched to the cases one-for-one. Interviews were completed with 734 subjects or their next-of-kin and included a food frequency list. A vitamin A index was developed for each subject based on the frequency of consumption of 29 food items. After adjustment for a number of potentially confounding variables (e.g., smoking, educational level, and use of vitamin supplements), there was evidence that vitamin A intake was inversely associated with lung cancer risk. The effect was most pronounced in the comparisons with the "living" controls and appeared strongest among cigarette smokers. Subjects in the lowest tertile of vitamin A intake had approximately twice the risk of lung cancer as those in the highest. Analyses of an index of carotenoids and of individual food items suggested that plant sources of vitamin A may play a more important role in producing the effect than do animal sources. PMID- 3562290 TI - The role of diet in prostate cancer. AB - This is a one-to-one, age- and race-matched case-control study involving 55 histologically confirmed black prostate cancer patients and 55 controls who were seen at three major hospitals in Washington, DC from 1982 to 1984. Personal interviews were conducted to obtain the number of times food items of specified serving size were consumed per week by cases and controls; the subjects were grouped according to the age periods 30-49 and 50 years and older. We then calculated the average daily consumption of each of 18 nutrients per 1,000 calories. There was a significant negative association between linoleic acid (p less than 0.04) for the 50 years and older group, thiamin (p less than 0.05) for those 30-49 years old, riboflavin (p less than 0.03) for the 50 and older group, and iron (p less than 0.05) for those 30-49 years old. The results of this study suggest that the intake of thiamin and iron (in subjects 30-49 years old), linoleic acid and riboflavin (in subjects 50 years and over) could be protective because control subjects consumed more of these nutrients than did the cases. PMID- 3562291 TI - Dietary fat, plasma lipoproteins, and immune function in middle-aged American men. AB - Dietary fat has been incriminated as a positive risk factor for the development of neoplasia in human populations. We used adipose tissue fatty acid analysis as an index of dietary fat intake to study the association between dietary fat and immune function in a group of 94 free-living American males (avg age 47 years). Immunocompetence was tested by a battery of T- and B-lymphocyte stimulation tests and also by natural killer (NK) cell activity. Correlations were sought between fatty acid composition, plasma lipids, and immune responsivity. The degree of unsaturation of the diet over a polysaturated-to-saturated fat ratio range of 0.54-1.01 had no predictable effect on the immune function. Stepwise regression analysis showed that the concentrations of plasma triglycerides and cholesterol and its subfractions did not explain any of the variance in the immune tests. Palmitic acid (16:0) was associated with 7% of the variance of the response to C. albicans and E. coli, perhaps through influencing B-cell activity. Stearic acid (18:0) was correlated negatively to concanavalin A responsivity (18% of the variance) and positively to NK activity (20% of the variance). If impaired in vitro immune function is a marker of increased risk for carcinogenesis, then our data do not support a role for dietary fat influencing in any systematic manner lymphocyte function in vitro, as reflected by proliferative response or NK activity. Further, plasma lipoproteins, in particular cholesterol levels, did not appear to affect any immune function test. It remains to be studied whether dietary fat, lipoproteins, or fat-soluble substances may influence membrane structure and function and prostaglandin formation as alternative pathways in the promotion of neoplasia. PMID- 3562292 TI - Vitamin A and tumor recurrence in bladder cancer. AB - Results are presented from an investigation concerning the effects of vitamin A on tumor recurrence in a group of 102 patients having early-stage bladder cancer. An odd's ratio of 1.34 was found for tumor recurrence between high and low consumers of vitamin A (p greater than 0.05). Moreover, the rate of tumor recurrence per 1,000 person-months at risk was found to be 1.8 times higher among low, relative to high, consumers of vitamin A (p less than 0.05). While these results are encouraging, larger data sets need to be assembled and analyzed before any definitive conclusions can be reached. PMID- 3562293 TI - Food habits of the people of the Caspian Littoral of Iran in relation to esophageal cancer. AB - A dietary survey was carried out in Mazanderan Province of the Caspian Littoral of Iran. The inhabitants of this province have the highest rate of esophageal cancer in the world. A total of 1,501 individuals, in 197 households, from 35 villages in different regions were studied. These regions, which were based on the staple food of the region, included the low-to-moderate risk areas of Shahsavar and Babol in central and western Mazanderan, where the staple diet is rice, and the high- and moderately high-risk areas of Turkoman Sahara (Gonbad and Gorgan) in the east, where the main food is local bread. Perhaps because of poverty and simplicity of the local dishes in the high-risk region, the inhabitants of Turkoman Sahara eat their food three to four times faster than do the people in the moderate- and low-risk regions. In this high-risk area, where the frequency of esophageal cancer is higher among females than among males, a special diet known as "majoweh" or "majum" is given to pregnant women. This food is a crushed mixture of sour pomegranate seeds, black pepper, dried raisins, and occasionally garlic; this combination irritates the esophagus because of the hot black pepper and the sharp, crushed pomegranate seeds. People in the high-risk region preserve their meat by sun drying, and a higher proportion of households in this region keep the preserved food for longer periods of time. Also, the inhabitants of the high-risk region drink more tea at a much higher temperature. Very little fruit and vegetables are consumed by the Turkomans of the high-risk region, whereas inhabitants in the low-risk area keep vegetables and citrus fruits as an important part of their usual diets. PMID- 3562294 TI - Dietary habits and colorectal cancer incidence in a second-defined kibbutz population. AB - The incidence of colorectal cancer in Israel is highest in European- and American born immigrants. This is believed to be related mainly to their dietary habits. To investigate this issue further, we compared the diets of a sample of members of a well-established kibbutz (BA), which was settled by immigrants of European origin, with the diets of an age- and sex-matched sample of European-born residents of Tel-Aviv and of a previously studied kibbutz (GB). The diet of the people of kibbutz BA compared with those in Tel-Aviv was significantly lower in poultry and significantly higher in polyunsaturated fats; it also had a higher polyunsaturated/saturated fats ratio. Compared with both the Tel-Aviv residents and the kibbutz GB members, the kibbutz BA members had a significantly lower intake of saturated fats; they also had a higher intake of dietary fiber, available carbohydrates, calories, and many minerals and vitamins. However, the incidence of colorectal cancers in the kibbutz BA population was slightly, but non-significantly, higher than expected, based on age, ethnic group, sex, and calendar year-specific national incidence rates. These results are in contrast to our earlier study in which we found that kibbutz GB had less colorectal cancer than expected; thus, the results of the current study are presently unexplained. PMID- 3562295 TI - Chronic toxicity of charred fish meat in Wistar rats. AB - An experiment was performed on Wistar rats to examine the possible carcinogenic effects of charred fish meat. Each group (of 30 male rats each) was fed one of the following diets: the standard diet mixed with 50% charred fish meat (Group 1), the standard diet mixed with 25% charred fish meat (Group 2), the standard diet alone (Group 3), or the 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) treatment in drinking water (Group 4); this last group served as positive control. The animals were observed for two years. No significant incidences of tumors were recorded. However, there were statistically significant incidences of nonspecific pathological lesions of the glandular stomach, such as erosion, regeneration, and hyperplastic epithelium. Also, an atypical epithelium of the stomach was found incidentally in two animals (Groups 1 and 2); this might suggest a premalignant condition. PMID- 3562296 TI - Fecal steroids and colorectal cancer. AB - The fecal steroid profiles of healthy subjects were compared with those of colorectal cancer (CRC) patients. The multicomponent profiles did not differ qualitatively in that CRC patients, like control subjects, had similar fecal steroids. The major bile acids detected in fecal extracts were lithocholic acid (LCA) and deoxycholic acid (DCA). The major sterol of animal origin was cholesterol and its bacterial metabolite coprostanol, whereas the major plant sterols were beta-sitosterol, stigmasterol, campesterol, and their corresponding bacterial metabolites. CRC patients excreted higher amounts of total major bile acids (LCA and DCA) than did the control group, but this difference was not significant. However, the LCA-to-DCA ratio was much higher in the CRC group [(1.43, p less than 0.01) compared with the control group (0.72)]. The control group excreted significantly higher amounts of total neutral sterols (p less than 0.001), sterols of animal origin (p less than 0.001), and plant sterols (p less than 0.001) compared with the CRC group; the plant sterols represented a much lower proportion of excreted total neutral sterols in the CRC group (p greater than 0.001) compared with the control group. We propose the following hypotheses. The LCA-to-DCA ratio may be an important discriminant market for CRC susceptibility. The fecal LCA-to-DCA ratio may depend on the differential hepatic synthesis of their respective precursors chenodeoxycholic acid (CDCA) and cholic acid. Hepatic synthesis of CDCA may be increased by more efficient conservation of dietary cholesterol because it has been shown that cholesterol of exogenous origin is the main precursor of this bile acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562297 TI - Diet and esophageal cancer in Calvados (France). AB - The role of nutrients and food factors in relation to esophageal cancer was observed in a large case-control study in a region having a high incidence of the disease. Several factors that increased or decreased the risk were identified. After adjusting for other covariates, we found that animal proteins and polyunsaturated fats had a significant protective effect. Separating the effects of specific nutrients was difficult because of the intercorrelation between individual intakes of most nutrients. Foods were not so highly intercorrelated. Fresh meat, citrus fruits, and oil were found to be protective. A dietary index combining these foods was used; between the lowest and the highest levels of intake, a nine-fold difference in risk was observed. This effect is added to that of alcohol, which remains the major risk factor. The adequacy of the concepts of nutrients and foods in epidemiological studies is discussed in addition to the theoretical and practical implications of the findings. PMID- 3562298 TI - [AIDS--acquired immunodeficiency syndrome]. PMID- 3562299 TI - [The fate of patients with chronic bronchitis during 3 years' observation in relation to respiratory function and pulmonary hemodynamics]. PMID- 3562300 TI - [Pulmonary function and pulmonary circulation in patients with chronic bronchitis after many years' observation]. PMID- 3562301 TI - [Long-term studies of inhabitants of industrial cities in Silesia with chronic bronchitis]. PMID- 3562302 TI - [Clinical usefulness of quantitative evaluation of microorganisms in the sputum in chemotherapy of pneumonia]. PMID- 3562303 TI - Afebrile pneumonitis in infants: predictors of outcome. AB - This study was performed to determine which elements of the history, physical examination, and laboratory data of infants with afebrile pneumonitis predict the need for hospitalization. We used a risk score based on clinical history and a respiratory score based on the respiratory physical examination, to assess 101 infants with afebrile pneumonitis in the emergency department. Admission and length of hospitalization were decided independently of the study. The population was divided into three groups depending on outcome: mild disease--outpatient management or hospitalization for up to 48 hours; moderate disease--three or more days of hospitalization; and severe disease--admission to the intensive care unit. Twenty-four infants were followed as outpatients. Seventy-seven children were hospitalized: 12 for 48 hours, and 61 for a mean of 4.5 days. Four children were admitted to the intensive care unit. Patients in group 2 versus group 1 were significantly younger and sicker on initial examination, as evidenced by a worse average respiratory score, general appearance, and severity of retractions. Other parameters, including risk score, did not predict course of illness as measured by length of hospitalization. Respiratory physical examination, especially general appearance and severity of retractions, and young age are associated with a worse outcome in afebrile pneumonitis. PMID- 3562304 TI - Hyperpyrexia in children: clinical implications. AB - A prospective study was done to determine the incidence of serious illness in children under two years of age with hyperpyrexia (temperature of 41.1 degrees C [106 degrees F] or greater). Nineteen children were seen and followed in the emergency department of Oklahoma Children's Memorial Hospital over a one-year period. The final clinical diagnoses included acute otitis media, pneumonia, acute gastroenteritis, roseola, and cellulitis of the leg. In the entire group there was no meningitis or subsequent death. One child was hospitalized. The statistical analysis (binomial test at the 0.05 level) confirms that the incidence of serious illness manifested only by high fever is no higher than 0.15. The mere presence of very high fever does not necessarily indicate a serious illness. Laboratory and other diagnostic work-up and hospitalization should be based on clinical evaluations, rather than done routinely. PMID- 3562305 TI - Forecasting asthmatic wheezing using temperature velocity. AB - A model was constructed to predict pediatric asthmatic wheezing visits to the emergency department. All wheezing visits to the Children's Hospital of Philadelphia Emergency Department were analyzed for 1982 and 1983, for ages two to 18. Nine thousand four hundred twenty-five visits fit the study requirements, 27% of the total number of emergency department visits for all causes. The a priori hypothesis used to construct the model was that temperature change, not absolute temperature, would be a good predictor of emergency department visits. Although not attempting to prove a cause-and-effect relationship, by studying temperature velocity (the rate of change of temperature) and the direction of change of temperature (a seasonal variable reflecting rising or falling temperature), a model was created that was highly significant (P less than 0.0001) and could explain 35% of the daily variation in asthmatic emergency department visits (R2 = 35%, r = 0.59). When weekly emergency department visits were analyzed, the model could explain 49% of the variation in the number of emergency department visits (R2 = 49%, r = 0.70). Carbon monoxide, barometric pressure, and relative humidity were also statistically significant predictors but were clinically insignificant, explaining only a few percentage points of the total variation. By taking advantage of the seasonal pattern of wheezing through the use of temperature velocity, predictive models for asthmatic wheezing can be greatly improved. They may also aid in planning emergency department staffing, and even help prevent emergency department visits by premedication or lifestyle change during high-risk periods. PMID- 3562306 TI - An animal model for the study of hemorrhagic shock from abdominal trauma in children. AB - Trauma is the most frequent cause of death in children over one year of age, and liver laceration secondary to blunt abdominal injury is frequently the major cause of hemorrhagic shock. In the current study, we have developed an animal model for the study of hemorrhagic liver lacerations in childhood. Using puppies six to 12 weeks of age, and three to nine kilograms in weight, we have been able to reliably produce shock (89%) without an excessive initial mortality rate (11%). The animals experienced a decrease in mean arterial pressure to 50% of the baseline level within 1.3 to eight minutes after the injury. This model will permit the study of various methods of resuscitation from blunt abdominal trauma in future experiments. PMID- 3562307 TI - Early coma in intussusception: endogenous opioid induced? AB - A decreased level of consciousness with little abdominal pain or gastrointestinal symptoms is an uncommon, but well described, presentation of infantile intussusception. Its etiology is unclear. We describe a 10-month-old male who presented with coma and miosis, reversible with bolus injections of naloxone on three separate occasions. No opiates were involved and an intussusception was subsequently found. We speculate that the coma and miosis were induced by an endogenous opioid which could also mask the abdominal pain, thus explaining this presentation of intussusception. If so, miosis would be a valuable clue for diagnosing such children. PMID- 3562309 TI - Massive pulmonary infarction in sickle cell anemia. PMID- 3562308 TI - Gastric perforation following cardiopulmonary resuscitation in a child: report of a case and review of the literature. AB - We report a case of gastric rupture complicating cardiopulmonary resuscitation in a 13 year old. The tear occurred on the lesser curvature of the stomach as in reported adult cases. A tear was not discovered until autopsy, despite extensive premortem investigation. In a comatose or paralyzed patient, laparotomy may be indicated in the evaluation of pneumoperitoneum following cardiopulmonary resuscitation. PMID- 3562310 TI - Spontaneous bilateral pneumothorax in an infant with bronchiolitis. AB - Spontaneous pneumothorax is an uncommon complication of bronchiolitis due to respiratory syncytial virus. Bilateral spontaneous pneumothorax in an infant with respiratory syncytial virus bronchiolitis has not been previously reported. We report the case of a four-month-old infant who presented in respiratory distress owing to respiratory syncytial virus bronchiolitis with bilateral pneumothoraces. The infant improved with evacuation of air from the chest. PMID- 3562311 TI - Sexual abuse of battered young children. AB - Four cases of battered children, in whom concurrent sexual abuse was present in the patient or siblings, are presented. The occurrence of both physical and sexual abuse in the same child has not received adequate attention in the literature, yet diagnostic and intervention procedures change drastically when both are present. The possibility of sexual abuse must be considered early in the course of caring for a physically abused infant or young child. PMID- 3562312 TI - The emergency physician in the courtroom: serving as an expert witness in cases of child abuse. PMID- 3562313 TI - Sudden onset of high fever and tachypnea. PMID- 3562314 TI - DSIP affects adrenergic stimulation of rat pineal N-acetyltransferase in vivo and in vitro. AB - The natural occurrence, sleep, and extra-sleep effects of delta sleep-inducing peptide (DSIP) have been shown by different laboratories. However, neither an in vitro assay system nor a probable mechanism of action of the peptide have been conclusively demonstrated so far. The recent finding that DSIP influences the nocturnal rise of N-acetyltransferase (NAT) activity in rat pineal led us to investigate a possible effect on pharmacologically induced NAT activity in vivo and in vitro. Stimulation of the enzyme with adrenergic drugs such as isoproterenol and phenylephrine was reduced by DSIP at doses of 150 and 300 micrograms/kg injected subcutaneously. In vitro, 6, 150 and 300 nM DSIP attenuated isoproterenol stimulation of the enzyme in cultured pineals, whereas 150 nM DSIP effectively reduced stimulation induced by a combination of the two drugs. The peptide alone did not influence NAT activity in vitro, but produced a slight stimulation in vivo. To our knowledge, these results represent the first report of a direct interaction of DSIP with adrenergic transmission. The in vitro system could prove useful for establishing possible mechanism(s) of action of the 'sleep peptide.' PMID- 3562315 TI - Quantitative autoradiography of angiotensin II receptors in the SHR brain. AB - Several lines of evidence indicate brain angiotensin II is associated with the elevation of blood pressure seen in the spontaneously hypertensive rat (SHR). These include an increased pressor response to intracerebroventricularly administered angiotensin II and a reduction of blood pressure in response to centrally administered angiotensin II receptor antagonists. Using quantitative receptor autoradiography, we have detected greater angiotensin II receptor binding in a number of discrete brain nuclei of the 6-week-old SHR when compared to age-matched Wistar-Kyoto controls. Tissue sections from various brain regions were labeled with [125I]-angiotensin II according to a previously described method. Autoradiograms were generated by apposing the labeled tissue sections to LKB Ultrofilm along with brain paste standards which contained known amounts of [125I]. Quantitation of the binding, utilizing computer-assisted microdensitometry, indicated greater [125I]-angiotensin II binding in several brain areas implicated in cardiovascular control including the subfornical organ, nucleus of the solitary tract, dorsal motor nucleus of the vagus, locus coeruleus, supraoptic nucleus and the organum vasculosum of the lamina terminalis. Scatchard analysis of the binding in the nucleus of the solitary tract indicated an increased receptor number (Bmax) was responsible for the change while binding in two forebrain structures, the subfornical organ and supraoptic nucleus, showed alterations in receptor number and affinity (Kd). Several other brain regions, unrelated to cardiovascular control, exhibited no change in [125I]-angiotensin II binding. Since the increased receptor binding was present primarily in brain regions related to cardiovascular control, we conclude that an increased angiotensin II receptor affinity and density is indicated as a factor in the etiology of the high blood pressure seen in the SHR. PMID- 3562316 TI - Distribution of neuropeptide K-immunoreactivity in the rat central nervous system. AB - The distribution of neuropeptide K (NPK), a 36-residue amidated peptide originally isolated from porcine brain, is described in the rat CNS by immunohistochemical methods. Antibodies were generated in rabbits to N-terminus and C-terminus regions of the peptide and the distribution of immunoreactive cell bodies and fibers was mapped in colchicine-treated and normal rat brains. Major areas of cell body staining included the medial habenular nucleus, the ventromedial nucleus of the hypothalamus, the interpeduncular nucleus, the lateral dorsal tegmental nucleus, the nucleus raphe pallidus, and the nucleus of the solitary tract. Some of the areas of dense NPK-fiber immunoreactivity included the ventral pallidum, the caudate-putamen, certain areas of the hypothalamus, the central and medial amygdaloid nuclei, the entopeduncular nucleus, the habenular nuclei, the substantia nigra pars reticulata, the caudal part of the spinal nucleus of the trigeminal nerve, the nucleus of the solitary tract and the dorsal horn of the spinal cord. A striking similarity exists between this pattern of immunoreactive staining and that described for substance P, suggesting that the tachykinin systems do not exist independently in the brain. The possible roles for multiple tachykinins in the brain are discussed. PMID- 3562317 TI - Catabolism of neurotensin by neural (neuroblastoma clone N1E115) and extraneural (HT29) cell lines. AB - The mechanisms by which neurotensin (NT) was inactivated by differentiated neuroblastoma and HT29 cells were characterized. In both cell lines, the sites of primary cleavages of NT were Pro7-Arg8, Arg8-Arg9 and Pro10-Tyr11 bonds. The cleavage at the Pro7-Arg8 bond was totally inhibited by N-benzyloxycarbonyl Prolyl-Prolinal and therefore resulted from the action of proline endopeptidase. This peptidase also contributed in a major way to the cleavage at the Pro10-Tyr11 bond. However the latter breakdown was partly due to an NT-degrading neutral metallopeptidase. Finally, we demonstrated the involvement of a recently purified rat brain soluble metalloendopeptidase at the Arg8-Arg9 site by the use of its specific inhibitor N-[1(R,S)-carboxy-2-Phenylethyl]-alanylalanylphenylalanine-p amino benzoate. The secondary processing of NT degradation products revealed differences between HT29 and N1E115 cells. Angiotensin converting enzyme was shown to degrade NT1-10 and NT1-7 in N1E115 cells but was not detected in HT29 cells. A post-proline dipeptidyl aminopeptidase activity converted NT9-13 into NT11-13 in HT29 cells but not in N1E115 cells. Finally bestatin-sensitive aminopeptidases rapidly broke down NT11-13 to Tyr in both cell lines. Models for the inactivation of NT in HT29 and N1E115 cells are proposed and compared to that previously described for purified rat brain synaptic membranes. PMID- 3562318 TI - Photoperiod-peptide interactions in the energy intake of Siberian hamsters. AB - Siberian hamsters (Phodopus sungorous sungorous) decrease their food intake when exposed to short ("winter-like") photoperiods. The cause of this naturally occurring hypophagia is unknown, but it may be due to a heightened sensitivity to the factors that normally terminate food intake in long photoperiods, such as the putative satiety peptides. The purpose of the present investigation was to test whether there would be an enhanced sensitivity to the inhibitory effects of some of these peptides on food intake in short relative to long days. Ad lib-fed, adult female Siberian hamsters were housed in a long photoperiod (LD 14:10) and injected with bombesin, glucagon, cholecystokinin octapeptide (CCK-8) and calcitonin (CT). Food intake was monitored 1, 2, 4, 6, and 24 hr post-injection. Bombesin and glucagon had no effect on food intake in long day-housed hamsters. CCK-8 and CT inhibited food intake; however, CCK-8 did so without any apparent behavioral disruption, while CT produced a marked and prolonged depression of behavior. After 10 weeks of exposure to a short photoperiod (LD 8:16) the hamsters were tested again. The previously ineffective dose of bombesin greatly inhibited food intake following short photoperiod exposure. In addition, an increased inhibition of food intake by CCK-8 was also found. In contrast, glucagon did not decrease food intake and CT still produced its non-specific, behaviorally disruptive effects. To our knowledge, this is the first demonstration that the effectiveness of a putative satiety peptide can be dependent upon a change in the photoperiod.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562319 TI - Interaction of bradykinin with sodium dodecyl sulfate and certain acidic lipids. AB - The striking change in the circular dichroism (CD) of bradykinin (BK) occasioned by its interaction with sodium dodecyl sulfate (SDS) is evidently due in large part to a change in the conformation of the C-terminal tetrapeptide moiety of the hormone. The full change in CD is induced by the binding of two molecules of monomeric SDS per peptide molecule, the complex being aggregated. Formation of the 1:2 BK-SDS complex apparently proceeds via intermediates of stoichiometry 1:1 and 2:1. The cooperative nature of the interaction is attributed to the SDS promoted aggregation of BK. Electrostatic interactions with the Arg residues appear important for the binding reaction per se. CD reveals that BK also interacts with acidic lipids which bear a net electrical charge (e.g., cerebroside sulfate and phosphatidyl inositol) but not with lipids bearing no net charge (e.g., cerebroside and phosphatidyl choline). The interactions are with particular mixed micelles of the lipid and the nonionic surfactant used for their solubilization, micellar size and structure being examined by surface tensiometry and electron microscopy. PMID- 3562320 TI - Correlation of structural changes in parathyroid hormone with its vascular action. AB - The analysis of the spectrum of circular dichroism (CD) of methionine-oxidized bovine parathyroid hormone peptide, bPTH(1-34) revealed that approximately 43% of the orderly conformation (alpha-helix and beta-sheet) was converted into random coil structure. This peptide failed to elicit any hypotensive response in rats at any of the tested doses from 0.01 to 0.05 mg/ml. The blue shift of tryptophan fluorescence and the increase in the fluorescence intensity of the fluorescence probe 2-p-toluidinylnaphthalene-6-sulfonate (TNS) bound to the oxidized peptide indicated that the more hydrophobic environment was generated in the tryptophan domain as well as the molecule as a whole when the methionines in the peptide were oxidized. Modification of arginine with 1,2-cyclohexanedione (CHD) reduced 30% to 50% of the hypotensive action of the peptide hormone. Similar results in the increase of hydrophobicity of the arginine-modified peptide were also observed. These studies suggest that the conformational changes due to the methionine oxidation or arginine modification may be related to the inactivation of the vascular activity of bPTH(1-34). PMID- 3562321 TI - Motilin and human pancreatic polypeptide measured in CSF from alcoholic and non alcoholic neurological patients. AB - Thirty-one CSF samples from alcoholics and non-alcoholic neurological patients were assayed for immunoreactive motilin and human pancreatic polypeptide (HPP). Both peptides were detected in all samples. Alcoholics without liver disease had significantly higher levels of motilin and lower levels of HPP than neurological controls. PMID- 3562322 TI - Endorphinic neurons are contacting the tuberoinfundibular dopaminergic neurons in the rat brain. AB - The anatomical relationships between endorphinic neurons and dopaminergic neurons were evaluated in the rat hypothalamus using a combination of immunocytochemistry and autoradiography. In the arcuate nucleus, endorphinic endings were seen making contacts with dopaminergic cell bodies and dendrites. No synapsis could be observed at the sites of contacts. These results strongly suggest that the endorphinic neurons are directly acting on dopaminergic neurons to modify the release of dopamine into the pituitary portal system. PMID- 3562323 TI - Carotid ligation alters cholecystokinin-8 (CCK-8) immunoreactivity in gerbil brains. AB - The unilateral or bilateral carotid arteries were ligated in gerbils used as a model of cerebral ischemia. The effect of different times of bilateral ischemia on the content of CCK-8 in fore regions of gerbil brain and the effect of 30 min of unilateral ischemia on the content of CCK-8 of the same regions in gerbils with or without neurological signs were observed. Our results show that the content of CCK-8 of cortex, basal ganglia, thalamus and hypothalamus decreased significantly. But, in brain stem it remained basically unchanged no matter whether the ischemia was unilateral or bilateral. This suggests that there is a close relationship between CCK-8 and cerebral ischemia, and raises the possibility that CCK-8 may be involved in cerebral ischemia through a yet unclear mechanism. PMID- 3562325 TI - [Calcium antagonists and bronchial asthma]. PMID- 3562324 TI - Endogenous opioids and opiate antagonists modulate the blood pressure of the spontaneously hypertensive rat. AB - Endogenous opioids have been implicated as modulators of the central nervous system regulation of blood pressure and heart rate. Whether these neuropeptides participate in blood pressure regulation in hypertension is unknown. To begin to study this question, we examined the response to opiate antagonists and agonists in the spontaneously hypertensive rat (SHR) and the normotensive Wistar-Kyoto (WKY) rat. The long-acting opiate antagonist naltrexone, 2.5 micrograms/kg, was injected into the lateral ventricle of the brain in awake, freely-moving SHR and produced a significant 19 mmHg decrease in mean arterial blood pressure compared to basal blood pressure (p less than 0.01); a decrease was not observed at a two logarithm lower dose. In contrast, naltrexone had no effect on the blood pressure of normotensive Wistar-Kyoto (WKY) rats. To evaluate a possible regulatory role for the predominantly kappa receptor active opioids, alpha- and beta-neo endorphin, 10 micrograms each, was administered to SHR on separate days by intracerebroventricular injection. alpha- and beta-neo-endorphin caused significant decreases in mean arterial blood pressure of 11 and 9 mmHg respectively, effects reversed by pre-treatment with the opiate antagonist, naloxone. Heart rate was unaffected by any of the injected opioids or antagonists. Our naltrexone results support the hypothesis that an endogenous opioid(s) contributes to the hypertensive state of the SHR. Additionally, alpha- and beta-neo-endorphin can lower blood pressure in this model. PMID- 3562326 TI - [Comparative evaluation of the usefulness of various methods for studying the serum IgE levels in the diagnosis of atopic bronchial asthma]. PMID- 3562327 TI - [Hyperventilation using cold air in detecting bronchial hyperreactivity compared with results of the histamine inhalation test and exercise test]. PMID- 3562328 TI - [Functional study of the respiratory system in hay fever]. PMID- 3562329 TI - [Remote results of the resuscitation of patients treated at the Intensive Care Center]. PMID- 3562330 TI - [Stomach cancer in patients under age 30]. PMID- 3562331 TI - [Lysosomal enzymes of peripheral blood lymphocytes in patients with stomach cancer]. PMID- 3562332 TI - [Neoplasm staging and possibilities of surgical treatment of cancer of the large intestine]. PMID- 3562333 TI - [Stomach cancer with an atypical hematologic picture]. PMID- 3562334 TI - [Microalbuminuria in diabetes mellitus type 1]. PMID- 3562335 TI - [Fibrinopeptide A in patients with diabetes mellitus complicated by angiopathy]. PMID- 3562336 TI - [Asymptomatic bacteriuria and arterial hypertension in patients with diabetes mellitus: the results of 8 years' observation]. PMID- 3562337 TI - [Value of the chlorpropamide-alcohol test in evaluating the risk of diabetes mellitus]. PMID- 3562338 TI - [Advances in the treatment of diabetic foot syndrome]. PMID- 3562339 TI - Anti-immunoglobulin antibody detection in adjuvant arthritis by an ELISA technique. AB - Sprague-Dawley rats, injected in the hind paw with heat-killed mycobacteria dispersed in oil, develop a severe polyarthritis. In this paper, we detected and quantified by a micro-ELISA technique autoantibodies against immunoglobulins in rats with adjuvant arthritis. Increased total anti-immunoglobulin antibodies levels were found from 3 days after induction and remained elevated until day 42. IgG anti-immunoglobulin antibodies in arthritic animals were significantly elevated during days 35-42. These results show that alterations in the humoral immune response (synthesis of anti-immunoglobulin antibodies) are present in adjuvant arthritis as they are in human rheumatoid arthritis. PMID- 3562340 TI - Metastatic tumors to the parotid and submandibular glands--analysis and differential diagnosis of 108 cases. AB - The distinction between primary salivary gland tumors and metastases of other primary tumors in salivary glands is of special importance for therapy and prognosis. In the files of the Salivary Gland Register, 10,944 cases were collected during 1965 and 1985. Among these cases, there were 108 cases of metastatic tumors to the parotid and submandibular gland. The pathohistological analysis of these tumors revealed the following data: 47 cases (43%) of metastatic tumors were localized in the parenchyma of the parotid gland (37 cases) or of the submandibular gland (10 cases). 61 cases (57%) displayed metastases in the lymph nodes of the parotid gland (38 cases) or of the submandibular gland (23 cases). The sublingual gland was free of metastatic tumors. 65 metastatic tumors originated from primary tumors in the neighborhood (head and neck). 32 tumors were carcinomas of the skin, 17 tumors were melanomas, and 13 tumors were nasopharyngeal cancers. Metastases of thyroid cancers were found in 3 cases. The relative frequency of metastases in the lymph nodes of the salivary glands is due to the intense drainage with lymph vessels and the presence of many lymph nodes which are localized especially in the gland parenchyma or around the parotid gland. 21 metastatic tumors originated from primary tumors distant from the head and neck region. There were metastases of lung cancers (7 cases), renal cancers (6 cases), mammary cancers (6 cases), colonic cancer (1 case) and uterus cancer (1 case). Clear cell carcinomas in salivary gland tissue should always be checked for a metastasis of a primary renal cancer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562341 TI - Morphometry of the breast fibroadenoma. AB - This work is concerned with a morphometric analysis of 23 breast fibroadenomas subdivided into four histological subgroups from purely pericanalicular to purely endocanalicular forms. The volume fractions (Vv) of the lumina and the total volume: epithelial surface ratios (Sv) showed a significant (P less than 0.001) correlation (r = + 0.64). In addition, the Vv and Sv series did not correlate with any of the histological subgroups. The data reported in this work suggest that the ductal epithelium proliferates in fibroadenomas, and that the subtypes are not related to the epithelial growth. PMID- 3562343 TI - Primary causes of perinatal death. An autopsy study of 556 cases in Greek infants. AB - The primary causes of death in 556 autopsy cases of perinatal death during the six years from 1979 through 1984 are discussed. On the basis of the clinical data and gross and microscopic findings, each case was assigned to one of the following categories of primary causes of death: a pulmonary hyaline membrane disease, infection, malformation, anoxia, immaturity, maternal causes, other causes, and unaccounted for Definitions of perinatal infant diseases, essential points of diagnosis, and statistics relating to perinatal infant death are also discussed. PMID- 3562342 TI - Fine structure of cellular and vascular reaction in brain tuberculomas: a model for phagocytosis in the CNS. AB - The fine structure of cells of the mononuclear phagocyte series (MPS) and a few other cells with phagocytic capacity, has been critically evaluated, mainly from an electronmicroscopic examination of the reactive border zone of 11 human brain tuberculomas, which provide ideal material for the study of macrophages. Most of them appeared to be blood monocyte-derived epithelioid cells of various forms and stages. The cytoplasm of these cells showed either more rough ER representing protein synthesising activity; or more frequently, phagosomes, phagolysosomes, dense bodies or empty vacuoles, representing various stages of ingestion and digestion of necrotic material. Often such material, which was more or less osmiophilic, was seen abundantly between the cells. These actively phagocytic cells occasionally undergoing, mitosis, are referred to as "epithelioid macrophages" and were morphologically similar to the "activated microglia" described in other conditions. They also showed a tendency to be closely adjacent to each other and occasionally fuse to form giant cells. There were also a number of lymphocytes and plasma cells. The latter showed various stages of active and granular or depleted and distended rough ER tubules, phagocytic activity and tendency to fuse. Expected vasculitis and small vessel necrosis formed part of this granulomatous reaction. Constituents of oedematous or necrosed brain tissue were seen immediately around the reactive zone of these tuberculomas, the most frequent being reactive astrocytes, many of which showed membrane-bound vacuoles. It is conceivable that the excessive pleomorphic cellular, vascular and necrotic reaction in these brain tuberculomas could have resulted from a delayed type of hypersensitivity to a very small quentity of antigenic tuberculoprotein, which probably initiates the chain of immunologic responses. PMID- 3562344 TI - Ultrastructural alterations and virus-like particles in lymph nodes of drug addicts with lymphadenopathy syndrome (LAS). AB - Lymph node biopsies from 16 cases of intravenous drug addicts with lymphadenopathy syndrome (LAS) have been examined at the electron microscope. The main ultrastructural alterations observed in the lymphocytes, dendritic reticulum cells and endothelial cells were tubulo-reticular structures (TRS), test tube and ring shaped forms (TRF) and nuclear pockets (NP). Images suggesting virus budding from lymphocytes and virus-like particles have also been found in 9 out of the 16 cases. The possibility to correlate the latter findings with a better knowledge of LAS evolution and prognosis is discussed. PMID- 3562345 TI - Occult papillary carcinoma of the thyroid gland revealed by cancer pericarditis. AB - We report a case of hemorrhagic exudative pericarditis in a 41-year-old man which was found to be due to metastatic dissemination of a 4 mm sclerosing carcinoma of the thyroid. Many psammoma bodies were found in the pericardial specimens and malignant cells with folliculoid pattern were observed in the pleural biopsy, arousing suspicion of occult papillary thyroid carcinoma. In the thyroid gland after total thyroidectomy a 4 mm sclerosing carcinoma was found. PMID- 3562347 TI - Cell proliferation studies in rat prostate. I. The proliferative role of basal and secretory epithelial cells during normal growth. AB - In the prostates of rats ranging from 10 days to 8 months of age, the proliferative activity of basal and secretory epithelial cells was studied. No clear evidence was found that basal cells alone represented the proliferative compartment, or that they were responsible for the replacement of secretory cells during normal turnover. Cell kinetic and morphological evidence indicated that basal and secretory cells were self-replicating cell types with discrete functions. PMID- 3562346 TI - Primary culture of epithelial cells derived from the rat ventral prostate: formation of three-dimensional acinus-like structure in collagen gel. AB - Rat ventral prostate epithelial cells were cultured in collagen gel after collagenase digestion. The primary cultures were mainly composed of single and spherical cells. After 10 days incubation in growth medium containing insulin, transferrin, and cholera toxin, there was a 3.8-fold increase in cell numbers, aggregates of which formed three-dimensional acinus-like structures. These structures consisted of one layer of cells surrounding the lumen. The cells were joined together with a junctional complex and had microvilli on the luminal surface and secretory vacuoles in the cytoplasm facing the lumen. The ultrastructural features of the cells were not altered by growth medium containing steroids. This culture system may prove to be very useful in elucidating proliferation, organization, and differentiation of prostatic epithelial cells in relation to the extracellular matrix and stromal cells. PMID- 3562348 TI - In vitro growth inhibition of Dunning rat prostate tumor by bone marrow factor. AB - Normal Copenhagen rat bone marrow was assayed for growth inhibition of cultured MAT LyLu rat prostate tumor cells. A marrow-derived factor was identified that had significant growth inhibitory activity in vitro against MAT LyLu as well as against DU-145 human prostate tumor and MBT-2 mouse bladder tumor cells but that was noninhibitory to normal rat fibroblasts. The factor was stable to degradation by acid, heat, freezing, trypsin, and carboxypeptidase B. The factor was nonreactive with Coomassie blue, and the molecular weight was estimated as less than 620 daltons. A similar factor was identified in normal human and normal rat sera. The presence of this factor in bone marrow may explain the absence of osseous metastases in the Dunning rat prostate tumor model. PMID- 3562349 TI - The effects of pulsed fluid irrigation on bony ingrowth in porous polyethylene implants. AB - Twelve adult dogs were used to evaluate the effect of pulsed isotonic saline irrigation on bony ingrowth. The distal supracondylar ridge of the knee was transected. Six dogs had the area irrigated with a pulsed lavage system for 15 sec and six dogs did not. A porous piece of polyethylene was then stapled to the cancellous surface. Three of each were evaluated histologically at 3 weeks and 6 weeks. The pulsed irrigation significantly decreased the depth of bone penetration into the sections of polyethylene. PMID- 3562350 TI - Fracture of polyethylene tibial component in a total knee replacement. A case report. AB - Aseptic loosening is the most common mode of failure for total knee replacements. Component breakage is rare, usually attributable to errors of design or manufacture. A case is presented in which rotational malplacement of the femoral component resulted in accelerated wear and eventual fracture of the polyethylene tibial component. PMID- 3562351 TI - Internal hemipelvectomy and reconstruction for malignant primary acetabular tumors. A report of five cases. AB - Five patients underwent hemipelvectomy and reconstruction for the treatment of a primary malignant tumor involving the acetabulum. There were no intraoperative complications and only one postoperative complication. All patients were ambulating within one week of surgery. During the follow up period which averaged 4 years, all patients remained ambulatory and pain-free, and none showed radiographic evidence of loosening or subsidence of the prosthesis or pins. PMID- 3562352 TI - Neural involvement in fractures of the distal radius. AB - A small series of patients with distal radius fractures were subjected to nerve conduction studies after healing of their fractures. A large number (52%) were found to have slowing of nerve conduction across the wrist, predominantly median. The age of those who were abnormal was significantly higher than those who were normal. No other factors appeared to influence the results. PMID- 3562354 TI - Subclavian vein thrombosis following fracture of the clavicle. A case report. AB - Clavicular fractures are common injuries, usually with uneventful sequela. A case of subclavian vein thrombosis following a clavicular shaft fracture is reported emphasizing the awareness and treatment of this uncommon complication. PMID- 3562353 TI - Wrist arthroplasty: a retrospective study. AB - A retrospective study was conducted to evaluate the long-term effectiveness of wrist arthroplasties in patients with various arthritic conditions. A total of 39 wrist arthroplasties were performed in 29 patients (average age, 52.5 years) by the orthopedic staff at Tulane University School of Medicine. Rheumatoid arthritis was the major presenting diagnosis in 84.6% of these operative cases and pain was the most common indication for surgery (79.5%). Postoperative relief of pain was reported in all of the cases reviewed, with an average follow up period of 51.2 months (range, 12 to 118 months). A group of 15 patients who were examined clinically had an average grip strength of 19.2 lb (range, 6 lb to 45 lb). Pinch measurements averaged 1.9 lb and arc of motion averaged 59.5 degrees (range, 20 degrees to 100 degrees) for these patients. Postoperative complications included dislocation (3 cases), fracture of the prosthesis (2 cases), and infection (2 cases). No complications were observed in 32 (82.1%) of the 39 cases reviewed. This retrospective study revealed that at an average follow up period of 51.2 months, pain relief was excellent and patient acceptance was good, with 94.9% of the wrists having been improved by the procedure. The majority (82.1%) of the cases were free of complication. It is concluded from this study that wrist arthroplasty is a viable alternative to wrist arthrodesis. PMID- 3562355 TI - Genu valgum associated with short stature. PMID- 3562356 TI - The use of CT scan in the evaluation of non-popliteal synovial cysts about the knee. AB - We investigated the diagnostic approach to non-popliteal synovial cysts about the knee. Included were all cases that occurred at the Wilford Hall USAF Medical Center in the past 5 years. The five patients all presented with a mass about the knee. The history and physical exam placed synovial cyst high on all five differential lists. All patients had a CT scan, and the CT failed to identify the cystic nature of the mass in any of them. We conclude that the CT scan is not useful in the evaluation of suspected non-popliteal synovial cysts about the knee. PMID- 3562357 TI - Pityriasis rubra pilaris in childhood: a long-term study of 29 cases. AB - Pityriasis rubra pilaris (PRP) is a dermatosis of unknown origin with a limited frequency in childhood (0.2% of our hospitalized pediatric patients). During the last 20 years we have observed 31 new cases; follow-up has been conducted in 29 children. The acute self-resolving form seems to be the most frequent in children, compared to adults. No cases of hereditary PRP have been observed, and no relationship between the severity of PRP and its prognosis has been reported. Since juvenile PRP has a relatively rapid course and a spontaneous resolution (a few months), it seems unnecessary to use potentially harmful drugs. Synthetic retinoids may be employed in patients whose disease is both persistent and disabling. PMID- 3562358 TI - Tinea faciei in infants caused by Trichophyton tonsurans. AB - Tinea faciei has been observed periodically in children, however, it is a relatively rare occurrence in infancy. We examined three infants with tinea faciei caused by Trichophyton tonsurans. Two of the patients were potassium hydroxide (KOH) negative for fungal hyphae but culture positive, while the third was both KOH and culture positive. Trichophyton tonsurans was isolated from the scalp of family members in two of the three infants. PMID- 3562359 TI - Epidermal nevus syndrome: report of association with transitional cell carcinoma of the bladder. AB - A 16-year-old boy with an extensive epidermal nevus and mild scoliosis had a transitional cell carcinoma of the bladder. The association of the epidermal nevus syndrome with a variety of other tumors and the rarity of bladder carcinoma in children may make the association more than coincidental. PMID- 3562360 TI - Childhood pemphigus foliaceus: case report and review of the literature. AB - Childhood pemphigus foliaceus typically causes erythema and scaling of the scalp. Sometimes, blisters and oozing are present, which often are misdiagnosed as either impetigo or seborrheic dermatitis. The eruption may progress to involve the trunk and limbs, the lesions often having an arcuate pattern. The diagnosis can be established by histologic and immunologic evaluation. In children, the disease seems to be less severe than pemphigus vulgaris, as is the case with adults, and we recommend a trial of topical steroids before embarking on systemic therapy. PMID- 3562361 TI - Acute miliary tuberculosis in a child with anhidrotic ectodermal dysplasia. AB - A 20-month-old boy with anhidrotic ectodermal dysplasia developed fever and papulopustular skin lesions. A skin biopsy showed the histologic changes of acute miliary tuberculosis. Anhidrotic ectodermal dysplasia is characterized by an absence of seromucous glands in the oropharynx and tracheobronchial tree, making children with this disease prone to viral and bacterial respiratory infections. Mild defects in their immunologic system have also been reported. We suggest that these abnormalities may have predisposed the patient to this rare form of cutaneous tuberculosis. PMID- 3562362 TI - Congenital self-healing reticulohistiocytosis: report of a case. AB - A newborn male infant presented with a single crateriform nodule in the region of the right iliac fossa. No extracutaneous involvement was found and the lesion involuted spontaneously without scarring in one month. Histology showed histiocytelike cells of which 10% to 15% contained Birbeck granules. S100 protein could not be demonstrated. This case possibly represents a solitary variant of congenital self-healing reticulohistiocytosis. PMID- 3562363 TI - Human fetal skin development. PMID- 3562364 TI - Management of vitiligo in children.Symposium. PMID- 3562365 TI - Aneurysmal subarachnoid hemorrhage. The critical need for prompt referral. PMID- 3562366 TI - The censorship of medicine in the United States. PMID- 3562367 TI - The multiply injured patient. Initial assessment and management. PMID- 3562368 TI - Diagnosis of stroke in young adults. AB - The cause of stroke in a young adult can usually be ascertained with proper workup. One of the most common causes is atherosclerotic cerebrovascular disease, and cigarette smoking is an important risk factor in young adults. Several types of nonatherosclerotic cerebral vasculopathy can also result in premature cerebral infarction; these include cervicocephalic arterial dissection, nonpenetrating traumatic arterial disease, moyamoya disease, fibromuscular dysplasia, vasculitis, and migraine. Cardiac embolism may play a more important role than was previously thought, and hematologic disorders (eg, sickle cell disease, polycythemia rubra vera, coagulation problems) are known to predispose patients to stroke. A careful history of risk factors and a thorough neurologic and cardiovascular examination followed by adequate testing, including angiography, are essential to diagnosis. PMID- 3562369 TI - Postoperative urinary retention. Guidelines and an algorithm. AB - Postoperative urinary retention is a common problem after surgery. Prevention includes obtaining a preoperative history and physical, having the patient void just before surgery, avoiding overhydration, and encouraging micturition soon after surgery. Management requires sterile catheterization, when indicated, to drain the urinary bladder completely. Urine cultures must be done when indwelling catheters are used. Antibiotics may be necessary. PMID- 3562371 TI - Psychological intervention in delirium. An important component of management. PMID- 3562370 TI - Health promotion for children. Key to a lifetime of health. AB - Evidence indicates that preventive healthcare in childhood reduces healthcare costs and enhances health. Physicians can assume a leadership role in promoting children's health by incorporating health promotion measures into their everyday practice, serving as resource persons or leaders in community and school efforts in health promotion, and lobbying for legislation aimed at preventive care. The goals of these efforts are to achieve a healthy childhood, provide a foundation for a healthy adulthood, and develop in children positive values about personal health responsibility and use of healthcare services. PMID- 3562372 TI - Fever of unknown origin. The general internist's approach. PMID- 3562373 TI - The patient with aches and pains. The general internist's approach. PMID- 3562374 TI - Intelligence testing of children. Key issues for physicians. PMID- 3562375 TI - Counterpoint. In defense of the community hospital. PMID- 3562376 TI - Sickle cell disease. Ways to reduce morbidity and mortality. PMID- 3562377 TI - Relative and absolute polycythemia. How to tell them apart. AB - Relative and absolute polycythemia can be differentiated by measuring red cell mass and plasma volume. Often no treatment is recommended for patients with relative polycythemia unless directed toward vascular complications; phlebotomy is definitely contraindicated. For patients with polycythemia vera, however, phlebotomy is used routinely to decrease blood viscosity, while myelosuppression is reserved for patients who are not relieved by phlebotomy alone. Secondary polycythemia is controlled by correcting the cause or by circumspect use of phlebotomy if the cause cannot be remedied. PMID- 3562378 TI - Laboratory tests to evaluate hereditary red cell disorders. PMID- 3562379 TI - Protection against electrocution. PMID- 3562381 TI - Neuroleptic malignant syndrome. PMID- 3562380 TI - Spinal manipulative therapy. PMID- 3562382 TI - Prevention of cardiovascular disease. Of what value are risk factor modification, exercise, fish consumption, and aspirin therapy? PMID- 3562383 TI - Colonic diverticular disease. Its spectrum in a community hospital. AB - A retrospective study of 239 patients who were hospitalized for diverticular disease is reported. Two thirds of patients had simple diverticulosis, and the remainder had gastrointestinal bleeding, evidence of microabscess, or more serious complications. The prevalence of bleeding on the left side in this series differs from the prevalence of right-sided bleeding noted in the literature, and this difference is unexplained. Only three patients in this series died (overall mortality, 1.2%); all had other associated life-threatening diseases. PMID- 3562384 TI - Peptic ulcer disease. The role of the primary care physician in therapeutic intervention. PMID- 3562385 TI - Kawasaki disease in a 4-year-old boy. AB - A 4-year-old boy experienced sudden fever, followed by a rash on the trunk and extremities and erythema of the pharynx. Five days later, the fever remained and erythema appeared on the oropharynx, tongue, and lips. The skin of the palms and soles became erythematous and indurated, and both conjunctivae became injected. Desquamation of the skin occurred on both thumbs and one finger, and an anterior cervical lymph node was found to be enlarged. The patient was diagnosed as having Kawasaki disease, and treatment with aspirin was started. The desquamation progressed to involve the entire surface of the palms and soles, and then symptoms resolved. Twenty years after recognition of Kawasaki disease, this enigmatic illness continues to defy attempts to understand its etiology and pathogenesis. Most experts agree that the cause is either an environmental toxin or an infectious agent, but other possible causative agents may need to be proposed and investigated. PMID- 3562386 TI - Effect of enzyme induction and inhibition on the fate of metronidazole and tinidazole in the rat. AB - The excretion routes of intact metronidazole and tinidazole were studied in rats kept in metabolism cages and cannulated for continuous bile collection. The nitroimidazoles were given intraarterially either alone or after a 5-day pretreatment with phenobarbitone (70 mg/kg/day intravenously) or after a single dose of cimetidine (50 mg/kg intraarterially). After 30 mg/kg, 27.0% of the metronidazole dose was excreted intact in 24-hr urine and 2.2% in bile. After tinidazole, the recoveries of the intact drug in urine and bile were 48.1% and 1.7%, respectively. After 90 mg/kg, the total recoveries of both drugs were 25 28% smaller than after 30 mg/kg. Phenobarbitone pretreatment did not affect metronidazole levels in plasma but decreased tinidazole levels at 4 hrs. The 24 hr recoveries of the intact nitroimidazoles in urine were significantly reduced by phenobarbitone while the 24-hr bile recoveries were not. Cimetidine treatment enhanced both metronidazole (at 1, 2 and 3 hrs) and tinidazole (only at 1 hr) concentrations in plasma, but this shift was not reflected in the 24-hr urine recoveries of the intact nitroimidazoles. Cimetidine doubled, however, the 24-hr bile recovery of the intact tinidazole. The calculations of the apparent degree of metabolism, assuming no methodological losses, showed that phenobarbitone increased the metabolism of tinidazole by about 62% and that of metronidazole only by about 16%. The effect of a single dose of cimetidine was negligible. PMID- 3562387 TI - Effects of methyl mercury on testicular functions in Macaca fascicularis monkeys. AB - These studies were performed to investigate the effects of MeHg on testicular function in Macaca fascicularis monkeys. In an in vivo study involving oral treatment of adult males Macaca fascicularis monkeys with MeHg for 20 weeks, changes in spermatozoal production, motility and morphology and in serum testosterone were followed before, during and after treatment. MeHg treatment significantly decreased % motile spermatozoa and scores for sperm speed and forward progression and increased % abnormal sperm tail forms, at sub-neurotoxic levels. The MeHg-induced increase in semen abnormalities was not accompanied by any significant changes in serum levels of testosterone. No consistent histological abnormalities were detected in testicular biopsies from the treated animals at the end of the treatment period. A good recovery pattern was observed for the MeHg effects on sperm motility while this was unclear for the effects on sperm morphology. PMID- 3562388 TI - 5-Hydroxytryptamine antagonists and the 5-methoxy-N,N-dimethyltryptamine-induced changes of postdecapitation convulsions. AB - The ability of various compounds to antagonise the 5-MeODMT induced prolongations of latency and duration of postdecapitation convulsions (PDCs) were compared. The 5-hydroxytryptamine (5-HT) receptor antagonists, mianserin, methergoline, cinanserin and methysergide antagonised the 5-MeODMT (0.5 to 4.0 mg/kg) induced prolongations of latency to onset of convulsions substantially and to a lesser extent the prolongation of duration. The efficacy of the 5-HT antagonists for blocking 5-MeODMT changes of PDCs was roughly of the order mianserin greater than cinanserin greater than methysergide greater than methergoline. Pirenperone, the 5-HT2 antagonist, and pimozide, the dopamine receptor antagonist did not antagonise the 5-MeODMT induced changes. Mianserin, methergoline, cinanserin and methysergide, by themselves, prolonged the duration of PDCs but did not affect latency. Pirenperone (0.25 mg/kg) prolonged both the latency and duration of the PDCs while pimozide (0.5-2.0 mg/kg) had no effect upon PDCs. This evidence suggests that 5-MeODMT induced changes of PDCs are mediated via 5-HT1 receptors and thus a reliable model to combine with other measures of spinal function is suggested. PMID- 3562389 TI - Tremorigenic effect and inhibition of tryptamine and serotonin receptor binding by beta-carbolines. AB - The abilities of some naturally occurring beta-carbolines (BCs), dihydro-BCs and tetrahydro-BCs to inhibit the specific binding of 3H-tryptamine (TA), 3H serotonin (5-HT) and 3H-ketanserine to rat brain membranes and to induce tremor in mice were studied. These compounds, particularly DHBCs and BCs, showed higher affinity for TA binding sites than to 5-HT1 or 5-HT2 binding sites inhibiting the former at nanomolar and the two latter ones at micromolar or high micromolar concentrations. The Ki values for norharmane, harmaline and harmine (17, 18 and 74 nM, respectively) for TA sites indicate the highest affinity so far described for natural beta-carbolines to any receptor sites and thus may indicate their major site of action. among the BC derivatives studied, the before mentioned harmala alkaloids were the most potent inducers of tremor in mice, although the orders of the tremorogenic potency and the binding to TA site did not correlate. It is suggested that especially the tremorigenic effect of BC derivatives is partly based on the binding to specific tryptamine receptors. PMID- 3562390 TI - Barbiturate and ethanol sleeping times and pharmacokinetics of propranolol in mice after intravenous administration of haem arginate. AB - Haem arginate is a new haem compound recently introduced for treatment of porphyrias. Previously haematin has been reported to increase certain hydroxylase activities in extrahepatic tissues, but even in therapeutic doses it impairs the microsomal foreign substance metabolism in the liver. Haem arginate at a dose equivalent to haem 10 mg/kg (threefold therapeutic dose) did not prolong the hexobarbital sleeping time of mice, 20 mg/kg did prolong the hexobarbital and possibly also the ethanol sleeping time. Haem arginate administered in high doses prior to oral propranolol did not alter the bioavailability of the latter. With regard to drug interactions haem arginate may be safer than haematin. PMID- 3562391 TI - A method using L-hyoscyamine for the study of muscarinic acetylcholine receptor binding in vivo. AB - Studies of muscarinic receptor concentration and comparative binding assays of agonists and antagonists are presently done in vitro by incubation and measurement of the binding to tissue homogenates of the radiolabelled potent antagonists 3H-scopolamine or 3H-quinuclidinyl benzilate. We have developed a technique based on gas chromatography-mass spectrometry that allows studies of the muscarinic receptor concentration to be performed in vivo under physiologic conditions. By injecting the optical antipodes of atropine, D- and L-hyoscyamine separately in mice and following their kinetics in different parts of the brain it was possible to separate the specific receptor binding of the active antipode L-hyoscyamine from that of the inactive antipode D-hyoscyamine, representing unspecific binding. Two hrs after the administration of L-hyoscyamine, 2 mg/kg intravenously, its concentration in brain was found to represent "maximum" specific binding. The physiological significance of specifically bound L hyoscyamine was tested on its blocking effect on oxotremorine induced tremor. PMID- 3562392 TI - Carcinogen metabolizing enzymes in nude mice. AB - Hepatic and cutaneous microsomal hydroxylating and conjugating enzymes from female and male NMRI nu/nu mice were analyzed, and the response of these enzymes to repeated exposures with 3-methylcholanthrene were studied. Sex differences were observed in basal activities of hydroxylating enzymes. These differences were not the same in the liver as in the skin and were reversed in female and male. Activity ratios of hepatic and cutaneous hydroxylating enzymes were between 40-200. The ratios between hydroxylating and conjugating enzymes were much lower in the skin than in liver. Furthermore the ratios were depending on hydroxylating enzymes. 3-Methylcholanthrene treatment increased both hydroxylating and conjugating enzymes in the liver and in the skin. Again, there were sex differences in the induction pattern, and also the induction in the liver was unrelated to that in the skin. There was no correlation in induction between hydroxylating and conjugating enzymes. PMID- 3562393 TI - Interaction of psychotropic drugs with brain muscarinic cholinoceptors: similarities of biperiden with pirenzepine in receptor binding properties. AB - It is generally accepted that there are at least three different subtypes of muscarinic cholinoceptors, pirenzepine being considered a selective M1 antagonist. In the present study, a number of different types of psychotropic drugs have been compared with pirenzepine and atropine as reference antimuscarinic drugs regarding their affinities for rat brain muscarinic cholinoceptors with the help of in vitro receptor binding studies. The most potent drugs, inhibiting 3H-1-quinuclidinyl benzilate (3H-QNB) binding at subnanomolar concentrations, were the antimuscarinic drugs scopolamine and atropine. Biperiden, promethazine, pirenzepine and some tricyclic antidepressants (amitriptyline, doxepin) were the next potent drugs, with IC50-values between 8.4 nM and 190 nM. The inhibition curves were steep and parallel giving Hill coefficients close to unity in all but two drugs studied. These exceptions were biperiden and pirenzepine both with Hill coefficients about 0.55. Thus, in addition to pirenzepine also biperiden seems to bind to the M1 receptor selectively. Additional receptor and functional studies are warranted to further elucidate the possible similarities of these two drugs. PMID- 3562394 TI - Acute effects of nomifensine on in vivo uptake and metabolism of dopamine, noradrenaline and serotonin in the rat brain. AB - Nomifensine, in contrast to all other antidepressants, inhibits the neuronal uptake of dopamine. The effect of this drug (10 mg/kg intraperitoneally) on the metabolism of dopamine, serotonin and noradrenaline was studied in the rat brain. After 1.5 hours, nomifensine increased the concentrations of homovanillic acid (HVA) in corpus striatum and total (free and conjugated) 3-methoxy, 4 hydroxyphenylglycol (MOPEG) in mesencephalon, but had no effect on the 5 hydroxyindoleacetic acid (5-HIAA) in pons/medulla oblongata and mesencephalon. The effect was identical with that of desipramine (25 mg/kg) on MOPEG and of imipramine (25 mg/kg) on 5-HIAA. Two methods ordinarily used for estimating turnover rates of monoamines were compared: accumulation of acid metabolites after probenecid (measuring efflux of metabolites from the brain) and accumulation of monoamine precursors after decarboxylase inhibition (measuring amine synthesis). The efflux was reduced for 5-HIAA and MOPEG but increased for HVA after nomifensine. Imipramine had the same effect on 5-HIAA and desipramine on MOPEG. Desipramine decreased the efflux of HVA from corpus striatum. In contrast, nomifensine did not change the synthesis of noradrenaline and serotonin significantly. Imipramine reduced the synthesis of serotonin in pons/medulla oblongata. In corpus striatum nomifensine, unlike imipramine, increased the concentration of 5-HIAA and synthesis of serotonin in spite of a decrease in efflux, probably because of a secondary effect from the dopaminergic action. The conclusion was made that there were more than one compartment of monoamine metabolites. The antidepressants could to some extent lead to a shift in the metabolism to sites more distant to the transport mechanism. PMID- 3562395 TI - [Angiographic vascular findings in pulmonary fibrosis]. PMID- 3562396 TI - [Short-term therapy with methylprednisolone in exacerbated obstructive respiratory tract diseases]. PMID- 3562397 TI - [Large bullous lung emphysema--diagnosis, therapeutic indications, therapeutic success]. PMID- 3562398 TI - [Chess player, visitor from a distant star, captain on a great river: Freud and Bateson--on the controversy between psychoanalysis and systems theory]. PMID- 3562399 TI - [A holistic classification scheme based on gestalt concepts, human ethology, systems theory and psychoanalysis]. PMID- 3562400 TI - [10 years of family therapy at a child guidance facility--development and developmental failure]. PMID- 3562401 TI - [Expert assessment of child welfare as a systemic-family therapy intervention]. PMID- 3562402 TI - [Family therapists' experiences of their families of origin. A report of experiences]. PMID- 3562403 TI - [Stuttering children and their families]. PMID- 3562404 TI - [Relation of early cognitive and communicative development in healthy and handicapped children]. PMID- 3562405 TI - [Child welfare in custody decisions--criteria from a developmental psychology viewpoint]. PMID- 3562406 TI - [Disorders of cognitive function in children and adolescents with acute psychoses and those at risk for schizophrenia]. PMID- 3562407 TI - [Parasitic larva as a cause of circumscribed liver lesions. Morphology and differential diagnosis]. PMID- 3562408 TI - [Decompensated benign nephrosclerosis--a forgotten disease]. PMID- 3562409 TI - [Disseminated cholesterol embolization. A commonly mistaken clinical complication of arteriosclerosis]. PMID- 3562410 TI - [The so-called trichoadenoma (Nikolowski)]. PMID- 3562411 TI - [Heterotopic gastric mucosa of the rectum]. PMID- 3562412 TI - [Extracranial extraneural metastasizing brain tumor]. PMID- 3562413 TI - [Features of the epidemiology of tuberculosis among children and adolescents]. PMID- 3562414 TI - [Ways of improving the prevention of recurrences of tuberculosis of the respiratory organs]. PMID- 3562416 TI - [Clinical value of diagnostic bronchoalveolar lavage in diffuse diseases of the lungs]. PMID- 3562415 TI - [Training of subintern-therapeutists in phthisiatry]. PMID- 3562417 TI - [Chief trends in the journal "Problemy tuberkulozy" in 1987]. PMID- 3562418 TI - [Clinico-roentgenologic features of newly diagnosed tuberculosis of the respiratory organs among adults today]. PMID- 3562419 TI - [Roentgenoendoscopic variants of tuberculosis of the intrathoracic lymph nodes of adults]. PMID- 3562420 TI - [Clinico-radionuclide studies in tuberculosis and non-tuberculous diseases of the lungs in adolescents]. PMID- 3562422 TI - [Levamisole in the treatment of late middle-aged pulmonary tuberculosis patients]. PMID- 3562421 TI - [Errors in the diagnosis of pulmonary tuberculosis]. PMID- 3562423 TI - [The course of tuberculosis of the respiratory organs complicated by primary carcinoma of the lung]. PMID- 3562424 TI - [Anatomo-topographic basis for surgery in tuberculous spondylitis]. PMID- 3562425 TI - [Aldozone--a new derivative of isoniazid synthesized using a monomeric hydrocarbon matrix as the base]. PMID- 3562426 TI - [Recommendations for the use of biochemical methods of testing in clinical practice (according to the findings of dissertations and papers in the journal "Problemy tuberkuleza")]. PMID- 3562427 TI - [Use of thoracoscopy in the diagnosis of tuberculous pleurisy]. PMID- 3562428 TI - [A case of tuberculous involvement of the liver]. PMID- 3562429 TI - [Status of the campaign against tuberculosis in the Latvian SSR]. PMID- 3562431 TI - Pancreatic microcirculation of dogs measured by hydrogen gas generated by electrolysis. AB - Electrochemically generated hydrogen gas was used to measure pancreatic regional blood flow in dogs by Koshu's method. This method is not necessary to inhale H2 gas and it is possible to generate H2 gas from H3O- in tissue in precise areas and to measure pancreatic regional blood flow easily, immediately, and steadily. Reliability and reproducibility were as good as for the H2 gas clearance method. Although the H2 gas clearance method has disadvantages in measuring pancreatic regional blood flow, especially in hypocirculation and in small animals, this new method can be used effectively. It will be useful in the investigation and examination of pathologic conditions in small animals and in humans. PMID- 3562430 TI - A rapid assay for serum immunoreactive lipase as a screening test for acute pancreatitis. AB - In 134 consecutive patients with acute abdominal pain, we evaluated the clinical role of a new rapid test for serum lipase based on latex agglutination. The results were compared with those obtained with a widely used lipase immunoassay as well as with serum amylase and pancreatic isoamylase measurements. Fifty-five healthy subjects were studied as controls. In 174 cases (121 patients and 53 controls) the results of the two lipase assays were in agreement. A positive lipase latex test was found in 10 of 12 patients with acute pancreatitis, in eight of 24 patients with other pancreatic diseases, and in 14 of 98 with nonpancreatic diseases. The sensitivity and specificity of this test were similar to those of the other pancreatic enzyme assays performed. The results indicate that the lipase latex agglutination test is useful for emergency screening for acute pancreatitis in patients with acute abdominal pain. PMID- 3562432 TI - Reproduction of postprandial neurotensin plasma levels by intravenous neurotensin and the effect of neurotensin on exocrine pancreatic secretion in humans. AB - A fatty meal releases neurotensin immunoreactivity from the small bowel in humans and dogs, and an infusion of synthetic neurotensin elicits exocrine pancreatic secretion in these species. It is not clear, however, which amount of exogenous neurotensin will reproduce endogenous neurotensin plasma levels as postprandial neurotensin immunoreactivity is composed of several fragments of neurotensin without biologic activity in addition to intact neurotensin. In order to clarify this question, we infused 1.25, 2.5, 5.0 and 7.5 pmol/kg/min synthetic Gln4 neurotensin in four volunteers, determined neurotensin plasma levels with a radioimmunoassay recognizing only intact neurotensin, and collected duodenal contents for estimation of pancreatic secretion. On another day, we determined neurotensin plasma levels after a fatty meal. Reverse-phase high-pressure liquid chromatography (HPLC) was performed on postprandial plasma samples. We found a stimulatory action of neurotensin on pancreatic secretion of volume enzymes and bicarbonate beginning with 1.25 pmol/kg/min neurotensin. The neurotensin plasma level after infusion of this dose of synthetic neurotensin was 69 pg/ml; after the meal, maximal neurotensin plasma concentration was 50 pg/ml (basal neurotensin plasma levels in both investigations were subtracted). HPLC indicated the presence of the tridecapeptide known to be the active molecular form of neurotensin in postprandial plasma. These results suggested that neurotensin plays a role as an endocrine hormone in the postprandial regulation of exocrine pancreatic secretion in humans. PMID- 3562433 TI - Cholecystokinin: a factor responsible for the enteral feedback control of pancreatic hypertrophyphy. AB - Chronic diversion of pancreatic and biliary secretions away from the proximal small intestine results in pancreatic hypertrophy in adult rats. Serum levels of cholecystokinin (CCK) were measured in age-matched control and surgically diverted rats at various times after operation by a radioimmunoassay method that was specific for the sulfated form of CCK. The concentration of CCK was markedly increased in bypassed rats as compared with controls. The increases in circulating CCK in bypassed rats was substantiated by a bioassay method that measured physiologically active CCK. The degree of pancreatic hypertrophy and the increase in CCK levels both progressed with time up to 23 days after surgery. Linear regression analysis showed an apparent direct correlation between pancreatic weights and serum CCK levels (r = 0.99). Feeding bypassed rats with diets containing various pancreatic and biliary supplements did not abolish the hyperplastic response of their pancreata. However, feeding with diets supplemented with bile partially suppressed the increase in serum CCK levels, while a diet containing Cotazyme and bile completely suppressed this increase. The discrepancy between serum CCK levels and the degree of pancreatic hypertrophy in the supplemented bypassed rats was further demonstrated by the lack of correlation using linear regression analysis (r = 0.33). The observed pancreatic hypertrophy in the absence of high serum levels of CCK in the bypassed rats fed bile and Cotazyme supplements suggests that serum hypertrophic factors other than CCK may also be involved in the enteral feedback regulation of pancreatic growth. PMID- 3562435 TI - Immunology of diabetes. A satellite symposium of the Sixth International Congress of Immunology. June 26-28, Edmonton, Canada. Abstracts. PMID- 3562434 TI - Dose-response effects of atropine on pancreatic secretory response to intravenous cerulein in dogs. AB - In conscious dogs with gastric and pancreatic fistulas, we studied the effect of i.v. atropine in doses ranging from 1.8 to 29 nmol/kg/h on the pancreatic secretory response to i.v. cerulein in doses ranging from 3.7 to 118 pmol/kg/h. Cerulein was given with an i.v. background infusion of secretin (20.5 pmol/kg/h), started 1 h before the lowest dose of cerulein was given. Secretin alone did not stimulate pancreatic protein output above basal. Doses of 7 and 29 nmol/kg/h of atropine significantly (p less than 0.05) decreased the protein output during secretin. A dose of 29 nmol/kg/h, but not lower doses, of atropine significantly inhibited the bicarbonate response to secretin. A dose of 3.7 pmol/kg/h and all higher doses of cerulein significantly stimulated bicarbonate and protein output above the value observed during secretin alone. None of the three doses of atropine given had any significant effect on the incremental bicarbonate and protein responses to cerulein. Secretin and cerulein did not alter basal heart rate; only the highest dose (29 nmol/kg/h) of atropine significantly increased heart rate. These findings are compatible with the hypothesis that cholinergic nerves do not alter the effect of exogenous cerulein, a CCK analogue, on pancreatic bicarbonate and protein secretion in dogs. PMID- 3562437 TI - Primary structures of canine pancreatic lipase and phospholipase A2 messenger RNAs. AB - cDNA clones coding for phospholipase A2 and lipase mRNA have been identified in a full-length cDNA library constructed from canine pancreatic poly (A) + mRNA. Phospholipase A2 mRNA contains 562 nucleotides and codes for a preproenzyme of 146 amino acids (Mr = 16,251) containing a 15 residue signal peptide (MetLysPheLeuValLeuAlaAlaLeuLeuThrValAlaAlaAla), a seven residue activation peptide (GluGlyGlyIleSerProArg), and a 124 residue mature enzyme, phospholipase A2 (79.2% homology with the porcine enzyme). The 5' nontranslated sequence contains a region where eight of nine bases show potential hybridization to the 3' end of 18S ribosomal RNA. Lipase mRNA contains 1,493 nucleotides and codes for a preenzyme with 467 amino acids (Mr = 51,489) which contains a 17 residue signal peptide (MetValSerIleTrpThrIleAlaLeuPheLeuLeuGlyAlaAlaLysAla) and a 450 residue mature enzyme, lipase (75.6% homology with porcine lipase). The 5' noncoding sequences for phospholipase A2 (28 bases) and lipase (34 bases) mRNAs both have an adenosine base three positions preceding the AUG initiation codon but otherwise demonstrate no homology. PMID- 3562436 TI - Role of cholecystokinin in the regulation of the interdigestive phase of pancreatic secretion. AB - The rate of pancreatic secretion during the interdigestive state varies with the phase of interdigestive motility. During phases II and III of interdigestive motility, pancreatic secretion is greatest, and minimal during phases I and IV. Pancreatic polypeptide and motilin have been reported to be increased during phases II and III but do not appear to be responsible for the stimulation of pancreatic secretion. We have investigated the role of cholecystokinin (CCK) in regulating pancreatic secretion during the interdigestive state. Eight volunteers underwent a study of interdigestive duodenal motility with a catheter that collected pancreatic secretions at the ligament of Treitz. The phase of motility was correlated with the output of trypsin and the plasma CCK levels. The output of trypsin during phases II and III was 0.9 +/- 0.2 and 1.0 +/- 0.2 mg/kg/h, respectively, and decreased to 0.3 +/- 0.1 mg/kg/h during phase IV-I (p less than 0.05). To determine if the output of trypsin during phases II and III was responsible for the increases in plasma CCK, the effect of intraduodenal trypsin, 3 mg/kg/h, in five volunteers was determined. The infusion significantly increased the output of trypsin to a mean of 3.1 +/- 1.9 mg/kg/h (p less than 0.05). The plasma CCK concentration increased with intraduodenal trypsin from 20.4 +/- 5 to 26.4 +/- 3.7 pg/ml (p less than 0.05). The infusion study was repeated in two volunteers with heat-inactivated trypsin. The mean CCK level rose from 19.6 +/- 4 to 23.8 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562438 TI - Effect of aging on pancreatic lipolytic enzymes. AB - Pancreatic lipolytic enzyme activities and plasma lipids were measured in three age groups of female Fisher 344 rats (3 months [young], 12 months [adult], and 27 months [old]) in order to evaluate age-related changes and a possible correlation of these parameters. Cholesterol esterase activity was measured in pancreas homogenate, while the lipase activity was further fractionated into heparin Sepharose unretained (lipase I) and retained (lipase II) fractions. In analogy to the lipolytic enzymes of the human pancreas, lipase I corresponds to pancreatic lipase and lipase II corresponds to pancreatic carboxylesterase. Plasma triglyceride and cholesterol levels were significantly higher in old as compared with adult and young rats. There was no significant correlation between plasma lipid and pancreatic enzyme activity levels. Cholesterol esterase and pancreatic lipase (lipase I) activity did not show any consistent change with age. Pancreatic carboxylesterase (lipase II), on the other hand, was consistently lower in adult and old animals. Although the importance of pancreatic carboxylesterase for triglyceride hydrolysis remains to be established, our results suggest that this enzyme is under long-term metabolic control. We suggest that early in life, high levels of this enzyme may be needed to supplement pancreatic lipase in order to optimize digestion of dietary fat required for optimal growth. PMID- 3562439 TI - Release of secretin by licorice extract in dogs. AB - To determine the effect of a fraction of licorice extract, FM100, on the endogenous release of secretin and exocrine pancreatic secretion, five dogs were prepared with chronic pancreatic fistulas and gastric cannulas. Intraduodenal administration of licorice extract (pH 7.4) in three different doses (0.5, 1.0, and 2.0 g) resulted in significant increases of both plasma secretin concentrations and pancreatic bicarbonate secretion in a dose-related manner. The plasma secretin concentration and pancreatic bicarbonate output produced by licorice extract correlated well. Intragastric administration of licorice extract (2 g) in 5% liver extract meal (in which pH was maintained at 5.5 by the intragastric titration method) resulted in significant increases of both plasma secretin concentration and pancreatic bicarbonate output. The increase in pancreatic bicarbonate secretion was completely abolished by intravenous infusion of a rabbit antisecretin serum in the two dogs so studied. Thus, the present study indicates that the endogenous release of secretion is involved in a mechanism of an increase in exocrine pancreatic secretin induced by FM100. PMID- 3562440 TI - Multicenter pathological study of chronic pancreatitis. Morphological regional variations and differences between chronic calcifying pancreatitis and obstructive pancreatitis. AB - To examine previous work carried out at a single center, i.e., France, on the pathologic features of chronic pancreatitis and to examine geographic differences, 359 cases of chronic pancreatitis from five centers were studied pathologically and the results analyzed according to appropriate statistical methods. It was found that it was easy to separate chronic calcifying pancreatitis from obstructive pancreatitis occurring distal to obstruction to the pancreatic duct by pathological means. On the other hand, geographic differences between France, Italy, Brazil, and South Africa, although present, were not sufficient for identification of a specific profile for each of the countries studied, and it was found that the minor differences were probably dependent on environmental rather than racial factors. PMID- 3562441 TI - Stimulatory effect of hypercalcemia on pancreatic secretion is prevented by pretreatment with cholecystokinin and cholinergic agonists. AB - Recently, we demonstrated that hypercalcemia causes marked stimulation of feline exocrine pancreatic secretion, and that this effect is absent when a large dose of cholecystokinin (CCK) is infused prior to induction of hypercalcemia. To investigate this effect in more detail, anesthetized cats were given calcium i.v. after preadministration of CCK or urecholine (a cholinergic agonist) at specific doses, or of saline as a control. We found that the hypercalcemia-induced stimulation of pancreatic protein secretion was abolished after preadministration of CCK at large doses. After the prestimulus dose was decreased or the calcium dose was increased, however, the pancreatic secretory response to hypercalcemia was preserved. In contrast, the response to a submaximal dose of CCK was unchanged after prestimulation with a large dose of CCK. Similar results were obtained when urecholine instead of CCK was used as prestimulus. These findings indicate that loss of pancreatic responsiveness to hypercalcemia following prestimulation with CCK is dependent on doses of both prestimulus and calcium used, and that it is not specific for prestimulation with CCK but also inducible by cholinergic agonists. They further suggest that this phenomenon is not due to exhaustion of pancreatic secretory capacity, but may reflect decreased sensitivity to the hypercalcemic stimulus instead. PMID- 3562442 TI - Effect of licorice extract (Fm100) on release of secretin and exocrine pancreatic secretion in humans. AB - We investigated the effect of a fraction of licorice extract (Fm100) on release of endogenous secretin in seven human volunteers using radioimmunoassay and exocrine pancreatic secretion using a dye dilution technique with polyethylene glycol 4000 as a non-absorbable marker. Intrajejunal administration of Fm100 (pH 6.5) in three different doses (200, 400, and 800 mg/30 min) resulted in significant increases in both plasma secretin concentration and pancreatic bicarbonate output in a dose-dependent manner (r = 0.737, p less than 0.001, and r = 0.483, p less than 0.01, respectively). However, it did not influence pancreatic secretion of protein or amylase. The correlation between plasma secretin concentrations and bicarbonate outputs was also significant (r = 0.483; p less than 0.01). These results indicate that endogenous secretin is released by Fm100 in humans and suggest strongly that the increased pancreatic bicarbonate secretion is attributable to the increased plasma concentration of secretin. PMID- 3562443 TI - Plasma cholecystokinin concentrations in patients with advanced chronic pancreatitis. AB - Plasma concentrations of cholecystokinin (CCK) have been reported to be elevated in patients with chronic pancreatitis. The elevations are suggested to be due to increased release of CCK from the upper small intestine secondary to the absence of protease activity (trypsin and chymotrypsin) in the intestinal lumen. We have studied plasma CCK levels before and after liquid as well as solid meals in eight patients with pancreatic insufficiency due to advanced chronic pancreatitis and in eight healthy controls. CCK concentrations were measured with a sensitive and specific radioimmunoassay using an antibody directed against the sulfated tyrosyl region of CCK. No differences in basal or maximal postprandial plasma CCK levels between patients and controls were observed. In the liquid meal study, basal CCK concentrations in patients and controls were 2.2 +/- 0.7 and 2.5 +/- 0.4 pM, respectively, with maximal postprandial concentrations of 9.6 +/- 2.2 and 11.2 +/ 1.4 pM. In the solid meal study, basal CCK concentrations in patients and controls were 2.5 +/- 0.6 and 2.6 +/- 0.4 pM, respectively, with maximal postprandial concentrations of 9.4 +/- 1.6 and 8.6 +/- 1.4 pM. The only difference observed was a significantly longer time interval to maximal plasma CCK levels in patients as compared with controls after the liquid meal. Two patients with no detectable trypsin activity in the small intestinal lumen during a Lundh test meal had basal CCK levels of 1.3 and 1.8 pM. Thus, the present study does not support the hypothesis that trypsin is involved in the regulation of CCK release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562444 TI - Endogenous CCK release and pancreatic growth in rats after feeding a proteinase inhibitor (camostate). AB - The serine proteinase inhibitor camostate was fed to rats in single, daily doses of 100 mg/kg, 200 mg/kg, and 400 mg/kg for 5, 10, or 15 days. Within 5 days, pancreatic size and protein, DNA, and enzyme content increased significantly. After prolonged administration, this trophic effect was more pronounced, and anticoordinate regulation of the synthetic rate of individual secretory proteins was observed. While enzyme content and protein synthesis of trypsinogen and chymotrypsinogen were increased, respective values for amylase were drastically reduced. Plasma levels of cholecystokinin (CCK) did not differ from controls when measured 24 h after administration of camostate. Immediately after oral feeding of camostate, CCK levels increased 10-fold above controls, reached a maximum after 90 min, and remained elevated for more than 6 h. Proglumide, a CCK-receptor antagonist, only slightly reduced the trophic action of the proteinase inhibitor. The data indicate that endogenous CCK release by a proteinase inhibitor is as potent in the modulation of pancreatic growth and individual enzyme synthesis as exogenous hormone application. PMID- 3562445 TI - Concentrations of secretin and CCK in plasma and pancreatico-biliary secretion in response to intraduodenal acid and fat. AB - To study the effect of emulsified oleic acid on pancreatic secretion and concentrations of secretin and cholecystokinin (CCK) in plasma, eight normal subjects received three sets of duodenal perfusates containing peptone pH 6.0 or pH 2.7, with and without 20 mM oleic acid. Pancreatic secretion was measured by an indicator dilution technique. At pH 6.0, peptone and oleic acid was about as effective as peptone pH 2.7 in stimulating secretin release. However, oleic acid in addition produced a three-fold increase in plasma CCK and was five times as effective as pH 2.7 in stimulating duodenal flow. Also, at pH 2.7, oleic acid augmented pancreatic secretion and concentrations of CCK and secretin in plasma. Duodenal output of amylase and bile salts was independent of the pH of infusate. Low pH alone was a very weak stimulant of CCK release and did not stimulate output of amylase and bile. Emulsified oleic acid is a potent releaser of secretin and CCK and augments the acid-induced pancreatic secretion. PMID- 3562446 TI - Pancreatic tissue pressure and pain in chronic pancreatitis. AB - Pancreatic tissue pressure (PTP) was measured peroperatively by the needle technique in 14 patients with chronic pancreatitis undergoing drainage operations for pseudocysts (six patients) or dilated ducts (eight patients). All patients suffered from severe abdominal pain before the operation, and a pain evaluation was made at discharge and after 8-18 months of observation. PTP was increased in all patients and was not different in the two groups. PTP decreased significantly in both groups after drainage. Pain relief at discharge was good or fair in 12 patients and poor in one (one patient died postoperatively). During observation, pain returned in four patients. Long-term pain relief was not related to PTP decrease, PTP after operation, type of operation, or patency of anastomosis as seen by endoscopic retrograde pancreaticography. PMID- 3562447 TI - Diagnosis and treatment of temporomandibular joint dysfunction. Advantages of computed tomography diagnosis. Stomatognathic treatment and acupuncture--a randomized trial. PMID- 3562448 TI - The length of the intraoral period of primary teeth. PMID- 3562449 TI - Developmental correlations in tooth formation timing in children with cleft lip and palate. PMID- 3562450 TI - Oral soft tissue pathology. An analysis of 6101 intraoral biopsies. PMID- 3562451 TI - A combination of acetylsalicylic acid and codeine phosphate versus acetylsalicylic acid as postoperative analgesics after mandibular third molar surgery. PMID- 3562452 TI - Quantitation of hepatic sinusoidal macrophages during the acute systemic inflammatory reaction in two animal species. AB - The participation of hepatic sinusoidal macrophages (HSM) in hepatocyte stimulation during the acute systemic inflammatory reaction has been suggested by recent in vitro investigations. A first attempt in studying the role of these cells in vivo would appear to be the quantitation of HSM at the different times of the inflammatory response, in order to determine whether the participation of HSM depends on the recruitment of blood monocytes to the liver or on the proliferation of resident cells. HSM were counted during the initial stages (0, 16, and 24 hr) of a turpentine-induced inflammation in the rat and the rabbit. They were identified on morphological grounds and were counted separately in the periportal and the perivenous areas of the hepatic lobule. No significant differences were found in the number of HSM per field at 0, 16, and 24 hr following the induction of inflammation. No variation in the distribution of these cells within the lobule could be detected during this period. These results do not support the hypothesis that the acute phase reaction is accompanied by an influx into the liver of newly recruited macrophages or by the proliferation of resident cells. Thus, if a commitment of HSM occurs in vivo during the acute systemic inflammation, it may depend on the activation of resident cells. PMID- 3562453 TI - Human aging: effect on the activation of lymphocyte cyclic AMP-dependent protein kinase by forskolin. AB - The effect of forskolin on freshly isolated human lymphocytes was characterized at the level of cyclic AMP-dependent protein kinase. Incubating lymphocytes in vitro with this potent adenylate cyclase activator led to time- and dose dependent activation of protein kinase. The amount of activation varied with the conditions of enzyme preparation, suggesting that lymphocyte cyclic AMP-dependent protein kinase was artifactually activated unless special precautions were taken during its preparation. Under these conditions, forskolin-dependent protein kinase activation was greater in lymphocytes isolated from young compared to elderly human subjects. These results demonstrate coupling between lymphocyte cyclic AMP production and cyclic AMP-dependent protein kinase activation decreases in an age-related manner in man. This decrease resembles the loss of lymphocyte adenylate cyclase activity reported previously and occurs without other changes in lymphocyte protein kinase that were detectable using these methods. The age-related decrease in protein kinase activation is probably accounted for, therefore, by the age-related decrease in the cyclic AMP synthesizing capacity of the lymphocyte. PMID- 3562454 TI - The treatment of Wilson's disease with zinc. IV. Efficacy monitoring using urine and plasma copper. AB - Progress has been made in establishing the efficacy and safety of oral zinc as a maintenance therapy for Wilson's disease. It is important to develop simple, noninvasive monitoring methods to assure the adequacy of zinc therapy in individual patients. In this paper we report the use of 24-hr urine copper and plasma copper measurements to monitor efficacy of zinc maintenance therapy in 30 Wilson's disease patients. In examples of therapeutic inadequacy such as noncompliance, these values increase. With continued long-term adequate therapy, they remain stable or decrease. These two simple monitoring tools appear to be very useful in monitoring Wilson's disease patients receiving zinc therapy. PMID- 3562455 TI - Poly(I):poly(C)-enhanced alveolar and peritoneal macrophage phagocytosis: quantification by a new method utilizing fluorescent beads. AB - Phagocytosis is an important immune function to quantify. This immune response may be modulated by exposure to biological response modifiers or by exposure to pollutants. A new technique for quantifying nonspecific phagocytosis of alveolar and peritoneal macrophages in the same animal has been developed that utilizes fluorescent polystyrene beads. When incorporated into inhalation studies, this technique can be used to determine whether the toxic effect of an inhaled pollutant is local (effect on alveolar macrophages), systemic (effect on peritoneal macrophages), or both local and systemic. This method results in a determination of both the level of phagocytosis (the percentage of phagocytic macrophages) and the macrophage specific activity (the number of beads phagocytized per macrophage). This method also allows a determination of adherence by quantifying the number of particles in contact with, but not phagocytized by, the macrophage. Macrophage preparations were incubated with fluorescent beads for 2 hr and cyto-centrifuged onto a glass slide. Fluorescent beads present on the slide or cell-associated but not ingested by phagocytosis were removed by immersing the slide containing the macrophage preparation in methylene chloride for 15-30 sec. Fluorescent beads ingested by phagocytosis were then easily quantified with a fluorescence microscope. This technique was used to assess the baseline levels of phagocytosis for rat alveolar and peritoneal macrophages from the same animal and the kinetics and level of enhanced phagocytosis for alveolar and peritoneal macrophages after injection with the interferon inducer polyinosinate-polycytidylate (poly(I):poly(C)). The kinetics of enhanced alveolar and peritoneal macrophage phagocytosis by poly(I):poly(C) were similar; however, stimulated phagocytic levels of peritoneal macrophages never reached the phagocytic activity observed for the resident, highly phagocytic alveolar macrophages. This elevated phagocytic activity is most likely due to interferon stimulated by particulate matter in the large volume of air processed by the lungs and is important for host defense against a number of different inhaled microorganisms. PMID- 3562456 TI - Efficacy of perfluorodecalin as an oxygen carrier for mouse and rat testes perfused in vitro. AB - Perfluorodecalin is a superior artificial oxygen carrier because of its high oxygen dissolving capacity, low toxicity, and short retention times within tissues. However, the instability of perfluorodecalin emulsions has hindered its application in blood substitutes. The present study addressed two questions. First, is perfluorodecalin deleterious to the endocrine function of testes? This question was examined by comparing testosterone secretion by testes perfused in vitro with medium incorporating either perfluorodecalin or erythrocytes as oxygen carriers. Second, can stable emulsions of perfluorodecalin be attained with the new surfactant Butronic U-1? This question was approached by determining the stability of perfluorodecalin emulsions containing either Butronic U-1 or Pluronic F-68, a proven ineffective surfactant. The experimental results support the efficacy of perfluorodecalin emulsions as oxygen carriers for mouse and rat testes perfused in vitro. Perfluorodecalin emulsions formed with Butronic U-1 were stable during the 4-hr perfusions but not during long-term storage. PMID- 3562458 TI - Hereditary and acquired complement deficiencies in animals and man. PMID- 3562457 TI - Abnormal tubulovesicular particles in brains of hamsters with scrapie. AB - Abnormal tubulovesicular particles of an average diameter of 23 nm have been observed in brains of mice with scrapie as well as in other animals with spongiform encephalopathies, but they were thought to be absent from the brains of hamsters with scrapie in which the highest known concentrations of the infectious agent occur. We observed in neuronal processes of hamsters as well as mice clusters of those tubulovesicular structures, most often in postsynaptic terminals. Such particles have now been seen regularly in both experimental and natural scrapie in all species examined as well as in other spongiform encephalopathies. PMID- 3562460 TI - Induced deficiencies in animals and man. PMID- 3562459 TI - Hereditary and acquired complement deficiencies in animals and man. Introduction. PMID- 3562461 TI - Reactions and side reactions to drugs. PMID- 3562462 TI - Dogs deficient in C3. PMID- 3562463 TI - Mice deficient in C5. PMID- 3562465 TI - Component deficiencies. 2. The fourth component. PMID- 3562464 TI - Summary of reported deficiencies. PMID- 3562466 TI - Component deficiencies. 4. The third component. PMID- 3562467 TI - Component deficiencies. 5. The fifth component. PMID- 3562468 TI - Component deficiencies. 6. The sixth component. PMID- 3562469 TI - Component deficiencies. 7. The seventh component. PMID- 3562470 TI - Component deficiencies. 8. The eighth component. PMID- 3562471 TI - Component deficiencies. 9. The ninth component. PMID- 3562472 TI - Deficiencies in regulator proteins. 1. C1 inhibitor. PMID- 3562473 TI - Deficiencies in regulator proteins. 3. Properdin. PMID- 3562474 TI - Deficiencies in regulator proteins. 4. Anaphylatoxin inactivator. PMID- 3562475 TI - Modulation by complement of immune complex processing in health and disease in man. PMID- 3562476 TI - The reactivity of the complement system. PMID- 3562477 TI - [Flavonoids of the leaves of Melissa officinalis L. (Lamiaceae)]. PMID- 3562478 TI - [The 4-amino-1,2-naphthoquinone derivatives of some psychotropic drugs of the desipramine type. Quinone-amine reactions, 23]. PMID- 3562479 TI - [Cardiovascular eicosanoids. Biosynthesis, pharmacology and nutritive intervention as well as analysis]. PMID- 3562480 TI - [X-ray diffractometry in pharmacy]. PMID- 3562481 TI - Chronic haloperidol effects on oral movements and radial-arm maze performance in rats. AB - Rats were examined for the development of adverse motor and cognitive effects during and after 24 weeks of chronic haloperidol (HAL) administration using an 8 arm maze and a computerized apparatus for measuring spontaneous oral movements. In the maze, HAL caused a significant decline in choice accuracy only during the first week of administration, whereas it caused a significant decline in locomotor speed throughout drug administration. There were no effects of HAL on maze behavior after withdrawal. Haloperidol reduced the number of mouth movements during drug administration, but after withdrawal there was a significant increase. This replicated a previous finding from our lab. The oral movements which did occur in the HAL-treated rats were slower than normal. The timing of the HAL-induced cognitive dysfunction was similar to the Parkinson-like disorder shown by patients given chronic neuroleptics, whereas the timing of the increase in oral movements after the withdrawal of HAL was more related to the appearance of tardive dyskinesia. There was evidence in both tests of a persisting sedation during chronic neuroleptic administration. PMID- 3562482 TI - The effects of ethanol on eye tracking in rhesus monkeys and humans. AB - The effects of ethanol on eye tracking function were compared in rhesus monkeys and humans using a similar experimental procedure. In Experiment 1, 3 rhesus monkeys were trained to visually track a projected image of a disk that oscillated sinusoidally along a horizontal plane on a screen. This training was accomplished using a procedure in which responses on a lever resulted in the delivery of water when the central area of the projected disk image was dimmed for a brief period. Intragastric administrations of ethanol at doses of 0.25 to 2 g/kg were tested during one-day test sessions using a cumulative dose procedure. Pursuit eye movements were disrupted at doses of 0.5 g/kg while lever pressing behavior was not disrupted until a dose of 2 g/kg was reached. In Experiment 2, pursuit eye movements of 6 humans were not disrupted when ethanol was given orally at cumulative doses of 0.25 to 1 g/kg, while microswitch pressing behavior was disrupted in some of the subjects at a dose of 0.5 g/kg. Blood ethanol levels increased in a dose-dependent manner in both species with higher levels in humans than in monkeys. The dose dependent effects observed in both species and qualitative similarities in some of the effects such as saccadic pursuit eye movements suggest that the eye tracking method employing monkeys is useful for predicting drug effects on sensory motor function in humans. PMID- 3562483 TI - Cholinergic involvement in the action of formetanate on operant behavior in rats. AB - Formetanate (FMT) is a formamidine acaricide/insecticide with a carbamate moiety in its molecular structure. FMT-induced lethality is reportedly due to inhibition of acetylcholinesterase. Here we report evidence of the neurochemical basis for the sublethal, behavioral effects of FMT in rats. In this experiment, 0.5 mg/kg of FMT (5 min before the 55-min test session) produced a pronounced suppression of response rates in rats trained to lever-press under a multiple fixed-interval 1-min fixed-interval 5-min schedule of milk reinforcement. Injections of scopolamine (0.1 mg/kg) and methylscopolamine (0.1 mg/kg) 15 min before FMT blocked the response rate suppression, whereas pretreatment with either mecamylamine (2 mg/kg) or hexamethonium (2 mg/kg) did not. These data suggest that FMT acts as an indirect agonist on central and peripheral muscarinic receptors, by inhibiting acetylcholinesterase, to produce changes in schedule controlled responding. PMID- 3562484 TI - Dopamine autoreceptor antagonists: effects on sleep-wake activity in the rat. AB - The effects of the putative dopamine (DA) autoreceptor antagonists cis-(+)-5 methoxy-1-methyl-2-(di-n-propylamino)tetralin, (+)-UH 232, and cis-(+)-5-methoxy 1-methyl-2-(n-propylamino)tetralin, (+)-AJ 76, on sleep-wake activity, EEG, and motor activity in the rat were studied. Both drugs induced a dose-dependent increase in wakefulness (W) and a reduction in non-REM sleep (NREMS). A definite tendency to a suppression of REM sleep (REMS) could also be observed. The results of spectral analysis indicated that EEG slow wave activity, a marker of sleep intensity, was particularly sensitive to the drugs. Slight differences between the two drugs were observed: (+)-AJ 76 seemed to be more efficacious than (+)-UH 232 in stimulating motor activity. (+)-UH 232 tended to suppress slow wave activity more strongly than (+)-AJ 76. It is suggested that the increase in W following administration of (+)-AJ 76 resulted predominantly from locomotor activation, while (+)-UH 232 might also act on dopaminergic mechanisms involved in the regulation of sleep. PMID- 3562485 TI - Differential effects of CGS 8216 and naltrexone on ingestional behaviour. AB - Effects of the pyrazoloquinoline CGS 8216 (a partial benzodiazepine receptor inverse agonist) and the opiate antagonist, naltrexone, were compared in several tests of ingestion in non-deprived and deprived male rats. Both naltrexone (0.1 10.0 mg/kg, SC) and CGS 8216 (1.25-10.0 mg/kg, IP) significantly reduced the consumption of a highly palatable saccharin-glucose solution by non-deprived rats. Both compounds were also effective in reducing, dose-dependently, the intake of palatable sweet or oily mash by non-deprived animals. Hence, naltrexone and CGS 8216 attenuated palatability-induced ingestional responses, and sweet taste was not necessary for this effect to occur. The two drugs also reduced the intake of the saccharin-glucose solution in food-deprived rats, but their effects diverged in water-deprived animals. CGS 8216 had relatively little effect in the thirsty animals, whereas the effect of naltrexone was enhanced. This difference was underscored in a final test of deprivation-induced consumption of water. Naltrexone reduced the drinking, but CGS 8216 had no effect. Taken together, these data indicate that CGS 8216 was more selective in its effects on ingestion. PMID- 3562487 TI - The interaction of d-amphetamine and naloxone differs for rats trained on separate fixed-interval or fixed-ratio schedules of reinforcement. AB - The effects of d-amphetamine and naloxone were investigated using two groups of rats trained on either an FR30 or F12 schedule of reinforcement. Amphetamine (0.1 1.0 mg/kg), and naloxone (1.0 and 10 mg/kg) administered separately reduced responding on the FR procedure in a dose-dependent manner. The combined administration of naloxone with amphetamine had an additive suppressive effect on responding. The same doses of amphetamine and naloxone, when given separately, did not significantly depress responding in the FI procedures. However, naloxone/amphetamine combinations produced a marked inhibition of lever-pressing. Naloxone did not alter the characteristic pattern of responding engendered by amphetamine in this schedule, as measured by the quarter-life and Index of Curvature. It appears that the type of procedure used is a critical factor in demonstrating the effects of naloxone on behavior, and the nature of naloxone/amphetamine interactions. PMID- 3562486 TI - Effect of pentylenetetrazol-induced convulsions on the development and expression of limbic kindled seizures. AB - Male Long-Evans rats experienced three convulsions induced by intravenously administered pentylenetetrazol (PTZ) and were then kindled by electrical stimulation of the olfactory bulb or amygdala. Pretreatment with PTZ did not alter the rate of kindling in either site but did enhance the expression of kindled seizures once generalization had occurred (PTZ-treated animals had significantly longer motor seizures, measured by clonus duration, than did saline treated controls). This suggests that PTZ-induced convulsions have selective effects on areas of the brain that are involved in the expression of the motor seizure. In addition, rats treated with PTZ after kindling had convulsions that were significantly longer in duration than any of their three pre-kindling convulsions, indicating that kindling produced an increased sensitivity to PTZ's convulsant effects. Comparison of this experiment with previous research suggests that the ability of a drug treatment to generate a kindling-like effect is related to the pattern of seizure activity that it produces. PMID- 3562488 TI - Changes in d-amphetamine elicited rotational behavior in rats exposed to uncontrollable footshock stress. AB - Male and female rats, selected on the basis of their rotational behavior in response to d-amphetamine, were exposed to either escapable footshock stress, inescapable footshock stress or no stress and were then given a shuttlebox escape task on the subsequent day. Following testing, the magnitude and direction of the animals' rotational responses to d-amphetamine were determined again. Inescapable footshock stress induced a selective change in the direction and intensity of rotational behavior that was dependent upon the subjects' sex and preexisting rotational bias. Right-rotating males and left-rotating females shifted their directional bias toward the opposite side, while left-rotating males and right rotating females displayed increased rotation in their pre-stress direction. Significant correlations were also noted between the intensity of pre-stress rotational behavior and performance on the shuttlebox shock escape task. The results are discussed with respect to stress' actions on the mesocortical dopamine system and how this system's sex-dependent asymmetrical organization may subserve part of the organism's general reaction to uncontrollable stress. PMID- 3562490 TI - Vinpocetine enhances retrieval of a step-through passive avoidance response in rats. AB - Vinpocetine, vincamine, apovincaminic acid, vinconate, aniracetam, Hydergine, and pemoline were evaluated for their ability to enhance retrieval of a step-through passive avoidance response in rats. The percentage of rats performing the avoidance response was found to decrease as a function of the number of days between training and retention testing (Day 1, 100%; Day 2, 65%; Day 3, 23%; Days 4 and 5, 0%). Vinpocetine administered 60 minutes prior to testing for retention significantly increased the number of rats performing the passive avoidance response. Retrieval enhancement was dose-related in an inverted U-shaped function with the effective doses at 18 and 30 mg/kg PO. In contrast, apovincaminic acid (1-400 mg/kg PO), vincamine (1-200 mg/kg PO), vinconate (1-200 mg/kg PO), aniracetam (1-300 mg/kg PO), Hydergine (0.1-10 mg/kg PO), and pemoline (1-30 mg/kg PO) were not effective. These data support the view that vinpocetine has cognition-activating abilities as defined in an animal model of memory retrieval. PMID- 3562489 TI - Cross-tolerance between muscarinic agonists: role of muscarinic receptors. AB - In order to explore the relationship between response to muscarinic agonists and brain muscarinic receptors, two mouse strains that differ in acute sensitivity (DBA and C3H) were injected chronically with DFP or infused with oxotremorine. Chronic DFP-treated DBA mice were not tolerant to DFP's effects on any measure, but they were cross-tolerant to the effects of oxotremorine on heart rate and body temperature. DFP-treated C3H mice were not tolerant to DFP or cross-tolerant to oxotremorine on any measure. Oxotremorine infusion resulted in tolerance to oxotremorine in both mouse strains, and chronically infused DBA mice were cross tolerant to DFP on five of the six measures. Oxotremorine-infused C3H mice were cross-tolerant to DFP on two of the measures. These results suggest that genetic factors influence the development of tolerance or cross-tolerance. These genetic factors do not seem to be related to changes in brain QNB binding. Both mouse strains showed comparable changes in QNB binding following chronic DFP and oxotremorine with DFP eliciting reductions in QNB binding in striatum and hippocampus and oxotremorine eliciting reductions in nearly every brain region. However, tolerance and cross-tolerance did not seem to correlate with changes in binding which suggests that the relationship between receptor changes and responses to muscarinic agonists must be examined further. PMID- 3562491 TI - An investigation of the role played by the superior colliculus and ventromedial thalamus in self-injurious behavior produced by intranigral microinjection of muscimol. AB - Bilateral injection of muscimol (30 or 60 ng) into the substantia nigra (pars reticulata) of rats produced a variety of stereotyped acts, self-injurious behavior (SIB), and antinociception. Bilateral electrolytic lesions of the superior colliculus strongly suppressed SIB without reducing the antinociceptive effects of intranigral muscimol. Electrolytic lesions of the ventromedial thalamus had no effect on behavioral responses to intranigral muscimol. These studies suggest that the SIB produced by intranigral muscimol is mediated by neuronal pathways that terminate in or pass through the superior colliculus. The ventromedial thalamus does not appear to play a role in mediating behavioral responses to intranigral muscimol. PMID- 3562492 TI - Naloxone sensitivity in squirrel monkeys under a schedule of shock titration. AB - In order to explore the conditions under which sensitivity to naloxone develops, naloxone's effects were examined in squirrel monkeys responding under a discrete trial schedule of shock titration. Naloxone's effects were examined prior to and following a chronic naloxone regimen in which 10 mg/kg of naloxone was administered daily for at least 21 days. The level at which monkeys maintained the shock and rates of responding were recorded. Prior to chronic administration, selective doses (1.0, 3.0 mg/kg) of naloxone decreased shock levels slightly. These decreases were accompanied by increases in response rates. Subsequent to chronic administration, shock levels were unaltered; however, rates of responding showed greater increases. These results suggest that, following chronic naloxone exposure, animals responding under a schedule of shock titration became more sensitive to the rate-increasing effects of naloxone, but not to naloxone's effects on shock intensity. PMID- 3562493 TI - Behaviourally specific interactions between naloxone and beta-phenylethylamine in an operant drug discrimination procedure in rats. AB - Rats were trained to discriminate phenylethylamine (PEA) at 30 mg/kg (IP). In subsequent generalization tests, it was found that naloxone had no effect on the discriminative stimulus (cue) properties of PEA, but it did potentiate PEA's dose related rate suppressant effects. Thus the potentiation by naloxone of PEA's effects was behaviourally specific and confined to drug effects on motoric behaviours. These data support the results of previous in vivo and in vitro studies, which suggest that interactions between endogenous PEA and endorphin systems may be functionally important. Such interactions could be of significance in stress-related behavioural disorders. PMID- 3562494 TI - Interactions of clonidine with phencyclidine and ketamine: studies of radial maze performance and righting reflex in rats. AB - Rats were trained to obtain food pellets in an 8-arm radial maze until a criterion of 89% efficiency, i.e., all arms entered within 9 arm entries, was reached in 5 consecutive sessions. Decreases in efficiency caused by phencyclidine (PCP; 4 to 9 mg/kg, IP, 15 min before testing) or ketamine (25 mg/kg, IP, 5 min) were attenuated when subjects were pretreated with clonidine (0.05 mg/kg, IP, 30 min). However, significant improvements in performance in the maze were not observed when clonidine (0.05 to 0.4 mg/kg, IP) was administered 15 min after PCP (9 mg/kg, IP, 45 min). Subsequent studies of righting reflex demonstrated an increased frequency and duration of anesthesia when clonidine (0.05 mg/kg, IP) was administered 15 minutes before PCP (12.5 to 50 mg/, IP) or ketamine (50 to 100 mg/kg, IP). When clonidine (0.05 mg/kg, IP) was administered 15 minutes before [3H]PCP (40 microCi/kg, IP), brain levels of tritium were reduced by 42 to 55%. The present findings do not support the suggestion that clonidine may be useful in the treatment of PCP intoxication. The data does indicate that pretreatment of surgical patients with clonidine may reduce the dose of ketamine required for anesthesia. PMID- 3562495 TI - Reinforcement reduces behavioural impairment under an acute dose of alcohol. AB - Two experiments employed a total of 25 male social drinkers who learned a complex psychomotor task (Tracometer) and subsequently performed it 20 times under alcohol (0.60 g absolute alcohol/kg) while blood alcohol concentrations (BAC) rose and fell. In each experiment, one group received reinforcement for drug compensatory performance (RP) and one received no reinforcement (P). The BACs associated with the onset and offset of behavioral impairment under the dose were measured, and these thresholds were significantly higher in RP than P groups; reinforcement delayed the onset and also hastened the offset of drug effects. The accelerated recovery from impairment was considered to imply that reinforcement may facilitate the adaptive process involved in acute tolerance. Since this same reinforcement treatment accelerates the development of tolerance to repeated doses of alcohol, the results of the present research suggest that the behavioural effect of acute and chronic doses may both be similarly influenced by environmental learning factors. PMID- 3562496 TI - Increased self-administration of cocaine following haloperidol: effect of ovariectomy, estrogen replacement, and estrous cycle. AB - Rats which have been trained to self-administer cocaine intravenously show a dose dependent increase in drug intake when pretreated with dopamine antagonists. This neuroleptic-induced increase in cocaine intake may be related to the antipsychotic potency and suggests that self-administration behavior may provide a useful model for evaluating neuroleptic activity. The present study examines the influence of ovarian hormones on the potency of the neuroleptic haloperidol using the cocaine self-administration model. It was found that the potency of haloperidol fluctuated across the estrous cycle with subjects in diestrus self administering more cocaine than animals tested in estrus or proestrus. It was also demonstrated that the potency of haloperidol was reduced significantly following ovariectomy (OVX), however this OVX-induced attenuation could not be reversed with a number of estrogen or catechol-estrogen treatments. To the extent that the self-administration model can reflect the potency of antipsychotic drugs, these data indicate that ovarian function can affect neuroleptic activity, although the hormone(s) involved remain unclear. The clinical implications of these data underscore the need to further examine the influence of female sex hormones on the therapeutic efficacy of antipsychotic drugs. PMID- 3562497 TI - Motivational vs. motor effects of striatal and pallidal gabergic projections to subthalamic and entopeduncular nuclei, ventromedial thalamus, and ventral globus pallidus. AB - Four GABA-terminal sites downstream from the rat corpus striatum were injected bilaterally with either a GABA agonist (muscimol 15-250 ng) or antagonist (picrotoxin 15-300 ng), and the effects on spontaneous locomotor activity or variable-interval hypothalamic self-stimulation were recorded. Significant changes in locomotor activity were produced at all four sites, as in previous studies. Two of the sites tested, the anterior globus pallidus and the thalamic ventromedial nucleus, also receive gabergic projections from the nucleus accumbens or from structures other than the basal ganglia; at these two sites, injection of either muscimol (depressant), or picrotoxin (facilitatory), had the same effect on self-stimulation as on locomotor activity. The two other sites tested, the entopeduncular nucleus and subthalamic nucleus, do not receive projections from the accumbens; in these two structures, muscimol enhanced locomotor activity but abolished self-stimulation; picrotoxin was without significant effect, or was disruptive. These results confirm previous reports that gabergic systems downstream from the striatum can mediate a simple, innate motor sequence (locomotion), but they fail to demonstrate a specific involvement of these pathways in learned behaviour (self-stimulation). PMID- 3562498 TI - The effects of ethanol on the offense and defensive behaviors of male and female rats during group formation. AB - In order to determine the effects of ethanol on social/agonistic interactions of rats in mixed-sex groups, saline or 0.3, 0.6, or 1.2 g/kg injections of ethanol were given to one male in 3 M, 3 F groups just prior to placement of the animals in a colony situation. Scores of offensive behaviors by the treated males generally declined as a function of dose level, but only with the 1.2 g/kg dose were behavior scores significantly different from the saline control. Ethanol effects on defensive and sexual behaviors were not significant. The proportions of attacks directed at females by males given higher ethanol doses increased sharply and significantly. Females were not attacked more by untreated males in the same groups where treated males showed selective attack on females. These findings suggest that increasing levels of ethanol administration may produce changes in male rats' choices of targets for attack, with females becoming relatively more likely to be targets. PMID- 3562499 TI - Biphasic dose-response relationship for effects of toluene inhalation on locomotor activity. AB - To investigate the effects of inhalation of toluene on spontaneous locomotor activity, rats were exposed to graded concentrations of toluene and locomotor activity was measured continuously before, during and after exposure. This study used a randomized, cross-over, graded-dose experimental design, with sham exposure as the control. The locomotor activity pattern during toluene exposure depended upon the toluene concentration in the air. At the lowest effective concentration (5000 ppm) locomotor activity increased monophasically during exposure, and decreased monophasically during recovery. At higher concentrations (10,000-15,000 ppm) locomotor activity initially increased in a concentration dependent manner. With continued exposure to the higher concentrations, locomotor activity decreased and eventually ceased at the highest concentration. Recovery from exposure to high concentrations of toluene was also biphasic. These results demonstrate that the behavioral responses to extremely high concentrations of toluene are characterized by biphasic actions as demonstrated both by analysis of concentration-response and time-action characteristics. Exposure to concentrations of toluene similar to those used in this study occurs during organic solvent abuse and glue sniffing in humans. PMID- 3562500 TI - Amphetamine-induced on- and off-wall rearing in adult laboratory rats. AB - Recently, Bauer reported that amphetamine did not increase rearing behavior in adult rats. This result is at variance with many earlier reports demonstrating that amphetamine does increase rearing behavior. Because Bauer's automated measure only detected rearing when it occurred on the wall of the cage, it is possible that amphetamine only increased rearing behavior that occurred off the wall, which was not measured in his study. Bauer also included non-habituated animals in his study which might account for the discrepant results. The present experiment was performed to determine if, indeed, there was a difference between amphetamine induced on- and off-wall rearing and to determine to what extent habituation affected both types of rearing. The findings demonstrated that both types of rearing increased following d-amphetamine administration for both habituated and non-habituated animals. However, at the highest dose of d amphetamine studied (4 mg/kg) rearing occurred mainly on the wall. Additionally, rearing behavior was found to increase following amphetamine when measured in the Digiscan Animal Activity Monitoring system which detects, but does not discriminate between, both on- and off-wall rearing. PMID- 3562501 TI - Differential convulsive susceptibility of high-activity and low-activity selected mice in response to GABA antagonists. AB - Lines of mice selectively-bred for High and Low-Activity in an open-field maze were tested for seizure susceptibility to three analeptics: flurothyl, pentylenetetrazol and bicuculline. The major finding was that two replicate High Activity lines were more susceptible to myoclonic convulsions but less susceptible to clonic convulsions than their respective replicate Low-Activity lines. The major exception to this finding was that the High and Low-Activity lines did not differ for bicuculline-induced clonus although females tended to conform to the general pattern. These results are interesting because they demonstrate that diametrically opposite susceptibility to myoclonus and clonus is not an isolated phenomenon. Similar seizure susceptibility patterns and activity differences have also been reported for the Long-Sleep and Short-Sleep selectively-bred mouse lines. Further, since the progenitor population of the High-Activity and Low-Activity lines were developed from strains that were also part of the progenitor population of the Long-Sleep and Short-Sleep lines, it is hypothesized that some of the same alleles underwent selection in both selective breeding programs. PMID- 3562502 TI - Age-dependent changes of brain GABA levels, turnover rates and shock-induced aggressive behavior in inbred strains of mice. AB - Shock-induced aggressive behavior (SIAB) is absent or very weak in C57BL/6 (C57) mice at the age of 12 weeks while it reaches high levels at the age of 20 weeks. This age-dependent increase of aggressive responses is absent in DBA/2 (DBA) mice. Aggressive C57 mice (20 week old) are characterized by lower GABA levels in amygdala, striatum and substantia nigra than both non-aggressive C57 (12 week old) and DBA mice (12-20 week old). Concerning turnover rate, C57 mice at the age of 20 weeks show lower turnover rate values in cerebellum and raphe and higher values in septum in comparison with 12 week old mice of the same strain. These results are discussed in terms of the role of GABA function in brain areas which are involved in the control of emotionality and aggressive behavior. PMID- 3562503 TI - Protein changes in the rat's prefrontal and "inferotemporal" cortex after exposure to visual problems. AB - The proteins D2 (N-CAM) and D3, both markers for brain neuronal membranes, MM, a marker for mitochondria, and CM, a cytoplasmic marker protein, were studied in the prefrontal (anteromedial) cortex and "inferotemporal" (Te2) cortex of rats by crossed immunoelectrophoresis. Three experimental groups were investigated: Rats trained to criterion in a visual pattern discrimination test (learning), those run as yoked controls and finally, rats kept in individual cages and not subjected to any training (passive). Statistical analysis indicated that behavioral procedures and marker proteins contributed significantly to the variation. Further analysis indicated that the significant changes occurred in the D3- and MM-protein and that both the learning and yoked control groups had significantly increased concentrations of these two proteins when compared to the passive group. Furthermore, the concentration of D3- and MM-protein in the yoked control group was significantly higher than that of the learning group. The results seem to indicate that changes in concentration of these proteins can be more easily related to the activity of "searching for an adequate behavioral strategy" than to the formation of an "engram". PMID- 3562504 TI - Co-dergocrine, cerebral glucose utilization and maze performance in middle-aged rats. AB - The objective of this study was to determine the effect of co-dergocrine in rats on local cerebral glucose utilization and performance in a complex T-maze. Middle aged (12-16 months) male Fischer-344 rats were given injections of co-dergocrine (3 or 10 mg/kg, IP) 35 min before behavioral testing or the administration of 2 deoxy-D-[1-14C]glucose ([14C]DG), a radiotracer for local cerebral glucose utilization (LCGU). Both doses stimulated LCGU in the locus ceruleus and median raphe nucleus and in subcortical structures associated with learning and memory (hippocampus and subiculum). The higher dose also stimulated LCGU in motor areas (caudate-putamen, globus pallidus, internal capsule). In contrast, co-dergocrine decreased LCGU in the frontal cortex. Poorer performance in a complex maze (increased shocks, errors and run time) was observed in middle-aged as compared with younger animals (3 months). Acute co-dergocrine treatment did not improve performance of middle-aged rats in this task. Thus, in the present experimental paradigm employing single dose administration, co-dergocrine's stimulation of LCGU was not associated with an alteration of maze performance in age-matched animals. PMID- 3562505 TI - Membrane activity, antioxidant, antiaggregatory and antihemolytic properties of four calcium channel blockers. AB - Four calcium channel blockers: nifedipine, fendiline, verapamil and diltiazem have been found to possess different affinity to cytomembranes of platelets and erythrocytes. Nifedipine bound to proteins of the external site of cytomembranes. Verapamil and fendiline possessed affinity to lipids of the cytoplasmic site of the cytomembranes. Diltiazem bound practically neither to erythrocyte nor to platelet membranes. All tested compounds were antioxidants, the strongest being fendiline. Antiaggregatory and antihemolytic properties of tested compounds were roughly correlated with their membrane activity. PMID- 3562506 TI - Effect of cadmium clonidine interaction in rats. AB - Clonidine (5, 15, 50 micrograms/Kg i.v) caused dose dependent initial transient pressor response which was blocked by cadmium acetate (1 mg/Kg i.v) in dose dependent manner in anaesthetized rats. Cadmium acetate did not antagonize the pressor response of noradrenaline (4 micrograms i.v) which was blocked by Priscoline (10 mg/Kg i.v). Results of these experiments indicate that cadmium specifically blocks the initial transient pressor activity of clonidine. Cadmium is devoid of any adrenolytic activity. Cadmium clonidine interaction is independent of post synaptic adrenoceptor involvement. PMID- 3562507 TI - Avoidance facilitation in adult mice by prenatal administration of the nootropic drug oxiracetam. AB - CD-1 mice prenatally exposed to saline solution or to the nootropic drug oxiracetam (50 mg/kg during the whole pregnancy) were tested, when adults, for locomotor activity and for shuttle-box avoidance acquisition. Prenatal drug exposure produced long-lasting effects, evident in mature offspring. At the age of two months, mice prenatally exposed to oxiracetam showed a slight but significant reduction in locomotor activity. At the age of three months, these animals exhibited higher performances than control mice in avoidance acquisition. PMID- 3562508 TI - Synthesis of alkyloxybenzamide derivatives as potential antimicrobial agents. AB - Three series of alkyloxybenzamido derivatives have been prepared. The first comprises N1-[4-(4-alkyloxybenzamido)benzoyl]-N2-substituted alkylidene hydrazine, the second involves 1-[4-(4-alkyloxybenzamido)benzoyl]-4-alkyl, aryl, or aralkyl-3-thiosemicarbazides, and the third includes 1-substituted-5-[4-(4 alkyloxybenzamido)phenyl]-1,3,4-triazole-2-t hione. Representative samples of the prepared compounds were tested for their in-vitro antimicrobial activity. PMID- 3562509 TI - Proton magnetic resonance (PMR) spectroscopic determination of mechlorethamine hydrochloride for injection in commercial unit doses. AB - A simple PMR spectroscopic method was developed for the quantitative determination of mechlorethamine hydrochloride for injection in commercial unit doses. Deuterium oxide was used as the PMR solvent and tert-butyl alcohol served as the internal standard. The mean +/- SD% recovery value of mechlorethamine hydrochloride from synthetic formulations was 99.5 +/- 0.83, with a coefficient of variation of 0.83%. The mean content of mechlorethamine hydrochloride in a group of ten commercial unit doses was 99.3% by the PMR method and 99.4% by the titrimetric method of U. S. P. XX. PMID- 3562510 TI - [Phase transformation of carbamazepine by the milling process]. AB - In the present paper the interconversion behavior of the carbamazepine modifications I, II and III under various grinding conditions (variation of milling aggregates, milling times and frequencies) were studied. Mechanical treatment of different crystal forms led to a uniform grinding product, which is characterized crystallographically as modification III. The kinetic of phase transformations were determined by means of various quantitative methods such as a IR-spectral, a X-ray-powder diffractional and a thermoanalytical one. The results obtained by different analytical methods accorded quite well. PMID- 3562511 TI - [Description of the process of in vitro liberation of matrix tablets]. AB - After a short description of the drug liberation process from a porous matrix the influence of the matrix forming substance on the drug liberation is characterized. The compression process is the decisive step in forming the hydrophobic, nondissolved matrix. The temporal lapse of the in vitro liberation process of the model drug quinidine is demonstrated by means of electronmicroscopical photographies. PMID- 3562513 TI - Enhancement of dissolution rate of hydrochlorothiazide via solid dispersion. AB - Solid dispersions of hydrochlorothiazide (1) in mannitol (2) and in dihydroxypropyltheophylline (3) were prepared by melting and solvent methods. For both systems, phase diagrams of simple eutectic type were obtained. A significant increase in dissolution rate was observed for 1/2 and 1/3 physical mixtures and solid dispersion as compared to pure drug. Solubility of 1 in 2 and in 3 solution at 27 degrees C and 37 degrees C was studied. At 37 degrees C the water solubility of the drug increased 3.7 times using 0.4 mol X 1(-1) 3. The solubilization of the drug by 3 in water was due to the formation 1 : 1 soluble complex. 1 tablets from physical mixtures and solid dispersion were prepared. Effect of ageing on the physical properties of the prepared 1 tablets was investigated. PMID- 3562512 TI - A study of some factors affecting the dissolution rate enhancement of sulfamethoxazole by crystallization in aqueous surfactant solutions. AB - Effects of crystallization of poorly water soluble sulfamethoxazole in aqueous surfactants solutions on its in vitro dissolution rates were investigated. Marked enhancement was observed. Infrared spectra studies on the prepared crystals indicated polymorphic changes. Some factors affecting the dissolution rate enhancement of crystals prepared in the presence of surfactant namely, the type of the dissolution apparatus, the method of preparation, the type of surfactant, the concentration of surfactant, and washing and soaking of the crystals, were studied. The results of the different effects and possible mechanisms involved are discussed. PMID- 3562515 TI - Some substituted imidazo[1,2-b] [1,2,4]triazines and 8H-pyrimido[1,2-b] [1,2,4]triazin-8-ones as potential antineoplastic agents. PMID- 3562514 TI - [The concentration of oxacillin and ampicillin (Penstabil) in serum and mother's milk in puerperal mastitis]. AB - In 23 women in childbed suffering from mastitis puerperalis the transport of oxacillin and ampicillin into the milk was investigated. Moreover the concentration of the antibiotics in the urine of babies nursed during therapy of their mothers with antibiotics was measured. After a regular taking (good compliance) the drug-concentrations in the serum and the milk of the mothers are higher than the minimal inhibiting concentrations necessary against the number of bacteria found in the milk. In the urine of suckling babies drug concentrations were differently high or undetectable as well. During the therapy of nursing mothers with antibiotics the milk should be misplaced. PMID- 3562516 TI - [The effect of the solubility of drugs on their liberation from polymethacrylate coated retard pellets]. PMID- 3562517 TI - [Determination of the threshold values of some barbiturates in blood and urine using thin-layer chromatography after administration of absorption resin Y29]. PMID- 3562518 TI - [Determination of the rate of swelling of compressed dosage forms using hydrophilic gel-forming agents]. PMID- 3562519 TI - [The biologic availability of acetylsalicylic acid suppositories]. PMID- 3562520 TI - [Changes in sensitivity to phenobarbital sodium in the sexual cycle (circaquadridian rhythm) in the female golden hamster]. PMID- 3562521 TI - [Dipeptidylpeptidase activities in brain and nerve tissue in man]. PMID- 3562522 TI - Toxicity of promazine and chlorpromazine to isolated rat hepatocytes and its modification by liposome entrapment. AB - Isolated rat hepatocytes were used to determine the relationship between magnitude of uptake by cells and cytotoxic effects of chlorpromazine (CPZ) and promazine (PZ). Cell injury was evaluated by the extent of leakage of cytoplasmic and lysosomal enzymes from cells to surrounding medium and by cytopathic changes seen under surface scanning electron microscopy, after drug exposure. The drug uptake was time- and dose-dependent; cell preparations exposed to equal concentrations of either drug in the medium contained a twice greater concentration of CPZ than of PZ. Cytoplasmic and lysosomal enzyme leakage from cells exposed to 200 and 500 microM of CPZ showed significantly greater toxicity than control cells or those exposed to PZ at the same concentration. Surface activity of drugs was determined to calculate their surface excess. The surface pressure of CPZ is about twice that of PZ at equimolar concentration and correlated with extent of drug uptake and toxicity, suggesting that the surfactibility could play a role in bioavailability and toxicity of these drugs to liver cell membranes. Cytotoxicity was decreased by entrapment of CPZ inside liposomes; up to 40% for lactate dehydrogenase leakage and 47% of beta glucuronidase, presenting further evidence for the potential use of liposomes. PMID- 3562523 TI - Medicine understood through nonmedical literature: contributions of selected women writers. PMID- 3562524 TI - Where you think you stand determines what you think you see. PMID- 3562525 TI - The efficacy of empathy in diagnosis and treatment. AB - An integrated, "holistic" approach to the sick patient is an ideal that remains elusive under the best of circumstances but especially if the importance of affective empathic interactions is not emphasized. Although models of psychosomatic and/or psychobiological approaches abound, and in spite of additional courses in medical school pertinent to psychological issues, the cognitive may prevail while the affective is left to languish. The problem may well be that the cognitive elements of humanism, which make for an educated practitioner, are easier to address and therefore attract the greater attention, while the affective learning, which makes for a humane and compassionate practitioner, is so much more difficult to encompass in a curriculum. The practicing physician, however, is likely to find that without greater nurturance of the capacity for empathy, psychosocial or psychosomatic conceptualizations are likely to have little impact on clinical care of patients. PMID- 3562526 TI - Back to Hippocrates: the physician's role as central to medicine. PMID- 3562528 TI - Saltem plus boni quam mali efficere conare: at least try to do more good than harm. PMID- 3562529 TI - Morality of animal sacrifice. PMID- 3562531 TI - Science and health care--whence and whither. PMID- 3562530 TI - Plato's cave revisited. A dialogue concerning medical epistemology. PMID- 3562532 TI - The distribution of intracellular alkali metals in Reference Man. AB - A review of recent literature and a re-analysis of data used in Publication 23 of the International Commission on Radiological Protection (ICRP) have revealed several problems regarding the distribution of the predominantly intracellular alkali metals potassium, rubidium and caesium in ICRP Reference Man. In this paper we re-evaluate the distribution of the intracellular alkali metals in humans and we offer an approach for selecting reference concentrations for the organs of a typical adult human. For non-skeletal tissues, reference values for K, Rb and Cs are determined as a trimmed weighted mean of reported values remaining after studies involving apparently questionable populations or measurement techniques have been eliminated. The skeleton is treated as a special case, with explicit consideration being given to the heterogeneous distribution of these elements among different regions and different types of skeletal tissue. The most significant suggested changes for the intracellular alkali metals are for Rb in the skeleton and total body. ICRP Reference Man has a total Rb content of 0.68 g, compared with our estimate of only 0.25 g, and a skeletal Rb content of 0.21 g, compared with our estimate of only 0.013 g. This has important dosimetric implications for radiorubidium, because the retention model for Rb given in ICRP Publication 30 assigns a large portion of an intake to the skeleton on the basis of the large skeletal Rb content assigned to Reference Man in ICRP Publication 23. PMID- 3562533 TI - Measurement of total body chlorine by prompt gamma in vivo neutron activation analysis. AB - A method of measuring total body chlorine (TBCl) by prompt gamma in vivo neutron activation analysis is described which depends on the same NaI(Tl) spectra used for determinations of total body nitrogen. From these spectra counts ratios of chlorine to hydrogen are derived and TBCl is determined using a model of body composition which depends on measured body weight, total body water (by tritium dilution) and protein (6.25 X nitrogen) as well as estimated body minerals and glycogen. The precision of the method based on scanning an anthropomorphic phantom is at present only approximately 9% (SD), for a patient dose equivalent of less than 0.30 mSv. Spectra collected from 67 normal volunteers (32 male, 35 female) yielded mean values of TBCl of 72 +/- 19 (SD) g in males and 53.6 +/- 15 g in females, in broad agreement with values reported by workers using delayed gamma methods. Results are also presented for two human cadavers analysed both by neutron activation and by conventional chemical analysis; the ratios of TBCl (neutron activation) to TBCl (chemical) were 0.980 +/- 0.028 (SEM) and 0.91 +/- 0.09. Finally, it is suggested that an improvement in precision will be achieved by increasing the scanning time (thereby increasing the radiation dose equivalent) and by adding two more detectors. PMID- 3562534 TI - A Mossbauer-effect study of autopsied lung tissue of asbestos workers. AB - A 57Fe Mossbauer-effect study of autopsied lung tissue from Canadian asbestos mine workers is presented. The spectra typically show large quantities of iron storage protein. This exhibits a quadrupole-split doublet at room temperature and both a doublet and a Zeeman-split sextet at 4.2 K, due to a distribution of particle sizes. A comparison is made with Mossbauer spectra of lung tissue from an individual not occupationally exposed to respirable asbestos, and with spectra of respirable chrysotile asbestos taken from Canadian mines. PMID- 3562535 TI - Development of an agar phantom adaptable for simulation of various tissues in the range 5-40 MHz. AB - A phantom, electrically adaptable for simulation of various tissues, was developed using agar as the jelly. This phantom has the following features: the dielectric property is specified in the range 5-40 MHz, the conductivity can be varied between 0.02 and 1.23 S m-1, the permittivity can be varied between 35 and 80, preparation and handling are readily facilitated; the original shape is retained for over one year, and it is free from deterioration caused by mould for at least one year. PMID- 3562536 TI - New tissue-equivalent phantom materials for negative pions. PMID- 3562537 TI - In vivo precision of total body calcium and sodium measurements by neutron activation analysis. PMID- 3562538 TI - Geometrical dependence of radionuclide ejection fraction. PMID- 3562539 TI - A specialised receiver coil for NMR imaging of female breasts. PMID- 3562540 TI - Optimisation of beam geometry for scanning equalization radiography (SER). PMID- 3562541 TI - Effects of approximation on postural sway in healthy subjects. AB - The effect of approximation on the postural sway of healthy subjects wearing a weighted belt around their pelvis was measured. Twenty subjects between the ages of 23 and 30 years stood on a polyurethane foam platform that amplified their postural sway and were filmed from a lateral view. All subjects wore markers over their mandibles, hips, and knees and were filmed three times with the weighted belt worn on a randomly selected trial. Frames from a 10-second interval of film from each trial were studied, and the summed displacement at each bony landmark between each frame of film was calculated. A significant decrease in displacement at the mandible (p less than .02) was found when the weighted belt was worn. The decrease in displacement was not significant at the hip or knee. Approximation was shown to decrease the postural sway of healthy subjects. Further study is indicated to investigate the effect of approximation on patient populations. PMID- 3562542 TI - Effect of head-neck position on elbow flexor muscle torque production. AB - The purpose of this study was to investigate whether the tonic neck reflex affects elbow flexor muscle torque production in healthy, young adults and which head-neck (H-N) positions have the greatest influence. Forty-eight male and female students between the ages of 18 and 35 years volunteered as subjects. Head neck positions involving the sagittal and horizontal planes and combinations of these were tested. The nondominant hand was used to apply tension to the lever of an isokinetic analyzer under both isometric (static) and isotonic (dynamic) conditions. Peak torque was determined for each H-N position under each condition. Differences in peak torque were elicited more easily from the female subjects than from the male subjects. Head-neck rotation (horizontal plane) appeared to have a greater influence on elbow flexor muscle torque production than movements in the sagittal plane, particularly when movements in the two planes were combined. We concluded, therefore, that H-N position must be considered during rehabilitation of the upper extremity. PMID- 3562543 TI - Assessment of strength deficits in eight paretic upper extremity muscle groups of stroke patients with hemiplegia. AB - This retrospective investigation was undertaken to describe and compare the initial and discharge strength deficits of eight upper extremity muscle groups of 42 patients who were hemiparetic secondary to cerebrovascular accidents (CVAs). Static strengths of the eight muscle groups were measured using a hand-held dynamometer, and strength deficits were calculated against the side ipsilateral to the side affected by the CVA. A two-way analysis of variance for repeated measures revealed significant differences (p less than .001) in the strength deficits of the eight muscle groups and between initial and discharge strength deficits. The strength deficits of the shoulder medial rotator and abductor muscle groups were significantly less than those of any other muscle group. No difference was found in the proportion of muscle groups improving in strength in patients tested within six weeks after the onset of hemiplegia versus patients tested six weeks later. Our results do not confirm the common expectation of relatively lesser involvement of the elbow flexor muscles after a CVA. The results do suggest that patients improve in muscle strength concurrent with a rehabilitation program. PMID- 3562544 TI - Physical fitness program for patients with psychiatric disorders. A clinical report. AB - The current practice of physical therapy rarely addresses the needs of patients with psychiatric disorders. The literature has shown that physical and psychological health are related intimately. This article describes a physical fitness training program designed for inpatients with mental illness in an acute care hospital setting. A training program consisting of group exercise sessions conducted three times a week for six weeks may enhance the patients' self-esteem and body image in a unique way. Physical therapy intervention should be broadened to address the special needs of the mentally disabled. PMID- 3562545 TI - [Phlebology consultation services open to physicians]. PMID- 3562547 TI - [The major physiologic stages of advancing age]. AB - Alterations of the function of two essential organs during ageing is studied: the heart and the kidney. Anatomical and hemodynamic alterations secondary to cardiac ageing are considered along with the essential role of coronary atherosclerosis. Clinical consequences because of the decreased performance of the left ventricle ensue, especially a diminution of the adaptability during stress. As far as ageing of the kidney is concerned, physiological consequences are studied, especially the renal clearance which conditions the therapeutic and/or toxic effect of medications. The difficulties of a reliable reflection of the condition of the kidneys by blood creatinin measurements, are demonstrated, because of the diminution of the lean mass and dehydration in elderly patients. Because of the difficulties in collecting 24 hours urine, methods of measurement of the creatinin clearance by estimation from blood creatinin levels are proposed. PMID- 3562546 TI - [A few initial truths and the practical value of cadexomer iodine in the ambulatory treatment of leg ulcers]. PMID- 3562548 TI - [The aging of connective tissue. Molecular and cellular aspects]. AB - Connective tissues are made of cells and extra-cellular matrix. The predominant cells in vascular connective tissue are smooth muscle cells, fibroblasts and endothelial cells. All these cells actively synthesize the macromolecules of the extracellular matrix. This matrix comprises four types of macromolecules: collagens (11 types known), proteoglycans (8 to 10 types known); elastin and structural glycoproteins (more than a dozen known). Ageing of the connective tissue concerns therefore ageing of its cells and the extracellular matrix. For all connective tissue cells, the limit of proliferation (limit of Hayflick) was verified. The ageing of the matrix is different according to the macromolecules considered: rigidification (cross-linking) of collagen, degradation of elastin, decrease and alteration of the proteoglycans ratio. Structural glycoproteins such as fibronectin may be increased in the plasma and the tissues. Connective tissues diseases are implanted on these qualitative and quantitative modifications of the connective tissues. PMID- 3562549 TI - [Aging of veins and venules]. AB - There is a distinction between natural ageing and excessive ageing. The problem is not only vascular, it is above all interstitial conjunctival; it is located in the trunk wall and in the initial collector walls; the capillary-venular section is, from this point of view, just a unit of structure and function. The clinical and anatomopathological aspects of venous ageing are known: they are those of phlebosclerosis and deposits of proteoglycanes, the lesions are non-homogenous, dispersed and constantly changing. The elderly patient lives in a state of stasis. Stasis creates exaggerated and uncontrollable histangic neogenesis, it is the backcloth of "micro-angiopathy of senescence", but if the membrane thickens, it is in order to counter the ill effects of stasis; it is a control reaction not one caused by lesion. It is vital to establish an analogy between vascular ageing and "plastic" ageing, the process of polymerization is the same and we shall produce the evidence of this on another occasion. PMID- 3562550 TI - [Isotopes in geriatric phlebology]. PMID- 3562551 TI - [The locomotor system and phlebology in the aged subject]. PMID- 3562552 TI - [Neurological problems in the aged subject]. AB - The neurological problems in elderly patients are dominated by cerebral vascular accidents and dementias. The incidence and the prevalence of cerebral vascular accidents has greatly decreased following measures of primary, secondary and tertiary prevention. The problem raised by dementias is one of a positive diagnosis (presently according to DSM III criteria) and mostly the problem of the differential diagnosis, i.e. the diagnosis of curable dementias or "false dementias". PMID- 3562553 TI - [Ambulatory treatment of vascular ulcers in the aged patient]. PMID- 3562554 TI - [Care and treatment of trophic disorders of the lower extremities of aged and hospitalized patients]. PMID- 3562555 TI - [Vascular ulcers of the lower extremities of aged patients]. AB - Of the importance of chronic veinous insufficiency in the etiology of the ischaemic troubles of the legs and also, for the same reasons, of the feet and toes, troubles often wrongly considered as exclusively of arterial origin. Of the interest of suppressing the points of veinous reflux, even when no varicose condition is detected, notably on the arteritic selected upon functional vascular explorations and T C Po2 (transcutaneous Oxygen pressure). In the present case, a frequent, not to say almost constant, indication of sclerotherapy and crossectomy (arch of the aorta). PMID- 3562556 TI - [The incidence of leg ulcers as a function of age]. AB - In this short paper, the author studies the occurrence of leg ulcers in relation to age and the cause of the ulcer. The data confirm practical ideas which are already well known. PMID- 3562557 TI - [Edema of the lower extremities in the aged patient]. AB - Oedema of the lower limbs in the elderly patient are sometimes easy to diagnose in cases of cardiac, renal or hepatic incompetence. But oedema can also be of venous origin: superficial (varicose) incompetence, or deep, with thrombosis (recent or previous] or compression. Certain oedema are of arterial origin when there is pain in the supine position, or after revascularization. Lymphostatic oedema are rarely primary, and most often indicate a pelvic tumour which has escaped diagnosis or has relapsed, sometimes following surgical or ionising treatment. A compressive treatment must take into account the arterial condition of the patient as well as any motor handicaps. PMID- 3562558 TI - [Sclerosis of varices in aged persons]. PMID- 3562560 TI - [Does the success of thrombolysis depend on the age of the patient?]. AB - This study raises the question whether the age of the patient has any influence on the results of the treatment of the post-phlebitic syndrome of the lower extremities by thrombolysis. Our study demonstrates that elderly patients respond to thrombolysis as well as young patients. PMID- 3562559 TI - [Deep venous thromboses in the aged patient. Clinical and therapeutic aspects]. AB - This paper looks at the question of whether the age of a patient has any bearing on the thrombolytic treatment of post-thrombotic syndrome in the lower limbs. Our study shows that elderly patients respond just as well to thrombolysis as young patients. PMID- 3562561 TI - [A Swiss indication for varicose vein surgery in patients over 60?]. AB - A retrospective investigation into 100 patients operated on after the age of 60 led to the following two conclusions: in 55 p. cent, the motivation for the operation was aesthetic, due to third age vanity; pedestrian activity at retirement age is considerable. The frequent appearance of cramp symptomology of various types prompts us to make a thorough investigation of the arterial circulation of all the older patients. Is there really a Helvetian indication? Certainly not as far as aesthetics are concerned, since this is a general tendency among retired people. But definitely yes when arterial causes of cramps during walking can be excluded. PMID- 3562562 TI - [Our experience in the treatment of essential varices in the aged patient]. PMID- 3562563 TI - [The prescription of drugs in geriatrics]. PMID- 3562565 TI - [Lymphangiographic appearance of stage III and IV chronic venous insufficiency]. PMID- 3562564 TI - [Histochemical comparison of the enzyme profiles of healthy veins and varicose veins]. AB - In the context of studies bearing on the enzymatic activity in healthy veins and varicose veins, sample sections of veins were excised in eight patients with primary varices of the long saphenous vein. The veins were subjected to histochemical methods for identifying enzymes. The histochemical dosage related to lactate-dehydrogenase, alkaline phosphatase, adenosine triphosphoric acid enzymes, as well as lysosomal beta-glucuronidase, non-specific esterase and phosphatase acid enzymes. The authors deal with the specific problems involved in the different enzymatic methods, and their relevance to prognosis. In conformity with the results of our histochemical studies, the comparison between the enzymatic profiles of healthy and varicose veins showed an increase in lysosmal enzyme activity in the vein walls leading to varicose degeneration. The increase in activity was more pronounced in the media than in the intima. A reverse pattern was observed in the behaviour of enzymes involved in energetic metabolism. The enzymatic activity in the venous wall leading to varicose degeneration proved to have decreased. This reduction in the enzymatic activity was more marked in the intima than in the media and was particularly pronounced in the case of the histochemical identification of adenosine triphosphoric acid Ca++. PMID- 3562566 TI - [Relation between insufficiency of the venae comitantes and varices]. AB - The author explains the relationship between geminal veins insufficiency and varicose veins. Anatomy, physiology, etiology, diagnosis and treatment are described. PMID- 3562567 TI - [Assessment of the efficacy of venous support by elastic bandages using transcutaneous measurement of oxygen pressure (TcPO2)]. AB - Venous contention with elastic bandages is widely used in the treatment of Venous Insufficiency. We have attempted to number the clinical improvement by measuring TcPO2. Our study includes 16 cases; divided as follows: 6 healthy subjects (reference), 5 patients with severe varicose veins of the lower extremities, without ulcer, and 5 patients with varicose veins with ulcer of the leg. Measurements were carried out before and after 10 hours of venous contention. For each patient we have used a light bandage (x) with stretching to 30 and 50% of its length, and a heavy bandage (x) with stretching of 20 and 40%. Our results show, after contention, a decreased TcPO2 in the reference group, but an improvement of this TcPO2 in patients with varicose veins, with or without ulcer. This improvement is more marked with the use of light bandages. PMID- 3562568 TI - [Crenotherapy of postphlebitic disease at Bagnoles-de-l'Orne studied by occlusive rheoplethysmography]. AB - We have attempted to demonstrate by occlusive rheoplethysmography the action of crenotherapy on post-phlebitic syndrome. At the end of the study, it appears that, if it is possible to calculate the tissue disinfiltration obtained at the end of the cure, the method should be completed by diversified and repeated examinations after the cure in order to specify the beneficial effect of the cure. PMID- 3562569 TI - [Dosage of O-beta hydroxyethylrutoside in chronic venous insufficiency]. AB - 45 patients suffering from varicose veins with or without a chronic insufficiency up to stage II, took 1, 2 or 3 g of Oc-beta hydroxyerhylrutoside P.O. Photo reflexometry and plethysmography with mercury gauge demonstrated the results. The various parameters showed the medication to be effective after 10 and 21 days of treatment. A dosage adjusted to the gravity of the venous involvement improves the venous pump of the leg and therefore the venous return. PMID- 3562570 TI - Photocleavage of DNA in the presence of synthetic water-soluble porphyrins. PMID- 3562571 TI - Excited-state properties of DNA methylated at the N-7 position of guanine and its free fluorophore at room temperature. PMID- 3562572 TI - Ultraviolet hypersensitivity of Cockayne syndrome lymphoblastoid lines--the effects of exogenous beta-nicotinamide adenine dinucleotide. PMID- 3562573 TI - A study of 1O2 production by immobilized sensitizer outside the solution. Measurement of 1O2 generation. PMID- 3562574 TI - Calcium control of phototactic orientation in Chlamydomonas reinhardtii: sign and strength of response. PMID- 3562575 TI - C4-cyclodimers of psoralen engaging the 4',5'-double bond. PMID- 3562576 TI - The photochemistry of specific tryptophan residues in proteins as analyzed by the fluorescent scanning of tryptic peptide maps. PMID- 3562577 TI - An instrument for simultaneous acquisition of fluorescence spectra and fluorescence lifetimes from single cells. PMID- 3562578 TI - Photo-induced oxidative activation of the antitumor drug 2N-methyl-9 hydroxyellipticinium in vitro. PMID- 3562579 TI - Three exponential fluorescence decay of horse liver alcohol dehydrogenase revealed by iodide quenching. PMID- 3562580 TI - Photoreaction of psoralen derivatives with structurally organized DNA. PMID- 3562581 TI - Laser flash spectroscopy of methylene blue with nucleic acids. PMID- 3562582 TI - Singlet oxygen generation by furocoumarins: effect of DNA and liposomes. PMID- 3562583 TI - Photoreaction of monofunctional 3-carbethoxypsoralen with DNA: identification and conformational study of the predominant cis-syn furan side monoadduct to thymine. PMID- 3562584 TI - Thermal-lensing and phosphorescence studies of the quantum yield and lifetime of singlet molecular oxygen (1 delta g) sensitized by hematoporphyrin and related porphyrins in deuterated and non-deuterated ethanols. PMID- 3562585 TI - Ergosterol (provitamin D2) triplet state: an efficient sensitiser of singlet oxygen, O2(1 delta g), formation. PMID- 3562586 TI - Genetic toxicology of the photosensitization of Chinese hamster cells by phthalocyanines. PMID- 3562587 TI - Photo-oxidation effects on beta-hydroxybutyrate dehydrogenase: studies of membrane fragments and intact mitochondria. PMID- 3562588 TI - Excision repair of pyrimidine dimers in marsupial cells. PMID- 3562589 TI - A comparison of mammalian cell sensitivity to either 254 nm or artificial "solar" simulated radiation. PMID- 3562590 TI - Photobleaching of a cyanine dye in solution and in membranes. PMID- 3562591 TI - Photokinetic and photophysical measurements of the sensitized photooxidation of the tryptophyl residue in N-acetyl tryptophanamide and in human serum albumin. PMID- 3562592 TI - Photosensitization of pyrimidine dimer splitting by a covalently bound indole. PMID- 3562593 TI - Induction of direct and indirect single-strand breaks in human cell DNA by far- and near-ultraviolet radiations: action spectrum and mechanisms. PMID- 3562594 TI - Urocanic acid photobiology. Photochemical binding of urocanic acid to bovine serum albumin. PMID- 3562595 TI - Comparison of the protein conformations between different forms (Pr and Pfr) of native (124 kDa) and degraded (118/114 kDa) phytochromes from Avena sativa. PMID- 3562596 TI - Proceedings of the eighth annual meeting of the IUPS (International Union of Physiological Sciences) Commission on Gravitational Physiology. 4-8 November 1986, Tokyo, Japan. PMID- 3562597 TI - Mechanisms of acute and chronic effects of microgravity. PMID- 3562598 TI - The ESA Anthrorack project: integrated research in human physiology. PMID- 3562599 TI - Mechanism of the increase in plasma volume during head-out water immersion (WI) in dogs. PMID- 3562600 TI - Physiological comparison of rat muscle in body suspension and weightlessness. PMID- 3562601 TI - Neurophysiological responses in suspended animal models. PMID- 3562602 TI - Effects of gravity on rhythmic activities in the phrenic and sympathetic nerve discharges. PMID- 3562603 TI - Comparative aspects of hematological responses in animal and human models in simulations of weightlessness and space flight. PMID- 3562604 TI - Metabolic adaptation in hypokinesia in humans. PMID- 3562605 TI - Controlled water immersion as a model of weightlessness. PMID- 3562606 TI - Directional difference in effects of long-term hyper-gravity upon the cardiac system of the hamsters. PMID- 3562607 TI - The effect of head-down tilt on the EEG response to mental arithmetic (MA). PMID- 3562608 TI - Chronic acceleration and organ size in domestic fowl. PMID- 3562609 TI - Cardiopulmonary response of rats to centrifugal accelerations. PMID- 3562610 TI - The response of skeletal muscle mass to changes in acceleration. PMID- 3562611 TI - Receptor mechanism and neuronal circuit subserving gravitational responses in crayfish. PMID- 3562612 TI - Physiological roles of calcium in light-induced gravitropism in Zea primary roots. PMID- 3562613 TI - The effects of exercise training on factors affecting orthostatic tolerance. PMID- 3562615 TI - Biodynamic response of subhuman primates to vibration. PMID- 3562614 TI - Gravitational cardiovascular adaptation in the giraffe. PMID- 3562616 TI - Physiological limitations of human tolerance to Gz acceleration. PMID- 3562617 TI - Central circulation during exposure to 7-day microgravity (head-down tilt, immersion, space flight). PMID- 3562618 TI - Hormonal regulation in space flights of varying duration. PMID- 3562619 TI - Effects of 7-day space flight on weight-bearing and non-weight-bearing bones in rats (Cosmos 1667). PMID- 3562620 TI - Body impedance measurement during Spacelab Mission D1. PMID- 3562621 TI - Magnetic effect on cardiopulmonary function in man. PMID- 3562622 TI - A unique relationship between Economos' theory on the largest land mammal and our dynamic theory of growth, maturation and ageing. PMID- 3562623 TI - Study of the initial period of adaptation to microgravity in the rat experiment onboard Cosmos-1667. PMID- 3562624 TI - Cardiovascular responses during 70 degrees head-up tilt: the effect of elevated body temperature and high alcohol blood levels. PMID- 3562625 TI - Changes of arterial and venous blood flow during orthostasis and the effect of atropine. PMID- 3562626 TI - Spacelab Life Sciences 1 and 2. Scientific research objectives. PMID- 3562627 TI - The effect of body position on ventilation and perfusion in the lung. PMID- 3562628 TI - Effects of graded head-up tilting on muscle sympathetic activities in man. PMID- 3562629 TI - Cardiovascular effects of head-up tilt as affected by a vasopressin analogue. PMID- 3562630 TI - 10 degrees head-down and -up tilting on the water intake and cardiovascular responses during mild exercise in woman. PMID- 3562631 TI - Cardiovascular responses of aged men to orthostatism during heat exposure. PMID- 3562632 TI - Cardiorespiratory responses to supine leg exercise during lower body negative pressure (LBNP). PMID- 3562633 TI - Effects of LBPP stocking on cardiovascular responses during rest and exercise in LBNP and upright position in woman. PMID- 3562634 TI - Increased cholinergic activity during gravitation-induced pre-syncope in man. PMID- 3562635 TI - Effects of lean body mass and aerobic power on LBNP tolerance in woman. PMID- 3562636 TI - Cerebellar adaptive function in altered vestibular and visual environments. PMID- 3562637 TI - Implications of otoconial changes in microgravity. PMID- 3562638 TI - Physiological responses during whole body suspension of adult rats. PMID- 3562639 TI - Influence of simulated weightlessness on maximal VO2 of untrained rats. PMID- 3562640 TI - Continuous determination of blood volume and blood sodium concentration on conscious rats: a potential tool for the analysis of water balance during weightlessness. PMID- 3562641 TI - Control of protein intake in golden hamsters. AB - Experiments were performed to investigate the behavioural responses of golden hamsters to manipulations of dietary protein availability. In the first experiment, hamsters were maintained on a protein-free diet and a powdered diet containing 64.8% protein (P64.8). When the P64.8 diet was progressively diluted with cornstarch, hamsters increased their intake of this diet fraction, but protein intake nevertheless declined. When the protein content of the diet was 16.2%, animals derived only 6% of total calories from protein and lost weight despite normal intake of calories. In the remaining experiments, hamsters were maintained on a self-selection regimen of high-protein chow, pure carbohydrate (sugar cubes), and pure fat (vegetable shortening). When high-protein chow was removed for either 5 or 10 days, total caloric intake and body weight declined, and hamsters selectively increased protein intake for several days after high protein chow was returned. Hamsters allowed access to high-protein chow for only one hour each day markedly increased the amount of high-protein chow they ate during this hour as protein-restriction continued, but still consumed only about 10% of their normal daily protein intake on this schedule and lost 20% of starting body weight in two weeks; when free access to high-protein chow was restored, these animals selectively increased their protein intake above pre restriction levels. Hamsters given access to high-protein chow only on alternate days demonstrated a relatively modest and slowly developing increase in protein intake, perhaps because they incurred only a moderate protein deficit. The results suggest that when protein intake falls below normal minimum requirements, hamsters will demonstrate an adaptive protein hunger but make only a limited adjustment to the dilution of a protein-containing diet fraction. PMID- 3562642 TI - Effects of detention and illumination on rats' exploratory behavior in a two-box apparatus. AB - The effects of detention and lighting intensity on the exploratory behavior of male Wistar rats have been investigated by means of several types of two-box apparatus. Experiments consisted of six consecutive daily trials. Step-through latency values were taken up to 180 sec. Even a very short detention (10 sec) within the starting box exerted a powerful inhibitory influence on the exploratory behavior of the subjects. Uniformly well-lighted surroundings (both boxes) exerted an equally powerful inhibitory influence on the same behavior. This inhibition was only slightly decreased by the availability of visual cues. Only in the apparatus in which at least one box was dark was the exploratory behavior well maintained. Both detention and bright lighting inhibited selectively the exploratory, locomotor behavior of these animals and did not inhibit other motor activities. In fact, groomings and attempts (abortive passages from one box into the other) were repeatedly performed during the increased step-through latency. These activities are discussed as indicators of a conflict between drives. PMID- 3562643 TI - Short-term responses of plasma norepinephrine, epinephrine, glucocorticoid and testosterone titers to social and non-social stressors in male guinea pigs of different social status. AB - The short-term effects on norepinephrine (NE), epinephrine (E), glucocorticoid (CS) and testosterone (T) levels of (a) taking blood samples, and (b) an agonistic encounter in an experienced fighter's home cage were examined in 15 male guinea pigs living in large heterosexual colonies for 8 to 19 months. Four tests were performed 1 month apart. In the 1st, 2nd and 3rd test 3 blood samples were taken from each male in a strange room within 30 min (sampling times were designated as 0, 20 and 30 min, respectively). In the 4th test blood samples were taken on the same time schedule, however, the males were given 10 min agonistic encounters 10 min after the initial blood sampling. The main findings were as follows: in response to taking blood samples and fighting CS and NE titers increased significantly, whereas E values did not change in a significant way. T titers decreased 10 min after the agonistic encounter. The % changes of NE, E, CS and T at 20 and 30 min did not differ whether an agonistic encounter took place or only blood samples were taken. According to their behaviors displayed in the colonies the males were divided into high (N = 6) and low (N = 9) ranking individuals. When only blood samples were taken the males' social status was only reflected by a tendency towards higher T levels in high ranking males, however not by NE, E and CS titers. High ranking males showed lower NE titers than low ranking males directly after the agonistic encounter. No further relationships between long-term social status and short-term endocrine responses were found. According to their behaviors displayed during the agonistic encounters the males were divided into fighters (F) (5 out of 6 high and 3 out of 9 low ranking individuals), and non-fighters (NF) (1 high, 6 low ranking individuals). F and NF did not differ in T and CS values, NE titers, however, were significantly higher in NF compared with F before, directly after the encounter as well as 10 min later. E was significantly higher in NF than in F directly after the encounter. One month before the contest prospective NF showed higher NE levels at 0, 20 and 30 min sampling times than prospective F when only blood samples were taken. These findings point to a more important role of catecholamines than CS and T in guinea pig intermale agonistic encounters. NE responsiveness may have predictive value for the behavior in contest situations. PMID- 3562644 TI - Infusion of cholecystokinin between meals into free-feeding rats fails to prolong the intermeal interval. AB - The sulfated octapeptide of cholecystokinin (CCK-8) was infused intraperitoneally into 7 free-feeding male Sprague Dawley rats over a 6-day period. Infusions were given near the end of each free-feeding meal (1.87 microgram/meal/rat), and also during the intermeal interval in gradually increasing doses (0.10-0.63 microgram/5 min/rat). Food intake was continuously monitored and the infusions were controlled by microcomputer. Meal patterns, total food intake, and body weights during drug infusion were compared with data collected during a baseline period when only saline was infused. Meal-contingent CCK-8 infusion produced a significant 29.9% decrease in meal size which persisted throughout the drug infusion period. Intermeal infusion of CCK-8 failed to prolong the intermeal interval (IMI) but it did initially prevent the compensatory decrease in IMI and increased feeding frequency expected after meal size was reduced. By the last day of drug infusion, total daily food intake recovered to baseline levels due to increased feeding frequency. Body weight was only transiently reduced by CCK-8 infusion. These findings show that tolerance does not develop to the action of CCK-8 to suppress meal size, and the administration of exogenous CCK-8 to free feeding rats does not persistently prolong the intermeal interval. PMID- 3562645 TI - Adrenal hormonal indices of stress in laboratory rats. AB - When individual rats were exposed to different intensities of a stressor, foot shock, plasma catecholamines were found to be sensitive and reliable indices of the stress. Plasma corticosterone did not perform as well. Similarly, levels of both plasma epinephrine and norepinephrine correlated highly significantly with a behavioral measure of the degree of stress--namely, the amount of movement about the cage seen during the 30 sec shock period. Importantly, this behavioral measure was as sensitive and reliable an index of stress as the catecholamines. However, use of either the catecholamines or this behavioral measure as a clinically useful measure of the level of stress was limited by the fact that their responses to the stressor were extremely short-lived. Nonetheless, because the catecholamines reliably and sensitively track the intensity of a stressor, they appear to be a good visceral measure of stress, perhaps the best currently available. But the behavioral concomitants of stress are quickly and easily quantifiable and present a wide range to study, starting with alerting, through a progression of more aroused motor activity, and ending with fight-flight. Because the behavioral concomitants of stress have not been as intensively studied as the endocrine ones, we believe that future efforts to find a clinically useful index of stress will be rewarded by a refocussing of attention away from the visceral respondent to the overt behavioral one. PMID- 3562646 TI - Pharmacological subtraction of the sensory controls over grasping in rats. AB - Catecholamine-depletion-induced catalepsy isolates and leaves intact an aggregate of allied reflexes (e.g., righting, standing still, bracing, and clinging) which involve all the body and limb segments in defending stable static equilibrium. Because other movement subsystems (locomotion, orienting, scanning, directed use of mouth or forepaws) are depressed, such animals cling in a vertical position for an abnormally long period of time. As a consequence, grasping reflexes may be studied independently of other responses. Haloperidol, a dopamine antagonist, abolishes visually elicited reaching and grasping, but leaves intact tactile and proprioceptive control of grasping. The grasping of haloperidol-treated rats can be further simplified by the pharmacological removal of the remaining sensory controls. The addition of morphine to haloperidol abolishes tactile grasping, while the addition of diazepam to haloperidol abolishes both tactile and proprioceptive (traction-elicited) grasping. Although visual, tactile, and proprioceptive grasping are abolished by haloperidol-plus-diazepam, some vestibular input to clinging remains: such rats, in response to being held vertically upright in the air, flex their digits with sufficient strength to allow them to cling vertically. The strength of forepaw digit flexion is severely diminished by labyrinthectomy, but the digits of the hindpaws appear to be unaffected. This residual non-labyrinthine digit gripping appears to be induced by proprioceptive inputs from the head, neck and torso in response to the vertical body position. Wrapping an elastic bandage snugly around the head and neck of a labyrinthectomized rat given haloperidol-plus-diazepam further diminishes the strength of forepaw digit flexion, and to a lesser degree hindpaw digit flexion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562647 TI - Recruitment time of conditioned opioid analgesia. AB - Three experiments examined the development of conditioned analgesia in rats exposed to stimuli that had previously been paired with footshock. In Experiment 1, tailflick latencies increased if the tailflick test for analgesia was immediately preceded by 90 sec of exposure to a context in which unsignaled shock had previously been administered. This analgesia was blocked by the opiate antagonist naloxone administered prior to exposure to the context on the test day. Experiment 2 determined that 90 and 300 sec of exposure to the conditioning context immediately prior to testing evoked comparable analgesia as indexed by increased latencies to pawlick in response to thermal stimulation (hotplate). However, no analgesia was evident in animals exposed to the aversive context for 5 sec immediately prior to the hotplate test relative to animals not exposed to that context. In Experiment 3, a 5-sec exposure to the aversive context produced analgesia comparable to a 90-sec exposure if an 85-sec delay intervened between the 5-sec exposure and the hotplate test. These results suggest that brief exposure to stimuli previously paired with shock can activate the endogenous opioid system, but the analgesic action of these opioids is delayed. Implications for the role of endogenous opioids in learning are discussed. PMID- 3562648 TI - The aromatase inhibitor, 1,4,6-androstatriene-3,17-dione (ATD), blocks testosterone-induced olfactory behaviour in the hamster. AB - The effect of ATD on olfactory investigation in intact and in castrated, testosterone-treated male hamsters was studied using subcutaneous silastic implants. In intact males, there was a dose-dependent action of ATD in reducing sniffing towards novel females and in eliminating the discrimination between females after pre-exposure to vaginal odour. Both sniffing and olfactory discrimination reappeared after removal of ATD implants. Neither the weight nor the general behavioural activity of treated males was affected, indicating a specific behavioural affect. Testosterone (T) maintained olfactory behaviour in castrated males. Untreated castrates and castrates with ATD + T implants showed reduced sniffing and showed no discrimination between females after exposure to female odour. We conclude that conversion of T to oestrogen plays an essential role in the control of male olfactory behaviour. PMID- 3562650 TI - Gonadal steroids and the extinction of conditioned taste aversions in young domestic fowl. AB - Three experiments using domestic chicks demonstrate that the extinction of a conditioned taste aversion to a green-coloured sucrose solution is slowed by the administration of testosterone or 5 alpha-dihydrotestosterone but is unaffected by estradiol. Testosterone slows extinction in male and female chicks to an equal extent. Previously described effects of testosterone on attentional and memory mechanisms have also been produced by low doses of estradiol so a separate mechanism must be postulated to explain the present results. It is probably similar to the mechanism responsible for a steroid-dependent slowing of extinction in rats since those effects are also androgenic and present in both sexes. PMID- 3562649 TI - Influence of postnatal rearing conditions on the response of squirrel monkey infants to brief perturbations in mother-infant relationships. AB - This study was designed to determine the behavioral and pituitary-adrenal responses of squirrel monkey mother-infant dyads reared under different housing conditions to either 1- or 6-hr separations. Dyads were reared either in an individual cage or in social groups of 3 mother-infant dyads. The two separation conditions consisted of removing either the mother or the infant to a novel test cage while the other member remained in the home cage. Group-reared infants displayed lower levels of plasma cortisol, movement, and vocalization when they remained in the home cage during separation compared to their responses in the novel cage. However, individually-reared infants displayed high cortisol and activity levels in both separation environments, and vocalization levels were higher at 1 hr in the home cage than in the novel cage. These results indicate that familiarity with the separation environment, per se, does not attenuate the behavioral or physiological responses of infants, but that familiar conspecifics, even in the absence of alloparenting, can benefit an infant during separation from its mother. Two additional test conditions assessed the responses of mother infant dyads when they were only momentarily separated and then immediately reunited in either the home cage or a novel cage. Reunion in the home cage evoked no cortisol or behavioral responses, but reunion in a novel cage resulted in significant elevations in infant cortisol levels and time in contact with the mother. The corticoid response of the mothers differed from their infants during separations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562651 TI - Effects of ethanol on aggression in three inbred strains of mice. AB - The effects of acutely administered ethanol (0, 0.5 and 1.0 g/kg, IP) were studied in 3 inbred strains of mice during 500 sec dyadic encounters with non drugged, intruder "standard opponents." The test animals were male C57, DBA and BALB strain mice which had been isolated for 14 or 28 days to promote aggression. The times allocated to 6 broad categories of behaviour were measured from videotape recordings. There was no significant effect of ethanol on threat behaviour or overt aggression, except in 14 day isolates of the DBA strain where aggressive behaviour was reduced by the high dose. This dose increased flight/defensive and freezing behaviour in C57 and BALB mice isolated for 14 days. Ethanol did not affect non-social or social investigative behaviour, except in BALB mice where social behaviour was significantly reduced by the high dose. Blood ethanol levels were similar in DBA and C57 strain mice but were significantly lower in BALB mice. PMID- 3562652 TI - Salt and water intake in Brattleboro rats with hypothalamic diabetes insipidus. AB - Brattleboro rats lacking vasopressin have an elevated plasma osmolality and a stimulated renin-angiotensin system relative to Long-Evans rats (LE). The current studies were performed to elucidate the factors controlling water and salt intake in the Brattleboro rat with diabetes insipidus (DI). DI and LE rats were given the choice of water and saline solutions ranging from 0.1-1.0% to assess palatability, dialyzed with isotonic glucose to test for sodium appetite after sodium depletion, and infused intracranially with an angiotensin II analogue (saralasin) to assess the role of angiotensin II in spontaneous salt and water intake. DI rats exhibited spontaneous salt intake which was not significantly different from LE rats and increased their intake of 3.0% NaCl following sodium depletion, although less reliably than LE rats. A significant proportion of those DI rats not developing a sodium appetite showed attenuation of their diabetes following dialysis. No evidence for involvement of angiotensin II in spontaneous salt and water intake was found. PMID- 3562653 TI - Enhancement of responses to sequential presentation of oral chemical irritants. AB - The irritative flavor compounds, capsaicin and piperine, were presented in sequence to the oral cavity of human subjects and rated for perceived intensity of irritation. Marked increases in perceived irritation were reported when the second-presented irritant differed from the first, as compared with control conditions in which the same irritant was repeated. This cross-enhancement is explained most simply by recruitment of additional receptors or fiber types, and implies a greater degree of specificity (narrowness of tuning) of trigeminal receptors than previously suggested by desensitization studies. PMID- 3562654 TI - An improved chamber for the observation and analysis of the sexual behavior of the female rat. AB - A new chamber designed to evaluate the sexual behavior of rats was found to have distinct advantages over chambers typically described in the literature. The new testing chamber is narrow, which maintains a male and female rat in the optimal orientation for the observer to view sexual behavior, i.e., in the side view. Moreover, the chamber consists of an upper and lower level, which allows the females an avenue of escape from the male. In Experiment 1 it was shown that use of the chamber increased the reliability of data gathered in evaluating the lordosis behavior of female rats. In Experiment 2 it was shown that the new chamber could be used to evaluate the pacing of copulation by female rats. PMID- 3562655 TI - A lack of avoidance of flank gland secretions by male Syrian hamsters. AB - It is commonly assumed that sexually dimorphic cutaneous glands are important in supporting inter-male aggression in rodents. Such an intimidation role has been hypothesized as the function of the hamsters' flank gland. Two experiments failed to find avoidance of male flank odors. In one, subordinate males entered and spent comparable amounts of time in clean areas and areas scented with the dominant's flank secretion. In the other study, males were found to respond differentially to flank odors obtained from the subject, a familiar and a novel male. Although the males seemed to have habituated to the odor of the familiar male, there was no suggestion of avoidance of any of these odors. It may be that the males' flank odor is relevant not to other males but to females. PMID- 3562656 TI - Handling facilitates the acquisition of lever-pressing for brain self-stimulation in the posterior hypothalamus of rats. AB - Adult male rats implanted with stimulating electrodes in the posterior hypothalamus-ventral tegmental area (PH-VTA) were allowed to learn to lever press for intracranial self-stimulation (ICSS) without any priming by the experimenter or use of external cues. Animals that had been handled for seven days prior to testing acquired the lever-pressing task more rapidly than non-handled animals. Prior handling had no effect on the amount of locomotor activity in a novel environment nor on the number of non-reinforced lever presses. This suggested that the effect of handling on ICSS acquisition was not due to a change in locomotor activity or exploratory behavior. Implanted rats that were injected before each session with d-amphetamine (0.25 mg/kg) or saline did not differ in their rates of acquisition of ICSS in PH-VTA. However, injected animals acquired ICSS more slowly than the non-injected (handled and non-handled) animals. These results suggest that mild stressors applied before acquisition testing can alter the rate of learning of an operant task for ICSS in the posterior hypothalamic region and that small routine manipulations of animals can affect learning in operant training situations. PMID- 3562657 TI - Prior stress and behaviorally conditioned histamine release. AB - Male guinea pigs were either handled ('stressed') or not disturbed ('non stressed') for four weeks prior to conditioning with a classical discrimination conditioning design. Animals were sensitized to bovine serum albumin (BSA) and four weeks later presented with either an odor (the CS+) paired with BSA or a second odor (the CS-) paired with saline. These pairs were presented in a random order for ten trials. Weekly blood samples were assayed for histamine and cortisol levels. Following the conditioning trials, animals were subjected to extinction trials during which the CS+ odor was presented but not paired with the BSA. The animals handled prior to the conditioning procedures learned the association between the odor and the BSA as indicated by increased histamine levels when exposed to the conditioned odor alone. The non-handled group did not learn. Additionally, the cortisol levels were significantly higher for the handled group vs. the non-handled group when the CS+ was presented during extinction. The role of stress in both learning and immunomodulation is discussed. PMID- 3562658 TI - Cardiovascular effects of 3-methylquercetin. PMID- 3562660 TI - Pharmacological studies on the antiulcerogenic activity of Chinese cinnamon. PMID- 3562659 TI - Antioxidant properties of the flavonoids silybin and (+)-cyanidanol-3: comparison with butylated hydroxyanisole and butylated hydroxytoluene. PMID- 3562661 TI - Effects of Sebastiana schottiana extracts on isolated smooth muscle contraction. PMID- 3562662 TI - [The effect of baldrinal on hematoipoetic cells in vitro, on the metabolic activity of the liver in vivo and on its analysis in proprietary drugs]. PMID- 3562663 TI - Comparison of the antiviral effects of naturally occurring thiophenes and polyacetylenes. PMID- 3562664 TI - Rotation locular countercurrent chromatography and quantitative 1H-nuclear magnetic resonance spectroscopy of the phorbol ester constituents of croton oil. PMID- 3562665 TI - Novel antiinflammatory flavonoids from Podophyllum versipelle cell culture. PMID- 3562666 TI - Isolation and hypoglycemic activity of oryzarans A, B, C, and D: glycans of Oryza sativa roots. PMID- 3562668 TI - [Revision of the Mental Health Act]. PMID- 3562667 TI - Antihepatotoxic principles of Wedelia chinensis herbs. PMID- 3562669 TI - [Epilepsy and suicide]. AB - Although statistics dealing with the causes of death are often difficult to compare, in some cases they indicate that suicide rates are high among people suffering from seizures. The author considers this critically. At present the number of attempted suicides among this group is at least five times higher than among the average population. The author reports on his own findings, on factors indicating potential suicide victims, and on the possible prevention of suicide, particularly in connection with pharmaceutical treatment. PMID- 3562670 TI - [Effectiveness of psychiatric departments at general hospitals]. AB - A few statistics referring to the psychiatric hospital of the Karl Marx University in Leipzig, which has taken over the function of a local psychiatric unit providing ward and semi-clinical treatment for the inhabitants of an urban district with 110,000 residents, are presented as an index of the work performed and success achieved by this sort of medical facility. The fact that full ward treatment with 64 beds is available is an important aspects. Transfers to specialized psychiatric hospitals are rare exceptions caused almost exclusively by a lack of in-house complementary facilities. PMID- 3562671 TI - [Psychological test differentiation of neurotic and organically induced performance disorders]. AB - Current methods of diagnosing psychological performance, which are primarily status-oriented, are inadequate to permit satisfactory differentiation between brain-organically and neurotically induced performance disturbances. We therefore attempted to contribute to the solution of this problem by adopting a new psychodiagnostic approach (measurement of intraindividual variability) and using multi-point measurements with the aid of attentiveness tests. The fact that 80 to 90% of 254 neurotic and brain-damaged subjects could be correctly diagnosed in the way indicates that the new approach to performance diagnosis is suitable for clinical use. PMID- 3562672 TI - [Psychosocial studies of surgically treated adults with unilateral total lip maxilla-palate clefts]. AB - The psychological status of 51 adult subjects who had received surgery at the appropriate time for cleft lip-palate was investigated by questionnaire (Giessen test). In respect of social dominance this revealed a significant deviation towards social subordination among those with cleft lips and palates, which is explicable in terms of the lengthy and continuous treatment and appears to be of great importance as a defence and adaptation mechanism to those concerned. The inclusion of psychologists in the interdisciplinary care of cleft lip-palate patients is proposed. PMID- 3562673 TI - [6 years of electroconvulsive therapy with dexamethasone]. AB - The author reports on an improvement in ECT in which Dexamethasone is used to prevent cerebral edema. This improved technique has been used for 823 EC treatment since 1979. Since then, no post-paroxysmal passage syndromes have been observed in gerontopsychiatric patients even in cases where ECT is applied relatively frequently. PMID- 3562674 TI - The relationship of dental crowding to tooth size, dental arch width, and arch depth. AB - This study was undertaken to answer the question, "Are there any differences in the mesiodistal tooth diameters, dental arch width and dental arch depth between the crowded and noncrowded dentitions?" The materials submitted for study consisted of the Orthoscan intraoral occlusograms of 89 subjects with well aligned dentition and those of 74 subjects with gross dental crowding. The tooth size and arch dimensions were measured from these intraoral occlusograms. The data were subjected to statistical treatment for comparison of noncrowded and crowded groups. The findings in this study lead to the following conclusions: The mesiodistal tooth diameters of the crowded group were significantly larger than those of the noncrowded group. The dental arch widths of the crowded group were significantly smaller than those of the noncrowded group. No substantial or significant difference in dental arch depth between the crowded and noncrowded subjects could be noted. From these findings it seems that tooth size and dental arch width are determining factors in the formation of dental crowding. Clinically, these results suggest that in the treatment of dental crowding, extraction of teeth and/or expansion of dental arches should be considered depending on what is the main causative factor. PMID- 3562675 TI - Effectiveness of estradiol and progesterone in inducing LH release in different stages in rat estrous cycles. AB - The effectiveness of estradiol (E2) and progesterone (P4) in inducing the release of the luteinizing hormone (LH) in the acutely ovariectomized (OVx) rats was studied. Female rats were Ovx in different stages of the estrous cycles and received a series of injections of E2 and P4. LH dynamic changes in the blood were examined in the afternoon of the following day after Ovx. Intact rats treated with oil vehicle or E2 and P4 were used as controls. The surgical operation and oil treatment did not interfere with the normal reproductive rhythm and LH secretion, but treatment with E2 and P4 did facilitate the LH release in some intact rats. E2 and P4 were very effective in inducing LH release in Ovx rats as compared with controls. Results indicated that E2 and P4 are essential substances in eliciting the LH surge, but their efficacies are dependent on the stage in the estrous cycles. PMID- 3562676 TI - The ionic requirements for the production of action potential in Achatina fulica Ferussac neuron. AB - The ionic requirement for the production of directly elicited action potentials of a tonically auto-active neuron (TAN) in the subesophageal ganglia of the giant African snail, Achatina fulica Ferussac, was studied electrophysiologically. Calcium free Ringer solution containing 1 mM EDTA reversibly abolished the directly elicited action potential. Verapamil (10 micrograms/ml) or cocaine (4 mg/ml) decreased both amplitude and Vmax of the action potentials. The amplitude of the action potential was also slightly decreased in sodium free choline Ringer. However, tetrodotoxin did not significantly affect either the amplitude or Vmax of the directly elicited action potentials. The results suggest that the ionic requirement for generating action potential in snail neuron is not an ordinary sodium spike. Both calcium and sodium ions may participate in carrying charges across the membrane of the action potential. PMID- 3562677 TI - SEM observations of the neural fold associated with neurulation in the rat. AB - The topography of the ectoderm was examined by scanning electron microscopy during neurulation in rat embryos at stage 24 (somites 8-11). A zone of altered cell morphology was observed along the crest of neural folds. This zone was located between the presumptive neural tube and the surface ectoderm and exhibited numerous rounded cell blebs, immediately prior to fusion between the folds. It is suggested that the observed surface alterations may reflect a change in the properties of the altered cell which correlate with initial adhesion between the folds. PMID- 3562678 TI - Psychiatric commitment and involuntary hospitalization: an ethical perspective. AB - As a psychiatrist, I have focused in this paper on the medical model view of commitment. Directed against the medical model is the civil liberties position, mostly put forward by attorneys, which values autonomy over beneficence and sees psychiatric decision-making as biased, imprecise, and too paternalistic. Like the moral principles they champion, neither of these positions is "wrong." The tension between them is inevitable and sometimes beneficial. The conflict is inevitable because the proponents differ in their missions and how they think. Attorneys (and philosophers) think in terms of the general case, of classes of situations, whereas psychiatrists focus on individuals as unique. Chodoff has also pointed out that the medical model is a utilitarian one, i.e. the morality of an act is determined by, on balance, whether it increases the good for the individual or society. The civil liberties position, on the other hand, is a deontological one, i.e. the end does not justify the means; some moral principles must be considered even if they do not lead to maximally good outcomes. This conflict between positions can be ultimately beneficial, if we recognize that each is fighting for a good. As a society, we should expect psychiatrists and other mental health professionals to try their utmost to treat the mentally ill, and attorneys to protect their rights. When we view it as such a moral dilemma, "we are confronted not with melodrama, a contest of right against wrong, but rather with tragedy, a conflict of one right--to be at physical liberty--against another right--to be free dehumanizing disease." PMID- 3562679 TI - The effects of a psychiatric patient education to medication program on post discharge compliance. AB - The effect of a structured program of education on subsequent psychiatric patient compliance with medication-taking was investigated. The subjects consisted of 150 hospitalized patients housed on four acute-care receiving wards and ready for discharge from Fallsview Psychiatric Hospital in Ohio. They were randomly assigned to one of three groups. Results indicated that subjects who received written information with verbal reinforcement were significantly more compliant than the control subjects. These findings suggest that, if the hand-out is discussed with them, the patients given medication handouts similar to those used in the study will comply with medication-taking after discharge at a higher rate than those given no hand-out. Implications of these findings for increased psychiatric patients' post-discharge compliance with medications are discussed. PMID- 3562680 TI - The psychiatric emergency room and follow-up services in the community. PMID- 3562681 TI - Increased specificity in measuring satisfaction. AB - The authors report a patient satisfaction study that addressed some of the methodological limitations of previous studies and attempted to increase the variance in satisfaction assessment by increasing the scope and specificity of inquiry. Same sex patient/therapist match, duration of therapy, individual therapy and treatment with staff social workers rather than psychiatric residents all were positively correlated with increased patient satisfaction. Satisfaction appeared to be a unitary dimension that could be tapped by a global score. Nonetheless, although overall satisfaction was high, one third of patients preferred an alternative treatment. PMID- 3562683 TI - [Developmental status and goals in occupational therapy. The "Guidelines for Occupational Therapy in Psychiatric Hospitals"]. AB - Work therapy, or ergotherapy, is a recognised and permanent part of psychiatric treatment and medical rehabilitation. It is also an essential part of psychiatric diagnosis and therapy; furthermore, it enables the patient to develop and stabilise a realistic image of himself and contributes to the prevention and reduction of damage caused by hospitalism. The present status of work therapy was checked in 74 psychiatric hospitals throughout the Federal Republic of Germany, resulting in the need for further development of present practical procedures. A working group was created by the Federal Ministry of Labour and National Welfare within the framework of the model programme for psychiatry, at the suggestion of a Federal Working Group of the organisations running public mental hospitals in the FRG. The aim of this working group was to develop a specialised concept of work therapy. The group consisted of experts from clinical practice as well as from the Federal German Labour Office Institution, psychiatric consultants of the Federal Government and the Land Governments, as well as from the Land Government sponsors of state social welfare services. The "Guidelines for Work Therapy in Psychiatric Hospitals and Departments of Psychiatry" are officially considered to be a suitable basis for further development work in the field of ergotherapy. PMID- 3562684 TI - [Aspects of ambulatory occupational therapy]. AB - The authors report on the organisation and structure of a work therapy system set up at the Department of Psychiatry of the University of Munster which also looks after outpatients. The authors' presentation takes into account that there are not yet enough setups of this kind in the Federal Republic of Germany. A comprehensive survey is given of the patients' motives to participate, their attitude towards their activities, and the therapeutic effects as experienced by the patients. The ranking of work therapy within the overall framework of comprehensive outpatient care is discussed. PMID- 3562682 TI - A different empirical perspective on sex bias in the diagnosis of DSM III axis II disorders. PMID- 3562686 TI - [Is Chestnut Lodge salt in the wound of psychoanalytic contributions to the treatment of schizophrenia?]. AB - In a catamnestic follow-up study of 226 patients treated psychotherapeutically in Chestnut Lodge on an inpatient basis, two-thirds of the schizophrenics and one third of the patients with affective disorder presented with an unfavourable course. Since the schizophrenics had a chronic type of schizophrenia, this result agrees largely with the general course of schizophrenia. Although it is a disappointing result, it does away with both myths and distorted stories told about Chestnut Lodge. Social considerations as well as those based on institution analysis and on family therapy led to the thesis that the external reality of life of the schizophrenic patient is involved in deciding his possibilities of development even if the therapeutic approach is based on intrapsychic factors. The institutional nature of Chestnut Lodge, involving care and exclusion, was an obstacle to fulfilling Chestnut Lodge's claim that the conditions for an experimental trial in psychotherapy of schizophrenia (which aims at uncovering and understanding the patient's disturbed subjectiveness) are fulfilled only by a type of social psychiatry that allows the patient to solve the task of mastering his life in an adequate manner. PMID- 3562685 TI - [Unemployment in psychiatric patients]. AB - Occupational activity was studied in a representative sample of 450 patients from 5 in- and out-patient psychiatric institutions: among the patients of working age 16.5% were unemployed, 11.9% received social relief, and 13.9% were on a premature retirement pension, i.e. all in all 42.3% had to give up occupational activity prematurely. Only 30.1% were gainfully employed. An analysis of the results according to diagnosis showed particularly schizophrenic patients to be at a disadvantage (highest rate of premature retirement pensioners, lowest rate of employers), as well as alcoholics (highest rate of unemployment). The occupational situation of neurotic and psychosomatic patients was affected in a less degree. The data were compared to those of the general population. Psychiatric patients, we had to confirm, are particularly at a disadvantage when unemployment is generally high. Another important factor, however, seems to be that patients, their families, doctors and employers estimate capacity of performance on account of the specific illness, thus calling for intensified efforts toward rehabilitation. PMID- 3562687 TI - [Work--its significance in the therapy and rehabilitation of chronic psychiatric patients]. AB - More and more chronic mental patients live in the communities and are jobless. Most of them cannot be expected to become gainfully employed in the near future, but the aim of all efforts should always be a permanent working place or at least meaningful activity. Due to the multitude of institutions participating in rehabilitation work the only chance of maximum utilisation of available chances can be achieved only by a local rehabilitation team. The article discusses the available scientific data on evaluation, success prediction, environmental structuralization and organisation of psychiatric working area. PMID- 3562688 TI - Mitral valve abnormalities and catecholamine activity in anxious patients. AB - We studied 38 anxiety disorder patients, 19 of whom had evidence of mitral valve abnormalities by two-dimensional echocardiography. The presence or absence of mitral valve abnormalities was not related to 3-methoxy-4 hydroxyphenylglycol/creatinine excretion, platelet and plasma monoamine oxidase type activity, or autonomic arousal as measured by blood pressure and resting heart rate. These findings fail to support the hypothesis that mitral valve abnormalities identify a specific subpopulation of anxious patients with differences in catecholamine function. PMID- 3562689 TI - Magnetic resonance imaging studies of the brains of schizophrenic patients. AB - Magnetic resonance imaging studies of the brains of schizophrenic and control subjects were performed using a 0.3 Tesla superconducting magnet. Quantitative measurements of ventricular size, sulcal width, and standardized image intensity were performed. There were no significant differences between schizophrenic and comparison subjects for linear or area measures related to ventricular size, corpus collusum size, or cortical atrophy. However, schizophrenics had a significantly higher image intensity in the inversion recovery mode (IR-30). Since the IR-30 images are T1 weighted, this suggests that there may be differences in T1 relaxation times in tissues in some areas of the brains of schizophrenics as compared to controls. However, more precise measurements of T1 relaxation time are needed to confirm this finding. PMID- 3562691 TI - The nature of emotional blunting: a factor-analytic study. AB - To investigate the components of emotional blunting, we factor-analyzed an emotional blunting scale, and examined the relationships between the derived factors and several clinical variables in two patient samples. Two factors were identified, corresponding to "lack of emotional expression" and "avolition". The "avolition" factor was strongly related to clinical improvement after treatment. Discriminant analyses indicated that schizophrenics could be differentiated from manics by emotional expression and from depressives by avolition. Scores on two shorter scales derived from the factors were also highly predictive of clinical improvement and diagnosis. These results indicate that emotional blunting can be differentiated into two easily measured components which may have different clinical significance. PMID- 3562690 TI - Rating scales in research: the case of negative symptoms. AB - Two measures of negative schizophrenic symptoms, the Scale for the Assessment of Negative Symptoms and the withdrawal-retardation subscale of the Brief Psychiatric Rating Scale, are found to be redundant when used together. Studies incorporating redundant measures have numerous disadvantages. Using multiple scales increases the cost and effort for the investigator, places a greater burden on research subjects, and compromises the interpretability of findings by increasing the probability of both Type I and Type II errors. A strategy for evaluating the use of multiple rating scales is suggested, and the theoretical basis of this strategy is discussed. PMID- 3562692 TI - Relationship of HLA to schizophrenia in 10 nuclear families. AB - We tested the hypothesis of linkage of HLA (human leukocyte antigens) and schizophrenia in 10 nuclear families that were ascertained on the basis of at least two siblings affected with chronic schizophrenia (SCH), as defined by Research Diagnostic Criteria, with or without superimposed affective disorder. All available parents and siblings were interviewed and typed for HLA antigens at the A, B, C, and Dr loci. Lod scores for linkage between HLA and a putative SCH locus were calculated using the program LIPED, assuming several possible models for the mode of transmission of the SCH locus. Linkage was also tested with DSM III schizotypal and paranoid personality disorders considered as part of the illness phenotype. The lod score analysis indicated that for most models of inheritance of schizophrenia, close linkage to HLA could be excluded. The results did not change if individuals with "spectrum" disorders were considered affected. We also tested for linkage using the affected sib-pair method which does not require any assumptions about the mode of transmission of the illness. The results of this analysis also indicated that linkage to HLA was very unlikely. If our results are considered together with other published studies, a susceptibility locus for schizophrenia or "schizophrenia spectrum" is not likely to be in the HLA region of chromosome 6. PMID- 3562693 TI - Diurnal rhythm of plasma MHPG in endogenous depression. PMID- 3562694 TI - Plasma dexamethasone levels in depression: oral vs. i.v. administration. PMID- 3562695 TI - Robert Waelder on psychoanalytic technique: five lectures. AB - Biographical information regarding Robert Waelder is readily available (Guttman, 1986), and this is not the place for it. The following is a rare and direct example of his "old-fashioned" teaching. "Old-fashioned" and "conservative" are criticisms often leveled at Waelder these days. Yet, "Old-fashioned is not precisely the word for Waelder.... He was a conservative in the best sense, as his later writings continued to prove, one who would not relinquish what is good for the sake of the supposed 'ideal' situation imagined by those restless for change. This was his ethic, and his conservatism was entirely humanitarian. He refused to idealize 'human nature' and tried to preserve the realism of his clinical sense in matters beyond the clinic" (Lewin, 1968, p. 9). PMID- 3562696 TI - Psychoanalysis and negotiation. AB - Somewhere between the image of psychoanalysis as suggestion and psychoanalysis as unearthing is that of analysis as negotiation. This is a picture of a mutual construction of reality by analyst and patient. Such an interaction allows for reciprocal input of the participants and a possible change in both. This paper sketches the role of negotiation throughout the entire process of treatment--from the initial rules, to the theory of the analyst, to the emergence of the transference, to the goal of the cure. The technique of psychoanalysis is said to lie in the process of negotiation. PMID- 3562697 TI - On the technique of analysis of the superego--an introduction. AB - As a result of Freud's ambiguity (and that of later analysts) regarding the nature of the superego and how to treat it in clinical practice, it has taken many years and many theoreticians to move from Freud's predilection to use it for purposes of "suggestion" in overcoming resistance, toward the concept of the superego as part of the ego's hierarchically mobilized defensive activities in the analytical process. Although much ambiguity persists, an attempt is made here to reduce it so that analytical technique may move forward to allow the superego to be analyzed as an unconscious conflict solution. PMID- 3562698 TI - Dreams and acting out. AB - Dreams can be used as containers that free patients from increased tension. This may be the principal function of certain types of dreams, called "evacuative dreams." They are dreams used for getting rid of unbearable affects and unconscious fantasies, or as a safety valve for partial discharge of instinctual drives. These dreams are observed primarily in borderline and psychotic patients, but can also be seen in the regressive states of neurotic patients during weekends and other periods of separation. Such dreams have to be differentiated from "elaborative dreams," which have a working-through function and stand in an inverse relationship to acting out: the greater the production of elaborative dreams, the less the tendency to act out, and vice versa. PMID- 3562699 TI - Some notes on insight and its failures. AB - Many patients who had been in a prior psychoanalysis or psychotherapy have a view that "insight" has not been useful to them. The previous treatment has often been condensed into a screen memory serving a variety of functions. An attempt is made in this paper to explore problems of the effectiveness of insight and its relation to a range of ego functions, transference issues, and related fantasy systems. PMID- 3562700 TI - An ego psychology-object relations theory approach to the transference. AB - This paper summarizes an ego psychology-object relations theory and its application to psychoanalytic technique, particularly to the analysis of the transference. The relative importance of verbal, nonverbal, and generally relational "channels" of communication in patients with differing degrees of transference regression is examined. The use of countertransference reactions in formulating transference interpretations is reviewed. The relations between unconscious meanings in the "here-and-now" and unconscious meanings in the "there and-then" are explored in the transferences of patients with varying degrees of severity of psychopathology. Differences with other theoretical approaches are highlighted throughout. PMID- 3562701 TI - A core process in psychoanalytic treatment. AB - A core mechanism of the psychoanalytic process is described. This involves the effects of treatment on an ongoing "unconscious intrapsychic process," which has specific points of vulnerability to pathology. The concept of an intrapsychic process described by the author in previous publications is an expanded formulation of the idea of thought as trial action and of the signal theory of anxiety. The psychoanalytic method alters the functioning of the ego astride this unconscious process, strengthening its control over anxiety, defense, trauma, and symptom formation. This is mutative in the psychoanalytic method. PMID- 3562702 TI - The dynamics of interpretation. AB - The patient's productions are a dynamic record of the conflicts of the past as they are recapitulated and re-experienced in the present. Much can be learned by closely studying the immediate effect of the analyst's interventions. Interpretation, especially of transference phenomena, will upset the equilibrium which has been effected and will enable the patient to understand how unconscious fantasies from the past continue to influence his perception and reactions in the present. Interpretation is a continuing process, unfolding in logical sequence. Transference may be an expression of the patient's resistance to recognizing an unconscious wish toward the original object. PMID- 3562703 TI - Effects of mood and severity on memory processes in depression and mania. PMID- 3562704 TI - Errors and mistakes: evaluating the accuracy of social judgment. PMID- 3562705 TI - The relation of empathy to prosocial and related behaviors. PMID- 3562706 TI - Child/adolescent behavioral and emotional problems: implications of cross informant correlations for situational specificity. PMID- 3562708 TI - Preparedness and phobias: a review. PMID- 3562707 TI - Sex differences in unipolar depression: evidence and theory. PMID- 3562709 TI - Self-reported type A behavior and marital status. PMID- 3562710 TI - Rimon's Brief Depression Scale, a rapid method for screening depression. PMID- 3562711 TI - Adjustment to relocation of long-stay patients with a psychiatric hospital setting. PMID- 3562712 TI - Punishment-induced aggression: a possible mechanism of child abuse. PMID- 3562713 TI - The Berserker/Blind Rage syndrome as a potentially new diagnostic category for the DSM-III. PMID- 3562714 TI - Sleep spindles in the EEGs of hyperactive children. PMID- 3562716 TI - Testing loneliness on the differential Loneliness Scale. PMID- 3562715 TI - Relation of depression to specific medical complaints in psychiatric inpatients. PMID- 3562718 TI - Corrected statistical analysis suggests casual transmission of AIDS in the African study on the Centers for Disease Control. PMID- 3562717 TI - Comparison of outcomes of behavioral family therapy given families with children and families with adolescents. PMID- 3562719 TI - Multidimensional health locus of control of pregnant women who smoke. PMID- 3562720 TI - Considerations in prewarning clients of the limitations of confidentiality. PMID- 3562721 TI - Factor structure of the Death Concern Scale: a replication. PMID- 3562722 TI - Effects of exhortation and scheduled visits on improving the psychological well being of institutionalized elderly persons. PMID- 3562724 TI - Traditional holidays and suicide. PMID- 3562723 TI - Effects of training on learning disabled students' creative written expression. PMID- 3562725 TI - Hysteroid-obsessoid personality and romantic love. PMID- 3562726 TI - Smoking and academic achievement: a pilot study. PMID- 3562727 TI - Relation between parent-rated adaptive behavior and school ratings of students referred for evaluation as educable mentally retarded. PMID- 3562728 TI - Empathy scores of nurses, psychiatrists and hospital administrators on the California Psychological Inventory. PMID- 3562729 TI - Clinical psychology in a new context. PMID- 3562730 TI - Israeli college students drinking problems: an exploratory study. PMID- 3562731 TI - Learning disabilities and other attributes as factors in delinquent activities among adolescents in a nonurban area. PMID- 3562732 TI - Differentiating under- and overcontrolled behavior of adolescent outpatients with the High School Personality Questionnaire. PMID- 3562733 TI - Factor structure and factorial replication of a new measure of the type A behavior pattern. PMID- 3562734 TI - Adolescents' self-disclosure of potentially embarrassing events. PMID- 3562735 TI - Note on psychological differences between 18-yr.-old Finnish females who use vs do not use oral contraceptives. PMID- 3562736 TI - Measuring resistance to hypnosis and its relationship to hypnotic susceptibility. PMID- 3562737 TI - Development of conservation and academic achievement in learning disabled children. PMID- 3562739 TI - Locus of control in children with epilepsy. PMID- 3562738 TI - Hassles and uplifts during the freshman year of medical school. PMID- 3562740 TI - Sexual arousal and aggression in a free-choice situation. PMID- 3562741 TI - Characterization of the prandial plasma corticosterone peak in the freely moving rat. AB - To characterize the prandial plasma corticosterone peak, three experiments were done on adult male Wistar rats: (1) the prandial hormone peak was followed at three different times of day, 0800 h, 1900 h, and 0100 h, in starved rats; (2) a 20% glucose solution was infused into the jugular vein or was given as a drinking solution after a 24-h starvation; (3) in order to determine the role of vagal proprioceptive inputs, the hormone peak was examined at two times of day, 0800 h and 0100 h, in starved vagotomized rats. The prandial hormone peak was more conspicuous at midnight than in the daytime. Exposure to food pellets without feeding failed to induce a hormone rise. The peak appeared after oral ingestion, but not after intravenous infusion, of glucose solution. Ingestion of water alone was without effect. The peak was not affected by bilateral vagotomy. Thus, as far as glucose as a metabolite is concerned, the possibility that glucose per se works directly on the brain or indirectly through glucoreceptors in the gut was excluded. Possible modes of action of glucose ingestion are discussed. PMID- 3562742 TI - Blockade of the LH surge and ovulation by GABA-T inhibitory drugs that increase brain GABA levels in rats. AB - The present experiments were designed to evaluate the effects of GABA increase in the brain on the LH surge and ovulation in female rats. GABA-transaminase (GABA T) inhibitory drugs were administered intraperitoneally in the early afternoon hours on the day before the expected ovulation. Gamma-acetylenic GABA (GAG) prevented the proestrus LH surge and ovulation in freely moving adult female rats. In a similar manner, GAG blunted the enhanced LH release found at 1800 h on the preovulatory day and the subsequent ovulation in PMSG-treated 32-day-old rats. LH secretion and ovulation in these animals was restored by administration of the selective GABA antagonist, bicuculline. The other GABA-T inhibitors, amino oxyacetic acid and gamma-vinyl GABA, produced similar effects to GAG in the PMSG treated rats. These results indicate that the increase of brain GABA levels during the preovulatory day alters LH release and prevents ovulation in rats. PMID- 3562744 TI - Familial correlation of memory function in schizophrenia. AB - Chronic schizophrenic patients with first- or second-degree schizophrenic relatives were evaluated for memory function. Wechsler memory scale scores were significantly correlated between index cases and relatives (r = 0.56, p less than 0.05), suggesting that poor memory function in schizophrenia may represent a familial subtype. PMID- 3562743 TI - Psychopathological correlates of plasma cortisol after dexamethasone suppression: a polydiagnostic approach. AB - Seventy-seven consecutively admitted inpatients with depressive syndromes were examined with the Present State Examination and classified according to eight different operational diagnoses of endogenous depression. All patients received a 1.5 mg dexamethasone suppression test (DST). Sensitivity, specificity and the corrected predictive values of DST nonsuppression (50 or more ng/ml at 0800 hr, 1600 hr, or 2300 hr), adjusted to a 50% prevalence of endogenous and nonendogenous depression, varied considerably depending on the diagnostic definition used. The highest predictive value (89.9%) was found with the Taylor Abrams criteria (sensitivity = 43.9%, specificity = 95.0%), and the lowest predictive value (53.3%) with DSM-III (sensitivity = 37.7%, specificity = 68.1%). Eliminating the patients with dexamethasone levels of less than 2000 pg/ml improved the diagnostic specificity of the DST for most of the eight definitions of endogenous depression. This further indicates that plasma dexamethasone levels should be analyzed in studies designed to explore the diagnostic utility of the DST. A significant, chance-corrected association between DST nonsuppression and the diagnosis of endogenous depression was found with clinical diagnosis (according to the International Classification of Diseases), and for four out of eight operational diagnoses (Newcastle Scale I, Newcastle Scale II, Taylor-Abrams Criteria, and Vienna Research Criteria). For the other diagnoses (Research Diagnostic Criteria, DSM-III, Michigan Discriminant Index, and Hamilton Endogenomorphy Index), no significant association was found. The RDC criterion "early or intermittent awakening" was the only one out of 28 diagnostic criteria tested which was significantly associated with DST nonsuppression. PMID- 3562745 TI - Psychological findings in chronic anal pain. AB - The psychological characteristics of 21 patients suffering from chronic anal pain were studied. They underwent a clinical interview and completed the Eysenck personality questionnaire, the Zung self-rating depression scale and an analogue scale for the assessment of perceived pain. Data derived from the self-rating scales were compared with those obtained from a matched control group afflicted with fissure-in-ano. The pain patients reported higher scores for neuroticism, psychoticism, depression and perceived pain than the controls. Fifty percent of the experimental group had suffered prior to the onset of pain from depressive disturbances, and 11 subjects reported at the clinical interview somatic symptoms which usually accompany depression. These results support the hypothesis that the pain symptom in some patients with chronic anal pain could represent the manifestation of an underlying depressive disturbance. PMID- 3562746 TI - The polydiagnostic interview: a structured interview for the polydiagnostic classification of psychiatric patients. AB - A structured interview (PODI) for the polydiagnostic evaluation of affective and schizophrenic disorders is presented. The interview includes elements of the Structured Clinical Interview for DSM-III (SCID) and of the Present State Examination (PSE). The central idea of this interview is to break down complex criteria into their elements, to assess a wide area of such elements, and to recombine them by a computer program according to different algorithms that are included in a greater number of operational diagnoses. Reliability data will be presented which show sufficiently high kappa and Yule coefficients for a selected set of diagnostic criteria for depressive, manic and psychotic disorders. The applicability of the PODI was established in about 180 interviews. PMID- 3562747 TI - Assessment of severity of suicide attempts. A trial with the dexamethasone suppression test and 2 rating scales. AB - In this study, the dexamethasone suppression test (DST) and 2 rating scales, the 'Echelle d'Evaluation de Risque Suicidaire' and the Pierce modified form of the Suicide Intent Scale, were administered to a group of 37 subjects admitted to the general hospital of Padua for suicide attempts. The purpose of our study was to verify if these tools could be considered useful in assessing the severity of the attempts. 10 subjects were DST-positive, but the test evidenced very low sensitivity and predictive value. The 2 rating scales demonstrated a good degree of concordance in identifying the adjustment disorder group as being at a lower risk for a serious attempt. PMID- 3562748 TI - Prognostication in schizophrenia. AB - A long-term follow-up study with a mean duration of 20.2 years was performed in 5 year periods for 280 male schizophrenic patients discharged 1946-1950. To avoid a heterogeneous evaluation of the prognosis the author combined the outcome variables 'symptomatology', 'working ability' and 'social integration' as 'overall prognostic index'. Thus the final results show that prognosis is favorable in one-half of the patients (50.7%), relatively favorable in less than one-fourth (21.8%) and unfavorable in about one-fourth of the cases (27.5%). The author stated further that the prognosis is correlated with less clinical and more socially determined factors. In most of the cases favorable and unfavorable prognostic variables are both simultaneously presented, which does not allow the prospective prediction of individual prognosis in schizophrenia. PMID- 3562749 TI - Perinatal distress and infectious disease as risk factors for catatonia. AB - A retrospective case control study was performed using the records of 60 catatonics, 189 noncatatonic schizophrenics, 262 schizophreniform disorder cases, 122 manics, 203 depressives and 134 surgical controls. This study suggests that perinatal distress and a history of severe infectious disease in childhood are more common among subjects with catatonia. Rheumatic fever is particularly common among the histories of catatonic patients. Although these findings did not occur in all cases of catatonia in the study, they may indicate a risk factor for some types of catatonia. PMID- 3562750 TI - Prevalence of some symptoms in adolescence and maturity: social phobias, anxiety symptoms, episodic illusions and idea of reference. AB - In order to compare the prevalence of certain symptoms in adolescence with those at other ages, 6,034 apparently normal subjects aged 9-60 years were studied by questionnaire. Fear of blushing and fear of being looked at showed a maximum in the mid-teens and a subsequent gradual decrease both in males and females. They were more common in females at most ages. The anxiety symptoms also showed a peak in the mid-teens but there was a period of relative increase in the forties. Episodic illusions and the idea of being talked about started to decrease with age in adolescence. PMID- 3562751 TI - ["Hansel and Gretel, my favorite fairy tale"]. PMID- 3562752 TI - [Research trends in psychotherapy and the study of neuroses in the last 15 years- a personal impression]. PMID- 3562753 TI - [Empirical assessment of alexithymia using the semantic differential]. PMID- 3562754 TI - [Contribution of psychosocial factors to the outbreak and course of acute viral hepatitis--report of a pilot study]. PMID- 3562755 TI - [Alopecia--a psychosomatic disease picture? I. Review of the literature]. PMID- 3562756 TI - [Approach to new paradigms or a return of established methods? On the development of psychiatric research]. PMID- 3562757 TI - [Systematic analogy and early organization of affect, physiologic adaptation and ego structure with reference to the development of individual psychosomatic constellation patterns]. PMID- 3562758 TI - [Psychosomatic rehabilitation in pension procedures]. PMID- 3562760 TI - A framework for the study of medical depression. PMID- 3562759 TI - [Diagnosis of borderline disorders: assessment of the reliability of the Diagnostic Interview for Borderline disorders]. PMID- 3562761 TI - Noncompliance in younger adults on hemodialysis. PMID- 3562762 TI - Bulimia in a peripartum cardiomyopathy patient. PMID- 3562763 TI - A mental syndrome associated with colonic carcinoma: limbic encephalitis? PMID- 3562764 TI - Low birth weight 1975-85 and perinatal mortality. PMID- 3562765 TI - Resource implications of orthopaedic waiting lists: implementing the Duthie proposals. PMID- 3562766 TI - Unnecessary hospitalisation among the elderly--patterns and characteristics. PMID- 3562767 TI - Public health management of meningococcal disease: indications from a one year national survey in Italy. PMID- 3562768 TI - Drinking, smoking and other factors in the epidemiology of unintentional non motor vehicle injuries. PMID- 3562769 TI - Aetiology of childhood blindness in Benin City, Nigeria. PMID- 3562770 TI - [The supply and demand for dentists in Puerto Rico: the years 1985, 1990 and 1995]. PMID- 3562771 TI - Incidence of insulin dependent diabetes mellitus in Puerto Rico: the University Pediatric Hospital experience. AB - The incidence of newly-diagnosed Insulin-dependent diabetes mellitus (IDDM) in a pediatric population has been found to increase with colder seasons in countries at latitudes where a marked weather change presumably triggers a higher prevalence of viral infections (especially respiratory), that may induce an insulitis which could be etiologically related with IDDM. In order to assess whether the opposite is true for a country with rather uniform climate, like Puerto Rico, we have studied the seasonal pattern of newly diagnosed IDDM seen at our institution during a 10 year period (1973-1982). Also, recent reports on a higher mortality from diabetes in Puerto Rico going from 16.6 in 1977 to 31.0 in 1983, prompted us to look at a possible secular trend of increasing incidence of IDDM. There were a total of 269 new cases of IDDM or 27 cases/year, with standard deviation (SD) of +/- 5.3, range 18 to 33, and no secular trend at all. Sex distribution was quite variable, having male:female (m/f) ratios from 1:2 to 3:1, and an over-all m/f of 13.3/13.6. Incidence of IDDM per month of year went from a low of 1.7 for April and November to a high of 3.0 for March and 2.9 for September, 2.8 for October, with a mean of 2.24 +/- 0.48 cases/month. Again, no significant seasonal differences were noted. Mean incidence for our "cold" months (November to April was 2.25/month; for our "hot" season (May to October) was 2.3/month; for our "rainy" season (July to December) 2.3 and for our "dry" season (January to April) 2.3/month. Thus, it appears that there are no such seasonal trends of IDDM In Puerto Rico. PMID- 3562772 TI - Lysis of red blood cells by extracts from benthic dinoflagellates. AB - Samples of the cultured benthic dinoflagellates Gambierdiscus toxicus and Ostreopsis lenticularis, both isolated from a shallow back reef habitat in southwestern Puerto Rico, were extracted in methanol, dried and resuspended in distilled water. After centrifugation, aliquots of the supernatant, or dilutions thereof, were added to suspensions of washed human and mouse red blood cells and incubated at different temperatures for different time periods. Further spectrophotometrical examinations of the samples showed a hemolytic activity against mouse and human red blood cells. The hemolytic activity of G. toxicus extract was 3 to 4 times greater than that of O. lenticularis and was less temperature-dependent. Such findings suggest that these two dinoflagellates produce chemically different hemolysins. PMID- 3562773 TI - Effect of distension of the urinary bladder on efferent cardiac sympathetic nerve fibres which respond to stimulation of atrial receptors. AB - The effect of distension of the urinary bladder on the activity in the efferent cardiac sympathetic nerves which responded to stimulation of atrial receptors or those which responded to stimulation of carotid baroreceptors or chemoreceptors, was studied in dogs anaesthetized with chloralose; the urinary bladder was distended with warm saline, small balloons were positioned at the right pulmonary vein-atrial junctions and distended with 1 cm3 saline, and the carotid sinuses were vascularly isolated and perfused with blood at constant flow. The efferent cardiac sympathetic nerve fibres which responded to stimulation of carotid baroreceptors and chemoreceptors by a decrease in activity always responded with an increase in activity in response to distension of the urinary bladder. In contrast, in those efferent cardiac sympathetic nerve fibres which did not respond to an increase in carotid sinus pressure, but responded to stimulation of atrial receptors by an increase in activity, distension of the urinary bladder neither caused a significant change in activity nor produced a reproducible pattern of response. It is concluded that the efferent cardiac sympathetic nerve fibres which respond to stimulation of atrial receptors are separate from those which respond to distension of the urinary bladder. PMID- 3562774 TI - Intracellular and whole-cell recordings from zona-free hamster eggs: significance of leak impalement artifact. AB - Measurements have been made of membrane potential and input resistance of zona free hamster eggs from single micro-electrode recordings. At room temperature (20 23 degrees C) the mean (+/- S.D.) values for the potential and resistance were 30 +/- 8 mV and 280 +/- 130 M omega (n = 94 eggs). At 37 degrees C the mean (+/- S.D.) values for the potential and resistance were -39 +/- 13 mV and 230 +/- 60 M omega (n = 60 eggs). The most negative potential recorded at room temperature was -51 mV in a cell which had an input resistance of 620 M omega. At 37 degrees C six eggs out of sixty had potentials more negative than -50 mV and three of these gave all-or-none action potentials in response to depolarizing current pulses. In a separate series of experiments with high resistance micro-electrodes (ca. 100 M omega) six eggs out of twenty-one had potentials more negative than -50 mV and four of these were electrically excitable. Transient potential recordings during impalement indicated that the potential was more negative than -30 mV but that the insertion of a micro-electrode produced a leak pathway with a resistance of about 10 M omega, substantially smaller than the steady-state estimates of the input resistance (see above). Whole-cell recordings with patch pipettes gave potentials in the range -30 to -80 mV and input resistances in the range 180 to 350 M omega (n = 8); four eggs gave action potentials in response to depolarizing current pulses passed through the patch pipette. It is concluded that the leak impalement artifact is so significant in micro-electrode recordings from hamster eggs that it prevents routine reliable potential measurements. PMID- 3562775 TI - Effects of removing milk from the mammary ducts and alveoli, or of diluting stored milk, on the rate of milk secretion in the goat. AB - Goats were milked frequently (at 10.00, 11.30, 13.00 and 14.30 h) between normal morning and afternoon milking, using a catheter to drain the milk stored in the cistern and large ducts of the mammary gland; no increase in the rate of milk secretion occurred. When the same study was repeated but oxytocin was injected to elicit milk ejection and empty the alveoli, the rate of milk secretion increased significantly. The stimulatory effect of frequent catheter-milking plus exogenous oxytocin was evident at peak lactation as well as during declining lactation. When milk stored in the mammary gland was diluted with an isosmotic sucrose solution, the rate of milk secretion increased significantly. Again this effect was apparent at all stages of lactation. These results are discussed in relation to the local inhibitor hypothesis on the modulation of milk secretion. PMID- 3562776 TI - Iron content and distribution in Japanese quail. AB - Determination of blood haematocrit and haemoglobin, plasma iron content, total iron binding capacity and phosphoprotein (vitellogenin), and the iron content of different organs (pectoral muscle, liver, spleen, intestine, femur bone marrow, blood, gonad and eggs, and feathers) were carried out in prelaying, onset of laying and full laying females, as well as in adult males. The whole iron content was also determined on incinerated specimens giving these results: 53.7 parts per million (p.p.m.) iron in the prelaying group, 54.5 p.p.m. iron at the onset of laying, 64.3 p.p.m. iron in full laying and 53.5 p.p.m. iron in males. The plumage represented 5-8% of the total body weight, and its iron content oscillated between 152-163 p.p.m. iron in males and non-laying females and 177.3 p.p.m. iron at full laying. The laying period induced important variations in plasma levels and in organ distribution, but not in haematological values. The first eggs laid were smaller (9.2 g) and richer in iron (427 micrograms iron) than those laid by older layers (11.8 g and 305 micrograms iron). The percentage distribution of the total iron content of organs was, in prelaying females: feathers, 21.9; blood, 56.6; pectoral muscle 8.1; liver, 9.7; intestine, 2.7. In laying females: 29.1; 46.6; 11.5; 7.4; 4.2. In males: 17.4; 59.6; 11.4; 7.9; 2.3. The increase in intestinal iron content in laying quails coincided with a double intake of food. This distribution differs from the mammalian model, as egg production (where each egg represented 2.5-5.5% of the total iron) and the great inert iron deposits in the plumage require an elaborate iron metabolism control system to cover all the iron needs in birds. PMID- 3562777 TI - Motilin secretion and the migrating myoelectric complex in the pig. AB - The concentration of motilin in plasma from the abdominal aorta and the hepatic portal vein and the net portal motilin output varied with the phase of the migrating myoelectric complex (m.m.c.) in five of six pigs fasted for 17 h. Maximum concentrations and output occurred 9-12 min before phase III in the duodenum or upper jejunum. In fed pigs m.m.c.s occurred and the first phase III in the duodenum occurred within 90 min of feeding. Both portal and arterial motilin concentrations were reduced after feeding and no longer varied with the phase of the m.m.c. Altered secretion of motilin after feeding did not appear to be associated with absorption of glucose as infusion of glucose (50 g/l, 10 ml/min) into the duodenum raised arterial and portal plasma glucose concentrations to post-prandial levels yet motilin concentrations and output rates still varied with the phase of the m.m.c. Infusions of motilin (1 or 10 ng/kg X min) into the portal vein of 17 h fasted pigs did not induce an extra phase III or alter the duration of the m.m.c. Hydrochloric acid (100 mmol/l) infused into the duodenum of fasted pigs at 10-21 ml/min increased the concentration of motilin in the portal blood but was without effect at 5 ml/min. Rapid injections of 50 ml hydrochloric acid into the duodenum also increased the portal motilin concentration. Hydrochloric acid infusion or injection did not alter the interval between phase IIIs. It is concluded that motilin secretion is a consequence of the m.m.c. or shows the same periodicity as the m.m.c. but that motilin is not an important factor in the initiation and control of the m.m.c. in the pig. PMID- 3562778 TI - Studies on the maturation of the small intestine of the fetal sheep. I. The effects of bilateral adrenalectomy. AB - The effect of bilateral adrenalectomy at 120 d gestation on subsequent maturation of proximal and distal small intestine was investigated in chronically catheterized fetal sheep. Ten adrenalectomized and fourteen controls were examined at 136 d; some following infusion of [3H]thymidine at 3-6 d or 4 h before termination of pregnancy. Mean plasma cortisol levels were 5.3 +/- 0.7 ng/ml in the adrenalectomized group; control values ranged from 14 to 39 ng/ml level during the 2-week experimental period. Fetal body growth was significantly increased following adrenalectomy. In the small intestine, growth of mucosal structures was reduced, especially in distal regions. Villus height was significantly reduced in both regions. External muscle thickness was significantly increased in both regions. Despite these changes there was no alteration in villus enterocyte morphology, nor were there any significant changes in villus or crypt densities. The proportion of crypt cells labelled with [3H]thymidine was unaffected by adrenalectomy. In proximal regions, migration rate of labelled enterocytes declined from 12.0 to 5.83% villus height/d (P less than 0.025) after adrenalectomy; there was no change in migration rate in distal regions. The estimated renewal time was greater in both proximal and distal regions in adrenalectomized compared with control fetuses. PMID- 3562779 TI - Studies on the maturation of the small intestine in the fetal sheep. II. The effects of exogenous cortisol. AB - The effect of cortisol on small intestinal maturation was investigated in catheterized fetal sheep by infusing 2 mg cortisol/d between 105 and 115 d gestation (term ca. 147 d). This treatment resulted in a fivefold increase in plasma cortisol compared with catheterized control fetuses of the same age. There were no detectable changes in enterocyte morphology after the cortisol infusion; the size and density of most intestinal components were largely unaffected by the treatment. By contrast, the kinetics of the enterocyte population were significantly altered by the raised cortisol levels. The proportion of crypt cells labelled was significantly increased from 0.20 +/- 0.04 to 0.33 +/- 0.03 in the proximal region (P less than 0.01) and from 0.22 +/- 0.03 to 0.31 +/- 0.02 in the distal region (P less than 0.01). The migration of enterocytes in both regions was significantly increased to nearly twice the control values (P less than 0.05). Correspondingly, renewal time was almost halved in both regions, while cell density was unchanged in distal and decreased in proximal regions. Hence cell loss appeared to have increased as a result of the cortisol infusion. The kinetic parameters for the villus enterocyte population of the fetuses receiving cortisol before 115 d were of similar magnitude to those previously seen in the normal near-term fetus. To this extent exogenous cortisol treatment given before a pre-partum surge mimicked the action of the endogenous hormone in late gestation. PMID- 3562781 TI - Public concern about the fate and effects of ionizing radiations released into our environment. PMID- 3562780 TI - Lung reflexes affecting the larynx in the pig, and the effect of pulmonary microembolism. AB - Laryngeal airflow resistance was measured in anaesthetized pigs during stimulation of lung vagal reflexes by injection of phenylbiguanide and of capsaicin, before and during pulmonary microembolism due to intravenous injection of hardened red blood cells; the microembolism caused pulmonary hypertension. The Breuer-Hering reflex was also assessed before and after pulmonary microembolism. Phenylbiguanide and capsaicin caused apnoea followed by rapid shallow breathing, hypertension, bradycardia and laryngeal constriction in inspiration and expiration. Most of these effects were abolished by bilateral cervical vagotomy. Pulmonary microembolism caused only small changes in breathing pattern, mainly a decrease in inspiratory time. After microembolism the Breuer-Hering reflex was enhanced, and injections of phenylbiguanide and capsaicin caused longer apnoeas by a vagal reflex. The changes in pattern of breathing and in lung reflexes after lung microembolism and during the associated pulmonary hypertension are consistent with an enhancement of pulmonary stretch receptor activity in this condition, but do not indicate any important role for C fibre reflexes. PMID- 3562782 TI - Brush border intestinal enzymes after multiple daily fractionation. AB - The modifications in brush border enzyme activity of the epithelial cell of the small intestine were studied after multiple daily fractionation (MDF) of 3 Gy X and 3 Gy X 2 X 2 (12 h split). Disaccharase and dipeptidase activities changed in the same way after irradiation. The results show that both total doses caused the three known phases of increase, decrease, and a return to normal. With MDF, activity at the end of irradiation was similar to or greater than that of controls and remained higher longer than a single dose of 8 Gy. However, the return to normal occurred sooner than after a single dose of 8 Gy. After 11 days, circadian oscillations of brush border enzyme activity appeared similar to those of controls in many segments of the intestine, reaching the highest activity during the night and the lowest in the afternoon. PMID- 3562784 TI - Chromosome condensation may enhance X-ray-related cell lethality in a temperature sensitive mutant (tsBN2) of baby hamster kidney cells (BHK21). AB - In the tsBN2 cell line, which has a temperature-sensitive defect in the regulatory mechanism for chromosome condensation, the lethal effect of X rays was enhanced by incubating the cells at a nonpermissive temperature (40 degrees C) following X irradiation. This enhancement was suppressed in the presence of cycloheximide, which inhibits induction of premature chromosome condensation. The findings obtained in the case of delayed incubation at 40 degrees C and in synchronized cells indicate that X-ray-related potentially lethal damage, which can be expressed by chromosome condensation, is produced in the cells at any stage of the cell cycle, but it is repairable for all cells except those at around the late G2-M phase, where chromosome condensation occurs at a permissive temperature (33.5 degrees C). These observations suggest that the high sensitivity of late G2-M cells to X rays is caused by the events associated with chromosome condensation. PMID- 3562783 TI - Microwaves and the cell membrane. III. Protein shedding is oxygen and temperature dependent: evidence for cation bridge involvement. AB - Microwaves (2450 MHz, 60 mW/g) are shown to result in the release or shedding of at least 11 low-molecular-weight proteins (less than or equal to 31,000 Da) from rabbit erythrocytes maintained in physiological buffer. Protein release was detected by gel electrophoresis of cell-free supernatants using sensitive silver staining. This release is oxygen dependent and occurs in 30 min for exposures conducted within the special temperature region of 17-21 degrees C, which is linked to a structural or conformational transition in the cell membrane. Shedding of 26,000 and 24,000 Da proteins is unique to microwave treatment, with enhanced release of 28,000 and less than or equal to 15,000 Da species during microwave compared to sham exposures. Two-dimensional isoelectric focusing further reveals that proteins of less than or equal to 14,000 Da shed during microwave treatment exhibit a pI of 6.8-7.3 not seen in sham-treated cells. Treatment of erythrocytes with a serine-directed protease inhibitor does not prevent release of proteins. However, when erythrocytes are maintained at 17-21 degrees C by conventional heating in the absence of divalent cations, release of 28,000-31,000 and less than or equal to 14,000 Da components is detected. This indicates that cation-bridge stability may be important for release of these proteins. The above results provide evidence that microwaves alter erythrocyte protein composition at temperatures linked to a transition in the cell membrane and that destabilization of salt bridges may play a role in an interaction mechanism for protein release. PMID- 3562785 TI - 16,16-Dimethyl prostaglandin E2 increases survival in mice following irradiation. AB - 16,16-Dimethyl prostaglandin E2 (DiPGE2), a stable analog of PGE2, increases the LD50/30 survival in CD2F1 male mice when given prior to ionizing radiation. Subcutaneous administration of 40 micrograms of DiPGE2 30 min prior to 60Co gamma irradiation extends the LD50/30 from 9.39 Gy in the control animals to 16.14 Gy in DiPGE2 treated, with a dose reduction factor of 1.72 [95% confidence limits: 1.62, 1.82]. The degree of protection is dependent on both the time of administration and the dose of the prostaglandin. Ten micrograms administered 5 min prior to receiving a lethal dose of 10 Gy provides 90% survival but only 10% survival if administered 30 min prior to irradiation. Experiments to determine the in vivo concentration of DiPGE2 in organs postinjection show increased levels over time, but these are not correlated with protection. At 30 min after injection, as much as 80% of the DiPGE2 present in the spleen and plasma is unmetabolized. These results suggest that the protection results from the physiologic action of DiPGE2 rather than direct in vivo detoxification of radicals. PMID- 3562786 TI - Renal damage in the mouse: the effect of d(4)-Be neutrons. AB - A further study on the response of the mouse kidney to d(4)-Be neutrons (EN = 2.3 MeV) is described. The results confirm and augment the work published previously by Stewart et al. [Br. J. Radiol. 57, 1009-1021 (1984)]; the present paper includes the data from a "top-up" design of experiment which extends the measurements of neutron RBE (relative to 240 kVp X rays) down to X-ray doses of 0.75 Gy per fraction. The mean RBE for these neutrons increases from 5.8 to 7.3 as X-ray dose per fraction decreases from 3.0 to 1.5 Gy in the kidney. This agrees with the predictions from the linear quadratic (LQ) model, based on the renal response to X-ray doses above 4 Gy per fraction. The mean RBE estimate from a single dose group at 0.75 Gy per fraction of X rays is, however, 3.9. This is below the LQ prediction and may indicate increasing X-ray sensitivity at low doses. Data from this study and from those published previously have been used to determine more accurately the shape of the underlying response to d(4)-Be neutrons; an alpha/beta ratio of 20.5 +/- 3.7 Gy was found. The best value of alpha/beta for X rays determined from these experiments was 3.04 +/- 0.35 Gy, in agreement with previous values. PMID- 3562787 TI - Enhanced misonidazole binding in the presence of AF-2. AB - The binding of misonidazole (MISO) in Chinese hamster V79 spheroids was increased several-fold in the presence of an equimolar concentration of AF-2 (2-[2-furyl]-3 [5-nitro-2-furyl]-acrylamide) or several other electron-affinic drugs. This results was unexpected since AF-2 is much more electron affinic than MISO and should therefore compete more effectively for electrons (i.e., AF-2 should inhibit MISO binding). Enhanced MISO binding by AF-2 occurred for both ring labeled and side chain-labeled MISO, was proportional to AF-2 concentration, and was greatest under anoxia. However, as the ratio of MISO to AF-2 increased, the effectiveness of AF-2 in enhancing MISO binding decreased. In contrast, MISO, even at high concentrations, did not affect AF-2 binding. Since AF-2 enhanced MISO binding significantly only when both drugs were present simultaneously, electron transfer processes are implicated. These results suggest that the sensitivity of MISO as a hypoxia probe may be significantly improved by the simultaneous administration of AF-2 or other nitrofurans. PMID- 3562788 TI - Measurement of DNA damage in mammalian cells using flow cytometry. AB - A technique for the detection of DNA damage induced by radiation insult has been developed. Cells were lysed with a buffer containing 2 M sodium chloride to release the DNA in a supercoiled form, the nucleoid. These were stained with the DNA intercalating dye, ethidium bromide, and exposed to laser light within a flow cytometer. Scattered and fluorescent light was analyzed from the laser/nucleoid interaction following irradiation of viable cells with gamma rays. The addition of ethidium bromide to prepared nucleoids caused a reduction in scattered light due to condensation of the nucleoid. Irradiation of cells prior to nucleoid production and ethidium bromide treatment restricted this condensation and produced a dose-dependent increase in laser scatter. Nucleoids derived from human lymphocytes showed enhanced light scatter from 5 Gy, compared to Chinese hamster ovary (CHO) fibroblasts where doses above 10 Gy were required. Up to 30 Gy CHO nucleoids showed a dose-dependent reduction in the ethidium bromide fluorescence. This technique allows detection of altered light scattering and fluorescent behavior of nucleoids after cellular irradiation; these may be related to structural changes within the nucleus induced by the radiation. The use of flow cytometry compared to other methods allows a rapid analysis of nuclear damage within individual cells. PMID- 3562789 TI - Endothelial alkaline phosphatase activity loss as an early stage in the development of radiation-induced heart disease in rats. AB - Alkaline phosphatase activity of capillary endothelial cells in the heart of Wistar and Sprague-Dawley rats was studied sequentially after single doses of 10, 15, 20, or 25 Gy. Following irradiation capillary density and alkaline phosphatase activity were focally lost before myocardial degeneration or clinical symptoms of heart disease developed. Recovery from both changes took place after doses of 10 or 15 Gy. The decrease in capillary density and enzyme activity showed the same strain difference in latency times and in the extent of the lesions as previously described for pathological and clinical signs of heart disease. PMID- 3562790 TI - Measurement of the restricted dose mean LET outside the primary beam of a 60Co radiotherapy unit. AB - A recently developed method for the direct measurement of the restricted dose mean LET (cutoff energy = 500 eV) of an unspecified photon or electron radiation field with the high-pressure ionization chamber has been utilized to investigate the variation of this radiobiologically important parameter outside the primary beam of a clinical 60Co unit. A small high-pressure tissue-equivalent ionization chamber was used, and its characteristics and experimental considerations for the present investigation are reported. Measurement of the restricted dose mean LET at the examined points outside the primary 60Co beam showed an increase of 50% with respect to the restricted dose mean LET of the uncollimated 60Co beam. No significant variation was noted with off-central axis distance, field size, wedge filter, or depth below Perspex slabs. Dose rates at the points of measurement outside the primary 60Co beam were 1-5% of the dose rate in the primary beam. PMID- 3562791 TI - Intramolecular cyclization in irradiated nucleic acids: correlation between high performance liquid chromatography and an immunochemical assay for 8,5' cycloadenosine in irradiated poly(A). AB - A correlation between high-performance liquid chromatography (HPLC) analysis and an in situ enzyme-linked immunosorbent assay (ELISA) for 8,5'-cycloadenosine formation in irradiated poly(A) has been established. The correlation shows that the ELISA precisely reflects changes in the combined yield of R- and S-8,5' cycloadenosine but that a correction factor must be applied to the ELISA values for accuracy. The HPLC analysis reveals that the intramolecular cyclization proceeds stereoselectively in irradiated poly(A) to preferentially produce the R isomer at pH 7.0 which is similar to the result for irradiated adenosine but in contrast to the result for 5'-AMP where the S isomer predominates at neutral pH. The HPLC analysis shows that two events originating in hydroxyl radical attack at the sugar phosphate backbone in poly(A); that is, adenine release and 8,5' cycloadenosine formation have somewhat different dose-yield responses. The formation of 8-hydroxyadenosine was detected in the HPLC chromatograms of poly(A) irradiated under N2O at neutral pH, and the yield of this compound was similar to the yield observed in 5'-AMP or adenosine irradiated under similar conditions. PMID- 3562792 TI - Heat-stress proteins of rat lung endothelial and mammary adenocarcinoma cells. AB - A rat mammary adenocarcinoma cell clone, MTC, and a rat lung endothelial cell clone, RLE cl.4, both syngeneic to the Fisher 344 rat, were compared for proteins synthesized at 37 degrees C and after a 1-h, 42 degrees C heat dose. The heat stress-induced or -enhanced synthesis of a series of molecular mass groups and isoelectric point species (isomers) was observed in both equilibrium and nonequilibrium two-dimensional gel electrophoresis. Tumor and endothelial cell heat-stress proteins (hsp) were strikingly similar with most hsp in 11 or 13 molecular mass groups having from 1 to 12 major isomers. In comparing the two cell types, 6 of about 23 major hsp isomers appeared different in equilibrium pH gels, with tumor cells seemingly exhibiting less synthesis of these 6 isomers. Four additional endothelial cell hsp isomers were apparent in nonequilibrium pH gels. Since two of these later hsp can be found at higher heat doses in tumor cells, some of these apparent differences between tumor and endothelial cells may be attributable to different dose ranges for induction of hsp. Fluorograms and silver-stained gels showed that several hsp were being synthesized at appreciable levels in unheated cells. However, there were hsp whose synthesis appeared to be de novo rather than representing enhanced synthesis of existing proteins. These last two observations were made in both tumor and normal cells. The constitutive levels of hsp synthesis appeared to be generally similar in unheated tumor and normal cells in vitro with few exceptions. These results indicate the presence of few unique hsp in syngeneic tumor and normal cells in vitro. However, focusing subsequent studies on the few differences may lead to insights concerning hyperthermic biology of tumor and normal cells, phenotypic differences between these cells, and roles of some hsp. PMID- 3562794 TI - The professional image: where are we now? PMID- 3562793 TI - Irradiation damage in chromatin isolated from V-79 Chinese hamster lung fibroblasts. AB - The effect of chromatin structure on the extent of radiation damage induced by low doses of 100 KeV X rays was investigated using a fluorescent assay for DNA unwinding. Chromatin was isolated from V-79 Chinese hamster lung fibroblast nuclei by partial digestion with micrococcal nuclease. Gel electrophoresis of the isolated DNA showed the molecular weight of the chromatin preparation to be 10.6 X 10(6) with a size range of 6.6-21.7 X 10(6) Da while a size of 10.2 +/- 0.9 X 10(6) Da was found by sedimenting the DNA in alkaline sucrose gradients. The repeat length of V-79 chromatin was found to be 194 +/- 3 bp. The typical nucleosomal repeat structure of the isolated chromatin and that of intact nuclei was identical. Irradiation with 50 and 100 Gy of 100 KeV X rays and analysis by alkaline sucrose density centrifugation indicated that V-79 chromatin sustained 0.56 +/- 0.19 and 0.69 +/- 0.09 single-strand breaks per 10 Gy per 10(8) Da of DNA, respectively. Irradiation with doses of 0.5-3.0 Gy of 100 KeV X rays and analysis by the fluorometric assay showed that the radiation sensitivity of V-79 chromatin decreases sharply on compaction with MgCl2. Histone H1 depletion, which inhibits compaction and causes chromatin to expand by increasing the linker from 26 to 48 bp, results in a considerable increase in the radiation sensitivity. It is concluded that radiation damage sustained by DNA is greatly influenced by chromatin structure. PMID- 3562795 TI - Reappraisal of the erect abdominal radiograph. PMID- 3562796 TI - Computed tomography scanning in spinal trauma. PMID- 3562798 TI - Quality assurance in simulators. PMID- 3562797 TI - A shot in the dark: foreign body localisation. PMID- 3562800 TI - From NMR signal to MR image. The basic physics of MR image formation. PMID- 3562799 TI - Radiography of the acute cervical spine. AB - The various injuries of the cervical spine have been defined and their appearances described, together with treatments in some instances. PMID- 3562801 TI - Discovering cosmic X-rays. PMID- 3562802 TI - Prosthetic dentistry. PMID- 3562803 TI - Intensive care nursing. PMID- 3562804 TI - Microradiography: a theoretical basis and practical applications. AB - If low magnification (less than 40x) is required of either thick soft tissue specimens (greater than 20 mm) containing contrast media filled structures or dense tissue, such as bone (greater than 5 mm), a diagnostic, radiographic tube and a 50 kVp setting would prove satisfactory. In this situation Kodak Type R film would provide the required resolution. When the same image enlargement is desired but the soft tissue (greater than 20 mm) does not contain contrast media or the dense tissue is thinner (0.5-5 mm), a specialized radiographic tube is necessary. The unit must be capable of generating a range of 30-40 kVp. Most mammography equipment will produce the necessary kilovoltage if neither a Faxitron nor the resources to build a unit are available. Once again the Kodak Type R or a similar industrial radiographic film would be the film of choice. When high magnification (greater than 40x) is required, indicating thin low density (10-20 mm) or high density (less than 0.5 mm) tissues are being examined, a specialized tube capable of producing 20 kVp is necessary. Kodak High Resolution glass plates or polyester-based film must be used to record the image. Due to grain size visible at high magnifications, both the Kodak Type R radiographic films and the Agfa photographic films proved unsuitable. PMID- 3562805 TI - A study of radiation safety education practices in acute care Texas hospitals. AB - A survey study was performed to assess the extent of radiation safety education and training in acute care Texas hospitals for radiologic technologists and other hospital personnel. The findings revealed a self-perceived need by hospital administrative personnel and were interpreted to suggest a quantitative need for increased radiation safety education for several classes of hospital personnel. The findings are discussed relative to potential certification requirements for technologists and implications for the training of other personnel. PMID- 3562806 TI - Film dosimetry for shaped electron fields. AB - The key to successful electron beam treatment planning is to realize that an electron beam does not behave like a photon beam, and that each electron field is unique and should be treated as such. Film dosimetry provides an efficient and accurate method of determining electron dose distributions for a particular field when compared to the cumbersome, time-consuming ion chamber in tissue equivalent material, thermoluminescent dosimeters (TLDs), or complex equivalent square calculations. PMID- 3562807 TI - Methods for evaluating image quality in magnetic resonance imaging. AB - A quality control program for magnetic resonance imaging is necessary to evaluate the major imaging characteristics and to monitor image performance constancy. The methods used to evaluate and monitor imaging quality characteristics and image quality variables are discussed. These imaging characteristics and methods may be utilized by the trained radiology technologist to assist in the continuation of a quality control program for magnetic resonance imaging. PMID- 3562808 TI - Predicting nuclear medicine students' performance on a national certification examination. PMID- 3562809 TI - Effects of radiation on genetic material. PMID- 3562810 TI - Recurrent colorectal carcinoma: evaluation with barium enema examination and CT. AB - The efficacy of the barium enema examination and abdominal computed tomography (CT) was investigated in 81 patients who had undergone operation for colorectal carcinoma. Recurrent disease was found in 52 patients and was divided into local (anastomotic and perianastomotic) and remote (distant and hepatic metastases) types. In 32 patients with locally recurrent carcinoma, the sensitivity of the barium enema examination was 88%; for CT it was 69%. Conversely, the barium enema examination was not useful for detecting remote metastases shown on CT, which disclosed disease at one or more sites in 47 (90%) of the 52 patients. CT best evaluated recurrences remote from the anastomosis, pelvic recurrences in patients with colostomies, and hepatic metastases. Barium enema examination and CT were therefore found to be complementary modalities. PMID- 3562811 TI - Barium intravasation: radiographic and CT findings in a nonfatal case. AB - A woman survived venous intravasation of barium complicating an abdominal barium study. Barium deposition in the reticuloendothelial system was evident by an increase in density in the liver, spleen, and bones on plain radiographs and marked elevation of attenuation values of these organs on computed tomographic scans. The literature on barium intravasation is reviewed. PMID- 3562813 TI - Budd-Chiari syndrome: CT observations. AB - The authors describe four patients with Budd-Chiari syndrome in whom contrast material-enhanced computed tomographic (CT) scans demonstrated low-density venous thrombosis in three sites not, to our knowledge, previously described with this modality. Thrombosis was seen in the portal circulation, the hepatic veins, and the intrahepatic inferior vena cava. It is known that concomitant portal vein thrombosis may be seen in 20% of patients with Budd-Chiari syndrome. Three of the four patients in the current study had this finding, one with extensive thrombosis of portal, mesenteric, and splenic veins and the other two with portal vein branch involvement. In one patient hepatic vein thrombosis was demonstrated with CT, and in three inferior vena cava clot was demonstrated. All four patients had the distinctive hepatic parenchymal contrast enhancement pattern seen in this condition, which the authors think may be at least partially caused by associated portal thrombosis. The presence of portal venous thrombosis should prompt the observer to consider the diagnosis of Budd-Chiari syndrome. Detection of hepatic vein clot confirms the diagnosis and may be seen in this condition in association with inferior vena cava thrombus. PMID- 3562812 TI - Abdominal pain in sickle cell disease: the role of CT. AB - Patients with either homozygous or heterozygous sickle cell disease may have frequent episodes of abdominal pain and/or fever of uncertain cause. While many of these episodes represent a so-called sterile crisis, the possibility of gross organ infarction and rupture, infection, or other complication cannot be ignored. Computed tomography (CT) was used to evaluate 30 such patients. Virtually all patients had splenic abnormalities, which could be considered clinically significant (rupture, hemorrhage) or insignificant (calcified spleen). In four patients hepatic abnormalities were found, including one case of multiple liver infarction, one of hepatic abscess, and two of retained intrahepatic gallstones after cholecystectomy. Two patients had significant acute renal abnormalities, including one case of interstitial nephritis and one of renal vein thrombosis. One patient had a ruptured periappendiceal abscess and one a pericolonic abscess. One patient had an abscess around a total hip replacement. CT was found to be an excellent and relatively noninvasive means of both initial investigation and subsequent follow-up. PMID- 3562814 TI - Abdominal lymphadenopathy in benign diseases: CT detection. AB - A review of 2,100 consecutive computed tomographic (CT) examinations yielded 160 cases of abdominal lymphadenopathy, of which nine (6%) were secondary to benign diseases. Contrary to previous reports, size, location, contour, density, relationship to the aorta, and presence of mass effect were not helpful in distinguishing benign from malignant lymphadenopathy. In some cases, ancillary CT findings, conventional radiographs, and clinical setting may suggest a specific benign entity. Benign processes should be considered in the differential diagnosis of abdominal lymphadenopathy in the appropriate clinical setting, particularly if the patient does not have a known carcinoma. PMID- 3562815 TI - Transcatheter embolization in the management of pulmonary hemorrhage. AB - A group of 306 patients with acute pulmonary hemorrhage were evaluated by means of bronchial arteriography and treated with transcatheter embolization. Specific causes for bleeding included lung abscess, chronic pneumonia, tuberculosis, lung cancer, and bronchiectasis. In 120 patients the hemoptysis was massive, with volumes exceeding 500 ml/day. The majority (n = 225) were treated during peak hemorrhage. Embolization was performed with one of three methods: particulate embolization with polyurethane or velour, obturation with the angiographic catheter combined with peripheral embolization by means of infused albumin macroaggregates, and regional infusion of sclerosing agents. Effective hemostasis was obtained initially in 278 patients (90.8%), including 87.5% of those treated during peak hemorrhage. In 26 of 28 cases without initial response, the pulmonary artery was the source of bleeding. Recurrent bleeding, within 1-4 days, requiring surgery was observed in 39 patients with initially successful hemostasis. Of 158 patients who were treated without surgery, subsequent episodes of hemoptysis occurred in 36. Combined methods of embolization may improve the efficacy of treatment of operable and inoperable patients with lung disease complicated by hemorrhage. PMID- 3562816 TI - Strangulation in child abuse: CT diagnosis. AB - The central nervous system is commonly affected in child abuse. Between April 1985 and July 1986 three infants were identified in whom the primary mode of injury had been strangulation. In each case computed tomography (CT) demonstrated a large cerebral infarction confined to vascular territories associated with small subdural hematomas. There was no history or visible evidence of significant head trauma. Autopsy of one infant confirmed the presence of a hemispheric infarct, thin subdural hematoma, and an area of subintimal hemorrhage in the carotid artery ipsilateral to the infarct. The remaining two patients survived with residual hemiparesis. CT findings of a large cerebral infarction with an associated subdural hematoma in an infant without a history of a significant trauma should suggest the possibility of child abuse and may be the primary manifestation of abuse in some patients. PMID- 3562817 TI - Percutaneous pyeloplasty in children: experience in three patients. AB - Three children with congenital ureteropelvic junction (UPJ) obstruction were treated with percutaneous pyeloplasty. A 22-gauge Chiba needle was placed within the renal pelvis, and the nephrostomy tract was dilated. A full-thickness incision was made endoscopically in the posterolateral wall of the narrowed UPJ. An internal stent was then placed and left in position for 6-8 weeks. Percutaneous surgery was successful in two of three cases. The unsuccessful procedure may have resulted from inadequate UPJ stenting. The authors believe percutaneous pyeloplasty can be safely and successfully performed in children with congenital UPJ stenosis. PMID- 3562818 TI - Parotid masses: MR imaging. AB - Over a 2-year period 20 patients who presented with masses in the parotid gland were evaluated with magnetic resonance (MR) imaging. T1-weighted images were obtained on a high-resolution, thin-section MR imaging system. When "cystic appearing" lesions were found, T2-weighted images were obtained in order to better characterize the tumor. As in other areas of the body, MR images of parotid tumors are not usually histologically specific. MR findings may be distinctive in rare cases and define the internal architecture of complex parotid masses. Although poor tumor margination was a clue to malignancy, this was not a consistent finding. The real advantage of MR imaging in evaluating parotid masses was its ability to accurately reveal the extraparotid or intraparotid location of a tumor and demonstrate the relationship of the tumor to the facial nerve. Small and medium-sized mass lesions could be seen as superficial or deep to the facial nerve. Larger masses producing some distortion of the normal course of the nerve made identification of the nerve more difficult, if not impossible. In malignant tumors with gross invasion of the facial canal, MR images can show the extent of nerve involvement. PMID- 3562819 TI - Parotid masses: MR imaging. AB - Twenty patients with surgically proved neoplasms of the parotid gland were evaluated in order to compare contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging. In 14 patients both CT and MR imaging examinations were performed, while in six only MR imaging was performed. Because contrast resolution is better with MR imaging, it appears to be superior to CT in distinguishing the parotid gland from surrounding structures. Four intraparotid lesions were more conspicuous on T2-weighted MR images than on CT scans. MR imaging appears to be superior to CT for evaluating parotid masses and for distinguishing neoplasms of the parotid gland from those originating within the parapharyngeal space. PMID- 3562820 TI - Hyperparathyroidism: comparison of MR imaging with radionuclide scanning. AB - Twenty-three patients with hyperparathyroidism were evaluated preoperatively with magnetic resonance (MR) imaging. Twenty patients also underwent thallium 201/technetium-99m scintigraphy. Of 22 patients with primary hyperparathyroidism, 12 had persistent or recurrent disease. One had secondary hyperparathyroidism due to end-stage renal disease. MR imaging allowed accurate localization of abnormal parathyroid glands in 64% evaluated prospectively and 82% evaluated retrospectively. Scintigraphy allowed localization of 60% evaluated prospectively and 70% retrospectively. The two imaging modalities together allowed detection of 68% evaluated prospectively and 91% retrospectively. MR imaging allowed detection of two of five mediastinal adenomas evaluated prospectively and four of five retrospectively. In patients who underwent both imaging studies, MR was more successful in those with previous neck surgery (73% evaluated prospectively and 91% retrospectively) than in those with no prior surgery (57% prospectively and 71% retrospectively). Scintigraphy allowed accurate localization in 64% evaluated prospectively and 64% retrospectively in patients with previous surgery versus 57% prospectively and 86% retrospectively in patients with no prior neck surgery. Four false-positive results were obtained with MR imaging and three with scintigraphy. MR imaging was useful for parathyroid localization in patients with hyperparathyroidism, particularly in patients requiring additional surgery. PMID- 3562821 TI - Pituitary adenomas in patients with Cushing disease: initial experience with Gd DTPA-enhanced MR imaging. AB - To assess the role of magnetic resonance imaging in the evaluation of adrenocorticotropic-hormone (ACTH)-producing pituitary adenomas, and the effect of intravenously administered gadolinium-diethylenetriaminepentaacetic acid (DTPA) on lesion/pituitary contrast, imaging was performed in 13 patients with clinical and chemical evidence of Cushing disease. Images were obtained at 0.5 T before and after the injection of Gd-DTPA (0.1 mmol/kg). Lesions were identified in eight of 12 precontrast and ten of 12 postcontrast studies. In these 12 patients adenomas were found at transsphenoidal surgery. The other patient, with normal images, was found to have an ectopic source of ACTH. Coronal images corresponded remarkably well with the neurosurgeon's intraoperative findings. Serial T1-weighted images disclosed early enhancement of the pituitary gland and delayed enhancement of the cystic adenomas. The discrepancy in times to peak enhancement accounted for improved lesion/pituitary contrast in some early images and for reversal or diminution of lesion/pituitary contrast in later images. PMID- 3562822 TI - Giant intracranial aneurysms: MR imaging. AB - Fifteen patients with giant intracranial aneurysms were examined with magnetic resonance (MR) imaging, computed tomography (CT), and angiography. MR imaging revealed a rounded extraaxial mass with evidence of intraluminal blood flow in 12 of the 15 cases. Signal void within the lumen was seen in all 12 of these cases. Other flow effects, such as even-echo rephasing, were seen in some cases. Complete thrombosis was seen in three giant aneurysms in which high signal intensity on T1- and T2-weighted images filled the lumen, and no flow effects were seen. Partial thrombosis was detected in four aneurysms as persistent areas of medium to high signal intensity within the lumen on T1- and T2-weighted images. In five cases, the cause of the intraluminal signal that was present was difficult to determine. The ability of MR to indicate flow within the lumen in 12 of 15 cases provided for greater diagnostic confidence than with CT, which was strongly suggestive of an extraaxial tumor in nine patients. Calcification of the wall of the aneurysm was better detected with CT. PMID- 3562823 TI - Dural fistulas involving the cavernous sinus: results of treatment in 30 patients. AB - Thirty symptomatic indirect carotid cavernous fistulas were treated between 1978 and 1986 with a variety of treatment modalities. Combined carotid artery and jugular vein compression resulted in a complete cure in seven of 23 patients (30%) and improvement in one additional patient. There were no complications from this treatment, which is performed by the patient on an outpatient basis. Patients in whom carotid jugular compression therapy failed or who demonstrated cortical venous drainage or visual decline were treated with intravascular embolization. Embolization resulted in complete cure in 17 of 22 (77%) and improvement in four of 22 (18%). One patient required surgical excision of the involved dura after embolization to achieve complete cure. There was one permanent complication (stroke), which resulted in mild weakness caused by clot formation on a catheter. PMID- 3562824 TI - Dural fistulas involving the transverse and sigmoid sinuses: results of treatment in 28 patients. AB - Twenty-eight symptomatic dural fistulas involving the transverse and sigmoid sinuses were treated between 1978 and 1986 with a variety of treatment modalities. Occipital artery compression therapy resulted in a complete cure in two of nine patients (22%) and improvement in three of nine (33%). There were no complications from this treatment. Patients who were excluded or in whom compression therapy failed were treated with embolization alone or in conjunction with surgery. Of the 17 patients who underwent embolization alone, ten were cured and six were improved. Six patients had a combination of embolization and surgery; four patients were cured and two improved. There were three complications in this series, one related to surgery and two related to embolization. PMID- 3562825 TI - Leptomeningeal metastasis: MR imaging. AB - Seven patients with central nervous system neoplasia and leptomeningeal metastases, proved either at initial diagnosis or on follow-up with contrast material-enhanced computed tomography (CT), were evaluated with magnetic resonance (MR) imaging. In two patients, diffuse sulcal enhancement on CT scans was inapparent on T1- or T2-weighted MR images. Likewise, in four patients diffuse cisternal enhancement on CT scans was not identifiable with MR. Nodular or focal cisternal masses were identified with both CT and MR imaging in three patients; in two, however, MR imaging provided less information. Ependymal and subependymal metastases identified with CT (two patients) were indistinguishable on MR images from periventricular abnormalities of radiation therapy and/or hydrocephalus. These findings suggest that leptomeningeal metastasis may be so subtle or inapparent as to be overlooked with MR imaging alone. Thus, CT and MR imaging should be considered complementary techniques for initial diagnosis and follow-up of tumors with a propensity for leptomeningeal metastasis. PMID- 3562826 TI - High-dose iohexol myelography. AB - Lumbar myelography was performed with high volumes of iohexol (15-24 ml) at a concentration of 180 mgI/ml (average dose, 20 ml) in 48 patients. In 44 patients receiving more than the currently recommended upper dose limit of 17 ml, the frequency of headache (41%), nausea (14%), and vomiting (9%) was comparable to results for routine-dose lumbar metrizamide myelography. Overall, adverse reactions were more frequent, particularly at the highest dose levels, than reported for conventional-dose iohexol myelography. However, there were no occurrences of neuropsychiatric disorder, encephalopathy, or seizure. High-dose technique allows superior visualization of upper lumbar and conus detail and may be advantageous in patients with large subarachnoid spaces and in multi-level examinations. This study supports the results of previous trials that suggested the relative safety of iohexol as a contrast agent and extends those observations to a higher dose range. Because of the increased rate of adverse reactions at the highest dose levels (despite the absence of major adverse reactions), iohexol should continue to be used conservatively, with doses carefully tailored to each examination. PMID- 3562827 TI - Occult breast cancer: prevalence and radiographic detectability. AB - The radiographic detectability of occult breast cancer has been difficult to determine. A prospective study of breast disease was carried out that involved the performance of subcutaneous mastectomies in 519 consecutive cases of traumatic or initially unexplained death in New Mexico. Routine mammograms and radiographs of 1-cm specimens were obtained. At least 18 biopsies were performed in each subject. Carcinoma was identified in ten subjects; one subject had metastatic carcinoma from the lung, and two subjects had bilateral breast cancer, for a total of 11 breast cancers identified with microscopic examination. Two of the cancers were seen on whole-breast mammograms, and six were seen on radiographs of thin-section specimens. Four of the 11 breast cancers were apparent only on histologic study of breast tissue that was not suggestive of malignancy. No cancer was found in subjects under the age of 39 years. Five carcinomas were found in the 40-69-year age group; six were found in the 70-year and over age group. No correlation was noted between the radiographic Wolfe parenchymal patterns and the prevalence of breast cancer. PMID- 3562828 TI - Light scanning versus mammography in breast cancer detection. AB - Transillumination light scanning of the breast was compared with screen-film mammography in a prospective study of 1,110 women referred to an outpatient imaging department. Each method was interpreted independently of the other but with knowledge of physical examination findings. Of 24 biopsy-proved cancers, 14 (58%) were detected with light scanning and 21 (88%) with mammography. The 77 false-positive light scan examinations were attributed to technical factors and the inability of light scanning to distinguish malignant from benign conditions on the basis of imaging features. Of the ten false-negative light scan examinations, two were retrospectively reclassified as positive, but light scans in the other eight cases remained normal in appearance. The authors conclude that transillumination light scanning is not competitive with mammography as a screening method for breast cancer detection. furthermore, they were unable to identify a select subpopulation of women who might benefit from light scanning as an adjunct to mammography. PMID- 3562829 TI - Screen-film mammographic technique for breast cancer screening. AB - The values of dose and signal-to-noise ratio (SNR) for many techniques and breast thicknesses were computed and compared with a reference technique and breast thickness to provide a valid basis upon which to select a screening technique for screen-film mammography. The reference consisted of a Min-R/OM1 combination (or its equivalent) exposed through a 4.5-cm thick breast via 28 kV and a molybdenum target-beryllium window tube with a 0.03-mm Mo filter. Radiographs of an improved breast phantom were used to relate computed relative SNR values of techniques to diameters of the smallest calcific and soft-tissue objects demonstrated in mammograms. Without use of a grid, four Mo target/filtration combinations yielded similar computed dose and SNR levels, as did a tungsten target tube operated at 23 kV without a filter. Operation of the latter tube at 27.5 kV with a 0.051-mm rhodium filter should reduce dose by half but also SNR by 22%. However, such operation with a grid should greatly improve imaging moderate to large breasts without increasing dose over reference values. PMID- 3562830 TI - Solitary pulmonary opacities: plain tomography. AB - New or enlarging solitary pulmonary opacities in 502 patients were evaluated with a plain tomographic procedure. Repeat chest radiographs in 64 patients and tomograms in 115 patients showed that the opacities were not nodules but were due to pneumonitis, rib lesions, thickened pleura, or another benign finding. Tomography demonstrated 85 of the 323 nodules to be calcified granulomas. The shape of the 238 uncalcified nodules was classified as benign, malignant, or indeterminate. None of the 38 nodules classified as benign proved to be malignant during 2 years of follow-up. Of the 33 nodules with a malignant shape, 31 proved to be malignant at operation or clinical follow-up. Among the 167 nodules characterized as indeterminate, 128 were benign and 39 were malignant on follow up. In this series, the plain tomographic procedure, including fluoroscopy and repeat chest radiography, allowed an accurate diagnosis in 67% of solitary pulmonary opacities. PMID- 3562831 TI - Value of chest radiography in excluding traumatic aortic rupture. AB - A retrospective review of chest radiographs from 205 patients with blunt chest trauma who also underwent aortography was performed. Forty-one of the 205 had aortographically proved aortic rupture. Discriminant analysis of 16 radiographic signs indicated that the most discriminating signs were loss of the aorticopulmonary window, abnormality of the aortic arch, rightward tracheal shift, and widening of the left paraspinal line without associated fracture. No single or combination of radiographic signs demonstrated sufficient sensitivity to indicate all cases of traumatic aortic rupture on plain chest radiographs without the performance of a large number of aortographically negative studies. The bedside anteroposterior "erect" view of the chest proved far more valuable than the supine view in detecting true-negative studies. Despite significant reader variability in the interpretation of the various radiographic signs, in general the analysis confirmed the role of chest radiography in this clinical situation, but suggests that its most beneficial use is in excluding the diagnosis and eliminating unwarranted aortography rather than in predicting aortic rupture. PMID- 3562832 TI - Intrathoracic Kaposi sarcoma in AIDS patients: radiographic-pathologic correlation. AB - The chest radiographs and postmortem pathologic findings in 24 patients with acquired immunodeficiency syndrome (AIDS) and autopsy-proved intrathoracic Kaposi sarcoma were reviewed. Premortem radiographic visualization of pulmonary lesions of Kaposi sarcoma depended on the extent of involvement and the presence of concomitant disease. In three patients (13%) the radiographs showed nodular opacities that corresponded in size and configuration to nodules seen at autopsy. In 21 patients (87%) the lesions were not radiographically identifiable, in some cases because they were obscured by infection. The positive and negative predictive values of four radiographic findings for intrathoracic Kaposi sarcoma were evaluated, using a control group of 14 AIDS patients without intrathoracic Kaposi sarcoma at autopsy. Findings with a high positive predictive value were parenchymal nodular and reticular opacities (100%), pleural effusions (89%), and hilar and/or mediastinal lymphadenopathy (92%). None of these findings is specific, but the presence of any one in a patient with AIDS should increase the possibility of intrathoracic involvement by Kaposi sarcoma. PMID- 3562833 TI - Radiographic parenchymal opacity, matching perfusion defect, and normal ventilation: a sign of pulmonary embolism? Work in progress. AB - By conventional criteria, perfusion defects that correspond to radiographic parenchymal opacities of similar size have less diagnostic significance for pulmonary embolism (PE) than perfusion defects in areas that are radiographically clear, regardless of the findings on ventilation scan. It was proposed that the demonstration of normal ventilation in areas with matched radiographic opacity and perfusion defects does support the diagnosis of PE. To test this hypothesis, a retrospective review was done of selected cases from a consecutive series of 85 pulmonary angiography studies. Cases were reviewed if the following criteria were met: chest radiography, ventilation-perfusion scintigraphy, and angiography of the relevant regions had all been performed within 24 hours of one another, and there was a radiographic opacity corresponding to the perfusion defect. Sixteen cases fulfilled these criteria. Six patients had normal ventilation in the regions of the radiographic infiltrate and perfusion defect, and all had PE. No patient had an area of opacity and perfusion defect and normal ventilation without PE. PMID- 3562834 TI - High-resolution CT of the lungs: an optimal approach. AB - The influences of kilovolt peak, milliamperage, reconstruction algorithm, targeting, and image magnification on thin-section (1.5-mm) computed tomography (CT) of the lung were studied in phantoms and patients. Retrospective targeted reconstruction (25-cm field of view) improved spatial resolution, while magnification did not. The bone reconstruction algorithm improved spatial resolution, compared with the standard algorithm, and in patients, bone algorithm images were considered superior to standard reconstructions. Although using the bone algorithm increases the visible image noise, increasing the kilovolt peak and the milliamperage can reduce this noise. However, in the patients studied, this reduction in noise was not usually judged as significant, except in the posterior, paravertebral part of the lung. An optimal technique for CT of the lung parenchyma should include thin-collimation, targeted scans reconstructed with a high-spatial-frequency algorithm and, in some patients, increased kilovolt peak or milliamperage. PMID- 3562835 TI - Fallopian tube obstruction: selective salpingography and recanalization. Work in progress. AB - Seven infertile women, in whom interstitial fallopian tube obstruction (IFTO) was suspected at hysterosalpingography and who were recommended for surgical evaluation and treatment, were treated with catheterization techniques. Selective salpingography with ostial injection demonstrated tubal patency in two patients; direct intratubal salpingography demonstrated patency in another patient. Four patients with a true IFTO underwent fallopian tube recanalization: in the first two, a small soft-tipped guide wire was used, and in the other two, a guide wire and 3-F catheter were used. The suggested catheterization techniques have the potential to make evaluation and treatment of IFTO more efficient, safer, and less expensive than presently used methods. PMID- 3562836 TI - Adenomyosis and leiomyoma: differential diagnosis with MR imaging. AB - To assess the capability of magnetic resonance (MR) imaging to enable differentiation of adenomyosis from leiomyoma, a prospective study was performed in 21 premenopausal patients with a strong clinical suggestion of adenomyosis. Histologic findings from hysterectomy (19 patients) and biopsy specimens (two patients) showed that eight patients had adenomyosis (three focal, five diffuse) and 12 had leiomyomas (five of the 12 also had microscopic foci of adenomyosis); one patient had a normal uterus. All eight cases of adenomyosis were correctly diagnosed from MR images. On T2-weighted MR images, diffuse adenomyosis appeared as a thickening of the junctional zone, whereas focal adenomyosis appeared as a low-signal-intensity mass poorly marginated from the adjacent myometrium. Ten of the 12 leiomyomas were correctly diagnosed from MR images. In the other two cases of leiomyoma, differentiation between focal adenomyosis and leiomyoma was not possible. Microscopic foci of adenomyosis were not demonstrated with MR imaging. PMID- 3562837 TI - Kidney changes after extracorporeal shock wave lithotripsy: appearance on MR imaging. AB - The occurrence of changes in the kidneys after extracorporeal shock wave lithotripsy (ESWL) was evaluated with magnetic resonance (MR) imaging in 34 patients, utilizing T1-weighted spin-echo pulse sequences. Five of the 34 patients underwent bilateral ESWL therapy before MR imaging. Of the 39 kidneys studied, 29 (74%) showed one or more changes on MR imaging: subcapsular or perinephric fluid (n = 10), focal (n = 16) or diffuse (n = 8) loss of the corticomedullary junction (CMJ), and focal areas of increased (n = 7) or decreased (n = 3) signal intensity. The CMJ changes were more prominent with increasing numbers of shock waves administered during the procedure. These relatively subtle changes detected on MR imaging may not be apparent with other imaging techniques. The long-term clinical significance of these findings is not yet known, although no apparent serious renal pathologic condition was detected. PMID- 3562838 TI - Renal obstruction from persistent struvite stone matrix: a complication of extracorporeal shock wave lithotripsy. AB - Struvite calculi occurring in patients with chronic urinary tract infections consist of an inorganic component of magnesium ammonium phosphate crystals and an underlying organic mucopolysaccharide matrix. Shock waves used to destroy these stones during extracorporeal shock wave lithotripsy (ESWL) therapy may affect the inorganic and organic components of the stone differently. In a 26-year-old woman, renal obstruction resulted from retained struvite stone matrix after ESWL therapy. PMID- 3562839 TI - Ovarian carcinoma: results of radiation therapy and chemotherapy in 83 patients. AB - Eighty-three patients with ovarian cancer who had undergone radiation therapy, chemotherapy, or both were evaluated. Eight patients had FIGO stage I, 12 had stage II, 61 had stage III, and two had stage IV disease. In 60 patients, radiation was delivered with open abdominopelvic field (30 Gy over 4 weeks), with or without a pelvic boost dose. Fifty-five patients received a combination of chemotherapeutic agents, and 30 received a single agent as initial therapy. The patients were divided into three groups. The 26 patients in group 1 received primary radiation therapy with or without adjuvant single-agent chemotherapy. The 34 patients in group 2 underwent radiation therapy after chemotherapy failed. The 23 patients in group 3 received combination chemotherapy. Nineteen patients (23%) achieved complete remission--eight from group 1, two from group 2, and nine from group 3. The 5-year actuarial survival for group 1 was 41% but was only 16% for both groups 2 and 3 combined (P = .026). Primary radiation therapy, with or without adjuvant single-agent chemotherapy, was superior to combination chemotherapy in patients with ovarian cancer. PMID- 3562840 TI - Pigmented villonodular synovitis: a report of MR imaging in two cases. AB - Although magnetic resonance (MR) imaging has been used to evaluate many musculoskeletal lesions, the MR appearance of pigmented villonodular synovitis (PVNS) has not been described in detail. The authors describe two cases of PVNS in the knee imaged with both computed tomography and MR. In both cases parts of each lesion had very low signal intensity on both short repetition time (TR)/echo time (TE) sequences and long TR/TE sequences. Other portions of both lesions had intermediate signal intensity (equal to or higher than that of muscle but lower than that of fat) on short TR/TE sequences and increasing signal intensity on longer TR/TE images. In one case, the lesion also had a cystic component that showed MR changes typical of complex fluid. The authors propose that the MR signal characteristics demonstrated in these cases may be explained by the unique tissue components of the lesion, particularly hemosiderin and fat. PMID- 3562841 TI - Radiology and the Health Policy Agenda for the American People. AB - Eleven radiologists appointed by the major radiological societies participated for the past 5 years in the development of the Health Policy Agenda for the American People. The Agenda is an action plan to address a wide variety of serious problems in medicine. The first phase involved establishment of 159 principles, broad value statements that were the foundation of the project. Phase 2 involved the development of policy proposals on 38 urgent issues for action in medical science; education; health resources; delivery mechanisms; evaluation, assessment, and control; and payment for services. These proposals are summarized in this report. The activities and recommendations of representatives for the field of radiology are described. The Agenda has been released, and an implementation phase has begun. It will likely be of great importance to the practice of radiology over the next decade. Important issues can be addressed by acting with the coalitions that are being formed from among the more than 150 participating organizations. PMID- 3562842 TI - Critical analysis of radiologist-patient interaction. AB - A critical incident interview technique was used to identify features of radiologist-patient interactions considered effective and ineffective by patients. During structured interviews with 35 radiology patients and five patients' parents, three general categories of physician behavior were described: attention to patient comfort, explanation of procedure and results, and interpersonal sensitivity. The findings indicated that patients are sensitive to physicians' interpersonal styles and that they want physicians to explain procedures and results in an understandable manner and to monitor their well being during procedures. The sample size of the study is small; thus further confirmation is needed. However, the implications for training residents and practicing radiologists in these behaviors are important in the current competitive medical milieu. PMID- 3562843 TI - Localization of occult breast lesions: practical solutions to problems of triangulation. AB - The preoperative triangulation and localization of some occult breast lesions can be complicated if the lesion is located deep in the breast. Based on the authors' experience of 1,400 localization procedures, standard breast positions were modified to help locate lesions that were difficult to see in two projections. Standard compression plates were also modified, allowing placement of fenestrations over deep lesions--especially those in the axillary tail of the breast--to facilitate safe, accurate localization. PMID- 3562844 TI - Modified mesh panel for radiation therapy treatment table. AB - The design and construction of a mesh panel for radiation therapy treatment tables is described. With the new design, sagging is virtually eliminated. The panels have been successfully used for a variety of patient sizes and weights. PMID- 3562845 TI - "Atraumatic" transjugular needle for portal vein puncture in swine. AB - A new coaxial needle-catheter system was designed for transjugular portal vein puncture in young domestic swine. It was tested in 32 animals and successfully entered the portal circulation via a hepatic vein or intrahepatic portion of the inferior vena cava. No complications were encountered. PMID- 3562846 TI - MR detection of liver metastases. PMID- 3562847 TI - Aluminum bone disease in children: radiographic features from diagnosis to resolution. PMID- 3562848 TI - Follow-up chest radiographs in Vietnam veterans: are they useful? PMID- 3562849 TI - In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications. PMID- 3562850 TI - Genetic background for multiple messengers. PMID- 3562851 TI - Functional studies of cholecystokinin-dopamine co-existence: electrophysiology and behavior. PMID- 3562852 TI - Molecules of intercellular communication in vertebrates, invertebrates and microbes: do they share common origins? PMID- 3562853 TI - Determination of carcinogen-induced macromolecular adducts in animals and humans. PMID- 3562854 TI - Carcinogenesis and adducts in animals and humans.Workshop. Cambridge, Mass., February 25, 1986. PMID- 3562855 TI - DNA adducts of cisplatin in nucleated peripheral blood cells and tissues of cancer patients. PMID- 3562856 TI - Tissue and cellular specificity for DNA adduct formation and persistence following in vivo exposure to chemicals. PMID- 3562857 TI - 32P-postlabeling assay to measure carcinogen-DNA adducts. PMID- 3562858 TI - DNA adduct formation and removal during chronic administration of a carcinogenic aromatic amine. PMID- 3562860 TI - Quantitation of carcinogen-DNA adducts with monoclonal antibodies. PMID- 3562859 TI - The molecular dosimetry of DNA adducts formed by continuous exposure of rats to alkylating hepatocarcinogens. PMID- 3562861 TI - Preliminary investigations of tissue specificity, species specificity, and strategies for identifying chemicals causing DNA adducts in human placenta. PMID- 3562862 TI - [Transmission of cellular information and protein phosphorylation reactions]. PMID- 3562863 TI - [Protein phosphorylation reactions: conjugation of the excitation reaction]. PMID- 3562864 TI - [Protein phosphorylation reactions: regulation of cellular proliferation]. PMID- 3562865 TI - Interference of the PAF-acether antagonist BN 52021 with endotoxin-induced hypotension in the guinea-pig. AB - Because of the potential role of PAF-acether in the pathogenesis of endotoxin shock, we examined the preventive and curative effects of BN 52021, a new PAF acether antagonist in guinea-pig challenged with S. Typhimurium endotoxin. A biphasic reduction of mean arterial pressure was elicited by i.v. endotoxin (300 micrograms/kg) in control animals, with a rapid drop of blood pressure (maximal decrease within 10 min), partial recovery at 20 min and a second gradual decrease after 30 min. Treatment with BN 52021 injected 15 min prior to endotoxin reduced the initial rapid drop of blood pressure from 38.5 +/- 5 mmHg in vehicle-treated controls (n = 15) to 17 +/- 3 mmHg (p less than 0.01) in animals treated with 1 mg/kg BN 52021(n = 10) and to 9.5 +/- 8 mmHg (p less than 0.01) in guinea-pigs treated with 6 mg/kg BN 52021 (n = 5). The early hypotensive phase was associated with severe thrombocytopenia-leukopenia; only the thrombocytopenia was reduced by BN 52021. The prolonged secondary phase of hypotension was reduced by BN 52021 pretreatment whereas a small increase of hematocrit persisted. The two phases of the arterial pressure profile during endotoxic shock were not observed in animals previously made thrombopenic by rabbit and anti-platelet serum and only the late hypotensive phase persisted. This late hypotension induced by endotoxin in thrombopenic animals was suppressed by BN 52021 pretreatment suggesting that BN 52021 may act via a platelet-independent mechanism. The intravenous injection of BN 52021 during the prolonged secondary phase of shock was followed by an immediate increase of the depressed blood pressure. This increase of blood pressure was dose-dependent, maximum at 6 mg/kg BN 52021, and observed in normal and thrombopenic animals. The interference of BN 52021 with endotoxin shock may be related to its PAF-acether antagonist properties and suggests that PAF-acether is an important participant in endotoxic shock. PMID- 3562866 TI - Leukotrienes increase levels of prostanoids in cerebrospinal fluid in piglets. AB - We investigated effects of exogenous leukotrienes (C4, D4, or E4) on levels of prostanoids in cerebrospinal fluid in newborn pigs (1-5 days). A "closed" cranial window was placed over the parietal cortex. Pial arterial diameter was measured with a microscope and electronic micrometer system. Levels in cerebrospinal fluid (CSF) of 6-keto-Prostaglandin F1 alpha (6-keto-PGF1 alpha), Thromboxane B2 (TXB2), and Prostaglandin E2 (PGE2) were measured by radioimmunoassay. Topical application of leukotrienes C4, D4, or E4 (5,000 ng/ml) similarly constricted pial arteries by 15 +/- 2% (n = 14) (mean +/- SEM). In addition, leukotrienes increased levels of 6-keto-PGF1 alpha from 806 +/- 136 to 1,612 +/- 304 pg/ml (n = 13), TXB2 from 161 +/- 31 to 392 +/- 81 pg/ml (n = 10), and PGE2 from 2,271 +/- 342 to 4,636 +/- 740 pg/ml (n = 13). Each type of leukotriene had similar effects on prostanoid synthesis. In other experiments (n = 5), we found that 2.0 ng/ml PGE2 in CSF dilated pial arteries by 24 +/- 8% and that 1.0 ng/ml PGI2 dilated pial arteries by 15 +/- 6%. These results indicate that leukotrienes are able to increase levels of prostanoids in cerebral cortex. PMID- 3562867 TI - Effect of acetylsalicylic acid on urinary excretion of prostaglandin E in stroke patients. AB - In 12 of 76 stroke patients complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), a significant increase in urinary prostaglandin E (PGE) (p less than 0.005), and a significant positive relationship between the plasma arginine vasopressin (AVR) level and urinary PGE excretion were observed (r = 0.72, p less than 0.05). The experimental results are consistent with the view that renal PGE acts as a modulator of ADH. Nowadays acetylsalicylic acid (ASA), an inhibitor of prostaglandin biosynthesis, is widely used in ischemic stroke, it was felt necessary to study the effect of this drug on urinary PGE excretion. Therefore various daily doses of ASA were given orally for 3 days to patients with ischemic stroke. PGE values in 24-hour urine samples were measured every day for 3 days before administration of the drug and for 3 days during ASA administration. In 10 patients who took 75 mg of ASA, the decrease in urinary PGE excretion was not statistically significant. On the other hand when ASA was administered 300 mg once in 19 patients or 300 mg 4 times in 11 cases, urinary PGE excretion decreased significantly (p less than 0.05 and p less than 0.05 respectively). In another group of 8 patients who were observed before, during and after the ASA administration, a daily oral dose of 300 mg for 3 days caused a significant decrease in urinary PGE excretion during these 3 days (p less than 0.05). The urinary PGE excretion returned to the control level within 3 days after cessation of the ASA administration. PMID- 3562868 TI - Antagonistic effect of KC-404, a new anti-asthmatic agent, on leukotriene D4 induced contractile responses in isolated guinea pig smooth muscles. AB - The inhibitory effects of KC-404, a novel clinically available anti-asthmatic drug, on leukotriene(LT) D4-, LTC4-, histamine- and acetylcholine(ACh)-induced contractile responses in isolated guinea pig lung parenchymal, tracheal and ileal longitudinal strips were compared using an organ bath system. In lung parenchyma, KC-404 antagonized LTD4 in a competitive fashion, whereas it antagonized histamine noncompetitively. The pA2 value against LTD4 was 7.39. KC-404 hardly antagonized LTC4 and ACh. A ranked order of potency estimated from its minimum effective concentrations (MEC) was LTD4 greater than histamine greater than LTC4 greater than ACh. In trachea, KC-404 antagonized LTC4 and LTD4 in a competitive fashion, while it antagonized histamine noncompetitively. The pA2 values against LTC4 and LTD4 were 5.99 and 6.51, respectively. KC-404 hardly antagonized ACh. A ranked order of the potency estimated from MEC was LTD4 greater than LTC4 greater than histamine greater than ACh. The pA2 values of KC-404 against LTD4 in lung parenchyma and trachea were little or not altered, while its inhibitory effect on histamine-induced contraction in trachea was markedly diminished by the pretreatment of tissues with indomethacin. In ileum, KC-404 noncompetitively antagonized all of the agonists used. A ranked order of the potency estimated from pD2 values was LTD4 divided by LTC4 greater than histamine greater than ACh. These results suggest that KC-404 is a selective antagonist of LTD4 and that it might interact with LTD4 receptor in airway smooth muscles but not in ileum. Another possibility that the drug might interact with LTD4 specific excitation contraction coupling mechanism was also discussed. PMID- 3562869 TI - Profiling of prostaglandin biosynthesis in biopsy fragments of human lung carcinomas and normal human lung by capillary gas chromatography-negative ion chemical ionization mass spectrometry. AB - Methods for the profiling of prostaglandin F2 alpha (PGF2 alpha), prostaglandin D2 (PGD2), prostaglandin E2 (PGE2), thromboxane B2 (TXB2) and 6-keto prostaglandin F1 alpha (6KPGF1 alpha) biosynthesis in tissue samples of clinical origin by capillary gas chromatography-negative ion chemical ionization mass spectrometry (CGC-NICIMS) are detailed. Aliquots (25 microliter 1) of incubates (1 ml volume) of human lung carcinoma and normal human lung tissue fragments (total protein content = 0.2 to 2.0 mg) were derivatized for vapor phase analysis in the presence of 0.75 to 1.60 ng of tetradeuterated analogs of PGE2, PGF2 alpha and 6KPGF1 alpha without prior extraction and/or chromatography. The derivatized analytes and internal standards were detected by simultaneous monitoring of ions at six different masses characteristic for each of the derivatized prostanoids. The inter-sample and intra-sample coefficients of variation for the assay method were typically less than 12%. The analysis of biological samples was completed with less than 2.5% of each derivatized sample per injection. The samples were of adequate purity for the identification and quantitation of each of the eicosanoids. The methods described in this report are highly selective and highly sensitive with detection limits of 0.1 to 0.2 picograms per injection. The analytical procedures provide the basis for comparisons of the qualitative and quantitative profiles of prostaglandin biosynthesis and should be adaptable for use in a variety of biological and clinical studies. PMID- 3562870 TI - [Psychoanalysis and anti-Semitism]. PMID- 3562871 TI - ["The air castle and the labyrinth"--Ernst Block's dream theory]. PMID- 3562872 TI - [Effect of psychoanalysis on German literature]. PMID- 3562873 TI - [The verbal behavior of the analyst in transference]. PMID- 3562874 TI - [Supportive treatment of exhibitionism. A psychoanalytic approach]. PMID- 3562875 TI - [Toward Italy! Youth and maturation in "Taugenichts"]. PMID- 3562876 TI - [Psychoanalytic and cultural change]. PMID- 3562877 TI - [Public health--conditions, perspectives and the role of medical sciences (report of the 4th Problem-Solving Team)]. PMID- 3562878 TI - [Status and prospects of the development of non-surgical clinical disciplines]. PMID- 3562879 TI - [Development of clinical sciences in Poland 1986-1995]. PMID- 3562880 TI - [Current status and prospects of laboratory diagnosis]. PMID- 3562881 TI - [Status and prospects of the development of mental health sciences and the science of mental disorders]. PMID- 3562882 TI - [Current status of ergonomics in Poland. Trends in the development of ergonomics]. PMID- 3562883 TI - Analysis of the Pavlovian properties of signals for punishment. PMID- 3562884 TI - Spatial learning set acquisition in rats. PMID- 3562885 TI - Early clinical experience with high-field 1.5 Tesla magnetic resonance imaging. AB - Despite early concerns regarding potential tissue attenuation of signal and lack of inherent contrast, magnetic resonance imaging at 1.5 Tesla has proved to be a valuable extension of magnetic resonance imaging. In this report, we review our initial experience in imaging of the central nervous system, abdomen, chest and pelvis. In the central nervous system, exquisite morphologic detail has been demonstrated. This has added both in terms of sensitivity and specificity to neuroradiologic diagnosis. In the chest and abdomen, despite problems with respiratory and cardiac motion, good morphologic detail can be obtained. In the thorax, our work has demonstrated the ability of magnetic resonance imaging to clearly define the relationship of masses to the hilum and mediastinum. Imaging of the great vessels with magnetic resonance imaging has also proved useful. In the abdomen, magnetic resonance imaging has been useful in looking at the extent of masses identified, in characterizing focal liver masses, and in staging a variety of neoplasms. The high contrast resolution and the ability to image in a variety of planes is particularly helpful in the pelvis. In the male pelvis our work has primarily dealt with staging extracapsular prostatic carcinoma. In the female pelvis, ascertaining the nature of adnexal masses and defining staging primary carcinomas and their response to therapy has been the major thrust of our efforts. Surface coils and other technical improvements will undoubtedly extend the range of application at high field. PMID- 3562886 TI - Thin slice CT study of solitary pulmonary nodules with emphasis on the relation to vasculatures. AB - Thin (2 mm) and thick (10 mm) slice X-ray computed tomography (CT) scanning was performed in 49 and 31 patients, respectively, to assess the morphology of solitary pulmonary nodules or masses and to determine the relationship between the tumor and surrounding vasculature. When the pulmonary vein passed singly into the tumor or was larger than the artery (pattern I), 38 of 40 nodules (95%) were malignant (p less than 0.001). When the pulmonary artery passed singly into the tumor or was larger than the vein (pattern II) and when no pulmonary vessel passed into the tumor but when a pulmonary vessel was compressed by the tumor or passed through it (pattern III), only 11 of 19 nodules (58%) were malignant. Based on the morphology and vasculature patterns the accuracy of diagnosis with thin slice CT was 80.9% while that of thick slice CT was 67.7%. Thin slice CT can increase the diagnostic accuracy of primary lung cancer. PMID- 3562887 TI - CT diagnosis of primary Budd-Chiari syndrome--membranous obstruction of the inferior vena cava. AB - Five cases with primary Budd-Chiari syndrome due to membranous obstruction of the hepatic segment of the inferior vena cava were examined by CT. In all cases, CT demonstrated caudate lobe enlargement, reticular low density within the liver parenchyma, splenomegaly, and collaterals via the ascending lumbar veins and azygous system. Pathological study revealed liver cirrhosis or fibrosis in all cases. In two cases, calcification was shown in the region of the hepatic segment of the inferior vena cava. Our results suggested that the CT appearance of primary Budd-Chiari syndrome was rather characteristic and useful in diagnosis, although membranous obliteration could not be shown directly on CT. PMID- 3562888 TI - A multiple regression analysis for predicting local control of esophageal carcinoma treated by intracavitary irradiation. AB - A multiple regression analysis for predicting local control of esophageal carcinoma treated by intracavitary irradiation is reported. In phase I, the value of predicting local control (VPLC) was determined by five parameters: VPLC = 1.38950 - 0.01571 X (age) + 0.04517 X (tumor length) + 0.62167 X (stenosis) + 0.94811 X (deep ulcer) - 0.02969 X (Total dose of intracavitary irradiation). From correlations between VPLC and the local control observed in 19 phase I patients, it was determined that a VPLC value of 0.5 or more predicted local failure and a VPLC of less than 0.5 signified successful local control. In phase II, prediction of local failure or local control was made for another 24 patients by calculating VPLC, and 22 of the 24 cases (91.7%) were correctly predicted. These results indicate that VPLC is a useful index for predicting of local control after intracavitary irradiation in cases with esophageal carcinoma. PMID- 3562889 TI - Local control and outcome of patients irradiated for isolated chest wall recurrences of breast cancer. AB - Between January 1970 and December 1978, 149 breast cancer patients with isolated chest wall recurrences developing after initial curative treatment (mastectomy with or without postoperative irradiation) were referred to the University Clinic for Radiotherapy and Radiobiology of Vienna. Following radiotherapy, survival was analysed in 134 patients with regard to the amount of disease in the chest wall at the time of treatment and local tumour control. Patients with "subclinical" disease (after excision of solitary recurrences) had a median survival time of 55 and 50 months for controlled and uncontrolled disease in the entire chest wall, respectively. The corresponding survival times for patients with "macroscopic" chest wall disease was 36 and 25 months, respectively. Local tumour control within the irradiated field was 69% for patients with subclinical disease and 49% for patients with macroscopic tumour manifestation. Freedom from tumours in the entire chest wall could be achieved in 41% of patients with subclinical and 24% of patients with macroscopic disease. The 5-year survival rate for patients with subclinical disease, with tumour control in the entire chest wall is 53%. Of all 134 patients, 22% survived 5 years from the time of local recurrence. PMID- 3562891 TI - Irradiation of bilateral orbital lymphoma: a non-coplanar technique with case reports. AB - Bilateral synchronous involvement of the orbits by lymphoma is an uncommon event. Therefore, the irradiation techniques for this disease are not well refined. Depending on the technique used, one has to decide between underdosing the anterior segment of the orbit and the frequently involved lacrimal glands or to tolerate shield related in homogeneities in the range of 40 to 50% as well as higher doses to the midline structures, e.g. the optic chiasma. To avoid the above shortcomings we developed a technique by which half the prescribed dose is delivered by pairs of beams angulated in the transverse plane and the other half by pairs of beams angulated in the sagittal plane. Film dosimetry in a phantom confirms that the entire orbit, including its anterior portion, is well covered, the lens is protected, and the dose to the mid-sagittal structures is not increased. The dose inhomogeneity is in the range of 20% which represents a substantial improvement over alternative methods. Two irradiated patients with bilateral orbital lymphoma are presented with local control and no ophthalmic or other side effects as of last follow-up. PMID- 3562890 TI - The efficiency of different combined treatment programs (combination chemotherapy radiotherapy) used for stage I-II Hodgkin's disease. AB - This study presents the analysis of results obtained in 237 Hodgkin's disease patients, stages I and II, treated with combined modality therapy. The overall and disease-free survival rates at 5 years were 96.6 and 85.2%, respectively. The study has demonstrated the superiority of the following treatment program: one cycle of combination chemotherapy + radiation therapy + 5 cycles of combination chemotherapy. It has been found possible to reduce the number of radiation fields in combined modality therapy: for patients with stage IA-IIA lymphocyte predominant or nodular sclerosing Hodgkin's disease it was sufficient only to treat clinically involved sites. Short- and long-term consequences of combined modality therapy have been analysed. PMID- 3562892 TI - Labeling of sarcoma associated monoclonal antibody with 111In, 67Ga and 125I. AB - Labeling of human sarcoma-associated murine monoclonal antibody (MAb) 23H7 with 67Ga and 111In by the bifunctional ligand method is reported. 67Ga was chelated to the MAb via desferrioxamine B and 111In via the cyclic anhydride of DTPA. Higher specific activity was obtained with 67Ga (4-5 microCi/micrograms) as compared with 111In (2 microCi/micrograms). The binding capacity of the MAb was confirmed by repeated indirect immuno-fluorescence assays performed before and after labeling. A fast blood clearance was observed: 33% recovered dose (R.D.) blood level 3 h post-injection as compared with 56% after injection of control polyclonal IgG. Preliminary results on chemically induced sarcoma bearing mice showed a relatively high tumor uptake of the labeled antibody. PMID- 3562893 TI - A new system for patient fixation in radiotherapy. AB - A new system for patient fixation in radiation treatment is described. The system consists of an airtight plastic bag with a contents of polysterol microspheres. A valve allows evacuation which results in a rigid close fitting cast. The system was compared with conventional foam cast fixation in 29 patients who were treated for carcinoma of the breast. The patients received radiation treatment over 22 fractions, and portal X-ray pictures were obtained at every second treatment. The portal films were compared with the stimulator radiographs and the variation in the position of the centre cross were measured in cranio-caudal and transversal direction as well as the rotation of the centre cross. The results showed that the daily reproducibility of the patient set-up was considerably improved by the new system, the centre cross deviation of the position of the actual radiation field to the centre cross of the intended field being less than 1 mm in 50% of the cases. The system is time-saving and cheap compared to conventional fixation systems. PMID- 3562894 TI - Lack of differential sparing of late ischaemic atrophy and early epidermal healing, after dose fractionation of mouse tails down to 2.6 Gy per fraction. AB - Long-term atrophy of irradiated mouse tails began after about 5 months, and the incidence rose steadily to the end of the lifespan. The major associated histological change was atherosclerosis in the single tail artery. The incidence of the ischaemic atrophy was dependent on the size of the irradiated volume. The probability of ischaemic atrophy assessed at 3 years after irradiation was little dependent on the dose. The fractionation effect was described by alpha/beta congruent to 30 Gy, which was not lower than the range of values applicable for healing of the early epidermal reactions on the tail. Hence the general finding of a sparing of late effects in tissues using low doses per fraction was not observed in these experiments using dose fractions down to 2.6 Gy and the present endpoints. PMID- 3562895 TI - Radiation dose enhancement therapy with iodine in rabbit VX-2 brain tumors. AB - Loading tissue with iodine enhances the radiation dose absorbed from low energy X rays. In order to test whether this is a useful procedure for treating brain tumors, we infused radiographic contrast media into rabbits carrying VX-2 brain tumors and delivered 15 Gy of 120 kVp X-rays in 3 fractions to the tumor. From CT scans we estimated that the dose enhancement was approximately 30%. The median survival times, after tumor detection on CT, of untreated rabbits, treated with radiation alone, and treated with radiation plus contrast media were 3, 25.5, 38.5 days, respectively. The repeated infusion of contrast media, 3.5 g of iodine per kg of body weight, did not affect kidney function as measured by serum creatinine levels. This method of enhancing radiation dose in brain tumors therefore appears promising. PMID- 3562896 TI - Radiosensitivity of cells in recurrent experimental tumours and the effectiveness of tumour retreatment. AB - Two experimental tumour models, a rat rhabdomyosarcoma (R-1) and a rat urether carcinoma (RUC-2) have been employed to evaluate the X-ray sensitivity of tumours recurrent after primary treatments with various doses of X-rays and to correlate changes in volume responses with the cellular radiosensitivity. The responsiveness of R-1 tumours, assessed from the volume reduction as a function of the time after treatment, was less for recurrent tumours, but their growth delay was slightly increased, while the X-ray sensitivity of the tumour cells, assessed by cell survival, was equal to that of the controls. For RUC-2 tumours, however, the reduction in volume after irradiation of the recurrent tumour was larger than after primary treatment, the growth delay was increased, but cell survival curves were not significantly different from those of the controls. It is concluded that differences in volume responses between untreated tumours and recurrent tumours are largely determined by a tumour bed effect (TBE) and that changes in cellular radiosensitivity in these tumours do not play a significant part. PMID- 3562897 TI - Serum T3 and rT3 levels in cancer patients with and without weight loss. PMID- 3562898 TI - Characterization of an amidated form of pancreatic polypeptide from the daddy sculpin (Cottus scorpius). AB - The primary structure of pancreatic polypeptide from the teleostean fish, Cottus scorpius (daddy sculpin) was established as: YPPQPESPGGNASPEDWAKYHAAVRHYVNLITRQRYNH2 The presence of a COOH-terminally alpha amidated amino acid was established using an HPLC method of general applicability. Although the peptide shows strong homology towards anglerfish pancreatic polypeptide (86%), homology towards porcine peptide YY (PYY) (61%) and porcine neuropeptide Y (NPY) (61%) was greater than towards porcine pancreatic polypeptide (PP) (47%). This result supports suggestions that the gene duplication events which led to PP, NPY and PYY formation took place after the time of divergence of fish and mammals. PMID- 3562899 TI - Identification and localization of material with gastrin-like immunoreactivity in the neural ganglion of a protochordate, Ciona intestinalis. AB - Little is known of the identity of gastrin/cholecystokinin (CCK)-like peptides in protochordates. These animals are at a level of organization corresponding to that from which the vertebrate line arose; in order to shed light on the origins of gastrin/CCK-like peptides, we have studied by immunochemical methods these peptides in a protochordate, Ciona intestinalis. In radioimmunoassay, boiling water extracts of the neural ganglion reacted with C-terminal specific gastrin/CCK antibodies, but not N-terminal or intact G17 specific antibodies. Of particular importance was the fact that a gastrin antibody which reacts weakly with CCK8 showed full activity with the Ciona material, suggesting that it resembles the C-terminus of gastrin. A single major peak was found by gel filtration and HPLC. In immunohistochemistry, nerve cell bodies were found in the cortical regions of the ganglion, and abundant fibres ramified in the central neuropile. We conclude that peptides of the gastrin/CCK series occur in nervous tissue in protochordates, and that while they are distinguishable from known forms of both gastrin and CCK, they resemble C-terminal fragments of the mammalian gastrins. PMID- 3562900 TI - Different peripheral and central antagonistic activity of new glutaramic acid derivatives on satiety induced by cholecystokinin in rats. AB - New glutaramic acid derivatives with cholecystokinin antagonistic activity were evaluated for their capacity to inhibit the satiety effect induced in the rat by intraperitoneal (i.p.) injection of cholecystokinin octapeptide (CCK-8). The most active compound, CR 1409, is about 4000 times more potent than proglumide when injected peripherally (i.p.). This compound competitively inhibits the action of CCK-8 at the receptor responsible for the satiety effect. In contrast, CR 1409, i.p. or intracerebroventricularly (i.c.v.) injected does not exhibit antagonistic effects when CCK-8 is administered i.c.v., confirming the existence of at least two different populations of CCK receptors. PMID- 3562901 TI - Receptor binding of pancreatic spasmolytic polypeptide (PSP) in rat intestinal mucosal cell membranes inhibits the adenylate cyclase activity. AB - The recently isolated pancreatic spasmolytic polypeptide, PSP, interacted with specific binding sites in the gastrointestinal tract and inhibited the adenylate cyclase activity in rat intestinal mucosal cell membranes. The binding sites appeared to be heterogeneous and Scatchard analysis of the binding data indicated the presence of at least two classes of sites. The high-affinity low-capacity binding sites and the low-affinity high-capacity binding sites had apparent dissociation constants of 1.3 X 10(-7) mol/l and 4.2 X 10(-6) mol/l, respectively. The PSP induced inhibition of the adenylate cyclase activity was independent of the stimulatory state of the enzyme. The basal activity as well as that stimulated by VIP and secretin was half maximally inhibited at approximately 3 X 10(-5) mol/l of PSP. The inhibitory effect of PSP was independent of the agonist concentration employed. PSP did not affect the receptor binding of VIP nor did VIP affect the receptor binding of PSP. PMID- 3562902 TI - Effect of vasoactive intestinal polypeptide (VIP) on steroidogenesis in women. AB - The VIPergic nervous system appears to be the major peptide-containing neuronal component in the female genital tract. Evidence has been put forward that exogenous VIP is able to stimulate progesterone secretion. In the present study the effect of human VIP (900 pmol/kg body weight per h i.v. during 30 min) on steroidogenesis in six female volunteers was investigated. The experiments were performed between the 6th and 14th day of their menstrual cycle, and peripheral venous blood was collected before, during and after infusion of VIP. The concentrations of VIP, oestradiol, progesterone, testosterone, androstenedione (AD), dihydrotestosterone (DHT), dehydroepiandrosterone sulphate (DHAS), sex hormone binding globulin (SHBG) and cortisol were measured. The infusion of VIP was accompanied by a 15% increase (P less than 0.05) in serum oestradiol concentrations, from a mean basal concentration of 0.58 nmol/l. The concentrations of testosterone and DHT also increased significantly. No effect of VIP on progesterone, AD, DHAS, SHBG or cortisol was observed. In the light of the presence of VIP in nerve fibres of the steroid producing tissue, this stimulatory effect of VIP might reflect a direct action on the ovary or the adrenal gland. PMID- 3562903 TI - Effect of pancreatic polypeptide on the motility of the guinea-pig small intestine in vitro. AB - The effect of porcine pancreatic polypeptide (PP) on the motor activity of the longitudinal and circular muscles of the guinea-pig isolated small intestine was investigated. PP (0.2-20 nM) inhibited cholinergic contractions of the longitudinal muscle in response to electrical field stimulation, the maximal effect being a 30% reduction of the contraction amplitude. Carbachol-induced contractions of the longitudinal muscle were not affected by PP (10 nM). PP (0.3 30 nM) also inhibited reflex contractions of the circular muscle elicited by balloon distension and recorded orally to the site of distension; the maximal effect was a 80% reduction of the reflex contraction. In contrast, carbachol induced contractions of the circular muscle remained unaltered by PP (10 nM). It was further found that PP (10 and 100 nM) enhanced the threshold intraluminal pressure at which peristaltic waves were triggered. All these effects of PP appeared to be transient. Taken together, these data indicate that PP does not act on intestinal smooth muscle but can modulate the activity of certain enteric neurones which are involved in the regulation of intestinal motility. PMID- 3562904 TI - Do enkephalins participate in vagal activation of gastric acid secretion in man? AB - The effects of the anticholinergic drug benzilonium bromide and the opiate receptor blocker naloxone, given alone or in combination, on the acid secretory response and on plasma gastrin releasing peptide (GRP) response to sham feeding was tested in eight duodenal ulcer (DU) patients. Naloxone alone had no effect on the acid secretion after sham feeding. Benzilonium reduced basal acid secretion and the acid response to sham feeding but did not abolish the response. The combination of benzilonium and naloxone was not more effective than benzilonium alone. Neither drug, nor the combination had any effect on plasma GRP following sham feeding. It is concluded that enkephalins are unlikely to participate in the acid response to sham feeding in patients with DU. PMID- 3562905 TI - Neuropeptide Y (NPY)-induced feeding behavior in female rats: comparison with human NPY ([Met17]NPY), NPY analog ([norLeu4]NPY) and peptide YY. AB - Porcine neuropeptide Y (pNPY) administered into the third ventricle of the brain is known to elicit a powerful feeding response in steroid-treated ovariectomized and intact male rats. The present study compared the effects of pNPY and 3 structurally related peptides, human NPY (hNPY), an analog of NPY (NPY-A, [norLeu4]NPY) and peptide YY (PYY) on feeding behavior in intact female rats. Intraventricular administration of pNPY, hNPY, NPY-A and PYY over a dose range of 0.5 to 10 micrograms evoked feeding behavior to a varying extent. Cumulative food intake during 60 and 120 min was increased in a dose-related fashion at 0.5 and 2.0 microgram for the 4 peptides. Whereas the 10-micrograms dose of pNPY evoked a feeding response smaller than that seen after 2 micrograms, the responses to either 10 micrograms hNPY or 10 micrograms PYY were similar to that seen after 2 micrograms. The effects of these peptides on the time spent eating were quite different: while pNPY increased the time spent eating, this effect was not dose related, whereas hNPY, NPY-A and PYY produced dose-related increments in the time spent eating. The most dramatic increment in local eating rate was observed after 2.0 micrograms pNPY, with lesser increments seen after 2.0 microgram hNPY and NPY A. This increased local eating was apparently responsible for the highest cumulative food intake observed. These results demonstrate that (a) 2 micrograms pNPY is equally effective in stimulating feeding behavior in intact female rats as it is in steroid-primed ovariectomized female and intact male rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3562906 TI - In vivo localization of radiolabeled monoclonal antibody to carcinoembryonic antigen (CEA) in a CEA-producing tumor--comparison with polyclonal antibody. AB - To compare accumulation of the 125I-labeled antibodies (anti-carcinoembryonic antigen (CEA) monoclonal antibody and polyclonal antibody) to a CEA-producing tumor (SC-2-JCK), an in vivo localization study was performed in nude mice. The tumor-to-blood ratio at 120 hours after injection rose to 4.6 for the monoclonal antibody, but remained at 1.3 for the polyclonal antibody. However, no differences were noted between the antibodies up to 72 hours after injection. In autoradiograms, selective accumulation of the tracer was noted in the tumor for both antibodies. However, no superiority or inferiority of imaging for either of the antibodies could be definitely determined. PMID- 3562907 TI - [Fundamental studies on thyroid stimulating hormone immunoradiometric assay kit (TSH RIABEAD II)]. AB - We have reported fundamental studies on the TSH immunoradiometric assay, using TSH RIABEAD II kit (Dainabot). The sensitivity of the assay was 0.03 mu IU/ml and its C.V. was 27.2%. Intra- and inter-assay C.V. were less than 5%. Dilution test and recovery test were good. Serum TSH level was 0.3-4.0 mu IU/ml in normal subjects, less than 0.03 mu IU/ml in untreated Graves' disease and subacute thyroiditis. Therefore, it was found that the clear difference exist in serum TSH levels between normal subjects and patients with untreated Graves' disease. There was a well correlation on the serum TSH levels between this method and TSH radioimmunoassay kit (Amerlex TSH, r = 0.983). Especially, the measurement of serum TSH levels, using immunoradiometric assay kit, was useful for the diagnosis of patients with Graves' disease. PMID- 3562908 TI - [A fundamental and clinical study of ferritin 'Eiken' radioimmunoassay kit]. AB - We have measured serum ferritin level using double antibody radioimmunoassay kit (Eiken ICL) and evaluated the characteristics of the kit and clinical usefulness. Satisfactory results were observed in standard curve, reproducibility, dilution and recovery test. In clinical evaluation, we have measured in normal subjects and patients with various diseases. The range in normal males and females were 13.0-158.7 ng/ml and 7.3-73.0 ng/ml, respectively. Serum ferritin level was elevated in patients with hepatoma, biliary cancer, lung cancer and other malignant diseases. Measurement of serum ferritin value would be useful in the monitoring of cancer patients. PMID- 3562909 TI - [Reduction of radiation dose to the worker in preparing the radiopharmaceutical solution by a simple shielding equipment]. AB - In order to reduce radiation dose to the hands of examiners who prepare and aspirate radiopharmaceuticals, we made a prototype of simplified manually operated dispense system, which the syringe and the vial shield with lead were set in the small box made of lead and lead glass. The result showed that our dispense system allowed substantial reduction of radiation dose to the hands and rapid preparation of radiopharmaceuticals compared with the conventional lead shield syringe system, and allowed closer operation, smaller dead volume and lower cost compared with the conventional automatic system. PMID- 3562910 TI - [The personal computer in radiologic activity. Reflections on informatics]. PMID- 3562911 TI - [Behavior and significance of phalangeal bone changes in uremic patients under periodic hemodialysis treatment]. AB - Bone damage in hand phalanges has been evaluated with reference to age and duration of hemodialysis (on the basis of 248 radiological observations), in 93 cases with chronic renal failure (age: 20-59 years). These patients were on regular dialytic treatment (RDT) from 1 to 138 months. 72% of the patients underwent several periodic (annual) controls using the mammographic technique. The radiologic evaluations have been arranged into groups according to age. Skeletal damage was more evident when RDT was prolonged. Bone damage increases with age in the first 48 months; afterwards, on the contrary, bone changes were more evident in middle aged patients. At the beginning of RDT, acroosteolysis was the most important change always present. Both subperiosteal and intracortical resorption are more evident increasing age and duration of RDT. Radiological changes give a clear picture of the possible histo-morphologic pattern that characterizes uremic osteodystrophy. PMID- 3562912 TI - [Direct radiographic magnification of the hands. A critical analysis]. AB - The value of direct magnification radiography of the hand and the wrist has been studied in 128 patients affected by rheumatic diseases. Only in a small group (3.17%) magnification determined a higher percentage of correct diagnosis; in the 17.06% of cases direct magnification radiography provided useful increase in information but did not change the diagnosis correctly reached by conventional techniques. In most cases (79.76%) magnification provided only a better image quality but no more information helpful for the diagnosis, because of the high level achieved by conventional techniques. Therefore direct magnification radiography must be used only in selected cases and not as routine radiographic technique. PMID- 3562913 TI - [Transbronchial needle aspiration of mediastinal masses during fiber bronchoscopy]. AB - The authors present their own experience in the diagnosis of thoracic adenopathies and mediastinal masses by transbronchial needle aspiration (Wang needle). The diagnostic usefulness and safety of the method is stressed. Radiology plays an important role in choosing biopsy site (by CT), in monitoring the procedure by fluoroscopy and looking for complications following completion of the examination. PMID- 3562914 TI - [Computer tomography aspect of afferent loop syndrome]. AB - Obstruction of the afferent loop may develop in patients who had a Billroth type II gastrectomy. The obstructed loop has a characteristic CT appearance. Four cases of afferent loop syndrome demonstrated by CT are described. PMID- 3562915 TI - [Celiac disease as a risk factor for digestive neoplasms]. AB - Coeliac disease is a primary malabsorption syndrome, whose gastrointestinal symptomatology regresses following a gluten-free diet. Several authors report an increased incidence of intestinal lymphoma in patients with longstanding coeliac disease; on the other hand the association of this malabsorption syndrome with malignant tumors of the esophagus, stomach or large bowel is not very common. The authors describe three cases of coeliac disease complicated after 5, 12 and 18 years by neoplasms of the esophagus, stomach and small bowel. It is stressed that in this disease patients must be monitored with periodic radiologic examinations, in the hope of detecting any malignancy at an early and perhaps treatable stage. PMID- 3562916 TI - [Multiple primary tumors of the colon]. AB - Nine cases of multiple primary carcinomas of the large intestine are reported in order to emphasize the importance of an accurate pre-operative search of the other neoplastic lesions after a first cancer diagnosis. As the multiple carcinomas are often in various growing stages it is necessary an accurate X-ray examination for the early cancer diagnosis. It can be concluded that all "at risk" patients (including those already treated by surgery) must be yearly controlled by radiological and endoscopic examinations to assure the best long term results. PMID- 3562917 TI - [Use of magnetic resonance in patients with portal hypertension before and after diversion intervention. Initial experience in 15 cases]. AB - Fifteen patients with portal hypertension were examined by magnetic resonance imaging (MRI) using spin-echo sequences. Sagittal and transaxial images were obtained in all cases. Ten subjects have been evaluated after portosystemic shunt operations (6 portocaval and 4 splenorenal shunts); 5 patients were studied by MRI before shunt placements. Angiographic correlation was obtained in 15 cases. In each of the preoperative examinations, MRI accurately depicted inferior vena cava, portal vein and splenic vein. Shunt patency was documented in 10/10 postoperative studies: portacaval shunts patency was better determined in the transaxial plane while splenorenal shunts were better demonstrated in the sagittal plane. Thus, MRI seems to be an accurate and noninvasive method for detecting portosystemic shunt patency without the use of intravenous contrast media and without patient exposure to radiation. PMID- 3562918 TI - [A formulation of iopamidol for the radiologic examination of the gastrointestinal tract. Preclinical studies]. AB - Animal studies were carried out using an oral solution of a low osmolality non ionic contrast medium iopamidol, developed for gastrointestinal examinations. The new formulation was evaluated for image quality in studies of the upper and lower gastrointestinal tract. Margins of safety were defined by subjecting the compound to a number of toxicological and pharmacological experiments. The experiments were designed to reveal qualitative and quantitative differences between the formulation of iopamidol and Gastrografin, a conventional ionic contrast medium. The results indicate that the formulation of iopamidol is safer than a conventional hypertonic water soluble contrast medium and diagnostically superior in the gastrointestinal tract examinations. PMID- 3562919 TI - [Quality control in urography with iopamidol and iohexol. A parallel comparison]. AB - Iohexol has a slightly higher osmolarity in comparison with iopamidol; therefore it might induce a more pronounced diuretic effect and then a better distension of the excretory pathway. A trial was carried out in two groups of 50 patients with normal renal function who underwent urography, namely with 50 ml (15 gI) of iopamidol and of iohexol. No significant differences in the evaluated parameters (nephrography, calyces, pelvis, ureters and bladder) have been found. Both contrast media allowed to perform good quality urographies. PMID- 3562920 TI - [Early angio-computer tomography of ruptured cerebral aneurysms in subarachnoid hemorrhage]. AB - In acute subarachnoid hemorrhage a ruptured cerebral aneurysm can be detected by Computed Angiotomography (Angio-CT). In a hyperdense cistern by extravasal blood, a round low-density defect on plain CT which turns into high-density nodular mass with afferent and efferent arteries, is an important finding of ruptured aneurysm. The inverting-density cisternal defect in connection with cerebral arteries is essential for the direct and early Angio-CT diagnosis of ruptured aneurysm. PMID- 3562921 TI - [Echocardiographic gating in non-cardiac digital angiography]. AB - This paper reports the results of the ECG-gating in non-cardiac digital subtraction angiography (DSA). One hundred and fifteen patients underwent DSA (126 examinations); ECG-gating was applied in 66/126 examinations: images recorded at 70% of R wave were subtracted. Artifacts produced by vascular movements were evaluated in all patients: only 40 examinations, carried out without ECG-gating, showed vascular artifacts. The major advantage of the ECG gated DSA is the more efficient subtraction because of the better images superimposition: therefore, ECG-gating can be clinically helpful. On the contrary, it could be a problem in arrhythmic or bradycardic patients. ECG-gating is helpful in DSA imaging of the thoracic and abdominal aorta and of the cervical and renal arteries. In the examinations of peripheral vessels of the limbs it is not so efficient as in the trunk or in the neck. PMID- 3562922 TI - [Results of radiotherapy of supraglottic laryngeal carcinomas observed at the Division of Radiotherapy of the District Hospital of Varese]. AB - The authors review the supraglottic laryngeal carcinomas examined in the Radiotherapy Department of the "Ospedale Regionale" of Varese, Italy, from 1979 to 1984. 255 patients have been monitored: 80 considered for radiotherapy alone and 77 for postoperatory radiotherapy treatment. The cumulative actuarial survival (pcs) after 60 months, for patients treated only with radiotherapy, is 0.66 +/- e.s. 0.07; for patients treated with post-operatory radiotherapy the cumulative actuarial survival (pcs) after 60 months is 0.49 +/- e.s. 0.11. The irradiation techniques are described and the results achieved fully discussed. PMID- 3562924 TI - [Use of grids in mammography]. AB - The authors report their experience in grid mammography in 265 patients. Image quality of grid mammograms was compared with conventional film-screen combination mammograms. The superior image quality of grid mammography, especially in large size breasts, was demonstrated. On the other hand the images obtained using grid fixed and Potter resulted almost alike. PMID- 3562923 TI - [Evaluation of the process of lumbo-aortic metastasis in carcinoma of the cervix uteri]. AB - Paraaortic lymph nodes involvement in patients with cervical carcinoma, even in less advanced stages, found in 100 cases examined, besides the data reported in literature, has driven the authors to locate, through the examination of lymphangiograms, the routes by which paraaortic metastases can occur. Authors pointed out different ways of invasion, besides the more common subsequent involvement going from pelvic to paraaortic nodes or from posterior channels that can lead to paraaortic spread without lesions in common iliac nodes. In detail lymphatic pathways have been opacified connecting distant nodal chains and finally external routes from external iliac lymph nodes directly to paraaortic chain. PMID- 3562925 TI - [Digital radiography with photo-emitting detectors. Technical note]. AB - A specification on a digital radiography system which has been recently installed, based on the principle of scanning laser stimulated luminescence, is explained in short. We have just verified the possibility, among the many potential advantages, to produce good images at the lowest doses and insensitive to over and under exposure. PMID- 3562926 TI - [Comparison between phantoms for quality control in xeromammography]. AB - An indicator of operating technique (phantom) is very useful for quality control in diagnostic radiology. We tested experimentally that the "Random Phantom" is the most suitable between those commercially available for xeromammography. In fact this indicator points out image quality alterations caused even by very small variations of the physical parameters affecting image quality. We did not test the phantoms for mammographic technique but we believe that the "Random" is the most suitable in this field too. PMID- 3562927 TI - [Congenital arteriovenous vertebral fistula]. PMID- 3562928 TI - [A rare localization of hydatidosis. Computer tomography study of the adrenal glands]. PMID- 3562929 TI - Alcohol-related hazardous behavior among college students. AB - This chapter compares a social learning and deterrence model for DUI among college students. Our assumption is that deviant behavior, or driving under the influence, is a result of social learning that occurs in ongoing interaction with significant others. A deterrence model that is concerned with the threat and fear of death and beliefs about the capacity of the driver to minimize danger when drunk and statutory commands through laws also play a role in such behavior. Using multivariate analysis, specifically discriminant function and multiple regression, we differentiate our sample into those who have "never," only once, and regularly DUI. The major item in the social learning model contributing to DUI is whether the respondent has ever been a passenger with a drunk driver. The deterrence model also has value since the number of "tricks" the respondent feels are useful in counteracting the influence of alcohol contributes to believed risk reduction. Results indicate that alone, the deterrence model fails to explain DUI. The social learning model with its emphasis on the proximate social environment is needed as a supplement to predict DUI among college students. Efforts to modify this hazardous behavior among college students will need to incorporate a social learning model along with the deterrence model. PMID- 3562930 TI - [Prosthetic arthroplasty in recent and old complex injuries of the shoulder]. AB - Thirty-four acute and 22 old injuries of the shoulder have been operated on, using either a humeral prosthesis (24 cases) or a total Neer prosthesis (32 cases). The mean age of the patients was 66 years. There were 32 acute and 13 old four-part fractures of the upper end of the humerus and 6 dislocations of the shoulder. The surgical technique and the method of rehabilitation are described. There were 17 post-operative complications, including 4 dislocations, 2 cases of secondary displacements of bone fragments and 2 loosenings of the glenoid component. In only 4 cases was a further operation needed. The results were analysed in 43 cases with a follow-up greater than one year. In 34 cases, there was no pain, but only 17 cases had more than 90 degrees of active flexion. There were no loosenings of the humeral stem. In two cases of humeral replacement, a narrowing of the joint space was noted. There was moderate peri-articular ossifications on 6 occasions. An upward displacement of the prosthesis was noted on 10 occasions, due to rupture of the rotator cuff. The results were much better in acute lesions than in chronic ones. The authors conclude that prosthetic replacement is indicated in severe fractures of the upper end of the humerus, whether acute or chronic, and if the patient is elderly. PMID- 3562931 TI - [Hematogenous osteomyelitis in the adult]. AB - Between 1960 and 1985, 39 cases of haematogenous osteomyelitis in adults have been treated. The clinical signs were somewhat different from those seen in children or adolescents. The difference was due to different patterns in the blood supply of adult bones. Three types are described: acute, sub-acute and suppurating. Some patients purely suffered pain. After the age of 50 the prognosis was much worse. All the cases were treated surgically by evacuation of pus, excision of sequestra and necrosed bone, muscle flaps or bone grafting by the Papineau technique. The results were satisfactory except in the elderly. PMID- 3562932 TI - [Anterior recurrent luxation of the shoulder. Postoperative recurrences]. AB - Seventy-nine recurrences have been seen after surgical procedures for recurrent dislocation of the shoulder. There were 58 "true" recurrences, 17 shoulders with anterior instability and 4 with instability in all directions. The "true" recurrences were more frequent in young people with a mean age of 20 years at the time of the first surgical procedure. Two-thirds of them occurred on the dominant side. Most of the cases had been treated by distal displacement or lengthening of the coracoid process (38 Trillat procedures, 8 Latarjet procedures and 8 Oudart procedures). Only two had been treated by a Bankart procedure. The main cause of recurrence was a failure of repair of the antero-inferior part of the joint. Twenty three cases were operated on again, the most usual procedures being the Trillat procedure and rarely the Latarjet or Eden Hybinette procedures. Six cases recurred once again. Cases with anterior instability were observed after the Trillat procedure. They were due to capsular laxity and did not have to be operated on again. Instability in multiple directions was observed in young women who continued to dislocate their shoulder inferiorly or posteriorly, despite two or three surgical procedures. PMID- 3562933 TI - [Epiphyseal closure correction in children. Apropos of 18 cases]. AB - The authors have performed 18 operative procedures to remove bony bridges across the growth plate in children. The causes of the formation of the bone bridge were many, including 10 after injury and 3 after infection. There were 9 good results and 9 failures. The causes of the failures were the extent of the bone bridge, sepsis as the causative lesion and technical errors during operation. The best results were obtained in cases where the bridge was peripheral, was easily approached and followed injury in young children. Extensive bridges located centrally had a poor prognosis. All the post-infective cases were failures. PMID- 3562934 TI - [Horizontal cubito-radial pinning in fractures of the distal radius including a postero-internal fragment]. AB - The authors describe 68 articular fractures of the lower end of the radius in which a postero-medial accessory fragment was displaced. They have made a study of the anatomy and fibrous connections of the fragment and conclude that this fragment is best maintained reduced by a transverse pin passed from the ulna towards the radius. They attach great importance in such fractures to injury to the triangular radio-ulnar ligament and to inferior radio-ulnar dislocation. PMID- 3562935 TI - [Peroneal nerve entrapment syndrome of the front of the foot. Treatment by neurolysis. Apropos of a bilateral case]. AB - A case of bilateral entrapment of the superficial peroneal nerve at the anterior aspect of the ankle was seen in a 51 year old patient. After failure of the conservative treatment, surgical neurolysis resulted in complete relief. PMID- 3562936 TI - [Trochanteric pseudoarthroses after total hip arthroplasty: their fixation with a new claw-plate]. AB - In the authors experience, non-union of the greater trochanter after its division occurred in 3p. 100 of cases. The treatment is difficult when non-union is well established. The authors have devised an original type of plate whose upper part is made of a double hook to grip the greater trochanter. The lower part of the plate is screwed to the femoral shaft. The use of this plate is combined with horizontal wiring to counteract the action of gluteus medius. Bone grafting is sometimes needed in addition. Nineteen cases were treated in this way, all with success. PMID- 3562937 TI - [Severe upper femoral epiphysiolysis. Invasive reduction by Dunn's technic: 11 cases]. AB - Eleven cases of slipped upper femoral epiphysis have been corrected and fixed, using Dunn's technique. Seven were chronic slips and four were acute slips with severe displacement. The children were aged between 11 and 15 years. The displacement was measured on lateral radiographs of the femoral neck and was type II in the acute cases and type III in chronic cases, ranging between 50 degrees and the maximum possible displacement. Acute cases were operated on between 2 and 15 days following the onset of the condition, and chronic cases were operated on between 2 and 14 months following the onset of the condition. Three acute cases were not reduced by closed methods, once because of the delay of 15 days and twice because of a deformity of the neck. In the fourth acute case closed reduction was insufficient. The follow-up was between 3 months and 10 years. There was one case of sepsis and one chondrolysis. PMID- 3562938 TI - [Contribution of x-ray computed tomography to the diagnosis and treatment of fractures of the acetabulum. Apropos of 88 cases]. AB - Eighty-eight recent fractures of the acetabulum have been investigated by standard antero-posterior and oblique radiographs and by CT scanning. The results of the two examinations have been compared. Whilst the type of fracture is well defined by radiography, CT scanning frequently reveals associated lesions, not seen on standard radiographs, which may have an effect on the relationship between the femoral head and the acetabulum. Thus, out of 28 cases with intra articular fragments, 18 were not visible on standard radiographs and were discovered by CT scan. Similarly, out of 25 peripheral impactions of the acetabulum, 16 were not visible on standard radiographs, of 12 notching lesions of the femoral head, nine were not visible and six out of 23 sacro-iliac displacements were not recognised. CT scanning improved the appreciation of congruence between the femoral head and the acetabular roof in 15 cases and between the femoral head and the acetabulum in 24 cases. Only in 17 patients was there complete agreement between standard radiographs and CT scans. In particular, there is no doubt about the value of CT scanning in comminuted fractures and in fractures of the posterior wall or posterior column. It is a useful adjunct in the choice between conservative and operative treatment. PMID- 3562940 TI - [Outcome of the femoropatellar joint in osteoarthritic genu varum after tibial wedge osteotomy for angulation. 10 to 13 year regression]. AB - The progressive radiological changes in the patello-femoral joint after upper tibial osteotomy performed for arthrosis of the knee were studied more than 10 years after the surgical procedure. The changes were found to be minimal. In cases where the patello femoral joint space was normal before the osteotomy, it was still so 10 years later. In half of the cases where the patello-femoral joint space was abnormal before the osteotomy, it had deteriorated 10 years later, the lesions being more severe on the medial facet of the patella. This change occurred in 11 cases. It was not affected by the extent of the valgus osteotomy, changes in the tibio femoral joint space or the technique of the osteotomy. The functional results could only be correlated with the changes in the tibio femoral joint space and not with those in the patello-femoral joint space. However, excellent results as regards the tibio femoral joint space could still be associated with pain in the patello-femoral joint when it was arthrotic before the osteotomy. Nevertheless, the authors conclude that an associated transposition of the tibial tubercle in association with upper tibial osteotomy is not worthwhile, since no failure in their series could be attributed to impairment of the patello-femoral joint. PMID- 3562939 TI - [Magnetic resonance imaging in the diagnosis of soft cervical disk hernia. Evaluation report on 20 cases previously examined by x-ray computed tomography]. AB - Twenty successive patients were examined using CT scanning followed by M.R.I. Thirteen were subsequently operated upon. The results are reported in detail, specifying which signals were used to make the diagnosis of cervical disc prolapse. Short sequences were used for degeneration in the herniated disc, disc protrusion into the spinal canal and compression of the spinal cord. Long sequences were used for indentations or blocks in the cerebro-spinal fluid column at the level of the disc prolapse. Ordinary disc degenerations and associated stenoses are also shown. The reliability of the method was established by comparison with radiographs and surgical findings which were shown to be positive in all the 13 cases treated surgically. The report discusses the difficulties and current limitations of magnetic resonance imaging such as the scarcity of machines, the supine position, the length of the examination, the mediocre quality of horizontal axial sections and difficulties in transmitting magnetic resonance information. There is expected to be rapid and decisive progress with the use of rapid imaging, the preferential choice of sequences, the use of scout views and closer collaboration between radiologist and clinician. A final section is devoted to a discussion of the relative merits of CT scanning and M.R.I. The latter has the advantage of providing total three-dimensional information, particularly in the sagittal plane with a better appreciation of the relationship between container and contents and a method which is strictly non-invasive with the use neither of contrast medium nor X-rays. The authors conclude that M.R.I. provides a positive contribution to the diagnosis of cervical disc protrusions and that this technique can, from now onwards, be considered the examination of choice. PMID- 3562941 TI - [Experimental study on a plaster cast in fractures of the carpal scaphoid. Clinical deductions]. AB - The displacement of the proximal and distal fragments of fractures of the carpal scaphoid have been studied in fresh cadavers. In 10 subjects, a comparison has been made between a below-elbow plaster, a moulded plaster gauntlet and an above elbow plaster. The most satisfactory immobilisation has been obtained with a moulded plaster gauntlet incorporating the proximal phalanx of the thumb and leaving the elbow free. PMID- 3562942 TI - [Spinal complications encountered in Larsen's syndrome. Apropos of 3 cases]. AB - The authors report 3 cases of Larsen's syndrome in which the spine was involved. There was one instability between C1 and C2 and another between C2 and C3. These two cases were treated by posterior grafting. All three cases presented with a severe thoraco lumbar kypho-scoliosis which was treated conservatively, but one of the scolioses had to be grafted later. It is concluded that cervical instability may be missed and needs to be looked for. The kypho-scoliosis appeared to be particularly progressive. PMID- 3562943 TI - [A case of epiphyseal osteoid osteoma]. AB - The authors describe a case of osteoid osteoma developing in the lower femoral epiphysis of a 9-year-old child. It was close to the growth plate and was recognised with the aid of digital angiography and tomo-densitometry. It was removed by a surgical approach across the growth plate. PMID- 3562944 TI - [A case of compression of the posterior tibial nerve by a synovial cyst with impact on the superior tibiofibular joint]. AB - The authors report a case of compression of the posterior tibial nerve by a cyst originating from the superior tibio-fibular joint. The clinical signs were dysesthesia of the sole of the foot and paresis of the toe flexors. The diagnosis was obtained by electromyographic studies. The patient recovered completely after surgical excision of the cyst, which had developed beneath the tendinous arch of origin of the soleus muscle. PMID- 3562945 TI - [Other responsibilities we have as pediatricians with our patients]. PMID- 3562946 TI - [Umbilical artery catheterization. A 6-year experience]. PMID- 3562947 TI - [Usefulness of the anamnesis in the detection of blood coagulation disorders]. PMID- 3562948 TI - [Familial microspherocytosis. A Study in 10 families]. PMID- 3562949 TI - [An air chamber for pressurized drugs]. PMID- 3562950 TI - [Comparison of 3 dietetic formulas in infants with acute diarrhea]. PMID- 3562951 TI - [Trisomy 22]. PMID- 3562952 TI - [Cerebral gigantism]. PMID- 3562953 TI - [Deep venous thrombosis and nephrotic syndrome]. PMID- 3562954 TI - [Klippel-Feil syndrome]. PMID- 3562955 TI - [Accident prevention in children and adolescents in Chile in the context of health for all by the year 2000]. PMID- 3562956 TI - [Development of renal function in newborn infants. Practical implications]. PMID- 3562957 TI - [Tests of autonomic cardiovascular function in chronic alcoholism. Analysis of 100 patients]. PMID- 3562958 TI - [Burkitt's lymphoma in relation to acquired immunodeficiency syndrome (AIDS)]. PMID- 3562959 TI - [Colic pain in the left iliac fossa in a young woman]. PMID- 3562960 TI - [Retrosternal pain and esophagitis caused by doxycycline. Apropos of 2 cases]. PMID- 3562961 TI - [Fibrinolytic treatment in Behcet's syndrome]. PMID- 3562962 TI - [Diphenylhydantoin and primary hypothyroidism]. PMID- 3562963 TI - [Tobacco. A question without an answer?]. PMID- 3562964 TI - [Retrospective value of blood triglycerides and lipoproteins in myocardial infarct]. PMID- 3562965 TI - [Hypertension, obesity, alcohol, tobacco and caffeine consumption before vascular diseases, in the statutory community of Navarra]. PMID- 3562966 TI - [Does physical exercise have a preventive effect in cardiovascular disease?]. PMID- 3562967 TI - [The CRONICAT program: experience in the prevention of cardiovascular diseases]. PMID- 3562968 TI - [Prevention of cardiovascular disease]. PMID- 3562969 TI - [Prospective study on coronary heart disease in Manresa: 15-year follow-up]. PMID- 3562970 TI - [Diet prevention for a long life. Relevance of fish consumption]. PMID- 3562971 TI - [Tobacco, a coronary disease risk factor]. PMID- 3562972 TI - [Critical review of geriatric preparations]. PMID- 3562973 TI - [Superimposed mass on the right pulmonary hilus]. PMID- 3562974 TI - [Cardiac insufficiency caused by an iatrogenic aorto-cava fistula. Apropos of a case]. PMID- 3562975 TI - [Cerebrovascular accident and Behcet disease]. PMID- 3562976 TI - [Lipoprotein indexes in coronary atheromatosis]. PMID- 3562977 TI - [Blood lipids in the rural population of Talavera (Castilla-La Mancha]. PMID- 3562978 TI - [Mediastinal adenopathies and cerebral lesion]. PMID- 3562979 TI - [Hypothyroidism and inappropriate antidiuretic hormone secretion syndrome]. PMID- 3562980 TI - [Hemoperitoneum caused by rupture of the graafian follicle as a complication of anticoagulant treatment]. PMID- 3562981 TI - [Central core bodies and rhabdomyolysis in a case of hyperosmolar diabetic coma]. PMID- 3562982 TI - [Hashimoto's thyroiditis and hyperparathyroidism: a casual association?]. PMID- 3562983 TI - [Tuberculosis control in children of school age: lessons from a tuberculin screening program]. PMID- 3562984 TI - [Avascular necrosis in systemic lupus erythematosus]. PMID- 3562985 TI - [Value of cranial computerized tomography in neurologic complications in immunodepressed patients. A semiologic analysis of the findings]. PMID- 3562986 TI - [Esophageal ulcers caused by doxycycline]. PMID- 3562987 TI - [Acute pancreatitis. An exceptional initial manifestation of Schoenlein-Henoch purpura]. PMID- 3562988 TI - [Association of severe lymphoproliferative manifestations and HTLV-III (HIV) infection in 3 drug addicts]. PMID- 3562989 TI - [Basic research in immunology and its impact in the fight against disease]. PMID- 3562990 TI - [Preliminary trials of embryo transfers in Baoule cattle in Burkina Faso]. PMID- 3562991 TI - [Reproductive performance and milk production of Holstein-Friesian cows in Morocco]. PMID- 3562993 TI - [Genetic improvement of N'Dama cattle. II. Calf growth before weaning at the Madina-Diassa ranch in Mali]. PMID- 3562992 TI - [Preliminary trials on estrus synchronization in Baoule cows]. PMID- 3562994 TI - [Growth performance and slaughtering traits of Limousin x Creole and Creole bull calves raised in sunlight and in shadow in Guadeloupe (French West Indies)]. PMID- 3562995 TI - [Influence of age, sex and race on the fattening of zebus fed with rice by products in North Cameroon]. PMID- 3562996 TI - [Dissemination of genetic counseling and prenatal diagnosis: impact of the physicians' knowledge]. AB - This article presents a survey carried out among 2,549 doctors (general practitioners, pediatricians, obstetricians and gynecologists) practicing in two south of France "departements" (administrative subdivisions): Bouches-du-Rhone and Hautes-Alpes. The influence of socio-demographic and professional characteristics on knowledge of prenatal diagnosis indicators is studied here for each specialty. While knowledge among general practitioners is apparently a product of their formal education, among gynecologists and obstetricians the most important factor seems to be professional experience. In France, the GP is a central figure in referrals for genetic counselling and prenatal diagnosis, hence the importance of improving his training and possibilities of continuing education. PMID- 3562997 TI - [Impact of alcoholism mortality on the entire population and on the active French population]. AB - Starting from the estimation of alcohol assigned deaths in the different causes of death of the CIM, 8th revision, the impact of alcoholism on the active and total french populations is measured using two demographic indices, life expectancy and active life expectancy, and the data of the year 1978. This impact is the same as accidents' one; for men it is more than double of the result obtained when "Alcoholic psychosis and alcoholism" and "Cirrhosis" causes of death are considered alone. PMID- 3562998 TI - [Surgical incidence of hydatidosis in the Sahel and Central Tunisia]. AB - A retrospective hospital survey of patients having undergone surgery for hydatidosis was undertaken in order to evaluate hydatic endemicity in central Tunisia and the Sahel. The study made it possible to establish the following: an average prevalence of 22.8 cases per 100,000 inhabitants; a significant underregistration of the illness, only 51.5% of the cases being reported; certain high-risk rural areas are characterized by a prevalence exceeding 40 per 100,000 inhabitants; the disease is more frequent among women; surgical hydatidosis is not rare among the very young and the very old; among adults, the liver is the first organ affected, followed by the lungs; among children, it is the opposite. Hydatidosis thus represents a commonly-occurring disease that is frequently underestimated in official statistics. A preventive program must be conceived to control this scourge. PMID- 3562999 TI - [An epidemic of cholera in the city of Pemba (Mozambique) in 1983]. AB - The purpose of the epidemiological study about 205 suspected hospitalized cases of cholera was to determinate which model of transmission was the most important. From the results, we noticed that direct non-waterborne has been more frequent than waterborne transmission (mainly in the infection of family contacts of index cases). We also found that virulence of the Vibrio cholerae El Tor responsible was quite close of virulence of the Vibrio cholerae classical. PMID- 3563000 TI - [What is a normal result?]. PMID- 3563002 TI - [Hepatic function after general anesthesia with compound 469 (isoflurane)]. PMID- 3563001 TI - [Alcoholic neurolysis of the celiac plexus in the treatment of cancer pain in the upper abdominal viscera: our experience]. PMID- 3563003 TI - [Comparative study between 50% fentanyl-N20/02 and 100% fentanyl-02 in heart surgery in adults]. PMID- 3563004 TI - [Reaction to surgical stress and its nutritional consequences]. PMID- 3563005 TI - [Thrombopathy caused by beta-lactam antibiotics]. PMID- 3563006 TI - [Rare respiratory obstruction during pneumonectomy]. PMID- 3563007 TI - [Hereditary familial telangiectasia: anesthetic and resuscitation considerations]. PMID- 3563008 TI - [Anesthetic implications of Rubinstein-Taybi syndrome]. PMID- 3563009 TI - [Catheterization of an extradural vein: an infrequent complication of epidural anesthesia]. PMID- 3563010 TI - [Postoperative caudal analgesia with morphine in pediatric surgery]. PMID- 3563011 TI - [Use of subcutaneous reservoirs in anesthesia]. PMID- 3563012 TI - [Serum ferritin in chronic hepatopathies. Study of its significance]. PMID- 3563013 TI - [Chronic hepatitis: value of clinical and biological features in its differentiation]. PMID- 3563014 TI - [Current trends in the surgical treatment of hepatic hydatidosis. Our experience in 97 patients]. PMID- 3563015 TI - [Discriminating power of the area of the manometric tracings of the inferior esophageal sphincter]. PMID- 3563016 TI - [Acute cholecystitis. Apropos of 150 cases]. PMID- 3563018 TI - [Leiomyomatous tumors of the digestive tract. Etiologic factors, criteria of malignancy and clinical study]. PMID- 3563017 TI - [Study of bilio-digestive anastomosis using isotopic monitoring]. PMID- 3563019 TI - [Carriers of hepatitis B virus]. PMID- 3563020 TI - [Peutz-Jeghers syndrome]. PMID- 3563021 TI - [Giant hepatic hemangioma: report of a case and review of the literature]. PMID- 3563022 TI - [Malignant cystic neoplasms of the pancreas]. PMID- 3563023 TI - [Retained gastric antrum: diagnostic and therapeutic considerations]. PMID- 3563025 TI - [Descriptive epidemiological study of the mortality and morbidity in cancer of the esophagus in Spain from 1951 to 1979]. PMID- 3563024 TI - [Splenic regeneration after partial splenectomy for hydatid cyst of the spleen]. PMID- 3563026 TI - [Hepatorenal polycystosis of the adult associated with achalasia]. PMID- 3563027 TI - [Hepatic hydatidosis. Study of a series of 7,435 cases. I: General aspects, epidemiology and diagnosis]. PMID- 3563028 TI - [Surgery of pancreatitis of biliary origin]. PMID- 3563029 TI - [Primary tumors of the duodenum: apropos of 14 cases]. PMID- 3563030 TI - [Tumors of the small intestine. Analysis of 19 cases]. PMID- 3563031 TI - [Frequency of carcinoma of the colon and stomach 1960-1979 in relation to dietary and migratory changes]. PMID- 3563032 TI - [Risk of acute appendicitis in patients over 60]. PMID- 3563034 TI - [Disorders of intestinal function in alcoholic subjects]. PMID- 3563033 TI - [Cimetidine and upper digestive hemorrhage: analysis of its effect in the most frequent causes. Trial in 411 patients]. PMID- 3563035 TI - [Abdominal varices in computerized axial tomography]. PMID- 3563036 TI - [Crohn disease in childhood: considerations apropos of 2 cases surgically treated]. PMID- 3563037 TI - [Cystic intestinal duplication in an adult]. PMID- 3563039 TI - [Surgical treatment of choledocholithiasis]. PMID- 3563040 TI - [Gastric metastasis of malignant melanoma]. PMID- 3563038 TI - [Cimetidine and toxic hepatitis]. PMID- 3563041 TI - [Hepatic hydatidosis. Study of a series of 7,435 cases. II: Surgical treatment, morbidity-mortality, medical treatment, hospitalization and socioeconomic implications]. PMID- 3563042 TI - [Implications of the arterialization of the sinusoid in its capillarization and in the maintenance of portal hypertension in the cirrhotic patient]. PMID- 3563043 TI - [Fibronectin and hepatopathy. (A new parameter in the evaluation of hepatocellular function)]. PMID- 3563044 TI - [Acute non-calculous cholecystitis]. PMID- 3563045 TI - [Lithiasis of the bile ducts. 5 years' experience]. PMID- 3563046 TI - [Criteria and results in the surgical treatment of Crohn disease]. PMID- 3563047 TI - [Meckel's diverticulum]. PMID- 3563048 TI - [Dilatation of the colon with intestinal pseudo-obstruction. 16 new cases of Ogilvie syndrome]. PMID- 3563049 TI - [Appendiceal plastron: comparative study of emergency appendectomy with conservative treatment (195 cases)]. PMID- 3563050 TI - [Digestive involvement in acquired immunodeficiency syndrome]. PMID- 3563052 TI - [Hirschsprung's disease with a short aganglionic segment: apropos of a case treated by anorectal myomectomy]. PMID- 3563051 TI - [Peritoneal hydatidosis or giant bilobulated hepatic cyst?]. PMID- 3563053 TI - [Trans-epiploic hernia: apropos of a new case]. PMID- 3563054 TI - [Lipoma of the colon: apropos of 2 cases]. PMID- 3563055 TI - [Ileocecal invagination due to non-Hodgkin's lymphoma]. PMID- 3563056 TI - [Primary biliary cirrhosis, CRST syndrome and Sjogren's syndrome. An uncommon association]. PMID- 3563057 TI - [Effect of theophylline on the histochemical function of the gastric mucosa in the rat]. PMID- 3563058 TI - [Physiopathological aspects of stress ulcer of the stomach and its prevention with prostaglandin E1 in rats]. PMID- 3563059 TI - [Carcinoma of the gastric stump (study of 14 cases)]. PMID- 3563060 TI - [Effectiveness of adjuvant monochemotherapy with 5-fluorouracil in patients gastrectomized for gastric cancer]. PMID- 3563061 TI - [Acute pancreatitis: fluid accumulation in the lesser omental sac and retroperitoneum]. PMID- 3563062 TI - [Prevent of pulmonary thromboembolism in surgery of the digestive system]. PMID- 3563063 TI - [Indications for the use of high-power laser in proctology]. PMID- 3563064 TI - [Endoscopic sphincterotomy. Review of the authors' experience]. PMID- 3563065 TI - [Viral DNA in the diagnosis of hepatitis B]. PMID- 3563066 TI - [Intestinal invagination in an adult. Analysis of 5 cases]. PMID- 3563067 TI - [Toxic megacolon caused by typhoid fever]. PMID- 3563068 TI - [Epidemiology and prevention of viral hepatitis]. PMID- 3563069 TI - [Effect of manganese poisoning on the levels of manganese and iron in rat viscera]. AB - Twenty rats were poisoned by manganese inhalation, and sacrificed six months after the first exposure. The tissue concentrations (in microgram/g dry weight) of manganese and iron were found in liver, pancreas, lung, kidney and suprarenal gland for atomic absorption spectrometry in control and experimental animals. The measurements show high tissue concentrations of manganese, especially in liver and pancreas of the experimental animals, as well as a little increase in the tissue concentrations of iron, fundamentally in liver, kidney and suprarenal gland. PMID- 3563070 TI - [Levels of manganese and iron in the brain of normal and manganese-poisoned rats]. AB - Forty rats were poisoned by manganese inhalation and were sacrificed after six and nine months. Tissue concentrations (in mg/g dry weight) were measured in brain, cerebellum and stem-brain of the experimental animals and the twenty control rats, for atomic absorption spectometry. The increase in tissue manganese concentrations were very pronounced in cerebellum, and minor in brain and stem brain. The tissue iron concentrations undergo a light increase in cerebellum and stem-brain. PMID- 3563071 TI - The respiration of rat brain mitochondria purified by phase partition. Effects of K+, Mg2+ and Ca2+. AB - Highly purified brain mitochondria have been prepared by Na+, NH4+ or K+ containing two-phase systems. K+ stimulated the basal rate of respiration in the three mitochondrial preparations. However, K+ only stimulated the maximal oxidation rate (state 3 respiration rates) in those mitochondria prepared by K+ free (Na+ or NH4+-containing) two-phase systems. The increase in the basal rates of respiration induced by exogenous K+ correlates with the mitochondrial swelling rates. The stimulatory effect of K+ on maximal oxidation rates seems to reflect the K+ depletion of brain mitochondria when prepared by K+-free procedures. PMID- 3563073 TI - [Determination of plasma oxalic acid by high-pressure liquid chromatography]. AB - A new specific and sensitive method for determination of oxalic acid in plasma by High Performance Liquid Chromatography (HPLC) is described. The plasma sample is deproteinized by ultrafiltration. The oxalic acid in the ultrafiltrate is purified by precipitation with CaCl2, new dilution of calcium oxalate precipitate, oxalic acid extraction with diethyl-ether and total dryness of the sample. The losses of oxalic acid during this process are evaluated by the addition of oxalic acid (U-14C) before the precipitation step. The dried samples are redissolved in mobile phase (o-H3PO4, 0.05 M) and injected into a HPLC chromatograph, with reversed phase column (Lichrosorb RP-8, Merck). Oxalate peak is detected spectrophotometrically at 220 nm with a retention time of 3.20 minutes. The method shows a mean recovery value of 82.11, with an intra-run and between-run CV values of 2.54 and 6.95 respectively. The oxalic acid measured in plasma by this method is 291 +/- 89 micrograms/100 ml plasma ultrafiltrate, in 16 normal subjects. PMID- 3563072 TI - [Changes in sialic acid content of the plasma membrane in hepatocellular proliferation]. AB - The content of sialic acid bound to the sinusoidal region of plasma membrane during the prereplicative phase after the intravenous injection of a solution containing triiodothyronine, amino acids, glucagon and heparin (T.A.G.H. solution) has been measured. The results obtained show that an important decrease in sialic acid content is produced as it occurs in the hepatic cells of hepatectomized animals. In order to know if sialidase activity is involved in the decrease of sialic acid content during liver regeneration, the activity of sinusoidal plasma membrane sialidases during the prereplicative phase after the partial hepatectomy has been studied. No modifications of sialidase activity were detected during this period of time indicating that this decrease in sialic acid content has to be produced by other mechanisms such as diminution in the synthesis of precursor molecules. On the other hand due to the importance of Ca2+ calmodulin complexes in the activation of the hepatic cell proliferation the possible implication of this complex on the loss of sialic acid, observing the effect of trifluoperazine (inhibitor of Ca2+-calmodulin complexes) during the prereplicative phase of liver regeneration has been studied. The results show a delay in the decrease of the amount of sugar studied from 10 to 12 hours compared to the results obtained with the hepatectomized rats that have not received trifluoperazine. PMID- 3563074 TI - Spinal projections of brainstem respiratory related neurons in the cat as revealed by retrograde fluorescent markers. AB - By means of retrograde axonal transport of fluorescent tracers, connections between brainstem respiratory related regions and the spinal cord has been studied in the cat. Neurons at the pneumotaxic center project bilaterally (90% ipsi-, 10% contra-) to cervical and lumbar spinal cord and ipsilaterally to thoracic levels. The ventrolateral nucleus of the tractus solitarius project mainly contralaterally (85%) to cervical levels and only contralaterally to thoracic levels; no efferent projections were found to lumbar levels. The ventral respiratory group showed a great number of neurons projecting to the spinal cord especially from the nucleus retroambiguus. Both nuclei, ambiguus and retroambiguus, project mainly contralaterally (70%) to the spinal cord. The Botzinger complex showed rather scarce bilateral projections to cervical and only ipsilateral projections to lower cervical, thoracic and lumber levels. PMID- 3563075 TI - Influence of superior cervical ganglion stimulation frequency on salivary secretion in the rabbit. Comparative study of parotid and mandibular glands. AB - Saliva secretion in response to the stimulation of the superior cervical ganglion (S.C.G.) at different frequencies (2, 3, 5, 10, 15, 20 Hz) has been studied in anaesthetized rabbits. The differences between the two major glands in this species were analyzed, with respect to the flow response, potassium, amylase and total protein content during the sympathetic stimulation. The stimulation of S.C.G. increased the salivary flow rate at all frequencies, on both parotid and mandibular gland. In the parotid gland the flow and stimulation frequency show a positive linear correlation which does not appear in the mandibular gland. In conclusion, the differences observed in the response to sympathetic stimulation in both glands seem to be due to distinct patterns of sympathetic innervation on different glandular elements. PMID- 3563076 TI - [Changes in thyroid function caused by continuous treatment with thiouracil in rats]. AB - Serum concentration evolution of thyroxine and triiodothyronine, and thyrotropin (TSH), have been studied in rats while they were given 6-propylthiouracil (PTU) as antithyroid drug, and during the recovery period after suppression of treatment. In the same way thyroid hypertrophy and plasmatic levels of thyrotropin were correlated. Animals received orally a daily dose of 1 mg/100 g body weight during thirty-five days and had a two week recovery period. Thyroid hormone concentrations in plasma were determined by immunoenzymatic assay ELISA with peroxidase as labelled enzyme. From the results obtained, it can be stated that chronic administration of PTU implies a continuous decrease in thyroid hormone concentrations in plasma, reaching nearly zero values, while after treatment, levels recover their normal values in a week's time. A parallelism exists between thyroid hypertrophy and pituitary TSH hypersecretion, due to a decrease in thyroid hormone levels. PMID- 3563077 TI - Influence of aerobic energy deficit, ouabain and harmaline on the phenylalanine and galactose active transport by snail intestine. AB - The effect of anaerobiosis (N2 bubbling of the medium) or 10(-4) M dinitrophenol on the penetration of 0.5 mM Phe in snail and rat everted intestine, in 2 min and 30 min incubation periods, has been studied. The aerobic energy deficit inhibits the amino acid net entry in both species, but whereas the active transport is annulled in rat, snail intestine is capable of continuing to accumulate Phe against a gradient. The prolonged action (30 min of preincubation) of 1 mM ouabain inhibits 0.1 mM Phe and 0.1 mM galactose entry in snail intestine. Amino acid uptake is far higher than the one obtained in the absence of Na+, in which condition Phe keeps accumulating against a gradient in the tissue water. Galactose active transport, instead, becomes null in the presence of the glucoside or in the absence of Na+. One mM harmaline is able to inhibit the initial entry of galactose into the tissue, while higher than 5 mM concentrations are required to inhibit that of Phe. Results confirm that snail intestine is capable of easily carrying out active transport processes with energy from anaerobic origin. On the other hand Phe transport is less sensitive to the absence of Na+, presence of ouabain or harmaline than that of galactose, so that contrary to what has been observed for the sugar, the active transport of the amino acid is not annulled in any of the three conditions. PMID- 3563078 TI - Prolactin response to stress in neonatally estrogenized male rats. AB - Male Wistar rats were injected either 500 micrograms of estradiol benzoate or olive oil on their first day of life. Blood samples were obtained from the adult by decapitation, by decapitation after 15 min of restraint, by decapitation 10 min after a 5 min period of ether exposure or by jugular venipuncture after 60 s of ether exposure. Prolactin (PRL) plasma levels were measured by RIA. The PRL levels in samples obtained by decapitation were similar to control and estrogenized groups. A similar response to restraint was also found in both groups. Sixty s of exposure to ether stress stimulates PRL secretion only in the estrogenized males, this effect being blocked by treatment with Normifensine (5 mg/kg two hours prior to blood sampling). These results suggested that estrogenized male rats show greater sensitivity to acute ether stress than the controls, and that changes in the dopaminergic system could be involved in this response. PMID- 3563079 TI - [Effect of intracerebroventricular injection of histamine on the behavior of the white rat]. AB - Previous references showed that the histamine injected peripherically produced a deterioration of the learning in experimental animals. The effects of 100 and 200 micrograms of histamine administered in the cerebral lateral ventricle, have been tested using an experimental paradigm which isolated attentional, motivational, and motor factor from the complex learned behavior. The obtained results showed to be similar to those produced by peripheric injection, and demonstrated a worsening in attentional, motivational, and motor parameters. PMID- 3563080 TI - [Purification of fibronectin using gelatin derivatives]. AB - This work compares two distinct methods, column and batch, for the purification of fibronectin, from different plasma fractions, using gelatin and one of its derivates (Hemoce, Behring). The yields of both techniques at quantitative as well as qualitative levels (levels of immunologically active fibronectin), are evaluated. The data indicate that better conservation of immunological immunological characteristics is obtained with the use of gelatin derivatives (Hemoce). The plasma fraction does not have significant influence on the process yields. PMID- 3563081 TI - [Glycometabolic effects of treatment with low-dose metformin]. PMID- 3563082 TI - [Autoimmune thrombocytopenic purpura and circulating immune complexes]. PMID- 3563083 TI - [Gynecomastia caused by Leydig cell neoplasms]. PMID- 3563084 TI - [Severe hypopotassemia 50 years after bilateral ureterosigmoidostomy intervention. Clinical and physiopathologic considerations]. PMID- 3563085 TI - [Dermatologic pathology and psychiatric monitoring. Description of a case]. PMID- 3563086 TI - [Clinico-endoscopic evaluation of advanced gastric cancer and small gastric cancer in an experience of 27,876 gastroscopies]. PMID- 3563088 TI - [Age and respiratory function. Natural history of the normal lung]. PMID- 3563087 TI - [Antiaggregating effect of indobufen. Preliminary results of a study of 20 patients]. PMID- 3563089 TI - [Rehabilitation of cerebral apoplexy--results based on 156 patients]. AB - 156 stroke patients were followed-up over a period of up to twelve months from the event. During that period they had participated repeatedly, or continually, in comprehensive inpatient rehabilitation programmes at the Bad Schallerbach rehabilitation centre, Austria. The services provided were characterized by a comprehensive medical, vocational and social orientation. Rehabilitation outcome assessment related to personal functioning levels (ADL performance, intellectual functioning, communication, social behaviour, etc.) as well as the basic working capacity. Based on medical findings, the results stated toward the end of our comprehensive rehabilitative efforts showed improvements of personal functioning by about 66 percent, and attainment of a basic working capacity in 22 percent of the patients. Outcomes varied for the different causes of stroke; three patients had died during the observation period due to renewed stroke. The principles to be observed in comprehensive rehabilitation are discussed, with special emphasis on those in stroke rehabilitation. PMID- 3563091 TI - [Occupational integration of patients with epilepsy]. AB - An overview is given initially of study findings pertaining to unemployment, work history and workplace experiences of people with epilepsy (disclosure, job reallocation, sick leaves, up-/downgrading, accidents). The author then describes new approaches to improving the vocational integration of persons with epilepsy, by focussing on the one hand on extending the range of occupational assessment, and the adoption of new job placement assessment, and the adoption of new job placement strategies on the other, which concurrently seek to influence those factors that are detrimental to the occupational outlook of the person with a seizure disorder (notably frequent seizures, psychiatric problems, low educational levels, negative employer attitudes). It is suggested that the feasibility of these new strategies, developed and field-tested primarily in the Anglo-American countries, should be verified within the social-legislational context of the Federal Republic of Germany. PMID- 3563090 TI - [Life satisfaction and the course of rehabilitation--a study of cardiovascular patients]. AB - At the beginning and at the end of inpatient cardiac rehabilitation, 105 male cardiac patients were examined with a newly designed questionnaire for life satisfaction assessment (Fragebogen zur Lebenszufriedenheit-FLZ). Data collection moreover included the Freiburg Personality Inventory, the Freiburg Somatic Complaints Lists, an adjective list assessing current mood, questionnaires on anamnestic data, treatment expectancies and life habits, as well as medical data. Significant correlations found between the FLZ and subjective or objective criteria of rehabilitation outcome indicate the importance of life satisfaction, with more content patients showing better outcomes. No mean value differences were found in respect of medical data, less content patients, however, reported more previous hospital stays and rehabilitation treatments. Also, there is a tendency for physician to discharge these patients as "unfit for work". 83 of these 105 patients participated in the follow-up study twelve months later. Life satisfaction is now lower, somatic complaints and emotional lability have increased. 90 percent of the patients with high life satisfaction, but only 66 percent of those with low life satisfaction, are back at work on follow-up. Fitness for work at follow-up, though primarily related to the rating given at the end of inpatient cardiac rehabilitation, is influenced to a high degree by non-medical factors. The results obtained underline the significance of patient illness behaviour, and point to a need for further improving individual psychological counseling during cardiac rehabilitation. PMID- 3563092 TI - [Development of community-based services for the mentally handicapped in the USA- on the way toward an integrated life]. AB - Services for mentally retarded adults have undergone major changes over the past 15 years in the United States of America. Through the impact of "normalization", the calls for implementing fundamental civil rights for all citizens, and by applying methods of an essentially behavioural nature, services have gradually been moved out of the institutional sector and into the local communities. A regional service delivery model established in the state of Nebraska illustrates this development toward individualized living and competitive employment in the community. PMID- 3563093 TI - [2d seminar on the nutrition and feeding of herbivores. Paris, 19 20 March 1986]. PMID- 3563094 TI - Longitudinal design and longitudinal analysis. A comparison of three approaches. PMID- 3563095 TI - Unraveling the effects of multiple life changes. A reanalysis. PMID- 3563097 TI - Intervention research approaches. PMID- 3563096 TI - Measuring intergenerational family relations. PMID- 3563098 TI - Evaluation research in long-term care. Scope and methodology. PMID- 3563099 TI - Plausible theories and the development of scientific theory. The case of aging research. PMID- 3563100 TI - Strategies for investigating effects of residential context. A study of depressed mood and major depression. PMID- 3563101 TI - Increased nickel concentrations in body fluids of patients with chronic alcoholism during disulfiram therapy. AB - Nickel concentrations were measured by electrothermal atomic absorption spectrophotometry in body fluids of 61 patients with chronic alcoholism during disulfiram treatment (tetraethylthiuram disulfide, 250 mg/day, po). Nickel concentrations in serum, whole blood, and urine were significantly increased at 12 hours after the initial dose of disulfiram. In serum and whole blood, the Ni concentrations reached a plateau after two weeks of treatment; in urine, the Ni concentrations increased progressively during the initial four months of treatment. During the interval from four months to three years of disulfiram treatment, the median concentrations of nickel in serum, whole blood, and urine were elevated 17-, 15-, and 39-fold, respectively, compared to pretreatment values. The effects of disulfiram on nickel metabolism evidently involve chelation of dietary nickel by diethyldithiocarbamate (DDC), a disulfiram metabolite, and gastrointestinal absorption of the Ni-DDC complex. Since animal studies have demonstrated cerebral uptake of the lipophilic Ni-DDC complex, nickel may possibly accumulate in brain cells of disulfiram-treated patients; physicians should therefore be cautious in administering disulfiram to persons with nickel-containing orthopedic prostheses or occupational exposures to nickel. PMID- 3563102 TI - Total protection from hypoxic liver damage by fructose. AB - The purpose of these experiments was to evaluate the effect of carbohydrates on hypoxic cell death in the perfused rat liver. Lactate dehydrogenase (LDH) was released maximally at rates up to 300 U/g/h after 40 to 60 min of hypoxia in control livers from fasted rats or in livers perfused with glucose (20 mM). Fructose (20 mM) prevented the release of LDH completely. Rates of anaerobic glycolysis indexed by release of lactate were around 150 mumol/g/h in livers perfused with fructose but were undetectable in livers perfused with glucose. The results demonstrate that fructose prevents hypoxic damage in the liver presumably by providing glycolytic ATP in the absence of oxygen. PMID- 3563103 TI - Spurious elevation of automated leukocyte counts induced by Fluosol DA 20%. AB - During studies with Fluosol DA 20% (FDA) in rats, an artifactual leukocytosis was observed when an impedance type electronic cell counter was used. The effect was found to be directly related to the duration of the interval between addition of an erythrocyte lysing fluid and counting, observed up to 11 d after transfusion with FDA, blood cell associated, reproducible in vitro, FDA concentration dependent, temperature dependent, and present when human blood was used instead of rat blood. Microscopically, the effect appears to be the result of agglutination of lysed erythrocyte membranes due to the interaction of erythrocytes, the emulsion component of FDA, and the quaternary ammonium salt component of the lysing fluid. These data suggest that FDA causes subtle changes in erythrocytes and raises the possibility that other cells may be similarly affected. PMID- 3563104 TI - The effect of ultrasound on the size of liposomes. PMID- 3563105 TI - The role of lipid peroxidation in the chemical-dependent activation of hepatic phospholipase C in vitro. AB - This study assessed the role of lipid peroxidation in the chemical-dependent activation of hepatic phospholipase C in vitro. Hepatocellular membranes (1000 X g) were incubated with sn-[1,3-14C] glycerol-3-P, ATP, CoA, palmitate, Ca2+, NaF and dithiothreitol to form membrane-bound, labeled phosphatidic acid. Membrane associated phosphatidate was incubated (10-45 min) with 2 mM Fe2+SO4 or 5mM CCl4 in the presence or absence of various antioxidants. Membranes exposed to Fe2+SO4 displayed an antioxidant-sensitive, 20-fold increase in malonic dialdehyde (MDA) formation without measurable increase in phospholipase C activity. In contrast, membranes exposed to 5 mM CCl4 displayed an antioxidant-insensitive, 2-3-fold increase in phospholipase C activity without significant increase in MDA production. These results suggest that under these incubation conditions in vitro, the CCl4-dependent activation of hepatic phospholipase C is not regulated by nor dependent upon the peroxidation of membrane phospholipids. PMID- 3563106 TI - Biochemical aspects of the mechanism of action of antiarrhythmic drugs on mitochondria. VIII. Effect on Ca2+ transport. AB - The effect of antiarrhythmic drugs (propranolol, lidoflazine, perhexiline maleate and iproveratril) on Ca2+ uptake and Na+-induced Ca2+ release by isolated rat heart mitochondria has been studied using arsenazo III as Ca2+ indicator. It was concluded that those drugs are not selective inhibitors either for Na+-induced Ca2+ release or for Ca2+ uptake. It seems possible that those drugs act by complexation with some components of the membrane, presumably with phospholipids. PMID- 3563107 TI - Studies of the hypotensive effect of calcium injected into lateral brain ventricles. AB - Calcium chloride (1-2 mumole) injected into lateral brain ventricles of pentobarbital anesthetized rats markedly decreases blood pressure. The hypotensive response is not affected by vagotomy and is characteristic calcium and barium since other polyvalent cations do not have the same effect. The calcium channel blocker, verapamil given into brain ventricles prevents the depressor effect of calcium suggesting that the hypotensive action of calcium is initiated intracellularly. The well documented lowering of blood pressure by increases in dietary intake of calcium may be mediated by increases in free calcium in cerebrospinal fluid. PMID- 3563108 TI - Plasma protein binding of nilvadipine, a new dihydropyridine calcium antagonist, in man and dog. AB - The in vitro protein binding of nilvadipine, a new dihydropyridine calcium antagonist, was studied by equilibrium dialysis, ultracentrifugation, and equilibrium gel filtration. In the experiment with equilibrium dialysis, nilvadipine was highly bound to the plasma of man (97.5-98.7%) and dog (99.1 99.2%) with no plasma concentration dependency in a range of 10-100 ng/ml. Ultracentrifugation gave lower protein binding than that by equilibrium dialysis. From the experiments with equilibrium dialysis and equilibrium gel filtration, we found that lipoproteins and albumin are the main nilvadipine binding proteins in the plasma. The protein binding of nilvadipine in human plasma was unaffected or slightly decreased in the presence of therapeutic concentration of phenytoin, diazepam, salicylic acid, propranolol, quinidine and trichloromethiazide. PMID- 3563110 TI - Reversible airway obstruction: neurohumoral mechanisms and treatment. Symposium, Florence, June 6-8, 1985. PMID- 3563109 TI - Effects of naltrexone in postnatal rats on the recovery of disturbed brain and lymphatic tissues after X-irradiation or ethylnitrosourea treatment in utero. AB - The role of endogenous opioid systems in preweaning development after intrauterine exposure to X-irradiation or ethylnitrosourea (ENU) was explored in rats using naltrexone, a potent antagonist of beta-endorphin. After daily s.c. injections of 50 mg/kg naltrexone only the prenatally untreated controls had body weights increased by 11% from control level on day 28 (weaning). In the X irradiated as well as the ENU-treated pups no significant effects of naltrexone on body weight gain were observed. However, brain weight increased in all animals under the influence of naltrexone, irrespective of prenatal treatment or the severity of brain lesions: 9.5% above control values in untreated offspring and 14% after X-irradiation (1 Gy) on gestation day 14. The brain weight of ENU treated rats (50 mg/kg on gest. day 14) was 13% higher after postnatal naltrexone application than that of their postnatally untreated counterparts. ENU (80 mg/kg) effects on the brain when given on gestation day 18 were ameliorated to 9.2% by naltrexone in the weaning period. Naltrexone significantly increased the thymus weight in controls. Prenatally treated animals also showed an increased thymus weight at weaning, presumably due to compensatory growth. In these cases naltrexone revealed a suppressive effect on the thymus, whereas spleen weight was apparently not influenced by naltrexone treatment. These results provide compelling evidence that endogenous opioid systems play a crucial role not only in normal development, but also in reparative growth events of the brain after prenatal injuries. The thymus, predominantly containing T-lymphocytes, seems to represent another sensitive system which is regulated under the influence of opioids. PMID- 3563111 TI - Role of the parasympathetic cholinergic system in normal and obstructed airways. AB - The cholinergic motor component of the parasympathetic nervous system supplies several structures which may be important in determining the resistance of normal and diseased airways. Lower airway smooth muscle. Here the nervous control is predominantly cholinergic and vagal, as shown by nerve and field stimulation experiments, and by inhibition of contraction by atropine. The cholinergic motor system can be driven reflexly, and most bronchoconstrictor reflexes have been established as vagal and cholinergic. The importance of other innervations, adrenergic and non-adrenergic, non-cholinergic, has not been established. Mucus secretion. As for smooth muscle, this has multiple innervation but, at least in health, the dominant control is vagal and cholinergic, and blocked by atropine. The importance of mucus secretion in causing airway obstruction has yet to be quantified. Sub-mucosal tissues. The effect of cholinergic nerves on the airway vasculature, and on associated structures such as mast cells, is a possibility requiring study. The larynx. Several recent studies have shown that laryngeal constriction occurs in lower airways disease, and must contribute to the changes in total airway resistance. This constriction would be cholinergic but atropine resistant. The nose. Cholinergic parasympathetic nerves cause nasal congestion and secretion, and therefore changes in nasal airflow resistance. This is a potentially important factor in changing the balance between nasal and oral breathing and thus affecting the conditioning of inspired air. PMID- 3563112 TI - Aerosol therapy of asthma: principles and applications. AB - Aerosols are the mainstay of therapy of reversible airflow obstruction. Currently available aerosols include bronchodilators such as beta-adrenoceptor agonists and anticholinergic agents which may be used alone or together with prophylactic, anti-inflammatory medications such as sodium cromoglycate and steroids. These agents are characterized by primarily topical activity and thus result in minimal systemic effects. By combining these medications in optimum doses, most patients can be readily managed. In patients with severe airway hyperreactivity, aerosols may need to be combined with oral sustained-release theophylline compounds and/or systemic steroids, the latter being used in minimum doses and if possible on alternate days to minimize adrenal suppression and steroid-related systemic complications. In recent years, an improved understanding of aerosol physics, pharmacology and airway physiology has led to greatly improved aerosol therapy with increasing emphasis on metered dose inhalers as the delivery system of choice while nebulizers are used less frequently except in hospital and pediatric applications. The use of intermittent positive-pressure devices for aerosol delivery has decreased considerably as physicians recognize that simpler delivery methods work equally well at much lower cost. While aerosol therapy techniques are now well worked out, research is continuing on methods of improving the efficiency of aerosol delivery and in the development of newer pharmacological agents such as longer-acting adrenoceptor agonists, calcium channel blockers, antagonists of mediators derived from arachidonic acid as well as higher dose aerosolized steroids. PMID- 3563113 TI - Mast cell-derived mediators and their role in cell-to-cell interactions in the lung. AB - Mast cells produce a variety of enzymes and vasoactive, chemotactic, and bronchoconstrictor substances in response to nonimmunologic as well as immunologic stimuli. These mast cell-derived mediators may act on airway smooth muscle, submucosal glands, epithelial cells, circulating blood cells, vascular cells, and other cell types. The secretory profile of a mast cell appears to depend on the specific stimulus applied. In addition, different populations of mast cells exist, and distinct enzymatic pathways may predominate in different cell types. The effect of mast cell-derived mediators on the various target cells may be direct or indirect. For example, mediators released by immunologic challenge of sensitized lung fragments or by nonimmunologic challenge of canine mastocytoma cells stimulate the transport of ions and water across the tracheal epithelium. This effect, however, is indirect, is blocked by indomethacin, and therefore appears to be dependent upon an intact cyclooxygenase pathway in the tracheal epithelium. Canine mastocytoma cells resemble normal mast cells in dog lung and skin, and can be propagated to provide a continuous source of large numbers of pure, identical mast cells for biochemical and physiologic studies. Studies of these cells and their inflammatory mediators will increase our understanding of the complex series of cell-to-cell interactions which are responsible for the pathophysiologic manifestations of obstructive lung disease. PMID- 3563114 TI - Leukotrienes and other eicosanoids as mediators of airway obstruction. AB - Prostaglandins and related compounds comprise an ubiquitous biological system which utilizes arachidonic acid (5,8,11,14-eicosatetraenoic acid) as a common cellular precursor to synthesize a great number of substances with a broad range of activities, including participation in the cellular and humoral events of inflammation and allergy. Briefly, prostaglandins and thromboxanes (TX) are formed in reactions initiated by the aspirin-sensitive fatty acid cyclooxygenase, whereas leukotrienes (LT) and several other compounds are generated by different lipoxygenases present in human tissues. In the field of asthma, the mast cell derived PGD2 alpha, as well as PGF2 alpha and TXA2 are known as reasonably potent bronchoconstrictors, and asthmatics are remarkably hyperreactive to inhalation of PGF2 alpha. However, the therapeutic failure of aspirin and related cyclooxygenase inhibitors in the treatment of asthma suggests that these compounds are less likely to be primary mediators. On the other hand, several lines of evidence indicate that three closely related leukotrienes, LTC4, LTD4 and LTE4, previously known as slow-reacting substance of anaphylaxis (SRS-A), have the potential to be major mediators of the airway perturbations characteristic of bronchial asthma. Thus, as documented both in experimental animals and in man, these leukotrienes are exquisitely potent in causing bronchial smooth muscle contraction, mucosal edema, and secretion of mucus into the lumen. In particular, LTC4, LTD4 and LTE4 have been linked to allergic asthma because allergen challenge is a potent stimulus for their release from, e.g., lung tissue of asthmatics. In fact, it has been documented that inhibition of leukotriene formation can block allergen-induced contractions of isolated human bronchi.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563115 TI - Direct-writing recorder of the frequency dependence of dynamic compliance analyzed from one cycle of breathing and pulmonary resistance: effect of fenoterol on asthmatic subjects. AB - We developed a new method of direct-writing recording of the frequency dependence of dynamic compliance analysed from one cycle of breathing and pulmonary resistance. Both pulmonary resistance (RL) and frequency dependence of dynamic compliance (Cdyn.f) are calculated by Fourier-series analysis of flow and transpulmonary pressure in a single cycle of breathing. RL was obtained from fundamental harmonics. Cdyn.f was calculated from 1st and 2nd harmonics and estimated by the ratio of Cdyn at 0.5 Hz to Cdyn at zero frequency, C0.5/C0. We used fenoterol aerosol which contained 0.2 mg of fenoterol with one puff of aerosol. Two puffs of fenoterol aerosol were used in each subject and followed changes of RL, C0 and C0.5 as long as 30 min. After fenoterol inhalation RL decreased considerably and C0.5/C0 cont [C0.5/(control C0)] increased. With time, while RL was kept stable, C0.5/C0 cont increased further. We suggest that fenoterol has a potent effect on the small airways which is enhanced with time. PMID- 3563116 TI - Effects of inhaled oxitropium and fenoterol, alone and in combination, in chronic airflow obstruction. AB - Twenty-four elderly male patients with moderate-to-severe chronic airway obstruction took part in a double-blind, placebo-controlled, randomized dose response and response-duration comparison of a new inhaled anticholinergic bronchodilator oxitropium bromide and the inhaled beta-agonist bronchodilator fenoterol hydrobromide. On 6 separate days lung function changes and side effects were monitored for 8 h after either placebo, oxitropium 100, 200 and 300 micrograms, fenoterol 400 micrograms, or oxitropium 200 micrograms plus fenoterol 400 micrograms. Fenoterol alone and in combination with oxitropium produced a rapid peak effect (mean delta FEV1 = 41.6 and 39.5%, respectively at 30 min). Oxitropium alone had a slow onset of action (peak delta FEV1 seen at 120 min: 100 micrograms = 22.7%, 200 micrograms = 29.9%, 300 micrograms = 28.2%). However, mean FEV1 remained within 5% of peak for 60 min after fenoterol, but for 180 min after each dose of oxitropium and after fenoterol plus oxitropium. No differences between oxitropium 200 and 300 micrograms were seen; however, these doses produced more prolonged bronchodilatation than did oxitropium 100 micrograms. The fenoterol-plus-oxitropium combination produced even more prolonged bronchodilatation. The only side effect, seen with each inhaler was a mildly unpleasant taste. No anticholinergic effects were seen. We conclude that oxitropium is an effective bronchodilator with slow onset but prolonged duration of action. In combination with fenoterol it produced both rapid and prolonged bronchodilatation in patients with chronic airflow obstruction. PMID- 3563117 TI - Functional aspects of reversible airway obstruction. AB - The determination of the prevailing site of bronchial constriction in asthma is of noteworthy interest as regards knowledge of the pathophysiological mechanisms of this disease, and of practical importance because the intrapulmonary distribution of inhaled drugs depends chiefly on airway caliber. To visualize the alteration of convective ventilation caused by the alterations of airway caliber, we developed a technique based on inhalation of a monodispersed aerosol of human albumin minimicrospheres (mean aerodynamic diameter 0.75 micron, geometric SD 1.19) labeled with 99mTc(Hamm). Intrapulmonary HAMM deposition is revealed externally by means of a gamma camera in 4 projections, soon after inhalation and 4 h later, when the mucociliary activity has removed the fraction of HAMM deposited in larger airways. In normal subjects, about 16% of the inhaled HAMM deposited in airways, mostly (90% of total deposited fraction) by sedimentation in airways peripheral to the 16th generation. We obtained 58 determinations of the HAMM deposition pattern in 38 patients (17 males and 21 females, mean age 35.2 +/- 16.8 years) with symptomatic or asymptomatic asthma, none under acute attack. At the same time we obtained the determination of bronchoconstriction degree by measuring the forced expiratory volume in 1 s (FEV1) and the airway resistance (Raw) by plethysmographic technique. In 10 asymptomatic patients with normal bronchoconstriction indexes, we revealed the pattern of HAMM deposition before and after a reduction of about 30% in FEV1 in induced by bronchial challenge with carbachol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563119 TI - [Histamine content of the sputum of patients with obstructive bronchitis]. AB - High histamine concentrations were measured in the sputum of patients with chronic obstructive bronchitis. The histamine concentration doubles or triples when the sputum is incubated for 24 and 72 h, respectively at 37 degrees C. The antibiotics therapy with doxycycline significantly inhibited the histamine formation in 8 patients, which was mainly caused by bacteria. In the sputum of one patient the histamine formation was reinforced in spite of the doxycycline therapy. The clinical importance of these findings is discussed. PMID- 3563118 TI - Influence of experimentally induced airway inflammation on the reactivity of cat lung parenchymal strips to histamine and acetylcholine. AB - The reactivity of cat lung parenchymal strips to histamine and acetylcholine in vitro was studied at various stages of inflammation of the airways induced experimentally by the intratracheal administration of turpentine oil or Staphylococcus aureus, both in aerosol form. With histamine, the contractile responses of the lung strips were enhanced depending on the stage of turpentine oil inflammation. Similarly, the lung strips responded more to histamine in the staphylococcal inflammation. The reactivity of the lung strips to acetylcholine remained mainly unaffected by either type of inflammation. PMID- 3563121 TI - Effect of mefenamic acid on bronchial tone in vivo. AB - Prostaglandins (PG) are very potent mediators which can dilate or constrict the bronchi. In order to evaluate the role of PG in the homeostasis of bronchial tone, we studied the effects of mefenamic acid, a potent cyclooxygenase inhibitor, on the pulmonary function tests of 20 volunteers. The subjects were studied randomly in two sessions, one with a placebo and one with mefenamic acid. Tablets (drug or placebo) were taken for 2 days with the pulmonary function tests performed in the afternoon of the second day. Sessions were performed at least 2 days apart. Parameters measured, including forced vital capacity, forced expiratory volume in 1 s, expiratory flows, functional residual capacity and specific airway conductance (SGaw), were similar in both sessions. The SGaw, which was previously reported to increase with cyclooxygenase inhibitors, was 0.23 +/- 0.06 s-1 X cm H2O-1 in the placebo session and 0.24 +/- 0.06 in the mefenamic acid session (mean +/- SD). This study shows that cyclooxygenase inhibitors have no effect on airway tone and strongly suggests that endogenous PG do not participate in the homeostasis of normal bronchial tone. PMID- 3563120 TI - Salbutamol versus atropine. Site of bronchodilatation in asthmatic patients. AB - The site of bronchodilatation produced by inhaled salbutamol (0.045 mg/kg) versus atropine (0.035 mg/kg) was investigated in 14 asthmatic young patients. No significant difference was found between the effects of the drugs on any of the large- or small-airway tests in those patients in whom bronchodilatation originated mainly in the large airways or when all patients were considered together. In those patients, however, in whom the small airways made the major contribution to the total airways resistance, atropine produced a higher increase in specific conductance, in maximal flow at all lung volumes and in density dependence of flow, but only the specific conductance showed a significant difference between the effects of the two drugs (p less than 0.01). It was concluded that in these patients atropine produced more bronchodilatation than salbutamol in both central and peripheral airways. These findings do not confirm previous studies which suggested that in asthmatic patients, as in normal subjects, atropine produces mainly central bronchodilatation, while salbutamol produces mainly peripheral bronchodilatation. The difference in doses, route of administration, time response and in the pretreatment severity and site of bronchodilatation could account for the disagreement between previous studies and the present one. PMID- 3563122 TI - Cardiovascular performance during bronchospasm in dogs. AB - In 8 anesthetized mongrel dogs, we studied the effects of carbachol-induced bronchoconstriction (BC) on the cardiovascular system. Inhalation of carbachol in an amount sufficient to produce at least a 50% decrease in lung conductance (GL) did not lead to significant changes in cardiac output, mean transmural left atrial (Pla) or right atrial pressure, end-diastolic left ventricular septal lateral dimension, left ventricular apex to base dimension, or in end-diastolic right ventricular septal to lateral dimension during expiration. Mean transmural pulmonary arterial pressure rose and mean transmural aortic pressure (Pao) fell during BC. During inspiration, there were significant increases in transmural left atrial pressure, Pla, associated with decreases in end-diastolic left ventricular septal-lateral and apex-base dimensions. End-diastolic right ventricular septal-lateral dimension increased during inspiration. Beat-to-beat aortic flow (Qao) decreased during inspiration, while pulmonary arterial flow increased. There were no changes in transmural Pao during inspiration measured at the nadir of aortic flow. During BC, these changes were exaggerated, but remained qualitatively the same. The magnitude of the inspiratory decrease in pleural pressure (Ppl) was shown to be linearly related to the magnitude of the change in GL, and the magnitude of the inspiratory decrease in Pao and Qao (pulsus paradoxus) was shown to be linearly related to the magnitude of the inspiratory swing in Ppl. Although vagotomy significantly altered the pattern of respiration such that tidal volume increased and respiratory rate decreased, it did not substantially alter the responses of the cardiovascular system to breathing during BC. We conclude: the inspiratory decrease in Pao and Qao (pulsus paradoxus) is associated with a decrease in left ventricular end-diastolic filling, and a stiffening of the left ventricle; these changes are exaggerated during BC as a result of the exaggerated inspiratory swings in Ppl; the effects on left ventricular dynamics are mediated only in part through increases in right ventricular end-diastolic filling operating through the mechanism of ventricular interdependence; changes in left ventricular afterload appear to play little role in determining the responses seen. PMID- 3563123 TI - Effects of respiratory stimulation on alae nasi electromyograms and respiratory changes in length in dogs. AB - The relationship between the electrical and mechanical activity of the nasal dilator muscle was assessed in 8 pentobarbital-anesthetized, tracheostomized, supine dogs. Alae nasi electromyograms (EMGs) were recorded with bipolar fine wire electrodes, and respiratory changes in muscle length were recorded contralaterally using sonomicrometry. During both resting and stimulated breathing, the intrabreath pattern of muscle shortening closely paralleled the intrabreath pattern of EMG activity. Increases in both alae nasi EMG and alae nasi inspiratory shortening occurred in response to single-breath airway occlusions, brief periods of asphyxia, progressive hyperoxic hypercapnia, and intravenous nicotine sulfate administration. With all interventions, the increases in mechanical activation of the alae nasi paralleled the increases in alae nasi electrical activity. These results indicate that alae nasi EMGs, closely reflect respiratory changes in alae nasi length under conditions in which no mechanical load is placed in the nasal muscle. PMID- 3563124 TI - Relationship between inflammation, alpha-1-acid glycoprotein and lidocaine tolerance during fiber-optic bronchoscopy. AB - The purpose of this study was to determine the relationship between inflammation, increased alpha-1-acid glycoprotein (AAG), and lidocaine tolerance during fiber optic bronchoscopy. Previous studies indicate that serum lidocaine levels vary widely from one individual to another. One reason for these variations may be the presence of an ongoing inflammatory process, which enhances serum AAG, a major binding protein of lidocaine. To test this hypothesis, we assayed free and bound lidocaine as well as AAG in the blood of 12 patients after administration of 9 mg/kg of lidocaine during fiber-optic bronchoscopy. Some of the subjects had clear evidence of inflammation or infection. A correlation was found between AAG and total and bound lidocaine but not between AAG and free lidocaine (which remained almost constant). Thus, in spite of the high total levels of lidocaine observed in some patients with inflammatory processes, the free fraction (which is the active and toxic fraction) remained low. PMID- 3563125 TI - [Pulmonary embolism after cardiac catheterization]. PMID- 3563126 TI - [A case of impending rupture of aortic arch aneurysm diagnosed by repeated NMR CT]. PMID- 3563127 TI - [111In-labeled platelets and 67Ga-DFO-DAS-fibrinogen for the detection of pulmonary thromboembolism]. PMID- 3563129 TI - [Analysis of regional ventilation using radionuclear method]. PMID- 3563128 TI - [Airway dynamics analyzed with radioaerosol clearance]. PMID- 3563130 TI - [Preoperative prediction of postoperative lung function using 81mKr ventilation lung scintigram]. PMID- 3563131 TI - [Significance of peripheral edema on increased venous tone in congestive heart failure]. PMID- 3563132 TI - [Clinical evaluation of thallium-201 myocardial scintigram in myocarditis]. PMID- 3563133 TI - [Effects of assistance during activities in pre- and post-defecation on the heart rate and oxygen consumption]. PMID- 3563134 TI - [Effects of sublingual nifedipine on hemodynamic and metabolic responses to exercise (Ergometer, 25W, 5 min.) in patients with severe congestive heart failure]. PMID- 3563135 TI - [Serial electrophysiologic studies with multiple drugs using transesophageal pacing in infants and children with paroxysmal supraventricular tachycardia]. PMID- 3563136 TI - [Long-term treatment of aprindine in supraventricular tachycardias]. PMID- 3563137 TI - [Diagnostic significance of P wave changes during treadmill exercise test in angina pectoris]. PMID- 3563138 TI - [Decreased coronary reserve in patients with hypertrophic cardiomyopathy--a study using split dose thallium-201 dipyridamole myocardial imaging]. PMID- 3563139 TI - [Reye's syndrome. Clinical experience at the Hospital Universitario of the Universidad Autonoma de Nueva Leon]. PMID- 3563140 TI - [Neuropathological lesions associated with chronic alcoholism]. PMID- 3563141 TI - [Non-surgical tubal occlusion: use of methylcyanoacrylate and the FEMCEPT device]. PMID- 3563142 TI - [Familial Mediterranean fever in Mexico City]. PMID- 3563143 TI - [Effect of pituitary adenoma on thyroid function and its development despite transphenoidal microsurgery]. PMID- 3563144 TI - [Poisonings: a retrospective study at the Gonzalez University Hospital 1980 1984]. PMID- 3563145 TI - [Brown tumor of secondary hyperparathyroidism. Report of a case associated with intestinal malabsorption syndrome in a patient with progressive systemic sclerosis]. PMID- 3563146 TI - [Pericentric inversion of chromosome 7 associated with 45,X Turner syndrome ]. PMID- 3563147 TI - [A 30-year-old woman with diabetes mellitus, generalized cutaneous hyperpigmentation and congestive heart failure]. PMID- 3563148 TI - [The National Institute of Health quality control program. III. Follow-up studies (phase 3)]. PMID- 3563149 TI - [Smell and taste of the truffle]. PMID- 3563150 TI - [Evaluation of the extent of malignant tumors of the nasal fossa and sinus (excluding connective tissue tumors), histology and classical surgery (paralateronasal approach)]. PMID- 3563152 TI - [Middle meatotomy: a solution to the containment of the sinus]. PMID- 3563151 TI - [Apropos of 63 malignant tumors of the nasal fossa and sinuses]. PMID- 3563153 TI - [Flaps in the surgical reconstruction of oral cavity and oropharyngeal cancers. Apropos of 67 cases]. PMID- 3563154 TI - [High-frequency bone audiometry]. PMID- 3563155 TI - [Dimension of the temporal resolution of the auditory system]. PMID- 3563156 TI - [Malignant lymphoepithelial lesion of the salivary gland]. PMID- 3563157 TI - [Association of abnormalities of the external ear and facial nerve with anomalies of other organs]. PMID- 3563158 TI - [Isolated bilateral paralysis of the tongue: review of the literature apropos of a case]. PMID- 3563159 TI - [Use of a bilobed flap in the repair of loss of substance of the distal portion of the nasal pyramid]. PMID- 3563160 TI - [Treatment of acute acoustic trauma: initial results of normovolemic hemodilution]. PMID- 3563161 TI - [Prolonged fever during treatment with acebutolol]. PMID- 3563162 TI - [Hepatitis during treatment with josamycin]. PMID- 3563163 TI - [Esophageal angina: detection by esophageal manometry with the methylergometrin maleate test]. AB - The purpose of this study was to assess the value of methylergonovine maleate administration as challenge test for abnormal oesophageal contractions. Manometric exploration of the oesophagus was performed before and after administration of methylergonovine maleate 0.4 mg in 28 patients suffering from retrosternal pain of proven extracardiac origin. Six patients had unexplainably suffered when receiving the drug during coronary arteriography (group A), while 22 had experienced no pain (group B). A group of 7 control subjects were explored at the same time and with the same procedure (group C). Methylergonovine maleate produced painful oesophageal abnormal contractions in 5 of the 6 patients in group A. The 6th patient in this group and 2 patients in group B had abnormal contractions without pain. Another group B patient developed coronary arterial spasm reversed by sublingual nitroglycerin. In the 2 group A patients who received nitroglycerin, the drug rapidly relieved the retrosternal pain and the abnormal contractions induced by methylergonovine maleate. This study demonstrates the value of oesophageal manometry with methylergonovine maleate test in patients with anginal pain but normal coronary arteriography. It also highlights the need for continuous ECG monitoring during the test, even when the patients had responded negatively to methylergonovine maleate during coronary arteriography. PMID- 3563164 TI - [Thyroid function of burned patients: effect of iodine therapy]. AB - Thyroid function was studied in 3 groups of adults (group I = 13 burned patients treated with non iodinated antiseptic, group II = 15 burned patients treated with polyvidone iodine, group III = 50 control subjects) in order to examine: the thyroid hormone status in burned patients, the possible incidence of plasma iodine overload on these endocrine parameters. Burned skin area and thyroid function were measured before treatment, then weekly for 3 weeks. Before treatment a decrease in plasma T4 and T3 with an increase in reverse T3 (rT3) and a decrease in plasma thyroxin binding globulin (TBG) were observed in burned patients. Free T4 index (T4/TBG) was normal, but T3 resin uptake (T3RU) was elevated. During treatment, plasma iodine increase sharply from 6.4 +/- 0.4 to 20.7 +/- 4.7 micrograms/100 ml (p less than 0.02) in group II. Endocrine parameters (not different between group I and II) progressively returned to normal, except for T3RU which remained elevated until the third week. rT3, T4 and T3RU correlated (p less than 0.001) with burned skin area. To conclude, the reversible particularities of thyroid function in burned patients are positively correlated with burned area. The thyroid function does not seen to be modified by plasma iodine overload. PMID- 3563165 TI - [Marfan's or Marfan-like syndrome: value of echocardiography]. AB - The purpose of this study of 6 cases of Marfan's or Marfan-like syndrome detected in 7077 echocardiographic examinations was to investigate the clinical value of echocardiography. The mean age of the patients was 40 years, and 4 of them (66 p. 100) were female. The diagnosis was based on the 4 criteria of Marfan's syndrome in 1 case, on 3 criteria in 2 cases and on 2 criteria in 3 cases. Four patients were known to have a previous cardiac murmur. Auscultation revealed a systolic murmur of mitral regurgitation in 3 cases (associated with a diastolic murmur of aortic regurgitation in 2 of them), a diastolic murmur of aortic regurgitation in 3 cases and a systolic murmur due to calcified bicuspid aortic valve in 1 case. ECG recorded a normal rhythm in 4 cases, atrial fibrillation in 2 cases of mitral regurgitation, and left ventricular hypertrophy in 3 cases. Chest X-ray showed cardiomegaly in 3 patients and severe kyphoscoliosis in one. Echocardiography visualized dilatation of the ascending aorta, severe (60 mm) in 1 case, in 3 patients; dilatation of the pulmonary artery in 1 patient; pansystolic mitral valve prolapse in 3 patients (associated with aortic and tricuspid valve prolapse in 2 of them after the disease had progressed); isolated aortic valve prolapse due to bicuspid valve in 2 patients; intracardiac calcifications in 3 patients; subaortic septal hypertrophy in 1 patient and calcified incompetent foramen ovale in 1 patient. Aortography performed in 3 patients disclosed an aneurysm of Valsalva's sinuses in 1 case and a mild aortic insufficiency in 2 cases. Two patients underwent cardiac catheterization for severe mitral regurgitation due to mitral valve prolapse requiring valve replacement, which was successfully done. Thus, echocardiography may provide an early diagnosis of Marfan's syndrome, since cardiovascular abnormalities are frequent in infancy. It also ensures a close follow-up of the disorders and it is useful in deciding whether treatment should be medical or surgical. It may detect formes frustes in a family with Marfan's syndrome, and it may define a borderline group of patients: those with Marfan like syndrome. In these patients the cardiovascular lesions are more preponderant and appear later than in the classical Marfan's syndrome; they are often difficult to differentiate from the lesions of Barlow's syndrome. PMID- 3563166 TI - [2 cases of pneumothorax following acupuncture]. PMID- 3563167 TI - [Neurological manifestations of Rendu-Osler-Weber disease. Apropos of 4 cases]. AB - Rendu-Osler-Weber disease is a generalized vascular dysplasia which also involves the central nervous system. The neurological manifestations of the disease are due either to primary intracranial or spinal vascular lesions or to neurological complications of other visceral lesions, notably those of the lung (arteriovenous fistulae). The prevention of ischaemic or infectious cerebral accidents rests on the anatomical (excision) or functional (selective embolization) exclusion of pulmonary arteriovenous fistulae, when present. PMID- 3563168 TI - [Chronic osteitis and arthritis of palmoplantar pustulosis. A familial form of B 27 negative spondylarthropathy]. AB - A 35-year old woman presented with pustulosis palmaris et plantaris evolving in acute episodes parallel to those of a rheumatic disease consisting of bilateral sacro-iliac arthritis, manubriosternal fusion and sterno-clavicular arthritis. Her brother had spondylitis compatible with the diagnosis of pustular osteo arthritis though without pustulosis. He presented with bilateral sacro-iliac arthritis, manubriosternal fusion, sterno-clavicular arthritis and an ossified fragment detached from the antero-inferior angle of C6. The two patients had the same HLA phenotype: A1, A9, B5, B41, CW4, DR2, DR4, absence of B27. In a specimen from the sacro-iliac joint the authors found active bone remodelling and inflammatory osteitis with fibrosis and infiltrates rich in mononucleate cells. An electron microscopic study--to the authors' knowledge, the first to be performed in such cases--demonstrated intracytoplasmic filamentous inclusions in two macrophages of the synovial fringe. Only one other case of the familial form has been published so far. Like the rheumatism of acne conglobata, the spondylitis of pustulosis palmaris et plantaris is one of the causes of sterno costo-clavicular hyperostosis. PMID- 3563169 TI - [Arthritis and palmoplantar pustulosis]. AB - Pustulosis palmaris et plantaris may be associated with a number of articular diseases. Known to be present in Fiessinger-Leroy-Reiter syndrome and psoriasis arthropatica, this skin disease has been classified by Japanese authors as a new nosological entity: pustular osteo-arthritis. Pustulosis palmaris et plantaris seems to represent a meeting point for axial rheumatisms close to ankylozing spondylitis. PMID- 3563170 TI - Continent urinary diversion. PMID- 3563171 TI - Continent urinary diversion. PMID- 3563172 TI - The continent ileal reservoir (Kock pouch) PMID- 3563174 TI - Substitution enterocystoplasty. PMID- 3563173 TI - Experience with the ileal bladder (Camey procedure) and cecoileal reservoirs for continent urinary diversion. AB - I have reviewed our own experience with the ileal bladder and with cecal and cecoileal reservoirs, along with the reported experiences of other investigators. Both of these major classes of diversion offer continent nonrefluxing storage of urine. I advise patients who are candidates for either type of procedure to weigh the prospect of urethral voiding (but enuresis with the ileal bladder) v a continent abdominal stoma that requires self-catheterization of variable difficulty with a cecoileal reservoir. The perfect urinary diversion does not exist. Greater experience in time and numbers is required to know if the newer procedures reviewed here are even as good as the ileal conduit. However, the potential for greater preservation of renal function and significantly improved quality of life cannot be denied. PMID- 3563175 TI - Bladder reconstruction in children. PMID- 3563176 TI - The Mitrofanoff principle in continent urinary reservoirs. PMID- 3563178 TI - Bladder replacement by ileocystoplasty following radical cystectomy. PMID- 3563177 TI - The continent cecal reservoir for urine. PMID- 3563179 TI - [Role and value of fine-needle puncture in the clinical assessment of cold nodules of the thyroid]. PMID- 3563180 TI - [Survey of the number of voluntary pregnancy interruptions practiced in Belgium in 1985]. PMID- 3563181 TI - [Treatment of bronchial asthma: a plea for bronchodilators via inhalation]. PMID- 3563183 TI - [Pulmonary cancer: treatment philosophy of advanced cases]. PMID- 3563182 TI - [Biological abnormalities in the initial stage of Guillain-Barre syndrome]. PMID- 3563184 TI - [The value of thermography in rheumatology]. PMID- 3563186 TI - [Epidural metastases at the level of the spine: a medical emergency]. PMID- 3563185 TI - [Obesity: current biochemical and therapeutic aspects]. PMID- 3563187 TI - [Current concept of the pathogenesis of asthma]. PMID- 3563188 TI - [Cancer. Face-to-face with death]. PMID- 3563189 TI - [General physiopathology of accidents linked to decompression or to the entry of gases into the body]. PMID- 3563191 TI - [The dumping syndrome. Physiopathology of the dumping syndrome]. PMID- 3563190 TI - [Diagnosis of hematuria in children]. PMID- 3563192 TI - [Medical treatment of the dumping syndrome]. PMID- 3563193 TI - [Tropical diseases and the Belgian practitioner. The case of malaria]. PMID- 3563194 TI - [Acute and chronic borrelioses transmitted by ticks along the Meuse River and in bordering regions]. PMID- 3563195 TI - [Tests for the detection of occult blood in feces and their place in the detection of colorectal cancers]. PMID- 3563196 TI - [Role of a screening center]. PMID- 3563197 TI - Perception of temperature on oral and facial skin. AB - The intensity of sensations of warmth and cold was measured psychophysically at 12 loci on the face and in the mouth in 20 human subjects. Significant differences were found among areas in the relative sensitivity to both cooling and warming, although the range of sensitivities was greater for warming than for cooling. Except for the vermilion lip and the tongue tip, oral regions were significantly less sensitive to warming than were facial regions. No such difference was found for cooling. The most posterior location tested on the hard palate, for example, exhibited a suprathreshold sensitivity to cooling that equaled or surpassed that of most locations on the face. The tongue tip and vermilion lip possessed relatively high sensitivity to both warming and cooling, with the former locus emerging as the most thermally sensitive oral area so far tested. PMID- 3563198 TI - Responses in the first or second somatosensory cortical area in cats during transient inactivation of the other ipsilateral area with lidocaine hydrochloride. AB - Simultaneous recordings were obtained from the primary and secondary somatosensory cortical areas (SI and SII) in cats anesthetized with ketamine or pentobarbital. A total of 40 individual neurons were studied (29 in SII and 11 in SI) before, during, and following injections of microliter quantities of lidocaine hydrochloride in the other ipsilateral cortical area. Activity in the cortex injected with the local anesthetic was monitored with single-neuron, multi neuron, or evoked potential responses to determine the time course of inactivation within 0.5-2 mm of the injection sites. Recording sites in both cortical locations were in the representations of the distal forelimb. Responses were elicited by transcutaneous electrical stimulation across the receptive fields with needle electrodes. Short-latency responses were synchronously activated, and, in those circumstances where single neurons were isolated in both areas, no overall differences in latency were noted. Anesthetization of either cortical area never blocked access of somatosensory information to the intact area, even when the injected cortex was completely silenced in the vicinity of the injection mass. In 15 SII neurons and 7 SI neurons, changes were seen in short-latency evoked responses to stimulation of their receptive fields or in background activity following local anesthesia of the other area through several cycles of injection and recovery. In 7 of these 15 SII cells, changes were noted in the timing and/or firing rates of the short-latency responses; changes were noted in the short-latency responses of 2 of these 7 SI cells while SII was silenced. In 11 SII and 6 SI cells, "background" activity that was recorded during the interstimulus intervals either increased (most cases) or decreased during local anesthesia of the other area. The results are discussed in reference to the hypothesis that primary sensory cortical areas feed information forward to secondary areas, and these feed back modulatory controls to the primary regions. PMID- 3563199 TI - Cortical involvement in dorsal horn cell hyperactivity and abnormal behavior in rats with dorsal root section. AB - Experiments were performed on rats using neurophysiological and behavioral techniques, in an attempt to study the role played by the somatosensory cortex in the abnormal spinal neuron activity and abnormal behavior observed after brachial plexus lesions. The onsets of both phenomena occur at the same postoperative period. Cortical controls exerted on spinal dorsal horn (DH) cells were studied using a transient and reversible cortical blockade, cortical spreading depression (CSD), applied contralateral to the spinal cord recording. In 28 intact animals, 55 cells were studied during the propagation of at least two CSDs. Only 4 of these cells presented a sustained decrease in their spontaneous activity during CSD, which may correspond to transient arrest of a descending tonic cortical facilitation. In 29 animals with dorsal root sections, 161 DH cells displayed abnormal burst activity, and 52 were examined with the CSD test. Thirty-five cells presented a long-duration change in their spontaneous activity during CSD; of these, 28 showed decreased activity (suppression of descending tonic facilitation) and 7 presented increased activity (suppression of descending tonic inhibition). More DH cells were influenced by the cortex in deafferented rats (67%) than in intact rats (7%). The cortical influence was also stronger, as the hyperactive cells were frequently rendered silent during CSD. These observations suggest that the abnormal activity is partly due to a descending cortical influence. Results of a behavioral study performed on 22 rats (one control group and two experimental groups with cortical ablations) showed that the self mutilating behavior, which develops at the same time as the abnormal DH cell activity, was reduced by unilateral cortical ablation, independent of the cortical region removed. The possible pathways involved in this cortical influence are examined in the discussion. PMID- 3563200 TI - [The significance of alkaline phosphatase in an ambulatory internal medicine clinic: clarification, diagnostic results, therapeutic consequences in 207 patients with elevated alkaline phosphatase]. PMID- 3563201 TI - [Mallet fingers and their treatment]. PMID- 3563202 TI - [Pathologic anatomical conference--chronic biventricular heart insufficiency in a radiologically non-enlarged heart]. PMID- 3563203 TI - [Humming sound in the neck]. PMID- 3563204 TI - [The case from practice (75). Patient: Mr. C.A., born 3-19-1966, unemployed]. PMID- 3563205 TI - [Urinary tract infection and pyelonephritis]. PMID- 3563206 TI - [Acute rhabdomyolysis--a problem in general practice?]. PMID- 3563207 TI - [Conservative therapy of chronic progressive kidney disease]. PMID- 3563208 TI - [What is new in nephrology?]. PMID- 3563209 TI - [Work on a display screen]. PMID- 3563210 TI - [Long-term effects of proximal selective vagotomy on acid secretion]. PMID- 3563211 TI - [Paraneoplastic syndromes in rheumatology and arthritis in the area of malignant tumors]. PMID- 3563212 TI - [Cough, fever and jaundice]. PMID- 3563214 TI - [The urine ketone test: obsolete or still current?]. PMID- 3563213 TI - [The case from practice (73). Patient: Mr. P.G., born 9-5-1948]. PMID- 3563215 TI - [Commonly encountered facial injuries: role of plastic and reconstructive surgery]. PMID- 3563216 TI - [Pain in the side and profuse perspiration]. PMID- 3563217 TI - [A case from practice (74). Patient: A.-W., H.R., born 1945, official (lactose intolerance)]. PMID- 3563218 TI - [Erysipelas and infectious cellulitis: classification, diagnostic approach and treatment]. PMID- 3563219 TI - [Diagnosis of foot dermatoses]. PMID- 3563220 TI - [Routine VDRL: still necessary in 1987]. PMID- 3563221 TI - [Recurrent infections in children: the point of view of a practitioner]. PMID- 3563222 TI - [Stable elastic intramedullary nailing in the treatment of fractures of long bones in children]. PMID- 3563223 TI - [Adolescents eat the way they live]. PMID- 3563224 TI - [The mentally handicapped and their parents]. PMID- 3563225 TI - [Drug therapy of chronic pain in cancer patients. Survey among hospitalized patients]. PMID- 3563226 TI - [Improvement of working conditions, one of the essential tasks of the occupational physician]. PMID- 3563227 TI - [Risks of work using cathode-ray screens: apropos of the Stockholm international congress, May 1986: "Work with Display Units"]. PMID- 3563228 TI - [The gas alarm intervention plan at the Ciba-Geigy plant in Monthey]. PMID- 3563229 TI - [Reflections on occupational medicine. Experience of a university institute]. PMID- 3563230 TI - [Medicine and parallel medicines]. PMID- 3563231 TI - [Hemostatic disorders and surgery]. PMID- 3563233 TI - [Eating to live]. PMID- 3563234 TI - [The occupational environment: a matter for the specialist]. PMID- 3563232 TI - [Results and late morbidity following the Marshall-Marchetti-Burch operation for treating stress urinary incontinence in women]. PMID- 3563235 TI - [Activities of the Swiss National Insurance Agency in the field of occupational medicine]. PMID- 3563236 TI - [The Neuchatel Department of Occupational Medicine and Industrial Hygiene. A brief sketch]. PMID- 3563237 TI - [Highs and lows of optimization in radioprotection]. PMID- 3563238 TI - [135 cases of polymyositis]. AB - The classification of 135 patients with either dermatomyositis (DM) or polymyositis (PM) showed 34 cases of DM and 56 cases of PM in adults, 6 cases of DM associated with cancer, 9 cases of DM in children, 16 cases of localized PM and 14 cases of an overlapping syndrome. Results of biological tests, erythrocyte sedimentation rate and serum enzyme determinations were inconstantly abnormal. The electromyograms were generally of a myogenic type with spontaneous activity in about half the cases. Muscle biopsy usually showed inflammation necrosis and regeneration, sometimes only of moderate severity only. Results were normal in several cases. In 21 patients only the pathognomonic perifascicular atrophy was reported. Proposed classifications are unsatisfactory. Polymyositis may be considered as a syndrome. Among the primary forms the distinction between acute dermatomyositis and subacute or chronic polymyositis is poorly defined and passage from one disorder to another is frequent. Pseudo-myasthenic forms are not entities and pseudo-myopathic types are actually muscular dystrophies. Associations with polymyositis are common and may consist only in the addition of one sign of no clinical significance (PM "plus"). The polymyositis lesion may be part of a syndrome such as Gougerot-Sjogren's or of another connective tissue disease. A system of diagnostic criteria uses numerical ratings of each criterion as a function of its semiologic importance. PMID- 3563239 TI - [Complex partial epileptic seizures as the initial symptom of subacute sclerosing panencephalitis]. AB - A 18 year-old boy, without a previous history, presented with psychomotor seizures and, 4 months after, mental deterioration. EEG showed focal epileptic abnormalities characterized by high amplitude spike waves in the left temporal region. Periodic complexes appeared after administration of Diazepam. CT scan showed mild cortical atrophy in the left temporal region. Measles virus HI antibody titers were 1/2048 in the serum and 1/64 in the CSF. The patient died one year after the first complex partial seizures. PMID- 3563240 TI - [Acute myopathy and hyperthyroidism]. AB - A 40 year-old woman with a rapidly progressive proximal muscle deficit of all four limbs had an acute myopathy secondary to hyperthyroidism. Biopsy of the quadriceps femoris revealed signs of non specific muscle impairment with type II fiber atrophy. Treatment with methimazole and correction of the thyroid condition led to rapid disappearance of the disorders. Eighteen months later the clinical status was normal and a second quadriceps femoris biopsy showed that the muscle had normalized. PMID- 3563241 TI - [Macrosaccadic oscillations symptomatic of cerebellar hemorrhage]. AB - Electro-oculographic recordings in a patient with an oculomotor disorder due to hemorrhage of the vermis showed macrosaccadic oscillations. Data from reported cases suggest the specific significance of this type of disorder for acute cerebellar lesions. PMID- 3563242 TI - [Isolated spinal cord involvement. Recurrence of sarcoidosis]. AB - Three months after having stopped a corticosteroid therapy prescribed for disseminated sarcoidosis, a 23 year-old man presented signs of thoracic spinal cord involvement, with a lymphocytic reaction in the CSF. The hypothesis of a recurrence of sarcoidosis was evoked, and, after a few days course of corticosteroid, the patient recovered; he had no functional sequelae, and did not present any recurrence 2 years after having stopped the treatment. The main characteristics of spinal cord sarcoidosis are summarized: occurrence during a usually previously known sarcoidosis, within weeks or months, located spinal cord involvement, sometimes with a syringomyelic syndrome, and lymphocytic CSF reaction. In this case, the lesion was probably an arachnoidal infiltration without tumorous process of the spinal cord. Corticosteroid must be prescribed at once, and for a long time, because the results of surgery are always poor. PMID- 3563243 TI - [Marchiafava-Bignami disease with favorable development]. AB - A 35 year-old right-handed woman with a history of alcoholism presented signs of interhemispheric disconnection. CT of the brain revealed a low-density areas in the corpus callosum. Two months later, clinical examination was normal, but the CT showed cystic area in the genu and splenium. MRI was also consistent with a lesion of the corpus callosum. CT and MRI did not show lesions in the hemispheric white matter. PMID- 3563244 TI - NREM sleep with low-voltage EEG in the rat. AB - NREM sleep in the rat has traditionally been defined by electroencephalographic (EEG) amplitudes above those of wakefulness (W) and paradoxical sleep (PS); we refer to this high-amplitude NREM sleep as "HS." We have found that approximately 5% of total time is occupied by episodes in which EEG amplitude is low, distinguishing it from HS; theta amplitude is low, distinguishing it from PS; and electromyographic (EMG) amplitude is low, distinguishing it from W. We have called these low-EEG, low-theta, low-EMG episodes "low-amplitude sleep" (LS). Three studies are done to elucidate additional characteristics of LS. Polygraphically scored 30-s epochs were matched with independent classifications of rat behavior as W, NREM, or PS; 87% of polygraphically scored LS epochs were matched with NREM sleep behavior. Response thresholds to noxious stimuli were lowest in W, intermediate and similar in LS and HS, and highest in PS. The incidence of PGO-type (ponto-geniculo-occipital) waves in W, HS, and LS were all very low in comparison with rates in PS. Thus, LS and HS exhibited similarly quiescent spontaneous behavior, similar intermediate response thresholds, and similar low rates of PGO-type activity. Accordingly, we have proposed that LS, along with HS, is an NREM sleep stage. PMID- 3563245 TI - Relationships among wake episode lengths, contiguous sleep episode lengths, and electroencephalographic delta waves in rats with suprachiasmatic nuclei lesions. AB - The lengths of sleep and wake episodes during 2 consecutive days of recording were measured in five rats lacking circadian rhythms owing to lesions of the suprachiasmatic nuclei. Total sleep (TS) episode lengths and the amount of NREM sleep and paradoxical sleep (PS) within each episode were examined in relationship to the lengths of the immediately preceding and the immediately following wake episodes. As putative measures of sleep intensity, average and maximum delta wave (1-4 Hz) incidence and amplitude within NREM were also examined in relation to adjacent wake episode lengths. For sleep episodes longer than 50 min (78% of daily sleep), TS episode lengths and amount of NREM within these episodes showed significant positive correlations with both prior and subsequent wake episode lengths. PS durations within sleep episodes also showed significant positive correlations with subsequent wake episode lengths, but little correlation with prior wake episode lengths. The results suggest that in the absence of sleep-wake circadian rhythms, sleep time is subject to short-term homeostatic regulation. Amounts of PS within sleep episodes were highly correlated (r = 0.84) with amounts of NREM. NREM delta wave incidence and amplitude showed no significant relationships with the lengths of prior or subsequent wake episodes, suggesting that variations in sleep intensity may not play a prominent role in the short-term homeostatic regulation of ad lib sleep. Delta wave incidence and amplitude were also not correlated with the duration of NREM episodes, but incidence during wake was positively correlated with wake episode duration, suggesting that delta density during wake may be an electrophysiological indicator of the propensity to sleep. PMID- 3563246 TI - Urinary catecholamines before and after tracheostomy in patients with obstructive sleep apnea and hypertension. AB - Obstructive apnea (asphyxia) is accompanied by acute elevation of systemic blood pressure. The usual nocturnal fall in blood pressure seen during sleep in normals may be absent in patients with repetitive apneas, and daytime systemic hypertension is reported to occur in up to 90% of such patients. Increased sympathetic activity in response to repetitive nocturnal episodes of asphyxia could explain the reversal of the diurnal pressure variation but not the daytime systemic hypertension in this setting. We examined diurnal variation in urinary catecholamines in eight subjects with severe apnea before and after tracheostomy. Five obese hypertensive subjects without apnea served as controls. Three urine specimens, two awake (7 a.m. to 3 p.m. and 3 p.m. to 11 p.m.) and one asleep (11 p.m. to 7 a.m.) were collected preoperatively and again 10-14 days postoperatively when the patient was free of pain and signs of stoma infection. All specimens were analyzed for epinephrine, norepineprine, metanephrine, and normetanephrine by liquid chromatography with electrochemical detection. Urinary epinephrine and metanephrine were not different between subjects and controls. Norepinephrine and normetanephrine were significantly higher in apneic subjects pretracheostomy as compared either with controls or with their own values posttracheostomy. Diurnal variation was not seen before or after tracheostomy. Only two of the controls showed significant diurnal variation in norepinephrine. We conclude that the absence of diurnal variation in catecholamines prior to tracheostomy reflects increased nocturnal sympathetic activity. Elevation of daytime norepinephrine and normetanephrine with return to control levels following tracheostomy implies increased sympathetic activity throughout the day. PMID- 3563247 TI - Treatment of chronic insomnia by restriction of time in bed. AB - A treatment of chronic insomnia is described that is based on the recognition that excessive time spent in bed is one of the important factors that perpetuates insomnia. Thirty-five patients, with a mean age of 46 years and a mean history of insomnia of 15.4 years, were treated initially by marked restriction of time available for sleep, followed by an extension of time in bed contingent upon improved sleep efficiency. At the end of the 8-week treatment program, patients reported an increase in total sleep time (p less than 0.05) as well as improvement in sleep latency, total wake time, sleep efficiency, and subjective assessment of their insomnia (all p less than 0.0001). Improvement remained significant for all sleep parameters at a mean of 36 weeks after treatment in 23 subjects participating in a follow-up assessment. Although compliance with the restricted schedule is difficult for some patients, sleep restriction therapy is an effective treatment for common forms of chronic insomnia. PMID- 3563248 TI - The non-entrained life of a young gentleman at Oxford. AB - Sleep logs over 9 months document the delayed sleep phase of a healthy male student at Oxford. The lack of any imperative zeitgebers also permits the rest activity cycle to exhibit very long (circabidian) days similar to those seen under conditions of temporal isolation. No psychopathology or subjective distress was associated with this unusual rest-activity cycle: It was a preferred life style. PMID- 3563249 TI - Ultrashort sleep-wake cycle: timing of REM sleep. Evidence for sleep-dependent and sleep-independent components of the REM cycle. AB - This study investigated the temporal structure of REM sleep in three experiments utilizing the ultrashort 7-min sleep, 13-min waking cycle. The experiments were carried out for 24 or 36 h, with and without previous sleep deprivation, under two experimental conditions of instructing subjects to fall asleep or to resist sleep. Multiple REM episodes occurred in all three experiments in the two experimental conditions, particularly during the night period. The first nocturnal REM period appeared 5 h after the nocturnal sleep gate, of which 80-100 min were accounted for by non-REM (NREM) sleep. Thereafter, REM episodes occurred periodically, with a mean inter-REM interval of 86 min. Only 14 min of this interval consisted of NREM sleep. We believe that these results suggest that although the activation of the REM oscillator is dependent on a critical accumulation of NREM sleep, once activated, it continues to function during brief periods of waking. PMID- 3563251 TI - Dream sources, associative mechanisms, and temporal dimension. AB - Using the technique of free association in an experimental setting, this author and colleagues previously found differences in the quality of memory traces involved in the production of REM and sleep onset (SO) dreams. The present study aims to answer two questions raised by those results: (a) Must the associative session be temporally contiguous to the dream production to gain access to the sources of the dream? (b) Are the differences between SO and REM associations due only to differences in structure and content of the two types of dream reports? Free associations with the same dream collected immediately after an experimental awakening were compared with those recalled 2 months later. A first group of results supports the hypothesis that free associations are sensitive to the proximity to the amount of dream production. A second group shows that the differences between SO and REM dreams noted in the previous research are not attributable to differences in formal characteristics of the report. PMID- 3563250 TI - Total and percentage REM sleep correlate with body weight in 36 middle-aged people. AB - Thirty-six volunteers of mean age 52 years had their sleep recorded in the laboratory on 5 consecutive nights. Eight factors were investigated as possible correlates of percentage REM sleep and of total minutes of REM sleep: age, height, weight, bedtime, arising time, oral temperature at bedtime and on arising, and total sleep time. REM percentage correlated significantly with body weight and with oral temperature at bedtime and correlated negatively with age. Owing to intercorrelations among the factors investigated, partial correlational analyses were done and revealed that body weight was the only factor that remained significantly correlated with REM percentage. Similarly, total sleep time and body weight were the only factors that remained significantly correlated with total minutes of REM sleep, whereas age and bedtime temperature just missed significance when other factors were held constant. PMID- 3563252 TI - Jactatio capitis nocturnus in association with major depression and borderline personality. PMID- 3563253 TI - [Autonomous intrathoracic goiter. Apropos of 2 new cases]. AB - An autonomous intrathoracic goiter (AIG) is a thyroid gland formation located in the thorax or, more precisely, the mediastinum. It is not a metastasis of thyroid cancer, and it has no parenchymatous or vascular connections with the cervical thyroid gland. It is fed by thoracic vessels and is observed in the absence of previous thyroidectomy. Its multiple appellations, and the fact that clinical reports often lack precision and detail, complicate investigations concerning AIG, a rare variety of mediastinal goitre (slightly more than 100 cases published). AIG is essentially caused by an abnormal embryonic development of the thyroid gland. It must be distinguished from migratory goitres partially resected and forgotten in the thorax after cervicotomy. This fully mediastinal tumour is usually removed by the thoracic approach. PMID- 3563254 TI - [Pleurisy in blood diseases: value of thoracoscopic poudrage]. AB - Twenty-five pleural effusions which occurred in 21 lymphoma patients (mean age: 50.6 +/- 4.6 years) were treated by pleural poudrage during thoracoscopy. The effusion was either serofibrinous (32%) or haemorrhagic (41%) or chylous (27%). The mean amount of fluid removed before poudrage was 5.2 +/- 0.6 litres. Thoracoscopy confirmed direct pleural invasion in 95.5% of the cases. Permanent pleural symphysis was obtained in all but 2 patients: one who required one single puncture withdrawing 400 cc, the other with mesothelioma on cured Hodgkin's disease, which was a failure. The mean duration of drainage was 4.8 +/- 0.2 days. The results obtained were identical with those reported with pleurisy in solid tumours. PMID- 3563255 TI - [Comparative study of plasma levels of 2 delayed-action theophyllines: Theostat 200 and Theodur 200, after a single evening dose]. AB - Plasma levels of two slow-release theophylline preparations, Theostat 200 and Theodur 200, administered in one single evening dose during steady state were compared in a double-blind cross-over study involving 10 male volunteers (mean age: 52.3 +/- 7.5 years) with chronic obstructive lung disease and free from pathology or treatment that might have interfered with theophylline kinetics. Mean areas under the drug plasma concentration curves were 222 +/- 101 mg.h/l with Theostat 200 and 264 +/- 114 mg.h/l with Theodur 200. Mean percentages of fluctuation were 72 +/- 13 and 71 +/- 17 respectively (N.S.). The free fractions measured at peak level were higher with Theodur (9 +/- 2.9 mg/l) than with Theostat (7.1 +/- 2.4 mg/l) (P less than 0.05). While mean values were approximately the same with the two products, interindividual variations were pronounced, with several plasma levels of Theostat 200 in areas regarded as ineffective and several plasma levels of Theodur 200 in areas regarded as toxic. This type of preparation therefore is mostly useful to patients who would benefit from high plasma levels of theophylline in the early morning. PMID- 3563256 TI - [Thoracic actinomycoses. General illustrated review of 4 surgical cases]. AB - Actinomycosis of the lung is rare and difficult to diagnose. Its good prognosis after medical treatment contrasts with the high frequency of surgical excision, due to the fact that pre-operative diagnosis is exceptional. Following a review of the recent bacteriological, radiological and therapeutic data available in the literature, 4 personal cases are presented. In all 4 cases actinomycosis was diagnosed post-operatively on the presence of yellow grains in the histological specimens. In 2 cases surgical excision proved impossible, but an almost complete radiological recovery could be obtained after prolonged treatment with co trimoxazole. This shows how important it is to be aware of the disease, to improve its diagnostic approach and to remember its sensitivity to antibacterial agents, even in well organized forms. PMID- 3563257 TI - [Exercise training for aged patients with respiratory insufficiency is possible. Apropos of 2 cases]. AB - Two patients aged 69 and 75 respectively and suffering from chronic obstructive lung disease (Par CO2 7.8 and 9.2 kPa at rest) were trained on a treadmill for 6 months. Twice a week, they were asked to walk for an increasing length of time (up to 30 min) and with increasing work load under continuous heart rate (HR) monitoring. On the remaining days of the week, they had to walk on their own during 30 min. Examinations performed before and after 3 and 6 months of training showed no change in lung function tests at rest, an increase in maximal work load, VO2 max and maximum HR, and a delayed anaerobic threshold. The subjects claimed greater fitness. This study demonstrates that elderly patients with respiratory impairment can benefit from exercise training, the changes observed consisting of better cardiac and metabolic adaptation to exercise. PMID- 3563258 TI - [Bioclinical conference in pneumology. Hopital Laennec. Case n. 4--February 1985. Interstitial pneumopathy associated with pulmonary infiltration by foamy macrophages]. PMID- 3563259 TI - [Bioclinical conference in pneumology. Hopital Laennec. Case n. 5--March 1985. Association of retinal thrombosis and pulmonary opacities in a female asthmatic patient]. PMID- 3563260 TI - [2 unusual manifestations of LAV-HTLV virus infection: BCGitis and pulmonary chickenpox]. AB - A patient with AIDS developed local complications of BCG vaccination and disseminated chickenpox with severe pneumonia. This cas suggests that AIDS patients should not receive BCG vaccination and that adults with severe chickenpox should be investigated for LAV/HTLV III virus carriage. PMID- 3563261 TI - [Intralysosomal granules in bronchial cells and ingestion of amiodarone. Apropos of a case of interstitial pneumonia]. PMID- 3563262 TI - [Analysis of lactate dehydrogenase isoenzymes in the diagnosis of pleural effusion]. PMID- 3563263 TI - [Arterial embolization in the treatment of hemobilia]. PMID- 3563264 TI - [Epilepsy and work]. PMID- 3563265 TI - [Ultrastructural aspects of fibroblasts and macrophages during the healing process in the skin of rats]. PMID- 3563267 TI - [Hemobilia: treatment by embolization of the hepatic artery]. PMID- 3563266 TI - [Vasodilator agents in the therapeutic arsenal of cardiac insufficiency]. PMID- 3563268 TI - [Incidence of cesarean section and the remuneration for assistance in delivery]. PMID- 3563269 TI - [Clinical and obstetrical indications for cesarean section in a teaching hospital, Jundiai (SP)]. PMID- 3563270 TI - [Munchausen syndrome: a case report]. PMID- 3563271 TI - [Histological lesions of the bladder mucosa in 91 autopsies]. PMID- 3563272 TI - [Healing process of the myometrium of albino rats after perforation. Morphometric aspects]. PMID- 3563273 TI - [Paraplegia due to spinal cord lesions. Epidemiological study in patients seeking rehabilitation]. PMID- 3563275 TI - [Refinements in facial rejuvenating surgery]. PMID- 3563274 TI - [Inguinal hernias. Critical analysis of 416 cases]. PMID- 3563277 TI - [Heart injuries involving 3 chambers]. PMID- 3563276 TI - [Ultrastructural aspects of the triads in the deltoid muscle of patients with Basedow-Graves disease]. PMID- 3563279 TI - [An unusual case of congenital toxoplasmosis]. PMID- 3563278 TI - [Sigmoidovaginal fistula. Report of 3 cases]. PMID- 3563280 TI - [Acute psychotic reactions and speech disorders induced by the rapid intravenous injection of lidocaine]. PMID- 3563281 TI - [Nephrogenic diabetes insipidus as the cause of fever of unknown origin in infancy: report of a case]. PMID- 3563282 TI - [Comparison between 2 combinations in the adjuvant chemotherapy of colon and rectum carcinomas]. PMID- 3563283 TI - [Role of Ureaplasma urealyticum in premature rupture of the membranes]. AB - In 79 hospitalized patients in delivery, the search for U. urealyticum was carried out at the level of the vagina, the rim of the placenta, the edge of the PRM orifice and in the throats of newborns, 3 groups were formed: group I: 38 term patients delivering after ARM, group II: 36 patients delivering after 28 weeks, with PRM group III: 5 patients with premature delivery without PRM. The results demonstrate: a highly significant correlation between the women with PRM and those who have a positive vaginal sample; a highly significant correlation between women with PRM and those who have a positive sample on the membranes; a significant correlation between women with PRM and those who have a positive sample on the placenta. The search for ureaplasma would be carried out in case of PRM. PMID- 3563284 TI - [Fetal bradycardia during pregnancy. Apropos of 2 cases without fetal distress]. AB - The authors report two cases of fetal bradycardia discovered at the beginning of the 8th month. The pregnancy history was normal. Sonography was helpful in the etiological diagnosis. It concerns a case of atrial extrasystole and another case of physiological bradycardia. The evolution was satisfactory with normal, spontaneous, vaginal delivery. During the pregnancy, the tracing combined a severe bradycardia around 80, a flat rhythm and an areactive rhythm. There was alternation with normal rhythms. The pregnancy history was reassuring. At the beginning of labor, the cardiac rhythm was normal. In the opposite case, vaginal delivery could only be advocated after determination of the capillary pH. PMID- 3563285 TI - [Profile of growth in stature and weight of Benin children, age 0-12 months, in an urban environment]. PMID- 3563286 TI - [A case of abdominal pregnancy at term with a live child]. AB - The authors report a new case of abdominal pregnancy with living baby. The analysis of this observation permits to present then the clinical and paraclinical characteristics of this exceptional localization of pregnancy and emphasize the surgical principles involved with its treatment, around the time of the term delivery. PMID- 3563287 TI - [How to improve the monitoring of anticoagulant therapy with antivitamins K. Recommendation of the Study Group on Hemostasis and Thrombosis]. AB - The study group on hemostasis and thrombosis calls the attention of the physicians to the fact that the Brussels community office has recommended the adoption of a new mode of expression of the results of the Quick time. PMID- 3563288 TI - [Histophysiology of the uterine isthmus]. AB - The uterine isthmus is morphologically defined as a topographic zone between the uterine corpus and the cervix, in very close association with the vasomusculary afferences. Architecturally isthmus corresponds to the connective-muscular function which is different by its thickness (from 2 mm to 10 mm) and by its morphology (digited, undulating sharp and regular). Histologically isthmus is made up by collagen fibers myometrial muscle cells, irregularly directed. The relationship of these two components reveal their functional synergy between the predominance of the connective tissue and the weakners of the muscle cells. The specific function of the isthmus and its autonomy depend: of the type and direction of the collagen fibers, and the quantity and arrangement the muscle cells, of the biochemical modifications and the variability of the ground substance moreover of the relations with the nervovascular endings. The isthmus incontinence is associated with these structural anomalies (muscular components, elastic fibers defects, connective tissue pathology, activity of the nerve endings, enzymatic troubles under hormonal control). PMID- 3563289 TI - [Computed tomography of uterine and ovarian cancer]. AB - The authors try to specify the place of Tomodensitometry in utero-ovarian cancers. The examination technique presents no particularities: at best, the interval and the depth of the cuts must be selected. In cervical cancers, the poor appreciation on TDM of adnexal and vaginal involvement renders this examination unsuitable for staging. On the contrary, it is absolutely necessary in order to make the diagnosis of recurrences. In cancers of the body of the uterus, almost always operated on, TDM presents very little interest for the initial work-up except for patients who are difficult to examine or are going to undergo irradiation. As for ovarian tumors, TDM may be useful to detect intra hepatic metastases before the first operation, to monitor patients undergoing chemotherapy: peritoneal carcinosis is inconstantly detected and TDM cannot replace a second look. PMID- 3563290 TI - [Pathology of breast tumors occurring before the age of 30 in Brazzaville]. AB - In 42 months, 175 patients (171 women and 4 men) were followed for mammary tumor in the Department of Medicine and Cancerology of l'Hopital General of Brazzaville. Among them, 63 files were retained for the study, corresponding to women under the age of 30. The study of these cases enabled the authors to establish the relatively important frequency of large tumors (larger than 5 cm), and the similarity of the general aspects of the pathology of mammary tumors, as compared to european studies. PMID- 3563291 TI - [Prenatal and postnatal care services in the People's Republic of Benin. Prevent or cure?]. PMID- 3563292 TI - [The cicatricial uterus and uterine dehiscence. Apropos of 20 cases]. AB - The authors intend to study 20 cases of uterine dehiscence or pre-rupture of cicatricial uterus owing to a better maternal and fetal prognosis as opposed to complete ruptures. They define the risks factors, i.e. aspects susceptible to weaken the scar, in the past history and during the pregnancy in progress. Finally, the study of semiology permits to establish the conditions of an early diagnosis of dehiscence. These results lead to insist on prevention which is based on a thorough knowledge of the past history and the obstetrical findings, the cephalo-pelvic comparison and the quality of the uterine scar. PMID- 3563293 TI - Hydrogen ion excretion and urinary concentration in the recovery phase of acute glomerulonephritis. PMID- 3563294 TI - [Post-transfusional serum haptoglobin in hematologic patients]. PMID- 3563296 TI - [Endocarditis caused by Streptococcus bovis and subjacent gastrointestinal disease]. PMID- 3563295 TI - [Alkaline reflux gastritis. Influence of vagotomy (experimental study in dogs)]. PMID- 3563297 TI - [Histochemistry of muscles in inflammatory myopathies]. PMID- 3563298 TI - [Reiter's syndrome in males and females: a case-control study]. PMID- 3563299 TI - [Systemic lupus erythematosus in males]. PMID- 3563300 TI - [Multiple myeloma--a rheumatological overview]. PMID- 3563301 TI - [Aneurysm of the pulmonary artery in Behcet's syndrome. Report of a case]. PMID- 3563302 TI - [Coexistence of rheumatoid arthritis and Reiter's syndrome: a case report and review of the literature]. PMID- 3563303 TI - [Pulse therapy in severe dermato/polymyositis with respiratory paralysis]. PMID- 3563304 TI - [Clinical and laboratory parameters in patients with systemic lupus erythematosus. Elaboration of a preliminary index of activity of the disease]. PMID- 3563305 TI - [Acute kidney failure secondary to ophidian bothropic and crotalid accidents. Analysis of 63 cases]. PMID- 3563307 TI - [Effect of subinhibitory concentrations of penicillin on antigens of group G streptococci]. PMID- 3563306 TI - [Rhabdomyolysis secondary to a crotalid bite (Crotalus durissus terrificus)]. PMID- 3563309 TI - [Longitudinal study of evoked responses (VEP, BAEP, SSEP) in multiple sclerosis]. AB - The Authors have examined 20 subjects affected by "possible" multiple sclerosis by means of a multimodal (VEP, BAEP, SEP) electrophysiologically evaluation longitudinally conducted during a time period of 1 year. The electrophysiological data obtained are related to the clinical picture, the disease's evolution, and to the adopted pharmacological therapy, in order to attempt a more precise diagnostic and prognostic assessment of these patients. PMID- 3563308 TI - [Histopathology of cutaneous leishmaniasis by Leishmania braziliensis braziliensis. 1. Histopathological patterns and study of the course of the lesions]. PMID- 3563310 TI - [Evaluation of risk factors and blood coagulation parameters in cerebral ischemia]. AB - Different parameters of coagulation and vascular risk factors have been studied in 24 subjects with previous strokes and in 21 control subjects matched by age. The two groups appeared statistically different for arterial pressure (max and min), glycemia, platelet aggregation ADP-induced and C1s-inactivator. Authors suggest to consider the changes of hemostasis as a vascular risk factor. PMID- 3563311 TI - [Bell's palsy. Longitudinal study of 120 cases]. AB - The Authors have studied 120 cases of Bell's palsy, who underwent regular controls along 360 days from the beginning of the disease. The study has been carried out by means of two different parameters of evaluation, a clinical and electrophysiological one, which allowed us to obtain very interesting results, especially as regards the prognostic aspect. PMID- 3563312 TI - [Supra- and subtentorial "hourglass" dermoid. Clinical case and review of the literature]. AB - Authors report a case of 58 year-old woman suffering from a "clepsydra" shaped dermoid tumor spreading from the middle cranial fossa to the left posterior cranial fossa. The diagnostic importance of computed cysternotomography and the minor diagnostic value of other techniques such as angiography and pneumoencephalography is emphasized. The clinical picture and the surgical procedure are discussed in relation to a review of data available in the literature. PMID- 3563313 TI - [Post-traumatic amnesia in the evaluation of minor cranial injuries]. AB - Quantitative assessment of brain damage is a primary condition for studies in neurotraumatology. Scored clinical evaluation, neurophysiological and neuroimaging techniques are usefully applied in highly disabled or comatose patients. In minor head injury (MHI), where focal neurological signs are excluded by definition, quantification of brain dysfunction is still uncertain. We compared the incidence of post-traumatic amnesia (PTA), skull fractures and altered Auditory Brainstem Responses (ABR) in 165 patients examined within 48 hours from a MHI. Skull fractures were found in 25%. They are, however, an indirect evidence of potential cerebral damage. ABR alterations, which show brainstem dysfunction, were present in 10% only. PTA exceeding 30 min occurred in 60% of MHI patients. This clinical method seems a sensitive method for assessing brain dysfunction even in MHI patients. PMID- 3563314 TI - [Further considerations on epilepsy in the follow-up of patients subjected to surgery for intracranial pathology]. AB - A retrospective study has been carried out on a pool of 210 pts. suffering from various intracranial lesions (tumours, abscesses, vascular malformations, hydrocephalus), submitted to neurosurgical operation. The main evidences of our investigation are: both early and tardive seizures are observed only related to supratentorial pathology, mainly to tumours; pts. with seizures before the operation present a major incidence of postoperative epilepsy; and pts. with early seizures have more often also late epilepsy. The Authors relate this evidence to a factor of individual predisposition; pharmacological prophylaxis can be really effective in reducing postoperative epilepsy. PMID- 3563315 TI - Invasion of the mouse eye by Onchocerca microfilariae. AB - Onchocerca cervicalis microfilariae (mf) were injected s.c. into the scalp between the eyes of CBA/H mice. Invasion was followed by slit-lamp biomicroscopy and H & E stained serial sections at varying times post infection. The first mf observed were found 24 hr p.i. on the corneal surface in tear fluid. At 48 hr mf were observed actively swimming in the anterior chamber and by 3 d in the corneal stroma. Histologically mf appeared in orbital muscle connective tissue, subcutaneously in the eyebrows at the eyelid/conjunctiva junction from 6 hr p.i. By 12 hr some mf had moved into the suprascleral muscle junctions, the sclera and into the superior corneal stroma. By 24 hr mf were present in larger numbers in all these sites. Mf were found in all eyes up to 42 d p.i. No mf were seen in any sections of the retina or optic nerve. Rabbit antiserum raised to mf, used in an avidin-biotin immunostain to check whether mf might have been hidden within the retinal nuclear layers, revealed no mf although they were plainly seen in other ocular tissues. Retinal invasion was induced by injection of mf into the lateral tail vein: serial sections revealed mf associated with blood vessels in the sclera, suprascleral muscle blocks and inner plexiform layer of the retina from 5 min p.i. PMID- 3563318 TI - The response of humans to surface and secreted antigens of Trichinella spiralis. AB - Biochemically characterised surface and secreted stage specific antigens were used to analyse the response of humans to infection with Trichinella spiralis. Immuno-coprecipitation and SDS-PAGE of labelled proteins were used to dissect the humoral response of Mexican and European infected sera to each component antigen. The results demonstrate that in man, like laboratory rodents, the response to each protein varies independently. In addition, they permit a more rational approach to the development of improved immuno-diagnostic techniques. PMID- 3563316 TI - Longevity of microfilariae following removal of the adult worms. AB - The present study was undertaken to determine the longevity of a population of microfilariae in a natural host following the removal of the adult worms without drug intervention. Four squirrel monkeys previously infected with Dipetalonema gracile were allowed to develop stable microfilaremias. All adult worms were then removed surgically from the peritoneal cavity. Weekly microfilaria counts were made on each animal and the decline in microfilariae recorded. At the time of adult worm removal, microfilaremias ranged from 750 to 12,500 mf/ml. The observed decline in microfilaria densities was gradual, but steady, in all animals. Microfilariae persisted in 1-ml blood samples for 60, 62, 91, and 101 weeks following removal of adult worms. The results indicate clearly that in a naturally produced population, in a natural definitive host, microfilariae survive for 60 to 100 weeks. The gradual decrease in microfilarial densities would appear to be the result of the death of specific batches or broods of microfilariae. The microfilariae which persisted in the blood the longest undoubtedly represent those which were produced just prior to the removal of the adult worms. It is postulated that because of the long life-span of microfilariae, female worms are not called upon to produce a continual supply of microfilariae, nor is the need for mating as frequent as might be expected. Equally important, the number of microfilariae which the host is called upon to phagocytize is considerably smaller than previously suggested. PMID- 3563317 TI - A comparison of the response of Dipetalonema viteae and Brugia pahangi adult worms to antifilarial agents in vitro. AB - The drug response of Dipetalonema viteae and B. pahangi under various culture conditions have been evaluated. B. pahangi female worms proved to be more susceptible to CGP 6140 (4-nitro-4'-(N-methyl)piperazinyl thiocarbonylido diphenylamine), CGP 20376 (N-(2-tert-butyl-5-methoxy-benzothiazol-6 yl)dithiocarbonic acid 5-(1-carboxyethyl)-ether) and amoscanate when glucose availability was restricted. This increased potency may be related to effects on glycogen metabolism by CGP 20376 and amoscanate. Using the parameters of parasite motility, survival, glucose consumption and microfilarial output, Eagles Minimum Essential Medium supplemented with 10% inactivated foetal calf serum plus either a 95% air:5% CO2 or a 95% N2:5% CO2 gas phase was shown to be highly suitable for short term maintenance (5 days). Examination of 12 drugs selected on their in vivo activity against B. pahangi and D. viteae demonstrated little difference between the drug susceptibilities of male and female worms. However, there were intrinsic differences between worm species. The relationship between these disparate susceptibilities and the reported in vivo efficacies of these drugs and the importance of selecting appropriate conditions for in vitro drug assays are discussed. Ivermectin at 10(-5) M caused a rapid flaccid paralysis and a complete suppression of microfilarial output by D. viteae. Despite continued paralysis of the worms they continued to utilise as much glucose as untreated worms over a 4 day period. PMID- 3563319 TI - Artificial feeding of west African Simulium damnosum Theobald s.l. (Diptera: Simuliidae) on man, domestic mammals and birds. AB - A population of known species composition (mainly Simulium damnosum s.s. with some S. sirbanum), was fed on chicken, guinea-fowl, rabbit, goat, sheep, and man, using simple techniques under similar conditions. Significant differences in feeding rates were found between the different host species, on different parts of the body, at times also between different individuals of the same species, and between techniques employed. On less favoured hosts wild-caught flies usually gave better results than laboratory emerged females. Taking both wild-caught and laboratory emerged flies into consideration, rabbit, man and guinea-fowl gave the best results, with the latter being particularly suitable. PMID- 3563320 TI - [Epidemiological importance of the animal reservoir of Trypanosoma brucei gambiense in the Congo. 1. Prevalence of animal trypanosomiasis in the foci of sleeping sickness]. AB - Parasitological and serological tests were performed in 1287 domestic animals originating from the Brazzaville area and three sleeping sickness foci in Congo. Nannomonas and Trypanozoon were the only sub-genera present in the blood of animals, with prevalences of 16.9% and 0.5%, respectively. The use of Testryp CATT allowed a better estimation of the real frequency of animal trypanosomiasis which in some foci, was found to be three times higher than the parasitological prevalence. Seven stocks of Trypanozoon were isolated from pigs and sheep. A biochemical analysis indicated that they belonged to the T.b. gambiense sub species. However, considering the low prevalence of T.b. gambiense infections in animals, it is doubtful that this reservoir plays an important epidemiological role. PMID- 3563321 TI - Cutaneous leishmaniasis in Ethiopia: I. Lymphocyte transformation and antibody titre. AB - The Ethiopian cutaneous leishmaniasis (ECL) caused by Leishmania aethiopica manifests itself in two different forms: The self-healing localized form (LCL) and the non-self-healing diffuse cutaneous leishmaniasis (DCL). In patients suffering from these two forms of ECL, the Leishmania antigen induced in-vitro lymphocyte response and the Leishmania specific antibody titres were investigated. Whole promastigotes and a soluble fraction thereof were used as antigens and antibody titres were determined by a newly developed enzyme immunosorbent assay (ELISA). Mononuclear cells from the majority of patients but not from healthy donors proliferated in response to soluble Leishmania antigen. In contrast, whole promastigotes induced a proliferation in both patients and controls. Only DCL-cases failed to proliferate in response to both leishmanial antigens. On the average, sera from DCL-patients contained higher titres of Leishmania specific antibodies than those from LCL-patients. One practical implication of these results is that lymphocyte proliferation in combination with specific antibody titre can be used as a reliable diagnostic tool in ECL. PMID- 3563323 TI - Teratogenic effects in mice exposed to single dose of X-rays and prolonged administration of caffeine during pregnancy. PMID- 3563322 TI - The agglutination of erythrocytes and Leishmania parasites by sandfly gut extracts: evidence for lectin activity. AB - Lysates of heads, hind- and midguts of male and female Phlebotomus papatasi were found to contain lectins or lectin-like molecules capable of agglutinating human red blood cell types of the ABO(H) system and promastigotes of Leishmania aethiopica, L. major and L. donovani but not L. hertigi hertigi promastigotes or Crithidia fasciculata choanomastigotes. The agglutination of erythrocytes from the human O Rhesus positive blood group by sandfly midgut extracts was inhibited by two disaccharides; trehalose and turanose. This is the first report of haemagglutinating and parasite agglutinating activity in sandflies (Psychodidae). PMID- 3563324 TI - [Sister chromatid exchange in human cells in vitro after exposure to lead chloride and ethyl alcohol and its metabolites]. PMID- 3563325 TI - [Nutrition of elderly persons in social welfare homes]. PMID- 3563326 TI - [Selection of methods of determining vitamin D levels in krill and its products]. PMID- 3563327 TI - [Effect of atmospheric pollution from steel plant emissions and the electric power plant "Stalowa Wola" on the levels of various metals in rain water]. PMID- 3563329 TI - [Preliminary studies on the growth and survival of selected pathogenetic dermatophytes in bottom sediments and sewage sludge]. PMID- 3563328 TI - [Boron in surface waters of various rivers and lakes in the Western Pomerania]. PMID- 3563330 TI - [Effect of new analogs of chitin synthesis inhibitors on the development of houseflies Musca domestica L]. PMID- 3563331 TI - [Determining formaldehyde level in shampoos, bath liquids and various household preparations]. PMID- 3563332 TI - [Differences in body height and body mass of schoolchildren from villages in various regions of the country]. PMID- 3563333 TI - [Transcatheter embolization of kidney tumors]. AB - Artificial embolisation of the renal artery or its branches was performed in 48 patients with renal carcinoma. Occlusion was effected by using Gelaspon or Ivalon sponges, metal spirals or a combination of both. This surgical intervention created favourable conditions for surgery. In about 80% of the patients pain occurred after embolisation, whereas more than half of them had fever or subfebrile temperatures. The use of Gelaspon sponge is recommended as the simplest and cheapest method of preoperative embolisation. To cut short the unpleasant effects of the postembolisation syndrome it appears to be best to operate 24 hours after embolisation. PMID- 3563335 TI - Problematic diagnosis of bronchial foreign bodies in children. AB - Bronchial foreign bodies by children are dangerous and require immediate therapeutic measures. Findings and significance of chest film in the diagnosis of bronchial foreign bodies in 24 children were analysed. All patients were symptomatic. 18 patients had an abnormal and 6 normal auscultation finding. In three cases the physician did not suspect aspiration, and the diagnosis was delayed, which caused the death of one child. Roentgenpositive foreign bodies were found in 8 and -negative in 16 cases. Secondary changes (obstructive emphysema, atelectasis, pneumonia) were seen in 16 cases. In emergency cases the chest films were analysed by physician and later by a radiologist, who found 88% of them to be abnormal. Fluoroscopy of expiratory chest film helps to detect the unilateral emphysema more distinctly. The diagnosis must always be confirmed with bronchoscopy and extraction thereby is the adequate treatment of bronchial bodies. PMID- 3563334 TI - [Simulation of vena cava thrombosis of the epigastrium following contrast medium bolus--stratification and jet phenomenon in the inferior vena cava following passage of a contrast medium bolus]. AB - Differences in the inflow pattern between the right and left renal vein seen in bolus contrast medium application can simulate vena cava thrombosis. PMID- 3563336 TI - Arteria lusoria. AB - Although variation in number and arrangement of the great vessels of the aortic arch are not rare, there are, nevertheless only a few developmental disorders which are of clinical significance. In this latter group, the arteria lusoria is an interesting variation from the radiologists' point of view. The aberrant right subclavian artery (a.r.s.a.) arises on the left side of the midline as the 4th branch of the aortic arch. From the aorta it runs behind the esophagus to reach the right upper extremity. Crossing the mediastinum obliquely, it makes an indentation on the posterior wall of the esophagus and may cause difficulty in swallowing, or, in childhood when the tracheal wall is less rigid, respiratory symptoms can develop. The radial pulse may be weaker on the right arm. PMID- 3563337 TI - [Roentgenologic diagnosis and differential diagnosis of carcinomatous lymphangiosis of the lungs]. AB - Generalised lymphatic carcinosis, also known as lymphangitis carcinomatosa, cannot be diagnosed by just one x-ray film of the thoracic organs. However, if an enhanced reticular striated pattern is seen, possibly associated with miliar stippling or hilar masses it is recommended to perform short-term follow-ups and comparisons with previous x-ray films. Lymphangitis carcinomatosa becomes probable if rapid progression of the findings or development of new lesions is seen besides the already existing ones and if this is associated with rapidly increasing dyspnoea. Pulmonary tomography will not yield highly significant results, but it can substantiate the diagnosis, the same applies to computed tomography of the thorax. CT is particularly important in differential diagnosis. Earliest possible diagnosis of lymphangitis carcinomatosa is of great importance for therapy, since it may be a first pointer towards an unknown metastasising primary tumor or haematogenous dissemination of already known tumours. PMID- 3563338 TI - [Normal cerebral circulation]. PMID- 3563339 TI - [Chronic arterial hypertension and cerebral ischemic complications]. PMID- 3563340 TI - [Role of spasm in cerebral circulatory pathology]. PMID- 3563341 TI - [Local circulatory phenomena in cerebral ischemia]. PMID- 3563343 TI - [Radiological studies of cerebral circulation]. PMID- 3563342 TI - [Physiopathology of cerebral hemorrhages]. PMID- 3563344 TI - [Sexually transmitted diseases. Epidemiological and socioeconomic considerations]. PMID- 3563345 TI - [Sexually transmitted diseases in the male homosexual]. PMID- 3563346 TI - [Chlamydial infections]. PMID- 3563347 TI - [Gonococcal infections]. PMID- 3563348 TI - [Management of male urethritis]. PMID- 3563349 TI - [Management of acute genital infection in the female]. PMID- 3563350 TI - [Recent syphilis to-day]. PMID- 3563351 TI - [Joint management of pregnancy at risk by the general practitioner and obstetrician]. PMID- 3563352 TI - [The death of the fetus in utero]. PMID- 3563353 TI - [Pregnancy involving a fatal risk for the mother]. PMID- 3563354 TI - [Viral and parasitic infections and pregnancy]. PMID- 3563355 TI - [Work and pregnancy]. PMID- 3563356 TI - [Pregnancy over the age of 40 is no longer a high-risk pregnancy]. PMID- 3563357 TI - Correction by propranolol of the abnormal catecholamine response to photostimulation of hypertensives with or without cerebral hemorrhage. PMID- 3563358 TI - Neuroradiological diagnosis of low-grade supratentorial gliomas. PMID- 3563359 TI - Habituation of orienting reaction in patients with multiple sclerosis. PMID- 3563360 TI - A brief inventory for assessing personality traits and disorders in children aged 8-11. PMID- 3563361 TI - [Occult fractures of the sacrum in aged osteoporotic patients]. AB - We are reporting 4 cases of unnoticed sacral fractures in osteoporotic women. Their mean age was 73 years. Only in one case the fracture was seen on a standard X-Ray. On the other hand, hyperfixation with isotopes on the sacrum formed a very characteristic H-shaped image. In two of these patients, the sacral fracture was confirmed by tomodensitometry, but this examination was unavailing in the third patient. In the 4th case, hyperfixation of the isotope was not significant. Only a guided bone biopsy and the favorable evolution of the disease enabled the diagnosis of sacral fracture. PMID- 3563362 TI - [Results of autopsy examination of knee cartilage in 120 patients dying in the hospital. I. Femoro-patellar joint]. AB - The authors have performed the pathological examination of the knees of 57 women and 63 men or 112 patients over the age of 50, who died in the hospital. The lesions of the patellar and trochlear cartilages were studied and classified according to four categories: stage I: non extended fissures; stage II: fissures extending over 25 p. cent of the articular surface; stage III: fissures associated with small deep ulcerations of the cartilage; stage IV: deeps and extended ulcerations of the articular cartilage exposing the sub-chondral bone. Cartilage alterations were found in 93.3 p. cent of the patellas; 26.2 p. cent of stage I; 22.5 p. cent of stage II, 27.1 p. cent of stage III; 17.5 p. cent of stage IV. These alterations are bilateral and symmetrical, most of the time. Their frequency and severity increase with age. Thus, deep and extended ulcerations (stage IV) of the patellar cartilage have a frequency of 1.9 p. cent before the age of 60.8 p. cent between 60 and 70 years, 13.6 p. cent between 70 and 80 years and 38.9 p. cent after 80 years. Alterations of the patellar cartilage are more frequent and more severe in women than in men. In 85.7 of the patellas they occupy both facets, overriding the patellar crest; more seldom, they are exclusively localized to the medial patellar facet (11.6 p. cent) or lateral facet (3.1 p. cent). Alterations of the trochlear cartilage, although more common are less frequent than that of the patellar cartilages. Patellar osteophytosis is very frequent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563363 TI - [Evaluation by biphotonic absorptiometry of bone mineral content and determination of the fracture threshold in a population of patients 60 to 75 years old]. AB - A measurement of the bony density of vertebrae and femur was carried out, in the course of a prospective study, in 99 patients between the ages of 60 and 75 years, living in northern France. 76 patients had no recognized problem of demineralization and 23 others were consulting for an evaluation of vertebral compression. The measurement of the bony density was done by biphotonic absorptiometry with a source of labelled Gadolinium. In women, a significant difference in the values obtained by absorptiometry in terms of the existence of vertebral compressions, symptomatic or not, is noted. A statistical study using the ROC curves method (Receiver Operating System) has enabled us to determine a threshold of high risk of vertebral fracture measured at 31 g or 0.85 g/cm2 in women, and 35 g or 0.85 g/cm2 in men. In addition, there is a significant correlation with the vertebral radiographical index as defined by Meunier. Among the various factors of influence which were studied, only the size and the morphotype seem to play an essential role in our study group. The comparative study of the densities measured in the femoral neck and the lumbar spine enabled us to find a very significant correlation in patients with as well as without compression (r = 0.714, p less than 0.001). Biphotonic absorptiometry proves therefore to be a method which may be used to define a group with a high fracture risk permitting to determine, as early as possible, therapeutic, curative and preventive measures. PMID- 3563364 TI - [Rheumatoid factors. Isotypes and severity of rheumatoid polyarthritis]. AB - The immuno-enzymatic method permits the separate study of rheumatoid factors (RF): IgM as well as IgG, IgA, IgE, IgD. In 43 patients with rheumatoid polyarthritis (RP), classic or definite, we have studied the correlations between the various parameters of articular and extraarticular activity of RP and the levels of each isotype of RF. A statistically significant correlation of the articular activity was found with RF IgG (p less than 0.01), RF IgA (p less than 0.01). As compared to RP without rheumatoid nodule, RPs with rheumatoid nodules presented a level of RF IgM (p less than 0.05), RF IgG, IgA, IgE (p less than 0.01) which was statistically higher; a statistically significant correlation was found between haptoglobin levels and those of RF IgG (p less than 0.01). A negative correlation, statistically significant, was found between CH 50 and the levels of RF IgM. This study confirms previous studies which were carried out with an immuno-enzymatic method of detection of RF isotypes. PMID- 3563366 TI - [Arthritis of the knee caused by Mycobacterium terrae]. PMID- 3563365 TI - [Fiessinger-Leroy-Reiter syndrome in Greenland. Clinical and epidemiological aspects]. AB - A clinical and epidemiological study of the Fiessinger Leroy Reiter syndrome was undertaken in Inuits from four Greenland cities, because of the frequency of HLA B27 antigen and venereal diseases in this population. A mean prevalence of 0.67 p. cent was found in Inuits from the west coast, of which 27.5 p. cent are carriers of the HLA B27 antigen. In Amassalik, on Greenland's east coast, where the frequency of B27 was estimated at 6.5 p. cent, the prevalence of the syndrome is 0.32 p. cent. Immunogenetic and preliminary familial data show that HLA B27 is present in 87.5 p. cent of the patients and that 34 p. cent have a close relative with the disease. Clinical data are comparable to those reported in the literature. Evolution is marred by frequent recurrences: 85 p. cent of the patients followed for more than ten (10) years present at least one recurrence. The total frequency of ankylosing spondylarthritis is 16.7 p. cent. It increases, in retrospect, to reach 45 p. cent in 22 patients followed for more than 15 years. PMID- 3563367 TI - [Bone isotope hypofixation in algodystrophy in children]. PMID- 3563368 TI - [Diagnosis and treatment of Borrelia burgdorferi infections in France. Apropos of 3 cases of Lyme disease of neurological form]. PMID- 3563369 TI - [Anaerobic cervical pyomyositis. Case report and review of the literature]. PMID- 3563370 TI - [Clinical tolerance of calcitonin as a function of the mode of administration. Value of non-injectable forms]. PMID- 3563371 TI - [Rheumatoid synovial cyst of the hip. Apropos of a case]. PMID- 3563372 TI - [Horton's disease and rhizomelic pseudopolyarthritis. Developmental data apropos of 95 cases]. AB - The many common factors linking rhizomelic pseudopolyarthritis and Horton's disease prompt to compare their respective evolutions and the long-term results of their treatments. The comparative study of 28 patients with temporal Horton's arteritis, proven histologically, and 28 rhizomelic pseudopolyarthritis without arteritis on biopsy, in a total population of 95 patients, confirms the similarity of their clinical and biological signs and show a closely related evolution in the three groups. The evolution leads to a cure approximately 16.4 +/- 14 months in 41 p. cent of the cases. 34 p. cent of the patients are at an advanced stage with a mean follow-up of 37 months and relapses during the weaning period were frequent. 25 p. cent of the patients died. Most deaths occur in the first month of the disease, and occur readily in patients who have received a short treatment with steroids discontinued because of a iatrogenic accident. Cerebral vascular accidents and coronary accidents, arterial hypertension and iatrogenic gastro-intestinal ulcerations are the most frequent complications. PMID- 3563373 TI - [Allergic angiitis and algodystrophy. The white hand phenomenon]. PMID- 3563374 TI - [Bacterial endocarditis caused by Streptococcus viridans disclosed by sacroiliitis]. PMID- 3563375 TI - [Muckle-Wells syndrome or association of joint pain attacks, urticarial outbreaks and sensory deafness?]. AB - The Muckle and Well's syndrome corresponding to a transmission of the autosomic dominant type, combines bouts of urticaria, episodes of arthralgias to a shrinking of the ear and a sensory deafness. Sometimes, it evolves into a renal amylosis. Sometimes, as the case presented here, it combines multiple malformations. Its place in nosology is imprecise. It is, at the same time, close to systemic urticaria, sensory deafness, amylosis and specially amylosis of the periodic disease. But the common link between the various elements of the syndrome remains undetermined, for the time being. PMID- 3563376 TI - [Papular mucinosis. Associated dermatologic and dysimmune aspects]. AB - Papular mucinosis (PM) is an overload disease mostly made of proteoglycans, essentially cutaneous and accompanied with a monoclonal gammapathy. In addition to the cutaneous lesions, vascular and neurological manifestations may be responsible for severe complications. The gammapathy, most often benign, does not seem always correlated with the skin involvement. We report the case of a patient with mucinosis associated with a rheumatoid polyarthritis, then with a systemic necrotizing angiitis. A review of the literature has enabled us to notice the frequency with which PM is accompanied with dysimmune diseases, especially lupus. PMID- 3563377 TI - [Multicentric reticulohistiocytosis. A case with unusual clinical, radiologic and ultrastructural aspects]. AB - We are reporting a case of multicentric reticulo-histiocytosis which is exceptional because of its gravity and the diversity of the clinical lesions: huge subcutaneous nodules, bone destruction in the spine responsible for spondylolisthesis, pulmonary fibrosis, acute pericarditis, laryngeal compression requiring a permanent tracheostomy. From ultrastructural observations, various hypotheses to explain the intra-macrophagic accumulation of membrane granules and lipids are discussed. PMID- 3563378 TI - [Fasciitis and Shulman's syndrome. A nosologic discussion]. AB - Eosinophilic fasciitis or Shulman's syndrome is linked to scleroderma, systemic sclerodermia as various types of localized sclerodermia, by a nosological relationship analyzed by the authors. But, excluding the one concerning eosinophilic fasciitis and deep morphea, the authors seem to believe that the current differences are still justified, since the clinical picture and the levels of the histological lesions vary from one entity to the other. The nosological debate concerning eosinophilic fasciitis demonstrates also that a histologically recognized fasciitis has no complete specificity. By far, it goes beyond sclerodermia. Inflammation of the fascia is possible in the course of disseminated lupus erythematosus and other connective tissue inflammations. It is also described beyond connective tissue inflammations during rhizomelic pseudo polyarthritis, and mostly in the course of three diseases: Texier's disease, drepanocytosis, and the spanish toxic syndrome, where it may be associated to a hypereosinophilia. PMID- 3563379 TI - [Pancreatic cytosteatonecrosis]. AB - If cutaneous panniculitis, made of dermo-hypodermic nodules, is the most constant manifestation of pancreatic cytosteatonecrosis, articular and bony localizations are quite frequent and sometimes the first manifestation of the disease. Articular lesions: monoarthritis, oligo-arthritis and mostly polyarthritis, often assume a very inflammatory picture; the synovial fluid is oily or puriform, and has a high content of polynuclear cells or macrophages with a foamy cytoplasm, lipid droplets, triglycerides, non-esterified fatty acids, and pancreatic enzymes; the most typical synovial lesion is a cytosteatonecrosis with adipocytes showing a huge lipidic vacuole. The bony lesions are mostly osteolytic, microgeodic lesions, or more extended ones, pseudo-tumoral without soft tissue invasion: more rarely, there is a periosteal thickening, bony infarctions, or epiphyseal osteonecrosis; these lesions do not always demonstrate a hyperfixation on scintigrams. The physiopathology of these various lesions is usually linked to a diffusion of pancreatic lipases, but other enzymes or enzymatic inhibitors also intervene, as well as a cytotoxic and local inflammatory activity of the fatty acids themselves. Surgical treatment of the pancreatic lesions, when possible, is the only treatment that is truly effective. PMID- 3563380 TI - [Behcet's disease with myositis]. PMID- 3563381 TI - [Changes in urinary serotonin in subjects treated with calcitonin]. AB - In a first stage, the authors have evaluated the relationship between plasma calcitonin and urinary serotonin in patients presenting a chronic pathology, mostly of respiratory nature. The results have demonstrated that plasma calcitonin and urinary elimination of serotonin were increased (p less than 0.05) in patients presenting a chronic pathology, compared to 16 healthy patients of the same age and sex. In a second stage, the authors have evaluated the variations of urinary serotonin 24 hours after injection of 100 U MRC of calcitonin from salmon, in the same patients. The results showed (p less than 0.001) an increase of urinary serotonin at 24 hours. This increase is not observed after injection of eel or human calcitonin. The effect of the various calcitonin on serotonin metabolism is discussed. PMID- 3563382 TI - [The bone in non-corticoid-treated sarcoidosis. A histomorphometric study]. AB - The sarcoidosis granuloma secretes 1-25 dihydroxyvitamin D (1-25(OH)2 D) at the origin of the hypercalcemia found in about 20 p. cent of sarcoidoses. Its mechanism was considered exclusively of a digestive nature, but the activity of osteoclastic stimulation of 1-25(OH)2 D must consider an associated bony origin. Nine patients with bouts of non-steroid sarcoidosis were studied by osseous histomorphometric analysis. In a patient with hypercalcemia and radiographic manifestations, a high degree of bone remodelling is demonstrated, with stimulation of osteoclastic and osteoblastic activity. In eight patients with normocalcemia, two subgroups are individualized: two patients present intramedullary sarcoidosis granulomas with increased contact resorption; six patients present a normal marrow: the total areas of resorption remain increased. It is concluded that the activity of osteoclastic resorption is increased in sarcoidosis, which may explain partially the hypercalcemia. The absence of titration of 1-25(OH)2 D in our study does not permit to precise the role of this enzyme in the genesis of hyperosteoclastosis, although this seems quite plausible. PMID- 3563383 TI - [Serum concentrations of 1,25-dihydroxyvitamin D in cases of osteomalacia, parathyroid dysfunction and idiopathic hypercalciuria]. AB - 1,25 dihydroxyvitamin D (1,25(OH)2 D) is the active metabolite of vitamin D and has an essential role in bony metabolism on the regulation of the calcium phosphorus balance. The circulating level of 1,2(OH)2 D is normally between 25 and 45 pg/ml. Isolation of the fraction to be titrated requires sophisticated purification techniques using high performance chromatography (HPLC). In osteomalacia secondary to a deficiency the mean level of 1,25(OH)2 D is low (14.1 +/- 6.9 pg/ml) because of substratum deficiency. Administration of vitamin D supplements is quickly followed by a supraphysiological increase of the level of active metabolite. The role of the parathyroid hormone on the activity of 1 hydroxylase is illustrated by the results of the titration in parathyroid dysfunctions: decrease of the mean level in hypoparathyroidism (18 +/- 6.9 pg/ml), and on the contrary, a significant increase in hyperparathyroidism (56.6 +/- 15.4 pg/ml) despite of a spread of the individual values. In 18 cases of idiopathic hypercalciuria, we have only observed an increase of 1,25(OH)2 D level, in two cases. Titration of 1,25(OH)2 D complements the calcium-phosphorus evaluation to precise the physiopathogenic mechanism of the disorders observed in various diseases. Its interpretation requires the joint measurement of the substratum level, 25-hydroxyvitamin D, and the evaluation of the parathyroid function. PMID- 3563384 TI - [Cutaneous necrotizing angiitis]. AB - The term necrotizing angiitis signifies a histological lesion combining an inflammatory infiltration rich in pycnotic polynuclear cells to fibrinoid deposits of the vessels wall and/or of the near by collagen. This type of lesions may affect vessels of small caliber or vessels with a muscular wall (arterioles). In the skin, with the term necrotizing angiitis, is implied a lesion affecting the small vessels of the dermis, capillaries and mostly post-capillary venules. The most frequent, by far, clinical manifestation is a palpable purpura; more seldom, it may be lesions of urticaria, livedo or necrotic lesions. these cutaneous necrotizing angiitis may represent alone the entire symptomatology; they may be associated with varied deep localizations of the same type and finally combine with or precede diseases perfectly defined in other respects, especially collagen diseases. Thus, the term necrotizing angiitis refer to a multitude of entities, syndromes which it is only possible to regroup with many clinical, immuno-pathological, etiological and biological data, each of these data alone being an insufficient reference to characterize them. PMID- 3563385 TI - [Articular manifestations of Behcet's disease. Apropos of 65 cases]. AB - The authors, in a series of 65 cases of Behcet's disease, notice 53% of rheumatological manifestations which are third in line after aphthosis and ocular disease. In order of decreasing frequency, it concerns arthritis (mono, oligo or poly-arthritis), arthralgias with an almost identical frequency, sacroiliitis, extraarticular involvement. These rheumatological manifestations are readily associated with necrotic pseudo-folliculitis and cutaneous aphthosis. PMID- 3563387 TI - [Epidemiologic analysis of mortality trends in cancer of the pancreas]. PMID- 3563388 TI - [Case material generated at an outpatient ophthalmology service]. PMID- 3563386 TI - [Lyme arthritis]. AB - Infection by spirochete Borrelia burgdorferi is mainly observed in the United States where it has taken the name of Lyme's disease, and in Europe. Its evolution may be very extended, in several phases. A few weeks after a tick-bite, the primary lesion appears, which is a chronic migrating erythema. In the following weeks or months, in the secondary phase, nerve lesions may appear, quite similar in Europe and in the United States, and cardiac lesions, mostly seen in the United States. In the following weeks, months, or years, during the tertiary phase, articular lesions may appear, frequent in the United States, much more unusual in Europe. Several years later, chronic lesions of the central nervous system may appear, described in the United States, and chronic skin lesions such as chronic atrophying acrodermatitis sometimes associated with destructive lesions of the joints underlying the skin lesion, which are only recognized in Europe. The discovery of the spirochete in a small number of these lesions, including the latest in the evolution, permits to think that, throughout this evolution, this disease is secondary to the persistence of the germ within the body; this explains the efficacy of the penicillin treatment, including in the oldest forms of the disease. Serology is quite reliable; but it becomes positive only 2 to 4 weeks after the onset of the chronic migrating erythema: needless to say the importance of this single cutaneous lesion which enables to make the diagnosis and requires the use of a tetracycline or penicillin treatment. PMID- 3563389 TI - [Program against endemic goiter in Extremadura. I. Iodine concentration in the public water supply]. PMID- 3563390 TI - [Health for all. An experience in the Canary Islands in health education as an instrument for community participation]. PMID- 3563391 TI - [Epidemiologic study of brucellosis in Cuenca Province]. PMID- 3563392 TI - [576 cases of infantile meningitis]. PMID- 3563393 TI - [Urinary infections in pediatric]. PMID- 3563394 TI - [Antimicrobial therapy in pregnancy]. PMID- 3563395 TI - Effects of presbycusis and other types of hearing loss on auditory brainstem responses. AB - Auditory brainstem responses were studied in 373 healthy individuals of various ages and with sensorineural hearing loss of differing degrees. 209 subjects were elderly and had a hearing loss which included a component of presbycusis. The remainder were young or middle-aged with cochlear hearing loss. Altogether 606 ears were tested. The old individuals had generally longer ABR wave latencies than the young subjects. The I-V interpeak latency (IPL) was also prolonged in the older age groups compared with the group of younger individuals, except for subjects with pronounced hearing loss. The results of the study indicate that an age-related dysfunction of the auditory pathway in the brainstem can be present in presbycusis. PMID- 3563396 TI - Normative multifrequency tympanometric data on otosclerosis. AB - Acoustic resistance, reactance and phase angle were assessed for the two probe tone frequencies (220 and 660 Hz) on 29 otosclerotic middle-ear systems under accurately defined experimental conditions. Only otosclerotics with normal tympanic membranes were accepted in this statistical survey. The main purpose of these measurements was to provide numerical data for middle-ear modelling. If nevertheless a diagnostic parameter is sought from these data, the immittance values can be compared with data obtained on 30 normals under identical experimental conditions. The phase angle at 660 Hz seems the best choice, but the discrimination power is still poor. PMID- 3563397 TI - A new baby-alarm based on tenseness of the cry signal. AB - Present-day conventional baby-alarms for hearing-impaired parents do not convey information about how the baby is feeling (happy, crying, or distressed). Consequently, the parent is forced to go to the baby to weigh up the situation visually. A new baby-alarm, FreDe 85, which determines the tenseness of the cry signal, has been tested by 10 deaf families with babies in the age range 3 to 21 months. The test families compared the illuminated pictures on the panel of the baby-alarm with the baby's situation. The parents could observe significantly different distributions of illuminated pictures in the three situations. Some families living in multi-storey flats experienced false alarms in the night, indicating the need to place the microphone closer to the baby. PMID- 3563398 TI - The use of a temporary extracochlear electrode in preoperative testing of permanent implant candidates. AB - This paper describes hearing and speech perception in 9 post-lingually deaf adults fitted with a temporary single electrode, surgically positioned close to the round window niche. After baseline testing, unaided and aided binaurally with the high-power Phonic Ear PE 845, each subject was admitted to hospital for a period of 7 days. During each test session, stimuli were presented directly to the electrode lead by means of an isolation unit. Current thresholds, upper tolerable limits and gap detection were measured for various acoustical waveforms and stimulus frequencies. A laryngograph was used to test the discrimination of prelinguistic and suprasegmental speech features. The results indicated that the prosthesis could provide acoustic sensations of loudness, pitch and duration that changed with stimulus waveform, level of current and frequency, and a gap threshold less than 50 msec. Lipreading appeared to be a necessary adjunct for consonant discrimination. PMID- 3563399 TI - Effects of signal duration on the 500-Hz masking-level difference. AB - Two experiments were conducted to study the masking-level difference (SoNo-S pi No thresholds) for 2-128-ms, 500-Hz tones in 32-dB pressure-spectrum level, continuous broadband noise. In Experiment 1 (N = 8) the Bekesy tracking procedure was used, whereas in Experiment 2 (N = 3) an adaptive, two-interval forced-choice (2IFC) psychophysical procedure was used. The data from both experiments indicated that as the signal duration was shortened from greater than or equal to 100 to approximately 10 ms the SoNo and S pi No threshold integration functions diverged, thereby producing an increase in the masking-level difference. For signal durations less than 10 ms, however, the SoNo and S pi No threshold functions converged and the masking-level difference decreased. In Experiment 2, the mean masking-level difference decreased significantly by 1.7 dB as the signal duration was shortened from 10 to 2 ms. This new finding, which was not anticipated, has recently been confirmed in another laboratory (Cokely & Hall, 1985). PMID- 3563400 TI - Hearing damage in military service. A study on 38,294 conscripts. AB - In an audiometric study on 38,294 conscripts, noise-induced high-frequency hearing deterioration during basic training (mean 245 days) was studied. On reporting for training, 29% were found to have hearing defects, predominantly in the high-frequency area. After training, high-frequency deterioration, predominantly unilateral or asymmetrical, was found in 5%. In 0.5%, this deterioration had reached a symptomatic level, causing minor handicap. In 0.03% (12 conscripts), it fulfilled the criterion of "10% hearing disability" applied in Swedish industrial insurance. The incidence of high-frequency deterioration rose from 3% in conscripts having 'normal' hearing on reporting, to 17% among those with the greatest hearing loss on reporting. This means that the presence of sensorineural hearing loss implies an increased risk of noise-induced hearing deterioration. No correlation was found between hearing status on reporting and magnitude of deterioration during training. The results imply that hearing data obtained on reporting for training should be taken into account in deciding the assignability of conscripts to noisy training courses and posts. PMID- 3563401 TI - Hearing thresholds as predictors of speech production performance. AB - A study was made of the relationship between pure-tone thresholds (500, 1000, and 2000 Hz) and teacher-rated speech production performance (SPP) of 214 students with hearing losses of 56 dB or greater in three different types of educational setting in Israel. Correlation coefficients of speech production performance (SPP) with the thresholds at 2000 Hz were found to be higher than with the other threshold measures, 500 and 1000 Hz, and vs. the better ear average. Similar results were found within each of the three educational settings and when multiple regression analyses were performed. It was concluded that hearing threshold at 2000 Hz was the best predictor of SPP. These results are discussed in the light of previous studies and suggestions for further research are made. PMID- 3563402 TI - Development of hearing loss during long-term exposure to occupational noise. A 20 year follow-up study. AB - Occupational noise-induced hearing loss is still responsible for the majority of occupational ailments and injuries, with very large sums being paid in compensation. Repeated hearing tests over a 20-year period have been performed on 319 employees of a timber processing firm, working in sawmills and paper pulp production, exposed to mean noise levels of around 95-100 dB (A) and in a chemicals division with mean noise exposure levels of 80-90 dB (A). During the observation period, mean hearing levels deteriorated slowly, especially at 4 kHz, but no dramatic changes from one year to another were seen. We therefore propose 3-year intervals between regular hearing tests in this type of industry where noise exposure is predominantly of the continuous type, thus releasing resources for more active measures against noise-induced hearing loss. Cases of manifest hearing loss or otherwise at risk must of course be followed up at shorter intervals. A remarkably large proportion of the employees in the chemicals division suffered a hearing loss corresponding to 10% disablement according to Swedish criteria, which raises the question of a possible relation between exposure to industrial solvents and hearing loss. PMID- 3563403 TI - In vitro tetraploidy in patients with non-hereditary colorectal adenoma and carcinoma. Support for a genetic influence on the pathogenesis of colorectal carcinoma. AB - One hundred and seventy-two patients (76 patients with colorectal cancer, 46 with adenoma of the colon or rectum, and 50 controls) were investigated for in vitro tetraploidy in dermal fibroblast monolayer cultures. The incidence of increased in vitro tetraploidy (IVT) among patients with adenoma or carcinoma was significantly different from that of controls. There was no difference in the incidence of IVT between the adenoma patients and those with colorectal cancer. IVT was investigated among different subgroups of adenoma and colorectal cancer patients and was only found to be related to an inherited tendency to colorectal cancer. PMID- 3563404 TI - Metronidazole pharmacokinetics in patients with hepatic encephalopathy. AB - The pharmacokinetics of metronidazole and its major metabolites was investigated in eight patients with liver cirrhosis and coma of grade 2 to 4 and in eight healthy controls. In the coma patients the systemic clearance of metronidazole was reduced (29 +/- 10 versus 83 +/- 14 ml/min, mean +/- SD; p less than 0.001) and the elimination half-life prolonged (20 +/- 9 versus 7.3 +/- 0.9 h; p less than 0.001), whereas the volume of distribution at steady state was unchanged (44 +/- 9 versus 48 +/- 7 l) as compared with the healthy controls. Investigation of the major elimination pathways of metronidazole showed that the decreased rate of elimination in the patients was mainly due to impaired hepatic drug oxidation. In four patients therapeutic plasma concentrations were achieved during 6 days' treatment with 500 mg metronidazole per 24 or 48 h. PMID- 3563405 TI - Tumour site: a prognostic factor in colorectal cancer? A multivariate analysis. AB - Data from 753 patients with single adenocarcinomas of the large intestine diagnosed and treated at Trondheim Regional and University Hospital between 1964 and 1978 were studied to determine the influence of tumour site on survival by adjusting for tumour stage, age, and sex. The Cox regression model was used. Although the clinicopathologic stage had the strongest association with prognosis, the tumour site independently influenced the mortality, which increased from the right colon via the transverse/left part of the colon to the rectum. PMID- 3563406 TI - Relationship between tobacco smoking and colorectal polyps. AB - A prospective endoscopic screening examination of a randomized population sample of 200 men and 200 women, aged 50-59 years, enabled the differentiation between individuals with and without polyps in the rectum and sigmoid colon. Both number of years of smoking and percentage years of life with smoking were associated with the presence of adenomas and hyperplastic polyps, both for men and women. No relationship was found between these factors or the daily number of cigarettes and the degree of dysplasia or the size or multiplicity of polyps. Two years' follow-up examination showed a tendency to fewer new polyps among male ex-smokers compared with smokers; however, the difference was not quite significant. No significant difference was found when comparing smokers with never smokers. In the relatively smaller groups of women no significant difference with regard to number of polyps was found among smokers, ex-smokers, and never smokers. The results provide evidence for an association between smoking and colorectal neoplasia and may suggest an initiating effect of smoking on carcinogenesis in the colon and rectum. PMID- 3563407 TI - Peptic ulcer and cancer: an examination of the relationship between chronic peptic ulcer and gastric carcinoma. AB - The relationship between peptic ulceration and gastric carcinoma has been examined using data from two large autopsy surveys. The first consisted of over 13,000 autopsies performed in a single hospital over a 20-year period and analysed retrospectively; the second was a prospective series of over 7000 autopsies carried out at 17 centres during a single year. In both, a lower than expected occurrence of coexistent gastric cancer was found in subjects with pathologic evidence of active or past gastric and duodenal ulceration. A statistical association between chronic gastric ulcer and lung cancer was noted. This study has failed to identify an increased risk of gastric carcinoma in patients with chronic gastric ulcer. PMID- 3563408 TI - Sucrase deficiency in Greenland. Incidence and genetic aspects. AB - The disaccharidase activities in small-intestinal surgical biopsy specimens from 97 Greenlanders were investigated. Five of the patients, or 5%, had sucrase deficiency. The diagnosis, sucrose malabsorption, was established by sucrose tolerance tests. In all parts of the world other than the arctic regions sucrase deficiency is a rare condition. The patients were divided into three separate groups in accordance with their sucrase activity. The middle group was considered to be heterozygote carriers of the sucrase-deficient gene. The number of people in the group corresponded to the theoretical number of heterozygotes in accordance with the Hardy-Weinberg equation, suggesting that sucrase deficiency is recessively inherited in a simple Mendelian fashion. Four of the five patients with sucrase deficiency had deficiency of lactase as well. The nutritional implications are discussed. PMID- 3563410 TI - Gastric emptying in patients with flatulent dyspepsia, with and without gallbladder disease. AB - It has been suggested that the symptoms of flatulent dyspepsia are caused by a functional disturbance of the upper gastrointestinal tract. The aim of this study was to investigate delayed gastric emptying as the basis of symptoms in patients with and without gallbladder disease and after cholecystectomy. There were 13 dyspeptic patients with gallbladder disease, 12 with normal gallbladders, and 13 post-cholecystectomy patients. Gastric emptying was measured by means of a 99mTc labelled scrambled egg meal and external scintillation counter. The rate of emptying in the symptomatic groups was compared with that in 24 asymptomatic normal control subjects and 12 non-dyspeptic patients with gallbladder disease. Delayed gastric emptying tended to occur in patients with gallbladder disease with and without dyspepsia and was not specifically associated with symptoms. PMID- 3563409 TI - Serum antibodies to gliadin in coeliac disease after gluten withdrawal. AB - Serum gliadin antibodies of the IgA and IgG classes were determined by the diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA) in 10 adult patients with villous atrophy of the small-intestinal mucosa. After introduction of a gluten-free diet a gradual decrease in serum gliadin antibody levels occurred, reaching statistical significance at 3 months of treatment for the IgA class (p less than 0.01) and at 6 months for the IgG class (p less than 0.05). A decrease of serum gliadin antibody levels after gluten withdrawal was related to an improvement of the intestinal mucosa and should thus be indicative of whether the patient is following the dietary recommendations. However, determination of gliadin antibody levels cannot replace small-intestinal biopsy, as there are a few patients in whom the antibody levels are not related to the morphology of the gut mucosa. PMID- 3563411 TI - Cigarette smoking delays gastric emptying of a radiolabelled solid food in healthy smokers. AB - The effect of cigarette smoking on gastric emptying was studied in 18 healthy volunteers by means of an isotopic method. Although the observed individual reactions were fairly variable, cigarette smoking significantly delayed gastric emptying of a solid meal. Potential mechanisms of action of cigarette smoking on gastric emptying are discussed, including the role of nicotine. The method of gastric emptying measurement was shown to be reproducible in the paired studies performed in 11 subjects. PMID- 3563412 TI - Computed tomography in staging of oesophageal carcinoma. AB - The computed tomographic (CT) findings in 45 patients with histologically proved oesophageal carcinoma are reviewed. In 20 of these patients the CT findings were correlated with findings at surgery (19 patients) or autopsy (1 patient). Correlation analysis showed that the accuracy of CT in assessing both invasion of adjacent organs and mediastinal and abdominal lymph node involvement is limited. Twenty-five patients were considered inoperable; in 15 of these the conclusion was based on CT findings of distant metastases (14 patients) or definite local invasion (1 patient). Ten patients were inoperable for other reasons (general health condition). We found the value of CT to be in detecting distant metastases, thus avoiding unnecessary radical surgery; it is not a reliable way of defining the primary tumour. PMID- 3563413 TI - Fasting and meal-stimulated plasma levels of neurotensin in obese patients after jejunoileal bypass with 3:1 or 1:3 jejunoileal ratio. AB - The functional role of the jejunum and ileum with regard to peripheral plasma levels of intact neurotensin and NH2-terminal immunoreactivity of neurotensin was studied by using jejunoileal bypass as a model. Plasma levels were measured by radioimmunoassay before and after jejunoileal bypass randomized to different jejunoileal ratios. Seven patients were studied before bypass surgery and 28 were examined after end-to-side jejunoileal bypass with 50 cm intestine in continuity and a 3:1 or 1:3 ratio between the length of the jejunal and ileal segments. Fasting levels of intact neurotensin were unchanged by surgery, whereas levels of NH2-terminal immunoreactivity were higher in bypass patients with a long ileal segment (37.5 cm) than in unoperated patients and in those with a short ileal segment (12.5 cm). Meal-stimulated levels of intact neurotensin were higher after 1:3 than 3:1 jejunoileal bypass. The levels of NH2-terminal immunoreactivity in patients with a short ileal segment and in controls were lower than in patients with a long ileal segment. The results show that postprandial levels of both intact neurotensin and NH2-terminal immunoreactivity are related to the length of the functioning ileum and that even a difference in length of 25 cm is reflected in the circulating levels of neurotensin. PMID- 3563414 TI - Esophageal scintigraphy: a comparison with esophagoscopy. AB - Fifty consecutive patients with different esophageal symptoms were investigated with esophageal endoscopy, transit scintigraphy, and gastroesophageal (GE) scintigraphy with extra-abdominal compression. Scintigraphic findings were abnormal in 27 of those 31 patients (87%) who were classified as abnormal at endoscopy. A prolonged transit time was the commonest finding, but hiatal hernia and GE reflux were also found. However, the scintigraphic procedure showed abnormalities in 6 of 19 (31%) who were classified as normal at endoscopy. Esophageal scintigraphy is recommended as a screening test before endoscopy is decided on. PMID- 3563415 TI - Variables predicting elevated portal pressure in alcoholic liver disease. Results of a multivariate analysis. AB - In 46 alcoholic patients the association of wedged-to-free hepatic-vein pressure with other variables (clinical, histologic, hemodynamic, and liver function data) was studied by means of multiple regression analysis, taking the wedged-to-free hepatic-vein pressure as the dependent variable. Four variables showed significant independent association with the wedged-to-free hepatic-vein pressure: indocyanine green clearance (p = 0.031), degree of necrosis (p = 0.023), degree of hepatic architectural destruction (graded as: preserved architecture, nodules alternating with preserved architecture, totally destroyed architecture) (p = 2.3 X 10(-6) and sex (p = 0.0024), male sex being associated with higher wedged-to-free hepatic-vein pressure. The multiple coefficient of determination (R2) was 0.63; thus, 63% of the variation in the wedged-to-free hepatic-vein pressure was 'explained' by variation in these four variables. PMID- 3563416 TI - Estimation of the 3-day faecal fat excretion and fat concentration as a differential test of malabsorption and maldigestion. AB - The diagnostic efficiency of estimating the faecal fat excretion and faecal fat concentration in uncontrolled 3-day collections was estimated from a prospective series of 87 consecutive patients. The diagnoses were established on the basis of morphologic criteria, and the assimilation was established from the faecal 14C triolein/3H-oleic acid test. These investigations showed the diagnostic sensitivity of the 3-day faecal fat excretion to be 90%. The 3-day mean faecal fat concentration was less than or equal to 5.1% w/w in patients with normal lipid assimilation. Of the patients with malassimilation 90% had a faecal fat concentration greater than or equal to 5.1% w/w. The faecal fat concentration was especially high in patients with maldigestion. When 10% w/w was used as the discrimination level between malabsorption and maldigestion, the faecal fat concentration correctly distinguished between these in 66% of the patients with malassimilation. The day-to-day variation of the faecal fat concentration was modest. Diagnosis of the lipid assimilation as estimated by the 1-day faecal fat concentration agreed with the diagnosis of the mean 3-day faecal fat concentration in 115 of the 122 1-day samples. The 1-day faecal fat concentration seems useful as a first screening test when malassimilation is suspected. PMID- 3563417 TI - Release and functional characterization of the leukotriene D4-metabolizing enzyme (dipeptidase) from human polymorphonuclear leucocytes. AB - Polymorphonuclear leucocytes released LTD4-dipeptidase activity in a time-, calcium-, and cell number-dependent fashion. The LTD4-dipeptidase released from polymorphonuclear leucocytes (PMN) by incubation with calcium (0.91 mM) was detectable up to a cell concentration of 1 X 10(6)/ml and increased with higher concentrations. Maximal LTD4-dipeptidase activity within the extracellular environment was detected after 15 min of incubation (2 X 10(7)/ml) in the presence of 2-4.5 mM calcium or after 30 min, when stimulation was carried out with 0.91 mM calcium. The activity of the released LTD4-dipeptidase was modulated by various metal ions and other compounds. The addition of Mn2+, Co2+, and Zn2+ (final concentration 1 mM) enhanced the LTD4-dipeptidase activity, while Cu2+ led to a complete inhibition. In the absence of exogenous calcium EDTA inhibited LTD4 dipeptidase. Calcium up to a concentration of 5 and 10 mM decreased the dipeptidase activity. The LTD4-dipeptidase is not affected by bestatin, leupeptin, or N-ethyl-maleinimide (NEM). The Km of LTD4-dipeptidase for LTD4 was 0.95 +/- 0.2 microM and Vmax was 737.5 +/- 112.5 pmol/min X mg protein (n = 3 +/- SEM). The highest LTD4-dipeptidase activity was obtained at physiological pH values. LTD4-dipeptidase activity can also be released from other cell types, but the enzyme activity from human PMN exceeded that of other cells (e.g. human lymphocytes/monocytes and basophils (LMB) and human lung cell suspension). PMID- 3563418 TI - Increased incidence of childhood bacterial meningitis. A 25-year study in a defined population in Sweden. AB - In a retrospective study in Orebro, Sweden 1956-1980, 201 cases of bacterial meningitis in children over the age of 1 month were analysed. The aetiology was Haemophilus influenzae in 123 cases, Neisseria meningitidis in 55 cases and Streptococcus pneumoniae in 19 cases. We registered a significant increase in incidence of H. influenzae meningitis from 5.6 (1956-1965) to 13.0 (1971-1980) per 100,000 children and year (p less than 0.01). The mortality decreased from 19% to 4% during the period studied. This decrease was primarily due to a reduced mortality in hospital later than 12 h after admission. Hearing impairment was the most frequent sequel (10%) and no change in frequency was observed during the 25 years studied. Hearing impairment was registered significantly more often in cases with a late admission to hospital (greater than 48 h) as compared to cases with an earlier admission (p less than 0.001). PMID- 3563420 TI - Antibiotic usage in surgery in a large teaching hospital. AB - A prevalence study of the antibiotic usage in the surgical departments at the Karolinska Hospital, Stockholm, showed that 126/517 hospitalized patients (24%) received antibiotics and that 100/306 operated patients (33%) received antibiotics. 44 (44%) of the operated patients were given their antibiotics as prophylaxis and 46 (37%) of all patients receiving antibiotics were given them as prophylaxis. Antibiotics were administered intravenously to 35 (28%) patients, orally to 75 (60%), and topically to 16 patients (13%) (eye department only). The most commonly used drugs in prophylaxis were isoxazolylpenicillins and trimethoprim-sulphonamide while cephalosporins accounted for a minor part. In therapy the most commonly used drug was isoxazolylpenicillin, followed by ampicillin derivatives, metronidazole, tetracyclines, trimethoprim-sulphonamide and cephalosporins. The pattern of antibiotic usage differed markedly between departments. PMID- 3563421 TI - Febrile pharyngitis as the primary sign of HIV infection in a cluster of cases linked by sexual contact. AB - Three cases of febrile pharyngitis were recorded retrospectively in a cluster of 5 men and 1 woman linked by sexual contact to a human immunodeficiency virus (HIV) carrier. In all 3 patients, a progression into clinical HIV disease was noted during an observation period of 20-25 months. The febrile pharyngitis developed similarly in each patient after an incubation time of 3-5 weeks. High fever of sudden onset and a sore bright red throat were accompanied by extreme lethargy and, in 2/3 patients, a morbilliform rash. The acute illness lasted 4-7 days and was followed by mild lymphadenopathy. All 3 patients were HIV seropositive 17-19 months later, when they first entered the study. By contrast, those 2 cases who did not fall ill, continued to be seronegative for 19-39 months after the exposure. Seroconversion of HIV could retrospectively be demonstrated in 1 of the 3 patients 2 weeks after the onset of the febrile illness. A simultaneous lack of rise in the EBV and CMV titres suggests HIV as the causative agent for this febrile mononucleosis-like pharyngitis. PMID- 3563419 TI - Effect of norfloxacin on human oropharyngeal and colonic microflora and multiple dose pharmacokinetics. AB - 10 healthy volunteers received 200 mg norfloxacin orally every 12 h for 7 days. Saliva, throat and faecal specimens were collected days 0, 3, 5, 7, 14 and 21 to study the effect of norfloxacin on the normal microflora. The concentrations of norfloxacin in serum, urine, saliva and faeces were determined by a microbiological method and all samples except faeces were also assayed by high pressure liquid chromatography (HPLC). The pharmacokinetics of norfloxacin were studied on day 3. The mean peak serum concentration (+/- SD) attained after 0.75 1.0 h was 0.75 +/- 0.15 mg/l measured by HPLC, and the mean terminal serum half life was 4.2 +/- 0.6 h. The mean cumulative urinary elimination was 29% during 12 h after dosing. There was no significant difference between values obtained by microbiological assay and by HPLC. The saliva concentration was approximately 30% of the serum levels 1.0-1.5 h after administration. No accumulation in faeces was found during the administration period, and mean concentrations were 940 mg/kg. The changes in the oropharyngeal flora were minor and only branhamella were affected. In the colonic flora, the number of enterobacteria was strongly depressed while the anaerobic microflora was only slightly affected. Two weeks after the administration period, both the oropharyngeal and colonic microflora had returned to normal. PMID- 3563422 TI - Successful non-surgical management of pyogenic liver abscess. AB - A 5-month-old infant presented with high fever, irritability, and poor feeding. Examination revealed an enlarged liver and neutropaenia. Ultrasonography was unhelpful, but a diagnosis of liver abscess was confirmed by computed tomography on day 4 of the illness. Gallium scan was normal on day 4 but showed a resolving liver abscess on day 6. Staphylococcus aureus was grown in blood culture. The infant recovered with antibiotic treatment alone. PMID- 3563423 TI - Amantadine for prophylaxis against influenza A. AB - Amantadine, 200 mg daily, for 5 days was used in an attempt to restrict the spread of influenza A in a hospital ward. After index cases of influenza A amantadine was given to 2 patients with clinical symptoms and to 8/10 patients who were not yet ill. No further case of clinical influenza was seen among the patients, but 3 of those receiving amantadine developed subclinical infection. No side effects of amantadine were noted. Amantadine was not given to any of the 23 hospital staff on duty. In this group 8 cases of influenza A appeared, 3 of them during the week after the introduction of amantadine to patients. PMID- 3563424 TI - Invasive haemophilus influenzae and meningococcal infections in Finland. A climatic, epidemiologic and clinical approach. AB - A nationwide epidemiological survey on invasive (blood and/or CSF culture positive) Haemophilus influenzae (HI) and meningococcal infections was performed in Finland in 1976-1980. The mean annual incidence of HI infection was 3.4/100,000 inhabitants (813 cases) vs. 2.0/100,000 (469 cases) of meningococcal infection. HI infections showed no geographical predilection, but meningococcal disease, mainly of group B, was more common in northern than in southern Finland (p less than 0.005). Meningitis accounted for 61% of the HI and 91% of the meningococcal infections. The overall fatality rates were 3.1% and 7.9%, respectively. Children accounted for 94% of the HI and 59% of the meningococcal cases. The overall annual incidence of bacterial meningitis in children (less than 15 years) was 19/100,000; in children less than 5 years it was 52/100,000. HI was the most common (62%) causative agent, followed by meningococci (18%) and pneumococci (5%). The fatality rate was 4%. Major neurological sequelae were found in 5%, minor ones in 16%. It was calculated that 42% of the cases of meningitis could have been prevented by vaccines now available on the market. Vaccines now under field investigation may increase the preventability to about 65%. PMID- 3563425 TI - Multivariate prognostication in bacterial meningitis of childhood. AB - A multivariate method for prognosticating the outcome of bacterial meningitis was computerized on the basis of initial clinical and laboratory data in 123 patients. The model, based on likelihood ratios, is simple and rapid. At the time of diagnosis, it predicted the outcome correctly in 104/123 cases (85%) in the basic group and in 67/98 independent controls (68%). The sensitivity of the method in predicting death or mild to severe neurological sequelae was 83% in both groups. The predictive value of a calculated good prognosis was 94% in the basic group and 97% in the control group, and that of a calculated poor prognosis was 63% and 26%, respectively. The predictive system can be used for rapid assessment of prognosis in individual patients and for comparisons between groups. PMID- 3563427 TI - Primary meningococcal arthritis. AB - Arthritis in meningococcal disease is not uncommon and can be caused by either septic invasion of joints or allergic manifestations. Primary meningococcal arthritis (PMA) is, on the other hand, a rare form of meningococcal disease presenting as an isolated septic arthritis without other signs of meningococcal disease. We describe here the first two cases of PMA reported from Scandinavia. The patients were males, 3 and 47 years old, both with arthritis in an ankle joint. PMA is most commonly seen among male infants. Large joints, mainly knee joints, are most often involved and not seldom is the disease polyarthritic. PMA may appear with a previous or on-going upper respiratory tract infection and/or a maculopapular skin rash. If properly treated the prognosis is good. PMID- 3563426 TI - Case fatality of meningococcal disease in western Norway. AB - In the period 1976-84, 211 patients hospitalized with meningococcal disease were examined for possible relation between various epidemiological parameters and fatality. The peak incidences were in the age groups 0-4 and 13-18 years, with teenage girls peaking 2 years ahead of the boys. The overall case fatality rate was 8.5%. In septicemic patients (without meningitis) hypotension and/or ecchymoses on admission correlated strongly with a poor prognosis. Most deaths occurred during the months of March and November, and none during the summer months. There was a significant clustering of deaths among patients admitted during the morning hours, probably due to delayed diagnosis and treatment during the night. Since almost all patients who died had skin bleedings on admission, frequent examination of the skin in cases with acute unexplained fever might have saved lives. PMID- 3563428 TI - Childhood lymphadenitis in a harsh northern climate due to atypical mycobacteria. AB - Between 1979 and 1983, 16 patients under 15 years of age living within 480 km of Edmonton, Alberta (latitude 53 degrees 34' N) were seen with cervical lymphadenitis caused by atypical mycobacteria. During this period only 4 cases of cervical lymphadenitis from Mycobacterium tuberculosis occurred in the same age and geographical grouping. Young children age 1-4 years accounted for most cases (14/16). The onset showed no seasonal preponderance and the nodal enlargement was either asymptomatic (8/16) or associated with only minor systemic symptoms. M. avium intracellulare scrofulaceum (6 cases) or M. avium intracellulare (4 cases) were identified on cultures from the infected node. In the remaining cases characteristic histopathology and acid fast bacilli were seen on biopsy specimens but no organisms could be cultured. Surgery was employed in all cases either for diagnosis or for therapy. This series demonstrates that atypical mycobacteria may cause childhood lymphadenitis throughout the year in a harsh inland Northern climate. The etiological pathogen can be difficult to culture but complete surgical excision of the infected node is usually curative. PMID- 3563429 TI - A water-borne outbreak of giardiasis in Sweden. AB - In the middle of October 1982 a large number of people living at Mjovik, a small community in the south-east of Sweden, fell ill after drinking municipal water contaminated with waste water. The epidemic curve showed one single outbreak without secondary cases. No pathogenic agents could be isolated from the water or sick persons. From some persons who fell ill again or did not recover new samples were taken and Giardia lamblia was then isolated from persons with remaining symptoms and previously affected persons. No parasite was found in persons without gastroenteritis. The outbreak at Mjovik was caused by at least 2 agents, 1 unidentified, with a short incubation time, contracted by 557 persons, and Giardia lamblia, with a longer incubation time, contracted by at least 56 persons. PMID- 3563430 TI - Comparison of three- and ten-day regimens with a sulfadiazine-trimethoprim combination and pivmecillinam in acute lower urinary tract infections. AB - 132 female hospital employees (mean age 32 years) with uncomplicated, bacteriologically verified acute lower urinary tract infection were included in a randomized study. The patients were treated for 3 or 10 days with a sulfadiazine trimethoprim combination (500 mg + 150 mg) b.i.d. or for 3 or 10 days with pivmecillinam (500 mg) t.i.d. The first follow-up evaluation was performed 3-5 days after the treatment. In both sulfadiazine-trimethoprim groups the cure rate was 97% and in both pivmecillinam groups 80%. This difference was mainly due to the occurrence of pivmecillinam-resistant Staphylococcus saprophyticus strains. 109 patients attended the second follow-up visit about 4 weeks after treatment. The prevalences of reinfections and relapses were 18% in both 3-day regimens and 4-7% in both 10-day regimens. No side-effects were reported in the 3-day sulfadiazine-trimethoprim group, while about 20% in the corresponding 10-day group had side-effects. Side-effects were not common in patients treated with pivmecillinam. PMID- 3563431 TI - Psychological versus physiological determinants of emotional arousal and its relationship to laboratory induced amnesia. PMID- 3563432 TI - Episodic remembering in young adults, 73-year-olds, and 82-year-olds. PMID- 3563433 TI - Dimensions of verbal denial in myocardial infarction. Correlates to 3 denial scales. PMID- 3563434 TI - Frequency specific chromatic adaptation in the human visual system. PMID- 3563435 TI - AIDS and social medicine: strategies for research. PMID- 3563436 TI - Birth weight distribution as an indicator of environmental effects on fetal development. AB - A medical birth registry was used for a geographical analysis of birth weight distribution. Nearly 900,000 Swedish singleton births, 1973-1981, were used for an analysis of the effect of some variables and for standardization for these variables. A marked change in the rate of low birth weight infants (LBW, less than 2,500 g) was seen in the country between 1976 and 1977. A U-formed effect of maternal age and of parity was demonstrated. A marked interaction between the effects of these two variables existed. Two social groups were compared and the well-known high rate of LBW infants associated with low socioeconomic conditions was demonstrated. Standardization for the variables mentioned influenced this effect only little but reduced the difference between the social groups concerning infants above 3.5 kg weight. The background data were used for analysis of restricted geographical areas. PMID- 3563437 TI - Is smoking sufficient to explain the large difference in lung cancer incidence between Finland and Norway? AB - In the 1960s, lung cancer among Finnish men was about 3.5 times as common as among Norwegian men. A study by Pedersen et al. in 1962 indicated that the difference in contemporary smoking habits could account for only part of the difference in lung cancer incidence in men between the countries. In that study, smoking habits in Finland and Norway were investigated via interviews of 8,700 people from six areas of each country. For the present study the Finnish and Norwegian cancer registries have followed lung cancer morbidity in those areas. When the interval between the recording of smoking habits and lung cancer incidence was 15 years, after adjustment for age and smoking habits, the Finnish males had a relative risk between 1.1 and 1.6 compared with Norwegian men. The results suggest that, given a sufficiently long latency period, almost the entire difference between Finnish and Norwegian men could be attributed to smoking habits. PMID- 3563438 TI - Home accidents among children and teenagers in a Swedish rural municipality. AB - The aim of this study was to investigate home accidents among children and teenagers with regard to incidence and severity and to compare the accident rate at home with that of nursing homes/day-care centres. All accidents in the age group 0-19 years, in a defined population, were, during a period of one year, registered at public care centres. Our findings show that home accidents contributed to 26% of all accidents in the age group 0-19 and about 10% of all health care consumption. The accident rate decreased with age. The severity was about the same as in other accidents. 10% were hospitalized. When time of exposure had been taken into consideration there was no difference as to incidence between the accident rate at home as compared with the rate in nursing homes/daycare centres. When comparing with studies in the past there seems to be a lower rate of home accidents which can be explained by secular changes and local preventive measures. PMID- 3563439 TI - Need for near vision in daily work in different occupational groups. AB - To evaluate the need, characteristics and proportion of occupational accurate close work in different socio-economic groups we sent a questionnaire to all 26- and 46-year-old people in the Jyvaskyla district. 1,503 (75%) of the 26-year-old subjects and 1,035 (78%) of the 46-year-old subjects returned the questionnaire. 71% of the 26-year-old subjects and 68% of the 46-year-old subjects reported that they need accurate near vision in their daily work. Accurate near vision was needed for reading and writing in 61% in the younger and 55% in the older age group, industrial quality control in 14% in the younger and in 26% in the older age group, Visual Display Unit work in 7% in both age groups, and other accurate close work in 19% in the younger and in 12% in the older age group. The results show that there is a need for accurate near vision in most occupations and indicate that the visual acuity and refraction of the employee requiring occupational accurate near vision should be examined when newly employed and when having problems with near work. PMID- 3563440 TI - The Tromso Heart Study: comparison of information from a short food frequency questionnaire with a dietary history survey. AB - In a group of 528 men, 30-54 years old, answers to various questions about dietary habits given in a questionnaire were compared to corresponding information given in a dietary history interview two years later. High concordance was found between the two methods for questions concerning types of foods most commonly used. For most food items, the mean intake according to the dietary recall corresponds well with intake reported in the questionnaire. For food items used every day in easily recorded units (slices of bread, cups of coffee, glasses of milk), the frequency questionnaire can be used to rank individuals according to consumption. For other food items, the concordance is less satisfactory. PMID- 3563441 TI - The self-fulfilling prophecy in dental prophylaxis. AB - This report deals with the influence of the self-fulfilling prophecy on dental prophylaxis. The aim was to test if this phenomenon had any influence on the treatment of patients, they and their therapeutist's perception of each other and the result of the prophylactic work. Sixty patients and 34 students were involved. The patients were randomly classified as "good" or "bad". Twenty-seven students had a patient from each group. Dental plaque and gingival inflammation were recorded before and after the treatment. No difference in improvement between the two groups could be shown. Both patients and students were interviewed about their experiences and feelings during the treatment. All patients were satisfied with their therapeutist. The students generally accepted the classification although they were made aware of the self-fulfilling prophecy. This was confirmed by a significantly higher frequency of patient drop-outs, broken appointments and critical notes about the patients in the "bad" group compared to the "good". The conclusions are that the self-fulfilling prophecy can be initiated by even minor notes in patient files, and that this affects the treatment of patients. PMID- 3563442 TI - [Demonstration of gram-negative bacteria and endotoxins in the air surrounding a sewage treatment plant: effect of contaminated aerosols on the health status of the staff]. AB - Data on airborne gram-negative bacteria and endotoxin contamination in a sewage treatment plant are reported and compared with data from similar plants in Scandinavia. Respiratory, digestive, and cutaneous symptoms were investigated on the basis of medical files. The contamination levels which can be considered safe are discussed in the light of the actual exposure of workers. PMID- 3563443 TI - [Hamartoma of the breast]. AB - Hamartoma (adenolipoma, fibradenolipoma, lipofibradenoma) of the breast, a rare, benign lesion, occurs in females. It is unilateral and displays an organoid structure. It is composed of lactiferous ducts, mammary glands, and connective and fatty tissue, surrounded by a pseudocapsule. It causes enlargement of the breast, usually without a localized lesion on palpation. Mammographic and intraoperative findings, however, are characteristic. Because the microscopic features of hamartoma are similar to those of other related benign lesions of the breast, diagnosis may be difficult by histologic examination alone; in addition, knowledge of radiologic, surgical and clinical findings may be required. PMID- 3563444 TI - [Diagnosis of lung embolism. Prospective study]. AB - In a prospective study over the years 1983-1985, 300 cases of acute pulmonary embolism were analyzed in relation to predisposing factors, clinical signs, arterial blood gas analysis and isotope perfusion scanning. Comparison of this prospective study with an earlier retrospective one showed similar results, with the exception of isotope scanning, an investigation which has gained increasing diagnostic reliability (highly suggestive results in 94% of patients with massive pulmonary embolism and in 64% with submassive pulmonary embolism). In two thirds of the cases the diagnosis was established during the first day after hospitalisation. In 10% of the patients pulmonary embolism occurred despite anticoagulant therapy. PMID- 3563445 TI - [Familial Mediterranean fever. Study of a Swiss child]. AB - Familial Mediterranean fever (FMF) has been observed in a Swiss child without ethnic predisposition. The case is analyzed and the current literature briefly reviewed. Recurrent attacks of fever, accompanied by abdominal pain, colic and arthritic symptoms, and often by pleuritic pain and a transitory skin rash, are the hallmarks of FMF, which is predominantly seen in ethnic groups of the Mediterranean area, notably Sephardic Jews, Turks and Armenians. However, it rarely occurs among individuals without an ethnic predisposition. Its most ominous manifestation is amyloidosis, which leads to chronic renal failure within a matter of years. Thanks to colchicine treatment, which is now widely accepted, patients often lead normal lives, and it appears that amyloidosis can be prevented. PMID- 3563446 TI - [Leiomyosarcoma of the inferior vena cava]. AB - We report a case of a grade II leiomyosarcoma of the suprarenal vena cava in a 56 year-old man. It was discovered during exploratory laparotomy for lower back and abdominal pain associated with intermittent renal failure of 8 months' duration and recent exertional dyspnea. The tumor was completely resected, with reimplantation of the right renal vein. Adjuvant radio- and chemotherapy were administered. The postoperative course was uneventful and the patient has been disease-free during follow-up of 12 months. The difficulties of preoperative diagnosis and surgical treatment of leiomyosarcoma of the inferior vena cava are discussed. PMID- 3563447 TI - [Polyposis of the nasal cavity and sinuses]. AB - In spite of many recent advances in basic science, the etiology and pathogenesis of nasal and paranasal polyps have still not been clarified. Well defined causal factors are hereditary diseases such as cystic fibrosis and primary ciliary dyskinesia. Allergic and non-allergic processes of the airways, particularly intrinsic asthma and intolerance to non-steroidal antiinflammatory drugs (NSAID), are implicated in the development of nasal polyposis. Histopathological studies of polyp tissue do not allow etiologic or prognostic conclusions, but are indispensable for the classification of structures involving clinical signs similar to nasal polyps. Causal antiallergic therapy is confined to the rare cases with an evident clinically relevant nasal allergy. Topical corticosteroids are effective in the treatment of nasal polyposis, but in extensive and obstructive polyps surgery is required. In severe polyposis of the ethmoid sinus endoscopically controlled endonasal ethmoidectomy is the surgical treatment of choice. PMID- 3563448 TI - [Cellular immunological clarification in HIV (LAV/HTLV-III) infections]. PMID- 3563449 TI - [Practical approach in an isolated abnormality of urinalysis]. AB - The three major abnormalities found in urinalysis (proteinuria, hematuria and pyuria) usually lead on to invasive investigations. It emerges that the general practitioner is able, with only a few simple non-invasive diagnostic methods, to establish a wide range of differential diagnoses with precise etiology and prognosis. PMID- 3563450 TI - [Review of diagnostic methods in allergy]. AB - To investigate the possible role of allergy in asthma or chronic rhinitis, four groups of tests can be used. The patient's history, which is the best way to determine the severity of the disease and the clinical relevance of the allergens detected by other diagnostic means. Tests which disclose an atopic constitution. The predictive value of the serum level of total IgE is somewhat lessened by 20 30% false positive and false negative results. Phadiatop, introduced in 1986, appears to be a more accurate screening test for respiratory allergy. Tests which disclose the presence of allergen-specific IgE, in the skin (skin tests) or in serum (RAST). Tests which reproduce the allergic disease in the shock organ (conjunctival, nasal and bronchial provocation tests). These tests are used in clinical research rather than in the routine diagnosis of allergy. PMID- 3563451 TI - [Glomerulonephritis in chronic bacterial infections]. AB - Five patients with chronic bacterial infections (two with osteomyelitis, two with infected vascular prostheses, one with soft tissue abscess), but without endocarditis, developed signs of glomerulonephritis and renal failure. Histological examination in three revealed mainly proliferative glomerular alterations. The outcome of glomerulonephritis paralleled the course of infection. Recovery or marked improvement occurred in three patients in whom the infection was cured, one case with smoldering infection eventually developed endstage renal failure, and one with persistent infection died from severe complications with acute renal failure. If renal failure occurs in the setting of suppurative infection, so-called infection-associated glomerulonephritis must be considered. Prompt and effective eradication of infection has an important bearing on the course of renal function. PMID- 3563453 TI - [Pleuropulmonary manifestations in chronic polyarthritis]. AB - Nine cases of rheumatoid arthritis with pleuropulmonary involvement illustrate the most common pulmonary symptoms of this disease: rheumatoid pleurisy, interstitial pneumopathy, pulmonary rheumatoid nodules and bacterial pleuropulmonary infections. Each of these pleuropulmonary manifestations may precede the joint disease and cause considerable diagnostic difficulties. Rheumatoid pleural effusion displays an interesting pathognomic constellation: low glucose- and elevated lactate-dehydrogenase concentration, acid pH, often pathologic C1q-binding assay, and characteristic cytomorphology of the pleural fluid. Interstitial pneumopathy is usually mild and slowly progressive. Additional spirometric tests to determine ventilation disturbances sometimes demonstrate airway obstruction. Lower-airway obstruction is probably not caused by the disease itself but may be due to other risk factors (eg cigarette smoking). Depending on their localization, intrapulmonary nodules may lead to severe complications (hemoptysis, bronchopleural fistula, pneumothorax, abscess formation). The possibility of pleuropulmonary infection must always be kept in mind as patients with rheumatoid arthritis have a higher susceptibility to infection. PMID- 3563452 TI - [Usefulness of urinary electrolyte determination]. AB - As a practical contribution to an understanding of the usefulness of measuring some electrolytes in urine, the author first recalls that elements measured in a 24-h urine sample provide nutritional informations, whereas those assayed in fasting morning urine generate data on renal tubular function. To illustrate the first point the author describes assessment of the etiology of hypercalciuria based on a knowledge of concomitant 24-h excretions of sodium, phosphate, urate and creatinine. On the second point, the author suggests dissociating the parameters of which only the urinary concentration is of interest (pH, lysozyme, gamma-glutamyl-transferase) from the parameters of which the excretion--either fractional (Na, K, Cl, P, Mg) or absolute (Ca)--should be calculated. Finally, the reader is reminded how to use the nomogram of Peacock, Robertson and Nordin to evaluate fasting urinary excretion of calcium, and how to use the nomogram of Walton and Bijvoet to estimate the renal threshold phosphate concentration. PMID- 3563454 TI - [Binding of bile salts and lysolecithin by various antacids in biological media]. AB - The in vitro capacity of several commercial antacids to bind bile acids and lysolecithin was measured in three different test media: 0.1 n HCl, natural human gastric juice and human gastric juice enriched with 5% protein. Antacids bind bile salts variably. In HCl and in natural and protein-enriched gastric juice the capacity to bind conjugated bile salts was higher (47-72%) for antacids with high aluminium content, such as Alucol, Andursil, Muthesa than for antacids with less aluminium such as Calamox and Riopan (17-18%). Binding of unconjugated bile salts did not show any corresponding difference. The test medium had little effect on binding capacity when pH was comparable. Natural gastric juice was slightly better with regard to binding of conjugated bile salts. The addition of protein had only minimal effect. Lysolecithin was equally heavily adsorbed by all tested antacids and in all three test conditions (85-100%). Since duodenogastral reflux contains mainly unconjugated bile salts, our results suggest that antacids with higher aluminium content should be preferred if binding of bile salt reflux is attempted. PMID- 3563456 TI - [A variation of the ulnar extensor muscle of the wrist in humans]. PMID- 3563457 TI - [Microvascularization of the goat placenta demonstrated by scanning electron microscopic examination of vessel casts]. PMID- 3563455 TI - [Staphylococcal infection after intramuscular injection]. AB - A 74-year-old woman and a 68-year-old man admitted to hospital for backache and somnolence both showed growth of Staphylococcus aureus in blood cultures. One patient died from septic shock. In both patients septicemia was secondary to a gluteal abscess after intramuscular injection of antirheumatic drugs. Diagnosis was particularly difficult due to lack of local signs. Local pain hardly differed from that of the original "rheumatic" backache. The literature is reviewed and diagnosis and treatment are discussed. PMID- 3563458 TI - [The fine structure of the nucleus ambiguus and the spinal accessory nucleus]. PMID- 3563459 TI - [The fine structure of the fibrous substratum of the conjunctival epithelium of sheep and goats]. PMID- 3563460 TI - Abdominal thermography in acute appendicitis. AB - Abdominal thermography was carried out in 50 patients with suspected acute appendicitis. Forty of these came to laparotomy and in 32 the diagnosis was confirmed. Thermography was not found to be useful in predicting those patients requiring surgery. PMID- 3563461 TI - Intravenous immunoglobulin therapy for idiopathic thrombocytopenic purpura. AB - Twenty-two patients with idiopathic thrombocytopenic purpura were treated with high-dose intravenous immunoglobulin infusions using an intact intravenous immunoglobulin preparation and a product designed for intramuscular administration. Seventeen patients (77%) responded favourably (rise in platelet count to 100 X 10(9)/1 or above). Children responded better than the adults, and the acute cases better than the chronic. Splenectomy and the presence of detectable platelet antibody had no effect on the response rate. Both products induced identical responses. PMID- 3563463 TI - Gastrointestinal tuberculosis. AB - In the developed countries gastrointestinal tuberculosis is no longer common in clinical practice. In this setting the importance of the condition lies in the vagaries of its presentation and the fact that it is eminently treatable, usually by a combination of chemotherapy and surgery. The clinical features and complications of gastrointestinal tuberculosis are highlighted by the seven cases which we report. Diagnosis and treatment of this condition is discussed and attention is drawn to the importance of case notification. Clinicians should bear in mind the diagnosis of gastrointestinal tuberculosis when dealing with any patient with non-specific abdominal symptoms. PMID- 3563462 TI - Use of nifedipine as the drug of third choice in management of hypertension. AB - Nifedipine has been used in the management of hypertension in 36 consecutive patients who could not tolerate, or were not controlled by, atenolol and thiazide diuretics. Mean supine blood pressure was reduced from 193/110 +/- 5/2 (SEM) mmHg to 162/91 +/- 5/2 mmHg at eight weeks and remained at that level for the six months of follow-up. Blood pressure reduction at four weeks was not always a predictor of final BP level. Eight patients could not tolerate atenolol, nine patients could not tolerate thiazide diuretics and four patients could not tolerate nifedipine. No significant changes in plasma urea, creatinine, sodium, potassium urate, 'total CO2' or glucose were observed. We conclude that nifedipine is a well-tolerated drug and may be useful after beta-blockers and thiazide have been tried in the management of hypertension. PMID- 3563464 TI - Intravascular haemolysis and acute renal failure induced by nomifensine. AB - Nomifensine is a widely used antidepressant agent with few side-effects but haemolytic anaemia with acute renal failure has been reported with both intermittent therapeutic dosage and self-inflicted overdose. We report here a case of acquired immune haemolytic anaemia with acute renal failure induced by second exposure to a single capsule of nomifensine. PMID- 3563465 TI - Simultaneous intussusception and volvulus in an adult due to a congenital fibrous band. PMID- 3563466 TI - Nontraumatic rhabdomyolysis and acute renal failure. AB - Four cases of acute renal failure occurring in association with unusual causes of nontraumatic rhabdomyolysis are reported. Three of the four were associated with drug overdoses. PMID- 3563467 TI - Endoscopic pancreatography in cystadenoma of the pancreas. AB - A case of mucinous cystadenoma of the tail of the pancreas is reported in which endoscopic retrograde cholangiopancreatography was used to define the surgical anatomy prior to operation. The demonstration of a normal proximal main duct allowed simple ligation of the body of the gland when the tail was excised. PMID- 3563468 TI - Clinical effectiveness of occlusal splint therapy in patients with classical migraine. AB - A clinically similar entity to classical migraine is seen in certain dental patients suffering from temporomandibular joint (TMJ) pain dysfunction syndrome. Patients selected for study gave symptoms of classical migraine on waking. Facial pain on waking is typical of some cases of TMJ dysfunction syndrome and the hypothesis was tested that some patients with symptoms of classical migraine were at the extreme end of the spectrum of dysfunction syndrome. However, rather than experience muscle or temporomandibular joint pain these patients had symptoms on waking which were typical of classical migraine. Nineteen patients with migraine symptoms were provided with acrylic occlusal splints for nocturnal wear. A good clinical response with considerable reduction in frequency and severity of pain attacks was achieved. PMID- 3563469 TI - Abnormal biochemical and cellular parameters in the blood of patients with Raynauds phenomenon. AB - Finger blood flow is decreased in Raynauds Phenomenon (RP). This may be due not only to vasospasm, but also to blood abnormalities. 40 patients with Raynauds Disease (RD), 28 with suspected RP (SS) and 42 with secondary Raynauds syndrome (RS) were enrolled and compared to 50 controls. Results from base-line samples show that those with RP have abnormal haemostasis and rheology whereas those with mild Raynauds, RD do not. Blood sampled after cold challenge in 15 RS patients and 15 controls show that both groups exhibit platelet activation after emersion. The degree of activation however was much more marked in the RS patients. We have shown that abnormalities of haemostasis and rheology are found in patients likely to have endothelial damage (RS). These changes are probably a consequence rather than a cause of the disease. After cold challenge the results become more abnormal and correlate with severity of disease. PMID- 3563470 TI - Inpatient cardiology in a rural district general hospital. AB - The pattern of cardiac admissions to a rural district general hospital has been analysed. Coronary artery disease is the major disorder, both as an acute and chronic problem. Other forms of heart disease are relatively uncommon. The absence of hypertension and hypertensive heart disease is striking. The deaths were mainly related to coronary artery disease. PMID- 3563471 TI - Home monitoring of blood pressure: usefulness as a predictor of persistent hypertension. AB - We set out to test the hypothesis that home blood pressure reflects "baseline" pressures measured at a general practitioner's surgery or in a hospital outpatient clinic. Twenty patients detected hypertensive during screening in general practice and 30 patients referred to a hospital hypertension clinic for revision of therapy were studied. All were instructed in the use of an electronic semiautomatic sphygmomanometer and measured blood pressure at home for a three day period. Home monitored blood pressure correctly predicted those patients whose diastolic blood pressure fell to below 95 mmHg by the third clinic visit in approximately 90% of all patients. In addition, in those whose blood pressure was high at home it remained so at the clinic or surgery after three visits. These data suggest that home monitoring of blood pressure may be a helpful alternative to repeated clinic visits before embarking on medical therapy. PMID- 3563472 TI - Cystic degeneration of the popliteal artery in a female patient--case report. PMID- 3563473 TI - Fulminant cardiac tamponade: an exceedingly rare presentation of squamous carcinoma of the bronchus in a male patient. AB - A 49 year old man presented with near-fatal, fulminant, haemorrhagic cardiac tamponade. He responded well to emergency pericardiocentesis and subsequent investigation revealed the cause to be an unknown squamous carcinoma of the bronchus with pericardial involvement. He died 13 weeks later. Such a dramatic presentation of this type of tumour in a male patient has not been previously described. PMID- 3563474 TI - Henoch Schonlein purpura presenting with pulmonary haemorrhage. AB - A young woman presented with arthralgia, a rash and dramatic haemoptysis, and renal involvement was indicated by proteinuria, haematuria and a rising serum creatinine. A systemic vasculitic disorder was suspected initially, but the diagnosis of Henoch-Schonlein purpura was established by the finding of mesangial IgA deposits on renal biopsy. Immunofluorescent study of renal biopsy material is vital to diagnosis where the clinical features of Henoch-Schonlein purpura and those of the systemic vasculitides with renal involvement prove to be indistinguishable. PMID- 3563475 TI - Spontaneous postpartum pneumomediastinum and pneumopericardium. AB - Pneumomediastinum and pneumopericardium are uncommon conditions usually associated with trauma to the chest and oesophagus. However, they may occur spontaneously with excessive coughing and straining and are rare complications of pregnancy. PMID- 3563476 TI - Toxic shock syndrome (TSS) in children. AB - Toxic shock syndrome is uncommon in the prepubertal age group. Two children presented with pyrexia, macular erythroderma, vomiting, hypotension and rapid deterioration of consciousness. One child had severe neurological involvement. The diagnosis of toxic shock syndrome was established in both cases by the exclusion of other causes and by culturing staphylococcus aureus. We postulate that the neurological manifestations were caused by a direct neurotoxic action of the staphylococcal-produced toxin. Both children made a complete recovery. PMID- 3563477 TI - AIDS: a threat to the heterosexual population. PMID- 3563478 TI - AIDS in Scotland: an update. PMID- 3563479 TI - Alcohol and hypertension. PMID- 3563480 TI - Severe pre-eclampsia in multiparous women: indication of an environmental triggering agent? AB - Two case histories are described with conflicting implications for the etiopathogenesis of pre-eclampsia. In both, typical proteinuric pre-eclampsia developed despite a history of previous normotensive pregnancy. In the first case, the disease was associated with a change of husband, consistent with the view that pre-eclampsia arises from an inadequate maternal immune response to paternal antigens inherited by the fetus. The second case, however, concerned a woman who developed pre-eclampsia for the first time in her third pregnancy by the same reproductive partner. We conclude that either more than one underlying cause can result in the clinical syndrome of pre-eclampsia, or that pre-eclampsia is caused by an environmental factor. The possibility that pre-eclampsia may be initiated by an infectious agent is briefly explored in the light of the clinical histories described and well-established epidemiological, clinical and laboratory data. PMID- 3563481 TI - Application of differential pulse anodic stripping voltammetry to the determination of heavy metals in environmental samples. AB - A reliable procedure for the determination of the trace metals Cd, Cu, Ni, Pb and Zn in liquid and solid environmental samples by an advanced voltammetric method has been developed. A convenient method of sample pretreatment is wet digestion in a HNO3/HClO4 mixture. The simultaneous voltammetric determination of Cd, Cu, Pb and Zn is made at pH 2 by differential pulse anodic stripping voltammetry (DPASV); the simultaneous determination of Ni and Co at pH 9 after adsorptive accumulation of the respective complex with dimethylglyoxime at the electrode is made by adsorption differential pulse voltammetry (ADPV). The particular advantages of the voltametric approach in food control for heavy metals are high sensitivity, good precision and accuracy, the possibilities for the simultaneous determination of groups of metals and low cost instrumentation. PMID- 3563482 TI - Bioaccumulation of metals by bivalves from the Limski Kanal (North Adriatic Sea). III. Copper distribution between Mytilus galloprovincialis (Lmk.) and ambient water. AB - Copper accumulation was studied in native mussels, Mytilus galloprovincialis, Lmk., from the Limski Kanal, North West Yugoslavia (Peninsula Istria), from June 1979 to June 1980. The distribution of copper between different body parts of the mussels is correlated with the concentrations of the different physico-chemical forms of copper in the ambient seawater. Free and labile complexes of dissolved Cu were electrochemically determined in a sample at a natural pH of approximately 8, "total" dissolved Cu was determined in acidified samples (pH 2), and Cu after acid decomposition of the suspended particulate matter was collected on 0.45 micron Millipore filters. The copper content correlates with the weight of the organs and with enhanced gametogenetic activity in the mussels. The copper concentrations in the total soft part and in the various organs are highly correlated with the dissolved "ionic" copper content of the ambient water. The particulate matter in the water column influences copper accumulation and its distribution within organs of the mussel. This conclusion arises because the concentration of copper in the mussels is highly correlated with the quantity of particulate material. The copper concentration varies very significantly with condition factors of the foot. Therefore, as the foot can be easily dissected, we propose this organ as a "sentinel" part of the mussel's body for "mussel watch", in the global monitoring program for copper surveillance. PMID- 3563483 TI - Bioaccumulation of metals by bivalves from the Limski Kanal (North Adriatic Sea). IV. Zinc distribution between Mytilus galloprovincialis, Ostrea edulis and ambient water. AB - From June 1979 to June 1980 the accumulation of zinc by the mussel Mytilus galloprovincialis and the oyster Ostrea edulis, from the Limski Kanal on the west coast of Istria, SR Croatia, Yugoslavia, was determined. The distribution of zinc within tissues and organs of mussels and oysters of the same length was related to the zinc concentration in the ambient water. Three physico-chemical forms of zinc can be distinguished in seawater: "ionic" dissolved (Zn electrochemically determined at the natural pH of seawater); "total" dissolved (Zn determined after sample acidification to pH 2); and particulate Zn (bound to suspended particles with a diameter 0.45 micron). The zinc content of different tissues and organs of both species increased significantly with an increase in their condition factors. Zinc concentration decreased significantly in all body parts of the oyster, but, in the mussel, only the foot was affected. Zinc concentrations in organs that are directly involved in the reproductive cycle showed a seasonal variation. The zinc concentration in the mantle of mussels was significantly and positively correlated with the "ionic" and "total" dissolved zinc content of water. Elevated amounts of particulate material suspended in the ambient water increase the filtration rate, which resulted in an accelerated accumulation of zinc by mussels, but not by oysters. Differences in zinc concentration between samples suggest that the dynamics of accumulation and loss may differ during the year; first, mainly as a consequence of the reproductive cycle in bivalves and the concentration of stimulants for filtration in the surrounding water, and second, by coastal input of Zn and by the amount of metal remobilized from the sediment. PMID- 3563484 TI - The determination of trace metals in sweat by anodic stripping voltammetry. AB - Sweating was induced on the forearm of subjects by pilocarpine iontophoresis, and the sweat collected on a small membrane filter. Zinc, cadmium, lead and copper were then determined in the filter by anodic stripping voltammetry (ASV) using one of two alternative techniques: leaching the filter with a supporting electrolyte (0.1 M NaNO3/0.002 M HNO3), followed by ASV of the leachate; or, direct ASV analysis of the trace metals in the membrane filter using a novel thin layer cell. Average values found for zinc, cadmium, lead and copper in sweat from males were (micrograms 1-1): 720, less than 3, 15 and 80, respectively. Copper in sweat from females was lower (23 micrograms l-1) than for males, although use of oral contraceptives appeared to increase copper concentration. PMID- 3563485 TI - Bone biology. PMID- 3563486 TI - Is alcoholism treatment effective? PMID- 3563487 TI - "Switching" in yeast and slime molds. PMID- 3563488 TI - Making contacts in the developing embryo. PMID- 3563489 TI - Antiarthritic gold compounds effectively quench electronically excited singlet oxygen. AB - Although certain gold [Au(I)] compounds have been used effectively in the treatment of rheumatoid arthritis for some years, the molecular basis for such therapeutic action has been unclear. One possible mechanism of the action of Au(I) compounds is that they protect unsaturated membrane lipids and proteins against oxidative degradation caused by activated phagocytes that are not properly regulated. In this study it has been shown that superoxide ion (O-2.), a product of activated phagocytes, can be oxidized to electronically excited singlet oxygen (O1(2)delta g), an agent that is capable of peroxidation of unsaturated fatty acid derivatives. It has also been shown that antiarthritic Au(I) compounds are effective deactivators of O1(2)delta g with quenching constants on the order of 10(7) M-1 sec-1. PMID- 3563490 TI - Identification of an amplified, highly expressed gene in a human glioma. AB - A gene, termed gli, was identified that is amplified more than 50-fold in a malignant glioma. The gene is expressed at high levels in the original tumor and its derived cell line and is located at chromosome 12 position (q13 to q14.3). The gli gene is a member of a select group of cellular genes that are genetically altered in primary human tumors. PMID- 3563491 TI - Breuning's accuser has grant deferred. PMID- 3563492 TI - Metabolic Catch-22 of exercise regimens. PMID- 3563493 TI - Brain grafts benefit Parkinson's patients. PMID- 3563494 TI - Answering autobiographical questions: the impact of memory and inference on surveys. AB - Survey questions often probe respondents for quantitative facts about events in their past: "During the last 2 weeks, on days when you drank liquor, about how many drinks did you have?" "During the past 12 months, how many visits did you make to a dentist?" "When did you last work at a full-time job?" are all examples from national surveys. Although questions like these make an implicit demand to remember and enumerate specific autobiographical episodes, respondents frequently have trouble complying because of limits on their ability to recall. In these situations, respondents resort to inferences that use partial information from memory to construct a numeric answer. Results from cognitive psychology can be useful in understanding and investigating these phenomena. In particular, cognitive research can help in identifying situations that inhibit or facilitate recall and can reveal inferences that affect the accuracy of respondents' answers. PMID- 3563495 TI - Steroidogenesis-activator polypeptide isolated from a rat Leydig cell tumor. AB - A cycloheximide-sensitive protein responsive to adenosine 3',5'-monophosphate has been postulated to participate in the regulation of cholesterol side-chain cleavage activity in steroidogenic tissues. Such a steroidogenesis activator polypeptide (SAP) had been isolated from rat adrenocortical tissue and partially characterized. Now a polypeptide with comparable chromatographic behavior and biological activity has been purified from the rat H-540 Leydig cell tumor in quantities sufficient for amino acid sequencing. The activator contains 30 amino acid residues and has a molecular weight of 3215. The synthetic construct based on this sequence is virtually equipotent with native H-540 tumor SAP in an adrenal mitochondrial cholesterol side-chain cleavage assay. Hormonal regulation of the intracellular concentration of this activator may control the rate of cholesterol metabolism in steroidogenic organs. PMID- 3563496 TI - It is diprotonated inorganic phosphate that depresses force in skinned skeletal muscle fibers. AB - The increases in the intracellular concentrations of inorganic phosphate and hydrogen ion accompanying fatigue of skeletal muscle appear to be the most important metabolic changes associated with the decrease in contractile force. Experiments on chemically skinned single fibers from rabbit psoas muscle with pH ranging between 6 and 7.25 demonstrate that the depression of maximal calcium activated force by inorganic phosphate correlates nicely with the concentration of the acidic (diprotonated) species. Therefore, in addition to the well-known depressant effect on the contractile machinery of lowering pH per se, any decrease of intracellular pH associated with fatigue further depresses force production by converting more of the total inorganic phosphate within the cell to the inhibitory diprotonated form. PMID- 3563497 TI - Cellular localization of somatomedin (insulin-like growth factor) messenger RNA in the human fetus. AB - The somatomedins or insulin-like growth factors (IGFs) are synthesized in many organs and tissues, but the specific cells that synthesize them in vivo have not been defined. By in situ hybridization histochemistry, IGF I (somatomedin C) and IGF II messenger RNAs were localized to connective tissues or cells of mesenchymal origin in 14 organs and tissues from human fetuses. IGF messenger RNAs were localized to perisinusoidal cells of liver, to perichondrium of cartilage, to sclera of eye, and to connective tissue layers, sheaths, septa, and capsules of each organ and tissue. All of the hybridizing regions are comprised predominantly of fibroblasts or other cells of mesenchymal origin. Because these cells are widely distributed and anatomically integrated into tissues and organs, they are ideally located for production of IGFs, which may exert paracrine effects on nearby target cells. PMID- 3563498 TI - Bipedal vertebrates. PMID- 3563499 TI - Values and science curricula. PMID- 3563500 TI - The future of science in space. PMID- 3563501 TI - Tobacco science wars. PMID- 3563503 TI - Report urges funds for conservation biology. PMID- 3563502 TI - Industry toxicologists keen on reducing animal use. PMID- 3563504 TI - Panel urges newborn sickle cell screening. PMID- 3563505 TI - Risk assessment and comparisons: an introduction. AB - Risk assessment is presented as a way of examining risks so that they may be better avoided, reduced, or otherwise managed. Risk implies uncertainty, so that risk assessment is largely concerned with uncertainty and hence with a concept of probability that is hard to grasp. The results of even the simplest risk assessments need to be compared with similar assessments of commonplace situations to give them some meaning. We compare and contrast some risk estimates to display their similarities and differences. PMID- 3563507 TI - Perception of risk. AB - Studies of risk perception examine the judgements people make when they are asked to characterize and evaluate hazardous activities and technologies. This research aims to aid risk analysis and policy-making by providing a basis for understanding and anticipating public responses to hazards and improving the communication of risk information among lay people, technical experts, and decision-makers. This work assumes that those who promote and regulate health and safety need to understand how people think about and respond to risk. Without such understanding, well-intended policies may be ineffective. PMID- 3563506 TI - Ranking possible carcinogenic hazards. AB - This review discusses reasons why animal cancer tests cannot be used to predict absolute human risks. Such tests, however, may be used to indicate that some chemicals might be of greater concern than others. Possible hazards to humans from a variety of rodent carcinogens are ranked by an index that relates the potency of each carcinogen in rodents to the exposure in humans. This ranking suggests that carcinogenic hazards from current levels of pesticide residues or water pollution are likely to be of minimal concern relative to the background levels of natural substances, though one cannot say whether these natural exposures are likely to be of major or minor importance. PMID- 3563508 TI - Risk assessment in environmental policy-making. AB - Environmental policy-making has become more dependent on formal, quantitative risk assessment because of increasing attention to the prevention of human health damage from toxic chemicals. Risk assessment helps set priorities for regulation of the very large numbers of chemicals that are of potential concern and helps direct limited social and government resources against the most significant risks. Although the scientific basis for risk assessment is often uncertain and the public and its representatives have often been confused by its use in regulatory decisions, the U.S. Environmental Protection Agency currently uses a variety of risk assessment techniques to set priorities, tailor regulations, and make decisions at particular sites. The Environmental Protection Agency also attempts to make the practice of risk assessment more consistent throughout the agency and to improve public understanding of the meaning of risk assessment and risk management. PMID- 3563509 TI - Health and safety risk analyses: information for better decisions. AB - Knowing the nature and magnitude of health and safety risks is helpful in setting priorities as well as in making decisions about pursuing recreational activities, foods, jobs, and other aspects of everyday living. "Risk-risk" situations require a choice among risky alternatives. "How safe" situations involve a more general choice as to how much of other desired activities to sacrifice for increased safety. "How safe" situations are inherently more difficult to manage, because they are subject to fuzzy thinking and rhetoric. The large uncertainties of current estimates must be conveyed explicitly to arrive at sensible decisions. PMID- 3563510 TI - The safety goals of the U.S. Nuclear Regulatory Commission. AB - In August 1986, after 6 years of effort, the U.S. Nuclear Regulatory Commission adopted a Policy Statement on safety goals for nuclear power reactors. The commission's qualitative goals state that individual members of the public should be provided a level of protection from the consequences of nuclear power plant operation such that they bear no significant additional risk to life and health, and societal risks to life and health from nuclear power should be comparable to or less than the risks of generating electricity by viable competing technologies and should not be a significant addition to other societal risks. The commission's safety goal Policy Statement also includes quantitative design objectives. PMID- 3563511 TI - Identification and localization of mutations at the Lesch-Nyhan locus by ribonuclease A cleavage. AB - Many mutations leading to human disease are the result of single DNA base pair changes that cannot be identified by Southern analysis. This has prompted the development of alternative assays for point mutation detection. The recently described ribonuclease A cleavage procedure, with a polyuridylic acid-paper affinity chromatography step, has been used to identify the mutational lesions in the hypoxanthine phosphoribosyltransferase (HPRT) messenger RNAs of patients with Lesch-Nyhan syndrome. Distinctive ribonuclease A cleavage patterns were identified in messenger RNA from 5 of 14 Lesch-Nyhan patients who were chosen because no HPRT Southern or Northern blotting pattern changes had been found. This approach now allows HPRT mutation detection in 50 percent of the cases of Lesch-Nyhan syndrome. The polyuridylic acid-paper affinity procedure provides a general method for analysis of low abundance messenger RNAs. PMID- 3563512 TI - Newly identified 'glutamate interneurons' and their role in locomotion in the lamprey spinal cord. AB - A new class of excitatory premotor interneurons that are important in the generation of locomotion in the lamprey has now been described. In the isolated spinal cord, these neurons act simultaneously with their postsynaptic motoneurons during fictive swimming. They are small and numerous, and they monosynaptically excite both motoneurons and inhibitory premotor interneurons. The excitatory postsynaptic potentials are depressed by an antagonist of excitatory amino acids. These interneurons receive reticulospinal input from the brain stem and polysynaptic input form skin afferents. A model of the network underlying locomotion based on the synaptic interactions of these neurons can now be proposed for the lamprey. PMID- 3563513 TI - Clathrin light chains LCA and LCB are similar, polymorphic, and share repeated heptad motifs. AB - The clathrin light chains fall into two major classes, LCA and LCB. In an intact clathrin triskelion, one light chain, of either class, is bound to the proximal segment of a heavy chain leg. Analysis of rat brain and liver complementary DNA clones for LCA and LCB shows that the two light chain classes are closely related. There appear to be several members of each class having deletions of varying length aligned at the same position. A set of ten heptad elements, characteristic of alpha-helical coiled coils, is a striking feature of the central part of each derived amino acid sequence. These observations suggest a model in which the alpha-helical segment mediates binding to clathrin heavy chains and the amino- and carboxyl-terminal segments mediate interactions with other proteins. They also suggest an explanation for the observed tissue dependent size variation for members of each class. PMID- 3563514 TI - The ethics of biotechnology. PMID- 3563515 TI - GAO report angers cancer officials. PMID- 3563516 TI - EPA indicts formaldehyde, 7 years later. PMID- 3563517 TI - How to ask about sex and get honest answers. PMID- 3563518 TI - Report blasts human development office. PMID- 3563519 TI - Glucocorticoid receptor mutants that define a small region sufficient for enhancer activation. AB - Transcriptional enhancement is a general mechanism for regulation of gene expression in which particular proteins bound to specific DNA sequences stimulate the efficiency of initiation from linked promoters. One such protein, the glucocorticoid receptor, mediates enhancement in a glucocorticoid hormone dependent manner. In this study, a region of the 795-amino acid rat glucocorticoid receptor that is active in transcriptional enhancement was identified. The active region was defined by expressing various receptor deletion mutants in stably and transiently transfected cells and examining the regulated transcription of hormone-responsive genes. Mutant receptors lacking as many as 439 amino-terminal amino acids retained activity, as did those with as many as 270 carboxyl-terminal amino acids deleted. This suggests that the 86-amino acid segment between the most extensive terminal deletions, which also includes sequences required for specific DNA binding in vitro, is sufficient for enhancer activation. In fact, a 150-amino acid receptor fragment that encompasses this segment mediates constitutive enhancement. PMID- 3563520 TI - Evidence for increased somatic cell mutations at the glycophorin A locus in atomic bomb survivors. AB - A recently developed assay for somatic cell mutations was used to study survivors of the atomic bomb at Hiroshima. This assay measures the frequency of variant erythrocytes produced by erythroid precursor cells with mutations that result in a loss of gene expression at the polymorphic glycophorin A (GPA) locus. Significant linear relations between variant frequency (VF) and radiation exposure were observed for three different variant cell phenotypes. The spontaneous and induced VFs agree with previous measurements of radiation-induced mutagenesis in other systems; this evidence supports a mutational origin for variant cells characterized by a loss of GPA expression and suggests that the GPA assay system may provide a cumulative dosimeter of past radiation exposures. VFs for some survivors differ dramatically from the calculated dose response, and these deviations appear to result primarily from statistical fluctuations in the number of mutations in the stem-cell pool. These fluctuations allow one to estimate the number of long-lived hemopoietic stem cells in humans. PMID- 3563521 TI - Cells in temporal cortex of conscious sheep can respond preferentially to the sight of faces. AB - To investigate whether the temporal cortex of a nonprimate species contains cells responsive to the sight of faces, a study was made in conscious sheep of the responses of neurons in this brain region to the sight of faces. Of 561 cells from which responses were recorded, 40 responded preferentially to faces. Different categories of these cells were influenced by dominance (presumably indicated by the presence and size of horns), breed and familiarity, and threatening faces such as those of humans and dogs. These results demonstrate that cells that respond preferentially to faces are present in the temporal cortex of a nonprimate species, and that the responses of these cells are influenced by factors relevant to social interaction. PMID- 3563522 TI - A small gold-conjugated antibody label: improved resolution for electron microscopy. AB - A general method has been developed to make the smallest gold-conjugated antibody label yet developed for electron microscopy. It should have wide application in domainal mapping of single molecules or in pinpointing specific molecules, sites, or sequences in supramolecular complexes. It permits electron microscopic visualization of single antigen-binding antibody fragments (Fab') by covalently linking an 11-atom gold cluster to a specific residue on each Fab' such that the antigenic specificity and capacity are preserved. The distance of the gold cluster from the antigen is a maximum of 5.0 nanometers when the undecagold-Fab' probe is used as an immunolabel. PMID- 3563523 TI - Glucocorticoid receptor-like antigen in lymphoma cell membranes: correlation to cell lysis. AB - S-49 mouse lymphoma cells undergo lysis when treated with glucocorticoids; the mechanism of this effect is not understood. A protein was detected in the plasma membrane of these cells by means of direct immunofluorescent labeling with a monoclonal antibody to the soluble glucocorticoid receptor. Cellular heterogeneity in the content of this glucocorticoid receptor-like molecule was evident. By immunoadsorption to antibody-coated tissue culture plates, the cells were separated into populations positive (100%) and depleted (38%) for this membrane antigen. Gel electrophoresis, specific immunoblot, and autoradiographic (binding of [3H]dexamethasone mesylate) analysis of the membrane proteins from the membrane antigen-positive group revealed multiple protein bands ranging in size from 85 to 145 kilodaltons. Furthermore, comparison of the glucocorticoid sensitivity of these groups of cells showed complete lysis of the membrane antigen-positive cells and only partial lysis of the antigen-deficient group, which suggests that the lysis response of cells to glucocorticoids is mediated by a glucocorticoid receptor-like molecule located in the plasma membrane. PMID- 3563524 TI - Nodal osteoarthritis of the toes. PMID- 3563525 TI - Renal involvement in mixed connective tissue disease: a longitudinal clinicopathologic study. AB - Eleven of 30 patients with MCTD, followed for a mean of 10 years, developed immune complex nephropathy (five membranous, two mesangial, one mixed, and one sclerosing) with NS in nine of 11. Another patient had membranous nephropathy at autopsy. Patients with renal disease tended to have more systemic manifestations than those without. NS was at times of abrupt onset, recurrent, and/or persistent. Anti-RNP and serum complement were not helpful in predicting nephritis. Seventy-two percent of nephropathy and 62% of NS episodes resolved or improved after corticosteroid therapy. Five patients became hypertensive, two developed chronic renal failure and required chronic dialysis, and one needed acute dialysis twice. One patient progressed to focal proliferative crescentic nephritis with necrotizing arteritis. Three patients with nephropathy died, two of pulmonary hypertension with acute cor pulmonale and one of overwhelming sepsis. Nephropathy is relatively common in MCTD, is associated with substantial morbidity, and with the risk of hypertension and chronic renal failure. PMID- 3563527 TI - [Value of bridging plate osteosynthesis in multiple fragment fracture damage of the femur in a clinical comparison]. PMID- 3563526 TI - Systemic lupus erythematosus and angioimmunoblastic lymphadenopathy: case report and review of the literature. PMID- 3563528 TI - [Craniocerebral trauma and femoral fracture in pediatric polytrauma]. PMID- 3563529 TI - [Anterior cruciate ligament reflex (LCA reflex)]. PMID- 3563530 TI - [Measurements of patellofemoral pressure and contact surface: cartilage abrasion as an isolated or concomitant measure in chondromalacia patellae of normal and malformed patellas. An experimental study]. PMID- 3563532 TI - [Results following conservative treatment of osseous ligament ruptures of the ankle joint in children]. PMID- 3563531 TI - [Stabilizing aids in the early functional treatment of fibular ligament rupture. A comparative experimental study]. PMID- 3563533 TI - [Isolated dislocation of the 5th carpometacarpal joint. A case report]. PMID- 3563534 TI - [Anterior cruciate ligamentplasty. Comparative results of various surgical technics]. PMID- 3563535 TI - [Early detection of diaphragmatic rupture]. PMID- 3563536 TI - [Bronchoscopy of lung contusion in severe thoracic trauma]. PMID- 3563537 TI - [Depressed skull fractures in children]. PMID- 3563538 TI - [Significance of the terminal screw in plate osteosynthesis with reference to the deformation behavior of the bone below the end of the plate]. PMID- 3563539 TI - [Experience in the treatment of closed injuries of the extensor tendons of the interphalangeal joint]. PMID- 3563540 TI - [Improved possibility for applying immobilizing bandages to the sleeping patient following interventions of the shoulder girdle and upper extremities]. PMID- 3563541 TI - [Corrective osteotomies of the distal forearm]. PMID- 3563542 TI - Quality of 1980 census data for American Indians. PMID- 3563543 TI - Female reproductive development: a hazards model analysis. PMID- 3563544 TI - Legalization of consensual unions in Mexico. PMID- 3563546 TI - Age differences between spouses in first marriages. PMID- 3563545 TI - Why not use contraception? Economics of fertility regulation among rural Egyptian women. PMID- 3563547 TI - Low-fertility childbearing decision making. PMID- 3563548 TI - Macroanalytic study of development and fertility: consideration of transition models. PMID- 3563549 TI - A suicide epidemic model. PMID- 3563551 TI - Effect of father's education on child's cognitive ability. PMID- 3563550 TI - Socioeconomic development, medical care, and nutrition as determinants of infant mortality in less-developed countries. PMID- 3563553 TI - Arab-American patients: a medical record review. AB - This exploratory study consisted of a medical record review of patients with Arabic surnames who utilized outpatient, inpatient, or emergency facilities of a university medical center and a public teaching hospital from 1975 to 1981. The purposes of the study were to describe help-seeking behavior of Arab-American patients, including why they sought care and whether they posed problems for providers, and to determine if the medical records identified culturally-related care needs. This report describes data from 106 charts reviewed with reference to demographic data, illness behavior, and use of facilities. The findings revealed more about charting habits of health professionals than about unique characteristics of patients in this ethnic group. PMID- 3563554 TI - Meningitis and unpaved roads. AB - Access to health care may be influenced by a variety of factors including ones attributable to the individual as well as ones attributable to the health care system. One category frequently referred to is 'geographic' factors of distance and travel time. In the present study, a previously undescribed geographic factor -unpaved roads--is shown to be a clinically important barrier to access. Using a case-control format, children admitted with bacterial meningitis are shown to have traveled farther over unpaved roads to get to a clinic than matched controls seen at the same time. With control groups matched for age and similar pre existing illness, the implication is that unpaved roads resulted in increased morbidity by reducing access. PMID- 3563552 TI - Some recent trends in infant mortality in the province of Marrakech, Morocco: a demographic transition in process. PMID- 3563555 TI - Development of a measure of potential health behaviour: a salience of lifestyle index. AB - The development of a salience of lifestyle index to measure potential health behaviour is described with its validation, including the relationship between the new index and various measures of preventive health behaviour. The complex cascade of antecedents which contribute to a decision to make or not make a specific lifestyle choice is summarised to clarify the contribution of the salience of lifestyle index to pure research and evaluative studies. PMID- 3563556 TI - Informed consent: the physicians' perspective. AB - Using the current controversy in breast cancer treatment as a model, this paper reports on physicians' attitudes and behavior in the use of informed consent. Findings are based on a survey of 170 oncologists from eight countries and representing three medical specialties. Physician responses indicate that they regarded informed consent as an intrusion into the doctor-patient relationship. Problems identified by the physicians included: decreasingly effective doctor patient communication; less personalized relationships with patients and curtailed freedom with regard to disclosure procedures. They also viewed the informed consent regulation as having a negative impact on their patient care. The constraints of obtaining informed consent reduced physicians' willingness to participate in scientific experiments. The consent form was seen to highlight their dual role as care-giver and scientific investigator, making them uncomfortable in dealing with patients. These findings demonstrate the ways in which legal restrictions associated with the introduction of new technologies critically affect the practice of medicine. PMID- 3563557 TI - Relationship of chronic stress, social support, and coping style to health among Namibian refugees. AB - This study investigates how social support and coping style affect the relationship between a traumatic chronic stressor and health status. A population of 88 Namibian refugees living in an equatorial region of Africa participated in the study. The central hypothesis was that social support and coping style moderate the relationship between length of stay in exile (a proxy measure of chronic stress) and health status (symptoms of generalized anxiety disorders, self-reported physical health status and length of stay in hospital). The results show that when social support is high the relationship between length of stay in exile and all three health outcomes is substantially reduced. When social support is low, the relation between stress and poor health outcomes is high. Coping style moderates the relationship between length of stay in exile and period of hospitalization but has no effect on level of anxiety or perceived health status. When both social support and coping style are simultaneously considered, the best results emerge. PMID- 3563558 TI - The family's adaptation to childhood leukemia. AB - This baseline study obtained data measuring the specific effects of the stress of childhood leukemia on family life and on the lives of individual family members. Mothers, fathers, siblings, and patients were included in the data collection. Specific variables measured were marital adjustment, anxiety level, dynamics of family interaction, and the school behavior of patients and siblings. The data were collected at designated intervals over a one year period beginning at the time of diagnosis. In addition, the data were utilized to speculate on those families that appeared to be at risk for the development of long-term psychosocial problems secondary to, or aggravated by the illness. Results indicated that patterns of coping for families, as well as for individual family members, were relatively constant over time. Families with predominantly stable relationships and adequate support within the family unit were able to maintain their usual quality of life over an extended period of time despite the onset of acute stress. However, families with pre-existing problems prior to diagnosis for the most part experienced increased deterioration in family life and had difficulty coping. Results of the Spielberger State-Trait Anxiety Scale, the Locke-Wallace Marital Adjustment Test, the Moos Family Environment Scale, the MMPI, and school data supporting these conclusions are given. PMID- 3563559 TI - The best of both worlds: bringing traditional medicine up to date. AB - If there is to be any real improvement in the health of the underserved populations of the world, there will have to be full utilization of all available resources, human and material. This is fundamental to the primary health care approach. Traditional practitioners constitute the most abundant and, in many cases, valuable health resources present in the community. They are important and influential members of their communities who should be associated with any move to develop health services at the local level. There have been varying responses to a number of key WHO resolutions that call on Member States to develop traditional medicine activities as part of their national health services. Some aspects of the work of WHO Collaborating Centres for Traditional Medicine and some current activities of the traditional medicine programme are described. A number of guiding principles which may help the Organization and other international and donor agencies working in this area are also suggested. PMID- 3563560 TI - Public awareness of AIDS in Rwanda. AB - AIDS is a rapidly growing epidemic in Kigali, Rwanda. To understand the level of public awareness of AIDS in that city, 33 informants (15 men and 18 women) were interviewed during September, 1985. Most (66.7%) said that they first heard of the disease only within the previous eight months. About half (46.9%) could not mention one or more AIDS symptoms. Younger informants and women reported less knowledge of AIDS symptoms. While nearly everyone recognized AIDS as a stigmatized disease, most informants apparently did not know why it is stigmatized. Only about one-third of the informants (34.4%) could correctly state the mode of AIDS transmission. People who are at greatest risk for the disease, unmarried men and women, were least likely to know how it is transmitted. Half (50.0%) of those informants who responded to the question of the origins of AIDS said that it began in 'America.' While many informants are frightened by the disease, no one has yet changed their sexual behavior as a response to the epidemic. All informants agreed that more information about AIDS should be made available in Rwanda. Preventive measures against the spread of AIDS are urgently needed in central Africa. PMID- 3563561 TI - Gender and symptoms of depression and anxiety among Kikuyu secondary school students in Kenya. AB - Numerous studies have confirmed that patterns of mental illness are influenced by sociocultural factors such as socioeconomic status and gender. This study describes the patterning of symptoms of depression and anxiety on a 20 item self report questionnaire, the Health Opinion Survey, completed by 159 Kikuyu secondary school students in Kenya. Significant quantitative differences in the responses of males and females to seven of the questions were found, including females reporting more depression symptoms than males. These results are compared to an earlier study of 116 Kikuyu adults in which the differences between males and females were greater. This paper contributes to the literature on the relationship between gender and depression while adding to the sparse descriptive literature on symptoms of depression and anxiety in normal African populations. PMID- 3563562 TI - Tai Dam health care practices: Asian refugee women in Iowa. AB - This study discusses several aspects of health care utilization and health care practices for a group of Tai Dam refugee women who today are living in central Iowa. Several important variables examined in this discussion include: ideas about illness etiology, choice and use of health care providers, birth control practices, and the use of preventive health care in the form of prenatal health care visits. Salient findings include: Tai Dam belief that the majority of illnesses are caused by temperature and weather changes or bad food and water, or that illnesses are caused by the supernatural. Two-thirds of the women do not use and have never used any form of birth control. Although the average Tai Dam woman had been living in the U.S. for seven years at the time of the study, communications with physicians and understanding of written medicine instructions is difficult for many due to language problems. One-quarter of the women are not covered by medical insurance of any kind. PMID- 3563563 TI - Patterns of rural hospital closure in the United States. AB - This is a case-control study of rural hospitals which closed between 1970 and 1980. Nonmetropolitan hospitals which closed were matched with a comparable set of hospitals which remained open, yielding 148 closures (cases) and 310 controls. Univariate and multivariate analyses indicate that closed hospitals differ from open hospitals in their internal characteristics, and that their geographical service areas also are significantly different. At the multivariate level, the most significant variables, as determined by stepwise discriminant analysis, are the ownership (profit) status of the hospital, occupancy rate, competitive beds within the county, scope of service, and county population change during the preceding decade. The nature of the discriminant functions differed between counties which were adjacent to metropolitan areas, and those which were not adjacent to metropolitan areas. Closed hospitals differ from open hospitals, as ascertained by standard data sources. Hospital closure reflects the interaction of internal hospital characteristics, and the characteristics of the hospital's service area. PMID- 3563564 TI - Applications of behavior modification to health promotion in the developing world. AB - This paper reviews the fundamental concepts and technology of behavior modification. Behavioral strategies are categorized as employing either 'pleasant' or 'unpleasant' consequences for accelerating or decelerating target behaviors. Subsequently, a review of the applications of this technology to wasteful fertility is provided. Given the additional importance of malnutrition and communicable diseases to the health in the developing world, behavioral approaches to their control are also reviewed or proposed. The article concludes with a discussion of the limitations and recommendations for use of behavior modification in health promotion in a developing country context. PMID- 3563566 TI - The role of the chemist in primary health care for children with minor complaints. AB - There has been considerable debate about the professional status of pharmacy and the relationship between pharmacists and the medical profession. There has been less emphasis on the consumers' view of chemists and on the use made of over-the counter remedies. This paper examines the actual and potential role of the chemist in dealing with minor complaints in young children. A sample of 54 mothers of young children were interviewed in a study examining the cultural context of childhood illness. The use which the mothers made of chemists for advice and for the purchase of proprietary medicines was examined. The findings of this aspect of the study are outlined, and the implications which these have for the role of the chemist within the primary health care team and lay health care network are discussed. In the light of this analysis tentative recommendations are made for an expansion of the role of the chemist in dealing with minor complaints in children. PMID- 3563565 TI - Patient satisfaction with the clinical encounter: social psychological determinants. AB - Patient-practitioner transactions in the ambulatory setting have become an increasingly important focus for research in recent years. In particular, there is growing interest in providing empirical support for our anecdotal, 'common sense' notions that clinical encounter experiences are a major determinant of outcomes such as the patient's satisfaction with the encounter. The present study was designed to look at this issue and addressed the following two research questions: Is there a relationship between fulfillment of patient requests for services and patient satisfaction with the clinical encounter? and What degree of satisfaction is explained by the qualities of the encounter as compared to the characteristics of the patient, physician, and system of health care? Four newly developed instruments were administered to a convenience sample of 144 adult patients and their physicians prior to and following actual visits to a University Family Practice Center. Meeting patients' requests increased their satisfaction with the encounter. At least 19% of the variance in patient satisfaction could be attributed to request fulfillment. The implications of these findings for future research into the doctor-patient relationship are discussed. PMID- 3563567 TI - Comparison of a dietary attitude index based on questionnaire data and a 7-day diet recall interview: a study among pregnant women. AB - It is expensive to obtain detailed information on the dietary habits of a large number of persons. If a short set of questions could give a fairly accurate description of the quality of food intake based on accepted norms, these questions could serve as a source of important proxy information of eating habits in a number of studies. In a random sample of women late in their pregnancy, information from a 7-day diet recall interview and questionnaire data on dietary attitude were compared. The sample consisted of 175 women, and 167 of these 175 women participated in the study. On the basis of the questionnaire data, an index were computed according to the Rasch model. No association was found between this index and the quality of food intake according to recommended daily dietary allowances for pregnant women. The questionnaire index was no useful substitute for the dietary recall interview. PMID- 3563569 TI - Proteins of excitable membranes. PMID- 3563568 TI - Recent work on bacteriorhodopsin. PMID- 3563571 TI - CME reexamined. PMID- 3563572 TI - The religious medical model: holy medicine and the Spiritual Behavior Inventory. AB - This paper describes the history and basis of the Spiritual Inventory from its beginning. Initially, the Inventory took the form of a casual interview. The advantage of an interview is clinical judgment and the ability to diagnose the spirituality of the patient. Analysis of spiritual behavior is a useful clinical tool. This paper also includes a detailed explanation of the role of the rabbi physician. PMID- 3563570 TI - Coordinate regulation of expression of synaptic proteins in skeletal muscle: studies with acetylcholine receptor. PMID- 3563573 TI - Seizures and hypothermia due to dietary water intoxication in infants. AB - I retrospectively describe 20 episodes of water intoxication in 19 infants, with hypothermia, seizures, and hyponatremia. Overdilution of formula or aggressive supplementation with water or clear juices were documented in 16 of the 20 episodes. Seizures and respiratory distress were severe enough in six cases to require intubation and ventilatory support. Marked diaphoresis was noted as a premonitory symptom to seizures in eight children. The children were an average of 5.1 +/- 4.3 months of age; serum sodium values averaged 118 +/- 4.3 mmol/L. No evidence of excess production of antidiuretic hormone was found. Water intoxication in infants is common, and I discuss its possible relationship to demyelinating disease of the central nervous system. PMID- 3563574 TI - Roentgenologic diagnosis of stress fractures and stress reactions. AB - We examined 26 athletes with continued pain after strenuous exercise. We found stress fractures in 15 patients, all of whom had positive roentgenographic studies. Seven of these 15 also had bone scans, all of which were positive. Five patients had stress reactions, all of which showed positive results on bone scan and negative roentgenographic results. Five had occult stress reactions manifested by pain, with normal roentgenographic and scintigraphic results, and one had minor pain not requiring radiologic studies. Stress reaction is contrasted with stress fracture by demonstrating the role of bone imaging in the diagnostic continuum of stress reaction to stress fracture. PMID- 3563575 TI - Carotodynia exposed: hyoid bone syndrome. AB - The hyoid bone syndrome, first described in 1954, is manifested by tenderness near the greater horn of the hyoid bone. In 1968, the syndrome was reported to be a form of insertion tendinosis, and injection of procaine HCl with corticosteroid at the tip of the greater horn was found to provide temporary relief of pain. I report 50 patients with the hyoid bone syndrome who had excision of the involved greater horn after one month of conservative medical treatment failed to relieve the pain. Operation promptly relieved pain in 45 (90%) of the patients. An understanding of the close relationship between the greater horn of the hyoid and the posterior pharynx and carotid sinus is important in detecting the hyoid bone syndrome. PMID- 3563576 TI - Laryngeal carcinoma in situ: a therapeutic dilemma. AB - Two patients having laryngeal carcinoma in situ and seven having carcinoma in situ with microinvasion were treated with laser mucosal dissection of the vocal cords followed by vaporization of adjacent or deeper tissue that appeared abnormal through the operating microscope. In these early cases the depth of vaporization was usually superficial, so the normal architecture of the vocal cords was preserved. Five patients had recurrence or persistence of abnormal tissue; three required one additional laser treatment and two required two additional treatments. After follow-up periods ranging from 18 to 60 months, all patients are presently free of laryngeal abnormalities. No surgical procedures or radiation treatments were required. I believe transoral endoscopic laser treatment of laryngeal carcinoma in situ with or without microinvasion is both feasible and desirable. PMID- 3563577 TI - Surgical management of congenital conductive deafness. AB - Today's otologic surgeon has the opportunity to restore normal serviceable hearing in patients with congenital conductive deafness using tympanoplasty with ossicular chain reconstruction, stapedectomy, or fenestration of the horizontal semicircular canal. The particular surgical approach used is determined by the abnormalities found in the congenitally deformed ear. I report a series of 18 patients who had operation for congenital conductive deafness during a four-year period at the Farrior Clinic. The study results show the efficacy of surgical reconstruction in producing an improvement in hearing. PMID- 3563578 TI - Apheresis in a community hospital: six years' experience. AB - We present our six-year experience with apheresis in a community hospital in northern Virginia. A total of 2,892 procedures were done, including 2,232 thrombocytaphereses on normal donors for collection of platelets and 660 therapeutic plasma exchanges in patients having a variety of disorders. We hope our experience will be helpful to those who contemplate setting up similar programs. PMID- 3563579 TI - Emergency surgery for pancreatic pseudocysts. AB - Pancreatic pseudocysts are a frequent complication of acute and chronic pancreatitis. The management of acute surgical emergencies associated with pseudocysts is unique. In a series of 117 patients with one or more pancreatic pseudocysts, 32% required urgent operation because of a cyst-related complication. The mean day of pseudocyst diagnosis was 7.8. Thirty percent of the patients had operation on the day of admission, while 70% required operation during cyst maturation because of an increase in size of the cyst or suspected rupture or infection. Twelve patients were found to have mature cysts at operation and had internal drainage, and external drainage was used in 56%. A pancreatic fistula developed in 22% of the patients, and septic complications occurred in 27% of surviving patients. The overall mortality was 18.9%. Mortality was 18% and 19%, respectively, for patients who had operation on the day of admission or during cyst maturation. PMID- 3563581 TI - Morphologic effects of percutaneous balloon pulmonary valvuloplasty. AB - Five patients with pulmonary valve stenosis and other cardiac anomalies had elective operative repair after percutaneous balloon pulmonary valvuloplasty. Four had reduction in pulmonary valve gradients from 67 +/- 9 mm Hg to 39 +/- 9 mm Hg (P less than .01), whereas one patient with a dysplastic pulmonary valve did not. Operative evaluation of the pulmonary valves revealed the morphologic effects of the balloon forces on the stenotic valves to be commissure splitting in one patient, cusp tear in one patient, and a combination of commissure splitting and cusp avulsion in two patients. There were no deaths. Patients with combined infundibular and pulmonary valve stenosis have a high potential for cusp avulsion due to fixation of the balloon in the infundibulum and retraction of the balloon into the ventricle during systole. Echocardiography, cardiac catheterization pressure gradients, and cineangiography should be used to assess infundibular stenosis and avoid percutaneous balloon angioplasty in patients who have combined pulmonary valve stenosis and infundibular pulmonary stenosis. PMID- 3563580 TI - Gallbladder surgery in patients over 60: is there an increased risk? AB - We reviewed the records of 101 patients over the age of 60 who had exploration and cholecystectomy in 1982 at Norfolk General Hospital. There were 52 elective and 49 emergency cases. Women comprised 57.4% of the patients, and almost 50% of the patients were over the age of 70. Forty-nine percent of the cases were emergencies. All but two of the patients had cholecystectomy. The average hospital stay was 12 days for the elective group and 19 days for the urgent group. Complications extended the average hospital stay to 23 days. Although complications developed in 35 patients, only 14 had major complications that were life-threatening and/or extended the hospital stay. Of these, four were in elective cases (7%) and the remainder (21%) were in the urgent group. A major complication more than doubled the average hospital stay to 29 days. There were three deaths (3% of the entire group), all in patients who had emergency exploration, and all in patients over age 70. We advocate earlier elective cholecystectomy for patients with symptomatic cholelithiasis--before patients reach an older age, when associated systemic diseases increase their overall risk should emergency operation be necessary. PMID- 3563582 TI - Intra-arterial thrombolysis for acute limb ischemia: a three-year experience. AB - Peripheral arterial thromboembolism and thrombosis of arterial grafts continue to threaten viability of extremities. Percutaneous intra-arterial thrombolysis (IAT) and angiodilatation have afforded limb salvage in some of these patients. Proper patient selection appears to be the hallmark of success with IAT. During a recent three-year period, we used IAT in 32 extremities in 28 patients who had acute arterial insufficiency. Before IAT, 16 extremities were painful at rest, and 16 had incapacitating claudication. The overall success rate was 38%, but some degree of thrombolysis occurred in 88%. Limb salvage was achieved in 27 of 32 extremities (84%). Only five of 17 limbs (29%) with arterial graft thrombosis required no operation or an operation of lesser magnitude than predicted before IAT. Of six extremities with native arterial embolism, four (67%) were completely cleared with IAT. Major complications occurred in eight cases (25%), with two IAT related deaths (6%). This study suggests that IAT is best reserved for individuals with acute limb ischemia caused by arterial embolus, those whose degree of ischemia would tolerate a 24-hour trial of IAT, and those whose femoral or tibial runoff is not likely to require remedial operation. PMID- 3563583 TI - Spironolactone and estrogen-progestin therapy for hirsutism. AB - Sixteen women with hirsutism used spironolactone, 100 mg daily without interruption, plus norethindrone (1 mg) and ethinyl estradiol (35 mg) for 21 of each 28 days. Clinical improvement occurred in 11 of the 16 patients and also in an additional patient when the dose of spironolactone was increased to 200 mg daily. Spironolactone 100 mg daily plus norethindrone and ethinyl estradiol resulted in significant reduction in serum total testosterone, serum free testosterone, and percentage of free testosterone. Side effects were infrequent. PMID- 3563584 TI - Chronic relapsing thrombotic thrombocytopenic purpura. AB - A 58-year-old man had anemia and thrombocytopenia immediately after a myocardial infarction; recovery occurred spontaneously, but relapses followed intercurrent infection and abdominal surgery. The terminal relapse was precipitated by gastric ulcer with hemorrhagic gastritis; this episode was characterized by fluctuating neurologic symptoms including coma. Autopsy studies confirmed the diagnosis of thrombotic thrombocytopenic purpura. This case shows that thrombotic thrombocytopenic purpura may occur de novo in adults as a relapsing syndrome with exacerbations precipitated by diverse events characterized by inflammation or tissue necrosis. PMID- 3563585 TI - Cardiac tamponade in systemic lupus erythematosus: an unusual initial manifestation. AB - I have described a patient in whom cardiac tamponade occurred as the initial clinical manifestation of SLE. Although pericarditis is a common clinical entity in SLE, cardiac tamponade with this disease is rare. If suspected, the diagnosis can be made by the proper selection of tests of serum and pericardial fluid, which should include the search for pericardial LE cells. This report emphasizes the importance of screening for connective tissue disease in patients with pericarditis. PMID- 3563586 TI - Fistula between the left anterior descending coronary artery and the pulmonary artery causing angina in two middle-aged patients. AB - Congenital coronary artery fistulas usually originate from the right coronary artery. Patients with such fistulas rarely reach middle age without symptoms or complications. In the cases presented here, a congenital fistula between the left anterior descending coronary artery and the pulmonary artery was discovered in a 55-year-old man and a 41-year-old man who were being evaluated for angina. The first patient also had coronary artery disease. Both fistulas were successfully treated with ligation and division. PMID- 3563587 TI - "Recurrence" of a plasma cell granuloma 11 years after initial resection. AB - Plasma cell granulomas of the lung are usually benign tumors found incidentally on chest x-ray film, though some have been found to be locally invasive. Our report of a plasma cell granuloma recurring 11 years after the initial resection emphasizes that complete surgical resection should be done whenever possible. PMID- 3563588 TI - Medullary carcinoma of the thyroid: papillary and pseudopapillary patterns. PMID- 3563589 TI - Transient diabetes insipidus and preeclampsia. AB - A woman with triplet gestation had polydipsia and polyuria during pregnancy. She subsequently had preeclampsia for which she was delivered. The presumed diabetes insipidus was transient, resolving by postpartum day 5. The association of preeclampsia and diabetes insipidus may be confusing to the practitioner. Careful attention to fluid status and consideration of this abnormality will lead to the best outcome when hypertension is accompanied by polydipsia and polyuria. PMID- 3563590 TI - Disseminated rhabdomyosarcoma of the urinary bladder in an adult. AB - A rare case of alveolar rhabdomyosarcoma of the urinary bladder, manifested as a systemic disease in a 51-year-old woman, was diagnosed at necropsy. Diffuse lytic bone lesions and extensive bone marrow involvement with a leukoerythroblastic blood picture led to an initial clinical diagnosis of a hematologic malignancy. PMID- 3563591 TI - Complete spontaneous regression of a cerebral arteriovenous malformation. PMID- 3563592 TI - Compartment syndrome in the newborn. AB - Femoral vein injury in a newborn infant after cardiac catheterization resulted in a threat of limb loss because of a compartment syndrome. The limb was saved by full-length medial and lateral skin and fascial incisions. PMID- 3563594 TI - Mandibular osteomyelitis. PMID- 3563593 TI - Pneumococcal vertebral osteomyelitis in an adult. AB - We have presented the case of an adult with a chronic and indolent pneumococcal vertebral osteomyelitis, mimicking a malignancy and making diagnosis difficult. The increased frequency of relatively penicillin-resistant strains of pneumococci necessitates susceptibility testing and complicates the selection of antibiotic therapy for serious pneumococcal infections. PMID- 3563595 TI - More (and the last) on circumcision. PMID- 3563596 TI - Rash from nicotine gum. PMID- 3563597 TI - Linking theory with action: the use of social and economic research to improve the control of tropical parasitic diseases. PMID- 3563598 TI - Proceedings of the 29th SEAMEO-TROPMED Seminar: Social and Economic Research in Tropical Diseases in Southeast Asia. 16-19 June, 1986, Kuala Lumpur. PMID- 3563599 TI - The role of the social scientists in the control of tropical diseases. PMID- 3563600 TI - Malaria on the Amazon frontier: economic and social aspects of transmission and control. PMID- 3563601 TI - Social and economic aspects of malaria in Singapore. AB - Singapore is both receptive and vulnerable to the introduction of malaria because of its location in a malarious zone. The social and economic factors that determined the incidence of malaria included rapid urban and industrial developments which created suitable environmental conditions for the breeding of Anopheles vectors, influx of foreign workers from the endemic countries and increased travel to the malarious areas. The public health significance of the interactions of these factors was exemplified by the occurrence of periodic localized outbreaks. The problem of introduction of drug-resistant falciparum malaria by travellers into the country was another matter of concern. However, the health authorities were fully committed in bringing these problems under control, with political support as well as regional and international collaboration. The result of these efforts was realised in 1982 when Singapore was certified malaria-free by the WHO. The strategies implemented included epidemiological and vector surveillance, health education and environmental health supervision of all major development projects in receptive areas. PMID- 3563602 TI - Human behavior and malaria. AB - Human behavior in malaria is often narrowly referred to behavior of the target populations in transmission and control of malaria. In this presentation it was discussed that such view is too narrow. A broader framework incorporating illness behavior and human behavior in malaria control bureaucracies is needed for the success of national malaria control programme. Literature under the three broad categories of human behavior in malaria is reviewed to justify future directions in human behavior research and their significance for successful malaria control. PMID- 3563603 TI - Culture, environment and people's perceptions: considerations in malaria control in the Philippines. PMID- 3563604 TI - The implementation of community participation in the control of malaria in rural Tanjung Pinang, Indonesia. AB - A study was undertaken to involve a hyperendemic community in Berakit village near Tanjung Pinang to participate actively in the control of malaria. Weekly chemoprophylaxis with chloroquine was given to all villagers of RK I with a population of about 700 for a period of one year. Nine cadres were selected from the community by the villagers for the distribution of the drug and coordinated by the head of the village. About 14-19 families were supervised by one cadre who was responsible for the weekly distribution of the drug to these families. The weekly dosage of the drug was adjusted according to age. The drug was taken in the presence of the cadres to assure the intake, and recorded by each cadre. The results showed that 93.7% of the villagers have taken the drug regularly. The remaining 6.3% of them showed refusal and irregular intake, or moved to another village during the period of prophylaxis. Although the drug has a bitter taste, most of the children were able to tolerate it. In general, mild side effects were reported and infrequently observed. Implementation of community participation to control malaria in this village showed good results which was reflected in the results of the malariometric surveys carried out before and after one year chemoprophylaxis. The spleen rate of about 600 villagers of RK I examined was 54.3% and the parasite rate 13.2% before the drug intervention. After one year chemoprophylaxis the spleen rate decreased to 21.7% and the parasite rate to 4.5% showing a significant difference. PMID- 3563605 TI - Health behavior, treatment-seeking patterns, and cost of treatment for patients visiting malaria clinics in western Thailand. AB - A clinic-based case-control study was conducted at two malaria clinics in western Thailand in order to investigate social and behavioral factors believed to be associated with malaria occurrence. The finding was that the malaria cases were predominantly male, under age 25 and single. The results showed a significant association for use of mosquito nets, conformance with DDT spraying and residing in forested areas two weeks before occurrence of illness with malaria. Analysis of symptoms revealed fever, headache and chills to be the major noticeable symptoms initiating treatment. Three basic treatment-seeking patterns were observed. The results of this study suggest that particular attention should be given to malaria health education for younger age groups and forest-related people. In addition, attention should also be given to ways of increasing awareness of symptoms, and motivation of people to use malaria clinics for malaria screening and treatment at onset of first symptoms in order to eliminate treatment-seeking at ineffective first sources. Malaria Voluntary Collaborators, Village Health Volunteers and Village Health Communicators have an important role in convincing people in malarious areas to use malaria clinics for malaria screening and treatment when the villagers develop malaria-like symptoms. This would reduce disease transmission and severity by reducing the delay for efficacious treatment and would also reduce the cost of malaria treatment. PMID- 3563606 TI - Social, behavioural, housing factors and their interactive effects associated with malaria occurrence in east Thailand. AB - This retrospective case-control study was carefully designed to investigate the principal factors that had effects on malaria occurrence. The findings of this study showed that malaria occurs less frequently among persons who have lived in the area for a long period of time, who have obtained education, who have a sizable annual family income. Malaria occurs more frequency among persons who work in or near the forest and persons who move into the forest frequently or occasionally as well as among persons whose houses are in close proximity of vector breeding sites. PMID- 3563607 TI - Cost and performance of malaria surveillance: the patients' perspectives. AB - The study sought to determine the average total costs incurred by patients attending three different types of malaria surveillance service (Malaria Clinics (MC), Village Health Centres (VHC) and Village Malaria Volunteers (VMV) and the factors affecting attendance at a particular type of service. All patients attending malaria surveillance points in two zones (3 and 7) in Region 1, were interviewed during the month of November 1985 (n = 2547) using structured questionnaires. Average total costs to patients varied between 140 Baht at VMVs in Zone 3 to 320 Baht at MCs in the same zone. Eight to fifteen percent was explicit cost (cost of travel and cost of self-prescribed drugs) with the remainder implicit costs (time costs). Average self treatment costs exceeded the average travelling costs incurred by patients attending each of the three types of service. Most patients sought diagnosis at a service point because of headache or fever. However in Zone 3, 20% of all patients sought blood testing and treatment because they had travelled outside their village. The average time between the onset of symptoms (fever or headache) and attendance at a service point ranged from 2.3 to 6.0 days. Many patients decided not to attend their nearest service point, 35% of patients at VMVs (Zone 3) and 80% of patients at MCs (Zones 3 and 7). The major single reason for not attending the nearest service point was convenience of travel.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563608 TI - A social and economic analysis of schistosomiasis: a conceptual framework and a research strategy. AB - This paper describes a broad conceptual framework for analyzing the social and economic aspects of schistosomiasis. In this framework, the household, in an attempt to improve its welfare, is assumed to make a variety of simultaneous decision based on a set of opportunities and constraints defined by its household resources and community environment, which are in turn influenced by public policies and programmes. The analytical gains from utilizing this broad framework in the study of the social and economic consequences of schistosomiasis, the transmission of the disease, and the demand for treatment from the perspective of more effective control of the disease are briefly noted. The paper also describes the research strategy being adopted by an ongoing research in the Philippines with attention to the intensive data requirements that the broad framework calls for. PMID- 3563609 TI - Human behavioural research applied to the leprosy control programme of Sarawak, Malaysia. AB - In 1984, in Sarawak, there were a total of 1,099 recorded cases of leprosy for a population of 1.3 million. However, for each case recorded, it is estimated that two others remain undiagnosed as a consequence of the stigmatization associated with leprosy. For the five year period, 1979-1983, an average of 29 new cases were detected each year of which 8.6 (30%) were deformed due to the late stages at which it was being reported. To increase the case-finding rate, human behavioural research was applied to the leprosy control programme so as to develop culture-specific health education packages aimed at self diagnosis and self referral in order to detect the large pool of undiagnosed cases hidden behind the veil of aversion, fear and ignorance. This was achieved through anthropological studies to identify how the various major ethnic groups perceived leprosy and their attitudes towards leprosy. Taking into account these findings, health education packages aimed at adults as well as children were developed for the Chinese as well as the non-Chinese, and consisted of newspaper articles, cartoon tape-slides, cartoon story books and posters. PMID- 3563610 TI - The development of culture-specific health education packages to increase case finding of leprosy in Sarawak. AB - For any health education to succeed, the people's perception of the disease, their beliefs and cultural practices are of utmost importance as these have tremendous influence on their acceptance of new ideas. It is therefore essential to develop appropriate health education packages based on the understanding of the traditional and socio-cultural belief systems of the people. Thus on the basis of anthropological studies, health education packages were developed for the leprosy control programme in Sarawak, aimed at both adults and children. Newspaper articles, cartoon tape-slides, cartoon story books as well as posters were developed for both Chinese as well as other groups such as Malays, Ibans and Kayans. These were field tested and are now used in the Rejang Valley of Sarawak. PMID- 3563611 TI - Knowledge, beliefs and attitudes on leprosy in Iloilo City Proper, Philippines. AB - This study attempts to find out the prevailing knowledge and beliefs in Iloilo City, Philippines regarding leprosy, its causation, mode of transmission, and care. Attitudes of people towards Hansenites and their offsprings are also looked into. Qualitative data are obtained from seven keypersons in the locality who were interviewed in-depth using the unstructured interview guide. Quantitative data are furnished by 100 household heads who were randomly chosen and by 70 senior student-nurses enrolled in the six colleges of nursing in the same city using an interview schedule and questionnaire respectively. Results reveal that 90% of the household heads and 45% of the students have inadequate knowledge on leprosy. None of the household heads and only two students have highly adequate knowledge pertaining to this disease. Leprosy is believed by both the household heads and students to be brought about by as well as supernatural causes. A great majority of the household heads (94%) and students (79%) attribute the cause of leprosy to germs. Blood predilection has been cited by the next highest proportion of both groups of respondents. The third highest proportion of the households heads attribute the cause of the illness to God's will, while among the students, the cause of this disease is believed to be spontaneous. The majority of household heads (94%) and students (95%) believe that skin to skin contact is the most possible mode of transmitting the disease. PMID- 3563612 TI - Evaluation of health education in leprosy control programme: methodological considerations. PMID- 3563613 TI - Psycho-social and environmental factors in triad model for the management of control programme: focus on leprosy. AB - The study addresses the question of how the qualitative aspect of the interaction between the people involved in the leprosy control programme affects the process of patients (P), service providers (SP) and satellite informants (SI) composed of community leaders, in the delivery of basic leprosy control services in two high leprosy endemic villages in La Union province, the Philippines. The interaction between P, SP and SI as an independent variable is imagined to be linked in a form of a triad, influenced by psycho-social and environmental variables. Data was gathered by conventional methods as interviews, historical research and use of rating scales as well as non-conventional methods as PUP, a locally developed standardized instrument which measures variables that determine a Filipino's adjustment to social situations, and photographic documentation. Statistical analysis was made on the independent variable and the dependent variable - an improved Leprosy Control Programme. It was observed that the stigmatization of Hansenites had deep historical roots with the policy of colonial administrations to isolate and segregate Hansenites. This stigma remains to the present and was observed to exist even among service providers: Low knowledge levels of patients on the causes of the disease on the one hand, and service providers on the cure, particularly on the use of Multiple Drug Therapy. The reorganization scheme of the Health Ministry also resulted in the slow down of leprosy control activities thereby affecting delivery of services. Individual personality traits and other psycho-social factors of P, SP and SI further contributed to the lag in service delivery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563614 TI - Comparison of knowledge on filariasis and epidemiologic factors between infected and uninfected respondents in a Malay community. AB - A study to identify the knowledge of infected and uninfected respondents on filariasis and epidemiologic factors in one endemic community in Malaysia to determine their role in the transmission and control of filariasis was carried out. The data were collected by non-participant observations and interviews using semi-structured schedules. The majority of respondents in both groups had knowledge of filariasis. There was no marked difference between male and female respondents, and similarly, there was fair distributions of knowledgeable respondents with and without some years of schooling. On filarial transmission, 9.2% of the infected said that filariasis was contacted through mosquito bites, while among the uninfected it was 7.4%. Within the infected, 14.8% thought that filarial worms entered the human body through the consumption of unhygenically prepared foods and drinks while, among the uninfected it was 20.4%. Both groups were aware of the presence of mosquitoes in their village. However, the majority did not associate this factor with host's susceptibility to filarial infections. Rather, they were of the opinion that personal hygiene and proper meals had something to do with filariasis. The findings showed there was general awareness of filariasis in the community which might indicate that the health campaigns had reached various levels of the population. Yet, they still lacked knowledge on disease transmission. Also, they did not make direct association between environment and exposure to mosquitoes bites though they were aware of their presence but which they regarded as not directly harmful to their health. PMID- 3563616 TI - The need for health behaviour and socio-economic research in tropical disease control. PMID- 3563615 TI - Factors affecting participation in blood examination and treatment of filariasis in Sorsogon, Philippines. PMID- 3563617 TI - The need for health behaviour and socio-economic research in malaria control in Thailand. AB - Malaria is still a disease of public health importance in Thailand despite the encouraging downward trend in the number of malaria cases during the past ten years. In the last few years there were still nearly a quarter of million malaria cases detected and about 3,000 malaria deaths yearly reported. The social and economic factors seem to play major roles in keeping low persistent transmission of malaria in certain communities especially those residing in and near forested areas, mountains and foothills in the places not far away from Thai-Kampuchea border in East Thailand and Thai-Burmese border in West Thailand. These communities consist of migrants and local native residents living in newly opened lands for agriculture, and some are remote areas where communication and transportation are inaccessible. Preliminary results on these people revealed some interesting social and economic problems and health behaviour of the people in connection with persistent malaria transmission among them. It is suggested that further investigation should be carried out on the social and economic elements in these communities including migratory pattern, their population characteristics and life, social behaviour, health belief and practice, malaria prone behaviour, etc. in association with malaria transmission among them. The results to be obtained may lead to the effective control measures of malaria in future. PMID- 3563618 TI - Problems in leprosy control and the need for human behaviour and socio-economic research. PMID- 3563619 TI - Acceptance of innovations. PMID- 3563620 TI - Geriatric euthanasia: attitudes and experiences of health professionals. PMID- 3563621 TI - Single parent women. A community study. PMID- 3563622 TI - The Italian psychiatric reform: some quantitative evidence. PMID- 3563623 TI - For a new use of life event questionnaires: study of the life events world of a population of male and female alcoholics. Preliminary results. PMID- 3563624 TI - [Psychopathologic characteristics of Portugese children in a Paris consultation center. A comparative study]. PMID- 3563625 TI - The interaction of sex-role identity and ideology conflicts with depression in women and men. PMID- 3563626 TI - [Health and life style of late middle-aged and elderly persons]. PMID- 3563627 TI - [Socio-hygienic problems of the life style and health of sheep breeders]. PMID- 3563628 TI - [Public health as a global problem of the contemporary world]. PMID- 3563629 TI - [Medico-social prerequisites for the resumption of work by disabled collective farm workers]. PMID- 3563630 TI - [Characteristics of the reproductive behavior and morbidity of women]. PMID- 3563632 TI - [Introduction of a unified registration and report form as the primary medical document and statistical processing by a computer at a polyclinic]. PMID- 3563631 TI - [Role of institutes for advanced training in raising physician competence in narcology]. PMID- 3563633 TI - [The role of practical training of students in the active role of the future physician]. PMID- 3563635 TI - [Current concepts concerning the nature, types and effectiveness prevention]. PMID- 3563636 TI - [Rehabilitation of patients with post-burn cicatricial deformities of the perioral region]. PMID- 3563637 TI - [Clinico-echoencephalographic study of alcoholic patients]. PMID- 3563634 TI - [An information system for managing public health in the Mongolian People's Republic]. PMID- 3563638 TI - [Cortisol clearance in hormonally-active adrenal cortex tumors]. PMID- 3563639 TI - [Morphology of the repair processes occurring after continuous laser irradiation]. PMID- 3563640 TI - [Surgical treatment of total post-burn contracture of the shoulder]. PMID- 3563641 TI - [Effect of peripheral vasodilator agents on the state of the microcirculatory bed in congestive circulatory failure]. PMID- 3563643 TI - [Disability in combined wrist trauma]. PMID- 3563642 TI - [Socio-psychological rehabilitation of patients with tuberculosis in sanatoria]. PMID- 3563644 TI - [Technical progress in endoscopy and deontological problems]. PMID- 3563645 TI - [Closed mitral instrumental commissurotomy in thrombosis of the left auricular appendage]. PMID- 3563646 TI - [Endoscopic and morphologic picture of the bronchial mucosa in chronic bronchitis caused by cotton dust]. PMID- 3563647 TI - [Surface-active properties of endobronchial washings in lung diseases]. PMID- 3563649 TI - [Treatment of chronic obstructive bronchitis with sidnofarm]. PMID- 3563648 TI - [Bronchial patency and blood kinins in chronic bronchitis]. PMID- 3563650 TI - [Evaluation of different methods of local treatment of gastric and duodenal ulcers]. PMID- 3563651 TI - [Electro- and rheoencephalography in reflex neurologic syndromes associated with cervical osteochondrosis]. PMID- 3563652 TI - [Differential diagnosis of syringomyelia and the syringomyelia syndrome in cervical osteochondrosis]. PMID- 3563653 TI - [Ontogenetic factors in epilepsy polymorphism]. PMID- 3563654 TI - [Disinfection of diphtheria carriers]. PMID- 3563655 TI - [Hypercitremia in food poisoning]. PMID- 3563656 TI - [Early detection of acute cardiac insufficiency following heart surgery]. PMID- 3563657 TI - [Differential diagnosis of subarachnoid hemorrhage in a hospital for infectious diseases]. PMID- 3563658 TI - [Effect of exchange plasmapheresis on systemic and regional blood flow in diffuse purulent peritonitis]. PMID- 3563659 TI - [Inguinal herniotomy--one of the causes of male infertility]. PMID- 3563660 TI - [Clinical value of determining the degree of morphologic differentiation of chondrosarcoma]. PMID- 3563661 TI - [Late results of the conservative treatment of melanoma of the skin]. PMID- 3563663 TI - [Anomalies of the renal veins and renotesticular reflux]. PMID- 3563664 TI - [Closed chest injuries]. PMID- 3563662 TI - [Hemoccult test in dispensary monitoring of patients after surgical treatment of cancer of the large intestine]. PMID- 3563665 TI - [Surgical treatment of cancer of the lungs in respiratory insufficiency]. PMID- 3563666 TI - [Isolated lesion of the inguinal lymph nodes as the 1st sign of cancer of the thyroid gland]. PMID- 3563667 TI - [Plasma gonadotropins and sex hormones in the hypothalamic pubertal syndrome in girls]. PMID- 3563668 TI - [Villous tumor of the rectum in a foreign body zone]. PMID- 3563669 TI - [Tactics of the thoracic surgeon and otorhinolaryngologist in reconstructive surgery of the larynx and trachea]. PMID- 3563670 TI - [Catecholamine metabolism in neck neoplasms]. PMID- 3563671 TI - [Status of immunity in essential hypertension]. PMID- 3563673 TI - [Fibrogastroscopy in preventive screening and patient monitoring]. PMID- 3563672 TI - [Pressing problems concerning endemic goiter]. PMID- 3563674 TI - [Generalized gout with involvement of the nervous system]. PMID- 3563675 TI - [Morphologic criteria for the diagnosis of gouty nephropathy]. PMID- 3563676 TI - [Endobronchial use of silver ions with low-frequency ultrasound in chronic nonspecific diseases of the lungs]. PMID- 3563677 TI - [Transthoracic administration of antibiotics in pneumonia]. PMID- 3563678 TI - [Treatment of cicatricial stenosis of the esophagus]. PMID- 3563679 TI - [Clinico-diagnostic features of early stomach cancer]. PMID- 3563680 TI - [Errors and complications in sacral anesthesia]. PMID- 3563681 TI - [Infarct of the intestines]. PMID- 3563682 TI - [Fibromuscular arterial dysplasia]. PMID- 3563683 TI - [Diagnosis of hemorrhages into a pituitary adenoma]. PMID- 3563684 TI - [Various features of cellular and humoral immunity in viral hepatitis in pregnant women]. PMID- 3563685 TI - [Epidemic parotitis in adults]. PMID- 3563686 TI - [Hospital infection with viral hepatitis B in hepatitis A]. PMID- 3563687 TI - [Differential diagnosis of toxic food infections and acute appendicitis]. PMID- 3563688 TI - [Fixed immune complexes in typhoid fever and the carrier state]. PMID- 3563689 TI - [Low-intensity laser irradiation in the treatment of suppurative wounds]. PMID- 3563690 TI - [Zollinger-Ellison syndrome]. PMID- 3563692 TI - [Treatment of subphrenic abscesses]. PMID- 3563691 TI - [Immunologic reactivity of patients with nonspecific ulcerative colitis treated with steroid hormones]. PMID- 3563693 TI - [Polarographic study of the skin in malignant tumors of the head and neck]. PMID- 3563694 TI - [Consecutive radiation and surgical treatment of cancer of the esophagus]. PMID- 3563696 TI - [Probability of occurrence of undesirable effects of drug interactions in the treatment of suppurative meningitis]. PMID- 3563695 TI - [Chemoradiotherapy of advanced forms of malignant neoplasms of the pharynx]. PMID- 3563698 TI - [Metastasis of intraepithelial cancer of the cervix uteri to the endometrium]. PMID- 3563697 TI - [The condition of the esophagus in functional disorders of the adrenal cortex]. PMID- 3563699 TI - [Complete regression of breast cancer and its lung metastases after chemohormonotherapy]. PMID- 3563700 TI - [Topography of the gastric mucosa in chronic gastritis (roentgenologic, endoscopic and histologic studies)]. PMID- 3563701 TI - [Immunologic prevention of postoperative suppurative-inflammatory complications in cancer of the stomach]. PMID- 3563702 TI - [Restoration of muscular function after their free transplantation with neurovascular anastomoses]. PMID- 3563703 TI - [Hemodynamic aspects of surgical treatment of atrial septal defects in moderate hypothermia]. PMID- 3563704 TI - [The hypothalamo-hypophyseo-thyroid system in hypothalamic pubertal syndrome]. PMID- 3563705 TI - [Magnetic resonance tomography of cystic lesions of the kidneys]. PMID- 3563706 TI - [Immunotherapy using T-activin in chronic viral hepatitis B in children]. PMID- 3563707 TI - [Chronic enteritis]. PMID- 3563708 TI - [An automated information system in the ambulatory care of adolescents]. PMID- 3563709 TI - [Economic evaluation of the treatment of patients with early-stage lung cancer]. PMID- 3563710 TI - [Valsalva's test in the diagnosis of circulatory insufficiency]. PMID- 3563711 TI - [Surgical tactics in ureterocele of a double kidney in children]. PMID- 3563712 TI - [Reflexotherapy in bronchial asthma]. PMID- 3563713 TI - [Modification of prostaglandin metabolism (increased susceptibility to thrombosis?) by roentgen contrast media in arteriography]. PMID- 3563714 TI - [Intraoperative cholangiography in the diagnosis of choledocholithiasis]. PMID- 3563715 TI - [Water-electrolyte disorders after head injuries]. PMID- 3563716 TI - [The importance of titrating immunoreactive calcitonin in medullary carcinoma of the thyroid gland]. PMID- 3563717 TI - [Surgical problems in the Gardner syndrome]. PMID- 3563718 TI - [The anterior abdominoperineal approach in the surgical resection of malignant processes in the rectum]. PMID- 3563719 TI - [An unusual injury of the ureter]. PMID- 3563720 TI - [A new method of preparing the large intestine before planned surgery and the results of clinical practice]. PMID- 3563721 TI - [Surgical treatment of heart valve defects]. PMID- 3563722 TI - [Aneurysms of the popliteal artery associated with atherosclerosis]. PMID- 3563723 TI - [The technic of transduodenal papillosphincterotomy using a conical probe]. PMID- 3563724 TI - [Gastroduodenopancreatectomy in the treatment of pancreatic carcinoma]. PMID- 3563725 TI - [Incidence of pulmonary embolism based on our surgical data]. PMID- 3563726 TI - [Rheumatoid factor isotypes and immune complex isotypes in juvenile rheumatoid arthritis]. PMID- 3563727 TI - [Long-term results of D-penicillamine treatment in rheumatoid arthritis]. PMID- 3563728 TI - [The coexistence of systemic lupus erythematosus and psoriatic arthritis]. PMID- 3563729 TI - [Sjogren's syndrome with partial hypopituitarism and renal tubular acidosis]. PMID- 3563730 TI - Association between cholangiographic angulation of the common bile duct and choledocholithiasis. PMID- 3563731 TI - Injuries of the pancreas and duodenum--results of a conservative approach. PMID- 3563732 TI - Vaso-active substances in ascitic fluid from animals with experimental pancreatitis. PMID- 3563733 TI - Controversies in surgery. Ileostomy or a pouch? PMID- 3563734 TI - Technical aids in surgery. A safe treatment for simple wounds of the colon. PMID- 3563735 TI - Superior vena cava thrombosis induced by intravenous catheterisation. A report of 2 cases. PMID- 3563736 TI - Aggressive chondroblastoma of the femoral head. A case report. PMID- 3563737 TI - [Masseter spasm as the presenting feature of malignant hyperpyrexia syndrome. A case report]. PMID- 3563738 TI - Postoperative chylous ascites after resection of an abdominal aortic aneurysm. A case report. PMID- 3563739 TI - Familial breast cancer. PMID- 3563740 TI - The problem of oesophageal cancer relative to other cancers in southern Africa- 1949-1979. PMID- 3563741 TI - Nutritional and immunological considerations in oesophageal carcinoma. PMID- 3563742 TI - Oesophageal cancer: In vivo behaviour and tissue culture. PMID- 3563743 TI - Cancer of the oesophagus--past, present and future. PMID- 3563744 TI - Mediastinoscopy and bronchoscopy in carcinoma of the oesophagus. PMID- 3563745 TI - Intraluminal treatment of oesophageal cancer with cobalt plus cis-platinum. PMID- 3563746 TI - Squamous carcinoma of the oesophagus. PMID- 3563747 TI - Oesophageal cytological abnormalities in Transkei and possible nutritional influences. PMID- 3563748 TI - Survival of black patients with oesophageal cancer. PMID- 3563749 TI - Oesophageal cancer risk factors common to endemic regions. PMID- 3563750 TI - Gynaecological oncology. PMID- 3563751 TI - Advances in forensic medicine. PMID- 3563752 TI - Mumps meningo-encephalitis. AB - Between July 1981 and June 1985, 49 cases (36 boys (73%) and 13 girls (27%] of mumps meningo-encephalitis confirmed by culture of the virus from the cerebrospinal fluid (CSF) were seen. Patients presented particularly in the late spring and early summer. A CSF cell count greater than 500 X 10(6)/l was obtained in 14 cases (28%), a total CSF protein greater than 0.8 g/l in 6 cases (12%) and a CSF glucose of less than 2.2 mmol/l in 2 cases (4%). Two cases are reported to illustrate the diagnostic problems which the infection may cause, particularly when the CSF changes resemble those of tuberculous meningitis. In 1 case neurogenic pulmonary oedema developed after a convulsion; this caused further diagnostic uncertainty. PMID- 3563753 TI - Pulmonary aspergilloma--indications for surgical intervention. An analysis of 22 cases. AB - Surgical resection of aspergillomas has generally been associated with excess mortality and morbidity; 22 patients who had a resection of complicated mycetomas were studied retrospectively. Indications for surgery were serious haemoptysis (14), massive haemoptysis (6), and recurrent infection (2). Extrapleural pneumonectomy was required in 9 patients and extrapleural lobectomy in 12; thoracoplasty alone was done in 1 patient. There was 1 hospital death (4.5%); 4 patients developed postoperative empyemas (18%), 2 with associated bronchopleural fistulas. Two further patients (9%) had stable postresectional spaces. Surgery for complicated aspergilloma was associated with significant postoperative morbidity. PMID- 3563754 TI - Pseudocholinesterase variation in southern African populations. AB - Genetic variation at both the E1 and E2 loci of pseudocholinesterase was studied in 7 southern African populations. In the Ashkenazim and Afrikaners, E1 locus variation was observed and the frequency of the E1a or 'atypical' allele was found to be 0.017 in the Ashkenazim and 0.016 in the Afrikaans-speaking population, similar to those observed in other caucasoid populations. The E1s, or 'silent' allele, was found to occur in the Afrikaans-speaking population at a frequency 2-3 times greater than in other Caucasians, giving an increased risk of scoline-sensitivity. The rarity of the E1a in the Negro and Khoisan populations was confirmed. All 7 populations showed variation at the E2 locus with high frequencies of the E2+ allele in the Caucasians and San, while Negroes showed relatively low frequencies. Coloureds showed intermediate frequencies, consistent with their historical origins. PMID- 3563755 TI - The epidemiology of schoolboy rugby injuries. AB - During one 18-week season, in which players from 26 high schools played 3,350 rugby matches, 495 injuries prevented players from participating in rugby for at least 1 week; 71% occurred during matches and 29% during practices. Injury was more common during the first 4 weeks of the season and again in the same time period after the mid-season vacation. At all ages, A-team players suffered the greatest number of injuries. The safest playing positions were tight-forward and scrum-half; the most dangerous loose-forward and in the back-line excluding the scrum-half. Overall, eightmen were the most often injured players. Of all injuries 55% occurred while the player was tackling or being tackled and 18% during the loose scrum/maul. The lower limb (37%), the head and neck (29%) and the upper limb (20%) were most commonly injured, and fractures (27%), ligament/tendon injuries (25%) and muscle injuries (17%) were commonest. However, concussion injuries were underreported in 19 of the 26 schools. This study shows: that monitoring rugby injuries through correspondence results in underreporting of injuries; that rugby injuries show specific trends with age, team level, playing position, time of the season and phase of play; and that players in the different positions suffer specific injuries in predictable phases of the game. Speed of play may be the most important aetiological factor in the majority of rugby injuries. PMID- 3563756 TI - Savings from generic drug substitution in the RSA--is its cost justified? AB - The causes of the recent rapid increases in health care costs in the RSA are briefly studied. Drug costs have increased largely through the use of new innovations, greater usage and price factors, but price increases have been below the rate of inflation. The savings in drug costs to be expected from the introduction of generic substitution have been calculated to be low in relation to overall health care costs, although of significance in relation to the survival of individual drug manufacturing businesses. The thrust towards generic substitution is possibly misplaced in that the potential savings in hospitalisation costs from the discovery of new drugs are so large that they justify the encouragement of the innovative drug manufacturers. PMID- 3563757 TI - Proteoglycans of articular cartilage in Mseleni joint disease. AB - Femoral heads were resected from patients with Mseleni joint disease, and cartilage present in 'islands' on the articulating surfaces and over marginal osteophytes was removed for study. Some specimens were grown in short-term organ culture and labelled with sulphur-35. Proteoglycans present in the tissue, and newly synthesised macromolecules were extracted, purified and assessed. The results indicated that very few of the proteoglycans present or synthesised during culture were capable of aggregation with hyaluronate and that the average size of the macromolecules was smaller than normal. In addition a large proportion of the proteoglycans were very small in size and were thought to resemble a molecule found in immature articular cartilage. The response to degenerative disease was unusual and may be peculiar to the Mseleni condition. PMID- 3563758 TI - Fish-tank granuloma. The first reported case in South Africa. AB - The first case of infection with the non-tuberculous mycobacterium, Mycobacterium marinum, in South Africa is reported. Of special interest was the linear nodular (sporotrichoid) appearance. PMID- 3563759 TI - Pancreaticoduodenectomy for pancreatic trauma. A case report. AB - Pancreatic trauma is uncommon and severe, combined pancreaticoduodenal injuries are rare. Different surgical techniques for the management of these injuries have been used. In this article a case of severe pancreaticoduodenal injury which required pancreaticoduodenectomy is reported. This case is unusual because there was no history of trauma, the serum amylase level and abdominal radiograph were normal and the abdominal findings on admission to hospital were minimal. A system of grading pancreatic trauma in terms of severity is advocated and the management of pancreaticoduodenal injuries is discussed. PMID- 3563760 TI - Juvenile pemphigus vulgaris. A case report. AB - A 13-year-old South African Indian boy who presented with oral mucosal lesions and skin blisters due to juvenile pemphigus vulgaris is described. Treatment with high-dose oral corticosteroids produced a prompt clinical response. Pemphigus vulgaris is rare in the young and this may lead to misdiagnosis and inappropriate therapy. PMID- 3563761 TI - Combined chemotherapy and irradiation therapy after radical surgery for leiomyosarcoma of the vulva. A case report. AB - Radical surgery failed to remove a leiomyosarcoma of the vulva completely, and residual tumour was left. Chemotherapy did not inhibit further local growth or the occurrence of secondary lesions in the lung. Irradiation therapy of the pelvis, including the area of the tumour, then successfully inhibited any further local growth, as evidenced by a marked decrease in size and eventual disappearance of the mass; however, the patient succumbed to distant metastasis. PMID- 3563762 TI - Two-dimensional echocardiography in the diagnosis of amoebic pericarditis. A case report. AB - A patient's pericardial effusion was confirmed by two-dimensional echocardiography, which also indicated an amoebic liver abscess as the source. The importance of routine liver scanning in investigation of pericardial effusion is emphasised. PMID- 3563764 TI - Hyperactivity and methylphenidate. PMID- 3563763 TI - Biliary ascariasis. A case report. AB - The presenting features, diagnosis and management of biliary ascariasis in an adult woman are described and the literature is reviewed. PMID- 3563765 TI - Maintenance of Pseudomonas antibiotic sensitivity in patients with cystic fibrosis treated with inhaled antibiotics. PMID- 3563766 TI - New tests for thyroid function. PMID- 3563767 TI - Kneipp therapy is alive and well and living in Germany. PMID- 3563768 TI - Health care needs in children's homes. PMID- 3563769 TI - Elective episiotomy in perspective. AB - In view of the present questioning of interventive obstetric practices such as the elective performance of episiotomy, the putative advantages of episiotomy are critically analysed. Recent prospective randomised studies support the growing body of evidence that the value of elective episiotomy is yet to be substantiated. PMID- 3563770 TI - Intramuscular buprenorphine compared with morphine for postoperative analgesia. AB - The postoperative analgesic efficacy of buprenorphine (Temgesic; R & C Pharmaceuticals) 0.004 mg/kg and morphine 0.15 mg/kg were compared in 60 patients, both agents given by intramuscular injection. According to patients, buprenorphine gave better analgesia. There was no difference in the number of analgesic injections the two groups received in the 24-hour postoperative period. Cardiovascular and respiratory systems were not depressed by either drug. Side effects were not marked, nausea being the most common in both groups. Morphine had a greater effect on the mood of patients. Buprenorphine proved a satisfactory analgesic for postoperative use by intramuscular injection. PMID- 3563771 TI - A sensitive immunoradiometric assay for serum thyroid-stimulating hormone. A first-line investigation for thyroid function. AB - The value of a highly sensitive immunoradiometric assay for thyroid-stimulating hormone (TSH) in distinguishing between hyperthyroid patients and normal controls is discussed. The assay has a sensitivity of 0.3 microU/ml and correctly categorised all patients in this study as either hyperthyroid or euthyroid. An approach to thyroid function testing using this sensitive TSH assay as a first line investigation is presented. PMID- 3563772 TI - Cervical analgesic discography. A test for diagnosis of the painful disc syndrome. AB - The cervical discogenic (painful disc) syndrome consists of scapular pain radiating to the head, shoulder and upper arm, often associated with paraesthesiae but without neurological deficit. Analgesic discography confirms the diagnosis and more accurately locates the pain-producing disc. In this series of patients analgesic discography followed by anterior cervical fusion with or without discectomy resulted in an 81% excellent or good result. Analgesic discography is the most effective test for location of the lesion in the painful disc syndrome. PMID- 3563773 TI - Water supplies and sanitary facilities in rural Transkei. AB - Between October 1982 and September 1983, an outbreak of cholera occurred in Transkei. A total of 678 patients with clinical illness were reported in a review of positive laboratory results. Subsequent to each report, the health department personnel began a rigorous contact-tracing process during which data on the environment were collected. A total of 1,157 standardised forms listing 6,615 persons were returned to the Epidemiological Unit. Of these respondents, 87.2% reported having 'no sanitary facilities available' and 96.4% 'no refuse disposal site'. Rivers, wells, springs, streams, dams and stagnant pools were recorded as the main sources of water supply in the study area. Whether this situation will remain unchanged or improve can be determined only by continued surveillance. PMID- 3563774 TI - Salmonella isolated from rooibos tea. AB - Various Salmonella serovars were isolated from rooibos tea, a natural, untreated agricultural product. The results of a study to identify the serovars is reported. The possibility of lizard origin is discussed and the low pathogenicity of the salmonellae isolated is highlighted. PMID- 3563775 TI - Dengue fever imported from India. A report of 3 cases. AB - After visiting Saudi Arabia and India a woman became ill within 1 week of her return to Durban. Dengue type 1 virus was isolated from acute-phase serum, and antibody seroconversion was demonstrated. This is the first case of dengue fever in the RSA since the 1926-1927 epidemic. The occurrence of this case, and 2 further suspected cases, emphasises the need for vigilance if another epidemic is to be avoided. PMID- 3563776 TI - Myocardial infarction after probable black mamba envenomation. A case report. AB - A probable direct toxic effect of elapid venom on the myocardium as evidenced by transient ECG changes and transiently elevated cardiac enzyme levels is described. The patient made good recovery with no residual cardiac damage. PMID- 3563777 TI - Subarachnoid haemorrhage. A report of 2 cases. AB - Two patients admitted to the medical intensive care unit with subarachnoid haemorrhage, one with the provisional diagnosis of 'sick sinus syndrome' the other as having an acute myocardial infarction complicated by ventricular tachycardia, are described and the arrhythmias associated with this condition are reviewed. PMID- 3563778 TI - Combined perilymphatic fistulas of the round window and lateral semicircular canal. A report of 2 cases. AB - Two patients with combined perilymphatic fistulas of both the round window and the lateral semicircular canal are presented. They became asymptomatic only when both fistulas were closed. In both cases the hearing improved concurrently. It is recommended that when a traumatic perilymphatic fistula is not cured by closing window fistulas, the lateral semicircular canal be explored. PMID- 3563779 TI - Apical hypertrophic cardiomyopathy. A case report. AB - The clinical, ECG and angiographic features of apical hypertrophic cardiomyopathy in a 24-year-old white man are reported. Only 4 non-Oriental cases have so far been described and the present case is the second from South Africa. Attention is drawn to the possibility that there are two distinct types of apical hypertrophic cardiomyopathy. PMID- 3563780 TI - Retinal complications in the acquired immunodeficiency syndrome. A case report. AB - Increasing numbers of patients with the acquired immunodeficiency syndrome (AIDS) are being reported. In the US literature the eye complications have been well documented but because so few cases of AIDS have been reported in South Africa, the retinal complications are largely unknown to those treating these patients. The retinal complications are due to cytomegalovirus (CMV) retinitis. The patient described here developed the typical signs in both eyes. It is essential to examine the fundi of AIDS patients regularly. The presence of cotton-wool spots always precedes CMV retinitis, which leads to blindness; it is also of prognostic significance since all reported patients with CMV retinitis have died. PMID- 3563781 TI - Acute conditions affecting epiploic appendages. A report of 4 cases. AB - Acute lesions of the epiploic appendages are rare. We present 4 cases of torsion of an appendix epiploica. Aspects of this condition and its complications are discussed. PMID- 3563782 TI - Improvements in health. PMID- 3563783 TI - Misuse of therapeutic drug monitoring. PMID- 3563784 TI - Strategy for prevention of coronary heart disease. PMID- 3563785 TI - Death due to a scorpion sting. PMID- 3563786 TI - Where is the endotracheal tube? PMID- 3563787 TI - Substance abuse and the media. PMID- 3563788 TI - Value of radiographic evidence of calcification of the aortic valve in adults with basal systolic ejection murmurs. AB - Severe aortic stenosis is an important, remediable and surgically correctable cause of symptoms and death. Diagnosis in adults and differentiation from minor degrees may be difficult. Aortic valve calcification visible on radiography or fluoroscopy is a sensitive but relatively nonspecific marker for the presence of critical aortic stenosis in patients with angina, dyspnoea or syncope. In 97% of patients with critical aortic stenosis analysed calcification was detected. PMID- 3563790 TI - Meconium during labour--self-medication and other associations. AB - Prior to artificial rupture of membranes, 498 women were questioned about obstetric and social factors including self-medication during pregnancy. Caesarean section (P less than 0,01) and low Apgar scores (P less than 0,001) were significantly more common in pregnancies complicated by fetal meconium passage. Meconium passage was more common in women who had recently taken castor oil (P less than 0,01) and possibly herbal substances called 'sihlambezo' (trend P less than 0,2). Use of laxatives or enemas and other obstetric risk factors were not associated with meconium passage. PMID- 3563789 TI - Pott's paraplegia. AB - Experience gained in the management of 261 patients with tuberculous paraplegia and paraparesis seen over a 17-year period is presented. A plea is made for prompt spinal canal decompression in all cases of tuberculosis of the spine with evidence of neurological involvement. PMID- 3563791 TI - The Cape Town Teenage Clinic. AB - Over a 6-month period 265 white females aged under 24 years attending the Teenage Clinic of the Western Cape Region of the Family Planning Association were interviewed at their first visit; 81% were sexually active. The age of menarche and the parents' marital status were important parameters of socio-sexual behaviour. The earlier the menarche, the higher the prevalence of coitus at a younger age, and the shorter the interval between menarche and the first coitus. Young age at first coitus, in turn, was associated with a higher prevalence of multiple sexual partners and smoking, and a longer period of unprotected intercourse before attending the clinic than among those who first attempted intercourse at a later age. Of those who had first experienced coitus at under 17 years, 37% came from single-parent families, compared with 12% of those in whom coitus was delayed until over 19 years of age. The important health and educational implications are discussed. PMID- 3563792 TI - Examination of sexually abused children. AB - The approach to the examination of sexually abused children differs from that of normal for sick children and also from that of adults who have been the victims of rape. While the physical and psychological welfare of the patient must be the prime concern, medico-legal aspects are equally important. In the interests of the patient the initial examination and subsequent management and follow-up should be done by those with specific skills and with the support of members of disciplines essential to the total management of the complex and not uncommon problem of sexual abuse in children. PMID- 3563793 TI - Application of irradiation as an immunosuppressive agent. AB - The concept of using total lymphoid irradiation (TLI) for immunosuppression is based on the prolonged and profound immunosuppressive effects observed after TLI in the treatment of patients with Hodgkin's disease. Pre-operative TLI of allograft recipients has been shown to be immunosuppressive when used alone or together with chemical immunosuppression. Fractionated TLI and allogeneic bone marrow injections produce stable chimaerism without graft-versus-host disease in inbred mice, rats and mongrel dogs and transplantation tolerance of skin and cardiac grafts in rats. In the primate, TLI and bone marrow injection result in significant tolerance of liver and kidney allografts. In 1959 sublethal whole body irradiation was used as an immunosuppressive agent for the first successful related-human renal allografts between non-identical twins. Despite the dangers of myelosuppression, recent clinical experience has shown TLI to be a useful immunosuppressant for organ transplantation, allowing decreased dosage of concomitant immunosuppressive drugs. PMID- 3563794 TI - Hypercalcaemia due to parathyroid adenoma and hypertrophic cardiomyopathy. A case report. AB - A patient with hypercalcaemia due to a parathyroid adenoma, and hypertrophic cardiomyopathy (HCM) is described. Although both conditions are common, it is suggested that the association between HCM and parathyroid hypercalcaemia may be more frequent than is accounted for by coincidence. PMID- 3563795 TI - Successful brush cytology in the early diagnosis of cancer of the oesophagus. A case report. AB - A case is reported of the first Xhosa patient known to have undergone a resection of a very early carcinoma of the oesophagus first diagnosed by abrasive brush cytology. PMID- 3563796 TI - Peritoneal encapsulation of small intestine. A case report. PMID- 3563797 TI - Mesenteric venous thrombosis associated with pregnancy and oral contraception. A case report. AB - Mesenteric vein thrombosis in a pregnant woman taking an oral contraceptive is reported. It is presumed that the hypercoagulable state of pregnancy combined with hormonal contraception led to the thrombosis. PMID- 3563798 TI - Spontaneous rupture of a benign cystic teratoma. A case report. AB - The case of a 44-year-old woman with spontaneous rupture of a benign cystic teratoma is presented. The clinical features of this rare phenomenon are described and the literature is reviewed. PMID- 3563799 TI - Diagnostic problems of leptomeningeal lymphoma. A report of 3 cases. AB - Three cases are presented in which occult lymphoreticular malignant tumour spread to the spinal and cranial subarachnoid spaces inducing a problematic neurological illness characterised by poorly localised neuralgic pain, slowly progressive paresis and, in 2 patients, papilloedema with computed tomographic evidence of ventricular dilatation. Despite intensive investigations, diagnosis was only achieved at autopsy. A progressive disturbance of spinal and cranial nerve function should direct the attention of the clinician to the possibility of diffuse meningeal involvement by a malignant or inflammatory process. PMID- 3563802 TI - An unusual cause of haemoperitoneum. A case report. AB - A case of pedunculated exogastric leiomyosarcoma presenting with haemoperitoneum is described. The difficulties in the diagnosis and management are discussed. PMID- 3563801 TI - Haemothorax of the newborn--an unusual cause of respiratory distress. A case report. AB - A newborn baby with acute respiratory distress caused by tension haemothorax is described. An abnormal clotting profile indicated that the haemothorax was possibly due to a clotting deficiency. Ultrasonography was useful in establishing that the cause of the radio-opacity was fluid. The baby's problem was rapidly resolved by drainage and blood transfusion. PMID- 3563800 TI - Advanced extra-uterine pregnancy associated with eclampsia. A report of 2 cases. AB - Two patients with advanced extra-uterine pregnancies developed fulminating pre eclampsia, providing firm evidence that the uterus is not essential to the process of pre-eclampsia. PMID- 3563804 TI - Arthroscopy--expertise, expedience and expectations. PMID- 3563803 TI - Therapy of radiation bowel damage. PMID- 3563805 TI - Factors influencing the optimisation of phenytoin therapy in epileptic paediatric patients. PMID- 3563806 TI - Pedigree studies as a tool for disease prevention. PMID- 3563807 TI - Day hospital fees and accessibility of essential health services--a follow-up study. PMID- 3563808 TI - Phenytoin overdose. PMID- 3563809 TI - Assessing the outcome. PMID- 3563811 TI - Hypertrophic cardiomyopathy in infancy and childhood. AB - Hypertrophic cardiomyopathy (HCM) presented in 10 children under 2 years of age (group 1) and in 5 between 3 and 8 years (group 2). The clinical, ECG, chest radiographic and echocardiographic features are reviewed and prognosis over a mean follow-up period of 3.5 years is reported. Patients in group 1 had more symptoms and 7 had evidence of heart failure at some stage; all had ECG abnormalities. Group 2 patients presented with murmurs and only 1 had heart failure. Medical management of these patients is discussed and the importance of accurate diagnosis stressed, since HCM may have a poor prognosis in childhood; 3 out of 15 patients have died. PMID- 3563810 TI - Maternal deaths from neurological complications of hypertensive crises in pregnancy. AB - Fourteen maternal deaths from eclampsia or severe pre-eclampsia where disturbed cerebral function, as evidenced by prolonged unconsciousness, was given as the main cause of death are reviewed. Prolonged duration of seizures, hypotensive/hypoxic episodes, cerebral oedema and intracranial haematomas were most frequently identified as causative agents in the development of cerebral dysfunction. Failure to maintain an airway and iatrogenically induced hypotension were the two most important contributory factors to the patients' deaths. Management recommendations to prevent this type of maternal death are given. PMID- 3563812 TI - Nutritional status of black children under 5 years old attending a municipal clinic in Bloemfontein. AB - In a limited study of apparently healthy black children attending a municipal clinic, between 15% and 20% had evidence of growth retardation. The need for routine growth monitoring at under-5 clinics is stressed. PMID- 3563813 TI - Comparison of milk consumption and its contribution to total sugar intake in South African and other schoolchildren. AB - Mean daily milk, lactose and energy intakes were measured in groups of South African school pupils of 9-16 years. Recommended dietary allowances (RDA) were not reached by any of the groups. In comparison, groups of Canadian, Nigerian and German schoolchildren of similar ages fell into two categories, namely high milk consumers and low milk consumers. Lactose and energy intakes for high consumers were 77% of the RDA, compared with 30-40% for low consumers. The lactose contribution to daily energy intake for Canadian children was 10.7% and for South African groups about 5%. Thus for South African children lactose contribution to total sugar intake may be half that of Canadian children. Exact proportions need to be defined. PMID- 3563814 TI - Postpartum sterilisation with the Filshie titanium silicone-rubber clip and subsequent pregnancy. AB - Pregnancy subsequent to postpartum Filshie clip sterilisation has occurred in 8 out of 789 patients operated on at Paarl Hospital since early 1983. As most pregnancies after sterilisation occur within 2 years, more failures can be expected. The use of this method has thus been discontinued. PMID- 3563815 TI - Predicting the outcome of labour. AB - A retrospective study of 50 primigravid patients delivered at Somerset Hospital, Cape Town, is reported. It was found that as the birth weight increases a larger brim area is necessary for successful vaginal delivery. The implications of this in terms of prediction of outcome of labour are discussed. PMID- 3563816 TI - Recommended standard theophylline doses are inadequate in chronic obstructive pulmonary disease. AB - Theophylline serum levels were measured in 34 adult patients suffering from chronic obstructive pulmonary disease. It was not possible to establish a simple relationship between the dose of theophylline and the serum levels measured. Only 53% of peak concentrations and 40% of trough concentrations were found to be within the recommended therapeutic range. In 82% of patients studied, two or more drugs in addition to theophylline, were required for adequate bronchodilation. For optimisation of theophylline therapy, the importance of measuring serum theophylline levels is stressed. PMID- 3563817 TI - Diagnosis of neurocysticercosis by enzyme-linked immunosorbent assay. AB - The detection of neurocysticercosis by enzyme-linked immunosorbent assay, the criterion used for determining seropositivity and the method of interpreting results are discussed. Serum and cerebrospinal fluid (CSF) samples from each of 212 patients were analysed. The results showed that in some patients positive antibody titres may be found in only one specimen. If both specimens are analysed 87% of neurocysticercosis patients can be detected serologically. However, if only CSF is tested, the detection rate falls to 67%. It is recommended that clinicians submit both serum and CSF samples for analysis. PMID- 3563818 TI - The effect of secretin stimulation on duodenogastric reflux. AB - Duodenogastric reflux was studied in normal dogs under basal fasting conditions and during secretin stimulation. Secretin increased the amount of bile reflux and promoted the production of lysolecithin from lecithin. PMID- 3563819 TI - Simulium dermatitis in man--clinical and biological features in South Africa. A case report. AB - Simulium bite reaction is described; the lesions were present mainly on the lower legs as palpable purpura, which persisted for 2 weeks with marked oedema and considerable discomfort. Simuliids are tiny bloodsucking flies, popularly known as blackflies or buffalo flies, belonging to the dipterous family Simuliidae. They occur world-wide, breed in fast-flowing streams, and are a major animal pest. This is the first description of blackfly bites in man in the South African literature. PMID- 3563820 TI - Multicentric pigmented Bowen's disease. A report of 2 cases. AB - Multicentric pigmented Bowen's disease is a rare form of intra-epidermal carcinoma characterised by its pigmented appearance as well as its confinement to the perineal region. Two examples of this disease are presented, illustrating the classic features of this disorder. PMID- 3563821 TI - Verrucous Bowen's disease in a black patient. A case report. AB - A rare verrucous form of Bowen's disease in a black subject is presented. Bowen's disease is extremely rare in blacks, but when it does occur, it tends to present in an atypical fashion. PMID- 3563822 TI - Acute autonomic neuropathy with Salmonella typhi infection. A case report. AB - Acute autonomic neuropathy is a well-described clinical entity that is easy to diagnose with appropriate bedside tests. This condition is described in a patient who had a concurrent Salmonella typhi infection. The relationship between the two conditions is not entirely clear, but the simultaneous disappearance of the S. typhi from stool, the drop in Widal titres and rather early recovery of the autonomic neuropathy tend to implicate S. typhi as the causative agent. PMID- 3563823 TI - Eosinophilic cystitis associated with Glanzmann's thrombasthenia. A case report. AB - Eosinophilic cystitis is a rare condition, only 41 cases having been recorded in the literature. Glanzmann's thrombasthenia has been documented more than 100 times. The presence of these two conditions in one patient has, to our knowledge, not yet been reported in the English-language literature. PMID- 3563825 TI - Cavernous haemangioma of the jejunum. PMID- 3563826 TI - Phenylketonuria (PKU) in the RSA. PMID- 3563824 TI - Bilharzial salpingitis and ectopic tubal pregnancy. PMID- 3563827 TI - Simultaneous occurrence of multiple myeloma and chronic lymphocytic leukaemia. PMID- 3563828 TI - Role of chelating agents in gas gangrene. PMID- 3563829 TI - Sexually transmitted diseases and tubal infertility. AB - To evaluate the association of genital herpes, genital warts, gonorrhea, and trichomoniasis with the occurrence of subsequent tubal infertility, 321 women who had tubal infertility were interviewed concerning their history of these sexually transmitted diseases (STD). The responses were compared to those of women who conceived children during the period the infertile women began trying to become pregnant. By a multivariate analysis, the comparisons were controlled for several confounding variables (e.g., use of an intrauterine device, cigarette smoking, number of prior pregnancies, number of sexual partners, and a history of the other STD). The risk of tubal infertility in women who reported at least one episode of gonorrhea after their last pregnancy, relative to that among other women, was 2.8 (95% confidence interval = 1.3-5.7). The relative risk of tubal infertility was also higher among women who reported a history of trichomoniasis (relative risk = 1.4; 95% confidence interval = 1.0-2.5) or genital warts (relative risk = 1.9; 95% confidence interval = 1.0-3.6). PMID- 3563830 TI - Colonization of sexually abused children with genital mycoplasmas. AB - Although sexually abused children are usually evaluated only for the presence of infections with Neisseria gonorrhoeae and Treponema pallidum, they are also at risk for acquiring other sexually transmitted organisms prevalent in the adult population. Accordingly, we examined pharyngeal, anorectal and genital specimens from 50 children who had been sexually abused and from 40 healthy children who served as controls; these specimens were cultured for Mycoplasma hominis and Ureaplasma urealyticum. M. hominis was isolated from the anorectal and vaginal cultures of 11 (23%) and 16 (34%), respectively, of 47 abused girls as compared with three (8%) and six (17%), respectively, of 36 controls. U. urealyticum was isolated from the anorectal and vaginal cultures of nine (19%) and 14 (30%), respectively, of the abused girls as compared with one (3%) and three (8%), respectively, of 36 controls. Colonization with genital mycoplasmas was not associated with any symptoms. PMID- 3563831 TI - Painful red leg nodules and syphilis: a consideration in patients with erythema nodosum-like illness. AB - An adolescent girl presented with the classical physical findings of painful red nodules on the legs; the lesions were suggestive of erythema nodosum. The usual underlying causes were explored and found to be absent. Because she was sexually active, the patient was also routinely screened for sexually transmitted diseases. A rapid plasma reagin test was performed and found to be strongly positive. The confirmatory fluorescent treponemal antibody test was also positive. A diagnosis of syphilis was made, and she was treated with benzathine penicillin G (2.4 X 10(6) units). This report is a reminder that when a patient is suspected of having erythema nodosum, the physician should check for syphilis as well as for tuberculosis, sarcoidosis, reaction to a drug, and streptococcal disease. Panniculitis can be an important clinical sign of secondary syphilis that should never be overlooked. PMID- 3563832 TI - A factitious case of acquired immunodeficiency syndrome. AB - A 27-year-old man presented with a history of acquired immunodeficiency syndrome and the new onset of weakness and numbness of the lower extremities. During the course of a prolonged and extensive evaluation fraught with iatrogenic complications, it was discovered that his complaints were fabricated and his history of having acquired immunodeficiency syndrome was factitious. PMID- 3563833 TI - Perianal Bowen's disease associated with anorectal warts: a case report. AB - The occurrence of anogenital warts has increased both in clinic and in private practice. Both sexes and all races are affected, with the highest prevalence in patients aged 15 to 40 years. The etiologic agent, the human papillomavirus (HPV), has been classified by DNA hybridization techniques into at least 42 types, of which types 16 and 18 are considered to carry a high risk for cancer. A patient who had been seen intermittently over a period of 26 years with perianal and anal warts that responded to treatment finally developed two granulomatous nodules morphologically different from the previous lesions. A biopsy confirmed that the nodules were typical of Bowen's disease, a precancerous lesion, and they were surgically excised. Thus, anogenital warts that fail to respond to conventional therapy or change in appearance warrant a biopsy and, where the technique is available, DNA typing to identify the viral pathogen. PMID- 3563834 TI - [Clinico-biological study of 45 patients with pernicious anemia]. PMID- 3563835 TI - [Hemophagocytic myeloma. Report of a case]. PMID- 3563836 TI - [Normal survival in vivo of Yt (a+) red blood cells in a patient with anti-Yta]. PMID- 3563837 TI - The effect of health on retirement. AB - Results from retirement research suggest the following conclusions about health, retirement, and the likely effects of the changes in retirement age made by the 1983 Social Security Amendments. First, after controlling for non-health-related factors, it is clear that older workers who are in poor health retire earlier than workers with similar economic circumstances who are in good health. Second, the research reviewed here tends to indicate that the response of the average worker to the changes made in the social security full retirement age by the 1983 amendments will be small. Estimates suggest than the average increase in the retirement age will be between zero and 3 months. Finally, while the evidence is much less certain, research results suggest that older workers in poor health may respond even less than the average worker. It is not possible to say precisely what will happen to lifetime incomes as a result of these changes. A small labor supply response suggests that not much of the lost social security benefits will be made up by additional earnings, either for workers on average or for workers in poor health. However, earnings are only part of the total income picture. Other than a brief mention, this article has not addressed how workers may adjust their savings behavior, or how private pensions may adjust, and particularly whether the potential for adjustment through these avenues is the same for workers in poor health as for the average worker. PMID- 3563838 TI - Developments in the equalization of treatment of men and women under social security in the Federal Republic of Germany. PMID- 3563839 TI - Endocrine surgery. PMID- 3563840 TI - Natural history of treated primary hyperparathyroidism. AB - A follow-up study of patients operated on for primary hyperparathyroidism revealed that recurrent hypercalcemia is uncommon in patients with solitary adenoma, but common in patients with multiglandular disease. The result of parathyroidectomy on the different symptoms of primary hyperparathyroidism is good. On the other hand, even after successful surgery, patients with primary hyperparathyroidism have poorer health than controls, and they also have a higher mortality rate. Most of the deaths in the primary hyperparathyroidism group are caused by cardiovascular disease. The effect of the preoperative serum calcium level on the later state of health is evident. PMID- 3563842 TI - Trends in tracheoesophageal fistula. AB - The changing trends in the management of patients with esophageal atresia, with or without tracheoesophageal fistula during 1974 to 1983, and its effect on survival and morbidity rates are analyzed herein. Of 139 patients in this series, 44 per cent were in Waterston group C. The over-all mortality rate was 25.5 per cent but this decreased consistently after 1980 to 11.0 per cent in 1983. The incidence of infants in the series who weighed less than 1.8 kilograms at birth increased from 7 per cent before 1979 to 18 per cent after 1979 and the survival rate increased from zero to 50 per cent. All six infants who were 30 to 34 weeks gestation and referred after 1979 survived. Severe pneumonia at admission decreased from 24 to 11 per cent in two five year periods. Delayed primary anastomosis and Livaditis circular myotomy overcame many problems of the "long gap" associated with pure esophageal atresia, resulting in successful anastomosis in all eight patients treated in the latter years. Of six patients who presented before 1979, three patients died and three required interposition grafts. Significant anastomotic leaks decreased from 14.7 to 3.2 per cent and the mortality rate decreased from 70 to zero per cent, reflecting many factors, such as extrapleural repair, use of total parenteral nutrition and improved neonatal, ventilatory and intensive care. PMID- 3563841 TI - Intra-arterial streptokinase in the treatment of acute arterial thrombosis. AB - Streptokinase and catheter thrombectomy were retrospectively compared in 25 patients who presented with acute ischemia to investigate whether the use of intra-arterial streptokinase offers an advantage in the treatment of acute arterial or graft thrombosis. Streptokinase was used in all patients presenting with acute thrombosis unless the ischemic limb would not tolerate the time required for clot lysis. Complete thrombolysis was achieved in 47 per cent of the occlusions treated with streptokinase and initial limb salvage rate in 37 per cent of the patients. Subsequent surgical procedures were required in seven of eight patients with successful thrombolysis. Catheter thrombectomy reestablished vessel or graft patency in 86 per cent of the procedures and achieved initial limb salvage in 67 per cent of the patients. Long term (greater than six months) patency was achieved in 25 per cent of the patients treated with streptokinase and 44 per cent of the patients with catheter thrombectomy. Streptokinase did not prevent the need for further surgical intervention, improve early patency of these vessels or promote limb salvage when compared with that of catheter thrombectomy. PMID- 3563843 TI - Gastric mucosal somatostatin-like immunoreactivity in peptic ulcer. AB - Somatostatin (SS) has been reported to exert potent inhibitory effects on gastric acid, pepsin and gastrin secretion. Although still controversial, the results of several studies have shown a possible influence of a local decrease in gastric somatostatin in the physiopathologic characteristics of peptic ulcer disease. In the present study, immunoreactive SS content (SLI) of antral (SLI-a), corpal (SLI c) and fundic (SLI-f) mucosal extracts was measured by radioimmunoassay (RIA) in control patients (C) and in those patients with duodenal ulcer (DU) or gastric ulcer (GU) to further study a possible role of SS in peptic ulcer disease. Fifty five patients (C = 20, DU = 21 and GU = 14) were included in the study. Gastric mucosal samples were obtained either by endoscopic biopsy (4.6 +/- 0.2 milligrams of weight) or operation (52.3 +/- 3.8 milligrams of weight). RIA was performed after a modified Arimura's method and results were expressed as nanograms per milligram of tissue plus or minus standard error of the mean. Chromatographic analysis of gastric mucosal extracts was performed on a Sephadex G-25 fine column. A great interindividual variation in SLI levels was observed (a range of 0.02 to 5.30 nanograms per milligram of weight). The mean SLI concentrations were: C (SLI-a, 2.55 +/- 0.45, SLI-c, 0.99 +/- 0.46 and SLI-f, 1.03 +/- 0.21); DU (SLI-a, 0.48 +/- 0.16, SLI-c, 0.43 +/- 0.13, and SLI-f, 0.58 +/- 0.12), and GU (SLI-a, 1.10 +/- 0.25, SLI-c, 0.40 +/- 0.10, and SLI-f, 0.81 +/- 0.24). Significantly greater amounts of SLI contents were found in the antrum of control patients as compared with those found in the corpus or fundus (p less than 0.05 and p less than 0.01, respectively). SLI-a levels were lower in peptic ulcer patients (DU, p less than 0.001 and GU, p less than 0.05) than in control patients. There was also a significant difference between SLI-a levels in DU versus GU patients (p less than 0.05). No significant differences were found in SLI-c and SLI-f contents in all three groups studied. In conclusion, these results suggest that decreased SS levels in antral gastric mucosa could be the alteration underlying the various physiopathologic mechanisms involved in the development of peptic ulcer disease. PMID- 3563844 TI - Immunity against tetanus and response to revaccination in surgical patients more than 50 years of age. AB - Several instances of fatal postoperative tetanus have been reported, and it has recently been stated that failure to secure adequate immunization for surgical patients may have medicolegal repercussions. In order to investigate according to which criteria for the immunization surgical patients can be considered protected, 178 patients who were more than 50 years of age and who were admitted electively during one year to two surgical departments were studied. To investigate immunity relative vaccination history, all patients admitted during the first two months were offered participation in this study. One hundred and twenty-seven (86 per cent) of these patients were studied by detailed registration of vaccination history and determination of antitoxin concentration in serum. Forty-seven per cent had never been vaccinated against tetanus and 67 per cent had antitoxin concentrations in serum below the protective level. To investigate in detail the duration of immunity and the effect of revaccination, patients with documented complete primary vaccination only were studied during the entire period. An additional 51 patients have been entered into the study during the last ten months. Antibody concentration in the serum corresponded to a continuous fall off in immunity after vaccination. Patients who had received a complete three dose primary vaccination within the last five years or a revaccination within the last ten years were well protected. Forty-four patients received revaccination during the study and were controlled by blood sample four weeks later. Every patient obtained satisfactory antibody concentrations, and it was concluded that no special requirements in recommendations for vaccination are needed, even for elderly patients. Thirteen patients who underwent extensive surgical procedures had serial blood samples taken every three days. Antitoxin concentrations in serum increased sigmoidally with time, and the slow initial increase suggested that revaccination should optimally be given some days before the operation to assure protection in the first few postoperative days. PMID- 3563845 TI - Accurate prognostic value of morphovolumetric analysis of advanced carcinoma of the stomach. AB - Two hundred and seventy-five patients with advanced carcinoma of the stomach invading the serosa were morphovolumetrically classified into three types: funnel, column and mountain. The funnel type, in which cancer cells narrowly invaded the deep wall compared with the extent of spread in the mucosa, was associated with less frequent metastases and a better prognosis (five year survival rate of 49 per cent). The column type, in which cancer cells invaded the deep wall as wide as the mucosa, and the mountain type, in which cancer cells widely invaded the deep wall, were associated with high frequent metastases and a poor prognosis (five year survival rates of 17 and 13 per cent, respectively). Division was also made into expanding and infiltrative types. In patients with the column type, those with infiltrative type had a poorer outcome than did those with the expanding type, while patients with the funnel type had a better prognosis than those with the other two types, regardless of the infiltration and expansion. The expanding type had a propensity for metastases to the liver and infiltrative type for peritoneal seeding. Combination of these classifications provides a prognostic evaluation and assessment of the behavior of advanced carcinoma of the stomach. PMID- 3563846 TI - Accelerated tissue repair induced by micrococcus varians. AB - The present investigation was undertaken to study the effect of inoculated Micrococcus varians organisms on developing granulation tissue in rats. Subcutaneously implanted hollow cylindrical cellulose sponges were used as an inductive matrix for the growth of granulation tissue. The control implants were injected immediately after implantation with 1 milliliter of physiologic saline solution while the experimental implants were injected with a corresponding volume of saline solution containing live micrococci 10(7) microorganisms per milliliter. Cytologic and bacteriologic analyses of wound fluid aspirated from the central dead space of the implants were carried out three, seven and 14 days after implantation. Local blood flow and albumin extravasation were measured on day seven and granulation tissue grown into the implants was analyzed chemically on days seven and 14. No macroscopic infection with pus formation occurred, while Micrococcus varians was cultured from each inoculated implant. In the inoculated implants, the number of wound fluid neutrophils, granulation tissue blood flow and albumin extravasation increased significantly above the control level. Correspondingly, the amounts of granulation tissue deoxyribonucleic acid, nitrogen, collagen hydroxyproline, hexosamines and uronic acids in the inoculated implants exceeded significantly the control value on both days seven and 14. To conclude, inoculation of experimental wounds with nonpathogenic Micrococcus varians organisms enhanced local inflammatory reaction and blood flow, and promoted granulation tissue formation. PMID- 3563847 TI - Low residue nutritional supplementation as an adjunct to mechanical preparation for surgical treatment of the colon. AB - The mechanical and nutritional efficacy of a low residue nutritionally complete liquid diet was evaluated as an adjunct for colonic preparation in patients undergoing large intestinal operations. The complete liquid diet was identical to more traditional clear liquid diets in terms of cleanliness of the intestine and general profile of bacterial flora. This complete diet was well accepted by patients and was superior in its provision of energy, protein, vitamins, minerals and nitrogen. The use of this low residue supplemental diet was associated with a statistically earlier return of intestinal function and a trend toward shorter length of hospitalization. The results of this study indicate that low residue nutritionally complete liquid diets not only offer comparable mechanical cleanliness but also outstanding nutritional advantages not obtained with traditional preparatory diets. PMID- 3563848 TI - Combined supraduodenal and transduodenal exploration of the common bile duct with sphincterotomy. AB - From a consecutive series of 2,221 cholecystectomies, 177 patients underwent combined supraduodenal and transduodenal exploration of the common bile duct and 390 were treated by supraduodenal exploration alone. The mortality rate after both exploration procedures was the same (2.8 per cent). However, two patients died of septic complications associated with duodenal fistulas in the combined exploration group. Five patients had retained stones in the common bile duct which subsequently flushed out with a saline solution irrigation administered through the T tube in three patients and the stone passed spontaneously in one patient. Clinically significant and biochemically documented acute pancreatitis occurred in five patients, one of whom died. Four patients had postoperative cholangitis develop which responded to antibiotic therapy. We are not aware of any patient who had common bile duct stones, chronic pancreatitis or ampullary stenosis after the combined procedure at follow-up study of between six months and 13 years. PMID- 3563849 TI - Operative technique and results of subtotal splenectomy for Gaucher disease. AB - Patients with type 1 (adult form) Gaucher disease complicated by massive splenomegaly and hypersplenism have previously been treated by total splenectomy. Subtotal splenectomy in Gaucher disease will retain splenic tissue which may protect the patient from the risk of overwhelming sepsis. Removal of at least 85 per cent of the splenic mass is necessary to eliminate hypersplenism and to decrease splenic size. The surgical technique and outcome of four patients undergoing subtotal splenectomy for massive splenomegaly due to type 1 Gaucher disease are discussed. PMID- 3563850 TI - Retrosternal esophagogastrostomy with the EEA stapler. AB - We performed an anastomosis of the cervical esophagus to the retrosternally shifted gastric tube with a new technique. The technique was applied successively to ten patients undergoing distal subtotal esophagectomy for carcinoma of the esophagus. In every patient, the technique was done easily and anastomoses were completed without any leakage, bleeding or stricture. PMID- 3563851 TI - Transduodenal distal lateral choledochoduodenostomy. PMID- 3563852 TI - Choledochoscopy without choledocotomy. AB - Choledochoscopy without choledochotomy can be performed in selected instances in which the cystic duct can be dilated to accommodate the fiberoptic instrument. This procedure may obviate choledochotomy and T-tube drainage performed routinely for exploration of the CBD. PMID- 3563853 TI - A new clamp for hepatic resection. PMID- 3563854 TI - Radiolucent Cholangioclip. AB - Use of the absorbable and radiolucent Cholangioclip in the performance of intraoperative cholangiography has been found to be rapid, technically simple, effective, complication-free and avoids radiopaque materials within the operative field. PMID- 3563855 TI - Resection of extracranial carotid artery aneurysm and correction of kink. PMID- 3563856 TI - Influence of injury severity on quality of survival after head injury. AB - The relationship between severity of injury [as determined by the Glasgow Coma Scale (GCS)] and the quality of survival (as determined by neuropsychological measurements and work return) were investigated in 54 conscious survivors within 16 months following head injury. While severely head injured (GCS less than or equal to 8) patients had more neuropsychological impairments in areas of intelligence, attention, memory, visuomotor speed, and motor skills than those with mild injuries (GCS greater than 8), performances after both types of injury were below normative levels in areas of learning, memory, and visuomotor speed. Unemployment increased after both severe and mild injuries, while employment status changed more frequently after severe injuries. Age had a minimal effect on neuropsychological and employment outcomes after minor head injuries (GCS greater than 13). The findings suggest that regardless of acute severity, closed head injury influences long-term quality of survival. PMID- 3563857 TI - Selective change of blood flow in experimental brain tumor with induced hypertension. AB - Blood flow within tumors is important from the standpoint of malignant tumor chemotherapy. It is known that the degree of tissue penetration of lipid-soluble anticancer agents depends on the amount of blood flow within the brain tumor. We investigated regional cerebral blood flow in rats with brain tumors. As compared with that of normal brain, the blood flow within the tumor was low and became significantly increased by inducing a hypertensive condition. These data suggest that the combination of anticancer agent and hypertensive drug is of value to enhance the effects of chemotherapy of brain tumor. PMID- 3563858 TI - Modified Mayo-Adams self-retaining retractor for carotid endarterectomy. AB - The authors describe the use of a Mayo-Adams self-retaining retractor modified for improved exposure of the distal internal carotid artery during carotid endarterectomy. PMID- 3563859 TI - Obliteration of the primary empty sella by transsphenoidal extradural balloon inflation: technical note. AB - Extradural inflation of a balloon with silicone via the transsphenoidal approach is an easy, safe, and effective technique for plugging the empty cavity of the sella and raising the entire sellar contents. It relieves headaches and visual symptoms secondary to the primary empty sella syndrome. PMID- 3563860 TI - Transcervical approach and screw fixation for upper cervical spine pathology. AB - The authors report on the use of transcervical approach and screw fixation for upper cervical spine pathology. They describe the direct osteosynthesis for odontoid fractures and atlantoaxial fixation using a screw fixation of the articular processes. The surgical technique is described and its advantages and disadvantages are discussed as are its indications. PMID- 3563861 TI - Choroid plexus papilloma: magnetic resonance, computed tomography, and angiographic observations. AB - Choroid plexus papillomas are rare intracranial neoplasms that are generally benign in nature. They are seen in both children and adults and have a male preponderance. Magnetic resonance imaging, a noninvasive diagnostic tool, demonstrated the intraventricular location and the surrounding anatomy with striking clarity, more effectively than angiography and computed tomography scanning. PMID- 3563862 TI - Congenital intramedullary spinal ependymal cyst. AB - A rare case of congenital intramedullary ependymal cyst of the dorsal cord in a 7 year-old boy associated with kyphoscoliosis and rachidian malformations of the dorsal spine is reported. Myelography suggested an intramedullary lesion. The posterior location and presence of a clear plane of cleavage from the medullary tissue enabled total enucleation of the cyst. Histological differentiation from other similar intradural cysts is discussed and the relevant literature is reviewed. This is the fifth such case reported in the literature. PMID- 3563863 TI - Vertebral hemangioma: retrograde embolization-stabilization with methyl methacrylate. AB - A new method, intraoperative retrograde embolization with a methyl methacrylate polymer injected into a vertebral hemangioma, is described. This method achieves complete intraoperative hemostasis and postoperative stabilization. No further stabilization procedures and radiation therapy are necessary. Preoperative selective angiography with embolization and consecutive laminectomy are required for this method. PMID- 3563864 TI - Traumatic giant aneurysm of the external carotid artery. AB - Because the main trunks of the external carotid artery and maxillary artery are well protected from blunt trauma and superficial penetrating wounds through their course, traumatic aneurysms on these arteries are extremely rare. A 75-year-old woman had struck her occipital region against a door but there was no trauma to the mandibuloauricular region. After 1 month, she noticed a pulsatile mass below her right auricle. At operation an aneurysm was found to be located just distal to the origin of the maxillary artery. PMID- 3563865 TI - Multiple intracerebral arteriovenous malformations. A case report and literature review. AB - The presence of multiple intracerebral arteriovenous malformations (AVMs) in a single patient has only been very rarely reported. We present a patient with three separate angiographically demonstrable intracerebral AVMs, all of which were radiologically demonstrated and surgically removed without residual neurological deficit. A literature survey was conducted and all the previously described cases of multiple intracerebral AVMs are discussed, along with the potential diagnostic and therapeutic implications. PMID- 3563866 TI - Rhinocerebral mucormycosis and low folate level. PMID- 3563867 TI - The expert witness--to serve or not to serve (and if so, for how much) PMID- 3563868 TI - Is the malpractice crisis hopeless? Perhaps not. PMID- 3563869 TI - Football head and neck injury. PMID- 3563870 TI - [Changes in the chest x-ray following postoperative irradiation of breast cancer]. AB - The radiogenic modifications of the thorax radiography were evaluated in 100 patients irradiated postoperatively for mammary carcinoma between January, 1980 and March, 1983. No adjuvant chemotherapy was given. A telecobalt unit was used for the irradiations. A computer-assisted planning (Evados) was applied in order to obtain an individual optimization especially for the fields situated at the thoracic walls. The average focal doses to the thoracic wall and the regional lymph nodes were between 50 and 52 Gy. Taking into consideration all modifications visualized by radiography, 65% of patients had subacute radiogenic reactions in the lungs, especially in the apex fields. In general the modifications had no clinical importance. Only seven patients presented more severe forms of pneumonitis with clinical symptoms. Fibroses were developed only in the apex fields; infraclavicular infiltrations were seen only in exceptional cases. There were no costal necroses, essential pleural reactions, or radiogenic enlargements of the heart shadow. The rate of pulmonary reactions with clinical symptoms is reduced as compared with former techniques, e.g. opposing tangential fields. The knowledge of anamnesis and typical radiographic modifications should help to avoid problems of differentiation between apex reactions and tuberculosis. PMID- 3563871 TI - Cell loss from viable and necrotic tumor regions after local gamma irradiation measured by 125I-UdR. AB - Using a tracer technique, loss of cells from perivascular and average tumor cells of the syngeneic mammary adenocarcinoma EO 771 in male C57Bl/6J mice may be measured in the living animal, by the use of 125-labelled 5-iodo-2'-deoxyuridine (125I-UdR). It was the purpose of this paper to compare measurements in vivo with those made in vitro following local 60Co-gamma irradiation in the absorbed dose range from 10 to 27.5 Gy, incorporation of radioactivity into DNA of tumor cells and activity loss from labelled tumor cells were measured externally by a special scintillation counter device. In addition, by injecting the vital dye "light green" into the mice the I-125-activity of the stained viable and unstained necrotic regions were separately measured for loss of activity following gamma irradiation. A comparison was made between radiation induced growth delay and the depression of 125I-UdR incorporation into DNA of the proliferating tumor cells. After local tumor irradiation with a dose of 27.5 Gy 60Co gamma rays an enhancement of the activity loss by 0.5% per hour was externally observed for the perivascular tumor cell population. A lower enhancement of 0.4% per hour was externally registered in the average tumor cell population. Both values were evaluated relative to sham-irradiated control tumors. The measurements on isolated tumors were in comparatively good agreement with the external values. The activity loss rate from the viable, euoxic tissue increased by 0.4% per hour after 27.5 Gy 60Co gamma rays and by 0.3% per hour in the average cell population, the latter representing a mixture of euoxic and hypoxic cells. The results demonstrate, that the external measurements are a good indicator for radiation effects under in vivo-conditions. PMID- 3563872 TI - Aspects of the volume effect in the linear-quadratic and cubic model. AB - The volume dependence of the linear quadratic survival function SLQ = exp ( (alpha D + beta D2)) and the cubic survival function Scub = exp (-(alpha D + beta D2 + delta D3)), which represent different stages of a useful approximation of the general dose-response relationship S = exp (-alpha 1D-alpha 2D2-alpha 3D3 ......-alpha nDn (terms of higher order)), has been regarded with respect to the tolerance doses of skin, spinal cord and brain, and the corresponding isoeffects have been compared with the results of a modified Ellis-formula Dt = (NSD)Vo T0.11 N0.24 (V/Vo)-0.158. In a second part, some theoretical models on the volume effect and the empirical power relation of the field size have been investigated by a formulation of the multi target theory by the aid of correlation functions. PMID- 3563873 TI - [Mandatory calibration of dosimeters used in radiotherapy]. AB - In the Federal Republic of Germany, therapy level dosimeters have been subjected to mandatory verification since January 1st, 1983. This paper informs of the legal foundations and the numerous regulations, which must be observed in particular by the manufacturers and users of these dosimeters. Moreover, the paper reports on the actual state of the pattern approvals of therapy level dosimeters, the experiences gained and the results of the verifications until November 1st, 1985. The appendix contains a survey of the patterns of therapy level dosimeters accepted up to now and their complementary devices. PMID- 3563874 TI - [Effectiveness of radiation therapy following breast-preserving surgery in breast carcinoma]. AB - Two patient groups submitted to different treatment schemes--with and without postoperative radiotherapy--were investigated in a retrospective study in order to find out the frequency of recurrences after conservative surgery in mammary carcinoma of the stages T1 and T2. Postoperative radiotherapy following to conservative surgery was found to be the most efficient method to prevent recurrences in patients presenting negative as well as positive axillary lymph node findings. During a follow-up period of 26 months, there was only one recurrence in 50 patients treated by conservative surgery and subsequent radiotherapy, whereas the recurrence rate of patients not irradiated after surgery was 23%. PMID- 3563875 TI - [Radiation therapy in malignant melanoma using accelerated fractionation. Remission and preliminary results of local tumor control]. AB - 25 target volumes in 14 patients were treated with accelerated fractionation. Eleven of twelve evaluable target volumes showed a complete remission. Three local recurrences occurred in 25 target volumes. A 35 cm long tumor came in a one and a half year during complete remission. PMID- 3563876 TI - [Clinical aspects and therapy of Kaposi's sarcoma]. AB - Three own cases are presented in order to discuss the clinical characteristics as well as the therapy of the Kaposi syndrome. This disease occurs very rarely. In its typical form it has to be classified as semi-malignant. Generally it takes an extended course over many years. In case of loco-regional tumors, radiotherapy is considered to be the method of choice. It should be performed in an extended field technique allowing to reduce the recurrence rate and to achieve a better local tumor control. The total dose is individually determined between 25 and 40 Gy. PMID- 3563877 TI - [Results of radiation therapy in brain metastases with reference to computerized tomography]. AB - Between 1979 and 1985, 193 patients were submitted to radiotherapy of the brain for formation of metastases. A primary irradiation was performed in 159 patients, 34 patients had been treated by surgery. The median survival time after diagnosis of all irradiated patients (40 to 60 Gy within four to six weeks) was 4.9 months, 22% of the patients survived one year. Patients with mammary carcinomas and patients with bronchial carcinomas showed marked differences in median survival times (4.2 and 6.9 months, respectively) and one-year survival rate (11% and 32%, respectively). In histologic examination, the extent of extracerebral formation of metastases was the decisive parameter for survival. At the end of radiotherapy, 47% of patients showed an amelioration in neurologic deficiency, 16% deteriorated. A follow-up by computed tomography with observation periods between four and 34 months was possible in 84 patients. Most of these patients showed improvement in computed tomography during a period of four to twenty weeks after the beginning of radiotherapy. Later on, about two thirds of the controlled patients had again deterioration with local progression or new formation of metastases in spite of total brain irradiation. A long-term normalization (greater than one year) was observed only in patients with mammary carcinomas. PMID- 3563878 TI - [Computer-assisted system for interstitial hyperthermia]. AB - The combination of interstitial radiotherapy and interstitial hyperthermia is more promising in the treatment of tumors than one of these methods alone. The unit developed by us uses the afterloading needles for heating up the tumor tissue with ohm current and for controlling the distribution of temperature in the target volume. Up to twelve needles are provided by one commutator with the R.F. current controlled by the computer. The temperature is measured by three thermistors per needle which are arranged at an axial distance of 2 cm each. The linearization of the thermistor characteristics and the control of cummutator and R.F. generator is performed by the computer over an interface constructed by us. In order to achieve a homogeneous distribution of temperature in the target volume and to avoid hot spots, we have examined several needle configurations by measuring in an homogeneous phantom. PMID- 3563879 TI - [Dosimetry of the hematopoietic system in radioiodine therapy of thyroid cancer]. AB - Twenty patients were submitted to thyroidectomy and treated with iodine-131. Ten out of them received 100 mCi, the other ten 200 mCi. The activity of the total body and of the blood was determined by experimental proceeding. The doses absorbed by blood and bone marrow were calculated on the basis of the experimentally determined values. For the exposure of the blood, a medium value of 0.44 rd/mCi was found after 100 mCi and a medium value of 0.47 rd/mCi after 200 mCi. The corresponding values for the bone marrow are 0.24 and 0.3 rd/mCi, respectively. The total exposure is thus not so high as has been indicated hitherto in literature. PMID- 3563880 TI - [The incidence of breast carcinoma following roentgen radiotherapy at the Marburg University Women's Clinic]. AB - A lot of women still object to mammography for fear of induction of carcinoma by radioactive rays. Even a large number of doctors are not informed about the fact that during the last ten years the dosage necessary for examination could be extremely reduced. In a follow-up examination of 61 females who had undergone a therapy of mastitis with a dosage of 3 X 80 R between 1949 and 1958, an enhanced risk of carcinoma could not be ascertained. PMID- 3563881 TI - [In-vivo marking of human tumors using BUDR for flow-cytometry determination of kinetic cell parameters]. AB - The flow-cytometry results of solid, human tumours are reported which were labelled with Bromodeoxyuridine in vivo. The preparation of the single cell suspension is prescribed. The S-phase percentage could be determined exactly in all cases but one. It is a rapid procedure which gives results in one day and the in vivo labelling had no adverse effects. PMID- 3563882 TI - Mesenteric venous thrombosis--1911 to 1984. AB - The objective of this study was to identify those patients in whom mesenteric venous thrombosis (MVT) is likely to develop and to review the pathophysiology, clinical presentation, diagnostic modalities, and patient outcome. We present a review of the literature from 1911 to 1984 with respect to 372 patients with MVT, including five of our own patients. Data on 99 of these patients were obtained from autopsy reports and were not included in the study. This disease is common in the sixth and seventh decades of life, with 81% of these older patients having associated illnesses. MVT involves segments of the small bowel, but rarely of the colon, with hemorrhagic infarcts rather than gangrene. This disease does not conform to a pattern, although a prodromal period of days or weeks of abdominal pain (which is usually out of proportion to physical findings), marked leukocytosis, and dehydration are all highly suggestive of MVT. Serosanguineous fluid obtained by means of peritoneal tap is a useful diagnostic tool. A high index of suspicion, early diagnosis, and prompt surgical intervention with the addition of anticoagulants seems to improve survival and reduce recurrence. PMID- 3563883 TI - Effects of pulmonary embolism on survival of patients with Greenfield vena caval filters. AB - The late mortality in 167 patients who had Greenfield vena caval filters inserted after episodes of acute pulmonary embolism is reported. The mean follow-up period of the survivors was 42 months; the mean survival time of the 48% who died was 9.3 months. The mortality rate in 50 comparable patients who did not have pulmonary embolism but had prophylactic filter insertion was 52% with a mean survival time of 9.4 months. The mean follow-up period of the survivors was 28 months. Age, mean pulmonary artery pressure, and severity of the initial embolic episode did not predict the increased rate of late mortality. We conclude that for patients who survive acute pulmonary embolism and have treatment to prevent recurrence, the embolic history of thromboembolism has little impact on late mortality, which is determined by their preexisting serious medical conditions. PMID- 3563884 TI - Interim results of treatment of breast cancer with breast conservation for all patients. AB - Since April 1979, all female patients who have come to this unit with carcinoma of the breast have received primary treatment with breast conservation. Until December 1984, 288 patients underwent local excision of the tumor with radical radiotherapy. After 1 to 5 years, the overall and recurrence-free survival rates have been comparable with those expected after mastectomy. Local recurrence occurred in 7 of 76 (9%) patients who had stage I disease, and in 16 of 181 (9%) and 3 of 27 (11%) patients with stage II and stage III disease, respectively. Eleven patients required a mastectomy to control recurrence of the cancer, and of the 29 patients who died of breast cancer, only three had symptomatic local disease at the time of death. PMID- 3563885 TI - Muscle amino acid flux in patients receiving branched-chain amino acid solutions after surgery. AB - The metabolism and efficacy of branched-chain amino acids (BCAAs)-enriched parenteral solutions in patients after surgery are unclear. This prospective clinical study compared two groups of patients (n = 13) receiving either a 25% BCAA solution or a 45% BCAA solution at 30 kcal/kg/day and 1.5 gm protein/kg/day for 7 days after operation. Whole-body nitrogen balance and forearm muscle amino acid and ketoacid flux were measured. There were no significant differences between the two groups in mean cumulative nitrogen balance (+13.1 gm versus +18.0 gm) between the two groups. Patients receiving the 45% BCAA solution had significant mean uptake of total BCAA, leucine, and isoleucine compared with results in patients receiving the 25% BCAA solution. Despite this increased uptake of BCAA in the 45% BCAA group, there was no increased efflux of alanine, glutamine, or the BCAA ketoacids, ketoisocaproic, ketoisovaleric, or ketomethylvaleric. However, increased release of aspartate was noted in the 45% BCAA group compared with the 25% BCAA group. Thus use of a 45% BCAA-enriched solution infused in patients after surgery results in a significant increase in forearm muscle uptake of the BCAA that is not demonstrated in whole-body nitrogen economics. PMID- 3563886 TI - Esophagogastric anastomosis performed with a stapler: the occurrence of leakage and stricture. AB - The circular stapler has lowered the leakage rate of an esophageal anastomosis to a level hitherto achieved by only a few surgeons performing hand anastomosis on selected patients with carcinoma of the esophagus. However, the esophageal anastomosis performed with a stapler is also associated with a high stricture rate. Our prospective study was conducted to determine the leakage rate and the incidence of stricture after esophagogastric anastomosis was performed with a stapler, the relationship of stricture to the size of the stapler, and the risk of stricture in relation to time. In a group of 174 patients with carcinoma of the thoracic esophagus, resection was performed, and a one-stage esophagogastric anastomosis was constructed. There were 33 hand anastomoses, 64 anastomoses with an EEA stapler (U.S. Surgical Corp., Norwalk, Conn.), and 77 anastomoses with an ILS stapler (Ethicon Ltd., Edinburgh, U.K.). The anastomotic leakage rate was 3.4% (6/174); 3% with the hand technique and 3.5% with the stapler technique (4.7% for the EEA and 2.6% for the ILS). After leakages and hospital deaths were excluded, 133 discharged patients were evaluated for the occurrence of anastomotic strictures. Only those who complained of dysphagia were investigated. The incidence of stricture for hand anastomosis was 8.7%-EEA 20% and ILS 10%; the overall incidence of anastomoses with a stapler was 14.5%. The true incidence would probably be higher if all patients were assessed by endoscopic or radiologic examination after operation. All three sizes of EEA staplers had a high incidence of stricture. For the ILS stapler the 25 mm size had the highest stricture rate (28.6%) of all groups, but for the 29 and 33 mm sizes, the incidences were 5.3% and 0%, respectively. Actuarial analysis showed an increasing risk of stricture with a reduction in the size of stapler used and was 32.5% and 35%, respectively, for the ILS 25 mm and EEA 25 mm staplers at 131/2 months. The risk of stricture occurrence was highest in the first 4 months. Treatment by bougienage was satisfactory. In conclusion, esophagogastric anastomosis performed with a stapler is a very safe procedure with respect to leakage but is associated with a high risk of stricture, except when the largest ILS staplers are used. However, dilatation readily overcomes the stricture occurrence and adequately compensates for the reduced leakage rate and its attendant serious consequences. PMID- 3563887 TI - Subcutaneous tissue oxygen tension falls during hemodialysis. AB - The effect of hemodialysis on subcutaneous tissue oxygen tension was studied in nine patients. During hemodialysis, blood pressure decreased, pulse increased, and all patients lost weight. Arterial blood oxygen tension fell insignificantly, from 79 to 73 mm Hg. Subcutaneous oxygen tension decreased from 52 to 28 mm Hg (p less than 0.001). Because adequate tissue oxygenation is necessary for wound healing and resistance to infection, we postulate that hemodialysis may contribute to the wound morbidity frequently seen in dialyzed patients. PMID- 3563888 TI - Foot blood flow measurements improve venous plethysmographic studies. AB - The time for foot volume restoration after exercise is widely used as a measure of venous regurgitation. Since this is also a function of arterial inflow rate, we have tested the hypothesis that uncorrected for arterial inflow, these tests may be misleading. Change in venous foot volume after elevation and on exercise was measured in 44 subjects. Arterial inflow was also determined. In a few patients arterial flow was varied by cooling or by exercise. The times of half volume restoration were measured. Calculated were: the rate of total blood flow into the foot; the rate of venous regurgitation; and "venous sufficiency indices" for elevation and for exercise with and without correction for arterial inflow rate. These indices combine volume and time data in a single numeric value. Volume change on elevation was uninfluenced by the rate of arterial inflow. Volume change on exercise and the halftime of volume restoration varied significantly with the rate of arterial inflow as did the "venous sufficiency indices." These variances were significantly reduced by correcting for arterial inflow rate. We conclude that for foot volume studies to measure regurgitation and for data obtained at different times to be comparable, corrections must be made for the rate of arterial inflow to the foot. PMID- 3563889 TI - The effect of acid perfusion on mucosal blood flow and intramural pH of rabbit duodenum. AB - To evaluate the role of blood flow for acid tolerance of the duodenal mucosa, we perfused the duodenums of anesthetized rabbits with different concentrations of hydrochloric acid (HCl). Acid perfusion stimulated blood flow to the duodenal wall in a concentration-dependent fashion up to 80 mmol/L HCl (0 mmol/L; 0.44 +/- 0.05, 10 mmol/L; 0.84 +/- 0.14, 50 mmol/L; 1.44 +/- 0.11, 80 mmol/L; 2.03 +/- 0.12, 100 mmol/L; 1.82 +/- 0.07 ml/gm/min X +/- SEM). The pH in the lamina propria of the mucosa, which was measured with antimony microelectrodes was not changed in experiments during perfusion with 50 and with 80 mmol/L HCl in normotension. Acidosis in the lamina propria could be demonstrated only when the duodenum was perfused with 100 and with 80 mmol/L HCl combined with hemorrhagic hypotension. Damage to the mucosa, which developed after 30 and 60 minutes of acid perfusion, also showed a H+-dependent pattern. Reduction of blood flow by hemorrhagic hypotension aggravated the morphologic damage. We conclude that luminal acid stimulates blood flow in the duodenum. The decrease in blood flow induced by hypotension results in a greater susceptibility to mucosal damage. PMID- 3563890 TI - Thrombogenicity of a fibronectin-coated, experimental polytetrafluoroethylene graft. AB - To determine if pretreatment of polytetrafluoroethylene (PTFE) vascular grafts with fibronectin (FN) increased platelet adherence to them and adversely affected their patency, we labeled autologous canine platelets with indium III-oxine and interposed a FN-coated, experimental, 4 mm inner diameter, 10 cm long PTFE prosthesis into one carotid artery of 10 dogs. An identical graft, lacking only the FN coating, was implanted as a control in the contralateral carotid artery. A second group of 10 dogs was similarly treated, but each animal received 2 grains of aspirin and 50 mg of dipyridamole (Persantine) daily, beginning 3 days before surgery and continuing for the duration of the experiment. By means of a quantitative, gamma-camera, platelet adherence to the grafts was studied for 5 days after implantation. Graft patency was assessed with the Doppler velocity meter and was confirmed by surgical reexploration when thrombosis was suspected. FN coating increased platelet adhesion to the grafts in animals untreated with aspirin by a factor of threefold to fivefold. In those animals receiving antiplatelet drugs, patency of FN-coated grafts at 5 days was significantly (p less than 0.05) higher (80%) than in untreated animals (27.2%). In addition, mean platelet deposition on the grafts in these animals was reduced compared with untreated controls. Thus although FN coating of PTFE grafts significantly increases their affinity for platelets, this effect can be effectively abolished by pretreatment with aspirin and dipyridamole. PMID- 3563891 TI - Giant hepatic hemangiomas: diagnostic and therapeutic dilemmas. AB - This report describes four cases of surgically treated giant hepatic hemangiomas which illustrate some diagnostic and therapeutic difficulties encountered in the management of this condition. An important diagnostic triad has emerged, which should alert the physician to the possibility of a complicated hepatic hemangioma: the clinical signs of an acute inflammatory liver process contrasted with a normal white blood cell count and liver function tests. Hemangiomas of the left lobe were either missed or poorly demonstrated on selective hepatic angiographic examination, and in two patients the diagnosis was made only at the time of laparotomy. Hepatic resection was successfully performed in all patients; there was minimal morbidity and none of the patients died. In two patients with multiple hemangiomas, only symptomatic or easily resectable lesions were removed. All patients are alive and well; three have been followed up for more than 5 years. We conclude that resection in asymptomatic cases should be carried out only in those cases that require a diagnostic laparotomy and in those where the lesion is easily resectable. The majority of patients with symptomatic and complicated tumors should undergo resection, but even in these patients continued conservative treatment is appropriate when the risk of major resection outweighs the small risk of live-threatening bleeding. PMID- 3563892 TI - Delayed resolution of high-pressure pulmonary edema or capillary leak. AB - Both clinical and experimental evidence suggest that the time course of edema formation is different from that of edema resolution. To better describe and quantify this difference, we followed the accumulation of high-pressure pulmonary edema in live dogs with the thermal-green dye (TGD) double-indicator technique at steady-state levels of lung liquid. We raised left atrial pressure (PLa) in steps of 5 to 10 mm Hg as high as 25 mm Hg and followed edema to steady-state levels. Lung water was then measured as PLa was lowered to initial values. By plotting steady-state edema against PLa, pressure-volume relationships were constructed. There was little change in edema until PLa reached approximately 15 mm Hg, at which point further changes in PLa were associated with large increases in lung liquid. At PLa = 25 mm/kg, the average lung water had increased by 10 ml/kg. In each animal there was slow resolution of edema with decreases in PLa from its peak back to its initial value, but in no animal was edema fully reabsorbed even though PLa was maintained at about 5 mm Hg for as long as 10 hours. Several possible explanations account for these observations. Water could be trapped in alveolar and central interstitial spaces. In addition, vessel closure in edematous lung units could further influence water reabsorption. These observations raise the possibility that pulmonary edema in the presence of normal filling pressures may represent resolution of a transient high-pressure edema as opposed to a capillary leak syndrome. PMID- 3563893 TI - Long-term biologic fate of neoarteries regenerated in microporous, compliant, biodegradable, small-caliber vascular grafts in rats. AB - Microporous, compliant, biodegradable vascular grafts prepared from a mixture of polyurethane [( PU], 95% weight) and poly-L-lactide [( PLLA] 5% weight) can function as temporary scaffolds for the regeneration of the arterial wall of small-caliber arteries. The purpose of this study was to determine the long-term biologic fate of these neoarteries that were regenerated in PU/PLLA vascular grafts. The PU/PLLA vascular grafts (1.5 mm internal diameter [ID]) were implanted into the abdominal aortas of rats (N = 8) and were evaluated 1 year after implantation by means of macroscopic inspection, light microscopy, and electron microscopy. All implants were patent; three implants were normally shaped, two were slightly dilated (+/- 10% of the original ID), and three implants were aneurysmal. Arterial pulsations were reduced but still visible in the normally shaped implants and absent in the other implants. In all implants, the neointima was complete. The neomedia varied among the implants: In the normally shaped implants, smooth muscle cells were predominantly circularly arranged as in normal arterial tissue; in the other implants, smooth muscle cells were predominantly longitudinally arranged. The neoadventitia showed a completely fragmented graft lattice, which was organized by fibrohistiocytic tissue. These results suggest that the pattern of arrangement of smooth muscle cells in the neomedia determines the ultimate biologic fate of neoarteries regenerated in microporous, compliant, biodegradable vascular grafts. Only those neoarteries with predominantly circularly arranged smooth muscle cells in the neomedia were able to function normally as an arterial substitute for a 1-year period after implantation into the rat abdominal aorta. PMID- 3563894 TI - Surgical treatment of renovascular hypertension caused by arteriosclerosis. II. Influence of preoperative risk factors and postoperative blood pressure response on late patient survival. AB - This study assesses the late survival of 103 patients with renovascular hypertension caused by arteriosclerosis who underwent reconstructive surgery during the period of 1959 through 1982. It provides a detailed analysis of the influence of preoperative factors and the postoperative blood pressure response to fatal and nonfatal cardiovascular events during follow-up. All patients suffered from severe hypertension. Arteriosclerosis was limited to the renal arteries in 52% of the patients, while 48% showed overt extrarenal arteriosclerosis. Hypertensive target organ damage was present in 68% of the patients. At a mean of 8.5 months postoperatively, 80% of the patients showed beneficial and 20% showed unsatisfactory blood pressure responses. These results were not related to the presence or absence of extrarenal arteriosclerosis. Overall, late (10 years) patient survival was significantly lower than the expected survival of a reference population (79% versus 92%; p less than 0.0001). Late patient survival was not influenced by the absence or presence of extrarenal arteriosclerosis (82% versus 82%) or target organ damage (83% versus 82%), but late survival was significantly better with beneficial (87%) than with unsatisfactory blood pressure responses (67%). This effect was especially conspicuous in the presence of extrarenal arteriosclerosis (88% versus 57%; p = 0.04) but not in its absence (86% versus 74%; p = 0.41). In terms of long-term survival, these findings clearly demonstrate the favorable effect of successful surgical treatment of patients with renovascular hypertension caused by arteriosclerosis. Moreover, they illustrate that the mere presence of preoperative extrarenal arteriosclerosis or target organ damage is not sufficient argument against surgical therapy. PMID- 3563895 TI - Continuous arteriovenous filtration: an effective treatment for surgical acute renal failure. AB - Continuous arteriovenous hemofiltration (CAVH) is a new method of renal replacement therapy that has several advantages in the surgical treatment of acute renal failure. We initially learned the technique in laboratory testing and then developed a management protocol. Since 1983 we have used CAVH to treat 61 patients with acute renal failure. This extracorporeal technique consists of arteriovenous cannulation of the femoral vessels, which provides continuous blood flow through a hollow-fiber membrane. Hydrostatic pressure (systole greater than 80 mm Hg) creates an ultrafiltrate at a typical rate of 12 L/day. Volume is replaced with an intravenous solution at a rate to achieve the desired fluid balance, usually a net loss of 1 to 2 L/day. This extracellular fluid exchange typically results in removal of 15 gm of urea nitrogen and 50 mEq of potassium per day. The technique can be used in most intensive care units and has relatively few complications. In addition to being a safe and effective means of renal replacement therapy for acute renal failure, CAVH is particularly advantageous for managing conditions of fluid overload in hemodynamically unstable patients. PMID- 3563896 TI - Surgical treatment of lymphedema: a report on 652 cases. AB - We performed the world's first lymphography, and 2 years later we focused our surgical methods on total superficial lymphangiectomy for the treatment of lymphedema. In the course of 40 years, we have studied the results of this treatment for edemas of lymphatic origin. We surgically treated 600 cases of lymphedema of the lower limb, 48 of the genital organs, and four of the upper limb and have had very promising results. Indications for surgical treatment of these edemas due to lymphatic blockage include the considerable inconvenience caused by the very large size of the extremity affected with lymphorrhagia or chylorrhagia, the severe lymphangitis that occurs in the course of their development, and finally the malignant degeneration of the lymphatic vessels in 1% of the cases. PMID- 3563898 TI - An alternative repair of major vascular injury inflicted during lumbar disk surgery. AB - A major iatrogenic injury involving the bifurcation of the aorta and the inferior vena cava during lumbar disk surgery was successfully repaired by completing the near transection of the right common iliac artery, venorraphy and aortorraphy of the wounds of the bifurcation, and end-to-end anastomosis of the left hypogastric artery to the right common iliac artery. PMID- 3563897 TI - Progression of a benign epithelial ampullary tumor to adenocarcinoma. AB - Benign tumors of the extrahepatic biliary ducts are rare. The high recurrence rate following local resection of these benign tumors is well known, but the development of one into a malignant tumor has received little attention. The recurrence 4 years after local excision of a benign periampullary tumor that developed into a well-differentiated papillar adenocarcinoma is described in this case report. Radical resection was performed by means of a pancreatoduodenectomy. The literature concerning the progression of benign extrahepatic tumors to adenocarcinomas is reviewed. PMID- 3563899 TI - Reiter's syndrome and recurrent peritonitis after appendectomy. AB - A 15-year-old male adolescent underwent an appendectomy for acute gangrenous appendicitis. One week after surgery, he underwent an exploratory laparotomy that revealed two pericecal abscesses, which were drained. Two weeks later, he had diffuse peritonitis and underwent another laparotomy, which revealed a sterile fibrinous peritonitis. Oligoarticular inflammatory arthritis, urethritis, and recurrent peritonitis subsequently developed. He was found to be positive for HLA B27 antigens. This case report illustrates that reactive arthritis (Reiter's syndrome) may develop after peritoneal infections. It also raises the possibility that the inflammatory process, which involves other serosal surfaces in Reiter's syndrome, may affect the peritoneum. PMID- 3563900 TI - Calcified pancreatic pseudocysts. AB - Extensive calcification of a pancreatic pseudocyst that permits visualization on plain abdominal radiographs is unusual. When such x-ray findings are encountered, a broad differential diagnosis can be made, which includes tumors, cysts, abscesses, or malformations of the adjacent structures. Two cases of calcified pancreatic pseudocysts are discussed. Calcified pancreatic pseudocysts may be a potential source of complications such as pain, bleeding, or infection. Because the cyst wall is mature and spontaneous resolution is unlikely, proper treatment of calcified pseudocysts consists of timely resection or internal drainage. PMID- 3563901 TI - [The multipurpose program "Health" for Moscow]. PMID- 3563902 TI - [Errors in the diagnosis of atypical forms of Sheehan's syndrome]. PMID- 3563903 TI - [Differential diagnosis of unconjugated hyperbilirubinemia]. AB - Eighty-four patients with unconjugated hyperbilirubinemia were examined for erythron. The authors managed to reveal a group of patients with evident signs of the derangement of the nucleus-containing cells of erythropoiesis which was manifested in the accumulation of SIA-positive material in the cytoplasm and by the presence of morphological abnormalities in the peripheral red blood cells. PMID- 3563904 TI - [Multicenter study of the efficacy of dimethyl sulfoxide in rheumatoid arthritis and osteoarthritis deformans]. PMID- 3563905 TI - [A case of successful treatment of bronchopulmonary aspergillosis]. PMID- 3563906 TI - [3 cases of death in bronchial asthma patients after consuming alcoholic beverages]. PMID- 3563907 TI - [Patterns of calcium metabolism in persons with different pathologic processes]. PMID- 3563908 TI - [Apolipoproteins B and A-I in the plasma of a random sample of an organized population of 20 to 59-year-old men and ischemic heart disease]. AB - The authors presented the results of a study of the level of blood plasma apo-B and apo-A-I in random samples (by age decades from 20 to 60) of the organized male population (n = 309) and additionally of CHD patients who were not entered into the random samples (n = 82). Age differences in the level of blood plasma apo-B and apo-A-I were noted; a significant positive correlation with age of the level of apolipoprotein B at the age of 20 to 59 and a negative correlation of apo-A-I in males aged 20 to 39 were revealed. By the percentile distribution of apo-LP-B and A-I the relative borders of their high and low values were defined in random samples of males aged 20 to 39 and 40 to 59. Significant differences in the prevalence of high and low levels of apo-B and apo-A-I were demonstrated among patients with CHD and persons without this pathology. PMID- 3563909 TI - [Comparative characteristics of the plasma lipid composition of 10-11-year-old schoolchildren in Moscow and Novosibirsk]. AB - The role of lipoproteins in the etiology of atherosclerosis has been proved by the present time and dyslipoproteinemia is considered one of the main risk factors like smoking and arterial hypertension. In 1983-1984 an epidemiological survey of a representative sample of schoolchildren was conducted in one of the Moscow districts and according to a unified program among standardized participants in Novosibirsk. As a result, regional normal limits and mean values of blood plasma lipids were established in the populations of schoolchildren aged 10-11 in Moscow and Novosibirsk, their comparative characteristics and interrelationships between physical development and a degree of puberty were studied. Considerable differences in the TG level of plasma were found. The fact might be due to regional nutrition habits. PMID- 3563910 TI - [Features of the epidemiologic characteristics of ischemic heart disease among scientific research workers]. AB - The peculiarities of prevalence of coronary heart disease (CHD), its main risk factors and their interrelationships were studied on the basis of the results of epidemiological surveys of an organized population of men aged 20 to 59 engaged in research, and an unorganized male population in one of Moscow districts. A similar CHD frequency was revealed in both populations (10.5 and 9.5%), however the prevalence of possible CHD was significantly higher among the research workers. In this group more unfavorable epidemiological conditions were noted with relation to such CHD risk factors as hypercholesterolemia, disturbed glucose tolerance, a low physical activity, with practically the same prevalence of excess body mass and lower frequency of arterial hypertension and smoking. The results obtained formed the basis for a design of measures on primary and secondary CHD prevention among research workers. PMID- 3563911 TI - [Prevention, dispensarization and the ambulatory-polyclinic service]. PMID- 3563912 TI - [Concentration of lipids in the skin, arterial wall and blood of patients with arteriosclerosis obliterans of the vessels of the lower extremities]. PMID- 3563913 TI - [The role of aerobic capacity and efficiency in determining the intensity of training therapy and physical rehabilitation in chronic ischemic heart disease]. AB - A number of values based on ergospirography results determining and limiting physical aerobic working capacity were studied by way of comparison in 35 patients with angina of effort with different threshold oxygen consumption. It was first established that aerobic capacities in chronic CHD were characterized not only by the power or cardiorespiratory productivity but also by the efficacy of the oxygen mechanism of energy production and realization of aerobic potentialities unrelated to one another. The informative value and usefulness of values of the threshold of anaerobic metabolism for determination of the optimum intensity of exercise therapy were revealed for expanding the aerobic capacities of patients with chronic CHD. PMID- 3563914 TI - [Phenotypical correlations in cardiologic patients]. AB - The role of pathologically changed connective tissue was shown on the basis of an analysis of significant correlation of 20 pairs of phenotypical traits in 84 of 285 men with cardiovascular changes. PMID- 3563916 TI - [Possibilities of correcting early hemodynamic changes in patients with chronic nonspecific lung diseases using the calcium antagonist corinfar]. PMID- 3563915 TI - [Alcohol and hypertension in sudden cardiac death, features of the status of the renin-angiotensin-aldosterone system]. AB - The activity of blood plasma renin and the renal cortical layer in persons who had suddenly died, was much lower in those with arterial hypertension than in those without it. A more pronounced increase in the activity of blood plasma renin and the renal cortex was noted in persons with hypertension who had died against a background of alcoholic intoxication as compared to persons without hypertension. In sudden cardiac death of persons without hypertension there was a positive correlation between plasma renin activity and alcohol concentration in the blood. Such a correlation was undetectable in the presence of hypertension. In small alcohol concentrations in the blood higher plasma renin activity values were noted in persons with hypertension than in those without it. Aldosterone concentration in the blood of patients with arterial hypertension and without it did not practically differ. The presence of alcohol in persons without hypertension resulted in a significant increase in aldosterone concentration in sudden cardiac death as compared to those with hypertension. A positive correlation between renin activity and aldosterone concentration was noted in all the groups under study. PMID- 3563917 TI - [Annual dispensarization of the population--at the level of current requirements]. PMID- 3563918 TI - [Evaluation of digestive functions in the work capacity evaluation of patients with cholelithiasis after cholecystectomy]. PMID- 3563920 TI - [A new method physical loading tests in the evaluation of functional status and the development of rehabilitation programs for patients with acute infectious diseases]. AB - The authors studied the potentialities of employment of a new method of exercise tests (cyclic bicycle ergometry) for the assessment of convalescents' function and working capacity following acute communicable diseases. The above method showed the relationship of convalescents' function and working capacity with a nosological form and stage of convalescence. It was established that some indices of patients' function did not return to normal by discharge. Different mechanisms were shown to lie in the basis of disturbances in various infections. A conclusion was made that convalescents were in need of differentiated pathogenetically founded and purpose-oriented recovery therapeutic measures which should be taken into account in drawing up programs for their rehabilitation and follow-up after acute communicable diseases. PMID- 3563919 TI - [Ways of reducing disability in rheumatoid arthritis]. AB - An analysis of primary disability of patients with rheumatoid arthritis (RA) in the Vinnitsa area over the period of 1981-1983 as compared to that of 1971-1973 showed a decrease in its proportion and the improvement of some indices of medical labor examination over the studied period confirming the efficacy of organizational measures in prophylactic medical examination of RA patients in the above area. PMID- 3563921 TI - [Evaluation of various immunologic tests for detection of chronic alcoholic patients at risk for cancer]. PMID- 3563922 TI - [Method of objective evaluation of the deontologic tactics of the physician]. PMID- 3563923 TI - [Preventive examination of the population of the medical district of an urban polyclinic]. AB - Prophylactic examination of the population in a district of a city out-patients clinic was performed. Altogether 689 persons (298 men and 391 women) aged 16 to 64 were examined. A great prevalence of chronic non-communicable diseases (CND) and common risk factors were revealed: CHD in 16.7% of the examinees, cerebral changes in 0.6%, diabetes mellitus in 3.9%, chronic bronchitis in 9.3%, arterial hypertension (AH) in 29.6%, smoking in 26.1%, disturbed carbohydrate tolerance in 15.7%, hypercholesterolemia in 13.5% and excess body mass in 35.5%. In 40% of the patients with AH it was combined with other chronic diseases necessitating a multidisciplinary approach to CND control in the patients with AH. The study showed that the population was not ready enough for prophylactic examination. PMID- 3563924 TI - [Prevalence of osteoarthrosis in the population]. PMID- 3563925 TI - [Attitude of specialists in different occupational groups to their health]. AB - A study was made of behavioral, psychological and somatic risk factors of development of coronary heart disease in 1311 specialists with higher education in 6 occupational groups within the framework of the cooperative program on multifactor prevention. There were no significant differences among groups with relation to smoking, physical activity and a balanced diet. Significant changes were established with relation to psychological stress and prevalence of cardiac diseases. There is no need to differentiate preventive measures for specialists of different occupations. PMID- 3563926 TI - [Complex system of ensuring remission of bronchial asthma]. PMID- 3563927 TI - [Acute pneumonia complicating chronic pyelonephritis in persons over 60-years old]. AB - A study was made of the clinical, x-ray and immunological features of acute pneumonias (AP) developing against a background of chronic pyelonephritis in 28 patients aged 60 and over this age. Routine microbiological inoculation of the sputum as well as noncultural methods (definition of antigen substances and specific antibodies in the blood serum) were employed for etiological deciphering. A modern program of etiological diagnosis ensured the detection of a wide spectrum of agents including viruses, Mycoplasma and Legionella. Pneumococci, streptococci, hemophilic bacteria in the form of monocultures as well as part of associations of microorganisms were shown to be the most frequent agents causing AP. The resistance of 495 strains of pneumococci, streptococci and hemophilic bacteria to antibiotics was considered. A low sensitivity of these cultures to tetracyclines and biseptol was observed. Caramycin and chloramphenicol were recommended for the treatment of AP combined with chronic pyelonephritis. PMID- 3563928 TI - Campomelic syndrome: concepts of the bowing and shortening in the lower limbs. AB - A comprehensive study (bone roentgenography, arteriography, gross dissection, microscopy of the long bones, and biochemical study of proteoglycan-aggregates in the hyaline cartilage) of the lower limbs in a full-term stillborn with the campomelic syndrome was performed. Hyaline cartilage immaturity of the long bones, dysplasia of growth plates, focal shaft dysplasia, and a defective length of the posterior femur and crus muscles were revealed. The genesis of the bowing and shortening of the long bones in the lower limbs is discussed. PMID- 3563929 TI - Craniofacial dysmorphogenesis following hypervitaminosis A in mice. AB - Malformations of the temporomandibular joint (TMJ), zygomatic arch, middle ear ossicles, and mandibular musculature following hypervitaminosis A were described in fetal mice. Pregnant mice (Mus musculus) were each given a 0.2-ml solution of corn oil containing 10,000 IU of retinol palmitate by gavage on day 8.7. Thirty eight fetal heads were collected and hemisected. The left hemiheads were serially sectioned, stained, and examined histologically. Right halves were cleared and double-stained with alizarin red and alcian blue. The craniofacial morphologies of the test mice were found to vary from normal to maximally involved (feature unidentifiable) even among littermates. Both inter- and intralitter variation were discussed. Errors in chondrogenesis were determined to have produced the variety of dysmorphologies observed. Changes in Meckel's cartilage affected both the TMJ and ossicles; the presence of ectopic cartilages affected the zygomatic arch; and the musculature was affected secondary to skeletal system changes. Several modes of vitamin A interference leading to craniofacial dysmorphogenesis have been proposed in the literature. It was determined that proposals implicating altered cellular differentiation were the most compatible with the in vivo data recorded here and elsewhere. PMID- 3563930 TI - Embryotoxicity of sex steroidal hormone combinations in nonhuman primates: I. Norethisterone acetate + ethinylestradiol and progesterone + estradiol benzoate (Macaca mulatta, Macaca fascicularis, and Papio cynocephalus). AB - Two sex steroid hormone combinations which have been used clinically as tests for detection of early pregnancy were examined for embryotoxic effects in macaques and baboons. Norethisterone acetate and ethinyl estradiol (NEA + EE) were orally administered to rhesus and cynomolgus monkeys and baboons at dosages ranging from one to 1,000 times the human dose equivalent (HDE) during days 20-50 of pregnancy. Progesterone and estradiol benzoate (P + EB) were delivered by two to six intramuscular injections to rhesus and cynomolgus monkeys between gestational days 20 and 35 at 0.1-25 X HDE. Fetuses were examined following cesarean section at 100 +/- 2 days (NEA + EE) or at term (P + EB). The results showed increased embryolethality over controls at 100-1,000 X HDE (NEA + EE) and at 10 and 25 X HDE (P + EB). Besides growth retardation, isolated cases of minor nongenital malformations were observed only in cynomolgus monkeys following treatment with both hormone combinations mainly at embryolethal dose levels and were considered spontaneous in nature. Virilization of female cynomolgus fetuses following NEA + EE treatment was manifested as two cases of clitoral enlargement in the 300 X HDE group and two cases of increased anogenital distance with reduced vaginal opening in the 1,000 X HDE group. The highest dose of NEA + EE was also maternally toxic, as two maternal deaths occurred at the end of the treatment period. One dead female cynomolgus fetus exposed to P + EB (10 X HDE) also exhibited masculinized external genitalia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563931 TI - Embryotoxicity of sex steroidal hormones in nonhuman primates: II. Hydroxyprogesterone caproate, estradiol valerate. AB - Two sex steroid compounds which have been used clinically for parenteral supportive therapy of pregnancy were examined for embryotoxic effects in rhesus and cynomolgus macaques. Hydroxyprogesterone caproate (HPC) alone or in combination with estradiol valerate (EV) were administered intramuscularly (i.m.) to pregnant monkeys at 7-day intervals between 20 and 146 days of gestation and fetuses were examined following cesarean section at 150 +/- 2 days. HPC alone was tested in both species at doses ranging from 0.01 X to 10 X the human dose equivalent (HDE); only rhesus monkeys were exposed to the HPC + EV combination at 0.1 X to 10 X HDE. Total embryolethality resulted following the administration of HPC alone and combined with EV at 1 X and 10 X HDE in rhesus monkeys; the level of abortions in cynomolgus monkeys exposed to HPC (0.1 X to 1 X HDE) was comparable to controls. A small number of nonspecific malformations and developmental variations observed in cynomolgus fetuses after HPC exposure were considered to be incidental findings. No anomalies were found in surviving rhesus monkey fetuses treated with HPC + EV. The results indicate that long-term in utero exposure to the progestin, HPC, alone or in combination with EV in rhesus and cynomolgus monkeys, is embryolethal but not teratogenic at doses up to ten times the human therapeutic dose. PMID- 3563932 TI - Anatomical defects associated with a feathering mutant (Ottawa naked) in domestic fowl. AB - An autosomal recessive mutation (Ottawa naked, nk) that causes abnormal feathering, fusion of the third and fourth toes, and low viability has been reported previously in the chicken. In the present study mutant individuals were examined from three different stocks: the original one in which the mutant was found and two outbred F2 stocks. Defects of the tail region were observed in all mutants from the original stock (20/20) and in 64% (16/25) of the mutants produced from the outcrossed stocks. The severity of the defects ranged from mild distortion and scoliosis of the coccygeal vertebrae to absence of all vertebrae from the lumbosacral level caudad. Forty percent (16/40) of the mutants from the original stock lacked caudal portions of the kidneys to varying degrees. Edematous areas were observed in 22% (15/67) of the embryos examined at 14 days of incubation. Other defects observed in the mutant embryos but not studied in detail are abnormal patterning or absence of scales, absence of the caudal spinal cord in embryos with severe rumplessness, and failure of the three metatarsal bones to fuse into a single element. Since all structures affected in the mutants differentiate primarily from or may be dependent upon the mesoderm, it is suggested that the site of gene action lies within this germ layer. A decrease was observed in both incidence and severity of the various defects following outcrossing, which suggests the presence of modifiers that influence the expression of the trait. PMID- 3563933 TI - Distribution, metabolism, and fetal uptake of pentavalent arsenic in pregnant mice following oral or intraperitoneal administration. AB - Pregnant CD-1 mice were treated with 20 (i.p.) or 40 (p.o.) mg/kg sodium arsenate on gestation day 18 (plug = day 1). Individual fetuses, pooled placentas and maternal blood, urine, liver, and kidneys were obtained from three or more litters at intervals up to 24 hours following treatment. Acid-digested samples were analyzed for total arsenic by hydride generation atomic absorption spectrophotometry. The rate of arsenic elimination from maternal samples was not influenced by administration route. First-order elimination followed a brief period of distribution, and the biological half-life was approximately 10 hours. Arsenic was found in most samples, with mean peak concentrations expressed as micrograms As/gm (wet wt.) or /ml (values listed are post-treatment sampling times in minutes or hours and concentrations for i.p. and for p.o. treated groups, respectively) as follows: fetuses-2, 3.5; 6, 0.8, placentas-2, 9.3; 1, 2.3, blood-10 minutes, 6.9; 1, 2.0, urine-1, 712; 2, 342, kidney-20 minutes, 25.4; 1, 11.0, liver-0.5, 7.9; 1, 11.7. By 24 hours, arsenic levels in fetuses and placentas had declined to 0.22 microgram/gm and 0.74 microgram/gm for i.p. and 0.33 microgram/gm and 0.57 microgram/gm for p.o. treatments, respectively. Fetal arsenic uptake and loss were more rapid following i.p. than p.o. treatments, and although the i.p. dose was only half that used p.o., peak fetal As+5 was almost fivefold higher following i.p. treatment. These results agree with the finding that oral dosing of pregnant mice with arsenate has less effect on the conceptus than does treatment by injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3563934 TI - Teratogenic effect of D-amphetamine sulphate: histodifferentiation and electrocardiogram pattern of mouse embryonic heart. AB - Pregnant albino mice (ICR random-bred strain) received daily injections of 50 or 100 mg/kg body weight of D-amphetamine sulphate between days 9 and 11 of gestation. Parallel control animals were injected with saline solution. Treated mice were sacrificed on day 15 or 19 of gestation. The embryos were examined for gross malformations and direct embryonic ECG recordings were made; they were weighed, and their hearts were carefully dissected. Microscopic sections of the heart were stained with hematoxylin and eosin. It was found that high doses of D amphetamine raised the incidence of mortality in the treated pregnant mice up to 40%. The resorption rate in the survivors was high (up to 58%) following the high dose of the drug. Up to 15% of the embryos from the treated groups showed gross malformations, including skeletal and eye malformations and exencephaly. The electrocardiogram (ECG) recordings in most 19-day-old embryos from both treated groups showed a pattern with prolonged Q-T interval (PQT), similar to that of control embryos in the intermediate developmental stages (days 14-16 of gestation). The ECG of control embryos (from day 17 on) resembled that of prenatal fetuses. Microscopically, the hearts of treated embryos showed a large number of undifferentiated cardiac myoblasts. It can be inferred that high doses of D-amphetamine affect embryonic development generally and delay the histodifferentiation of the myocardium, resulting in incomplete maturation of the cardiac muscles, thus leading to the immature ECG pattern, with PQT intervals. PMID- 3563935 TI - Dose- and stage-related sex difference in the incidence of cytosine arabinoside induced digit anomalies in the mouse fetus. AB - Pregnant mice of the Jc1:ICR strain were injected intraperitoneally with a single dose of 2.5, 5, or 10 mg/kg of cytosine arabinoside (Ara-C) on day 9.5 or 10.5 of gestation (dg). Mice were killed on 18.4 dg, and the incidences of digit anomalies were compared between male and female fetuses. In the group treated with 10 mg of Ara-C on 9.5 dg, oligodactyly of the hindlimbs was produced more frequently in male fetuses. In the group treated with 5 mg of Ara-C on 10.5 dg, oligodactyly of the forelimbs tended to occur more frequently in male fetuses. Also, in this group, oligodactyly of the hindlimbs occurred more frequently in male fetuses, whereas polydactyly occurred more frequently in female fetuses. The observed difference in the incidences of digit anomalies between male and female fetuses may be explained either in terms of the sex-related time lag in the critical period for digit development or by a probable sex difference in embryonic susceptibility to Ara-C. PMID- 3563936 TI - Search for teratogenic risks with the aid of malformation registries. AB - A summary is given of experiences in the use of the Swedish registries of birth defects for causal epidemiological studies. Case-control studies and cohort studies are described and exemplified. The application of case-control techniques to cohorts of women selected for probable or possible exposure is also described. The importance of using large-scale registry studies in the search for common but low-risk teratogens is stressed. PMID- 3563937 TI - Studies of the effect of 0.4-Gy and 0.6-Gy prenatal X-irradiation on postnatal adult behavior in the Wistar rat. AB - Thirty-four pregnant Wistar rats were X-irradiated on the 9th or 17th day of gestation at a dosage level 0.4 Gy or 0.6 Gy or were sham-irradiated. All mothers were allowed to deliver their offspring, and litters were limited to a maximum of eight on day 2. On day 30, 224 offspring were weaned and raised until 60 days of age, at which time testing began. Each rat randomly received, in random order, three of the following six behavioral tests: Water T-maze, Conditioned Avoidance Response, Forelimb Hanging, Activity Wheel, Swimming, and Open Field. There were no statistically significant differences between the irradiated and control groups for maternal weight or weight gain or mean litter size, although the litter size of the 17th day 0.6-Gy group was slightly lower. Among offspring irradiated with 0.6 Gy on the 17th day, 3-day-old neonates' weights were significantly reduced. Offspring irradiated on the 17th day with 0.6 Gy exhibited higher Conditioned Avoidance Response 5th-day and retest avoidance scores than did the controls. There were also significant sex differences in responses within the irradiated and control groups for several tests, which were unrelated to radiation exposure. The results of this study indicate that low-level X irradiation during the fetal period of rat gestation results in neonatal growth retardation and subtle behavioral alterations that may be manifested in adult life. Growth retardation may be the most sensitive indicator of subtle effects that result from low-level prenatal exposure to X-rays. PMID- 3563938 TI - Anomalous neural differentiation induced by 5-bromo-2'-deoxyuridine during organogenesis in the rat. AB - The influence of 5-bromo-2'-deoxyuridine (BrdU) on rat embryo development and neurogenesis was investigated using a rat conceptus culture system during organogenesis (pregnancy days 10-13). The embryos and visceral yolk sacs of conceptuses cultured with BrdU were examined for overall growth, morphological anomalies, incorporation of radiolabeled BrdU into DNA, and neurotransmitter enzyme activities in embryos. In addition, neural tubes from cultured whole embryos were isolated and mechanically dissociated into fragments and cultured again to assess neural cell differentiation into neuron-like cells. BrdU was found to incorporate differentially into embryonic and visceral yolk sac DNA with simultaneous stage-specific retardation and anomalous organogenesis in proportion to the increasing concentrations used. Neural tube differentiation of cultured embryos was markedly altered, and there were morphologically distinct neural anomalies. The neurite outgrowth from neuroblast cells (type 1) of explanted spinal neural tube fragments from BrdU-treated embryos was markedly reduced in length and number compared to those from similar areas of embryos grown without BrdU. In contrast, BrdU at the same doses did not affect differentiation of a number of neural tissue-related enzymes. These results indicate that BrdU incorporation into DNA of primordial embryonic cells significantly affects neurogenesis and differentiation of neurites from neuroblasts, which is a specific neural cytodifferentiation characteristic of neuronal cells. PMID- 3563939 TI - Effects of protein deficiency on the teratogenicity of cytochalasins in mice. AB - The developmental toxicity of cytochalasins B (CB) and D (CD) was evaluated in protein-deprived mice. Pregnant CD-1 mice were assigned to control (26%), 16%, 8%, or 4% dietary protein groups on gestation day 1 and dosed by gavage with 0 or 1.5 mg/kg CB or CD on gestation day 8 (plug = day 1). They were killed and subjected to teratological examination on day 18. CD, but not CB, increased prenatal mortality but failed to interact significantly with dietary protein level. Fetal weights were decreased in the 4% and 8% dietary protein groups, but cytochalasin treatment did not exacerbate this effect. Cytochalasin treatment was associated with gross fetal malformations, primarily neural tube defects. Although CB and CD did not significantly increase the percentage of grossly malformed fetuses per litter, the data was suggestive of such an effect, and the incidence of affected litters was increased by cytochalasin treatment in all but the 4% protein group. Skeletal defects, such as jaw malformations, rib or sternebrae variations, and unossified skull bones appeared to be increased by both cytochalasin treatment and dietary protein deficiency. The differences from control values were nonsignificant, however, except for some cases of cytochalasin effects on skull ossification. These results show a general lack of effect of protein deprivation on the developmental toxicity of cytochalasins. PMID- 3563940 TI - Abnormalities of the ear associated with exencephaly in mouse fetuses induced by maternal exposure to cadmium. AB - Exencephaly was induced in mouse fetuses by maternal injection of cadmium chloride (CdCl2) on day 7 of gestation. The heads of exencephalic, nonexencephalic experimental, and control fetuses were embedded in paraffin and sections were stained with hematoxylin and eosin. Compared to those of controls, the ears of the exencephalic fetuses were smaller (microtia) and low set. The meatal plug representing the external auditory canal was thick, variously branched, and often directed inferiorly. Usually, there were just two ossicles. The stapedial artery, facial nerve, and stapedius muscle were hypoplastic; the tensor tympani was small or absent. There were 1.0 to 2.0 turns of the cochlea in contrast to 2.5 turns in the controls. The organ of Corti was underdifferentiated; the spiral ganglion had fewer cells. In the control, the long axes of the anterior and posterior semicircular ducts were at right angles to each other and in vertical planes, but in the exencephalics, they tended more laterally towards the horizontal plane. The differentiation of the cristae ampullares and maculae was also severely affected. In several specimens, the entire membranous labyrinth had been distended; these labyrinths also had unusual epithelial infoldings. In cadmium-treated nonexencephalic fetuses, the external ears were normal and appropriate to the body size; five of them were examined histologically; in all, the five middle ear contents were hypoplastic; in three, the cochlea had a maximum of two turns and the organ of Corti, crista ampullaris, and macula were hypoplastic. By an analogy to abnormalities of mutants with neural tube defects, it is suggested that the exencephaly induced by cadmium might affect the differentiation of the ear. Partial involvement of the ear in nonexencephalic experimental embryos may be the result of direct action of cadmium during critical stages of development. PMID- 3563941 TI - Ethyl alcohol-induced cardiovascular malformations in the chick embryo. AB - Chick embryos incubated for 72-80 hours were exposed to various volumes (0.20 0.40 m1/egg) of 50% ethyl alcohol. Examination of embryos at day 14 of incubation showed that higher doses of ethanol decreased the survival rate of embryos compared with control embryos. Three major categories of cardiovascular malformations were observed in this study: intracardiac anomalies characterized primarily by isolated ventricular septal defect, ventricular septal defect with overriding aorta, double outlet right ventricle or common aorticopulmonary trunk; aortic arch anomalies; and subclavian artery anomalies. Frequencies of embryos with intracardiac anomalies were equal to or greater than 64.8% in the six groups exposed to ethanol. Administration of ethanol also induced high frequencies of embryos with subclavian artery anomalies (11.2-89.1%). Absence or hypoplasia of the right and/or left secondary subclavian artery was commonly associated with persistence of the corresponding primary subclavian artery. Bilateral absence and/or hypoplasia of the secondary subclavian arteries was more common than unilateral anomalies, whereas absence of the left secondary subclavian artery was more commonly observed than an absent right secondary subclavian artery. No embryos in the two control groups combined (n = 94) demonstrated aortic arch or subclavian artery anomalies. PMID- 3563942 TI - On the divergence of genes in multigene families. AB - Statistical properties of the amount of divergence of genes in multigene families are studied. The model considered is an infinite-site neutral model with unbiased intrachromosomal conversion, unbiased interchromosomal conversion, and recombination. By considering the time back to the most recent common ancestor of two genes, both the probability of identity and the moments of S, the number of sites that differ between two sampled genes, are obtained. We find that if recombination rates are large or conversion is always interchromosomal, then the expectation of S is 4N mu n where N is the population size, mu is the rate of mutation per generation per gene and n is the number of genes in the gene family, as the conversion rates approach zero, the moments of divergence do not approach the moments of divergence with conversion rates equal to zero, and it is possible for a decrease in the rate of intrachromosomal conversion to result in a higher probability of identity, but a greater mean divergence of the two genes. PMID- 3563943 TI - Individual and population sex allocation patterns. AB - A variety of sex allocation models is considered in which the reproductive returns on investment in males differ from the returns on investment in females, the amounts of resources available for reproduction vary in the population, the costs of making male and female reproductive structures differ, and the conception sex ratio may be fixed and there may be an initial minimum investment per offspring. Results of these models include quantitative predictions for both individual- and population-level sex allocation, an opportunity to study the magnitude of changes in predicted patterns as key variables change, and therefore an analysis of the robustness of Fisher's equal investment theory. One example is that Fisher's argument is extremely robust for high fecundity organisms, but, in low fecundity organisms, is sensitive to differences between the sexes in reproductive returns on investment per offspring, a situation that occurs in many vertebrates to which Fisher's theory is often applied. A second example is that individual- and population-level patterns often depend strongly on the distribution of resources available for reproduction among individuals in the population. PMID- 3563945 TI - Robin Hoods and good Samaritans: the role of patients in health care distribution. PMID- 3563944 TI - The medical profession and the corporatization of the health sector. PMID- 3563946 TI - Cost containment as a professional challenge. PMID- 3563947 TI - Consumers, physicians, and payors: a triad of conflicting interests. PMID- 3563948 TI - The ideal advocate and limited resources. PMID- 3563949 TI - Cost containment and physicians' decisions: rethinking the philosophy of medicine. PMID- 3563950 TI - A study of the foundations of ethical decision-making of nurses. PMID- 3563951 TI - [Diseases of the digestive system in pregnancy]. PMID- 3563952 TI - [Heart diseases and pregnancy]. PMID- 3563953 TI - [Infection and pregnancy]. PMID- 3563954 TI - [Thrombosis, embolism, intravascular coagulation in pregnancy]. PMID- 3563955 TI - [Which drugs should not be prescribed in pregnancy]. PMID- 3563956 TI - [Psychological and psychiatric aspects of pregnancy]. PMID- 3563957 TI - [Kidney diseases and hypertension in pregnancy]. PMID- 3563958 TI - Current status of low molecular weight heparin. PMID- 3563959 TI - Interaction of vasopressin with human blood platelets: dependency on Mg2+. AB - Arginine-vasopressin (AVP) in the presence of Mg2+ but not in the absence of bivalent cations led to accumulation of [32P]-phosphatidic acid [( 32P]-PA) in human blood platelets. Mg2+ also enhanced the specific binding of [3H]-AVP to intact platelets. The concentrations of the cation which enabled AVP to cause half maximal rise of [32P]-PA and those inducing half maximal [3H]-AVP-binding were of the same order. It is concluded that the stimulation of phosphatidyl inositide breakdown by AVP in presence of Mg2+ is at least partially due to a Mg2+-induced enhancement of specific AVP-binding to the platelet membranes. PMID- 3563960 TI - Hepatitis-free interval after clotting factor therapy in first infused haemophiliacs. AB - Post-infusion hepatitis is known to occur very frequently in haemophiliacs after treatment with unheated commercial clotting factor concentrates, obtained from large plasma donation pool. On the contrary, single-donor cryoprecipitate is likely to carry a lower risk of transmitting hepatitis. To evaluate this hypothesis, we retrospectively reviewed the medical records of 25 first infused haemophiliacs (from 1981 to 1984) treated with unheated commercial clotting factor concentrates (n = 19) or cryoprecipitate (n = 6). The hepatitis-free interval after the beginning of therapy was expressed as exposure days. The end point of each patient, i.e. the hepatitis occurrence, was defined as an increase of amino-transferases (ALT and AST) and/or the seroconversion of HBV-markers, which were checked every three months. The life-table method and log-rank test showed that cryoprecipitates had a significantly longer hepatitis-free interval (p = 0.0131, log-rank test) and a lower risk of transmitting hepatitis (p = 0.01 0.05, life-table method) than the commercial concentrates. However, the safety of cryoprecipitate therapy was shown to cover only a few exposure days, and so the real advantage of this product depends on the bleeding frequency of the patient concerned. We believe that these methods and our findings may be useful to assess and compare the safety of the new "heat-treated" clotting factor concentrates. PMID- 3563961 TI - Prolonged bleeding time, reduced platelet aggregation, altered PAF-acether sensitivity and increased platelet mass are a trait of asthma and hay fever. AB - In a case control study 31 asymptomatic patients with asthma and/or hay fever and 31 normal controls had their bleeding time measured using the Simplate II device and venostasis. Mean bleeding time in the atopic group (527 s) was significantly prolonged compared to the controls (393 s) (p less than 0.0005). Platelet aggregation to collagen and ADP (but not to PAF-acether) was significantly depressed in the atopics. Mean circulating platelet mass was significantly greater in atopics than in the controls (p = 0.006). Stepwise multiple regression analysis showed that within the control group bleeding time was best predicted by platelet mass (p = 0.007). No such relationship was found in the atopics. However stepwise multiple regression analysis showed that bleeding time in the atopics (but not in the controls) was best predicted by PAF-acether induced platelet aggregability (p less than 0.05). In neither group was bleeding time related to collagen induced platelet thromboxane B2 production. It is hypothesised that in respiratory atopy the depressed aggregatory function of platelets is not compensated for sufficiently by an increase in platelet mass, leading to prolongation of the bleeding time. This haemostatic imbalance, whose cause remains to be established, appears to constitute a trait of atopy. PMID- 3563962 TI - Comparative study of size, total protein, fibrinogen and 5-HT content of human and canine platelet density subpopulations. AB - The size, total protein, fibrinogen and 5-HT content were evaluated in density subpopulations of human and canine platelets fractionated in linear arabinogalactan gradients. The methodology was assessed to ascertain that platelet separation was by density and to discard artifactual changes and platelet release during the procedure. EDTA or PGE1 increased the size of human PRP-platelets, but not of dog platelets. In humans, high density (HD) platelets were 1.26 times larger and contained 1.88 times more fibrinogen, 2.23 times more 5-HT and 1.37 times more protein than low density (LD) platelets; in dogs, these density cohorts did not differ in protein content, but LD platelets were 1.29 times larger and had 1.33 times more fibrinogen and 5-HT than HD platelets. These findings suggest that cell density is mostly dependent on the protein content per unit volume of platelets (and not on dense bodies). The differences in fibrinogen and 5-HT content between HD and LD cohorts in humans and dogs may be related to platelet age. The difference in volume between HD and LD platelets in dogs is of uncertain interpretation. PMID- 3563963 TI - Heparin-induced osteoporosis in rats. AB - In order to study the effect of heparin in inducing osteoporosis, 30 female rats were divided in two groups and treated with daily injections of 2 IU heparin/g body weight for 33 and 65 days and compared with the same number of rats acting as controls. The mineral bone mass in the femora of the animals was measured quantitatively. A significant (p less than 0.001) reduction in bone mineral mass was found in the heparin-treated animals. This effect was present to the same degree after 33 days as after 65 days of treatment. It is concluded that heparin in this dose causes osteoporosis in rats after 33 days and that the described method can be used as an experimental model for further studies on this topic. PMID- 3563964 TI - Neutralization of a low molecular weight heparin (LHN-1) and conventional heparin by protamine sulfate in rats. AB - The neutralization of a low molecular weight heparin (LHN-1) and conventional heparin (CH) by protamine sulfate has been studied in vitro and in vivo. In vitro, the APTT activity of CH was completely neutralized in parallel with the anti-Xa activity. The APTT activity of LHN-1 was almost completely neutralized in a way similar to the APTT activity of CH, whereas the anti-Xa activity of LHN-1 was only partially neutralized. In vivo, CH 3 mg/kg and LHN-1 7.2 mg/kg was given intravenously in rats. The APTT and anti-Xa activities, after neutralization by protamine sulfate in vivo, were similar to the results in vitro. In CH treated rats no haemorrhagic effect in the rat tail bleeding test and no antithrombotic effect in the rat stasis model was found at a protamine sulfate to heparin ratio of about 1, which neutralized APTT and anti-Xa activities. In LHN-1 treated rats the haemorrhagic effect was neutralized when APTT was close to normal whereas higher doses of protamine sulfate were required for neutralization of the antithrombotic effect. This probably reflects the fact that in most experimental models higher doses of heparin are needed to induce bleeding than to prevent thrombus formation. Our results demonstrate that even if complete neutralization of APTT and anti-Xa activities were not seen in LHN-1 treated rats, the in vivo effects of LHN-1 could be neutralized as efficiently as those of conventional heparin. The large fall in blood pressure caused by high doses of protamine sulfate alone was prevented by the prior injection of LHN-1. PMID- 3563965 TI - Haemophilia B Leyden in Greece. AB - In this paper, a five generation Greek family is described with haemophilia B. The disease is characterized by a normal ox-brain prothrombin time, normal levels of the vitamin-K dependent clotting factors VII and X and a proportional reduction of factor IX activity and antigen levels all of which is consistent with the cross-reacting material negative form of haemophilia B. However, in this family the factor IX levels in the three patients of generation V are around 1 U/dl while the three older patients in generation III have factor IX levels ranging from 28 to 44 U/dl. In the oldest patient of generation V we observed a rise of the factor IX level from 1 U/dl up to the age of 13 to 10 U/dl at age 14. In addition, the older patients have very mild bleeding symptoms or none at all, while the young ones have occasional spontaneous haemorrhages in muscles and joints, compatible with severe or moderately severe haemophilia. The disease appears to be similar to haemophilia B Leyden which has been described in a Dutch family. PMID- 3563966 TI - Characterization of an abnormal antithrombin (Milano 2) with defective thrombin binding. AB - Four members of an Italian family (two with histories of venous thromboembolism) had a qualitative defect of antithrombin III reflected by normal antigen concentrations and half-normal antithrombin activity with or without heparin. Anti-factor Xa activities were consistently borderline low (about 70% of normal). For the propositus' plasma and serum the patterns of antithrombin III in crossed immunoelectrophoresis with or without heparin were indistinguishable from those of normal plasma or serum. A normal affinity of antithrombin III for heparin was documented by heparin-sepharose chromatography. Affinity adsorption of the propositus' plasma to human alpha-thrombin immobilized on sepharose beads revealed defective binding of the antithrombin III to thrombin-sepharose. Hence the molecular defect of this variant appears to be at the active site responsible for binding and neutralizing thrombin, thus accounting for the low thrombin inhibitory activity. PMID- 3563967 TI - Piretanide: a new synthetic fibrinolytic and anti-platelet agent. AB - Piretanide, 4-phenoxy-3-(1-pyrrolidinyl)-5-sulfamoyl benzoic acid, a potent diuretic, enhances endogenous plasma fibrinolytic activity after a single dose of 6 mg administered orally. Acceleration of fibrinolytic activity becomes manifest within 1 h, reaches its peak in 3 h and is associated with little change in fibrinogen, however, it is accompanied with diminished urokinase excretion initially. Piretanide does not cause lysis of fibrin in vitro in any concentration. Primary platelet aggregation, induced by adenosine-diphosphate, is inhibited by piretanide, in vivo. In in vitro experiments piretanide leads to effective inhibition of ADP-induced platelet aggregation with complete inhibition at 5 mM concentration. Piretanide, after ingestion of a single dose of 6 mg, causes highly significant decrease of platelet factor-4 release. PMID- 3563968 TI - The negative impact of biological variation in the effect and clearance of warfarin on methods for prediction of dose requirements. AB - Within-individual variation over time in the clearance (Cl) and effect (PT%) of warfarin, was measured in 25 inpatients (group I) studied after standard single or individualized split loading doses and 1-3 times (n = 16) 8-16 weeks later during maintenance. Mean Cl (2.5 +/- 0.9 ml/min) was similar in both phases but significant changes occurred in 6/16 patients, exceeding those expected from within-individual variation alone (defined by its 95% tolerance limits -24% to +62%). Initial PT% (21 +/- 5) was unaffected by dosing schedule, total or free plasma warfarin, varying between patients by only 18-24%. Mean initial and maintenance dose-PT% ratios (8.2 mg/d: 21% and 4.1 mg/d: 40%) were similar but significant changes in sensitivity to warfarin occurred in 4/16 patients. In group I and 64 other outpatients on maintenance therapy, between-individual variability was 36-52% for Cl and 49-56% for effect. PT% correlated best (r = 0.56) with free and total plasma warfarin but poorly with dose (r = 0.29), with only 30% of PT% variance explained at best, due to high between patient variability. Warfarin dose prediction whether based on extrapolation from initial effects to the maintenance phase, or on iterative methods not allowing for between- or within-patient variation in warfarin clearance or effect which may occur independently over time, have not improved on empirical therapy. This, due to the elements of biological variability as well as the intricacy of the warfarin-prothrombin complex interaction not captured by any kinetic-dynamic model used for prediction to date. PMID- 3563969 TI - Role of red blood cells in the early stages of platelet activation by collagen. AB - Red blood cells (RBC) increase the proaggregatory capacity of a cell-free supernatant obtained by stimulating platelet-rich plasma (PRP) samples with collagen (1 microgram/ml) as measured by the BASIC wave; this effect increases with the number of RBC and is proportionally greater with a lower number of platelets or when lower collagen concentrations are used. Aspirin (ASA) modifies the RBC behaviour in relation to their platelet-collagen interaction. This is demonstrated by the fact that when PRP and RBC obtained from the same subjects before and two hours after the ingestion of ASA (0.5 g) were mixed, it was found that non-ASA-RBC stimulate ASA-PRP, probably through a platelet cyclooxygenase independent pathway; ASA-RBC, however, stimulate non-ASA-PRP, but not ASA-PRP, which suggests that they may need an active platelet cyclooxygenase system for their action. This effect of ASA on RBC is not transient and was also observable 48 h after ASA ingestion. In addition, it was found that ASA-RBC greatly increase the activation of a mixture containing a small proportion of non-ASA-PRP in ASA PRP, a situation that is expected to be encountered "in vivo" after ASA treatment. This effect of ASA-RBC on platelet activation may help to explain the sometimes contradictory clinical effect of aspirin as an antithrombotic drug. PMID- 3563970 TI - Three abnormal fibrinogen variants with the same amino acid substitution (gamma 275 Arg----His): fibrinogens Bergamo II, Essen and Perugia. AB - We report on three unrelated individuals with the same uncommon type of dysfibrinogenemia, originating from Bergamo, Essen and Perugia. None of them showed bleeding symptoms while the Bergamo patient and members of her family presented with a thrombotic tendency. The presence of a defective fibrinogen was suggested by prolonged thrombin and reptilase times. Furthermore, fibrinogen concentrations of less than 0.28 g/L were determined by the functional assay whereas values of 1.5-2.4 g/L were measured by heat precipitation or electroimmunoassay. Fibrinogen was isolated by affinity chromatography on insoluble fibrin monomer. The rate of fibrinopeptide release by thrombin was normal while the fibrin polymerization reaction was strongly delayed. An abnormal peptide (gamma 265-310) was isolated by high-performance liquid chromatography after cyanogen bromide cleavage of the purified gamma-chain of fibrinogen Bergamo II and Essen. The same peptide was also isolated following cyanogen bromide treatment of the intact fibrinogen Perugia. Sequence analyses of these peptides demonstrated the same amino acid exchange in all three fibrinogens: gamma 275 arginine----histidine. The described fibrinogen variants appear to possess a molecular defect which has thus far only been observed in fibrinogen Haifa. PMID- 3563971 TI - The need for standardization of low molecular weight heparin (LMWH) PMID- 3563972 TI - Experimental venous thrombosis in rats: a new way to express the results. PMID- 3563973 TI - Improved synthetic inactivators of plasmin. AB - Synthetic inhibitors for plasmin of the peptidyl chloromethyl ketone type are described which have increased effectiveness due to side-chains which improve affinity to auxiliary binding regions of the active center. PMID- 3563975 TI - Ibuprofen as an antagonist of inhibitors of fibrinolysis in wound fluid. AB - Fibrin plate assay revealed that rat serum and wound fluid harvested from seven day subcutaneously implanted wound chambers prevented fibrinolysis. Samples of wound fluid from one to four hour burns displayed greater inhibiting activity than unburned or 24 hour old burns. Ibuprofen, a non-steroid anti-inflammatory drug, reversed the blocking of fibrinolysis in wound fluid, but it had no action on rat serum. The activity of ibuprofen appears unrelated to the synthesis of prostanoids. Fractionation of wound fluid and serum by column chromatography showed differences in elutions of inhibitors of fibrinolysis. Serum fractions having molecular weights greater than 60,000 prevented fibrinolysis and they were unaffected by the addition of ibuprofen. Fractionations of wound fluid produced a number of inhibitors, some of which had molecular weights of approximately 40,000. This inhibitor(s) was not detected in serum and was reversed by adding ibuprofen. Wound fluid has a fibrinolytic inhibitor which differs from that in the circulatory system, and which may be critical to the vascular changes of burn trauma. PMID- 3563974 TI - Molecular characterization of the antithrombin III tours deficiency. PMID- 3563976 TI - Shear stress activation of platelets with subsequent refractoriness. AB - Platelet rich plasma was prepared with soybean trypsin inhibitor (SBTI) as anticoagulant, to preserve normal Ca++-concentration, and subsequently tested in an aggregometer. Shear stress alone, induced by stirring, resulted in platelet aggregation and disaggregation. Such platelets showed only minor aggregational response on the addition of ADP, indicating that the platelets had been partly desensitized towards ADP-stimulation. When the stirrer was started at the same time as the addition of 1.6 microM ADP, the aggregation velocity was related to the speed of the stirrer. Disaggregation always started 1.5 min after the stimulus. Platelet shape change was apparently not influenced by the stirring. Since platelets from SBTI-anticoagulated blood could be aggregated by stirring alone, we examined the effect of centrifugation of whole blood at 50 xg for 3 and 10 min. Signs of transient aggregation and release of alpha-granule content were respectively observed. PMID- 3563977 TI - Inhibitory interference of red cells in the measurement of whole blood platelet aggregation by the impedance method. PMID- 3563978 TI - A new experimental model of venous thrombosis in rats involving partial stasis and slight endothelium alterations. AB - Venous thrombus formation is induced in rats using saline flushing in a venous bag created in the vena cava and subsequent stasis by stricture of the vein. Maximum thrombus weight is obtained in 15 minutes. Neither flushing nor partial stasis alone could trigger thrombus formation during this time. Transmission electron microscopy demonstrated that flushing induces discrete endothelial lesions with no evident desendothelialisation areas. Anticoagulant agents are found to be active in preventing thrombus formation. However, heparin or related compounds such as pentosan polysulphate are active at dose levels not demonstrating anticoagulant activity. Thrombosis could be induced in thrombocytopenic rats indicating the non-involving of platelets. Moreover, aspirin did not prevent thrombus formation. Ticlopidine, another antiplatelet agent, did show an activity which might not involved platelets. This model thus possesses the features necessary for reliable investigation of potential antithrombotic agents for human use. PMID- 3563980 TI - Enhancement of prothrombin activation on platelets by endothelial cells and mechanism of activation of factor V. AB - Factor Xa-catalyzed prothrombin activation occurs on cellular surfaces, including those of vascular endothelial cells. In a reconstituted model, endothelial cells and platelets acted synergistically to maximally activate prothrombin in the presence of Factor Xa. Synergism was observed at platelet concentrations less than 1 X 10(8)/ml. Thrombin formation was required for optimal prothrombin activation by endothelial cells and Factor Xa, with thrombin serving as an activator of Factor V. These data provide additional support for the hypothesis that vascular endothelium is a physiologic surface for hemostasis. PMID- 3563979 TI - Increased platelet calcium in thrombosis and related disorders and its correction by nifedipine. AB - Using chlorotetracycline (CTC) as a probe we studied calcium homeostasis of platelets in various disorders. Studied were healthy subjects and patients with disorders where platelets play an important role. These included thromboses, hypertension, diabetes mellitus, vasculitis, immune thrombocytopenia, thrombotic thrombocytopenic purpura, myelofibrosis, hemolytic anemias and uremia. Significant elevation of calcium levels were observed in all of these disorders except uremia. Nifedipine reduced or normalized the increased levels in most patients and its discontinuation resulted in a return of the abnormality. We propose that platelets in thromboses and related disorders are exposed to subcritical concentrations of activating factors, leading to enhanced calcium influx and elevated free cytoplasmic calcium followed by elevated resting dense tubular calcium. Nifedipine appears to protect platelets from these stimuli and coupled with their known action on vessel walls, calcium channel blockers show promise as antiatherogenic as well as antithrombotic agents. PMID- 3563981 TI - The thrombopenic effect of ellagic acid in the rat. Another model of platelet stimulation "in vivo". AB - In the rat, intravenous injection of large doses (30 mg/Kg) of ellagic acid (EA) induced a decrease in the plasma level of fibrinogen and in the blood platelet content and an increase of the activated partial thromboplastin time. The long lasting thrombocytopenia was inhibited by heparin (4 mg/Kg), defibrase (20 U/Kg), clocoumarol (4 mg/Kg) and CCI 17810 (120 mg/Kg). It was not inhibited by aspirin (90 mg/Kg), indomethacin (8 mg/Kg), ketoprofen (4-10 mg/Kg), epsilon-aminocaproic acid (150 mg/Kg), methysergide (4 mg/Kg), chlorpromazine (10 mg/Kg) and promethazine (4 mg/Kg). On the contrary, the small doses of indomethacin (4 mg/Kg) and of ketoprofen (0.5-2 mg/Kg) increased the thrombopenic effect of EA. EA induced the accumulation of Cr51-labelled platelets into the lungs and the liver, accompanied by a 64% fall in Cr51 blood radioactivity. The platelet stimulating effect of EA would depend on an intravascular coagulation which occurs in the whole cardiovascular system. It is suggested that the pro aggregating derivatives of arachidonic acid had a minor role in this stimulation. The intravascular coagulation induced by EA was accompanied by a swelling of the lymph nodes and of the spleen. In immune platelet depleted rats, EA induced only the swelling of lymph nodes. PMID- 3563982 TI - DDAVP-induced correction of prolonged bleeding time in patients with congenital platelet function defects. AB - In 37 patients with prolonged bleeding time, where thrombocytopenia, von Willebrand's disease or deficiency of other coagulation factors could be excluded, we have evaluated the effect of a DDAVP-infusion (0.2 ug/kg) together with tranexamic acid (10 mg/kg). Patients with acquired impairment of primary hemostasis were not included, except two cases where this could have been a contributing factor. The bleeding time was completely normalized in 27 cases and partially corrected in three more patients. The predominant feature among those, who did not respond, was a pattern compatible with thrombasthenia or cyclooxygenase deficiency, as assessed by platelet aggregation studies. Among the patients, in whom DDAVP was effective, this drug was thereafter successfully used as an alternative to blood products in 8 cases during and after surgery or delivery. PMID- 3563983 TI - Evidence for an anti-aggregatory effect of adenosine at physiological concentrations and for its role in the action of dipyridamole. AB - The effects of physiological adenosine concentrations on platelet aggregation in vitro were studied. Furthermore, we evaluated the effect of elevated adenosine levels in vivo, produced by the administration of dipyridamole, on platelet aggregation in whole blood. Platelet aggregation in plasma was significantly inhibited in vitro by adenosine at all concentrations tested in the physiological range (0.1-1.0 microM, 14-63% inhibition). Dipyridamole by itself had no effect at a therapeutic plasma concentration in vitro. Ten patients with ischaemic cerebrovascular disease were given 100 mg dipyridamole orally, and the level of adenosine increased from 0.22 to 0.29 microM (p less than 0.05). This was accompanied by a decrease in ADP-induced platelet aggregation in whole blood (17 to 15 ohms, p less than 0.05). When dipyridamole was infused in 11 healthy subjects, the adenosine level was not significantly elevated but the platelet aggregation was inhibited (from 13 to 11 ohms, p less than 0.05). It is concluded that adenosine may be of importance in the physiological regulation of platelet aggregation. Furthermore, dipyridamole treatment is associated with an anti aggregatory effect that is probably mediated by its effect on endogenous adenosine levels. PMID- 3563985 TI - [Self-inflicted wounds]. PMID- 3563984 TI - Hereditary antithrombin III (AT III) deficiency and atypical localization of a coumarin necrosis. PMID- 3563986 TI - [A waterborne outbreak of Campylobacter jejuni infection]. PMID- 3563987 TI - [Polycythemia and smoking]. PMID- 3563988 TI - [Knee problems in soldiers]. PMID- 3563989 TI - [Axillary lymphoid nodes in breast cancer]. PMID- 3563990 TI - [Splenectomy. Postoperative complications and mortality]. PMID- 3563992 TI - [Malignant melanoma--amelanotic type]. PMID- 3563991 TI - [Gallstone ileus]. PMID- 3563995 TI - [Trends in modern psychiatry with introductory history. Which are the central problems? How does the development progress?]. PMID- 3563993 TI - [Acute thyroxine poisoning]. PMID- 3563994 TI - [New analytical methods in primary health care]. PMID- 3563996 TI - [The incidence of pathological neonatal icterus]. AB - A prospective study of 535 neonates about the incidence of neonatal jaundice on the third day of life revealed a mean (+/- SD) serum total bilirubin concentration of 176.5 +/- 70.I mumol/l (10.3 +/- 4.0 mg/dl). 27.8% of the infants had pathologic jaundice, defined as a serum total bilirubin concentration of 220 mumol/l (12.9 mg/dl) or more. After correction for prematurity en dysmaturity, mean serum total bilirubin concentration was 176.8 +/- 71.8 mumol/l (10.3 +/- 4.2 mg/dl) and 29.0% of the infants showed pathologic jaundice. Except for vacuum extraction, which was accompanied with a significantly increased incidence of pathological jaundice, other perinatal factors were not associated with a significantly increased incidence of pathological jaundice on the third day of life. PMID- 3563997 TI - [Neonatal ascites caused by urine leakage]. AB - Two neonates, born with an extremely distended abdomen due to ascites, are described. A leakage of urine, secondary to urinary tract obstruction by urethral valves, was the cause of peritoneal fluid accumulation. Analysis of the peritoneal fluid is an important step in differential diagnosis, because only in ascites of urinary origin the creatinine- and ureaconcentrations exceed those of plasma. Treatment consists of temporary urinary diversion followed by operative relief of the obstruction. PMID- 3563998 TI - Protein secretion by choroid plexus: isolated apical fragments synthesize protein in vitro. AB - Protein synthesis was studied in the isolated rat choroid plexus. When the choroid plexus was studied by transmission electron microscopy, membrane-bound structures were often observed in the ventricular space. These structures appear to bud from the apical surface of the epithelial cells. In the present study, we attempted to isolate these membrane-bound cellular fragments from the choroid plexus and to determine their ability to synthesize proteins. The apical fragments (aposomes) were isolated from the choroid plexus by allowing tissue explants to incubate in media (37 degrees C) for 1 h. The tissue was removed and the media, now containing aposomes, was incubated with [S35]methionine (100 microCi). The media was collected and analysed by SDS-PAGE followed by fluorography. Parallel [S35]methionine incubations were done with whole tissue explants. The SDS-PAGE protein derived from the aposomes was similar to the profile derived from the tissue. In addition, proteins detected in CSF had relative molecular weights comparable to the products synthesized by aposomes. These observations suggest that aposomes provide an additional route of entry for proteins into CSF. PMID- 3563999 TI - Subfilament organization in myosin filaments of the fast abdominal muscles of the lobster, Homarus americanus. AB - The myosin filaments of the fast abdominal muscle of the lobster are about 2.7 microns long with a diameter of about 20 nm. They have a low density core in transverse sections except for a short portion in the middle of the filaments about 140 nm in length which is solid. In the solid region the diameter of the filaments is 25 nm. The wall of the filaments is made up of 12 subfilaments arranged in six pairs in a single layer around the wall. The spacing between the subfilaments of a pair is 3.4 nm and the spacing between successive pairs is 8.4 nm. An extra density is present on the inner surface of the wall of the filament along the entire length of the tubular portion of the filament. This density is always adherent to the wall and in serial transverse sections of the same filament its position changes from section to section without any apparent pattern to the change. No structural organization could be detected in this extra density. PMID- 3564000 TI - Evidence for suppression of potassium conductance by noradrenaline in smooth muscle of guinea-pig vas deferens. AB - The ionic dependency was examined in the reversal potential of the NA-induced membrane depolarization of smooth muscle of the guinea-pig vas deferens, using the double sucrose-gap method. In the control (5.9 mM K) solution and solutions containing 20 and 60 mM K ions, replaced with equimolar amount of Na ions, the reversal potential was negative to the membrane potential at the steady state in each solution, by 19.5, 15.1 and 13.2 mV, respectively. Taking account that the higher external K concentration causes the larger membrane depolarization, these results indicate that the reversal potential shifted toward the positive direction as the external K concentration was increased. On the other hand, the calculated equilibrium potential of K ions in those solutions is -88, -52 and -24 mV, respectively. In those solutions, furthermore, the equilibrium potential of Na ions is 42, 38 and 29 mV, respectively. However, the equilibrium potentials of Ca and Cl ions should be unchanged. Therefore, it is suggested that the reversal potential of the NA-induced depolarization varied in the given different solutions compatibly only with the change in the K equilibrium potential. This provides evidence that in this tissue, NA induces a reduction in the K conductance of the cell membrane. PMID- 3564001 TI - Possible relationship between the release of calcium ions and inactivation of the potassium conductance induced by noradrenaline in smooth muscle of the guinea-pig vas deferens. AB - In order to examine whether any change in cytoplasmic Ca2+ concentration occurs during the noradrenaline (NA)-induced change in the membrane potential, the isometric tension of smooth muscle of the guinea-pig vas deferens was recorded together with membrane potentials using the sucrose-gap method. NA induced a depolarization and an increase in cytoplasmic Ca2+ comprising two (initial and second) phases. In time courses, the depolarization and the second phase of the increase in cytoplasmic Ca2+ were similar. Only at the phase around the onset of the depolarization, the membrane conductance was increased but then, it was decreased. Lowering the external Ca2+ concentration and application of D600 suppressed all of the NA-induced responses. In addition, D600 diminished the size of the NA-induced decrement in the membrane conductance. The present results suggest that the initial phase of the increase in the cytoplasmic Ca2+ is due to the influx of Ca2+ and the second phase, probably to the release of Ca2+ from some intracellular stores. It was discussed that the release of Ca2+ might occur at the internal surface of the membrane, and the membrane might be left less permeable to K+ as a result. PMID- 3564002 TI - New bioptic method for submucosal tumor of the gastrointestinal tract. AB - Biopsy for the submucosal tumor has not been established and it is extremely rare that tumor tissues are obtained by usual biopsy forceps except in cases showing ulceration. Moreover, tumor tissues from the ulcerated site often showed degeneration or necrosis, and are difficult for pathohistological diagnosis. In addition, the biopsies are often associated with bleeding. We have developed a new biopsy method. Briefly, a small amount of pure ethanol is injected topically into the surface of submucosal tumor to produce a small ulcer for biopsy, and several days later a biopsy specimen is obtained from the exposed tumor at the ulcer bottom. We performed this method for 12 lesions in 12 cases. In 64 of 100 bioptic specimens, tumor tissue was obtained and in all cases pathohistological diagnosis could be established. We believe this method will be important to determine the indication of endoscopic treatment or surgical operation, and for follow up observation. PMID- 3564003 TI - Significant regression of the tumor combined with the high level of plasma cortisol by low-dose administration of O, p'-DDD in a case with Cushing's syndrome caused by adrenocortical carcinoma. AB - The effect of o, p'-DDD on a functioning adrenocortical carcinoma is described. A 52-year-old woman, who had a huge adrenocortical carcinoma and pulmonary metastasis, was treated by a low-dose administration of o, p'-DDD, which reduced the tumor size. The excretion of urinary 17-OHCS was decreased, whereas plasma cortisol was not decreased but rather increased. This was considered to be caused that o, p'-DDD functioned as a cytotoxic factor which did not improve the states of hyperkalemia, hyperglycemia and hypertension. This suggested that monitoring to measure multiple steroids in addition to plasma cortisol and urinary 17-OHCS was useful for recognizing the general conditions of patients with adrenocortical carcinoma receiving o, p'-DDD therapy. PMID- 3564004 TI - Angiotensin II-induced tachyphylactic constrictions in isolated and perfused canine mesenteric arteries. AB - The stainless steel cannula inserting method was used to investigate the effects of angiotensin II on isolated and perfused dog mesenteric arteries with and without indomethacin treatment, or with and without intraluminal saponin treatment which removed the endothelium. In non-treated preparations, angiotensin II was intraluminally administered repetitively at 10, 20, 30 or 60 min inervals. Each period of angiotensin II causes tachyphylaxis. The order of degree of tachyphylaxis was 10 greater than 20 greater than 30 greater than 60 min intervals. Relatively large doses much readily caused tachyphylaxis. Tachyphylaxis was not affected by phentolamine-treatment preparations. In indomethacin (5 mg)-treated preparations, the angiotensin II-induced tachyphylaxis was significantly less than that in non-treated ones. In small doses of angiotensin II, tachyphylaxis did not appear in the majority of cases in indomethacin-treated preparations. In deendothelial preparations which were induced by intraluminal administration of saponin (1 and 3 mg), the tachyphylaxis was induced similar to non-saponin treated preparations. It is concluded that prostaglandin may partially participate in induction of angiotensin-induced tachyphylaxis, the prostaglandin may be synthesized in the inside of vasculature, and a large dose of angiotensin II induces tachyphylaxis unrelated to production of prostaglandin. PMID- 3564005 TI - Effect of antispastic drugs on rapid force generation of spastic muscle. AB - The effect of antispastic drugs, dantrolene sodium and baclofen, on the initiation of rapid knee extension was examined in 8 normal subjects and 8 patients with spastic hemiparesis. Three biomechanical variables, the latency between EMG onset of the rectus femoris and rise of tension (TLT), that between the rise of tension and the maximum tension of knee extension (FTmax) and the maximum tension attained (Fmax), were measured before and after administration of one of the drugs. Dantrolene sodium increased TLT, but did not change FTmax or Fmax. The increase of TLT was remarkable in the normal subjects and the non affected side, compared to the affected side of the patients. Baclofen did not modify TLT or FTmax, but decreased Fmax. The decrease of Fmax was definite in the normal subjects while it was negligible in the affected side of the patients. Clinical implications and pathophysiological mechanisms of these results were discussed. PMID- 3564006 TI - Validity of Ewald's law in the horizontal semicircular canals and the vestibular nuclei: electron microscopic observation and quantitative [14C]-2-deoxy-D-glucose study. AB - Two series of experiments were performed by using a total of 36 guinea pigs. The 1st series was to compare the influence of rotatostimulation on the bilateral cristae ampullare. After repeating the rotatostimulation with the cupulometric mode (the terminal turning velocity: 450 degrees/sec) for 48 hr, ultrastructural changes of sensory cells were found in 9 of 17 animals with transmission electron microscopy. They showed stronger influences on the ampullopetal flow side with the exception of one animal. In the 2nd series, the difference in excitability between the bilateral vestibular nuclei was investigated on 6 guinea pigs which were exposed to the clockwise constant angular acceleration of 1 degree/sec2 for 8 min. The autoradiographic study with [14C]-2-deoxy-D-glucose (the 2-DG) revealed that the rotation-induced glucose uptake was increased significantly in the superior and the medial vestibular nuclei of the ampulloptal flow side. The results of the two series of experiments suggest the predominance of the ampullopetal effect not only in the horizontal semicircular canals but also in the vestibular nuclei. PMID- 3564007 TI - Trimethoprim interference in methotrexate assay by an enzyme inhibition assay kit. AB - Spurious methotrexate (MTX) concentrations in sera and cerebrospinal fluids from leukemia patients who were given trimethoprim (TMP) were estimated using an MTX assay kit which is based on its inhibition of dihydrofolate reductase. The interference of TMP with MTX was confirmed in the assay system. A concentration of 0.17 microgram/ml of TMP gave a value for an apparent MTX of 10 microM. PMID- 3564008 TI - Our nation's health care system. PMID- 3564009 TI - Alternative delivery systems: an overview. PMID- 3564010 TI - HMOs and PPOs: an operational guide. PMID- 3564011 TI - Alternative delivery systems and their impact on physicians. PMID- 3564012 TI - HMOs and PPOs: similarities and differences. PMID- 3564013 TI - The effects of differential induction of cytochrome P-450, carboxylesterase and glutathione S-transferase activities on malathion toxicity in mice. AB - The organophosphorous pesticide malathion is metabolized by three hepatic enzyme systems: the microsomal cytochrome P-450-dependent monooxygenase system, the microsomal carboxylesterases, and the cytosolic glutathione S-transferases. We produced differential induction of these three enzyme systems in mice with phenobarbital and 2(3)-tert-butyl-4-hydroxyanisole (BHA) and examined the effects of the induction on the inhibition of acetylcholinesterases by malathion. Phenobarbital not only significantly induced hepatic microsomal cytochrome P-450 (p less than 0.05) but also increased microsomal carboxylesterase activity (p less than 0.05). BHA not only increased the activity of microsomal carboxylesterases (p less than 0.05) but also substantially increased cytosolic glutathione S-transferase activity (p less than 0.05). Despite the differential effects of phenobarbital and BHA on the three enzyme systems, neither agent protected the mice against malathion toxicity. PMID- 3564014 TI - Biochemical and histochemical alterations following acute soman intoxication in the rat. AB - Rats injected with a nonlethal acute dose (100 micrograms/kg, sc) of soman (pinacolyl methylphosphonofluoridate) exhibited signs of anticholinesterase toxicity beginning at 5-15 min with increasing severity and lasting for 4-6 hr. Generalized tremors and seizure activity indicated comparatively greater involvement of the central cholinergic system than peripheral neuromuscular effects. During peak toxicity, all the brain regions tested showed more than 95% inhibition of acetylcholinesterase (AChE) activity. The cortex area was maximally affected (99% inhibition). Among skeletal muscles, soleus AChE was most severely affected (94%) and extensor digitorum longus (EDL) the least (72%). Inhibition of EDL AChE occurred at a much slower rate than in brain and other muscles. Significant recovery of AChE activity was seen by 48-72 hr after soman treatment in both brain and skeletal muscles. By Day 7, recovery was virtually complete in skeletal muscles but not in brain, although significant recovery had occurred by this time. Muscle fiber necrosis developed within 6 hr in the soleus and diaphragm, while no necrotic fibers were found in the EDL. The 16 S AChE molecular form showed the fastest recovery of the AChE isozymes in all three muscles. Full recovery was seen after 7 days in soleus and was increased to greater than control activity in diaphragm and EDL. The inhibition pattern of butyrylcholinesterase (BuChE) activity was similar to that described for AChE activity, but the recovery was comparatively faster. Carboxylesterase activity in plasma was decreased to less than 10% of control within 1 hr and recovered to 53% of control within 24 hr. No significant inhibition was seen in hepatic carboxylesterase activity. It can be concluded that soman-induced acute toxicity is directly related to the rate and degree of AChE inhibition. A significant amount of soman binds to non-AChE enzymes with serine sites such as BuChE and carboxylesterases. PMID- 3564015 TI - The oxidation of alpha-beta unsaturated aldehydic products of lipid peroxidation by rat liver aldehyde dehydrogenases. AB - Lipid peroxidation of microsomal membranes produces a large number of aldehydes, alcohols, and ketones, of which some are cytotoxic. trans-4-Hydroxy-2-nonenal (4HN) and trans-2-hexenal (HX) are two alpha-beta unsaturated aldehydes which are major and minor lipid peroxidation products, respectively. The role of aldehyde dehydrogenase (ALDH) in the oxidation of 4HN and HX was examined using semipurified mitochondrial, cytosolic, and microsomal ALDH isozymes prepared from male Sprague-Dawley rat liver. High- and low- affinity mitochondrial and high affinity cytosolic ALDH isozymes were able to oxidize 4HN. The affinities of the three isozymes for 4HN, reported as the V/K values, are 0.258, 0.032 and 0.030 nmol NADH formed/min/mg protein/mumol 4HN/liter, respectively. The low-affinity cytosolic and microsomal forms of ALDH are unable to oxidize 4HN. The high affinity mitochondrial, low-affinity cytosolic, and microsomal ALDH isozymes oxidized HX, displaying V/K values of 0.600, 0.058, and 0.058 nmol NADH formed/min/mg protein/mumol HX/liter, respectively. Oxidation of HX by the low affinity mitochondrial and high-affinity cytosolic isozyme was not detected. This study indicates that ALDH may participate in the in vivo metabolism of cytotoxic aldehydic products formed during lipid peroxidation. PMID- 3564016 TI - Halothane hepatotoxicity in Fischer 344 rats pretreated with isoniazid. AB - Male Fischer 344 rats were used to investigate the hepatic effects of exposure to halothane under normoxic conditions (FIO2 = 0.21) in isoniazid-treated rats. Animals were treated with saline or isoniazid (50 mg/kg) for 7 days and then were exposed to either 1% halothane or air for 2 hr. One-half of the rats from each treatment and exposure group were killed 24 hr postexposure; the remaining were killed 4 days postexposure. Twenty-four hours following halothane exposure, serum transaminase levels were significantly elevated in isoniazid- compared with saline-treated rats (i.e., aspartate aminotransferase = twofold; alanine aminotransferase = seven-fold). Cholesterol levels were significantly depressed by halothane exposure in both saline- and isoniazid-treated rats. Other serum parameters indicative of hepatic and renal function were not different: alkaline phosphatase, total protein, total bilirubin, hematocrit, uric acid, creatinine, urea nitrogen, Na+, K+, Ca2+, and inorganic phosphate. Neither saline-treated nor isoniazid-treated rats exposed to air exhibited histologic evidence of hepatic damage. Halothane-exposed rats, however, showed a circumscribed disruption of cellular morphology. The most severe lesions were observed with isoniazid-treated animals with extensive pericentral hepatocellular necrosis and infiltration by leucocytes and Kupffer cells. Serum concentrations of two products of the oxidative metabolism of halothane, trifluoroacetic acid and bromide, were significantly elevated in isoniazid- compared with saline-treated rats. Serum levels of fluoride, a product of reductive metabolism, were not different. These results strongly suggest that hepatic injury following halothane administration can be produced by intermediates of oxidative metabolism. PMID- 3564017 TI - Electrophysiologic changes following treatment with organophosphorus-induced delayed neuropathy-producing agents in the adult hen. AB - Although clinical, pathological, and biochemical effects of organophosphorus induced delayed neuropathy (OPIDN) have been intensively investigated in the adult hen, detailed electrophysiological studies are lacking. Adult white leghorn hens were treated with a single oral dose of either 30 mg/kg tri-2-cresyl phosphate (TOCP), 750 mg/kg TOCP, 4 mg/kg di-n-butyl-2,2-dichlorovinyl phosphate (DBCV), or 30 mg/kg di-n-butyl-2,2-dichlorovinyl phosphinate (DBCV-P). The 750 mg/kg TOCP and DBCV, but not the 30 mg/kg TOCP and DBCV-P, treatments resulted in clinical signs of OPIDN and mild to marked damage of the tibial nerve 21 days after dose. Twenty-four hr lymphocyte neurotoxic esterase (NTE) inhibition was used as an index of brain NTE inhibition for the various organophosphorus compound (OP) treatment. Twenty-four hr lymphocyte NTE inhibition for 30 mg/kg TOCP, 750 mg/kg TOCP, DBCV, and DBCV-P was 54.1, 87.1, 84.8, and 68.3%, respectively. Twenty-one days after dose, the TOCP-treated hens exhibited some abnormalities in conduction velocity and action potential duration in the tibial or sciatic nerves. No abnormalities were observed in action potential parameters of either the DBCV or DBCV-P treatments. Neurotoxic OP (TOCP and DBCV) treatment resulted in decreased refractoriness in the tibial nerve, increased refractoriness in the sciatic nerve, and elevated strength duration threshold for both nerves. These changes were not present in nerves from DBCV-P (a non neurotoxic NTE inhibitor)-treated hens. These results suggest that refractory period and strength duration abnormalities in peripheral nerve correlate well with the production of OPIDN and are evident without coincident clinical signs or histopathology. PMID- 3564018 TI - Effects of perfluorodecanoic acid on thyroid status in rats. AB - Treatment of rats with toxic doses of perfluorodecanoic acid (PFDA) results in reduction in feed intake, body weight, serum thyroxine (T4) and triiodothyronine (T3) concentrations, resting heart rates, and body temperatures. Some of these effects resemble changes characteristic of hypothyroidism. Therefore the effects of PFDA on functional thyroid status were examined to relate changes in thyroid status with signs of PFDA toxicity. In the present study, the dose-related effects of PFDA on plasma thyroid hormone concentrations and a number of indices of thyroid status were investigated and compared with signs of PFDA toxicity. Young adult male Sprague-Dawley rats were given single intraperitoneal doses of PFDA (20, 40, or 80 mg/kg), and subsequent changes were evaluated 7 days after dosing. Decreases in body weight and feed intake were used as measures of PFDA toxicity and ranged from minimal to severe. Plasma T4 concentrations and free thyroxine index were drastically reduced at all doses, and these changes were mimicked by pair feeding only at the high dose of PFDA (80 mg/kg). Plasma T3 concentrations were not affected by PFDA treatment, whereas pair feeding at the high-dose level (80 mg PFDA/kg) resulted in a significant reduction (ca. 50% from unlimited-fed control) in T3. Although PFDA caused a dose-dependent decrease in thyroid gland weight which was not completely paralleled by pair feeding, thyroid histology was unremarkable. PFDA treatment resulted in a small decrease in basal metabolic rate (8% at 80 mg PFDA/kg). A greater reduction (ca. 18%) in basal metabolic rate was observed in vehicle-treated controls pair-fed to rats of the 80 mg PFDA/kg dose group. Thermogenesis, as measured by oxygen consumption and body core temperatures, was not greatly affected by PFDA treatment, and these changes were paralleled by pair feeding. Reductions in plasma T4 concentration and free thyroxine index at a low dose of PFDA (20 mg/kg) indicate that PFDA induced hypothyroxinemia can be dissociated from its overtly toxic effects (i.e., severe hypophagia and body weight loss) observed at higher doses. The results obtained here suggest that despite alterations in plasma thyroid hormone levels there is no consistent pattern of effects on functional thyroid status which could explain the overt toxicity of PFDA. PMID- 3564019 TI - Pathologic changes following acute methyl isocyanate inhalation and recovery in B6C3F1 mice. AB - Male and female mice were exposed by inhalation to 0, 3, 10, and 30 ppm methyl isocyanate for 2 hr followed by a 91-day recovery period. Sixteen of 80 (20%) male mice in the 30-ppm group died following exposure with seven deaths occurring in the first 24 hr. Two female mice died, one each in the 30- and 10-ppm concentration groups. Five mice/sex/group were examined at 2 hr and at 1, 3, 7, 14, 28, 49, and 91 days following exposure. Treatment-related changes were restricted to the respiratory system. At 30 ppm there was extensive necrosis and erosion of the respiratory and olfactory epithelia in the nasal cavity. Severe necrosis and epithelial erosion were also found in the trachea and main bronchi. Epithelialization occurred rapidly and most of the denuded turbinates were covered by flattened epithelium by Day 3. On the turbinates, recovery was essentially complete with the exception of small areas in the olfactory epithelia where lesions were present in the male mice through Day 91. In the trachea and major bronchi, fibrin and cellular debris were present in the airways, which in some cases had organized and formed intraluminal fibrotic projections. These projections became covered by respiratory epithelium. The intraluminal projections and bronchial fibrosis persisted to Day 91. In the males, where the fibrosis was more severe, chronic alveolitis and atelectasis were found. In mice exposed to 3 or 10 ppm, there appeared to be complete recovery. These inhalation studies indicate that methyl isocyanate exposure of mice at or near lethal concentrations causes reversible lesions in the nose and persistent intraluminal and mural fibrosis of the major bronchi. PMID- 3564020 TI - Induction of hepatic metallothionein following administration of urethane. AB - Induction of hepatic metallothionein (MT) by urethane (ethyl carbamate) was characterized. Male CF-1 mice were treated with urethane (0, 0.5, 1.0, 1.5, and 2 g/kg; ip) and 18 hr later hepatic MT concentrations were determined with the Cd hemoglobin radioassay. Urethane (1 g/kg and higher) significantly increased hepatic MT levels, resulting in a 14-fold increase after 2 g/kg. Time-course experiments indicated that MT levels were increased significantly at 6 hr after administration of urethane (1.5 g/kg) and reached a maximum between 12 and 24 hr. Gel filtration, anion-exchange chromatography, and ultraviolet spectral analysis were used to characterize the protein induced by urethane. Pretreatment with actinomycin-D prevented induction of MT by urethane. Administration of equimolar dosages (20 mmol/kg) of urethane, N-hydroxyurethane, and methyl carbamate indicated that urethane and N-hydroxyurethane induce MT but that methyl carbamate does not. MT induction was also not observed with other commonly used anesthetics (pentobarbital and phenobarbital). In conclusion, urethane induces hepatic MT but this effect is not related to its anesthetic action, nor is it a common property of all carbamates. PMID- 3564021 TI - Induction of ornithine decarboxylase activity in weanling rat pancreas by an orally administered soy protein isolate. AB - The induction of ornithine decarboxylase activity in weanling rat pancreas by a trypsin inhibitor-containing soy protein isolate has been studied. Oral administration of the isolate at 0.8, 1.6, 4.0, 6.0, and 8.0 mg/g body wt produced marked elevations in enzyme activity, a response which was proportional to the amount of isolate administered. Ornithine decarboxylase activity was measured at 2, 4, 6, 8, 12, and 24 hr after the isolate was given. A statistically significant increase in enzyme activity was evident as early as 2 hr after treatment; maximal activity occurred at 6 hr and was approximately 140 times greater than the PMID- 3564022 TI - The binding of ciamexone to globin: its demonstration and some accompanying effects in rats. AB - The 2-cyanaziridines Ciamexone and Azimexone in doses of 100 and 500 mg/kg lead to a reversible dose-dependent formation of thermolabile hemoglobin and Heinz bodies, a lowered erythrocyte count, and splenomegaly. According to our investigations these effects may have been caused by a covalent binding of the 2 cyanaziridines or their metabolites to globin in the erythrocytes. This binding was shown by gel electrophoresis using 14C-labeled Ciamexone. The change of the globin had no influence on the oxygen affinity of the hemoglobin. PMID- 3564023 TI - A phosphorothionate isomer protects against the pneumotoxicity caused by O,O,S trimethyl phosphorothioate. AB - O,O,S-Trimethyl phosphorothioate (OOS-TMP), an impurity in many organophosphorus insecticides, causes pneumotoxicity in rats at low doses (20 mg/kg) resulting in increases in bronchopulmonary lavage lactate dehydrogenase (LDH) activity and morphological alterations of bronchiolar epithelium. Coadministration of the nontoxic isomer, O,O,O-trimethyl phosphorothioate (OOO-TMP), at 1% of the toxicant dose, has been found to protect against the increase in LDH levels and morphological changes in bronchioles caused by OOS-TMP. Since OOO-TMP appears to require metabolic activation for pneumotoxicity, the effects of OOO-TMP on pulmonary and hepatic P-450 content and P-450-mediated monooxygenases were examined as a possible biochemical mechanism of antagonism. Oral treatment with OOO-TMP (0.5, 1.0, and 4.0 mg/kg) decreased pulmonary P-450 levels by 23 to 50% at 2 and 6 hr, while no changes were detected in hepatic P-450 levels. Lung microsomal 7-ethoxycoumarin O-deethylase (7-Ec) was inhibited by 71 to 100%, while liver 7-Ec was inhibited by 26 to 52%. p-Nitroanisole demethylase activity was decreased 22 to 47% following treatment with the two highest dose levels of OOO-TMP. These results further support the view that the lung is a target organ of delayed toxicity produced by OOS-TMP, and that the antagonistic effect of OOO TMP is due to alterations in the metabolic activation processes of OOS-TMP in the lung and/or liver. PMID- 3564024 TI - In vitro cytotoxicity of allyl alcohol and bromobenzene in a novel organ culture system. AB - Two well-known hepatotoxicants, allyl alcohol (AA) and bromobenzene (BB), were studied using an in vitro system of cultured liver slices from control and phenobarbital-treated rats, respectively. Dose- and time-dependent increases in media lactate dehydrogenase (LDH), and decreases in slice K+ content and in protein synthesis were observed in rat liver slices incubated with either compound at concentrations between 0.1 and 1 mM over a period of 6 hr. The histopathological changes which occurred in the intoxicated slices appeared to parallel these biochemical changes. Additionally, the toxicity of either BB or AA, evaluated at 4 hr, was inhibited when slices were preincubated for 30 min with beta-ethyl-2,2-diphenylvalerate hydrochloride (SKF 525-A) (0.1 mM) or pyrazole (1.0 mM), respectively. In this in vitro incubation system the cytotoxicity of xenobiotics can be studied under conditions where the multicellular hepatic lobular architecture is partially maintained, and alterations in biochemical and functional processes may be correlated to pathological changes. PMID- 3564025 TI - Immunopathologic effects of nickel subsulfide on the primate pulmonary immune system. AB - The effects of nickel subsulfide (Ni3S2) on the pulmonary immune system were evaluated in cynomolgus monkeys that had been previously immunized and repeatedly challenged with sheep red blood cells in specific lung lobes. After instillation of Ni3S2, at a final dose of 0.06 mumol/g lung, in one immunized and one control lobe of each monkey, bronchoalveolar lavage cells were evaluated for alterations in cell number and function. Neither numbers of antibody-forming cells nor natural killer (NK) cell conjugate formation were altered in immunized lobes of nickel-exposed animals regardless of individual lung lobe nickel exposure. Macrophage phagocytic activity was significantly decreased, and target cell killing by conjugate-forming NK cells was increased in all lobes independent of antigen or nickel exposure in all nickel-exposed animals. Histologic sections of nickel-exposed lobes were characterized by mild focal accumulations of macrophages and lymphocytes within the interstitium and alveoli and by perivenular lymphoid infiltration and follicle formation. We conclude that alveolar macrophages are sensitive to the toxic effects of nickel and that local instillation of Ni3S2 in the subhuman primate lung results in suppression of pulmonary alveolar macrophage function accompanied by a secondary increase in NK cell-mediated killing of target cells. PMID- 3564026 TI - Daunomycin inhibits the uptake of adenine, amino acids, and glucose into cardiac myocytes. AB - Daunomycin and adriamycin are widely used antitumor agents which induce dose dependent cardiotoxicity. The mechanisms by which daunomycin causes cardiotoxicity have been investigated in neonatal rat cardiac myocytes maintained in tissue culture. Daunomycin inhibited the uptake of adenine, amino acids, and deoxyglucose in a dose-dependent fashion. The uptake of both adenine and methionine was inhibited without any delay while the glucose uptake (deoxyglucose) was inhibited after a delay of 2 hr. Since daunomycin affected the uptake of both adenine and amino acids without any delay and since daunomycin did not affect the incorporation of adenine into nucleotide and amino acids into proteins once these were transported into the cell, it is possible the daunomycin exerted these effects by acting directly on the cell membrane. Thus, one of the early toxic manifestations of anthracycline antibiotics may be on the transport of nutrients such as amino acids, glucose, and adenine. PMID- 3564027 TI - Interaction of T-2 toxin with bovine carrier erythrocytes: effects on cell lysis, permeability, and entrapment. AB - Hemolysis, morphological changes, binding, and effect on encapsulation of exogenous substances were used as a basis to study the interaction of the trichothecene mycotoxin, T-2 toxin, with erythrocytes. T-2 toxin did not cause hemolysis of bovine erythrocytes but readily hemolyzed rat erythrocytes. T-2 toxin interaction with bovine erythrocytes was minimal because T-2 toxin did not bind appreciably to the erythrocytes. Entrapment of T-2 toxin in carrier erythrocytes was independent of toxin concentration, and interaction of T-2 toxin with erythrocytes did not affect the entrapment of the markers sucrose or inulin. T-2 toxin rapidly diffuses from carrier erythrocytes with less than 20% remaining after 4 hr of incubation. Cross-linking of the erythrocyte membrane with glutaraldehyde prevents T-2 toxin efflux from carrier erythrocytes. PMID- 3564028 TI - Corneal epithelial wound closure in tissue culture: an in vitro model of ocular irritancy. AB - The influence of 13 test agents on the ability of cultured rabbit corneal epithelial cells to migrate and re-cover a wound has been utilized to evaluate an in vitro model of ocular irritancy. Cells were grown under standard conditions and monitored for adequate cell density. Seven days after subculture, replicate wounds were produced and cultures were exposed to varying concentrations of a test agent in culture medium for 24 hr. Following exposure, cultures were fixed and stained to reveal remaining wound areas which were quantitated by computerized planimetry and compared to evaluate the deleterious effects of the test agents. The test ranks irritants in an order similar to that described in the literature for both in vivo and in vitro tests. This tissue culture model is conceptually simple, quantitative, and an alternative to the corneal component of whole animal testing for ocular irritancy. PMID- 3564030 TI - Cyclophosphamide in the seminal fluid of males, its transmission to females by mating, and its effects on pregnancy outcome. PMID- 3564029 TI - Regulation of intracellular glutathione in rat embryos and visceral yolk sacs and its effect on 2-nitrosofluorene-induced malformations in the whole embryo culture system. AB - The dysmorphogenic effects of 2-nitrosofluorene (NF) in vitro were modulated in Day 10 rat embryos by agents which regulate intracellular glutathione (GSH) levels. The incidence of abnormal axial rotation caused by NF alone increased in a dose-dependent manner at NF concentrations in excess of 25 microM. No effects were observed at 15 microM NF and doses of 100 microM resulted in a 100% incidence of mortality. L-Buthionine-S,R-sulfoximine (BSO), an inhibitor of GSH synthesis, produced malformations (50%) in embryos exposed to 15 microM NF but produced no additional effects on embryos at higher NF concentrations. BSO treatment alone resulted in a greater than 50% decrease in GSH content in visceral yolk sacs and had a lesser but likewise significant effect (15% decrease) on the GSH content of embryos. Protein content was inversely affected as embryonic levels were increased by 20% and yolk sac levels were unchanged. When BSO was added in combination with NF at the onset of the culture period, embryonic GSH decreased in a dose-dependent manner, suggesting a relatively low rate of embryonic GSH turnover that could be increased by addition of an exogenous substrate capable of forming adducts with and removing GSH from the cells. 2-Oxothiazolidine-4-carboxylate (OTC), a compound which is enzymatically modified to provide an additional source of intracellular cysteine and increase GSH synthesis, produced no significant changes in embryonic or yolk sac GSH when added alone to the culture medium. When OTC (5 mM) was added in combination with NF, however, NF-elicited malformations were eliminated. This was also the case at 100 microM NF in which OTC not only prevented malformations but completely protected embryos against the loss in viability. The GSH and protein levels were indistinguishable from controls when OTC and NF were added simultaneously except for the 41 microM NF dose at which a highly significant increase in both embryonic and yolk sac protein was observed. This study clearly demonstrates the potential importance of GSH in the modulation of chemical dysmorphogenesis and provides an important new tool for the study of mechanisms of developmental toxicity. PMID- 3564031 TI - Application of a hepatocyte-erythrocyte coincubation system to studies of cyanide antidotal mechanisms. AB - A coincubation system composed of hepatocytes in primary monolayer culture and erythrocytes suspended in the culture medium was developed and used as a model for investigations of mechanisms of cyanide antidote action at the cellular level. Hepatocyte ATP was used as the cytotoxicity indicator. Treatment of rat hepatocytes in the coincubation system with KCN (1.0 mM) for 10 min at 37 degrees C selectively reduced hepatocyte ATP levels to 33 +/- 15% of control (no KCN added) levels. 4-dimethylaminophenol (DMAP), cobalt(II) chloride, sodium nitrite, sodium thiosulfate, or a combination of the last two antidotes added to the KCN containing medium significantly reversed ATP depression and the response was concentration dependent. The relative effectiveness, on a molar basis, was estimated to be DMAP greater than CoCl2 much greater than NaNO2 congruent to Na2S2O3. NaNO2 and DMAP induced methemoglobin formation in the absence of cyanide and cyanmethemoglobin formation in its presence; erythrocytes were required in the medium for effectiveness. CoCl2 produced neither cyanmethemoglobin nor thiocyanate in appreciable quantities nor required erythrocytes for antagonism. Na2S2O3 converted cyanide to thiocyanate and reversed ATP depression without erythrocytes in the medium. The addition of erythrocytes increased these rates significantly and to a greater extent than albumin. The overall results are consistent with previously proposed modes of action for these antidotes. However, the enhancement in cyanide metabolism and ATP recovery with Na2S2O3 and erythrocytes in the system was unexpected and raises the possibility that erythrocytes may contribute to cyanide disposition and antagonism in vivo when this antidote is administered. PMID- 3564032 TI - The effects of blood flow and detoxification on in vivo cholinesterase inhibition by soman in rats. AB - The in vivo time course of cholinesterase inhibition was measured in brain, lung, spleen, hind limb skeletal muscle, diaphragm, intestine, kidney, heart, liver, and plasma of rats receiving 90 micrograms/kg soman, im. This dose of soman produced severe respiratory depression and transient hypertension, but no significant changes in the cardiac output or heart rate of anesthetized rats. The rate and maximal extent of in vivo cholinesterase inhibition by soman varied widely among the tissues. Although cardiac output was unchanged by soman administration, the blood flow in heart, brain, and lung (bronchial arterial flow and arteriovenous shunts) was increased, whereas blood flow in spleen, kidney, and skeletal muscle was decreased. The relative importance of tissue blood flow, tissue levels of cholinesterase and acetylcholinesterase, and tissue levels of soman-detoxifying enzymes (diisopropyl-fluorophosphatase and carboxylesterase) in determining the in vivo rate and maximal extent of cholinesterase inhibition was examined by multiple regression analysis. The best multiple regression model for the maximal extent of cholinesterase inhibition could explain only 63% of the observed variation. The best multiple regression model for the in vivo rate of cholinesterase inhibition contained three independent variables (blood flow, carboxylesterase, and cholinesterase) and could account for 94% of the observed variation. Of these three variables blood flow was the most important, accounting for 79% of the variation in the in vivo rate of cholinesterase inhibition. This suggests that it may be possible to use a flow-limited physiological pharmacokinetic model to describe the kinetics of in vivo cholinesterase inhibition by soman. PMID- 3564033 TI - Central-peripheral delayed neuropathy caused by diisopropyl phosphorofluoridate (DFP): segregation of peripheral nerve and spinal cord effects using biochemical, clinical, and morphological criteria. AB - Systemic injection of diisopropyl phosphorofluoridate (DFP; 1 mg/kg, sc) causes delayed neuropathy in hens. This effect is associated with a high level of organophosphorylation of neuropathy target esterase (NTE) followed by an intramolecular rearrangement called "aging." Phenylmethanesulfonyl fluoride (PMSF) also attacks the active center of NTE but "aging" cannot occur. This compound does not cause neuropathy and protects against a subsequent challenge systemic dose of DFP. Intraarterial injection of DFP (0.185 mg/kg) into only one leg of hens caused a high NTE inhibition (greater than 80%) in the sciatic nerve of the injected leg, but not in other parts of the nervous system (37% average). A unilateral neuropathy with typical histopathological lesions developed in the injected leg. PMSF (0.55 mg/kg) injected into each sciatic artery caused 47% inhibition of sciatic nerve NTE but only 17-22% inhibition of NTE elsewhere; it did not produce clinical or histopathological lesions. When these hens were challenged with DFP (1 mg/kg, sc), high inhibition of residual-free NTE (greater than 85%) occurred throughout the nervous system and clinical signs of a syndrome different from the classical delayed neuropathy developed: this spinal cord type of ataxia was associated with histopathological lesions in the spinal cord but not in peripheral nerve. PMSF (1 mg/kg) injected into only one sciatic artery caused selective protective inhibition of sciatic nerve NTE of that leg. After systemic challenge by DFP, clinical effects expressed were a combination of spinal cord ataxia plus unilateral peripheral neuropathy. The challenge dose of DFP (1 mg/kg, sc) was insufficient to produce clear histopathological lesions in unprotected peripheral nerves although spinal lesions were found in these hens. Thus clinical evaluation of the peripheral nervous system by means of walking tests and a simple test of "leg retraction" reflexes was more sensitive and specific in diagnosis of peripheral neuropathy than was the histopathology. PMID- 3564034 TI - Discriminative stimulus properties of toluene in the mouse. AB - Little is known about the nature of the acute intoxication produced by exposure to high concentrations of toluene such as that which occurs with spills and in solvent abusers. The intoxication may be similar to that produced by classic central nervous system depressants such as the barbiturates. To investigate this hypothesis, drug discrimination procedures were used to compare the acute effects produced by toluene and pentobarbital (PB). Mice were trained to discriminate toluene (100 mg/kg, ip) from vehicle in a two-lever task in which responding was under the control of a fixed-ratio 20 (FR20) schedule of food presentation. Generalization tests were conducted after 20-min inhalation exposures to toluene (150-3600 ppm) and 20 min after injections with either PB (5-30 mg/kg) or morphine (3-20 mg/kg). Most mice generalized to inhaled toluene and to PB in a concentration- or dose-related fashion, but not to morphine. These results show that the effects of injected toluene can be established as a discriminative stimulus in mice, and that these stimulus effects are independent of route of administration. Shared discriminative stimulus properties with PB suggest that toluene produces an acute intoxication like that of other classic CNS depressants. PMID- 3564036 TI - The effect of formaldehyde exposure upon the mononuclear phagocyte system of mice. AB - The vapors of formaldehyde have been reported to represent a potential health hazard, resulting in an increased incidence of carcinomas of the nasal turbinates in experimental animals. To determine the potential role of alterations in the mononuclear phagocyte system (MPS) induced by inhalation of formaldehyde, we studied the systemic effects of exposure upon macrophages. Specifically, we examined the effects of formaldehyde exposure upon development of the MPS by use of an established system of quantitative objective markers, which characterizes and classifies populations of murine macrophages into several developmental stages. Exposure of mice to 15 ppm of formaldehyde for 6 hr daily for 3 weeks did not alter the number or impair the function of resident peritoneal macrophages, although this exposure increased (approximately twofold) competence for release of H2O2 from the macrophages. Furthermore, formaldehyde exposure did not alter the tumoricidal activation or differentiation of macrophages produced by the defined stimulant MVE-2. The data thus indicate that exposure of mice to formaldehyde can induce selective systemic alterations in the function of the MPS for H2O2 production, a change which has been shown in other studies to increase the frequency of mutagenesis. PMID- 3564035 TI - 5-Hydroxytryptamine and thromboxane in platelets from rats treated with monocrotaline pyrrole. AB - Monocrotaline pyrrole (MCTP), a metabolite of the plant toxin monocrotaline, produces pulmonary vascular injury, pulmonary hypertension, and right ventricular enlargement (RVE) in rats by an unknown mechanism. A role for platelets has been suggested by the observation that antibody-induced thrombocytopenia reduces the RVE caused by MCTP. The platelet can release a number of vasoconstrictive agents, such as 5-hydroxytryptamine (5HT) and thromboxane A2 (TxA2), that could possibly contribute to pulmonary hypertension. It was of interest to determine whether treatment with MCTP alters platelet 5HT content or alters the release of TxA2 in platelet-rich plasma (PRP) in response to aggregation. Fourteen days following treatment with MCTP when pulmonary hypertension is well-established and RVE is present, the concentration of 5HT in washed platelets or in platelet-poor plasma was not different in treated and control rats. One day following treatment with MCTP, before lung injury is evident, the concentration of TxB2, a stable metabolite of TxA2, was higher in unstimulated PRP from treated rats than in control rats. The concentration of TxB2 was also examined in PRP at 4 days (when lung injury first appears), 7 days (when pulmonary arterial pressure first increases), and 14 days after treatment with MCTP (when RVE is evident). At 4, 7, or 14 days following treatment there was no difference in the concentration of TxB2 in unstimulated PRP from MCTP-treated and control rats. Following stimulation with arachidonic acid, the release of TxB2 at maximal aggregation was not different in PRP from MCTP-treated and control rats at any time after treatment. The rate of release of TxB2 was lower in PRP from rats treated with MCTP 7 days earlier, but was not different at any other time following treatment. At concentrations up to 250 micrograms/ml, MCTP added in vitro to PRP from untreated rats did not affect the concentration of TxB2 released during aggregation induced by arachidonic acid. Only at very high concentrations (1 mg/ml) did MCTP abolish the aggregation response and depress TxB2 release in PRP. These results indicate that MCTP treatment does not affect platelet 5HT content and does not affect basal TxB2 production or TxB2 release by platelets stimulated in vitro. PMID- 3564037 TI - Biochemical quantitation and histochemical localization of carboxylesterase in the nasal passages of the Fischer-344 rat and B6C3F1 mouse. AB - Inhalation exposure of rats and mice to glycol ether acetates and acrylate esters causes degeneration of the olfactory epithelium but not of the respiratory epithelium. Since these compounds are metabolized via carboxylesterase to acids that are toxic to the olfactory epithelium, the activity and cellular distribution of carboxylesterase in the nasal passages of rats and mice were studied. Olfactory mucosal carboxylesterase in both rats and mice was found to have a Vmax value for the hydrolysis of p-nitrophenyl butyrate approximately 3 to 6 times larger than that for respiratory mucosa. Similarly, the second-order rate constant for binding and catalysis, V/K, was approximately four times greater in olfactory mucosa than in respiratory mucosa of both rats and mice. These data demonstrate that the olfactory mucosa of rats and mice hydrolyze carboxylesters more efficiently than the respiratory mucosae. Enzyme histochemistry was employed to identify the individual cells within the respiratory and olfactory mucosae which contain carboxylesterase activity. All cell types of the respiratory epithelium had some carboxylesterase activity, with varying intensities between individual cell populations. Ciliated and cuboidal epithelial cells were most active in this region. In the olfactory mucosa, however, Bowman's glands stained most intensely, sustentacular cells demonstrated moderate activity, and no activity was detectable in olfactory sensory cells. Together, these data quantitate carboxylesterase activity in nasal mucosal homogenates and localize the enzyme in individual cell types. The data suggest that olfactory mucosa may metabolize carboxylesters to acids more readily than respiratory mucosa. However, such metabolism does not occur in the target cell population, the olfactory sensory neurons, raising the possibility of intercellular migration of toxic acid metabolites. PMID- 3564038 TI - Induction of metallothionein-I and metallothionein-II in rats by cadmium and zinc. AB - In this study, induction of the isoforms of metallothionein (MT) by Cd and Zn was determined with a high-performance liquid chromatography method. Rats were injected (sc) with Cd (1-100 mumol/kg) or Zn (100-10,000 mumol/kg) and concentrations of MT-I and MT-II in liver, kidney, and pancreas were measured 24 hr later. In control rats, only MT-II was detected in liver, whereas both forms were detected in kidney. In liver, Cd treatment increased MTs at all dosages tested such that concentrations of MT-I and MT-II were approximately equal. Zn (100-1000 mumol/kg) increased concentrations of MT-II about three times higher than MT-I, but higher dosages increased both isoforms to similar levels. Time course experiments indicated that, at all times after Cd administration (30 mumol/kg), concentrations of MT-I and MT-II in liver were similar. However, with Zn treatment (1000 mumol/kg), MT-II levels were three times higher than MT-I at all times after 6 hr. In kidney, no differences in induction of the isoforms was observed following Cd or Zn treatment. In pancreas, Zn (300-10,000 mumol/kg) induced MT-I and MT-II to similar levels. Thus, in liver and kidney, Cd induced MT-I and MT-II similarly over a wide range of dosages. However, Zn treatment preferentially increased hepatic MT-II at low dosages but induced MT-I and MT-II to similar levels at high dosages. In contrast, Zn induced MT-I and MT-II to similar levels in kidney and pancreas. PMID- 3564040 TI - Alteration of cytosolic calcium levels in PC12 cells by potassium cyanide. AB - The effect of KCN on cytosolic Ca2+ levels was measured in PC12 cells using Quin II/AM, a fluorometric calcium indicator. The resting cytosolic Ca2+ concentration, 115.0 +/- 4.9 nm, increased gradually and steadily over a 30-min time period following addition of 10(-4), 10(-3), or 10(-2)M KCN to the cells. After 15 min, 10(-3) and 10(-2)M KCN produced a three- and sixfold increase in the cytosolic Ca2+ concentration, respectively. In K+-depolarized cells, KCN induced a more rapid rise of intracellular calcium than in cells treated with KCN or KCI alone. KCN and/or K+-induced accumulation of cytosolic Ca2+ was blocked when the cells were pretreated with 10(-5)M diltiazem (a calcium channel blocker). These results demonstrate in a cell model that cyanide induces an accumulation of cytosolic Ca2+ and this additional cytosolic Ca2+ load appears to originate primarily from the extracellular compartment. This study supports previous reports implicating calcium as an intracellular mediator of cyanide toxicity. PMID- 3564039 TI - Synergistic interaction of ozone and respirable aerosols on rat lungs. III. Ozone and sulfuric acid aerosol. AB - Previously we have demonstrated that a synergistic interaction, as evaluated by several biochemical, toxicological, and morphological responses of the lung, results from exposure of rats to ozone (O3) in conjunction with moderate concentrations of acidic, but not neutral, aerosols. To extend these studies, groups of rats were continuously exposed to either O3 or sulfuric acid aerosol alone, or to combinations of these pollutants. Pulmonary responses from these rats were measured by assay, after exposures for 6 hr to 7 days, of total lavageable protein content, total lung tissue protein content after 5, 7, or 9 days of exposure, or apparent collagen synthesis rates from lung tissue after 7 days of exposure. While the lavageable protein content from rats exposed for 3 days to 0.1 or 1.0 mg/m3 of sulfuric acid aerosol alone was not different from control values, significant elevations from control values were observed from groups exposed to 0.12, 0.20, or 0.64 ppm of O3. Synergy was demonstrated by this assay upon exposure of rats to 0.20 ppm of O3 in conjunction with 0.1, 0.5, or 1.0 mg/m3 of sulfuric acid aerosol. Similarly, the tissue protein content from rats exposed to 0.1 or 1.0 mg/m3 of sulfuric acid aerosol alone was indistinguishable from control values. Significant elevations from control values were observed by this assay from groups of rats exposed to 0.64 or 0.20 ppm of O3, and a synergistic interaction was demonstrated between 0.64 ppm of O3 and 1.0 mg/m3 of sulfuric acid aerosol. Furthermore, synergy was observed by quantification of increased total lung protein between 0.20 ppm of O3 + 40 micrograms/m3 and higher concentrations of sulfuric acid aerosol. Values of the lung collagen synthesis rate from rats exposed to 0.1, but not 1.0, 0.5, or 0.04 mg/m3 of sulfuric acid aerosol were significantly higher than values from lungs of control animals. Significant elevations from control values were also observed by this assay from groups of rats exposed to 0.64 or 0.20 ppm of O3. A synergistic interaction was demonstrated by the collagen synthesis rate assay between groups of rats exposed to 0.64 ppm of O3 + 0.20 mg/m3 and higher concentrations of sulfuric acid aerosol or between groups exposed to 0.20 ppm of O3 + 40 micrograms/m3 and higher concentrations of sulfuric acid aerosol. These results demonstrate synergy between O3 and sulfuric acid aerosol upon exposure to concentrations of each pollutant at or near peak hourly ambient levels in polluted urban atmospheres. PMID- 3564041 TI - Chlorinated hydrocarbon-induced peroxisomal enzyme activity in relation to species and organ carcinogenicity. AB - Trichloroethylene (TCE), perchloroethylene (PER), and pentachloroethane (PENT) are widely used industrial chemicals that cause an increased incidence of hepatocellular carcinoma in mice and a very low incidence of renal tubular adenocarcinoma in rats. A recent study (C. R. Elcombe, M. S. Rose, and I.S. Pratt (1985), Toxicol. Appl. Pharmacol. 79, 365-376) suggested that the species difference in the hepatocarcinogenicity of TCE seen between rats and mice was due to a species difference in peroxisomal proliferation and cell proliferation. The purpose of the present investigation was to understand better the association of peroxisome proliferation in the species-specific hepatocarcinogenicity, and nephrocarcinogenicity of TCE, PER, and PENT. TCE (1000 mg/kg body wt), PER (1000 mg/kg body wt), PENT (150 mg/kg body/wt), the metabolite trichloroacetic acid (TCA; 500 mg/kg body wt) or the potent peroxisome proliferating agent Wy-14,643 (WY; 50 mg/kg body wt) was administered by gavage to male F-344 rats and B6C3F1 mice for 10 days. Cyanide-insensitive palmitoyl CoA oxidation activity (PCO) was used to measure the peroxisome proliferation response. Of the chlorinated hydrocarbons, TCE and PER elevated PCO activity in mouse liver whereas only TCE elevated rat liver and kidney PCO. All agents increased PCO activity in the kidneys of mice. None of the chlorinated hydrocarbons induced a PCO response stronger than WY. These results support an association between peroxisome proliferation and hepatic tumors in mice following TCE and PER, but not PENT, administration and suggest that chlorinated hydrocarbon-induced peroxisome proliferation does not correlate with species-specific renal carcinogenicity. PMID- 3564042 TI - Species-related differences in the inhibition of brain acetylcholinesterase by paraoxon and malaoxon. AB - Interspecies comparisons indicate that fish are relatively more resistant to acute intoxication with parathion and paraoxon than are rodents. In contrast, fish are more sensitive to malathion and malaoxon. The following investigation was designed to determine if species-related differences in the sensitivity of brain acetylcholinesterase (AChE) to inhibition by paraoxon and malaoxon could contribute to the interspecies differences in toxicity. Brain AChE activity was significantly greater in fathead minnows and rainbow trout than in rats and mice. The fathead minnow and rainbow trout IC50 values for paraoxon were 228- to 1879 fold greater than the corresponding values for rat and mouse. Similarly, the Ki (bimolecular inhibition constant) was 159- to 1663-fold greater in rodents than in fish, which reflected both a higher KA (association constant) and kp (phosphorylation constant) in rodents. The rodent IC50 values for malaoxon were 30-80% that of the fish IC50, and the Ki was 30-50% greater in rodents than in fish. These data suggest that the greater sensitivity of rodent brain AChE to inhibition by paraoxon may contribute to the greater toxicity of parathion and paraoxon in rodents than in fish. In contrast, the lack of correlation between the inhibition of brain AChE by malaoxon and species-related differences in acute I D50 suggests that other factors, such as the limited carboxylesterase activity in fish, may be responsible for this species selectivity. PMID- 3564043 TI - Reproductive effects of four phthalic acid esters in the mouse. AB - These studies compared the reproductive toxicity of four phthalates by a continuous breeding protocol. Mice were given diets with diethyl phthalate (DEP) (0.0, 0.25, 1.25, or 2.5%), di-n-butyl phthalate (DBP) (0.0, 0.03, 0.3, or 1.0%), di-n-hexyl phthalate (DHP) (0.0, 0.3, 0.6, or 1.2%), or di(2-ethylhexyl) phthalate (DEHP) (0.0, 0.01, 0.1, or 0.3%). Both male and female CD-1 mice were dosed for 7 days prior to and during a 98-day cohabitation period. Reproductive function was evaluated during the cohabitation period by measuring the numbers of litters per pair and of live pups per litter, pup weight, and offspring survival. There was no apparent effect on reproductive function in the animals exposed to DEP, despite significant effects on body weight gain and liver weight. DBP exposure resulted in a reduction in the numbers of litters per pair and of live pups per litter and in the proportion of pups born alive at the 1.0% amount, but not at lower dose levels. A crossover mating trial demonstrated that female mice, but not males, were affected by DBP, as shown by significant decreases in the percentage of fertile pairs, the number of live pups per litter, the proportion of pups born alive, and live pup weight. DHP in the diet resulted in dose-related adverse effects on the numbers of litters per pair and of live pups per litter and proportion of pups born alive at 0.3, 0.6, and 1.2% DHP in the diet. A crossover mating study demonstrated that both sexes were affected. DEHP (at 0.1 and 0.3%) caused dose-dependent decreases in fertility and in the number and the proportion of pups born alive. A crossover mating trial showed that both sexes were affected by exposure to DEHP. These data demonstrate the ability of the continuous breeding protocol to discriminate the qualitative and quantitative reproductive effects of the more and less active congeners as well as the large differences in reproductive toxicity attributable to subtle changes in the alkyl substitution of phthalate esters. PMID- 3564044 TI - Alteration of effective exposure of dam and embryo to caffeine and its metabolites by treatment of mice with beta-naphthoflavone. AB - The effect of treatment of pregnant C57BL/6J (B6) and AKR/J (AKR) mice with the cytochrome P-450 inducing agent beta-naphthoflavone (beta NF) on caffeine metabolism and on exposure of dam and embryo to caffeine and to its metabolites theophylline (TP), theobromine (TB), paraxanthine (PX), and trimethyluric acid (TMUA) was investigated. Treated dams were given either 20 or 80 mg beta NF/kg ip on Days 9 and 10 of gestation. Caffeine, 175 mg/kg, was given ip on Days 11 and 12 of gestation. Concentrations of caffeine and its metabolites were monitored in maternal plasma and in embryo homogenates at 0.083, 0.25, 0.5, 1, 2, 4, and 6 hr after the second caffeine injection. Effective exposure was expressed as the area under the concentration-time curve from 0 to 6 hr. Caffeine loss in B6 mice was best described by an expression incorporating capacity-limited kinetics. Pretreatment induced formation of TB and PX, while it induced elimination of all three of the monodemethylated metabolites, in B6 mice. Consequently, pretreatment caused marked reductions in exposure of B6 dams and embryos to both caffeine and TP. Exposure to TB and PX was less consistently affected, although it was reduced by pretreatment with 80 mg beta NF/kg. In contrast, exposure of AKR dams and embryos to caffeine and its metabolites was only slightly affected by beta NF pretreatment. The prevalence of paw malformations in the offspring of treated mice correlated well with effective exposure to both caffeine and TP, but not at all with the administered caffeine dose. PMID- 3564045 TI - Protective role of renal metallothionein against Cd nephropathy in rats. AB - Rats were treated with four types of Cd compound: CdCl2, Cd bound (Cd-peptide), and Cd bound to metallothionein (Cd-MT). This treatment caused no nephropathy. Subsequently, toxic doses of Cd compounds were administered to these pretreated rats and their effects on renal function were examined. When 1.4 mg Cd/kg as Cd Cys was administered, marked increases in urinary protein, glucose, and amino acid were observed. However, when the animals were pretreated with 1 mg Cd/kg/day as CdCl2 for 3 days, and 1.4 mg Cd/kg as Cd-Cys was administered 24 hr later, no renal damage was observed. Such a protective effect against the nephrotoxic action of Cd-Cys was also shown by pretreatment with Cd-Cys, Cd-peptide, or Cd MT. Furthermore such a phenomenon was also observed when the nephropathy was caused by Cd-peptide or Cd-MT. The efficacy of pretreatment depended on the time before subsequent administration of Cd and the dose used for pretreatment. Incorporation of Cd into the liver and the kidney was not altered by the pretreatment. No matter in which form the nephrotoxic dose of Cd was administered, the incorporated Cd was distributed between particulates and cytosol; 3 hr after administration, cytosolic Cd was present in almost equal amounts in the high-molecular-weight and the MT fractions in the nonpretreated rats. However, after pretreatment, more of the Cd subsequently administered was found in the MT fraction. These results suggest that MT participates in the detoxication mechanism against Cd in the kidney, as it does in the liver. PMID- 3564046 TI - The absorption, tissue distribution and excretion of di-n-octyltin dichloride in rats. AB - In this study the absorption, tissue distribution and excretion of 14C-labeled di n-octyltin dichloride ([14C]DOTC) in rats were investigated after oral and intravenous (i.v.) administration. Although after i.v. administration with 1.2 mg [14C]DOTC/kg body weight the tissue radioactivity was about 3-4 times higher than after oral administration with 6.3 mg [14C]DOTC/kg body weight, the relative tissue accumulation was found to be the same after the oral and i.v. dosage. The highest amount of radioactivity was found in liver and kidney, and to a lesser degree in adrenal, pituitary and thyroid glands. The lowest activity was recovered from blood and brain. No selective accumulation was observed in thymus, although it has been reported that thymus atrophy is the most sensitive parameter of DOTC toxicity in rats. For all tissues a time dependent decrease in radioactivity was found, except for kidney. The excretion of radioactivity in feces and urine was determined after a single i.v. or oral dose of 1.2 and 2 mg [14C]DOTC, respectively. After i.v. administration most of the radioactivity was excreted in the feces which was characterized by a biphasic excretion pattern. In orally treated rats more than 80% of the radioactivity was already excreted in the feces during the first day after administration. This indicated that only a small part of the DOTC was absorbed, which was calculated to be approximately 20% of the dose. Similar half-life values of 8.3 and 8.9 days were obtained from the fecal excretion of radioactivity after the i.v. and oral administration, respectively. The urinary excretion of radioactivity appeared to be independent of the body burden, since the daily amount of radioactivity excreted in urine was nearly the same independent of the route of administration as well as the time after administration. PMID- 3564047 TI - Acute biological effects of commercial cresyl diphenyl phosphate in rats. AB - A commercial cresyl diphenyl phosphate preparation was analyzed to contain approximately 35% of triphenyl phosphate, 45% of cresyl diphenyl phosphates, 18% of dicresyl phenyl phosphates and 2% of tricresyl phosphates. The product was almost free of the o-cresyl isomers as revealed by the analysis of its alkaline hydrolysis products. A single intraperitoneal injection (150 or 300 mg/kg) caused an induction of microsomal cytochrome P-450 in the liver of Wistar rats with a concomitant increase in the activities of mixed function monooxygenases and proliferation of smooth endoplasmic reticulum 24 h after the treatment. These effects were not detected in the kidneys. The morphological changes in hepatocytes included the enlargement of nuclei and mitochondria with increased cristae. The hepatic morphology returned to normal 2 weeks after the treatment. The activity of pseudocholine esterase in blood was inhibited 4 h and 24 h after the injection but the effect levelled off. The concentration of the organophosphates in blood and liver decreased rapidly with only traces detected in blood after 24 h. No effects on the activities of cerebral and muscle acetylcholine esterase were observed. The treatment (300 mg/kg) inhibited the brain--2',3'-cyclic nucleotide 3'-phosphohydrolase through the 2-week observation period associated with demyelination in peripheral nerves. PMID- 3564048 TI - Interaction of piperine with rat liver microsomes. AB - Pretreatment of adult male albino rats with piperine did not induce cytochrome P 450 whereas safrole did cause such induction. Piperine and safrole interacted with different forms of cytochrome P-450 as indicated by their in vivo effect on drug metabolising enzymes and mixed function oxidases and electrophoretic patterns. Incubation of piperine or safrole with dithionite- or NADPH-reduced microsomes from untreated rats resulted in a modified type II difference spectrum with an absorption maximum at 427 nm and a trough at 408 nm. PMID- 3564049 TI - Metabolic disposition of piperine in the rat. AB - After oral administration of piperine (170 mg/kg) to rats, the metabolites in bile and urine were examined by thin-layer chromatography, high-performance liquid chromatography and combined gas chromatography-mass spectrometry. Four metabolites of piperine, viz. piperonylic acid, piperonyl alcohol, piperonal and vanillic acid were identified in the free form in 0-96 h urine whereas only piperic acid was detected in 0-6 h bile. Based on these results, a pathway for the biotransformation of piperine in rats is proposed. PMID- 3564050 TI - Cisplatin nephrotoxicity: role of filtration and tubular transport of cisplatin in isolated perfused kidneys. AB - Isolated perfused rat kidneys were used to determine the contribution of filtration and tubular transport of cisplatin to its nephrotoxicity. Perfusion of kidneys with 0.5 mM cisplatin concomitantly reduced tubular reabsorption of electrolytes and glomerular filtration rate in a time-dependent manner. These renal functional changes were similar to those obtained following in vivo cisplatin treatment (10 mg/kg). In vitro exposure to cisplatin reduced the renal clearance of organic ions without reducing renal perfusate flow, suggesting that renal hemodynamic changes do not mediate cisplatin-induced proximal tubular dysfunction. Inhibition of organic ion transport also was observed in non filtering perfused kidneys treated with 0.5 mM cisplatin, implying that filtration of cisplatin is not a prerequisite for induction of toxicity. These data also suggest that cisplatin transport from a basolateral site may be important in the development of acute nephrotoxicity. PMID- 3564051 TI - Glutathione peroxidase and glutathione transferase activity in rat lung and liver following cadmium inhalation. AB - A 2-h inhalation exposure to 4.6 mg Cd/m3 decreased pulmonary total glutathione peroxidase (GSH Px) activity and non-selenium peroxidase (GSH non-Se-Px) activity but had no effect on GSH selenium peroxidase (Se-Px) activity. Seventy-two hours after exposure there was an increase in total GSH Px and GSH Se-Px activity and a decrease in GSH non-Se-Px activity. Exposure to 0.44 mg Cd/m3 for 2 h caused no effect on GSH Se-Px at either 0 or 72 h post exposure, but total GSH Px and GSH non-Se-Px activities were decreased up to 72 h post exposure. Exposure to 4.6 mg Cd/m3 caused an increase in hepatic GSH Se-Px activity 72 h post exposure, but no other significant changes were observed in the liver. Changes in GSH non-Se-Px activity did not relate to changes in GSH transferase (Tr) activity. The data suggest that alterations in GSH Px activity by Cd2+ may be due to changes in GSH non-Se-Px activity and that changes in pulmonary GSH Tr and GSH non-Se-Px activities may not be as closely linked as in the liver. PMID- 3564052 TI - The effect of probenecid on acute N-(3,5-dichlorophenyl)succinimide-induced nephrotoxicity in the Fischer 344 rat. AB - N-(3,5-Dichlorophenyl)succinimide (NDPS), an experimental agricultural fungicide, has been shown to produce selective nephrotoxicity in rats. Previous studies have shown that a metabolite(s) of extrarenal origin contributes to acute NDPS-induced nephrotoxicity. The purpose of this study was to determine if the organic acid transport inhibitor probenecid could modify the renal toxicity produced by NDPS administration. Male Fischer 344 rats were administered a single intraperitoneal (i.p.) injection of probenecid (60, 90 and 120 mg/kg) or 0.9% saline (1.0 ml/kg) followed 30 min later by NDPS (0.4 or 1.0 mmol/kg, i.p.) or sesame oil (2.5 ml/kg, i.p.) Renal function was monitored at 24 h and 48 h. Probenecid (60 mg/kg) did not markedly alter NDPS-induced renal effects on either post-treatment day. However, pretreatment with probenecid (90 or 120 mg/kg) blocked or attenuated the diuresis, increased proteinuria, decreased tetraethylammonium (TEA), uptake, elevation in blood urea nitrogen (BUN) concentration and increased kidney weight produced by NDPS (0.4 mmol/kg) administration. Only increased kidney weight and BUN concentration, and decreased lactate-stimulated p-aminohippurate (PAH) uptake were altered by probenecid (120 mg/kg) pretreatment when NDPS (1.0 mmol/kg) was given. NDPS-induced changes in renal morphology were not prevented by pretreatment with any probenecid dose. These results suggest that at least one nephrotoxic metabolite of NDPS is an organic acid. However, this acidic metabolite might not be the major nephrotoxic metabolite or a precursor to the major nephrotoxic metabolite(s). The identity of these metabolites remains to be determined. PMID- 3564053 TI - Effects of cadmium in rat hepatocytes: interaction with aluminum. AB - The influence of aluminium (Al) chloride on toxic responses to cadmium (Cd) chloride of hepatocytes isolated from fed rats were investigated. Hepatocytes exposed to 50-200 microM Al took up the Al-ion more efficiently when the cells were simultaneously incubated with 50 microM Cd for 60 min. Aluminium (50-200 microM) could not prevent the release of about 50% of lactate dehydrogenase (LDH) from cells due to 50 microM Cd. Aluminium itself increased LDH leakage only to a moderate extent, indicating the low toxicity of Al to hepatocytes. Cadmium diminished the total hepatocellular thiols (protein + non-protein) and, even more pronounced, the acid soluble thiols after 60 min of incubation. However, this response to Cd was inhibited by simultaneous exposure to 50-200 microM Al in an Al concentration-dependent manner. Concomitantly, the Cd-dependent lipid peroxidation (LPO; measured as thiobarbituric acid reactants) at 60 min was decreased by Al, which itself did not enhance basal LPO in hepatocytes. These data show that Al partly protects hepatocytes from Cd-induced depletion of acid soluble thiols (i.e. reduced glutathione) and from stimulation of LPO. However, Al did not prevent the Cd-induced damage of the cell membrane. PMID- 3564054 TI - Uptake and distribution of aluminium in rat hepatocytes and its effect on enzyme leakage and lactate formation. AB - Aluminium (Al) chloride (10-200 microM) increased the Al content in hepatocytes isolated from fed male rats in a time- and concentration-dependent manner. After 60 min of incubation with 100 microM Al about 45% of cellular Al was found each in the mitochondrial and the postmitochondrial fraction of hepatocytes, whereas about 5% of Al sedimented with nuclei and cell debris. Concomitantly, the leakage of lactate dehydrogenase (LDH), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased in the presence of Al time- and concentration dependently, but only to a moderate extent. Aluminium (10-200 microM) also accelerated the formation of lactate by hepatocytes. No significant differences were found in Al uptake and distribution and its effect on LDH leakage and lactate formation when the metal ion was given as AlCl3, Al(NO3)3 or Al(lactate)3. Al concentrations (AlCl3) exceeding 250 microM severely disturbed the determination of LDH, AST and lactate in a cell free system. The data suggest only a moderate toxicity of Al compounds to isolated hepatocytes, when given in amounts approximating (patho)physiological conditions. PMID- 3564055 TI - Effect of prolonged administration of clofibric acid and di-(2 ethylhexyl)phthalate on hepatic enzyme activities and lipid peroxidation in the rat. AB - Male Sprague-Dawley rats were fed diets containing either 0.5% clofibric acid (CA) or 2% di-(2-ethylhexyl)phthalate (DEHP) for 2 years. Both compounds produced liver enlargement which was accompanied by the formation of liver nodules. Hepatic peroxisomal and microsomal fatty acid oxidising enzyme activities were induced in both large nodules and host tissue (i.e. tissue remaining after removal of large nodules) preparations from CA and DEHP treated rats. In contrast, little change in catalase activity was observed and the activities of cytosolic GSH peroxidase and GSH S-transferases were markedly reduced. Increased lipid peroxidation was observed by measurement of conjugated dienes in host tissue homogenates from CA and DEHP treated rats. Microsomal NADPH-dependent lipid peroxidation was also stimulated. Histological examination revealed extensive lipofuscin deposition in non-nodular, but not in nodular, tissue sections from treated rats. These results demonstrate that prolonged peroxisome proliferation can result in lipid peroxidation and that certain enzymes which metabolise hydrogen peroxide and organic hydroperoxides are either little affected or markedly inhibited. PMID- 3564056 TI - In vivo and in vitro hepatotoxicity and metabolism of acetaminophen in Syrian hamsters. AB - The purpose of this investigation was to correlate the in vitro and in vivo toxicity of the hepatotoxicant, acetaminophen. Hamsters were pretreated with either phenobarbital (70 mg/kg) or 3-methylcholanthrene (20 mg/kg) or an appropriate vehicle for 3 days. In non-pretreated hamsters, single doses of acetaminophen (200-400 mg/kg i.p.) caused elevations in serum alanine aminotransferase and sorbitol dehydrogenase activities in a dose-related manner. 3-Methylcholanthrene significantly potentiated, while phenobarbital significantly reduced acetaminophen-induced elevations in serum liver enzyme activities. Both phenobarbital and 3-methylcholanthrene significantly reduced acetaminophen plasma T1/2 while only 3-methylcholanthrene increased APAP clearance. Phenobarbital pretreatment increased the urinary excretion of APAP-glucuronide. Exposure of isolated hepatocytes to acetaminophen (0.01-2.0 mM) resulted in concentration related decreases in hepatocyte viability. Cells from 3-methylcholanthrene pretreated hamsters were more markedly susceptible to acetaminophen toxicity than cells isolated from non-induced animals. Hepatocytes isolated from phenobarbitol pretreated animals were slightly but significantly more susceptible to acetaminophen toxicity than cells from control animals. Hepatocytes isolated from 3-methylcholanthrene pretreated animals had increased formation of an acetaminophen-glutathione conjugate compared to control. Pre-treatment with either phenobarbital or 3-methylcholanthrene enhanced glucuronidation of acetaminophen in vitro. These data demonstrate a lack of correlation between in vivo hepatotoxicity and in vitro cytotoxicity in that phenobarbital pre-treatment protected hamsters from acetaminophen-induced liver toxicity, but failed to protect hepatocytes exposed to acetaminophen in vitro. PMID- 3564057 TI - Coagulant component in Cerastes cerastes (Egyptian sand viper) venom. AB - A coagulant component has been purified from Cerastes cerastes venom, using gel filtration on a Sephadex G 100 (fine) column followed by chromatography on a Bio Rex 70 column. This compound had a proteolytic effect and could coagulate human plasma deficient in factor VIII or (VIII + IX) with the formation of a firm clot. It could also clot plasma deficient in factor X, but the clot formed was soft and not complete. The compound had no effect on platelet aggregation and was nontoxic. This compound is believed to be primarily a factor X activator, as it could replace factor VIII in hemophilic plasmas. PMID- 3564058 TI - Botulinum A neurotoxin unlike tetanus toxin acts via a neuraminidase sensitive structure. AB - The binding and effects of tetanus and botulinum A neurotoxins were studied on mouse spinal cord cultures treated with neuraminidase. In untreated cultures both neurotoxins blocked synaptic transmission. Treatment of the cell cultures with neuraminidase, 25 mU/ml for 24 hr, decreased the potency of botulinum A neurotoxin. At 7 X 10(-11) M no toxin effect on inhibitory or excitatory synapses was observed, whereas at higher concentrations of the toxin the concentration response curve was shifted to the right by a factor of about 30. Surprisingly, the action of tetanus toxin over a large concentration range was unaffected by pretreatment of the neurones with the enzyme. Accordingly, neurones treated with neuraminidase failed to bind 125I-botulinum A neurotoxin, whereas labelled tetanus toxin was still fixed by cell bodies, as well as by neurites, as shown by histoautoradiography. Chromatographic extraction of gangliosides from cultures prelabelled with 14C-glucosamine showed a dramatic loss in the contents of polysialogangliosides following treatment with neuraminidase. Our results indicate that neuraminidase-sensitive structures might be important for the action of botulinum A neurotoxin. The effect of tetanus toxin appears to be mediated by a different site which is insensitive to neuraminidase. PMID- 3564059 TI - Isolation and spectral characteristics of four toxins from the dinoflagellate Ptychodiscus brevis. AB - Four ichthyotoxins were isolated from crude toxic extracts of Ptychodiscus brevis using a combination of solvent partitioning, thin layer chromatography and reversed phase high pressure liquid chromatography. The toxins were analyzed by mass, infrared, 1H- and 13C-NMR spectroscopy and were found to constitute two structural families of two toxins each: brevetoxins 1 and 2 and brevetoxins 3 and 4. Comparison with literature data indicates that brevetoxins 1 and 2 are identical to the previously described and characterized 11-ring polyether toxins brevetoxins C and B, respectively. The other two compounds (brevetoxins 3 and 4) also represent a structural pair (with chloroacetone and alpha-methylene-propanal side chains, respectively) which has a different, but related, basic ring structure. PMID- 3564061 TI - Large scale purification of toxins from the venom of the scorpion Androctonus australis Hector. AB - A large scale procedure for purification of the toxins in the venom of the North African scorpion Androctonus australis has been developed. This procedure optimizes the sequence of the steps, leading to better yields of toxins and shortening of the time. It is possible to use 10-15 g batches of venom and also prevent cross-contamination of the toxins. High pressure liquid chromatography has been used to separate AaH I and I', two isotoxins which differ by one amino acid residue in position 17: valine or isoleucine. The procedure allows the characterization of a new toxin active in mice, AaH IV, which represents 0.6 and 2.5% of the venom weight and toxicity, respectively. This new component has been characterized as an alpha toxin made up of 61 amino acid residues and having a neutral isoelectric point. PMID- 3564060 TI - Comparison of amino terminal region of three isoenzymes of phospholipases A2 (TFV PL-Ia, TFV PL-Ib, TFV PL-X) from Trimeresurus flavoviridis (habu snake) venom and the complete amino acid sequence of the basic phospholipase, TFV PL-X. AB - Three phospholipases (PLA2s) isolated from Japanese habu snake (Trimeresurus flavoviridis) venom differ from each other in the physiological symptoms induced in animals. The amino acid compositions and amino terminal sequences of these isoenzymes have been compared. TFV PL-Ia and TFV PL-Ib resemble each other very closely, but TFV PL-X has a distinctly different amino acid composition and amino terminal region. The complete amino acid sequence of the basic PLA2, TFV PL-X, was determined by sequencing the four peptides obtained by the cleavage of Asp Pro bonds. The overlapping peptide was obtained by cleaving tryptophanyl bond and the carboxy terminal region was determined by sequencing the chymotryptic peptide. TFV PL-X consisted of a single chain of 122 amino acid residues, including 14 half-cystine residues. It is a group II A PLA2 and is homologous with the phospholipase super family. However, it has a distinctly different sequence compared with the other PLA2s from the venom of Trimeresurus species. PMID- 3564062 TI - Histopathological studies on experimental marine toxin poisoning. I. Ultrastructural changes in the small intestine and liver of suckling mice induced by dinophysistoxin-1 and pectenotoxin-1. AB - Sequential ultrastructural changes were studied in mouse digestive organs after i.p. injections of dinophysistoxin-1 and pectenotoxin-1, causative agents of diarrhetic shellfish poisoning. Dinophysistoxin-1, a diarrheagenic substance, produced severe mucosal injuries in the small intestine within 1 hr after the administration of the toxin. The injuries were divided into 3 consecutive stages: extravasation of villi vessels, degeneration of absorptive epithelium and desquamation of the degenerated epithelium from the lamina propria. In contrast to dinophysistoxin-1, pectenotoxin-1, a non-diarrheagenic toxin from diarrhetic shellfish poisoning causative mussels, resulted in no abnormalities in the small intestine, but did cause characteristic liver injuries. Within 1 hr after the injection of pectenotoxin-1 numerous non-fatty vacuoles appeared in the hepatocytes around the periportal regions of the hepatic lobules. Electron microscopic observations with colloidal iron demonstrated that these vacuoles originated from invaginated plasma membranes of the hepatocytes. PMID- 3564063 TI - A study of toxin production by Gambierdiscus toxicus in culture. AB - The dinoflagellate Gambierdiscus toxicus was cultivated under different environmental conditions. By an improved toxin extraction procedure the toxicity of methanol extracts was evaluated. Medium composition, temperature decrease, origin (clonal or not clonal) and culture age did not significantly modify toxin production. The discharge of trichocysts and the abundance of bacteria did not affect the toxicity of the dinoflagellate. The toxin yield of G. toxicus cultures was quite stable and a mean of 1100 cells were sufficient to kill one 20 g mouse within 24 hr. PMID- 3564064 TI - Evidence for the presence of histamine in Gaboon viper (Bitis gabonica) venom. AB - Venom from B. gabonica produced a dose-dependent contraction of both isolated guinea-pig ileum and rabbit aortic strip preparations. The venom-induced contraction was not antagonised by pretreatment with atropine, phentolamine, methysergide or indomethacin, however, it was blocked by the prior addition of chlorpheniramine or cyproheptadine. Upon exhaustive dialysis of the venom, the dialysate contracted both preparations, while the dialysed venom had no effect. Paper and thin-layer chromatography of the venom showed a spot with an Rf value corresponding to authentic histamine. Biological assay of the crude venom on the guinea-pig ileum showed that it contained the equivalent of 2-10 micrograms of histamine per mg dry weight of crude venom. pA2 values for chlorpheniramine using either the venom or histamine as agonists were not significantly different. PMID- 3564065 TI - Effects of Naja haje (Egyptian cobra), Naja naja (hooded cobra), Naja nigricollis (spitting cobra) and Naja mossambica mossambica (Mozambique spitting cobra) venoms on the isolated guinea-pig tracheal muscle. AB - Venoms from N. haje, N. naja, N. nigricollis and N. mossambica were tested on the isolated guinea-pig trachea. The four venoms (1-30 micrograms/ml) contracted the tracheal smooth muscle after a delay of 40-60 sec. A second challenge with the venoms caused either no or a much reduced contraction or a relaxant effect. The contraction could be prevented by pretreatment with antihistaminics, but not by atropine, methysergide or indomethacin, indicating that it is due to histamine release by the venoms. This release requires extracellular Ca2+, as it could be prevented by pretreatment with verapamil. Under conditions which prevented histamine release or its effect, each of the four venoms resulted in a reproducible relaxant effect which was not blocked by propranolol. It is concluded that the venoms have one or more component(s) causing histamine release which masks the relaxation caused by another component(s) of the venoms. PMID- 3564066 TI - The origin of snakes and evolution of the venom apparatus. PMID- 3564067 TI - Safety evaluation of Streptomyces murinus glucose isomerase. AB - A glucose isomerase enzyme, obtained from Streptomyces murinus, was produced by a fermentation process and subjected to a series of tests to investigate its safety in use and manufacture. It was not mutagenic (Ames test, using liquid culture) nor did it provoke chromosomal damage (rat bone marrow cytogenetics test). It did not contain (nor did the organism produce) antimicrobial activity or macrolidpolyene antibiotics. It had no teratogenic activity when administered to pregnant rats at 100,000 ppm in the diet. It was without effect upon rats when administered at this dietary concentration for 4 weeks. Dietary administration at 5000, 15,000 or 50,000 ppm to rats for 13 weeks resulted in nephrocalcinosis in females at all dosages (probably a physiological response to the altered calcium:phosphate ratio in the admixed diet) and status spongiosus in the brains of males receiving 50,000 ppm. As the finding of nephrocalcinosis in rats is generally agreed to be of no toxicological importance with regard to the use in man, the dietary concentration of 15,000 ppm was considered to be highest no effect level. This level corresponds to an intake of some 1000 mg/kg/day, which represents approximately 8000 times the human intake based on a conservative estimation. PMID- 3564068 TI - Age-related susceptibility to dibromochloropropane. AB - To compare the acute toxic responses of weanling and adult rats to dibromochloropropane (DBCP), male 4- and 9-week-old rats were given subcutaneously 250 mg/kg DBCP. As compared to 4-week-old rats, 9-week-old rats showed higher mortality, more progressive weight loss and severer tissue injuries in the testis, kidney, intestine and lymphoid organs. These results indicated that weanling rats were less susceptible to DBCP toxicity. PMID- 3564069 TI - Induction of hepatic oxidative and conjugative drug metabolism in the hamster by N-substituted imidazoles. AB - Three antimycotic N-substituted imidazoles, clotrimazole, tioconazole and miconazole, were able to induce hepatic microsomal cytochrome P-450 and monooxygenase reactions in both male and female hamsters to an extent similar to that seen with phenobarbital treatment. Imidazole treatment did not alter the cytochrome P-450 concentration, and ketoconazole treatment decreased it. Cytosolic sulfo- and glutathione transferases were not significantly altered by any imidazole. Induction of microsomal morphine glucuronosyltransferase activity by each compound generally paralleled the effect on cytochrome P-450 in females but induction was not evident in males. Clotrimazole treatment, in contrast to phenobarbital treatment, also caused a large induction of l-naphthol glucuronosyltransferase in females. The potential for antimycotic imidazoles to alter the hepatotoxicity of compounds will require consideration of the inductive changes in both Phase I and Phase II drug metabolizing enzymes in addition to their known inhibitory effects on Phase I oxidations. The inductive effects differ for each imidazole, and in the hamster model, depend upon the sex of the animal. PMID- 3564070 TI - Effect of trimethyltin on ornithine decarboxylase in various regions of the mouse brain. AB - Male C57B1/6N mice, 8-10 weeks old were given a single oral dose of 0, 1.0 or 3.0 mg/kg body weight of trimethyltin hydroxide (TMT). Levels of ornithine decarboxylase (ODC) activity were measured in several brain areas, 1, 2 and 7 days later. The lower dose of TMT produced a decrease of ODC in the caudate nucleus and hippocampus at all time points studied. Hypothalamus, cerebellum and brain stem levels of this enzyme were unaltered. At the higher dose of TMT, ODC activity in hippocampus, cerebellum and brain stem were increased relative to controls at 1 and 2 days after treatment, while other regions were not significantly affected. These elevated ODC levels returned to control values within 7 days. Thus, trimethyltin treatment causes changes in ODC activity in a region and dose-specific manner. PMID- 3564071 TI - Effect of disulfiram on milk transfer and tissue distribution of lead in the neonatal rat. AB - The effect of disulfiram (tetraethylthiuram disulphide) on uptake and tissue distribution of 203Pb was studied in neonatal rats exposed to lead via dams' milk. In the dams, treatment with disulfiram greatly increased the 203Pb concentration in brain and liver and decreased 203Pb concentration in plasma and erythrocytes, as compared to controls given only 203Pb. However, in the pups of disulfiram-treated dams total uptake of 203Pb was reduced by 50% and the concentration of 203Pb in brain and liver was significantly reduced. Consistent with these findings, the level of 203Pb in the maternal milk was lower in the disulfiram-treated dams compared to controls. It is suggested, that the lower lactational transfer and uptake of lead in the neonatal rat after treatment of the dams with disulfiram is due to retention and strong binding of lead to tissue components in the dams after formation of a lead-dithiocarbamate complex. PMID- 3564073 TI - The use of N-acetylcysteine long after an acetaminophen overdose in mice. AB - N-Acetylcysteine (NAC), given to mice 5 h after an LD50 dose of acetaminophen, decreased 24-h survival to 33%. The reduction in survival observed for late NAC is significantly lower than the survival observed for the LD50 dose alone (53%), and is in sharp contrast to the 100% survival reported for the early use of NAC. PMID- 3564072 TI - Haematological abnormalities induced by feeding a common artificial sweetener, saccharin, in ICR Swiss mice. AB - Haematological studies were carried out to investigate the possible deleterious effects of an extensively used artificial sweetener, saccharin, on albino mice, after feeding it for 1 year at the rate of 0.0 (control), 0.5, 1.0 and 1.5 g/kg body weight/day. Feeding of the chemical at 1.0 and 1.5 g/kg/day revealed a marked decrease in total erythrocyte count (TEC), haemoglobin content (Hb) and packed cell volume (PCV), suggesting the occurrence of anaemia. Differential leucocyte count (DLC) showed a marked increase in the number of polymorphonuclear neutrophils. Saccharin toxicity, in terms of induction of haematological abnormalities in albino mice, is discussed. PMID- 3564074 TI - Pharmacokinetics of isoprene in mice and rats. AB - Pharmacokinetic analysis of isoprene inhaled by male Wistar rats and male B6C3F1 mice showed saturation kinetics in both species. Below atmospheric concentrations of 300 ppm in rats and in mice the rate of metabolism is directly proportional to the concentration. The low accumulation of isoprene in the body at low atmospheric concentrations suggests transport limitation of the metabolism. Only small amounts of isoprene taken up are exhaled as unchanged substance (15% in rats and 25% in mice). Its half life in rats is 6.8 min and in mice 4.4 min. At concentrations above 300 ppm the rate of metabolism does not increase further in proportion to the atmospheric concentration. It finally approaches maximal values of 130 mumol/(h X kg) body weight at atmospheric concentrations above 1500 ppm in rats, and 400 mumol/(h X kg) body weight at concentrations above 2000 ppm in mice. This indicates limited production of the two possible mono-epoxides of isoprene at high concentrations. Isoprene is endogenously produced and is systemically available. Its production rate is 1.9 mumol/(h X kg) in rats, and 0.4 mumol/(h X kg) in mice, respectively. Part of the endogenous isoprene is exhaled by the animals but it is metabolized to a greater extent: the rate of metabolism of endogenously produced and systemically available isoprene is 1.6 mumol/(h X kg) (rats) and 0.3 mumol/(h X kg) (mice). PMID- 3564075 TI - Effects of cytochalasin E on H+ and volume secretion in gastric fistula rats. AB - Effects of cytochalasin E on the secretion of H+ and volume of gastric juice were investigated in gastric fistula rats. Direct exposure of the gastric mucosa to cytochalasin E (5-20 micrograms/ml) inhibited H+ secretory rate in all of the pentagastrin-, histamine- as well as non-stimulated rats but it did not affect the secretory volume of gastric juice. The inhibitory action of cytochalasin E on H+ secretion had a rapid onset and showed a dose-dependent pattern. The mechanism of inhibitory action was not related to its interaction with plasma membrane receptors or membrane enzyme, K+-stimulated ATPase. Interference with cellular energy production as well as alteration of microfilament function, which are essential for H+ production and secretion respectively, are likely to be the bases of the cytochalasin inhibition. PMID- 3564078 TI - A practical evaluation of accuracy with the standard deviation index (SDI) chart method. Second report. Report covering the period from April 1980 to March 1983. AB - To evaluate the accuracy of laboratory data for 18 items determined with an Technicon SMAC (Sequential Multiple Analyzer Computer), the SDI chart method was used in investigating the data according to five kinds of control survey programs from April 1980 to March 1983. The results can be summarized as follows: Inorganic phosphorus showed a gradual downward shift, arriving at the minus side of SDI in all control surveys. Potassium showed a particularly large fluctuation as was the case in the previous evaluation. The other items were relatively stable (i.e., showed less fluctuation), although many of them showed an upward shift. Some of the control survey programs yielded biased evaluation results. Thus, the SDI chart method proved to allow, as one of the external quality control techniques, observation of long-term, slight changes without necessitating any complicated calculation. Furthermore, it was confirmed that this is a practically useful method of accuracy evaluation because it allows overall evaluation of the data from various control survey programs on the same graph. PMID- 3564077 TI - Inverse effects of colchicine on the induction of long microvillous-like processes by cytochalasin B in cultured chick embryonic duodena. AB - Previously, the author reported that long microvillous-like processes (long processes) containing core actin filaments seemed to be related to the formation of previllous ridges in the chick embryonic duodenum and that similar long processes were induced by cytochalasin B (CB) treatment. The appearance of long processes by CB (polymerization of core actin filaments) seemed to be related to the ability of cell proliferation. In this study, the effect of colchicine on the induction of long processes by CB was examined in 11-day-old chick embryonic duodena in the culture system. The results were as follows: The induction of long processes by CB was inversely influenced by the concentration of colchicine; the appearance of long processes by CB was differently influenced by local parts of the epithelial cells in the presence of colchicine; and alteration of the arrangement of intracellular actin elicited by CB and colchicine was confirmed by immunohistochemistory using actin antiserum. It was also suggested that sudden intracellular alterations elicited by higher concentrations of colchicine may act as a trigger of cell division differing from normal conditions. PMID- 3564079 TI - Delta check system for detection and further management of laboratory errors. First report. Graphical presentation of results. AB - The delta check system is effective for detecting errors that may occur during the whole course of tests, from the time a laboratory test is ordered until it is interpreted. This system detects errors that exceed the preestablished values by comparing present data with the most adjacent ones in all items for each case. Graphical presentation of delta-checked data led to easier judgment as to whether such a difference is due to erroneous testing or changes in the patient's condition on the basis of whether a difference in values is limited to a particular item or is common to pathologically associated multiple ones. Furthermore, since test items were classified by analytical instruments, it became easier for us to determine at which process of the testing an error occurred. This report gives the present status of utilization of delta check system in our laboratory. PMID- 3564076 TI - An adult case of Fanconi's syndrome associated with membranous nephropathy. AB - An adult case of Fanconi's syndrome associated with membranous nephropathy is described. Renal biopsy specimens revealed typical features of membranous nephropathy associated with severe tubulo-interstitial changes in light microscopy, electron microscopy and immunofluorescent microscopy. The nephrotic syndrome due to membranous nephropathy was observed at the time of definite diagnosis of Fanconi's syndrome in this patient. It is suggested that renal tubular injuries in some patients with membranous nephropathy might be an important factor in the pathogenesis and/or development of Fanconi's syndrome. PMID- 3564080 TI - Changes in the contrast sensitivity of an amblyopic eye after losing the other normal eye. AB - A man aged 17 had an amblyopic left eye with central fixation and lost his normal right eye by an accident. After the accident, spontaneous improvement of the visual acuity of the amblyopic left eye was rapid. Just after the accident, overall contrast sensitivity of the left eye was considerably less than that of a normal adult. Improvement of the contrast sensitivity was recorded first at low spatial frequencies and then at high spatial frequencies. However, the contrast sensitivity at medium spatial frequencies remained less than that of a normal adult. These results suggest that lateral inhibitory processes may be relatively undeveloped or receptive fields do not develop to be as small as those of normal adults. PMID- 3564081 TI - Blood levels and distribution of talampicillin and bacampicillin in NZW rabbits. AB - Parameters for blood concentrations of the peroral antibiotics talampicil in and bacampicillin, in NZW rabbits were determined using a two compartment model. On the basis of these pharmacokinetic parameters, a three compartment model was prepared for the concentrations of these drugs in the tongue, gingiva, submandibular gland, parotid gland, cervical lymph-node and mandibular bone. Simulation curves based on the parameters of tissue concentrations revealed visual conformity to the measured values. PMID- 3564082 TI - Effect of membrane lipid environment on the activity of bovine adrenal 3-oxo delta 5-steroid isomerase. AB - The 3-oxo-delta 5-steroid isomerase (EC 5.3.3.1) activity from bovine adrenal cortex microsomes can be extracted in soluble form by the use of appropriate detergents, although recovery of enzyme activity is low (ca. 2%). Activity is restored upon removal of detergent and reconstitution of the enzyme into phospholipid vesicles. Both Km and Vmax of 3-oxo-delta 5-steroid isomerase of intact microsomes increase as the pH is raised from 7.5 to 9.5, with a particularly sharp increase (6- to 8-fold) above pH 8.5. The kinetic parameters of a detergent-solubilized isomerase preparation show little increase from pH 7.5 to 9.0, but isomerase reconstituted into artificial phospholipid vesicles demonstrates a 6- to 10-fold increase in both Km and Vmax over this pH range. Addition of Ca++ (1 mM) enhances the pH dependence of both Km and Vmax of the membrane-bound isomerase, causing a slight rise in Vmax/Km. PMID- 3564083 TI - Stereochemical course of the hydroboration of highly hindered steroidal olefins. A ready synthesis of 14 beta- and 8 alpha,14 beta-steroids. AB - Hydroboration of 5 alpha-cholest-8-ene, 5 alpha,14 beta-cholest-8-ene and 5 alpha,14 beta-cholest-7-ene provides a simple route to oxygenated steroids with 14 beta- and 8 alpha,14 beta- unnatural stereochemistry. PMID- 3564084 TI - Binding of (3H)7 alpha,17 alpha-dimethyl-19-nortestosterone (mibolerone) to progesterone receptors: comparison with binding of (3H)R5020 and (3H)ORG2058. AB - The binding characteristics of (3H)7 alpha,17 alpha-dimethyl-19-nortestosterone [3H)DMNT) to progesterone receptors (PgR) of calf uterine tissue cytosol were determined and compared to those of the synthetic progestins (3H)ORG2058 and (3H)R5020. Scatchard plot analysis of the equilibrium binding data showed that (3H)DMNT binds to calf uterine PgR with a KD of 2.35 +/- 1.1 nM. This value is slightly higher than that of (3H)R5020 (KD = 1.16 +/- 0.4 nM) and (3H)ORG2058 (KD = 1.04 +/- 0.65 nM). Analysis of dissociation kinetics showed that (3H)DMNT dissociates much more rapidly from the receptor than the other two ligands. Competition experiments showed that ORG2058 has a lower inhibition constant (Ki) than DMNT. Sucrose density gradient (SDG) analysis of PgR showed that (3H)ORG2058 PgR complexes sediment as 8S, (3H)R5020-PgR complexes sediment as 8S and 4S, and (3H)DMNT-PgR complexes sediment as 8S entities along with dissociated (3H)steroid. These data suggest that (3H)DMNT binds to PgR with lower affinity than (3H)ORG2058 and (3H)R5020. The number of binding sites detected with (3H)DMNT are significantly lower than those measured with (3H)ORG2058. PMID- 3564085 TI - Identification and quantification of 6 beta-hydroxydexamethasone as a major urinary metabolite of dexamethasone in man. AB - Identification of 6 beta-hydroxydexamethasone as a major urinary metabolite of dexamethasone in man has been accomplished by nuclear magnetic resonance spectroscopy and gas chromatography-mass spectrometry. Mass fragmentographic measurements revealed that more than 30% of the intravenously or orally administered dexamethasone dose was excreted in the 24-h urine as 6 beta hydroxydexamethasone, while only a small fraction of the dose was excreted as unchanged dexamethasone and its glucuronic acid conjugate. PMID- 3564086 TI - Binding of 5 alpha-dihydroprogesterone and other progestins to female rat anterior pituitary nuclear extracts. AB - The specific binding of 5 alpha-dihydroprogesterone (5 alpha-DHP), progesterone and R5020 to anterior pituitary nuclear extracts was studied using ovariectomized rats treated with estradiol benzoate and progesterone. The binding equilibrium association constant for 5 alpha-dihydroprogesterone with different preparations of nuclear extract ranged from 4.0 +/- 0.54 microM-1 to 59 +/- 10 microM-1. The association constants for progesterone and R5020 were 0.39 +/- 0.81 nM-1 and 1.5 +/- 0.15 nM-1, respectively. The binding of 5 alpha-DHP was specific in that it could be competed only by R5020, progesterone and 5 alpha-DHP and not by other progesterone metabolites and other hormonal steroids tested. With [3H] progesterone and [3H]R5020 as ligands the most efficient competitors also were R5020, progesterone and 5 alpha-DHP. Estrogen priming of ovariectomized rats consistently and significantly increased the number of binding sites for all three progestins and subsequent progesterone treatment enabled their detection at higher levels in the nuclei. PMID- 3564087 TI - Synthesis of 18,19-dihydroxycorticosterone. AB - A four-step synthesis of 18,19-dihydroxycorticosterone 5c, starting with 19,21 dihydroxy-3,20-dioxopregn-5-ene-18,11 beta-lactone-di-(ethylene ketal) 2, is presented. Reduction of 2 with sodium aluminum bis-(methoxyethoxy)hydride gave 11 beta,18,19,21-tetrahydroxy-pregn-5-ene-3,20-dione-di-(ethylene ketal) 3a. Acetylation furnished the corresponding 18,19,21-triacetate 3b, which on treatment with a mixture of perchloric and acetic acids gave 18,19 dihydroxycorticosterone 18,19,21-triacetate 4b. Mild saponification yielded the title compound which, on the basis of ir and nmr spectra, exists as one C-20 isomer of the hemiacetal structure 5c. Periodate oxidation of 5c gave the expected 11 beta, 19-dihydroxy-3-oxoandrost-4-ene-17 beta, 18-carbolactone 6b. PMID- 3564088 TI - Identification of 17 alpha,20 beta,21-trihydroxy-4-pregnen-3-one as the major ovarian steroid produced by the teleost Micropogonias undulatus during final oocyte maturation. AB - This study describes the identification of 17 alpha,20 beta, 21-trihydroxy-4 pregnen-3-one (20 beta-dihydro-11-deoxycortisol, 20 beta-S) as a major steroid product of the ovary of Atlantic croaker (Micropogonias undulatus) incubated in vitro. This is the first report which describes 17 alpha,20 beta,21-trihydroxy-4 pregnen-3-one as a major product of teleost steroidogenic tissue. The steroid was identified by a variety of methods, including HPLC, TLC, GC-MS, UV absorbance, and reactions with specific enzymes. Full grown oocytes, prior to final oocyte maturation (FOM), accumulated only small amounts of 20 beta-S. However, a substantial increase in 20 beta-S production occurred at the time of FOM. These results suggest that 20 beta-S is a maturational steroid in this species. PMID- 3564089 TI - Additional predisposing risk factors for atherothrombotic cerebrovascular disease among treated hypertensive volunteers. AB - A 7-year prospective study of a cohort of 107 neurologically normal elderly hypertensive volunteers (mean age, 65.8 +/- 8.3 years) was undertaken to investigate the predictive validities of additional risk factors for atherothrombotic cerebrovascular disease including stroke, transient ischemic attacks, reversible ischemic neurological deficits, and multi-infarct dementia. This longitudinal study has been in progress now for 7 years with a mean follow up interval of 50.12 +/- 5.76 months. Among 107 formerly symptom-free, normal hypertensive volunteers, 25 (23%) have developed cerebrovascular disease, 7 (6.5%) sustained a stroke, 10 (9.3%) developed multi-infarct dementia, and 18 (16.8%) have transient ischemic attacks. None have suffered intracranial hemorrhage. Mean gray matter cerebral blood flow (CBF) values measured at the initial visit were sensitive predictors of cerebrovascular disease. Eight of 16 hypertensives (50%) with initial CBF values below 60.0 ml/100 g/min now exhibit signs and symptoms of cerebrovascular disease, while 11 of 43 hypertensives (25.6%) with initial CBF values between 60.1 and 69.9 ml/100 g/min and only 6 of 48 (12.5%) with initial CBF levels above 70.0 developed cerebrovascular disease. Incidence of cerebrovascular disease among cigarette smoking hypertensive volunteers (32.5%) was significantly greater than among nonsmokers (17.2%). PMID- 3564090 TI - NMR-neuropathologic correlation in stroke. AB - True, three-dimensional proton nuclear magnetic resonance imaging at 0.147 tesla was performed postmortem on 2 patients embodying various stroke syndromes, including chronic (4 and 15 years) infarction, subacute (within 1 week) bland infarction, acute (2 days) hemorrhagic infarction, and hematoma secondary to ruptured aneurysm. A third patient, with subcortical arteriosclerotic encephalopathy, so-called Binswanger's disease, was examined antemortem using a 0.6 tesla scanner. Nuclear magnetic resonance images were reconstructed at levels matching the pathologic specimens. Qualitative and, when available, quantitative comparisons between the results of nuclear magnetic resonance imaging and pathology were carried out. Areas of qualitatively prolonged T1 and T2 relaxation times on nuclear magnetic resonance imaging were more extensive than the corresponding areas of chronic infarction noted pathologically and were determined to be infarcts plus the adjacent areas of Wallerian degeneration. Hemorrhagic infarction, without evidence of blood on computed tomography, was found to have mildly prolonged T1 and T2 relaxation times, between those of normal brain and chronic infarction; a 10-day-old hematoma had a very short T1, slightly shorter than that of white matter, and a mildly prolonged T2, with values between those of white and gray matter. Subcortical arteriosclerotic encephalopathy was found to have areas of prolonged T1 and T2 relaxation times involving almost the entire white matter of the corona radiata. PMID- 3564091 TI - Is acute alcohol ingestion a risk factor for ischemic stroke? Results of a controlled study in middle-aged and elderly stroke patients at three urban medical centers. AB - To assess the role of acute alcohol ingestion as a risk factor for cerebral infarction, we administered a pretested questionnaire to 205 middle-aged and elderly acute ischemic stroke patients and 410 outpatient controls matched by age, sex, race, and method of hospital payment. Paired Mantel-Haenszel analysis revealed that alcohol ingestion within 24 (p = 0.07) and 72 (p = 0.001) hours of stroke onset and medical histories of smoking (p less than 0.0001), hypertension (p less than 0.001), and transient ischemic attacks (p = 0.051) were more common among stroke index cases than controls. Matched multiple logistic analysis revealed that both hypertension (p less than 0.05) and smoking (p less than 0.05) were independently associated with stroke, while alcohol consumption was not. In analyses to assess the possibility of mutual confounding effects of independent variables, the effect of alcohol ingestion was lost when adjusting for smoking. We conclude that acute alcohol ingestion is not an independent risk factor for cerebral infarction in middle-aged and elderly patients. The apparent association between alcohol ingestion and ischemic stroke may be the result of the confounding effects of smoking. PMID- 3564092 TI - Clinical vasospasm after subarachnoid hemorrhage: response to hypervolemic hemodilution and arterial hypertension. AB - Delayed neurologic deterioration from vasospasm remains the greatest cause of morbidity and mortality following subarachnoid hemorrhage. The authors assess the incidence and clinical course of symptomatic vasospasm following subarachnoid hemorrhage using a uniform management protocol over a 24-month period. One hundred eighteen consecutive patients were admitted to the neurovascular surgery service within 2 weeks of subarachnoid hemorrhage not attributed to trauma, tumor, or vascular malformation (113 patients had aneurysms). Early surgery was performed whenever possible, and hypertensive hypervolemic hemodilution therapy was instituted at the first sign of clinical vasospasm. Forty-two patients (35.6%) developed characteristic signs and symptoms of clinical vasospasm with angiographic verification of spasm in 39 cases. All patients with clinical vasospasm received hypervolemic hemodilution therapy aiming for a hematocrit of 33-38%, a central venous pressure of 10-12 mm Hg (or a pulmonary wedge pressure of 15-18 mm Hg), and a systolic arterial pressure of 160-200 mm Hg (120-150 mm Hg for unclipped aneurysms) for the duration of clinical vasospasm. Over the course of treatment, 60% of patients with clinical vasospasm had sustained improvement by at least 1 neurologic grade, 24% maintained a stable neurologic status, and 16% continued to worsen. At the end of hypervolemic hemodilution therapy, 47.6% had become neurologically normal, 33.3% had a minor neurologic deficit, and 19% had a major neurologic deficit or were dead. There were 3 instances of cardiopulmonary deterioration (7%), all of which were in patients without Swan Ganz catheters, and all resolved with appropriate diuresis. One patient rebled and died while on hypervolemic hemodilution therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3564093 TI - The paramedian diencephalic syndrome: a dynamic phenomenon. AB - The paramedian diencephalic syndrome is characterized by a clinical triad: hypersomnolent apathy, amnesic syndrome, and impaired vertical gaze. We studied 4 cases with computed tomography evidence of bilateral diencephalic infarctions. Each case began abruptly with hypersomnolent apathy followed by fluctuations from appropriate affect, full orientation, and alertness to labile mood, confabulation, and apathy. Speech varied from hypophonia to normal; handwriting varied from legible script to gross scrawl. Psychological testing revealed poor learning and recall, with low performance scores. In 3 patients the predominant abnormality was in downward gaze. PMID- 3564094 TI - A brief episode of severe arterial hypertension induces delayed deterioration of brain function and worsens blood flow after transient multifocal cerebral ischemia. AB - Transient arterial hypertension occurs sporadically following cerebral air embolism and may occur during the acute phase of stroke. This study used an animal model of multifocal cerebral ischemia induced by air embolism and reversed by recompression to assess the effect of induced hypertension on the evoked response recovery, local cerebral blood flow, intracranial pressure, and brain water in 19 anesthetized dogs (Canis familiaris). Six received 0.4 ml of air via the internal carotid artery, 8 received intracarotid air and 10 micrograms/kg norepinephrine to produce transient hypertension, and 5 received intracarotid saline and norepinephrine. The average evoked response recovery in the air-only group was 58.3 +/- 7.7% (mean +/- SEM) of control after 4 hours of recompression; the air plus hypertension group recovery was 15.4 +/- 2.7% (p less than 0.01). The final evoked response in the dogs receiving hypertension alone did not differ from control values. Seven of 8 dogs in the air plus hypertension group had very low blood flows; only 1 of 4 in the air-only group had very low flows. The amount of brain water and the intracranial pressure were not detectably different at the end of treatment among all 3 groups. These results support a role for endothelial damage produced by air and hypertension in potentiating the process of postischemic hypoperfusion. PMID- 3564095 TI - An epidemiologic study of cerebrovascular disease in western Japan: with special reference to transient ischemic attacks. AB - The prevalence and incidence ratios of cerebrovascular disease, with special reference to transient ischemic attack (TIA), were studied in the towns of Daisen and Ama in western Japan. There have been no previous reports on this subject in Japan. The prevalence ratios of TIA were estimated to be 4.4 in Daisen and 2.0 in Ama per 1,000 people over 40 years old. The ratio of carotid arterial system TIA to vertebrobasilar arterial system TIA was about 1 to 1. The incidence ratios of stroke were 319.6 in Daisen and 314.5 in Ama per 100,000 people of all ages. The prevalence ratios of stroke were estimated to be 14.8 in Daisen and 13.5 in Ama per 1,000 people of all ages. The prevalence ratio of TIA in Japan is about one third to one-half of that in Western countries. However, the prevalence of complete stroke is much higher in Japan compared with that in Western countries. Therefore, the ratio of TIA to stroke is much lower in Japan than in Western countries. The obstruction of small intracranial arteries, in addition to heart disease, might play an important role in TIA in Japan, whereas in Western countries TIA might be mostly caused by heart disease or the atherosclerosis of extracranial arteries. PMID- 3564096 TI - Clinico-epidemiologic study of stroke in Akita, Japan. AB - An analysis was performed of 2,168 consecutive stroke patients who were examined by computed tomography and entered into a hospital-based stroke registry in Akita Prefecture, Japan. The occurrence of cerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage was 30, 55, and 14%, respectively. Age-specific rates of subarachnoid hemorrhage were higher in women than men; other types of stroke showed a preponderance in men. Total strokes increased in the winter; this seasonal difference was confined to cerebral hemorrhage. Putaminal hemorrhages predominated in the younger age groups; thalamic hemorrhage and cerebellar hemorrhage were predominant in the older age groups. The increased accuracy of the diagnosis of stroke subtypes by the use of computed tomography in this study is in contrast to other community-based epidemiologic studies that have relied solely on clinical diagnosis. This increased accuracy is seen to be the reason that new ratios of stroke subtype incidence have been identified. PMID- 3564097 TI - Blood flow through cerebral collateral vessels one month after middle cerebral artery occlusion. AB - Acute occlusion of a middle cerebral artery (MCA) reduces cerebral blood flow in normotensive Wistar-Kyoto rats (WKY) and in stroke-prone spontaneously hypertensive rats (SHRSP). The goal of this study was to determine whether MCA occlusion produces a sustained reduction in cerebral blood flow or whether collateral vessels restore blood flow to normal levels. We measured blood flow through cerebral collateral vessels to the territory of the occluded MCA and to homologous tissue of the other hemisphere in WKY 1 month after occlusion of the MCA. Cerebral blood flow, measured with microspheres, was restored to normal levels under control conditions in the territory of the occluded MCA. During vasodilatation produced by seizures, blood flow and vascular conductance were increased to similar levels in tissue distal to the site of MCA occlusion and in the homologous tissue of the other hemisphere. MCA occlusion did not produce infarction in any of the WKY. In contrast, 1 month after MCA occlusion in SHRSP, a large atrophic infarct was invariably present in the territory of the occluded MCA. The number of collateral vessels to the territory of the MCA do not differ in SHRSP and WKY. Internal diameter and orientation of the anastomotic vessels differ in SHRSP and WKY. We conclude that, after 1 month of MCA occlusion, changes in the collateral vessels supplying the territory of the occluded MCA in WKY were sufficient to restore blood flow to normal under control conditions and to virtually normal levels during vasodilatation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3564098 TI - Effect of 5-minute ischemia on regional pH and energy state of the gerbil brain: relation to selective vulnerability of the hippocampus. AB - Adult male gerbils were submitted to 5-minute cerebral ischemia by bilateral carotid artery occlusion. At the end of ischemia and at various recirculation times ranging from 15 to 120 minutes, brains were frozen in situ and the regional distribution of ATP, glucose, and tissue pH was studied on coronal cryostat sections by bioluminescent and fluoroscopic techniques. During ischemia ATP was completely depleted, glucose decreased to less than 10% of control, and regional tissue pH decreased from 7.04-7.09 to about 6.0. After the beginning of recirculation tissue pH and the regional content of metabolites exhibited a triphasic course. After 15 minutes pH returned to or even above normal, and ATP- and glucose-induced bioluminescence normalized. However, there was a secondary deterioration of both tissue acidosis and the metabolic state after 30 minutes. After longer recirculation times changes again improved and returned to normal within 2 hours. These changes were similar in all brain regions with the exception of the CA1 sector of the hippocampus, where the transient normalization of tissue pH was absent after 15 minutes of recirculation. This finding is in line with the previously observed microcirculatory insufficiency of this area and demonstrates that the CA1 sector of the hippocampus suffers more pronounced postischemic acidosis than other less vulnerable regions of the brain. PMID- 3564100 TI - Breathing 100% oxygen after global brain ischemia in Mongolian Gerbils results in increased lipid peroxidation and increased mortality. AB - Exposure of Mongolian gerbils to a 100% oxygen atmosphere after 15 minutes of global brain ischemia resulted in a marked increase in the production of pentane, an in vivo product of lipid peroxidation. Much less pentane production occurred in animals subjected to global brain ischemia then exposed to an air atmosphere and in animals exposed to a 100% oxygen atmosphere without ischemia. Gerbils placed in 100% oxygen for 3-6 hours after 15 minutes of ischemia also had a threefold increase in 14-day mortality compared with gerbils subjected to ischemia and then placed in an air atmosphere. These findings raise a serious question about the use of oxygen-enriched atmospheres during reperfusion following ischemia. PMID- 3564099 TI - Lipid metabolism, cerebral metabolic rate, and some related enzyme activities after brain infarction in rats. AB - Multiple infarcts were produced in cerebral hemispheres of rats by injecting calibrated 50-micron microspheres into the left internal carotid artery, and alterations in lipid and energy metabolism were evaluated 24 hours later in the embolized hemisphere. Total phospholipid content was decreased by 26%, but the different classes of phospholipids were not equally affected. Phosphatidylinositol and phosphatidylserine levels were decreased by about 40% and phosphatidylcholine and phosphatidylethanolamine by 25%, while sphingomyelin level remained unchanged. There was a 3.2-fold increase in total free fatty acid content with a relatively larger rise in polyunsaturated free fatty acids 20:4 and 22:6 (20-fold increase). Determination of enzyme activities showed decreases in Na+,K+-ATPase (-21%) and hexokinase (-14%) but no changes in phosphofructokinase and pyruvate kinase. Study of energy metabolism using the closed system method of Lowry et al showed a significant depression (-36%) of the cerebral metabolic rate. Taken together, these data suggest a relation between lipid alterations and dysfunction of energy metabolism. Phospholipid degradation with subsequent free fatty acid release and alteration in membrane-bound enzymes may have a direct effect on metabolic machinery and may slow cerebral metabolic rate. PMID- 3564101 TI - Effect of ketamine on cerebral cortical blood flow and metabolism in rabbits. AB - The effects of intravenous ketamine (1 mg/kg) on cerebral cortical blood flow and O2 uptake were evaluated in 13 anesthetized, ventilated rabbits. Blood flow was measured either directly (Group 1) or by the H2 clearance method (Group 2). In those animals of Groups 1 and 2 with normal control arterial pH (pHa), ketamine produced a significant increase in cerebral cortical blood flow of 18 and 34%, respectively, but had no effect on cerebral cortical O2 uptake. However, in rabbits with low control pHa, ketamine caused an increase in blood flow (30%) accompanied by a significant increase in O2 uptake (22%). Ketamine produced nonsignificant changes in mean arterial blood pressure and arterial blood gases, except for a significant reduction in pressure in animals with low pHa. It is concluded that ketamine is a cerebral vasodilator without cerebral metabolic effect when mean arterial blood pressure and arterial PCO2, PO2, and pH are held constant at physiologic levels. The vasodilator effect of ketamine is probably due to direct dilating action or activation of a cholinergic cerebral vasodilator system. PMID- 3564102 TI - Cholinergic cerebral vasodilator effect of ketamine in rabbits. AB - To analyze the mechanism of the cerebral vasodilator effect of ketamine in anesthetized rabbits, we measured the internal carotid blood flow with an electromagnetic flowmeter, the arterial pressure, intracranial pressure, end tidal CO2, and the electroencephalogram. Ketamine injection (1 mg/kg) induced a significant cerebral vasodilatation that was blocked by scopolamine, a cholinergic antagonist. In contrast, the increase in cerebral blood flow after ketamine was additive to the cerebral vasodilator actions of inhaled CO2 and of physostigmine infusion, two procedures that activate cholinergic mechanisms. These observations suggest that in rabbits, ketamine activates a cholinergic cerebral vasodilator system. PMID- 3564103 TI - Effects of antihypertensive treatment on the cerebral microvasculature of spontaneously hypertensive rats. AB - Experiments were performed in anesthetized 18-19-week-old spontaneously hypertensive rats (SHR) to evaluate the effects of delayed antihypertensive treatment on cerebrovascular function. Animals were treated for 25 +/- 1 days with an oral antihypertensive regimen consisting of hydralazine, reserpine, and chlorothiazide, resulting in normotension within 2 weeks. Cerebral arterioles were examined via a constantly suffused open cranial window and video microscopy. Resting cerebral blood flow was measured using radioactive microspheres and the reference organ method. While untreated SHR exhibited reductions in arteriolar diameter compared with normotensive Wistar Kyoto rats (WKY), treatment restored arteriolar dimensions to normal. Increments in microvascular wall area, associated with medial hypertrophy in untreated SHR, were completely reversed in treated SHR to a magnitude not different from control. Resting cerebral blood flow was, however, decreased in treated SHR compared with both untreated SHR and WKY; this was due to an increase in total cerebrovascular resistance compared with WKY. Additionally, microvascular pressure in the largest arterioles in treated SHR was reduced compared with both WKY and untreated SHR. There was a significant increase in the relative pressure drop accounted for by the arterial vessels upstream from the cerebral microcirculation in treated SHR. These results suggest that 1) cerebral microvascular abnormalities induced by chronic hypertension are reversed by delayed antihypertensive therapy, and 2) there is a persistent elevation in cerebrovascular resistance upstream from the microcirculation representing large vessel adaptations that may not be readily reversible with treatment. PMID- 3564105 TI - Ischemia in normo- and hyperglycemic rats: effects on brain water and electrolytes. AB - Previous investigations have shown that preischemic hyperglycemia worsens cerebral outcome. This study sought to delineate the temporal relations between postischemic brain edema and the development of spontaneous epileptic activity. Fasted rats were subjected to 10 minutes of forebrain ischemia. One-half of the animals were made hyperglycemic by glucose infusion prior to ischemia. At serial recirculation intervals regional specific gravity and cortical electrolytes were measured. Normoglycemic animals showed a biphasic increase in brain water content that was fully resolved by 96 hours and had no convulsive activities. Hyperglycemic brains, although displaying a slower resolution from an initial transient decrease in specific gravity, also developed an interval with normal water content that persisted at 18 hours postischemia. At 24 hours, an increase in water content recurred and was soon followed by the onset of seizure activity. Cortical electrolyte changes were unremarkable until seizures occurred. Significant increases in total Na+, Cl-, and Ca2+ and a decrease in K+ were then seen. We conclude that while the normoglycemic brain is capable of resolving postischemic edema in this model, the hyperglycemic brain develops a delayed secondary increase in water content followed by the onset of seizure activity accompanied by a deterioration of ionic homeostasis. PMID- 3564104 TI - Quantitative measurement of blood flow velocity in feline pial arteries during hemorrhagic hypotension and hypercapnia. AB - Due to methodologic difficulties, few investigations have been made on the blood flow velocity in the cerebral microcirculation. Using a newly developed video camera method, we simultaneously measured the blood flow velocity and diameter of pial arteries during hemorrhagic hypotension, after blood pressure recovery, and during CO2 inhalation in cats. When the mean arterial blood pressure was lowered from 129.7 +/- 6.6 to 71.5 +/- 4.1 mm Hg, the blood flow velocity inevitably decreased from 36.6 +/- 5.3 to 27.0 +/- 3.9 mm/sec (p less than 0.001). The calculated blood flow rate [pi X (diameter/2)2 X flow velocity] was preserved in cases with concomitant vasodilation. Conversely, the blood flow velocity increased from 25.3 +/- 5.1 to 31.0 +/- 5.4 mm/sec (p less than 0.001) after mean arterial blood pressure recovery from 67.1 +/- 3.7 to 129.8 +/- 5.8 mm Hg. The blood flow rate was again preserved in vessels with a vasoconstrictive response. Each pial artery apparently dilated or constricted in proportion to the decrease or increase in flow velocity during blood pressure changes, maintaining a constant cerebral blood flow. This indicated the importance of the pial arteries in the mechanisms of cerebral blood flow autoregulation. During 5% CO2 inhalation, the blood flow velocity increased markedly from 25.4 +/- 4.6 to 37.2 +/- 10.0 mm/sec (p less than 0.05), while the pial artery diameter (85.0 +/- 13.7 microns) increased by 9.6 +/- 1.5% (p less than 0.01). The increased flow velocity might be attributable to preferential dilatation of small arterioles or intraparenchymal vessels during hypercapnia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3564106 TI - Functional arterial changes in chronic cerebrovasospasm in monkeys: an in vitro assessment of the contribution to arterial narrowing. AB - Cerebral arteries from monkeys with chronic cerebral vasospasm arising from experimental subarachnoid hemorrhage produced 5-6 days previously were examined for changes in their functional properties in an attempt to understand the basis of the narrowing. Hemorrhage was caused by puncture of the internal carotid artery just proximal to the circle of Willis. Segments taken close to the origins of the anterior and middle cerebral arteries consistently showed decreased distensibility. In addition, they exhibited large, prolonged, spontaneous increases in muscle tone. Other alterations observed include a marked reduction in the capacity of the vessel wall to contract, reduction in constrictor and dilator nerve influences on vascular tone, and some increased sensitivity to serotonin. Small pial arteries (150-200 micron o.d.) from the side of the injury showed large spontaneous irregular increases in tone. It is proposed that 5-6 days after experimental subarachnoid hemorrhage in monkeys the change most responsible for persistent narrowing in the larger arteries is an increased rigidity of the vessel wall. This is probably caused by an inflammatory response. In the smaller arteries, abnormal spontaneous contractile activity is a major factor in narrowing. This activity is not stretch-dependent. We suggest that the initial cause of the arterial narrowing after hemorrhage is the action of vasoactive substances released in the close vicinity of the arterial wall, which lead to tissue damage, abnormal tone, and an inflammatory response with fibrosis. PMID- 3564107 TI - Impairment of endothelium-dependent vasodilation induced by acetylcholine and adenosine triphosphate following experimental subarachnoid hemorrhage. AB - The effect of subarachnoid hemorrhage (SAH) on endothelium-dependent vasodilation of isolated rabbit basilar artery was examined using an isometric tension recording method. Thirty-five rabbits that had 2 successive blood injections were divided into 3 groups: normal animals (control), 4 days, and 3 weeks after the first SAH. Acetylcholine (ACh) (10(-6)-10(-4) M) and adenosine triphosphate (ATP) (10(-6)-10(-4) M) were used to evoke dose-dependent vasodilation of isolated arterial rings previously contracted by 10(-6) M serotonin. In the animals killed 4 days after the first SAH, both ACh- and ATP-induced relaxation were suppressed, and the degree of relaxation of this group was 38 +/- 4.5% (mean +/- SEM) and 22 +/- 3.9% of the initial contractile tone in response to 10(-4) M ACh and 10(-4) M ATP, respectively. Suppression of the relaxation induced by ATP was seen even in the animals killed 3 weeks after the first SAH. Moreover, pretreatment with hemoglobin (10(-6) and 10(-5) M) inhibited endothelium-dependent vasodilation induced by ACh in the arterial rings from the animals killed 4 days after the first SAH. The present experiments suggest that impairment of the endothelium dependent vasodilation following SAH may be involved in the pathogenesis of cerebral vasospasm. PMID- 3564108 TI - Identification and quantitative analysis of hydroxy-eicosatetraenoic acids in rat brains exposed to regional ischemia. AB - To clarify possible roles in the pathogenesis of ischemic brain edema, identification and quantitative analysis of hydroxy-eicosatetraenoic acids (HETEs) in rat brains exposed to middle cerebral artery occlusion were carried out using high-performance liquid chromatography. Rat brain sampling was done by in situ freezing 24 and 72 hours after occlusion. Only a small amount of 15-HETE was found in control rat brains. Twenty-four hours after ischemia, 11-HETE appeared, and the amount of 15-HETE tended to increase. Seventy-two hours after ischemia, when brain edema reached its maximum, 5-, 8-, 9-, 11-, 12-, and 15 HETEs were identified, and the amounts of all HETEs except 8- and 12-HETE were significantly increased. The detection of 5-HETE in ischemic rat brain indicates the simultaneous production of leukotrienes in the same brain area. The above results support the view that lipoxygenase products may play significant roles in the formation of ischemic brain edema. PMID- 3564109 TI - Analysis of inhalation rCBF data. AB - Relative to other approaches that have been recommended, fitting all head data, solving for a time shift, and including an air passage artifact term in the model significantly improved the estimate of gray matter blood flow by the inhalation technique. A robust algorithm, which incorporates these features, has been developed. Formulas which facilitate implementation of this algorithm are reported. An artifact from large scalp arteries was not significant and does not need to be included in the model. PMID- 3564110 TI - Motor performance in rats exposed to severe forebrain ischemia: effect of fasting and 1,3-butanediol. AB - Functional assessment of animals following experimental cerebral ischemia is often difficult due to the passive nature of many neurologic exams. We attempted to increase the objectivity of motor function evaluation by adapting quantifiable behavioral tests and actively testing rats' motor capability following a cerebral ischemic insult. It was hypothesized that active testing would reveal motor deficits which were not readily apparent upon casual observation and that such testing would provide a more sensitive means of experimental neurologic assessment. Wistar rats were exposed to reversible severe forebrain ischemia using the four-vessel occlusion technique. Motor function was evaluated using the total motor score (sum of scores for screen test, balance beam test, and prehensile-traction test) over the 48 hours which followed 20 minutes of cerebral ischemia. To manipulate neurologic outcome, rats were fed or fasted the day prior to ischemia and then pretreated with either 1,3-butanediol or saline. Fasted saline-treated animals demonstrated improved total motor performance compared with fed animals by 48 hours after ischemia. There was no improvement in motor performance by fasted vs. fed rats from among the butanediol-treated animals. Pretreatment with butanediol resulted in significantly better total motor performance among fasted rats 24 hours after ischemia; however, by 48 hours postischemia, no difference was detectable. This is the first demonstration of motor deficits produced by four-vessel occlusion in rats. The motor tests devised appear to be adequately sensitive to detect changes in motor function that are not apparent with passive observation in this model. PMID- 3564111 TI - Effect of 5-lipoxygenase inhibitor on experimental delayed cerebral vasospasm. AB - Experimental delayed cerebral vasospasm was produced in canine basilar arteries by 2 successive injections, 2 days apart, of fresh autogenous arterial blood into the cisterna magna. When angiographic evidence of delayed vasospasm was confirmed 7 days after the initial intracisternal blood injection, a selective inhibitor of 5-lipoxygenase, 2-(12-hydroxydodeca-5,10-diynyl)-3,5,6-trimethyl-1,4-benzoqu inone (AA-861), was infused intravenously at 6.5 X 10(-4) mg/kg/min for 2 hours. However, angiographic evidence of delayed vasospasm was not reversed, and mean regional cerebral blood flow was not significantly increased. In other studies, oral doses of AA-861 at 100 mg/kg/day were given twice a day for 7 days after the initial intracisternal blood injection. In the treated group, angiographic evidence of delayed vasospasm was significantly reduced, and the contractile property of excised basilar arteries in response to vasoconstrictor agents was significantly improved. It is suggested that leukotrienes, 5-lipoxygenase products of arachidonic acid, might be important etiologic factors responsible for the development of delayed vasospasm and that AA-861 would have a therapeutic effect not on the reduction of delayed vasospasm once developed but on the prevention of the development of delayed vasospasm. PMID- 3564112 TI - Atypical progressive stroke syndrome associated with oral contraceptives and cigarette use. AB - We report a case of progressive multifocal intracranial distal arterial branch occlusive disease in a young adult who smoked heavily and used oral contraceptives. The distribution of the angiographic lesions and the associated telangiectasias and rete mirabile resemble Moya-Moya disease except for clearly absent proximal carotid arterial disease. This type of distal multifocal cerebral arterial occlusive pattern appears to be a very rare manifestation of cigarette and oral contraceptive use. The patient has remained without symptoms for greater than 3 years off oral contraceptives and cigarettes and on antiplatelet agents. PMID- 3564114 TI - Clinimetrics in stroke research. PMID- 3564113 TI - Acute stroke therapy trials: an introduction to recurring design issues. AB - We discuss selected issues concerning the design of stroke treatment trials. Key issues include the type of stroke studied, the time interval from stroke onset to patient entry, and whether to include cardioembolic strokes and allow concomitant therapy. PMID- 3564115 TI - Primary intracerebral hemorrhage and heart weight: a clinicopathologic case control review of 218 patients. AB - The mean heart weight as a measure of arterial hypertension of patients who died from spontaneous intracerebral hemorrhage (primary intracerebral hemorrhage or PIH) was compared with that of controls from the same autopsy population. All patients with valvular or congenital heart disease or disease processes associated with myocardial infiltration were excluded. In 206 cases of PIH, hypertension was diagnosed if heart weight greater than or equal to the mean heart weight of autopsy controls for either sex, plus 1.5 SD. Only 94 (46%) of all cases of PIH were hypertensive by this criterion. However, hypertension was five times more frequent in the cases than in the controls. The site of hemorrhage was clearly defined in 183 cases (88.8%) only. Of these, 80 (43.7%) had lobar hemorrhage and 69 (37.7%) bled in the basal ganglia. Only 26 cases (12.6%) had evidence of previous cerebral or myocardial infarction and there was no instance of previous intracerebral hemorrhage. These data show that arterial hypertension was present in about half the cases of PIH and suggest that other as yet unidentified risk factors for PIH may be more common than is realized. Patients who died from PIH had been healthy all their lives with no evidence of cardiovascular or cerebrovascular disease, and the PIH was their first evidence of disease. PMID- 3564116 TI - Prognosis of carotid siphon stenosis. PMID- 3564117 TI - Aspirin and the kidneys in patients with cerebral ischemia. PMID- 3564118 TI - [Dynamics of the electrical activity of the organs of experimental animals in the late postmortem period]. PMID- 3564119 TI - [Establishment of the time of death by the dynamic postmortem changes in the formed elements of the blood]. PMID- 3564120 TI - [Determination of the time of death by the dynamic activity of potassium ions in cadaveric synovial fluid]. PMID- 3564121 TI - [Possibility of determining the intravitality of rib fractures]. PMID- 3564122 TI - [Senile fractures of the upper femoral epiphysis in forensic medicine practice]. PMID- 3564123 TI - [Diagnostic criteria of the x-ray manifestations of the maxillodental system following tooth extraction]. PMID- 3564124 TI - [Status and tasks of further improvement in the forensic diagnosis of alcoholic intoxication]. PMID- 3564125 TI - [Methodological and procedural problems in performing expert evaluation of human hair]. PMID- 3564126 TI - [Changes in the ethanol concentration of internal cadaveric organs in the early postmortem period]. PMID- 3564127 TI - [Analytical and forensic medical assessment of poisons in forensic chemistry research on biological matter]. PMID- 3564128 TI - [Biochemical indices of liver failure in persons abusing alcohol]. PMID- 3564129 TI - [Use of the Iskra-226 computer in forensic medicine practice]. PMID- 3564130 TI - [Rapid method for the quantitative determination of carboxyhemoglobin using the PPK-01 device]. PMID- 3564131 TI - [Case of sudden death in systemic lupus erythematosus]. PMID- 3564132 TI - [Rare case of an automobile injury]. PMID- 3564133 TI - [Multiple stab and cutting injuries in suicide]. PMID- 3564134 TI - [Organization of expertise on alcoholic intoxication in East Germany]. PMID- 3564135 TI - [Blood microcirculatory pathways in death from acute arterial blood loss]. PMID- 3564136 TI - Nephrotic syndrome in blacks: histopathologic perspectives. PMID- 3564137 TI - Kidney disease in blacks in North America--an overview. PMID- 3564138 TI - Heroin nephropathy. PMID- 3564140 TI - Medical therapy for renal failure in blacks--urban US geographic perspectives. PMID- 3564139 TI - Systemic lupus erythematosus--the nephrologist's viewpoint. PMID- 3564141 TI - Renal disease in Africa and the Caribbean: an overview. PMID- 3564142 TI - The politician-doctor nexus. PMID- 3564144 TI - Hepatobiliary diseases in tropical Africa--the Ibadan experience. PMID- 3564143 TI - Inflow occlusion technique for correction of coarctation of the inferior vena cava causing the Budd Chiari syndrome. PMID- 3564145 TI - Relationship between gastric acid secretion and total serum pepsinogen level in duodenal ulcer. PMID- 3564146 TI - Alkaline phosphatase isoenzymes in the differential diagnosis of cholestasis. PMID- 3564147 TI - Tropical sprue--a clinical, biochemical and histopathological study. PMID- 3564148 TI - A simple hydrosurgery apparatus for hepatic surgery. PMID- 3564149 TI - Whose name and how many names should be on a scientific paper? PMID- 3564150 TI - [Smith-Lemli-Opitz syndrome: evaluation of the correlations between individual traits as an approach to the study of heterogeneity]. AB - A computer analysis was used to study heterogeneity of the Smith-Lemli-Opitz syndrome (SLOS) with or without certain anomalies and to determine intrafamilial phenotypical variability. The analysis of 83 SLOS cases showed significant differences in average values of intragroup similarity, estimated for the cases with cleft palate and without it and those with or without polydactyly. The degree of intragroup similarity in familial cases appeared to be twice as high as in sporadic ones. These data confirm the hypothesis on genetic heterogeneity of SLOS with some allelic forms. PMID- 3564152 TI - [Interdependence of the cell cycles of mammalian sister cells in monolayer cultures detected through their desynchronization by UV microirradiation]. AB - The duration and variability of cell cycles in epithelial and fibroblast-like mammalian sister cells with different types of intercellular contacts were estimated using time-lapse cinemicrographic technique. To study a possible interrelation between cell cycles of the sister cells, one cell in each pair of sister cells was inactivated by selective UV microbeam irradiation at the beginning of its cell cycle. It is shown that this action may delay the cycle of the intact cell as well. Such an interrelation of sister cells was found only at the G1 phase of the cell cycle and only in epithelial cells. PMID- 3564151 TI - [Ultrastructure of the lymphocytes in lymphoid organs following cryopreservation with PEO-400 protection]. AB - Electron microscopic examination of lymphocytes after cryopreservation with PEO 400 used as a cryoprotectant has shown that changes in the cytoplasmic membrane structures are of reversible character after thawing. Programmed freezing with a period of temperature holding is beneficial for lymphocyte cryopreservation. PMID- 3564153 TI - [Ultrastructure of rat oocytes during the induction of superovulation]. AB - The ultrastructure of ovocytes, fixed no later than 4-5 hours after the beginning of ovulation, the number of cells with the signs of organelle alterations is increased. This is presumably connected with a change in conditions of hormonal regulation of late stages of gametogenesis. PMID- 3564154 TI - [Dual-channel microfluorometer-photometer based on standard block assemblies and units]. AB - The principles of construction and methods of practical realizing of double-wave microfluorometers-photometers for investigation of molecular processes in cells and cell populations are considered. PMID- 3564156 TI - [Further comment on the usefulness of neutral red for measuring the pH of cells and cellular organoids]. PMID- 3564155 TI - [Characteristics of the ultrastructural organization of metaphase chromosomes in mouse embryos in the early cleavage stages]. AB - The structural organization of the mouse metaphase chromosomes in the early embryonic development (I-IV cleavages) was studied using serial ultrathin section. It was shown that in the first cleavage the metaphase chromosomes consist of DNP fibrils 20-25 nm in diameter, which are distributed nonuniformly along the chromosomes. It was suggested that parts of chromosomal arms formed by tightly packing DNP fibrils may correspond to the G-bands revealed by the routine Giemsa staining. In metaphase chromosomes of 8-16-cell embryos DNP fibrils form chromonema--thick threads about 90 nm in diameter. The chromonemata are evenly organized along chromosomal arms. The centromeric heterochromatin always consists of DNP fibrils tightly arranged in a block having no chromonemal level of organization. In all the cells studied chromosomes form structural contacts (associations) by their centromeric heterochromatin regions. PMID- 3564157 TI - [Leptofibrils in rat ventricular cardiomyocytes in vitro]. AB - The presence of leptofibrils in ventricular myocytes of the heart of the 2- and 14-day old rats in 8-day old cultures was shown and their structure was investigated. Leptofibrils are seen only in myocytes on a definite stage of differentiation. Leptofibrils are attached to Z-bands running parallel or perpendicular to myofibrils. The period of their cross striation varies from 135 to 215 nm. Possible functions of the leptofibrils are discussed. PMID- 3564158 TI - [Proliferative processes in the myocardium in different parts of the heart during the creation of experimental myocardial infarct of the left ventricle in 2- and 3 week-old rats]. AB - As a result of 30 times repeated injections of 3H-thymidine (3HTdr) to neonate rats, beginning from days 13 or 21 post partum, ca. 20 and 10% of myonuclei in the left and right atria were labeled, respectively, while in both ventricles cumulative labeling of myocytes was nearly ten times lower. In rats of the same age with experimental infarction of the left ventricular myocardium the number of myonuclei labeled after 30-fold 3HTdr injections increased in atria up to 40-50%, in perinecrotic myofibers of the left ventricles up to 8-11%, and in myofibers of the left and right ventricle located far from the necrotic foci up to 3-4 and 2 3%, respectively. In some of rats subendocardial and/or subepicardial layers of the surviving left ventricular myocardium contained up to 15-35% of labeled myonuclei. Thus, in neonatal rats the extent of DNA synthesis reactivation in the nuclei of cardiomyocytes, the majority of which have recently completed normal ontogenetic proliferation, is, on the whole, of the same order as found in similar experiments on adult rats (Rumiantsev, Kassem, 1976; Oberpriller et al., 1984). However, still immature ventricular myocytes of neonatal rats resume mitotic cycle easier than those of adult animals which is evidenced not only by higher numbers of 3HTdr labeled myonuclei in subepicardial and subendocardial ventricular myocardia of some rats, but even more by reactivation of DNA synthesis in a limited fraction (2-3%) of the whole population of non perinecrotic myocytes in both ventricles. Besides, reactive proliferation of cardiomyocytes in the atria of neonate rats, unlike in adults, starts on day 3 rather than on day 5 after infarction is induced. In the atria of neonatal rats polyploidization of myonuclei at later postinfarction stages is less pronounced than in adult rats which may be accounted for by formation of individual daughter nuclei during acytokinetic mitoses or, more seldom, by completion of cytotomy. PMID- 3564159 TI - [Tolerance of different cell types for hypotonic action]. AB - The behavior of cells with different structure of cytoskeleton was studied in the hypotonic media: protoplasts, embryonal mouse fibroblasts and transformed mouse fibroblasts (L-line). Protoplasts were most sensitive to the hypotonic media. They began to disrupt in the hypotonic medium 4:1, and in the hypotonic medium 1:7 a complete lysis of cells was observed. Transformed mouse fibroblasts were disrupted in the medium diluted 1:15, while embryonal mouse fibroblasts were not disrupted in the medium diluted 1:31. Moreover, in the hypotonic conditions an essential difference was observed between the cells studied. Embryonal mouse fibroblasts are more tolerant to the hypotonic conditions than L-cells and protoplasts. It is suggested that the cytoskeleton may define the cell tolerance in hypotonic media. PMID- 3564160 TI - [DNA repair in mammalian nerve cells. I. DNA synthesis in the neocortex of rats induced by gamma irradiation]. AB - A study was made of the DNA synthesis in cerebral cortex of rats, aged 14 and 60 days, after gamma-irradiation in vivo in a dose of 7 Gy, the 3H-thymidine incorporation into DNA being determined.137 Cs-radiation induces additional DNA synthesis in the neocortex tissue and in neurons. In the cortex of 14 day-old rats, the induced DNA synthesis stops 2 hours after irradiation, whereas in the cortex of 60 day-old rats and in neurons of rats of both the age groups DNA synthesis is proceeding for 3-3.5 hours. Specificity of DNA reparation processes in non-dividing cells is discussed. PMID- 3564161 TI - [Ultradian fluctuations in the natural antitumor resistance of mice undergoing transplantation and chemical carcinogenesis]. AB - A study was made of the mouse life span in relation to the time of tumor cell injection on an hourly basis, while the carcinogenic effect was studied in relation to the time of urethan injection. Changes in both the values were shown to vary with ultradian rhythms. It was found that natural killer cell activity against tumor cells, migration index of normal spleen cells in the presence of tumor cells and the activity of carcinogen-metabolising enzyme system of intact animals also exhibited ultradian oscillations. It is assumed that oscillations of natural resistance against transplantable or chemically-induced tumor may be due to the changes of these parameters. PMID- 3564162 TI - Frequency of lesions and operative results in surgical neonates. PMID- 3564163 TI - Congenital hepatic fibrosis in Turkish children. PMID- 3564164 TI - Treatment of enuresis: a study with imipramine, amitriptyline, chlordiazepoxide clidinium and piracetam. PMID- 3564165 TI - Height and bone age of Turkish children with goiter where this condition is endemic. PMID- 3564166 TI - Clinical examination of the depth of the gingival sulcus in primary dentition. PMID- 3564167 TI - Renal and axillary thrombosis in an infant of a diabetic mother. PMID- 3564169 TI - A case of sirenomelia. In one of a pair of identical twins, and in association with exomphalos. PMID- 3564168 TI - Sudden respiratory difficulty and cardiac arrest due to Ascaris lumbricoides aspiration after open heart surgery. PMID- 3564171 TI - Focusing of shock-waves in the Dornier lithotripter. PMID- 3564172 TI - [The general practitioner and the incontinent woman]. PMID- 3564170 TI - Visibility and stability of a 12-tungsten atom complex in the scanning transmission electron microscope. AB - A complex consisting of 12 tungsten atoms has been studied in terms of signal-to noise (S/N) and dose response in the scanning transmission electron microscope (STEM), to evaluate its suitability for use as a approximately 1 nm resolution biological label. Molecular weight of the complex was measured as a function of radius of integration, and results were in agreement with the calculated formula weight. S/N was highest at the lowest radius of integration (0.25 nm), and decreased monotonically with increasing radius. The complex was clearly visible at a dose of 4 X 10(3) e/nm2, and exhibited negligible mass loss (approximately 8%) after an accumulated dose of 1.28 X 10(5) e/nm2. Beam-induced motion was small, 0.46 nm rms after 4 X 10(4) e/nm2. Some intensity fluctuations were observed between successive scans of the same clusters, for which a diffraction based explanation is advanced. Upon suitable functionalization, the tungsten complex is expected to complement the undecagold cluster already in use for site specific labeling. PMID- 3564173 TI - [When should treatment of prostate cancer begin?]. PMID- 3564174 TI - [Effects of hemiacidrin on the formation of concretions around and in bladder catheters]. PMID- 3564175 TI - [Recommendations of the consensus conference on hypertension in aged patients]. PMID- 3564176 TI - [Toxic oil syndrome. Etiology, hypotheses and mechanisms]. PMID- 3564177 TI - [Epidemiologic surveillance and the environment. 3]. PMID- 3564178 TI - [Tobacco mosaic virus and chronic pulmonary diseases]. PMID- 3564179 TI - [Clinical review of 10 patients with acquired immunodeficiency syndrome]. PMID- 3564180 TI - [Fatal risk in anticoagulant treatment (apropos of 50 intracranial hemorrhages)]. PMID- 3564181 TI - [Hypertension in pregnancy. Elements of physiopathology and their therapeutic consequences]. PMID- 3564182 TI - [Sudden infant death]. PMID- 3564183 TI - [What is your diagnosis? Hemophilus parainfluenzae endocarditis]. PMID- 3564184 TI - [Pharmacologic and metabolic interactions between alcohol and promethazine]. PMID- 3564186 TI - [Mechanisms of drug interactions]. PMID- 3564187 TI - [Pharmacology at the University of Montreal]. PMID- 3564185 TI - [In vitro test for studying sensitivity to Ara-C in leukemic patients]. PMID- 3564189 TI - [Recruitment of angiotensin receptors by concanavalin A in the rabbit aorta]. PMID- 3564188 TI - [Multidisciplinary research on cardiac arrhythmias and their pharmacological or surgical treatment]. PMID- 3564190 TI - [Drug surveillance: example of bayesian imputation of an adverse reaction]. PMID- 3564191 TI - [Vitamin D and the pharmacology of anomalies of phospho-calcium homeostasis. General review]. PMID- 3564192 TI - [Potentiation of hepatotoxicity by ketones and ketogenic agents]. PMID- 3564193 TI - [Secondary sclerosis of the bladder neck].